While every physician is perfectly familiar with the facts just
stated, it seems worth while to give them as a probable explanation of
what is to follow. Within the last few years the medical profession
and the public of this country have been asked to believe that a
combination of cottage cheese--or its equivalent--with a small amount
of glycerophosphates is capable, when sold under a proprietary name and
with the right kind of advertising, of producing physiologic effects
that are little short of marvelous.
The name of this elixir of life is Sanatogen, and it is doubtful if
the history of modern advertising furnishes any more notable example
of the commercial potentialities of publicity than that exhibited in
the exploitation of this product. The Sanatogen advertising campaign
is probably the most skilful piece of work of its kind ever done.
On both sides of the Atlantic, every effort has been made to endow
the advertisements with a dignity which, to those who know the very
ordinary nature of the product advertised, is grotesquely out of
keeping. Only the highest-class magazines and newspapers have been
patronized; the “copy” has been so written as to appeal not to the
ignorant but to the intelligent. Testimonials from men whose names are
well known, even though by training and education they are incompetent
to pass judgment on a product of this kind, and fulsomely laudatory
letters from men whose education and training should have taught them
better--both have been used with all the skill of the trained publicity
man. In short, Sanatogen stands as a monument to the power of printers’
ink.
The claims for this product have already been referred to in The
Journal, but it will do no harm to bring them again before our readers.
Here are some taken from advertisements:
“The Re-Creator of Lost Health.”
“Sanatogen is ... a rebuilding food.”
“... revitalizes the overworked nervous system.”
“Specific nerve tonic action.”
“Most reliable and scientific of all nutrients.”
“... _in certain diseases_ it exerts a _specific action_ which
renders it a valuable adjunct to other curative measures.”
“It stimulates metabolic activity of tissue cells and secures more
complete oxidation of energy-yielding elements.”
“Sanatogen nourishes the system in a persistent, gradual,
cumulative way, so that its best effects unfold themselves in a
systematic, substantial progression to health and strength. It
follows that a regular and prolonged administration of Sanatogen is
necessary for the attainment of lasting results.”
“Sanatogen is a scientific compound, every particle of which
represents the finest concentrated, tissue-constructing nutriment,
endowed with unique revitalizing and rejuvenating powers.”
“Sanatogen contains over 700 per cent. more tissue-building, life
sustaining nourishment than wheat flour.”
Truly a wonderful preparation--if these statements are true! But they
are false--most of them at least. And in that many who can ill afford
it may be led to pay a ruinously high price for a very ordinary food,
the statements are viciously and cruelly false.
In view of the properties with which Sanatogen is credited, its
composition is naturally a matter of more than ordinary interest. What
is this life-giving product? A package of Sanatogen was purchased and
subjected to examination and analysis in the Association’s laboratory.
Our chemists report:
LABORATORY REPORT
Sanatogen is a fine, nearly white powder having a faint yellowish
tinge. A circular which is enclosed in the package states:
“Sanatogen is a definite organic combination of 95 per cent.
of pure, specially prepared casein and 5 per cent. of sodium
glycerophosphate,...”
Qualitative tests indicated the presence in Sanatogen of casein,
sodium, a phosphorous compound and glycerin or a glycerin compound.
Starch and sugars were absent. Quantitative analysis showed that the
composition of the specimen was essentially as follows:
Water (loss at 130 C.) 8.60
Ash 6.23
Casein and other proteins (N × 6.38) 83.10
Casein (N in precipitated casein × 6.38) 80.57
Proteins other than casein (by difference) 2.53
Sodium glycerophosphate (NaC_{3}H_{7}O_{6}P) (P in
filtrate from casein precipitation × 6.79) 5.59
Insoluble matter 0.84
Undetermined 1.87
While these results show that the claims concerning the composition of
Sanatogen are not entirely correct, they indicate that the essential
element in Sanatogen is casein.
The slight variation between the composition claimed for Sanatogen
and the composition as determined by chemical analysis is of minor
importance. Whether there is 83 per cent. of casein as found by the
Association’s chemists or 95 per cent. as asserted by the manufacturers
matters little. The important fact is that casein makes up about
nine-tenths of the preparation and, as must be perfectly evident,
Sanatogen derives whatever food value it may have from that casein.
Casein is known in its commonest form as the curd in milk, or as
“cottage cheese.” After the cream has been separated, the milk which
remains contains nearly all the casein and milk sugar originally
present but practically none of the fat.
WHY NOT COTTAGE CHEESE?
Whence comes the stimulation of metabolic activity, the wonderful
nourishment of the system, the marvelous revitalizing and rejuvenating
power claimed for Sanatogen? Not from the sodium glycerophosphate,
for the consensus of opinion among leading physiologists indicates
that phosphorus in the form of glycerophosphates has little influence
on metabolism. Not from the glycerin, surely, for even granting that
glycerin has food value the amount present is so small as to be
negligible. The real source of energy in Sanatogen, then, lies in the
casein which comprises about nine-tenths of its ingredients.
=======================+=========+==============+============
| | Cost of | Calories.
Kind of Food Material |Price per|1,000 Calories|Energy for
| Pound | Energy | One Dollar
-----------------------+---------+--------------+------------
Sanatogen | $4.54 | $3.01 | 332
Celery | .05 | .77 | 1,300
Eggs ($0.36 per doz.) | .24 | .16 | 6,300
Milk ($0.07 per qt.) | .035 | .11 | 8,850
Pork, loin roast | .12 | .10 | 10,350
Butter | .30 | .09 | 11,250
Mackerel, salt dressed | .10 | .08 | 11,850
Beef, stew meat | .05 | .07 | 15,300
Wheat bread | .06 | .05 | 20,000
Rice | .08 | .05 | 20,250
Sugar | .06 | .03 | 29,200
Pork, fat salt | .12 | .03 | 29,500
Potatoes | .01 | .03 | 29,500
Beans, white | .05 | .03 | 30,400
Oatmeal | .04 | .02 | 45,000
Cornmeal | .025 | .02 | 65,400
Wheat flour | .025 | .02 | 65,400
-----------------------+---------+--------------+------------
Of course Sanatogen, being composed largely of casein, has some food
value. What that food value is may be seen by the accompanying table
which compares the yield of energy for Sanatogen with that of a number
of staple food products, the figures for the latter having been adapted
from Professor Atwater’s calculations. This table shows that, from
the standpoint of economy in the purchase of energy, no other food
in the list is so poor as Sanatogen. While the manufacturers claim
that “Sanatogen contains over 700 per cent. more tissue-building,
life-sustaining nourishment than wheat flour,” the table shows that one
dollar’s worth of wheat flour contains as much energy as one hundred
and ninety-seven dollars’ worth of Sanatogen!
AN INQUIRY
Like all “patent medicines,” Sanatogen is exploited by the testimonial
route. Actors, authors, politicians and not a few physicians--the
latter, to the credit of the American profession, be it said, being
chiefly Europeans--have testified to the wonderful properties of
this product. Believing that it would be of interest to learn what
scientific men thought of Sanatogen a letter of inquiry was written
to several men whose training particularly fits them to express an
impartial opinion on a question of this kind. The following inquiry,
expressed in practically the same words, was propounded:
Is it possible for a product, even if it has the composition claimed
for Sanatogen, to have properties as a food and medicine which are
claimed for this preparation?
The replies to this inquiry are interesting and instructive, although
they are what might have been expected from men whose judgment has not
been warped by the glittering claims of the Sanatogen publicity agents.
[Illustration: Some of the reasons for the sale of Sanatogen! A few
specimen advertisements of Sanatogen’s enormously expensive advertising
campaign.]
THE REPLIES
Dr. Lewellys F. Barker, professor of medicine, Johns Hopkins
University, medical department, says in part:
“If Sanatogen consists simply of casein and sodium glycerophosphate,
it is pretty obvious that all of its good effects (except perhaps
the psychic influence of taking an expensive and, to the layman,
mysterious remedy) can be gotten by including milk and eggs in the
food....
“The objection to Sanatogen lies, it seems to me, not in the
assertion of its proprietors that it is a ‘food and a tonic,’ but
in the misleading of the public and physicians into the belief that
it possesses extraordinary powers which make it worth while to pay
the price charged for it in order to get it. Very extravagant claims
are being made for it in advertisements in the lay press. If just as
much, and more, good in the form of ‘food and tonic’ can be obtained
from a dollar’s worth of milk and eggs as from a dollar and ninety
cents’ worth of Sanatogen, it is surely the duty of the medical
profession to inform the public of that fact.”
Dr. Frank Billings, professor of medicine and head of the Department of
Medicine, University of Chicago, expresses his opinion thus:
“Of course, the thing is a fraud both as a food and as a tonic. Even
if it met all the requirements of the statements made of it by the
makers, it would not be any more of a food than as much casein taken
in milk and probably not as good; or any more than some other albumin
taken in some other form. I do not know just what pharmacologists
say of the glycerophosphate of soda, but so far as my own clinical
observations go I never saw any result from its use that could be
called specific, that is, due to the drug.”
Dr. Richard C. Cabot, assistant professor of clinical medicine, Harvard
Medical School, says:
“In reply to your letter respecting the properties of Sanatogen, I
would say that in my opinion it is vastly improbable that it has the
properties claimed for it in the advertisements which you enclosed to
me. I have no doubt that it is a fairly good food. I see no reason to
believe that the phosphorus that it contains has any special action.”
Otto Folin, professor of biological chemistry, Harvard Medical School,
expresses himself thus:
“For myself, or for any one who would take my advice, I would prefer
a glass of milk to Sanatogen when hungry and plain glycerophosphate
to Sanatogen when in need of a tonic.
“Medicated feed used to be sold for horses. To me the ‘food tonic’
combination represents one of the most unscrupulous fake ideas used
by manufacturers of patented articles to fool the public.”
Ludvig Hektoen, professor of pathology, University of Chicago, says in
part:
“In my opinion, no attention whatsoever should be paid to the claims
advanced in favor of ‘Sanatogen’ as food and as medicine, because
the statements made in the advertisements of this product are
extravagant, misleading and quackish.”
J. H. Long, professor of chemistry and director of chemical
laboratories, Northwestern University Medical School, expresses the
following opinion:
“With every reading of the advertising literature of the Sanatogen
Company I am more and more impressed by the gross exaggeration of the
claims made for this mixture of casein and sodium glycerophosphate.
Cow’s milk contains 3-1/2 to 4 per cent. of casein, associated with
soluble phosphates. It is absurd to think that this casein after
precipitation from the milk has a greater nutritive value than it has
in its native condition. Casein, at best, is probably less valuable
as a food than are certain other proteins, because of its lack of
some of the amino groups essential in tissue building, and the
addition of a glycerophosphate cannot supply this deficiency.
“This is not the first attempt to exploit casein preparations. The
earlier efforts failed in practice because they were based on a wrong
conception concerning the physiologic value and importance of this
protein. The assumption that in the case of Sanatogen a ‘definite
organic combination’ with the glycerophosphate is formed cannot be
taken seriously by chemists. We have witnessed many such efforts to
palm off mixtures as definite organic compounds, and in this way to
claim for them a value in excess of that which they actually possess.”
[Illustration: WHAT ONE DOLLAR WILL BUY IN FOOD ENERGY! A COMPARISON
OF THE CALORIC VALUES OF SANATOGEN, COW’S MILK, SUGAR AND WHEAT FLOUR.
BASED ON THE TABLE ACCOMPANYING THIS ARTICLE.]
Graham Lusk, professor of physiology, Cornell University Medical
College, after calling attention to the falsity of the claim that
Sanatogen is “a life-sustaining agent in disease,” says:
“If one considers the casein content alone, the dose of Sanatogen
recommended in the circular would furnish, at best, about what is
contained in a pint of milk, or one-fourth of the total of the
protein necessities of the body--using a low protein requirement.
That sodium glycerophosphate has any distinctly beneficial
physiologic action has never, to my knowledge, been shown.
“It is a great pity that the public does not realize the splendid
and economical value of milk, bread and the ordinary vegetables,
cereals and meats, as true ‘tonic food stuffs,’ in contradistinction
to prepared nostrums whose sale depends on a psychic stimulus applied
to a susceptible populace.”
H. Gideon Wells, associate professor of pathology, University of
Chicago, says:
“There is nothing in my knowledge of physiologic chemistry which
would lead me to believe that a mixture of chemically isolated casein
and sodium glycerophosphate would possess any effect more favorable
than that of a corresponding amount of milk. I can easily believe
that it would be less valuable than milk. The successful practice
of many commercial houses, of isolating one of the constituents of
our food, and ascribing to it marvelous nutritive or therapeutic
properties, is one of the most telling bits of evidence of the
inadequacy of the education of the medical profession in physiology
and physiologic chemistry that can be conceived.”
The consensus of opinion thus expressed is only what might have been
expected from men who could discuss the problem in a purely judicial
spirit and with a freedom from that bias which seems to be inseparable
from the consideration of the simplest of mixtures that have been
glorified by a proprietary name.
THE TYRANNY OF WORDS
Herr Teufelsdröckh was right when he panegyrized clothes. And the
worship of clothes is carried to the extreme nowhere so much as in
the case of word-clothes. The most plebeian things when bedecked in
sufficiently imposing word-finery are endowed with the attributes
of royalty before which the average intellect bows down. Neither
cottage-cheese nor glycerophosphates, when exposed naked to the world,
commands any overweening respect; combined and dressed in the magic
word “Sanatogen,” they receive the homage of those whose judgment is
blinded by the glittering trappings of word-finery. Some day, possibly,
there will be a democracy of intellect which will refuse to prostrate
itself before mere word-raiment and will insist on appraising things
at their naked worth. When that day comes, proprietary humbugs like
Sanatogen will have become as extinct as the dodo and the great
auk.--(_From The Journal A. M. A., April 20, 1912._)
The Bauer Chemical Company’s “Reply”
_To the Editor_:--Our attention has been called to a most unfair
and unwarranted attack on Sanatogen which appears in your esteemed
publication [April 20, p. 1216]. The article is such a perversion of
the actual facts, and so completely--if not intentionally--misleading
that we request, as a matter of common justice, that you give this
reply equal publicity to your attack. The admiration and respect
we have felt for your journal and our appreciation of the place
it holds in the field of medical journalism, made your attack on
a product like Sanatogen, representing so definitely the most
painstaking and scientific research, the last thing expected. Indeed,
it seems inconceivable that a journal apparently so alive to its
responsibilities could publish broadcast an article so calculated to do
harm, without first giving those whose interests are most at stake an
opportunity to substantiate their claims.
