testimonials. Those which we quote are merely samples. To sum up the
results of this analysis: Of the testimonials some are said to be
unauthorized; a number were written with so little thought that the
writers had since forgotten their very existence; the conclusions
expressed in most are not in fact justified by the writers’ mature
judgment and experience. A number of writers admit that their
experience is insufficient to determine whether the supposed good
results were due to the medicine used or to other influences. Of course
such evidence is unworthy of credit and happily, very little is now
being furnished by doctors; even our courts refuse to admit it.
In short, the published formula shows that Neurilla is nothing more
than a preparation of discredited drugs; it is exploited largely by
means of carelessly formed and thoughtlessly expressed opinions of
physicians. It is recommended that this report be published as an
illustration of such methods and as a protest against them.
[Editorial Comment.--Neurilla is advertised in the following
publications:
_Archives of Pediatrics_,
_Atlanta Journal Record of Medicine_,
_Charlotte Medical Journal_,
_Indianapolis Medical Journal_,
_International Journal of Surgery_,
_Journal of Nervous and Mental Diseases_,
_Medical Herald_,
_New York Medical Record_,
_Medical Review of Reviews_,
_Medical Sentinel_,
_Medical Standard_,
_Pacific Medical Journal_,
_Southern Practitioner_,
_Texas Medical Journal_,
_Woman’s Medical Journal_,
_Eclectic Medical Journal_,
_Ellingwood’s Therapeutist_,
_Journal of the American Institute of Homeopathy_.]
--(_From The Journal A. M. A., March 27, 1914._)
NEUROSINE, DIOVIBURNIA, GERMILETUM AND PALPEBRINE
Report of the Council on Pharmacy and Chemistry
Neurosine, Dioviburnia, Germiletum and Palpebrine are “shotgun”
proprietaries typical of the polypharmacy of the past three or four
decades. They are marketed by the Dios Chemical Company, St. Louis, Mo.
On the recommendation of the referee, the Council has authorized the
publication of this report.
W. A. Puckner, Secretary.
Neurosine
According to the manufacturers, each fluidounce of Neurosine represents:
“Bromid of potassium, C. P. 40 grains
“Bromid of sodium, C. P. 40 grains
“Bromid of ammonium, C. P. 40 grains
“Bromid of zinc 1 grain
“Extract Lupulin 32 grains
“Cascara sagrada, fl. ex. 40 minims
“Extract Henbane .075 grain
“Extract Belladonna .075 grain
“Extract Cannabis indica .60 grain
“Oil Bitter Almonds .060 grain
“Aromatic Elixirs.”
No physician would think for a moment of prescribing all of the drugs
contained in Neurosine for any one condition. Yet physicians are urged
to use this nostrum in insomnia, hysteria, neurasthenia, migraine,
neuralgia, delirium tremens and in a host of other conditions.
It is recommended in the treatment of epilepsy on this ground:
“Neurosine is presented in a very palatable and agreeable form
and can be administered for an indefinite time without untoward
by-effects as so often attends the use of the commercial bromides.
In order to secure lasting benefits the treatment should be
extended over a long period of time.”
The evident implication here is that the recognized drawbacks of bromid
medication are due to impurities present in the commercial bromids and
that the teachings of modern medicine with regard to caution in the use
of bromids do not apply in the case of Neurosine.
The assurance is offered:
“Neurosine contains no chloral, morphin or other objectionable
drug--a fact of the utmost importance when administering medicines
to neurotic women.”
“As a nerve-calmative and sleep-producer nothing can excel
Neurosine ... It should be borne in mind that this preparation
contains no opium, morphine, chloral or habit-forming drugs ...
Neurosine being a harmless remedy is especially indicated for
neurotic individuals.”
Apart from cannabis indica, Neurosine contains no efficient hypnotic.
Cannabis indica is a dangerous drug, whose administration to “neurotic
individuals” is by no means free from danger--especially when it is
given under a proprietary name that carries no warning of its presence.
Here is another recommendation--this time for chorea:
“All authorities recommend the bromides, hyoscyamus and cannabis
indica in this disease. These remedies are all combined in
Neurosine, the ideal calmative for both children and adults.”
On the contrary, practically “all [medical] authorities” will admit
that it is undesirable to keep a child under the influence of bromids
if this can be avoided. Such treatment is mentioned only for use as
a last resort in extreme cases. Hyoscyamus and cannabis indica are
mentioned in connection with chorea by few authorities, and then merely
as probably valueless.
Not content with recommending the promiscuous use of this already
too complex mixture, the Dios Chemical Company advises physicians
to combine it with iron, when chalybeate and tonic effects are
to be combined with “a nervine,” with acetanilid for “irritable
cough,” headache and neuralgia, with antipyrin in asthma and with
Dioviburnia--another Dios nostrum--in all female ailments.
Dioviburnia[AE]
[AE] For articles on other viburnum preparations, see pp. 218 and 409.
Dioviburnia, another Dios nostrum, according to the label, has the
following composition:
“Every fl. oz. contains 3-4 dr. each of the fl. extracts,
Viburnum Prunifolium, Viburnum Opulus, Dioscorea Villosa, Aletris
Farinosa, Helonias Dioica, Mitchellae [_sic_] Repens, Caulophyllum
Thalictroides, Scutellaria Laterifolia.” [Lateriflora?--Ed.]
Further, according to the label, Dioviburnia contains 18 per cent.
alcohol. If this statement is correct then the “formula” is false, for
the fluid extracts named contain from 25 to 73 per cent. of alcohol.
As--according to the “formula”--these fluid extracts constitute
three-fourths of Dioviburnia, the average alcohol-content in the whole
mixture must of necessity be much above 18 per cent.[59] According to
the makers, Dioviburnia is “unexcelled” for:
“Amenorrhea, Dysmenorrhea, Leucorrhea, Puerperal Convulsions,
Prolapsus Uteri, Menorrhagia, Threatened Abortion, Parturition,
Subinvolution, Miscarriage, and a general relaxed condition of the
uterus and appendages, together with the various aches and pains
peculiar to women.”
[59] Five of these fluidextracts have their alcohol-content determined
by the Pharmacopeia or National Formulary. Three are not recognized and
hence their alcohol-content is not defined by law. The alcohol-content
of the mixture of fluidextracts said to be in Dioviburnia has been
kindly furnished by five leading pharmaceutical houses. If the lowest
alcohol-content of the several fluidextracts is made the basis of
calculation, Dioviburnia should contain at least 30.75 per cent. of
alcohol, or more than half as much again as the amount declared on the
label.
Around the sample bottle of Dioviburnia is wrapped a booklet entitled
“A Treatise on Uterine Diseases and Obstetrical Hints,” said to be
“For the Profession Only.” The booklet has been prepared, physicians
are told, to present “some very valuable suggestions” regarding
the treatment of female disorders and the attention of the medical
profession is “earnestly” called to the “very remarkable medicine,”
Dioviburnia. Further, it is said that Dioviburnia was devised by the
Dios Chemical Company because there was an “absolute necessity” for
some really efficient internal treatment in female diseases. The
company backs up its statements by such claims as:
“The most valuable preparation, therapeutically, ever offered.”
“[Contains] every essential for toning up the female organs of
generation, and relieving pain.”
“A general and special tonic, antispasmodic and invigorating
cordial.”
While the company directs the attention of physicians to the
“well-known, therapeutical effects of each individual constituent” of
Dioviburnia, there is in reality little positive evidence regarding
the action of any of the drugs contained in the nostrum. Most writers
on materia medica do not even mention these drugs and the few who
do discuss them, either question or deny their medicinal value. But
if every drug claimed to be present in Dioviburnia had some actual
demonstrated therapeutic properties, it still would be impossible
to predict the action of such a combination in the many and varied
conditions for which it is exploited. Certainly there is no warrant for
such statements as:
“In Painful Dysmenorrhea [_sic_] Dioviburnia is especially
indicated, and its continued use will invariably give relief.”
“In cases of Leucorrhea of long standing, Dioviburnia, together
with local treatment, invariably gives relief.”
“Dioviburnia is efficient in cases of subinvolution; it cures by
its tonic effects....”
The effects of the drugs alleged to be present in Dioviburnia are not
such as to justify the hope of either “cure” or “invariable relief.” In
a way the Dios Chemical Company seems to recognize the inefficiency of
Dioviburnia since it frequently suggests that it be used in combination
with drugs of known value; but it ascribes all favorable results to its
own product:
“In chronic constipation fluid extract of cascara sagrada aromatic
may be combined with Dioviburnia.”
“In cases of habitual abortion, depending on syphilitic taint, a
prescription containing the following should be used during the
entire pregnancy:
℞ “Hydrarg. Chlor. Corros gr. 1
“Potass. Iodid dram 1
“Dioviburnia ounces 16”
“An Anemic or Chlorotic patient, suffering with absence of the
menstrual flow, should take DIOVIBURNIA combined with Iron.”
“In leucorrhea depending on endocervicitis, hot astringent douches
once daily should be given. Local applications of iodin are useful
in chronic conditions. Internally, D i o v i b u r n i a promotes
healing.”
“Rest in bed, hot douches of a one-half per cent. solution of
compound cresol solution and D i o v i b u r n i a internally, a
teaspoonful every 3 hours will rarely fail to cure endometritis in
a few days.”
“In specific vaginitis, a solution of potassium permanganate (1 to
1000) should be used as a douche twice daily. Internally give the
following:
“Sodii benzoate 1/2 ounce
“Dioviburnia 16 ounces
“M. sig., Teaspoonful every three hours.”
“Prolapsus Uteri is benefited, and often cured, by DIOVIBURNIA
combined with local treatment in the shape of tampons, pessaries,
electricity, etc.”
If Dioviburnia will cure specific vaginitis, anemia, etc., so will a
cobblestone make excellent soup. All that is necessary in the former
case is to add certain potent drugs that might be indicated in the
pathologic conditions mentioned and, in the latter case, to combine
suitable amounts of beef, chicken, green turtle or vegetables, with
herbs and other seasoning.
Germiletum
Germiletum is a member of the large class of alkaline antiseptic
solutions with excessively complex formulas. In this case not only
is the formula complex but also the Dios Chemical Company finds it
impossible even to assign a constant composition to it--at least the
“formulas” which appear on the different styles of Germiletum labels
and advertising circulars vary greatly.
The company says:
“We appeal only to the Doctor’s judgment of his estimation of the
formula.”
“Doctor you will readily determine from the formula the class of
cases in which you have a right to expect satisfactory results.”
Yet the “formulas” given present so great a variety and such confusion
that it is not clear even to a chemist just what the Dios Company wants
the medical profession to regard as the composition of Germiletum.
The following statements of “composition” have appeared at various
times:
1. In an advertising circular sent out some time ago:
“[HBF_{4} + BOH (OC_{6}H_{4}COOH)_{2}
+ BOH (OC_{6}H_{3}COOH)_{2} + C_{3}H_{5}BO_{3}
+ CH_{2}O + C_{10}H_{14}O
+ C_{10}H_{20}O + C_{24}H_{28}N_{3}Cl.]”
2. In advertising circulars which have been received of late, being
wrapped with a sample package and with the “large size” trade package:
“[C_{7}H_{6}O_{2} + H_{3}BO_{3} + C_{3}H_{5}BO_{3}
+ (CH_{2}O)_{3} + C_{10}H_{20}O + C_{10}H_{14}O + C_{2}H_{6}O]”
3. In another advertising circular:
“Germiletum is a slightly alkaline chemical solution of
Borohydrofluoric Acid, Borosalylbenzoic Acid, Boroglycerine,
Formaldehyde with Menthol, Thymol and Antiseptic Aromatics.”
4. On the label of a sample package sent through the mails during 1914,
and on the label of a “small size” trade package purchased in 1914:
“FORMULA.--Borohydrofluoric Acid, Borosalylbenzoic Acid,
Boroglycerine, Formaldehyde with Menthol, Thymol, Amyl Acetate and
other Antiseptic Aromatics.”
5. In the circular which was wrapped around the sample package referred
to above, and around the “large size” trade package purchased at the
same time that the “small size” package was bought:
“Germiletum is a slightly alkaline chemical solution of Borobenzoic
Acid, Boroglycerine Formaldehyde, with Menthol, Thymol and other
Antiseptec [_sic_] Aromatics.”
6. On the sample package, on the “small size” trade package and on the
wrappers of the “large size” trade package:
“Alcohol 18 per cent.; Formalin 3/4 M. per oz.; Amyl Acetate 1/3 M.
per oz.” (also written “Acetate Amyl.”)
The label on the large trade package states that Germiletum contains
“Formalin 1/2 M. per oz.”
One and all of these various formulas spell mystery. The existence
of some of the constituents is problematic; even if the theoretical
possibility of such combinations be conceded, some of them could not
exist in Germiletum, for they would be broken up by the alkaline fluid.
