PART III

CONTRIBUTIONS FROM THE JOURNAL: NOSTRUMS

ALLEOTONE

The formula of this preparation, given in the literature, reads as

follows:

Alcoholici (Monatomic) gr. 1/1000

Quininæ Sulphatis gr. 1/384

Ac. Sulph. Dil. (10 per cent.) gtt. 2-1/2

Ac. Nitrici Dil. (10 per cent.) gtt. 1/77

Ac. Butanol-Dioic gr. 1/3

Tr. Ferri Chloridi gtt. 1/26

Aquæ gtt. xx

The formula is worthless. It can only mislead and mystify and the

greater part of the literature is a mere jumble of inaccurate and

mystifying statements. The various constituents of the preparation are

taken up as follows. The advertising literature states:

“Monatomic Alcohol is one of the constituents of all nerve tissue:

It is a product of the replacement of one atom of hydrogen of the

hydrocarbons by their hydroxyl group H.O.”

This information does not inform, since there is a vast number of

monatomic alcohols and of every description. The assertion that the

preparation “contains a salt” would be perfectly analogous and just as

enlightening. Of “Ferri Chlo” the literature says:

“Ferri Chlo is found with all proteids and nucleins and herein acts

as magnetic iron, aiding the play of the electrical travel.”

The first assertion is untrue, for iron does not exist as chlorid in

the cells of the body, but as some organic iron compound; neither is it

found in all proteids, but principally in nucleo-albumins; and not all

proteids contain nucleo-albumins. The assertion that the iron chlorid

“acts as magnetic iron aiding the play of the electric travel” is

nonsensical and on a par with the electric belt method of exploitation,

and suggests forcibly the class to which Alleotone belongs. The

literature further states:

“Sulphuric and nitric acids act in removing hydrogen atoms and

substitute atoms of the radical NO_{2}; that is, as hydrogen

tranquilizes the speed of burning or oxidation, its action is

substituted by the atom nitrogen which is energy itself, nitrogen

being the base of all explosives.”

Sulphuric acid is certainly an oxidizing agent and in virtue thereof

removes hydrogen; but not in a solution whose concentration with

respect to sulphuric acid is approximately only 0.82 per cent. The

statement that nitrogen is the “base of all explosives” is another

example of the methods of the promoters. As it is a well-known fact,

however, that nitrogen itself is one of the least reactive of gaseous

elements, little confidence can be placed in such remarks as “Nitrogen

which is energy itself.” Another mystifying term used in the formula

is “Ac. Butanol-Dioic,” which is a true chemical name, certainly,

but it is one by which few physicians will recognize simple malic

acid, an ordinary vegetable acid widely distributed in ripe fruits,

such as apples and pears, and possessing the properties simply of a

relatively weak organic acid. To describe it as exercising any potent

influence “in the oxidation of the phosphorus as lecithin in the

cell”--especially in the extremely low concentration in which it is

stated to exist in Alleotone--is simply an absurd juggling with words.

It is not much to be wondered at that the public should be taken in

by pseudoscientific “literature”; but it is not only strange, it is

discreditable to our profession, that among its members should be

found any to accept such rubbish as the above quoted “literature” as

information worth acting on--yet such there are, judging from the

testimonials.--(_Abstracted from The Journal A. M. A., Feb. 1, 1908._)

The Commercial Value of Adverse Criticism

For skilful attempts to convert a “knock” into a “boost,” commend

us to the discredited nostrum exploiter. The federal Food and Drugs

Act did much to bring out this amiable quality--possibly developed

it. While somewhat ancient history, it is well to call to mind what

happened when the excise authorities insisted either that the “patent

medicine” booze, Peruna, have some medicine put in it, or else that

its manufacturers should go into the saloon business. Hartman at once

got out a new label stating that “for a number of years a multitude of

grateful friends” had urged “that Peruna be given a slight laxative

quality.” Thenceforth the innocents and near-innocents could get their

perunaese jag only at the risk of a “bad quarter of an hour.”

One of the latest attempts to wriggle out of an uncomfortable position,

and at the same time make capital out of the wriggling, is seen in the

advertising of Alleotone, a nostrum of the pseudoscientific type, which

was shown up in The Journal of Feb. 1, 1908. The “formula” furnished is

for the most part a jargon of misleading and mystifying nonsense and

fulfils the same purpose as the voluble “patter” of the gentleman who

is manipulating three shells and a pea at the county fair.

Every constituent of the “formula” was discussed in The Journal and the

absurdities and impossibilities of each dwelt on. Did the manufacturers

of Alleotone feel downcast over the exposure of their humbug? Not to

judge by their advertising, for they write to physicians that “since

the A. M. A. analyzed Alleotone it has made great strides”--direction

not specified. But the choicest piece of impudence, and one that but

for its dishonesty would be laughable, is found in this portion of

their advertising pamphlet:

[Illustration]

In the original, the words “With amendments suggested in the Journal

of the American Medical Association, Feb. 1, 1908,” and also

“(Cholesterin.)” and “(Malic Acid.),” which we have underscored in the

illustration, are printed in red and have been added to the original

“formula.” Such are the uses of adversity.

What claim, if any, the exploiter of this nostrum--B. F. Copeland--has

to medical or pharmaceutical knowledge, we do not know. In fact, to

be consistent with the “ethics” of the nostrum business he need have

none. Such knowledge, indeed, tends to hamper that free play of the

imagination so necessary in this work. We understand that he has at

different times been in charge of a stave factory and connected with

a brokerage firm, which may exert some subtle influence in developing

the ability to relieve suffering humanity, though the connection is

not quite clear. One would imagine, however, that the keen business

instinct, untrammeled by any considerations of conscience, which is

exhibited in the exploitation of Alleotone, would in purely commercial

pursuits have long since assured a competence.--(_From The Journal

A. M. A., Oct. 17, 1908._)

BAUME ANALGESIQUE BENGUE

A physician writes asking for the formula of Baume Analgésique Bengué.

This product is another of the “patent-medicine”–“ethical-proprietary”

type of nostrums. In Great Britain, it is advertised to the public as

“A Wonderful Remedy for Rheumatism, Gout, Neuralgia.” In this country,

the exploiters find that space in cheap medical journals, reinforced

by the aid of undiscriminating physicians, is a cheaper method of

getting the stuff to the public. According to the statements of the

manufacturers, Bengué’s Analgesic Balm contains “menthol, salicylate

of methyl and lanolin.” When analyzed by the chemists of the British

Medical Association, it was reported to have the following composition:

Menthol 18 per cent.

Methyl salicylate 20 per cent.

Lanolin, anhydrous 54 per cent.

A fat, apparently lard 8 per cent.

The estimated cost of the ingredients of a 50-cent tube of Bengué’s

Analgesic Balm, according to the British chemists, is 2-1/2 cents.

Evidently this imposingly named product is practically a lanolin

ointment containing oil of wintergreen and menthol. Similar products

are catalogued by various pharmaceutical houses under various names

and with varying degrees of frankness concerning their composition.

Two firms give the medical profession full details regarding the

composition of their products: The H. K. Mulford Company, who sell it

under the name “Methyl Salicylate Ointment,” and the Pitman-Myers Co.,

who name their product “Anodyne Balm, P-M Co.” Some other firms are

not so frank. Parke, Davis & Co., for instance, sell “a combination

of methyl salicylate and menthol with a lanolin base” under the name

“Analgesic Balm,” but do not give the quantities of the ingredients;

Frederick Stearns & Co. sell “Analgesic Cream, Stearns” without giving

the quantities; Nelson Baker & Co. sell “Anti-Neuralgic Ointment,” and

no quantities are given.--(_From The Journal A. M. A., Dec. 14, 1912._)

ANTIDIABETICUM--BAUER

In Germany the makers of nostrums, their methods and their products are

systematically exposed by the Society for the Suppression of Quackery

(Deutsche Gesellschaft zur Bekämpfung des Kurpfuschertums) through its

publication, the _Geseundheitslehrer_, under the aggressive editorship

of Dr. Kantor.

Ludwig Bauer,[104] the manufacturer of “Antidiabeticum,” inserted

advertisements in daily papers asserting that for his “humanitarian

efforts” the society “Opera Educativa pacifica” in Rome had granted him

a diploma and placed his publications in the celebrated “Bibliotheca

Marciazzi.” Dr. Kantor, editor of the _Gesundheitslehrer_, declared

that, according to information received from the German Consulate

in Rome, no such society existed there, and the library referred to

probably was the Bibliotheca Marciana in Florence, which, like other

public libraries, accepts all donations without critical examination.

To offset these exposures, the promoter of Antidiabeticum published

advertisements libeling Dr. Kantor and attacking the Society for

Suppression of Quackery. This resulted in suits and counter-suits for

libel between Dr. Kantor and the directors of the antiquackery society

on the one side and the promoter of Antidiabeticum on the other.

As a result of the recent combined trial, the court declared that

Dr. Kantor’s charges had been substantiated and the manufacturer of

Antidiabeticum was fined 600 marks or forty days’ imprisonment, while

apparently on purely technical grounds Dr. Kantor was fined 50 marks

or five days’ imprisonment. The costs were divided between Bauer and

Dr. Kantor in the proportion of 11 to 1. As Bauer in the course of the

trial made further libelous charges, Dr. Kantor has lately started new

proceedings against Bauer. The incessant persecution of Dr. Kantor was

described in an editorial in The Journal, May 20, 1911, p. 1486.

[104] According to a report in the _Allgemeine medizinische

Central-Zeitung_ Jan. 6, 1912, p. 14.

The persecution of Dr. Kantor previously described shows no signs

of abatement nor has Dr. Kantor given evidence of loss of courage.

Some of the German medical societies have subscribed for the

_Gesundheitslehrer_ for each of their members. It is written in popular

style for the masses and is a sharp and effective weapon for the

campaign against quackery.--(_From The Journal A. M. A., April 27,

1912._)

ANTIKAMNIA

The Nostrum and Its Method of Exploitation

Our readers will be interested to learn some of the remarkable

properties which, according to the statements of the manufacturers,

this Antikamnia possesses. We quote from the advertising literature:

The well-known nerve specialist (?), Dr. Harley, in an interview

published in the _London Daily Express_, says: “I have treated more

than one American for nervousness and ‘brain fag’ directly due to

their incessant energy. I had a young man in here this morning who

complained of headache ‘in the back of the neck.’ He was threatened

with congestion of the brain, and seemed somewhat aggrieved when I

told him he had been trying to do too much. I also treated a young

American woman who, since her arrival in London, had apparently

been living on Antikamnia tablets by the advice of her physician.

It was the only thing, she said, which kept her ‘braced up’ for the

strain of sight-seeing.”

(Why did the young woman consult this Dr. Harley--for the drug habit?)

Note the following:

For the severe pains of rheumatism, dysmenorrhea, neuralgia,

gout, sciatica and lumbago, as well as for the lightning pains of

locomotor ataxia, there can be no quicker and more lasting relief

obtained than by the administration of Antikamnia and codeine

tablets.

Imagine an intelligent physician trying to treat the diseases

mentioned below with the various impotent means of the pharmacopeia

and physiological therapy when he might depend on Antikamnia! We quote

again:

As a Pain Reliever.--In headache, cephalalgia, hemicrania, migraine

[some other words might have been thrown in so as still more to

emphasize the headache business], myalgia, coryza, la grippe and

its sequelae, the lightning pains of locomotor ataxia and all pains

due to irregular menstruation.

As an Anodyne or Sedative.--In alcoholic delirium, indigestion,

cardialgia, gastralgia, dyspepsia, hysteria, insomnia, inebriety,

car-sickness, sea-sickness, worry and sight-seer’s fatigue.

As an Antipyretic.--In typhoid, intermittent, puerperal and

malarial fevers, bronchitis, pneumonia, pleurisy, and tuberculosis.

As an Anti-Neuralgic.--In acute or chronic neuralgia, facial

neuralgia, earache, pain about the teeth, angina pectoris,

neurasthenia, palpitation, pains of locomotor ataxia and sciatica.

As an Anti-Rheumatic.--In acute or chronic rheumatism and gout,

fever and pleurodynia.

There is no remedy so useful and attended with such satisfactory

results as Antikamnia tablets in the treatment of melancholia

with vasomotor disturbances, anemic headaches, emotional

distress, and active delusions of apprehension and distrust. They

increase arterial tension and promote digestion, as well as being

particularly serviceable in relieving the persistent headache which

accompanies nervousness.

In neurasthenia, in mild hysteroid affections, and in the various

neuralgias, particularly ovarian, and in the nervous tremor so

often seen in confirmed drunkards, they are of peculiar service.

In angina pectoris this drug has a beneficial action; it relieves

the pain and distress in many cases, even when amyl nitrite and

nitroglycerin have failed entirely. In pseudo-angina, frequently

observed in hysterical women, its action is all that can be desired.

Patients who suffer from irritable, weak, or palpitating heart,

needing at times a pain reliever, can take Antikamnia tablets,

without untoward after-effects, knowing that the heart is being

fortified. In delirium tremens, they relieve when there are great

restlessness, insomnia, the general lowering of the nerve power.

