PART II_The Propaganda for Reform in Proprietary Medicines, Vol. 1 of 2

CONTRIBUTIONS FROM THE CHEMICAL LABORATORY

ANUSOL HEMORRHOIDAL SUPPOSITORIES[AO]

W. A. Puckner and L. E. Warren

[AO] See also Anusol Suppositories, p. 280.

An abstract of an article concerning “anusol suppositories” was

published in The Journal, Jan. 23, 1909. This gave the results of an

analysis by a foreign chemist, J. F. Suyver, which were to the effect

that “anusol suppositories” contained no “anusol.” Schering & Glatz,

the American agents for “anusol” suppositories, took exceptions to the

abstract, asked that The Journal retract, and submitted the findings

of a chemist in support of their claim that the suppositories do

contain “anusol.” To determine the composition of “anusol hemorrhoidal

suppositories” as they are found on the American market, trade packages

were purchased (April 6, 1909) and submitted to examination[90] in the

Association’s laboratory.

[90] Details of the quantitative analysis of “Anusol Hemorrhoidal

Suppositories” appear in the annual report for 1909 of the Chemical

Laboratory of the American Medical Association.

According to the claims of the manufacturers, 12 suppositories contain:

“Anusoli 7.5 grams.

“Zinc oxid 6.0 grams

“Balsam Peruv 1.5 grams

“Ol. theobrom 19.0 grams

“Ungt. cerat 2.5 grams”

Calculated to percentages the formula reads:

Anusoli 20.54 per cent.

Zinc oxid 16.44 per cent.

Balsam Peruv 4.11 per cent.

Ol. theobrom 52.06 per cent.

Ungt. cerat 6.85 per cent.

When this product was submitted to the Council some time ago, Schering

& Glatz stated that, according to the manufacturer, “anusol” is

the “iodo resorcin sulphonate of bismuth, having the following

rational formula: [C_{6}H_{2}ISO_{2}.O(OH)_{2}]_{3}Bi. In the

meta-dioxybenzol C_{6}H_{4}(OH)_{2}, the resorcin, one H has been

replaced by one I, and for another H the sulfonic-acid group SO_{2}-OH

has been substituted, so that meta-dioxybenzol is transformed into

C_{6}H_{2}ISO_{2}-OH(OH)_{2}. In the sulfonic acid the H of OH is

replaced by Bi and, as Bi is trivalent the above rational formula

results.”

According to this formula “anusol” should contain:

Iodin 32.99 per cent.

Sulphur 8.34 per cent.

Bismuth 18.07 per cent.

And the “anusol” suppositories should contain:

Iodin 6.77 per cent.

Sulphur 1.71 per cent.

Bismuth 3.71 per cent.

Examination showed that the suppositories contain about 0.08 per cent.

iodin, or 1.2 per cent. of the amount claimed; 0.28 per cent. sulphur,

or 16.3 per cent. of what is claimed; 0.71 per cent. bismuth, or 19 per

cent. of what is claimed; and zinc equivalent to 16.5 per cent. zinc

oxid, or about 100 per cent. of claim.

From the standpoint of the iodin content alone, assuming that all

of the iodin found is present in the form of “anusol,” the results

of the examination of the product (as found on the American market)

verifies, for all practical purposes, Suyver’s statement that “anusol

suppositories contain no anusol,” for the quantity of iodin present

is so minute (about 1/82 of that required by the formula) as to

be unworthy of serious consideration. The presence of sulphid in

appreciable amounts was demonstrated showing that the sulphur is

present, at least in part, in the form of sulphid and not as sulphonate

as is claimed. In a measure, too, this is in accord with the findings

of Suyver, who concluded that, in the product which he examined, the

bismuth was present in the form of sulphid. The proportions of sulphur

and of bismuth (respectively about 1/6 and 1/5 of the required amounts)

indicate still further that the product is not all that it is claimed

to be.

A specimen submitted by Schering & Glatz to the Council two years ago

contained 0.99 per cent. iodin, or 1.3 per cent. of the amount claimed;

0.23 per cent. sulphur, or 13.4 per cent. of the claimed amount; and

0.52 per cent. bismuth, or 14 per cent. of what is claimed by the

formula. Since the above determinations were made another specimen of

Anusol Hemorrhoidal Suppositories was received from Schering & Glatz,

July 16, 1909. This sample was found to contain about: 0.075 per cent.

iodin, or 1.1 per cent. of the amount required by the formula; 0.265

per cent. of sulphur, or 15.5 per cent. of the requirement and 0.88 per

cent. bismuth, or 23.7 per cent. of the required amount. It will thus

be seen that the composition of the oldest specimen and also that of

the specimen recently sent, corresponds in a general way to that of the

one first examined.

Whether judgment be based on the determination of the bismuth, the

sulphur or the iodin, the results just given clearly show that the

claims made concerning the composition of “Anusol Hemorrhoidal

Suppositories” are not substantiated by the facts.--(_From The Journal

A. M. A., Oct. 2, 1909._)

AROMATIC DIGESTIVE TABLETS

W. A. Puckner and L. E. Warren

It has been amply demonstrated[91] that pepsin and pancreatin, when in

solution, mutually destroy each other; if the solution be acid, the

pepsin destroys the pancreatin; if alkaline, the pancreatin destroys

the pepsin. By using the characteristic effect of pepsin on proteids

in acid medium and that of pancreatin on proteids and starches in an

alkaline solution it can readily be demonstrated that commercial liquid

preparations labeled as containing both of these ferments actually

contain only one ferment. They are misbranded.

[91] U.S. Pharmacopeia, 8th revision, p. 334.

Besides the liquid a goodly number of solid preparations, chiefly

tablets, containing pepsin and pancreatin are offered to the

profession. Among these are tablets consisting simply of pepsin and

pancreatin. Since pepsin and pancreatin interact only when in solution,

it is quite possible to prepare tablets which contain these ferments.

The use of such tablets is, however, unscientific, since one or the

other of the ferments is destroyed when it comes in contact with the

fluids of the digestive tract. In addition to simple tablets containing

pepsin and pancreatin only there is at present a host of “digestive

tablets” on the market. Among these are some which must be classed with

the “digestive impossibilities” (Reports of the Council on Pharmacy

and Chemistry, 1910, Vol. 1, p. 41). The preparations referred to are

tablets claimed to contain pepsin, pancreatin, diastase, hydrochloric

acid and lactic acid. When it is considered that the United States

Pharmacopeia defines hydrochloric acid as “a liquid composed of 31.9

per cent. by weight of absolute hydrochloric acid (HCl = 36.16) and

68.1 per cent. of water,” i. e., a solution of hydrogen chlorid, a

gas, in water, it would at first appear that the incorporation of

any appreciable quantity of hydrochloric acid in tablets would be

impracticable. Hydrochloric acid, however, possesses to a limited

extent the property of combining loosely with protein substances so

that it becomes possible to bring about its combination with pepsin

and similar substances to form compounds which are relatively stable

at ordinary temperatures. Because of the volatility of the free acid

and its limited combining power with protein substances (100 gm. boiled

beef combine with 2 gm. absolute hydrochloric acid[92]), the quantity

of acid in any tablet can never be large, much less than sufficient to

be of any therapeutic value.

[92] Hemmeter, Diseases of the Stomach, Edition 3, p. 250.

A number of firms offer “digestive tablets” for sale having formulas of

which the following may be considered typical:

Sacch. Pepsin 4 grains

Pure Pancreatin 1 grain

Diastase 1/4 grain

Aromatic Powder 1/4 grain

Lactic Acid 1/8 grain

Hydrochloric acid 1/8 grain

Some manufacturers use United States Pharmacopeia pepsin in place of

the saccharated article; others do not give the exact quantities of

hydrochloric acid which their product is supposed to contain, but

make use of the indefinite expression “q. s.;” still others state

merely that hydrochloric acid is present, but make no claim whatever

concerning the quantity.

From purely theoretical considerations it is possible that the tablets

referred to might contain appreciable amounts of hydrochloric acid.

Since the formulas for some of the tablets furnish no information

concerning the content of hydrochloric acid, it seemed worth while

to determine the quantity, if any, actually present in some of the

tablets on the market. Accordingly a trade package of “digestive

aromatic tablets,” as put up under the label of each of six American

manufacturers, was purchased and submitted to examination in the

Association laboratory.

Qualitative tests made on specimens from each brand of tablets

demonstrated the absence of uncombined hydrochloric acid in each.

Further tests[93] showed that hydrochloric acid in protein combination

was present essentially in the amounts claimed in three of the

specimens. In two of the others hydrochloric acid was entirely absent;

in the remaining one only the merest traces of hydrochloric acid could

be found.

[93] Details of this analysis appear in the annual report for 1910 of

the Chemical Laboratory of the American Medical Association.

+-----------------------------------------+

| H. K. MULFORD COMPANY |

| “_DIGESTIVE AROMATIC_” |

| “Pepsin, Sacch. 4 grains |

| “Pancreatin 1/2 grain |

| “Diastase 1/16 grain |

| “Acid Lactic 1/8 grain |

| “Acid Hydrochloric 1/8 grain |

| “Aromatic Powder 1/4 grain |

| “Dose: 1 or 2 tablets.” |

+-----------------------------------------+

In the above formula each tablet is said to contain 1/8 grain

hydrochloric acid. This amount is equivalent to 0.002584 gm. (1/25

grain) absolute hydrochloric acid. Analysis demonstrated that each

tablet contains about 0.00267 gm. hydrochloric acid (absolute HCl)

or essentially the amount claimed. The average dose of diluted

hydrochloric acid United States Pharmacopeia is 1 c.c., equivalent to

0.1049 gm. absolute hydrochloric acid. To obtain this quantity from the

above preparation the patient would be required to swallow more than

three dozen of the tablets.

+-----------------------------------------+

| WM. S. MERRELL CHEMICAL COMPANY |

| “_DIGESTIVE AROMATIC, 5 GRAINS_” |

| “Pepsin 80 parts |

| “Pancreatin 10 parts |

| “Diastase 1 part |

| “Acid Lactic 1 part |

| “Acid Hydrochloric 3 parts |

| “Aromatic Powder 5 parts” |

+-----------------------------------------+

Calculation shows that each tablet should contain about 0.0031 gm. of

absolute hydrochloric acid. The analysis indicated that each tablet

contains about 0.0030 gm. hydrochloric acid (absolute HCl) in protein

combination, or practically the amount claimed. One pharmacopeial dose

of hydrochloric acid is contained in 35 of the tablets.

+-----------------------------------------+

| PARKE, DAVIS & COMPANY |

| “_DIGESTIVE AROMATIC_” |

| “Saccharated Pepsin 4 grains |

| “Pure Pancreatin 1 grain |

| “Diastase 1/4 grain |

| “Aromatic Powder 1/4 grain |

| “Lactic Acid. |

| “Hydrochloric Acid. |

| “Dose: 1 to 3 tablets.” |

+-----------------------------------------+

Chlorid is present in small amounts, but quantitative examination

indicated that hydrochloric acid, either free or in protein combination

is absent. An ammonium salt is present in small quantities.

