,transcriber's notes3 ,in this transcription1 paired equals symbols indicate bold text and paired underscores denote italicised text4 ,a single underscore followed by paired curly brackets indicates that the enclosed characters are subscripted1 e4g4 in the chemical formula ,c#c;,h#h,o#c4 ,footnotes are located below the relevant paragraphs4 ,the text contains uncommon characters that will not necessarily display correctly with all viewing devices4 ,if some of the characters look abnormal1 first ensure that the device's character encoding is set to ,unicode 7,,utf-#h74 ,the default font might also need to be changed to a ,unicode font such as ,arial ,unicode ,,ms1 ,deja,vu1 ,segoe ,,ui ,symbol or ,free,serif4 ,the book contains quotations1 comments and reports relating to debates between medical authorities and pharmaceutical suppliers1 and the text is formatted in such a way 7in both the original and in this transcription7 as to help readers differentiate the parties to the debates4 ,in this plain-text transcription1 wording originating from pharmaceutical sources is displayed with greater indentation1 while that from medical authorities has lesser indentation2 however1 this pattern is not entirely consistent4 ,inconsistent use of opening and closing quotation marks is as in the original4 ,there are numerous hyphenation and spelling inconsistencies1 the most noticeable perhaps being the inclusion or omission of a final #8e' from chemical terms such as oxid_/oxide4 ,these remain as in the original4 ,a representative list of the inconsistencies is appended at the end of the transcription together with a list of the spelling errors that have been corrected silently4 ,inconsistent formatting of fractions1 e4g4 #a-d cf4 #a_/d is as in the original4 ,the text contains various words1 phrases and comments enclosed by square brackets4 ,these were inserted by the authors4 ,a few omissions noted by the transcriber have been inserted within curly brackets to help differentiate them - hence of a be 84 ,a missing full stop and a missing parenthesis have each been inserted silently2 redundant duplicated punctuation 74 17 has been deleted silently2 and on page #bii a duplicated phrase has been deleted silently1 viz4 this dread disease is no longer a matter of doubt4 ,several large landscape-format tables have been modified in this transcription to fit narrower viewing screens and #8key's added to identify the column headings4 ,a mathematical error in ,table #b on page #cij is as in the original - ,rat #d average weight gain_/loss should be #b4a not #b4g4 ,table #aa on page #ddd contains a footnote cross-reference to ,tables #h and #aj but these do not exist4 ,,the ,,propaganda ,,for ,,reform --,,in-- ,proprietary ,medicines ,part ,i4 ,council ,reports ,part ,,ii4 ,laboratory ,contributions ,part ,,iii4 ,contributions from the ,journal3 ,nostrums ,part ,,iv4 ,contributions from the ,journal3 ,miscellany ,ninth ,edition ,,reprinted ,,from ,,the ,,journal ,,of ,,the ,,american ,,medical ,,association ,,preface ,from time to time ,the ,journal of the ,american ,medical ,association has published the reports of the ,council on ,pharmacy and ,chemistry and the ,chemical ,laboratory1 as well as other matter on proprietary medicines4 ,repeated requests for some of the matter have led to the compilation of 8,the ,propaganda for ,reform in ,proprietary ,medicines10 which1 in the present volume1 attains its ninth edition4 ,the seventh1 eighth and ninth editions have been compiled on slightly different principles from their predecessors4 ,the therapeutic reform work of ,the ,journal and of the ,association's ,chemical ,laboratory was at first confined almost entirely to the criticism and analysis of the so-called ethical proprietaries4 ,this was right2 the medical profession owed it to the public to combat the nostrum evil within its own ranks4 ,as the more flagrant evils of the 8ethical proprietary0 question were mitigated1 the ,association has turned the light on the more widespread and dangerous 8patent medicine0 evil4 ,the articles devoted to 8patent medicines0 or quackery being naturally of greater interest to the general public than to the medical profession1 the number of inquiries from laymen regarding various quacks and nostrums has steadily increased4 ,it has been thought best1 therefore1 to publish separately#a all of the matter from ,the ,journal relative to quackery and to those nostrums exploited only or chiefly to the public1 and to include in the ,propaganda for ,reform practically none of the matter that is of direct interest primarily to laymen4 ,in one or two instances in which the subjects were of equal interest to the profession and to the public matter that has already appeared in 8,nostrums and ,quackery0 is also given here2 but as a general rule the contents of the ninth edition of 8,the ,propaganda for ,reform0 are of strictly professional interest4 ,those physicians who are desirous of obtaining in convenient form the matter dealing with 8patent medicines0 should order the book 8,nostrums and ,quackery0 or the various pamphlets on the same subjects that have been issued since 8,nostrums and ,quackery0 came from the press4 #a ,this matter appears in 8,nostrums and ,quackery10 a #gjj-page book1 and also in various pamphlets4 ,write for the descriptive price-list of publications dealing with the nostrum evil4 ,the ninth edition of 8,propaganda for ,reform0 contains a number of new articles1 greatly increasing the size of the book4 ,it also contains one novel feature which greatly enhances its value4 ,the index includes references not only to articles in the book1 but also to matter on proprietaries not accepted by the ,council on ,pharmacy and ,chemistry which appeared in ,the ,journal of the ,american ,medical ,association and elsewhere4 ,this index makes of this edition of 8,propaganda for ,reform0 a very full work of reference on proprietaries which are undeserving of recognition4 ,it should be understood1 however1 that not all articles indexed are condemned2 some are merely discussed and compared4 ,,table ,,of ,,contents ,,part ,i3 ,,council ,,reports ,,page ,acetanilid ,mixtures #i ,agar-,lac #aj ,anasarcin and ,anedemin #aa ,maignen ,antiseptic ,powder #ai ,tyree's ,antiseptic ,powder #ba ,apergels #bf ,aseptikons #bf ,betul-,ol #bg ,peacock's ,bromides and ,chionia #bh ,bromidia #ca ,cactus ,grandiflorus #cf ,calcreose #dj ,campho-,phenique #dj ,celerina1 ,aletris ,cordial and ,kennedy's ,pinus ,canadensis1 ,light and ,dark #dc ,cineraria ,maritima #di ,hagee's ,cordial of the ,extract of ,cod ,liver ,oil ,compound #ea ,wampole's ,perfected and ,tasteless ,preparation of an ,extract of ,cod ,liver #eb ,waterbury's ,metabolized ,cod-,liver ,oil ,compound #ed ,waterbury's ,compound #eg ,colchi-,sal #eh ,cypridol ,capsules #ei ,cystogen1 ,cystogen ,aperient and ,cystogen-,lithia #fj ,cysto-,sedative #fa ,taka-,diastase and ,liquid ,taka-,diastase #fb ,digalen ,omitted from ,n4 ,n4 ,r4 #fh ,dioradin ,refused ,recognition #gc ,echinacea #gi ,echtisia1 ,ecthol and ,echitone #ha ,ergoapiol #hb ,erpiol 7,dr4 ,schrader7 #hc ,false ,unicorn 7,helonias7 #hd ,formurol #he ,gastrogen ,tablets #hg ,glyco-,heroin1 ,smith #hh ,glyco-,thymoline #ib ,glycozone #ie ,gardner's ,syrup of ,hydriodic ,acid #ig ,hyperol #ajj ,ingluvin #aja ,intestinal ,antiseptic ,w-,a #ajc ,bannerman's ,intravenous ,solution #aje ,iodalia #ajf ,iodex #ajg ,iodia #ajh ,burnham's ,soluble ,iodine #aaj ,iodotone #aac ,iosaline #aac ,nourry ,wine #aae ,labordine #aae ,lactobacilline ,omitted from ,n4 ,n4 ,r4 #abj ,reexamination of ,lactopeptine #aba ,meat and ,beef ,juices #abc ,valentine's ,meat ,juice #abi ,medicinal ,foods #aca ,migrainin #ace ,neurilla #acf ,neurosine1 ,dioviburnia1 ,germiletum and ,palpebrine #aci ,oxychlorine #adg ,pam-,ala1 ,another ,worthless ,quinin ,substitute #adi ,papayans ,bell #aea ,passiflora and ,daniel's ,concentrated ,tincture of ,passiflora #aef ,liquid ,combinations ,containing ,pepsin and ,pancreatin #aeg ,pepto-,mangan 7,gude7 #aei ,liquid ,petrolatum or 8,russian ,mineral ,oil0 #afa ,clinical ,experience with ,liquid ,paraffin 7,liquid ,petrolatum7 #afg ,angier's ,emulsion #afi ,phecolates1 ,phecolax1 ,phecozymes and ,phecotones #agd ,phenol ,sodique #age ,phytin and ,fortossan #agh ,prunoids #agh ,sal ,hepatica #agi ,sanmetto #ahb ,secretogen #ahe ,sinkina #ahh ,somnos #aic ,succus ,alterans #aie ,sulpho-,lythin #aif ,taurocol #aih ,tri-,iodides1 ,three ,chlorides and ,maizo-,lithium #aih ,thialion #bje ,unguentum ,selenio ,vanadic 7,v4 ,roemer7 #bjg ,unicorn ,root1 ,wild ,yam and ,wild ,indigo #bjh ,proprietary ,vanadium ,preparations #bji ,venarsen #bab ,venodine #bad ,veracolate #baf ,hayden's ,viburnum ,compound #bah ,vin ,mariani #bba ,virol #bbe ,,part ,,ii3 ,,contributions ,,from ,,the ,,chemical ,,laboratory ,anusol ,hemorrhoidal ,suppositories #bbg ,aromatic ,digestive ,tablets #bbi ,burnham's ,soluble ,iodin #bcc 8,hydrocyanate of ,iron-,tilden0 #bce ,hymosa #bch ,micajah's ,medicated ,uterine ,wafers #bdj ,noitol and ,anadol #bde ,pix ,cresol #bdg ,saliodin #bdi ,theobromin ,sodium ,salicylate ,versus 8,diuretin02 ,the ,economical ,aspect #bea ,unguentine #bed ,uricedin #bef ,uriseptin #bef ,zemacol #bei ,zyme-,oid #bfa ,,part ,,iii3 ,,contributions ,,from ,,the ,,journal3 ,,nostrums ,alleotone #bfd ,baume ,analgsique ,bengu #bfg ,antidiabeticum-,bauer #bfg ,antikamnia #bfh ,anusol ,suppositories #bhj ,aspiro-,lithine #bha ,bell-,ans 7,pa-,pay-,ans1 ,bell7 #bhb ,biosol #bhd ,bromin-,iodin ,compound #bhe ,calmine #bhf ,camphenol #bhg ,chologen #bhh ,hagee's ,cordial of ,cod-,liver ,oil #bhi ,waterbury's ,compound ,once ,more #bia ,collyrium-,wyeth #bib ,diatussin #bic ,enteronol #bid ,expurgo 7,sanol7 ,anti-,diabetes #bii ,formamint #cjc ,gomenol #cjd ,headache ,cures #cje ,hectine #cjh ,hydronaphthol #cjh ,hydrozone #cji ,hypoquinidol #caj ,iodonucleoid #caj ,iridium #cab ,iron ,tropon #cac ,kutnow's ,powder #cad ,lymph ,compound ,r-,h and ,orchitic ,fluid ,tablets #cag ,lysol--,the ,evolution of a ,proprietary #cah ,thompson's ,malted ,food ,company #cai ,manola #cbc ,mercol #cbf ,midol and ,nurito #cbg ,mu-col #cbi ,narkine #cbi ,papine #ccj ,pasadyne #ccb ,pas-,avena #ccc ,pertussin #ccd ,phenalgin--,a ,typical ,example #cce ,pheno-,bromate #cdc ,phenolphthalein #cdc ,mixed ,vaccine and ,phylacogens #cdf ,the ,danger in ,protonuclein1 a ,preparation ,containing ,thyroid #cdh ,purgen #cdi ,pyo-,atoxin #cej ,resinol #ceb ,resor-,bisnol #cec ,robinol and ,sevetol #cec ,salacetin #cef ,sal-,codeia-,bell #ceg ,sanatogen #ceh ,sanatogen3 a ,scientific ,investigation of ,its ,alleged ,action on the ,recuperating ,powers of the ,blood #cgh ,the ,feeding ,value of ,sanatogen ,compared with ,commercial ,casein with ,respect to ,maintenance and ,growth #che ,poehl's ,spermin in ,arteriosclerosis #cie ,syrup of ,cocillana ,compound #cif ,aubergier's ,syrup of ,lactucarium #cii ,tartarlithine #dja ,thoxos #djb ,trypsogen #djc ,tyree's ,antiseptic ,powder #djd ,vapo-,cresolene #djh ,vasogen and ,iodovasogen #djh ,viburnum ,compound--and other ,nostrums #dji ,wheeler's ,nerve ,vitalizer #daa ,zymotoid #dab ,,part ,,iv3 ,,contributions ,,from ,,the ,,journal3 ,,miscellaneous ,,matter ,acetphenetidin and ,phenacetin--,their ,relative ,purity #dad ,clean ,advertising #dah ,lippincott's ,magazine #dai ,medical ,journal ,advertising #dbb ,medical ,journals and the ,great ,american ,fraud #dbf ,the ,army and ,navy ,medical ,record #dcb ,the ,medical ,times ,advertisements #dch ,cause for ,optimism #ddj ,the ,comparative ,nutrient ,value of ,cod ,liver ,oil and ,cod ,liver ,oil ,cordials #ddb ,diabetic ,foods ,offered for ,sale in the ,united ,states #ddf ,the ,jireh ,diabetic ,food ,company #dea ,the ,name 8,epinephrin0 ,versus the ,name 8,adrenalin0 #ded ,the ,hord ,sanitarium #def ,the ,german ,propaganda for ,reform #deh ,the ,german ,council on ,pharmacy and ,chemistry #dei ,grand ,prix and ,gold ,medals for ,sale #dfb ,the ,hypophosphite ,fallacy #dfd ,buffalo ,lithia ,water #dfg ,meat ,extracts and ,meat ,juices #dgj ,pharmaceutical ,manufacturers and the ,great ,american ,fraud #dgd ,dowd's ,phosphatometer #dgf ,amorphous ,phosphorus #dgh ,,the ,,propaganda ,,for ,,reform ,,in ,,proprietary ,,medicines ,,part ,i ,,council ,,reports ,,acetanilid ,,mixtures,a ,report of the ,council on ,pharmacy and ,chemistry ,a ,see also ,labordine1 p4 #aae2 ,headache ,cures1 p4 #cje2 ,anadol1 p4 #bdd2 ,phenalgin1 #cce4 ,to the ,council on ,pharmacy and ,chemistry3 ,in response to the request of your chairman we have investigated the below-mentioned preparations and report as follows3 ,specimens of the articles were bought in different cities in the open market1 and in original sealed packages1 and were analyzed by some of us or under our direction4 ,each article was examined by at least two chemists1 and some were subjected to several analyses4 ,while certain of the preparations are represented as being chemical compounds1 the specimens examined were all found to be mixtures1 the principal ingredient being acetanilid4 ,the percentage proportions of acetanilid given below are the minimum obtained by any of the analysts4 ,soda and ammonia1 combined with carbonic acid1 are calculated and reported as sodium bicarbonate and as ammonium carbonate 7,u4 ,s4 ,p47 respectively4 ,salicylic acid is calculated and reported as sodium salicylate4 ,diluents and other constituents than those reported were not determined4 ,,ammonol ,according to the analyses of the contents of the original sealed packages as purchased1 this was found to be a mixture1 and to contain the following ingredients approximately in the proportions given3 ,acetanilid4 ,sodium ,bicarb4 ,ammonium ,carb4 #ej4 #be4 #bj4 ,,antikamnia,b ,b ,see also ,antikamnia1 ,the ,nostrum and ,its ,method of ,exploitation1 page #bfh4 ,according to the analyses of the contents of the original sealed packages as purchased1 this was found to be a mixture1 and to contain the following ingredients approximately in the proportions given3 ,acetanilid ,caffein ,citric ,acid ,sodium ,bicarb4 #fh4 #e4 #e4 #bj4 ,,koehler',s ,,headache ,,powders ,according to the analyses of the contents of the original sealed packages as purchased1 this was found to be a mixture1 and to contain the following ingredients approximately in the proportions given3 ,acetanilid ,caffein #gf4 #bb4 ,,orangeine ,according to the analyses of the contents of the original sealed packages as purchased1 this was found to be a mixture1 and to contain the following ingredients approximately in the proportions given3 ,acetanilid ,sodium ,bicarb4 ,caffein #dc4 #ah4 #aj4 ,other constituents said to be present were not determined4 ,,phenalgin,c ,c ,see also ,phenalgin--,a ,typical ,example1 p4 #cce4 ,according to the analyses of the contents of the original sealed packages as purchased1 this was found to be a mixture1 and to contain the following ingredients approximately in the proportions given3 ,acetanilid ,sodium ,bicarb4 ,ammonium ,carb4 #eg4 #bi4 #aj4 ,certain packages of phenalgin were purchased which on analysis did not show ammonium carbonate4 ,,salacetin,d ,d ,see also ,salacetin1 p4 #cef4 ,according to the analyses of the contents of the original sealed packages as purchased1 this was found to be a mixture1 and to contain the following ingredients approximately in the proportions given3 ,acetanilid ,sodium ,bicarb4 ,sodium ,salicylate #dc4 #ba4 #bj4 ,we recommend that this report be printed in ,the ,journal of the ,american ,medical ,association4 ,respectfully submitted1 ,j4 ,h4 ,long1 ,m4,s41 ,sc4,d41 ,w4 ,a4 ,puckner1 ,ph4,g41 ,committee on ,chemistry1 ,s4 ,p4 ,sadtler1 ,ph4,d41 ,council on ,pharmacy and ,j4 ,stieglitz1 ,ph4,d41 ,chemistry of the ,a4 ,m4 ,a4 ,h4 ,w4 ,wiley1 ,m4,d41 ,ph4,d41 7,from ,the ,journal ,a4 ,m4 ,a41 ,june #c1 #aije74 ,,agar-,,lac ,report of the ,council on ,pharmacy and ,chemistry ,agar-lac1 said to be the product of 8,agar-lac1 ,inc410 is sold by ,e4 ,fougera and ,company1 ,new ,york4 ,the following 8formula0 for ,agar-lac is published3 8,agar-,agar with ,lactic ,ferments ,grs4 #d-a_/b ,phenolphthalein ,grs4 #a_/b0 ,regarding the 8lactic ferment10 the identity of which is not declared by the manufacturer and for the viability of which no precautions appear to be taken1 the ,council's expert on lactic acid ferments reported that ,bacillus bulgaricus was present in small numbers only and that there were at least two other bacteria present1 one of which is a gas-former of the ,bacillus coli type4 ,the ,council found that the amount of agar-agar in ,agar-lac and the identity of the 8lactic ferment0 are not declared2 that the name 8,agar-lac0 is blown in the glass and that the method of its exploitation will lead laymen to use it to their detriment2 that the claims that it 8facilitates assimilation of proteids0 and that it is of value as an aid to 8gastro-intestinal digestion0 give a false value to the mixture and that the claims emphasize the action of agar-agar when from the composition it is evident that the phenolphthalein action will predominate2 that the name does not indicate its predominating constituent1 phenolphthalein1 and that the use of a ready-made combination of cathartic drugs1 such as agar-agar and phenolphthalein with lactic acid ferments1 is unscientific4 ,the ,council therefore refused recognition to ,agar-lac4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ad1 #aiad47 ,,anasarcin ,,and ,,anedemin ,reports of the ,council on ,pharmacy and ,chemistry and ,comments ,thereon ,the following reports were submitted to the ,council by the subcommittee to which these articles were assigned3 ,,anasarcin ,to the ,council on ,pharmacy and ,chemistry3--,your subcommittee to whom ,anasarcin 7,anasarcin ,chemical ,co41 ,winchester1 ,tenn47 was assigned1 herewith submits its report3 ,this remedy is offered in two forms3 8,anasarcin ,tablets10 a pretended combination of the active principles of oxydendron arboreum1 sambucus canadensis1 and urginea scilla2 and 8,anasarcin ,elixir10 said to contain the active principles of oxydendron1 sambucus1 hepatica and potassium nitrate4 ,the advertisements of these articles conflict with the rules of the ,council as follows3 ,with ,rules #a and #b3 ,the composition of these articles is kept secret1 in that the proportion of the ingredients is not furnished4 ,the statement that it contains the 8active principles0 is misleading1 since these are for the most part unknown4 ,with ,rule #f3 ,the description of the pharmacologic action of ,anasarcin agrees practically with that of squill4 ,no material part of its effects can be attributed to the other ingredients4 ,nevertheless1 the advertisement studiously cultivates the impression that ,anasarcin has no relation whatever to the digitalis group in which scilla is commonly placed4 ,the claims are therefore misleading4 ,the claim of its infinite superiority to digitalis1 the claims that it cures neurasthenia1 eliminates uric acid in rheumatism1 and is useful in obesity1 cystitis1 lumbago and eclampsia1 dyspepsia and asthma1 and that it works wonders in exophthalmic goiter1 appear exaggerated or false4 ,the recommendation of its indiscriminate use in nephritis1 for lowering the blood-pressure and the statement 7contradicted in the firm's own literature7 that it is not depressing1 are actually dangerous4 ,it is recommended that the articles be refused recognition1 and that the report1 with explanations1 be published4 ,,anedemin ,to the ,council3--,your subcommittee to whom ,anedemin 7,anedemin ,chemical ,co41 ,winchester1 ,tenn47 was assigned herewith submits its report3 ,anedemin is an evident imitation of ,anasarcin4 ,it is marketed as tablets1 said to contain the isolated active principles of strophanthus1 apocynum1 squill and sambucus1 chemically combined4 ,the quantities are not stated4 ,the therapeutic claims are copied almost literally from the ,anasarcin circulars and are equally false4 ,anedemin1 therefore1 conflicts with ,rules #a1 #e1 #f and #g4 ,it is recommended that this report be published1 with comments4 ,the reports were adopted by the ,council and are herewith published4 ,w4 ,a4 ,puckner1 ,secretary4 ,anasarcin ,this wonderful remedy1 ,anasarcin1 has already been exposed in these columns 7,the ,journal ,a4 ,m4 ,a41 ,jan4 #bg1 #aijf71 but it deserves additional mention1 as it teaches several important lessons of general application4 ,it is a typical example of the revival1 under a new name and a thin disguise1 of an old1 time-worn article1 squill1 presumably because experience has demonstrated its general inferiority to other drugs4 ,anasarcin further illustrates the dangers involved in the use of semi-secret nostrums4 ,it also shows how a short experience with a widely advertised but little understood drug is apt to lead to conclusions which more extensive experience demonstrates to be entirely fallacious4 ,the first lesson is1 that formulas are not always what they seem4 ,a hasty glance at the formula of ,anasarcin tablets1 the basis of the ,anasarcin dropsy cure1 creates the impression that it is a non-secret remedy2 for it is said to represent a combination of the active principles of oxydendron1 sambucus and scilla4 ,as a matter of fact1 it is a secret nostrum of the insidious kind4 ,a formula which omits the quantities of its potent ingredients means very little4 ,further than this1 we do not hesitate to charge that the claimed composition is a deliberate deception4 ,the circulars emphasize the claim that ,anasarcin consists of the isolated principles1 and not of the crude drugs4 ,now1 the isolated active principles of sambucus and oxydendron are not on the market1 for the good and sufficient reason that no active principles have ever been isolated4 ,are we to believe that the ,anasarcin ,company has surpassed the accredited chemists and has discovered such principles and is isolating them8 ,we shall have more to say on this subject presently2 but any one in the least familiar with the difficulties attending the isolation of organic principles knows such an idea to be preposterous4 ,indeed1 it is absolutely incompatible with the exhibition of ignorance of the elementary facts of pharmaceutical chemistry which is given by these people when they call the active principles of digitalis and squill 8alkaloids40 ,it is an axiom that the effects of a mixture can only be understood if the action of its components are known4 ,so far as we know1 the physiologic effects of oxydendron and sambucus have never been scientifically investigated1 for the simple reason that they are too slight and indefinite to promise results4 ,both are credited with some slight1 obscure diuretic action4 ,oxydendron1 the sour wood or sorrel tree1 is a small tree of the heath family1 the acid leaves of which are said to be chewed by hunters for their pleasant taste and for the relief of thirst4 ,sambucus is the common elder4 ,it is most unlikely that these two innocuous substances should play any part in the claimed powerful effect of ,anasarcin2 they are evidently put in the formula1 we do not say in the preparation1 to obscure the fact that ,anasarcin is composed principally of squill4 ,that this is so can be gathered unmistakably from a study of the pharmacologic action of ,anasarcin as described by its promoters3 ,acting primarily on the heart and arterial systems through the nerve ganglia1 a natural physiologic balance is established between the arterial and venous systems1 whereby effusions 444 are eliminated4444 ,coincident with this action there is a noteworthy slowing of the pulse4444 ,if the remedy is pushed1 can be brought down to #bj or #cj beats per minute4444 ,its physiological action is to stimulate the cardiac motor-ganglia through the cardiac plexus of the sympathetic system and at the same time exert an inhibitory influence upon the cardiac fibers of the pneumogastric1 thereby dilating the arterioles1 slowing the heart's action1 and increasing the force of the systole4444 ,the prolonged diastole allows the ventricle time to completely fill1 and the more forcible contraction causes the mitral valve to close more thoroughly and at the same time increases pressure in the coronary arteries1 serving thereby the double purpose of relieving pulmonary engorgement and increasing heart nutrition4 ,anasarcin will nauseate some persons4 ,to appreciate fully the meaning of this description of the actions of ,anasarcin1 it should be compared with the effects of the digitalis group1 to which squill belongs4 ,the following account is quoted literally from a recent text-book of pharmacology 7,sollmann73 ,the phenomena of the therapeutic stage of digitalis action are said to be3 #a4 ,slowing of the heart1 with systole and diastole both lengthened4 #b4 ,increased strength of beat1 leading to greater efficiency of the individual contractions1 and to an increase in the total efficiency4 #c4 ,a tendency to the systolic phase4 #d4 ,a rise of blood-pressure1 due mainly to the increased action of the heart1 but partly also to a vasoconstriction4 ,the therapeutic action may be explained1 in part1 as follows3 ,a larger amount of blood will be thrown into the aorta and coronary circulation4 ,the first effect will be an improved nutrition of the heart4444 ,the tonic action 444 narrows the ring of the valves1 brings them together1 narrows the orifice4444 ,the venous congestion will tend to be relieved4 ,this relief 444 will fall in the first place on the lungs4444 ,the lowering of the venous pressure will tend to cause absorption of the effusions4 ,the nauseant action of squill1 which is alluded to in connection with ,anasarcin1 is too well known to require more than a mention4 ,in brief1 then1 it appears from the statements of the ,anasarcin ,company that the action of the remedy is that of squill and that the other ingredients are a mere blind4 ,it is1 of course1 well known that squill can be used as a substitute for digitalis in cardiac dropsy1 although it is generally considered very inferior to the latter drug4 ,rose ,bradford1 for instance1 states3 8,squill is not used to any extent in the treatment of cardiac disease and cardiac dropsy1 digitalis being a far more efficient and less toxic substance40 ,however1 it has been frequently observed that digitalis occasionally fails1 and it may then be replaced successfully by another member of the group4 ,at all events1 it is very likely that squill is a fairly efficient substitute for digitalis1 especially when it is supplemented by a very free course of ,epsom salts and by potassium nitrate 7the active ingredient of ,anasarcin ,elixir71 both of which are stated to be essential adjuvants to the ,anasarcin 7or squill7 tablets4 ,there can be no objection to the use of squill when it is indicated2 but any one who wishes to use it should do so with his eyes open1 knowing what substance he is using and how much 7which he does not in ,anasarcin72 knowing also that it has the same indications and limitations as digitalis4 ,he should not be misled by such statements as the following3 8,does what dropsy medicaments have hitherto failed to accomplish40 8,superior to digitalis1 strophanthus1 scoparius1 squills1 acetate of potash and the hydragogue cathartics all put together40 8,the only known relief how modest6 and permanent cure of dropsies40 8,unrivaled heart tonic40 8,the most powerful agent known40 ,any one wishing to use squill should take the trouble to acquaint himself with the results obtained by competent and independent observers1 and not rely on it in eclampsia1 septicemia1 8vices of civilization10 all forms of neurasthenia1 as 8an active eliminator of uric acid in rheumatism10 in hepatic cirrhosis1 dyspepsia1 asthma1 obesity1 cystitis 7671 lumbago1 exophthalmic goiter1 etc4 ,he should also learn the contra-indications to the use of squill1 deducible from the fact that it causes vasoconstriction and raises the blood-pressure 7prohibiting its use in ,bright's disease and arteriosclerosis71 and that it produces marked gastric irritation1 consequently nausea and depression1 that it is a very toxic agent1 and that the dangers of cumulative action must be borne in mind4 ,in respect to these the advertisements of the ,anasarcin people are little short of criminal1 for these state3 8,safe in administration40 8,non-toxic as ordinarily administered40 8,will nauseate some persons10 but 8the reaction from the temporary depression is prompt40 8,in ,bright's disease1 both the interstitial and parenchymatous forms of nephritis1 acute or chronic1 no remedy 444 to equal it in efficacy40 8,without increasing the debility of the patient or interfering with nutrition by producing loss of appetite44440 8,this treatment is to be continued without cessation until all symptoms of dropsy have disappeared40 ,physicians who are inclined to disregard this warning1 and who follow the advice of the ,anasarcin people1 should remember that their patients--or their friends--will put the blame for the results1 which are bound to follow sooner or later1 on the prescribers1 and not on the deceptive advertisements of the ,anasarcin ,chemical ,company4 ,there is another little matter which throws an illuminating side-light on the ,anasarcin ,company4 ,they take every occasion to say that ,anasarcin is 8not offered to the laity10 8never sold to the laity10 etc42 but witness the following1 which was found in the ,retail ,druggist of ,may1 #aijf1 p4 #agi4 ,the italics are ours4 ,,cure ,,for ,,dropsy4 8,as every druggist knows1 dropsy has been one of the incurable diseases when caused either from heart1 liver or kidney trouble4 ,a pharmacist in ,winchester1 ,tenn41 has worked out a remedy called ,anasarcin1 which he is exploiting to the physicians1 and his remedy is showing itself as possessing great merit4 ,several hopeless cases have been treated as a last resort by ,anasarcin and in a very short time the patient has shown marked improvement and has effected permanent cures4 8,the result of the cases as handled by the physician with the aid of ,anasarcin has been so easily and quickly cured that physicians of ,tennessee and the southern states are high in their praises of the remedy4 ,the company which now manufactures and sells it is known as the ,anasarcin ,chemical ,co41 of ,winchester1 ,tenn4 ,any druggist who knows of a case of dropsy would be conferring a favor on the patient and mankind in general by telling the party or his physician of the southern pharmacist1 and we have no doubt but what a prompt relief and permanent cure would be affected40 ,probably means effected4--,ed4 ,anedemin ,if we are disposed to doubt the vaunted scientific ability of the ,anasarcin ,company1 we are forced to admire their business methods1 at least1 if there is any truth in the saying that imitation is the seal of success4 ,anasarcin has had this rather undesirable compliment paid to it1 for its native town of ,winchester has given birth to another remedy1 ,anedemin1 which looks like a fair-haired twin brother4 ,the ,anedemin ,company has adopted ,anasarcin almost bodily4 ,the name--8opposed to edema0--is about as close as the copyright laws permit4 ,the pharmacologic and therapeutic claims agree almost literally with those of ,anasarcin and contain the same exaggerations and dangerous misstatements4 ,there is the same emphasis on free purgation with ,epsom salts4 ,the dose is the same4 ,both are marketed at #b4jj for a box of #ajj--only the ,anedemin people have adopted the prize package device of throwing in #bj or #cj tablets extra1 for good measure1 and give a discount of #ge cents or so4 ,illustration3 ,laboratory and ,warehouse of the ,anasarcin ,chemical ,company1 ,winchester1 ,tenn4 ,in short1 the ,anedemin ,company has appropriated all of ,anasarcin which they considered of any value4 ,it is1 therefore1 rather suggestive that they drew the line at the formula4 ,anasarcin is said to contain squill1 sambucus and oxydendron2 ,anedemin discards the oxydendron and reinforces the squill with strophanthus and apocynum4 ,notwithstanding this material change in composition1 the actions are described as identical2 this is again rather suggestive4 ,the ,anedemin ,company1 like the ,anasarcin ,company1 scorns crude drugs and claims to use only the isolated principles4 ,it was saved the trouble of discovering active principles for strophanthus and apocynum1 for these are known2 but it managed to find some scope for its inventive genius1 8both drugs being so chemically treated and disposed as to absolutely eliminate all objectionable and disagreeable properties and effects0 so as to convert a vasoconstrictor action into a dilator action2 so as to render them non-toxic and non-cumulative2 so as to deprive apocynum of its characteristic nauseant effect4 ,who can say that the days of miracles are past8 ,even this is not the limit of ,anedemin alchemy2 if we are to believe their claims1 they have succeeded in forcing strophanthin1 apocynum1 scillain1 etc41 to combine with each other3 8,it is a definite chemical compound of the active principles0 of these drugs6 ,this makes the achievements of ,emil ,fischer in synthesizing sugars and proteids appear as mere child's play4 ,since the formulas were completed1 however1 clinical reports have been numerous enough--almost too numerous1 if we are to believe them4 ,anedemin has been on the market for less than three years2 the circulars emphasize that testimonials and endorsements are not solicited4 ,nevertheless1 we are told that it is 8endorsed by over fifty thousand clinicians throughout the ,united ,states40 ,since the total number of physicians in the ,united ,states and ,canada is only about #abh1jjj1 this means that nearly every second physician has endorsed ,anedemin4 ,the ,anasarcin ,company solicits endorsements and they seem to do the larger business4 ,hence the majority of physicians of the ,united ,states must have written an endorsement of either ,anedemin or ,anasarcin1 or both4 ,or is this statement another 8invention08 ,it is a little peculiar that nearly all the endorsements come from small towns in sparsely settled districts2 practically none from the centers of population4 ,does this mean that dropsy is more common in the rural communities than in the cities8 ,,the ,,inventors ,,of ,,anasarcin ,,and ,,anedemin ,even the newspapers1 when they tax our credulity with pretended scientific 8discoveries10 feel the moral obligation of justifying themselves by telling us something of the personality and experience of the discoverers4 ,we may ask1 therefore1 who are these expert pharmaceutic and synthetic chemists1 these manufacturers of active principles1 these skilled clinicians of wide experience1 who have 8intelligently built up the formula by wide application08 ,what are we told of these men who ask us to believe1 on their mere assurance1 in miracles and feats of magic2 who tell us that they have converted neutral principles into alkaloids1 that they have effected definite chemical compounds between these neutral principles1 that they have discovered principles that do not exist1 that they have changed the actions of these principles to suit their wishes1 that1 in short1 they have reversed the laws of ,nature8 ,these companies are located in ,winchester1 ,tenn41 a town of about #a1ejj inhabitants1 situated in an agricultural country4 ,the town boasts of neither scientific schools1 colleges1 universities nor laboratories4 ,the ,anasarcin ,company was organized in #aijb1 the incorporators and directors being ,dr4 ,john ,w4 ,grisard and his sons1 ,dr4 ,john ,p4 ,grisard1 ,b4 ,a4 ,grisard1 and ,a4 ,f4 ,grisard1 and ,will ,e4 ,walker1 all of ,winchester4 ,dr4 ,john ,w4 ,grisard seems to be the originator and promoter of ,anasarcin4 ,w4 ,e4 ,walker is an insurance solicitor of ,winchester and is not actively identified with the business4 ,we are informed that he owns but a single share of stock having a face value of #ajj1 and that he was added to the company in order to comply with the laws of ,tennessee1 which require five directors for any corporation4 ,dr4 ,john ,w4 ,grisard1 the father1 has practically retired1 but still has a general supervising interest in the business4 ,there is no regularly licensed pharmacist or chemist connected with the company4 ,the office is in the rear of a jewelry store in the business part of ,winchester and on the second floor above4 ,according to our reporter1 an office force of about ten stenographers and clerks handles the correspondence and labels and sends out the preparation which is made in a crude frame building located on a side street and without laboratory equipment4 ,according to our reporter1 the work is done by the ,grisards and a colored man4 ,the ,anedemin ,chemical ,company was organized in #aije with a capital of #bj1jjj1 the incorporators and directors being ,dr4 ,t4 ,b4 ,anderton1 ,floyd ,estill1 ,j4 ,j4 ,lynch1 ,j4 ,m4 ,littleton and ,i4 ,g4 ,phillips1 all residents of ,winchester1 and all lawyers with the exception of ,dr4 ,t4 ,b4 ,anderton4 ,a ,mr4 ,gordon1 a clerical employee of the company1 is reported to have active charge of the business1 to prepare the medicine and conduct the correspondence4 ,the office headquarters1 laboratory and complete outfit of the ,anedemin ,company comprises two rooms over the law office of ,estill ,littleton4 ,no one connected with the company is a regularly licensed pharmacist or graduate chemist4 ,of the six physicians located in ,winchester1 three 7#ej per cent47 are engaged in the dropsical cure business4 ,poor ,winchester6 ,aside from their connection with these two nostrums1 these physicians may be estimable and worthy citizens1 but where1 pray1 did they find the extensive clinical facilities and pharmaceutical knowledge necessary for their wonderful and epoch-making discovery8 ,were they aided in their scientific work by the four lawyers connected with the ,anedemin ,company or by the insurance solicitor who is a director of the ,anasarcin ,company8 ,did the #a1ejj inhabitants of the town furnish the vast clinical material necessary for discovering and working out the formulas of these two preparations8 ,if so1 we fear that dropsical affections are much more prevalent in ,winchester than in any other known spot on the globe4 ,this matter should be investigated4 ,without doubt the vital statistics of ,franklin ,county would be most interesting and we commend them to the special attention of the medical profession in ,tennessee4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #d and #aa1 #aijg47 ,,maignen ,,antiseptic ,,powder ,report of the ,council on ,pharmacy and ,chemistry ,the report which appears below was submitted by a referee and after adoption by the ,council was sent to the manufacturer for comment1 in accordance with the ,council's regular procedure in such cases4 ,the manufacturer's comments were transmitted to a second referee1 who reported that after a careful consideration of the manufacturer's reply he saw no valid reason for a modification of the report4 ,the referee also reported that a visit to the ,maignen ,institute further served to convince him of the viciousness of the treatment as given and that the records made by the persons in the employ of the institute were too inadequate to serve as clinical evidence4 ,on the referee's recommendation1 the report as originally adopted was reendorsed by the ,council and authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,maignen ,antiseptic ,powder is marketed by the 8,maignen ,institute for the ,study of ,bacterial ,diseases10 ,philadelphia4 ,it is claimed to be a mixture of calcium hydroxid1 sodium carbonate1 aluminum sulphate and boric acid1 but no statement as to the amount of the several constituents is furnished4 ,its action depends on the sodium hydroxid which is formed when the powder is treated with water1 #a ,gm4 of the powder as now submitted to the ,council yielding #j4cb ,gm4 of sodium hydroxid 7,na,o,h7 and a specimen obtained a year ago yielding #j4bh ,gm4 ,its promiscuous use is recommended both to physicians and to the public with claims which are extravagant1 preposterous and even dangerous4 ,a pamphlet1 clearly intended for the laity1 entitled 8,what ,is ,catarrh80 gives direction for the 8sterilization0 of the nose1 throat1 stomach1 lungs1 eyes1 gums1 mouth and the genito-urinary tract4 ,the following1 taken from this pamphlet1 illustrates the absurdity of the claims made for ,maignen ,antiseptic ,powder3 8,,sterilization ,,of ,,the ,,stomach 8,,take of the ,maignen ,antiseptic ,powder half the quantity raised on a dime1 scant4 8,,add to a tumbler of water1 preferably warm1 and stir4 8,,drink ,,slowly4 8,,this ,,is ,,what ,,may ,,happen3 8#a74 ,belching may be the first indication of the sterilization of the stomach4 8#b74 ,the excess of acidity is corrected4 8#c74 ,the fermentation is stopped4 8#d74 ,the sterilization extends to the ,intestinal ,tract4 8#e74 ,the bowels are regulated without purgation4 8#f74 ,the whole metabolic process is improved4 8,,when ,,and ,,how ,,often ,,to ,,drink ,,the ,,antiseptic ,,solution4 8a74 ,for ,indigestion1 whenever distressed1 before or after meals4 8b74 ,for ,constipation1 half an hour before breakfast or last thing at night4 8c74 ,for ,gastro-,intestinal troubles1 such as ,typhoid ,fever1 ,dysentery and ,cholera1 which are the most serious forms of catarrhal inflammation1 take half a tumbler or a whole tumbler of hot water with half the quantity of ,powder raised on a dime every hour1 and between times a glass of generous sic wine4 8,,remarks 8,the sterilization recommended here is a plain disinfecting process which does not interfere with medical treatment4 ,it is1 on the contrary1 of great assistance to it4 8,it has been found very effective in breaking up the cigarette habit4 ,it does away with the craving by removing the morbid irritation of the mucous membrane40 ,eighty-eight disorders are listed in a pamphlet entitled 8,antiseptic ,therapeutics0 all of which are reported as having been treated with success4 ,the dangerous character of the ,maignen 8sterilization0 propaganda is illustrated by a pamphlet 8,first ,aid to ,baby-,sick0 and by the recommendation on the trade package3 8,to prevent ,blood ,poisoning1 ,lockjaw1 ,hydrophobia and ,infectious ,diseases40 ,the legend on the trade package and the advertising matter contained in it are likely to lead the public to place dependence on a weak sodium hydroxid solution as a means of preventing blood-poison1 lockjaw1 hydrophobia and infectious diseases4 ,the pamphlet 8,first ,aid to ,baby-,sick0 recommends its use in sore eyes1 teething and sore mouth1 sore throat1 running ears1 running nose1 sore chest1 summer complaint1 skin troubles and infection after vaccination2 if any trust is put in these claims1 they are bound to lead to the sacrifice of many infants through neglect of proper treatment4 ,patent ,no4 #a1jhf1cci has been granted on this powder to ,p4 ,j4 ,a4 ,maignen of ,philadelphia by the ,u4 ,s4 patent office on the following specification of claim made in the application3 8#a4 ,a process for destroying microorganisms on living tissue1 without injuring the latter 444 whereby the growth of such organisms is inhibited and their substance dissolved without deleterious effect upon contiguous healthy tissue40 ,with brazen assurance this grant has been twisted by the unscrupulous promoters into a government endorsement of the preparation4 ,it1 of course1 means nothing of the sort1 as1 no doubt1 in accordance with legal routine the patent was granted without any investigation by the patent office to determine the effectiveness of the powder for the purpose claimed4 ,in view of the dangerous1 unwarranted and absurd claims made for ,maignen ,antiseptic ,powder the referee recommends that it be refused recognition1 and that the ,council declare its agreement with views expressed in the article 8,maignen ,pulv40 published in ,the ,journal1 ,feb4 #ae1 #aiac1 p4 #ecg1 particularly the following3 8,the germicidal powers of strong alkalies have long been known1 but the inconvenience of their application to tissues and mucous membranes has prevented their use4 ,that they will be of service when sufficiently diluted not to irritate the tissues is improbable1 for the antiseptic power of such solution is slight and the disinfectant value practically nil40 ,because the ,maignen ,institute has twisted the granting of ,u4 ,s4 patent ,no4 #a1jhf1cci into a quasi-endorsement of the claims made for ,maignen ,antiseptic ,powder it is recommended that a copy of this report be sent to the ,commissioner of ,patents as a protest against the present law1 which authorizes the granting of patents on unproved and improbable medical claims4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ad1 #aiad47 ,,tyree',s ,,antiseptic ,,powder,e ,report of the ,council on ,pharmacy and ,chemistry with ,comments ,e ,see also ,tyree's ,antiseptic ,powder1 p4 #djd4 ,tyree's antiseptic powder was assigned for examination to a subcommittee of the ,council1 which made the following report3 ,to the ,council on ,pharmacy and ,chemistry3--,your subcommittee1 to whom was assigned ,tyree's ,pulv4 ,antiseptic ,comp41 marketed by ,j4 ,s4 ,tyree1 ,washington1 ,d4 ,c41 reports as follows3 ,the label on the package states3 8,this preparation is a scientific combination of borate of sodium1 alumen1 carbolic acid1 glycerin and the crystallized principles of thyme1 eucalyptus1 gaultheria and mentha1 in the form of a powder10 etc4 ,the statement that the powder contains the crystalline principles of thyme1 eucalyptus1 gaultheria and mentha is vague and misleading1 since the chief medical constituents of eucalyptus and gaultheria are liquids1 but it tends to convey the impression that the powder contains the essential constituents of these drugs1 namely1 thymol1 oil of eucalyptus or eucalyptol1 oil of wintergreen1 or methyl salicylate1 and menthol4 ,the literature supplied to physicians claims its composition to be3 8,parts1 sod4 bor41 #ej2 alumen1 #ej2 ac4 carbol41 #e2 glycerin1 #e2 the cryst4 principles of thyme1 #e2 eucalyptus1 #e2 gaultheria1 #e1 and mentha1 #e40 ,the composition1 therefore1 might be expressed as follows3 ,sodium borate 7borax7 #ej parts1 or #ch4df per cent4 ,alum #ej parts1 or #ch4df per cent4 ,phenol 7carbolic acid7 #e parts1 or #c4he per cent4 ,glycerin #e parts1 or #c4he per cent4 ,thymol #e parts1 or #c4he per cent4 ,oil of eucalyptus or eucalyptol #e parts1 or #c4he per cent4 ,oil of gaultheria 7or methyl salicylate7 #e parts1 or #c4he per cent4 ,menthol #e parts1 or #c4he per cent4 ,analysis of specimens purchased from different sources in the open market were made under our direction4 ,the reports of the chemists show that ,tyree's antiseptic powder contains no borax1 or mere traces only1 and that it contains no alum1 or mere traces only4 ,instead1 the analyses show that boric acid and zinc sulphate are the essential constituents4 ,the amounts of carbolic acid1 thymol1 menthol1 etc41 contained in the powder1 if present1 were far below the quantities indicated by the formula4 ,the presence of glycerin could not be demonstrated1 and1 if present1 the amount must be very small4 ,one chemist reports3 ,the result of analysis shows that different samples differ slightly in composition1 but that the following indicates the average composition of the product3 ,per ,cent4 ,zinc sulphate1 anhydrous #ae4ef ,boric acid #ha4bf ,volatile matter at #ajj ,c4 for four hours #j4de ,the undetermined portion consists of salicylic acid1 carbolic acid1 menthol and eucalyptol2 possibly other antiseptic agents may be present in very minute quantities4 ,from the above findings we conclude that ,tyree's antiseptic powder is a mixture of boric acid and dried zinc sulphate and antiseptic bodies1 such as menthol1 salicylic acid and carbolic acid1 eucalyptol1 etc4 ,from this it can be readily seen that the label1 which is supposed to set forth the composition of ,tyree's antiseptic powder1 is not in accord with the facts4 ,the powder does not contain either borate of sodium or alum1 and the presence of glycerin could not be established4 ,the antiseptic agents1 exclusive of the boric acid1 are present only in small amounts4 ,the report of another analysis concludes as follows3 ,it evidently contains less than the amount stated of the principles of thyme1 eucalyptus1 wintergreen and mint4 ,it also contains a very small amount indeed of carbolic acid1 much less than that stated4 ,we have been unable to identify certainly the presence of glycerin1 and it is doubtful if it be present4 ,from the result of the analysis we feel confident that the preparation is to all intents and purposes a mixture of boric acid and sulphate of zinc4 ,the carbolic acid1 thyme1 eucalyptus1 wintergreen1 etc41 if present1 are present only in sufficient amount to give the compound a satisfactory odor4 ,in view of the fact that ,j4 ,s4 ,tyree has given wide publicity to a formula which the preceding report has shown to be a deliberate misrepresentation of facts1 it is recommended that the article be refused recognition by the ,council on ,pharmacy and ,chemistry1 and that this report be published in ,the ,journal of the ,american ,medical ,association4 ,the recommendation of the subcommittee was adopted by the ,council in accordance with which the report is published4 ,w4 ,a4 ,puckner1 ,secretary4 ,mr4 ,tyree1 in a letter to ,dr4 ,simmons 7which he states he writes at the request of ,dr4 ,kebler of the ,drug ,laboratory of the ,department of ,agriculture1 though he is under no moral or financial obligation to do so71 says that it has been his intention to inform the medical profession of his reasons for changing the formula of ,tyree's ,antiseptic ,powder from an alum and borax base to a boracic acid and zinc base4 ,he states that this change was made at the suggestion of prominent physicians connected with hospital clinics on nose and throat1 venereal and other conditions and that he has had in contemplation the omission from the label of the various conditions to which the preparation is applicable4 ,mr4 ,tyree1 it will be seen1 assumes the right to sell to physicians a preparation with a descriptive formula which he acknowledges is false1 and he presumes to use his own pleasure as to the time when he will inform them of its true composition4 ,mr4 ,tyree does not state when he changed the formula4 ,we do not know whether it was a year ago1 five years ago or ten years ago1 but we do know that the package which was used in making the first analysis was purchased as early as last ,february1 and the first chemist's report was submitted to the ,council ,march #e1 #aijf4 ,on ,april #d ,mr4 ,tyree was notified by the ,council that the composition of ,tyree's ,antiseptic ,powder did not correspond to the formula published by him4 ,whether or not ,mr4 ,tyree is justified in offering our profession a preparation as composed chiefly of borax and alum when in reality it is chiefly composed of boric acid and zinc sulphate1 we leave physicians to judge4 ,discrepancies ,between ,facts and ,claims--,unfortunate ,attempts of ,mr4 ,tyree at ,explanation ,a report from the ,council on ,pharmacy and ,chemistry on ,tyree's ,antiseptic ,powder appeared in ,the ,journal1 ,oct4 #bj1 #aijf4 ,this showed that the preparation1 advertised as a 8scientific combination of borate of sodium1 alumen1 carbolic acid1 glycerin and the crystallized principles of thyme1 eucalyptus1 gaultheria and mentha1 in the form of a powder40 was essentially a mixture of boric acid and sulphate of zinc--approximately four-fifths of the former to one-fifth of the latter4 8,the carbolic acid1 thyme1 eucalyptus1 wintergreen1 etc41 if present1 are present only in sufficient amount to give the compound a satisfactory odor40 ,as will be remembered1 in the correspondence published at that time1 ,mr4 ,tyree attempted to explain the discrepancies between his statements and the proved facts by intimating that he had recently changed the formula1 and that it was his intention 8on or about the first of ,february to state to the medical profession his reasons for changing the formula10 and that the change had been made 8a short time ago1 at the suggestion of several prominent gentlemen40 ,since that time1 through circulars and other advertisements1 ,mr4 ,tyree has attempted to explain the matter in various ways4 ,in his latest circular letter he seems to make a deliberate attempt to mislead our profession and to misrepresent facts to a degree that makes it almost impossible to believe that the circular came from a man who claims to be honorable4 ,first1 however1 we shall take this opportunity to publish some matter which we have had in reserve since the first expos was made last ,october4 ,when it was realized that ,mr4 ,tyree intended to defend himself by claiming that a change had recently been made in the powder1 we took occasion to try to secure some of the preparation that had been on the market for a long time4 ,in this we succeeded very well4 ,from a ,chicago druggist one package was bought which had been in the store at least since ,july1 #aijb--;how much longer is not known4 ,the druggist from whom the powder was obtained bought the drug store in ,july1 #aijb1 and this powder was on hand at that time1 none having been bought since4 ,this particular powder was analyzed by a chemist1 who found the composition practically the same as that given in the ,council's report1 this chemist estimating that it contained approximately #ha per cent4 boric acid and #ad per cent4 anhydrous zinc sulphate4 ,bearing in mind that for at least four years and ten months ,tyree's ,powder has been essentially the same as it is today1 this letter is very interesting3 7,the comments in brackets are1 of course1 ours47 8,j4 ,s4 ,,tyree1 8,chemist1 8,,washington1 ,d4 ,c4 8,april #af1 #aijg4 8,dr4 --------1 8----1 8,my ,dear ,sir3--,doctors and medical publications of extreme and prejudicial minds often hold and express opinions in honorable faith1 but like all critics1 they are not always familiar with the conditions composing their opinions1 and are often given to expressing them without knowledge of the true motives and facts in the case4 8,if you will read an article that appeared in one of the medical weeklies some time ago ,the ,journal of the ,american ,medical ,association1 of course and which has been copied by several of its offsprings not many we regret to say relating to ,tyree's ,antiseptic ,powder1 you will see that ,i had previously informed the editor as well as his council of investigators1 that at the suggestion of prominent physicians1 extensive clinical experimenting sic were being made with some slight 6 6 6 changes in my powder1 the object being to develop and extend its usefulness in new lines ,it had already been recommended for about everything#b and at the same time make it more acceptable to the general run of the profession4 ,i also notified this editor that these investigations would not be completed until the first of the present year1 after which time these slight 6 6 6 changes in the formula of ,tyree's ,powder would be announced4 ,it is now the middle of ,may2 when and where were the changes announced8#c #b ,from the circular accompanying a package bought over a year ago1 we find the powder recommended for the following conditions3 8,for ,leucorrhea1 ,gonorrhea1 ,vaginitis1 ,pruritus1 ,ulcerated conditions of the mucus membrane4444 ,scrofulous1 ,syphilitic and ,varicose ,ulcers 444 for ,spraying the ,nose and ,throat1 444 for immediate deodorizing and disinfecting 444 for prickly heat1 poison oak1 squamous eczema and other conditions of similar nature4444 ,as a deodorant and prophylactic in dental work1 444 for disinfecting offensive cavities 444 for profuse and offensive perspiration1 swelling1 soreness and burning of the body and feet4444 ,as a delightful toilet preparation after the bath and shaving40 #c ,last ,january the national ,food and ,drugs ,act went into effect2 one of its provisions is that the label must not lie4 ,this is not the exact verbiage1 but it means the same thing4 ,so1 instead of repeating the old false statements1 the new label of ,tyree's antiseptic powder contains nothing whatever about the composition2 the law does not require that it should--unless the preparation contains certain specified drugs4 ,why is the formula omitted8 8,there is nothing new1 startling or dangerous in such changes in formulas4 ,the ,pharmacopeias and national books of authority are continuously improving their formulas4 ,it is the same with every preparation on the market4 ,mr4 ,tyree1 as a nostrum maker1 is in a position to know4 ,his plea evidently is3 8,i am no worse than others40 ,the apparent difficulty in my case is caused by my exceptional frankness 8exceptional frankness0 is good under the circumstances with the profession in telling them when and where8 about this improvement before ,i was ready to announce full details and particulars1 or place my improved sic powder on the market4 8,yours very truly1 8,j4 ,s4 ,tyree40 ,for years ,mr4 ,tyree has been misleading physicians by making false statements regarding the composition of his powder and regarding its value as a therapeutic agent4 ,when exposed he tries to defend himself and his business by statements and excuses that are worthy of a schoolboy trying to get out of a bad scrape4 ,we would respectfully suggest to him that he either take his wonderful powder off the market1 or--which would probably amount to the same thing--tell the truth1 and the whole truth1 about it4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ah1 #aijg47 ,,apergols,f ,abstract of ,report of the ,council on ,pharmacy and ,chemistry ,f ,for abstract of report on ,ergoapiol see p4 #hb2 for the unabridged report of the ,council's action on ,apergols1 see ,reports ,council ,pharm4 and ,chem41 #aiad1 p4 #fd4 ,apergols1 put out by ,h4 ,k4 ,wampole ,co41 ,inc41 is alleged to be a 8,uterine ,stimulant40 ,apergols is apparently an inversion of the name ,ergoapiol and the preparation appears to have essentially the same formula1 namely3 ,apiol #e min4 ,oil ,savine #a_/b min4 ,ergotin #a gr4 ,aloin #a_/h gr4 ,aromatics q4 s4 ,as in ,ergoapiol1 the constituent referred to in the formula as 8,apiol0 appears to be oleoresin of parsley-seed instead of the definite substance apiol described in ,new and ,nonofficial ,remedies4 ,in general the claims made for ,apergols are the same as those made for ,ergoapiol 7see p4 #hb74 ,the ,council refused admission to ,apergols because they are advertised indirectly to the public1 because of unwarranted therapeutic claims1 because of the non-descriptive name and because the product is unscientific4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ab1 #aiad47 ,,aseptikons ,report of the ,council on ,pharmacy and ,chemistry ,aseptikons are vaginal suppositories sold by the ,chinosol ,co4 of ,new ,york4 ,each suppository is said to contain3 ,ac4 ,salicylici #b gr4 ,ac4 ,borici #aj gr4 ,quin4 purae 7,alkal47 #a gr4 ,chinosol #b gr4 ,but4 ,cacao #fj gr4 ,the following claims appear in advertisements3 8,these suppositories are indicated in cervicitis1 leucorrhea1 specific and non-specific vulvo-vaginitis and in all cases where complete vaginal antisepsis is desired40 8,non ,toxic1 ,non ,irritating2 ,no ,damage to ,membranes4 ,yet a ,more ,powerful ,antiseptic than ,bichloride40 ,the ,council decided that the foregoing claims in the absence of evidence must be held exaggerated and likely to mislead1 and also that the claim 8,stronger than ,bichloride0 which appears on the box is misleading4 ,the position of the ,council is that 8,in the case of pharmaceutical preparations or mixtures the trade name must be so framed as to indicate the most potent ingredients40 ,the name ,aseptikons does not give any indication of the ingredients of the product4 ,the ,council holds that 8,the combination of two or more remedies in a mixture must be considered contrary to scientific medicine unless a distinct reason exists for such combination40 ,no evidence has been submitted to establish the value of the combination in ,aseptikons4 ,on the basis of the evidence submitted the ,council voted that ,aseptikons be refused recognition because unwarranted and misleading therapeutic claims are made1 because the name does not indicate its potent constituents1 and because the combination of two or more remedies in a mixture is considered contrary to scientific medicine unless a distinct reason exists for such combination4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ad1 #aiad47 ,,betul-,,ol,g ,abstract of ,report of the ,council on ,pharmacy and ,chemistry ,g ,for the unabridged report of the ,council's action on ,betul-ol1 see ,reports ,council ,pharm4 and ,chem41 #aiad1 p4 #fb4 ,betul-ol 7,e4 ,fougera and ,co41 ,new ,york7 is a methyl salicylate preparation advertised to physicians 7and indirectly to the public7 as an external analgesic and anti-rheumatic4 ,the statements regarding its composition are vague1 misleading and1 as shown by examination in the ,chemical ,laboratory of the ,american ,medical ,association1 untrue4 ,the therapeutic claims are based on discarded theories4 ,although the alleged superiority of natural over synthetic salicylates has been disproved1 physicians are urged to use ,betul-ol because it contains1 or is alleged to contain1 a natural salicylate4 ,another discarded theory is pressed into service in the claim that the chloral in the mixture will be absorbed and converted into chloroform in the blood4 ,the recommendations for the use of ,betul-ol in rheumatism are likely to lead the public to the self-treatment of rheumatism4 ,in view of the serious complications and sequelae of rheumatic fever this recommendation is utterly unjustifiable and a danger to public health--even if the external application of this mixture in uncertain doses were as effective as a proper internal use of salicylates--a theory contrary to experience and unsupported by adequate evidence4 ,the ,council therefore refused recognition to ,betul-ol4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ab1 #aiad47 ,,peacock',s ,,bromides ,,and ,,chionia ,reports of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following reports on ,peacock's ,bromides and ,chionia1 sold by the ,peacock ,chemical ,company1 ,st4 ,louis4 ,w4 ,a4 ,puckner1 ,secretary4 ,,peacock',s ,,bromides ,this is another nostrum of the ordinary mixture type4 ,of the various statements concerning composition furnished by the company1 the following gives as much information as any3 8,in ,peacock's ,bromides it is designed to unite fifteen grains of the purest bromides of ,potassium1 ,sodium1 ,ammonium1 ,calcium and ,lithium1 in such proportion as to insure the bromine equivalent of potassium bromide4 ,each fluid drachm about equals1 in medicinal strength1 fifteen grains of potassium bromide40 ,the label on the trade package indicates the presence of #aj per cent4 of alcohol4 ,it will be observed that the proportions of the different bromids are not stated4 ,hence1 the assertion of the ,peacock ,chemical ,company that 8there is nothing secret in this compound0 cannot be true4 ,a physician prescribing it cannot know how much of each ingredient he is giving2 it may be #ad-a_/b grains of potassium bromid and #a_/h grain each of sodium1 ammonium1 calcium and lithium bromid1 or any other of an enormous number of possible permutations of the proportions4 ,while the theoretical basis of bromid medication is not yet fully settled1 the weight of the best pharmacologic authority and clinical experience is decidedly against the dogmatic claim of the ,peacock ,chemical ,company that 8the best result is obtained by prescribing a combination of bromides40 ,and if there were any advantage in prescribing such a combination1 the physician ought to regulate the proportions4 ,the following quotations are from the advertising matter3 8,being uniform in purity and therapeutic power1 it can be relied upon to produce clinical results which it is believed cannot be obtained from the use of commercial bromide substitutes40 8,the purity1 quality and constant uniformity of this high grade product have long made it a standard bromide preparation40 ,these claims are unfounded4 ,the analyses published in the concern's own advertising 8literature0 show a variation of #h per cent41 in the bromid content1 which certainly indicates a sufficient lack of uniformity4 ,again quoting3 8,in order to insure the best results the bromides must be pure1 i4 e41 free from alkalies and almost free from chlorides4 ,the ,u4 ,s4 ,p4 allows three per cent4 of chlorides4 ,peacock's ,bromides contains the least possible amount of this impurity4 ,bromism is therefore less frequent in those cases in which this preparation is employed40 ,in view of the claim of low chlorid content1 it is interesting to note that the analyses above referred to show that the chlorid content is actually higher than that of some other bromid preparations on the market4 ,the claim of merit on the ground of freedom from chlorids is1 of course1 absurd1 and must be regarded as an attempt to play upon the credulity of the doctor4 ,as a matter of fact1 the average individual takes with his food many times the amount of chlorid he could possibly take in contaminated bromid4 ,the #aj per cent4 of alcohol would undoubtedly have a greater disturbing influence on the bromid action than the amount of chlorid that might be present in any bromid on the market4 ,then we have the statement that1 owing to this freedom from chlorids3 8,bromism is therefore less in those cases in which the preparation is employed40 ,sodium chlorid1 even as an impurity1 would retard rather than favor the development of bromism2 sodium chlorid is even used as an antidote in bromid poisoning4 ,the therapeutic claims lay stress on the value of the bromids in sleeplessness1 epilepsy1 sexual excitement1 tetanus1 infantile convulsions1 chorea1 delirium tremens1 the climacteric1 migraine1 headache due to pelvic conditions1 ovarian neuralgia1 etc4 ,these and other claims1 while too vague to be branded as falsehoods1 are misleading and not in accordance with modern teaching or practice2 the latter recognize the limitations of bromid therapy as well as its scope and advantages4 ,for instance1 in epilepsy the company asserts that3 8,large doses must be given if we expect to control the convulsions4 ,we are to be guided by the frequency and the severity of the seizures1 the saturation of the system by bromides and by the age of the patient4 ,the rule is #8large doses for long periods but with occasional periodic monthly or quarterly omissions4' ,when we have succeeded in controlling the convulsions in so far as greatly diminishing the frequency and severity of the attacks we may then attempt to decrease the dose1 but the results must be carefully watched4 ,increase in frequency of convulsive seizures is a sign that the bromides must again be pushed as before40 ,the best modern clinical teaching concerning the treatment of epilepsy is that bromids should be avoided except as a last resort4 ,bromids do not cure1 and the amount necessary to control the convulsions may produce a degree of mental hebetude that is a greater evil than the disease itself4 ,it is recommended that the preparation be held ineligible for admission to ,n4 ,n4 ,r41 because of its conflict with ,rules #a1 #d1 #f and #aj of the ,council1 and that this report be published4 ,,chionia ,chionia1 according to the statement of the ,peacock ,chemical ,company1 which exploits the product1 contains #ai per cent4 alcohol and is 8,a ,preparation of ,chionanthus ,virginica40#d #d ,of ,chionanthus ,virginica or fringe-tree1 the ,council on ,pharmacy and ,chemistry in its #aiab report on 8,some ,unimportant ,drugs0 said3 8,the drug is much used by eclectics and homeopathists1 especially as a depurant in hepatic and syphilitic disorders4444 ,the claims for this remedy are not supported by experimental evidence and clinical reports of its use fail to show indications of discriminating critical observation4 ,it is not noticed by most pharmacologic authorities40 ,this preparation is advertised particularly as 8a potent hepatic stimulant0 and special claims are made for it in various disturbances of the liver3 8,chionia is very well adapted in the treatment of hepatic congestion owing to its specific action in depleting the portal circulation40 ,in passive congestion of the liver1 the manufacturers would have us believe 8444 we have a drug in ,chionia that will stimulate the circulation of the blood and lymphatics of the liver as well as stimulate its physiological activities and instead of the patient vomiting the blood an internal depletion of the liver occurs40 8444 in cases of simple jaundice due to circulatory 7congestive7 changes in the liver1 ,chionia is the drug #8par excellence' that will rapidly cause a disappearance of this symptom40 ,as a prophylactic against eclampsia1 if a history of torpidity of the liver is obtained3 8,,chionia should be used during the major portion of child-bearing period because it acts directly on the liver stimulating its functional activity40 ,chionanthus virginica has never been shown to have the slightest pharmacologic activity and no evidence is presented that its offspring1 ,chionia1 has any therapeutic value whatever in any disturbance of the liver4 ,the promoters themselves indicate a lack of faith in their own preparation1 for they advise the use of old and efficient forms of treatment along with ,chionia--heart tonics and laxatives in passive congestion of the liver1 mercurial purge or podophyllin and sodium phosphate in 8biliousness10 and quinin in malaria4 ,finally1 with delightful ,english and elaborate insouciance1 they advise in the treatment of eclampsia3 8,in all cases the uterus should be emptied as quick as possible4 7,version of ,csarian ,section470 ,the physician who prescribes ,chionia promotes a fraud4 ,the ,council held ,chionia ineligible for admission to ,n4 ,n4 ,r4 ,editorial ,comment3 ,in ,peacock's ,bromides and ,chionia the ,peacock ,chemical ,company has1 for a third of a century1 been foisting on the medical profession nostrums composed of drugs that are easily combined in any proportion that the physician may want to prescribe4 ,the company has been inflicting on the unthinking physician pseudo-scientific rubbish in the form of advertising literature that should long ago have been regarded as an insult to the intelligence of the medical profession4 ,the following medical journals are carrying advertisements of ,peacock's ,bromides and ,chionia3 ,alienist and ,neurologist ,american ,journal of ,surgery ,american ,medicine ,archives of ,pediatrics ,atlanta ,journal-,record of ,medicine ,buffalo ,medical ,journal ,charlotte ,medical ,journal ,chicago ,medical ,recorder ,denver ,medical ,times and ,utah ,medical ,journal ,eclectic ,medical ,journal ,ellingwood's ,therapeutist ,indianapolis ,medical ,journal ,international ,journal of ,surgery ,lancet-,clinic ,louisville ,monthly ,journal of ,medicine and ,surgery ,maryland ,medical ,journal ,medical ,brief ,medical ,fortnightly ,medical ,herald ,medical ,record ,medical ,review of ,reviews ,medical ,sentinel ,medical ,standard ,medical ,summary ,medical ,times ,medical ,world ,nashville ,journal of ,medicine and ,surgery ,new ,orleans ,medical and ,surgical ,journal ,new ,york ,medical ,journal ,pacific ,medical ,journal ,southern ,practitioner ,texas ,medical ,journal ,texas ,medical ,news ,therapeutic ,gazette ,wisconsin ,medical ,recorder ,woman's ,medical ,journal --7,from ,the ,journal ,a4 ,m4 ,a41 ,april #c1 #aiae47 ,,bromidia ,report of the ,council on ,pharmacy and ,chemistry ,the following report was submitted to the ,council by a member of its ,committee on ,therapeutics1 with the recommendation that publication be authorized4 ,this recommendation was adopted4 ,w4 ,a4 ,puckner1 ,secretary4 ,bromidia 7,battle ,co41 ,st4 ,louis7 at once suggests bromids2 yet ,bromidia is essentially a chloral rather than a bromid preparation4 ,this nostrum illustrates the need of the provision in the ,council's ,rule #h under which recognition is refused pharmaceutical mixtures whose names do not indicate their most potent ingredients4 ,while the chloral content of ,bromidia has been given considerable publicity1 yet the preparation is used both by physicians and by the public without due consideration of its potent ingredient4 ,this fact is attested not only by the fatal results which have followed its use but also by the many reports of habit formation4 ,as long ago as in #ahhg a fatal case of poisoning was reported#e to the medical society of the ,district of ,columbia due to an overdose taken by a ,bromidia addict4 ,the physician who reported this case also gave his experience with another patient who had the ,bromidia habit4 ,in the discussion of the paper a number of cases were reported by others present in which ,bromidia had been taken without a physician's advice and with more or less grave symptoms of poisoning4 #e ,the ,journal ,a4 ,m4 ,a41 ,july #i1 #ahhg1 p4 #ee4 ,in the report of a death of one who had been a slave to ,bromidia it was said3#f 8,when the body was found1 there were eleven one-ounce ,bromidia bottles about the room or on his person4 ,nine were entirely empty and the other two were about half full4 ,none of these bottles indicated that they had been purchased on a physician's prescription1 only the druggist's label marked #8,bromidia' being on them40 #f ,the ,journal ,a4 ,m4 ,a41 ,april #ba1 #aijf1 p4 #abbj4 ,dr4 ,horatio ,c4 ,wood1 ,jr41 gave#g a striking illustration of how preparations like ,bromidia come to be used even by physicians without consideration of their constituents3 #g ,the ,journal ,a4 ,m4 ,a41 ,april #ba1 #aijf1 p4 #abbj4 8,within an hour after his father1 a ,brooklyn physician1 had given him a dose of bromid1 ,h4,g4,p41 a prodigal son1 died yesterday at his father's home in ,brooklyn4 ,two years ago1 when he appeared to have sown his wild oats1 the father made him superintendent of his country place1 near ,grants ,mills1 ,delaware ,county4 ,a week ago the son left his place1 and at #a o'clock yesterday morning appeared at his father's ,brooklyn home4 ,he was nervous1 and at #i a4 m4 begged for a sedative4 8#8,i prescribed the usual quantity of bromidia1' the young man's father told a reporter4 #8,he was weak and had suffered from weak heart and kidney trouble for some time4' 8,an hour later the father found the son dying and administered restoratives1 but to no avail40 ,a circular1 8,the ,advantages of ,bromidia10 makes it plain how physicians come to use a preparation like ,bromidia without consideration of its potent constituent4 ,in this circular the presence of chloral is at first frankly admitted1 then it is suggested that in the combination the evil effects of chloral are completely eliminated and in the end the impression is left that ,bromidia is practically innocuous4 ,thus at the beginning while arguing that ,bromidia is better than extemporaneous preparations the chloral content is plainly acknowledged3 8,in the untoward effects so frequently attending the use of extemporaneously prepared mixtures of chloral and the bromides1 may be found the reason for ,,bromidia',s preference when the need for a hypnotic agent arises4 ,were it not for the well known disadvantages of these drugs which become still more marked with their continued use1 there could be no special need for such a preparation as ,,bromidia 7,battle71 for the therapeutic powers of chloral and the bromides are among the most positive facts in medicine40 ,again3 8,it was to meet the growing professional demand for a combination of chloral and the bromides with their evil effects eliminated1 that led to the manufacture of ,,bromidia 7,battle740 ,then1 suggesting the indiscriminate use of ,bromidia--as an entity as ,dr4 ,wood suggests--the claim is made that3 8444 its constituents have been chosen with a view of enabling ,bromidia to meet every requirement for an agent of its class40 8,owing to the exceptional purity of its component parts and its freedom from untoward effects when continued over long periods1 this product will be found of the highest utility in epilepsy40 8444 its action is that of chloral and the bromides minus their evil effects40 ,finally ,bromidia becomes a simple bromid preparation4 ,thus an advertisement reads3 8,bromidia's 7,battle7 ,marked ,sedative and ,antispasmodic ,qualities eminently fit it for the treatment of ,maniacal ,excitement1 ,epilepsy1 ,spasmodic ,asthma1 ,convulsive ,seizures of ,reflex ,origin1 ,sexual ,neuroses1 and other disorders attendant upon nervous irritability4 8,through its exhibition1 the fullest therapeutic power of the bromides may be secured with a minimum of their evil effects2 a feature of the greatest service when the necessity for continued treatment becomes necessary40 ,in addition to the general invitation to use ,bromidia in epilepsy and various nervous disorders1 a circular also recommends its use in typhoid1 a recommendation1 which1 if followed1 may turn the scale in favor of a fatal result4 ,the circular states3 8,as a soothing agent in the extreme restlessness and irritability of typhoid fever and other infectious diseases1 ,,bromidia 7,battle7 is a therapeutic weapon of definite service4 ,relief of the headache of typhoid may also be secured through the use of ,,bromidia 7,battle74 ,by means of its administration for the above purposes1 the patient's strength is conserved and as a result he is much better prepared to stand the force of the infection40 ,particularly vicious is the recommendation that it be given to children4 ,thus1 in a pamphlet entitled 8,effective ,drugs ,effectively ,combined03 8,another point of advantage to be found in bromidia is the ease with which it is borne by children4 ,owing to this tolerance1 it is of distinct service in a considerable list of disorders of childhood4 ,thus1 of course1 employed with care and an understanding of its potency1 bromidia has a field of usefulness in chorea1 laryngismus stridulus1 and whooping-cough4 ,in other nervous disorders of childhood--those attending acute infections1 for instance--bromidia is a definitely indicated therapeutic aid1 owing to the soothing influence exerted by even a moderate dose and the absence of untoward effects4 ,more specifically1 the correcting influence of bromidia in the night-terrors of children may be mentioned40 ,formerly advertisements asserted that each fluidram of ,bromidia contained3 8,chloral hydrate #ae grains 8,potassium bromid #ae grains 8,extract of ,cannabis indica #a_/h grain 8,extract of henbane #a_/h grain0 ,this formula also appears on the label of a sample package sent through the mails during #aiad4 ,a recent circular contains a somewhat different formula4 ,instead of 8#a_/h gr4 each of gen4 ,imp4 ,ext4 ,cannabis ,ind4 and ,hyoscyam40 as was formerly claimed1 each fluidram of ,bromidia is now said1 not to 8contain0 but to 8represent10 not the extracts but the far less potent drugs 8,cannabis indica #a_/h grain1 ,hyoscyamus #a_/h grain10 thus3 8,chloral hydrate #ae grains 8,pot4 brom4 #ae grains 8,cannabis indica #a_/h grain 8,hyoscyamus #a_/h grain0 ,furnishing still greater variety1 the labels on a recently purchased bottle of ,bromidia1 where under the ,food and ,drugs ,act the presence of narcotic drugs must be declared1 read3 8,alcohol #aj per cent41 ,chloral ,hydrate1 #ia grs4 per ounce4 ,cannabis indica indeterminate in finished product40 8,in the manufacture of ,,bromidia to each drachm of fluid used are added #ae grains of pure chloral hydrate and purified brom4 pot41 and #a_/h grain each of gen4 imp4 ext4 cannabis ind4 and hyosciam40 ,these various statements as to the composition of ,bromidia leave one very much 8in the air40 ,as chloral and potassium bromid are easily determined and since lying on the labels of widely exploited proprietaries has become somewhat risky recently1 it is probable that the statements on the trade package are to be depended on and that each fluidram of ,bromidia contains something like #ab grains each of chloral and potassium bromid and not #ae grains as the medical profession has been and is being told4 ,pharmacists who have attempted to put up a nonproprietary preparation similar to or1 more correctly1 having the alleged composition of ,bromidia have found it practically impossible to do so4 ,the reason is that extract of cannabis indica is almost insoluble in a menstruum such as that found in ,bromidia4 ,the ,national ,formulary1 first edition1 listed ,mistura ,chlorali et ,potassii ,bromidi ,composita of which it was said3 8,each fluidram contains #ae grains each of ,chloral and of ,bromid of ,potassium1 and #a_/h grain each of ,extract of ,indian ,cannabis and ,extract of ,hyoscyamus40 ,in this the pharmacists attempted to incorporate the cannabis indica by using the tincture of the drug and suspending it by the addition of tincture of soap bark4 ,in the present edition of the ,national ,formulary1 the preparation is made by triturating the extract of cannabis indica with pumice stone and then filtering the finished product4 ,this gives an 8elegant0 preparation--but one from which the cannabis indica is filtered out6 ,a sad commentary on the ,national ,formulary4 ,it should not be supposed1 however1 that the manufacturers of ,bromidia have solved the problem that has baffled the pharmacists2 not at all4 ,bromidia probably contains no more cannabis indica than does its ,national ,formulary prototype4 ,the statement on the present trade packages1 that the amount of cannabis indica in ,bromidia is 8indeterminate10 is but a tardy acknowledgment of the fact that the stuff has not1 and never had1 the amount of cannabis indica claimed for it for so many years4 ,the 8indications0 named on the ,bromidia labels are1 in common with nostrums of this type1 but suggestions for self-drugging4 ,they will appeal to the layman who has purchased1 either by prescription or otherwise1 an 8original package0 of ,bromidia and who may imagine he suffers from 8nervousness10 8sleeplessness10 8headache0 or 8neuralgia40 ,but while the manufacturers in their advertising matter have on the whole not disguised the presence of chloral so much as they have attempted to make it appear that the chloral has been robbed of its dangers--for all hypnotics if used thoughtlessly are dangerous--after all the name has created the false impression that ,bromidia is a bromid preparation4 ,it is because of this false impression carried by its name1 that ,bromidia came to be used indiscriminately by the profession and in the course of time still more indiscriminately and recklessly by the public4 ,bromidia is a vicious chloral preparation masquerading under a misleading name4 ,that physicians have been impressed by the claims of its harmlessness and by the mystery connected with the formula is not a credit to the intelligence of our profession4 ,there is no doubt but that physicians are responsible for the use and abuse of this chloral preparation by the public4 ,there is no scientific or rational excuse for a ready-made preparation of this sort4 ,when chloral or a bromid is indicated the proper dose of each of these1 if they are to be combined1 should be determined for each patient4 ,potassium bromid and chloral hydrate both are readily soluble in water1 syrup or elixirs and it is a simple matter to prescribe the required dose of chloral and of bromid dissolved in some aromatic water like cinnamon-water 7,aqua ,cinnamomi71 in some syrup like syrup of orange 7,syrupus ,aurantii7 or in an elixir like the aromatic elixir 7,elixir ,aromaticum7 or adjuvant elixir 7,elixir ,adjuvans74 ,if this mixture is prescribed thus the physician is alive1 alike to the dangers and the limitations of the drugs2 if it is prescribed under a misleading proprietary name1 the physician endangers his patient1 stultifies his profession and tends to perpetuate the great ,american fraud4 ,editor's ,note4--,a list of some of the medical journals that advertise ,bromidia3 ,texas ,medical ,news ,nashville ,journal of ,medicine ,surgery ,medical ,brief ,annals of ,surgery ,charlotte ,medical ,journal ,medical ,sentinel ,memphis ,medical ,monthly ,laryngoscope ,medical ,world ,medical ,review of ,reviews ,louisville ,monthly ,journal ,indianapolis ,medical ,journal ,monthly ,cyclopedia ,medical ,bulletin ,journal of ,nervous ,mental ,diseases ,maryland ,medical ,journal ,merck's ,archives ,iowa ,medical ,journal ,medical ,standard ,southern ,practitioner ,new ,orleans ,medical ,surgical ,journal ,therapeutic ,gazette ,medical ,herald ,medical ,times ,texas ,medical ,journal ,wisconsin ,medical ,recorder ,international ,journal of ,surgery ,vermont ,medical ,monthly ,atlanta ,journal-,record of ,medicine ,st4 ,paul ,medical ,journal ,hospital ,bulletin of the ,university of ,maryland ,denver ,medical ,times ,buffalo ,medical ,journal ,medical ,review ,ellingwood's ,therapeutist ,eclectic ,medical ,journal ,massachusetts ,medical ,journal --7,from ,the ,journal ,a4 ,m4 ,a41 ,may #af1 #aiad47 ,,cactus ,,grandiflorus ,report of the ,council on ,pharmacy and ,chemistry,h ,h ,a reprint of various articles discussing ,cactus ,grandiflorus1 ,cactin--now called ,cactoid--7,abbott ,alkaloidal ,company7 and ,cactina ,pillets 7,sultan ,drug ,company7 will be sent on receipt of a #b-;cent stamp4 ,the ,council voted that cactus grandiflorus should not be accepted for ,new and ,nonofficial ,remedies1 and that a statement be prepared for ,the ,journal giving the reasons for this action4 ,accordingly the following report has been adopted by the ,council and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,cactus ,grandiflorus ,the therapeutic value of this plant has been variously estimated by different observers4 ,experimental evidence as to its action is scanty and no complete chemical examination has ever been made4 ,reputable men have testified that some of the plants of the cactus family contain very active principles1 but so far experiments seem to prove that cactus grandiflorus has neither the action of digitalis nor that of strychnin4 ,the principal contributions1 clinical and experimental1 for and against the drug1 are set out below4 ,,experimental ,,evidence ,o4 ,h4 ,myers#h worked with a product which he calls cactina and which he regards as the active principle of the drug4 7,as no such substance as cactina is described in any materia medica1 it is impossible to state what ,myers really used47 ,he found that it had a strychnin-like action and raised the blood-pressure4 #h ,new ,york ,med4 ,jour41 #ahia1 liii1 #fha-fhc4 ,hatcher comes to the conclusion3 8,either ,myers' work was a pure fabrication or he was dealing not with cactin but with a substance similar to the pellotin of ,heffter1 the action of which resembles that of strychnin to a certain extent40 ,e4 ,boinet and ,j4 ,boy-,teissier#i experimented with an aqueous extract1 an alcoholic extract1 and with an alkaloid which they call 8cactine40 ,they concluded from three sets of experiments on frogs that extract of cactus produces1 in ten minutes1 a temporary increase in the heart's action which frequently repeated doses are required to maintain2 and that large doses slow the heart and produce arrhythmia4 #i ,bull4 gn4 de thrap41 #ahia1 cxxi1 #cdc-cdi4 ,l4 ,e4 ,sayre#aj experimented with a preparation of cactus1 made from the stem of the plant1 by injecting it into the dorsal lymph space of the frog4 ,there was seemingly an increase in the amplitude of the heart's action and an indication of a strengthened beat or increased force4 #aj ,am4 ,pharm4 ,assn41 #aijf1 liv1 #dje4 ,r4 ,a4 ,hatcher#aa states that it is possible that cactus grandiflorus1 under certain conditions1 may contain a principle with a strychnin-like action4 ,but ,hatcher made ten experiments on frogs1 four on cats1 six on dogs1 two on rabbits1 and one on a guinea-pig1 with ,cactina pillets of the ,sultan ,drug ,company and the ,cactin of the ,abbott ,alkaloidal ,company4 ,from #a to #ae pillets in frogs and up to #be in dogs were used at each dose4 ,in no single instance was there any evidence of a digitalis-like or strychnin-like action1 or1 in fact1 of any decided action of any kind whatever4 #aa ,the ,journal ,a4 ,m4 ,a41 ,sept4 #ba1 #aijg1 pp4 #ajba-ajbd4 ,gordon ,sharp#ab was unable to obtain either alkaloid or glucosid from the plant1 but found a series of resins that caused contraction of the blood-vessels of a frog4 ,this was not a digitalis-like contraction1 but depended1 he believed1 on simple acidity4 ,on the heart of the frog the resins have little or no effect1 comparisons being made with digitalis in the same animals4 ,there is no proof that cactus grandiflorus itself shortens diastole1 or in fact1 that it has any special action on the heart muscle at all4 ,sharp experimented on himself with large doses of an extract made with alcohol #a to #e1 but got no noticeable results4 ,he thinks that the plant may have some slight diuretic action4 #ab ,practitioner1 ,london1 #ahid1 iii1 #ddd-ddf4 ,sayre submitted the preparation which he used in his experiments for more careful testing to ,e4 ,m4 ,houghton1 who reported that it had practically no action on the heart4 ,in commenting on ,houghton's results1 ,reid ,hunt said that they were confirmed by his own experiments4 ,he did not deny1 however1 that the drug might have some therapeutic effect and that1 in very large doses1 it did affect the kidneys4 ,s4 ,a4 ,matthews#ac found one preparation of cactus 7cactin--,abbott7 absolutely inert so far as any effect on the heart is concerned4 ,he found that cactina 7,sultan ,drug ,co47 in very large doses depressed both the circulation and respiration4 ,in this regard it differs from strychnin1 and it has no resemblance to the action of digitalis1 strophanthus or any of the heart stimulants4 ,a dose of from #aj to #ab pillets administered intravenously to a #aj to #ab kg4 dog exerted little or no influence on the heart or circulation2 the larger dose may cause a slight fall in blood-pressure4 ,when #gj or more pillets were administered within two and a half hours the animal generally died4 #ac ,the ,journal ,a4 ,m4 ,a41 ,march #ba1 #aijh1 pp4 #ief-ieh4 ,the work of ,boinet and ,boy-,teissier also has been criticized by ,hatcher on the ground that their most positive results were obtained with an alkaloid which no one at this day is able to prepare4 ,the results quoted in this report1 however1 were obtained by the use of extracts of cactus so that it does not seem that they should be entirely rejected1 whatever their value may be4 ,,clinical ,,evidence ,clinical observations have been more abundant than exact1 and a favorable action of the drug in some organic diseases of the heart has been reported2 other observers would limit its use to functional arrhythmia1 insisting that it is not a substitute for digitalis or aconite1 but that it occupies a place distinct from either of those remedies4 ,p4 ,w4 ,williams#ad recommends cactus for functional heart disease1 but1 as a rule1 found it useless in organic disease4 ,he thinks it one of a class of remedies which act on the accelerator nerves and sympathetic ganglia1 shortening the diastole and stimulating the spinal vasomotor nerve centers4 ,williams apparently relied on ,myers for his knowledge of the pharmacologic action1 and his paper is a fair example of the clinical studies of cactus4 #ad ,practitioner1 ,london1 #ahia1 xlvii1 #bff-bgc4 ,ellingwood#ae claims that cactus is a cardiac tonic1 acting on the accelerator nerves and heart ganglia1 increasing muscular force and arterial tension4 ,he recommends it in both organic and functional diseases4 #ae ,med4 ,rec41 ,new ,york1 #aije1 lxvii1 #heg4 ,boinet and ,boy-,teissier found that therapeutic doses of #dj drops of tincture of cactus were without effect on the normal heart4 ,in patients with noisy asystole 7asystolie bruyante7 the same dose produced no appreciable effect4 ,in the period of latent non-compensation of true cardiac patients1 from #hj to #ajj drops a day increased the force of the failing heart4 ,in patients with secondary heart disease with arrhythmia of nervous origin1 daily doses of #hj1 #ajj and #abj drops of the tincture were well tolerated for weeks2 they seemed to increase the fulness of the pulse and regulated its rhythm4 ,in spite of such large doses1 these observers never noticed any symptoms that could be attributed to a cumulative action4 ,it must be remembered that the precise preparation of cactus which they used is not known4 ,aulde#af recommends it as a cardiac tonic free from cumulative effects4 #af ,practitioner1 ,london1 xlvii1 #bbc2 ,therap4 ,gaz41 #ahij4 ,gordon ,sharp says3 8,the therapeutics of the subject1 ,i think1 are clear enough4 ,cactus grandiflorus cannot be included in our list of cardiac drugs4 ,it is not even a simple stomachic tonic and at most all one can say is that it has small diuretic action40 ,hatcher says3 8,clinical testimony is so conflicting that between the extreme views of ,gordon ,sharp and those of ,ellingwood there is room for an honest difference of opinion concerning cactus grandiflorus40 ,matthews himself took #ajj granules of cactin 7#a_/fg gr4--#a mg4 each71 #be every four hours1 without experiencing the least effect4 ,,conclusions ,reliable conclusions regarding the therapeutic use of cactus grandiflorus are rendered difficult on account of several factors4 #a4 ,it is uncertain what part of the plant contains the active principle if one exists2 and its nature is unknown4 ,the ,national ,standard ,dispensatory states that its 8activity must be confined to the flower in some special stage of its development or to a certain part of it or to some parts gathered with it40 ,this uncertainty may explain the negative results obtained by some observers1 but it makes the drug one that cannot be generally relied on and gives an excellent opportunity for the exploitation of proprietary preparations4 #b4 ,some of the experimental work and much of the clinical evidence has been obtained and published under proprietary auspices4 ,for this reason many of the therapeutic claims made for the drug must be viewed as merely the reflection of the exaggerated statements made by the advertisers of proprietary preparations4 #c4 ,the value of clinical evidence when unsupported by an animal experimentation is much diminished by the tendency of enthusiastic and untrained observers to attribute to the drug given the effect really due to general remedial measures1 psychic suggestion and so forth4 ,while it must be admitted that valuable remedies may exist whose therapeutic properties cannot be revealed by animal experimentation1 yet in the absence of such experimental evidence conclusions should be drawn with extreme caution4 ,bearing these conditions in mind1 the following statements seem to be justified3 7a7 ,the botanical1 chemical and pharmaceutical properties of cactus are not sufficiently determined to make any available preparation a reliable remedy4 7b7 ,there is some evidence that cactus may be capable of affecting the animal heart and nervous system1 but its action is not that ordinarily attributed to it4 ,it does not increase the force of the heart-beat4 7c7 ,while there is some clinical testimony as to its usefulness in functional diseases of the heart1 the indications for its administration are at present too uncertain to afford a safe basis for recommending it4 #d4 ,while the drug may be deserving of further experimental and clinical investigation1 this should be carried on in reliable pharmacologic laboratories and in clinics provided with facilities for exact observation4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #ab1 #aiaj47 ,,calcreose ,report of the ,council on ,pharmacy and ,chemistry ,in response to inquiries and in view of the extensive advertising propaganda1 the ,council1 on ,dec4 #ai1 #aiac1 took up for consideration ,calcreose 7,maltbie ,chemical ,company1 ,newark1 ,n4 ,j474 ,examination showed that the preparation contained1 in loose combination1 approximately equal weights of creosote and lime4 ,the claims made in the advertising 8literature0 were extravagant and uncritical1 and the ,council therefore held ,calcreose ineligible for ,new and ,nonofficial ,remedies4 ,in ,june1 #aiad1 at the request of the ,maltbie ,chemical ,company1 the ,council undertook a reconsideration of the preparation4 ,the advertising claims were now found more conservative4 ,before the existing claims could be judged1 however1 the ,council deemed it necessary to require from the company satisfactory proof 7#a7 that the large doses of ,calcreose recommended and administered actually furnish large amounts of creosote to the blood1 and 7#b7 that patients taking these large doses do not suffer from digestive disturbances1 loss of nutrition1 albumin in the urine or phenol urine1 as claimed4 ,the ,council accordingly advised the company of this requirement1 at the same time stipulating that nothing in the report should be interpreted as indicating a belief on the part of the ,council that enormous doses of creosote are necessary for1 or will promote a cure of tuberculosis4 ,the ,maltbie ,chemical ,company has not up to the present date furnished this proof1 but has evinced a disposition to make the ,council's holding ,calcreose under advisement appear in the guise of a quasi-approval4 ,it is therefore recommended that ,calcreose be refused recognition for conflict with ,rule #f4--7;,from the ,journal ,a4 ,m4 ,a41 ,june #bf1 #aiae47 ,,campho-,,phenique ,report of the ,council on ,pharmacy and ,chemistry and ,some ,comments ,thereon ,the following report was submitted to the ,council on ,pharmacy and ,chemistry by the subcommittee to which ,campho-,phenique had been assigned3 ,to the ,council on ,pharmacy and ,chemistry3--,campho-,phenique1 sold by the ,campho-,phenique ,co41 ,st4 ,louis1 ,mo41 is claimed to be composed of phenol #di per cent41 and camphor #ea per cent4 ,examination of specimens1 purchased in the open market1 made under our direction1 demonstrates that the statements made in regard to the composition are not true4 ,instead of containing #di per cent4 of phenol 7carbolic acid71 the analysis showed that it contains not more than #bj per cent4 ,instead of containing #ea per cent4 of camphor1 the analysis demonstrates that the amount of camphor is not more than #ch per cent4 ,besides phenol and camphor1 a third substance was found which proved to be liquid petrolatum and to be present to the extent of #ch per cent4 or more4 ,since the statements made in regard to the composition of ,campho-,phenique are deliberate misrepresentations of the facts1 it is recommended that the article be not approved4 ,besides ,campho-,phenique1 the above-mentioned firm also sells a preparation labeled ,campho-,phenique ,powder4 ,while no statement in regard to the composition of this product is made on the label or in the literature1 such expressions as 8,campho-,phenique in a powdered form0 and 8,powdered ,campho-,phenique0 lead to the inference that it has essentially the same composition as that stated for the liquid preparation4 ,an examination of a specimen of ,campho-,phenique ,powder purchased in the open market showed that #ib per cent4 of it was a talcum-like inorganic substance4 ,the remaining #h per cent4 consisted chiefly of camphor with a small amount of phenol4 ,in view of the fact that ,campho-,phenique ,powder contains very little phenol1 but instead consists chiefly of an inorganic talcum-like substance1 its name is misleading and deceptive4 ,it having been shown that ,campho-,phenique ,powder corresponds to a camphorated talcum powder1 the claims that it 8has no equal as a dry dressing10 that it is 8absolutely superior to iodoform10 and that it has 8all the excellent properties of aristol and iodoform10 are unwarranted4 ,it is recommended that the article be not approved1 and that this report be published4 ,the recommendations of the subcommittee were adopted by the ,council1 and in accordance therewith the above report is published4 ,w4 ,a4 ,puckner1 ,secretary4 ,campho-,phenique ,the above report on a much advertised 8ethical0 proprietary medicine is worthy of the thoughtful consideration of the members of the medical profession1 as it illustrates admirably some of the conditions connected with this proprietary medicine business4 ,,the ,,formula ,a ,,fake ,first1 it illustrates the fact that the published formulas of the 8ethical0 proprietaries are not always reliable4 ,the ,campho-,phenique ,company has been very willing to give out a formula1 purporting their product to be #ea per cent4 camphor and #di per cent4 phenol 7carbolic acid74 ,now1 these two drugs will make a liquid mixture1 and any druggist can make it1 and the mixture will have about the same consistency and appearance as ,campho-,phenique4 ,but its effect differs decidedly from that of ,campho-,phenique4 ,some months ago a very intelligent physician1 in discussing the proprietary medicine business1 said that in some cases physicians could not get druggists to make preparations which were as satisfactory as those which could be bought ready-made4 ,he cited ,campho-,phenique as an illustration4 ,he said that he had used this preparation for burns1 etc41 but as he did not like to use preparations put up by companies about which he knew nothing1 he asked his druggist to make the mixture in accordance with the published formula4 ,the druggist's preparation was not satisfactory2 it had a decidedly different effect from ,campho-,phenique1 and so he tried another druggist4 ,this druggist also followed the published formula1 but his results1 too1 differed materially from the proprietary article4 ,the various analyses that have been made show why the preparations put up by the druggists did not resemble that made by the company2 since1 according to the analyses1 ,campho-,phenique consists of #dj per cent4 liquid petrolatum1 which is an inert but soothing diluent1 while instead of #di per cent4 of carbolic acid1 as claimed1 it really contains less than #bj per cent4 ,this is an entirely different proposition4 ,now1 if the physician referred to above will have his druggist make a mixture of #bj per cent4 of carbolic acid1 #dj per cent4 of camphor and #dj per cent4 of liquid petrolatum1 and will then compare this resulting compound with ,campho-,phenique1 he will find that there is not much difference4 ,furthermore1 he will realize that there is nothing either new or wonderful about the preparation4 ,camphorated oil and carbolized oil are both in common use4 ,campho-,phenique is apparently simply a mixture of the two4 ,,the ,,powder ,,still ,,worse ,so much for the liquid4 ,the powder seems to be something entirely different1 for1 according to the chemist's report1 over #ij per cent4 of it is inert1 absorbent1 talcum-like material4 ,there is enough camphor and carbolic acid to give the powder an odor and thus mislead physicians1 especially those who are in the habit of taking for granted that whatever statements nostrum manufacturers make are true4 ,perhaps it is a fairly good dressing for wounds--at least it will do no harm--but its name is misleading and deceptive4 ,for all practical purposes it is essentially a camphorated talcum powder4 ,,company ,a 8,,patent-,,medicine0 ,,concern ,the second interesting phase of this 8ethical0 proprietary is that it illustrates another point1 i4 e41 that many of these articles are supplied to our profession by those who are not legitimate manufacturing pharmacists4 ,the ,campho-,phenique ,company of ,st4 ,louis1 according to all reports1 is owned and controlled by a gentleman named ,ballard4 ,this 8company0 supplies the medical profession with the preparations under consideration and also with ,chloro-,phenique and ,scrofonol4 ,we are informed that this same ,mr4 ,ballard is the principal owner1 if not the sole owner1 of quite a number of 8patent-medicine0 companies1 such as ,ballard-,snow ,liniment ,co41 ,brown's ,iron ,bitters ,co41 ,mayfield ,medicine ,mfg4 ,co41 ,smith ,bile ,beans ,co41 ,swain's ,laboratory1 and several others4 ,we learn from the wholesale drug trade lists that these various 8companies0 make and sell1 besides the ,campho-,phenique preparations1 ,ballard-,snow ,liniment1 ,ballard's ,herbine1 ,brown's ,iron ,bitters1 ,dr4 ,herrick's ,pills1 ,richardson's ,life-,preserving ,bitters1 ,smith's ,bile ,beans1 ,swain's ,all ,healing ,ointment1 and several other 8patent medicines40 ,it is hardly necessary to make any further comments4 ,the whole business is nauseating to those who know the actual conditions of this nostrum business and how our profession is being deluded4 ,the ,campho-,phenique matter is not an exception2 it is simply another illustration of these conditions4 ,the majority of 8ethical0 proprietaries are foisted on our profession1 either without any formula accompanying them1 or with a 8formula0 that is a fake4 ,the majority of the 8ethical0 proprietaries are manufactured and supplied to physicians1 with instructions regarding their use1 by men who bear the same relation to legitimate pharmacy that the veriest quack that ever swindled a credulous public bears to scientific medicine4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bj1 #aijg47 ,,celerina1 ,,aletris ,,cordial ,,and ,,kennedy',s ,,pinus ,,canadensis1 ,,light ,,and ,,dark ,report of the ,council on ,pharmacy and ,chemistry ,the following reports on products of the ,rio ,chemical ,company have been submitted by a referee4 ,the ,council recommends that they be published1 as the preparations discussed are glaring instances of nostrums exploited through physicians on unscientific claims and false representations4 ,w4 ,a4 ,puckner1 ,secretary4 ,celerina ,celerina belongs to what ,samuel ,hopkins ,adams calls the 8bracer0 type of nostrum4 ,according to the label it contains #db per cent4 alcohol 7whisky contains about #ej per cent474 ,the other ingredients of ,celerina are declared to be as follows3 8,each fluidounce represents ,forty grains each ,kola1 ,viburnum1 ,forty-eight grains ,celery1 ,twenty grains ,cypripedium1 ,sixteen grains ,xanthoxylum and ,aromatics4 8,dose--#a or #b teaspoonfuls #c times a day40 ,kola contains a very small percentage each of caffein and theobromin4 ,it is impossible for the infinitesimal amounts of these alkaloids in an ordinary dose of ,celerina to produce any physiologic effect4 ,viburnum has been called a 8uterine sedative10 whatever that may be4 ,its only real activity is the psychic one due to its taste and odor4 ,celery at one time was credited with being both an antispasmodic and a nerve stimulant--a remarkable combination of opposing qualities6 ,scientific investigation has failed to show that celery has any physiologic or therapeutic activities4 ,if it had the slightest medicinal value1 the rational course would be to prescribe it in its fresh and natural state4 ,the small dose contained in a teaspoonful of ,celerina is inappreciable and not even equivalent to that contained in a stalk of celery4 ,ladyslipper1 more imposing under the ,latin name of 8cypripedium10 is a flowering plant with a legendary reputation as an 8antispasmodic and nerve stimulant40 ,it has been in the therapeutic scrap-heap for years4 ,it contains a little tannic acid1 gallic acid and a volatile oil4 ,even a tannic acid action cannot be expected from a teaspoonful of a preparation containing #bj grains of ladyslipper to the ounce4 ,prickly ash 7xanthoxylum7 has never been shown to have any activity other than that of a local irritant1 especially to mucous membranes4 ,the slight 8bite0 from this drug would be entirely covered up by the alcohol in ,celerina4 ,any stimulating effect which this drug may have on the stomach is greatly inferior to that produced by a very small glass of ordinary ginger ale4 ,in short1 there is no ingredient in ,celerina1 except the alcohol1 that has any recognizable activity2 and the alcohol content is nearly as great as that of ordinary whisky4 ,some of the claims and recommendations for this nostrum are3 8,celerina 7,nerve ,tonic71 for ,nervousness1 ,hysteria1 ,insomnia1 ,nervous ,indigestion1 ,languid and ,debilitated ,conditions1 ,recovery from ,alcoholic ,excess40 ,think of prescribing an alcoholic nostrum four times a day to promote recovery from alcoholic excess6 8,,neurasthenia3 ,the bane of the general practitioner2 the puzzle of the neurologist2 the juicy fruit of the quack and faddist2 the opportunity of the intelligent therapist4444 ,for the medical treatment ,,celerina is the preparation of wide utility40 ,the sang froid with which the exploiters of this nostrum refer to other 8quacks and faddists0 as reaping 8juicy fruit0 from neurasthenics would command admiration were it not so pitiful4 8,celerina has substantial endorsement in nervous disorders characterized by ,aphonia 7nervous740 ,of course1 the disappearance of nervous aphonia might follow the application of any treatment whatever1 be it ,eddyism1 ,chiropractic1 ,peruna or ,celerina4 ,in 8,,climacteric 7the ,menopause7 flattering results have been reported from a combination of equal parts ,celerina and ,aletris ,cordial ,rio40 8,teaspoonful doses after meals and upon retiring have proven efficacious in 8dyspepsia0 when other remedies have failed40 ,here is a good example of proprietary-house therapeutics3 ,such widely different conditions as digestive trouble and the climacteric are to be treated with a combination of alcohol1 simple bitters and aromatics6 ,why not order a cocktail under its own name8 ,it would be equally efficacious1 less mysterious and its dangers might be better realized6 8,a teaspoonful or two in three tablespoonfuls of boiling hot water for insomnia upon retiring40 ,any other hot toddy at bedtime 7and it need not cost a dollar a bottle7 might give relief2 but the intelligent physician to-day recognizes the danger of prescribing alcohol in such conditions4 8,in the case of brain workers who suffer from nervous excitability and mental fatigue1 the administration of ,celerina in teaspoonful doses1 three times a day and at bedtime1 rapidly controls the condition and increases mental capacity40 ,and the same effect follows its use3 8,in cases involving worry1 anxiety1 overwork1 and excesses of various kinds44440 ,moreover3 8,celerina is the most prompt and efficient of remedies for devitalized or broken-down constitutions--doses four times a day40 ,the statement made by its manufacturers that this preparation is free from narcotics or habit-forming drugs is not true4 ,alcohol is both a narcotic and a habit-forming drug4 ,as in the case of other nostrums containing no potent drugs but alcohol1 ,celerina is recommended for various diseased conditions in combination with a familiar form of treatment by drugs of more or less value4 ,the physician who thoughtlessly prescribes one of these combinations will without doubt unthinkingly attribute any subsequent improvement to the ,celerina4 ,thus1 for malaria1 a prescription of quinin and ,celerina is advised2 for chorea in children1 arsenic with ,celerina2 in 8,convalescence from ,la ,grippe10 strychnin sulphate1 ,fowler's solution1 and ,celerina2 for impotence1 nux vomica1 dilute phosphoric acid and ,celerina4 ,in none of these conditions would ,celerina affect favorably anything except the pockets of the exploiters2 in some1 as in the chorea of children1 the alcohol would be positively detrimental4 ,of course1 the value of such prescriptions 7so far as they have any apart from the fictitious value lent by the alcohol7 resides altogether in the standard drugs prescribed with ,celerina4 ,there is no possible excuse for writing a prescription for ,celerina1 either in original package or mixed with well-known or valuable drugs4 ,the sooner it is realized that this preparation has no place in medicine1 should never be prescribed by physicians and is essentially nothing but alcohol and bitters exploited under a fancy name1 the better for the public health and the science of medicine4 ,the continued sale and use of ,celerina is a disgrace to the medical profession4 ,aletris ,cordial ,aletris ,cordial is a nostrum containing therapeutically worthless drugs in alcohol 7#bh per cent474 ,the 8formula0 on the label reads3 8,each fluidounce represents ten grains ,aletris1 thirty grains ,helonias and thirty grains ,scrophularia40 ,at one time these drugs had some vogue1 chiefly as domestic remedies4 ,they have been discarded as valueless by modern scientific medicine4 ,aletris1 or unicorn root 7,aletris farinosa71 contains a bitter principle and starch4 ,the remarkable uterine tonic properties formerly ascribed to it have not been confirmed by reliable observers4 ,it is practically worthless4#ag #ag ,see ,unicorn ,root1 ,wild ,yam1 and ,wild ,indigo1 p4 #bjh4 ,helonias1 or false unicorn 7,chamaelirium luteum71 is asserted to be a hemostatic and uterine tonic4 ,no trustworthy evidence has ever been offered in support of the claims made for this drug2 reliable medical literature contains no reference to it2 it has no valid claim on the attention of physicians4#ah #ah ,see ,false ,unicorn 7,helonias71 p4 #hd4 ,scrophularia1 or figwort 7,scrophularia marilandica71 contains a principle which has a digitalis-like action on the heart4 ,its activity is so slight in comparison with that of digitalis1 however1 that there was nothing to be gained by studying it4 ,the drug is consequently little known and is not mentioned in critical works on pharmacology4 ,if the drug were therapeutically active in the quantities used1 another danger would be added to that of the alcohol content of ,aletris ,cordial4 ,since the recommended dose 7a teaspoonful7 contains1 if the formula be correct1 only about #d grains of figwort1 this drug too may be regarded as practically inert in this preparation4 ,not one of these drugs has been deemed worthy of mention in the ,pharmacopeia4 ,the ,council has previously discussed them and declared them valueless 7,reports ,council ,pharm4 and ,chem41 #aiji1 p4 #adf2 #aiaj1 p4 #aj2 #aiab1 p4 #db74 ,in ,aletris ,cordial1 then1 there is no ingredient capable of producing any other effect than the alcohol stimulation and such psychic effect as may be due to the bitter taste4 ,yet physicians are asked to believe that 8,probably no remedy is so uniformly successful in the prevention of threatened miscarriage as ,,aletris ,,cordial ,rio40 8,,habitual ,,miscarriage can be effectually overcome by the systematic use of ,aletris ,cordial ,rio40 8444 regulates the local circulation and imparts normal tone and strength to the uterine muscle40 8,the use of ,aletris ,cordial ,rio throughout pregnancy goes far to assure normal1 uncomplicated labor40 ,such claims as these1 when made for a mixture containing no therapeutically active constituent except alcohol1 are absolutely preposterous4 ,it should be noted that the declared alcohol content of ,aletris ,cordial is much higher than that of the strongest wines1 and1 in the light of medical experience1 quite high enough to promote the formation of the alcohol habit in a steady user4 ,the following recommendation1 taken from the company's 8,budding into ,womanhood0 circular1 therefore1 is outrageous3 8,many medical practitioners recommend to mothers the use of ,aletris ,cordial ,rio for their growing daughters1 ranging in age from twelve to eighteen years44440 ,it is to be hoped that no medical practitioner is so heedless of consequences as to prescribe for adolescent girls a worthless nostrum capable of creating a craving for alcohol4 ,the temperance societies might with profit take steps to inform laymen1 especially women1 concerning the worthlessness of this nostrum1 the risk involved in taking it1 and the outrageous character of the recommendations made for it by the manufacturers4 ,kennedy's ,pinus ,canadensis1 ,light and ,dark 7,abican and ,darpin7 ,kennedy's ,pinus ,canadensis1 ,light 7recently renamed 8,abican07 and ,dark 7renamed 8,darpin07 are also exploited by the ,rio ,chemical ,company4 ,although they have been on the market some thirty or forty years they appear to have achieved no marked degree of commercial success4 ,yet they have been imitated by most of the pharmaceutic houses4 ,they are of interest chiefly through the barefaced fraud involved in their exploitation4 ,,composition ,,claimed ,apparently the dark preparation 78,darpin07 was first put on the market2 then the light one 78,abican07 was offered1 to be used only 8as an injection and externally40 ,the reason for the existence of the light preparation evidently was the objectionable property of the dark1 which stained linen4 ,the two preparations are both said to be extracts of ,pinus ,canadensis or hemlock bark4 ,a circular issued some years ago contained the following statement3 8,pinus ,can4 7,ken47--,dark--,a non-alcoholic extract of ,pinus ,canadensis1 to each fluidounce of which is added #j4dh grains ,thymol4 8,pinus ,can4 7,ken47--,light--,a non-alcoholic extract of ,pinus ,canadensis1 to each fluidounce of which is added #bd grains each of pure ,alum ,potash and ,sulphate of ,zinc and #j4dh grains of ,thymol40 ,the labels on the packages of the light and dark preparations sent out to-day bear1 respectively1 only the following references to composition1 the first on the dark and the second on the light3 8,each fluidounce also contains #j4dh grains ,thymol40 8,a non-alcoholic preparation of ,pinus ,canadensis1 to which is added twenty-four grains each pure alum potash and sulphate of zinc and #j4dh grains thymol to the fluidounce40 ,,actual ,,composition 8,darpin0 or ,kennedy's ,pinus ,canadensis1 ,dark1 does contain tannin1 but1 as the simplest of chemical tests demonstrate1 ,pinus ,canadensis1 ,light1 does not contain tannin4 ,it might as truthfully be called maple syrup or beef tea4 ,it is almost a work of supererogation to discuss the therapeutic claims made for preparations sold under false pretenses as to composition4 ,it is enough to mention that ,kennedy's ,pinus ,canadensis1 ,dark or ,light1 is recommended in ,albuminuria ,diarrhea-,dysentery ,fetid ,perspiration ,endometritis ,fissures ,fistula ,gonorrhea ,hemorrhage from the ,nose ,uterine ,hemorrhage ,leucorrhea ,nasal and ,pharyngeal ,catarrh ,piles ,sore ,throat ,ulceration of the ,cervix ,the intelligent physician of to-day knows that his forefathers in the days of the stage-coach employed tannic acid in its crude form and treated intestinal disease in a very unsatisfactory manner2 he knows1 further1 that advances in our knowledge of pathology have rendered the use of tannic acid in gastro-intestinal therapeutics largely unnecessary and that when it is used it should be in some form that will pass the stomach unchanged4 ,so far as its use as local application is concerned1 he knows1 without need of instruction from the ,rio ,chemical ,company1 when tannin is indicated1 and the ,pharmacopeia furnishes a suitable preparation for the physician so that he need not resort to an unscientific nostrum like ,darpin4 ,the physician who is competent to treat a case of gonorrhea does not need to be told that alum and zinc sulphate may be useful in such conditions1 and he does not want them palmed off on him for something else under the name of ,pinus ,canadensis1 ,light1 ,abican or what not4 ,also1 he prefers to use them1 when they are needed1 singly and in strength suited to the conditions of the individual case4 ,editorial ,comment4--,celerina1 ,aletris ,cordial and ,kennedy's ,pinus ,canadensis1 ,light and ,dark1 appear to be the entire output of the ,rio ,chemical ,company1 which was one of the earliest of the various companies organized by ,james ,j4 ,lawrence of ,medical ,brief fame4 ,the business was moved from ,st4 ,louis to ,new ,york ,city in #aija4 ,according to what we believe to be reliable information1 the ,rio ,chemical ,company is now composed of ,james ,p4 ,dawson1 president2 ,william ,w4 ,conley1 vice-president and treasurer2 and ,e4 ,d4 ,pinkerton1 secretary4 ,these also constitute the directors4 ,it appears that ,james ,p4 ,dawson is a member of the law firm of ,dawson and ,garven1 ,st4 ,louis2 ,e4 ,d4 ,pinkerton is said to be ,miss ,effie ,d4 ,pinkerton1 stenographer for ,dawson and ,garven4 ,we know little concerning ,william ,w4 ,conley except that he appears to be in charge of the establishment in ,new ,york4 ,we find no evidence that he is either a chemist or a pharmacist2 his name does not appear in the membership list of the ,american ,chemical ,society or of the ,american ,pharmaceutical ,association1 nor can we discover that he has published anything in the way of chemistry or pharmacy4 ,as a matter of fact1 the ,rio ,chemical ,company is another of the pseudo-chemical companies created to exploit one or more proprietaries--in this instance ,celerina1 ,aletris ,cordial and ,pinus ,canadensis4 ,the following medical journals carry advertisements of the ,rio products 7or did late in #aiad73 ,american ,journal of ,surgery1 ,american ,medicine1 ,denver ,medical ,times and ,utah ,medical ,journal1 ,eclectic ,medical ,journal1 ,international ,journal of ,surgery1 ,interstate ,medical ,journal1 ,massachusetts ,medical ,journal1 ,medical ,brief1 ,medical ,century1 ,medical ,council1 ,medical ,review of ,reviews1 ,medical ,sentinel1 ,medical ,standard1 ,texas ,medical ,journal and ,woman's ,medical ,journal44--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ac1 #aiae47 ,,cineraria ,,maritima ,report of the ,council on ,pharmacy and ,chemistry ,occasional inquiries in regard to the therapeutic value of ,cineraria maritima caused the ,council to consider the drug with reference to its fitness for inclusion in ,n4 ,n4 ,r4 among non-official1 non-proprietary remedies4 ,the following report1 having been submitted to the ,council by a subcommittee1 was adopted and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,to the ,council3--,the juice of a plant referred to as ,cineraria maritima was at one time supposed to be of value in the treatment of cataract and certain other affections of the eye4 ,no scientific evidence is available to show that the drug is therapeutically active1 and its value is no doubt correctly estimated by ,dr4 ,casey ,wood1 who 78,ophthalmic ,therapeutics10 p4 #ddf2 ,cleveland ,press1 ,chicago1 #aiji7 says3 8,still1 a few respectable names have been associated with its ,cineraria maritima employment in that capacity and it only remains to be said that the instillation into the conjunctival sac of a preparation of this or any other member of the ,senecio family has about as much effect on the resolution or dispersal of opacities due to organic changes in the lens as pouring the same down the back of the patient's neck60 ,the plant from which ,cineraria maritima juice is claimed to be prepared is commonly referred to in literature as ,cineraria maritima1 but is more correctly described as ,senecio cineraria1 ,d4 ,c4 ,it may be considered a matter of indifference whether a remedy like this be advertised for the treatment of such diseases as cataract1 providing its application could do no harm1 but it must be remembered that it is recommended also for other diseases of the eye in which its use1 by postponing efficient treatment1 would be the means of serious damage or even loss of vision4 ,since there is no evidence to show that this drug is of any therapeutic value1 it is recommended that it be not admitted to the list of non-official1 non-proprietary remedies in ,n4 ,n4 ,r41 and that the ,council formally expresses its opinion that the drug1 as judged by the evidence which is available1 is without value in the treatment of cataract or similar diseases of the eye4 ,editorial ,comment4--,cineraria maritima would long since have been relegated to the limbo of discarded and discredited drugs had it not been given a semiproprietary character by a ,st4 ,louis nostrum house--the ,walker ,pharmacal ,company--which1 like the ,manola ,chemical ,company1 is1 we understand1 practically a subsidiary concern of the ,luyties ,homeopathic ,pharmacy ,company4 ,the ,walker concern exploits this drug under the name ,succus ,cineraria ,maritima 7,walker74 ,its method of exploitation consists in publishing testimonials1 which it dignifies with the name 8clinical reports10 from men whom it designates as 8representative physicians40 ,as indicative of what constitutes representative physicians1 we find that of the seven testimonials given in their pamphlet the names of three of the signers are not to be found in any medical directory4 ,the exploitation of ,succus ,cineraria ,maritima 7,walker7 is the oft-repeated story of the resurrection of discarded and worthless drugs for the purpose of creating proprietorship in a nostrum4 ,cineraria maritima is worthless2 its therapeutic value is nil4 ,by the prodigal use of printers' ink1 the medical profession--and through it the public--has been humbugged into believing that it possesses curative value4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #aa1 #aiaa47 ,,hagee',s ,,cordial ,,of ,,the ,,extract ,,of ,,cod ,,liver ,,oil ,,compound,i ,report of the ,council on ,pharmacy and ,chemistry ,i ,see also the reports on ,wampole's ,preparation and ,waterbury's ,compound1 following this2 also ,hagee's ,cordial1 p4 #bhi2 ,the ,comparative ,nutrient ,value of ,cod ,liver ,oil and ,cod ,liver ,oil ,cordials1 p4 #ddb4 ,this is one of the 8oilless0 cod liver cordials4 ,like other manufacturers of such extracts1 the ,katharmon ,chemical ,company1 ,st4 ,louis1 which owns ,hagee's ,cordial1 attempts to trade on the reputation long enjoyed by cod liver oil as a promoter of growth and nutrition4 ,the following is the statement of composition furnished by the company3 8,each fluid ounce of ,hagee's ,cordial of the extract of ,cod ,liver ,oil ,compound represents the extract obtainable from #a_/h fluid ounce of ,cod ,liver ,oil 7the fatty portion being eliminated71 #f grs4 ,calcium ,hypophosphite1 #c grs4 ,sodium ,hypophosphite1 #a_/b gr4 ,salicylic ,acid 7made from ,oil ,wintergreen71 with ,glycerin and ,aromatics40 ,and here are some of the therapeutic claims3 8,tonic1 ,stimulant1 ,alterative1 ,reconstructive1 ,nutritive and ,digestive40 8,useful in phthisis pulmonalis1 scrofula and all chronic pectoral complaints1 coughs1 colds1 brain exhaustion1 nervous debility1 palsy1 chronic cutaneous eruptions and impaired digestion40 ,of course1 these absurd claims hark back to the time of the prevalence of the now discarded theory that the valuable properties of cod liver oil reside1 not in the fat1 but in certain nitrogenous1 alkaloid-like constituents present in infinitesimal amounts4 ,further 8playing up0 this theory3 8,the prescriber may know that in our preparation he is getting1 in easily assimilable and palatable form1 the very properties that make cod liver oil the best of reconstructives4 8,when you prescribe cod liver oil you are after the active principles--why not give the active principles themselves40 ,proprietary manufacturers usually ignore scientific investigations which establish facts adverse to proprietary claims2 but the same proprietary manufacturers are quick to seize on any theory that can be twisted into support of their interests4 ,thus1 recent investigations having shown that cod liver oil1 like butter and egg yolk1 possesses certain growth-promoting properties not found in some other fats1 the promoters of ,hagee's ,cordial claim these properties of cod liver oil for their extract4 ,they assert3 8,recent ,chemical ,investigations of ,cod ,liver ,oil show that the active principles contain the nutritive qualities attributed to the whole oil40 ,the ,council has previously expressed the opinion#ai that the preponderance of evidence indicates that whatever therapeutic value cod liver oil may have depends chiefly1 if not entirely1 on its fat 7oil74 ,there never was any evidence or scientific authority for the theory that the therapeutic value of cod liver oil was independent of its fat content4 ,the fact that the fat is the growth-promoting element has already been shown1 and ,j4 ,p4 ,street1 chemist for the ,connecticut ,agricultural ,experiment ,station 7,the ,journal ,a4 ,m4 ,a41 ,feb4 #bj1 #aiae1 p4 #fch71 in a series of experiments on a number of the so-called extracts of cod liver or cod liver oil 7including ,hagee's ,cordial7 has conclusively demonstrated that the growth-promoting properties of the oil are not to be found in the extracts4 ,street placed rats on a ration not sufficient to maintain normal nutrition and growth for an extended period4 ,after the rats had been on this ration for some time and a failure to maintain weight was indicated1 an amount of dealcoholized ,hagee's ,cordial was substituted for a portion of the lard contained in the ration4 ,later ,hagee's ,cordial was replaced by cod liver oil4 #ai ,the ,journal ,a4 ,m4 ,a41 ,oct4 #i1 #aiji1 p4 #abja4 ,street says3 8,none of the four rats did well on ,hagee's ,cordial2 in fact1 they lost #a4b to #ae4d gm4 during feeding periods of from seven to fourteen days40 8,the rats failed so quickly when put on ,hagee's ,cordial that in two cases the animals did not recover even when put on the full cod liver oil ration40 8444 the four rats during the ,hagee period1 instead of gaining the normal #bd gm41 actually lost #cf4b gm41 while during the cod liver oil period instead of gaining #aad gm41 they gained #aef4d gm40 8,the inferiority of ,hagee's ,cordial as a reconstructive and a nutrient compared with ordinary cod liver oil is apparent40 ,hagee's ,cordial of the ,extract of ,cod ,liver ,oil ,compound has neither the nutritive qualities nor the reconstructive efficacy of cod liver oil4 ,this mixture is worthless for the conditions for which it is advertised1 and is marketed under misleading and unwarranted claims4 ,it is recommended that ,hagee's ,cordial be held ineligible for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #aj1 #aiae47 ,,wampole',s ,,perfected ,,and ,,tasteless ,,preparation ,,of ,,an ,,extract ,,of ,,cod ,,liver,j ,report of the ,council on ,pharmacy and ,chemistry ,j ,see also reports on ,hagee's ,cordial preceding and ,waterbury's ,compound following this2 also ,the ,comparative ,nutrient ,value of ,cod ,liver ,oil and ,cod ,liver ,oil ,cordials1 p4 #ddb4 ,wampole's ,preparation is another of the oil-free 8extracts0 of cod liver4 ,the following formula 7which1 be it observed1 is non-quantitative and therefore practically worthless7 is published by the owners1 ,henry ,k4 ,wampole ,co41 ,inc43 8,contains a solution of an extractive obtainable from fresh cod livers1 the oily or fatty portion being afterward eliminated4 ,this extractive is combined with ,liquid ,extract of ,malt1 ,fluid ,extract of ,wild ,cherry and ,compound ,syrup of ,hypophosphites 7containing ,calcium1 ,sodium1 ,potassium1 ,iron1 ,manganese1 ,quinin and ,strychnin740 ,an alcohol content of #ag per cent4 is declared on the label4 ,the following claims are typical of those made for the preparation3 8,this grease1 or oil1 is not present in ,wampole's ,preparation of the ,extract1 which is palatable and1 at the same time1 very efficient as a stimulant to the centers of nutrition and assimilation4 ,it is unsurpassed as a reconstructive tonic 4440 8,cases with a marked tendency to pulmonary troubles1444 if a timely impulse be given them will easily shake off the impending evil4 ,wampole's ,preparation gives that timely impulse 4440 ,in the ,council's opinion1 as previously expressed1#bj such therapeutic value as there may be in cod liver oil is chiefly1 if not altogether1 due to the fat 7oil74 ,lately1 the investigations of ,j4 ,p4 ,street of the ,connecticut ,agricultural ,experiment ,station have definitely disproved the claims made for the ,wampole's and similar preparations4 ,in ,street's experiments1 rats were placed on a ration insufficient for normal nutrition and growth4 ,after the rats had been on the ration for a time long enough for inability to maintain weight to become evident1 dealcoholized ,wampole preparation was substituted for a portion of the lard contained in the ration4 ,later the ,wampole preparation was replaced by cod liver oil4 ,from these experiments it appears that1 although the ,wampole preparation is said to contain malt extract and sugar1 it does not show the advantage over ordinary cod liver oil as a source of nutriment which is claimed for it by the manufacturers4 ,street emphasizes that the ,wampole preparation does not possess to any marked degree the reconstructive properties of cod liver oil1 butter fat and egg yolk1 on which foods rats gain weight rapidly and steadily after having been on a deficient diet4 ,street calls attention to the fact that the amount of alcohol consumed daily by the user of the ,wampole preparation 7the equivalent of #j4g fluidounces of whiskey7 explains to a considerable extent the asserted tonic virtues of the preparation4 #bj ,the ,journal ,a4 ,m4 ,a41 ,oct4 #i1 #aiji1 p4 #abja4 7,see following report1 this volume47 ,though offered as an efficient substitute for cod liver oil1 ,wampole's 8,perfected and ,tasteless ,preparation of an ,extract of ,cod ,liver0 lacks both the nutritive and the reconstructive properties and is marketed under an indefinite name and unwarranted and untrue claims4 ,it is recommended that ,wampole's ,preparation be held ineligible for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #aj1 #aiae47 ,,waterbury',s ,,metabolized ,,cod-,,liver ,,oil ,,compound,k ,report of the ,council on ,pharmacy and ,chemistry and ,laboratory ,contribution on ,which ,it ,is ,based ,k ,see also preceding reports on ,hagee's ,cordial and ,wampole's ,preparation2 also ,waterbury's ,compound once more1 p4 #bia2 ,the ,comparative ,nutrient ,value of ,cod ,liver ,oil and ,cod ,liver ,oil ,cordials1 p4 #dbb4 ,the following report has been adopted by the ,council and its publication directed ,w4 ,a4 ,puckner1 ,secretary4 ,to the ,council3--,your committee on pharmacology has read with interest the contribution from the ,association's laboratory on ,waterbury's ,metabolized ,cod-,liver ,oil ,compound4 ,the report shows that misleading and false statements are made in regard to the composition of the product and also that exaggerated and unwarranted claims are made for its therapeutic value4 ,in view of the attempt of the ,waterbury ,chemical ,co4 to create a false impression in regard to the therapeutic value of the composition of its product1 it is recommended that the following report be adopted and published3 ,the ,council believes that there is a preponderance of evidence to indicate that whatever therapeutic value cod-liver oil has1 that value depends chiefly1 if not entirely1 on its fat 7oil74 ,in the opinion of the ,council1 the word cod-liver oil should not be used in connection with any preparation unless it consists to a large extent 7#be per cent4 or more7 of cod-liver oil4 ,since ,waterbury's ,metabolized ,cod-,liver ,oil ,compound contains no appreciable quantity of cod-liver oil1 the name is incorrect and misleading1 and as a cod-liver oil preparation it is believed to be wholly valueless4 ,the ,council has previously voted that ,waterbury's ,cod-,liver ,oil ,compound be refused recognition because of conflict with ,rules #a and #f4--7;,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #i1 #aiji47 ,,contribution ,,from ,,the ,,chemical ,,laboratory ,,of ,,the ,,american ,,medical ,,association ,waterbury's ,metabolized ,cod-,liver ,oil ,compound ,w4 ,a4 ,puckner and ,l4 ,e4 ,warren ,a full page advertisement of ,waterbury's ,metabolized ,cod-,liver ,oil ,compound appeared in the ,iowa ,medical ,journal1 ,march #ae1 #aiji1 in the form of a letter purporting to give the results of an analysis of the product made for the firm by a ,chicago chemist4 ,in this letter-advertisement the chemist states at the outset that the results of his examination 8are somewhat at variance with the statements made in ,the ,journal40 ,these statements he quotes as follows3 #a4 ,it is a clear liquid and no globules of oil are seen under the microscope4 ,it is therefore not an emulsion4 #b4 ,it is of acid reaction when mixed with water and remains clear when strongly acidified4 ,hence it does not contain a soap1 and is not a saponification of fat4 #c4 ,it mixes with water without precipitation1 hence1 it can not contain more than traces of a fatty acid4 ,the chemist admits in his letter to the firm that his analyses verify statements #a and #c1 but regarding statement #b he says3 8,i find that your preparation is acid in reaction1 but when strongly acidified gives a distinct turbidity within #aj minutes and a voluminous precipitate within #a hour4 ,this precipitate is shown to consist of fatty acids of cod-liver oil1 which are thrown down by the splitting of the soaps1 on acidifying either with sulphuric or hydrochloric acid40 ,from these results he states that to him it seems that the 8preparation does not deserve the statement that it contains no soap1 as there is no question whatever of the presence of cod-liver oil40 ,while in the letter published in this advertisement the chemist claims to have demonstrated the presence in the product of 8saponified cod-liver oil10 he omits to mention the quantities of the soap present4 ,in the article that originally appeared in ,the ,journal 7,oct4 #ac1 #aijf71 in addition to the three paragraphs quoted by the chemist1 the following statements were made3 8,by these simple tests a physician is easily able to demonstrate that the preparation does not contain cod-liver oil4 ,it is therefore valueless for the purpose of nutrition for which we give the oil4 ,more careful analysis confirms the results of these tests and shows that it contains no fat or fatty acids 7except the merest traces744440 ,at the time these statements were published in ,the ,journal1 the ,st4 ,paul ,medical ,journal1 ,october1 #aijf1 contained an advertisement for ,waterbury's ,metabolized ,cod-,liver ,oil ,compound1 which contained this statement3 8,the only tasteless preparation on the market which contains ,cod-,liver ,oil in its entirety4 ,the metabolized product is obtained by the action of digestive ferments on pure ,cod-,liver ,oil40 ,in the ,ohio ,medical ,journal of ,feb4 #ae1 #aijg1 there appeared in the form of an advertisement what purported to be an analysis of ,waterbury's ,metabolized ,cod-,liver ,oil ,compound by ,prof4 ,c4 ,n4 ,kinney of ,drake ,university4 ,while ,professor ,kinney made a quantitative analysis of the preparation1 the quantities were omitted from the analysis as published4 ,a footnote added by the ,waterbury ,chemical ,company called attention to this fact and closed as follows3 8,any physician who is not satisfied with the analysis we will be only too glad to furnish the complete analysis by our representatives40 ,if this weirdly constructed sentence meant anything1 it meant that the complete analysis would be furnished on request4 ,such requests to the company1 however1 from various sources failed to elicit the information required nor was the 8complete analysis0 forthcoming4 ,the inference to be drawn is fairly plain4 ,in a circular accompanying the product as sold at present1 this statement occurs3 ---------------------------------------- -------- ,,waterbury',s ,,metabolized ,,cod ,,liver ,,oil ,,compound ,with ,creosote and ,guaiacol or ,plain ,,does ,,contain ,,cod ,,liver ,,oil ,,does ,,allay ,,fermentation ,,does ,,aid ,,digestion ,,does ,,assist ,,assimilation ,,but ,,does ,,not ,,disturb ,,the ,,stomach ---------------------------------------- -------- ,as previous examination disclosed only the merest traces of cod-liver oil in the product though claims were made that it 8represents cod-liver oil in its entirety10 and in view of the fact1 too1 that present advertisements emphatically declare that cod-liver oil is present in the preparation as now sold1 it was thought best to examine some of the preparation with especial reference to the quantities of fatty acids from cod-liver oil4 ,illustration3 ,,old ,,label ,,new ,,label ,it is interesting in this connection to note that this product is no longer being sold under the name 8,metabolized ,cod ,liver ,oil ,compound40 ,see the illustrations of the old and new labels4 ,the results of the examination are briefly as follows3 ,the total quantity of acids isolated amounted to about #j4c per cent41 and of this amount about two-thirds was salicylic acid4 ,thus it appears from the examination of the specimens bought on the open market that the preparation contains at most but #j4a per cent4 of the fatty acids from cod-liver oil1 a totally insignificant quantity4 ,notwithstanding the protestations by the manufacturers1 in the form of published analyses and circulars1 it is seen that the statements published in ,the ,journal1 ,oct4 #ac1 #aijf1 p4 #abjg1 are essentially substantiated2 it is further evident that the product does not deserve to be designated as a cod-liver oil preparation4 ,to obtain a medicinal dose of cod-liver oil the patient would be compelled to swallow the contents of a bottle of this mixture1 and as the product contains #aa per cent4 alcohol the patient who did so would probably experience a degree of exhilaration not referable to cod-liver oil4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #i1 #aiji47 ,declared ,misbranded ,this product of the ,waterbury ,chemical ,company1 of ,des ,moines1 ,iowa1 was exposed in ,the ,journal of the ,american ,medical ,association1 ,october #i1 #aiji4 ,in ,may1 #aiaj1 the ,united ,states ,government issued a notice of judgment in which it was declared that ,waterbury's ,metabolized ,cod ,liver ,oil ,compound was misbranded4 ,the court rendered its decree of condemnation and forfeiture4--,notice of ,judgment1 ,no4 #cjc4 ,,waterbury',s ,,compound ,report of the ,council on ,pharmacy and ,chemistry ,the ,waterbury ,chemical ,company having requested that the ,council reconsider its action of four years ago 7see preceding report7 on the product then known as ,waterbury's ,cod-,liver ,oil ,compound1 now called ,waterbury's ,compound1 the matter was submitted to a referee4 ,the referee reported that the statement now made as to the composition of this product is as follows3 8,made from ,cod ,liver ,oil1 ,digestive ,ferments1 ,malt ,extract ,unfermented1 ,hypophosphites ,comp4 ,special1 ,ext4 ,cherry1 ,eucalyptus1 ,aromatics1 etc40 ,he held that the ,waterbury ,chemical ,company has not submitted satisfactory evidence to indicate that the objections of the ,council's former unfavorable report have been met2 that there is no evidence that the product is a substitute for cod-liver oil in any way2 and that under the present methods of exploitation it constitutes what is at least an inferential fraud2 and recommended that no further consideration be given to ,waterbury's ,compound4 ,the report was adopted by the ,council4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #bj1 #aiae47 ,,colchi-,,sal ,report of the ,council on ,pharmacy and ,chemistry ,colchi-,sal1 said to be made by the ,anglo-,american ,pharmaceutical ,co41 ,ltd41 ,new ,york1 is advertised1 sold and 8guaranteed0 7sic7 by ,e4 ,fougera and ,co41 ,inc41 ,new ,york4 ,according to the label of a recently purchased specimen3 8,each ,capsule contains ,cannabis ,indica 7,active ,principle of7 #a-ejjth ,grain 7#a_/h ,milligram72 ,colchicine 7,crystallized7 #a-bejth ,grain 7#a_/d ,milligram72 ,methyl ,salicylate #bj ,centigrams40 ,the advertising circular around the bottle adds that the mixture also contains 8appropriate aromatic adjuvants40 ,it is recommended in 8,gouty and ,chronic ,rheumatic ,manifestations10 8acute cases of ,gout10 8intestinal auto-intoxication or dyspepsia10 8bilious headaches10 etc4 ,salicylates are generally recognized as valuable in acute manifestations of acute articular rheumatism2 colchicum is useless in these conditions4 ,both salicylates and colchicum are practically useless in chronic rheumatic and in chronic gouty affections4 ,for dyspepsia1 bilious headache1 etc41 salicylates are distinctly contra-indicated and the drastic purgation produced by colchicum would not be thought desirable4 ,though methyl salicylate administered internally is not generally considered so efficient as sodium salicylate1 it is asserted that the former 8444 is found far more effective than salicylate of soda or other salicylic derivatives when given in conjunction with colchicine as ,colchi-,sal40 ,further1 the highly improbable and unsubstantiated claim is made that 8the active principle of ,cannabis indica0 7whatever that may be7 8corrects any tendency of the colchicine to irritate the gastro-intestinal tract0 and that the 8appropriate aromatic adjuvants0 8prevent intolerance of the methyl salicylate40 ,colchi-,sal is put up in a way to appeal to the public2 the bottle has the name 8,colchi-,sal0 blown in the glass2 the label gives full instruction for the use of ,colchi-,sal1 and also the price1 suggesting that the preparation may be freely purchased4 ,wrapped around the bottle is a circular advising its use in various affections4 ,the physician who acts on the advice that it is well to 8insist on the pharmacist dispensing original bottles 4440 of the 8little green capsules0 actually suggests to his patient the use of this preparation of methyl salicylate and colchicum in conditions in which these drugs may do much harm and in which proper treatment is imperative4 ,colchi-,sal is typical of unscientific ready-to-take proprietaries4 ,it was held ineligible for ,new and ,nonofficial ,remedies because of its secret composition1 viz41 the unknown nature of the 8active principle of ,cannabis indica0 7,rule #a72 because the circular in the package and the name blown in the bottle constitute advertisement to the laity 7,rule #d72 because the claim that cannabis indica removes the gastro-intestinal irritation1 and the claim of the superiority of methyl salicylate are unwarranted therapeutic claims 7,rule #f72 because the name does not indicate the presence of the habit-forming cannabis indica1 and because of its unscientific composition 7,rule #aj74--7;,from ,the ,journal ,a4 ,m4 ,a41 ,march #bj1 #aiae47 ,,cypridol ,,capsules ,report of the ,council on ,pharmacy and ,chemistry ,having voted that ,cypridol ,capsules be refused recognition1 the ,council directed that for the information of physicians publication of the following report be authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,cypridol ,capsules1 sold by ,e4 ,fougera ,co41 ,new ,york1 are stated to be 8,bottled in the ,new ,york ,laboratories of ,vial1 late ,rigaud and ,chapoteaut1 ,paris10 and to contain1 in each capsule1 #b mg4 7#a_/cb grain7 mercuric iodid 7biniodid of mercury7 dissolved in a fatty oil4 ,they are claimed to permit the administration of mercury without danger of salivation--an obvious misrepresentation4#ba ,cypridol ,capsules are marketed in a way to appeal to the public4 ,if they are once prescribed1 the directions on the bottle and the full instructions for the treatment of syphilis by means of ,cypridol and by other proprietaries sold by ,fougera ,co4 is likely to lead the patient to attempt the treatment of this malady on his own accord1 and thus probably to forfeit his chances of cure4 ,cypridol is a vicious example of the 8ready-to-take0 proprietaries4 #ba ,physicians who desire to use a solution of mercuric iodid in oil should direct their pharmacist to prepare it according to the method suggested by ,lemaire 7,repert4 pharm41 xxi1 #ig-ajb1 from ,chem4 ,abst41 #aiji1 p4 #addd71 viz43 ,one gm4 of mercuric iodid is dissolved in #ej c4c4 sterilized castor oil by warming to about #gj degrees1 #c gm4 guaiacol are added and the solution made up to #ajj c4c4 with sterilized poppy oil4 ,or according to a later suggestion 7,dunning3 ,proc4 ,am4 ,pharm4 ,assn41 #aiaj1 p4 #aabc73 one gm4 of mercuric iodid is dissolved in #ii gm4 of a mixture of equal parts of sterilized castor and olive oils1 by warming on the water-bath4 ,cypridol ,capsules are in conflict with the rules of the ,council as follows3 ,rule #d3 ,the dosage1 price1 etc41 on the label1 and the name 8,cypridol0 blown in the bottle1 all tend to a direct self-prescribing by the public4 ,in addition to the objectionable statements on the bottle itself1 the preparation is put up in patent medicine style and is accompanied by a circular giving full directions for the use of this and of other proprietaries for the treatment of syphilis in all of its stages4 ,the circular states that 8a #a per cent4 solution of bin-iodide of mercury in an aseptic oil0 is 8,an ,improved ,specific in the ,treatment of ,syphilis10 and after lauding the virtues of ,cypridol1 gives full directions for the treatment of syphilis in its various stages by means of ,capsules of ,cypridol augmented1 during periodical cessation of treatment1 by 8small doses of iodide of strontium 7,paraf-,javal's standard solution1 thirty grains to the ounce740 ,further1 the circular expounds the need of 8a toning up of the general system0 and by means of obsolete theories and obviously untrue assertions recommends 8,chapoteaut's ,wine another of their proprietary preparations1 each ounce of which contains #aj grains of phospho-glycerate of lime4 ,this is a delicious1 nutritive tonic4 ,a pint bottle costs #a4jj40 ,rule #f3 ,whereas it is evident that ,cypridol1 depending for its effects on mercuric iodid1 the ordinary well-known hydrargyri iodidum rubrum of the ,u4 ,s4 ,pharmacopeia1 must naturally have the properties of a mercuric compound1 unwarranted claims such as the following are made3 8,,cypridol does not render patients anemic4 ,ptyalism never follows the administration of the capsules or injections4 ,on the contrary1 patients rapidly put on flesh and keep well4 ,there are no diarrhoeas or other symptoms of intolerance even when the dose is pushed40 ,rule #h3 ,the non-informing name 8,cypridol0 for a mercuric iodid preparation is bound to lead to its use without consideration of the fact that a potent mercury preparation is being used1 requiring a careful adjustment of dosage1 a consideration of the needs of the individual case1 a correct diagnosis1 etc4 ,while the advertising propaganda argues that 8physicians recognize the advantage of prescribing this solution of mercuric iodide in an aseptic oil under the name of #8,cypridol1' because it does not betray to the laity the fact that mercury is being used10 not only the physician but also the patient has a right to know1 and ought to know1 the potent character of the remedy which is being administered4 ,it is recommended that ,cypridol be refused recognition and that publication of this report be authorized4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ai1 #aiad47 ,,cystogen1 ,,cystogen ,,aperient ,,and ,,cystogen-,,lithia,l ,abstract of ,report of the ,council on ,pharmacy and ,chemistry ,l ,for the unabridged report of the ,council's action on ,cystogen1 ,cystogen ,aperient and ,cystogen-,lithia1 see ,reports ,council ,pharm4 and ,chem41 #aiad1 p4 #ff4 ,cystogen is the therapeutically suggestive name applied to hexamethylenamin by the ,cystogen ,chemical ,company4 ,while investigation has shown that hexamethylenamin yields formaldehyd only in the presence of an acid and consequently can produce an antiseptic effect only in the gastric juice and in the urine1 it is claimed that ,cystogen is an 8intestinal antiseptic0 and that it 8bears its disinfectant and antitoxic qualities into well-nigh every important bodily cavity40 ,as the sale of a simple drug even with the aid of the most extravagant claims probably did not offer sufficient opportunity for an extensive proprietary propaganda1 the ,cystogen ,company has put out two other preparations1 ,cystogen ,aperient and ,cystogen-,lithia1 and finds it an easy matter by means of extravagant claims1 unwarranted assertions and pseudo-scientific arguments to recommend the use of one or another1 or often all three1 in a well-nigh endless number of diseases4 ,as the continued patronage of the medical profession cannot be relied on for proprietaries of this sort1 the ,cystogen ,chemical ,company takes good care that every ,cystogen prescription is likely to spread the ,cystogen gospel among the people4 ,the ,council has directed publication of its report on the ,cystogen products to call attention to the way in which a simple drug of established value may be made the basis of an extensive proprietary propaganda4 ,a conservative discussion of the action of hexamethylenamin appears in the ,council's publication1 8,useful ,drugs40 ,the ,council therefore refused recognition to ,cystogen1 ,cystogen ,aperient and ,cystogen-,lithia4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ab1 #aiad47 ,,cysto-,,sedative ,report of the ,council on ,pharmacy and ,chemistry ,cysto-,sedative is sold by ,strong1 ,cobb and ,company1 ,cleveland1 ,ohio1 with the claim3 8,each fluid ounce represents3 ,thuja ,occidentalis1 #c-a_/b grains4 ,pichi1 #ah grs4 ,saw ,palmetto berries1 #cf grs4 ,triticum ,repens1 #cf grs4 ,hyoscyamus #h grs4 ,all inert extractive matter being eliminated40 ,the therapeutically active constituents of arbor vit1 pichi1 saw palmetto and couch grass have never been isolated--indeed1 it has not been proved that all of these drugs contain any therapeutically active constituents4 ,yet the absurd claims are made that all inert matter has been eliminated and each lot of drug used in the preparation of ,cysto-,sedative is 8tested in reference to its medicinal activity40 ,equally preposterous is the claim3 8,in formulating ,cysto-,sedative each drug entering into its composition was subjected to careful study clinically to determine the exact proportion required when combined to increase their efficiency as a whole4 ,cysto-,sedative is scientifically prepared1 the proportion of each individual drug being so finely adjusted as to increase their therapeutic action in the conditions for which they are intended1 forming a preparation always reliable and of the very highest medicinal activity40 ,some other extravagant claims made for this complex unscientific mixture are3 8,it gives relief in almost every form of cystitis and prostatitis44440 8,the best results are obtained in the worst chronic cases of cystitis and prostatitis44440 8,in ,cystitis1 ,urethritis1 ,prostatitis1 ,inflammation of the ,vesicle ,neck1 complicated with ,gonorrhoea1 ,enuresis1 ,painful ,micturition1 the action of ,cysto-,sedative is prompt40 ,the ,council voted that ,cysto-,sedative be refused recognition4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ab1 #aiad47 ,,taka-,,diastase ,,and ,,liquid ,,taka-,,diastase ,report of the ,council on ,pharmacy and ,chemistry ,some time ago it was decided that a reexamination should be made of ,taka-,diastase and ,liquid ,taka-,diastase1 both of which had previously been rejected1 to ascertain whether or not the preparations were in accord with the claims made for them by the manufacturers4 ,accordingly1 the matter was referred to a committee of the ,council1 and an examination of specimens of these two preparations bought in the market was made4 ,the referee's report1 which appears below1 according to the usual procedure1 and before final confirmation by the ,council1 was first submitted to the manufacturers of ,taka-,diastase for comment4 ,the report recommends that the rejection of ,taka-,diastase and ,liquid ,taka-,diastase be allowed to stand1 and that the report be published4 ,parke1 ,davis ,co41 in their reply1 which is given in full below1 claim that the report is unjust concerning ,liquid ,taka-,diastase1 because the period of activity of the preparation has been greatly prolonged by reducing the amount of alcohol from #ah per cent4 to #aj per cent4 and by adding glycerin4 ,they reiterate their claims for the digestive power of ,taka-,diastase1 but admit that it will not reduce the stated amount of starch to the colorless end-point in ten minutes 7the standard method for the valuation of diastase74 ,they further state that they would change the word 8digest0 on the label to 8liquefy40 ,the conclusion of the report having been questioned1 the entire matter was referred to a member of the ,council's staff of clinical consultants4 ,his report1 which1 also1 is given in full below1 states that the material before him was sufficient to decide the matter1 and no further tests were necessary4 ,he concludes that the claims of the manufacturers regarding the strength and properties of the material are erroneous and exaggerated2 that the literature still sent out by ,parke1 ,davis ,co4 is misleading2 and that if substitution of the word 8liquefy0 for 8digest0 were endorsed by the ,council confusion would result which would give an exaggerated and false value to ,taka-,diastase4 ,he therefore recommends that the report of the reinvestigation of ,taka-,diastase be accepted by the ,council and published4 ,this report of the second referee was referred to ,parke1 ,davis ,co4 with the request that they state more definitely the actual amylolytic strength of their preparations4 ,to this they replied that they had no desire to discuss the subject further1 or to make any additional statements4 ,in accordance with the second referee's recommendations1 the ,council confirmed its provisional action and voted that the rejection of ,taka-,diastase and ,liquid ,taka-,diastase be allowed to stand1 and that the report which appears below be authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,,referee',s ,,report ,,on ,,taka-,,diastase ,,and ,,liquid ,,taka-,,diastase ,following is the report of the committee to which was referred the reexamination of ,taka-,diastase and ,liquid ,taka-,diastase3 ,some time ago a comparison was made of the various methods proposed for the valuation of preparations claimed to have amylolytic power4 ,this work was reported in ,the ,journal1#bb and the method proposed for the testing of diastase preparations now appears in ,new and ,nonofficial ,remedies4#bc ,in view of the incorrect and exaggerated claims made for ,taka-,diastase1 the ,council in #aijh was obliged to rescind its acceptance and to direct its omission from ,new and ,nonofficial ,remedies4 ,the report contained the following reference to ,taka-,diastase 7,parke1 ,davis ,company71 a product that had been accepted for inclusion with ,new and ,nonofficial ,remedies3 #bb ,the ,journal ,a4 ,m4 ,a41 ,july #aa1 #aijh1 p4 #adj4 #bc ,new and ,nonofficial ,remedies1 #aiab1 p4 #fh2 ,the ,journal ,a4 ,m4 ,a41 ,april #ae1 #aiaa1 ,part #b1 p4 #ah4 8,the widest discrepancy between the values as claimed by the manufacturer and those found by actual tests seems to be shown in the case of ,taka-,diastase4 ,the liquid preparation has been tested a number of times in different samples and has always been found weak4 ,some samples1 in fact1 were quite inert4 ,this ferment appears to lose strength very rapidly in solution1 as the manufacturers now concede4 ,the stability of the solid product is also far from satisfactory1 and appears to be less than that of the ferment as marketed some years ago4 ,the two samples examined recently were weak40 ,more than three years have now elapsed since the publication of the ,council's findings regarding ,taka-,diastase--sufficient time1 it is believed1 for the manufacturers to modify either their claims or the product itself1 and thus again make it eligible for inclusion with ,new and ,nonofficial ,remedies4 ,with this idea in mind new specimens of ,taka-,diastase and ,liquid ,taka-,diastase were purchased from a ,chicago drug house and the preparations reinvestigated4 ,the following is the report of this reinvestigation4 ,,report ,,of ,,the ,,reexamination ,in our report on the diastase preparations three years ago1 it was recommended that ,taka-,diastase be removed from ,new and ,nonofficial ,remedies1 because the examinations showed that it did not have the digestive strength claimed for it4 ,this was true both for ,taka-,diastase itself and for ,liquid ,taka-,diastase4 ,so far as the latter was concerned1 the starch-converting power was practically nil in those preparations which had been in the drug stores for some months4 ,during the last few weeks new tests have been carried out with several samples of the ,taka-,diastase preparations and the results obtained are essentially the same as those obtained in the former examinations4 ,the liquid preparation is still extremely weak in starch-converting power1 while we found that ,taka-,diastase itself would convert only #af4f parts of pure anhydrous starch to the colorless end-point in ten minutes1 as explained below4 ,in our method of experimentation we determine the weight of the diastase in question which will convert a given weight of starch in uniform paste to the so-called colorless end-point in ten minutes1 that is to the point where it will no longer give any color reaction with a standard iodin solution4 ,the standard starch weight in #ej c4c4 always is #a gm4 or #a1jjj mg4 and to a series of flasks containing this amount of starch1 maintained at a constant temperature of #dj ,c41 the