,transcriber's notes3 ,in this transcription1 paired underscores denote italicised text and a indicates a superscripted character4 ,a downward arrow preceding curly brackets indicates that the bracketed character7s7 are subscripted1 e4g4 ,h4 ,the text contains some 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such as ,arial ,unicode ,,ms1 ,deja,vu1 ,segoe ,,ui ,symbol or ,free,serif4 ,symbols representing male and female have been replaced by ,m and ,f in the handheld version4 ,subscripted and superscripted characters do not always display correctly on handheld devices4 ,the book contained innumerable typographical errors affecting spelling1 punctuation and formatting4 ,most spelling errors have been corrected silently1 but spelling variants that mainly reflect contemporary spellings in the original quoted sources1 have been left unchanged4 ,a list of the corrections and variations can be seen at the end of the transcription4 ,punctuation anomalies 7errors1 omissions1 duplications7 have mostly been corrected silently1 but missing apostrophes have not been corrected because of uncertainty about intended meaning4 ,a few missing quotation marks have been inserted within curly brackets and missing words inserted by the transcriber1 e4g4 sic and have also been enclosed within curly brackets to differentiate them from the numerous words and phrases inserted by the authors4 ,redundant duplicated words have been deleted4 ,astute readers will probably note persisting inconsistencies involving italics1 fonts1 hyphenation1 ellipses1 accents1 and ligatures 7ae_/1 oe_/7 that have been left unchanged because they have no impact on interpretation of the text4 ,the ,table of ,contents does not correspond accurately with headings used in the text4 ,footnotes are generally located below the relevant paragraphs2 however1 footnotes that are cross-referenced multiple times have not been duplicated4 ,an error in footnote numbering was corrected silently1 and a missing footnote #abj was inserted after being identified in the original source4 ,over-sized tables have been compressed and where appropriate a key has been inserted to assist the reader4 ,,the ,,propaganda ,,for ,,reform ,,in ,proprietary ,medicines ,,volume #b ,part ,i ,reports of the ,council ,part ,,ii ,contributions from the ,laboratory ,part ,,iii ,journal ,contributions3 ,proprietary ,products ,part ,,iv ,journal ,contributions3 ,miscellany ,,press ,,of ,,american ,,medical ,,association1 ,,five ,,hundred ,,and ,,thirty-,,five ,,north ,,dearborn ,,street1--,,chicago #aibb ,,copyright1 #aibb ,,by ,,the ,,american ,,medical ,,association ,,preface ,,to ,,volume #b ,there were nine editions of the first volume of ,the ,propaganda for ,reform in ,proprietary ,medicines4 ,the ninth edition contained the most important reports of the ,council on ,pharmacy and ,chemistry and of the ,chemical ,laboratory4 ,it contained also those articles from ,the ,journal of the ,american ,medical ,association 7up to1 and including1 #aiaf7 which dealt with the problems of proprietaryship in medicine and the furtherance of rational drug therapy4 ,the present volume contains similar material covering the period from ,january1 #aiag1 to ,april1 #aibb1 inclusive4 ,like ,volume #a1 this volume is divided into four parts3 ,part ,i4 ,,the ,,council ,,on ,,pharmacy ,,and ,,chemistry3 ,this section presents the principles and rules which govern the ,council in the examination of medicaments1 together with articles and reports bearing on the work of the ,council1 and the most important reports of the ,council from #aiag to ,april1 #aibb1 inclusive4 ,part ,,ii4 ,,the ,a4 ,m4 ,a4 ,,chemical ,,laboratory3 ,this section1 besides presenting the aims and objects of the ,association's ,chemical ,laboratory1 also outlines some of the ,laboratory's work which is of particular interest to physicians4 ,part ,,iii4 ,,contributions ,,from ,,the ,,journal3 ,proprietary ,products3 ,this part contains articles on proprietary medicinal preparations and the methods by which they are exploited1 which have appeared in ,the ,journal ,a4 ,m4 ,a4 ,part ,,iv4 ,,contributions ,,from ,,the ,,journal3 ,,miscellany3 ,in this section are articles dealing with matters of interest to the medical profession but not coming strictly under the classification of proprietary medicinal preparations4 ,a comparison of the material that has appeared in ,volume #a of ,the ,propaganda for ,reform with that which appears in this volume will reveal the changing conditions in the proprietary medicine field4 ,many of the reports in the first volume brought out the fact that medicinal preparations were at that time foisted on the profession with false claims of composition2 reports of this character are less conspicuous in the present volume4 ,many of the reports in ,volume #b deal with unwarranted therapeutic claims1 especially those advanced for animal organ preparations1 serums1 vaccines1 preparations for intravenous medication1 etc4 ,the present volume will also be found of interest in its portrayal of the changed conditions in the proprietary medicine business brought about by the ,world ,war4 ,special attention is directed to the index in this volume4 ,it is1 in effect1 a bibliography1 including references not only to articles in this book but also 7#a7 to articles which appeared in ,volume #a2 7#b7 to articles on the same general subject in ,the ,journal of the ,american ,medical ,association1 and 7#c7 to the articles appearing in the annual reports of the ,council on ,pharmacy and ,chemistry and of the ,a4 ,m4 ,a4 ,chemical ,laboratory1 but not reprinted in either volume of the ,propaganda for ,reform in ,proprietary ,medicines4 ,,preface ,,to ,,volume #a3 ,,ninth ,,edition ,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 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 public1 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 ,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 ,,resolution ,,endorsing ,,the ,,work ,,of ,,the ,,council ,,on ,,pharmacy ,,and ,,chemistry ,presented at the ,san ,francisco ,session and ,signed by ,all the ,members of the ,house of ,delegates in ,attendance ---------------------------------------- --------------------------- ,resolved1 ,we1 ,members of the ,house of ,delegates of the ,american ,medical ,association1 believe that every effort must be made to do away with the evils which result from the exploitation of the sick for the sake of gain4 ,earnestly believing that the continued toleration of secret1 semisecret1 unscientific or untruthfully advertised proprietary medicines is an evil that is inimical to medical progress and to the best interest of the public1 we declare ourselves in sympathy with1 endorse and by our best efforts will further1 the work which has been1 and is being1 done by the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association in the attempt to eliminate this evil4 ---------------------------------------- --------------------------- ,,table ,,of ,,contents ,,part ,i3 ,,council ,,reports ,,page ,foreword #a ,official ,rules of the ,council on ,pharmacy and ,chemistry #c ,the ,council on ,pharmacy and ,chemistry1 ,present and ,future #ab 8,accepted by the ,council on ,pharmacy and ,chemistry0 #ai ,helping the ,council #bj ,delays in ,passing on ,products #bj ,cooperation of the ,pharmaceutical ,houses #ba ,budwell's ,emulsion of ,cod-,liver ,oil1 ,nos4 #a and #b #bb ,rheumalgine #bc ,gray's ,glycerine ,tonic #bd ,tongaline and ,ponca ,compound #bf ,alfatone #bh ,uricsol #cj ,jubol #ca ,urodonal #cb ,formamint #cc ,hydragogin #da ,filudine #da ,lactopeptine and ,elixir ,lactopeptine #dc ,iodum-,miller and ,iod-,izd-,oil 7,miller's7 #di ,elixir ,iodo-,bromide of ,calcium ,comp4 8,without ,mercury0 and 8,with ,mercury0 #eb ,lecithin ,preparations ,omitted from ,n4 ,n4 ,r4 #ec ,proprietary ,names for ,liquid ,petrolatum #ee ,seng #ee ,frosst's ,blaud ,capsules #ef ,tyree's ,elixir of ,buchu and ,hyoscyamus ,compound #eg ,hydroleine #eh ,curative ,vaccine1 ,bruschettini #eh ,stearn's ,wine #ei ,protonuclein and ,protonuclein ,beta #ei ,hydropsin #fa ,digitalysatum #fc ,so-,called ,secretin ,preparations #fd ,has ,secretin a ,therapeutic ,value8 #fe ,radio-,rem #gi ,olio-,phlogosis #gi ,the ,hypophosphite ,fallacy #hj ,pulvoids ,calcylates #he ,sulfuryl ,monal #hf ,mark ,white ,goiter ,serum and ,mark ,white ,iodinized ,oil #hg ,kora-,konia #ib ,the ,therapeutic ,value of the ,glycerophosphates #ic ,hydras #if ,bromin-,iodin ,compound #ig ,ammonium ,hypophosphite ,omitted from ,n4 ,n4 ,r4 #ih ,alphozone ,omitted from ,n4 ,n4 ,r4 #ii ,calcium ,glycerophosphate and ,sodium ,glycerophosphate ,omitted from ,n4 ,n4 ,r4 #ii ,gardner's ,syrup of ,ammonium ,hypophosphite ,omitted from ,n4 ,n4 ,r4 #ajj ,gluten ,products ,made by the ,kellogg ,food ,company #ajj ,iodo-,mangan ,omitted from ,n4 ,n4 ,r4 #ajf ,liquid ,albolene #ajf ,naphey's ,medicated ,uterine ,wafers #ajg ,nujol #ajh ,pulvoids ,natrium ,compound #ajh ,saloform #aaj ,secretogen #aaj ,iron ,citrate ,green #aae ,aspirin #aaf ,pil4 ,cascara ,compound-,robins #aag ,casta-,flora #aah ,firwein #aai ,firolyptol ,plain and ,firolyptol with ,kreosote #abj ,biniodol #aba ,comparative ,symptoms ,resulting from the ,use of ,several ,oily ,suspensions of ,red ,mercuric ,iodid 7,mercury ,biniodid7 #abc ,corpora ,lutea 7,soluble ,extract71 ,parke1 ,davis ,co4 #abh ,wheeler's ,tissue ,phosphates #abi ,the ,claimed ,galactagogue ,effects of ,nutrolactis and ,goat's ,rue ,not ,substantiated #aca ,the ,alleged ,galactagogue ,action of ,galega and ,nutrolactis #aca ,the ,russell ,emulsion and the ,russell ,prepared ,green ,bone #acd ,brom-,i-,phos #acf ,creosote-,delson and ,creofos #acg ,triner's ,american ,elixir of ,bitter ,wine #aci ,trimethol #adj ,ferrivine1 ,intramine and ,collosol ,iodine #add ,eskay's ,neuro ,phosphates #adf ,k-,y ,lubricating ,jelly #adg ,ziratol #adh ,gonosan #aej ,alcresta ,ipecac #aec ,iodeol and ,iodagol #aed ,capsules ,bismuth ,resorcinol ,compound ,not ,admitted to ,n4 ,n4 ,r4 #aeg ,dixon's ,tubercle ,bacilli ,extract and ,dixon's ,suspension of ,dead ,tubercle ,bacilli #aeh ,formosol #aeh ,iodolene1 a ,solution of ,iodin in ,liquid ,petrolatum1 ,inadmissible to ,n4 ,n4 ,r4 #aei ,kalak ,water #afj ,minson's ,soluble ,iodin 8,kelpidine0 ,not ,admitted to ,n4 ,n4 ,r4 #afa ,nutone #afb ,tri-,arsenole1 ,l4 ,o4 ,compound ,no4 #a and ,l4 ,o4 ,compound ,no4 #b #afc ,unctol #aff ,v-,e-,m 7,schoonmaker ,laboratories1 ,inc47 #aff ,hemo-,therapin #afh ,venosal #afi ,secretin-,beveridge and the ,u4 ,s4 ,patent ,law #agj ,the ,question of the ,stability of ,secretin #aga ,need for ,patent ,law ,revision #agg ,surgodine #ahj ,medeol ,suppositories #aha ,guaiodine #ahc ,several 8,mixed0 ,vaccines ,not ,admitted to ,n4 ,n4 ,r4 #ahd ,ophthalmol-,lindemann #ahi ,silvol ,ineligible for ,n4,n4,r #ahi ,katharmon #aia ,iodinized ,emulsion 7,scott7 and ,creosotonic 7,scott7 #aib ,campetrodin and ,campetrodin ,no4 #b #aic ,carminzym #aid ,phillips' ,phospho-,muriate of ,quinine ,comp #aig ,b4 ,iodine and ,b4 ,oleum ,iodine #aih ,b4 ,iodine ,products #aii ,antithyroid ,preparations 7,antithyroidin-,moebius and ,thyreoidectin7 ,omitted from ,n4 ,n4 ,r4 #bjb ,cephaelin and ,syrup ,cephaelin-,lilly ,omitted from ,n4 ,n4 ,r4 and ,syrup ,emetic-,lilly ,not ,accepted #bjc ,colalin ,omitted from ,n4 ,n4 ,r4 #bjc ,foral #bjd ,granular ,effervescent ,bromide and ,acetanilid ,compound-,mulford #bjf ,holadin and ,bile ,salt ,mixtures #bjg ,liquor ,santaiva1 ,s4 ,d41 ,omitted from ,n4 ,n4 ,r4 #baa ,maltzyme1 ,maltzyme with ,cascara ,sagrada1 ,maltzyme with ,cod ,liver ,oil1 ,maltzyme ,ferrated and ,maltzyme with ,yerba ,santa ,omitted from ,n4 ,n4 ,r4 #baa ,methaform ,omitted from ,n4 ,n4 ,r4 #bab ,pineal ,gland1 ,red ,bone-,marrow and ,thymus ,gland and ,their ,preparations ,omitted from ,n4 ,n4 ,r4 #bac ,piperazine and ,lycetol ,omitted from ,n4 ,n4 ,r4 #bad ,stanolind ,liquid ,paraffin ,omitted from ,n4 ,n4 ,r4 #bad ,westerfield's ,digitalis ,tablets #bae ,xeroform-,heyden and ,bismuth ,tribromphenate-,merck ,omitted from ,n4 ,n4 ,r4 #baf ,cream of ,mustard ,refused ,recognition #bah 8,pluriglandular0 ,mixtures #bah ,cerelene ,not ,admitted to ,n4 ,n4 ,r4 #bai ,collosol ,cocaine ,not ,admitted to ,n4 ,n4 ,r4 #bba ,cuprase ,not ,admitted to ,n4 ,n4 ,r4 #bbb ,collosol ,preparations #bbc ,pulvoids ,calcylates ,compound #bbf ,proteogens of the ,wm4 ,s4 ,merrell ,company #bbg 8,arsenoven ,s4 ,s40 and 8,arseno-,meth-,hyd0 #bca ,hormotone and ,hormotone ,without ,post-,pituitary #bcd ,formaldehyde ,lozenges #bce ,lavoris #bcg ,medinal #bci ,omission of ,cotarnin ,salts 7,stypticin and ,styptol7 from ,n4 ,n4 ,r4 #bdj ,micajah's ,wafers and ,micajah's ,suppositories #bda ,alkalithia #bdb ,arhovin ,omitted from ,n4 ,n4 ,r4 #bdc ,chloron1 ,chlorax and ,number 8#c0 #bdd ,elarson ,omitted from ,n4 ,n4 ,r4 #bdh ,iodiphos #bdi ,mervenol and ,armervenol ,not ,admitted to ,n4 ,n4 ,r4 #bdi ,normal ,phenol ,serum 7,cano7 and ,methyl-,phenol ,serum 7,cano7 ,not ,accepted for ,n4 ,n4 ,r4 #bea ,soamin ,omitted from ,n4 ,n4 ,r4 #bec ,some ,mixed ,vaccines ,not ,admitted to ,n4 ,n4 ,r4 #bed ,somnoform #bee ,tablets ,formothalates #bef ,triple ,arsenates with ,nuclein #bef 8,anti-,pneumococcic ,oil0 and the ,use of ,camphor in ,pneumonia #beg ,dial 8,ciba0 #bei ,apothesine #bfj ,eumictine #bfb ,platt's ,chlorides #bfc ,anti-,tuberculous ,lymph ,compound 7,sweeny7 and ,anti-,syphilitic ,compound 7,sweeny7 #bff ,syrup ,leptinol 7,formerly ,syrup ,balsamea7 #bfh ,formitol ,tablets1 ,,ii #bga ,sukro-,serum and ,aphlegmatol #bgc ,supsalvs ,not ,admitted to ,n4 ,n4 ,r4 #bgd ,hypodermic ,solution ,no4 #ac1 ,iron1 ,arsenic and ,phosphorus ,compound ,not ,accepted for ,n4 ,n4 ,r4 #bge ,parathesin ,not ,admitted to ,n4 ,n4 ,r4 #bgf ,chlorlyptus #bgg ,aquazone 7,oxygen ,water7 #bij ,coagulen-,ciba ,omitted from ,n4 ,n4 ,r4 #bij ,ferric ,cacodylate ,omitted from ,new and ,non-,official ,remedies #bib ,libradol #bic ,helmitol ,omitted from ,n4 ,n4 ,r4 #bie ,spirocide ,not ,admitted to ,n4 ,n4 ,r4 #bif ,digifolin-,ciba ,not ,admitted to ,n4 ,n4 ,r4 #bih ,some of ,loesser's ,intravenous ,solutions #bii 8,national ,iodine ,solution0 ,not ,admitted to ,n4 ,n4 ,r4 #cjj ,mon-,arsone ,not ,admitted to ,n4 ,n4 ,r4 #cjb ,oxyl-,iodide ,not ,admitted to ,n4 ,n4 ,r4 #cjd ,quassia ,compound ,tablets #cjf ,toxicide #cjg ,pil4 ,mixed ,treatment 7,chichester7 #caj ,atophan ,omitted from ,n4 ,n4 ,r4 #cac ,urotropin ,omitted from ,n4 ,n4 ,r4 #caf ,styptysate ,not ,admitted to ,n4 ,n4 ,r4 #cah ,lipoidal ,substances 7,horovitz7 ,not ,admitted to ,n4 ,n4 ,r4 #cbj ,yeast ,preparations and ,vitamin ,b ,concentrates #cba ,,part ,,ii3 ,,contributions ,,from ,,the ,a4 ,m4 ,a4 ,,chemical ,,laboratory ,the ,chemical ,laboratory of the ,american ,medical ,association #cbb ,the ,work of the ,american ,medical ,association ,chemical ,laboratory #cbb ,lead in 8,akoz0 #cbh ,sodium ,acetate in ,warming ,bottles #cbi ,anti-,syphilitic ,compound 7,sweeny7 #ccj 8,ambrine0 and ,paraffin ,films #ccj ,the ,stability of ,iodine ,ointments #ccg ,iodolene and the ,solubility of ,iodin in ,liquid ,petrolatum #cdd ,american-,made ,synthetic ,drugs--,i #cdd ,standardization of ,commercial ,bismuth ,tribromphenate #cdh ,standardization of ,procain and ,examination of the ,market ,supply #cee ,deterioration of ,sodium ,hypochlorite ,solutions #ceh ,syphilodol #cei ,cerelene #cfb ,dr4 ,de ,sanctis' ,rheumatic and ,gout ,pills #cfc ,iodex and ,liquid ,iodex #cfe ,,part ,,iii3 ,,contributions ,,from ,,the ,,journal3 ,,proprietary ,,products ,iodin in ,liquid ,petrolatum #cfg ,american-,made ,synthetic ,drugs--,,ii #cfi ,nostrums in ,retrospect #cgi ,bell-,ans 7,pa-,pay-,ans ,bell7 #chj ,anasarcin and ,anedemin #chc ,pepto-,mangan #chg ,cactina ,pillets #cia ,ammonol and ,phenalgin #cic ,fellows' ,syrup1 and ,other ,preparations of the ,hypophosphites #cie ,shotgun ,nostrums #cih ,tyree's ,antiseptic and ,aseptinol #dja ,neurosine and the ,original ,package ,evil #djd ,anasarcin ,advertising #djg ,antimeristem-,schmidt #djh ,antiphlogistine #dji 8,auto-,hemic ,serum0 #dji 8,autolysin0 ,advertising #dac 8,basic ,cancer ,research0 and 8,cosmopolitan ,cancer ,research ,society0 #dad ,seleni-,bascca #daf ,bell-,ans 7,papayans1 ,bell7 #dah ,campho-,phenique #dah 8,cinchophen03 ,formerly 8,atophan0 #dai 8,collosols03 ,an ,uncritical ,english ,endorsement #dbj ,cotton ,process ,ether #dba ,dionol #dbb ,the ,eli ,products of ,eli ,h4 ,dunn #dbd ,glover's ,cancer ,serum #dbe ,glyco-,thymoline and ,poliomyelitis #dbg ,glykeron3 ,cold ,storage ,testimonials #dbh ,gray's ,glycerine ,tonic3 8,whose ,bread ,i ,eat ,his ,song ,i ,sing0 #dbi ,hagee's ,cordial of ,cod ,liver ,oil #dbi ,hypno-,bromic ,compound #dcj ,intravenous ,compound 7,loffler7 #dcj ,intravenous ,specialties #dce ,iodex #dcf ,the ,william ,f4 ,koch ,cancer ,remedy #dcg ,the ,lucas ,laboratories' ,products #ddj 8,phylacogens0 #dda ,pineoleum ,advertising ,methods #ddb 8,proteal ,therapy0 and ,henry ,smith ,williams #ddc ,proteogens #dde ,pulvane #dej ,sal ,hepatica #dea ,salicon #dec ,so-,called ,secretin ,preparations #ded ,succus ,cineraria ,maritima #dee ,tekarkin #deh ,tyree's ,antiseptic ,powder ,again #dfb ,wheeler's ,tissue ,phosphates #dfc ,briefer ,paragraphs #dfe ,,part ,,iv3 ,,contributions ,,from ,,the ,,journal3 ,,miscellany ,albert ,abrams1 ,a4,m41 ,m4,d41 ,,ll4,d41 ,f4,r4,m4,s4 #dgb ,acetylsalicylic ,acid1 ,not ,aspirin #dhj ,the ,allied ,medical ,associations of ,america #dhf 8,arsenicals0 #dia ,beer and ,cancer ,cures #did ,biologic ,therapeutics and ,its ,commercial ,domination #dif ,capell's ,uroluetic ,test #dig ,chemotherapy and ,tumors #dii ,the ,direct ,sales ,company #eaj ,discoveries and ,discoverers #eaa 8,drug ,reform0 #eac ,drug ,therapy3 ,the ,fallibility of ,textbooks #eae ,thomas ,webster ,edgar #eae ,glycerophosphates #ebj ,influenza ,vaccine #ebj ,intravenous ,therapy #ebb ,iodin ,fumes #ebc ,italian ,physico-,chemical ,company #ebd ,what is ,liquid ,petrolatum8 #ebf ,the ,lowenthal ,postgraduate ,course #ebg ,medical ,society of the ,united ,states #eca ,the ,national ,formulary--,a ,review of the ,fourth ,edition #ece ,nonspecific ,protein ,therapy #ecf ,willard ,ealon ,ogden #ech 8,patents0 #edb ,pharmaceutical ,barnums #ede ,the ,pharmacopeia #edf ,physician's ,stock in ,prescription ,products #edh ,pituitary ,gland ,preparations #edi ,proprietorship in ,medicine #eej ,philip ,rahtjen and ,his ,discoveries #eec ,sodium ,cacodylate in ,syphilis #eee ,tablets3 ,dependability of ,dosage #eef ,therapeutic ,evidence3 ,its ,crucial ,test #eeg 8,vaccines in ,toxic ,conditions0 #efj ,vitamins3 ,their ,distribution #efa ,the ,william ,a4 ,webster ,co4 and the ,direct ,pharmaceutical ,co4 #efd ,yeast #eff ,briefer ,paragraphs #egj ,,the ,,propaganda ,,for ,,reform ,,in ,,proprietary ,,medicines ,,part ,i ,,reports ,,of ,,the ,,council ,,on ,,pharmacy ,,and ,,chemistry ,,foreword ,,the ,,council ,,on ,,pharmacy ,,and ,,chemistry ,the ,council on ,pharmacy and ,chemistry was established by the ,american ,medical ,association primarily for the purpose of gathering and disseminating such information as would protect the medical profession--and thus the public--in the prescribing of proprietary medicinal articles4 ,the ,council consists of sixteen members1 fifteen appointed for a term of five years without pay1 and the sixteenth1 a secretary1 who is also the director of the ,chemical ,laboratory of the ,american ,medical ,association 7see ,part ,,ii74 ,at the present time 7#aiba7 the membership is3 ,c4 ,l4 ,alsberg1 ,a4,m41 ,m4,d41 ,chief of the ,bureau of ,chemistry1 ,u4 ,s4 ,department of ,agriculture1 ,washington1 ,d4 ,c4 ,c4 ,w4 ,edmunds1 ,m4,d41 ,professor of ,materia ,medica and ,therapeutics1 ,university of ,michigan ,medical ,school1 ,ann ,arbor4 ,r4 ,a4 ,hatcher1 ,ph4,g41 ,m4,d41 ,professor of ,pharmacology1 ,cornell ,university ,medical ,college1 ,new ,york ,city4 ,a4 ,w4 ,hewlett1 ,m4,d41 ,professor of ,medicine1 ,leland ,stanford ,junior ,university ,school of ,medicine1 ,san ,francisco4 ,john ,howland1 ,m4,d41 ,professor of ,pediatrics1 ,johns ,hopkins ,university ,medical ,department1 ,baltimore4 ,reid ,hunt1 ,m4,d41 ,professor of ,pharmacology1 ,medical ,school1 ,harvard ,university1 ,boston4 ,w4 ,t4 ,longcope1 ,a4,b41 ,m4,d41 ,new ,york4 ,g4 ,w4 ,mc,coy1 ,m4,d41 ,director of the ,hygienic ,laboratory1 ,u4 ,s4 ,public ,health ,service1 ,washington1 ,d4 ,c4 ,lafayette ,b4 ,mendel1 ,ph4,d41 ,sc4,d41 ,professor of ,physiological ,chemistry1 ,sheffield ,scientific ,school1 ,yale ,university1 ,new ,haven4 ,f4 ,g4 ,novy1 ,sc4,d41 ,m4,d41 ,professor of ,bacteriology1 ,university of ,michigan ,medical ,school1 ,ann ,arbor4 ,w4 ,w4 ,palmer1 ,b4,s41 ,m4,d41 ,bard ,professor of ,medicine1 ,columbia ,university ,college of ,physicians and ,surgeons1 ,new ,york4 ,w4 ,a4 ,puckner1 ,phar4,d41 ,secretary of the ,council1 ,director of the ,chemical ,laboratory of the ,american ,medical ,association1 ,chicago4 ,l4 ,g4 ,rowntree1 ,m4,d41 ,sc4,d41 ,professor of ,medicine1 ,mayo ,foundation1 ,rochester4 ,g4 ,h4 ,simmons1 ,m4,d41 ,,ll4,d41 ,chairman of the ,council1 ,editor of ,the ,journal of the ,american ,medical ,association1 ,chicago4 ,torald ,sollmann1 ,m4,d41 ,professor of ,pharmacology and ,materia ,medica1 ,western ,reserve ,university ,school of ,medicine1 ,cleveland4 ,julius ,stieglitz1 ,ph4,d41 ,sc4,d41 ,chem4,d41 ,professor of ,chemistry1 ,university of ,chicago1 ,vice-,chairman of the ,council1 ,chicago4 ,at its first meeting in #aije1 the ,council began examining the proprietary and nonofficial medicinal preparations offered to physicians of the ,united ,states1 and authorized the publication of a book 7,new and ,nonofficial ,remedies7 containing descriptions of those preparations which were deemed worthy of the consideration of physicians4 ,it also issued reports 7,reports of the ,council on ,pharmacy and ,chemistry7 to the medical profession on those preparations which were not eligible4 ,the ,council adopted a set of rules by which to measure the eligibility of each preparation for admission to ,new and ,nonofficial ,remedies4 ,these rules were designed primarily to protect the public--through the medical profession--against fraud1 undesirable secrecy and objectionable advertising in connection with proprietary medicinal articles4 ,the rules originally adopted have been subjected to revision from time to time to meet changing conditions4 ,for the information of those who wish to familiarize themselves with the work of the ,council the rules which are now in force 7#aiba7 follow this introduction4 ,a summary is also to be found in the article1 8,the ,work of the ,council on ,pharmacy and ,chemistry1 ,present and ,future10 page #ab4 ,since #aijf1 the ,council has issued ,new and ,nonofficial ,remedies annually4 ,in each issue are listed and described the articles that stand accepted on ,january #a of the year of publication4 ,the book describes proprietary medicinal articles on the ,american market that are found eligible under the rules1 and also such nonproprietary1 nonofficial articles as give promise of therapeutic usefulness1 listing the acceptable brands4 ,articles of a similar character are grouped together1 and each group is preceded by a general discussion for the purpose of comparison4 ,since #aijh1 the ,council has also issued an annual volume1 8,reports of the ,council on ,pharmacy and ,chemistry10 which contains reports on proprietary medicines that were found inadmissible to ,new and ,nonofficial ,remedies4 ,the reports issued prior to #aiaf--;and deemed of sufficient interest to physicians--were reprinted in the ,propaganda for ,reform in ,proprietary ,medicines1 ninth edition 7#aiaf74 ,the more important reports issued from #aiaf to #aiba1 inclusive1 are in this volume4 ,while it is the chief function of the ,council to investigate and report on proprietary medicinal preparations1 its work has broadened so that the ,council's work may now be characterized as a propaganda for the rational use of drugs4 ,thus1 its ,committee on ,therapeutic ,research encourages the investigation of questions concerning the actions of drugs4 ,these investigations are brought together in the 8,annual ,reports of the ,therapeutic ,research ,committee40 ,the ,council also has a committee on medical teaching which has issued the publication 8,useful ,drugs10 a concise1 but thorough and up-to-date1 discussion of the more important drugs4 ,in addition1 the ,council appointed a committee to prepare an 8,epitome of the ,u4 ,s4 ,pharmacopeia and ,national ,formulary10 in which are presented those portions of the ,united ,states ,pharmacopeia and the ,national ,formulary that are of interest to physicians and in which is given a concise statement of the therapeutic usefulness of such drugs and preparations4 ,,official ,,rules ,,of ,,the ,,council ,,on ,,pharmacy ,,and ,,chemistry ,may #a1 #aiba ,introduction ,the following rules have been adopted by the ,council primarily with the object of protecting the medical profession and the public against fraud1 undesirable secrecy and objectionable advertising in connection with proprietary medicinal articles4 ,,new ,,and ,,nonofficial ,,remedies4--,the book ,new and ,nonofficial ,remedies contains a description of proprietary articles which have been accepted as conforming to the rules of the ,council2 and of such simple nonproprietary and nonofficial substances as seem of sufficient importance to warrant their inclusion4 ,,mixtures4--,for admission to ,n4 ,n4 ,r41 proprietary pharmaceutical mixtures must comply with the rules2 and1 to determine such compliance1 they will be investigated by the ,council4 ,the ,council1 however1 endorses the principle that prescriptions should be written on the basis of the therapeutic effects of the individual ingredients4 ,for this reason1 it includes in this book only those mixtures that present some real advantage4 ,there is also an appendix in which are included those proprietary articles which1 so far as known to the ,council1 comply with the rules1 but which do not possess sufficient originality to be admitted to the body of the book4 ,rules ,governing the ,admission of ,proprietary ,articles to the ,book ,new and ,nonofficial ,remedies ,,definition ,,of ,,proprietary ,,articles4--,the term 8proprietary article10 in this place1 shall mean any chemical1 drug or similar preparation used in the treatment of diseases1 if such article is protected against free competition1 as to name1 product1 composition or process of manufacture1 by secrecy1 patent1 copyright1 or by any other means4 ,rule #a4--;,,composition4--,no article will be accepted for inclusion in the book ,new and ,nonofficial ,remedies1 or retained therein1 unless its composition be furnished to the ,council for publication4 ,for simple substances1 the scientific name and the chemical formula1 rational or structural1 if known1 should be supplied4 ,for mixtures1 the amount of each active medicinal ingredient in a given quantity of the article must be stated4 ,the general composition of the vehicle1 its alcoholic percentage1 and the identity of the preservatives must be furnished4 ,rule #b4--;,,identification4--,no article will be accepted or retained unless suitable tests for determining its composition are furnished to the ,council4 ,in the case of chemical compounds1 these shall consist of tests for identity and purity4 ,in the case of mixtures1 description of methods for determining the amount and active strength of the potent ingredients shall be furnished1 if practicable4 ,rule #c4--;,,direct ,,advertising4--,no article that is advertised to the public will be accepted or retained2 but this rule shall not apply to3 7a7 disinfectants1 germicides and antiseptics1 provided the advertising is limited to conservative recommendations for their use as prophylactic applications to superficial cuts and abrasions of the skin and to the mucous surfaces of the mouth1 pharynx and nose 7but not to those of the eye1 and the gastro-intestinal and genito-urinary tracts7 and provided they are not advertised as curative agents 7see comments to ,rule #c72 and 7b7 nonmedicinal food preparations1 except when advertised in an objectionable manner4 ,rule #d4--;,,indirect ,,advertising4--,no article will be accepted or retained if the label1 package or circular accompanying the package contains the names of diseases in the treatment of which the article is said to be indicated4 ,the therapeutic indications and properties may be stated1 provided such statements do not suggest self-medication4 ,dosage may be indicated4 7,this rule shall not apply to remedies with which self-medication is altogether improbable1 to vaccines and antitoxins or to directions for administering or applying remedies when similar immediate1 heroic treatment is indicated47 ,rule #e4--;,,false ,,claims ,,as ,,to ,,origin4--,no article will be accepted or retained concerning which the manufacturer or his agents make false or misleading statements as to source1 raw material from which made1 or method of collection or preparation4 ,rule #f4--,,unwarranted ,,therapeutic ,,claims4--,no article will be accepted or retained concerning which the manufacturer or his agents make unwarranted1 exaggerated or misleading statements as to the therapeutic value4 ,rule #g4--,,poisonous ,,substances4--,the principal label on an article containing 8poisonous0 or 8potent0 substances must state plainly the amount of each of such ingredients in a given quantity of the product4 ,rule #h4--,,objectionable ,,names4--,proprietary names for medicinal articles will be recognized only when the ,council shall deem the use of such exclusive names to be in the interest of public welfare4 ,names which are misleading or which suggest diseases1 pathologic conditions or therapeutic indications will not be recognized 7the provision against therapeutically suggestive names does not apply to serums1 vaccines and antitoxins1 or to foods74 ,in the case of pharmaceutical preparations or mixtures1 the name must be so framed as to indicate the most potent ingredients4 ,rule #i4--,,patented ,,products ,,and ,,protected ,,names4--,if the article is patented--either process or product1 or both--the number of such patent or patents must be furnished to the ,council4 ,furthermore1 if the name of an article is registered1 or the label copyrighted1 the registration 7trademark7 number and a copy of the protected label should be furnished the ,council4 ,in case of registration in foreign countries1 the name under which the article is registered should be supplied4 ,rule #aj4--,,unscientific ,,and ,,useless ,,articles4--,no article will be accepted or retained which1 because of its unscientific composition1 is useless or inimical to the best interests of the public or of the medical profession4 ,explanatory ,comments on the ,rules ,,introduction4--,the ,council on ,pharmacy and ,chemistry was established in ,february1 #aije1 by the ,american ,medical ,association1 primarily for the purpose of gathering and disseminating such information as will protect the medical profession in the prescribing of proprietary medicinal articles4 ,in pursuance of this object1 the ,council examines the articles on the market as to their compliance with definite rules designed to prevent fraud1 undesirable secrecy and the abuses which arise from advertising directly or indirectly to the laity4 ,such articles as appear to conform to the rules are accepted2 and their essential features are described in the annual publication of the ,council1 ,new and ,nonofficial ,remedies1 if they come within the scope of this book4 ,these descriptions are based in part on investigations made by1 or under1 the direction of the ,council1 but in part also on evidence or information supplied by the manufacturer or his agents4 ,such interested statements are examined critically1 and are admitted only if they appear to be in conformity with the evidence4 ,it is1 however1 manifestly impossible for the ,council to investigate the composition of every complex pharmaceutical mixture1 or to check thoroughly every therapeutic claim2 it can give only an unbiased judgment on the available evidence4 ,criticisms and corrections of the descriptions which may aid in the revision of the matter will be appreciated4 ,the ,council judges an article entirely by the facts in evidence at the time of its admission4 ,previous noncompliance with the rules 7short of intentional fraud7 does not prevent the favorable consideration of an article which is in accord with existing rules4 ,infringements of the rules after acceptance of an article for ,new and ,nonofficial ,remedies1 or the discovery that the ,council's information was incorrect1 will cause the acceptance to be reconsidered4 ,an article is accepted for ,new and ,nonofficial ,remedies1 and will continue to be included in the book1 with the understanding that serious violations of the rules1 after acceptance1 will be followed by the omission of the article and publication of the reasons for such omission4 ,the ,council desires physicians to understand that the admission of an article does not imply a recommendation4 ,acceptance simply means that no conflict with the rules has been found by the ,council4 ,,duration ,,of ,,acceptance4--,unless an agreement to the contrary is made at the time of acceptance1 articles admitted to ,new and ,nonofficial ,remedies will be retained for a period of three years1 provided that during that period they comply with the rules and regulations which were in force at the time of their acceptance4 ,at the end of this period all articles will be carefully reexamined for compliance with existing rules4 ,particular weight will be given to the question as to whether recent evidence has substantiated claims as to the therapeutic value of any preparation1 this evidence to consist partly of recent statements in the literature and partly of the general esteem in which the preparation is held by clinical consultants of the ,council4 ,the reacceptance of articles after such reexamination shall be for three years unless a shorter period is specified4 ,any amendments to the rules1 by specific requirements or by interpretation1 which may be made after the acceptance of an article1 shall not apply to such article until the period of acceptance has elapsed4 ,at the end of this period the article1 if it is not eligible under the amended rules1 will be omitted4 ,,the ,,scope ,,of ,,new ,,and ,,nonofficial ,,remedies ,,and ,,appendix4--,to aid physicians and manufacturers in deciding what articles come within the scope of this book1 or1 in other words1 to enable physicians to recognize whether an article which is not described in ,new and ,nonofficial ,remedies has been omitted because it does not need admission or because it has been rejected1 the ,council furnishes the following more detailed definitions3 ,,official ,,articles4--,articles official in the ,u4 ,s4 ,p4 or ,n4 ,f4 do not require consideration by the ,council if they are marketed under the official name and if no unestablished therapeutic claims are made for them4 ,these do not require consideration by the ,council1 since standards for them are provided in these books1 and enforced under the provisions of the federal ,food and ,drugs ,act1 except that they may be mentioned for information4 ,consideration by the ,council becomes necessary if a ,u4 ,s4 ,p4 or ,n4 ,f4 product is offered for sale under a name other than that1 or the synonyms1 under which the product is described in one of these books of standards1 or if the proprietors or their agents advance claims that the product possesses therapeutic properties other than those commonly accredited to it4 ,,modifications ,,of ,u4 ,s4 ,p4 ,,and ,n4 ,f4 ,,products4--,a pharmacopeial or ,national ,formulary product which is marketed under the official title or synonym1 but with well-founded claims that its purity1 permanence1 palatability or other physical properties excel the official standard1 may1 if no extraordinary therapeutic properties are asserted1 be considered as an official article and held not to be within the scope of ,new and ,nonofficial ,remedies4 ,when such products are marketed under the claim that they possess therapeutic properties other than those commonly accredited to the ,u4 ,s4 ,p4 or ,n4 ,f4 products of which they are modifications1 they shall be subject to the consideration of the ,council4 ,,specifically ,,exempted ,,preparations4--,foods1 in general1 unless marketed with the claim that they possess therapeutic properties shall not1 at the present time1 be considered by the ,council4 ,mechanical appliances1 at the present time1 shall not be considered by the ,council4 ,mineral waters 7natural71 at the present time1 shall not be considered by the ,council4 ,with these exceptions1 products which in the judgment of the ,council are manufactured and marketed in conformity to the principles underlying the rules of the ,council may be accepted for ,n4 ,n4 ,r4 ,products which are manufactured and marketed in a manner which does not conform to the principles underlying the rules of the ,council shall not be accepted for ,n4 ,n4 ,r4 ,the burden of proof in establishing claims for therapeutic properties of products considered by the ,council shall lie with the proprietor or1 when a foreign made product1 with the agent who markets the product in the ,united ,states4 ,to avoid confusion with nonofficial substances marketed under similar names1 the ,council recommends that official substances be prescribed by their official titles1 followed by the abbreviation 8,u4 ,s4 ,p40 or 8,n4 ,f402 thus3 ,tinctura ,nucis ,vomicae1 ,u4 ,s4 ,p42 ,elixir ,gentianae1 ,n4 ,f4 ,,substances ,,described ,,in ,,new ,,and ,,nonofficial ,,remedies4--,in the body of the book will be described simple proprietary substances and their preparations2 proprietary mixtures if they have originality or other important qualities which1 in the judgment of the ,council1 entitle them to such place1 and important1 nonproprietary1 unofficial articles4 ,the ,council recommends that when the latter are prescribed1 they be indicated by the abbreviation1 8,n4 ,n4 ,r410 thus insuring to the prescriber the quality of these articles laid down in the book4 ,,proprietary ,,mixtures4--,a mixture will be considered as proprietary1 and therefore requiring consideration by the ,council for admission to the book or appendix1 if it contains any proprietary article2 if it is marketed under a name which is in any way protected1 or if its manufacturer claims for it any unusual therapeutic qualities4 ,proprietary mixtures which are marketed in conformity with the rules are listed in the appendix of the book under the names of the respective manufacturers4 ,such proprietary mixtures are not admitted to the body of the book1 save in the exceptional cases cited in the preceding paragraph4 ,,nonproprietary ,,mixtures ,,of ,,official ,,substances4--,since the ingredients of such mixtures do not require consideration by the ,council1 and since the mixtures are not open to the proprietary abuses which call for the work of the ,council1 it is not necessary that they should be investigated by the ,council4 ,the physician must judge whether such mixtures should be directed to be prepared by the pharmacist1 or whether he is justified in ordering a ready-made preparation4 ,if he decides to use a ready-made1 nonproprietary preparation1 he must judge for himself whether it is marketed in accordance with the rules4 ,it should1 however1 be remembered that the application of a trade name to any substance makes it proprietary4 ,explanation of ,rule #a3 ,composition ,secrecy ,objectionable4--,it is not only the right but also the duty of the physician to know the essential composition of what he prescribes2 the ,council cannot compromise on this proposition4 ,vehicles and ,preservatives4--,in the case of mixtures1 not only the potent ingredient1 but also the general character of the vehicle1 the presence of alcohol1 and the identity of preservatives1 or of any other substance1 whether added or present as an impurity1 must be stated if these can under any circumstances affect the therapeutic action of the article4 ,this1 as a rule1 does not mean the publication of trade secrets1 such as flavors or the details of the working formula4 ,trade ,secrets4--,furthermore1 trade secrets will not be received as confidential by the ,council1 since it accepts information only with the distinct understanding that this may be freely published1 at its discretion4 ,inspection of ,factories4--,the ,council does not accept invitations to inspect factories2 its concern is with the finished products4 ,on the other hand1 the ,council requires that the information be complete and accurate as to medicinal ingredients4 ,unofficial ,constituents4--,unofficial constituents of proprietary mixtures must be presented by the manufacturer in the regular way and must be acted on by the ,council before the preparations containing them can be accepted4 ,fraud4--,when it appears that a manufacturer has made a deliberately false statement concerning a product1 he is asked to furnish an explanation2 and if this is not satisfactory1 the product will not be accepted1 even if the false statement is subsequently corrected or omitted4 ,testimonials4--,the foregoing paragraph applies not only to statements made to the ,council1 but also to statements furnished to physicians by the manufacturer or his agents1 even when these statements are in the guise of testimonials4 ,explanation of ,rule #b3 ,identification ,in order to avoid errors in the case of chemical compounds1 and to guard against adulterations1 lack of potency or strength1 and the mistaking of one chemical for another1 it is necessary to have at hand suitable tests4 ,tests1 etc4--,if these facts have appeared in the literature1 or in standard textbooks1 reference to them will be sufficient2 but with new chemicals1 especially synthetics1 the manufacturer or his representatives will be required to supply such tests