Only the vivid picture of a crisis in locomotor ataxia or the agony

of a true migraine, can impress the observer with the full value of

this pain reliever.

The following testimonials are from physicians:

Dr. Caleb Lyon, an old Bellevue practitioner, in referring to

antikamnia and codein tablets, says:

In my practice they accompany the maid from her virgin couch to

her lying-in chamber, assuaging the perplexities of maidenhood and

easing the trials of maternity with most gratifying results. I

earnestly hope that the proprietors of this valuable remedial agent

will keep it up to its present standard of purity and excellence.

Dr. Walter M. Fleming, A.M., M.D., New York City, writes:

... With all the experience of more than a quarter of a century,

in the treatment of winter cough, and all its complications of

laryngeal, bronchial and pulmonary irritability, dyspnea, asthmatic

spasms, and finally whooping cough--usually the most persistent

and tenacious of all these membranous maladies--I find no one

remedy more strongly indicated, or which yields more prompt and

satisfactory results than Antikamnia and heroin tablets, composed

of Antikamnia 5 grains and heroin hydrochloride 1/12 grain....

Result: a prompt and efficient expectorant, at once relaxing the

harsh and rasping cough, releasing the tenacious, sticky and

gelatinous mucus which is soon readily expectorated, while the

soothing influence of the Antikamnia is at once manifested, greatly

to the comfort and contentment of the patient.

... Independent of the fact of the direct applicability of this

remedy to the various membranous maladies of the lungs, bronchi,

fauces and nose, it proves also, an invariable remedy in all

febrile cases where anodyne is required. This, together with

its analgesic and antipyretic merits, eminently qualify this

combination for a responsive agent in the treatment of nearly all

the numerous febrile attacks characterized by pain, nervousness,

insomnia and their accompanying symptoms.

“Antikamnia and Quinin”

If there is any virtue in the particular combination known as

“Antikamnia,” a physician prescribing the tablets supposed to contain

combinations of “Antikamnia” and some other drugs should have some

guarantee that they contain those remedies. Take, for example, the

tablets advertised and sold as “Antikamnia and quinin.” It might

reasonably be supposed that the tablets contained the combination known

as “Antikamnia”; this, however, seems not to be the case. Previous

analyses, as published[105] by us, have shown that antikamnia contains

approximately 20 per cent. of sodium bicarbonate, yet two chemists,

working separately, have been unable to find this ingredient in the

tablets advertised and sold as “Antikamnia and quinin.” Are we to

understand, therefore, that the manufacturers do not consider the

bicarbonate of sodium of importance in their preparation, Antikamnia;

or are they guilty of misrepresentation and of misleading physicians in

omitting this constituent from their product Antikamnia when that is

combined with the bisulphate of quinin? The above statement regarding

the omission of bicarbonate of sodium from the quinin combination may

be verified by any physician who desires to make a few simple chemical

tests--carbonic acid is not given off when the tablets are treated with

dilute acids, as would be the case if sodium bicarbonate were present.

Further, while the ordinary Antikamnia contains no constituent not

soluble either in water or in chloroform, and while quinin bisulphate

is readily soluble in water, the tablets said to contain Antikamnia

and quinin bisulphate, when treated successively with water and with

chloroform, leave a residue of more than 18 per cent.

[105] The Journal A. M. A., June 3, 1905; reproduced on page 9 of this

book.

One of the chemists who analyzed the preparation for us, in commenting

on this in a letter, says: “The matter which is insoluble in water,

alcohol or in chloroform, i. e., the substance which is neither

‘Antikamnia’ nor quinin bisulphate, amounts to more than 18 per cent.

in ‘Antikamnia and quinin bisulphate tablets.’ The tablets weigh close

to five grains and are said to contain 2.5 grains each of Antikamnia

and quinin bisulphate. How is this possible when each tablet contains

almost one grain of foreign substance (chiefly starch)?”

Further comment is superfluous. We have presented facts to our readers

and leave, them to draw their own conclusions.--(_From The Journal

A. M. A., July 1, 1905._)

Adding Insult to Injury

When the Council on Pharmacy and Chemistry began its work of

independent and scientific investigation of proprietary preparations,

some of the questions asked were:

“What guarantee has the medical profession that the formulas of these

proprietary medicines are not changed at the will of the manufacturers?

How can the physician who confidingly prescribes them for his patients

know that the preparation which he orders to-day is the same as that

which was furnished him last year, or which may be given him next year,

under the same name?”

At once a wail, as of injured innocence, went up from countless venders

of proprietary medicines, who replied with one voice:

“The honor and reputation of the proprietors and manufacturers

is sufficient guarantee of the stability and permanence of these

preparations.”

So vehement were their protestations and so well simulated were their

declarations of Pecksniffian virtue that many physicians were deceived

thereby. Many medical journals (whose views were, perhaps, slightly

biased by the consideration of fat advertising contracts) also were

apparently convinced. But the fact was overlooked that guarantees based

on honor are of value only in proportion to the amount and quality of

honor possessed by the guarantors.

The enactment of the national Food and Drugs Act is bringing many

things to light. Some of them are interesting, some would be amusing

were they not so utterly despicable. Among other things, it has

furnished a demonstration of the value of the “honorable assurances” of

nostrum venders.

The nostrum Antikamnia has pointed out many a moral in the campaign

in the last two years. It was hardly to be hoped that it would

deliberately furnish a demonstration of the utter lack of honesty on

the part of a certain class of proprietary manufacturers. Yet, relying

apparently on the ignorance of the public and the long-continued

lethargy of the medical profession, its promoters have, in the last

few weeks, unwittingly convicted and stultified themselves. When

the pure food law went into effect, the proprietors of this mixture

found themselves in a sad dilemma; if they labeled their mixture in

accordance with the provisions of the law they would have to admit

that it contained acetanilid and that the charges against them were

true. Failing to comply with the law, they must go out of business.

The latter alternative was not to be thought of. The profits gained

by selling, with the aid of careless or ignorant physicians, a five-

or ten-cent mixture for $1 were too great to be surrendered without a

struggle. The same brilliant intellect, perhaps, that first saw the

commercial possibilities in the business said: “Change the formula.

Phenacetin is about as cheap as acetanilid; the patent has just expired

and consequently we can get it at a low price. Let us substitute

phenacetin for acetanilid.”

As a result the profession is treated to an edifying exhibition of

virtue triumphant, a wolf so completely covered by the harmless coat of

a sheep that he flatters himself that his wolfish nature is completely

concealed. No longer are skulls and skeletons sent out in calendar form

as grinning advance agents to be displayed in every doctor’s office,

but instead a beautiful domestic scene, showing a convalescent child

nestling in the arms of its mother. The familiar “AK,” however, as

usual, is in the lower right-hand corner. And what a change in labels!

No longer is Antikamnia a chemical entity, but the label now openly but

ingenuously declares that “Antikamnia tablets in this original package

contain 350 grains of acetphenetidin, U. S. P., per ounce. Guaranteed

under the Food and Drugs Act, June 30, 1906. Serial No. 10.” While,

below, as an entirely unnecessary display of conformity to the Pure

Food Act, appears this statement:

The Antikamnia tablets in this original ounce package contain

no acetanilid, antifebrin, antipyrin, alcohol, morphin, opium,

codein, heroin, cocain, alpha- or beta-eucain, arsenic, strychnin,

chloroform, cannabis indica or chloral hydrate.

Truly, Satan is appearing as an angel of light. What a gratification it

is to the long exploited profession to know that Antikamnia contains

no alcohol, no chloroform, no cannabis indica, no chloral hydrate. How

unfortunate that this spontaneous display of confidence is not carried

far enough to inform the profession of the ingredients, aside from

phenacetin, contained in the mixture!

The label is an admission that the nostrum does not contain what it was

never supposed to contain, with the exception of acetanilid, and is

directly an attempt to conceal the real contents. The proprietors know

that the dear public, whose “pains, headaches, neuralgias, women’s

aches and ills, grippal neuroses, nervousness, insomnia, rheumatism,

lightning pains of locomotor ataxia, sciatica, etc.,” they are

longing to assuage, will not know that acetphenetidin is the official

designation for what is popularly known as phenacetin, and that this

dangerous product is found in the new mixture in the proportion of

approximately 4 grains to a 5-grain tablet. Evidently they also presume

considerably on the ignorance of our profession, or why should they

make the brazen statement that four grains of phenacetin is the “most

reliable remedy” for the long list of diseases enumerated on their

advertising calendar?

[Illustration: A reduced reproduction of a full-page Antikamnia

advertisement appearing in the New York _World Almanac_, 1911.]

When the formula for which such wonderful virtues were claimed was

suddenly thrown overboard, was the medical profession, which by its

short-sighted patronage had built up this business, notified in any

way of the change? Search the new advertising matter of this nostrum

from beginning to end and you will not find one word to show that

“The Antikamnia tablets in this original ounce package” differ in the

slightest particular from those sold to the profession and the public

for years past. This being true (and the statements of the promoters

themselves are our authority for it), what remains of the pratings of

“honor” and the “guarantee of the manufacturers”? Has a physician no

right to know when a change is made in the formula of a preparation

which he has been prescribing for years?

What assurance has the profession that, at any moment, a cheaper or

more dangerous drug may not be substituted for “acetphenetidin” if

thereby the law can be evaded or the profits of the delectable business

enhanced?

How can any conscientious physician prescribe, for those who confide

their lives to his care, a preparation the stability of the formula of

which must depend absolutely on its owner’s whim?

How can a physician with the slightest sense of responsibility to his

patients allow his office to be used as a free advertising bureau

for a preparation manifestly founded and developed on deceit and

misrepresentation?

How can any medical journal, except those avowedly and unblushingly

seeking to aid the nostrum maker to exploit the profession, whose

interests they claim to serve, continue to carry the deceptive and

misleading advertisement of a twice exposed fraud?

How can any physician with a particle of self-respect or manhood

continue to support, by subscription or contribution, any medical

journal which, by accepting such advertising, allies itself with the

army of deceit and chicanery?--(_Abstracted from The Journal A. M. A.,

Jan. 26, 1907._)

Still Further Duplicity

When the Food and Drugs Act went into effect the manufacturers of this

preparation, instead of continuing to put out the same mixture as

they had been doing radically changed the composition by substituting

acetphenetidin (phenacetin) for acetanilid. By doing this the company

avoided the disagreeable necessity for acknowledging on the label

that the nostrum contained acetanilid, as was shown by the analysis

published in The Journal, June 3, 1905. In addition to stating that

the package of Antikamnia contained acetphenetidin, the company also

stated that it contained no “acetanilid, antifebrin, antipyrin,

alcohol, morphin, opium, codein, heroin, cocain, strychnin, chloroform,

cannabis indica, or chloral hydrate.” Knowing that the nostrum was

being advertised in Great Britain and Canada as well as in the

United States, The Journal obtained some Antikamnia from London, and

it was analyzed in the Association’s laboratory. As was suspected,

the analysis showed that Antikamnia as sold abroad has the same

composition now as it had in the United States before the Food and

Drugs Act went into force, viz.: Acetanilid, 67.75 per cent.; caffein,

4.88 per cent., and citric acid and sodium bicarbonate, by difference,

25.36 per cent. This corresponds with the analysis previously made

and published in The Journal, June 3, 1905. The Antikamnia on the

market in this country was also analyzed and it was found to contain:

acetphenetidin (phenacetin), 72.05 per cent.; caffein, 13.95 per cent.;

citric acid and sodium bicarbonate, 14 per cent. The preparation sold

as “Antikamnia and Quinin” was also analyzed, and it was found that

starch had been substituted for the bicarbonate of sodium which is

found in the Antikamnia itself. The details of the analyses are given

with the following comments: “The above are brief statements of bald

facts. Two of these should be emphasized: (1) When the Food and Drugs

Act went into force, January, 1907, the manufacturers of Antikamnia,

rather than acknowledge the truth of the past--we can imagine no other

reason--materially and radically changed the composition of their

preparation, and did this without notifying the medical profession

or intimating in any way, so far as we can learn, that such a change

had been made. We have no doubt they believed they had a right to do

as they pleased with their own; that it was nobody’s business but

theirs what they did with their own preparation, or how they changed

it. As they never had told physicians what it contained, there was

no reason why they should do so now. This is logical and we cannot

blame the manufacturers so long as the medical profession is willing

to be humbugged. (2) For the same reason, we presume, they claim

that they have a right to continue to use acetanilid in the product

for the foreign market. The Food and Drugs Act applies only to the

United States, of course, and acetanilid being cheaper, why not use

it? What is the difference if one is more dangerous than the other?

The fact that the Antikamnia sold abroad differs from that sold in

this country some may say is of no special interest to us. Still this

fact is worth noting: The dose of acetphenetidin--phenacetin--(7-1/2

grains) is nearly double that of acetanilid (4 grains): one becoming

accustomed to a certain dosage of the nostrum as sold in this country

might, while abroad, unwittingly be led to take a double dose of

acetanilid.--(_Abstracted from The Journal A. M. A., Feb. 8, 1908._)

Samples, Form Letters and “Prescriptions” Sent to the Laity

_To the Editor_:--The enclosed “literature” is being sent broadcast

to the laity by the Antikamnia people and still a great many of the

physicians throughout the country are prescribing the preparation

thus advertised. Will the time ever come when the medical fraternity

will awaken to the fact that it has been humbugged by a great many

manufacturing concerns? I certainly hope so.