diastase dilutions are added4 ,these diastase dilutions are made by dissolving small1 accurately weighed amounts of the sample in some small1 constant volume of water1 usually #e or #aj c4c4 and they are then poured into the starch flasks at the right temperature1 and agitated regularly4 ,tests are made by taking a few drops from each flask and mixing with the iodin solution4 ,the end-point is reached when a dilution is found which1 at ten minutes from the mixing time1 gives no color with the iodin reagent4 ,the first set of tests is taken as a general guide1 and quite accurate results may be obtained in a second set of dilutions4 ,we first used a sample of ,taka-,diastase bought in the open market4 ,it was found that #adj mg4 were required to convert the gram of starch as explained4 ,this is equivalent to a conversion of #g4ad parts of starch by #a part of the ,taka-,diastase4 ,a new1 and possibly fresher1 sample was then obtained and the test repeated4 ,with this new sample it was found that #fj mg4 were necessary to convert the gram of starch to the colorless end-point in ten minutes1 from which it follows that #a part of the ferment will convert #af4f parts of starch to the colorless end-point in the same time4 ,with a new sample of ,liquid ,taka-,diastase obtained simultaneously it was found that #c4e c4c4 were necessary to convert #a gram of starch to the colorless end-point in ten minutes4 ,as a fluidounce of this liquid is said to contain #bj grains of the solid it will be seen that the results approximately agree with those of the first sample of the solid1 and that they are both very low4 ,in the earlier tests #af parts of starch converted by #a part of the ferment was the value found4 ,these results are in close agreement with values reported by ,sherman 7,jour4 ,am4 ,chem4 ,soc41 xxxii1 #ajgc7 for a sample of recent purchase4 ,he found a conversion of #ea parts of starch to the colorless end-point in thirty minutes for one sample1 while for another he found #ff parts1 in the same time4 ,it will be noted that our time limit is ten minutes4 ,it is worthy of note that for a perfectly fresh and specially prepared sample furnished by ,dr4 ,takamine1 a conversion of #bgh parts in thirty minutes was found by ,sherman4 ,taking the time into consideration1 it will be seen that the results are about the same for the market samples as those found by us and much lower than claimed1 as well as much lower than for other makes of similar products4 ,the difference in the behavior of fresh specially prepared ,taka-,diastase and the market sample is very clearly shown4 ,no one questions the fact that fresh laboratory samples of ,taka-,diastase may show a moderate converting power on starch4 ,but we have to deal with the activity of market samples only1 and ,sherman's work and our own show the low digesting power of the product as physicians may secure it on the market4 ,the marked difference in activity between perfectly fresh and ordinary market samples of ,taka-,diastase is very clearly shown also in a recent paper published by ,wohlgemuth4#bd ,in the digestion of starch paste to the 8dextrin0 stage ,wohlgemuth found in the commercial sample a strength approximately a hundred times less than that observed in a fresh sample sent him by ,dr4 ,takamine4 #bd ,wohlgemuth3 ,biochem4 ,ztschr41 ,march #ah1 #aiab4 ,wohlgemuth's results were obtained by a method not essentially different from ours1 with this difference1 however1 that he digested through #bd hours in the cases reported1 and carried the reaction to the 8dextrin0 stage only1 in place of to a colorless end-point4 ,making the proper reductions1 it is evident that the actual values found by him for the market samples bought in ,germany are not greater than those reported by us4 ,the reference to the work of ,sherman is made because1 in a following paper in the same journal1 he recommends the use of salt as an activator in finding the strength of certain diastase preparations4 ,it is well known that dialyzed diastase preparations and starch of highest purity have but slight action on each other2 a little salt increases the activity greatly1 and also increases the activity of commercial diastase preparations4 ,these facts ,sherman utilizes in working out a method for valuation of commercial diastases4 ,the facts were well known to us at the time of our former report1 but it was not thought best to depart from the general method which had been in use by all analysts following the general scheme of ,roberts4 ,quite recently1 ,i4 ,bang has published a paper on the investigation of diastase 7,biochem4 ,ztschr41 xxxii1 #dag7 in which he studies the behavior of sodium chlorid and other salts on the rapidity of starch conversion1 and finds that a much smaller amount of salt than ,sherman recommends brings the maximum increase4 ,the method employed in our former tests is a good comparative method1 and this is all that may be claimed at present for any method4 ,by adding salt to our starch solution the activity of ,panase and other ferments is likewise greatly increased4 ,for ,panase1 a preparation possessing rather high starch-converting power1 we have recently found an increase of about #cj per cent4 in the converting power1 with salt present4 ,working to loss of blue color1 merely1 it is possible in this way to get a higher value than that claimed by the manufacturer4 ,there is no practical gain in using the salt for our purpose as the methods are at best arbitrary1 and the results only comparative4 ,taking all the facts into consideration1 it is recommended that the rejection of ,taka-,diastase and ,liquid ,taka-,diastase be allowed to stand and that1 in view of their extensive exploitation1 this report be authorized for publication so that physicians may know the facts4 ,this report was referred to ,parke1 ,davis ,co41 and they made the following reply3 8,the report submitted in your letter of the #bc;d is1 we contend1 erroneous and unjust3 first1 to our ,liquid ,taka-,diastase1 because over three years ago we changed our formula1 reducing the alcohol from #ah per cent4 to #aj per cent41 increasing the glycerin and thus prolonging greatly the period of activity4 8,as for our regular ,taka-,diastase1 our claim is and has been for years simply that ,taka-,diastase will digest or hydrolyze #aej times its weight of starch in ten minutes1 under proper conditions4 ,we do not claim1 we do not permit our representatives to claim1 that ,taka-,diastase will completely transform starch1 to the colorless end-point1 into sugars4 ,taka-,diastase is used to supplement a deficiency of ptyalin and converts the starch into soluble material with great rapidity1 thus giving the gastric fluid immediate access to the proteids4 8,if in the enclosed labels the word #8digest' were replaced with the word #8liquefy1' the claim could not be assailed by the most carping critic4 ,to save any possible question1 we shall therefore make this change in our label1 having it read3 #8,taka-,diastase will liquefy #aej times its weight of starch in ten minutes1 under proper conditions4' ,is there the slightest question in your mind that this statement as just quoted is entirely correct and entirely supported by clinical experience8 8,it is our conviction that ,taka-,diastase has a very remarkable power to hydrolyze starch either in the test-tube or in the stomach1 and that this property is of great utility in clinical work4 ,we do not claim that its conversion of the starch into sugars is complete1 to the colorless end-point of the ,johnson test2 and on this point we have been perfectly frank with the ,council1 as well as with every physician who has taken sufficient interest to inquire40 ,in view of the above protest1 the matter was submitted to a second referee1 who reported as follows3 8,your referee on the matter of ,taka-,diastase has made a careful investigation of the reports and correspondence submitted1 and begs to make the following report3 8,the question at issue1 viz41 whether ,taka-,diastase should be included in ,new and ,nonofficial ,remedies1 ,i believe1 can be determined by the material before me1 and further tests of the material are not necessary4 8,the letter of the makers of ,taka-,diastase admits that the early claims regarding the strength and properties of the material were erroneous and exaggerated4 ,since the product was once admitted to ,new and ,nonofficial ,remedies1 it may be claimed that as the ,council on ,pharmacy and ,chemistry must have been in error then1 it may be now4 ,your referee does not consider this supposition worth discussing4 ,the conclusion he draws is that the ,council was too hasty in accepting the preparation1 and that the incident shows how much better it would be in all cases to accept no remedy until sufficient time has been given for conclusive tests4 8,the literature still sent out by ,parke1 ,davis ,co4 regarding ,taka-,diastase is misleading and of a kind more appropriate for a nostrum than a standard chemical substance4 ,what would we think if morphin1 quinin or even heroin were advertised in the same way8 ,i cite the statement1 #8,taka-,diastase digests starchy food with vigor and directness4' ,it seems to the referee that the proposition to modify the label to indicate the amount of starch which is liquefied rather than the amount which is saccharified1 in accordance with the ,council's standard1 is bound to lead to confusion and to give an exaggerated and false value to ,taka-,diastase4 8,your referee recommends that the report of the reinvestigation of ,taka-,diastase which has been submitted to me1 be made available to the medical profession1 and that the rejection of ,taka-,diastase and ,liquid ,taka-,diastase be allowed to stand40 ,this report of the second referee was submitted to ,parke1 ,davis ,co41 with the request that they state more explicitly their claims regarding the activity of ,taka-,diastase and ,liquid ,taka-,diastase1 in order that1 if they decided to revise their claims for the preparations1 such revision of claims might be published along with the reports of the ,council4 ,they replied3 8,answering your note of the #aeth instant3 ,we have no desire to discuss further the subject of your letter of ,february #bd1 or to make any statement beyond that set forth in our letter to you of ,dec4 #bg1 #aiaa40--7;,from ,the ,journal ,a4 ,m4 ,a41 ,july #f1 #aiab47 ,,digalen ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,digalen is a proprietary said to contain a soluble form 7digitoxinum solubile ,cloetta7 of digitoxin1 the chief active principle of digitalis4 ,this preparation was accepted#be by the ,council in #aiji for inclusion in ,new and ,nonofficial ,remedies4 ,the ,council had not at that time determined whether ,digalen contained 8soluble amorphous digitoxin10 as claimed1 or not4 ,the product was accepted merely as a standardized soluble and fairly stable digitalis preparation4 #be ,the ,journal ,a4 ,m4 ,a41 ,sept4 #aa1 #aiji1 p4 #hfi4 ,after the acceptance of ,digalen1 the therapeutic claims made for it by the manufacturers increased in extravagance4 ,meanwhile1 evidence was brought forward by various independent investigators which tended not only to show that these therapeutic claims were unfounded1 but also to discredit the claim that ,digalen contained a principle chemically identical with digitoxin4 ,in view of the obscurity of the whole subject of the chemistry of the digitalis principles1 the latter claim 7that ,digalen was a solution of 8amorphous digitoxin07 had been an academic issue at the time of the acceptance of the product4 ,when1 however1 the manufacturers of ,digalen sought to mislead physicians by increased and unwarranted therapeutic claims1 the ,council felt that investigation of the whole matter was imperatively demanded to decide whether or not ,digalen should be retained in ,n4 ,n4 ,r4 ,the questions at issue were3 7#a7 the presence in ,digalen of 8amorphous digitoxin02 7#b7 the constancy of composition and reliability of action of ,digalen1 and 7#c7 the claim that it causes less gastric disturbance than digitoxin4 ,no satisfactory proof has yet been offered that ,digalen contains 8amorphous digitoxin40 ,the mass of evidence tends to show that ,digalen is not constant in composition or reliable in action1 and that1 when given in doses corresponding in therapeutic activity1 ,digalen causes quite as much gastric disturbance as the official galenical preparations of digitalis4 ,the outcome of protracted negotiations between the ,council and the ,hoffmann-,la ,roche ,chemical ,works may be summed up as follows3 #a4 ,the manufacturers promise to hold in abeyance the claim regarding the presence of 8amorphous digitoxin40 #b4 ,they refuse to concede the variable composition of ,digalen4 #c4 ,they reassert the claim that ,digalen is superior to other digitalis products with respect to liability to cause gastric irritation and consequent vomiting4 ,in view of the unsatisfactory character of the reply on the second and third points1 the ,council voted that ,digalen be omitted from ,n4 ,n4 ,r4 and that publication of the report on ,digalen which appears below be authorized1 as well as of the two reports#bf 7,a and ,b7 referred to therein4 #bf ,these reports 7,a1 first report on ,digalen and ,b1 examination of ,digalen ,tablets7 will be published in the #aiad ,annual ,council ,reports4 ,a reprint of the entire matter dealing with the rejection of ,digalen will be sent on receipt of a two-cent stamp4 ,w4 ,a4 ,puckner1 ,secretary4 ,referee's ,report on ,digalen ,because of persistent conflict with ,rule #f 7unwarranted therapeutic claims7 and ,rule #a 7composition7 it is recommended that ,digalen be omitted from ,new and ,nonofficial ,remedies2 also that a copy of the report be sent to the manufacturers1 and that publication of this report and the two previous reports submitted to the ,council be authorized4 ,the nature of the problems involved necessitates a somewhat extended discussion of the subject4 ,digalein 7liquid7 is said to contain #a part of soluble amorphous digitoxin ,cloetta in #a1jjj parts of glycerin and #a1fjj parts of water with #g4e per cent4 of alcohol4 ,one c4c4 is said to contain #j4jjjc gm4 of the amorphous digitoxin4 ,digalen was accepted by the ,council#bg and the following footnote was appended to the description in ,new and ,nonofficial ,remedies3 #bg ,the ,journal ,a4 ,m4 ,a41 ,sept4 #aa1 #aiji1 p4 #hfi4 8,the ,council has not determined whether digalen contains #8soluble amorphous digitoxin' or not1 but accepts it simply as a soluble digitalis preparation40 ,tablets of ,digalen were accepted by the ,council as a dosage form of ,digalen4 ,each tablet is said to represent #j4e c4c4 7eight minims7 of ,digalen 7liquid74 ,one of the principal considerations which led the ,council to accept ,digalen was that it was regarded as affording a fairly constant and stable preparation of digitalis suitable for intravenous administration4 ,if ,digalen is not fairly stable and of fairly constant composition it has no obvious advantage over an active soluble digitalis preparation1 such as digitalein4 ,the evidence now at hand seems to show3 #a4 ,digalen is not of constant composition or activity4 #b4 ,the manufacturers1 or their agents1 continue to make misleading statements4 #c4 ,it is merely a solution of certain digitalis principles1 probably of digitalen mainly1 in impure form4 ,,composition ,cloetta#bh prepared a soluble amorphous substance which he called 8,digitoxinum solubile ,cloetta10 but no information concerning the method of preparation has been published4 #bh ,cloetta3 ,mnchen4 med4 ,wchnschr41 #aijd1 ,no4 #cc4 ,cloetta reported the result of an elementary analysis of his product which he compared to the analyses of digitoxin 7crystalline7 made by ,schmiedeberg and by ,kiliani1 and stated that there could be no doubt concerning the chemical identity of the two substances4 ,kiliani#bi characterized as preposterous ,cloetta's claim that the active constituent of ,digalen is chemically identical with digitoxin and stated that ,digalen was merely an impure digitalein4 ,kiliani has recently reiterated the statement that the so-called 8amorphous digitoxin0 is not identical with digitoxin4#cj #bi ,kiliani3 ,mnchen4 med4 ,wchnschr41 #aijg1 p4 #hhf4 #cj ,kiliani3 ,am4 ,jour4 ,pharm41 #aiac1 lxxxv1 #bbd4 ,cloetta's failure to publish his method of preparing ,digalen places an additional burden of proof on him 7or the manufacturers of ,digalen71 concerning the identity of the product1 and in the face of ,kiliani's denial of the correctness of ,cloetta's contention we must have strong corroborative evidence of ,cloetta's claim before we can accept it as being established4 ,the difficulties of dealing with the chemistry of digitalis are so well known that they hardly require further mention here1 but under the circumstances ,cloetta cannot be considered as being wholly unprejudiced1 and1 while the same might perhaps be said of ,kiliani1 such evidence as can be deduced tends strongly to support ,kiliani's view1 and to disprove the contention of ,cloetta4 ,there is much confusion regarding the names which have been applied to the various principles obtained from digitalis1 and while it is undesirable that an established name should be given to a newly discovered principle1 one might overlook this if no effort were made to associate the therapeutic actions of the two substances to an extent which the truth did not justify4 ,while the ,council at that time did not challenge the existence of 8amorphous digitoxin0 and made no attempt to determine the identity with digitoxin of the substance forming the basis of ,digalen1 the manufacturers of ,digalen have sought to show that ,digalen and digitoxin were identical so far as their therapeutic actions were concerned1 but that ,digalen lacked the disadvantages of digitoxin4 ,what was a purely academic question when the acceptance of ,digalen was under discussion by the ,council becomes a matter of very great practical importance when the manufacturers of ,digalen seek to mislead the physician by these claims4 ,the evidence which lends support to the view that ,digalen and digitoxin are wholly dissimilar may be summarized as follows3 ,digalen differs greatly in its physical properties from digitoxin and in certain of its physiologic actions1 as the manufacturers themselves state1 ,digalen being amorphous1 and soluble in water1 while digitoxin is crystalline and insoluble in water4 ,the manufacturers state that ,digalen differs from digitoxin in certain of its physiologic actions1 but the two substances do indeed differ far more than they admit4 ,cloetta and the manufacturers of ,digalen lay especial stress on the claim that ,digalen is cumulative to a far less extent than digitoxin1 and that it has far less tendency to cause gastric disturbance than the latter4 ,the first of these claims is true2 the second is the very opposite of the truth1 as we shall show4 ,we know nothing of the structure of any of the digitalis principles1 and even though one were to admit 7purely for the sake of argument7 that ,digalen and digitoxin were chemical isomers1 that fact could not be taken to lend any support to the contention that the two substances were identical1 in the face of the established fact that they differ physically and physiologically in nearly every particular1 and agree only in that they both cause standstill of the heart in the same way--an action possessed also by so dissimilar a substance as barium4 ,the manufacturers of ,digalen support the claim of the identity of their product with digitoxin by stating that 8,digalen is a solution of the most active glucoside of digitalis40#ca ,of course1 it is very generally admitted that digitoxin is the most active principle of digitalis1 though there is some question concerning its glucosidal nature4 #ca ,clinical ,suggestions and ,reports1 ,december1 #aiab1 p4 #bd4 ,digalen is in fact far less active than digitoxin1 as has been shown by a number of independent observers,m 7,worth ,hale1 #aiaj2 ,hatcher and ,brody1 #aiaj2 ,neave1 #aijg2 ,miller1 #aijh2 the referee2 ,weis1 #aiab74 ,m ,owing to lack of space a portion of the report is here omitted4 ,a detailed discussion of these results is included in the full report contained in the reprint4 ,the essential fact which appears from the investigation of ,weis is that ,digalen did not behave like digitoxin in any case4 ,hale also found that ,digalen gave atypical actions in which the effects on the central nervous system became prominent4 ,the referee can corroborate these observations of ,hale's on frogs1 but the convulsive symptoms were prominent with some specimens of ,digalen on mammals1 though not with others1 the more recent specimens of the preparation showing the action prominently4 ,the results of all these biologic tests1 as well as of the physical tests made by ,weis1 certainly lend no support to the contention of ,cloetta that the potent constituent of ,digalen is identical with digitoxin1 but1 on the contrary1 they show conclusively that the two substances differ widely in many essentials1 and the continued claim of the manufacturers that the 8amorphous digitoxin0 said to be contained in ,digalen is the same as digitoxin1 or that it is the most active glucosid of digitalis1 can be considered only as misleading1 and therefore in conflict with the rules of the ,council4 ,,constancy ,,of ,,composition ,,and ,,acidity ,the manufacturers of ,digalen continue to claim that it is of constant and uniform activity1#cb and they imply this even when they do not state it in those words2 for example1 a substance cannot be considered reliable if it is variable in activity4 8,digalen is ,absolutely ,reliable4 ,it is ,standardized and consequently always uniform4 ,it does not produce gastric disturbances40 #cb ,advertisement ,brit4 ,med4 ,jour41 ,april #bf1 #aiac4 ,that the foregoing is absolutely untrue can be shown abundantly4 ,hale#cc found digalen not to be uniformly stable2 ,weis found very different degrees of activity for ,digalen in the liquid and tablet forms1 the tablets being but one-third as active as the liquid1 and the referee found very great variations in the activity of different specimens of ,digalen1 one specimen being almost inert4 ,the results obtained by ,miller show that ,digalen is sometimes very slightly active1 or not at all so4 #cc ,hale3 ,hyg4 ,lab4 ,bull41 #gd4 ,the foregoing citations show conclusively that ,digalen is not of uniform activity4 ,when reliability is claimed for ,digalen in contrast to the known variability of digitalis1 it must be considered as tantamount to the claim that ,digalen is not subject to such variability and it must be held that the manufacturers make misleading statements when they assert that ,digalen is absolutely reliable4 ,the manufacturers claim that ,digalen does not produce gastric disturbances 7see advertisement cited74 ,it is quite true that when small doses of ,digalen are used therapeutically it fails to produce gastric disturbances because it is of such slight activity1 as previously stated1 but when it is used in amounts which correspond in activity to such doses of the ordinary galenical preparations of digitalis as commonly cause nausea and vomiting it does cause gastric disturbances quite as readily as the latter4 ,among the clinicians who have found that ,digalen causes gastric disturbances may be cited3 ,veiel1#cd ,mueller1#ce ,eichhorst#cf and ,teichmann4#cg #cd ,veiel3 ,mnchen4 med4 ,wchnschr41 #aijf1 liii1 #badj4 #ce ,mueller3 ,mnchen4 med4 ,wchnschr41 #aiji1 lvi1 #ijd4 #cf ,eichhorst3 ,deutsch4 med4 ,wchnschr41 #aije1 xxxi1 #di4 #cg ,teichmann3 ,therap4 d4 ,gegenw41 #aijg1 xlviii1 #aii4 ,eggleston and ,hatcher#ch compared the emetic and cardiac activity of ,digalen and numerous other digitalis bodies and preparations and found that the emetic activity of ,digalen was decidedly greater in proportion to its cardiac 7or therapeutic7 action than was that of digitalis or digitoxin4 #ch ,eggleston1 ,cary1 and ,hatcher1 ,robert1 ,a43 ,the ,emetic ,action of the ,digitalis ,bodies1 ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ae1 #aiac1 p4 #dii4 ,in the absence of any evidence to controvert this clinical and experimental evidence1 the continued claim that ,digalen does not disturb the stomach must be looked on as deliberate misrepresentation4 ,,misleading ,,therapeutic ,,claims ,the recommendation that ,digalen be dismissed from ,n4 ,n4 ,r4 is made with the full appreciation of the fact that the manufacturers of ,digalen and their agents have repeatedly stated that they desired to comply with the rules of the ,council1 and that they have withdrawn several statements to which the ,council has taken exception1 but the fact remains that despite these reiterations the advertisements of ,digalen continue to embody statements which the ,council can only consider misleading4 ,the ,council believes that the following advertisements constitute gross therapeutic exaggerations3 8,digalen a sheet anchor in pneumonia2 a strong support to the heart in this deadliest of infectious diseases among adults4 ,the prompt action of ,digalen1 by intravenous or intramuscular injection makes it possible to save lives which might be otherwise hopelessly lost4 ,the best digitalis preparation which we have at the present time40#ci #ci ,advertisement in ,am4 ,med41 ,january and ,february1 #aiac4 8,the digitalis for children4 ,because its dosage can be controlled4 ,endorsed by pediatrists everywhere40#dj #dj ,advertisement in ,merck's ,arch41 ,april1 #aiac4 8,the myocarditis of ,tuberculosis so frequently encountered1 especially in the advanced stage of the disease1 may be controlled with the aid of ,digalen4 ,the standard digitalis preparation40#da #da ,south4 ,medical ,journal1 ,january to ,may1 #aiac1 inclusive4 8,digalen is ,absolutely ,reliable4 ,it is standardized and consequently always uniform4 ,it does not produce gastric disturbances40#db #db ,advertisement in ,brit4 ,med4 ,jour41 ,april #bf1 #aiac4 ,digalen is not a sheet anchor in pneumonia1 for there is no drug deserving such a title4 ,digalen has no action which other digitalis preparations lack1 and cannot save lives otherwise hopelessly lost4 ,the dosage of ,digalen cannot be controlled any better than that of other digitalis preparations1 since its activity is variable4 ,we cannot control the myocarditis of advanced tuberculosis by this or any other means4 ,,claimed ,,superiority ,various digitalis principles1 including digitoxin1 digitalin 7true7 and digitalein1 have been known for many years4 ,therapeutically they have been found wanting and there appears to be no basis for the continued claim that ,digalen has any superiority over these several digitalis principles4 ,on the contrary1 the evidence is accumulating that ,digalen has no advantage in any particular over a solution of digitalein1 and misleading claims of the manufacturers and their agents certainly interfere with the formation of that calm and unbiased opinion on the part of the general practitioner1 which1 when applied to the non-proprietary digitalis principles has caused them to fall into disuse4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #e1 #aiad47 ,,dioradin ,,refused ,,recognition ,report of the ,council on ,pharmacy and ,chemistry ,a preparation called ,dioradin was placed on the market as a cure for consumption three years ago in ,europe and somewhat later in this country4 ,it was first submitted to the ,council in ,july1 #aiaa4 ,because of the manifestly unwarranted claims made for its use in the treatment of tuberculosis1 the ,council voted that the product be refused recognition for conflict with ,rule #h1 without at that time taking under consideration the question whether or not it was in conflict with other rules of the ,council4 ,in ,june1 #aiab1 further consideration of ,dioradin was requested4 ,the ,american agent having promised a reform in the methods of advertising1 the ,council considered the available evidence regarding the identity and value of the preparation4 ,examination of evidence regarding the composition of ,dioradin--claimed to consist of radium chlorid1 iodoform and menthol in an ether-oil solution--showed serious discrepancies as to the amount of radium as well as to the identity and amounts of other constituents4 ,it was further found that the experimental evidence was insufficient and biased4 ,then1 too1 in view of the difficulty of judging the effects of medicines in tuberculosis1 the clinical data were unconvincing4 ,there was nothing to prove that the reported improvements1 even if they actually occurred1 were to be ascribed to the mixture as a whole rather than to any one of its constituents4 ,as a result of these findings1 the ,council voted that ,dioradin be refused recognition and that the publication of these facts be authorized4 ,in accordance with its regular procedure1 it also submitted the report to the agent4 ,in reply the agent submitted evidence which showed that he was not responsible for the misstatements about ,dioradin but offered no facts that affected the ,council's findings4 ,the entire matter having been referred to a second referee1 minor modifications of the first draft of the report were authorized4 ,since then the ,dioradin ,company has submitted two reports of examinations of ,dioradin made for the company in ,germany showing a higher radium content than that previously found4 ,these reports do not alter the facts brought out in the report of the ,council that the composition of ,dioradin has been variable1 which past variability arouses a feeling of uncertainty or lack of confidence4 ,in view of this the amended report was ordered published and appears below4 ,w4 ,a4 ,puckner1 ,secretary4 ,,first ,,submission ,,of ,,dioradin ,dioradin1 a preparation for the treatment of consumption originated by ,dr4 ,r4 de ,szendeffy1 ,budapest1 ,hungary1 was submitted to the ,council by ,louis ,gero1 ,ltd41 ,new ,york1 with the following statement of composition3 8,a radio-active preparation of ,menthol1 ,iodin and ,radium ,barium ,chlorid #a_/aj of a drop2 in ether solution40 ,a circular which accompanied the submission stated3 8,preparation ,no4 #c of ,dioradin contains not only terpins but also iodin salts4444 ,in view of the fact that emanations of the radium as well as the combinations of the evasive iodin terpins enter into the organism through the lung44440 ,later these indefinite statements of composition were supplemented by the following3 8,in #ajj c4c4 there are3 #a gr4 ,iodoform4 #e ,menthol4 #aj drops ,radium chlorid solution 7#a milligr4 in #ajj c4c4 of water74 #e gr4 ether4 #ij ,oil 7ol4 amygd4 frig4 press740 ,in a circular contained in the package these claims were made3 8,the preparations of the ,dioradin are based on the miraculous effects which scientific researches have shown in regard to the different sicknesses treated with radium4 8,it is generally known that radium1 even if externally employed1 has proved itself to be a bactericidal remedy4 ,its effect is multiplied if one employs it internally even in infinitesimal doses1 in consequence of its permanent action of emanation on the organism4 8,the preparations of the ,dioradin contain the radium itself4 ,for this reason their antiseptic and bactericidal effect is much more intensive than with medicaments which contain only its emanation1 which disappears in a short time40 ,in view of the general extravagance of the claims made for its therapeutic action the preparation was rejected without considering other possible conflicts with the rules of the ,council4 ,,second ,,submission ,,of ,,dioradin ,having been advised of the rejection by the ,council of ,dioradin the ,american agency1 which in the meantime had become the ,dioradin ,co41 requested further consideration4 ,the ,council therefore took up the subject again4 ,after certain typographical errors had been corrected the following was now given as the composition3 8#a gram ,iodoform4 #e grams ,menthol4 #aj drops ,radium ,chlorid ,solution 7containing #a milligram of radium chlorid in #ajj cubic centimeters of water74 #e grams ,ether4 #hi grams expressed oil of almond4 ,this liquid is put up in ampules containing one cubic centimeter of liquid40 ,in support of the therapeutic claims for ,dioradin the ,american agent submitted literature consisting chiefly of articles by ,dr4 ,bernheim of ,paris4 ,before reporting on the requested reconsideration of ,dioradin the referee directed the secretary of the ,council to point out to the ,american agent that in the formula given1 the amount of non-volatile matter should be about #ij per cent41 whereas the report of the ,lederle ,laboratories which accompanied the request for reconsideration states that but #gb4jh per cent4 was found in the analysis4 ,in reply the agent stated that he had called the attention of ,dr4 ,szendeffy 7the originator of ,dioradin7 to the discrepancies concerning non-volatile matter and that he felt sure the discrepancy was wholly accidental 7sic74 ,in a later communication the agent submitted a statement of analysis from the ,lederle ,laboratories of a new specimen of ,dioradin according to which the amount of non-volatile matter agreed essentially with the amount claimed by the agent4 ,the referee1 having examined the evidence1 is of the opinion that the statement of composition is misleading and that the therapeutic claims are unwarranted1 thus3 ,,discrepancies ,,in ,,radium ,,content ,the chief claims for its therapeutic value are based on the radium content1 yet the discrepancies and contradictions1 regarding this are serious4 ,in connection with the reconsideration of this product the agent presented a certificate of chemical examination by the ,lederle ,laboratories in which the following statement was made as to the radio-activity3 8,examination shows the preparation to possess slight radioactivity1 corresponding in activity to less than #a-aj1jjj of #a milligram of radium bromid per ampule4 ,according to the sworn statement of ,dr4 ,a4 de ,szendeffy1 the originator of ,dioradin1 the preparation contains #aj drops of radium chlorid solution 7#a milligram in #ajj cubic centimeters of water7 in #ajj cubic centimeters of the preparation4 ,this would correspond to #e-a1jjj milligram of radium chlorid in #ajj cubic centimeters1 or about #a-bj1jjj of #a milligram per ampule40 ,a cursory reading of this paragraph gives the impression that ,dioradin possesses fully the amount of radio-activity claimed by its originator1 ,dr4 ,a4 de ,szendeffy4 ,this impression is greatly strengthened by the concluding paragraph of the ,lederle report1 which says3 8,in conclusion1 our examination shows that the preparation submitted to us as ,dioradin possesses radio-activity1 and contains a fixed oil 7apparently expressed oil of almond71 iodoform1 menthol and ether1 thus confirming the sworn statement of ,dr4 ,a4 de ,szendeffy in regard to the composition of this product40 ,on inquiry as to the method used by the ,lederle ,laboratories1 in determining radio-activity the agent submitted a further statement of the ,lederle ,laboratories which describes the gamma ray test by which the determination was made and a radium value equivalent to #j4jjjjda mg4 of radium bromid per capsule was obtained4 ,the report then says3 8,the variations of the single measurements from the mean in the case of the natural leak and the leak with the ,dioradin near were so large that we did not feel justified in assigning much accuracy to the figure1 #j4jjjjda1 but stated that the amount of radium per capsule could not be greater than #j4jjja mg41 with the possibility of there being a much smaller amount present40 ,it is evident that the wording of the reports of the ,lederle ,laboratories is liable to give the impression that their examination confirms the claims made for ,dioradin4 ,it is further evident from these reports that the amount of radio-active matter has not been definitely ascertained but that it is at the best very small4 ,the unreliability of the claims for radium content of ,dioradin was recently shown by ,buechner1#dc who found a specimen obtained from an apothecary to contain but #a-a1jjj of the amount claimed4 #dc ,buechner3 ,pharm4 ,weekblad1 ,march #b1 #aiab1 p4 #afa4 ,,volatile ,,and ,,non-,,volatile ,,matter ,the varying claims regarding the content of volatile and non-volatile matter throw doubt on the entire composition of ,dioradin1 for if the statement as to these is wrong the rest of the statement regarding composition cannot be given credence4 ,in the first submission of ,dioradin about #hi per cent4 of non-volatile matter was claimed but in the report of the analysis by the ,lederle ,laboratories1 which accompanied the resubmission1 only about #gb per cent4 was found4 ,later the ,lederle ,laboratories reported that an examination of a new specimen of ,dioradin had shown about #ij per cent4 of non-volatile matter4 ,the discrepancies between the composition claimed for ,dioradin and that found for the product in the first ,lederle report has shown that the agent was quite ignorant of the composition of the product which he was selling4 ,,indefiniteness ,,of ,,the ,,iodin ,,content ,the label on the trade package of ,dioradin first submitted to the ,council stated that the product contained iodoform2 a similar statement was made in the submission of the product2 the circular accompanying the first submission stated that 8iodin salts0 were contained in the product while the iodin content was referred to further on in this circular as 8combinations of evasive iodin terpins40 ,in ,bernheim's papers1 which have been used to advertise ,dioradin1 and which are referred to in the same circular1 the iodin compound is called 8iode peptonis10 which1 according to information stated by the ,american agent to have come from ,budapest1 is to be translated 8iodized peptone40 ,what is the meaning of this confusion8 ,one would naturally suppose that the preparation to be sold in this country contains iodoform in an ether-oil solution while the one used by ,bernheim and ,dieupart#dd was stated to contain an ethereal solution of 8iodized peptone40 ,this is another mystification1 for an ethereal solution of any kind of peptone would be a novelty4 ,the matter is of some importance1 for ,bernheim and ,dieupart lay great stress on the difference between 8peptonized iodin0 and other iodin 7loc4 cit41 p4 #ccc7 and of the superiority of ethereal over oily solutions 7loc4 cit41 p4 #ccd74 ,the ,american agents1 however1 in the second submission1 state that this is all a mistake2 that the ,dioradin used by ,bernheim is the same ,dioradin which was submitted to the ,council2 and that this does not contain1 and never did contain1 the ethereal solution of 8iode peptonis0 to which ,bernheim attached so great importance4 ,bernheim 7report to ,medical ,congress of ,lyons7 himself has come to the same conclusion2 for five months after his first paper he believes that the 8special salt of radium0 7sic7 is the principal agent2 so that the 8peptonized iodin0 must be unimportant1 and in a cablegram of ,july #d1 #aiab1 he now informs the ,dioradin ,company that the formula was incorrectly given in his first papers 8owing to my ignorance of actual composition10 and that all the ,dioradin used by him was of the composition stated in the submission to the ,council4 #dd ,bernheim and ,dieupart3 ,revue ,internationale de la ,tuberculose1 ,may1 #aiaa1 p4 #ccf4 ,while this vindicates the good faith of the ,american ,dioradin ,company1 it does not clear up the mystery4 ,the question occurs at once3 ,what led ,dr4 ,bernheim to make such positive statements8 ,was he drawing purely on his imagination8 ,if so1 why did his imagination take this peculiar special direction8 ,or if he did have some reason to imagine the 8iode peptonis10 who supplied this reason8 ,and if1 at that time1 he was given to understand by ,szendeffy1 who must have supplied him with the material1 that it contained the iodized peptone1 how can he be positive at this time1 that it did not contain it8 ,has he actually analyzed the old material8 ,there is also a further question which needs to be answered4 ,why has ,dr4 ,szendeffy waited until ,dioradin was rejected by the ,council before correcting ,bernheim's serious misapprehension1 in the meantime permitting the circulation of ,bernheim's paper8 ,until these questions have been satisfactorily answered1 the element of mystery about the composition of ,dioradin cannot be cleared away4 ,,experimental ,,evidence ,the available experimental evidence regarding 8,dioradin0 is restricted to some quotations from its inventor ,szendeffy1 in the paper of ,bernheim and ,dieupart 7p4 #ccd74 ,these1 if confirmed1 would show that radium alone has practically no effect on cultures of tubercle or colon bacilli2 that #j4a gm4 of 8iode-menthol0 7concentration not stated7 checks the growth of the acid-fast organisms2 and that this antiseptic efficiency can be nearly doubled by the addition of a little radium4 ,no quantitative data are given1 so that it is difficult to judge the accuracy of the observation4 ,granting that it is correct1 it would have little bearing on the therapeutic actions of ,dioradin1 for there is nothing to show that the effective test-tube concentration is reached in the pulmonary tissues4 ,it is also claimed that the injection of ,dioradin prevents tubercle infection4 ,the referee believes that the ,council and the medical profession should hesitate to accept this conclusion without further details2 and these would require confirmation by unprejudiced observers4 ,,clinical ,,evidence ,the ,dioradin ,company submits considerable clinical data in favor of ,dioradin4 ,it must be remembered that most favorable opinions have been published1 from time to time1 about scores of 8consumption cures10 which have mysteriously lost their efficiency when their novelty wore away4 ,there is no more reason to doubt the good faith of those who are enthusiastic about ,dioradin than of those who have been enthusiastic about other 8cures40 ,there appear to be features in the course of tuberculosis which make the judgment of therapeutic measures peculiarly difficult4 ,it is possible that impartial clinical trials of ,dioradin by tuberculosis experts appointed by the ,council might facilitate judgment as to the actual efficiency of ,dioradin4 ,the referee doubts1 however1 whether this would advance the ,council very much toward the acceptance of the substance4 ,such an investigation would be so lengthy that it should not be undertaken until the ,dioradin ,company itself has offered at least presumptive evidence in this direction1 especially in view of the adverse report recently made by ,cecil ,wall4#de ,ten tuberculous patients were treated by ,wall in strict accordance with the method outlined to him by ,bernheim1 yet ,wall concludes that none of the cases1 though treated accurately in accordance with the instructions1 can be quoted to justify any of the claims for the therapeutic efficiency of ,dioradin4 ,the ,council cannot undertake lengthy investigations of this character until it is put in possession of data which would show to its satisfaction that such investigations would probably be fruitful4 #de ,wall1 ,c43 ,brit4 ,med4 ,jour41 ,july #bj1 #aiab1 p4 #aji4 ,,conclusions ,from investigations made1 it appears that the claims in regard to the composition of ,dioradin have contained vague statements and contradictions which arouse a feeling of uncertainty and lack of confidence4 ,until this uncertainty is cleared away1 ,dioradin cannot be considered as complying with ,rule #a4 ,the experimental data are insufficient and unconvincing4 ,some favorable clinical reports have been submitted1 but the accuracy of the observations is to be questioned and they are more than offset by the negative results observed by ,cecil ,wall4 ,as might be expected1 other negative results1 if observed1 have not been submitted and there is nothing in the manufacturer's claim to show whether the improvement reported is really due to the peculiar mixture called ,dioradin or to any one of its ingredients4 ,it is therefore recommended that ,dioradin be not accepted for ,new and ,nonofficial ,remedies4 ,in view of the extensive advertising of this preparation and because of the admittedly incorrect statements in the earlier papers it is recommended that publication of this report be authorized4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bf1 #aiab47 ,,echinacea ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has voted to reject several non-proprietary articles and has recommended that the reasons for their rejection be given in ,the ,journal2 among these is echinacea4 ,the following paper has been submitted by a subcommittee with the recommendation that it be published4 ,this recommendation was adopted4 ,w4 ,a4 ,puckner1 ,secretary4 ,echinacea ,when this drug was first introduced1 it was a typical nostrum1 with exaggerations regarding its therapeutic value that were somewhat more gross than usual4 ,it was later adopted by the eclectic school without being freed from the stigmata of its origin4 ,it was also pressed into use as the main ingredient of such proprietary preparations as ,echafolta1 ,ecthol ,eusoma1 etc4 ,efforts have been made to get the regular profession to use it in these various forms4 ,according to ,j4 ,u4 ,lloyd 7,pharm4 ,review1 vol4 xxii1 p4 #i-ad71 the introduction of echinacea into eclectic medicine is due to the efforts of ,dr4 ,h4 ,f4 ,c4 ,meyer to increase the sale of ,meyer's ,blood ,purifier1 a secret remedy containing it4 ,the following is a literal copy of the label on this nostrum3 ---------------------------------------- -------------------- ,,meyer',s ,,blood ,,purifier ,,directions ,this is a powerful drug as an ,alterative and ,antiseptic cases3 ,rheumatism1 ,sick ,headache1 ,erysipelas1 ,dyspepsia1 ,old ,sores and ,biles1 ,open ,wounds1 ,dizziness1 ,scrofula and ,sore ,eyes4 ,in case of ,poisoning by ,herbs1 ,c41 take the double dosis1 and ,bites of ,rattlesnakes take three ounces three times a day1 until the swelling is gone4 ,this is an absolute cure within #bd hours4 ---------------------------------------- -------------------- ,after ,lloyd had identified the plant1 ,meyer put the preparation out under another form with the following label3 ---------------------------------------- ---------------------- ,,echinacea ,,angustefolia ,this is a powerful drug as an ,alterative and ,antiseptic in all tumorous and ,syphilitic indications2 old chronic wounds1 such as fever sores1 old ulcers1 ,carbuncles1 ,piles1 eczema1 wet or dry1 can be cured quick and active2 also ,erysipelas4 ,it will not fail in ,gangrene4 ,in fever it is a specific2 typhoid can be adverted in two to three days2 also in ,malaria1 ,malignant1 ,remittent and ,mountain fever it is a specific4 ,it relieves pain1 swelling and inflammation1 by local use1 internal and external4 ,it has not and will not fail to cure ,diphtheria quick4 ,it cures bites from the bee to the rattlesnake1 it is a specific4 ,has been tested in more than fifty cases of mad dog bites in human and in every case it prevented hydrophobia4 ,it has cured hydrophobia4 ,it is perfectly harmless1 internal and external4 ,dose4--,one half to one fluid-drachm #c or #d times a day4 ,manufactured by ,h4 ,c4 ,f4 ,meyer1 ,m4,d4 ,price1 ,pawnee ,city1 ,neb41 ,u4 ,s4 ,a4 ,patent ---------------------------------------- ---------------------- ,these absurd claims of an evidently ignorant man have passed into the more recent proprietary advertising matters and into much of the eclectic writings4 ,indeed1 the seemingly impossible had been attained by even surpassing ,meyer's all-but-all-embracing claims4 ,not content with endorsing echinacea as a positive and speedy 8specific0 for rattlesnake bite1 syphilis1 typhoid fever1 malaria1 diphtheria and hydrophobia1 later enthusiasts have credited it with equally certain curative effects in tuberculosis1 tetanus and exophthalmic goiter1 and with the power of retarding the development of cancer4 ,it is worth noticing--although it is not surprising--that these far-reaching claims have been made on no better basis than that of clinical trials by unknown men who have not otherwise achieved any general reputation as acute1 discriminating and reliable observers4 ,no attempt seems to have been made to verify these claims by accurate scientific methods1 clinical or otherwise1 although this could very easily have been done4 ,not one of the eulogistic reporters and exploiters seems to have considered it worth while to determine by the simplest control experiments whether the drug possesses any bactericidal or antiseptic powers whatever4 ,it is therefore not very strange that discriminating physicians have failed to show much enthusiasm4 ,one of the warmest endorsers of echinacea1 ,c4 ,s4 ,chamberlain 7who later became the president of the ,eusoma ,pharmaceutical ,company71 complains that he has been unable to interest regular physicians in the remedy4 ,he reviews the statements of previous authors and reports eight cases of infection1 only two being acute or extensive1 in which he used it with asserted success4 ,in view of the lack of any scientific scrutiny of the claims made for it1 echinacea is deemed unworthy of further consideration until more reliable evidence is presented in its favor4 ,,references ,meyer1 ,h4 ,f4 ,c43 ,eclectic ,med4 ,jour41 #ahhg2 ,goss3 ,chicago ,med4 ,times1 #ahhh2 ,hages3 ,eclectic ,med4 ,jour41 #ahhh2 ,shelly3 ,medical ,gleaner1 #ahid2 ,lloyd1 ,c4 ,g43 ,eclectic ,med4 ,jour41 #ahig2 ,lloyd1 ,j4 ,u43 ,eclectic ,med4 ,jour41 #ahig2 ,lloyd1 ,j4 ,u43 ,pharm4 ,review1 xxii1 #i-ad2 ,schnitz1 ,elsie ,m43 ,wis4 ,med4 ,recorder1 #ahih1 ii1 #bjb2 ,white1 ,j4 ,n43 ,texas ,med4 ,news1 #ahih1 viii1 #aaj-aac2 ,stinson1 ,j4 ,c43 ,therap4 ,gazette1 #aijj2 ,hale1 ,e43 ,lancet-,clinic1 ,march1 #aija2 ,thielen1 ,b4 ,f43 ,echafolta1 ,its ,uses in ,dental ,surgery1 ,dental ,reg41 #aijc1 vii1 #dfb-dfe2 ,gorse1 ,c4 ,a43 ,new ,albany ,med4 ,herald1 #aijc-d1 xxii1 #chd2 ,chamberlain1 ,c4 ,s43 ,louisville ,monthly ,jour4 ,med4 ,surg41 #aijd-e1 xi1 #bai-bbc2 ,lancet-,clinic1 #aije1 ,m4 ,s41 liv1 #bgi-bhc2 ,ellingwood1 ,f43 ,therap4 ,gazette1 #aije1 #c1 ,s41 xxi1 #bih-cjj2 ,french1 ,j4 ,m43 ,med4 ,brief1 #aije1 xxxiii1 #ecg2 ,mathews1 ,a4 ,b43 ,georgia ,pract41 #aije1 i1 #acg-adj4--7;,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bg1 #aiji47 ,,echtisia1 ,,ecthol ,,and ,,echitone ,report of the ,council on ,pharmacy and ,chemistry ,echtisia 7,wm4 ,s4 ,merrell ,chemical ,co471 ,ecthol 7,battle and ,co47 and ,echitone 7,strong1 ,cobb and ,co47 are proprietary preparations each of which is alleged to contain echinacea as its chief constituent4 ,in #aiji the ,council examined into the claims made for echinacea4 ,this drug has been claimed to be a 8specific0 for rattlesnake bite1 syphilis1 typhoid fever1 malaria1 diphtheria and hydrophobia4 ,enthusiasts have credited it with equally certain curative effects in tuberculosis1 tetanus1 and exophthalmic goiter and with power of retarding the development of cancer4 ,of course there is no reliable or trustworthy evidence to substantiate these claims4 ,echinacea is not often prescribed under its own name1 but is employed as an ingredient in proprietary preparations mixed with other little-used or obsolete substances4 ,thus ,echtisia is said to contain echinacea1 wild indigo1 arbor vitae and poke root2 ,ecthol1 to have echinacea and arbor vitae2 ,echitone1 to consist of echinacea1 pansy and blue flag4 ,naturally the manufacturers of such proprietaries make use of all available optimistic reports in promoting their sale1 while each manufacturer ascribes special and peculiar virtues to the combination represented in his particular preparation4 ,the ,merrell ,chemical ,company claims that baptisia 7wild indigo7 is a 8destroyer0 of devitalizing elements in the blood 8a vitalizer of the blood as well02 that thuja 7arbor vitae7 is a 8perfect antiseptic and a generator of vital force in disorganized tissues10 and that a long list of diseases1 including diphtheria1 syphilitic sciatica and gonorrheal rheumatism1 8are all more or less amenable to full doses0 of phytolacca 7poke root74 ,strong1 ,cobb and ,co4 maintain that ,iris versicolor 7blue flag7 is 8one of the most powerful excitants of the biliary1 salivary and pancreatic secretions10 and that the 8principal sphere of action of ,viola tricolor pansy is in the gastro-intestinal canal and the skin40 ,there is no satisfactory evidence that the claims for any of these substances are any more reliable than those for echinacea4 ,notwithstanding1 ,strong1 ,cobb and ,co4 claim for ,echitone 8not only the virtues of its constituent parts1 but a wider field and a particular therapeutic value of its own02 ,battle and ,co41 maintain that ,ecthol is the 8#8,ideal ,corrector' of depraved conditions of the fluids and tissues10 while the ,merrell ,company urges the virtues of ,echtisia in a list of diseases ranging from acne to appendicitis and from gangrene to rattlesnake bite4 ,the ,council refused recognition to these three products and directed publication of reports to call attention to the exaggerated1 unwarranted and often utterly absurd claims made for these and similar preparations4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #b1 #aiae47 ,,ergoapiol,n ,abstract of ,report of the ,council on ,pharmacy and ,chemistry ,n ,for abstract of report on a similar mixture1 see ,apergols1 p4 #bf2 for unabridged report of the ,council's action on ,apergols and ,ergoapiol see ,reports ,council ,pharm4 and ,chem41 #aiad1 p4 #fd4 ,ergoapiol 7,martin ,h4 ,smith ,co41 ,new ,york7 is a mixture put up in capsules1 each of which is said to contain ,apiol 7,special ,m4 ,h4 ,s47 #e grains ,ergotin #a grain ,oil ,savin #a_/b grain ,aloin #a_/h grain ,examination discloses the fact that1 contrary to the claim made1 each capsule1 instead of containing #e grains of apiol1 really contains some liquid preparation of the type of oleoresin of parsley seed4 ,ergoapiol is recommended 7on the label7 for such diseases as 8,amenorrhea1 ,dysmenorrhea and other ,menstrual ,disorders10 while a circular enclosed in the package contains many suggestions that may be counted on to lead to its indiscriminate and uncritical use4 ,ergoapiol is an unscientific1 shot-gun mixture of drugs having widely different therapeutic effects4 ,where the action of parsley is desired1 the effects of ergot would ordinarily1 be contra-indicated2 furthermore1 neither aloin or savin would be called for in conditions that demanded the effects of apiol4 ,it would be impossible to predict the action of a mixture of this kind in the varying conditions for which its use is advised by the manufacturers4 ,to combine four drugs of dissimilar action in fixed proportions for the routine treatment of conditions which have little in common except that they involve the female generative organs1 is unscientific and absurd4 ,the ,council refused admission to ,ergoapiol4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ab1 #aiad47 ,,erpiol 7,,dr4 ,,schrader7 ,report of the ,council on ,pharmacy and ,chemistry ,the original rules of the ,council governing the acceptance of articles have recently been modified1 particularly by adoption of ,rule #aj1 which reads3 8,unscientific and ,useless ,articles4--,no article will be admitted which1 because of its unscientific composition1 is useless or inimical to the best interests of the public or of the medical profession40 ,in view of these modifications1 the ,council is reconsidering the articles already accepted with the view of determining their compliance with the rules as amended4 ,in line with this the ,council reconsidered ,erpiol 7,dr4 ,schrader71 manufactured by the ,william ,s4 ,merrell ,chemical ,company1 and from the evidence given below concluded that one of the constituents1 gossypin1 is inert and its use unscientific4 ,the ,council therefore voted that ,erpiol 7,dr4 ,schrader7 be omitted from ,new and ,nonofficial ,remedies and authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,erpiol ,in consequence of the more thorough scrutiny now given by the ,council to the therapeutic value of the remedies admitted to ,new and ,nonofficial ,remedies1 the ,council has reconsidered ,erpiol 7,dr4 ,schrader71 previously accepted for ,new and ,nonofficial ,remedies4 ,erpiol 7,dr4 ,schrader7 is the name applied to capsules containing apiol1 ergotin and gossypin1 which are sold as an emmenagogue4 ,the first two ingredients have a recognized value in the treatment of diseases of the female generative organs4 ,the third1 gossypin1 is a preparation from cotton-root bark1 belonging to the somewhat indefinite class of pharmaceutical preparations known as resinoids4 ,cotton-root bark 7,gossypii radicis cortex1 ,u4 ,s4 ,p47 has been credited by some with pharmacologic and therapeutic properties1 similar to ergot1 especially in its action on the uterus2 experiments on pregnant animals do not confirm this view4 ,most authorities on gynecology either make no reference whatever to the drug or ascribe little or no value to it4 ,the preparations from the dried bark are inert4 ,from reports made to him1 ,professor ,j4 ,u4 ,lloyd concluded 7,eclectic ,med4 ,jour41 #ahgf1 xxxvi1 #ede7 that a prime fluidextract of fresh cotton-root bark is an active therapeutic agent and deserving the attention of the medical profession1 while that of the dry bark is inert and worthless4 ,the gossypin on the market is made from the dried bark4 ,professor ,lloyd1 who is considered an authority on eclectic medicine1 says3 8,were it left to me to admit or exclude it1 by reason of its therapeutical position1 ,i should exclude it1 because1 in my opinion1 it has never been demonstrated1 in clinical practice1 to be worthy of any therapeutic recognition whatever40 ,as the available evidence indicates that gossypin is an inert preparation1 ,erpiol 7,dr4 ,schrader7 was considered in conflict with ,rule #aj and the ,council has therefore voted that it be deleted from ,new and ,nonofficial ,remedies4--7,from the ,journal ,a4 ,m4 ,a41 ,june #c1 #aiaa47 ,,false ,,unicorn 7,,helonias7 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council voted to refuse to recognize false unicorn as a non-proprietary article and the following statements1 submitted by a subcommittee1 were ordered published4 ,w4 ,a4 ,puckner1 ,secretary4 ,false ,unicorn-,helonias ,helonias dioica1 or more properly ,chamlirium luteum1 is a plant1 preparations of which enter into various proprietary mixtures for diseases of the female pelvic organs4 ,in the advertisements of these preparations it is usually credited with hemostatic powers and is asserted to be a uterine tonic4 ,there is practically no reference to this drug in reliable medical literature1 and as there is no evidence worthy of credence to support the claims made for it1 the drug was not considered deserving of a place in the ,pharmacopeia4 ,hence1 it may be regarded as a drug not worthy of attention of physicians4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bg1 #aiji47 ,,formurol ,report of the ,council on ,pharmacy and ,chemistry ,formurol1 ,citrocoll and ,aspirophen were submitted to the ,council by the ,cellarius ,company of ,san ,francisco4 ,the manufacturers having failed to substantiate the claims they make for these products1 the ,council has voted that the preparations be refused recognition4 ,the ,council also authorized the publication of the following report1 which deals particularly with one of the preparations--,formurol4 ,w4 ,a4 ,puckner1 ,secretary4 ,formurol is the product of the ,chemische ,fabrik ,falkenberg1 ,falkenberg-,gruenau1 near ,berlin1 ,germany4 ,the ,cellarius ,company1 ,san ,francisco1 acting as selling agents for the ,united ,states1 submitted ,formurol 7along with ,aspirophen and ,citrocoll1 also made by the same firm7 to the ,council1 with the statement that it is 8hexamethylentetraminsodium-citrate10 and that it has the following composition3 8,c#f;,h#g,o#g,na4,c#f;,h#ab,n#d40 ,zernik1#df who examined these products1 reported that ,aspirophen1 ,citrocoll and ,formurol do not have the composition that is claimed for them by the ,fabrik ,falkenberg4 ,formurol1 he states1 is not a definite chemical compound1 but a mixture of hexamethylenamin and sodium citrate4 ,the agents were advised of this fact by the ,council and were asked to submit evidence to substantiate their claims4 ,no such evidence was submitted4 #df ,zernik3 ,arb4 a4 d4 ,pharmazeut4 ,inst4 d4 ,univ4 ,berlin1 #aijg1 iv1 #df4 ,since a compound having the composition that is claimed for ,formurol is theoretically possible1 the ,council requested that the product be examined in the ,association ,laboratory to determine whether it still was the simple mixture reported by ,zernik1 or whether1 perhaps1 it now possessed the formula claimed for it4 ,the following report was made by the ,association chemists3 ,formurol1 as submitted to the ,council1 was in the form of tablets weighing about #a gm4 each and appeared to be composed of a fine white substance interspersed with some transparent particles4 ,the tablets were readily soluble in water1 were odorless and possessed a slightly acid taste4 ,the aqueous solution responded to tests for hexamethylenamin1 citrate and sodium4 ,to determine whether hexamethylenamin was present in the free or the combined state1 the method of ,zernik was employed4 ,this consists in the extraction of ,formurol with chloroform1 which dissolves out hexamethylenamin1 leaving insoluble sodium citrate4 ,as the use of the solvent1 chloroform1 would seem to preclude decomposition of such a hypothetical compound as 8hexamethylenamin-sodium-citrate10 the extraction of hexamethylenamin from ,formurol may be taken to demonstrate its presence in the free state4 ,that ,formurol is not a compound of hexamethylenamin1 but a mixture of hexamethylenamin and sodium citrate1 was further indicated by the appearance of the crushed tablets described above4 ,further1 on the low-power microscope the powder was found to be composed of transparent crystals and white opaque particles which appeared to be masses of minute crystals4 ,when treated with chloroform the transparent crystals dissolved1 leaving the white masses intact1 demonstrating the presence of two distinct substances1 one soluble and the other insoluble in chloroform4 ,it having been demonstrated that the residue obtained by evaporation of chloroform could not be weighed as hexamethylenamin1 due to enclosed chloroform1 the amount of this substance in the residue was determined4 ,the method used has been described in the ,report of the ,chemical ,laboratory of the ,american ,medical ,association1 ,vol4 ,i1 p4 #ee1 and depends on the decomposition of hexamethylenamin by means of sulphuric acid to form ammonium sulphate and formaldehyd4 ,from this solution the ammonia is liberated1 distilled and determined by titration and from the ammonia found the amount of hexamethylenamin is calculated4 ,by this method ,formurol was found to contain 7a7 #ce4db per cent4 and 7b7 #ce4cb per cent41 or an average of #ce4cg per cent4 hexamethylenamin4 ,the residue insoluble in chloroform was shown to consist essentially of disodium hydrogen citrate by determining the amount of sodium 7,na7 contained in ,formurol4 ,the percentage of sodium calculated from the amount of sodium sulphate found was 7a7 #aa4ch per cent4 and 7b7 #aa4bj per cent41 or an average of #aa4bi per cent41 equivalent to #fb4ej per cent4 disodium hydrogen citrate4 ,as a check on this determination1 the amount of material contained in ,formurol which is insoluble in chloroform was determined4 ,it was found to be 7a7 #fc4bc per cent4 and 7b7 #fc4di per cent41 making an average of #fc4cf per cent41 and thus agreeing fairly well with the results obtained when the sodium content was assumed to be disodium hydrogen citrate4 ,from this analysis it appears that ,formurol is not a definite compound of hexamethylenamin and sodium citrate1 but instead is a mixture of these substances consisting approximately of hexamethylenamin #ce4cg per cent4 and sodium acid citrate 7disodium hydrogen citrate7 #fc4cf per cent41 practically a mixture of #a part hexamethylenamin and #b parts sodium acid citrate4 ,these results agree with those reported by ,zernik#dg and show that the product now1 as then1 is not true to claims4 #dg ,therap4 d4 ,gegenw41 ,february1 #aiji4 ,in view of the findings of the laboratory1 it is recommended that ,formurol be refused recognition4 ,as the exploitation of well-known remedies under false and misleading names is detrimental to the progress of medicine1 it is recommended that publication of this report be authorized4 ,editorial ,note3 ,this report illustrates once more the value of the ,council on ,pharmacy and ,chemistry and the ,chemical ,laboratory to the medical profession4 ,before the ,council was organized there was no agency to protect the physician's interests in the matter of pharmaceuticals4 ,under the old rgime ,formurol would have been heralded as a new 8synthetic0 of the most approved made-in-,germany type--and the claims would have gone unchallenged4 ,to-day its status is made clear and the profession is informed4 ,only those who have closely studied the question can realize what a wonderful power for commercial probity the ,council has proved4 ,under the laissez faire system of the past1 many large pharmaceutical firms gave little attention to the accuracy of the claims made for their products4 ,if the advertising gave good 8pulling0 results1 that was all that was asked or expected4 ,within the past five years a wonderful change has taken place in this regard1 and firms of the better class have so modified their advertising as to make it not only conservative in tone1 but to approximate scientific accuracy4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ba1 #aiaa47 ,,gastrogen ,,tablets ,report of the ,council on ,pharmacy and ,chemistry ,the ,bristol-,myers ,co41 ,brooklyn1 ,n4 ,y41 sells ,gastrogen ,tablets which are described as 8,a ,neutralizing ,digestive0 to be 8used in connection with ,sal ,hepatica40 ,sal ,hepatica1 it will be remembered1 is another product of the ,bristol-,myers ,company and has been the subject of previous unfavorable comment4 ,the label on a recently purchased package of ,gastrogen ,tablets contains the following3 8,for gastric distress1 weak stomach and dyspepsia1 one to two tablets after eating2 repeat in half an hour if needed4 8,also indicated in nausea1 flatulence1 sour stomach and heartburn40 ,while these recommendations sound as if they were addressed to the public1 ,gastrogen ,tablets are advertised in medical publications and hence come within the scope of the ,council4 ,gastrogen ,tablets are said to be composed of pepsin1 calcium carbonate1 calcium phosphate and 8aromatics40 ,as each tablet1 according to the label1 contains #g grains of calcium carbonate 7chalk71 the recommended dosage would in most cases be sufficient to neutralize the gastric fluids in the stomach and would thus tend to prevent the pepsin from exerting its digestive effects4 ,the means adopted to relieve one symptom of dyspepsia1 in other words1 defeats the action of the means for relieving the indigestion4 ,the fact is that patients who need an antacid do not need pepsin1 while those who need pepsin will be harmed by the administration of an antacid4 ,gastrologists hold that1 except in rare cases1 the evidence tends to show that wherever there is a sufficiency of hydrochloric acid there is a sufficiency of pepsin4 ,when pepsin is lacking it should be administered along with hydrochloric acid to make it effective4 ,the ,council voted that ,gastrogen ,tablets be refused recognition4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ab1 #aiad47 ,,glyco-,,heroin1 ,,smith ,report of the ,council on ,pharmacy and ,chemistry ,the following report was submitted to the ,council by a referee and publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,glyco-,heroin1 ,smith 7,martin ,h4 ,smith ,co41 ,new ,york7 is marketed in a showy 8patent-medicine0 type of package1 the label on which announces the presence of #a_/b grain of heroin to the fluidounce and admits the presence of #c4e per cent4 alcohol1 an active ingredient that is not discussed in any way in the literature sent out by the manufacturer4 ,the composition of ,glyco-,heroin1 ,smith1 is given as follows3 8,each teaspoonful represents3 ,heroin #a_/af grain1 ,white ,pine ,bark #c-a_/b grains1 ,ammonium ,hypophosphite #c grains1 ,balsam ,tolu #a_/d grain1 ,hyoscyamus #a grain1 ,glycerin ,q4 ,s40 ,the alcohol is not mentioned in the formula4 ,the advertising matter says of the merits of the formula3 8,despite the fact that heroin1 which is universally recognized as an invaluable respiratory sedative1 is a conspicuous element of ,glyco-,heroin1 ,smith1 the other constituents1 henbane1 ammonia hypophosphite1 balsam tolu and white pine bark are factors of no less importance2 indeed1 it is through the concerted action of its several ingredients that the preparation proves so notably beneficial in the class of affections in which it is indicated4 ,the constantly increasing popularity of the preparation in the treatment of respiratory affections is the best adducible evidence of its value in such disorders40 ,the absurdity of this assertion will be appreciated on comparing the nature1 quantities and activities of the several ingredients4 ,thus1 while heroin1 a potent habit-forming drug1 is present in unusually large proportions1 tolu1 an innocuous or comparatively harmless product1 is said to be represented by #a_/d grain1 a relatively small quantity1 hardly sufficient to impart even a distinctive taste or flavor4 ,ammonium hypophosphite1 in the amount said to be present1 may be considered to be practically useless1 while the dose of hyoscyamus1 an additional narcotic1 is fairly large4 ,the white pine bark present is probably as active as would be a corresponding amount of white pine shavings or of turpentine sufficient to give the preparation a slight odor4 ,the vehicle1 glycerin1 is claimed to be 8notably advantageous10 but not a word occurs in the discussion by the manufacturer in regard to the presence of alcohol1 which is certainly quite as active medicinally as the balsam of tolu and contributes fully as much to the flavor or taste of the preparation as does the white pine bark4 ,in prominent type on the outer label of the trade package we are told that the preparation is intended for the treatment of 8,,cough1 ,,asthma1 ,,phthisis1 ,,pneumonia1 ,,bronchitis1 ,,laryngitis1 ,,whooping-,,cough ,,and ,,kindred ,,infections40 ,in much smaller type3 8,glyco-,heroin 7,smith7 is distinctly a product designed expressly for the use of physicians40 ,the circular included with the trade package1 however1 bears statements which would tend to encourage self-drugging by the layman1 and in view of the manner in which the preparation is exploited are undoubtedly intended to do so4 ,for instance3 8,bronchitis4--,in the acute form of bronchitis1 ,glyco-,heroin 7,smith7 acts most happily4 ,it tends to diminish the congestion and inflammation of the lining of the air passages1 relieves the pain and institutes repair4444 8,phthisis4--,in the treatment of the cough of phthisis1 ,glyco-,heroin 7,smith7 is used with the most gratifying results4 ,it checks the night sweats1 acts favorably upon the reflexes1 increases expectoration and induces refreshing sleep4 8,asthma4--,the preparation diminishes the intensity of the paroxysms and lengthens the intervals between their recurrence4 ,by the administration of the preparation1 asthmatic attacks can frequently be aborted4 8,pneumonia4--,in the initial stage of pneumonia1 the preparation exercises a calming1 antipyretic and sedative effect4 ,in the latter stages of the disease1 the analgesic and expectorant properties of the product are well displayed4 8,whooping-,cough4--,administered in doses of from five to ten drops this preparation affords surprisingly satisfactory results4 ,the cough rapidly loses its spasmodic character and the frequency of the paroxysms is considerably diminished40 ,how cruelly misleading the literature put out by the manufacturer of this nostrum is1 will be apparent from a comparison of the rather large dose of heroin in a teaspoonful of the nostrum and the directions on the package that3 8,the adult dose of ,glyco-,heroin 7,smith7 is one teaspoonful repeated every two hours or at longer intervals1 as the case may require4 8,children of #aj or more years1 from a quarter to a half-teaspoonful4 8,children of #c years or more1 #e to #aj drops40 ,a ,,wicked ,,falsehood ,included in much of the advertising matter that has been put out is the bare-faced untruth that the preparation does not produce narcotism or habituation4 ,here is a quotation from an undated circular3 8,glyco-,heroin 7,smith7 is decidedly preferable to preparations containing codeine or morphine1 by reason of the fact that it does not produce narcotism1 constipation1 gastric disturbance nor habituation1 even though its administration be protracted40 ,that this assertion is not in keeping with facts is evidenced by the recent report of a study on the sale and use of heroin made by the ,u4 ,s4 ,department of ,agriculture4 ,from the information gathered it appears that the sales of heroin and heroin-containing preparations have increased greatly1 particularly in those states which have rigid laws preventing the indiscriminate sale of morphin and cocain4 ,investigation of the subject establishes the fact that many drug victims who formerly used morphin and cocain1 and who under the new laws find it difficult to obtain these substances1 have begun using heroin1 the sale of which is not as yet carefully restricted under state laws4 ,the drug is said to be fully as dangerous as morphin1 and by many is held to be much worse1 for the reason that it occasionally kills the victim outright1 and its habitual use is far harder to overcome than that of other drugs4 ,phillips1#dh in discussing the prevalence of the heroin habit1 reports1 among others1 the case of a physician aged #fj who began to take heroin because he suffered from a chronic cough and thought there was no danger of habit from the use of this drug because he believed the statements of various manufacturing firms who claimed that there was no danger of habit4 #dh ,phillips1 ,john3 ,prevalence of the ,heroin ,habit1 ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ad4 #aiab1 p4 #badf4 ,in a pamphlet now being distributed to the medical profession1 entitled1 8,glyco-,heroin 7,smith71 an exposition of its components together with references to its value in the treatment of ,bronchitis1 ,cough1 ,cough of ,phthisis1 ,laryngitis1 ,pneumonia and allied disorders of the ,respiratory ,tract10 the several alleged uses of the nostrum in the treatment of cough1 8,regardless of the nature of its underlying cause1 444 whether of recent origin or of long duration10 are discussed at length1 and eminent practitioners with degrees extending the width of the printed page are quoted in support of the statements made4 ,while it may be permissible for a theoretically trained medical tyro who lays claim to the right of appending the abbreviations ,m4,a41 ,m4,d41 ,d4,c4,l41 ,l4,r4,c4,p4 to his name to laud a heterogeneous habit-forming cough-syrup like ,glyco-,heroin1 ,smith1 similar testimonials from a man entitled to append ,ph4,g41 ,m4,s41 ,m4,d4 to his name makes one doubt the value of the training1 either scientific1 pharmaceutical or medical1 that has been given the poor unfortunate who1 according to his own statements1 indiscriminately doses a female patient of #g and a male patient of #dj with huge doses of heroin every two1 four or six hours4 ,the danger of contributing to the spread of the heroin habit by the use of preparations of this type is indicated by an editorial in ,the ,journal of the ,american ,medical ,association1#di which points out that although heroin and its hydrochlorid have been in use but a few years they have already established themselves among the habit-forming drugs and have become sufficiently conspicuous in this respect to awaken the thinking public to the deplorable results for which they may become responsible4 ,phillips1#a in the article mentioned above1 quotes ,petty1 who reports that in the last #aej cases of drug habit coming under his care he saw eight cases of heroin addiction4 ,three of these were initial cases2 in one the patient had been cured of the opium habit1 but following an operation heroin was prescribed1 and the habit followed4 ,the remaining four patients purposely substituted heroin for morphin1 to which they had been addicted4 #di ,facts about ,heroin1 ,current ,comment1 ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ba1 #aiab1 p4 #bbfb4 ,,the ,,growth ,,of ,,heroin ,,addiction ,the imminent danger of substituting heroin for either morphin or cocain is shown by the fact1 reported by the ,u4 ,s4 ,department of ,agriculture1 that during the early months of #aiac the coroner's office in ,philadelphia ,county1 ,pa41 held inquests on five sudden deaths from heroin poisoning4 ,in each case the victim was a heroin fiend and took an overdose4 ,drug fiends are apparently able to consume relatively large quantities of morphin or cocain1 but any sudden and material increase in the amount of heroin taken is liable to prove fatal4 ,as indicating the wide sale of this substance1 it is known that one druggist in ,pennsylvania whose store is located in an undesirable section of his city has been buying heroin tablets in #be1jjj lots4 ,,glyco-,,heroin1 ,,smith1 ,a 8,,patent ,,medicine0 ,the popularity of ,glyco-,heroin1 ,smith1 as a household nostrum is suggested by the fact that one of the larger department-store type of drug-stores in the city of ,philadelphia lists this preparation in its 8patent-medicine0 catalogue at #a4ge per bottle and sells it freely to all who care to buy4 ,this is due to the fact that ,pennsylvania1 like many other states1 does not include heroin in the prohibited list of habit-forming drugs that can be supplied only on physicians' prescriptions4 ,to what extent ,glyco-,heroin1 ,smith1 is responsible for developing the rapidly growing heroin habit is of course problematic4 ,it is reasonable1 however1 to suppose that a preparation1 each teaspoonful of which contains so large a dose of heroin as does this nostrum1 when taken as repeatedly and as indiscriminately as is directed by the manufacturer1 would offer possibilities for harm sufficient in number to induce the thinking medical practitioner to avoid its use altogether and at least to suggest to even the most commercial dabbler in the healing art the desirability of carefully considering its potency for harm before endorsing its use in the treatment of 8cough and kindred affections40--7,from the ,journal ,a4 ,m4 ,a41 ,june #f1 #aiad47 ,,glyco-,,thymoline ,report of the ,council on ,pharmacy and ,chemistry ,the ,council1 having voted that ,glyco-,thymoline be refused recognition1 authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary ,glyco-,thymoline 7,kress and ,owen ,company1 ,new ,york7 is a typical example of a 8patent medicine0 advertised to the public through the doctors4 ,bottles of the mixture with the name blown in the glass are issued to physicians for distribution to patients1 and the circular which comes around the bottle more or less directly recommends it for use in almost every form of infectious disease4 ,,composition ,,and ,,varying ,,formulas ,different formulas for ,glyco-,thymoline have appeared4 ,at one time it was said to contain3 8,sodium #bd1 ,boric ,acid #d1 ,benzoin #d1 ,acid ,salicylic #j4cc1 ,eucalyptol #j4cc1 ,thymoline #j4ag1 ,betula ,lenta #j4jh1 ,menthol #j4jh1 ,pini ,pumilionis #j4ag1 ,glycerin and solvents1 q4s40 ,another formula1 which appeared about the same time1 was3 8,benzo-,salicyl4 ,sod4 #cc4cc1 ,eucalyptol #j4cc1 ,thymol #j4ag1 ,salicylate of ,methyl from ,betula ,lenta #j4af1 ,pini ,pumilionis #j4ag1 ,glycerin and solvents q4s40 ,a later formula was like the second except that it included 8,menthol1 #j4jh40 ,analysis in the chemical laboratory of the ,american ,medical ,association showed that ,glyco-,thymoline contained borax1 but no boric acid2 sodium salicylate1 but no salicylic acid2 sodium benzoate1 but no benzoin2 the compound benzo-salicyl4 sod4 could not be determined1 but a mixture of sodium benzoate and sodium salicylate was demonstrable4#ej ,later ,puckner pointed out#ea that while such a combination as benzo-salicylate of sodium is known1 it could not possibly be present in ,glyco-,thymoline because the alkalinity of this mixture would decompose the compound4 ,as the manufacturers evidently recognize that false formulas can no longer be made plausible1 only vague statements as to the composition are now offered4 #ej ,the ,formula for ,glyco-,thymoline1 ,pharmacology ,department1 ,the ,journal ,a4 ,m4 ,a41 ,jan4 #i1 #aiji1 p4 #adg4 #ea ,puckner1 ,w4 ,a43 ,rep4 ,chem4 ,lab41 ,a4 ,m4 ,a41 #aiaj1 iii1 #g4 ,two points should be noted in this connection3 #a4 ,glyco-,thymoline conflicts with ,rule #a of the ,council on ,pharmacy and ,chemistry1 which declares that no article shall be accepted for inclusion with ,new and ,nonofficial ,remedies unless its composition be furnished4 #b4 ,no matter which published formula be accepted as correct1 it is at best a weak antiseptic4 ,the antiseptic ingredients present cannot act as germicides in the strength in which they are used1 or in the alkaline solution on the unique virtues of which the circular lays so much stress 78the one antiseptic solution based on the alkalinity and saline strength of normal blood074 ,as shown by ,verhoeff and ,ellis1#eb undiluted ,glyco-,thymoline does not kill ,staphylococcus aureus in four hours4 ,it evidently1 they say1 8could have but little if any greater therapeutic value than sterile salt solution40 #eb ,verhoeff1 ,f4 ,h41 and ,ellis1 ,edward ,keith3 ,the ,bactericidal ,values of ,some ,widely ,advertised ,antiseptics1 ,the ,journal ,a4 ,m4 ,a41 ,june #bi1 #aijg1 p4 #bage4 ,,dangerous ,,recommendations ,in ,diphtheria3 8,case-reports0 in the advertising pamphlet describe the treatment of diphtheria with ,glyco-,thymoline4 ,it is surely unnecessary to point out that1 whatever the possible merits of ,glyco-,thymoline or its ingredients1 they are utterly irrelevant here4 ,but let a 8case-report0 be quoted3 844444444444441 ,m4,d41 states3 #8,i have many an interesting story of ,glyco-,thymoline4 ,i just finished up a family in which ,i was treating five cases of diphtheria--two of which presented diphtheritic membrane in nasal cavity4 ,i decided not to use antitoxin in these cases4 ,i used only the regular constitutional treatment and ,glyco-,thymoline as a local antiseptic4 ,i believe the ,glyco-,thymoline worked wonders4 ,my cases are all now in good health1 with no after troubles4 ,i think it an ideal antiseptic for every trouble in nose and throat4'0 ,words of denunciation fall flat before the complacent self-revelation of the physician who 8decided not to use antitoxin40 ,surely if any other physicians have been misguided by this example1 there must be many another 8interesting story of ,glyco-,thymoline0 to tell--not to speak of other families that have been 8finished up40 ,in ,ophthalmia ,neonatorum3 ,we gain from the same advertising pamphlet the following information on prophylaxis3 8,the treatment in the past has consisted of instillation of silver nitrate1 boric acid1 salts of mercury1 nucleinated salts of silver and mercury1 etc4 4441 but these agents have proved to be failures as an absolute specific4444 ,during the past few months experiments have demonstrated the efficacy of a new mode of treatment that is both rapid and thorough1 and devoid of danger in its use4 ,this method consists of thorough irrigation of the eyes in fully developed cases of the disease with a solution of ,glyco-,thymoline40 ,at the very best1 ,glyco-,thymoline is a weak1 a very weak antiseptic--not a germicide4 ,to assert1 or even to imply1 that it is superior to the well-tried and efficacious ,cred method of treatment for ophthalmia in the new-born is cruelly wicked4 ,in ,consumption3 ,this from the same pamphlet3 8,the indifference of phthisical patients toward the maintenance of sanitary conditions is proverbial4 8,that the environment of all such patients should be absolutely aseptic both for the good of the patient and for the welfare of those who are brought into contact with them is a well-established fact40 ,it is1 instead1 an ill-established fiction4 ,to talk about maintaining an 8absolutely aseptic0 environment under any practical conditions of daily life is to talk nonsense2 the thing is impossible1 even were it desirable4 ,but1 not to be distracted from the main issue by subsidiary falsehoods3 8,in ,glyco-,thymoline we have an antiseptic which1 while mild and soothing 444 is still a powerful agent for promoting asepsis1 and a potent factor in the maintenance of sanitary environment in the sick room4 8,inhaled from a vaporizer or a fine spray atomizer1 it will loosen the mucus in a marvelous manner and in a wonderfully short time1 shorten the paroxysms of coughing to a marked degree1 at the same time reducing the danger of contagion to a minimum40 ,and this is the preparation1 it will be remembered--this 8powerful agent for promoting asepsis0--which1 when applied in undiluted strength1 was unable to kill ,staphylococcus aureus in four hours6 ,it would be a waste of space to cite further evidence to show that the advertising of ,glyco-,thymoline is in conflict with ,rule #f of the ,council1 which provides that no article shall be accepted 8concerning which the manufacturer or his agents make unwarranted1 exaggerated or misleading statements as to the therapeutic value40 ,it is further in conflict with ,rule #d1 against indirect advertising by means of the label1 package or circular accompanying the package4 ,,claims ,,to ,,originality ,hatcher and ,wilbert have pointed out that from a therapeutic point of view the composition of ,glyco-,thymoline is based on the formula of the widely known 8compound solution of sodium borate10 or ,dobell's solution4 ,for the phenol in the original1 a mixture of antiseptic acids and volatile oils has been substituted4 ,,summary ,glyco-,thymoline is in conflict with ,rules #a and #d of the ,council on ,pharmacy and ,chemistry1 because of its indefinite composition and the method of advertising it to the public4 ,it is in conflict with ,rules #aj1 #f and #h1 in that it is an unscientific1 shot-gun mixture sold under unwarranted therapeutic claims and under a misleading name4 ,altogether it must be considered an unscientific heterogeneous mixture1 in which a few valuable ingredients are hidden by the useless shrubbery which surrounds them4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #aj1 #aiad47 ,,glycozone ,report of the ,council on ,pharmacy and ,chemistry1 with ,comments ,a number of specimens of ,glycozone purchased in the open market were examined by a subcommittee4 ,the product was found to be a mixture of approximately #ij per cent4 glycerin1 #e per cent4 glyceric acid1 a small amount of water and traces of undetermined matter4 ,the absence of hydrogen peroxid or other peroxids was demonstrated4 ,in its report the subcommittee held that3 7#a7 ,the name of the product is objectionable and misleading2 7#b7 the statements made in regard to its composition also are misleading2 7#c7 the claims for its therapeutic value are exaggerated and untrue4 ,since the objectionable statements have been given wide publicity among physicians as well as among the laity1 the subcommittee recommended that attention should be called to the matter in ,the ,journal4 ,the report of the subcommittee was adopted by the ,council4 ,w4 ,a4 ,puckner1 ,secretary4 ,comment3--,while the name gives the impression that ozone or some similar substance is an essential constituent of ,glycozone1 or else that the preparation is a compound or derivative of ozone1 and while the earlier advertisements stated that ,glycozone was 8glycerine combined with ozone10 the examination made by the ,council shows that there is no basis of fact for such inferences4 ,in the advertisements the 8chemical formula0 ,c#c;,h#f,o#d ,c#c;,h#h,o#c appears under the word ,glycozone4 ,from the ,council's report it is apparent that ,c#c;,h#f,o#d stands for glyceric acid and the ,c#c;,h#h,o#c for glycerin1 and that these1 therefore1 indicate the chief constituents of ,glycozone4 ,few1 doubtless1 would recognize the first formula as being that of a glyceric acid1 a product practically unknown in medicine1 nor would many associate glycerin with the second4 ,the evident intent is that physicians should accept the formula as a badge of respectability4 ,according to the label on a trade package1 ,glycozone is 8prepared only by ,charles ,marchand1 chemist10 and is 8an absolute cure for dyspepsia1 catarrh of the stomach1 ulcer of the stomach1 heart-burn10 etc4 ,the label further reads3 8,this remedy is positively harmless4 ,by destroying the microbian element in the stomach it prevents the fermentation of food and stimulates digestion40 ,an examination of medical literature fails to reveal any basis for these claims4 ,while glycerin possesses some antiseptic properties1 it is evident that the glycerin which constitutes #ij per cent4 of this remedy is not the agent that gives the glycozone such phenomenal virtues4 ,general literature contains nothing that would indicate that glyceric acid in any quantity1 with or without glycerin1 possesses these miraculous properties4 ,if by 8microbian element0 is meant microbic organisms1 the statement is without foundation4 ,there is nothing in this product which possesses these bactericidal powers4 ,the circular which accompanied a trade package envelops the preparation in an air of mystery4 ,derivation from1 or close relation to1 ozone and hydrogen peroxid is vaguely hinted at1 without definite assertion4 ,thus1 the chief therapeutic properties of glycozone and hydrozone are compared as follows3 8,hydrozone instantly destroys the microbian element1 leaving the tissues beneath in a healthy condition40 8,glycozone acts more slowly1 but not less certain as a stimulant to healthy granulations40 ,illustration3 ,much-reduced photographic reproduction of one of the older ,glycozone advertisements4 ,attention is directed to the false claim that this nostrum is 8glycerin combined with ozone40 ,there is no similarity between the action of hydrozone1 which is a hydrogen peroxid preparation1 and glycozone1 which consists of a mixture of glycerin and glyceric acid4 ,the representation is false and misleading4 ,the following statement1 also1 is an unwarranted exaggeration of the facts3 8,as an internal medication in fermentation of food1 catarrhal and inflammatory conditions of the stomach1 and intestinal disorders1 its action is prompt and effective1 giving immediate relief to the patient40 ,the following is another illustration of the vague statements made3 ,after asserting that ,glycozone is hygroscopic and that it will deteriorate by absorption of water unless securely corked1 it is stated that 8,its healing properties increase with age40 ,whatever mysterious ingredient there may be present in this mixture to justify the statement that the healing properties increase with age can only be conjectured4 ,to humbug the patient further1 the circular advises him to use only a 8silver1 glass or hard rubber spoon40--7,from the ,journal ,a4 ,m4 ,a41 ,june #e1 #aiji47 ,,gardner',s ,,syrup ,,of ,,hydriodic ,,acid ,report to the ,council on ,pharmacy and ,chemistry ,the following report on ,gardner's ,syrup of ,hydriodic ,acid was submitted to the ,council by a subcommittee3 ,this product was first taken under consideration in ,february1 #aijf4 ,reference to several committees was necessary1 on account of the peculiar claims for the pharmaceutical1 and especially the therapeutic1 superiority of this preparation4 ,at this time1 as the ,council did not have the necessary facilities for investigating therapeutic claims1 the product was approved by the ,council4 ,since this time1 however1 the manufacturers have laid especial stress in their advertisements on some highly improbable claims1 stating1 for instance1 that this ,syrup of ,hydriodic ,acid possesses 8all the advantages1 with none of the objectionable symptoms caused by potassium iodid1 or other forms of iodin medication40 ,to one with even an elementary knowledge of chemistry1 the absurdity of this statement should be evident4 ,the alkaline reaction of the tissues makes it impossible that hydriodic acid should persist as such in the body4 ,in fact1 the iodin must circulate in precisely the same form1 whether administered originally as potassium iodid or as hydrogen iodid4 ,the qualitative identity of the therapeutic actions is further proof of this fact1 were such needed4 ,since the most important objectionable symptoms of iodid medication arise after the absorption of the drugs1 and since hydrogen iodid is conceded to be readily absorbed1 it is evident that these symptoms must be equally liable to occur with hydrogen iodid as with potassium iodid1 provided that equivalent doses of iodin are administered4 ,an apparent difference in clinical results would arise if one drug were habitually given in smaller doses than the other4 ,since1 however1 the iodin is present in the body in precisely the same form1 whether it is administered as a hydrogen iodid or potassium iodid1 it is evident that a given degree of therapeutic effect would correspond to an identical tendency to iodism1 whichever drug was used4 ,if1 as appears to be the case1 the use of hydriodic acid is commonly restricted to those cases in which only minimal doses of iodin are required1 the relative infrequency1 or even absence of symptoms with such doses would not prove that the drug itself is less apt to cause them than is the potassium salt4 ,these facts are in reality self-evident2 but since the ,council now has proper facilities for obtaining the views and experiences of clinicians1 it voted to submit the statement in question to its staff of clinical consultants1 and to be guided by their advice4 ,,opinions ,,of ,,the ,,clinical ,,staff ,the following is an epitome of the replies of the eleven members of this staff who had used the article or who expressed an opinion to the questions sent out by the ,council3 #a4 ,,query3 8,do you think it possible that such a preparation could be devoid of the usual effects of iodin preparations80 ,eight reply that they consider this1 a priori1 impossible2 three stamp the statement as highly improbable1 but do not care to say that it would be impossible4 ,one of the correspondents remarks3 8,while distinctly taking the position that under many conditions we must accept clinical results which we find not explainable by our theoretical knowledge1 where the conditions are so simple as in this case and where we know that the iodin1 whether administered as hydrogen iodid or potassium iodid1 must behave in the same way1 after absorption1 ,i believe that no properly educated and correct thinking physician can or will1 after due consideration1 fail to reject the claims of superiority made by the proprietors of this preparation40 #b4 ,,query3 8,would you consider it necessary to make clinical experiments to settle this question80 ,seven of the correspondents consider this superfluous2 four of these have had some experience with the article4 ,four1 who have not used this product1 consider a clinical test advisable4 ,under ,query #c we discuss the results of such tests4 #c4 ,,query3 8,when using ,gardner's ,syrup of ,hydriodic ,acid1 have you ever noticed from it any of the objectionable effects of iodin preparations80 ,six of the correspondents have not used it1 or are uncertain whether or not they used the product made by ,gardner4 ,one correspondent remarks3 8,never used it4 ,repelled by claims of superiority which exaggerate disadvantages of potassium iodid and overlook the small amount of iodin used in the preparation advertised40 ,the five clinicians who have prescribed the preparation report as follows3 #a4 ,objectionable iodin effects in two cases1 both patients being intolerant of all iodin preparations4 #b4 ,has only prescribed it once or twice1 but thinks he has seen iodism in one case1 some years ago2 does not recall clearly4 #c4 ,no2 but has used this make very little1 and then always in very small but continued doses4 #d4 ,no1 always used it in small doses4 #e4 ,yes1 several cases in children2 typical coryza1 etc41 with doses of three drams three times a day4 ,,conclusions3 ,it appears that typical iodism occurred in several cases1 after doses corresponding to #aj grains or less of potassium iodid per day1 and this is a rather limited clinical material4 ,objectionable iodin effects are1 therefore1 not uncommon4 ,several correspondents remark that the relative infrequency of iodism is easily explainable by the fact that syrup is rarely employed in conditions which demand an active iodin medication and that it is1 therefore1 always taken in small doses4 ,in fact1 the main if not the only point of superiority of the syrup appears to be in its flavor4 ,these clinical opinions and experiences1 therefore1 are in complete agreement with the judgment of the committee1 namely1 that the therapeutic claims made by the manufacturers for this article are exaggerated and misleading4 ,,other ,,misstatements ,the above is by no means the only misstatement in the printed matter issued by this manufacturer4 ,in the publication1 8,the ,applications of ,iodin10 issued in #aijg1 there occur the following misleading statements which1 since they refer to plainly chemical facts1 did not require submission to the clinical staff3 ,that the administration of potassium iodid after meals greatly impairs its physiologic action 8by its chemical union with the various food products0 7page #ai74 ,so far as the committee knows1 potassium iodid does not combine with the food products in the stomach4 8,iodid of potassium1 having an alkaline reaction1 neutralizes the hydrochloric acid in the gastric secretions1 causing indigestion1 loss of appetite and depression0 7page #ai74 ,the ,united ,states ,pharmacopeia states1 under ,potassii ,iodidum3 8,its aqueous solution is neutral or has a slightly alkaline reaction on litmus paper40 ,the slight occasional alkalinity would be physiologically insignificant1 and it is absurd to claim that this alkalinity causes 8indigestion1 loss of appetite and depression40 8,the dose of iodid of iron is so small that the amount of iodin contained therein is of little advantage0 7page #ai74 ,as a matter of fact1 the pharmacopeial average dose 7#a c4c47 of the ,syrup of ,iodid of ,iron contains as much iodin 7#j4he grains7 as a teaspoonful of ,gardner's ,syrup of ,hydriodic ,acid 7#j4hc grains74 8,in hydriodic ,acid the iodin is in combination with hydrogen1 one of the elements of the natural secretions of the body1 and is1 therefore1 in physiologic harmony0 7page #ba74 ,no comment is needed4 ,it is implied elsewhere 7page #bi7 that potassium iodid decomposes more readily1 with the liberation of iodin1 than does hydrogen iodid4 ,this is contrary to the prevailing opinion1 and would require definite evidence before it could be accepted4 ,it is also stated the large doses of potassium iodid in syphilis are necessary1 because the gastric decomposition prevents complete absorption4 ,this is certainly untrue1 for potassium iodid is absorbed almost quantitatively4 ,these1 and numerous other misstatements1 constitute violations of ,rule #f2 and it is1 therefore1 recommended that ,gardner's ,syrup of ,hydriodic ,acid be removed from the list of remedies approved by the ,council2 it is further recommended that this report be published4 ,the ,council postponed final action on the report1 pending its submission to ,r4 ,w4 ,gardner4 ,this having been done1 and the reply of ,mr4 ,gardner submitted to the ,council1 the above report was adopted and ordered published4 ,w4 ,a4 ,puckner1 ,secretary4 7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ad1 #aijh47 ,,hyperol ,report of the ,council on ,pharmacy and ,chemistry ,the ,purdue ,frederick ,company1 exploiters of ,gray's ,glycerine ,tonic1 have recently been advertising to the medical profession a nostrum called ,hyperol4 ,the following report to the ,council1 by the referee1 was adopted and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,according to the label1 ,hyperol is 8,a ,utero-,ovarian ,corrective and ,tonic40 ,the circular accompanying the trade package states that it is3 8,indicated in all functional diseases of women such as3 ,amenorrhea1 ,dysmenorrhea1 ,menorrhagia1 ,metrorrhagia1 ,subinvolution1 and in all conditions requiring a utero-ovarian corrective and tonic40 ,from another circular we learn that3 8,hyperol is a combination of ,hydrastine1 ,aloin1 ,iron1 ,apiol and ,ergotin4 ,its components to a certain extent will indicate its action1 but the therapeutic effects of each ingredient seem to be augmented to an unusual degree by use in this particular combination4 ,the proportions of each have been determined by extensive clinical experimentation1 and the formula seems to be exactly balanced to produce the best therapeutic effects in all derangements of the utero-ovarian functions40 ,this 8formula0 is not very enlightening and a physician who wrote for further details was told that ,hyperol contained3 ,hydrastin #a_/dj gr4 ,aloin #a_/ab gr4 ,iron salts #c gr4 ,apiol 7,special7 #c ,ergotin #a gr4 ,and excipients4 ,if this is correct1 then1 so far as its active ingredients are concerned1 ,hyperol is but a mixture of well-known drugs1 having contradictory properties4 ,according to the claims in the circular quoted above1 it is useful both in amenorrhea and in menorrhagia4 ,the mixture is as unscientific as it is unnecessary4 ,it cannot be adapted to any individual case2 when ergot is indicated1 apiol would naturally be contra-indicated2 if aloes is appropriate1 hydrastis may defeat the object sought4 ,it is unnecessary because no intelligent physician would prescribe such a combination of drugs in any given case4 ,the claims are exaggerated1 improbable and foolish4 ,hyperol conflicts with the following rules of the ,council3 ,rule #d1 in that statements on the label and in the circular enclosed with the trade package advertise it to the public in the treatment of diseases4 ,rule #f1 in that exaggerated and unwarranted claims are made for its therapeutic qualities4 ,rule #h1 in that the name of this pharmaceutical mixture fails to disclose the potent constituents4 ,rule #aj1 in that it is unscientific4 ,it is recommended that publication of this report be authorized to call attention to the unscientific character of such complex mixtures4 ,editor's ,note3 ,hyperol is advertised in ,american ,medicine and the ,st4 ,paul ,medical ,journal4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ah1 #aiad47 ,,ingluvin ,report of the ,council on ,pharmacy and ,chemistry ,a subcommittee of the ,council reported that unwarranted claims and misrepresentation were made for ,ingluvin by its manufacturers1 ,william ,r4 ,warner ,co41 recommended that the preparation be refused recognition and that the report be submitted to ,warner ,co4 for action4 ,the report was submitted to the firm1 and after waiting one month and no acknowledgement or reply having been received1 the ,council directed its publication4 ,it is as follows3 ,,report ,,on ,,ingluvin ,ingluvin is manufactured by ,w4 ,r4 ,warner ,co41 chemists1 ,philadelphia1 ,pa4 ,the printed matter contains numerous claims and representations of which the following are specimens3 8,a positive specific for indigestion1 dyspepsia and the most effective remedy in obstinate cases of vomiting of gestation4444 ,a specific for vomiting in pregnancy in doses of from #aj to #bj grains1 and a potent and reliable remedy for the cure of marasmus1 cholera infantum1 indigestion1 dyspepsia1 and sick stomach caused from debility of that organ4 ,it is superior to the pepsin preparations since it acts with more certainty1 and effects cures where they fail4444 ,the natural glycocholic acid in ,ingluvin is the active principle and the most efficient agent in the treatment of all stomachic and enteric disorders40 ,two samples were purchased at different times in the open market and on examination found to consist essentially of powdered meat fiber mixed with what appeared to be a membranous tissue resembling the lining of a gizzard4 ,both samples on being tested by the method prescribed by the ,u4 ,s4 ,pharmacopeia for estimating the strength of pepsin were found to possess little1 if any1 proteolytic activity4 ,in order to determine whether or not the lining of a fowl's gizzard possesses proteolytic action1 a fresh gizzard was secured1 the lining washed slightly with water1 then removed and on using one-half of same in place of pepsin as prescribed by the ,pharmacopeial method1 it was found to digest #aj grams of albumin within the time limit4 ,pepsin1 when properly kept1 does not lose its strength to any material extent4 ,a careful examination was made for the presence of glycocholic acid1 claimed to be the active principle of ,ingluvin1 but its presence could not be established4 ,furthermore1 the anatomic relations of the fowl are such as to preclude its presence4 ,the above shows that ,ingluvin does not possess nearly as much proteolytic activity as ordinary saccharated pepsin recognized by the #ahhj ,pharmacopeia1 which was prepared on the basis of digesting #cjj times its weight of egg albumin4 ,inasmuch as no glycocholic acid is present in ,ingluvin1 it would seem that saccharated pepsin would be far more efficacious in treating the abnormal conditions for which ,ingluvin is recommended in the advertising circulars4 ,furthermore1 the claims made for the preparation are grossly extravagant4 ,a communication from ,warner ,co4 has been received since the above report was adopted1 in which it is stated3 8,the reason that previous letter was not replied to was because we were desirous of securing all the information possible on the subject4 ,since that time we have made considerable research and also made laboratory investigation1 and are enclosing the accumulated data with diagram of a part of the alimentary canal showing the esophagus1 crop and gizzard40 ,much of the other matter submitted is immaterial4 ,the following1 so far as it means anything1 seems to confirm the correctness of the report of the ,council's referee that ,ingluvin is practically devoid of proteolytic activity3 8444 the therapeutic activity must be due to the bitter property1 rather than any proteolytic activity1 and it probably increases1 thereby1 the functional activity of the stomach1 by which the normal digestive process is increased4 ,ingluvin in a #j4d per cent4 hydrochloric acid solution at #cg to #dj ,c4 or if mixed with an aqueous solution of pepsin under the same conditions possesses an acrid1 bitter taste and increases the secretion of the saliva and this is practically the same condition as when in the stomach1 it no doubt stimulates the depressed mucosa peptic glands and increases gastric solution40 ,w4 ,a4 ,puckner1 ,secretary4 ,,comments ,the fallacies attending the use of digestive ferments in most stomach diseases have been previously noted in ,the ,journal4#ec ,in most digestive disorders a deficiency of the digestive ferment has not been proved4 ,in cases in which pepsin is lacking1 its administration is valueless unless it is combined with large doses of hydrochloric acid1 and it is doubtful whether this combination is either necessary or conspicuously useful4 ,there is1 however1 something so alluring about medication by digestive ferments which are assumed to supply a physiologic need1 that since their discovery they have formed a fertile field for the activity of the manufacturer of proprietaries4 ,as by scientific laboratory tests1 it is possible to determine whether a given preparation has digestive power1 the manufacturers of ,ingluvin avoid this point by claiming that the remedy acts1 not on the food1 but on the stomach itself4 ,that remedies may exist which act as stimulants to the digestive secretions can not be denied1 although at the present time this power has not been satisfactorily demonstrated4 ,the proprietors of ,ingluvin1 finding that proteolytic activity is not to be attributed to this preparation of chickens' gizzards1 announce a new therapeutic fact in the claim that 8the natural glycocholic acid in ,ingluvin is the active principle and the most efficient agent in the treatment of all stomachic and enteric disorders4 ,according to the report made to the ,council there is no glycocholic acid in this preparation1 nor is it possible1 from the anatomic arrangements of the fowl's digestive apparatus1 for it to get there4 ,by all the tests which can be applied to determine its value this preparation is of much less value in digestive disorders than saccharated pepsin1 which was discontinued in the ,pharmacopeia because of its inferiority to the other forms of the ferment4 #ec ,feb4 #b1 #aijg1 p4 #dae1 and ,feb4 #i1 #aijg1 p4 #eba4 ,the repudiation1 by the manufacturers1 of the more absurd claims made for ,ingluvin1 shows the need of maintaining an attitude of healthy skepticism toward the advertised therapeutic virtues of proprietary preparations4 ,if a physician is disposed to use digestive ferments1 he should give preference to the official preparations1 and ferments from other sources should be required to stand the exact tests which demonstrate the worthlessness of so many preparations on the market4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #aa1 #aijh47 ,,intestinal ,,antiseptic ,w-,a ,report of the ,council on ,pharmacy and ,chemistry ,the ,council voted that ,intestinal ,antiseptic ,w-,a be refused recognition1 and that the publication of the following report be authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,abbott ,alkaloidal ,company advertises 8,intestinal ,antiseptic ,w-,a0 as 8444 ,a scientifically blended and physiologically adjusted mixture1 of the pure sulphocarbolates of calcium1 sodium and zinc1 grs4 #e1 with bismuth subsalicylate1 gr4 #a-d and aromatics40 ,this formula is in conflict with ,rule #a in that it does not state in what proportion the sulphocarbolates are present4 ,the name 8,intestinal ,antiseptic ,w-,a0 is in conflict with ,rules #d and #h1 since it is therapeutically suggestive4 ,the preparation is in conflict with ,rules #f and #aj1 in that exaggerated claims are made for it1 no evidence being submitted to prove the superior value of the mixture4 ,the most serious of these conflicts consists in the exaggerated and misleading therapeutic claims4 ,the advertisements say3 8,this combination has no equal as an antiseptic and inhibitive agent in typhoid fever1 diarrhea1 dysentery10 etc4 8,numerous cleverly devised and scientifically constructed intestinal antiseptics have been introduced to the profession1 but not one of them has ever rivaled for one moment these salts in popularity40 8444 we are convinced that no small share of the credit for the reduction of the death rate in infantile diarrheas is due to the widespread application of this general method of treatment1 associated of course with the calomel clean-out and the regulation of diet1 now known to be essential40 8,but the use of the sulphocarbolates is not restricted to diseases of the alimentary canal1 although in the summer diarrheas1 gastric fermentation1 intestinal indigestion1 typhoid fever1 dysentery--indeed in all alimentary disturbances--it is the one essential remedy4 ,it is also indicated in practically all infectious diseases40 8,typhoid ,fever 7in this disease the ,w-,a ,intestinal ,antiseptic is of great value2 used early1 with the proper synergistic cleanout1 it will often cut short the disease740 ,these extreme claims exceed the limits of permissible optimism1 unless they are supported by strong dependable evidence4 ,they contrast sharply with the low esteem in which the phenolsulphonates 7sulphocarbolates7 are generally held4 ,to accept these claims1 and to justify encouraging physicians to rely on them1 it would be necessary to establish3 ,first1 that feasible concentrations have a distinct antiseptic action on cultures of intestinal bacteria4 ,this experiment could be easily made1 but the claims do not seem to be based on evidence of this kind4 ,second1 that the preparation actually checks putrefaction in the intestines4 ,there are several methods by which this proof may be attempted2 but the claims do not appear to be based on evidence of this kind4 ,third1 that the preparation actually has a favorable influence on the progress of diseases4 ,this sort of evidence is exposed to so many fallacies that it would have to be gathered very carefully and critically1 duly discounting the effect of other treatment2 for instance1 by comparison with similar cases which do not receive this preparation4 ,this is especially important2 and yet we find directions to use this preparation in conjunction with active cathartic treatment1 which in itself has considerable influence on the conditions for which this preparation is recommended4 ,no evidence of this kind is presented4 ,the testimonials contained in the advertisements cannot be considered as serious evidence4 ,none present any indication of accurate record or proper control of conditions1 or of the performance of control observations4 ,they are superficial impressions1 to which little or no weight can be attached4 ,it is recommended that ,intestinal ,antiseptic ,w-,a be considered ineligible for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ai1 #aiad47 ,,bannerman',s ,,intravenous ,,solution ,report of the ,council on ,pharmacy and ,chemistry ,bannerman's ,intravenous ,solution 7,wm4 ,bannerman and ,co41 ,chicago7 was refused recognition because vague1 indefinite and misleading statements were made regarding its composition1 because it was recommended for anemia1 tuberculosis and syphilis under grossly exaggerated and unwarranted claims and because the intravenous injection of complex and indefinite mixtures is unscientific and dangerous4 ,notice of the action of the ,council having been sent to the ,bannerman ,company1 the firm submitted a revised statement of composition and also a revised advertising circular4 ,the claim is made that ,bannerman's ,intravenous ,solution 8is a compound of only the purest and proven efficient ,u4 ,s4 ,p4 drugs40 ,according to the latest statement3 ,each #aj c4c4 of ,bannerman's ,solution contains3 ,hydrargyri ,albuminas ,mercury ,content #a #a-i ,gr4 or #j4jge ,gm4 ,ferri ,albuminas ,iron ,content #d #a-d ,grs4 or #j4bhf ,gm4 ,sodii ,chloridum #f #a-e ,grs4 or #j4dab ,gm4 ,calcii ,salicylicum #d ,grs4 or #j4bf ,gm4 ,guaiacol #d ,grs4 or #j4bf ,gm4 ,creosote 7,beechwood7 #e ,grs4 or #j4cb ,gm4 ,the solvent is said to be distilled water4 ,the formula is unsatisfactory in several particulars4 ,the stated amounts of some of the ingredients are in excess of their solubility in water2 the nature and amount of albumin contained in the 8,hydrargyri ,albuminas0 and 8,ferri ,albuminas0 are not given2 the claim that the solution contains only ,u4 ,s4 ,p4 drugs is not true4 ,but the main objection to the preparation is its unscientific character and the unwarranted therapeutic claims made for it4 ,even though a patient had all three diseases1 syphilis1 tuberculosis and anemia1 it would be most irrational to use a shotgun prescription1 containing1 in fixed unvarying proportions1 mercury for the syphilis1 iron for the anemia and germicides for the tuberculosis4 ,in syphilis the mercury-content of ,bannerman's ,solution is inadequate2 in anemia the intravenous administration of iron is unwarranted1 and in tuberculosis there is no evidence that the injection of bactericides is efficient4 ,exception must be taken1 moreover1 to the statement that 8its use is absolutely safe40 ,the danger of anaphylaxis from repeated injections of albuminates cannot be disregarded1 and as ,j4 ,f4 ,anderson1 director of the ,hygienic ,laboratory1 has pointed out#ed we know little of the secondary or remote effects of the intravenous injection of toxic substances2 some of them probably do permanent harm4 #ed ,the ,journal ,a4 ,m4 ,a41 ,july #d1 #aiad1 p4 #a4 ,such claims as the following require no comment3 8,it builds up and increases the hemoglobin in the blood4 8,it increases the number of red blood corpuscles4 8,it regulates the white cells4 8,it stimulates cell growth2 therefore1 it is reconstructive4 8,it is a powerful antiseptic4 8,it is useful in any septic condition40 ,in view of the facts given1 the ,council again refused recognition to ,bannerman's ,intravenous ,solution4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #b1 #aiae47 ,,iodalia,o ,abstract of ,report of the ,council on ,pharmacy and ,chemistry ,o ,for the unabridged report of the ,council's action on ,iodalia1 see ,reports ,council ,pharm4 and ,chem41 #aiad1 p4 #fi4 ,iodalia is sold by ,geo4 ,j4 ,wallau1 ,inc41 with the claim that because of the peculiar combination in which it contains iodin it is a valuable and efficient substitute for iodids4 ,the preparation was examined in the ,chemical ,laboratory of the ,american ,medical ,association1 which reported to the ,council that1 contrary to claim1 iodin in the form present in ,iodalia would1 when administered1 act like an ordinary iodid4 ,further the proportion of iodin present was so small that to administer the equivalent of #bj grains of potassium iodid it would be necessary to give the contents of a one-dollar bottle of ,iodalia4 ,in view of this report it is evident that the claim that ,iodalia is 8always well tolerated0 and that it cannot produce 8symptoms of iodism0 is true only because of the small percentage of iodin it contains4 ,the claims made in the advertising matter1 that ,iodalia is an efficient iodin medication in the treatment of syphilis1 that it is a suitable substitute for cod-liver oil and that it may be used in anemia1 dysmenorrhea1 dyspepsia1 malaria and diseases of the heart1 are entirely unwarranted4 ,iodalia is exploited in a way to suggest its use to the public for a host of diseases4 ,particularly reprehensible are the recommendations contained in a circular which accompanies the trade package that ,iodalia3 8444 offers the same protection against grippe1 bronchitis1 pneumonia1 tuberculosis1 pleurisy and other infectious diseases that vaccine does against small pox 4440 8,it is also the best preventive against the slight infections and ailments to which debilitated and delicate children are subject40 ,the ,council voted that ,iodalia be refused recognition4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ab1 #aiad47 ,,iodex ,report of the ,council on ,pharmacy and ,chemistry ,iodex is manufactured by ,menley and ,james1 ,ltd41 ,new ,york4 ,it is advertised as 8444 an embodiment of vaporized iodin in an organic base1 reduced and standardized at #e per cent4 by incorporation with a refined petroleum product40 ,the advertising conveys the impression that the effects of free iodin are to be obtained from the preparation2 it is said to contain 8#e per cent4 ,therapeutically ,free ,iodine10 and to do 8444 everything the doctor expects of ,,free iodin employed by inunction1 without one physical or therapeutic drawback40 ,the statements are also made that the preparation 8neither stains1 irritates1 blisters or cracks the skin10 and that 8thirty minutes after inunction iodin can be found in the urine40 ,the following report of an examination made by the ,chemical ,laboratory of the ,american ,medical ,association has been submitted to the ,council3 8,iodex is dark green1 practically black4 ,the green color is apparent when the ointment is rubbed on the skin1 but disappears on continued rubbing4 ,this nonstaining property is explained by the results of a test for free iodin1 made on five specimens1 four of which yielded only minute traces of free iodin1 while the fifth yielded none4 ,of course1 the statements that ,iodex is an #8,effective ,free ,iodin ,application ,without ,drawbacks' and also a means of #8,really ,efficient ,external ,iodine ,therapy ,without ,stain or ,irritation' contradict each other4 ,free iodin cannot be present in a sufficient quantity to be therapeutically efficient in any application which does not stain or irritate the skin4 8,the total iodin content of the five specimens was found to be #b4fc per cent4--a little over one-half of the content claimed4 8,absorption and excretion experiments were performed to test the claim that #8thirty minutes after inunction iodin can be found in the urine4' ,in several subjects1 from #a to #b gm4 of ,iodex was rubbed on the skin of the forearms1 and the urine1 for periods varying from seven to seventy-two hours1 was collected and tested for iodin4 ,in all of the tests the results were negative40 ,iodex is advertised as beneficial in muscular soreness1 sprains1 sciatica1 neuritis1 chronic rheumatism1 enlarged glands1 orchitis1 epididymitis1 gout1 burns and dermatomycoses4 ,it is also said to be 8,indicated in ,glandular ,enlargements1 ,inflammatory ,conditions1 ,various ,joint ,diseases1 ,rheumatism1 ,skin ,diseases1 ,chilblains1 etc41 etc40 ,to sum up3 #a4 ,as shown in the foregoing laboratory report1 the composition is incorrectly stated1 for the actual iodin content is only about half of that claimed4 #b4 ,it is not true that the action of ,iodex is essentially that of free iodin1 which is the impression conveyed by the advertising4 #c4 ,the assertion made in the advertising1 that iodin may be found in the urine shortly after ,iodex has been rubbed on the skin1 has been experimentally disproved4 ,in view of these findings1 the ,council voted that ,iodex be refused recognition for conflict with ,rules #a1 #d and #f4--7;,from ,the ,journal ,a4 ,m4 ,a41 ,june #ai1 #aiae47 ,,iodia ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,iodia was adopted by the ,council and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,iodia is put on the market by ,battle and ,company1 under the claim that it contains potassium iodid in combination with iron phosphate and vegetable 8principles40 ,it is extravagantly recommended for use in many and varied conditions4 ,for instance1 it is 8an unexcelled altero-reconstructive10 8almost a specific0 in eczema and rheumatism and 8a highly efficient form of iodin10 which will not produce iodism6 ,the therapeutic effects of iodids result from a chemical transformation by which molecular iodin is set free in the tissues1 thus producing a mild degree of iodism4 ,it follows1 then1 that a preparation which cannot give rise to the symptoms of iodism cannot be expected to produce the therapeutic effects of the iodids4 ,the claim that ,iodia is therapeutically efficient without producing iodism therefore justifies suspicion1 to put it mildly4 ,in view of the exaggerated tone of the advertising1 together with the fact that a report from the ,chemical ,laboratory of the ,american ,medical ,association showed marked discrepancies between the formula and the composition of ,iodia1 it seemed desirable to investigate this product4 ,the report of the laboratory1 which is given below1 shows conflict with ,rule #a 7secrecy of composition7 and with ,rule #b 7false claims of standardization74 ,a discussion of the claims made for ,iodia follows the report4 ,,laboratory ,,report ,the composition of ,iodia is given thus3 8,formula4--,iodia is a combination of active principles obtained from the green roots of ,stillingia1 ,helonias1 ,saxifraga1 ,menispermum and aromatics4 ,each fluid drachm also contains two and one-half grains ,iod4-,potas4 and one and one-half grains ,phos4-,iron40 ,we are told that3 8,its several ingredients are selected with scrupulous care1 and the most exacting methods are constantly employed to insure absolute uniformity and maximum therapeutic potency40 ,this 8formula0 is an absurdity3 ,first1 the amounts of the 8active principles0 of the plants named are not given2 second1 these 8principles10 with the possible exception of menispermum alkaloids1 have not been isolated2 and1 third1 ferric phosphate and potassium iodid are incompatible6 ,incidentally1 there are no methods whereby it is possible to secure 8absolute uniformity0 of a mixture such as ,iodia is claimed to be4 ,qualitative tests demonstrated the absence of iron and the absence of all but traces of phosphorus compounds 7#j4jae gm4 phosphorus per #ajj c4c474 ,minute traces of alkaloids1 possibly from menispermum1 were found 7that amount being about #j4jjd gm4 per hundred c4c4 of the preparation74 ,therapeutically this quantity is entirely negligible4 ,determinations of iodid demonstrated the presence of only about #fj per cent4 of the amount of potassium iodid claimed4 ,the 8formula0 for ,iodia is false and misleading4#ee #ee ,it should be noted that the discrepancies here reported between the actual and the claimed composition of ,iodia were pointed out more than thirty years ago by ,a4 ,b4 ,lyons 7,detroit ,lancet1 ,october1 #ahhb1 vi1 #aeg-h71 who found that ,iodia was deficient in iodid content and practically free from iron4 ,,dangerous ,,recommendations ,one of the ,iodia labels reads3 8,,indications4--,syphilitic1 scrofulous and cutaneous diseases1 dysmenorrhea1 menorrhagia1 leucorrhea1 amenorrhea1 impaired vitality1 habitual abortion and general uterine debility40 ,such recommendations are likely to lead to self-drugging in conditions that are not only dangerous to the individual but also a menace to the community4 ,the preparation thus conflicts with ,rule #d of the ,council4 ,after admitting the need of efficient iodid medication in certain stages of syphilis and after exaggerating the frequence and severity of symptoms of iodism1 an advertising circular entitled 8,practical ,therapeutics0 asserts3 8,iodia then is the preparation of iodid of potassium to be preferred whenever it requires to be administered in large doses or for prolonged periods of time444 8,not only does the association of the iodid of potassium with the vegetable alteratives offer a measure of protection against iodism but the latter exert depurative effects on their own account 4440 ,it is generally accepted that in certain stages of syphilis the only hope of success lies in efficient iodin medication4 ,the exploiters of ,iodia state that a dose of the nostrum contains #b-a_/b grains of potassium iodid2 actually it contains only #a-a_/b grains4 ,to urge physicians and the public to depend on this product for efficient iodid medication constitutes an unwarranted therapeutic exaggeration 7,rule #f7 which approaches criminality4 ,the reason ,iodia does not produce iodism is that1 in the doses recommended1 the iodin action is extremely feeble4 ,likening the human body to a factory and discussing the 8break downs0 which are likely to occur1 a circular entitled 8,always ,trustworthy0 says3 8,when administered in proper dosage1 ,iodia stimulates organic functions1 promotes the elimination of waste products1 and re-establishes metabolic activity4 ,it increases the solvent properties of the blood1 and arrests abnormal tissue metamorphosis4 ,in other words1 it lends material assistance to weakened cells and curbs those unduly active4 ,iodia1 obviously1 has a wide range of indications4 ,it has been most generally and successfully employed1 however1 in ,syphilitic1 ,scrofulous and ,cutaneous ,diseases1 ,rheumatic and ,gouty ,ailments1 ,dysmenorrhea1 ,menorrhagia1 ,leucorrhea1 ,amenorrhea1 ,impaired ,vitality1 ,habitual ,abortion and ,general ,uterine ,debility1 and wherever a reliable altero-reconstructive is required40 ,these recommendations show that in addition to the objections already given1 this nostrum is an unscientific shot-gun mixture4 ,this brings it in conflict with ,rule #aj 7unscientific articles inimical to the medical profession and the public74 ,it is recommended that ,iodia be refused recognition4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ba1 #aiad47 ,,burnham',s ,,soluble ,,iodine,p ,report of the ,council on ,pharmacy and ,chemistry ,p ,see also ,burnham's ,soluble ,iodine1 p4 #bcc4 ,the ,council has authorized publication of the following report on ,burnham's ,soluble ,iodine4 ,w4 ,a4 ,puckner1 ,secretary4 ,burnham's ,soluble ,iodine is offered to the medical profession by the ,burnham ,soluble ,iodine ,company1 ,auburndale1 ,mass41 under the claim that by 8444 a new process hitherto unknown to chemistry1 444 ,iodine is converted into a soluble article--soluble in water and soluble in gastric secretions and in the tissues40 ,beyond this no statement as to the qualitative or quantitative chemical identity of ,burnham's ,soluble ,iodine is furnished2 this secrecy1 of course1 has given the preparation a certain mysterious prestige among unthinking physicians4 ,burnham's ,soluble ,iodine was examined in the ,chemical ,laboratory of the ,american ,medical ,association some six years ago and was found to be an alcoholic solution of free iodin 7approximately #c gm4 per hundred c4c47 and combined iodin in the form of iodid 7equivalent to about #b gm4 of potassium iodid per hundred c4c474 ,thus the total iodin content was somewhat less than half of that of the official ,tincture of ,iodin 7,tr4 ,iodi71 which contains #g gm4 of free iodin and #e gm4 of potassium iodid to each #ajj c4c4 ,the official tincture1 diluted one-half1 therefore1 would be essentially equivalent to the ,burnham preparation1 both being miscible with water4 ,the ,burnham ,soluble ,iodine ,company objected to the conclusions drawn1 from this analysis1 but admitted the correctness of the analysis itself4 ,any one who gathered his first knowledge of the subject from the ,burnham advertising might readily infer that no soluble iodin had been known prior to ,burnham's ,soluble ,iodine4 ,this1 of course1 is not the case2 the method of producing a solution of iodin by the use of an iodid has long been known4 ,the following statement is not only obviously untrue but also nonsensical3 8,in all the history of iodin medication1 covering a period of laboratory research of many years duration1 every effort to produce a free iodin1 prior to the evolution of ,burnham's ,soluble ,iodine1 was attended by failure40 ,the company lays stress on the assumed superiority over the iodids of a preparation containing free iodin4 ,this assumption is based on a fallacy4 ,those who regard free iodin as superior to combined iodin forget that free iodin taken by the mouth is converted in the intestines1 by the action of the alkaline intestinal secretions1 into an iodid with a small amount of iodate1 while administered intravenously 7a procedure that1 while advocated by the ,burnham concern1 is therapeutically indefensible71 it enters into combination with the alkaline salts and proteins of the blood4 ,the free iodin in ,burnham's ,soluble ,iodine must act in the system as an iodid1 and the whole iodin content1 to furnish a correct estimate of the value of the preparation1 should be reckoned as an iodid4 ,bearing this in mind1 then1 it is evident that the doses of ,burnham's ,soluble ,iodine recommended by the manufacturers are extremely small4 ,they range from #bj minims 7equivalent to #a grain of potassium iodid7 to #a_/b minim 7equivalent to #a_/dj grain of potassium iodid74 ,from #e to #bj minims 7equivalent to about #a_/d to #a grain of potassium iodid7 is the dosage recommended for syphilis2 from 8#a to #c minims equivalent to from #a_/bj to #c_/bj grain of potassium iodid three to six times daily0 for typhoid and other intestinal diseases4 ,no wonder the exploiters can say that this nostrum does not irritate the intestines1 that it is 8non-irritating to the weakest stomach0 and that there is an 8entire absence of toxic action from maximum doses06 ,its alleged freedom from the irritating and untoward effects of ordinary iodids is due1 not to any inherent superiority of the preparation1 but to the insignificant amount of iodid present4 ,the preparation is advertised for use in an extremely wide range of diseases1 in some of which iodid therapy is recognized as of value1 while in others it is generally regarded as either worthless or harmful4 ,given orally or intravenously 7the recklessness of the latter method should again be emphasized7 ,burnham's ,soluble ,iodine is claimed to be of3 8444 great utility as an internal antiseptic in tubercular affections 4440 ,since1 as previously explained1 free iodin1 when introduced into the body1 enters into chemical combination before it has a chance to permeate the tissues1 and since the alkali iodids possess very slight 7in fact1 for this purpose1 negligible7 antiseptic powers1 it is evident that this claim is unfounded4 ,so1 for the same reason1 is the claim that 8as an intestinal antiseptic10 ,burnham's ,soluble ,iodine is3 8444 efficient in ,typhoid ,fever1 ,enteritis and other intestinal diseases40 ,it is recommended in exophthalmic goiter1 notwithstanding that this condition is generally recognized as contraindicating the administration of iodids1 which excite the action of the thyroid gland1 and which therefore must be used with great circumspection4 ,an especially indefensible recommendation is that #a_/b minim of ,burnham's ,soluble ,iodine 7equivalent to #a_/dj grain of potassium iodid7 be administered every five minutes in 8membranous croup0--diphtheria--until relief from dyspnea is obtained4 ,but1 of all the extravagant claims made for this preparation1 perhaps the following is the most reprehensible3 8,in the treatment of ,phthisis1 in its various forms1 clinical evidence clearly indicates that the use of ,,soluble ,,iodine affords the most potent method of treatment available4 ,dose--#b minims1 increasing to #e minims in four ounces water before meals40 ,remove the mystery and tell physicians that a dose of #a_/aj or #a_/d of a grain of potassium iodid is 8the most potent method of treatment available0 in tuberculosis and the absurdity becomes self-evident4 ,nor is this the worst feature of the advice here offered4 ,iodin1 by combining with the fatty acids of tuberculous tissues1 promotes their autolysis and consequently their softening and breaking down4 ,the products of this autolysis are carried by the lymphatics to healthy tissues and thus may spread the infection4 ,therefore the use of iodids in tuberculosis1 even in small dosage1 should not be undertaken lightly4 ,it is recommended that ,burnham's ,soluble ,iodine1 a semi-secret preparation1 exploited by means of extravagant and dangerous therapeutic claims1 be held ineligible for admission to ,new and ,nonofficial ,remedies1 and that this report be published4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ae1 #aiae47 ,,iodotone,q ,abstract of ,report of the ,council on ,pharmacy and ,chemistry ,q ,for the unabridged report of the ,council's action on ,iodotone1 see ,reports ,council ,pharm4 and ,chem41 #aiad1 p4 #gb4 ,eimer and ,amend1 ,new ,york1 who market ,iodotone1 state that it is a solution of hydrogen iodid 7hydriodic acid7 in glycerin1 containing #a grain of iodin to each fluid dram4 ,the unwarranted assertion is made that ,iodotone 8444 will produce the constitutional effect of iodine in a shorter time than other preparations 4440 ,this cannot be true1 for it is certain that1 because of the alkaline reactions of the tissues1 iodids1 whether administered as hydrogen iodid or as alkali iodids1 must circulate in precisely the same form and therefore exert the same therapeutic effects in precisely the same way4 ,eimer and ,amend further assert that the ordinary iodids may to advantage be replaced by ,iodotone4 ,the absurdity of this claim is apparent when it is considered that it will be necessary to administer nearly one fluidounce of glycerin to obtain an amount of ,iodotone equivalent to a #aj-;grain dose of potassium iodid4 ,the additional claim that ,iodotone will not disturb the stomach or produce the usual disagreeable symptoms of iodism is evidently unwarranted1 for it is generally conceded that symptoms of iodism can be avoided only at the risk of insufficient iodin medication4 ,because of these unwarranted and misleading claims and because the name ,iodotone would tend toward the uncritical use of the preparation as a general tonic1 the ,council voted that ,iodotone be refused recognition4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ab1 #aiad47 ,,iosaline ,report of the ,council on ,pharmacy and ,chemistry ,iosaline is a rheumatism remedy for external application4 ,in view of the misleading and unwarranted claims which are made for it1 the ,council voted that ,iosaline be refused recognition and recommended publication of the ,committee's report which appears below4 ,w4 ,a4 ,puckner1 ,secretary4 ,,committee',s ,,report ,the following sweeping but rather indefinite claims are made for ,iosaline4 8,iosaline is a penetrator and overcomes the objectionable escharotic properties of ,iodine2 it is readily absorbed and may be used without discomfort or discoloration40 8,the strong analgesic properties of ,iosaline make it especially useful in controlling pain in cases of ,neuralgia1 ,rheumatism1 ,gout1 and ,arthritis ,deformans40 ,as there are few1 if any1 known iodin compounds which are 8readily absorbed0 through the skin and which will not at the same time produce discoloration or discomfort1 it was thought worth while to take up the examination of ,iosaline4 ,the results of this examination are reported by the ,chemical ,laboratory of the ,association as follows3 ,laboratory ,report3--,iosaline is advertised by the ,iosaline ,company of ,new ,york1 as a remedy for the treatment by external application1 of rheumatism1 gout1 neuralgia1 pneumonia and numerous other diseases4 ,concerning its composition the following statements are made3 8,a transparent1 non-staining gelatinoid of combined iodine with menthol and methyl salicylate4 8,alcohol #jgj4 per cent4 8,chemical tests demonstrate the preparation to contain #e per cent4 of iodine40 ,the placing of a cipher before the percentage figure for alcohol1 though perhaps accidental and not meant to mislead1 might cause a hasty or careless reader to understand #g per cent4 or 4#jg per cent41 instead of #gj per cent41 as the proportion of alcohol present4 ,the preparation examined was a very pale yellowish1 translucent solid having a strong odor of methyl salicylate and a fainter odor of menthol4 ,a package sold for #b ounces contained #ea4g gm4 ,qualitative tests indicated the presence of alcohol1 an iodid1 menthol1 methyl salicylate1 potassium1 sodium1 combined fatty acids and a trace of glycerin4 ,thyroid extract was not found4 ,quantitative examination indicated the following approximate composition for ,iosaline3 ,alcohol 7by weight7 #dh4je per cent4 ,menthol #b4jg per cent4 ,methyl salicylate #aj4be per cent4 ,potassium iodid 7#d4be per cent4 iodin7 #e4ee per cent4 ,soap #ab4fh per cent4 ,glycerin a trace ,water and undetermined matter to make #ajj per cent4 ,iosaline1 therefore1 appears to be a solidified1 watery-alcoholic solution of soap containing potassium iodid1 menthol and methyl salicylate4 ,physiologic tests carried out by rubbing the preparation on the skin and afterward testing the saliva and the urine for an iodid indicated that none of the potassium iodid is absorbed4 ,since ,iosaline is claimed to contain #gj per cent4 of alcohol and #e per cent4 of iodin1 the alcohol content is but #fh4g per cent4 and the iodin content but #he per cent4 of the amounts claimed4 ,the phrase 8combined iodin0 is evidently meant to mislead1 and adds the element of mystery on which preparations of this class rely so largely4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #ae1 #aiac47 ,,nourry ,,wine,r,s ,abstract of ,report of the ,council on ,pharmacy and ,chemistry ,r ,for the unabridged report of the ,council's action on ,nourry ,wine1 see ,reports ,council ,pharm4 and ,chem41 #aiad1 p4 #gd4 ,s ,for reports and articles on other acetanilid mixtures1 see pp4 #i1 #bdd1 #bfh1 #cje4 ,nourry ,wine 7,e4 ,fougera and ,co41 ,new ,york7 is a proprietary iodin preparation said to contain #ab per cent4 of alcohol and #a-a_/b grains of iodin in combination with tannin to the fluidounce4 ,experiments made in the ,a4 ,m4 ,a4 ,chemical ,laboratory demonstrate that the iodin contained in ,nourry ,wine is present either in the form of iodid ions or in a form very readily yielding iodid ions and that therefore its action will be that of ordinary iodid4 ,yet a circular asserts3 8,the ,nourry ,wine is the one preparation 444 able to introduce into the organism the active metalloid liberated little by little from the organic combination44440 ,while ,nourry ,wine contains but an insignificant proportion of iodin1 the circular claims that 8,nourry ,wine presents a high dose of iodin40 ,further1 the label on ,nourry ,wine and the circular which is wrapped with it suggests its use in a number of diseases in which iodin medication is considered of minor importance4 ,these recommendations1 bolstered up by testimonials from twelve to twenty-five years old1 are likely to lead the public if not the medical profession to use this weak iodid wine where efficient treatment is called for4 ,the attempt is made to give a further false value to ,nourry ,wine in the minds of those who prize everything that is foreign by the suggestion that it comes from ,france when in reality it is made in ,new ,york4 ,in conclusion the ,council held that1 though the alcohol of the wine is the most potent constituent1 the constant use in the advertising matter of the term 8,nourry ,wine10 unqualified by the adjective 8,iodinated10 was mischievous as likely to lead to the thoughtless use of the preparation in cases unsuitable for iodin medication4 ,the ,council refused recognition to ,nourry ,wine4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ab1 #aiad47 ,,labordine ,a ,report by the ,council and ,some ,pertinent ,comments ,added ,thereto ,the following report was submitted to the ,council on ,pharmacy and ,chemistry by the subcommittee which examined ,labordine3 ,to the ,council on ,pharmacy and ,chemistry3--,your subcommittee presents the following report on ,labordine1 sold by the ,labordine ,pharmacal ,co41 ,st4 ,louis4 ,labordine is advertised to physicians as having the following composition3 ,apium ,graveolens 7true active principle7 8,process-,laborde0 #ce-c_/h ,gaultheria ,fragrantissima 7true active principle7 8,process-,laborde0 #be-a_/h ,acete ,amide-,phenyle #ae-a_/h ,quinina #a-a_/h ,benzoyl-,sulphyonic-,imide #bc-a_/d ,it is stated to be a 8vegetable antipyretic02 that 8it reduces temperature without heart depression10 and physicians are warned to 8avoid acetanilid poisoning and danger from other coal-tar antipyretics40 ,illustration ,while the 8formula0 and the statement just quoted are sufficient evidence of the fraudulent character of the product1 yet an abstract of the reports of the chemists who analyzed it is given further to demonstrate its character4 ,taking the average of the reports of analyses1 labordine contains3 ,acetanilid #cg4i ,free salicylic acid #f4i ,quinin present ,corn starch present ,milk sugar #cd4g ,this report of analysis only makes apparent that ,labordine is not what it is claimed to be4 ,while it is claimed to contain #bc-a_/d per cent4 saccharin1 this substance was not present1 or mere traces only4 ,while1 in a disguised way1 it is stated to contain #ae-a_/h per cent4 acetanilid1 it contained nearly #dj per cent4 ,it is recommended that ,labordine be not approved and that this report be published4 ,the recommendation of the subcommittee was adopted by the ,council1 and in accordance therewith the above report is published4 ,w4 ,a4 ,puckner1 ,secretary4 ,,comments ,a concrete illustration of some general principles previously laid down is furnished by a nostrum too unimportant to be of any value1 save to 8point a moral and adorn a tale40 ,about thirteen years ago ,labordine was advertised under the name of ,analgine-,labordine1 8,a purely vegetable product10 8a combination of the active principles of ,camellia ,thea1 ,apium ,graveolens1 saccharin and carbohydrates10 8,superior to ,antipyrine1 ,phenacetine1 ,antifebrine1 ,acetanilid0--note the use of two names for the same thing--8or any of their imitations10 and 8unexcelled by any coal-tar product or their compounds40 ,in #ahid the name was changed to ,labordine1 in order1 as its owner stated1 to prevent its being mistaken for a coal-tar product of similar name4 ,what its composition was at this time we do not know1 since there is no guarantee of the permanence nor stability of nostrum formulas except 8the honor and reputation of the manufacturers10 which1 as investigation has shown1 is not always unimpeachable4 ,there has been nothing to prevent alteration of the formula1 if the proprietors desired1 with every change in the moon4 ,but the name and the general tone of the advertising has been the same4 ,the claim of superiority over coal-tar products has been constantly made4 ,as to the present conditions1 a circular enclosed with a sample of ,labordine1 recently sent from the ,st4 ,louis office1 contains the formula given above in the report of the ,council4 ,in the same circular are also found these illuminating statements3 8,the medical profession has long appreciated the dangers involved in the administration of various mineral remedies now so commonly employed1 and the value of a safe1 effective and reliable vegetable antipyretic is universally recognized4 ,such a remedy is ,labordine4 ,it is purely vegetable in its composition and produces none of the evil after-effects of the coal-tar derivatives4444 ,labordine 444 is a purely vegetable cardiac stimulant4444 ,there is nothing mysterious about ,labordine or its constituents4444 ,the #8,process-,laborde' gives the true active principles of the ,celery and ,indian ,wintergreen1 something heretofore difficult to obtain4 ,to this is added the fact that absolutely chemically pure ,acet-,amide-,phenyle is used4 ,the latter is the most valuable and1 in fact1 the only vegetable antipyretic known40 ,the above report of the ,council shows the following facts3 #a4 ,apium ,graveolens 7true active principle71 8,process-,laborde0 is probably powdered celery seed4 ,one chemist says3 8,the powder has the characteristic odor of celery1 while a microscopic examination shows the presence of a substance having the characteristic structure of seeds in general40 ,if celery seed has any 8active principle0 it has never been isolated4 ,as to its therapeutic value1 nothing whatever is known4 ,it is1 we understand1 highly beneficial in the case of singing canaries1 but authorities in scientific therapeutics have never discovered that it possessed any remarkable medicinal qualities4 #b4 ,gaultheria ,fragrantissima 7true active principle71 8,process-,laborde10 is probably ordinary everyday salicylic acid4 ,one analysis showed salicylic acid to be present to the amount of about #g per cent4 ,the question of whether or not salicylic acid could in any way be considered the 8true active principle0 of ,gaultheria ,fragrantissima1 was submitted to ,prof4 ,john ,uri ,lloyd of ,cincinnati1 the eminent authority on the chemistry of the proximate principles of plants1 who replies3 8,the advertisement is evidently so worded that1 although the name of the ,indian plant ,gaultheria ,fragrantissima is employed1 its true and active principle being wintergreen oil1 the concoctor can mystify his patrons and at the same time use the well-known wintergreen oil1 made in ,america1 which in my opinion1 so far as any chemical test might be concerned1 could not be distinguished from the methyl salicylic acid 7wintergreen oil7 derived from the ,indian plant4 ,concerning whether salicylic acid is a proximate constituent of ,gaultheria ,fragrantissima1 in my opinion1 it would be a misnomer to make such an announcement4 ,salicylic acid1 per se1 does not exist1 in my opinion1 in the plants mentioned1 being made by chemistry40 #c4 ,the third and most important ingredient in this 8purely vegetable antipyretic0 is brazenly announced as 8,acet-,amide-,phenyle10 but it is only necessary to say that this imposing designation is an attempt to 8,frenchify0 a scientific name for acetanilid4 ,analysis shows that this coal-tar product is present to the amount of #cg4i per cent41 or #a4hi grains in a #e-;grain tablet4#ef ,in other words1 this imposing ,labordine1 made by a mysterious and elsewhere unheard of 8,process-,laborde10 is simply one more of the many acetanilid powders that have been foisted on our profession and that have filled our journals for years past4 ,the only thing in it that is of practical therapeutic value is #b grains of acetanilid to a #e-;grain tablet4 ,the statement that ,labordine is a purely vegetable preparation is probably intended by the proprietors as a good joke on the medical profession4 ,acetanilid is not usually regarded as a vegetable product1 at least it is not ordinarily found in market gardens4 ,the only vegetable source from which acetanilid can be obtained is the beautiful flowering coal-tar bush1 from which so many other nostrum vendors obtain their 8perfectly harmless1 purely vegetable antipyretics10 all composed of acetanilid and something to hide it4 ,if the statements made by one of the company's employees and quoted below are true1 ,labordine is not 8manufactured and made chemically pure in the laboratories of the ,labordine ,pharmacal ,company10 for this company has no laboratory1 and its product is manufactured for it4 #ef ,since this article was prepared we find that the national ,food and ,drugs ,act has forced the proprietors of ,labordine to put on the label the amount of acetanilid it contains1 viz41 #dj per cent41 or #b grains in a #e grain tablet4 #d4 ,our readers will be interested to know that the important ingredient entered under the imposing name of ,benzoyl-,sulphyonic-,imide is simply a highly scientific name for saccharin4 ,even on this point1 however1 the formula is misleading1 since it claims #bc-a_/d per cent4 of this substance1 whereas the analysis shows that the presence of saccharin could not be proved4 ,if it is present at all it is in quantities much less than stated1 and so small as to be difficult of recognition4 ,instead it appears that the product contains common starch and about #ce per cent4 of milk sugar4 ,,the ,,company ,,itself ,one of the humiliating phases of the proprietary medicine business is that1 in many instances1 these preparations are foisted on our profession by men who know nothing of medicine1 pharmacy or chemistry1 yet who not only presume to concoct our medicines for us1 but also assume to instruct us how to use them4 ,gould's ,commercial ,register for #aijg gives the officers of the ,labordine ,pharmacal ,company as ,h4 ,m4 ,coudrey1 president2 ,m4 ,crawley1 vice-president1 and ,d4 ,e4 ,gamble1 ,jr41 secretary and treasurer4 ,the place of business is given as #dbj ,market street1 ,st4 ,louis4 ,we are informed that ,harry ,m4 ,coudrey is an insurance agent and the present member of ,congress from the ,twelfth ,missouri ,district2 that ,mark ,crawley is a clerk in the insurance office of ,h4 ,m4 ,coudrey2 and that ,mr4 ,gamble is cashier in the same office4 ,a recent visit of a representative of ,the ,journal to #dbj ,market street1 ,st4 ,louis1 showed that the office of the ,labordine ,pharmacal ,company is in ,room #ab on the third floor of an old dilapidated building4 ,there was no sign on the door of the office1 but on the wall next to an old elevator was a very small sign which read 8,labordine ,chemical ,company1 ,room #ab40 ,the office at the time of the visit was apparently in charge of a young woman about #bj years old4 ,careful scrutiny of the furniture and fixtures showed that the room contained an old oak roll-top desk in one corner and a kitchen table1 on which were piled about half a dozen packages of ,labordine4 ,the floor of the room was bare and very dirty4 ,in an adjoining room1 the door of which was open1 was piled a lot of broken furniture4 ,no laboratories nor chemical apparatus were visible4 ,the young woman in charge stated that ,labordine was made by the ,mallinckrodt ,chemical ,works1 at ,no4 #cfjj ,north ,second ,street1 ,st4 ,louis4 ,this is a fair sample of nostrums and of the methods of exploiting them4 ,the bitterly humiliating fact about the whole business is that a preparation1 advertised under such palpably misleading claims1 could actually be advertised in medical journals1 even in journals of a supposedly high scientific standard1 and could be bought and prescribed for years by supposedly intelligent and conscientious physicians4 ,it is not supposed that every physician should be enough of a chemist to detect the ridiculous discrepancies between the published formula and the therapeutic claims made for such a mixture4 ,but that members of a supposedly learned profession should fail to have enough interest in the preparations they prescribe for their confiding patients to find out that acetanilid is being masked under an obsolete and little used name1 that under an imposing polysyllabic designation is hidden saccharin1 that the so-called 8active principle ,process-,laborde0 7whatever that may be71 is equivalent only to one-third grain of salicylic acid in a #e-;grain tablet1 and that the advertising matter sent out for years by this company contained absolute falsehoods regarding the composition and therapeutic benefits of its preparation1 is certainly just cause for shame and humiliation4 ,if a physician1 knowing the composition of ,labordine1 wishes to prescribe it and prescribes it intelligently1 he has a perfect right to do so4 ,if he wishes his patient to have #b grains of acetanilid1 #a_/bj of a grain of quinin1 and #a_/c of a grain of salicylic acid1 and considers a mixture of ground celery seed1 starch and milk sugar as a proper vehicle for this medication1 no one will question his right to administer it4 ,no physician1 however1 has any right1 either moral or professional1 to prescribe a preparation1 concerning the ingredients of which he knows absolutely nothing4 ,is it possible that such carelessness may be one of the causes of waning public confidence in our profession8 ,we leave it to our readers to determine whether such a moral can be drawn from this typical nostrum story4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #cj1 #aijg47 ,,lactobacilline ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,franco-,american ,ferment ,company has advised the ,council on ,pharmacy and ,chemistry that1 in advertising its products1 it will no longer conform to the rules of the ,council4 ,this is evident4 ,the ,franco-,american ,ferment ,company has distributed circulars in which the public is informed that auto-intoxication is the cause of innumerable ills ranging all the way from arteriosclerosis1 rheumatism and gout to chronic headache1 odorous perspiration1 nervous disorders and melancholia2 that the ,bulgarian bacillus 8is a wonderful corrective or remedy0 for all these conditions1 and that the ,lactobacilline products are the only preparations of ,bulgarian bacillus 8to be had in ,america which bear his ,professor ,metchnikoff's personal endorsement0--by inference1 the only reliable products4 ,in view of the action of the ,franco-,american ,ferment ,company1 and of the tendency of their advertising to cause the public to exaggerate slight ailments into alarming conditions1 the ,council has voted that the several ,lactobacilline products of this concern be deleted from ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ag1 #aiae47 ,,reexamination ,,of ,,lactopeptine,t ,report to the ,council on ,pharmacy and ,chemistry ,t ,see also ,liquid ,combinations ,containing ,pepsin and ,pancreatin1 p4 #aeg4 ,a reprint of articles bearing on this subject1 issued under the title ,digestive ,impossibilities1 will be sent on receipt of a #b-;cent stamp4 ,in #aijg the ,council on ,pharmacy and ,chemistry published a report on ,lactopeptine4 ,at that time it was shown that ,lactopeptine did not have the composition claimed for it4 ,the same claims as to composition are still being made for the product4 ,in view of this fact1 a second examination of ,lactopeptine has been made and the result reported to the committee on chemistry4 ,the report confirms the ,council's findings of six years ago4 ,after adoption by the committee1 it was adopted by the ,council and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,,second ,,examination ,,of ,,lactopeptine ,two specimens of ,lactopeptine in original unbroken packages were recently examined4 ,one of these was an ,american preparation said to be produced by the ,new ,york ,pharmaceutical ,association at ,yonkers and the other an ,english preparation from ,john ,morgan ,richards and ,sons1 ,london4 ,when ,lactopeptine was first examined by the ,council about six years ago1 it was found to be little more than weak saccharated pepsin1 and did not contain the other ferments which were claimed by the manufacturers to be present4 ,a statement concerning this was published in the ,council ,reports for #aije-aijh1 p4 #dc4 ,because of claims recently made by the exploiters that this preparation contains not only pepsin but also pancreatin1 diastase1 lactic acid and hydrochloric acid1 and that the failure to recognize these must be due to the lack of ability of the chemists making the examination1 it seemed worth while to undertake a new series of tests on samples from two sources mentioned1 the products on the ,british and ,american markets4 ,the label on the ,british sample gives the following as the composition3 ,sugar of ,milk #dj ounces ,pepsin #h ounces ,pancreatine #f ounces ,ptyalin or ,diastase #d drachms ,lactic ,acid #e fl4 drachms ,hydrochloric ,acid #e fl4 drachms ,the label on the ,american sample gives no quantities but states that it 8represents a combination of the principal digestive and enzymogenic agents1 ,pepsin1 ,pancreatin1 ,diastase1 ,lactic and ,hydrochloric ,acids1 in the proper proportion to insure best results40 ,we have examined both preparations for starch-digesting power according to the methods employed in our previous examinations of such ferments and already reported4 ,diastase and the amylopsin of pancreatin seem to be completely absent1 or1 if present at all1 in such minute traces that digestion of starch is not shown after one hour when quantities running from #fj mg4 up to #aej mg4 were allowed to act on #ejj mg4 of starch made up into paste4 ,these tests were repeated1 always with the same results1 and were controlled by digestions of the same starch with other diastase preparations of known value4 ,tryptic activity appears likewise to be absent1 as in weak alkaline solution after fifteen hours' digestion no effect on coagulated egg albumin or fibrin was observed when #ajj mg4 of each preparation was used with #a gm4 of the protein material4 ,as was found in the previous investigation the two products have some peptic activity1 but this activity is comparatively weak1 as about #bjj mg4 of each preparation are required to digest #aj gm4 of coagulated egg albumin with #j4b per cent4 hydrochloric acid in three hours at #dj ,c4 7#ajd ,f471 and #ajj mg4 portions were unable to completely digest #aj gm4 portions of egg albumin with acid of the same strength in four hours at #ej ,c4 7#abb ,f474 ,hydrochloric acid is absent1 as might be expected from the character of the preparation1 and the amount of combined chlorid is small2 but qualitative tests were obtained for organic acid resembling in behavior lactic acid1 which is probably present in combined form4 ,it must be reaffirmed then that in digestive activity both the ,lactopeptine purchased in the ,united ,states and that bought in ,england are essentially weak saccharated pepsins4 ,editorial ,note4--,the report of #aijg demonstrated that ,lactopeptine was at that time a weak saccharated pepsin4 ,the present report shows that ,lactopeptine1 as it is sold both in the ,united ,states and ,great ,britain1 is still the same weak pepsin preparation4 ,by the false statements which appear on the ,lactopeptine labels the exploiters lay themselves liable to prosecution under the ,food and ,drugs ,act--just as they have laid themselves liable for the past six years4 ,the continued exploitation of this preparation warrants a restatement of facts that have been given many times before3 #a4 ,a preparation having the composition claimed for ,lactopeptine--a powder containing pepsin1 pancreatin1 diastase1 lactic acid and hydrochloric acid--cannot be produced commercially4 #b4 ,even if such a combination were available1 the acidity of the mixture itself and of the gastric juice would in all probability