for publication1 as will assure an intelligent opinion of these products4 ,physiologic ,standardization4--,in cases in which chemical methods of identification are unknown or unreliable1 physiologic standardization should be employed4 ,the ,council considers the phrase 8physiologically standardized0 or 8assayed0 as misleading unless the standard and method are published in sufficient detail to permit of their control by independent investigators4 ,it is evident that when no standard is published1 it is impossible to know whether the quality is high or low1 and the conscientious manufacturer who sets for himself a high standard is placed on a level with the dishonest or careless one who adopts a low standard4 ,again1 if the process of standardization is not published1 it is impossible to learn1 without actual trial1 the relative value of one preparation as compared with that of another manufacturer1 or to confirm or disprove the statements of the manufacturer as to the quality of his product4 ,standardization of ,disinfectants and ,germicides4--,no disinfectant or germicide of the phenol type will be accepted for ,new and ,nonofficial ,remedies whose phenol coefficient1 determined according to the method of the ,hygienic ,laboratory1 ,u4 ,s4 ,p4 ,h4 ,s41 is not stated on the label of the preparation4 ,explanation of ,rule #c3 ,direct ,advertising ,lay ,advertising4--,the impossibility of controlling the irresponsible claims which are usually made in advertisements to the public1 the well-known dangers of suggesting by descriptions of symptoms to the minds of the people that they are suffering from the many diseases described1 the dangers of the unconscious and innocent formation of a drug habit1 and the evils of harmful self-medication1 including the dangers of the spread of many infectious and contagious diseases when hidden from the physician1 and similar well-known considerations1 are the reasons for discouraging1 in the interest1 and for the safety1 of the public1 this reprehensible form of exploitation4 ,advertising in medical journals1 etc41 distributed solely to physicians1 does not come within the scope of this rule4 ,exceptions4--,in the case of subjects on which the public should be instructed1 as the use of disinfectants1 germicides1 antiseptics and foods1 advertisements to the public1 if not in objectionable forms1 are considered admissible4 ,in no case shall such advertisements include recommendations for use as curative agents1 nor shall the names of any diseases be mentioned in exploitation4 ,if the preparation is sufficiently toxic to require caution in its use to prevent poisoning1 this fact shall be stated on the label4 ,on account of the deplorable results which would follow any abuse of this privilege1 the conscientious cooperation of manufacturers and their agents in adhering strictly to the limitations laid down is asked2 and for the same reason the acceptance of an article which is so advertised as to infringe on these limitations in any essential way 7as by naming diseases or by making false and exaggerated claims7 shall be summarily rescinded1 and the reasons for such action may be published without notice to manufacturer or agent4 ,a disinfectant1 germicide or antiseptic will be accepted for description in ,new and ,nonofficial ,remedies1 and an article of this class which has already been accepted will continue to be included in ,new and ,nonofficial ,remedies only on the explicit understanding by the manufacturer and agent that such infringements of the rule will be followed by deletion of the article and by publication of the facts as described4 ,foods4--,we may divide the foods into three groups4 ,the first group contains the ordinary foods1 including the well-known breakfast foods4 ,these do not come under the supervision of the ,council in any way4 ,the second group includes a large and important class of manufactured products1 such as invalid and infant foods1 which in a sense stand between the first and third groups4 ,the public has the same interest in these foods that the physician has1 and usually is supplied with full information concerning them4 ,while the primary recommendation of these articles should naturally come from the physician1 it cannot be expected that their continued use should depend on repeated prescriptions4 ,information concerning this group of foods would come naturally and properly from a physician1 and the collection and dissemination of this information may very properly be included in the work of this ,council4 ,as the products in this class are used extensively1 it is not proper to limit their advertising to medical journals1 but the advertising should be permitted in the lay press so long as it is conducted in a manner compatible with the rules of the ,council4 ,the third group includes medicinal foods proper1 such as predigested foods4 ,these have a relatively low food value and are characterized by a high alcohol or preservative content4 ,they frequently contain strictly medicinal substances1 or food substances for which distinct therapeutic properties are claimed4 ,these products should be used only on the advice of the physician1 and the advertisements should be restricted as in the case of ordinary medicines4 ,advertisements in ,foreign ,countries4--,the ,council deals primarily1 in the interest of the public and of the medical profession1 with articles proposed for admission to ,new and ,nonofficial ,remedies1 and1 in determining the status of any article1 must take into consideration any statements made regarding it or any method of advertising it employed by the manufacturer or his authorized agents or representatives1 whether in this country or abroad4 ,the ,council will not regard as within its scope1 however1 questions concerning the marketing of articles 7except the matter of direct advertising to the laity and unwarranted claims or misrepresentations7 in any country which has a public body corresponding to this ,council4 ,explanation of ,rule #d3 ,indirect ,advertising ,matter ,distributed ,solely to ,physicians4--,it should be remembered that the sole intent of this rule is to protect the physician1 so that in prescribing a proprietary medicine he shall not unconsciously advertise proprietary preparations4 ,the rule imposes no restriction on the legitimate methods of bringing a remedy to the attention of the profession1 such as advertising in medical journals1 circulars and other printed matter distributed solely to physicians4 ,the rule applies only to the package as it may reach the patient4 ,naming ,diseases on ,labels4--,the naming of diseases on the label or package is not necessary1 as is shown by the very large number of proprietary products which have been successfully introduced without resorting to this expedient4 ,this method of popularizing a proprietary remedy with the laity is most objectionable1 and should not be tolerated in any form4 ,in general1 therapeutic indications should be omitted from the label and package4 ,the ,council will not insist on this point1 however1 when such indications are so given as not to promote self-medication1 particularly in diseases which require expert diagnosis and supervision4 ,it will be considered an infringement of the rule if an article be marketed in bottles which have the name of the article blown into the glass1 or if otherwise the name or initials or other distinctive mark of the article is permanently stamped on the container1 on the article itself1 or is on the stoppers or seals4 ,articles which are marketed in any of these ways are not accepted for ,new and ,nonofficial ,remedies4 ,readily removable labels are not objectionable1 nor is the permanent affixing of the firm's initials or name to the trade package if such initials or name is not suggestive of the article4 ,the ,council does not countenance the use of an accepted article for advertising other articles which have not been accepted by the ,council4 ,explanation of ,rule #e3 ,false ,claims as to ,origin ,source4--,no false or misleading statement in regard to an article can be permitted concerning the source of material from which it is made1 or the persons by whom it is made4 ,some glaring frauds of this nature have been perpetrated in the past1 and this rule is intended to prevent such imposition4 ,explanation of ,rule #f3 ,unwarranted ,therapeutic ,claims ,therapeutic ,questions4--,this rule insists that the claims of manufacturers or agents concerning the therapeutic properties of their products must be compatible with demonstrable facts4 ,manufacturers will be held responsible for all statements made or quoted in their advertising 8literature0 regarding their products4 ,recognizing the existence of honest differences of opinion on many therapeutic questions1 the ,council desires to be liberal in the application of this rule4 ,it is natural that a manufacturer should be partial toward his own product1 and a moderate degree of emphasis in advertising may not be objectionable4 ,the ,council1 however1 will not admit claims which are neither in harmony with already accepted facts nor supported by acceptable evidence4 ,in doubtful cases the ,council considers these questions with the advice and cooperation of its staff of clinical consultants4 ,clinical ,evidence4--,to be acceptable1 the clinical evidence must offer objective data with such citation of authority as will enable the ,council to confirm the facts and establish the scientific value of the conclusions drawn4 ,clinical data are worthless when the author is not cited4 ,the facts on which claims with regard to the value of a remedy are based must have been rendered accessible for investigation and confirmation by disinterested observers1 either through publication or through the records of a hospital or other institution4 ,explanation of ,rule #g3 ,poisonous ,substances ,poisons4--,for the information of the pharmacist or dispenser1 and to enable him to safeguard the interests of the patient and the physician1 all articles containing such potent agents as the poisonous alkaloids and other organic substances and the salts of some of the metals should have the exact amount of these ingredients which is contained in the average adult dose stated on the label4 ,explanation of ,rule #h3 ,objectionable ,names 8,coined0 ,names4--,many of the abuses connected with proprietary medicines arise from 8coined0 proprietary trade names4 ,such names will not be recognized by the ,council unless in particular instances the ,council shall deem their use to be in the interest of public welfare4 ,in every such exception the burden of proof1 both for establishing and for continuing the exception1 lies with those who market the product4 ,proprietary 78,trade07 ,names ,when ,permitted4--,in consideration of the benefits which may come from the discovery of a therapeutic agent1 the ,council concedes to the person or firm which1 by right of discovery1 controls such a product the right to name it4 ,the ,council will offer no opposition to an arbitrary name for such a new product1 provided it is not misleading1 therapeutically suggestive1 or otherwise subversive of scientific pharmacy and therapeutics4 ,if the discovery that a previously known substance has therapeutic value is deemed of sufficient importance1 the ,council may recognize a name for such a substance if the name is applied by the person who makes the discovery2 or1 with the consent of the discoverer or in the absence of any protest on his part1 the ,council may recognize a name applied by the firm which first makes such a product available to physicians4 ,in the interest of rational drug therapy1 the ,council recommends that trade names be coined so as to indicate the potent element or constituent4 ,scientific ,names4--,when the proprietary or trade name for an article is considered insufficiently descriptive of its chemical composition or pharmaceutical character1 the ,council may require as a condition for the acceptance of such articles that a descriptive scientific name satisfactory to the ,council appear on the labels1 circulars and advertisements for such an article4 ,for all definite chemical substances it is required that the scientific name be given prominence on the labels1 in circulars and advertisements4 ,proprietary ,names for ,unoriginal ,articles4--,proprietary names will not be recognized for articles which are included in the ,u4 ,s4 ,pharmacopeia or ,national ,formulary or for unessential modifications of such articles4 ,neither will proprietary names be recognized for substances or mixtures which are described in medical or pharmaceutical publications4 ,in the marketing of unoriginal articles1 the legitimate interests of the producer are fully served by identifying such products by appending the name or initials of the manufacturer or agent1 or by the use of a general brand mark4 ,no objection will be made by the ,council to the use of such brand marks1 provided that in no case shall such mark be used as a designation for an individual article4 ,for any product which1 by reason of the absence or lapse of patent rights or for other reasons1 is open to manufacture by more than one firm1 the ,council reserves the right to select a common name and to provide standards of identity1 purity and strength1 and then will accept such article only if it is marketed under the title adopted as the ,n4 ,n4 ,r4 name or the name under which such article was introduced 7to which may be appended the firm's identifying mark74 ,n4 ,n4 ,r4 to ,u4 ,s4 ,p4--,when an article which has been accepted for ,new and ,nonofficial ,remedies is admitted to the ,u4 ,s4 ,pharmacopeia or ,national ,formulary1 it will be omitted from ,new and ,nonofficial ,remedies one year after such standardization if the name of such article is used in these standards either as the main title for the product or as a synonym4 ,if the name under which the article is described in ,new and ,nonofficial ,remedies is not used in these books of standards1 the proprietary preparation will be retained provided the official name is given prominence on the labels and in the circulars and advertisements of such article4 ,when the ,council adopts a common name for an article that has been admitted under another name1 it will be continued under the older name only on condition that the ,council name be given prominence on the label and in the circulars and advertisements for such article4 ,pharmaceutical ,preparations and ,mixtures4--,these1 with rare exceptions1 are not original in composition and there is seldom any reason why they should be endowed with arbitrary names4 ,on the contrary1 it is important that the prescriber should be reminded constantly of their potent ingredients4 ,therapeutically ,suggestive ,names4--,articles bearing therapeutically suggestive names will not be accepted for ,new and ,nonofficial ,remedies1 first1 because they are likely to lead physicians into prescribing names instead of remedies1 and second1 because they tend to encourage unwarranted self-medication by the laity4 ,even if the name is at first apparently meaningless to the public1 its meaning will soon be understood because patients soon learn the technical names applied to their diseases and symptoms4 ,the prohibition against therapeutically suggestive names is not applied to serums1 vaccines and antitoxins1 because the accepted nomenclature of the specific organisms used in their preparation makes this unavoidable and because self-medication with them is improbable4 ,explanation of ,rule #i3 ,patents1 ,trademarks1 ,copyrights1 ,etc4 ,protection4--,this information is important as a means of determining the legal status of medicinal articles and as an aid to their ready recognition in current publications4 ,explanation of ,rule #aj3 ,unscientific and ,useless ,articles ,unscientific ,compounds4--,the use of articles which are unessential modifications of official or established nonproprietary articles is unscientific and serves no useful purpose4 ,the ,council will not accept products which are scientifically unsound and which1 therefore1 must be considered useless or inimical to the best interest of the medical profession and the public4 ,this class includes compounds or mixtures containing an excessive number of active ingredients2 those compounds or mixtures the components of which are of no probable assistance to one another1 and those articles which are of no therapeutic value4 ,unessential ,modifications of ,official ,substances4--,the subterfuge of obtaining proprietary rights over an official or established nonproprietary product1 by introducing unessential modifications1 also tends to confusion and abuses1 and such articles will not be admitted by the ,council4 ,essential and important modifications1 however1 will receive recognition4 7,the ,council interprets the term 8established nonproprietary product0 as applying to a preparation of any formula which has been published through any recognized or reasonably accessible channel of publication1 prior to its appropriation or modification by a manufacturer47 ,duplicates of biologic products accepted under the name of the manufacturers will not be accepted under the names of the distributors4 ,,the ,,council ,,on ,,pharmacy ,,and ,,chemistry1 ,,present ,,and ,,future,a ,w4 ,a4 ,puckner1 ,phar4,d4 ,secretary1 ,council on ,pharmacy and ,chemistry ,a ,read before the ,chicago ,medical ,society1 ,march #bf1 #aiai4 ,the ,world ,war marked an epoch in the existence of the ,council on ,pharmacy and ,chemistry1 as it did in all human endeavors4 ,the information and experience which had been accumulated by the ,council during its thirteen years' existence was drawn on by our government1 directly or indirectly1 and it also received consideration in ,england1 ,france1#a ,belgium1 ,holland1#b ,italy1#c ,sweden and elsewhere4 ,in the world wide readjustment that has begun1 the efforts of the ,council1 past and present1 will influence the plans of those who engage in the manufacture or sale of medicines1 and1 undoubtedly1 will be the incentive to the establishment of similar bodies in other countries4 #a 8,new and ,nonofficial ,remedies0 in ,france1 ,foreign ,news1 ,j4 ,a4 ,m4 ,a4 #ga3acca 7,oct4 #ai7 #aiah2 #gj3aghc 7,june #h7 #aiah4 #b ,nederl4 ,tjdschr4 v4 ,geneesk4 ,oct4 #e1 #aiah1 p4 #abja4 #c ,an ,italian ,view of the ,proprietary ,evil1 ,foreign ,news1 ,j4 ,a4 ,m4 ,a4 #ga3hdj 7,sept4 #g7 #aiah2 ,the ,council on ,pharmacy and ,chemistry and the ,patriotic ,medical ,league in ,italy1 ibid4 #ga3iah 7,sept4 #ad7 #aiah4 ,as secretary of the ,council almost from the time of its organization in #aije1d and knowing the work of its members and its collaborators1 ,i am firmly convinced that this body has deserved the endorsement and support given it by the ,american medical profession4 ,i welcome this opportunity to present an outline of the ,council's past activities and to speak of some of the problems of the future1 because ,i feel assured that a knowledge of its endeavor to improve drug therapy will increase the profession's confidence in the ,council and add to the number of its supporters4 #d ,although the ,council on ,pharmacy and ,chemistry was established in #aije1 it is likely that only a small percentage of physicians know just what the ,council is1 or have any conception as to its personnel and its ability to judge the available evidence for proprietary medicaments4 ,the personnel has changed from time to time since #aije4 ,at present its membership is3 ,c4 ,l4 ,alsberg1 ,a4,m41 ,m4,d41 chief of the ,bureau of ,chemistry1 ,u4 ,s4 ,department of ,agriculture1 ,washington1 ,d4 ,c42 ,r4 ,a4 ,hatcher1 ,ph4,g41 ,m4,d41 professor of pharmacology1 ,cornell ,university ,medical ,college1 ,new ,york ,city2 ,a4 ,w4 ,hewlett1 ,m4,d41 professor of medicine1 ,leland ,stanford ,junior ,university ,medical ,school1 ,san ,francisco2 ,john ,howland1 ,m4,d41 professor of pediatrics1 ,johns ,hopkins ,university ,department of ,medicine1 ,baltimore2 ,reid ,hunt1 ,m4,d41 professor of pharmacology1 ,harvard ,university ,medical ,school1 ,boston2 ,henry ,kraemer1 ,ph4,d41 professor of pharmacognosy1 ,university of ,michigan ,college of ,pharmacy1 ,ann ,arbor1 ,mich42 ,w4 ,t4 ,longcope1 ,a4,b41 ,m4,d41 ,bard ,professor of the ,practice of ,medicine1 ,college of ,physicians and ,surgeons of ,columbia ,university1 ,new ,york ,city2 ,g4 ,w4 ,mc,coy1 ,m4,d41 director of the ,hygienic ,laboratory1 ,united ,states ,public ,health ,service1 ,washington1 ,d4 ,c42 ,lafayette ,b4 ,mendel1 ,ph4,d41 ,sc4,d41 professor of physiologic chemistry1 ,sheffield ,scientific ,school1 ,yale ,university1 ,new ,haven1 ,conn42 ,f4 ,g4 ,novy1 ,m4,d41 ,sc4,d41 professor of bacteriology1 ,university of ,michigan1 ,ann ,arbor1 ,mich42 ,w4 ,w4 ,palmer1 ,b4,s41 ,m4,d41 associate professor of medicine1 ,college of ,physicians and ,surgeons of ,columbia ,university1 ,new ,york ,city2 ,l4 ,g4 ,rowntree1 ,m4,d41 professor of medicine1 ,university of ,minnesota ,medical ,school1 ,minneapolis2 ,torald ,sollmann1 ,m4,d41 professor of pharmacology and materia medica1 ,medical ,department1 ,western ,reserve ,university1 ,cleveland2 ,julius ,stieglitz1 ,ph4,d41 ,sc4,d41 ,chem4,d41 vice chairman of the ,council1 professor of chemistry1 ,university of ,chicago1 ,chicago2 ,g4 ,h4 ,simmons1 ,m4,d41 ,,ll4,d41 chairman of the ,council1 editor of ,the ,journal of the ,american ,medical ,association1 ,chicago1 and ,w4 ,a4 ,puckner1 ,phar4,d41 secretary of the ,council1 director of the ,chemical ,laboratory of the ,american ,medical ,association1 ,chicago4 ,,the ,,council',s ,,activities ,organized primarily for the purpose of putting a stop to false declarations with regard to the composition of proprietary medicines1 the ,council's activities have broadened until its work may be characterized as 8a propaganda for the rational use of drugs40 ,the following are some of its activities3 #a4 ,new and ,nonofficial ,remedies4--,this is an annual volume1 issued by the ,council4 ,it describes both proprietary and nonofficial1 nonproprietary drugs which are deemed worthy of consideration by the medical profession4 ,to be admitted to this book1 a preparation must comply with certain definite rules which stipulate1 in effect1 that its composition be declared1 that no untrue or grossly exaggerated claims be made for it1 and that it shall give promise of having therapeutic value4 ,with the exception of a few which are still under consideration1 the ,council has considered all proprietaries whose owners or accredited agents have requested that an examination of the products be made1 and it has admitted to the book those which were found eligible4 ,in addition1 the ,council has examined all of the more important or widely exploited proprietaries1 even when no examination was requested1 and it has admitted those of this group which were found eligible4 ,further1 the ,council has admitted to the book certain nonofficial1 nonproprietary articles which seemed to give promise of therapeutic usefulness1 and it has established standards for the control of their identity and purity1 and listed those brands which complied with these standards4 ,as most proprietary medicines are of a more or less experimental nature1 they are accepted for inclusion in ,new and ,nonofficial ,remedies only for a limited time--usually a period of three years4 ,at the expiration of the period of acceptance1 each preparation is reexamined and retained only if the claims made for it and the present day knowledge of its value permit this action4 ,since manufacturers give information only in regard to their own products1 ,new and ,nonofficial ,remedies groups together articles of a similar character1 and includes in each case a general discussion of the group for the purpose of comparison1 not only with each other1 but also with the established or pharmacopeial drugs which members of the group are intended to supplant4 ,in brief1 ,new and ,nonofficial ,remedies is a book in which are described preparations that have been accepted by the ,council4 ,the description includes facts that the physician should have4 ,it is a book that should be in the hands of every physician who prescribes medicines1 and who wishes to know the facts regarding the newest remedies4 ,it is the only book in which he can find information relative to proprietary medicines that are worthy of his patronage4 ,it will protect the physician who makes use of it against the wiles of the promoters of products not worthy of his patronage4 ,it would certainly be of use to the physician when the detail man calls on him1 for if he were being importuned to prescribe or use samples of something which he had not heretofore used and which he was unable to find in ,n4 ,n4 ,r41 he might ask the detail man why4 ,in the nature of things few physicians are sufficiently expert in chemistry and allied sciences to be able unerringly to discriminate between the true and the false as regards many preparations that he is asked to prescribe4 #b4 ,the ,reports of the ,council on ,pharmacy and ,chemistry4--,a medicament may be inadmissible to ,new and ,nonofficial ,remedies for various reasons2 it may be worthless or irrational1 its composition may be secret or indefinite1 or it may be exploited under exaggerated or unwarranted claims or in a way otherwise detrimental to the public health and scientific medicine4 ,of these various reasons which make an article unacceptable1 the manufacturer obviously may remove all except the first1 viz41 worthlessness or irrationality4 ,consequently1 a preparation which has been presented for admission is not definitely rejected until after its proprietor has been informed of the objections to his product and has failed to bring the preparation in conformity with the ,council's rules4 ,when a preparation is found definitely inadmissible to ,new and ,nonofficial ,remedies1 that is1 when the proprietor cannot or will not make it acceptable1 the ,council prepares a report for publication4 ,these reports are sent for publication to ,the ,journal of the ,american ,medical ,association1 and later published in the annual 8,reports of the ,council on ,pharmacy and ,chemistry40 ,the more important of these are also published in the book1 8,the ,propaganda for ,reform in ,proprietary ,medicines40 #c4 ,useful ,drugs4--,since the domination of proprietary medicines1 which was retarding medical advance and threatening therapeutic chaos1 had been made possible only by the insufficient and inefficient instruction given in medical schools in subjects having to do with drugs1 the ,council appointed a ,committee on ,medical ,teaching to secure the cooperation of teachers in materia medica1 pharmacology and related branches4 ,this committee has endeavored to effect an improvement in these courses of instruction4 ,one of the results of this work was the selection of a list of drugs to serve as a basis of materia medica instruction and thus insure that medical students shall be better informed with regard to the therapeutic worth of a few well established drugs1 rather than1 as in the past1 leaving school with a smattering of knowledge about many drugs4 ,the outcome of these efforts is the publication of 8,useful ,drugs10 a concise but thorough and up-to-date discussion of the actions1 uses and dosage of the more important drugs4 ,the list of drugs presented in this book is now the basis of instruction in many schools2 and many state examining boards are confining their materia medica questions to the drugs in the list4 #d4 ,epitome of the ,u4 ,s4 ,p4 and ,n4 ,f4--,to encourage the use of official drugs and to make available an estimate of their therapeutic value1 a committee of the ,council prepared an abstract of the ,u4 ,s4 ,pharmacopeia and the ,national ,formulary4 ,this booklet1 the 8,epitome of the ,u4 ,s4 ,pharmacopeia and ,national ,formulary10 presents those portions of these books which are of interest to physicians1 and in addition1 gives a concise statement of the therapeutic usefulness of the drugs and preparations described in them4 #e4 ,patent ,law ,reform4--,some of the worst abuses connected with the exploitation of proprietary medicines have been made possible by our patent and trademark laws and the method of their interpretation and enforcement4 ,the ,council1 therefore1 appointed a committee to study these laws and the various propositions advanced for their improvement4 ,this committee has published1 from time to time1 reports on various phases of our patent and trademark laws and recently summarized these reports in an address#e sent to the commissioner of patents and the interested congressional committees4 ,it is hoped that by means of these reports physicians will be enabled to give intelligent support to a revision of the patent and trademark laws when legislation is proposed4 #e ,need for ,patent ,law ,revision1 ,a4 ,m4 ,a4 ,council on ,pharmacy and ,chemistry ,reports1 #aiag1 p4 #acj4 #f4 ,therapeutic ,research4--,through its ,committee on ,therapeutic ,research1 and with the aid of funds provided by the ,board of ,trustees of the ,american ,medical ,association1 the ,council has encouraged the investigations of questions which might lead to a better understanding of the action of drugs4 ,these investigations are brought together in the annual reports of the ,committee on ,therapeutic ,research1 and are an important addition to our knowledge of drug action4 ,in the past1 the ,council has in particular encouraged the investigation of the action and therapeutic value of widely used drugs regarding which our knowledge is still unsatisfactory4 ,these investigations have included a study of the action of strychnin in cardiac disease1 a comparison of the action of absorption and excretion of iodid preparations1 a study of the pharmacology of the opium alkaloids1 etc4 ,appreciating that the available knowledge of proprietary drugs is one sided in that it comes from investigations made by interested pharmaceutical concerns or from investigations made at the instigation of these firms1 the ,council is planning a comprehensive study of many of the synthetic drugs that have gained some vogue during recent years4 ,,the ,,future ,medical research1 and efficient instruction in therapeutics and related subjects1 spell a diminishing influence of commercial medicine over rational therapeutics4 ,the fact that the present shortage of ,german synthetics has not handicapped seriously the practice of medicine should be a lesson to ,american physicians for many years to come4 ,on the other hand1 it must be remembered that the publicity given to the reports of the ,council and to other contributions toward rational therapeutics by ,the ,journal of the ,american ,medical ,association1 the journals of the state organizations1 and a few personally owned publications1 is as nothing when compared with the persistent and wide publicity given to the propaganda of the proprietary houses4 ,while a report setting forth the objections to a proprietary is published but once1 the firm's laudatory pronouncement goes forth again and again until the ,council's report is completely overwhelmed and forgotten4 ,manufacturers of proprietaries not only keep in close touch with the practicing physician by means of house organs1 special 8literature10 or by traveling representatives1 but many of the firms1 through the meritorious lines of pills1 tablets1 tinctures1 etc41 which they put out1 also obtain and hold the good will and confidence of a large proportion of the medical profession4 ,furthermore1 some of these firms may gain the confidence of the medical profession through these high grade pharmaceuticals1 and certain of their proprietaries may be of distinct therapeutic value but may fail to be acceptable for ,new and ,nonofficial ,remedies1 because they do not conform to the reasonable rules of the ,council4 ,these firms do not find it profitable to force the sale of their regular nonproprietary pharmaceuticals by unwarranted claims or objectionable methods1 yet they may consider it good business to market certain proprietary products by means of claims which are extravagant and without warrant1 and which will lead to indiscriminate use by the profession and the public4 ,in a word1 where there is one dollar spent on behalf of rational medicine1 thousands are spent for the purpose of increasing the sale of preparations which directly or indirectly are a detriment to the public health1 to medicine1 and to the pocketbook4 ,that the day of the secret nostrum of the pseudo-chemical company is not yet past is well illustrated by the recent introduction of an asserted arsphenamin preparation called 8,syphilodol40 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory proved one form of this asserted ,french discovery to be essentially a pill of mercurous iodid4 ,another form of ,syphilodol 7for intravenous administration7 had all the characteristics of water1 and appeared devoid of any potent ingredient4 ,though the advertising sent out by the promoters in regard to its composition was suspiciously evasive1 the ,illinois ,medical ,journal published an advertisement of 8,syphilodol10 which1 possibly by a coincidence1 appeared above an appeal to 8,our ,readers0 to use wares advertised in that journal4 ,while such rank deceptions as 8,syphilodol0 are not common1 there are more subtle deceptions that are even more dangerous4 ,types of widely exploited remedies of today comprise so-called ethical specialties composed of well known and established drugs 7with 8jokers0 hidden away somewhere7 or preparations which have a plausibly fascinating pseudo-scientific background of radiant energy1 colloidal chemistry1 nonspecific protein reaction1 or something of the sort4 ,the latter class of preparations in particular appeal to physicians who are striving hard to keep pace with modern science4 ,exposure of their fallacies requires most careful consideration on the part of the ,council4 ,progress toward a rational and scientific drug therapy must continue1 and1 therefore1 it is important that the ,council on ,pharmacy and ,chemistry should continue to make the investigation of proprietary medicines its chief work4 ,investigation of a proprietary medicine1 however1 and a report of such investigation are of value in direct ratio only to the number of physicians who read the report1 endorse it and act in accordance with its conclusions4 ,in order that you may determine to what extent those preparations which are admitted to ,new and ,nonofficial ,remedies deserve your interest and confidence1 it will be worth while briefly to outline the rules which govern the ,council in the admission of articles to ,new and ,nonofficial ,remedies4 ,,rules ,,governing ,,the ,,acceptance ,,of ,,articles ,,for ,n4 ,n4 ,r4 ,composition4--,rules #a and #b1 and in a measure #e1 #g1 and #i1 deal with the composition of articles4 ,rule #a requires that the quantitative composition of an article be furnished the ,council for publication4 ,rule #b requires that the manufacturer furnish methods whereby the composition of products that are definite chemicals or the potent constituents of mixtures may be determined4 ,the ,council does not require that the process of manufacture of an article be declared unless this becomes necessary in order to judge its composition4 ,rule #e requires that statements with regard to the origin and source of an article shall be truthful4 ,rule #g requires that for the guidance of the dispenser1 the amounts of poisonous ingredients of a preparation be placed on the label4 ,rule #i requires that if patent rights are claimed for a product1 the ,council be informed on this point4 ,that it is not only the right but also the duty of the physician to know the composition of what he prescribes for his patients is so generally admitted that few have attempted to market preparations of avowedly secret composition4 ,when the ,council first began its work1 it was common to see chemical formulas or statements of composition published which a chemist or a pharmacist was able to pronounce at a glance as impossible4#f ,it was not unusual to find that the promoter published 8a formula0 for his preparation1 rather than 8the formula40#g ,today1 however1 a more prudent1 if not more honest1 course is pursued4 ,this gives a 8formula0 which is correct so far as it goes1 but which fails to divulge the actual composition of a preparation4 ,when it is considered that many physicians are not any too conversant with the chemistry and pharmacy of drugs1 it is not surprising that some administered the proprietary 8,venarsen10 regarding the composition of which they had only the vague statement that it was 8444 a comparatively nontoxic organic arsenic compound1 #j4f gm4 representing #bdg mg4 7#c-c_/d grains7 of metallic arsenic in chemical combination 4440 in the belief that a preparation similar to that first introduced as salvarsan was being used4 ,that 8,venarsen0 contained its arsenic as sodium cacodylate--a notoriously inactive state of combination--does not justify the intravenous administration of a drug of unknown composition4 #f ,puckner1 ,w4 ,a43 ,the ,abuse of ,chemical ,formulas1 ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory #c3g1 #aiaj4 #g ,the ,formula for ,glyco-,thymoline1 ,j4 ,a4 ,m4 ,a4 #eb3adg 7,jan4 #i7 #aiji4 ,while for the present it probably is not feasible to require1 on the part of those who manufacture medicinal preparations1 such professional training as is required of those who prescribe and those who dispense them1 it certainly is not too much to require1 as does ,rule #b1 that a manufacturer shall be able to demonstrate that his preparation has the composition claimed for it4 ,nor is it sufficient for him to know that the ingredients claimed as constituents were used in the manufacture4 ,the fallacy of his method of reasoning was furnished by the physician who reported that he had personally added the required amount of mercuric iodid for a batch of 8,mercol0 which1 nevertheless1 was devoid of mercury4#h ,acceptance of this rule by manufacturers will permit physicians to have a more accurate knowledge of the composition of preparations such as 8,taka-,diastase0#i and 8,iodeol04#aj #h ,hunt1 ,reid1 and ,seidell1 ,atherton3 ,howell's ,mercol1 ,j4 ,a4 ,m4 ,a4 #eb3bbe 7,jan4 #af7 #aiji4 ,howell's ,mercol ,again3 ,another ,analysis ,fails to ,reveal the ,presence of ,mercury1 ,j4 ,a4 ,m4 ,a4 #eb3aeie 7,may #ae7 #aiji4 #i ,taka-,diastase and ,liquid ,taka-,diastase3 ,report of the ,council on ,pharmacy and ,chemistry1 ,j4 ,a4 ,m4 ,a4 #ei3ej 7,july #f7 #aiab4 #aj ,iodeol and ,iodagol3 ,report of the ,council on ,pharmacy and ,chemistry1 ,j4 ,a4 ,m4 ,a4 #fi3agbe 7,nov4 #ag7 #aiag4 ,a requirement similar to that of ,rule #e is contained in the ,federal ,food and ,drugs ,act and so no objection has been made to this rule which requires a truthful statement of the origin and source of articles4 ,an illustration for the need of the rule was furnished by the one time popular 8,vin ,mariani0#aa which1 though very ,french in its makeup1 was found to be largely of the 8made in the ,united ,states0 variety of tipple4 #aa ,vin ,mariani3 ,official ,report of ,council on ,pharmacy and ,chemistry--,with ,comments1 ,j4 ,a4 ,m4 ,a4 #dg3agea 7,nov4 #bd7 #aijf4 ,the issuance of a patent for a medicinal product does not prove that such a product presents a discovery or that its owner is entitled to a temporary monopoly1 yet it is only fair to physicians and to other manufacturers that notice of such patent claims be given4 ,hence1 the ,council publishes in ,new and ,nonofficial ,remedies the information bearing on this point4 ,lay ,advertising4--,rules #c and #d provide against the recognition of articles that are advertised to the public directly or indirectly1 exempting from this requirement preparations which the ,council believes are safe to be so advertised4 ,it has been held with some justice that certain shotgun proprietaries are purchased by the public with as much circumspection as they are ordered by those physicians who are addicted to the prescribing of them2 but even the exploiters of these mixtures have not denied that the use of medicines by the public on its own initiative is surrounded with many objections4 ,hence the practice of self medication should not be encouraged by prescribing or using those preparations advertised for public use4 ,the only objection to the rule has come from a firm which markets a brand of liquid petrolatum1 the ,standard ,oil ,company of ,indiana4 ,the ,council has considered the question of exempting simple laxatives from the restrictions of ,rules #c and #d as it has exempted antiseptics and nonmedicinal foods4 ,the conclusion was1 however1 that the excessive use of a simple laxative like a liquid petrolatum1 when prompted by newspaper exploitation1 is likely to be detrimental to health by overuse as well as by misuse4 ,the indirect advertisement to the public1 which ,rule #d provides against1 has been the means of inducing the extensive lay use of 8,antikamnia10 8,bromidia0 and 8,fellows' ,syrup40 ,naturally ,rule #d has been bitterly opposed by most proprietary firms4 ,arguing that many physicians dispense their own drugs1 pharmaceutical firms have insisted that every medicinal preparation should bear on its label1 not only the dose of the preparation1 but also a statement of the diseases in which the article is indicated4 ,whether manufacturers anticipated the profession's resentment toward the claim that physicians determine the treatment and perhaps the diagnosis by means of the statements on labels1 or because the ,shirley amendment to the ,food and ,drugs ,act makes the proprietor responsible for therapeutic claims on the label of a medicine1 it is a fact that fewer preparations than formerly need to be refused on account of infringement on this rule4 ,in fact1 some thoroughly objectionable proprietaries make a show of being 8ethical0 by omitting all therapeutic discussion from the labels of their preparations4 ,therapeutic ,claims4--,rule #f makes ineligible for ,new and ,nonofficial ,remedies any articles regarding which the manufacturer or his agents make unwarranted1 exaggerated or misleading statements as to the therapeutic value4 ,recognizing the long established custom of therapeutic exaggeration1 it has been most difficult to determine the degree of conservatism which might with fairness be required of a manufacturer4 ,in view of the common acceptance of individual impressions as dependable evidence1 it is often almost embarrassing to declare as incompetent the statement of some well meaning and all-too-kind-hearted doctor4 ,however1 as the pitfalls of haphazard clinical trials become better known and the physician's mistrust of glowing accounts of marvelous cures more outspoken1 the manufacturers' claims will be more moderate4 ,nomenclature4--,were it possible to enact and enforce a law which would oblige manufacturers to sell their medicinal products under properly descriptive names and which would make it illegal for a physician to prescribe it unless he understood the meaning of such properly descriptive titles1 then the ,council might safely disband4 ,in that case1 physicians would discontinue the use of most proprietary preparations in favor of established drugs1 and successful newcomers might each year be counted on the fingers of one hand4 ,such a rational nomenclature is not to be thought of1 at least in our generation4 ,rule #h requires that the name of an article shall not be misleading1 that it shall not be therapeutically suggestive1 and that established drugs shall not be disguised by fanciful titles4 ,it recognizes the right of discoverers of new drugs to name their discoveries1 and interposes no objection to arbitrary names for such products so long as such names are not misleading or do not suggest the therapeutic uses of the products4 ,as the rule provides against the recognition of coined names for established nonproprietary drugs1 so it requires that mixtures of drugs shall bear names descriptive of their composition4 ,it would be a long step forward if physicians would recognize more fully the objections to the many proprietaries which have1 as their only point of originality1 a non-descriptive name for an old drug or a mixture of well known drugs4 ,it is an encouraging sign that the ,federal ,trade ,commission1 when issuing licenses for the manufacture of synthetic drugs introduced under ,german patents1 stipulated that all manufacturers authorized to make a given drug shall use the same name for it4 ,irrational ,articles4--,rule #aj provides against the recognition of an article which1 because of its composition1 is useless or inimical to the best interests of the public and medical profession4 ,this rule excludes medicaments which 7#a7 are unessential modifications of established articles1 or 7#b7 are of no therapeutic value or 7#c7 are irrational4 ,with regard to the recognition of mixtures or compounds containing two or more active ingredients1 the ,council requires that the manufacturer establish the rationality of its combination4 ,the rule has prevented the recognition of many unnecessary so-called ethical specialties4 ,though a mass of testimonials was often to be had for them1 these contained no evidence that the mixture was superior to its potent ingredient1 or that its therapeutic effect had been determined4 ,that there is a healthy tendency to use single drugs for their definite action and to discard combinations 7be they shotgun proprietaries or 8mixed0 vaccines7 is perhaps best illustrated by the fact that at the last revision of the ,u4 ,s4 ,pharmacopeia a considerable number of complex antiquities were omitted from that book4 ,feeling confident that this meets with the endorsement of the profession1 the ,council is examining more critically the evidence for the value of pharmaceutical mixtures4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #aj1 #aiai47 8,,accepted ,,by ,,the ,,council ,,on ,,pharmacy ,,and ,,chemistry0 ,under the caption given above1 the ,journal of the ,missouri ,state ,medical ,association1 in its ,july issue1 speaks editorially as follows3 ,the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association is a department of our national organization that has not received the plaudits and encomiums of a wildly joyous medical profession nor the grateful praises of the enthusiastic manufacturer of pharmaceuticals4 ,the ,council seems indeed to be the unloved child of the entire family of subsidiary bodies of the association4 ,perhaps the reason for this may be found in the character of its duties1 for the ,council must expose fraud1 sometimes in high places1 and protect the physician from being duped by avaricious persons and by persons who are themselves sometimes the victims of their own credulity4 ,it thus happens that the sale of some proprietary article previously held in high esteem by the practitioner proves valueless1 perhaps even fraudulent4 ,the practitioner1 however1 may have credited much of his success in treating certain conditions to that preparation and the maker has had success in accumulating dollars from its sale and both parties emit a loud and vicious roar against the ,council1 because they both lose money4 ,nobody wants to be 8protected0 against making money--make it honestly1 if possible1 but make it--but this black sheep among the ,councils of the ,american ,medical ,association insists on their making their money honestly6 ,despite many obstacles thrown into its path1 the ,council on ,pharmacy and ,chemistry has serenely pursued its allotted tasks1 corrected its mistakes1 improved its methods1 and today stands as the only medium to which the honest physician may turn for information--not misinformation--regarding proprietary articles4 ,during the war the ,council and the chemical laboratory were in close cooperation with the ,surgeon-,general's ,office1 testing and investigating every article offered to the government for the treatment of sick soldiers4 ,the variety and the number of fakish and fraudulent stuff offered to the ,surgeon-,general was a pitiable exhibit of the mental gymnastics of some people4 ,just now the ,council and the laboratory have a new and important field before them1 i4 e41 to protect the physicians against worthless and useless serums1 vaccines and synthetics4 ,it will be the ,council's unpleasant duty to expose the fraudulent and useless among these articles and stamp truth on those found worthy4 ,we seem to have wandered from the topic in our caption1 but not so in reality1 because the burden of our thought is to lend our influence to the spread of the motto of the ,advertising ,clubs of the ,world1 namely1 8,truth in ,advertising40 ,it is our purpose to stimulate a larger degree of enthusiasm for the work of the ,council on ,pharmacy and ,chemistry and the ,chemical ,laboratory1 a more generous flow of inquiries concerning articles unfamiliar to the physician1 and particularly to urge that the words 8,accepted by the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association0 be printed on the label and on all advertising circulars of proprietary articles that have been admitted to ,new and ,nonofficial ,remedies4 ,then1 when pamphlets and circulars are received by physicians they will read the statements of manufacturers with sympathetic understanding and with full confidence in the verity of the declarations4 ,the importance of creating just that sort of receptivity in the mind of the prospective buyer is so well known to the astute publicity expert that it is needless for us to dwell on its advantages4 ,every proprietary article advertised in our journal1 in ,the ,journal of the ,american ,medical ,association1 and in the other state association journals1 as well as in several well-edited privately owned journals1 does in effect say to the reader that the articles so advertised are accepted by the ,council because only proprietary articles so accepted are accepted by us4 ,the fact is further acknowledged when these firms are permitted to exhibit their goods at our annual sessions for again the rule is enforced that only proprietary articles which have been approved by the ,council may be placed on display4 ,why not complete the circle of ideas--it would not be a 8vicious circle0--by printing on labels1 in advertisements and circulars1 the words3 8,accepted by the ,council on ,pharmacy and ,chemistry08--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #b1 #aiai47 ,,helping ,,the ,,council ,if they were built that way1 the members of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association might become discouraged at the apparent indifference of many members of the medical profession to their efforts4 ,there are many physicians who1 while figuratively patting the ,council on the back1 actually do nothing to aid its efforts4 ,on the other hand1 there are men in the profession who give the ,council active support instead of merely passive appreciation4 ,the letter that follows was written by such a man to a pharmaceutical concern3 ,i am receiving circular advertising from you concerning ---- ---- solution1 and ,i am writing to suggest that until these products have been approved by the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association1 you are wasting your postage on the practice4 ,aside from the fact that these products do not appeal to me personally1 ,i feel that ,i am not in a position to judge the value of such products and ,i depend entirely on the large clinical opportunities of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association in addition to their laboratory facilities1 in such matters as these4 ,i may1 therefore1 with all due respect1 suggest that 444 it will pay you to eliminate my name from your mailing list4 ,the members of the ,council on ,pharmacy and ,chemistry are working week in and week out without remuneration4 ,few appreciate how much these scientific men are doing for rational therapeutics2 fewer still realize how much has been accomplished through their efforts1 or how much more could be accomplished if every physician who at least believes in the work of the ,council would give it his full support4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #f1 #aibj47 ,,delays ,,in ,,passing ,,on ,,products ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,council frequently receives inquiries--some of them accompanied by expressions of impatience--concerning articles1 reports on which appear to be delayed4 ,it therefore seems advisable to make a statement of some of the factors which enter into this problem4 ,the ,council fully realizes the importance of giving prompt information to the profession with regard to proprietary medicines under consideration4 ,it therefore acts as soon as sufficient information is available to justify a definite judgment1 and publishes its conclusions as soon as possible4 ,when adequate information is available at the outset1 there is no delay in the publication of the ,council's conclusions4 ,unfortunately1 but very naturally1 there are many cases in which the information available at the time the product is submitted is not sufficient to justify the ,council in coming to definite conclusions for or against the preparation4 ,in some cases the manufacturer possesses the required information1 but to obtain it from him takes time2 in other cases the manufacturer does not possess the information--perhaps he did not realize the inadequacy of his evidence until the subject was brought to his attention by the ,council4 ,such cases might be dealt with in either one of two ways3 ,the ,council might at once reject the article because the claims for it are not supported by adequate evidence2 or1 the ,council might suspend judgment and give the manufacturer an opportunity to supply the information4 ,the first method--immediate rejection--would obviously be felt by manufacturers as a hardship4 ,to afford the fullest possible opportunity for the presentation of the case1 the ,council follows the second method2 that is1 it suspends judgment and withholds publication of a report until reasonable time has been afforded for furnishing the required information1 provided the manufacturer or agent appears to be making honest and diligent efforts to supply it4 ,the collection and compilation of such information is sometimes a lengthy process1 especially when the products are of foreign manufacture4 ,although it would be easier for the ,council to render an immediate decision than to assist manufacturers to supply the data necessary for the formation of an authoritative judgment1 the ,council cannot yield to importunities for hasty action4 ,it must rely on the medical profession to bear in mind that the character of a product under consideration by the ,council has not yet been determined4 ,the ,council holds that1 during this stage1 a product is suitable1 at most1 for experimental use4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiae1 p4 #aai47 ,,cooperation ,,of ,,the ,,pharmaceutical ,,houses ,report of the ,council on ,pharmacy and ,chemistry ,in reply to the suggestion made last year by ,president ,bevan that there should be closer cooperation between the large pharmaceutical houses and the ,council on ,pharmacy and ,chemistry1 the ,council submitted to the ,board of ,trustees of the ,american ,medical ,association the statement which appears below3 8,,cooperation ,,of ,,the ,,pharmaceutical ,,houses3 ,at the opening meeting of the ,house of ,delegates last year1 ,president ,arthur ,dean ,bevan suggested the desirability of greater cooperation between the large pharmaceutical houses and the ,council on ,pharmacy and ,chemistry4 ,the need of such cooperation has been recognized by the ,council from the first4 ,in no one direction has the ,council made greater effort than in its endeavor to secure the fullest cooperation of the various pharmaceutical houses4 ,the difficulty has been1 and always must be1 the fundamental antagonism between objectives that are largely commercial on the one hand and purely scientific on the other4 ,nevertheless1 the ,council has always believed--and has acted on the belief--that there is a possible middle ground wherein the interests of therapeutics would not be injured but would go hand in hand with a commercial development based on enlightened self-interest4 8,the profits to be made by a pharmaceutical house from the sale of a staple drug--a pharmacopeial1 ,national ,formulary1 or nonproprietary preparation--which enters into free competition with other drugs of the same kind1 are moderate2 the profits to be made from the sale of a proprietary medicine on which the manufacturer holds a monopoly are usually large--sometimes enormous4 ,there are1 broadly1 two kinds of proprietary preparations advertised to physicians3 ,one represents laborious research ending in the production of a new medicinal chemical2 this product can be patented and the manufacturer can obtain a seventeen-year monopoly on its manufacture and sale4 ,the other represents no research but comprises simple mixtures--frequently of the 8shotgun0 variety--of well known pharmaceuticals1 or biologic products sold under trade names4 ,as these do not represent anything new or original the manufacturer is unable to obtain a patent1 but by means of the trade name he can and does obtain a perpetual monopoly4 ,this1 from a business standpoint1 is more valuable than the limited monopoly granted by a patent4 ,it is not surprising that proprietary remedies of the latter type flourish so long as physicians unthinkingly accept and prescribe them solely on the manufacturer's valuation4 8,the ,council has practically the undivided support of manufacturers of medicinal chemicals2 that is1 of proprietaries of the first mentioned type4 ,but pharmaceutical firms which have found it profitable to promote proprietaries of the second type--8specialties10 unscientific or ordinary mixtures of pharmaceuticals or biologic products sold under trade names--have not supported the ,council4 8,when the ,council was organized1 it was hoped and believed that all the large pharmaceutical houses would find it possible and desirable1 if not actually more profitable1 to shape their business methods so as to make their proprietary and other articles conform to those conservative standards on which the ,council bases its rules1 and thus render such articles acceptable for ,new and ,nonofficial ,remedies4 ,it soon developed1 however1 that the methods of the pseudochemical companies1 whose sales propaganda in the interest of unscientific nostrums with its attending damage to scientific medicine had led to the establishment of the ,council1 had found their lodgment in most of the pharmaceutical houses4 ,it was a genuine disappointment to the ,council to find that some of the large and old-established firms were not only unwilling to cooperate with the ,council1 but in many instances exhibited a definite antagonism to the ,council's work4 8,the object--and duty--of the officers of pharmaceutical houses is primarily to pay dividends to their stockholders4 ,through skilful advertising or the persuasiveness of 8detail men10 they are able to induce physicians to prescribe their controlled products1 on which there are large profits1 even though such products have not only not been accepted by the ,council1 but in many instances1 have been disapproved4 ,is it any wonder that concerns which put out such products are indifferent or openly antagonistic to the work of the ,council8 ,the matter is largely one of business policy4 ,when the medical profession as a unit will support the ,council in its work1 then such firms will find it good business policy to accede to ,dr4 ,bevan's suggestion--but not before40 ,evidently the problem resolves itself into this3 ,the ,council1 constituted of scientific men1 working without remuneration in the interest of scientific medicine and the medical profession1 expects--and rightfully--the cooperation and support of the members of that profession4 ,what is needed1 therefore1 is the active1 sympathetic cooperation of physicians2 the cooperation of pharmaceutical houses will follow as a matter of course4 7,j4 ,a4 ,m4 ,a4 #gd3abce ,may #a #aibj47 ,the following is the recommendation of the ,reference ,committee to which the ,report of the ,board of ,trustees was referred3 8,a perusal of the ,trustees' ,report1 #8,cooperation of the ,pharmaceutical ,houses'1 is well worth the time of every member of the profession1 and your committee would emphasize the statement of the ,trustees3 #8,the ,council1 constituted of scientific men1 working without remuneration in the interest of scientific medicine and the medical profession expects--and rightfully--the cooperation and support of the members of that profession4 ,what is needed1 therefore1 is the active sympathetic cooperation of physicians2 the cooperation of pharmaceutical houses will follow as a matter of course4' 8,your committee would go still further and move that a vote of thanks of the ,house be extended to those scientific men who have devoted so much valuable time to the welfare of the ,association40 7,j4 ,a4 ,m4 ,a41 #gd3acbb ,may #h #aibj2 from ,reports of ,council on ,pharmacy and ,chemistry1 #aibj1 p4 #ef74 ,w4 ,a4 ,puckner1 ,secretary4 ,,budwell',s ,,emulsion ,,of ,,cod-,,liver ,,oil1 ,,nos4 #a ,,and #b ,report of the ,council on ,pharmacy and ,chemistry ,the ,budwell ,pharmacal ,company1 ,lynchburg1 ,virginia1 which markets these preparations1 claims that 8,no4 #a0 contains cod liver oil1 8,iodide of ,arsenic10 8,iodide of ,calcium10 and 8,iodide of ,manganese40 8,no4 #b0 is said to contain in addition to the ingredients of ,no4 #a1 creosote carbonate and guaiacol4 ,it is known that arsenous iodid is decomposed by contact with water4 ,it is recognized that creosote carbonate is unstable and prone to liberate creosote4 ,iodide of manganese not being official1 the supply on the market is not controlled in any way3 ,tests of purity are not prescribed by the ,pharmacopeia1 the ,national ,formulary1 ,new and ,nonofficial ,remedies or other books of standards4 ,therefore doubt must be expressed as to the accuracy of the formulas as given4 ,the ,council cannot accept such statements of composition without further evidence4 8,no4 #a0 is commended for use in 8,chronic ,rheumatism1 ,glandular ,swellings1 later forms of ,syphilis1 convalescence from ,scarlet ,fever1 ,la ,grippe and ,malaria1 ,chronic ,malarial ,infection1 ,marasmus1 ,joint or other suppuration of standing1 diseases of skin1 chorea1 anaemia1 neurasthenia1 obstinate neuralgia1 scrofulous affections in general1 and diarrhea or dysentery 7subacute or chronic7 in childhood40 8,no4 #b0 is said to be 8,prepared especially for the treatment of ,chronic ,throat1 ,nasal1 ,bronchial and ,pulmonary ,diseases40 ,in the advertising circular statements regarding the various ingredients of ,budwell's ,emulsion are quoted from obsolete text books4 ,these statements1 for the most part1 do not represent modern opinions on the subject4 ,for instance1 the circular praises the action of guaiacol as eliminated directly by the lungs1 thus exerting a beneficial local effect and causing bacilli to diminish in numbers or to disappear4 ,all of this is directly contradicted in authoritative modern publications on pharmacology1 which hold that the excretion of guaiacol by the lungs is infinitesimal and its action on bacilli is nil4 ,the ,council held the preparations in conflict with its rules as follows3 #a4 ,many of the therapeutic claims are exaggerations4 #b4 ,the method of exploitation amounts to an indirect invitation to the public to use these preparations as 8consumption cures40 #c4 ,the preparations are unscientific1 they constitute a reprehensible invitation to uncritical prescribing and their use is inimical to the best interests of the profession and the public4 ,it is difficult to imagine in what conditions such a combination would be indicated4 ,these preparations are a remnant of the days of polypharmacy4 ,their use is not in keeping with present medical thought and practice4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #bj1 #aiae47 ,,rheumalgine ,report of the ,council on ,pharmacy and ,chemistry ,rheumalgine 7,eli ,lilly ,co41 ,indianapolis7 is put up both in tablet form and as a liquid4 ,each tablet1 or teaspoonful of the liquid1 is said to contain3 8,strontium salicylate from ,natural ,oil #e gr4 ,hexamethylenamin #b gr4 ,colchicine #a_/bjj gr40 ,the advertising matter contains several statements regarding the individual ingredients to which objection must be made4 ,it is claimed 7quoting from ,hare7 that strontium salicylate 8444 is not so disagreeable to the taste as the corresponding sodium salts1 and more important still1 it is far less apt to disorder the stomach40 8,taste0 is a difficult subject to dispute2 but in the experience of the referee1 patients object more to the strontium than to the sodium salt4 ,no evidence is submitted to prove that the strontium salt is less apt to disorder the stomach4 ,in observations made under the direction of the referee1 the nauseant and emetic doses are about the same as1 or even less than1 those of sodium salicylate4 ,under hexamethylenamin1 the recommendations are not confined to its recognized use as a urinary antiseptic2 it is also said to be 8unexcelled0 as a 8germicide10 and to prevent the formation of urate and phosphate deposits4 ,these statements are contrary to facts4 8,rheumalgine 444 may be used in all cases where the salicylates are indicated4 ,it is superior to preparations containing sodium salicylate1 in that it does not cause nausea or disturb the digestion40 ,both the preceding statements are misleading4 ,the necessity of giving #a_/bjj grain of colchicin for each #e grains of salicylate would certainly interfere with the use of adequate doses of the latter4 ,the colchicin would produce digestive disturbance quite apart from the salicylate4 ,the mixture is described as3 8444 ,,antirheumatic1 ,,antipyretic1 ,,urinary ,,antiseptic1 ,,and ,,uric ,,acid ,,eliminant4 ,useful in ,acute ,articular and ,chronic ,rheumatism1 ,muscular ,pains1 ,lumbago1 ,sciatica1 ,migraine of the ,rheumatic1 ,gout1 and in ,nervous ,irritability of the ,gouty or ,lithemic40 ,the facts are3 ,salicylates are useful in some of these conditions1 colchicin occasionally in a few1 hexamethylenamin in none4 ,the combination is conducive to uncritical prescribing4 ,for instance1 salicylates are effective in acute articular rheumatism2 hexamethylenamin and colchicin are useless2 salicylates are of very little use in chronic rheumatism1 sciatica and nervous irritability1 while hexamethylenamin and colchicin are useless in these conditions2 colchicin is sometimes effective in gout1 salicylates perhaps also2 hexamethylenamin is not4 ,attention should also be called to the high dosage of colchicin1 namely1 #a_/ajj to #a_/ej of a grain of the alkaloid1 every three or four hours1 the dose then to be 8slightly reduced10 but continued for several days2 or in chronic cases1 #a_/ajj to #a_/cj grain per day1 continued indefinitely4 ,this dosage appears high1 if a really active preparation is used4 ,finally1 the name 8,rheumalgine0 encourages thoughtless and unscientific prescribing4 ,if a mixture is used at all1 the prescriber should be constantly reminded of its composition4 ,it is therefore recommended that ,rheumalgine be held in conflict with ,rules #f 7unwarranted therapeutic claims71 #h 7nondescriptive name7 and #aj 7unscientific composition74--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #bf1 #aiae47 ,,gray',s ,,glycerine ,,tonic ,report of the ,council on ,pharmacy and ,chemistry ,the ,council adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,gray's ,glycerine ,tonic ,comp4 7,purdue ,frederick ,company1 ,new ,york7 is a mixture said to be made according to a prescription of the late ,dr4 ,john ,p4 ,gray1 superintendent of the state hospital1 ,utica1 ,new ,york4 ,as to the composition1 the following statement is furnished by the company3 8,this preparation is a combination of ,glycerine1 ,sherry ,wine1 ,gentian1 ,taraxacum and ,phosphoric ,acid with carminatives40 ,the label declares the presence of #aa per cent4 alcohol1 and the dose is given at from two teaspoonfuls to a tablespoonful4 ,a study of the ingredients will show that1 aside from the alcohol1 the mixture contains but one really active drug1 gentian4 ,essentially1 then1 8,gray's ,glycerine ,tonic0 is a mixture which1 in addition to the narcotic effect of the alcohol1 depends on a bitter1 gentian1 for whatever therapeutic action it may possess4 ,the bitters1 of which gentian is a type1 were once credited with many therapeutic virtues which time has shown they do not possess4 ,pharmacologic research has demonstrated that their utility consists in stimulating the appetite through their action on the taste buds4 ,on this account they were believed also to increase the secretion of the gastric juice by a psychic impression4 ,more recently1 however1 even this has been questioned--by ,carlson1 for instance4 ,these facts are fully understood1 presumably1 by all physicians4 ,yet1 according to the advertising circular1 this 8tonic10 which1 for all practical purposes1 is merely a simple bitter1 is good for thirty-two diseases ranging from amenorrhea to whooping cough6 ,the conditions in which ,gray's ,glycerine ,tonic is asserted to be especially efficient are described on the label of the bottle and the outside wrapper1 in popular terms1 more or less typical of 8patent medicine0 exploitation1 such as 8catarrhal conditions10 and 8stomach derangements40 ,similar statements are contained in the leaflet accompanying the trade package4 ,for instance3 8,it is1 therefore1 an effective1 reliable tonic in nervous exhaustion1 general debility1 impoverished conditions of the blood and nervous system1 ,bright's disease1 diseases of the liver1 disorders of the urinary organs1 etc40 8,it is an unexcelled restorative in that very common class of cases in which there is no positive organic disease1 but the patient complains that he #8does not feel well' or #8is out of sorts4'0 ,here are some of the claims made in other advertising matter3 8,all stages of bronchitis 444 are rapidly improved by the use of ,gray's ,glycerine ,tonic ,comp4 ,this remedy has a direct tonic influence upon the circulation of the respiratory mucous membrane2 it relieves congestion and restores tone to weakened blood vessels40 8444 improves the appetite1 gives valuable aid to the digestive and absorptive processes1 and reinforces cellular nutrition in ways that insure a notable gain in vitality and strength40 ---------------------------------------- ------------------------- ,in ,gastro-,intestinal ,catarrh --and other afflictions of the stomach and bowels characterized by muscular weakness and glandular insufficiency--there is no remedy more prompt and effective in its action than ,gray's ,glycerine ,tonic ,comp4 ,under its systematic administration the appetite is restored1 the alimentary processes greatly improved1 the nutrition promoted and every vital function throughout the body given a new and substantial impetus4 ,as the digestive and assimilative functions are restored to their normal efficiency1 a notable increase in the restorative and recuperative powers of the body naturally follow4 ,,the ,,purdue ,,frederick ,,co4 #ace ,christopher ,street1 ,new ,york ,city ---------------------------------------- ------------------------- ,mention ,,illinois ,,medical ,,journal when writing to advertisers4 ,illustration3 ,this appeared in a journal owned and controlled by the second largest state medical association of the country4 ,even granting that gentian may improve the appetite1 how absurd it is to claim that this mixture 8relieves congestion10 8restores tone to weakened blood vessels10 8gives aid to the absorptive processes10 8reinforces cellular nutrition10 or increases vitality6 ,neither the composition of ,gray's ,glycerine ,tonic nor the clinical evidence warrants the belief that it has any therapeutic value other than that due to the psychic effect of the bitter drug gentian4 ,physicians who have prescribed it have done so because of the advertising4 ,this nostrum has been kept so constantly before the eyes of medical men that they think of ,gray's ,glycerine ,tonic when they cannot remember the official drugs that may be indicated in the case4 ,the moral is that liberal advertising will sell anything4 ,it is recommended that ,gray's ,glycerine ,tonic ,comp4 be declared not eligible for inclusion in ,new and ,nonofficial ,remedies on account of conflict with ,rules #a1 #f1 #h and #aj4 ,editorial ,note4--,an old practice in hospitals--happily now practically obsolete--was to have certain stock mixtures prepared in bulk4 ,among these there was usually a so-called tonic mixture1 used in a more or less haphazard manner when nothing in particular seemed indicated4 ,such a stock mixture was used in the ,state ,hospital for the ,insane at ,utica1 ,n4 ,y41 during the many years that ,dr4 ,john ,p4 ,gray was superintendent 7from the early fifties to the early eighties71 although it is very doubtful whether he originated the mixture4 ,after the death of ,dr4 ,gray--so the story runs--one of his sons1 with a partner1 formed the firm of ,purdue ,frederick ,company1 and began the exploitation of the elder ,dr4 ,gray's name1 in connection1 presumably1 with this stock preparation4 ,as indicated in the ,council's report1 ,gray's ,glycerine ,tonic ,comp4--and what an absurd name6--is simply a mixture of ordinary drugs1 requiring no skill whatever in compounding4 ,if there is a physician living who cannot write a prescription offhand as good as this formula1 that physician should either go back to a medical school or change his vocation4 ,there is1 and can be1 no excuse for prescribing such a ready-made mixture1 for every cross-roads drugstore has the ingredients and any pharmacist worthy of the name could compound it4 ,among the scores of nostrums that disgrace the medical profession of this country1 none is more typical of all that is inimical to scientific medicine1 to the medical profession and above all to the public--for1 after all is said1 it is the public that ultimately is humbugged4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #aj1 #aiae47 ,,tongaline ,,and ,,ponca ,,compound ,report of the ,council on ,pharmacy and ,chemistry ,the ,council1 having considered 8,tongaline10 8,tongaline ,tablets10 8,tongaline and ,lithia ,tablets10 8,tongaline and ,quinine ,tablets0 and 8,ponca ,compound ,tablets10 found these preparations ineligible for ,new and ,nonofficial ,remedies and authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,,tongaline ,tongaline 7,mellier ,drug ,co41 ,st4 ,louis7 is a fancy name given to what is essentially a sodium salicylate mixture4 ,the air of mystery created by the name permits the manufacturers to make claims for the product which would be ludicrous if the medical profession was fully conversant with the very ordinary character of the preparation4 ,tongaline receives its name from tonga1 an inert1 long-discarded mixture of various barks and herbs said to be gathered and prepared by ,fiji ,islanders4 ,its constituents evidently tend to vary with the collector4 ,the history of the introduction of this indefinite combination of simples is thus given in ,the ,journal1 ,may #aj1 #aiac4 8,a supply of the crude drug was carried to ,england by a man who had lived for a short time in the ,fiji ,islands and it was placed in the hands of a retail house in ,london4 ,this occurred about #ahgi4 ,in #ahhj1 two ,english physicians of repute published laudatory articles on the therapeutic value of tonga in neuralgia and rheumatism4 ,this created a demand for the drug which extended to the ,united ,states40 ,time showed that tonga was inert therapeutically1 and authorities on pharmacology now no longer notice it4 ,as the ,council previously reported1#ab the indefinite character of the mixture should1 alone1 be sufficient to exclude it from practical therapeutics4 ,during the temporary popularity of tonga1 the proprietary mixture ,tongaline was put on the market for physicians' use by the ,mellier ,drug ,company1 ,st4 ,louis4 ,in this1 tonga was named as the active ingredient4 ,the commercial interests thus involved have faithfully nourished and kept alive the 8tonga0 myth4 #ab ,reports of the ,council on ,pharm4 and ,chem41 #aiab1 p4 #dj4 ,in a recent advertising booklet1 8,the ,therapeutic ,properties of the ,ingredients of ,tongaline10 the virtues of tonga1 blue cohosh1 colchicum1 jaborandi and salicylic acid are discussed4 ,the label of a recently purchased bottle reads3 8,tongaline contains ,tonga1 ,cimicifuga ,racemosa1 ,salicylate of ,sodium 7the salicylic acid being made from pure natural oil7 ,colchicum and ,pilocarpin40 ,it will be noticed that ,tongaline is 8made from the pure1 natural oil40 ,in fact1 the statement is repeated in red ink1 in large letters running across the face of the label1 thus emphasizing the alleged importance of this assertion4 ,in this connection it is only necessary to recall that it has been proved clinically1 chemically and physiologically that there is absolutely no difference between the salicylic acid made from the natural oil and the synthetic4 ,the formula was thus commented on in the article previously quoted from ,the ,journal3 8,tongaline 444 is essentially a preparation of sodium salicylate1444 ,the ,mellier ,drug ,company realized the impossibility of creating any marked demand for a nostrum unless it had some real drugs in it--hence the presence of the salicylates4 ,what the actual composition of ,tongaline is1 no one but the manufacturers know4 ,at one time the following was given as the formula3 ,fluid ,tonga #cj grains ,extract of ,cimicifuga ,racemosa #bj grains ,sodium ,salicylate #aj grains ,pilocarpin ,salicylate #a_/ajj grain ,colchin ,salicylate #a_/ejj grain 8,these amounts refer to the quantity of drugs in each fluidram of the preparation4 ,whether the nostrum still has this composition we do not know1 but assuming that it has1 it is quite evident that sodium salicylate is the essential and active ingredient40 ,the therapeutic indications given on the label of the bottle are3 8,rheumatism1 ,neuralgia1 ,grippe1 ,gout1 ,nervous ,headache1 ,sciatica1 ,lumbago1 ,malaria1 ,tonsillitis1 ,heavy ,colds1 ,excess of ,uric ,acid1 and wherever the use of the ,salicylates is indicated40 ,in a recent booklet this semisecret salicylate mixture is recommended1 not only in conditions in which salicylates are indicated1 but also combined with aconite for rheumatic fever1 with benzoate of soda in the treatment of 8grippe10 with potassium bromid in nervous headaches1 with gelsemium1 glycerin and whisky for 8heavy colds10 with ammonium chlorid1 stramonium and cimicifuga in 8rheumatic dysmenorrhea10 and even with mercury biniodid as a treatment of syphilitic eruptions6 8,when administered with good judgment1 ,tongaline exerts a stimulating effect upon every organ of elimination2 cleansing the complex sewerage system and putting it into working order4 ,when this is done1 the sluggish blood current begins to flow more freely2 the lymphatic and glandular systems to give up and carry off the toxic products1 so long retained 4440 ,,tongaline ,,tablets ,then because of a 8desire to put ,tongaline in a more compact and convenient form10 the same concern puts on the market ,tongaline ,tablets4 ,whether ,tongaline ,tablets are of the same composition1 the doctor who prescribes them is not advised4 ,in this form we have ,tongaline and ,lithia ,tablets1 and ,tongaline and ,quinin ,tablets4 ,presumably those who are attracted by the word 8lithia0 are sufficiently uncritical to be content with the statement that3 8,the addition of ,lithia to ,tongaline presents a most useful combination which does not rely upon its action on the kidneys alone as is the case with ,lithia salts or ,lithia waters as administered 4440 ,and the foregoing quotation1 be it remembered1 is for the information of the medical profession6 ,tongaline and ,lithia ,tablets1 we are informed1 are3 8444 particularly indicated for certain diseases which are caused by deposits of urates in the joints and kidneys1 and can be used with much benefit for many people who indulge in generous or intemperate habits of living40 ,tongaline and ,quinine ,tablets are also exploited without statement of composition4 ,the promoters are probably justified in feeling that physicians who prescribe quinin in combination with 8,tongaline0 care little about the dosage4 ,it is unnecessary to discuss the silly claims made for ,tongaline and its combinations1 although it is worth while to point out that the prescribing of such nostrums by physicians is an imposition1 if not a fraud1 on the public4 ,,ponca ,,compound ,ponca ,compound1 also made by the ,mellier ,drug ,company1 ,st4 ,louis1 is a 8female weakness remedy0 in tablet form4 ,the name suggests that 8ponca0 is a medicinal substance1 and1 in fact1 at one time1 8,ext4 ,ponca0 was named as an ingredient4 ,the nature of 8,ext4 ,ponca0 was apparently never explained4 ,it is now replaced in the 8formula0 by 8senecin10 and the only information concerning the composition at present given is3 8,ponca ,compound ,tablets ,contain ,extract of ,mitchella ,repens1 ,senecin1 ,helonin1 ,caulophyllin and ,viburnin40 ,this 8formula0 is practically meaningless1 not only because the amount of each ingredient is not stated1 but also because 8senecin10 8helonin10 8caulophyllin0 and 8viburnin0 are in themselves variable mixtures of unknown composition4#ac #ac ,see ,report of the ,council on ,pharmacy and ,chemistry on 8,resinoids and ,concentrations10 ,j4 ,a4 ,m4 ,a41 ,nov4 #ac1 #aiji1 p4 #afee4 ,presumably1 8senecin10 8helonin10 8caulophyllin0 and 8viburnin0 are extractives of some kind prepared1 respectively1 from senecio aureus 7life root71 helonias dioica 7false unicorn71 calophyllum thalictroides 7blue cohosh7 and viburnum prunifolium or opulus 7black haw or cramp bark74 ,these are1 one and all1 practically inert drugs4 ,there is no reason to believe that any or all of them can have any beneficial influence in the many and varied conditions for which ,ponca ,compound is advertised4 ,the following are excerpts from the advertising matter3 8,ponca ,compound is a remedy of a very beneficial character for ,functional1 ,uterine and ,ovarian troubles1 which will respond to internal treatment1 especially when digital examination or surgical interference is undesirable40 8,ponca ,compound is also valuable during gestation and after parturition40 8,uterine ,alterative for ,leucorrhoea1 ,dysmenorrhoea1 ,amenorrhoea1 ,metritis1 ,endometritis1 ,menorrhagia1 ,metrorrhagia1 ,irregular ,menstruation1 ,subinvolution1 ,painful ,pregnancy40 ,it is recommended that ,tongaline and ,ponca ,compound and all their preparations be held in conflict with ,rule #a1 in view of their semisecret and indefinite composition2 with ,rule #f1 for the grossly exaggerated therapeutic claims made for them2 with ,rule #h1 because of their misleading names1 and with ,rule #aj1 in view of their unscientific character as irrational combinations4 ,it is also recommended that this report be published4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #ag1 #aiae47 ,,alfatone ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has found ,alfatone ineligible for ,new and ,nonofficial ,remedies and has authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,alfalfa is good cattle feed but only nostrum exploiters have suggested its use as a medicine for human beings4 ,while it may seem a waste of time to discuss the medicinal value of alfalfa its recent exploitation by the ,norwich ,pharmacal ,company1 ,norwich1 ,n4 ,y41 as 8a reconstructive tonic and nutrient0 in the form of a mixture called 8,alfatone10 calls for comment4 ,according to the label on the preparation3 8,each fluidounce represents3 ,alcohol #ae per cent4 ,medicago sativa 