+-----------------------------------------+

| SHARP & DOHME |

| “_DIGESTIVE AROMATIC_” |

| “Pepsin, Sacch., U. S. P. 4 grains |

| “Pancreatin, pure 1 grain |

| “Diastase 1/4 grain |

| “Aromatic Powder 1/4 grain |

| “Lactic Acid q. s. |

| “Hydrochloric Acid q. s.” |

+-----------------------------------------+

Small quantities of chlorid are present. Quantitative examination

indicated that hydrochloric acid in protein combination is present only

in very small amounts, each tablet containing but about 0.00034 gm.

of absolute acid, or about 0.34 per cent. of the pharmacopeial dose.

Ammonia is absent. Inasmuch as more than 300 of these tablets would be

required to furnish a pharmacopeial dose of hydrochloric acid, this

firm’s interpretation of the expression “q. s.” would prove interesting.

+-----------------------------------------+

| TRUAX, GREENE & COMPANY |

| “_SYNERGIA_” |

+-----------------------------------------+

“Synergia” is claimed to be composed of “pepsin, pancreatin, veg.

diastase, lactic acid, hydrochloric acid and aromatics; dose, 1 to 3

tablets.” The specimen contained no hydrochloric acid, either free or

in protein combination. A trace of ammonia and small quantities of

chlorid were found.

+-----------------------------------------+

| THE FRASKE TABLET COMPANY |

| “Pepsin Sacch. 80 parts |

| “Pancreatin, Pure 10 parts |

| “Diastase 1 part |

| “Lactic Acid 1 part |

| “Hydrochloric Acid 3 parts |

| “Aromatic Powder 6 parts |

| “Dose: 1 to 2 tablets. |

| “Each tablet represents (5) grains of |

| the above mixture.” |

+-----------------------------------------+

According to the formula hydrochloric acid (31.9 per cent. absolute

HCl) represents 3 parts in 101 of the preparation from which the

tablets are made. Each tablet (containing 5 grains of the mixture)

should have 0.00307 gm. absolute hydrochloric acid. Analysis showed

that each tablet contains hydrochloric acid in protein combination

equivalent to an average of 0.003066 gm. absolute hydrochloric acid,

or essentially the amount claimed. It would be necessary to give 34

tablets to administer a pharmacopeial dose of hydrochloric acid.

[Editorial Note: The above indicates that the use of such tablets is

irrational, unscientific and that it should be condemned. The only

constituent of these tablets, other than the aromatics, which might

possibly be of benefit in stomach troubles, is the pepsin. But even

if it be assumed that the diastase and pancreatin could exert their

characteristic effects, their aid to digestion (metabolism) would be

but slight, because their amounts in the tablets are too small to be of

any value.

It is claimed that the tablets contain diastase in amounts varying from

1/20 to 1/4 grain. Assuming the diastase used to be of first-class

quality, i. e., capable of converting 200 times its own weight of

starch into soluble products, the quantity of one tablet would be

capable at the most of digesting but from 10 to 50 grains of starch,

an amount equal at the most to but a small spoonful of oatmeal or a

very dainty bite of bread. In the same way the quantity of pancreatin

is insufficient to be of any material aid in digestion should it in

some way escape destruction in the stomach and still retain its full

activity when it reaches the alkaline juices of the intestines. One

grain of pancreatin of full United States Pharmacopeia strength will

digest only 25 grains of starch or the proteids in about 100 c.c. of

milk.

Saccharated pepsin, which was formerly official, was required to digest

300 times its own weight of moist egg albumin, while the pepsin that

is now official is required to digest ten times that amount, or 3,000

times its own weight. It is evident, therefore, that the tablets

should contain sufficient pepsin to digest appreciable amounts of

protein. No intelligent physician would prescribe these tablets simply

for the pepsin they contain or are supposed to contain; if he wanted to

give pepsin he would prescribe the drug in the simple form.

Clinical experience has shown that in the majority of cases of

so-called dyspepsia the stomach contents contain too much rather than

too little hydrochloric acid, and wherever there is a sufficiency of

acid there is usually no decrease in the secretion of pepsin. In many

of such cases, too, digestion is normal, or even more active than

normal, but even when it is imperfect there is seldom any lack of

pepsin.

Insufficient digestive power is most often due to a deficiency of

hydrochloric acid and not to lack of pepsin in the stomach contents.

In the tablets under consideration, however, hydrochloric acid is

present--if at all--in the most ridiculously minute quantities;

quantities that are so small as to preclude any therapeutic effect

except that due to the psychic element.

These tablets, with their six or more ingredients, are typical “shotgun

prescriptions.” Such prescriptions catch the unthinking doctor as

well as the self-drugging public, for, while clinical experience and

physiologic experiments have demonstrated that the old ideas regarding

the value of these digestives and ferments were erroneous, the public

and many members of the medical profession still seem to be influenced

by the old theories.

In conclusion we must not lay all the blame on the manufacturing firms

for supplying these absurd combinations; the physician who prescribes

them should assume a large share of it. If the doctors did not use them

the manufacturing concerns would soon stop putting them on the market.

We hope, however, that those manufacturing concerns that like to be

classed as reputable will cease to disgrace their catalogues with what

they know to be therapeutic absurdities.]--(_From The Journal A. M. A.,

Aug. 20, 1910._)

BURNHAM’S SOLUBLE IODIN[AP]

W. A. Puckner and A. H. Clark

[AP] See also report on Burnham’s Soluble Iodine, p. 110

Burnham’s Soluble Iodin, according to the manufacturers, is one of the

most noteworthy “discoveries” of the age. The advertisements aim to

create an impression that while the product contains iodin, pure and

simple, yet by some secret process this element has been so changed

as no longer to possess its usual properties. The Burnham Soluble

Iodin Company makes such extravagant claims for its product and

gives such wide publicity to these claims that it seemed advisable,

in the interests of the profession, to determine the nature of the

preparation. Its examination was accordingly taken up in the laboratory

of the American Medical Association.

From the analysis, we conclude that Burnham’s Soluble Iodin is a

solution of iodin in alcohol made miscible with water by the presence

of some iodid. Wilbert[94] and other investigators have arrived at

practically the same conclusion.

[94] Proc. Am. Pharm. Assn., 1903, li, 409.

Whatever the secret process, hinted at in the advertisements, by which

this preparation is evolved, the fact remains that when one prescribes

Burnham’s Soluble Iodin, one is prescribing iodin, together with an

iodid, the nature of which is hard to determine. The iodid is not

present as potassium iodid, nor, entirely, at least, as hydrogen iodid

(hydriodic acid), but this is of slight importance compared with the

fact that it is a solution in alcohol of free iodin and an iodid, and

therefore is essentially the same as Lugol’s solution.

The amount of iodin found corresponds approximately to 3 gm. of free

iodin and 2 gm. of combined iodin in 100 c.c. of the solution. Lugol’s

solution contains 5 gm. free iodin, and 10 gm. potassium iodid in

100 c.c.

BURNHAM’S SOLUBLE IODIN TABLETS

Burnham’s Soluble Iodin Tablets are light brown compressed tablets,

stamped with the letters B. S. I. in monogram. Each tablet is said to

contain 3 minims Burnham’s Soluble Iodin.

The average weight of each tablet was found to be 0.3526 gm.; since

Burnham’s Soluble Iodin was found to have a specific gravity of .8527

and to contain 4.5 per cent. total iodin, the tablets should contain

approximately 2.3 per cent. total iodin, about one-half to two-thirds

of which, depending on the condition of the “Soluble Iodin” from which

they are made, should be free iodin. Instead of this, only 0.317 per

cent. free iodin and 1.57 per cent. total iodin was found. Analysis

shows that Burnham’s Soluble Iodin tablets contain approximately

one-fourth the amount of free iodin and approximately two-thirds

the amount of total iodin which should be contained therein if, in

accordance with the label, each tablet contains 3 minims of Burnham’s

Soluble Iodin.

COMMENT

The literature put out by the Burnham Soluble Iodin Company is

in itself enough to condemn the products it advertises. The much

emphasized statement of the company that

“=Something had to be done; and Burnham’s Soluble Iodin is that

which has been done=”

fulfils, in its blatant assertiveness, all the requirements of nostrum

advertising. The results of the analyses are not, therefore, a surprise.

Secrecy is just as essential today to the successful exploitation of

this class of proprietaries as it was before the demand for formulas

became so universal. The requirement of publicity is evaded, therefore,

in one of two ways: Either a formula is given which is false, or

at least meaningless, or else the claim is made that the method of

preparing the product is a unique and remarkable secret that is

possessed only by the manufacturers. The Burnham Soluble Iodin Company

uses the latter device.

Meanwhile, physicians will be perfectly justified in viewing with

suspicion all claims based on such conspicuously unscientific premises,

more especially so when these claims fail to find substantiation on

careful and painstaking analyses. In brief, whenever the physician

wishes to administer free iodin, Lugol’s solution (Liquor Iodi

Compositus, U. S. P., Physician’s Manual, page 84) is an inexpensive

and perfectly available preparation.--(_From the Journal A. M. A.,

March 28, 1908._)

“HYDROCYANATE OF IRON--TILDEN”

W. A. Puckner and W. S. Hilpert

Among the many inquiries received regarding the composition of secret

remedies was one in reference to “Hydrocyanate of Iron” manufactured by

the Tilden Company, New Lebanon, N. Y. This preparation is advertised

as being “unexcelled as a remedy for epilepsy, hysteria, chorea,

neurasthenia, locomotor ataxia, neuralgia, migraine, anemic headaches,

and all convulsive or reflex neuroses dependent on impairment of the

brain or spinal cord.” It is also said to be “valuable in uterine

reflex neuroses due to congestion; in amenorrhea due to anemia and

chlorosis and suppressed menstruation.”

The term “hydrocyanate of iron” is an unfamiliar one and is not found

in any available reference work on chemistry. Thinking that the term

might have been loosely applied to ferrocyanid of iron, or Prussian

blue (a compound once suggested for epilepsy, but long ago considered

useless), the correspondent wrote to the manufacturers asking if such

were the case. The Tilden Company answered:

“... our preparation Hydrocyanate of Iron is not Prussian blue in

any sense of the word. Prussian blue has no curative properties as

applied to all forms of epilepsy. Prussian blue is Ferrocyanid of

Iron while our preparation is Hydrocyanate of Iron.”

The only statements in the Tilden Company’s advertising matter

regarding the composition of hydrocyanate of iron are the following:

“Hydrocyanate of Iron (Tilden’s) is a correct and scientific

combination of well known principles.”

“Hydrocyanate of Iron (Tilden’s) combines well known properties of

ferruginous salts with the sedative action of Hydrocyanic acid.”