destroy the pancreatin before it could reach the intestinal tract4 #c4 ,even if every constituent could exert its proper function at the right time1 the administration of such a shotgun mixture would be unscientific and uncalled for4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #b1 #aiac47 ,,meat ,,and ,,beef ,,juices,u ,report of the ,council on ,pharmacy and ,chemistry ,u ,see also following report on ,valentine's ,meat ,juice and article on ,meat ,extracts and ,meat ,juices1 p4 #dgj4 ,the following was submitted to the ,council by a subcommittee3 ,to the ,council3--,while meat extracts contain only traces of coagulable proteids and have little food value1 meat juices are prepared by a process which ensures the presence in the finished product of considerable quantities of coagulable proteids and they therefore have considerable value as foods4 ,many preparations which are sold as beef juices or meat juices have no right to these designations4 ,since the public and physicians are likely to be misled by the names given to these products and by the false claims which are made for them as foods and depend on them in the nourishment of the sick1 it is important that their composition and their value as foods should be known4 ,in the following report is presented the results of an examination of some of the commercial products found on the ,american market4 ,the report shows that ,wyeth's ,beef ,juice 7,john ,wyeth ,bro41 ,philadelphia71 ,bovinine 7,the ,bovinine ,co41 ,new ,york71 ,carnine 7,carnine ,co41 ,fougera ,co41 ,new ,york71 and ,valentine's ,meat ,juice 7,m4 ,j4 ,valentine1 ,richmond1 ,va47 are sold under names which are incorrect1 that their composition is not correctly stated by the manufacturers and that false and misleading statements are made in regard to their value as food4 ,it is recommended that the products named be refused recognition for conflict with ,rules #a1 #f and #h4 ,since these preparations are typical of many others on the market1 and as their use is a menace to the public health it is recommended that the report be published4 ,this report was adopted by the ,council4 ,w4 ,a4 ,puckner1 ,secretary4 ,beef or meat juices are clearly to be distinguished from beef or meat extracts4 ,the word 8juice0 applies solely to the fluid portion remaining in fresh meat after proper cooling and storing and may be obtained by pressure or diffusion with or without a low degree of heat4 ,under heavy pressure freshly chopped meat will yield from #be per cent4 to #dj per cent4 of a thick reddish juice and if the meat is previously frozen or heated to #fj ,c41 as much as #ej per cent4 may be obtained4 ,this gives some idea as to the probable cost of preparing beef juice at home4 ,the chief characteristics of meat juice are the presence of a considerable proportion of coagulable protein and a low content of meat bases4 ,that above represents the nature of these commodities as usually understood by the medical profession1 is clearly shown by this quotation3#eg #eg ,brunton1 ,sir ,lauder3 8,disorders of ,assimilation1 ,digestion1 etc410 p4 #ahc4 8,one or two teaspoonfuls of this 7meat juice7 are added to a teacupful of cold or warm water1 which1 however1 must not be boiling1 or otherwise the albumin would be coagulated1 but it may1 however1 be sufficiently warm to drink comfortably40 ,beef juice is considered by some physicians of much dietetic service and believed to represent liquid food in concentrated form4 ,w4 ,o4 ,atwater1#eh relative to this product says3 8,beef juice obtained from the best steak which has been merely warmed through over the coals and then entirely deprived of soluble substance by a screw press1 is undoubtedly the most concentrated of the liquid foods40 #eh ,bull4 ,no4 #ba1 ,u4 ,s4 ,dept4 ,agricult41 ,office of ,experiment ,stations4 ,the latter authority gives a number of analyses of beef juices prepared under known conditions4 ,,definition ,,of ,,meat ,,juice ,meat juice is defined by the standards committee of the ,association of ,official ,agricultural ,chemists as the fluid portion of muscle fiber obtained by pressure or otherwise1 and may be concentrated by evaporation at a temperature below the coagulating point of the soluble protein4 ,the solids contain not more than #ae per cent4 of ash1 not more than #b4e per cent4 of sodium chlorid 7calculated from the total chlorin present71 not more than #d nor less than #b per cent4 of phosphoric acid 7,p#b,o#e71 and not less than #ab per cent4 of nitrogen4 ,the nitrogenous bodies contain not less than #ce per cent4 of coagulable proteins and not more than #dj per cent4 of meat bases4 ,meat juices of commerce are supposed to be made by subjecting properly prepared meat to heavy pressure with subsequent concentration of the juice in vacuo at a low temperature4 ,the latter is necessary because if the temperature is raised to any material extent the valuable coagulable1 soluble proteins referred to above are precipitated and lost4 ,in order to establish a basis of comparison relative to the composition of natural raw beef juice a number of samples were prepared under known conditions and submitted to analysis4 ,the results contained in the subjoined table clearly show that meat juices made under known conditions vary according to the mode of preparation1 but it is evident that practically one-half of the nitrogen is present as coagulable protein4 ,,food ,,values ,in order to arrive at the food value of any commodity it is necessary to consider its chemical composition1 available potential energy1 absorbability1 etc4 ,on referring to the analytical table it will be found that the amount of inorganic material in meat juices ,nos4 #g and #aj is unduly high4 ,it appears that sodium chlorid1 per se1 has been added to both ,bovinine and ,wyeth's ,beef ,juice probably as a preservative in the latter and for condimental purposes in the former4 ,the relative and absolute proportions of phosphatic material in both products is excessive4 ,the other constituents present in the ash are those usually found in meat products4 ,the amount of sugar and glycerin in ,carnine is interesting4 ,these agents may be added for preserving purposes1 but the resulting product1 on account of its syrupy appearance1 leads to the belief and is so represented1 that it is a concentrated food4 ,glycerin is also present in ,bovinine and ,valentine's meat juice4 ,bovinine in addition contains about #h per cent4 alcohol4 ,the total nitrogen content of the trade products excepting ,carnine1 is greater than the amount of nitrogen present in meat juices proper1 but the relative amount of nitrogen present as coagulable protein--the valuable part of meat juice--is much greater in the latter4 ,in fact1 the amount of coagulable protein present in ,valentine's ,meat ,juice may be considered nil1 which indicates that an unduly high temperature is used in its preparation4 ,in this connection it should also be noted that even a moderate elevation of temperature influences the chemical composition of meat juices4 ,for example1 the coagulable matter present in ,nos4 #c1 #d and #e1 is approximately one-half that present in ,nos4 #a and #b1 which appears to indicate that the best product can be made without the use of any heat whatever4 ,several of the trade products1 namely ,nos4 #g1 #h and #i1 contain about as much coagulable material as meat juice made by heating beef to #fj ,c4 ,according to the formula appearing in a circular of the ,bovinine ,company1 a part of the coagulable matter is present in the form of egg albumin1 but the company claims egg albumin is not used at present4 ,in the case of ,carnine1 the coagulable matter appears to be introduced by the use of blood itself4 ,the exact nature of the coagulable protein matter in ,wyeth's ,beef ,juice has not been ascertained4 ,it is well known to manufacturers and physiologic chemists that it is practically impossible to manufacture a genuine meat juice possessing a reasonable amount of coagulable proteins1 which is stable without a preservative4 ,meat juices1 in addition to the coagulable protein material1 contain other protein bodies such as albumoses and peptones4 ,these bodies are largely formed from the original protein bodies present in the meat juice during the process of manufacture4 ,they are highly nutritious and largely and readily absorbed from the alimentary canal1 but the amount of these bodies present in the trade products is relatively small excepting in ,bovinine1 which is not a meat juice1 particularly when the high prices are considered4 ,a considerable proportion of the nitrogenous matter contained in ,valentine's and ,wyeth's products is present in the form of amino bodies frequently included in the general term1 8extractives40 ,these bodies may be oxidized in the body and thus supply heat in a manner similar to alcohol1 but it should be remembered that there still appears to be a wide difference of opinion among various observers on this point4 ,some appear to be of the opinion that the amino bodies are devoid of food value in that these bodies appear in the urine practically unchanged4 ,it would1 therefore1 appear that the value of the amino bodies is largely of a stimulant character4 ,the food value of meat juices1 therefore1 resides largely1 if not solely1 in the coagulable and other protein material present4 ,comparing the calorific value or potential energy available in meat juices proper on this basis with that present in the commercial products1 excluding ,bovinine1 it will be seen that on the average the genuine meat juices--that is1 those made by pressure1 direct from the meat itself as wanted--are much superior to the commercial products1 notwithstanding the marked concentration in some cases4 ,the calories given in the accompanying table do not include sugar1 alcohol or any other added material of this character4 ,,wyeth',s ,,beef ,,juice 8,wyeth's ,beef ,juice0 is not a true beef juice1 but resembles rather a diluted meat extract4 ,it contains much added inorganic matter1 is low in coagulable proteins1 and considering the degree of concentration1 relatively deficient in nutritive value4 ,some of the claims contained in the circular accompanying this preparation1 in view of its composition set forth above1 may be of interest3 8,wyeth's ,beef ,juice 4441 containing two fluid ounces and representing three pounds of prime lean beef14440 8444 beef extracts made by the ,liebig process are utterly devoid of the valuable and nutritious albuminous constituents of meat14440 ,wyeth's ,beef ,juice 8should not be compared with ordinary beef extract14440 ,,composition ,,of ,,meat ,,juices ,,column ,,headings3 #a ,name of ,preparation #b ,per cent4 volatile matter #ajj ,c4 #c ,per cent4 inorganic matter #d ,per cent4 sodium chlorid #e ,per cent4 phosphoric pentoxid 7,p#b,o#e7 #f ,per cent4 ether extract1 glycerol and undetermined matter #g ,per cent4 total nitrogen #h ,per cent4 coagulable proteins 7,n #f4be7 #i ,per cent4 other proteins 7,n #f4be7 #aj ,amino bodies 7,n #c4ab7 #aa ,calories per #ejj gm4 obtained from protein factor #d4h #ab ,calories per #ejj gm4 obtained from amino bodies factor #j4ef #a #b #c #d #e #f #g #h #i #aj #aa #ab ---------------------------------------- ----------------------------- ,,trade ,,products3 ,chuck beef1 cold pressed #hf4he #a4hf 4#bj 4#ca #a4cba4gdf4ac #b4id 4#ijbag4fh #b4eb ,round beef1 cold pressed #he4gf #a4ec 4#ab 4#cg 4#geb4jhh4ef #b4cga4jcbfb4cb #b4hh ,chuck beef pressed at #fj ,c4 #ia4ij #a4bi 4#ai 4#bi 4#haa4jib4ef #b4ej 4#hdaba4dd #b4ce ,chuck beef pressed at #fj ,c4 #hi4ef #a4bg 4#af 4#cg #b4iha4jic4jj #b4fc 4#eface4ab #a4eg ,round beef pressed at #fj ,c4 #ij4fe #a4cf 4#af 4#cf #b4jia4afd4be 4#caa4cdaji4dd #c4ge ,chuck beef heated six hours before pressing #ih4aa 4#ci 4#je 4#ab 4#be 4#bd4444 #a4jj 4#be #bd4jj 4#gj #fj-ajj ,c4 ,,made ,,in ,,laboratory3 ,beef ,juice1 ,john ,wyeth ,bro41#eh4hdaf4baf4gac4bgab4eac4aeb4hh #c4eff4jjaed4efaf4hj ,philadelphia1 ,pa4 ,v ,bovinine1 ,the ,bovinine ,co41 #ge ,w4 ,houston ,st41#hj4dj #a4eea4je 4#ji #c4fdb4cfc4chaj4ge 4#bhcci4ab 4#gh ,new ,york ,city ,w ,x ,carmine ,co41 ,lefranco1 ,paris1 ,france2 ,imported by ,fougera ,co41 ,agents1 ,new ,york #bd4hj 4#hf 4#ji 4#ccfh4id 4#ifb4be #b4ef 4#eiaae4dd #a4fe ,city ,y ,z ,meat ,juice1 ,m4 ,j4 ,valentine1 #eg4fdaj4bfa4ggc4dabj4dac4jf 4#ai #e4ddf4jface4abaf4ig ,richmond1 ,va4 ,,aa ,,ab ---------------------------------------- ----------------------------- ,v ,including #j4bj per cent4 as ,,nh#c2 ,w #h4ag per cent4 alcohol found2 ,x #c4a per cent4 glycerol found2 ,y vacuum #gj ,c42 ,z #dg4ej per cent4 cane sugar--#ad4b per cent4 glycerol found2 ,,aa #h per cent4 of glycerol found4 ,,ab including #j4bb per cent4 ,,nh#c2 ,the several samples of beef juice were prepared from practically fat free1 finely comminuted1 chuck and round beef1 first by pressure at the ordinary temperature2 second1 by heating the prepared meat for several hours at #fj ,c41 then submitting to pressure4 ,sample ,no4 #f was made from chuck beef1 prepared as above1 by heating six hours at from #fj to #ajj ,c41 and expressing after cooling4 ,it is not a beef juice proper but was prepared1 analyzed and added to the list for information4 ,its composition resembles several commercial articles closely4 ,a number of products represented and sold as meat juice in the ,united ,states were analyzed and the results recorded in the accompanying table4 ,,bovinine ,bovinine1 advertised as a 8condensed beef juice prepared by a cold process0 is a mixture of alcohol1 glycerin1 added sodium chlorid1 and apparently some form of defibrinated blood4 ,according to the manufacturer's literature egg albumin was used formerly but this ingredient is said to be no longer employed4 ,it is not a meat juice in any sense of the word4 ,numerous misrepresentations will be found on the label and in the literature of ,bovinine1 of which the following are typical3 8,the blood of selected steers prepared by a cold process1 furnishing a perfect food1 free from insoluble elements40 8,the rapidity with which ,bovinine is absorbed and assimilated in the stomach 4440 8,it supplies complete nutrition to the patient40 8,bovinine contains all the elements of the animal1 vegetable and mineral kingdoms for the production of new blood with great rapidity4 ,its principal constituents have been selected with a view to furnish the largest amount of nutriment in the most condensed form and all the resources of modern chemical analysis have been brought to bear on this important problem40 ,a series of experiments carried out with dogs under anesthesia1 by injecting ,bovinine into the stomach1 the pyloric end of which was ligated1 shows that ,bovinine is not readily absorbed and assimilated by the stomach as claimed4 ,the amount of protein material found in the stomach at the end of one-half hour to one hour and a quarter was practically equal to the amount introduced by the ,bovinine4 ,it is also represented that ,bovinine is of great service in case of an irritable stomach4 ,this is not borne out by experiment4 ,bovinine fed to dogs by the mouth1 either alone or mixed with food1 induced vomiting1 which was less marked when ,bovinine was given with the regular diet4 ,an examination of the urine of these animals showed a marked diminution of the amount of indican1 while the ethereal sulphates were enormously increased1 both absolutely and relatively1 when ,bovinine was given4 ,experiments on rabbits have shown that ,bovinine injected into the peritoneal cavity was invariably followed by large quantities of albumin in the urine1 which persisted for from twenty-four to forty-eight hours4 ,thirty to #ej c4c4 per kilo given by mouth daily caused emaciation and weakness2 in some cases1 irritation of the gastro-intestinal canal1 with death of the animal in from seven to twelve days4 ,,carnine ,carnine is a ,french preparation imported into the ,united ,states by ,fougera ,co41 of ,new ,york ,city4 ,in physical appearance it looks like highly concentrated food1 but analysis shows that it consists of a small proportion of defibrinated blood dissolved in a mixture of syrup and glycerol1 the whole agreeably flavored4 ,it is represented as a 8juice of rare meat1 prepared by cold process4 ,each tablespoonful represents #ajj gm4 of raw meat1 or #c-a_/b ounces40 ,it is clear that ,carnine is not a meat juice in any sense of the word4 ,,valentine',s ,,meat ,,juice ,valentine's ,meat ,juice resembles in physical appearance taste1 odor and by chemical analysis a diluted meat extract4 ,the nutritive value of meat extracts is virtually nil1 as is well known by the medical profession4 ,notwithstanding the composition of ,valentine's ,meat ,juice and the fact that beef extract represents little nutritive value1 the manufacturer makes the following misleading representations3 8,the two-ounce oval bottle1 adopted for the ,meat ,juice contains the concentrated juice of four pounds of the best beef1 exclusive of fat2 or the condensed essence of one and a half pints of pure liquid juice which is obtained from the flesh of beef40 8,the use of hot water with the ,meat ,juice changes its character and impairs its value40 ,italics in original4--,ed4 ,the company must certainly be aware of the fact that its product contains little1 if any1 coagulable proteids4 ,,conclusions ,in conclusion3 ,neither ,bovinine nor ,carnine is a meat juice1 the former is anything but palatable and the latter soon cloys4 8,valentine's ,meat ,juice0 and 8,wyeth's ,beef ,juice0 are virtually diluted meat extracts1 which are known to possess little food value4 ,a physician depending on any of the foregoing products to supply material nourishment1 in case of serious illness1 is deceiving himself1 starving his patients1 and may be lessening their chances for recovery4 ,if a patient recovers while using these commodities1 it is certainly not due to the food value contained in them--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bj1 #aiji47 ,,valentine',s ,,meat ,,juice,,ac ,report of the ,council on ,pharmacy and ,chemistry ,,ac ,see also preceding report on ,meat and ,beef ,juices1 and article on ,meat ,extracts and ,meat ,juices1 p4 #dgj4 ,some time ago the ,council authorized publication of a report,,ac dealing with the composition and claims made for a number of the more generally advertised meat and beef juices4 ,among these was ,valentine's ,meat ,juice4 ,this it was shown was sold under an incorrect name1 the claims for its composition were not truthfully stated and its exploiters made false and misleading claims in regard to its food value4 ,as ,valentine's ,meat ,juice is still widely advertised the referee in charge of this class of products deemed a reexamination of the product advisable4 ,this was made and on it was based the following report which has been submitted to the ,council1 adopted1 and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,your referee has had examined recently purchased specimens of ,valentine's ,meat ,juice 7,valentine's ,meat ,juice ,company1 ,richmond1 ,va474 ,the examination shows that it has virtually the same composition as that given in the report of the ,council 8,meat and ,beef ,juices0 published in ,the ,journal1 ,nov4 #bj1 #aiji4 ,it contains practically no coagulable protein material1 one of the products characteristic of a meat juice4 ,it is essentially a diluted meat extract4 ,the following statement found in former circulars now seems to have been eliminated3 8,the two-ounce oval bottle1 adopted for the ,meat ,juice contains the concentrated juice of four pounds of the best beef1 exclusive of fat2 or the condensed essence of one and a half pints of pure liquid juice which is obtained from the flesh of beef40 ,an endeavor is still made1 however1 to convey the idea that the product contains coagulable protein1 as shown by the following3 8,boiling water changes the character of the preparation40 8,the use of boiling water with the ,meat-,juice changes the character of the ,preparation40 ,the proprietors undoubtedly know that the product does not contain any coagulable material and that the statements just quoted are plain misrepresentations4 ,the advertising circular contains a large number of 8,testimonials of the ,medical ,profession40 ,as all are undated1 one cannot tell how old these testimonials are4 ,one physician recommends it highly for hypodermic use2 another says1 8,i have kept cases on it and it alone for days1 without attempting to give any other food1 and the results have been entirely satisfactory40 ,according to another1 it is 8most invaluable in typhoid fever and also in diphtheria40 ,valentine's ,meat ,juice conflicts with the following rules of the ,council3 ,rule #a1 in that its composition is not correctly given2 ,rule #f1 in that unwarranted therapeutic claims are made1 the profession being led to believe that the product is highly nutritious and is valuable in the treatment of pneumonia1 diphtheria and typhoid fever2 ,rule #h1 in that the name is objectionable1 for while sold as a meat juice1 in reality it has the character of a meat extract4 ,valentine's ,meat ,juice is a fraud on the public1 and in view of its continued exploitation under false claims1 the referee recommends that the ,council reiterate its former condemnation and authorize the publication of this report4 ,editor's ,note4--,the difference between meat extracts and meat juices was fully discussed in the previous report of the ,council1 ,meat 8juices0 are made by the cold expression of meat with subsequent evaporation1 in such a way that the nutritious coagulable proteins remain in solution4 ,in making meat 8extracts10 heat is used which almost completely removes the coagulable proteins and thus renders it practically devoid of nutrient qualities4 ,a list of some of the medical journals that carry advertisements of ,valentine's ,meat ,juice1 follows3 ,pediatrics ,old ,dominion ,journal of ,medicine ,surgery ,medical ,world ,virginia ,medical ,semi-,monthly ,medical ,times ,american ,medicine4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #b1 #aiad47 ,,medicinal ,,foods ,a report1 of which the following is an abstract1 was submitted to the ,council on ,pharmacy and ,chemistry by the subcommittee which examined the medicinal foods3 ,in order to determine the food value of any food product it is necessary to consider the following points3 ,chemical composition2 available potential energy2 absorbability and cost4 ,no attempt is made in this article to discuss each of these features separately1 but they are utilized as required4 ,the ingredients on which the food value of any article of food depends are the proteid substances1 carbohydrates1 fats1 certain inorganic bodies and--under certain conditions--alcohol4 ,the amount of each of these present in a preparation must be established by chemical analysis4 ,from the results thus obtained it is possible to calculate the potential energy represented by a given food product4 ,in this report the potential or food value is expressed in the large or kilocalorie1 that is1 the amount of heat required to raise the temperature of one kilogram of water one degree centigrade4 ,the factors employed in this report for expressing in calories the actual amount of energy utilized by the system are #d4h for proteid substances1 #d4a for carbohydrates1 and #i4b for fats4 ,the accompanying table embodies the results obtained by submitting all the well-known so-called 8predigested foods0 to chemical examination4 ,the table as published in ,the ,journal included columns on3 ,price of bottle1 number of cubic centimeters in a bottle1 cost per #ejj cubic centimeters1 reaction1 specific gravity1 percentage of non-volatile residue1 ash1 percentage of nitrogen1 calories as proteids in #ejj grams1 carbohydrates before inversion1 alcohol by volume1 average recommended adult dose per diem in cubic centimeters1 cost per diem to supply #a1dcj calories4 ,these columns were eliminated from this abstract1 as they were unessential1 so far as the practical value of the article is concerned4 ,in most cases two samples of the same brand were purchased at an interval of about six months4 ,all the analyses were made before ,jan4 #a1 #aijg4 ,some of the preparations contain much glycerin which does not1 so far as known at present1 possess any recognized food value1 although there are a number of experiments on record to indicate that it influences metabolism4 ,the percentage of nitrogen accredited to each of these products represents the total amount of nitrogen1 irrespective of the nature of the nitrogenous substances1 although some of this nitrogen has no nutritive value4 ,by multiplying the percentage of nitrogen found by the factor #f4be we obtain the percentage of nitrogenous matter 7proteids7 contained in the various preparations4 ,by multiplying the number of grams of nitrogenous matter present in #ejj grams of material by the factor #d4h it is found that the potential energy available by the nitrogenous matter varies from #aj4c calories to #aec4a calories4 ,five hundred grams of the material is made the basis of calculation1 because it approximates a pint1 the amount usually believed to be present in the various trade packages1 and because it affords a ready basis of calculation4 ,the carbohydrates are represented by cane sugar1 maltose1 dextrin and invert sugar4 ,lactose is probably also present in some1 but it is impossible to establish this4 ,by multiplying the number of grams of carbohydrates present in #ejj grams of the foods by the factor #d4a we obtain the potential energy represented by the carbohydrate1 which varies from #aa4c to #cai4b calories4 ,the total calorific value of both proteids and carbohydrates ranges from #ed4g to #cig4e calories4 ,the total food value of an equal quantity of milk1 including fat1 approximates #cfj calories4 ,the value of alcohol as a food product pure and simple in disease is1 however1 an open question4 ,there is no doubt whatever but that it acts to a certain degree as a food even here1 not as a tissue builder1 but as a saver of fat and carbohydrate material1 and in order to give the preparations in question full value as food products1 the calories represented by the alcohol1 are credited to each preparation1 as are the proteids and carbohydrates4 ,the factor usually recognized for expressing the calorific value of alcohol is #g4 ,by multiplying the number of grams of alcohol present in #ejj grams of material by #g1 the number of calories varies from #dbj to #feh4 ,on looking over the literature and printed matter distributed by some manufacturers1 the physician is frequently left under the impression that these preparations contain all the essential constituents necessary for maintaining normal nutrition of the body1 as is clearly shown by the following quotation3 8,contains sufficient nutritive material to maintain normal nutrition of the body1 a valuable food in typhoid fever1 pneumonia1 tuberculosis1 444 and all the conditions of the system associated with enfeebled digestion and malnutrition40 ,in order to show the insidiousness of such representations it is only necessary to give the actual food value of the average daily dose 7the average amount to be taken for twenty-four hours7 recommended by the various manufacturers for their products4 ,the average adult daily dose recommended varies from #ej to #aej c4c4 ,the total available calories per daily dose based on the proteid and carbohydrate bodies varies from #i4h to #aaj4e4 ,adding to these figures the amount of energy represented by the alcohol1 in each case1 the total available calories varies from #ee4j to #bii4e4 ,the number of calories per diem in sickness should not fall much below #a1ejj during twenty-four hours4 ,,tabulated ,,results ,,of ,,examinations ,,of ,,medicinal ,,foods ,,column ,,headings3 #a ,name of ,preparation and ,manufacturer #b ,glycerin and undetermined matter #c ,per cent nitrogenous matter 7#f4bf7 #d ,calories as proteids in #ejj grams #e ,carbohydrates after inversion #f ,calories as carbohydrates in #ejj grams #g ,calories as proteids and carbohydrates in #ejj grams #h ,alcohol1 by weight #i ,calories as alcohol in #ejj grams #aj ,calories as proteids and carbohydrates per diem dose #aa ,total calories in per diem dose,,ad #ab ,number c4c4 required per diem to supply #a1dcj calories #a #b #c #d #e #f #g #h #i #aj #aa #ab ---------------------------------------- --------------------------------- ,carpanutrine --,john ,wyeth #bh4ded4bhajb4g #e4cdaji4ebab4bab4edcg4e #be4e #gh4ja1ajj4g ,brother ,carpanutrine --,john ,wyeth #ba4bif4bdadi4h #e4ghaah4ebfh4cad4jdij4j #cb4b #ia4j #idb4i ,brother ,liquid ,peptones --,eli ,lilly #c4fcd4ejajh4j #f4jeabd4jbcb4jah4jfcj4j #fi4f #beh4f #hbi4d ,company4 ,liquid ,peptones1 with ,creosote --,eli ,lilly #d4cdc4hd #ib4bac4dgbgf4acfh4cah4jfcj4jaaj4e #bii4e #gaf4b ,company ,nutrient ,wine of ,beef ,peptone-- #ad4igj4fd #ae4dae4dccaf4ccca4gag4efab4e #ff4c #ahh4h #geg4d ,armour ,company ,nutrient ,wine of ,beef ,peptone-- #ac4gjj4dc #aj4cae4egcai4bcbi4eag4jeie4j #fe4i #ahd4i #ggc4c ,armour ,company ,nutritive ,liquid ,peptone--,parke1 #a4jba4hf #dd4fab4hibfd4bcjh4hah4hfeh4j #gd4b #bcb4a #gci4e ,davis ,company ,nutritive ,liquid ,peptone--,parke1 #a4iea4af #bg4hac4aibgj4dbih4bag4gfai4e #ga4e #bbj4b #ggi4b ,davis ,company ,peptonic ,elixir --,wm4 ,merrell #c4bab4ed #fa4jaa4dfbcd4ibie4iaf4eegg4e #ec4c #aeg4b #hah4f ,chemical ,company ,tonic ,beef ,s4 ,d4-- #ab4iac4dj #ha4f #b4cf #dh4dacj4jab4jdbj4j #ac4j #ee4ja1cjj4j ,sharp ,dohme ,tonic ,beef ,s4 ,d4-- #ab4fcc4bh #gh4g #b4bb #de4eabd4bac4jdee4j #ab4d #eg4ia1bcd4d ,sharp ,dohme ,liquid ,peptone --,stevenson #j4dda4ha #dc4d #j4ee #aa4c #ed4gab4jdbj4j #i4h #he4da1ejf4h ,jester ,company ,cow's ,milk 7#c4h per cent4 -- #c4ej #hd4j #d4hj #ih4dahb4d -- -- #g4ca1dbi4fb1jjj4j fat7 ---------------------------------------- --------------------------------- ,,ad ,total calories per diem dose includes the calories of alcohol in the liquid medicinal foods and the calories of the fat in milk4 ,in order to get a fair conception of the actual food value of these various preparations1 it is desirable to make some comparison which can be readily comprehended by every physician4 ,the amount of good milk necessary each twenty-four hours to sustain the vitality of a patient during a serious illness is not less than #fd ounces1 or approximately #b1jjj c4c4 ,the food value in calories represented by this amount of good milk may be placed at #a1dcj4 ,this includes not only the proteid and carbohydrate matter1 but the fat as well4 ,by comparing this available potential energy with the total energy available in the predigested foods under consideration1 it can be readily seen that if a physician depends on the representations made by some of the manufacturers1 and feeds his patient accordingly1 he is resorting to a starvation diet4 ,the largest number of available calories1 including alcohol1 present in any of the recommended daily doses1 is less than one-fifth of the number of calories represented by #b1jjj c4c4 of milk2 and the calories represented by the daily dose of the preparation poorest in food products is only one-twenty-fifth of the amount present in #b1jjj c4c4 of milk4 ,these figures tell their own story4 ,making #b1jjj c4c4 of milk the basis of calculation1 and estimating the amount of the various preparations required to yield this number of calories1 it is found that the quantity to be administered daily to supply #a1dcj calories1 including alcohol1 varies from #gaf4b to #a1ejf4b c4c4 ,in many cases the amount of alcohol exhibited by these quantities would keep the patient in an alcoholic stupor continually4 ,the cost necessary to supply this energy varies from #a4dh to #c4ci4 ,compare these prices with the cost of two quarts of milk4 ,is further comment necessary8 ,it is urged in justification of the use of preparations of this class that they contain constituents not found in our ordinary foods and in a more perfectly assimilable condition4 ,as pointed out above1 these so-called predigested foods contain no fats2 the carbohydrates in them are the ordinary sugars present in our common foods1 while the proteins belong to the peptone or albumose class4 ,it is for these latter that the greatest claims are made1 but even here no value can be pointed out not found in whey1 peptonized full milk or peptonized skimmed milk4 ,there is likewise another point of considerable importance to consider in this connection4 ,the terms peptone and albumose include bodies of very uncertain composition1 and their suitableness as food substances depends largely on how they are prepared4 ,animal experiments have shown that nitrogen equilibrium may be maintained1 for a time at least1 by use of enzymic hydrolytic products of the proteins1 even where the hydrolysis has been carried far beyond the so-called peptone stage1 but it appears to be likewise true that the mixtures secured by acid or high temperature steam hydrolysis have no such value4 ,some of these1 indeed1 may exhibit a toxic behavior4 ,this is true in particular of some of the commercial varieties of peptone1 and until more is known of the source of the bodies of protein character employed in the makeup of these 8predigested0 mixtures it is unwise to assume anything concerning the food value of the nitrogen compounds found in them by analysis or even to dignify them by the name of foods4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,may #aa1 #aijg47 ,,migrainin ,report of the ,council on ,pharmacy and ,chemistry ,the ,council1 having voted to rescind the acceptance of ,migrainin and to omit it from ,new and ,nonofficial ,remedies 7,appendix71 directed publication of the report given below4 ,w4 ,a4 ,puckner1 ,secretary4 ,,supplemental ,,report ,,on ,,migrainin ,to the ,council3--,koechl ,co41 ,american agents for ,migrainin 7,meister ,lucius ,bruning7 asserted that this preparation was a mixture of antipyrin #he parts1 caffein #i parts and citric acid #f parts4 ,the experiments of ,f4 ,zernik 7,apoth4-,ztg41 #aijf1 p4 #fhf71 however1 showed that ,migrainin consisted of antipyrin #ij4hh parts1 caffein #h4d parts and citric acid #j4de parts4 ,when the attention of ,koechl ,co4 was called to this they informed the ,council1 on ,june #bj1 #aijg1 that the formula they gave was given them direct by the manufacturers abroad and that they1 ,koechl ,co41 did not question its accuracy4 ,they1 however1 offered to 8write abroad and have the manufacturers confirm the formula as given40 ,on ,july #bc1 #aijg1 ,koechl ,co4 wrote the secretary of the ,council that the manufacturers had informed them that ,migrainin contains #ij per cent4 antipyrin and #i4a per cent4 caffein citrate4 ,this being an acknowledgment that the former statement submitted was incorrect1 the ,council voted that the approval of ,migrainin should be reconsidered4 ,examination of the product1 therefore1 was taken up in the ,association's laboratory and an original specimen1 purchased in ,chicago1 was found to contain moisture #j4g per cent41 antipyrin #ij4ic per cent41 and instead of caffein citrate #i4a per cent41 citric acid #j4ea per cent41 caffein #h4ec per cent4 ,this analysis agreed essentially with the composition of ,migrainin as found by ,zernik4 ,while the discrepancies between the statement of the firm and the facts are perhaps not great1 nevertheless they show that even the formula last given is incorrect1 and that the statements of ,koechl ,co41 while no doubt made in good faith1 were in this instance unreliable4 ,in recent advertising matter issued by ,koechl ,co41 8phenozon-caffein citrate0 is given as a synonym for ,migrainin1 one circular stating that 8,migrainin is phenozon-caffein citrate10 etc4 ,in the same circular the following also appears3 8,in the treatment of migraine with phenacetin or antipyrin1 the attack is delayed1 while with ,migrainin it is usually permanently stayed40 ,this will1 no doubt1 lead physicians to infer that ,migrainin is not a mixture of antipyrin and caffein citrate1 but that it is some new compound4 ,while the firm disclaims any intention to mislead1 it does not offer to withdraw or modify this circular4 ,it is recommended1 therefore1 that the approval of ,migrainin be rescinded and that it be omitted from ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #e1 #aiji47 ,,neurilla ,report of the ,council on ,pharmacy and ,chemistry ,the following report was adopted by the ,council4 ,its publication was authorized to show how a practically worthless mixture may be exploited by means of ill-considered testimonials4 ,w4 ,a4 ,puckner1 ,secretary4 ,neurilla1 which appears to be the sole product of the ,dad ,chemical ,company1 ,new ,york1 is advertised as 8,the ,ideal ,nerve ,calmant40 8444 a nerve tonic 444 indicated in cases where the nerve centers are poorly nourished and over-sensitive 4440 8444 a stimulant to the nervous system40 8,a ,valuable ,aid in the ,treatment of ,fevers1 ,colds1 ,la ,grippe1 etc40 ,the following non-quantitative and indefinite formula is given on the label of a recently purchased bottle of ,neurilla3 8,prepared from ,scutellaria ,lateriflora1 ,passiflora ,incarnata and ,aromatics40 8,proportion of ,alcohol #bj4c4 8,made by ,dad ,chemical ,co41 ,new ,york1 ,u4 ,s4 ,a4 8,dose1 ,one ,teaspoonful ,four ,times a ,day40 ,according to the formula1 then1 this mixture contains1 aside from alcohol and aromatics1 two vegetable drugs1 scutellaria and passiflora1 on which the alleged virtues of the preparation must be presumed to depend4 ,scutellaria lateriflora1 or skullcap1 is a bitter drug1 one of the many 8herbs0 to which1 on wholly unreliable 8clinical evidence10 therapeutic properties were at one time ascribed4 ,most pharmacologists do not mention the drug1 and those who do generally state that it has very feeble therapeutic properties4 ,it was admitted to the ,pharmacopeia1 but in #aiji its deletion was recommended by a committee of the ,section on ,practice of ,medicine of the ,american ,medical ,association 7,the ,journal ,a4 ,m4 ,a41 ,sept4 #d1 #aiji1 p4 #gib74 ,we understand that the next edition of the ,pharmacopeia will omit mention of skullcap4 ,passiflora incarnata1 or passion-flower1 is another 8herb10 which1 although known for about seventy years1 has never gained the confidence of the medical profession and has not even been admitted to the ,pharmacopeia4 ,according to a ,council ,report3 8,none of the evidence is sufficient to show that passiflora has therapeutic value2 hence it is deemed inadvisable to include the drug in the list of nonofficial remedies0 7,the ,journal ,a4 ,m4 ,a41 ,march #ai1 #aiaj1 p4 #ihc74 ,on these two obsolescent 8herbs10 then1 rest the remarkable claims made for ,neurilla4 ,a certain degree of appetizing effect may be expected from the bitter taste and a very slight degree of physical stimulus from the alcohol4 ,except for these effects--and they are largely delusive and temporary--the preparation is therapeutically inert and worthless4 ,the evidence on which the manufacturers of ,neurilla base their therapeutic claims appears to consist of testimonials from physicians4 ,as a matter of fact1 this is true of practically all of the large group of nostrums of which ,neurilla is typical4 ,an analysis of these ,neurilla testimonials brings out clearly what such 8evidence0 is worth4 ,,ill-,,considered ,,testimonials ,the testimonials for ,neurilla have been given with reference to indefinite conditions of nervousness that border on the psychic and include hysteria1 neurasthenia1 neuralgia and the like4 ,nervousness and indigestion are two diseases in which suggestion1 especially when aided by bitters and alcohol1 produces temporarily a feeling of improvement4 ,as an illustration1 take the following testimonial3 8,but more striking was the following case3 ,one evening between #e and #f o'clock ,i was sent for1 family lives near me1 and ,i was informed that the young lady had promised to be bridesmaid1 a function she had never performed4 ,her mother said the daughter would certainly drop in her tracks as she walked up to the altar with the procession1 and they had about concluded to send a note saying to the parents of the bride that she could not come1 although that would be very disagreeable 7and no less offensive1 said ,i74 ,they agreed with me4 ,i ordered ,neurilla for two hours4 ,she went to church1 and1 ,i was informed the next morning1 passed through the dreaded ordeal simply fatigued1 and was now fast asleep on account of the nice effect of ,neurilla40 ,it might provoke a smile to think that a manufacturer would publish so silly a testimonial were it not that the very fact of its publication indicates that there are medical men thoughtless enough to read and accept such stuff as reliable evidence as to the value of any product4 ,,testimonials ,,given ,,long ,,ago--,,the ,,remedy ,,abandoned ,a number of physicians who had given testimonials were asked in writing whether the testimonials were genuine and whether they still entertained the high opinion of ,neurilla expressed at a former date4 ,several replied that1 if they had ever given such testimonials1 they had forgotten the circumstance4 ,from the replies received we select the following3 ,the testimonial which bears ,dr4 ,a's name reads3 8,i am using ,neurilla with most satisfactory results40 ,dr4 ,a now says3 8,as to its positive value as a therapeutic agent ,i have not used it enough to know4444 ,if the language you quote 444 appears as given in or as a #8testimonial' it must in some way be garbled and appears wholly without my knowledge or consent40 ,dr4 ,b is quoted as having written3 8,i do not often lend my influence to furthering the fame of a proprietary remedy1 but ,i have achieved such excellent results from the use of ,neurilla as a calmative in hysteria and other nervous disorders1 that ,i feel its manufacturers are entitled to an acknowledgment of gratitude from me40 ,dr4 ,b writes3 8,i have not prescribed a dose of the nostrum in years4 ,the use of my name in connection with ,neurilla is unauthorized40 ,dr4 ,c once wrote3 8,i have used ,neurilla with good results40 ,dr4 ,c now writes3 8,in re #8,neurilla' ,i think ,i used the preparation once or twice and it seemed to do good work1 but if due to the preparation or other influences1 ,i am not able to verify4 ,i have not used it since nor will1 as ,i am opposed to using these preparations except in certain cases where the contains remedies whose value ,i have verified under the most rigid tests4 8,p4 ,s4 ,this testimonial must have been given many years ago40 ,dr4 ,d's testimonial is admitted to be based on a single case3 8,i am using ,neurilla in a bad case of neuralgic tic with very good results on an aged lady4 ,she has taken several bottles1 and is still taking it with very good results40 ,dr4 ,d sums up his later experience by saying3 8,i have long since abandoned the use of ,neurilla in practice40 ,the following bears ,dr4 ,e's name3 8,i endorse ,neurilla without hesitation4 ,it meets all indications for which it is intended40 ,this is what ,dr4 ,e writes now3 8,as to the enclosed testimonial in regard to ,neurilla said to be written by me ,i have no recollection4 ,i am not prescribing ,neurilla40 ,dr4 ,f's experience is similar4 ,the testimonial credited to him reads3 8,i have prescribed ,neurilla in nervous disorders with good results40 ,dr4 ,f now writes3 8,i don't remember of ever having prescribed #8,neurilla' or of having given a testimonial for it or any other patent medicine if ,i knew it to be so40 ,,summary ,in the booklet from which the foregoing are taken1 there are forty testimonials4 ,those which we quote are merely samples4 ,to sum up the results of this analysis3 ,of the testimonials some are said to be unauthorized2 a number were written with so little thought that the writers had since forgotten their very existence2 the conclusions expressed in most are not in fact justified by the writers' mature judgment and experience4 ,a number of writers admit that their experience is insufficient to determine whether the supposed good results were due to the medicine used or to other influences4 ,of course such evidence is unworthy of credit and happily1 very little is now being furnished by doctors2 even our courts refuse to admit it4 ,in short1 the published formula shows that ,neurilla is nothing more than a preparation of discredited drugs2 it is exploited largely by means of carelessly formed and thoughtlessly expressed opinions of physicians4 ,it is recommended that this report be published as an illustration of such methods and as a protest against them4 ,editorial ,comment4--,neurilla is advertised in the following publications3 ,archives of ,pediatrics1 ,atlanta ,journal ,record of ,medicine1 ,charlotte ,medical ,journal1 ,indianapolis ,medical ,journal1 ,international ,journal of ,surgery1 ,journal of ,nervous and ,mental ,diseases1 ,medical ,herald1 ,new ,york ,medical ,record1 ,medical ,review of ,reviews1 ,medical ,sentinel1 ,medical ,standard1 ,pacific ,medical ,journal1 ,southern ,practitioner1 ,texas ,medical ,journal1 ,woman's ,medical ,journal1 ,eclectic ,medical ,journal1 ,ellingwood's ,therapeutist1 ,journal of the ,american ,institute of ,homeopathy4 --7,from ,the ,journal ,a4 ,m4 ,a41 ,march #bg1 #aiad47 ,,neurosine1 ,,dioviburnia1 ,,germiletum ,,and ,,palpebrine ,report of the ,council on ,pharmacy and ,chemistry ,neurosine1 ,dioviburnia1 ,germiletum and ,palpebrine are 8shotgun0 proprietaries typical of the polypharmacy of the past three or four decades4 ,they are marketed by the ,dios ,chemical ,company1 ,st4 ,louis1 ,mo4 ,on the recommendation of the referee1 the ,council has authorized the publication of this report4 ,w4 ,a4 ,puckner1 ,secretary4 ,neurosine ,according to the manufacturers1 each fluidounce of ,neurosine represents3 8,bromid of potassium1 ,c4 ,p4 #dj grains 8,bromid of sodium1 ,c4 ,p4 #dj grains 8,bromid of ammonium1 ,c4 ,p4 #dj grains 8,bromid of zinc #a grain 8,extract ,lupulin #cb grains 8,cascara sagrada1 fl4 ex4 #dj minims 8,extract ,henbane 4#jge grain 8,extract ,belladonna 4#jge grain 8,extract ,cannabis indica 4#fj grain 8,oil ,bitter ,almonds 4#jfj grain 8,aromatic ,elixirs40 ,no physician would think for a moment of prescribing all of the drugs contained in ,neurosine for any one condition4 ,yet physicians are urged to use this nostrum in insomnia1 hysteria1 neurasthenia1 migraine1 neuralgia1 delirium tremens and in a host of other conditions4 ,it is recommended in the treatment of epilepsy on this ground3 8,neurosine is presented in a very palatable and agreeable form and can be administered for an indefinite time without untoward by-effects as so often attends the use of the commercial bromides4 ,in order to secure lasting benefits the treatment should be extended over a long period of time40 ,the evident implication here is that the recognized drawbacks of bromid medication are due to impurities present in the commercial bromids and that the teachings of modern medicine with regard to caution in the use of bromids do not apply in the case of ,neurosine4 ,the assurance is offered3 8,neurosine contains no chloral1 morphin or other objectionable drug--a fact of the utmost importance when administering medicines to neurotic women40 8,as a nerve-calmative and sleep-producer nothing can excel ,neurosine 444 ,it should be borne in mind that this preparation contains no opium1 morphine1 chloral or habit-forming drugs 444 ,neurosine being a harmless remedy is especially indicated for neurotic individuals40 ,apart from cannabis indica1 ,neurosine contains no efficient hypnotic4 ,cannabis indica is a dangerous drug1 whose administration to 8neurotic individuals0 is by no means free from danger--especially when it is given under a proprietary name that carries no warning of its presence4 ,here is another recommendation--this time for chorea3 8,all authorities recommend the bromides1 hyoscyamus and cannabis indica in this disease4 ,these remedies are all combined in ,neurosine1 the ideal calmative for both children and adults40 ,on the contrary1 practically 8all medical authorities0 will admit that it is undesirable to keep a child under the influence of bromids if this can be avoided4 ,such treatment is mentioned only for use as a last resort in extreme cases4 ,hyoscyamus and cannabis indica are mentioned in connection with chorea by few authorities1 and then merely as probably valueless4 ,not content with recommending the promiscuous use of this already too complex mixture1 the ,dios ,chemical ,company advises physicians to combine it with iron1 when chalybeate and tonic effects are to be combined with 8a nervine10 with acetanilid for 8irritable cough10 headache and neuralgia1 with antipyrin in asthma and with ,dioviburnia--another ,dios nostrum--in all female ailments4 ,dioviburnia,,ae ,,ae ,for articles on other viburnum preparations1 see pp4 #bah and #dji4 ,dioviburnia1 another ,dios nostrum1 according to the label1 has the following composition3 8,every fl4 oz4 contains #c-d dr4 each of the fl4 extracts1 ,viburnum ,prunifolium1 ,viburnum ,opulus1 ,dioscorea ,villosa1 ,aletris ,farinosa1 ,helonias ,dioica1 ,mitchellae sic ,repens1 ,caulophyllum ,thalictroides1 ,scutellaria ,laterifolia40 ,lateriflora8--,ed4 ,further1 according to the label1 ,dioviburnia contains #ah per cent4 alcohol4 ,if this statement is correct then the 8formula0 is false1 for the fluid extracts named contain from #be to #gc per cent4 of alcohol4 ,as--according to the 8formula0--these fluid extracts constitute three-fourths of ,dioviburnia1 the average alcohol-content in the whole mixture must of necessity be much above #ah per cent4#ei ,according to the makers1 ,dioviburnia is 8unexcelled0 for3 8,amenorrhea1 ,dysmenorrhea1 ,leucorrhea1 ,puerperal ,convulsions1 ,prolapsus ,uteri1 ,menorrhagia1 ,threatened ,abortion1 ,parturition1 ,subinvolution1 ,miscarriage1 and a general relaxed condition of the uterus and appendages1 together with the various aches and pains peculiar to women40 #ei ,five of these fluidextracts have their alcohol-content determined by the ,pharmacopeia or ,national ,formulary4 ,three are not recognized and hence their alcohol-content is not defined by law4 ,the alcohol-content of the mixture of fluidextracts said to be in ,dioviburnia has been kindly furnished by five leading pharmaceutical houses4 ,if the lowest alcohol-content of the several fluidextracts is made the basis of calculation1 ,dioviburnia should contain at least #cj4ge per cent4 of alcohol1 or more than half as much again as the amount declared on the label4 ,around the sample bottle of ,dioviburnia is wrapped a booklet entitled 8,a ,treatise on ,uterine ,diseases and ,obstetrical ,hints10 said to be 8,for the ,profession ,only40 ,the booklet has been prepared1 physicians are told1 to present 8some very valuable suggestions0 regarding the treatment of female disorders and the attention of the medical profession is 8earnestly0 called to the 8very remarkable medicine10 ,dioviburnia4 ,further1 it is said that ,dioviburnia was devised by the ,dios ,chemical ,company because there was an 8absolute necessity0 for some really efficient internal treatment in female diseases4 ,the company backs up its statements by such claims as3 8,the most valuable preparation1 therapeutically1 ever offered40 8,contains every essential for toning up the female organs of generation1 and relieving pain40 8,a general and special tonic1 antispasmodic and invigorating cordial40 ,while the company directs the attention of physicians to the 8well-known1 therapeutical effects of each individual constituent0 of ,dioviburnia1 there is in reality little positive evidence regarding the action of any of the drugs contained in the nostrum4 ,most writers on materia medica do not even mention these drugs and the few who do discuss them1 either question or deny their medicinal value4 ,but if every drug claimed to be present in ,dioviburnia had some actual demonstrated therapeutic properties1 it still would be impossible to predict the action of such a combination in the many and varied conditions for which it is exploited4 ,certainly there is no warrant for such statements as3 8,in ,painful ,dysmenorrhea sic ,dioviburnia is especially indicated1 and its continued use will invariably give relief40 8,in cases of ,leucorrhea of long standing1 ,dioviburnia1 together with local treatment1 invariably gives relief40 8,dioviburnia is efficient in cases of subinvolution2 it cures by its tonic effects44440 ,the effects of the drugs alleged to be present in ,dioviburnia are not such as to justify the hope of either 8cure0 or 8invariable relief40 ,in a way the ,dios ,chemical ,company seems to recognize the inefficiency of ,dioviburnia since it frequently suggests that it be used in combination with drugs of known value2 but it ascribes all favorable results to its own product3 8,in chronic constipation fluid extract of cascara sagrada aromatic may be combined with ,dioviburnia40 8,in cases of habitual abortion1 depending on syphilitic taint1 a prescription containing the following should be used during the entire pregnancy3 8,hydrarg4 ,chlor4 ,corros gr4 #a 8,potass4 ,iodid dram #a 8,dioviburnia ounces #af0 8,an ,anemic or ,chlorotic patient1 suffering with absence of the menstrual flow1 should take ,,dioviburnia combined with ,iron40 8,in leucorrhea depending on endocervicitis1 hot astringent douches once daily should be given4 ,local applications of iodin are useful in chronic conditions4 ,internally1 ,d i o v i b u r n i a promotes healing40 8,rest in bed1 hot douches of a one-half per cent4 solution of compound cresol solution and ,d i o v i b u r n i a internally1 a teaspoonful every #c hours will rarely fail to cure endometritis in a few days40 8,in specific vaginitis1 a solution of potassium permanganate 7#a to #ajjj7 should be used as a douche twice daily4 ,internally give the following3 8,sodii benzoate #a_/b ounce 8,dioviburnia #af ounces 8,m4 sig41 ,teaspoonful every three hours40 8,prolapsus ,uteri is benefited1 and often cured1 by ,,dioviburnia combined with local treatment in the shape of tampons1 pessaries1 electricity1 etc40 ,if ,dioviburnia will cure specific vaginitis1 anemia1 etc41 so will a cobblestone make excellent soup4 ,all that is necessary in the former case is to add certain potent drugs that might be indicated in the pathologic conditions mentioned and1 in the latter case1 to combine suitable amounts of beef1 chicken1 green turtle or vegetables1 with herbs and other seasoning4 ,germiletum ,germiletum is a member of the large class of alkaline antiseptic solutions with excessively complex formulas4 ,in this case not only is the formula complex but also the ,dios ,chemical ,company finds it impossible even to assign a constant composition to it--at least the 8formulas0 which appear on the different styles of ,germiletum labels and advertising circulars vary greatly4 ,the company says3 8,we appeal only to the ,doctor's judgment of his estimation of the formula40 8,doctor you will readily determine from the formula the class of cases in which you have a right to expect satisfactory results40 ,yet the 8formulas0 given present so great a variety and such confusion that it is not clear even to a chemist just what the ,dios ,company wants the medical profession to regard as the composition of ,germiletum4 ,the following statements of 8composition0 have appeared at various times3 #a4 ,in an advertising circular sent out some time ago3 8,,hbf#d ,,boh 7,,oc#f;,h#d;,,cooh7#b ,,boh 7,,oc#f;,h#c;,,cooh7#b ,c#c;,h#e;,,bo#c ,,ch#b,o ,c#aj;,h#ad,o ,c#aj;,h#bj,o ,c#bd;,h#bh,n#c;,cl40 #b4 ,in advertising circulars which have been received of late1 being wrapped with a sample package and with the 8large size0 trade package3 8,c#g;,h#f,o#b ,h#c;,,bo#c ,c#c;,h#e;,,bo#c 7,,ch#b,o7#c ,c#aj;,h#bj,o ,c#aj;,h#ad,o ,c#b;,h#f,o0 #c4 ,in another advertising circular3 8,germiletum is a slightly alkaline chemical solution of ,borohydrofluoric ,acid1 ,borosalylbenzoic ,acid1 ,boroglycerine1 ,formaldehyde with ,menthol1 ,thymol and ,antiseptic ,aromatics40 #d4 ,on the label of a sample package sent through the mails during #aiad1 and on the label of a 8small size0 trade package purchased in #aiad3 8,,formula4--,borohydrofluoric ,acid1 ,borosalylbenzoic ,acid1 ,boroglycerine1 ,formaldehyde with ,menthol1 ,thymol1 ,amyl ,acetate and other ,antiseptic ,aromatics40 #e4 ,in the circular which was wrapped around the sample package referred to above1 and around the 8large size0 trade package purchased at the same time that the 8small size0 package was bought3 8,germiletum is a slightly alkaline chemical solution of ,borobenzoic ,acid1 ,boroglycerine ,formaldehyde1 with ,menthol1 ,thymol and other ,antiseptec sic ,aromatics40 #f4 ,on the sample package1 on the 8small size0 trade package and on the wrappers of the 8large size0 trade package3 8,alcohol #ah per cent42 ,formalin #c_/d ,m4 per oz42 ,amyl ,acetate #a_/c ,m4 per oz40 7also written 8,acetate ,amyl407 ,the label on the large trade package states that ,germiletum contains 8,formalin #a_/b ,m4 per oz40 ,one and all of these various formulas spell mystery4 ,the existence of some of the constituents is problematic2 even if the theoretical possibility of such combinations be conceded1 some of them could not exist in ,germiletum1 for they would be broken up by the alkaline fluid4 ,as illustrating the contradictions which the formulas present3 ,while the wrapper of the 8large size0 trade package claims that ,germiletum contains #c_/d minims ,formalin 7,formalin is a proprietary name for a #dj per cent4 formaldehyd solution7 the label on the bottle claims only #a_/b minim4 ,again1 while the composition expressed in chemical symbols asserts that 8,h#c;,,bo#c0 7boric acid7 is a constituent of ,germiletum1 the 8formula0 which follows it states that ,germiletum has an alkaline reaction2 hence it cannot contain much boric acid4 ,finally1 the 8small size0 bottle of ,germiletum purchased at the same time as the 8large size0 bottle and also the label of a sample package sent through the mails to a physician in #aiad1 give as a constituent 8,borohydrofluoric ,acid10 which is mentioned neither on the label of the 8large size0 trade package nor in the pamphlet wrapped around it4 ,the only information which these contradictory 8formulas0 can convey to a physician is that ,germiletum is an unscientific1 varying mixture of many drugs4 ,a trade package1 having the name 8,germiletum0 blown in the glass1 bears on the label recommendations for its use in the treatment of 8catarrh10 8,gastritis1 ,stomatitis1 ,gastric and ,intestinal ,catarrh10 8,leucorrhea and ,uterine ,diseases10 8,hemorrhoids10 8,whooping ,cough10 8,tonsilitis and other forms of sore throat0 and 8,eczema40 ,the following statement on the label is designed to induce physicians to place false confidence in ,germiletum to the danger of their patients3 8,the lying-in-room should be thoroughly sprayed with ,germiletum4 ,can be relied upon to destroy the living particles which so generally constitute contagion40 ,this claim1 as well as the assertion which appears on the label of a sample package and of the 8small size0 trade package that it is 8,,par-,,excellent ,,in ,,obstetrical ,,practice0 is almost criminal1 as ,fussell#fj has said1 since to depend on any preparation of this sort is to court disaster4 #fj ,fussell1 ,m4 ,h43 ,dangers of ,certain ,ethical ,proprietary ,preparations to ,both ,physicians and ,public1 ,the ,journal ,a4 ,m4 ,a41 ,oct4 #g1 #aiaa1 p4 #aaif4 ,the booklet around the trade package makes the claim that ,germiletum 8is the best antiseptic0--evidently largely because it is claimed to be 8the blandest of all0--and that it is 8thoroughly germicidal0 and even that it is 8the best disinfectant obtainable40 ,it also contains such unwarranted and misleading claims and suggestions as3 8444 preparatory to all operative work--,germiletum should be used freely in spraying the atmosphere 4440 8,operative wounds1 whether large or small1 can be rendered thoroughly antiseptic by freely spraying them with ,germiletum44440 8444 it may be given internally in many dyspepsias and in all zymotic diseases4444 ,in such conditions ,germiletum is the ideal internal antiseptic and disinfectant40 ,in the present advertising1 no evidence whatever is offered for the value of ,germiletum1 the ,dios ,company contenting itself with unsupported claims and cant phrases such as 8444 the truth is only reached through a final appeal to intelligent practical experience40 ,in the old circulars only crude1 uncritical and meaningless tests to establish the antiseptic value of ,germiletum are reported and none whatever as to its germicidal action4 ,in the advertising matter sent out some time ago1 for instance1 were given 8,microscopical1 ,bacteriological and ,chemical ,tests1 ,comparing ,germiletum with ,carbolic ,acid40 ,these tests have no value whatever1 unless it be to show the worthlessness of the preparation4 ,this is particularly true as regards a series of experiments on 8,germiletum as a ,preventive of ,lactic ,fermentation10 in which one part of ,germiletum in thirty parts of milk did not prevent fermentation4 ,such effect as indicated is probably due to the formaldehyd present4 ,the tests show the absurdity of using the preparation for internal and external purposes4 ,the referee challenges the therapeutic claims on the basis that they are extravagant and unsubstantiated4 7,the ,chemical ,laboratory of the ,american ,medical ,association reports that the alkalinity of ,germiletum corresponds approximately to a #a per cent4 borax solution47 ,palpebrine ,according to the ,dios ,chemical ,company1 ,palpebrine is 8,a ,reliable ,external ,ocular ,antiseptic0 having1 it is said1 the following composition3 8444 each fluid ounce contains #a_/aaf grain ,sulphate of ,morphia1 #a_/g grain ,sulphate of ,zinc1 #a_/aa grain ,bi-,chloride of ,mercury1 #e-c_/h grains ,boric ,acid1 #c_/d grain ,salicylic ,acid40 ,the essential virtues ascribed to ,palpebrine1 according to its makers1 are its harmlessness and its therapeutic efficiency due1 presumably1 to its complex composition3 8,attention is called to the constituents of this formula1 each one of which is used by ophthalmologists4 ,their combination in ,palpebrine is such as to blend their action in a very happy manner4 ,palpebrine acts as an antiseptic1 an irritant1 an astringent1 and a nerve tonic to the mucous membrane of the eye40 8,palpebrine is superior in its action to the remedies now in use4 ,it contains all the constituents of ,aqua ,conradi 444 ,but to these are added a number of other agents which will prove it to be of much greater value and give it a broader field for action40 ,in all external afflictions of the eye the free use of ,palpebrine is suggested in such statements as3 8,they general practitioners will therefore gladly receive from our hands an efficacious preparation which may be used with perfect safety40 8,the name of our preparation--,palpebrine1 is derived from the ,latin palpebra1 the eyelid1 and is well fitted1 as it designates at a glance the sphere of action of ,palpebrine40 8,with the assistance of ,palpebrine the general practitioner can successfully treat all cases of external eye disease ordinarily encountered in his practice40 ,one of the members of the ,council staff of clinical consultants calls attention to the fact that much vitally valuable time might be lost in a case of iritis1 for example1 which being unrecognized1 should be treated with ,palpebrine on the strength of the ,dios ,chemical ,company's advertisements4 ,even more dangerous is the recommendation of ,palpebrine for the prevention of ophthalmia in the newborn1 especially as this recommendation is coupled with an attempt to discredit the established treatment with silver nitrate solution3 8,the use of severe remedies for this purpose has been discarded by most physicians44440 ,while it is doubtless true that ophthalmia neonatorum may be averted by other drugs than silver salts1 it is utterly unjustifiable to suggest that the established method of treatment by means of silver salt irrigations has been generally discarded4 ,editorial ,note4--,the four nostrums mentioned above have been grouped together for publication to call attention to one phase of the proprietary business4 ,a fact not mentioned in the ,council's report is that these nostrums are manufactured and promoted by a concern that belongs to a type we have often designated 8pseudo-chemical0 companies4 ,by this is meant companies that are not in the legitimate business of pharmacy or chemistry1 but organized to exploit one1 two or in some instances half a dozen proprietaries4 8,patent medicines0 are exploited by this class of 8companies40 ,the ,dios ,chemical ,company is not a chemical company1 except in name4 ,j4 ,h4 ,chambers1 the founder so far as we can learn1 never claimed any special knowledge of chemistry1 pharmacy or medicine4 ,the officers at the present time are3 ,j4 ,h4 ,chambers1 president2 ,m4 ,e4 ,chambers1 vice-president2 ,leslie ,t4 ,chambers1 treasurer1 and ,arthur ,chambers1 secretary4 ,m4 ,e4 is the wife of ,j4 ,h41 and ,leslie ,t4 and ,arthur are sons4 ,this is simply one illustration of the fact noted above4 ,some physicians have been and are prescribing nostrums originated1 manufactured and advertised by laymen who are not in the legitimate pharmacy business4 ,in addition1 such physicians have been accepting the statements of laymen1 not only as to the composition of the nostrums1 but as to their use4 ,in every state the practice of pharmacy is regulated by law3 before assuming the responsibility of compounding medicines a druggist must have studied and passed an examination in pharmacy4 ,public safety demands and the law requires it4 ,there are some doctors1 however1 who will allow laymen who are not chemists1 pharmacists or physicians to formulate and compound a prescription and tell them what it is good for and how to use it4 ,the ,dios ,chemical ,company is not an isolated instance3 we have already referred to some2 we shall take occasion to refer to others in the future4 ,that such concerns flourish is a reflection not so much on the shrewd laymen who exploit the medical profession--and through it the public--as it is on the physicians who cast their scientific training to the winds and permit themselves to be thus exploited4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #i1 #aiae47 ,,oxychlorine ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,oxychlorine has been submitted to the ,council by the subcommittee to which it was assigned3 ,to the ,council on ,pharmacy and ,chemistry3--,your subcommittee submits the following report3 ,the ,oxychlorine ,chemical ,company1 #acbf ,wabash ,avenue1 ,chicago1 states in its advertising literature that3 8,chemically1 ,oxychlorine is the tetraborate of sodium and potassium combined with oxychlorid of boron1 thus3 #f 7,na,k,b#d,o#g7 ,b,o,cl#c40 ,analysis of ,oxychlorine showed3 ,potassium #ab4bf per cent4 ,sodium #h4bj per cent4 ,chloric acid--,,clo#c #be4cb per cent4 ,nitric acid--,,no#c #ba4gj per cent4 ,boric acid anhydrid--,b#b,o#c #ah4fc per cent4 ,water1 calculated #ac4bi per cent4 ,thus1 ,oxychlorine is not a definite chemical substance of the composition claimed1 but instead is a mixture of alkali chlorate and nitrate with boric acid4 ,assuming that the chlorate is present as potassium chlorate and the nitrate as sodium nitrate1 the analysis above quoted corresponds to a mixture approximately as follows3 ,potassium chlorat #cg4ai ,sodium nitrate #bi4gf ,sodium and potassium tetraborate #b4ah ,boric acid #cj4eb ,undetermined #j4ce ------ #ajj4jj ,your committee recommends that ,oxychlorine be not approved and that this report be published4 ,the report of the subcommittee was adopted by the ,council1 and in accordance with the recommendation is published herewith4 ,w4 ,a4 ,puckner1 ,secretary4 ,in commenting on the above report it is hardly necessary to call attention to the palpable untruthfulness of the furnished formula or its lack of correspondence to the real composition of the preparation1 to the imposing claims made by its pseudo-scientific exploiters or the absurdities1 from a chemical standpoint1 of the statements made in their literature4 ,these features are more or less common to all nostrums4 ,the physician who prescribes or uses ,oxychlorine under the impression that he is getting a definite and unique chemical compound described as tetraborate of sodium and potassium combined with oxychlorid of boron is1 according to our chemists1 getting simply a mixture of potassium chlorate1 sodium nitrate 7or1 perhaps1 sodium chlorate and potassium nitrate71 and boric acid in about equal amounts4 ,more than one-third of this mixture is potassium 7or sodium7 chlorate1 drugs by no means harmless4 ,in order that there may be no suspicion of unfairness to the promoters of the preparation1 we quote from one of the advertising circulars sent out by the ,oxychlorine ,company3 8,oxychlorine owes its recognition as a therapeutic agent to its six principal qualities3 8#a4 ,it will oxygenate the blood at the seat of application1 maintain nutrition and heal an uninfected solution of continuity of first intention without scar formation4 8#b4 ,it will disorganize all pus and ferment-producing micro-organisms1 their toxins1 ferments and ptomains4 8#c4 ,it will restore an inflamed mucous membrane to its normal condition1 except where the membrane is sclerosed or atrophied4 8#d4 ,it will destroy pathogenic micro-organisms and their toxins in the blood current4 8#e4 ,it will stimulate the blood to absorb more oxygen in the lungs than it at the time carries4 ,we do not know what this means2 perhaps the ,oxychlorine ,company does4 8#f4 ,it is absolutely harmless to the tissues and will not destroy a living cell40 ,surely these people must have access to physiologic and chemical authorities not found in modern medical libraries1 or else their esoteric researches into the mysteries of life must have carried them far beyond the ken of our most advanced workers along these lines4 ,the scientific world would receive with great interest information as to how a mixture of potassium chlorate1 sodium nitrate and boric acid oxygenates blood1 maintains nutrition and causes healing without scar formation4 ,a mixture which will destroy micro-organisms and yet will not destroy a living cell certainly shows a fine sense of selection and discrimination not heretofore expected of a combination of chemicals or of a chemical compound4 ,how like the wonderful elixir of medieval times1 which was to the ,christian a tonic and to the heathen a poison6 ,here is another claim made for this nostrum3 8,two or three rectal injections of a one or two per cent4 solution of ,oxychlorine and ten grain doses given six to eight times per day is the best and most reliable treatment for typhoid fever40 ,if #hj grains of ,oxychlorine contain #cj grains of potassium chlorate1 three rectal injections each consisting of #a pint of #b per cent4 solution1 would contain approximately #afj grains of potassium chlorate4 ,such an injection might prove decidedly dangerous1 especially when used by one ignorant of its true composition4 ,however1 the physician1 not the promoters1 bears the responsibility4 ,oxychlorine sells at #c4ej a pound2 the ingredients can be obtained for about #dd cents a pound4 ,perhaps the margin of profit is intended as a reward due the promoters for the profound physiologic discoveries announced in their reading matter4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #f1 #aiji47 ,,pam-,,ala1 ,,another ,,worthless ,,quinin ,,substitute ,report of the ,council on ,pharmacy and ,chemistry ,the following report of a referee on ,pam-ala1 an asserted malaria specific1 was adopted by the ,council and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,soon after publication of the ,council's report on ,sinkina1 an alleged malaria specific proved worthless1 the referee's attention was called to ,pam-ala1 which is sold under very similar claims4 ,according to the advertisements which have been appearing in ,southern medical journals1 ,pam-ala is 8,a new and effective remedy for ,,malaria40 ,the label describes ,pam-ala as 8,an ,effective ,vegetable ,remedy ,for ,,malaria4 ,guaranteed free of any ,quinine1 or other harmful sic drugs40 ,it is said to be indicated in 8,malarial ,intermittent and ,remittent ,fevers1 especially curative in ,chronic ,malaria and ,malarial ,cachexia and all conditions even where ,quinine fails40 ,one tablespoonful three times a day is said to be the 8,curative ,dose10 while one tablespoonful three times a week is stated to be a 8,prophylactic ,dose40 ,the label further claims that ,pam-ala 8,surpasses ,quinine in its action and has none of its ,disadvantages40 ,assertions that ,pam-ala is superior to quinin are followed by the usual 8guarantee0 claim3 8,guaranteed by the ,pam-,ala ,co4 under the ,drugs ,act1 ,june1 #aijf1 ,ser4 ,no4 #biji ,a40 ,finally1 the label says that it is 8,endorsed by ,medical ,authorities ,throughout the world40 ,as regards the composition1 a circular says that 8,,pam-,,ala is a purely vegetable remedy for the cure1 without ,quinine1 of all forms of ,malaria40 8#8,,pam-,,ala' is derived from a plant of the genus ,umbelliferae1 a native of the mountainous regions of ,mexico and northern parts of ,south ,america4 ,its medicinal properties have not been known to anyone but the native ,indians1 who for years past have used it as a specific in all forms of fever and malarial diseases so prevalent in tropical countries4 ,the seeds are more active as a therapeutic agent than the dried-up plant2 hence their collection for medicinal purposes requires special skill in the selection of the same so as to be able to extract all the possible medicinal properties from them1 viz41 its active principle4 ,an oil may be abstracted from the seeds which is of a yellow color with an intense characteristic odor40 ,at the close of the circular the following unenlightening formula appears3 ,each fluid ounce contains3 ,ext4 ,fid4 ,pam-ala #aj per cent4 ,alcohol #ae per cent4 ,ol4 ,aurant ,syr4 ,sacchari aqua ad4 q4 s4 #ajj per cent4 ,in addition to being a cure for malaria1 ,pam-ala is claimed to have a 8favorable influence upon the broncho-pneumonia of measles 44410 8will avert an attack of acute catarrh10 and 8abort acute tonsilitis40 ,the testimonials are of the usual character4 ,most of them seem to have been given some four years ago by physicians in ,italy1 ,cuba1 ,porto ,rico1 ,guatemala1 etc41 and therefore cannot readily be looked into4 ,two are of more recent date and come from physicians in this country4 ,they furnish good illustrations of the manner in which proprietary concerns make use of opinions hastily formed and thoughtlessly put in writing4 ,one testimonial was given in ,july1 #aiab3 8,i take pleasure in testifying to the seemingly marvelous and gratifying effect of ,pam-ala in #b cases of malaria44440 ,on ,jan4 #b1 #aiad1 its writer1 in reply to an inquiry whether in the light of continued experience1 his first estimate of ,pam-ala had been confirmed1 wrote3 8444 ,since then ,i tried ,pam-ala on a number of cases without any results whatever2 in fact my patients seemed to get worse until ,i resorted to the usual treatment of malaria1 mercurial laxative followed with quinin4 ,i was too hasty in stating that ,pam-ala cured malaria4 ,i now know and have known since ,august1 #aiab1 that ,pam-ala will not cure malaria44440 ,the writer of the second testimonial is reported to have written that he tried ,pam-ala 8on a most pronounced case of malarial spleen with the most excellent results0 and that he 8also tried ,pam-ala on a case of ,malarial ,cystitis and ,hematuria1 with entire satisfaction40 ,in reply to inquiry this physician admits that he was 8very favorably impressed with the preparation at the time40 ,he states that at that time he was also trying out ,sinkina and that after six months he 8discontinued the use of both as the results did not warrant further investigation40 ,he concludes3 8,with due allowance for the fact that certain cases will for a time improve on any kind of treatment1 new or old1 ,i see no reason for supplanting or even augmenting1 the recognized treatment for malarial conditions1 with either ,pam-ala or ,sinkina40 ,incidentally it should be mentioned that this physician also noted the general similarity of ,sinkina and ,pam-ala4 ,he observes3 8,the physical appearance and properties of the two preparations seem to be identical1 the advertising matter and literature are surprisingly alike and the only marked difference seems to be that one remedy is purported to be prepared from a #8new' ,south ,american plant and the other from an equally fresh discovered addition to ,asiatic flora40 ,,what ,,is ,,pam-,,ala8 ,from a comparison of the statements regarding the composition which are made for ,sinkina and for ,pam-ala1 as well as from the physical characteristics of the preparation1 particularly the odor and taste1 it seems evident that the essential constituent is oil of cumin4 ,although definite proof that oil of cumin forms the essential constituent of ,pam-ala would have shown the worthlessness of this nostrum for the reason that the clinical investigation of ,sinkina proved the worthlessness of oil of cumin1 it did not seem worth while to the referee that this be demonstrated by chemical analysis4 ,it seemed to him that in such cases as these1 the secrecy with which the identity of the preparation is surrounded1 as well as the extravagant and highly improbable claims1 should be sufficient to condemn it4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #bh1 #aiad47 ,,papayans ,,bell,,af ,report of the ,council on ,pharmacy and ,chemistry ,,af ,see also ,bell-,ans 7,papayans ,bell71 p4 #bhb4 ,the following report of a subcommittee was submitted to1 and adopted by1 the ,council and its publication directed4 ,w4 ,a4 ,puckner1 ,secretary4 ,papayans 7,bell7 made by ,bell ,co41 ,orangeburg1 ,n4 ,y41 is said to consist of the 8digestive principle obtained by our own exclusive process from the fruit of ,carica papaya1 combined with willow charcoal1 chemically pure sodium bicarbonate and aromatics40 ,the following statement appears on the package3 8,for the treatment of dyspepsia1 flatulence1 nausea1 vertigo1 hyperacidity1 palpitation and other symptoms of indigestion and the vomiting of pregnancy4 ,peritonitis1 cholera morbus1 alcoholism and seasickness40 8,digests every variety of food1 removes every symptom of indigestion1 restores the entire digestive tract to a normal condition40 ,the dosage is recommended as follows3 8,from one to three tablets before meals1 or two hours after eating4 ,in severe cases1 three tablets dissolved in hot water and repeated as necessary40 ,a circular which accompanies the package details the therapeutic virtues of the preparation and contains what purports to be extracts from medical journals1 in which ,papayans is recommended4 ,examination of specimens purchased in the open market showed them to contain the following ingredients3 ,charcoal1 sodium bicarbonate1 ginger1 saccharin and oil of gaultheria4 ,as the product is said to contain papain1 the presence of enzymes was tested for1 with the result that it was found to possess neither proteolytic nor amylolytic properties4 ,the results of our examination are in accord with the results obtained by a member of the ,council1 who examined the product independently1 and who writes3 8,we have made some extended tests with ,papayans ,bell1 and find that the tablets consist essentially of sodium bicarbonate and charcoal1 with a little flavoring matter4 ,we find no digesting power for starch or egg albumin4 ,at any rate1 no appreciable change follows in the albumin in three hours1 and no conversion to sugar in the same time1 or change of starch to a point where the iodin reaction is weakened4 ,the product seems to be practically inert40 ,it is recommended that ,papayans ,bell be refused recognition1 and that publication of this report be authorized4 ,comment3 ,it will be remembered that two other products of ,messrs4 ,bell ,company have been discussed in this department3 ,salacetin 7,bell7#fa and ,sal-,codeia 7,bell74#fb ,salacetin was examined with several 8synthetics0 which all turned out to be mere acetanilid mixtures4 ,salacetin1 advertised as 8a combination1 with heat1 of ,salicylic and ,glacial ,acetic ,acids and ,phenylamine0 when examined 8was found to be a mixture and to contain the following ingredients approximately in the proportion given3 ,acetanilid #dc2 sodium bicarbonate1 #ba2 and ammonium carbonate1 #bj40 ,sal-,codeia 7,salacetin-,codein7 therefore1 would be the same with codein added4 #fa ,see p4 #cef4 #fb ,see p4 #ceg4 ,papayans 7,bell7 seems to be consistently fulfilling the life-history of the average nostrum4 ,made of well-known drugs and invested by its manufacturers--or exploiters--with virtues absurdly disproportionate to the known properties of the alleged constituents of the nostrum1 the preparation was introduced to the world via the medical profession4 ,with the help of thoughtless physicians1 aided by a skilful and aggressive advertising campaign and augmented by the 8free sample0 device1 the business grew and prospered4 ,the bottles with the name and address of the company blown in the glass and with the varied therapeutic indications for the nostrum printed both on the label and on the circular in which the bottle is wrapped1 have carried the manufacturer's message to the drug-taking public4 ,apropos of this point1 the recent 8literature0 contains what purports to be endorsements of the nostrum by medical journals4 ,thus there is quoted from the ,new ,york ,medical ,journal1 ,jan4 #b1 #aiji1 in part1 the following recommendation3 8444 we venture to suggest to our readers who have not tried this remedy that they prescribe one original sealed package of ,papayans 7,bell7 and that they carefully note the results from its use40 ,italics ours4--,ed4 ,having seen an 8original sealed package0 we believe that we can predict the 8results from its use40 ,on any patient not mentally unbalanced1 the result would be that the next dose of ,papayans 7,bell7 he thought that he needed would be purchased from the druggist direct4 ,that such results are not hypothetical is evidenced by the statements of the exploiters of ,papayans 7,bell7 that 8the annual sale now exceeds four hundred million tablets40 ,assuming that statement to be true1 it would be necessary for every physician in the ,united ,states to prescribe over three thousand of these tablets every year--if they reached patients only through the physician6 ,the company's own figures indicate that the time is about ripe to take care of this vast army of self-drugging laymen and recent circular letters seem to recognize it4 ,the physician is notified that druggists are now furnished with ,papayans 7,bell7 8in sealed packages of thirty and one hundred tablets40 ,the medical man is told that the firm has 8not forgotten the days when physicians' orders made our success possible0 and it says it is 8sincerely grateful to the doctors who gave us orders in the days when we were struggling for recognition40 ,this tacit admission of the value of the physician as an unpaid agent for nostrum houses should be given thought by those physicians who prescribe such preparations4 ,while1 so far as we know1 ,bell ,co4 have not yet advertised in the daily press1 they are not averse to furnishing the laity with samples when requested4 ,an ,ohio physician sent us the following letter received by a young woman who had written asking for samples3 ---------------------------------------- ------------------ ,miss ,x---- ,y----1 ,z----4 ,dear ,madam3 ,as requested1 we are mailing you sample of our ,papayans 7,bell7 for ,indigestion4 ,if a sufferer from ,indigestion1 we want you to give it a thorough trial as directed and note remarkable results that we believe you will get from its use4 ,kindly write us if you are unable to obtain it from your local druggist1 as it is stocked by nearly every good drugstore in the ,united ,states4 ,yours truly1 ,bell ,co4 ---------------------------------------- ------------------ ,evidently ,bell ,co41 while admitting that their financial success is largely due to the kindly1 though misguided1 efforts of physicians1 are not going to let a little thing like loyalty to the medical profession interfere with a possible sale of their tablets4 ,,the ,l4 ,d4 ,,johns ,,company ,a discussion of the methods of ,bell ,company would not be complete without reference to a concern which seems to be closely connected with it3 the ,l4 ,d4 ,johns ,company1 whose 8only product0 is a sugar-coated laxative tablet4 ,regarding the 8sugar coated0 tablet1 a visitor at the place of business of ,bell ,company and the ,l4 ,d4 ,johns ,company wrote3 8,these companies apparently are not in possession of any tablet coating machines and in questioning on this point stated that some of their tablets were sent out to be coated40 ,there is a sameness regarding the claims for the laxative tablets of the two companies that might lead one to suspect that the same individual prepared both circulars4 ,for instance3 ,,cascarans 7,,bell7 8,taken as directed1 it permanently removes the great majority of cases of habitual constipation40 8444 a harmless vegetable preparation40 8444 for the removal of pimples1 yellowness and greasiness of the skin 4440 8444 one tablet at night1 one night and morning1 or1 in severe cases1 one three time a day1 gradually decreasing the frequency of the dose as improvement permits40 ,,dr4 ,,johns' ,,tablets 8,taken as directed 444 permanently remove the great majority of cases of habitual constipation1 torpid liver and sick headache40 8,a harmless vegetable remedy40 8444 removes pimples1 blotches1 sallowness and greasiness of the skin 4440 8,one at night1 one night and morning1 or1 in severe cases1 one three times a day4 ,gradually decrease the frequency of the dose as improvement permits40 ,according to a leaflet sent out with samples by the ,l4 ,d4 ,johns ,company1 the company is capitalized for #ejj1jjj1 divided into #ej1jjj shares at #aj each2 these shares are sold to those physicians who will agree 8to prescribe the tablets at every suitable opportunity1 to introduce them to other physicians0 and 8to promote their sale in every ethical way60 ,if the list of physicians' names and addresses which the company sends out as comprising the eastern stockholders is to be relied on1 it would seem that many medical men are promoting their sale4 ,in prescribing it is1 of course1 8necessary to specify #8,dr4 ,johns' ,tablets ,no ,,xxx 7,original bottle74'0 ,as the name is on the bottle1 it is not unbelievable that1 as the company says in its prospectus1 because of 8our method of advertising1 a large and very profitable business is being created40 ,that the ,l4 ,d4 ,johns ,company expects to profit by the self-drugging which this method of prescribing fosters is evident3 8,physicians not stockholders in this company suffer from the continual refilling of their prescriptions and from the recommendation of the preparation prescribed by patients to others4 ,italics ours4--,ed4 ,our stockholders benefit by the refilling of their prescriptions and by these recommendations40 ,put baldly the case amounts to this3 ,physicians who prescribe 8,dr4 ,johns' ,tablets0 not only are likely to foster self-drugging1 but they will reap dividends therefrom4 ,truly a nice business to be in6 ,while ,bell ,company and the ,l4 ,d4 ,johns ,company are said to be entirely distinct1 they are to be found at the same address at ,orangeburg1 ,new ,york1 and as will be seen1 the officers of the two companies are more or less related4 ,,bell ,,co4 ,l4 ,d4 ,,johns ,,co4 ,president ,john ,l4 ,dodge ,president ,secretary ,geo4 ,c4 ,tennant ,vice-,president ,vice-,president ,chas4 ,b4 ,smith ,secretary and ,treasurer ,,exploiting ,,the ,,profession ,nostrum promoters have two simple ways of 8working0 the medical profession4 ,the first--and the more profitable--is1 by lavish distribution of free samples1 to get physicians to prescribe the blown-in-the-glass 8original package0 with the inevitable result of large sales direct to the laity4 ,by the second method1 which is merely a modification of the first1 the physician furnishes the capital for floating the nostrum and then takes his share of the resulting profits4 ,there may not be quite as much money in the second method for the promoter1 but then the risks are correspondingly less4 ,if the firm fails1 the stockholders are the losers2 the promoter is not necessarily 8out0 anything4 ,from a commercial standpoint1 a combination of the two methods is1 of course1 ideal--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ad1 #aiji47 ,,passiflora ,,and ,,daniel',s ,,concentrated ,,tincture ,,of ,,passiflora,,ag ,report of the ,council on ,pharmacy and ,chemistry ,,ag ,see also ,pasadyne1 p4 #ccb4 ,the ,council has voted that the drug passiflora 7passion flower7 be not accepted for ,new and ,nonofficial ,remedies1 and has recommended that the following article be published in ,the ,journal4 ,it is considered important to call attention1 not only to the lack of reliable evidence of the therapeutic value of passiflora1 but also to the absurdity of the claims which are made for ,daniel's ,concentrated ,tincture of ,passiflora1 a preparation which has been already refused recognition4 ,w4 ,a4 ,puckner1 ,secretary4 ,passiflora ,although passiflora was introduced into medicine nearly seventy years ago1 the literature concerning it is not very extensive2 it is not mentioned in the standard works on pharmacology and its chemistry seems never to have been worked out4 ,there appears1 also1 to be no record of experimental investigations of the drug with reference to its pharmacologic action1 except an article by ,i4 ,ott1#fc who used 8,daniel's ,concentrated ,tincture40 ,ott claimed that it lessened the reflex irritability of the cord and paralyzed motion by acting on the motor centers in the cord1 and that it increased the rate of respiration4 ,he also stated that because of its action on the vasomotor centers it reduced the frequency of the heart-beat and lowered arterial tension1 but that these effects were only temporary4 #fc ,med4 ,bull41 #ahih1 xx1 #deg-dfd4 ,on the clinical side the reports are not numerous and such as have been made do not appear to be based on very extensive trials nor on conditions of observation that would entitle them to more than slight consideration4 ,s4 ,d4 ,bullington#fd reports good results1 but no cure1 in one case of epilepsy1 and improvement in a case of insomnia4 ,w4 ,j4 ,stapleton#fe recommends it in the form of a concentrated tincture 7not the one advertised so extensively71 and states that he has used it with great success in insomnia1 hysteria1 neurasthenia1 neuralgia1 nervous and physical prostration1 and in alcoholism4 ,in his opinion its action is most apparent in cases of nervousness due to causes other than pain4 ,s4 ,harnsberger#ff reports two cases in which partial blindness followed the taking of potassium bromid and passion flower4 #fd ,nashville ,jour4 ,med4 and ,surg41 #ahig1 lxxxi1 #ajg-aji4 #fe ,detroit ,med4 ,jour41 #aijd-e1 lv1 #ag4 #ff ,virginia ,med4 ,semimonthly1 #ahih-i1 iii1 #cib4 ,extravagant and inconsistent claims are made for ,daniel's concentrated tincture of passiflora in the advertising literature1 where it is recommended for such a wide range of diseases as asthma1 typhoid fever1 convulsions and paralysis4 ,none of the evidence is sufficient to show that passiflora has therapeutic value2 hence it is deemed inadvisable to include this drug in the list of nonofficial remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #ai1 #aiaj47 ,,liquid ,,combinations ,,containing ,,pepsin ,,and ,,pancreatin,,ah ,report of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association ,,ah ,see also ,reexamination of ,lactopeptine1 p4 #aba4 ,a reprint of articles bearing on this subject is issued under the title ,digestive impossibilities4 ,the following report was submitted to the ,council by a subcommittee3 ,to the ,council on ,pharmacy and ,chemistry3--,the ,u4 ,s4 ,pharmacopeia1 #hth revision1 pages #ccd-e1 states3 8,pepsin and pancreatin in solution are incompatible with one another4 ,if the solution be neutral or alkaline the pancreatin gradually destroys the pepsin1 and if acid the pepsin destroys the pancreatin40 ,the correctness of this statement has been amply demonstrated by the reports which have been submitted to the ,council from time to time on liquid preparations claimed to contain these two ferments4 ,thus an elixir was investigated which was by the manufacturers claimed to contain 8the five active agents of digestion1 pepsin1 veg4 ptyalin1 pancreatin1 lactic and hydrochloric acids10 and to be 8superior to all other remedies in dyspepsia and diseases arising from imperfect digestion10 and the committee which investigated the article in question reported that 8it was impossible to establish the presence of either the proteolytic or the amylolytic ferment40 ,similarly1 on another liquid preparation1 which was said to contain 8pancreatin1 pepsin1 lactic and muriatic acids1 etc40 444 8the combined principles of digestion to aid in digesting animal and vegetable cooked food1 fatty and amylaceous substances10 the committee reported 8this product possessed only very slight proteolytic action and failed to digest #b per cent4 of its own weight of starch40 ,again1 the report on still another preparation stated3 8,but while it was said to contain pancreatin1 the ,u4 ,s4 ,p4 test for the valuation of pancreatin failed to indicate this ferment40 ,the report on yet another elixir1 claimed to be 8the only true digestant1 because it contains the enzymes of all the glands which are necessary for digestion10 showed that this article did not contain 8any appreciable enzyme activity1 either amylolytic or proteolytic40 ,the correctness of these findings of the committee of the ,council was generally acknowledged by the manufacturers when their attention was called to the matter4 ,thus1 one manufacturer of digestive ferments writes3 8,we will ask you to hold this matter up until you hear from us further on the subject4 ,the reason for this request is that we have been going over our liquid preparations very carefully in order to be sure that after aging they would contain the ferments that we put into them4 ,the pancreatic ferments in alcoholic liquids seem to lose their strength40 ,the chemist for a large manufacturing house writes3 8,there are now on the market a number of preparations in which pepsin and pancreatin are combined in liquid form1 and the result is that we have had numberless requisitions from our representatives that we also market such a preparation4 ,as the result of this we have carried out a series of experiments no less than four or five times in order to determine whether pepsin1 diastase1 and pancreatin would retain their activity in the form of a syrup1 wine or elixir4 ,we have proved incontrovertibly that this cannot be done4 ,while any two of these substances1 or even all three of them1 can be dispensed in the form of a liquid by the retail druggist and will retain their normal activity for as long a period as three to six weeks1 yet if allowed to stand sufficiently long1 they mutually destroy each other2 so that in a combination of pancreatin and pepsin the pancreatic enzyme is lost and the pepsin greatly injured1 and where diastase is present1 both diastase and pepsin 7or diastase and pancreatin7 mutually destroy each other40 ,since it has been demonstrated that pepsin and pancreatin cannot exist in one and the same solution for any reasonable length of time1 it becomes apparent that liquid preparations said to contain these two ferments are sold under impossible claims4 ,it is therefore recommended3 #a4 ,,that ,,the ,,council ,,on ,,pharmacy ,,and ,,chemistry ,,refuse ,,to ,,approve ,,liquid ,,preparations ,,that ,,are ,,claimed ,,to ,,contain ,,both ,,pepsin ,,and ,,pancreatin4 #b4 ,,that ,,the ,,medical ,,profession ,,through ,,the ,,journal ,,of ,,the ,,american ,,medical ,,association ,,be ,,advised ,,of ,,the ,,fallacy ,,of ,,employing ,,such ,,combinations4 #c4 ,,that ,,the ,,attention ,,of ,,manufacturers ,,be ,,called ,,to ,,the ,,worthlessness ,,of ,,such ,,incompatible ,,liquid ,,preparations ,,of ,,pepsin ,,and ,,pancreatin1 ,,and ,,that ,,they ,,be ,,urged ,,to ,,cease ,,offering ,,such ,,products ,,to ,,the ,,profession4 #d4 ,,that1 ,,since ,,the ,,national ,,formulary ,,has ,,recognized ,a ,,preparation ,,of ,,this ,,kind ,,under ,,the ,,title 8,,elixir ,,digestivum ,,compositum10 ,,the ,,american ,,pharmaceutical ,,association ,,be ,,requested ,,to ,,instruct ,,its ,,committee ,,on ,,the ,,national ,,formulary ,,to ,,omit ,,this ,,preparation ,,from ,,the ,,next ,,edition4 ,the recommendations of the subcommittee were adopted by the ,council and publication of the report directed4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #b1 #aijg47 ,w4 ,a4 ,puckner1 ,secretary4 ,,pepto-,,mangan 7,,gude7 ,report of the ,council on ,pharmacy and ,chemistry ,the following report was adopted by the ,council and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,about ten years ago the ,m4 ,j4 ,breitenbach ,company circulated what pretended to be an abstract of the report of a government commission for the investigation of the anemia then prevalent in ,porto ,rico4 ,the company asserted that 8this report alone would suffice to establish ,pepto-,mangan at once as the foremost hematinic known40 ,examination of the official report of the commission#fg revealed the fact that the administration of iron in hookworm anemia was considered of secondary importance1 and that of the various preparations of iron1 ,blaud's pill was found to be more efficient than ,pepto-,mangan 7,gude74 ,a protest#fh was made at this time by the commission against the unwarranted use of its report by the ,breitenbach ,company4 #fg ,the ,journal1 ,sept4 #bc1 #aije1 p4 #icd4 #fh ,the ,journal1 ,oct4 #g1 #aije1 p4 #ajii4 ,later the ,breitenbach ,company sent out a report pretending to prove that at the ,infants ,hospital1 ,randall's ,island1 ,new ,york ,city1 ,pepto-,mangan 7,gude7 had been found a most superior preparation in the treatment of infantile anemia4 ,inspection of the hospital records and daily charts of the cases disclosed#fi a remarkable disparity between the claims of the ,pepto-,mangan pamphlet and the real results of treatment4 ,and so here1 also1 as well as in the ,porto ,rico commission's report the trials1 selected by the ,breitenbach ,company prove the limitations and non-superiority of ,pepto-,mangan4 #fi ,the ,journal1 ,april #f1 #aijg1 p4 #aaig4 ,the preceding false reports1 though no longer circulated1 have never been definitely withdrawn and while it is now generally conceded that the good results in anemia are obtained by the administration of the various simple inorganic iron preparations the ,breitenbach ,company still attempts to convey the impression that ,pepto-,mangan 7,gude7 is of most superior efficacy4 ,thus the present ,pepto-,mangan circular attempts to discredit by obsolete and absurd or untrue statements the various preparations of iron which are in general use and to carry the impression that only iron and manganese1 in the particular form and proportion in which they are contained in ,pepto-,mangan--namely1 #c parts ,fe to #a part ,mn--are useful for the treatment of anemia1 chlorosis1 etc4 ,thus contrary to general conceptions1 the impression is given that the now generally accepted course of chlorosis is due to the three varieties of insufficiency of certain blood elements3 7#a7 insufficiency of manganese1 7#b7 insufficiency of iron1 7#c7 insufficiency of iron and manganese2 and that the administration of iron often fails because manganese is not supplied to the system at the same time and in sufficient amounts4 ,the following statement is made3 8,doctor3 8,if you have a case of ,,anaemia1 ,,chlorosis1 or ,,amenorrhoea1 that shows no visible sign of improvement1 and you have exhausted the entire list of ,nauseating ,iron preparations with little or no effect1 it is because the blood is deficient in that essential oxidizing constituent1 ,,manganese1 in a soluble1 readily assimilable form1 the best being in combination with iron40 ,another extravagant claim3 8,usually after taking it for a week its restorative influence on the functions of the stomach is felt2 appetite reappears1 and the general health is improved by the increase in bodily warmth1 an effect directly due to manganese40 ,the following statement implies that ,pepto-,mangan is absorbed unchanged1 for which there is no justification3 8,as the ferruginous and manganic ingredients of ,pepto-,mangan 7,gude7 exist in the form of organic peptonates1 they have already undergone the changes necessary to insure prompt absorption and appropriation by the circulating fluid40 ,the following declaration implies that it repairs the individual defective blood-cells which is1 of course1 also ridiculous3 8,that ,pepto-,mangan 7,gude7 quickly and efficiently builds up defective red blood cells1 and generates1 or at least potently encourages the formation of new ones1 and materially increases their richness in hemoglobin1 has been abundantly demonstrated44440 ,the ,m4 ,j4 ,breitenbach ,company is still trying to mislead physicians2 it also aims to make use of them in its direct appeal to the physicians' patients4 ,for instance1 the name 8,pepto-,mangan 7,gude70 blown in the bottle1 the advertising circular suggesting ,pepto-,mangan as the treatment for anemia1 etc41 and the recommendation to physicians that it be prescribed in 8original bottles0 all tend to encourage the use of ,pepto-,mangan by the public with the likelihood that it will be depended on where good food and fresh air are of prime importance4 ,the attempt to exploit it directly to the public is further attested by the advertisements of department-store drug departments4 ,it is evident from the foregoing that ,pepto-,mangan 7,gude7 is in conflict with ,rules #d and #f and therefore not eligible for admission to ,new and ,nonofficial ,remedies4--7,from ,reports ,council ,pharm4 and ,chem41 #aiad1 p4 #aba47 ,,liquid ,,petrolatum ,,or 8,,russian ,,mineral ,,oil0,,ai ,report of the ,council on ,pharmacy and ,chemistry ,,ai ,see also following reports on ,clinical ,experience with ,liquid ,paraffin 7,liquid ,petrolatum7 and ,angier's ,emulsion4 ,the following report was submitted to the ,council by a referee and its publication authorized by the ,council4 ,w4 ,a4 ,puckner1 ,secretary4 ,petroleum has been in use as a medicine from time immemorial4 ,it was known to ,herodotus #djj years before ,christ and is mentioned by ,plutarch1 ,dioscorides1 ,pliny and other early writers4 ,it was extensively used by the ,arabians and evidently played an important part in the practice of medicine in ,india1 being known to the ,bengalese as ,muthe ,katel4 ,the raw product was the substance used in earlier times and differed much in character and composition1 as obtained from different sources4 ,as an internal remedy it was early employed in chronic pulmonary affections1 in obstinate skin diseases1 in rheumatism1 and for the expelling of tapeworms4 ,it was extensively used for these several purposes in ,france under the name of 8,oleum ,gabianum0 and in ,north ,america as 8,seneka oil40 ,the internal use of the refined product may be traced to a patent granted to ,robert ,a4 ,chesebrough of ,new ,york1 in ,june1 #ahgb1 for the manufacture of a 8new and useful product from petroleum1 named vaseline40 ,this name was originally applied only to a semisolid preparation1 but later a liquid product known as liquid vaseline was marketed and for a time exploited as a cure for coughs1 colds1 consumption and a number of other diseases and conditions4 ,the liquid petrolatum has since become known under a variety of names1 proprietary and otherwise1 in addition to being used as a substitute or an adulterant for other1 more costly1 fats and oils4 ,some of the names applied to the product are3 ,adepsine oil ,neutralol ,amilee ,olo ,atoleine ,paraffin ,oil ,atolin ,paroline ,blandine ,petralol ,crysmalin ,petro ,deeline ,petrolax ,glyco ,petrolia ,glycoline ,petronol ,glymol ,petrosio ,heavy petroleum oil ,rock ,oil ,liquid ,albolene ,russian liquid petrolatum ,liquid ,cosmoline ,russian mineral oil ,liquid ,fossiline ,russian paraffin oil ,liquid ,geoline ,russol ,liquid ,paraffin ,saxol ,liquid ,petrolatum ,terraline ,liquid ,saxoline ,terralbolia ,liquid ,vaseline ,usoline ,mineral ,glycerin ,water-white mineral oil ,mineral ,oil ,white paraffin oil4 ,a preparation similar to that official in the ,pharmacopeia of the ,united ,states as liquid petrolatum has been included in many1 if not all1 of the foreign pharmacopeias1 the official titles under which this preparation is recognized being as follows3 ,petrolatum ,liquidum1 ,u4 ,s4 ,pharmacopeia2 ,paraffinum ,liquidum1 pharmacopeias of ,great ,britain1 ,germany1 the ,netherlands1 ,japan1 ,belgium1 ,austria1 ,denmark1 ,switzerland1 ,sweden1 ,servia1 ,italy1 ,hungary and ,russia2 ,oleum ,paraffinae1 ,spanish ,pharmacopeia2 ,vaselinum ,liquidum1 ,french ,pharmacopeia1 and ,oleum ,vaselini 7as a synonym7 pharmacopeias of ,denmark and ,russia4 ,the requirements of the several pharmacopeias differ somewhat and the specific gravity as given is as follows3 ,u4 ,s4 ,p4 ,,viii1 #aije #j4hgj to #j4idj at #be ,ph4 ,brit4 ,,iv1 #ahie #j4hhe to #j4hij at #ae4e ,b4 ,p4 ,c4 ,,ii1 #aiaa1 usually #j4hge or lower at #ae ,ph4 ,germ4 ,v1 #aiaj1 at least #j4hhe at #ae ,ph4 ,ross4 ,,vi1 #aiaj #j4hhj to #j4hhe at #ae ,ph4 ,hung4 ,,iii1 #aiji #j4hh to #j4hi at #ae ,ph4 ,ital4 ,,iii1 #aiji #j4hge to #j4hij at #ae ,ph4 ,fr4 ,v1 #aijh1 about #j4hge at #ae ,ph4 ,serb4 ,,ii1 #aijh1 about #j4hhj at #ae ,ph4 ,svec4 ,,ix1 #aijh #j4hh to #j4ij at #ae ,ph4 ,helv4 ,,iv1 #aijg #j4hhj to #j4hhe at #ae ,ph4 ,dan4 ,,vii1 #aijg1 at least #j4hhj at #ae ,ph4 ,austr4 ,,viii1 #aijf1 at least #j4hhj at #ae ,ph4 ,belg4 ,,iii1 #aijf1 not below #j4hhj at #ae ,ph4 ,japon4 ,,iii1 #aijf #j4hge to #j4ide at #ae ,ph4 ,ndl4 ,,iv1 #aije1 not below #j4hfj at #ae ,ph4 ,hisp4 ,,vii1 #aije #j4hdj at #ae ,for pharmaceutical purposes1 liquid petrolatum may be divided into two grades1 the lighter or more limpid oil1 used extensively as a vehicle for oil sprays1 and the heavier1 more viscid oil generally recognized in ,european pharmacopeias and used as an ingredient of ointments and more recently as a remedy in the treatment of intestinal stasis4 ,under petrolatum liquidum the ,u4 ,s4 ,p4 recognizes a mixture of hydrocarbons1 chiefly of the methane series1 which occurs as a colorless or very slightly yellowish1 oily1 transparent liquid without odor or taste and having a specific gravity of about #j4hgj to #j4idj at #be ,c4 ,for the ,u4 ,s4 ,p4 ,,ix1 it is proposed to change this requirement somewhat so as to have it apply to a transparent liquid free from fluorescence1 without odor or taste and having a specific gravity of from #j4hde to #j4idj at #be ,c4 ,such a requirement would include all of the available paraffin oils irrespective of origin4 ,the now commonly available commercial liquid petrolatum1 used for pharmaceutical purposes1 is practically colorless and all of the better grades are free from odor or taste4 ,the specific gravity varies from #j4hee to #j4hie4 ,the lighter oils1 having a specific gravity of from #j4hfj to #j4hgj1 are usually preferred in the making of oil sprays or solutions of substances to be used as local applications4 ,the product having a specific gravity above #j4hge evidently contains a considerable amount of dissolved solid paraffin which separates out at temperatures at or below #j ,c41 but readily dissolves again at temperatures above #aj ,c4 ,there is considerable difference in the chemical composition of the paraffin oils obtained from various sources4 ,the ,american oil consists largely of hydrocarbons of the methane series1 while the ,russian oil contains naphthenes or hydrocarbons of the benzene series1 having the empirical composition of ethylene1 7,cn,h#bn7 which may be considered as hydrogenated aromatic hydrocarbons1 though they behave with reagents very much in the same way as do the hydrocarbons of the methane series4 ,mineral oils with a naphthene base are best suited for making white petrolatum1 and at the present time the production of the colorless water-white liquid petrolatum appears to be confined largely or almost exclusively to the crude product of the ,baku district of ,russia1 though it is asserted that it is now also made from the ,hanover 7,germany7 crude oil and that some is being produced by 8cracking0 the white solid paraffin4 ,it is also said that the ,american oil can be made water white but that it is not being so produced at present for economic reasons2 the yellowish oil1 free from fluorescence1 having a very wide sale1 both as a lubricant and as a substitute for lard oil and other of the more costly lubricating oils4 ,from a pharmaceutical point of view it would appear important to note the physical characteristics of the oil and to insist on absence of color1 absence of odor and taste1 absence of acid and of alkali and a specific gravity in harmony with the purposes for which the oil is to be used4 ,during the past year or two liquid petrolatum has attracted considerable attention as a remedy in the treatment of intestinal stasis or chronic constipation1 the practice of using it having been developed largely through its recommendation by ,sir ,w4 ,arbuthnot ,lane and his associates4 ,this use of liquid petrolatum and of petrolatum products generally is by no means novel4 ,n4 ,a4 ,randolph#gj of ,philadelphia was among the first to suggest its use for this purpose in an article published in #ahhe4 ,randolph also appears to have been the first to experiment with petrolatum and to determine its non-absorbability from the intestinal tract4 ,in an article#ga in #ahhd he concludes that 8pure petrolatum while entirely unirritating to the digestive tract is valueless as a foodstuff40 #gj ,randolph1 ,n4 ,a43 ,therap4 ,gaz41 ix1 #gcb4 #ga ,randolph1 ,n4 ,a43 ,proc4 ,acad4 ,nat4 ,sc41 ,philadelphia1 #ahhd1 p4 #bha4 ,the experiments recorded by ,randolph were evidently prompted by the fact that vaseline and a number of imitation products then on the market were being sold as substitutes for lard and butter1 and opinions regarding the food value of petroleum products appear to have differed very materially4 ,following the experiments of ,randolph1 ,robert ,hutchison in #ahii made a series of experiments to demonstrate that petroleum1 petrolatum1 paraffin and related products were absolutely unassailable by any of the digestive fluids1 despite the 8large vogue that had of late years been given to various petroleum emulsions1 chiefly by ingenious and unterrified advertising40 ,he came to practically the same conclusions arrived at by ,randolph fifteen years earlier and pointed out that 8liquid paraffin in one sense may be regarded as an artificial intestinal mucus and might in that way have some value on certain forms of constipation40 ,william ,duffield ,robinson#gb reports on the use of a perfectly refined colorless and odorless petrolatum1 supposedly of ,american origin4 ,he was able to show that all of the product passed unchanged through the intestinal tract and could be regained from the feces4 ,in his conclusions he expressed the belief that the effect of the administration of these petroleum products is far more than as a simple intestinal lubricant4 ,in over fifty selected cases in which nutrition1 digestion and body-weight were impaired1 and the purest oil administered in #a- or #b-;dram doses each day for a period of from four to six months1 there was in every instance an improvement of weight1 health and feeling of well-being4 ,the administration of refined paraffin oil gave no discomfort in any instance1 even in cases in which nearly a pint was given in a few hours4 #gb ,robinson3 ,william ,duffield3 ,med4 ,news1 #aijj1 lxxvii1 #ef4 ,william ,ewart#gc suggests liquid paraffin as a safe agent for the local treatment of the lesions in typhoid fever4 ,he says in part3 8,mineral oil1 such as petrolatum or paraffin1 is neither absorbed nor dissolved2 therefore1 after all absorbable ingestions are taken up by the lacteals1 it will still remain in the bowel4 ,in this way pure liquid paraffin is valuable1 precisely because it is inert2 moreover1 it might some day1 perhaps1 be made the vehicle for effective topical remedies40 #gc ,ewart1 ,william3 ,brit4 ,med4 ,jour41 #aijb1 ii1 #aeje4 ,a4 ,d4 ,schmidt#gd quotes ,stubenrath as having given liquid paraffin in the treatment of chronic constipation1 and he himself gave as much as #bj gm4 of liquid paraffin to adults without observing any injurious effect whatever4 ,he says1 8,as a result of the administration of liquid paraffin1 the feces are softened considerably and are found under the microscope to contain numerous minute globules of paraffin40 ,he was1 however1 unable to recover from the feces the entire quantity of paraffin administered and believes that a certain portion of it1 probably the fractions with a low boiling-point1 are absorbed or possibly oxidized in the organism4 #gd ,schmidt1 ,a4 ,d43 ,mnchen4 med4 ,wchnschr41 #aije1 lii1 #aigj4 ,maurice ,vejux ,tyrode#ge also refers to the use of liquid petroleum in the treatment of constipation4 #ge ,tyrode1 ,maurice ,vejux3 ,boston ,med4 and ,surg4 ,jour41 #aiaj1 clxii1 #fgc4 ,sir ,w4 ,arbuthnot ,lane in his recommendations of liquid petrolatum calls it an ideal remedy for stasis1 but cautions against the use of the lighter oil as extensively prescribed in this country as a vehicle for sprays in nose and throat work4 ,paraffin oil is not absorbed from the alimentary tract and so far as known exerts no deleterious influence4 ,it is usually given in quantities of from #aj to #bj c4c4 half an hour or an hour before meals or in larger doses1 from #cj to #ej c4c41 at one time on retiring4 ,from available evidence it appears that comparatively huge doses may be administered without the production of any untoward results4 ,according to many observers1 liquid paraffin should not be given with or after meals because of the inhibiting influence that it may have on the digestion of food4 ,it is not soluble in water or the ordinary solvents and therefore cannot be diluted4 ,the denser oils are preferably slightly warmed or drunk with warm water so as to obviate the disagreeable slimy sensation that persists when taken cold4 ,volatile oils may be used in moderate amounts to give a distinctive taste to the otherwise rather insipidly tasteless paraffin oil4 ,among the more desirable oils to be used for this purpose would be oil of peppermint1 oil of cinnamon1 oil of betula or methyl salicylate and oil of cloves4 ,from #b to #aj drops of any of these oils can be added to a pint of the oil4 ,when larger doses of the oil are to be given at one time1 it would1 of course1 be advisable to use a comparatively smaller quantity of the volatile oil as a flavor4#gf #gf ,in addition to the articles referred to in the preceding footnotes1 the following are of interest in connection with this subject3 ,editorial1 ,therap4 ,gaz41 #ahhe1 ix1 #cec4 ,junker1 ,f4 ,a43 ,med4 ,record1 ,london1 #ahhe1 xiii1 #ejf4 ,editorial1 ,med4 ,news1 #ahhf1 xlviii1 #aje4 ,dunbar3 ,deutsch4 med4 ,wchnschr41 #ahif1 xxii1 #cc4 ,stubenrath1 ,franz ,casimir3 ,mnchen4 med4 ,wchnschr41 #ahig1 xliv1 #fci4 ,london ,letter1 ,med4 ,news1 #ahii1 lxxiv1 #ejd4 ,hutchison1 ,robert3 ,brit4 ,med4 ,jour41 #ahii1 i1 #gbd4 ,schlesinger1 ,e4 ,g43 ,boston ,med4 and ,surg4 ,jour41 #aiac1 clxix1 #ad4 ,lane1 ,w4 ,arbuthnot3 ,brit4 ,med4 ,jour41 #aiac1 ii1 #aabf2 ,proc4 ,roy4 ,soc4 ,med41 #aiac1 vi1 #di2 ,surg4 ,gynec4 and ,obst41 #aiac1 xvi1 ,no4 #f4 ,jordan1 ,alfred ,c43 ,practitioner1 ,london1 ,february1 #aiac4 ,chrysospathes1 ,j4 ,g43 ,zentralbl4 f4 ,chir41 #aiac1 ,no4 #de2 abstr41 ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ac1 #aiac1 p4 #bbja4 ,from the foregoing it would appear that apart from the ,pharmacopeia of the ,united ,states1 practically all other known pharmacopeias describe a water-white mineral oil under the title 8,paraffinum ,liquidum0 or 8,liquid ,paraffin0 as a colorless1 odorless1 tasteless1 non-fluorescent1 oily liquid1 free from acids1 alkalies and organic impurities4 ,as explained before1 the specific gravity of the preparation as recognized in other countries and as offered on the ,american market at the present time varies considerably1 and there appears to be some difference of opinion as to the exact nature of the product that is preferable for use for different purposes4 ,this matter requires further investigation4 ,since the definition of liquid petrolatum in the ,u4 ,s4 ,pharmacopeia permits the use of fluorescent products of widely varying specific gravities1 it is recommended that physicians who desire the water-white non-fluorescent 7,russian7 mineral oil should use the term 8,petrolatum ,liquidum1 ,grave10 or 8,paraffinum ,liquidum1 ,b4 ,p410 if the heavy product recommended by ,lane is desired1 and 8,petrolatum ,liquidum1 ,leve0 if the light varieties are required4 ,it is further recommended that under the foregoing names1 manufacturers and pharmacists be requested to dispense the products1 in accordance with the following descriptions3 ,petrolatum ,liquidum1 ,grave4--,heavy 7,russian7 ,liquid ,petrolatum4--,paraffinum ,liquidum1 ,b4 ,p41 liquid paraffin4--,a transparent1 colorless1 tasteless1 non-fluorescent1 oily liquid1 odorless when cold but giving off a faint petroleum odor on heating4 ,this preparation should correspond to the requirements of the ,british ,pharmacopeia for liquid paraffin and have a specific gravity of about #j4hhe to #j4hij at #ae ,c4 ,it is insoluble in water or alcohol but soluble in boiling absolute alcohol and readily soluble in ether1 chloroform1 carbon disulphid1 petroleum benzin1 benzene and fixed and volatile oils4 ,it serves as a solvent for volatile oils and related substances like camphor1 menthol and thymol4 ,this is the type of preparation used by ,sir ,w4 ,arbuthnot ,lane1 and his associates for internal administration4 ,it is also used as a basis for ointments and salves and as a local application to wounds1 ulcers and in certain forms of skin diseases in which a simple protective is desired4 ,petrolatum ,liquidum1 ,leve4--,light 7,russian7 ,liquid ,petrolatum4--,a transparent1 colorless1 tasteless1 non-fluorescent1 oily liquid1 odorless when cold1 but giving off a faint petroleum odor on heating4 ,in other respects this preparation should correspond to the pharmacopeial tests for liquid petrolatum and have a specific gravity of about #j4hfj to #j4hge at #ae ,c4 ,like the heavy variety of liquid petrolatum1 it is insoluble in water and alcohol1 but soluble in boiling absolute alcohol and rapidly soluble in ether1 chloroform1 carbon disulphid1 petroleum benzin1 benzene and fixed and volatile oils4 ,it serves as a solvent for volatile oils and related substances like camphor1 menthol and thymol4 ,this is a type of preparation extensively used as a vehicle for the oily sprays in nose and throat work4 ,it is also being used as one of the constituents in the now popular paraffin oil cold cream and has been used to some extent for internal administration in the treatment of chronic stasis4 ,being more limpid than the preparation preferred by ,lane1 it is more readily taken1 though greater care must be exercised in securing a sample devoid of the lighter fractions of petroleum distillates4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #cj1 #aiad47 ,,clinical ,,experience ,,with ,,liquid ,,paraffin 7,,liquid ,,petrolatum7,,aj ,a ,comparative ,investigation ,made ,under the ,auspices of the ,council on ,pharmacy and ,chemistry,,ak ,w4 ,a4 ,bastedo1 ,m4,d41 ,new ,york ,,aj ,see also preceding report on ,liquid ,petrolatum or 8,russian ,mineral ,oil0 and following report on ,angier's ,emulsion4 ,,ak ,this investigation was made under the auspices of the ,committee on ,therapeutic ,research of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association4 ,at the request of the committee1 ,dr4 ,w4 ,a4 ,bastedo has prepared this critical review of the reports made by those who collaborated in this investigation4 ,during the past three or four years1 8mineral oil0 has come into extensive use in the treatment of constipation4 ,preparations of the ,russian and the ,american oil1 both heavy and light1 have appeared on the market1 but there have been no satisfactory data on which to base a selection of oil for use4 ,therefore1 in order to obtain reliable clinical information concerning the relative efficiency of the different oils1 the ,therapeutic ,research ,committee of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association submitted samples of the oils to various clinicians for testing4 ,the following is a synopsis of the investigation1 which ,i have prepared at the request of the committee4 ,the collaborators were advised that specimens of the best obtainable light ,russian liquid petrolatum1 heavy ,russian liquid petrolatum and an ,american brand of liquid petrolatum would be sent out1 but that1 to avoid bias1 these specimens would be distinguished only by numbers or letters4 ,the oils sent out were 7#a7 a light 8,russian0 liquid petrolatum having a specific gravity of #j4hfj at #bj ,c41 7#b7 a heavy 8,russian0 liquid petrolatum having a specific gravity of #j4hhe at #bj ,c41 and 7#c7 an 8,american0 liquid petrolatum having a specific gravity of #j4heg at #bj ,c4 and being markedly fluorescent4 ,the collaborators were advised that the reports should furnish information as to size and frequency of dose1 the agreeableness to the taste1 the effect on the stomach1 the number and character of the stools1 the degree of admixture of the oil with the other ingredients of the stool1 the degree of leakage of oil about the anus1 and the need of other cathartic measures4 ,reports have been received from ,drs4 ,l4 ,f4 ,barker1 ,w4 ,a4 ,bastedo1 ,j4 ,b4 ,champion1 ,henry ,a4 ,christian with ,c4 ,k4 ,drinker and ,f4 ,a4 ,hatch1 ,alfred ,stengel and ,r4 ,l4 ,wilbur4 ,,conclusions ,the conclusions to be drawn from the clinical reports are3 ,dosage4--,half an ounce to #c ounces a day4 ,in the same patient1 the same amount of each of the oils was required4 ,frequency of ,dose4--,the same amount daily seemed as efficient when given in one dose as when given in divided doses two or three times a day4 ,agreeableness to the ,taste4--,there is a difference of opinion in this regard4 ,two reports favored the heavy ,russian oil4 ,one report favored the light ,russian petrolatum4 ,but the taste of any of the samples was so slight as to be a negligible quantity after the patient had taken the remedy for two or three days4 ,stomach ,effects4--,in about #bj per cent4 of the patients1 the oil produced a slight degree of nausea or tended to repeat4 ,this is most likely in patients who have gastric stagnation with retarded emptying of the stomach4 ,all the oils acted the same in this regard4 ,vomiting was reported in two cases4 ,number of ,stools4--,to produce one or two copious stools a day the dose required varied considerably1 but there was no difference noted on account of difference in the specific gravity or character of the oils4 ,character of ,stools4--,the stools were soft1 usually formed1 sometimes mushy1 obviously greasy4 ,they had a peculiar odor described as sour4 ,their consistency varied with the dose1 but was the same for the different kinds of oil4 ,admixture of ,oil with ,other ,ingredients of ,stool4--,generally well mixed1 but from time to time a patient would have a stool of free oil4 ,this occurred with all varieties of oil4 7,it necessitated reduction of the dose1 and if then the bowels were not active enough1 the administration in addition of cascara1 aloin1 etc47 ,leakage ,about the ,anus4--,a disagreeable feature complained of by many is that when they take enough of the oil to move the bowels1 there is sufficient leakage from the anus to keep the neighboring skin continually in a greasy condition1 and sometimes to stain the clothes4 ,that there is any difference in this regard between the oils has not been determined4 ,in the reports1 one clinician noted no differences that were not negligible4 ,another was slightly in favor of ,no4 #b 7heavy ,russian7 as regards taste4 ,a third reporter did not make comparative tests4 ,a fourth is slightly in favor of 8,b0 7heavy ,russian7 as regards taste and general suitability4 ,all of the findings of this investigation are based on hospital cases4 ,a fifth reporter favored ,no4 #a 7light ,russian petrolatum74 ,he considered it the most prompt in its effect1 the most uniform in results1 and the most prone to give a satisfactory admixture of the oil with the other materials4 ,the difference1 however1 from the other oils was not marked4 ,another reporter noted no special differences4 ,,summary ,the results of this clinical investigation appear to warrant the conclusion that so far as therapeutic results are concerned the differences in the action of the three varieties of liquid petrolatum1 namely1 light ,russian liquid petrolatum1 heavy ,russian liquid petrolatum and ,american liquid petrolatum1 are too slight to be of importance4 ,hence the choice between the lighter and the heavier oils1 and between the ,russian and the ,american is an open one1 to be determined not by therapeutic differences1 but by palatability1 dependent on the degree to which the refinement of the oil is carried out4 ,the ,u4 ,s4 ,pharmacopeia1 the revision of which is now nearing completion1 no doubt will furnish standards which will insure a suitable product4 ,from the findings of the foregoing report it would appear that a satisfactory standard might permit the use of either ,russian or ,american oil1 if suitably refined so as to be as nearly as possible devoid of odor and taste4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #f1 #aiae47 ,,angier',s ,,emulsion,,al ,report of the ,council on ,pharmacy and ,chemistry ,,al ,see also preceding reports on ,liquid ,petrolatum or 8,russian ,mineral ,oil0 and ,clinical ,experience with ,liquid ,paraffin 7,liquid ,petrolatum74 ,angier's ,emulsion is essentially a petroleum product4 ,when it was first put on the market commercial interests had been fostering the idea that petroleum products had food-value1 and the manufacturers of ,angier's ,emulsion1 making use of the idea1 advertised it as a 8food-medicine0 and an 8ideal substitute for cod-liver oil40 ,the impression thus created has been kept alive through persistent advertising in spite of scientific proof to the contrary4 ,to-day many who know that petroleum products have no food-value are still likely unconsciously to class ,angier's ,emulsion among nutrients4 ,although the manufacturers now advertise this product as 8purely mechanical in its action10 they yet show a disposition to profit by the old misapprehension1 since1 so far from expressly disavowing the old claims as erroneous1 they mingle with the new ones vague claims of 8tonic and reconstructive merits0 apparently designed to sustain1 in those who do not take time to consider the evidence carefully1 the old faith in the claimed nutritive qualities of the preparation4 ,while the ,council judges a preparation by the claims made for it at present1 and not by any past misstatements when these have been thoroughly corrected1 the past advertising of ,angier's ,emulsion so instructively illuminates the scientific worthlessness of proprietary therapeutic claims in general1 and the whole course of its history is so typical that the referee has thought it well to review the subject briefly4 ,the ,council has authorized the publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,angier's ,petroleum ,emulsion was brought out in #ahha--that is to say1 before the food-value of petroleum products had been experimentally disproved4 ,its advertising history well illustrates the weed-like vitality of a financially profitable therapeutic fallacy4 ,the shifting claims made for this preparation are such good examples of the generally unreliable therapeutic pretensions of proprietary medicines--whether of the 8patent medicine0 or of the 8ethical proprietary0 type--that it has been deemed advisable to present a brief review of the conflicting claims made for it at various times4 ,a ,,petroleum ,,product ,angier's ,emulsion is described by the manufacturers as containing1 in addition to 8our specially purified ,petroleum10 8the combined hypophosphites of lime and soda1 chemically pure glycerine1 and the necessary emulsifying agents40 ,so far as the hypophosphites are concerned1 it is probably unnecessary to remark that the latest researches bring to light no evidence that they influence metabolism in the slightest degree4 ,the ,angier ,chemical ,company apparently accepts this view1 for in its advertising stress is laid exclusively on the merits of the emulsion as a petroleum product4 ,it is therefore proper to consider it from this point of view4 ,the history of the internal use of liquid petrolatum was sketched in a recent ,council report4#gg ,as mentioned at that time1 a number of petroleum products were put on the market some thirty years ago as substitutes for lard and butter4 ,contemporary opinions regarding the food value of such products differed widely4 #gg ,liquid ,petrolatum or 8,russian ,mineral ,oil10 p4 #afa4 ,there never was any scientific evidence to support the view that petroleum and its derivatives are assimilable by the animal organism4 ,in fact1 so far as we can learn1 there was no scientific investigation of the problem until ,randolph's experiments in #ahhd4 ,these were probably the first to demonstrate the non-absorbability of petroleum and its valuelessness as a foodstuff4 ,in #ahii ,robert ,hutchison conclusively demonstrated by experiment that petrolatum1 paraffin and related products were absolutely unassailable by any of the digestive fluids1 and therefore could not possibly have any food value4 ,various investigators later confirmed these findings4 ,,first ,,advertised ,,as ,a 8,,food-,,medicine0 ,let us now take up the advertising history of this nostrum4 ,in #ahie it was sold under these claims3 8444 a #8,food-,medicine' that is far more than a substitute for cod-liver oil02 8444 a ,food-,medicine that is readily assimilated and helps to digest other foods40 ,in #ahig it was an3 8,ideal ,substitute for ,cod ,liver ,oil40 ,in #ahii it3 8444 conserves heat and energy by furnishing more material for oxidation40 ,in #aijb it3 8444 supplants tissue waste by tissue reconstruction40 ,the promoters of ,angier's ,emulsion thus for some time ignored the status definitely assigned to petroleum products by the experiments of ,randolph1 ,hutchison and others4 ,this was only natural4 ,if petrolatum was absolutely inert in the alimentary canal 7and this was now proved beyond controversy7 then an emulsion prepared from it most certainly was not a 8food-medicine10 could not 8supplant tissue waste10 or 8conserve heat and energy40 ,all the credit which previous 8unterrified and ingenious advertising0 7to quote ,hutchison7 had accumulated for ,angier's ,emulsion was bound up with the view that petroleum products were foodstuffs4 ,,later ,,advertised ,,as ,,non-,,absorbable ,the non-absorbability of liquid petrolatum1 however1 suggested to ,robinson1 ,schmidt1 ,lane and others1 a new therapeutic use for it in the treatment of chronic constipation4 ,this method has rapidly gained popularity and it is not surprising1 therefore1 that the promoters of ,angier's ,emulsion changed their claims accordingly1 and now began to base their advertising chiefly on the proved properties of petrolatum4 ,in #aiaj the emulsion was advertised for the treatment of chronic diarrhea on these grounds3 8444 given by the mouth1 it passes to the lowermost portions of the intestines without changing its identity2 hence it exerts antiseptic1 soothing and demulcent properties upon every inch of the intestinal tract1 from the duodenum to the rectum40 ,the old claims1 however1 were not discarded altogether1 for in #aiaa the preparation was recommended for children's diseases as3 8444 an aid to appetite and digestion and a splendid tonic and builder40 ,before long the attempt was made to weave together the claims based on opposed and mutually incompatible properties4 ,in #aiab we find ,angier's ,emulsion recommended because it3 8444 corrects digestive disturbance and promotes normal action of the bowels4 ,at the same time it has a most invigorating tonic influence upon the general health40 ,in #aiad medical men are advised through the advertising pages of the ,british ,medical ,journal of the3 8444 tonic and reconstructive merits of ,angier's ,emulsion40 ,a pamphlet on 8,constipation10 which is 8,presented to ,physicians with ,compliments of the ,angier ,chemical ,company0 7copyright1 #aiac2 still distributed in #aiad7 informs physicians that ,angier's ,emulsion is3 8444 purely mechanical in its action40 ,notwithstanding this1 we are told later on in the same pamphlet that it3 8444 facilitates1 hastens and assists the processes of digestion and assimilation40 444 8is a most efficacious remedy in ,pulmonary ,tuberculosis because it not only maintains normal nutrition1 but also exerts a well-defined specific palliative influence upon the cough and other symptoms of the disease40 ,evidently the advertisement is written in the hope that in one paragraph a claim based on the proved properties of petroleum products may be substantiated1 while in another a totally different and inconsistent claim may be glibly insinuated in vague phrases designed to lull thought and thus perform the remarkable feat of securing credence for two contradictory statements4 ,,unwarranted ,,and ,,misleading ,,claims ,further evidence that ,angier's ,emulsion is at present exploited both to the medical profession and to the public under claims that are unwarranted and misleading1 if not as palpably untrue as the claims made in the past1 is found on the wrapper of a trade package purchased in #aiad and in the circular accompanying it4 ,note the following3 8,indicated in ,diseases of the ,throat and ,lungs and of the ,digestive ,apparatus4 ,useful in ,general ,debility and ,wasting ,diseases1 ,especially when due to ,faulty ,nutrition4 ,the antiseptic properties of the ,emulsion particularly adapt it to the treatment of diseases of septic or bacterial origin40 8,angier's ,petroleum ,emulsion is indicated in affections of the throat1 lungs and intestinal tract--both subacute and chronic4 ,in diseases of the digestive apparatus due to catarrhal1 ulcerative or tuberculous conditions1 its peculiar soothing1 healing and aseptic properties make its use especially beneficial4 ,wasting diseases1 particularly when due to faulty nutrition1 are greatly benefited by its use1 one of the most noticeable effects being a prompt and decided increase in weight40 ,it is1 of course1 unnecessary to point out that1 since petroleum is non-absorbable1 ,angier's ,emulsion contains no ingredient capable of affecting the respiratory mucous membrane except by local application1 for which1 indeed1 this preparation is evidently not intended4 ,,composition ,,and ,,formulas ,according to a circular which was contained in a trade package recently purchased 8,each fluidounce of ,angier's ,petroleum ,emulsion with hypophosphites contains3 #cc-a_/c per cent4 of our specially purified ,petroleum2 #i grains of the combined hypophosphites of lime and soda1 chemically pure glycerin and the necessary emulsifying agents40 ,as regards the nature of the product referred to under the indefinite term 8petroleum0 the circular states that ,angier's ,emulsion is3 8444 prepared with refined petroleum specially purified for the purpose4 ,by a process peculiarly our own the crude petroleum1 obtained from special wells is so purified that all taste and odor and all objectionable and irritating properties are removed1 while the full medicinal value of the oil is retained44440 ,the composition assigned to ,angier's ,emulsion in an advertising pamphlet 8,the ,petroleum ,idea10 issued in #aijg differs in that it is said to contain 8specially purified crude petroleum0 and that each fluidounce is said to contain #b4hd grains of benzoate of sodium4 ,while these quotations convey the impression that certain medicinal constituents of the 8specially purified0 product obtained from 8special wells0 are 8retained10 a pamphlet recommending the use of ,angier's ,emulsion for the treatment of constipation assures us that it produces the 8mechanical effects of the purest petroleum0 and that it is 8purely mechanical in its action40#gh #gh ,as is the custom in the exploitation of proprietary medicines1 the preparation which is the firm's main output--the leader--is made to do duty as an advertising medium for auxiliary preparations4 ,thus the ,angier ,emulsion booklet advises the use of ,angier's ,throat ,tablets4 ,these tablets are alleged to be composed essentially of elm bark and petroleum1 are claimed to 8promote appetite and aid digestion10 and it is stated that 8their healing action on all mucous surfaces makes them decidedly beneficial1 not only to the pulmonary tract but on the digestive areas as well40 ,angier's ,throat ,tablets were examined in the ,association's ,laboratory to determine the amount and kind of petroleum present in the tablets4 ,extraction of the tablets with ether yielded a petroleum product which resembled in every way the product obtained from the emulsion4 ,slightly less than #ab per cent4 of the tablet was composed of the petroleum oil4 ,the part insoluble in ether appeared to consist essentially of elm bark1 with gum and sugar4 ,,laboratory ,,report ,the statements regarding the identity of the 8petroleum0 are so unsatisfactory and contradictory 7in one place 8refined petroleum specially purified for the purpose10 in another 8specially purified crude petroleum0--in one place 8medicinal0 and in another 8purely mechanical in its action07 that the help of the ,chemical ,laboratory of the ,association was invoked to establish the character of the petroleum product and to determine the presence or absence of sodium benzoate1 at one time declared by the manufacturers to be present but later omitted from the formula4 ,the ,association's chemists reported3 8,from a specimen of ,angier's ,emulsion recently purchased there was separated by the customary methods of analysis1 a yellow fluorescent1 unsaponifiable1 semi-solid residue which has all the properties of ordinary yellow petrolatum of a consistence somewhat softer than the product described in the ,pharmacopeia4 ,it was much more dense than the colorless1 non-fluorescent liquid petrolatum now in vogue as a laxative4 ,the preparation contained benzoate1 both in the form of free benzoic acid and also in the form of a water-soluble salt probably sodium benzoate40 ,the petroleum product contained in the emulsion was thus shown to be intermediate between the ordinary 7solid7 and the liquid petrolatum4 ,it also appears that a benzoate is still present1 though no longer mentioned in the formula4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #ab1 #aiad47 ,,phecolates1 ,,phecolax1 ,,phecozymes ,,and ,,phecotones ,report of the ,council on ,pharmacy and ,chemistry ,phecolates1 ,phecolax1 ,phecozymes and ,phecotones were submitted by ,f4 ,waldo ,whitney1 ,new ,york1 with 8literature0 indicating that they are designed to form parts of a system of treatment founded on the theory of autotoxemia1 which they are supposed to prevent by their action on the functions of the intestinal canal4 ,the different preparations consist in the main of mixtures of well-known remedies4 ,the basic preparation is ,phecolates1 which contains bile salts in combination with phenyl salicylates and benzo-naphthol in about one-eighth the regular doses and hence not likely to be of any real service4 ,since the proportions of these ingredients ought to be regulated by the physician according to the needs of the individual patient1 they should not be combined in fixed proportions4 ,the name is not so framed as to indicate the principal ingredients4 ,phecolax contains1 in addition to the ingredients of ,phecolates1 phenolphthalein and cascarin1 of each one-half grain4 ,phecozyme is made more complex than ,phecolax by the introduction of additional phenyl salicylate and of pancreatin4 ,phecotone contains ten ingredients4 ,extravagant claims such as the following are made3 8,our ,health is governed by our bowels2 ,our bowels are governed by our nerves2 ,our nerves are governed by our digestion2 our digestion is governed by ,phecolates40 ,the ,council voted to refuse recognition to ,phecolates1 ,phecolax1 ,phecozymes and ,phecotones as unscientific articles with objectionable names4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ba1 #aiad47 ,,phenol ,,sodique ,report of ,examination by ,council on ,pharmacy and ,chemistry and ,comments ,an examination of this article by a subcommittee of the ,council on ,pharmacy and ,chemistry revealed unscrupulous claims which are a positive menace to public health4 ,in view of this the ,council has directed the publication of the following comments4 ,w4 ,a4 ,puckner1 ,secretary4 ,,comments ,phenol ,sodique was not submitted to the ,council by the manufacturers1 but was taken up because it is advertised to both physicians and the public4 ,some advertisements state3 8,phenol ,sodique was the standard antiseptic thirty years ago4 ,it's the same today40 ,if this were true1 it would be high time to call a halt2 for the unscrupulous claims made for this nostrum1 and the effrontery with which they are pushed1 are only rivaled by those of the most shameless 8patent medicines40 ,the firm of ,hance ,bros4 ,white poses as a reputable pharmaceutical manufacturing house1 but how it can reconcile this position with their method of exploiting this product passes all understanding4 ,in the original package of ,phenol ,sodique 7the latest was purchased on ,june #bj1 #aijg71 there are little booklets and a folder describing the marvelous properties of the nostrum4 ,the booklets do not refer to ,phenol ,sodique1 but they are very instructive4 ,they are entitled3 8,dyspepsia10 8,worm ,news10 and 8,catarrh10 advertising 8,dyspepsia ,stop0--some form of dyspepsia tablets1 a remedy for round worms1 and 8,catarrh ,stop10 apparently some mild antiseptic tablets4 ,these booklets are addressed frankly to the laity1 although recourse to a physician is1 generously1 advised if the patient does not respond to treatment6 ,the folly of prescribing 8original packages0 which contain popular literature has been so often emphasized that further comment seems superfluous4 ,the following from 8,catarrh10 however1 throws an interesting sidelight on the scientific status of ,hance ,bros4 ,white3 ---------------------------------------- ---------------- 8,catarrh is due to a minute insect in the inner lining membrane of the nose4 ,this insect multiplies rapidly1 and1 unless checked1 and destroyed1 will produce the worst results40 ---------------------------------------- ---------------- ,to return1 however1 to ,phenol ,sodique3 ,the folder is also evidently intended for the lay public rather than for physicians2 at least1 if we are to credit ,hance ,bros4 ,white with any intelligence whatsoever4 ,it is headed3 8,montyon ,prize of ,encouragement1 ,awarded by the ,institute of ,france1 #ahfa40 ,this is rather ancient1 but what follows indicates that a little restraint would have been better than encouragement4 ,the circular is a compact treatise on self-medication--apparently all that is necessary to retain or regain health is the use of ,phenol ,sodique1 externally and internally4 ,the following conditions are among those specifically named as amenable to this remedy4 ,smallpox1 measles1 scarlatina1 erysipelas1 puerperal fever1 typhoid fever1 cholera1 diarrhea1 cramps1 burns and scalds1 bites1 cuts and wounds1 excoriations1 chilblains1 chaps1 sore throat1 scratches1 catarrh1 tetter1 sunburn1 swollen veins1 ulcers1 hemorrhages1 bruises1 piles1 gangrene1 carbuncle1 itching1 insect stings1 ivy poison1 cold in the head1 bunions1 inflamed eyes1 eczema1 ringworm1 rheumatism1 pains1 toothache1 seat worms1 etc4--besides numerous diseases of animals4 ,no antiseptic1 whatever its composition1 could by any possibility accomplish anything like what is claimed for ,phenol ,sodique1 so that the composition of the article is really of little importance4 ,this is evidently appreciated by the manufacturers1 for they have kept the composition a profound secret1 except in so far as it is implied in the name4 ,an inquiry addressed to ,hance ,bros4 ,white1 under date of ,april #bg1 #aijg1 six months ago1 has remained unanswered4 ,the ,council1 therefore1 directed an analysis of ,phenol ,sodique4 ,this was carried out at the chemical laboratory of the ,american ,medical ,association1 and a check analysis was made by an independent firm of chemists4 ,this shows that ,phenol-,sodique contains something like #j4e or #j4ff per cent4 of phenols1 dissolved in about #j4ge per cent4 of sodium hydroxid4 ,in other words1 it appears to be essentially a very dilute alkaline solution of some impure coal-tar product1 presumably a crude carbolic acid4 ,the analysis could not profitably be carried further1 because the amount of the antiseptic agent is so very small4 ,the consideration of this analysis1 in connection with the claims made for ,phenol-,sodique1 leaves little doubt as to one reason for the secrecy concerning its composition2 although no educated physician could be deceived into believing for a moment that ,phenol-,sodique could fulfil the promises of its promoters1 even if it were 8the best antiseptic1 hemostatic and disinfectant on the market10 as the manufacturers say in their advertisements4 ,from its composition1 it can only have the very moderate and ordinary antiseptic qualities of a dilute phenol or cresol solution1 modified only to a very slight extent by the free alkali4 ,according to the manufacturers1 however1 8,phenol-,sodique is a wonderful preparation40 ,just how wonderful appears from these extracts from the dissertations in the pamphlet which is enclosed in the package4 8,catarrh1 ,old ,colds1 etc4--,drink every morning and evening a glass of water containing ten to thirty drops of ,phenol-,sodique 4440 8,small-,pox4--,to prevent attack take internally three or four times a day1 fifteen or twenty drops of ,phenol-,sodique in one tablespoonful of sugar and water4444 8,measles1 ,scarlatina and ,erysipelas4--,same treatment as for ,small-pox40 8,typhoid ,fever4--,to prevent attack take internally three or four times a day1 fifteen or twenty drops of ,phenol-,sodique40 8,cholera4--,to prevent1 spread sawdust or sand1 wet with ,phenol-,sodique1 in apartments4 8,the very best precaution is to drink1 morning and evening1 a glass of water containing from fifteen to thirty drops of ,phenol-,sodique4444 8444 ,premonitory ,diarrhea4--444 ,drink a teaspoonful of ,phenol-,sodique diluted in an ounce of water44440 ,this is the kind of therapeutics and prophylaxis taught to the medical profession by their self-appointed instructors1 the proprietors6 ,but this matter has a serious as well as a ludicrous side3 ,what is the proper epithet to apply to those who1 knowingly and intentionally1 impress on the ignorant lay public that one can with impunity expose himself to smallpox1 cholera1 typhoid or scarlet fever1 or measles1 by taking a few drops of very dilute carbolic acid1 or by sprinkling a little on sawdust8 ,what must be the consequences to those who trust in these assurances8 ,and what should be the lawful penalty for those whose blunted moral instincts permit them wilfully to endanger the lives of others for a little financial gain8 ,it would be interesting to know the real opinion of the responsible members of the firm of ,hance ,bros4 ,white on these questions4 ,the ,montyon ,prize was awarded by the ,french ,institute in #ahfa--;forty-six years ago--how many victims a year8--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #i1 #aijg47 ,,phytin ,,and ,,fortossan ,report of the ,council on ,pharmacy and ,chemistry ,phytin1 manufactured by the ,society of ,chemical ,industry1 ,basel1 ,switzerland1 and sold by ,a4 ,klipstein and ,co41 is an organic phosphorus compound said to be the 8,acid ,calcium-,magnesium ,salt of ,phytinic ,acid 7,inosit ,phosphoric ,acid or ,anhydro-,oxymethylene-,diphosphoric ,acid70 obtained from cereals and legumes4 ,the trade package of ,phytin constitutes an indirect advertisement to the public4 ,the ,council rejected ,phytin because unwarranted and exaggerated therapeutic claims are made for this product based on the entirely undemonstrated assumptions3 7#a7 that phosphorus is assimilated only from organic combinations 7it is even implied that this must be in the form of ,phytin1 and that milk is incapable of supplying the phosphorus needs of infants72 7#b7 that a long list of diseases1 ranging from rickets to hysteria1 are due to deranged phosphorus metabolism2 7#c7 that all these diseases are cured or markedly benefited by ,phytin4 ,in brief1 the claims rehearse every point of the more or less discredited phosphorus propaganda1 in exactly the same way as it was rehearsed successively by the exploiters of hypophosphites1 lecithin1 glycerophosphates1 and amorphous phosphorus4 ,it is conceded by the writers of the advertising pamphlets for ,phytin that the preceding claims were erroneous2 but no evidence is given to warrant the belief that the ,phytin claims are less erroneous4 ,the misleading statements are most extreme4 ,by the use of bold type particular stress is laid on the preposterous and vicious claim that ,phytin 8radically and permanently removes sexual debility40 ,fortossan is a preparation of ,phytin and sugar of milk1 also manufactured by the ,society of ,chemical ,industry1 ,basel1 ,switzerland1 and sold by ,a4 ,klipstein and ,co4 ,since ,fortossan is a simple preparation of ,phytin the ,council voted that the rejection of ,phytin should also apply to ,fortossan4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #cj1 #aiae47 ,,prunoids ,report of the ,council on ,pharmacy and ,chemistry ,prunoids are tablets put out by the ,sultan ,drug ,company1 ,st4 ,louis4 ,they are said to be3 8,made of ,phenolphthalein 7one and one-half grains in each71 ,cascara ,sagrada1 ,de-emetinized ,ipecac and ,prunes40 ,the following report on the composition of ,prunoids is submitted by the ,association's ,laboratory3 8,from an examination of ,prunoids it is concluded that the amount of cascara or extract of cascara in the preparation is very small4 ,also the quantity of 8de-emetinized ipecac0 is insignificant4 ,the claim is made3 8,the levulose of prunes1 a constituent of ,prunoids1 is hygroscopic and thus when brought into contact with the saliva of the mouth or contents of the stomach1 disintegrates and prompt medication is insured40 8,actually the amount of prunes which may be present in ,prunoids is negligible4 ,for all practical purposes1 therefore1 ,prunoids are phenolphthalein40 ,according to the information included on and in the box ,prunoids are 8,an ,ideal ,laxative1 ,purgative1 and ,intestinal ,tonic0 444 8particularly adapted to the treatment of constipation 4440 ,they are said to act as an 8intestinal tonic0--a claim which in the light of the examination is obviously unwarranted--and because of this1 it is said that they3 8,will permanently remove constipation without causing after constipation40 ,the trade package assures the purchaser that ,prunoids are3 8,recommended by ,physicians ,generally40 ,a circular sent to physicians makes the unwarranted claim that ,prunoids are 8especially serviceable0 in 8444 ,neurasthenia1 ,jaundice1 ,chlorosis1 ,rheumatism1 ,gout 4440 and that 8444 their success in gouty diathesis and vague rheumatic symptoms tends to confirm the opinion expressed by some physicians that they have a solvent action on uric acid40 ,in the following the haphazard and ill-considered use of purgatives is suggested3 8,for the expectant mother1 or in the treatment of female diseases1 for bowel elimination1 no happier or safer selection can be made40 ,the ,council refused recognition to ,prunoids because the statement of composition is incomplete and therefore meaningless2 because unwarranted therapeutic claims are made for them2 because the name 8,prunoids0 gives the false impression that they depend on prunes for their effect2 and because it is irrational and a detriment to medicine to disguise a well-known drug by means of a misleading name and to attempt to create the impression of special virtues by combining it with superfluous drugs4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #b1 #aiae47 ,,sal ,,hepatica ,report of the ,council on ,pharmacy and ,chemistry ,sal ,hepatica1 marketed by the ,bristol-,myers ,co4 of ,new ,york1 has been refused recognition by the ,council1 because its composition is secret2 because it is advertised indirectly to the public for the treatment of diseases2 because exaggerated and unwarranted claims are made for its therapeutic qualities2 and because the name fails to indicate its chief constituents but does suggest its use in liver disorders4 ,the ,council has authorized the publication of the report of its referee1 because it is an important illustration of the ways in which physicians are being made parties to the introduction to the public of a patent medicine1 whose indiscriminate use must often have resulted in harm1 direct or indirect4 ,w4 ,a4 ,puckner1 ,secretary4 ,the report of the referee follows3 ,sal ,hepatica is a saline laxative sold by the ,bristol-,myers ,company of ,new ,york4 ,no information seems to be given regarding its composition except such as is contained in the following vague and uninforming phrases3 8,effervescent saline combination1 hepatic stimulant1 laxative and an eliminant of irritating toxins40 8,sal ,hepatica is a saline combination containing the alterative and laxative properties similar to the natural #8,bitter ,waters' of ,europe with the addition of sodium phosphate40 8444 more palatable and efficient than sodium phosphate alone or other salines40 ,a circular around the bottle contains the following3 8,we invite the physicians' careful consideration of the merits of ,sal ,hepatica in the treatment of ,rheumatism and ,gout1 in ,constipation and ,auto-intoxication1 and to its highly important property of cleansing the entire alimentary tract1 thereby eliminating and preventing the absorption of irritating toxins and relieving the conditions arising from indiscretion in eating and drinking40 ,in the same circular1 its promiscuous use is invited in these terms3 8,owing to its palatability1 ,sal ,hepatica is particularly well adapted to the requirements of childhood or the feeble and delicate40 ,further suggesting its use in the treatment of that popular1 if somewhat vague ailment1 8biliousness10 we read3 8,it is especially valuable where there is intestinal sluggishness arising from functional derangements of the liver or portal circulation44440 ,as further suggestive of its all-around 8goodness10 are the claims3 8,it increases the appetite and promotes digestion by stimulating the flow of gastric juice40 8,in rheumatism and gout ,sal ,hepatica furnishes the physician with an ideal eliminant1 usually affording prompt relief40 ,the label on the ,sal ,hepatica bottle suggests--both to physicians and to the public--its use in the following diseases and conditions3 8,derangements of the stomach and liver40 8,affections of the kidneys40 8,bilious attacks40 8#8,summer complaints1' colic and alcoholic excesses40 8,headache1 dizziness1 heartburn and seasickness40 8,acute indigestion40 8,gastric1 hepatic and renal disorders40 8,especially beneficial in rheumatism and gout40 ,from these quotations it is evident that ,sal ,hepatica is in conflict with3 ,rule #a1 in that its composition is not disclosed1 although statements are made which are likely to give a false impression as to what it is2 ,rule #d1 in that the statements on the label and in the circular around the bottle advertise it to the public and thus make the physician who recommends it an advance agent for the nostrum2 ,rule #f1 in that exaggerated and unwarranted claims are made for its therapeutic qualities1 and1 ,rule #h1 in that its name fails to indicate its chief constituents1 but does suggest its use in liver disorders4 ,the absurd claims made for this preparation are such as to put it in the 8patent medicine0 class4 ,even the most credulous members of the medical profession certainly can take no stock in the claim that a preparation can be an 8eliminant0 of uric acid1 a hepatic stimulant1 a remedy for gout1 rheumatism1 liver disease1 indigestion1 etc4 ,why then should such a preparation be tolerated8 ,in its conflict with ,rule #d ,sal ,hepatica belongs to that class of nostrums which have been so successfully exploited by manufacturers through the unwitting efforts of thoughtless and careless physicians4 ,the ,bristol-,myers ,company has been most liberal in distributing free samples1 evidently with the assurance that physicians would do the rest4 ,thus1 at the present time1 the profession is being supplied with a package containing one regular #be-;cent bottle and five single-dose vials bearing the name ,sal ,hepatica4 ,if only a small percentage of the physicians who receive these samples distribute them1 the increase in ,sal ,hepatica consumers may be imagined4 ,how successful this scheme of the ,bristol-,myers ,company has been is only too evident4 ,sal ,hepatica is one of the best-selling laxatives in department stores and drug stores to-day4 ,while the evils of indiscriminate purgation are now generally recognized1 the referee wishes to quote and to indorse the pertinent comments on this subject by ,the ,journal3#gi #gi ,the ,journal ,a4 ,m4 ,a41 ,march #bf1 #aiaj1 p4 #ajga4 8,the abuse of saline cathartics by the public is an evil deserving of serious attention4 ,rightly or wrongly1 the laity fear constipation and naturally take what they are taught to believe is the cheapest and simplest course for its relief1 self-drugging by means of saline cathartics or the extensively advertised purgative mineral waters4 ,this habit is responsible for much of the distressing spastic constipation that exists1 and its accompanying neurasthenia4 ,the advertisement and sale to the laity of such a nostrum as 8,sal ,hepatica0 can only increase these evil results and the physician who aids and abets the evil by using the preparation should reflect whether he is thereby not only encouraging a fraud on the public but also1 what is even worse1 helping to impair the public health40 ,it is recommended that this report be authorized for publication in order that physicians may know the extent to which they have been made to act as advance agents for 8patent medicines40 ,it is hoped its publication may suggest to those who in thoughtlessness have recommended ,sal ,hepatica1 that they go to their materia medica and renew acquaintance with the host of simple and efficient laxative salts which are available--magnesium sulphate1 sodium sulphate1 sodium phosphate and the palatable effervescing preparations of these which the ,pharmacopeia provides--effervescent magnesium sulphate 7,magnesii ,sulphas ,effervescens1 ,u4 ,s4 ,p471 effervescent sodium phosphate 7,sodii ,phosphas ,effervescens1 ,u4 ,s4 ,p474--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #g1 #aiad47 ,,sanmetto ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,sanmetto 7,od ,chemical ,company1 ,new ,york7 has been adopted by the ,council on ,pharmacy and ,chemistry1 which authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,sanmetto is one of the oldest proprietaries on the market4 ,its advertisements have been familiar to the readers of medical journals for several decades past4 ,it is a typical nostrum4 ,it is secret although the promoters have published various 8near-formulas40 ,the following are some of the statements regarding composition3 8,a ,scientific ,blending of ,true ,santal and ,saw ,palmetto with ,soothing ,demulcents in a ,pleasant ,aromatic ,vehicle40 ,as this did not disclose the identity of the demulcents or the quantity of the alleged active constituents1 the 8formula0 was1 of course1 meaningless4 ,again it is3 8,a ,scientific blending of true ,santal and ,saw ,palmetto in a pleasant aromatic vehicle40 ,here the reference to 8soothing demulcents0 is omitted4 ,the information furnished physicians at the present time is3 8,it is a blend of harmonizing drugs40 ,a letter from a physician requesting