7,alfalfa7 #abj grains ,taraxacum #b-a_/b grains ,gentian #a grain ,berberine ,hydrochloride #a_/dj grain ,glycerin and ,aromatics40 8,dose4--,one to three fluidrams 7#d to #ab c4c47 #d times daily40 ,each maximum dose1 therefore1 should represent #de grains of alfalfa1 #a grain of taraxacum 7dandelion71 #c_/h grain of gentian1 #a_/ajj grain of berberin hydrochlorid1 and #bg minims of alcohol4 ,since the bitter drugs are present in such small amounts that the preparation is almost devoid of bitterness1 and as the medicinal value of alfalfa is practically nil1 it is evident that whatever action ,alfatone may have is due to the stimulant effects of the alcohol4 ,some of the claims made for ,alfatone are3 8,a reconstructive nutritive tonic indicated in general debility1 neurasthenia1 convalescence1 etc40 8444 a ,galactagogue of merit as well40 8444 improves the appetite1 aids the processes of digestion and assimilation1 facilitates elimination and effects gradual but decided gains in strength1 vitality and weight40 ,it is suggested that3 8444 in case of idiosyncrasy the addition of ,tr4 ,nux ,vomica #e to #aj minims to the dose1 unless contraindicated1 will secure excellent results40 ,the ,norwich ,pharmacal ,company naively remarks3 8,the dearth of medical literature on ,alfalfa has lead us to present below a few of the findings of the ,bureau of ,plant ,industry of the ,department of ,agriculture 444 as well as those from several state experiment stations 4440 ,here are the 8findings03 8444 ,digestible nutrients in #ajj pounds of ,alfalfa1444 ,protein1 #aa4j pounds2 ,carbohydrates1 #ci4f pounds2 ,ether ,extract1 #a4b pounds40 8444 ,the high value of ,alfalfa is due to the amount of protein that it contains2 to the large percentage of protein that is digestible and the palatability of ,alfalfa40 8444 ,table showing pounds of elements removed from the soil by one ton of crop4 ,alfalfa ,wheat ,potash #di4gi #ab4eb ,phosphoric ,acid #h4bg #i4jh ,lime #dc4ea #b4ie ,nitrogen #dd4ja #bb4cj0 8444 ,the abundance of muscle and bone producing material in ,alfalfa makes this crop especially good40 ,thus estimates of the value of a farm crop and cattle fodder are made to do service as testimonials to its therapeutic merit for human beings6 ,has the 8patent medicine0 promoter ever dared to insult the intelligence of his patrons by a cruder absurdity8 ,yet it is not to the nontechnical and unscientific public1 but to a profession presumably scientifically trained in pharmacology and therapeutics that this concern presumes to offer its fodder tincture on the basis of testimony to the agricultural value of the fodder plant4 ,alfatone is a worthless alcoholic cordial4 ,the audacity of the attempt to promote its sale by a discourse on the merits of a well-known fodder plant is the sole reason for devoting any attention to it4 ,it is recommended that ,alfatone be held ineligible for ,new and ,nonofficial ,remedies1 and that this report be published4 ,editorial ,note4--,what a comment on ,american medicine that a concern can even contemplate the possibility of making a commercial success of the sale of such a silly nostrum as ,alfatone6 ,and yet1 when one remembers that a proprietary in which oats constitutes one ingredient 78,pas-,avena07 for years has been advertised to physicians and presumably prescribed by them1 it is not altogether inexplicable that business men should get the impression that the medical profession is 8easy0 enough to 8fall for0 anything in the line of proprietary mixtures4 ,perhaps we may look forward to being offered proprietaries based on other cheap and well-known fodder plants4 ,tincture of ,timothy ,hay1 ,blue ,grass ,tonic1 ,cornhusk ,wine6 ,why not8 ,the enterprising companies that may put them out can easily publish tables to show the digestible nutrients in each and indubitable testimony can be furnished to prove the excellence of any of them as stock feed4 ,if a pitchforkful of timothy hay makes a good fattening ration for a growing steer why should not a teaspoonful of tincture of timothy hay make a 8reconstructive tonic and nutrient0 dose for a man8 ,if an arm load of thistles 7carduus7 makes a luscious food for equus asinus why should not a pinch of thistle in alcohol and water be a good 8tonic08 ,great are the possibilities6 ,they are limited only by the gullibility of the medical profession and the public4 ,certain it is that some proprietary manufacturers are firmly convinced that no combination can be too preposterous to be worth trying on the medical profession4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #g1 #aiae47 ,,articles ,,refused ,,recognition ,report of the ,council on ,pharmacy and ,chemistry ,below appear abstracts of the ,council's actions on articles refused recognition which were not deemed of sufficient importance to require lengthy reports4 ,uricsol ,uricsol is marketed by the ,uricsol ,chemical ,company1 formerly of ,los ,angeles1 now of ,boston4 ,regarding its composition only vague statements are made4 ,in an advertising pamphlet it is promised that the formula will be sent to physicians on request4 ,such a request from a physician elicited the following statement3 8,,uricsol is a non-irritating1 alkaline solution1 containing ,lithium ,citrate1 ,acid ,citric and ,potassium ,nitrate1 together with a saline laxative in the form of ,glycero ,sodium ,phosphate1 with ,vegetable ,tonics added40 ,the ,association ,laboratory has made an examination of ,uricsol to determine its composition and reports as follows3 ,,laboratory ,,report ,a trade package purchased in ,march1 #aiae1 from a wholesale drug house was labeled3 8,uricsol ,rheumatic ,remedy1 ,uric ,acid ,solvent1 ,kidney and ,liver ,stimulant1 ,manufactured by the ,uricsol ,chemical ,co41 ,los ,angeles1 ,cal40 ,this package was wrapped in a circular entitled 8,the ,great ,california ,remedy--,uricsol40 ,the preparation is a viscid1 slightly turbid light brown liquid1 with a faintly aromatic odor and a salty1 bitter taste4 ,the diluted solution is acid in reaction toward litmus and phenolphthalein and alkaline toward methyl orange4 ,qualitative tests showed a presence of phosphate1 citrate1 nitrate1 sodium1 glycerin1 and a small amount of lithium in aqueous solution4 ,besides these a small amount of some organic1 nonalkaloidal substance was found1 which from its bitter taste suggested gentian4 ,from the qualitative tests it appeared that the phosphate was the predominating ingredient and accordingly a phosphate determination was made4 ,the results1 calculated to sodium phosphate1 ,u4 ,s4 ,p41 indicated the presence of #fd4bj gm4 per #ajj c4c41 held in solution by citric acid and sodium nitrate4 ,uricsol evidently is a solution containing a large amount of sodium phosphate with small amounts of lithium1 nitrate1 citric acid and glycerin1 with probably some vegetable extract4 ,in general ,uricsol is similar to the once widely exploited proprietary 8,melachol10 which has been frequently imitated4 ,a preparation essentially identical is in the ,united ,states ,pharmacopeia1 under the title 8,compound ,solution of ,sodium ,phosphate40 ,the ,uricsol ,company calls its preparation 8444 the latest word in the treatment of ,rheumatism and that allied group of ailments which is caused by an excess of ,uric ,acid40 ,hay fever1 bronchial asthma and neuritis are conditions in which it is recommended4 ,the claim is made that 8,uricsol quickly controls ,vasomotor ,rhinitis and eliminates such conditions from the system40 8,in fact1 it will correct ,,faulty ,,metabolism40 ,to a few practitioners of an older generation the pharmacologic basis of a remedy for rheumatism was sufficiently defined by saying that it increased the solubility of uric acid or affected it in some way4 ,this theory is obsolete2 there is not1 and never was1 any reliable evidence on which to base the theory that rheumatism is in any way caused by uric acid4 ,the exploitation of ,uricsol as a 8uric acid solvent0 is merely another illustration of the way in which nostrum manufacturers play on disproved theories4 ,of course the claim that sodium phosphate has any particular power to control vasomotor rhinitis1 hay fever1 asthma1 and to correct faulty metabolism is foolish4 ,to summarize3 ,uricsol is a mixture of well-known drugs1 marketed with false claims as to therapeutic action1 with misleading and meaningless statements as to composition and under a name which invites uncritical prescribing4 ,uricsol is held ineligible to inclusion in ,new and ,nonofficial ,remedies4 ,jubol ,the following ridiculous statements are addressed1 not to the laity1 but to the medical profession3 ,,do ,,you ,,suffer ,,from ,constipation--,hemorrhoids--,enteritis- -,mucous discharge--,pituita--,acidity of the stomach--,vertigo--,sick ,headache--,disturbed ,sleep--,insomnia--,sallow ,complexion--,coated ,tongue--,offensive breath--,fatigue and depression--,boils--,pimples8 8,,one of these symptoms alone shows that there is defective or insufficient function of the intestines1 even if the stools are regular4 8,excrements remain too long in the intestine and set up fermentation4 ,the harmful poisons and ,ptomains which they produce are re-absorbed by the blood and poison the whole system4 8,the ,intestines must be cleared and re-educated with ,,jubol4 8,jubolise your ,intestines40 ,jubol tablets are sold in the ,united ,states by ,geo4 ,j4 ,wallau1 ,inc41 ,new ,york1 and are said to be prepared by ,j4 ,l4 ,chatelain1 ,paris1 ,france4 ,the following incomplete and nonquantitative 8formula0 is furnished3 8444 compounded chiefly 6 of ,agar-,agar1 ,biliary ,extracts and pure ,extracts from all the intestinal ,glands40 ,it is asserted that 8,the tablets are coated with a protective covering in order that they may act on the intestine only40 ,the tablets contained in a regular-size trade package1 obtained direct from the agent1 readily separated into two halves and disintegrated within a few minutes when agitated with water4 ,it is thus evident that1 under ordinary conditions1 the intestinal ferments in ,jubol 7if they are present1 as claimed7 would be destroyed during their passage through the stomach4 ,in direct tests1 however1 practically no tryptic activity was demonstrated4 ,the composition of ,jubol is not declared2 grossly unwarranted and incorrect claims are made for its therapeutic actions2 the name does not indicate the alleged ingredients and so much of the composition as is declared indicates an unscientific mixture4 ,the ,council decided that ,jubol should be held ineligible for ,new and ,nonofficial ,remedies1 and that this report should be published4 ,urodonal ,urodonal is said to be 8produced in the laboratory of ,j4 ,l4 ,chatelain10 ,paris1 ,france4 ,it is marketed in this country by ,geo4 ,j4 ,wallau1 ,inc41 ,new ,york4 ,the preparation is claimed to be a chemical compound1 and the advertising matter furnishes a 8formula10 which consists of the formulas of lysidin1 sidonal and hexamethylenamin1 connected by plus signs3 ,h,c ,az ,,co,h--,c--,,oh ,az,h ,az ,h,c ,c--,,ch ,h,c ,,choh ,h,c ,,ch ,h,c ,,ch ,,ch ,az,h ,,ohhc ,,ch ,h,c ,,ch ,az4,,ch ,az4,,ch ,az ,,cho ,az,h ,,ch ,that the substance is a chemical compound is highly improbable1 and no evidence has been submitted to substantiate the claim4 ,on the contrary1 in the following statement the phrase 8based on0 is a virtual admission that the preparation is merely a mixture3 8,urodonal 444 is a granular effervescent preparation based on methylglyoxalidine ,lysidine1 quinate of diethylene-diamine ,sidonal and hexamethylene-tetramine ,formin1 urotropine40 ,mystery is added by the mention of undefined 8special products0 in the following3 8,the fact of combining these two salts lysidin and sidonal in ,urodonal1 in strictly determined proportions and in the presence of special products1 gives this preparation very considerable power in dissolving uric acid40 ,these contradictory statements of composition conflict with ,rule #a4 ,urodonal is marketed in typical 8patent medicine0 style3 the name 8,urodonal0 is blown in the bottle and the label contains a list of 8,indications10 including rheumatism1 gout and gravel 7,rule #d74 ,that this form of marketing has introduced it to the public is suggested by the following in an advertising circular3 8444 ,urodonal is now popular--even classic--throughout the world1 where thousands of doctors and millions of patients agree in asserting that #8,urodonal is to rheumatism what quinine is to fever4'0 ,there are also other indications that the mixture is to be exploited to the laity4 ,for instance1 the ,u4 ,s4 distributor sends out a portrait of ,sarah ,bernhardt bearing the legend3 8,i am positive that ,,urodonal preserves youth's freshness with clearness and strength to brain and heart4 ,i have taken it for two years with the greatest benefit4 ,sarah ,bernhardt40 ,a circular advises this mixture 8,for all who suffer from ,arthritis1 ,rheumatism1 ,arterio-,sclerosis1 ,renal and ,bilious ,lithiasis1 ,headache1 ,gout1 ,gravel1 ,lumbago1 ,sciatic ,pains1 ,neuralgia and all uric acid troubles40 8,in fact1 ,urodonal is five times more active than piperazine1 and thirty-seven times more active than lithia4 ,we are1 therefore1 entitled to say that no other eliminator of uric acid can be compared with it40 8,being #cg times more active than lithia1 it clears the heart valves of any sandy substances which may clog them1 and checks the atheromatous degeneration of the blood vessels40 ,these extracts indicate sufficiently the extravagant tone of the advertising 7,rule #f73 ,none of the ingredients are notably active in dissolving uric acid when administered by mouth4 ,none produce any marked increase of uric acid elimination4 ,no intelligent physician would use a uric acid solvent for 8bilious lithiasis02 and their usefulness in the other conditions is open to doubt1 to put it mildly4 ,although the preparation is a simple mixture1 the name does not indicate the components1 but inclines to therapeutic suggestion 7,rule #h74 ,nothing is to be gained by combining several drugs which are useless1 severally1 for the purpose intended1 as in the present case 7,rule #aj74 ,urodonal is marketed under inconsistent statements of composition and with exaggerated therapeutic claims2 the name is nondescriptive and the mixture is unscientific4 ,the ,council decided that the preparation should be declared ineligible for conflict with ,rules #a1 #d1 #f1 #h and #aj and that this report should be published4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ad1 #aiae47 ,,formamint ,report of the ,council on ,pharmacy and ,chemistry ,the following report has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,formamint is a proprietary medicine manufactured by the ,a4 ,wulfing ,company 7,new ,york1 ,london and ,berlin71 which is affiliated with the ,bauer ,chemical ,company4 ,it has been widely advertised in ,europe for several years1 and is now on the ,american market2#ad it is advertised in this country both in newspapers and medical journals4 #ad ,the ,journal ,a4 ,m4 ,a41 ,feb4 #bd1 #aiab1 p4 #egb4 ,following is a brief review of the more important alleged investigations that have been reported from time to time in various ,european journals4 ,in 8,the ,therapeutical ,value of ,foramint in ,septic ,affections of the ,oro-,pharynx10 ,de ,santi#ae quotes ,rosenberg1#af who reports the successful use of ,formamint in cases of streptococcus infections1 tonsillitis and acute symptoms of chronic sore throat4 ,according to ,seifert1#ag ,formamint is a chemical combination of formaldehyd and milk sugar4 ,when the tablets are dissolved in the saliva1 #j4ja per cent4 of formaldehyd in its 8status nascendi0 is liberated and exercises a strong disinfectant action4 ,seifert states that the preparation is markedly palatable1 since it contains a little citric acid to render the taste cool and refreshing4 ,in some experiments with streptococci1 pneumococci1 typhoid and diphtheria bacilli1 ,seifert found that a solution of one tablet in #aj c4c4 of water destroyed these germs in from five to ten minutes4 ,a solution of the same strength was also added to culture tubes of broth1 agar1 and gelatin1 with the result that no growth occurred in them1 while distinct and characteristic development of the bacteria took place in control tubes4 ,he does not state1 however1 how much ,formamint solution was added to the mediums4 #ae ,de ,santi3 ,medical ,magazine #af3ada1 #aijg4 #af ,rosenberg3 ,lancet1 ,london #b3ahga1 #aije4 #ag ,seifert3 ,pharmakol4 u4 therap4 ,rundschau1 #aijd1 ,no4 #ad2 quoted by ,de ,santi 7,note #b74 ,daus#ah reports successful treatment of tonsillitis1 mumps and middle ear diseases4 ,in these cases no other gargles or mouth washes were used4 ,he states that no indication of irritant or other injurious action made its appearance even after large doses4 ,in the same article1 ,f4 ,levy reports experiments as follows3 ,agar plates were prepared with a culture of streptococcus from a severe case of quinsy4 ,one half of the plate was rubbed with saliva containing ,formamint in solution4 7,the strength of the solution used is not given47 ,in twenty-four hours streaks of growth had appeared on one portion of the plates while the part on which the ,formamint saliva had been rubbed remained sterile4 ,daus also found that agar and broth cultures of streptococcus shaken with ,formamint saliva remained sterile4 #ah ,daus3 ,med4 ,klin4 #b3daaj1 #aijf4 ,rheinboldt1#ai investigating the effects of ,formamint and of ordinary formaldehyd on animals1 concludes that formaldehyd is toxic in action while ,formamint is not4 #ai ,rheinboldt3 ,deutsch4 med4 ,wchnschr4 #cb3ehg1 #aijf4 ,illustration3 ,how the exploiters of ,formamint capitalize the medical profession4 ,miniature reproductions of typical ,formamint advertisements appearing in the newspapers4 ,rosenberg#bj corroborates this statement4 ,he also found that agar plates of ,bacillus prodigiosus were killed by ,formamint solutions in about four hours4 ,he fails1 however1 to give the strength of his ,formamint solutions4 #bj ,rosenberg3 ,therap4 d4 ,gegen4 #g3ee1 #aije4 ,wingrave#ba suggests the use of ,formamint for infants6 ,he recommends that a tablet be crushed and wrapped in 8butter cloth40 ,the ends of the cloth are to be tied with thread1 the ,formamint is to be moistened1 and the packet is to be held in the mouth of the baby several times each day4 #ba ,wingrave3 ,lancet1 ,london #b3ajfg1 #aijf4 ,young#bb published the results of some experiments by himself and ,delpine on the human throat4 ,they dissolved a tablet in the mouth and made swab cultures with the following results3 ,immediately after taking the tablet #j colonies #aj minutes after taking the tablet #ce colonies #cj minutes after taking the tablet #aej colonies #bb ,young3 ,lancet1 ,london #a3ige1 #aijh4 ,they found no staphylococci at any time4 ,other results of swabbing various parts of the throat before and after the use of ,formamint1 reported by these investigators1 show enormous reductions in the count1 claimed to be due to the action of ,formamint4 ,the count was made on agar at #cg ,c41 but they fail to state the time elapsing between taking the ,formamint and making the swab4 ,young also reports favorable clinical results in cases of scarlet fever1 diphtheria1 sore throat1 and the like4 ,it must be noted1 however1 that they state that the mouth and fauces must first be thoroughly cleansed by swabbing and douching before ,formamint is used4 ,,the 8,,chemical ,,compound0 ,,claim ,the claims made in the advertising literature of ,formamint are very extravagant4 ,many are highly improbable4 ,these statements will be discussed later4 ,the statement is made that ,formamint is a new chemical compound3 8,formamint is ,pentamethanallactose1 #e ,,choh ,c,h,o4 ,it is an original combination of ,formaldehyde with ,lactose1 a definite chemical compound4 ,the ,formaldehyde molecule is locked up in it until solution in the saliva takes place1 when the ,formaldehyde is liberated in its nascent state and is therefore active without being irritant40 ,furthermore the makers contend that this new chemical compound is entirely harmless4 ,for example1 ,daus1#e in an article on 8,the ,disinfectant ,action of ,formic ,aldehyde on ,mucous ,membranes10 declares3 8,no indication of irritant or other injurious action made its appearance even after large doses4 ,the urine remained free from albumin and sugar40 ,such statements as these are found in the advertising literature3 8,formamint tablets are absolutely harmless and innocuous1 even to little children40 8,when dissolved in the saliva1 ,formamint ,tablets liberate slowly ,nascent ,formaldehyde in a most active yet non-irritant form40 ,they maintain that ,formamint is not only absolutely harmless1 but actually beneficial to the tissues4 ,it may be used 8to tone up and strengthen the tissues1 prevent hoarseness1 and allay irritation in singers1 public speakers10 etc4 ,the claims urged as to its germicidal power are indeed glittering4 ,this 8new chemical compound0 is claimed to liberate formaldehyd in some new and peculiar condition which1 while it has a soothing and tonic effect on the cells of the human tissues1 can at the same time quickly kill any form of bacterial life4 8,dissolving readily1 it releases its germicidal1 antiseptic qualities1 which impregnate the saliva and are carried naturally and easily around the mouth and in the deepest crevices of the throat--destroying the germs where they are causing the mischief4 ,formamint prevents and destroys infectious germ life in a soothing grateful way40 8,in the saliva it frees a germicide1 fatal to germs but harmless to the most delicate membranes4 ,and flowing into every tiny corner of the gums1 tonsils and throat1 into places where no gargle ever reaches1 it most effectively disinfects the throat40 ,the claims as to the preventive and curative effects of the preparation cover a large portion of the category of human ailments and distresses4 ,the following quotations indicate some of its supposed properties3 8444 it is therefore self-evident that ,formamint should be looked upon as a necessary part of the treatment of all forms of tonsillitis40 8,the value of ,formamint is equally great in diphtheric tonsillitis1 or as a prophylactic 4440 8,the extraordinary success which ,i had with ,formamint in a school epidemic of scarlet fever during ,may and ,june1 #aijg1 was the determining factor which induced me to abandon the use of inhalations1 gargles1 local applications in the treatment of diseases of the throat1 and to use ,formamint exclusively for the future40 8,there are naturally many similar conditions in which ,formamint may be used as a prophylactic1 notably scarlet fever1 mumps1 streptococcal and staphylococcal sore throats1 #8milk outbreaks' of sore throat1 drain throats1 hospital throats1 and the like40 8,formamint ,tablets are indicated in ,angina1 ,tonsillitis1 ,pharyngitis1 ,stomatitis1 ,gingivitis1 ,glossitis1 ulceration1 spongy or bleeding gums1 ,pyorrhea ,alveolaris1 #8,smoker's ,sore ,throat1' ,abscess or ,boils1 etc40 8,as a ,prophylactic against ,diphtheria1 ,scarlet ,fever1 ,influenza1 ,measles1 ,epidemic poliomyelitis1 and other pathogenic micro-organisms4 ,to neutralize putrefaction products in and about the teeth1 correct fermentative processes1 deodorize and purify the breath1 etc40 8,to tone up1 and strengthen the tissues1 prevent hoarseness and allay irritation in singers1 public speakers1 neutralize the effects of dust-infection or disinfect the saliva or sputum in ,influenza1 ,tuberculosis1 etc40 ,one man declares that along with specific constitutional treatment he 8had the best results from the use of ,formamint tablets0 in a case of syphilitic ulceration of the tongue4 ,in short1 ,formamint is recommended for the treatment or prevention of almost everything1 from a bad breath to such grave conditions as scarlet fever1 diphtheria and tuberculosis1 conditions in which a delay in proper treatment--for instance1 in diphtheria1 a failure to administer antitoxin--may result in the death of the patient4 ,a series of investigations was therefore undertaken in order to discover whether the extravagant claims regarding the germicidal power of ,formamint could be verified4 ,experimental ,data ,two fifty-cent bottles of ,wulfing's ,formamint were purchased in the open market and were kept well stoppered to prevent deterioration4 ,qualitative tests showed the presence of formaldehyd and the amount was determined quantitatively by the hydrogen peroxid method as given by ,sutton4#bc ,the results were respectively1 #a4ii per cent4 and #b4jc per cent4 of formaldehyd4 #bc ,sutton3 ,volumetric ,analysis1 ,edition #aj1 p4 #cij4 ,illustration3 ,two ,formamint advertisements reproduced in miniature typical of those appearing in a certain type of medical journals4 ,some determinations were made of the germicidal power of ,formamint in vitro1 that is1 under controlled laboratory conditions4 ,a twenty-four-hour plain agar culture of ,staphylococcus aureus was washed off in #aj c4c4 of sterile #j4he per cent4 sodium chlorid solution4 ,a #a3ajj1jjj dilution of this was made in each of three flasks containing #ajj c4c4 of sterile saliva4 ,flask #a contained #a per cent4 of ,formamint1 ,flask #b1 #e per cent42 ,flask #c1 containing no ,formamint1 was kept as a control4 ,at intervals samples were removed and dilutions made and plated in duplicate on standard agar4 ,the plates were incubated twenty-four hours at #cg ,c41 and plates containing less than #bjj colonies were counted4 ,the results are given in ,table #a4 ,after seven days there was no appreciable difference in the plates4 ,another test was made by adding a #a per cent4 ,formamint solution to plain agar plates inoculated with ,b4 coli4 ,a twenty-four-hour plain agar culture of ,b4 coli was washed off in #aj c4c4 of sterile #j4he per cent4 sodium chlorid solution4 ,a #a3a1jjj1jjj dilution was made of this and #a c4c4 added to each plate4 ,varying amounts of #a per cent4 solution of ,formamint were added to each plate4 ,they were incubated seventy-two hours at #cg ,c4 ,after seven days' incubation the count was the same4 ,the results are given in ,table #b4 ,another experiment was made thus3 ,one loopful of a twenty-four-hour plain agar culture of ,streptococcus lacticus was mixed with a tube of ,north medium4 ,one loopful from the inoculated tube was mixed with a second tube of ,north medium4 ,both tubes were poured into ,petri dishes and allowed to cool4 ,one half of each plate was well smeared with a #aj per cent4 solution of ,formamint in saliva4 ,after twenty-four hours' incubation at #cg ,c41 only a few colonies appeared on the side to which the ,formamint had been applied1 while the other half was thickly covered with colonies4 ,,table #a4--,,showing ,,time ,,in ,,which ,,cultures ,,of ,,staphylococcus ,,aureus ,,were ,,killed ,,by ,,different ,,amounts ,,of ,,formamint ,amount of ,formamint ,period of ,average ,count ,count on ,flask in ,saliva ,standing at #cg ,c4 ,when ,plated of ,saliva ,without 7,per ,cent47 7,hours7 ,formamint ---------------------------------------- -------------------------- #a #c #cb #cbjj #a #f #j #gjjj #e #a ,few #ejjj #e #b #j #dajj #e #c #j #cbjj99 #e #f #j #gjjj99 ---------------------------------------- -------------------------- 99 ,the last two observations were made at the same time as on the #a per cent4 solutions4 ,this work so far corroborates that reported in the literature quoted by the manufacturers4 ,but the fact that a compound is a germicide when brought into intimate contact with bacteria in a solution or medium in a test tube or flask does not prove that it will be effective when used in the human throat4 ,,the ,,alleged ,,germicidal ,,action ,an attempt was made to discover whether or not the claims advanced by the manufacturers as to the perfect germicidal action of ,formamint in all the nooks and crannies of the mouth and throat could be confirmed4 ,,table #b4--;,,count ,,of ,b4 ,,coli ,,cultures ,,with ,,different ,,amounts ,,of ,,formamint ,no4 c4c4 of #a per cent4 ,formamint #j #j4a #j4c #j4e #j4g #a4j #a4e #b4j #c4j ,count #afj #cc #ci #bf #ae #ab #b #j #j ---------------------------------------- ------------------------------ ,the first step in attacking this problem was to make comparative counts of the number of bacteria in the throat before and after the use of ,formamint4 ,the methods employed were as follows3 ,the throat was gargled with #ej c4c4 of sterile #j4he per cent4 sodium chlorid solution4 ,in each case the same length of time1 as far as possible1 was used in the process4 ,the liquid was collected in a sterile flask4 ,the gargling in a series of experiments was begun not less than two hours after a meal4 ,after some preliminary work the following dilutions of the #ej c4c4 of salt solution were found sufficient3 #a3a1jjj1 #a3aj1jjj and #a3ajj1jjj4 ,plates were made in duplicate from each dilution and incubated seventy-two hours at #cg ,c4 ,the counts were made on plates containing less than #bjj colonies4 ,except where otherwise noted standard agar was used4 ,the mediums were always prepared in the same way4 ,all the work was carried out under conditions as nearly natural as possible4 ,the ,formamint was taken according to the directions accompanying the trade package4 ,every opportunity was given the ,formamint to penetrate all the crypts and recesses about the mouth and throat4 ,the tablet was allowed to dissolve as slowly as possible1 the time usually being five to six minutes1 and saliva was thoroughly forced around the mouth before being swallowed4 ,plating was always done immediately after gargling so that no growth could occur in the salt solution4 ,the results are given in ,table #c4 ,the numbers are average counts from several plates and calculated to show the number of bacteria washed out by the #ej c4c4 of salt solution4 ,,table #c4--,,showing ,,that ,,formamint ,,does ,,not ,,greatly ,,decrease ,,the ,,number ,,of ,,bacteria ,,in ,,the ,,throat ,no4 ,found ,no4 ,found ,time ,amount ofin ,throat in ,throat ,conditions of ,test ,since ,formamint ,before ,after ,preceding ,used ,use of ,use of ,test ,formamint ,formamint ---------------------------------------- -------------------------- ,normal 444 #j #ae1fjj1jjj 444 ,normal #a hour #j #ch1ejj1jjj 444 ,normal #a hour #j #cj1ejj1jjj 444 ,normal 444 #j #ab1ejj1jjj 444 ,normal #a hour #j #ad1ejj1jjj 444 #a hour #j #bc1ejj1jjj 444 ,tablet dissolved in mouth #f days #a tablet 444 #ae1jjj1jjj and throat gargled one hour later ,throat again gargled two #a hour #j 444 #aj1jej1jjj hours after ,formamint was used ,normal #g days #j #fb1jjj1jjj 444 ,normal #a hour #j #gb1ejj1jjj 444 ,normal 444 444 #fa1jjj1jjj 444 ,tablets were taken1 one #b days #ab 444 #ci1ajj1jjj per hour1 and throat gargled onehour after last tablet was taken ,throat was again gargled #b #a hour #j 444 #ei1jjj1jjj hours after taking last tablet ,normal #e days #j #ce1jjj1jjj 444 ,normal #a hour #j #fb1jjj1jjj 444 ,normal #a hour #j #gb1jjj1jjj 444 ,one tablet was taken each #d days #bd 444 #age1jjj1jjj half hour for #ab hours tablets consecutively4 ,throat was gargled one hour after last tablet was taken ,throat was again gargled #a hour #j 444 #afh1gej1jjj two hours after last tablet was taken ,normal #c days #j #abi1fjj1jjj 444 ,normal #a hour #j #agg1jjj1jjj 444 ,normal #a hour #j #adg1jjj1jjj 444 ,normal #c days #j #gi1jjj1jjj 444 ,one tablet was taken #a hour #a 444 #hc1bjj1jjj immediately after preced- ing gargle4 ,throat was again gargled at end of one hour ,throat was again gargled #b #a hour #j 444 #acd1gej1jjj hours after tablet was taken ,normal conditions except #ai days #j #cb1fjj1jjj 444 that mouth and teeth were throughly washed with soap just before gargling ,same as above #a hour #j #cc1abe1jjj 444 ,same as above #a hour #j #dj1cge1jjj 444 ,teeth were not washed4 #b days #j #cc1ejj1jjj 444 ,otherwise normal con- ditions ,same as above #a hour #j #dc1ccj1jjj 444 ,same as above #a hour #j #ed1jjj1jjj 444 ,same as above #a hour #j #ej1jjj1jjj 444 ,same as above #a hour #j #fg1jjj1jjj 444 ,mouth and teeth thoroughly #b days #j #e1bgj1jjj 444 washed with soap just before throat was gargled ,same as above #a hour #j #aj1iaf1jjj 444 ,same as above #a hour #j #h1bge1jjj 444 ,normal conditions1 but #a #c days #j #bbh1gej1jjj 444 c4c4 of sterile rabbit's blood was added to each plate ,count from the same gargle #j #j #fj1fbe1jjj 444 as above4 ,no blood used in the plates ,normal conditions1 but #a hour #j #dca1bej1jjj 444 count was made on blood agar ,count from the same gargle #j #j #ei1fbe1jjj 444 asabove4 ,no blood used in the plates ,normal conditions1 count #b days #j #fhc1cjj1jjj 444 was made on blood agar ,same gargle as above1 but #j #j #eh1ejj1jjj 444 count was made on plain agar ,one tablet was taken just #a hour #a tablet 444 #eeh1cjj1jjj after preceding gargle4 ,after one hour throat was again gargled4 ,count on blood agar ,same gargle as above1 but #j #a tablet 444 #ee1hge1jjj count was made on plain agar ,normal conditions #b days #j #gi1abe1jjj 444 ,one tablet was taken just #a hour #a tablet 444 #ef1bej1jjj ten minutes before gargle #af min4 was made ,normal conditions #b days #j #df1gej1jjj 444 ,one tablet was taken just #a hour #a tablet 444 #ch1ejj1jjj ten minutes before throat was gargled ,teeth and mouth were thor- #e days #j #dg1cgj1jjj 444 oughly washed with soap just before gargle was made ,teeth washed as above and #a hour #a tablet 444 #ba1bbe1jjj #a tablet taken #aj minutes before gargle was made ---------------------------------------- -------------------------- ,finally a determination was made of the number of streptococci in the throat before and after the use of ,formamint4 ,the throat was gargled in the manner previously described4 ,the streptococcus count was made by the dilution method as given by ,heinemann4#bd ,culture tubes were used instead of fermentation tubes4 ,one per cent4 dextrose broth was the medium employed4 ,one cubic centimeter was added to each of a series of ten tubes for each dilution and the following dilutions were used3 #a3aj1jjj1 #a3ajj1jjj and #a3a1jjj1jjj4 #bd ,heinemann3 ,laboratory ,guide in ,bacteriology1 p4 #hf4 ,the results given in ,table #d are the average count from a number of dilutions and are reported as the total number washed out by the #ej c4c4 of salt solution4 ,,table #d4--,,showing ,,that ,,formamint ,,fails ,,to ,,reduce ,,the ,,number ,,of ,,streptococci ,,in ,,the ,,throat ,no4 ,found ,no4 ,found ,time ,amount of in ,throat in ,throat ,conditions ,since ,formamint ,before ,after of ,test ,preceding ,used ,use of ,use of ,test ,formamint ,formamint ---------------------------------------- ----------------- ,normal 4444 #j #a1bjj1jjj 4444 ,one tablet was taken and throat gargled one hour later #d days #a tablet 4444 #ad1gej1jjj ,normal #c days #j #i1iej1jjj 4444 ,one tablet was taken and throat gargled ten minutes later #a hour #a tablet 4444 #h1jjj1jjj ,discussion ,the contention that ,formamint contains formaldehyd was confirmed by analysis4 ,the manufacturers also maintain that ,formamint is a new1 definite chemical compound1 consisting of five molecules of formaldehyd and one molecule of lactose1 and that when dissolved in the saliva the formaldehyd is liberated in some new and peculiar form1 which they call nascent formaldehyd4 ,this new kind of formaldehyd is1 according to the advertising literature1 especially powerful in its germicidal properties and at the same time has absolutely no irritating or harmful effects4 ,,not ,a ,,chemical ,,compound ,thoms1#be retained as an expert by the ,german government1 decided1 after a series of chemical investigations1 that ,formamint was not a definite chemical compound1 but that it was probably a solid solution of formaldehyd in lactose4 ,he proved that when the process of manufacture was carried out in exactly the way called for by the ,formamint patents1 compounds containing a greater or less per cent4 of formaldehyd could be made while the other properties remained similar to those of ,formamint4 ,the composition of the final product depended on the proportion of the components used in the process4 ,therefore ,formamint did not form a safe means of uniform dosage4 #be ,thoms3 ,arb4 a4 d4 ,pharm4 ,inst4 d4 ,universitt1 ,berlin #aa3baj1 #aiad4 ,as a result of ,thoms' work the ,german courts held that ,formamint was not a new chemical compound4 ,consequently the ,formamint patent 7,number #ahijcf7 was annulled in ,berlin1 ,nov4 #bi1 #aiac4 ,again the contention that formaldehyd in the nascent or active condition is less poisonous and irritating than in its ordinary form is contrary to what would be expected from the behavior of such compounds4 ,if it were liberated1 as claimed1 in the 8nascent0 condition1 it would be1 for that very reason1 not only more active but also more harmful4 ,as a matter of fact1 ,formamint did have an irritant effect on the worker who carried out these investigations4 ,when one tablet was taken each hour for twelve consecutive hours1 marked irritation of the intestinal tract resulted4 ,there was almost sufficient nausea to cause vomiting and uneasiness in the alimentary canal following the experiment4 ,when the twenty-four tablets were taken the results were similar but more pronounced4 ,this is decidedly in contradiction to the assertions of the manufacturers4 ,otto ,seifert1#bf moreover1 cites the following3 8,by ,effects3 ,only a few patients complain of an unpleasant sharp taste1 burning of the tongue 7,seifert1 ,sklarek74 ,among the general symptoms observed are urticaria-like exanthems 7,glaser1 ,roters71 which are accompanied by nausea1 vomiting1 headache1 insomnia and vertigo1 burning and irritability especially in the larynx 7,meissner72 phenomena of poisoning 7,geissler72 gastric disturbances 7,engelmann72 renal irritation 7,steinhard72 unsuited for diabetics 7,voit740 #bf ,seifert1 ,otto3 ,die ,nebenwirkungen der modernen ,arzneimittel1 #aiae4 ,the contention that ,formamint1 when mixed directly with mediums and left in contact with bacteria1 will kill the organisms was corroborated4 ,thus the statements and pictures in the booklet1 8,the ,gospel of ,prevention10 which is enclosed with each bottle of ,formamint1 showing the inhibition of growth of air bacteria on plates containing ,formamint are no doubt true and authentic4 ,finally1 the claim that ,formamint is an almost perfect throat disinfectant was by no means confirmed1 as a glance at the tables will show4 ,one hour after it is taken1 even when a tablet was used each half hour for twelve hours1 the number of bacteria in the throat was practically the same as when ,formamint was not used4 ,even ten minutes after taking a tablet the number of bacteria in the throat was never greatly reduced1 as is maintained by the manufacturers4 ,,has ,,no ,,selective ,,action ,formamint exerts no selective action in killing off the very delicate organisms which are more apt to be pathogenic4 ,when the comparative counts were made on blood agar which would favor the growth of the delicate parasitic organisms1 no reduction whatever was shown by the use of ,formamint4 ,the number of streptococci was found to be the same1 within limits of experimental error1 ten minutes after taking a tablet as it was before the tablet was taken4 ,therefore it seems that ,formamint fails1 as any such germicide would be expected to fail1 to kill bacteria in the crypts and recesses of the throat1 for when dissolved in the mouth it cannot reach and remain in contact with the organisms long enough to kill them before it is swallowed4 ,,summary ,summed up1 the investigation shows3 #a4 ,that the claims made for ,formamint are extravagant and misleading4 #b4 ,that the recommendations for the use of these tablets may be1 in some cases1 fraught with danger and are a menace1 not only to the health of the individual1 but also to the safety of the community4 #c4 ,that the claim that ,formamint is a definite chemical compound is false4 #d4 ,that the use of ,formamint may produce marked irritation of the intestinal tract4 #e4 ,that ,formamint is not a throat disinfectant1 as the manufacturers maintain1 but its action on the bacteria of the throat is an almost negligible one and dependence on ,formamint for the prevention of infection and for curing disease is not only unwise but dangerous4 #f4 ,that ,formamint conflicts with the rules of the ,council4 ,false statements are made with regard to its composition 7,rule #a72 grossly unwarranted claims are made for its therapeutic properties 7,rule #f71 and therefore its exploitation to the public 7,rules #c and #d7 is a public danger4 ,it is recommended that this report be published1 to call attention not only to the falsity of the claims made for1 and the danger in the use of1 ,formamint1 but also to emphasize the utter inefficiency of all such methods of 8disinfecting0 the throat4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bh1 #aiae47 ,,hydragogin ,report of the ,council on ,pharmacy and ,chemistry ,hydragogin 7,c4 ,bischoff ,co41 ,new ,york1 selling agents7 is advertised as 8a most powerful diuretic and cardiac tonic40 ,the composition given is3 8,fifteen parts of the remedy contain #j4e parts oxysaponin1 #a4e parts tincture of digitalis1 #b4e parts tincture of strophanthus1 scillipicrin and scillitoxin1 the active principles of scilla maritima1 and alcohol40 ,it is not clear from this statement whether #ae parts of ,hydragogin contain #b4e parts of tincture of strophanthus1 plus unspecified amounts of scillipicrin and scillitoxin1 or #b4e parts of a mixture1 in unspecified proportions1 of tincture of strophanthus1 scillipicrin and scillitoxin4 ,the activity of strophanthus1 after it enters the blood stream1 is about fifty times that of digitalis2 hence1 if the former proportion is the true one1 in giving an amount of ,hydragogin which ensures the full therapeutic effect of the digitalis1 one would administer an almost certainly fatal amount of