There never has been a time that we have not been ready to meet any
request from The Journal, or the respected gentlemen composing the
Council on Pharmacy and Chemistry, for all information and data
concerning Sanatogen. Had we had the slightest inkling that our
product--or the claims made for it--were open to question or criticism,
we would gladly have submitted all of the evidence, clinical,
experimental, and theoretical, on which every statement, however
simple, has been based.
To make a response is difficult, because your article is not written
in a fair, unprejudiced spirit. In fact, although one would expect a
sober, serious consideration of a matter so fraught with importance
(if your contention is right) your whole attitude is one of ridicule
and jocularity. Is it right to present scientific material in such
a way and show so little respect for those who have offered you no
affront or done you no injury? A little investigation would have shown
you that the statements we have made about Sanatogen are based on the
experiences and opinions of such men as von Noorden, C. A. Ewald,
Duhrssen, Eulenburg, Neisser, Binswanger, von Leyden, Krafft-Ebing,
Tillmanns, Tunnicliffe, and thousands of other earnest, reputable
physicians. Any one might differ with their conclusions, but is it
courteous or decent to hold them up to ridicule and contumely?
Can a discussion thus conducted hope to solve a scientific problem or
accomplish any real good?
It would hardly seem so, and with all due respect we cannot help but
feel that the situation has its analogy in the legal doctrine, “when
you have no evidence, ridicule and abuse your opponent and his client.”
Sanatogen is a definite organic combination of (in round numbers)
95 per cent. casein and 5 per cent. glycerophosphate of sodium. The
analysis as published in The Journal fails to show that this statement
is untrue. The slight deviation as to the amount of casein present is
explained by the fact that The Journal’s figures include the moisture,
while ours are on the dry substance. Inasmuch as nearly all the
moisture is absorbed after the product leaves the laboratories and is
therefore added weight, the figures should be on the dry substance.
It is hinted in the article that Sanatogen is a mere mixture of
ingredients, in fact one of the gentlemen you quote openly intimates
so. To this we say most emphatically that _anyone asserting Sanatogen
to be a mere mechanical mixture of ingredients and not a definite
chemical compound either wilfully misstates the facts or does not
know_. Sanatogen represents a new idea or discovery in the domain of
invalid dietetics and as such its process of manufacture as well as the
product are protected by U. S. Letters Patent.
Assuredly it is the definite chemical combination found in Sanatogen
on which the special value of this product as a medicinal food and
tonic depends. A mere mixture of ingredients would represent only the
sum-total of their individual virtues, but a definite combination of
such ingredients means the formation of a new compound with properties
of its own which far transcend those of any simple mixture of the
original ingredients.
To compare Sanatogen to cottage cheese is the height of absurdity--as
it was probably intended to be. The casein of Sanatogen is perhaps
the most carefully purified milk protein available, and this fact
is of essential importance when considering the value of Sanatogen
as a medicinal food. To compare the casein of Sanatogen with crude
commercial casein or with cottage cheese is as ridiculous as to compare
a crude drug with the refined element. The same applies to the matter
of cost. We suggest that an attempt be made to prepare purified casein
according to Hammarsten’s method, if one wishes to determine what labor
and expense is involved in the operation. Possibly it will be found
cheaper to buy Hammarsten’s casein in the open market where the price
is $3.50 per pound wholesale! And it is not a proprietary product,
either.
Further, to compare the economic value of Sanatogen on the basis of
calories is as unscientific as it is deliberately misleading. If the
caloric standard only counted, a pound of oleomargarine would be as
valuable as fifty eggs, a pound of laundry soap as valuable as a
pound of choice beef. Sanatogen is not intended or recommended to
replace ordinary foodstuffs. It is not recommended as a caloric or
heat producer, but as a food-tonic supplying the essential elements of
tissue construction and cell-repair in easily and perfectly assimilable
form.
Digestibility, ease and completeness of assimilation count a great
deal, and are the sole determining factors in cases of illness. Again,
starch and fat are not essential substances to life. Without protein we
cannot live. Exclude everything else from a patient’s dietary, and he
will live. Exclude protein and it is only a question of time before he
dies. It is evident, therefore, that to measure the value of a given
food in calories only is misleading and dangerous, and an editorial in
your valuable publication of November 4 last distinctly points this
out.
[Illustration: Specimens of Sanatogen advertising--(1913).]
According to the most careful and extensive experiments, covering
a large number of scientifically studied cases, Sanatogen is not
approached in the matter of rapidity of digestion and absorption by
any other known foodstuff. That such a product does exert a definite
stimulating or activating effect on the digestive and assimilative
functions, thus promoting the digestion and appropriation of nutritive
material has been demonstrated over and over again. That the organic
phosphorus of Sanatogen is almost completely retained and assimilated
has been proved beyond doubt by carefully conducted metabolism
experiments. That from this, and from the stimulating action on
phosphorus and nitrogen metabolism, a favorable effect on the nervous
system could result, is conceivable. That such an effect does actually
take place has been demonstrated clinically in literally thousands of
cases.
As to our advertisements and literature: Every claim made emanates
from the freely recorded statements of competent observers, checked
and rechecked by men who have been absolutely free from all bias or
prejudice. And these opinions, moreover, are not the superficial,
passing views of a few physicians. Instead our claims are based on
the voluntary, unbiased written reports of clinical experiences by
over 15,000 practicing physicians--among whom a goodly proportion
are members of your esteemed Association--and on over 150 published
articles in the leading medical journals of the world, some of which
your journal has considered of sufficient importance to present to
its readers in abstract form, suppressing, it is true, all mention of
Sanatogen, although thereby the original was sadly emasculated, if not
actually falsified.
Among the physicians who have carefully tested Sanatogen and determined
its dietetic and therapeutic properties are many men of truly
international reputation, men who are as far above suspicion as was
Caesar’s wife. At least one of these men was the honorary guest of your
Association a few years ago.
It is such men that your article holds up to contempt and dishonor when
you allow the false inference to go forth that Sanatogen is a mixture
of casein and glycerophosphates. It is such men’s careful researches
and experience that you attempt to offset by the snap judgment of men
whom we claim, without the slightest intent of disparaging them, to
be in the present instance unfitted to give an opinion on Sanatogen
inasmuch as they--with perhaps one honorable exception--have never
tested or used the product. Their lack of definite knowledge of
Sanatogen is shown by their persistent references to casein and the
glycerophosphates, as though these two ingredients were separate and
not chemically combined. To consider Sanatogen a mixture is to lose the
vital detail of its specific value.
Now after all, is this a fair, judicial spirit, is this true scientific
enquiry? Are we to accept offhand judgments in preference to the
opinions of those who speak from years of observation of the effects of
Sanatogen? In the name of justice and fair play, is it right for the
great Journal of the A. M. A. to ignore and suppress the accumulated
evidence in favor of Sanatogen and cite instead the cursory opinions
of men who have never seen Sanatogen, tested or observed its effect,
who by the very nature of your enquiry must have been influenced
subconsciously in favor of your side of the matter.
[Illustration: The above is a reduced reproduction of a full-page
advertisement in a magazine devoted to pseudo-scientific fads. The
advertising pages of this magazine reek with frauds.]
During the twelve years Sanatogen has been used, prescribed and
recommended by thousands of competent physicians, it has been free from
all secrecy. The truth has been told at all times. From the first we
have cooperated with the profession. Never have we failed to safeguard
the doctor’s interests. Never have we suggested by word or inference
that any person should employ Sanatogen to the exclusion of medical
treatment. Not a day passes but we refer people who inquire about this
or that bodily ill, to their physicians for advice.
We regret the length of this letter but feel that the scientific
character of Sanatogen, its well-defined chemistry and the respect we
owe to the men who have not hesitated to give their honest opinions
concerning its food and tonic effects, make it imperative that we
refute at once errors and misleading statements, and correct to the
best of our ability the wrong impression you have allowed to go forth.
The clinical reports and statements and the scientific evidence on
which we have based our claims are constantly available and may be
examined by any responsible person for verification or any other
legitimate purpose.
We have tried to make this article temperate, fair and free from ill
temper and ill feeling. We only ask for justice and feel that you will
be willing--possibly anxious--to correct, so far as you can, the great
wrong you have done us.
The Bauer Chemical Co.
By F. W. Hehmeyer, Resident Manager.
[Comment: We devote considerable space to the above free advertisement
of Sanatogen, as The Journal does not want to be accused of being
unfair, even to patent medicine venders. As our readers will recognize,
the above is simply a reiteration of the statements that have been
published in the advertisements of Sanatogen. The song that runs
through all the advertising matter is that Sanatogen is a chemical
compound, and since it is a chemical compound it therefore possesses
properties not to be found in the ordinary mixture. It is the old, old
story; the “synthetic” argument is as hoary as the nostrum business
itself but fortunately the medical profession is no longer easily
fooled by it.
As a matter of fact, even assuming for the sake of argument that the
casein and glycerophosphate in Sanatogen are in chemical combination,
it would be a union of the loosest kind, which on entering the
digestive tract must be broken up into its more stable components,
casein and glycerophosphate. To claim that Sanatogen possesses any
properties not possessed by its essential constituents is a silly piece
of pseudo-scientific claptrap.
Of the testimonials on Sanatogen we shall at this time have nothing to
say; The Journal has in the past repeatedly shown the worthlessness of
this kind of evidence.
We have nothing to retract, rather we would emphasize and, had we
space, enlarge on what we have already published, for we believe that
a large and unfortunate portion of the public, that can ill afford
it, is paying a ruinously high price for a substance having a very
mediocre food value. That indigent consumptives, for instance, should
be led by glittering falsehoods to squander on Sanatogen money that
should go for “food tonics” of infinitely greater value, such as eggs,
milk, vegetables and meats, is not only economic waste but inhuman
cruelty.--Ed.]--(_From The Journal A. M. A., May 18, 1912._)
The Sanatogen “Grand Prix”
A number of letters have been received recently expressing surprise
that Sanatogen had been granted a “grand prix” at the Exhibition of
Medical and Surgical Material held in London at the same time that the
Seventeenth International Congress of Medicine was in session. The
correspondents have asked what such an “honor” meant. The company which
exploits Sanatogen in the United States has not been slow to apprise
the American public of the award. It has gone further and has written
the advertising managers of magazines--including those that had refused
Sanatogen advertisements--directing their attention to the fact that
Sanatogen was awarded a “grand prize” and opining that “this unusual
distinction” should make plain “the desirability of the presence of
Sanatogen in the advertising columns of your esteemed publication.”
Those familiar with the methods of awarding prizes, medals and
certificates to commercial firms and their products at expositions and
exhibitions attach little weight to the “honors” thus conferred. It
is a fact that most purchasers of large--and expensive--exhibit space
at such exhibitions receive some kind of award which, it is tacitly
understood, will be a useful advertising asset. Every one can call to
mind many food products of mediocre quality that have flaunted on their
labels the gold medals received at various expositions.
Nevertheless, it seemed worth while to find out just what the
connection was between the commercial exhibition at which Sanatogen
received the grand prize and the Seventeenth International Congress of
Medicine. The following facts were developed: The commercial exhibition
was entirely distinct and separate from the scientific exhibit of the
Congress. It was managed and conducted by a British drug journal which
had been giving annual “exhibitions” of its own for some years past,
and this took the place of its regular exhibition. Immediately after
the awards were made public the advertising pages of this drug journal
were filled with full-page advertisements of the various products
that received prizes. It may interest our readers to know that while
the cottage-cheese-glycerophosphate product Sanatogen received a
“grand prize” two other proprietary cottage-cheese-glycerophosphate
products received “gold medals” at the same time. In the pharmaceutical
department of the exhibit a widely--and fraudulently--advertised
“patent medicine” received a silver medal! From the facts given
it should not be difficult to appraise at its right value the
“honor” conferred on Sanatogen. The fact that the exploiters of
this preparation are trying to make capital out of this “award” is
significant.
[Illustration: Nor is even the Asiatic neglected in the Sanatogen
advertising campaign. Here is reproduced an advertisement appearing
in an Asian sporting newspaper published in India. The original
advertisement was 10 inches by 15 inches.]
Among the members of the Award Jury whose names were given by this
drug journal were three men of prominence in Great Britain, to whom
we have written. A reply has been received from one, Dr. Stephen
Paget, who says: “I was not on the jury, nor do I know anything about
the matter.... I had nothing whatever to do with the awarding of
prizes.”--(_From The Journal A. M. A., Oct. 11, 1913._)
A Restatement of the Case
The case against Sanatogen has been pretty plainly given at different
times in The Journal, but the sale of the stuff goes on--thanks to
the power of advertising. One criticism that has been made of this
patent medicine is the exorbitant price charged for it. This objection,
although but an incidental one, is the one that apparently appeals to
the layman more strongly than the much more serious criticism, fraud
in exploitation. You arrest the attention of the average man when
you appeal to his purse; he resents paying an exorbitant price for
anything. This probably accounts for the fact that this particular
criticism has apparently hurt the sale of Sanatogen to a greater
degree than the more serious objections made to the preparation. This
also accounts, doubtless, for the fact that the attempts to answer
The Journal criticisms, by those who are selling Sanatogen, have been
largely devoted to the one point--its outrageously high price.