information as to the exact composition of ,sanmetto recently elicited the following reply3 8444 ,sanmetto is a blending of true santal and saw palmetto with soothing demulcents in a pleasant aromatic vehicle4 ,the demulcents are introduced not only for the purpose of modifying the irritant properties of the santal1 but to add distinctively to the soothing properties of the finished product upon the mucous membrane of the urinary tract1 and are not mentioned in our published formula for the simple fact that if we gave them1 then we would do the advertising and the substitute manufacturer would engage in the #8unfair competition' of putting on the market his concoction1 claiming to be made exactly after our formula1 without spending a cent for advertising1 relying upon our propaganda work to sell his substitute1 although not the same article as nor equivalent to ,sanmetto1 from the fact that he would be working in the dark as to the processes in the manufacture of our product4 ,there is no mineral substance in ,sanmetto1 nor any other ingredient that is detrimental in any way whatsoever4444 8,,od ,,chem4 ,,co41 8,m4 ,haman1 ,pres't40 ,,the ,,value ,,of ,,santal ,,and ,,saw ,,palmetto ,the foregoing warrants the assumption that the active ingredients of the mixture are sandalwood oil and saw palmetto4 ,there was a period when the internal treatment of gonorrhea had a marked vogue4 ,balsamic remedies received the approbation of the medical profession as the most specific of internal remedies for this disease4 ,as a representative of this class1 sandalwood oil was very highly esteemed and had great popularity4 ,as in other similar instances1 this popularity was commercialized and the drug became the basis of many secret or semisecret mixtures1 including 8specialties0 of pharmaceutical houses4 ,sabal or saw palmetto is an official drug which at one time was used in genito-urinary affections1 but now is seldom used1 presumably because it has been found practically worthless4 ,it is not mentioned by most pharmacologists1 and those who do mention it regard it as of doubtful value4 ,it is included among the preparations recommended for deletion as given in the report of the ,committee on the ,pharmacopeia of the ,american ,medical ,association 7,the ,journal1 ,sept4 #d1 #aiji1 p4 #gib74 ,even granting that sandalwood oil and saw palmetto do have therapeutic value1 no one would think of regarding either or both of these preparations as of use except in inflammatory conditions of the genito-urinary tract1 especially gonorrhea4 ,if one is to believe the advertisements1 however1 the combination of these drugs in ,sanmetto is a wonderful medicine4 ,one might even conclude that there are few conditions in which it cannot be given with profit4 ,for instance3 8,in ,nervous ,diseases1 especially ,neurasthenic cases with origin in some sexual or genito-urinary disorder1 for its action as a vitalizing tonic and reconstructive1 restoring nutrition to germ plasm1 relieving pathological conditions and for soothing and sustaining the nerves controlling the parts40 ,bear in mind in reading the foregoing statement and the following that we are concerned with two drugs whose effects are exerted on mucous membranes especially of the genito-urinary tract4 8,in ,gestation ,cases1 showing tendency to albumin and convulsions1 for toning the pelvic organs1 clearing up the urine and cleansing the urinary bladder and outlet4 ,in the ,lying-in-,room for relieving the affections of urethra and bladder1 painful strangury of the urethra and painful micturition due to the pressure of ftal head upon the neck of the bladder and upon the urethra during labor1 and infection1 either septic or gonorrheal40 8,in ,weakness of the ,kidneys1 causing loss in tone and general health and ,impairment of ,eyesight--for strengthening the kidneys and bladder and toning the nervous system2 and also for aiding in the constitutional treatment of ,gonorrheal ,infection of the ,eyes4 8,in the treatment of the ,prostate1 ,testes1 ,mamm1 ,ovaries1 and ,urethra1 ,kidneys and ,bladder1 for its soothing1 slightly antiseptic1 aphrodisiac1 toning and restoring action to the mucous membrane and glands4 ,by its use the parts affected in many cases returning to their normal condition40 ,while the reference to its aphrodisiac action and to the restoration of parts to the normal may have little interest to physicians1 it may be counted on to appeal to the sexual neurasthenic4 ,in premature senility3 8,sanmetto 444 is unexcelled as a vitalizing tonic to the withered glands of the reproductive system1 promoting their normal secretory activity40 ,these claims are not only absurd but also harmful2 they tend to perpetuate a hypochondriacal state of mind in the class of patients appealed to--the sexual neurasthenic4 ,there is1 however1 a more serious side2 the tendency of certain other claims made for the preparation are vicious and dangerous as well as misleading4 ,the advertising claims are likely to induce some physicians--those who accept advertising 8literature0 as dependable--to belittle the importance of serious diseases of the sexual organs and to be content with ,sanmetto1 which1 even if it gave as good results as other balsamic remedies1 would be1 at best1 only a halfway measure4 ,this in an advertising pamphlet physicians are given this advice as to the treatment of gonorrhea4 8,to provide the needed rest the patient should be instructed to simply keep the parts clean with warm water for the first week and let the discharge continue until you can control it by internal medication4 ,i wish to emphasize the fact that there is no way that any acutely inflamed portion of the genito-urinary tract can get the rest required so completely as by administration of ,sanmetto4444 ,after the acute gonorrhea has begun to subside the ,sanmetto should be aided by mild astringent injections40 ,if there is any well-established fact in medicine1 it is that gonorrhea is a serious disease--serious alike to the sufferer and to the community--and one which needs careful attention from the very first4 ,to claim1 either directly or by implication1 that it can be cured by such a mixture designed to act on the kidneys1 bladder and nervous system is false and dangerous doctrine4 ,the physician who prescribes ,sanmetto prescribes a secret medicine for conditions which he is presumably competent to treat with simple remedies of which he knows the origin and action and which he can vary to suit the needs of the individual4 ,sanmetto is a secret nostrum the exploitation of which is an invitation to haphazard1 uncritical therapy and a menace to public health4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #ac1 #aiae47 ,,secretogen ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report dealing with two internal secretion specialties--,secretogen ,elixir and ,secretogen ,tablets--to call attention to the unfounded and extravagant claims made for this class of products4 ,w4 ,a4 ,puckner1 ,secretary4 ,test tube experiments show that pepsin hydrolyzes proteins in acid solutions2 that pancreatin digests protein in alkaline liquids1 and that diastase converts starch into sugar4 ,based on these facts1 it was assumed that these ferments would aid digestion4 ,this assumption was correct if limited to certain cases of dyspepsia in which it can be shown that certain ferments are absent or deficient4 ,but this limitation was not realized or remembered2 on the contrary1 the indiscriminate use of digesting ferments in all kinds of cases of indigestion became widespread and still continues1 although to a less extent4 ,herein lies the great disappointment that has followed the use of these ferments4 ,more recently hormones were discovered1 and while their importance has not been fully worked out1 it has been assumed that they are responsible for the secretion of digestive ferments1 and that in their absence this secretion fails4 ,without waiting for proof of this assumption1 that is1 that digestive failure is due to lack of hormones1 proprietary medicine promoters are already placing on the market various secretion specialties4 ,as an example of this new class of specialties and of the unfounded claims made for them1 your referee presents the following report on ,secretogen ,elixir and ,secretogen ,tablets offered to physicians by the ,g4 ,w4 ,carnrick ,company4 ,secretogen ,elixir is said to contain pancreatic secretin obtained from the duodenum with #a_/aj of #a per cent4 of hydrochloric acid4 ,secretogen ,tablets are said to be prepared from pure secretin and succus entericus obtained from the epithelial cells of the duodenum4 ,the claims for ,secretogen are based on the physiologic action of secretin as described by various observers4 ,to determine whether these claims are justified it becomes necessary to review the evidence advanced to prove that secretin stimulates the digestive glands4 ,secretin is a hormone1 a chemical substance produced by the action of hydrochloric acid on a previously formed substance1 8prosecretin10 contained in the cells of the intestinal mucous membrane1 especially of the duodenum4 ,secretin is absorbed by the blood and carried to the pancreas1 liver and intestinal mucosa1 which are thereby stimulated to produce their characteristic secretions1 namely1 bile1 pancreatic juice and succus entericus4 ,when secretin is injected into the blood1 it causes an increase in the flow of these secretions4 ,some observers have claimed that secretin is absent in cases of diabetes in which the pancreas is still found normal4 ,wentworth#hj reported several cases of marasmus in which he found no evidence of prosecretin4 ,this deficiency1 he believes1 is the cause of this disease4 #hj ,wentworth1 ,a4 ,h43 ,the ,cause of ,infantile ,atrophy1 ,deduced from a ,study of ,secretin in ,normal and ,atrophic ,infants1 ,the ,journal ,a4 ,m4 ,a41 ,july #bj1 #aijg1 p4 #bjd4 ,the ,carnrick ,company1 adopting the foregoing views1 namely1 that secretin is necessary to secure the normal action of pancreas1 liver and intestine1 as proved1 placed on the market their specialty 8,secretogen10 to take the place of the missing secretin4 ,the foregoing conclusion cannot1 however1 be sustained4 ,there are numerous cases in which no hydrochloric acid is produced in the stomach and hence--as it is produced by the action of hydrochloric acid--no secretin can be produced in the intestine4 ,yet in these cases the pancreatic juice and bile are secreted in normal amounts and digestion goes on normally after the food leaves the stomach4 ,in such cases the pancreas and liver must be stimulated to secretion by some other mechanism than secretin4 ,the proof that the absence of secretin is characteristic of diabetes or of marasmus is not yet available4 ,sweet and ,pemberton#ha found that many circumstances interfered with the extraction of secretin1 so that the mere failure to obtain it in a given case is not proof of its absence1 unless the various inhibiting influences are given due consideration4 ,the conclusions reached by these authors are that 8the evidence so far adduced that secretin is absent in some varieties 7of diabetes7 does not seem conclusive10 and that 8the specific absence or deficiency of secretin in marasmus seems to remain as yet unproven40 #ha ,sweet1 ,j4 ,e41 and ,pemberton1 ,r43 ,experimental ,observations on ,secretin1 ,arch4 ,int4 ,med41 ,february1 #aijh1 p4 #bca4 ,the favorable reports of ,moore#hb in regard to the use of secretin in diabetes are not confirmed by the experience of ,foster#hc in five cases1 or by the case reported by ,dakin and ,ransom4#hd #hb ,moore1 ,edie and ,abram3 ,biochem4 ,jour41 #aijf1 i1 #bh2 ibid41 i1 #ddf4 #hc ,foster1 ,n4 ,b43 ,cases of ,diabetes ,treated with ,secretin1 ,jour4 ,biol4 ,chem41 ,january1 #aijg4 #hd ,dakin1 ,h4 ,d41 and ,ransom1 ,c4 ,c43 ,treatment of ,case of ,diabetes with ,secretin1 ,jour4 ,biol4 ,chem41 ,january1 #aijg4 ,in regard to the use of secretin in intestinal disorders1 the ,g4 ,w4 ,carnrick ,company refers to an article by ,j4 ,w4 ,beveridge4#he ,an examination of this article shows it to be unscientific and uncritical4 ,the author presents four cases to 8demonstrate the peculiar potency exercised by secretin40 ,of the first he says3 #he ,beveridge1 ,j4 ,wallace3 ,secretin1 ,am4 ,jour4 ,gastro-,enterology1 ,april1 #aiad1 p4 #agj4 8,stomach was dilated1 food delay1 seventy-two hours2 hyperacidity1 vomiting daily1 five to twelve times1 urine high specific gravity1 over #c per cent4 urea1 trace albumen40 ,the patient improved somewhat after gastro-enterostomy with removal of the gallbladder2 the vomiting ceased1 but the stools continued clay-colored and the high urea output still kept up4 ,secretin was given1 and after this the report continues3 8,the stools became normal in color at the end of the second month1 weight gradually increased until #abb-c_/d pounds was reached1 and the urea is now normal1 averaging about #a per cent40 ,this case is offered to prove the absence of secretin and its effect when given by the mouth4 ,as evidence of hepatic insufficiency the author apparently relies on the color of the stools1 and for pancreatic insufficiency he cites the high urea output4 ,he claims that when the pancreas does not furnish an efficient secretion1 the proteins of the food fail to be converted into amino-acids1 and instead1 raise the percentage of urea4 ,consequently1 he concludes that a high percentage of urea indicates the absence of secretin4 ,it is usually held that a high percentage of urea depends on two factors1 ingestion of a large amount of protein and concentration of the urine4 ,the author gives no data as to the amount of albuminous food1 the amount of urine1 or whether the percentage of urea was learned by examining a single specimen or the total quantity for twenty-four hours4 ,the mildest judgment that can be passed on such clinical data is that they are totally inadequate4 ,without doubt the percentage of urea could have been reduced to 8normal0 by causing the patient to drink water freely4 ,the remaining cases show similar hasty conclusions from insufficient data1 rendering them worthless as evidence4 ,the ,g4 ,w4 ,carnrick ,company introduces a number of testimonials as to the value of ,secretogen4 ,these testimonials are similar to all testimonials4 ,they include no evidence of careful diagnosis1 and present an uncritical estimate of the results4 ,they show that the writers have given ,secretogen ,elixir or ,tablets indiscriminately in almost the whole range of digestive disorders1 in nephritis1 neuralgia1 liver disease and gallstones1 exophthalmic goiter1 neurasthenia1 epilepsy1 etc4 ,as dependable evidence1 these testimonials are not worthy of consideration4 ,a rational basis for the therapeutic value of ,secretogen is lacking for the following reasons3 #a4 ,no evidence has been presented that the absence of secretin is a cause of gastro-intestinal diseases4 ,it is usually present1 and if not present1 as in achylia gastrica1 there is evidently some compensating arrangement by which the pancreas is stimulated to perform its regular functions4 #b4 ,there is no evidence that secretin in any form is physiologically active when administered by the mouth4 ,,references ,fleig1 ,m4 ,c43 ,action de la scrtine1 ,arch4 gn4 de md41 lxxx1 #bd4 ,charles1 ,j4 ,r43 ,treatment of ,diabetes with ,secretin1 ,bristol ,med4-,chir4 ,jour41 ,september1 #aijf2 ,med4 ,press and ,circular1 ,nov4 #ba1 #aijf4 ,meltzer1 ,s4 ,j43 ,animal ,experimentation in ,relation to our ,knowledge of ,secretions1 ,especially in ,internal ,secretions1 ,the ,journal ,a4 ,m4 ,a41 ,may #g1 #aiaj1 p4 #aejf4 ,wentworth1 ,a4 ,h43 ,the ,cause of ,infantile ,atrophy1 ,deduced from ,a ,study of ,secretin in ,normal and ,atrophic ,infants1 ,the ,journal ,a4 ,m4 ,a41 ,july #bj1 #aijg1 p4 #bjd4 ,bambridge and ,beddard3 ,guy's ,hospital ,reports1 #aijg1 lxi1 #afa4 ,enriquez and ,hallion3 ,nuevas nociones sobre la digestion4 ,secretin1 ,importancia fisiologica y patologica1 ,transactions of #adth ,int4 ,med4 ,congress1 ,madrid1 #aijd4 ,enriquez3 ,la ,scrtine ,mdication acide duodnale ,stimulation de function scrtiniques chez l'homm41 ,rev4 de4 thrap4 md4-chir41 ,paris1 #aijd1 lxxi1 #ahg4 --7,from ,the ,journal ,a4 ,m4 ,a41 ,may #a1 #aiae47 ,,sinkina ,report of the ,council on ,pharmacy and ,chemistry ,sinkina is a malaria 8cure0 put on the market by the ,metropolitan ,pharmacal ,company1 ,new ,york4 ,the product was presented to the ,council on ,pharmacy and ,chemistry for admission to ,new and ,nonofficial ,remedies and was rejected because insufficient evidence was submitted to substantiate the improbable claims made for it4 ,the manufacturers were sent a copy of the report stating that their product was refused recognition4 ,in view of the advertising that was persisted in after its rejection1 the ,council's referee for ,sinkina submitted the preparation to clinical tests4 ,both the original report and the results of the clinical tests are given in the following report1 which was submitted to the ,council and recommended for publication4 ,the complete report having been sent to the manufacturers and their reply considered1 the ,council authorizes its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,,the ,,council',s ,,first ,,report ,the ,council1 after investigating the claims made for ,sinkina1 declared the product unworthy of recognition and adopted the following report1 which was sent to the manufacturers3 ,no experimental evidence regarding the therapeutic value has been submitted4 ,the clinical evidence is scant and not of such character as to deserve much consideration1 no sufficient precautions having been adopted to avoid wrong conclusions4 ,judging from the evidence at hand the preparation is simply a dilute sugar-alcohol-water solution containing a little oil of cumin--,roman caraway4 ,it is highly improbable that such a liquid would have the therapeutic effects claimed for it by the ,metropolitan ,pharmacal ,company4 ,in view of the improbable claims made for ,sinkina1 and the failure to substantiate them by suitable evidence1 it is recommended that the preparation be refused recognition without at this time considering the claims made in regard to the identity and amount of the drug claimed to be the essential constituent4 ,in spite of its rejection ,sinkina was persistently advertised4 ,it was thought advisable1 therefore1 to submit the preparation to clinical tests4 ,this was done and the results are given in the following report3 ,,the ,,clinical ,,report ,the following quotations indicate the claims made for this preparation3 8,in malarial conditions there is nothing that acts so promptly and efficaciously as ,sinkina4 ,sinkina destroys radically every trace of the parasite in the blood from the time of its first appearance1 builds up the damaged corpuscles1 revitalizes the system1 and completely eliminates every trace of the disease4 ,sinkina is deservedly termed the ,specific for ,malaria40 ,these claims were supported by testimonials which usually gave no indication of a demonstration of the presence or absence of malarial plasmodia in the blood4 ,the following is an example showing the character of most of the evidence presented by the manufacturers3 8,three weeks ago ,i prescribed ,sinkina for a negro man #dj years of age suffering from a double tertian malarial infection having a chill every afternoon for four consecutive days4 ,he came to my office about #h a4 m4 and was due to have a chill about #f p4 m4 ,i gave him the sample of ,sinkina and directed him to take a tablespoonful at once1 also at noon and again at #d p4 m41 and to continue taking it in same size dose three times a day till he had taken it all4 ,he reported to me in a week from that date and told me he was feeling fine and that he hadn't had any more chills4 ,the patient up to this time is apparently cured40 ,as the claims were supported by a few testimonials purporting to be based on exact investigations1 the ,council submitted the preparation to careful laboratory and clinical tests4 ,for this investigation the ,council was fortunate in securing the help of physicians actively engaged in the study of malaria4 ,experiments were made in vitro with the preparation2 #a ounce of ,sinkina was used1 and its action was compared with that of #aj grains of quinin sulphate4 ,when these were added to cultures of malarial plasmodia in proportion corresponding to #a ounce of ,sinkina or #aj grains of quinin sulphate for a #aej-pound man1 the quinin was found to be unfailingly antagonistic to the malarial organism1 the drug prevented the segmentation of the organism1 and finally killed it in about thirty-six hours4 ,the ,sinkina did not kill the parasite after seventy-two hours of continued action1 and the parasites segmented in the presence of it just as actively as they did in the control4 ,the investigator was furnished with two sets of preparations in plain prescription bottles so as to avoid all influence of the personal equation4 ,one set consisted of ,sinkina1 the other of a mixture of alcohol1 sugar and water with some oil of cumin4 ,the investigator reported that1 so far as the tests on the cultures of malarial plasmodia were concerned1 he could not determine any difference in the results obtained with the oil of cumin preparation1 made in the laboratory of the ,association1 and those obtained with the ,sinkina of the ,metropolitan ,pharmacal ,company4 ,clinical trials were made by three independent investigators4 ,two of them received the two sets of preparations described4 ,,first ,,investigation ,the first investigator treated two cases with ,sinkina3 one was of the ordinary estivo-autumnal type and the other an ordinary tertian4 ,,cases #a ,,and #b4--;,a good many schizonts were present in the blood of each patient forty-eight hours after the administration of ,sinkina4 ,in the instance of the case of tertian the patient had his chill forty-eight hours after the medicine had been started4 ,as the ,sinkina failed to produce any effect the patients were then put on quinin to stop the disease4 ,,case #c4--,the patient had taken #aj grains of quinin on the day on which the experiment was begun4 ,he had the tertian form of the disease1 and plasmodia were quite numerous at the beginning4 ,the quinin was discontinued and ,sinkina was given in doses of #a ounce three times a day4 ,the day following the administration of #aj grains of quinin and #a ounce of ,sinkina1 no parasites could be found in the blood4 ,the ,sinkina was continued in the doses mentioned4 ,on the seventh day the patient had another chill1 and a great many parasites were found in his blood4 ,the ,sinkina was discontinued and the patient was at once relieved by quinin4 ,this investigator gives it as his opinion1 based on these observations1 that the preparation 7,sinkina7 is absolutely worthless in the treatment of malaria1 and he does not think it necessary to make any further experiments with it4 ,,second ,,investigation ,the second investigator treated two cases of tertian malarial fever with these preparations until it was satisfactorily proved that the drug was having no effect on the presence of the parasites in the blood1 when he began the administration of quinin4 ,,case #d4--;,after the use of the remedies for one week the investigator still found young rings half-grown and gametes present in the blood4 ,apparently there was a relative increase in the number of parasites4 ,he then began the administration of quinin4 ,blood-smears taken the next day after #dj grains of quinin had been taken showed one parasite after eighteen minutes' search of one slide1 and two after thirty minutes' search of a second slide4 ,at the end of a week's treatment the patient was discharged recovered4 ,the blood examination of two slides was negative4 ,,case #e4--,this was a case of tertian malaria4 ,after treatment for five days with ,sinkina the blood still showed tertian parasites with increase in the size of the spleen1 and the preparation was without effect on the clinical course of the disease4 ,quinin was then begun1 and the blood examination became negative at the end of three days4 ,the investigator concludes that the preparations furnished him were absolutely worthless in the treatment of two cases of the tertian form of malarial fever1 and that these solutions had no effect on the presence of the parasites in the peripheral circulation4 ,in a case of quartan malaria1 both of the preparations 7cumin oil mixture and ,sinkina71 sent by the ,association ,laboratory1 were without effect on the plasmodia in the blood4 ,this investigator employed the solution made by the ,association ,laboratory 7cumin oil mixture7 as well as ,sinkina1 and was unable to note any differences between them4 ,,third ,,investigation ,the third investigator began the trial of ,sinkina at the instance of the manufacturers1 and used it in three cases1 two of them being benign tertian malaria and one case of mixed infection 7benign tertian and estivo-autumnal74 ,,case #f4--,this was one of the cases of benign tertian malaria4 ,the patient gave a clinical history of malaria with chills occurring on alternate days for a little over a week4 ,there was an immediate cessation of all clinical symptoms1 and three days after the patient had been on #a_/b ounce of ,sinkina three times daily there was no evidence of any plasmodia in his blood2 his additional treatment consisted of #e grains of calomel the evening of the first day with a saline the next morning4 ,before the patient was put on treatment1 numerous parasites of both the asexual and sexual forms were observed4 ,the patient remained in bed for a few days1 and then returned to work4 ,a week later he was again taken ill with a return of all of his previous clinical symptoms4 ,,case #g4--,this case was one of mixed infection 7benign tertian and estivo-autumnal74 ,the patient had a clinical history of malaria dating back two weeks1 with a maximum temperature of #ajd on admission4 ,tertian rings1 estivo-autumnal rings and crescents were found in the blood4 ,the patient was placed in bed1 given thorough eliminating treatment1 and #a_/b ounce of ,sinkina was administered four times daily4 ,his clinical symptoms ran on for two days with no change1 and there was no difficulty in finding the plasmodia in blood-smears1 which were taken twice daily4 ,the dose was then doubled and at the end of four days more there was no change in either his clinical symptoms or the blood-findings4 ,the patient was then placed on #aj grains of quinin sulphate with #ae drops of diluted hydrochloric acid three times daily1 to which he responded in less than forty-eight hours and made an uneventful recovery4 ,,case #h4--,this was the other case of benign tertian malaria4 ,the patient had chills every other day while on the treatment1 and laboratory diagnosis confirmed the clinical findings4 ,experimental treatment was carried on for four days1 with a negative result4 ,the investigator calls attention to the fact that the first case in which improvement resulted does not show any necessary connection with the ,sinkina administered1 for many cases of benign tertian malaria will clear up in just as short a time under any line of treatment1 while practically all will eventually do so4 ,this investigator later reported another case and transmitted a clinical chart4 ,,case #i4--,this patient was admitted to the hospital1 ,dec4 #cj1 #aiab1 with a history of having had malaria for some weeks4 ,the diagnosis was confirmed by a blood examination4 ,he was then carried for four days without treatment other than rest in bed and a liquid diet4 ,his symptoms subsided by the third day4 ,on the fourth day a count of the parasites was made which showed that there were #a1afj asexual parasites and #bfj sexual forms to every thousand leukocytes4 ,the following day he was placed on ,sinkina1 #a ounce three times daily4 ,there was exacerbation of symptoms on the following day1 which gradually increased until the fourth day1 remaining about stationary for a day or so4 ,the fifth day after the patient had been placed on ,sinkina1 another count of the parasites showed #e1fjj asexual parasites and #cjj sexual forms to the thousand leukocytes1 this being an increase of #d1ddj asexual forms and forty sexual forms to every thousand leukocytes4 ,with the second count of parasites the dose of ,sinkina was increased to #b ounces every four hours1 the patient being kept on this until ,january #ad1 without result4 ,he was then placed on quinin1 with a complete reduction of the temperature to normal and the disappearance of the parasites from the blood4 ,the investigator also reported a case of benign tertian malaria4 ,,case #aj4--,this was in a child of #h years which was treated by the investigator's confrre and gave similar negative results4 ,blood examination showed numerous parasites4 ,the child was placed on #a ounce of ,sinkina three times a day and kept on it for two weeks4 ,the clinical picture remained unaltered1 and parasites could be detected in numbers whenever examinations were conducted4 ,a gradually increasing enlargement of the spleen was also noted4 ,at the end of two weeks quinin was substituted1 and the child went on to a rapid and uneventful recovery4 ,this investigator also concludes that the claim put forth by the ,metropolitan ,pharmacal ,company that ,sinkina is a specific in the treatment of the malarial fevers is entirely without foundation1 and that the firm will be unable to demonstrate to the contrary4 ,these investigations demonstrate that ,sinkina is not a specific against malaria1 and that it has no more effect than a mixture of oil of cumin1 sugar1 alcohol and water4 ,they further show the fallacy1 first1 of concluding from a temporary cessation of the symptoms in malaria that the disease has been cured and1 second1 of ascribing such temporary improvement to the influence of a remedy which has no known effect on the malarial organism4--7,from the ,journal ,a4 ,m4 ,a41 ,sept4 #bg1 #aiac47 ,,somnos ,report of the ,council on ,pharmacy and ,chemistry ,to the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association3--,your subcommittee1 to whom was assigned ,somnos1 ,h4 ,k4 ,mulford ,company1 submits the following report of experiments1 undertaken to compare the effects of ,somnos with those of chloral hydrate4 ,these experiments demonstrate that the statements made in regard to the action of ,somnos are in conflict with ,rule #f of the ,council1 which requires3 8,no article will be admitted or retained concerning which the manufacturer or his agents make unwarranted1 exaggerated or misleading statements as to the therapeutic value40 ,it is1 therefore1 recommended that ,somnos be not approved for inclusion in the book until the claims made for it are corrected4 ,it is also recommended that the report be published3 ,the ,pharmacology of ,somnos ,when these experiments were begun1 ,april1 #aijf1 there was nothing in the advertising literature on ,somnos to indicate whether this article is a solution or a pure substance4 ,on the label on the bottle1 in the circular accompanying the bottle1 and in the booklet 8,somnos10 the word ,somnos seemed to be used as a synonym of 8,chorethanal alcoholate10 ,c#i;,h#aa,o#e;,cl#i1 and physicians were prescribing and pharmacists dispensing it in the belief that it was a pure substance4 8,the pure substance2 some kind of an alcohol2 nothing to do with choral10 was the way the druggist from whom the samples were purchased put it4 ,thus information absolutely indispensable for any rational comparison of ,somnos with other hypnotics was withheld from the physician4#hf #hf ,two weeks ago 7,journal ,a4 ,m4 ,a41 ,sept4 #a1 #aijf1 p4 #fie7 it was pointed out that the manufacturers now give this information1 but in a wholly unnecessarily obscure form4 ,hence1 before beginning the physiologic experiments it was necessary to determine the strength of the preparation2 for this purpose three chlorin determinations 7by the ,carius method7 were made4 ,on the assumption that all the chlorin present was in combination as chloral glycerate1 ,c#c;,h#e;,c,cl#c4;,c7,,oh7#bc ,c#i;,h#aa,o#f;,cl#i1 and calculating the percentage of this in ,somnos1 the following results were obtained3 7#a7 #e4aa per cent42 7#b7 #e4ae per cent42 7#c7 #e4aj per cent4 ,somnos1 therefore1 was found to contain approximately #e per cent4 of chloral glycerate and its physiologic action was compared with that of a #e per cent4 solution of hydrated chloral4 ,in some experiments the hydrated chloral was dissolved in water2 in others1 in #aj per cent4 alcohol 7,somnos was found to contain at this time about this percentage of alcohol72 in other experiments glycerin was added1 as ,somnos was found to contain this substance4 ,no very marked differences were found in the physiologic action of the three solutions4 ,,fatal ,,dose ,,of ,,somnos ,,for ,,the ,,lower ,,animals ,the booklet on ,somnos states that 8,somnos has no toxicology02 that while chloral hydrate causes 8acute poisoning10 8deep coma10 etc41 ,somnos is 8harmless in twenty times the dose prescribed10 8coma unknown1 etc40 ,the physician would scarcely suspect from such statements that ,somnos is as poisonous a substance as solutions containing hydrated chloral in corresponding amount2 that such is the case is shown by the following experiments4 ,these experiments were necessarily made on the lower animals4 ,while such results do not enable us to draw very definite conclusions as to the absolute toxicity of poison for man1 the results on animals are conclusive as regards the relative toxicity for man of such closely related drugs as hydrated chloral and ,somnos4#hg #hg ,that portion of the report describing the experiments on animals is here omitted4 ,it was printed in full in ,the ,journal and in the ,report of the ,council on ,pharmacy and ,chemistry1 #aije-aijh4 99 99 99 99 99 ,,conclusions ,to sum up our results on the physiologic action of ,somnos3 ,we have been completely unable to verify the claims of the manufacturers that ,somnos is less toxic than hydrated chloral1 or that it has a less depressing effect on temperature1 respiration or circulation4 ,on the contrary1 the physiologic effects are indistinguishable from those of hydrated chloral1 doubtless because the action of ,somnos is simply the action of hydrated chloral4 ,we can see nothing in the animal experiments or in the chemical composition which would suggest that ,somnos would possess therapeutic advantages over an elixir of hydrated chloral of corresponding strength4#hh ,it is to be hoped that physicians who have been blindly using ,somnos without even knowing the strength of the preparation1 much less what it is1 will compare its effects with those of a #e per cent4 elixir of hydrated chloral4#hh--7;,abbreviated from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #ae1 #aijf47 #hh ,the booklet on ,somnos1 8,somnos1 a ,pharmacological ,report10 which is referred to here1 contains a 8,therapeutic ,index to the ,usefulness of ,somnos40 ,we give below a list of diseases mentioned in this index to show the wide range of usefulness 787 that is claimed for this chloral compound4 ,abortions4 ,abscess--of brain1 kidney1 liver1 tonsils1 parotid gland1 mediastinum2 in appendicitis1 glanders1 perinephritic1 retropharyngeal1 pyemic1 pelvic1 ovarian4 ,somnos lessens pain and quiets nervous state4 ,tablespoonful1 repeated once or twice4 ,use liberally4 ,alcoholism--full doses repeated often4 ,gives calm sleep4 ,no blood changes like those produced by chloral4 ,anemias--progressive and secondary4 ,somnos has no deleterious action on blood as is common with other hypnotics4 ,aneurism4 ,angina4 ,apoplexy4 ,appendicitis4 ,arthritis4 ,arsenical poisoning4 ,arteriosclerosis4 ,asthma4 ,biliary colic1 ,bright's disease4 ,carbuncle4 ,carcinoma4 ,catarrh4 ,cellulitis4 ,cerebrospinal fever4 ,chlorosis4 ,cholecystitis4 ,chordee4 ,chorea4 ,cirrhosis4 ,coccydynia4 ,colic4 ,colitis4 ,concussion4 ,confusional ,insanity4 ,contusions4 ,convulsions4 ,coryza4 ,cough4 ,cramps4 ,cystitis4 ,delirium4 ,diabetes4 ,diarrhea4 ,diphtheria4 ,dropsy4 ,dysmenorrhea4 ,dyspnea4 ,ear4 ,emphysema4 ,empyema4 ,endocarditis4 ,endometritis4 ,epididymitis4 ,epilepsy4 ,erysipelas4 ,fevers4 ,fistula4 ,gallstones4 ,gastralgia or ,gastrodynia4 ,gastritis4 ,gonorrhea4 ,goiter4 ,gout4 ,hallucinations4 ,hay fever4 ,headache4 ,heart ,disease4 ,hemicrania4 ,hiccough4 ,hydronephrosis4 ,hydrophobia1 ,hydrothorax4 ,hyperesthesia4 ,hysteria4 ,indigestion4 ,inflammation4 ,insomnia4 ,kidney disease4 ,laryngitis4 ,liver abscess4 ,cirrhosis4 ,lobar pneumonia4 ,lockjaw4 ,locomotor ataxia4 ,lumbago4 ,mal de mere4 ,malarial fever4 ,meningitis4 ,migraine4 ,melancholia4 ,metritis4 ,morphinism4 ,muscular rheumatism4 ,myelitis4 ,myocarditis4 ,myositis4 ,nephritis4 ,nervous dyspepsia4 ,neuralgia1 occipito-cervical1 etc4 ,neurasthenia4 ,neuritis4 ,night sweats4 ,orchitis4 ,otitis media4 ,parethesia4 ,paralysis4 ,parotitis4 ,peliosis rheumatica4 ,pericarditis4 ,perimetritis4 ,perihepatitis4 ,perichondritis4 ,peritonitis4 ,pertussis4 ,petit mal4 ,pharyngitis4 ,phthisis4 ,pleurisy4 ,pneumonia4 ,post-epilepsy4 ,prolapsed uterus4 ,pseudo angina pectoris4 ,purpura4 ,rabies4 ,rheumatic fever4 ,salpingitis4 ,sarcoma4 ,scarlet fever4 ,smallpox4 ,spasms4 ,stomach4 ,stomatitis4 ,sunstroke4 ,tenesmus4 ,tetanus4 ,tonsillitis4 ,trauma4 ,trismus4 ,typhoid fever4 ,typhus fever4 ,ulcers4 ,urticaria4 ,varicella4 ,vomiting4 ,vulvitis4 ,yellow fever4 ,,succus ,,alterans ,report of the ,council on ,pharmacy and ,chemistry ,the following report was adopted by the ,council3 ,it is1 believed that unwarranted and exaggerated therapeutic claims are made for ,succus ,alterans by its manufacturers1 ,eli ,lilly ,co41 ,indianapolis4 ,in view of the disastrous results which may follow1 if1 from the statements made1 physicians should be led to rely on the product as a treatment for syphilis1 it is recommended that ,succus ,alterans be refused recognition and that this fact be published with comments4 ,w4 ,a4 ,puckner1 ,secretary4 ,comment3 ,succus ,alterans is a preparation which has been put on the market for some years by ,eli ,lilly ,co41 as a remedy for syphilis4 ,the serious character of this disease and especially the deplorable results that ensue from its improper or insufficient treatment1 should make a firm hesitate to advise any treatment for it which experience has not demonstrated to be at least as efficacious as that which is generally accepted and well proved4 ,succus ,alterans is the result of a combination of circumstances2 no one person is responsible for it4 ,it was probably the natural desire for a remedy free from the occasional injurious results of mercury that led ,dr4 ,j4 ,marion ,sims to advocate the use of a collection of indigenous ,american plant drugs1 sarsaparilla1 stillingia1 xanthoxylum1 etc41 which had a local reputation for the cure of syphilis4 ,these drugs are supposed to be inert when the dried plants were used1 and this gave an opportunity for the development of a nostrum4 ,the ingredients are well known1 but as their virtues are supposed to be lost in drying1 the physician can not have his druggist compound them1 but must1 perforce1 prescribe the proprietary combination4 ,those who consented to experiment with the new remedy soon found that the claims to curative properties were unfounded1 but the strong commercial interests backing it have prolonged its life to the present time4 ,authorities on syphilis either say nothing about the preparation or mention it merely to condemn2 but the proprietors of the nostrum continue to assert that it is not only practically a specific in syphilis1 but now recommend it for various derangements of the blood and all sorts of skin diseases4 ,this being the case1 what shall the wise physician do8 ,shall he blindly follow an authority of a past generation or shall he recognize that the claims of an interested manufacturer ought not to weigh against the consensus of his present-day confrres who have given the treatment of syphilis their special attention8 ,the exploitation of such a preparation is deserving of strong censure4 ,by such methods the firm places itself on the same plane as those nostrum venders1 who advertise certain antiseptic sprays and gargles as cures for epidemic meningitis and diphtheria and thereby deprive credulous victims of the curative antitoxin treatment4 ,succus ,alterans is not a new remedy on trial for its possibilities of improvement in therapeutics2 it is an old mixture which has been tried and found wanting4--7,from the ,journal ,a4 ,m4 ,a41 ,june #bf1 #aiji47 ,,sulpho-,,lythin ,report of the ,council on ,pharmacy and ,chemistry ,sulpho-,lythin is sold by the ,laine ,chemical ,company1 ,new ,york4 ,in the literature sent to physicians it is said3 8,this product1 the sulpho-phosphite of sodium and lithium 7non-effervescent71 is entirely new and is unique in its action40 ,chemical analysis of a specimen of ,sulpho-,lythin purchased in the open market indicated its composition to be3 ,sodium sulphate1 anhydrous #aj4ea ,disodium hydrogen phosphate1 anhydrous #ef4fg ,sodium thiosulphate1 anhydrous #bj4gh ,sodium chlorid #e4ih ,lithium1 as citrate #c4ab ,sulphur1 free #j4af ,moisture #a4ec ,loss #a4be ,the examination1 therefore1 shows that ,sulpho-,lythin is a mixture consisting mainly of sodium sulphate and sodium phosphate and sodium thiosulphate4 ,the statement that it is a 8sulpho-phosphite of sodium and lithium10 therefore1 is not correct1 and a statement that 8it is entirely new and unique in its action0 appears unwarranted and misleading4 ,it is1 therefore1 recommended that the preparation be refused recognition4 ,it is also recommended that an article be prepared for publication calling attention to the exaggerated claims made for ,sulpho-,lythin4 ,the recommendations of the subcommittee were adopted by the ,council and in accordance therewith the report is published with comments1 substantially as follows3 ,the formula means that it is a solution of well-known salts1 some of them under partially disguised names4 ,every one knows what ,glauber's salts are good for4 ,disodium hydrogen phosphate is ordinary common sodium phosphate4 ,sodium thiosulphate is familiar as sodium hyposulphite1 the 8hypo0 of the photographers4 ,every one knows1 of course1 that sodium chlorid is common salt4 ,examination and analysis of various specimens of this product demonstrated that its composition is not always the same4 ,as an indication of the ignorance of the promoters of this nostrum it is interesting to note that the label on one of the bottles purchased states that it is a 8sulphophosphate0 instead of a sulphophosphite4 ,extravagant claims are made for this simple mixture of laxative salts1 and these with the methods of using it are printed on the labels1 and while it is claimed to be only advertised to the profession1 the physician is repeatedly advised in the advertisements to 8order always an original 7six ounce7 bottle to prevent substitution40 ,the natural result of this would be1 of course1 to put the patient in the way of prescribing it for himself and to spread the advertisement of the drug among the public4 ,difficulty has been experienced in finding out who the promoters of this nostrum are and the correspondence in regard to it is published4 ,they seem to prefer to be known by their corporate title of ,laine ,chemical ,company only4 ,it is a sample of many other so-called ethical proprietary drugs1 most of which are simple mixtures of well-known drugs which physicians are using every day and which require no skill in their compounding4 ,their proprietors not only presume to sell and advertise medicines but also to tell the physicians how to treat their patients4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #h1 #aijf47 ,,taurocol ,report of the ,council on ,pharmacy and ,chemistry ,the ,paul ,plessner ,company1 ,detroit1 places on the market ,taurocol ,tablets and ,taurocol ,compound ,tablets4 ,the company makes a pretense of giving the formula--minus any quantities--thus3 8,taurocol is a combination of bile salts1 extracts of cascara sagrada1 phenolphthalein and aromatics40 ,the 8formula0 given for ,taurocol ,compound ,tablets is3 8,taurocol 7,bile ,salts7 ,gramme 4#abif ,pepsin #a-cjjj 4#jcbd ,pancreatic ,ext 4#jcbd ,extract ,nux ,vomica 7#a_/h gr47 4#jjha ,aromatics ,q4 ,s40 ,a comparison of these two 8formulas0 with those furnished for ,veracolate and ,veracolate with ,pancreatin and ,pepsin shows that they are nearly the same4 ,the claims made for the ,taurocol preparations are essentially those made for ,veracolate preparations1 as instance the following1 which appears on a physician's sample of ,taurocol3 8,for ,hepatic ,insufficiency1 ,intestinal ,putrefaction1 ,habitual ,constipation40 ,likewise the following1 found on a ,taurocol circular1 duplicates claims made for ,veracolate3 8444 ,directly stimulates the liver cells1 producing an abundant flow of bile rich in cholates1 solvent of cholesterin and a biliary antiseptic40 ,taurocol is objectionable for the reasons that apply to ,veracolate1 and ,taurocol ,compound ,tablets are subject to the objections that apply to ,veracolate with ,pepsin and ,pancreatin4 7,see p4 #baf47 ,the ,council therefore refused recognition to ,taurocol and its preparations4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bd1 #aiae47 ,,tri-,,iodides1 ,,three ,,chlorides ,,and ,,maizo-,,lithium ,report of the ,council on ,pharmacy and ,chemistry ,as an illustration of unreliability of claims and the unscientific character of proprietary mixtures1 the ,council has authorized publication of the following reports on ,tri-,iodides1 ,three ,chlorides and ,maizo-,lithium1 products of the ,henry ,pharmacal ,co4 7,j4 ,f4 ,ballard1 proprietor74 ,w4 ,a4 ,puckner1 ,secretary4 ,tri-,iodides 7,henry7 ,tri-,iodides 7,henry ,pharmacal ,co41 ,st4 ,louis7 is a nostrum whose ingredients apparently were selected at random4 ,since the effects of such a mixture cannot be predicted1 no thoughtful physician would think of prescribing in any one condition all the drugs named in the formula of ,tri-,iodides--if he had to write out the prescription4 ,yet because the misleading name of the preparation gives it the semblance of a therapeutic entity--and because it is advertised in medical journals--a certain number of physicians thoughtlessly prescribe this shotgun mixture4 ,,laboratory ,,report ,regarding the composition of 8,tri-,iodides0 the ,association's ,chemical ,laboratory makes the following report3 ,a trade package of ,henry's ,tri-,iodides purchased in #aiaj bore the following formula on the label3 8,colchicin1 #a-bj grain1 8,phytolaccin1 #a-aj grain1 8,solanin1 #a-c grain1 8,sodium ,salicylate1 ,c4 ,p41 #aj grains1 8,iodic ,acid 7equal to #g_/cb gr4 of ,iodine7 in two fluid drachms of ,aromatic ,cordial40 ,in the circular which was wrapped with the bottle the wording of the formula differs somewhat from the foregoing1 8iodic acid0 of the label being replaced by 8hydro-iodic acid40 ,while the label on the bottle named 8phytolaccin0 as one of the constituents the label on the carton which contained the bottle gave 8decandrin40 ,the following formula appears on a trade package purchased ,june1 #aiad3 8,colchicine1 #a-bjj ,grain1 8,phytolacca1 #a #a-e ,grain1 8,mydriatic ,alkaloids1 #a-ejj ,grain4 8,sodium ,salicylate1 #c #a-b ,grain4 8,iodic ,acid 7equal to #g-abe ,grain of ,iodine7 in two fluid drachms40 ,the differences between the formulas are striking4 ,colchicin has been reduced from #a_/bj grain to #a_/bjj grain2 sodium salicylate from #aj grains to #c-a_/b grains2 iodin 7claimed to be present as iodic acid7 from #g_/cb grain to #g_/abe grain4 8,phytolaccin0 78,decandrin07 has been replaced by 8,phytolacca0 and 8,solanin0 by 8,mydriatic ,alkaloids40 ,while the formula for the preparation has been changed1 the circular accompanying the package still refers to 8solanin0 7in some parts of the circular wrongly spelled 8salonin07 and 8phytolaccin40 ,as no principle having the characteristic effects of poke-root is known to have been isolated the terms 8decandrin0 and 8phytolaccin0 are meaningless4 ,the circular states that solanin is an alkaloid obtained from the sprouts of ,solanum tuberosum1 but wrongly calls this plant 8bittersweet0 instead of potato4 ,at the market price the amount of solanin claimed1 according to the old formula1 to be present in a bottle of ,tri-,iodides1 would cost #a4fj1 although a bottle of the preparation sold at wholesale for #fg cents4 ,tri-,iodides is a dark brown1 mobile liquid having a faint clove-like odor and a mawkish1 sweet taste4 ,salicylate was found in considerable amounts4 ,traces of alkaloids were found1 a portion of which appeared to be colchicin4 ,iodic acid and its salts were absent1 although claimed by the formula to be present4 ,potassium iodid was present4 ,determinations of the iodin by distillation with ferric ammonium sulphate solution and sulphuric acid indicated the presence of about #a4fh gm4 of iodin 7equivalent to #b4ah gm4 of potassium iodid7 in each #ajj c4c4 of the preparation4 ,this is equivalent to about #g4fe grains of iodin per fluidounce1 or more than thirty-four times the amount claimed by the formula on the bottle4 ,an approximate determination of the salicylic acid by extraction of the acidified preparation with ether and evaporation of the solvent indicated about #b4fg gm4 in #ajj c4c41 equivalent to #c4ji gm4 of sodium salicylate1 or about #ad4aa grains per fluidounce4 ,since the amount of sodium salicylate claimed is #c4e grains in #b fluidrams or #ad grains in each fluidounce1 the amount found agrees essentially with the claims4 ,,absurd ,,claims ,it should be unnecessary1 after pointing out the conflict between the name and the published formula1 between the formula and the actual composition1 and between the composition and all established therapy1 to discuss this heterogeneous and unscientific mixture further4 ,a few specimen absurdities1 however1 may be quoted from the advertising 8literature03 8444 ,free of the ,disagreeable ,effects of the ,alkaline ,iodides40 ,tri-,iodides1 according to the laboratory report1 depends for its iodin action on potassium iodid4 8444 we have an assimilable form of vegetable hydriodates4 8,the hydriodates of these valuable vegetable alkaloids afford the specific alterative action of iodine without such disagreeable results as the iodism produced by the ordinary iodides40 8,the hydriodates0 is an obsolete term formerly applied to iodids of vegetable alkaloids4 ,iodids of vegetable alkaloids1 if present at all in ,tri-,iodides1 are present in negligible amounts4 8,containing ,iodine in an available form1 it is obvious that the formula must be beneficial in the majority of syphilitic skin lesions40 ,the falsity of the first two of these claims and the mischievousness of the last are self-evident4 ,it would be possible1 but is unnecessary1 to produce an almost unlimited amount of evidence to show the transparent character of the deception by which this preparation is exploited4 ,the referee feels that the nostrum will have been sufficiently characterized when he has mentioned further that the name 8,henry's ,tri-,iodides0 is blown in the glass of the bottle1 that the label contains the recommendation 8,for ,gout1 ,rheumatism and other ,diathetic ,diseases10 and that the circular accompanying the bottle recommends the use not only of ,tri-,iodides1 but also of ,three ,chlorides1 ,maizo-,lithium1 ,campho-,phenique and ,satyria in the treatment of many diseases4 ,three ,chlorides 7,henry7 ,three ,chlorides 7,henry7 is advertised as3 8,an oxygen-carrying ferruginous preparation1 suitable for prolonged treatment of children1 adults and the aged4 ,indicated in anemia and convalescence from acute diseases and surgical operations40 ,the following report on the composition of ,three ,chlorides is submitted by the ,association's ,chemical ,laboratory3 ,,laboratory ,,report ,it is claimed that each fluidram of ,henry's ,three ,chlorides contains3 8,mercuric ,bichlorid #a-gb ,gr4 8,arsenic ,chloride #a-dj ,gr4 8,proto-,chloride ,iron #b-be ,gr4 8 444 in a cordial of ,calisaya ,alkaloids40 ,the preparation is a pale yellow1 clear solution having an odor of alcohol4 ,the addition of potassium ferricyanid solution does not produce any blue coloration1 thus demonstrating the absence of ferrous chlorid 7iron protochlorid74 ,instead potassium ferrocyanid solution produces at once an intense blue precipitate and potassium sulphocyanate solution an intense red coloration1 thus proving the presence of iron in the ferric condition4 ,it is obvious that the claimed superiority of ,three ,chlorides over preparations containing ferric iron is absurd4 ,since it contains iron in the ferric condition1 ,three ,chlorides decomposes soluble iodids with the liberation of free iodin4 ,the assertion that it is a suitable 8vehicle0 for the administration of iodids is likely to lead the physician unwittingly to administer free iodin4 ,as the laboratory report shows1 the 8formula0 of ,three ,chlorides 7,henry7 is incorrect1 for protochlorid of iron 7ferrous chlorid7 was absent from the preparation4 ,there is1 however1 a more serious objection to the formula than the misstatement of fact4 ,when the physician is dealing with conditions that call for mercury1 arsenic or iron1 it is irrational and unscientific to prescribe a preparation containing these three drugs in fixed proportions4 ,,objectionable ,,advertising ,three ,chlorides is marketed in bottles having the name 8,three ,chlorides0 blown in the glass1 in a carton containing a circular extolling the curative powers of this and other proprietaries of the same concern4 ,thus a physician who prescribes ,three ,chlorides is likely to place in the hands of his patient the advice that 8,three ,chlorides 444 is suitable for the prolonged treatment of children 4440 8,in tertiary syphilis1 with or without potassium iodide1 it holds first rank among remedies directed against the specific taint 4440 ,further1 that 8,maizo-,lithium0 is3 8,a ,genito-,urinary ,sedative0 and a 8remarkable uric-acid solvent40 ,also that 8,satyria0 is3 8,an ,ideal ,genito ,tonic and ,nerve ,reconstituent40 8,indicated in ,prostatic trouble1 ,cystitis1 ,urethritis1 ,gonorrhea1 ,gleet1 ,leucorrhea1 ,sexual ,debility and ,impotence40 ,we are told that 8,as a hematinic1 the protochloride of iron justifies the confidence of the medical profession40 8,the protochloride1 more than any other salt of iron1 stimulates the paptic sic and hydrochloric glandular system of the stomach1 increasing the flow of acid gastric juice40 ,it is unnecessary to discuss the truth or falsity of these assertions1 since ,three ,chlorides does not contain the protochlorid of iron4 ,for the same reason1 it is obvious that the small amount of iron which it contains is the only possible justification for the claim that the preparation is 8444 ,non-,productive of 444 ,constipation or ,teeth ,discoloration40 ,it is hardly necessary to point out that it is a therapeutic exaggeration to claim that ,three ,chlorides is of particular value in the treatment of tertiary syphilis1 that in eczema it is 8the most effective remedy10 that in any form of constipation it is 8the remedy par excellence10 or that 8,after arresting malarial attacks with quinine1 the combination of iron1 arsenic and mercury with calisaya is an essential requisite40 8,whenever gastric troubles and digestive disturbances furnish a contra-indication to iron1 this contra-indication disappears when the iron is combined with arsenic40 8,the simultaneous exhibition of small doses of arsenic and bichloride of mercury1 besides augmenting the effect of iron upon the red blood-cells1 completely obviates the tendency to vascular congestion and hemorrhage40 ,finally1 the suggestion that by the use of ,three ,chlorides iodids may be prevented from causing iodism is absurd4 ,in short1 whatever may be the advisability of prescribing iron1 arsenic or mercury in any given case1 it is irrational to prescribe them in fixed proportions4 ,a physician who is induced by the exaggerated advertising claims to prescribe these drugs in a proprietary mixture1 under a non-informative name1 does grave injustice to his patients4 ,maizo-,lithium ,maizo-,lithium 7,henry ,pharmacal ,co41 ,st4 ,louis7 is one of the many proprietary lithium preparations based on the disproved theory that lithium dissolves uric acid deposits in the body4 ,the label on a trade package states that3 8,maizo-,lithium promptly facilitates the elimination of the uric and phosphatic deposits from the system40 ,as might be expected1 the promoter of ,maizo-,lithium ascribes a long list of ills to 8uric and phosphatic deposits10 and argues that1 therefore1 ,maizo-,lithium is the proper treatment3 8,in lithemia1 hematuria1 incipient diabetes1 cystitis1 urethritis1 pyelitis and ,,all inflamed conditions requiring a non-irritating diuretic40 8,inflamed conditions10 naturally1 include almost all of the real or imaginary ills of kidney1 bladder1 etc4 ,maizo-,lithium is distinguished from its congeners chiefly by the claim that it contains a mythical or problematical compound1 maizenate of lithium4 ,,laboratory ,,report ,the following report on the composition of ,maizo-,lithium has been submitted by the ,chemical ,laboratory of the ,american ,medical ,association3 ,the promoter of ,maizo-,lithium makes the following statement on the label concerning the composition of the preparation3 8,each fluid drachm contains two grains maizenate of lithium40 ,the following is also found in a circular which is enclosed with the trade package of ,maizo-,lithium3 8,maizo-,lithium1 the remarkable uric acid solvent1 is a nascent chemic union of maizenic acid1 obtained from green corn silk1 with the alkaline base lithium forming maizenate lithium1 of which the mother liquid carries two grains to each drachm40 ,standard works on organic chemistry and pharmacology1 such as ,beilstein's ,organische ,chemie and ,cushny's ,pharmacology and ,therapeutics1 do not mention maizenic acid4 ,neither is it mentioned in comprehensive bibliographies of phyto-chemical investigations1 such as ,huseman-,hilger's ,die ,pflanzenstoffe or ,wehmer's ,die ,pflanzenstoffe4 ,the first to use the term appears to have been a ,dr4 ,vautier 7,arch4 md4 belg471 but his publication is not available to the laboratory4 ,rademacher and ,fischer 7,amer4 ,jour4 ,pharm41 #ahhf1 lviii1 #cfi7 claim to have isolated the substance from green corn-silk1 but the record of their work is unsatisfactory and indefinite and therefore their results could not be verified2 it seems unlikely1 however1 that they isolated a pure proximate principle4 ,examination of ,maizo-,lithium demonstrated the absence of bromids1 chlorids1 phosphates1 sulphates1 acetates1 benzoates1 salicylates and tartrates--combinations in which lithium might be expected to be present4 ,the presence of a citrate1 however1 was shown by the usual tests4 ,lithium and sodium were present4 ,free acid was absent4 ,determination of lithium citrate and of sodium citrate indicated the presence of a total of about #c4g gm4 of these two salts in each #ajj c4c4 of the preparation1 or about #b4a grains in each fluidram4 ,about #be per cent4 of the total salts appeared to be lithium citrate4 ,the examination1 therefore1 does not demonstrate the presence of 8maizenate of lithium10 but does show that ,maizo-,lithium contains a mixture of lithium citrate and sodium citrate4 ,tests for citric acid and citrates were made on a commercial specimen of fluidextract of corn-silk4 ,the results were negative1 although the preparation had an acid reaction to litmus4 ,the presence of maizenate of lithium in ,maizo-,lithium--in fact1 its actual existence--thus failed of demonstration4 ,in view of this fact1 it was felt that the burden of proof rested on the promoter of ,maizo-,lithium to supply some satisfactory evidence with regard to this substance4 ,the following letter was therefore1 sent to ,james ,f4 ,ballard3 8,according to the label on a recently purchased bottle of ,maizo-,lithium1 each fluidram of this preparation contains #b grains of #8maizenate of lithium4' ,from an examination made in this laboratory we are inclined to conclude that this statement is not in accordance with the facts4 ,a search of chemical and pharmaceutical publications does not reveal that such a compound as #8maizenate of lithium' has ever been isolated and described1 and we are very much inclined to question its existence4 ,we should be pleased to receive from you any evidence which you may care to send in substantiation of your claim in regard to the content of #8maizenate of lithium' in ,maizo-,lithium--particularly a specimen of #8maizenate of lithium' or the method by which it is produced40 ,while this letter was sent ,oct4 #ac1 #aiad1 no evidence has been submitted up to date 7,january1 #aiae7 to substantiate the asserted presence of maizenate of lithium in ,maizo-,lithium4 ,the report just given shows that the manufacturer has found it expedient to surround his worthless nostrum with a cloak of mystery4 ,a discussion of the jumble of uncritical claims1 baseless assertions and evident falsehoods presented in favor of ,maizo-,lithium would seem a waste of time when the secrecy of this nostrum is all-sufficient for its condemnation4 ,editorial ,note4--,when the ,council on ,pharmacy and ,chemistry was started we announced that we did not see any clear line of demarcation between 8patent medicines0 and many so-called 8ethical proprietaries40 ,time has not caused us to change our opinion4 ,as we have already shown1 and as we shall have occasion to show in the future1 not a few of the 8ethical proprietaries0 offered to physicians are being advertised by those who are pushing the rankest of 8patent medicines40 ,the three preparations mentioned above are sold--and presumably manufactured--by ,mr4 ,ballard1 of ,st4 ,louis4 ,mr4 ,ballard is the promoter of ,ballard's ,snow ,liniment1 ,brown's ,iron ,bitters1 ,herbine1 ,dr4 ,herrick's ,vegetable ,liver ,pills1 ,swaim's ,panacea1 ,renne's ,pain ,killing ,oil1 etc4 ,he is also the promoter of ,campho-,phenique1 exposed in ,the ,journal some eight years ago4#hi ,the spectacle is not an edifying one4 ,a manufacturer with one hand offers the public a profusion of cure-alls1 while with the other he endeavors to foist on the medical profession preparations which are just as fraudulent4 ,some day our profession will awake to the disgrace of it all4 ,it will also awake to the fact1 which should have been evident ere this1 that the nostrum business would cease if physicians would refuse to accept into their offices1 even as a gift1 the nostrum-promoting medical journals that live off this trade4 ,fraudulent 8patent medicines0 will continue to thrive just so long as newspapers will publish 8patent medicine0 advertisements2 fraudulent 8ethical proprietaries0 will continue to exist just so long as medical journals will advertise such proprietaries4 ,as the better class of newspapers are rejecting 8patent medicine0 advertising on their own volition1 so are the better class of medical journals rejecting advertisements of fraudulent proprietaries4 ,some newspapers will continue to carry nostrum advertising until their subscribers raise a protest that will cause the business department to take notice2 so1 too1 some medical journals will continue to share the profits with the nostrum exploiters until an outraged medical profession repudiates such publications4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #f1 #aiae47 #hi ,the ,journal ,a4 ,m4 ,a41 ,april #bj1 #aijg1 reprinted in 8,propaganda for ,reform10 #hth ,edition4 ,,thialion ,report of the ,council on ,pharmacy and ,chemistry ,the following report was submitted to the ,council by a subcommittee which examined ,thialion 7,vass ,chemical ,company73 ,to the ,council on ,pharmacy and ,chemistry3--,we beg leave to report on ,thialion as follows3 ,thialion is sold by the ,vass ,chemical ,co41 ,danbury1 ,conn4 ,in the literature supplied to physicians and in the advertisements in medical journals1 ,thialion is stated to be 8a laxative salt of lithia0 with the chemical formula 8#c,li#b,o4,na,o4,,so#c4g;,,ho40 8,sodio-trilithic anhydrosulphate0 is given as a synonym4 ,an elaborate graphic or structural formula is also given4 ,according to analyses1 this preparation is a mixture consisting chiefly of sodium sulphate and sodium citrate with very small amounts of lithium1 the average of several estimations indicating the following composition3 ,sodium citrate #eh4f ,sodium sulphate1 anhydrous #bf4f ,sodium chlorid #c4c ,lithium citrate1 anhydrous #a4h ,water #i4g ,thus1 the advertising literature is a deliberate misrepresentation of the facts4 ,it is1 therefore1 recommended that the preparation be refused recognition1 and that this report be published4 ,the recommendations of the subcommittee were adopted by the ,council and in accordance therewith the above report is published4 ,w4 ,a4 ,puckner1 ,secretary4 ,in publishing the above report1 the ,council is presenting to the medical profession another object lesson1 and one that illustrates how easily our profession is being humbugged4 ,there are several things that we may learn from the report on this nostrum1 but at this time we will take up only one phase of the lesson4 ,many of the scientific chemical compounds and derivatives given us by the ,german chemists have been distinct advancements and have proved to be valuable additions to our therapeutic agents2 further1 they were received with so much favor by physicians that they have been profitable for those who made them4 ,it is not strange1 therefore1 that imitators should appear4 ,one of the first was our old friend1 ,antikamnia 7which was introduced as a 8new synthetical0 compound74 ,this was followed by ,ammonol1 ,phenalgin1 ,salacetin1 and a host of others having acetanilid as their principal ingredient4 ,illustration3 ,this picturesque 8graphic formula0 for ,thialion appears with many of the advertisements4 ,to most of us it looks formidable1 wonderfully and deeply scientific and non-understandable2 to a chemist it looks absurd4 ,but there are hundreds of other so-called 8new chemical0 compounds among the 8ethical0 proprietaries on the market aside from the acetanilid mixtures4 ,these wonderful compounds1 by the mysterious union of their ingredients1 possess therapeutic properties different from1 or more powerful for good than the drugs from which they are made4 ,at least1 this is what we are told1 and this is what many believe or they would not sell so well4 ,there is another factor worth noticing connected with this subject3 ,when to the claim that the mixture is a 8chemical compound0 is added a complex chemical formula1 it prevents the impertinent question1 8,what is it80 ,for isn't the 8formula0 there1 and is not the information given without the asking8 ,most of us have been so overcome by the display of the chemical knowledge of the nostrum maker that we have been afraid to expose our ignorance by asking for information or explanation4 ,and thus the promoter avoids perplexing questions1 which1 if answered truthfully1 would spell bankruptcy4 ,to a chemist the formula of ,thialion furnished by the ,vass ,chemical ,company signifies nothing4 ,to a physician who possesses but little knowledge of chemistry1 it will seem impressive1 and he may absorb the idea that it stands for a preparation that is the result of exhaustive scientific research4 ,to the chemist1 this formula will appear as a jumble of symbols and numbers that mean nothing4 ,it is not worth while to call attention to the simplicity of this simple mixture of ordinary salts1 for it is too self-evident4 ,as to the remarkable therapeutic qualities of ,thialion1 the reader is referred to that ably edited 8scientific0 periodical1 the ,uric ,acid ,monthly1 and to the mass of 8literature0 relating to this wonderful remedy4 ,while there is a ridiculous side to this business1 there is also a serious one4 ,those who have been making money out of us undoubtedly laugh in their sleeves at our gullibility1 but to us as members of a presumably learned and intelligent profession1 it is not a laughing matter4 ,the whole nostrum business is a shame and a disgrace4--7,modified from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #c1 #aijf47 ,,unguentum ,,selenio ,,vanadic 7,v4 ,,roemer7 ,report of the ,council on ,pharmacy and ,chemistry ,unguentum ,selenio ,vanadic 7v4 ,roemer7 is an ointment manufactured by ,a4 von ,roemer1 ,brooklyn1 ,n4 ,y41 and put on the market by ,schering and ,glatz1 ,new ,york4 ,it is claimed to contain #a per cent4 of selenium oxycyanid and #a per cent4 of vanadium chlorid 8so prepared and incorporated into a modified lanolin base as to insure complete absorption40 ,the preparation is recommended in the later stages of inoperable carcinoma1 sarcoma1 epithelioma and other malignant tumors1 as a substitute for morphin and other narcotics to control pain1 as a modifying 7ante-operative7 treatment in the middle stage of malignant cases presenting the characteristics of being inoperable1 and as a prophylactic treatment of recurrences and metastases following excision of malignant tumors4 ,it is also recommended for use in slow-healing surgical wounds1 abscesses1 tuberculous and mixed septic and gangrenous processes1 etc41 in lupus1 acne1 eczema1 psoriasis1 scabies1 erythemata1 adenomata1 angiomata1 papillomata1 etc4 ,the use of the ointment is further recommended by systemic inunction in septicemia1 pneumonia1 erysipelas1 cerebrospinal meningitis1 septic rheumatism1 septic neuritis1 etc4 ,the ,council voted that the preparation be not accepted for inclusion with ,new and ,nonofficial ,remedies because no evidence has been submitted that the vanadium and selenium are absorbed or that they produce any of the effects claimed4 ,when the preceding report was sent to ,schering and ,glatz1 the firm expressed surprise that evidence of the absorption of selenium and vanadium should be requested4 ,on ,june #h the firm wrote that within a few days one or more tests would be sent by which the presence of selenium and vanadium in the urine could be demonstrated4 ,these tests were not received4 ,so far 7,november1 #aiad7 no evidence of the value of the preparation either in carcinoma or in any of the very long list of other diseases in which it is recommended has been submitted1 and1 the pharmacologic evidence that such a preparation would be of value in such conditions being practically nil1 the ,council authorized publication of this report4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ba1 #aiad47 ,,unicorn ,,root1 ,,wild ,,yam ,,and ,,wild ,,indigo ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has voted that recognition be refused to the following3 ,unicorn ,root 7,aletris farinosa71 ,wild ,yam 7,dioscorea villosa71 and ,wild ,indigo 7,baptisia tinctoria7 and has authorized the publication of the following statements4 ,w4 ,a4 ,puckner1 ,secretary4 ,unicorn ,root--,aletris ,farinosa ,unicorn ,root 7,aletris farinosa7 contains a bitter principle and starch4 ,remarkable powers as a uterine tonic have been ascribed to it but have not been realized by reliable observers1 the drug being practically valueless in these conditions4 ,it enters into the composition of a number of nostrums4 ,as a bitter it is superfluous and it should not be included among non-official drugs4 ,wild ,yam--,dioscorea ,villosa ,wild ,yam 7,dioscorea villosa7 has been little used in medicine4 ,it contains a saponin and an acrid resin1 and is said to possess expectorant1 diaphoretic and--in large doses--emetic properties4 ,it has been recommended as a remedy in biliary colic and in muscular rheumatism4 ,its value in such conditions has not been verified to an extent entitling it to consideration as a useful remedy4 ,wild ,indigo--,baptisia ,tinctoria ,wild ,indigo 7,baptisia tinctoria7 has been in use--chiefly by the eclectics--for about three-quarters of a century1 but there is no satisfactory evidence that it has any therapeutic value4 ,the following text-books on pharmacology do not even mention wild indigo3 ,cushny1 ,brunton1 ,dixon1 ,binz1 ,sollmann4 ,it is not official in the ,united ,states or other leading pharmacopeias4 ,a preparation of wild indigo is advertised with extravagant claims for its therapeutic action1 but these claims are not supported by any substantial evidence4 ,other virtues ascribed to wild indigo are its properties as a cardiac and hepatic stimulant and its value in sepsis1 particularly in typhoid fever4 ,it actually has emetic and cathartic properties1 but even these are inferior to those possessed by many other drugs4 ,it is very evident that a drug possessing the extraordinary merits that have been claimed for wild indigo would not have remained unnoticed by the leading authorities on pharmacology and therapeutics1 especially after its prolonged use in medicine4 ,owing1 therefore1 to the lack of substantial evidence of its usefulness1 baptisia is not considered as of sufficient importance to warrant its inclusion in the list of non-official drugs4 ,it is probably entirely superfluous4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bb1 #aiaj47 ,,proprietary ,,vanadium ,,preparations ,report of the ,council on ,pharmacy and ,chemistry on ,products of ,vanadium ,chemical ,co43 ,vanadiol1 ,vanadioseptol1 ,phospho-,vanadiol1 ,vanadoforme1 etc4 ,vanadiol and preparations thereof1 the products of the ,vanadium ,chemical ,company1 were submitted to the ,council4 ,after thorough investigation it was concluded that the company has not1 and never has had1 any reliable evidence for the therapeutic claims it has presented to the medical profession regarding these products4 ,accordingly the ,council voted that the several products under consideration be not accepted for inclusion with ,new and ,nonofficial ,remedies4 ,the findings of the ,council having been submitted to the ,vanadium ,chemical ,company and its reply considered1 the ,council authorized publication of the report which appears below4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,vanadium ,chemical ,company1 ,pittsburgh1 ,pa41 submitted to the ,council on ,pharmacy and ,chemistry for inclusion in ,new and ,nonofficial ,remedies the following products3 ,vanadiol1 ,vanadioseptol1 ,phospho-,vanadiol1 ,vanadium ,solution for ,intravenous and ,hypodermic ,use and ,vanadoforme4 ,at the same time1 the company submitted statements and 8literature0 regarding the composition and therapeutic value of these products4 ,the committee to which the matter was referred1 after carefully considering both the matter presented and certain modifications in the advertising matter to which the company consented1 reported that the evidence1 especially that relating to the therapeutic value of the preparations1 was insufficient to warrant the acceptance of the articles4 ,since the validity of therapeutic claims can be determined to a certain extent by experimental investigation1 the ,council decided to postpone final action until sufficient dependable evidence as to the therapeutic value had been submitted4 ,accordingly1 a series of questions was sent to the ,vanadium ,chemical ,company for the purpose of learning on what pharmacologic evidence the therapeutic claims were based4 ,after waiting several months1 the information requested not being furnished1 the ,council took final action on the products4 ,this action was based both on the evidence originally submitted and on the advertising matter being sent out by the company at the time4 ,briefly1 ,vanadiol is said to contain a compound of vanadium with oxygen and chlorin1 which gives up its oxygen to readily oxidizable substances1 such as the blood4 ,in addition to this compound it contains an oxidizing agent 7sodium chlorate7 which is said to serve as a source of oxygen1 so that1 according to the theory of the promoters1 ,vanadiol acts in the animal system as an oxygen-carrier4 ,the following is quoted from an advertising circular3 8,most thorough and conclusive physiological tests were made on guinea-pigs and other animals1 which established undoubted evidence as to the truth of this theory4 8,,influence 8,under the influence of ,vanadiol and the other derivatives1 the appetite is increased1 there is greater ability to peptonize ingested proteid material1 and1 through the improvement in the assimilative powers and the checking of abnormal fermentations1 leads to an increase in weight4 ,a greater excretion of urea follows their use4 ,phagocytic action is promoted by an increase in the leucocytes4 ,all phases of the elimination of waste materials are favored by the positive increase in the number of red blood corpuscles and the percentage of hemoglobin1 hematogenesis being thereby rendered more perfect4 ,the beneficent effect of nascent 7active7 oxygen1 upon the red corpuscles and upon tissue cells of low vitality are matters of common knowledge4 ,the results obtained from the vanadium derivatives are not drug effects1 but are due to improved metabolism1 which in turn is due to the removal of microbian toxins1 and the general stimulation of cell activity4 8,in a tubercular organism1 the action of ,vanadiol is two-fold4 ,first1 it acts as an antiseptic and antitoxin1 combating the ,koch bacilli and neutralizing their poison4 ,second1 as a reconstituent of the economy1 to which it furnishes nascent oxygen1 fortifying the defenseless cells by the very element that is necessary to make them healthy and resistant40 8,in ,anemia and ,chlorosis1 the blood cells lack oxygen1 and in ,neurasthenia the nerve cells are deficient4 ,vanadiol brings both blood and nerve cells from a condition of weakness and decay into vital energy1 by furnishing them with active oxygen in a manner that had not been possible by any other medicine40 8,vanadiol accelerates the work of digestion by producing ,h,cl in small doses2 it does not hinder the peptonization of albuminoids as do beta-naphthol1 salicylic acid1 boric acid1 etc41 when used as a stomachal antiseptic1 but on the contrary it favors1 by hydrochloric acid1 the transformation of albuminoids into peptone without the assistance of pepsin4 ,thus1 ,vanadiol1 when given to consumptives1 favors the digestion of large amounts of proteid materials and causes oxidation of toxins of the stomach4 ,the stomachic action is reflected in other parts of the organism by the stimulation of the chief functions2 the pulse becomes stronger and muscular strength increases2 and1 last1 but of greatest importance1 is the tremendous increase which will be noted in the hemoglobin and the red cell count40 8,phospho-,vanadiol1 a combination of ,vanadiol with an easily assimilable organic phosphorus1 is an active accelerator of general nutrition with a special action on the nervous system40 ,such remarkable statements as these are past credence1 certainly1 unless they are supported by scientific evidence4 ,and evidence1 either in support or in contradiction of the claims made1 could be obtained2 for many of these actions1 at least1 are capable of proof by animal experimentation4 ,the ,vanadium ,chemical ,company was asked to furnish such proof but failed to do so4 ,the inference is plain6 ,the committee has concluded that the company has not1 and never has had1 any reliable evidence on which to base the therapeutic claims it has presented to the medical profession4 ,here another fact should be noted4 ,it is the connection shown in ,the ,journal1 ,june #bb1 #aiab1 of the general manager of the ,vanadium ,chemical ,company1 ,f4 ,m4 ,turner1 with a fraudulent obesity cure concern1 the ,dr4 ,turner ,company of ,syracuse1 ,n4 ,y4 ,it seems1 moreover1 by all the evidence available1 that ,f4 ,m4 ,turner is not authorized to use the title ,m4,d42 yet1 under this title his name appeared on cards representing the ,vanadium ,chemical ,company and under this title1 also1 he published an article in a medical journal recommending to the medical profession the use of ,vanadiol4 ,later this article was distributed as an advertising circular by the ,vanadium ,chemical ,company4 ,turner's connection with the ,dr4 ,turner ,company is known and acknowledged by the ,vanadium ,chemical ,company1 yet it still retains him as general manager6 ,while there is not necessarily any direct relation between the personnel of a proprietary manufacturing company and the value of that company's product1 it is natural that the medical profession should view with distrust any concern managed by one who has previously been connected with such a fraud as the ,turner obesity cure4 ,the committee therefore recommends that the preparations of the ,vanadium ,chemical ,company be refused recognition1 and that this report be authorized for publication4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ah1 #aiac47 ,,venarsen ,report of the ,council on ,pharmacy and ,chemistry ,the report which appears below was sent to the ,intravenous ,products ,company for consideration4 ,having considered the firm's reply1 the ,council has authorized publication of its report along with the explanation sent by the ,intravenous ,products ,company in reference to the variable composition reported for ,venarsen1 namely1 that 8only the first few experimental ampules1 sent to the doctors for clinical tests1 were made without the ,mercuric ,iodide40 ,w4 ,a4 ,puckner1 ,secretary4 ,this product is prepared by the ,intravenous ,products ,company1 ,denver4 ,the advertising circulars contain inconsistent statements as to its composition4 ,according to one circular ,venarsen is 8444 a comparatively non-toxic organic arsenic compound1 #j4f ,gm4 representing #bdg ,mg4 7#c-c_/d grains7 of metallic arsenic in chemical combination44440 ,according to another circular ,venarsen is 8444 a comparatively non-toxic organic arsenic compound1 #j4f ,gm41 representing #bdg ,mg4 7#c-c_/d grains7 of metallic arsenic and 4#gh ,mg4 7#c_/bej grain7 metallic mercury in chemical combination40 ,neither one of these statements gives any information as to the actual composition of the product4 ,inquiry addressed to the manufacturers elicited the reply that3 8,venarsen contains in each #e c4c4 #j4f ,gm4 ,sodium ,dimethyl ,arsenate1 4#jjaf grams of ,mercuric ,iodide1 4#jjdh grams of ,sodium ,iodide in solution in a suitable vehicle for intravenous administration40 ,the following report of the examination of ,venarsen is submitted by the ,association's ,chemical ,laboratory3 ,,laboratory ,,report ,three ampules of ,venarsen were examined4 ,the first ampule was labeled 8,a comparatively non-toxic organic arsenic compound1 representing #bdg ,mg4 7#c-c_/d grs47 of metallic arsenic in chemical combination4 #e c4c4--#j4f ,gm40 ,practically the same statement appeared in an advertising circular wrapped around the ampule4 ,the second and third ampules bore labels identical with the first4 ,the circulars differed from that accompanying the first ampule in that the presence of mercury is also announced1 thus3 8,venarsen is a comparatively non-toxic organic arsenic compound1 #j4f ,gm41 representing #bdg ,mg4 7#c-c_/d grains7 of metallic arsenic and 4#gh ,mg4 7#c_/bej grain7 metallic mercury in chemical combination and is so prepared and enhanced as to present the ingredients to the blood in their most acceptable form40 ,thus1 although the potent elements said to be contained in ,venarsen are named1 its chemical character 7the combination in which the elements occur7 is not disclosed4 ,the ampules contained a transparent1 odorless solution1 possessing the yellow color of salvarsan solution 7an aqueous solution of sodium cacodylate1 mercuric iodid and sodium iodid in the amounts said to be present in ,venarsen is colorless74 ,qualitative tests demonstrated the presence in each of the three ampules of sodium cacodylate 7sodium dimethyl arsenate71 and the absence of arsenites1 arsenates1 phosphates1 arsanilates 7atoxyl1 soamin7 and arsenphenolamins 7salvarsan1 neosalvarsan74 ,titrated with normal hydrochloric acid1 using methyl orange as indicator 7as outlined in ,new and ,nonofficial ,remedies1 #aiae1 p4 #dj71 the three ampules were found to contain the equivalent of respectively1 #j4bai1 #j4bec and #j4baf ,gm41 or an average of #j4bdd ,gm4 arsenic4 7,according to statements of the firm each #e c4c4 of ,venarsen contains #j4f ,gm4 sodium dimethyl arsenate sodium cacodylate1 equivalent to #j4bdg ,gm4 arsenic or #da4ff per cent4 ,sodium dimethyl arsenate1 as described in ,new and ,nonofficial ,remedies1 contains #c molecules of water and #ce per cent4 arsenic4 ,this indicates that the sodium dimethyl arsenate used in ,venarsen contains less water of crystallization than the ,n4 ,n4 ,r4 product74 ,neither mercury nor iodid could be found in the first ampule4 7,the company has since explained that mercury was absent only from the first experimental samples47 ,the second and third ampules contained iodid and mercury in small amount4 ,the exact quantity was not determined because1 on the basis of the mercury content declared1 a single accurate mercury estimation would have required the purchase of something like #be to #ajj ampules4 ,as each ampule sells for two dollars1 the cost of the material was considered prohibitive4 ,from the foregoing we conclude that the first ampule examined consisted essentially of a solution containing #j4fbe ,gm4 of sodium cacodylate1 ,n4 ,n4 ,r41 while the second and third ampules contained #j4gbb ,gm4 and #j4fag ,gm4 sodium cacodylate1 respectively1 and in addition1 a mercury compound1 probably mercuric iodid1 dissolved by sodium iodid4 ,in other terms1 ,venarsen as now marketed is a simple solution containing approximately #i grains of sodium cacodylate1 #a_/dj grain of mercury 8biniodide0 and #c_/d grain of sodium iodid to each full dose4 ,in the past the preparation has been in conflict--especially serious because of the potent character of the drug--with ,rule #a 7secrecy of composition74 ,the manufacturers have removed this conflict by furnishing a statement of composition2 and it is to be expected that they will likewise take steps to remove the manifestly erroneous impression now likely to be gathered from the circulars1 namely1 that the preparation is rather analogous to salvarsan4 ,these conflicts1 however1 call for comment1 since physicians have doubtless used the material under misapprehensions4 ,as to therapeutic claims1 the preparation is said to be effective and safe in syphilis2 8lower toxicity and greater spirochaetacidal power than other known arsenic compounds0 are among the claims4 ,no real evidence for either of these claims is presented4 ,sodium cacodylate has been tried as an antisyphilitic1 but with indifferent success2 certainly the results have not been comparable to those of salvarsan4 ,the mercury could conceivably enhance its effect1 but the dosage appears too small and the course too short for this influence to be pronounced4 ,moreover1 a careful physician would not give arsenic and mercury in fixed proportions4 ,the claim of comparative non-toxicity is probable enough from what is known about the cacodylate4 ,no physician should feel 8safe10 however1 when injecting intravenously #j4f gm4 of sodium cacodylate every four to six days4 ,aside from the grave dangers of intravenous injection in general1 the possibility of idiosyncrasies to arsenicals should always be borne in mind4 ,finally1 ,venarsen is claimed to be 8indicated0 in pellagra1 tuberculosis1 anemia1 etc4 ,no evidence is presented on which to base an opinion as to its efficiency in pellagra4 ,those who have studied that disease would not be likely to resort to this treatment4 ,in tuberculosis and anemia1 there is no sufficient advantage in giving the cacodylate intravenously4 ,to summarize1 ,venarsen treatment consists essentially in the intravenous injection of large doses of sodium cacodylate4 ,the other ingredients1 as well as the name1 merely constitute so much mystification4 ,while the cacodylate probably has some effect on the conditions for which it is advised1 there is no evidence that its value even approaches that of salvarsan in syphilis1 or that the intravenous use is preferable to the ordinary methods4 ,the dangers are manifest1 although they may not be so great as with salvarsan4 ,no justification has been established for its use in tuberculosis and pellagra4 ,physicians who wish to try intravenous cacodylate administration should have a full realization of the dangers of such treatment1 and in order to avoid further risks1 will do well to refrain from combining other drugs with the cacodylate in fixed proportions4 ,it is recommended that ,venarsen be held in conflict with ,rule #f 7unwarranted therapeutic claims71 ,rule #g 7poisonous ingredients not stated on label71 ,rule #h 7name does not express the chemical composition7 and ,rule #aj 7unscientific combination7 and that this report be published4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #bb1 #aiae47 ,,venodine ,report of the ,council on ,pharmacy and ,chemistry ,venodine 7,the ,intravenous ,products ,co41 ,denver71 according to information sent to the ,council1 is 8an ,intravenous ,iodine ,compound0 put up in ampules each of which contains 8#bh grains of ,sodium ,iodide1 #a_/h grain each of ,beechwood ,creosote and ,guaiacol in a suitable vehicle1 and excipients to enhance its compatibility with the circulating blood40 ,the 8,therapeutic ,indications0 include 8infectious diseases1 such as syphilis1 tuberculosis1 bronchitis1 bacteraemias associated with chronic and acute nephritis 7,bright's disease71 and other infections40 ,the ,council held as unwarranted and grossly exaggerated the following therapeutic claims3 7#a7 that the full therapeutic value of iodin medication cannot be readily obtained except by intravenous injection2 7#b7 that ,venodine is 8of exceptional value in tuberculosis02 7#c7 that in pneumonia ,venodine 8combines the anaesthetic properties of creosote and guaiacol with the germicidal value of iodine02 7#d7 that 8,venodine 7or its iodine component7 has long enjoyed an exceptional reputation0 as of great value in many infectious diseases including bacteremias4 ,the facts on these points are the following3 #a4 ,since iodids are easily absorbed from the mucous membrane of the gastro-intestinal tract and are usually well tolerated by the stomach1 there is no reason for resorting to intravenous injection in their administration4 #b4 ,the indiscriminate administration of iodids for pulmonary tuberculosis is strongly to be condemned4 ,the cases in which they can be given to tuberculous patients without doing harm must be very carefully selected4 #c4 ,there is no evidence either that creosote is excreted by the lungs in sufficient quantity to exert an anesthetic influence or that iodin is present in the circulation of the lungs or in the bronchial secretions in a form which is capable of exerting any germicidal action whatever4 #d4 ,it is generally held that the systemic administration of iodin compounds in bacteremias is useless4 ,the ,council also held the name 8,venodine0 objectionable in that it fails to indicate the chief ingredient 7sodium iodid7 of this simple pharmaceutical mixture4 ,the statement in a circular that 8,venodine is a sterile solution representing #a4ed ,gm4 7#bd grains7 of iodine in chemical combination together with creosote and guaiacol0 is likely to lead physicians to use the preparation without considering that its chief constituent is the well-known substance sodium iodid1 particularly so since no reference to sodium iodid is made in the circular4 ,furthermore1 the ,council held that the combination of two such similar substances as creosote and guaiacol 7the second a constituent of the first7 as given in the published formula1 stamps ,venodine as unscientific2 it adds mystery to the preparation1 but does not increase its efficiency1 and is therefore against the best interests of the public4 ,the ,council voted that ,venodine be held ineligible for conflict with ,rules #f1 #h and #aj4 ,this report having been submitted to the manufacturers1 in accordance with the ,council's custom1 and the reply affording no reason for modifying the findings1 its publication has now been authorized4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #bf1 #aiae47 ,,veracolate,,am ,report of the ,council on ,pharmacy and ,chemistry ,,am ,for report on a similar compound1 see ,taurocol1 p4 #aih4 8,veracolate 7plain710 8,veracolate with ,pancreatin and ,pepsin0 and 8,veracolate with ,iron1 ,quinine and ,strychnine0 are proprietary tablets marketed by the ,marcy ,company1 ,boston4 8,veracolate 7plain740--,for this the following non-quantitative formula is given3 8,a compound containing the bile acids1 sodium glycocholate1 sodium taurocholate with cascara sagrada and phenolphthalein40 ,the dose is three tablets4 ,examination in the ,chemical ,laboratory of the ,american ,medical ,association of a specimen of 8,veracolate 7plain70 indicated that there was about #bj mg4 7#a_/c grain7 of phenolphthalein to each tablet4 ,one dose1 therefore 7three tablets71 would contain #a grain of phenolphthalein--an average dose4 8,veracolate with ,pepsin and ,pancreatin40--,the following 8formula0 is given for this mixture3 8,veracolate #a-a_/d grain 8,pure ,pancreatin #a grain 8,pepsin aseptic 7#a3c1jjj7 #a_/b grain 8,oil peppermint #a_/aj min40 7,note the presence of two mutually incompatible digestive ferments47 8,veracolate with ,iron1 ,quinine and ,strychnine40--,this is stated to have the following 8formula03 8,veracolate #a-a_/h grain 8,reduced ,iron #a grain 8,quinine ,sulphate #c_/h grain 8,strychnine ,sulphate #a_/ajj grain0 ,it will be noticed that these mixtures increase in complexity until a combination of seven diverse ingredients1 a veritable shotgun mixture1 is evolved4 ,in none of the 8formulas0 are the proportions of the purgative drugs in ,veracolate stated4 ,in the second 8formula10 the digestants might as well be omitted1 for the pancreatin is destroyed by peptic digestion and hence cannot pass the stomach while the pepsin is useless without hydrochloric acid1 and1 at any rate1 of no value in the intestine4 ,if one is indicated1 the other is not4 ,yet this unscientific and complex combination of purgatives1 mutually incompatible digestive ferments1 and oil of peppermint is called3 8,a scientific ,blending of ,digestive ,ferments1 ,cholagogues and ,carminatives40 8444 for all forms of indigestion and dyspepsia40 ,and the third1 an equally irrational and complex combination1 is termed 8,the ,ideal ,cholagogic ,tonic06 ,extravagant and ,misleading ,claims4--,true to type1 the claims are magnified in accordance with the number of ingredients4 ,for instance1 of 8,veracolate 7plain710 we are told3 8,veracolate is a true cholagogue and biliary disinfectant as it directly stimulates the liver cells producing an increased flow of limpid bile4 ,although not a purgative1 it moves the bowels and is definite and dependable in its action40 8,the action of ,veracolate is to bring about a profuse flow of healthy bile which prevents bile stasis4 ,as the flow of bile is stimulated so antiseptic action ensues1 calculi softened and the concretion and mucous eliminated4 ,mucosal swelling is diminished and the infection which is usually present is antagonized4 ,relief is in plain evidence4 ,as a result of the treatment the skin1 eyes and urine become normal in appearance in a short time1 the appetite and digestion improve and soreness in the region of the gall-bladder is entirely relieved40 ,similarly1 it is said of 8,veracolate with ,pancreatin and ,pepsin0 that3 8,it causes a natural flow of bile which checks fermentation1 prevents the absorption of toxines and causes the food elements to be emulsified and thus rendered easy of assimilation4 ,all this conduces to a natural movement of the bowels4 ,digestion is at once improved and the epigastric pain1 nervous symptoms and headache disappear40 8,veracolate with ,iron1 ,quinine and ,strychnine0 is said to be indicated in3 8,hepatic ,torpor accompanied by ,anemia1 ,chlorosis1 ,debility1 ,neurasthenia and ,neuroses40 ,and the physician is asked to believe that it will3 8444 give gratifying results in all nervous1 anemic1 and #8run down' conditions in which the liver function is usually subnormal40 ,the objections to 8,veracolate 7plain70 are that it is semi-secret in composition1 unscientific in combination and exploited under unwarranted claims4 ,the same criticisms hold with reference to 8,veracolate with ,pancreatin and ,pepsin0 and 8,veracolate with ,iron1 ,quinine and ,strychnine40 ,these products are discreditable to the medical and pharmaceutical profession alike and their use is against the public good4 ,the ,council therefore refused recognition to ,veracolate and its preparations4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bd1 #aiae47 ,,hayden',s ,,viburnum ,,compound,,an ,report of the ,council on ,pharmacy and ,chemistry ,,an ,see also report on ,dioviburnia1 p4 #ada1 and article on ,viburnum ,compound and ,other ,nostrums1 p4 #dji4 ,the following report on ,hayden's ,viburnum ,compound was prepared by a member of the ,council's ,committee on ,therapeutics4 ,the ,council held the preparation in conflict with its rules and authorized publication of the referee's report4 ,w4 ,a4 ,puckner1 ,secretary4 ,hayden's ,viburnum ,compound1 according to the advertising circulars1 was first compounded in #ahfj by ,w4 ,r4 ,hayden4 ,the medical profession is told that ,w4 ,r4 ,hayden 8444 found by his experiments that a combination of the active principles of ,viburnum ,opulus1 ,dioscorea ,villosa1 combined with aromatics1 proved a valuable remedy for ,spasmodic ,dysmenorrhea40 ,as in #ahfj ,w4 ,r4 ,hayden was not a physician 7he received a diploma from the ,eclectic ,medical ,college1 ,new ,york1 in #ahfg71 and1 so far as we can learn1 he was not a pharmacist or chemist1 one wonders what kind of 8experiments0 he made4 ,hayden's ,viburnum ,compound is put on the market by the ,new ,york ,pharmaceutical ,company of ,bedford ,springs1 ,mass4 ,the name of this concern may sound imposing1 until it is realized that it is merely a trade name adopted by ,hayden in exploiting his nostrum4 ,the advertising matter formerly claimed that ,scutellaria 7skull-cap7 was one of the ingredients of ,hayden's ,viburnum ,compound4 ,as this is no longer mentioned1 it is fair to assume that even the manufacturer does not consider the composition to be of vital importance4 ,stress is laid on the superior efficacy of viburnum opulus in the conditions for which the preparation is recommended2 it is emphasized that it is viburnum opulus1 and not viburnum prunifolium1 that is the important ingredient of ,hayden's ,viburnum ,compound4 ,the label1 in accordance with the requirements of the ,food and ,drugs ,act1 declares that the preparation contains #ej per cent4 alcohol4 ,the claim is made3 8,it is free from all narcotics and leaves no unpleasant after-effects40 ,the medical profession is told that ,hayden's ,viburnum ,compound is a remedy in3 8,hysteria1 ,bilious ,colic1 ,cramps of ,cholera ,morbus1 ,muscular ,cramps1444 ,nervous ,diseases of ,pregnancy1 ,threatened ,abortion1 ,post-,partum ,pains1 ,puerperal ,convulsions1 ,rigid ,os1 ,dysmenorrhea1 ,menorrhagia40 ,,discussion ,,of ,,alleged ,,ingredients ,viburnum ,opulus 7,cramp ,bark74--,botanists and pharmaceutical chemists declare that this drug has not been on the ,american market for many years1 if ever1 and that the drug used and even described as viburnum opulus is really the bark of another plant4 ,viburnum opulus and its preparations are therefore to be dropped from the next ,united ,states ,pharmacopeia4 ,the principal constituents of viburnum opulus are stated to be a glucosid1 viburnin1 a bitter resin1 and a little tannin1 with small amounts of earthy carbonates and phosphates and organic acids 7,culbreth1 ,ed4 #d1 #aijf1 p4 #eia74 ,the glucosid and resin being bitter1 the drug might have a slight stomachic action 7if1 indeed1 any such effect is actually produced by 8bitters072 the small amount of tannin might make it slightly astringent2 its fruit acids 7citric and malic7 might make it slightly diuretic4 ,even if viburnum opulus were present in ,hayden's ,viburnum ,compound there is no clinical or laboratory proof that it1 if given alone--without alcohol or other drug--has any antispasmodic or nervous sedative action4 ,dioscorea ,villosa 7,wild ,yam74--,this drug contains a saponin and an acrid1 irritant resin4 ,it has never been proved clinically or experimentally that this drug has any action whatever except that its irritant resin might1 if taken in sufficient quantity1 cause irritation of the stomach and vomiting4 ,aromatics4--,the irritation produced by concentrated aromatics causes increased peristalsis and consequently may1 if there is no obstruction1 relieve intestinal stasis and intestinal colics4 ,therefore1 a preparation containing large amounts of aromatics1 especially if given in hot water1 would have practically the same effects in the 8cramps of a cholera morbus0 or other forms of acute diarrhea as a home-brewed cup of spiced tea--and no more4 ,alcohol4--,this drug is a muscle relaxant1 and sufficient doses might1 by relieving spasm1 relax a muscularly contracted os uteri and relieve post-partum pains4 ,alcohol dilates the blood-vessels both in the abdomen and on the surface of the body4 ,it may thus either relieve uterine bleeding by lowering the blood-pressure and causing more blood to go to other parts1 or increase uterine bleeding by relieving arterial and muscle spasm4 ,alcohol is also a habit-forming narcotic 7,hayden's ,viburnum ,compound is advertised as 8free from all narcotics067 and when habitually used by either males or females tends to impair the capacity to produce normal offspring4 ,even if the manufacturer's 8formula0 be accepted1 ,hayden's ,viburnum ,compound contains no therapeutically active ingredient except alcohol and aromatics4 ,the recommended dose of this preparation is 8444 two teaspoonfuls in six of boiling hot water or milk and one teaspoonful of sugar1 every fifteen or twenty minutes until relief is obtained40 8,frequently after taking the ,viburnum ,compound the patient will sleep soundly for several hours from the sudden cessation of pain2 in such cases she should never be awakened through any fear of oversleeping1 as ,hayden's ,viburnum ,compound does not contain any narcotic whatever1 nor does it leave any disagreeable after-effects1 and it may be given to a child when necessary without any special caution40 ,read the foregoing and then remember that it means that one teaspoonful of alcohol 7the equivalent of two teaspoonfuls of whisky7 is to be given in hot water1 every fifteen or twenty minutes until relief is obtained and the patient is asleep4 ,why not use plain language and say 8until she is drunk08 ,the thoughtful physician would consider it decidedly unwise to give alcohol to a young girl1 to a prospective mother1 or to a young mother1 except under extraordinary circumstances4 ,he would know that the menstrual pains for which this preparation is recommended are likely to be recurrent1 and that the repeated taking of alcohol for recurrent pain is fraught with danger--the danger of initiating the alcohol habit4 ,if1 however1 a physician does elect to give alcohol as a drug1 he must let the conditions that govern each individual case determine whether it is not better to give it as whisky1 or to disguise it in a prescription of his own4 ,above all the physician should be conscious that he is giving the drug1 alcohol2 and this is not the case when he prescribes a ready-made nostrum4 ,if he writes a prescription containing whisky or other alcoholic he will take measures to avert the dangers inseparable from the use of this drug4 ,,conclusions #a4 ,even if the manufacturer's formula for ,hayden's ,viburnum ,compound be accepted1 it is apparent that any therapeutic activity the preparation may have is due essentially to the alcohol and aromatics4 #b4 ,alcohol is a narcotic drug1 and a habit-forming drug4 ,physicians ordering this preparation may1 by so doing1 be initiating the alcohol habit4 #c4 ,whatever result is obtained by the use of ,hayden's ,viburnum ,compound in the treatment of uterine or pelvic disturbances1 is due to the alcohol it contains4 ,the fact that menstrual pains are likely to recur might1 when this preparation is relied on1 become a factor in the formation of the alcohol habit4 #d4 ,whatever result is obtained by the administration of ,hayden's ,viburnum ,compound in the treatment of gastro-intestinal disturbances is due to the alcohol and the aromatics it contains4 #e4 ,whisky has the same alcoholic content 7#ej per cent47 as ,hayden's ,viburnum ,compound2 the dangers in the use of whisky are well known and its value as a therapeutic agent is being questioned more and more every year4 ,holding the exploitation of this proprietary a danger to the public and a detriment to scientific medicine1 the referee recommends publication of this report as a protest against such irrational therapeutics4 ,the profession should recognize that most1 if not all1 of the preparations recommended for painful menstruation and for all kinds of pelvic pain contain large percentages of alcohol1 and that whatever physiologic effect is produced is1 for all practical purposes1 due to the alcohol4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bc1 #aiae47 ,,vin ,,mariani ,report by ,council on ,pharmacy and ,chemistry--,with ,comments ,thereon ,this preparation was assigned to a subcommittee of the ,council and the following is an abstract of the report of the committee3 ,samples of ,vin ,mariani and of the literature distributed by the manufacturers were examined4 ,it appears that the beverage or medicine known as 8,vin ,mariani0 is a preparation of red wine1 apparently imported from ,bordeaux1 and fortified1 in this country1 by an alcoholic preparation of coca leaves or other parts of the coca plant4 ,the committee considered first1 the character of the red wine as imported4 ,a sample received from the port of ,new ,york1 ,march #aj1 #aije1 from ,henry ,clausel ,co41 ,bordeaux1 and consigned to ,mariani ,co41 on analysis was found to have the following composition3 ,specific gravity #j4iiei ,alcohol by volume per cent4 #aj4ii ,extract per cent4 #b4bgi ,volatile acids per cent4 #j4jiad ,ash per cent4 #j4bhja ,reducing sugar trace4 ,pol4 direct degrees --#j4h ,pol4 invert degrees --#j4g ,k4,so ,m4 per liter #j4jib ,a sample of ,vin ,mariani1 as bought in the open market in an original package1 has also been analyzed and found to have the following composition3 ,specific gravity #a4jabe ,alcohol by volume per cent4 #af4ae ,extract per cent4 #h4fjb ,ash per cent4 #j4bgg ,glycerin per cent4 #j4ddd ,volatile acid per cent4 #j4jgdg ,tartaric acid per cent4 #j4bdjj ,alkaloids 7coca bases7 per cent4 #j4jbej ,cane sugar per cent4 #b4ce ,reducing sugar per cent4 #c4ch ,the increased alcoholic strength of ,vin ,mariani over the ,bordeaux wine from which it is made1 as shown by this analysis1 doubtless comes from the alcohol extract containing the coca bases1 as already stated4 ,approximately #f per cent4 of sugar is also added to the wine4 ,judging from the analysis1 therefore1 ,vin ,mariani corresponds to a mixture of an alcoholic preparation of coca leaves and ordinary ,bordeaux red wine1 with the addition of about #f per cent4 of sugar4 ,vin ,mariani conflicts with ,rule #e1 which requires that 8,no article will be admitted or retained1 concerning which the manufacturer or his agents make misleading statements as to geographical source1 raw material from which made1 or method of collection1 or preparation10 by stating in the advertising literature that3 8,the ,united ,states government1 under the ,pure ,food ,law of ,march #c1 #aijc1 further emphasizes all previous analyses of ,vin ,mariani by admitting ,mariani's wine as absolutely pure and unadulterated40 ,whatever may have been the intent of the above statement1 its effect is to deceive4 ,the conjunction of the terms 8,vin ,mariani0 and 8,mariani's wine0 can only be construed as meaning the same thing4 ,inasmuch as it does not appear that ,vin ,mariani is imported into this country1 it would not have been possible for the ,united ,states government to inspect it1 and as to the wine obtained from ,henry ,clausel ,co41 from ,bordeaux1 it is not in any sense ,mariani's wine except that of ownership4 ,it is the opinion of the committee that this phrase can only result in deception and the construction of the language strongly favors the supposition that it is intentionally meant to deceive4 ,this false claim is practically repeated in the other pamphlets published by the ,vin ,mariani ,company1 although not always in the same words4 ,this preparation also conflicts with ,rule #f1 which states that 8,no article will be admitted or retained of which the manufacturer or his agents make unwarranted1 exaggerated or misleading statements as to therapeutic value10 in that the firm's letter-heads have printed on them the following3 8,vin ,mariani purifies the blood stream1 strengthens the circulation1 stimulates muscular fiber and nerve tissue1 is a respiratory stimulant1 strengthens the heart muscles1 and is an emergency food in the absence of all other nutriment4 ,successfully employed as an adjuvant in anemia1 debility1 diseases of the chest1 nervous troubles1 muscular or mental overstrain1 neurasthenia1 and allied conditions1 and in certain cases of protracted convalescence40 ,the committee believes that ,vin ,mariani is intended as a beverage rather than as a medicine4 ,the report concludes3 8,the committee recommends1 therefore1 that ,vin ,mariani be refused recognition and that this report be published in full or in part40 ,in accordance with this recommendation the above extract of the report is herewith published4 ,w4 ,a4 ,puckner1 ,secretary4 ,,vin ,,mariani ,,made ,,in ,,this ,,country ,according to the above report1 ,vin ,mariani as imported is simply an ordinary cheap ,french wine1 the preparation sold in this country as ,vin ,mariani being compounded in this country4 ,yet the advertising literature1 the label on the bottle1 etc41 state directly or indirectly that it is a ,french preparation4 ,until recently--presumably until the vendors realized that the truth regarding this point would come out--the advertisements in medical journals contained an analysis made by a chemist in ,paris4 ,the shape of the bottle1 the character of the printed matter accompanying the bottle1 etc41 are evidently intended to convey the impression that it is imported4 ,so far1 then1 as this point is concerned1 ,vin ,mariani is sold under gross misrepresentations and is a fraud4 ,illustration3 ,advertisements of ,vin ,mariani before and after national ,food and ,drugs ,act went into effect4 ,,advertised ,,to ,,the ,,public ,vin ,mariani was at one time advertised to the public in this country1 but1 so far as we know1 it is not at the present time2 at least1 not directly4 ,yet it is most effectively advertised to the public indirectly1 and this with little expense to the promoters1 the cost of the circular around the bottle being the only expense--doctors who prescribe it do the rest4 ,if those who are in the habit of prescribing ,vin ,mariani will examine the advertising that goes into the hands of their patients they will realize how true it is that our profession is responsible for much of the 8patent-medicine0 taking4 ,few laymen could withstand the temptation to buy the stuff for any ailment that comes along when they read in the circular that this 8medicine10 which their doctor evidently thinks is a good thing1 is so highly recommended1 for all the ills that befall us mortals1 by the ,pope of ,rome1 the ,czar and the ,czarina of ,russia1 the ,queen of ,england1 the ,shah of ,persia1 the ,king of ,norway and ,sweden1 the ,queen of ,portugal1 the ,queen of ,saxony1 the ,crown ,prince of ,cambodia1 ,ferdinand of ,bulgaria1 and by a whole list of ambassadors1 generals1 politicians1 musicians1 actresses1 etc4 ,the testimonials of these great men and women are enough to convince the most skeptical that this remarkable medicine will do everything but raise the dead--and under favorable circumstances accomplish even this4 ,and still more--it will win battles6 ,witness this from the governor-general of ,madagascar3 8,we were refreshed by ,vin ,mariani1 and before morning carried the stronghold40 ,alexander ,dumas and ,emile ,zola are credited with calling it 8the elixir of life40 ,one very strange thing about the testimonials in the circular used in this country is that all are written by foreigners4 ,but ,americans 7,president ,mc,kinley--think of it--among others7 are honored by having their testimonials quoted in the circulars used on the other side of the ,atlantic4 ,why8 ,is it possible that the testimonials are fakes8 ,,an ,,ethical ,,cure-,,all ,here are a few of the conditions that the circular says ,vin ,mariani is good for3 8,anemia1 winter cough1 debility1 vocal weakness1 la grippe1 continued fevers1 bronchitis1 nervous troubles1 muscular weakness1 diseases of the aged1 malaria1 melancholia1 overwork1 neurasthenia1 impotence1 malnutrition1 depression1 heart troubles1 wasting diseases1 mental overstrain1 and in certain cases of protracted convalescence40 ,the following quotations are taken from blotters--circulated in this country--which are evidently intended for the laity1 as well as for physicians3 8,vin ,mariani creates and sustains vigor and energy4 ,guards against wasting diseases4 ,when everything else has failed try it to prove merits40 8,lung1 ,throat and ,stomach ,troubles benefited by ,vin ,mariani2 this ,ideal ,french ,tonic strengthens entire system of ,body1 ,brain and ,nerves40 8,most ,efficacious1 ,most ,agreeable1 ,unequaled by anything in ,fortifying1 ,strengthening1 ,refreshing40 ,,why ,,blame ,,the ,,layman ,,for ,,using ,,nostrums8 ,can we blame the layman for using ,peruna1 ,wine of ,cardui1 etc41 simply because they are advertised1 when there are physicians who1 for the same reason1 prescribe concoctions that are just as quackish and just as useless8 ,and can editors of medical journals consistently find fault with newspapers for carrying advertisements of fraudulent 8patent medicines0 when they themselves admit to their pages advertisements of nostrums that are no less fraudulent and of no more value8 ,,member ,,of ,,proprietary ,,association ,one word more3 ,there is an organization known as the ,proprietary ,association of ,america1 but it is usually referred to in common parlance as the 8patent-medicine0 men's association4 ,it will be remembered that last year we printed a list of the members of this body1 among which was the ,vin ,mariani ,company4 ,it will be remembered also that in the list were the names of certain firms who were supplying medicines to physicians1 but practically all these resigned from membership and their resignations were published by us4 ,we have not had the pleasure of publishing the resignation of the ,vin ,mariani ,company4 ,on the contrary1 we note that at the last annual meeting of the 8patent-medicine0 men's association this firm was still an active member1 ,mr4 ,a4 ,l4 ,jaros1 who stands for the ,mariani ,company in this country1 being one of those registered at the meeting4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bf1 #aijf47 ,,virol ,report of the ,council on ,pharmacy and ,chemistry ,virol1 sold in the ,united ,states by the ,etna ,chemical ,company1 is put out by ,virol1 ,ltd41 ,london1 ,england4 ,it is said to be 8,a preparation of bone marrow1 red bone marrow of medullary structure of ox rib and calf bones1 eggs1 malt extract1 and lemon syrup made from fresh fruit40 8,marrow fat is emulsified with extract of malt1 lemon syrup and eggs1 it is further enriched with soluble phosphates of lime1 iron and soda1 and glycerine solution of red bone marrow40 ,many of the therapeutic claims made for ,virol the ,council considered grossly exaggerated2 among them are the following3 8444 a complete food for children40 8444 a complete nutrient40 8,the value of the ,lime-,salts 7representing the ,egg ,shells7 contained in ,virol is fully illustrated in its influence upon ,rickets2 whilst ,struma1 ,chronic ,bronchitis1 ,anaemia and ,influenza are all combated by its use in a degree1 which1 we venture to say1 has never been approached40 8,the fat1 as represented by the ,marrow-bone and ,egg ,yolk1 is so minutely divided that it admits of even far more rapid absorption by the villi of the intestine than milk40 8,it is an ideal form of food1 readily digested and assimilated in the weakest of conditions40 8,virol has a marked effect on the metabolism of the body1 increasing the production of opsonins and stimulating phagocytosis4 ,as an adjuvant to the natural defensive processes of the patient in all diseases of bacterial origin its value can scarcely be over-estimated40 ,the objections of the ,council were transmitted to ,virol1 ,ltd4 ,the firm's reply was reported to the ,council by the referee of the ,committee on ,therapeutics who held that no adequate or satisfactory answer had been made to the objections raised against the advertising claims for ,virol4 ,the claims made for ,virol being unsubstantiated and unwarranted1 the ,council voted that the preparation be refused recognition4 ,in accordance with the practice of the ,council1 the exploiters of ,virol were afforded an opportunity to comment on the foregoing statement before its publication4 ,on their objecting to the findings1 the entire matter was turned over to a second referee4 ,this referee1 in making his report1 reviewed the claims made for ,virol and commented on the lack of evidence to substantiate these claims4 ,he stated that a chemical analysis of the preparation had yielded the following result3 8,sugar1 as maltose #fj4j per cent4 8,fat #ac4b per cent4 8,proteins #c4b per cent4 8,ash #a4f per cent4 8,water and volatile matter #ba4f per cent4 8,there is no appreciable diastatic action4 ,a little glycerol is present in the volatile matter4 ,the preparation is therefore an extract of malt with fat and a small amount of protein40 ,he then continues3 8,that ,virol has food value cannot be denied1 but that it has sufficient value to warrant the claims of the manufacturers is not evident4 ,virol cannot be considered a complete food1 as the advertising literature reiterates1 or an ideal food for infants4 ,the amount of protein is far too low in comparison with the carbohydrates to warrant this view4 ,the dosage recommended is not large4 ,thirty gm4 a day would furnish only about #a gm4 of protein and #d gm4 of fat4 ,the #c teaspoonfuls a day recommended for children would furnish protein and fat even below this4 8,if employed alone it cannot be a complete or sufficient food1 and if employed along with other articles of diet--milk and bread1 for example--it is not easy to see wherein lies the efficacy of the small weights of fat and protein added in the form of ,virol4 ,here the demand made on our credulity is too great1 as the protein in the preparation is the familiar protein of eggs1 meat and malt1 and the fat largely that from the egg-yolk and marrow1 according to the claims4 ,it is not known that any specific virtues reside in these bodies1 or in the egg-shells1 also claimed as present4 8,in the opinion of the present referee there is nothing in the composition of ,virol to justify the claims made for it4 ,the judgment and recommendations of the first referee follow from the facts and must be accepted by the ,council40 ,the ,council directed that the previously prepared report be allowed to stand and that it be published along with a suitable reference to the report of the second referee4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #bj1 #aiae47 ,,part ,,ii ,,contributions ,,from ,,the ,,chemical ,,laboratory ,,anusol ,,hemorrhoidal ,,suppositories,,ao ,w4 ,a4 ,puckner and ,l4 ,e4 ,warren ,,ao ,see also ,anusol ,suppositories1 p4 #bhj4 ,an abstract of an article concerning 8anusol suppositories0 was published in ,the ,journal1 ,jan4 #bc1 #aiji4 ,this gave the results of an analysis by a foreign chemist1 ,j4 ,f4 ,suyver1 which were to the effect that 8anusol suppositories0 contained no 8anusol40 ,schering ,glatz1 the ,american agents for 8anusol0 suppositories1 took exceptions to the abstract1 asked that ,the ,journal retract1 and submitted the findings of a chemist in support of their claim that the suppositories do contain 8anusol40 ,to determine the composition of 8anusol hemorrhoidal suppositories0 as they are found on the ,american market1 trade packages were purchased 7,april #f1 #aiji7 and submitted to examination#ij in the ,association's laboratory4 #ij ,details of the quantitative analysis of 8,anusol ,hemorrhoidal ,suppositories0 appear in the annual report for #aiji of the ,chemical ,laboratory of the ,american ,medical ,association4 ,according to the claims of the manufacturers1 #ab suppositories contain3 8,anusoli #g4e grams4 8,zinc oxid #f4j grams 8,balsam ,peruv #a4e grams 8,ol4 theobrom #ai4j grams 8,ungt4 cerat #b4e grams0 ,calculated to percentages the formula reads3 ,anusoli #bj4ed per cent4 ,zinc oxid #af4dd per cent4 ,balsam ,peruv #d4aa per cent4 ,ol4 theobrom #eb4jf per cent4 ,ungt4 cerat #f4he per cent4 ,when this product was submitted to the ,council some time ago1 ,schering ,glatz stated that1 according to the manufacturer1 8anusol0 is the 8iodo resorcin sulphonate of bismuth1 having the following rational formula3 ,c#f;,h#b;,,iso#b4,o7,,oh7#bc;,bi4 ,in the meta-dioxybenzol ,c#f;,h#d7,,oh7#b1 the resorcin1 one ,h has been replaced by one ,i1 and for another ,h the sulfonic-acid group ,,so#b-,,oh has been substituted1 so that meta-dioxybenzol is transformed into ,c#f;,h#b;,,iso#b-,,oh7,,oh7#b4 ,in the sulfonic acid the ,h of ,,oh is replaced by ,bi and1 as ,bi is trivalent the above rational formula results40 ,according to this formula 8anusol0 should contain3 ,iodin #cb4ii per cent4 ,sulphur #h4cd per cent4 ,bismuth #ah4jg per cent4 ,and the 8anusol0 suppositories should contain3 ,iodin #f4gg per cent4 ,sulphur #a4ga per cent4 ,bismuth #c4ga per cent4 ,examination showed that the suppositories contain about #j4jh per cent4 iodin1 or #a4b per cent4 of the amount claimed2 #j4bh per cent4 sulphur1 or #af4c per cent4 of what is claimed2 #j4ga per cent4 bismuth1 or #ai per cent4 of what is claimed2 and zinc equivalent to #af4e per cent4 zinc oxid1 or about #ajj per cent4 of claim4 ,from the standpoint of the iodin content alone1 assuming that all of the iodin found is present in the form of 8anusol10 the results of the examination of the product 7as found on the ,american market7 verifies1 for all practical purposes1 ,suyver's statement that 8anusol suppositories contain no anusol10 for the quantity of iodin present is so minute 7about #a_/hb of that required by the formula7 as to be unworthy of serious consideration4 ,the presence of sulphid in appreciable amounts was demonstrated showing that the sulphur is present1 at least in part1 in the form of sulphid and not as sulphonate as is claimed4 ,in a measure1 too1 this is in accord with the findings of ,suyver1 who concluded that1 in the product which he examined1 the bismuth was present in the form of sulphid4 ,the proportions of sulphur and of bismuth 7respectively about #a_/f and #a_/e of the required amounts7 indicate still further that the product is not all that it is claimed to be4 ,a specimen submitted by ,schering ,glatz to the ,council two years ago contained #j4ii per cent4 iodin1 or #a4c per cent4 of the amount claimed2 #j4bc per cent4 sulphur1 or #ac4d per cent4 of the claimed amount2 and #j4eb per cent4 bismuth1 or #ad per cent4 of what is claimed by the formula4 ,since the above determinations were made another specimen of ,anusol ,hemorrhoidal ,suppositories was received from ,schering ,glatz1 ,july #af1 #aiji4 ,this sample was found to contain about3 #j4jge per cent4 iodin1 or #a4a per cent4 of the amount required by the formula2 #j4bfe per cent4 of sulphur1 or #ae4e per cent4 of the requirement and #j4hh per cent4 bismuth1 or #bc4g per cent4 of the required amount4 ,it will thus be seen that the composition of the oldest specimen and also that of the specimen recently sent1 corresponds in a general way to that of the one first examined4 ,whether judgment be based on the determination of the bismuth1 the sulphur or the iodin1 the results just given clearly show that the claims made concerning the composition of 8,anusol ,hemorrhoidal ,suppositories0 are not substantiated by the facts4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #b1 #aiji47 ,,aromatic ,,digestive ,,tablets ,w4 ,a4 ,puckner and ,l4 ,e4 ,warren ,it has been amply demonstrated#ia that pepsin and pancreatin1 when in solution1 mutually destroy each other2 if the solution be acid1 the pepsin destroys the pancreatin2 if alkaline1 the pancreatin destroys the pepsin4 ,by using the characteristic effect of pepsin on proteids in acid medium and that of pancreatin on proteids and starches in an alkaline solution it can readily be demonstrated that commercial liquid preparations labeled as containing both of these ferments actually contain only one ferment4 ,they are misbranded4 #ia ,u4,s4 ,pharmacopeia1 #hth revision1 p4 #ccd4 ,besides the liquid a goodly number of solid preparations1 chiefly tablets1 containing pepsin and pancreatin are offered to the profession4 ,among these are tablets consisting simply of pepsin and pancreatin4 ,since pepsin and pancreatin interact only when in solution1 it is quite possible to prepare tablets which contain these ferments4 ,the use of such tablets is1 however1 unscientific1 since one or the other of the ferments is destroyed when it comes in contact with the fluids of the digestive tract4 ,in addition to simple tablets containing pepsin and pancreatin only there is at present a host of 8digestive tablets0 on the market4 ,among these are some which must be classed with the 8digestive impossibilities0 7,reports of the ,council on ,pharmacy and ,chemistry1 #aiaj1 ,vol4 #a1 p4 #da74 ,the preparations referred to are tablets claimed to contain pepsin1 pancreatin1 diastase1 hydrochloric acid and lactic acid4 ,when it is considered that the ,united ,states ,pharmacopeia defines hydrochloric acid as 8a liquid composed of #ca4i per cent4 by weight of absolute hydrochloric acid 7,h,cl #cf4af7 and #fh4a per cent4 of water10 i4 e41 a solution of hydrogen chlorid1 a gas1 in water1 it would at first appear that the incorporation of any appreciable quantity of hydrochloric acid in tablets would be impracticable4 ,hydrochloric acid1 however1 possesses to a limited extent the property of combining loosely with protein substances so that it becomes possible to bring about its combination with pepsin and similar substances to form compounds which are relatively stable at ordinary temperatures4 ,because of the volatility of the free acid and its limited combining power with protein substances 7#ajj gm4 boiled beef combine with #b gm4 absolute hydrochloric acid#ib71 the quantity of acid in any tablet can never be large1 much less than sufficient to be of any therapeutic value4 #ib ,hemmeter1 ,diseases of the ,stomach1 ,edition #c1 p4 #bej4 ,a number of firms offer 8digestive tablets0 for sale having formulas of which the following may be considered typical3 ,sacch4 ,pepsin #d grains ,pure ,pancreatin #a grain ,diastase #a_/d grain ,aromatic ,powder #a_/d grain ,lactic ,acid #a_/h grain ,hydrochloric acid #a_/h grain ,some manufacturers use ,united ,states ,pharmacopeia pepsin in place of the saccharated article2 others do not give the exact quantities of hydrochloric acid which their product is supposed to contain1 but make use of the indefinite expression 8q4 s420 still others state merely that hydrochloric acid is present1 but make no claim whatever concerning the quantity4 ,from purely theoretical considerations it is possible that the tablets referred to might contain appreciable amounts of hydrochloric acid4 ,since the formulas for some of the tablets furnish no information concerning the content of hydrochloric acid1 it seemed worth while to determine the quantity1 if any1 actually present in some of the tablets on the market4 ,accordingly a trade package of 8digestive aromatic tablets10 as put up under the label of each of six ,american manufacturers1 was purchased and submitted to examination in the ,association laboratory4 ,qualitative tests made on specimens from each brand of tablets demonstrated the absence of uncombined hydrochloric acid in each4 ,further tests#ic showed that hydrochloric acid in protein combination was present essentially in the amounts claimed in three of the specimens4 ,in two of the others hydrochloric acid was entirely absent2 in the remaining one only the merest traces of hydrochloric acid could be found4 #ic ,details of this analysis appear in the annual report for #aiaj of the ,chemical ,laboratory of the ,american ,medical ,association4 ---------------------------------------- - ,h4 ,k4 ,,mulford ,,company 8,,digestive ,,aromatic0 8,pepsin1 ,sacch4 #d grains 8,pancreatin #a_/b grain 8,diastase #a_/af grain 8,acid ,lactic #a_/h grain 8,acid ,hydrochloric #a_/h grain 8,aromatic ,powder #a_/d grain 8,dose3 #a or #b tablets40 ---------------------------------------- - ,in the above formula each tablet is said to contain #a_/h grain hydrochloric acid4 ,this amount is equivalent to #j4jjbehd gm4 7#a_/be grain7 absolute hydrochloric acid4 ,analysis demonstrated that each tablet contains about #j4jjbfg gm4 hydrochloric acid 7absolute ,h,cl7 or essentially the amount claimed4 ,the average dose of diluted hydrochloric acid ,united ,states ,pharmacopeia is #a c4c41 equivalent to #j4ajdi gm4 absolute hydrochloric acid4 ,to obtain this quantity from the above preparation the patient would be required to swallow more than three dozen of the tablets4 ---------------------------------------- - ,,wm4 ,s4 ,,merrell ,,chemical ,,company 8,,digestive ,,aromatic1 #e ,,grains0 8,pepsin #hj parts 8,pancreatin #aj parts 8,diastase #a part 8,acid ,lactic #a part 8,acid ,hydrochloric #c parts 8,aromatic ,powder #e parts0 ---------------------------------------- - ,calculation shows that each tablet should contain about #j4jjca gm4 of absolute hydrochloric acid4 ,the analysis indicated that each tablet contains about #j4jjcj gm4 hydrochloric acid 7absolute ,h,cl7 in protein combination1 or practically the amount claimed4 ,one pharmacopeial dose of hydrochloric acid is contained in #ce of the tablets4 ---------------------------------------- - ,,parke1 ,,davis ,,company 8,,digestive ,,aromatic0 8,saccharated ,pepsin #d grains 8,pure ,pancreatin #a grain 8,diastase #a_/d grain 8,aromatic ,powder #a_/d grain 8,lactic ,acid4 8,hydrochloric ,acid4 8,dose3 #a to #c tablets40 ---------------------------------------- - ,chlorid is present in small amounts1 but quantitative examination indicated that hydrochloric acid1 either free or in protein combination is absent4 ,an ammonium salt is present in small quantities4 ---------------------------------------- - ,,sharp ,,dohme 8,,digestive ,,aromatic0 8,pepsin1 ,sacch41 ,u4 ,s4 ,p4 #d grains 8,pancreatin1 pure #a grain 8,diastase #a_/d grain 8,aromatic ,powder #a_/d grain 8,lactic ,acid q4 s4 8,hydrochloric ,acid q4 s40 ---------------------------------------- - ,small quantities of chlorid are present4 ,quantitative examination indicated that hydrochloric acid in protein combination is present only in very small amounts1 each tablet containing but about #j4jjjcd gm4 of absolute acid1 or about #j4cd per cent4 of the pharmacopeial dose4 ,ammonia is absent4 ,inasmuch as more than #cjj of these tablets would be required to furnish a pharmacopeial dose of hydrochloric acid1 this firm's interpretation of the expression 8q4 s40 would prove interesting4 ---------------------------------------- - ,,truax1 ,,greene ,,company 8,,synergia0 ---------------------------------------- - 8,synergia0 is claimed to be composed of 8pepsin1 pancreatin1 veg4 diastase1 lactic acid1 hydrochloric acid and aromatics2 dose1 #a to #c tablets40 ,the specimen contained no hydrochloric acid1 either free or in protein combination4 ,a trace of ammonia and small quantities of chlorid were found4 ---------------------------------------- - ,,the ,,fraske ,,tablet ,,company 8,pepsin ,sacch4 #hj parts 8,pancreatin1 ,pure #aj parts 8,diastase #a part 8,lactic ,acid #a part 8,hydrochloric ,acid #c parts 8,aromatic ,powder #f parts 8,dose3 #a to #b tablets4 8,each tablet represents 7#e7 grains of the above mixture40 ---------------------------------------- - ,according to the formula hydrochloric acid 7#ca4i per cent4 absolute ,h,cl7 represents #c parts in #aja of the preparation from which the tablets are made4 ,each tablet 7containing #e grains of the mixture7 should have #j4jjcjg gm4 absolute hydrochloric acid4 ,analysis showed that each tablet contains hydrochloric acid in protein combination equivalent to an average of #j4jjcjff gm4 absolute hydrochloric acid1 or essentially the amount claimed4 ,it would be necessary to give #cd tablets to administer a pharmacopeial dose of hydrochloric acid4 ,editorial ,note3 ,the above indicates that the use of such tablets is irrational1 unscientific and that it should be condemned4 ,the only constituent of these tablets1 other than the aromatics1 which might possibly be of benefit in stomach troubles1 is the pepsin4 ,but even if it be assumed that the diastase and pancreatin could exert their characteristic effects1 their aid to digestion 7metabolism7 would be but slight1 because their amounts in the tablets are too small to be of any value4 ,it is claimed that the tablets contain diastase in amounts varying from #a_/bj to #a_/d grain4 ,assuming the diastase used to be of first-class quality1 i4 e41 capable of converting #bjj times its own weight of starch into soluble products1 the quantity of one tablet would be capable at the most of digesting but from #aj to #ej grains of starch1 an amount equal at the most to but a small spoonful of oatmeal or a very dainty bite of bread4 ,in the same way the quantity of pancreatin is insufficient to be of any material aid in digestion should it in some way escape destruction in the stomach and still retain its full activity when it reaches the alkaline juices of the intestines4 ,one grain of pancreatin of full ,united ,states ,pharmacopeia strength will digest only #be grains of starch or the proteids in about #ajj c4c4 of milk4 ,saccharated pepsin1 which was formerly official1 was required to digest #cjj times its own weight of moist egg albumin1 while the pepsin that is now official is required to digest ten times that amount1 or #c1jjj times its own weight4 ,it is evident1 therefore1 that the tablets should contain sufficient pepsin to digest appreciable amounts of protein4 ,no intelligent physician would prescribe these tablets simply for the pepsin they contain or are supposed to contain2 if he wanted to give pepsin he would prescribe the drug in the simple form4 ,clinical experience has shown that in the majority of cases of so-called dyspepsia the stomach contents contain too much rather than too little hydrochloric acid1 and wherever there is a sufficiency of acid there is usually no decrease in the secretion of pepsin4 ,in many of such cases1 too1 digestion is normal1 or even more active than normal1 but even when it is imperfect there is seldom any lack of pepsin4 ,insufficient digestive power is most often due to a deficiency of hydrochloric acid and not to lack of pepsin in the stomach contents4 ,in the tablets under consideration1 however1 hydrochloric acid is present--if at all--in the most ridiculously minute quantities2 quantities that are so small as to preclude any therapeutic effect except that due to the psychic element4 ,these tablets1 with their six or more ingredients1 are typical 8shotgun prescriptions40 ,such prescriptions catch the unthinking doctor as well as the self-drugging public1 for1 while clinical experience and physiologic experiments have demonstrated that the old ideas regarding the value of these digestives and ferments were erroneous1 the public and many members of the medical profession still seem to be influenced by the old theories4 ,in conclusion we must not lay all the blame on the manufacturing firms for supplying these absurd combinations2 the physician who prescribes them should assume a large share of it4 ,if the doctors did not use them the manufacturing concerns would soon stop putting them on the market4 ,we hope1 however1 that those manufacturing concerns that like to be classed as reputable will cease to disgrace their catalogues with what they know to be therapeutic absurdities4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bj1 #aiaj47 ,,burnham',s ,,soluble ,,iodin,,ap ,w4 ,a4 ,puckner and ,a4 ,h4 ,clark ,,ap ,see also report on ,burnham's ,soluble ,iodine1 p4 #aaj ,burnham's ,soluble ,iodin1 according to the manufacturers1 is one of the most noteworthy 8discoveries0 of the age4 ,the advertisements aim to create an impression that while the product contains iodin1 pure and simple1 yet by some secret process this element has been so changed as no longer to possess its usual properties4 ,the ,burnham ,soluble ,iodin ,company makes such extravagant claims for its product and gives such wide publicity to these claims that it seemed advisable1 in the interests of the profession1 to determine the nature of the preparation4 ,its examination was accordingly taken up in the laboratory of the ,american ,medical ,association4 ,from the analysis1 we conclude that ,burnham's ,soluble ,iodin is a solution of iodin in alcohol made miscible with water by the presence of some iodid4 ,wilbert#id and other investigators have arrived at practically the same conclusion4 #id ,proc4 ,am4 ,pharm4 ,assn41 #aijc1 li1 #dji4 ,whatever the secret process1 hinted at in the advertisements1 by which this preparation is evolved1 the fact remains that when one prescribes ,burnham's ,soluble ,iodin1 one is prescribing iodin1 together with an iodid1 the nature of which is hard to determine4 ,the iodid is not present as potassium iodid1 nor1 entirely1 at least1 as hydrogen iodid 7hydriodic acid71 but this is of slight importance compared with the fact that it is a solution in alcohol of free iodin and an iodid1 and therefore is essentially the same as ,lugol's solution4 ,the amount of iodin found corresponds approximately to #c gm4 of free iodin and #b gm4 of combined iodin in #ajj c4c4 of the solution4 ,lugol's solution contains #e gm4 free iodin1 and #aj gm4 potassium iodid in #ajj c4c4 ,,burnham',s ,,soluble ,,iodin ,,tablets ,burnham's ,soluble ,iodin ,tablets are light brown compressed tablets1 stamped with the letters ,b4 ,s4 ,i4 in monogram4 ,each tablet is said to contain #c minims ,burnham's ,soluble ,iodin4 ,the average weight of each tablet was found to be #j4cebf gm42 since ,burnham's ,soluble ,iodin was found to have a specific gravity of 4#hebg and to contain #d4e per cent4 total iodin1 the tablets should contain approximately #b4c per cent4 total iodin1 about one-half to two-thirds of which1 depending on the condition of the 8,soluble ,iodin0 from which they are made1 should be free iodin4 ,instead of this1 only #j4cag per cent4 free iodin and #a4eg per cent4 total iodin was found4 ,analysis shows that ,burnham's ,soluble ,iodin tablets contain approximately one-fourth the amount of free iodin and approximately two-thirds the amount of total iodin which should be contained therein if1 in accordance with the label1 each tablet contains #c minims of ,burnham's ,soluble ,iodin4 ,,comment ,the literature put out by the ,burnham ,soluble ,iodin ,company is in itself enough to condemn the products it advertises4 ,the much emphasized statement of the company that 8,something had to be done2 and ,burnham's ,soluble ,iodin is that which has been done0 fulfils1 in its blatant assertiveness1 all the requirements of nostrum advertising4 ,the results of the analyses are not1 therefore1 a surprise4 ,secrecy is just as essential today to the successful exploitation of this class of proprietaries as it was before the demand for formulas became so universal4 ,the requirement of publicity is evaded1 therefore1 in one of two ways3 ,either a formula is given which is false1 or at least meaningless1 or else the claim is made that the method of preparing the product is a unique and remarkable secret that is possessed only by the manufacturers4 ,the ,burnham ,soluble ,iodin ,company uses the latter device4 ,meanwhile1 physicians will be perfectly justified in viewing with suspicion all claims based on such conspicuously unscientific premises1 more especially so when these claims fail to find substantiation on careful and painstaking analyses4 ,in brief1 whenever the physician wishes to administer free iodin1 ,lugol's solution 7,liquor ,iodi ,compositus1 ,u4 ,s4 ,p41 ,physician's ,manual1 page #hd7 is an inexpensive and perfectly available preparation4--7,from the ,journal ,a4 ,m4 ,a41 ,march #bh1 #aijh47 8,,hydrocyanate ,,of ,,iron--,,tilden0 ,w4 ,a4 ,puckner and ,w4 ,s4 ,hilpert ,among the many inquiries received regarding the composition of secret remedies was one in reference to 8,hydrocyanate of ,iron0 manufactured by the ,tilden ,company1 ,new ,lebanon1 ,n4 ,y4 ,this preparation is advertised as being 8unexcelled as a remedy for epilepsy1 hysteria1 chorea1 neurasthenia1 locomotor ataxia1 neuralgia1 migraine1 anemic headaches1 and all convulsive or reflex neuroses dependent on impairment of the brain or spinal cord40 ,it is also said to be 8valuable in uterine reflex neuroses due to congestion2 in amenorrhea due to anemia and chlorosis and suppressed menstruation40 ,the term 8hydrocyanate of iron0 is an unfamiliar one and is not found in any available reference work on chemistry4 ,thinking that the term might have been loosely applied to ferrocyanid of iron1 or ,prussian blue 7a compound once suggested for epilepsy1 but long ago considered useless71 the correspondent wrote to the manufacturers asking if such were the case4 ,the ,tilden ,company answered3 8444 our preparation ,hydrocyanate of ,iron is not ,prussian blue in any sense of the word4 ,prussian blue has no curative properties as applied to all forms of epilepsy4 ,prussian blue is ,ferrocyanid of ,iron while our preparation is ,hydrocyanate of ,iron40 ,the only statements in the ,tilden ,company's advertising matter regarding the composition of hydrocyanate of iron are the following3 8,hydrocyanate of ,iron 7,tilden's7 is a correct and scientific combination of well known principles40 8,hydrocyanate of ,iron 7,tilden's7 combines well known properties of ferruginous salts with the sedative action of ,hydrocyanic acid40 ,the last statement would lead one to expect the presence of available iron and cyanogen ions4 ,in fact1 the inference to be drawn from all the company's 8literature0 is that 8hydrocyanate of iron0 is a definite chemical compound in the same sense as is ferrocyanid of iron1 and that inference is still further borne out in the letter to our correspondent4 ,this being the case1 the ,tilden ,company was again written to and asked for the chemical formula of 8hydrocyanate of iron10 with the following result3 8,replying to your inquiry regarding the formula of ,hydrocyanate of ,iron we beg to state the composition of this preparation is a trade secret and we therefore do not care to furnish the desired information40 ,this reply verified the opinion already formed that 8hydrocyanate of iron0 is a secret preparation4 ,its analysis was then taken up in the ,association's laboratory4 ,,examination ,,of ,,the ,,tablets ,the product appears on the market in cartons said to contain one ounce of one-grain tablets4 ,on the cartons1 in addition to the name of the preparation and the name and address of the manufacturers1 are the names of diseases for which it is recommended4 ,the tablets1 in the specimens analyzed1 were dark blue1 rather hard and slightly bitter in taste and had an average weight of #j4achb gm41 or about #b grains4 ,they were found to be practically insoluble in water and dilute mineral acids2 aqueous oxalic acid solution partially dissolved them1 yielding a blue solution4 ,boiling with alkali hydroxid solution decomposed the tablets1 yielding iron in an insoluble form and a solution of alkali ferrocyanid1 as demonstrated by the appearance of a deep blue precipitate on the addition of ferric chlorid solution4 ,the portion insoluble in alkali when boiled with hydrochloric acid yielded a solution containing iron1 approximately equivalent to #ej per cent4 ,prussian blue4 ,these properties are all characteristic of ,prussian blue1 and1 taken together1 identify ,prussian blue as a constituent of 8hydrocyanate of iron 7,tilden740 ,the insoluble residue from the iron determination possessed the properties and constituents of talc and constituted practically one-half of the tablets4 ,extraction of the tablets with chloroform or ether in the presence of ammonium hydroxid yielded a small amount of organic material which contained bodies having the properties of1 and responding to tests for1 quinin or cinchona alkaloids and caffein4 ,the presence of a salicylate was also indicated4#ie #ie ,details of the quantitative analysis of 8,hydrocyanate of ,iron--,tilden0 appear in the annual report for #aiji of the ,chemical ,laboratory of the ,american ,medical ,association4 ,from the analysis it is concluded that 8hydrocyanate of iron 7,tilden70 is essentially a mixture of approximately equal parts of talc and ,prussian blue1 containing traces of organic matter having the general properties of alkaloids4 ,comment3 ,when a firm exploits an abandoned remedy for so hopeless a disease as epilepsy under a name not known to chemistry and with a false representation of its pharmacologic qualities1 such action may rightly be assumed to show ignorance or worse4 8,hydrocyanate of iron10 if it means anything1 means the cyanid of iron1 but the preparation put out under that name is1 according to our chemists1 not cyanid of iron1 but the ferrocyanid of iron commonly known as ,prussian blue4 ,this substance has been tried for epilepsy and abandoned4 ,yet the firm recommends it as a 8peerless remedy0 for this disease3 8,the ,tilden ,company holds the key to the situation in the treatment of epilepsy4 ,we have the remedy that does the work40 ,not that epilepsy is the only disease for which this hypothetical chemical compound may be prescribed4 ,torticollis has been 8successfully treated with hydrocyanate of iron40 ,in chorea1 we are told 8a richer and better blood supply0 should be furnished the nervous and vascular system and 8the irritation of the motor centers0 must be allayed4 8,hydrocyanate of iron serves admirably to accomplish both of these purposes4 ,it carries the hemoglobin to the blood in its most easily assimilable form and its hydrocyanic acid possesses remarkable sedative powers44440 ,it is not possible for it to have any value in anemia because of its insolubility1 yet we are told3 8,in conditions marked by poverty of the blood producing anemia or chlorosis1 reacting on the nervous system and calling for a chalybeate1 hydrocyanate of iron 7,tilden's7 takes a front rank among the remedies of this class1 combining as it does the blood enriching qualities of ferrum with the sedative action of hydrocyanic acid40 ,as ,prussian blue yields no appreciable quantity of hydrocyanic acid under the conditions existing in the animal organism1 8the sedative action of hydrocyanic acid0 must be as hypothetical as the chalybeate properties attributed to it4 ,it is strange that a manufacturer1 in introducing a new chemical compound1 should have to assure his customers that it 8contains no opium or alkaloid of that drug1 cocain1 chloral hydrate1 conium or any of the bromids40 ,imagine a firm putting1 let us say1 potassium iodid--a definite chemical compound--on the market and solemnly guaranteeing that it contained no cocain or chloral hydrate6 ,would the ,tilden ,company of twenty-five years ago have served such mental pabulum in its advertising matter8 ,one would think that the dictates of common humanity would protect the unfortunate epileptic from the machinations of the nostrum maker1 especially from the exploitation of a remedy that has been tried and found wanting4 ,a nostrum1 however1 merely has to measure up to one standard3 ,will it pay8 ,meeting this requirement nothing else matters4--7,from the ,journal ,a4 ,m4 ,a41 ,june #ai1 #aiji47 ,,hymosa ,w4 ,a4 ,puckner and ,w4 ,s4 ,hilpert ,frequent requests for information regarding the composition of hymosa1 manufactured by the ,walker ,pharmacal ,co41 ,st4 ,louis1 and a perusal of the extensive and nostrum-like advertising the product is receiving1 made a chemical examination of this preparation seem desirable4 ,if the label is to be believed1 hymosa has been of use in 8acute and chronic muscular and articular rheumatism1 gout1 sciatica1 lumbago1 pleurodynia and neuralgia1 whether due to uric acid diathesis or not 4440 ,the composition of hymosa as given by the proprietors is set forth in the following statement3 8444 ,hymosa1 in which the remedies ,frangula1 ,actea ,spicata1 ,stellaria ,media1 ,franciscea ,uniflora1 ,rhus ,toxicodendron1 ,passiflora ,incarnata1 ,phytolacca ,decandra and ,echinacea ,angustifolia are combined in the proportions which experience has shown will obtain the quickest and best results without any of the stomach and heart complications so often following the administration of salicylic acid40 8,contains no ,salicylic ,acid40 ,thus the explicit statement is made that hymosa contains certain vegetable drugs 7most of them obsolete and valueless7 and that it does not contain salicylic acid4 ,by inference the claim repeatedly is made that the nostrum does not contain any salicylates4 8444 ,hymosa has achieved most remarkable results in overcoming rheumatism in cases where salicylates have been tried in vain 4440 8,salicylic acid was not successful in this case of rheumatism of the stomach40 8,negative results from salicylates--,hymosa cures40 8444 the salicylates didn't help8 ,then we must try ,hymosa40 ,still harping on the undesirability of salicylates and the value of hymosa the advertising pamphlets state3 8,salicylic ,acid ,replaced4 ,the ,use of ,this ,dangerous ,agent in ,rheumatism ,obviated40 8,it seems that the use of the dangerous and ineffective salicylic acid will soon be given up and hymosa take its place40 8,former methods of treating rheumatism 444 have been very unsatisfactory 444 because of the heart and stomach difficulties brought on by salicylates of which most rheumatism remedies are composed40 8,could not tolerate the salicylates40 ,finally in a letter issued to physicians we are told3 8444 you will find hymosa to possess prompt and positive curative action with the additional advantage of avoiding the heart and stomach complications1 which the salicylates too often cause40 ,it is evident from the above quotations1 in which the salicylates are denounced specifically or by implication1 and from the label which states that no salicylic acid is present1 that the exploiters of the nostrum deliberately intended to give the impression that hymosa is free from salicylates or salicylic acid and contains only the vegetable or plant drugs enumerated4 ,the very fact that the proprietors make such repeated efforts to give the impression that hymosa is free from salicylates is in itself sufficient to arouse suspicion and hence in the examination particular attention was given to the detection of salicylic acid or salicylates with the following results3 ,illustration3 ,reproduction 7reduced7 of an advertisement of ,hymosa4 ,this indicates the attempt made to convey1 by implication1 the idea that the salicylates are absent from ,hymosa4 ,examination4--,hymosa as purchased on the market is a dark brown liquid with an odor of sassafras and a rather sweetish taste1 reacting acid to litmus4 ,qualitative tests having indicated the presence of salicylate1 iodid1 sodium1 potassium1 alcohol and some organic matter1 presumably sugars and some plant extractives1 these were determined quantitatively4#if ,it was found that a part of the salicylate was present as free salicylic acid and part in a combined form4 ,the sodium determinations indicated that all the salicylate1 excepting that in the form of free salicylate acid1 was present as sodium salicylate4 ,from the results of the potassium estimations1 it was evident that the iodin was present in the form of potassium iodid4 #if ,details of this analysis appear in the annual report for #aiaj of the ,chemical ,laboratory of the ,american ,medical ,association4 ,from the results of the analysis it is believed that the preparation has approximately the following composition3 ,salicylic ,acid #j4cb gm4 ,sodium ,salicylate #a4ae gm4 ,potassium ,iodid #j4cb gm4 ,sugars and extractives #d4fj gm4 ,alcohol1 ,u4 ,s4 ,p4 #af4hf c4c4 ,water to make #ajj4jj c4c4 ,these results indicate that hymosa is essentially a solution containing salicylic acid1 sodium salicylate1 potassium iodid1 alcohol1 sugars and plant extractives in the proportions given above1 and show that the various statements referred to1 regarding the absence of salicylic acid and salicylates are misleading and untrue4 ,it further illustrates the repeatedly demonstrated fact that nostrums exploited as wonderful and new discoveries are new in name only--and whatever therapeutic value they possess depends on old and tried medicinal agents4 ,editorial ,note3 ,in describing the methods employed by the manufacturers of ,manola in exploiting their product1 attention was called to the fact that the ,manola ,company was reported as being a subsidiary affair of the ,luyties ,homeopathic ,pharmacy ,company of ,st4 ,louis4 ,it is reported that this same company also operates the ,walker ,pharmacal ,company1 which exploits ,hymosa and ,psa-avena4--7,from the ,journal ,a4 ,m4 ,a41 ,june #aa1 #aiaj47 ,,micajah',s ,,medicated ,,uterine ,,wafers ,w4 ,a4 ,puckner and ,w4 ,s4 ,hilpert ,evidently touched by the generosity of the manufacturer in sending him a sample and literature1 but not too favorably impressed by the claims made for the preparation referred to1 a correspondent writes3 ,i enclose a valuable sample and literature just received4 ,such a palpable humbug as ,micajah's ,uterine ,wafers would hardly seem to need notice were it not probably true that many practitioners habituated to the use of samples are still influenced by the glowing accounts of cures wrought2 especially when attested by such a name and title as 8,elmore ,palmer1 ,m4,d41 ,ex-,president ,western ,new ,york ,medical ,society40 ,this secret gynecologic medicament is recommended for anything from 8,pruritis ,vulv10 8,enlargement of the ,womb10 8,displacements10 8,cystocele and ,rectocele10 to the 8,menopause40 ,following the definition that by her 8stomach0 a woman means anything from her chin to her knees1 the ex-president with truly noble impartiality has with the wonderful ,micajah wafers wrought lightning cures all the way from 8stone-bruise0 of the heel to nasal polyp and influenza1 and some of them are male patients too4 ,with the foregoing as an impetus to investigate the nature of this much advertised nostrum1 the wafers were submitted to analysis by the ,association laboratory4 ,the report follows3 ,,laboratory ,,findings ,trade packages of the wafers purchased on the open market bear the name of the preparation and that of the manufacturers1 ,micajah ,co41 ,warren1 ,pa4 ,the label states that the nostrum is a3 8,disinfectant1 astringent and local alterative of the greatest virtue4 ,a remedy for the local treatment of the diseases of women4 ,inflammation1 engorgement and prolapse of the womb1 vaginitis1 leucorrhea1 menstrual derangements and the disturbances incidental to the menopause4 ,also highly recommended for affections of the mucous membranes in general1 particularly those of the nose1 the throat1 the rectum1 and for gonorrhea1 cystitis1 etc40 8,this box contains wafers for three months' treatment40 8,price per box #a4jj40 ,the box contained #be tablets1 and a circular entitled1 8,hints on the treatment of diseases of women10 in which directions for the treatment of many diseases are given4 ,it ends with a paragraph which contains the following statement3 8,there is no doubt that the field of usefulness of ,micajah's ,wafers can be indefinitely enlarged by the ingenuity and therapeutic skill of the physician40 ,much of the advertising 8literature0 is in the form of leaflets1 brochures and small pamphlets full of testimonials by physicians4 ,micajah's uterine wafers as found on the market are white1 hexagonal tablets1 odorless and possessing an astringent taste4 ,the wafers are soluble in water with extreme difficulty4 ,hot hydrochloric acid and alkali hydroxids dissolve the powdered tablets readily1 leaving a slight residue which under the microscope and by physical tests was identified as lycopodium4 ,the acid solution of the wafers responded to qualitative tests which indicated the presence of potassium1 sodium1 aluminum sulphate1 borate and a mere trace of a fatty material4 ,quantitative estimation of boric acid1 aluminum sulphate1 sodium and potassium were made1 which indicated that ,micajah's ,uterine ,wafers consist of alum more or less anhydrous or 8burnt10 boric acid and borax in approximately the following proportions3#ig #ig ,details of this analysis appear in the annual report for #aiaj of the ,chemical ,laboratory of the ,american ,medical ,association4 ,alum1 dried #ei4hf per cent4 ,borax1 dried #ae4fb per cent4 ,boric acid #e4fg per cent4 ,water of hydration #ah4he per cent4 ,the average weight of the tablets is #j4ggia gm 7#aa4h grains7 and allowing for the fact that the quantity of water present in commercial exsiccated alum varies1 each tablet would contain approximately #j4dihf gm4 7#g4h grains7 burnt alum2 #j4bccg gm4 7#c4f grains7 crystallized borax1 and #j4jdfg gm4 7#j4g grain7 boric acid4 ,,comment ,judging from the 8literature0 that goes with the packages of this nostrum1 one might imagine that it was put up absolutely for the layman1 but this is not the case4 ,it is advertised only in medical journals and not directly to the public4 ,but direct advertising to the public is not necessary2 for every physician who prescribes these wafers at the same time places in the hands of his patient advertising matter intended to influence that patient--and it usually does4 ,as a result this preparation is being bought by the public direct4 ,to what extent we do not know1 but physicians are responsible for it4 ,probably if physicians realized that the same interests that control ,piso's ,consumption ,cure also control ,micajah's ,medicated ,uterine ,wafers they would not be so ready to act as the unpaid agents for the concern4 ,that such simple astringents and feeble antiseptics as alum1 borax and boric acid could have such remarkable curative effects on uterine diseases is absurd4 ,the serious aspect of the matter is1 that1 by the encouragement given them in the advertising literature to treat themselves1 women may neglect proper surgical or medical attention in the early stages of serious diseases such as cancer or dangerous pelvic infections1 until they get beyond the hope of proper management4 ,but when nostrum promoters urge the use of such inefficient remedies in the treatment of gonorrhea1 it is time to look at the matter seriously4 ,considering the vital social significance of the venereal diseases1 the employment of useless remedies can only favor the spread of these infections1 which cause such a large proportion of the diseases which afflict women particularly4 ,the medical profession for the most part has become mentally calloused to the exaggerated claims of the nostrum makers and does not make sufficient effort to condemn them4 ,there may be some physicians1 however1 who use such preparations as these wafers in their practice1 as is indicated by the circulars wherein the manufacturers suggest that their 8usefulness can be indefinitely enlarged by the ingenuity and therapeutic skill of the physician40 ,it is only occasionally that a physician voices his indignation as to these humbugs1 as in the case of the physician whose letter is quoted above4--7,from the ,journal ,a4 ,m4 ,a41 ,march #bf1 #aiaj47 ,the ,firm ,replies ,to the ,editor3--,we have read with interest the report of your committee on pharmacology recently published in ,the ,journal1 on the subject of ,micajah's ,medicated ,uterine ,wafers1 and your comments thereon4 ,we are of the opinion that1 in your laudable efforts to reform the practice of pharmacology1 it is not your desire or intention to act other than justly and fairly1 and therefore1 with this belief1 we submit the