strophanthus4 ,whatever the proportion of strophanthus may be1 however1 the administration of a mixture of digitalis and strophanthus in fixed proportions is indefensible4 ,at times it is advisable to follow one of these drugs with the other in the treatment of cardiac disease4 ,the simultaneous administration of the two continuously in fixed proportions1 however1 is injudicious1 because of the great difference between their rates of absorption and in their activity after they enter the blood stream4 ,the action of digitalis1 moreover1 persists much longer than does that of strophanthus4 ,an advertising circular contains the following claim3 8,the well-known diuretic properties of digitalis1 strophanthus and squills are greatly enhanced by the addition of the oxysaponin40 ,this is not true4 ,saponins are not synergistic with digitalis therapeutically2 on the contrary1 they exert a purely deleterious action on the heart when they enter the circulation4 ,the symptoms of cardiac disease are often difficult to distinguish from the toxic actions of the digitalis bodies4 ,since these bodies must often be given to the point of beginning toxic action in order to induce the full therapeutic effects1 it is obvious that the administration of a mixture of digitalis1 strophanthus1 saponin and active principles of squill is especially liable to induce serious toxic effects which cannot be distinguished from the symptoms of the disease4 ,hydragogin is a shotgun mixture of semisecret composition2 it is marketed under a therapeutically suggestive name1 and advertised by means of unwarranted therapeutic claims4 ,it is therefore in conflict with ,rules #a1 #f1 #h and #aj4 ,the ,council held ,hydragogin ineligible for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #d1 #aiae47 ,,filudine ,report of the ,council on ,pharmacy and ,chemistry ,filudine is said to be prepared by ,j4 ,l4 ,chatelain1 ,paris1 and is sold in this country by ,geo4 ,j4 ,wallau1 ,inc41 ,new ,york4 ,it is offered as a remedy for 8biliary insufficiency10 8hepatic insufficiency10 8intestinal dyspepsia10 8all affections of the liver 7diabetes1 cirrhosis1 cancer1 etc4710 8malaria10 8obesity0 and 8tuberculosis40 ,no quantitative information is furnished as to the composition of the preparation and there are noteworthy discrepancies in the various statements regarding the ingredients4 ,in one number of 8,treatment10 a self-styled 8,review0 of medical literature 7actually devoted to advertising the preparations sold by ,wallau71 we are told that 8,this product ,filudine is a more concentrated and potent extract of the liver1 with which is combined an extract of the spleen4 ,the liver and the spleen are so intimately interdependent1 that the addition of a splenary extract to the liver extract is a signal improvement from which a synergistic action results4 ,thiarfine is also added1 as it helps somewhat to combat the anaemia from which all diabetics suffer more or less40 ,thiarfine is said to be 8,thiomethylarsinate of ,caffein1 a new salt discovered by ,m4 ,chatelain40 ,another circular1 which gives an imposing formula for 8thiarfine0 or 8thiomethylarsinate of caffein10 states that 8,sulphurated methylarsinate is an arsenical preparation devoid of all toxicity on account of the intimate joining of its composing parts40 ,and that 8,filudine can never be contraindicated40 ,a statement of composition in a later number of 8,treatment10 however1 says that biliary extracts are components1 in addition to the liver and spleen extracts4 ,moreover1 thiarfine1 the 8new salt discovered by ,m4 ,chatelain10 is no longer 8thiomethylarsinate10 but 8thiocinnamate of caffein02 and a new formula is furnished for it4 ,we are told that 8,methyl-arsinate cannot be used in cases where fever is present44440 8,m4 ,chatelain at first studied the action of thiomethylarsinate2 clinical and physiological experimentation led him1 however1 to adopt thiocinnamate of caffein1 of greater activity and with no contraindications40 ,nevertheless the same absence of contraindications was urged in favor of ,filudine when it was said to contain the now discarded thiomethylarsinate of caffein4 ,the following are some of the unwarranted and even absurd claims3 8,filudine restores the liver's functions4 ,it is to the liver what digitalis is to the heart2 it overcomes the insufficiency and stimulates the debilitated organ40 ,in malaria 8it is the only true specific when associated with quinine40 8,filudine is 444 the ideal medication for tuberculosis1 conforming as it does with the most recent researches in the therapeusis of this affection40 8,we will not go as far as to say that ,opotherapy completely restores unhealthy livers1 for although the lesions of the hepatic parenchyma may be obliterated by regeneration1 the lesions of the connective tissues are permanent1 and may be observed at the postmortem examination4 ,the new cells1 however1 do not present the same unhealthy conditions as those of the former diseased gland which they have replaced1 and the liver can therefore function normally1 so that the patient lives on2 and he is satisfied with that40 8,therefore1 while regenerating the liver with ,filudine1 we cleanse it and combat its congested state with ,urodonal4 ,we cause it to produce urea from the excess of uric acid which it contains40 8,by the judicious and harmonious combination of the beneficial effects of ,filudine and ,urodonal1 physicians not only possess the means of treating by rational methods ,cirrhosis of the ,liver in its various forms 7which is one of the most terrible diseases which can afflict anyone7 but what is still better1 they can cure it40 8,the liver of a person suffering from obesity being incapable of fulfilling its functions in regard to the fatty tissues1 the rational and up-to-date method of treatment is therefore to restore to the system1 in the form of ,filudine1 the liver extracts which are lacking40 ,filudine is a mixture of semisecret composition4 ,the therapeutic claims are manifestly unwarranted4 ,the name is not indicative of the composition1 whatever that may be1 and no rational excuse is offered for the combination of liver and spleen extracts 7with or without bile extracts7 with 8thiomethylarsinate0 or 8thiocinnamate0 of caffein4 ,the ,council therefore held ,filudine ineligible for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #ah1 #aiae47 ,,lactopeptine ,,and ,,elixir ,,lactopeptine ,report of the ,council on ,pharmacy and ,chemistry ,mixtures of pepsin and pancreatin are therapeutically irrational2 the two substances are not indicated in the same conditions1 nor can they act together4 ,under physiologic conditions1 such mixtures are chemically impossible3 in a liquid medium the ingredients destroy each other4 ,lactopeptin is manufactured by the ,new ,york ,pharmacal ,association1 ,yonkers1 ,n4 ,y4 ,it is sold under the claim that it contains1 pepsin1 diastase1 pancreatin1 lactic acid and hydrochloric acid4 ,this product was among the first proprietary preparations examined by the ,council on ,pharmacy and ,chemistry4 ,the report of the investigation was published in ,the ,journal1 ,march #af1 #aijg1 p4 #iei4 ,the preparation was found to be practically inert--8essentially a weak saccharated pepsin10 devoid of tryptic activity4 ,six years later it was still widely advertised with the same irrational claims4 ,a referee 7,a7 therefore examined ,lactopeptine 7powdered7 for the ,council in #aiac1 and confirmed the previous findings4 ,the referee's report was published in ,the ,journal1 ,aug4 #b1 #aiac1 p4 #ceh4 ,nearly four months after this publication1 the manufacturer protested against the report1 maintaining1 contrary to the findings of the ,council1 that ,lactopeptine possesses pancreatic activity and contains 8loosely combined0 hydrochloric acid4 ,referee ,a therefore repeated his examination1 and a second referee 7,b71 independently1 examined specimens of ,lactopeptine 7powder7 purchased on the open market for the purpose shortly before4 ,a few specimens examined by these two referees showed a slight tryptic activity2 most of them showed none4 ,the amount of hydrochloric acid present was insignificant4 ,the reports of the two referees were referred to the manufacturers1 who again protested vehemently against these findings1 this time on the ground that the specimens were old4 ,the manufacturers also cited the work of three chemists to disprove the findings of the referees1 and demanded that the ,council reexamine ,lactopeptine1 making use of fresh specimens4 ,the ,council refused for the following reasons3 #a4 ,so long as the packages of ,lactopeptine are not dated1 the activity of specimens known to be fresh is of no practical importance4 ,the activity of the actual market supply is the only question of interest to the profession4 ,the only fair test is that made on specimens representative of the product sold to the ultimate consumer4 #b4 ,the evidence presented by the manufacturers did not warrant a reexamination1 since the work of two of the chemists cited substantially corroborates the results obtained by the ,council's referees from the fresher specimens4 ,the figures for tryptic activity obtained by the third chemist cited by the manufacturers could not be accepted by the ,council1 since it was at variance with all other known results of investigations of ,lactopeptine4 #c4 ,as stated at the outset1 whatever the tryptic activity of the mixture1 it is therapeutically useless4 ,a demonstration of tryptic activity in a mixture containing both pepsin and pancreatin is of merely theoretical interest4 ,such activity1 of course1 cannot be expected1 even on theoretical grounds1 in liquid mixtures like ,elixir ,lactopeptine4 ,the ,council therefore again declared ,lactopeptine 7powder and tablets7 and ,elixir ,lactopeptine ineligible for ,new and ,nonofficial ,remedies and authorized publication of the following statement4 ,w4 ,a4 ,puckner1 ,secretary ,,the ,,council',s ,,report ,lactopeptine powder 7,new ,york ,pharmacal ,association1 ,yonkers1 ,n4 ,y47 was examined by the ,council in #aijg4 ,at that time it was claimed to contain 8444 the five active agents of digestion--pepsin1 diastase 7veg4 ptyalin71 pancreatin1 lactic acid and hydrochloric acid--combined in the proper proportion to insure the best results40 ,the examination showed that the preparation was essentially 8a weak saccharated pepsin10 containing but small amounts of pepsin1 no hydrochloric acid1 or mere traces only1 and no diastase or pancreatin 7,the ,journal1 ,march #af1 #aijg74 ,in #aiac1 the product was reexamined1 because the claims1 as to both composition and therapeutic value1 were still being made4 ,samples were tested both of the ,american product1 and of a ,british product from ,john ,morgan ,richards ,sons1 ,london4 ,the original findings were confirmed and the results were published in ,the ,journal1 ,aug4 #b1 #aiac1 p4 #ceh4 ,nearly four months later 7,november #bd7 the ,new ,york ,pharmacal ,association wrote to the ,council1 objecting to the findings and maintaining that ,lactopeptine possesses pancreatic activity and contains 78in loose chemical combination07 hydrochloric acid4 ,in accordance with the custom of the ,council1 the work was sent back for review to the referee 7,a71 whose conclusions were then tested by a second referee 7,b71 a physiologic chemist1 not a member of the ,council1 selected because of his special knowledge of the subject4 ,in ,december1 #aiac1 ,referee ,a made a large number of new tests to determine proteolytic and amylolytic power4 ,his results show that the ferment activity of the preparation is so low as to merit no recognition in practical use4 ,the tests also show that the amount of lactic acid or 8loosely combined ,h,cl0 7or both7 present is too small to have any appreciable physiologic activity and therefore to be of any therapeutic value4 ,nine samples of ,lactopeptine purchased in the open market in ,december1 #aiac1 and ,january1 #aiad1 were examined by ,referee ,b early in #aiad4 ,his studies show absence of amylase in all samples2 presence of pepsin1 giving weak reactions even when compared with those of old pepsin preparations2 complete absence of trypsin in seven out of nine samples1 tryptic reaction being obtained in two samples1 in one of which the reaction1 8slight at best and of no practical import10 was obtained only after treatment for twelve hours or more4 ,the presence of tryptic activity in two out of the nine samples may be due to the fresher condition of these specimens1 as indicated by the serial numbers4 ,the evidence shows that it is a commercial impossibility to market mixtures of pepsin1 pancreatin and lactic acid so that they can display any material tryptic activity4 ,it should be reaffirmed that mixtures combining peptic and pancreatic activities are not feasible1 because pepsin cannot act except in the presence of acid1 and pancreatin is destroyed by acid and by peptic activity4 ,furthermore1 in conditions in which pancreatin is called for1 pepsin is not1 and vice versa2 therefore the administration of mixtures of pepsin and pancreatin would be unjustified1 even if both constituents could be expected to exert activity4 ,the foregoing observations apply to ,lactopeptine in powder and tablet form4 ,while mixtures of pepsin and pancreatin are unscientific and unjustified1 theoretically the two substances may coexist in a solid preparation1 and the activity of such a preparation is consequently a proper subject of investigation4 ,theoretically as well as practically1 however1 pepsin and pancreatin cannot exist together in solution4 ,the claims made for ,elixir ,lactopeptine and all other liquid preparations sold as mixtures of pepsin and pancreatin are therefore impossible4 ,the ,council has previously taken action 7,the ,journal1 ,feb4 #b1 #aijg1 p4 #dcd7 refusing to approve for inclusion with ,new and ,nonofficial ,remedies such preparations1 calling the attention of the medical profession and of manufacturers to their worthlessness1 and requesting the ,american ,pharmaceutical ,association to instruct its committee on the ,national ,formulary to omit from the next edition of that work a liquid preparation of pepsin and pancreatin recognized under the title of 8elixir digestivum compositum40 ,it is recommended that the ,council reaffirm this previous action1 and that ,lactopeptine and ,elixir ,lactopeptine be declared ineligible for ,new and ,nonofficial ,remedies because of conflict with ,rule #aj 78,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 profession074 ,manufacturers' ,protest and ,council's ,answer ,the foregoing was submitted1 together with the findings of the two referees1 to the manufacturers4 ,they protested again1 alleging that3 ,,age ,,of ,,specimens ,first4--,the specimens of ,lactopeptine examined by the second referee were old4 ,the dates of manufacture corresponding to the several batch numbers are supplied by the manufacturers as follows3 #bbge 7,powder7 ,september1 #aijh #bcja 7,powder7 ,june1 #aiji #bcab 7,powder7 ,december1 #aiji #bcdh 7,powder7 ,october1 #aiaa #bceb 7,powder7 ,december1 #aiaa #bcfd 7,powder7 ,july1 #aiab #bcgd 7,powder7 ,march1 #aiac #bchc 7,powder7 ,october1 #aiac #afch 7,tablets7 ,october1 #aiaa ,the manufacturers assert that they do not understand how specimens of these ages could have been purchased on the open market in #aiac and #aiad1 inasmuch as their agents are and long have been instructed to take up from the druggist all lots of ,lactopeptine which1 as indicated by the batch numbers1 have attained 8any appreciable age40 ,the age of the specimens1 the manufacturers declare1 deprives the table in the second referee's report of 8all significance or interest40 ,as previously stated1 however1 the specimens of ,lactopeptine examined were purchased on the open market in various localities in unbroken packages1 in ,december1 #aiac1 and ,january1 #aiad4 ,they thus represent stock used in filling physicians' prescriptions or sold to the public4 ,neither the referees nor any one connected with the ,council had any means of knowing the age of the specimens until the dates of manufacture were furnished by the ,new ,york ,pharmacal ,association4 ,the first tests of the second referee were made in ,february1 #aiad1 on ,specimens #bcgd and #bchc1 which were then1 it would appear1 about one year old and four months old1 respectively4 ,the ,council has repeatedly urged that pharmaceutical substances which are subject to deterioration should be dated by the manufacturer1 and a similar suggestion has been made by the ,bureau of ,chemistry of the ,u4 ,s4 ,department of ,agriculture concerning mixtures containing enzymes4 ,notwithstanding the instructions which the ,new ,york ,pharmacal ,association claims to have given its agents1 the market supply of ,lactopeptine in ,december1 #aiac1 and ,january1 #aiad1 was not composed of new stock1 and until the manufacturers adopt the practice of dating packages1 there can be no assurance that it will be fresh4 ,in this connection1 it is of interest to note that the ,bureau of ,chemistry of the ,u4 ,s4 ,department of ,agriculture has issued a warning that it will judge such products by the degree of their activity when they reach the consumer1 i4 e41 as they are found on the market4 ,,reports ,,of ,,other ,,chemists ,second4--,the ,new ,york ,pharmacal ,association cites the work of several chemists1 who have examined ,lactopeptine and report the presence of tryptic activity4 ,dr4 ,s4 ,r4 ,benedict in ,december1 #aiac1 reported to the ,council 8distinct0 tryptic activity 7digestion in twelve hours by ,lactopeptine of #d4b times its weight of fibrin containing #ej per cent4 moisture7 in specimens examined by him4 ,these specimens were numbered #bchb1 and were therefore probably manufactured in ,october1 #aiac2 compare the dates furnished by the manufacturer for the specimens used by the second referee4 ,no tests against other preparations possessing tryptic activity are reported1 and ,dr4 ,benedict expressly disclaims any opinion as to the therapeutic value of the preparation4#bg ,dr4 ,p4 ,b4 ,hawk1 whose report was submitted by the manufacturers1 found in ,lactopeptine by ,fermi's method one-fifth tryptic activity of that of ,merck's pancreatin1 and by ,grtzner's method an activity of #ah per cent4 of the pancreatin4 ,a test for the production of tryptophan was reported positive4 ,the ,new ,york ,pharmacal ,association also submitted a report from ,dr4 ,a4 ,w4 ,balch1 who found pepsin1 rennin1 trypsin1 steapsin1 amylopsin and lactic acid present in ,lactopeptine2 also an amount of combined hydrochloric acid in #a gm4 the equivalent of #a4je c4c4 tenth normal solution or #j4jjchc gm4 hydrochloric acid4 7,he reports digestion in twenty-four hours by ,lactopeptine of #be times its own weight of fibrin4 8,an active extract of pancreas reacted exactly like the ,lactopeptine solution407 ,the serial numbers of the specimens tested by ,hawk and ,balch are not given1 but no doubt they were fresh4 #bg ,dr4 ,benedict's personal communication to a member of the ,council is as follows3 8,in the report of the ,council upon ,lactopeptine which you sent to me1 ,i find the following statement3 #8,careful examination failed to show the presence of either diastase or pancreatin4' ,in this connection ,i will cite to you the following experiment carried out by myself3 ,a package containing a #a-ounce bottle of ,lactopeptine 7powder7 with seal unbroken was purchased in the open market and opened in this laboratory4 ,the label bore the special ,number #f #bchb4 ,two hundred milligrams of this product was dissolved in #ej c4c4 of a #j4be per cent4 solution of sodium carbonate in water4 ,this solution was divided into two portions of #be c4c4 each4 ,one of these portions was boiled at once1 and after cooling was added to #a gm4 of moist fibrin contained in a flask4 ,the other portion 7unboiled7 was also added to #a gm4 of moist fibrin contained in a flask4 ,both flasks 7after addition of #e c4c4 of toluene to each7 were stoppered and placed in an incubator at #cg degrees1 and left there for twelve hours4 ,examination of the two flasks at the end of this period showed that the one to which the unboiled solution of ,lactopeptine powder had been added contained much less solid protein than did the other4 ,although this fact was obvious to the naked eye1 the exact extent of digestion in the two flasks was determined by heating both to boiling1 acidifying with acetic acid1 diluting to definite volume1 filtering and determining the nitrogen in the filtrate by ,kjeldahl's method4 ,subtracting the trace of nitrogen contained in the filtrate of the control flask1 the results showed that #db per cent4 of the original fibrin present had been dissolved by the unboiled ,lactopeptine solution4 ,this can be ascribed only to tryptic activity under the conditions of this experiment4 ,furthermore1 this is not simply a #8trace' of activity1 but is at least sufficiently marked to warrant a statement that this sample showed a distinct tryptic activity4 ,inasmuch as ,i have obtained exactly similar results with two other samples of ,lactopeptine 7powder7 7these being the only ones ,i have examined71 ,i am inclined to question the correctness of the ,council's statement regarding the absence of trypsin from this preparation4 ,as noted above1 a fresh preparation was used4--,ed4 8,may ,i again add that ,i am making no statement regarding therapeutic value of preparation1 and that ,i have no opinion upon that matter one way or the other8 ,my work was undertaken solely out of interest to see whether trypsin could exist in the powder 7which gives a markedly acid solution when dissolved in water74 ,the ,elixir ,lactopeptine could theoretically show no tryptic activity1 nor have ,i found any trace of such activity in one sample of the ,elixir examined4 8,in making use of any of the contents of my letters kindly include the statement that my work upon ,lactopeptine was done without remuneration of any kind1 and was done only for the scientific interest attached to the question40 ,,conclusions ,the ,new ,york ,pharmacal ,association demanded that the referee reexamine ,lactopeptine1 making use of fresh specimens4 ,the ,council held that this was unnecessary1 for the following reasons3 #a4 ,the previous finding of the ,council1 that specimens of ,lactopeptine found on the open market are essentially weak saccharated pepsins1 is not to be refuted by examination of fresh specimens4 ,even if it be assumed that all old specimens of ,lactopeptine have been withdrawn from the market since the last purchase of specimens for the use of the ,council's referee1 there can be no assurance that the stock will be constantly kept fresh4 ,unless the manufacturers date their product1 physicians cannot know that their prescriptions are filled with fresh material4 ,nor is it reasonable to ask that the ,council examine the market supply of any given proprietary at a time selected by the manufacturers4 #b4 ,without entering into all questions of detail in the analyses1 the ,council is willing to accept the reports of ,drs4 ,benedict and ,hawk as representative of fresh ,lactopeptine powder4 ,it is therefore unnecessary for the ,council to make further experiments along this line4 ,the results of these two chemists in no wise contradict the conclusions of the ,council's referees1 being comparable with those obtained by the referee on the fresher specimens used by them4 ,the experiments of ,drs4 ,hawk and ,benedict show a degree of tryptic activity which1 though chemically not negligible1 is quite without significance practically1 even if it could be assumed that the trypsin in the fresh ,lactopeptine escaped destruction in the stomach4 ,the figures for tryptic activity given by ,dr4 ,benedict do not differ materially from those of the first referee4 ,those of ,professor ,hawk show a tryptic activity of from #ah to #bj per cent4 of that of commercial pancreatin--and commercial pancreatins ordinarily are of low tryptic activity1 if not inert 7see ,long and ,muhleman3 ,arch4 ,int4 ,med41 ,february1 #aiad1 p4 #cad47 ,the reports of these chemists present no reason for changing the conclusion that 8it is a commercial impossibility to market mixtures of pepsin1 pancreatin and lactic acid so that they can display any material tryptic activity40 ,the results which ,dr4 ,balch obtained in a test for tryptic activity show a marked discrepancy with those obtained by ,drs4 ,hawk and ,benedict1 not to mention the ,council's referees1 and also with the fact that only about #aa per cent4 of 8pancreatin0 is claimed in the published formula of ,lactopeptine4 ,the ,council is unable to accept ,dr4 ,balch's result for trypsin or rennin as reliable4 ,his other results are without significance and call for no special comment4 #c4 ,even if tryptic activity were conceded to ,lactopeptine1 the preparation1 like all preparations containing pepsin and pancreatin1 would still be1 as previously stated1 therapeutically irrational4 ,the ,council approved the report4 ,report of ,referee ,a ,in view of the manufacturer's reiteration of the claims for ,lactopeptine powder1 ,i have carried out further experiments to determine its proteolytic and amylolytic power4 ,for the proteolytic test ,i used fresh1 well washed fibrin and examined samples of ,lactopeptine powder numbered as follows3 ,no4 #a4 ,a part of the ,english product examined and reported on last spring4 ,no4 #b4--;,a fresh bottle obtained at a ,chicago retail drug store in ,december1 #aiac4 ,no4 #c4 ,a fresh bottle obtained at a ,chicago retail store in ,december1 #aiac4 ,portions of #a gm4 each of these samples were mixed with #e gm4 fibrin1 #ajj mg4 of sodium carbonate and #ej c4c4 of water in flasks4 ,a little toluene was added to each flask1 which was then closed with a tuft of cotton and the mixtures were incubated at #dj degrees through twenty-four hours4 ,at the end of that time there was no marked change in the quantity of the fibrin remaining in each flask1 the larger part by far being undigested4 ,as a control ,i used the sample of an active commercial trypsin1 of which ,i added #ejj mg4 to the same quantity of water1 fibrin and sodium carbonate4 ,this was digested in the same bath at the same time4 ,the digestion was practically completed in less than ten minutes1 only minute flakes of the fibrin remaining4 ,it is evident that the digestive power of the ,lactopeptine must be extremely low1 and only a small fraction of that exhibited by a commercially good trypsin4 ,in an experiment with the ,english sample carried out through nineteen hours as above1 using #b gm4 of fibrin and #ajj mg4 of ferment1 it was found by nitrogen tests on the filtrate that about #ab4b per cent4 of the protein had been brought into solution1 an amount which is practically without importance in a digestion of such duration4 ,to test the starch digestive power ,i have made a large number of experiments4 ,in a series just completed ,i mixed #a gm4 portions of ,samples #a and #b with water to make #ajj c4c4 volumes4 ,before making up to the final volumes #j4e c4c4 of normal sodium hydroxid was added to neutralize the slight acidity of the ferment as shown by phenolphthalein4 ,of these mixtures #d1 #f1 #h and #aj c4c4 portions were mixed with #ej c4c4 of #a per cent4 starch paste and incubated at #dj degrees to find the colorless end-point in the starch digestion1 by the iodin test4 ,at the end of twenty-two hours the iodin reaction was as strong as at the beginning1 indicating no appreciable starch digestion4 ,to the flasks in which no digestion had taken place under these conditions1 #e mg4 of a pancreas ferment was added4 ,this gave an almost immediate conversion to the colorless end-point4 ,this ferment was a sample of ,holadin which had been in the laboratory about a year4 ,the #e mg4 completed the reaction to the colorless end-point in less than ten minutes4 ,in a similar test ,i used #b gm4 of ,lactopeptine ,no4 #c1 made up to #ajj c4c4 with #a4b c4c4 of normal alkali4 ,ten and #ae c4c4 portions were incubated with #ej c4c4 of #a per cent4 starch paste through twenty hours at #dj degrees with no apparent result4 ,the ,holadin then added1 #e mg4 being used1 completed the conversion in less than ten minutes4 ,this shows that the medium was a proper one for the test and that the ,lactopeptine must be extremely weak4 ,no sugar tests were made because the ,lactopeptine contains milk sugar to the extent of about #fj per cent4 ,similar results for both protein and starch digestives have been obtained in a large number of experiments4 ,these here quoted show that the ferment activity of the preparation is so low as to merit no recognition practically4 ,the digestion of a few milligrams of fibrin or starch after many hours of contact1 while being perhaps scientifically possible1 is of no value when we come to a consideration of the use of such bodies as digestive ferments in medicine4 ,the amount of lactic acid or 8loosely combined ,h,cl0 present in ,lactopeptine is very small1 since the total acid which may be titrated by sodium hydroxid and phenolphthalein is measured by #j4e c4c4 of the normal hydroxid for #a gm4 of the ,lactopeptine powder1 in the mean4 ,in different samples examined the range was found to be from #j4da c4c4 to #j4f c4c4 ,tests with methyl orange1 methyl red and other indicators showed that the free acidity is but trifling2 if the whole of this acid1 as measured by phenolphthalein1 were calculated to ,h,cl1 the amount would be too small to have any appreciable physiologic activity1 in view of the daily dose recommended1 #aj to #bj grains of the powder4 ,report of ,referee ,b ,the following table gives a summary of the results of my investigations on ,lactopeptine4 ,the numbers in the extreme left-hand column are the manufacturer's identifying marks4 ,these1 it is assumed1 run serially1 the higher numbers indicating fresher specimens4 ,,table ,,showing ,,enzymic ,,power ,,of ,,lactopeptine ,,preparations ,amylase ,pepsin ,rennin ,trypsin ,lipase #bbge - - - #bcja - - - #bcab - - - #bcdh - - - #bceb - - - #bcfd - 787 - #bcgd - - 787 #bchc - 787 #afch 7tablets7 - - - ,pancreatin 7,old7 - 44 44 - ,the conclusions in the foregoing summary depend on the following criteria3 ,amylase3 removal of starch 7paste71 small in proportion to begin with4 ,pepsin3 solution of small shreds of fresh fibrin in acid media4 ,rennin3 curdling of milk in moderate excess4 ,trypsin3 solution of small shreds of fresh fibrin in neutral and alkaline media1 and tryptophan test4 ,lipase3 coloration of litmus-milk2 exact color controls4 ,all tests were suitably controlled4 ,the responses for pepsin were weak even when compared with those of old pepsin preparations4 ,in the table above1 the interrogation points in parentheses 787 refer to results that were obtained after treatment for from twelve to twenty-four hours and indicates that the change was slight at best and of no practical import4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bc1 #aiae1 with additions47 ,,iodum-,,miller ,,and ,,iod-,,izd-,,oil 7,,miller',s7 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,a referee has submitted to the ,council the following report of the ,chemical ,laboratory of the ,american ,medical ,association on ,iodum-,miller and ,iod-,izd-,oil 7,miller's7 7,iodum-,miller ,co41 ,kansas ,city1 ,mo473 ,the unsatisfactory statements made in regard to the composition of ,iodum-,miller and the far-reaching therapeutic recommendations for it induced the laboratory to make a chemical examination of the preparation4 ,it claimed more or less directly that the preparation is entirely new and possesses novel characteristics4 ,it is asserted that 8,iodum-,miller is made from ,soot ,iodine1 which is our own product4 ,this ,soot ,iodine is ,,soluble ,,in ,,water before being combined with its base ,c4,p4 ,glycerine40 ,no information regarding 8soot iodine0 is offered and an inquiry sent to the proprietors by a physician brought only the noncommittal reply that 8soot iodine0 8is made from ,resublime resublimed8 ,iodine by a chemical process which renders it soluble in water before being combined with its base40 ,iodum-,miller is said to contain 8,active ,free ,iodine #b4b grams per #ajj c4c41 #aj4 grains per fluid ounce1 #a4g by weight40 8,in addition to the active free iodine 444 ,,iodum-,,miller carries a still greater per cent of ,iodine in its basic combination44440 ,according to the label1 the preparation is 8,an ,iodine for ,external and ,internal use 444 #de drops equals #a dr4 by weight4 ,each drop equals the per cent4 of iodine in #a gr4 potas4 iodide40 ,iodum-,miller is a heavy1 dark liquid having an odor characteristic of ether 7ethyl oxid74 ,qualitative tests revealed the presence of glycerin1 free iodin1 iodid and potassium4 ,the specific gravity at #be degrees was #a4bhd4 ,direct titration with sodium thiosulphate solution indicated the presence of #a4fh per cent4 of free iodin4 ,a determination of the total iodin content by the ,hunter method indicated #c4jf per cent4 ,subtraction of the amount of free iodin found from the total amount of iodin present1 gives #a4ch per cent4 combined iodin4 ,assuming this to be present as potassium iodid1 as appears probable from the qualitative examination and from the quantitative determination of potassium1 #a4hj per cent4 potassium iodid is indicated4 ,from this examination it is concluded that ,iodum-,miller is1 essentially1 a solution of iodin and potassium iodid in glycerin1 containing #a4fh per cent4 free iodin and #a4hj per cent4 potassium iodid4 ,the examination contradicts the assumption that ,iodum-,miller is either novel in principle or new4 ,moreover1 accepting the firm's statement that #de drops weigh #a dram 7#fj grains7 the examination shows that one drop equals not 8the per cent4 of iodine in #a gr4 potas4 iodide0 but instead1 the per cent4 of iodin in only #a_/bj grain potassium iodid4 ,as the statement that 8,each drop equals the per cent4 of iodine in #a gr4 potas4 iodide0 appears on the label of the trade package1 ,iodum-,miller would seem to be misbranded under the federal ,food and ,drugs ,act4 ,the recommended internal dosage of ,iodum-,miller 7from #a_/b to #bj drops7 is equivalent to from #a_/dj to #a grain of potassium iodid4 ,its external efficacy in comparison with that of other iodin preparations may be estimated by comparing the respective free iodin contents1 since the germicidal power of combined iodid is negligible4 ,while ,iodum-,miller contains #b4ae gm4 free iodin in #ajj c4c41 tincture of iodin contains #g gm4 per #ajj c4c4 and compound solution of iodin 7,lugol's solution7 contains #e gm4 free iodin in #ajj gm4 ,among the advertising literature is a circular which purports to be a 8,certificate from ,kansas ,city ,testing ,laboratory1 by ,roy ,cross1 ,secretary40 ,the 8certificate0 attempts to prove that ,iodum-,miller is vastly superior to the official tincture of iodin as a germicide1 asserting that 8,in the process of dissolving tincture of iodin in water1 a very large amount of the iodin is lost by precipitation44440 ,this is not true of the tincture of iodin which is now official1 though it is true of the tincture official in former editions of the ,pharmacopeia4 ,the report ignores completely the widely used aqueous solution of iodin4 ,iod-,izd-,oil 7,miller's7 is said to be an 8,iodine ,combination0 made 8from the same ,soluble ,soot ,iodine as is ,,iodum-,,miller40 ,it is said to 8liberate ,free ,soluble ,iodine0 when applied to the skin1 mucous surfaces1 etc4 ,it is further defined as 8,soluble ,iodine combined with water-white ,hydrocarbon ,oil0 and is said to liberate 8,soluble ,iodine #b per cent40 ,while these statements suggest that ,iod-,izd-,oil 7,miller's7 contains the iodin-potassium iodid combination contained in ,iodum-,miller1 analysis indicated the oil to be a simple solution of iodin in liquid petrolatum4 ,quantitative determinations indicated1 not #b per cent4 of iodin1 as claimed1 but only #j4db per cent4 and all of this was present as free iodin4 ,,referee',s ,,report ,the following therapeutic claims appear on the label of a bottle of ,iodum-,miller3 8,,external ,,indications 8,tuberculosis1 ,pneumonia1 ,pleurisy1 ,cough1 ,sore ,throat1 ,pyorrhea1 ,tonsilitis1 ,rheumatism1 ,spinal ,irritation1 ,boils1 ,felons or any ,pain4 ,periostitis1 ,carbuncles1 ,fistula in ,ano1 ,goiter1 ,blood ,poison1 ,diseases of ,uterus and appendages 7apply full strength on cotton wrapped applicator71 ,gonorrhea1 acute or chronic in both sexes1 ,orchitis1 ,bubo1 ,prostatitis1 ,swellings1 ,enlarged ,glands1 ,etc40 8,,internal ,,indications 8,pneumonia1 ,tuberculosis1 ,pleurisy1 ,typhoid ,fever1 ,syphilis1 ,catarrh of ,mucous surface of ,alimentary ,canal1 ,autotoxemia1 ,vomiting of ,pregnancy1 ,rheumatism1 ,chronic ,glandular and ,organic ,affections40 ,the 8certificate0 from the ,kansas ,city ,testing ,laboratory1 mentioned above1 states that ,iodum-,miller was found to have a germicidal value nineteen times greater than carbolic acid--a somewhat remarkable finding in view of the fact that iodin dissolved by means of potassium iodid in alcohol or water1 when tried on the typhoid bacillus has recently been found to possess only four times the germicidal value of carbolic acid in a solution of the same strength 7,maben and ,white3 ,chem4 and ,drug41 ,jan4 #cj1 #aiae1 p4 #add74 ,the 8certificate0 further states that the test 8shows available iodine as found in ,,iodum-,,miller to have the greatest bactericidal power of any substance that we have ever tested that can be used medicinally40 ,there is no reason to believe that the desire to please its patrons has led the 8testing laboratory0 astray from the literal truth4 ,the laboratory's experience may be limited and the statement therefore entirely correct as far as it goes4 ,no mention1 however1 is made of any tests comparing the germ-destroying power of ,iodum-,miller with that of tincture of iodin1 which contains #g per cent4 free iodin1 unless the casual statement that 8,iodum-,miller sterilized the skin more quickly0 than tincture of iodin1 be taken to imply such tests4 ,it is not clear1 however1 by what means the laboratory was able to determine that there were no bacteria left alive in the skin after application of tincture of iodin and ,iodum-,miller2 no details are given of the methods used in arriving at this conclusion4 ,a circular says that ,iodum-,miller 8444 gives the ,greatest ,bactericidal and ,therapeutic ,action1 whether used ,internally1 ,externally1 ,hypodermically or ,intravenously40 ,in the light of the preceding report of the ,chemical ,laboratory of the ,association1 these claims require little comment4 ,the laboratory has shown that the free iodin content 7and consequently the germicidal efficiency7 of ,iodum-,miller is less than half that of ,lugol's solution1 and less than a third of that of the official tincture of iodin4 ,as for the advice to use ,iodum-,miller internally in diseases ranging from pneumonia to syphilis and from typhoid to tuberculosis1 in order to be convinced of its dangerous character1 it is necessary only to recall that this treatment is equivalent to the administration of small doses of iodid--from #a_/dj to #a grain of potassium iodid4 ,the mystery being removed from the composition of ,iodum-,miller1 the absurd extravagance of the claims made for it becomes manifest4 ,the criticisms of the ,council on the recommendations for ,burnham's ,soluble ,iodine 7,the ,journal ,a4 ,m4 ,a41 ,may #ae1 #aiae1 p4 #afgc7 apply in almost every particular to ,iodum-,miller4 ,unwarranted therapeutic claims are made for ,iodum-,miller2 incorrect statements are made with regard to its composition and that of ,iod-,izd-,oil 7,miller's72 and the application of a trade name to both of these products is unjustifiable1 since neither is original4 ,it is therefore recommended that ,iodum-,miller and ,iod-,izd-,oil 7,miller's7 be held ineligible for ,new and ,nonofficial ,remedies--7,abstracted in ,the ,journal ,a4 ,m4 ,a41 ,oct4 #b1 #aiae47 ,,elixir ,,iodo-,,bromide ,,of ,,calcium ,,comp4 8,,without ,,mercury0 ,,and 8,,with ,,mercury0 ,report of the ,council on ,pharmacy and ,chemistry ,the ,tilden ,company1 ,new ,lebanon1 ,n4 ,y41 and ,st4 ,louis1 ,mo41 sells 8,elixir ,iodo-,bromide of ,calcium ,comp4 without ,mercury0 and 8,elixir ,iodo-,bromide of ,calcium ,comp4 with ,mercury40 ,the latter is said to contain1 in addition to the ingredients of the former1 #a_/ajj grain mercuric chlorid in each fluidram4 ,according to the label the formula of the elixir 8without mercury0 is3 8,formula--,salts of ,iodine1 ,bromine1 ,potassium1 ,sodium1 ,calcium1 ,magnesium with ,stillingia1 ,sarsaparilla1 ,rumex1 ,dulcamara1 ,lappa1 ,taraxacum1 ,menispermum40 ,a recent circular declares that the elixir contains3 8444 a number of the most powerful alteratives of the pharmacopeia such as chemically pure iodin1 magnesium1 potassium with sarsaparilla1 stillingia1 prickly ash1 burdock1 taraxacum1 etc4 444 ,each fluidounce contains seventy-two grains of the combined salts40 ,the same circular also alleges that each dram of the preparation contains3 8444 the equivalent of one and one-half grains of the combined iodids1 potassium and calcium 4440 ,it will be observed that1 7#a7 the two statements quoted from the circular make no reference to bromids2 7#b7 the statement that each dram contains 8the equivalent0 of #a-a_/b grains of the combined iodids1 potassium and calcium1 accounts for but #ab of the #gb grains of 8the combined salts0 per fluidounce declared in the preceding quotation2 7#c7 the circular mentions the presence of a drug--prickly ash--not declared on the label and1 finally 7#d7 none of the 8formulas0 gives the quantities of all of the several constituents4 ,it is evident from these 8formulas0 that the ,tilden ,company continues its policy of concealment and mystification as exemplified in the cases of ,hydrocyanate of ,iron1 ,tilden 7discussed in ,the ,journal1 ,june #ai1 #aiji1 p4 #bjjh71 ,febrisol 7,the ,journal1 ,june #bi1 #aiab1 p4 #bjdc7 and ,respirazone 7,the ,journal1 ,june #ad1 #aiac1 p4 #ahii74 ,in the circular just quoted 78,the ,conquest of ,syphilis071 all hope for the syphilitic is declared to rest in mercury and iodin1 and it is implied that only through ,elixir ,iodo-,bromide of ,calcium ,comp4 is it possible to obtain the greatest good from these drugs4 8,were the cleansing influences of these two drugs mercury and iodin unavailable to the luetic patient1 he1 truly1 would be as pitiable an object as the leper 444 8,modern ,pharmacy has devised no better means of utilizing these anti-syphilitics than ,elixir ,iodo-,bromide of ,calcium ,comp4 7,tilden7 with or without mercury4444 ,the ,elixir1 in proper dosage1 acts in specific fashion and is adapted for use in all stages of the disease4 8,in the early months 444 ,elixir ,iodo-,bromide of ,calcium ,comp4 7,tilden7 with mercury is a trustworthy weapon and the physician need have no fear but that it will subjugate the disease 444 8,when 444 the virulent stage is passed 444 ,elixir ,iodo-,bromide of ,calcium ,comp4 7,tilden7 without mercury may be given the patient with every assurance that medicine's most aggressive measures are being resorted to 444 ,from time to time1 up to the very end of the time honored three years' period of treatment1 it is well to put the patient back on the bichloride1 using for this purpose the form of the ,elixir administered in the first stages of the disease 444 8,this regime 444 will indubitably antidote the virus of syphilis and eradicate from the organism its every vestige40 ,while it seems incredible that any physician would jeopardize the health--even the life--of a patient by accepting this boastful magniloquence as sound therapeutic advice1 still the fact that certain medical journals lend their advertising pages to advertisements for ,tilden's ,elixir with the caption 8,the ,conquest of ,syphilis0 makes it incumbent on the ,council to record its condemnation of the employment of this unscientific1 semisecret mixture4 ,it is recommended that ,elixir ,iodo-,bromide of ,calcium ,comp4 8without mercury0 and 8with mercury0 be held in conflict with ,rule #a 7secrecy of composition71 ,rule #f 7unwarranted therapeutic claims7 and ,rule #aj 7unscientific composition74--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #f1 #aiae47 ,,lecithin ,,preparations ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report was sent to the manufacturers of the various lecithin preparations mentioned therein4 ,as the replies of the manufacturers were obviously written from the commercial point of view and did not affect the ,council's conclusion that lecithin1 when indicated1 would be given more advantageously in the form of yolk of egg than in the less pure manufactured product1 the ,council directed that the report be published1 together with extracts from the replies of the manufacturers4 ,w4 ,a4 ,puckner1 ,secretary4 ,commercial lecithin preparations are at best very impure substances2 all are more or less altered from the original composition4 ,even with great care1 the methods of extraction and drying always produce considerable decomposition2 and in some cases the phosphorus and nitrogen contents bear but little relation to the theoretical values4 7,long1 ,j4 ,h43 ,jour4 ,am4 ,chem4 ,soc41 xxx1 #hha4 ,mc,lean1 ,hugh3 ,chem4 ,abstracts1 ,may #bj1 #aiae74 ,there is not the slightest reliable evidence that commercial lecithin has any advantage over the lecithin contained in natural foods2 the weight of probability is on the other side4 ,the doses recommended1 moreover1 are absurdly small2 and the amount thus administered is without practical value4 ,why administer a few milligrams of a more or less decomposed lecithin when it is possible to give a far larger weight of a purer substance in the form of yolk of egg8 ,in view of these considerations the ,council voted that the following proprietary products be omitted from the next edition of ,n4 ,n4 ,r43 ,glycerole of ,lecithin ,lecibrin ,lecithin ,solution ,lecithol ,neuro-,lecithin-,abbott and that the general article on 8,lecithin ,preparations0 be transferred to the annual ,council ,reports as a matter of record4 ,the report was submitted to the manufacturers4 ,their replies were evidently based on commercial consideration1 and called for no modification in the report4 ,the referee recommended that the preceding report be published together with the following extracts from the replies of the manufacturers3 ,from ,armour and ,company3 8,we are selling a good deal of ,lecithol and it seems to be giving satisfactory results in some quarters4444 ,we shall continue to advertise ,lecithol along the lines we have employed heretofore40 ,from the ,abbott ,laboratories3 8,we can assure you of our confidence in the therapeutic value of ,neuro-,lecithin4 ,this has been attested by the reports of favorable results sent us by many physicians1 as well as by the periodical literature of the last few years which contains a considerable number of very encouraging references to lecithin therapy40 ,from ,fairchild ,bros4 ,foster3 8,we would like simply to say that the physician and the ,council must be aware of the circumstances and the purposes which actuated us in placing lecithin at disposal1 viz41 the studies--research--of lecithin and the properties attributed to it and which led to inquiry for and consideration of it4 ,the quantities proposed for medicinal use were not suggested by us2 the suggestion of lecithin in small quantities as a therapeutic agent was obviously directed by those who proposed it4444 ,the question whether lecithin1 per se1 has therapeutic properties in contrast to lecithin as naturally contained in food substances1 is something we do not undertake to decide4 ,the ,council1 on purely theoretical grounds1 decides in the negative notwithstanding clinical experience--internal and hypodermic--and thus would deny lecithin the status of a new and nonofficial remedy1 worthy of at least tentative progressive clinical consideration4 ,we can only say that we offered bona fide lecithin and that we did not make the investigation of lecithin a pretext for the sale of all sorts of lecithin #8jumbles' with lecithin in small proportions1 taking their name and making their bid on lecithin40 ,below appears the general article which has been omitted from ,n4 ,n4 ,r43 ,lecithin ,preparations ,lecithins are fat-like bodies belonging to the group of phosphatides4 ,they all consist of glyceryl esters containing two fatty acid radicals and the phosphoric acid radical in which one of the residual hydrogens is replaced by the choline group4 ,the fatty acid may be palmitic1 oleic or stearic and various combinations are known to exist2 for example1 distearyl lecithin1 stearyl palmityl lecithin and so on4 ,the commercial lecithins usually include the closely related kephalins4 ,on saponification the lecithins split more or less readily into choline1 the fatty acids and glycerophosphoric acid1 and by fusion with alkali nitrate and carbonate they yield alkali phosphate4 ,they occur1 free or in combination as lecithoproteins1 most abundantly in certain animal tissues1 but there are also vegetable lecithins4 ,the lecithins of commerce are obtained usually from yolks of eggs or from calves' or sheep's brains4 ,numerous processes have been devised for the preparation of lecithin from egg-yolk or animal tissue4 ,from egg-yolk it may be obtained by making an alcoholic extract and precipitating by cadmium chloride4 ,the precipitate is washed with alcohol and ether1 mixed with #hj per cent4 alcohol and warmed with the proper amount of ammonium carbonate to remove the cadmium4 ,after filtering hot and concentrating the filtrate the lecithin is thrown down by cooling to a low temperature--#aj ,c4 or below4 ,the precipitate is taken up in chloroform and reprecipitated by acetone4 ,from tissues it is obtained by extracting with warm alcohol and ether1 concentrating the extract1 precipitating with acetone and repeating the operations4 ,pure lecithin is white1 but the commercial preparations are yellowish-brown wax-like solids1 which are not soluble in water but form milky emulsions which exhibit the myeline figures under the microscope4 ,the solubility in cold alcohol or ether is slight1 but heat aids it4 ,lecithins are not soluble in acetone4 ,they are hygroscopic and the water mixtures undergo decomposition on standing4 ,they darken on exposure to air and light4 ,the alcoholic solution is precipitated by platinum or cadmium chloride4 ,it is decomposed by alkalies with the formation of choline and trimethylamine4 ,the ash contains phosphoric acid4 ,the different lecithins contain from #c4hd to #d4ab per cent4 of phosphorus and #a4gc to #a4hf per cent4 of nitrogen4 ,the ratio of nitrogen to phosphorus should be at #a to #b4ba4 ,lecithin is incompatible with alkalies2 it should be kept in well-stoppered bottles and should be protected from the light4 ,the content of lecithin 7plus kephalin7 in tissues is about as follows3 ,per ,cent4 ,egg-yolk #h to #ab ,egg-white #j4a to #j4b ,liver #b4j to #c4j ,kidney #b4j to #c4f ,lung #b4j to #c4j ,pancreas #b4j to #c4j ,actions and ,uses4--,the lecithin preparations have been recommended in many pathologic conditions1 especially in malnutrition and sexual debility4 ,moderate doses are said to bring about a marked retention of nitrogen and phosphorus1 but satisfactory proof of this is lacking4 ,it is extremely unlikely that the small doses which have been recommended in pill or tablet form or in emulsions can have any perceptible action1 in view of the fact that many of our natural foods contain much greater weights of available lecithins than the medicinal doses provide4 ,there is no good basis for the statement that the free lecithin has a greater food value or is more readily assimilated than is the substance as found in eggs or tissue4 ,the reverse proposition is much more likely to be true1 especially when it is considered that the commercial preparations are usually somewhat altered or decomposed in the process of separation4 ,dosage4--,given by the mouth in the form of pills1 tablets or glycero-alcoholic emulsions4 ,the amount of actual lecithin ingested in this way is usually small because of the doubtful purity of the original preparation4 ,several doses1 as commonly administered1 would be required to furnish the amount of lecithin present in a small egg4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiae1 p4 #abb47 ,,proprietary ,,names ,,for ,,liquid ,,petrolatum ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has accepted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,a former report of the ,council 7,liquid ,petrolatum or 8,russian ,mineral ,oil10 ,report ,council ,pharm4 and ,chem41 ,the ,journal1 ,may #cj1 #aiad1 p4 #agdj7 called attention to the large number of concerns that were placing on the market liquid petrolatum as a proprietary under coined names4 ,since then the number of such products has increased4 ,the ,council has been requested by several concerns to consider their products put out under proprietary brand names4 ,the rules of the ,council affirm that 8the application of #8trade names' to official or established nonproprietary substances tends to confusion and fosters many abuses40 ,in accordance with this general ruling1 the ,council has invariably refused to countenance proprietary names applied to liquid petrolatum4 ,the ,council holds that proprietary or coined names for this substance are detrimental to medical progress1 since they are sure to foster the impression that the particular product is different from liquid petrolatum4 ,manufacturers have been advised that there is no objection to distinguishing their products by the addition of their firm name or the initial representing the firm name2 for instance1 8,liquid ,petrolatum1 ,a4 ,b4 and ,co40 or 8,liquid ,petrolatum1 ,smith40 ,the ,council also believes that such designations as 8,star ,liquid ,petrolatum0 or 8,liquid ,petrolatum1 ,anchor ,brand10 may be regarded as unobjectionable1 provided that the words 8,liquid ,petrolatum0 are always used in connection with the brand designation and given equal prominence4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiae1 p4 #abg47 ,,seng ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,seng 7,sultan ,drug ,co41 ,st4 ,louis7 is called by the manufacturers3 8444 a palatable preparation of ,panax 7,ginseng7 in an aromatic vehicle40 ,regarding ginseng 7,panax quinquefolia7 the ,united ,states ,dispensatory1 nineteenth edition1 page #afjc1 says3 8,the extraordinary medicinal virtues formerly ascribed to ginseng had no other existence than in the imagination of the ,chinese4 ,it is little more than a demulcent1 and in this country is not employed as a medicine40 ,no discussion of ginseng is to be found in the more recently published books on pharmacology1 materia medica and therapeutics1 evidently because their authors agree with this estimate4 ,on the other hand1 physicians are told through the medium of advertisements appearing in medical journals that ,seng is3 8,an efficient remedy in all affections in which the gastro-intestinal glands need stimulating4 8,exceptionally useful in atonic indigestion1 malnutrition1 convalescence from the acute diseases1 and all digestive disorders characterized by deranged or depressed functions40 7,woman's ,medical ,journal1 ,july1 #aiad47 ,according to the label1 ,seng is indicated in 8indigestion10 8malassimilation10 8malnutrition0 and 8wasting diseases40 ,it is also stated--though the preparation is admitted to contain #ah per cent4 of alcohol--that to give babies 8ten to fifteen drops in water or milk during feeding0 is a proper procedure and that 8,for ,colic1 ,flatulency1 etc41 the dose for an adult or child may be repeated every half hour until relieved40 ,the following are some of the exaggerated therapeutic claims made for this preparation of a worthless drug3 8,as a result of its administration the gastro-intestinal secretions are augmented1 the digestion of food is substantially increased1 and fermentative processes are promptly overcome40 8,seng will specifically encourage the secretion of the juices in the entire alimentary tract 4440 ,the formula furnished for ,seng is non-quantitative and therefore meaningless4 ,the preparation is exploited in a manner to encourage its ill-advised use by the public1 and exaggerated and unwarranted therapeutic claims are made for it4 ,the use of an inefficient or worthless drug like ginseng1 moreover1 is detrimental to rational therapeutics4 ,the ,council therefore voted that ,seng be refused recognition for conflict with ,rules #a1 #d1 #f and #aj4--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiae1 p4 #abi47 ,,frosst',s ,,blaud ,,capsules ,report of the ,council on ,pharmacy and ,chemistry ,frosst's ,blaud ,capsules and ,frosst's ,blaud1 ,arsenic and ,strychnine ,capsules were submitted to the ,council by ,c4 ,e4 ,frosst ,co41 ,montreal1 ,canada4 ,this firm claims1 on the authority of the report of a firm of analytical chemists1 that3 8444 of three leading ,blaud preparations bought by us on the open market1 the iron in ,frosst's ,blaud ,capsules showed the highest percentage of ,ferrous carbonate40 ,the ,chemical ,laboratory of the ,american ,medical ,association found this claim unjustified4 ,the laboratory reported that there was no especial difference in the ferrous iron content of the various ,blaud pills found on the market1 and that among ten specimens examined1 the total iron content was the lowest in the ,frosst specimen4 ,in view of this the ,council refused recognition to ,frosst's ,blaud ,capsules and ,frosst's ,blaud1 ,arsenic and ,strychnine ,capsules4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiae1 p4 #afd47 ,,tyree',s ,,elixir ,,of ,,buchu ,,and ,,hyoscyamus ,,compound ,report of the ,council on ,pharmacy and ,chemistry ,each dessertspoonful of this preparation is said to represent ,buchu ,leaves #c-a_/b grains ,uva ,ursi #a-a_/h grains ,pareira ,brava #a-a_/h grains ,hyoscyamus #a-a_/b grains ,hops #a-a_/b grains ,acetate ,potash #g-a_/b grains ,spirits ,nitre #e grains ,alcohol #e per cent4 7by volume70 ,the manufacturer1 ,j4 ,s4 ,tyree1 ,washington1 ,d4 ,c41 offers this formula to the medical profession with the following claim3 8,approximate composition made sic by quantitative and qualitative analysis of the finished product40 ,it is also claimed that 8,an even greater advantage of ,tyree's ,buchu and ,hyoscyamus ,compound over other drugs1 lies in the fact that every constituent of the former is required to conform to a fixed standard of active principle strength2 hence the results derivable from it are absolutely uniform40 ,these pretentious claims of scientific accuracy look rather absurd to chemists4 ,many of the substances present in buchu1 hops1 hyoscyamus1 uva ursi and pareira brava are also present in other drugs2 hence it would never occur to a pharmaceutical chemist to try to ascertain the composition of such a mixture as ,tyree's ,elixir by 8quantitative and qualitative analysis of the finished product10 much less to determine the 8active principle strength0 of each ingredient1 for no methods are known by which this can be done4 ,it is claimed that1 because of the care exercised in making ,tyree's ,elixir 8444 the results derivable from it are absolutely uniform40 ,a moment's reflection1 however1 must compel any physician to attribute this statement1 on the most charitable construction1 to sheer ignorance4 ,of course1 even a definite chemical principle1 such as quinin1 does not exert uniform clinical action1 for clinical conditions vary1 and accordingly the patient may or may not be cured4 ,it is simply preposterous to claim that the clinical results obtained from such substances as hops1 pareira brava1 buchu and uva ursi are absolutely uniform4 ,a peculiarly vicious claim is that the elixir renders the mucous surfaces of the genito-urinary tract 8hostile to the multiplication of the gonococci40 ,since infection with the gonococcus produces the direst results1 any claim which means in plain ,english that the remedy assists in producing a cure or in preventing infection with that organism cannot be condemned too strongly4 ,uva ursi1 to be sure1 has some slight antiseptic action but it is devoid of any curative action in gonorrhea and the minute amounts that are present in the ,tyree elixir are of no more protective value against gonorrheal infection than a grain of hexamethylenamin would be4 ,it is further claimed that the elixir is a 8specific0 for 8,inflammation of the ,bladder1 ,bright's ,disease1 ,renal ,colic1 ,suppurative ,nephritis1 ,acute ,cystitis1 ,urethritis1 ,catarrh of the ,bladder it would be interesting to know what distinction the manufacturer draws between #8,inflammation of the ,bladder1' #8,cystitis' and #8,catarrh of the ,bladder'1 ,acidemia1 ,edema1 ,vesical ,catarrh of ,old ,age1 ,lithemia0 and that ascites and anasarca 8can be reduced greatly to the satisfaction of the patient1 and honor of the physician0 by using a mixture of ,tyree's ,elixir and infusion of digitalis4 ,such claims as these do not merit serious discussion1 for they carry their own refutation4 ,it is recommended that ,tyree's ,elixir of ,buchu and ,hyoscyamus ,compound be held in conflict with ,rules #e1 #f and #aj and that publication of this report be authorized4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiae1 p4 #afg47 ,,hydroleine ,report of the ,council on ,pharmacy and ,chemistry ,hydroleine 7,charles ,n4 ,crittenton ,company1 ,new ,york7 is a cod liver oil emulsion said to contain #de per cent4 of cod liver oil1 a trace of salicylic acid and #ah-a_/b grains of 8,pancreatin1 ,etc410 per ounce4 ,the advertising claims are based largely on the theory that cod liver oil is 8that particular fat which dietetic experience and physiological chemistry have proved to be most digestible40 ,as a matter of fact1 while the superior digestibility of cod liver oil over other oils has often been asserted1 neither 8dietetic experience0 nor 8physiological chemistry0 have 8proved0 this by definite observations4 ,the ,crittenton ,company claims that it is more readily split than other oils4 ,this is probably not true1 easy emulsification of the raw oil being often confounded with easy splitting4 ,this latter claim1 however1 is offered in justification of the name 8,hydroleine10 which the ,crittenton ,company interprets as 8hydrated oil40 ,a circular wrapped around the bottle contains the assertion that 8,cod ,liver ,oil has long been held in high esteem by the medical profession for the treatment of a large number of serious diseases40 ,this recommendation is likely to lead the public to place undue reliance on ,hydroleine in the grave conditions mentioned4 ,the preparation is in conflict with the rules of the ,council inasmuch as its name does not indicate its composition1 unwarranted therapeutic claims are made for it1 and the exploitation is likely to give the public unwarranted confidence in its value4 ,the ,council therefore held ,hydroleine ineligible for ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiae1 p4 #aga47 ,,curative ,,vaccine1 ,,bruschettini ,report of the ,council on ,pharmacy and ,chemistry ,curative ,vaccine1 ,bruschettini1 manufactured by ,a4 ,bruschettini1 ,genoa1 ,italy1 is claimed to have the properties 8of acting directly on the tubercular bacillus1 bringing directly into the field and determining a hyperproduction of antibacillar and antitoxic substances40 ,the use of the preparation is said to be indicated in 8all forms of tuberculosis40 ,a referee reported to the ,council that he had examined the available information and believed that the use of this product had no satisfactory experimental basis4 ,the method of preparation appears to be based more on theoretical considerations than on experimental basis4 ,on the recommendation of the ,committee on ,serums and ,vaccines the ,council voted that ,curative ,vaccine1 ,bruschettini1 be not accepted because 7#a7 the method used for the production of the vaccine was not satisfactorily stated2 7#b7 the theory on which its use is based has not been satisfactorily confirmed1 and 7#c7 the value of the product is not upheld by satisfactory clinical evidence4 ,the ,council's findings1 in accordance with its procedure1 were sent to the manufacturers for comment4 ,his reply was considered by a new referee who found that the matter presented did not warrant a revision of the ,council's conclusions4 ,accordingly the ,council directed publication of its findings4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiae1 p4 #agf47 ,,stearns' ,,wine ,report of the ,council on ,pharmacy and ,chemistry ,frederick ,stearns ,co4 market a preparation known as 8,stearns' ,wine10 8,stearns' ,wine of ,cod ,liver ,ext4 with ,peptonate of ,iron10 and as 8,vinum ,ext4 ,morrhuae1 ,stearns40 ,the constituents are said to be 8concentrated extract of fresh cod livers10 8,peptonate of ,iron0 and a 8fine quality of prime ,sherry ,wine0 containing #ah per cent4 of alcohol4 ,this preparation was at one time marketed through the medical profession1 but is now advertised direct to the public in typical 8patent medicine0 style4 ,the label on a recently purchased bottle of ,stearns' ,wine contains the following statements3 8,,stearns ,,wine is an ideal tonic for elderly people1 for weak1 pale and delicate children and convalescents4 8,,stearns ,,wine has for many years been successfully prescribed in the treatment of general or nervous exhaustion1 anemia1 malnutrition1 loss of appetite1 loss of sleep1 faulty circulation and impoverished blood supply40 ,the scope of the recommendations for the preparation is further indicated in a booklet accompanying the bottle1 which begins3 8,,stearns' ,,wine1 ,what ,it ,is and ,why ,it ,is ,good for ,you40 ,the conclusion is3 8,,stearns' ,,wine is a safe medicine for the young1 middle-aged and old4 ,it is a safeguard to the family health40 ,it is not necessary to discuss either these all-embracing claims as to the therapeutic efficacy of the mixture or the fallacies presented in favor of cod-liver extract and peptonate of iron4 ,the ,council reaffirms the opinion that whatever therapeutic value cod liver may have resides chiefly1 if not entirely1 in its fatty constituents 7,the ,journal1 ,oct4 #i1 #aiji2 ,reports ,council ,pharm4 and ,chem41 #aiji1 p4 #aae74 ,a confirmation of this opinion has recently been furnished by the investigations of ,prof4 ,j4 ,p4 ,street 7,the ,journal ,a4 ,m4 ,a41 ,feb4 #bj1 #aiae1 p4 #fch7 of several cod liver cordials1 one of which 7,vinol7 like ,stearns' ,wine1 is described as a wine of cod liver extract with peptonate of iron4 ,stearns' ,wine is essentially an alcoholic stimulant4 ,it is not 8a safe medicine for the young1 middle-aged and old40 ,the unwarranted therapeutic claims and the recommendations for its indiscriminate use bring it into conflict with ,rules #d and #f4 ,the ,council voted that ,stearns' ,wine be held ineligible for inclusion in ,n4 ,n4 ,r4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiae1 p4 #agg47 ,,protonuclein ,,and ,,protonuclein ,,beta ,report of the ,council on ,pharmacy and ,chemistry ,the ,council had adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,protonuclein1 with other products of ,reed and ,carnrick1 was examined by the ,council in #aijg and found ineligible for admission to ,new and ,nonofficial ,remedies4 ,according to the patent specifications1 it is prepared 8from the thyroid and thymus glands1 brain 7pineal glands and pituitary body71 bone-marrow1 pancreas1 spleen1 liver1 salivary glands1 ,brunner's glands1 ,lieberkhn's follicles and peptic glands40 ,these various glandular bodies1 it is said1 are dried at a temperature below #acj ,f4 7preferably between #ajj and #aaj72 the fat is removed by ether1 the dried glands disintegrated1 the connective tissue removed by sifting and the resulting powder coated with an ether solution of benzoin and mixed with milk sugar4 ,the dose is three to ten tablets 7#i to #cj grains7 daily4 ,protonuclein ,beta is said to be produced by the addition to ,protonuclein of an equal amount of nucleoplasm and protoplasm of the spleen4 ,the dose is from two cubes 7each #e grains7 three times a day to three cubes four times a day 7#cj to #fj grains daily74 ,special advantages over ordinary nuclein are attributed to ,protonuclein1 in which1 it is claimed1 certain unaltered cells remain that are more easily assimilated by the leukocytes than are ordinary proteins1 thus leading to a multiplication of cells4 ,in the early advertising ,protonuclein was claimed to be3 8444 an exact physiological product derived from the lymphoid structures of the body without the use of chemical agents4444 ,so delicate is ,protonuclein that any chemical agent is liable to disturb its cellular activity40 ,after its examination of the product in #aijg 7,the ,journal1 ,oct4 #e1 #aijg1 p4 #aaih71 the ,council concluded that any distinction between the action of ,protonuclein and that of ordinary nuclein was purely speculative and highly improbable4 8,if the active ingredients are really so unstable that they are destroyed by all chemical agents1 as claimed1 it seems impossible that the activity would be preserved when ,protonuclein is given by mouth and therefore subjected to the very profound changes of digestion40 ,at that time the importance of thyroid as an ingredient had not been emphasized4 ,the following year1 however1 ,hunt and ,seidell 7,the ,journal ,a4 ,m4 ,a41 ,oct4 #bd1 #aijh7 reported the results of an investigation which showed that ,protonuclein was a diluted thyroid preparation1 as skilfully disguised as in the antifats ,rengo and ,marmola4 ,hunt later pointed out 7,the ,journal1 ,feb4 #a1 #aiac1 p4 #chd7 that the amount of nuclein contained in a dose of ,protonuclein probably would not have the slightest effect1 especially when given by mouth4 ,the following are extracts from the ,protonuclein advertising matter3 8,for cancer1 infectious fevers 7measles1 scarlet fever1 typhoid and septicaemia7 and as a prophylactic40 8,protonuclein3 ,an ideal prophylactic for all infectious ,diseases40 8,a true alterative and tissue builder40 8,the value of ,protonuclein depends upon its ability to increase cell power and promote tissue strength4 ,it is therefore needed whenever the organism is below the normal standard1 more especially in ,anaemia1 ,typhoid1 ,neoplasms and as a ,prophylactic40 ,all the foregoing claims and recommendations are supposed to be based on certain alleged discoveries which the ,council has previously characterized as 8a tissue of vague speculations 444 in direct conflict with the known facts of physiologic chemistry40 ,as for the third claim1 ,hunt and ,seidell have commented on the danger of recommending thyroid1 the most powerful tissue-destroying drug known1 as a 8tissue builder40 ,protonuclein ,beta1 it is said3 8444 combines the reconstructive action of ,protonuclein with the action of the vital principle of the spleen1 making it a distinct product for use in all tubercular troubles1 including phthisis1 localized joint affections and scrofular conditions40 ,this product1 according to the manufacturers1 is based on the work of a certain ,dr4 ,bayle of ,cannes1 ,france4 ,dr4 ,bayle said that he had treated tuberculous patients with fresh ground up spleen of hogs 7#be-ajj grams per day71 mixed with fruit preserve or bouillon2 in cases in which this brought on gastro-intestinal disorders1 extract of the spleen pulp was administered hypodermically4 ,bayle reported extraordinary improvements in the physical and mental conditions of his patients even after a few days of this treatment2 over #ij per cent4 of his tuberculous patients1 according to him1 improved or were cured4 ,this applied to all types and stages of tuberculosis in man4 8,with the spleen pulp treatment tuberculous glands disappear like syphilis lesions on administration of mercury and iodids40 ,this 8spleen specific0 of ,bayle lacks scientific foundation2 ,bayle's own cases were not adequately controlled1 and no notice has been taken of ,bayle's report by experts on tuberculosis4 ,hence it practically lacks both confirmation and contradiction4 ,the spleen is invaded by tubercle bacilli quite as frequently as are the kidneys and the liver2 it has no special toxic action on these bacilli4 ,nor is there any reason to believe that the end products of gastric and intestinal digestion of spleen pulp1 after absorption into the blood1 exert such toxic action4 ,it cannot be assumed that these end products indirectly aid the healing processes through improved metabolism1 for there is no evidence that they have any specific nutritive or stimulating action after such absorption4 ,altogether1 what we know of the physiology and pathology of the spleen does not warrant us in looking for a 8specific0 against tuberculosis in this organ4 ,if1 however1 the known facts did justify any hope that the spleen might furnish such a specific1 manufacturers would not be warranted in exploiting or physicians in prescribing spleen products as a remedy for tuberculosis until control experiments on animals had confirmed the therapeutic value of these products4 ,in a chronic disease like tuberculosis1 no conclusions that are scientifically valid can be drawn from clinical cases until many cases have been observed for years under suitable conditions4 ,right here it may be said that the clinical 8evidence0 offered in favor of ,protonuclein ,beta is worthless4 ,the observations which have been reported on this product are not such as to permit any valid final conclusions to be drawn with regard to its value4 ,the rational method of proving the worth of an alleged new specific such as this is by animal experimentation4 ,so far as we know1 neither ,dr4 ,bayle nor the ,reed and ,carnrick company has performed any such experiments with 8spleen pulp0 or ,protonuclein ,beta2 nor are we aware that any competent investigator has done so4 ,there is1 to the best of our knowledge1 no scientific evidence on which to base the claims for ,protonuclein ,beta4 ,the ,council reaffirms its former action with regard to ,protonuclein4 ,the objections made to ,protonuclein apply with equal force to ,protonuclein ,beta4 ,in view of the lack of evidence1 the claims for ,protonuclein ,beta are unwarranted and the product is ineligible to ,n4 ,n4 ,r4 on account of noncompliance with ,rules #a1 #f and #h4--7;,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #a1 #aiaf47 ,,hydropsin ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,hydropsin is marketed by the ,ernst ,bischoff ,company1 ,inc41 ,new ,york4 ,its composition is thus described3 8,hydropsin is the standardized dialysate of ,digitalis purpurea1 ,betula alba1 ,scilla maritima1 ,juniperis communis1 and ,herniaria glabra2 or1 stated otherwise1 it is the juice of these drugs1 dialyzed and physiologically standardized40 8,each fluid dram represents ,digitalysatum #g gtts41 and #b gtts4 each of the dialysates of ,betula1 ,herniaria1 ,juniper and ,scilla40 ,the composition of ,hydropsin must be considered essentially secret since the amounts of the several constituent drugs in a given amount of 8dialysate0 are not disclosed4 ,the active principle of juniper is a volatile oil which is practically insoluble in water2 it is difficult to believe that the 8juice0 of juniper submitted to dialysis could contain any material amount of the active constituent4 ,no information is given as to the method used whereby the several dialysates are 8physiologically standardized40 ,it therefore remains to be proved that the manufacturer of ,hydropsin possesses any method whereby the dialysates of juniper 7,juniperis communis71 birch 7,betula alba1 the common ,european birch7 and knot weed 7,herniaria glabra7 are so standardized4 ,the claim is made that3 8,herniaria has long been recognized as one of the most valuable drugs in the treatment of dropsical affections due to cardiac impairment40 ,on the contrary1 ,herniaria belongs to that large class of drugs which have been tried1 found wanting and abandoned4 ,it is a very old remedy1 and the claims made for it are an inheritance from the early herbalists1 with whom it was very popular4 ,according to ,king's ,american ,dispensatory1 it was 8principally employed to cure hernia 7hence its name7 and to increase the flow of urine4 ,it was also said to increase the flow of bile4444 ,internally and externally1 it was praised in snake-bites1 and the powdered plant was employed to kill maggots on unhealthy sores of horses4 ,it was reputed to #8crush' and expel calculi from the kidneys and bladder44440 ,the ,ernst ,bischoff ,company says that3 8,betula exerts both an antiseptic and stimulating influence on the urinary passages and is particularly serviceable where a catarrhal condition of the bladder exists4 ,when combined with other diuretics1 as in ,hydropsin1 the drug affords highly satisfactory results in the treatment of ascites1 cardiac dropsy and hydrothorax40 ,birch is another drug which has been discarded4 ,few textbooks on materia medica even mention it4 ,that it can materially affect the action of such powerful drugs as squill and digitalis is exceedingly doubtful4 ,an unwarranted implication--that in this preparation the powerful drugs digitalis and squill have been deprived of their dangerous qualities--is the assertion3 8,dialysis1 removing all resins and colloidals1 results in better tolerance on part of sensitive patients1 and in more rapid absorption and elimination2 which1 in turn1 means early therapeutic effects and little or no fear of toxic accumulation40 ,that removal of colloids and resins materially affects the tolerance of these drugs is improbable4 ,to claim that because of their removal1 there need be 8little or no fear of toxic accumulation0 is utterly without warrant4 ,the claim that one preparation containing digitalis is less likely to produce cumulative effect than any other digitalis preparation is contradicted by a mass of evidence4 ,it is claimed that ,hydropsin affects 8favorably all forms of dropsy or ,edema that are at all amenable to medical treatment40 ,there can be no question but that squill and digitalis1 or1 better1 either singly1 used in suitable cases1 may relieve dropsical effusions2 but to claim that such a complex mixture as ,hydropsin can favorably affect all forms of dropsy that are amenable to medical treatment is on its face unwarranted4 ,the claim is made that3 8,by reason of its unusual potency and relative harmlessness1 ,hydropsin may be employed to great advantage in all cases where it is desirable to increase the volume of urine without injury to the renal structures40 ,on the basis of the claimed composition1 the action of ,hydropsin must be essentially that of digitalis or of digitalis and squill4 ,consequently1 if it possesses 8unusual potency10 it cannot possess 8relative harmlessness10 and vice versa4 ,neither digitalis nor squill should be employed 8in all cases0 of nephritis1 even if it is 8desirable to increase the volume of urine40 ,the composition claimed for ,hydropsin brands it as an irrational mixture in which potent drugs are combined with1 and more or less covered up by1 others that are obsolete and inefficient4 ,the name1 instead of indicating its composition1 suggests diseases in which it may be thoughtlessly and indiscriminately used4 ,the claim that the danger of toxic or cumulative action has been removed1 if accepted by physicians1 tends to uncritical use with possible disastrous results4 ,hydropsin is ineligible for ,new and ,nonofficial ,remedies because of conflict with ,rules #a1 #b1 #f1 #h and #aj4--7;,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #h1 #aiaf47 ,,digitalysatum ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,digitalysatum is sold in the ,united ,states by ,ernst ,bischoff ,company1 ,inc41 ,new ,york4 ,the firm claims that it is a dialysate prepared from the juice of freshly gathered digitalis1 containing all the active principles1 and representing the fresh plant weight for weight4 ,it is said to be standardized physiologically and to contain #ab per cent4 alcohol4 ,sterisol-,digitalysatum1 intended for injection1 appears to be the 8dialysate0 without alcohol1 diluted with equal parts of physiologic sodium chlorid solution4 ,the ,council some years ago found both products ineligible for ,new and ,nonofficial ,remedies because of unwarranted therapeutic claims4 ,the preparations are still being advertised to physicians under claims which imply superiority to all other digitalis preparations4 ,for instance3 8,digitalysatum is the diuretic par excellence in cardiac insufficiency 4440 8,digitalysatum as a diuretic and cardiac stimulant is in a class by itself1 being quick of action1 uniform in strength1 and well tolerated40 8,digitalysatum differs from other forms of digitalis in these respects3444 ,digitalysatum is free from fat1 resins and colloids1 and is therefore well-borne by sensitive patients--the young and the feeble--and is quickly absorbed and eliminated44440 ,the ,council has elsewhere#bh expressed the conviction that tincture of digitalis produces the full therapeutic effects of digitalis2 that1 when properly made1 the tincture is as stable as any liquid preparation of digitalis now available1 and that attempts to enhance the reputation of proprietary products by exaggerating the disadvantages of the official preparation are to be deplored4 ,no adequate evidence is offered of the claimed superiority of action of ,digitalysatum4 #bh ,report on ,proprietary ,digitalis ,preparations1 ,j4 ,a4 ,m4 ,a41 ,dec4 #d1 #aiae1 p4 #bjbd4 ,by implication1 the claim is made that ,digitalysatum is superior to other digitalis preparations in respect to toxicity3 8,free from fat1 resins and colloidals1 it is always well borne and is quickly absorbed and eliminated4 ,no case of toxic accumulation 7faulty elimination7 has ever been reported40 ,that ,digitalysatum is free from the dangers of toxic cumulation is highly improbable2 in fact1 it is inconsistent with the statement that the preparation contains all the constituents found in the fresh plant4 ,even if instances of cumulative action have not been reported this does not prove that such cumulative action does not occur4 ,the tincture of digitalis has the systemic side-effects of digitalis in no greater degree than the various proprietary preparations4 ,attempts to create the impression that ,digitalysatum possesses all the virtues of digitalis without its chief disadvantage are to be condemned as likely to lead to incautious use of the preparation4 ,these exaggerated claims are in the main made indirectly1 but they are none the less inimical to sound therapy4 ,the ,council therefore declared ,digitalysatum ineligible for ,new and ,nonofficial ,remedies and voted that this report be published4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #h1 #aiaf47 ,,so-,,called ,,secretin ,,preparations ,report of the ,council on ,pharmacy and ,chemistry ,the ,council authorized the following report for publication1 and voted to endorse the work of ,professor ,carlson discussed therein4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,council has not accepted for inclusion in ,new and ,nonofficial ,remedies any preparations said to contain secretin or prosecretin as their active ingredient4 ,a report giving the reasons for the rejection of one 7the first of the so-called secretin preparations marketed7 was published early last year2#bi an article on secretin1 based on work undertaken at the request of the ,council on ,pharmacy and ,chemistry1 is now published4#cj #bi ,secretogen1 ,j4 ,a4 ,m4 ,a41 ,may #a1 #aiae1 p4 #aeah4 #cj ,carlson1 ,a4 ,j42 ,lebensohn1 ,j4 ,e41 and ,pearlmann1 ,s4 ,j43 ,has ,secretin a ,therapeutic ,value8 ,j4 ,a4 ,m4 ,a4 #ff3agh 7,jan4 #ae7 #aiaf4 ,lest the appearance of this detailed study of secretin1 