who wrote it knows nothing about medicine and cannot correctly use
the English language: “The qualifications of Medicinal Iridium are
its simplicity, purity, harmless under prolonged use, easily borne by
the stomach.” “It has been observed that when Medicinal Iridium acts
as a laxative, it will regulate the same.” “Called the family group,
Iridium and Osmium are destined to become the world’s benefactors
in medicinal properties, thereby creating a new chapter in medical
science.” The circular quotes some supposed “excerpts from hundreds
of letters on file, written by physicians, in the hope that they may
attract your attention,” which bear marks of having been written
by the same person who wrote the circular. Note the quality of the
following statements: “Iridium has a power, purity and simplicity that
pleases me; now I can make progress.” “I say to you frankly, Iridium
is my standard. I can get results and make progress. I am confident it
aids the fibrin in the blood.” “Dr. X is pushing Iridium on five or
six cases.” It is not explained who Dr. X is, but it has this to say
about him: “Dr. X is an eminent practitioner. He has made a remarkable
record with Iridium and has so far never failed on cases of Jacksonian
epilepsy; experimental tests have shown that Iridium increases
blood-corpuscles.”
The man who signs himself president of the Platinum Company of
America is said to be a lawyer, but is not working at it, and was
formerly a promoter, fiscal agent, etc. It should not be difficult
for the physician to fix the status of iridium under this sort of
exploitation.--(_From The Journal A. M. A., April 23, 1910._)
IRON TROPON
The composition of Iron Tropon seems to have varied from time to time.
The manufacturers formerly stated that it contained fat, sugar, pepsin
and iron in organic combination with albumin, and its use was advocated
both as a food and as a medicine. It was not claimed to contain over
1 per cent. of pepsin, but tests failed to show that it contained any
pepsin, or if any, such a small amount that there was not sufficient
to digest the albumin in Iron Tropon itself. It was also claimed that
the iron, being in organic combination with the albumin, possessed
advantages over the widely used aromatic fluid preparations of iron.
Tests, however, showed that the iron was not in organic combination,
though even had it been, late investigations fail to demonstrate the
superiority of the organic over inorganic iron compounds.
The manufacturers state in their later “literature” that Iron Tropon
is a tonic and a food; that it is a compound of the food albumin
tropon, 2.5 per cent. of iron in its most assimilable form, and enough
chocolate to flavor it agreeably. It will be noted that they now make
no claim for pepsin, nor do they state that it contains iron in organic
form. In the dose recommended, a teaspoonful three times a day for an
adult, the patient gets something over a grain of iron, and he might
as well take an equivalent quantity of Blaud’s mass, the value of which
has been proved.
As a food, Iron Tropon, weight for weight, is about equal to beans and
a little better than flour, although it contains a larger percentage
of protein than either. In the dose stated, an invalid would get
about 50 calories, or about 1/40 the necessary nourishment for a day.
Tests have also shown that the albumin is difficult of digestion.
In spite of this fact, the advertisement of Iron Tropon states: “A
patient who takes Iron Tropon receives not only the benefit of iron
medication, but at the same time his economy is supplied with perfectly
assimilable albumin in sufficient quantity.” It will thus be seen that
the claim for pepsin in this preparation has been abandoned, that the
statement as to the iron being in organic form has been modified, and
that the food value of the albumin is exaggerated; but perhaps the
manufacturers do not expect the physician to apply his arithmetic to
such problems.--(_From The Journal A. M. A., April 23, 1910._)
KUTNOW’S POWDER
Which Is It, a “Proprietary” or a “Patent Medicine”?
The term “patent medicine” has been applied, rather loosely, to those
nostrums sold and exploited directly to the public, while the name
“proprietary” has been given such preparations as are advertised only
to the medical profession. As has been many times exemplified by
reports in The Journal, the distinction is often a very fine one and
the dividing line frequently reaches the vanishing point.
It is not unusual, for instance, for “proprietary” preparations
to be foisted on the medical profession until a certain number of
testimonials (of doubtful value, it is true, but still testimonials)
have been ingeniously wheedled out of physicians and the product
rather generously prescribed. When this objective point has been
reached the manufacturer comes into the open and advertises the nostrum
to the public direct and the testimonials previously given for the
“proprietary” are used as advertising assets for the “patent medicine.”
Then again there are certain preparations which are “proprietaries”
or “patent medicines” according to the location. On one side of the
Atlantic the product is advertised to physicians only, while on the
other side it runs indiscriminately on the billboards and in the
newspapers. One of the best examples of this last class is Kutnow’s
Powder. In England, where it originated, this preparation, which
“dissolves and eliminates uric acid,” is consistently lined up with
Beecham’s Pills and Pink Pills for Pale People. Full-page newspaper
advertisements announce the fact that free samples will be
+----------------------------+
| “SENT TO ALL APPLICANTS” |
+----------------------------+
In the United States, however, Kutnow’s have learned from their wide
advertising experience that a cheaper and surer way of introducing a
nostrum to the public is to advertise it to the medical profession
only. By means of advertisements in medical journals (whose space is
much less expensive than that of the daily papers) and the liberal
distribution of samples which are
+----------------------------------+
| “SENT FREE TO PHYSICIANS ONLY” |
+----------------------------------+
the medical profession becomes the unpaid “barker” for the nostrum
manufacturer. At present, therefore, Kutnow’s Powder is--in the United
States--an ethical (!) “proprietary.”
[Illustration]
There exists in this country, as most of our readers know, an
organization of “patent medicine” manufacturers whose “reason for
being” is to get full value received for the $40,000,000 paid annually
in advertising nostrums in the newspapers of the country. This
organization is known as the Proprietary Association of America. The
now familiar “red clause” in the advertising contracts by which the
newspaper forfeits its contract if state laws are enacted that are
inimical to the “patent medicine” interests, is a creation of this
organization and has been most effective in making the newspapers the
unpaid lobbyists of the nostrum interests. The “silence clause” is
another “joker” in the contracts by which the agreement is canceled
if matter detrimental to the nostrum “is permitted to appear in the
reading columns” of the paper. It is little wonder that with such
weapons the “patent medicine” manufacturer has assumed an arrogance
that is as disgusting as it is serious.
Great Britain, too, has its “patent medicine” men’s organization, which
is known as the Proprietary Articles Trades Association. Of both these
honorable bodies Mr. S. Kutnow of Kutnow Brothers, Ltd., is, or was, a
conspicuous member. At a recent meeting of the British organization,
Mr. Kutnow worked himself into a fine frenzy of indignation because
of some articles that had appeared in the _Pharmaceutical Journal_ of
London on the subject of “Secret Remedies and Proprietaries.” As these
articles did not specifically mention Kutnow’s Powder, and as evidence
was directed against only those preparations as were most disreputable,
it is evident that Mr. Kutnow now appraises his own product at its face
value. He gave his opinion of the _Pharmaceutical Journal_ and told
the meeting that when the advertising man for that journal solicited
advertising he refused to have any more dealings with him owing to the
articles that had appeared in the _Pharmaceutical Journal_. He declared
that he was quite independent of any newspaper or journal, and was able
to take care of himself.
Therein Mr. Kutnow is mistaken; he is not independent of newspapers
and journals. On the contrary, he and others of his ilk are
most subserviently dependent on them. Let reputable papers and
medical journals refuse, for but one year, to carry the high-flown
advertisements of his Anglo-American Patent-Proprietary, and his firm
would perforce seek some worthier, if less profitable, line of business.
The editor of the _Pharmaceutical Journal_ resents Mr. Kutnow’s
“implied assumption that by inserting paid announcements in the
advertising columns of a newspaper, he or any one else, can dictate the
policy of that organ.”
The _Pharmaceutical Journal_, it should be said, is the official
organ of the Pharmaceutical Society of Great Britain, and is the
most influential organ of the drug trade in the British Isles. It is
refreshing to note, in these days of “canned” editorials and paid
“write-ups” masquerading as original articles, that there is still to
be found a journal that can not be bought.
One wonders whether a large experience in the advertising world, and
especially his membership in the Proprietary Association of America,
has unconsciously led Mr. Kutnow to assume that muzzling the press
is one of the perquisites of the large purchasers of advertising
space.--(_From The Journal A. M. A., Aug. 31, 1907._)
LYMPH COMPOUND R-H AND ORCHITIC FLUID TABLETS
A physician wrote The Journal:
“I have under my care a patient with chronic parenchymatous
nephritis. Microscopic examination shows occasional epithelial casts,
with hyaline and granular casts. The patient feels well and appears
to enjoy the best of health. Please give me your opinion on the
use, in such a case, of the lymph injections put out by the Animal
Therapy Company of Chicago, from whom I have just received a supply
of literature.”
The Journal replied as follows:
“The Council on Pharmacy and Chemistry took up for consideration
the ‘Lymph Compound R-H,’ and ‘Orchitic Fluid Tablets,’ sold by the
Animal Therapy Company and refused them recognition.
“The treatment of a case of chronic parenchymatous nephritis is a
task requiring the best judgment and the greatest knowledge that the
physician can command. From the first his aim should be to do no
harm, and with this in view he will recognize that since we do not
know the cause of this disease, and since we are unable to influence
the essential process in the kidney, the administration of a remedy
capable of doing harm should be undertaken only under the clearest
indications. It is probable that the remedy proposed, containing,
it is asserted, a mixture of foreign proteins, might injure healthy
kidneys, to say nothing of sick ones. It is well known that foreign
proteins, such as the white of egg, if they enter the circulation
unchanged, are excreted by the kidney and are liable to produce
serious irritation, which in the case of parenchymatous nephritis
might easily aggravate the existing condition and frustrate all
other efforts at a cure. More especially is it imperative to do no
harm when, as in the case reported by our correspondent, the patient
appears to be in good health. Two questions should be raised in that
case. First, is there any evidence that the occasional excretion
of a few casts, whatever may be their variety, is actually doing
the patient any harm? And second, since there are no symptoms, what
possible improvement could be expected from treatment? It is admitted
that we have no remedy which can affect an essential change in the
condition of the diseased kidney. What must be done in such a case
is to spare the kidney--to require of it the minimum of functional
activity. In such a case, the physician who introduces an animal
protein, foreign to the human system, would be taking a serious
responsibility. The chances are that it would do harm; how great,
no one can tell. If the physician can really make up his mind to
experiment at the risk of the life of his patient, this case appears
to be one unusually favorable to the manufacturer of the serum.
There are chances that the diagnosis may be incorrect and that such
a condition of the urine does not indicate a serious condition of
the kidney. It is frequently the case after an acute infection, or
some similar irritation, that the kidney continues for some time
to excrete albumin and casts, but the condition eventually clears
up. In such a case, if the serum did no harm it would be given the
credit of curing the patient, who recovers in spite of it. It is a
little unfortunate, however, for the purpose of such demonstration
that the patient is said to feel well. If only he could be persuaded
that he has a serious disease so that he might be somewhat depressed
mentally, the effect of the cure would be more remarkable!
“If the physician to whom such a patient comes for advice, instead
of taking the wise course of seeking reliable information, were to
take at their face value the statements of interested commercial
manufacturers--if he were to administer this unknown and dangerous
remedy, the effects of which he cannot predict--he would commit a
breach of trust more culpable than the most vicious attempts of the
nostrum-maker to mislead the physician and the public.”--(_From the
Journal A. M. A., Dec. 14, 1912._)
LYSOL-THE EVOLUTION OF A PROPRIETARY
Regarding certain proprietary preparations and their equivalents found
in the pharmacopeias or other standard works of reference, it is often
questioned whether the proprietary is the original and the official
preparation the imitation, or vice versa. As a general proposition,
medicinal compounds and preparations are not born but evolved, as in
the case of epinephrin, in which the credit of discovery belongs to
no one person, but to several.[108] So it is often the case that the
proprietary and official preparations may be based one on the other,
while both are usually based on some preparation which antedates them.
This is well illustrated by the proprietary preparation Lysol, the
practical equivalent of which--liquor cresolis compositus--is official
in the United States Pharmacopeia. After the discovery of phenol
(carbolic acid) and the recognition of its germicidal value, it was
gradually learned that other phenolic compounds occurring in the crude
distillates from tar and wood were more efficient and less poisonous
than phenol (carbolic acid). When this was discovered, attempts of
course were made to utilize these higher and more efficient phenols,
which meant that their insolubility in water had to be overcome. In
these attempts there were efforts to form new compounds as well as
a search for simple solvents. While the first failed, because these
compounds were less efficient than the phenol from which they were
made, a simple solvent was found in soap. The first attempt to utilize
the solvent power of soap gave creolin, a mixture of the so-called
crude carbolic acid (really containing but little phenol and consisting
largely of higher phenols along with inert hydrocarbons) with soap.