following statements for your consideration1 with the hope that you will see fit to publish them4 #a4 ,we do not seek by word or deed the patronage of the laity1 and what few sales are made to the public are not of our contriving1 nor should we be held responsible for them1 any more than is the manufacturer of quinin to be blamed for the universal use of that drug4 #b4 ,our literature should not be considered extravagant1 for it is for the most part made up of clinical reports received from physicians and based on the unsolicited testimonials in our possession from hundreds of practitioners1 many of whom have used ,micajah's ,wafers in practice from five to twenty years and they are therefore as well grounded as are the clinical reports concerning any preparation4 #c4 ,in the past year we have endeavored to place our preparation on a higher ethical basis by stating in our advertisements what our wafers contain1 and by eliminating whatever seems to us open to criticism4 #d4 ,that the ingredients of the preparation are 8simple0 is no reason for considering them valueless4 ,h4 ,a4 ,kelly1 in his work on medical gynecology1 page #bff1 recommends these ingredients in a variety of conditions4 ,bandler also made important recommendations bearing on this subject in his 8,medical ,gynecology10 #aiji edition1 page #dgb4 ,we feel we have the right to recommend this preparation for these and similar conditions1 especially when our statements are backed up by the clinical experience of numerous general practitioners4 #e4 ,that the owner of ,micajah's ,wafers holds stock in a corporate firm which manufactures proprietary medicines and toilet articles1 advertised to the laity1 should not militate for or against our right to market a meritorious preparation on strictly ethical lines to the medical profession1 inasmuch as many of the largest drug houses cater to both the doctor and the proprietary interests1 and several are actively engaged in exploiting so-called nostrums4 #f4 ,we enclose a recent advertisement which has been accepted after investigation of our methods by careful medical journals1 and we now believe we are conducting our business in entire conformity with the best interests of the medical profession and we feel certain of the true merits of our article4 ,micajah ,company1 ,warren1 ,pa4 ,comment3 ,this letter brings out still more strongly the points raised in the article which appeared in ,the ,journal1 ,march #bf1 #aiaj4 ,being unable to analyze motives we must perforce1 accept ,micajah ,co4's statement that they 8do not seek by word or deed the patronage of the laity40 ,in the comments on the laboratory's report it was very explicitly stated that this nostrum was advertised only in medical journals and not directly to the public4 ,inasmuch1 however1 as the container in which this product comes has printed on it the various diseases in which the 8wafers0 are indicated1 as1 moreover1 within the container there is a leaflet which describes in detail the use of the preparation in a list of pathologic states varying from 8enlargement of the womb0 to 8gonorrhea in the male10 and1 finally1 as the name 8uterine wafers0 would seem in itself to be a plain bid to the public1 we still maintain that 8one might imagine that is was put up absolutely for the layman40 ,the proposition that advertising matter should not be considered extravagant because it is largely 8made up of clinical reports received from physicians0 is an argument that is as old as the nostrum business itself--and as fallacious as it is old4 ,unfortunately1 as our files show1 the most extravagant statements made for proprietary products frequently emanate from men who legally are entitled to write ,m4,d4 after their name4 ,the fact that it is not the manufacturer but a ,buffalo physician who tells of the marvelous results he obtained from the use of ,micajah's ,medicated ,uterine ,wafers in forty-three cases comprising no fewer than thirty-six pathologic conditions from 8otitis media0 to 8injured toe10 and from 8bunion0 to 8ophthalmia neonatorum0 does not exempt the firm that prints such stuff from the charge that its 8literature0 is not merely extravagant1 but ridiculously so4 ,as ,micajah ,co4 say1 because the ingredients of their preparation are simple is no reason for considering them valueless4 ,on the contrary1 if the 8wafers0 were truthfully exploited for what they are and what they will do1 their very simplicity would be a virtue4 ,but such has not been done4 ,and therein lies the viciousness of nostrums4 ,simple mixtures of well-known drugs are foisted on the medical profession with no hint as to their composition and with claims made that are not only false1 but would immediately be recognized as absurd1 if their actual composition were known4 ,that a mixture of borax and alum may be of value in some of the simple ailments of the female genital tract can easily be granted4 ,that relief might follow the use of suppositories made of these ingredients--especially when supplemented by an increased attention to simple cleanliness--can also be admitted4 ,to say1 however1 that such medicaments will quickly and permanently cure gonorrhea1 urethritis1 endometritis1 etc41 is foolish1 false and vicious4--7,from the ,journal ,a4 ,m4 ,a41 ,april #af1 #aiaj47 ,,noitol ,,and ,,anadol ,w4 ,a4 ,puckner and ,l4 ,e4 ,warren ,noitol ,the ,journal received an inquiry concerning the composition of ,noitol1 a preparation which is being advertised to the medical profession as a 8specific0 for the cure of eczema and certain other cutaneous diseases4 ,the preparation is manufactured by the ,wheeler ,chemical ,works1 ,chicago4 ,trade packages of ,noitol were purchased and examined in the ,association laboratory4 ,on the label of the package1 ,noitol--an inversion of the word 8lotion0--is described as follows3 ---------------------------------------- ---------------------- ,,noitol 7,dr4 ,bradbury's ,eczema ,lotion47 ,for ,external ,application ,only6 ,our ,most ,popular ,specialty4 ,a specific for the cure of ,eczema1 ,scrofulous and ,syphilitic ,eruptions1 ,lupus1 ,salt ,rheum1 ,tetter1 ,itch4 ,this remedy is composed of valuable ,oils1 combined with ,vegetable and ,mineral ,acids in such proportions as cause a rapid and permanent cure of the above complaints4 ---------------------------------------- ---------------------- ,noitol is a clear1 nearly colorless1 acid solution1 the greater portion of which is water4 ,its specific gravity is #a4jjig at #be ,c4 ,qualitative tests demonstrated the presence of a chlorid1 a nitrate1 a mercuric salt1 free acid and glycerin4 ,no 8oils0 or 8vegetable acids0 could be found4 ,analysis#ih of the preparation indicated that its composition is essentially as follows3 #ih ,details of this analysis are published in the annual report for #aiaj of the ,chemical ,laboratory of the ,american ,medical ,association4 ,mercuric ,chlorid #j4jdfc gm4 in #ajj c4c4 ,mercuric ,nitrate #j4jdej gm4 in #ajj c4c4 ,glycerin #a4cjba gm4 in #ajj c4c4 ,nitric ,acid #a4jbfe gm4 in #ajj c4c4 ,water 7by difference7 #ih4eede gm4 in #ajj c4c4 ,from the above it appears that ,noitol is simply a weak1 acid solution of mercury salts--the total being approximately equivalent to a #a to #a1jjj bichlorid of mercury solution--exploited under a meaningless name4 ,it is but one more example of the old1 old story of a well-known remedy being sold at a high price under a name which is in no way indicative of its composition1 and under claims which are absurdly false4 ,the price of the mixture is #b4jj a pint2 the estimated cost1 exclusive of the container1 is about #f cents a gallon1 or1 put another way3 the price of a pint bottle1 it is estimated1 would make a barrel 7#ca gallons7 of the nostrum4 ,the incorrect statement concerning its components1 the unwarranted therapeutic claims made for it1 and the exorbitant price easily place ,noitol in the front rank among the 8patent medicine0 frauds4 ,yet it is advertised to physicians as an ethical proprietary and is evidently being prescribed by them4 ,anadol ,in the circular matter accompanying the trade package of the preparation1 8,noitol10 described above1 a preparation called 8,anadol0 is described4 ,anadol is claimed to be an analgesic and antipyretic4 ,in the descriptive circular there is no information concerning the composition of the preparation1 but from the general therapeutic description the physician might easily be led to believe that 8,anadol0 is a distinct chemical substance4 ,to reduce temperature the physician is advised to push the administration of ,anadol in #aj grain doses until the febrile condition is under control or until a maximum of #gj grains of the preparation has been ingested4 ,the circular further states3 8444 in this lies the special value of ,,anadol2 there are no annoying by-effects2 the stomach bears the remedy well and neither circulation1 respiration1 nor the nerve centers show the least disturbance40 ,as no evidence could be obtained concerning the composition of ,anadol and1 as the preparation is being brought to the attention of physicians by means of circulars in connection with the distribution of ,noitol1 it seemed worth while to take up its examination in the ,association laboratory4 ,accordingly a trade package of the material which had passed into interstate commerce was purchased4 ,qualitative tests demonstrated the presence of sodium1 a carbonate1 caffein and acetanilid1 the latter in considerable quantities4 ,analysis#ii indicated that the composition of the specimen examined is essentially as follows3 ,acetanilid #gi per cent4 ,caffein #a per cent4 ,sodium bicarbonate #bj per cent4 #ii ,details of this analysis are published in the annual report for #aiaj of the ,chemical ,laboratory of the ,american ,medical ,association4 ,since1 according to the circular1 it is permissible to prescribe #gj grains of this preparation within #b-a_/b hours1 a patient thus treated would receive no less than #ee grains of acetanilid6 ,in view of the numerous cases of poisoning due to the misuse of acetanilid 78,the ,harmful ,effects of ,acetanilid1 ,antipyrin and ,phenacetin10 ,u4 ,s4 ,dept4 ,agric41 ,bur4 ,chem41 ,bull4 ,no4 #abf7 the physician should be apprised of the composition of ,anadol4 ,editorial ,note3 ,the chemical investigations reported above emphasize once more the need of such an institution as the ,association's laboratory and again demonstrates the value of its work4 ,at first sight it seems disheartening to find that physicians are so easily humbugged4 ,yet when it is remembered that it is impracticable for physicians either to analyze such products themselves or to go to the expense of having chemists do it for them1 it is evident that the fault lies not so much with the physicians as with the conditions that make the exploitation of such frauds possible4 ,it is on the public that the burden ultimately falls1 for it is the layman who has to pay two dollars for a few cents' worth of medicine4 ,but--and this is far more serious--that the physician should be urged to dose his patient with an insidiously dangerous drug to a point far beyond the limits of safety1 is little less than criminal4 ,yet so long as unknown medicinal products are prescribed just so long will this danger be a very real one4--7,from the ,journal ,a4 ,m4 ,a41 ,may #ba1 #aiaj47 ,anadol ,declared ,misbranded ,anadol was analyzed at the ,bureau of ,chemistry and the chemists reported that it contained over #hb per cent4 of ,acetanilid4 ,as the labels did not bear any statement as to the quantity of acetanilid contained in the nostrum1 the stuff was declared misbranded and the defendant1 on pleading guilty1 was fined4--,notice of ,judgment ,no4 #gie4 ,,pix ,,cresol ,w4 ,a4 ,puckner and ,w4 ,s4 ,hilpert ,in a paper on 8,the ,abuse of ,chemical ,formulas0#ajj several examples were given of the various methods employed by 8patent-medicine0 concerns to give standing to their products by assigning to them a chemical formula4 ,in some cases the formulas given are impossible1 in other cases they may represent the chemical composition of only one constituent or it may be an attempt at both4 ,to a chemist such formulas are absurd and on seeing a formula which he knows to be wrong he naturally thinks 8,fake10 8,ignorance10 or both4 ,just such a formula 7,c#e;,h#f,n4,,so7 applied to a product called ,pix ,cresol1 manufactured by the ,pix ,cresol ,chemical ,co41 ,kansas ,city1 ,mo41 attracted our attention4 ,no mention of such a formula can be found in such works as ,richter's most complete ,index of ,carbon ,compounds1 nor the three supplemental volumes published1 #aija-aije1 by the ,german ,chemical ,society and ,beilstein's ,organic ,chemistry 7#c;d ,ed474 ,this fact1 supplemented by inquiries from correspondents as to the composition of the substance made it seem worth while to make a chemical examination of it4 #ajj ,puckner1 ,w4 ,a43 ,report of the ,chemical ,laboratory of the ,american ,medical ,association1 iii1 #g4 ,the examination was made and showed that the essential constituent was oxyquinolin sulphate4 ,as potassium sulphate was also found it was concluded that ,pix ,cresol was a preparation containing a mixture of oxyquinolin sulphate and potassium sulphate1 which has also been known in the past under the proprietary name1 8,chinosol40 ,at this time a letter was referred to the laboratory containing the report of an analysis of ,pix ,cresol1 which showed the presence of oxyquinolin sulphate but no potassium sulphate4 ,as this indicated that ,pix ,cresol contained as its essential constituent the substance now sold as ,chinosol1 the laboratory purchased a new specimen of ,pix ,cresol from the ,chicago representative of the ,pix ,cresol ,co4 ,the examination#aja of this specimen showed that it consisted of approximately #ba per cent4 oxyquinolin sulphate1 about #h4c per cent4 potassium sulphate and the remainder almost entirely milk sugar4 #aja ,the analytical details will be published in the annual report of the laboratory4 ,it is evident1 then1 that both the specimen of ,pix ,cresol obtained directly from the manufacturers and also the one purchased more recently from the ,chicago agent1 contain as an essential constituent ,chinosol of the composition sold formerly4 ,the substance now sold under the name ,chinosol and described in ,new and ,nonofficial ,remedies is pure oxyquinolin sulphate1 and as the exploiters of ,pix ,cresol probably obtain their supply of oxyquinolin sulphate from the ,chinosol ,company1 the sole ,american agents for ,chinosol1 it is to be expected that ,pix ,cresol should change in composition4 ,it is probable that the analysis referred to the laboratory deals with a more recent specimen than the two examined in the ,association laboratory4 ,editorial ,note3 ,in view of the ,council on ,pharmacy and ,chemistry's findings1 viz41 that chinosol is a powerful antiseptic but a feeble germicide and considering that ,pix ,cresol contains but #ba per cent4 oxyquinolin sulphate1 the absurdity of the following claims made for ,pix ,cresol require no further comment3 8,pix ,cresol is an ,absolutely ,sure and ,yet ,perfectly ,safe1 ,never ,failing ,destroyer of ,pus 7,staph4 ,pyogenes ,aureus470 8,it is germicidal1 bactericidal1 bacillicidal4 ,it is certain as a micro-organism destroyer4 ,it destroys absolutely40 8,ridding the blood of germs1 it aids in rendering it replete with oxygen----40 8,it kills the germs40 8,no organism that is causative of morbid processes can withstand it40 8,it destroys micro-organisms of all kinds4 ,it destroys them absolutely40 8,the germ's tenacity of life does not avail against its action as germicide40 8,it destroys the spores and toxins utterly40 ,a further estimate of the pseudo-chemical company1 bearing the name of this 8strongest1 safest1 least expensive medical antiseptic1 disinfectant and deodorizer known0 may be gained by a cursory glance at some of its 8specialties03 8,maizinin compound1 ,positive ,chill and ,malaria ,specific0 the firm says1 8prepares the parasites for execution by the leukocytes40 ,it is said to contain arsenic1 while the name implies the presence of some plant drug4 8,psora1 the ,syphilis ,specific10 is a shot-gun mixture said to be 8the scientific combination of the soluble ,triple ,iodids with the active principles of ,echinacea1 ,cascara amagra1 ,berberis aquif41 and ,phytolacca rad410 and is claimed to make 8the syphilitic lesions disappear and fail to return40 8,rectoids--,cones for the treatment of all rectal trouble10 are said to be 8a combination of ,rectin 7,pix7 compounded from ,buckeye1 ,collinsonia1 ,hamamelis1 ,belladonna1 ,pix ,cresol40 8,tablets for the ,female--,pix ,cresol ,uterettes10 it is said1 8for sanitary purposes may be continued forever 4440 ,when one realizes that this sort of pseudo-scientific twaddle is accepted by many physicians at its face value1 the outlook for therapeutics seems dark1 indeed4 ,so long as the existence of such concerns is tolerated by the medical profession1 so long will there be a crying need for a 8,propaganda for ,reform in ,proprietary ,medicines40--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #aj1 #aiaa47 ,,saliodin ,w4 ,a4 ,puckner and ,a4 ,h4 ,clark ,the ,council on ,pharmacy and ,chemistry refused recognition to ,saliodin because it conflicts with ,rules #a and #f1 and directed publication of the following4 ,w4 ,a4 ,puckner1 ,secretary4 ,saliodin is sold by the ,saliodin ,chemical ,co41 ,scranton1 ,pa4 ,in the literature and on the trade package the following 8formula0 is given3 ---------------------------------------- ------------------ ,,formula ,each ,grs4 ,,xx of ,saliodin contains approximately3 ,salicylic ,acid1 7,aceto-,salicylate7 ,grs4 ,,xv ,iodine1 7,iodate7 ,equivalent to ,iodide ,potass ,grs4 ,,xv ,acetic ,acid1 7,acetate7 ,equiv4 to ,acetate ,potass ,grs4 ,v ,aconite ,equiv4 to 88 ,tr4 ,aconite ,r4 ,gtts4 ,,iv ,bryonia 88 ,tr4 ,bryonia1 ,gtts4 ,v ,colchicum ,vin ,colchicum ,r4 ,gtts4 ,,xv ,capsicum ,tr4 ,capsicum ,gtts4 ,,ii ,oil ,gaultheria ,,iii ---------------------------------------- ------------------ ,this formula being indefinite and vague1 the examination of saliodin was taken up in the ,association laboratory4 ,from the analysis we calculate the composition of saliodin to be approximately equivalent to a mixture of3 ,sodium salicylate #eg4ed ,potassium iodid #a4ah ,potassium acetate #cj4jj ,matter volatile at #acj 7oil of anise1 oil of gaultheria1 moisture1 etc47 #h4aj ,undetermined 7extractive87 #c4ah ------ #ajj4jj ,the analysis shows that the formula is not only indefinite and vague1 but incorrect and false4 ,to emphasize the incorrectness of the published formula the following comment on its first two items is offered3 ,in the 8formula0 it is stated that #bj grains of saliodin contain approximately 8salicylic acid 7aceto-salicylate7 ,grs4 ,,xv40 ,the statement is not clear1 but conveys the impression that #bj grains of saliodin contain an amount of aceto-salicylate1 a salt of acetyl-salicylic acid 7aspirin71 equivalent to #ae grains of salicylic acid4 ,but the chemical examination shows that it contains neither acetyl-salicylic acid1 nor salt of acetyl-salicylic acid1 nor even salicylic acid itself4 ,in the place of these1 the analysis shows that over half of saliodin is the common1 every-day sodium salicylate4 ,illustration3 ---------------------------------------- ----------------------- ,it is an 8,iodated1 ,aceto-,salicylate with ,adjuvants10 and the ,,specific treatment for every form of ,,uric ,,acid ,,diathesis4 8,saliodin0 is a ,,solvent and ,,eliminant of ,,uric ,,acid and is a happy combination of ,salicylic ,acid1 ,iodine1 ,acetic ,acid1 ,aconite1 ,bryonia1 ,colchicum1 ,capsicum and ,gaultheria and chemically appears in the form of a ,,pink1 ,,greyish ,,powder soluable in water #a to #c--;dose grs4 ,x to grs4 ,,xxx2 for the ,,exclusive ,,use ,,of ,,physicians--put up in one ounce bottles2 price ,,per ,,ounce #a4ej4 ,is manufactured ,,only by the ,saliodin ,chemical ,co4 8,,saliodin is ,,specifically indicated in ,,rheumatism1 ,,gout ,,neuralgia1 ,,malaria and ,,la ,,grippe2 is ,,analgesic1 ,,antipyretic2 an ,,intestinal ,,antiseptic1 ,,diaphoretic1 ,,diuretic1 ,,expectorant1 ,,deobstruent1 ,,sialagogue1 ,,cholagogue1 ,,emmenagogue1 ,,anti-,,syphilitic1 ,,gonocococidal1 ,,parasiticidal1 ,,aseptic1 ,,bactericidal and ,,alterative4 ,doctor1 you may prescribe ,saliodin with confidence wherever ,,iodine or a ,,salicylate is indicated4 ,used both internally and externally4 ---------------------------------------- ----------------------- ,reproduction 7much reduced7 of a paragraph in the advertising pamphlet on ,saliodin4 ,note the twenty-one indications for ,saliodin4 ,lest some condition might be overlooked1 we are advised to use it 8internally and externally40 ,isn't this scientific therapy8 ,according to the 8formula10 each #bj grains of saliodin contains 8iodin 7iodate71 equivalent to iodid potass4 ,grs4 ,,xv40 ,this statement1 too1 is vague1 but conveys the impression that #bj grains of saliodin contain an amount of iodin1 in combination as an iodate1 which corresponds in iodin content to #ae grains of potassium iodid4 ,but the analysis shows that the product does not contain any iodate whatever1 and that the amount of iodin contained in it is sufficient to account for only #a_/d grain of potassium iodid in each #bj grains of saliodin4 ,,comments ,the above report is published simply as another example of the 8ethical proprietaries0 that physicians are asked to prescribe4 ,it is not unique4 ,it is neither better nor worse than hundreds of others4 ,to show what absurdities appear in the 8literature0 787 that is sent to physicians1 we reproduce a paragraph from an advertising pamphlet4 ,the promoters' statement as to the composition of the product is absurd1 but not more so than are the claims made for it as a therapeutic agent4 ,there is not a 8patent medicine0 on the market for which any more blatant1 extravagant and ridiculous claims are made4 ,the manner of exploiting saliodin is another illustration of the tendency on the part of nostrum-makers to advertise their wares through pseudo-scientific articles published in a certain class of medical journals4 ,in the pamphlet sent out by the ,saliodin ,company appears a reprint of an article from the ,philadelphia ,medical ,summary of ,february1 #aije4 ,it is entitled 8,a ,similarity in the ,etiologic ,factors of ,rheumatism and ,malaria10 and was written by ,j4 ,c4 ,denston1 ,m4,d4 ,in it occurs this statement3 8,the manufacturers 7of saliodin7 publish their formula and1 ,i think1 distribute samples and literature on request40 ,the charming ingenuousness of this statement is fully realized when it is understood that ,j4 ,c4 ,denston is the president of the ,saliodin company4 ,this is also another illustration of what is now a common occurrence1 viz43 men who are engaged in manufacturing proprietary products and who have an ,m4,d4 degree use that degree as a commercial asset1 and by this means the average reader is led to think that articles written by them in praise of their own products are spontaneous tributes from practicing physicians4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bf1 #aijg47 ,,theobromin ,,sodium ,,salicylate ,,versus 8,,diuretin03 ,,the ,,economical ,,aspect ,w4 ,a4 ,puckner and ,paul ,n4 ,leech ,the following inquiry is from ,dr4 ,reid ,hunt1 recently appointed professor of pharmacology at ,harvard ,medical ,school3 8,have you ever made an examination of the theobromin sodium salicylates on the market to determine if they are identical with #8,diuretin8' ,the description of theobromin sodium salicylate in ,new and ,nonofficial ,remedies agrees with the statements as to the composition of ,diuretin1 but ,i wondered if1 at times at least1 the theobromin sodium salicylate on the market might be a simple mixture of theobromin and sodium salicylate just as the ,caffeinae ,sodio-,salicylas1 ,n4 ,f41 seems to be a simple mixture4 ,diuretin is quoted in current price-lists at #a4ge an ounce1 whereas the price of theobromin sodium salicylate is only #ce cents an ounce4 ,many hospitals use diuretin1 and both physicians and students often have only hazy ideas as to what it is4 ,if the preparations of theobromin sodium salicylate now on the market are identical with ,diuretin they should certainly be used1 not only because they are less expensive1 but because the descriptive name will continually remind the physicians of what they are using40 ,theobromin for some time has been regarded as a valuable therapeutic agent4 ,the obstacle to its use has been its insolubility and the consequent uncertainty of the degree of its absorption4 ,for this reason a soluble salt of theobromin1 theobromin sodium salicylate1 first introduced and advertised under the proprietary name 8,diuretin10 has come to be used to a considerable extent4 ,theobromin sodium salicylate--also called theobromin and sodium salicylate--is prepared by interaction1 in molecular proportions1 of theobromin1 sodium hydroxid and sodium salicylate1 the theobromin first being treated with sodium hydroxid in the presence of a suitable solvent1 then the sodium salicylate added and the whole brought to dryness4 ,the soluble compound which is formed is generally considered to be a double salt of theobromin sodium and sodium salicylate4 ,theobromin sodium salicylate is described in ,new and ,nonofficial ,remedies and in several foreign pharmacopeias4 ,it is also to be described in the forthcoming ,united ,states ,pharmacopeia4 ,although the product is not controlled by patents of any kind1 and although it is offered for sale under its chemical name by the leading chemical manufacturers at from #ce to #de cents per ounce1 the proprietary product1 ,diuretin1 sells for #a4ge an ounce4 ,this is probably because the manufacturers think that those who have been using it under its chemically non-descriptive but therapeutically suggestive title1 ,diuretin1 will remain ignorant of the fact that the same product is on the market under its chemical name4 ,in view of these conditions1 emphasized by ,dr4 ,hunt's letter1 it was deemed important to examine the market-supply of theobromin sodium salicylate and to compare the several specimens with the proprietary brand ,diuretin4 ,the following specimens1 purchased in #a-ounce original packages1 were examined3 ,diuretin1 8,knoll10 ,knoll ,co4 ,theobromine and ,sodium ,salicylate1 ,mallinckrodt ,chemical ,works4 ,theobromine and ,sodium ,salicylate1 ,merck ,co4 ,theobromine and ,sodium ,salicylate ,powder1 ,powers-,weightman-,rosengarten ,co4 ,theobromine and ,sodium ,salicylate1 8,roche10 ,hoffmann-,la ,roche ,chemical ,works4 ,theobromine and ,sodium ,salicylate1 ,squibb1 ,e4 ,r4 ,squibb ,sons4 ,the theobromin content prescribed for theobromin sodium salicylate by the various standards ranges from #de to #ej per cent41 that of ,new and ,nonofficial ,remedies being the highest4 ,a requirement of not less than #df4e per cent4 theobromin in the dried powder has been proposed for the new ,u4 ,s4 ,pharmacopeia4 ,the methods of quantitative estimation laid down by the various authorities are all very similar and consist1 in the main1 of a determination of water1 of the sodium hydroxid1 free and in combination with theobromin1 and of the theobromin itself4 ,for the theobromin estimation the following method was employed3 ,a weighed sample 7about #b gm7 which had previously been dried1 under slightly reduced pressure1 over sulphuric acid1 to constant weight1 was dissolved in five times its weight of warm water4 ,two drops of phenolphthalein were added1 and the solution titrated with normal hydrochloric acid4 ,to the neutral solution1 #a drop of #aj per cent4 ammonium hydroxid solution was added1 and the mixture allowed to stand1 with occasional stirring1 for three and one-half hours at the temperature of #ae ,c4 ,the precipitate was filtered on a weighed ,gooch crucible1 washed with just ten times the weight 7of the original sample taken7 of water 7temperature #ae ,c47 and the precipitate dried at from #ajj to #ajd4 ,to the weight obtained1 a correction factor 7proved satisfactory by quantitative extraction experiments on the filtrate7 of #j4ac gm4 was added1 for every #b grams of the original sample taken4 ,the full details of the examination will be published in the #aiad ,reports of the ,a4 ,m4 ,a4 ,chemical ,laboratory4 ,the results of the examination have been abstracted and are compiled in the accompanying table3 ,,summary ,,of ,,analysis ,gm4 in ,price,mois-,alkalin4,theo- ,theo- ,physical #a-,ounceper ture1as ,na,o,h bromin4 bromin4 ,appearance,bottle ,ounce,per on ,dry in ,dry in ,orig4 ,,aq ,cent4,powder ,powder ,specimen ,,ar ,per,,ar ,per,,ar ,per ,cent4 ,cent4 ,cent4 ---------------------------------------- ----------------------- ,diuretin #c #bh4e #a4ge #j4ja #aj4dd #dh4fa #dh4fa ,pure ,white ,theo4 #c ,sod4 ,sal4 ,pure ,white #bg4e #j4ce #a4hi #i4ie #df4aa #de4bd ,m4 ,c4 ,w ,theo4 #a ,sod4 ,sal4 ,pure ,white #bi4j #j4ce #j4dh #aj4ch #dg4hg #dg4eh ,merck ,theo4 #c ,sod4 ,sal4 ,pure ,white #bi4a #j4ce #b4df #aj4cj #dg4eg #df4ci ,p4 ,w4 ,r4 ,co4 ,theo4 #c ,sod4 ,sal4 ,pink #bh4f #j4ce #b4bg #i4ib #di4je #dg4ib ,roche ,theo4 #a ,sod4 ,sal4 ,pure ,white #bf4h #j4de #j4ci #i4ig #df4hb #df4fc ,squibb ---------------------------------------- ----------------------- ,,aq ,in this column1 #a1 #b and #c denote the following3 #a4 ,quite crystalline1 under microscope4 #b4 ,fairly crystalline1 under microscope4 #c4 ,not crystalline1 under microscope4 ,,ar ,average of determinations4 ,while the results show some variation in the moisture content and also in the actual theobromin content of the dried specimens1 the variation is unimportant4 ,the products in their original state 7undried71 as compared in relation to the theobromin content 7the highest percentage of theobromin being #dh4fa1 the lowest #de4bd71 reveal a variation of only about #c per cent4--a variation which is negligible in the case of drugs such as theobromin4 ,from the preceding investigation1 it is concluded that 7#a7 practically there is no difference between the non-proprietary brands of 8theobromin sodium salicylate0 and 8,diuretin20 7#b7 the several specimens examined were not simple mixtures of 8theobromin0 and 8sodium salicylate02 7#c7 essentially all the brands complied with the standards laid down and can be rated as satisfactory2 7#d7 8,diuretin10 though sold at an exorbitant price1 is not superior to the product supplied under the descriptive term 8theobromin sodium salicylate10 and 7#e7 8,diuretin0 sells wholesale for #a4ge an ounce1 against #ce cents for the 8theobromin sodium salicylate10 and therefore its employment cannot be interpreted otherwise than as a useless and unnecessary expense4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #d1 #aiad47 ,,unguentine ,w4 ,a4 ,puckner and ,a4 ,h4 ,clark ,attention has been called at various times to the fact that the value of a published 8formula0 to a proprietary remedy is in direct ratio to the reliability of the manufacturer publishing it4 ,when medical journals first insisted on their advertisers letting physicians know the contents of the remedies they wished to sell them1 medical literature reeked with formulas--some of them of weird and wonderful design4 ,since the advent of the ,food and ,drugs ,act1 which requires that labels shall approximate truthfulness1 and particularly since the ,council on ,pharmacy and ,chemistry has investigated a number of proprietary remedies1 the publication of 8formulas0 is not so common4 ,unguentine1 manufactured by the ,norwich ,pharmacal ,co41 is one of those remedies whose advertisement for years always included 8a formula02 more recently1 however1 this is not in evidence4 ,in an advertisement which appeared about ten years ago1 the 8formula0 given is3 8,carbolic acid #b per cent4 8,ichthyol #e per cent4 8,alum #ae to #af per cent40 ,it was claimed that1 by a special process of their own1 the manufacturers had eliminated most of the astringent properties of the alum1 rendering it non-irritant4 ,it was also stated that 8the base of ,unguentine is pure petrolatum40 ,later the manufacturers seem to have changed the composition of their product1 or at least the 8formula0 given in the advertisements was changed4 ,thus it appeared3 8,alum #ae per cent4 8,zinc oxid #e per cent4 8,carbolic acid #b per cent4 8,ichthyol #e per cent4 8,aromatics and antiseptic oils with specially prepared petrolatum and animal fat base40 ,the introduction of zinc oxid1 aromatic and antiseptic oils and animal fat was a new feature4 ,somewhat later1 and particularly since the passage of the national ,food and ,drugs ,act1 no formula or other statement regarding the composition seems to have appeared in the advertisements in the medical press4 ,in the #aijf price-list 7p4 #agj7 the following formula appears3 8,unguentine represents3 8,alum 7non-irritating7 #ae per cent4 8,phenol #b per cent4 8,ichthyol #e per cent4 8,zinc oxid #e per cent4 8,aromatic and antiseptic oils1 with especially prepared petrolatum and purified animal fat40 ,in the price-list issued for #aijh--;after the ,food and ,drugs ,act went into effect--the following appears3 8,unguentine represents3 8,alum compound 7non-irritating7 8,phenol1 8,ichthyol1 8,zinc oxid1 8,aromatic and antiseptic oils1 with especially prepared petrolatum and purified animal fat40 ,thus the proportions are omitted1 and alum becomes 8alum compound10 whatever that may mean4 ,in view of the conflicting statements made by the ,norwich ,pharmacal ,company1 in regard to their leading specialty1 ,unguentine1 and especially because much stress was laid on the filing of their 8guarantee0 under the ,food and ,drugs ,act1 it was decided to ascertain of what ,unguentine really consists4 ,from our analysis we conclude that ,unguentine contains not alum but aluminum acetate 7small amounts of alum may be present as impurities in the aluminum acetate71 zinc oxid1 or more probably impure zinc carbonate1 and that the entire quantity of both does not exceed #e per cent4 ,it contains no ichthyol1 or if any but the merest traces1 and less than #a per cent4 of phenol4 ,the aromatic oils amount to not more than approximately #a per cent4 in all4 ,the ointment-base is1 in the main1 petrolatum4 ,in ,unguentine we have1 therefore1 another proprietary 8specialty10 regarding the composition of which indefinite1 false or misleading statements have been made--this irrespective of protestation of honesty by the firm4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #bg1 #aiji47 ,,uricedin ,w4 ,a4 ,puckner and ,a4 ,h4 ,clark ,in view of the results of investigations by ,zernik of ,uricedin as sold in ,germany1 and because it is being advertised to physicians in this country1 an examination of this product was made in the laboratory of the ,american ,medical ,association4 ,zernik's report shows how this remedy has varied in its composition as put on the market in ,germany4 ,from their analysis the authors find that ,uricedin is not a definite chemical compound as is claimed1 but is a simple mixture whose composition is approximately3 ,sodium sulphate 7anhydrous7 #fa4eb per cent4 ,sodium citrate 7anhydrous7 #bi4fb per cent4 ,sodium chlorid #b4ac per cent4 ,citric acid 7anhydrous7 #c4be per cent4 ,moisture #b4ec per cent4 ,undetermined #j4ie per cent4 ------ #ajj4jj ,uricedin1 therefore1 is not a definite chemical compound as claimed1 but a simple mixture which consists essentially of sodium sulphate 7dried ,glauber salt7 #b_/c1 and sodium citrate #a_/c4 ,it is1 therefore1 a typical nostrum1 and1 as it appears1 one the composition of which is changed from time to time to suit the whim of the manufacturer4 ,the therapeutic claims made for it are of the usual extravagant character4 ,according to a recent advertisement it is 8used successfully for ,gouty ,diathesis1 urinary ,calculi1 ,rheumatoid ,arthritis10 8useful in ,migraine1 ,occipital ,headache1 ,epilepsy1 ,hay ,fever1 ,asthma10 etc4 ,if such a simple mixture will do all that this one is claimed to do1 let us use it1 but prescribe its ingredients under their proper names4 ,such a mixture would cost only a few cents a pound1 but this nostrum is listed at #a4be a bottle of five ounces1 or probably #a4ge at retail1 and this for the benefit of its foreign manufacturers and their agents4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bc1 #aijg47 ,,uriseptin ,w4 ,a4 ,puckner and ,w4 ,s4 ,hilpert 8,uriseptin10 manufactured by the ,gardner-,barada ,chemical ,co4 of ,chicago and claimed to be a 8urinary antiseptic1 uric acid solvent and diuretic10 was examined in the laboratory of the ,american ,medical ,association to determine to what extent the claims made for it are justified4 ,the preparation as purchased in the open market bears a label which presents the claims of the manufacturers1 emphasized by the chemical analysis duly signed by an analyst and attested by a notary4 ,accompanying is a reproduction of part of the label4 ,illustration3 ---------------------------------------- ---------- ,,analysis ,sample of 8,uriseptin0 manufactured by the ,gardner-,barada ,chemical ,co41 ,chicago4 ,ill41 was found to contain3 ,specific ,gravity at #ae4e ,c #a4jgaf ,total ,solids #bj4db p4c4 ,alcohol 7,ethyl7 #g4ff p4c4 ,water 7by ,difference7 #ga4ib p4c4 ,total ,ash #a4df p4c4 ,lithium ,oxide #j4ej p4c4 ,formaldehyde #e4fb p4c4 ,acidity #ajj cc equals #f4d cc ,normal ,alkali4 ,sugars ,present ,couch ,grass ,extract ,present ,corn ,silk ,extract ,present ,the ,total ,solids consist mainly of the sugars and extract of corn silk and couch grass4 ,the couch grass and corn silk extracts were determined by taste and smell in comparison with authentic samples of same products4 ,the ,lithium ,oxide and the ,formaldehyde are in combination in the ,uriseptin and together represent #bf4gg grains per liquid oz4 ,i remain1 ,yours very truly1 7,signed7 ,dr4 ,edwd4 ,gudeman4 ,state of ,illinois ss4 ,county of ,cook ,subscribed and sworn to before me this #acth day of ,may1 #aije4 7,signed7 ,paul ,e4 ,buedefeldt1 ,notary ,public4 ---------------------------------------- ---------- ---------------------------------------- ----------- ,,uriseptin ---------------------------------------- ----------- ,,formula 7,see analysis74 ,each fluid ounce of ,uriseptin contains ,formaldehyde combined with ,lithium dissolved in concentrated liquid extract of ,corn ,silk and ,couch ,grass1 and will liberate a sufficient quantity of ,formaldehyde 7#bd grains7 to impregnate the daily secretion of urine 7#de-ej fluid ounces7 to a #a-ajjj solution4 ,,properties ,urinary ,antiseptic4 ,uric ,acid ,solvent4 ,diuretic4 ,,indications ,diseases of the urinary tract and their complications--,nephritis1 ,pyelitis1 ,urethritis1 ,gonorrhea1 ,gleet1 ,cystitis1 ,bacteriuria1 ,uremia1 ,phosphaturia1 ,prostatitis4 ,diseases dependent on uric acid diathesis--,gout1 ,rheumatism1 ,calculus1 ,asthma and generally as an antiseptic and uric acid solvent4 ,,dose ,tablespoonful night and morning1 or one to two teaspoonfuls four times a day1 preferably in hot water4 ---------------------------------------- ----------- ,reduced photographic reproduction of part of the ,uriseptin label4 ,before the examination had extended very far it was found that discrepancies existed between facts and claims1 and by the time the analysis was complete ,uriseptin was found to be in the same class as many other proprietary remedies that have been discussed in these columns4 ,our examination shows that the most misleading statement is that concerning the 8lithium-formaldehyd0 compound the presence of which is claimed1 more or less directly1 by both the manufacturers and the analyst employed by the manufacturers4 ,although the chemical properties of lithium and formaldehyd indicate in themselves that the existence of such a compound would be most improbable1 yet considerable time was spent in searching the chemical literature for such a compound4 ,thorough search1 however1 demonstrated that no such compound1 nor any that even approximated it1 has been described4 ,the question then arose as to the form in which the lithium and the formaldehyd are present4 ,the statements regarding its properties as a urinary antiseptic and the fact that the preparation is said to liberate formaldehyd slowly in the bladder point strongly to the presence of hexamethylenamin4 ,tests#ajb were applied to demonstrate whether the formaldehyd was present as a lithium compound1 and if not1 whether it existed in the form of hexamethylenamin4 ,by these the presence of hexamethylenamin was proved and the absence of formaldehyd in other combinations demonstrated4 ,this fact alone shows that the preparation is deliberately marketed under a false claim1 and it shows further that the analysis on the label is worthless4 ,the quantitative method of analysis demonstrated the presence of #e4ea gm4 hexamethylenamin per #ajj c4c4 7#be4ae grains per fluidounce74 #ajb ,these appear in the annual report for #aijh of the ,chemical ,laboratory of the ,american ,medical ,association2 they were also published in full in ,jour4 ,am4 ,chem4 ,soc41 ,september1 #aijh2 an outline of the analysis appeared in ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bi1 #aijh4 ,besides the hexamethylenamin1 ,uriseptin contains lithium and a benzoate4 ,concerning the latter nothing is said in the analysis1 whose worthlessness is again demonstrated4 ,by quantitative methods ,uriseptin was found to contain lithium and a benzoate in such proportions as would indicate that the lithium and the benzoate radicle exist as lithium benzoate4 ,this fact is further indicated by the claims made for the preparation regarding its properties as a uric acid solvent1 for which purpose lithium benzoate is often used4 ,again1 the demonstration that the formaldehyd present is in combination as hexamethylenamin precluded any possible chemical combination between lithium and formaldehyd and adds another strong point in support of the conclusion that the lithium and benzoic acid are in combination as lithium benzoate4 ,,conclusion ,by chemical analysis the active ingredients of ,uriseptin are shown to be hexamethylenamin1 approximately #e4e gm4 per #ajj c4c4 7about #be gr4 to each fluidounce71 and lithium benzoate1 approximately #j4gj gm4 per #ajj c4c4 7about #aa grains to each fluidounce71 neither of which compounds is mentioned in the advertising matter on the label or in the so-called 8analysis0 on the label4 ,the statements concerning the composition of ,uriseptin are false and appear to be a deliberate attempt to mislead physicians4 ,comment4--,investigation of the various 8patent0 and so-called 8ethical proprietaries0 advertised to the public and to the medical profession shows that those that have any value as therapeutic agents depend for that value on some well known drug or drugs4 ,hence1 while many proprietaries have some virtue1 the ingredients which are of any value are so concealed by the coined and 8near-scientific0 names applied to them that these drugs are usually unrecognizable4 ,the many and various acetanilid mixtures furnish examples of this class of proprietaries4 ,and now we find another example in that much advertised nostrum1 ,uriseptin4 ,according to our chemists1 the chief ingredients of ,uriseptin are hexamethylenamin and lithium benzoate4 ,hexamethylenamin is a valuable so-called urinary antiseptic--probably one of the best we have4 ,it is a pity that more physicians do not know the value of this drug in and of itself2 it is a common ingredient of many proprietaries1 and yet too seldom prescribed under its true name4 ,there is no reason for its being given in the form of a nostrum2 it requires no skill in compounding1 for it is best given in its powdered form1 either in capsules or otherwise4 ,so that1 like acetanilid1 the old argument of the nostrum men that the preparation needs skill in compounding will not hold4 ,if a physician wants to prescribe hexamethylenamin let him prescribe it in its simplest and best form1 and thus know exactly what he is giving4 ,lithium benzoate also has its rightful place in the materia medica1 but not hidden in a proprietary mixture to be prescribed unknowingly4 ,it is hard to conceive of any one thing that operates more disastrously against scientific therapeutics than the vicious practice of marketing under proprietary names standard and valuable drugs1 with their identity purposely concealed4 ,yet how frequently it is done4 ,well-known drugs of unquestioned worth are combined with those that are little known and of doubtful value1 or more likely absolutely worthless1 the mixture is put on the market under a high-sounding name and it is exploited through physicians as a panacea for all kinds of diseases4 ,in this1 as in so many other instances1 an 8analysis0 made to order is given to lend an air of apparent respectability and scientific standing to the preparation or to its exploiters1 with the object1 of course1 of misleading physicians into thinking they are reading unbiased testimony4 ,in addition1 the 8literature0 accompanying the preparation is usually a jargon of pseudo-scientific verbiage put in to serve the same purpose as the analysis--that of catching the careless physician4 ,this state of affairs will continue just so long as the medical profession will tolerate it--and no longer4 ,so long as members of our profession will prescribe proprietaries on the statements of their owners--as to both their composition and their therapeutic value--just so long will pseudo-chemical and pseudopharmaceutical companies fatten at the expense of the medical profession and to the detriment of the public health4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bi1 #aijh47 ,,zemacol ,w4 ,a4 ,puckner and ,w4 ,s4 ,hilpert ,attention has been called to the vague and mysterious statements regarding a preparation called ,zemacol1 manufactured by the ,norwich ,pharmacal ,co41 ,norwich1 ,n4 ,y4 ,because of the unsatisfactory statements regarding the composition of the preparation1 it was considered of sufficient interest to make an analysis and determine its chemical constituents4 ,accordingly specimens of the preparation were obtained and examined4 ,the preparation ,zemacol 7,norwich ,pharmacal ,co471 as found on the market1 is a thick1 pink1 mucilaginous liquid1 highly perfumed and having besides a suggestion of a phenolic odor4 ,the bottle bears a label on which appear the following statements3 8,a colloidal emollient containing extract of the rete mucosum of the healthy yearling lamb1 combined with glycerin1 salicylic acid and other antiseptic and aromatic oils4 ,useful in eczema and diseases of the integument where cell destruction is a prominent factor40 ,in the advertising matter the following claims are made3 8,an advance in animal therapy44440 8444 increases the nutritive activity of the cell tissue of the skin through the absorbable extract of the rete mucosum40 8444 clinical tests show its efficacy in both the so-called moist and dry eczematous conditions of all parts of the cutaneous surfaces40 8444 rich in animal cells40 ,since nothing could be found in the literature regarding the therapeutic action of an extract of the rete mucosum of the sheep1 it was thought possible that the statements on the label were given simply as a vague and mysterious means of indicating the presence of wool-fat 7lanolin71 and tests were made to determine the presence or absence of the latter substance4 ,a substance was isolated from ,zemacol which had the physical properties of1 and responded to some of the chemical tests for1 wool-fat2 but it was found in such small quantities as to indicate that it was not present as an active constituent4 ,since there are no definite tests for the detection of serums or animal extracts the presence or absence of these could not be demonstrated4 ,further examination indicated the presence of salicylic acid1 a gummy material1 having the properties of tragacanth and glycerin4 ,it is practically free from inorganic matter4 ,by distillation a small quantity of oil was isolated1 which possesses the characteristic odor of the preparation4 ,quantitative estimations#ajc indicated the presence of the above-mentioned constituents in approximately the following quantities3 #ajc ,details of this analysis appear in the annual report for #aiaj of the ,chemical ,laboratory of the ,american ,medical ,association4 ,per ,cent4 ,gummy matter having the properties of tragacanth #b4jb ,salicylic acid #j4fg ,matter having the general properties of wool-fat 7lanolin7 #j4bj ,glycerin #e4ej ,volatile matter 7water and alcohol7 #ia4jj ,aromatic oils and phenol-like bodies ,trace ,the results of the above analysis1 together with advertising matter regarding ,zemacol1 were submitted to ,dr4 ,william ,allen ,pusey1 professor of dermatology and clinical dermatology1 ,college of ,physicians and ,surgeons1 ,chicago1 and past chairman of the ,section on ,dermatology of the ,american ,medical ,association1 with the inquiry whether or not there was any record of investigations regarding the therapeutic value of an extract of the rete mucosum of the sheep and whether in his opinion the claims made for ,zematol would be warranted4 ,the following reply was received3 8,so far as ,i know1 nobody ever thought of or proposed the use of an extract of rete mucosum as a therapeutic agent and if a serious suggestion of that sort had ever been made ,i believe ,i would know it4 ,i can conceive of no service which such an extract could render and ,i think the suggestion of it is a highly fantastic idea4 ,from the analysis which you furnish ,i should say that the mixture described is substantially the ordinary #b per cent4 solution of tragacanth in glycerin and water with a little antiseptic added to keep it from decomposing4 ,that is a commonly known lotion1 modifications of which are used in practically every hospital as a hand lotion1 and has no magical virtues whatever4 ,incidentally1 ,i should think it cost1 aside from the labor1 about twenty cents a gallon to make it40--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ad1 #aiaj47 ,,zyme-,,oid ,w4 ,a4 ,puckner and ,w4 ,s4 ,hilpert ,zyme-oid1 manufactured by the ,oxychlorine ,chemical ,company of ,chicago1 is advertised as 8a powerful gastro-intestinal antiferment0 which will 8arrest and prevent bacterial fermentation in any portion of the intestinal tract1 whether the media be acid or alkaline40 ,these extravagant statements1 like many others made regarding the properties of zyme-oid1 are very similar in character to those made in the circulars accompanying the preparation oxychlorine1 manufactured by the same firm and exposed in ,the ,journal1 ,july #f1 #aijg1 page #ed4 7,see page #adg of this book47 ,as examples1 several parallel statements help to show this similarity4 ,the formula 787 of oxychlorine1 as expounded on the label1 is given in full1 while in the case of zyme-oid only a hint is given as to its composition1 but still sufficient to point to a similarity between the two3 ,,oxychlorine ,,zyme-,,oid 8,oxychlorine is a tetraborate 8,zyme-,oid is a double borate of sodium and potassium com- salt40 bined with oxychlorid of boron1 thus3 7#f,na,k,b#d,o#g7 ,b,o,cl#c40 ,in the matter of claims for chemical stability the two seem to be very closely allied3 ,oxychlorine is 8a stable salt ,zyme-oid is 8a product which is under all conditions until stable enough for keeping pur- brought in contact with sub- poses1 but which readily yields oxygenated organic matter40 nascent oxygen in the presence of bacterial products40 ,the therapeutic properties attributed to these sister products are even more similar1 for we find that3 8,oxychlorine is adapted to all 8,zyme-oid is a powerful gastro- morbid and abnormal fermentative intestinal antiferment40 alimentary states40 ,many more statements and claims could be quoted to show a similarity between1 amounting almost to an identity of1 oxychlorine and zyme-oid4 ,with these facts in mind1 the analysis of zyme-oid was undertaken in order to compare it with the previously examined oxychlorine and to determine to what extent the claims made for zyme-oid are upheld by its composition4 ,the analysis indicated1 as was expected1 that zyme-oid is essentially the same as oxychlorine as is shown in the following1 quoted from the report of the analysis of each3 ,,analysis ,,of ,,oxychlorine ,,analysis ,,of ,,zyme-,,oid ,potassium 7,k7 #ab4bf ,potassium 7,k7 #ac4ej ,sodium 7,na7 #h4bj ,sodium 7,na7 #i4hd ,chlorate 7,cl,o#c7 #be4cb ,chlorate 7,cl,o#c7 #bg4ej ,nitrate 7,,no#c7 #ba4gj ,nitrate 7,,no#c7 #bd4bb ,boric acid anhydrid ,boric acid anhydrid 7,b#b,o#c7 #ah4fc 7,b#b,o#c7 #ac4db ,water1 calculated #ac4bi ,water1 calculated #aj4db ,assuming that the chlorate in zyme-oid is present as potassium chlorate and the nitrate is present as sodium nitrate1 the figures obtained by analysis correspond to a mixture approximately as follows3 ,potassium chlorate 7,k,cl,o#c7 #dj4dc ,sodium ,nitrate 7,na,n,o#c7 #cc4bb ,potassium tetraborate 7,k#b;,b#d,o#g7 #a4fj ,sodium tetraborate 7,na#b;,b#d,o#g7 #c4ca ,boric acid #ba4ad ,from the results of the analysis and from the physical properties of zyme-oid we conclude1 just as was done in the case of oxychlorine1 that the preparation is not a definite chemical compound1 but is essentially a mixture of alkali chlorate and nitrate with boric acid1 probably produced by fusing together the constituents4 ,,comment ,an examination of the claims made for the firm's two products1 while1 as already proved1 disclosing many points of similarity1 will also show one remarkable difference4 ,we refer to the skilful indefiniteness that pervades the claims made for zyme-oid and which defies scientific refutation4 ,this verbal obscurity is becoming daily more common in the 8literature0 of firms marketing nostrums4 ,since the ,council has analyzed many of the much-advertised articles and proved the unreliability of the pseudo-scientific claims made for them1 the more cautious of the nostrum-mongers have modified the matter descriptive of their products4 ,they have called to their aid the principle that words were given to man to conceal thought rather than to express it1 and they have reduced equivocation to a fine art4 ,wherever it was possible to put forward claims by implication rather than by expression this has been done4 ,to substantiate further the claims made by the manufacturers of zyme-oid for their product1 a laboratory report is brought in evidence4 ,this report1 which is written more in the style of a peruna testimonial than that of a conservative scientific statement1 fails to verify the claim that zyme-oid is a 8double borate salt10 but confines itself to a statement of its harmlessness and its anti-fermentative properties4 ,in passing1 it seems regrettable that scientific laboratories should1 for a pecuniary consideration1 be willing to jeopardize their reputations by lending their names to the furtherance of nostrum exploitation4 ,the results of the examination of zyme-oid demonstrate that the product is no more worthy of the physician's consideration than its close1 and equally worthless1 relative1 oxychlorine4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #bc1 #aijh47 ,,part ,,iii ,,contributions ,,from ,,the ,,journal3 ,,nostrums ,,alleotone ,the formula of this preparation1 given in the literature1 reads as follows3 ,alcoholici 7,monatomic7 gr4 #a_/ajjj ,quinin ,sulphatis gr4 #a_/chd ,ac4 ,sulph4 ,dil4 7#aj per cent47 gtt4 #b-a_/b ,ac4 ,nitrici ,dil4 7#aj per cent47 gtt4 #a_/gg ,ac4 ,butanol-,dioic gr4 #a_/c ,tr4 ,ferri ,chloridi gtt4 #a_/bf ,aqu gtt4 xx ,the formula is worthless4 ,it can only mislead and mystify and the greater part of the literature is a mere jumble of inaccurate and mystifying statements4 ,the various constituents of the preparation are taken up as follows4 ,the advertising literature states3 8,monatomic ,alcohol is one of the constituents of all nerve tissue3 ,it is a product of the replacement of one atom of hydrogen of the hydrocarbons by their hydroxyl group ,h4,o40 ,this information does not inform1 since there is a vast number of monatomic alcohols and of every description4 ,the assertion that the preparation 8contains a salt0 would be perfectly analogous and just as enlightening4 ,of 8,ferri ,chlo0 the literature says3 8,ferri ,chlo is found with all proteids and nucleins and herein acts as magnetic iron1 aiding the play of the electrical travel40 ,the first assertion is untrue1 for iron does not exist as chlorid in the cells of the body1 but as some organic iron compound2 neither is it found in all proteids1 but principally in nucleo-albumins2 and not all proteids contain nucleo-albumins4 ,the assertion that the iron chlorid 8acts as magnetic iron aiding the play of the electric travel0 is nonsensical and on a par with the electric belt method of exploitation1 and suggests forcibly the class to which ,alleotone belongs4 ,the literature further states3 8,sulphuric and nitric acids act in removing hydrogen atoms and substitute atoms of the radical ,,no#b2 that is1 as hydrogen tranquilizes the speed of burning or oxidation1 its action is substituted by the atom nitrogen which is energy itself1 nitrogen being the base of all explosives40 ,sulphuric acid is certainly an oxidizing agent and in virtue thereof removes hydrogen2 but not in a solution whose concentration with respect to sulphuric acid is approximately only #j4hb per cent4 ,the statement that nitrogen is the 8base of all explosives0 is another example of the methods of the promoters4 ,as it is a well-known fact1 however1 that nitrogen itself is one of the least reactive of gaseous elements1 little confidence can be placed in such remarks as 8,nitrogen which is energy itself40 ,another mystifying term used in the formula is 8,ac4 ,butanol-,dioic10 which is a true chemical name1 certainly1 but it is one by which few physicians will recognize simple malic acid1 an ordinary vegetable acid widely distributed in ripe fruits1 such as apples and pears1 and possessing the properties simply of a relatively weak organic acid4 ,to describe it as exercising any potent influence 8in the oxidation of the phosphorus as lecithin in the cell0--especially in the extremely low concentration in which it is stated to exist in ,alleotone--is simply an absurd juggling with words4 ,it is not much to be wondered at that the public should be taken in by pseudoscientific 8literature02 but it is not only strange1 it is discreditable to our profession1 that among its members should be found any to accept such rubbish as the above quoted 8literature0 as information worth acting on--yet such there are1 judging from the testimonials4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #a1 #aijh47 ,the ,commercial ,value of ,adverse ,criticism ,for skilful attempts to convert a 8knock0 into a 8boost10 commend us to the discredited nostrum exploiter4 ,the federal ,food and ,drugs ,act did much to bring out this amiable quality--possibly developed it4 ,while somewhat ancient history1 it is well to call to mind what happened when the excise authorities insisted either that the 8patent medicine0 booze1 ,peruna1 have some medicine put in it1 or else that its manufacturers should go into the saloon business4 ,hartman at once got out a new label stating that 8for a number of years a multitude of grateful friends0 had urged 8that ,peruna be given a slight laxative quality40 ,thenceforth the innocents and near-innocents could get their perunaese jag only at the risk of a 8bad quarter of an hour40 ,one of the latest attempts to wriggle out of an uncomfortable position1 and at the same time make capital out of the wriggling1 is seen in the advertising of ,alleotone1 a nostrum of the pseudoscientific type1 which was shown up in ,the ,journal of ,feb4 #a1 #aijh4 ,the 8formula0 furnished is for the most part a jargon of misleading and mystifying nonsense and fulfils the same purpose as the voluble 8patter0 of the gentleman who is manipulating three shells and a pea at the county fair4 ,every constituent of the 8formula0 was discussed in ,the ,journal and the absurdities and impossibilities of each dwelt on4 ,did the manufacturers of ,alleotone feel downcast over the exposure of their humbug8 ,not to judge by their advertising1 for they write to physicians that 8since the ,a4 ,m4 ,a4 analyzed ,alleotone it has made great strides0--direction not specified4 ,but the choicest piece of impudence1 and one that but for its dishonesty would be laughable1 is found in this portion of their advertising pamphlet3 ,illustration ,in the original1 the words 8,with amendments suggested in the ,journal of the ,american ,medical ,association1 ,feb4 #a1 #aijh10 and also 87,cholesterin470 and 87,malic ,acid4710 which we have underscored in the illustration1 are printed in red and have been added to the original 8formula40 ,such are the uses of adversity4 ,what claim1 if any1 the exploiter of this nostrum--,b4 ,f4 ,copeland--has to medical or pharmaceutical knowledge1 we do not know4 ,in fact1 to be consistent with the 8ethics0 of the nostrum business he need have none4 ,such knowledge1 indeed1 tends to hamper that free play of the imagination so necessary in this work4 ,we understand that he has at different times been in charge of a stave factory and connected with a brokerage firm1 which may exert some subtle influence in developing the ability to relieve suffering humanity1 though the connection is not quite clear4 ,one would imagine1 however1 that the keen business instinct1 untrammeled by any considerations of conscience1 which is exhibited in the exploitation of ,alleotone1 would in purely commercial pursuits have long since assured a competence4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ag1 #aijh47 ,,baume ,,analgesique ,,bengue ,a physician writes asking for the formula of ,baume ,analgsique ,bengu4 ,this product is another of the 8patent-medicine0-8ethical-proprietary0 type of nostrums4 ,in ,great ,britain1 it is advertised to the public as 8,a ,wonderful ,remedy for ,rheumatism1 ,gout1 ,neuralgia40 ,in this country1 the exploiters find that space in cheap medical journals1 reinforced by the aid of undiscriminating physicians1 is a cheaper method of getting the stuff to the public4 ,according to the statements of the manufacturers1 ,bengu's ,analgesic ,balm contains 8menthol1 salicylate of methyl and lanolin40 ,when analyzed by the chemists of the ,british ,medical ,association1 it was reported to have the following composition3 ,menthol #ah per cent4 ,methyl salicylate #bj per cent4 ,lanolin1 anhydrous #ed per cent4 ,a fat1 apparently lard #h per cent4 ,the estimated cost of the ingredients of a #ej-;cent tube of ,bengu's ,analgesic ,balm1 according to the ,british chemists1 is #b-a_/b cents4 ,evidently this imposingly named product is practically a lanolin ointment containing oil of wintergreen and menthol4 ,similar products are catalogued by various pharmaceutical houses under various names and with varying degrees of frankness concerning their composition4 ,two firms give the medical profession full details regarding the composition of their products3 ,the ,h4 ,k4 ,mulford ,company1 who sell it under the name 8,methyl ,salicylate ,ointment10 and the ,pitman-,myers ,co41 who name their product 8,anodyne ,balm1 ,p-,m ,co40 ,some other firms are not so frank4 ,parke1 ,davis ,co41 for instance1 sell 8a combination of methyl salicylate and menthol with a lanolin base0 under the name 8,analgesic ,balm10 but do not give the quantities of the ingredients2 ,frederick ,stearns ,co4 sell 8,analgesic ,cream1 ,stearns0 without giving the quantities2 ,nelson ,baker ,co4 sell 8,anti-,neuralgic ,ointment10 and no quantities are given4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ad1 #aiab47 ,,antidiabeticum--,,bauer ,in ,germany the makers of nostrums1 their methods and their products are systematically exposed by the ,society for the ,suppression of ,quackery 7,deutsche ,gesellschaft zur ,bekmpfung des ,kurpfuschertums7 through its publication1 the ,geseundheitslehrer1 under the aggressive editorship of ,dr4 ,kantor4 ,ludwig ,bauer1#ajd the manufacturer of 8,antidiabeticum10 inserted advertisements in daily papers asserting that for his 8humanitarian efforts0 the society 8,opera ,educativa pacifica0 in ,rome had granted him a diploma and placed his publications in the celebrated 8,bibliotheca ,marciazzi40 ,dr4 ,kantor1 editor of the ,gesundheitslehrer1 declared that1 according to information received from the ,german ,consulate in ,rome1 no such society existed there1 and the library referred to probably was the ,bibliotheca ,marciana in ,florence1 which1 like other public libraries1 accepts all donations without critical examination4 ,to offset these exposures1 the promoter of ,antidiabeticum published advertisements libeling ,dr4 ,kantor and attacking the ,society for ,suppression of ,quackery4 ,this resulted in suits and counter-suits for libel between ,dr4 ,kantor and the directors of the antiquackery society on the one side and the promoter of ,antidiabeticum on the other4 ,as a result of the recent combined trial1 the court declared that ,dr4 ,kantor's charges had been substantiated and the manufacturer of ,antidiabeticum was fined #fjj marks or forty days' imprisonment1 while apparently on purely technical grounds ,dr4 ,kantor was fined #ej marks or five days' imprisonment4 ,the costs were divided between ,bauer and ,dr4 ,kantor in the proportion of #aa to #a4 ,as ,bauer in the course of the trial made further libelous charges1 ,dr4 ,kantor has lately started new proceedings against ,bauer4 ,the incessant persecution of ,dr4 ,kantor was described in an editorial in ,the ,journal1 ,may #bj1 #aiaa1 p4 #adhf4 #ajd ,according to a report in the ,allgemeine medizinische ,central-,zeitung ,jan4 #f1 #aiab1 p4 #ad4 ,the persecution of ,dr4 ,kantor previously described shows no signs of abatement nor has ,dr4 ,kantor given evidence of loss of courage4 ,some of the ,german medical societies have subscribed for the ,gesundheitslehrer for each of their members4 ,it is written in popular style for the masses and is a sharp and effective weapon for the campaign against quackery4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bg1 #aiab47 ,,antikamnia ,the ,nostrum and ,its ,method of ,exploitation ,our readers will be interested to learn some of the remarkable properties which1 according to the statements of the manufacturers1 this ,antikamnia possesses4 ,we quote from the advertising literature3 ,the well-known nerve specialist 7871 ,dr4 ,harley1 in an interview published in the ,london ,daily ,express1 says3 8,i have treated more than one ,american for nervousness and #8brain fag' directly due to their incessant energy4 ,i had a young man in here this morning who complained of headache #8in the back of the neck4' ,he was threatened with congestion of the brain1 and seemed somewhat aggrieved when ,i told him he had been trying to do too much4 ,i also treated a young ,american woman who1 since her arrival in ,london1 had apparently been living on ,antikamnia tablets by the advice of her physician4 ,it was the only thing1 she said1 which kept her #8braced up' for the strain of sight-seeing40 7,why did the young woman consult this ,dr4 ,harley--for the drug habit87 ,note the following3 ,for the severe pains of rheumatism1 dysmenorrhea1 neuralgia1 gout1 sciatica and lumbago1 as well as for the lightning pains of locomotor ataxia1 there can be no quicker and more lasting relief obtained than by the administration of ,antikamnia and codeine tablets4 ,imagine an intelligent physician trying to treat the diseases mentioned below with the various impotent means of the pharmacopeia and physiological therapy when he might depend on ,antikamnia6 ,we quote again3 ,as a ,pain ,reliever4--,in headache1 cephalalgia1 hemicrania1 migraine some other words might have been thrown in so as still more to emphasize the headache business1 myalgia1 coryza1 la grippe and its sequelae1 the lightning pains of locomotor ataxia and all pains due to irregular menstruation4 ,as an ,anodyne or ,sedative4--,in alcoholic delirium1 indigestion1 cardialgia1 gastralgia1 dyspepsia1 hysteria1 insomnia1 inebriety1 car-sickness1 sea-sickness1 worry and sight-seer's fatigue4 ,as an ,antipyretic4--,in typhoid1 intermittent1 puerperal and malarial fevers1 bronchitis1 pneumonia1 pleurisy1 and tuberculosis4 ,as an ,anti-,neuralgic4--,in acute or chronic neuralgia1 facial neuralgia1 earache1 pain about the teeth1 angina pectoris1 neurasthenia1 palpitation1 pains of locomotor ataxia and sciatica4 ,as an ,anti-,rheumatic4--,in acute or chronic rheumatism and gout1 fever and pleurodynia4 ,there is no remedy so useful and attended with such satisfactory results as ,antikamnia tablets in the treatment of melancholia with vasomotor disturbances1 anemic headaches1 emotional distress1 and active delusions of apprehension and distrust4 ,they increase arterial tension and promote digestion1 as well as being particularly serviceable in relieving the persistent headache which accompanies nervousness4 ,in neurasthenia1 in mild hysteroid affections1 and in the various neuralgias1 particularly ovarian1 and in the nervous tremor so often seen in confirmed drunkards1 they are of peculiar service4 ,in angina pectoris this drug has a beneficial action2 it relieves the pain and distress in many cases1 even when amyl nitrite and nitroglycerin have failed entirely4 ,in pseudo-angina1 frequently observed in hysterical women1 its action is all that can be desired4 ,patients who suffer from irritable1 weak1 or palpitating heart1 needing at times a pain reliever1 can take ,antikamnia tablets1 without untoward after-effects1 knowing that the heart is being fortified4 ,in delirium tremens1 they relieve when there are great restlessness1 insomnia1 the general lowering of the nerve power4 ,only the vivid picture of a crisis in locomotor ataxia or the agony of a true migraine1 can impress the observer with the full value of this pain reliever4 ,the following testimonials are from physicians3 ,dr4 ,caleb ,lyon1 an old ,bellevue practitioner1 in referring to antikamnia and codein tablets1 says3 ,in my practice they accompany the maid from her virgin couch to her lying-in chamber1 assuaging the perplexities of maidenhood and easing the trials of maternity with most gratifying results4 ,i earnestly hope that the proprietors of this valuable remedial agent will keep it up to its present standard of purity and excellence4 ,dr4 ,walter ,m4 ,fleming1 ,a4,m41 ,m4,d41 ,new ,york ,city1 writes3 444 ,with all the experience of more than a quarter of a century1 in the treatment of winter cough1 and all its complications of laryngeal1 bronchial and pulmonary irritability1 dyspnea1 asthmatic spasms1 and finally whooping cough--usually the most persistent and tenacious of all these membranous maladies--,i find no one remedy more strongly indicated1 or which yields more prompt and satisfactory results than ,antikamnia and heroin tablets1 composed of ,antikamnia #e grains and heroin hydrochloride #a_/ab grain4444 ,result3 a prompt and efficient expectorant1 at once relaxing the harsh and rasping cough1 releasing the tenacious1 sticky and gelatinous mucus which is soon readily expectorated1 while the soothing influence of the ,antikamnia is at once manifested1 greatly to the comfort and contentment of the patient4 444 ,independent of the fact of the direct applicability of this remedy to the various membranous maladies of the lungs1 bronchi1 fauces and nose1 it proves also1 an invariable remedy in all febrile cases where anodyne is required4 ,this1 together with its analgesic and antipyretic merits1 eminently qualify this combination for a responsive agent in the treatment of nearly all the numerous febrile attacks characterized by pain1 nervousness1 insomnia and their accompanying symptoms4 8,antikamnia and ,quinin0 ,if there is any virtue in the particular combination known as 8,antikamnia10 a physician prescribing the tablets supposed to contain combinations of 8,antikamnia0 and some other drugs should have some guarantee that they contain those remedies4 ,take1 for example1 the tablets advertised and sold as 8,antikamnia and quinin40 ,it might reasonably be supposed that the tablets contained the combination known as 8,antikamnia02 this1 however1 seems not to be the case4 ,previous analyses1 as published#aje by us1 have shown that antikamnia contains approximately #bj per cent4 of sodium bicarbonate1 yet two chemists1 working separately1 have been unable to find this ingredient in the tablets advertised and sold as 8,antikamnia and quinin40 ,are we to understand1 therefore1 that the manufacturers do not consider the bicarbonate of sodium of importance in their preparation1 ,antikamnia2 or are they guilty of misrepresentation and of misleading physicians in omitting this constituent from their product ,antikamnia when that is combined with the bisulphate of quinin8 ,the above statement regarding the omission of bicarbonate of sodium from the quinin combination may be verified by any physician who desires to make a few simple chemical tests--carbonic acid is not given off when the tablets are treated with dilute acids1 as would be the case if sodium bicarbonate were present4 ,further1 while the ordinary ,antikamnia contains no constituent not soluble either in water or in chloroform1 and while quinin bisulphate is readily soluble in water1 the tablets said to contain ,antikamnia and quinin bisulphate1 when treated successively with water and with chloroform1 leave a residue of more than #ah per cent4 #aje ,the ,journal ,a4 ,m4 ,a41 ,june #c1 #aije2 reproduced on page #i of this book4 ,one of the chemists who analyzed the preparation for us1 in commenting on this in a letter1 says3 8,the matter which is insoluble in water1 alcohol or in chloroform1 i4 e41 the substance which is neither #8,antikamnia' nor quinin bisulphate1 amounts to more than #ah per cent4 in #8,antikamnia and quinin bisulphate tablets4' ,the tablets weigh close to five grains and are said to contain #b4e grains each of ,antikamnia and quinin bisulphate4 ,how is this possible when each tablet contains almost one grain of foreign substance 7chiefly starch780 ,further comment is superfluous4 ,we have presented facts to our readers and leave1 them to draw their own conclusions4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #a1 #aije47 ,adding ,insult to ,injury ,when the ,council on ,pharmacy and ,chemistry began its work of independent and scientific investigation of proprietary preparations1 some of the questions asked were3 8,what guarantee has the medical profession that the formulas of these proprietary medicines are not changed at the will of the manufacturers8 ,how can the physician who confidingly prescribes them for his patients know that the preparation which he orders to-day is the same as that which was furnished him last year1 or which may be given him next year1 under the same name80 ,at once a wail1 as of injured innocence1 went up from countless venders of proprietary medicines1 who replied with one voice3 8,the honor and reputation of the proprietors and manufacturers is sufficient guarantee of the stability and permanence of these preparations40 ,so vehement were their protestations and so well simulated were their declarations of ,pecksniffian virtue that many physicians were deceived thereby4 ,many medical journals 7whose views were1 perhaps1 slightly biased by the consideration of fat advertising contracts7 also were apparently convinced4 ,but the fact was overlooked that guarantees based on honor are of value only in proportion to the amount and quality of honor possessed by the guarantors4 ,the enactment of the national ,food and ,drugs ,act is bringing many things to light4 ,some of them are interesting1 some would be amusing were they not so utterly despicable4 ,among other things1 it has furnished a demonstration of the value of the 8honorable assurances0 of nostrum venders4 ,the nostrum ,antikamnia has pointed out many a moral in the campaign in the last two years4 ,it was hardly to be hoped that it would deliberately furnish a demonstration of the utter lack of honesty on the part of a certain class of proprietary manufacturers4 ,yet1 relying apparently on the ignorance of the public and the long-continued lethargy of the medical profession1 its promoters have1 in the last few weeks1 unwittingly convicted and stultified themselves4 ,when the pure food law went into effect1 the proprietors of this mixture found themselves in a sad dilemma2 if they labeled their mixture in accordance with the provisions of the law they would have to admit that it contained acetanilid and that the charges against them were true4 ,failing to comply with the law1 they must go out of business4 ,the latter alternative was not to be thought of4 ,the profits gained by selling1 with the aid of careless or ignorant physicians1 a five- or ten-cent mixture for #a were too great to be surrendered without a struggle4 ,the same brilliant intellect1 perhaps1 that first saw the commercial possibilities in the business said3 8,change the formula4 ,phenacetin is about as cheap as acetanilid2 the patent has just expired and consequently we can get it at a low price4 ,let us substitute phenacetin for acetanilid40 ,as a result the profession is treated to an edifying exhibition of virtue triumphant1 a wolf so completely covered by the harmless coat of a sheep that he flatters himself that his wolfish nature is completely concealed4 ,no longer are skulls and skeletons sent out in calendar form as grinning advance agents to be displayed in every doctor's office1 but instead a beautiful domestic scene1 showing a convalescent child nestling in the arms of its mother4 ,the familiar 8,,ak10 however1 as usual1 is in the lower right-hand corner4 ,and what a change in labels6 ,no longer is ,antikamnia a chemical entity1 but the label now openly but ingenuously declares that 8,antikamnia tablets in this original package contain #cej grains of acetphenetidin1 ,u4 ,s4 ,p41 per ounce4 ,guaranteed under the ,food and ,drugs ,act1 ,june #cj1 #aijf4 ,serial ,no4 #aj40 ,while1 below1 as an entirely unnecessary display of conformity to the ,pure ,food ,act1 appears this statement3 ,the ,antikamnia tablets in this original ounce package contain no acetanilid1 antifebrin1 antipyrin1 alcohol1 morphin1 opium1 codein1 heroin1 cocain1 alpha- or beta-eucain1 arsenic1 strychnin1 chloroform1 cannabis indica or chloral hydrate4 ,truly1 ,satan is appearing as an angel of light4 ,what a gratification it is to the long exploited profession to know that ,antikamnia contains no alcohol1 no chloroform1 no cannabis indica1 no chloral hydrate4 ,how unfortunate that this spontaneous display of confidence is not carried far enough to inform the profession of the ingredients1 aside from phenacetin1 contained in the mixture6 ,the label is an admission that the nostrum does not contain what it was never supposed to contain1 with the exception of acetanilid1 and is directly an attempt to conceal the real contents4 ,the proprietors know that the dear public1 whose 8pains1 headaches1 neuralgias1 women's aches and ills1 grippal neuroses1 nervousness1 insomnia1 rheumatism1 lightning pains of locomotor ataxia1 sciatica1 etc410 they are longing to assuage1 will not know that acetphenetidin is the official designation for what is popularly known as phenacetin1 and that this dangerous product is found in the new mixture in the proportion of approximately #d grains to a #e-;grain tablet4 ,evidently they also presume considerably on the ignorance of our profession1 or why should they make the brazen statement that four grains of phenacetin is the 8most reliable remedy0 for the long list of diseases enumerated on their advertising calendar8 ,illustration3 ,a reduced reproduction of a full-page ,antikamnia advertisement appearing in the ,new ,york ,world ,almanac1 #aiaa4 ,when the formula for which such wonderful virtues were claimed was suddenly thrown overboard1 was the medical profession1 which by its short-sighted patronage had built up this business1 notified in any way of the change8 ,search the new advertising matter of this nostrum from beginning to end and you will not find one word to show that 8,the ,antikamnia tablets in this original ounce package0 differ in the slightest particular from those sold to the profession and the public for years past4 ,this being true 7and the statements of the promoters themselves are our authority for it71 what remains of the pratings of 8honor0 and the 8guarantee of the manufacturers08 ,has a physician no right to know when a change is made in the formula of a preparation which he has been prescribing for years8 ,what assurance has the profession that1 at any moment1 a cheaper or more dangerous drug may not be substituted for 8acetphenetidin0 if thereby the law can be evaded or the profits of the delectable business enhanced8 ,how can any conscientious physician prescribe1 for those who confide their lives to his care1 a preparation the stability of the formula of which must depend absolutely on its owner's whim8 ,how can a physician with the slightest sense of responsibility to his patients allow his office to be used as a free advertising bureau for a preparation manifestly founded and developed on deceit and misrepresentation8 ,how can any medical journal1 except those avowedly and unblushingly seeking to aid the nostrum maker to exploit the profession1 whose interests they claim to serve1 continue to carry the deceptive and misleading advertisement of a twice exposed fraud8 ,how can any physician with a particle of self-respect or manhood continue to support1 by subscription or contribution1 any medical journal which1 by accepting such advertising1 allies itself with the army of deceit and chicanery8--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bf1 #aijg47 ,still ,further ,duplicity ,when the ,food and ,drugs ,act went into effect the manufacturers of this preparation1 instead of continuing to put out the same mixture as they had been doing radically changed the composition by substituting acetphenetidin 7phenacetin7 for acetanilid4 ,by doing this the company avoided the disagreeable necessity for acknowledging on the label that the nostrum contained acetanilid1 as was shown by the analysis published in ,the ,journal1 ,june #c1 #aije4 ,in addition to stating that the package of ,antikamnia contained acetphenetidin1 the company also stated that it contained no 8acetanilid1 antifebrin1 antipyrin1 alcohol1 morphin1 opium1 codein1 heroin1 cocain1 strychnin1 chloroform1 cannabis indica1 or chloral hydrate40 ,knowing that the nostrum was being advertised in ,great ,britain and ,canada as well as in the ,united ,states1 ,the ,journal obtained some ,antikamnia from ,london1 and it was analyzed in the ,association's laboratory4 ,as was suspected1 the analysis showed that ,antikamnia as sold abroad has the same composition now as it had in the ,united ,states before the ,food and ,drugs ,act went into force1 viz43 ,acetanilid1 #fg4ge per cent42 caffein1 #d4hh per cent41 and citric acid and sodium bicarbonate1 by difference1 #be4cf per cent4 ,this corresponds with the analysis previously made and published in ,the ,journal1 ,june #c1 #aije4 ,the ,antikamnia on the market in this country was also analyzed and it was found to contain3 acetphenetidin 7phenacetin71 #gb4je per cent42 caffein1 #ac4ie per cent42 citric acid and sodium bicarbonate1 #ad per cent4 ,the preparation sold as 8,antikamnia and ,quinin0 was also analyzed1 and it was found that starch had been substituted for the bicarbonate of sodium which is found in the ,antikamnia itself4 ,the details of the analyses are given with the following comments3 8,the above are brief statements of bald facts4 ,two of these should be emphasized3 7#a7 ,when the ,food and ,drugs ,act went into force1 ,january1 #aijg1 the manufacturers of ,antikamnia1 rather than acknowledge the truth of the past--we can imagine no other reason--materially and radically changed the composition of their preparation1 and did this without notifying the medical profession or intimating in any way1 so far as we can learn1 that such a change had been made4 ,we have no doubt they believed they had a right to do as they pleased with their own2 that it was nobody's business but theirs what they did with their own preparation1 or how they changed it4 ,as they never had told physicians what it contained1 there was no reason why they should do so now4 ,this is logical and we cannot blame the manufacturers so long as the medical profession is willing to be humbugged4 7#b7 ,for the same reason1 we presume1 they claim that they have a right to continue to use acetanilid in the product for the foreign market4 ,the ,food and ,drugs ,act applies only to the ,united ,states1 of course1 and acetanilid being cheaper1 why not use it8 ,what is the difference if one is more dangerous than the other8 ,the fact that the ,antikamnia sold abroad differs from that sold in this country some may say is of no special interest to us4 ,still this fact is worth noting3 ,the dose of acetphenetidin--phenacetin--7#g-a_/b grains7 is nearly double that of acetanilid 7#d grains73 one becoming accustomed to a certain dosage of the nostrum as sold in this country might1 while abroad1 unwittingly be led to take a double dose of acetanilid4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #h1 #aijh47 ,samples1 ,form ,letters and 8,prescriptions0 ,sent to the ,laity ,to the ,editor3--,the enclosed 8literature0 is being sent broadcast to the laity by the ,antikamnia people and still a great many of the physicians throughout the country are prescribing the preparation thus advertised4 ,will the time ever come when the medical fraternity will awaken to the fact that it has been humbugged by a great many manufacturing concerns8 ,i certainly hope so4 ,j4 ,w4 ,du,val1 ,m4,d41 ,wichita ,falls1 ,texas4 ,comment3--,the 8literature0 referred to by our correspondent consists of a form letter and a small pamphlet4 ,the letter was similar to the one reproduced herewith4 ,illustration ,the pamphlet accompanying the letter is entitled 8,practical ,prescriptions10 and contains a list of diseases and morbid states arranged alphabetically from 8,alcoholism10 8,asthma0 and 8,backache10 to 8,wind10 8,women's ,pains0 and 8,worry40 ,for the one hundred and twenty-two conditions listed1 8,antikamnia10 8,antikamnia and ,codein0 or 8,laxative ,antikamnia and ,quinin0 are prescribed1 demonstrating that the 8prescriptions0 are more 8practical0 than scientific4 ,in many respects the methods of the proprietors of 8headache powders0 and 8anti-pain pills0 are less offensive to one's sense of professional decency than the course pursued by the ,antikamnia people4 ,the former have at least never recommended their products as 8ethical proprietaries02 they have not used medical men as their unpaid agents2 the claims made for their products have been no more exaggerated2 and they have not found it necessary1 from the requirements of the ,food and ,drugs ,act1 to substitute acetphenetidin for acetanilid to avoid giving the lie to their former claims4 ,as to the query propounded by our correspondent3 ,we are optimistic enough to believe that the time he longs for is already here4 ,the fact that the proprietors of nostrums of the ,antikamnia type are finding it necessary to advertise to the laity is1 in itself1 evidence of the diminishing demand for such products on the part of the medical profession4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ah1 #aijh47 ,antikamnia in ,america and ,great ,britain ,the following letter from the ,antikamnia ,chemical ,company to ,the ,journal was received about ,august #a1 #aiab3 8,you have at various times represented in your ,journal that the ,antikamnia sold in foreign countries1 particularly in ,great ,britain1 has a different formula from the ,antikamnia sold in the ,united ,states1 and you have also published alleged formulas of each to show wherein they are supposed to differ4 8,we hereby respectfully notify you that the ,antikamnia formula is the same for all countries1 and the publication of any statements to the effect that the formula of ,antikamnia is different in ,great ,britain1 or any other foreign country1 from that sold in the ,united ,states is a libel1 and will be prosecuted as such40 ,on the receipt of this a letter was written to a correspondent in ,london requesting him to purchase in the open market a package of ,antikamnia4 ,this was done and the original sealed package reached the ,association's laboratory a few days ago4 ,careful analysis of this specimen shows it to contain acetanilid but no acetphenetidin1 while the ,antikamnia sold in the ,united ,states contains acetphenetidin but no acetanilid4 ,the company's protest to the contrary notwithstanding1 the formula of some ,antikamnia1 at least1 is still different in ,great ,britain from that sold in the ,united ,states4 ,it is possible1 of course1 that some time in the future the composition of every package of this nostrum on sale in the ,united ,kingdom will be similar to that of every package sold in the ,united ,states4 ,it is even possible that 8,antikamnia ,quinin0 tablets will--or do--actually consist of quinin and the mixture called ,antikamnia--although1 as ,the ,journal has shown1 this has not been the case in the past4 ,since the patent expired on acetphenetidin1 this drug has become so cheap--it can be bought at wholesale for less than #f cents an ounce--that1 commercially it must make very little difference whether acetanilid or acetphenetidin is used in the manufacture of ,antikamnia4 ,but the question arises3 ,have our ,british confrres been notified of the change in formula8 ,a careful study of the ,antikamnia advertisements in ,english medical journals shows that the ,british medical profession has been given no more consideration by this concern than was the ,american medical profession when the change in composition was made on this side4 ,but then why should it be8 ,physicians1 ,british or ,american1 who are addicted to the prescribing of secret proprietaries such as ,antikamnia have little need of formulas--8,theirs not to reason why60 ,the medical profession on both sides of the ,atlantic has never known the exact composition of ,antikamnia and does not know it now4 ,physicians who call for preparations of the ,antikamnia type are prescribing names1 not drugs4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bf1 #aiab47 ,again1 ,antikamnia ,illustration3 ,reproductions of portions of pages in the booklets sent out by the ,antikamnia ,chemical ,company to physicians 7on the right71 and laymen 7on the left71 respectively4 ,those who do not realize the character of the ,antikamnia concern naturally imagine the quotation here given from ,the ,journal is a comparatively recent one4 ,notice that no dates are given4 ,as a matter of fact1 it is twenty-two years old4 ,dr4 ,mc,intyre1 who wrote it1 has been dead eleven years4 ,in season and out of season ,the ,journal has exposed the ,antikamnia fraud until it would seem that its readers would become weary of the very name4 ,there is nothing new to say about this dangerous stuff1 and yet the number of inquiries indicates that thousands of ,the ,journal's readers do not know of the previous exposures4 ,more than fifteen years ago ,the ,journal ceased carrying the ,antikamnia advertisement2 more than ten years ago it notified its readers that the nostrum was being advertised to the public by means of circular letters2 more than six years ago it proved that1 when the ,food and ,drugs ,act went into effect1 acetphenetidin had been substituted for acetanilid in ,antikamnia evidently in order that the presence of the older drug1 of whose dangers the public had been made aware might not have to be admitted2 more than five years ago ,the ,journal showed that the ,antikamnia sold in the ,british ,isles still contained acetanilid1 and as late as last ,october it verified this statement although threatened with prosecution for libel by the ,antikamnia ,chemical ,company4 ,yet1 in spite of all these exposures1 not a week passes that we do not receive one or more letters calling attention to the ,antikamnia fraud4 ,most of these letters deal with one1 or more1 of three points3 first1 the fact that the stuff is being advertised to the public by means of circular letters and that sample 8vest-pocket boxes0 of this dangerous drug are being sent through the mail to laymen2 second1 that ,antikamnia is being advertised in newspapers1 and1 third1 that in the booklets sent out by the ,antikamnia ,chemical ,company both to the medical profession and to the public1 a paragraph is quoted from an article by ,dr4 ,john ,h4 ,mc,intyre that appeared in ,the ,journal4 ,illustration3 ,photographic reproductions of two typical ,antikamnia advertisements now appearing in newspapers all over the country4 ,these tablets are advertised in various newspapers as being 8safe0 and neither 8depressant0 nor 8habit-forming0--three separate and distinct falsehoods4 ,the first two points have already been discussed so frequently that it seems hardly worth while to take them up again in detail1 though it might be said that the medical profession has at last become so familiar with this widespread humbug that the ,antikamnia ,chemical ,company has finally gone over body and soul to the newspapers4 ,so far as we can learn only three publications professing to be medical journals still carry the ,antikamnia advertisement4 ,these three are3 ,southern ,practitioner ,therapeutic ,record ,pacific ,medical ,journal ,as is usual in such cases1 the ,british medical journals are not so particular1 and we still find ,antikamnia advertised in3 ,medical ,press and ,circular ,glasgow ,medical ,journal ,journal ,tropical ,medicine and ,hygiene ,dublin ,journal ,medical ,science ,lancet ,canada ,lancet ,practitioner ,the reproduction of the ,mc,intyre quotation is evidently adopted by the ,antikamnia concern as a means of 8playing even0 with ,the ,journal for the unpleasant things it has said about it4 ,in quoting ,dr4 ,mc,intyre1 the ,antikamnia ,chemical ,company carefully avoids giving the date on which the article appeared4 ,as a matter of fact1 the article was printed in ,the ,journal over twenty years ago 7,july #d1 #ahia71 and ,dr4 ,mc,intyre himself has been dead for eleven years4 ,presumably1 however1 the ,antikamnia ,chemical ,company will continue to mislead1 either directly or by inference1 until the end of the chapter4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ab1 #aiac47 ,,anusol ,,suppositories 8,in ,hemorrhoids and all ,inflammatory ,rectal ,diseases1 let your first thought ,continue to be ,anusol ,hemorrhoidal ,suppositories2 they have ,earned your lasting ,confidence40 ,thus speaks an attractive folder recently sent to physicians4 ,with a prodigal use of superlatives1 the medical profession is told that these suppositories have for years 8maintained their ,world-,wide ,reputation0 as the 8,most ,effective1 the ,safest 444 the ,most ,economical and 444 the ,most ,credit-,bringing of all ,topical ,rectal ,remedies40 ,the short memory of the public is notorious2 from the point of view of the proprietary exploiter1 the short memory of the medical profession must be equally well known4 ,how1 otherwise1 would a firm try to make physicians believe that a product had 8earned0 their 8lasting confidence0 when the result of an examination by the ,association's chemists1 published in ,the ,journal1#ajf had shown that ,anusol ,hemorrhoidal ,suppositories contained practically no 8anusol40 ,moreover1 as the ,association's findings were a practical verification of the findings of a foreign chemist who also had failed to find any 8anusol0 in ,anusol ,suppositories1 it is not quite clear what is meant by the term 8world-wide reputation40 ,incidentally1 the observant physician will notice that the list of the ingredients given on the ,anusol ,suppositories labels of #aiac differ from those of the vintage of four years ago4 ,the label of the old boxes gave the ingredients thus3 ,bismuth4 iodo-resorcinsulfon 7,anusol71 ,zinc oxydat4 pur41 ,balsam ,peruv41 ,ol4 cacao1 ,unguent cereum4 #ajf ,oct4 #b1 #aiji2 see p4 #bbg of this volume4 ,on the latest label1 however1 we find these ingredients given3 8,bismuth oxyiodid and resorcinsulphonate with ,zinc oxid and ,balsam ,peru1 incorporated in suitable base40 ,what will the formula be four years hence8--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #aa1 #aiac47 ,,anusol ,,suppositories ,to the ,editor3--,in the 8,propaganda for ,reform0 department of the ,october #aa issue of ,the ,journal1 you published a short notice on ,anusol ,suppositories4 ,we desire to correct the impression which your readers may have received1 viz43 that there is any actual difference between ,anusol ,suppositories of the present and ,anusol ,suppositories of the past4 ,we wish1 therefore1 to state that the composition of ,anusol ,suppositories has not been changed2 the only modification that we have made is a revision of the label to the effect that the active medicinal ingredient of the preparation is a mixture of bismuth oxyiodid and bismuth resorcinsulphonate in place of bismuth iodoresorcin-sulphonate4 ,the latter was originally claimed by the manufacturers1 discovered to be doubtful by an investigation in the laboratory of the ,american ,medical ,association1 as well as by one on the part of a foreign chemist1 and finally disproved to our satisfaction by an independent investigation on our part4 ,we feel that the remark 8,what will the formula be four years hence80 will carry the impression to your readers that the composition has frequently been changed and is likely to be changed again1 and it is for this reason that we request the above correction and an assurance to the contrary4 ,the statement in the note that 8,anusol ,suppositories have been proved to contain no ,anusol0 is also likely to create an entirely erroneous impression4 ,we dropped the use of the word 8anusol10 as designating a definite chemical substance more than two years ago1 and changed all our propaganda matter accordingly4 ,schering ,glatz4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ca1 #aiad47 ,,aspiro-,,lithine ,aspiro-lithine is another comparatively new example of the custom of proprietary manufacturers in putting forward old drugs under a new name and with them bidding for the favor of physicians4 ,an inquiry has been received concerning this mixture4 ,it is prepared by ,mc,kesson ,robbins and is said to contain in each tablet #e grains of acetysalicylic acid 7aspirin7 and #b-a_/b grains of acid citro-tartrate of lithium4 ,it is recommended for all the purposes for which acetysalicylic acid is commonly used1 and on account of the lithium added is claimed to have much greater virtues than either of these drugs alone or of both combined4 ,we had hoped that the time had passed for reputable houses to employ such time-worn methods1 but probably they will not stop so long as physicians encourage them by continuing to use such preparations4 ,acetysalicylic acid is a good drug1 whose value is pretty well known4 ,it is further known that lithium salts do not possess any great medicinal virtue4 ,just what acid citro-tartrate of lithium may be is hard to tell1 for chemistries do not recognize such a substance4 ,the name presumably is intended to hide the real nature of the preparation4 ,but if there be any advantage in combining lithium salts with acetysalicylic acid in a prescription1 it is a simple proposition and requires no great skill1 either on the part of the physician who writes the prescription or on the part of the druggist who puts it up1 and such mixtures as aspiro-lithine1 with the exaggerated claims made for them1 should be avoided in the physician's prescribing4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #bh1 #aiaj47 ,,bell-,,ans 7,,pa-,,pay-,,ans1 ,,bell7,,as ,another 8,patent ,medicine0 ,foisted on the ,public ,through the ,medical ,profession ,,as ,see also report on ,papayans ,bell1 p4 #aea4 ,with such nostrums as ,antikamnia and ,resinol fresh in mind as flagrant examples of 8patent medicines0 introduced to the public through the medical profession1 what follows regarding ,bell-ans1 or1 as it is better remembered by physicians1 ,pa-pay-ans 7,bell7 will take on an added interest4 ,briefly1 ,bell-ans is the new name of a tablet that1 according to chemists' reports1 is essentially charcoal1 baking soda and ginger1 flavored with oil of wintergreen4 ,its selling point1 in the past at least1 has been the alleged presence of papain4 ,this drug1 ,bell ,co4 allege1 is present in their tablets and they claim is 8the digestive principle obtained by our own exclusive process from the fruit of ,carica papaya40 ,as long ago as #aiji1 the ,council on ,pharmacy and ,chemistry attempted to find papain present in what was then called ,pa-pay-ans 7,bell7 and to determine the digestive power of the tablets but with negative results4 ,the efforts of other chemists were equally unavailing4 ,in ,january1 #aiad1 ,bell and ,company changed the name of the product 8,pa-pay-ans 7,bell70 to 8,bell-ans40 ,as ,the ,journal remarked soon after1 it seemed probable that1 as the name of a nostrum of this kind is the manufacturer's most valuable asset1 the name was hardly changed1 as was alleged1 for purely euphonious reasons4 ,it seemed more likely that as analyses had indicated there was not1 and probably never had been1 any appreciable amount of papain in the product1 the change of name might be due to the fear that some day the misleading name might bring the preparation in conflict with the federal ,food and ,drugs ,act4 ,for years physicians have realized that the methods of exploitation of ,pa-pay-ans 7,bell7 have been such as to make the medical profession a vast free advertising agency for the nostrum4 ,so far as we know ,pa-pay-ans 7,bell7 has never been advertised in lay journals--newspapers1 etc4 ,certain medical journals1 however1 have1 for a long time1 carried the advertisements of ,pa-pay-ans 7,bell7--and later of ,bell-ans--while ,bell ,co4 has been lavish in its distribution of free samples1 blotters and other advertising paraphernalia direct to the medical profession4 ,illustration3 ,miniature facsimile of a letter received by a layman4 ,it was accompanied by a small box of ,bell-ans4 ,two points are worth noting3 8444 one hundred thousand physicians are now prescribing it02 8any druggist will tell you0 that it is perfectly harmless6 ,now it seems ,bell and ,company are going direct to the public by means of vest-pocket samples and letters4 ,the letter1 a miniature facsimile of which we reproduce1 is one addressed to laymen and accompanies a vest-pocket box of the nostrum4 ,here are some of the things that ,bell and ,company claim ,bell-ans will do3 8,it removes flatulence1 vertigo1 weakness and other symptoms of indigestion quickly and pleasantly40 8,it relieves vomiting in pregnancy1 alcoholism1 seasickness and cholera morbus44440 8,to promote appetite1 digestion and the elimination of toxic and waste material prescribe the ,bell-ans44440 8444 prevent eruptions1 nausea1 vertigo1 pain1 etc44440 8444 remove distention1 pain1 weakness1 depression1 etc44440 8,there is no derangement of the digestive organs upon which the proper dose of ,bell-ans 7,pa-pay-ans1 ,bell7 will not act quickly1 pleasantly and favorably44440 ,there is no physician living who really believes such claims as these6 ,yet on the medical profession rests the responsibility for the exploitation of this nostrum4 ,those medical journals which accept advertisements for things of this kind are not so much to blame as those physicians who unprotestingly tolerate the journals that do so4 ,privately owned medical journals are published1 usually1 as a commercial proposition2 they reflect1 to a greater or less extent1 the attitude of their readers1 subscribers and contributors4 ,there are at least three medical journals which carry the advertisements of ,bell-ans4 ,they are the ,new ,york ,medical ,journal1 the ,international ,journal of ,surgery and the ,massachusetts ,medical ,journal4 ,bell-ans 7,pa-pay-ans1 ,bell7 possesses the virtues--and they are few--and the limitations--and these are many--inherent to a mixture of bicarbonate of soda1 ginger and charcoal4 ,any druggist could put up just as good a remedy1 and any physician could write a prescription for a better one in those cases in which he might think it indicated4 ,the whole secret of the commercial success of ,bell-ans lies in the mystery of its composition and the fraudulence of the claims that have been made for it4 ,the same tablets put out under a non-proprietary name1 as an open formula and with claims that were reasonable and true1 would have had practically no sale4 ,the commercial success of ,bell-ans is a monument whose foundation rests equally on the unscrupulousness of the manufacturer and on the gullibility of a learned profession4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #af1 #aiae47 ,,biosol ,dr4 ,a4 ,n4 ,lakin1 ,state ,line1 ,ind41 writes3 8,kindly advise me concerning ,biosol4 ,i am sending you herewith a pamphlet describing this product4 ,on the last page note clinical report from ,dr4 ,buchman of the ,indiana ,medical ,association and president of the ,department of ,public ,health1 ,fort ,wayne1 ,ind40 ,h4 ,hille1 once of ,heidelberg1 now of ,oak ,park1 ,ill41 having reached the conclusion that mineral starvation is the cause of all diseases1 devoted his talents to finding a remedy4 ,he claims to have found it and calls it 8,biosol40 ,he published his discovery in a pamphlet entitled 8,facts of ,modern ,science10 and recently published an article in the ,medical ,record giving his ideas on this mineral point of view4 ,biosol is an indescribable mixture of alcohol1 carbohydrates1 and many and various mineral bodies--ranging all the way from sodium1 potassium1 calcium and magnesium to silicon1 copper1 uranium and thorium--the amount of each being in most cases extremely minute4 ,it is said to be a valuable food as well as medicine4 ,a dose of this food might keep a rabbit alive for several hours1 and a man who could stand the expense and escape death from delirium tremens might live on three quarts of the mixture per day4 ,human beings have little occasion to fear mineral starvation1 and may obviate whatever danger there may be with a drink of milk4 ,like other living creatures1 we may be thankful that we are furnished in our own bodies with a living bioplasm which can use the minerals of the waters and the rocks and which has its own laboratory in which to prepare organic compounds to suit its needs4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #h1 #aiac47 ,,bromin-,,iodin ,,compound ,the ,life-,history of a ,nostrum ,a correspondent writes for information concerning a remedy known as ,bromin-,iodin ,comp41 which he says is manufactured by the ,bromin-,iodin ,chemical ,company1 formerly of ,binghamton1 ,n4 ,y41 but now located in ,san ,diego1 ,calif4 ,in ,the ,journal for ,feb4 #e1 #ahih1 appeared an article by ,dr4 ,c4 ,w4 ,ingraham1 ,binghamton1 ,n4 ,y41 entitled 8,five ,years' ,successful ,experience with a ,special ,mode of ,treating ,pulmonary ,tuberculosis40 ,this 8special mode0 of treatment consisted in using what ,dr4 ,ingraham called 8bromin-iodin compound10 which he said had the following formula3 ,iodin gr4 #a_/b ,bromin gr4 #a_/ad ,phosphorus gr4 #a_/ajj ,thymol gr4 #b_/c ,sterilized oil fl4 dr4 #a ,this 8hypodermic treatment of phthisis0 was widely advertised in the late nineties by the ,bromin-,iodin ,chemical ,co1 ,binghamton1 ,n4 ,y41 and was but one of the innumerable 8treatments0 for pulmonary tuberculosis that have risen1 had their day and1 more or less gracefully1 retired4 ,it was first sold 8to physicians only0 for hypodermic administration4 ,in #aijf1 however1 physicians were told by the company that 8if we find it impossible to secure your cooperation 444 we will be compelled to do business with the druggists in your locality 4440 ,apparently they found such cooperation impossible1 because a leaflet was issued to the laity and the statement was made that they intended to advertise 8all over ,north ,america in publications of national and international circulation1 as well as in local newspapers 4440 ,naturally the laity couldn't be expected to administer this treatment by the hypodermic method and it is not surprising to read that 8experiment has proved that the same solution can be taken internally40 ,in addition to the advertising leaflet1 the public also was provided with a 8pocket calendar good for #bjj years0 which contained numerous testimonials from physicians laudatory of the 8bromin-iodin0 treatment4 ,the layman who received one of the leaflets was told that if he was suffering from 8asthma1 bronchitis1 colds1 consumption1 coughs1 eczema1 goiter1 hay fever1 neuralgia1 rheumatism 444 also constipation and kidney troubles10 and his recovery was 8not as rapid as it should be10 should1 moreover1 his physician refuse to use the bromin-iodin compound 8it might not be a bad idea to discharge him0 and get a physician who would6 ,at the time this 8treatment0 was first tried by its 8inventor10 the results given in fifty cases were3 ,first stage1 #ij per cent4 cures2 second stage1 #ej per cent4 cures2 third stage1 no cures1 but improvement in several cases2 this was in #ahie4 ,it now appears that this 8treatment0 has after a period of 8patent-medicine0 exploitation come back into the 8ethical proprietary0 field4 ,presumably a mixture such as that represented by the 8formula0 did not lend itself to administration by mouth2 there was nothing to do1 therefore1 but enlist the aid of 8easy0 physicians in furthering its sale4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #d1 #aiaj47 ,,calmine ,new ,names for ,old ,drugs 8,calmine1 the new ,hypnotic10 is another example of the ingenuity of the exploiters of proprietary preparations in coining new names for old drugs and the recklessness with which exploiters herald forth renamed remedies to the profession and the public as new and wonderful discoveries4 ,this is what the promoters1 sustained by a calm confidence in the credulity of the profession1 have to say3 ,in the medical circles throughout the country a good deal of interest and even enthusiasm over this new hypnotic is noticeable4 ,very few drug products have attracted so much attention as this one4 ,a really satisfactory hypnotic and sleep-inducer1 which ,calmine certainly seems to be1 has been awaited expectantly for many years4 ,of course1 we have always had agents of this sort--a new one has come out at frequent intervals--but none of them have 8filled the bill02 they have been prescribed only because there was nothing better to be had4 ,now this new and wonderful discovery is nothing but ,veronal-sodium 7sodium diethyl-barbiturate7 under another name4 ,it is the sodium salt of the more or less favorably known hypnotic1 ,veronal 7diethyl-barbituric acid74 ,it is also sold as ,medinal1 and differs from ,veronal only in that the combination with sodium has made it more readibly soluble1 and thus1 it is claimed1 its absorption is more prompt4 ,veronal is protected abroad by a trade-mark and in this country by a patent1 and this1 undoubtedly1 is responsible for the introduction of this sodium salt under these fanciful names1 because ,veronal could not be sold without infringing on the patent4 ,this in turn induced the manufacturers of ,veronal1 in self-protection1 also to put the sodium salt on the market1 and now we have it under the name of ,calmine4 ,this probably is only the beginning2 soon we may look for it under a host of other names and the usual result will follow3 thoughtless physicians who have had poor results with it under one name will try it under others4 ,or worse still1 physicians will thoughtlessly combine ,veronal with ,calmine or with ,medinal in the same prescription1 thus giving a dangerous dose4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ad1 #aiaa47 ,,camphenol ,camphenol is made by ,johnson ,johnson1 ,new ,brunswick1 ,n4 ,j4 ,under the name of the article on the carton appears the following formula3 ,c#aj;,h#af,o,c#f;,h#d7;,,ch#c7,,oh,c#f; ,h#e,,oh4 ,this formula consists of the chemical formulas for camphor1 cresol and phenol1 written one after another1 and from this one would conclude that ,camphenol is a compound of camphor1 phenol and cresol in molecular proportions4 ,examination shows1 however1 that ,camphenol is but a modification of the well-known camphorated phenol 7the liquid produced when solid camphor and phenol are triturated together74 ,in ,camphenol a part of the phenol1 in the camphorated phenol1 has been replaced by cresol1 and this liquid has been diluted and emulsified with gelatin or some similar substance and perfumed4 ,in other words1 this preparation is an emulsion containing relatively small quantities of cresol1 phenol and camphor and is another illustration of the attempts of would-be pharmaceutical houses to produce new synthetics in the simplest manner possible--that of writing the chemical formulas of the constituents of a remedy in a way to indicate a chemical combination4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #e1 #aiaj47 ,,chologen ,the proprietary ,chologen is interesting some of our readers and several have sent us samples and literature4 ,dr4 ,philip ,marvel1 ,atlantic ,city1 ,n4 ,j41 for example1 writes3 8,by the way1 ,i am to-day sending you by mail a package which the ,council on ,pharmacy and ,chemistry may care to tackle1 or it may not4 ,i shall not be insulted any way1 but since these chologen preparations are being used a good deal by various globe trotters1 who sometimes hook up for a short stay here1 ,i feel it might be of some interest to know #8what fools these mortals be' and how much the profession is being fooled with them40 ,chologen as a medical treatment for gall-stones has been before the ,german public for a number of years1 and it is somewhat singular that so simple a method1 which could be easily prescribed by the physician if it had merit1 should exhibit such remarkable vitality in proprietary form in spite of evidence going to show that it rests on erroneous principles4 ,the ,council rejected it as an unscientific mixture4 ,the treatment is somewhat liberal1 consisting of the use1 in varying successions1 of three kinds of tablets3 ,no4 #a1 calomel and podophyllin2 ,no4 #b1 calomel1 and ,no4 #c1 calomel1 podophyllin1 camphor and menthol4 ,the proprietors tell us that the treatment should be proceeded with in spite of disturbances1 such as diarrhea and pain in the abdomen1 and that it should be repeated regularly in intervals for some years1 so long as any trouble exists or recurrence is threatened4 8,a course0 of ,chologen tablets should be taken two or three times a year1 ,no4 #a being given for ten days1 then ,nos4 #a and #b for forty days and ,no4 #c for ten days4 ,it is worthy of note that experimental work seems to have been performed in the attempt to show that bile produced by this remedy will cause the disintegration and solution of gall-stones4 ,normal bile has a certain solvent action on gall-stones1 but calomel and podophyllin have no demonstrable effect in increasing the amount of bile4 ,we had imagined that these facts were generally known4 ,it is somewhat discouraging to reflect that some physicians entertain so low an estimate of their ability to prescribe such well-known remedies as calomel and podophyllin that they must use them in the fixed combinations provided by ,dr4 ,glaser4 ,if the self-respecting physician does not consider himself insulted by a proprietary manufacturer who presumes to tell him how to use such well-known remedies1 this is a good sign that he needs to take a postgraduate course in materia medica and elementary prescription-writing4 ,we feel that medical writers must be short of subjects when they devote papers to the exploitation of proprietaries consisting of these simple ingredients4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #a1 #aiac47 ,,hagee',s ,,cordial ,,of ,,cod-,,liver ,,oil,,at ,fraud and ,deception ,connected with ,so-,called ,cod-,liver ,oil ,preparations ,,at ,see also report on ,hagee's ,cordial1 p4 #ea4 ,the introduction of cod-liver oil as a supposedly easily assimilable nutrient and reconstructive was followed by its extensive use in wasting diseases1 especially in phthisis1 in the treatment of which it came to be considered almost essential1 as it was supposed to possess some mysterious power different from that of other oils4 ,its unpalatable character led to various devices to render it tasteless and make it more acceptable to the stomach4 ,emulsions containing the oil in mixture with other substances were put on the market and served a useful purpose4 ,but the oily nature1 imperfectly concealed1 was disagreeable to many1 and gradually other preparations appeared which attempted to retain the supposed therapeutic virtues of cod-liver oil while dispensing with its disagreeable character4 ,this attempt has been carried to the extreme that in many of the cod-liver oil preparations now on the market the oil has been entirely eliminated and all that is left of the oil is the name4 ,this is a species of fraud which has been tolerated too long1 but which will be kept up so long as physicians are willing to be duped4 ,some of these articles are said to 8represent0 the oil and to possess all its virtues4 ,others are said to contain oil1 while still others are stated to contain 8all the valuable constituents40 ,what is the standard by which we may determine the true value of these preparations and by which we may determine whether or not we1 and through us our patients1 are being humbugged8 ,a ,,food ,,or ,,medicine--,,which8 ,is cod-liver oil to be considered a food or a medicine8 ,a food1 certainly4 ,as a food its value will consist in the fats it contains4 ,these fats are more easily oxidizable and are considered more digestible than other fats because of the presence of compounds derived from the liver which favor its emulsification and enable it to penetrate the mucous membrane more easily than other fats4 ,aside from their nutrient properties we have no evidence that the fats of cod-liver oil possess any therapeutic value2 if the oil possesses therapeutic qualities they must reside in its non-fatty constituents1 and the activity of these non-fatty constituents is not acknowledged by those who have investigated them scientifically4 ,most pharmacologists believe that whatever virtue there is in cod-liver oil depends on its qualities as an easily assimilable fat4 ,on the whole1 we must conclude with ,cushny that 8cod-liver oil has not been shown to have any action apart from that of an easily digested food1 and its superiority to some other fats and oils has not been satisfactorily established40 ,if1 then1 the value of cod-liver oil depends on the presence of fat as its nutritive constituent1 the amount of fat a preparation contains will determine the worth or worthlessness of such a preparation2 at all events1 a preparation claiming to represent cod-liver oil which does not contain fat in some form is fraudulent4 ,,how ,,to ,,prove ,,or ,,disprove ,,the ,,presence ,,of ,,cod-,,liver ,,oil ,fats may be changed to fatty acids or to soaps1 as occurs under the influence of pancreatic juice in digestion1 and still retain their nutritive value1 but it is not possible to manipulate them in any way so that they are still valuable as food1 and yet do not respond to easily applied chemical tests which demonstrate their fatty nature4 ,any preparation of cod-liver oil in which fat or fatty acid is not recognizable by proper tests is valueless as food1 since its food value depends on the amount of fat or fatty acid present4 ,an elementary knowledge of chemistry and the application of a few simple tests will enable any physician to learn for himself whether or not a preparation contains fat or fatty acids4 ,the preparations claiming to 8represent0 cod-liver oil are in liquid form1 and if they contain oil it must be one of the following forms3 #a4 ,an emulsion of the oil which may be miscible with water1 but from which the fat tends to separate and rise to the top4 ,in this form the fat can be seen as globules under the microscope4 #b4 ,a solution1 resulting from the saponification of the oil1 containing a soap which usually will be alkaline in reaction1 especially when mixed with water1 and from which fatty acids are separated as a precipitate when the solution is acidified4 #c4 ,a solution of fatty acids4 ,this will be acid in reaction and will be precipitated by the addition of water1 in which the fatty acids are not soluble4 ,hagee's ,cordial of ,cod-,liver ,oil ,hagee's ,cordial of ,cod-,liver ,oil ,compound is said to 8represent #cc per cent4 of pure ,norwegian cod-liver oil10 with other ingredients1 in perfect solution4 ,it is also claimed1 according to the advertising pamphlet1 that 8in this preparation we have every beneficial constituent of the best and purest ,norwegian cod-liver oil40 ,put to the above three tests1 however1 ,hagee's cordial of cod-liver oil is not1 #a1 an emulsion of cod-liver oil2 #b1 is not a saponification of cod-liver oil2 and1 #c1 does not contain fatty acids4 ,it therefore contains no cod-liver oil4 ,the only nutrients in the mixture1 revealed by analysis1 are sugar1 alcohol and glycerin1 none of which is contained in cod-liver oil4 ,in this case the manufacturer misleads by the use of the word 8represents02 he is careful not to say 8contains10 although the average reader would not be apt to notice the nice distinction4 ,the manufacturer unwittingly admits that it contains no oil when he says that it 8contains everything of value except the grease40 ,what else there is of value in cod-liver oil besides the 8grease0 we do not know4 ,certainly1 if we estimate the value of the remedy by its nutrient properties1 it must be set down as practically worthless1 if not fraudulent1 for although a mixture of sugar1 alcohol and glycerin does possess certain nutrient value1 the materials can be purchased for it far more cheaply in the open market4 ,it is evident that claims are made for this preparation which cannot be substantiated4 ,again1 some of the so-called cod-liver oil preparations are termed extracts of cod-liver oil1 but are not in fact made from the oil1 but from the cod-livers instead4 ,they are preparations which1 if honestly made1 might be worthy of trial1 but they are improperly called 8extracts0 of cod-liver oil1 since they do not contain the fat1 which is the active constituent of the oil1 but the extractives from the liver which may or may not possess therapeutic virtues4 ,so far as we know1 however1 no satisfactory evidence is forthcoming to indicate that such extractives have any therapeutic value4 ,the attempt to modify cod-liver oil for therapeutic purposes may be pronounced a failure and the large variety and extensive sale of these preparations appear to be owing to the fact that physicians do not recall the ordinary facts of chemistry and fail to apply simple tests with little technical skill1 but too readily accept as facts the statements of the manufacturers4--7,modified from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ac1 #aijf47 ,,waterbury',s ,,compound ,,once ,,more,,au ,,au ,see pp4 #ed1 #eg and #ddb4 ,most of our readers will remember what ,the ,journal has published about a product that used to be sold as 8,waterbury's ,metabolized ,cod-,liver ,oil ,compound40 ,briefly1 it was shown by a report of the ,council on ,pharmacy and ,chemistry and a contribution from the ,association's laboratory1 that this 8,cod-,liver ,oil ,compound0 contained practically no cod-liver oil6 ,later the federal government declared the stuff misbranded4 ,the product is now sold under the name 8,waterbury's ,compound40 ,it was recently stated in this department that 8,waterbury's ,compound0 was one of the proprietary preparations advertised both in 8display0 form and also in the form of an 8original article10 in the ,army and ,navy ,medical ,record--a fraudulent publication that offered its editorial pages for sale4 ,physicians are now receiving from the ,waterbury ,chemical ,company a reprint of what purports to be an editorial from the ,army and ,navy ,medical ,record entitled1 8,one of ,america's ,most ,valuable ,preparations40 ,the preparation1 of course1 is 8,waterbury's ,compound40 ,the company in sending out this reprint also reproduces on the reverse side the title-heading of the ,army and ,navy ,medical ,record4 ,all of which goes to show that some concerns not only do not mind being found in bad company1 but seem proud of it4 ,by the way1 we wonder whether those physicians who are still prescribing this nostrum think they are prescribing a preparation containing cod-liver oil6--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ae1 #aiac47 ,,collyrium-,,wyeth 8,i should be glad of any information about ,wyeth's ,collyrium and would also like to know if the position taken by this concern measures up to the requirements of the ,council on ,pharmacy and ,chemistry40 ,this inquiry was received from a ,boston physician1 who enclosed with his note the letter quoted below that he had received from ,john ,wyeth ,brother1 ,philadelphia1 the makers of the preparation in question3 8,we have your letter of the #bb;d inst41 in which you request us to send to you formula for #8,collyrium1' and in reply thereto1 beg to advise1 being a corporation you will1 we think appreciate why we are not at liberty to disclose the various formulas under which our preparations are made4 ,such is the competition in the trade that secrecy in this respect is a valuable asset4 8,you will not for a moment think that we take this position through any distrust of your discretion or good faith1 but because we feel that our duty to the stockholders of the company prohibits us from disclosing our formulas4 8,let us assure you however1 that the eyewash contains only the simplest and most harmless remedies well known to the medical profession40 ,john ,wyeth ,brother seek the patronage of the medical profession and desire physicians to use their preparations1 but 8being a corporation0 they 8are not at liberty to disclose the various formulas0 of these preparations4 ,in other words1 they expect physicians of the country to prescribe 8patent medicines0 of whose composition they must be ignorant and to rely wholly on the word of ,john ,wyeth ,brother as to the innocuousness of these products4 ,the letter is an insult to the physician to whom it was written4 ,if physicians were not so apathetic in cases of this kind1 the corporation of ,john ,wyeth ,brother would long since have been forced 8off the fence0--it would have become either a 8patent medicine0 concern or would have confined its activities to the manufacture of pharmaceutical products and ethically exploited proprietaries4 ,now what about this ,collyrium-,wyeth8 ,it was analyzed in the ,chemical ,laboratory of the ,american ,medical ,association and the chemists report3 8,the specimen of ,collyrium-,wyeth examined was a clear1 colorless liquid having a faint odor like benzaldehyd4 ,qualitative tests demonstrated the presence of antipyrin1 free boric acid and sodium borate4 ,acetanilid1 ammonium salts1 glycerin1 nitrates1 phosphoric acid and pyramidon were absent4 ,such potent alkaloids as atropin1 cocain1 homatropin and pilocarpin1 which are often used in ocular surgery1 were not found4 ,preparations of goldenseal were not present4 ,quantitive examination indicated that the composition of the preparation examined is essentially as follows3 8,antipyrin #j4da gm4 8,sodium borate #j4ee gm4 8,boric acid #b4ad gm4 8,water 7by difference7 to make #ajj4jj c4c40 ,the secret of such a formula must indeed be a 8valuable asset60 ,we venture the assertion that if the medical profession did its duty1 the corporation of ,john ,wyeth ,brother would find that its 8duty to the stockholders of the company0 constrained it to abandon secret 8patent medicines0 and to confine its activities to a legitimate line of pharmaceutical products4 ,an examination of the firm's pricelist reveals but a very few secret-formula preparations of the type represented by ,collyrium1 hence it would probably not seriously damage the business of the firm either to eliminate all such formulas from its pricelist or to enable the physician to use them intelligently1 if they deserve it4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ag1 #aiac47 ,,diatussin ,dr4 ,i4 ,fleiss1 ,new ,york1 writes3 8,please state the value of ,diatussin1 of ,bischoff ,co1 in pertussis4 ,since pertussis is such an intractable disease1 anything which promises improvement is apt to attract the physician's attention40 ,according to an advertising circular1 issued by ,e4 ,bischoff ,co1 purporting to be a 8reprint from the ,munich ,medical ,weekly10 ,diatussin is 8444 a dialysate of ,herb ,thymi and ,pinguiculae40 ,the latter is said to be known in the ,alps as 8blue fatweed40 ,the only further information as to the composition of this preparation is the statement that 8the dialysate of this blue fatweed is said by the manufacturer to contain a proteolytic ferment40 ,the writer of the article recounts how1 after trying a host of remedies1 he finally had such success in the treatment of whooping-cough that 8444 a whole procession of mothers with children affected by whooping-cough came to me from a neighboring village1 only because several children from this place had been quickly cured by the dialysate40 ,nevertheless1 while the 8procession of mothers0 appears to have been impressed by the virtues of ,diatussin1 the writer of the article1 rather modestly for contributors of this sort1 admits that 8,i am1 of course1 well aware1 that the small number of cases under my observation allows of no decisive conclusion2 it is only the object of these lines to interest a wider circle in tests40--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ag1 #aiac47 ,,enteronol ,the 8,greatest ,germicide ,known to ,science60 ,this preparation is put on the market by the ,enteronol ,company1 ,oswego1 ,n4 ,y41 which declares that ,enteronol is 8the greatest antiseptic and germicide known to science10 and that it 8destroys the germs of typhoid fever1 acute and chronic diarrhea1 dysentery1 cholera infantum1 cholera morbus1 summer complaint1 ,asiatic cholera1 etc41 within two hours40 ,the formula furnished by the company reads as follows3 8,ipecac1 sub4 nit4 bismuth1 latalia rad41 camphor1 lupulin1 caffein and rheum40 ,the attention of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association was directed to this preparation by a correspondent who had received a circular from the ,enteronol ,company4 ,he sent a dollar to the company asking for a sample of 8latalia rad40 that he might study the drug botanically1 as he was unfamiliar with it4 ,he expected to receive by return mail a sample of root or bark1 but instead1 he received three boxes of ,enteronol and the information that as 8latalia rad40 costs from #be to #de a pound the company could not afford to send samples4 ,in a circular letter sent out by this company 8latalia rad40 is said to grow on the sides of the ,himalaya ,mountains in ,india1 and that the company is unable to obtain enough for its own use4 ,this statement is probably correct1 and no one else could secure the drug either4 ,a sample of ,enteronol was submitted to ,professor ,day1 of the ,university of ,illinois1 and to ,professor ,kraemer of the ,philadelphia ,college of ,pharmacy4 ,professor ,day reports that he was 8unable to find any mention of the drug of #8latalia rad4' which is stated as one of the ingredients of this preparation4 ,i have searched the usual works of reference on pharmacognosy without being able to find any reference to a drug of this name4 ,a microscopic examination of the tablets shows the presence of rhubarb and of ginger1 but no lupulin1 at least not in substance2 nor could ,i locate definitely any ipecac1 also stated to be one of the ingredients4 ,since ginger is not stated to be one of the ingredients of the compound1 it1 perhaps1 may be the mysterious stranger #8latalia rad4' ,i was unable to locate any of the ordinary astringent drugs1 such as kino1 krameria1 or nutgall40 ,the results of ,professor ,kraemer's examination were practically identical with those obtained by ,professor ,day4 ,a report from the chemical laboratory of the ,american ,medical ,association states that as ,professors ,kraemer and ,day suggested the presence of alum1 tests were made for this substance4 ,the analysis1 details of which are given1 leads to the conclusion that alum is the chief constituent of ,enteronol4 ,the report adds strongly to the impression that 8latalia rad40 is simply a ruse to catch the unwary and trusting physician who lacks the time to look into the botany of every new plant discovered1 and who is willing to trust the honesty of every manufacturer4 ,attention is also directed to the fact that while bismuth and caffein are mentioned as ingredients tests made in the laboratory failed to discover either of these substances4 ,since there is no lupulin1 no ipecac1 no caffein1 no bismuth1 and possibly no 8latalia rad40 one is forced to the conclusion that the 8formula0 is meaningless and worthless1 and that it is simply used to satisfy the demand for formulas for proprietary remedies4 ,this is one more beautiful illustration of the absurdity of accepting a preparation because the 8formula is on every package40--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,march #ba1 #aijh47 ,an ,invitation to ,the ,journal to ,humbug the ,profession ,the ,journal has received a circular letter from the ,enteronol ,company1 in which the following liberal offer is made3 8,we are willing to take one-fourth or one-half page #8ad' in your ,journal for a year at the regular rate1 on condition that you accept payment therefor in our ,,guaranteed #g per cent41 preferred stock at par2 or if you desire1 in ,,enteronol at the net wholesale price to physicians40 ,not that this offer is made exclusively to ,the ,journal3 8,a large number of medical journals have accepted the foregoing proposition2 many carrying this advertising for several years already40 8,our company is cooperative2 we paying no cash for advertising4 ,the company is owned principally by physicians1 medical journals1 and druggists40 ,the journals of which we have record that carry the enteronol advertisement are3 ,kansas ,city ,medical ,record1 ,milwaukee ,medical ,journal1 ,toledo ,medical and ,surgical ,reporter1 ,proctologist1 ,pediatrics1 and the ,atlanta ,journal-,record of ,medicine4 ,if the statements made by the ,enteronol ,co4 are true1 we might infer that these journals are being paid for advertising space either with 8preferred stock0 or with the nostrum itself4 ,as we have previously shown1 however1 the veracity of the enteronol advertising matter is by no means unimpeachable4 ,enteronol1 it will be remembered1 was exposed in ,the ,journal1 ,march #ba1 #aijh4 ,it is advertised as the 8greatest antiseptic and germicide known to science10 and possesses 787 such remarkable power that it 8destroys the germs of typhoid fever1 acute and chronic diarrhea1 dysentery1 cholera infantum1 cholera morbus1 summer complaint1 ,asiatic cholera1 etc41 within two hours40 8,the original product is found only high up on the sides of the loftiest mountains in the world--the ,himalayas of ,india40 ,,the 8,,literature0 ,,formula ,of course1 it has a 8formula03 ,ipecac ,lupulin ,sub4 nit bismuth ,latalia rad4 ,caffein ,camphor ,rheum ,this seems very open and above board1 except as to quantities1 until one tries to find out what 8latalia rad40 is2 then it is discovered that it is the 8mysterious stranger0 of pharmacognosy4 ,experts to whom this 8remedy0 was submitted were unable even to find mention of such a drug or plant as 8latalia rad40 ,nor was this the only fake found concerning the stuff2 carefully conducted experiments repeatedly carried out in the ,association's laboratory failed to disclose even a trace of bismuth subnitrate or caffein4 ,these experiments did show1 however1 that the tablets contained an amount of aluminum corresponding to over #be per cent4 of crystallized alum4 ,this led to the conclusion that alum1 whose presence is not even hinted at in the 8formula10 is the chief constituent of enteronol and as a corollary that the formula is meaningless and worthless4 ,,the ,,label ,,formula ,there is a curious lack of coordination between the 8formula0 as printed on the label and that given in the 8literature40 ,the ,food and ,drugs ,act1 it will be remembered1 makes lying on the label illegal1 and therefore dangerous2 statements in advertising matter that does not accompany the product1 however1 are not controlled by that law4 ,the 8formula0 in the 8literature0 we have already given2 the 8formula0 on the label gives the following ingredients3 ,ipecac ,lupulin ,sub4 nit4 bismuth ,opium1 #a_/d gr4 ,caffein ,camphor ,rheum ,two things about this are worth noting3 ,one is that the name of the ingredient on which the manufacturer lays so much stress--latalia rad41 the mysterious ,himalayan plant--is absent from the label4 ,this would seem to indicate that what has already been intimated by ,the ,journal--namely1 that latalia rad4 is a figment of the imagination--is a fact4 ,the second noticeable thing about the label 8formula10 as distinct from the 8formula0 in the advertising matter1 is that on the label we find there is opium in the preparation4 ,why is no mention made of the presence of this potent drug in the advertising matter8 ,to determine how nearly the present statements made by the ,enteronol ,company approximate truthfulness1 our chemists were asked to examine the nostrum as it is now sold4 ,their report follows3 ,,laboratory ,,findings ,an original package of enteronol tablets was purchased on the open market and submitted to the ,association laboratory for examination4 ,in general appearance1 odor and taste the new tablets are similar to those previously examined4 ,the formula for the old tablets was given as 8,ipecac1 ,sub4 nit4 bismuth1 ,latalia rad41 ,camphor1 ,lupulin1 ,caffein1 ,rheum10 and is still used in the circular4 ,but the label on the trade package no longer mentions 8latalia rad40 ,since the presence of 8latalia rad410 in the old tablets1 was questioned1 and as new labels have ceased to display the name1 it was thought possible that caffein and bismuth might now be constituents of enteronol1 as the drugs are still mentioned in the new formula on the label4 ,accordingly1 enteronol was examined chemically to verify the statements on the label regarding the presence of caffein and bismuth in the tablets4 ,the specimen submitted to the laboratory some time ago was found to contain neither bismuth nor caffein4 ,by employing the same methods as were used before 7the usual tests for detecting caffein and bismuth71 neither caffein nor bismuth could be demonstrated4 ,it is thus evident that this new specimen of enteronol1 the statement on the label to the contrary notwithstanding1 contains neither bismuth nor caffein--at least1 in appreciable quantities4 ,one would think that the discrepancy between 8formulas0 and facts would prove of interest to the stockholders of the ,enteronol ,company1 especially as we are told that the policy of the company is to have 8practical men as stockholders40 ,we are informed3 8,therefore1 we have physicians1 advertising experts1 printers1 publishers1 engravers1 boxmakers1 lithographers1 druggists1 lawyers1 traveling salesmen1 officers and men holding executive positions in various manufacturing and commercial corporations1 editors of medical publications1 bishops1 clergymen and missionaries--men from all the fields particularly valuable commercially for our great enterprise40 ,yet if the physician-stockholders do not care to concern themselves about the composition of the nostrum from the sale of which they derive dividends1 it can hardly be expected that the boxmakers or traveling salesmen will be interested4 ,,stock ,,for ,,sale ,medical journals are not alone in being invited to participate in the exploitation of this nostrum1 vide a circular letter from the ,enteronol ,company addressed 8,to ,investors03 8,we offer at par of #aj each1 #a1jjj shares of our ,guaranteed #g per cent4 ,preferred ,stock1 cumulative dividends1 payable quarterly 444 ,profits on business done last year were #ed cents for every dollar expended 444 ,we guarantee absolute security for your investment4 ,safer than a bank40 ,italics ours4--,ed4 ,we are told that at present the ,enteronol ,company manufactures two products3 a castor-oil preparation1 known as fig-ol1 and enteronol4 ,very shortly1 however1 the company expects to 8add seven equally efficient products40 8,the average cost to manufacture1 ready to ship1 a dollar's worth of these goods is less than ten cents40 8,in enteronol alone1 the company has fortunes and the only thing needed to bring tremendous results and dividends of #ajj per cent4 is the proper amount of judicious advertising40 ,here are some samples of the judicious 787 advertising3 8,one ,christian missionary1 the ,rev4 ,paul ,singh of ,jubbulpore1 ,india1 testifies that he cured thirteen severe cases of ,asiatic ,cholera with a box containing less than thirty tablets0 of enteronol4 8,wm4 ,f4 ,oldham1 bishop of ,southern ,asia1 writes us that enteronol cured nine cases out of ten of ,asiatic ,cholera4 ,now just think of ,india and ,china with their #hjj1jjj1jjj people who are dying by the thousands of a disease which we have the power to cure so easily40 ,how like a discourse by that delightful character of ,mark ,twain's--the visionary ,colonel ,sellers--this reads4 ,as he said about his 8,infallible1 ,imperial1 ,oriental ,optic ,liniment03 8,why in the ,oriental countries 444 every square mile of ground upholds its thousands on thousands of struggling human creatures--and every separate and individual devil of them's got the ophthalmia40 ,the prospective stockholder is told that an ordinary business concern reaches the limit of financial possibilities in a few years1 but3 8,not so with the ,enteronol ,company--it is a mail-order business and the world is its territory40 ,even so with ,colonel ,sellers' 8,optic ,liniment03 8444 it's a patent medicine whose field of operations is the solid earth40 ,and we are told elsewhere that 8about four-fifths of the outstanding stock is held by the medical profession alone06 ,and this stuff is advertised in medical journals66 ,we are sometimes in danger of being too optimistic regarding the results of the propaganda for reform in proprietary medicine4 ,cases like this act as a corrective4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bj1 #aiji47 ,,expurgo 7,,sanol7 ,,anti-,,diabetes ,one ,more ,fraudulent ,nostrum for ,diabetes ,expurgo ,anti-,diabetes is sold and advertised in the ,united ,states by the ,expurgo ,manufacturing ,company1 ,chicago4 ,the concern is the ,united ,states branch of a ,canadian company1 the ,sanol ,manufacturing ,company1 ,ltd41 ,winnipeg1 which sells its product in ,canada under the name of 8,sanol ,anti-,diabetes40 ,the parent company is said to have been incorporated under the ,manitoba laws in #aiab and to have for its officers and directors the following men3 ,charles ,beyer1 ,president4 ,frank ,beyer1 ,vice-,president4 ,charles ,bauer1 ,secretary-,treasurer and ,manager4 ,the manager of the ,united ,states branch in ,chicago is said to be one ,e4 ,m4 von ,amerongen4 ,the stuff is such an evident fraud that one would imagine that even intelligent laymen could not be deceived by it4 ,nevertheless medical journals both in the ,united ,states and ,canada have accepted advertisements for this preparation and physicians--of a certain type--have been found to give testimonials for it4 ,the medical profession is circularized widely by the concern and 8write-ups0 have appeared in pseudomedical journals4 ,some of the claims made for ,expurgo ,anti-,diabetes are3 8,the only positive cure for ,diabetes40 8,it never fails to effect a ,cure in every case of this disease1 in whatever form it may present itself provided the patient has not reached the last stages of the malady40 8,expurgo ,anti-,diabetes is the ,new ,cure for this deadly affliction40 8,diabetes is certainly curable by our new discovery--,expurgo ,anti-,diabetes1 provided that the course of the disease has not progressed to the extent that the vital organs are irreparably damaged40 8444 thanks to the discovery of ,expurgo ,anti-,diabetes1 the cure of this dread disease is no longer a matter of doubt40 8,with the exception of very advanced cases of ,diabetes 444 all diabetes can be cured by ,expurgo ,anti-,diabetes40 ,such claims one would imagine would be more than sufficient to make plain1 even to the most uncritical of physicians1 the evident fraudulence of ,expurgo ,anti-,diabetes4 ,nevertheless1 the advertisements of this fraud have appeared during #aiac in the following medical journals3 ,medical ,times ,medical ,brief ,medical ,summary ,buffalo ,medical ,journal ,louisville ,monthly ,journal ,iowa ,medical ,journal ,canada ,lancet ,detroit ,medical ,journal ,medical ,herald ,medical ,review of ,reviews ,medical ,standard ,medical ,review ,therapeutic ,record ,medical ,fortnightly ,indianapolis ,medical ,journal ,southwest ,journal of ,medicine and ,surgery ,western ,canada ,medical ,journal ,dominion ,medical ,monthly ,canadian ,medical ,association ,journal ,canadian ,practitioner and ,review ,massachusetts ,medical ,journal ,physicians will recognize that1 with but few exceptions1 most of these journals are utterly unrepresentative of scientific medicine4 ,the ,army and ,navy ,medical ,record1 shown in ,the ,journal recently as a journalistic fraud1 contained an editorial puff of ,expurgo ,anti-,diabetes4 ,the fact that the ,expurgo ,company reprints the 8editorial0 from the ,army and ,navy ,medical ,record as a 8voluntary and unsolicited reference0 and distributes it among physicians1 indicates how rotten are the props on which the superstructure of this fraud rest4 ,another alleged 8voluntary and unsolicited reference0 used by the ,expurgo ,company is taken from the ,therapeutic ,record of ,louisville1 ,kentucky4 ,the advertising pages of the ,therapeutic ,record reek with frauds and it has more than once given editorial endorsement to some of the frauds that it advertises4 ,the following enlightening letter is alleged to have been written by the editor of the ,therapeutic ,record to the ,expurgo ,company in ,february1 #aiac3 ,gentlemen3--,your favor of ,february #adth came duly to hand4 ,let me advise you to pay no earthly attention to the proceedings of the ,medical ,society where your product was criticized4 ,these people exert no influence with the practical up-to-date element of the profession and are doing you as they do others4 ,never fear--you will succeed--your remedy is all right4 ,no man can talk down a meritorious product4 ,i stand ready to help you in any way at any time4 ,with sincere regards1 ,i am1 ,robert ,c4 ,kenner1 ,m4,d41 ,editor1 the ,therapeutic ,record4 ,this1 it will be noticed1 was written in ,february4 ,soon thereafter the ,therapeutic ,record was carrying the ,expurgo advertisement1 and the ,june1 #aiac1 issue contained a puff on ,expurgo1 entitled 8,a ,contribution to the ,medical ,treatment of ,diabetes40 ,the quid pro quo is fairly evident4 ,,the ,,alleged ,,formula ,the formula for this nostrum is never published1 although in some of the advertising matter it is claimed that it is 8at the disposal of physicians40 ,a physician wrote to the ,expurgo ,manufacturing ,company1 asking for the formula4 ,he was told that the preparation was 8exclusively derived from the vegetable kingdom10 from which one may recognize a family likeness to the 8dope0 put out by the immortal ,lydia ,pinkham4 ,further1 to copy the letter exactly3 8,the ingredients of which ,antidiabetes is composed are chiefly3 8fructus syzigii jambulani 8cortex syzigii jambulani 8flores ,rosmarini 8fructus ,anisi stellati 8,extr4 fl4 ,col 8,extr4 fl4 ,condurango 8,extr4 fl4 ,chin spir4 spiss4 8,extr4 fl4 ,calami 8,extr4 fl4 ,gentian40 ,the recipient of this noncommittal and uninforming 8formula0 again wrote the ,expurgo ,manufacturing ,company1 asking for quantities4 ,evidently this nostrum concern considered such a request a piece of impertinent inquisitiveness1 for it replied to the physician in these terms1 given verbatim et literatim3 8,dear ,sir3--,yours of the #afth duly to hand4 ,we note that you state #8444 ,i do not like to be working in the dark1 and you can readily see that this is the case unless ,i know how much of each ingredient ,i am giving4444' 8,in your letter of the #fth you asked for the composition1 which you promptly received4 ,we would like to state that we are dealing with about #fjj ,doctors4 ,some of them asked for the formula1 which they received4 ,they are all very conscientious gentlemen and none of them ever pretended #8to work in the dark4' ,you know furthermore that none of these ingredients is harmful in any way and yet #8work in the dark4' ,you know that if there were any harmful ingredients in our preparations1 we would expose ourselves to imprisonment4 ,if you are so anxious to know all about it1 why do you not analyse our medicine8 ,this would enlighten you in your #8perfect darkness4' ,if you want to deprive your patients and yourselves of the indisputable good of our preparations1 simply do not prescribe them4 ,why finally do you not write to the ,doctors whose names we gave1 who know enough to be able to enlighten those who need it4 ,truly yours ,the ,expurgo ,mfg4 ,co41 ,c4 ,m4 v4 ,amerongen1 ,manager4 ,more than a year ago1 a ,wisconsin physician1 himself a sufferer from diabetes1 wrote ,the ,journal that for three months he had been using ,expurgo ,anti-,diabetes which the ,expurgo people had sent him4 ,he declared that the nostrum had greatly reduced the percentage of sugar in his urine4 ,in its reply1 ,the ,journal asked him whether1 in testing his urine he had used portions of twenty-four hour specimens or merely individual specimens4 ,his attention was called to the fact that most of the nostrums for diabetes are diuretics which1 by increasing the amount of urine passed1 give an apparent decrease in the amount of sugar excreted4 ,a few days later1 the physician wrote again1 stating that he had committed the very error ,the ,journal had suspected1 and reporting that an examination of a twenty-four-hour specimen showed that the glucose-excretion1 instead of being diminished1 actually increased4 ,this matter was referred to editorially in ,the ,journal1 ,nov4 #i1 #aiab1 under the title1 8,a ,possible ,fallacy in ,testing ,diabetic ,urine40 ,specimens of ,expurgo ,anti-,diabetes were examined in the ,association's laboratory and the chemist's report follows3 ,,laboratory ,,report ,illustration3 ,the letter head of the ,expurgo ,manufacturing ,co4 ,note the claim that ,expurgo ,anti-,diabetes is 8the only positive cure for diabetes40 ,and this stuff is foisted on the profession through the medical press6 8,the specimen of ,expurgo ,anti-,diabetes 7,sanol ,anti-,diabetes7 examined1 was a light-brown1 opaque liquid1 having a faintly aromatic odor and bitter taste4 ,the specimen contained considerable amounts of brown1 insoluble residue resembling the deposits often found in fluid extracts4 ,the absence of ammonium salts1 iodids1 glycerin1 hexamethylenamin1 of antipyrin1 pyramidon and similar substances and of such purgatives as aloes1 frangula1 rhubarb1 etc41 was indicated4 ,potent alkaloids such as aconitin1 cocain1 morphin and strychnin were not found4 ,qualitative tests indicated the presence of traces of phosphates1 sulphates1 reducing sugars1 caffein and cinchona alkaloids4 ,alcohol was present only in traces4 ,small quantities of chlorids1 sodium and a salicylate were found4 ,the residue on drying amounted to #b4i gm4 in each #ajj c4c4 ,a determination of the salicylic acid indicated approximately #j4ag gm4 in each #ajj c4c41 which is equivalent to less than #j4b gm4 of sodium salicylate per #ajj c4c4 7about #a grain to the ounce74 ,evidently the preparation contains plant extractives in aqueous solution and small amounts of sodium salicylate and sodium chlorid40 ,summed up1 the chemist's report shows that ,expurgo ,anti-,diabetes is essentially a watery solution of plant extractives with small quantities of sodium salicylate and salt4 ,the exploiters claim their stuff contains the fruit and bark of jambul1 rosemary1 star anise and fluid extract of calamus1 cinchona1 cola1 condurango1 and gentian4 ,since fluidextracts in general are strongly alcoholic and since the laboratory's analysis shows that the preparation contains only traces of alcohol1 the fluidextracts of the various drugs1 if present at all1 must be in an infinitesimal amount4 ,jambul was in vogue as a remedy for diabetes about twenty years ago4 ,it was tried and found wanting1 and has long since been relegated to the therapeutic scrap heap4 ,sanol1 therefore1 is but one more proprietary humbug1 foisted on the profession under fraudulent claims1 and having for its essential constituent a drug that has long been discarded by scientific men and resurrected for the purposes of quackery4 ,expurgo will probably be used by uncritical and unthinking physicians and its existence will be artificially prolonged through the venality of pseudo-medical journals4 ,that the medical profession should tolerate such an evident fraud is not to its credit4 ,there is no excuse1 either moral or otherwise1 for a physician giving his patients nostrums of whose composition he is ignorant1 and that is what is done whenever ,expurgo ,anti-,diabetes is prescribed4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bd1 #aiad47 ,,formamint ,the ,profession to ,be ,worked ,again ,formamint ,tablets are widely advertised and extravagantly exploited to the laity in ,great ,britain4 ,large and expensive advertisements appear in the ,english magazines and newspapers and the tablets are pushed under the most preposterous claims4 ,the preparation is put out1 we understand1 by the same concern that exploits ,sanatogen4 ,the medical profession of this country is now being circularized and advertisements are appearing in medical journals4 ,they already appear in the ,medical ,record1 ,new ,york ,medical ,journal and ,american ,journal of ,clinical ,medicine4 ,it seems then that this is another product which1 for the time being at least1 is to be a 8patent medicine0 on the other side of the ,atlantic and an 8ethical proprietary0 on this4 ,doubtless the distinction will be a temporary one and as soon as ,american physicians have furnished the requisite number of testimonials and have recommended it to a sufficient number of their patients the advertisements will be quietly dropped from the ,american medical journals and the advertising pages of newspapers and magazines will be called into service4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bg1 #aiab47 ,the ,so-,called ,germ-,killing ,throat ,tablet ,formamint tablets have recently been put on the ,american market by the same concern that exploits ,sanatogen1 the 8food tonic0 or 8tonic food0--according to whether one reads ,european or ,american newspapers4 ,formamint tablets are being introduced to the ,american public by that cheapest of all methods of advertising 8patent medicines10 through the medical profession4 ,it is not advertised in ,american newspapers or lay magazines--at present4 ,for some years this product has been advertised in newspapers and other periodicals in ,europe under such claims as the following3 8,formamint shields humanity against infectious disease40 8,cures and prevents sore throat40 8,the dangers of infection from diseases like diphtheria1 scarlet fever1 measles1 tonsillitis1 sore throat1 mumps1 etc41 have now been reduced to an absolute minimum4 ,this is due to the discovery of ,wulfing's ,formamint--the #8germ-killing throat tablet4'0 8,cleanses the mouth and throat from disease germs as easily and rapidly as dirt is removed from the skin40 8,formamint will certainly prevent diphtheria40 8,quickly render the whole mouth and throat thoroughly antiseptic40 8,formamint destroys these diphtheria germs so rapidly that when a physician mixed a little ,formamint with water and added it to the germs taken from the throat of a patient dangerously ill with diphtheria they were all killed within ten minutes40 ,such are some of the claims by which ,formamint goes to the ,european public4 ,doubtless it will be only a matter of time when the required number of testimonials from ,american physicians are forthcoming when we may expect to find the newspapers of this country heralding through their advertising pages the fact that ,formamint is 8recommended by thousands of ,american physicians40 ,the medical journals that are lending their pages to this preliminary advertising campaign are the following3 ,new ,york ,medical ,journal ,medical ,record ,american ,medicine ,american ,journal of ,clinical ,medicine ,medical ,review of ,reviews ,how much longer will the medical profession permit itself to be used as an unwitting agency for the exploitation of 8patent medicines08 ,the game has been worked so often that it has become transparently thin4 ,it is evidently not worn out1 however1 or shrewd nostrum promoters would not waste their time or money on it4 ,that it should still be considered workable is complimentary neither to the standard of advertising ethics of medical journals that accept the ,formamint advertisements nor to the intelligence of the members of the medical profession who will 8fall for it40--7,the ,journal ,a4 ,m4 ,a41 ,feb4 #bd1 #aiab47 ,,gomenol ,a correspondent sends some advertising matter on ,gomenol and calls attention to the number of diseases for which the preparation is recommended3 ,gomenol is apparently a volatile oil4 ,it is a proprietary said to come from ,france1 and to be prepared from a species of cajuput 7,melaleuca viridiflora1 ,gaertn474 ,this plant is closely related to the cajuput tree or swamp tea-tree 7,melaleuca leucodendron1 ,linn7 from which the official oil of cajuput is obtained4 ,the oils from these two plants are very similar in composition and presumably in therapeutic properties4 ,the oil of the first-named plant appears not to be marketed except in the form of the proprietary1 ,gomenol4 ,it probably has no advantage over the official oil of cajuput1 while in the form of ,gomenol it costs about four times as much4 ,the following are some of the claims made for ,gomenol in the advertising circulars4 ,they need no comment4 8,a real specific for suppurations and catarrh4444 ,it immunizes tissues1 excites their vitality and favors the formation of new cells4444 8,the least trace of ,gomenol prevents the growth in vitro of the streptococcus1 the tuberculous bacillus and the gonococcus40--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #d1 #aiad47 ,,headache ,,cures,,av ,harmful ,effects of ,acetanilid1 ,antipyrin and ,acetphenetidin ,,av ,see also report on ,acetanilid ,mixtures1 p4 #i4 ,the ,united ,states ,department of ,agriculture ,bulletin#ajg ,no4 #abf1 issued ,july #c1 #aiji1 sets forth the results of an investigation conducted by the ,bureau of ,chemistry with regard to the harmful effects of acetanilid1 antipyrin and acetphenetidin4 ,during recent years the use of these remedies and preparations containing them by the people at large1 without the supervision of the physician1 has increased rapidly and investigation has shown that coincidently there has been a marked increase in the number of cases of poisoning reported1 in the number of fatalities1 and in the number of instances of habitual use4 #ajg ,the ,harmful ,effects of ,acetanilid1 ,antipyrin and ,phenacetin1 by ,l4 ,f4 ,kebler1 ,ph4,g41 ,m4,d41 chief ,division of ,drugs1 ,bureau of ,chemistry1 with the collaboration of ,drs4 ,f4 ,p4 ,morgan and ,philip ,rupp1 assistant chemists4 ,since the passage of the ,food and ,drugs ,act1 ,june #cj1 #aijf1 the attention of the ,department of ,agriculture has been directed to this subject1 particularly in connection with the branding of drug products containing one or more of these agents1 and an attempt has been made to obtain full and reliable data with regard to their poisonous qualities with the object of furnishing information to the public which would enable them to understand that these remedies should be employed with caution in the absence of reliable medical advice4 ,the information obtained with regard to the number of an inquiry addressed to medical practitioners in the ,united ,states with