The last statement would lead one to expect the presence of available

iron and cyanogen ions. In fact, the inference to be drawn from

all the company’s “literature” is that “hydrocyanate of iron” is a

definite chemical compound in the same sense as is ferrocyanid of

iron, and that inference is still further borne out in the letter to

our correspondent. This being the case, the Tilden Company was again

written to and asked for the chemical formula of “hydrocyanate of

iron,” with the following result:

“Replying to your inquiry regarding the formula of Hydrocyanate

of Iron we beg to state the composition of this preparation is a

trade secret and we therefore do not care to furnish the desired

information.”

This reply verified the opinion already formed that “hydrocyanate of

iron” is a secret preparation. Its analysis was then taken up in the

Association’s laboratory.

EXAMINATION OF THE TABLETS

The product appears on the market in cartons said to contain one

ounce of one-grain tablets. On the cartons, in addition to the name

of the preparation and the name and address of the manufacturers,

are the names of diseases for which it is recommended. The tablets,

in the specimens analyzed, were dark blue, rather hard and slightly

bitter in taste and had an average weight of 0.1382 gm., or about

2 grains. They were found to be practically insoluble in water

and dilute mineral acids; aqueous oxalic acid solution partially

dissolved them, yielding a blue solution. Boiling with alkali

hydroxid solution decomposed the tablets, yielding iron in an

insoluble form and a solution of alkali ferrocyanid, as demonstrated

by the appearance of a deep blue precipitate on the addition of

ferric chlorid solution. The portion insoluble in alkali when

boiled with hydrochloric acid yielded a solution containing iron,

approximately equivalent to 50 per cent. Prussian blue. These

properties are all characteristic of Prussian blue, and, taken

together, identify Prussian blue as a constituent of “hydrocyanate

of iron (Tilden).” The insoluble residue from the iron determination

possessed the properties and constituents of talc and constituted

practically one-half of the tablets. Extraction of the tablets with

chloroform or ether in the presence of ammonium hydroxid yielded

a small amount of organic material which contained bodies having

the properties of, and responding to tests for, quinin or cinchona

alkaloids and caffein. The presence of a salicylate was also

indicated.[95]

[95] Details of the quantitative analysis of “Hydrocyanate of

Iron--Tilden” appear in the annual report for 1909 of the Chemical

Laboratory of the American Medical Association.

From the analysis it is concluded that “hydrocyanate of iron

(Tilden)” is essentially a mixture of approximately equal parts of

talc and Prussian blue, containing traces of organic matter having

the general properties of alkaloids.

Comment: When a firm exploits an abandoned remedy for so hopeless a

disease as epilepsy under a name not known to chemistry and with a

false representation of its pharmacologic qualities, such action may

rightly be assumed to show ignorance or worse. “Hydrocyanate of iron,”

if it means anything, means the cyanid of iron, but the preparation

put out under that name is, according to our chemists, not cyanid of

iron, but the ferrocyanid of iron commonly known as Prussian blue.

This substance has been tried for epilepsy and abandoned. Yet the firm

recommends it as a “peerless remedy” for this disease:

“The Tilden Company holds the key to the situation in the treatment

of epilepsy. We have the remedy that does the work.”

Not that epilepsy is the only disease for which this hypothetical

chemical compound may be prescribed. Torticollis has been “successfully

treated with hydrocyanate of iron.” In chorea, we are told “a richer

and better blood supply” should be furnished the nervous and vascular

system and “the irritation of the motor centers” must be allayed.

“Hydrocyanate of iron serves admirably to accomplish both of these

purposes. It carries the hemoglobin to the blood in its most easily

assimilable form and its hydrocyanic acid possesses remarkable

sedative powers....”

It is not possible for it to have any value in anemia because of its

insolubility, yet we are told:

“In conditions marked by poverty of the blood producing anemia

or chlorosis, reacting on the nervous system and calling for

a chalybeate, hydrocyanate of iron (Tilden’s) takes a front

rank among the remedies of this class, combining as it does the

blood enriching qualities of ferrum with the sedative action of

hydrocyanic acid.”

As Prussian blue yields no appreciable quantity of hydrocyanic acid

under the conditions existing in the animal organism, “the sedative

action of hydrocyanic acid” must be as hypothetical as the chalybeate

properties attributed to it.

It is strange that a manufacturer, in introducing a new chemical

compound, should have to assure his customers that it “contains no

opium or alkaloid of that drug, cocain, chloral hydrate, conium or any

of the bromids.” Imagine a firm putting, let us say, potassium iodid--a

definite chemical compound--on the market and solemnly guaranteeing

that it contained no cocain or chloral hydrate!

Would the Tilden Company of twenty-five years ago have served such

mental pabulum in its advertising matter?

One would think that the dictates of common humanity would protect

the unfortunate epileptic from the machinations of the nostrum maker,

especially from the exploitation of a remedy that has been tried

and found wanting. A nostrum, however, merely has to measure up to

one standard: Will it pay? Meeting this requirement nothing else

matters.--(_From the Journal A. M. A., June 19, 1909._)

HYMOSA

W. A. Puckner and W. S. Hilpert

Frequent requests for information regarding the composition of hymosa,

manufactured by the Walker Pharmacal Co., St. Louis, and a perusal of

the extensive and nostrum-like advertising the product is receiving,

made a chemical examination of this preparation seem desirable. If the

label is to be believed, hymosa has been of use in “acute and chronic

muscular and articular rheumatism, gout, sciatica, lumbago, pleurodynia

and neuralgia, whether due to uric acid diathesis or not ...”

The composition of hymosa as given by the proprietors is set forth in

the following statement:

“... Hymosa, in which the remedies Frangula, Actea Spicata,

Stellaria Media, Franciscea Uniflora, Rhus Toxicodendron,

Passiflora Incarnata, Phytolacca Decandra and Echinacea

Angustifolia are combined in the proportions which experience

has shown will obtain the quickest and best results without any

of the stomach and heart complications so often following the

administration of salicylic acid.”

“Contains no Salicylic Acid.”

Thus the explicit statement is made that hymosa contains certain

vegetable drugs (most of them obsolete and valueless) and that it does

not contain salicylic acid. By inference the claim repeatedly is made

that the nostrum does not contain any salicylates.

“... Hymosa has achieved most remarkable results in overcoming

rheumatism in cases where salicylates have been tried in vain ...”

“Salicylic acid was not successful in this case of rheumatism of

the stomach.”

“Negative results from salicylates--Hymosa cures.”

“... the salicylates didn’t help? Then we must try Hymosa.”

Still harping on the undesirability of salicylates and the value of

hymosa the advertising pamphlets state:

“Salicylic Acid Replaced. The Use of This Dangerous Agent in

Rheumatism Obviated.”

“It seems that the use of the dangerous and ineffective salicylic

acid will soon be given up and hymosa take its place.”

“Former methods of treating rheumatism ... have been very

unsatisfactory ... because of the heart and stomach difficulties

brought on by salicylates of which most rheumatism remedies are

composed.”

“Could not tolerate the salicylates.”

Finally in a letter issued to physicians we are told:

“... you will find hymosa to possess prompt and positive curative

action with the additional advantage of avoiding the heart and

stomach complications, which the salicylates too often cause.”

It is evident from the above quotations, in which the salicylates are

denounced specifically or by implication, and from the label which

states that no salicylic acid is present, that the exploiters of the

nostrum deliberately intended to give the impression that hymosa is

free from salicylates or salicylic acid and contains only the vegetable

or plant drugs enumerated. The very fact that the proprietors make

such repeated efforts to give the impression that hymosa is free from

salicylates is in itself sufficient to arouse suspicion and hence in

the examination particular attention was given to the detection of

salicylic acid or salicylates with the following results:

[Illustration: Reproduction (reduced) of an advertisement of Hymosa.

This indicates the attempt made to convey, by implication, the idea

that the salicylates are absent from Hymosa.]

_Examination._--Hymosa as purchased on the market is a dark brown

liquid with an odor of sassafras and a rather sweetish taste,

reacting acid to litmus. Qualitative tests having indicated the

presence of salicylate, iodid, sodium, potassium, alcohol and some

organic matter, presumably sugars and some plant extractives, these

were determined quantitatively.[96] It was found that a part of the

salicylate was present as free salicylic acid and part in a combined

form. The sodium determinations indicated that all the salicylate,

excepting that in the form of free salicylate acid, was present as

sodium salicylate. From the results of the potassium estimations, it

was evident that the iodin was present in the form of potassium iodid.

[96] Details of this analysis appear in the annual report for 1910 of

the Chemical Laboratory of the American Medical Association.

From the results of the analysis it is believed that the preparation

has approximately the following composition:

Salicylic Acid 0.32 gm.

Sodium Salicylate 1.15 gm.

Potassium Iodid 0.32 gm.

Sugars and extractives 4.60 gm.

Alcohol, U. S. P. 16.86 c.c.

Water to make 100.00 c.c.

These results indicate that hymosa is essentially a solution containing

salicylic acid, sodium salicylate, potassium iodid, alcohol, sugars and

plant extractives in the proportions given above, and show that the

various statements referred to, regarding the absence of salicylic acid

and salicylates are misleading and untrue. It further illustrates the

repeatedly demonstrated fact that nostrums exploited as wonderful and

new discoveries are new in name only--and whatever therapeutic value

they possess depends on old and tried medicinal agents.

[Editorial Note: In describing the methods employed by the

manufacturers of Manola in exploiting their product, attention was

called to the fact that the Manola Company was reported as being a

subsidiary affair of the Luyties Homeopathic Pharmacy Company of St.

Louis. It is reported that this same company also operates the Walker

Pharmacal Company, which exploits Hymosa and Psa-avena.]--(_From the

Journal A. M. A., June 11, 1910._)

MICAJAH’S MEDICATED UTERINE WAFERS

W. A. Puckner and W. S. Hilpert

Evidently touched by the generosity of the manufacturer in sending him

a sample and literature, but not too favorably impressed by the claims

made for the preparation referred to, a correspondent writes:

I enclose a valuable sample and literature just received. Such a

palpable humbug as Micajah’s Uterine Wafers would hardly seem to need

notice were it not probably true that many practitioners habituated

to the use of samples are still influenced by the glowing accounts of

cures wrought; especially when attested by such a name and title as

“Elmore Palmer, M.D., Ex-President Western New York Medical Society.”

This secret gynecologic medicament is recommended for anything

from “Pruritis Vulvæ,” “Enlargement of the Womb,” “Displacements,”

“Cystocele and Rectocele,” to the “Menopause.”

Following the definition that by her “stomach” a woman means anything

from her chin to her knees, the ex-president with truly noble

impartiality has with the wonderful Micajah wafers wrought lightning

cures all the way from “stone-bruise” of the heel to nasal polyp and

influenza, and some of them are male patients too.