This was followed in 1884 by Schenkel’s discovery that a portion of
this “crude carbolic acid” could be made soluble in water by treatment
with soap. Schenkel was refused a patent on the ground that any soap
manufacturer should be permitted to add phenol to his soap, but in
1889 a patent for a cresol-soap solution was granted to Damann, who
used cresol, a constituent of “crude carbolic acid.” The preparation
was put on the market and has since been widely advertised under the
proprietary name “Lysol.”[109] It is thus seen that Lysol is a good
example of the way in which manufacturers appropriate the discoveries
of others, develop them and turn them to proprietary use.
[108] The Journal A. M. A., March 25, 1911, pp. 901, 910.
[109] Pharm. Ztg., Oct. 14, 1908, p. 817.
The ill-deserved patent protection for Lysol happily expired long
ago and the product can now be made by anyone. In view of the
non-descriptive character of the name “Lysol” and the danger in using
such names in connection with potent and poisonous remedies, this
cresol-soap solution has been admitted to pharmacopeias, not under the
original name “Lysol,” but under descriptive names such as that in the
United States Pharmacopeia--“liquor cresolis compositus.”--(_From The
Journal A. M. A., Dec. 14, 1912._)
THOMPSON’S MALTED FOOD COMPANY
And Its Blood, Nerve and Tissue Builder, “Hemo”
During the past eighteen months The Journal has received inquiries
from physicians in various parts of the country asking for information
regarding “Thompson’s Malted Food Company” of Waukesha, Wis., which for
some time has been selling and trying to sell its stock to physicians
and others. In reply The Journal called attention to the fallacy of any
concern trying to induce people to purchase its stock on the ground
that the Bromo-Seltzer company, the Postum Cereal company and others
had been successful.
[Illustration: A miniature reproduction of a full-page advertisement of
“Hemo” appearing in a Milwaukee paper. The original covered 341 square
inches.]
The earlier name for the Thompson concern was “American Malted Food
Company” and originally it had its office and factory in Milwaukee. Its
products are “Malted Milk,” “Malted Beef-Peptone” and “Hemo.” As long
ago as 1911 the company was sending out glowing descriptions of the
money that might be expected to be made by investing in the concern,
which was then known as the American Malted Food Company. According to
the company’s booklet it was estimated that in the United States and
Canada alone $20,000,000 worth of dry malt food products were consumed
annually. Further:
“On the most conserving estimate the American Malted Food Company
will supply 5 per cent. of the demand or $1,000,000 of the
consumption from the very outset....”
At the time this was written (1911) the company claimed that its stock
had “been advanced over 100 per cent. in one year’s time” and that
even then it had “found it advisable to curtail the sale of stock so as
not to exceed the prescribed number of shares to any one person.” In
1914, however, the company still had its representatives in the field
offering stock for sale.
In November, 1913, one physician wrote that three years previously
he had purchased stock in the company and _at that time_ (1910) was
given to understand that dividends would be paid in at least a year!
He has received no dividends to date. Other physicians have written
that the company’s agents in attempting to sell stock have given the
impression that the concern either is paying dividends or is about to
pay dividends. Still other physicians say that the agents made no claim
to them that the concern was paying dividends. To quote from a few of
many letters together with the date of the communications:
“Alluring promises of big profits in the near future have been held
out by the canvassers....” (September, 1913).
“No actual promise was made but it was ‘estimated’ that dividends
would be declared ‘about the first of the year’” (November, 1913).
“After I said I wouldn’t buy any stock was told the company was
already paying dividends and I was turning down a good thing.”
(March, 1914).
“The agent gave me to understand that the profits of the company
were enormous and that large dividends would be paid in the near
future.” (March, 1914).
“Mr. ---- [the agent] told me the company expected to pay dividends
as soon as all the stock had been sold.” (May, 1914.)
“The agent gave me to understand that they were about to pay very
generous dividends and that it was a chance to get in on the ground
floor on a good thing.” (May, 1914).
The price asked for stock during the past year or more has been $1.50
a share, the par value of the stock being held at $1.00. At various
times, however, the stock seems to have been purchasable from other
sources at a much lower figure. A physician writing September, 1913,
stated that he had just been solicited to purchase stock in the
Thompson Malted Food Company at $1.50 a share, and that immediately
he wrote to two firms, one in Chicago and one in Milwaukee, that sell
unlisted securities, asking the price of Thompson’s Malted Food Company
stock. Both brokers expressed the opinion, according to the physician,
that at 90 cents a share the stock would be a “good buy,” and both
offered to undertake to secure stock at that price. One of the concerns
sent a circular to the physician offering the stock at 80 cents. The
physician thereon canceled his order for stock which he had made at
$1.50 and declared that if he bought at all he would buy from other
sources.
HEMO
At the present time the product that Thompson’s Malted Food Company
seems to be “pushing” is a product it calls “Hemo.” According to
advertisements, Hemo is “the food that builds up weak stomachs.” Hemo,
we are told, contains “the iron of spinach, the juices of prime beef,
the tonic properties of selected malt in powdered form and the richest
sweet milk.” Furthermore, “Hemo contains the active principle of
selected barley malt ...”--whatever the “active principle” of barley
malt may be.
According to the Thompson Malted Food Company “80 per cent. of the
American citizens” are “troubled with anemia” and it is for them that
“Hemo has been especially prepared.” In a sentence:
“It is a well-known fact that organic iron can be obtained from
animal life as well as from vegetable life, and as the digestive
organs of a majority of the people are not equal to the task
of supplying their bodies with a sufficient amount of organic
iron to maintain a supply of a good quality blood, the lack of
which results in numerous nervous ailments--insomnia, diabetes,
rheumatism, anemia, tuberculosis, etc., it has been found necessary
to secure for mankind organic iron in a form that will be
concentrated, palatable and most easily assimilated.”
This is a sample of the farrago of pseudo-scientific nonsense sent
out by this concern in its attempt to sell “Hemo.” To continue the
quotation:
“With this object in view, the laboratories of Thompson’s Malted
Food Company have successfully produced and successfully tried out
Hemo on the most desperate cases.”
In a letter addressed to a physician-stockholder, the statement is
made: “Our Hemo-Malted Milk has never had and never will have an equal
as a builder of blood, nerve and tissue ... it will build tissue, nerve
and blood in less time than any other food heretofore known.”
Disregarding the question whether or not this is a stock jobbing scheme
or whether the purchase of the stock is a good investment, there is
another side to the matter. It must be evident that the public is not
getting a square deal when physicians are financially interested in
the products they prescribe for, or recommend to, the sick. Whatever
the value of the Thompson products, the method of exploitation and
the attempts on the part of the company to get physicians financially
interested in its ventures, are to be deprecated. If laymen of a
speculative turn of mind wish to invest in the stock of companies
putting out “bottled energy,” “blood builders” and “nerve repairers”
that is their business, but it is certainly neither conducive to the
scientific practice of medicine nor to the interest of the public
for physicians to be financially interested in products of this
sort.--(_From The Journal A. M. A., Oct. 24, 1914._)
MANOLA
Physicians as Unpaid Pedlers of Nostrums
One of the most disheartening features of the fight against the
proprietary evil within the profession is the slowness with which
physicians awake to their responsibilities in the matter. It is a
notorious fact, familiar to physicians against advertising men alike,
that the simplest and cheapest way to introduce a nostrum to the public
is through the instrumentality of the medical profession. Ever since
the birth of the proprietary evil in this country, shrewd manufacturers
have persuaded doctors to act as unpaid pedlers for their wretched
nostrums and to become _particeps criminis_ in the exploitation of such
wares.
Manola is an alcoholic nostrum with just enough more or less inert
medicinal products added to exempt it from the internal revenue tax,
but not enough to prevent its being used as a tipple by those who
object to taking their “toddy” in a simpler form. It is prepared by
the Luyties Pharmacy Company of St. Louis, a homeopathic concern whose
hahnemannian leanings are not so strong but that it is willing to
cater to the various sectarian schools of medicine as well as to the
regular profession. Since the promoters realize, doubtless, that to
put this stuff out under a homeopathic label might not be conducive to
stimulating physicians’ confidence, Manola is labeled: “Prepared only
by the Manola Company, St. Louis.” In other words, it is the old dodge
of forming subsidiary companies for the purpose of hiding the identity
of the real owners. In this connection, it is worth reminding our
readers, incidentally, that the Walker Pharmacal Company, St. Louis, is
another subsidiary concern of the Luyties Pharmacy Company, created for
the purpose of pushing another nostrum--Hymosa.
Manola is seldom advertised in medical journals. Instead the Luyties
Pharmacy Company has discovered a more effective method of “putting
one over” on physicians and druggists. The method which has been
pursued for years and which, under the same title and subtitle that
head this article, was exposed in The Journal as long ago as May 6,
1905, consists in sending to physicians a letter containing three
postcards--unstamped, of course. With the postcard there is a slip that
reads:
INSTRUCTION FOR OBTAINING
3 BOTTLES OF MANOLA FREE
_Dear Doctor_: Fill out the attached cards Nos. 1 and 2. Mail No.
1 to _us_ and hand Nos. 2 and 3 to _your druggist_. Impress upon
him the necessity of mailing postal card No. 3 _direct_ to us, and
_not_ to his jobber.
Yours truly,
THE MANOLA COMPANY.
The postcards are numbered, respectively, 1, 2 and 3. Here is No. 1:
[Illustration:
+-----------------------------------------------------+
| 1 Mail This Card to the Manola Co., St Louis, Mo. |
| Date____________ 19__ |
| THE MANOLA COMPANY |
| St. Louis, Mo. |
| Gentlemen: |
| I have requested Mr. ________________________ |
| druggist, to order one dozen bottles of MANOLA for |
| my prescription. Please include with his order |
| three bottles for me, as per your offer. |
| |
| DR. ____________ |
| CHICAGO ILL. |
+-----------------------------------------------------+
]
Dr Ezymark writes the name of his druggist on Card 1, puts a stamp on
it and mails it to the Manola Company, alias Luyties Pharmacy Co.
Card 2, addressed to his druggist, also is filled out by Dr. Ezymark.
Here it is:
[Illustration:
+-----------------------------------------------------+
| 2 Please Hand This Card to Your Druggist |
| |
| Mr. ____________ Druggist. |
| Please order of the Manola Company, St. Louis, Mo., |
| _1 dozen bottles of Manola_, all of which I agree |
| to prescribe in my practice. By filling out card |
| No. 3 and forwarding it to the Manola Company, |
| St. Louis, Mo., they will include for me, with your |
| order, three bottles of Manola, free, for clinical |
| purposes. |
| Yours truly, |
| _____________ M.D. |
| Town ____________ |
+-----------------------------------------------------+
]
Then the doctor, acting the part of errand-boy, delivers Card 2 and
also Card 3 to his druggist. Here is Card 3:
[Illustration:
+-----------------------------------------------------+
| 3 PLEASE FILL OUT AND MAIL THIS CARD TO THE MANOLA |
| CO., ST.LOUIS, MO., NOT TO YOUR JOBBER |
| Date ____________ 19__ |
| |
| THE MANOLA COMPANY, St. Louis, Mo., |
| Gentlemen: |
| Please ship me/us as per your offer |
| |
| 1 DOZEN manola AT $8.00 per dozen. |
| 1/4 dozen MANOLA, free, for Dr. ____________ |
| Ship through my jobber: |
| M ______________ Signed ____________ Druggist. |
| Town ___________ Town ______________ |
| State __________ State _____________ |
+-----------------------------------------------------+
]
This, Mr. Goat, the druggist, has to fill out, affix a stamp and send
to the Manola Company. In return for all this, Mr. Goat has his shelves
loaded up with a dozen bottles of Manola and, for that privilege
pays $8 out of his own pocket. Dr. Ezymark gets three free bottles.
Incidentally, he also gets the contempt of his druggist--and of such
patients as learn of it.
The only one who profits by all this is the Luyties Pharmacy Co., alias
the Manola Co., alias the Walker Pharmacal Company.
Evidently this method of exploitation pays; that it does pay is a
disgrace to the medical profession. To those physicians who have in the
past acted as pedlers for Manola we would say: If your patients really
need sherry wine let them purchase it under its own name and at the
ordinary market price. You will then know what they are getting and
you will be able to retain not only your own self-respect but also the
respect of your druggist and the public.
The Composition of Manola
Examination of Manola in the Association laboratory indicates that
its composition is consistent with its origin, for its medicinal
ingredients are present in truly homeopathic quantities. The laboratory
report follows:
An examination of an original bottle of Manola gave the following
results:
Specific gravity at 25 C. 1.0329
Alcohol 18.00 per cent. by vol.
Non-volatile matter
(residue on evaporation) 15.93 gm. in 100 c.c.
Ash .96 gm. in 100 c.c.
Phosphoric pentoxid (P_{2}O_{5}) .0668 gm. in 100 c.c.