regard to their personal experience with these drugs2 and1 second1 the study of the cases of poisoning recorded in medical literature4 ,nearly a thousand letters1 each containing eighteen questions1 were addressed by the department to physicians throughout the country1 the object being to secure information which would represent as closely as possible the conditions existing among the people at large so far as the harmful effects of the drugs in question are concerned4 ,four hundred replies were received4 ,the information obtained with regard to the number of instances quoted in medical literature in which poisoning1 death1 or habitual use has been known to result from the administration of acetanilid1 antipyrin1 and acetphenetidin is set forth in ,section ,a of the accompanying table4 ,the information summarized in ,section ,b is based on the data submitted by physicians4 ,granting that the #ebe physicians who did not reply had no cases to report1 the question may profitably be asked1 if #ibe physicians have observed #had cases of poisoning by these drugs1 #bh deaths which are attributed to their use1 and #acf instances of habitual use1 how many such cases have in all probability been observed by the #abe1jjj physicians scattered throughout the ,united ,states8 ,the summary1 ,c1 includes both the number of cases recorded in medical literature and those reported by physicians4 ,,poisoning ,,by ,,acetanilid1 ,,antipyrin ,,and ,,phenacetin ,a4--,cases ,recorded in ,medical ,literature ,,habitual ,,poisoning4 ,,death4 ,,use4 ,acetanilid #big #ac #cb ,antipyrin #dhh #aj 44 ,acetphenetidin #gj #c #a --- -- -- ,total #hee #bf #cc ,b4--,data ,submitted by ,physicians ,,habitual ,,poisoning4 ,,death4 ,,use4 ,acetanilid #fad #af #aab ,antipyrin #aje #e #g ,acetphenetidin #ie #g #ag --- -- -- ,total #had #bh #acf ,c4--,total ,number of ,cases ,,habitual ,,poisoning4 ,,death4 ,,use4 ,acetanilid #iaa #bi #add ,antipyrin #eic #ae #g ,acetphenetidin #afe #aj #ah ---- -- --- ,total #a1ffi #ed #afi ,the bulletin contains information with regard to dosage1 the extent to which these drugs are employed by physicians1 poisoning and habitual use1 the nature of the ill effects produced1 etc4 ,it also contains references to the recorded cases of poisoning1 together with a brief abstract of each case4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #ca1 #aiji47 ,sanatoriums and the ,acetanilid ,habit ,to the ,editor3--,i enclose herewith a 8form0 letter and question blank which ,i received recently from ,st4 ,louis4 ,i may be entirely too wary but ,i am suspicious that this is a collection of 8statistics0 to combat the work of the medical profession in educating the physician and the laity in the harmfulness of acetanilid and similar preparations4 ,g4 ,h4 ,benton1 ,m4,d41 ,chester1 ,w4 ,va4 ,sterling-,worth ,sanitarium4 ,comment3 ,the letter which ,dr4 ,benton encloses is in facsimile form and purports to come from ,uriel ,s4 ,boone1 ,m4,d41 of ,st4 ,louis1 who states that he is 8preparing an exhaustive article for publication in a leading medical journal0 on the question1 8,is acetanilid a habit-forming drug80 ,to obtain the necessary data ,dr4 ,boone is 8writing to every hospital and sanitarium in the ,united ,states40 ,examination of the question blank which accompanies the form letter discloses the fact that information is wanted regarding not acetanilid alone1 but also antipyrin and acetphenetidin 7phenacetin74 ,the last question asked runs as follows3 8,if your records of cases of habitual use of these drugs are incomplete1 would you allow a reputable physician to investigate the above-mentioned cases so that he could write with positiveness about them1 and1 if necessary1 make oath to the truth of his report80 ,italics ours4--,ed4 ,dr4 ,boone opines that the recipients of his queries 8may hesitate to answer0 the question just quoted1 but he trusts that its importance will be evident when he explains that 8it is currently reported that the manufacturers of acetanilid1 phenacetin1 etc41 have decided to prosecute all libelers of these drugs0 ,italics again ours4--,ed4 and he wishes to make no statement that he 8can not substantiate under oath40 ,surely the life of the collector of medical statistics is unusually hazardous4 ,for the purpose of aiding ,dr4 ,boone in his arduous search for truth on the 8much mooted question1 #8,is acetanilid a habit-forming drug8'0 we direct his attention to a work that should prove of invaluable assistance4 ,we refer to ,bulletin #abf of the ,bureau of ,chemistry1 entitled 8,the ,harmful ,effects of ,acetanilid1 ,antipyrin and ,phenacetin40 ,this interesting study to which we have previously called attention records #aab cases of the acetanilid habit4 ,of this number at least #ej1 or #dd4f per cent4 of the cases were those of patients who took proprietary preparations of the drug4 ,from this we would not wish to give any bias to ,dr4 ,boone's statistics4 ,we hardly expect1 however1 that such will be the case4 ,dr4 ,boone's name appears as the author of an article entitled 8,a ,therapeutic ,study of ,antikamnia and ,heroin ,tablets0--an article that has been very extensively 8quoted0 and has been sent out in its entirety by the ,antikamnia ,chemical ,company4 ,under these circumstances we may be forgiven if we venture the opinion that ,dr4 ,boone is not likely to be unduly prejudiced against 8headache tablets0 in general and fake 8synthetic0 coal-tar mixtures in particular4 ,we await with breathless interest the appearance of ,dr4 ,boone's 8exhaustive article0 and we must confess to some degree of curiosity regarding the name of the 8leading medical journal0 in which these valuable data will appear4--7,modified from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ad1 #aiji47 ,,hectine ,hectine is a ,french proprietary and is stated to be1 chemically1 sodium benzosulphoamino-phenyl-arsenate4 ,if the asserted composition is correct1 ,hectine is similar to atoxyl1 which is described in ,new and ,nonofficial ,remedies1 #aiad1 page #ch4 ,hectine has not been examined by the ,council on ,pharmacy and ,chemistry4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #h1 #aiad47 ,,hydronaphthol ,a correspondent having requested information regarding the composition of 8,hydronaphthol10 the product was investigated in the ,association laboratory1 which reports as follows3 ,hydronaphthol is sold by ,seabury ,johnson4 ,the label on a trade package of ,hydronaphthol gives no clew as to the nature of the product4 ,the statements on the labels do1 however1 make the claim that ,hydronaphthol is an antiseptic of great power1 also that it is non-toxic and therefore may be used with impunity2 thus the following statements are made3 8,a harmless1 practically odorless1 non-poisonous1 non-corrosive antiseptic44440 8444 it is non-poisonous and can be employed with perfect immunity as a preservative44440 ,the substance has the characteristic appearance1 odor and taste of naphthol4 ,it responded to all the tests of the ,united ,states ,pharmacopeia for betanaphthol1 with the exception of the melting point1 which was found to be #aai ,c4 instead of #abb ,c41 an indication of impurity4 ,it is evident1 therefore1 that ,hydronaphthol is merely a trade-name for betanaphthol4 ,while resublimed betanaphthol is listed at #aj cents an ounce1 ,hydronaphthol is listed at #ge cents an ounce4 ,hydronaphthol thus furnishes one more illustration of the fact that most proprietary medicines for which the most extravagant claims are made are but old and well-known remedies sold under a fancy name at a price far in advance of that charged for the constituent or constituents4 ,the exploiters are extremely positive in their statements regarding the non-toxic character of the preparation4 ,yet1 as a matter of fact1 betanaphthol is by no means harmless2 it has been absorbed by the diseased skin with injury to the kidney and with fatal results4 ,in some cases injury to the eye has also occurred4 ,these toxic actions should be known to the practitioner4 ,from #c to #d gm4 7#a dram7 applied to the skin has produced death 7,stern3 ,therap4 ,monatshefte1 #aijj1 p4 #afe74 ,when a manufacturer advertises a preparation which possesses potentialities for harm1 and especially when he puts it out under a name which conceals its identity1 it is incumbent on him to warn the customer of possible injurious or inconvenient actions instead of proclaiming that the preparation is harmless4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #c1 #aiaj47 ,,hydrozone ,the moral principle governing the action of secret proprietary and patent medicine men is an unknown quantity2 sometimes it would seem to be a negative one4 ,just how much lower in the scale of humanity a man can go than to prey on the fears of a people in the time of a terrible epidemic for the sake of a few dollars we do not know4 ,there may be something more despicable1 but what is it8 ,two weeks ago we referred to the cold-blooded methods of the ,peruna people2 this week we reproduce an advertisement from the ,new ,orleans ,states that tells another story of man's inhumanity to man4 ,illustration ,this brings up the problem that we are trying to solve1 viz43 8,what is the difference between a #8secret proprietary medicine' advertised in medical journals to physicians and a #8patent medicine' advertised in newspapers to the public80 ,hydrozone is being advertised in nearly all medical journals1 and at the same time in newspapers4 ,where shall we place it8 ,and if hydrozone1 with the methods recently adopted to exploit it1 is tolerated in the medical press1 why not peruna8 ,,hypoquinidol ,an examination of the advertising matter fails to show that ,r4 ,w4 ,gardner makes any definite statement in regard to the nature or the composition of his ,hypo-,quinidol4 ,certain statements made in the literature sound much as if the article might be some sort of a quinin hypophosphite preparation4 ,but if this is true1 its action would be the same as other salts of quinin and the extravagant claims made could not be substantiated4 ,it is said to be a 8non-toxic quinin40 ,it is safe to say that a quinin which will not produce the toxic symptoms--cinchonism--either is not absorbed in sufficient quantity or has been so changed that it no longer has the therapeutic properties of quinin4 ,altogether ,hypo-,quinidol must be put down as a preparation the composition of which is kept secret and regarding which extravagant and highly improbable statements are made4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #aj1 #aiad47 ,,iodonucleoid ,an ,iodin ,product ,under a ,misleading ,name ,information has been frequently asked concerning ,iodonucleoid1 a product not included in ,new and ,nonofficial ,remedies4 ,the ,association ,laboratory after investigating this preparation reported as follows3 ,this preparation was at one time considered for inclusion with ,new and ,nonofficial ,remedies1 and at that time was examined in this laboratory4 ,the examination showed that iodonucleoid contains3 ,phosphorus #j4gi per cent4 ,calcium #j4dc per cent4 7,equal to #j4f per cent4 ,ca,o74 ,iodin #bd4b per cent4 ,when #b gm4 was dissolved in tenth-normal potassium hydroxid volumetric solution and acetic acid added until faintly acid1 an abundant1 white1 flocculent precipitate formed4 ,this precipitate was collected1 washed with water1 transferred to a beaker1 phenolphthalein added and tenth-normal potassium hydroxid volumetric solution run in until a pink color was produced4 ,this required #ae c4c4 of tenth-normal alkali4 ,subtracting from the #b gm4 of iodonucleoid the #bd per cent4 iodin1 leaves #a4eb gm42 this divided by the c4c4 of alkali used indicates an equivalent weight of #ajac4 ,authorities differ widely regarding the amount of phosphorus contained in nuclein from different sources1 the figures ranging from #b4i per cent4 to as high as #aj per cent4 ,if the nuclein from which iodonucleoid purports to be made contained but #b4i per cent4 phosphorus1 the preparation1 after allowing for #bd per cent4 iodin1 should still contain #b4b per cent4 phosphorus instead of the #j4gi per cent4 found by analysis4 ,a true nuclein should contain no calcium4 ,if iodonucleoid is a casein compound of iodin we might expect to find1 if the casein had been freed from milk by acidulation without further purification1 both calcium and phosphorus4 ,the equivalent weight of casein is given by ,long 7,jour4 ,am4 ,chem4 ,soc41 #aijf1 xxviii1 #cgb7 as #aabd4 ,this figure was obtained on a casein of high purity1 and the figure of #ajac given above agrees fairly well with ,long's figure for casein4 ,the evidence1 therefore1 indicates that iodonucleoid is a compound of iodin and casein1 and not a nuclein compound4 ,the findings of the laboratory were at that time submitted to ,prof4 ,john ,h4 ,long of ,northwestern ,university1 who said3 8,we have also made a number of examinations of iodonucleoid4 ,we determined in it the iodin and found the amount #bd4b per cent4 by weight1 which is a little more than that claimed by the manufacturer4 ,we have also tested the solubility of this substance and find it to behave about as your laboratory did4 ,as you know1 we have been making a number of preparations from casein1 and recently we have determined the combining power of casein with various acids1 including hydriodic acid4 ,this acid when evaporated in moderately strong solution with casein yields finally a hard1 dry mass1 which may be ground up to a powder resembling very closely the preparation under discussion4 ,various amounts of iodin may be combined here1 depending on the strength of the iodin solution used1 and we have secured some containing over #ce per cent4 of iodin4 ,several of these preparations resemble closely iodonucleoid1 so far as solubility1 appearance and reaction with alkalies on titration are concerned4 ,i am unable1 therefore1 to distinguish this preparation from the casein compounds which we are making40 ,from this it would appear that iodonucleoid is not a compound of nuclein1 as indicated by the name1 but instead is a casein compound of iodin4 ,iodonucleoid1 then1 seems to be another one of the many iodin 8substitutes0 which have been put on the market4 ,other iodin substitutes are ,iodalbin1 manufactured by ,parke1 ,davis ,co42 ,iodipin manufactured by ,e4 ,merck ,co41 and ,sajodin1 manufactured by the ,farbenfabriken of ,elberfeld ,co4 ,as these products have been examined by the ,council and found eligible for inclusion with ,new and ,nonofficial ,remedies1 physicians who wish to use substitutes for potassium iodid would do well to use them instead of a product presented under a misleading name4 ,physicians should understand1 however1 that these organic iodin compounds are non-irritating because the iodin is held in such combination that it is much less active4 ,it seems probable that they are therapeutically active only to the extent that the iodin content is dissociated from the organic compound and concerted into ionic iodin4 ,a discussion of a number of iodin substitutes is found in an article by von ,notthafft 7,monatsh4 f4 prakt4 ,dermat41 ,oct4 #ae1 #aiaj1 p4 #cdc71 which was abstracted and commented on in ,the ,journal1 ,march #d1 #aiaa1 p4 #fhe4 ,von ,notthafft believes that the lower degree of toxicity which these remedies exhibit has its basis in a feebler activity2 either the substitutes evolve too little iodin or they split it off with greater difficulty4 ,physicians should1 therefore1 view with some distrust the claims of manufacturers that their products are not only non-irritating but at the same time possess unusual therapeutic efficiency4 ,this will apply with especial force if there is any tendency to conceal the nature or origin of the combination4--7,the ,journal ,a4 ,m4 ,a41 ,july #bb1 #aiaa47 ,,iridium ,dr4 ,c4 ,a4 ,dexter1 ,columbus1 ,ga41 asks for information concerning the use of iridium in the treatment of acute and chronic rheumatism4 ,iridium is a well-known element although we have not found that it has been used as a medicine2 however1 we presume our correspondent refers to 8,iridium 7,medicinal710 sold by the ,platinum ,company of ,america4 ,we are not able to locate this company1 but in their advertising circular 8,iridium 7,medicinal70 is said to be 8an agent for the blood1 a laxative1 an alterative1 indicated in all disorders of the stomach1 in ,jacksonian epilepsy10 and 8a specific in rheumatism40 ,as to its origin1 it is said in the circular1 8the platinum sands are associated with and composed of iridium0 and some other elements1 so that as far as the circular gives information the nostrum is alleged to contain the element iridium4 ,a few statements quoted from the circular will show that the person who wrote it knows nothing about medicine and cannot correctly use the ,english language3 8,the qualifications of ,medicinal ,iridium are its simplicity1 purity1 harmless under prolonged use1 easily borne by the stomach40 8,it has been observed that when ,medicinal ,iridium acts as a laxative1 it will regulate the same40 8,called the family group1 ,iridium and ,osmium are destined to become the world's benefactors in medicinal properties1 thereby creating a new chapter in medical science40 ,the circular quotes some supposed 8excerpts from hundreds of letters on file1 written by physicians1 in the hope that they may attract your attention10 which bear marks of having been written by the same person who wrote the circular4 ,note the quality of the following statements3 8,iridium has a power1 purity and simplicity that pleases me2 now ,i can make progress40 8,i say to you frankly1 ,iridium is my standard4 ,i can get results and make progress4 ,i am confident it aids the fibrin in the blood40 8,dr4 ,x is pushing ,iridium on five or six cases40 ,it is not explained who ,dr4 ,x is1 but it has this to say about him3 8,dr4 ,x is an eminent practitioner4 ,he has made a remarkable record with ,iridium and has so far never failed on cases of ,jacksonian epilepsy2 experimental tests have shown that ,iridium increases blood-corpuscles40 ,the man who signs himself president of the ,platinum ,company of ,america is said to be a lawyer1 but is not working at it1 and was formerly a promoter1 fiscal agent1 etc4 ,it should not be difficult for the physician to fix the status of iridium under this sort of exploitation4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bc1 #aiaj47 ,,iron ,,tropon ,the composition of ,iron ,tropon seems to have varied from time to time4 ,the manufacturers formerly stated that it contained fat1 sugar1 pepsin and iron in organic combination with albumin1 and its use was advocated both as a food and as a medicine4 ,it was not claimed to contain over #a per cent4 of pepsin1 but tests failed to show that it contained any pepsin1 or if any1 such a small amount that there was not sufficient to digest the albumin in ,iron ,tropon itself4 ,it was also claimed that the iron1 being in organic combination with the albumin1 possessed advantages over the widely used aromatic fluid preparations of iron4 ,tests1 however1 showed that the iron was not in organic combination1 though even had it been1 late investigations fail to demonstrate the superiority of the organic over inorganic iron compounds4 ,the manufacturers state in their later 8literature0 that ,iron ,tropon is a tonic and a food2 that it is a compound of the food albumin tropon1 #b4e per cent4 of iron in its most assimilable form1 and enough chocolate to flavor it agreeably4 ,it will be noted that they now make no claim for pepsin1 nor do they state that it contains iron in organic form4 ,in the dose recommended1 a teaspoonful three times a day for an adult1 the patient gets something over a grain of iron1 and he might as well take an equivalent quantity of ,blaud's mass1 the value of which has been proved4 ,as a food1 ,iron ,tropon1 weight for weight1 is about equal to beans and a little better than flour1 although it contains a larger percentage of protein than either4 ,in the dose stated1 an invalid would get about #ej calories1 or about #a_/dj the necessary nourishment for a day4 ,tests have also shown that the albumin is difficult of digestion4 ,in spite of this fact1 the advertisement of ,iron ,tropon states3 8,a patient who takes ,iron ,tropon receives not only the benefit of iron medication1 but at the same time his economy is supplied with perfectly assimilable albumin in sufficient quantity40 ,it will thus be seen that the claim for pepsin in this preparation has been abandoned1 that the statement as to the iron being in organic form has been modified1 and that the food value of the albumin is exaggerated2 but perhaps the manufacturers do not expect the physician to apply his arithmetic to such problems4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bc1 #aiaj47 ,,kutnow',s ,,powder ,which ,is ,it1 a 8,proprietary0 or a 8,patent ,medicine08 ,the term 8patent medicine0 has been applied1 rather loosely1 to those nostrums sold and exploited directly to the public1 while the name 8proprietary0 has been given such preparations as are advertised only to the medical profession4 ,as has been many times exemplified by reports in ,the ,journal1 the distinction is often a very fine one and the dividing line frequently reaches the vanishing point4 ,it is not unusual1 for instance1 for 8proprietary0 preparations to be foisted on the medical profession until a certain number of testimonials 7of doubtful value1 it is true1 but still testimonials7 have been ingeniously wheedled out of physicians and the product rather generously prescribed4 ,when this objective point has been reached the manufacturer comes into the open and advertises the nostrum to the public direct and the testimonials previously given for the 8proprietary0 are used as advertising assets for the 8patent medicine40 ,then again there are certain preparations which are 8proprietaries0 or 8patent medicines0 according to the location4 ,on one side of the ,atlantic the product is advertised to physicians only1 while on the other side it runs indiscriminately on the billboards and in the newspapers4 ,one of the best examples of this last class is ,kutnow's ,powder4 ,in ,england1 where it originated1 this preparation1 which 8dissolves and eliminates uric acid10 is consistently lined up with ,beecham's ,pills and ,pink ,pills for ,pale ,people4 ,full-page newspaper advertisements announce the fact that free samples will be ---------------------------- 8,,sent ,,to ,,all ,,applicants0 ---------------------------- ,in the ,united ,states1 however1 ,kutnow's have learned from their wide advertising experience that a cheaper and surer way of introducing a nostrum to the public is to advertise it to the medical profession only4 ,by means of advertisements in medical journals 7whose space is much less expensive than that of the daily papers7 and the liberal distribution of samples which are ---------------------------------- 8,,sent ,,free ,,to ,,physicians ,,only0 ---------------------------------- the medical profession becomes the unpaid 8barker0 for the nostrum manufacturer4 ,at present1 therefore1 ,kutnow's ,powder is--in the ,united ,states--an ethical 767 8proprietary40 ,illustration ,there exists in this country1 as most of our readers know1 an organization of 8patent medicine0 manufacturers whose 8reason for being0 is to get full value received for the #dj1jjj1jjj paid annually in advertising nostrums in the newspapers of the country4 ,this organization is known as the ,proprietary ,association of ,america4 ,the now familiar 8red clause0 in the advertising contracts by which the newspaper forfeits its contract if state laws are enacted that are inimical to the 8patent medicine0 interests1 is a creation of this organization and has been most effective in making the newspapers the unpaid lobbyists of the nostrum interests4 ,the 8silence clause0 is another 8joker0 in the contracts by which the agreement is canceled if matter detrimental to the nostrum 8is permitted to appear in the reading columns0 of the paper4 ,it is little wonder that with such weapons the 8patent medicine0 manufacturer has assumed an arrogance that is as disgusting as it is serious4 ,great ,britain1 too1 has its 8patent medicine0 men's organization1 which is known as the ,proprietary ,articles ,trades ,association4 ,of both these honorable bodies ,mr4 ,s4 ,kutnow of ,kutnow ,brothers1 ,ltd41 is1 or was1 a conspicuous member4 ,at a recent meeting of the ,british organization1 ,mr4 ,kutnow worked himself into a fine frenzy of indignation because of some articles that had appeared in the ,pharmaceutical ,journal of ,london on the subject of 8,secret ,remedies and ,proprietaries40 ,as these articles did not specifically mention ,kutnow's ,powder1 and as evidence was directed against only those preparations as were most disreputable1 it is evident that ,mr4 ,kutnow now appraises his own product at its face value4 ,he gave his opinion of the ,pharmaceutical ,journal and told the meeting that when the advertising man for that journal solicited advertising he refused to have any more dealings with him owing to the articles that had appeared in the ,pharmaceutical ,journal4 ,he declared that he was quite independent of any newspaper or journal1 and was able to take care of himself4 ,therein ,mr4 ,kutnow is mistaken2 he is not independent of newspapers and journals4 ,on the contrary1 he and others of his ilk are most subserviently dependent on them4 ,let reputable papers and medical journals refuse1 for but one year1 to carry the high-flown advertisements of his ,anglo-,american ,patent-,proprietary1 and his firm would perforce seek some worthier1 if less profitable1 line of business4 ,the editor of the ,pharmaceutical ,journal resents ,mr4 ,kutnow's 8implied assumption that by inserting paid announcements in the advertising columns of a newspaper1 he or any one else1 can dictate the policy of that organ40 ,the ,pharmaceutical ,journal1 it should be said1 is the official organ of the ,pharmaceutical ,society of ,great ,britain1 and is the most influential organ of the drug trade in the ,british ,isles4 ,it is refreshing to note1 in these days of 8canned0 editorials and paid 8write-ups0 masquerading as original articles1 that there is still to be found a journal that can not be bought4 ,one wonders whether a large experience in the advertising world1 and especially his membership in the ,proprietary ,association of ,america1 has unconsciously led ,mr4 ,kutnow to assume that muzzling the press is one of the perquisites of the large purchasers of advertising space4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ca1 #aijg47 ,,lymph ,,compound ,r-,h ,,and ,,orchitic ,,fluid ,,tablets ,a physician wrote ,the ,journal3 8,i have under my care a patient with chronic parenchymatous nephritis4 ,microscopic examination shows occasional epithelial casts1 with hyaline and granular casts4 ,the patient feels well and appears to enjoy the best of health4 ,please give me your opinion on the use1 in such a case1 of the lymph injections put out by the ,animal ,therapy ,company of ,chicago1 from whom ,i have just received a supply of literature40 ,the ,journal replied as follows3 8,the ,council on ,pharmacy and ,chemistry took up for consideration the #8,lymph ,compound ,r-,h1' and #8,orchitic ,fluid ,tablets1' sold by the ,animal ,therapy ,company and refused them recognition4 8,the treatment of a case of chronic parenchymatous nephritis is a task requiring the best judgment and the greatest knowledge that the physician can command4 ,from the first his aim should be to do no harm1 and with this in view he will recognize that since we do not know the cause of this disease1 and since we are unable to influence the essential process in the kidney1 the administration of a remedy capable of doing harm should be undertaken only under the clearest indications4 ,it is probable that the remedy proposed1 containing1 it is asserted1 a mixture of foreign proteins1 might injure healthy kidneys1 to say nothing of sick ones4 ,it is well known that foreign proteins1 such as the white of egg1 if they enter the circulation unchanged1 are excreted by the kidney and are liable to produce serious irritation1 which in the case of parenchymatous nephritis might easily aggravate the existing condition and frustrate all other efforts at a cure4 ,more especially is it imperative to do no harm when1 as in the case reported by our correspondent1 the patient appears to be in good health4 ,two questions should be raised in that case4 ,first1 is there any evidence that the occasional excretion of a few casts1 whatever may be their variety1 is actually doing the patient any harm8 ,and second1 since there are no symptoms1 what possible improvement could be expected from treatment8 ,it is admitted that we have no remedy which can affect an essential change in the condition of the diseased kidney4 ,what must be done in such a case is to spare the kidney--to require of it the minimum of functional activity4 ,in such a case1 the physician who introduces an animal protein1 foreign to the human system1 would be taking a serious responsibility4 ,the chances are that it would do harm2 how great1 no one can tell4 ,if the physician can really make up his mind to experiment at the risk of the life of his patient1 this case appears to be one unusually favorable to the manufacturer of the serum4 ,there are chances that the diagnosis may be incorrect and that such a condition of the urine does not indicate a serious condition of the kidney4 ,it is frequently the case after an acute infection1 or some similar irritation1 that the kidney continues for some time to excrete albumin and casts1 but the condition eventually clears up4 ,in such a case1 if the serum did no harm it would be given the credit of curing the patient1 who recovers in spite of it4 ,it is a little unfortunate1 however1 for the purpose of such demonstration that the patient is said to feel well4 ,if only he could be persuaded that he has a serious disease so that he might be somewhat depressed mentally1 the effect of the cure would be more remarkable6 8,if the physician to whom such a patient comes for advice1 instead of taking the wise course of seeking reliable information1 were to take at their face value the statements of interested commercial manufacturers--if he were to administer this unknown and dangerous remedy1 the effects of which he cannot predict--he would commit a breach of trust more culpable than the most vicious attempts of the nostrum-maker to mislead the physician and the public40--7,from the ,journal ,a4 ,m4 ,a41 ,dec4 #ad1 #aiab47 ,,lysol-,,the ,,evolution ,,of ,a ,,proprietary ,regarding certain proprietary preparations and their equivalents found in the pharmacopeias or other standard works of reference1 it is often questioned whether the proprietary is the original and the official preparation the imitation1 or vice versa4 ,as a general proposition1 medicinal compounds and preparations are not born but evolved1 as in the case of epinephrin1 in which the credit of discovery belongs to no one person1 but to several4#ajh ,so it is often the case that the proprietary and official preparations may be based one on the other1 while both are usually based on some preparation which antedates them4 ,this is well illustrated by the proprietary preparation ,lysol1 the practical equivalent of which--liquor cresolis compositus--is official in the ,united ,states ,pharmacopeia4 ,after the discovery of phenol 7carbolic acid7 and the recognition of its germicidal value1 it was gradually learned that other phenolic compounds occurring in the crude distillates from tar and wood were more efficient and less poisonous than phenol 7carbolic acid74 ,when this was discovered1 attempts of course were made to utilize these higher and more efficient phenols1 which meant that their insolubility in water had to be overcome4 ,in these attempts there were efforts to form new compounds as well as a search for simple solvents4 ,while the first failed1 because these compounds were less efficient than the phenol from which they were made1 a simple solvent was found in soap4 ,the first attempt to utilize the solvent power of soap gave creolin1 a mixture of the so-called crude carbolic acid 7really containing but little phenol and consisting largely of higher phenols along with inert hydrocarbons7 with soap4 ,this was followed in #ahhd by ,schenkel's discovery that a portion of this 8crude carbolic acid0 could be made soluble in water by treatment with soap4 ,schenkel was refused a patent on the ground that any soap manufacturer should be permitted to add phenol to his soap1 but in #ahhi a patent for a cresol-soap solution was granted to ,damann1 who used cresol1 a constituent of 8crude carbolic acid40 ,the preparation was put on the market and has since been widely advertised under the proprietary name 8,lysol40#aji ,it is thus seen that ,lysol is a good example of the way in which manufacturers appropriate the discoveries of others1 develop them and turn them to proprietary use4 #ajh ,the ,journal ,a4 ,m4 ,a41 ,march #be1 #aiaa1 pp4 #ija1 #iaj4 #aji ,pharm4 ,ztg41 ,oct4 #ad1 #aijh1 p4 #hag4 ,the ill-deserved patent protection for ,lysol happily expired long ago and the product can now be made by anyone4 ,in view of the non-descriptive character of the name 8,lysol0 and the danger in using such names in connection with potent and poisonous remedies1 this cresol-soap solution has been admitted to pharmacopeias1 not under the original name 8,lysol10 but under descriptive names such as that in the ,united ,states ,pharmacopeia--8liquor cresolis compositus40--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ad1 #aiab47 ,,thompson',s ,,malted ,,food ,,company ,and ,its ,blood1 ,nerve and ,tissue ,builder1 8,hemo0 ,during the past eighteen months ,the ,journal has received inquiries from physicians in various parts of the country asking for information regarding 8,thompson's ,malted ,food ,company0 of ,waukesha1 ,wis41 which for some time has been selling and trying to sell its stock to physicians and others4 ,in reply ,the ,journal called attention to the fallacy of any concern trying to induce people to purchase its stock on the ground that the ,bromo-,seltzer company1 the ,postum ,cereal company and others had been successful4 ,illustration3 ,a miniature reproduction of a full-page advertisement of 8,hemo0 appearing in a ,milwaukee paper4 ,the original covered #cda square inches4 ,the earlier name for the ,thompson concern was 8,american ,malted ,food ,company0 and originally it had its office and factory in ,milwaukee4 ,its products are 8,malted ,milk10 8,malted ,beef-,peptone0 and 8,hemo40 ,as long ago as #aiaa the company was sending out glowing descriptions of the money that might be expected to be made by investing in the concern1 which was then known as the ,american ,malted ,food ,company4 ,according to the company's booklet it was estimated that in the ,united ,states and ,canada alone #bj1jjj1jjj worth of dry malt food products were consumed annually4 ,further3 8,on the most conserving estimate the ,american ,malted ,food ,company will supply #e per cent4 of the demand or #a1jjj1jjj of the consumption from the very outset44440 ,at the time this was written 7#aiaa7 the company claimed that its stock had 8been advanced over #ajj per cent4 in one year's time0 and that even then it had 8found it advisable to curtail the sale of stock so as not to exceed the prescribed number of shares to any one person40 ,in #aiad1 however1 the company still had its representatives in the field offering stock for sale4 ,in ,november1 #aiac1 one physician wrote that three years previously he had purchased stock in the company and at that time 7#aiaj7 was given to understand that dividends would be paid in at least a year6 ,he has received no dividends to date4 ,other physicians have written that the company's agents in attempting to sell stock have given the impression that the concern either is paying dividends or is about to pay dividends4 ,still other physicians say that the agents made no claim to them that the concern was paying dividends4 ,to quote from a few of many letters together with the date of the communications3 8,alluring promises of big profits in the near future have been held out by the canvassers44440 7,september1 #aiac74 8,no actual promise was made but it was #8estimated' that dividends would be declared #8about the first of the year'0 7,november1 #aiac74 8,after ,i said ,i wouldn't buy any stock was told the company was already paying dividends and ,i was turning down a good thing40 7,march1 #aiad74 8,the agent gave me to understand that the profits of the company were enormous and that large dividends would be paid in the near future40 7,march1 #aiad74 8,mr4 ---- the agent told me the company expected to pay dividends as soon as all the stock had been sold40 7,may1 #aiad47 8,the agent gave me to understand that they were about to pay very generous dividends and that it was a chance to get in on the ground floor on a good thing40 7,may1 #aiad74 ,the price asked for stock during the past year or more has been #a4ej a share1 the par value of the stock being held at #a4jj4 ,at various times1 however1 the stock seems to have been purchasable from other sources at a much lower figure4 ,a physician writing ,september1 #aiac1 stated that he had just been solicited to purchase stock in the ,thompson ,malted ,food ,company at #a4ej a share1 and that immediately he wrote to two firms1 one in ,chicago and one in ,milwaukee1 that sell unlisted securities1 asking the price of ,thompson's ,malted ,food ,company stock4 ,both brokers expressed the opinion1 according to the physician1 that at #ij cents a share the stock would be a 8good buy10 and both offered to undertake to secure stock at that price4 ,one of the concerns sent a circular to the physician offering the stock at #hj cents4 ,the physician thereon canceled his order for stock which he had made at #a4ej and declared that if he bought at all he would buy from other sources4 ,,hemo ,at the present time the product that ,thompson's ,malted ,food ,company seems to be 8pushing0 is a product it calls 8,hemo40 ,according to advertisements1 ,hemo is 8the food that builds up weak stomachs40 ,hemo1 we are told1 contains 8the iron of spinach1 the juices of prime beef1 the tonic properties of selected malt in powdered form and the richest sweet milk40 ,furthermore1 8,hemo contains the active principle of selected barley malt 4440--whatever the 8active principle0 of barley malt may be4 ,according to the ,thompson ,malted ,food ,company 8#hj per cent4 of the ,american citizens0 are 8troubled with anemia0 and it is for them that 8,hemo has been especially prepared40 ,in a sentence3 8,it is a well-known fact that organic iron can be obtained from animal life as well as from vegetable life1 and as the digestive organs of a majority of the people are not equal to the task of supplying their bodies with a sufficient amount of organic iron to maintain a supply of a good quality blood1 the lack of which results in numerous nervous ailments--insomnia1 diabetes1 rheumatism1 anemia1 tuberculosis1 etc41 it has been found necessary to secure for mankind organic iron in a form that will be concentrated1 palatable and most easily assimilated40 ,this is a sample of the farrago of pseudo-scientific nonsense sent out by this concern in its attempt to sell 8,hemo40 ,to continue the quotation3 8,with this object in view1 the laboratories of ,thompson's ,malted ,food ,company have successfully produced and successfully tried out ,hemo on the most desperate cases40 ,in a letter addressed to a physician-stockholder1 the statement is made3 8,our ,hemo-,malted ,milk has never had and never will have an equal as a builder of blood1 nerve and tissue 444 it will build tissue1 nerve and blood in less time than any other food heretofore known40 ,disregarding the question whether or not this is a stock jobbing scheme or whether the purchase of the stock is a good investment1 there is another side to the matter4 ,it must be evident that the public is not getting a square deal when physicians are financially interested in the products they prescribe for1 or recommend to1 the sick4 ,whatever the value of the ,thompson products1 the method of exploitation and the attempts on the part of the company to get physicians financially interested in its ventures1 are to be deprecated4 ,if laymen of a speculative turn of mind wish to invest in the stock of companies putting out 8bottled energy10 8blood builders0 and 8nerve repairers0 that is their business1 but it is certainly neither conducive to the scientific practice of medicine nor to the interest of the public for physicians to be financially interested in products of this sort4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bd1 #aiad47 ,,manola ,physicians as ,unpaid ,pedlers of ,nostrums ,one of the most disheartening features of the fight against the proprietary evil within the profession is the slowness with which physicians awake to their responsibilities in the matter4 ,it is a notorious fact1 familiar to physicians against advertising men alike1 that the simplest and cheapest way to introduce a nostrum to the public is through the instrumentality of the medical profession4 ,ever since the birth of the proprietary evil in this country1 shrewd manufacturers have persuaded doctors to act as unpaid pedlers for their wretched nostrums and to become particeps criminis in the exploitation of such wares4 ,manola is an alcoholic nostrum with just enough more or less inert medicinal products added to exempt it from the internal revenue tax1 but not enough to prevent its being used as a tipple by those who object to taking their 8toddy0 in a simpler form4 ,it is prepared by the ,luyties ,pharmacy ,company of ,st4 ,louis1 a homeopathic concern whose hahnemannian leanings are not so strong but that it is willing to cater to the various sectarian schools of medicine as well as to the regular profession4 ,since the promoters realize1 doubtless1 that to put this stuff out under a homeopathic label might not be conducive to stimulating physicians' confidence1 ,manola is labeled3 8,prepared only by the ,manola ,company1 ,st4 ,louis40 ,in other words1 it is the old dodge of forming subsidiary companies for the purpose of hiding the identity of the real owners4 ,in this connection1 it is worth reminding our readers1 incidentally1 that the ,walker ,pharmacal ,company1 ,st4 ,louis1 is another subsidiary concern of the ,luyties ,pharmacy ,company1 created for the purpose of pushing another nostrum--,hymosa4 ,manola is seldom advertised in medical journals4 ,instead the ,luyties ,pharmacy ,company has discovered a more effective method of 8putting one over0 on physicians and druggists4 ,the method which has been pursued for years and which1 under the same title and subtitle that head this article1 was exposed in ,the ,journal as long ago as ,may #f1 #aije1 consists in sending to physicians a letter containing three postcards--unstamped1 of course4 ,with the postcard there is a slip that reads3 ,,instruction ,,for ,,obtaining #c ,,bottles ,,of ,,manola ,,free ,dear ,doctor3 ,fill out the attached cards ,nos4 #a and #b4 ,mail ,no4 #a to us and hand ,nos4 #b and #c to your druggist4 ,impress upon him the necessity of mailing postal card ,no4 #c direct to us1 and not to his jobber4 ,yours truly1 ,,the ,,manola ,,company4 ,the postcards are numbered1 respectively1 #a1 #b and #c4 ,here is ,no4 #a3 ,illustration3 ---------------------------------------- ------------- #a ,mail ,this ,card to the ,manola ,co41 ,st ,louis1 ,mo4 ,date #ai ,,the ,,manola ,,company ,st4 ,louis1 ,mo4 ,gentlemen3 ,i have requested ,mr4 druggist1 to order one dozen bottles of ,,manola for my prescription4 ,please include with his order three bottles for me1 as per your offer4 ,,dr4 ,,chicago ,,ill4 ---------------------------------------- ------------- ,dr ,ezymark writes the name of his druggist on ,card #a1 puts a stamp on it and mails it to the ,manola ,company1 alias ,luyties ,pharmacy ,co4 ,card #b1 addressed to his druggist1 also is filled out by ,dr4 ,ezymark4 ,here it is3 ,illustration3 ---------------------------------------- ------------- #b ,please ,hand ,this ,card to ,your ,druggist ,mr4 ,druggist4 ,please order of the ,manola ,company1 ,st4 ,louis1 ,mo41 #a dozen bottles of ,manola1 all of which ,i agree to prescribe in my practice4 ,by filling out card ,no4 #c and forwarding it to the ,manola ,company1 ,st4 ,louis1 ,mo41 they will include for me1 with your order1 three bottles of ,manola1 free1 for clinical purposes4 ,yours truly1 ,m4,d4 ,town ---------------------------------------- ------------- ,then the doctor1 acting the part of errand-boy1 delivers ,card #b and also ,card #c to his druggist4 ,here is ,card #c3 ,illustration3 ---------------------------------------- ------------- #c ,,please ,,fill ,,out ,,and ,,mail ,,this ,,card ,,to ,,the ,,manola ,,co41 ,,st4,,louis1 ,,mo41 ,,not ,,to ,,your ,,jobber ,date #ai ,,the ,,manola ,,company1 ,st4 ,louis1 ,mo41 ,gentlemen3 ,please ship me_/us as per your offer #a ,,dozen manola ,,at #h4jj per dozen4 #a_/d dozen ,,manola1 free1 for ,dr4 ,ship through my jobber3 ,m ,signed ,druggist4 ,town ,town ,state ,state ---------------------------------------- ------------- ,this1 ,mr4 ,goat1 the druggist1 has to fill out1 affix a stamp and send to the ,manola ,company4 ,in return for all this1 ,mr4 ,goat has his shelves loaded up with a dozen bottles of ,manola and1 for that privilege pays #h out of his own pocket4 ,dr4 ,ezymark gets three free bottles4 ,incidentally1 he also gets the contempt of his druggist--and of such patients as learn of it4 ,the only one who profits by all this is the ,luyties ,pharmacy ,co41 alias the ,manola ,co41 alias the ,walker ,pharmacal ,company4 ,evidently this method of exploitation pays2 that it does pay is a disgrace to the medical profession4 ,to those physicians who have in the past acted as pedlers for ,manola we would say3 ,if your patients really need sherry wine let them purchase it under its own name and at the ordinary market price4 ,you will then know what they are getting and you will be able to retain not only your own self-respect but also the respect of your druggist and the public4 ,the ,composition of ,manola ,examination of ,manola in the ,association laboratory indicates that its composition is consistent with its origin1 for its medicinal ingredients are present in truly homeopathic quantities4 ,the laboratory report follows3 ,an examination of an original bottle of ,manola gave the following results3 ,specific gravity at #be ,c4 #a4jcbi ,alcohol #ah4jj per cent4 by vol4 ,non-volatile matter 7residue on evaporation7 #ae4ic gm4 in #ajj c4c4 ,ash 4#if gm4 in #ajj c4c4 ,phosphoric pentoxid 7,p#b,o#e7 4#jffh gm4 in #ajj c4c4 ,total alkaloids 4#jjdg gm4 in #ajj c4c4 ,calcium ,traces4 ,magnesium ,traces4 ,iron ,traces4 ,sodium ,traces4 ,arsenic ,traces4 ,manola is a light amber colored liquid having the odor and taste of sherry wine4 ,the above analysis indicates that it is nothing more than wine1 fortified with alcohol and a slight amount of medicinal substances added4 ,the non-volatile matter appears to be nearly all sugar1 glycerin1 or some similar substance and the presence of less than one gram of ash to #ajj c4c4 excludes the presence of more than a small amount of organic salts4 ,from the amount of phosphorus found there appears to be about one dose of phosphoric acid to a twenty-ounce bottle4 ,arsenic is present in such small amounts that the ordinary hydrogen sulphid test failed to show its presence and the delicate ,gutzeit's test had to be used to detect it4--7,modified from ,the ,journal ,a4 ,m4 ,a41 ,april #b1 #aiaj47 ,,mercol ,r4 ,hunt and ,a4 ,seidell1 ,washington1 ,d4 ,c41 report the result of an examination of a preparation called ,howell's ,mercol1 manufactured by ,h4 ,b4 ,howell ,co41 ,ltd41 ,new ,orleans1 and claimed to be a #a per cent4 solution of mercuric iodid in a non-irritating neutral menstruum1 and recommended for hypodermic use in the treatment of syphilis4 ,their examination indicates1 as they say1 8that although the manufacturers of ,mercol may have used a mercuric iodid in its preparation1 they have not succeeded in obtaining a #a per cent4 solution of this compound in their #8non-irritating neutral menstruum4' ,it is furthermore evident that the sample examined as above outlined contains none1 or at most only traces1 of biniodid of mercury40 ,it is stating it mildly to say that a manufacturer is careless who claims to make an efficient preparation of what is almost a specific for one of the most serious of diseases but which contains practically none of the essential active ingredient4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #af1 #aiji47 ,the ,component ,parts and the ,finished ,product ,after the appearance of the first article1 a physician wrote stating he had seen ,mercol manufactured1 following the process in detail and had himself weighed out a sufficient quantity of mercuric iodid to produce a #a per cent4 solution4 ,he protested that the firm 8had no desire to foist on the medical profession or the public a fraud40 ,with his letter he sent a sample of the particular batch of ,mercol which he had seen manufactured4 ,this sample was analyzed with the same care and thoroughness that the previous sample had been1 and the practical absence of mercuric iodid was again demonstrated4 ,while ,the ,journal does not question the honesty and good faith of either the manufacturers or the physician1 it maintains that claims for remedial agent should be based on the finished product rather than on the component parts used in its manufacture4 ,without attempting to explain what has become of the mercuric iodid1 it insists that the important fact1 and the one that vitally concerns both patient and physician1 is that the finished product fails to contain it4 ,if the manufacturer has made an honest mistake in supposing he could produce a #a per cent4 solution of mercuric iodid in liquid petrolatum1 he will doubtless see that the mistake is corrected4 ,if1 on the other hand1 he is governed by commercial considerations only1 the misrepresentation will probably be perpetuated4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ae1 #aiji47 ,,midol ,,and ,,nurito ,pyramidon ,entering the ,patent-,medicine ,field ,repeated warnings to the public of the dangers of acetanilid1 antipyrin and acetphenetidin and the requirement in the ,food and ,drugs ,act which makes it obligatory to declare the presence of acetanilid and acetphenetidin on the labels of 8patent medicines10 have been responsible for the growing unpopularity of nostrums containing these drugs4 ,,midol ,during the past few months advertisements have appeared in the newspapers of a new 8headache cure10 the advertising slogan of which is that it 8contains no acetanilid or phenacetin40 ,the name of this preparation is ,midol and it is sold under the following claims3 8,instantly relieves headache1 neuralgia1 toothache40 8,has no depressing effect40 8,more effective than antipyrin1 acetanilid1 phenacetin or similar pain-relieving products40 8,midol is the one safe-to-take aid of sufferers of headache40 8,quickly relieves pain of whatever nature40 8,there is no cumulative action40 8,no bad effect upon the heart or other organs40 ,an original package of ,midol was purchased and examined in the ,association laboratory4 ,the chemists' report follows3 8,midol is sold in the form of white tablets each weighing1 on an average1 #j4dbe gm4 or about six and one-half grains4 ,the tablets are soluble in water1 chloroform or benzene to the extent of about #hj per cent4 ,the soluble portion appeared to be largely composed of starch1 with about #d4e per cent4 of some inorganic matter1 probably talc4 ,the chloroform soluble portion was found to consist chiefly of pyramidon1 chemically known as dimethyl-dimethylamino-pyrazolon4 ,besides pyramidon1 the chloroform soluble matter contained a small quantity of caffein and may have contained small amounts of other substances4 8,from examination it is concluded that ,midol depends essentially on pyramidon for its therapeutic effect40 ,pyramidon is a proprietary preparation derived from1 and having the antipyretic and anodyne properties of1 antipyrin4 ,while some observers have asserted that it is more likely to cause collapse than are either antipyrin or acetphenetidin there is no positive evidence of this assertion4 ,that the use of pyramidon has been until recently practically restricted to physicians may account for the fact that its toxic effects are not as well known as are those of antipyrin1 acetphenetidin1 acetanilid1 etc41 which for some years have been indiscriminately used by the public4 ,as the use of pyramidon as a 8patent medicine0 now bids fair to become as general as the better known antipyretics1 it is probable that its toxicology will become better known4 ,it is interesting to note that pyramidon in the form of ,midol is put on the ,american market by the ,general ,drug ,company1 which also acts as a distributor of salvarsan 78#fjf074 ,the ,general ,drug ,company is said to have for its president1 ,w4 ,m4 ,hoge1 who was formerly employed in the comptroller's office during the administration of ,herman ,a4 ,metz1 and the latter being employed by the ,consolidated ,color and ,chemical ,works and being president of ,victor ,koechl ,co4 ,the ,general ,drug ,company1 in its price list to physicians1 lists the 8ethical proprietary0 pyramidon1 but contains no mention of its 8patent medicine0 ,midol4 ,,nurito ,midol is not the only 8patent medicine0 in which pyramidon is the essential drug4 ,nurito1 which is advertised as 8not a patent medicine but a proprietary preparation10 is a nostrum put on the market by the ,magistral ,chemical ,co41 ,new ,york4 ,here are some of the claims3 8,only ,u4 ,s4 ,p4 ingredients are used in ,nurito40 8,guaranteed to relieve or your money refunded1 ,rheumatism1 ,sciatica1 ,neuritis40 8,there is no compound known in medicine that so rationally1 scientifically and effectively removes waste and poisons from the human system as ,nurito40 ,the ,association's laboratory recently analyzed a specimen of ,nurito4 ,the report follows3 ,a dollar-size package of ,nurito was purchased and found to contain seven powders4 ,the powders ranged in weight from #i to #ab grains1 the average weight being nearly #aa grains4 ,the presence of pyramidon1 phenolphthalein and milk sugar was demonstrated4 ,alkaloids1 acetanilid1 acetphenetidin1 chlorids1 bromids1 iodids1 heavy metals1 starch and sulphates were absent4 ,quantitative examination indicated that the composition of ,nurito is essentially as follows3 ,milk sugar #cd per cent4 ,phenolphthalein #f per cent4 ,pyramidon #fj per cent4 ,each powder1 therefore1 contains about #b-b_/c grains of milk sugar1 #b_/c of a grain of phenolphthalein and #f-b_/c grains of pyramidon4 ,what was said of pyramidon in the preceding article applies equally well here4 ,the claim that ,nurito is composed of 8,u4 ,s4 ,p4 ingredients0 is evidently a falsehood4 ,the chief therapeutic ingredients are pyramidon and phenolphthalein1 neither of which is described in the ,united ,states ,pharmacopeia4--7,from the ,journal ,a4 ,m4 ,a41 ,aug4 #aj1 #aiab47 ,,mu-,,col ,salt and ,borax as ,wonder-,workers 8,mu-col1 for ,cleansing ,mucous ,membranes0 is a nostrum put on the market by the ,mu-col ,company 7,inc471 ,buffalo1 ,new ,york4 ,as a specimen of the claims made for the preparation1 the following is typical3 8,mu-col obtains most gratifying results in catarrhal inflammations of the mucous membranes4 ,leucorrhea1 ,tonsillitis1 ,sore ,throat1 ,cystitis1 ,internal ,hemorrhoids1 ,nasal ,catarrh and ,pus ,cases respond at once to irrigation with ,mu-col solution4 ,strong solutions of ,mu-col have proven of sterling value in treating ,hives1 ,prickly ,heat1 ,ivy ,poison1 ,sunburn1 ,eczema1 ,typhoid and ,scarlet ,fever40 ,this1 and much more ,mu-col will do--according to its manufacturers6 ,no wonder physicians want to know the composition of ,mu-col4 ,as the manufacturers do not give this information the aid of the ,association's ,laboratory was invoked4 ,let the chemists speak3 ,,laboratory ,,report 8,the specimen examined was a white powder1 and from the odor1 thymol1 eucalyptol1 camphor and oil of wintergreen could be recognized4 ,qualitatively sodium1 chlorid and borate were found4 ,zinc1 benzoate1 phenolsulphonate and sulphate could not be found4 ,the solution was alkaline to litmus4 ,gravimetric determination of chlorid as silver chlorid and titration of borax by ,thompson's method indicated sodium chlorid 7,na,cl7 #dg4b per cent41 sodium borate 7,na#b;,b#d,o#gaj;,h#b,o7 #ej4a per cent4 8,it thus appears that ,mu-col is a mixture of ordinary salt and borax in equal parts with the addition of a small amount of aromatic substances40 ,mu-col will do just what a solution of salt and borax will do--no more1 no less4 ,and yet1 it is claimed3 8,mu-col has been successfully used since the year #aijj by more than #ej1jjj physicians1 which has proven it to be the most ,efficient1 ,economical and acceptable1 preparation in its field40--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #g1 #aiad47 ,,narkine ,the ,intangible ,product of the ,tilden ,laboratory ,a little book1 published by the ,druggists ,circular1 and called 8,modern ,materia ,medica10 gives in dictionary form the information regarding new remedies which that journal publishes in its monthly issues4 ,such information is not always acceptable to the manufacturers of various preparations of doubtful value4 ,a case in point is brought to notice with reference to a remedy called ,narkine1 put out by the ,tilden ,company of ,st4 ,louis4 ,in this little book the following appears3 8,narkine is described as #8an opium preparation from which all deleterious qualities have been eliminated'2 an unsupportable claim1 as all opiates and other hypnotics are essentially deleterious40 ,the ,tilden ,company wrote to the ,druggists ,circular1 stating that they guaranteed ,narkine 8to be absolutely free from coal-tar or opium derivatives10 yet the 8literature0 of the company describes it as 8a specially prepared product of opium devoid of the nauseating and disagreeable properties of this drug1 yet possessing the anodyne and soporific principles of same in the highest degree40 ,to remove from opium all its derivatives and yet retain the anodyne and soporific principles attached to nothing in particular1 indicates a degree of pharmaceutical skill seldom attained4 ,one is irresistibly reminded of the ,cheshire cat in 8,alice in ,wonderland10 whose smile remained long after the cat had vanished4 ,the absurdity of the thing1 however1 has apparently not occurred to many physicians1 for these disembodied spirits of the pharmacologic world are evidently being prescribed4 ,the ,druggists ,circular is to be congratulated on exposing this latest pharmaceutical freak4 ,it does so in a rather striking manner by means of photographic reproductions of the claims of the ,tilden ,company4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bd1 #aijh47 ,,papine ,a ,disguised ,morphin ,solution ,to the thinking physician it should be evident that a preparation containing morphin must possess not only all of the valuable properties of this drug1 but also all of the objectionable ones4 ,there are still some physicians1 apparently1 who give credence to the assertions of the manufacturers concerning the morphin preparation from which1 it is claimed1 all of the undesirable morphin effects have been removed4 ,the following query from a correspondent illustrates this fact3 8,will you inform me as to the contents of #8,papine'8 ,i have a case of chronic interstitial nephritis1 and my consultant insists on giving this preparation4 ,i asked him if he knew what drugs it contained and his answer was #8one-eighth of a grain of morphin with the objectionable parts of the drug removed4'0 ,the query was referred to the ,association ,laboratory1 which submitted the following report3 ,for many years ,papine has been advertised by its makers1 ,battle ,company1 ,st4 ,louis1 as an anodyne4 ,in the circulars ,papine is described in part as follows3 8,papine represents in pharmaceutical form the purely anodyne principles of opium freed from the narcotic and tetanising constituents40 8,papine is the anodyne or pain-relieving principle of opium1 the narcotic and convulsive elements being eliminated4 ,one fluid drachm is equal in anodyne power to one-eighth grain of morphin40 8,through special methods of preparation1 the anodyne and analgesic principles of ,papaver somniferum are so extracted as to free them of the narcotic and convulsive elements that ever have been1 and must ever continue to be serious objections to the use of opium and its common derivatives4444 ,no demand is more regularly made on the physician than that for the relief of pain1 and to be able to afford it promptly and completely1 without the slightest deleterious action1 is an advantage that cannot be overestimated40 8,unlike most derivatives and preparations of opium1 ,papine neither nauseates nor constipates2 nor does it inhibit the secretory functions of the body40 8,in conditions of extreme nervousness1 especially in women1 recourse to morphin is attended by the very real danger of the formation of a habit4 ,lastly1 opium and its alkaloids must not be administered to persons whose kidneys are not in good working order on account of the risk of toxic accumulation40 8,no such restriction exists in respect of ,papine1 its action being exerted exclusively on the element pain2 in other words1 it is purely anodyne40 8,papine does not nauseate1 constipate nor create a habit40 ,illustration3 ,the ,papine label before 7on left7 and after 7on right7 the passage of the ,food and ,drugs ,act4 ,and the exploiters of this morphin solution have the effrontery to claim that it does not create a habit6 ,from these statements the incautious physician might be led to infer that ,papine is a preparation analogous or similar to the official tincture of deodorized opium4 ,formerly in the manufacture of the latter preparation1 in addition to removal of the odorous substances1 narcotin1 then thought to be the principal convulsive alkaloid1#aaj was also removed4 ,by the process for the manufacture of this tincture1 which is now official in the ,united ,states ,pharmacopeia1 most of the narcotine is found in the finished preparation4 ,while it is a comparatively simple matter to remove the narcotin from opium and its preparations1 thus eliminating most of the commonly reputed 8convulsive elements10#aaa to remove the 8narcotic elements0 from opium would result in destroying the integrity of the product4 ,the reasons for this are that morphin is the most powerful narcotic substance found in opium1 and it is present in the largest proportion of any of the alkaloidal constituents4 ,its removal from an opium preparation would1 therefore1 render that preparation practically valueless4 #aaj ,narcotin is now known to possess very little physiologic effect4 #aaa ,of the opium alkaloids1 laudanin and thebain possess the most powerfully tetanizing properties1 but they are present in opium in too small quantities to produce any noticeable effect4 ,neither of these alkaloids is removed by the usual processes for 8denarcotizing0 opium4 ,from ,papine1 however1 the morphin has not been removed1 for since the passage of the ,food and ,drugs ,act the label has to admit that ,papine contains #a grain of morphin in each ounce6 ,a specimen of ,papine was examined and found to be nothing more than a simple aqueous-alcoholic solution of morphin1 containing glycerin4 ,the preparation is flavored to imitate cherry and colored with cochineal4 ,with the exception of morphin1 neither narcotin1 codein nor other opianic alkaloids were found1 while meconic acid1 a characteristic constituent of opium1 was absent4 ,since ,papine is claimed not to cause constipation1 and as is well known1 this condition is frequently produced by morphin1 it seemed possible that ,papine might contain laxative substances4 ,on examination1 however1 no cascara1 rhubarb1 phenolphthalein or laxative salts were found4 ,while ,battle ,co4 have persistently exploited ,papine as being an opium preparation having none of the objectionable qualities of opium1 the analysis shows that the paradoxical claims made for it cannot be substantiated4 ,in prescribing morphin there is an abundance of official preparations to choose from1 and there certainly is no necessity or excuse for resorting to the much more expensive and in no way superior ,papine4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bi1 #aiaa47 ,,pasadyne,,aw ,,aw ,see also report on ,passiflora and ,daniel's ,tincture1 p4 #aef4 ,a physician asks3 8,can you tell me the formula of a preparation on the market called ,pasadyne1 put up by ,john ,b4 ,daniel1 ,atlanta1 ,georgia80 ,according to the manufacturer ,pasadyne is a tincture of passion-flower4 ,formerly this nostrum was sold under the title 8,daniel's ,concentrated ,tincture of ,passiflora ,incarnata40 ,while the manufacturer claims marvelous virtues for this preparation1 made from 8the fruit1 roots and vines of the passion-flower or ,may-pop10 passiflora 7passion flower7 is now generally recognized as being of little if any value4 ,a circular makes the following absurd statement3 8,chloral and the bromids1 before the recognition and advent into medicine of ,pasadyne 7,daniel's ,concentrated ,tincture of ,passiflora ,incarnata71 were widely employed in all turbulent states of the psyche and1 notwithstanding their many untoward1 even sometimes dangerous effects1 were held in high favor by physicians4 ,for that matter1 they still retain some of their old-time popularity1 but since the superior value of ,pasadyne 7,daniel's ,concentrated ,tincture of ,passiflora ,incarnata7 has been demonstrated to the profession's satisfaction1 the erstwhile high esteem in which chloral and the bromids were held1 is fast waning and ere long ,pasadyne will have crowded them out40 ,the reasons why the drug passiflora was not deemed of sufficient value and hence1 along with the ,daniel preparation1 was refused recognition1 are given in a report of the ,council on ,pharmacy and ,chemistry4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,march #h1 #aiac47 ,,pas-,,avena ,how ,its ,formula ,evades the ,food and ,drugs ,act ,pas-,avena is a widely advertised 8nerve sedative and hypnotic40 ,the preparation is put on the market by the ,pas-,avena ,company of ,new ,york ,city4 ,as a headliner the advertisements of the remedy state that the formula has always been on every bottle1 and this1 ,the ,journal states1 has a twofold object3 ,it aims to give the impression that the preparation is non-secret1 and it is calculated to inspire confidence in the--apparently--scientific nature of the product4 ,as a matter of fact1 it should do neither4 ,the preparation is essentially secret in its composition because of the presence in the formula of an unknown quantity and the liability to change of formula at the whim of the manufacturer4 ,on the bottles some time ago the following formula was given3 ,each tablespoonful contains3 ,passiflora #bj minims4 ,avena sativa #aj minims4 ,somnalgesine 7,c#cj;,h#bh,n#e,o#f7 #b grains4 ,the first two ingredients are plants in whose therapeutic value but little confidence is placed4 ,somnalgesine1 the third constituent1 is a secret preparation1 the chemical formula of which the manufacturers were kind enough to add4 ,to a chemist1 however1 the formula is absurd and impossible1 and is included either because of the manufacturer's ignorance or because of an intent to deceive the profession4 ,since the ,food and ,drugs ,act became law1 the label of ,pas-,avena has been changed to read3 ,alcohol #h4cg per cent4 by volume4 ,anilipyrine #af4jj grains per fluid ounce4 ,guaranteed under the ,food and ,drugs ,act of ,june #cj1 #aijf4 ,substitution of anilpyrine for somnalgesine gives little more information4 ,chemists may recognize this as a name applied to a mixture said to be formed by the fusion of two molecules of antipyrin and one molecule of acetanilid4 ,to physicians1 however1 the name carries with it the same mystery as did somnalgesine4 ,attention is directed to the fact that by publishing the guarantee under the pure food laws the company presumes to disperse all doubt and criticism1 assuming that the majority of physicians will be satisfied with the guarantee as it stands4 ,inasmuch as the preparation contains acetanilid and antipyrin1 however1 the manufacturers are disregarding that part of the ,food and ,drugs ,act which requires that the name of the parent substance--in this case acetanilid and antipyrin--be put in parenthesis4 ,the laws are so well defined that physicians appear to be content to do nothing1 firmly believing that they are safe from the defrauding methods of unscrupulous manufacturers4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,march #g1 #aijh47 ,proprietary ,house ,insolvent--and ,physicians ,lose8 ,the ,pas-,avena ,chemical ,company1 whose product1 ,pas-,avena1 was exposed in ,the ,journal a few months ago1 has recently failed1 according to our pharmaceutical exchanges4 ,in recording the fact1 one journal says3 8,it is reported that considerable stock of this company had been sold to physicians40 ,at this time1 when physicians are importuned daily to invest money in various wildcat pharmaceutical concerns1 this sentence might well be used 8to point a moral or adorn a tale40 ,,pertussin ,dr4 ,l4 ,a4 ,roberts1 ,dorchester1 ,mass41 writes3 8,please tell me what the composition of ,pertussin is40 ,pertussin is a proprietary whooping-cough remedy manufactured by the ,kommandantan ,apotheke1 ,berlin4 ,a 8physician's sample0 bottle of this preparation sent out by ,lehn ,fink bears a label on which appears the following3 8#ajj parts ,pertussin contains3 #a_/b ,ol4 ,thymi1 et ,thymol #ba-a_/b ,ext4 ,thymi #8,taeschner' #ej ,saccharum #b ,glycerinum #f-a_/d ,alcohol #ai-c_/d ,aqua ,destillata0 ,while it never has had much vogue in this country it has been and still is used in ,germany4 ,it belongs to that class of vegetable preparations which1 since they contain no distinctive principle1 are difficult to analyze--particularly as concerns the 8joker0 in the formula1 in this case 8,ol4 ,thymi1 et ,thymol0 and 8,ext4 ,thymi #8,taeschner'0--hence there has been much dispute in ,germany as to the composition of this nostrum4 ,in general1 it appears that whatever virtues it has are due to some preparation of common thyme in a menstruum containing water1 sugar and alcohol4 ,at one time the preparation was found to contain potassium bromid2 but tests recently made in the ,a4 ,m4 ,a4 ,chemical ,laboratory indicated the absence of either bromids or iodids4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #h1 #aiac47 ,,phenalgin--,a ,,typical ,,example,,ax ,,ax ,for reports and articles on other coal-tar preparations1 see pp4 #i1 #aae1 #bdd1 #bfh1 #cje4 ,last ,june#aab we devoted considerable space to the extravagant therapeutic claims made for 8,phenalgin0 by its venders4 ,at this time we propose to refer to the misinformation--to use a conservative term--that the ,etna ,chemical ,company has promulgated regarding the composition of their preparation4 #aab ,see ,the ,journal ,a4 ,m4 ,a41 ,june #bd1 #aije1 p4 #aiig4 ,in ,june1 #aije1 the ,council on ,pharmacy and ,chemistry officially published to the medical profession of the ,united ,states the information that repeated examinations showed that 8,phenalgin0 is a simple mixture of acetanilid and sodium bicarbonate or ammonium carbonate4 ,so far as we know1 no direct denial of the truth of this has been made4 ,there has appeared what we presume is meant as an answer2 it is couched in this sentence1 ,phenalgin is just what we have always said it to be4 ,from this expression--which has been repeated in bold1 black letters in practically all the advertisements since last ,june--we presume that we are to understand that in the past they have stated what it is4 ,it would have been just as easy and more satisfactory if the ,phenalgin people1 instead of saying3 8,phenalgin is just what we have always said it to be10 had said what it is1 since the average physician has neither the time nor the inclination to look up their literature4 ,for the benefit of those who desire to know what the venders of ,phenalgin 8have said it to be10 we have gone over their advertising literature of the past1 with the following results1 which are in the form of quotations from their advertisements3 ,an ,american ,coal-,tar ,product--,phenalgin--the only synthetic stimulant1 non-toxic1 antipyretic1 analgesic and hypnotic4 ,phenalgin is the ,,only ammoniated ,synthetic ,coal-,tar ,product made from ,chemically ,pure ,materials ,what have the ,ammonol people to say to this8--,ed4 ,a synthetic ,coal-,tar ,product of the ,amido-,benzine series1 containing ,nascent ,ammonia4 ,these two chemicals 8stimulant ammonia of coal-tar origin0 and 8chemically pure phenylacetamid0 combine under certain conditions so as to obtain a produce which he ,dr4 ,cyrus ,edson named ,phenalgin or ,ammoniated ,phenylacetamide4 ,phenalgin is a compound of peculiar character which can not be extemporaneously made into tablets from the powdered drug1 without seriously changing and impairing its medicinal qualities4 ,we believe these quotations are sufficient to show what the ,etna ,chemical ,company has 8always said it to be40 ,in going over the literature for several years past we find the above stated in the same1 or similar1 words in nearly all of it4 ,from the above four statements may be deduced3 #a4 ,they have stated that ,phenalgin is a synthetic#aac preparation2 #b1 they have conveyed the impression that ,phenalgin is a chemical compound2 #c1 they have announced repeatedly that it is the 8only0 preparation of the kind1 and #d1 they have claimed that ,phenalgin is non-toxic4 #aac ,dunglison's ,dictionary3 8,synthetic--,in chemistry the formation of a more complex body by the union of simpler bodies40 ,dorland's ,dictionary3 8,synthesis--,the artificial building up of a chemic compound by the union of its elements40 8,union0 is not mixing4 ,we believe that these four statements represent in plain ,english what the above quotations mean4 ,they are all absolutely false4 ,phenalgin is not synthetic2 it is not a chemical compound2 it is not the only ammoniated phenylacetamide1 or the only acetanilid mixture containing carbonate of ammonium--and it is most positively toxic4 ,in one place it is stated that ,dr4 ,cyrus ,edson ,employed his great facilities for chemical research and opportunities for chemical experiment for the purpose of producing a formula for a combination of stimulant ammonia of coal-tar origin 7sic7 and chemically pure phenylacetamide1 also a coal-tar product 444 which he named phenalgin1 or ammoniated phenylacetamide4 ,in another place we read that ,phenalgin is made ,under the immediate personal supervision of the original inventor of ammoniated coal-tar products4 ,by comparing this last quotation--which is from a current--#aije--;advertisement--with the preceding one it will be noticed that we are asked to believe that ,phenalgin is made 8under the immediate supervision of0 ,dr4 ,cyrus ,edson--and yet ,dr4 ,cyrus ,edson died ,dec4 #b1 #aijc4 ,this is equal to ,lydia ,pinkham's prescribing for the suffering women of ,america when the dear old soul had been dead for over twenty years4 ,we have before us a full-page advertisement taken from a recent number of a weekly medical journal1 which possibly is meant as an answer to the announcement of the ,council on ,pharmacy and ,chemistry that ,phenalgin is a simple acetanilid mixture4 ,the advertisement is divided into two parts2 the first part is as follows3 ---------------------------------------- ------------------- ,,facts ,,about ,,acetanilidum 7,,ancient ,,history7 ,it has long been recognized that ,acetanilidum and most other coal-tar products are apt to exert a depressing influence upon the heart1 but there has never been any doubt about its great value as a pain reliever and temperature reducer4 ,its therapeutic value has1 however1 been practically nullified by the danger of cyanosis and other evils caused by its well-known depressant action and the difficulty of obtaining it in a pure state4 ,it being known that certain deleterious substances are often to be found in ,commercial ,acetanilidum and that much of the injurious effect attributed to this drug is entirely traceable to these impurities4#aad ---------------------------------------- ------------------- #aad ,this sentence is not complete1 but1 of course1 this is immaterial4 ,little things like an incomplete sentence do not count4 ,the above are also falsehoods4 ,the therapeutic value of acetanilid is not 8practically nullified 444 by the difficulty of obtaining it in a pure state40 ,neither is it true that 8much of the injurious effect attributed to this drug is entirely traceable to these impurities40 ,while deleterious substances may be found in commercial acetanilid1 they are not found in the substance offered as medicinally pure acetanilid by reputable firms4 ,pure medicinal acetanilid is a cheap article1 costing less than #cj cents a pound1 for it is a substance that is easily and cheaply purified4 ,it is a fact that the injurious effects are in the acetanilid itself and not in the impurities it may occasionally contain4 ,the second half of the advertisement in part is as follows3 ---------------------------------------- ------------------- ,,facts ,,about ,,phenalgin 7,,modern ,,science7 ,more than a decade ago the late ,dr4 ,cyrus ,edson1 then ,health ,commissioner for ,new ,york ,city and ,new ,york ,state1 recognizing the value of chemically pure ,acetanilidum as a therapeutic agent1 if it could be deprived of its depressant quality1 employed his great facilities for chemical research and opportunities for chemical experiment for the purpose of producing a formula for a combination of ,stimulant ,ammonia of coal-tar origin and chemically pure ,phenylacetamide1 also a coal-tar product4 ,these two chemicals combine under certain conditions so as to obtain a product which he named ,phenalgin or ,ammoniated ,phenylacetamide4 ---------------------------------------- ------------------- ,there is more of the same character4 ,in the first place1 we call attention to the fact that 8,phenylacetamide0 is substituted for 8,acetanilidum0 when it is to go into ,phenalgin4 ,to mystify is one of the 8tricks of the trade40 ,few physicians keep up with chemical terms and1 therefore1 are not supposed to know that ,phenylacetamide is one of the chemical names for ,acetanilid4 ,the reference here to ,dr4 ,cyrus ,edson brings up another fact1 and that is that the ,etna ,chemical ,company tries to convey the idea that ,dr4 ,edson was the originator of ,phenalgin4 ,we have always understood that ,dr4 ,cyrus ,edson had something to do with pushing ,ammonol and1 if we remember rightly1 got into some trouble thereby4 ,we do not know the exact facts1 but the following letter shows that he had a leaning toward another 8ammoniated phenylacetamid40 ,the letter is dated 8,new ,york1 ,oct4 #f1 #ahid10 and is addressed to the 8,ammonol ,chemical ,company40 8,during the past six or eight months ,i have used ,ammonol extensively in my private practice4 ,i have found it excellent in the treatment of neuralgias and for rheumatism4 ,i have also verified your statement in two cases that were suffering from alcoholism4 ,my experience justifies me in saying that it is the safest and best of the analgesic coal-tar derivatives4 8,very truly yours1 ,cyrus ,edson1 ,m4,d40 ,it may be of interest to know that the principal member of the firm of the ,etna ,chemical ,company was at one time a member of the ,ammonol ,company1 and it is usually understood1 we believe1 that ,phenalgin is practically the same as ,ammonol--in fact1 the analyses published regarding the two preparations show this to be a fact4 ,we must make one more quotation3 ,it makes little difference to a physician whether ,phenalgin is a mixture or a compound or a synthetic1 with a name that would destroy the orthographic balance of the universe1 provided it is just what he has always found it to be4 ,very complimentary to the intelligence and common sense of physicians1 is it not8 ,suppose some fellow should get up a scheme to exploit a mixture of quinin and some cheap1 harmless substance1 say1 starch--equal parts of each4 ,suppose he gives it a fanciful name1 puts it on the market at a high price1 say #a4be an ounce1 and announces it as a new synthetic with wonderful therapeutic qualities4 ,suppose that the schemer then adopts the nostrum vender's methods of fooling physicians into using his product by getting some to give testimonials1 others to furnish write-ups1 and then subsidizes medical journals through liberal advertising to print both the testimonials and the write-ups4 ,the preparation would1 of course1 prove to be a good thing if it were used in liberal quantities where quinin would ordinarily be used1 and some patients using it would get well even if quinin were not indicated4 ,then with the psychologic effect of the testimonials1 the write-ups1 and good1 strong claims rightly pushed1 unthinking physicians would do the rest4 ,and then1 after a while1 when the schemer had gotten to the point where1 each year1 he was making a fortune out of his preparation1 suppose some 8self-appointed chemists0 should examine into the preparation and discover that it was nothing but quinin and starch1 and so announce to the doctors of the country2 what would the doctors say8 ,that it makes little difference 8provided it is just what he has always found it to be60 ,this analogy is not far-fetched1 for it is practically what has been done with ,phenalgin4 ,one difference is that since quinin costs as much per ounce as acetanilid does per pound1 the profits on the acetanilid mixture would be sixteen times greater than that of our imaginary preparation4 ,another difference is that acetanilid is really a dangerous drug1 unless used with care1 both in its immediate and in its remote effects2 quinin is far less so4 8,little difference0 indeed1 whether we are being buncoed or not6 ,evidently6 ,in conclusion1 we charge the ,etna ,chemical ,company with intentionally misleading and deceiving the members of the medical profession1 in that the said company has in its literature and its advertisements conveyed the impression 7whether directly stated or not73 ,first1 that its preparation1 ,phenalgin1 is a synthetic compound2 second1 that ,phenalgin requires special skill in its preparation2 third1 that ,phenalgin has therapeutic values which it does not possess2 and1 fourth1 that ,phenalgin is non-toxic4 ,we also charge that on account of these and other misrepresentations1 this company has inveigled physicians into prescribing and using a simple mechanical mixture of common well-known cheap drugs--for which an extravagantly high price is charged--under the supposition that this combination of cheap drugs is a chemical compound of special and peculiar merit as a therapeutic agent1 and1 therefore1 worthy of their confidence4 ,our object in again giving space to this preparation--and practically all we have said applies to the other acetanilid mixtures that are exploited under fictitious names or as chemical compounds 7such as ammonol1 antikamnia and salacetin or sal-codeia--,bell7--is to impress on physicians1 by a typical example1 the shamefulness of the deceptions practiced on them by nostrum manufacturers to the great injury of the public and of the medical profession4 ,a ,pharmaceutical ,secret ,which ,should ,not ,be ,lost ,dr4 ,gregory ,costigan1 ,new ,york ,city1 writes under date of ,january #ba1 as follows3 8,i have been carefully reading and enthusiastically approving your articles on the nostrum evil1 and have been impressed more than usual on the existence of quack advertising in medical journals as set forth in last paragraph and quotation on page #bjf1 bottom of first column1 of your issue of ,jan4 #bj1 #aijf4 8,in ,merck's ,archives1 page #aa1 we are told in an advertisement on #8,phenalgin' that it #8is a compound of peculiar character which cannot be extemporaneously made from powdered drug' and #8our process of manufacturing tablets is coincident with the manufacture of ,phenalgin and is the result of a long series of careful experiments by which we are able to produce tablets of ,phenalgin in a friable condition without losing any of its volatile constituents or undergoing chemical changes from heat or moisture'6 ,inasmuch as ,phenalgin tablets are not covered with a waterproof coating ,i think this is a remarkable statement to make1 and the manufacturing of a drug coincident with the manufacture of a tablet must be a very remarkable performance1 especially because it #8retains the full therapeutic value of the drug unimpaired' while the advertisement asserts that no other manufacturer is cognizant of this wonderful method4 ,this ad4 is for the perusal of physicians only4 ,the ,etna ,chemical ,company owes it to the medical and pharmaceutical world not to let this secret die with the company's dissolution4 ,it owes it as a duty to the coming generations of science immediately to jot down the full data of this wonderful performance1 to put it away in an age-proof safe and not allow it to be lost to humanity as were a great many other arts that were well known to the ancients4 ,let them keep it secret now and profit by it1 but do not let it be lost to posterity40--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ac1 #aijf1 and ,jan4 #bi1 #aijf47 ,an ,ethical 787 ,proprietary ,exploited ,under ,fraudulent and ,lying ,claims ---------------------------------------- --------------------- 8,,phenalgin ,,is ,,just ,,what ,,we ,,have ,,always ,,said ,,it ,,to ,,be40 --,etna ,chemical ,co4 in #aije4 8,phenalgin is a synthetic 8,unlike the coal-tar synthetic1 coal-tar product40 phenalgin is a stimulant --,etna ,chem4 ,co4 in #ahih4 rather than a depressant40 --,etna ,chem4 ,co4 in #aiaj4 ,,tempus ,,omnia ,,revelat6 ---------------------------------------- --------------------- 8,phenalgin is a synthetic coal-tar product0--thus ran the advertisements some years ago1 when the medical profession was willing to take--or was compelled to take--the word of the manufacturer of proprietary remedies at its face value4 ,then the ,council on ,pharmacy and ,chemistry was brought into existence4 ,one of the first pieces of work done by the ,council was the publication of the results of a number of analyses of headache powders4 ,phenalgin was among them4 ,analysis showed that ,phenalgin was not a synthetic but a simple mixture of the following ingredients in the proportions given3 ,acetanilid #eg parts ,sodium bicarbonate #bi parts ,ammonium carbonate #aj parts ,the ,etna ,chemical ,company1 which puts out this product1 was considerably disturbed by the ,council's exposure4 ,it 8came back0 at the ,american ,medical ,association with the slogan 8,phenalgin is just what we have always said it to be40 ,what1 up to that time1 the ,etna ,chemical ,company had 8always said0 ,phenalgin to be1 was3 #a4--,phenalgin is a synthetic4 #b4--,phenalgin is the only preparation of the kind4 #c4--,phenalgin is non-toxic4 ,these1 in brief1 were the three things that ,phenalgin had been asserted to be4 ,each statement has been proved to be a definite and unequivocal falsehood4 ,phenalgin is not and never was a 8synthetic40 ,phenalgin is not and never was the only acetanilid mixture containing carbonate of ammonium4 ,phenalgin is not and never was in any sense of the word non-toxic4 ,phenalgin1 in short1 possesses the properties--both good and bad--that are common to acetanilid4 ,it is a mixture that the merest tyro in pharmacy could dispense and for which any sophomore medical student could write a prescription without stopping to think4 ,acetanilid sells at #h cents an ounce wholesale2 ,phenalgin at #a4jj an ounce1 wholesale4 ,all these facts and many more were given to the profession by the ,council on ,pharmacy and ,chemistry in ,the ,journal more than six years ago--before even the ,food and ,drugs ,act came into effect4 ,after that law became operative1 the ,etna ,chemical ,company was compelled to say something on the label that it had never said before1 namely1 that ,phenalgin contained #ej per cent4 acetanilid4 ,but the law not only required them to add a fact to their label1 but it also compelled them to remove a falsehood4 ,when the pure food law went into effect1 ,phenalgin was labeled a 8malaria germicide40 ,it is not a malaria germicide and never was a malaria germicide1 and the ,etna ,chemical ,company dared not risk taking the question into court so it removed the statement4 ,unfortunately the ,food and ,drugs ,act exercises no control over the lying statements that may be made for drugs elsewhere than on the label4 ,so it is that physicians within the last two or three weeks have received a booklet on ,phenalgin containing the following assertions for this acetanilid mixture3 8,without the slightest harm1 injury or depressing effect40 8,is never followed by depression40 8,its prolonged administration does not give rise to destructive blood metamorphosis40 8,is of great value in the treatment of neuralgia 7especially in the anemic470 8,freedom from the deleterious action or habit-forming tendencies of the opiates40 8,it aids in destroying the malarial parasite40 8,safest and most dependable of analgesics40 ,it will be seen by this that while the ,food and ,drugs ,act has forced a certain degree of truthfulness on the ,phenalgin labels1 the advertising matter is as fraudulent and as untruthful as ever it was4 ,it is true that the assertion that it is a synthetic is no longer made1 possibly because the medical profession has been so thoroughly enlightened on the much-overworked 8synthetic0 fraud that the falsehood is no longer profitable4 ,in other respects1 the assertions are just as false as ever4 ,it is said to have no depressing effect--and yet it is acetanilid4 ,it is said to produce no habit--and yet it is acetanilid4 ,it is said to have no injurious effect on the blood--and yet it is acetanilid4 ,it is said to be the safest analgesic--and yet it is acetanilid4 ,how long will the medical profession continue to be hoodwinked by means of such transparent falsehoods8 ,the ,phenalgin concern takes much credit to itself because on the cartons in which the bottles of ,phenalgin come1 it is stated that the product is 8for dispensing purposes only40 ,yet1 as a matter of fact1 practically any layman can go to any drug store and obtain this product1 for the druggist appraises this spectacular piece of ,pecksniffian virtue at its face value--a joke4 ,why1 if intended only for physicians1 would it be necessary to include with every bottle a circular naming the diseases1 for which this acetanilid mixture is supposed to be good--8headache10 8colds10 8lumbago10 8scanty menstruation10 8pain in any part of the body0--and why is the name of the product and of the firm making it blown into the bottle8 ,to sum up then1 ,phenalgin is as big a humbug as ,peruna ever was4 ,it is sold to-day under claims that are just as false as those used six years ago4 ,the ,etna ,chemical ,company is perpetrating a stupendous fraud on the medical profession to-day and it is doing it not only through the agency of the ,united ,states mail1 but with the aid and support of the following medical journals--and others--in which the ,phenalgin advertisement appears3 ,medical ,record ,new ,york ,medical ,journal ,pediatrics ,lancet-,clinic ,american ,journal of ,surgery ,international ,journal of ,surgery ,american ,medicine ,american ,journal of ,obstetrics ,medical ,century ,pacific ,medical ,journal ,dietetic and ,hygienic ,gazette ,medical ,standard ,eclectic ,medical ,journal ,am4 ,jour4 of ,clinical ,medicine ,it is conceivable that in some cases it is not easy for those editors and publishers of medical journals who insist on relying on their own judgment to satisfy themselves that certain preparations are not worthy of being advertised4 ,no such difficulty occurs in the case of ,phenalgin4 ,here the issues are clear cut4 ,the product is exploited under claims that are both false and vicious and their falsity and viciousness are perfectly evident to any freshman medical student4 ,the only charitable explanation of the appearance of the ,phenalgin advertisements in the medical journals listed is that the editors and publishers have not given the subject the attention it deserves and to which their readers are entitled4 ,perhaps it would help if their attention were called to the matter by their subscribers4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bg1 #aiab47 ,,pheno-,,bromate ,an analysis of this preparation made at the instance of the ,new ,haven ,medical ,association1 by its chemist1 and sent by ,dr4 ,charles ,j4 ,foote of ,new ,haven to ,the ,journal is in part as follows3 ,the package was marked 8,sample package1 ,pheno-,bromate4 ,the ,pheno-,bromate ,company1 ,new ,york1 ,u4 ,s4 ,a40 ,the box contained a number of tablets and a package of powders in papers marked1 8,physicians' #aj grain powders1 ,pheno-,bromate40 ,the substance in the papers was a white crystalline powder not homogeneous4 ,it was completely soluble in hot water4 ,the hot water solution on cooling yielded a mass of thin crystalline plates4 ,this material was found to melt at #aac4e ,c4 ,it gave no color with ferric chlorid and a positive isonitril test4 ,the portion insoluble in ether amounted to #di4h per cent4 of the powder and consisted of potassium bromid4 ,quantitative determinations of potassium and bromin in the original solution confirmed this result4 ,in my opinion1 the powder consists of approximately equal quantities of acetanilid and potassium bromid4 ,qualitative tests of the tablets indicated that they had the same composition except for a small quantity of some excipient not entirely soluble in water4 ,yours truly1 ,herbert ,e4 ,smith1 ,chemist ,new ,haven ,medical ,association4 ,before the ,food and ,drugs ,act ,pheno-,bromate was advertised as 8a synthetic combination of the phenetidin and bromid groups1 and not1 as is the case with many analgesics and antipyretics1 a mixture of various coal-tar derivatives0 and as 8the safest and best of all sedatives40 ,the dose recommended in most cases is #bj grains--equal to #aj grains each of acetanilid and potassium bromid4 ,since the ,food and ,drugs ,act has gone into effect its label states that it is 8a perfect combination of a phenol and bromin derivative containing #bhb grains of acetphenetidin1 ,u4 ,s4 ,p41 per ounce40 ,what a boon it was to mendacious manufacturers that the patent rights on phenacetin expired before the ,food and ,drugs ,act went into effect4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,july #ad1 #aijf1 and ,april #ah1 #aijh47 ,,phenolphthalein ,phenolphthalein has long been used as an indicator in chemical reactions1 but its use as a therapeutic agent#aae is comparatively new4 ,when its laxative properties were first discovered it was exploited as a proprietary in ,germany1 and it was not long before the enterprising manufacturers in this country saw in it a potential gold mine and now nearly every proprietary drug manufacturer in this country has coined a proprietary name for it and is exploiting it1 either alone or in combination with one or more other laxatives1 and with more or less unwarranted claims4 #aae ,those who wish to study the action and use of this drug further will find references to articles in ,the ,journal as follows3 ,the ,journal1 ,jan4 #e1 #aijg1 pp4 #fd and #gj2 ,march #cj1 #aijg1 p4 #aacc2 ,april #bj1 #aijg1 p4 #acea2 ,nov4 #ba1 #aijh1 p4 #aghb2 ,nov4 #bh1 #aijh1 p4 #ahhf4 ,the first page mentioned discusses the introduction of phenolphthalein into medicine4 ,phenolphthalein itself has certain pretty well defined properties1 but when a little of some other drug has been added wonderful therapeutic possibilities are claimed for the combination4 ,the drug also has a definite market value and the pure substance in the form of powder1 tablets or pills could not be sold at a price greatly in excess of the market value4 ,thus manufacturers1 from business policy1 add to it other drugs4 ,there are now on the market numerous more or less secret and 8fancy0 preparations of phenolphthalein for which a price is charged out of all proportion to the value of the preparation4 ,among these are3 ,phenolphthalein ,laxative 7,el ,zernac ,co474 ,exurgine 7,bischoff ,co474 ,probilin 7,schering ,glatz74 ,prunoids 7,sultan ,drug ,co474 ,laxine 7,columbus ,pharmacal ,co474 ,phenolax ,wafers 7,upjohn ,co474 ,laxaphen 7,parke1 ,davis ,co474 ,phenalein 7,pax ,chemical ,co474 ,thalosen 7,abbott ,alkaloidal ,co474 ,laxothalen ,tablets 7,pitman-,myers ,co474 ,veracolate 7,marcy ,co474 ,and additional preparations are still coming out6 ,some of the preparations contain only the phenolphthalein with a coined non-descriptive proprietary name attached1 but most of them contain in addition one or more of such drugs as cascara1 sulphur1 prune1 senna1 salicylic acid1 ipecac and aromatics4 ,the exploitation of phenolphthalein in this way gives opportunity to the manufacturers to make all sorts of strong claims1 some of them directly contradictory1 for their preparations4 ,for instance1 ,phenolax1 which is said to contain phenolphthalein and cane sugar1 is claimed to be 8a great success for all forms of constipation1 intestinal atony and hepatic torpor40 ,of ,laxothalen1 which is said to contain phenolphthalein1 aromatics and sugar1 it is stated that 8its action is confined to the bowel and it has practically no hepatic action40 ,of ,prunoids1 which is said to contain phenolphthalein1 cascara1 de-emetized ipecac and prunes1 we have the old familiar statement that 8the harmonious blending of the several ingredients will give results that cannot be obtained through their use separately1 nor will their use be followed by after-constipation40 ,at the time phenolphthalein was beginning to be exploited in this country ,the ,journal#aaf suggested that physicians who wished to try the remedy should prescribe it under its own name and not under fancy1 coined names4 ,since phenolphthalein occurs in the form of an insoluble and tasteless powder there is no reason why special pharmaceutical preparations of it should be placed on the market4 ,it can be prescribed in powder form1 in pills1 capsules or tablets4 ,thus given1 the true therapeutic action of the drug would be apparent and its actual value arrived at4 #aaf ,the ,journal1 ,march #cj1 #aijg1 p4 #aacc4 ,the vice of this unscientific habit of prescribing names instead of drugs is stated in a forcible way in a letter received from ,dr4 ,v4 ,e4 ,simpson1 a teacher of materia medica and therapeutics in the medical department of the ,university of ,louisville4 ,he says3 8,recently ,p4 ,d4 ,co4's representative left on my desk a sample labeled #8,laxaphen4' ,the formula given is3 phenolphthalein1 gr4 viii2 salicylic acid1 gr4 #c_/e1 in each fluidounce1 #8incorporated in a palatable chocolate base4' ,now1 in the first place1 this name is one that the public will easily learn and will soon call for2 in the second place1 it is not a name that carries with it even a suggestion of its contents2 and1 finally1 the physician acquires the habit of mechanically prescribing names instead of drugs1 and in the burdening of his memory with the myriad of fantastic labelings he finds it impossible to remember even the drugs any one contains1 much less the exact proportions of those drugs4 ,then suppose that a consultation is had2 the consultant asks what is being given and the attendant answers that he is giving #8laxaphen4' ,the consultant1 perhaps1 has not been sampled and inquires about it2 the attendant must answer4 #8,oh1 it contains some phenolphthalein and a salicylate1 but ,i have forgotten the exact proportions4 ,i have the literature on my desk4' ,had he used ,u4 ,s4 ,p4 and ,n4 ,f4 remedies1 which the consultant and every other doctor in the land has access to and should have some knowledge of1 this embarrassment would not occur40 ,all of the above should remind the physician that he should write simple prescriptions1 for drugs whose action he knows1 adapted to the particular case and not for money-making combinations under fanciful1 non-descriptive names exploited by the proprietary manufacturers4 ,in this way he will not only save money for himself and his patients1 but he will be giving them exact and effective treatment1 he will know exactly what he is giving and learn for himself its effect1 and he will be following the only method which entitles him to be called a scientific physician4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #cj1 #aiaj47 ,,mixed ,,vaccine ,,and ,,phylacogens,,ay ,,ay ,a reprint of articles on the subject of ,phylacogens originally published in ,the ,journal is issued under the title 8,the ,phylacogens3 ,a ,menace to ,rational ,therapy40 ,the noted advance in therapeutics shown in the development of vaccine therapy has brought with it grave dangers as well as advantages4 ,we have1 on a number of occasions1 discussed in special articles and in editorials the dangers which threatened from the rapid commercialization of this new method4 ,the unscientific character of mixed vaccines and of the mixed filtered products of a number of vaccines marketed as 8,phylacogens0 has been especially emphasized and the danger from their indiscriminate use pointed out4 ,a little over a year ago we published a series of articles dealing with the whole subject in which the nature of mixed vaccines was described#aag as follows3 #aag ,bacterial ,vaccine ,therapy3 ,its ,indications and ,limitations1 p4 #cg1 reprinted from ,the ,journal ,a4 ,m4 ,a41 ,april #bf ,june #bh1 #aiac1 price #aj cents4 8,the mixed stock vaccine of commerce is a makeshift4 ,it is offered as a substitute for correct diagnosis4 ,like all such makeshifts in science1 it is doomed to failure4444 ,a burden is being forced on the profession which will speedily assume the proportions attained by proprietary drug combinations4 ,the menace cannot be counteracted unless physicians will accept the guidance of unselfish1 non-commercial interests and refuse to purchase and use mixed commercial vaccines40 ,this admonition to seek the guidance of unbiased scientific observers is deserving of special emphasis at the present time4 ,five weeks ago we published the address of the chairman of the ,section on ,pharmacology and ,therapeutics1 ,dr4 ,john ,f4 ,anderson1#aah one of our foremost workers in this branch of biologic science1 in which attention was very forcibly drawn to the dangers involved in the use of biologic products of non-specific character4 ,he says3 #aah ,anderson1 ,john ,f43 ,some ,unhealthy ,tendencies in ,therapeutics1 ,the ,journal ,a4 ,m4 ,a41 ,july #d1 #aiad1 p4 #a4 8,bacterial therapy undoubtedly in some cases is a most valuable method of treatment2 but when the claim is made that a combination of the dead bodies or the filtered products of a number of different bacteria are useful for the treatment of certain diseases with a different specific cause1 it would seem that the suggestion closely approaches quackery40 ,further he says3 8,aside from the doubtful practice of the indiscriminate use of unproved methods of treatment1 it has seemed to me that a great injustice is done the patient by their use1 since some of the preparations that have been widely exploited have been shown to be harmful in certain instances and even to have caused death4 ,so the first step in attempting to remedy conditions is to awaken the physician to the importance of ignoring the claims of those who are pushing these new methods until their usefulness and harmlessness has been clearly demonstrated by those best in a position to do so40 ,as a result of scientific methods in teaching therapeutics1 physicians have gradually given up almost entirely the use of 8shotgun0 prescriptions and now prescribe a drug or a combination of a few drugs1 each given for the purpose of exerting a definite action4 ,on the other hand1 the purveyors of bacterial vaccines have gradually increased the number of different bacteria in their mixed vaccines until some of those now advertised for sale contain as many as seven different kinds of bacteria1 and some of the 8,phylacogens0 contain the filtered products of at least eleven bacterial species6 ,under the present federal laws there does not seem to be any way in which the federal government can do more than is being done at present4 ,it is a case in which the physician becomes the sole guardian of the patient committed to his care4 ,he is the one and the only responsible individual4 ,he cannot throw the blame for bad results back to the manufacturer4 ,when he subjects his patient to the possibility of harm by the use of these unscientific and dangerous preparations1 the physician assumes the responsibility1 whether he wants to or not4 ,if physicians would report their failures when these vaccines are used1 and especially report the fatalities consequent on their use1 with the name of the manufacturer of the particular product used1 we are quite sure there would result lessening in the enthusiasm of the purveyors of these products4 ,when tempted by the optimistic statements of the interested manufacturer of these mixtures to give them a trial the physician should remember that the warnings of disinterested scientists are of far more value than uncritical clinical reports put out under commercial auspices4 ,this we quote from a recent book by ,victor ,c4 ,vaughan1#aai ,president of the ,american ,medical ,association3 #aai ,vaughan1 ,victor ,c43 ,protein ,split ,products in ,relation to ,immunity and ,disease1 #aiac1 p4 #bbf4 8,every time an unbroken protein is introduced into the body it carries with it1 and as a part of it1 a poison4 ,from the very careless1 rash1 and unwarranted way in which #8vaccines' of most diverse origin and composition are now used in the treatment of disease1 this matter certainly cannot be understood or its danger appreciated by those who subject their patients to such risk4 ,it should be clearly understood that all proteins contain a poisonous group--a substance which in a dose of #j4e mg4 injected intravenously kills a guinea-pig4 ,this poison is present in all the so-called #8vaccines' now so largely used1 and it is not strange that death occasionally follows the use of #8,phylacogen' or similar preparations4 ,not only do these proteins contain a poison1 but when introduced parenterally the poison is set free1 not in the stomach1 from which it may be removed1 but in the blood and tissues4 ,it is possible that vaccine therapy may become of great service in the treatment of disease4 ,even now there are occasional brilliant results which are reported while the failures and disasters are not so widely advertised40 ,such a warning as this quotation contains1 from a man so eminent as ,dr4 ,vaughan1 merits and should receive the careful attention of medical men2 at least it should have as much weight as the 8clinical evidence0 spread broadcast among our profession by commercial houses4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bi1 #aiad47 ,,the ,,danger ,,in ,,protonuclein1 ,a ,,preparation ,,containing ,,thyroid ,protonuclein was the subject of a little article in our ,queries and ,minor ,notes ,department1 ,nov4 #af1 #aiab1 page #ahab4 ,dr4 ,reid ,hunt1 ,washington1 ,d4 ,c41 writes3 8,to the ,editor3--,i have been requested by a physician to call your attention to certain statements which might well have been added to your reply to ,j4 ,a4 ,c4 in regard to ,protonuclein4 ,dr4 ,seidell and ,i examined several samples of ,protonuclein some time ago#abj and by chemical and physiologic tests found that they contained the equivalent of #aj per cent4 thyroid of #j4a per cent4 iodin strength 7the actual amount of thyroid may have been greater or less for we did not know the percentage of iodin in the thyroid used74 ,the dose recommended on the bottle was #f to #ab grains every three or four hours2 this represents from #j4f to #a4b grains of some of the commercial thyroid powders1 and is sufficient to cause pronounced thyroid effects in many conditions4 ,protonuclein was advertised as a #8perfectly harmless antitoxin1 tissue-builder1' etc41 although the dose of thyroid did not differ materially from that in #8,rengo' and #8,marmola1' two anti-fat nostrums which we examined at the same time4 ,we called attention to the danger of using thyroid1 the most powerful tissue-destroying drug known1 in cases of typhoid1 phthisis1 etc41 for which protonuclein was recommended1 though these are conditions in which the physician is supposed to be exerting every effort to build up the tissues4 #abj ,hunt1 ,reid1 and ,seidell1 ,atherton3 ,commercial ,thyroid ,preparations and ,suggestions as to the ,standardization of ,thyroid1 ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bd1 #aijh1 p4 #ache4 8,you also speak of the #8high' nuclein content 7#j4bh per cent4 phosphorus73 the largest recommended dose would contain only about #a_/c grain of nucleic acid--an amount which probably has not the slightest effect1 especially when given by the mouth4 8,a sample of #8,protonuclein ,special' was found to have twice as much thyroid as the ordinary ,protonuclein2 this also was stated to be #8perfectly harmless4'0--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #a1 #aiac47 ,,purgen ,the physicians of the ,united ,states are receiving a neat package containing samples of a ,german proprietary--,purgen4 ,the container is an ingenious one and1 besides the tablets1 includes a circular in ,english1 although mailed in ,europe1 describing the remarkable virtues of this 8new synthetic aperient40 ,it has been considered strange that this proprietary1 which has been advertised so thoroughly in ,europe1 ,australia1 etc41 should not have made its appearance in this country4 ,now it is here1 and it is well that physicians should know what ,purgen is and not be mystified and misled by the literature that they may receive regarding the preparation4 ,the following appeared in ,the ,journal1 ,jan4 #e1 #aijg1 page #fd1 and is reprinted now as being especially timely3 ,the report of a case of poisoning by ,purgen 7phenolphthalein7 is the occasion for some pertinent observations by ,dr4 ,g4 ,brasch as to the proper introduction of such remedies to the medical profession 7,ztschrift fr ,medizinalbeamte1 ,abst4 in ,apotheker-,zeitung1 ,no4 #ei1 #aijf74 ,he agrees with ,best that all such remedies should first receive a thorough trial in an institution subject to state supervision1 before they are advertised to the medical profession1 so that their harmlessness in appropriate doses may be ascertained by a method free from liability to error4 ,the manner in which the manufacturers introduced ,purgen to the profession and the laity is to be condemned1 and probably led to the symptoms of poisoning exhibited in the case of ,dr4 ,best and tends to discredit a remedy which is harmless and efficient if used in proper doses4 ,the manufacturer of such a preparation is inclined1 for obvious reasons1 to put the dose of his preparation much too high4 ,the most important point1 however1 is the objectionable character of the names given to such articles4 ,the organic compound phenolphthalein has been known for a long time and has been widely used as an indicator4 ,accidentally it was discovered that phenolphthalein possessed laxative properties and thereon it was proposed 7#aija7 as a medicine under the name 8,purgen40 ,it is sold in tablets containing #j4je1 #j4a and #j4e grain phenolphthalein mixed with sugar and flavored with vanilla4 ,the author says3 8,but it is very desirable--and ,i regard this as the most important part of my communication--that phenolphthalein should be received into the materia medica under its own name4 ,the addition of vanilla and sugar is to the highest degree superfluous and the arbitrary dosage in three strengths with the ridiculous designations1 #8baby1' #8for adults1' #8for patients confined to bed1' are merely calculated to prejudice the physician who is accustomed to individualize in his prescriptions1 against a remedy which is in itself an excellent one40 ,as explanatory to the last sentence1 it should be stated that in ,europe ,purgen is put up in three dosage forms1 8infant ,purgen for children10 containing #c_/d of a grain2 8adult ,purgen for chronic constipation10 containing #a-a_/b grains1 and 8strong ,purgen for invalids10 containing #g-a_/b grains4 ,the form in which it is being sampled in this country is in the medium dose1 #a-a_/b grains4 ,physicians should remember that the promoters of ,purgen are simply introducing a chemical well known to laboratory workers for the last twenty years1 which has been recognized as an aperient for at least seven years1 and which can be purchased for #dj cents an ounce1 whereas an ounce of phenolphthalein in the form of ,purgen will cost #c4bj wholesale4 ,the enthusiastic praise of the remedy1 found in the advertising circulars1 should be subjected to critical judgment on account of its source and motives4 ,it is undoubtedly true1 however1 as we have previously stated1 that phenolphthalein is worthy of a trial4 ,in the ,british ,medical ,journal1 ,oct4 #ah1 #aijb1 ,f4 ,w4 ,tunnicliffe speaks of the virtues of phenolphthalein1 and the conclusions reached by him were that it is a useful aperient1 without irritating action on the kidneys1 and is especially valuable in jaundice1 its depressing action on the circulation being less than sulphate of magnesia4 ,phenolphthalein is not in the ,pharmacopeia1 but has been included in 8,new and ,nonofficial ,remedies0 by the ,council on ,pharmacy and ,chemistry4 ,from this we quote3 ,actions and ,uses4--,phenolphthalein acts as a purgative1 but appears to possess no further physiologic action4 ,a case of poisoning from taking #a gm4 7#ae grains7 is reported4 ,dosage4--,for adults the average dose is #j4a to #j4b gm4 7#a4e to #c grains7 given as powder1 in cachets1 capsules or pills4 ,it may be given with safety in doses of #j4e gm4 7#h grains71 and these doses seem to be necessary to secure its effects in bedridden patients or in obstinate cases4 ,we have gone into this matter again so that our readers may have some knowledge of this remedy1 and we hope that if they conclude to try it they will use the chemical itself and under its own name4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #ad1 #aijg47 ,,pyo-,,atoxin 8,to the ,editor3--,i am sending you a sample of a proprietary preparation that for the past two or three years has been largely retailed in the ,south and ,southwest as a new combination that liberates larger amounts of formaldehyd1 etc41 in the genito-urinary tract than any known agent1 that it is a methylene-formate1 entirely new1 etc4 8,i asked the representative why he had not submitted a specimen to the ,council1 and his reply was that like ,wyeth and others they did not get a fair report1 or something to this effect4 ,my reasons for trying to find the truth for their claims is that quite a number of general practitioners have asked me regarding this ,pyo-,atoxin4 8,w4 ,p4 ,dey1 ,m4,d41 ,jacksonville1 ,fla40 ,dr4 ,dey sent with the foregoing letter a box of ,pyo-,atoxin which bore this label3 ,pyo-,atoxin ,reg4 in ,u4 ,s4 ,pat4 ,office 7,capsules7 7,pheno-,methylene-,formate7 8,hurley0 ,an ,antitoxic ,agent ,indicated in ,gonorrhoea1 ,cystitis1 ,pyelitis and ,bacteriuric ,conditions4 ,,dose3 ,one capsule four to six times daily1 ,followed by large glass of water4 ,guaranteed by ,h4 ,o4 ,hurley1 ,manufacturing ,pharmacist1 ,louisville1 ,ky4 ,under the ,food and ,drugs ,act1 ,june #cj1 #aijf ,serial ,no4 #agaj4 ,the pseudoscientific synonym 8pheno-methylene-formate0 carries the idea that ,pyo-,atoxin is a definite chemical substance4 ,it is unnecessary to say that the term 8pheno-methylene-formate0 is a meaningless one and its use reminds one of those preparations exploited seven or eight years ago before the ,council began to expose these mixtures masquerading as definite chemical compounds4 ,the chemical laboratory was asked to investigate this preparation and the following is a report of the chemists3 8,the box contained thirty gelatin capsules coated with some black substance giving them the appearance of some of the popular gonorrhea nostrums4 ,when the capsules were opened they were found to contain a powder--about #j4ce gm4 or #e grains per capsule--composed of large white or colorless crystals mixed with a smaller amount of a fine dark powder4 ,the crystals when separated out and dissolved yielded the characteristic tests for hexamethylenamin4 ,a solution of the entire capsule content was deep blue and responded to the ,u4 ,s4 ,p4 tests for methylene blue4 8,as a result of these and other tests it was concluded that ,pyo-,atoxin consisted essentially of two pharmacopeial drugs--hexamethylenamin and methylene blue4 ,a quantitative determination of the constituents was considered unnecessary4 ,from its general appearance and properties1 however1 the hexamethylenamin probably constitutes approximately from #fj to #hj per cent4 of the preparation40 ,it thus appears that the capsules contain a mixture consisting essentially of two well-known official substances1 the value and particularly the limitations of which should be known by physicians by this time4 ,this nostrum is simply another example of how physicians are being humbugged4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ad1 #aiad47 ,,resinol ,the ,philadelphia branch of the ,american ,pharmaceutical ,association issued a pamphlet some two years ago in which the following appeared relative to ,resinol and similar products3 ,illustration 8,within recent years there have been introduced a number of compound ointments that in their supposed range of therapeutic usefulness are scarcely equaled and certainly not excelled by the magic unguents of the quacks and charlatans of continental ,europe1 who1 several centuries ago1 essayed to cure all manner of disease by inunction or the simple application of compound ointments of secret composition4 8,as typical of this modern class of panaceas we may mention ,resinol4 ,this preparation is being widely advertised at the present time in the daily papers as a valuable adjunct to ,resinol ,soap in the treatment of all kinds and varieties of diseases of the skin4 ,the makers of this particular mixture1 in the form of an ointment1 modestly assert that it will cure all skin diseases1 and is also #8,specific for ,pruritus ,ani1 ,itching ,piles1 and ,pruritus ,vulv4'0--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #f1 #aiji47 ,,resor-,,bisnol ,resor-,bisnol was considered by the ,council and refused recognition4 ,the following formula for ,resor-,bisnol was at one time given in advertisements in a number of medical journals3 8,a scientific combination1 in nicely balanced proportions of ,bismuth ,salts of antiseptic acids of the aromatic series1 and ,resorcin4 8,each #ajj parts contains #bj parts ,resorcin1 and #eb parts ,bismuth ,oxid1 combined with antiseptic acids40 ,besides this formula other 8formulas0 equally indefinite1 vague and misleading have been given in lieu of an actual statement of composition1 thus3 8---- is a mixture of resorcin and bismuth salts of phenic acids such as salicylates1 etc41 and an aromatic alcoholate4 ,its composition is as follows4 ,bismuth salts of phenic acids #fj per cent4 ,aromatic alcoholate of bismuth #bj per cent4 ,resorcin #bj per cent40 ,the product was recently analyzed in our chemical laboratory4 ,the chemists report as follows3 8,a specimen of ,resor-,bisnol examined by us consisted of a light brown powder possessing a characteristic odor and a taste at first sweetish and then bitter4 ,it was found to be only partially soluble in water4 ,the examination indicates that ,resor-,bisnol is probably a mixture consisting essentially of a basic bismuth salicylate 7bismuth subsalicylate71 a basic gallate of bismuth 7bismuth subgallate71 a basic compound of beta-naphthol 7bismuth betanaphtholate7 and resorcinol 7resorcin740 ,it thus appears that ,resor-,bisnol is probably a simple mixture of well-known substances4 ,in other words1 the ,resor-,bisnol advertising and literature are typical of that issued by various nostrum houses3 it conceals the truth in a mass of semi-scientific verbiage1 and while not frankly false1 it deceives by what is left unsaid rather than by what is said4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #a1 #aiab47 ,,robinol ,,and ,,sevetol ,revamping ,discarded ,theories for ,commercial ,purposes ,it is astonishing how rapidly medical hypotheses become theories and theories are accepted for established facts1 when such alleged facts are favorable to commercial enterprise4 ,yet1 as a matter of fact1 the manufacturers of proprietary preparations are under a moral obligation1 at least1 to tell the truth with reference to the scientific basis for their claims4 ,to draw from exploded theories reasons for the use of proprietary preparations is reprehensible1 not only because it may lead physicians to use preparations which are worthless1 but also because it tends to confirm in the physician's mind opinions which science has discarded4 ,robinol ,john ,wyeth and ,brother put up a mixture of glycerophosphates which they call ,robinol4 ,in their description of the properties of this mixture they say3 8,phosphorus exists in the brain1 nervous system1 and vital organs as lecithin1 of which glycerophosphoric acid is the most important constituent and is essential to the vital processes for the reproduction of life and maintenance of metabolism in old age1 impotence1 etc40 ,the first impression on reading this sentence is that it suggests that glycerophosphates are essential to the vital processes1 although the statement strictly applies to phosphorus4 ,the next sentence confirms this impression and the mind glissades from the accepted fact of the existence of phosphorus in nervous tissue to the unfounded hypothesis that the glycerophosphates are necessary to supply the essential element4 ,in the next sentence the circular continues3 8,in nervous and general debility the glycerophosphates as exhibited in ,robinol1 are preferable to the mineral phosphates as they contribute the essential constituent of nerve tissue and are absorbed by the cells more readily than any phosphate of vegetable or inorganic origin40 ,this statement is utterly unfounded4 ,it is in direct opposition to the conclusions of pharmacologists4 ,the glycerophosphoric acid radical is1 to be sure1 found in the lecithin of nervous tissues1 but its source is not known4 ,there is no evidence either that it must be present in the food or that it must be taken as medicine in order that the brain and nervous tissues shall be nourished4 ,when the glycerophosphates are taken there is no evidence that they enter into the composition of the brain or nervous tissue4 ,they are excreted in the urine and feces as phosphates4 ,it has never been shown that glycerophosphates are absorbed any more readily than other phosphates4 ,but the advertising circular has still more information to impart to physicians3 8,in that group of maladies characterized by faulty nutrition1 due to the excessive elimination of phosphorus from the body1 as is evidenced by the fatigue and weakness following acute attacks and present in many chronic affections1 during the course of fevers and in the later stages of phthisis and all diseases of the nervous system1 physicians will find the tonic chalybeate properties of the glycerophosphates of great value40 ,physicians know1 if the nostrum makers do not1 how difficult it is to determine whether there is an excessive elimination of phosphorus from the body4 ,the bulk of the phosphates found in the urine are derived from the food and so little comes from the metabolism of the nervous system that it is not easy to prove that any disease is due to excessive elimination of phosphorus from the body4 ,that fatigue and weakness are due to such a loss of phosphorus is mere assumption1 a convenient theory for the exploiters of glycerophosphates4 ,but admitting that nervous waste or faulty nutrition is characterized by the loss of phosphorus1 it is easier1 cheaper and more rational to supply such loss by the use of phosphorus-containing foods1 such as milk and eggs1 and there is not the slightest evidence that the loss of phosphorus will be influenced in any way by giving a supply in the form of glycerophosphates4 ,thus1 in order to bolster up the sale of a simple solution of glycerophosphates1 vague theories and improbable hypotheses are dressed in all the dignity of scientific facts4 ,sevetol ,there was a time1 perhaps a generation ago1 when physiologists taught that fats were absorbed into the blood in the form of a fine emulsion4 ,this theory has been definitely disproved and it is now known that fats enter the blood only after a chemical splitting into glycerol and fatty acids1 the latter being1 to a large extent1 combined with alkalies in the form of soaps4 8,sevetol10 another ,wyeth preparation1 is presented to the profession under the claim that it is a very fine emulsion of fats1 every portion of which 8is readily absorbed through the intestinal wall40 ,to quote3 8,the administration of ,sevetol1 therefore1 does not tax the digestive power of the patient1 for it is absorbed with very little effort on the part of the digestive apparatus2 and even if the organs of digestion be involved1 neither the weakness of the patient nor the severity of the symptoms necessarily contra-indicates its use4 ,the amount ingested is limited only by the power of assimilation exhibited in the tissues1 and it may be given in large doses for a continued period of time1 or until symptoms of overfeeding are produced1 such as coated tongue1 anorexia1 constipation1 headache and lassitude4 ,when these symptoms appear1 the administration of ,sevetol should be temporarily discontinued and a mild but effective laxative given for several days1 after which its use may be resumed40 ,while the language just quoted is a little more exalted and dignified than that found in typical 8patent medicine0 advertisements1 the thought it expresses qualifies it for a place in the 8,lydia ,pinkham0 or 8,peruna0 class4 ,every sophomore medical student knows1 if he gives the matter any thought1 that ,sevetol must undergo the same process of digestion as any other fat4 ,it must be broken up into a fatty acid and glycerol1 and saponified before it can be absorbed4 ,it is plainly evident that the amount of ,sevetol which can be taken is limited not only by the power of assimilation1 but also by the power of digestion4 ,the symptoms mentioned in the advertisement and ascribed to overfeeding1 are the symptoms1 not of a system saturated with absorbed fat1 but of digestive organs rebelling against an unusual diet4 ,the exploitation of ,sevetol is but one more case of turning to commercial account an exploded theory4 ,isn't it about time that our profession demanded that the purveyors of medicinal products tell the truth8 ,and isn't it time1 too1 that we cease taking our pharmacology and therapeutics from proprietary manufacturers8--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #d1 #aiad47 ,,salacetin ,some time ago we wrote to ,messrs4 ,bell ,co41 calling their attention to the fact that we had made an examination#aba of their product1 salacetin1 and that as a result of such examination it was found to be a mixture1 which did not coincide exactly with their description of it4 ,they replied3 8,our description of salacetin is correct and we have nothing more to impart except that anyone publishing any different formula from that given in our circulars will be held responsible by us40 #aba ,the ,journal ,a4 ,m4 ,a41 ,june #c1 #aije2 reproduced on page #aj of this book4 ,the description they give is as follows3 ,prepared by the interaction1 with heat1 of salicylic acid1 glacial acetic acid1 and purified phenylamine4 ,this sounds very scientific1 but when we remember that acetanilid is a result of the action of glacial acetic acid on phenylamine 7anilin7 their description is cute1 to say the least4 ,of course1 there is 8interaction with heat0 when salicylic acid is combining with bicarbonate of sodium to form salicylate of sodium4 ,further1 there is1 no doubt1 some 8interaction with heat0 when the substances are rubbed together in mixing them and when they are going through the mill to form tablets1 not to mention the heated imagination of the promoters of this 8synthetic40 ,the following taken from the advertising literature furnished by the manufacturers and distributed by them1 is quoted to show the claims made for this preparation3 ,salacetin is free from ,toluodine and produces no harmful cyanosis4 ,in the treatment of ,acute ,bronchitis1 ,grippe1 ,influenza1 ,tonsillitis1 ,lithemic ,headaches1 ,rheumatism and ,neuralgias1 it relieves pain1 reduces inflammation and abnormal temperature1 and eliminates uric acid more quickly and thoroughly than the salicylates1 and without causing depression or stomachic or renal irritation4 ,have personally interviewed thousands of physicians1 including every prominent one in the ,east1 and can honestly state that we have never known of anything at once so efficient and so unobjectionable in the removal of rheumatic and neuralgic pain and other symptoms of the uric-acid accumulation4444 ,in ,la ,grippe and ,acute ,bronchitis it relieves pain and coughing1 reduces inflammation and temperature1 makes the patient comfortable1 and checks the progress of the disease4 ,in ,tonsillitis its action is specific4444 ,in ,acid ,cystitis1 it neutralizes acidity1 reduces inflammation and removes irritation4444 ,in ,dysmenorrhea it relieves pain and congestion with no hallucinations1 constipation or danger of a drug habit4 ,in ,dysmenorrhea and ,ovarian ,neuralgias try ,sal-,codeia--,bell4 ,it will relieve the pain as well as morphia4 ,it will not check any secretions1 induce any habit1 cause any depression or inconvenience of any kind4 ,of course1 it is well understood that acetanilid is a valuable remedy in many instances1 if used with caution and when indicated4 ,it certainly has some therapeutic value4 ,there is no doubt that it relieves pain of various kinds4 ,it is to be presumed that combining salicylate of sodium with it will have certain beneficial effects in certain rheumatic conditions1 on the supposition that salicylate of sodium and acetanilid are both used with more or less success in certain of these conditions4 ,also1 the combining of bicarbonate of sodium1 carbonate of ammonium1 caffein1 citric acid1 one or several of these1 may result in a fairly good combination1 but these combinations can be found in the list of preparations of all our large manufacturing pharmaceutical houses1 which supply them at one-tenth of the cost of these secret remedies4 ,the physician in using these preparations put out by reputable recognized manufacturing pharmaceutical houses not only is prescribing preparations that are non-secret1 but is using remedies that cost one-tenth as much as the secret preparations1 which are exploited under fanciful names and pushed by ridiculous claims4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #a1 #aije47 ,,sal-,,codeia--,,bell ,according to the advertisements 8,salacetin0 8444 is a combination with heat of salicylic and glacial acetic acids with phenylamine1 the irritating1 depressing and blood-corpuscle destroying elements removed40 ,according to the ,committee on ,chemistry of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association1 whose report was published in ,the ,journal of the ,american ,medical ,association ,june #c1 #aije1 p4 #agia1 8,salacetin0 is a mixture of acetanilid1 salicylate of sodium and bicarbonate of sodium4 ,sal-,codeia 7,salacetin-,codein7 therefore would be the same as above with codein added4 ,of course1 acetanilid and codein will relieve pain 7it could not do otherwise7 and consequently make a very good combination in certain conditions1 if not used too often and if used with care4 ,although the continued use of codein is not likely to produce a drug habit1 it1 as well as acetanilid1 does so sometimes1 and it must be remembered that codein is a motor paralysant1 and is not the best combination to be used with acetanilid4 ,for those who wish to give a combination of acetanilid1 salicylate of sodium and codein1 the following prescription is suggested3 ,acetanilid i #d ,sodii bicarbonatis ss #b ,sodii salicylatis ss #b ,codein sulph4 gr4 vi #d ,m4 et div4 chart ,no4 xxiv4 ,this will make five-grain powders which may be put in papers1 capsules1 cachets or tablets4 ,each will contain #b-a_/b grains 7#j4ae gm47 of acetanilid and #a-a_/d grains 7#j4jge gm47 each of sodium salicylate and sodium bicarbonate1 with #a_/d grain 7#j4jae gm47 of codein4 ,the doses of acetanilid and of codein approximate the average adult doses1 but the sodium salicylate1 to have any appreciable effect1 must be increased1 for #a-a_/d grains of salicylate of sodium in a dose is insignificantly small4 ,sodium salicylate with acetanilid makes a fairly good combination in certain rheumatic troubles1 but it is not indicated by any means as a cure-all1 as one would judge from the literature sent out by the ,sal-,codeia-,bell people4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #d1 #aije47 ,,sanatogen ,cottage ,cheese--,the ,new ,elixir of ,life,,az ,,az ,see also ,medical ,journals and ,sanatogen1 p4 #dca4 ,the psychology of advertising is nowhere better exemplified than in the 8patent medicine0 and proprietary fields4 ,the reason is evident4 ,knowing that the general tendency of the human organism is toward health rather than toward disease and that the 8healing power of nature0--vis medicatrix natur--will account for a large proportion of recoveries from sickness1 it is not to be wondered at that thousands of preparations sold for medicinal purposes receive credit that is entirely undeserved4 ,the awarding of such undeserved credit is largely due to the universal tendency of those who are not trained in science to apply the post hoc1 ergo propter hoc argument in all matters relating to health and disease4 ,john ,smith suffers from a passing indisposition4 ,when he recovers he credits his recovery to whatever he may have done just preceding that recovery4 ,if he has received medical attention1 the physician gets the credit2 if he has taken 8absent treatment10 ,christian ,science is responsible2 if he has taken sugar pills1 8,prof40 ,munyon gets the praise--while1 as a matter of fact1 if he had taken none of these he would have recovered since he was only temporarily indisposed4 ,nor are laymen the only ones that fall into such errors4 ,many physicians who prescribe new1 widely-advertised preparations are likely to give those products credit for whatever favorable change may take place in their patients' condition4 ,this failing is not a modern one4 ,in #ahdb ,dr4 ,benjamin ,brodie wrote3 8,we have no doubt that many well-instructed medical practitioners have not sufficiently considered what course a given disease would take if it were left to itself2 and as to others1 it is not possible that they should have any real knowledge on the subject4 ,with the majority of persons a recovery will generally pass for a cure40 ,illustration3 ,greatly reduced photographic reproduction of a full-page ,sanatogen advertisement appearing in the ,london ,graphic4 ,the ,graphic was one of the ,london magazines that refused to accept an advertisement of the book issued by the ,british ,medical ,association1 exposing 8patent-medicine0 frauds4 ,,the ,,power ,,of ,,advertising ,while every physician is perfectly familiar with the facts just stated1 it seems worth while to give them as a probable explanation of what is to follow4 ,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 capable1 when sold under a proprietary name and with the right kind of advertising1 of producing physiologic effects that are little short of marvelous4 ,the name of this elixir of life is ,sanatogen1 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 product4 ,the ,sanatogen advertising campaign is probably the most skilful piece of work of its kind ever done4 ,on both sides of the ,atlantic1 every effort has been made to endow the advertisements with a dignity which1 to those who know the very ordinary nature of the product advertised1 is grotesquely out of keeping4 ,only the highest-class magazines and newspapers have been patronized2 the 8copy0 has been so written as to appeal not to the ignorant but to the intelligent4 ,testimonials from men whose names are well known1 even though by training and education they are incompetent to pass judgment on a product of this kind1 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 man4 ,in short1 ,sanatogen stands as a monument to the power of printers' ink4 ,the claims for this product have already been referred to in ,the ,journal1 but it will do no harm to bring them again before our readers4 ,here are some taken from advertisements3 8,the ,re-,creator of ,lost ,health40 8,sanatogen is 444 a rebuilding food40 8444 revitalizes the overworked nervous system40 8,specific nerve tonic action40 8,most reliable and scientific of all nutrients40 8444 in certain diseases it exerts a specific action which renders it a valuable adjunct to other curative measures40 8,it stimulates metabolic activity of tissue cells and secures more complete oxidation of energy-yielding elements40 8,sanatogen nourishes the system in a persistent1 gradual1 cumulative way1 so that its best effects unfold themselves in a systematic1 substantial progression to health and strength4 ,it follows that a regular and prolonged administration of ,sanatogen is necessary for the attainment of lasting results40 8,sanatogen is a scientific compound1 every particle of which represents the finest concentrated1 tissue-constructing nutriment1 endowed with unique revitalizing and rejuvenating powers40 8,sanatogen contains over #gjj per cent4 more tissue-building1 life sustaining nourishment than wheat flour40 ,truly a wonderful preparation--if these statements are true6 ,but they are false--most of them at least4 ,and in that many who can ill afford it may be led to pay a ruinously high price for a very ordinary food1 the statements are viciously and cruelly false4 ,in view of the properties with which ,sanatogen is credited1 its composition is naturally a matter of more than ordinary interest4 ,what is this life-giving product8 ,a package of ,sanatogen was purchased and subjected to examination and analysis in the ,association's laboratory4 ,our chemists report3 ,,laboratory ,,report ,sanatogen is a fine1 nearly white powder having a faint yellowish tinge4 ,a circular which is enclosed in the package states3 8,sanatogen is a definite organic combination of #ie per cent4 of pure1 specially prepared casein and #e per cent4 of sodium glycerophosphate14440 ,qualitative tests indicated the presence in ,sanatogen of casein1 sodium1 a phosphorous compound and glycerin or a glycerin compound4 ,starch and sugars were absent4 ,quantitative analysis showed that the composition of the specimen was essentially as follows3 ,water 7loss at #acj ,c47 #h4fj ,ash #f4bc ,casein and other proteins 7,n #f4ch7 #hc4aj ,casein 7,n in precipitated casein #f4ch7 #hj4eg ,proteins other than casein 7by difference7 #b4ec ,sodium glycerophosphate 7,na,c#c;,h#g,o#f,p7 7,p in filtrate from casein precipitation #f4gi7 #e4ei ,insoluble matter #j4hd ,undetermined #a4hg ,while these results show that the claims concerning the composition of ,sanatogen are not entirely correct1 they indicate that the essential element in ,sanatogen is casein4 ,the slight variation between the composition claimed for ,sanatogen and the composition as determined by chemical analysis is of minor importance4 ,whether there is #hc per cent4 of casein as found by the ,association's chemists or #ie per cent4 as asserted by the manufacturers matters little4 ,the important fact is that casein makes up about nine-tenths of the preparation and1 as must be perfectly evident1 ,sanatogen derives whatever food value it may have from that casein4 ,casein is known in its commonest form as the curd in milk1 or as 8cottage cheese40 ,after the cream has been separated1 the milk which remains contains nearly all the casein and milk sugar originally present but practically none of the fat4 ,,why ,,not ,,cottage ,,cheese8 ,whence comes the stimulation of metabolic activity1 the wonderful nourishment of the system1 the marvelous revitalizing and rejuvenating power claimed for ,sanatogen8 ,not from the sodium glycerophosphate1 for the consensus of opinion among leading physiologists indicates that phosphorus in the form of glycerophosphates has little influence on metabolism4 ,not from the glycerin1 surely1 for even granting that glycerin has food value the amount present is so small as to be negligible4 ,the real source of energy in ,sanatogen1 then1 lies in the casein which comprises about nine-tenths of its ingredients4 ,cost of ,calories4 ,kind of ,food ,material ,price per#a1jjj ,calories,energy for ,pound ,energy ,one ,dollar ---------------------------------------- ------------------ ,sanatogen #d4ed #c4ja #ccb ,celery 4#je 4#gg #a1cjj ,eggs 7#j4cf per doz47 4#bd 4#af #f1cjj ,milk 7#j4jg per qt47 4#jce 4#aa #h1hej ,pork1 loin roast 4#ab 4#aj #aj1cej ,butter 4#cj 4#ji #aa1bej ,mackerel1 salt dressed 4#aj 4#jh #aa1hej ,beef1 stew meat 4#je 4#jg #ae1cjj ,wheat bread 4#jf 4#je #bj1jjj ,rice 4#jh 4#je #bj1bej ,sugar 4#jf 4#jc #bi1bjj ,pork1 fat salt 4#ab 4#jc #bi1ejj ,potatoes 4#ja 4#jc #bi1ejj ,beans1 white 4#je 4#jc #cj1djj ,oatmeal 4#jd 4#jb #de1jjj ,cornmeal 4#jbe 4#jb #fe1djj ,wheat flour 4#jbe 4#jb #fe1djj ---------------------------------------- ------------------ ,of course ,sanatogen1 being composed largely of casein1 has some food value4 ,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 products1 the figures for the latter having been adapted from ,professor ,atwater's calculations4 ,this table shows that1 from the standpoint of economy in the purchase of energy1 no other food in the list is so poor as ,sanatogen4 ,while the manufacturers claim that 8,sanatogen contains over #gjj per cent4 more tissue-building1 life-sustaining nourishment than wheat flour10 the table shows that one dollar's worth of wheat flour contains as much energy as one hundred and ninety-seven dollars' worth of ,sanatogen6 ,,an ,,inquiry ,like all 8patent medicines10 ,sanatogen is exploited by the testimonial route4 ,actors1 authors1 politicians and not a few physicians--the latter1 to the credit of the ,american profession1 be it said1 being chiefly ,europeans--have testified to the wonderful properties of this product4 ,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 kind4 ,the following inquiry1 expressed in practically the same words1 was propounded3 ,is it possible for a product1 even if it has the composition claimed for ,sanatogen1 to have properties as a food and medicine which are claimed for this preparation8 ,the replies to this inquiry are interesting and instructive1 although they are what might have been expected from men whose judgment has not been warped by the glittering claims of the ,sanatogen publicity agents4 ,illustration3 ,some of the reasons for the sale of ,sanatogen6 ,a few specimen advertisements of ,sanatogen's enormously expensive advertising campaign4 ,,the ,,replies ,dr4 ,lewellys ,f4 ,barker1 professor of medicine1 ,johns ,hopkins ,university1 medical department1 says in part3 8,if ,sanatogen consists simply of casein and sodium glycerophosphate1 it is pretty obvious that all of its good effects 7except perhaps the psychic influence of taking an expensive and1 to the layman1 mysterious remedy7 can be gotten by including milk and eggs in the food4444 8,the objection to ,sanatogen lies1 it seems to me1 not in the assertion of its proprietors that it is a #8food and a tonic1' 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 it4 ,very extravagant claims are being made for it in advertisements in the lay press4 ,if just as much1 and more1 good in the form of #8food and tonic' can be obtained from a dollar's worth of milk and eggs as from a dollar and ninety cents' worth of ,sanatogen1 it is surely the duty of the medical profession to inform the public of that fact40 ,dr4 ,frank ,billings1 professor of medicine and head of the ,department of ,medicine1 ,university of ,chicago1 expresses his opinion thus3 8,of course1 the thing is a fraud both as a food and as a tonic4 ,even if it met all the requirements of the statements made of it by the makers1 it would not be any more of a food than as much casein taken in milk and probably not as good2 or any more than some other albumin taken in some other form4 ,i do not know just what pharmacologists say of the glycerophosphate of soda1 but so far as my own clinical observations go ,i never saw any result from its use that could be called specific1 that is1 due to the drug40 ,dr4 ,richard ,c4 ,cabot1 assistant professor of clinical medicine1 ,harvard ,medical ,school1 says3 8,in reply to your letter respecting the properties of ,sanatogen1 ,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 me4 ,i have no doubt that it is a fairly good food4 ,i see no reason to believe that the phosphorus that it contains has any special action40 ,otto ,folin1 professor of biological chemistry1 ,harvard ,medical ,school1 expresses himself thus3 8,for myself1 or for any one who would take my advice1 ,i would prefer a glass of milk to ,sanatogen when hungry and plain glycerophosphate to ,sanatogen when in need of a tonic4 8,medicated feed used to be sold for horses4 ,to me the #8food tonic' combination represents one of the most unscrupulous fake ideas used by manufacturers of patented articles to fool the public40 ,ludvig ,hektoen1 professor of pathology1 ,university of ,chicago1 says in part3 8,in my opinion1 no attention whatsoever should be paid to the claims advanced in favor of #8,sanatogen' as food and as medicine1 because the statements made in the advertisements of this product are extravagant1 misleading and quackish40 ,j4 ,h4 ,long1 professor of chemistry and director of chemical laboratories1 ,northwestern ,university ,medical ,school1 expresses the following opinion3 8,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 glycerophosphate4 ,cow's milk contains #c-a_/b to #d per cent4 of casein1 associated with soluble phosphates4 ,it is absurd to think that this casein after precipitation from the milk has a greater nutritive value than it has in its native condition4 ,casein1 at best1 is probably less valuable as a food than are certain other proteins1 because of its lack of some of the amino groups essential in tissue building1 and the addition of a glycerophosphate cannot supply this deficiency4 8,this is not the first attempt to exploit casein preparations4 ,the earlier efforts failed in practice because they were based on a wrong conception concerning the physiologic value and importance of this protein4 ,the assumption that in the case of ,sanatogen a #8definite organic combination' with the glycerophosphate is formed cannot be taken seriously by chemists4 ,we have witnessed many such efforts to palm off mixtures as definite organic compounds1 and in this way to claim for them a value in excess of that which they actually possess40 ,illustration3 ,,what ,,one ,,dollar ,,will ,,buy ,,in ,,food ,,energy6 ,a ,,comparison ,,of ,,the ,,caloric ,,values ,,of ,,sanatogen1 ,,cow',s ,,milk1 ,,sugar ,,and ,,wheat ,,flour4 ,,based ,,on ,,the ,,table ,,accompanying ,,this ,,article4 ,graham ,lusk1 professor of physiology1 ,cornell ,university ,medical ,college1 after calling attention to the falsity of the claim that ,sanatogen is 8a life-sustaining agent in disease10 says3 8,if one considers the casein content alone1 the dose of ,sanatogen recommended in the circular would furnish1 at best1 about what is contained in a pint of milk1 or one-fourth of the total of the protein necessities of the body--using a low protein requirement4 ,that sodium glycerophosphate has any distinctly beneficial physiologic action has never1 to my knowledge1 been shown4 8,it is a great pity that the public does not realize the splendid and economical value of milk1 bread and the ordinary vegetables1 cereals and meats1 as true #8tonic food stuffs1' in contradistinction to prepared nostrums whose sale depends on a psychic stimulus applied to a susceptible populace40 ,h4 ,gideon ,wells1 associate professor of pathology1 ,university of ,chicago1 says3 8,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 milk4 ,i can easily believe that it would be less valuable than milk4 ,the successful practice of many commercial houses1 of isolating one of the constituents of our food1 and ascribing to it marvelous nutritive or therapeutic properties1 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 conceived40 ,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 name4 ,,the ,,tyranny ,,of ,,words ,herr ,teufelsdrckh was right when he panegyrized clothes4 ,and the worship of clothes is carried to the extreme nowhere so much as in the case of word-clothes4 ,the most plebeian things when bedecked in sufficiently imposing word-finery are endowed with the attributes of royalty before which the average intellect bows down4 ,neither cottage-cheese nor glycerophosphates1 when exposed naked to the world1 commands any overweening respect2 combined and dressed in the magic word 8,sanatogen10 they receive the homage of those whose judgment is blinded by the glittering trappings of word-finery4 ,some day1 possibly1 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 worth4 ,when that day comes1 proprietary humbugs like ,sanatogen will have become as extinct as the dodo and the great auk4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bj1 #aiab47 ,the ,bauer ,chemical ,company's 8,reply0 ,to the ,editor3--,our attention has been called to a most unfair and unwarranted attack on ,sanatogen which appears in your esteemed publication ,april #bj1 p4 #abaf4 ,the article is such a perversion of the actual facts1 and so completely--if not intentionally--misleading that we request1 as a matter of common justice1 that you give this reply equal publicity to your attack4 ,the admiration and respect we have felt for your journal and our appreciation of the place it holds in the field of medical journalism1 made your attack on a product like ,sanatogen1 representing so definitely the most painstaking and scientific research1 the last thing expected4 ,indeed1 it seems inconceivable that a journal apparently so alive to its responsibilities could publish broadcast an article so calculated to do harm1 without first giving those whose interests are most at stake an opportunity to substantiate their claims4 ,there never has been a time that we have not been ready to meet any request from ,the ,journal1 or the respected gentlemen composing the ,council on ,pharmacy and ,chemistry1 for all information and data concerning ,sanatogen4 ,had we had the slightest inkling that our product--or the claims made for it--were open to question or criticism1 we would gladly have submitted all of the evidence1 clinical1 experimental1 and theoretical1 on which every statement1 however simple1 has been based4 ,to make a response is difficult1 because your article is not written in a fair1 unprejudiced spirit4 ,in fact1 although one would expect a sober1 serious consideration of a matter so fraught with importance 7if your contention is right7 your whole attitude is one of ridicule and jocularity4 ,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 injury8 ,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 ,noorden1 ,c4 ,a4 ,ewald1 ,duhrssen1 ,eulenburg1 ,neisser1 ,binswanger1 von ,leyden1 ,krafft-,ebing1 ,tillmanns1 ,tunnicliffe1 and thousands of other earnest1 reputable physicians4 ,any one might differ with their conclusions1 but is it courteous or decent to hold them up to ridicule and contumely8 ,can a discussion thus conducted hope to solve a scientific problem or accomplish any real good8 ,it would hardly seem so1 and with all due respect we cannot help but feel that the situation has its analogy in the legal doctrine1 8when you have no evidence1 ridicule and abuse your opponent and his client40 ,sanatogen is a definite organic combination of 7in round numbers7 #ie per cent4 casein and #e per cent4 glycerophosphate of sodium4 ,the analysis as published in ,the ,journal fails to show that this statement is untrue4 ,the slight deviation as to the amount of casein present is explained by the fact that ,the ,journal's figures include the moisture1 while ours are on the dry substance4 ,inasmuch as nearly all the moisture is absorbed after the product leaves the laboratories and is therefore added weight1 the figures should be on the dry substance4 ,it is hinted in the article that ,sanatogen is a mere mixture of ingredients1 in fact one of the gentlemen you quote openly intimates so4 ,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 know4 ,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 ,u4 ,s4 ,letters ,patent4 ,assuredly it is the definite chemical combination found in ,sanatogen on which the special value of this product as a medicinal food and tonic depends4 ,a mere mixture of ingredients would represent only the sum-total of their individual virtues1 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 ingredients4 ,to compare ,sanatogen to cottage cheese is the height of absurdity--as it was probably intended to be4 ,the casein of ,sanatogen is perhaps the most carefully purified milk protein available1 and this fact is of essential importance when considering the value of ,sanatogen as a medicinal food4 ,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 element4 ,the same applies to the matter of cost4 ,we suggest that an attempt be made to prepare purified casein according to ,hammarsten's method1 if one wishes to determine what labor and expense is involved in the operation4 ,possibly it will be found cheaper to buy ,hammarsten's casein in the open market where the price is #c4ej per pound wholesale6 ,and it is not a proprietary product1 either4 ,further1 to compare the economic value of ,sanatogen on the basis of calories is as unscientific as it is deliberately misleading4 ,if the caloric standard only counted1 a pound of oleomargarine would be as valuable as fifty eggs1 a pound of laundry soap as valuable as a pound of choice beef4 ,sanatogen is not intended or recommended to replace ordinary foodstuffs4 ,it is not recommended as a caloric or heat producer1 but as a food-tonic supplying the essential elements of tissue construction and cell-repair in easily and perfectly assimilable form4 ,digestibility1 ease and completeness of assimilation count a great deal1 and are the sole determining factors in cases of illness4 ,again1 starch and fat are not essential substances to life4 ,without protein we cannot live4 ,exclude everything else from a patient's dietary1 and he will live4 ,exclude protein and it is only a question of time before he dies4 ,it is evident1 therefore1 that to measure the value of a given food in calories only is misleading and dangerous1 and an editorial in your valuable publication of ,november #d last distinctly points this out4 ,illustration3 ,specimens of ,sanatogen advertising--7#aiac74 ,according to the most careful and extensive experiments1 covering a large number of scientifically studied cases1 ,sanatogen is not approached in the matter of rapidity of digestion and absorption by any other known foodstuff4 ,that such a product does exert a definite stimulating or activating effect on the digestive and assimilative functions1 thus promoting the digestion and appropriation of nutritive material has been demonstrated over and over again4 ,that the organic phosphorus of ,sanatogen is almost completely retained and assimilated has been proved beyond doubt by carefully conducted metabolism experiments4 ,that from this1 and from the stimulating action on phosphorus and nitrogen metabolism1 a favorable effect on the nervous system could result1 is conceivable4 ,that such an effect does actually take place has been demonstrated clinically in literally thousands of cases4 ,as to our advertisements and literature3 ,every claim made emanates from the freely recorded statements of competent observers1 checked and rechecked by men who have been absolutely free from all bias or prejudice4 ,and these opinions1 moreover1 are not the superficial1 passing views of a few physicians4 ,instead our claims are based on the voluntary1 unbiased written reports of clinical experiences by over #ae1jjj practicing physicians--among whom a goodly proportion are members of your esteemed ,association--and on over #aej published articles in the leading medical journals of the world1 some of which your journal has considered of sufficient importance to present to its readers in abstract form1 suppressing1 it is true1 all mention of ,sanatogen1 although thereby the original was sadly emasculated1 if not actually falsified4 ,among the physicians who have carefully tested ,sanatogen and determined its dietetic and therapeutic properties are many men of truly international reputation1 men who are as far above suspicion as was ,caesar's wife4 ,at least one of these men was the honorary guest of your ,association a few years ago4 ,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 glycerophosphates4 ,it is such men's careful researches and experience that you attempt to offset by the snap judgment of men whom we claim1 without the slightest intent of disparaging them1 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 product4 ,their lack of definite knowledge of ,sanatogen is shown by their persistent references to casein and the glycerophosphates1 as though these two ingredients were separate and not chemically combined4 ,to consider ,sanatogen a mixture is to lose the vital detail of its specific value4 ,now after all1 is this a fair1 judicial spirit1 is this true scientific enquiry8 ,are we to accept offhand judgments in preference to the opinions of those who speak from years of observation of the effects of ,sanatogen8 ,in the name of justice and fair play1 is it right for the great ,journal of the ,a4 ,m4 ,a4 to ignore and suppress the accumulated evidence in favor of ,sanatogen and cite instead the cursory opinions of men who have never seen ,sanatogen1 tested or observed its effect1 who by the very nature of your enquiry must have been influenced subconsciously in favor of your side of the matter4 ,illustration3 ,the above is a reduced reproduction of a full-page advertisement in a magazine devoted to pseudo-scientific fads4 ,the advertising pages of this magazine reek with frauds4 ,during the twelve years ,sanatogen has been used1 prescribed and recommended by thousands of competent physicians1 it has been free from all secrecy4 ,the truth has been told at all times4 ,from the first we have cooperated with the profession4 ,never have we failed to safeguard the doctor's interests4 ,never have we suggested by word or inference that any person should employ ,sanatogen to the exclusion of medical treatment4 ,not a day passes but we refer people who inquire about this or that bodily ill1 to their physicians for advice4 ,we regret the length of this letter but feel that the scientific character of ,sanatogen1 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 effects1 make it imperative that we refute at once errors and misleading statements1 and correct to the best of our ability the wrong impression you have allowed to go forth4 ,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 purpose4 ,we have tried to make this article temperate1 fair and free from ill temper and ill feeling4 ,we only ask for justice and feel that you will be willing--possibly anxious--to correct1 so far as you can1 the great wrong you have done us4 ,the ,bauer ,chemical ,co4 ,by ,f4 ,w4 ,hehmeyer1 ,resident ,manager4 ,comment3 ,we devote considerable space to the above free advertisement of ,sanatogen1 as ,the ,journal does not want to be accused of being unfair1 even to patent medicine venders4 ,as our readers will recognize1 the above is simply a reiteration of the statements that have been published in the advertisements of ,sanatogen4 ,the song that runs through all the