As illustrating the contradictions which the formulas present: While
the wrapper of the “large size” trade package claims that Germiletum
contains 3/4 minims Formalin (Formalin is a proprietary name for a
40 per cent. formaldehyd solution) the label on the bottle claims
only 1/2 minim. Again, while the composition expressed in chemical
symbols asserts that “H_{3}BO_{3}” (boric acid) is a constituent of
Germiletum, the “formula” which follows it states that Germiletum
has an alkaline reaction; hence it cannot contain much boric acid.
Finally, the “small size” bottle of Germiletum purchased at the same
time as the “large size” bottle and also the label of a sample package
sent through the mails to a physician in 1914, give as a constituent
“Borohydrofluoric Acid,” which is mentioned neither on the label of the
“large size” trade package nor in the pamphlet wrapped around it. The
only information which these contradictory “formulas” can convey to a
physician is that Germiletum is an unscientific, varying mixture of
many drugs.
A trade package, having the name “Germiletum” blown in the glass, bears
on the label recommendations for its use in the treatment of “catarrh,”
“Gastritis, Stomatitis, Gastric and Intestinal Catarrh,” “Leucorrhea
and Uterine Diseases,” “Hemorrhoids,” “Whooping Cough,” “Tonsilitis and
other forms of sore throat” and “Eczema.”
The following statement on the label is designed to induce physicians
to place false confidence in Germiletum to the danger of their patients:
“The lying-in-room should be thoroughly sprayed with Germiletum.
Can be relied upon to destroy the living particles which so
generally constitute contagion.”
This claim, as well as the assertion which appears on the label of
a sample package and of the “small size” trade package that it is
“PAR-EXCELLENT IN OBSTETRICAL PRACTICE” is almost criminal, as
Fussell[60] has said, since to depend on any preparation of this sort
is to court disaster.
[60] Fussell, M. H.: Dangers of Certain Ethical Proprietary
Preparations to Both Physicians and Public, The Journal A. M. A., Oct.
7, 1911, p. 1196.
The booklet around the trade package makes the claim that Germiletum
“is the best antiseptic”--evidently largely because it is claimed to be
“the blandest of all”--and that it is “thoroughly germicidal” and even
that it is “the best disinfectant obtainable.” It also contains such
unwarranted and misleading claims and suggestions as:
“... preparatory to all operative work--Germiletum should be used
freely in spraying the atmosphere ...”
“Operative wounds, whether large or small, can be rendered
thoroughly antiseptic by freely spraying them with Germiletum....”
“... it may be given internally in many dyspepsias and in all
zymotic diseases.... In such conditions Germiletum is the ideal
internal antiseptic and disinfectant.”
In the present advertising, no evidence whatever is offered for
the value of Germiletum, the Dios Company contenting itself with
unsupported claims and cant phrases such as
“... the truth is only reached through a final appeal to
intelligent practical experience.”
In the old circulars only crude, uncritical and meaningless tests
to establish the antiseptic value of Germiletum are reported and
none whatever as to its germicidal action. In the advertising matter
sent out some time ago, for instance, were given “Microscopical,
Bacteriological and Chemical Tests, Comparing Germiletum with Carbolic
Acid.” These tests have no value whatever, unless it be to show the
worthlessness of the preparation. This is particularly true as regards
a series of experiments on “Germiletum as a Preventive of Lactic
Fermentation,” in which one part of Germiletum in thirty parts of milk
did not prevent fermentation. Such effect as indicated is probably due
to the formaldehyd present. The tests show the absurdity of using the
preparation for internal and external purposes. The referee challenges
the therapeutic claims on the basis that they are extravagant and
unsubstantiated. (The Chemical Laboratory of the American Medical
Association reports that the alkalinity of Germiletum corresponds
approximately to a 1 per cent. borax solution.)
Palpebrine
According to the Dios Chemical Company, Palpebrine is “A Reliable
External Ocular Antiseptic” having, it is said, the following
composition:
“... each fluid ounce contains 1/116 grain Sulphate of Morphia, 1/7
grain Sulphate of Zinc, 1/11 grain Bi-Chloride of Mercury, 5-3/8
grains Boric Acid, 3/4 grain Salicylic Acid.”
The essential virtues ascribed to Palpebrine, according to its makers,
are its harmlessness and its therapeutic efficiency due, presumably, to
its complex composition:
“Attention is called to the constituents of this formula, each
one of which is used by ophthalmologists. Their combination in
Palpebrine is such as to blend their action in a very happy manner.
Palpebrine acts as an antiseptic, an irritant, an astringent, and a
nerve tonic to the mucous membrane of the eye.”
“Palpebrine is superior in its action to the remedies now in use.
It contains all the constituents of Aqua Conradi ... But to these
are added a number of other agents which will prove it to be of
much greater value and give it a broader field for action.”
In all external afflictions of the eye the free use of Palpebrine is
suggested in such statements as:
“They [general practitioners] will therefore gladly receive from
our hands an efficacious preparation which may be used with perfect
safety.”
“The name of our preparation--Palpebrine, is derived from the Latin
_palpebra_, the eyelid, and is well fitted, as it designates at a
glance the sphere of action of Palpebrine.”
“With the assistance of Palpebrine the general practitioner can
successfully treat all cases of external eye disease ordinarily
encountered in his practice.”
One of the members of the Council staff of clinical consultants calls
attention to the fact that much vitally valuable time might be lost
in a case of iritis, for example, which being unrecognized, should be
treated with Palpebrine on the strength of the Dios Chemical Company’s
advertisements. Even more dangerous is the recommendation of Palpebrine
for the prevention of ophthalmia in the newborn, especially as this
recommendation is coupled with an attempt to discredit the established
treatment with silver nitrate solution:
“The use of severe remedies for this purpose has been discarded by
most physicians....”
While it is doubtless true that ophthalmia neonatorum may be averted by
other drugs than silver salts, it is utterly unjustifiable to suggest
that the established method of treatment by means of silver salt
irrigations has been generally discarded.
[Editorial Note.--The four nostrums mentioned above have been grouped
together for publication to call attention to one phase of the
proprietary business. A fact not mentioned in the Council’s report
is that these nostrums are manufactured and promoted by a concern
that belongs to a type we have often designated “pseudo-chemical”
companies. By this is meant companies that are not in the legitimate
business of pharmacy or chemistry, but organized to exploit one, two
or in some instances half a dozen proprietaries. “Patent medicines”
are exploited by this class of “companies.” The Dios Chemical Company
is not a chemical company, except in name. J. H. Chambers, the
founder so far as we can learn, never claimed any special knowledge
of chemistry, pharmacy or medicine. The officers at the present time
are: J. H. Chambers, president; M. E. Chambers, vice-president;
Leslie T. Chambers, treasurer, and Arthur Chambers, secretary. M. E.
is the wife of J. H., and Leslie T. and Arthur are sons.
This is simply one illustration of the fact noted above. Some
physicians have been and are prescribing nostrums originated,
manufactured and advertised by laymen who are not in the legitimate
pharmacy business. In addition, such physicians have been accepting
the statements of laymen, not only as to the composition of the
nostrums, but as to their use. In every state the practice of
pharmacy is regulated by law: before assuming the responsibility of
compounding medicines a druggist must have studied and passed an
examination in pharmacy. Public safety demands and the law requires
it. There are some doctors, however, who will allow laymen who are
not chemists, pharmacists or physicians to formulate and compound a
prescription and tell them what it is good for and how to use it.
The Dios Chemical Company is not an isolated instance: we have already
referred to some; we shall take occasion to refer to others in the
future. That such concerns flourish is a reflection not so much on the
shrewd laymen who exploit the medical profession--and through it the
public--as it is on the physicians who cast their scientific training
to the winds and permit themselves to be thus exploited.]--(_From The
Journal A. M. A., Jan. 9, 1915._)
OXYCHLORINE
Report of the Council on Pharmacy and Chemistry
The following report on Oxychlorine has been submitted to the Council
by the subcommittee to which it was assigned:
_To the Council on Pharmacy and Chemistry_:--Your subcommittee
submits the following report: The Oxychlorine Chemical Company, 1326
Wabash Avenue, Chicago, states in its advertising literature that:
“Chemically, Oxychlorine is the tetraborate of sodium and potassium
combined with oxychlorid of boron, thus: 6 (NaKB_{4}O_{7})
BOCl_{3}.”
Analysis of Oxychlorine showed:
Potassium 12.26 per cent.
Sodium 8.20 per cent.
Chloric acid--CLO_{3} 25.32 per cent.
Nitric acid--NO_{3} 21.70 per cent.
Boric acid anhydrid--B_{2}O_{3} 18.63 per cent.
Water, calculated 13.29 per cent.
Thus, Oxychlorine is not a definite chemical substance of the
composition claimed, but instead is a mixture of alkali chlorate and
nitrate with boric acid. Assuming that the chlorate is present as
potassium chlorate and the nitrate as sodium nitrate, the analysis
above quoted corresponds to a mixture approximately as follows:
Potassium chlorat 37.19
Sodium nitrate 29.76
Sodium and potassium tetraborate 2.18
Boric acid 30.52
Undetermined 0.35
------
100.00
Your committee recommends that Oxychlorine be not approved and that
this report be published.
The report of the subcommittee was adopted by the Council, and in
accordance with the recommendation is published herewith.
W. A. Puckner, Secretary.
In commenting on the above report it is hardly necessary to call
attention to the palpable untruthfulness of the furnished formula or
its lack of correspondence to the real composition of the preparation,
to the imposing claims made by its pseudo-scientific exploiters or
the absurdities, from a chemical standpoint, of the statements made
in their literature. These features are more or less common to all
nostrums. The physician who prescribes or uses Oxychlorine under
the impression that he is getting a definite and unique chemical
compound described as tetraborate of sodium and potassium combined
with oxychlorid of boron is, according to our chemists, getting simply
a mixture of potassium chlorate, sodium nitrate (or, perhaps, sodium
chlorate and potassium nitrate), and boric acid in about equal amounts.
More than one-third of this mixture is potassium (or sodium) chlorate,
drugs by no means harmless.
In order that there may be no suspicion of unfairness to the promoters
of the preparation, we quote from one of the advertising circulars sent
out by the Oxychlorine Company:
“Oxychlorine owes its recognition as a therapeutic agent to its six
principal qualities:
“1. It will oxygenate the blood at the seat of application,
maintain nutrition and heal an uninfected solution of continuity of
first intention without scar formation.
“2. It will disorganize all pus and ferment-producing
micro-organisms, their toxins, ferments and ptomains.
“3. It will restore an inflamed mucous membrane to its normal
condition, except where the membrane is sclerosed or atrophied.
“4. It will destroy pathogenic micro-organisms and their toxins in
the blood current.
“5. It will stimulate the blood to absorb more oxygen in the lungs
than it at the time carries. [We do not know what this means;
perhaps the Oxychlorine Company does.]
“6. It is absolutely harmless to the tissues and will not destroy a
living cell.”
Surely these people must have access to physiologic and chemical
authorities not found in modern medical libraries, or else their
esoteric researches into the mysteries of life must have carried them
far beyond the ken of our most advanced workers along these lines.
The scientific world would receive with great interest information as
to how a mixture of potassium chlorate, sodium nitrate and boric acid
oxygenates blood, maintains nutrition and causes healing without scar
formation. A mixture which will destroy micro-organisms and yet will
not destroy a living cell certainly shows a fine sense of selection and
discrimination not heretofore expected of a combination of chemicals
or of a chemical compound. How like the wonderful elixir of medieval
times, which was to the Christian a tonic and to the heathen a poison!
Here is another claim made for this nostrum:
“Two or three rectal injections of a one or two per cent. solution
of Oxychlorine and ten grain doses given six to eight times per day
is the best and most reliable treatment for typhoid fever.”
If 80 grains of Oxychlorine contain 30 grains of potassium chlorate,
three rectal injections each consisting of 1 pint of 2 per cent.
solution, would contain approximately 160 grains of potassium chlorate.
Such an injection might prove decidedly dangerous, especially when used
by one ignorant of its true composition. However, the physician, not
the promoters, bears the responsibility.
Oxychlorine sells at $3.50 a pound; the ingredients can be obtained
for about 44 cents a pound. Perhaps the margin of profit is intended
as a reward due the promoters for the profound physiologic discoveries
announced in their reading matter.--(_From The Journal A. M. A., July
6, 1909._)
PAM-ALA, ANOTHER WORTHLESS QUININ SUBSTITUTE
Report of the Council on Pharmacy and Chemistry
The following report of a referee on Pam-ala, an asserted malaria
specific, was adopted by the Council and its publication authorized.
W. A. Puckner, Secretary.
Soon after publication of the Council’s report on Sinkina, an alleged
malaria specific proved worthless, the referee’s attention was called
to Pam-ala, which is sold under very similar claims.