Total alkaloids .0047 gm. in 100 c.c.
Calcium Traces.
Magnesium Traces.
Iron Traces.
Sodium Traces.
Arsenic Traces.
Manola is a light amber colored liquid having the odor and taste of
sherry wine. The above analysis indicates that it is nothing more
than wine, fortified with alcohol and a slight amount of medicinal
substances added. The non-volatile matter appears to be nearly all
sugar, glycerin, or some similar substance and the presence of less
than one gram of ash to 100 c.c. excludes the presence of more than
a small amount of organic salts. From the amount of phosphorus found
there appears to be about one dose of phosphoric acid to a twenty-ounce
bottle. Arsenic is present in such small amounts that the ordinary
hydrogen sulphid test failed to show its presence and the delicate
Gutzeit’s test had to be used to detect it.--(_Modified from The
Journal A. M. A., April 2, 1910._)
MERCOL
R. Hunt and A. Seidell, Washington, D. C., report the result of an
examination of a preparation called Howell’s Mercol, manufactured by
H. B. Howell & Co., Ltd., New Orleans, and claimed to be a 1 per cent.
solution of mercuric iodid in a non-irritating neutral menstruum, and
recommended for hypodermic use in the treatment of syphilis. Their
examination indicates, as they say, “that although the manufacturers
of Mercol may have used a mercuric iodid in its preparation, they have
not succeeded in obtaining a 1 per cent. solution of this compound in
their ‘non-irritating neutral menstruum.’ It is furthermore evident
that the sample examined as above outlined contains none, or at most
only traces, of biniodid of mercury.” It is stating it mildly to
say that a manufacturer is careless who claims to make an efficient
preparation of what is almost a specific for one of the most serious of
diseases but which contains practically none of the essential active
ingredient.--(_Abstracted from The Journal A. M. A., Jan. 16, 1909._)
The Component Parts and the Finished Product
After the appearance of the first article, a physician wrote stating
he had seen Mercol manufactured, following the process in detail and
had himself weighed out a sufficient quantity of mercuric iodid to
produce a 1 per cent. solution. He protested that the firm “had no
desire to foist on the medical profession or the public a fraud.”
With his letter he sent a sample of the particular batch of Mercol
which he had seen manufactured. This sample was analyzed with the
same care and thoroughness that the previous sample had been, and the
practical absence of mercuric iodid was again demonstrated. While The
Journal does not question the honesty and good faith of either the
manufacturers or the physician, it maintains that claims for remedial
agent should be based on the finished product rather than on the
component parts used in its manufacture. Without attempting to explain
what has become of the mercuric iodid, it insists that the important
fact, and the one that vitally concerns both patient and physician,
is that the finished product fails to contain it. If the manufacturer
has made an honest mistake in supposing he could produce a 1 per cent.
solution of mercuric iodid in liquid petrolatum, he will doubtless see
that the mistake is corrected. If, on the other hand, he is governed by
commercial considerations only, the misrepresentation will probably be
perpetuated.--(_From The Journal A. M. A., May 15, 1909._)
MIDOL AND NURITO
Pyramidon Entering the Patent-Medicine Field
Repeated warnings to the public of the dangers of acetanilid, antipyrin
and acetphenetidin and the requirement in the Food and Drugs Act
which makes it obligatory to declare the presence of acetanilid
and acetphenetidin on the labels of “patent medicines,” have been
responsible for the growing unpopularity of nostrums containing these
drugs.
MIDOL
During the past few months advertisements have appeared in the
newspapers of a new “headache cure,” the advertising slogan of which is
that it “contains no acetanilid or phenacetin.”
The name of this preparation is Midol and it is sold under the
following claims:
“Instantly relieves headache, neuralgia, toothache.”
“Has no depressing effect.”
“More effective than antipyrin, acetanilid, phenacetin or similar
pain-relieving products.”
“Midol is the one safe-to-take aid of sufferers of headache.”
“Quickly relieves pain of whatever nature.”
“There is no cumulative action.”
“No bad effect upon the heart or other organs.”
An original package of Midol was purchased and examined in the
Association laboratory. The chemists’ report follows:
“Midol is sold in the form of white tablets each weighing, on an
average, 0.425 gm. or about six and one-half grains. The tablets are
soluble in water, chloroform or benzene to the extent of about 80 per
cent. The soluble portion appeared to be largely composed of starch,
with about 4.5 per cent. of some inorganic matter, probably talc. The
chloroform soluble portion was found to consist chiefly of pyramidon,
chemically known as dimethyl-dimethylamino-pyrazolon. Besides
pyramidon, the chloroform soluble matter contained a small quantity
of caffein and may have contained small amounts of other substances.
“From examination it is concluded that Midol depends essentially on
pyramidon for its therapeutic effect.”
Pyramidon is a proprietary preparation derived from, and having the
antipyretic and anodyne properties of, antipyrin. While some observers
have asserted that it is more likely to cause collapse than are
either antipyrin or acetphenetidin there is no positive evidence of
this assertion. That the use of pyramidon has been until recently
practically restricted to physicians may account for the fact that
its toxic effects are not as well known as are those of antipyrin,
acetphenetidin, acetanilid, etc., which for some years have been
indiscriminately used by the public. As the use of pyramidon as a
“patent medicine” now bids fair to become as general as the better
known antipyretics, it is probable that its toxicology will become
better known.
It is interesting to note that pyramidon in the form of Midol is put on
the American market by the General Drug Company, which also acts as a
distributor of salvarsan (“606”). The General Drug Company is said to
have for its president, W. M. Hoge, who was formerly employed in the
comptroller’s office during the administration of Herman A. Metz, and
the latter being employed by the Consolidated Color and Chemical Works
and being president of Victor Koechl & Co. The General Drug Company,
in its price list to physicians, lists the “ethical proprietary”
pyramidon, but contains no mention of its “patent medicine” Midol.
NURITO
Midol is not the only “patent medicine” in which pyramidon is the
essential drug. Nurito, which is advertised as “not a patent medicine
but a proprietary preparation,” is a nostrum put on the market by the
Magistral Chemical Co., New York. Here are some of the claims:
“Only U. S. P. ingredients are used in Nurito.”
“Guaranteed to relieve or your money refunded, Rheumatism,
Sciatica, Neuritis.”
“There is no compound known in medicine that so rationally,
scientifically and effectively removes waste and poisons from the
human system as Nurito.”
The Association’s laboratory recently analyzed a specimen of Nurito.
The report follows:
A dollar-size package of Nurito was purchased and found to contain
seven powders. The powders ranged in weight from 9 to 12 grains, the
average weight being nearly 11 grains. The presence of pyramidon,
phenolphthalein and milk sugar was demonstrated. Alkaloids,
acetanilid, acetphenetidin, chlorids, bromids, iodids, heavy metals,
starch and sulphates were absent. Quantitative examination indicated
that the composition of Nurito is essentially as follows:
Milk sugar 34 per cent.
Phenolphthalein 6 per cent.
Pyramidon 60 per cent.
Each powder, therefore, contains about 2-2/3 grains of milk sugar,
2/3 of a grain of phenolphthalein and 6-2/3 grains of pyramidon.
What was said of pyramidon in the preceding article applies equally
well here. The claim that Nurito is composed of “U. S. P. ingredients”
is evidently a falsehood. The chief therapeutic ingredients are
pyramidon and phenolphthalein, neither of which is described in the
United States Pharmacopeia.--(_From the Journal A. M. A., Aug. 10,
1912._)
MU-COL
Salt and Borax as Wonder-Workers
“Mu-col, for Cleansing Mucous Membranes” is a nostrum put on the market
by the Mu-col Company (Inc.), Buffalo, New York. As a specimen of the
claims made for the preparation, the following is typical:
“Mu-col obtains most gratifying results in catarrhal inflammations
of the mucous membranes. Leucorrhea, Tonsillitis, Sore Throat,
Cystitis, Internal Hemorrhoids, Nasal Catarrh and Pus Cases respond
at once to irrigation with Mu-col solution. Strong solutions of
Mu-col have proven of sterling value in treating Hives, Prickly
Heat, Ivy Poison, Sunburn, Eczema, Typhoid and Scarlet Fever.”
This, and much more Mu-col will do--according to its manufacturers!
No wonder physicians want to know the composition of Mu-col. As the
manufacturers do not give this information the aid of the Association’s
Laboratory was invoked. Let the chemists speak:
LABORATORY REPORT
“The specimen examined was a white powder, and from the odor,
thymol, eucalyptol, camphor and oil of wintergreen could be
recognized. Qualitatively sodium, chlorid and borate were found.
Zinc, benzoate, phenolsulphonate and sulphate could not be found.
The solution was alkaline to litmus. Gravimetric determination of
chlorid as silver chlorid and titration of borax by Thompson’s
method indicated sodium chlorid (NaCl) 47.2 per cent., sodium borate
(Na_{2}B_{4}O_{7}+10H_{2}O) 50.1 per cent.
“It thus appears that Mu-col is a mixture of ordinary salt and borax
in equal parts with the addition of a small amount of aromatic
substances.”
Mu-col will do just what a solution of salt and borax will do--no more,
no less. And yet, it is claimed:
“Mu-col has been successfully used since the year 1900 by more than
50,000 physicians, which has proven it to be the most Efficient,
Economical and acceptable, preparation in its field.”--(_From The
Journal A. M. A., Feb. 7, 1914._)
NARKINE
The Intangible Product of the Tilden Laboratory
A little book, published by the _Druggists Circular_, and called
“Modern Materia Medica,” gives in dictionary form the information
regarding new remedies which that journal publishes in its monthly
issues. Such information is not always acceptable to the manufacturers
of various preparations of doubtful value. A case in point is brought
to notice with reference to a remedy called Narkine, put out by the
Tilden Company of St. Louis. In this little book the following appears:
“Narkine is described as ‘an opium preparation from which all
deleterious qualities have been eliminated’; an unsupportable claim,
as all opiates and other hypnotics are essentially deleterious.”
The Tilden Company wrote to the _Druggists Circular_, stating that
they guaranteed Narkine “to be absolutely free from coal-tar or opium
derivatives,” yet the “literature” of the company describes it as
“a specially prepared product of opium devoid of the nauseating and
disagreeable properties of this drug, yet possessing the anodyne
and soporific principles of same in the highest degree.”
To remove from opium all its derivatives and yet retain the anodyne
and soporific principles attached to nothing in particular, indicates
a degree of pharmaceutical skill seldom attained. One is irresistibly
reminded of the Cheshire cat in “Alice in Wonderland,” whose smile
remained long after the cat had vanished.
The absurdity of the thing, however, has apparently not occurred to
many physicians, for these disembodied spirits of the pharmacologic
world are evidently being prescribed.
The _Druggists Circular_ is to be congratulated on exposing this
latest pharmaceutical freak. It does so in a rather striking manner
by means of photographic reproductions of the claims of the Tilden
Company.--(_From The Journal A. M. A., Oct. 24, 1908._)
PAPINE
A Disguised Morphin Solution
To the thinking physician it should be evident that a preparation
containing morphin must possess not only all of the valuable properties
of this drug, but also all of the objectionable ones. There are still
some physicians, apparently, who give credence to the assertions of
the manufacturers concerning the morphin preparation from which, it is
claimed, all of the undesirable morphin effects have been removed. The
following query from a correspondent illustrates this fact:
“Will you inform me as to the contents of ‘Papine’? I have a case of
chronic interstitial nephritis, and my consultant insists on giving
this preparation. I asked him if he knew what drugs it contained
and his answer was ‘one-eighth of a grain of morphin with the
objectionable parts of the drug removed.’”
The query was referred to the Association Laboratory, which submitted
the following report:
For many years Papine has been advertised by its makers, Battle
& Company, St. Louis, as an anodyne. In the circulars Papine is
described in part as follows:
“Papine represents in pharmaceutical form the purely anodyne
principles of opium freed from the narcotic and tetanising
constituents.”
“Papine is the anodyne or pain-relieving principle of opium, the
narcotic and convulsive elements being eliminated. One fluid drachm
is equal in anodyne power to one-eighth grain of morphin.”
“Through special methods of preparation, the anodyne and analgesic
principles of _Papaver somniferum_ are so extracted as to free
them of the narcotic and convulsive elements that ever have been,
and must ever continue to be serious objections to the use of
opium and its common derivatives.... No demand is more regularly
made on the physician than that for the relief of pain, and to be
able to afford it promptly and completely, without the slightest
deleterious action, is an advantage that cannot be overestimated.”
“Unlike most derivatives and preparations of opium, Papine neither
nauseates nor constipates; nor does it inhibit the secretory
functions of the body.”
“In conditions of extreme nervousness, especially in women,
recourse to morphin is attended by the very real danger of the
formation of a habit. Lastly, opium and its alkaloids must not be
administered to persons whose kidneys are not in good working order
on account of the risk of toxic accumulation.”