With the foregoing as an impetus to investigate the nature of this

much advertised nostrum, the wafers were submitted to analysis by the

Association laboratory. The report follows:

LABORATORY FINDINGS

Trade packages of the wafers purchased on the open market bear the

name of the preparation and that of the manufacturers, Micajah & Co.,

Warren, Pa. The label states that the nostrum is a:

“Disinfectant, astringent and local alterative of the greatest

virtue. A remedy for the local treatment of the diseases of women.

Inflammation, engorgement and prolapse of the womb, vaginitis,

leucorrhea, menstrual derangements and the disturbances incidental

to the menopause. Also highly recommended for affections of the

mucous membranes in general, particularly those of the nose, the

throat, the rectum, and for gonorrhea, cystitis, etc.”

“This box contains wafers for three months’ treatment.”

“Price per box $1.00.”

The box contained 25 tablets, and a circular entitled, “Hints on the

treatment of diseases of women,” in which directions for the treatment

of many diseases are given. It ends with a paragraph which contains the

following statement:

“There is no doubt that the field of usefulness of Micajah’s Wafers

can be indefinitely enlarged by the ingenuity and therapeutic skill

of the physician.”

Much of the advertising “literature” is in the form of leaflets,

brochures and small pamphlets full of testimonials by physicians.

Micajah’s uterine wafers as found on the market are white, hexagonal

tablets, odorless and possessing an astringent taste. The wafers are

soluble in water with extreme difficulty. Hot hydrochloric acid and

alkali hydroxids dissolve the powdered tablets readily, leaving a

slight residue which under the microscope and by physical tests was

identified as lycopodium.

The acid solution of the wafers responded to qualitative tests which

indicated the presence of potassium, sodium, aluminum sulphate,

borate and a mere trace of a fatty material. Quantitative estimation

of boric acid, aluminum sulphate, sodium and potassium were made,

which indicated that Micajah’s Uterine Wafers consist of alum more or

less anhydrous or “burnt,” boric acid and borax in approximately the

following proportions:[97]

[97] Details of this analysis appear in the annual report for 1910 of

the Chemical Laboratory of the American Medical Association.

Alum, dried 59.86 per cent.

Borax, dried 15.62 per cent.

Boric acid 5.67 per cent.

Water of hydration 18.85 per cent.

The average weight of the tablets is 0.7791 gm (11.8 grains) and

allowing for the fact that the quantity of water present in commercial

exsiccated alum varies, each tablet would contain approximately

0.4986 gm. (7.8 grains) burnt alum; 0.2337 gm. (3.6 grains)

crystallized borax, and 0.0467 gm. (0.7 grain) boric acid.

COMMENT

Judging from the “literature” that goes with the packages of this

nostrum, one might imagine that it was put up absolutely for the

layman, but this is not the case. It is advertised only in medical

journals and not directly to the public. But direct advertising to

the public is not necessary; for every physician who prescribes these

wafers at the same time places in the hands of his patient advertising

matter intended to influence that patient--and it usually does. As a

result this preparation is being bought by the public direct. To what

extent we do not know, but physicians are responsible for it. Probably

if physicians realized that the same interests that control Piso’s

Consumption Cure also control Micajah’s Medicated Uterine Wafers they

would not be so ready to act as the unpaid agents for the concern.

That such simple astringents and feeble antiseptics as alum, borax

and boric acid could have such remarkable curative effects on uterine

diseases is absurd. The serious aspect of the matter is, that, by

the encouragement given them in the advertising literature to treat

themselves, women may neglect proper surgical or medical attention in

the early stages of serious diseases such as cancer or dangerous pelvic

infections, until they get beyond the hope of proper management. But

when nostrum promoters urge the use of such inefficient remedies in the

treatment of gonorrhea, it is time to look at the matter seriously.

Considering the vital social significance of the venereal diseases,

the employment of useless remedies can only favor the spread of these

infections, which cause such a large proportion of the diseases which

afflict women particularly.

The medical profession for the most part has become mentally calloused

to the exaggerated claims of the nostrum makers and does not make

sufficient effort to condemn them. There may be some physicians,

however, who use such preparations as these wafers in their practice,

as is indicated by the circulars wherein the manufacturers suggest

that their “usefulness can be indefinitely enlarged by the ingenuity

and therapeutic skill of the physician.” It is only occasionally that

a physician voices his indignation as to these humbugs, as in the case

of the physician whose letter is quoted above.--(_From the Journal

A. M. A., March 26, 1910._)

The Firm Replies

_To the Editor_:--We have read with interest the report of your

committee on pharmacology recently published in The Journal, on the

subject of Micajah’s Medicated Uterine Wafers, and your comments

thereon.

We are of the opinion that, in your laudable efforts to reform the

practice of pharmacology, it is not your desire or intention to act

other than justly and fairly, and therefore, with this belief, we

submit the following statements for your consideration, with the hope

that you will see fit to publish them.

1. We do not seek by word or deed the patronage of the laity, and

what few sales are made to the public are not of our contriving,

nor should we be held responsible for them, any more than is the

manufacturer of quinin to be blamed for the universal use of that

drug.

2. Our literature should not be considered extravagant, for it is for

the most part made up of clinical reports received from physicians

and based on the unsolicited testimonials in our possession from

hundreds of practitioners, many of whom have used Micajah’s Wafers

in practice from five to twenty years and they are therefore as well

grounded as are the clinical reports concerning any preparation.

3. In the past year we have endeavored to place our preparation on a

higher ethical basis by stating in our advertisements what our wafers

contain, and by eliminating whatever seems to us open to criticism.

4. That the ingredients of the preparation are “simple” is no reason

for considering them valueless. H. A. Kelly, in his work on medical

gynecology, page 266, recommends these ingredients in a variety of

conditions. Bandler also made important recommendations bearing on

this subject in his “Medical Gynecology,” 1909 edition, page 472. We

feel we have the right to recommend this preparation for these and

similar conditions, especially when our statements are backed up by

the clinical experience of numerous general practitioners.

5. That the owner of Micajah’s Wafers holds stock in a corporate

firm which manufactures proprietary medicines and toilet articles,

advertised to the laity, should not militate for or against our right

to market a meritorious preparation on strictly ethical lines to the

medical profession, inasmuch as many of the largest drug houses cater

to both the doctor and the proprietary interests, and several are

actively engaged in exploiting so-called nostrums.

6. We enclose a recent advertisement which has been accepted after

investigation of our methods by careful medical journals, and we now

believe we are conducting our business in entire conformity with the

best interests of the medical profession and we feel certain of the

true merits of our article.

Micajah & Company, Warren, Pa.

[Comment: This letter brings out still more strongly the points raised

in the article which appeared in The Journal, March 26, 1910. Being

unable to analyze motives we must perforce, accept Micajah & Co.’s

statement that they “do not seek by word or deed the patronage of

the laity.” In the comments on the laboratory’s report it was very

explicitly stated that this nostrum was advertised only in medical

journals and not directly to the public. Inasmuch, however, as the

container in which this product comes has printed on it the various

diseases in which the “wafers” are indicated, as, moreover, within the

container there is a leaflet which describes in detail the use of the

preparation in a list of pathologic states varying from “enlargement

of the womb” to “gonorrhea in the male,” and, finally, as the name

“uterine wafers” would seem in itself to be a plain bid to the public,

we still maintain that “one might imagine that is was put up absolutely

for the layman.”

The proposition that advertising matter should not be considered

extravagant because it is largely “made up of clinical reports received

from physicians” is an argument that is as old as the nostrum business

itself--and as fallacious as it is old. Unfortunately, as our files

show, the most extravagant statements made for proprietary products

frequently emanate from men who legally are entitled to write M.D.

after their name. The fact that it is not the manufacturer but a

Buffalo physician who tells of the marvelous results he obtained from

the use of Micajah’s Medicated Uterine Wafers in forty-three cases

comprising no fewer than thirty-six pathologic conditions from “otitis

media” to “injured toe,” and from “bunion” to “ophthalmia neonatorum”

does not exempt the firm that prints such stuff from the charge that

its “literature” is not merely extravagant, but ridiculously so.

As Micajah & Co. say, because the ingredients of their preparation are

simple is no reason for considering them valueless. On the contrary, if

the “wafers” were truthfully exploited for what they are and what they

will do, their very simplicity would be a virtue. But such has not been

done. And therein lies the viciousness of nostrums. Simple mixtures of

well-known drugs are foisted on the medical profession with no hint as

to their composition and with claims made that are not only false, but

would immediately be recognized as absurd, if their actual composition

were known.

That a mixture of borax and alum may be of value in some of the

simple ailments of the female genital tract can easily be granted.

That relief might follow the use of suppositories made of these

ingredients--especially when supplemented by an increased attention to

simple cleanliness--can also be admitted. To say, however, that such

medicaments will quickly and permanently cure gonorrhea, urethritis,

endometritis, etc., is foolish, false and vicious.]--(_From the Journal

A. M. A., April 16, 1910._)

NOITOL AND ANADOL

W. A. Puckner and L. E. Warren

Noitol

The Journal received an inquiry concerning the composition of Noitol,

a preparation which is being advertised to the medical profession as a

“specific” for the cure of eczema and certain other cutaneous diseases.

The preparation is manufactured by the Wheeler Chemical Works, Chicago.

Trade packages of Noitol were purchased and examined in the Association

laboratory. On the label of the package, Noitol--an inversion of the

word “lotion”--is described as follows:

+--------------------------------------------------------------+

| NOITOL |

| (Dr. Bradbury’s Eczema Lotion.) |

| For External Application Only! |

| Our Most Popular Specialty. |

| A specific for the cure of Eczema, Scrofulous and Syphilitic |

| Eruptions, Lupus, Salt Rheum, Tetter, Itch. This remedy is |

| composed of valuable Oils, combined with Vegetable and |

| Mineral Acids in such proportions as cause a rapid and |

| permanent cure of the above complaints. |

+--------------------------------------------------------------+

Noitol is a clear, nearly colorless, acid solution, the greater portion

of which is water. Its specific gravity is 1.0097 at 25 C.

Qualitative tests demonstrated the presence of a chlorid, a nitrate, a

mercuric salt, free acid and glycerin. No “oils” or “vegetable acids”

could be found.

Analysis[98] of the preparation indicated that its composition is

essentially as follows:

[98] Details of this analysis are published in the annual report for

1910 of the Chemical Laboratory of the American Medical Association.

Mercuric Chlorid 0.0463 gm. in 100 c.c.

Mercuric Nitrate 0.0450 gm. in 100 c.c.

Glycerin 1.3021 gm. in 100 c.c.

Nitric Acid 1.0265 gm. in 100 c.c.

Water (by difference) 98.5545 gm. in 100 c.c.

From the above it appears that Noitol is simply a weak, acid solution

of mercury salts--the total being approximately equivalent to a 1 to

1,000 bichlorid of mercury solution--exploited under a meaningless

name. It is but one more example of the old, old story of a well-known

remedy being sold at a high price under a name which is in no way

indicative of its composition, and under claims which are absurdly

false.