According to the advertisements which have been appearing in Southern
medical journals, Pam-ala is “A new and effective remedy for MALARIA.”
The label describes Pam-ala as “An Effective Vegetable Remedy For
MALARIA. Guaranteed free of any Quinine, or other harmful [_sic_]
drugs.” It is said to be indicated in “Malarial Intermittent and
Remittent Fevers, especially curative in Chronic Malaria and
Malarial Cachexia and all conditions even where Quinine fails.”
One tablespoonful three times a day is said to be the “Curative
Dose,” while one tablespoonful three times a week is stated to be a
“Prophylactic Dose.” The label further claims that Pam-ala “Surpasses
Quinine in its action and has none of its Disadvantages.” Assertions
that Pam-ala is superior to quinin are followed by the usual
“guarantee” claim: “Guaranteed by the Pam-Ala Co. under the Drugs
Act, June, 1906, Ser. No. 2909 A.” Finally, the label says that it is
“Endorsed by Medical Authorities Throughout the world.”
As regards the composition, a circular says that “PAM-ALA is a purely
vegetable remedy for the cure, without Quinine, of all forms of
Malaria.” “‘PAM-ALA’ is derived from a plant of the genus Umbelliferae,
a native of the mountainous regions of Mexico and northern parts of
South America. Its medicinal properties have not been known to anyone
but the native Indians, who for years past have used it as a specific
in all forms of fever and malarial diseases so prevalent in tropical
countries. The seeds are more active as a therapeutic agent than the
dried-up plant; hence their collection for medicinal purposes requires
special skill in the selection of the same so as to be able to extract
all the possible medicinal properties from them, viz., its active
principle. An oil may be abstracted from the seeds which is of a yellow
color with an intense characteristic odor.”
At the close of the circular the following unenlightening formula
appears:
Each fluid ounce contains:
Ext. Fid. Pam-ala 10 per cent.
Alcohol 15 per cent.
Ol. Aurant Syr. Sacchari aqua ad. q. s. 100 per cent.
In addition to being a cure for malaria, Pam-ala is claimed to have a
“favorable influence upon the broncho-pneumonia of measles ...,” “will
avert an attack of acute catarrh,” and “abort acute tonsilitis.”
The testimonials are of the usual character. Most of them seem to have
been given some four years ago by physicians in Italy, Cuba, Porto
Rico, Guatemala, etc., and therefore cannot readily be looked into. Two
are of more recent date and come from physicians in this country. They
furnish good illustrations of the manner in which proprietary concerns
make use of opinions hastily formed and thoughtlessly put in writing.
One testimonial was given in July, 1912:
“I take pleasure in testifying to the seemingly marvelous and
gratifying effect of Pam-ala in 2 cases of malaria....”
On Jan. 2, 1914, its writer, in reply to an inquiry whether in the
light of continued experience, his first estimate of Pam-ala had been
confirmed, wrote:
“... Since then I tried Pam-ala on a number of cases without any
results whatever; in fact my patients seemed to get worse until
I resorted to the usual treatment of malaria, mercurial laxative
followed with quinin. I was too hasty in stating that Pam-ala cured
malaria. I now know and have known since August, 1912, that Pam-ala
will not cure malaria....”
The writer of the second testimonial is reported to have written that
he tried Pam-ala “on a most pronounced case of malarial spleen with
the most excellent results” and that he “also tried Pam-ala on a case
of Malarial Cystitis and Hematuria, with entire satisfaction.” In reply
to inquiry this physician admits that he was “very favorably impressed
with the preparation at the time.” He states that at that time he was
also trying out Sinkina and that after six months he “discontinued the
use of both as the results did not warrant further investigation.” He
concludes:
“With due allowance for the fact that certain cases will for a
time improve on any kind of treatment, new or old, I see no reason
for supplanting or even augmenting, the recognized treatment for
malarial conditions, with either Pam-ala or Sinkina.”
Incidentally it should be mentioned that this physician also noted the
general similarity of Sinkina and Pam-ala. He observes:
“The physical appearance and properties of the two preparations
seem to be identical, the advertising matter and literature are
surprisingly alike and the only marked difference seems to be that
one remedy is purported to be prepared from a ‘new’ South American
plant and the other from an equally fresh discovered addition to
Asiatic flora.”
WHAT IS PAM-ALA?
From a comparison of the statements regarding the composition which
are made for Sinkina and for Pam-ala, as well as from the physical
characteristics of the preparation, particularly the odor and taste, it
seems evident that the essential constituent is oil of cumin. Although
definite proof that oil of cumin forms the essential constituent
of Pam-ala would have shown the worthlessness of this nostrum for
the reason that the clinical investigation of Sinkina proved the
worthlessness of oil of cumin, it did not seem worth while to the
referee that this be demonstrated by chemical analysis. It seemed to
him that in such cases as these, the secrecy with which the identity of
the preparation is surrounded, as well as the extravagant and highly
improbable claims, should be sufficient to condemn it.--(_From The
Journal A. M. A., Feb. 28, 1914._)
PAPAYANS BELL[AF]
Report of the Council on Pharmacy and Chemistry
[AF] See also Bell-Ans (Papayans Bell), p. 282.
The following report of a subcommittee was submitted to, and adopted
by, the Council and its publication directed.
W. A. Puckner, Secretary.
Papayans (Bell) made by Bell & Co., Orangeburg, N. Y., is said to
consist of the “digestive principle obtained by our own exclusive
process from the fruit of _Carica papaya_, combined with willow
charcoal, chemically pure sodium bicarbonate and aromatics.” The
following statement appears on the package: “For the treatment of
dyspepsia, flatulence, nausea, vertigo, hyperacidity, palpitation
and other symptoms of indigestion and the vomiting of pregnancy.
Peritonitis, cholera morbus, alcoholism and seasickness.” “Digests
every variety of food, removes every symptom of indigestion, restores
the entire digestive tract to a normal condition.” The dosage is
recommended as follows: “From one to three tablets before meals, or two
hours after eating. In severe cases, three tablets dissolved in hot
water and repeated as necessary.”
A circular which accompanies the package details the therapeutic
virtues of the preparation and contains what purports to be extracts
from medical journals, in which Papayans is recommended.
Examination of specimens purchased in the open market showed them
to contain the following ingredients: Charcoal, sodium bicarbonate,
ginger, saccharin and oil of gaultheria. As the product is said to
contain papain, the presence of enzymes was tested for, with the
result that it was found to possess neither proteolytic nor amylolytic
properties. The results of our examination are in accord with the
results obtained by a member of the Council, who examined the product
independently, and who writes:
“We have made some extended tests with Papayans Bell, and find that
the tablets consist essentially of sodium bicarbonate and charcoal,
with a little flavoring matter. We find no digesting power for starch
or egg albumin. At any rate, no appreciable change follows in the
albumin in three hours, and no conversion to sugar in the same time,
or change of starch to a point where the iodin reaction is weakened.
The product seems to be practically inert.”
It is recommended that Papayans Bell be refused recognition, and that
publication of this report be authorized.
Comment: It will be remembered that two other products of Messrs. Bell
& Company have been discussed in this department: Salacetin (Bell)[61]
and Sal-Codeia (Bell).[62] Salacetin was examined with several
“synthetics” which all turned out to be mere acetanilid mixtures.
Salacetin, advertised as “a combination, with heat, of Salicylic and
Glacial Acetic Acids and Phenylamine” when examined “was found to be a
mixture and to contain the following ingredients approximately in the
proportion given: Acetanilid 43; sodium bicarbonate, 21; and ammonium
carbonate, 20.” Sal-Codeia (Salacetin-Codein) therefore, would be the
same with codein added.
[61] See p. 356.
[62] See p. 357.
Papayans (Bell) seems to be consistently fulfilling the life-history
of the average nostrum. Made of well-known drugs and invested by its
manufacturers--or exploiters--with virtues absurdly disproportionate to
the known properties of the alleged constituents of the nostrum, the
preparation was introduced to the world via the medical profession.
With the help of thoughtless physicians, aided by a skilful and
aggressive advertising campaign and augmented by the “free sample”
device, the business grew and prospered. The bottles with the name
and address of the company blown in the glass and with the varied
therapeutic indications for the nostrum printed both on the label
and on the circular in which the bottle is wrapped, have carried the
manufacturer’s message to the drug-taking public.
Apropos of this point, the recent “literature” contains what purports
to be endorsements of the nostrum by medical journals. Thus there is
quoted from the _New York Medical Journal_, Jan. 2, 1909, in part, the
following recommendation: “... we venture to suggest to our readers who
have not tried this remedy that they prescribe one _original sealed
package_ of Papayans (Bell) and that they carefully note the results
from its use.” [Italics ours.--Ed.] Having seen an “original sealed
package” we believe that we can predict the “results from its use.” On
any patient not mentally unbalanced, the result would be that the next
dose of Papayans (Bell) he thought that he needed would be purchased
from the druggist direct.
That such results are not hypothetical is evidenced by the statements
of the exploiters of Papayans (Bell) that “the annual sale now exceeds
four hundred million tablets.” Assuming that statement to be true,
it would be necessary for every physician in the United States to
prescribe over three thousand of these tablets every year--if they
reached patients only through the physician! The company’s own figures
indicate that the time is about ripe to take care of this vast army
of self-drugging laymen and recent circular letters seem to recognize
it. The physician is notified that druggists are now furnished with
Papayans (Bell) “in sealed packages of thirty and one hundred tablets.”
The medical man is told that the firm has “not forgotten the days
when physicians’ orders made our success possible” and it says it is
“sincerely grateful to the doctors who gave us orders in the days when
we were struggling for recognition.” This tacit admission of the value
of the physician as an unpaid agent for nostrum houses should be given
thought by those physicians who prescribe such preparations.
While, so far as we know, Bell & Co. have not yet advertised in the
daily press, they are not averse to furnishing the laity with samples
when requested. An Ohio physician sent us the following letter received
by a young woman who had written asking for samples:
+----------------------------------------------------------+
| |
| Miss X---- Y----, |
| Z----. |
| |
| Dear Madam: As requested, we are mailing you sample of |
| our Papayans (Bell) for Indigestion. |
| |
| If a sufferer from Indigestion, we want you to give it a |
| thorough trial as directed and note remarkable results |
| that we believe you will get from its use. |
| |
| Kindly write us if you are unable to obtain it from your |
| local druggist, as it is stocked by nearly every good |
| drugstore in the United States. Yours truly, |
| Bell & Co. |
| |
+----------------------------------------------------------+
Evidently Bell & Co., while admitting that their financial success is
largely due to the kindly, though misguided, efforts of physicians, are
not going to let a little thing like loyalty to the medical profession
interfere with a possible sale of their tablets.
THE L. D. JOHNS COMPANY
A discussion of the methods of Bell & Company would not be complete
without reference to a concern which seems to be closely connected with
it: the L. D. Johns Company, whose “only product” is a sugar-coated
laxative tablet. Regarding the “sugar coated” tablet, a visitor at the
place of business of Bell & Company and the L. D. Johns Company wrote:
“These companies apparently are not in possession of any tablet coating
machines and in questioning on this point stated that some of their
tablets were sent out to be coated.” There is a sameness regarding the
claims for the laxative tablets of the two companies that might lead
one to suspect that the same individual prepared both circulars. For
instance:
CASCARANS (BELL)
“Taken as directed, it permanently removes the great majority of
cases of habitual constipation.”
“... a harmless vegetable preparation.”
“... for the removal of pimples, yellowness and greasiness of the
skin ...”
“... one tablet at night, one night and morning, or, in severe
cases, one three time a day, gradually decreasing the frequency of
the dose as improvement permits.”
DR. JOHNS’ TABLETS
“Taken as directed ... permanently remove the great majority of
cases of habitual constipation, torpid liver and sick headache.”
“A harmless vegetable remedy.”
“... removes pimples, blotches, sallowness and greasiness of the
skin ...”
“One at night, one night and morning, or, in severe cases, one
three times a day. Gradually decrease the frequency of the dose as
improvement permits.”
According to a leaflet sent out with samples by the L. D. Johns
Company, the company is capitalized for $500,000, divided into 50,000
shares at $10 each; these shares are sold to those physicians who
will agree “to prescribe the tablets at every suitable opportunity,
to introduce them to other physicians” and “to promote their sale in
every ethical way!” If the list of physicians’ names and addresses
which the company sends out as comprising the eastern stockholders is
to be relied on, it would seem that many medical men are promoting
their sale. In prescribing it is, of course, “necessary to specify
‘Dr. Johns’ Tablets No XXX (_Original bottle_).’” As the name is on
the bottle, it is not unbelievable that, as the company says in its
prospectus, because of “our method of advertising, a large and very
profitable business is being created.” That the L. D. Johns Company
expects to profit by the self-drugging which this method of prescribing
fosters is evident:
“Physicians not stockholders in this company suffer from
the continual refilling of their prescriptions and from the
recommendation of the _preparation prescribed by patients_ to
others. [Italics ours.--Ed.] Our stockholders _benefit_ by the
refilling of their prescriptions and by these recommendations.”