“No such restriction exists in respect of Papine, its action being
exerted exclusively on the element pain; in other words, it is
purely anodyne.”
“Papine does not nauseate, constipate nor create a habit.”
[Illustration: The Papine label before (on left) and after (on right)
the passage of the Food and Drugs Act. And the exploiters of this
morphin solution have the effrontery to claim that it does not create a
habit!]
From these statements the incautious physician might be led to infer
that Papine is a preparation analogous or similar to the official
tincture of deodorized opium. Formerly in the manufacture of the
latter preparation, in addition to removal of the odorous substances,
narcotin, then thought to be the principal convulsive alkaloid,[110]
was also removed. By the process for the manufacture of this tincture,
which is now official in the United States Pharmacopeia, most of
the narcotine is found in the finished preparation. While it is a
comparatively simple matter to remove the narcotin from opium and
its preparations, thus eliminating most of the commonly reputed
“convulsive elements,”[111] to remove the “narcotic elements” from
opium would result in destroying the integrity of the product. The
reasons for this are that morphin is the most powerful narcotic
substance found in opium, and it is present in the largest proportion
of any of the alkaloidal constituents. Its removal from an opium
preparation would, therefore, render that preparation practically
valueless.
[110] Narcotin is now known to possess very little physiologic effect.
[111] Of the opium alkaloids, laudanin and thebain possess the most
powerfully tetanizing properties, but they are present in opium in too
small quantities to produce any noticeable effect. Neither of these
alkaloids is removed by the usual processes for “denarcotizing” opium.
From Papine, however, the morphin has not been removed, for _since the
passage of the Food and Drugs Act_ the label has to admit that Papine
contains 1 grain of morphin in each ounce!
A specimen of Papine was examined and found to be nothing more than a
simple aqueous-alcoholic solution of morphin, containing glycerin. The
preparation is flavored to imitate cherry and colored with cochineal.
With the exception of morphin, neither narcotin, codein nor other
opianic alkaloids were found, while meconic acid, a characteristic
constituent of opium, was absent. Since Papine is claimed not to cause
constipation, and as is well known, this condition is frequently
produced by morphin, it seemed possible that Papine might contain
laxative substances. On examination, however, no cascara, rhubarb,
phenolphthalein or laxative salts were found.
While Battle & Co. have persistently exploited Papine as being an
opium preparation having none of the objectionable qualities of opium,
the analysis shows that the paradoxical claims made for it cannot be
substantiated. In prescribing morphin there is an abundance of official
preparations to choose from, and there certainly is no necessity or
excuse for resorting to the much more expensive and in no way superior
Papine.--(_From The Journal A. M. A., April 29, 1911._)
PASADYNE[AW]
[AW] See also report on Passiflora and Daniel’s Tincture, p. 156.
A physician asks: “Can you tell me the formula of a preparation on the
market called Pasadyne, put up by John B. Daniel, Atlanta, Georgia?”
According to the manufacturer Pasadyne is a tincture of passion-flower.
Formerly this nostrum was sold under the title “Daniel’s Concentrated
Tincture of Passiflora Incarnata.” While the manufacturer claims
marvelous virtues for this preparation, made from “the fruit, roots and
vines of the passion-flower or May-pop,” passiflora (passion flower) is
now generally recognized as being of little if any value.
A circular makes the following absurd statement:
“Chloral and the bromids, before the recognition and advent into
medicine of Pasadyne (Daniel’s Concentrated Tincture of Passiflora
Incarnata), were widely employed in all turbulent states of the
psyche and, notwithstanding their many untoward, even sometimes
dangerous effects, were held in high favor by physicians. For
that matter, they still retain some of their old-time popularity,
but since the superior value of Pasadyne (Daniel’s Concentrated
Tincture of Passiflora Incarnata) has been demonstrated to the
profession’s satisfaction, the erstwhile high esteem in which
chloral and the bromids were held, is fast waning and ere long
Pasadyne will have crowded them out.”
The reasons why the drug passiflora was not deemed of sufficient
value and hence, along with the Daniel preparation, was refused
recognition, are given in a report of the Council on Pharmacy and
Chemistry.--(_Abstracted from The Journal A. M. A., March 8, 1913._)
PAS-AVENA
How Its Formula Evades the Food and Drugs Act
Pas-Avena is a widely advertised “nerve sedative and hypnotic.” The
preparation is put on the market by the Pas-Avena Company of New York
City. As a headliner the advertisements of the remedy state that
the formula has always been on every bottle, and this, The Journal
states, has a twofold object: It aims to give the impression that the
preparation is non-secret, and it is calculated to inspire confidence
in the--apparently--scientific nature of the product. As a matter of
fact, it should do neither. The preparation is essentially secret in
its composition because of the presence in the formula of an unknown
quantity and the liability to change of formula at the whim of the
manufacturer. On the bottles some time ago the following formula was
given:
Each tablespoonful contains:
Passiflora 20 minims.
Avena sativa 10 minims.
Somnalgesine (C_{30}H_{28}N_{5}O_{6}) 2 grains.
The first two ingredients are plants in whose therapeutic value but
little confidence is placed. Somnalgesine, the third constituent, is
a secret preparation, the chemical formula of which the manufacturers
were kind enough to add. To a chemist, however, the formula is absurd
and impossible, and is included either because of the manufacturer’s
ignorance or because of an intent to deceive the profession. Since the
Food and Drugs Act became law, the label of Pas-Avena has been changed
to read:
Alcohol 8.37 per cent. by volume.
Anilipyrine 16.00 grains per fluid ounce.
Guaranteed under the Food and Drugs Act of June 30, 1906.
Substitution of anilpyrine for somnalgesine gives little more
information. Chemists may recognize this as a name applied to a mixture
said to be formed by the fusion of two molecules of antipyrin and one
molecule of acetanilid. To physicians, however, the name carries with
it the same mystery as did somnalgesine. Attention is directed to the
fact that by publishing the guarantee under the pure food laws the
company presumes to disperse all doubt and criticism, assuming that
the majority of physicians will be satisfied with the guarantee as it
stands. Inasmuch as the preparation contains acetanilid and antipyrin,
however, the manufacturers are disregarding that part of the Food and
Drugs Act which requires that the name of the parent substance--in this
case acetanilid and antipyrin--be put in parenthesis. The laws are
so well defined that physicians appear to be content to do nothing,
firmly believing that they are safe from the defrauding methods of
unscrupulous manufacturers.--(_Abstracted from The Journal A. M. A.,
March 7, 1908._)
Proprietary House Insolvent--and Physicians Lose?
The Pas-Avena Chemical Company, whose product, Pas-Avena, was exposed
in The Journal a few months ago, has recently failed, according to our
pharmaceutical exchanges. In recording the fact, one journal says:
“It is reported that considerable stock of this company had been
sold to physicians.”
At this time, when physicians are importuned daily to invest money in
various wildcat pharmaceutical concerns, this sentence might well be
used “to point a moral or adorn a tale.”
PERTUSSIN
Dr. L. A. Roberts, Dorchester, Mass., writes: “Please tell me what the
composition of Pertussin is.”
Pertussin is a proprietary whooping-cough remedy manufactured by the
Kommandantan Apotheke, Berlin. A “physician’s sample” bottle of this
preparation sent out by Lehn & Fink bears a label on which appears the
following:
“100 parts Pertussin contains:
1/2 Ol. Thymi, et Thymol
21-1/2 Ext. Thymi ‘Taeschner’
50 Saccharum
2 Glycerinum
6-1/4 Alcohol
19-3/4 Aqua Destillata”
While it never has had much vogue in this country it has been and still
is used in Germany. It belongs to that class of vegetable preparations
which, since they contain no distinctive principle, are difficult to
analyze--particularly as concerns the “joker” in the formula, in this
case “Ol. Thymi, et Thymol” and “Ext. Thymi ‘Taeschner’”--hence there
has been much dispute in Germany as to the composition of this nostrum.
In general, it appears that whatever virtues it has are due to some
preparation of common thyme in a menstruum containing water, sugar and
alcohol. At one time the preparation was found to contain potassium
bromid; but tests recently made in the A. M. A. Chemical Laboratory
indicated the absence of either bromids or iodids.--(_From The Journal
A. M. A., March 8, 1913._)
PHENALGIN--A TYPICAL EXAMPLE[AX]
[AX] For reports and articles on other coal-tar preparations, see
pp. 9, 115, 244, 268, 305.
Last June[112] we devoted considerable space to the extravagant
therapeutic claims made for “Phenalgin” by its venders. At this time
we propose to refer to the misinformation--to use a conservative
term--that the Etna Chemical Company has promulgated regarding the
composition of their preparation.
[112] See The Journal A. M. A., June 24, 1905, p. 1997.
In June, 1905, the Council on Pharmacy and Chemistry officially
published to the medical profession of the United States the
information that repeated examinations showed that “Phenalgin” is
a simple mixture of acetanilid and sodium bicarbonate or ammonium
carbonate. So far as we know, no direct denial of the truth of this has
been made. There has appeared what we presume is meant as an answer; it
is couched in this sentence,
Phenalgin is just what we have always said it to be.
From this expression--which has been repeated in bold, black letters in
practically all the advertisements since last June--we presume that we
are to understand that in the past they have stated what it is.
It would have been just as easy and more satisfactory if the Phenalgin
people, instead of saying: “Phenalgin is just what we have always said
it to be,” had said what it is, since the average physician has neither
the time nor the inclination to look up their literature.
For the benefit of those who desire to know what the venders of
Phenalgin “have said it to be,” we have gone over their advertising
literature of the past, with the following results, which are in the
form of quotations from their advertisements:
An American Coal-Tar Product--Phenalgin--the only synthetic
stimulant, non-toxic, antipyretic, analgesic and hypnotic.
Phenalgin is the ONLY ammoniated Synthetic Coal-Tar Product made
from Chemically Pure Materials [What have the Ammonol people to say
to this?--Ed.]
A synthetic Coal-Tar Product of the Amido-Benzine series,
containing Nascent Ammonia.
These two chemicals [“stimulant ammonia of coal-tar origin” and
“chemically pure phenylacetamid”] combine under certain conditions
so as to obtain a produce which he [Dr. Cyrus Edson] named
Phenalgin or Ammoniated Phenylacetamide.
Phenalgin is a compound of peculiar character which can not be
extemporaneously made into tablets from the powdered drug, without
seriously changing and impairing its medicinal qualities.
We believe these quotations are sufficient to show what the Etna
Chemical Company has “always said it to be.” In going over the
literature for several years past we find the above stated in the same,
or similar, words in nearly all of it. From the above four statements
may be deduced: 1. They have stated that Phenalgin is a synthetic[113]
preparation; 2, they have conveyed the impression that Phenalgin is a
chemical compound; 3, they have announced repeatedly that it is the
“only” preparation of the kind, and 4, they have claimed that Phenalgin
is non-toxic.
[113] Dunglison’s Dictionary: “Synthetic--In chemistry the formation
of a more complex body by the union of simpler bodies.” Dorland’s
Dictionary: “Synthesis--The artificial building up of a chemic compound
by the union of its elements.” “Union” is not mixing.
We believe that these four statements represent in plain English what
the above quotations mean. They are all absolutely false. Phenalgin
is not synthetic; it is not a chemical compound; it is not the only
ammoniated phenylacetamide, or the only acetanilid mixture containing
carbonate of ammonium--and it is most positively toxic.
In one place it is stated that Dr. Cyrus Edson
Employed his great facilities for chemical research and
opportunities for chemical experiment for the purpose of producing
a formula for a combination of stimulant ammonia of coal-tar origin
(sic) and chemically pure phenylacetamide, also a coal-tar product
... which he named phenalgin, or ammoniated phenylacetamide.
In another place we read that Phenalgin is made
Under the immediate personal supervision of the original inventor
of ammoniated coal-tar products.
By comparing this last quotation--which is from a
current--1905--advertisement--with the preceding one it will be
noticed that we are asked to believe that Phenalgin is made “under the
immediate supervision of” Dr. Cyrus Edson--and yet Dr. Cyrus Edson died
Dec. 2, 1903. This is equal to Lydia Pinkham’s prescribing for the
suffering women of America when the dear old soul had been dead for
over twenty years.
We have before us a full-page advertisement taken from a recent number
of a weekly medical journal, which possibly is meant as an answer
to the announcement of the Council on Pharmacy and Chemistry that
Phenalgin is a simple acetanilid mixture. The advertisement is divided
into two parts; the first part is as follows:
+-----------------------------------------------------------+
| FACTS ABOUT ACETANILIDUM (ANCIENT HISTORY) |
| |
| It has long been recognized that Acetanilidum and most |
| other coal-tar products are apt to exert a depressing |
| influence upon the heart, but there has never been any |
| doubt about its great value as a pain reliever and |
| temperature reducer. Its therapeutic value has, however, |
| been practically nullified by the danger of cyanosis and |
| other evils caused by its well-known depressant action |
| and the difficulty of obtaining it in a pure state. It |
| being known that certain deleterious substances are often |
| to be found in Commercial Acetanilidum and that much of |
| the injurious effect attributed to this drug is entirely |
| traceable to these impurities.[114] |
+-----------------------------------------------------------+
[114] This sentence is not complete, but, of course, this is
immaterial. Little things like an incomplete sentence do not count.