The price of the mixture is $2.00 a pint; the estimated cost, exclusive

of the container, is about 6 cents a gallon, or, put another way:

the price of a pint bottle, it is estimated, would make a barrel (31

gallons) of the nostrum. The incorrect statement concerning its

components, the unwarranted therapeutic claims made for it, and the

exorbitant price easily place Noitol in the front rank among the

“patent medicine” frauds. Yet it is advertised to physicians as an

ethical proprietary and is evidently being prescribed by them.

Anadol

In the circular matter accompanying the trade package of the

preparation, “Noitol,” described above, a preparation called “Anadol”

is described. Anadol is claimed to be an analgesic and antipyretic.

In the descriptive circular there is no information concerning the

composition of the preparation, but from the general therapeutic

description the physician might easily be led to believe that “Anadol”

is a distinct chemical substance.

To reduce temperature the physician is advised to push the

administration of Anadol in 10 grain doses until the febrile condition

is under control or until a maximum of 70 grains of the preparation has

been ingested. The circular further states:

“... in this lies the special value of ANADOL; there are no

annoying by-effects; the stomach bears the remedy well and neither

circulation, respiration, nor the nerve centers show the least

disturbance.”

As no evidence could be obtained concerning the composition of Anadol

and, as the preparation is being brought to the attention of physicians

by means of circulars in connection with the distribution of Noitol,

it seemed worth while to take up its examination in the Association

laboratory. Accordingly a trade package of the material which had

passed into interstate commerce was purchased.

Qualitative tests demonstrated the presence of sodium, a carbonate,

caffein and acetanilid, the latter in considerable quantities.

Analysis[99] indicated that the composition of the specimen examined is

essentially as follows:

Acetanilid 79 per cent.

Caffein 1 per cent.

Sodium bicarbonate 20 per cent.

[99] Details of this analysis are published in the annual report for

1910 of the Chemical Laboratory of the American Medical Association.

Since, according to the circular, it is permissible to prescribe 70

grains of this preparation within 2-1/2 hours, a patient thus treated

would receive no less than 55 grains of acetanilid! In view of the

numerous cases of poisoning due to the misuse of acetanilid (“The

Harmful Effects of Acetanilid, Antipyrin and Phenacetin,” U. S. Dept.

Agric., Bur. Chem., Bull. No. 126) the physician should be apprised of

the composition of Anadol.

[Editorial Note: The chemical investigations reported above emphasize

once more the need of such an institution as the Association’s

laboratory and again demonstrates the value of its work. At first

sight it seems disheartening to find that physicians are so easily

humbugged. Yet when it is remembered that it is impracticable for

physicians either to analyze such products themselves or to go to the

expense of having chemists do it for them, it is evident that the

fault lies not so much with the physicians as with the conditions that

make the exploitation of such frauds possible. It is on the public

that the burden ultimately falls, for it is the layman who has to pay

two dollars for a few cents’ worth of medicine. But--and this is far

more serious--that the physician should be urged to dose his patient

with an insidiously dangerous drug to a point far beyond the limits of

safety, is little less than criminal. Yet so long as unknown medicinal

products are prescribed just so long will this danger be a very real

one.]--(_From the Journal A. M. A., May 21, 1910._)

Anadol Declared Misbranded

Anadol was analyzed at the Bureau of Chemistry and the chemists

reported that it contained over 82 per cent. of Acetanilid. As the

labels did not bear any statement as to the quantity of acetanilid

contained in the nostrum, the stuff was declared misbranded and the

defendant, on pleading guilty, was fined.--[_Notice of Judgment No.

795._]

PIX CRESOL

W. A. Puckner and W. S. Hilpert

In a paper on “The Abuse of Chemical Formulas”[100] several examples

were given of the various methods employed by “patent-medicine”

concerns to give standing to their products by assigning to them a

chemical formula. In some cases the formulas given are impossible,

in other cases they may represent the chemical composition of only

one constituent or it may be an attempt at both. To a chemist such

formulas are absurd and on seeing a formula which he knows to be

wrong he naturally thinks “Fake,” “Ignorance,” or both. Just such

a formula (C_{5}H_{6}N.SO) applied to a product called Pix Cresol,

manufactured by the Pix Cresol Chemical Co., Kansas City, Mo.,

attracted our attention. No mention of such a formula can be found in

such works as Richter’s most complete Index of Carbon Compounds, nor

the three supplemental volumes published, 1901-1905, by the German

Chemical Society and Beilstein’s Organic Chemistry (3d Ed.). This fact,

supplemented by inquiries from correspondents as to the composition of

the substance made it seem worth while to make a chemical examination

of it.

[100] Puckner, W. A.: Report of the Chemical Laboratory of the American

Medical Association, iii, 7.

The examination was made and showed that the essential constituent

was oxyquinolin sulphate. As potassium sulphate was also found it

was concluded that Pix Cresol was a preparation containing a mixture

of oxyquinolin sulphate and potassium sulphate, which has also been

known in the past under the proprietary name, “Chinosol.” At this

time a letter was referred to the laboratory containing the report of

an analysis of Pix Cresol, which showed the presence of oxyquinolin

sulphate but no potassium sulphate. As this indicated that Pix Cresol

contained as its essential constituent the substance now sold as

Chinosol, the laboratory purchased a new specimen of Pix Cresol from

the Chicago representative of the Pix Cresol Co. The examination[101]

of this specimen showed that it consisted of approximately 21 per cent.

oxyquinolin sulphate, about 8.3 per cent. potassium sulphate and the

remainder almost entirely milk sugar.

[101] The analytical details will be published in the annual report of

the laboratory.

It is evident, then, that both the specimen of Pix Cresol obtained

directly from the manufacturers and also the one purchased more

recently from the Chicago agent, contain as an essential constituent

Chinosol of the composition sold formerly. The substance now sold under

the name Chinosol and described in New and Nonofficial Remedies is pure

oxyquinolin sulphate, and as the exploiters of Pix Cresol probably

obtain their supply of oxyquinolin sulphate from the Chinosol Company,

the sole American agents for Chinosol, it is to be expected that Pix

Cresol should change in composition. It is probable that the analysis

referred to the laboratory deals with a more recent specimen than the

two examined in the Association laboratory.

Editorial Note: In view of the Council on Pharmacy and Chemistry’s

findings, viz., that chinosol is a powerful antiseptic but a feeble

germicide and considering that Pix Cresol contains but 21 per cent.

oxyquinolin sulphate, the absurdity of the following claims made for

Pix Cresol require no further comment:

“Pix Cresol is an Absolutely Sure and Yet Perfectly Safe, Never

Failing Destroyer of Pus (_Staph. Pyogenes Aureus._)”

“It is germicidal, bactericidal, bacillicidal. It is certain as a

micro-organism destroyer. It destroys absolutely.”

“Ridding the blood of germs, it aids in rendering it replete with

oxygen----.”

“It kills the germs.”

“No organism that is causative of morbid processes can withstand

it.”

“It destroys micro-organisms of all kinds. It destroys them

absolutely.”

“The germ’s tenacity of life does not avail against its action as

germicide.”

“It destroys the spores and toxins utterly.”

A further estimate of the pseudo-chemical company, bearing the name

of this “strongest, safest, least expensive medical antiseptic,

disinfectant and deodorizer known” may be gained by a cursory glance at

some of its “specialties”:

“Maizinin compound, Positive Chill and Malaria Specific” the firm says,

“prepares the parasites for execution by the leukocytes.” It is said to

contain arsenic, while the name implies the presence of some plant drug.

“Psora, the Syphilis Specific,” is a shot-gun mixture said to be

“the scientific combination of the soluble Triple Iodids with the

active principles of Echinacea, Cascara amagra, Berberis aquif., and

Phytolacca rad.,” and is claimed to make “the syphilitic lesions

disappear and fail to return.”

“Rectoids--Cones for the treatment of all rectal trouble,” are said to

be “a combination of Rectin (Pix) compounded from Buckeye, Collinsonia,

Hamamelis, Belladonna, Pix Cresol.”

“Tablets for the Female--Pix Cresol Uterettes,” it is said, “for

sanitary purposes may be continued forever ...”

When one realizes that this sort of pseudo-scientific twaddle is

accepted by many physicians at its face value, the outlook for

therapeutics seems dark, indeed. So long as the existence of such

concerns is tolerated by the medical profession, so long will

there be a crying need for a “Propaganda for Reform in Proprietary

Medicines.”--(_From The Journal A. M. A., June 10, 1911._)

SALIODIN

W. A. Puckner and A. H. Clark

[The Council on Pharmacy and Chemistry refused recognition to Saliodin

because it conflicts with Rules 1 and 6, and directed publication of

the following.

W. A. Puckner, Secretary.]

Saliodin is sold by the Saliodin Chemical Co., Scranton, Pa. In the

literature and on the trade package the following “formula” is given:

+----------------------------------------------------------+

| FORMULA |

| Each Grs. XX of Saliodin contains approximately: |

| ℞ |

| Salicylic Acid, (Aceto-Salicylate) Grs. XV |

| Iodine, (Iodate) Equivalent to Iodide Potass Grs. XV |

| Acetic Acid, (Acetate) Equiv. to Acetate Potass Grs. V |

| Aconite Equiv. to ?? Tr. Aconite R. Gtts. IV |

| Bryonia " " ?? Tr. Bryonia, Gtts. V |

| Colchicum " " Vin Colchicum R. Gtts. XV |

| Capsicum " " Tr. Capsicum Gtts. II |

| Oil Gaultheria " " ♏ III |

+----------------------------------------------------------+

This formula being indefinite and vague, the examination of saliodin

was taken up in the Association laboratory.

From the analysis we calculate the composition of saliodin to be

approximately equivalent to a mixture of:

Sodium salicylate 57.54

Potassium iodid 1.18

Potassium acetate 30.00

Matter volatile at 130° (oil of anise, oil of

gaultheria, moisture, etc.) 8.10

Undetermined (extractive?) 3.18

------

100.00

The analysis shows that the formula is not only indefinite and vague,

but incorrect and false.

To emphasize the incorrectness of the published formula the following

comment on its first two items is offered:

In the “formula” it is stated that 20 grains of saliodin contain

approximately “salicylic acid (aceto-salicylate) Grs. XV.” The

statement is not clear, but conveys the impression that 20 grains

of saliodin contain an amount of aceto-salicylate, a salt of

acetyl-salicylic acid (aspirin), equivalent to 15 grains of salicylic

acid. But the chemical examination shows that it contains neither

acetyl-salicylic acid, nor salt of acetyl-salicylic acid, nor even

salicylic acid itself. In the place of these, the analysis shows that

over half of saliodin is the common, every-day sodium salicylate.