Put baldly the case amounts to this: Physicians who prescribe “Dr.
Johns’ Tablets” not only are likely to foster self-drugging, but they
will reap dividends therefrom. Truly a nice business to be in!
While Bell & Company and the L. D. Johns Company are said to be
entirely distinct, they are to be found at the same address at
Orangeburg, New York, and as will be seen, the officers of the two
companies are more or less related.
BELL & CO. L. D. JOHNS CO.
_President_ John L. Dodge _President_
_Secretary_ Geo. C. Tennant _Vice-President_
_Vice-President_ Chas. B. Smith _Secretary and Treasurer_
EXPLOITING THE PROFESSION
Nostrum promoters have two simple ways of “working” the medical
profession. The first--and the more profitable--is, by lavish
distribution of free samples, to get physicians to prescribe the
blown-in-the-glass “original package” with the inevitable result of
large sales direct to the laity. By the second method, which is merely
a modification of the first, the physician furnishes the capital for
floating the nostrum and then takes his share of the resulting profits.
There may not be quite as much money in the second method for the
promoter, but then the risks are correspondingly less. If the firm
fails, the stockholders are the losers; the promoter is not necessarily
“out” anything. From a commercial standpoint, a combination of the two
methods is, of course, ideal--(_From The Journal A. M. A., Aug. 14,
1909._)
PASSIFLORA AND DANIEL’S CONCENTRATED TINCTURE OF PASSIFLORA[AG]
Report of the Council on Pharmacy and Chemistry
[AG] See also Pasadyne, p. 332.
The Council has voted that the drug passiflora (passion flower) be not
accepted for New and Nonofficial Remedies, and has recommended that
the following article be published in The Journal. It is considered
important to call attention, not only to the lack of reliable evidence
of the therapeutic value of passiflora, but also to the absurdity
of the claims which are made for Daniel’s Concentrated Tincture of
Passiflora, a preparation which has been already refused recognition.
W. A. Puckner, Secretary.
Passiflora
Although passiflora was introduced into medicine nearly seventy years
ago, the literature concerning it is not very extensive; it is not
mentioned in the standard works on pharmacology and its chemistry
seems never to have been worked out. There appears, also, to be no
record of experimental investigations of the drug with reference to
its pharmacologic action, except an article by I. Ott,[63] who used
“Daniel’s Concentrated Tincture.” Ott claimed that it lessened the
reflex irritability of the cord and paralyzed motion by acting on
the motor centers in the cord, and that it increased the rate of
respiration. He also stated that because of its action on the vasomotor
centers it reduced the frequency of the heart-beat and lowered arterial
tension, but that these effects were only temporary.
[63] Med. Bull., 1898, xx, 457-464.
On the clinical side the reports are not numerous and such as have
been made do not appear to be based on very extensive trials nor on
conditions of observation that would entitle them to more than slight
consideration. S. D. Bullington[64] reports good results, but no cure,
in one case of epilepsy, and improvement in a case of insomnia. W. J.
Stapleton[65] recommends it in the form of a concentrated tincture (not
the one advertised so extensively), and states that he has used it with
great success in insomnia, hysteria, neurasthenia, neuralgia, nervous
and physical prostration, and in alcoholism. In his opinion its action
is most apparent in cases of nervousness due to causes other than
pain. S. Harnsberger[66] reports two cases in which partial blindness
followed the taking of potassium bromid and passion flower.
[64] Nashville Jour. Med. and Surg., 1897, lxxxi, 107-109.
[65] Detroit Med. Jour., 1904-5, lv, 17.
[66] Virginia Med. Semimonthly, 1898-9, iii, 392.
Extravagant and inconsistent claims are made for Daniel’s concentrated
tincture of passiflora in the advertising literature, where it is
recommended for such a wide range of diseases as asthma, typhoid fever,
convulsions and paralysis.
None of the evidence is sufficient to show that passiflora has
therapeutic value; hence it is deemed inadvisable to include this drug
in the list of nonofficial remedies.--(_From The Journal A. M. A.,
March 19, 1910._)
LIQUID COMBINATIONS CONTAINING PEPSIN AND PANCREATIN[AH]
Report of the Council on Pharmacy and Chemistry of the
American Medical Association
[AH] See also Reexamination of Lactopeptine, p. 121. A reprint of
articles bearing on this subject is issued under the title Digestive
impossibilities.
The following report was submitted to the Council by a subcommittee:
_To the Council on Pharmacy and Chemistry_:--The U. S. Pharmacopeia,
8th revision, pages 334-5, states: “Pepsin and pancreatin in solution
are incompatible with one another. If the solution be neutral or
alkaline the pancreatin gradually destroys the pepsin, and if
acid the pepsin destroys the pancreatin.” The correctness of this
statement has been amply demonstrated by the reports which have been
submitted to the Council from time to time on liquid preparations
claimed to contain these two ferments.
Thus an elixir was investigated which was by the manufacturers
claimed to contain “the five active agents of digestion, pepsin,
veg. ptyalin, pancreatin, lactic and hydrochloric acids,” and to be
“superior to all other remedies in dyspepsia and diseases arising
from imperfect digestion,” and the committee which investigated the
article in question reported that “it was impossible to establish the
presence of either the proteolytic or the amylolytic ferment.”
Similarly, on another liquid preparation, which was said to
contain “pancreatin, pepsin, lactic and muriatic acids, etc.” ...
“the combined principles of digestion to aid in digesting animal
and vegetable cooked food, fatty and amylaceous substances,”
the committee reported “this product possessed only very slight
proteolytic action and failed to digest 2 per cent. of its own weight
of starch.”
Again, the report on still another preparation stated: “But while it
was said to contain pancreatin, the U. S. P. test for the valuation
of pancreatin failed to indicate this ferment.”
The report on yet another elixir, claimed to be “the only true
digestant, because it contains the enzymes of all the glands which
are necessary for digestion,” showed that this article did not
contain “any appreciable enzyme activity, either amylolytic or
proteolytic.”
The correctness of these findings of the committee of the Council was
generally acknowledged by the manufacturers when their attention was
called to the matter. Thus, one manufacturer of digestive ferments
writes: “We will ask you to hold this matter up until you hear from
us further on the subject. The reason for this request is that we
have been going over our liquid preparations very carefully in order
to be sure that after aging they would contain the ferments that we
put into them. The pancreatic ferments in alcoholic liquids seem to
lose their strength.”
The chemist for a large manufacturing house writes: “There are now on
the market a number of preparations in which pepsin and pancreatin
are combined in liquid form, and the result is that we have had
numberless requisitions from our representatives that we also market
such a preparation. As the result of this we have carried out a
series of experiments no less than four or five times in order to
determine whether pepsin, diastase, and pancreatin would retain their
activity in the form of a syrup, wine or elixir. We have proved
incontrovertibly that this cannot be done. While any two of these
substances, or even all three of them, can be dispensed in the form
of a liquid by the retail druggist and will retain their normal
activity for as long a period as three to six weeks, yet if allowed
to stand sufficiently long, they mutually destroy each other; so that
in a combination of pancreatin and pepsin the pancreatic enzyme is
lost and the pepsin greatly injured, and where diastase is present,
both diastase and pepsin (or diastase and pancreatin) mutually
destroy each other.”
Since it has been demonstrated that pepsin and pancreatin cannot
exist in one and the same solution for any reasonable length of
time, it becomes apparent that liquid preparations said to contain
these two ferments are sold under impossible claims. It is therefore
recommended:
1. THAT THE COUNCIL ON PHARMACY AND CHEMISTRY REFUSE TO APPROVE
LIQUID PREPARATIONS THAT ARE CLAIMED TO CONTAIN BOTH PEPSIN AND
PANCREATIN.
2. THAT THE MEDICAL PROFESSION THROUGH THE JOURNAL OF THE AMERICAN
MEDICAL ASSOCIATION BE ADVISED OF THE FALLACY OF EMPLOYING SUCH
COMBINATIONS.
3. THAT THE ATTENTION OF MANUFACTURERS BE CALLED TO THE WORTHLESSNESS
OF SUCH INCOMPATIBLE LIQUID PREPARATIONS OF PEPSIN AND PANCREATIN,
AND THAT THEY BE URGED TO CEASE OFFERING SUCH PRODUCTS TO THE
PROFESSION.
4. THAT, SINCE THE NATIONAL FORMULARY HAS RECOGNIZED A PREPARATION
OF THIS KIND UNDER THE TITLE “ELIXIR DIGESTIVUM COMPOSITUM,” THE
AMERICAN PHARMACEUTICAL ASSOCIATION BE REQUESTED TO INSTRUCT ITS
COMMITTEE ON THE NATIONAL FORMULARY TO OMIT THIS PREPARATION FROM THE
NEXT EDITION.
The recommendations of the subcommittee were adopted by the Council and
publication of the report directed.--(_From The Journal A. M. A., Feb.
2, 1907._)
W. A. Puckner, Secretary.
PEPTO-MANGAN (GUDE)
Report of the Council on Pharmacy and Chemistry
The following report was adopted by the Council and its publication
authorized.
W. A. Puckner, Secretary.
About ten years ago the M. J. Breitenbach Company circulated what
pretended to be an abstract of the report of a government commission
for the investigation of the anemia then prevalent in Porto Rico. The
company asserted that “this report alone would suffice to establish
Pepto-Mangan at once as the foremost hematinic known.” Examination of
the official report of the commission[67] revealed the fact that the
administration of iron in hookworm anemia was considered of secondary
importance, and that of the various preparations of iron, Blaud’s pill
was found to be more efficient than Pepto-Mangan (Gude). A protest[68]
was made at this time by the commission against the unwarranted use of
its report by the Breitenbach Company.
[67] The Journal, Sept. 23, 1905, p. 934.
[68] The Journal, Oct. 7, 1905, p. 1099.
Later the Breitenbach Company sent out a report pretending to prove
that at the Infants Hospital, Randall’s Island, New York City,
Pepto-Mangan (Gude) had been found a most superior preparation in the
treatment of infantile anemia. Inspection of the hospital records
and daily charts of the cases disclosed[69] a remarkable disparity
between the claims of the Pepto-Mangan pamphlet and the real results of
treatment. And so here, also, as well as in the Porto Rico commission’s
report the trials, selected by the Breitenbach Company prove the
limitations and non-superiority of Pepto-Mangan.
[69] The Journal, April 6, 1907, p. 1197.
The preceding false reports, though no longer circulated, have never
been definitely withdrawn and while it is now generally conceded that
the good results in anemia are obtained by the administration of the
various simple inorganic iron preparations the Breitenbach Company
still attempts to convey the impression that Pepto-Mangan (Gude) is
of most superior efficacy. Thus the present Pepto-Mangan circular
attempts to discredit by obsolete and absurd or untrue statements the
various preparations of iron which are in general use and to carry the
impression that only iron and manganese, in the particular form and
proportion in which they are contained in Pepto-Mangan--namely, 3 parts
Fe to 1 part Mn--are useful for the treatment of anemia, chlorosis,
etc. Thus contrary to general conceptions, the impression is given that
the now generally accepted course of chlorosis is due to the three
varieties of insufficiency of certain blood elements: (1) insufficiency
of manganese, (2) insufficiency of iron, (3) insufficiency of iron and
manganese; and that the administration of iron often fails because
manganese is not supplied to the system at the same time and in
sufficient amounts. The following statement is made:
“Doctor:
“If you have a case of ANAEMIA, CHLOROSIS, or AMENORRHOEA, that
shows no visible sign of improvement, and you have exhausted the
entire list of Nauseating Iron preparations with little or no
effect, it is because the blood is deficient in that _essential
oxidizing constituent_, _MANGANESE_, in a soluble, readily
assimilable form, the best being in combination with iron.”
Another extravagant claim:
“Usually after taking it for a week its restorative influence on
the functions of the stomach is felt; appetite reappears, and the
general health is improved by the increase in bodily warmth, an
effect directly due to manganese.”
The following statement implies that Pepto-Mangan is absorbed
unchanged, for which there is no justification:
“As the ferruginous and manganic ingredients of Pepto-Mangan
(Gude) exist in the form of organic peptonates, they have already
undergone the changes necessary to insure prompt absorption and
appropriation by the circulating fluid.”
The following declaration implies that it repairs the individual
defective blood-cells which is, of course, also ridiculous:
“That Pepto-Mangan (Gude) quickly and efficiently builds up
defective red blood cells, and generates, or at least potently
encourages the formation of new ones, and materially increases
their richness in hemoglobin, has been abundantly demonstrated....”