The above are also falsehoods. The therapeutic value of acetanilid is
not “practically nullified ... by the difficulty of obtaining it in
a pure state.” Neither is it true that “much of the injurious effect
attributed to this drug is entirely traceable to these impurities.”
While deleterious substances may be found in _commercial_ acetanilid,
they are not found in the substance offered as medicinally pure
acetanilid by reputable firms. Pure medicinal acetanilid is a cheap
article, costing less than 30 cents a pound, for it is a substance
that is easily and cheaply purified. It is a fact that the injurious
effects are in the acetanilid itself and not in the impurities it may
occasionally contain.
The second half of the advertisement in part is as follows:
+-----------------------------------------------------------+
| FACTS ABOUT PHENALGIN (MODERN SCIENCE) |
| |
| More than a decade ago the late Dr. Cyrus Edson, then |
| Health Commissioner for New York City and New York State, |
| recognizing the value of chemically pure Acetanilidum as |
| a therapeutic agent, if it could be deprived of its |
| depressant quality, employed his great facilities for |
| chemical research and opportunities for chemical |
| experiment for the purpose of producing a formula for a |
| combination of Stimulant Ammonia of coal-tar origin and |
| chemically pure Phenylacetamide, also a coal-tar product. |
| These two chemicals combine under certain conditions so |
| as to obtain a product which he named Phenalgin or |
| Ammoniated Phenylacetamide. |
+-----------------------------------------------------------+
There is more of the same character. In the first place, we call
attention to the fact that “Phenylacetamide” is substituted for
“Acetanilidum” when it is to go into Phenalgin. To mystify is one of
the “tricks of the trade.” Few physicians keep up with chemical terms
and, therefore, are not supposed to know that Phenylacetamide is one of
the chemical names for Acetanilid.
The reference here to Dr. Cyrus Edson brings up another fact, and
that is that the Etna Chemical Company tries to convey the idea that
Dr. Edson was the originator of Phenalgin. We have always understood
that Dr. Cyrus Edson had something to do with pushing Ammonol and, if
we remember rightly, got into some trouble thereby. We do not know
the exact facts, but the following letter shows that he had a leaning
toward another “ammoniated phenylacetamid.” The letter is dated “New
York, Oct. 6, 1894,” and is addressed to the “Ammonol Chemical Company.”
“During the past six or eight months I have used Ammonol
extensively in my private practice. I have found it excellent
in the treatment of neuralgias and for rheumatism. I have also
verified your statement in two cases that were suffering from
alcoholism. My experience justifies me in saying that it is the
safest and best of the analgesic coal-tar derivatives.
“Very truly yours,
Cyrus Edson, M.D.”
It may be of interest to know that the principal member of the firm
of the Etna Chemical Company was at one time a member of the Ammonol
Company, and it is usually understood, we believe, that Phenalgin
is practically the same as Ammonol--in fact, the analyses published
regarding the two preparations show this to be a fact.
We must make one more quotation:
It makes little difference to a physician whether Phenalgin is
a mixture or a compound or a synthetic, with a name that would
destroy the orthographic balance of the universe, provided it is
just what he has always found it to be.
Very complimentary to the intelligence and common sense of physicians,
is it not?
Suppose some fellow should get up a scheme to exploit a mixture of
quinin and some cheap, harmless substance, say, starch--equal parts of
each. Suppose he gives it a fanciful name, puts it on the market at a
high price, say $1.25 an ounce, and announces it as a new synthetic
with wonderful therapeutic qualities. Suppose that the schemer then
adopts the nostrum vender’s methods of fooling physicians into using
his product by getting some to give testimonials, others to furnish
write-ups, and then subsidizes medical journals through liberal
advertising to print both the testimonials and the write-ups. The
preparation would, of course, prove to be a good thing if it were used
in liberal quantities where quinin would ordinarily be used, and some
patients using it would get well even if quinin were not indicated.
Then with the psychologic effect of the testimonials, the write-ups,
and good, strong claims rightly pushed, unthinking physicians would do
the rest. And then, after a while, when the schemer had gotten to the
point where, each year, he was making a fortune out of his preparation,
suppose some “self-appointed chemists” should examine into the
preparation and discover that it was nothing but quinin and starch, and
so announce to the doctors of the country; what would the doctors say?
That it makes little difference “provided it is just what he has always
found it to be!”
This analogy is not far-fetched, for it is practically what has been
done with Phenalgin. One difference is that since quinin costs as much
per ounce as acetanilid does per pound, the profits on the acetanilid
mixture would be sixteen times greater than that of our imaginary
preparation. Another difference is that acetanilid is really a
dangerous drug, unless used with care, both in its immediate and in its
remote effects; quinin is far less so.
“Little difference” indeed, whether we are being buncoed or not!
Evidently!
In conclusion, we charge the Etna Chemical Company with intentionally
misleading and deceiving the members of the medical profession, in that
the said company has in its literature and its advertisements conveyed
the impression (whether directly stated or not): First, that its
preparation, Phenalgin, is a synthetic compound; second, that Phenalgin
requires special skill in its preparation; third, that Phenalgin
has therapeutic values which it does not possess; and, fourth, that
Phenalgin is non-toxic.
We also charge that on account of these and other misrepresentations,
this company has inveigled physicians into prescribing and using a
simple mechanical mixture of common well-known cheap drugs--for which
an extravagantly high price is charged--under the supposition that
this combination of cheap drugs is a chemical compound of special and
peculiar merit as a therapeutic agent, and, therefore, worthy of their
confidence.
Our object in again giving space to this preparation--and practically
all we have said applies to the other acetanilid mixtures that are
exploited under fictitious names or as chemical compounds (such as
ammonol, antikamnia and salacetin or sal-codeia--Bell)--is to impress
on physicians, by a typical example, the shamefulness of the deceptions
practiced on them by nostrum manufacturers to the great injury of the
public and of the medical profession.
A Pharmaceutical Secret Which Should Not Be Lost
Dr. Gregory Costigan, New York City, writes under date of January 21,
as follows:
“I have been carefully reading and enthusiastically approving your
articles on the nostrum evil, and have been impressed more than usual
on the existence of quack advertising in medical journals as set
forth in last paragraph and quotation on page 206, bottom of first
column, of your issue of Jan. 20, 1906.
“In _Merck’s Archives_, page 11, we are told in an advertisement on
‘Phenalgin’ that it ‘is a compound of peculiar character which cannot
be extemporaneously made from powdered drug’ and ‘our process of
manufacturing tablets is coincident with the manufacture of Phenalgin
and is the result of a long series of careful experiments by which
we are able to produce tablets of Phenalgin in a friable condition
without losing any of its _volatile_ constituents or undergoing
chemical changes from heat or moisture’! Inasmuch as Phenalgin
tablets are not covered with a waterproof coating I think this is
a remarkable statement to make, and the manufacturing of a drug
coincident with the manufacture of a tablet must be a very remarkable
performance, especially because it ‘retains the full therapeutic
value of the drug unimpaired’ while the advertisement asserts that no
other manufacturer is cognizant of this wonderful method. This ad. is
for the perusal of physicians only. The Etna Chemical Company owes it
to the medical and pharmaceutical world not to let this secret die
with the company’s dissolution. It owes it as a duty to the coming
generations of science immediately to jot down the full data of this
wonderful performance, to put it away in an age-proof safe and not
allow it to be lost to humanity as were a great many other arts that
were well known to the ancients. Let them keep it secret now and
profit by it, but do not let it be lost to posterity.”--(_From The
Journal A. M. A., Jan. 13, 1906, and Jan. 29, 1906._)
An Ethical (?) Proprietary Exploited Under Fraudulent
and Lying Claims
+-------------------------------------------------------------+
| “PHENALGIN IS JUST WHAT WE HAVE |
| ALWAYS SAID IT TO BE.” |
| --_Etna Chemical Co. in 1905._ |
| |
| “Phenalgin is a synthetic “Unlike the coal-tar synthetic, |
| coal-tar product.” phenalgin is a stimulant |
| --_Etna Chem. Co. in 1898._ rather than a depressant.” |
| --_Etna Chem. Co. in 1910._ |
| |
| TEMPUS OMNIA REVELAT! |
+-------------------------------------------------------------+
“Phenalgin is a synthetic coal-tar product”--thus ran the
advertisements some years ago, when the medical profession was willing
to take--or was compelled to take--the word of the manufacturer of
proprietary remedies at its face value. Then the Council on Pharmacy
and Chemistry was brought into existence. One of the first pieces of
work done by the Council was the publication of the results of a number
of analyses of headache powders. Phenalgin was among them. Analysis
showed that Phenalgin was not a synthetic but a simple mixture of the
following ingredients in the proportions given:
Acetanilid 57 parts
Sodium bicarbonate 29 parts
Ammonium carbonate 10 parts
The Etna Chemical Company, which puts out this product, was
considerably disturbed by the Council’s exposure. It “came back” at the
American Medical Association with the slogan “Phenalgin is just what we
have always said it to be.” What, up to that time, the Etna Chemical
Company had “always said” Phenalgin to be, was:
1.--Phenalgin is a synthetic.
2.--Phenalgin is the only preparation of the kind.
3.--Phenalgin is non-toxic.
These, in brief, were the three things that Phenalgin had been asserted
to be. Each statement has been proved to be a definite and unequivocal
falsehood. Phenalgin is not and never was a “synthetic.” Phenalgin
is not and never was the only acetanilid mixture containing carbonate
of ammonium. Phenalgin is not and never was in any sense of the word
non-toxic. Phenalgin, in short, possesses the properties--both good
and bad--that are common to acetanilid. It is a mixture that the
merest tyro in pharmacy could dispense and for which any sophomore
medical student could write a prescription without stopping to think.
Acetanilid sells at 8 cents an ounce wholesale; Phenalgin at $1.00 an
ounce, wholesale.
All these facts and many more were given to the profession by the
Council on Pharmacy and Chemistry in The Journal more than six years
ago--before even the Food and Drugs Act came into effect. After that
law became operative, the Etna Chemical Company was compelled to say
something on the label that it had never said before, namely, that
Phenalgin contained 50 per cent. acetanilid. But the law not only
required them to add a fact to their label, but it also compelled
them to remove a falsehood. When the pure food law went into effect,
Phenalgin was labeled a “malaria germicide.” It is not a malaria
germicide and never was a malaria germicide, and the Etna Chemical
Company dared not risk taking the question into court so it removed the
statement.
Unfortunately the Food and Drugs Act exercises no control over the
lying statements that may be made for drugs elsewhere than on the
label. So it is that physicians within the last two or three weeks have
received a booklet on Phenalgin containing the following assertions for
this acetanilid mixture:
“Without the slightest harm, injury or depressing effect.”
“Is never followed by depression.”
“Its prolonged administration does not give rise to destructive
blood metamorphosis.”
“Is of great value in the treatment of neuralgia (especially in the
anemic.)”
“Freedom from the deleterious action or habit-forming tendencies of
the opiates.”
“It aids in destroying the malarial parasite.”
“Safest and most dependable of analgesics.”
It will be seen by this that while the Food and Drugs Act has forced a
certain degree of truthfulness on the Phenalgin labels, the advertising
matter is as fraudulent and as untruthful as ever it was. It is true
that the assertion that it is a synthetic is no longer made, possibly
because the medical profession has been so thoroughly enlightened
on the much-overworked “synthetic” fraud that the falsehood is no
longer profitable. In other respects, the assertions are just as
false as ever. It is said to have no depressing effect--and yet
it is acetanilid. It is said to produce no habit--and yet it is
acetanilid. It is said to have no injurious effect on the blood--and
yet it is acetanilid. It is said to be the safest analgesic--and yet
it is acetanilid. How long will the medical profession continue to be
hoodwinked by means of such transparent falsehoods?
The Phenalgin concern takes much credit to itself because on the
cartons in which the bottles of Phenalgin come, it is stated that
the product is “for dispensing purposes only.” Yet, as a matter of
fact, practically any layman can go to any drug store and obtain
this product, for the druggist appraises this spectacular piece of
Pecksniffian virtue at its face value--a joke. Why, if intended only
for physicians, would it be necessary to include with every bottle
a circular naming the diseases, for which this acetanilid mixture
is supposed to be good--“headache,” “colds,” “lumbago,” “scanty
menstruation,” “pain in any part of the body”--and why is the name of
the product and of the firm making it blown into the bottle?