The fundamental objection to Sanatogen is not its high price, but the
attempt to ascribe to a mixture of casein and glycerophosphates powers
not possessed by these ingredients--in other words, the misleading and
fraudulent claims made for it. Even if it were sold at cost price, the
stuff, as at present advertised, would still be a fraud. The nub of
the whole matter is: The claims made for Sanatogen are unwarranted,
misleading and fraudulent.
SOME FRAUDULENT CLAIMS
The constituents of Sanatogen are casein and sodium glycerophosphate.
These two very ordinary substances possess, so the Sanatogen people
would have us believe, peculiar properties when they are brought
together in chemical combination. Sanatogen, they claim, is a
chemical combination of these constituents. The claim may be a good
“selling-point,” but it cannot be, and is not, seriously taken by
chemists. But even supposing, for the sake of argument, that sodium
glycerophosphate and casein could be combined, there is not a scintilla
of evidence to show that such a combination could survive the
destructive influence of digestion and be absorbed. Whether Sanatogen
is a chemical combination of casein and sodium glycerophosphate or a
mere mechanical mixture of these two substances is really immaterial.
In either case, it would be separated into its constituent parts
by the digestive juices and would have the properties of sodium
glycerophosphate and casein, and nothing more.
Remembering this, let us examine once more some of the claims made for
this patent medicine:
“Sanatogen is a nerve and tissue food for which the brain, spinal
cord and the nerves have a special predilection.”
“... practically identical with the main ingredient of nerve and
muscle cells....”
“Sanatogen stands pre-eminent in its power to feed the nerve
centers, to promote healthy digestion, to give strength and
endurance to the entire system.”
“... food for tired nerves....”
“... a rational, scientific nerve-food.”
To the physiologist, the term “nerve-food” is an absurdity. The
processes of digestion reduce the albuminous substances (proteins, such
as casein) of the food to simpler forms. This is true no matter what
may be their source. Whether the proteins are derived from the gluten
of wheat, the casein of milk or the albumin of egg, one will “feed the
nerves” just as well as the other. And Sanatogen “feeds the nerves”
no more than, in fact not as much as, do bread and meat and eggs. Of
course, the casein in Sanatogen has food-value, but so has ordinary
casein--cottage cheese, “pot cheese,” or the German _Schmierkäse_, for
instance--and it is both false and fraudulent to claim for the casein
in Sanatogen any greater nutritive value than that possessed by the
casein in ordinary milk. To pretend that there are wonderful properties
in the protein of Sanatogen when just as good protein can be purchased
(for much less money) from the milkman, is to perpetrate a fraud on the
purchaser. Here are some more claims:
“... marvelous revitalizer of nerve health.”
“... Sanatogen has positive reconstructive force in neurasthenia.”
“If You need New Strength and Vitality You should at once get
acquainted with Sanatogen.”
Strangely like the “lost manhood” advertisements, this last. And this,
also:
“... has brought new strength, new vitality and new relish of life
to thousands upon thousands who suffered from starved nerves....”
“Countless people ... have regained fresh health and vigor through
the vitalizing and invigorating effects of Sanatogen.”
Of course Sanatogen is not sold as a “consumption cure.” No such crude
claims as these emanate from the skilled advertising agents employed
by the Sanatogen people. If they did they could not get space in
high-grade magazines! As a preventive of consumption, however, we find:
“Sanatogen ... creates new tissue and nerve capital ... This nerve
capital will ... save the individual from attacks of acute disease.
Against tuberculosis it is an excellent investment.”
Also, it is a pick-me-up! Thus:
“Sanatogen promises to pick you up when run down--_it does so_.”
Most people are under the necessity of working for a living. If we are
to believe the Sanatogen advertisements, it seems remarkable that the
human race has managed to jog along for so many centuries without this
product, for we read:
“It is practically indispensable to all who are unable to take
prolonged rest....”
Naturally we do not expect to find the coarse, “free-to-you-my-sister”
type of claims in Sanatogen advertisements. Nevertheless:
“Women ... find in Sanatogen a genuine sustaining agent.”
[Illustration: Sanatogen is advertised heavily in the British Isles.
Here are some greatly reduced advertisements appearing in British
magazines. The three largest advertisements shown here measured in the
original 10 inches by 14 inches, each.]
Finally, we would respectfully direct the attention of those gentlemen
of the medical profession who have so far forgotten the dignity of
their calling as to give fulsome puffs for this casein-glycerophosphate
product to the following claims and ask whether they really subscribe
to them:
“... it revivifies the nerves, promoting sleep and helping
digestion....”
“... it builds up the blood, creating new strength and the power to
do and accomplish.”
“... Sanatogen is a _natural_, healthful food and tonic....”
“... a health and strength giving food and tonic composed of those
very elements which make cell and tissue grow.”
“Blood and tissues alike hunger for Sanatogen as their concentrated
nourishment.”
“Sanatogen is the one food tonic that commands your absolute
confidence.”
How many intelligent physicians really believe that there is the
slightest basis of fact for the claims we have quoted? Yet it is by
means of these claims that Sanatogen is being foisted on a public that
looks to the medical profession for enlightenment and truth. And every
quotation in this article is taken from advertising matter issued
during the current year, 1913!
In closing, let us reiterate: The objections to Sanatogen are primarily
the objection to any fraud. It is being sold under unscientific,
misleading and fraudulent claims; moreover, although this is of
less importance, the purchaser pays an extraordinary price for a
most ordinary product. We believe the time will come when even the
artificial stimulus of vast advertising appropriations will be
insufficient to overcome the inertia inherent in a product of small
merit. When that time comes, Sanatogen will die a natural death. In
the meantime, its exploiters are reaping a golden harvest, of which no
small part is being divided among publishers, medical and otherwise.
And the credulous among the sick and suffering pay the bills!--(_From
The Journal A. M. A., Dec. 6, 1913._)
SANATOGEN: A SCIENTIFIC INVESTIGATION OF ITS ALLEGED ACTION ON THE
RECUPERATING POWERS OF THE BLOOD
Sanatogen, the new elixir of life compounded of casein and
glycerophosphates, has been noticed in _The Journal_ from time to time.
It will be remembered that, while it has been claimed that “Sanatogen
contains over 700 per cent. more tissue-building, life sustaining
nourishment than wheat flour,” the facts are that one dollar’s worth
of wheat flour contains as much energy as one hundred and ninety-seven
dollars’ worth of Sanatogen! To this the manufacturers rejoin, in
effect, that the casein and glycerophosphates in Sanatogen, being
in chemical combination, possess a mystical and esoteric virtue not
measurable in terms of the food-value of the several ingredients. The
fact is, of course, that even assuming, for the sake of argument, that
the ingredients of Sanatogen are in chemical combination, the compound
cannot have any effect on the organism different from that of the
uncombined casein and glycerophosphate, for the union must be of the
loosest kind and must be broken up as soon as the preparation enters
the digestive tract.
Testimonials are published in the Sanatogen “literature” which show
results in a variety of conditions; cerebral concussion, alcoholic
gastritis, anemia, etc. The patient is given a chance to recover with
rest, proper diet--and Sanatogen. And the recovery which ensues is
attributed to Sanatogen!
Not all of these testimonials are as naive as that of the Right
Reverend the Bishop of Bath and Wells, who contributes the following
bit of second-hand testimony:
“You may like to hear that I am informed by my private secretary
that a member of his family has derived _very remarkable benefit_
from using Sanatogen.”
[Illustration: Above is a photographic reproduction of one of the
exhibits made at Atlantic City at the last annual meeting of the
American Medical Association.
Jar 1 contains 3-1/3 ounces of the casein-glycerophosphate combination
made abroad and sold under the name “Sanatogen;” it costs One Dollar.
Jar 2 contains 2 pounds 13-1/2 ounces of a casein-glycerophosphate
combination made by an American casein company; it costs One Dollar.
For the same money, then, one gets nearly 15 times as much of this
casein-glycerophosphate combination made in America as when the
casein-glycerophosphate combination is sold under the name “Sanatogen”
and manufactured abroad.
Jar 3 contains one dollar’s worth of pure casein. The casein entirely
fills the jar, although the weight of the material is the same as the
weight of the casein-glycerophosphate combination in Jar 2. Pure casein
is more bulky than the casein-glycerophosphate combination.
Again we would emphasize that the chief objection to Sanatogen is not
its high price, but the fraudulent claims under which it is sold.]
The following selections perhaps fairly represent the value to science
of the clinical evidence offered. Describing a case of vomiting from
cerebral concussion:
“I ordered an ice-bag to the head, a mustard leaf to the
epigastrium, absolute recumbency in bed and small feeds of
Sanatogen with water. This diet was continued for three days, but
the vomiting ceased the second day.”
And here a case of “hungry tired nerves”:
“I have just had a recovery in a remarkable case which scores a
victory for Sanatogen. The patient, a man 63, had been treated for
some years past for heart trouble. When he came to me, however,
I diagnosed his trouble as ‘hungry tired nerves.’ I put him on
Sanatogen and eupeptics. In a month he was much improved.”
In a serious case of the “American disease”:
“I tried Sanatogen on a woman suffering from extreme neurasthenia
and debility. For the past six weeks I have had, and still have,
her under rest-cure treatment, during which time I have given her
Sanatogen. I have been very much elated with the treatment.”
Anemia in a girl of 23 working in a bookbindery:
“I promptly decided to use Sanatogen. In addition, I was able to
secure the girl’s absence from work so that she had the advantage
of outdoor life and sunshine. Improvement was rapid.... Both a
priori and from results obtained it seems almost justifiable to
speak of Sanatogen as a specific in ordinary uncomplicated anemia.”
Note that in all these cases two or more remedial factors were
introduced, yet any favorable result is promptly ascribed to only
one factor, Sanatogen! And the factor of spontaneous improvement
irrespective of all remedial measures is also ignored.
A “SCIENTIFIC” TESTIMONIAL
Every physician knows that the kind of evidence just quoted has
the same scientific value as that of the average “patent medicine”
testimonial--none whatever. The exploiters of Sanatogen put forward
some testimony, however, that purports to have a certain authority.
This is a statement to the effect that “Sanatogen acts as a strong
stimulus as far as the recuperative powers of the blood are concerned.”
This claim is based on biologic experiments carried out by two
physicians, Drs. G. Mann and J. G. Gage, the record of whose work was
published in the _Lancet_, Oct. 19, 1912. The article of Mann and Gage
was gone over with some care and the experiments there described did
not seem to justify the conclusions reached by the authors. As it had
been published in the _Lancet_, a medical journal of standing, whose
publishers apparently thought it of sufficient importance to warrant
the expense of a colored plate insert, it seemed worth while to have
the work of Mann and Gage reviewed and its conclusions checked by
parallel experiments. A. J. Carlson, professor of physiology at the
University of Chicago, was asked to do this work and kindly undertook
it. His report follows:
Report of Professor Carlson
I am asked to review the work done by Drs. G. Mann and J. G. Gage, from
which they draw the following conclusions:
“Sanatogen [sodium caseinogenate glycerophosphates] further
stimulates blood cells to undergo nuclear division, which during the
early period is mostly amitotic.... Therefore, it is evident that
Sanatogen acts as a strong stimulus as far as the recuperative powers
of the blood are concerned.”
Three series of experiments were made and reported by Drs. Mann and
Gage, comparing the histology of the blood in starvation and during
the height of digestion. The experiments of the first series were
made on six students, the starvation period being thirty-six hours,
ordinary food being taken after the thirty-six hours’ fast, so far as
can be gathered from Dr. Mann’s report. It was found that during the
height of digestion the nuclei of the lymphocytes and leukocytes stain
more deeply, and that there is a slight decrease in the cytoplasm and
consequent diminution in the size and number of the granules of the
neutrophil and the eosinophil cells, in comparison with the blood
during fasting.
The experiments of the second series were made on 100 frogs that had
starved for months, blood-films being taken at varying periods after
feeding 1 gm. Sanatogen. The changes noted in the white blood-cells
of the frogs were practically identical with those described in the
case of the six students. Increased cell division is stated to occur.
The nuclei of the erythrocytes stain more deeply and the cells are
increased in size, and exhibit increased cell division twenty-four
hours after the feeding.
The third series consisted of one experiment on Dr. Mann himself. He
fasted twenty hours and then took 15 gm. of Sanatogen in a cup of
water. Practically the only change noted in the blood after the feeding
was a deeper staining of the nuclei of the white cells. To quote:
“The changes in the granules of the polymorphonuclear leukocytes
and in the eosinophils were much less marked than in the specimens
supplied by the students, and the diminution in the size of the
white cells was so insignificant as to be hardly noticeable.”
Assuming that the blood-changes reported are correct, is the conclusion
warranted that Sanatogen is a powerful recuperative stimulant to the
blood?
In the first place, it remains to be proved, for there is as yet
positively no evidence, that the deeper staining of the nuclei during
digestion and absorption of a protein meal represents “recuperative
power of the blood” or processes of “feeding” on the part of the white
cells. The actual significance of these changes requires further
investigation. The increased division of the blood-cells described by
Dr. Mann in the frogs was not observed by him in man. This phenomenon
in the frogs is, in all probability, associated with the extraordinary
length of the starvation period (months) and the well-known seasonal
variations in the physiology of this species.
In the second place, waiving for the moment the question of the
significance of the blood-changes observed, the evidence, so far as it
goes, points to the conclusion that the greater affinity of the nuclei
of the white cells for the stain is brought about by the feeding of any
protein food. The experiments do not demonstrate any different or more
marked effect from Sanatogen than from other protein foods.
The test on the six students with ordinary food can be considered
as a control on the single Sanatogen test on Dr. Mann himself. The
blood-changes in the students were more marked than in Dr. Mann.