The M. J. Breitenbach Company is still trying to mislead physicians; it
also aims to make use of them in its direct appeal to the physicians’
patients. For instance, the name “Pepto-Mangan (Gude)” blown in the
bottle, the advertising circular suggesting Pepto-Mangan as the
treatment for anemia, etc., and the recommendation to physicians that
it be prescribed in “original bottles” all tend to encourage the use
of Pepto-Mangan by the public with the likelihood that it will be
depended on where good food and fresh air are of prime importance. The
attempt to exploit it directly to the public is further attested by the
advertisements of department-store drug departments.
It is evident from the foregoing that Pepto-Mangan (Gude) is in
conflict with Rules 4 and 6 and therefore not eligible for admission to
New and Nonofficial Remedies.--(_From Reports Council Pharm. and Chem.,
1914, p. 121._)
LIQUID PETROLATUM OR “RUSSIAN MINERAL OIL”[AI]
Report of the Council on Pharmacy and Chemistry
[AI] See also following reports on Clinical Experience with Liquid
Paraffin (Liquid Petrolatum) and Angier’s Emulsion.
The following report was submitted to the Council by a referee and its
publication authorized by the Council.
W. A. Puckner, Secretary.
Petroleum has been in use as a medicine from time immemorial. It
was known to Herodotus 400 years before Christ and is mentioned
by Plutarch, Dioscorides, Pliny and other early writers. It was
extensively used by the Arabians and evidently played an important part
in the practice of medicine in India, being known to the Bengalese as
Muthe Katel. The raw product was the substance used in earlier times
and differed much in character and composition, as obtained from
different sources.
As an internal remedy it was early employed in chronic pulmonary
affections, in obstinate skin diseases, in rheumatism, and for the
expelling of tapeworms. It was extensively used for these several
purposes in France under the name of “Oleum Gabianum” and in North
America as “Seneka oil.”
The internal use of the refined product may be traced to a patent
granted to Robert A. Chesebrough of New York, in June, 1872, for
the manufacture of a “new and useful product from petroleum, named
vaseline.” This name was originally applied only to a semisolid
preparation, but later a liquid product known as liquid vaseline
was marketed and for a time exploited as a cure for coughs, colds,
consumption and a number of other diseases and conditions.
The liquid petrolatum has since become known under a variety of names,
proprietary and otherwise, in addition to being used as a substitute or
an adulterant for other, more costly, fats and oils. Some of the names
applied to the product are:
Adepsine oil Neutralol
Amilee Olo
Atoleine Paraffin Oil
Atolin Paroline
Blandine Petralol
Crysmalin Petro
Deeline Petrolax
Glyco Petrolia
Glycoline Petronol
Glymol Petrosio
Heavy petroleum oil Rock Oil
Liquid Albolene Russian liquid petrolatum
Liquid Cosmoline Russian mineral oil
Liquid Fossiline Russian paraffin oil
Liquid Geoline Russol
Liquid Paraffin Saxol
Liquid Petrolatum Terraline
Liquid Saxoline Terralbolia
Liquid Vaseline Usoline
Mineral Glycerin Water-white mineral oil
Mineral Oil White paraffin oil.
A preparation similar to that official in the Pharmacopeia of the
United States as liquid petrolatum has been included in many, if not
all, of the foreign pharmacopeias, the official titles under which this
preparation is recognized being as follows:
Petrolatum Liquidum, U. S. Pharmacopeia; Paraffinum Liquidum,
pharmacopeias of Great Britain, Germany, the Netherlands, Japan,
Belgium, Austria, Denmark, Switzerland, Sweden, Servia, Italy, Hungary
and Russia; Oleum Paraffinae, Spanish Pharmacopeia; Vaselinum Liquidum,
French Pharmacopeia, and Oleum Vaselini (as a synonym) pharmacopeias of
Denmark and Russia.
The requirements of the several pharmacopeias differ somewhat and the
specific gravity as given is as follows:
U. S. P. VIII, 1905 0.870 to 0.940 at 25°
Ph. Brit. IV, 1895 0.885 to 0.890 at 15.5°
B. P. C. II, 1911, usually 0.875 or lower at 15°
Ph. Germ. V, 1910, at least 0.885 at 15°
Ph. Ross. VI, 1910 0.880 to 0.885 at 15°
Ph. Hung. III, 1909 0.88 to 0.89 at 15°
Ph. Ital. III, 1909 0.875 to 0.890 at 15°
Ph. Fr. V, 1908, about 0.875 at 15°
Ph. Serb. II, 1908, about 0.880 at 15°
Ph. Svec. IX, 1908 0.88 to 0.90 at 15°
Ph. Helv. IV, 1907 0.880 to 0.885 at 15°
Ph. Dan. VII, 1907, at least 0.880 at 15°
Ph. Austr. VIII, 1906, at least 0.880 at 15°
Ph. Belg. III, 1906, not below 0.880 at 15°
Ph. Japon. III, 1906 0.875 to 0.945 at 15°
Ph. Ndl. IV, 1905, not below 0.860 at 15°
Ph. Hisp. VII, 1905 0.840 at 15°
For pharmaceutical purposes, liquid petrolatum may be divided into two
grades, the lighter or more limpid oil, used extensively as a vehicle
for oil sprays, and the heavier, more viscid oil generally recognized
in European pharmacopeias and used as an ingredient of ointments and
more recently as a remedy in the treatment of intestinal stasis.
Under petrolatum liquidum the U. S. P. recognizes a mixture of
hydrocarbons, chiefly of the methane series, which occurs as a
colorless or very slightly yellowish, oily, transparent liquid without
odor or taste and having a specific gravity of about 0.870 to 0.940 at
25 C. For the U. S. P. IX, it is proposed to change this requirement
somewhat so as to have it apply to a transparent liquid free from
fluorescence, without odor or taste and having a specific gravity of
from 0.845 to 0.940 at 25 C.
Such a requirement would include all of the available paraffin oils
irrespective of origin. The now commonly available commercial liquid
petrolatum, used for pharmaceutical purposes, is practically colorless
and all of the better grades are free from odor or taste. The specific
gravity varies from 0.855 to 0.895. The lighter oils, having a specific
gravity of from 0.860 to 0.870, are usually preferred in the making of
oil sprays or solutions of substances to be used as local applications.
The product having a specific gravity above 0.875 evidently contains
a considerable amount of dissolved solid paraffin which separates
out at temperatures at or below 0 C., but readily dissolves again at
temperatures above 10 C.
There is considerable difference in the chemical composition of the
paraffin oils obtained from various sources. The American oil consists
largely of hydrocarbons of the methane series, while the Russian oil
contains naphthenes or hydrocarbons of the benzene series, having
the empirical composition of ethylene, (C_{n}H_{2n}) which may be
considered as hydrogenated aromatic hydrocarbons, though they behave
with reagents very much in the same way as do the hydrocarbons of the
methane series.
Mineral oils with a naphthene base are best suited for making white
petrolatum, and at the present time the production of the colorless
water-white liquid petrolatum appears to be confined largely or almost
exclusively to the crude product of the Baku district of Russia, though
it is asserted that it is now also made from the Hanover (Germany)
crude oil and that some is being produced by “cracking” the white solid
paraffin.
It is also said that the American oil can be made water white but
that it is not being so produced at present for economic reasons; the
yellowish oil, free from fluorescence, having a very wide sale, both
as a lubricant and as a substitute for lard oil and other of the more
costly lubricating oils.
From a pharmaceutical point of view it would appear important to note
the physical characteristics of the oil and to insist on absence of
color, absence of odor and taste, absence of acid and of alkali and a
specific gravity in harmony with the purposes for which the oil is to
be used.
During the past year or two liquid petrolatum has attracted
considerable attention as a remedy in the treatment of intestinal
stasis or chronic constipation, the practice of using it having been
developed largely through its recommendation by Sir W. Arbuthnot Lane
and his associates. This use of liquid petrolatum and of petrolatum
products generally is by no means novel. N. A. Randolph[70] of
Philadelphia was among the first to suggest its use for this purpose
in an article published in 1885. Randolph also appears to have
been the first to experiment with petrolatum and to determine its
non-absorbability from the intestinal tract. In an article[71] in 1884
he concludes that “pure petrolatum while entirely unirritating to the
digestive tract is valueless as a foodstuff.”
[70] Randolph, N. A.: Therap. Gaz., ix, 732.
[71] Randolph, N. A.: Proc. Acad. Nat. Sc., Philadelphia, 1884, p. 281.
The experiments recorded by Randolph were evidently prompted by
the fact that vaseline and a number of imitation products then on
the market were being sold as substitutes for lard and butter, and
opinions regarding the food value of petroleum products appear to
have differed very materially. Following the experiments of Randolph,
Robert Hutchison in 1899 made a series of experiments to demonstrate
that petroleum, petrolatum, paraffin and related products were
absolutely unassailable by any of the digestive fluids, despite the
“large vogue that had of late years been given to various petroleum
emulsions, chiefly by ingenious and unterrified advertising.” He came
to practically the same conclusions arrived at by Randolph fifteen
years earlier and pointed out that “liquid paraffin in one sense may be
regarded as an artificial intestinal mucus and might in that way have
some value on certain forms of constipation.”
William Duffield Robinson[72] reports on the use of a perfectly
refined colorless and odorless petrolatum, supposedly of American
origin. He was able to show that all of the product passed unchanged
through the intestinal tract and could be regained from the feces.
In his conclusions he expressed the belief that the effect of the
administration of these petroleum products is far more than as a
simple intestinal lubricant. In over fifty selected cases in which
nutrition, digestion and body-weight were impaired, and the purest
oil administered in 1- or 2-dram doses each day for a period of from
four to six months, there was in every instance an improvement of
weight, health and feeling of well-being. The administration of refined
paraffin oil gave no discomfort in any instance, even in cases in which
nearly a pint was given in a few hours.
[72] Robinson: William Duffield: Med. News, 1900, lxxvii, 56.
William Ewart[73] suggests liquid paraffin as a safe agent for the
local treatment of the lesions in typhoid fever. He says in part:
“Mineral oil, such as petrolatum or paraffin, is neither absorbed nor
dissolved; therefore, after all absorbable ingestions are taken up
by the lacteals, it will still remain in the bowel. In this way pure
liquid paraffin is valuable, precisely because it is inert; moreover,
it might some day, perhaps, be made the vehicle for effective topical
remedies.”
[73] Ewart, William: Brit. Med. Jour., 1902, ii, 1505.
A. D. Schmidt[74] quotes Stubenrath as having given liquid paraffin in
the treatment of chronic constipation, and he himself gave as much as
20 gm. of liquid paraffin to adults without observing any injurious
effect whatever. He says, “As a result of the administration of liquid
paraffin, the feces are softened considerably and are found under
the microscope to contain numerous minute globules of paraffin.” He
was, however, unable to recover from the feces the entire quantity
of paraffin administered and believes that a certain portion of it,
probably the fractions with a low boiling-point, are absorbed or
possibly oxidized in the organism.
[74] Schmidt, A. D.: München. med. Wchnschr., 1905, lii, 1970.
Maurice Vejux Tyrode[75] also refers to the use of liquid petroleum in
the treatment of constipation.
[75] Tyrode, Maurice Vejux: Boston Med. and Surg. Jour., 1910, clxii,
673.
Sir W. Arbuthnot Lane in his recommendations of liquid petrolatum calls
it an ideal remedy for stasis, but cautions against the use of the
lighter oil as extensively prescribed in this country as a vehicle for
sprays in nose and throat work.
Paraffin oil is not absorbed from the alimentary tract and so far
as known exerts no deleterious influence. It is usually given in
quantities of from 10 to 20 c.c. half an hour or an hour before meals
or in larger doses, from 30 to 50 c.c., at one time on retiring.
From available evidence it appears that comparatively huge doses
may be administered without the production of any untoward results.
According to many observers, liquid paraffin should not be given
with or after meals because of the inhibiting influence that it may
have on the digestion of food. It is not soluble in water or the
ordinary solvents and therefore cannot be diluted. The denser oils are
preferably slightly warmed or drunk with warm water so as to obviate
the disagreeable slimy sensation that persists when taken cold.
Volatile oils may be used in moderate amounts to give a distinctive
taste to the otherwise rather insipidly tasteless paraffin oil. Among
the more desirable oils to be used for this purpose would be oil of
peppermint, oil of cinnamon, oil of betula or methyl salicylate and oil
of cloves. From 2 to 10 drops of any of these oils can be added to a
pint of the oil. When larger doses of the oil are to be given at one
time, it would, of course, be advisable to use a comparatively smaller
quantity of the volatile oil as a flavor.[76]
[76] In addition to the articles referred to in the preceding
footnotes, the following are of interest in connection with this
subject:
Editorial, Therap. Gaz., 1885, ix, 353.
Junker, F. A.: Med. Record, London, 1885, xiii, 506.
Editorial, Med. News, 1886, xlviii, 105.
Dunbar: Deutsch. med. Wchnschr., 1896, xxii, 33.