J. W. DuVal, M.D., Wichita Falls, Texas.

Comment:--The “literature” referred to by our correspondent consists of

a form letter and a small pamphlet. The letter was similar to the one

reproduced herewith.

[Illustration]

The pamphlet accompanying the letter is entitled “Practical

Prescriptions,” and contains a list of diseases and morbid states

arranged alphabetically from “Alcoholism,” “Asthma” and “Backache,”

to “Wind,” “Women’s Pains” and “Worry.” For the one hundred and

twenty-two conditions listed, “Antikamnia,” “Antikamnia and Codein” or

“Laxative Antikamnia and Quinin” are prescribed, demonstrating that the

“prescriptions” are more “practical” than scientific.

In many respects the methods of the proprietors of “headache powders”

and “anti-pain pills” are less offensive to one’s sense of professional

decency than the course pursued by the Antikamnia people. The

former have at least never recommended their products as “ethical

proprietaries”; they have not used medical men as their unpaid agents;

the claims made for their products have been no more exaggerated; and

they have not found it necessary, from the requirements of the Food and

Drugs Act, to substitute acetphenetidin for acetanilid to avoid giving

the lie to their former claims.

As to the query propounded by our correspondent: We are optimistic

enough to believe that the time he longs for is already here. The fact

that the proprietors of nostrums of the Antikamnia type are finding

it necessary to advertise to the laity is, in itself, evidence of

the diminishing demand for such products on the part of the medical

profession.--(_From The Journal A. M. A., April 18, 1908._)

Antikamnia in America and Great Britain

The following letter from the Antikamnia Chemical Company to The

Journal was received about August 1, 1912:

“You have at various times represented in your Journal that the

Antikamnia sold in foreign countries, particularly in Great

Britain, has a different formula from the Antikamnia sold in the

United States, and you have also published alleged formulas of each

to show wherein they are supposed to differ.

“We hereby respectfully notify you that the Antikamnia formula is

the same for all countries, and the publication of any statements

to the effect that the formula of Antikamnia is different in Great

Britain, or any other foreign country, from that sold in the United

States is a libel, and will be prosecuted as such.”

On the receipt of this a letter was written to a correspondent in

London requesting him to purchase in the open market a package of

Antikamnia. This was done and the original sealed package reached the

Association’s laboratory a few days ago. Careful analysis of this

specimen shows it to contain acetanilid but no acetphenetidin, while

the Antikamnia sold in the United States contains acetphenetidin but

no acetanilid. The company’s protest to the contrary notwithstanding,

the formula of some Antikamnia, at least, _is_ still different in

Great Britain from that sold in the United States. It is possible, of

course, that some time in the future the composition of every package

of this nostrum on sale in the United Kingdom will be similar to that

of every package sold in the United States. It is even possible that

“Antikamnia & Quinin” tablets will--or do--actually consist of quinin

and the mixture called Antikamnia--although, as The Journal has shown,

this has not been the case in the past. Since the patent expired on

acetphenetidin, this drug has become so cheap--it can be bought at

wholesale for less than 6 cents an ounce--that, commercially it must

make very little difference whether acetanilid or acetphenetidin

is used in the manufacture of Antikamnia. But the question arises:

Have our British confrères been notified of the change in formula? A

careful study of the Antikamnia advertisements in English medical

journals shows that the British medical profession has been given

no more consideration by this concern than was the American medical

profession when the change in composition was made on this side.

But then why should it be? Physicians, British or American, who are

addicted to the prescribing of secret proprietaries such as Antikamnia

have little need of formulas--“Theirs not to reason why!” The medical

profession on both sides of the Atlantic has never known the exact

composition of Antikamnia and does not know it now. Physicians who call

for preparations of the Antikamnia type are prescribing names, not

drugs.--(_From The Journal A. M. A., Oct. 26, 1912._)

Again, Antikamnia

[Illustration: Reproductions of portions of pages in the booklets sent

out by the Antikamnia Chemical Company to physicians (on the right),

and laymen (on the left), respectively. Those who do not realize the

character of the Antikamnia concern naturally imagine the quotation

here given from The Journal is a comparatively recent one. Notice that

no dates are given. As a matter of fact, it is twenty-two years old.

Dr. McIntyre, who wrote it, has been dead eleven years.]

In season and out of season The Journal has exposed the Antikamnia

fraud until it would seem that its readers would become weary of the

very name. There is nothing new to say about this dangerous stuff, and

yet the number of inquiries indicates that thousands of The Journal’s

readers do not know of the previous exposures. More than fifteen years

ago The Journal ceased carrying the Antikamnia advertisement; more

than ten years ago it notified its readers that the nostrum was being

advertised to the public by means of circular letters; more than six

years ago it proved that, when the Food and Drugs Act went into effect,

acetphenetidin had been substituted for acetanilid in Antikamnia

evidently in order that the presence of the older drug, of whose

dangers the public had been made aware might not have to be admitted;

more than five years ago The Journal showed that the Antikamnia sold

in the British Isles still contained acetanilid, and as late as last

October it verified this statement although threatened with prosecution

for libel by the Antikamnia Chemical Company.

Yet, in spite of all these exposures, not a week passes that we do not

receive one or more letters calling attention to the Antikamnia fraud.

Most of these letters deal with one, or more, of three points: first,

the fact that the stuff is being advertised to the public by means of

circular letters and that sample “vest-pocket boxes” of this dangerous

drug are being sent through the mail to laymen; second, that Antikamnia

is being advertised in newspapers, and, third, that in the booklets

sent out by the Antikamnia Chemical Company both to the medical

profession and to the public, a paragraph is quoted from an article by

Dr. John H. McIntyre that appeared in The Journal.

[Illustration: Photographic reproductions of two typical Antikamnia

advertisements now appearing in newspapers all over the country. These

tablets are advertised in various newspapers as being “safe” and

neither “depressant” nor “habit-forming”--three separate and distinct

falsehoods.]

The first two points have already been discussed so frequently that

it seems hardly worth while to take them up again in detail, though

it might be said that the medical profession has at last become so

familiar with this widespread humbug that the Antikamnia Chemical

Company has finally gone over body and soul to the newspapers. So

far as we can learn only three publications professing to be medical

journals still carry the Antikamnia advertisement. These three are:

_Southern Practitioner_

_Therapeutic Record_

_Pacific Medical Journal_

As is usual in such cases, the British medical journals are not so

particular, and we still find Antikamnia advertised in:

_Medical Press and Circular_

_Glasgow Medical Journal_

_Journal Tropical Medicine and Hygiene_

_Dublin Journal Medical Science_

_Lancet_

_Canada Lancet_

_Practitioner_

The reproduction of the McIntyre quotation is evidently adopted by the

Antikamnia concern as a means of “playing even” with The Journal for

the unpleasant things it has said about it. In quoting Dr. McIntyre,

the Antikamnia Chemical Company carefully avoids giving the date on

which the article appeared. As a matter of fact, the article was

printed in The Journal over twenty years ago (July 4, 1891), and Dr.

McIntyre himself has been dead for eleven years. Presumably, however,

the Antikamnia Chemical Company will continue to mislead, either

directly or by inference, until the end of the chapter.--(_From The

Journal A. M. A., April 12, 1913._)

ANUSOL SUPPOSITORIES

“In Hemorrhoids and all Inflammatory Rectal Diseases, let your first

thought Continue to be Anusol Hemorrhoidal Suppositories; they have

Earned your lasting Confidence.” Thus speaks an attractive folder

recently sent to physicians. With a prodigal use of superlatives, the

medical profession is told that these suppositories have for years

“maintained their World-Wide Reputation” as the “Most Effective, the

Safest ... the Most Economical and ... the Most Credit-Bringing of all

Topical Rectal Remedies.” The short memory of the public is notorious;

from the point of view of the proprietary exploiter, the short memory

of the medical profession must be equally well known. How, otherwise,

would a firm try to make physicians believe that a product had “earned”

their “lasting confidence” when the result of an examination by the

Association’s chemists, published in The Journal,[106] had shown that

Anusol Hemorrhoidal Suppositories contained practically no “anusol.”

Moreover, as the Association’s findings were a practical verification

of the findings of a foreign chemist who also had failed to find any

“anusol” in Anusol Suppositories, it is not quite clear what is meant

by the term “world-wide reputation.” Incidentally, the observant

physician will notice that the list of the ingredients given on the

Anusol Suppositories labels of 1913 differ from those of the vintage of

four years ago. The label of the old boxes gave the ingredients thus:

Bismuth. iodo-resorcinsulfon (Anusol), Zinc oxydat. pur., Balsam

Peruv., Ol. cacao, Unguent cereum.

[106] Oct. 2, 1909; see p. 227 of this volume.

On the latest label, however, we find these ingredients given:

“Bismuth oxyiodid and resorcinsulphonate with Zinc oxid and Balsam

Peru, incorporated in suitable base.”

What will the formula be four years hence?--(_From The Journal

A. M. A., Oct. 11, 1913._)

ANUSOL SUPPOSITORIES

_To the Editor_:--In the “Propaganda for Reform” department of the

October 11 issue of The Journal, you published a short notice on

Anusol Suppositories. We desire to correct the impression which

your readers may have received, viz.: that there is any actual

difference between Anusol Suppositories of the present and Anusol

Suppositories of the past. We wish, therefore, to state that the

composition of Anusol Suppositories has not been changed; the only

modification that we have made is a revision of the label to the

effect that the active medicinal ingredient of the preparation is a

mixture of bismuth oxyiodid and bismuth resorcinsulphonate in place

of bismuth iodoresorcin-sulphonate. The latter was originally claimed

by the manufacturers, discovered to be doubtful by an investigation

in the laboratory of the American Medical Association, as well as

by one on the part of a foreign chemist, and finally disproved to

our satisfaction by an independent investigation on our part. We

feel that the remark “What will the formula be four years hence?”

will carry the impression to your readers that the composition has

frequently been changed and is likely to be changed again, and it is

for this reason that we request the above correction and an assurance

to the contrary.

The statement in the note that “Anusol Suppositories have been proved

to contain no Anusol” is also likely to create an entirely erroneous

impression. We dropped the use of the word “anusol,” as designating

a definite chemical substance more than two years ago, and changed

all our propaganda matter accordingly. Schering & Glatz.--(_From The

Journal A. M. A., Jan. 31, 1914._)

ASPIRO-LITHINE

Aspiro-lithine is another comparatively new example of the custom of

proprietary manufacturers in putting forward old drugs under a new name

and with them bidding for the favor of physicians. An inquiry has been

received concerning this mixture. It is prepared by McKesson & Robbins

and is said to contain in each tablet 5 grains of acetysalicylic

acid (aspirin) and 2-1/2 grains of acid citro-tartrate of lithium.

It is recommended for all the purposes for which acetysalicylic acid

is commonly used, and on account of the lithium added is claimed to

have much greater virtues than either of these drugs alone or of both

combined.

We had hoped that the time had passed for reputable houses to employ

such time-worn methods, but probably they will not stop so long as

physicians encourage them by continuing to use such preparations.

Acetysalicylic acid is a good drug, whose value is pretty well known.

It is further known that lithium salts do not possess any great

medicinal virtue. Just what acid citro-tartrate of lithium may be is

hard to tell, for chemistries do not recognize such a substance. The

name presumably is intended to hide the real nature of the preparation.

But if there be any advantage in combining lithium salts with

acetysalicylic acid in a prescription, it is a simple proposition and

requires no great skill, either on the part of the physician who writes

the prescription or on the part of the druggist who puts it up, and

such mixtures as aspiro-lithine, with the exaggerated claims made for

them, should be avoided in the physician’s prescribing.--(_From The

Journal A. M. A., May 28, 1910._)

BELL-ANS (PA-PAY-ANS, BELL)[AS]

Another “Patent Medicine” Foisted on the Public Through the Medical

Profession

[AS] See also report on Papayans Bell, p. 151.

With such nostrums as Antikamnia and Resinol fresh in mind as flagrant

examples of “patent medicines” introduced to the public through the

medical profession, what follows regarding Bell-ans, or, as it is

better remembered by physicians, Pa-pay-ans (Bell) will take on an

added interest. Briefly, Bell-ans is the new name of a tablet that,

according to chemists’ reports, is essentially charcoal, baking soda

and ginger, flavored with oil of wintergreen. Its selling point, in

the past at least, has been the alleged presence of papain. This drug,

Bell & Co. allege, is present in their tablets and they claim is “the

digestive principle obtained by our own exclusive process from the

fruit of _Carica papaya_.” As long ago as 1909, the Council on Pharmacy

and Chemistry attempted to find papain present in what was then called

Pa-pay-ans (Bell) and to determine the digestive power of the tablets

but with negative results.

The efforts of other chemists were equally unavailing.