To sum up then, Phenalgin is as big a humbug as Peruna ever was. It
is sold to-day under claims that are just as false as those used six
years ago. The Etna Chemical Company is perpetrating a stupendous fraud
on the medical profession to-day and it is doing it not only through
the agency of the United States mail, but with the aid and support of
the following medical journals--and others--in which the Phenalgin
advertisement appears:
_Medical Record_
_New York Medical Journal_
_Pediatrics_
_Lancet-Clinic_
_American Journal of Surgery_
_International Journal of Surgery_
_American Medicine_
_American Journal of Obstetrics_
_Medical Century_
_Pacific Medical Journal_
_Dietetic and Hygienic Gazette_
_Medical Standard_
_Eclectic Medical Journal_
_Am. Jour. of Clinical Medicine_
It is conceivable that in some cases it is not easy for those editors
and publishers of medical journals who insist on relying on their
own judgment to satisfy themselves that certain preparations are not
worthy of being advertised. No such difficulty occurs in the case of
Phenalgin. Here the issues are clear cut. The product is exploited
under claims that are both false and vicious and their falsity and
viciousness are perfectly evident to any freshman medical student.
The only charitable explanation of the appearance of the Phenalgin
advertisements in the medical journals listed is that the editors and
publishers have not given the subject the attention it deserves and
to which their readers are entitled. Perhaps it would help if their
attention were called to the matter by their subscribers.--(_From The
Journal A. M. A., Jan. 27, 1912._)
PHENO-BROMATE
An analysis of this preparation made at the instance of the New Haven
Medical Association, by its chemist, and sent by Dr. Charles J. Foote
of New Haven to The Journal is in part as follows:
The package was marked “Sample package, Pheno-Bromate. The
Pheno-Bromate Company, New York, U. S. A.” The box contained a number
of tablets and a package of powders in papers marked, “Physicians’
10 grain powders, Pheno-Bromate.” The substance in the papers was a
white crystalline powder not homogeneous. It was completely soluble
in hot water. The hot water solution on cooling yielded a mass of
thin crystalline plates. This material was found to melt at 113.5 C.
It gave no color with ferric chlorid and a positive isonitril test.
The portion insoluble in ether amounted to 49.8 per cent. of the
powder and consisted of potassium bromid. Quantitative determinations
of potassium and bromin in the original solution confirmed this
result. In my opinion, the powder consists of approximately equal
quantities of acetanilid and potassium bromid. Qualitative tests of
the tablets indicated that they had the same composition except for a
small quantity of some excipient not entirely soluble in water. Yours
truly,
Herbert E. Smith,
Chemist New Haven Medical Association.
Before the Food and Drugs Act Pheno-Bromate was advertised as “a
synthetic combination of the phenetidin and bromid groups, and not,
as is the case with many analgesics and antipyretics, a mixture of
various coal-tar derivatives” and as “the safest and best of all
sedatives.” The dose recommended in most cases is 20 grains--equal to
10 grains each of acetanilid and potassium bromid. Since the Food and
Drugs Act has gone into effect its label states that it is “a perfect
combination of a phenol and bromin derivative containing 282 grains of
acetphenetidin, U. S. P., per ounce.” What a boon it was to mendacious
manufacturers that the patent rights on phenacetin expired before the
Food and Drugs Act went into effect.--(_Abstracted from The Journal
A. M. A., July 14, 1906, and April 18, 1908._)
PHENOLPHTHALEIN
Phenolphthalein has long been used as an indicator in chemical
reactions, but its use as a therapeutic agent[115] is comparatively
new. When its laxative properties were first discovered it was
exploited as a proprietary in Germany, and it was not long before the
enterprising manufacturers in this country saw in it a potential gold
mine and now nearly every proprietary drug manufacturer in this country
has coined a proprietary name for it and is exploiting it, either alone
or in combination with one or more other laxatives, and with more or
less unwarranted claims.
[115] Those who wish to study the action and use of this drug further
will find references to articles in The Journal as follows: The
Journal, Jan. 5, 1907, pp. 64 and 70; March 30, 1907, p. 1133; April
20, 1907, p. 1351; Nov. 21, 1908, p. 1782; Nov. 28, 1908, p. 1886. The
first page mentioned discusses the introduction of phenolphthalein into
medicine.
Phenolphthalein itself has certain pretty well defined properties, but
when a little of some other drug has been added wonderful therapeutic
possibilities are claimed for the combination. The drug also has a
definite market value and the pure substance in the form of powder,
tablets or pills could not be sold at a price greatly in excess of the
market value. Thus manufacturers, from business policy, add to it other
drugs. There are now on the market numerous more or less secret and
“fancy” preparations of phenolphthalein for which a price is charged
out of all proportion to the value of the preparation. Among these are:
Phenolphthalein Laxative (_El Zernac Co._).
Exurgine (_Bischoff & Co._).
Probilin (_Schering & Glatz_).
Prunoids (_Sultan Drug Co._).
Laxine (_Columbus Pharmacal Co._).
Phenolax Wafers (_Upjohn Co._).
Laxaphen (_Parke, Davis & Co._).
Phenalein (_Pax Chemical Co._).
Thalosen (_Abbott Alkaloidal Co._).
Laxothalen Tablets (_Pitman-Myers Co._).
Veracolate (_Marcy Co._).
And additional preparations are still coming out! Some of the
preparations contain only the phenolphthalein with a coined
non-descriptive proprietary name attached, but most of them contain
in addition one or more of such drugs as cascara, sulphur, prune,
senna, salicylic acid, ipecac and aromatics. The exploitation of
phenolphthalein in this way gives opportunity to the manufacturers to
make all sorts of strong claims, some of them directly contradictory,
for their preparations. For instance, Phenolax, which is said to
contain phenolphthalein and cane sugar, is claimed to be “a great
success for all forms of constipation, intestinal atony and hepatic
torpor.” Of Laxothalen, which is said to contain phenolphthalein,
aromatics and sugar, it is stated that “its action is confined to the
bowel and it has practically no hepatic action.” Of Prunoids, which
is said to contain phenolphthalein, cascara, de-emetized ipecac and
prunes, we have the old familiar statement that “the harmonious
blending of the several ingredients will give results that cannot be
obtained through their use separately, nor will their use be followed
by after-constipation.”
At the time phenolphthalein was beginning to be exploited in this
country The Journal[116] suggested that physicians who wished to try
the remedy should prescribe it under its own name and not under fancy,
coined names. Since phenolphthalein occurs in the form of an insoluble
and tasteless powder there is no reason why special pharmaceutical
preparations of it should be placed on the market. It can be prescribed
in powder form, in pills, capsules or tablets. Thus given, the true
therapeutic action of the drug would be apparent and its actual value
arrived at.
[116] The Journal, March 30, 1907, p. 1133.
The vice of this unscientific habit of prescribing names instead of
drugs is stated in a forcible way in a letter received from Dr. V. E.
Simpson, a teacher of materia medica and therapeutics in the medical
department of the University of Louisville. He says:
“Recently P. D. & Co.’s representative left on my desk a sample
labeled ‘Laxaphen.’ The formula given is: phenolphthalein, gr. viii;
salicylic acid, gr. 3/5, in each fluidounce, ‘incorporated in a
palatable chocolate base.’ Now, in the first place, this name is one
that the public will easily learn and will soon call for; in the
second place, it is not a name that carries with it even a suggestion
of its contents; and, finally, the physician acquires the habit of
mechanically prescribing names instead of drugs, and in the burdening
of his memory with the myriad of fantastic labelings he finds it
impossible to remember even the drugs any one contains, much less the
exact proportions of those drugs. Then suppose that a consultation
is had; the consultant asks what is being given and the attendant
answers that he is giving ‘laxaphen.’ The consultant, perhaps, has
not been sampled and inquires about it; the attendant must answer.
‘Oh, it contains some phenolphthalein and a salicylate, but I have
forgotten the exact proportions. I have the literature on my desk.’
Had he used U. S. P. and N. F. remedies, which the consultant and
every other doctor in the land has access to and should have some
knowledge of, this embarrassment would not occur.”
All of the above should remind the physician that he should write
simple prescriptions, for drugs whose action he knows, adapted to the
particular case and not for money-making combinations under fanciful,
non-descriptive names exploited by the proprietary manufacturers. In
this way he will not only save money for himself and his patients, but
he will be giving them exact and effective treatment, he will know
exactly what he is giving and learn for himself its effect, and he
will be following the only method which entitles him to be called a
scientific physician.--(_From The Journal A. M. A., April 30, 1910._)
MIXED VACCINE AND PHYLACOGENS[AY]
[AY] A reprint of articles on the subject of Phylacogens originally
published in The Journal is issued under the title “The Phylacogens: A
Menace to Rational Therapy.”
The noted advance in therapeutics shown in the development of vaccine
therapy has brought with it grave dangers as well as advantages.
We have, on a number of occasions, discussed in special articles
and in editorials the dangers which threatened from the rapid
commercialization of this new method. The unscientific character of
mixed vaccines and of the mixed filtered products of a number of
vaccines marketed as “Phylacogens” has been especially emphasized and
the danger from their indiscriminate use pointed out. A little over
a year ago we published a series of articles dealing with the whole
subject in which the nature of mixed vaccines was described[117] as
follows:
[117] Bacterial Vaccine Therapy: Its Indications and Limitations,
p. 37, reprinted from The Journal A. M. A., April 26 June 28, 1913,
price 10 cents.
“The mixed stock vaccine of commerce is a makeshift. It is offered
as a substitute for correct diagnosis. Like all such makeshifts
in science, it is doomed to failure.... A burden is being forced
on the profession which will speedily assume the proportions
attained by proprietary drug combinations. The menace cannot be
counteracted unless physicians will accept the guidance of unselfish,
non-commercial interests and refuse to purchase and use mixed
commercial vaccines.”
This admonition to seek the guidance of unbiased scientific observers
is deserving of special emphasis at the present time. Five weeks ago we
published the address of the chairman of the Section on Pharmacology
and Therapeutics, Dr. John F. Anderson,[118] one of our foremost
workers in this branch of biologic science, in which attention was very
forcibly drawn to the dangers involved in the use of biologic products
of non-specific character. He says:
[118] Anderson, John F.: Some Unhealthy Tendencies in Therapeutics, The
Journal A. M. A., July 4, 1914, p. 1.
“Bacterial therapy undoubtedly in some cases is a most valuable
method of treatment; but when the claim is made that a combination
of the dead bodies or the filtered products of a number of different
bacteria are useful for the treatment of certain diseases with a
different specific cause, it would seem that the suggestion closely
approaches quackery.”
Further he says:
“Aside from the doubtful practice of the indiscriminate use of
unproved methods of treatment, it has seemed to me that a great
injustice is done the patient by their use, since some of the
preparations that have been widely exploited have been shown to
be harmful in certain instances and even to have caused death. So
the first step in attempting to remedy conditions is to awaken the
physician to the importance of ignoring the claims of those who are
pushing these new methods until their usefulness and harmlessness has
been clearly demonstrated by those best in a position to do so.”
As a result of scientific methods in teaching therapeutics, physicians
have gradually given up almost entirely the use of “shotgun”
prescriptions and now prescribe a drug or a combination of a few drugs,
each given for the purpose of exerting a definite action. On the other
hand, the purveyors of bacterial vaccines have gradually increased
the number of different bacteria in their mixed vaccines until some
of those now advertised for sale contain as many as seven different
kinds of bacteria, and some of the “Phylacogens” contain the filtered
products of at least eleven bacterial species!
Under the present federal laws there does not seem to be any way in
which the federal government can do more than is being done at present.
It is a case in which the physician becomes the sole guardian of the
patient committed to his care. He is the one and the only responsible
individual. He cannot throw the blame for bad results back to the
manufacturer. When he subjects his patient to the possibility of harm
by the use of these unscientific and dangerous preparations, the
physician assumes the responsibility, whether he wants to or not.
If physicians would report their failures when these vaccines are used,
and especially report the fatalities consequent on their use, with the
name of the manufacturer of the particular product used, we are quite
sure there would result lessening in the enthusiasm of the purveyors of
these products.
When tempted by the optimistic statements of the interested
manufacturer of these mixtures to give them a trial the physician
should remember that the warnings of disinterested scientists are
of far more value than uncritical clinical reports put out under
commercial auspices.
This we quote from a recent book by Victor C. Vaughan,[119] President
of the American Medical Association:
[119] Vaughan, Victor C.: Protein Split Products in Relation to
Immunity and Disease, 1913, p. 226.