[Illustration:

+---------------------------------------------------------------+

| It is an “Iodated, Aceto-Salicylate with Adjuvants,” and the |

| SPECIFIC treatment for every form of URIC ACID DIATHESIS. |

| “Saliodin” is a SOLVENT and ELIMINANT of URIC ACID and is a |

| happy combination of ℞ Salicylic Acid, Iodine, Acetic Acid, |

| Aconite, Bryonia, Colchicum, Capsicum and Gaultheria and |

| chemically appears in the form of a PINK, GREYISH POWDER |

| soluable in water 1 to 3--dose grs. X to grs. XXX; for the |

| EXCLUSIVE USE OF PHYSICIANS--put up in one ounce bottles; |

| price PER OUNCE $1.50. Is manufactured ONLY by the Saliodin |

| Chemical Co. “SALIODIN is SPECIFICALLY indicated in |

| RHEUMATISM, GOUT NEURALGIA, MALARIA and LA GRIPPE; is |

| ANALGESIC, ANTIPYRETIC; an INTESTINAL ANTISEPTIC, DIAPHORETIC,|

| DIURETIC, EXPECTORANT, DEOBSTRUENT, SIALAGOGUE, CHOLAGOGUE, |

| EMMENAGOGUE, ANTI-SYPHILITIC, GONOCOCOCIDAL, PARASITICIDAL, |

| ASEPTIC, BACTERICIDAL and ALTERATIVE. Doctor, you may |

| prescribe Saliodin with confidence wherever IODINE or a |

| SALICYLATE is indicated. Used both internally and externally. |

+---------------------------------------------------------------+

Reproduction (much reduced) of a paragraph in the advertising

pamphlet on Saliodin. Note the twenty-one indications for Saliodin.

Lest some condition might be overlooked, we are advised to use it

“internally and externally.” Isn’t this scientific therapy?]

According to the “formula,” each 20 grains of saliodin contains

“iodin (iodate), equivalent to iodid potass. Grs. XV.” This

statement, too, is vague, but conveys the impression that 20 grains

of saliodin contain an amount of iodin, in combination as an iodate,

which corresponds in iodin content to 15 grains of potassium iodid.

But the analysis shows that the product does not contain any iodate

whatever, and that the amount of iodin contained in it is sufficient

to account for only 1/4 grain of potassium iodid in each 20 grains of

saliodin.

COMMENTS

The above report is published simply as another example of the “ethical

proprietaries” that physicians are asked to prescribe. It is not

unique. It is neither better nor worse than hundreds of others.

To show what absurdities appear in the “literature” (?) that is sent to

physicians, we reproduce a paragraph from an advertising pamphlet. The

promoters’ statement as to the composition of the product is absurd,

but not more so than are the claims made for it as a therapeutic agent.

There is not a “patent medicine” on the market for which any more

blatant, extravagant and ridiculous claims are made.

The manner of exploiting saliodin is another illustration of the

tendency on the part of nostrum-makers to advertise their wares through

pseudo-scientific articles published in a certain class of medical

journals. In the pamphlet sent out by the Saliodin Company appears

a reprint of an article from the Philadelphia _Medical Summary_ of

February, 1905. It is entitled “A Similarity in the Etiologic Factors

of Rheumatism and Malaria,” and was written by J. C. Denston, M.D. In

it occurs this statement: “The manufacturers (of saliodin) publish

their formula and, _I think_, distribute samples and literature on

request.” The charming ingenuousness of this statement is fully

realized when it is understood that J. C. Denston is the president of

the Saliodin company. This is also another illustration of what is

now a common occurrence, viz.: men who are engaged in manufacturing

proprietary products and who have an M.D. degree use that degree as a

commercial asset, and by this means the average reader is led to think

that articles written by them in praise of their own products are

spontaneous tributes from practicing physicians.--(_From The Journal

A. M. A., Oct. 26, 1907._)

THEOBROMIN SODIUM SALICYLATE VERSUS “DIURETIN”: THE ECONOMICAL ASPECT

W. A. Puckner and Paul N. Leech

The following inquiry is from Dr. Reid Hunt, recently appointed

professor of pharmacology at Harvard Medical School:

“Have you ever made an examination of the theobromin sodium

salicylates on the market to determine if they are identical with

‘Diuretin?’ The description of theobromin sodium salicylate in

New and Nonofficial Remedies agrees with the statements as to the

composition of Diuretin, but I wondered if, at times at least,

the theobromin sodium salicylate on the market might be a simple

mixture of theobromin and sodium salicylate just as the Caffeinae

Sodio-Salicylas, N. F., seems to be a simple mixture. Diuretin is

quoted in current price-lists at $1.75 an ounce, whereas the price

of theobromin sodium salicylate is only 35 cents an ounce. Many

hospitals use diuretin, and both physicians and students often have

only hazy ideas as to what it is. If the preparations of theobromin

sodium salicylate now on the market are identical with Diuretin they

should certainly be used, not only because they are less expensive,

but because the descriptive name will continually remind the

physicians of what they are using.”

Theobromin for some time has been regarded as a valuable therapeutic

agent. The obstacle to its use has been its insolubility and the

consequent uncertainty of the degree of its absorption. For this reason

a soluble salt of theobromin, theobromin sodium salicylate, first

introduced and advertised under the proprietary name “Diuretin,” has

come to be used to a considerable extent.

Theobromin sodium salicylate--also called theobromin and sodium

salicylate--is prepared by interaction, in molecular proportions, of

theobromin, sodium hydroxid and sodium salicylate, the theobromin

first being treated with sodium hydroxid in the presence of a suitable

solvent, then the sodium salicylate added and the whole brought to

dryness. The soluble compound which is formed is generally considered

to be a double salt of theobromin sodium and sodium salicylate.

Theobromin sodium salicylate is described in New and Nonofficial

Remedies and in several foreign pharmacopeias. It is also to be

described in the forthcoming United States Pharmacopeia.

Although the product is not controlled by patents of any kind, and

although it is offered for sale under its chemical name by the

leading chemical manufacturers at from 35 to 45 cents per ounce, the

proprietary product, Diuretin, sells for $1.75 an ounce. This is

probably because the manufacturers think that those who have been using

it under its chemically non-descriptive but therapeutically suggestive

title, Diuretin, will remain ignorant of the fact that the same product

is on the market under its chemical name. In view of these conditions,

emphasized by Dr. Hunt’s letter, it was deemed important to examine

the market-supply of theobromin sodium salicylate and to compare the

several specimens with the proprietary brand Diuretin.

The following specimens, purchased in 1-ounce original packages, were

examined:

Diuretin, “Knoll,” Knoll & Co.

Theobromine and Sodium Salicylate, Mallinckrodt Chemical Works.

Theobromine and Sodium Salicylate, Merck & Co.

Theobromine and Sodium Salicylate Powder, Powers-Weightman-Rosengarten

Co.

Theobromine and Sodium Salicylate, “Roche,” Hoffmann-La Roche Chemical

Works.

Theobromine and Sodium Salicylate, Squibb, E. R. Squibb & Sons.

The theobromin content prescribed for theobromin sodium salicylate by

the various standards ranges from 45 to 50 per cent., that of New and

Nonofficial Remedies being the highest. A requirement of not less than

46.5 per cent. theobromin in the dried powder has been proposed for the

new U. S. Pharmacopeia.

The methods of quantitative estimation laid down by the various

authorities are all very similar and consist, in the main, of a

determination of water, of the sodium hydroxid, free and in combination

with theobromin, and of the theobromin itself. For the theobromin

estimation the following method was employed:

A weighed sample (about 2 gm) which had previously been dried, under

slightly reduced pressure, over sulphuric acid, to constant weight,

was dissolved in five times its weight of warm water. Two drops of

phenolphthalein were added, and the solution titrated with normal

hydrochloric acid. To the neutral solution, 1 drop of 10 per cent.

ammonium hydroxid solution was added, and the mixture allowed to

stand, with occasional stirring, for three and one-half hours at the

temperature of 15 C. The precipitate was filtered on a weighed Gooch

crucible, washed with just ten times the weight (of the original sample

taken) of water (temperature 15 C.) and the precipitate dried at

from 100 to 104. To the weight obtained, a correction factor (proved

satisfactory by quantitative extraction experiments on the filtrate) of

0.13 gm. was added, for every 2 grams of the original sample taken.

The full details of the examination will be published in the 1914

Reports of the A. M. A. Chemical Laboratory. The results of the

examination have been abstracted and are compiled in the accompanying

table:

SUMMARY OF ANALYSIS

============+==========+=======+=====+=====+========+========+========

------------+----------+-------+-----+-----+--------+--------+--------

Diuretin | 3 | 28.5 |$1.75| 0.01| 10.44 | 48.61 | 48.61

| | | | | | |

Theo. | 3 | | | | | |

Sod. Sal. |Pure White| 27.5 | 0.35| 1.89| 9.95 | 46.11 | 45.24

M. C. W | | | | | | |

| | | | | | |

Theo. | 1 | | | | | |

Sod. Sal. |Pure White| 29.0 | 0.35| 0.48| 10.38 | 47.87 | 47.58

| | | | | | |

Theo. | 3 |

Sod. Sal. |Pure White| 29.1 | 0.35| 2.46| 10.30 | 47.57 | 46.39

| | | | | | |

Theo. | 3 | | | | | |

Sod. Sal. | Pink | 28.6 | 0.35| 2.27| 9.92 | 49.05 | 47.92

Roche | |

| | | | | | |

Theo. | 1 | | | | | |

Sod. Sal. |Pure White| 26.8 | 0.45| 0.39| 9.97 | 46.82 | 46.63

------------+----------+-------+-----+-----+--------+--------+--------

[AQ] In this column, 1, 2 and 3 denote the following:

1. Quite crystalline, under microscope.

2. Fairly crystalline, under microscope.

3. Not crystalline, under microscope.

[AR] Average of determinations.

While the results show some variation in the moisture content and also

in the actual theobromin content of the dried specimens, the variation

is unimportant. The products in their original state (undried), as

compared in relation to the theobromin content (the highest percentage

of theobromin being 48.61, the lowest 45.24), reveal a variation of

only about 3 per cent.--a variation which is negligible in the case of

drugs such as theobromin.

From the preceding investigation, it is concluded that (1) practically

there is no difference between the non-proprietary brands of

“theobromin sodium salicylate” and “Diuretin;” (2) the several

specimens examined were not simple mixtures of “theobromin” and

“sodium salicylate”; (3) essentially all the brands complied with the

standards laid down and can be rated as satisfactory; (4) “Diuretin,”

though sold at an exorbitant price, is not superior to the product

supplied under the descriptive term “theobromin sodium salicylate,” and

(5) “Diuretin” sells wholesale for $1.75 an ounce, against 35 cents

for the “theobromin sodium salicylate,” and therefore its employment

cannot be interpreted otherwise than as a useless and unnecessary

expense.--(_From The Journal A. M. A., April 4, 1914._)

UNGUENTINE

W. A. Puckner and A. H. Clark

Attention has been called at various times to the fact that the value

of a published “formula” to a proprietary remedy is in direct ratio

to the reliability of the manufacturer publishing it. When medical

journals first insisted on their advertisers letting physicians

know the contents of the remedies they wished to sell them, medical

literature reeked with formulas--some of them of weird and wonderful

design. Since the advent of the Food and Drugs Act, which requires

that labels shall approximate truthfulness, and particularly since

the Council on Pharmacy and Chemistry has investigated a number of

proprietary remedies, the publication of “formulas” is not so common.