Stubenrath, Franz Casimir: München. med. Wchnschr., 1897, xliv, 639.
London Letter, Med. News, 1899, lxxiv, 504.
Hutchison, Robert: Brit. Med. Jour., 1899, i, 724.
Schlesinger, E. G.: Boston Med. and Surg. Jour., 1913, clxix, 14.
Lane, W. Arbuthnot: Brit. Med. Jour., 1913, ii, 1126; Proc. Roy. Soc.
Med., 1913, vi, 49; Surg. Gynec. and Obst., 1913, xvi, No. 6.
Jordan, Alfred C.: Practitioner, London, February, 1913.
Chrysospathes, J. G.: Zentralbl. f. Chir., 1913, No. 45; abstr., The
Journal A. M. A., Dec. 13, 1913, p. 2201.
From the foregoing it would appear that apart from the Pharmacopeia of
the United States, practically all other known pharmacopeias describe
a water-white mineral oil under the title “Paraffinum Liquidum” or
“Liquid Paraffin” as a colorless, odorless, tasteless, non-fluorescent,
oily liquid, free from acids, alkalies and organic impurities. As
explained before, the specific gravity of the preparation as recognized
in other countries and as offered on the American market at the present
time varies considerably, and there appears to be some difference of
opinion as to the exact nature of the product that is preferable for
use for different purposes. This matter requires further investigation.
Since the definition of liquid petrolatum in the U. S. Pharmacopeia
permits the use of fluorescent products of widely varying specific
gravities, it is recommended that physicians who desire the water-white
non-fluorescent (Russian) mineral oil should use the term “Petrolatum
Liquidum, Grave,” or “Paraffinum Liquidum, B. P.,” if the heavy product
recommended by Lane is desired, and “Petrolatum Liquidum, Leve” if the
light varieties are required. It is further recommended that under the
foregoing names, manufacturers and pharmacists be requested to dispense
the products, in accordance with the following descriptions:
=Petrolatum Liquidum, Grave.=--Heavy (Russian) Liquid
Petrolatum.--Paraffinum Liquidum, B. P., liquid paraffin.--A
transparent, colorless, tasteless, non-fluorescent, oily liquid,
odorless when cold but giving off a faint petroleum odor on heating.
This preparation should correspond to the requirements of the British
Pharmacopeia for liquid paraffin and have a specific gravity of about
0.885 to 0.890 at 15 C. It is insoluble in water or alcohol but soluble
in boiling absolute alcohol and readily soluble in ether, chloroform,
carbon disulphid, petroleum benzin, benzene and fixed and volatile
oils. It serves as a solvent for volatile oils and related substances
like camphor, menthol and thymol.
This is the type of preparation used by Sir W. Arbuthnot Lane, and his
associates for internal administration. It is also used as a basis
for ointments and salves and as a local application to wounds, ulcers
and in certain forms of skin diseases in which a simple protective is
desired.
=Petrolatum Liquidum, Leve.=--Light (Russian) Liquid Petrolatum.--A
transparent, colorless, tasteless, non-fluorescent, oily liquid,
odorless when cold, but giving off a faint petroleum odor on
heating. In other respects this preparation should correspond to the
pharmacopeial tests for liquid petrolatum and have a specific gravity
of about 0.860 to 0.875 at 15 C. Like the heavy variety of liquid
petrolatum, it is insoluble in water and alcohol, but soluble in
boiling absolute alcohol and rapidly soluble in ether, chloroform,
carbon disulphid, petroleum benzin, benzene and fixed and volatile
oils. It serves as a solvent for volatile oils and related substances
like camphor, menthol and thymol.
This is a type of preparation extensively used as a vehicle for the
oily sprays in nose and throat work. It is also being used as one of
the constituents in the now popular paraffin oil cold cream and has
been used to some extent for internal administration in the treatment
of chronic stasis. Being more limpid than the preparation preferred by
Lane, it is more readily taken, though greater care must be exercised
in securing a sample devoid of the lighter fractions of petroleum
distillates.--(_From The Journal A. M. A., May 30, 1914._)
CLINICAL EXPERIENCE WITH LIQUID PARAFFIN (LIQUID PETROLATUM)[AJ]
A Comparative Investigation Made Under the Auspices of the
Council on Pharmacy and Chemistry[AK]
W. A. Bastedo, M.D., New York
[AJ] See also preceding report on Liquid Petrolatum or “Russian Mineral
Oil” and following report on Angier’s Emulsion.
[AK] This investigation was made under the auspices of the Committee
on Therapeutic Research of the Council on Pharmacy and Chemistry of
the American Medical Association. At the request of the committee, Dr.
W. A. Bastedo has prepared this critical review of the reports made by
those who collaborated in this investigation.
During the past three or four years, “mineral oil” has come into
extensive use in the treatment of constipation. Preparations of the
Russian and the American oil, both heavy and light, have appeared on
the market, but there have been no satisfactory data on which to base
a selection of oil for use. Therefore, in order to obtain reliable
clinical information concerning the relative efficiency of the
different oils, the Therapeutic Research Committee of the Council on
Pharmacy and Chemistry of the American Medical Association submitted
samples of the oils to various clinicians for testing. The following is
a synopsis of the investigation, which I have prepared at the request
of the committee.
The collaborators were advised that specimens of the best obtainable
light Russian liquid petrolatum, heavy Russian liquid petrolatum and
an American brand of liquid petrolatum would be sent out, but that, to
avoid bias, these specimens would be distinguished only by numbers or
letters. The oils sent out were (1) a light “Russian” liquid petrolatum
having a specific gravity of 0.860 at 20 C., (2) a heavy “Russian”
liquid petrolatum having a specific gravity of 0.885 at 20 C., and (3)
an “American” liquid petrolatum having a specific gravity of 0.857 at
20 C. and being markedly fluorescent. The collaborators were advised
that the reports should furnish information as to size and frequency of
dose, the agreeableness to the taste, the effect on the stomach, the
number and character of the stools, the degree of admixture of the oil
with the other ingredients of the stool, the degree of leakage of oil
about the anus, and the need of other cathartic measures.
Reports have been received from Drs. L. F. Barker, W. A. Bastedo, J. B.
Champion, Henry A. Christian with C. K. Drinker and F. A. Hatch, Alfred
Stengel and R. L. Wilbur.
CONCLUSIONS
The conclusions to be drawn from the clinical reports are:
_Dosage._--Half an ounce to 3 ounces a day. In the same patient, the
same amount of each of the oils was required.
_Frequency of Dose._--The same amount daily seemed as efficient when
given in one dose as when given in divided doses two or three times a
day.
_Agreeableness to the Taste._--There is a difference of opinion in this
regard. Two reports favored the heavy Russian oil. One report favored
the light Russian petrolatum. But the taste of any of the samples was
so slight as to be a negligible quantity after the patient had taken
the remedy for two or three days.
_Stomach Effects._--In about 20 per cent. of the patients, the oil
produced a slight degree of nausea or tended to repeat. This is most
likely in patients who have gastric stagnation with retarded emptying
of the stomach. All the oils acted the same in this regard. Vomiting
was reported in two cases.
_Number of Stools._--To produce one or two copious stools a day the
dose required varied considerably, but there was no difference noted on
account of difference in the specific gravity or character of the oils.
_Character of Stools._--The stools were soft, usually formed, sometimes
mushy, obviously greasy. They had a peculiar odor described as sour.
Their consistency varied with the dose, but was the same for the
different kinds of oil.
_Admixture of Oil with Other Ingredients of Stool._--Generally well
mixed, but from time to time a patient would have a stool of free oil.
This occurred with all varieties of oil. (It necessitated reduction
of the dose, and if then the bowels were not active enough, the
administration in addition of cascara, aloin, etc.)
_Leakage About the Anus._--A disagreeable feature complained of by
many is that when they take enough of the oil to move the bowels,
there is sufficient leakage from the anus to keep the neighboring skin
continually in a greasy condition, and sometimes to stain the clothes.
That there is any difference in this regard between the oils has not
been determined.
In the reports, one clinician noted no differences that were not
negligible. Another was slightly in favor of No. 2 (heavy Russian)
as regards taste. A third reporter did not make comparative tests. A
fourth is slightly in favor of “B” (heavy Russian) as regards taste
and general suitability. All of the findings of this investigation
are based on hospital cases. A fifth reporter favored No. 1 (light
Russian petrolatum). He considered it the most prompt in its effect,
the most uniform in results, and the most prone to give a satisfactory
admixture of the oil with the other materials. The difference, however,
from the other oils was not marked. Another reporter noted no special
differences.
SUMMARY
The results of this clinical investigation appear to warrant the
conclusion that so far as therapeutic results are concerned the
differences in the action of the three varieties of liquid petrolatum,
namely, light Russian liquid petrolatum, heavy Russian liquid
petrolatum and American liquid petrolatum, are too slight to be of
importance. Hence the choice between the lighter and the heavier
oils, and between the Russian and the American is an open one, to
be determined not by therapeutic differences, but by palatability,
dependent on the degree to which the refinement of the oil is carried
out. The U. S. Pharmacopeia, the revision of which is now nearing
completion, no doubt will furnish standards which will insure a
suitable product. From the findings of the foregoing report it would
appear that a satisfactory standard might permit the use of either
Russian or American oil, if suitably refined so as to be as nearly as
possible devoid of odor and taste.--(_From The Journal A. M. A., March
6, 1915._)
ANGIER’S EMULSION[AL]
Report of the Council on Pharmacy and Chemistry
[AL] See also preceding reports on Liquid Petrolatum or “Russian
Mineral Oil” and Clinical Experience with Liquid Paraffin (Liquid
Petrolatum).
Angier’s Emulsion is essentially a petroleum product. When it was first
put on the market commercial interests had been fostering the idea that
petroleum products had food-value, and the manufacturers of Angier’s
Emulsion, making use of the idea, advertised it as a “food-medicine”
and an “ideal substitute for cod-liver oil.” The impression thus
created has been kept alive through persistent advertising in spite of
scientific proof to the contrary. To-day many who know that petroleum
products have no food-value are still likely unconsciously to class
Angier’s Emulsion among nutrients. Although the manufacturers now
advertise this product as “purely mechanical in its action,” they yet
show a disposition to profit by the old misapprehension, since, so
far from expressly disavowing the old claims as erroneous, they mingle
with the new ones vague claims of “tonic and reconstructive merits”
apparently designed to sustain, in those who do not take time to
consider the evidence carefully, the old faith in the claimed nutritive
qualities of the preparation.
While the Council judges a preparation by the claims made for it
at present, and not by any past misstatements when these have been
thoroughly corrected, the past advertising of Angier’s Emulsion so
instructively illuminates the scientific worthlessness of proprietary
therapeutic claims in general, and the whole course of its history is
so typical that the referee has thought it well to review the subject
briefly. The Council has authorized the publication of the following
report.
W. A. Puckner, Secretary.
Angier’s Petroleum Emulsion was brought out in 1881--that is to say,
before the food-value of petroleum products had been experimentally
disproved. Its advertising history well illustrates the weed-like
vitality of a financially profitable therapeutic fallacy. The
shifting claims made for this preparation are such good examples
of the generally unreliable therapeutic pretensions of proprietary
medicines--whether of the “patent medicine” or of the “ethical
proprietary” type--that it has been deemed advisable to present a brief
review of the conflicting claims made for it at various times.
A PETROLEUM PRODUCT
Angier’s Emulsion is described by the manufacturers as containing,
in addition to “our specially purified Petroleum,” “the combined
hypophosphites of lime and soda, chemically pure glycerine, and the
necessary emulsifying agents.” So far as the hypophosphites are
concerned, it is probably unnecessary to remark that the latest
researches bring to light no evidence that they influence metabolism in
the slightest degree. The Angier Chemical Company apparently accepts
this view, for in its advertising stress is laid exclusively on the
merits of the emulsion as a petroleum product. It is therefore proper
to consider it from this point of view.
The history of the internal use of liquid petrolatum was sketched in
a recent Council report.[77] As mentioned at that time, a number of
petroleum products were put on the market some thirty years ago as
substitutes for lard and butter. Contemporary opinions regarding the
food value of such products differed widely.
[77] Liquid Petrolatum or “Russian Mineral Oil,” p. 161.
There never was any scientific evidence to support the view that
petroleum and its derivatives are assimilable by the animal organism.
In fact, so far as we can learn, there was no scientific investigation
of the problem until Randolph’s experiments in 1884. These were
probably the first to demonstrate the non-absorbability of petroleum
and its valuelessness as a foodstuff.
In 1899 Robert Hutchison conclusively demonstrated by experiment that
petrolatum, paraffin and related products were absolutely unassailable
by any of the digestive fluids, and therefore could not possibly have
any food value. Various investigators later confirmed these findings.