advertising matter is that ,sanatogen is a chemical compound1 and since it is a chemical compound it therefore possesses properties not to be found in the ordinary mixture4 ,it is the old1 old story2 the 8synthetic0 argument is as hoary as the nostrum business itself but fortunately the medical profession is no longer easily fooled by it4 ,as a matter of fact1 even assuming for the sake of argument that the casein and glycerophosphate in ,sanatogen are in chemical combination1 it would be a union of the loosest kind1 which on entering the digestive tract must be broken up into its more stable components1 casein and glycerophosphate4 ,to claim that ,sanatogen possesses any properties not possessed by its essential constituents is a silly piece of pseudo-scientific claptrap4 ,of the testimonials on ,sanatogen we shall at this time have nothing to say2 ,the ,journal has in the past repeatedly shown the worthlessness of this kind of evidence4 ,we have nothing to retract1 rather we would emphasize and1 had we space1 enlarge on what we have already published1 for we believe that a large and unfortunate portion of the public1 that can ill afford it1 is paying a ruinously high price for a substance having a very mediocre food value4 ,that indigent consumptives1 for instance1 should be led by glittering falsehoods to squander on ,sanatogen money that should go for 8food tonics0 of infinitely greater value1 such as eggs1 milk1 vegetables and meats1 is not only economic waste but inhuman cruelty4--,ed4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ah1 #aiab47 ,the ,sanatogen 8,grand ,prix0 ,a number of letters have been received recently expressing surprise that ,sanatogen had been granted a 8grand prix0 at the ,exhibition of ,medical and ,surgical ,material held in ,london at the same time that the ,seventeenth ,international ,congress of ,medicine was in session4 ,the correspondents have asked what such an 8honor0 meant4 ,the company which exploits ,sanatogen in the ,united ,states has not been slow to apprise the ,american public of the award4 ,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 8grand prize0 and opining that 8this unusual distinction0 should make plain 8the desirability of the presence of ,sanatogen in the advertising columns of your esteemed publication40 ,those familiar with the methods of awarding prizes1 medals and certificates to commercial firms and their products at expositions and exhibitions attach little weight to the 8honors0 thus conferred4 ,it is a fact that most purchasers of large--and expensive--exhibit space at such exhibitions receive some kind of award which1 it is tacitly understood1 will be a useful advertising asset4 ,every one can call to mind many food products of mediocre quality that have flaunted on their labels the gold medals received at various expositions4 ,nevertheless1 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 ,medicine4 ,the following facts were developed3 ,the commercial exhibition was entirely distinct and separate from the scientific exhibit of the ,congress4 ,it was managed and conducted by a ,british drug journal which had been giving annual 8exhibitions0 of its own for some years past1 and this took the place of its regular exhibition4 ,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 prizes4 ,it may interest our readers to know that while the cottage-cheese-glycerophosphate product ,sanatogen received a 8grand prize0 two other proprietary cottage-cheese-glycerophosphate products received 8gold medals0 at the same time4 ,in the pharmaceutical department of the exhibit a widely--and fraudulently--advertised 8patent medicine0 received a silver medal6 ,from the facts given it should not be difficult to appraise at its right value the 8honor0 conferred on ,sanatogen4 ,the fact that the exploiters of this preparation are trying to make capital out of this 8award0 is significant4 ,illustration3 ,nor is even the ,asiatic neglected in the ,sanatogen advertising campaign4 ,here is reproduced an advertisement appearing in an ,asian sporting newspaper published in ,india4 ,the original advertisement was #aj inches by #ae inches4 ,among the members of the ,award ,jury whose names were given by this drug journal were three men of prominence in ,great ,britain1 to whom we have written4 ,a reply has been received from one1 ,dr4 ,stephen ,paget1 who says3 8,i was not on the jury1 nor do ,i know anything about the matter4444 ,i had nothing whatever to do with the awarding of prizes40--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #aa1 #aiac47 ,a ,restatement of the ,case ,the case against ,sanatogen has been pretty plainly given at different times in ,the ,journal1 but the sale of the stuff goes on--thanks to the power of advertising4 ,one criticism that has been made of this patent medicine is the exorbitant price charged for it4 ,this objection1 although but an incidental one1 is the one that apparently appeals to the layman more strongly than the much more serious criticism1 fraud in exploitation4 ,you arrest the attention of the average man when you appeal to his purse2 he resents paying an exorbitant price for anything4 ,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 preparation4 ,this also accounts1 doubtless1 for the fact that the attempts to answer ,the ,journal criticisms1 by those who are selling ,sanatogen1 have been largely devoted to the one point--its outrageously high price4 ,the fundamental objection to ,sanatogen is not its high price1 but the attempt to ascribe to a mixture of casein and glycerophosphates powers not possessed by these ingredients--in other words1 the misleading and fraudulent claims made for it4 ,even if it were sold at cost price1 the stuff1 as at present advertised1 would still be a fraud4 ,the nub of the whole matter is3 ,the claims made for ,sanatogen are unwarranted1 misleading and fraudulent4 ,,some ,,fraudulent ,,claims ,the constituents of ,sanatogen are casein and sodium glycerophosphate4 ,these two very ordinary substances possess1 so the ,sanatogen people would have us believe1 peculiar properties when they are brought together in chemical combination4 ,sanatogen1 they claim1 is a chemical combination of these constituents4 ,the claim may be a good 8selling-point10 but it cannot be1 and is not1 seriously taken by chemists4 ,but even supposing1 for the sake of argument1 that sodium glycerophosphate and casein could be combined1 there is not a scintilla of evidence to show that such a combination could survive the destructive influence of digestion and be absorbed4 ,whether ,sanatogen is a chemical combination of casein and sodium glycerophosphate or a mere mechanical mixture of these two substances is really immaterial4 ,in either case1 it would be separated into its constituent parts by the digestive juices and would have the properties of sodium glycerophosphate and casein1 and nothing more4 ,remembering this1 let us examine once more some of the claims made for this patent medicine3 8,sanatogen is a nerve and tissue food for which the brain1 spinal cord and the nerves have a special predilection40 8444 practically identical with the main ingredient of nerve and muscle cells44440 8,sanatogen stands pre-eminent in its power to feed the nerve centers1 to promote healthy digestion1 to give strength and endurance to the entire system40 8444 food for tired nerves44440 8444 a rational1 scientific nerve-food40 ,to the physiologist1 the term 8nerve-food0 is an absurdity4 ,the processes of digestion reduce the albuminous substances 7proteins1 such as casein7 of the food to simpler forms4 ,this is true no matter what may be their source4 ,whether the proteins are derived from the gluten of wheat1 the casein of milk or the albumin of egg1 one will 8feed the nerves0 just as well as the other4 ,and ,sanatogen 8feeds the nerves0 no more than1 in fact not as much as1 do bread and meat and eggs4 ,of course1 the casein in ,sanatogen has food-value1 but so has ordinary casein--cottage cheese1 8pot cheese10 or the ,german ,schmierkse1 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 milk4 ,to pretend that there are wonderful properties in the protein of ,sanatogen when just as good protein can be purchased 7for much less money7 from the milkman1 is to perpetrate a fraud on the purchaser4 ,here are some more claims3 8444 marvelous revitalizer of nerve health40 8444 ,sanatogen has positive reconstructive force in neurasthenia40 8,if ,you need ,new ,strength and ,vitality ,you should at once get acquainted with ,sanatogen40 ,strangely like the 8lost manhood0 advertisements1 this last4 ,and this1 also3 8444 has brought new strength1 new vitality and new relish of life to thousands upon thousands who suffered from starved nerves44440 8,countless people 444 have regained fresh health and vigor through the vitalizing and invigorating effects of ,sanatogen40 ,of course ,sanatogen is not sold as a 8consumption cure40 ,no such crude claims as these emanate from the skilled advertising agents employed by the ,sanatogen people4 ,if they did they could not get space in high-grade magazines6 ,as a preventive of consumption1 however1 we find3 8,sanatogen 444 creates new tissue and nerve capital 444 ,this nerve capital will 444 save the individual from attacks of acute disease4 ,against tuberculosis it is an excellent investment40 ,also1 it is a pick-me-up6 ,thus3 8,sanatogen promises to pick you up when run down--it does so40 ,most people are under the necessity of working for a living4 ,if we are to believe the ,sanatogen advertisements1 it seems remarkable that the human race has managed to jog along for so many centuries without this product1 for we read3 8,it is practically indispensable to all who are unable to take prolonged rest44440 ,naturally we do not expect to find the coarse1 8free-to-you-my-sister0 type of claims in ,sanatogen advertisements4 ,nevertheless3 8,women 444 find in ,sanatogen a genuine sustaining agent40 ,illustration3 ,sanatogen is advertised heavily in the ,british ,isles4 ,here are some greatly reduced advertisements appearing in ,british magazines4 ,the three largest advertisements shown here measured in the original #aj inches by #ad inches1 each4 ,finally1 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 them3 8444 it revivifies the nerves1 promoting sleep and helping digestion44440 8444 it builds up the blood1 creating new strength and the power to do and accomplish40 8444 ,sanatogen is a natural1 healthful food and tonic44440 8444 a health and strength giving food and tonic composed of those very elements which make cell and tissue grow40 8,blood and tissues alike hunger for ,sanatogen as their concentrated nourishment40 8,sanatogen is the one food tonic that commands your absolute confidence40 ,how many intelligent physicians really believe that there is the slightest basis of fact for the claims we have quoted8 ,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 truth4 ,and every quotation in this article is taken from advertising matter issued during the current year1 #aiac6 ,in closing1 let us reiterate3 ,the objections to ,sanatogen are primarily the objection to any fraud4 ,it is being sold under unscientific1 misleading and fraudulent claims2 moreover1 although this is of less importance1 the purchaser pays an extraordinary price for a most ordinary product4 ,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 merit4 ,when that time comes1 ,sanatogen will die a natural death4 ,in the meantime1 its exploiters are reaping a golden harvest1 of which no small part is being divided among publishers1 medical and otherwise4 ,and the credulous among the sick and suffering pay the bills6--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #f1 #aiac47 ,,sanatogen3 ,a ,,scientific ,,investigation ,,of ,,its ,,alleged ,,action ,,on ,,the ,,recuperating ,,powers ,,of ,,the ,,blood ,sanatogen1 the new elixir of life compounded of casein and glycerophosphates1 has been noticed in ,the ,journal from time to time4 ,it will be remembered that1 while it has been claimed that 8,sanatogen contains over #gjj per cent4 more tissue-building1 life sustaining nourishment than wheat flour10 the facts are that one dollar's worth of wheat flour contains as much energy as one hundred and ninety-seven dollars' worth of ,sanatogen6 ,to this the manufacturers rejoin1 in effect1 that the casein and glycerophosphates in ,sanatogen1 being in chemical combination1 possess a mystical and esoteric virtue not measurable in terms of the food-value of the several ingredients4 ,the fact is1 of course1 that even assuming1 for the sake of argument1 that the ingredients of ,sanatogen are in chemical combination1 the compound cannot have any effect on the organism different from that of the uncombined casein and glycerophosphate1 for the union must be of the loosest kind and must be broken up as soon as the preparation enters the digestive tract4 ,testimonials are published in the ,sanatogen 8literature0 which show results in a variety of conditions2 cerebral concussion1 alcoholic gastritis1 anemia1 etc4 ,the patient is given a chance to recover with rest1 proper diet--and ,sanatogen4 ,and the recovery which ensues is attributed to ,sanatogen6 ,not all of these testimonials are as naive as that of the ,right ,reverend the ,bishop of ,bath and ,wells1 who contributes the following bit of second-hand testimony3 8,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 ,sanatogen40 ,illustration3 ,above is a photographic reproduction of one of the exhibits made at ,atlantic ,city at the last annual meeting of the ,american ,medical ,association4 ,jar #a contains #c-a_/c ounces of the casein-glycerophosphate combination made abroad and sold under the name 8,sanatogen20 it costs ,one ,dollar4 ,jar #b contains #b pounds #ac-a_/b ounces of a casein-glycerophosphate combination made by an ,american casein company2 it costs ,one ,dollar4 ,for the same money1 then1 one gets nearly #ae times as much of this casein-glycerophosphate combination made in ,america as when the casein-glycerophosphate combination is sold under the name 8,sanatogen0 and manufactured abroad4 ,jar #c contains one dollar's worth of pure casein4 ,the casein entirely fills the jar1 although the weight of the material is the same as the weight of the casein-glycerophosphate combination in ,jar #b4 ,pure casein is more bulky than the casein-glycerophosphate combination4 ,again we would emphasize that the chief objection to ,sanatogen is not its high price1 but the fraudulent claims under which it is sold4 ,the following selections perhaps fairly represent the value to science of the clinical evidence offered4 ,describing a case of vomiting from cerebral concussion3 8,i ordered an ice-bag to the head1 a mustard leaf to the epigastrium1 absolute recumbency in bed and small feeds of ,sanatogen with water4 ,this diet was continued for three days1 but the vomiting ceased the second day40 ,and here a case of 8hungry tired nerves03 8,i have just had a recovery in a remarkable case which scores a victory for ,sanatogen4 ,the patient1 a man #fc1 had been treated for some years past for heart trouble4 ,when he came to me1 however1 ,i diagnosed his trouble as #8hungry tired nerves4' ,i put him on ,sanatogen and eupeptics4 ,in a month he was much improved40 ,in a serious case of the 8,american disease03 8,i tried ,sanatogen on a woman suffering from extreme neurasthenia and debility4 ,for the past six weeks ,i have had1 and still have1 her under rest-cure treatment1 during which time ,i have given her ,sanatogen4 ,i have been very much elated with the treatment40 ,anemia in a girl of #bc working in a bookbindery3 8,i promptly decided to use ,sanatogen4 ,in addition1 ,i was able to secure the girl's absence from work so that she had the advantage of outdoor life and sunshine4 ,improvement was rapid4444 ,both a priori and from results obtained it seems almost justifiable to speak of ,sanatogen as a specific in ordinary uncomplicated anemia40 ,note that in all these cases two or more remedial factors were introduced1 yet any favorable result is promptly ascribed to only one factor1 ,sanatogen6 ,and the factor of spontaneous improvement irrespective of all remedial measures is also ignored4 ,a 8,,scientific0 ,,testimonial ,every physician knows that the kind of evidence just quoted has the same scientific value as that of the average 8patent medicine0 testimonial--none whatever4 ,the exploiters of ,sanatogen put forward some testimony1 however1 that purports to have a certain authority4 ,this is a statement to the effect that 8,sanatogen acts as a strong stimulus as far as the recuperative powers of the blood are concerned40 ,this claim is based on biologic experiments carried out by two physicians1 ,drs4 ,g4 ,mann and ,j4 ,g4 ,gage1 the record of whose work was published in the ,lancet1 ,oct4 #ai1 #aiab4 ,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 authors4 ,as it had been published in the ,lancet1 a medical journal of standing1 whose publishers apparently thought it of sufficient importance to warrant the expense of a colored plate insert1 it seemed worth while to have the work of ,mann and ,gage reviewed and its conclusions checked by parallel experiments4 ,a4 ,j4 ,carlson1 professor of physiology at the ,university of ,chicago1 was asked to do this work and kindly undertook it4 ,his report follows3 ,report of ,professor ,carlson ,i am asked to review the work done by ,drs4 ,g4 ,mann and ,j4 ,g4 ,gage1 from which they draw the following conclusions3 8,sanatogen sodium caseinogenate glycerophosphates further stimulates blood cells to undergo nuclear division1 which during the early period is mostly amitotic4444 ,therefore1 it is evident that ,sanatogen acts as a strong stimulus as far as the recuperative powers of the blood are concerned40 ,three series of experiments were made and reported by ,drs4 ,mann and ,gage1 comparing the histology of the blood in starvation and during the height of digestion4 ,the experiments of the first series were made on six students1 the starvation period being thirty-six hours1 ordinary food being taken after the thirty-six hours' fast1 so far as can be gathered from ,dr4 ,mann's report4 ,it was found that during the height of digestion the nuclei of the lymphocytes and leukocytes stain more deeply1 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 cells1 in comparison with the blood during fasting4 ,the experiments of the second series were made on #ajj frogs that had starved for months1 blood-films being taken at varying periods after feeding #a gm4 ,sanatogen4 ,the changes noted in the white blood-cells of the frogs were practically identical with those described in the case of the six students4 ,increased cell division is stated to occur4 ,the nuclei of the erythrocytes stain more deeply and the cells are increased in size1 and exhibit increased cell division twenty-four hours after the feeding4 ,the third series consisted of one experiment on ,dr4 ,mann himself4 ,he fasted twenty hours and then took #ae gm4 of ,sanatogen in a cup of water4 ,practically the only change noted in the blood after the feeding was a deeper staining of the nuclei of the white cells4 ,to quote3 8,the changes in the granules of the polymorphonuclear leukocytes and in the eosinophils were much less marked than in the specimens supplied by the students1 and the diminution in the size of the white cells was so insignificant as to be hardly noticeable40 ,assuming that the blood-changes reported are correct1 is the conclusion warranted that ,sanatogen is a powerful recuperative stimulant to the blood8 ,in the first place1 it remains to be proved1 for there is as yet positively no evidence1 that the deeper staining of the nuclei during digestion and absorption of a protein meal represents 8recuperative power of the blood0 or processes of 8feeding0 on the part of the white cells4 ,the actual significance of these changes requires further investigation4 ,the increased division of the blood-cells described by ,dr4 ,mann in the frogs was not observed by him in man4 ,this phenomenon in the frogs is1 in all probability1 associated with the extraordinary length of the starvation period 7months7 and the well-known seasonal variations in the physiology of this species4 ,in the second place1 waiving for the moment the question of the significance of the blood-changes observed1 the evidence1 so far as it goes1 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 food4 ,the experiments do not demonstrate any different or more marked effect from ,sanatogen than from other protein foods4 ,the test on the six students with ordinary food can be considered as a control on the single ,sanatogen test on ,dr4 ,mann himself4 ,the blood-changes in the students were more marked than in ,dr4 ,mann4 ,although ,mann and ,gage say that six frogs were used as controls1 they do not say how the controls were treated1 or draw any comparisons between the controls and the frogs fed with ,sanatogen4 ,so far as the report goes1 therefore1 the only basis for comparison is afforded by the work of one of ,dr4 ,mann's pupils1 ,h4 ,g4 ,butterfield4 ,this worker1 as quoted by ,mann1 found that on feeding newts after two weeks' starvation with a worm the size of a wooden match1 the nuclei of all tissues 7excepting nerve cells7 take a much deeper stain than in the control animals4 ,to pronounce ,sanatogen1 on the basis of the facts reported1 a 8powerful stimulus0 to blood-formation is a piece of special pleading1 if not of downright disingenuousness4 ,considered on its own merits1 the work would not have appeared to me worthy of being repeated for the purpose of checking up such obviously unwarranted conclusions4 ,in order to comply with the request made of me1 however1 ,i have repeated ,dr4 ,mann's experiments3 ,,experiments ,,by ,,professor ,,carlson ,i4 ,,tests ,,on ,,man 7,a4 ,j4 ,c47 #a4 ,thirty-six hours' fast followed by a meal of #be gm4 ,sanatogen in water4 #b4 ,thirty-six hours' fast followed by a meal of #be gm4 casein in water4 #c4 ,thirty-six hours' fast followed by a meal of #bjj c4c4 of milk4 ,,ii4 ,,tests ,,on ,,rats #a4 ,four animals1 seventy-two hours' fast followed by a meal of ,sanatogen in water4 #b4 ,two animals1 seventy-two hours' fast followed by a meal of crackers and milk4 #c4 ,two animals1 seventy-two hours' fast followed by a meal of casein in water4 #d4 ,two animals1 seventy-two hours' fast followed by a meal of casein and sodium glycerophosphate in water4 ,blood-films were taken at intervals during the fasting period and for twenty-four hours after feeding was resumed4 ,the technic of fixing and staining given by ,drs4 ,mann and ,gage was followed in every detail in order to make my results comparable with their findings4 ,,results ,my results may be summarized as follows3 #a4 ,the only change in the blood-cells that could be detected with certainty in rats or in man1 after feeding with ,sanatogen or after feeding with other foods1 was a deeper staining of the nuclei of the white cells in the films taken after feeding as compared with the films taken during fasting4 ,this difference is generally distinct1 and unmistakable1 although individual cells can always be found in the fasting and the feeding preparations that show no difference in affinity for the dyes4 ,to this extent my results confirm those of ,mann and ,gage4 ,i was not able1 however1 to make out any constant difference in the size of the cells1 quantity of cytoplasm1 or size and number of cytoplasmic granules similar to those reported by ,mann and ,gage4 #b4 ,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 milk1 crackers1 casein1 and casein and sodium glycerophosphate4 ,this is true for the tests both on man and on rats4 #c4 ,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 man1 probably owing to the longer starvation period in the case of rats4 ,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 investigation4 ,it may be related to the change in the titration alkalinity of the blood rather than an evidence of 8recuperative power0 on the part of the blood1 as it is well known that starvation induces acidosis1 while during digestion the alkalinity of the blood is distinctly increased4 ,if we assume that increased staining reaction during digestion indicates 8increased recuperative power of the blood0 it follows that such common and inexpensive foods as milk1 crackers and casein are just as 8powerful stimuli0 to this recuperation as ,sanatogen4 ,the extensive researches of ,mendel and ,osborne have shown that casein is in a certain sense a perfect food in that it is1 in normal animals1 capable of promoting growth and maintaining nitrogenous equilibrium1 at least for long periods of time4 ,the burden of proof1 however1 rests with the promoters of ,sanatogen to show that the casein in ,sanatogen is superior to the natural product of the cow4 ,conclusion ,from the findings in ,professor ,carlson's report on this disguised puff of a mendaciously exploited proprietary1 about all that remains to be said is that it is humiliating to find such pseudo-science1 not only built up by members of a profession trained in science1 but also given currency and authority by a medical journal of high standing4--7,from the ,journal ,a4 ,m4 ,a41 ,sept4 #bf1 #aiad47 ,as to ,sanatogen ,for several years it has been known by physiologists that all proteins taken into the stomach are disintegrated into their fundamental components1 the amino-acids1 and that they are not absorbed at all as proteins1 except in most minute amounts under exceptional conditions4 ,therefore1 no matter what protein is taken as food1 the material obtained from this protein by the body is a group of amino-acids1 always pretty much the same except in relative proportions1 whatever the food4 ,a few proteins lack certain essential amino-acids1 but any ordinary diet supplies enough1 and more than enough1 of each and every amino-acid4 ,furthermore1 since the proteins are completely disintegrated before absorption1 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 compound4 ,all the facts stated above are elementary1 and should be known by any and every physician who pretends to keep even approximately abreast of the science of medicine4 ,if there are any who do not know these fundamentals1 and from certain unwelcome evidence we fear there are1 they must be resigned to being told just where they stand4 ,certainly they have no good excuse for their lack of information1 for the physiologists and biochemists have informed them of modern advances in innumerable ways4 ,for ten years and more these facts have been discussed and demonstrated in societies and in medical publications4 ,and yet--there is ,sanatogen1 prescribed by ,geheimrats1 ,hofrats and also by doctors1 and testimonialed as abundantly by men with medical degrees as ,duffy's whisky is by centenarians4 ,one can merely throw up his hands4 ,if1 as the exploiters of ,sanatogen declare1 the product 8has been endorsed by von ,noorden1 ,ewald1 ,duhrssen1 ,eulenburg1 ,neiser1 ,binswanger1 ,leyden1 ,krafft-,ebing1 ,tillmanns1 ,tunnicliffe and thousands of other earnest1 reputable physicians10 we can only say that their earnestness has not been in the direction of grasping fundamental advances in medical sciences1 however great the reputation they have gained may be4 ,the article by ,john ,phillips ,street that follows is another report of exact experimental observation which shows1 as was obvious beforehand1 that ,sanatogen has the properties of its constituents1 namely1 casein and glycerophosphates4 ,nothing more nor nothing less could be the case4 ,bottling dried cottage cheese plus some glycerophosphates1 and raising the price many times1 may increase its psychic effect1 but it will not alter its physiologic action4 ,these facts we have presented often enough1 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 free4 ,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 surprising4 ,by blatant and persistent advertising1 the public can be fooled into buying any product--however valueless--for which medicinal claims are made4 ,but that physicians should prove equally gullible is a sorry commentary on the scientific attainments of the followers of a learned profession4--7,modified from ,editorial in ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ba1 #aiad47 ,,the ,,feeding ,,value ,,of ,,sanatogen ,,compared ,,with ,,commercial ,,casein ,,with ,,respect ,,to ,,maintenance ,,and ,,growth ,john ,phillips ,street1 ,m4,s4 ,chemist ,connecticut ,agricultural ,experiment ,station ,,new ,,haven1 ,,conn4 ,the proprietary preparation 8,sanatogen0 is claimed to consist of about #ie per cent4 casein and #e per cent4 sodium glycerophosphate4 ,the analysis of ,c4 ,b4 ,morison#abb is as follows3 #abb ,morison1 ,c4 ,b43 ,rept4 ,conn4 ,agri4 ,exper4 ,station1 #aiab1 p4 #aig4 ,water #i4ig ,total nitrogen #ab4ha ,nitrogen1 ppt4 by acetic acid #ab4ed ,casein #hj4ja ,ether extract #j4aa ,ash #e4ei ,sulphur1 total #j4gc ,sulphur in casein #j4fd ,phosphorus1 total #a4di ,phosphorus in casein #j4fi ,phosphorus in inorganic form #j4aa ,in connection with the above analysis it was demonstrated that sodium glycerophosphate was present4 ,sanatogen1 therefore1 consists essentially1 on the water-free basis1 of about #ij per cent4 casein and #e per cent4 sodium glycerophosphate1 with a small amount of an unidentified nitrogenous compound containing both sulphur and phosphorus1 and a small amount of phosphorus in organic combination4 ,the manufacturers claim that the two essential ingredients exist in ,sanatogen as a definite chemical compound4 ,certain authorities1 on the other hand1 have insisted that the casein and glycerophosphate have not been chemically combined and that ,sanatogen is simply a mechanical mixture of the two4 ,which claim is correct we will not consider here1 for indeed it is of little importance1 for whether or not chemically combined the action of the digestive fluids of the body would speedily break down the alleged compound into its constituents1 and the body would have casein and the glycerophosphate offered for its use1 just the same as though they had been offered as a mere mechanical mixture4 ,it being apparent that ,sanatogen consists almost entirely of casein and sodium glycerophosphate1 the former well-known ingredient making up nine-tenths of its weight1 the question naturally arises how a mixture of these two common substances can acquire1 simply by that admixture1 unusually valuable properties not possessed by the two components4 ,leading physiologists quite generally agree that phosphorus in the form of glycerophosphates influences metabolism very little4 ,furthermore1 it is obvious that the food value of the small amount of glycerin present must be slight4 ,it is apparent therefore1 that whatever nutriment or energy ,sanatogen supplies must be dependent on its main constituent casein4 ,sanatogen is commonly sold at retail in #ajj gm4 or #bjj gm4 packages for #a and #a4ij1 respectively4 ,it is possible that in larger quantities these prices might be shaded somewhat1 but the fact remains that the ordinary retail purchaser of ,sanatogen pays for it about #a cent per gram1 or about #d4ej per pound4 ,if the value of ,sanatogen depends on its casein1 one might ask1 in all fairness1 why should the patient pay #d4ej per pound for ,sanatogen when he can secure ordinary commercial casein for #h4e to #aj cents per pound6 7,the ,casein ,mfg4 ,co4 of ,new ,york quoted to me their ,no4 #fj casein at #aj cents per pound in #e-pound lots1 #h4e cents per pound f4 o4 b4 ,bainbridge1 ,n4 ,y41 in #ajj-pound lots1 and #h4e cents per pound1 freight paid1 in #ejj-pound lots47 ,i have purchased ,sanatogen from a wholesale druggist at the rate of #b4ge for #djj gm41 or #c4ab per pound1 so that under the most favorable conditions the cost of ,sanatogen is more than thirty times as great as the commercial casein in question4 ,is the consumer justified in paying this exceedingly high price for purified casein8 ,the following feeding experiments were carried out to answer this query4 ,,feeding ,,experiments ,white rats were chosen for the experimental animals because of their adaptability for tests of this kind1 as shown by the extended successful experience of ,osborne and ,mendel1 and also because1 by using white rats1 ,i could take advantage of the equipment and the experience of my colleagues1 ,dr4 ,t4 ,b4 ,osborne1 ,prof4 ,l4 ,b4 ,mendel and ,miss ,edna ,l4 ,ferry4 ,the value of ,sanatogen as compared with commercial casein was studied from two points of view3 #a4 ,its value in maintaining the weight of mature rats4 #b4 ,its value in promoting the growth of young rats4 ,i4 ,,the ,,maintenance ,,of ,,weight ,,of ,,mature ,,rats ,the ,sanatogen used contained #ab4hh per cent4 of nitrogen1 and the casein1 #ab4hb per cent41 so that from the point of view of nitrogen content they were practically equivalent1 gram for gram4 ,six healthy male animals were selected1 ,rats #a1 #b and #c being fed the casein ration and ,rats #d1 #e and #f the ,sanatogen ration4 ,at the beginning of the experiment the casein rats were #beg1 #cfj and #cgf days old2 the ,sanatogen rats1 #bdi1 #cba and #bge days old1 respectively4 ,these weight conditions1 if anything1 slightly favored the ,sanatogen rats1 as they were slightly less mature1 and a greater growth might naturally be expected4 ,the rations fed had the following percentage composition3 ,ration #a ,ration #b ,casein #bj ,sanatogen #bj ,protein-free milk,,ba #bh ,protein-free milk,,ba #bh ,lard #h ,lard #ad ,unsalted butter #ah ,unsalted butter #ah ,corn starch #bf ,corn starch #bj ,,ba ,osborne and ,mendel3 ,feeding ,experiments with ,isolated ,food ,substances1 ,carnegie ,inst4 of ,washington1 ,publ4 #aef1 #aiaa1 ,part #b1 p4 #hj4 ,the rats were weighed twice a week for nine weeks1 a record of the food consumed also being kept4 ,table #a shows the weekly weights of the casein rats1 the weekly gain or loss1 and the weekly consumption of food4 ,table #b gives similar data for the ,sanatogen rats4 ,illustration3 ,chart #a4--;,growth curves of ,rats #a1 #b and #c1 on ,ration #a3 ,casein4 ,illustration3 ,chart #b4--;,growth curves of ,rats #d1 #e and #f1 on ,ration #b3 ,sanatogen4 ,certainly the above data show no superiority of ,sanatogen over commercial casein4 ,in fact the results might be taken to suggest a slight advantage for the cheaper article1 if one were warranted in drawing fine distinctions from a limited number of animals4 ,to conclude1 a comparative feeding of six male white rats during nine weeks showed no nutritive superiority of ,sanatogen1 costing #c4ab per pound1 over commercial casein costing #aj cents per pound4 ,,ii4 ,,the ,,promotion ,,of ,,growth ,,in ,,young ,,rats ,in the second series of experiments ten male rats were used with four different rations4 ,in these1 casein and ,sanatogen were compared1 using both ,osborne and ,mendel's 8protein-free milk0 and their 8artificial protein-free milk ,,iv40#abc ,butter fat was also substituted for the unsalted butter used in ,rations #a and #b4 #abc ,osborne and ,mendel3 ,jour4 ,biol4 ,chem41 #aiac1 xv1 #cag4 ,the percentage composition of the rations fed was as follows3 ,ration #c ,ration #e ,casein #bj ,casein #bj ,protein-free milk #bh ,artificial p4-f4 milk ,,iv #bi ,lard #h ,lard #h ,butter-fat #ah ,butter-fat #ah ,corn starch #bf ,corn starch #be ,ration #d ,ration #f ,sanatogen #bj ,sanatogen #bj ,protein-free milk #bh ,artificial p4-f4 milk ,,iv #bi ,lard #ad ,lard #ad ,butter-fat #ah ,butter-fat #ah ,corn starch #bj ,corn starch #ai ,two male rats were used with each of ,rations #c and #d1 and three with each of ,rations #e and #f4 ,they were all healthy young rats ranging from #eg to #ga days old4 ,as in the first series of experiments the rats were weighed twice a week and a record kept of the food consumed4 ,rations #c and #d were fed for seventy-seven days1 ,rations #e and #f for thirty-five days4 ,table #c shows the weekly weights and gains or losses of the rats fed ,rations #c and #d4 ,rat #h suffered more or less from diarrhea during a considerable part of the experiment1 covering a period from ,march #af to ,april #i1 and from ,april #ac to ,may #aa4 ,the food intake correspondingly decreased during those periods4 ,,table #a4--,,weights ,,of ,,casein ,,rats1 ,,on ,,ration ,,no4 #a1 ,,over ,a ,,period ,,of ,,nine ,,weeks,,bb ,rat #a ,rat #b ,rat #c ---------------------------------------- --------------- ,date ,weight1,gain ,food ,weight1,gain ,food ,weight1,gain ,food gm4 or ,eaten1 gm4 or ,eaten1 gm4 or ,eaten1 ,loss1 gm4 ,loss1 gm4 ,loss1 gm4 gm4 gm4 gm4 ---------------------------------------- ---------------------- #a_/b #bdj4j -- -- #bfd4f -- -- #cad4a -- -- #a_/i #bej4h #aj4h #gc4g #bgj4i #f4c #he4b #cad4f #j4e #ie4g #a_/af #bfd4c #ac4e #hi4c #bhd4i #ad4j #ii4b #cjh4g -#e4i #aag4i #a_/bc #bgd4i #aj4f #ij4g #bic4e #h4f #ajg4g #cac4h #e4a #aaf4e #a_/cj #bgh4f #c4g #hj4b #cjd4e #aa4j #ajj4e #cbb4b #h4d #aaf4g #b_/f #bgh4c -#j4c #hb4d #bid4b -#aj4c #ig4j #caa4b -#aa4j #aai4i #b_/ac #bhh4g #aj4d #he4e #bha4e -#ab4g #id4b #cjh4b -#c4j #abe4f #b_/bj #bhf4d -#b4c #hf4a #bic4c #aa4h #hf4h #cji4j #j4h #abf4h #b_/bg #bhg4f #a4b #ha4a #big4f #d4c #ajj4g #cjc4d -#e4f #abi4c #c_/f #bib4f #e4j #hj4a #cjg4d #i4h #ajc4a #bib4d -#aa4j #aja4j ,total -- #eb4f #gei4a -- #db4h #hgd4d -- -#ba4ga1jdi4d ,average per week -- #e4h #hd4c -- #d4h #ig4b -- -#b4d #aaf4f ---------------------------------------- ---------------------- ,,bb ,the growth curves of ,rats #a1 #b and #c are given in ,chart #a4 ,,table #b4--,,weights ,,of ,,sanatogen ,,rats1 ,,ration ,,no4 #b1 ,,over ,a ,,period ,,of ,,nine ,,weeks,,bc ,rat #d ,rat #e ,rat #f ---------------------------------------- -------------- ,date ,weight1,gain ,food ,weight1,gain ,food ,weight1,gain ,food gm4 or1 ,eaten1 gm4 or ,eaten1 gm4 or ,eaten1 ,loss gm4 ,loss1 gm4 ,loss1 gm4 gm4 gm4 gm4 ---------------------------------------- --------------------- #a_/b #bea4h -- -- #bij4f -- -- #bid4j -- -- #a_/i #beg4a #e4c #gc4d #big4b #f4f #hf4c #bhi4a - #d4i #eh4d #a_/af #bfb4d #e4c #hi4h #bib4d - #d4h #hh4i #bhf4a - #c4j #gf4h #a_/bc #bgd4d #ab4j #ig4c #bie4g #c4c #ib4h #bhg4f #a4e #he4h #a_/cj #bhb4g #h4c #ie4e #bii4e #c4h #ib4c #bih4f #aa4j #ij4i #b_/f #bgi4h - #b4i #ig4g #bhd4b -#ae4c #hg4g #bib4i - #e4g #hi4h #b_/ac #bga4b - #h4f #if4a #bhj4j - #d4b #id4i #bie4a #b4b #ii4g #b_/bj #beg4e -#ac4g #ia4f #bgd4i - #e4a #if4d #bif4j #j4i #ic4i #b_/bg #beh4j #j4e #ic4e #bgc4j - #a4i #ajc4c #bie4j - #a4j #ie4a #c_/f #bgj4i #ab4i #id4h #bgh4a #e4a #id4i #cjf4c #aa4c #hi4d ,total -- #ai4ahbi4g -- -#ab4e #hcg4e -- #ab4c #ggi4h ,average #b4g per week -- #ib4b -- - #a4d #ic4a -- #a4d #hf4f ---------------------------------------- --------------------- ,,bc ,the growth curves of ,rats #d1 #e and #f are given in ,chart #b4 ,,table #c4--;,,comparative ,,weights ,,of ,,rats ,,fed ,,rations #c ,,and #d ,weights of ,rats1 ,ration #c1 ,weights of ,rats1 ,ration #d1 ,casein1 ,protein-,free ,milk ,sanatogen1 ,protein-,free ,milk ---------------------------------------- ----------------- ,rat #g ,rat #h ,rat #i ,rat #aj ,date ---------------------------------------- ------------ ,weight1,gain ,weight1,gain ,weight1,gain ,weight1,gain gm4 or gm4 or gm4 or gm4 or ,loss1 ,loss1 ,loss1 ,loss1 gm4 gm4 gm4 gm4 ---------------------------------------- ----------------- #c_/i #adb4b -- #ajh4j -- #abg4h -- #ajg4j -- #c_/af #aeb4h #aj4f #abj4c #ab4c #abi4a #a4c #aaf4j #i4j #c_/bc #afe4g #ab4i #ace4a #ad4h #add4f #ae4e #acd4e #ah4e #c_/cj #agh4f #ab4i #adj4d #e4c #afj4j #ae4d #adi4h #ae4c #d_/f #ahg4h #i4b #adh4h #h4d #agc4a #ac4a #adc4h -#f4j #d_/ac #aih4e #aj4g #aeg4f #h4h #ahe4f #ab4e #aff4a #bb4c #d_/bj #bjd4f #f4a #afd4f #g4j #aid4h #i4b #agi4d #ac4c #d_/bg #baj4c #e4g #afg4b #b4f #bjd4f #i4h #aia4j #aa4f #e_/d #bbc4j #ab4g #agi4f #ab4d #bbb4i #ah4c #bjd4g #ac4g #e_/aa #bbc4f #j4f #aia4f #ab4j #bcf4d #ac4e #baj4h #f4a #e_/ah #bca4e #g4i #bjc4f #ab4j #bdj4j #c4f #bah4f #g4h #e_/be #bcg4d #e4i #bac4i #aj4c #bdg4c #g4c #bbf4g #h4a ,total -- #ie4b -- #aje4i -- #aai4e -- #aai4g ---------------------------------------- ----------------- ,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 growth4 ,the slightly increased gains shown by ,rats #i and #aj are entirely incommensurate with the cost of the ,sanatogen4 ,all of the rats showed a vigorous growth and exceeded the average weight expected for rats of their respective ages1 based on the long series of observations of ,osborne and ,mendel1 as shown in ,table #d4 ,illustration3 ,chart #c4--;,growth curves of ,rats #g1 #h1 #i and #aj on ,rations #c1 ,casein1 protein-free milk1 and #d1 ,sanatogen1 protein-free milk4 ,,table #d4--,,weight ,,of ,,rats #g ,,to #aj ,,compared ,,with ,,average ,,weight ,,of ,,rat ,,of ,,same ,,age ,average ,weight ,rat ,age in ,days ,final weight1 for rat of gm4 ,same ,age1 gm4 ---------------------------------------- --------- #g #adh #bcg #bjd #h #ach #bad #bja #i #ade #bdg #bjd #aj #acd #bbg #aig ---------------------------------------- --------- ,illustration3 ,chart #d4--;,growth curves of ,rats #aa1 #ab and #ac1 on ,ration #e3 ,casein1 artificial protein-free milk4 ,illustration3 ,chart #e4--;,growth curves of ,rats #ad1 #ae and #af1 on ,ration #f3 ,sanatogen1 artificial protein-free milk4 ,,table #e4--,,weights ,,of ,,rats ,,fed ,,ration #e1 ,,casein1 ,,artificial ,,protein-,,free ,,milk,,bd ,rat #aa ,rat #ab ,rat #ac ---------------------------------------- --------- ,date ,weight1,gain or ,weight1,gain or ,weight1,gain or gm4 ,loss1 gm4 gm4 ,loss1 gm4 gm4 ,loss1 gm4 ---------------------------------------- ---------------- #c_/i #acb4a -- #aaj4j -- #ii4j -- #c_/af #acj4d -#a4g #aaf4h #f4h #aaj4c #aa4c #c_/bc #acf4h #f4d #acj4h #ad4j #ajh4f -#a4g #c_/cj #acg4a #j4c #ach4j #g4b #ajj4b -#h4d #d_/f #abg4a -#aj4j #adc4i #e4i #ie4e -#d4g #d_/ac #aab4d -#ad4g #adc4f -#j4c #ij4j -#e4e ,total -- -#ai4g -- #cc4f -- -#i4j #d_/bj #adf4g #cc4g #agj4g #bg4a #ajd4j #ad4j ---------------------------------------- ---------------- ,,bd ,date #d_/bj covers use of mixed food4 ,rat #ac suffered more or less from diarrhea throughout the whole experiment1 and ,rat #af suffered similarly during the first two weeks4 ,the results secured by ,rations #e and #f compared with ,rations #c and #d1 the only difference being that natural protein-free milk was used in the latter and artificial protein-free milk in the former1 are most striking4 ,such results were anticipated from the experience of ,osborne and ,mendel in feeding similar materials4 ,all of my rats1 except ,rat #ac1 a casein rat1 showed a decided loss in weight after five weeks' feeding on rations containing artificial protein-free milk4 ,these losses amounted to #ai4g1 #i4j1 #bc4a1 #f4g and #bg4f gm41 whereas rats fed on the same rations1 except for the form of protein-free milk1 gained1 during the same period of five weeks1 #ef4c1 #di4f1 #eg4h and #ei4a gm4 ,the fact that one casein ,,table #f4--,,weights ,,of ,,rats ,,fed ,,ration #f4--,,sanatogen1 ,,artificial ,,protein-,,free ,,milk,,be ,rat #ad ,rat #ae ,rat #af ---------------------------------------- ----------- ,date ,weight1,gain or ,weight1,gain or ,weight1,gain or gm4 ,loss1 gm4 gm4 ,loss1 gm4 gm4 ,loss1 gm4 ---------------------------------------- ---------------- #c_/i #aah4d -- #aaa4c -- #aja4c -- #c_/af #abf4b #g4h #aaf4b #d4i #ajj4j -#a4c #c_/bc #abf4f #j4d #abc4d #g4b #ih4j -#b4j #c_/cj #abd4g -#a4i #abc4c -#j4a #ih4g #j4g #d_/f #aaj4b -#ad4e #aab4c -#aa4j #hh4g -#aj4j #d_/ac #ie4c -#ad4i #ajd4f -#g4g #gc4g -#ae4j ,total -- -#bc4a -- -#f4g -- -#bg4f #d_/bj #acj4c #ce4j #ace4c #cj4g #ajf4d #cb4g ---------------------------------------- ---------------- ,,be ,date #d_/bj covers use of mixed food4 rat fed on the artificial protein-free milk showed a substantial gain is without significance1 as such exceptions to the general rule occur occasionally1 and1 furthermore1 this rat also during the last week of the experiment likewise lost weight4 ,the extent of these losses compared with what the average normal male rat weighs at a corresponding age is shown in ,table #g4 ,,table #g4--,,weight ,,of ,,rats #aa ,,to #af ,,compared ,,with ,,average ,,weight ,,of ,,rat ,,of ,,same ,,age ,average ,weight ,rat ,age1 ,days ,final ,weight1 of ,rat of gm4 ,same ,age1 gm4 ---------------------------------------- ------- #aa #ajf #aab #afg #ab #ajf #add #afg #ac #ii #ij #afb #ad #ajf #ie #afg #ae #ib #aje #aec #af #if #gd #aeh ---------------------------------------- -------- ,that these losses in weight were not due to any inherent weakness in the rats is shown by the fact that by feeding ,rats #aa to #af for one week after the termination of the experiment with ,osborne and ,mendel's 8mixed food0 7a mixture of dog bread1 sunflower seeds1 vegetables and meat7 very large gains were secured in every instance1 ranging from #ad to #ce gm4 ,the growth curves for ,rats #g to #af are shown in ,charts #c1 #d and #e4 ,to conclude1 ,a ,,comparative ,,feeding ,,of ,,four ,,male ,,white ,,rats ,,during ,,eleven ,,weeks1 ,,showed1 ,,if ,,anything1 ,a ,,slightly ,,greater1 ,,but ,,insignificant1 ,,increase ,,in ,,weight ,,for ,,sanatogen ,,over ,,commercial ,,casein4 ,,in ,a ,,ration ,,in ,,which ,,artificial ,,had ,,been ,,substituted ,,for ,,natural ,,protein-,,free ,,milk1 ,,sanatogen ,,showed ,,no ,,advantage ,,over ,,commercial ,,casein ,,in ,,checking ,,the ,,failure ,,in ,,weight ,,of ,,the ,,rats4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ba1 #aiad47 ,,poehl',s ,,spermin ,,in ,,arteriosclerosis ,a physician addressed the following inquiry to ,the ,journal3 8,in a recent number of the ,gazette md4 belge1 ,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 #8,sperminum ,poehl1' an advertised remedy which ,i have always distrusted and never prescribed4 ,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 it40 ,x4 ,y4 ,z4 ,the ,journal replied3 ,apparently the exploitation of ,poehl's spermin passed several years ago from the domain of experimental medicine to that of nostrums advertised to the laity4 ,so far as we know1 it has received no recent discussion from reliable clinicians or experimenters4 ,in some medical journals1 as also in lay journals1 it is true1 one still reads that ,poehl's spermin is successfully applied in 8neurasthenia1 senile marasmus1 anemia1 rachitis1 gout1 chronic rheumatism1 syphilis1 hysteria1 tuberculosis1 typhus1 diseases of the heart1 nephritis1 tabes dorsalis1 paralysis1 neurasthenic impotence1 overwork1 acute diseases1 and for convalescents40 ,few quack advertisements would differ much from this puff of ,poehl's spermin4 ,so far as we know1 there is no reason to fear injurious results from the use of the remedy2 neither might any good be expected from its use in arteriosclerosis4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ae1 #aiaa47 ,,syrup ,,of ,,cocillana ,,compound ,a physician in a small town in ,nebraska writes3 8,in looking over a prescription file not long ago ,i found a prescription which ,i copied and am sending to you4 ,it is a good example of shotgun prescribing4 ,i do not give the name of the prescriber1 and you will please not mention from whence this comes4 ,the doctor who wrote this has had about ten years' experience40 ,here is the prescription given exactly as transmitted by our correspondent3 ,sp4 sticta ,gtt xv ,sp4 ipecac ,gtt x ,sp4 bryonia ,gtt x ,sp4 macrotys i ,bromoform ,bronchial ,anodyne ii ,syrup ,cocillana ,comp4 q4 s4 ad vi ,teaspoonful every two or three hours4 ,it is evident that the prescriber is an eclectic4 ,as a matter of fact1 in a second letter from the physician who forwarded the prescription1 we are informed that the prescriber is a graduate of an eclectic institution not a thousand miles from where he practices4 ,the 8,sp40 in the prescription does not mean 8,spiritus10 but specific tincture4 ,the prescriber is an advocate of specific remedies1 one of which should fit the condition1 but he is broad-minded enough to call help from the outside1 and so adds fifteen other remedies to the specific selected1 including alcohol4 ,the inability of one mind to remember all the ingredients of so complex a mixture will explain the fact that ipecac is duplicated1 occurring both as a specific tincture and as an ingredient of ,bromoform ,bronchial ,anodyne4 ,the latter1 the manufacturers tell us1 contains in one fluidounce3 ,alcohol #e per cent4 ,bromoform #h drops ,ipecac #a_/b gr4 ,ammonium bromid #bd grs4 ,benzoin #a gr4 ,syrup ,cocillana ,comp41 one of the 8elegant specialties0 of ,parke ,davis ,co41 of which they certainly ought to be very proud1 contains1 we are told1 in one fluidounce3 ,alcohol #e per cent4 ,heroin hydrochlorid #h_/bd gr4 ,tinct4 of euphorbia pilulifera #abj min4 ,syrup of wild lettuce #abj min4 ,tinct4 of cocillana #dj min4 ,syrup of squill comp4 #bd min4 ,cascarin1 ,p4 ,d4 ,co4 #h grs4 ,menthol #h_/ajj gr4 ,this 8elegant specialty0 of ,parke1 ,davis ,co4 is not only a shotgun prescription1 but has as one of its ingredients a mixture itself containing three ingredients1 namely3 ,syrup ,squill ,comp4 7,coxe's ,hive ,syrup71 making ten in all--a beautiful example of scientific pharmacy4 ,we wonder if our eclectic brother really appreciated that his prescription1 written out1 would be as follows3 ,sp4 sticta ,gtt xv ,sp4 ipecac ,gtt x ,sp4 bryonia ,gtt x ,sp4 macrotys i ,alcohol #e per cent4 ,bromoform #h drops ,ipecac #a_/b gr4 ,ammonium bromid #bd grs4 ,benzoin #a gr4 ,alcohol #e per cent4 ,heroin hydrochlorid #h_/bd gr4 ,tinct4 of euphorbia pilulifera #abj min4 ,syrup of wild lettuce #abj min4 ,tinct4 of cocillana #dj min4 ,fluidextract of squill #fj min4 ,fluidextract of senega #fj min4 ,antimony and potassium tartate #a gr4 ,cascarin1 ,p4 ,d4 ,co4 #h grs4 ,menthol #h_/ajj gr4 ,to use a slang expression1 this is certainly going some6--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #ah1 #aiaa47 8,a ,cough ,syrup with a ,history0 ,the following letter was received from ,dr4 ,geo4 ,p4 ,tolman1 ,watsonville1 ,cal43 ,to the ,editor3--,the enclosed advertisement was underscored and mailed to me by my druggist4 ,the properties of cocillana are similar to ipecac4 ,the dose of the fluidextract is from #aj to #bj minims4 ,each fluidounce of the extraordinary 767 dark-colored cough marvel of ,p4 ,d4 ,co4 contains #dj minims of the tincture4 ,if the tincture of cocillana is #aj per cent4 7the average tincture strength7 you can see that to get a minimal dose of the drug you would have to take #b-a_/b fluidounces of the syrup4 8,query3 ,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 ,p4 ,d4 ,co4 save the nation and make a few dollars for the druggist80 8,the secret of its prompt recognition lay in its unusual composition40 ,nay2 its prompt recognition lay in liberal and persistent advertising4 8,it quickly made a #8hit' with physicians0--because too many physicians1 like other human beings1 are susceptible to the psychology of advertising4 ,here is the 8unusual composition10 as given by the manufacturers3 8,tinct4 ,euphorbia pilulifera1 #abj mins42 ,syrup ,wild ,lettuce1 #abj mins42 ,tinct4 ,cocillana1 #dj mins42 ,syrup ,squill ,compound1 #bd mins42 ,cascarin 7,p4 ,d4 ,co471 #h grs42 ,heroin hydrochloride1 #h-bd gr42 ,menthol1 #h-ajj gr40 ,the following is a reproduction of the advertisement referred to3 ,illustration3 ---------------------------------------- -------------------- ,a cough syrup with a history4 ,syrup ,cocillana ,compound established itself with the medical profession in a single season4 ,it was introduced in #aijf4 ,the secret of its prompt recognition lay in its unusual composition4 ,the formula showed a rare combination of astringents and sedatives4 ,it quickly made a 8hit0 with physicians4 ,the name 8,syrup ,cocillana ,compound0 soon began to appear on prescriptions4 ,today this agent is the most widely prescribed of all preparations for cough4 ,syrup ,cocillana ,compound is a profitable product for the druggist to sell4 ,it commands a good price4 ,being totally unlike the common1 ordinary dark-colored 8cough mixtures0 it does not enter into competition with them4 ,be prepared to dispense it4 ,supplied in pint1 #e-pint and gallon bottles4 ,home ,offices and ,laboratories1 ,,parke1 ,,davis ,,co4 ,detroit1 ,michigan4 ---------------------------------------- -------------------- ,as we have said above1 ,parke1 ,davis ,co4 should be proud of this 8elegant specialty40 ,it would be hard to find a better specimen of a shotgun prescription2 not only does the prescription contain eight ingredients1 but one of these ingredients 7compound syrup of squill7 itself contains three4 ,as our correspondent correctly states1 the drug from which the name 7not the action7 of the preparation is derived comes from ,bolivia and has properties similar--but evidently inferior--to ipecac4 ,that it possesses but little therapeutic value is perhaps best evidenced by the fact that1 in spite of the propaganda made for it by ,parke1 ,davis ,co41 neither the drug nor any preparation of it is listed1 so far as we know1 by any other large pharmaceutical house1 with one exception4 ,besides cocillana the preparation contains two other obsolete drugs1 wild lettuce and euphorbia pilulifera4 ,the activity of the 8cough syrup10 it is needless to say1 depends in the main on the drug which is more or less buried in the published formula3 heroin hydrochlorid4 ,at one time ,parke1 ,davis ,co4 admitted that the preparation owed its chief value to heroin4 ,in a letter to the ,council on ,pharmacy and ,chemistry the firm said3 8,the physiologic action of this syrup is that which would be suggested by the constituents4 ,because of its activity the most prominent action would be that characteristic of heroin hydrochlorid40 ,without doubt the important ingredient1 from the point of view of therapeutic potency1 is the heroin2 and it is this drug doubtless1 that makes the mixture a good 8repeater40 ,syrup ,cocillana ,compound is a nostrum sailing under false colors4 ,whether its continued use is due to its mysterious1 meaningless1 misleading name or merely to insistent and persistent advertising methods of ,parke1 ,davis ,co4 is a question4 ,neither explanation is any credit to the medical profession which tolerates it1 or to the physician who prescribes it4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ae1 #aiac47 ,,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 mysteries4 ,physicians have frequently wondered why they were unable to obtain from the syrup of lactucarium1 ,u4 ,s4 ,p41 the therapeutic results which they were able to obtain from a proprietary product known as ,aubergier's ,syrup of ,lactucarium1 sold by ,fougera ,co4 at an exorbitant price and put up in 8patent-medicine0 style4 ,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 preparation4 ,with the advent of the ,food and ,drugs ,act the secret of the soporific effect of the ,aubergier product was explained--it contains morphin4#abd #abd ,technically1 this is incorrect1 as the company had inconspicuously stated in the 8literature0--not on the label--that the preparation contained 8extract of opium40 ,the practical difficulties of making a satisfactory syrup of lactucarium are not realized by most physicians4 ,to such the following note1 presented at a meeting of the ,pennsylvania ,pharmaceutical ,association by ,mr4 ,louis ,emanuel1 president of the ,pennsylvania ,pharmacy ,board1 will prove enlightening3 8,did you ever make a syrup of lactucarium direct from the crude drug8 ,if you did1 shake hands1 and let me hail you as a brother1 a brother pharmacist in fact worthy of the title4 ,if you did not1 ,i am sorry for you2 you have missed something worth knowing4 8,the ,american ,journal of ,pharmacy tells us that in #ahea #8,aubergier cultivated lactuca and poppy on a larger scale1 in order to obtain lactucarium and opium4 ,please note the latter for further reference4 ,in lactucarium he found lactucin1 mannite1 resin1 cerin1 asparmid1 brown coloring-substance and oxalic acid4' ,in #ahfj1 in the same publication1 ,proctor says3 #8,the attention of the medical practitioners has of late been turned to the syrup of lactucarium1 and the preparation sold usually by apothecaries in this city is that known as ,aubergier's1 a ,french preparation1 made by dissolving #cj parts of alcoholic extract of lactucarium in #ejj parts of boiling water1 straining the liquor and adding #ae1jjj parts of boiling simple syrup1 which is kept boiling1 and albuminous water added from time to time until it is clarified4' ,in '#ff1 '#gg1 '#gh1 '#hb and '#hd various writers produced elaborate dissertations on the supposed improved methods of making this syrup1 but not one has had the temerity of inquiring into the therapeutic value of this preparation1 or to examine the ,french preparation to ascertain whence comes its vaunted superiority4 8,the ,french1 it is said1 are an impressionable people1 but they appear to have a limit2 they do not take any chances on plain syrup of lactucarium4 ,theirs contains the added product1 extract of opium4 ,this implies a lack of faith in soporific properties of lactucarium1 and displays a recklessness in regard to cost and labor4 8,the ,national ,dispensatory1 fifth edition1 says3 8,the utility of retaining lactucarium as an official medicine is very doubtful4 ,it may possibly be desirable as a hypnotic for very impressionable persons1 with whom faith in a remedy supplies its want of intrinsic efficiency40 8,the official modus operandi for making this syrup looks laborious1 but the innocent-looking task of reducing the drug to a coarse powder is a revelation to the uninitiated4 8,it was a hot day in ,july and it took my #age-pound clerk and me all that day to reduce #ej gm4 of lactucarium to a satisfactory condition4 ,the stuff looked like old pieces of discarded rubber shoes1 and it really appeared to act like rubber4 ,after perspiring all day with the ,pharmacopeia and iron mortar1 imagine our disgust1 if you can1 on reading in the ,national ,dispensatory the following3 8,this alcoholic preparation of lactucarium is quite as valueless and more objectionable than the syrup of the same drug40 8,moral3 ,why pay #f4ej a pound for material that has no medicinal value1 and is so hard to manipulate as lactucarium when decrepit rubber shoes are so cheap8 ,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 material40 ,one of the advantages claimed for ready-made prescriptions over the made-to-order variety1 or even over pharmacopeial preparations1 is that they are more elegant in appearance and less offensive to the nostrils and palate4 ,this is the common experience of physicians who1 having prescribed some ready-made mixture1 wish to change the dose of one of its constituents and write a prescription or ask their pharmacists to prepare a similar preparation4 ,the inability of the pharmacist to prepare a preparation even approaching the original in appearance1 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 attainments4 ,but these conclusions1 although natural1 are based on false premises4 ,as the proprietary did not have the composition declared on the label1 a mixture based on the formula differed more or less widely from the proprietary it was expected to resemble4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #i1 #aiab47 ,a ,protest and a ,reply ,three months after publishing the foregoing we received a nine-page communication from ,comar ,co4 of ,paris1 the promotors of ,aubergier's ,syrup of ,lactucarium1 in which they took issue with some of the statements in our article4 ,the company claimed that a possible reason for the difficulty experienced by ,mr4 ,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 employs4 ,furthermore1 it said that the presence of morphin in the product was acknowledged before the passage of the ,food and ,drugs ,act4 ,on more careful investigation1 we find that this is true--that the presence of 8a certain proportion of extract of opium0 in the preparation was mentioned even before the federal ,food and ,drugs ,act compelled the morphin content to be published on the label4 ,technically1 then1 ,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 morphin2 practically it was right4 ,the information that ,comar ,co4 gave to physicians was buried in its advertising 8literature0 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 morphin4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #i1 #aiab47 ,,tartarlithine ,tartarlithine was examined by two chemists whose reports indicate that it is an effervescing preparation composed approximately of #bj per cent4 of carbonate of lithium and about #hj per cent4 of tartaric acid4 ,thus it is simply another of the hundreds of lithia preparations on the market offered for the cure of rheumatism4 ,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 disease4 ,while the advertisement carries the idea that ,tartarlithine is a product of the ,tartarlithine ,company1 and that ,mc,kesson and ,robbins are simply selling agents1 we are informed that the business is owned by ,mc,kesson and ,robbins1 who under this style manufacture a remedy for rheumatism4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,april #bc1 #aijg47 ,,thoxos ,thoxos is a 8specialty0 of ,john ,wyeth and ,brother4 ,from an advertising circular we learn that it 8offers to the physician a rational treatment for ,rheumatism1 both the ,subacute and ,chronic forms1 ,lithemia1 ,rheumatic ,arthritis1 ,gout1 ,sciatica and the various manifestations of uric diathesis10 and that 8it is a palatable solution of ,strontium and ,lithium soluble salts1 thirty-two grains1 combined with twenty-four minims ,wine of ,colchicum ,seed and a vegetable alterative1 in each fluidounce1 flavored with aromatics40 ,this 8formula0 does not indicate the acid with which the metals strontium and lithium are combined1 or what the 8vegetable alterative0 is2 it is essentially a secret preparation4 ,to learn what the missing and presumably active ingredients are an analysis was made by our chemists4 ,,laboratory ,,report ,one original bottle of ,thoxos1 ,john ,wyeth and ,brother1 ,philadelphia1 was purchased and submitted to analysis4 ,the bottle contained a brown liquid having an aromatic odor and a sweet taste4 ,the specific gravity of the liquid was #a4aah at #ae ,c4 7#fj ,f47 ,the solution was acid to litmus4 ,qualitatively the following constituents were detected3 strontium1 potassium1 sodium1 lithium1 ammonium1 salicylate1 iodid1 glycerin1 alkaloid1 alcohol and water4 ,by the smell and taste1 oil of wintergreen1 or methyl salicylate1 and oil of sassafras were recognized4 ,positive tests for a saponin-like body indicated the probable presence of sarsaparilla4 ,quantitatively the following results were obtained3 ,ammonia 7,,nh#c7 #j4jjf per cent4 ,lithium 7,li7 #j4ac per cent4 ,sodium 7,na7 #j4jc per cent4 ,strontium 7,sr47 #a4jc per cent4 ,iodid 7,i7 #j4df per cent4 ,salicylate 7,c#f;,h#d4,,oh4,,coo7 #d4ai per cent4 ,glycerin #ai4b per cent4 ,from the analytic results it would appear that the preparation contains approximately potassium iodid1 #j4fg gm4 per hundred c4c41 or #c grains per fluidounce2 lithium salicylate ,li7,c#g;,h#e,o#c71 #j4i gm4 per hundred c4c41 or #d grains per fluidounce2 strontium salicylate ,sr7,c#g;,h#e,o#c7b-b;,h#b,o1 #e4ge gm4 per hundred c4c41 or #bf grains per fluidounce1 and some salicylic acid combined with sodium and also in the free state4 ,the total salicylate found is equal to #e4dg gm4 of sodium salicylate per hundred c4c41 or #be grains per fluidounce4 ,as strontium salicylate and lithium salicylate are now generally considered to differ but slightly1 if at all1 in their action from that of sodium salicylate1 each dose of ,thoxos1 #a teaspoonful or #d c4c41 may be considered the equivalent of #j4b gm4 or #c grains of sodium salicylate with a fractional dose of colchicum4 ,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 colchicum1 one that any doctor could write and any druggist dispense4 ,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 combinations4 ,to prescribe ,thoxos is to prescribe a name1 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 flooded4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #ba1 #aiad47 ,,trypsogen ,besides exploiting a clay poultice--8,antithermoline0--the ,g4 ,w4 ,carnrick ,company appears to be chiefly concerned in the promotion of 8internal secretion0 specialties2 a class of preparations the therapeutic value of which is problematical4 ,thus it markets the diabetes remedy1 8,trypsogen0 tablets1 said to contain 8the enzyme of the islands of ,langerhans with the tryptic and amylolytic ferments of the pancreas0 along with gold bromid and arsenic bromid2 ,secretogen ,elixir1 said to be 8prepared from gastric secretin obtained from the pyloric antrum and pancreatic secretin from the duodenum1 combined with the enzymes of the peptic glands1 and one-twentieth of one per cent4 ,h,cl02 ,secretogen ,tablets1 said to be 8prepared from prosecretin and succus entericus obtained from the epithelial cells of the duodenum1 combined with pancreatic extract02 ,kinazyme1 8a preparation of extract of spleen1 reinforced with trypsin1 amylopsin and calcium lactate40 ,while great claims have been made for ,trypsogen and while it has been most widely advertised1 it is the consensus of opinion of the most eminent students of the question that pancreas is not really efficacious in diabetes4 ,were it of any value in this disease1 it would have won world-wide recognition for itself ere now1 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 clinical1 as well as animal1 experimentation that followed4 ,as the conditions of experiment in this question are extremely complex1 it is not surprising that occasionally apparently positive results should have been obtained4 ,were it really useful1 it should have yielded positive results much more uniformly4 ,furthermore1 if pancreas were really efficacious in the treatment of diabetes mellitus1 the addition of arsenic1 of gold1 of bromid would be entirely unnecessary4 ,even were it granted that pancreas extracts are valuable in the treatment of diabetes1 and that gold and arsenic also have beneficial effects1 it is our opinion that ,trypsogen should be considered an unscientific shotgun mixture1 because fixed combinations of remedies of different potencies1 such as arsenic1 gold1 bromid and pancreas1 are therapeutically erroneous1 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 poisoning4 ,antithermoline and ,trypsogen were at one time described in ,new and ,nonofficial ,remedies4 ,these preparations were omitted when the ,council's rules were revised some years ago4 ,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 business1 and paid less attention to the therapeutic worth of a remedy2 thus at that time it admitted both ,antithermoline and ,trypsogen to ,new and ,nonofficial ,remedies4 ,since then the ,council has modified its rules to exclude unscientific mixtures marketed under names that are misleading or therapeutically suggestive4 ,accordingly it rescinded the acceptance of ,antithermoline1 which was essentially the official clay poultice1 ,cataplasma ,kaolini1 ,u4 ,s4 ,p4 ,for similar reasons and because the therapeutic claims were held unwarranted ,trypsogen has been omitted from ,new and ,nonofficial ,remedies4 ,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 remedies1 whose claims have received no scientific confirmation4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #a1 #aiac47 ,,tyree',s ,,antiseptic ,,powder,,bf ,now ,advertised ,direct to the ,public as the 8,best ,preventative ,known0 ,,bf ,see also report1 p4 #ba4 ,when the history of the 8patent medicine0 business comes to be written impartially and fairly1 it will be realized that we1 the medical profession1 have been in no small degree responsible for its growth4 ,not a few widely advertised nostrums owe their commercial success solely to the ill considered use accorded them by physicians1 to whom they were first exploited4 ,as a well-known and brilliant advertising man once said3 8,the patent medicine of the future is one that will be advertised only to doctors4 ,some of the most profitable remedies of the present time are of this class4 ,they are called proprietary remedies4 ,the general public never hears of them through the daily press4 ,all their publicity is secured through the medical press1 by means of the manufacturer's literature1 sometimes gotten out in the shape of a medical journal1 and through samples to doctors4444 ,the medical papers will reap the harvest and the physician himself1 always so loud in the denunciation of #8patent medicines1' will be the most important medium of advertising at the command of the proprietary manufacturer4 ,in fact1 he is that to-day40 ,illustration3 ,advertisement from a newspaper--,tyree's ,powder as a 8,patent ,medicine0 of the 8,preventive0 ,type4 ,of the conditions here described probably no better example can be found than ,tyree's ,antiseptic ,powder4 ,for years this preparation was advertised to the medical profession under claims that were fraudulent as to both composition and therapeutic effect4 ,analysis published in ,the ,journal#abe proved that the formula given out by ,tyree was absolutely false and that the preparation was1 essentially1 nothing but a simple mixture of sulphate of zinc and boric acid4 #abe ,oct4 #bj1 #aijf1 and ,may #ah1 #aijg4 ,from the first it would seem that the manufacturers of this mixture had for their objective point that period when1 thanks to the use of the nostrum by physicians1 it would be widely purchased by the public4 ,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 8formula0--for a formula was forthcoming4 ,the ,journal itself1 until seven years ago1 carried the advertisements with a 8formula0 until chemical examination proved the falsity of the formula1 and of the therapeutic claims made for the product4 ,the medical profession in its turn prescribed the nostrum and the 8original package0 scheme did the rest4 ,illustration3 ,advertisement from ,medical ,journal--,tyree's ,powder as a ,highly ,respectable 8,ethical ,proprietary40 ,now1 it seems1 ,tyree considers his preparation so well known that he can be independent either of the assistance of the physician or of his good-will4 ,for ,tyree's powder now goes to the public direct and newspaper readers find it advertised as3 8,ideal for douche40 8,unequalled as a douche40 8,best preventative known40 8,unequalled as a preventative40 8,has no equal as a preventative40 ,and the following1 whose very truth must bring the blush of shame to all physicians who have the interest of scientific medicine at heart3 8,prescribed by physicians all over the world for twenty-one years40 8,ask your doctor or send for booklet40 8,used by doctors for the last twenty-one years40 8,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 years40 ,not that ,tyree has entirely forsaken the medical journals1 although he seems to be dropping them one by one4 ,at the beginning of this year at least fifteen medical journals were carrying the ,tyree advertisement2 by ,march the number had fallen to seven1 while in ,june the only journals carrying it were3 ,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 787 of the nostrum4 ,incidentally these leaflets advertise1 in addition1 ,tyree's 8,elixir ,buchu and ,hyoscyamus ,comp410 which is recommended1 in various combinations1 for such conditions as acute nephritis1 epilepsy1 neurasthenia1 gonorrhea and delirium tremens4 ,bearing in mind the claim that is made in the newspaper advertisements that ,tyree's ,antiseptic ,powder is the 8best preventative0 known1 it is interesting to see what ,tyree has to say to those druggists whom he offers to supply with circulars for free distribution3 8,as these circulars deal with the care of rubber goods1 for both medicinal and toilet purposes1 they are of great value to the customer and will be retained for further reference4 ,they are boosters for your rubber goods sales1 too40 ,that a nostrum of this sort should go to the public is not surprising1 but that it should have reached the public through the instrumentality of the medical profession is a serious reflection on the judgment of physicians4 ,but the incident has a bright side4 ,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 advertising1 is cause for optimism4 ,it means that physicians are no longer prescribing1 indiscriminately1 proprietary products and that they are refusing to be1 what they have been in the past1 the unpaid distributing agents for nostrum venders4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bd1 #aiab47 ,,vapo-,,cresolene ,vapo-,cresolene has been examined in the ,american ,medical ,association's laboratory and the chemists' report follows3 ,according to the statements on the trade package1 ,vapo-,cresolene 8is a product of coal-tar possessing far greater power than carbolic acid in destroying germs of disease40 ,it is recommended as a remedy for a number of diseases1 including croup1 catarrh and diphtheria4 ,according to the manufacturers1 it should be used only in 8the ,cresolene vaporizer10 which makes it 8unequaled for the disinfection of sick rooms0 and the 8safest and simplest method of destroying infection and purifying the air40 ,from the examination we conclude that ,vapo-,cresolene is essentially cresol and corresponds in every respect to cresol ,u4 ,s4 ,p4 7,physician's ,manual1 page #cf74 ,this report indicates that ,vapo-,cresolene is a member of that class of proprietaries in which an ordinary product is endowed1 by the manufacturer1 with extraordinary virtues4 ,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 phenols1 this particular product need not have been mentioned4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #d1 #aijh47 ,,vasogen ,,and ,,iodovasogen ,another ,case in ,which ,independent ,analyses and ,manufacturers' ,labels ,disagree ,vasogen1 a product of ,pearson ,company1 ,hamburg1 ,germany1 has been put on the market under the various designations1 8oxygenated vaseline10 8water-soluble hydrocarbon0 and 8oxygenated carbon40 ,the manufacturers1 and also their ,american agents1 ,lehn ,fink1 claim that by a special process the apparent impossibility of saponifying petrolatum has been overcome with ,vasogen as the result4 ,disinterested chemists who have analyzed ,vasogen find that the product consists essentially of an ammonium soap and petrolatum--practically an ammonia liniment mixed with petrolatum4 ,just as petrolatum under its various trade names was at one time recommended as a universal ointment base1 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-indicated4 ,iodovasogen1 recommended for external application as a substitute for tincture of iodin1 was examined by ,zernik in #aije1 who found that the iodin existed not as a free iodin1 but chiefly as ammonium iodid4 ,the therapeutic character of the preparation is thus entirely different from that to be inferred from the labels and elsewhere1 since the counter-irritant effects of free iodin are of course absent in ammonium iodid4 ,pearson ,co4 now claim that when ,zernik's findings were published they immediately modified their statements on the label in accordance with the truth4 ,this is denied by ,dr4 ,lungwitz1 the editor of the ,therapeutische ,rundschau 7,apotheker ,zeitung1 #aijh1 p4 #ijj71 who vigorously criticizes the misrepresentation made by ,pearson ,co4 in regard to ,iodovasogen4 ,he calls attention to the fact that1 while ,zernick's results were published over three years ago1 the labels which are in use today still bear the statement that ,iodovasogen consists of ,vasogen #ij parts and resublimed iodin #aj parts1 and ,vasogen #id parts and resublimed iodin #f parts1 respectively4 ,as ,iodovasogen and ,vasogen in various combinations are being advertised to the physicians in the ,united ,states1 the above information from our ,german exchanges is worthy of consideration4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ac1 #aiji47 ,,viburnum ,,compound--,,and ,,other ,,nostrums ,a number of drugs have some reputation for therapeutic value without there being any particular evidence to substantiate the claims4 ,viburnum1 concerning which we recently received the following letter1 is one of these drugs3 ,to the ,editor3--,have you made an analysis of ,viburnum ,compound8 ,extravagant claims are being made for it and ,i cannot put my hand on any data4 ,a patient has asked me concerning it and ,i wish to advise her honestly4 ,i do not know but that there may be several 8viburnum compounds40 ,i rarely use any of these 8put-up0 preparations1 and hence know but little about them4 ,a4 ,j4 ,hesser1 ,m4,d41 ,pittsburgh1 ,pa4 ,no analysis of ,hayden's ,viburnum ,compound1 to which our correspondent refers1 has been made in the ,association laboratory4 ,according to advertising circulars1 the preparation contains ,american skullcap 7,scutellaria lateriflora71 cramp-bark 7,viburnum opulus7 and wild yam 7,dioscorea villosa74 ,since these drugs contain no well-defined therapeutically active ingredients1 an analysis of the preparation would necessarily be unsatisfactory4 ,a number of drugs have in some way obtained a reputation as being valuable in the treatment of diseases of women1 without their therapeutic claims ever having been proved4 ,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 7sometimes with therapeutically active drugs7 and exploited for the cure of female disorders1 under most extravagant and usually absurd claims4 ,thus 8,pierce's ,favorite ,prescription0 is advertised as containing black cohosh1 blue cohosh1 goldenseal1 lady's-slipper and false unicorn-root2 8,dioviburnia0 7,dios ,chemical ,co47 as containing ,american skullcap1 cramp-bark1 wild yam1 blue cohosh1 black haw1 star-grass1 trailing arbutus and false unicorn-root2 8,viburnumal0 7,louisville ,pharmacal ,works7 as containing ,american skullcap1 cramp-bark1 wild yam1 star-grass and motherwort4 ,most pharmaceutical houses1 following the lead of nostrum-makers1 put similar mixtures on the market2 for example3 8,elixir of ,viburnum ,compound0 7,nelson1 ,baker ,co47 is said to contain cramp-bark1 ,american skullcap and wild yam2 8,elixir of ,hydrastis and ,viburnum ,compound0 7,smith1 ,kline ,french ,co471 cramp-bark1 goldenseal1 ,jamaica dogwood and pulsatilla2 8,elixir of ,hydrastis and ,cramp ,bark ,compound0 7,parke1 ,davis ,co471 cramp-bark1 hydrastis1 ,jamaica dogwood and pulsatilla2 8,fluid ,extract of ,cramp ,bark ,compound0 7,h4 ,k4 ,mulford ,co471 ,american skullcap1 cramp-bark and wild yam2 8,mother's ,cordial0 7,eli ,lilly ,co471 cramp-bark1 blue cohosh1 false unicorn and squaw vine2 8,uterine ,sedative ,elixir0 7,eli ,lilly ,co471 cramp-bark1 goldenseal1 ,jamaica dogwood and pulsatilla2 8,vibutero0 7,fred4 ,stearns ,co471 cramp-bark1 wild yam1 black haw1 squaw vine1 ,jamaica dogwood1 saw palmetto and pulsatilla4 ,practically all of these drugs except goldenseal are ignored in the standard works on pharmacology4 ,further1 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 experience4 ,the fact is that the popularity of preparations of this kind is purely an artificially created one4 ,a nostrum containing1 let us say1 extractives of some little-used or worthless drugs is put on the market and heavily advertised4 ,should it be advertised in a manner to make it sell1 a host of imitations appear and the large pharmaceutical houses put out substitutes for it4 ,the uncritical physician does the rest4 ,he prescribes it indiscriminately in the class of cases for which it is advertised4 ,naturally1 a certain proportion of the patients who take it recover1 and the recoveries are credited to the nostrum4 ,a vicious circle is thus established and the demand for the stuff increases4 ,its sale1 together with the sale of similar products1 continues until the overwhelming experience of those who have prescribed it proves its uselessness4 ,in the meantime the manufacturers have reaped a harvest1 at the expense both of the public and of the medical profession4 ,and the manufacturers' excuse for putting such absurd 8specialties0 on the market is that physicians prescribe them6--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ca1 #aiab47 ,,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 nostrum4 ,as an example of the latter class ,wheeler's ,nerve ,vitalizer was examined in the ,association laboratory and found to be not a vitalizer1 as the name implies1 but rather a nerve sedative4 ,the results of the examination follow3 ,wheeler's ,nerve ,vitalizer was packed in a carton bearing the name of the preparation1 its manufacturers1 8,the ,j4 ,w4 ,brant ,co41 ,ltd41 ,albion1 ,mich410 and an exhaustive list of the diseases for which the product is intended1 besides the general statement that it is a cure for 8all nervous diseases40 ,the 8,vitalizer0 is a brown1 syrupy liquid having a peculiar salty taste partially masked by licorice4 ,qualitative tests showed the presence of sodium1 potassium and bromin1 and no other acid radicals except small quantities of chlorin4 ,it was decided therefore that the preparation contained a mixture of sodium and potassium bromids4 ,in order to separate the chlorin and bromin the preparation was evaporated1 charred1 extracted with water and acetic acid and potassium permanganate added and the mixture distilled with steam until all the bromin had been distilled over1 thus leaving the chlorin in the distilling flask4 ,the solution in the distilling flask was then treated with silver nitrate and the chlorin estimated in the usual way4 ,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 bromin4 ,by this method several samples of #e c4c4 each of the preparation yielded an average of #j4jjei cm4 silver chlorid or #j4jjab gm4 per c4c4 ,the total silver haloids obtained by direct precipitation of the diluted preparation was found to be #j4caeh gm4 per c4c41 thus leaving #j4cadf gm4 silver bromid to be calculated to bromin4 ,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 difference4 ,by this method the quantity of sodium found calculated to sodium bromid gave the following results3 7a7 #j4jfbi gm4 and 7b7 #j4jfcb gm41 or an average of #j4jfc gm4 per c4c4 ,from the potassium estimations the following were calculated3 7a7 #j4abfd gm4 potassium bromid and 7b7 #j4abei gm4 potassium bromid per c4c41 an average of #j4abfa gm4 potassium bromid per c4c4 ,the bromids calculated from the sodium and potassium determinations were found to be #j4jfcj gm4 sodium bromid and #j4abfa gm4 potassium bromid per c4c41 the equivalent of #j4caci gm4 silver bromid4 ,the total silver bromid obtained was #j4cadf gm41 showing practical agreement with the total bromids calculated from the sodium and potassium determinations4 ,the preparation contained then #f4cj gm4 sodium bromid and #ab4fa gm4 potassium bromid per #ajj c4c41 or #i4gc grains of potassium bromid and #d4hf grains sodium bromid1 a bromid content equal to #ae4ce grains potassium bromid per fluid dram4 ,,zymotoid ,a ,fraud of the ,liquozone-,oxytonic-,septicide ,type ,dr4 ,arnold's ,zymotoid1 a nostrum manufactured by ,arnold's ,zymotoid ,company1 ,rockford1 ,ill41 is claimed to be an 8antiseptic1 germicide and antiphlogistic0 which 8has absolutely no peer in medicine40 ,according to the statements of the manufacturer1 ,zymotoid is 8successfully employed not only as an external dressing on all wounded and diseased surfaces1 but in all zymotic conditions wherein a reliable antiseptic and germicide is needed internally40 ,and in telling physicians of the great value of ,zymotoid the company says3 8,we assured them that if they would simply place ,zymotoid #8next' to any wounded surface--and nothing else--they would have no inflammation1 no suppuration1 no infection or blood poison4 ,its prompt use in all cases where such trouble arises gives immediate and certain relief40 ,this is a large contract to be undertaken by ,zymotoid--or any other preparation--which1 as will be shown1 consists principally of boric acid and water4 ,the company also appends to its announcement concerning ,zymotoid a number of the usual testimonials and a lot of alleged 8case reports40 ,zymotoid seems to be exploited principally by circulars addressed to physicians and by agents who attempt to sell it to physicians4 ,they also try to work factories and other large employers of labor4 ,in their circular to physicians they claim that 8,zymotoid is strictly ethical40 ,and 8we publish its composition40 ,the composition given is3 8sulphur1 niter1 cinnamon and boric acid in gaseous solution40 ,it is also claimed to be 8a 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 child40 ,on the label of the ,zymotoid package is the following3 8,zymotoid is a concentrated chemical compound consisting of the solids and gases of sulphur1 potassium nitrate1 cinnamon and carbon held in a solution of boric acid40 ,a specimen of ,zymotoid was examined by our chemists and their report follows4 ,as will be seen1 it is simply another fraud of the ,liquozone-,oxytonic-,septicide type4 ,,laboratory ,,report ,,on ,,zymotoid ,zymotoid is a pale yellow liquid having a strong odor like sulphur dioxid4 ,no odor suggestive of cinnamon was observed even after the sulphur dioxid had been fixed by the addition of an alkali4 ,qualitative tests indicated the presence of boric acid1 sulphuric acid1 sulphur dioxid and traces each1 of a nitrate1 potassium and some unidentified organic matter4 ,alkaloids1 cinnamic acid1 glycerin and soaps were absent4 ,from the results of the quantitative examination it is concluded that the composition of ,zymotoid is essentially as follows3#abf #abf ,details of the analysis appear in the annual reports of the ,chemical ,laboratory4 ,boric acid 7,h#c;,,bo#c7 #j4fcg gm4 ,sulphur dioxid 7,,so#b7 #j4abi gm4 ,sulphuric acid 7,h#b,,so#d7 #j4jdh gm4 ,potassium nitrate trace ,unidentified organic matter trace ,water 7by difference7 to make #ajj c4c4 ,the analysis shows that but for the presence of boric acid the composition of ,zymotoid is similar to other fraudulent 8microbe killers0 which have been exploited in recent years and of which some have been declared misbranded by the federal government4 ,for example1 8,radam's ,microbe ,killer0#abg was found by the federal chemists to be composed of water1 containing small quantities of sulphur dioxid and sulphuric acid4 8,liquozone10 another nostrum which was widely exploited a few years ago1 is said to have a similar composition4#abh ,according to an analysis made at the ,north ,dakota ,agricultural ,experiment ,station1#abi 8,oxytonic0 has a similar composition4 ,the nostrum 8,septicide10 was found by the federal chemists to be composed of water with small quantities of sulphur dioxid1 sulphuric acid and a trace of a nitrate4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #f1 #aiab47 #abg ,the ,journal ,a4 ,m4 ,a41 ,july #af1 #aiaj1 p4 #bce4 #abh ,the ,journal ,a4 ,m4 ,a41 ,march #bh1 #aijh1 p4 #ajfe4 #abi ,the ,journal ,a4 ,m4 ,a41 ,jan4 #a1 #aiaj1 p4 #fc4 ,,part ,,iv ,,contributions ,,from ,,the ,,journal3 ,,miscellaneous ,,matter ,,acetphenetidin ,,and ,,phenacetin--,,their ,,relative ,,purity ,until six years ago the chemical product known as phenacetin was patented both as to process and to product4 ,as the patent ran out at that time1 anyone1 of course1 could manufacture it4 ,it was placed in the ,pharmacopeia under the name 8acetphenetidin40 ,it is on the market now under both names1 8phenacetin0 and 8acetphenetidin40 ,the price of the former is five times#acj that of the latter1 hence it is rather important to know whether or not one is1 in any way1 better or purer than the other4 ,the original patentees or manufacturers1 the ,farbenfabriken of ,elberfeld ,company1 market the product under the name 8phenacetin0 and also under the official name 8acetphenetidin10 the former at about #cc cents an ounce and the latter at about #f or #g cents an ounce4 ,evidently these people believe that acetphenetidin is all right since their price-list says3 8,our product is of the highest standard of purity10 and in another place3 8,on account of the low price of acetphenetidinum1 ,u4 ,s4 ,p41 it is especially suitable for the manufacture of medicinal specialties1 such as headache powders1 etc40 ,remember that it is the manufacturers of phenacetin who say this4 #acj ,phenacetin is listed at #cc cents an ounce1 acetphenetidin at #ih cents a pound in quarter-pound lots4 ,the question arose whether or not phenacetin differs from acetphenetidin4 ,if it does1 then physicians should know it4 ,an inquiry was addressed to ,farbenfabriken of ,elberfeld ,company and also to ,lehn ,fink1 two firms which market the product in this country under both names1 asking in what respect the two products differ4 ,no answer was received from either firm4 ,with the object of answering the question our chemists have investigated the preparations on the market1 both those sold under the name 8phenacetin0 and those under the official title 8acetphenetidin40 ,the following is a summary of their report3#aca #aca ,full details of analysis are published in ,volume ,v of the annual report of the ,chemical ,laboratory4 ,,the ,,chemists' ,,report ,physical ,appearance4--,all the specimens were found to be fine white crystalline powders1 differing somewhat in appearance as follows3 ,four specimens--,acetphenetidin 7,farbenfabriken71 ,phenacetin 7,specimen #aacb--;,farbenfabriken71 ,phenacetin 7,specimen #bacb--;,farbenfabriken7 and ,acetphenetidin 7,squibb7--appeared very much alike1 each being a very fine crystalline powder1 differing only slightly as to fineness4 ,five other specimens--,phenacetin 7,lehn ,fink71 ,acetphenetidin1 ,u4 ,s4 ,p4 7,lehn ,fink71 ,acetphenetidin 7,merck71 and two specimens of ,acetphenetidin 7,powers-,weightman-,rosengarten71 had the same general appearance1 each consisting of a fine crystalline powder containing a considerable proportion of large rectangular plates4 ,three specimens--,acetphenetidin 7,mallinckrodt7 and two specimens of ,acetphenetidin 7,powers-,weightman-,rosengarten7--had the same general appearance1 being a moderately fine and homogeneous crystalline powder4 ,when examined microscopically with a low-power lens the ,mallinckrodt product appeared to consist principally of rectangular prisms and the ,powers-,weightman-,rosengarten product to be made up largely of plates4 #acb 8,specimen #a0 is a specimen of the product regularly sold in this country4 8,specimen #b0 is a specimen of a product sold in ,england and whose resale in this country was prohibited by the manufacturers4 ,identity4--,all of the specimens when tested side by side responded to and complied with the identity tests of the ,united ,states1 ,british1 ,german1 ,swiss1 ,dutch1 ,swedish1 ,spanish1 and ,danish pharmacopeias4 ,the reactions given by the several specimens were all the same1 showing no difference in any case4 ,melting-,points4--,as a further proof of identity and similarity the melting-points of the different specimens were taken and found to be3 ,acetphenetidin 7,farbenfabriken71 #acd4b ,c42 ,phenacetin 7,specimen #a--;,farbenfabriken7 #acc4g ,c42 ,phenacetin 7,lehn ,fink71 #acd4g ,c42 ,acetphenetidin 7,lehn ,fink7 #acd4i ,c42 ,acetphenetidin 7,powers-,weightman-,rosengarten71 7#a7 #acd4c ,c41 7#b7 #acc4f ,c41 7#c7 #acd4g ,c41 7#d7 #acd4g ,c42 ,acetphenetidin 7,squibb7 #acd4b ,c42 ,acetphenetidin 7,merck71 #acd4h ,c41 and ,acetphenetidin 7,mallinckrodt71 #acd4b ,c4 ,the melting-point is given as #ace ,c4 in the ,british1 ,french and ,spanish pharmacopeias1 and as #acd to #ace ,c4 in the ,united ,states1 ,german1 ,swiss1 ,danish1 ,swedish and ,dutch pharmacopeias4 ,thus all comply with the standard given in our pharmacopeia and most foreign pharmacopeias with two exceptions and those respectively only #j4c ,c4 and #j4d ,c4 low4 ,absence of ,acetanilid4--,the absence of acetanilid in all the specimens was indicated by the bromin test of the ,united ,states1 ,british1 ,german1 ,swiss1 ,dutch1 ,swedish and ,danish pharmacopeias4 ,absence of ,carbonizable ,matter4--,the absence of carbonizable matter was shown in all specimens by the sulphuric acid test of the ,united ,states1 ,british1 ,german1 ,french1 ,swiss1 ,dutch1 ,swedish and ,spanish pharmacopeias4 ,water-,soluble ,matter4--,all specimens when tested for excess of water-soluble matter came well within the limit 7#j4ej per cent47 set by the ,french pharmacopeia1 the greatest amount being #j4bj per cent4 ,ash4--,when heated1 all the specimens were found to yield practically no ash1 the residues from #a gm4 samples weighing in no case more than #j4jjjd gm4 ,absence of ,paraphenetidin4--,when tested by the methods of the ,united ,states1 ,british1 ,german and ,french pharmacopeias1 the absence of an impurity of paraphenetidin was shown in all specimens1 with the exception of one specimen obtained from ,powers-,weightman-,rosengarten ,co41 which gave a positive1 though not strong1 reaction and two other specimens of the same firm which reacted still more faintly4 ,,table ,,showing ,,results ,,of ,,analyses ,,of ,,various ,,specimens ,,of ,,acetphenetidin ,,and ,,phenacetin,,bg ,,column ,,headings3 ,a ,melting ,point 7,corr47 ,c4 ,b ,water-,soluble ,matter in1 per ,cent4 ,c ,ash1 per ,cent4 ,d ,paraphenetidin1 ,u4 ,s4 ,p4 ,test,,bh ,e ,paraphenetidin1 ,swiss ,test,,bh ,physical ,name ,appearance ,a ,b ,c ,d ,e ---------------------------------------- ---------------------- ,acetphenetidin ,very fine #acd4b #j4ag #j4jb - 7,farbenfabriken7 homogeneous 7#a7 crystalline powder ,phenacetin ,very fine #acc4g #j4jf #j4jj - 7,farbenfa- homogeneous briken7 crystalline powder ,phenacetin ,fine crystalline #acd4g #j4aa #j4jb - 7,lehn ,fink7 powder1 not uniform ,acetphenetidin ,fine crystalline #acd4h #j4ac #j4jj - 7,lehn ,fink7 powder1 not uniform ,acetphenetidin ,homogeneous #acd4c #j4ai #j4jc 7,p4 ,w4 ,r47 7#a7 crystalline powder ,acetphenetidin ,homogeneous #acd4g #j4af #j4jb 7,p4 ,w4 ,r47 7#b7 crystalline powder ,acetphenetidin ,homogeneous #acd4g #j4ad #j4jb 7,p4 ,w4 ,r47 7#c7 crystalline powder ,acetphenetidin ,fine crystalline #acc4f #j4bj #j4ja - - 7,p4 ,w4 ,r47 7#d7 powder ,acetphenetidin ,fine crystalline #acd4c #j4ai #j4jj - 7,squibb7 powder ,acetphenetidin ,fine crystalline #acd4h #j4ae #j4jc - - 7,merck7 powder ,acetphenetidin ,fine crystalline #acd4b #j4aa #j4ja - - 7,mallinckrodt7 powder ---------------------------------------- ---------------------- ,,bg ,in all cases identity was confirmed2 acetanilid was absent2 carbonizable matter was absent4 ,,bh ,in this column plus indicates presence2 minus1 absence4 ,while this firm's product alone gave any reaction whatever when the ,u4 ,s4 ,p4 test for paraphenetidin was applied with the test of the ,swiss pharmacopeia1 all but ,acetphenetidin 7,mallinckrodt71 ,acetphenetidin 7,merck7 and one specimen of ,powers-,weightman-,rosengarten ,co4 gave positive1 though very faint1 reactions1 indicating that the majority of specimens1 including those of the original manufacturer1 contain a minute trace of this impurity4 ,our findings regarding the product of ,powers-,weightman-,rosengarten ,co4 having been communicated to this firm1 their correctness was acknowledged4 ,at the same time the firm wrote3 8,all that we have on hand now gives negative tests for paraphenetidin1 and we believe our present records are correct when we state that all lots which we are supplying now1 and have been supplying for some time past1 answer all ,u4 ,s4 ,p4 requirements40 ,this examination appears to demonstrate that the chemical substance1 para-acetphenetidin1 whether sold as acetphenetidin1 ,u4 ,s4 ,p41 or as phenacetin1 is practically identical4 ,the impurity of the product of some of the specimens coming from ,powers-,weightman-,rosengarten ,co4 is too slight to be considered dangerous4 ,furthermore1 a comparison of the 8lot numbers0 indicates that this firm has been improving its product steadily so that in the future its assurances of an unimpeachable product may be relied on4 ,inasmuch1 therefore1 as acetphenetidin complies with all the pharmacopeial requirements as to identity and purity1 in just the same way as phenacetin1 which sells for as high as five times the price of acetphenetidin1 physicians need not hesitate in using the title of the ,u4 ,s4 ,p4 8acetphenetidin0 when prescribing this produce4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #af1 #aiab47 ,acetphenetidin and ,phenacetin ,a physician-pharmacist writes3 8,if a prescription calls for #8phenacetin1' should the pharmacist dispense #8phenacetin-,bayer'--that is1 the phenacetin manufactured by the original patentee--or would he be justified in dispensing the official acetphenetidin1 manufactured by any reliable chemical or pharmaceutical house80 ,unless the pharmacist happens to know that the physician in writing the prescription desired the ,bayer brand1 he would be justified in dispensing acetphenetidin1 ,u4 ,s4 ,p4 ,as a general thing1 physicians use the word 8phenacetin0 without intending to prescribe any particular brand or make1 simply because they are familiar with this word and are not familiar with the official term 8acetphenetidin40 ,they will doubtless continue to use the term 8phenacetin0 and we know of no sufficient reason for doing otherwise4 ,during the life of the patent the word 8phenacetin0 became a familiar one1 and the product became generally known by this term4 ,but a coined name for a patented article loses its proprietary character and becomes the common name of the article when the patent expires4 ,in other words1 when the patent expires1 not only the product but also the name itself becomes common property4 ,this principle has been recognized by the courts4 ,those who formerly controlled the product and the name 8phenacetin0 evidently recognized this principle1 for they have taken no steps to prosecute a firm in this country which sells the product openly under the name 8phenacetin40 ,it might be added that the preparation is official in most foreign pharmacopeias under the name 8phenacetin40 ,in agreement also with this principle the ,council on ,pharmacy and ,chemistry 7,the ,journal1 ,april #bg1 p4 #abih7 lists in ,new and ,nonofficial ,remedies such products as 8lanolin10 8phenacetin10 8sulphonal0 and 8trional0 as non-proprietary names applied to ,adeps lan hydrosus1 ,u4 ,s4 ,p41 ,acetphenetidinum1 ,u4 ,s4 ,p41 ,sulphonmethanum1 ,u4 ,s4 ,p41 and ,sulphonethylmethanum1 ,u4 ,s4 ,p41 respectively4 ,in view of these facts--and also bearing in mind the findings of the ,association's ,chemical ,laboratory 7,the ,journal1 ,march #af1 p4 #hja7 that the preparations on the market under the title 8acetphenetidin0 are of equal quality with the preparations sold under the name 8phenacetin0--the pharmacist should recognize that acetphenetidin is identical with phenacetin1 is prescribed1 provided1 of course1 that no special brand of phenacetin is ordered4 ,it is the physician's privilege1 of course1 to specify the goods of a particular manufacturer1 but in view of the fact brought out above that all brands of this chemical have tested up to the ,u4 ,s4 ,p4 standard1 it is placing an unnecessary burden on the pharmacist to require him to have on hand many different brands of one substance4 ,the physician should save this privilege for use when prescribing some product that differs materially in its various forms on the market1 as for example in the case of certain fluidextracts4 ,physicians will doubtless find that the above comments will interest their local pharmacists4 ,it is of mutual value for physicians to talk these matters over with their pharmacists4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #e1 #aiab74 ,,clean ,,advertising ,it is individual effort that counts for most in every movement for better things--socially1 economically or politically4 ,realizing this1 ,the ,journal repeatedly urges physicians who write regarding various fraudulent advertisements to enter their individual1 personal protest against the continuation of such advertisements4 ,within the past few months ,the ,journal has had brought to its attention a good example of what may be accomplished by personal effort in cleaning up the advertising pages of a fraternal publication4 ,the ,royal ,neighbor1 official organ of a fraternal organization1 until comparatively recently1 carried numerous fraudulent medical advertisements4 ,fake liquor cures1 rheumatism cures1 tapeworm expellers1 tobacco-habit cures1 asthma and hay-fever cures1 epilepsy cures1 etc41 disgraced its advertising pages4 ,these called forth protests from ,dr4 ,e4 ,a4 ,hall1 ,henry1 ,ill41 who addressed letters to the official physicians of the fraternal order that the ,royal ,neighbor represents1 objecting to such advertisements4 ,these letters in turn reached the advertising manager1 and it was not long before the board of managers took the matter up for consideration and decided to eliminate this class of advertising from their official organ4 ,by ,december1 #aiac1 the ,royal ,neighbor came to its readers clean4 ,there is no doubt that the same results can be duplicated in similar cases4 ,whether they are will depend on the amount of active work done by individuals interested in the question of clean advertising4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ad1 #aiad47 ,,lippincott',s ,,magazine ,its ,advertising--a ,protest and an ,excuse ,a few days ago a physician wrote to ,the ,journal enclosing two advertisements taken from the current issue of ,lippincott's magazine4 ,one of these was a half-page advertisement of that outrageous fraud1 the 8,oxydonor20 the other was a full-page advertisement of ,j4 ,b4 ,lippincott ,company1 ,philadelphia1 calling for salesmen 8to present standard medical books to physicians only40 ,the physician sending in this material asked us to send to ,lippincott's a pamphlet showing the fraudulence of the ,oxydonor4 ,instead of doing so1 we sent the pamphlet to the physician and suggested that he write a personal letter in the belief that individual missionary work is the most effective way of fighting fraud4 ,accordingly the doctor wrote to ,lippincott's and received in reply this letter from the advertising department of that publication3 8,your letter of the #bc;d received1 and in reply beg to say that we do not approve of fraudulent advertising1 and we have never before been advised that the advertisement to which you call our attention was objectionable4 ,in fact1 we know nothing whatever about it4 ,italics ours4--,ed4 ,it came to us1 as do most of the others1 through an advertising agency1 and while we do not willingly publish anything that is fraudulent or objectionable1 it is not our custom to verify the claims of advertisers ,italics1 again1 ours4--,ed4 especially when the same copy is being run in almost every other high-grade publication4 8,we have a very high regard for the ,american ,medical ,association1 and they undoubtedly are doing a splendid work in ridding the country of fake medical preparations1 but the mere fact that they condemn some of our advertisers is hardly sufficient proof for us to refuse the advertising1 because1 if the advertiser desires to do so1 he can make us prove in the courts that he is a faker1 or claim damages from us for refusing to publish his advertisement4 ,our italics4--,ed4 ,if the ,american ,medical ,association will guarantee to protect the publishers against loss from damage suits brought by advertisers whose business they refuse to accept1 then1 we believe that the publishers would gladly reject them1 but not many of the publishers are in a position to investigate the merits of all the advertising that is offered1 especially when the claims are backed up by affidavits of reputable people who believe themselves to have been cured by the preparation4 8,we certainly do not wish to jeopardize our medical publications by advertising fake schemes or propositions of any kind1 and we thank you for writing us concerning the matter and will now look into this particular case40 ,illustration3 ,photographic reproduction 7much reduced7 of two advertisements from ,january1 #aiad1 ,lippincott's4 ,one of a fraudulent quasi-medical device1 the 8,oxydonor02 the other1 calling for salesmen to introduce 8standard medical books to physicians40 ,this letter discloses the workings of the brain of an advertising man of the old school4 ,the principles enunciated therein are those that dominated the advertising field until quite recently4 ,they represent the laissez faire doctrine as applied to advertising4 ,at that time the only unacceptable advertising copy was that which would debar the publication using it from the ,united ,states mails4 ,this was the yardstick by which all advertising was measured at that time4 ,the economic conscience has since awakened4 ,there are few reputable magazines today1 we venture to believe1 that would be willing to go on record to the effect that it is not their 8custom to verify the claims of advertisers40 ,the modern1 progressive advertising man recognizes not only the responsibilities his profession imposes1 but also realizes that1 from the narrower view of enlightened self-interest1 the greatest menace to the future of modern advertising is the fraudulent advertisement4 ,the claims on the part of the advertising department of ,lippincott's that it dares not refuse to accept fraudulent advertisements because the advertiser might bring suit against it for refusing to accept his advertisement is a statement whose falsity is exceeded only by its silliness4 ,equally preposterous is the statement that ,lippincott's will willingly refuse to accept fraudulent advertisements provided the ,american ,medical ,association will guarantee to protect the ,lippincott ,company against loss from damage suits that may be brought by the exploiters of the frauds whose advertisements are refused4 ,it may be news to ,lippincott's to learn that there are a score and more of newspapers and magazines that are accepting the findings of the ,american ,medical ,association on medical frauds and rejecting advertisements of such frauds4 ,there are many newspapers that send us the medical advertising 8copy0 submitted to them and ask for an opinion on it4 ,when that opinion is unfavorable1 these papers refuse such advertisements4 ,this is being done daily4 ,we have yet to hear of any 8patent medicine0 faker or quack even threatening to bring suit because his advertisements have been rejected4 ,the advertising department of ,lippincott's may therefore take heart4 ,when an advertisement of an outrageous fake like the ,oxydonor is submitted to it1 instead of accepting the money for it1 meantime muttering an inaudible protest at the unfortunate position in which it has been placed1 it may look the fraud in the eye and say ,boo6 ,the faker will not bite4 ,before leaving the subject1 we are constrained to refer to ,lippincott's medical publication1 the ,annals of ,surgery4 ,we begin to realize now why that journal offers a welcome haven to such products as ,sal ,hepatica1 ,bromidia1 ,papine1 ,gray's ,glycerin ,tonic1 ,fellows' ,syrup of ,hypophosphites1 et al4 ,presumably the same 8custom0 obtains in the acceptance of advertising for the ,annals of ,surgery as for ,lippincott's1 namely that the ,lippincott ,company does 8not verify the claims of advertisers40 ,possibly the ,annals of ,surgery is afraid that1 should it reject the ,sal ,hepatica advertisement1 for instance1 it might he haled into court6 ,let us trust1 for their peace of mind1 that the publishers of the ,annals of ,surgery do not receive an advertisement from ,old ,doc ,hartman for a full page display of ,peruna4 ,the mental anguish they would undergo in reluctantly accepting this advertisement--under the fear that ,hartman would 8claim damages0 if it were rejected--is painful to contemplate4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #g1 #aiad47 ,,medical ,,journal ,,advertising ,and ,methods of ,obtaining ,paid-,up ,subscribers ,time was when the postal authorities were lenient with publishers4 ,the names of individuals who had ever subscribed for publications of a certain class were carried on the books indefinitely1 whether they paid their subscriptions or not4 ,this permitted a padding of the circulation figures4 ,of late years1 however1 the postoffice department requires publishers to have bona-fide paid-up subscriptions if they wish their publications to be carried at the low second-class rate4 ,certain medical journals have been hard put to it to get a circulation that would be at all attractive to the advertisers1 on whose money they depend for continued existence4 ,many and various have been the schemes devised whereby the dwindled circulation might be 8boosted40 ,subscriptions could not be given away because the postal laws forbade it4 ,one ingenious method of obviating this difficulty is worked in this fashion3 ,dr4 ,john ,doe writes an article that appears in a reputable medical journal4 ,a few days after its appearance1 ,dr4 ,doe receives a letter from the editor and publisher of a medical journal that is in need of a subscription list4 ,he is told that the editor has read his article with much interest and would appreciate receiving from ,dr4 ,doe a brief abstract of it4 ,he does not expect the doctor to go to the trouble of making this abstract for nothing4 ,he will1 therefore1 on receipt of the abstract credit ,dr4 ,doe with three years' subscription for himself or for one year for himself and one year for each of any other two doctors he may name4 ,for every doctor that bites on this scheme the publisher increases his circulation by three copies and the federal officials are assured that they are paid-up subscriptions--not paid for in cash1 it is true1 but in 8abstracts40 ,all of this preliminary to a letter recently received3 ,to the ,editor3--,enclosed find letter which speaks for itself4 ,now what ,i should like to know from you is the following3 ,is the ,charlotte ,medical ,journal all it should be8 ,should a doctor contribute to a journal--thereby adding to its prestige and circulation--that carries questionable matter in the advertising pages8 ,if the above journal is off color1 does that act as a bar for good men to contribute8 ,very truly yours1 ,l4 ,j4 ,genella1 ,m4,d41 ,new ,orleans1 ,la4 ,the letter which our correspondent encloses is on the stationery of the ,charlotte ,medical ,journal and signed by the editor of that journal4 ,here it is3 8,my ,dear ,doctor ,genella3--,i have just looked over an article of yours published in the ,new ,orleans ,medical and ,surgical ,journal entitled #8,clinical ,studies in ,pituitary ,irritation1 with ,report of ,case4' ,i would be very glad indeed to have you send me a manuscript or article for the ,charlotte ,medical ,journal4 ,your style of writing is very attractive4 8,if you will send me an article for the journal1 ,i will be glad to publish same and will place your name on my complimentary mailing list4 ,under separate cover ,i am sending you a copy of the journal4 8,of course ,i will expect the article to be typewritten40 ,whether or not this is a modification of the 8abstract0 scheme or an attempt to boost the circulation of the ,charlotte ,medical ,journal are questions we shall not attempt to answer4 ,as to the questions propounded by our correspondent1 they have been answered many times in these pages4 ,we turn to one of the recent copies of the ,charlotte ,medical ,journal and examine its advertising pages4 ,on one of the first we find ,anasarcin1 a product whose fraudulent character was described at some length in ,the ,journal1 ,may #d and #aa1 #aijg4 ,on another page we find ,tongaline1 which has also come in for a fair share of attention 7see ,the ,journal1 ,sept4 #bc1 #aijf1 and ,may #aj1 #aiac74 ,a little farther over we find a half-page advertisement of ,bannerman's ,intravenous ,solution1 a nostrum first exploited as a 8consumption cure0 and now as a cure-all 7see ,the ,journal1 ,may #ca1 #aiac74 ,cactina ,pillets 7see ,the ,journal1 ,march #ab1 #aiaj71 ,hagee's ,cordial of the ,extract of ,cod-,liver ,oil 7see ,the ,journal1 ,oct4 #ac1 #aijf71 ,burnham's ,soluble ,iodin 7see ,the ,journal1 ,march #bh1 #aijh71 ,ecthol 7see ,the ,journal1 ,march #ac1 #aiji71 ,bromidia 7see ,the ,journal1 ,april #ba1 #aijf71 ,papine 7see ,the ,journal1 ,april #bi1 #aiaa71 ,phenalgine--two advertisements 7see ,the ,journal1 ,jan4 #ac1 and #bg1 #aijf1 and ,jan4 #bg1 #aiab7 and ,sal ,hepatica 7see ,the ,journal1 ,march #bf1 #aiaj7 are some more products which have attained unenviable notoriety but found a safe haven in the advertising pages of the ,charlotte ,medical ,journal4 ,neither must we fail to refer to the advertisement of ,duffy's ,malt ,whiskey 7see ,the ,journal1 ,nov4 #bc1 #aiab71 which looks thoroughly at home4 ,does our correspondent--in fact1 does any conscientious physician having the interest of scientific medicine at heart--want to do anything that will tend to perpetuate therapeutic fraud8 ,subscribing for or contributing to medical journals whose income is largely derived from nostrums that are as vicious as many of the 8patent medicines0 advertised in the daily press hampers the medical profession in its fight for honesty in therapeutics and renders largely abortive its fight against fraudulent 8patent medicines40 ,so long as the accredited organs of the medical profession tolerate fraudulent 8ethical proprietaries0 in their advertising pages1 just so long will the protests of physicians against the swindling advertisements of 8patent medicines0 in the daily press fall largely on deaf ears--and justly so4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #aa1 #aiac47 ,a ,physician ,places the ,responsibility for ,fraudulent ,advertising ,where ,it ,belongs 8,to the ,editor3--,the ,journal has had much to say in recent years regarding the ethics1 or lack of same1 in advertising matter exploited by its contemporaries4 ,it has been criticized by many for the stringency of its attack2 it has been criticized by very few because it did not go far enough4 ,is it not about time to get to the root of the matter8 8,in the last number see p4 #dbf1 this book dissatisfaction is expressed with the advertising policy of the ,medical ,times4 ,nothing finer6 ,go to it6 ,but is the method of attack right8 ,i have before me a sample copy of the ,american ,journal of ,surgery4 ,among other articles is one on diseases of joints and the bone marrow by a man very favorably known in ,denver4 ,he was #8ethical' enough to be accorded a place on the program in the ,section on ,medicine at ,minneapolis4 ,another contributor from ,baltimore remarks that he took a patient to the ,university ,hospital4 ,can it be possible that ,johns ,hopkins is admitting men to its wards and clinics that are below par in professional morals8 ,another article appears from a well-known orthopedic man of ,washington1 ,d4 ,c4 ,personally1 ,i see very little to commend in the advertising columns of the ,american ,journal of ,surgery4 8,i1 who confess to a state bordering on youth1 may be very wrong2 but ,i believe that the trouble will be solved only when men who claim to have any professional distinction refuse to contribute to journals whose pages are not clean from cover to cover4 ,pardon the presumption1 ,mr4 ,editor1 but were you ever tempted to print anything like this3 8#8,last week's issue of the ,new ,york ,medical ,squall contains an article on 8,duodenal ,ulcer0 by ,john ,doe1 the well-known ,chicago surgeon4 ,dr4 ,doe doubtless knows as well as any one the disreputable character of the ,squall's advertising matter1 but like most of our great men1 is unable to restrain his appetite for journalistic publicity4' 8,physicians read medical journals because they contain literature that is worth while4 ,jump on your erring editorial brethren1 ,mr4 ,editor1 but please remember that the problem of eliminating bogus advertisements will be solved when the so-called leaders of our profession show enough manhood to refuse literary support to publications whose columns are in disrepute4 ,while castigating the little sinner1 please don't let the big sinner go scot free4 8,clinton ,e4 ,harris1 ,m4,d41 ,grinnell1 ,iowa40 ,dr4 ,harris sums up the situation correctly4 ,no small degree of responsibility rests on the prominent members of the medical profession who lend their support either as subscribers for or contributors to those medical journals whose advertising pages are a stench in the nostrils of thinking physicians4 ,dr4 ,harris asks why ,the ,journal does not condemn the advertising columns of the ,american ,journal of ,surgery4 ,the ,journal has done so more than once and in no uncertain terms1 both in the ,propaganda department and editorially4 ,at one time it said3 8,in circular letters and in an editorial announcement in its ,december issue1 the ,american ,journal of ,surgery #8features'--to use a newspaper term--some of the contributors to its ,january issue4 ,the list comprises men who hold1 or have held1 high offices in the ,american ,medical ,association4 ,presidents1 vice-presidents1 chairmen1 secretaries and members of sections of the ,association--these are some of the men whose names appear as contributors to this nostrum-promoting publication4 ,is it any wonder that the proprietors of the ,american ,journal of ,surgery assume an attitude of indifference to the class of proprietary preparations which they admit to the pages of their publication80 ,what was the result of ,the ,journal thus directing the attention of its readers to the ,american ,journal of ,surgery8 ,in the next issue of the ,american ,journal of ,surgery appeared a seven-column editorial tirade1 entitled 8,an ,unwarranted ,attack on the ,president and ,other ,eminent ,members of the ,american ,medical ,association and on the ,leading ,medical ,journals of the ,country40 ,on many and various occasions has ,the ,journal called attention to the very evils that ,dr4 ,harris deplores1 and for the benefit of those who care to look up the matter these references to some of the articles are appended3 8,the ,mote and the ,beam10 editorial1 ,nov4 #ah1 #aiaa4 8,activity or ,passivity--,sympathy or ,sacrifice10 editorial1 ,dec4 #i1 #aiaa4 8,cui ,bono10 editorial1 ,dec4 #af1 #aiaa4 8,medical ,journals and the ,great ,american ,fraud10 ,propaganda ,department1 ,dec4 #af1 #aiaa4 8,the ,profession ,must ,apply the ,penalty10 editorial1 ,jan4 #ac1 #aiab4 8,fraudulent ,advertising in ,high-,class ,medical ,journals10 editorial1 ,jan4 #d1 #aiac4 8,demand ,clean ,advertising10 editorial1 ,jan4 #d1 #aiac4 8,medical ,journals and the ,great ,american ,fraud10 editorial1 ,jan4 #ah1 #aiac4 8,a ,good ,principle to ,apply10 editorial1 ,may #ac1 #aiac4 8,medical ,journal ,advertising10 ,propaganda ,department1 ,oct4 #aa1 #aiac4 8,medical ,journals and the ,great ,american ,fraud10 ,propaganda ,department1 ,oct4 #ah1 #aiac4 8,medical ,journals and the ,great ,american ,fraud10 ,propaganda ,department1 ,nov4 #a1 #aiac4 8,the ,medical ,times' ,advertisements10 ,propaganda ,department1 ,nov4 #h1 #aiac4 ,in another letter on the same subject its writer says3 8,i think the time has arrived when we have a right to expect real leadership from the #8big men' of the profession40--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bb1 #aiac47 ,,medical ,,journals ,,and ,,the ,,great ,,american ,,fraud ,how the ,medical ,times ,aids and ,abets ,quackery1 with the ,moral ,support of ,members of the ,medical ,profession ,two letters have been received1 both from physicians4 ,one comes from ,new ,york ,city and the other from ,alexandria1 ,va4 ,each letter contained an advertisement of the ,kellam ,hospital1 ,richmond1 ,va41 cut from the ,medical ,times4 ,here is the ,new ,york letter3 8,to the ,editor3--,i am enclosing an advertisement clipped from the ,medical ,times4 ,it seemed to me an especially flagrant example of what may happen in the absence of proper supervision of the advertising pages of a medical magazine4 ,the condition would seem all the worse in this instance as among the #8,board of ,contributing ,editors' are listed men like ,howard ,lilienthal of ,new ,york and ,almuth ,c4 ,vandiver1 who is ,counsel for the ,medical ,society of the ,county of ,new ,york4 ,the ,medical ,times is sent to two of the physicians who live at this address without charge and without solicitation4 ,many advertisements of proprietary preparations are inserted in type indistinguishable from that of the body of the magazine and it is of course possible that its financial backing comes entirely from the manufacturers of these drugs40 ,illustration3 ,fig4 #a4--,photographic reproductions from the ,medical ,times4 ,do the gentlemen whose names appear in the list of the 8,board of ,contributing ,editors0 realize that they are lending an air of respectability to an otherwise disreputable business8 ,and this is from ,virginia3 8,to the ,editor3--,the statements made in the advertisement of the ,kellam ,hospital in the ,october number of the ,medical ,times are so out of the ordinary that ,i ask you to tell us something if you can of their institution and its methods of cure4 ,can such things as are stated in this advertisement be true8 #8,physicians ,treated ,free8' #8,endorsed by the ,senate and ,legislature of ,virginia8' ,what can all this mean to the sufferer from cancer8 ,if true1 let the whole world of sufferers know the glorious news40 ,collier's paid its respects to the ,kellam concern some time ago and we cannot do better than quote from its pages4 ,thus3 ,illustration3 ,fig4 #b4--,one way of drumming up trade in the 8cancer cure0 business6 ,the ,kellam ,hospital sends letters like this to the postmasters of small towns asking these government officials to furnish it with what1 in the parlance of quackery1 is known as a 8sucker list40 ,a delightful business1 isn't it8 ,and this1 gentlemen of the 8,board of ,contributing ,editors10 is the sort of thing to which you are lending your influence and good names6 8,grief is the portion of the ,kellam ,cancer ,hospital1 of ,richmond1 ,virginia1 because in these editorials it has been grouped with other exemplars of the ,great ,american ,fraud4 ,it offers the invariable and hollow mockery of testimonials and endorsements1 which1 as has been repeatedly shown1 can be wheedled1 browbeaten or bribed out of the victims of any form of quackery4 ,it1 of course1 courts the fullest investigation1 and desires that we send a representative to investigate whether its claims are not well founded4 ,unsuspected by the ,messrs4 ,kellam1 our representative has already investigated their claims1 notably their statement that they are endorsed by the ,legislature of the ,state of ,virginia4 ,upon request for a copy of the endorsement they forwarded a weak subterfuge1 and finally1 on pressure1 admitted that they could not produce the proof they had boasted4 ,for their further consideration we present a brief parallel3 ,,from ,,the ,,kellam ,,circular ,,from ,a ,,kellam ,,letter ,the ,cancer is removed without ,we do not claim to 8cure them the use of the knife or ,x-,ray all40 ,we go further1 and on 444 ,no roots or fibers left2 our part1 we agree to treat1 free hence it can not return4 of charge1 any patient who suffers a recurrence after having been treated by our method4 8,the italics are our own1 but we cheerfully present them for elucidation to the ,kellam ,hospital4 ,a little careful thought devoted to reconciling the irreconcilable may help them to forget their woe4 ,meanwhile1 they make themselves out worse than they really are by pretending to withhold from the bitter need of humanity a true1 non-surgical cure for cancer4 ,if this were true2 if1 indeed1 they had solved the problem which has baffled the greatest minds of modern science2 if1 having a genuine cure for the dreadful ailment which claims its increasing thousands of tortured victims yearly1 they secrete their discovery for the sake of a few paltry dollars1 then they are as cold-hearted as the sailors who pass within fair hail of the naked island on which some shipwrecked crew is starving1 and keep their stony eyes on the compass4 ,they have not even the excuse of the fanatical among the ,christian ,scientists who1 denying the existence of pain1 refuse to take measures to ease the cancer victim's suffering even at the last4 ,human nature is seldom so callous40 ,as for the ,medical ,times3 ,this publication for years contained comparatively little advertising4 ,then it came into the hands of ,romaine ,pierson1 who also owns the ,practical ,druggist4 ,mr4 ,pierson is not a physician and to him the medical profession is but a commercial problem4 ,he is publishing a medical journal for the money there is in it1 and for this he is not to be censured4 ,questions of advertising policy1 in such circumstances1 are determined on a commercial basis4 ,when an advertising contract is submitted1 for a product that physicians would know to be fraudulent1 the question that arises is1 8,can it be put over80 ,manifestly1 a medical journal published purely as a business venture would not dare long to fly in the face of the opinions of those from whom it received its support--its subscribers and contributors4 ,if our correspondents will go through the advertising columns of the ,medical ,times they will find many1 many other frauds1 less cruel perhaps than the ,kellam advertisement1 but no less disreputable or discreditable to the medical profession4 ,after all is said and done1 it is enlightened public opinion that is causing publishers of lay magazines and newspapers to eliminate fraudulent 8patent medicine0 and quack advertisements4 ,until the medical profession takes an equally enlightened stand1 physicians may expect to be afflicted with such commercial medical journals as the ,medical ,times1 the ,international ,journal of ,surgery1 the ,american ,journal of ,surgery1 ,american ,medicine1 and several other papers that are published primarily in the interest of the advertiser4 ,when such journals as these find they cannot get a circulation among physicians so long as they carry advertisements similar to many now appearing in their pages1 these advertisements will be eliminated1 but not before4 ,many physicians are receiving such journals at a nominal price or1 as one of our correspondents notes1 free4 ,the physician who permits such journals to come to his office must share with the paid subscribers the responsibility for the low standard of medical journalism4--7,from the ,journal ,a4 ,m4 ,a41 ,oct4 #ah1 #aiac47 ,two ,physicians ,express ,themselves on the ,ethics of ,medical ,journalism ,after the preceding article was in type1 we received1 in the same mail1 two letters that are so apropos that we reproduce them4 ,the first was from a town in ,illinois1 and was dated ,october #aa4 ,here it is3 ,to the ,editor3--,about two weeks ago1 a representative of the ,surgery ,publishing ,company1 ,new ,york1 ,n4 ,y41 came to ---- ,ill4 soliciting subscriptions for the ,american ,journal of ,surgery4 ,together with numerous others ,i subscribed--chiefly on the strength of the contributors whose articles appeared in the sample numbers shown by the agent4 ,since receiving the first number 7,october7 one look at the advertising pages has shown me why the subscription price for a year and a quarter is one dollar4 ,anasarcin1 ,tongaline1 ,cactina ,pillets1 ,hagee's ,cordial of ,ext4 ,cod ,liver1 ,burnham's ,soluble ,iodin1 ,papine1 ,phenalgine1 ,anusol1 etc41 etc4 ,i have written to the ,surgery ,publishing ,company1 telling them in no uncertain language that there is no room on my reading desk for such4 ,have you ever exposed this journal1 and the attitude of our big1 brilliant1 eminent men in permitting their articles--presumably original--to fill space in such a journal8 ,yes6 ,the ,journal1 ,dec4 #af1 #aiaa1 pp4 #b1jjj and #b1jac4 ,this letter is not for publication--at least not with name of city4 ,keep up the good work4444 ,the other1 dated ,october #aj1 follows3 ,to the ,editor3--,that little story about medical journal advertising and methods of obtaining paid-up subscribers1 in this week's ,journal makes me blush 7p4 #dbb1 this book74 ,i am guilty4 ,unlike ,dr4 ,genella1 ,i swallowed the bait--but the bait was even more tempting in my case2 the flattering 8editor0 offered me twenty-five subscriptions to distribute among my friends1 all for an 8abstract40 ,thank goodness1 ,i only accepted five subscriptions1 but worse luck1 ,i sent them to young men by preference4 ,so ,i am a deep-dyed offender indeed4 ,extenuating circumstances affected my susceptibility somewhat1 however4 ,i have noticed that prominent men like ,beverly ,robinson1 ,a4 ,rose1 ,tom ,a4 ,williams1 ,wayne ,babcock1 and ,morris--the latter1 at least1 a really able man and a brilliant writer--contribute to these peanut journals occasionally4 ,if they do1 why not ,i8 ,there's nothing like being in big company1 you know4 ,so far as ,i know1 my 8abstract0 has not yet been published4 ,on looking over the sample copy of this monthly ,i found an advertisement printed right in the list of contents--in fact1 it was the second 8original article0 in the issue1 as brave and respectable as you please6 ,then1 with characteristic ,hibernian impetuosity ,i got out my machine and pounded that editor a strong protest with a dire command not to use my 8abstract0 in his miserable organ4 ,but ,i have never received the manuscript1 nor any reply to my stern rebuke4 ,i wish ,i had been cautious like ,dr4 ,genella4 ,wm4 ,brady1 ,m4,d41 ,elmira1 ,n4 ,y4 --7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ah1 #aiac47 ,the ,responsibility of ,physicians ,the responsibility of medical journals for the continued existence of at least a part of the 8great ,american fraud10 has been referred to in these pages many times4 ,within the past few weeks ,the ,journal has called attention to the inconsistency of reputable physicians of high ideals lending their moral1 and often financial1 support to those medical journals whose advertising pages are a disgrace to the profession4 ,specifically1 the ,medical ,times--originally a homeopathic medical journal--has been referred to1 among others1 as an example of this type of journalism4 ,it must1 however1 be regarded simply as a type1 for it is no better and no worse than many other medical journals4 ,several letters have been received on the subject1 some of which we reproduce4 ,the first one is from ,dr4 ,george ,g4 ,ross of ,philadelphia3 8,i was very much jarred on receiving the last issue of ,the ,journal to find under the ,propaganda for ,reform an article concerning the ,medical ,times1 among the list of whose contributing editors my name appears4 ,i enclose you herewith a copy of my letter of resignation to the ,medical ,times4 ,i have a very dim recollection of what occurred at the time that ,i was asked to give my name as a contributing editor4 ,as ,i recollect it1 however1 at that time the journal was a respectable and ethical publication4 ,i had been asked by a friend of mine to write an article giving my opinion of the effects of college athletics on undergraduates4 ,this was at the time that ,dr4 ,stokes had issued his order about athletics at ,annapolis4 ,i want personally to thank you and the committee for the exposure of this journal and for having drawn my attention to the fact that ,i was unwittingly aiding and abetting such a journal4 ,i trust that if you have space in some future number of ,the ,journal1 you will do me the justice to publish all or part of this letter40 ,because he feels that he has 8unwittingly been put in an unfavorable light10 ,dr4 ,james ,a4 ,babbitt1 also of ,philadelphia1 sends ,the ,journal a copy of a letter written by him to the editor of the ,medical ,times4 ,here it is3 8,for reasons of which you are probably cognizant1 ,i deem it advisable to resign from the board of contributing editors of the ,medical ,times1 and desire that this resignation be accepted at once and my name not appear in further issues40 ,what shall be done1 asks ,dr4 ,sidney ,thompson of ,humboldt1 ,tennessee1 in such cases as the following8 ,says ,dr4 ,thompson3 8,in the ,propaganda for ,reform1 in ,the ,journal1 ,october #ah1 #aiac1 in closing your article on #8,medical ,journals and the ,great ,american ,fraud1' you say3 #8,the physician who permits such journals to come to his office must share with the paid subscribers the responsibility for the low standard of medical journalism4' ,now ,i agree with you in everything you have said about the ,medical ,times1 but what ,i want to know is how to keep such journals from coming into your office4 ,the ,medical ,times has been coming to me for a number of years with repeated duns for the subscription price4 ,i have written to them several times that ,i did not want the journal and never expected to pay for it1 but still it comes4 ,i have a vague recollection that ,i bit at an offer to send it three or four months free1 not knowing what it was1 but ,i never authorized them to enter my name as a regular subscriber40 ,the simplest course in such a case as that described by ,dr4 ,thompson1 is to write on the unwelcome publication the word 8refused0 and either drop it in the nearest mail-box or hand it back to the postman4 ,the courts have held that a person who continues to accept publications is legally liable for the payment of such publications4 ,the postoffice department1 however1 has ruled that a magazine--either monthly or weekly--may not be sent at second-class rates for more than one year after the expiration of a bona fide subscription4 ,at the expiration of that time1 stamps must be affixed and the publications sent at third-class postal rates4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #a1 #aiac47 ,medical ,journals and ,sanatogen,,bi ,,bi ,see also ,sanatogen1 p4 #ceh4 ,we have frequently referred to the inquiries that are received by this office from newspaper and magazine editors asking for information about products whose advertisements they have been offered4 ,one of the greatest difficulties in the way of accomplishing the good that such inquiries otherwise might lead to is the lack of uniform action on the part of the medical press of the country4 ,a specific instance may be given4 ,a layman wrote to a high-glass weekly magazine published in ,new ,york ,city protesting against an advertisement of ,sanatogen which the magazine was carrying1 and sending a reprint of ,the ,journal's article on this product4 ,the advertising manager of the magazine in question wrote back that he had seen ,the ,journal's article1 but had sought further information regarding the preparation from the editor of a medical journal in his city4 ,the medical editor recommended that the magazine accept the ,sanatogen advertisement1 so the advertising manager said1 and in view of this1 the manager suggested that possibly the article published by the ,american ,medical ,association in its journal was inspired by some 8personal prejudice40 ,giving weight to the probability that the advertising manager went for his information to a source that he knew would be favorable to the acceptance of the advertisement1 the fact remains that it is a disgraceful state of affairs when editors of medical journals will give vicious advice in matters on which they are supposedly competent to pass4 ,the probability is1 of course1 that the medical journal whose editor was questioned contained the self-same advertisement that the lay magazine was carrying4 ,and the advertising manager of the magazine was willing to accept--because such information coincided with his wishes--information that on its face must be biased1 and rejected advice--that did not meet his approval--because of a purely supposititious 8personal prejudice40 ,it is probably asking too much to expect advertising managers not to go to sources that are likely to be favorable for information about products whose advertisements are offered to them4 ,but we have a right to expect that physicians1 editors of medical journals1 should no longer be participes criminis in the furtherance of the great ,american fraud4 ,if our strictures on ,sanatogen are unfair1 if the ,council on ,pharmacy and ,chemistry rejected the product in mere pique1 if the opinions of such men as ,billings1 ,cabot1 ,hektoen and ,lusk are to be brushed aside as 8personal prejudice10 if this mixture of cottage cheese and glycerophosphates really is the marvelous product which its exploiters claim--then indeed not only have the editors of medical journals a right to praise it1 but it is also their duty to proclaim these wonders in their editorial pages4 ,if1 on the other hand1 this much-vaunted preparation is a very ordinary mixture sold at an extraordinary price1 if indigent consumptives and others are being inveigled into spending dollars for a preparation whose food value could be duplicated for a few cents--then in the name of humanity and common decency let the editors of medical journals proclaim these facts1 and not let their scientific judgment be blinded by the glitter of advertising contracts4--7,modified from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ah1 #aiac47 ,,the ,,army ,,and ,,navy ,,medical ,,record ,a ,fraudulent ,publication ,whose ,editorial ,opinions ,are for ,sale ,whenever a business assumes certain proportions1 subsidiary businesses spring up to cater to the needs of the larger enterprise4 ,for some years the nostrum business has grown so large that it has furnished a more or less precarious life for many individuals who have catered to it4 ,there are1 for instance1 men whose trade it is to obtain testimonials2 others1 claiming a long string of imposing degrees1 will furnish fake reports and bogus analyses2 still others issue at irregular intervals publications with high-sounding names which sell editorial indorsement to the products of concerns such as are willing to pay the price asked4 8,journals0 of this type have been called to the attention of our readers at different times2 the ,new ,york ,health ,journal and the ,united ,states ,health ,reports come to mind at this moment4 ,both of these had their day and died a natural death1 as all such publications must when once the public is cognizant of their true character4 ,,two ,,letters ,more recently the attention of ,the ,journal has been called to a publication calling itself the ,army and ,navy ,medical ,record4 ,a physician in the ,south sends a letter he has received from the ,army and ,navy ,medical ,record reading as follows3 8,we have had many favorable reports reach us relative to your most excellent institution1 and1 as you are doubtless aware1 we come in direct contact with a large number of ,army and ,navy and other government attachs who have sons that they desire to provide with a medical education combined with the higher course included in your up-to-date laboratory methods and the sciences incidental to clinical medical practice4 8,if you will regard the proposition as confidential1 we will agree to carry a one-fourth page advertisement of your university at the nominal rate of #ch per year1 provided this amount is forwarded in advance at the time copy is furnished2 and we will further promise to editorially indorse and recommend your school and its methods without qualification or exception4 ,our italics4--,ed4 ,this article you should be able to use 7and are authorized to do so7 after publication for advertising purposes4 8,we will also be able1 and are willing1 to furnish you with a desirable list of probable candidates from time to time4 8,kindly let us hear from you at once1 if interested1 and oblige1 8,yours with best wishes1 8,the ,army and ,navy ,medical ,record1 8,arthur ,g4 ,lewis1 ,managing ,editor40 ,the physician to whom this was addressed made a notation on the letter to the effect that 8this looks crooked40 ,a few weeks later1 ,dr4 ,v4 ,c4 ,vaughan1 dean of the ,university of ,michigan1 ,department of ,medicine and ,surgery1 sent in a letter from the ,army and ,navy ,medical ,record which he had received in his official capacity at the university4 ,here is the letter2 again the italics are ours3 8,we are gratified to advise you that in our efforts to select a strictly ethical and high-grade institution of medicine that this magazine could consistently indorse and recommend1 we have decided on the ,university of ,michigan1 ,department of ,medicine and ,surgery1 as the institution in your territory to whom our special publicity concession will be made this year4 8,you are doubtless aware that we come in direct contact with a very large number of ,army and ,navy and other government attachs1 also physicians in private practice who have sons that they desire to provide with a medical education1 combined with the higher courses included in your up-to-date methods4 8,for personal reasons we are particularly anxious to favor your institution1 and frankly believe that we can prove of material service to you4 ,the special proposition1 to be regarded by you as strictly confidential1 is that we will publish a full one-half page announcement of your institution for the term of one year1 you to merely pay a nominal expense charge of #ch for the year's service4 ,as our regular rate is #abe per annum for this service1 the necessity of regarding the matter between ourselves is apparent4 ,transparently so4--,ed4 ,we further propose1 without expense to you1 to editorially indorse and recommend your institution and its methods without qualification or exception4 ,an electrotype illustration may be used1 without charge4 8,it is important1 however1 that we hear from you promptly4 ,awaiting your immediate reply1 we are1 with best wishes1 8,yours faithfully1 8,the ,army and ,navy ,medical ,record1 8,arthur ,g4 ,lewis1 ,managing ,editor40 ,dr4 ,vaughan1 in forwarding the matter to ,the ,journal1 wrote that on receipt of the offer just given1 he 8was uncertain whether its writer was a knave or a fool40 ,after inquiring into the matter somewhat thoroughly1 he concluded that 8the managing editor of the ,army and ,navy ,medical ,record is both a knave and a fool40 ,,the ,,army ,,and ,,navy ,,magazine ,the ,journal had the ,army and ,navy ,medical ,record under investigation before these two letters were received and1 as a result1 the following facts seem to be pretty well substantiated4 ,herbert ,c4 ,lewis1 with his brother1 ,arthur ,g41 conducted from ,washington1 ,d4 ,c41 a publication called the ,army and ,navy ,magazine4 ,in ,the ,journal's nostrum file there is a booklet put out by the ,renova ,distributing ,company describing the wonderful virtues of its product1 8,anti-,jag10 which1 as its name might intimate1 is a 8liquor cure0 of the fake variety4 ,one page of this booklet is given over to what purports to be 8,a ,letter from a ,great ,magazine ,editor40 ,the letter is dated ,june #ai1 #aijj1 from ,washington1 ,d4 ,c41 and says that 8the editor of the ,army and ,navy ,magazine takes pleasure in stating that from his own personal knowledge he has found #8,anti-,jag' to be one of the most reliable medicines ever introduced for the permanent cure of drunkenness40 ,and more to the same effect4 ,the letter is signed 8,herbert ,c4 ,lewis1 editor40 ,the publishing offices of the ,army and ,navy ,magazine are at #fjf ,f ,street1 ,n4 ,w41 ,washington1 ,d4 ,c4 ,the building at this address is known as the ,baltic ,building4 ,herbert ,c4 ,lewis is said to be a printer by trade4 ,the ,army and ,navy ,medical ,record seems to have been started within the last few months by ,arthur ,g4 ,lewis4 ,it does business from two addresses1 the ,baltic ,building1 ,washington1 ,d4 ,c41 and the ,maple ,villa ,sanitarium1 ,hammonton1 ,n4 ,j4 ,lewis is said to have purchased the ,maple ,villa ,sanitarium recently1 but apparently his chief source of income is the ,army and ,navy ,medical ,record4 ,he is alleged to have claimed that some medical officials of the government are interested with him in this publication but that these officials do not wish their names known4 ,we do not blame them4 ,illustration3 ,photographic facsimile of a letter sent by the ,army and ,navy ,medical ,record to the dean of ,university of ,michigan1 ,department of ,medicine and ,surgery1 offering one hundred and twenty-five dollars' worth of advertising space for a 8nominal0 thirty-eight dollars--with editorial indorsements and recommendations thrown in for good measure6 ,,advertisements ,,as ,,editorials ,a glance through two issues of the ,army and ,navy ,medical ,record makes perfectly plain the character of the publication4 ,the ,january-,february1 #aiac1 number leads off with articles by well-known medical officers in the ,army1 the ,navy and the ,public ,health ,service4 ,these have been copied from other publications4 ,then comes an editorial entitled 8,a ,much ,needed ,dietary ,reform10 devoted to the laudation of 8,postum10 the widely advertised coffee substitute4 ,following this is an editorial on 8,the ,philosophy of ,hypnotics0 in which aconitine1 saline laxative and digitalin are each given a 8boost40 ,then comes an 8original article0 7save the mark67 entitled 8,the ,physiological ,pathology of ,consumption40 ,this is by 8,alfred ,s4 ,gubb1 ,m4,d41 ,l4,r4,c4,p41 ,london1 ,m4,r4,c4,s41 ,eng41 ,d4,p4,h41 etc4 etc41 ,aix-les-,bains1 ,savoie1 ,france40 ,two pages are devoted to this4 ,the 8joker0 appears in the third paragraphs from the end--,fellows' ,syrup of ,hypophosphites4 ,dioxogen receives more than three pages of editorial mention under the caption 8,the ,sterilization of ,milk with ,dioxogen40 ,under 8,another ,new ,electrical ,wonder--,magnified ,sound10 the 8,acousticon0 is given a two-and-a-quarter page write-up4 8,what ,wise ,men ,wear0 is the title of a four-page article--unsigned--devoted to the laudation of suspensories in general and the 8,o-,p-,c ,suspensory0 in particular4 ,dr4 ,h4 ,f4 ,boatman1 ,los ,angeles1 contributes a short article on 8,a ,case of ,advanced ,pulmonic ,tuberculosis ,treated with ,injections of ,dioradin10 while our good old friend ,willard ,h4 ,morse1 ,m4,d41 8,f4,s4,sc4 7,lond4710 the champion fake-testimonial-giver of the country1 writes more or less entertainingly on 8,putting on a ,mustard ,plaster40 ,the article has nothing to do with mustard plasters but has a good deal to do with 8,zumota10 a nostrum recommended as a substitute for the mustard plaster4 ,these are but a few of the nostrums to which the editorial and reading pages of the ,army and ,navy ,medical ,record are devoted4 ,in the ,june-,july issue1 ,arthur ,g4 ,lewis becomes bolder4 ,the leading article is entitled 8,first ,aid in the ,navy10 by ,c4 ,f4 ,stokes1 ,surgeon-,general1 ,united ,states ,navy4 ,there is nothing to indicate that this article was not contributed to the ,army and ,navy ,medical ,record by its author4 ,as a matter of fact1 it originally appeared in an official publication1 the ,united ,states ,naval ,medical ,bulletin for ,january1 #aiac1 and was reprinted by ,lewis without credit and without permission4 ,following the article by ,dr4 ,stokes is another1 unsigned1 entitled 8,the ,passing of #8,the ,pie ,habit4'0 ,this describes the surprise of the students of ,harvard ,university at being served breakfast cereals instead of pie at their noonday meal and suggests that 8,shredded ,wheat ,biscuits0 make a 8delicious dessert40 ,a two-and-a-half page article on the 8,danger of ,corrosive ,sublimate in ,vaginal ,douche0 is reprinted from the ,lancet-,clinic of ,september1 #aijc4 ,the reason for resurrecting this ten-year-old article becomes apparent before one gets half through it4 ,it deals not so much with the danger of corrosive sublimate as with the marvelous--alleged--properties of ,tyree's ,antiseptic ,powder4 ,dr4 ,claude ,c4 ,keeler1 ,denver1 has a three-page article on the 8,medical ,treatment of ,pulmonary ,tuberculosis40 ,the 8medical treatment0 referred to is ,waterbury's ,compound4 ,an editorial entitled 8,one ,notch ,ahead of ,morphin0 is devoted to that vicious morphin solution sold under the proprietary name 8,papine40 ,another on 8,the ,treatment of ,catarrh by ,palliatives and ,curatives0 deals with a widely advertised 8patent medicine10 8,kondon's ,catarrhal ,jelly40 ,what appears to be a contributed article by ,charles ,wardell ,stiles of the ,united ,states ,public ,health ,service on 8,country ,schools and ,rural ,sanitation0 has really been 8lifted0 from an official publication without credit and1 needless to say1 without ,dr4 ,stiles' permission4 ,but medicinal preparations are not the only things to which the ,army and ,navy ,medical ,record gives editorial indorsement4 ,all advertising matter1 apparently1 is grist to its mill4 ,sandwiched in between articles on 8,public ,health ,administrations0 and 8,important ,army ,medical ,lectures0 is a dissertation on 8,the ,millennium of ,shirt ,construction10 in which are sung the virtues of the tailless shirt6 ,a little farther along the ,hawaiian pineapple is extolled1 while the last pages of the issue are devoted to various banking concerns4 ,in addition to the advertisements appearing throughout the reading and editorial pages of these two issues of the ,army and ,navy ,medical ,record1 there are a number of display advertisements4 ,there is no reason to suppose1 at least in the majority of cases1 that the advertisers had the slightest reason to suspect the nature of the ,army and ,navy ,medical ,record4 ,several pages are devoted to financial advertisements1 there being more than forty banks that have 8fallen for0 the wiles of ,arthur ,g4 ,lewis4 ,in view of the letters received by the deans of medical colleges and other educational institutions1 the display advertisements of schools and colleges have a special interest to physicians4 ,schools for girls1 polytechnics1 colleges of music1 veterinary1 dental and medical schools--all are to be found in this cosmopolitan publication4 ,among the therapeutic products advertised--in the advertising pages--are3 ,fellows' ,syrup of ,hypophosphites #a cover page ,kondon's ,catarrhal ,jelly #a_/b page ,expurgo ,anti-,diabetes #a_/b page ,laxol #a_/b page ,campho-,phnique #a_/b page ,palpebrine #a_/b page ,zumota #a_/b page ,sanmetto #a_/d page ,while in the reading pages the following products are puffed3 ,tyree's ,antiseptic ,powder4 ,waterbury's ,compound4 ,papine4 ,kondon's ,catarrhal ,jelly4 ,ranier ,natural ,soap4 ,iodia 7,battle74 ,creo-,derma4 ,fellows' ,syrup of ,hypophosphites4 ,tannalbin4 ,expurgo ,anti-,diabetes4 ,zumota4 ,sulfothen4 ,dioxogen4 ,palpebrine4 ,bannerman's ,intravenous ,solution4 ,daniel's ,concentrated ,tincture of ,passiflora4 ,peacock's ,bromides4 ,aletris ,cordial ,rio4 ,gonosan4 ,digipuratum4 ,dioradin4 ,pepto-,fer4 ,lactol4 ,campho-,phnique4 ,summed up3 ,the ,army and ,navy ,medical ,record is but another of the parasites of quackery4 ,it is not entered as second-class matter and it has probably no bona-fide circulation4 ,while it is claimed to be 8,devoted to the ,interest of the ,medical and ,surgical ,corps of the ,army and ,navy1 the ,public ,health ,marine ,hospital ,service and the ,red ,cross ,society0 it is actually devoted to none of these4 ,it is devoted to the exploitation of the advertising public for the special financial benefit of the man who calls himself its editor--,arthur ,g4 ,lewis4 ,advertising contracts are obtained under false and fraudulent pretenses4 ,in brief1 ,arthur ,g4 ,lewis is using the good name of the various medical services of the ,united ,states government to further his swindling operations4 ,he has written letters to honorable physicians making dishonest and insulting propositions to deceive and defraud the public4 ,editorial indorsements of the ,army and ,navy ,medical ,record mean nothing except that money has been paid for them4 ,in short1 the ,army and ,navy ,medical ,record is a fraud1 and its 8editor10 ,arthur ,g4 ,lewis1 a faker4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #be1 #aiac47 ,,the ,,medical ,,times ,,advertisements ,in ,which ,are ,discussed ,some 8,oversights0 and the ,ethics of ,journalism ,two or three weeks ago we published letters from two physicians calling attention to an advertisement of a 8cancer cure0 hospital appearing in the ,medical ,times4 ,as a result of ,the ,journal's comments1 some of the physicians who were listed as 8contributing editors0 of the ,medical ,times wrote that they had requested that their names be withdrawn from this list4 ,in reply to at least some of these letters1 the editor of the ,medical ,times wrote asking them to reconsider their decision and offering as an excuse the statement that the appearance of the 8cancer cure0 hospital advertisement was an oversight4 ,in this connection the following letter from the ,medical ,times1 addressed to ,the ,journal of the ,american ,medical ,association1 is pertinent3 8,gentlemen3--,we note in your issue of ,october #ah an article calling attention to an advertisement which appears in the columns of this journal1 and to which your editor rightly objects4 8,the advertisement in the ,times was the result of an oversight1 and it will not reappear4 8,while we are indebted to you for thus bringing the matter to our attention1 we cannot but feel that a letter written to us would have been more in keeping with the ethics of journalism4 8,very truly yours1 ,the ,medical ,times40 ,it will be noticed that this letter1 like the letters sent to other physicians1 ignores altogether the most important point made by ,the ,journal in its criticism of that publication's advertising policy4 ,the ,journal said in this connection3 8,if our correspondents will go through the advertising columns of the ,medical ,times they will find many1 many other frauds1 less cruel perhaps than the ,kellam advertisement1 but no less disreputable or discreditable to the medical profession40 ,the ,medical ,times apologizes for the advertisement of the ,kellam ,cancer ,cure ,hospital but ignores altogether the fact that the hospital advertisement was but one of many equally discreditable4 ,we turn to recent issues of the ,medical ,times and we find it fairly reeking with advertisements of proprietary preparations that are a disgrace to the medical profession1 many of them having been repeatedly exposed in ,the ,journal4 ,we find1 for instance1 a quarter-page advertisement of the ,expurgo ,manufacturing ,company4 8,expurgo ,anti-,diabetes10 we are solemnly told in the pages of the ,medical ,times is3 8,the only reliable and thoroughly tested remedy for the cure of ,diabetes ,mellitus and ,insipidus40 ,this wretched fraud1 which also is advertised in true 8patent medicine0 style direct to the public1 is presented to a presumably intelligent profession as a 8cure0 for a disease which so far has baffled the best brains in the scientific world4 8,expurgo ,lapis0 we are told1 also via the ,medical ,times is3 8,the only known cure for gall-stones1 kidney and bladder stones1 gravel and all kidney trouble arising from uric-acid origin40 ,did ,kilmer's ,swamp-,root ever claim more8 8,diabetes is no longer an incurable disease0 runs the advertisement of the ,jireh ,diabetic ,food ,company1 yet the editor of the ,medical ,times must know that in ,the ,journal#acc and in the reports of state chemists the ,jireh diabetic foods have been shown time and again to be among the most dangerous and fraudulently exploited products sold to the unfortunate diabetic4 #acc ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ad1 #aiab1 ,march #bb1 #aiac1 and ,april #e1 #aiac2 see also p4 #dea1 this book4 ,phenalgin1#acd twin brother to the ,antikamnia fraud1 shouts its inferential falsehoods in a half-page display4 ,micajah's ,wafers1#ace the alum-borax mixture long advertised as a cure for gonorrhea1 endometritis1 etc41 may also be found1 as well as many other preparations exposed at various times by ,the ,journal4 ,for example3 ,anasarcin1#acf ,campho-,phenique1#acg ,papine1#ach ,bromidia1#aci ,cactina ,pillets1#adj ,pluto ,water1#ada ,prunoids1#adb ,sanatogen#adc and ,sal ,hepatica4#add #acd ,pages #aj and #cce1 this book4 #ace ,page #bdj1 this book4 #acf ,page #aa1 this book4 #acg ,page #dj1 this book4 #ach ,page #ccj1 this book4 #aci ,nostrums and ,quackery1 ,ed4 #b1 p4 #ehi2 page #ca1 this book4 #adj ,page #cf1 this book4 #ada ,the ,journal1 ,march #bi1 #aiac1 p4 #ajac4 #adb ,page #agh1 this book4 #adc ,nostrums and ,quackery1 ,ed4 #b1 p4 #dgj2 page #ceh1 this book4 #add ,nostrums and ,quackery1 ,ed4 #b1 p4 #fci2 page #agi1 this book4 ,what excuse can the ,medical ,times offer for the presence of these frauds in its pages8 ,are these1 too1 8the result of an oversight08 ,presumably for thus bringing to its attention these various other disreputable advertisements1 ,the ,journal will be accused again of violating 8the ethics of journalism40 ,if calling attention to fraudulent advertisements is out of keeping with the ethics of journalism1 what1 pray1 must be said of publications that are willing to share in the profits of such fraudulent exploitation8 ,but1 and we cannot repeat it too often1 the ,medical ,times is but one of a class1 neither worse nor better than many other medical journals whose financial support comes from the proprietary interests rather than from the medical profession4 ,the responsibility for the existence of these journals really rests not on the business men who conduct them on a commercial basis1 but on the physicians who tolerate or encourage them in any way4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #h1 #aiac47 ,,cause ,,for ,,optimism ,a ,clean ,medical ,journal--the ,south ,texas ,medical ,record ,fortunately1 there are forces at work in the medical profession that make for optimism4 ,an editorial in the last issue--,april1 #aiae--of the ,south ,texas ,medical ,record1 the official organ of the ,south ,texas ,district ,medical ,association1 is especially significant4 ,while not a large journal1 the ,south ,texas ,medical ,record could well stand as an example to medical publications of a much more pretentious character4 ,its advertising pages are above reproach and the journal is a credit alike to its editors and to those members of the profession whose support makes its existence possible4 ,in the editorial referred to1 entitled1 8,honest ,advertising--,let ,us ,cleanse ,our ,own ,linen ,first10 the editor-in-chief1 ,dr4 ,w4 ,burton ,thorning1 says3 8,a recent editorial1 entitled #8,honest ,advertising1' in a daily newspaper1 furnished the occasion for an editorial comment in the ,january number of the ,southwestern ,hospital ,reporter4 ,the latter1 while taking the ground that the newspaper was inconsistent in uttering high editorial sentiments and in adjoining columns printing patent medicine advertisements1 implied that newspaper men should be allowed some latitude in the matter of accepting advertising1 on the plea of being laymen and therefore not expected to possess the same amount of information concerning patent #8dope' that medical men have4 8,it would appear to be a fair assumption that a layman1 even though a highly educated and able editor of a great newspaper1 does not know1 and cannot be expected to know1 the depth of depravity to which the consumption cure faker and the cancer quack can descend4 8,granting that the newspaper man accepts the advertisements through ignorance of the facts concerning their possibilities for evil1 what can be offered in defense of the medical editor who accepts advertising matter equally pernicious in its influence8 8,indeed1 it is not so many years since many of the so-called ethical medical journals carried the ads of some of the most notorious quacks this country has ever known4 8,doubtless there are few1 if any1 who do so at the present time1 but1 on the other hand1 there are only a few who do not advertise unethical institutions1 and questionable proprietary medicines4 ,as a matter of fact some of the most widely advertised patent medicines of today were formerly advertised as ethical proprietaries in medical periodicals1 the great majority of which are still serving as a sort of preparatory school for advertisements that will presently appear in the lay press4 8,what shall be offered in defense of the medical publication which continues to publish the advertising matter of hundreds of proprietaries which the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association has shown to be either generally worthless or an out and out fake8 8,can the medical editor plead ignorance8 ,hardly4 ,to do so would be to admit utter incapacity4 ,there is only one inference to be drawn2 the publication needs the money and is not overparticular regarding its source4 8,there is a remedy1 however1 a remedy absolutely certain in its results4 ,if every physician in the ,united ,states for a period of three months would positively refuse to receive at his desk a medical journal containing questionable advertising1 this blotch on medical journalism could be erased4 8,it is true that many of them would sink1 never to rise again1 but the profession would be better off without those whose existence