Although Mann and Gage say that six frogs were used as controls, they
do not say how the controls were treated, or draw any comparisons
between the controls and the frogs fed with Sanatogen. So far as the
report goes, therefore, the only basis for comparison is afforded by
the work of one of Dr. Mann’s pupils, H. G. Butterfield. This worker,
as quoted by Mann, found that on feeding newts after two weeks’
starvation with a worm the size of a wooden match, the nuclei of all
tissues (excepting nerve cells) take a much deeper stain than in the
control animals. To pronounce Sanatogen, on the basis of the facts
reported, a “powerful stimulus” to blood-formation is a piece of
special pleading, if not of downright disingenuousness. Considered on
its own merits, the work would not have appeared to me worthy of being
repeated for the purpose of checking up such obviously unwarranted
conclusions. In order to comply with the request made of me, however, I
have repeated Dr. Mann’s experiments:
EXPERIMENTS BY PROFESSOR CARLSON
I. TESTS ON MAN (A. J. C.)
1. Thirty-six hours’ fast followed by a meal of 25 gm. Sanatogen in
water.
2. Thirty-six hours’ fast followed by a meal of 25 gm. casein in
water.
3. Thirty-six hours’ fast followed by a meal of 200 c.c. of milk.
II. TESTS ON RATS
1. Four animals, seventy-two hours’ fast followed by a meal of
Sanatogen in water.
2. Two animals, seventy-two hours’ fast followed by a meal of
crackers and milk.
3. Two animals, seventy-two hours’ fast followed by a meal of
casein in water.
4. Two animals, seventy-two hours’ fast followed by a meal of
casein and sodium glycerophosphate in water.
Blood-films were taken at intervals during the fasting period and for
twenty-four hours after feeding was resumed. The technic of fixing and
staining given by Drs. Mann and Gage was followed in every detail in
order to make my results comparable with their findings.
RESULTS
My results may be summarized as follows:
1. The only change in the blood-cells that could be detected with
certainty in rats or in man, after feeding with Sanatogen or after
feeding with other foods, was a deeper staining of the nuclei of the
white cells in the films taken after feeding as compared with the
films taken during fasting. This difference is generally distinct,
and unmistakable, although individual cells can always be found in
the fasting and the feeding preparations that show no difference in
affinity for the dyes. To this extent my results confirm those of Mann
and Gage. I was not able, however, to make out any constant difference
in the size of the cells, quantity of cytoplasm, or size and number of
cytoplasmic granules similar to those reported by Mann and Gage.
2. There was no difference in the affinity for stains on the part of
the white blood-cells in films taken after feeding Sanatogen and those
taken after feeding milk, crackers, casein, and casein and sodium
glycerophosphate. This is true for the tests both on man and on rats.
3. The above-mentioned difference in the staining of the cell nuclei
was somewhat more marked in the tests on rats than in the tests on man,
probably owing to the longer starvation period in the case of rats.
It has already been stated that the significance of this increased
affinity for dyes in the nuclei of the white blood-cells must be
determined by further investigation. It may be related to the change
in the titration alkalinity of the blood rather than an evidence of
“recuperative power” on the part of the blood, as it is well known that
starvation induces acidosis, while during digestion the alkalinity of
the blood is distinctly increased. If we assume that increased staining
reaction during digestion indicates “increased recuperative power of
the blood” it follows that such common and inexpensive foods as milk,
crackers and casein are just as “powerful stimuli” to this recuperation
as Sanatogen.
The extensive researches of Mendel and Osborne have shown that casein
is in a certain sense a perfect food in that it is, in normal animals,
capable of promoting growth and maintaining nitrogenous equilibrium,
at least for long periods of time. The burden of proof, however, rests
with the promoters of Sanatogen to show that the casein in Sanatogen is
superior to the natural product of the cow.
Conclusion
From the findings in Professor Carlson’s report on this disguised puff
of a mendaciously exploited proprietary, about all that remains to be
said is that it is humiliating to find such pseudo-science, not only
built up by members of a profession trained in science, but also given
currency and authority by a medical journal of high standing.--(_From
the Journal A. M. A., Sept. 26, 1914._)
As to Sanatogen
For several years it has been known by physiologists that all proteins
taken into the stomach are disintegrated into their fundamental
components, the amino-acids, and that they are not absorbed at all as
proteins, except in most minute amounts under exceptional conditions.
Therefore, no matter what protein is taken as food, the material
obtained from this protein by the body is a group of amino-acids,
always pretty much the same except in relative proportions, whatever
the food. A few proteins lack certain essential amino-acids, but
any ordinary diet supplies enough, and more than enough, of each and
every amino-acid. Furthermore, since the proteins are completely
disintegrated before absorption, it follows that any adventitious
chemical substance that is bound to a protein taken in the food does
not enter the blood and circulate in the body in the same protein
compound.
All the facts stated above are elementary, and should be known by any
and every physician who pretends to keep even approximately abreast
of the science of medicine. If there are any who do not know these
fundamentals, and from certain unwelcome evidence we fear there are,
they must be resigned to being told just where they stand. Certainly
they have no good excuse for their lack of information, for the
physiologists and biochemists have informed them of modern advances
in innumerable ways. For ten years and more these facts have been
discussed and demonstrated in societies and in medical publications.
And yet--there is Sanatogen, prescribed by Geheimrats, Hofrats and
also by doctors, and testimonialed as abundantly by men with medical
degrees as Duffy’s whisky is by centenarians. One can merely throw up
his hands. If, as the exploiters of Sanatogen declare, the product
“has been endorsed by von Noorden, Ewald, Duhrssen, Eulenburg, Neiser,
Binswanger, Leyden, Krafft-Ebing, Tillmanns, Tunnicliffe and thousands
of other earnest, reputable physicians,” we can only say that their
earnestness has not been in the direction of grasping fundamental
advances in medical sciences, however great the reputation they have
gained may be.
The article by John Phillips Street that follows is another report of
exact experimental observation which shows, as was obvious beforehand,
that Sanatogen has the properties of its constituents, namely, casein
and glycerophosphates. Nothing more nor nothing less could be the
case. Bottling dried cottage cheese plus some glycerophosphates, and
raising the price many times, may increase its psychic effect, but it
will not alter its physiologic action. These facts we have presented
often enough, but the amount of paid advertising the proprietors
of this compound find it profitable to carry in the United States
makes us feel obliged to give them this bit free. That laymen may be
persuaded to purchase Sanatogen in the belief that it possesses some
occult powers not to be found in its constituents is not surprising.
By blatant and persistent advertising, the public can be fooled into
buying any product--however valueless--for which medicinal claims are
made. But that physicians should prove equally gullible is a sorry
commentary on the scientific attainments of the followers of a learned
profession.--(_Modified from Editorial in The Journal A. M. A._, Nov.
21, 1914._)
THE FEEDING VALUE OF SANATOGEN COMPARED WITH COMMERCIAL CASEIN
WITH RESPECT TO MAINTENANCE AND GROWTH
John Phillips Street, M.S.
Chemist Connecticut Agricultural Experiment Station
NEW HAVEN, CONN.
The proprietary preparation “Sanatogen” is claimed to consist of about
95 per cent. casein and 5 per cent. sodium glycerophosphate. The
analysis of C. B. Morison[122] is as follows:
[122] Morison, C. B.: Rept. Conn. Agri. Exper. Station, 1912, p. 197.
Water 9.97
Total nitrogen 12.81
Nitrogen, ppt. by acetic acid 12.54
Casein 80.01
Ether extract 0.11
Ash 5.59
Sulphur, total 0.73
Sulphur in casein 0.64
Phosphorus, total 1.49
Phosphorus in casein 0.69
Phosphorus in inorganic form 0.11
In connection with the above analysis it was demonstrated that
sodium glycerophosphate was present. Sanatogen, therefore, consists
essentially, on the water-free basis, of about 90 per cent. casein
and 5 per cent. sodium glycerophosphate, with a small amount of
an unidentified nitrogenous compound containing both sulphur and
phosphorus, and a small amount of phosphorus in organic combination.
The manufacturers claim that the two essential ingredients exist in
Sanatogen as a definite chemical compound. Certain authorities, on the
other hand, have insisted that the casein and glycerophosphate have
not been chemically combined and that Sanatogen is simply a mechanical
mixture of the two. Which claim is correct we will not consider here,
for indeed it is of little importance, for whether or not chemically
combined the action of the digestive fluids of the body would speedily
break down the alleged compound into its constituents, and the body
would have casein and the glycerophosphate offered for its use, just
the same as though they had been offered as a mere mechanical mixture.
It being apparent that Sanatogen consists almost entirely of casein and
sodium glycerophosphate, the former well-known ingredient making up
nine-tenths of its weight, the question naturally arises how a mixture
of these two common substances can acquire, simply by that admixture,
unusually valuable properties not possessed by the two components.
Leading physiologists quite generally agree that phosphorus in the form
of glycerophosphates influences metabolism very little. Furthermore,
it is obvious that the food value of the small amount of glycerin
present must be slight. It is apparent therefore, that whatever
nutriment or energy Sanatogen supplies must be dependent on its main
constituent casein.
Sanatogen is commonly sold at retail in 100 gm. or 200 gm. packages for
$1 and $1.90, respectively. It is possible that in larger quantities
these prices might be shaded somewhat, but the fact remains that the
ordinary retail purchaser of Sanatogen pays for it about 1 cent per
gram, or about $4.50 per pound. If the value of Sanatogen depends on
its casein, one might ask, in all fairness, why should the patient pay
$4.50 per pound for Sanatogen when he can secure ordinary commercial
casein for 8.5 to 10 cents per pound! (The Casein Mfg. Co. of New York
quoted to me their No. 60 casein at 10 cents per pound in 5-pound lots,
8.5 cents per pound f. o. b. Bainbridge, N. Y., in 100-pound lots, and
8.5 cents per pound, freight paid, in 500-pound lots.) I have purchased
Sanatogen from a wholesale druggist at the rate of $2.75 for 400 gm.,
or $3.12 per pound, so that under the most favorable conditions the
cost of Sanatogen is more than thirty times as great as the commercial
casein in question.
Is the consumer justified in paying this exceedingly high price for
purified casein? The following feeding experiments were carried out to
answer this query.
FEEDING EXPERIMENTS
White rats were chosen for the experimental animals because of
their adaptability for tests of this kind, as shown by the extended
successful experience of Osborne and Mendel, and also because, by using
white rats, I could take advantage of the equipment and the experience
of my colleagues, Dr. T. B. Osborne, Prof. L. B. Mendel and Miss Edna
L. Ferry.
The value of Sanatogen as compared with commercial casein was studied
from two points of view:
1. Its value in maintaining the weight of mature rats.
2. Its value in promoting the growth of young rats.
I. THE MAINTENANCE OF WEIGHT OF MATURE RATS
The Sanatogen used contained 12.88 per cent. of nitrogen, and the
casein, 12.82 per cent., so that from the point of view of nitrogen
content they were practically equivalent, gram for gram.
Six healthy male animals were selected, Rats 1, 2 and 3 being
fed the casein ration and Rats 4, 5 and 6 the Sanatogen ration.
At the beginning of the experiment the casein rats were 257, 360
and 376 days old; the Sanatogen rats, 249, 321 and 275 days old,
respectively. These weight conditions, if anything, slightly favored
the Sanatogen rats, as they were slightly less mature, and a greater
growth might naturally be expected.
The rations fed had the following percentage composition:
Ration 1 Ration 2
Casein 20 Sanatogen 20
Protein-free milk[BA] 28 Protein-free milk[BA] 28
Lard 8 Lard 14
Unsalted butter 18 Unsalted butter 18
Corn starch 26 Corn starch 20
[BA] Osborne and Mendel: Feeding Experiments with Isolated Food
Substances, Carnegie Inst. of Washington, Publ. 156, 1911, Part 2,
p. 80.
The rats were weighed twice a week for nine weeks, a record of the
food consumed also being kept. Table 1 shows the weekly weights of
the casein rats, the weekly gain or loss, and the weekly consumption
of food. Table 2 gives similar data for the Sanatogen rats.
[Illustration: Chart 1.--Growth curves of Rats 1, 2 and 3, on Ration 1:
Casein.]
[Illustration: Chart 2.--Growth curves of Rats 4, 5 and 6, on Ration 2:
Sanatogen.]
Certainly the above data show no superiority of Sanatogen over
commercial casein. In fact the results might be taken to suggest a
slight advantage for the cheaper article, if one were warranted in
drawing fine distinctions from a limited number of animals.
To conclude, _a comparative feeding of six male white rats during nine
weeks showed no nutritive superiority of Sanatogen, costing $3.12 per
pound, over commercial casein costing 10 cents per pound_.
II. THE PROMOTION OF GROWTH IN YOUNG RATS
In the second series of experiments ten male rats were used with
four different rations. In these, casein and Sanatogen were
compared, using both Osborne and Mendel’s “protein-free milk” and
their “artificial protein-free milk IV.”[123] Butter fat was also
substituted for the unsalted butter used in Rations 1 and 2.
[123] Osborne and Mendel: Jour. Biol. Chem., 1913, xv, 317.
The percentage composition of the rations fed was as follows:
Ration 3 Ration 5
Casein 20 Casein 20
Protein-free milk 28 Artificial p.-f. milk IV 29
Lard 8 Lard 8
Butter-fat 18 Butter-fat 18
Corn starch 26 Corn starch 25
Ration 4 Ration 6
Sanatogen 20 Sanatogen 20
Protein-free milk 28 Artificial p.-f. milk IV 29
Lard 14 Lard 14
Butter-fat 18 Butter-fat 18
Corn starch 20 Corn starch 19
Two male rats were used with each of Rations 3 and 4, and three with
each of Rations 5 and 6. They were all healthy young rats ranging
from 57 to 71 days old. As in the first series of experiments
the rats were weighed twice a week and a record kept of the food
consumed. Rations 3 and 4 were fed for seventy-seven days, Rations 5
and 6 for thirty-five days.