“Every time an unbroken protein is introduced into the body it
carries with it, and as a part of it, a poison. From the very
careless, rash, and unwarranted way in which ‘vaccines’ of most
diverse origin and composition are now used in the treatment of
disease, this matter certainly cannot be understood or its danger
appreciated by those who subject their patients to such risk. It
should be clearly understood that all proteins contain a poisonous
group--a substance which in a dose of 0.5 mg. injected intravenously
kills a guinea-pig. This poison is present in all the so-called
‘vaccines’ now so largely used, and it is not strange that death
occasionally follows the use of ‘Phylacogen’ or similar preparations.
Not only do these proteins contain a poison, but when introduced
parenterally the poison is set free, not in the stomach, from which
it may be removed, but in the blood and tissues. It is possible
that vaccine therapy may become of great service in the treatment
of disease. Even now there are occasional brilliant results which
are reported while the failures and disasters are not so widely
advertised.”
Such a warning as this quotation contains, from a man so eminent as Dr.
Vaughan, merits and should receive the careful attention of medical
men; at least it should have as much weight as the “clinical evidence”
spread broadcast among our profession by commercial houses.--(_From The
Journal A. M. A., Aug. 29, 1914._)
THE DANGER IN PROTONUCLEIN, A PREPARATION CONTAINING THYROID
Protonuclein was the subject of a little article in our Queries and
Minor Notes Department, Nov. 16, 1912, page 1812. Dr. Reid Hunt,
Washington, D. C., writes:
“_To the Editor_:--I have been requested by a physician to call your
attention to certain statements which might well have been added
to your reply to J. A. C. in regard to Protonuclein. Dr. Seidell
and I examined several samples of Protonuclein some time ago[120]
and by chemical and physiologic tests found that they contained the
equivalent of 10 per cent. thyroid of 0.1 per cent. iodin strength
(the actual amount of thyroid may have been greater or less for
we did not know the percentage of iodin in the thyroid used). The
dose recommended on the bottle was 6 to 12 grains every three or
four hours; this represents from 0.6 to 1.2 grains of some of the
commercial thyroid powders, and is sufficient to cause pronounced
thyroid effects in many conditions. Protonuclein was advertised as a
‘perfectly harmless antitoxin, tissue-builder,’ etc., although the
dose of thyroid did not differ materially from that in ‘Rengo’ and
‘Marmola,’ two anti-fat nostrums which we examined at the same time.
We called attention to the danger of using thyroid, the most powerful
tissue-destroying drug known, in cases of typhoid, phthisis, etc.,
for which protonuclein was recommended, though these are conditions
in which the physician is supposed to be exerting every effort to
build up the tissues.
[120] Hunt, Reid, and Seidell, Atherton: Commercial Thyroid
Preparations and Suggestions as to the Standardization of Thyroid,
The Journal A. M. A., Oct. 24, 1908, p. 1385.
“You also speak of the ‘high’ nuclein content (0.28 per cent.
phosphorus): the largest recommended dose would contain only about
1/3 grain of nucleic acid--an amount which probably has not the
slightest effect, especially when given by the mouth.
“A sample of ‘Protonuclein Special’ was found to have twice as much
thyroid as the ordinary Protonuclein; this also was stated to be
‘perfectly harmless.’”--(_From The Journal A. M. A., Feb. 1, 1913._)
PURGEN
The physicians of the United States are receiving a neat package
containing samples of a German proprietary--Purgen. The container is
an ingenious one and, besides the tablets, includes a circular in
English, although mailed in Europe, describing the remarkable virtues
of this “new synthetic aperient.” It has been considered strange that
this proprietary, which has been advertised so thoroughly in Europe,
Australia, etc., should not have made its appearance in this country.
Now it is here, and it is well that physicians should know what Purgen
is and not be mystified and misled by the literature that they may
receive regarding the preparation.
The following appeared in The Journal, Jan. 5, 1907, page 64, and is
reprinted now as being especially timely:
The report of a case of poisoning by Purgen (phenolphthalein) is
the occasion for some pertinent observations by Dr. G. Brasch as to
the proper introduction of such remedies to the medical profession
(_Ztschrift für Medizinalbeamte, Abst. in Apotheker-Zeitung_,
No. 59, 1906). He agrees with Best that all such remedies should
first receive a thorough trial in an institution subject to state
supervision, before they are advertised to the medical profession,
so that their harmlessness in appropriate doses may be ascertained
by a method free from liability to error. The manner in which the
manufacturers introduced Purgen to the profession and the laity is to
be condemned, and probably led to the symptoms of poisoning exhibited
in the case of Dr. Best and tends to discredit a remedy which is
harmless and efficient if used in proper doses. The manufacturer
of such a preparation is inclined, for obvious reasons, to put the
dose of his preparation much too high. The most important point,
however, is the objectionable character of the names given to such
articles. The organic compound phenolphthalein has been known for a
long time and has been widely used as an indicator. Accidentally it
was discovered that phenolphthalein possessed laxative properties
and thereon it was proposed (1901) as a medicine under the name
“Purgen.” It is sold in tablets containing 0.05, 0.1 and 0.5 grain
phenolphthalein mixed with sugar and flavored with vanilla. The
author says: “But it is very desirable--and I regard this as the
most important part of my communication--that phenolphthalein
should be received into the materia medica under its own name. The
addition of vanilla and sugar is to the highest degree superfluous
and the arbitrary dosage in three strengths with the ridiculous
designations, ‘baby,’ ‘for adults,’ ‘for patients confined to bed,’
are merely calculated to prejudice the physician who is accustomed
to individualize in his prescriptions, against a remedy which is in
itself an excellent one.”
As explanatory to the last sentence, it should be stated that in Europe
Purgen is put up in three dosage forms, “infant Purgen for children,”
containing 3/4 of a grain; “adult Purgen for chronic constipation,”
containing 1-1/2 grains, and “strong Purgen for invalids,” containing
7-1/2 grains. The form in which it is being sampled in this country is
in the medium dose, 1-1/2 grains.
Physicians should remember that the promoters of Purgen are simply
introducing a chemical well known to laboratory workers for the
last twenty years, which has been recognized as an aperient for at
least seven years, and which can be purchased for 40 cents an ounce,
whereas an ounce of phenolphthalein in the form of Purgen will cost
$3.20 wholesale. The enthusiastic praise of the remedy, found in the
advertising circulars, should be subjected to critical judgment on
account of its source and motives.
It is undoubtedly true, however, as we have previously stated,
that phenolphthalein is worthy of a trial. In the _British Medical
Journal_, Oct. 18, 1902, F. W. Tunnicliffe speaks of the virtues of
phenolphthalein, and the conclusions reached by him were that it is
a useful aperient, without irritating action on the kidneys, and
is especially valuable in jaundice, its depressing action on the
circulation being less than sulphate of magnesia.
Phenolphthalein is not in the Pharmacopeia, but has been included
in “New and Nonofficial Remedies” by the Council on Pharmacy and
Chemistry. From this we quote:
_Actions and Uses._--Phenolphthalein acts as a purgative, but appears
to possess no further physiologic action. A case of poisoning from
taking 1 gm. (15 grains) is reported. _Dosage._--For adults the
average dose is 0.1 to 0.2 gm. (1.5 to 3 grains) given as powder, in
cachets, capsules or pills. It may be given with safety in doses of
0.5 gm. (8 grains), and these doses seem to be necessary to secure
its effects in bedridden patients or in obstinate cases.
We have gone into this matter again so that our readers may have some
knowledge of this remedy, and we hope that if they conclude to try it
they will use the chemical itself and under its own name.--(_From The
Journal A. M. A., Sept. 14, 1907._)
PYO-ATOXIN
“_To the Editor_:--I am sending you a sample of a proprietary
preparation that for the past two or three years has been largely
retailed in the South and Southwest as a new combination that
liberates larger amounts of formaldehyd, etc., in the genito-urinary
tract than any known agent, that it is a methylene-formate, entirely
new, etc.
“I asked the representative why he had not submitted a specimen to
the Council, and his reply was that like Wyeth and others they did
not get a fair report, or something to this effect. My reasons for
trying to find the truth for their claims is that quite a number of
general practitioners have asked me regarding this Pyo-Atoxin.
“W. P. Dey, M.D., Jacksonville, Fla.”
Dr. Dey sent with the foregoing letter a box of Pyo-Atoxin which bore
this label:
Pyo-Atoxin
Reg. in U. S. Pat. Office
(Capsules)
(Pheno-Methylene-Formate)
“Hurley”
An Antitoxic Agent Indicated in
Gonorrhoea, Cystitis, Pyelitis and
Bacteriuric Conditions.
DOSE: One capsule four to six times daily,
Followed by large glass of water.
Guaranteed by
H. O. Hurley,
Manufacturing Pharmacist,
Louisville, Ky.
Under the Food and Drugs Act, June 30, 1906
Serial No. 1710.
The pseudoscientific synonym “pheno-methylene-formate” carries the idea
that Pyo-Atoxin is a definite chemical substance. It is unnecessary
to say that the term “pheno-methylene-formate” is a meaningless one
and its use reminds one of those preparations exploited seven or
eight years ago before the Council began to expose these mixtures
masquerading as definite chemical compounds.
The chemical laboratory was asked to investigate this preparation and
the following is a report of the chemists:
“The box contained thirty gelatin capsules coated with some black
substance giving them the appearance of some of the popular gonorrhea
nostrums. When the capsules were opened they were found to contain
a powder--about 0.35 gm. or 5 grains per capsule--composed of large
white or colorless crystals mixed with a smaller amount of a fine
dark powder. The crystals when separated out and dissolved yielded
the characteristic tests for hexamethylenamin. A solution of the
entire capsule content was deep blue and responded to the U. S. P.
tests for methylene blue.
“As a result of these and other tests it was concluded
that Pyo-Atoxin consisted essentially of two pharmacopeial
drugs--hexamethylenamin and methylene blue. A quantitative
determination of the constituents was considered unnecessary. From
its general appearance and properties, however, the hexamethylenamin
probably constitutes approximately from 60 to 80 per cent. of the
preparation.”
It thus appears that the capsules contain a mixture consisting
essentially of two well-known official substances, the value and
particularly the limitations of which should be known by physicians by
this time. This nostrum is simply another example of how physicians are
being humbugged.--(_From The Journal A. M. A., Feb. 14, 1914._)
RESINOL
The Philadelphia branch of the American Pharmaceutical Association
issued a pamphlet some two years ago in which the following appeared
relative to Resinol and similar products:
[Illustration]
“Within recent years there have been introduced a number of compound
ointments that in their supposed range of therapeutic usefulness are
scarcely equaled and certainly not excelled by the magic unguents
of the quacks and charlatans of continental Europe, who, several
centuries ago, essayed to cure all manner of disease by inunction or
the simple application of compound ointments of secret composition.
“As typical of this modern class of panaceas we may mention
Resinol. This preparation is being widely advertised at the present
time in the daily papers as a valuable adjunct to Resinol Soap
in the treatment of all kinds and varieties of diseases of the
skin. The makers of this particular mixture, in the form of an
ointment, modestly assert that it will cure all skin diseases, and
is also ‘Specific for Pruritus Ani, Itching Piles, and Pruritus
Vulvæ.’”--(_From The Journal A. M. A., Nov. 6, 1909._)
RESOR-BISNOL
Resor-Bisnol was considered by the Council and refused recognition.
The following formula for Resor-Bisnol was at one time given in
advertisements in a number of medical journals:
“A scientific combination, in nicely balanced proportions of
Bismuth Salts of antiseptic acids of the aromatic series, and
Resorcin.
“Each 100 parts contains 20 parts Resorcin, and 52 parts Bismuth
Oxid, combined with antiseptic acids.”
Besides this formula other “formulas” equally indefinite, vague
and misleading have been given in lieu of an actual statement of
composition, thus:
“---- is a mixture of resorcin and bismuth salts of phenic acids
such as salicylates, etc., and an aromatic alcoholate. Its
composition is as follows.
Bismuth salts of phenic acids 60 per cent.
Aromatic alcoholate of bismuth 20 per cent.
Resorcin 20 per cent.”
The product was recently analyzed in our chemical laboratory. The
chemists report as follows:
“A specimen of Resor-Bisnol examined by us consisted of a light
brown powder possessing a characteristic odor and a taste at first
sweetish and then bitter. It was found to be only partially soluble
in water. The examination indicates that Resor-Bisnol is probably a
mixture consisting essentially of a basic bismuth salicylate (bismuth
subsalicylate), a basic gallate of bismuth (bismuth subgallate),
a basic compound of beta-naphthol (bismuth betanaphtholate) and
resorcinol (resorcin).”