depends upon #8phoney' advertising4 ,there are1 unfortunately1 several ,american journals whose reading pages are well and carefully edited and a credit to medical literature1 whose advertising pages carry such undesirable matter that the educated physician can only feel a sense of disgust4 8,such journals could very well succeed on the quality of their reading matter and undoubtedly would increase their circulation enough to more than offset the loss in advertising40--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #bi1 #aiae47 ,,the ,,comparative ,,nutrient ,,value ,,of ,,cod ,,liver ,,oil ,,and ,,cod ,,liver ,,oil ,,cordials,,bj ,john ,phillips ,street1 ,m4,s4 ,chemist1 ,connecticut ,agricultural ,experiment ,station ,,new ,,haven1 ,,conn4 ,,bj ,see also reports on ,hagee's ,cordial1 pp4 #ea1 #bhi2 ,wampole's ,preparation1 pp4 #eb1 #ddb1 and ,waterbury's ,compound1 pp4 #ed1 #eg1 #bia4 ,for a long time cod liver oil has been recognized as an easily assimilable nutrient and reconstructive and of special value in wasting diseases4 ,the unpalatability of the oil1 however1 has led to various devices to make it tasteless or to render it more acceptable to the stomach4 ,emulsions containing the oil in mixture with other substances were exploited1 and doubtless served a useful purpose4 ,the oil1 however1 but imperfectly concealed1 was still disagreeable to many1 and other preparations began to appear on the market1 which claimed to retain the therapeutic virtues of cod liver oil without its disagreeable characteristics4 ,this practice has been carried so far that now we find for sale cod liver oil preparations from which the oil has been removed in its entirety1 and only the name remains4 ,certain of these products claim to 8represent0 the oil and to retain all its virtues2 others are said to contain oil1 while still others claim 8all the valuable constituents0 of the oil without the oil itself4 ,in the past1 cod liver oil has been considered a food rather than a medicine1 and its value attributed to the easily digestible and metabolizable oil it contains4 ,this position1 however1 has been disputed4 ,by some its therapeutic value has been attributed to the small amount of iodin present in the oil1 but in recent years the suggestion has been made that its special potency depends on its peculiar fatty acids4 ,in this connection the ,u4 ,s4 ,dispensatory#ade says3 #ade ,u4 ,s4 ,dispensatory1 ,ed4 #ai1 p4 #hfj4 8,other oleaginous substances1 certainly not less nutritious1 have not been equally efficient1 though taken in much larger quantities4 ,if this be the true explanation1 persons living chiefly on milk1 which abounds in oil1 or on fat pork1 ought to show a special exemption from scrofulous complaints4 ,the probability appears to us to be that1 in consequence of some peculiar principle or principles it contains1 it exercises a stimulant and alterative influence on the processes of assimilation and nutrition1 thereby aiding in the production of healthy tissue40 ,indeed1 ,osborne and ,mendel#adf have shown in their experiments on albino rats that by substituting cod liver oil for a portion of the lard in their standard diets1 growth was resumed after failure on foods containing commercial lard alone as the source of fat4 ,similar results were secured with butter-fat and egg yolk fat4 #adf ,osborne1 ,t4 ,b41 and ,mendel1 ,l4 ,b43 ,jour4 ,biol4 ,chem41 #aiad1 xvii1 #dja4 ,in the light of the theories advanced for the therapeutic value of cod liver oil1 and the results secured by ,osborne and ,mendel with the oil itself2 it seemed a profitable study to examine some of the prominent 8oilless0 preparations on the market to determine whether or not the claims made for them as nutrients were justified4 ,certain of the so-called cod liver oil preparations are termed 8extracts0 of cod liver oil1 and are not made from the oil1 but from the cod livers instead4 ,as has been well said1#adg 8,they are preparations1 which1 if honestly made1 might be worthy of trial1 but they are improperly called #8extracts' of cod liver oil1 since they do not contain the fat1 which is the active constituent of the oil1 but the extractives from the liver1 which may or may not possess therapeutic virtues4 ,so far as we know1 however1 no satisfactory evidence is forthcoming to indicate that such extractives have any therapeutic value40 #adg ,fraud and ,deception ,connected with ,so-,called ,cod ,liver ,oil ,preparations1 ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ac1 #aijf1 p4 #abjg4 ,it was with preparations of this class that our experiments were made4 ,four of the more extensively advertised brands were selected1 as they represent rather distinct types of this class of products1 as the following claims of their label will show3 ,hagee's ,cordial of the ,extract of ,cod ,liver ,oil1 ,compound4--8,tonic1 stimulant1 alterative1 reconstructive1 nutritive and digestive40 8,each fluid ounce represents the extract obtainable from #a_/c fluid ounce of cod liver oil 7the fatty portion being eliminated71 #f grs4 calcium hypophosphite1 #c grs4 sodium hypophosphite1 #a_/b gr4 salicylic acid 7made from oil wintergreen71 with glycerin and aromatics40 ,vinol4--8,the modern tonic reconstructor containing the medicinal extractives of fresh cod livers with peptonate of iron40 8,when the blood is poor1 when more fresh blood is needed1 when the weak need strength1 when the throat and lungs are affected1 ,,take ,,vinol40 ,wampole's ,perfected and ,tasteless ,preparation of an ,extract of ,cod ,liver4--8,contains a solution of an extractive obtainable from fresh cod livers1 the oily or fatty portion being afterward eliminated4 ,this extractive is combined with liquid extract of malt1 fluid extract of wild cherry and compound syrup of hypophosphites 7containing calcium1 sodium1 potassium1 iron1 manganese1 quinine and strychnine740 ,waterbury's ,compound1 ,plain4--8,made from cod liver oil1 digestive ferments1 malt extract unfermented1 hypophosphites comp4 special1 ext4 cherry1 eucalyptus1 aromatics1 etc40 ,thus we have represented in our experiments an 8extract0 with hypophosphites1 one with peptonate of iron1 one with malt extract and hypophosphites and the alkaloids quinin and strychnin1 and one with malt extract and hypophosphites without alkaloids4 ,in order to prepare a dry ration of suitable keeping properties1 it was necessary to remove the alcohol and water from the various preparations4 ,this was done by evaporation under reduced pressure at from #dj to #ee ,c4 7#ajd to #aca ,f474 ,in the case of ,hagee's ,cordial it was claimed that one fluidounce of the preparation represented #a_/c fluidounce of cod liver oil1 and in the subsequent substitution for cod liver oil in our rations1 this ratio was used for all four products4444 ,these are very dissimilar preparations1 the alcohol ranging from #g4ej to #ah4fi per cent41 the extract from #h4gb to #ci4ec per cent4 7#aj4ha of the #ac4ah gm4 of extract in ,hagee's ,cordial being glycerin71 the ash from #j4cje to #a4ifg per cent41 the reducing sugars from #a4ce to #ag4aj per cent41 and the glycerin from a trace to #aj4ha per cent4 ,wampole's contained quinin and strychnin1 the others no alkaloids2 salicylates were present in all but ,wampole's2 saccharin in ,hagee's4 ,the ,pettenkoffer test for biliary acids gave a negative result in ,hagee's and ,wampole's2 in ,vinol and ,waterbury's1 small amounts of fatty acids were obtained1 amounting to #j4jaf and #j4jcb gm4 per hundred c4c41 respectively1 quite insignificant amounts4 ,the feeding experiments were made on albino rats of both sexes1 which were placed1 when about #f weeks old1 on a standard ration1 ,no4 #g1 and after several months1 when a failure to maintain weight was indicated1#adh an amount of dealcoholized cordial extract equivalent to #ah per cent4 of cod liver oil was substituted for a portion of the lard1 the cordial extract later being replaced by an equivalent amount of cod liver oil4 #adh ,osborne and ,mendel have shown 7,jour4 ,biol4 ,chem41 #aiac1 xv1 #caa7 that mixtures of purified protein1 lard1 starch and protein-free milk have been singularly efficient for a time in promoting growth of young rats4 ,in from sixty to #ajj days or more1 however1 normal growth stops2 the animals may remain at constant weight for a few days1 or grow very slowly1 and then suddenly decline and die unless a change is made in the diet4 ,the substitution of butter-fat1 egg yolk fat1 or cod liver oil for a portion of the lard in the ration1 in the experiments of these authorities1 brought prompt recovery and continuation of normal growth4 ,,summary ,table #aa gives a summary of the actual gains of the fifteen rats on the four rations1 compared with the gains shown by cod liver oil and those shown by normal rats at the same period of their life history4 ,,table #aa4--,,summary ,,of ,,results,,bk ,total ,total ,average ,average ,rations ,normal ,actual ,normal ,actual ,gain1 ,gain1 ,gain1 ,gain1 ,gm4 ,gm4 ,gm4 ,gm4 ---------------------------------------- --------------- ,hagee ration #bd -#cf4b #f -#i4a ,cod liver oil ration #aad #aef4d #bh4e #ci4a ,vinol ration #db -#a4e #aj4e -#j4d ,cod liver oil ration #db #hg4e #aj4e #ba4i ,wampole ration #hc #ea4d #bj4h #ab4i ,cod liver oil ration #fb #ha4e #ae4e #bj4d ,waterbury ration #cb #j4c #aj4g #j4a ,cod liver oil ration #db #hg4d #ad #bi4a ---------------------------------------- --------------- ,,bk ,in this table are given the totals and averages of the figures already presented in ,tables #d1 #f1 #h and #aj4 ,in considering the effect of these preparations as general medicines1 their alcohol content must not be overlooked4 ,hagee's ,cordial contains #g4ej per cent4 of alcohol by volume1 ,vinol #ah4fj per cent41 ,wampole's ,preparation #af4ei per cent41 and ,waterbury's ,compound #aa4be per cent4 ,full strength whisky contains #ej per cent4 of alcohol by volume4 ,by following the doses prescribed by the manufacturers of these preparations1 the user would consume daily the following equivalents of full strength whisky3 ,in ,hagee's ,cordial #j4bd fluidounce ,in ,vinol #j4h fluidounce ,in ,wampole's ,preparation #j4g fluidounce ,in ,waterbury's ,compound #j4f fluidounce ,these amounts of alcohol are by no means negligible and doubtless explain to a considerable extent the source of the alleged tonic virtues of these preparations4 ,the results of the experiments may be summarized as follows3 ,hagee's ,cordial failed to sustain rats during periods of seven and fourteen days1 the rats showing a loss in weight of #cf4b gm41 instead of the normal gain of #bd gm4 ,vinol in two cases sustained and in two cases failed to sustain growth during periods of from eleven to thirty-five days1 the net loss in weight of the four rats being #a4e gm41 instead of the normal gain of #db gm4 ,wampole's ,preparation in three ,cases sustained and in one case promoted growth in rats during periods of eighteen and thirty-nine days1 showing1 however1 only #ea4d gm4 gain in weight instead of the normal #hc gm4 ,waterbury's ,compound in two cases sustained and in one case failed to sustain rats during periods of fourteen and thirty days1 the net gain in weight1 however1 being but #j4c gm4 instead of the normal #cb gm4 ,cod liver oil showed a gain of #db4d gm4 over the normal1 while with the same rats ,hagee's ,cordial showed a loss of #fj4b gm4 ,cod liver oil showed a gain of #de4e gm4 over the normal1 while with the same rats ,vinol showed a net loss of #dc4e gm4 ,cod liver oil showed a gain of #ai4e gm4 over the normal1 while with the same rats ,wampole's ,preparation showed a loss of #ca4f gm4 ,cod liver oil showed a gain of #de4d gm4 over the normal1 while with the same rats ,waterbury's ,compound showed a net loss of #ca4g gm4 ,not only did cod liver oil show a marked superiority as a source of nutriment over ,hagee's ,cordial1 ,vinol1 ,wampole's ,preparation and ,waterbury's ,compound1 but it also showed a remarkable reconstructive and recuperative power in its ability to enable rats to gain weight rapidly and steadily after having suffered from a deficiency in nutriment when fed the four preparations named above4--7,abbreviated from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #bj1 #aiae47 ,,diabetic ,,foods ,,offered ,,for ,,sale ,,in ,,the ,,united ,,states ,a ,preliminary ,report ,john ,phillips ,street1 ,m4,s4 ,chemist1 ,connecticut ,agricultural ,experiment ,station ,,new ,,haven1 ,,conn4 ,recent references in ,the ,journal to gluten flours and certain other foods offered for the use of diabetics suggest that a preliminary report of an investigation just about completed in my laboratory by ,prof4 ,l4 ,b4 ,mendel and myself might be useful to many diabetics and to physicians who are called on to arrange their dietaries4 ,in #aijf this laboratory1 then under the direction of ,dr4 ,a4 ,l4 ,winton1 who is now with the ,department of ,agriculture1 made its first examination of commercial diabetic foods4 ,in nearly every year since it has analyzed various other brands as they appeared on the market4 ,the demand for the reports on these foods and the many inquiries directed to us have led us to make a more extensive review of the situation1 and to collect as far as possible all information as to the quality of the so-called 8diabetic0 foods offered to the ,american public4 ,that the present state of the market is unsatisfactory is well known1 and the inferiority 7from the diabetic's point of view7 of many of the products at present offered is unfortunately familiar to all careful dietitians4 ,the most dangerous feature of the present situation is that the unsuspecting patient is led to purchase foods1 generally at an exorbitant price1 which are not only misrepresented but which may be positively harmful to him4 ,in this day of self-medication this condition is all the greater menace to the diabetic4 ,without any attempt to suggest methods of treatment for diabetes1 which is the province of the physician1 ,i may say that it is well recognized that diabetes is primarily a disturbance of nutrition1 in which the normal ability of the body to make use of carbohydrates is more or less completely impaired4 ,all recent authorities agree in placing the chief emphasis on the role of diet in the management of this disease4 ,janeway1 ,benedict1 ,joslin1 ,futcher1 ,falta1 ,strauss1 von ,noorden and other writers on diabetes could be quoted at length in support of this view4 ,the importance of a restriction of the carbohydrates in certain cases and certain aspects of diabetes is admitted by practically all competent authorities4 ,in order to prescribe a starch-free and sugar-free dietary1 which at times is necessary1 and to know accurately the actual amount of these carbohydrates contained in the various available foods1 the physician must rely on the cooperation of the chemist to furnish this requisite information4 ,this is our excuse1 if any be needed1 for our present investigation4 ,there seems to be some uncertainty as to what sort of preparation is entitled to be sold as a 8diabetic0 food4 ,granting the desirability of feeding the patient all the carbohydrate he can tolerate1 and recognizing the possible value of the oatmeal1 potato1 rice and other treatments1 in which a relative abundance of carbohydrate is fed for a limited period1 it would seem that a low percentage of carbohydrates should be a requisite for a 8diabetic0 food4 ,certainly no special food containing nearly as much carbohydrate as a normal food of the same class should be entitled to this appellation4 ,flours1 breads1 biscuits1 chocolates1 breakfast-foods1 macaroni1 etc41 containing only a slightly lowered percentage of carbohydrates1 are no more entitled to be called 8diabetic0 foods than the normal foods themselves4 ,it is true that1 when a patient's carbohydrate tolerance is well established1 the use of foods containing #bj1 #be and even #ce per cent4 of carbohydrates might be permissible1 when used under the direction of a competent physician2 but when a strict diet is necessary1 such as is required to determine this tolerance1 even these relatively low percentages are objectionable1 if not dangerous4 ,it has been our purpose to include in this investigation1 as nearly as possible1 all available data on the composition of all diabetic foods sold in ,america4 ,our report1 therefore1 will be in part compiled1 but in greater part will consist of our original analyses4 ,it will show #eci analyses of about #djj brands1 #bjj of which are our own new analyses and #aaj those made in this laboratory in previous years4 ,while the purpose of this preliminary note is to call attention to the better preparations rather than to emphasize those which are obviously objectionable and fraudulent1 it may not be out of place to summarize briefly our findings in general4 ,the full details of the investigation are now being prepared for publication and will shortly be issued as a report from the ,connecticut ,agricultural ,experiment ,station4 ,one hundred and eight samples of sixty-eight brands of flours and meals are included in the report4 ,sixty-seven of these were sold as 8gluten0 flours1 twenty of which did not even satisfy the low government standard of #ce per cent4 protein4 ,twelve samples contained less than #ac per cent4 carbohydrates1 while the remaining gluten flours ranged from #bh to #gf per cent4 ,the soy bean flours contained from #bc to #bf per cent4 of carbohydrates1 the almond meals #ag per cent41 and a cotton-seed flour #ba per cent4 ,other 8diabetic0 flours1 not specifically sold as 8gluten0 flours1 contained from #fg to #hj per cent4 ,the purchaser of gluten flours at the present time may obtain preparations containing from #hg to #aa per cent4 of protein and from #d to #gf per cent4 of carbohydrates1 at a cost of from #i cents to #a4ef per pound4 ,in view of the government's low standard for gluten flour1 and because of the wide variations in composition found in the brands at present on the market1 proper protection of the diabetic demands that the manufacturers of these flours should be required to state on the label the guaranteed percentages of both protein and carbohydrates4 ,three samples of ,american soft gluten breads contained from #ce to #cg per cent4 of carbohydrates2 two other brands contained #di and #ed per cent41 little1 if any1 lower than found in ordinary wheat bread4 ,one hundred and forty-eight analyses of #aab brands of hard breads1 biscuits1 rusks1 cakes and other bakery products are included4 ,eight brands of ,luftbrot1 or aerated bread1 are reported2 two of these contained from #i to #ab per cent4 of carbohydrates1 one #bj per cent41 two from #ca to #cc1 and the other three from #dd to #ed per cent4 ,a number of the brands of rolls1 biscuits1 breads1 etc41 showed satisfactorily low percentages of carbohydrates1 thirty-five samples containing from #a to #be per cent41 forty-four samples containing from #ce to #ee per cent41 and forty-one over #ee per cent41 seven of the latter exceeding #gb per cent4 ,the cost of the ,luft breads ranged from #ga cents to #b4cc per pound4 ,biscuits1 containing #aa per cent4 or less of carbohydrates1 cost from #gb cents to #c per pound4 ,a number of brands1 containing from #dc to #gg per cent41 cost from #c to #c4fj per pound4 ,even the cheaper preparations1 containing from #ej to #gg per cent41 no better1 and in some cases even worse1 for the diabetic's use than ordinary bread1 cost from #cj to #da cents per pound4 ,fourteen samples of breakfast-foods were analyzed1 five of which contained from #dd to #ed per cent4 of carbohydrates1 somewhat lower percentages than normal4 ,seven of the ten brands of recommended macaroni1 noodles1 etc41 contained over #gj per cent4 of carbohydrates1 the other three from #db to #ea per cent4 ,the analyses are given of fourteen samples of peanut butter1 five of almond paste and butter1 two of pine-nuts1 one of almonds and ten of miscellaneous nut foods4 ,as was to be expected1 most of these preparations proved to be suitable diabetic foods4 ,the peanut butters contained from #ab to #bj per cent4 of carbohydrates1 with an average of #ae per cent4 ,the three almond pastes contained from #cj to #dj per cent41 one showing an addition of #aa per cent4 cornstarch4 ,the two almond butters contained only #g and #h per cent41 the pine-nuts from #c to #h per cent41 and the almonds #af per cent4 ,the other nut preparations contained from #f to #dd per cent4 carbohydrates4 ,seven brands of diabetic chocolates contained from #aj to #ej per cent4 carbohydrates1 while four cocoas contained from #ba to #ea per cent4 ,the chocolates cost from #a4fc to #b4jf per pound1 and the cocoas were similarly expensive4 ,two sugar-free milks were examined which were true to name1 containing only the merest traces of carbohydrates4 ,one 8diabetic0 baking-powder examined contained no starch1 another brand from #ad to #af per cent4 ,various jams1 preserves and other fruit products were examined which contained from #a4bd to #g per cent4 of invert sugar1 percentages far below the normal4 ,a currant-juice contained only #j4he per cent4 of invert sugar4 ,four of the fruit preparations were artificially colored with a coal-tar dye--a permitted color to be sure1 but seemingly quite out of place in foods intended primarily for the use of invalids4 ,as already stated1 the main purpose of this investigation was not so much to detect fraud as to secure information which would be of benefit to the diabetic and to the physician who seeks foods suitable for a low carbohydrate diet4 ,in the accompanying tabulations a summary is given of the brands1 sold as diabetic foods1 which showed less than #ce per cent4 of carbohydrates1 arranged in the order of their carbohydrate#adi content4 ,a date in parentheses following a brand name signifies that the brand named showed variations in different years2 in other cases1 in which the agreement was close1 the results have been averaged4 #adi ,in the tables 8carbohydrates0 is used as synonymous with 8nitrogen-free extract40 ,,brands ,,showing ,,under #e ,,per ,,cent4 ,,of ,,carbohydrates ,per ,cent4 ,casoid ,baking ,powder 4#j ,dr4 ,bouma ,sugar-,free ,fat-,milk 4#j ,whiting's ,sugar-,free ,milk 4#j ,rademann's ,currant ,juice 8ohne ,zucker0 #j4i ,kalaria ,batons 7#aiji7 #j4i ,glidine #a4j ,casoid ,sugarless ,marmalade #a4b ,casoid ,sugarless ,jam #a4e ,kalari ,biscuit #a4g ,casoid ,dinner ,rolls #b4a ,casoid ,flour #b4b ,jireh ,diatetic ,pine ,nuts #c4d ,rademann's ,preserved ,fruits1 8entzuckert0 #c4e ,kellogg's ,protose #c4f ,barker's ,gluten ,food 8,a0 #d4a ,kellogg's ,pine ,nuts #d4b ,kellogg's #hj ,per ,cent4 ,gluten ,biscuit #d4d ,bischof's ,gluten ,flour #e4j ,,brands ,,showing ,,from #e ,,to #aj ,,per ,,cent4 ,,of ,,carbohydrates ,per ,cent4 ,casoid ,biscuits ,no4 #b #e4f ,rademann's ,preserved ,fruits 8in eigenen ,saft0 #e4g ,barker's ,gluten ,food 8,b0 #e4i ,kellogg's ,nuttolene #f4c ,nashville ,sanitarium ,nutcysa #f4c ,huntley and ,palmer's ,akoll ,biscuit #f4e ,nashville ,sanitarium ,nutfoda #f4h ,rademann's ,preserved ,fruits 8ohne ,zucker0 #g4j ,muller's ,tomatoes fr ,diabetiker #g4c ,barker's ,gluten ,food 8,c0 #g4g ,kalari ,batons 7#aiac7 #g4g ,casoid ,biscuits ,no4 #c #g4h ,kellogg's #hj ,per ,cent4 ,gluten 7#aiab7 #g4i ,casoid ,biscuits ,no4 #a #h4j ,kellogg's ,almond ,butter #h4b ,fromm's ,uni ,bread #i4j ,metcalf's ,vegetable ,gluten 7#aiac7 #i4h ,,brands ,,showing ,,from #aj ,,to #ae ,,per ,,cent4 ,,of ,,carbohydrates ,per ,cent4 ,kellogg's ,pure ,gluten ,biscuit 7#aijf7 #aj4b ,health ,food ,pure ,washed ,gluten ,flour 7#aiac7 #aa4a ,health ,food ,alpha ,diabetic ,wafers #aa4c ,loeb's ,imported ,gluten ,flour #aa4h ,health ,food ,no4 #a ,proto ,puffs #aa4i ,kellogg's ,potato ,gluten ,biscuit 7#aijf1 #aiji7 #aa4i ,kellogg's ,nut ,meal #ab4a ,kellogg's #hj ,per ,cent4 ,gluten 7#aiji7 #ab4e ,nashville ,sanitarium ,nut ,butter #ac4j ,kellogg's ,nut ,butter #ac4i ,bischof's ,diabetic ,gluten ,bread #ad4c ,jireh ,diabetic ,baking ,powder #ae4j ,peanut ,butter 7range from #ab to #bj7 #ae4j ,,brands ,,showing ,,from #ae ,,to #bj ,,per ,,cent4 ,,of ,,carbohydrates ,per ,cent4 ,casoid ,chocolate ,almonds #af4a ,california ,paper ,shell ,almonds #af4c ,callard's ,cocoanut ,biscuit #af4d ,rademann's ,diabetiker-,chokolade #af4i ,health ,food ,almond ,meal #af4i ,callard's ,ginger ,biscuit #ah4a ,callard's ,prolactic ,biscuit #ai4c ,,brands ,,showing ,,from #bj ,,to #be ,,per ,,cent4 ,,of ,,carbohydrates ,per ,cent4 ,callard's ,almond ,shortbreads #bj4g ,callard's ,casoid ,rusks #bj4h ,rademann's ,diabetiker-,makronen #bj4h ,health ,food ,protosoy ,diabetic ,wafers #ba4b ,jireh ,patent ,cotton-,seed ,flour #ba4c ,casoid ,lunch ,biscuit #ba4f ,rademann's ,diabetiker-,chokolade ,biscuit #ba4i ,cereo ,soy ,bean ,gruel ,flour #bc4g ,health ,food ,salvia ,sticks #bd4j ,health ,food ,protosoy ,soy ,flour #bd4e ,metcalf's ,soja ,bean ,meal #be4j ,,brands ,,showing ,,from #be ,,to #ce ,,per ,,cent4 ,,of ,,carbohydrates ,per ,cent4 ,jireh ,soja ,bean ,meal #be4h ,brusson ,chocolat with ,added ,gluten #bf4d ,rademann's ,diabetiker-,stangen #bg4j ,rademann's ,diabetiker-,dessert-,gebck #bg4e ,nashville ,sanitarium ,malted ,nut ,food #bg4e ,metcalf's ,vegetable ,gluten 7#aijf7 #bh4a ,health ,food ,pure ,washed ,gluten ,flour 7#aijf7 #bi4e ,fromm's ,luft ,bread #cj4g ,spencer's ,almond ,paste #ca4f ,fromm's ,conglutin-,diabetiker-,schokolade #cb4g ,health ,food ,no4 #b ,proto ,puffs #cc4c ,ferbuson ,gluten ,bread #cc4f ,gum ,gluten ,breakfast ,food #cd4b --7,from ,the ,journal ,a4 ,m4 ,a41 ,june #bh1 #aiac47 ,,the ,,jireh ,,diabetic ,,food ,,company ,the ,company ,rises to ,explain in a ,brief ,note of ,one ,thousand ,words ,exploiters of fraudulent and dangerous pharmaceutical products have no love for ,the ,journal4 ,when such products are exposed in these pages1 their manufacturers seldom reply to the criticisms except through indirect channels4 ,then the replies are frequently replete with billingsgate and denunciation of ,the ,journal and its editor1 the ,association and the medical profession generally4 ,we have1 at different times1 had to call the attention of the public and the medical profession to the fraudulence and dangers of some of the products of the ,jireh ,diabetic ,food ,company4 ,we have shown that the ,jireh company lied boldly and directly so long as it could do so without getting into the courts1 and that it lies inferentially still2 we have shown that ,jireh flour had practically as much carbohydrate as ordinary flour2 we have shown that1 probably to escape prosecution under the ,food and ,drugs ,act1 the ,jireh concern has coined the word 8diatetic0 and substituted it for the word 8diabetic10 which used to appear in its advertisements2 we have shown that the claim made for the ,jireh products that they are 8starch-changed0 was a false one1 and that the company has modified this to 8starch-treated10 presumably to avoid being haled into the courts under the 8pure food law20 we have shown1 in short1 the unreliability both of the ,jireh concern and of its products4 ,two or three weeks ago a ,new ,york physician wrote to ,the ,journal for information regarding the ,jireh products4 ,we sent him such matter as had been published on the subject1 and he showed this material to a patient who was using the ,jireh products4 ,the patient1 in turn1 expressed her opinion of the product to the retailer from whom she had been purchasing it4 ,a day or two later she received a letter from the ,jireh ,diabetic ,food ,company1 which1 in spite of its length and discursiveness1 we publish in full1 so that physicians may know just what this company thinks of them4 ,the letter1 which is dated ,nov4 #bj1 #aiac1 really belongs in the 8,knocks and ,boosts0 department1 but its length prevents its use there4 ,here it is3 8,we learned through ,mess4 ,cushman ,co4 that you are a constant user of ,jireh ,foods for some time past1 and that recently a certain derogatory statement was brought to your attention relative to our product4 ,we feel an explanation is due you for two reasons4 8,first1 because we want you to continue using ,jireh ,foods and thus receive the benefits of the same2 and second1 that the remarks called to your attention are not only libelous1 but are in no way pertinent enough to detract from the value of our product4 ,in the first place1 we want to state that the particular journal in question has been endeavoring to injure our business for some time past and that we are not the only descent sic manufacturers of foods that are suffering in this way at the hands of the editors of this particular magazine4 ,since you are interested in the ,jireh ,foods1 you may be more interested to learn why this particular magazine is so anxious to injure our reputation4 ,the reason is very obvious if you will take into account the fact that this magazine is the official journal of the medical association of this country which is known as the backer of the medical trust4 ,it is very clear to you1 no doubt1 that there are some physicians1 particularly those that are associated with the magazine1 who are anxious to stamp out of existance sic such concerns that offer a bona fide product1 a meritorious product which actually produces the required results1 without the aid of medicine4 8,for the particular maladies for which we offer our foods1 we have been very successful1 consequently the antagonism on the part of this particular journal is the logical thing4 ,in addition to this1 however1 and perhaps more important to us1 is the fact that the editors of this magazine have made it known to us that they will not approve of our product until such time that we care to be dominated by the moving influence of the magazine in question4 ,they want us to supply them with the private formula which we use for manufacturing our foods and to enlighten them and show them the various processes applied to our products to produce the required results4 ,as a bona fide and ethical business house1 we absolutely and unqualifiedly refuse to comply with this wish1 and will always refuse to do so1 no matter how often they may attack us4 ,we stand strictly on principle in this matter and propose to run our business in our own way1 and will not1 under any circumstances1 allow a magazine or anybody else dictate to us under what conditions we are allowed to do our business4 8,the remarks which they make would perhaps hurt us some if they emanated from a source that was qualified to judge the merits of our food4 ,the absurd side of the issue1 and perhaps the comical side of it1 is the fact that the honorable gentlemen who assume to condemn a product1 know less about the disease for which the product is offered1 and much less about diet and foods than the average layman4 ,consequently1 we consider it simply absurd to allow them to step into our business and dictate policy to us4 ,this is the jist sic of the discontent that prevails between the magazine editors and ourselves1 and as long as we refuse to comply with their wish1 we certainly cannot expect them to speak well of us4 ,it has become a notorious fact in the medical profession that their criticisms are almost valueless1 inasmuch as they stop at nothing in order to create sensationalism1 and have attacked not only ourselves1 but every bona fide manufacturer of foods and drugs in this country who has refused to fall in line with them4 8,this explanation1 we trust1 will appeal to your good judgment and will convince you of what is said about us is untrue4 ,furthermore1 our business has grown to colossal proportions1 notwithstanding their endeavors to crush us4 ,we call your attention to a most peculiar fact3 that is1 that they make no comment whatsoever as to the product and its therapeutic value in the treatment of diabetes4 ,you notice they make an awful play on our literature1 which was changed merely to suit conditions in business4 ,we also wish to call your attention to another peculiar fact1 and that is that a great majority of the physicians who are in with this magazine readily recommended our foods1 and we also believe that your physician1 after reading this letter1 will feel the same way as most physicians do in relation to our foods4 ,we believe that your physician is perfectly willing to be convinced that our foods are as represented to be1 and the very best clinical evidence as this is the effect our foods have had upon you4 ,finally1 if the foods are palatable and wholesome and have alleviated the annoying symptoms of ,diabetes1 then why should you be guided by the opinions of demagogues and yellow journalists8 8,you may be pleased to learn that our foods have received the attention of ,dr4 ,wiley1 the well-known chemist and food scientist of this country1 and we have now in our possession his reports showing the very high standard of our foods4 ,this1 in our opinion1 is of more consequence than all the harangue which those venerable gentlemen of the magazine may indulge in4 8,we want to convince you without an atom of doubt that we are honest and bona fide in everything we say1 and we extend to you a hearty invitation to call at the first opportunity and shall be glad to tell you anything you may wish to know4 ,thus awaiting the pleasure of this visit1 we beg to remain 8,yours very truly1 8,jireh ,diabetic ,food ,co40 ,we learn from this letter that ,the ,journal's 8remarks0 on the ,jireh product are 8libelous40 ,we have made them many times and for several years past2 if libelous1 the manufacturer has excellent grounds for damages4 ,we learn1 too1 that our remarks 8are in no way pertinent enough to detract from the value0 of the ,jireh products4 ,why1 then1 take any notice of them8 ,we learn1 moreover1 for the hundred-and-first time1 that ,the ,journal is the official organ of the 8medical trust10 and we are told that 8there are some physicians0 that are opposed to the ,jireh ,foods because these products cure diabetes without the use of medicine6 ,the ,journal1 so the company says1 wants the ,jireh ,diabetic ,food ,company to supply its 8private formula0 and to show the 8various processes0 by which the ,jireh products are made4 ,such statements indicate that the ,jireh ,diabetic ,food ,company does not confine its mendacity to the mere advertising of its product1 where the necessity for lying is naturally great4 ,the ambiguous remarks regarding ,dr4 ,wiley are evidently intended to convey the idea that the doctor approves of the ,jireh products4 ,dr4 ,wiley was sent a copy of the ,jireh letter and his attention directed to the statements appearing therein regarding himself4 ,he replied3 8,in regard to the ,jireh products and their claims that our reports show the very high standing of their foods1 ,i would say that ,i consider such a claim entirely false4444 ,we did examine five or six products in our own laboratory1 however1 and found them to be of very fair composition per se1 but not of a composition that afforded any legitimate basis for their claims4 ,we entirely disapproved 444 three of the products making special claim as to their fitness for diabetics4 ,italics ours4--,ed4 ,these were the ,wheat ,nuts1 the ,jireh ,flour and the ,patent ,barley4 ,two of the other products were passed with a non-committal rating1 which means that they are not actually disapproved1 but the star marking is not accorded4 ,these products were the dietetic ,rusks and the ,macaroni4 ,for the latter especially no specific claims seem to be made4 ,we called attention1 however1 to the generally objectionable juggling of terms indulged in by this company44440 ,the ,jireh concern says that in spite of the efforts of ,the ,journal to 8crush0 it1 8our business has grown to colossal proportions40 ,of this the ,new ,york physician who sends us the letter says3 8,their #8colossal proportions' must have received a slight jar or they would not have taken time to write such a letter40--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #bj1 #aiac47 ,,the ,,name 8,,epinephrin0 ,,versus ,,the ,,name 8,,adrenalin0,,bl ,,bl ,a reprint of the letter from ,parke1 ,davis ,co4 referred to in this article1 together with the discussion thereof1 will be sent on receipt of a #b-;cent stamp4 ,there are thirty or more different brands of the blood-pressure-raising principle of the suprarenal gland on the market1 five being in this country alone4 ,these products are identical so far as their chief constituent is concerned2 they differ1 however as to the solvent and preservative used4 ,the processes of manufacture of some of them are patented2 all of them are sold under trade names4 ,until two years ago there was no common name applicable to this active principle2 whenever reference was made to it a trade name had to be used4 ,at that time the ,council on ,pharmacy and ,chemistry1 realizing the need of a generic term1 adopted 8epinephrin0 as such a term4 ,this name was selected in part because ,abel had adopted it in #ahii2 in part because1 so far as could be discovered1 it was the name under which1 through ,abel's publications1 the substance first appeared in medical literature2 and in part because it seemed to be the only suitable one not already appropriated by some commercial firm4 ,after the publication of the ,council's report1 ,the ,journal began gradually to use the term in those cases in which it seemed clear that the proprietary term was used in a generic sense4 ,the substitution of the name 8epinephrin0 for 8adrenalin0 in the abstracts of certain foreign articles caused ,parke1 ,davis ,co4 to write a letter of protest which called forth the discussion appearing in the ,propaganda ,department of this issue4 ,the amount of space devoted to this matter may be criticized and considered unwarranted by those who do not realize the importance of the subject4 ,the criticism is to a certain degree1 just4 ,the somewhat inordinate length of the article is due in part to the unfortunate fact that1 in availing themselves of the courtesy extended by ,the ,journal1 ,parke1 ,davis ,co41 in their reply1 have injected into the discussion side-issues1 such as the priority of discovery1 the superiority of their product1 etc41 whereas the question under discussion is simply that which relates to the name4 ,it is1 however1 not altogether a matter for regret that the discussion has been thus broadened1 for it brings before our readers many facts regarding the discovery of an important medicinal agent that are not generally known1 at least by physicians4 ,whether or not 8adrenalin0 is superior to 8adrin10 8suprarenalin10 8suprarenin10 8adnephrin10 or to any other of the preparations is entirely immaterial in this connection4 ,the point is that the active principle of the suprarenal gland is on the market under various trade names1 and that a name common to all has been selected to be used when no particular brand is referred to4 ,the fact that 8adrenalin0 is regarded by many1 both here and abroad1 as a common1 generic name does not alter the fact that it is claimed as a trade name by a commercial house and1 therefore1 presumably at least1 cannot be used except as such4 ,among the facts brought out in this discussion1 one stands out clearly3 that ,abel deserves as much credit for the discovery as any other man1 if not more4 ,credit belongs to ,takamine for making use of reactions which were already well known4 ,his work was a step in the progress of knowledge of the substance1 but it was a step which he could not have taken but for what others1 ,abel especially1 had accomplished and published4 ,abel's magnificent work1 covering several years1 deserves as much credit1 to say the least1 as that of ,takamine4 ,and it should be kept in mind that the former worked in the interest of science1 and published his results for the benefit of all4 ,he had no hope of pecuniary reward1 asked for none1 and received none4 ,let us repeat1 however1 that these are side issues2 the question is simply that of name4 ,it cannot be too strongly emphasized that 8epinephrin0 is a true scientific name for the active principle of the suprarenal gland1 and that it should be used on all occasions when the active principle and not some particular firm's make is referred to4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #be1 #aiaa47 ,,the ,,hord ,,sanitarium 8,propaganda for ,reform ,department3--,one often hears it declared that the present time is the worst ever known for a young man to make a fortune or get a start to one4 8,all a mistake1 as the enclosed letter from the ,hord ,skinatarium will certify4 ,at #be this equals #b1ejj for #ajj cases1 #be1jjj for #a1jjj cases1 and all any young doctor needs is a little push to be as rich as ,j4 ,d4 in a few months4 ,if you know of any cases send 'em in and get your #be4 8,k4 ,t4 ,crossen1 ,m4,d41 ,carbondale1 ,ohio40 ,with his letter ,dr4 ,crossen encloses a circular letter from the ,hord ,sanitarium1 8,for ,liquor and ,drug ,habits1 ,a ,cure ,positively ,guaranteed10 and an unsigned check on the ,farmers ,national ,bank1 ,shelbyville1 ,indiana1 for #be payable to himself4 ,printed on the check in large red letters is the statement3 8,,this ,,check ,,will ,,be ,,countersigned ,,upon ,,you ,,bringing ,,or ,,sending ,,us ,a ,,patient40 ,illustration3 ,fig4 #a4--,photographic reproduction of the unsigned check that the ,hord ,sanitarium sends to physicians4 ,illustration3 ,fig4 #b4--,part of the letter that accompanies the check for twenty-five dollars4 ,the ,journal has received these circular letters and unsigned checks by the hundreds from physicians who have expressed very frankly their contempt of the kind of business the ,hord ,sanitarium is engaged in4 ,these correspondents seem to have overlooked the fact that ,the ,journal has already commented editorially on this particular insult to the medical profession4 ,for this reason we reprint the editorial note1 8,ethics60 from ,the ,journal1 ,sept4 #bg1 #aiac3 8,we will pay you #be for each patient that you bring or send us40 ,thus1 to physicians1 writes the ,hord ,sanitarium of ,shelbyville1 ,indiana1 and continues3 8,we have a perfect and an absolute cure for all liquor and drug addictions40 ,fearing doubtless that those to whom these offers are made may be disgusted with the first proposition and will realize the evident falsity of the second1 the concern encloses a list of references 8showing the high moral and professional standing of our sanitarium40 ,the ,hord ,sanitarium emphasizes further that it does a strictly 8no cure no pay0 business4 ,suspiciously similar is the offer made by the ,mizer ,sanatorium of ,coshocton1 ,ohio1 ,blake ,v4 ,mizer1 manager4 ,not many months ago ,mr4 ,mizer was running the ,hord ,sanitorium 7the concern's own spelling71 which at that time advertised 8the only guaranteed cure40 ,now1 ,mr4 ,mizer hurls invectives at those concerns that make 8unreasonable guarantees0 and adds virtuously that 8we resort to no such unethical and pretended guarantee in order to do business40 ,nevertheless1 in small type in the northwest corner of his stationery1 ,mr4 ,mizer admits that his 8proposition0 is no cure no pay4 ,the fees of the ,mizer ,sanatorium 8are #abe to #bej1 depending on the room40 ,the physician's rake-off is 8#bj per cent4 of the above40 8,this10 explains ,mr4 ,mizer blandly1 8is simply a matter between ourselves and does not concern the patient in any way40 ,of course not4 ,all the patient has to do is to pay the bills4 ,and the ,mizer ,sanatorium is 8conducted along ethical 444 lines0--,mr4 ,mizer says so4 ,the ,mizer ,sanatorium has odd ideas of what constitutes ethics1 medical or otherwise1 for not long ago it advertised1 in such medical journals as would accept its 8copy10 that 8medical ethics prevents the statement here of the whole truth about the ,mizer treatment40 ,of course medical ethics never prevented truthful statements of any kind4 ,a dirty business2 no other words express it4 ,when the ,hord ,sanitarium and the ,mizer ,sanatorium claim to cure all cases of drug or liquor addiction1 they make claims that are false--cruelly false4 ,when these concerns try to drum up trade by offering secret commissions to physicians they insult an honorable profession4 ,the fact that they send out this sort of advertising matter is presumptive proof that there are some physicians who will patronize them4 ,such as do so are unfair to their patients and untrue to the ideals of medicine4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ca1 #aiad47 ,,the ,,german ,,propaganda ,,for ,,reform ,appreciation by a ,german ,lay ,publication ,of all those interested in the reform of the proprietary drug business1 the patient has the most at stake--and the public is beginning to understand this fact4 ,if physicians are slow in recognizing the necessity for improvement1 laymen will eventually demand reform in their own interests4 ,the movement1 therefore1 will not be halted by the indifference of the unprogressive element of the medical profession4 ,new evidence of this fact is furnished by a recent editorial comment by the ,german lay periodical1 ,wohlfahrt und ,wirtschaft 7,public ,welfare and ,economics71 on the ,arzneimittel-,kommission1 a ,german organization resembling in purpose if not in scope the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association4 8,one would suppose10 says this lay journal1 8that medicinal preparations which did not win the approval of scientific medicine would not be used by any physician1 but the contrary is the case4 ,in fact1 those new medicinal preparations or old ones with new names that flood the market far surpass the actual demand according to the judgment of all authorities4 ,the impartial advisers in this field1 practitioners and members of medical faculties1 demand1 as a matter of public welfare that this overproduction should be regulated in the interests of the sick1 the consumers2 but1 unfortunately1 a medical man1 like any one else1 is impressed by the suggestion from advertising done on a large scale40 ,the movement for reform1 ,wohlfahrt und ,wirtschaft goes on to explain1 is not exclusively a medical one4 ,it is a part of the reaction of 8economic common sense0 against a too individualistic commercial system which leads to overproduction4 ,in other words1 it is a reaction against the system of making things because they can be sold rather than because they are needed4 ,the interests of producers need to be harmonized with those of consumers1 not merely in the drug trade alone1 but throughout the commercial world4 ,wohlfahrt und ,wirtschaft quotes with unqualified approval the ,arzneimittel,kommission's statement of its position3 ,an industry which serves the science of healing must be guided by that science4 7,eine ,industrie die der ,heilwissenschaft dient1 hat sich nach der ,heilwissenschaft zu richten47 ,the movement for reform in ,germany has apparently gathered sufficient impetus among the laity to go on of its own momentum1 even though1 with one exception1 ,german medical journals1 reluctant to lose the advertising of drug houses by publishing criticisms of their wares1 have become lukewarm1 if not antagonistic1 to the efforts of the ,arzneimittel,kommission4 ,the one exception is the ,therapeutische ,monatshefte1 which1 in its ,may issue1 quotes in full the editorial just referred to and makes the following comment3 8,these lines reveal such intimate knowledge and correct judgment of existing conditions that the suggestions advanced in regard to possible reforms deserve serious consideration4 ,for us physicians the editorial is important in that it recognizes that the efforts of the profession to accomplish the reforms aimed at are rational and beneficial from the standpoint of general economics and the public welfare40--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #ac1 #aiad47 ,,the ,,german ,,council ,,on ,,pharmacy ,,and ,,chemistry ,at the meeting of the ,german ,congress for ,internal ,medicine in #aiaa1 a ,german council on pharmacy and chemistry1 ,die ,arzneimittelkommission des ,kongresses fr innere ,medizin1 was organized1 with purposes similar to those for which the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association was created4 ,as practically nothing has been done to restrict the advertising of proprietaries in ,germany1 the task of the commission was tremendous4 ,its work has been noted in ,the ,journal from time to time4#aej ,a review of what has been done up to the present is given by ,heubner1#aea and indicates some differences between conditions in ,germany and this country4 ,the members of the commission found confronting them the same evils that met the early efforts of the ,american council1 namely1 dominant proprietary interests1 a subservient and financially interested medical press and an indifferent profession4 ,moreover1 the pecuniary interest of the editors of ,german medical journals in the profits of advertising seems to be more direct and more important than in ,america4 ,the ,german commission1 in ,heubner's opinion1 was placed at a disadvantage compared with the ,american council from the first4 ,funds for investigation were lacking1 and the commission had no journal in which its objects could be presented to the medical profession4 ,at the beginning of its work the commission established rules very similar to those of the ,american ,council on ,pharmacy and ,chemistry4 ,it listed the articles advertised in ,german medical journals in three groups3 7#a7 those which conformed to the rules of the commission in the method of advertising2 7#b7 those which violated the rules1 and 7#c7 those whose classification could not be determined4 ,this amounted to an attack on advertising in medical journals and was undoubtedly premature4 ,it aroused at once the antagonism not only of the proprietary interests but also of the medical press4 #aej ,a ,german ,council on ,pharmacy and ,chemistry1 ,propaganda1 ,the ,journal ,a4 ,m4 ,a41 ,july #bg1 #aiab1 p4 #bia2 ,current ,comment1 ,aug4 #aj1 #aiab1 p4 #deb4 ,reform in the ,advertising of ,proprietary ,medicinal ,articles1 ,berlin ,letter1 ,dec4 #g1 #aiab1 p4 #bjha4 ,heubner1 ,w43 ,wnsche zur ,reform des ,arzneivertriebes1 ,therap4 ,monatsh41 #aiab1 xxvi1 ,no4 #aa2 abstr41 ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ad1 #aiab1 p4 #baie4 #aea ,heubner3 ,die ,arzneimittelkommission des deutschen ,kongresses fr innere ,medizin1 ,therap4 ,monatsh41 #aiad1 xxviii1 #ahe4 8,the establishment of the lists of medicines encountered opposition or hindrance from three sources10 says ,heubner1 8first1 from the pharmaceutical and chemical manufacturing interests2 second1 from the medical press1 and third1 from the medical profession itself4 ,the #8trade' naturally was irritated at any attempt to interfere with #8business1' and brought forward a number of reasons why the procedure adopted by the commission was especially calculated to injure the #8general welfare4' ,this opposition was to be expected and might be disregarded4 ,the extent to which the medical press was dependent on the drug trade1 however1 had not been foreseen4 ,the same journals in which for many years all sorts of articles on the evils in the trade in medicines had appeared showed themselves decidedly cool or emphatically critical toward the accomplished fact of the #8lists of remedies4' ,in hastily written articles a whole series of mistakes in general and in particular were published4444 ,one thing1 however1 was not explicitly stated--namely1 that in any event the lists of remedies must be rejected1 and for this the cogent reason was anxiety in regard to advertisements4 ,the editors had been sufficiently warned4 ,the ,therapeutische ,monatshefte1 which had not submitted to the wish of a great industrial firm in another matter1 was punished for this offense by the withdrawal of all its advertisements4 ,none of the other publishers wanted to risk such a reduction in income1 and none of the editors was willing to undertake the risk to the extent of a conflict with his publisher4 ,curiously1 the idea does not seem to have arisen that if the threatened publishers had made common cause they might have freed their editors from the distressing burden of improper advertisements with scarcely any risk at all40 ,heubner believes that another motive influencing the editors was the fact that their efforts in behalf of reform1 sporadic and ineffective at the best1 had been replaced by the propaganda of the commission4 ,it seems clear that the opposition from the press was due not to principle chiefly but to financial pressure4 ,the editors1 however unworthy their motives1 nevertheless exerted1 as in other cases1 a powerful influence on public opinion4 ,among the medical public1 opposition was encountered because many physicians were interested--sometimes financially--in one or more of the discredited remedies4 ,the mass of the profession either were not interested or misunderstood the position of the council4 ,despite the obstacles encountered and the difficulties involved1 the council and the ,congress of ,internal ,medicine have not wavered4 ,heubner1 however1 sums up the work of the council in a rather pessimistic tone1 as follows3 8,what are the results of the great amount of labor1 self-sacrifice1 hopeful courage and wasted money8 ,two journals pretend to be doing wonders in that they are eliminating some of the worst misstatements1 distortions1 obscurations and concealments of truth in the advertisements4 ,physicians at certain intervals receive lists of preparations1 the manufacturers of which as a rule do not need to pay any attention to the council because their dealings are directly with the public1 because their advertisements are usually made to physicians by word of mouth1 or their preparations have already a sufficient reputation--no matter for what reason4444 8,there is little doubt that the results have not paid for the efforts expended4 ,there is no doubt that the whole enterprise will amount to nothing more than a splash in the water if the work is not extended1 just as a preliminary skirmish must remain without effect unless followed up by the main army4 ,the main army in this case is the ,german medical profession4 ,however gratifying the progressive attitude of some individuals and1 in fact1 of some associations1 such as that of ,wurtemburg1 may be1 the fact remains that the profession in ,germany is not advancing but rather tends to retrograde4 ,the support which the executive committee of the ,aerztevereinsbund at first accorded to the efforts of the council was later limited4 ,all further progress depends on the developments of the near future4 ,will sufficient power be given to the ,german medical profession after settlement with the insurance societies to permit them to follow the example of their ,american colleagues8 8,it should be made perfectly clear10 ,heubner insists1 8that we are concerned with questions of importance for the standing and influence of the medical profession among the people1 and1 consequently1 for the conditions of its future existence4 ,but even now the consequences of the prevailing indifference to the traffic in nostrums are making themselves felt4 ,the prevalence of self-medication1 which was lately recognized by a ,berlin court as the normal for #8slight' affections and which has already been made an argument against the extension of the compulsory prescription law1 is merely a result of the great evil based on the loss of control by the medical profession of the remedies it employs4 ,only centralized and energetic measures on the part of the organized profession can secure a reformation of the intolerable conditions that prevail in the field of modern industry in medicine and foodstuffs4 ,the ,american ,medical ,association and the ,german ,arzneimittelkommission have shown that a little sacrifice and energy can secure a condition in which the medical profession becomes a powerful factor1 able to dictate in the field of the trade in medicine instead of letting itself be dictated to40--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ah1 #aiad47 ,,grand ,,prix ,,and ,,gold ,,medals ,,for ,,sale ,max ,kaiser ,offers to ,procure 8,awards of ,merit0 at ,various ,international ,exhibitions--,price1 ,four ,hundred ,dollars ,there was a time when the manufacturer who could point to the 8,grand ,prix0 or the 8,gold ,medal0 his product had been awarded at some exhibition was considered to have a valuable advertising asset4 ,possibly there was a time when medals and prizes were awarded with an eye single to the excellencies of the goods and bore no relation to the amount of money paid by exhibitors to the organizers of the exhibition4 ,possibly there are1 even today1 occasional awards made on a basis of pure merit1 but they are probably few and far between4 ,the matter which follows throws an interesting light on this subject4 ,within the past two months manufacturers have received a letter on the stationery of the 8,international ,exhibition1 ,paris1 #aiad40 ,the letter came from the 8,commissioner-,general0 of the exhibition1 one ,max ,kaiser1 #bd ,holborn1 ,london1 ,e4 ,c4 ,here it is3 8,dear ,sirs3--,i beg to draw your attention to the great ,,international ,,exhibition of ,alimentation1 ,pure ,food1 ,hygiene1 ,beverages1 ,drugs and allied trades1 which will be held at ,paris in ,march1 #aiad1 inviting you to partake with your manufacture at this ,,international ,,exhibit4 ,i beg to point out that the aim of this ,exhibition is to introduce ,foreign ,manufactured ,goods1 ,proprietary ,articles1 ,patents1 etc41 to the ,french and ,foreign ,markets1 and to open up or extend new channels for such goods4 8,a ,commercial ,office at the ,exhibition ,building1 under the ,commissioner ,general's own supervision1 with a well-trained staff1 will do everything required in the interest of ,exhibitors1 such as effect sales by circularizing1 or inviting prominent buyers to call at your particular stall to judge for themselves the merits of your ,exhibit1 and in this way bring the ,american ,manufacturers in direct touch with the ,foreign ,markets and the ,buying ,public4 8,this ,commercial ,office will also negotiate with the ,representatives on your behalf3 at the same time undertaking to arrange your ,exhibit1 supply all necessary fittings1 decoration1 the display1 maintenance1 repacking and returning of the ,exhibit1 and also to represent you before the ,public and ,jury in such a manner as to make certain that your ,exhibit shall be awarded first honors 7,,grand ,,prize ,,or ,,gold ,,medal74 8,you will understand that such an award obtained at this ,,international ,,exhibition means an everlasting advertisement as an official acknowledgment and convincing proof to the ,superior ,quality of your goods1 and will certainly put you in front of your competitors on the home market1 and naturally increase your sales considerably4 8,i might mention here that many a big business has been built up and small concerns been prominently brought to the notice of the ,public by ,exhibiting4 ,in many cases ,i have been able to interest ,authorities and ,reigning ,houses in ,exhibits under my care1 and ,i have opened up or extended markets for firms ,exhibiting under my direction4 8,i enclose herewith a list containing some of the most prominent ,american and ,english ,firms whom ,i have represented at ,european ,exhibitions and for whom ,i achieved splendid results4 8,i could arrange your ,exhibit for the amount of #djj1 to be paid one-half on allotment and the balance on receipt of an award 7,grand ,prize or ,gold ,medal74 8,trusting that this will be of interest to you1 ,i shall be pleased to receive your reply by return mail1 and give you any further particulars you may desire4 ,yours faithfully1 ,the ,commissioner ,general4 7,signed7 ,max ,kaiser4 8,i can also accept ,exhibits on exactly the same terms for the ,,international ,,exhibition1 ,rome1 #aiad40 ,illustration3 ,photographic reproduction 7reduced7 of the letter-head of the stationery on which ,max ,kaiser offers to 8make certain0 that those who exhibit their products under his direction--price1 #djj--shall receive a ,grand ,prix or ,gold ,medal4 ,the list ,mr4 ,kaiser enclosed with his letter was a printed sheet1 giving the names of a number of ,american and ,british manufacturers whom ,kaiser claims to have 8represented0 at various 8,international ,exhibitions40 ,the majority of the concerns named are breweries1 but there is a good sprinkling of 8patent medicine0 companies and a few miscellaneous manufacturers4 ,in the ,american list there are two nostrum concerns named that will be more or less familiar to our readers4 ,they are3 ,alonzo ,o4 ,bliss ,company1 ,washington1 ,d4 ,c4 ,this company sells 8the ,great ,blood ,purifier1 ,kidney and ,liver ,regulator0 known as 8,bliss' ,native ,herbs40 ,according to ,max ,kaiser1 the ,alonzo ,o4 ,bliss ,company obtained one ,grand ,prize and one ,gold ,medal4 ,waterbury ,chemical ,company1 ,des ,moines1 ,iowa4 ,this company exploits what used to be known as 8,waterbury's ,cod-,liver ,oil ,compound10 which1 from its lack of cod-liver oil1#aeb was impelled to change its name to 8,waterbury's ,compound40 ,kaiser states that the ,waterbury ,chemical ,company received four ,grand ,prix and four ,gold ,medals4 #aeb ,see ,waterbury's ,compound1 pp4 #ed1 #eg and #bia4 ,briefly the proposition submitted by ,max ,kaiser is this3 ,for #djj he will make all arrangements for a manufacturers' exhibit at one of the numerous 8,international ,exhibitions40 ,further1 he practically guarantees that this exhibit will receive either a 8grand prize0 or a 8gold medal02 in fact1 the manufacturer need not complete the payment of ,kaiser's charges until the prize or medal has been awarded6 ,the value of 8awards0 obtained in this way is1 of course1 evident4 ,as the public becomes better informed on the subject of international exhibitions1 the grand prix1 gold medals1 and other 8awards0 made at such exhibitions will be appraised at their true value4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #ad1 #aiad47 ,,the ,,hypophosphite ,,fallacy ,an ,example of the ,perpetuation of a ,false ,theory by ,advertising ,a false therapeutic notion born of speculation soon dies a natural death if exposed unsupported to the cold world of facts1 but when nursed by commercial interests it may be kept alive for generations4 ,interesting examples of this1 to name but two or three1 are the misconceptions perpetuated during the past half century concerning 8lithia10 the 8natural0 salicylates and the hypophosphites4 ,take1 for instance1 the lithia delusion4 ,the supposed solvent powers of lithium compounds for uric acid were soon disproved to the satisfaction of scientists1 but proprietors of lithia waters and nostrums for gout and rheumatism still harp on the old string and utilize long-exploded theories4 ,take1 again1 the alleged superiority of 8natural0 to 8synthetic0 salicylates4 ,in spite of experimental proof to the contrary1 proprietary interests have been able for twenty years to persuade a large part of the medical profession that the effects of pure salicylic acid made artificially differ from the effects of the same substance obtained from natural sources4 ,the altogether undeserved continued popularity of hypophosphites affords a striking example of the influence of advertising in perpetuating therapeutic error1 for hypophosphites are given on a theory long since disproved4 ,it may be interesting to trace the origin and history of the theory on which the practice of prescribing the hypophosphites is founded4 ,the early part of the last century was prolific in chemical discoveries1 and1 as a corollary1 in chemical theories of disease4 ,many of the theories arose from the hasty application of the chemical properties of new elements and compounds to the explanation of the processes in the living body1 without due consideration of the conditions prevailing in the animal organism4 ,,the ,,element ,,phosphorus ,the element phosphorus is eager for oxygen and readily oxidizable4 ,when taken into the system it acts as a violent poison1 and1 in view of this1 it was at first supposed--although the supposition was based on no scientific data--that it would prove to be a powerful therapeutic agent when given in minute doses4 ,in its elementary form1 phosphorus is difficult to handle1 and therefore not convenient for use4 ,hence it was natural that a compound should be sought which could be used as a substitute for the element4 ,broadly speaking1 phosphorus forms three classes of salts varying in the degree of oxidation3 the phosphates1 containing the most oxygen1 the phosphites1 containing less1 and the hypophosphites1 least of the three4 ,the phosphates1 being saturated with oxygen1 undergo little change in the body1 and because of this were thought to be of little value in therapeutics4 ,the phosphites contain less oxygen1 are unstable and are not used in medicine4 ,the hypophosphites1 containing still less oxygen1 stand nearest to elementary phosphorus and are easily decomposed and readily oxidized to phosphates4 ,hence the theory that the hypophosphites would furnish an admirable source from which to obtain the action of the element phosphorus4 ,,churchill',s ,,theory ,the hypophosphites were introduced into medicine about #ahee1 as a substitute for elementary phosphorus by a ,dr4 ,churchill of ,paris1 and later of ,london1 who advocated their use as a specific remedy for consumption4 ,churchill conceived the theory that phthisis is caused by a lack of oxygen in the tissues2 he therefore sought an agent capable of increasing oxidation4 ,he was led to the use of hypophosphites for this purpose on the supposition that phosphorus exists in the organism as a biologic element in a lower degree of oxidation than the phosphate4 ,he supposed that this form of phosphorus acts by its chemical affinity as an initiatory agent in attracting and utilizing the inspired oxygen4 ,he believed that when this form of phosphorus1 which he called the 8phosphide element10 is deficient in quantity 7because it had been oxidized into phosphate1 or because the supply from natural sources was deficient71 the degree of oxidation of the tissues is less than normal4 ,therefore he advocated the use of hypophosphites to supply the lacking oxidizing constituent4 ,he believed this 8phosphide element0 not only to be essential for the oxidation of the tissues1 but also to be the source of energy of the nervous system4 ,,the ,,facts ,the theory was a pretty one2 the facts1 however1 did not support it4 ,subsequent investigations indicate that instead of consumption being due to a lack of oxygen1 there is in that disease really an increased oxidation2 in other words1 the respiratory exchanges in this disease are exaggerated4 ,the existence in the system of a form of phosphorus less highly oxidized than the phosphates is unproved4 ,no evidence has been produced to show that phosphorus acts as an energizer of oxidation4 ,there is no proof that the hypophosphites enter into general metabolism or affect disease processes in any way4 ,not only is there no scientific evidence for the utility of the hypophosphites1 but science has long since demonstrated their worthlessness4 ,in #ahie ,boddaert#aec published researches showing that hypophosphites are rapidly eliminated through the kidneys unchanged4 ,similar results have been reached by ,paquelin and ,joly1 who attributed to the hypophosphites only the action of diuretics4 ,in #aija ,massol and ,gamel#aed found by animal experimentation that the hypophosphites did not act as diuretics1 but that the hypophosphorous acid was completely eliminated in the form of sodium hypophosphite4 ,the urea was not increased and the relation of urea to total nitrogen remained the same4 ,their results indicated no increase of oxidizing actions within the system4 ,finally1 ,massol and ,gamel examined the urine of patients taking hypophosphites and found the same conditions3 the results were the same as in the experiments on animals4 #aec ,boddaert3 ,arch4 de pharmacod41 #ahie1 #b4 #aed ,massol and ,gamel3 ,jour4 de pharm4 et de chem41 #aija1 xiv1 #ccg4 ,,proprietary ,,therapeutics ,in spite of these facts the hypophosphites continue to be employed by many practitioners4 ,why8 ,because the theory1 being plausible at the time when such chemical theories were popular1 gained a certain recognition and was accepted without scientific investigation4 ,thus the hypophosphites came into use4 ,it was not long before they were taken up by certain manufacturers1 and the theory on which their use was based became a commercial asset4 ,as a result the theory1 which uncommercialized would have died of inanition1 was kept alive by continued advertisement4 ,the manufacturer of proprietaries having settled on a plausible theory on which to sell his products has no further need for science4 ,thus1 while these theories are no longer to be found in accredited text-books1 they are still preached by the proprietary interests4 ,an elaborate pamphlet on 8,iodine and ,phosphorus10 containing statements which are known to be false1 is one firm's text-book supplied to physicians to-day1 and contains long quotations from ,dr4 ,churchill's writings of sixty years ago4 ,this book contains no intimation that these theories have been overthrown4 ,it is poor economy to waste money in changing literature when the old theories and the old plausible reasoning will sell goods just as well4 ,consequently the old errors are drummed into those physicians who are willing to read their physiology from the neat monographs of proprietary literature and to sit at the feet of glib salesmen who expound to them the proprietary theory of therapeutics4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #be1 #aiad47 ,,buffalo ,,lithia ,,water ,contains ,one-,fifth as ,much ,lithium as ,potomac ,river ,water ,some years ago1 ,alexander ,haig evolved the theory that most diseases are due to uric acid4 ,the data on which he founded his theory were not corroborated by scientific men1 and investigation showed that his methods were unreliable4 ,in spite of the fact that ,haig's theories are utterly discredited1 and have been for years1 the uric acid fallacy still persists1 although it is now largely confined to the public4 ,shrewd business men1 especially those who are more intent on making money than they are concerned with the manner in which that money is made1 owe much to ,haig's theory4 ,as a business proposition1 uric acid has been one of the best-paying fallacies on the market--and possibly still is4 ,it is only necessary to refer to ,the ,journal's recent article#aee on the ,turnock mail-order medical fraud to emphasize this fact4 #aee ,the ,journal ,a4 ,m4 ,a41 ,may #bc1 #aiad1 p4 #afge4 ,illustration3 ,showing how 8,buffalo ,lithia ,water0 in the course of time became 8,buffalo ,lithia ,springs ,water40 ,the government has shown that1 to obtain a therapeutic dose of lithium from ,buffalo ,lithia ,springs ,water1 it would be necessary to drink #bjj1jjj gallons of the water4 ,the government also declared that ,potomac ,river water contained five times as much lithium as does ,buffalo ,lithia ,springs ,water4 ,contemporary with1 and to a certain extent a corollary of1 the uric acid fallacy was another1 viz41 that lithium would eliminate uric acid4 ,this at once gave a good working principle for the proprietary men4 ,uric acid1 we were told1 causes disease2 lithium1 we were also told1 would eliminate uric acid2 therefore1 lithium is the new elixir of life6 ,could anything be simpler8 ,accepting this theory1 it was inevitable that mineral waters containing lithium salts should become highly popular4 ,many exploiters of mineral waters began to place most emphasis on the lithium salts in their waters even in those cases in which lithium was present in such infinitesimal amounts as to render its detection impossible by any but spectroscopic methods4 ,one of the best known1 because most widely advertised1 of the so-called lithia waters is ,buffalo ,lithia ,water--or what used to be called ,buffalo ,lithia ,water4 ,after the ,federal ,food and ,drugs ,act came into effect1 by which falsification on the label was penalized1 the name of ,buffalo ,lithia ,water was changed to ,buffalo ,lithia ,springs ,water4 ,the reason for this change was that when ,buffalo ,lithia ,water was subjected to examination by the government chemists it was found to contain so little lithium that the amount present was unweighable--it could be demonstrated only by the spectroscope4 ,it was evidently1 therefore1 not a lithia water in that it did not contain--at least in quantities that could be consumed--an amount of lithium that would give the therapeutic effects of lithium3 ,possibly the company imagined that by changing the name from 8,buffalo ,lithia ,water0 to 8,buffalo ,lithia ,springs ,water0 it had cleverly evaded the federal law4 ,their argument was to this effect3 ,the springs from which this water is taken are known as ,buffalo ,lithia ,springs2 therefore1 it is not a misstatement of facts to call this ,buffalo ,lithia ,springs ,water4 ,,what ,,is ,a ,,lithia ,,water8 ,the ,supreme ,court of the ,district of ,columbia1 holding a district court1 has recently given an opinion on the ,buffalo ,lithia ,springs ,water case4 ,the findings of the court are refreshingly simple1 and characterized by that broad commonsense view that is becoming increasingly more common among modern jurists4 ,read ,judge ,gould's opinion as to what constitutes a lithia water3 8,speaking generally1 and as an individual of average intelligence and information1 it would seem that if one were offered a water which the vendor told him was a #8lithia' water1 one would have the right to expect enough lithium in the water to justify its characterization as such1 thus differentiating it from ordinary potable water2 and this amount would reasonably be expected to have some effect on the consumer of the water by reason of the presence of the lithium40 ,certainly a reasonable attitude1 and one which the man in the street not only can understand but will agree with4 ,then came the question as to the actual lithium content of ,buffalo ,lithia ,springs ,water1 and the court said3 8,for a person to obtain a therapeutic dose of lithium by drinking ,buffalo ,lithia ,water he would have to drink from one hundred and fifty thousand to two hundred and twenty-five thousand gallons of water per day4 ,it was further testified1 without contradiction1 that ,potomac ,river water contains five times as much lithium per gallon as the water in controversy40 ,,some ,,testimonials ,here1 then1 is a water that has for years been advertised first1 in medical journals1 and later1 in lay publications1 as a 8lithia water0 yet1 actually1 it contains less lithium1 five to one1 than is to be found in ordinary river water4 ,this is a point for physicians to ponder well over4 ,turn to the back volumes of medical journals and read1 both in the advertising and reading pages1 the elaborate testimonials1 given by men high in the medical profession1 on the marvelous effects obtained by the use of ,buffalo ,lithia ,water4 ,read the following in light of the fact that the water from the ,potomac ,river contains five times as much lithium as ,buffalo ,lithia ,water3 8,in the class of cases in which lithia1 soda and potash are regarded as most specially indicated1 ,i have obtained far better results from the ,buffalo ,lithia ,waters than from any of the preparations of the lithium salts of the ,pharmacopeia40 7,statement by a member of the ,faculty of ,medicine of ,paris1 ,france1 etc47 8,its ,buffalo ,lithia ,water therapeutic effects1 in my practice1 have been vastly superior to those obtained from ,lithia ,tablets or other ,lithia preparations40 7,statement by an ex-president of the ,university ,college of ,medicine1 ,richmond1 ,va41 etc47 8,it ,buffalo ,lithia ,water is strikingly superior to emergency solutions of lithia tablets and pure water1 even where the said solution is an exceedingly strong one40 7,statement by a former ,professor of ,clinical ,medicine of the ,college of ,physicians and ,surgeons1 ,new ,york1 and vice-president of the ,american ,medical ,association1 etc47 8,when ,lithia is indicated1 ,i prescribe ,buffalo ,lithia ,water in preference to the ,salts of ,lithia1 because it is therapeutically superior to laboratory preparations of ,lithia40 7,statement by a former professor in the ,medical ,college of ,virginia and ex-president of the ,medical ,society of ,virginia1 etc47 8,buffalo ,lithia ,water 444 by its richness of composition of ,lithia1 is of marvelous efficacy1 in cases of gout1 of chronic1 articular1 and muscular rheumatism 4440 etc4 7,statement by former ,physician in ,ordinary to the ,pope2 ,member of ,academy of ,rome1 etc47 8,i have tried carbonate of lithia dissolved in water in various proportions2 but it certainly does not have the same effect as ,buffalo ,lithia ,water40 7,statement by a former ,surgeon-,general of the ,u4 ,s4 ,army1 etc47 ,these are but a few of many testimonials from physicians that might be quoted4 ,they are interesting from many points of view4 ,they show the worthlessness of testimony of this sort--no matter from what source--and the fallacy of that based on so-called clinical evidence4 ,to go back to the court's findings3 ,in the case of the government against ,buffalo ,lithia ,springs ,water1 one other judicial opinion is worthy of attention1 that referring to the attempt on the part of the exploiters of the water to circumvent1 on a technicality1 the evident intent of the ,food and ,drugs ,act4 ,said ,judge ,gould3 8,the argument seems to be that if ,buffalo ,lithia ,springs are falsely named1 being called #8,lithia' ,springs1 when they do not flow water containing lithium1 therefore the proprietors have the right to sell the product as being ,buffalo ,lithia ,springs ,water1 thus perpetuating on the public the misnomer connected with the origin of the water4 ,it is not apparent how the deceit practiced on the public by the label is mitigated by carrying it back to the designation of the spring from which the water comes40 ,for years no one1 apparently1 ever criticized the claims made for this product4 ,finally1 we got the ,food and ,drugs ,act and the federal officials1 acting under the authority vested in them by that law1 in ,december1 #aiaj1 declared ,buffalo ,lithia ,water misbranded4 ,thus this old established vested interest was attacked4 ,the company1 of course1 fought4 ,it first demurred to the charge brought1 and in ,april1 #aiab1 the demurrer was sustained4 ,at the same time an amended libel was filed by the government1 which the company again demurred to4 ,this demurrer was overruled in ,june1 #aiab1 whereon the company in ,december1 #aiab1 filed an answer denying that the water was misbranded4 ,the question has now 7#aiad7 been finally decided by the court sitting as a jury1 the matter having been submitted by agreement to the court4 ,buffalo ,lithia ,water has been sold since #ahgh4 ,during this period undoubtedly many physicians have prescribed enormous quantities of this water1 and many more laymen have taken the water on their own initiative1 based on the advertised claims made for it4 ,practically all who purchased the water1 whether directly or on the advice of physicians1 did so in the belief that they were getting lithium4 ,had they known that1 to get a therapeutic dose of lithium they would have had to drink #bjj1jjj gallons of ,buffalo ,lithia ,water1 they would have felt1 and rightly so1 that they were the victims of an expensive hoax4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #ac1 #aiad47 ,,meat ,,extracts ,,and ,,meat ,,juices,,bm ,their ,composition and ,relative ,values ,,bm ,see ,report of the ,council on ,pharmacy and ,chemistry on 8,meat and ,beef ,juices10 p4 #abc4 ,the ,bureau of ,chemistry of the ,department of ,agriculture has recently given in ,bulletin ,no4 #aad much new and valuable data regarding the commercial meat products4 ,the work contained in this bulletin is practically an elaboration or continuation of that published in ,the ,journal of ,may #aa1 #aijg1 p4 #afab4 ,it was taken up to determine the condition and quality of meat preparations in general and from the results obtained to prepare tentative standards for the preparation and composition of such meat preparations4 ,the results as well as the methods of analysis of many meat products are given1 showing the composition and relative value of the various preparations4 ,the comments of many investigators regarding the food value of such products is also a valuable contribution to the knowledge of meat extracts1 and will help in deciding the real value of the preparations4 ,the preparations taken up are divided into three general classes 7#a7 ,solid and ,fluid ,meat ,extracts2 7#b7 ,meat ,juices2 7#c7 ,miscellaneous ,preparations4 ,for each of these the tentative standards submitted by the ,committee on ,food ,standards of the ,association of ,official ,agricultural ,chemists are given along with the tabulated results of the chemical analysis4 ,the preparations examined showed1 for the most part1 that they conformed to the standards1 and only those which are at variance in one or more particulars will be mentioned in this review4 ,,solid ,,meat ,,extracts ,for solid meat extracts the following are the requirements3 8,meat extract is the product obtained by extracting meat with boiling water and concentrating the liquid portion by evaporation after removal of fat1 and contains not less than #ge per cent4 total solids of which not over #bg per cent4 is ash and not over #ab per cent4 is sodium chlorid 7calculated from the total chlorin present71 not over #j4f per cent4 is fat and not less than #g per cent4 is nitrogen4 ,the nitrogenous compounds contain not less than #dj per cent4 of meat bases and not less than #aj per cent4 of kreatin40 ,with the above as the standard1 several of the solid meat extract preparations examined were not up to grade on one or more points1 though in some cases it is true they were very slightly below the standard set4 ,the following products were found wanting in some respects and the requirements which they failed to meet are given3 8,,rex0 ,,brand ,,beef ,,extract 7,cudahy ,packing ,co41 ,omaha7 contained #bf4ej per cent4 water instead of the standard #be per cent4 ,,extract ,,of ,,beef ,,premier 7,libby1 ,mc,neil ,libby1 ,chicago7 contained #cj4ib per cent4 of ash instead of the standard #bg per cent42 #ah4cb per cent4 of sodium chlorid 7standard1 #ab per cent472 #f4jb nitrogen 7standard1 #g per cent474 ,,beef ,,extract 7,swift ,co41 ,chicago7 contained #ac4ea per cent4 sodium chlorid 7standard1 #ab per cent472 #f4fj per cent4 nitrogen 7standard1 #g per cent474 ,,beef ,,extract1 ,,coin ,,special 7,g4 ,h4 ,hammond ,co41 ,hammond1 ,ind47 contains #ac4be per cent4 of sodium chlorid 7standard1 #ab per cent472 and #f4hf per cent4 nitrogen 7standard1 #g per cent474 ,with these few exceptions1 the solid meat extracts were found to comply with the standards given4 ,,fluid ,,meat ,,extracts ,for fluid meat extract the following standards have been suggested3 8,fluid meat extract is identical with meat extract except that it is concentrated to a lower degree and contains not more than #ge per cent4 and not less than #ej per cent4 of total solids40 ,according to this standard all excepting one of the fluid meat extracts examined were found to be below grade in one respect1 that of solids4 ,the following are preparations examined and the percentage of solids found3 ,per cent4 ,,concentrated ,,fluid ,,beef ,,extract 7,armour ,co41 ,chicago7 #db4be ,,meat ,,juice 7,valentine's ,meat ,juice ,co41 ,richmond1 ,va47 #db4cf ,,beef ,,juice 7,john ,wyeth ,bro41 ,philadelphia7 #da4af ,,vigoral 7,armour ,co41 ,chicago7 #ej4jf 8,,rex0 ,,fluid ,,beef ,,extract 7,cudahy ,packing ,co41 ,omaha7 #dd4ja ,,fluid ,,extract ,,of ,,beef 7,cibilis ,co41 ,new ,york7 #ce4cg ,,fluid ,,beef ,,jelly 7,mosquera-,julia ,food ,co41 ,detroit7 #ca4jc ,special notice is directed to the price of some of these preparations1 which in spite of their large water content1 are higher priced than some of the solid meat extracts4 ,,meat ,,juices ,the following is given as the standard for preparations of meat juice3 8,meat juice 444 is the fluid portion of muscle fiber obtained by pressure or otherwise1 and may be concentrated by evaporation at a temperature below the coagulating point of the soluble proteids4 ,the solids contain not more than #ae per cent4 of ash1 not more than #b4e per cent4 of sodium chlorid 7calculated from the total chlorin present71 not more than #d per cent4 nor less than #b per cent4 of phosphoric acid 7,p#b,o#e71 and not less than #ab per cent4 of nitrogen4 ,the nitrogenous bodies contain not less than #ce per cent4 of coagulable proteids and not more than #dj per cent4 of meat bases40 ,it is especially noticeable among the meat juices1 so called1 that none shows any appreciable amount of coagulable proteids4 ,valentine's ,meat ,juice and ,wyeth's ,beef ,juice1 besides being below the standard in total solids as fluid extracts1 are misbranded when called meat or beef juices1 as can readily be seen by comparing the results of the analyses and the standard4 ,wyeth's ,beef ,juice is advertised as containing 8all the albuminous principles of beef in an active and soluble form0 and 8in an unaltered form0--two statements that are on the face of them untrue and misleading4 ,to say that all the albuminous principles of meat are present is to say that not only the juice of the meat but all the fiber is present1 which evidently is not true4 ,then again1 to say that it is present in an unaltered form is far from the facts1 for1 as is stated on page #ah of the ,bulletin3 8,it appears impracticable to prepare a true meat juice for market1 as the temperature necessary for the preservation of food products in hermetically sealed packages coagulates the proteids and changes the nature of the product40 ,on page #ee3 8,when prepared under the best possible conditions a commercial meat extract is1 of necessity1 in order that it may not spoil1 deprived of the greater part of the coagulable proteids1 which constitute the chief nutritious elements of the juice40 ,on examining the tables of analysis1 it is seen that ,wyeth's ,beef ,juice contains but #bc per cent4 of its total proteids in a coagulable form1 while the standard calls for #ce per cent41 thus showing it to be no more valuable as a food product than any other so-called meat juice1 the statements of the manufacturers to the contrary notwithstanding4 ,in the case of ,valentine's ,meat ,juice we note a large discrepancy between the standard requirements and the results of the government analysis1 for instead of the proteid matter containing #ce per cent4 in the coagulable form1 it contains but #a4f per cent4 ,these figures show1 then1 that ,valentine's preparation contains practically no coagulable proteids1 and since the quantity of these measures the food value of such preparations1 the conclusion must be drawn that ,valentine's ,meat ,juice has practically no value as a food and should certainly not be classed as a meat juice4 ,bovinine1 another widely advertised meat preparation1 which1 according to statements on 8,the ,bovinine ,co4's0 letter head1 is 8a concentrated beef juice0 and 8the only perfect food in the world0 was analyzed and found below the standard set for meat juices1 since it contains only #c4ch per cent4 of coagulable proteids4 ,yet in spite of this discrepancy1 the manufacturers of ,bovinine persist in exploiting it as a food1 stating it to be 8444 a concentrated easily assimilable1 nitrogenous food10 and in another place it is stated that ,bovinine 8is an ideal food40 ,as it is deficient in coagulable proteids and thus below the requirements as a food1 it is misbranded when called a food of any sort1 for to quote again the ,bulletin1 page #ee3 8444 meat extracts 444 must not be looked on as representing in any notable degree the food value of the beef or other meat from which they are derived02 and1 again3 8,they are not1 however1 concentrated foods1 having1 on the contrary1 but comparatively little nutritive value40 ,taken individually or as a class1 meat extracts are not to be considered foods1 and should1 therefore1 not be advertised as such1 a conclusion which the government officials have come to and voiced in the conclusion of the ,bulletin as follows3 ,,value ,,and ,,limitations 8,it seems to be the consensus of opinion among scientific investigators who have studied this question that the food value of these meat extracts is rather limited1 and although they are a source of energy to the body they must not be looked on as representing in any notable degree the food value of the beef or other meat from which they are derived4 ,when prepared under the best possible conditions a commercial meat extract is of necessity1 in order that it may not spoil1 deprived of the greater part of the coagulable proteids1 which constitute the chief nutritious elements of the juice40--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bc1 #aijh47 ,,pharmaceutical ,,manufacturers ,,and ,,the ,,great ,,american ,,fraud ,at various times we have given more or less complete accounts of the prosecutions the ,united ,states ,government has brought against nostrum exploiters under the ,food and ,drugs ,act4 ,one of the more recent of these1 while of comparatively little interest per se1 is of importance to the medical profession1 because of certain elements connected with it4 ,the case is known technically as 8,notice of ,judgment ,no4 #bhd0 and deals with the 8,alleged ,misbranding of ,danderine40 ,the gist of the case is as follows3 ,casks of ,danderine--a widely advertised 8hair tonic0--were shipped in carload lots from ,michigan to ,west ,virginia1 where the product was bottled1 labeled and put in condition to be retailed4 ,danderine contains a percentage of alcohol which1 while given on the labels of the bottles in which it is sold1 was not stated on the casks in which the preparation was shipped in bulk4 ,the government sought to confiscate1 under the ,food and ,drugs ,act1 sixty-five casks thus shipped because the quantity or proportion of alcohol in the casks was not stated4 ,the ,knowlton ,danderine ,company resisted the confiscation and the court upheld the company's claim4 ,the point in this case which is--or should be--of interest to the medical profession is to be found in the 8statement of facts0 presented by the ,knowlton ,danderine ,company in its own defense4 ,here it is said that3 8,parke1 ,davis ,co41 who are mentioned in the said libel as shippers 444 are under contract with the said ,knowlton ,danderine ,company 444 to compound the said formula 4440 ,elsewhere it is stated3 8,parke1 ,davis ,co4 were 444 the manufacturing agents1 under contract1 of the owner1 the ,danderine ,company 4440 ,this evidently means that ,parke1 ,davis ,co41 who are generally supposed to manufacture only 8ethical0 preparations--proprietary or otherwise--and as such to desire the respect and good wishes of the medical profession1 are in the business of furnishing the supplies for nostrum venders4 ,what ,danderine is1 it is hardly necessary to specify4 ,the widely distributed advertisements of this 8hair tonic0 nostrum with the slogan3 8,danderine ,grows ,hair and ,we ,can ,prove ,it0 are sufficiently well-known to all who read to make a lengthy disquisition on the product unnecessary4 ,it is interesting in this connection to note that according to newspaper dispatches the ,danderine ,company has absorbed the ,sterling ,remedy ,company1 which exploits 8,cascarets40 ,three years ago a physician1 who is also a pharmacist1 wrote to the ,medical ,world regarding the manufacture of ,cascarets3 8444 ,i have positive evidence1 which ,i will gladly submit1 that ,p41 ,d4 ,co41 make all of them ,cascarets1 and that they have a contract with the ,cascaret people not to make anything similar for any one else40 ,in the circular which comes in the ,danderine packages two other 8specialties0 are advertised3 8,neuralgine0 for 8sick1 weak1 tired nerves0 and 8,drake's ,palmetto ,compound0 for 8weak stomachs1 sluggish livers1 disordered kidneys10 and various other derangements of the system4 ,the question naturally arises1 are these1 too1 shipped in casks from ,parke1 ,davis ,co41 and merely bottled and labelled in ,west ,virginia8 ,not that the ,danderine case is the first one in which ,parke1 ,davis ,co4 have been exposed as manufacturers of nostrum supplies4 8,vitaopathy0 a method of 8treatment0 practiced by the notorious ,new ,york ,institute of ,physicians and ,surgeons in the person of 8,prof40 ,adkin and apparently consisting of 8absent treatment0 and pills1 was finally put out of business by a fraud-order from the post office department4 ,the concern used to advertise3 8,in ,professor ,adkin's laboratory1 his chemists are daily engaged in extracting the life-and-health-giving principle from rare vegetables1 fruits and plants40 8,prof40 ,adkin had no laboratory2 his chemists1 according to the government report1 were ,parke1 ,davis ,co41 from whom he purchased the tablets which formed part of his stock-in-trade of quackery4 ,the ,nutriola ,company of ,chicago was declared fraudulent by the postal authorities and a full account of the methods of this fake medical concern appeared in ,the ,journal1 ,april #bh1 #aijf4 ,nutriola was advertised as3 8,the greatest ,chemical-,medical ,preparation ever prepared by the skill of man40 8,nutriola and ,nature are the only invincible conquerors of diseases ever known40 ,the promoter of this scheme was one ,edward ,f4 ,hanson1 who was questioned by the government inspectors regarding the manufacture of the ,nutriola nostrum4 ,quoting from the government report3 8,q4 ,please name the chemists who now manufacture the remedies of the ,nutriola ,company40 8,a4 ,parke1 ,davis ,company1 ,detroit2 ,e4 ,l4 ,patch ,manufacturing ,company1 ,stoneham1 ,mass42 ,seabury ,johnson1 ,new ,york40 ,not that the course pursued by ,parke1 ,davis ,co4 is by any means an exceptional one in the pharmaceutical world4 ,it may be recalled that ,the ,journal has previously referred to the fact that ,sharp ,dohme are reported to make or to have made the 8,getwell ,tablets0 for the 8patent medicine0 concern which exploits the nostrum2 and that ,frederick ,stearns ,co4 make or did make the widely advertised 8cures0 ,shac and ,zymole ,trokeys also has been mentioned4 ,that ,seabury ,johnson made preparations for a fake medicine concern was brought to light by ,mr4 ,adams in the 8,great ,american ,fraud0 series4 ,and unquestionably there are many others4 ,the attitude taken by such houses seems to be that they are willing to furnish anything in the pharmaceutical line that anyone is willing to pay for1 whether it is for legitimate use of the physician or pharmacist or for furthering the business by which the ignorant or gullible sick are humbugged and defrauded4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #b1 #aiaj47 ,,dowd',s ,,phosphatometer ,dowd's ,phosphatometer1 according to its inventor1 is a device 8for taking the phosphatic index or pulse of the nervous system40 ,its originator1 ,j4 ,henry ,dowd1 ,m4,d41 ,buffalo1 ,n4 ,y41 writes enthusiastically of his instrument3 8,physicians who use the ,phosphatometer are sending #ej per cent4 less patients away for consultation1 getting #ge per cent4 better results at home1 because the ,phosphatometer tells the cause and what to do1 and the ,comp4 ,phosphorus ,tonic gives results in #hj per cent4 of all conditions of illness40 ,the 8,comp4 ,phosphorus ,tonic0 referred to in the above quotation is a sideline of ,dr4 ,dowd's1 put out by the ,richardson ,company1 of ,buffalo4 ,the stationery of the ,richardson ,company gives its address as #ccd ,franklin ,street1 but directs that all communications be addressed to #dj ,north ,pearl ,street1 which is the private address of ,j4 ,henry ,dowd4 ,according to the ,buffalo directories1 #ccd ,franklin ,street is the drug store of ,arthur ,e4 ,reimann4 ,to those who read the ,dowd 8literature10 the ,phosphatometer will appear to be either one of the wonders of the age or an unscientific absurdity4 ,to the thinking man it will be the latter4 ,it pretends to determine the amount of phosphates in the system4 ,this is accomplished--alleged--by taking the second urine passed in the morning and mixing a portion of it in the instrument with a solution which is the well-known magnesia mixture4 ,the height to which the crystals settle in ten minutes determines1 according to ,dowd1 the amount of phosphates6 ,was ever a test devised that violated more of the first principles of quantitative chemical analysis8 ,if so1 we never heard of it4 ,dowd's system does not require any determination of the amount of urine passed in twenty-four hours or even of the amount passed at the second micturition in the morning4 ,if a patient whose urine was being 8tested0 by the ,dowd method1 should drink two cups of coffee for breakfast instead of one1 his urine might be so dilute that the phosphates would fall below the 8normal0 mark4 ,dowd says that his ,phosphatometer 8takes the pulse of the nervous system40 ,what about the patient who eats several eggs or consumes a sweetbread or other nuclein-containing articles of diet8 ,the increased amount of phosphates in such a diet might easily lead to an apparent excess in the urine4 ,every physician1 nay1 every sophomore medical student1 knows that the amount and kind of food ingested governs almost entirely the amount of phosphates excreted in the urine4 ,what actually does 8,dowd's ,phosphatometer10 when used according to instructions1 show8 ,it shows the presence of phosphates in the urine2 it permits a guess--with not the slightest claim to accuracy--as to the amount in the specimen tested2 it gives no possible clue to the normal or abnormal relation of the phosphates in the urine or as to whether the source of the crystals precipitated is the nerve tissue or the food4 ,yet here are some of the claims made for it3 8,the ,phosphatometer shows nervous metabolism the same as the ureometer shows muscular2 the former errs in about #c per cent42 the latter in #dj per cent40 8,the ,phosphatometer shows the amount of nerve food being used and present in the nerve cells40 8,over #ej per cent4 of pain and human suffering is due to the nerves crying for food2 the ,phosphatometer will show the true cause in ten minutes40 8,the ,index not only tells the present condition1 but foretells the future1 thus preventing serious complications which might arise40 8,the ,phosphatometer measures the amount of phosphorus in the system40 8,the ,dowd ,phosphatometer not only takes blood-pressure1 it tells how to regulate it40 8,the ,phosphatometer measures the amount of phosphorus in the nerve cells2 it is as positive in nerve troubles as the x-ray in fractures40 ,these claims are essentially false4 ,as a matter of fact1 a simple examination of the urine for phosphates cannot tell us the condition of the nervous system4 ,this must be evident from the fact that only a portion of the phosphates is excreted in the urine1 a very considerable part passing out with the feces4 ,further1 the bulk of the phosphorus excreted comes from the food and only a small portion from the waste of the nervous system4 ,the amount excreted by the urine which comes from torn-down nerve tissue is so small that it is practically impossible to estimate variations in it even by the most careful analytic methods4 ,in brief1 ,dowd's 8scientific method0 is nothing more than unscientific humbug4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #bj1 #aiac47 ,,amorphous ,,phosphorus,,bn ,a ,practically ,inert ,substance ,introduced as a ,valuable ,therapeutic ,agent ,,bn ,the so-called amorphous phosphorus is in reality a crystalline body and is more correctly called red phosphorus to distinguish it from the ordinary or yellow phosphorus4 ,it is the ordinary or yellow phosphorus which is official as 8,phosphorus40 ,amorphous phosphorus is a chemical anomaly contrasting markedly with ordinary phosphorus in its physical1 chemical and pharmacologic properties4 ,ordinary phosphorus is soluble in certain solvents1 such as oil2 amorphous phosphorus is insoluble4 ,ordinary phosphorus is poisonous2 amorphous phosphorus is not poisonous4 ,ordinary phosphorus has been regarded as of some therapeutic value2 amorphous phosphorus1 because of its insolubility and other physical properties1 has never been so regarded4 ,pharmacologists1 therefore1 have paid very little attention to it4 ,some of them do not even mention it1 though there are a few accounts of experimental work4 ,no1#aef in experiments on the action of phosphorus with yeast1 found that yeast acted on ordinary phosphorus1 producing ,,ph#c 7hydrogen phosphid71 but on amorphous phosphorus it had no action4 ,his experiments show that amorphous phosphorus was not toxic to animals4 #aef ,no1 ,j43 ,action compare du phosphore blanc et du phosphore rouge sur la matire vivante1 ,compt4 rend4 ,soc4 de biol41 #ahii1 #aje1 i1 #chj4 ,thornton#aeg quotes ,reese as publishing a report of a case in which #cj grains of amorphous phosphorus were taken by a young woman with suicidal intent1 but no toxic symptoms were manifested4 ,thornton found it non-toxic to animals4 #aeg ,thornton1 ,e4 ,q43 ,the ,advantages of ,amorphous ,phosphorus over the ,official ,form1 ,therap4 ,gaz41 #ahid1 xxxv1 #ai4 ,tr4 ,pan4 ,am4 ,med4 ,congress1 #ahic1 ,washington1 #ahie1 p4 #a1dch4 ,witthaus and ,becker 7,medical ,jurisprudence1 ,forensic ,medicine and ,toxicology1 iv1 #fce7 say3 8,the form of phosphorus is practically non-poisonous1 probably by reason of its insolubility4 ,it has been administered to dogs to the extent of #bjj gm4 7nearly half a pound7 in twelve days without causing poisoning40 ,c4 ,d4 ,f4 ,phillips 7,materia ,medica1 ,pharmacology and ,therapeutics1 ,inorganic ,substances1 ,ed4 #c1 p4 #df7 makes the following statement3 8,amorphous phosphorus has been1 by some observers1 credited with physiologic activity4 ,thus1 ,bednar used it for a long period in small doses1 and observed symptoms of excitation1 trembling and clonic convulsions2 but as much as #a ounce has been given to dogs without perceptible effect4 ,thompson1 in twelve carefully observed cases1 found its action nil1 and plausibly attributes its supposed powers to a slight admixture of ordinary phosphorus 7,pharm4 ,jour41 #ahge74 ,i believe it is practically inert40 ,,how ,,introduced ,the foregoing represents our scientific knowledge as to the action of amorphous phosphorus4 ,now1 however1 comes ,dr4 ,i4 ,l4 ,nascher and introduces amorphous phosphorus as a remedy of remarkable value for the arteriosclerosis of old age4 ,the method of introduction is somewhat peculiar4 ,the treatment seems first to have been brought to notice through a printed slip sent to medical journals generally4 ,this slip consisted of an extract from ,nascher's book on old age1 which at the time had not been published6 ,nascher also published an article on this subject in an obscure journal1 the ,american ,practitioner1 for ,december1 #aiac4 ,neither the matter copied from his book nor the article referred to contain a single scientific fact that would warrant the claims made for it as a therapeutic agent4 ,no record is given of animal experiments1 and the clinical evidence presented certainly cannot be regarded as scientific4 ,as already stated1 this form of phosphorus has not been previously used and has been regarded as without effect on the human system because of its insolubility in any of the liquids of the body4 ,nascher himself has not been able to find any new way to dissolve it4 ,he says3 8,i made a number of experiments to find a solvent4 ,the only substance which appears to dissolve it is serum1 but ,i am still uncertain whether it is a solution or a very fine suspension4 ,the phosphorus is precipitated in a few days1 but the serum remains tinged40 ,the fact that it separates from the serum on standing is quite conclusive evidence that it is insoluble in that liquid4 ,since no way of making it soluble has been discovered1 there is no reason for expecting it to have any effect on the system4 ,an insoluble and non-absorbable substance can produce no general systemic effect2 if1 when ingested1 it produces any effect whatever1 this effect must be local and will be shown by symptoms of gastro-intestinal disturbance4 ,nascher1 however1 took #ae grains1 and no symptoms of gastro-intestinal disturbance followed4 ,hence1 we must conclude that it is without effect on the gastro-intestinal mucous membrane4 ,while ,nascher records no experiments on animals which is much to be regretted1 he did experiment on himself and says3 8,ten grains produced a frontal headache1 restlessness1 excessive mental stimulation1 ideas arising with such vividness as to appear as actual occurrences4 ,there was a sense of weight or oppression in the stomach and priapism1 the latter probably psychic1 as ,i was looking for such a result4 ,these symptoms passed away in a few hours40 ,without doubt his explanations of the priapism can be applied to the whole experience2 whatever symptoms there were1 they were unquestionably psychic4 ,the consideration of these subjective symptoms may be dismissed1 since it is reasonable to assume that an insoluble1 unabsorbable substance which produces no disturbance of the gastro-intestinal tract will have no effect on the rest of the organism4 ,amorphous phosphorus did not produce such symptoms as ,nascher relates in experiments similar to his made by us4 ,the drug was taken in #aj-;grain doses by six different individuals4 ,in no case did the symptoms described by ,nascher follow2 in fact1 there were no symptoms whatever4 ,,nascher',s ,,theory ,nascher1 after relating his subjective experiences and those of his patients1 proceeds to build a theory to account for the unproved action of amorphous phosphorus in disease1 especially in arteriosclerosis4 ,it would have been more appropriate if before advancing the theory1 he had made some experiments to prove that the substance has some action4 ,but we give his theory as found in the quotation from his book1 sent to medical journals1 as already referred to4 ,here it is3 8,amorphous ,phosphorus in ,senile ,arteriosclerosis3 ,the author has used the red amorphous phosphorus in senile arteriosclerosis for several years4 ,given originally as a substitute for ordinary phosphorus in senile debility1 it was found that it was eliminated as amorphous phosphate of lime and that the lime elimination was thereby increased4 ,weil's experiments showed that the lime elimination in arteriosclerosis was diminished4 ,phosphorus has the property of combining with lime and increasing the lime assimilation4 ,in the small doses which can be given when the ordinary phosphorus is employed1 the phosphorus will combine with the lime of the food and increase the amount of lime salts in the body4 ,when given as amorphous phosphorus1 the dose is #b grains or more several times a day1 and with a lime-free diet the lime required for the combination necessary to secure the elimination of the phosphorus excess is drawn from the abnormal lime deposits4 ,this appears to be the rationale of the treatment and explains the good results obtained from its use4 ,from #8,diseases of ,old ,age1' by ,i4 ,l4 ,nascher1 ,m4,d41 to be published shortly40 ,thus1 according to ,nascher1 the phosphorus1 after being oxidized to phosphoric acid1 catches the calcium and drags it out of the system6 ,what are the facts8 ,the human body contains a large store of phosphates which are excreted in the urine in combination with sodium and potassium--and yet these do not draw the calcium from the blood1 brain and bones6 ,to be blunt1 ,nascher's theory is absurd4 ,the calcium in its various deposits in the body is already combined with phosphoric acid4 ,why should the phosphorus introduced take calcium from the phosphate radical with which it is already in combination8 ,nascher asserts that the phosphorus which is introduced as amorphous phosphorus is excreted as amorphous phosphate of lime within twenty-four hours4 ,how does he know it is8 ,it is1 of course1 very appropriate that amorphous phosphorus should form the amorphous phosphate of lime1 but1 unfortunately1 phosphates made from the ordinary phosphorus also are precipitated in the amorphous condition4 ,by what private mark does ,dr4 ,nascher identify the amorphous phosphate produced by his amorphous phosphorus8 ,is it not a fact that he found the urine alkaline and detected a precipitate of amorphous calcium phosphate--always present in alkaline urine--and concluded that this must be his particular amorphous phosphorus in combination with calcium8 ,dr4 ,nascher makes no record of examinations of the feces1 although a great part--sometimes the greater part--of ingested phosphorus is found in the feces in experimental work on phosphorus metabolism4 ,if he had examined the feces he would doubtless have found the total quantity of amorphous phosphorus unchanged4 ,nascher refers to several cases in which he has used this remedy and states that he had the most gratifying results4 ,so far as we can learn1 the benefit was entirely in the subjective symptoms of the patient4 ,it seems evident1 therefore1 that his claims for the value of this remedy rest on no better foundation than an unproved theory without experimental basis4 ,,its ,,commercialization ,thus far we have considered only the scientific aspects of amorphous phosphorus therapy4 ,it is unfortunate that we cannot stop here4 ,some of our readers will have seen in recent medical journals half-page advertisements of amorphous phosphorus reading3 ,the striking physical and chemical properties possessed by common phosphorus1 together with the fact that phosphorus is one of the constituents of nerve-tissue1 are probably responsible for the reputation which this element acquired generations ago as a remedy for sexual impotence and mental decay4 ,among scientific men this reputation was a fleeting one1 for1 when put to the test1 the product failed4 ,like so many products with a similar history1 the unearned reputation it obtained from medical men survived in the minds of the laity1 and1 as is always the case1 the survival has been taken advantage of by quacks4 ,among charlatans and nostrum makers phosphorus is still in vogue4 8,weak men's specialists0 and venders of 8lost manhood0 and alleged aphrodisiac drugs 8play up0 the phosphorus fallacy for all it is worth4 ,it is worth noting that the present exploitation of amorphous phosphorus is following along somewhat similar lines4 ,the asserted actions of amorphous phosphorus are such as may be calculated to appeal to the sexual neurasthenic4 ,there is no doubt that the ,sharp ,dohme advertisements will bring about an extensive use of this remedy1 especially by the uncritical4 ,the psychic element--which plays so large a part in the sexual neurasthenic--will result in favorable reports being given on the drug4 ,articles may be expected to appear in a certain class of medical journals1 telling of the marvelous results that ,dr4 ,john ,doe has had in the use of 8,pill ,phosphorus ,amorphous ,s4 ,d40 ,a luxuriant crop of testimonials may be expected to follow1 and the tout ensemble will go far to sustain the ,sharp ,dohme propaganda4 ,illustration3 ,reproduction--reduced--of half-page advertisement appearing in medical journals4 ,we are prompted to believe that ,messrs4 ,sharp ,dohme do not fully realize the potentialities for harm that lie in their present exploitation of amorphous phosphorus4 ,it hardly seems possible that a firm of standing would knowingly put on the market and advertise a worthless drug with an appeal to susceptible1 infirm old men4 ,the function of introducing new remedies to the medical profession is a responsible one1 and a firm that assumes it should have among its officers some one sufficiently conversant with pharmacologic science to prevent such unscientific absurdities as that exhibited in the marketing of amorphous phosphorus1 especially under such claims as those contained in the advertisements4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #g1 #aiad47 ,dr4 ,nascher's ,reply to ,the ,journal's ,article--,comments ,to the ,editor3--,regarding the article on ,amorphous ,phosphorus in the ,march #g issue of ,the ,journal of the ,american ,medical ,association1 ,i want first of all to clear myself of the implied charge of commercialism in connection with the marketing of the ,pill ,phosphorus ,amorphous by ,sharpe ,dohme4 ,i have never had anything to do with the manufacture or sale of those pills1 never had any business dealings with ,sharpe ,dohme and ,i have no commercial interest whatsoever in either this or any other drug or drug house4 ,i knew nothing about the advertisement which you reproduced until ,i saw it in the medical journals4 ,i immediately protested against this unwarranted use of my name and was assured that the statement 8,made under the direction of ,doctor ,i4 ,l4 ,nascher1 ,new ,york10 was not made for the purpose of misleading and that the ad4 would be immediately withdrawn4 ,i gave my approval to the pills made by this firm as ,i would give my approval to the pills made by any other reliable house for ,i claim the right to endorse any drug or preparation which ,i believe to be of value whether it is approved by the ,council of on ,pharmacy and ,chemistry or not4 ,in your general charge of commercialism you make it appear that the exploitation of amorphous phosphorus had the ulterior purpose of appealing to the sexual neurasthenic along the lines of the 8lost manhood0 ads4 ,so far as this relates to ,sharpe ,dohme1 ,i have no interest1 but you have included me in your general denunciation4 ,the only reference ,i ever made to aphrodisiac effects of ,amorphous ,phosphorus1 in all my writings1 is contained in these words in the four-page article in the ,american ,practitioner1 8,in a few cases aphrodisiac effects were noticed40 ,i have never recommended amorphous phosphorus as an aphrodisiac and in the chapters on 8,impotence and ,neurasthenia0 in my book on 8,diseases of ,old ,age10 ,i have not mentioned amorphous phosphorus at all4 ,you say 8the treatment seems first to have been brought to notice through a printed slip sent to medical journals generally40 ,this slip containing an extract from my book which was then in press was sent out about four months ago while ,i have referred to amorphous phosphorus repeatedly in medical articles during the past three years4 ,in my paper on ,senile ,debility1 ,medical ,record1 ,jan4 #ba1 #aiaa1 ,i said amorphous phosphorus had no effect1 as ,i was then looking for the usual effects of the ordinary phosphorus4 ,in a paper on ,senile ,mentality1 ,international ,clinics1 ,vol4 #d1 #bast series1 ,i said ,i was using amorphous phosphorus but had not yet determined its value4 ,i recommended it in several of my papers1 articles and lectures in #aiab and #aiac after ,i had found that under its use in some cases of senile arteriosclerosis1 symptoms were relieved4 ,i sent these slips to the medical journals as a general reply to many inquiries ,i received about amorphous phosphorus and ,i stated this in the letters ,i sent with the slips to some editors4 ,further inquiries for more information led me to write the paper which appeared in the ,december issue of that 8obscure journal0 the ,american ,practitioner4 ,i felt that a medical journal which carried articles by ,sir ,james ,barr1 ex-president of the ,british ,medical ,association1 ,sir ,r4 ,w4 ,philip1 ,r4 ,murray ,leslie1 ,halliday ,sutherland1 and such ,american authorities as ,adami1 ,hare1 ,brooks1 ,hirschberg1 ,knopf1 ,starkey1 ,ely1 ,bissell1 ,wilcox1 ,col4 ,maus1 ,u4 ,s4 ,a41 etc41 was a representative high class journal and ,i was pleased to have my paper in it4 ,to take up the scientific criticism of amorphous phosphorus1 permit me to say at the outset that ,i am a general practitioner1 specially interested in geriatrics1 and more concerned about obtaining favorable clinical results in my cases than in solving laboratory problems4 ,nevertheless ,i have tried for years to obtain the cooperation of expert laboratory workers to help me determine the properties1 chemical1 physical and physiological1 of amorphous phosphorus4 ,in #aiji or #aiaj the ,rockefeller ,institute1 in reply to my request for permission to experiment there with amorphous phosphorus1 said it did not accept volunteer workers4 ,four heads of college laboratories could not spare the time4 ,i asked the ,council on ,pharmacy and ,chemistry last ,november to take up its investigation and was informed that it could not do so at present4 ,i have been perforce compelled to depend mainly on empirical methods with such little experimentation as the facilities of the physician's office permitted and such little literature as ,i could find4 ,you reject empirical methods as being unscientific notwithstanding the fact that most of our therapeutic knowledge is based on empiricism4 7,i use the terms empirical and empiricism here in the sense of knowledge obtained from experience and observation1 not in the bad sense in which they might be construed47 ,it would therefore be folly on my part to argue with you that ,i have obtained beneficial results from amorphous phosphorus in many cases of senile arteriosclerosis4 ,i did not obtain such results from a single dose1 but gave it in some cases for many weeks or months4 ,it is unfair to judge of the value of a drug from a single dose or several doses unless it is a drug which is expected to show immediate effects4 ,it would be greater folly on my part to pit my knowledge of pharmacy and chemistry against the knowledge of your staff of experts4 ,i can but repeat what ,i have said on many occasions that under the persistent use of amorphous phosphorus in cases of senile arteriosclerosis symptoms were frequently relieved4 ,i never claimed that amorphous phosphorus will cure arteriosclerosis4 ,in the chapter on ,arteriosclerosis in my book ,i say3 8,senile arteriosclerosis being a natural1 normal condition1 is incurable in the sense that it can be neither prevented nor removed4 ,the best that we can hope for is to retard its progress and relieve disagreeable symptoms1 etc40 ,you say in reference to the elimination of the amorphous phosphorus as amorphous phosphate of calcium1 8,is it not a fact that he 7,i7 found the urine alkaline and detected a precipitate of amorphous calcium phosphate--always present in alkaline urine--and concluded that this must be his particular amorphous phosphorus in combination with calcium80 ,no4 ,the specimens of urine were examined in reliable laboratories and ,i have reports showing acid and neutral urine as well as alkaline urine having the amorphous phosphate precipitate4 ,nor is the amorphous phosphate 8always present in alkaline urine40 ,as for the theory ,i advanced1 it is simply a theory based on reasoning without facts to prove it4 ,if ,i had facts to prove it1 it would no longer be a theory or open for discussion4 ,being a theory1 it is the province of the wise man to ridicule it and call it absurd4 ,i will confess that your criticism of it is not clear to me and ,i still do not see its absurdity4 ,i don't see what relation your argument1 that the phosphates of sodium and potassium do not draw the calcium from the blood1 brains and bones1 has to the theory ,i advanced4 ,it is true that ,i have no private mark by which ,i can identify the amorphous phosphate produced by amorphous phosphorus1 but such argument is puerile4 ,when medical science has so far progressed that the physician will be able to put his tag on the molecule of drug substance and follow it through the various metabolic processes to its final elimination we will not need any ,council on ,pharmacy and ,chemistry to decry what it cannot understand4 ,let me say here that scientific criticism does not stoop to ridicule for ridicule is usually based on animus or bias4 ,the conclusive proof of the value of a drug is not its action on the healthy dog1 frog or guinea-pig but its action on the individual patient1 and no amount of animal experimentation can dispose of the personal factor which is so marked in senile cases4 ,this is no criticism of animal experimentation as a whole but of the insistence on animal experimentation to determine the value of a drug in a class of cases for which the healthy animal can furnish no comparison4 ,you say amorphous phosphorus is practically inert and quote ,no1 ,witthaus and ,becker1 ,thornton and ,phillips4 ,the quotations of the first three are little more than statements that amorphous phosphorus is non-toxic4 ,phillips makes two references1 one of which is to ,badner who obtained decided effects from its prolonged use4 ,thornton1 whom you quote in your contention that amorphous phosphorus is inert1 says that on prolonged use in doses of #c_/aj grains every two hours it produced headache1 vertigo1 mental excitement1 priapism1 etc4 7,see footnote under ,phosphorus1 ,u4 ,s4 ,dispensatory74 ,shoemaker's ,materia ,medica and ,therapeutics says it is toxic and is called the servant-girl's poison4 ,phillips suggested that ,badner probably used an impure drug4 ,i suggested that ,thornton probably used an impure drug4 ,on the other hand1 ,badner and ,thornton obtained positive results from prolonged use1 not from the single dose4 ,you say it has not been used on account of its insolubility in any of the liquids of the body4 ,roscoe and ,schorlemmer1 quoting ,neuman1 said if injected into the blood the usual symptoms of phosphorus poisoning appear4 ,in a letter from ,dr4 ,hatcher he says ,nass injected #j4b gm4 of the purest amorphous phosphorus into a rabbit's vein and the animal presented the usual symptoms of phosphorus poisoning4 ,there are also references to amorphous phosphorus action in ,kobert's ,lehrbuch der ,intoxicationen1 in ,blythe's ,poisons1 etc4 ,you say of your four quotations1 8the foregoing represents our scientific knowledge as to the action of amorphous phosphorus40 ,did you not know of these other authorities1 or are their statements unscientific1 or were they omitted because they disprove your contention that amorphous phosphorus is practically inert8 ,your denunciation of ordinary phosphorus has no bearing on the subject as ,i do not recommend the amorphous phosphorus as a substitute for the other4 ,i have worked for eight years to arouse medical and public interest in the aged and their ailments and ,i cannot afford charges of commercialism1 foisting worthless drugs as aphrodisiacs or other unethical conduct to stand against me4 ,as for the charge of unscientific work1 ,i can only point to my work on ,diseases of ,old ,age1 and my medical papers1 and express the hope that others better equipped for laboratory research will take up the laboratory investigation of amorphous phosphorus4 ,i have faith in its therapeutic value and believe competent clinical observers will have favorable results from it in suitable cases4 ,i4 ,l4 ,nascher1 ,m4,d41 ,new ,york4 ,comment4--,accompanying the preceding letter was a note from ,dr4 ,nascher in which he says3 8,i want this published in full without elision or change4 ,if you do not intend to publish it as written1 ,i want it returned and enclose postage40 ,the letter therefore is given in full in spite of the fact that much of it is irrelevant to the question discussed4 ,dr4 ,nascher's protest to ,sharpe and ,dohme against the 8unwarranted use0 of his name in connection with 8,pill ,phosphorus ,amorphous1 ,s ,d0 seems to have resulted in various modifications of the phrases connecting his name with the exploitation of this pill4 ,what was apparently the original advertisement1 contained the phrase3 8,made under the direction of ,dr4 ,i4 ,l4 ,nascher1 ,new ,york40 ,later advertisements1 while identical in all other respects with the first1 had this phrase modified to read3 8,made at the suggestion of ,dr4 ,i4 ,l4 ,nascher1 ,new ,york40 ,still other advertisements1 also identical with the first in other respects1 are modified to read3 8,made with the approval of ,dr4 ,i4 ,l4 ,nascher1 ,new ,york40 ,that ,dr4 ,nascher was directly or indirectly connected with the commercializing of this product1 ,the ,journal has never suggested1 inferentially or otherwise4 ,that the exploitation of amorphous phosphorus by ,sharpe and ,dohme is one that appeals to the sexual neurasthenic1 no one who has read the advertisements can deny4 ,as a matter of fact1 it would be difficult to sell phosphorus in any form as a medicament1 without appealing to the sexual neurasthenic4 ,the word 8phosphorus0 has become1 in the minds of both laymen and physicians1 more or less synonymous with the treatment of so-called sexual weakness and it is a practical impossibility to divorce the word from the idea suggested4 ,how true this is1 ,dr4 ,nascher himself unwittingly admits when he tells that the result of his first experiment on himself with amorphous phosphorus was a priapism that he acknowledges was 8probably psychic1 as ,i was looking for such a result40 ,but the ,sharpe and ,dohme advertisements plainly state that the amorphous phosphorus pill they are marketing is a 8new and successful method of treatment for 444 functional and senile impotence44440 ,dr4 ,nascher's explanation of how he came to send out the slip regarding amorphous phosphorus to medical journals leaves him the victim of an unfortunate coincidence4 ,it is at least unusual for authors to send out advance extracts from books that are about to be published1 especially when such extracts deal wholly with a drug that is coincidently being introduced as a new proprietary product by some enterprising pharmaceutical house4 ,dr4 ,nascher takes exception to our statement that the treatment seems first to have been brought to notice through the printed slip sent to medical journals1 and states that he has 8referred to amorphous phosphorus repeatedly in medical articles appearing during the last three years40 ,his articles for #aiab and #aiac have been examined for the purpose of learning when the treatment as now presented to the profession was first announced4 ,in his article 8,errors in the ,treatment of ,senile ,cases10 ,new ,york ,medical ,journal1 ,oct4 #ab1 #aiab1 he speaks of the iodids in senile arteriosclerosis1 but says nothing about amorphous phosphorus4 ,it may be assumed1 therefore1 that the treatment had not been brought to general notice at that time4 ,the new treatment is very briefly described in the ,new ,york ,medical ,journal1 ,july #ac1 #aiac1 in an article whose title1 8,longevity and ,rejuvenescence0 gave no indication that it dealt with amorphous phosphorus4 ,under the circumstances1 it is not strange that its therapeutic value was not learned of until ,dr4 ,nascher's printed slips were sent out4 ,dr4 ,nascher admits that his theory is based on empirical methods4 ,most of the serious errors in therapeutics have had their origin in this very method4 ,it was on just such methods that physicians reported wonderful results in the use of alleged 8lithia waters0 that actually contained less lithium than ordinary river water6 ,so unscientific is the empirical method that it is hardly worth taking the space to demonstrate its imperfections4 ,neither is it worth while to discuss the question of a constant occurrence of a sediment of amorphous calcium phosphate in alkaline urine4 ,if there are exceptions to this rule1 they must be rare indeed4 ,in ,the ,journal's article authors were quoted to show that amorphous phosphorus is regarded as inert4 ,it was not suggested that the authorities referred to were all that could be found4 ,dr4 ,nascher refers to ,thornton1 ,shoemaker1 ,neuman1 ,blythe and ,kobert1 and asks whether the various statements on the subject1 made by these men1 are unscientific or were 8omitted because they disproved0 the contention that amorphous phosphorus is practically inert4 ,thornton's article was omitted because it is unscientific in that he does not report experiments made by himself1 but refers to an unpublished paper by one ,kelly4 ,who ,kelly is1 or was1 he does not tell us4 ,kelly's report1 therefore1 should be and was disregarded1 since it is the work of an unknown author and there is nothing in the article to indicate that ,thornton was in any position to vouch for ,kelly's work4 ,incidentally1 it may be said that ,kelly's report merely recorded subjective symptoms2 ,dr4 ,nascher himself indicates his distrust of ,kelly's alleged results by suggesting that an impure preparation was used6 ,shoemaker's report was not given1 for a similar reason4 ,shoemaker says3 8,amorphous phosphorus is almost completely destitute of taste or odor1 has no immediate caustic effect1 and is claimed to be less toxic than white phosphorus2 but in the form of matches ,italics ours4--,ed4 has caused many deaths and is known as the #8servant girls' poison4'0 ,it is well known that commercial amorphous phosphorus is usually impure1 and it is more than probable that if toxic effects were produced by the ingestion of match-heads1 these matches were made either of white phosphorus or of very impure red phosphorus4 ,in any case1 ,shoemaker's statement has no bearing whatever on the pharmacologic action of pure amorphous phosphorus4 ,the statement of ,neuman quoted from ,roscoe and ,schorlemmer1 as well as that of ,nass1 referred to by ,hatcher1 had no bearing on the question at issue1 as these men injected the material into the blood-stream4 ,if1 when the amorphous phosphorus is injected into the blood1 it produces the ordinary symptoms of phosphorus poisoning1 one would naturally expect the same symptoms when the substance is given by mouth--if amorphous phosphorus were soluble or absorbable4 ,the fact that such symptoms are not produced when amorphous phosphorus is taken into the alimentary canal1 sustains the views held by chemists1 pharmacologists and physicians1 that the drug is practically insoluble and unabsorbable--in other words1 inert4 ,dr4 ,nascher declares that he 8never claimed that amorphous phosphorus will cure arteriosclerosis40 ,yet he insists that amorphous phosphorus removes lime from the 8abnormal lime deposits0 that occur in arteriosclerosis4 ,what is this but claiming curative action8 ,summed up1 ,dr4 ,nascher's own admissions amply confirm the main contentions of ,the ,journal's article4 ,he admits that he has no experimental basis for the use of this remedy2 he admits that his theory 8is simply a theory without facts to prove it40 ,the only conclusions that can be reached from his reply coincide closely with the very statement made by ,the ,journal1 and which we here reiterate3 8,it seems evident1 therefore1 that his claims for the value of this remedy rest on no better foundation than an unproved theory without experimental basis40--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #bh1 #aiad47 ,,index 7,including ,references to ,articles ,not ,contained in ,this ,book7 ,the following is an index 7#a7 to topics discussed in this volume1 and 7#b7 to products discussed in reports and other articles not included here3 #a4 ,the references to topics discussed or mentioned in this volume are printed in ,,capitals4 #b4 ,the references to articles published elsewhere are printed in small letters4 ,these references include papers published in ,the ,journal of the ,american ,medical ,association1 papers published in the 8,annual ,reports of the ,council on ,pharmacy and ,chemistry0 and a few published in the 8,annual ,reports of the ,chemical ,laboratory of the ,american ,medical ,association40 ,a number of these papers have appeared both in ,the ,journal and in the ,council ,reports4 ,in such cases1 for the benefit of those who may not have access to files of both ,the ,journal and the ,council ,reports1 references are given to both sources4 ,some of this matter is also issued in reprint form4 ,,page ,,abbott ,,alkaloidal ,,company1 #cg1 #ajc1 #cdd ,,abican1 #dg ,,acetanilid1 ,,harmful ,,effects ,,of1 #cje ,,acetanilid ,,mixtures1 #i ,,acetphenetidin ,,and ,,phenacetin--,,their ,,relative ,,purity1 #dad ,,acetphenetidin1 ,,harmful ,,effects ,,of1 #cje ,,acousticon1 #dcf ,,adepsine ,,oil1 #afa ,,adkin1 8,,professor01 #dge ,,adrenalin1 ,,name1 ,,versus ,,the ,,name ,,epinephrin1 #ded ,,advertising1 ,,clean1 #dah ,,agar-,,lac ,,and ,,agar-,,lac1 ,,inc41 #aj ,agmel 7,maguey ,products ,co471 ,the ,journal1 ,oct4 #ab1 #aiab1 p4 #acib4 ,agurin ,tablets 7,bayer ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afb4 ,,akoll ,,biscuit1 #ddi ,,albolene1 ,,liquid1 #afa ,alborum 7,whitehouse ,chemical ,co41 ,inc471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abi4 ,aletrin1 ,the ,journal1 ,nov4 #ac1 #aiji1 p4 #afee2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #ace4 ,aletris ,compound1 ,elixir 7,parke1 ,davis and ,co41 ,ray ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,,aletris ,,cordial1 #df ,,aletris ,,farinosa1 #bjh ,alfatone 7,norwich ,pharmacal ,company71 ,the ,journal1 ,aug4 #g1 #aiae1 p4 #edh2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #fb4 ,,alienist ,,and ,,neurologist1 ,,advertising ,,in1 #ca ,alkaline ,digestine 7,parke1 ,davis and ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,alkalol 7,alkalol ,company71 ,the ,journal1 ,nov4 #f1 #aiae1 p4 #affe4 ,,alleotone1 #bfd ,,almond ,,preparations1 ,,various ,,diabetic1 #dej ,,american ,,journal ,,of ,,clinical ,,medicine1 ,,advertising ,,in1 #cjc1 #cjd1 #cdb ,,american ,,journal ,,of ,,obstetrics1 ,,advertising ,,in1 #cdb ,,american ,,journal ,,of ,,surgery1 ,,advertising ,,in1 #ca1 #di1 #cdb1 #dbd1 #dbi ,,american ,,malted ,,food ,,company1 #cai ,,american ,,medicine1 ,,advertising ,,in1 #ca1 #di1 #aca1 #cjd1 #cdb1 #dbi ,,von ,,amerongen1 ,e4 ,m41 #bii ,,amilee1 #afa ,amolin ,deodorant ,powder 7,amolin ,chemical ,co471 ,the ,journal1 ,feb4 #bb1 #aijh1 p4 #fbf2 ,reports ,chem4 ,lab41 #aiji1 p4 #fc4 ,,ammonol1 #i ,,ammonol ,,chemical ,,company1 #cch ,,amorphous ,,phosphorus1 #dgh ,,anadol1 #bdf ,,analgesic ,,balm1 ,,bengu',s1 #bfg ,,analgesic ,,cream1 ,,stearns'1 #bfg ,,analgine-,,labordine1 #aag ,analutos and ,analutos ,tablets 7,royal ,pharmaceutical ,works1 ,meppel1 ,holland71 ,the ,journal1 ,feb4 #bj1 #aiae1 p4 #fhd2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ace4 ,,anasarcin1 #aa1 #ab ,,anasarcin ,,chemical ,,company1 #aa1 #ah ,,anderton1 ,,dr4 ,t4 ,b41 #ah ,,anedemin1 #aa1 #ab1 #af ,,anedemin ,,chemical ,,company1 #ab1 #af1 #ah ,,angier ,,chemical ,,company1 #agj ,,angier',s ,,petroleum ,,emulsion1 #afi ,,angier',s ,,throat ,,tablets1 #agc ,,anglo-,,american ,,pharmaceutical ,,company1 ,,ltd41 #eh ,,animal ,,therapy ,,company1 #cag ,anistamina 7,m4 ,olivetti71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afb4 ,,annals ,,of ,,surgery1 ,,advertising ,,in1 #ce1 #dba ,,anodyne ,,balm1 ,p-,m ,,company1 #bfg ,,antidiabeticum-,,bauer1 #bfg ,,anti-,,jag1 #dcd ,,antikamnia1 #i1 #bfh1 #cjg ,antikamnia and ,quinin 7,antikamnia ,chemical ,co471 ,the ,journal1 ,july #a1 #aije1 p4 #ee4 ,,antikamnia ,,chemical ,,company1 #bgg1 #bgi1 #cjg ,antimeristem-,schmidt 7,laboratorium ,w4 ,schmidt71 ,the ,journal1 ,march #h1 #aiac1 p4 #gff4 ,,anti-,,neuralgic ,,ointment1 #bfg ,antiphlogistine 7,denver ,chemical ,manufacturing ,company71 ,the ,journal1 ,june #a1 #aijg1 p4 #ahge4 ,,antipyrin1 ,,harmful ,,effects ,,of1 #cje ,,antiseptic ,,powder1 ,,maignen1 #ai ,,antiseptic ,,powder1 ,,tyree',s1 #ba1 #djd1 #dcf ,antiseptic ,tablets1 ,clover 7,sharp ,dohme71 ,the ,journal1 ,aug4 #bf1 #aiaa1 p4 #gee4 ,,antiseptic ,w-,a1 ,,intestinal1 #ajc ,,antithermoline1 #djc ,,anusol ,,hemorrhoidal ,,suppositories1 #bbg1 #bhj1 #bha ,,apergols1 #bf ,arbor ,vitae1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ch4 ,,archives ,,of ,,pediatrics1 ,,advertising ,,in1 #ca ,,armour ,,co41 #acc1 #dgb ,,army ,,and ,,navy ,,magazine1 #dcd ,,army ,,and ,,navy ,,medical ,,record1 #bib1 #cjj1 #dcb ,,arnold',s ,,zymotoid ,,and ,,arnold',s ,,zymotoid ,,company1 #dab ,,aromatic ,,digestive ,,tablets1 #bbi ,,aseptikons1 #bf ,,aspiro-,,lithine1 #bha ,,aspirophen1 #he ,,atlanta ,,journal-,,record ,,of ,,medicine1 ,,advertising ,,in1 #ca1 #ce1 #bif ,,atoleine1 #afa ,,atolin1 #afa ,,aubergier',s ,,syrup ,,of ,,lactucarium1 #cii ,autolysin 7,autolysin ,laboratory71 ,the ,journal1 ,july #bd1 #aiae1 p4 #ccf2 ,nov4 #f1 #aiae1 pp4 #afdg1 #affb4 ,avenin ,compound ,tablets 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,baby ,taeniafuge ,grape 7,grape ,capsule ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agd4 ,bacillicide 7,prophytol ,products ,co471 ,the ,journal1 ,nov4 #ad1 #aiad1 p4 #aggh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abe4 ,,baking ,,powder1 ,,casoid1 #ddi ,,baking ,,powder1 ,,jireh ,,diabetic1 #dej ,bakurol 7,sharp ,dohme71 ,the ,journal1 ,july #aj1 #aiae1 p4 #age4 ,,ballard1 ,j4 ,f41 #aab1 #aih ,,ballard-,,snow ,,liniment ,,company1 #dc ,,ballard',s ,,snow ,,liniment1 #bje ,baneberry1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ch4 ,baptisin1 ,the ,journal1 ,nov4 #ac1 #aiji1 p4 #afee2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #ace4 ,,bannerman1 ,,wm41 ,,co41 ,,and ,,bannerman',s ,,intravenous ,,solution1 #aje ,,baptisia ,,tinctoria1 #bji ,,barker',s ,,gluten ,,foods1 #ddi1 #dej ,,battle ,,co41 #ca1 #ha1 #ajh1 #ccj ,,bauer1 ,,charles1 #bii ,,bauer1 ,,ludwig1 #bfg ,,bauer ,,chemical ,,company1 #cff ,,baume ,,analg,,sique ,,bengu1 #bfg ,bee1 ,honey1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ch4 ,,beef ,,extracts1 ,,juices ,,and ,,preparations1 #abc1 #acc1 #dga1 #dgb ,,bell ,,co41 #aea1 #bhb1 #cef ,,bell-,,ans 7,,pa-,,pay-,,ans1 ,,bell71 #aea1 #bhb ,benetol 7,northern ,chemical ,assn471 ,the ,journal1 ,april #ae1 #aiaa1 p4 #aabh2 ,reports ,chem4 ,lab41 #aiaa1 p4 #hb4 ,,betul-,,ol1 #bg ,,beyer1 ,,charles ,,and ,,frank1 #bii ,,biosol1 #bhd ,,bischof',s ,,diabetic ,,gluten ,,bread1 #dej ,,bischof',s ,,gluten ,,flour1 #ddi ,,bischoff ,,co41 #bic1 #cdd ,,biscuit1 ,,various ,,diabetic1 #ddi1 #dej ,bismuth ,iodo-,resorcin ,sulphonate1 ,the ,journal1 ,feb4 #aa1 #aiaa1 p4 #dda2 ,reports ,chem4 ,lab41 #aiaa1 p4 #ad4 ,bismuth1 ,opium and ,phenol ,tablets 7,hance ,bros4 ,white1 ,wm4 ,s4 ,merrell ,chemical ,co41 ,parke1 ,davis ,co41 ,sharp ,dohme1 ,f4 ,stearns ,co41 ,truax1 ,greene ,co41 ,h4 ,k4 ,wampole ,co41 ,wm4 ,r4 ,warner ,co471 ,the ,journal1 ,july #be1 #aijh1 p4 #ccj2 ,dec4 #ag1 #aiaj1 p4 #bafi2 ,may #f1 #aiaa1 p4 #acdd2 ,reports ,chem4 ,lab41 #aiji1 p4 #bh2 #aiaj1 p4 #he2 #aiaa1 p4 #bb4 ,bitter ,bark1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,bladder ,wrack1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,,blandine1 #afa ,blandine ,laxative1 ,mulford 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #acf4 ,blaud ,capsules and ,blaud ,arsenic and ,strychnine ,capsules1 ,frosst's 7,c4 ,e4 ,frosst ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afd4 ,,bliss1 ,,alonzo ,o41 ,,company1 #dfc ,blood ,tonic1 ,alterative 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,blue ,cohosh1 ,the ,journal1 ,sept4 #aa1 #aiae1 p4 #igb4 ,,boatman1 ,h4 ,f41 #dcf ,boneset1 ,tall1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,,boone1 ,,uriel ,s41 #cjg ,borolyptol 7,palisade ,mfg4 ,co471 ,the ,journal1 ,nov4 #ae1 #aiac1 p4 #ahab4 ,,bouma1 ,,dr41 ,,sugar-,,free ,,fat-,,milk1 #ddi ,,bovinine1 #abc1 #abe1 #abf ,,bovinine ,,company1 #abc ,,bradbury',s ,,eczema ,,lotion1 #bde ,,brant1 ,j4 ,w41 ,,company1 ,,ltd1 #daa ,,breads1 ,,various ,,diabetic1 #dej ,,breakfast ,,food1 ,,gum ,,gluten1 #dej ,,breitenbach1 ,m4 ,j41 ,,company1 #aei ,,bristol-,,myers ,,company1 #hg1 #agi ,brobor 7,gaynor-,bagstad ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afd4 ,bromides with ,cypripedium ,compound 7,truax1 ,greene ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,,bromides1 ,,peacock',s1 #bh ,,bromidia1 #ca ,,bromin-,,iodin ,,chemical ,,company ,,and ,,bromin-,,iodin ,,compound1 #bhe ,bromo-,mangan 7,reinschild ,chemical ,company71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afe4 ,broom ,corn1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,,brown',s ,,iron ,,bitters1 #bje ,,brown',s ,,iron ,,bitters ,,company1 #dc ,bruschettini ,curative ,vaccine 7,a4 ,bruschettini71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agf4 ,,brusson ,,chocolate ,,with ,,added ,,gluten1 #dej ,,buchu ,,and ,,hyoscyamus ,,comp41 ,,tyree',s ,,elixir1 #djg ,buchu and ,hyoscyamus ,compound1 ,tyree's ,elixir of 7,j4 ,s4 ,tyree71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afg4 ,buchu and ,pareira ,compound ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,buchu1 ,juniper and ,acetate ,potassium1 ,elixir of 7,pitman-,moore ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aff4 ,budwell's ,emulsion of ,cod-,liver ,oil1 ,nos4 #a and #b 7,budwell ,pharmacal ,company71 ,the ,journal1 ,feb4 #bj1 #aiae1 p4 #fhd2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ace4 ,,buffalo ,,lithia ,,water1 #dfg ,,buffalo ,,medical ,,journal1 ,,advertising ,,in1 #ca1 #ce1 #cjj ,,burnham',s ,,soluble ,,iodine1 #aaj1 #bcc ,,burnham',s ,,soluble ,,iodine ,,company1 #aaj ,,butters1 ,,various ,,diabetic1 #dej ,,cactin 7,,now ,,cactoid71 #cg ,cactin 7,the ,abbott ,laboratories7 and ,cactina 7,sultan ,drug ,company71 ,the ,journal1 ,sept4 #ba1 #aijg1 p4 #ajba2 ,march #ba1 #aijh1 p4 #ief2 ,april #d1 #aijh1 p4 #aadj2 ,aug4 #f1 #aiaj1 p4 #dee4 ,,cactina1 #cf ,,cactina ,,pillets1 #cg ,,cactus ,,grandiflorus1 #cf ,cactus ,grandiflorus1 ,the ,journal1 ,sept4 #ba1 #aijg1 p4 #ajba2 ,jan4 #g1 #aiaa1 p4 #bf4 ,calcidin ,abbott and ,calcidin ,tablets 7,the ,abbott ,laboratories71 ,the ,journal1 ,sept4 #g1 #aijg1 p4 #hfe2 ,reports ,chem4 ,lab41 #aiji1 p4 #g4 ,,calcreose1 #dj ,,callard',s ,,preparations ,,for ,,diabetics1 #dej ,,calmine1 #bhf ,,camphenol1 #bhg ,,campho-,,phenique1 #dj1 #bje ,,campho-,,phenique ,,company1 #dj1 #db ,,campho-,,phenique ,,powder1 #da ,,canada ,,lancet1 ,,advertising ,,in1 #bgi1 #cjj ,,canadian ,,medical ,,association ,,journal1 ,,advertising ,,in1 #cjj ,,canadian ,,practitioner ,,and ,,review1 ,,advertising ,,in1 #cjj ,,cancer ,,hospital 7,,kellam71 #dbf ,cannabis ,compound1 ,syrup of 7,pitman-,moore ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afh4 ,captol 7,mlhens ,kropff71 ,the ,journal1 ,sept4 #aj1 #aiaj1 p4 #iei2 ,reports ,chem4 ,lab41 #aiaj1 p4 #gj4 ,,carnine1 #abc1 #abe1 #abh ,,carnine ,,company1 #abc ,,carnrick1 ,g4 ,w41 ,,company1 #ahe1 #djc ,caroid and ,essence of ,caroid 7,mead1 ,johnson ,co471 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #aji4 ,,carpanutrine1 #acc ,casca-,aletris 7,pullen-,richardson ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,,cascarans 7,,bell71 #aed ,,cascarets1 #dge ,,casoid ,,diabetic ,,preparations1 #ddi1 #dej ,caviblen 7,a4 ,grimme71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agf4 ,cedron ,seed1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,,celerina1 #dc ,,cellarius ,,company1 #he ,celery and various ,elixirs of ,celery 7,hance ,bros4 ,white1 ,nelson1 ,baker ,co41 ,parke1 ,davis ,co41 ,ray ,chemical ,co41 ,smith1 ,kline ,french ,co41 ,f4 ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,cellasin 7,mead ,johnson ,co471 ,the ,journal1 ,sept4 #ab1 #aijh1 p4 #ica2 ,oct4 #cj1 #aiji1 p4 #adif2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #aih2 #aiji1 p4 #aah4 ,,cereo ,,soy ,,bean ,,gruel ,,flour1 #dej ,,chamaelirium ,,luteum1 #hd ,,chamberlain1 ,c4 ,s41 #ha ,,chambers1 ,,arthur ,,and ,,leslie ,t41 #adg ,,chambers1 ,j4 ,h4 ,,and ,m4 ,e41 #adf ,,chapoteaut',s ,,wine1 #fj ,,charlotte ,,medical ,,journal1 ,,advertising ,,in1 #ca1 #ce1 #dbb ,,chemische ,,fabrik ,,falkenberg1 #he ,,chesebrough1 ,,robert ,a41 #afa ,,chicago ,,medical ,,recorder1 ,,advertising ,,in1 #ca ,,chinosol1 #bdh ,,chinosol ,,company1 #bf1 #bdh ,chiodrastis 7,h4 ,k4 ,wampole ,co471 ,chionacea 7,nelson1 ,baker ,co41 ,inc471 ,elixir ,chionanthus ,compound 7,ray ,chemical ,co471 and ,elixir ,chionanthus 7,special7 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,,chionia1 #cj ,,chloro-,,phenique1 #db ,,chocolate1 ,,proprietary ,,diabetic1 #dej ,,chologen1 #bhh ,chologestin 7,f4 ,h4 ,strong ,co471 ,the ,journal1 ,dec4 #aa1 #aiae1 p4 #bajh4 ,chromiac ,tablets 7,maltbie ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,,cibilis ,,company1 #dgb ,,cineraria ,,maritima1 #di ,citarin 7,the ,bayer ,company1 ,inc471 ,the ,journal1 ,feb4 #bj1 #aiae1 p4 #fhe2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ace4 ,,citrocoll1 #he ,,clausel1 ,,henry1 ,,co41 #bba ,clover ,compound1 ,syrup ,red 7,nelson1 ,baker ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,,cocillana ,,compound1 ,,syrup ,,of1 #cif ,cod ,liver ,ext41 ,stearns' ,wine of1 with ,peptonate of ,iron 7,frederick ,stearns ,co474 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agg4 ,,cod ,,liver ,,oil ,,and ,,cod ,,liver ,,oil ,,cordials1 ,,comparative ,,nutrient ,,value ,,of1 #ddb ,cod-,liver ,oil1 ,budwell's ,emulsion of1 ,nos4 #a and #b 7,budwell ,pharmacal ,co471 ,the ,journal1 ,feb4 #bj1 #aiae1 p4 #fhd2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ace4 ,,cod ,,liver ,,oil ,,preparations1 #ea1 #eb1 #ed1 #eg1 #bhi1 #ddb ,cohosh1 ,blue1 and ,fluidextract ,blue ,cohosh ,compound 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,colchi-,methyl ,capsules 7,h4 ,k4 ,wampole ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afi4 ,,colchi-,,sal1 #eh ,,collyrium-,,wyeth1 #bib ,,columbus ,,pharmacal ,,company1 #cdd ,,comar ,,co41 #dja ,compound1 ,waterbury's 7,waterbury ,chemical ,co471 ,the ,journal1 ,march #bj1 #aiae1 p4 #ajaf2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ach4 ,condurango1 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #ed4 ,,conley1 ,,william ,w41 #di ,,consolidated ,,color ,,and ,,chemical ,,works1 #cbh ,,copeland1 ,b4 ,f41 #bff ,corydalis ,compound1 ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,,cosmoline1 ,,liquid1 #afa ,coto and ,cotoin1 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #ci4 ,,cotton-,,root ,,bark1 #hd ,,coudrey1 ,h4 ,m41 #aai ,,cramp ,,bark ,,compound1 ,,fluid ,,extract ,,of1 #daj ,,crawley1 ,m41 #aai ,,crysmalin1 #afa ,cuprase 7in 8,chemotherapy and ,tumors071 ,the ,journal1 ,april #ag1 #aiae1 p4 #abhc2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #bh4 ,,cudahy ,,packing ,,company1 #dga1 #dgb ,curare and ,curarin1 ,the ,journal1 ,jan4 #ae1 #aiaj1 p4 #bai2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #g4 ,,cypridol ,,capsules1 #ei ,cystitis ,tablet 7,parke1 ,davis ,co41 ,smith1 ,kline ,french ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,,cystogen1 ,,cystogen ,,aperient1 ,,cystogen-,,lithia ,,and ,,cystogen ,,chemical ,,company1 #fj ,,cysto-,,sedative1 #fa ,,dad ,,chemical ,,company1 #acf ,damiana1 ,allan's ,compound ,extract of 7,allan-,pfeiffer ,chemical ,co471 ,the ,journal1 ,july #ai1 #aiac1 p4 #baa4 ,,danderine1 #dgd ,,daniel1 ,,john ,b41 #ccb ,,daniel',s ,,concentrated ,,tincture ,,of ,,passiflora1 #aef1 #ccb ,,darpin1 #dg ,,dawson1 ,,james ,p41 #di ,,deeline1 #afa ,,denston1 ,j4 ,c41 #bea ,,denver ,,medical ,,times ,,and ,,utah ,,medical ,,journal1 ,,advertising ,,in1 #ca1 #ce1 #di ,,detroit ,,medical ,,journal1 ,,advertising ,,in1 #cjj ,diabetic ,biscuit and ,flour and other ,foods1 ,jireh 7,jireh ,diabetic ,food ,company71 ,the ,journal1 ,march #bb1 #aiac1 p4 #ibb1 and ,dec4 #ad1 #aiab1 p4 #bagd4 ,,diabetic ,,foods ,,offered ,,for ,,sale ,,in ,,the ,,united ,,states1 #ddf ,dianol ,i1 ,dianol ,,ii and ,dianol ,,iii 7,kalle ,co471 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #cd4 ,diastos1 ,liquor 7,h4 ,k4 ,mulford ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,,diatussin1 #bic ,,digalen1 #fh ,,dietetic ,,and ,,hygienic ,,gazette1 ,,advertising ,,in1 #cdb ,,digestive ,,tablets1 ,,aromatic1 #bbi ,digestive ,tonic 7,truax1 ,greene ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,digitalis preparations1 proprietary1 ,the ,journal1 ,dec4 #d1 #aiae1 p4 #bjbd2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #hi4 ,digitalone 7,parke1 ,davis ,co471 ,the ,journal1 ,june #ab1 #aiji1 p4 #aich2 ,dec4 #g1 #aiab1 p4 #bjgd2 ,jan4 #aa1 #aiac1 p4 #adc4 ,digitalysatum 7,e4 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,council ,pharm4 ,chem41 #aiaa1 p4 #ei4 ,,sanmetto1 #ahb ,,sanol ,,anti-,,diabetes ,,and ,,sanol ,,manufacturing ,,co41 ,,ltd4 1 #bii ,,satyria1 #bjb ,,saxol1 ,,liquid ,,saxoline1 #afa ,,schering ,,glatz1 #bjg1 #bbg1 #cdd ,scopolamin-,morphin ,mixtures1 ,the ,journal1 ,feb4 #e1 #aiaj1 p4 #ddf2 ,feb4 #ab1 #aiaj1 p4 #eaf2 ,june #g1 #aiac1 p4 #ahad2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #aa4 ,,scrofonol1 #dc ,scullcap ,compound1 ,fluidextract 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,,seabury ,,johnson1 #cjh1 #dgf ,,secretogen ,,elixir ,,and ,,tablets1 #ahe ,secretogen and ,elixir ,secretogen 7,g4 ,w4 ,carnrick ,co471 ,the ,journal1 ,jan4 #ae1 #aiaf1 p4 #agh2 ,reports ,council ,pharm4 ,chem41 p4 #ii4 ,sedobrol 8,roche0 7,hoffman-,la,roche ,chemical ,works71 ,the ,journal1 ,jan4 #b1 #aiae1 p4 #ga2 ,reports ,council ,pharm4 ,chem41 #aiad4 ,selenium compounds 7in 8,chemotherapy and ,tumors071 ,the ,journal1 ,april #ag1 #aiae1 p4 #abhc2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #bh4 ,semprolin 7,w4 ,browning ,co471 ,the ,journal1 ,july #aj1 #aiae1 p4 #age4 ,,seneka ,,oil1 #afa ,seng 7,sultan ,drug ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #abi4 ,,septicide1 #dac ,serum ,vaccine1 ,bruschettini 7,r4 ,g4 ,berlingieri71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abg4 ,seven-,bark1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,,sevetol1 #cec1 #cee ,,shac1 #dgf ,,sharp ,,dohme1 #acc1 #bca1 #dgf ,,sinkina1 #adi1 #aej1 #aea1 #ahh ,sirolin 7,sirolin ,co471 ,the ,journal1 ,june #ba1 #aiac1 p4 #aigd4 ,,smith ,,bile ,,beans ,,co4 ,,and ,,smith',s ,,bile ,,beans1 #dc ,,smith1 ,,charles ,b41 #aee ,,smith1 ,,kline ,,and ,,french ,,co41 #daj ,,smith1 ,,martin ,h41 ,,co41 #hb1 #hh ,,society ,,of ,,chemical ,,industry1 #agh ,,soja ,,bean ,,meals1 #dej ,,somnalgesine1 #ccc ,,somnos1 #aic ,sourwood and ,sourwood ,elixirs 7,eli ,lilly ,co4 and ,parke1 ,davis ,co471 ,reports ,council ,pharm4 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,mulford ,co41 ,parke1 ,davis ,co41 ,ray ,chemical ,co4 and ,smith1 ,kline ,french ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 pp4 #db1 #dg4 ,stone ,root1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,,strong1 ,,cobb ,,co41 #fa1 #ha ,strychnin ,arsenate1 ,the ,journal1 ,sept4 #bd1 #aiaj1 p4 #aabh2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #gd4 ,,succus ,,alterans1 #aie ,,succus ,,cineraria ,,maritima 7,,walker71 #ej ,sugar ,cane1 ,chinese1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,,sulpho-,,lythin1 #aif ,,sultan ,,drug ,,company1 #cg1 #agh1 #cdd ,,suspensory1 ,o-,p-,c1 #dcf ,,swaim',s ,,panacea1 #bje ,,swain',s ,,all-,,healing ,,ointment ,,and ,,swain',s ,,laboratory1 #dc ,swan's ,rheumatic ,bacterin 7,mixed7 ,no4 #dg 7,swan-,myers ,co471 ,the ,journal1 ,nov4 #f1 #aiae1 p4 #affb2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afj4 ,,swift ,,co41 #dga ,,synergia1 #bca ,,syrup ,,of ,,cocillana ,,compound1 #cif ,,syrup ,,of ,,hydriodic ,,acid1 ,,gardner',s1 #ig ,,syrup ,,of ,,lactucarium1 ,,aubergier',s1 #cii ,syrup of ,malt1 ,williams' 7,american ,malt ,extract ,co471 ,the ,journal1 ,sept4 #d1 #aiae1 p4 #hie4 ,,szendeffy1 ,,dr4 ,r4 ,,de1 #gd ,tablogestin 7,f4 ,h4 ,strong ,co471 ,the ,journal1 ,dec4 #aa1 #aiae1 p4 #bajh4 ,,taka-,,diastase ,,and ,,liquid ,,taka-,,diastase1 #fb ,tannyl 7,charles ,goslar71 ,reports ,chem4 ,lab41 #aiab1 p4 #ajh4 ,,tartarlithine ,,and ,,tartarlithine ,,co41 #dja ,,taurocol ,,tablets ,,and ,,compound ,,tablets1 #aih ,,tennant1 ,,george ,c41 #aee ,,terralbolia1 ,,terraline1 ,,names ,,for ,,liquid ,,petrolatum1 #afa ,,texas ,,medical ,,journal1 ,,advertising ,,in1 #ca1 #ce1 #di ,,texas ,,medical ,,news1 ,,advertising ,,in1 #ca1 #ce ,,thalosen1 #cdd ,,theobromin ,,sodium ,,salicylate ,,versus ,,diuretin1 #bea ,,therapeutic ,,gazette1 ,,advertising ,,in1 #ca1 #ce ,,therapeutic ,,record1 ,,advertising ,,in1 #bgi1 #cjj ,,thialion1 #bje ,thiocol and ,syrup ,thiocol-,roche 7,hoffmann-,la ,roche ,chemical ,works71 ,the ,journal1 ,june #ba1 #aiac1 p4 #aigd2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #af4 ,thioform 7,otto ,hann ,bro471 ,reports ,chem41 ,lab41 #aiji1 p4 #gi4 ,,thompson',s ,,malted ,,food ,,co41 #cai ,,thoxos1 #djb ,,three ,,chlorides 7,,henry71 #aih1 #bja ,,tilden ,,co41 #bce1 #cbi ,,toledo ,,medical ,,and ,,surgical ,,reporter1 ,,advertising ,,in1 #bif ,tonga and various tonga preparations 7,hance ,bros4 ,white1 ,eli ,lilly ,co41 ,william ,s4 ,merrell ,chemical ,co41 ,nelson1 ,baker ,co41 ,parke1 ,davis ,co41 ,ray ,chemical ,co41 ,sharp ,dohme1 ,f4 ,stearns ,co41 ,william ,r4 ,warner ,co4 and ,h4 ,k4 ,wampole ,co471 ,the ,journal1 ,may #aj1 #aiac1 p4 #adgh2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,tongaline and ,tongaline ,tablets 7,mellier ,drug ,co471 ,the ,journal1 ,july #ag1 #aiae1 p4 #bfi2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #eh4 ,,tonic ,,beef1 ,s4 ,d41 #acc ,toxinol 7,hughes ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,,tri-,,iodides1 #aih1 #aii ,trifolium preparations1 various 7,hance ,bros4 ,white1 ,eli ,lilly ,co41 ,william ,s4 ,merrell ,chemical ,co41 ,h4 ,k4 ,mulford ,co41 ,parke1 ,davis ,co41 ,ray ,chemical ,co4 and ,f4 ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 pp4 #ci1 #dj4 ,trilene ,tablets1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,trophonine 7,reed ,carnrick ,co471 ,the ,journal1 ,oct4 #e1 #aijg1 p4 #aaih2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #gi4 ,,truax1 ,,greene ,,co41 #bca ,,trypsogen1 #djc ,tubercle ,vaccine1 ,non-,virulent1 ,sherman's 7,g4 ,h4 ,sherman71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abh4 ,tuberculin ,test ,plate1 ,keller's 7,a4 ,h4 ,keller71 ,the ,journal1 ,dec4 #ai1 #aiad1 p4 #bbej4 ,tuberculoids 7,columbus ,pharmacal ,company71 ,the ,journal1 ,feb4 #bb1 #aijh1 p4 #gjd4 ,tubo-,arg 7,tubo ,pharmacal ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #age4 ,turkey ,corn1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,,turner1 ,f4 ,m41 ,,and ,,the ,,dr4 ,,turner ,,co41 #baa ,,tyree1 ,j4 ,s41 #ba1 #dje ,,tyree',s ,,antiseptic ,,powder1 #ba1 #djd ,,tyree',s ,,elixir ,,buchu ,,and ,,hyoscyamus ,,comp41 #djg ,tyree's ,elixir of ,buchu and ,hyoscyamus ,compound 7,j4 ,s4 ,tyree71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afg4 ,ulax ,salt 7,f4 ,h4 ,strong ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #age4 ,,unguentine1 #bed ,,unguentum ,,selenio ,,vanadic 7,v4 ,,roemer71 #bjg ,,unicorn ,,root1 #bjh ,,united ,,states ,,health ,,reports1 #dcc ,,upjohn ,,co41 #cdd ,uranoblen 7,a4 ,grimme71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agf4 ,urasol 7,organic ,chemical ,mfg4 ,co471 ,the ,journal1 ,sept4 #e1 #aijh1 p4 #hah2 ,may #h1 #aiji1 p4 #aeaa2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #aff2 #aiji1 p4 #fd4 ,,uric ,,acid ,,monthly1 #bjg ,,uricedin1 #bef ,uricsol 7,uricsol ,chemical ,co471 ,the ,journal1 ,aug4 #ad1 #aiae1 p4 #fch2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #adi4 ,,uriseptin1 #bef ,urodonal 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,aug4 #ad1 #aiae1 p4 #fci2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aec4 ,uron 7,uron ,chemical ,company71 ,the ,journal1 ,nov4 #c1 #aijf1 p4 #aejj2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #bf4 ,,usoline1 #afa ,,uterine ,,sedative ,,elixir1 #daj ,uterine ,sedative1 ,elixir 7,eli ,lilly ,co471 ,the ,journal1 ,aug4 #ca1 #aiab1 p4 #gce2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,uterine tonics1 various 7,abbott ,alkaloidal ,co41 ,girard ,chemical ,co41 ,maltbie ,chemical ,co41 ,h4 ,k4 ,mulford ,co41 ,nelson1 ,baker ,co41 ,parke1 ,davis ,co4 and ,f4 ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 pp4 #da1 #df4 ,,uterine ,,wafers1 ,,micajah',s ,,medicated1 #bdj ,vaccine1 ,curative1 ,bruschettini 7,a4 ,bruschettini71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agf4 ,vaccine1 ,friedmann's 7,standard ,distributing ,co471 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #acf4 ,,vaccine1 ,,mixed1 #cdf ,vaccine1 ,non-,virulent ,tubercle ,bacillus 7,g4 ,h4 ,sherman71 ,the ,journal1 ,sept4 #bj1 #aiac1 p4 #igi4 ,,valentine1 ,m4 ,j41 #abc ,,valentine',s ,,meat ,,juice1 #abc1 #abe1 #abi ,,valentine',s ,,meat ,,juice ,,co41 #dgb ,vanadic ,acid1 ,the ,journal1 ,may #i1 #aijh1 p4 #aedh2 ,july #bd1 #aiji1 p4 #cji4 ,,vanadiol1 ,,vanadioseptol ,,and ,,vanadium ,,solution ,,for ,,intravenous ,,and ,,hypodermic ,,use1 #bji ,vanadium1 ,the ,journal1 ,june #c1 #aiaa1 p4 #afdh4 ,,vanadium ,,chemical ,,co41 #bja1 #baa ,,vanadoforme1 #baj ,,vapo-,,cresolene1 #djh ,,vaseline1 ,,liquid1 #afa ,,vasogen1 #djh ,,vass ,,chemical ,,co41 #bje ,,venarsen1 #bab ,,venodine1 #bad ,,veracolate1 #baf1 #cdd ,,vermont ,,medical ,,monthly1 ,,advertising ,,in1 #ce ,veroform ,germicide 7,veroform ,hygienic ,co471 ,the ,journal1 ,nov4 #bb1 #aiac1 p4 #aibj4 ,,vial1 ,,new ,,york ,,laboratories ,,of1 #ei ,viburn-,ovaro 7,ray ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,,viburnum ,,compound1 ,,elixir ,,of1 #daj ,,viburnum ,,compound1 ,,hayden',s1 #bah1 #dji ,viburnum preparations1 various 7,fraser ,tablet ,co41 ,parke1 ,davis ,co4 and ,smith1 ,kline ,french ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,,viburnumal1 #daj ,,vibutero1 #daj ,,vigoral1 #dgb ,,vin ,,mariani1 #bba ,,vinol1 #ddc ,vinum ,ext4 ,morrhuae1 ,stearns 7,frederick ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agg4 ,,virginia ,,medical ,,semi-,,monthly1 ,,advertising ,,in1 #aca ,,virol ,,and ,,virol1 ,,ltd41 #bbe ,,vitaopathy1 #dge ,,walker ,,pharmacal ,,co41 #ej1 #bch1 #bdj ,,walker1 ,,will ,e41 #ah ,,wallau1 ,,george ,j41 ,,inc41 #ajf ,,wampole1 ,,henry ,k41 ,,co41 ,,inc41 #bf1 #eb ,,wampole',s ,,perfected ,,and ,,tasteless ,,preparation ,,of ,,an ,,extract ,,of ,,cod ,,liver1 #eb1 #ddc ,,warner1 ,w4 ,r41 ,,co41 #aja ,water ,eryngo1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,,waterbury ,,chemical ,,co41 #ed1 #eg1 #dfc ,,waterbury',s ,,compound1 #ed1 #eg1 #bia1 #ddc ,,western ,,canada ,,medical ,,journal1 ,,advertising ,,in1 #cjj ,,wheeler ,,chemical ,,works1 #bde ,,wheeler',s ,,nerve ,,vitalizer1 #daa ,whiteruss 7,lubric ,oil ,co471 ,the ,journal1 ,july #aj1 #aiae1 p4 #age4 ,white ,sulphur ,salts 7,white ,sulphur ,springs1 ,inc471 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad4 ,,whiting',s ,,sugar-,,free ,,milk1 #ddi ,,whitney1 ,f4 ,,waldo1 #agd ,,wild ,,indigo1 #bji ,,wild ,,yam1 #bjh ,williams' ,syrup of ,malt 7,american ,malt ,extract ,co471 ,the ,journal1 ,sept4 #d1 #aiae1 p4 #hie2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aee4 ,,wine1 ,,chapoteaut',s1 #fj ,wine of ,cod ,liver ,ext4 with ,peptonate of ,iron1 ,stearns' 7,frederick ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agg4 ,,wisconsin ,,medical ,,recorder1 ,,advertising ,,in1 #ca1 #ce ,,woman',s ,,medical ,,journal1 ,,advertising ,,in1 #ca1 #di ,,wyeth',s ,,beef ,,juice1 #abc1 #abe1 #abf ,,wyeth1 ,,john1 ,,brother1 #abc1 #acc1 #bei1 #bib1 #ced1 #djb1 #dgb ,xanol 7,wm4 ,s4 ,merrell ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #fd4 ,,yam1 ,,wild1 #bjh ,yogurt 7,yogurt ,co471 ,the ,journal1 ,jan4 #cj1 #aiji1 pp4 #cgb1 #cig4 ,,zemacol1 #bei ,,zymotoid1 #dab ,,zyme-,,oid1 #bfa ,,zymole ,,trokeys1 #dgf ,,zumota1 #dcf ,spelling inconsistencies3 quinin_/quinine soluble_/solubile_/soluable glucosid_/glucoside peroxid_/peroxide oxid_/oxide ,hydrastin_/,hydrastine small-pox_/smallpox protochlorid_/protochloride narcotin_/narcotine anilpyrine_/anilipyrine vender_/vendor chemic_/chemical strychnin_/strychnine pseudo-scientific_/pseudoscientific semi-secret_/semisecret beta-naphthol_/betanaphthol to-day_/today acetyl-salicylic_/acetysalicylic indorse_/endorse indorsement_/endorsement gm4_/,gm4 ,spelling corrections3 folowing -- following wafer -- water ,amedemin -- ,anedemin ,prepration -- ,preparation he -- the decription -- description administation -- administration oven -- even test -- tests constitutent -- constituent iutensive -- intensive accurary -- accuracy ,helionas -- ,helonias ,phamacopeia -- ,pharmacopeia cancerns -- concerns repiration -- respiration commitee -- committee ampoules -- ampules fradulent -- fraudulent ,thp -- ,the ,diastate -- ,diastase diminshed -- diminished acetphenentidin -- acetphenetidin #a1afi -- #a1ffi 7in table7 effciency -- efficiency that -- than thought -- bought ,furthemore -- ,furthermore bareley -- barley acetphentidin - acetphenetidin prramidon -- pyramidon valuless -- valueless containg -- containing ,american -- ,america article -- articles nessary -- necessary out -- our strotium -- strontium sercretin -- secretin radicles -- radicals ,speciment -- ,specimen atained -- attained wo -- woe wounders -- wonders lives -- livers matire -- matire ,geseundhitslehrer -- ,geseundheitslehrer readibly -- readily alkoloids -- alkaloids is -- it methol -- menthol amyolytic -- amylolytic