FIRST ADVERTISED AS A “FOOD-MEDICINE”
Let us now take up the advertising history of this nostrum. In 1895 it
was sold under these claims:
“... a ‘Food-Medicine’ that is far more than a substitute for
cod-liver oil”;
“... a Food-Medicine that is readily assimilated and helps to
digest other foods.”
In 1897 it was an:
“Ideal Substitute for Cod Liver Oil.”
In 1899 it:
“... conserves heat and energy by furnishing more material for
oxidation.”
In 1902 it:
“... supplants tissue waste by tissue reconstruction.”
The promoters of Angier’s Emulsion thus for some time ignored the
status definitely assigned to petroleum products by the experiments of
Randolph, Hutchison and others. This was only natural. If petrolatum
was absolutely inert in the alimentary canal (and this was now proved
beyond controversy) then an emulsion prepared from it most certainly
was not a “food-medicine,” could not “supplant tissue waste,” or
“conserve heat and energy.” All the credit which previous “unterrified
and ingenious advertising” (to quote Hutchison) had accumulated for
Angier’s Emulsion was bound up with the view that petroleum products
were foodstuffs.
LATER ADVERTISED AS NON-ABSORBABLE
The non-absorbability of liquid petrolatum, however, suggested to
Robinson, Schmidt, Lane and others, a new therapeutic use for it in
the treatment of chronic constipation. This method has rapidly gained
popularity and it is not surprising, therefore, that the promoters of
Angier’s Emulsion changed their claims accordingly, and now began to
base their advertising chiefly on the proved properties of petrolatum.
In 1910 the emulsion was advertised for the treatment of chronic
diarrhea on these grounds:
“... given by the mouth, it passes to the lowermost portions of
the intestines without changing its identity; hence it exerts
antiseptic, soothing and demulcent properties upon every inch of
the intestinal tract, from the duodenum to the rectum.”
The old claims, however, were not discarded altogether, for in 1911 the
preparation was recommended for children’s diseases as:
“... an aid to appetite and digestion and a splendid tonic and
builder.”
Before long the attempt was made to weave together the claims based on
opposed and mutually incompatible properties. In 1912 we find Angier’s
Emulsion recommended because it:
“... corrects digestive disturbance and promotes normal action
of the bowels. At the same time it has a most invigorating tonic
influence upon the general health.”
In 1914 medical men are advised through the advertising pages of the
_British Medical Journal_ of the:
_“... tonic and reconstructive merits of Angier’s Emulsion.”_
A pamphlet on “Constipation,” which is “Presented to Physicians with
Compliments of the Angier Chemical Company” (copyright, 1913; still
distributed in 1914) informs physicians that Angier’s Emulsion is:
_“... purely mechanical in its action.”_
Notwithstanding this, we are told later on in the same pamphlet that it:
“... facilitates, hastens and assists the processes of digestion
and assimilation.” ... “is a most efficacious remedy in Pulmonary
Tuberculosis because it not only maintains normal nutrition, but
also exerts a well-defined specific palliative influence upon the
cough and other symptoms of the disease.”
Evidently the advertisement is written in the hope that in one
paragraph a claim based on the proved properties of petroleum products
may be substantiated, while in another a totally different and
inconsistent claim may be glibly insinuated in vague phrases designed
to lull thought and thus perform the remarkable feat of securing
credence for two contradictory statements.
UNWARRANTED AND MISLEADING CLAIMS
Further evidence that Angier’s Emulsion is at present exploited both
to the medical profession and to the public under claims that are
unwarranted and misleading, if not as palpably untrue as the claims
made in the past, is found on the wrapper of a trade package purchased
in 1914 and in the circular accompanying it. Note the following:
“Indicated in Diseases of the Throat and Lungs and of the
Digestive Apparatus. Useful in General Debility and Wasting
Diseases, Especially when due to Faulty Nutrition. The antiseptic
properties of the Emulsion particularly adapt it to the treatment
of diseases of septic or bacterial origin.”
“Angier’s Petroleum Emulsion is indicated in affections of the
throat, lungs and intestinal tract--both subacute and chronic. In
diseases of the digestive apparatus due to catarrhal, ulcerative or
tuberculous conditions, its peculiar soothing, healing and aseptic
properties make its use especially beneficial. Wasting diseases,
particularly when due to faulty nutrition, are greatly benefited
by its use, one of the most noticeable effects being a prompt and
decided increase in weight.”
It is, of course, unnecessary to point out that, since petroleum is
non-absorbable, Angier’s Emulsion contains no ingredient capable of
affecting the respiratory mucous membrane except by local application,
for which, indeed, this preparation is evidently not intended.
COMPOSITION AND FORMULAS
According to a circular which was contained in a trade package recently
purchased
“Each fluidounce of Angier’s Petroleum Emulsion with hypophosphites
contains: 33-1/3 per cent. of our specially purified Petroleum; 9
grains of the combined hypophosphites of lime and soda, chemically
pure glycerin and the necessary emulsifying agents.”
As regards the nature of the product referred to under the indefinite
term “petroleum” the circular states that Angier’s Emulsion is:
“... prepared with refined petroleum specially purified for the
purpose. By a process peculiarly our own the crude petroleum,
obtained from special wells is so purified that all taste and odor
and all objectionable and irritating properties are removed, while
the full medicinal value of the oil is retained....”
The composition assigned to Angier’s Emulsion in an advertising
pamphlet “The Petroleum Idea,” issued in 1907 differs in that it is
said to contain “specially purified crude petroleum” and that each
fluidounce is said to contain 2.84 grains of benzoate of sodium.
While these quotations convey the impression that certain medicinal
constituents of the “specially purified” product obtained from “special
wells” are “retained,” a pamphlet recommending the use of Angier’s
Emulsion for the treatment of constipation assures us that it produces
the “mechanical effects of the purest petroleum” and that it is “purely
mechanical in its action.”[78]
[78] As is the custom in the exploitation of proprietary medicines,
the preparation which is the firm’s main output--the leader--is made
to do duty as an advertising medium for auxiliary preparations. Thus
the Angier Emulsion booklet advises the use of Angier’s Throat Tablets.
These tablets are alleged to be composed essentially of elm bark and
petroleum, are claimed to “promote appetite and aid digestion,” and
it is stated that “their healing action on all mucous surfaces makes
them decidedly beneficial, not only to the pulmonary tract but on the
digestive areas as well.” Angier’s Throat Tablets were examined in the
Association’s Laboratory to determine the amount and kind of petroleum
present in the tablets. Extraction of the tablets with ether yielded
a petroleum product which resembled in every way the product obtained
from the emulsion. Slightly less than 12 per cent. of the tablet was
composed of the petroleum oil. The part insoluble in ether appeared to
consist essentially of elm bark, with gum and sugar.
LABORATORY REPORT
The statements regarding the identity of the “petroleum” are so
unsatisfactory and contradictory (in one place “refined petroleum
specially purified for the purpose,” in another “specially purified
crude petroleum”--in one place “medicinal” and in another “purely
mechanical in its action”) that the help of the Chemical Laboratory of
the Association was invoked to establish the character of the petroleum
product and to determine the presence or absence of sodium benzoate, at
one time declared by the manufacturers to be present but later omitted
from the formula. The Association’s chemists reported:
“From a specimen of Angier’s Emulsion recently purchased there was
separated by the customary methods of analysis, a yellow fluorescent,
unsaponifiable, semi-solid residue which has all the properties of
ordinary yellow petrolatum of a consistence somewhat softer than
the product described in the Pharmacopeia. It was much more dense
than the colorless, non-fluorescent liquid petrolatum now in vogue
as a laxative. The preparation contained benzoate, both in the form
of free benzoic acid and also in the form of a water-soluble salt
probably sodium benzoate.”
The petroleum product contained in the emulsion was thus shown to be
intermediate between the ordinary (solid) and the liquid petrolatum.
It also appears that a benzoate is still present, though no longer
mentioned in the formula.--(_From The Journal A. M. A., Sept. 12,
1914._)
PHECOLATES, PHECOLAX, PHECOZYMES AND PHECOTONES
Report of the Council on Pharmacy and Chemistry
Phecolates, Phecolax, Phecozymes and Phecotones were submitted by F.
Waldo Whitney, New York, with “literature” indicating that they are
designed to form parts of a system of treatment founded on the theory
of autotoxemia, which they are supposed to prevent by their action
on the functions of the intestinal canal. The different preparations
consist in the main of mixtures of well-known remedies. The basic
preparation is Phecolates, which contains bile salts in combination
with phenyl salicylates and benzo-naphthol in about one-eighth the
regular doses and hence not likely to be of any real service. Since the
proportions of these ingredients ought to be regulated by the physician
according to the needs of the individual patient, they should not be
combined in fixed proportions. The name is not so framed as to indicate
the principal ingredients.
Phecolax contains, in addition to the ingredients of Phecolates,
phenolphthalein and cascarin, of each one-half grain.
Phecozyme is made more complex than Phecolax by the introduction of
additional phenyl salicylate and of pancreatin.
Phecotone contains ten ingredients.
Extravagant claims such as the following are made:
“Our Health is governed by our bowels; Our bowels are governed by
our nerves; Our nerves are governed by our digestion; our digestion
is governed by Phecolates.”
The Council voted to refuse recognition to Phecolates, Phecolax,
Phecozymes and Phecotones as unscientific articles with objectionable
names.--(_From The Journal A. M. A., Nov. 21, 1914._)
PHENOL SODIQUE
Report of Examination by Council on Pharmacy and Chemistry
and Comments
An examination of this article by a subcommittee of the Council on
Pharmacy and Chemistry revealed unscrupulous claims which are a
positive menace to public health. In view of this the Council has
directed the publication of the following comments.
W. A. Puckner, Secretary.
COMMENTS
Phenol Sodique was not submitted to the Council by the manufacturers,
but was taken up because it is advertised to both physicians and the
public. Some advertisements state: “Phenol Sodique was the standard
antiseptic thirty years ago. It’s the same today.” If this were true,
it would be high time to call a halt; for the unscrupulous claims made
for this nostrum, and the effrontery with which they are pushed, are
only rivaled by those of the most shameless “patent medicines.”
The firm of Hance Bros. & White poses as a reputable pharmaceutical
manufacturing house, but how it can reconcile this position with
their method of exploiting this product passes all understanding. In
the original package of Phenol Sodique (the latest was purchased on
June 20, 1907), there are little booklets and a folder describing
the marvelous properties of the nostrum. The booklets do not refer
to Phenol Sodique, but they are very instructive. They are entitled:
“Dyspepsia,” “Worm News,” and “Catarrh,” advertising “Dyspepsia
Stop”--some form of dyspepsia tablets, a remedy for round worms,
and “Catarrh Stop,” apparently some mild antiseptic tablets. These
booklets are addressed frankly to the laity, although recourse to a
physician is, generously, advised if the patient does not respond to
treatment! The folly of prescribing “original packages” which contain
popular literature has been so often emphasized that further comment
seems superfluous. The following from “Catarrh,” however, throws an
interesting sidelight on the scientific status of Hance Bros. & White:
+--------------------------------------------------------+
| “Catarrh is due to a minute insect in the inner lining |
| membrane of the nose. This insect multiplies rapidly, |
| and, unless checked, and destroyed, will produce the |
| worst results.” |
+--------------------------------------------------------+
To return, however, to Phenol Sodique: The folder is also evidently
intended for the lay public rather than for physicians; at least, if we
are to credit Hance Bros. & White with any intelligence whatsoever. It
is headed: “Montyon Prize of Encouragement, Awarded by the Institute
of France, 1861.” This is rather ancient, but what follows indicates
that a little restraint would have been better than encouragement.
The circular is a compact treatise on self-medication--apparently all
that is necessary to retain or regain health is the use of Phenol
Sodique, externally and internally. The following conditions are
among those specifically named as amenable to this remedy. Smallpox,
measles, scarlatina, erysipelas, puerperal fever, typhoid fever,
cholera, diarrhea, cramps, burns and scalds, bites, cuts and wounds,
excoriations, chilblains, chaps, sore throat, scratches, catarrh,
tetter, sunburn, swollen veins, ulcers, hemorrhages, bruises, piles,
gangrene, carbuncle, itching, insect stings, ivy poison, cold in the
head, bunions, inflamed eyes, eczema, ringworm, rheumatism, pains,
toothache, seat worms, etc.--besides numerous diseases of animals.
No antiseptic, whatever its composition, could by any possibility
accomplish anything like what is claimed for Phenol Sodique, so that
the composition of the article is really of little importance. This
is evidently appreciated by the manufacturers, for they have kept the
composition a profound secret, except in so far as it is implied in
the name. An inquiry addressed to Hance Bros. & White, under date of
April 27, 1907, six months ago, has remained unanswered. The Council,
therefore, directed an analysis of Phenol Sodique. This was carried out
at the chemical laboratory of the American Medical Association, and a
check analysis was made by an independent firm of chemists.