Table 3 shows the weekly weights and gains or losses of the rats fed
Rations 3 and 4.
Rat 8 suffered more or less from diarrhea during a considerable part
of the experiment, covering a period from March 16 to April 9, and
from April 13 to May 11. The food intake correspondingly decreased
during those periods.
TABLE 1.--WEIGHTS OF CASEIN RATS, ON RATION NO. 1,
OVER A PERIOD OF NINE WEEKS[BB]
=======+====================+====================+=====================
| Rat 1 | Rat 2 | Rat 3
+-------+-----+------+-------+-----+------+-------+-----+-------
Date |Weight,|Gain |Food |Weight,|Gain |Food |Weight,|Gain |Food
| gm. | or |Eaten,| gm. | or |Eaten,| gm. | or |Eaten,
| |Loss,| gm. | |Loss,| gm. | |Loss,| gm.
| | gm. | | | gm. | | | gm. |
-------+-------+-----+------+-------+-----+------+-------+-----+-------
1/2 | 240.0 | -- | -- | 264.6 | -- | -- | 314.1 | -- | --
1/9 | 250.8 |+10.8| 73.7| 270.9 | +6.3| 85.2| 314.6 | +0.5| 95.7
1/16 | 264.3 |+13.5| 89.3| 284.9 |+14.0| 99.2| 308.7 | -5.9| 117.9
1/23 | 274.9 |+10.6| 90.7| 293.5 | +8.6| 107.7| 313.8 | +5.1| 116.5
1/30 | 278.6 | +3.7| 80.2| 304.5 |+11.0| 100.5| 322.2 | +8.4| 116.7
2/6 | 278.3 | -0.3| 82.4| 294.2 |-10.3| 97.0| 311.2 |-11.0| 119.9
2/13 | 288.7 |+10.4| 85.5| 281.5 |-12.7| 94.2| 308.2 | -3.0| 125.6
2/20 | 286.4 | -2.3| 86.1| 293.3 |+11.8| 86.8| 309.0 | +0.8| 126.8
2/27 | 287.6 | +1.2| 81.1| 297.6 | +4.3| 100.7| 303.4 | -5.6| 129.3
3/6 | 292.6 | +5.0| 80.1| 307.4 | +9.8| 103.1| 292.4 |-11.0| 101.0
Total | -- |+52.6| 759.1| -- |+42.8| 874.4| -- |-21.7|1,049.4
| | | | | | | | |
Average| | | | | | | | |
per | | | | | | | | |
week | -- |+ 5.8| 84.3| -- |+4.8 | 97.2| -- |-2.4 | 116.6
-------+-------+-----+------+-------+-----+------+-------+-----+-------
[BB] The growth curves of Rats 1, 2 and 3 are given in Chart 1.
TABLE 2.--WEIGHTS OF SANATOGEN RATS, RATION NO. 2,
OVER A PERIOD OF NINE WEEKS[BC]
=======+====================+=============+======+=======+=====+======
| Rat 4 | Rat 5 | Rat 6
+-------+-----+------+-------+-----+------+-------+-----+------
Date |Weight,|Gain |Food |Weight,|Gain |Food |Weight,|Gain |Food
| gm. | or, |Eaten,| gm. | or |Eaten,| gm. | or |Eaten,
| |Loss | gm. | |Loss,| gm. | |Loss,| gm.
| | gm. | | | gm. | | | gm. |
-------+-------+-----+------+-------+-----+------+-------+-----+------
1/2 | 251.8 | -- | -- | 290.6 | -- | -- | 294.0 | -- | --
1/9 | 257.1 |+ 5.3| 73.4 | 297.2 |+ 6.6| 86.3| 289.1 |- 4.9| 58.4
1/16 | 262.4 |+ 5.3| 89.8 | 292.4 |- 4.8| 88.9| 286.1 |- 3.0| 76.8
1/23 | 274.4 |+12.0| 97.3 | 295.7 |+ 3.3| 92.8| 287.6 |+ 1.5| 85.8
1/30 | 282.7 |+ 8.3| 95.5 | 299.5 |+ 3.8| 92.3| 298.6 |+11.0| 90.9
2/6 | 279.8 |- 2.9| 97.7 | 284.2 |-15.3| 87.7| 292.9 |- 5.7| 89.8
2/13 | 271.2 |- 8.6| 96.1 | 280.0 |- 4.2| 94.9| 295.1 |+ 2.2| 99.7
2/20 | 257.5 |-13.7| 91.6 | 274.9 |- 5.1| 96.4| 296.0 |+ 0.9| 93.9
2/27 | 258.0 |+ 0.5| 93.5 | 273.0 |- 1.9| 103.3| 295.0 |- 1.0| 95.1
3/6 | 270.9 |+12.9| 94.8 | 278.1 |+ 5.1| 94.9| 306.3 |+11.3| 89.4
Total | -- |+19.1|829.7 | -- |-12.5| 837.5| -- |+12.3| 779.8
| | | | | | | | |
Average| |+ 2.7| | | | | | |
per | | | | | | | | |
week | -- | | 92.2 | -- |- 1.4| 93.1| -- |+ 1.4| 86.6
-------+-------+-----+------+-------+-----+------+-------+-----+------
[BC] The growth curves of Rats 4, 5 and 6 are given in Chart 2.
TABLE 3.--COMPARATIVE WEIGHTS OF RATS FED RATIONS 3 AND 4
=====+=============================+=============================
| Weights of Rats, Ration 3, | Weights of Rats, Ration 4,
|Casein, Protein-Free Milk |Sanatogen, Protein-Free Milk
+-------------+---------------+-----------------------------
| Rat 7 | Rat 8 | Rat 9 | Rat 10
Date +-------+-----+-------+-------+-------+------+-------+------
|Weight,|Gain |Weight,|Gain |Weight,|Gain |Weight,|Gain
| gm. | or | gm. | or | gm. | or | gm. | or
| |Loss,| |Loss, | |Loss, | |Loss,
| | gm. | | gm. | | gm. | | gm.
-----+-------+-----+-------+-------+-------+------+-------+------
3/9 | 142.2 | -- | 108.0 | -- | 127.8 | -- | 107.0 | --
3/16 | 152.8 |+10.6| 120.3 | +12.3 | 129.1 | +1.3| 116.0 | +9.0
3/23 | 165.7 |+12.9| 135.1 | +14.8 | 144.6 | +15.5| 134.5 | +18.5
3/30 | 178.6 |+12.9| 140.4 | +5.3 | 160.0 | +15.4| 149.8 | +15.3
4/6 | 187.8 | +9.2| 148.8 | +8.4 | 173.1 | +13.1| 143.8 | -6.0
4/13 | 198.5 |+10.7| 157.6 | +8.8 | 185.6 | +12.5| 166.1 | +22.3
4/20 | 204.6 | +6.1| 164.6 | +7.0 | 194.8 | +9.2| 179.4 | +13.3
4/27 | 210.3 | +5.7| 167.2 | +2.6 | 204.6 | +9.8| 191.0 | +11.6
5/4 | 223.0 |+12.7| 179.6 | +12.4 | 222.9 | +18.3| 204.7 | +13.7
5/11 | 223.6 | +0.6| 191.6 | +12.0 | 236.4 | +13.5| 210.8 | +6.1
5/18 | 231.5 | +7.9| 203.6 | +12.0 | 240.0 | +3.6| 218.6 | +7.8
5/25 | 237.4 | +5.9| 213.9 | +10.3 | 247.3 | +7.3| 226.7 | +8.1
Total| -- |+95.2| -- | +105.9| -- |+119.5| -- |+119.7
-----+-------+-----+-------+-------+-------+------+-------+------
The difference in the gains in weight shown by the four rats are not
great and certainly do not warrant the conclusion that Sanatogen
possesses any marked superiority over the commercial casein in
promoting growth. The slightly increased gains shown by Rats 9 and
10 are entirely incommensurate with the cost of the Sanatogen. All
of the rats showed a vigorous growth and exceeded the average weight
expected for rats of their respective ages, based on the long series of
observations of Osborne and Mendel, as shown in Table 4.
[Illustration: Chart 3.--Growth curves of Rats 7, 8, 9 and 10 on
Rations 3, Casein, protein-free milk, and 4, Sanatogen, protein-free
milk.]
TABLE 4.--WEIGHT OF RATS 7 TO 10 COMPARED WITH AVERAGE WEIGHT
OF RAT OF SAME AGE
=======+==============+==============+==============
| | |Average Weight
Rat | Age in Days | Final weight,| for rat of
| | gm. | Same Age, gm.
-------+--------------+--------------+--------------
7 | 148 | 237 | 204
8 | 138 | 214 | 201
9 | 145 | 247 | 204
10 | 134 | 227 | 197
-------+--------------+--------------+--------------
[Illustration: Chart 4.--Growth curves of Rats 11, 12 and 13, on Ration
5: Casein, artificial protein-free milk.]
[Illustration: Chart 5.--Growth curves of Rats 14, 15 and 16, on Ration
6: Sanatogen, artificial protein-free milk.]
TABLE 5.--WEIGHTS OF RATS FED RATION 5, CASEIN, ARTIFICIAL
PROTEIN-FREE MILK[BD]
=====+==================+==================+==================
| Rat 11 | Rat 12 | Rat 13
+--------+---------+--------+---------+--------+-------
Date | Weight,|Gain or | Weight,|Gain or | Weight,|Gain or
| gm. |Loss, gm.| gm. |Loss, gm.| gm. |Loss, gm.
-----+--------+---------+--------+---------+--------+---------
3/9 | 132.1 | -- | 110.0 | -- | 99.0 | --
3/16 | 130.4 | -1.7 | 116.8 | +6.8 | 110.3 | +11.3
3/23 | 136.8 | +6.4 | 130.8 | +14.0 | 108.6 | -1.7
3/30 | 137.1 | +0.3 | 138.0 | +7.2 | 100.2 | -8.4
4/6 | 127.1 | -10.0 | 143.9 | +5.9 | 95.5 | -4.7
4/13 | 112.4 | -14.7 | 143.6 | -0.3 | 90.0 | -5.5
Total| -- | -19.7 | -- | +33.6 | -- | -9.0
4/20 | 146.7 | +33.7 | 170.7 | +27.1 | 104.0 | +14.0
-----+--------+---------+--------+---------+--------+---------
[BD] Date 4/20 covers use of mixed food.
Rat 13 suffered more or less from diarrhea throughout the whole
experiment, and Rat 16 suffered similarly during the first two weeks.
The results secured by Rations 5 and 6 compared with Rations 3 and 4,
the only difference being that natural protein-free milk was used in
the latter and artificial protein-free milk in the former, are most
striking. Such results were anticipated from the experience of Osborne
and Mendel in feeding similar materials. All of my rats, except Rat 13,
a casein rat, showed a decided loss in weight after five weeks’ feeding
on rations containing artificial protein-free milk. These losses
amounted to 19.7, 9.0, 23.1, 6.7 and 27.6 gm., whereas rats fed on the
same rations, except for the form of protein-free milk, gained, during
the same period of five weeks, 56.3, 49.6, 57.8 and 59.1 gm. The fact
that one casein
TABLE 6.--WEIGHTS OF RATS FED RATION 6.--SANATOGEN, ARTIFICIAL
PROTEIN-FREE MILK[BE]
=====+==================+========+=========+========+=========
| Rat 14 | Rat 15 | Rat 16
+--------+---------+--------+---------+--------+---------
Date | Weight,|Gain or | Weight,|Gain or | Weight,|Gain or
| gm. |Loss, gm.| gm. |Loss, gm.| gm. |Loss, gm.
-----+--------+---------+--------+---------+--------+---------
3/9 | 118.4 | -- | 111.3 | -- | 101.3 | --
3/16 | 126.2 | +7.8 | 116.2 | +4.9 | 100.0 | -1.3
3/23 | 126.6 | +0.4 | 123.4 | +7.2 | 98.0 | -2.0
3/30 | 124.7 | -1.9 | 123.3 | -0.1 | 98.7 | +0.7
4/6 | 110.2 | -14.5 | 112.3 | -11.0 | 88.7 | -10.0
4/13 | 95.3 | -14.9 | 104.6 | -7.7 | 73.7 | -15.0
Total| -- | -23.1 | -- | -6.7 | -- | -27.6
4/20 | 130.3 | +35.0 | 135.3 | +30.7 | 106.4 | +32.7
-----+--------+---------+--------+---------+--------+---------
[BE] Date 4/20 covers use of mixed food.
rat fed on the artificial protein-free milk showed a substantial
gain is without significance, as such exceptions to the general rule
occur occasionally, and, furthermore, this rat also during the last
week of the experiment likewise lost weight. The extent of these
losses compared with what the average normal male rat weighs at a
corresponding age is shown in Table 7.
TABLE 7.--WEIGHT OF RATS 11 TO 16 COMPARED WITH AVERAGE WEIGHT
OF RAT OF SAME AGE
=====+===========+===============+================
| | | Average Weight
Rat | Age, Days | Final Weight, | of Rat of
| | gm. | Same Age, gm.
-----+-----------+---------------+----------------
11 | 106 | 112 | 167
12 | 106 | 144 | 167
13 | 99 | 90 | 162
14 | 106 | 95 | 167
15 | 92 | 105 | 153
16 | 96 | 74 | 158
-----+-----------+---------------+-----------------
That these losses in weight were not due to any inherent weakness in
the rats is shown by the fact that by feeding Rats 11 to 16 for one
week after the termination of the experiment with Osborne and Mendel’s
“mixed food” (a mixture of dog bread, sunflower seeds, vegetables and
meat) very large gains were secured in every instance, ranging from 14
to 35 gm.