In January, 1914, Bell and Company changed the name of the product

“Pa-pay-ans (Bell)” to “Bell-ans.” As The Journal remarked soon after,

it seemed probable that, as the name of a nostrum of this kind is the

manufacturer’s most valuable asset, the name was hardly changed, as was

alleged, for purely euphonious reasons. It seemed more likely that as

analyses had indicated there was not, and probably never had been, any

appreciable amount of papain in the product, the change of name might

be due to the fear that some day the misleading name might bring the

preparation in conflict with the federal Food and Drugs Act.

For years physicians have realized that the methods of exploitation

of Pa-pay-ans (Bell) have been such as to make the medical

profession a vast free advertising agency for the nostrum. So far

as we know Pa-pay-ans (Bell) has never been advertised in lay

journals--newspapers, etc. Certain medical journals, however, have,

for a long time, carried the advertisements of Pa-pay-ans (Bell)--and

later of Bell-ans--while Bell & Co. has been lavish in its distribution

of free samples, blotters and other advertising paraphernalia direct to

the medical profession.

[Illustration: Miniature facsimile of a letter received by a layman.

It was accompanied by a small box of Bell-ans. Two points are worth

noting: “... one hundred thousand physicians are now prescribing it”;

“any druggist will tell you” that it is perfectly harmless!]

Now it seems Bell and Company are going direct to the public by means

of vest-pocket samples and letters. The letter, a miniature facsimile

of which we reproduce, is one addressed to laymen and accompanies a

vest-pocket box of the nostrum.

Here are some of the things that Bell and Company claim Bell-ans will

do:

“It removes flatulence, vertigo, weakness and other symptoms of

indigestion quickly and pleasantly.”

“It relieves vomiting in pregnancy, alcoholism, seasickness and

cholera morbus....”

“To promote appetite, digestion and the elimination of toxic and

waste material prescribe the Bell-ans....”

“... prevent eruptions, nausea, vertigo, pain, etc....”

“... remove distention, pain, weakness, depression, etc....”

“There is no derangement of the digestive organs upon which the

proper dose of Bell-ans (Pa-pay-ans, Bell) will not act quickly,

pleasantly and favorably....”

There is no physician living who really believes such claims as

these! Yet on the medical profession rests the responsibility for the

exploitation of this nostrum. Those medical journals which accept

advertisements for things of this kind are not so much to blame as

those physicians who unprotestingly tolerate the journals that do

so. Privately owned medical journals are published, usually, as a

commercial proposition; they reflect, to a greater or less extent,

the attitude of their readers, subscribers and contributors. There

are at least three medical journals which carry the advertisements of

Bell-ans. They are the _New York Medical Journal_, the _International

Journal of Surgery_ and the _Massachusetts Medical Journal_.

Bell-ans (Pa-pay-ans, Bell) possesses the virtues--and they are

few--and the limitations--and these are many--inherent to a mixture of

bicarbonate of soda, ginger and charcoal. Any druggist could put up

just as good a remedy, and any physician could write a prescription for

a better one in those cases in which he might think it indicated. The

whole secret of the commercial success of Bell-ans lies in the mystery

of its composition and the fraudulence of the claims that have been

made for it. The same tablets put out under a non-proprietary name, as

an open formula and with claims that were reasonable and true, would

have had practically no sale. The commercial success of Bell-ans is a

monument whose foundation rests equally on the unscrupulousness of the

manufacturer and on the gullibility of a learned profession.--(_From

The Journal A. M. A., Jan. 16, 1915._)

BIOSOL

Dr. A. N. Lakin, State Line, Ind., writes:

“Kindly advise me concerning Biosol. I am sending you herewith a

pamphlet describing this product. On the last page note clinical

report from Dr. Buchman of the Indiana Medical Association and

president of the Department of Public Health, Fort Wayne, Ind.”

H. Hille, once of Heidelberg, now of Oak Park, Ill., having reached

the conclusion that mineral starvation is the cause of all diseases,

devoted his talents to finding a remedy. He claims to have found it and

calls it “Biosol.” He published his discovery in a pamphlet entitled

“Facts of Modern Science,” and recently published an article in the

_Medical Record_ giving his ideas on this mineral point of view. Biosol

is an indescribable mixture of alcohol, carbohydrates, and many and

various mineral bodies--ranging all the way from sodium, potassium,

calcium and magnesium to silicon, copper, uranium and thorium--the

amount of each being in most cases extremely minute. It is said to be

a valuable food as well as medicine. A dose of this food might keep a

rabbit alive for several hours, and a man who could stand the expense

and escape death from delirium tremens might live on three quarts of

the mixture per day. Human beings have little occasion to fear mineral

starvation, and may obviate whatever danger there may be with a drink

of milk. Like other living creatures, we may be thankful that we are

furnished in our own bodies with a living bioplasm which can use the

minerals of the waters and the rocks and which has its own laboratory

in which to prepare organic compounds to suit its needs.--(_From The

Journal A. M. A., March 8, 1913._)

BROMIN-IODIN COMPOUND

The Life-History of a Nostrum

A correspondent writes for information concerning a remedy known as

Bromin-Iodin Comp., which he says is manufactured by the Bromin-Iodin

Chemical Company, formerly of Binghamton, N. Y., but now located in San

Diego, Calif. In The Journal for Feb. 5, 1898, appeared an article by

Dr. C. W. Ingraham, Binghamton, N. Y., entitled “Five Years’ Successful

Experience with a Special Mode of Treating Pulmonary Tuberculosis.”

This “special mode” of treatment consisted in using what Dr. Ingraham

called “bromin-iodin compound,” which he said had the following formula:

Iodin gr. 1/2

Bromin gr. 1/14

Phosphorus gr. 1/100

Thymol gr. 2/3

Sterilized oil fl. dr. 1

This “hypodermic treatment of phthisis” was widely advertised in the

late nineties by the Bromin-Iodin Chemical Co, Binghamton, N. Y., and

was but one of the innumerable “treatments” for pulmonary tuberculosis

that have risen, had their day and, more or less gracefully, retired.

It was first sold “to physicians only” for hypodermic administration.

In 1906, however, physicians were told by the company that “if we find

it impossible to secure your cooperation ... we will be compelled to

do business with the druggists in your locality ...” Apparently they

found such cooperation impossible, because a leaflet was issued to

the laity and the statement was made that they intended to advertise

“all over North America in publications of national and international

circulation, as well as in local newspapers ...” Naturally the laity

couldn’t be expected to administer this treatment by the hypodermic

method and it is not surprising to read that “experiment has proved

that the same solution can be taken internally.” In addition to the

advertising leaflet, the public also was provided with a “pocket

calendar good for 200 years” which contained numerous testimonials

from physicians laudatory of the “bromin-iodin” treatment. The layman

who received one of the leaflets was told that if he was suffering

from “asthma, bronchitis, colds, consumption, coughs, eczema, goiter,

hay fever, neuralgia, rheumatism ... also constipation and kidney

troubles,” and his recovery was “not as rapid as it should be,” should,

moreover, his physician refuse to use the bromin-iodin compound “it

might not be a bad idea to discharge him” and get a physician who would!

At the time this “treatment” was first tried by its “inventor,”

the results given in fifty cases were: First stage, 90 per cent.

cures; second stage, 50 per cent. cures; third stage, no cures, but

improvement in several cases; this was in 1895. It now appears that

this “treatment” has after a period of “patent-medicine” exploitation

come back into the “ethical proprietary” field. Presumably a mixture

such as that represented by the “formula” did not lend itself to

administration by mouth; there was nothing to do, therefore, but enlist

the aid of “easy” physicians in furthering its sale.--(_From The

Journal A. M. A., June 4, 1910._)

CALMINE

New Names for Old Drugs

“Calmine, the new Hypnotic,” is another example of the ingenuity of

the exploiters of proprietary preparations in coining new names for

old drugs and the recklessness with which exploiters herald forth

renamed remedies to the profession and the public as new and wonderful

discoveries.

This is what the promoters, sustained by a calm confidence in the

credulity of the profession, have to say:

In the medical circles throughout the country a good deal of

interest and even enthusiasm over this new hypnotic is noticeable.

Very few drug products have attracted so much attention as this one.

A really satisfactory hypnotic and sleep-inducer, which Calmine

certainly seems to be, has been awaited expectantly for many years.

Of course, we have always had agents of this sort--a new one has

come out at frequent intervals--but none of them have “filled the

bill”; they have been prescribed only because there was nothing

better to be had.

Now this new and wonderful discovery is nothing but Veronal-sodium

(sodium diethyl-barbiturate) under another name. It is the sodium

salt of the more or less favorably known hypnotic, Veronal

(diethyl-barbituric acid). It is also sold as Medinal, and differs

from Veronal only in that the combination with sodium has made it more

readibly soluble, and thus, it is claimed, its absorption is more

prompt. Veronal is protected abroad by a trade-mark and in this country

by a patent, and this, undoubtedly, is responsible for the introduction

of this sodium salt under these fanciful names, because Veronal could

not be sold without infringing on the patent. This in turn induced the

manufacturers of Veronal, in self-protection, also to put the sodium

salt on the market, and now we have it under the name of Calmine. This

probably is only the beginning; soon we may look for it under a host of

other names and the usual result will follow: thoughtless physicians

who have had poor results with it under one name will try it under

others. Or worse still, physicians will thoughtlessly combine Veronal

with Calmine or with Medinal in the same prescription, thus giving a

dangerous dose.--(_From The Journal A. M. A., Jan. 14, 1911._)

CAMPHENOL

Camphenol is made by Johnson & Johnson, New Brunswick, N. J. Under

the name of the article on the carton appears the following formula:

C_{10}H_{16}O━C_{6}H_{4}(CH_{3})OH═C_{6}H_{5}OH. This formula

consists of the chemical formulas for camphor, cresol and phenol,

written one after another, and from this one would conclude that

Camphenol is a compound of camphor, phenol and cresol in molecular

proportions. Examination shows, however, that Camphenol is but a

modification of the well-known camphorated phenol (the liquid produced

when solid camphor and phenol are triturated together). In Camphenol

a part of the phenol, in the camphorated phenol, has been replaced by

cresol, and this liquid has been diluted and emulsified with gelatin or

some similar substance and perfumed. In other words, this preparation

is an emulsion containing relatively small quantities of cresol, phenol

and camphor and is another illustration of the attempts of would-be

pharmaceutical houses to produce new synthetics in the simplest manner

possible--that of writing the chemical formulas of the constituents

of a remedy in a way to indicate a chemical combination.--(_From The

Journal A. M. A., Nov. 5, 1910._)

CHOLOGEN

The proprietary Chologen is interesting some of our readers and several

have sent us samples and literature. Dr. Philip Marvel, Atlantic City,

N. J., for example, writes:

“By the way, I am to-day sending you by mail a package which the

Council on Pharmacy and Chemistry may care to tackle, or it may

not. I shall not be insulted any way, but since these chologen

preparations are being used a good deal by various globe trotters,

who sometimes hook up for a short stay here, I feel it might be of

some interest to know ‘what fools these mortals be’ and how much the

profession is being fooled with them.”

Chologen as a medical treatment for gall-stones has been before the

German public for a number of years, and it is somewhat singular that

so simple a method, which could be easily prescribed by the physician

if it had merit, should exhibit such remarkable vitality in proprietary

form in spite of evidence going to show that it rests on erroneous

principles. The Council rejected it as an unscientific mixture. The

treatment is somewhat liberal, consisting of the use, in varying

successions, of three kinds of tablets: No. 1, calomel and podophyllin;

No. 2, calomel, and No. 3, calomel, podophyllin, camphor and menthol.

The proprietors tell us that the treatment should be proceeded with in

spite of disturbances, such as diarrhea and pain in the abdomen, and

that it should be repeated regularly in intervals for some years, so

long as any trouble exists or recurrence is threatened. “A course” of

Chologen tablets should be taken two or three times a year, No. 1 being

given for ten days, then Nos. 1 and 2 for forty days and No. 3 for ten

days.

It is worthy of note that experimental work seems to have been

performed in the attempt to show that bile produced by this remedy will

cause the disintegration and solution of gall-stones. Normal bile has

a certain solvent action on gall-stones, but calomel and podophyllin

have no demonstrable effect in increasing the amount of bile. We had

imagined that these facts were generally known.

It is somewhat discouraging to reflect that some physicians entertain

so low an estimate of their ability to prescribe such well-known

remedies as calomel and podophyllin that they must use them in the

fixed combinations provided by Dr. Glaser. If the self-respecting

physician does not consider himself insulted by a proprietary

manufacturer who presumes to tell him how to use such well-known

remedies, this is a good sign that he needs to take a postgraduate

course in materia medica and elementary prescription-writing. We

feel that medical writers must be short of subjects when they devote

papers to the exploitation of proprietaries consisting of these simple

ingredients.--(_From The Journal A. M. A., Feb. 1, 1913._)

HAGEE’S CORDIAL OF COD-LIVER OIL[AT]

Fraud and Deception Connected with So-Called

Cod-Liver Oil Preparations

[AT] See also report on Hagee’s Cordial, p. 51.