This shows that Phenol-Sodique contains something like 0.5 or 0.66 per
cent. of phenols, dissolved in about 0.75 per cent. of sodium hydroxid.
In other words, it appears to be essentially a very dilute alkaline
solution of some impure coal-tar product, presumably a crude carbolic
acid. The analysis could not profitably be carried further, because the
amount of the antiseptic agent is so very small.
The consideration of this analysis, in connection with the claims
made for Phenol-Sodique, leaves little doubt as to one reason for the
secrecy concerning its composition; although no educated physician
could be deceived into believing for a moment that Phenol-Sodique
could fulfil the promises of its promoters, even if it were “the
best antiseptic, hemostatic and disinfectant on the market,” as the
manufacturers say in their advertisements.
From its composition, it can only have the very moderate and ordinary
antiseptic qualities of a dilute phenol or cresol solution, modified
only to a very slight extent by the free alkali. According to the
manufacturers, however, “Phenol-Sodique is a wonderful preparation.”
Just how wonderful appears from these extracts from the dissertations
in the pamphlet which is enclosed in the package.
“_Catarrh, Old Colds, etc._--Drink every morning and evening a
glass of water containing ten to thirty drops of Phenol-Sodique ...”
“_Small-Pox._--To prevent attack take internally three or four
times a day, fifteen or twenty drops of Phenol-Sodique in one
tablespoonful of sugar and water....
“_Measles, Scarlatina and Erysipelas._--Same treatment as for
Small-pox.”
“_Typhoid Fever._--To prevent attack take internally three or four
times a day, fifteen or twenty drops of Phenol-Sodique.”
“_Cholera._--To prevent, spread sawdust or sand, wet with
Phenol-Sodique, in apartments.
“The very best precaution is to drink, morning and evening,
a glass of water containing from fifteen to thirty drops of
Phenol-Sodique....
“... _Premonitory Diarrhea._--... Drink a teaspoonful of
Phenol-Sodique diluted in an ounce of water....”
This is the kind of therapeutics and prophylaxis taught to the medical
profession by their self-appointed instructors, the proprietors!
But this matter has a serious as well as a ludicrous side: What is the
proper epithet to apply to those who, knowingly and intentionally,
impress on the ignorant lay public that one can with impunity expose
himself to smallpox, cholera, typhoid or scarlet fever, or measles, by
taking a few drops of very dilute carbolic acid, or by sprinkling a
little on sawdust? What must be the consequences to those who trust in
these assurances? And what should be the lawful penalty for those whose
blunted moral instincts permit them wilfully to endanger the lives of
others for a little financial gain? It would be interesting to know the
real opinion of the responsible members of the firm of Hance Bros. &
White on these questions.
The Montyon Prize was awarded by the French Institute in
1861--forty-six years ago--how many victims a year?--(_From The Journal
A. M. A., Nov. 9, 1907._)
PHYTIN AND FORTOSSAN
Report of the Council on Pharmacy and Chemistry
Phytin, manufactured by the Society of Chemical Industry, Basel,
Switzerland, and sold by A. Klipstein and Co., is an organic phosphorus
compound said to be the “Acid Calcium-Magnesium Salt of Phytinic Acid
(Inosit Phosphoric Acid or Anhydro-Oxymethylene-Diphosphoric Acid)”
obtained from cereals and legumes.
The trade package of Phytin constitutes an indirect advertisement to
the public.
The Council rejected Phytin because unwarranted and exaggerated
therapeutic claims are made for this product based on the entirely
undemonstrated assumptions: (1) that phosphorus is assimilated only
from organic combinations (it is even implied that this must be in the
form of Phytin, and that milk is incapable of supplying the phosphorus
needs of infants); (2) that a long list of diseases, ranging from
rickets to hysteria, are due to deranged phosphorus metabolism; (3)
that all these diseases are cured or markedly benefited by Phytin.
In brief, the claims rehearse every point of the more or less
discredited phosphorus propaganda, in exactly the same way as it was
rehearsed successively by the exploiters of hypophosphites, lecithin,
glycerophosphates, and amorphous phosphorus. It is conceded by the
writers of the advertising pamphlets for Phytin that the preceding
claims were erroneous; but no evidence is given to warrant the belief
that the Phytin claims are less erroneous.
The misleading statements are most extreme. By the use of bold type
particular stress is laid on the preposterous and vicious claim that
Phytin
“radically and permanently removes sexual debility.”
Fortossan is a preparation of Phytin and sugar of milk, also
manufactured by the Society of Chemical Industry, Basel, Switzerland,
and sold by A. Klipstein and Co. Since Fortossan is a simple
preparation of Phytin the Council voted that the rejection of Phytin
should also apply to Fortossan.--(_From The Journal A. M. A., Jan. 30,
1915._)
PRUNOIDS
Report of the Council on Pharmacy and Chemistry
Prunoids are tablets put out by the Sultan Drug Company, St. Louis.
They are said to be:
“Made of Phenolphthalein (one and one-half grains in each), Cascara
Sagrada, De-emetinized Ipecac and Prunes.”
The following report on the composition of Prunoids is submitted by the
Association’s Laboratory:
“From an examination of Prunoids it is concluded that the amount of
cascara or extract of cascara in the preparation is very small. Also
the quantity of “de-emetinized ipecac” is insignificant. The claim is
made:
“The levulose of prunes, a constituent of Prunoids, is hygroscopic
and thus when brought into contact with the saliva of the mouth or
contents of the stomach, disintegrates and prompt medication is
insured.”
“Actually the amount of prunes which may be present in Prunoids is
negligible. For all practical purposes, therefore, Prunoids are
phenolphthalein.”
According to the information included on and in the box Prunoids are
“An Ideal Laxative, Purgative, and Intestinal Tonic” ...
“particularly adapted to the treatment of constipation ...”
They are said to act as an “intestinal tonic”--a claim which in the
light of the examination is obviously unwarranted--and because of this,
it is said that they:
“Will permanently remove constipation without causing after
constipation.”
The trade package assures the purchaser that Prunoids are:
“Recommended by Physicians Generally.”
A circular sent to physicians makes the unwarranted claim that Prunoids
are “especially serviceable” in “... Neurasthenia, Jaundice, Chlorosis,
Rheumatism, Gout ...” and that
“... their success in gouty diathesis and vague rheumatic symptoms
tends to confirm the opinion expressed by some physicians that they
have a solvent action on uric acid.”
In the following the haphazard and ill-considered use of purgatives is
suggested:
“For the expectant mother, or in the treatment of female diseases,
for bowel elimination, no happier or _safer_ selection can be made.”
The Council refused recognition to Prunoids because the statement
of composition is incomplete and therefore meaningless; because
unwarranted therapeutic claims are made for them; because the name
“Prunoids” gives the false impression that they depend on prunes for
their effect; and because it is irrational and a detriment to medicine
to disguise a well-known drug by means of a misleading name and to
attempt to create the impression of special virtues by combining it
with superfluous drugs.--(_From The Journal A. M. A., Jan. 2, 1915._)
SAL HEPATICA
Report of the Council on Pharmacy and Chemistry
Sal Hepatica, marketed by the Bristol-Myers Co. of New York, has been
refused recognition by the Council, because its composition is secret;
because it is advertised indirectly to the public for the treatment of
diseases; because exaggerated and unwarranted claims are made for its
therapeutic qualities; and because the name fails to indicate its chief
constituents but does suggest its use in liver disorders.
The Council has authorized the publication of the report of its
referee, because it is an important illustration of the ways in which
physicians are being made parties to the introduction to the public of
a patent medicine, whose indiscriminate use must often have resulted in
harm, direct or indirect.
W. A. Puckner, Secretary.
The report of the referee follows:
Sal Hepatica is a saline laxative sold by the Bristol-Myers Company of
New York. No information seems to be given regarding its composition
except such as is contained in the following vague and uninforming
phrases:
“Effervescent saline combination, hepatic stimulant, laxative and
an eliminant of irritating toxins.”
“Sal Hepatica is a saline combination containing the alterative
and laxative properties similar to the natural ‘Bitter Waters’ of
Europe with the addition of sodium phosphate.”
“... more palatable and efficient than sodium phosphate alone or
other salines.”
A circular around the bottle contains the following:
“We invite the physicians’ careful consideration of the merits
of Sal Hepatica in the treatment of Rheumatism and Gout, in
Constipation and Auto-intoxication, and to its highly important
property of cleansing the entire alimentary tract, thereby
eliminating and preventing the absorption of irritating toxins and
relieving the conditions arising from indiscretion in eating and
drinking.”
In the same circular, its promiscuous use is invited in these terms:
“Owing to its palatability, Sal Hepatica is particularly well
adapted to the requirements of childhood or the feeble and
delicate.”
Further suggesting its use in the treatment of that popular, if
somewhat vague ailment, “biliousness,” we read:
“It is especially valuable where there is intestinal sluggishness
arising from functional derangements of the liver or portal
circulation....”
As further suggestive of its all-around “goodness,” are the claims:
“It increases the appetite and promotes digestion by stimulating
the flow of gastric juice.”
“In rheumatism and gout Sal Hepatica furnishes the physician with
an ideal eliminant, usually affording prompt relief.”
The label on the Sal Hepatica bottle suggests--both to physicians and
to the public--its use in the following diseases and conditions:
“Derangements of the stomach and liver.”
“Affections of the kidneys.”
“Bilious attacks.”
“‘Summer complaints,’ colic and alcoholic excesses.”
“Headache, dizziness, heartburn and seasickness.”
“Acute indigestion.”
“Gastric, hepatic and renal disorders.”
“Especially beneficial in rheumatism and gout.”
From these quotations it is evident that Sal Hepatica is in conflict
with:
_Rule 1_, in that its composition is not disclosed, although statements
are made which are likely to give a false impression as to what it is;
_Rule 4_, in that the statements on the label and in the circular
around the bottle advertise it to the public and thus make the
physician who recommends it an advance agent for the nostrum;
_Rule 6_, in that exaggerated and unwarranted claims are made for its
therapeutic qualities, and,
_Rule 8_, in that its name fails to indicate its chief constituents,
but does suggest its use in liver disorders.
The absurd claims made for this preparation are such as to put it in
the “patent medicine” class. Even the most credulous members of the
medical profession certainly can take no stock in the claim that a
preparation can be an “eliminant” of uric acid, a hepatic stimulant, a
remedy for gout, rheumatism, liver disease, indigestion, etc. Why then
should such a preparation be tolerated?
In its conflict with Rule 4 Sal Hepatica belongs to that class of
nostrums which have been so successfully exploited by manufacturers
through the unwitting efforts of thoughtless and careless physicians.
The Bristol-Myers Company has been most liberal in distributing free
samples, evidently with the assurance that physicians would do the
rest. Thus, at the present time, the profession is being supplied with
a package containing one regular 25-cent bottle and five single-dose
vials bearing the name Sal Hepatica. If only a small percentage of the
physicians who receive these samples distribute them, the increase in
Sal Hepatica consumers may be imagined. How successful this scheme of
the Bristol-Myers Company has been is only too evident. Sal Hepatica is
one of the best-selling laxatives in department stores and drug stores
to-day.
While the evils of indiscriminate purgation are now generally
recognized, the referee wishes to quote and to indorse the pertinent
comments on this subject by The Journal:[79]
[79] The Journal A. M. A., March 26, 1910, p. 1071.
“The abuse of saline cathartics by the public is an evil deserving
of serious attention. Rightly or wrongly, the laity fear constipation
and naturally take what they are taught to believe is the cheapest
and simplest course for its relief, self-drugging by means of
saline cathartics or the extensively advertised purgative mineral
waters. This habit is responsible for much of the distressing
spastic constipation that exists, and its accompanying neurasthenia.
The advertisement and sale to the laity of such a nostrum as “Sal
Hepatica” can only increase these evil results and the physician
who aids and abets the evil by using the preparation should reflect
whether he is thereby not only encouraging a fraud on the public but
also, what is even worse, helping to impair the public health.”
It is recommended that this report be authorized for publication in
order that physicians may know the extent to which they have been
made to act as advance agents for “patent medicines.” It is hoped
its publication may suggest to those who in thoughtlessness have
recommended Sal Hepatica, that they go to their materia medica and
renew acquaintance with the host of simple and efficient laxative
salts which are available--magnesium sulphate, sodium sulphate, sodium
phosphate and the palatable effervescing preparations of these which
the Pharmacopeia provides--effervescent magnesium sulphate (Magnesii
Sulphas Effervescens, U. S. P.), effervescent sodium phosphate (Sodii
Phosphas Effervescens, U. S. P.).--(_From The Journal A. M. A., Feb. 7,
1914._)
SANMETTO
Report of the Council on Pharmacy and Chemistry
The following report on Sanmetto (Od Chemical Company, New York) has
been adopted by the Council on Pharmacy and Chemistry, which authorized
its publication.
W. A. Puckner, Secretary.