The growth curves for Rats 7 to 16 are shown in Charts 3, 4 and 5.
To conclude, A COMPARATIVE FEEDING OF FOUR MALE WHITE RATS DURING
ELEVEN WEEKS, SHOWED, IF ANYTHING, A SLIGHTLY GREATER, BUT
INSIGNIFICANT, INCREASE IN WEIGHT FOR SANATOGEN OVER COMMERCIAL CASEIN.
IN A RATION IN WHICH ARTIFICIAL HAD BEEN SUBSTITUTED FOR NATURAL
PROTEIN-FREE MILK, SANATOGEN SHOWED NO ADVANTAGE OVER COMMERCIAL CASEIN
IN CHECKING THE FAILURE IN WEIGHT OF THE RATS.--(_From The Journal
A. M. A., Nov. 21, 1914._)
POEHL’S SPERMIN IN ARTERIOSCLEROSIS
A physician addressed the following inquiry to The Journal:
“In a recent number of the _Gazette méd. belge_, I read a detailed
report of five cases of arteriosclerosis in which the patients were
all markedly improved and some of them apparently cured by a course
of ‘Sperminum Poehl,’ an advertised remedy which I have always
distrusted and never prescribed. I am now suffering myself from a
somewhat advanced case of arteriosclerosis and would like to try this
remedy if the Council has learned anything in favor of it and if
there is no reason to fear bad effects from it.”
X. Y. Z.
The Journal replied:
Apparently the exploitation of Poehl’s spermin passed several years ago
from the domain of experimental medicine to that of nostrums advertised
to the laity. So far as we know, it has received no recent discussion
from reliable clinicians or experimenters. In some medical journals,
as also in lay journals, it is true, one still reads that Poehl’s
spermin is successfully applied in “neurasthenia, senile marasmus,
anemia, rachitis, gout, chronic rheumatism, syphilis, hysteria,
tuberculosis, typhus, diseases of the heart, nephritis, tabes dorsalis,
paralysis, neurasthenic impotence, overwork, acute diseases, and for
convalescents.” Few quack advertisements would differ much from this
puff of Poehl’s spermin. So far as we know, there is no reason to fear
injurious results from the use of the remedy; neither might any good
be expected from its use in arteriosclerosis.--(_From The Journal
A. M. A., April 15, 1911._)
SYRUP OF COCILLANA COMPOUND
A physician in a small town in Nebraska writes: “In looking over a
prescription file not long ago I found a prescription which I copied
and am sending to you. It is a good example of shotgun prescribing. I
do not give the name of the prescriber, and you will please not mention
from whence this comes. The doctor who wrote this has had about ten
years’ experience.”
Here is the prescription given exactly as transmitted by our
correspondent:
Sp. sticta Gtt xv
Sp. ipecac Gtt x
Sp. bryonia Gtt x
Sp. macrotys Ʒi
Bromoform Bronchial Anodyne ℥ii
Syrup Cocillana Comp. q. s. ad ℥vi
Teaspoonful every two or three hours.
It is evident that the prescriber is an eclectic. As a matter of fact,
in a second letter from the physician who forwarded the prescription,
we are informed that the prescriber is a graduate of an eclectic
institution not a thousand miles from where he practices. The “Sp.”
in the prescription does not mean “Spiritus,” but specific tincture.
The prescriber is an advocate of specific remedies, one of which
should fit the condition, but he is broad-minded enough to call help
from the outside, and so adds fifteen other remedies to the specific
selected, including alcohol. The inability of one mind to remember
all the ingredients of so complex a mixture will explain the fact
that ipecac is duplicated, occurring both as a specific tincture and
as an ingredient of Bromoform Bronchial Anodyne. The latter, the
manufacturers tell us, contains in one fluidounce:
Alcohol 5 per cent.
Bromoform 8 drops
Ipecac 1/2 gr.
Ammonium bromid 24 grs.
Benzoin 1 gr.
Syrup Cocillana Comp., one of the “elegant specialties” of Parke Davis
& Co., of which they certainly ought to be very proud, contains, we are
told, in one fluidounce:
Alcohol 5 per cent.
Heroin hydrochlorid 8/24 gr.
Tinct. of euphorbia pilulifera 120 min.
Syrup of wild lettuce 120 min.
Tinct. of cocillana 40 min.
Syrup of squill comp. 24 min.
Cascarin, P. D. & Co. 8 grs.
Menthol 8/100 gr.
This “elegant specialty” of Parke, Davis & Co. is not only a shotgun
prescription, but has as one of its ingredients a mixture itself
containing three ingredients, namely: Syrup Squill Comp. (Coxe’s Hive
Syrup), making ten in all--a beautiful example of scientific pharmacy.
We wonder if our eclectic brother really appreciated that his
prescription, written out, would be as follows:
Sp. sticta Gtt xv
Sp. ipecac Gtt x
Sp. bryonia Gtt x
Sp. macrotys Ʒi
Alcohol 5 per cent.
Bromoform 8 drops
Ipecac 1/2 gr.
Ammonium bromid 24 grs.
Benzoin 1 gr.
Alcohol 5 per cent.
Heroin hydrochlorid 8/24 gr.
Tinct. of euphorbia pilulifera 120 min.
Syrup of wild lettuce 120 min.
Tinct. of cocillana 40 min.
Fluidextract of squill 60 min.
Fluidextract of senega 60 min.
Antimony and potassium tartate 1 gr.
Cascarin, P. D. & Co. 8 grs.
Menthol 8/100 gr.
To use a slang expression, this is certainly going some!--(_From The
Journal A. M. A., March 18, 1911._)
“A Cough Syrup with a History”
The following letter was received from Dr. Geo. P. Tolman, Watsonville,
Cal.:
_To the Editor_:--The enclosed advertisement was underscored and
mailed to me by my druggist. The properties of cocillana are similar
to ipecac. The dose of the fluidextract is from 10 to 20 minims. Each
fluidounce of the extraordinary (!) dark-colored cough marvel of P. D.
& Co. contains 40 minims of the tincture. If the tincture of cocillana
is 10 per cent. (the average tincture strength) you can see that to get
a minimal dose of the drug you would have to take 2-1/2 fluidounces of
the syrup.
“Query: Can we still hang on to the old-fashioned cough mixtures
freshly compounded by our druggists or shall we put our shoulders to
the wheel and help P. D. & Co. save the nation and make a few dollars
for the druggist?”
“The secret of its prompt recognition lay in its unusual composition.”
Nay; its prompt recognition lay in liberal and persistent advertising.
“It quickly made a ‘hit’ with physicians”--because too many physicians,
like other human beings, are susceptible to the psychology of
advertising. Here is the “unusual composition,” as given by the
manufacturers:
“Tinct. Euphorbia pilulifera, 120 mins.; Syrup Wild Lettuce, 120
mins.; Tinct. Cocillana, 40 mins.; Syrup Squill Compound, 24 mins.;
Cascarin (P. D. & Co.), 8 grs.; Heroin hydrochloride, 8-24 gr.;
Menthol, 8-100 gr.”
The following is a reproduction of the advertisement referred to:
[Illustration:
+------------------------------------------------------------+
| A cough syrup with a history. |
| |
| =Syrup Cocillana Compound= established itself with the |
| medical profession in a single season. It was introduced |
| in 1906. The secret of its prompt recognition lay in its |
| unusual composition. The formula showed a rare combination |
| of astringents and sedatives. It quickly made a “hit” with |
| physicians. The name “Syrup Cocillana Compound” soon began |
| to appear on prescriptions. Today this agent is the most |
| widely prescribed of all preparations for cough. |
| |
| =Syrup Cocillana Compound= is a profitable product for |
| the druggist to sell. It commands a good price. Being |
| totally unlike the common, ordinary dark-colored “cough |
| mixtures” it does not enter into competition with them. |
| Be prepared to dispense it. |
| |
| Supplied in pint, 5-pint and gallon bottles. |
| |
| Home Offices and Laboratories, PARKE, DAVIS & CO. |
| Detroit, Michigan. |
+------------------------------------------------------------+
]
As we have said above, Parke, Davis & Co. should be proud of this
“elegant specialty.” It would be hard to find a better specimen of a
shotgun prescription; not only does the prescription contain eight
ingredients, but one of these ingredients (compound syrup of squill)
itself contains three.
As our correspondent correctly states, the drug from which the name
(not the action) of the preparation is derived comes from Bolivia and
has properties similar--but evidently inferior--to ipecac. That it
possesses but little therapeutic value is perhaps best evidenced by
the fact that, in spite of the propaganda made for it by Parke, Davis
& Co., neither the drug nor any preparation of it is listed, so far as
we know, by any other large pharmaceutical house, with one exception.
Besides cocillana the preparation contains two other obsolete drugs,
wild lettuce and euphorbia pilulifera. The activity of the “cough
syrup,” it is needless to say, depends in the main on the drug which
is more or less buried in the published formula: heroin hydrochlorid.
At one time Parke, Davis & Co. admitted that the preparation owed its
chief value to heroin. In a letter to the Council on Pharmacy and
Chemistry the firm said:
“The physiologic action of this syrup is that which would be
suggested by the constituents. Because of its activity the
most prominent action would be that characteristic of heroin
hydrochlorid.”
Without doubt the important ingredient, from the point of view of
therapeutic potency, is the heroin; and it is this drug doubtless,
that makes the mixture a good “repeater.” Syrup Cocillana Compound
is a nostrum sailing under false colors. Whether its continued use
is due to its mysterious, meaningless, misleading name or merely to
insistent and persistent advertising methods of Parke, Davis & Co. is a
question. Neither explanation is any credit to the medical profession
which tolerates it, or to the physician who prescribes it.--(_From The
Journal A. M. A., Feb. 15, 1913._)
AUBERGIER’S SYRUP OF LACTUCARIUM
That clause in the Federal Food and Drugs Act which requires certain
potent drugs to be declared on the label of the proprietary mixtures
containing them has been responsible for clearing up many mysteries.
Physicians have frequently wondered why they were unable to obtain from
the syrup of lactucarium, U. S. P., the therapeutic results which they
were able to obtain from a proprietary product known as Aubergier’s
Syrup of Lactucarium, sold by Fougera & Co. at an exorbitant price
and put up in “patent-medicine” style. The milk-juice of lettuce once
bore the reputation of being a soporific--a reputation that has been
artificially maintained largely through the effects of the Aubergier
preparation. With the advent of the Food and Drugs Act the secret
of the soporific effect of the Aubergier product was explained--it
contains morphin.[124]
[124] Technically, this is incorrect, as the company had
inconspicuously stated in the “literature”--not on the label--that the
preparation contained “extract of opium.”
The practical difficulties of making a satisfactory syrup of
lactucarium are not realized by most physicians. To such the following
note, presented at a meeting of the Pennsylvania Pharmaceutical
Association by Mr. Louis Emanuel, president of the Pennsylvania
Pharmacy Board, will prove enlightening:
“Did you ever make a syrup of lactucarium direct from the crude drug?
If you did, shake hands, and let me hail you as a brother, a brother
pharmacist in fact worthy of the title. If you did not, I am sorry
for you; you have missed something worth knowing.
“The _American Journal of Pharmacy_ tells us that in 1851 ‘Aubergier
cultivated lactuca and poppy on a larger scale, in order to
obtain lactucarium and opium. Please note the latter for further
reference. In lactucarium he found lactucin, mannite, resin, cerin,
asparmid, brown coloring-substance and oxalic acid.’ In 1860, in
the same publication, Proctor says: ‘The attention of the medical
practitioners has of late been turned to the syrup of lactucarium,
and the preparation sold usually by apothecaries in this city is
that known as Aubergier’s, a French preparation, made by dissolving
30 parts of alcoholic extract of lactucarium in 500 parts of boiling
water, straining the liquor and adding 15,000 parts of boiling simple
syrup, which is kept boiling, and albuminous water added from time to
time until it is clarified.’ In ’66, ’77, ’78, ’82 and ’84 various
writers produced elaborate dissertations on the supposed improved
methods of making this syrup, but not one has had the temerity of
inquiring into the therapeutic value of this preparation, or to
examine the French preparation to ascertain whence comes its vaunted
superiority.
“The French, it is said, are an impressionable people, but they
appear to have a limit; they do not take any chances on _plain_ syrup
of lactucarium. Theirs contains the added product, extract of opium.
This implies a lack of faith in soporific properties of lactucarium,
and displays a recklessness in regard to cost and labor.
“The National Dispensatory, fifth edition, says:
“The utility of retaining lactucarium as an official medicine is
very doubtful. It may possibly be desirable as a hypnotic for very
impressionable persons, with whom faith in a remedy supplies its
want of intrinsic efficiency.”
“The official modus operandi for making this syrup looks laborious,
but the innocent-looking task of reducing the drug to a coarse powder
is a revelation to the uninitiated.
“It was {a} hot day in July and it took my 175-pound clerk and me all
that day to reduce 50 gm. of lactucarium to a satisfactory condition.
The stuff looked like old pieces of discarded rubber shoes, and it
really appeared to act like rubber. After perspiring all day with the
Pharmacopeia and iron mortar, imagine our disgust, if you can, on
reading in the National Dispensatory the following:
“This alcoholic preparation of lactucarium is quite as valueless
and more objectionable than the syrup of the same drug.”
“Moral: Why pay $6.50 a pound for material that has no medicinal
value, and is so hard to manipulate as lactucarium when decrepit
rubber shoes are so cheap? You can have just as much fun on a hot
summer day in reducing the latter to a coarse powder with clean sand
in an iron mortar as you can with the more expensive material.”