The introduction of cod-liver oil as a supposedly easily assimilable

nutrient and reconstructive was followed by its extensive use in

wasting diseases, especially in phthisis, in the treatment of which

it came to be considered almost essential, as it was supposed to

possess some mysterious power different from that of other oils. Its

unpalatable character led to various devices to render it tasteless

and make it more acceptable to the stomach. Emulsions containing the

oil in mixture with other substances were put on the market and served

a useful purpose. But the oily nature, imperfectly concealed, was

disagreeable to many, and gradually other preparations appeared which

attempted to retain the supposed therapeutic virtues of cod-liver oil

while dispensing with its disagreeable character. This attempt has been

carried to the extreme that in many of the cod-liver oil preparations

now on the market the oil has been entirely eliminated and all that

is left of the oil is the name. This is a species of fraud which

has been tolerated too long, but which will be kept up so long as

physicians are willing to be duped. Some of these articles are said to

“represent” the oil and to possess all its virtues. Others are said to

contain oil, while still others are stated to contain “all the valuable

constituents.” What is the standard by which we may determine the true

value of these preparations and by which we may determine whether or

not we, and through us our patients, are being humbugged?

A FOOD OR MEDICINE--WHICH?

Is cod-liver oil to be considered a food or a medicine? A food,

certainly. As a food its value will consist in the fats it contains.

These fats are more easily oxidizable and are considered more

digestible than other fats because of the presence of compounds

derived from the liver which favor its emulsification and enable it

to penetrate the mucous membrane more easily than other fats. Aside

from their nutrient properties we have no evidence that the fats of

cod-liver oil possess any therapeutic value; if the oil possesses

therapeutic qualities they must reside in its non-fatty constituents,

and the activity of these non-fatty constituents is not acknowledged by

those who have investigated them scientifically. Most pharmacologists

believe that whatever virtue there is in cod-liver oil depends on its

qualities as an easily assimilable fat.

On the whole, we must conclude with Cushny that “cod-liver oil has not

been shown to have any action apart from that of an easily digested

food, and its superiority to some other fats and oils has not been

satisfactorily established.”

If, then, the value of cod-liver oil depends on the presence of fat as

its nutritive constituent, the amount of fat a preparation contains

will determine the worth or worthlessness of such a preparation; at all

events, a preparation claiming to represent cod-liver oil which does

not contain fat in some form is fraudulent.

HOW TO PROVE OR DISPROVE THE PRESENCE OF COD-LIVER OIL

Fats may be changed to fatty acids or to soaps, as occurs under the

influence of pancreatic juice in digestion, and still retain their

nutritive value, but it is not possible to manipulate them in any way

so that they are still valuable as food, and yet do not respond to

easily applied chemical tests which demonstrate their fatty nature.

Any preparation of cod-liver oil in which fat or fatty acid is not

recognizable by proper tests is valueless as food, since its food value

depends on the amount of fat or fatty acid present. An elementary

knowledge of chemistry and the application of a few simple tests will

enable any physician to learn for himself whether or not a preparation

contains fat or fatty acids.

The preparations claiming to “represent” cod-liver oil are in liquid

form, and if they contain oil it must be one of the following forms:

1. An emulsion of the oil which may be miscible with water, but from

which the fat tends to separate and rise to the top. In this form the

fat can be seen as globules under the microscope.

2. A solution, resulting from the saponification of the oil, containing

a soap which usually will be alkaline in reaction, especially when

mixed with water, and from which fatty acids are separated as a

precipitate when the solution is acidified.

3. A solution of fatty acids. This will be acid in reaction and will be

precipitated by the addition of water, in which the fatty acids are not

soluble.

Hagee’s Cordial of Cod-Liver Oil

Hagee’s Cordial of Cod-Liver Oil Compound is said to “represent 33

per cent. of pure Norwegian cod-liver oil,” with other ingredients,

in perfect solution. It is also claimed, according to the advertising

pamphlet, that “in this preparation we have every beneficial

constituent of the best and purest Norwegian cod-liver oil.” Put to

the above three tests, however, Hagee’s cordial of cod-liver oil is

not, 1, an emulsion of cod-liver oil; 2, is not a saponification of

cod-liver oil; and, 3, does not contain fatty acids. It therefore

contains no cod-liver oil. The only nutrients in the mixture, revealed

by analysis, are sugar, alcohol and glycerin, none of which is

contained in cod-liver oil.

In this case the manufacturer misleads by the use of the word

“represents”; he is careful not to say “contains,” although the

average reader would not be apt to notice the nice distinction. The

manufacturer unwittingly admits that it contains no oil when he says

that it “contains everything of value except the grease.” What else

there is of value in cod-liver oil besides the “grease” we do not know.

Certainly, if we estimate the value of the remedy by its nutrient

properties, it must be set down as practically worthless, if not

fraudulent, for although a mixture of sugar, alcohol and glycerin does

possess certain nutrient value, the materials can be purchased for it

far more cheaply in the open market. It is evident that claims are made

for this preparation which cannot be substantiated.

Again, some of the so-called cod-liver oil preparations are termed

extracts of cod-liver oil, but are not in fact made from the oil,

but from the cod-livers instead. They are preparations which, if

honestly made, might be worthy of trial, but they are improperly called

“extracts” of cod-liver oil, since they do not contain the fat, which

is the active constituent of the oil, but the extractives from the

liver which may or may not possess therapeutic virtues. So far as we

know, however, no satisfactory evidence is forthcoming to indicate that

such extractives have any therapeutic value.

The attempt to modify cod-liver oil for therapeutic purposes may be

pronounced a failure and the large variety and extensive sale of

these preparations appear to be owing to the fact that physicians do

not recall the ordinary facts of chemistry and fail to apply simple

tests with little technical skill, but too readily accept as facts the

statements of the manufacturers.--(_Modified from The Journal A. M. A.,

Oct. 13, 1906._)

WATERBURY’S COMPOUND ONCE MORE[AU]

[AU] See pp. 54, 57 and 442.

Most of our readers will remember what The Journal has published about

a product that used to be sold as “Waterbury’s Metabolized Cod-Liver

Oil Compound.” Briefly, it was shown by a report of the Council on

Pharmacy and Chemistry and a contribution from the Association’s

laboratory, that this “Cod-Liver Oil Compound” contained practically

no cod-liver oil! Later the federal government declared the stuff

misbranded.

The product is now sold under the name “Waterbury’s Compound.” It was

recently stated in this department that “Waterbury’s Compound” was

one of the proprietary preparations advertised both in “display” form

and also in the form of an “original article,” in the _Army and Navy

Medical Record_--a fraudulent publication that offered its editorial

pages for sale. Physicians are now receiving from the Waterbury

Chemical Company a reprint of what purports to be an editorial from

the _Army and Navy Medical Record_ entitled, “One of America’s Most

Valuable Preparations.” The preparation, of course, is “Waterbury’s

Compound.” The company in sending out this reprint also reproduces

on the reverse side the title-heading of the _Army and Navy Medical

Record_. All of which goes to show that some concerns not only do not

mind being found in bad company, but seem proud of it. By the way,

we wonder whether those physicians who are still prescribing this

nostrum think they are prescribing a preparation containing cod-liver

oil!--(_From The Journal A. M. A., Nov. 15, 1913._)

COLLYRIUM-WYETH

“I should be glad of any information about Wyeth’s Collyrium and

would also like to know if the position taken by this concern

measures up to the requirements of the Council on Pharmacy and

Chemistry.”

This inquiry was received from a Boston physician, who enclosed with

his note the letter quoted below that he had received from John Wyeth &

Brother, Philadelphia, the makers of the preparation in question:

“We have your letter of the 22d inst., in which you request us to

send to you formula for ‘Collyrium,’ and in reply thereto, beg to

advise, being a corporation you will, we think appreciate why we

are not at liberty to disclose the various formulas under which our

preparations are made. Such is the competition in the trade that

secrecy in this respect is a valuable asset.

“You will not for a moment think that we take this position through

any distrust of your discretion or good faith, but because we feel

that our duty to the stockholders of the company prohibits us from

disclosing our formulas.

“Let us assure you however, that the eyewash contains only the

simplest and most harmless remedies well known to the medical

profession.”

John Wyeth & Brother seek the patronage of the medical profession and

desire physicians to use their preparations, but “being a corporation”

they “are not at liberty to disclose the various formulas” of these

preparations. In other words, they expect physicians of the country to

prescribe “patent medicines” of whose composition they must be ignorant

and to rely wholly on the word of John Wyeth & Brother as to the

innocuousness of these products.

The letter is an insult to the physician to whom it was written. If

physicians were not so apathetic in cases of this kind, the corporation

of John Wyeth & Brother would long since have been forced “off the

fence”--it would have become either a “patent medicine” concern or

would have confined its activities to the manufacture of pharmaceutical

products and ethically exploited proprietaries. Now what about this

Collyrium-Wyeth? It was analyzed in the Chemical Laboratory of the

American Medical Association and the chemists report:

“The specimen of Collyrium-Wyeth examined was a clear, colorless

liquid having a faint odor like benzaldehyd. Qualitative tests

demonstrated the presence of antipyrin, free boric acid and sodium

borate. Acetanilid, ammonium salts, glycerin, nitrates, phosphoric acid

and pyramidon were absent. Such potent alkaloids as atropin, cocain,

homatropin and pilocarpin, which are often used in ocular surgery, were

not found. Preparations of goldenseal were not present. Quantitive

examination indicated that the composition of the preparation examined

is essentially as follows:

“Antipyrin 0.41 gm.

“Sodium borate 0.55 gm.

“Boric acid 2.14 gm.

“Water (by difference) to make 100.00 c.c.”

The secret of such a formula must indeed be a “valuable asset!” We

venture the assertion that if the medical profession did its duty, the

corporation of John Wyeth & Brother would find that its “duty to the

stockholders of the company” constrained it to abandon secret “patent

medicines” and to confine its activities to a legitimate line of

pharmaceutical products. An examination of the firm’s pricelist reveals

but a very few secret-formula preparations of the type represented by

Collyrium, hence it would probably not seriously damage the business

of the firm either to eliminate all such formulas from its pricelist

or to enable the physician to use them intelligently, if they deserve

it.--(_From The Journal A. M. A., May 17, 1913._)

DIATUSSIN

Dr. I. Fleiss, New York, writes:

“Please state the value of Diatussin, of Bischoff & Co, in pertussis.

Since pertussis is such an intractable disease, anything which

promises improvement is apt to attract the physician’s attention.”

According to an advertising circular, issued by E. Bischoff & Co,

purporting to be a “reprint from the _Munich Medical Weekly_,”

Diatussin is “... a dialysate of Herbæ Thymi and Pinguiculae.” The

latter is said to be known in the Alps as “blue fatweed.” The only

further information as to the composition of this preparation is the

statement that “the dialysate of this blue fatweed is said by the

manufacturer to contain a proteolytic ferment.” The writer of the

article recounts how, after trying a host of remedies, he finally had

such success in the treatment of whooping-cough that “... a whole

procession of mothers with children affected by whooping-cough came

to me from a neighboring village, only because several children from

this place had been quickly cured by the dialysate.” Nevertheless,

while the “procession of mothers” appears to have been impressed by

the virtues of Diatussin, the writer of the article, rather modestly

for contributors of this sort, admits that “I am, of course, well

aware, that the small number of cases under my observation allows of no

decisive conclusion; it is only the object of these lines to interest a

wider circle in tests.”--(_From The Journal A. M. A., May 17, 1913._)

ENTERONOL

The “Greatest Germicide Known to Science!”

This preparation is put on the market by the Enteronol Company, Oswego,

N. Y., which declares that Enteronol is “the greatest antiseptic and

germicide known to science,” and that it “destroys the germs of typhoid

fever, acute and chronic diarrhea, dysentery, cholera infantum, cholera

morbus, summer complaint, Asiatic cholera, etc., within two hours.”

The formula furnished by the company reads as follows: “Ipecac, sub.

nit. bismuth, latalia rad., camphor, lupulin, caffein and rheum.” The

attention of the Council on Pharmacy and Chemistry of the American

Medical Association was directed to this preparation by a correspondent

who had received a circular from the Enteronol Company. He sent a

dollar to the company asking for a sample of “latalia rad.” that he

might study the drug botanically, as he was unfamiliar with it. He

expected to receive by return mail a sample of root or bark, but

instead, he received three boxes of Enteronol and the information that

as “latalia rad.” costs from $25 to $45 a pound the company could not

afford to send samples. In a circular letter sent out by this company

“latalia rad.” is said to grow on the sides of the Himalaya Mountains

in India, and that the company is unable to obtain enough for its own

use. This statement is probably correct, and no one else could secure

the drug either. A sample of Enteronol was submitted to Professor

Day, of the University of Illinois, and to Professor Kraemer of the

Philadelphia College of Pharmacy. Professor Day reports that he was

“unable to find any mention of the drug of ‘latalia rad.’ which is

stated as one of the ingredients of this preparation. I have searched

the usual works of reference on pharmacognosy without being able to

find any reference to a drug of this name. A microscopic examination

of the tablets shows the presence of rhubarb and of ginger, but no

lupulin, at least not in substance; nor could I locate definitely any

ipecac, also stated to be one of the ingredients. Since ginger is not

stated to be one of the ingredients of the compound, it, perhaps, may

be the mysterious stranger ‘latalia rad.’ I was unable to locate any

of the ordinary astringent drugs, such as kino, krameria, or nutgall.”