Unguentine, manufactured by the Norwich Pharmacal Co., is one of those

remedies whose advertisement for years always included “a formula”;

more recently, however, this is not in evidence. In an advertisement

which appeared about ten years ago, the “formula” given is:

“Carbolic acid 2 per cent.

“Ichthyol 5 per cent.

“Alum 15 to 16 per cent.”

It was claimed that, by a special process of their own, the

manufacturers had eliminated most of the astringent properties of the

alum, rendering it non-irritant. It was also stated that “the base of

Unguentine is pure petrolatum.” Later the manufacturers seem to have

changed the composition of their product, or at least the “formula”

given in the advertisements was changed. Thus it appeared:

“Alum 15 per cent.

“Zinc oxid 5 per cent.

“Carbolic acid 2 per cent.

“Ichthyol 5 per cent.

“Aromatics and antiseptic oils with specially

prepared petrolatum and animal fat base.”

The introduction of zinc oxid, aromatic and antiseptic oils and

animal fat was a new feature. Somewhat later, and particularly since

the passage of the national Food and Drugs Act, no formula or other

statement regarding the composition seems to have appeared in the

advertisements in the medical press. In the 1906 price-list (p. 170)

the following formula appears:

“Unguentine represents:

“Alum (non-irritating) 15 per cent.

“Phenol 2 per cent.

“Ichthyol 5 per cent.

“Zinc oxid 5 per cent.

“Aromatic and antiseptic oils, with especially

prepared petrolatum and purified animal fat.”

In the price-list issued for 1908--after the Food and Drugs Act went

into effect--the following appears:

“Unguentine represents:

“Alum compound (non-irritating)

“Phenol,

“Ichthyol,

“Zinc oxid,

“Aromatic and antiseptic oils, with especially

prepared petrolatum and purified animal fat.”

Thus the proportions are omitted, and alum becomes “alum compound,”

whatever that may mean.

In view of the conflicting statements made by the Norwich Pharmacal

Company, in regard to their leading specialty, Unguentine, and

especially because much stress was laid on the filing of their

“guarantee” under the Food and Drugs Act, it was decided to ascertain

of what Unguentine really consists.

From our analysis we conclude that Unguentine contains not alum but

aluminum acetate (small amounts of alum may be present as impurities

in the aluminum acetate), zinc oxid, or more probably impure zinc

carbonate, and that the entire quantity of both does not exceed 5 per

cent. It contains no ichthyol, or if any but the merest traces, and

less than 1 per cent. of phenol. The aromatic oils amount to not more

than approximately 1 per cent. in all. The ointment-base is, in the

main, petrolatum.

In Unguentine we have, therefore, another proprietary “specialty,”

regarding the composition of which indefinite, false or misleading

statements have been made--this irrespective of protestation of honesty

by the firm.--(_From The Journal A. M. A., March 27, 1909._)

URICEDIN

W. A. Puckner and A. H. Clark

In view of the results of investigations by Zernik of Uricedin as sold

in Germany, and because it is being advertised to physicians in this

country, an examination of this product was made in the laboratory

of the American Medical Association. Zernik’s report shows how this

remedy has varied in its composition as put on the market in Germany.

From their analysis the authors find that Uricedin is not a definite

chemical compound as is claimed, but is a simple mixture whose

composition is approximately:

Sodium sulphate (anhydrous) 61.52 per cent.

Sodium citrate (anhydrous) 29.62 per cent.

Sodium chlorid 2.13 per cent.

Citric acid (anhydrous) 3.25 per cent.

Moisture 2.53 per cent.

Undetermined 0.95 per cent.

------

100.00

Uricedin, therefore, is not a definite chemical compound as claimed,

but a simple mixture which consists essentially of sodium sulphate

(dried Glauber salt) 2/3, and sodium citrate 1/3. It is, therefore, a

typical nostrum, and, as it appears, one the composition of which is

changed from time to time to suit the whim of the manufacturer. The

therapeutic claims made for it are of the usual extravagant character.

According to a recent advertisement it is “used successfully for

Gouty Diathesis, urinary Calculi, Rheumatoid Arthritis,” “useful in

Migraine, Occipital Headache, Epilepsy, Hay Fever, Asthma,” etc. If

such a simple mixture will do all that this one is claimed to do, let

us use it, but prescribe its ingredients under their proper names.

Such a mixture would cost only a few cents a pound, but this nostrum

is listed at $1.25 a bottle of five ounces, or probably $1.75 at

retail, and this for the benefit of its foreign manufacturers and their

agents.--(_Abstracted from The Journal A. M. A., Nov. 23, 1907._)

URISEPTIN

W. A. Puckner and W. S. Hilpert

“Uriseptin,” manufactured by the Gardner-Barada Chemical Co. of

Chicago and claimed to be a “urinary antiseptic, uric acid solvent

and diuretic,” was examined in the laboratory of the American Medical

Association to determine to what extent the claims made for it are

justified.

The preparation as purchased in the open market bears a label which

presents the claims of the manufacturers, emphasized by the chemical

analysis duly signed by an analyst and attested by a notary.

Accompanying is a reproduction of part of the label.

[Illustration:

+--------------------------------------------------+

| ANALYSIS |

| |

| Sample of “Uriseptin” manufactured by the |

| Gardner-Barada Chemical Co., Chicago. Ill., |

| was found to contain: |

| |

| Specific Gravity at 15.5 C 1.0716 |

| Total Solids 20.42 p.c. |

| Alcohol (Ethyl) 7.66 p.c. |

| Water (by Difference) 71.92 p.c. |

| Total Ash 1.46 p.c. |

| Lithium Oxide 0.50 p.c. |

| Formaldehyde 5.62 p.c. |

| Acidity 100 cc equals 6.4 cc Normal Alkali. |

| |

| Sugars Present |

| Couch Grass Extract Present |

| Corn Silk Extract Present |

| |

| The Total Solids consist mainly of the sugars |

| and extract of corn silk and couch grass. The |

| couch grass and corn silk extracts were |

| determined by taste and smell in comparison |

| with authentic samples of same products. The |

| Lithium Oxide and the Formaldehyde are in |

| combination in the Uriseptin and together |

| represent 26.77 grains per liquid oz. I remain, |

| Yours very truly, |

| (Signed) Dr. Edwd. Gudeman. |

| |

| State of Illinois} _ss._ |

| County of Cook } |

| |

| Subscribed and sworn to before me this 13th |

| day of May, 1905. |

| (Signed) Paul E. Buedefeldt, |

| Notary Public. |

+--------------------------------------------------+

+---------------------------------------------------+

| URISEPTIN |

+---------------------------------------------------+

| FORMULA |

| (See analysis). |

| |

| Each fluid ounce of Uriseptin contains |

| Formaldehyde combined with Lithium dissolved |

| in concentrated liquid extract of Corn Silk |

| and Couch Grass, and will liberate a sufficient |

| quantity of Formaldehyde (24 grains) to |

| impregnate the daily secretion of urine (45-50 |

| fluid ounces) to a 1-1000 solution. |

| |

| PROPERTIES |

| |

| Urinary Antiseptic. Uric Acid Solvent. |

| Diuretic. |

| |

| INDICATIONS |

| |

| Diseases of the urinary tract and their |

| complications--Nephritis, Pyelitis, Urethritis, |

| Gonorrhea, Gleet, Cystitis, Bacteriuria, Uremia, |

| Phosphaturia, Prostatitis. Diseases dependent |

| on uric acid diathesis--Gout, Rheumatism, |

| Calculus, Asthma and generally as an antiseptic |

| and uric acid solvent. |

| |

| DOSE |

| |

| Tablespoonful night and morning, or one to |

| two teaspoonfuls four times a day, preferably |

| in hot water. |

+---------------------------------------------------+

Reduced photographic reproduction of part of the Uriseptin label.]

Before the examination had extended very far it was found that

discrepancies existed between facts and claims, and by the time the

analysis was complete Uriseptin was found to be in the same class as

many other proprietary remedies that have been discussed in these

columns.

Our examination shows that the most misleading statement is that

concerning the “lithium-formaldehyd” compound the presence of which

is claimed, more or less directly, by both the manufacturers and the

analyst employed by the manufacturers. Although the chemical properties

of lithium and formaldehyd indicate in themselves that the existence

of such a compound would be most improbable, yet considerable time

was spent in searching the chemical literature for such a compound.

Thorough search, however, demonstrated that no such compound, nor any

that even approximated it, has been described.

The question then arose as to the form in which the lithium and the

formaldehyd are present. The statements regarding its properties as

a urinary antiseptic and the fact that the preparation is said to

liberate formaldehyd slowly in the bladder point strongly to the

presence of hexamethylenamin.

Tests[102] were applied to demonstrate whether the formaldehyd was

present as a lithium compound, and if not, whether it existed in the

form of hexamethylenamin. By these the presence of hexamethylenamin

was proved and the absence of formaldehyd in other combinations

demonstrated. This fact alone shows that the preparation is

deliberately marketed under a false claim, and it shows further that

the analysis on the label is worthless. The quantitative method of

analysis demonstrated the presence of 5.51 gm. hexamethylenamin per

100 c.c. (25.15 grains per fluidounce).

[102] These appear in the annual report for 1908 of the Chemical

Laboratory of the American Medical Association; they were also

published in full in Jour. Am. Chem. Soc., September, 1908; an outline

of the analysis appeared in The Journal A. M. A., Aug. 29, 1908.

Besides the hexamethylenamin, Uriseptin contains lithium and a

benzoate. Concerning the latter nothing is said in the analysis, whose

worthlessness is again demonstrated. By quantitative methods Uriseptin

was found to contain lithium and a benzoate in such proportions as

would indicate that the lithium and the benzoate radicle exist as

lithium benzoate. This fact is further indicated by the claims made for

the preparation regarding its properties as a uric acid solvent, for

which purpose lithium benzoate is often used. Again, the demonstration

that the formaldehyd present is in combination as hexamethylenamin

precluded any possible chemical combination between lithium and

formaldehyd and adds another strong point in support of the conclusion

that the lithium and benzoic acid are in combination as lithium

benzoate.

CONCLUSION

By chemical analysis the active ingredients of Uriseptin are shown

to be hexamethylenamin, approximately 5.5 gm. per 100 c.c. (about 25

gr. to each fluidounce), and lithium benzoate, approximately 0.70 gm.

per 100 c.c. (about 11 grains to each fluidounce), neither of which

compounds is mentioned in the advertising matter on the label or in

the so-called “analysis” on the label. The statements concerning the

composition of Uriseptin are false and appear to be a deliberate

attempt to mislead physicians.