One of the advantages claimed for ready-made prescriptions over the
made-to-order variety, or even over pharmacopeial preparations, is
that they are more elegant in appearance and less offensive to the
nostrils and palate. This is the common experience of physicians who,
having prescribed some ready-made mixture, wish to change the dose
of one of its constituents and write a prescription or ask their
pharmacists to prepare a similar preparation. The inability of the
pharmacist to prepare a preparation even approaching the original in
appearance, color or taste usually leads to increased confidence in
the skill of the manufacturer of the proprietary and a correspondingly
decreased belief in the pharmacist’s professional attainments. But
these conclusions, although natural, are based on false premises. As
the proprietary did not have the composition declared on the label,
a mixture based on the formula differed more or less widely from the
proprietary it was expected to resemble.--(_From The Journal A. M. A.,
Nov. 9, 1912._)
A Protest and a Reply
Three months after publishing the foregoing we received a nine-page
communication from Comar & Co. of Paris, the promotors of Aubergier’s
Syrup of Lactucarium, in which they took issue with some of the
statements in our article. The company claimed that a possible reason
for the difficulty experienced by Mr. Louis Emmanuel in trying to make
the Syrup of Lactucarium from the crude drug is that he did not use
the same variety of Lactucarium that it employs. Furthermore, it said
that the presence of morphin in the product was acknowledged before
the passage of the Food and Drugs Act. On more careful investigation,
we find that this is true--that the presence of “a certain proportion
of extract of opium” in the preparation was mentioned even before
the federal Food and Drugs Act compelled the morphin content to be
published on the label. Technically, then, The Journal was incorrect
in making the implication that the medical profession was not apprised
of the fact that Aubergier’s Syrup of Lactucarium contained morphin;
practically it was right. The information that Comar & Co. gave to
physicians was buried in its advertising “literature” so that it is
fair to assume that not one physician in ten thousand knew--previous to
the Food and Drugs Act--that Aubergier’s Syrup of Lactucarium contained
morphin.--(_From The Journal A. M. A., Nov. 9, 1912._)
TARTARLITHINE
Tartarlithine was examined by two chemists whose reports indicate
that it is an effervescing preparation composed approximately of 20
per cent. of carbonate of lithium and about 80 per cent. of tartaric
acid. Thus it is simply another of the hundreds of lithia preparations
on the market offered for the cure of rheumatism. This in spite of
the fact that scientific investigation and clinical experience have
demonstrated that lithia is of very little use in the treatment of that
disease. While the advertisement carries the idea that Tartarlithine is
a product of the Tartarlithine Company, and that McKesson and Robbins
are simply selling agents, we are informed that the business is owned
by McKesson and Robbins, who under this style manufacture a remedy for
rheumatism.--(_Abstracted from The Journal A. M. A., April 23, 1907._)
THOXOS
Thoxos is a “specialty” of John Wyeth and Brother. From an advertising
circular we learn that it “offers to the physician a rational treatment
for Rheumatism, both the Subacute and Chronic forms, Lithemia,
Rheumatic Arthritis, Gout, Sciatica and the various manifestations of
uric diathesis,” and that “it is a palatable solution of Strontium and
Lithium soluble salts, thirty-two grains, combined with twenty-four
minims Wine of Colchicum Seed and a vegetable alterative, in each
fluidounce, flavored with aromatics.” This “formula” does not
indicate the acid with which the metals strontium and lithium are
combined, or what the “vegetable alterative” is; it is essentially a
secret preparation. To learn what the missing and presumably active
ingredients are an analysis was made by our chemists.
LABORATORY REPORT
One original bottle of Thoxos, John Wyeth and Brother, Philadelphia,
was purchased and submitted to analysis. The bottle contained a
brown liquid having an aromatic odor and a sweet taste. The specific
gravity of the liquid was 1.118 at 15 C. (60 F.) The solution
was acid to litmus. Qualitatively the following constituents
were detected: strontium, potassium, sodium, lithium, ammonium,
salicylate, iodid, glycerin, alkaloid, alcohol and water. By the
smell and taste, oil of wintergreen, or methyl salicylate, and oil
of sassafras were recognized. Positive tests for a saponin-like body
indicated the probable presence of sarsaparilla.
Quantitatively the following results were obtained:
Ammonia (NH_{3}) 0.006 per cent.
Lithium (Li) 0.13 per cent.
Sodium (Na) 0.03 per cent.
Strontium (Sr.) 1.03 per cent.
Iodid (I) 0.46 per cent.
Salicylate (C_{6}H_{4}.OH.COO) 4.19 per cent.
Glycerin 19.2 per cent.
From the analytic results it would appear that the preparation
contains approximately potassium iodid, 0.67 gm. per hundred c.c., or
3 grains per fluidounce; lithium salicylate [Li(C_{7}H_{5}O_{3})],
0.9 gm. per hundred c.c., or 4 grains per fluidounce; strontium
salicylate [Sr(C_{7}H_{5}O_{3})_{2}-2H_{2}O], 5.75 gm. per hundred
c.c., or 26 grains per fluidounce, and some salicylic acid combined
with sodium and also in the free state. The total salicylate found is
equal to 5.47 gm. of sodium salicylate per hundred c.c., or 25 grains
per fluidounce.
As strontium salicylate and lithium salicylate are now generally
considered to differ but slightly, if at all, in their action from
that of sodium salicylate, each dose of Thoxos, 1 teaspoonful or 4
c.c., may be considered the equivalent of 0.2 gm. or 3 grains of sodium
salicylate with a fractional dose of colchicum. Hence this nostrum--for
this is the correct definition--is a mixture of no more value than a
prescription of sodium salicylate with a fractional dose of potassium
iodid and colchicum, one that any doctor could write and any druggist
dispense. Yet it is doubtless prescribed by physicians under the belief
that it possesses some occult power not to be found in ordinary drugs
and their combinations. To prescribe Thoxos is to prescribe a name, and
the patient who takes it would be as well off if he went to the nearest
drug store and purchased a bottle of any of the thousand and one
rheumatism cures with which the country is flooded.--(_From The Journal
A. M. A., March 21, 1914._)
TRYPSOGEN
Besides exploiting a clay poultice--“Antithermoline”--the G. W.
Carnrick Company appears to be chiefly concerned in the promotion
of “internal secretion” specialties; a class of preparations the
therapeutic value of which is problematical. Thus it markets the
diabetes remedy, “Trypsogen” tablets, said to contain “the enzyme of
the islands of Langerhans with the tryptic and amylolytic ferments of
the pancreas” along with gold bromid and arsenic bromid; Secretogen
Elixir, said to be “prepared from gastric secretin obtained from the
pyloric antrum and pancreatic secretin from the duodenum, combined with
the enzymes of the peptic glands, and one-twentieth of one per cent.
HCl”; Secretogen Tablets, said to be “prepared from prosecretin and
succus entericus obtained from the epithelial cells of the duodenum,
combined with pancreatic extract”; Kinazyme, “a preparation of extract
of spleen, reinforced with trypsin, amylopsin and calcium lactate.”
While great claims have been made for Trypsogen and while it has
been most widely advertised, it is the consensus of opinion of the
most eminent students of the question that pancreas is not really
efficacious in diabetes. Were it of any value in this disease, it
would have won world-wide recognition for itself ere now, in view
of the great enthusiasm with which the discovery of the relation of
the pancreas to diabetes was received and of the enormous amount of
clinical, as well as animal, experimentation that followed. As the
conditions of experiment in this question are extremely complex, it is
not surprising that occasionally apparently positive results should
have been obtained. Were it really useful, it should have yielded
positive results much more uniformly.
Furthermore, if pancreas were really efficacious in the treatment of
diabetes mellitus, the addition of arsenic, of gold, of bromid would be
entirely unnecessary.
Even were it granted that pancreas extracts are valuable in the
treatment of diabetes, and that gold and arsenic also have beneficial
effects, it is our opinion that Trypsogen should be considered an
unscientific shotgun mixture, because fixed combinations of remedies
of different potencies, such as arsenic, gold, bromid and pancreas,
are therapeutically erroneous, as they do not permit of that accurate
adjustment of dosage of each ingredient that is indispensable to obtain
maximum benefit with minimum danger of poisoning.
Antithermoline and Trypsogen were at one time described in New and
Nonofficial Remedies. These preparations were omitted when the
Council’s rules were revised some years ago.
When the Council was first organized it undertook only the correction
of the most serious abuses that had become a part of the proprietary
medicine business, and paid less attention to the therapeutic worth
of a remedy; thus at that time it admitted both Antithermoline and
Trypsogen to New and Nonofficial Remedies. Since then the Council has
modified its rules to exclude unscientific mixtures marketed under
names that are misleading or therapeutically suggestive. Accordingly
it rescinded the acceptance of Antithermoline, which was essentially
the official clay poultice, Cataplasma Kaolini, U. S. P. For similar
reasons and because the therapeutic claims were held unwarranted
Trypsogen has been omitted from New and Nonofficial Remedies.
It is to be regretted that the progress of research should be hindered
and the value of genuine products of internal secretion be depreciated
by confusion with such shotgun mixtures and asserted remedies, whose
claims have received no scientific confirmation.--(_From The Journal
A. M. A., Nov. 1, 1913._)
TYREE’S ANTISEPTIC POWDER[BF]
Now Advertised Direct to the Public as the “Best Preventative Known”
[BF] See also report, p. 21.
When the history of the “patent medicine” business comes to be written
impartially and fairly, it will be realized that we, the medical
profession, have been in no small degree responsible for its growth.
Not a few widely advertised nostrums owe their commercial success
solely to the ill considered use accorded them by physicians, to whom
they were first exploited. As a well-known and brilliant advertising
man once said:
“The patent medicine of the future is one that will be advertised
only to doctors. Some of the most profitable remedies of the
present time are of this class. They are called proprietary
remedies. The general public never hears of them through the daily
press. All their publicity is secured through the medical press,
by means of the manufacturer’s literature, sometimes gotten out in
the shape of a medical journal, and through samples to doctors....
The medical papers will reap the harvest and the physician himself,
always so loud in the denunciation of ‘patent medicines,’ will be
the most important medium of advertising at the command of the
proprietary manufacturer. In fact, he is that to-day.”
[Illustration: Advertisement from a newspaper--Tyree’s Powder as a
“Patent Medicine” of the “Preventive” Type.]
Of the conditions here described probably no better example can be
found than Tyree’s Antiseptic Powder. For years this preparation was
advertised to the medical profession under claims that were fraudulent
as to both composition and therapeutic effect. Analysis published
in The Journal[125] proved that the formula given out by Tyree was
absolutely false and that the preparation was, essentially, nothing but
a simple mixture of sulphate of zinc and boric acid.
[125] Oct. 20, 1906, and May 18, 1907.
From the first it would seem that the manufacturers of this mixture
had for their objective point that period when, thanks to the use of
the nostrum by physicians, it would be widely purchased by the public.
Lavish advertising was done in medical journals and Tyree’s Antiseptic
Powder gained admission to the pages of even those journals which
required the publication of a “formula”--for a formula was forthcoming.
The Journal itself, until seven years ago, carried the advertisements
with a “formula” until chemical examination proved the falsity of
the formula, and of the therapeutic claims made for the product. The
medical profession in its turn prescribed the nostrum and the “original
package” scheme did the rest.
[Illustration: Advertisement from Medical Journal--Tyree’s Powder as a
Highly Respectable “Ethical Proprietary.”]
Now, it seems, Tyree considers his preparation so well known that he
can be independent either of the assistance of the physician or of
his good-will. For Tyree’s powder now goes to the public direct and
newspaper readers find it advertised as:
“Ideal for douche.”
“Unequalled as a douche.”
“Best preventative known.”
“Unequalled as a preventative.”
“Has no equal as a preventative.”
And the following, whose very truth must bring the blush of shame to
all physicians who have the interest of scientific medicine at heart:
“Prescribed by physicians all over the world for twenty-one years.”
“Ask your doctor or send for booklet.”
“Used by doctors for the last twenty-one years.”
“One of the highest tributes paid Tyree’s Antiseptic Powder is the
fact that the most successful physicians have been using it for the
last twenty-one years.”
Not that Tyree has entirely forsaken the medical journals, although he
seems to be dropping them one by one. At the beginning of this year at
least fifteen medical journals were carrying the Tyree advertisement;
by March the number had fallen to seven, while in June the only
journals carrying it were:
_Medical Record
American Journal of Obstetrics
Chicago Medical Recorder
Pacific Medical Journal_
Those who answer the newspaper advertisements receive a free sample of
the powder and several leaflets and circulars giving the various uses
(?) of the nostrum. Incidentally these leaflets advertise, in addition,
Tyree’s “Elixir Buchu and Hyoscyamus Comp.,” which is recommended, in
various combinations, for such conditions as acute nephritis, epilepsy,
neurasthenia, gonorrhea and delirium tremens.
Bearing in mind the claim that is made in the newspaper advertisements
that Tyree’s Antiseptic Powder is the “best preventative” known, it is
interesting to see what Tyree has to say to those druggists whom he
offers to supply with circulars for free distribution:
“As these circulars deal with the care of rubber goods, for both
medicinal and toilet purposes, they are of great value to the
customer and will be retained for further reference. They are
boosters for your rubber goods sales, too.”
That a nostrum of this sort should go to the public is not surprising,
but that it should have reached the public through the instrumentality
of the medical profession is a serious reflection on the judgment of
physicians. But the incident has a bright side. That the exploiters of
this nostrum no longer find it profitable to use medical journals as a
means of getting their stuff to the public but must needs use the more
expensive newspaper advertising, is cause for optimism. It means that
physicians are no longer prescribing, indiscriminately, proprietary
products and that they are refusing to be, what they have been in the
past, the unpaid distributing agents for nostrum venders.--(_From The
Journal A. M. A., Aug. 24, 1912._)
VAPO-CRESOLENE
Vapo-Cresolene has been examined in the American Medical Association’s
laboratory and the chemists’ report follows:
According to the statements on the trade package, Vapo-Cresolene “is
a product of coal-tar possessing far greater power than carbolic
acid in destroying germs of disease.” It is recommended as a remedy
for a number of diseases, including croup, catarrh and diphtheria.