The results of Professor Kraemer’s examination were practically

identical with those obtained by Professor Day. A report from the

chemical laboratory of the American Medical Association states that

as Professors Kraemer and Day suggested the presence of alum, tests

were made for this substance. The analysis, details of which are

given, leads to the conclusion that alum is the chief constituent of

Enteronol. The report adds strongly to the impression that “latalia

rad.” is simply a ruse to catch the unwary and trusting physician who

lacks the time to look into the botany of every new plant discovered,

and who is willing to trust the honesty of every manufacturer.

Attention is also directed to the fact that while bismuth and caffein

are mentioned as ingredients tests made in the laboratory failed

to discover either of these substances. Since there is no lupulin,

no ipecac, no caffein, no bismuth, and possibly no “latalia rad.”

one is forced to the conclusion that the “formula” is meaningless

and worthless, and that it is simply used to satisfy the demand

for formulas for proprietary remedies. This is one more beautiful

illustration of the absurdity of accepting a preparation because the

“formula is on every package.”--(_Abstracted from The Journal A. M. A.,

March 21, 1908._)

An Invitation to The Journal to Humbug the Profession

The Journal has received a circular letter from the Enteronol Company,

in which the following liberal offer is made:

“We are willing to take one-fourth or one-half page ‘ad’ in your

Journal for a year at the regular rate, on condition that you

accept payment therefor in our GUARANTEED 7 per cent., preferred

stock at par; or if you desire, in ENTERONOL at the net wholesale

price to physicians.”

Not that this offer is made exclusively to The Journal:

“A large number of medical journals have accepted the foregoing

proposition; many carrying this advertising for several years

already.”

“Our company is cooperative; we paying no cash for advertising. The

company is owned principally by physicians, medical journals, and

druggists.”

The journals of which we have record that carry the enteronol

advertisement are: _Kansas City Medical Record_, _Milwaukee Medical

Journal_, _Toledo Medical and Surgical Reporter_, _Proctologist_,

_Pediatrics_, and the _Atlanta Journal-Record of Medicine_. If the

statements made by the Enteronol Co. are true, we might infer that

these journals are being paid for advertising space either with

“preferred stock” or with the nostrum itself. As we have previously

shown, however, the veracity of the enteronol advertising matter is by

no means unimpeachable.

Enteronol, it will be remembered, was exposed in The Journal, March 21,

1908. It is advertised as the “greatest antiseptic and germicide known

to science,” and possesses (?) such remarkable power that it “destroys

the germs of typhoid fever, acute and chronic diarrhea, dysentery,

cholera infantum, cholera morbus, summer complaint, Asiatic cholera,

etc., within two hours.” “The original product is found only high up

on the sides of the loftiest mountains in the world--the Himalayas of

India.”

THE “LITERATURE” FORMULA

Of course, it has a “formula”:

Ipecac Lupulin

Sub. nit bismuth Latalia rad. Caffein

Camphor Rheum

This seems very open and above board, except as to quantities, until

one tries to find out what “latalia rad.” is; then it is discovered

that it is the “mysterious stranger” of pharmacognosy. Experts to

whom this “remedy” was submitted were unable even to find mention of

such a drug or plant as “latalia rad.” Nor was this the only fake

found concerning the stuff; carefully conducted experiments repeatedly

carried out in the Association’s laboratory failed to disclose even a

trace of bismuth subnitrate or caffein. These experiments did show,

however, that the tablets contained an amount of aluminum corresponding

to over 25 per cent. of crystallized alum. This led to the conclusion

that alum, whose presence is not even hinted at in the “formula,” is

the chief constituent of enteronol and as a corollary that the formula

is meaningless and worthless.

THE LABEL FORMULA

There is a curious lack of coordination between the “formula” as

printed on the label and that given in the “literature.” The Food and

Drugs Act, it will be remembered, makes lying on the label illegal, and

therefore dangerous; statements in advertising matter that does not

accompany the product, however, are not controlled by that law. The

“formula” in the “literature” we have already given; the “formula” on

the label gives the following ingredients:

Ipecac Lupulin

Sub. nit. bismuth Opium, 1/4 gr. Caffein

Camphor Rheum

Two things about this are worth noting: One is that the name of the

ingredient on which the manufacturer lays so much stress--latalia

rad., the mysterious Himalayan plant--is absent from the label. This

would seem to indicate that what has already been intimated by The

Journal--namely, that latalia rad. is a figment of the imagination--is

a fact. The second noticeable thing about the label “formula,” as

distinct from the “formula” in the advertising matter, is that on the

label we find there is opium in the preparation. Why is no mention made

of the presence of this potent drug in the advertising matter?

To determine how nearly the present statements made by the Enteronol

Company approximate truthfulness, our chemists were asked to examine

the nostrum as it is now sold. Their report follows:

LABORATORY FINDINGS

An original package of enteronol tablets was purchased on the open

market and submitted to the Association laboratory for examination.

In general appearance, odor and taste the new tablets are similar

to those previously examined. The formula for the old tablets was

given as “Ipecac, Sub. nit. bismuth, Latalia rad., Camphor, Lupulin,

Caffein, Rheum,” and is still used in the circular. But the label

on the trade package no longer mentions “latalia rad.” Since the

presence of “latalia rad.,” in the old tablets, was questioned,

and as new labels have ceased to display the name, it was thought

possible that caffein and bismuth might now be constituents of

enteronol, as the drugs are still mentioned in the new formula on the

label. Accordingly, enteronol was examined chemically to verify the

statements on the label regarding the presence of caffein and bismuth

in the tablets.

The specimen submitted to the laboratory some time ago was found to

contain neither bismuth nor caffein. By employing the same methods

as were used before (the usual tests for detecting caffein and

bismuth), neither caffein nor bismuth could be demonstrated. It is

thus evident that this new specimen of enteronol, the statement on

the label to the contrary notwithstanding, contains neither bismuth

nor caffein--at least, in appreciable quantities.

One would think that the discrepancy between “formulas” and facts

would prove of interest to the stockholders of the Enteronol Company,

especially as we are told that the policy of the company is to have

“practical men as stockholders.” We are informed:

“Therefore, we have physicians, advertising experts, printers,

publishers, engravers, boxmakers, lithographers, druggists,

lawyers, traveling salesmen, officers and men holding executive

positions in various manufacturing and commercial corporations,

editors of medical publications, bishops, clergymen and

missionaries--men from all the fields particularly valuable

commercially for our great enterprise.”

Yet if the physician-stockholders do not care to concern themselves

about the composition of the nostrum from the sale of which they derive

dividends, it can hardly be expected that the boxmakers or traveling

salesmen will be interested.

STOCK FOR SALE

Medical journals are not alone in being invited to participate in

the exploitation of this nostrum, _vide_ a circular letter from the

Enteronol Company addressed “To Investors”:

“We offer at par of $10 each, 1,000 shares of our Guaranteed 7 per

cent. Preferred Stock, cumulative dividends, payable quarterly ...

Profits on business done last year were 54 cents for every dollar

expended ... _We guarantee absolute security for your investment.

Safer than a bank._” [Italics ours.--Ed.]

We are told that at present the Enteronol Company manufactures two

products: a castor-oil preparation, known as fig-ol, and enteronol.

Very shortly, however, the company expects to “add seven equally

efficient products.”

“The average cost to manufacture, ready to ship, a dollar’s worth

of these goods is less than ten cents.”

“In enteronol alone, the company has fortunes and the only thing

needed to bring tremendous results and dividends of 100 per cent.

is the proper amount of judicious advertising.”

Here are some samples of the judicious (?) advertising:

“One Christian missionary, the Rev. Paul Singh of Jubbulpore,

India, testifies that he cured thirteen severe cases of Asiatic

Cholera with a box containing less than thirty tablets” [of

enteronol].

“Wm. F. Oldham, bishop of Southern Asia, writes us that enteronol

cured nine cases out of ten of Asiatic Cholera. Now just think of

India and China with their 800,000,000 people who are dying by the

thousands of a disease which we have the power to cure so easily.”

How like a discourse by that delightful character of Mark Twain’s--the

visionary Colonel Sellers--this reads. As he said about his

“Infallible, Imperial, Oriental Optic Liniment”:

“Why in the Oriental countries ... every square mile of

ground upholds its thousands on thousands of struggling human

creatures--and every separate and individual devil of them’s got

the ophthalmia.”

The prospective stockholder is told that an ordinary business concern

reaches the limit of financial possibilities in a few years, but:

“Not so with the Enteronol Company--it is a mail-order business and

the world is its territory.”

Even so with Colonel Sellers’ “Optic Liniment”:

“... it’s a patent medicine whose field of operations is the solid

earth.”

And we are told elsewhere that “about four-fifths of the outstanding

stock is held by the medical profession alone”!

And this stuff is advertised in medical journals!!

We are sometimes in danger of being too optimistic regarding the

results of the propaganda for reform in proprietary medicine. Cases

like this act as a corrective.--(_From The Journal A. M. A., Nov. 20,

1909._)

EXPURGO (SANOL) ANTI-DIABETES

One More Fraudulent Nostrum for Diabetes

Expurgo Anti-Diabetes is sold and advertised in the United States

by the Expurgo Manufacturing Company, Chicago. The concern is the

United States branch of a Canadian company, the Sanol Manufacturing

Company, Ltd., Winnipeg, which sells its product in Canada under the

name of “Sanol Anti-Diabetes.” The parent company is said to have

been incorporated under the Manitoba laws in 1912 and to have for its

officers and directors the following men:

Charles Beyer, President.

Frank Beyer, Vice-President.

Charles Bauer, Secretary-Treasurer and Manager.

The manager of the United States branch in Chicago is said to be one

E. M. von Amerongen.

The stuff is such an evident fraud that one would imagine that

even intelligent laymen could not be deceived by it. Nevertheless

medical journals both in the United States and Canada have accepted

advertisements for this preparation and physicians--of a certain

type--have been found to give testimonials for it. The medical

profession is circularized widely by the concern and “write-ups” have

appeared in pseudomedical journals. Some of the claims made for Expurgo

Anti-Diabetes are:

“The only positive cure for Diabetes.”

“It never fails to effect a Cure in every case of this disease, in

whatever form it may present itself provided the patient has not

reached the last stages of the malady.”

“Expurgo Anti-Diabetes is the New Cure for this deadly affliction.”

“Diabetes is certainly curable by our new discovery--Expurgo

Anti-Diabetes, provided that the course of the disease has not

progressed to the extent that the vital organs are irreparably

damaged.”

“... thanks to the discovery of Expurgo Anti-Diabetes, the cure of

this dread disease is no longer a matter of doubt.”

“With the exception of very advanced cases of Diabetes ... all

diabetes can be cured by Expurgo Anti-Diabetes.”

Such claims one would imagine would be more than sufficient to

make plain, even to the most uncritical of physicians, the evident

fraudulence of Expurgo Anti-Diabetes. Nevertheless, the advertisements

of this fraud have appeared during 1913 in the following medical

journals:

_Medical Times_

_Medical Brief_

_Medical Summary_

_Buffalo Medical Journal_

_Louisville Monthly Journal_

_Iowa Medical Journal_

_Canada Lancet_

_Detroit Medical Journal_

_Medical Herald_

_Medical Review of Reviews_

_Medical Standard_

_Medical Review_

_Therapeutic Record_

_Medical Fortnightly_

_Indianapolis Medical Journal_

_Southwest Journal of Medicine and Surgery_

_Western Canada Medical Journal_

_Dominion Medical Monthly_

_Canadian Medical Association Journal_

_Canadian Practitioner and Review_

_Massachusetts Medical Journal_

Physicians will recognize that, with but few exceptions, most of these

journals are utterly unrepresentative of scientific medicine.

The _Army and Navy Medical Record_, shown in The Journal recently

as a journalistic fraud, contained an editorial puff of Expurgo

Anti-Diabetes. The fact that the Expurgo Company reprints the

“editorial” from the _Army and Navy Medical Record_ as a “voluntary and

unsolicited reference” and distributes it among physicians, indicates

how rotten are the props on which the superstructure of this fraud rest.

Another alleged “voluntary and unsolicited reference” used by the

Expurgo Company is taken from the _Therapeutic Record_ of Louisville,

Kentucky. The advertising pages of the _Therapeutic Record_ reek with

frauds and it has more than once given editorial endorsement to some

of the frauds that it advertises. The following enlightening letter is

alleged to have been written by the editor of the _Therapeutic Record_

to the Expurgo Company in February, 1913:

_Gentlemen_:--Your favor of February 14th came duly to hand. Let me

advise you to pay no earthly attention to the proceedings of the

Medical Society where your product was criticized. These people

exert no influence with the practical up-to-date element of the

profession and are doing you as they do others. _Never fear--you

will succeed--your remedy is all right. No man can talk down a

meritorious product. I stand ready to help you in any way at any

time._

With sincere regards, I am,

Robert C. Kenner, M.D.,

Editor, the _Therapeutic Record_.