Comment.--Investigation of the various “patent” and so-called “ethical

proprietaries” advertised to the public and to the medical profession

shows that those that have any value as therapeutic agents depend

for that value on some well known drug or drugs. Hence, while many

proprietaries have some virtue, the ingredients which are of any value

are so concealed by the coined and “near-scientific” names applied to

them that these drugs are usually unrecognizable. The many and various

acetanilid mixtures furnish examples of this class of proprietaries.

And now we find another example in that much advertised nostrum,

Uriseptin.

According to our chemists, the chief ingredients of Uriseptin are

hexamethylenamin and lithium benzoate. Hexamethylenamin is a valuable

so-called urinary antiseptic--probably one of the best we have. It is

a pity that more physicians do not know the value of this drug in and

of itself; it is a common ingredient of many proprietaries, and yet too

seldom prescribed under its true name. There is no reason for its being

given in the form of a nostrum; it requires no skill in compounding,

for it is best given in its powdered form, either in capsules or

otherwise. So that, like acetanilid, the old argument of the nostrum

men that the preparation needs skill in compounding will not hold. If a

physician wants to prescribe hexamethylenamin let him prescribe it in

its simplest and best form, and thus know exactly what he is giving.

Lithium benzoate also has its rightful place in the materia medica, but

not hidden in a proprietary mixture to be prescribed unknowingly. It

is hard to conceive of any one thing that operates more disastrously

against scientific therapeutics than the vicious practice of marketing

under proprietary names standard and valuable drugs, with their

identity purposely concealed. Yet how frequently it is done. Well-known

drugs of unquestioned worth are combined with those that are little

known and of doubtful value, or more likely absolutely worthless, the

mixture is put on the market under a high-sounding name and it is

exploited through physicians as a panacea for all kinds of diseases.

In this, as in so many other instances, an “analysis” made to order is

given to lend an air of apparent respectability and scientific standing

to the preparation or to its exploiters, with the object, of course,

of misleading physicians into thinking they are reading unbiased

testimony. In addition, the “literature” accompanying the preparation

is usually a jargon of pseudo-scientific verbiage put in to serve the

same purpose as the analysis--that of catching the careless physician.

This state of affairs will continue just so long as the medical

profession will tolerate it--and no longer. So long as members of our

profession will prescribe proprietaries on the statements of their

owners--as to both their composition and their therapeutic value--just

so long will pseudo-chemical and pseudopharmaceutical companies fatten

at the expense of the medical profession and to the detriment of the

public health.--(_From The Journal A. M. A., Aug. 29, 1908._)

ZEMACOL

W. A. Puckner and W. S. Hilpert

Attention has been called to the vague and mysterious statements

regarding a preparation called Zemacol, manufactured by the Norwich

Pharmacal Co., Norwich, N. Y. Because of the unsatisfactory statements

regarding the composition of the preparation, it was considered of

sufficient interest to make an analysis and determine its chemical

constituents. Accordingly specimens of the preparation were obtained

and examined.

The preparation Zemacol (Norwich Pharmacal Co.), as found on the

market, is a thick, pink, mucilaginous liquid, highly perfumed and

having besides a suggestion of a phenolic odor. The bottle bears a

label on which appear the following statements:

“A colloidal emollient containing extract of the rete mucosum

of the healthy yearling lamb, combined with glycerin, salicylic

acid and other antiseptic and aromatic oils. Useful in eczema and

diseases of the integument where cell destruction is a prominent

factor.”

In the advertising matter the following claims are made:

“An advance in animal therapy....”

“... increases the nutritive activity of the cell tissue of the

skin through the absorbable extract of the rete mucosum.”

“... clinical tests show its efficacy in both the so-called moist

and dry eczematous conditions of all parts of the cutaneous

surfaces.”

“... rich in animal cells.”

Since nothing could be found in the literature regarding the

therapeutic action of an extract of the rete mucosum of the sheep, it

was thought possible that the statements on the label were given simply

as a vague and mysterious means of indicating the presence of wool-fat

(lanolin), and tests were made to determine the presence or absence

of the latter substance. A substance was isolated from Zemacol which

had the physical properties of, and responded to some of the chemical

tests for, wool-fat; but it was found in such small quantities as to

indicate that it was not present as an active constituent. Since there

are no definite tests for the detection of serums or animal extracts

the presence or absence of these could not be demonstrated. Further

examination indicated the presence of salicylic acid, a gummy material,

having the properties of tragacanth and glycerin. It is practically

free from inorganic matter. By distillation a small quantity of oil was

isolated, which possesses the characteristic odor of the preparation.

Quantitative estimations[103] indicated the presence of the

above-mentioned constituents in approximately the following quantities:

[103] Details of this analysis appear in the annual report for 1910 of

the Chemical Laboratory of the American Medical Association.

Per Cent.

Gummy matter having the properties of tragacanth 2.02

Salicylic acid 0.67

Matter having the general properties of wool-fat

(lanolin) 0.20

Glycerin 5.50

Volatile matter (water and alcohol) 91.00

Aromatic oils and phenol-like bodies Trace

The results of the above analysis, together with advertising matter

regarding Zemacol, were submitted to Dr. William Allen Pusey, professor

of dermatology and clinical dermatology, College of Physicians and

Surgeons, Chicago, and past chairman of the Section on Dermatology of

the American Medical Association, with the inquiry whether or not there

was any record of investigations regarding the therapeutic value of an

extract of the rete mucosum of the sheep and whether in his opinion the

claims made for Zematol would be warranted. The following reply was

received:

“So far as I know, nobody ever thought of or proposed the use of

an extract of rete mucosum as a therapeutic agent and if a serious

suggestion of that sort had ever been made I believe I would know it.

I can conceive of no service which such an extract could render and

I think the suggestion of it is a highly fantastic idea. From the

analysis which you furnish I should say that the mixture described

is substantially the ordinary 2 per cent. solution of tragacanth in

glycerin and water with a little antiseptic added to keep it from

decomposing. That is a commonly known lotion, modifications of which

are used in practically every hospital as a hand lotion, and has no

magical virtues whatever. Incidentally, I should think it cost, aside

from the labor, about twenty cents a gallon to make it.”--(_From The

Journal A. M. A., May 14, 1910._)

ZYME-OID

W. A. Puckner and W. S. Hilpert

Zyme-oid, manufactured by the Oxychlorine Chemical Company of Chicago,

is advertised as “a powerful gastro-intestinal antiferment” which

will “arrest and prevent bacterial fermentation in any portion of

the intestinal tract, whether the media be acid or alkaline.” These

extravagant statements, like many others made regarding the properties

of zyme-oid, are very similar in character to those made in the

circulars accompanying the preparation oxychlorine, manufactured by the

same firm and exposed in The Journal, July 6, 1907, page 54. (See page

147 of this book.)

As examples, several parallel statements help to show this similarity.

The formula (?) of oxychlorine, as expounded on the label, is given

in full, while in the case of zyme-oid only a hint is given as to its

composition, but still sufficient to point to a similarity between the

two:

OXYCHLORINE ZYME-OID

“Oxychlorine is a tetraborate “Zyme-Oid is a double borate

of sodium and potassium com- salt.”

bined with oxychlorid of boron,

thus: (6NaKB_{4}O_{7}) BOCl_{3}.”

In the matter of claims for chemical stability the two seem to be very

closely allied:

Oxychlorine is “a stable salt Zyme-oid is “a product which is

under all conditions until stable enough for keeping pur-

brought in contact with sub- poses, but which readily yields

oxygenated organic matter.” nascent oxygen in the presence of

bacterial products.”

The therapeutic properties attributed to these sister products are even

more similar, for we find that:

“Oxychlorine is adapted to all “Zyme-oid is a powerful gastro-

morbid and abnormal fermentative intestinal antiferment.”

alimentary states.”

Many more statements and claims could be quoted to show a similarity

between, amounting almost to an identity of, oxychlorine and zyme-oid.

With these facts in mind, the analysis of zyme-oid was undertaken in

order to compare it with the previously examined oxychlorine and to

determine to what extent the claims made for zyme-oid are upheld by its

composition. The analysis indicated, as was expected, that zyme-oid

is essentially the same as oxychlorine as is shown in the following,

quoted from the report of the analysis of each:

ANALYSIS OF OXYCHLORINE ANALYSIS OF ZYME-OID

Potassium (K) 12.26 Potassium (K) 13.50

Sodium (Na) 8.20 Sodium (Na) 9.84

Chlorate (ClO_{3}) 25.32 Chlorate (ClO_{3}) 27.50

Nitrate (NO_{3}) 21.70 Nitrate (NO_{3}) 24.22

Boric acid anhydrid Boric acid anhydrid

(B_{2}O_{3}) 18.63 (B_{2}O_{3}) 13.42

Water, calculated 13.29 Water, calculated 10.42

Assuming that the chlorate in zyme-oid is present as potassium chlorate

and the nitrate is present as sodium nitrate, the figures obtained by

analysis correspond to a mixture approximately as follows:

Potassium chlorate (KClO_{3}) 40.43

Sodium Nitrate (NaNO_{3}) 33.22

Potassium tetraborate (K_{2}B_{4}O_{7}) 1.60

Sodium tetraborate (Na_{2}B_{4}O_{7}) 3.31

Boric acid 21.14

From the results of the analysis and from the physical properties of

zyme-oid we conclude, just as was done in the case of oxychlorine, that

the preparation is not a definite chemical compound, but is essentially

a mixture of alkali chlorate and nitrate with boric acid, probably

produced by fusing together the constituents.

COMMENT

An examination of the claims made for the firm’s two products, while,

as already proved, disclosing many points of similarity, will also

show one remarkable difference. We refer to the skilful indefiniteness

that pervades the claims made for zyme-oid and which defies scientific

refutation. This verbal obscurity is becoming daily more common in

the “literature” of firms marketing nostrums. Since the Council

has analyzed many of the much-advertised articles and proved the

unreliability of the pseudo-scientific claims made for them, the more

cautious of the nostrum-mongers have modified the matter descriptive of

their products. They have called to their aid the principle that words

were given to man to conceal thought rather than to express it, and

they have reduced equivocation to a fine art. Wherever it was possible

to put forward claims by implication rather than by expression this has

been done.

To substantiate further the claims made by the manufacturers of

zyme-oid for their product, a laboratory report is brought in evidence.

This report, which is written more in the style of a peruna testimonial

than that of a conservative scientific statement, fails to verify the

claim that zyme-oid is a “double borate salt,” but confines itself to a

statement of its harmlessness and its anti-fermentative properties. In

passing, it seems regrettable that scientific laboratories should, for

a pecuniary consideration, be willing to jeopardize their reputations

by lending their names to the furtherance of nostrum exploitation. The

results of the examination of zyme-oid demonstrate that the product is

no more worthy of the physician’s consideration than its close, and

equally worthless, relative, oxychlorine.--(_From The Journal A. M. A.,

May 23, 1908._)

The Propaganda for Reform in Proprietary Medicines, Vol. 1 of 2 · 第 6 / 12 章