It thus appears that Resor-Bisnol is probably a simple mixture of
well-known substances. In other words, the Resor-Bisnol advertising and
literature are typical of that issued by various nostrum houses: it
conceals the truth in a mass of semi-scientific verbiage, and while not
frankly false, it deceives by what is left unsaid rather than by what
is said.--(_From The Journal A. M. A., June 1, 1912._)
ROBINOL AND SEVETOL
Revamping Discarded Theories for Commercial Purposes
It is astonishing how rapidly medical hypotheses become theories and
theories are accepted for established facts, when such alleged facts
are favorable to commercial enterprise. Yet, as a matter of fact, the
manufacturers of proprietary preparations are under a moral obligation,
at least, to tell the truth with reference to the scientific basis for
their claims. To draw from exploded theories reasons for the use of
proprietary preparations is reprehensible, not only because it may lead
physicians to use preparations which are worthless, but also because
it tends to confirm in the physician’s mind opinions which science has
discarded.
Robinol
John Wyeth and Brother put up a mixture of glycerophosphates which they
call Robinol. In their description of the properties of this mixture
they say:
“Phosphorus exists in the brain, nervous system, and vital organs
as lecithin, of which glycerophosphoric acid is the most important
constituent and is essential to the vital processes for the
reproduction of life and maintenance of metabolism in old age,
impotence, etc.”
The first impression on reading this sentence is that it suggests that
_glycerophosphates_ are essential to the vital processes, although the
statement strictly applies to phosphorus. The next sentence confirms
this impression and the mind glissades from the accepted fact of the
existence of phosphorus in nervous tissue to the unfounded hypothesis
that the glycerophosphates are necessary to supply the essential
element. In the next sentence the circular continues:
“In nervous and general debility the glycerophosphates as exhibited
in Robinol, are preferable to the mineral phosphates as they
contribute the essential constituent of nerve tissue and are
absorbed by the cells more readily than any phosphate of vegetable
or inorganic origin.”
This statement is utterly unfounded. It is in direct opposition to the
conclusions of pharmacologists. The glycerophosphoric acid radical is,
to be sure, found in the lecithin of nervous tissues, but its source
is not known. There is no evidence either that it must be present in
the food or that it must be taken as medicine in order that the brain
and nervous tissues shall be nourished. When the glycerophosphates are
taken there is no evidence that they enter into the composition of the
brain or nervous tissue. They are excreted in the urine and feces as
phosphates. It has never been shown that glycerophosphates are absorbed
any more readily than other phosphates.
But the advertising circular has still more information to impart to
physicians:
“In that group of maladies characterized by faulty nutrition, due
to the excessive elimination of phosphorus from the body, as is
evidenced by the fatigue and weakness following acute attacks and
present in many chronic affections, during the course of fevers and
in the later stages of phthisis and all diseases of the nervous
system, physicians will find the tonic chalybeate properties of the
glycerophosphates of great value.”
Physicians know, if the nostrum makers do not, how difficult it is
to determine whether there is an excessive elimination of phosphorus
from the body. The bulk of the phosphates found in the urine are
derived from the food and so little comes from the metabolism of the
nervous system that it is not easy to prove that any disease is due
to excessive elimination of phosphorus from the body. That fatigue
and weakness are due to such a loss of phosphorus is mere assumption,
a convenient theory for the exploiters of glycerophosphates. But
admitting that nervous waste or faulty nutrition is characterized by
the loss of phosphorus, it is easier, cheaper and more rational to
supply such loss by the use of phosphorus-containing foods, such as
milk and eggs, and there is not the slightest evidence that the loss of
phosphorus will be influenced in any way by giving a supply in the form
of glycerophosphates. Thus, in order to bolster up the sale of a simple
solution of glycerophosphates, vague theories and improbable hypotheses
are dressed in all the dignity of scientific facts.
Sevetol
There was a time, perhaps a generation ago, when physiologists taught
that fats were absorbed into the blood in the form of a fine emulsion.
This theory has been definitely disproved and it is now known that fats
enter the blood only after a chemical splitting into glycerol and fatty
acids, the latter being, to a large extent, combined with alkalies in
the form of soaps.
“Sevetol,” another Wyeth preparation, is presented to the profession
under the claim that it is a very fine emulsion of fats, every portion
of which “is readily absorbed through the intestinal wall.” To quote:
“The administration of Sevetol, therefore, does not tax the
digestive power of the patient, for it is absorbed with very
little effort on the part of the digestive apparatus; and even
if the organs of digestion be involved, neither the weakness
of the patient nor the severity of the symptoms necessarily
contra-indicates its use. The amount ingested is limited only by
the power of assimilation exhibited in the tissues, and it may
be given in large doses for a continued period of time, or until
symptoms of overfeeding are produced, such as coated tongue,
anorexia, constipation, headache and lassitude. When these symptoms
appear, the administration of Sevetol should be temporarily
discontinued and a mild but effective laxative given for several
days, after which its use may be resumed.”
While the language just quoted is a little more exalted and dignified
than that found in typical “patent medicine” advertisements, the
thought it expresses qualifies it for a place in the “Lydia Pinkham”
or “Peruna” class. Every sophomore medical student knows, if he gives
the matter any thought, that Sevetol must undergo the same process of
digestion as any other fat. It must be broken up into a fatty acid
and glycerol, and saponified before it can be absorbed. It is plainly
evident that the amount of Sevetol which can be taken is limited
not only by the power of assimilation, but also by the power of
digestion. The symptoms mentioned in the advertisement and ascribed to
overfeeding, are the symptoms, not of a system saturated with absorbed
fat, but of digestive organs rebelling against an unusual diet.
The exploitation of Sevetol is but one more case of turning to
commercial account an exploded theory. Isn’t it about time that our
profession demanded that the purveyors of medicinal products tell the
truth? And isn’t it time, too, that we cease taking our pharmacology
and therapeutics from proprietary manufacturers?--(_From The Journal
A. M. A., July 4, 1914._)
SALACETIN
Some time ago we wrote to Messrs. Bell & Co., calling their attention
to the fact that we had made an examination[121] of their product,
salacetin, and that as a result of such examination it was found to
be a mixture, which did not coincide exactly with their description
of it. They replied: “Our description of salacetin is correct and we
have nothing more to impart except that anyone publishing any different
formula from that given in our circulars will be held responsible by
us.”
[121] The Journal A. M. A., June 3, 1905; reproduced on page 10 of this
book.
The description they give is as follows:
Prepared by the interaction, with heat, of salicylic acid, glacial
acetic acid, and purified phenylamine.
This sounds very scientific, but when we remember that acetanilid
is a result of the action of glacial acetic acid on phenylamine
(anilin) their description is cute, to say the least. Of course, there
is “interaction with heat” when salicylic acid is combining with
bicarbonate of sodium to form salicylate of sodium. Further, there is,
no doubt, some “interaction with heat” when the substances are rubbed
together in mixing them and when they are going through the mill to
form tablets, not to mention the heated imagination of the promoters of
this “synthetic.”
The following taken from the advertising literature furnished by the
manufacturers and distributed by them, is quoted to show the claims
made for this preparation:
Salacetin is free from Toluodine and produces no harmful cyanosis.
In the treatment of Acute Bronchitis, Grippe, Influenza,
Tonsillitis, Lithemic Headaches, Rheumatism and Neuralgias, it
relieves pain, reduces inflammation and abnormal temperature,
and eliminates uric acid more quickly and thoroughly than the
salicylates, and without causing depression or stomachic or renal
irritation.
Have personally interviewed thousands of physicians, including
every prominent one in the East, and can honestly state that
we have never known of anything at once so efficient and so
unobjectionable in the removal of rheumatic and neuralgic pain
and other symptoms of the uric-acid accumulation.... In La Grippe
and Acute Bronchitis it relieves pain and coughing, reduces
inflammation and temperature, makes the patient comfortable, and
checks the progress of the disease. In Tonsillitis its action is
specific.... In Acid Cystitis, it neutralizes acidity, reduces
inflammation and removes irritation.... In Dysmenorrhea it relieves
pain and congestion with no hallucinations, constipation or danger
of a drug habit.
In Dysmenorrhea and Ovarian Neuralgias try Sal-Codeia--Bell. It
will relieve the pain as well as morphia. It will not check any
secretions, induce any habit, cause any depression or inconvenience
of any kind.
Of course, it is well understood that acetanilid is a valuable
remedy in many instances, if used with caution and when indicated.
It certainly has some therapeutic value. There is no doubt that it
relieves pain of various kinds. It is to be presumed that combining
salicylate of sodium with it will have certain beneficial effects
in certain rheumatic conditions, on the supposition that salicylate
of sodium and acetanilid are both used with more or less success in
certain of these conditions. Also, the combining of bicarbonate of
sodium, carbonate of ammonium, caffein, citric acid, one or several of
these, may result in a fairly good combination, but these combinations
can be found in the list of preparations of all our large manufacturing
pharmaceutical houses, which supply them at one-tenth of the cost of
these secret remedies. The physician in using these preparations put
out by reputable recognized manufacturing pharmaceutical houses not
only is prescribing preparations that are non-secret, but is using
remedies that cost one-tenth as much as the secret preparations,
which are exploited under fanciful names and pushed by ridiculous
claims.--(_From The Journal A. M. A., July 1, 1905._)
SAL-CODEIA--BELL
According to the advertisements “Salacetin”
“... is a combination with heat of salicylic and glacial
acetic acids with phenylamine, the irritating, depressing and
blood-corpuscle destroying elements removed.”
According to the Committee on Chemistry of the Council on Pharmacy
and Chemistry of the American Medical Association, whose report was
published in _The Journal of the American Medical Association_ June
3, 1905, p. 1791, “Salacetin” is a mixture of acetanilid, salicylate
of sodium and bicarbonate of sodium. Sal-Codeia (Salacetin-Codein)
therefore would be the same as above with codein added. Of course,
acetanilid and codein will relieve pain (it could not do otherwise)
and consequently make a very good combination in certain conditions,
if not used too often and if used with care. Although the continued
use of codein is not likely to produce a drug habit, it, as well as
acetanilid, does so sometimes, and it must be remembered that codein
is a motor paralysant, and is not the best combination to be used with
acetanilid. For those who wish to give a combination of acetanilid,
salicylate of sodium and codein, the following prescription is
suggested:
℞ Acetanilid Ʒ i 4|
Sodii bicarbonatis Ʒ ss 2|
Sodii salicylatis Ʒ ss 2|
Codein sulph. gr. vi |4
M. et div. chart No. xxiv.
This will make five-grain powders which may be put in papers, capsules,
cachets or tablets. Each will contain 2-1/2 grains (0.15 gm.) of
acetanilid and 1-1/4 grains (0.075 gm.) each of sodium salicylate and
sodium bicarbonate, with 1/4 grain (0.015 gm.) of codein.
The doses of acetanilid and of codein approximate the average adult
doses, but the sodium salicylate, to have any appreciable effect, must
be increased, for 1-1/4 grains of salicylate of sodium in a dose is
insignificantly small. Sodium salicylate with acetanilid makes a fairly
good combination in certain rheumatic troubles, but it is not indicated
by any means as a cure-all, as one would judge from the literature sent
out by the Sal-Codeia-Bell people.--(_From The Journal A. M. A., Nov.
4, 1905._)
SANATOGEN
Cottage Cheese--The New Elixir of Life[AZ]
[AZ] See also Medical Journals and Sanatogen, p. 431.
The psychology of advertising is nowhere better exemplified than in
the “patent medicine” and proprietary fields. The reason is evident.
Knowing that the general tendency of the human organism is toward
health rather than toward disease and that the “healing power of
nature”--_vis medicatrix naturæ_--will account for a large proportion
of recoveries from sickness, it is not to be wondered at that thousands
of preparations sold for medicinal purposes receive credit that is
entirely undeserved. The awarding of such undeserved credit is largely
due to the universal tendency of those who are not trained in science
to apply the _post hoc, ergo propter hoc_ argument in all matters
relating to health and disease.
John Smith suffers from a passing indisposition. When he recovers he
credits his recovery to whatever he may have done just preceding that
recovery. If he has received medical attention, the physician gets
the credit; if he has taken “absent treatment,” Christian Science is
responsible; if he has taken sugar pills, “Prof.” Munyon gets the
praise--while, as a matter of fact, if he had taken none of these he
would have recovered since he was only temporarily indisposed.
Nor are laymen the only ones that fall into such errors. Many
physicians who prescribe new, widely-advertised preparations are likely
to give those products credit for whatever favorable change may take
place in their patients’ condition. This failing is not a modern
one. In 1842 Dr. Benjamin Brodie wrote: “We have no doubt that many
well-instructed medical practitioners have not sufficiently considered
what course a given disease would take if it were left to itself;
and as to others, it is not possible that they should have any real
knowledge on the subject. With the majority of persons a recovery will
generally pass for a cure.”
[Illustration: Greatly reduced photographic reproduction of a full-page
Sanatogen advertisement appearing in the London _Graphic_. The
_Graphic_ was one of the London magazines that refused to accept an
advertisement of the book issued by the British Medical Association,
exposing “patent-medicine” frauds.]