This, it will be noticed, was written in February. Soon thereafter the

_Therapeutic Record_ was carrying the Expurgo advertisement, and the

June, 1913, issue contained a puff on Expurgo, entitled “A Contribution

to the Medical Treatment of Diabetes.” The _quid pro quo_ is fairly

evident.

THE ALLEGED FORMULA

The formula for this nostrum is never published, although in some

of the advertising matter it is claimed that it is “at the disposal

of physicians.” A physician wrote to the Expurgo Manufacturing

Company, asking for the formula. He was told that the preparation was

“exclusively derived from the vegetable kingdom,” from which one may

recognize a family likeness to the “dope” put out by the immortal Lydia

Pinkham. Further, to copy the letter exactly:

“The ingredients of which Antidiabetes is composed are chiefly:

“fructus syzigii jambulani

“cortex syzigii jambulani

“flores Rosmarini

“fructus Anisi stellati

“Extr. fl. Colæ

“Extr. fl. Condurango

“Extr. fl. Chinæ spir. spiss.

“Extr. fl. Calami

“Extr. fl. Gentianæ.”

The recipient of this noncommittal and uninforming “formula” again

wrote the Expurgo Manufacturing Company, asking for quantities.

Evidently this nostrum concern considered such a request a piece of

impertinent inquisitiveness, for it replied to the physician in these

terms, given _verbatim et literatim_:

“_Dear Sir_:--Yours of the 16th duly to hand. We note that you

state ‘... I do not like to be working in the dark, and you can

readily see that this is the case unless I know how much of each

ingredient I am giving....’

“In your letter of the 6th you asked for the composition, which

you promptly received. We would like to state that we are dealing

with about 600 Doctors. Some of them asked for the formula, which

they received. They are all very conscientious gentlemen and none

of them ever pretended ‘to work in the dark.’ You know furthermore

that none of these ingredients is harmful in any way and yet ‘work

in the dark.’ You know that if there were any harmful ingredients

in our preparations, we would expose ourselves to imprisonment.

If you are so anxious to know all about it, why do you not

analyse our medicine? This would enlighten you in your ‘perfect

darkness.’ If you want to deprive your patients and yourselves of

the indisputable good of our preparations, simply do not prescribe

them. Why finally do you not write to the Doctors whose names we

gave, who know enough to be able to enlighten those who need it.

Truly yours

The Expurgo Mfg. Co.,

C. M. v. Amerongen, Manager.

More than a year ago, a Wisconsin physician, himself a sufferer from

diabetes, wrote The Journal that for three months he had been using

Expurgo Anti-Diabetes which the Expurgo people had sent him. He

declared that the nostrum had greatly reduced the percentage of sugar

in his urine. In its reply, The Journal asked him whether, in testing

his urine he had used portions of twenty-four hour specimens or merely

individual specimens. His attention was called to the fact that most of

the nostrums for diabetes are diuretics which, by increasing the amount

of urine passed, give an apparent decrease in the amount of sugar

excreted. A few days later, the physician wrote again, stating that he

had committed the very error The Journal had suspected, and reporting

that an examination of a twenty-four-hour specimen showed that the

glucose-excretion, instead of being diminished, actually increased.

This matter was referred to editorially in The Journal, Nov. 9, 1912,

under the title, “A Possible Fallacy in Testing Diabetic Urine.”

Specimens of Expurgo Anti-Diabetes were examined in the Association’s

laboratory and the chemist’s report follows:

LABORATORY REPORT

[Illustration: The letter head of the Expurgo Manufacturing Co. Note

the claim that Expurgo Anti-Diabetes is “the only positive cure for

diabetes.” And this stuff is foisted on the profession through the

medical press!]

“The specimen of Expurgo Anti-Diabetes (Sanol Anti-Diabetes)

examined, was a light-brown, opaque liquid, having a faintly aromatic

odor and bitter taste. The specimen contained considerable amounts

of brown, insoluble residue resembling the deposits often found in

fluid extracts. The absence of ammonium salts, iodids, glycerin,

hexamethylenamin, of antipyrin, pyramidon and similar substances and

of such purgatives as aloes, frangula, rhubarb, etc., was indicated.

Potent alkaloids such as aconitin, cocain, morphin and strychnin

were not found. Qualitative tests indicated the presence of traces

of phosphates, sulphates, reducing sugars, caffein and cinchona

alkaloids. Alcohol was present only in traces. Small quantities of

chlorids, sodium and a salicylate were found. The residue on drying

amounted to 2.9 gm. in each 100 c.c. A determination of the salicylic

acid indicated approximately 0.17 gm. in each 100 c.c., which is

equivalent to less than 0.2 gm. of sodium salicylate per 100 c.c.

(about 1 grain to the ounce). Evidently the preparation contains

plant extractives in aqueous solution and small amounts of sodium

salicylate and sodium chlorid.”

Summed up, the chemist’s report shows that Expurgo Anti-Diabetes

is essentially a watery solution of plant extractives with small

quantities of sodium salicylate and salt. The exploiters claim their

stuff contains the fruit and bark of jambul, rosemary, star anise and

fluid extract of calamus, cinchona, cola, condurango, and gentian.

Since fluidextracts in general are strongly alcoholic and since the

laboratory’s analysis shows that the preparation contains only traces

of alcohol, the fluidextracts of the various drugs, if present at all,

must be in an infinitesimal amount.

Jambul was in vogue as a remedy for diabetes about twenty years ago. It

was tried and found wanting, and has long since been relegated to the

therapeutic scrap heap. Sanol, therefore, is but one more proprietary

humbug, foisted on the profession under fraudulent claims, and having

for its essential constituent a drug that has long been discarded by

scientific men and resurrected for the purposes of quackery. Expurgo

will probably be used by uncritical and unthinking physicians and

its existence will be artificially prolonged through the venality of

pseudo-medical journals. That the medical profession should tolerate

such an evident fraud is not to its credit. There is no excuse, either

moral or otherwise, for a physician giving his patients nostrums of

whose composition he is ignorant, and that is what is done whenever

Expurgo Anti-Diabetes is prescribed.--(_From The Journal A. M. A., Jan.

24, 1914._)

FORMAMINT

The Profession to Be Worked Again

Formamint Tablets are widely advertised and extravagantly exploited to

the laity in Great Britain. Large and expensive advertisements appear

in the English magazines and newspapers and the tablets are pushed

under the most preposterous claims. The preparation is put out, we

understand, by the same concern that exploits Sanatogen. The medical

profession of this country is now being circularized and advertisements

are appearing in medical journals. They already appear in the _Medical

Record_, _New York Medical Journal_ and _American Journal of Clinical

Medicine_.

It seems then that this is another product which, for the time being at

least, is to be a “patent medicine” on the other side of the Atlantic

and an “ethical proprietary” on this. Doubtless the distinction will

be a temporary one and as soon as American physicians have furnished

the requisite number of testimonials and have recommended it to a

sufficient number of their patients the advertisements will be quietly

dropped from the American medical journals and the advertising pages

of newspapers and magazines will be called into service.--(_From The

Journal A. M. A., Jan. 27, 1912._)

The So-Called Germ-Killing Throat Tablet

Formamint tablets have recently been put on the American market by

the same concern that exploits Sanatogen, the “food tonic” or “tonic

food”--according to whether one reads European or American newspapers.

Formamint tablets are being introduced to the American public by that

cheapest of all methods of advertising “patent medicines,” through the

medical profession. It is not advertised in American newspapers or lay

magazines--at present. For some years this product has been advertised

in newspapers and other periodicals in Europe under such claims as the

following:

“Formamint shields humanity against infectious disease.”

“Cures and prevents sore throat.”

“The dangers of infection from diseases like diphtheria, scarlet

fever, measles, tonsillitis, sore throat, mumps, etc., have now

been reduced to an absolute minimum. This is due to the discovery

of Wulfing’s Formamint--the ‘germ-killing throat tablet.’”

“Cleanses the mouth and throat from disease germs as easily and

rapidly as dirt is removed from the skin.”

“Formamint will certainly prevent diphtheria.”

“Quickly render the whole mouth and throat thoroughly antiseptic.”

“Formamint destroys these [diphtheria] germs so rapidly that when

a physician mixed a little Formamint with water and added it to

the germs taken from the throat of a patient dangerously ill with

diphtheria they were all killed within ten minutes.”

Such are some of the claims by which Formamint goes to the European

public. Doubtless it will be only a matter of time when the required

number of testimonials from American physicians are forthcoming when

we may expect to find the newspapers of this country heralding through

their advertising pages the fact that Formamint is “recommended by

thousands of American physicians.” The medical journals that are

lending their pages to this preliminary advertising campaign are the

following:

_New York Medical Journal_

_Medical Record_

_American Medicine_

_American Journal of Clinical Medicine_

_Medical Review of Reviews_

How much longer will the medical profession permit itself to be used

as an unwitting agency for the exploitation of “patent medicines”? The

game has been worked so often that it has become transparently thin. It

is evidently not worn out, however, or shrewd nostrum promoters would

not waste their time or money on it. That it should still be considered

workable is complimentary neither to the standard of advertising ethics

of medical journals that accept the Formamint advertisements nor to the

intelligence of the members of the medical profession who will “fall

for it.”--(_The Journal A. M. A., Feb. 24, 1912._)

GOMENOL

A correspondent sends some advertising matter on Gomenol and calls

attention to the number of diseases for which the preparation is

recommended:

Gomenol is apparently a volatile oil. It is a proprietary said to come

from France, and to be prepared from a species of cajuput (_Melaleuca

viridiflora_, Gaertn.). This plant is closely related to the cajuput

tree or swamp tea-tree (_Melaleuca leucodendron_, Linné) from which the

official oil of cajuput is obtained. The oils from these two plants are

very similar in composition and presumably in therapeutic properties.

The oil of the first-named plant appears not to be marketed except

in the form of the proprietary, Gomenol. It probably has no advantage

over the official oil of cajuput, while in the form of Gomenol it costs

about four times as much. The following are some of the claims made for

Gomenol in the advertising circulars. They need no comment.

“A real specific for suppurations and catarrh.... It immunizes

tissues, excites their vitality and favors the formation of new

cells....

“The least trace of Gomenol prevents the growth _in vitro_

of the streptococcus, the tuberculous bacillus and the

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

HEADACHE CURES[AV]

Harmful Effects of Acetanilid, Antipyrin and Acetphenetidin

[AV] See also report on Acetanilid Mixtures, p. 9.

The United States Department of Agriculture Bulletin[107] No. 126,

issued July 3, 1909, sets forth the results of an investigation

conducted by the Bureau of Chemistry with regard to the harmful effects

of acetanilid, antipyrin and acetphenetidin. During recent years the

use of these remedies and preparations containing them by the people at

large, without the supervision of the physician, has increased rapidly

and investigation has shown that coincidently there has been a marked

increase in the number of cases of poisoning reported, in the number of

fatalities, and in the number of instances of habitual use.

[107] The Harmful Effects of Acetanilid, Antipyrin and Phenacetin,

by L. F. Kebler, Ph.G., M.D., chief Division of Drugs, Bureau of

Chemistry, with the collaboration of Drs. F. P. Morgan and Philip Rupp,

assistant chemists.

Since the passage of the Food and Drugs Act, June 30, 1906, the

attention of the Department of Agriculture has been directed to this

subject, particularly in connection with the branding of drug products

containing one or more of these agents, and an attempt has been made to

obtain full and reliable data with regard to their poisonous qualities

with the object of furnishing information to the public which would

enable them to understand that these remedies should be employed with

caution in the absence of reliable medical advice.

The information obtained with regard to the number of an inquiry

addressed to medical practitioners in the United States with regard

to their personal experience with these drugs; and, second, the study

of the cases of poisoning recorded in medical literature. Nearly a

thousand letters, each containing eighteen questions, were addressed by

the department to physicians throughout the country, the object being

to secure information which would represent as closely as possible the

conditions existing among the people at large so far as the harmful

effects of the drugs in question are concerned. Four hundred replies

were received.

The information obtained with regard to the number of instances quoted

in medical literature in which poisoning, death, or habitual use has

been known to result from the administration of acetanilid, antipyrin,

and acetphenetidin is set forth in Section A of the accompanying table.

The information summarized in Section B is based on the data submitted

by physicians. Granting that the 525 physicians who did not reply

had no cases to report, the question may profitably be asked, if 925

physicians have observed 814 cases of poisoning by these drugs, 28

deaths which are attributed to their use, and 136 instances of habitual

use, how many such cases have in all probability been observed by the

125,000 physicians scattered throughout the United States? The summary,

C, includes both the number of cases recorded in medical literature and

those reported by physicians.

POISONING BY ACETANILID, ANTIPYRIN AND PHENACETIN

A.--Cases Recorded in Medical Literature

HABITUAL

POISONING. DEATH. USE.

Acetanilid 297 13 32

Antipyrin 488 10 ..