According to the manufacturers, it should be used only in “the
Cresolene vaporizer,” which makes it “unequaled for the disinfection
of sick rooms” and the “safest and simplest method of destroying
infection and purifying the air.” From the examination we conclude
that Vapo-Cresolene is essentially cresol and corresponds in every
respect to cresol U. S. P. (Physician’s Manual, page 36).
This report indicates that Vapo-Cresolene is a member of that class
of proprietaries in which an ordinary product is endowed, by the
manufacturer, with extraordinary virtues. The type is so common and has
been referred to so frequently that but for the dangers attendant on
the inhalation of any of the phenols, this particular product need not
have been mentioned.--(_From The Journal A. M. A., April 4, 1908._)
VASOGEN AND IODOVASOGEN
Another Case in Which Independent Analyses and
Manufacturers’ Labels Disagree
Vasogen, a product of Pearson & Company, Hamburg, Germany, has been put
on the market under the various designations, “oxygenated vaseline,”
“water-soluble hydrocarbon” and “oxygenated carbon.” The manufacturers,
and also their American agents, Lehn & Fink, claim that by a special
process the apparent impossibility of saponifying petrolatum has been
overcome with Vasogen as the result. Disinterested chemists who have
analyzed Vasogen find that the product consists essentially of an
ammonium soap and petrolatum--practically an ammonia liniment mixed
with petrolatum.
Just as petrolatum under its various trade names was at one time
recommended as a universal ointment base, so vasogen is recommended
promiscuously as a vehicle for remedies applied externally and even
for internal medication--needless to say in many cases in which it is
directly contra-indicated.
Iodovasogen, recommended for external application as a substitute for
tincture of iodin, was examined by Zernik in 1905, who found that the
iodin existed not as a free iodin, but chiefly as ammonium iodid. The
therapeutic character of the preparation is thus entirely different
from that to be inferred from the labels and elsewhere, since the
counter-irritant effects of free iodin are of course absent in ammonium
iodid. Pearson & Co. now claim that when Zernik’s findings were
published they immediately modified their statements on the label in
accordance with the truth. This is denied by Dr. Lungwitz, the editor
of the _Therapeutische Rundschau_ (_Apotheker Zeitung_, 1908, p. 900),
who vigorously criticizes the misrepresentation made by Pearson & Co.
in regard to Iodovasogen. He calls attention to the fact that, while
Zernick’s results were published over three years ago, the labels which
are in use today still bear the statement that Iodovasogen consists of
Vasogen 90 parts and resublimed iodin 10 parts, and Vasogen 94 parts
and resublimed iodin 6 parts, respectively.
As Iodovasogen and Vasogen in various combinations are being advertised
to the physicians in the United States, the above information from
our German exchanges is worthy of consideration.--(_From The Journal
A. M. A., Feb. 13, 1909._)
VIBURNUM COMPOUND--AND OTHER NOSTRUMS
A number of drugs have some reputation for therapeutic value without
there being any particular evidence to substantiate the claims.
Viburnum, concerning which we recently received the following letter,
is one of these drugs:
_To the Editor_:--Have you made an analysis of Viburnum Compound?
Extravagant claims are being made for it and I cannot put my hand on
any data. A patient has asked me concerning it and I wish to advise
her honestly. I do not know but that there may be several “viburnum
compounds.” I rarely use any of these “put-up” preparations, and
hence know but little about them.
A. J. Hesser, M.D., Pittsburgh, Pa.
No analysis of Hayden’s Viburnum Compound, to which our correspondent
refers, has been made in the Association laboratory. According to
advertising circulars, the preparation contains American skullcap
(_Scutellaria lateriflora_), cramp-bark (_Viburnum opulus_) and wild
yam (_Dioscorea villosa_). Since these drugs contain no well-defined
therapeutically active ingredients, an analysis of the preparation
would necessarily be unsatisfactory.
A number of drugs have in some way obtained a reputation as being
valuable in the treatment of diseases of women, without their
therapeutic claims ever having been proved. It is said that some
were used by the aborigines for such affections and we find a
considerable number of them combined in various nostrums (sometimes
with therapeutically active drugs) and exploited for the cure of
female disorders, under most extravagant and usually absurd claims.
Thus “Pierce’s Favorite Prescription” is advertised as containing
black cohosh, blue cohosh, goldenseal, lady’s-slipper and false
unicorn-root; “Dioviburnia” (Dios Chemical Co.) as containing American
skullcap, cramp-bark, wild yam, blue cohosh, black haw, star-grass,
trailing arbutus and false unicorn-root; “Viburnumal” (Louisville
Pharmacal Works) as containing American skullcap, cramp-bark, wild yam,
star-grass and motherwort.
Most pharmaceutical houses, following the lead of nostrum-makers,
put similar mixtures on the market; for example: “Elixir of Viburnum
Compound” (Nelson, Baker & Co.) is said to contain cramp-bark, American
skullcap and wild yam; “Elixir of Hydrastis and Viburnum Compound”
(Smith, Kline & French Co.), cramp-bark, goldenseal, Jamaica dogwood
and pulsatilla; “Elixir of Hydrastis and Cramp Bark Compound” (Parke,
Davis & Co.), cramp-bark, hydrastis, Jamaica dogwood and pulsatilla;
“Fluid Extract of Cramp Bark Compound” (H. K. Mulford Co.), American
skullcap, cramp-bark and wild yam; “Mother’s Cordial” (Eli Lilly &
Co.), cramp-bark, blue cohosh, false unicorn and squaw vine; “Uterine
Sedative Elixir” (Eli Lilly & Co.), cramp-bark, goldenseal, Jamaica
dogwood and pulsatilla; “Vibutero” (Fred. Stearns & Co.), cramp-bark,
wild yam, black haw, squaw vine, Jamaica dogwood, saw palmetto and
pulsatilla. Practically all of these drugs except goldenseal are
ignored in the standard works on pharmacology. Further, the results of
careful examination by the Council on Pharmacy and Chemistry of the
therapeutic claims made for most of them shows that these claims are
not sustained by reliable clinical experience.
The fact is that the popularity of preparations of this kind is
purely an artificially created one. A nostrum containing, let us say,
extractives of some little-used or worthless drugs is put on the market
and heavily advertised. Should it be advertised in a manner to make it
sell, a host of imitations appear and the large pharmaceutical houses
put out substitutes for it. The uncritical physician does the rest. He
prescribes it indiscriminately in the class of cases for which it is
advertised. Naturally, a certain proportion of the patients who take
it recover, and the recoveries are credited to the nostrum. A vicious
circle is thus established and the demand for the stuff increases. Its
sale, together with the sale of similar products, continues until the
overwhelming experience of those who have prescribed it proves its
uselessness. In the meantime the manufacturers have reaped a harvest,
at the expense both of the public and of the medical profession. And
the manufacturers’ excuse for putting such absurd “specialties” on the
market is that physicians prescribe them!--(_From The Journal A. M. A.,
Aug. 31, 1912._)
WHEELER’S NERVE VITALIZER
Names of nostrums often mislead by the use of fake nomenclature giving
erroneous ideas regarding the composition of the preparation or
misrepresenting the true action of the nostrum. As an example of the
latter class Wheeler’s Nerve Vitalizer was examined in the Association
laboratory and found to be not a vitalizer, as the name implies, but
rather a nerve sedative. The results of the examination follow:
Wheeler’s Nerve Vitalizer was packed in a carton bearing the name
of the preparation, its manufacturers, “The J. W. Brant Co., Ltd.,
Albion, Mich.,” and an exhaustive list of the diseases for which
the product is intended, besides the general statement that it is
a cure for “all nervous diseases.” The “Vitalizer” is a brown,
syrupy liquid having a peculiar salty taste partially masked by
licorice. Qualitative tests showed the presence of sodium, potassium
and bromin, and no other acid radicals except small quantities of
chlorin. It was decided therefore that the preparation contained a
mixture of sodium and potassium bromids. In order to separate the
chlorin and bromin the preparation was evaporated, charred, extracted
with water and acetic acid and potassium permanganate added and the
mixture distilled with steam until all the bromin had been distilled
over, thus leaving the chlorin in the distilling flask. The solution
in the distilling flask was then treated with silver nitrate and
the chlorin estimated in the usual way. The quantity thus obtained
was subtracted from the total silver bromid and chlorin obtained by
precipitating a solution of the preparation with silver nitrate and
the remainder calculated to bromin.
By this method several samples of 5 c.c. each of the preparation
yielded an average of 0.0059 cm. silver chlorid or 0.0012 gm. per
c.c. The total silver haloids obtained by direct precipitation of the
diluted preparation was found to be 0.3158 gm. per c.c., thus leaving
0.3146 gm. silver bromid to be calculated to bromin.
The total sodium and potassium was obtained in the usual way and
the potassium determined as the chlor-platinate and the sodium
calculated from the difference. By this method the quantity of sodium
found calculated to sodium bromid gave the following results: (a)
0.0629 gm. and (b) 0.0632 gm., or an average of 0.063 gm. per c.c.
From the potassium estimations the following were calculated: (a)
0.1264 gm. potassium bromid and (b) 0.1259 gm. potassium bromid per
c.c., an average of 0.1261 gm. potassium bromid per c.c.
The bromids calculated from the sodium and potassium determinations
were found to be 0.0630 gm. sodium bromid and 0.1261 gm. potassium
bromid per c.c., the equivalent of 0.3139 gm. silver bromid. The
total silver bromid obtained was 0.3146 gm., showing practical
agreement with the total bromids calculated from the sodium and
potassium determinations.
The preparation contained then 6.30 gm. sodium bromid and 12.61 gm.
potassium bromid per 100 c.c., or 9.73 grains of potassium bromid and
4.86 grains sodium bromid, a bromid content equal to 15.35 grains
potassium bromid per fluid dram.
ZYMOTOID
A Fraud of the Liquozone-Oxytonic-Septicide Type
Dr. Arnold’s Zymotoid, a nostrum manufactured by Arnold’s Zymotoid
Company, Rockford, Ill., is claimed to be an “antiseptic, germicide and
antiphlogistic” which “has absolutely no peer in medicine.” According
to the statements of the manufacturer, Zymotoid is “successfully
employed not only as an external dressing on all wounded and diseased
surfaces, but in all zymotic conditions wherein a reliable antiseptic
and germicide is needed internally.” And in telling physicians of the
great value of Zymotoid the company says:
“We assured them that if they would simply place Zymotoid ‘next’
to any wounded surface--and nothing else--they would have no
inflammation, no suppuration, no infection or blood poison. Its
prompt use in all cases where such trouble arises gives immediate
and certain relief.”
This is a large contract to be undertaken by Zymotoid--or any other
preparation--which, as will be shown, consists principally of boric
acid and water. The company also appends to its announcement concerning
Zymotoid a number of the usual testimonials and a lot of alleged “case
reports.”
Zymotoid seems to be exploited principally by circulars addressed to
physicians and by agents who attempt to sell it to physicians. They
also try to work factories and other large employers of labor. In their
circular to physicians they claim that “Zymotoid is strictly ethical.”
And “we publish its composition.” The composition given is: “sulphur,
niter, cinnamon and boric acid in gaseous solution.” It is also claimed
to be “a chemical compound--not a mixture--which is wholly non-toxic
and can be used as freely as desired internally absolutely without harm
to the smallest child.” On the label of the Zymotoid package is the
following:
“Zymotoid is a concentrated chemical compound consisting of the
solids and gases of sulphur, potassium nitrate, cinnamon and carbon
held in a solution of boric acid.”
A specimen of Zymotoid was examined by our chemists and their
report follows. As will be seen, it is simply another fraud of the
Liquozone-Oxytonic-Septicide type.
LABORATORY REPORT ON ZYMOTOID
Zymotoid is a pale yellow liquid having a strong odor like sulphur
dioxid. No odor suggestive of cinnamon was observed even after
the sulphur dioxid had been fixed by the addition of an alkali.
Qualitative tests indicated the presence of boric acid, sulphuric
acid, sulphur dioxid and traces each, of a nitrate, potassium
and some unidentified organic matter. Alkaloids, cinnamic acid,
glycerin and soaps were absent. From the results of the quantitative
examination it is concluded that the composition of Zymotoid is
essentially as follows:[126]
[126] Details of the analysis appear in the annual reports of the
Chemical Laboratory.
Boric acid (H_{3}BO_{3}) 0.637 gm.
Sulphur dioxid (SO_{2}) 0.129 gm.
Sulphuric acid (H_{2}SO_{4}) 0.048 gm.
Potassium nitrate trace
Unidentified organic matter trace
Water (by difference) to make 100 c.c.
The analysis shows that but for the presence of boric acid the
composition of Zymotoid is similar to other fraudulent “microbe
killers” which have been exploited in recent years and of which some
have been declared misbranded by the federal government. For example,
“Radam’s Microbe Killer”[127] was found by the federal chemists to be
composed of water, containing small quantities of sulphur dioxid and
sulphuric acid. “Liquozone,” another nostrum which was widely exploited
a few years ago, is said to have a similar composition.[128] According
to an analysis made at the North Dakota Agricultural Experiment
Station,[129] “Oxytonic” has a similar composition. The nostrum
“Septicide,” was found by the federal chemists to be composed of water
with small quantities of sulphur dioxid, sulphuric acid and a trace of
a nitrate.--(_From The Journal A. M. A., April 6, 1912._)
[127] The Journal A. M. A., July 16, 1910, p. 235.
[128] The Journal A. M. A., March 28, 1908, p. 1065.
[129] The Journal A. M. A., Jan. 1, 1910, p. 63.