Acetphenetidin 70 3 1

--- -- --

Total 855 26 33

B.--Data Submitted by Physicians

HABITUAL

POISONING. DEATH. USE.

Acetanilid 614 16 112

Antipyrin 105 5 7

Acetphenetidin 95 7 17

--- -- --

Total 814 28 136

C.--Total Number of Cases

HABITUAL

POISONING. DEATH. USE.

Acetanilid 911 29 144

Antipyrin 593 15 7

Acetphenetidin 165 10 18

---- -- ---

Total 1,669 54 169

The bulletin contains information with regard to dosage, the extent to

which these drugs are employed by physicians, poisoning and habitual

use, the nature of the ill effects produced, etc. It also contains

references to the recorded cases of poisoning, together with a brief

abstract of each case.--(_From The Journal A. M. A., July 31, 1909._)

Sanatoriums and the Acetanilid Habit

_To the Editor_:--I enclose herewith a “form” letter and question blank

which I received recently from St. Louis. I may be entirely too wary

but I am suspicious that this is a collection of “statistics” to combat

the work of the medical profession in educating the physician and the

laity in the harmfulness of acetanilid and similar preparations.

G. H. Benton, M.D., Chester, W. Va.

Sterling-Worth Sanitarium.

Comment: The letter which Dr. Benton encloses is in facsimile form

and purports to come from Uriel S. Boone, M.D., of St. Louis, who

states that he is “preparing an exhaustive article for publication

in a leading medical journal” on the question, “Is acetanilid a

habit-forming drug?” To obtain the necessary data Dr. Boone is “writing

to every hospital and sanitarium in the United States.” Examination of

the question blank which accompanies the form letter discloses the fact

that information is wanted regarding not acetanilid alone, but also

antipyrin and acetphenetidin (phenacetin). The last question asked runs

as follows:

“If your records [of cases of habitual use of these drugs] are

incomplete, would you allow a reputable physician to investigate

the above-mentioned cases so that he could write with positiveness

about them, and, if necessary, _make oath to the truth of his

report_?” [Italics ours.--Ed.]

Dr. Boone opines that the recipients of his queries “may hesitate to

answer” the question just quoted, but he trusts that its importance

will be evident when he explains that “it is currently reported that

the manufacturers of acetanilid, phenacetin, etc., _have decided to

prosecute all libelers of these drugs_” [Italics again ours.--Ed.] and

he wishes to make no statement that he “can not substantiate under

oath.” Surely the life {of} the collector of medical statistics is

unusually hazardous.

For the purpose of aiding Dr. Boone in his arduous search for truth

on the “much mooted question, ‘Is acetanilid a habit-forming drug?’”

we direct his attention to a work that should prove of invaluable

assistance. We refer to Bulletin 126 of the Bureau of Chemistry,

entitled “The Harmful Effects of Acetanilid, Antipyrin and Phenacetin.”

This interesting study to which we have previously called attention

records 112 cases of the acetanilid habit. Of this number at least

50, or 44.6 per cent. of the cases were those of patients who took

proprietary preparations of the drug.

From this we would not wish to give any bias to Dr. Boone’s statistics.

We hardly expect, however, that such will be the case. Dr. Boone’s

name appears as the author of an article entitled “A Therapeutic

Study of Antikamnia and Heroin Tablets”--an article that has been

very extensively “quoted” and has been sent out in its entirety by

the Antikamnia Chemical Company. Under these circumstances we may be

forgiven if we venture the opinion that Dr. Boone is not likely to

be unduly prejudiced against “headache tablets” in general and fake

“synthetic” coal-tar mixtures in particular. We await with breathless

interest the appearance of Dr. Boone’s “exhaustive article” and we must

confess to some degree of curiosity regarding the name of the “leading

medical journal” in which these valuable data will appear.--(_Modified

from The Journal A. M. A., Aug. 14, 1909._)

HECTINE

Hectine is a French proprietary and is stated to be, chemically, sodium

benzosulphoamino-phenyl-arsenate. If the asserted composition is

correct, Hectine is similar to atoxyl, which is described in New and

Nonofficial Remedies, 1914, page 38. Hectine has not been examined by

the Council on Pharmacy and Chemistry.--(_From The Journal A. M. A.,

Aug. 8, 1914._)

HYDRONAPHTHOL

A correspondent having requested information regarding the composition

of “Hydronaphthol,” the product was investigated in the Association

laboratory, which reports as follows:

Hydronaphthol is sold by Seabury & Johnson. The label on a trade

package of Hydronaphthol gives no clew as to the nature of the

product. The statements on the labels do, however, make the claim

that Hydronaphthol is an antiseptic of great power, also that it is

non-toxic and therefore may be used with impunity; thus the following

statements are made:

“A harmless, practically odorless, non-poisonous, non-corrosive

antiseptic....”

“... it is non-poisonous and can be employed with perfect immunity

as a preservative....”

The substance has the characteristic appearance, odor and taste

of naphthol. It responded to all the tests of the United States

Pharmacopeia for betanaphthol, with the exception of the melting

point, which was found to be 119 C. instead of 122 C., an indication

of impurity. It is evident, therefore, that Hydronaphthol is merely a

trade-name for betanaphthol. While resublimed betanaphthol is listed at

10 cents an ounce, Hydronaphthol is listed at 75 cents an ounce.

Hydronaphthol thus furnishes one more illustration of the fact that

most proprietary medicines for which the most extravagant claims

are made are but old and well-known remedies sold under a fancy

name at a price far in advance of that charged for the constituent

or constituents. The exploiters are extremely positive in their

statements regarding the non-toxic character of the preparation. Yet,

as a matter of fact, betanaphthol is by no means harmless; it has

been absorbed by the diseased skin with injury to the kidney and with

fatal results. In some cases injury to the eye has also occurred.

These toxic actions should be known to the practitioner. From 3

to 4 gm. (1 dram) applied to the skin has produced death (Stern:

_Therap. Monatshefte_, 1900, p. 165). When a manufacturer advertises

a preparation which possesses potentialities for harm, and especially

when he puts it out under a name which conceals its identity, it

is incumbent on him to warn the customer of possible injurious or

inconvenient actions instead of proclaiming that the preparation is

harmless.--(_From The Journal A. M. A., Sept. 3, 1910._)

HYDROZONE

The moral principle governing the action of secret proprietary and

patent medicine men is an unknown quantity; sometimes it would seem to

be a negative one. Just how much lower in the scale of humanity a man

can go than to prey on the fears of a people in the time of a terrible

epidemic for the sake of a few dollars we do not know. There may be

something more despicable, but what is it? Two weeks ago we referred to

the cold-blooded methods of the Peruna people; this week we reproduce

an advertisement from the New Orleans _States_ that tells another story

of man’s inhumanity to man.

[Illustration]

This brings up the problem that we are trying to solve, viz.: “What

is the difference between a ‘secret proprietary medicine’ advertised

in medical journals to physicians and a ‘patent medicine’ advertised

in newspapers to the public?” Hydrozone is being advertised in nearly

all medical journals, and at the same time in newspapers. Where shall

we place it? And if hydrozone, with the methods recently adopted to

exploit it, is tolerated in the medical press, why not peruna?

HYPOQUINIDOL

An examination of the advertising matter fails to show that R. W.

Gardner makes any definite statement in regard to the nature or the

composition of his Hypo-Quinidol. Certain statements made in the

literature sound much as if the article might be some sort of a quinin

hypophosphite preparation. But if this is true, its action would be

the same as other salts of quinin and the extravagant claims made

could not be substantiated. It is said to be a “non-toxic quinin.”

It is safe to say that a quinin which will not produce the toxic

symptoms--cinchonism--either is not absorbed in sufficient quantity or

has been so changed that it no longer has the therapeutic properties of

quinin. Altogether Hypo-Quinidol must be put down as a preparation the

composition of which is kept secret and regarding which extravagant and

highly improbable statements are made.--(_From The Journal A. M. A.,

Jan. 10, 1914._)

IODONUCLEOID

An Iodin Product Under a Misleading Name

Information has been frequently asked concerning Iodonucleoid, a

product not included in New and Nonofficial Remedies. The Association

Laboratory after investigating this preparation reported as follows:

This preparation was at one time considered for inclusion with New

and Nonofficial Remedies, and at that time was examined in this

laboratory. The examination showed that iodonucleoid contains:

Phosphorus 0.79 per cent.

Calcium 0.43 per cent.

(Equal to 0.6 per cent. CaO).

Iodin 24.2 per cent.

When 2 gm. was dissolved in tenth-normal potassium hydroxid

volumetric solution and acetic acid added until faintly acid, an

abundant, white, flocculent precipitate formed. This precipitate

was collected, washed with water, transferred to a beaker,

phenolphthalein added and tenth-normal potassium hydroxid volumetric

solution run in until a pink color was produced. This required

15 c.c. of tenth-normal alkali. Subtracting from the 2 gm. of

iodonucleoid the 24 per cent. iodin, leaves 1.52 gm.; this divided by

the c.c. of alkali used indicates an equivalent weight of 1013.

Authorities differ widely regarding the amount of phosphorus

contained in nuclein from different sources, the figures ranging

from 2.9 per cent. to as high as 10 per cent. If the nuclein from

which iodonucleoid purports to be made contained but 2.9 per cent.

phosphorus, the preparation, after allowing for 24 per cent. iodin,

should still contain 2.2 per cent. phosphorus instead of the 0.79 per

cent. found by analysis. A true nuclein should contain no calcium. If

iodonucleoid is a casein compound of iodin we might expect to find,

if the casein had been freed from milk by acidulation without further

purification, both calcium and phosphorus. The equivalent weight of

casein is given by Long (_Jour. Am. Chem. Soc._, 1906, xxviii, 372)

as 1124. This figure was obtained on a casein of high purity, and the

figure of 1013 given above agrees fairly well with Long’s figure for

casein. The evidence, therefore, indicates that iodonucleoid is a

compound of iodin and casein, and not a nuclein compound.

The findings of the laboratory were at that time submitted to Prof.

John H. Long of Northwestern University, who said:

“We have also made a number of examinations of iodonucleoid. We

determined in it the iodin and found the amount 24.2 per cent. by

weight, which is a little more than that claimed by the manufacturer.

We have also tested the solubility of this substance and find it to

behave about as your laboratory did. As you know, we have been making

a number of preparations from casein, and recently we have determined

the combining power of casein with various acids, including hydriodic

acid. This acid when evaporated in moderately strong solution with

casein yields finally a hard, dry mass, which may be ground up to

a powder resembling very closely the preparation under discussion.

Various amounts of iodin may be combined here, depending on the

strength of the iodin solution used, and we have secured some

containing over 35 per cent. of iodin. Several of these preparations

resemble closely iodonucleoid, so far as solubility, appearance and

reaction with alkalies on titration are concerned. I am unable,

therefore, to distinguish this preparation from the casein compounds

which we are making.”

From this it would appear that iodonucleoid is not a compound of

nuclein, as indicated by the name, but instead is a casein compound of

iodin.

Iodonucleoid, then, seems to be another one of the many iodin

“substitutes” which have been put on the market. Other iodin

substitutes are Iodalbin, manufactured by Parke, Davis & Co.; Iodipin

manufactured by E. Merck & Co., and Sajodin, manufactured by the

Farbenfabriken of Elberfeld Co. As these products have been examined by

the Council and found eligible for inclusion with New and Nonofficial

Remedies, physicians who wish to use substitutes for potassium iodid

would do well to use them instead of a product presented under a

misleading name. Physicians should understand, however, that these

organic iodin compounds are non-irritating because the iodin is held

in such combination that it is much less active. It seems probable

that they are therapeutically active only to the extent that the iodin

content is dissociated from the organic compound and concerted into

ionic iodin.

A discussion of a number of iodin substitutes is found in an article by

von Notthafft (_Monatsh. f. prakt. Dermat._, Oct. 15, 1910, p. 343),

which was abstracted and commented on in The Journal, March 4, 1911,

p. 685. Von Notthafft believes that the lower degree of toxicity which

these remedies exhibit has its basis in a feebler activity; either the

substitutes evolve too little iodin or they split it off with greater

difficulty. Physicians should, therefore, view with some distrust the

claims of manufacturers that their products are not only non-irritating

but at the same time possess unusual therapeutic efficiency. This will

apply with especial force if there is any tendency to conceal the

nature or origin of the combination.--(_The Journal A. M. A., July 22,

1911._)

IRIDIUM

Dr. C. A. Dexter, Columbus, Ga., asks for information concerning the

use of iridium in the treatment of acute and chronic rheumatism.

Iridium is a well-known element although we have not found that it has

been used as a medicine; however, we presume our correspondent refers

to “Iridium (Medicinal),” sold by the Platinum Company of America.

We are not able to locate this company, but in their advertising

circular “Iridium (Medicinal)” is said to be “an agent for the blood,

a laxative, an alterative, indicated in all disorders of the stomach,

in Jacksonian epilepsy,” and “a specific in rheumatism.” As to its

origin, it is said in the circular, “the platinum sands are associated

with and composed of iridium” and some other elements, so that as far

as the circular gives information the nostrum is alleged to contain the

element iridium.