after the rejection of so-called secretin preparations1 should be interpreted 7as manufacturers whose products have been rejected have endeavored to interpret such action7 as a case of first condemning a preparation and then getting the facts1 the ,council's methods1 and their application in this case1 may be briefly stated4 ,the ,council maintains that1 when a manufacturer places a product on the market1 the burden of proof is on that manufacturer to show that the properties of his product are in accordance with his claims for it4 ,as stated in the introduction to ,n4 ,n4 ,r41 8it is 444 manifestly impossible for the ,council to investigate the composition of every complex pharmaceutical mixture1 or to check thoroughly every therapeutic claim2 it can give only an unbiased judgment on the available evidence40 ,acting on this principle1 the ,council examined the claims made for ,secretogen1 an alleged secretin product manufactured by the ,g4 ,w4 ,carnrick ,company4 ,the conclusion was that these claims were in absolute conflict with the available evidence as to the action of secretin4 ,it is not necessary to review this subject again4 ,it will suffice to state that the claims made for ,secretogen rest on two fundamental propositions3 7#a7 that deficiency of secretin 7or1 rather1 of prosecretin7 in the intestinal mucosa is a factor in gastro-intestinal diseases2 7#b7 that secretin given by the mouth is absorbed and produces increased secretion of the pancreatic and intestinal juices and of the bile4 ,from an examination of the evidence available1 including that submitted by the manufacturers1 the ,council concluded3 8#a4 ,no evidence has been presented that the absence of secretin is a cause of gastro-intestinal disease4 #b4 ,there is no evidence that secretin in any form is physiologically active when administered by mouth40 ,that these conclusions were justified is shown again by the review given by ,carlson of the literature1 much of which was also reviewed in the ,council's previous report4 ,since the claims of the ,carnrick ,company were not supported by any satisfactory evidence1 no further investigation on the ,council's part was necessary to warrant rejection of the product4 ,the ,council did not undertake to determine1 for instance1 whether or not ,secretogen and similar products actually contain secretin2 the determination of this point was immaterial here1 in view of the conclusiveness of the evidence that secretin given by mouth has no physiologic action4 ,since firms other than the ,g4 ,w4 ,carnrick ,company are manufacturing alleged secretin preparations1 and since recommendations for the use of secretin preparations in gastro-intestinal diseases have even crept into textbooks1 it seemed desirable to obtain further information on certain points4 ,the ,council therefore requested ,prof4 ,a4 ,j4 ,carlson of the ,university of ,chicago to check the results of previous investigators with regard to the action of secretin administered by mouth or directly into the intestine1 and1 in addition1 to investigate the secretin content of certain alleged secretin preparations4 ,carlson and his co-workers1 like all previous investigators1 found that secretin given by mouth1 or introduced even in enormous doses directly into the intestine1 is entirely inactive4 ,they also found that marked destruction of secretin followed contact for one minute with human gastric juice and that secretin is rapidly oxidized and rendered inert in contact with the air4 ,further1 they were unable to demonstrate the presence of secretin in samples of ,secretogen and another supposed secretin preparation 7,duodenin7 bought on the open market4 ,in the case of ,secretogen there was one exception3 one bottle was found which contained a little secretin1 but it was necessary to administer 7by intravenous injection1 of course7 the entire contents of the bottle 7#ajj tablets7 to obtain 8a small but unmistakable secretin reaction40 ,in these studies the methods employed were those by which secretin was discovered4 ,it is only by the use of such methods that the presence or absence of secretin can be determined4 ,apparently the manufacturers who place so-called secretin preparations on the market do not make use of these methods1 by which alone even the composition of their products can be determined4 ,carlson and his collaborators conclude3 8,there is as yet no reliable evidence that lack of secretin is a primary or important factor in any disease4 ,even should this be established1 secretin therapy1 to be effective1 must be intravenous4 ,secretin has not yet been prepared in sufficiently pure state to render possible intravenous injection in man without injurious effects4 ,and even when this is attained1 the very fleeting action of secretin will in all probability render secretin therapy as futile in all the diseases in which it is theoretically indicated as epinephrin therapy is in ,addison's disease40 ,in short1 secretin is as ineffective taken by mouth as it would be rubbed on the skin4 ,the referee recommends that the work of ,professor ,carlson be endorsed4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ae1 #aiaf47 ,,has ,,secretin ,a ,,therapeutic ,,value8,b ,a4 ,j4 ,carlson1 ,ph4,d41 ,j4 ,e4 ,lebensohn1 ,m4,s41 and ,s4 ,j4 ,pearlman1 ,b4,s4 ,chicago ,b ,from the ,hull ,physiological ,laboratory of the ,university of ,chicago4 ,b ,this investigation was undertaken at the request of the ,council on ,pharmacy and ,chemistry4 ,the following report1 having been submitted to the ,council1 received its endorsement 7see preceding report of the ,council on ,pharmacy and ,chemistry1 8,so-,called ,secretin ,preparations074 ,it is well established that acid chyme in the duodenum is the normal stimulus to the secretion of pancreatic juice4#ca ,interaction of the acid with the duodenal mucosa liberates into the blood stream a substance which1 circulating through the pancreas1 excites the latter to activity4 ,this exciting substance has been termed 8secretin40 ,it can be prepared artificially by macerating duodenojejunal mucosa in #j4d per cent4 hydrochloric acid1 neutralizing the boiling mixture1 and filtering4 ,a few cubic centimeters of the filtrate injected into a vein produce invariably a powerful secretion of pancreatic juice4#cb ,that a 8chemical messenger0 is at the basis of the duodenal acid reflex has been proved by even more crucial experiments--transfusion 7,wertheimer1#cc ,enriquez and ,hallion#cd71 cross circulation 7,fleig1#ce ,matuso#cf71 and perfusion of the isolated pancreas 7,huston#cg74 #ca ,pawlow3 ,the ,work of the ,digestive ,glands1 #aiab4 #cb ,bayliss and ,starling3 ,jour4 ,physiol4 #bh3cbe1 #aijb4 #cc ,wertheimer3 ,compt4 rend4 ,soc4 de biol4 #ed3dge1 #aijb4 #cd ,enriquez and ,hallion3 ,compt4 rend4 ,soc4 de biol4 #ee3bcc1 #cfc1 #aijc4 #ce ,fleig3 ,arch4 internat4 de ,physiol41 #aj3bjf1 #aiaj4 #cf ,matuso3 ,jour4 ,physiol4 #de3dgg1 #aiac4 #cg ,huston3 ,ann4 et bull4 ,soc4 roy4 de sc4 md4 et nat4 #gj3agh1 #aiab4 ,,properties ,,of ,,secretin ,prosecretin4--,secretin is soluble in water1 yet a watery extract of intestinal scrapings is without action1#cb even after being submitted to acid treatment4#ch ,starling therefore holds that secretin exists in the intestinal mucosa in an inactive form1 as 8prosecretin40 ,the content of the intestine in prosecretin decreases from the duodenum down1 so that one is unable to demonstrate any prosecretin in the last #b-a_/b feet of the ileum4 ,prosecretin is insoluble in water1 acetone1 absolute alcohol or ether4 ,secretin1 on the other hand1 is readily soluble in water1 normal salt solution and diluted alcohol 7#gj per cent471 but likewise insoluble in absolute alcohol and ether4 #ch ,starling3 ,lancet1 ,london #b3dcc1 #aije4 ,preparation4--,all of the more dissociated acids liberate secretin from intestinal mucosa on boiling4 ,their action is dependent on the degree of dissociation1#ci carbonic and boric acids being inactive4#dj ,secretin can also be prepared with strong soaps 7from #aj to #cj per cent4 sodium oleate71 alcohol 7#gj per cent41#da #j4f per cent4 sodium chlorid#cf74 ,the acid and soap in the duodenum produce secretion2 there is no necessary correspondence between the action of a substance in the intestine and that obtained by injection after boiling mucosa with it4 ,the sodium chlorid1 bile1 maltose and glucose produce some secretion by the latter method yet none by the former4#cf ,on the other hand1 ether1 chloral and oil of mustard excite secretion when in the intestine1 but no secretin can be prepared from boiled mucosa by their action4 ,the irritation of the lining cell has produced the necessary hydrolysis4#ch ,in well-controlled experiments1 ,wertheimer and ,le,page#db found that after the introduction of acid1 secretion is secreted into the lumen of the intestine4 ,matuso#cf confirmed their results1 and found this a satisfactory method for the preparation of secretin4 ,it is said that secretin can be obtained by merely boiling the mucosa with water1 but the results are inconstant4#dc #ci ,frouin and ,lalou3 ,compt4 rend4 ,soc4 de biol41 #ga3ahi1 #aiaa4 #dj ,camus3 ,compt4 rend4 ,soc4 de biol41 #aijb1 #ed3ddb1 #aijb4 #da ,fleig3 ,jour4 de physiol4 et de path4 gn4 #f3cb1 #ej1 #aijd4 #db ,wertheimer and ,le,page3 ,jour4 de physiol4 et de path4 gn4 #d3ajfa1 #ajgj1 #aijb4 #dc ,stepp3 ,jour4 ,physiol4 #dc3dda1 #aiab4 ,action4--,secretin is an excitant not only of the pancreatic juice but also of the liver and the intestinal mucosa4 ,the flow of bile is markedly accelerated 7,henri and ,portier1#dd ,enriquez and ,hallion#de71 likewise that of succus entericus 7,delezenne and ,frouin1#df ,bottazzi and ,gabrielli#dg71 and intestinal peristalsis is stimulated 7,enriquez and ,hallion1#dh ,falloise#di74 ,injections of secretin produce a marked vasodilatation1 but the secretory effect is independent of the blood pressure changes4 ,the pancreas is not readily fatigued by secretin4 ,bayliss and ,starling#ej have obtained undiminished flow after eight hours of continuous injection4 ,our experience confirms this result4 ,also1 equal doses of secretin give corresponding results at various intervals4 ,moreover1 anesthesia does not affect the flow4 ,secretin is unrecoverable from the glands even after two hours of continuous injection4#ea ,the juice obtained by secretin has been subject to many studies4#eb ,it is of high alkalinity 7about seventh normal71 contains all the pancreatic ferments1 and corresponds in all respects to the juice obtained in digestion from permanent pancreatic fistulas4#ec #dd ,henri and ,portier3 ,compt4 rend4 ,soc4 de biol4 #ed3fbj1 #aijb4 #de ,enriquez and ,hallion3 ,presse md4 #a3aje1 #aijc4 #df ,delezenne and ,frouin3 ,compt4 rend4 ,soc4 de biol4 #ef3cai1 #aijd4 #dg ,bottazzi and ,gabrielli3 ,arch4 internat4 de physiol4 #aaa3aef1 #aije4 #dh ,enriquez and ,hallion3 ,bull4 gn4 de thr4 #afb3bjb1 #aiaa4 #di ,falloise3 ,bull4 de l',acad4 roy4 de ,belgique #e3ide1 #aijb4 #ej ,bayliss and ,starling 7,note #b74 ,matuso 7,note #f74 ,arch4 internat4 de physiol4 #aj3cce1 #aiaa4 #ea ,dixon and ,hamill3 ,jour4 ,physiol41 #aiji1 xxxv1 #cad4 #eb ,bayliss and ,starling3 ,jour4 ,physiol41 #aijd1 xxx1 #fa4 ,bierry3 ,compt4 rend4 ,soc4 de biol41 #aijg1 lxii1 #dcc4 ,bierry and ,terroine3 ,compt4 rend4 ,acad4 de sc41 #aije1 cxli1 #adf4 ,lalou3 ,comp4 rend4 ,acad4 de sc41 #aiaj1 xxix1 #hbd4 ,morel3 ,compt4 rend4 ,soc4 de biol41 #aiji1 lxvii1 #cf4 ,strassano and ,billoro3 ,compt4 rend4 ,soc4 de biol41 #aijb1 liv1 #icg4 #ec ,bayliss and ,starling 7,note #bc74 ,specificity4--,in a maceration of the duodenojejunal mucosa1 such as we have in secretin1 the known substances are proteoses and peptones1 acid amins1 bile salts1 beta-imidazolethylamin1 cholin1 gelatin and inorganic salts4 ,these substances1 individually and severally1 together with their derivatives1 are devoid of secretory action4 ,chemically1 secretin1 is then a specific entity4 ,but like epinephrin1 in its distribution1 it is nonspecific4 ,active preparations have been made from an extraordinary variety of animals among the different classes of vertebrates 7,camus1#ed ,bayliss and ,starling1#ee ,chapman#ef74 ,it is likewise found in the new-born and in the fetus4#eg ,its action1 however1 like its chemical composition1 is markedly specific4 ,it stimulates the flow of pancreatic juice1 bile and succus entericus4 ,its effect on the gastric glands is negative1 and on the saliva likewise4#eh ,on the other hand1 no other extracts produce pancreatic secretion4 ,dr4 ,koch1 who1 in collaboration with ,dr4 ,keeton and ,dr4 ,luckhardt1 has done the most recent work on gastrin#ei 7a substance that most nearly resembles secretin7 and has isolated an extremely active preparation1 finds that gastrin injection has likewise no effect on the pancreas4 ,camus and ,gley1#fj with crude preparations1 had previously obtained a similar result4 #ed ,camus3 ,jour4 de physiol4 et de path4 gn4 #d3iih1 #aijb4 #ee ,bayliss and ,starling3 ,jour4 ,physiol4 #bi3agd1 #aijc4 #ef ,chapman3 ,proc4 ,linnaean ,soc41 ,new ,south ,wales #a3ib1 #aije4 #eg ,camus3 ,compt4 rend4 ,soc4 de biol4 #fa3ei1 #aijf4 ,hallion and ,lequex3 ,compt4 rend4 ,soc4 de biol4 #fa3cc1 #aijf4 #eh ,derouaux3 ,arch4 internat4 de physiol4 #c3dd1 #aije4 ,lambert and ,myer3 ,compt4 rend4 ,soc4 de biol4 #ed3ajdd1 #aijb4 ,starling3 ,lancet1 ,london #b3eja1 #aije4 #ei ,keeton and ,koch3 ,am4 ,jour4 ,physiol4 #cg3dha1 #aiae4 #fj ,camus and ,gley3 ,compt4 rend4 ,soc4 de biol4 #ed3fdh1 #aijb4 ,lability4--,neutral secretin is but feebly attacked by a temperature of #ajj ,c4 ,if heated in an autoclave 7so as to prevent oxidation71 this temperature can be continued for thirty minutes without any change in its activity4 ,increasing the temperature increases the speed of destruction1 so that at #adj ,c4 the destructive action is marked4#fa ,autoclaving at #ae pounds for fifteen minutes1 as an ordinary sterilization of culture mediums1 produces1 we found1 a distinct though not serious decrease in activity4 ,secretin acidified to fifth-normal with hydrochloric acid loses #fj per cent4 of its activity on fifteen minutes boiling4 ,secretin1 alkalinized to fifth-normal with sodium hydroxid loses #ie per cent4 of its activity in five minutes' boiling2 decreases to a trace in thirty minutes1 and disappears entirely in sixty minutes4 ,at room temperature1 with fifth-normal alkalinity1 #hj per cent4 of secretin is destroyed in eight hours4#fa ,the destruction probably means a secondary cleavage of the secretin molecule itself4 #fa ,lalou 7,note #ba74 ,may3 ,jour4 ,physiol4 #cj3djj1 #aijd4 ,secretin is oxidized readily4 ,if left standing uncovered for a summer's day1 the preparation will be inactive4#ea ,even if kept in the ice-chest 7no other precaution being taken71 its activity is lost in a very few days4 ,sunlight undoubtedly hastens the oxidative process4 ,if care is taken as to sterility1 however1 and the secretin is kept in the ice-chest1 well stoppered and in a dark flask1 it will retain its activity for several weeks4 ,dixon and ,hamill#ea claimed that secretin disappears quantitatively on passage through a ,berkefeld filter at #e mm4 pressure4 ,lalou1#fb using higher pressure1 was unable to confirm the finding1 but obtained a marked decrease in activity4 ,our results are in accord with those of ,lalou4 #fb ,launoy3 ,arch4 internat4 de ,physiol4 #c3fb1 #aijf4 ,morel and ,terroine3 ,compt4 rend4 ,soc4 de biol4 #fg3cf1 #aiji4 ,zunz3 ,arch4 internat4 de physiol4 #h3aha1 #aiji4 ,lalou3 ,jour4 de physiol4 #ad3dfe1 #aiab4 ,analogy to ,epinephrin4--,the analogy of secretin to epinephrin does not generally receive enough emphasis4 ,both substances are nonspecific in distribution1 but specific chemically1 and especially physiologically1 epinephrin acting on the myoneural junctions1 secretin on intestinal digestion4 ,they are both relatively simple substances of low molecular weight1 and subject to rapid oxidation whereby their properties disappear4 ,the action in both cases is very transient4 ,they are the two examples of what ,starling calls the 8acute hormones10 in which it is essential that reaction take place immediately1 and shall disappear as soon as the exciting cause is removed4#fc #fc ,starling3 ,proc4 ,roy4 ,soc4 ,med41 #h1 ,no4 #d1 #aiad1 ,therap4 and ,pharm4 ,section1 p4 #bi4 ,,clinical ,,use ,,of ,,secretin ,diabetes ,mellitus4--,moore1 ,edie and ,abram#fd were the first to suggest a therapeutic value for secretin1 having obtained favorable results with secretin administration in diabetes4 ,they argued that the internal secretion of the pancreas may be stimulated by secretin1 and that some cases of diabetes may be due to lack of this necessary excitant4 ,owing to the importance of the question1 their announcement was followed quickly by numerous investigations by other observers4 ,previously1 ,spriggs1 at the suggestion of ,starling1 had tried intravenous injections of secretin free from depressor substance in a diabetic patient1 and had obtained negative results4 ,moore1 ,edie and ,abram gave their secretin by mouth over long periods4 ,of the five cases cited in their first paper1 two were negative4 ,the third was that of a man1 aged #be1 who received daily #cj c4c4 of secretin4 ,after a latent period of three weeks1 the sugar suddenly fell1 and after four months the urine was sugar-free4 ,six months later a relapse occurred with the development of phthisis and death4 ,the other two patients were a boy1 aged #g1 and a girl1 aged #i1 whose urine in from three to five weeks became sugar free during the secretin treatment in spite of severe diabetes4 ,one of these patients later relapsed4#fe ,bainbridge and ,beddard#ff gave secretin a thorough trial in three cases with negative results1 and are disposed to attribute the results of ,moore to dieting4 ,dakin and ,ransom#fg cited one case1 secretin being given for twelve weeks1 with negative results2 ,foster1#fe nine cases1 all negative2 ,charles1#fh three cases1 all negative4 ,crofton1#fi however1 gave secretin a trial in one case with favorable results4 ,moore1 ,edie and ,abram1 in a later paper1#gj report a large number of cases tried with the majority of results negative1 though in some cases an improvement in the digestion1 and in certain cases an increase of weight was noted4 #fd ,moore1 ,edie and ,abram3 ,biochem4 ,jour41 #a3bh1 #aijf4 #fe ,foster3 ,jour4 ,biol4 ,chem41 #b3big1 #aijf4 #ff ,bainbridge and ,beddard3 ,biochem4 ,jour41 #a3dbi1 #aijf4 #fg ,dakin and ,ransom3 ,jour4 ,biol4 ,chem41 #b3cje1 #aijf4 #fh ,charles3 ,med4 ,press and ,cir41 #acc3egh1 #aijf4 #fi ,crofton3 ,lancet1 ,london1 #agf3fjg1 #aiji4 #gj ,moore1 ,edie and ,abram3 ,biochem ,jour41 #c3hb1 #aijh4 ,one method of testing the basis of ,moore's theory would be by examining the prosecretin content of the intestine in diabetics4 ,bainbridge and ,beddard found1 in the paper referred to1#ff that from five of the six cases of diabetics examined postmortem1 little or no secretin could be prepared2 but in a subsequent report of seven cases1#ga they found only one in which the secretin obtained was scanty4 ,the failure to obtain secretin in some cases they claim is probably due to the rapid postmortem degeneration of diabetic tissue4 ,evans1#gb in ,starling's laboratory1 found that in dogs made recently diabetic by total pancreatectomy1 but little secretin could be obtained4 ,hedon and ,lisbonne1#gc and ,pemberton and ,sweet#gd report1 on the contrary1 that the duodenum of diabetic dogs is rich in prosecretin4 ,bainbridge and ,beddard1#ga working on a diabetic cat1 likewise found prosecretin to be present in normal quantity4 #ga ,bainbridge and ,beddard3 ,biochem4 ,jour4 #c3hb1 #aijh4 #gb ,evan3 ,jour4 ,physiol4 #dd3dfa1 #aiab4 #gc ,hedon3 ,compt4 rend4 ,soc4 de biol4 #gd3cge1 #aiac4 #gd ,pemberton1 ,ralph1 and ,sweet1 ,j4 ,e43 ,further ,studies on the ,influence of the ,ductless ,glands on the ,pancreas1 ,arch4 ,int4 ,med41 ,may1 #aiaj1 p4 #dff4 ,digestive ,disturbances4--,secretin for digestive disturbance was first used in the 8acid duodenal medication0 of ,enriquez4#ge ,this consisted in the giving of tartaric acid in thick keratin capsules1 the acid not being liberated until the duodenum was reached1 where it provoked the formation of secretin4 8,the secretin mechanism10 he says1 8is probably capable of pathologic disturbance as would result1 for example1 with diminished acidity of chyme1 disturbance of the normal motility of the stomach or pylorus1 or diminished prosecretin in the mucosa4 ,such a condition would produce disturbance of the pancreatic1 biliary and intestinal secretions1 and interfere with intestinal movements1 with a clinical syndrome of intestinal dyspepsia as a result1 among the chief and most constant symptoms of which would be constipation40 8,the acid duodenal medication0 was submitted to wide clinical use1 and very favorable results in certain obstinate cases of constipation were reported4 ,in regard to 8diminished prosecretin in the mucosa10 ,wentworth#gf has claimed that in infantile atrophy such is the condition1 but ,sweet and ,pemberton#gg have found that the difficulty of preparing secretin from human duodenums is such as to render ,wentworth's findings inconclusive4 #ge ,enriquez3 ,bull4 du ,lab4 de biol4 ,appliq4 #b1 ,no4 #b-,no4 #h1 #aijd4 #gf ,wentworth1 ,a4 ,h43 ,the ,cause of ,infantile ,atrophy1 ,j4 ,a4 ,m4 ,a41 ,july #bj1 #aijg1 p4 #bjd4 #gg ,sweet1 ,j4 ,e41 and ,pemberton1 ,ralph3 ,experimental ,observations on ,secretin1 ,arch4 ,int4 ,med41 ,february1 #aijh1 p4 #bca4 ,beveridge#gh suggests the use of secretin in 7a7 pyloric stenosis1 7b7 pancreatic insufficiency1 7c7 hepatic stimulation and cirrhosis of the liver 7d7 to stimulate peristalsis in colonic stasis1 7e7 in gastro-enterostomy and short-circuiting of the intestines4 ,he claims to have used it in over a hundred cases with 8brilliant results10 and cites four typical histories4 ,the ,g4 ,w4 ,carnrick ,company1 which manufactures 8,secretogen10 an alleged secretin preparation1 cites a number of authorities#gi as also recommending secretin for digestive disorders4 ,harrower1 who is or was connected with the ,carnrick ,company1 in clinical journals#hj has ardently advocated the use of secretin for a large number of maladies4 #gh ,beveridge3 ,am4 ,med4 #bj3bee1 #aiad4 #gi ,lockwood1 ,g4 ,r43 ,diseases of ,stomach1 #aiac1 ,chapter on ,achylia4 ,bassler1 ,anthony3 ,am4 ,jour4 ,gastro-,enter41 #aiad2 ,kemp1 ,r4 ,c43 ,diseases of ,stomach1 ,intestine and ,pancreas1 #aiab4 ,reed1 ,boardman3 ,am4 ,jour4 ,gastro-,enter41 ,october1 #aiab4 ,ewald 7,therapie der ,gegenwart1 #aiae1 p4 #e7 reports favorable results with ,secretogen in one of thirteen cases4 #hj ,harrower3 ,pediatrics #be3dcj1 #aiac2 ,new ,york ,m4 ,j4 #aah3cae1 #aiac2 ,arch4 f4 ,verdauungskr4 #bj3egg1 #aiad4 ,,physiologic ,,considerations ,throughout its clinical use1 secretin has been given by mouth2 but its direct introduction into the intestine of a dog under anesthesia in even enormous quantities is without effect4 ,this fact1 first observed by ,bayliss and ,starling1#cb was confirmed by ,fleig1#ha and ,matuso1#cf and our personal experiments have convinced us of its truth4 ,matuso found that ordinary secretin and that obtained from intestinal lumen gave equally negative results4 ,large quantities of active secretin1 moreover1 acidified to #j4b per cent4 hydrochloric acid1 and left in the ileum for fifteen minutes1 were still negative4 ,wertheimer and ,duvillier1#hb in a previous paper on this subject1 had likewise found that acid solutions of secretin 7which might be considered more normal for the intestine than when neutral71 when introduced into the ileum gave negative or inconstant results4 ,they conclude that it is more likely that the pancreas does not respond to such minimal stimuli1 than that the secretin is not absorbed4 #ha ,flieg3 ,arch4 gn4 de md4 #aia3adhb1 #aijc4 #hb ,wertheimer and ,duvillier3 ,compt4 rend4 ,soc4 de biol4 #fh3ece1 #aiaj4 ,the destructive action of the digestive enzymes leads us to believe that it is in inactive form that secretin is absorbed4 ,like epinephrin1 it cannot pass through the digestive tract4 ,bayliss and ,starling state that it is destroyed by one hour's tryptic digestion4 ,lalou#fb worked with the action on secretin of pepsin1 dog's gastric juice1 pancreatic juice1 succus entericus and erepsin1 and found in each case a destructive effect1 even almost after mixing2 and after five minutes over #ge per cent4 of the activity had disappeared4 ,matuso#cf introduced #cj c4c4 of active secretin into the intestine1 removed it five minutes later1 and found that no activity remained4 ,other methods of administration have been tried4 ,subcutaneous injections are practically negative 7,matuso1#cf ,hallion#hc7 and intrapleural injections are likewise negligible 7,bayliss and ,starling#ee74 #hc ,hallion3 ,presse md4 #bj3dcc1 #aiab4 ,starling#fc finds that continued intravenous injections of secretin in a healthy dog produces after a time severe symptoms of collapse1 which1 he believes1 are due to change in the intestinal mucous membrane caused by the entry and non-neutralization of the strongly alkaline pancreatic juice4 ,intestinal digestion seems little affected in achylia gastrica 7,stockton1#hd ,ehrman and ,lederer1#he ,bayliss and ,starling#cb74 ,this may be due to other secretin stimulants as fats1 or to the action of the nervous mechanisms 7,meltzer#hf74 #hd ,stockton3 ,in ,osier and ,mc,crae's ,modern ,medicine #c3ai1 #aiad4 #he ,ehrman and ,lederer3 ,deutsch4 med4 ,wchnschr4 #ce3hgi1 #aiji4 #hf ,meltzer1 ,s4 ,j43 ,the ,factors of ,safety in ,animal ,structure and ,animal ,economy1 ,j4 ,a4 ,m4 ,a41 ,feb4 #bc1 #aijg1 p4 #fee4 ,,the ,,destruction ,,of ,,secretin ,,by ,,human ,,gastric ,,juice ,we have carried out in detail experiments on the digestive effect of human gastric juice on secretin4 ,our results in every respect confirm the findings of ,lalou1#fb who worked with commercial pepsin and dog's gastric juice1 but are even more striking because of the much superior quality of pure human gastric juice4 ,methods4--,the human gastric juice was obtained from ,mr4 ,v41 the gastric fistula case of our laboratory4 ,the chemical and digestive characters of his juice are discussed in a recent paper4#hg ,in the different experiments1 different samples of gastric juice were used4 ,the secretin employed was always freshly prepared4 ,digestion was carried out in the incubator at #ch ,c4 with the reaction of #j4d per cent4 acid1 and the end of the period was marked by either boiling the mixture or 7in the first two experiments7 by turning the mixture alkaline4 ,the action of the preparation1 we proved1 was not influenced by the method used4 ,the dogs on which the preparations were tested were prepared for carotid blood pressure1 injection into the external jugular vein1 and cannula in the pancreatic duct1 essentially the methods of ,bayliss and ,starling#cb being employed4 ,the preparations were injected at body temperature after being neutralized and filtered4 ,except for the addition of normal salt solution instead of gastric juice1 the control injections of secretin were submitted to exactly the same treatment as the other preparations4 #hg ,carlson3 ,am4 ,jour4 ,physiol4 #ch3bdh1 #aiae4 ,results4--,our results are embodied in ,table #a4 ,we assured ourselves before beginning the series that incubation of secretin with boiled gastric juice produced no change4 ,it is to be noted in the table that each experiment is a unit complete in itself1 beginning and ending with a control injection of secretin4 ,special attention is called to the marked destruction that follows contact of human gastric juice with secretin for merely one minute4 ,in ,experiment #d1 using #a c4c4 of human gastric juice1 the action fell to #ad drops from an original secretion of #ba2 in ,experiment #e1 using #h c4c4 of gastric juice1 the action fell to #f drops from an original secretion of #bj4 ,of interest also is the rate at which we get complete destruction of secretin4 ,this is practically #b hours for #b c4c4 with secretin giving originally #aaj drops 7,experiment #b1 ,fig4 #a71 or #cj minutes for #e c4c4 with a secretin giving originally #ec drops 7,experiment #f74 ,these results are practically parallel1 though they were obtained with different samples of gastric juice and in different experiments4 ,,table #a4--,,the ,,destruction ,,of ,,secretin ,,by ,,human ,,gastric ,,juice ,secretion of ,pancreatic ,juice in ,drops ---------------------------------------- -------------- ,no4 ,quan-#aj ,c4c4c ,the ,secretin ,after ,incubation #aj ,c4c4 of tity,secretin with ,human ,gastric ,juice ,secretin ,exper-of ,control ---------------------------------,contro l iment,gas- --,begin- --,end of tric ning ,dig4 ,secre-,dig4 ,secre-,dig4 ,secre-,experi- ,juice,experi- ,time1 tion ,time1 tion ,time1 tion ment ,used1 ment ,hrs4 ,rate ,hrs4 ,rate ,hrs4 ,rate ,c4c4 ---------------------------------------- -------------------- #a #b #bh #f #j #d #j #b #j #af #b #b #aaj #b #g #a-a_/b #ah #a #ah #da #c #b #dj #a #g #c_/d #g #a_/d #h #ca #d #a #ba #a_/b #aa #a_/d #ab #a_/fj #ad #ah #e #h #bj #a_/b #a #a_/d #c #a_/fj #f #ah #f #e #ec #a_/b #b 44 44 44 44 44 ---------------------------------------- -------------------- ,we also tried the effect of keeping the digestive time constant and varying the amount of gastric juice employed4 ,increasing the quantity of gastric juice used increases the quantity of secretin destroyed 7,table #b74 ,,table #b4--;,,experiment #g99 ,pancreatic ,preparation ,juice ,drops #aj c4c4 secretin #bj #aj c4c4 secretin digested with #j4e c4c4 gastric juice #ae #aj c4c4 secretin digested with #c c4c4 gastric juice #ac #aj c4c4 secretin digested with #aj c4c4 gastric juice #h 99 ,the digestive time was kept constant at fifteen minutes4 7,the gastric juice used had been diluted with stomach washings47 ,the reader will observe in ,table #a that the results obtained from the control injection of secretin at the beginning of the experiment is uniformly greater than that obtained after several injections of digested secretin4 ,in view of the established fact that equal quantities of secretin can generally be relied on to produce results1#ba one might suggest that the injections of the split products of secretin have inhibited to some degree the action of the pancreas4 ,we can submit the data in ,table #c in support of this view1 showing among other things that the action of secretin is not influenced by previous injections of inert depressor substances1 though it by the injection of the cleavage products of secretin4 7,the various injections in the experiments were made at about fifteen-minute intervals74 ,we have carefully analyzed the reaction in blood pressure that follows the injection of the various preparations4 ,we find no constant effect4 ,digested secretin gives a fall in blood pressure that is at times less1 at times equal1 and at other times greater 7,fig4 #a7 than that produced by the original preparation4 ,besides the bearing that it has on the therapeutic use of secretin1 this destructive action of the digestive enzymes is also of prime physiologic interest4 ,failure to realize it has led to misconceptions as to the intrinsic nature of secretin4 ,,table #c4--;,,experiments #h ,,and #i ,pancreatic ,preparations ,juice ,drops ,experiment #h3 #aj c4c4 secretin1 five injections of inert depressor substances #bi #aj c4c4 secretin1 two injections of completely digested secretin #bh #aj c4c4 secretin1 eight injections of inert depressor substances #af #aj c4c4 secretin #af ,experiment #i3 #aj c4c4 secretin 7control1 beginning of experiment7 #ba #aj c4c4 secretin1 after thirty minutes incubation with #a c4c4 boiled gastric juice #bg #aj c4c4 secretin1 after thirty minutes incubation with #a c4c4 fresh gastric juice #aa #aj c4c4 secretin 7control1 end of experiment7 #ah ,the findings of ,lalou1 confirmed by us1 explain the anomaly that has led ,delezenne#hh to put forward the antisecretin theory4 #hh ,delezenne and ,pozerski3 ,jour4 de ,physiol41 #ad3edj1 #aiab4 ,,secretin ,,has ,,no ,,action ,,when ,,given ,,by ,,mouth ,it is a constant claim that so many and complex are the factors concerned in physiologic processes1 that it is not unusual for clinical deductions to establish themselves in the face of a priori laboratory dicta4 ,we considered it desirable1 therefore1 to test the action of secretin1 orally administered1 in the most direct manner1 and the one freest from possible criticism4 ,with this in view1 we performed a series of experiments on normal unanesthetized dogs having permanent pancreatic fistulas4 ,method4--,in the operations for permanent pancreatic fistulas we followed closely the technic developed by ,pawlow1#hi and with excellent results4 ,the dogs maintain themselves in splendid condition if proper care is taken4 ,this consists in feeding them only with bread and milk1 and giving sodium bicarbonate daily4 ,the dogs were given this treatment in the evening so that experimental procedure might be carried on in the day with empty stomach under constant conditions4 ,freshly prepared secretin in large quantities was given by stomach tube to these dogs1 and the response of the pancreas studied and compared with the response obtained from control preparations4 ,the same preparation was generally not given on consecutive days4 #hi ,pawlow3 ,ergeb4 de ,physiol41 ,o41 p4 #bff1 #aijb4 ,,table #d4--;,,detail ,,of ,,typical ,,experiments ,dogs with pancreatic fistulas1 showing that secretin given by mouth has no action on the pancreas ,rate of ,secretion of ,pancreatic ,juice in ,c4c4 per ,hr4 ------------------------------------ ,continuous ,continuous ,secretion ,secretion ,material ,fed by ,stomach ,tube ,before ,feeding ,after ,feeding -------------------------------- ,first,second,third,first,second,third ,hour ,hour ,hour ,hour ,hour ,hour ---------------------------------------- --------------------- #aej c4c4 active secretin1 slightly acid #f4e #c4f #c4i #bj4j #f4j #h4j #aej c4c4 active secretin1 slightly alkaline #ac4j #aa4j #e4j #bc4j #bf4j #ab4j #aej c4c4 secretin passed through ,berkefeld #g4h #g4e #g4d #bc4j #ac4j #aa4j #aej c4c4 extract of colon #aa4f #ab4j #aa4d #cj4j #ai4f #ad4h #aej c4c4 extract of gastric mucosa #aj4j #g4j #h4j #bc4j #g4e #d4j #aej c4c4 extract of muscle #f4i #aa4j #f4d #ce4j #e4j #g4j #aej c4c4 #j4d ,h,cl 7diluted to #bej c4c47 #f4j #h4j #d4j #cc4j #cf4j #ag4j ---------------------------------------- --------------------- ,results4--,we have data from six dogs with a total of seventy-six experiments4 ,as shown in ,table #d1 the administration of secretin causes an increase in the flow of pancreatic juice1 but the administration of inert substances as extracts of colon1 gastric mucosa or muscle causes a like increase4 ,the activity of the secretin may be reduced to a low value by exposure to sunlight1 or filtering through a ,berkefeld filter1 yet the response of the pancreas is not correspondingly reduced4 ,the secretion that occurs in the control cases1 every one will admit1 is but secondary to the production of gastric juice with its accompanying hydrochloric acid1 that is1 excited by virtue of the extractives and water in the preparations4 ,such1 we can prove1 is the only action of secretin4 ,a mixture of gelatin1 peptone and salt water1 the chief incidental constituents of a secretin preparation1 gives as striking results as ever obtained from secretin administration4 ,yet the objection may be made that the response of the pancreas that is due to the incidental constituents of secretin is maximal1 and that the secretin consequently has no opportunity to display its particular potency4 ,but1 as inspection of the accompanying tables illustrate1 the administration of hydrochloric acid shows that the response is by no means maximal4 ,let us cite a striking experiment4 ,for three hours before the administration of hydrochloric acid1 the secretion in cubic centimeters was respectively #bi4d1 #aa4ge and #ce4d c4c42 for the three hours after1 respectively #hh4j1 #di4j and #dj4e c4c4 ,illustration3 ,fig4 #a4--,tracings 7reduced two-thirds7 showing failure of ,secretogen1 ,elixir ,secretogen1 and ,duodenin to stimulate the flow of pancreatic juice even when administered intravenously in amounts three times greater than that recommended to be given by mouth4 ,dog3 light ether anesthesia2 cannula in the pancreatic duct2 a1 carotid blood pressure2 b1 flow of pancreatic juice in drops2 c1 signal showing where the intravenous injections were made4 ,tracing ,a3 ,reading from left to right1 the five intravenous injections are3 7#a7 three tablets of ,secretogen digested with #ae c4c4 #j4d per cent4 hydrochloric acid and neutralized2 7#b7 three tablets of ,secretogen boiled in #ae c4c4 #j4d per cent4 hydrochloric acid and neutralized2 7#c7 three tablets of ,secretogen in #ae c4c4 #j4i per cent4 sodium chlorid2 7#d7 three tablets of ,secretogen in #ae c4c4 of #gj per cent4 alcohol2 7#e7 #ae c4c4 ,elixir ,secretogen4 ,tracing ,b3 reading from left to right1 the four intravenous injections are3 7#a7 #e c4c4 secretin made fresh from dog's duodenal mucosa2 7#b7 three tablets of ,duodenin digested in #ae c4c4 #j4d per cent4 hydrochloric acid and neutralized2 7#c7 three tablets of ,duodenin boiled in #ae c4c4 #j4d per cent4 hydrochloric acid and neutralized2 7#d7 three tablets of ,duodenin in #ae c4c4 sodium chlorid 7#j4i per cent474 ,,table #e4--,,summary ,,of ,,experiments ,dogs with pancreatic fistula1 weight #ad kg4 ,secretin given by mouth ,rate of ,secretion of ,pancreatic ,juice in ,no4 of ,c4c4 ,per ,hour ,increase ,experi- ,material ,fed ---------------- in ment ,three ,three ,c4c4 ,hours ,hours ,before ,after ,feeding ,feeding ---------------------------------------- ------------------------ #c ,secretin slightly acid #e #aa #f #e ,secretin slightly alkaline #bd #cj #f #d ,secretin passed through ,berkefeld #ah #bc #e #a ,secretin exposed to sun for #d hrs #af #bi #ac #b ,extract of colon 7rabbit7 #ai #bi #aj #c ,extract of gastric mucosa #ad #bc #i #c ,extract of muscle #h #af #h #b ,mixture of gelatin1 peptone and #bc #cc #aj salt #a #a per cent4 peptone solution #f #h #b #d #j4b per cent4 hydrochloric acid #ac #cg #bd #c ,milk and bread #g #bj #ac ---------------------------------------- ------------------------ ,it is possible by large doses of sodium bicarbonate given shortly before the administration of a preparation so to depress the stomach that it does not respond with the usual production of hydrochloric acid4 ,under these conditions the administration of secretin is uniformly negative1 but the administration of hydrochloric acid on the contrary still serves to increase the pancreatic secretion 7,table #f74 ,,table #f4--,,secretin ,,in ,,experimental 8,,achylia ,,gastrica0 ,rate of ,secretion of ,pancreatic ,juice in ,c4c4 ,per ,hour --------------------------------------- ,exp4 ,material ,fed ,continuous ,secretion ,secretion ,after ,no4 ,before ,feeding99 ,feeding ----------------------------------- ,first ,second,third ,first ,second,third ---------------------------------------- ----------------------- #a #h4g #g4e #f4h #c4j #a4j #d4h #b #aej c4c4 secretin #d4e #f4e #aj4j #f4j #g4e #g4f #c #ae4f #h4a #af4j #c4i #d4i #b4i #a #aej c4c4 #d ,h,cl #i4h #g4j #f4j #fe4a #bh4j #g4a #b 7diluted to #bej c4c47 #ag4d #ah4e #ag4j #cd4j #ah4j #bj4j ---------------------------------------- ----------------------- 99 ,five gm4 ,na ,,hco given at beginning of each first two hours4 ,,commercial ,,preparations ,,of ,,secretin ,secretogen and ,elixir ,secretogen4--,the ,carnrick ,company offers ,secretogen#ij for use in a large number of conditions4 ,the following indications for the use of the preparation purport to be based on clinical tests covering a period of several years3 dyspepsia1 and the indigestions generally1 fermentative disorders1 gastric catarrh1 flatulence1 nausea2 pancreatic insufficiency1 intestinal indigestion2 gastric secretory deficiencies1 apepsia2 constipation and hepatic torpor2 intestinal stasis2 diarrhea2 infantile diarrhea1 8summer complaint10 marasmus1 inanition and malnutrition2 gastric atony and dilatation2 cholecystitis and gallstones2 nephritis1 neurasthenia1 cachexia and cancer2 epilepsy and high blood pressure4 ,testimonials are presented as to results in most of these conditions4 #ij ,secretogen1 ,report of the ,council on ,pharmacy and ,chemistry1 ,j4 ,a4 ,m4 ,a41 ,may #a1 p4 #aeah1 #aiae4 ,a quantity of 8,secretogen0 and 8,elixir ,secretogen0 was bought in the open market1 and the preparations were tested on suitably prepared dogs4 ,the tablets were ground1 thoroughly macerated with the solvent used 7water1 normal salt solution1 alcohol1 or #j4d per cent4 hydrochloric acid71 and filtered4 ,if hydrochloric acid was used1 the pulverized tablets were boiled with it1 in the manner that secretin is made from duodenal mucosa1 and the preparations neutralized previous to injection4 ,the injections were made in from #ae to #bj c4c4 of the solvent4 ,all the operations were carried on immediately before the experiment1 and as rapidly as possible1 so as to avoid oxidation4 ,the ,elixir ,secretogen was injected directly1 without dilution4 ,,table #g4--,,summary ,,of ,,typical ,,experiments ,,showing ,,the ,,absence ,,of ,,secretin ,,in 8,,secretogen0 ,,and 8,,elixir ,,secretogen0 ,,except ,,in ,,occasional ,,tests ,,when ,,administered ,,in ,,enormous ,,doses ,dogs under ether anesthesia ,secretion of ,pancreatic ,juice in ,drops1 ,quantity of ,following ,intravenous ,injection ,exp4 ,secretogen ---------------------------------------- --------- ,no4 and ,elixir ,secretogen in ,secretogen ,control ------------------------ ,control ,used99 #aj ,c4c4 ,distilled#j4d #gj #j4i;,elixir#aj ,c4c4 ,secretin ,water ,h,cl ,alcohol,na,cl ,secretin ---------------------------------------- ----------------------- #a ,secretogen1 #a tablet2 #aji #j #j #j #j #j #ei ,elixir1 #ae c4c4 #a ,secretogen1 #f tablets 444 44 #j 44 44 44 44 #b ,secretogen1 #c tablets2 #af #j #j #j #j #a787 #af ,elixir1 #ae c4c4 #c ,secretogen1 #e tablets 444 44 #a787 44 44 44 44 #d ,secretogen1 #be tablets #ad 44 #a787 44 44 44 #h #e ,secretogen1 #ajj tablets #aaj 44 44 44 #ba 44 #fg #f ,secretogen1 #ajj tablets2 #ai 44 #e 44 #a #b787 #h ,elixir1 #abe c4c4 #g ,elixir1 #ej c4c4 444 44 44 44 44 #a787 44 ---------------------------------------- ----------------------- 99 ,one to three tablets is 7according to the label7 the therapeutic dose of ,secretogen2 #d to #ab c4c4 the dose of ,elixir ,secretogen4 ,results4--,in only one case was a slight response obtained1 the others gave none4 ,small and large doses were equally inert 7,table #g1 ,figs4 #b1 #c74 ,the preparations1 though inert1 always produced a depression in blood pressure1 sometimes even greater than that caused by active secretin4 ,among our many tests1 one bottle was found1 however1 to be a little different from the rest 7,experiment #d74 ,its entire content1 #ajj tablets1 had been ground and boiled in #j4i per cent4 sodium chlorid4 ,the extract on injection was found to have a small but unmistakable secretin reaction1 equivalent to about #b c4c4 of the control secretin used4 ,but repeated experiments were unable to duplicate this result4 ,the 8,secretogen0 and 8,elixir ,secretogen0 were all supposedly fresh preparations1 the retail drug store informing us that a fresh supply was obtained from the wholesale house each week4 ,secretogen1 then1 contains practically no secretin1 and even if it did contain secretin1 it can have no effect on the pancreas when taken by mouth4 ,the indications for ,secretogen1 therefore1 are based on false premises1 and the testimonials are worthless4 ,illustration3 ,fig4 #b4--,tracings 7reduced one-half7 showing no stimulation of the pancreas by ,secretogen1 ,elixir ,secretogen1 and ,duodenin1 even when administered intravenously in quantities one hundred times greater than the therapeutic dose by mouth4 ,dog3 ,light ether anesthesia2 cannula in the pancreatic duct2 a1 carotid blood pressure2 b1 flow of pancreatic juice in drops4 ,tracing ,a3 at x1 intravenous injection of #aj c4c4 secretin prepared from duodenal mucosa of dog4 ,tracing ,b3 at x1 intravenous injection of #ajj tablets of ,secretogen digested with #j4d hydrochloric acid and neutralized4 ,tracing ,c3 at x1 intravenous injection of #ajj tablets of ,secretogen1 prepared as in ,tracing ,b4 ,tracing ,d3 at x1 intravenous injection of #ej c4c4 ,elixir ,secretogen4 ,tracing ,e3 at x1 intravenous injection of #ajj tablets of ,duodenin 7dissolved in #j4i per cent4 sodium chlorid74 ,duodenin4--,this is a preparation manufactured by ,armour ,company1 which purports to be 8secretin plus enterokinase40 ,the claims for this product are similar to those for ,secretogen1 but somewhat less sweeping4 ,according to the manufacturers1 8,duodenin 7,armour7 is recommended in the treatment of intestinal disorders where an increased flow of pancreatic1 hepatic and intestinal secretion is desired4 ,it is of specific value in proteid digestion on the theory that secretin and enterokinase stimulate the pancreas and activate its secretion40 ,illustration3 ,fig4 #c4--,tracings 7reduced one-half7 showing practically complete destruction of secretin by the gastric juice4 ,dog under light ether anesthesia2 cannula in the pancreatic duct2 a1 carotid blood pressure2 b1 record of flow of pancreatic juice in drops4 ,time1 twenty-five minutes4 ,tracing ,a3 intravenous injection of #aj c4c4 secretin 7prepared fresh from dog's duodenal mucosa7 at x4 ,tracing ,b3 intravenous injection 7at x7 of #aj c4c4 of the same secretin as in ,tracing ,a1 after being digested in normal human gastric juice at #cg ,c4 for two hours4 ,we bought a quantity of ,duodenin in the open market1 and carried out on this product the same series of experiments as that used in the case of ,secretogen4 ,the results were similarly negative 7,table #h74 ,,table #h4--,,summary ,,of ,,typical ,,experiments ,,showing ,,the ,,absence ,,of ,,secretin ,,in 8,,duodenin0 ,dogs under ether anesthesia ,secretion of ,pancreatic ,juice in ,drops1 ,following ,intravenous ,injection ,exp4 ,number ---------------------------------------- --------- ,no4 ,duodenin ,control ,duodenin in ,control ,tablets #aj ,c4c4---------------------------- #aj ,c4c4 ,used ,secretin,distilled #j4d #gj #j4i ,secretin ,water ,h,cl ,alcohol ,na,cl ---------------------------------------- ------------------ #a #c #bi #j #j #j #a787 #bh #a #f 444 44 #a787 44 44 44 #b #ah #af 44 #f 44 44 #af #c #e #ad 44 #j #j #j #h #c #be 444 44 #a787 44 44 44 #d #ajj #aaj 44 #j 44 44 #fg #e #aej #ai 44 #j 44 #j #h ---------------------------------------- ------------------ ,in regard to both ,secretogen and ,duodenin1 we assume that the manufacturers have tried to put secretin in them1 but have been unable because they have failed1 in all likelihood1 to check their methods by physiologic standardization4 ,these firms do not give any details as to the procedure they employed in their manufacture of secretin4 ,desiccated secretin of extreme potency has been prepared by various physiologists1#ia #a mg4 7#a_/fd grain7 of which is active when given intravenously4 ,it is difficult to conceive that any of these methods were used in the preparation of ,secretogen or ,duodenin4 #ia ,stepp 7,note #ac74 ,dale and ,laidlow3 ,jour4 ,physiol4 #dd3aa1 #aiab4 ,launoy and ,ochslin3 ,comp4 rend4 ,soc4 de biol41 #gd3cch1 #aiac4 ,,conclusions #a4 ,secretin is quickly destroyed by gastric juice and by trypsin4 #b4 ,secretin is not absorbed in active form from the alimentary tract4 #c4 ,the presence of secretin or prosecretin cannot be demonstrated in the commercial preparations 8,secretogen10 8,elixir ,secretogen0 and 8,duodenin0 even when the therapeutic dose of the preparations is given intravenously4 ,in the case of 8,secretogen10 intravenous injection of #ajj times the therapeutic dose reveals occasionally an insignificant trace of secretin4 ,,discussion ,,of ,,results ,it is1 of course1 objectionable that preparations containing no secretin should be advertised to the medical profession as containing this substance4 ,the more important blunder1 however1 consists in the attempt to offer such preparations for oral administration1 because even chemically pure secretin would be equally ineffective when taken by mouth4 ,there is as yet no reliable evidence that lack of secretin is a primary or important factor in any disease4 ,even should this be established1 secretin therapy1 to be effective1 must be intravenous4 ,secretin has not yet been prepared in sufficiently pure state to render possible intravenous injection in man without injurious effects4 ,and even when this has been attained1 the very fleeting action of secretin will in all probability render secretin therapy as futile in all the diseases in which it is theoretically indicated as epinephrin therapy is in ,addison's disease4 ,but there remains the alleged favorable effect from secretin therapy by mouth in various diseases in man4 ,it is1 perhaps1 impertinent for laboratory men to comment on these clinical results4 ,the ordinary 8testimonials0 need not be considered1 but we should like to ask the serious worker who thinks he has actually obtained good results from secretin therapy how certain he is of the causal relation between the giving of secretin or alleged secretin and the abatement of the disease4 ,when a therapeutic measure not only lacks a positive basis in physiology and pathology but runs contrary to all the well-established experimental facts in these fundamental medical sciences1 is it too much to ask that positive clinical findings be subjected to more than usual critical analysis before acceptance8 8,clinical tests10 it is said1 8covering a period of several years have proved that neither the condition in the stomach during digestion nor those in the intestine prevent the secretin from entering intact into the circulation40 ,when we meet claims such as this1 should we not scrutinize the 8tests0 as well as the men who make them8 ,we are indebted to ,dr4 ,j4 ,h4 ,moorehead for assistance in part of the surgical work4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ae1 #aiaf47 ,,articles ,,refused ,,recognition ,report of the ,council on ,pharmacy and ,chemistry ,below appear abstracts of the ,council's action on articles refused recognition which were not deemed of sufficient importance to require lengthy reports3 ,radio-,rem ,the ,radium ,therapy ,company1 ,schieffelin ,co41 selling agents1 submitted to the ,council radium emanation generators called 8,radio-,rem ,outfits10 designed to generate respectively #bjj1 #a1jjj1 #b1jjj1 #e1jjj and #aj1jjj ,mache units per twenty-four hours4 ,those who are well informed on the subject of radium therapy are of the opinion that the administration of small amounts of radium emanation such as generated by certain outfits is without therapeutic value4 ,it has been stated that at the ,radium ,institute of ,london the minimum preliminary dose is #ahe microcuries 7#ejj1jjj ,mache units71 and as many as #eee microcuries 7#a1ejj1jjj ,mache units7 are employed4 ,in consideration of these facts the ,council voted not to accept any radium emanation generator which produces less than #b microcuries of emanation during twenty-four hours4 ,accordingly1 while accepting ,radio-,rem ,outfit ,no4 #e1 claimed to produce #aj1jjj ,mache units 7#c4g microcuries7 and ,radio-,rem ,outfit ,no4 #d1 claimed to produce #e1jjj ,mache units 7#a4h microcuries71 the ,council voted not to accept ,radio-,rem ,outfit ,no4 #c1 claimed to produce #b1jjj ,mache units 7#j4gd microcurie71 ,radio-,rem ,outfit ,no4 #b1 claimed to produce #a1jjj ,mache units 7#j4cg microcurie71 and ,radio-,rem ,outfit ,c1 claimed to produce #bjj ,mache units 7#j4jg microcurie74 ,this report having been submitted to ,schieffelin ,co4 and their reply considered1 the ,council authorized publication of the report4 ,see also ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #fca4 ,olio-,phlogosis ,olio-,phlogosis1 a liquid preparation to be applied externally by means of a cotton pad1 is advertised by the ,mystic ,chemical ,company1 ,kansas ,city1 ,mo41 thus3 8,doctor3 ,don't fail to use ,olio-,phlogosis liberally for ,pneumonia1 ,bronchitis and ,pleurisy4 ,it works quickly4 ,olio-,phlogosis is as far ahead of all medicated kaolin plasters as these plasters were ahead of the old-time moist and soggy poultices40 ,a pamphlet advises the use of ,olio-,phlogosis in 8444 all cases of ,inflammation and ,congestion1 such as ,pneumonia1 ,bronchitis1 ,pleurisy1 ,croup1 ,boils1 ,carbuncles1 ,rheumatism1 ,swollen ,glands1 ,peritonitis1 ,ovaritis1 as a ,surgical ,dressing1 ,mamitis ,mastitis 787 ,vaginitis and ,metritis 7on cotton tampon to deplete these parts71 ,septic ,wounds1 ,old ,ulcers1 ,chilblain1 ,eczema1 ,neuralgia1 ,inflammation of the ,eyes and ,ears1 ,alveolar ,inflammation1 ,burns1 ,scalds1 ,etc40 ,according to the information sent to the ,council by the ,mystic ,chemical ,company1 ,olio-,phlogosis has the following composition per gallon3 ,ol4 ,eucalyptus ,gaultheria drs4 #h ,ol4 ,abies ,canadensis drs4 #h ,ol4 ,abies ,canadensis drs4 #b ,ol4 ,thyme 7white7 drs4 #b ,resublimated ,iodin crystals grs4 #cb ,resorcin drs4 #a ,acid ,boracic ,c4 ,p4 drs4 #b ,quinine ,bisulphate drs4 #d ,sodium ,thiosulphate drs4 #c-a_/b ,glycerin ,c4 ,p4 q4 s4 ad gal4 #a ,a nonquantitative formula which appears on the label of a sample bottle sent to a physician enumerates the same ingredients except the sodium thiosulphate4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reports that no free iodin could be detected in the preparation4 ,apparently1 then1 ,olio-,phlogosis is essentially a skin irritant applied by means of cotton2 it can be expected to be just about as effective as the old-fashioned cotton pneumonia jacket1 used in conjunction with an aromatic skin irritant1 such as camphorated oil or wintergreen or menthol ointment4 ,the odor may have some psychic effect1 and it is possible that some of the oily matter may be absorbed by the skin4 ,that such small amounts1 even if absorbed1 can produce any considerable systemic effect1 however1 is highly improbable1 and the advice that this preparation be relied on in pneumonia1 pleurisy1 peritonitis1 etc41 is pernicious4 ,in the few cases of pneumonia in which heat is indicated1 the plain cotton pad will usually be found sufficient4 ,if the physician consider the addition of a skin irritant desirable1 it is easy to select one from the official preparations4 ,it will be far more rational to do so than to invoke the aid of a mystic name and a complex formula to which the patient and his family1 at least1 will be led to give unmerited credit4 ,the claims made for ,olio-,phlogosis are unwarranted2 its composition is complex and irrational1 and the nondescriptive but therapeutically suggestive name is likely to lead to uncritical use4 ,the ,council voted that the product be refused recognition for conflict with ,rules #f1 #h and #aj1 and that this report be published4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ai1 #aiaf47 ,,the ,,hypophosphite ,,fallacy ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,the introduction of hypophosphites into medicine was due to an erroneous and now discarded theory as to the cause of tuberculosis of which one ,dr4 ,j4 ,f4 ,churchill of ,london1 and later of ,paris1 was the promulgator and propagandist4#ib ,this theory was that the so-called 8tuberculosis diathesis0 was due to a deficiency of phosphorus in the blood4 ,believing that the hypophosphites1 while nontoxic1 were capable of further oxidation in the organism1 ,churchill recommended them as the best means of supplying the supposedly lacking phosphorus4 ,it is now known that tuberculosis is not due to a deficiency of phosphorus4 ,of more importance is the fact1 now known1 that little phosphorus1 if any1 is assimilated from the hypophosphites--far less than from phosphorus compounds of ordinary food4#ic ,there is no justification for giving hypophosphites for the sake of their phosphorus content4 ,for various reasons1 however--partly from force of habit and partly because of the power of advertising--many physicians still prescribe hypophosphite preparations1 and consequently1 they are still included in the ,pharmacopeia and in textbooks on materia medica and therapeutics4 ,they are put out in the form of 8specialties0 and of proprietary preparations1 and are lauded extravagantly by the manufacturers of the latter4 #ib ,churchill1 ,j4 ,f43 ,de la cause immdiate et du traitement spcifique de la phthisie pulmonaire et des maladies tuberculeuses1 ,paris1 #aheh4 #ic ,the ,hypophosphite ,fallacy1 ,j4 ,a4 ,m4 ,a41 ,april #be1 #aiad1 p4 #acdf4 ,although the overwhelming weight of evidence was against the probability that the hypophosphite preparations are of value as therapeutic agents1 the ,council thought it well to investigate the subject4 ,dr4 ,w4 ,mc,kim ,marriott of ,baltimore was therefore requested to review the evidence for and against the therapeutic usefulness of the hypophosphites and to conduct such experiments as seemed necessary4 ,his report has already appeared in ,the ,journal4#id #id ,marriott1 ,w4 ,mc,kim3 ,the ,therapeutic ,value of the ,hypophosphites1 ,j4 ,a4 ,m4 ,a41 ,feb4 #ab1 #aiaf1 p4 #dhf4 ,dr4 ,marriott found that nine observers 7,paquelin and ,joly1 ,vermeulen1 ,boddaert1 ,massol and ,gamel1 ,panzer1 ,delaini and ,berg71 who endeavored to test the alleged utilization of the hypophosphites in the organism1 reported that there is complete1 or practically complete1 elimination of hypophosphites in the urine1 with little or no effect on the body4 ,only one experimenter 7,patta7 claimed that a considerable amount of ingested hypophosphite was retained in the body2 however1 he used a method now known to be inaccurate and made obvious errors in calculation1 so that his conclusions were unwarranted4 ,since the evidence was even to this extent contradictory1 ,marriott performed a series of experiments4 ,the methods of this study and details of results are described in his paper1 in which he also discusses the experiments of some other observers4 ,marriott writes3 8,none of the subjects of the experiment ,marriott's experienced any effect whatsoever from the administration of the drug4444 ,almost all of the ingested hypophosphite is promptly eliminated unchanged4444 8,these experiments ,forbes' demonstrate conclusively that the hypophosphites possess no specific value as a source of phosphorus for the body4 ,this is not to be wondered at in view of the fact that #he per cent4 of the phosphorus ingested in the form of hypophosphite is excreted unchanged1 and there is no proof that even the remaining #ae per cent4 is available to the organism4 ,it is doubtful if there are any conditions in which the body suffers from lack of phosphorus4 ,even should such conditions exist1 phosphorus1 in the form that it occurs in the ordinary foods1 or as phosphates1 is more efficient in supplying the deficit than hypophosphites that must be oxidized before utilization and which are only about #ae per cent4 oxidized1 if at all4 ,for example1 half a glass of milk contains more available phosphorus than three large doses of hypophosphites of #ae grains each1 as great a dosage as is usually given4 8,what1 then1 is the therapeutic value of hypophosphites8 ,there is no reliable evidence that they exert a physiologic effect2 it has not been demonstrated that they influence any pathologic process2 they are not #8foods4' ,if they are of any use1 that use has never been discovered40 ,in view of the foregoing1 it seemed to the ,council advisable to examine the claims under which a few of the proprietary hypophosphite preparations are marketed4 ,the following are representative3 ,,fellows' ,,syrup ,,of ,,hypophosphites ,no very exact information concerning the composition is furnished by the manufacturers 7,fellows ,medical ,mfg4 ,co41 ,new ,york74 ,they say that the product 8444 contains the chemically pure hypophosphites of iron1 quinin1 strychnin1 calcium1 manganese and potassium1 agreeably blended in the form of a bland1 stable syrup with a slightly alkaline reaction4444 8,each fluid drachm contains the equivalent of #a-fdth of a grain of pure strychnin40 ,the ,fellows' ,hypophosphites advertising furnishes something like a barometer of the popular status of hypophosphites4 ,in one circular 7undated1 but1 from certain references contained in it1 presumably issued ten or fifteen years ago7 we read3 8,it is an indubitable fact that the hypophosphites have earned the distinction of having their therapeutic value more completely established than have any other remedial agents4444 it is only by accepting the current view1 which was originally advanced by ,mr4 ,fellows1 that we can satisfactorily account for the incontestable fact that the hypophosphites are of supreme importance in the treatment of a very extensive variety of affections4444 the hypophosphites increase the consumption of oxygen and the elimination of carbon dioxide4 ,in this manner1 they stimulate nutrition and promote constructive metamorphosis4444 ,it is now universally conceded that the widespread utility of the hypophosphites is due to the fact that they substantially improve metabolic processes1 thus increasing the disease-resisting capacity of all the tissues40 ,the circular1 continuing1 emphasizes the 8incomparable phosphorus-contributing properties0 of ,fellows' ,syrup1 its 8extraordinary reconstructive properties0 and 8the magnificent results which invariably attend its employment in the treatment of anemia1 chronic bronchitis1 chlorosis1 neurasthenia1 mollities ossium1 delayed union of fractures1 rickets1 convalescence10 etc4 ,a circular bearing the copyright date #aiad1 on the other hand1 admits that3 8,the theories for the favorable action of ,fellows ,syrup of ,hypophosphites have undergone several changes40 ,the same circular further maintains1 however1 that3 8444 the fact has never been challenged that in ,fellows ,syrup of ,hypophosphites we have one of the most efficient1 most complete1 most all-around tonics and roborants in the materia medica40 ,no attempt is made to base this assertion on the therapeutic action of the constituents4 ,in other words1 the old theory1 which formed the basis for the popularity of ,fellows' ,syrup1 has been thrown overboard1 but no substitute is deemed necessary2 the momentum already acquired is apparently regarded as sufficient to insure its continued sale4 ,fellows' ,syrup of ,hypophosphites is a semisecret1 unscientific preparation--an affront to sound therapy--exploited by means of extravagant and misleading statements4 ,,syrupus ,,roborans 7,,syrup ,,hypophosphites ,,comp4 ,,with ,,quinin1 ,,strychnin ,,and ,,manganese7 ,little information concerning this preparation seems to be furnished at present by the manufacturers1 ,arthur ,peter ,co41 ,louisville1 ,ky4 ,according to an old circular1 it contains1 in each fluidounce1 ,grains 8,hypophos4 ,potass4 #a-a_/b ,hypophos4 ,manganese #a ,hypophos4 ,lime #a ,hypophos4 ,iron #a-a_/b ,hypophos4 ,quinin #f_/af ,hypophos4 ,strichnin #a_/af 8#a_/abh grain ,strychnia to ,teaspoonful40 ,further1 according to the same circular3 8,the ,hypophosphites are especially useful in all diseases where there is a lack of nutrition4444 ,they are the best of all remedies in ,rachitis1 non-union of fractures1 ,osteomalacia and ,syphilitic ,periostitis40 ,as for ,syrupus ,roborans itself3 8,this elegant preparation is 444 the best general tonic and reconstructive known40 ,the unwarranted therapeutic claims formerly made for it seem to be no longer circulated4 ,syrupus ,roborans is an unscientific1 shotgun mixture4 ,,schlotterbeck',s ,,solution ,,hypophosphites ,,of ,,lime ,,and ,,soda 7,,liq4 ,,hypophosphitum1 ,,schlotterbeck',s7 ,the ,schlotterbeck ,foss ,co41 ,portland1 ,maine1 the manufacturers1 say of their preparation3 8,this solution contains #cj grains of the combined ,hypophosphites of ,lime and ,soda to the ounce4 ,it contains ,no ,sugar1 ,no ,acid and it is ,perfectly ,neutral40 8,indications for use4--,galactostasis1 ,imperfect ,metabolism1 ,neurasthenia1 ,nervous ,dyspepsia1 ,insomnia1 ,convalescence1 ,acetonuria1 ,cyclic ,vomiting in ,infants1 ,diabetes1 ,starvation1 ,deficiency of ,lime1 ,mother's ,teeth during ,pregnancy1 ,dentition of ,infants1 ,rachitis1 ,furunculosis1 ,vomiting of ,pregnancy1 ,obesity40 8,migraine is often caused by conditions for which this ,solution is one of the most satisfactory remedies30 8,in ,insomnia due to advancing age1 it will often act as a hypnotic44440 ,of the hypophosphites the ,schlotterbeck ,foss ,company say3 8,if #8damning it with faint praise' on the part of some of the leading medical authorities1 or utterly condemning it as useless1 on the part of others1 would kill a medicine1 the ,hypophosphites would long since have disappeared as medicinal agents4 ,negative testimony in regard to the value of a drug does not settle anything40 ,of their own preparation they say3 8,when we get the results that ought to follow the administration of ,hypophosphites1 we have proved that ,schlotterbeck's ,solution enters the system unchanged40 8,this ,solution is primarily a blood and nerve tonic and chemical food40 ,schlotterbeck's ,solution of ,hypophosphites of ,lime and ,soda is a semisecret preparation marketed under claims that are both unwarranted and misleading4 ,,robinson',s ,,hypophosphites ,according to the manufacturers1 the ,robinson-,pettet ,company1 ,louisville1 ,ky41 each fluidounce of this preparation contains3 8,hypophosphites ,soda #b gr4 ,hypophosphites ,lime #a-a_/b gr4 ,hypophosphites ,iron #a-a_/b gr4 ,hypophosphites ,quinin #c_/d gr4 ,hypophosphites ,strychnine #a_/af gr40 ,it is claimed to be 8,nutritive1 ,tonic ,alterative4 ,a ,standard ,remedy in the treatment of ,pulmonary ,phthisis1 ,bronchitis1 ,scrofulous ,taint1 ,general ,debility1 etc4 ,stimulates ,digestion1 promotes ,assimilation40 ,the declared composition of the preparation is unscientific1 and the therapeutic claims are unwarranted4 ,,eupeptic ,,hypophosphites ,nelson1 ,baker ,co41 ,detroit1 ,mich41 who market ,eupeptic ,hypophosphites1 call this preparation3 8,a superior combination containing the ,hypophosphites of ,potassium1 ,calcium1 ,iron and ,manganese1 and the bitter tonics1 ,quinin and ,strychnin1 agreeably associated with natural digestive ferments of the pancreatic secretion4 ,it is thus a general reconstructive tonic4444 ,the remedy is of especial value in the treatment of mental and nervous affections4444 ,it is indicated in pulmonary tuberculosis1 in all wasting diseases1 in debilitated conditions generally and in all exhaustion from over work40 ,on the basis of the manufacturer's statement1 ,eupeptic ,hypophosphites must be regarded as a semisecret1 unscientific1 shotgun preparation1 exploited through unwarranted therapeutic claims4 ,,mcarthur',s ,,syrup ,,of ,,the ,,hypophosphites ,,comp4 7,,lime ,,and ,,soda7 ,so far as the recent literature and trade package are concerned1 no information as to the composition of this product is furnished beyond what is conveyed in the name4 ,the advertising for ,mc,arthur's ,syrup1 like that for ,fellows' ,syrup and ,peters' ,syrupus ,roborans1 has been modified as time has passed4 ,a few years ago it was advertised under such claims as the following3 8444 ,has ,stood the ,test during many years for unequaled efficacy in the treatment of ,tuberculosis4444 ,indicated also as a ,tonic and ,tissue ,builder in convalescence from ,fevers1 in ,nervous ,diseases1 ,rickets1 ,senile ,debility and ,bronchitis40 8,its use is indicated in 444 diseases of the chest1 chronic cough1 throat affections1 general debility1 brain exhaustion1 cholera infantum and wasting diseases of children40 ,at present no definite claims seem to be made for it2 the manufacturers evidently find the magic name of hypophosphites sufficient to evoke the spell for which the advertisement writer's aid was once sought4 ,a testimonial contained in a circular which seems to be still used illustrates both the kind of aura which surrounds hypophosphites in the minds of physicians who are still living in the past1 and the kind of logic which has made the reputation of this and many other equally worthless preparations4 8,just about six years ago ,i had a severe attack of ,la ,grippe which almost killed me4 ,left me with ,asthma 7,catarrh7 and a severe cough4 ,did not get out of the house for three months4 ,took over a dozen bottles ,mc,arthur's ,hypophos4--came out all right and since then worked hard1 but last ,fall took another cold1 but worked on1 used ,mc,arthur's ,hypophos41 am using it now1 am on my #abth bottle4 8,i have five or six patients whom ,i have put on ,mc,arthur's ,hypophos41 but ,i do not prescribe the single bottle1 but wholesale no less than half dozen bottles4 ,one patient is on his #bdth bottle with orders to get another half dozen and keep it up all winter4 ,i have given the same order to all 7keep it up all winter7 and ,i myself intend to do the same1 for with its use ,i have lost no time--rain or shine ,i am doing my work4 ,i know what it has done for me and what it is doing for my patients40 ,it would be hard to find a more characteristic example of the nave mental processes of the simple folk who in all good faith write testimonials for worthless medicines4 ,this well-meaning practitioner 7a homeopath1 by the way71 because he 8came out all right0 after an attack of grip1 returns all praise to ,mc,arthur's ,hypophosphites1 which he has taken 8wholesale40 ,not the faintest doubt of the validity of his post hoc ergo propter hoc argument seems to glimmer across his consciousness4 ,mc,arthur's ,syrup of the ,hypophosphites is an irrational preparation4 ,while its faults are fewer and less glaring than those of some other proprietaries1 the circulation of such a testimonial as the one just quoted is sufficient of itself to cast suspicion on the product4 ,,borcherdt',s ,,malt ,,olive ,,with ,,hypophosphites1 ,,maltzyme ,,with ,,hypophosphites ,,and ,,maltine ,,with ,,olive ,,oil ,,and ,,hypophosphites ,these preparations are now described in the appendix to ,new and ,nonofficial ,remedies4 ,borcherdt's ,malt ,olive with ,hypophosphites 7,borcherdt ,malt ,extract ,company1 ,chicago7 is said to contain in each #ajj c4c41 #j4fd gm4 each of calcium and sodium hypophosphites1 with malt extract1 olive oil and glycerine4 ,maltzyme with ,hypophosphites 7,malt-,diastase ,company1 ,new ,york7 is said to contain1 in each #ajj c4c41 #j4d gm4 each of calcium1 sodium and potassium hypophosphites and #j4jje gm4 each of iron and manganese hypophosphites1 with maltzyme4 ,maltine with ,hypophosphites 7,maltine ,company1 ,brooklyn1 ,n4 ,y47 is said to contain in each #ajj c4c41 #j4fd gm4 each of calcium and sodium hypophosphites and #j4db gm4 of iron hypophosphite1 with maltine4 ,maltine with ,olive ,oil and ,hypophosphites 7,maltine ,company1 ,brooklyn1 ,n4 ,y47 is said to contain1 in each #ajj c4c41 #j4f gm4 each of calcium and sodium hypophosphites1 with maltine and olive oil4 ,in general1 no therapeutic claims are made for these mixtures so far as the hypophosphites are concerned4 ,the addition of hypophosphites to such mixtures is irrational and1 since it tends to perpetuate the hypophosphite fallacy1 detrimental to sound therapeutics4 ,,the ,,council',s ,,action ,the ,council endorsed the conclusions of the work of ,dr4 ,marriott referred to above1 and noted3 7#a7 that the therapeutic use of hypophosphites 7except possibly in some cases as a convenient means of administering the positive element in the salt1 as ammonium in ammonium hypophosphite or calcium in calcium hypophosphite7 is irrational2 7#b7 that the merits of each hypophosphite salt submitted for consideration under the foregoing exception must be judged individually1 and 7#c7 that ,fellows' ,syrup of ,hypophosphites1 ,peters' ,syrupus ,roborans1 ,schlotterbeck's ,solution ,hypophosphites of ,lime and ,soda1 ,robinson's ,hypophosphites1 the ,eupeptic ,hypophosphites of ,nelson1 ,baker ,co41 and ,mc,arthur's ,syrup of the ,hypophosphites are ineligible for inclusion in ,new and ,nonofficial ,remedies1 and that ,borcherdt's ,malt ,olive with ,hypophosphites1 ,maltzyme with ,hypophosphites1 ,maltine with ,hypophosphites1 and ,maltine with ,olive ,oil and ,hypophosphites be deleted from the appendix of ,n4 ,n4 ,r4 ,of these preparations1 all are in conflict with ,rule #aj2 ,fellows' ,syrup1 ,schlotterbeck's ,solution1 ,robinson's ,hypophosphites and ,nelson1 ,baker ,co4's ,eupeptic ,hypophosphites are in conflict with ,rule #f2 the ,fellows1 ,schlotterbeck1 and ,nelson1 ,baker preparations are also in conflict with ,rule #a4--7;,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #b1 #aiaf47 ,,pulvoids ,,calcylates ,report of the ,council on ,pharmacy and ,chemistry ,pulvoids ,calcylates #e grains was submitted by the ,drug ,products ,company1 ,inc41 ,new ,york1 under the following claims as to composition3 8,when ingested represents the following chemical formulas3 ,,oh7 ,c,h ,,coo7 ,ca4#b;,h,o ,sr47,c,h,o7 #b;,h,o40 8,strontium ,di-,salicylate #b-a_/b grs4 and our especially prepared ,salt of ,calcium and ,acid ,salicylic adjusted in such nascent form1 that these pulvoids upon ingestion will promptly form ,calcium ,neutral ,di-,salicylate #b-a_/b gr40 8,a combination of ,calcium and ,strontium ,di-,salicylate1 in seemingly true chemical union40 ,these statements are rather vague1 possibly because they are an attempt to mystify4 ,the product1 however1 may be assumed to be a mixture 7not a chemical combination7 of calcium salicylate and strontium salicylate4 ,the therapeutic claims made for the preparation are3 8,superior to ordinary salicylates4 ,can be taken continuously and indefinitely without gastric irritation1 insuring maximum efficiency40 8,reports show surprisingly good results1 even where the sodium salt fails40 ,as there is no evidence to show that strontium salicylate1 calcium salicylate or a mixture of the two salts has any advantage over sodium salicylate1 these claims cannot be accepted4 ,the name and the statement of composition are objectionable in that they do not reveal the identity of the drugs in 8,calcylates0 and in suggesting that this preparation possesses radical advantages over salicylates in other forms4 ,the ,drug ,products ,company was told that the facts just mentioned rendered 8,pulvoids ,calcylates0 ineligible for ,new and ,nonofficial ,remedies4 ,the company in its reply objected to the ,council's conclusions1 and in support of its position submitted testimonials from a number of physicians4 ,the reply of the company embodied no facts or arguments which had not been considered by the ,council's referee1 and the testimonials from physicians contained no evidence to show that the combination has any real advantage over sodium salicylate4 ,the ,council therefore declared 8,pulvoids ,calcylates0 ineligible for ,new and ,nonofficial ,remedies for the following reasons3 ,unwarranted therapeutic claims are made for the mixture 7,rule #f72 the name does not describe the composition 7,rule #h71 and the mixture is an unessential modification of an established remedy 7sodium salicylate7 7,rule #aj74--7;,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #i1 #aiaf47 ,,sulfuryl ,,monal ,report of the ,council on ,pharmacy and ,chemistry ,sulfuryl ,monal is said to be manufactured by ,monal ,frres1 manufacturing chemists of ,nancy1 ,france4 ,it is sold in the ,united ,states by ,george ,j4 ,wallau1 ,inc41 ,new ,york ,city4 ,according to the label3 ,contains3 ,sulfuryl 7combined polysulphurets7 #j4ce centigr40 8,each ,pastille ,liberates3 ,nascent sulphurretted ,hydrogen #b cub4 cent40 ,the ,chemical ,laboratory of the ,american ,medical ,association was requested to check the amount of available hydrogen sulphid4 ,an original bottle of ,sulfuryl ,monal was used2 this contained tablets having the taste of licorice extract and an odor of hydrogen sulphid4 ,the tablets were found to liberate about #f c4c4 hydrogen sulphid to each tablet4 ,among the claims made for the preparation are3 8,dissolved by the saliva1 ,sulfuryl ,monal reaches the stomach where1 under the influence of the gastric juice1 it generates nascent sulphuretted hydrogen4 ,professor ,albert ,robin's remarkable researches have proven that it is in the nascent state that drugs produce the greatest effect with the smallest dose4444 ,being thus eliminated by the entire respiratory tract3 the lungs1 bronchi and the throat1 the sulphurretted hydrogen passes from the interior to the exterior1 that is to say1 goes right through these organs which are1 as a consequence1 thoroughly cleansed1 antisepticized and freed of the pathogenic micro-organisms4444 ,then1 again1 part of the sulphuretted hydrogen1 liberated in the stomach1 is eliminated by the mouth and acts as an antiseptic and disinfectant of the mucous membranes of the throat and mouth4 ,hence ,sulfuryl ,monal is a perfect protective agent against contagious diseases4444 ,numerous clinical tests have demonstrated its real efficacy in diseases of the throat and of the respiratory tract3 laryngitis1 pharyngitis1 hoarseness1 granulations1 tonsillitis1 colds1 bronchitis1 pulmonary catarrh1 asthma1 emphysema1 grippe1 whooping cough1 simple and infectious pneumonia1 and in the first stage of pulmonary tuberculosis40 ,the sulphids are practically ignored in modern textbooks4 ,there is a rather extensive clinical literature on the subject1 particularly in connection with sulphur waters2 this1 however1 offers no good evidence for the therapeutic value of sulphids4 ,probably the tradition in their favor is largely due to the old popular idea that a disagreeable taste or odor is a mark of a good remedy4#ie #ie ,liquid ,sulphur--,sulphume1 ,j4 ,a4 ,m4 ,a41 ,dec4 #b1 #aiaa1 p4 #ahec4 ,when hydrogen sulphid is introduced into the body1 the small amounts that appear in the expired air are insufficient for quantitative demonstration and it is highly improbable that the amount thus excreted has any germicidal action1 or that enough is excreted in the lungs to cause irritation and a reaction4 ,the claim that ,sulfuryl ,monal is 8a perfect protective agent against contagious diseases0 is unwarranted2 the recommendation for its use in 8simple and infectious pneumonia1 and in the first stage of pulmonary tuberculosis0 is dangerous and vicious4 ,the ,council declared ,sulfuryl ,monal ineligible for ,new and ,nonofficial ,remedies and authorized publication of this report4 ,editorial ,note44--,with one exception1 this product does not appear to be advertised in medical journals4 ,we find1 however1 in the gallery of nostrums that grace the advertising pages of the ,international ,journal of ,surgery1 that ,sulfuryl ,monal has its place4 ,according to an advertisement that has been running some months in this publication1 8affections of the throat and respiratory organs respond promptly0 to ,sulfuryl ,monal whose 8effects are rapid and certain0 even in 8incipient tuberculosis40 ,this preposterous pronouncement is no worse than many others appearing in the same journal1 but it is bad enough to indicate how uncritical must be the physicians who support--by subscription or contribution--publications that are still debasing scientific medicine4--7,from ,the ,journal ,a4 ,m ,a41 ,sept4 #af1 #aiaf47 ,,mark ,,white ,,goiter ,,serum ,,and ,,mark ,,white ,,iodinized ,,oil ,report of the ,council on ,pharmacy and ,chemistry ,the 8,mark ,white ,goiter ,serum ,laboratories0 of ,chicago asked the ,council to consider its products 8,mark ,white ,goiter ,serum0 and 8,mark ,white ,iodinized ,oil40 ,the 8serum0 was claimed to be an 8antibody blood serum from a goat with thyroidosis0 while the 8,iodinized ,oil0 was said to contain 8about #d grains of iodin0 to 8each c4c40 ,the therapeutic indications for the treatment were given as3 8,simple or ,exophthalmic ,goiter1 ,hyperthyroidism-dosis1 ,thyrosis1 ,thyroidosis1 ,thyrotoxicosis1 ,dementia40 ,an ampule 7#b c4c47 of the 8serum0 is to be injected into the thyroid to be followed one week later by an ampule 7#b c4c47 of the 8,iodinized ,oil40 ,repetition of this 8treatment0 once or twice a month is advised4 ,the ,council asked for more specific information as to the composition of the remedies1 particularly as to the preparation and nature of the serum2 it also asked for evidence of the therapeutic value of the preparations4 ,in reply1 ,mark ,white wrote3 8,all that ,i can say regarding the serum is that it is made from the blood of goats with thyroid affection1 and it has been found that the serum from these goats has antibodies which control1 or has curative effect upon thyroid affections when injected into thyroid glands of either humans or animals4 ,as to the iodinised oil1 it is only an adjunct or side treatment which is not always used or indicated1 and will only be furnished to the physician for use in case in his judgment his patient needs it4 ,we shall also advise the use of quinin 444 when indicated44440 ,the ,council was referred for further information to a paper by ,rachel ,watkins1 ,m4,d41 published in the ,illinois ,medical ,journal4 ,it is to be noted1 incidentally1 that the letterheads used by ,white in his correspondence bore in one corner the notation 8,rachel ,watkins1 ,m4,d41 ,practice ,limited to ,goiter and ,other ,disorders of the ,thyroid ,glands10 and in the other1 8,mark ,white1 ,goiter ,research40 ,the information regarding the composition of this goiter treatment1 as furnished in ,dr4 ,watkins' paper1 was to this effect3 8,the medical treatment consists of the administration of a blood serum derived from a thyrodized goat4 ,formula3 ,iodine #j4af grams according to a correction by ,mark ,white1 this should read #j4bf gm41 oil #j4be c4c41 serum q4 s4 #a c4c40 ,this description of the treatment differs from that furnished to the ,council by ,mark ,white in that here the iodin and oil appear to be combined with the serum4 ,dr4 ,watkins' 8formula0 implies that the iodin is a routine medication1 thus contradicting ,white's statement1 which1 in turn1 is at variance with the statements made in submitting the treatment4 ,illustration3 ,photographic reproductions 7greatly reduced7 of some of the letterheads used by the ,mark ,white concern during the past five years4 ,the ,council does not accept any biologic product until its sale in interstate commerce has been authorized by the secretary of the treasury in accordance with the federal law regulating the sale of viruses1 serums1 toxins and analogous products4 ,the sale of the ,mark ,white ,goiter ,serum has not been so authorized2 consequently even if the preparation complied with other rules of the ,council it could not be accepted4 ,in addition1 however1 this treatment conflicts with other ,council rules4 ,the statements regarding its composition are indefinite and contradictory 7,rule #a72 the evidence presented to support the therapeutic claims is insufficient in itself and does not appear to have been checked by any disinterested authority 7,rule #f74 ,moreover1 the recognized variation in the morphology and pathology of the types of goiter render it impracticable to treat cases of goiter by any routine procedure4 ,the foregoing report was submitted to the ,mark ,white ,goiter ,serum ,laboratory4 ,in reply1 a letter signed 8,mark ,white1 ,v4,m4,d410 was received1 which read1 in part3 8444 we hope at some future time to be able to give you more detailed information1 but as you possibly appreciate that we have experienced for some time a demand on the part of many physicians that we furnish to them our therapy1 which necessitates us furnishing it before all the detailed work has yet been accomplished1 and ,i trust that you will be so kind as to bear patiently with us until we are better in a position to make a complete scientific application and report to you40 ,white wrote further3 8,the serum and iodized oil may be mixed for immediate use1 but could not be put up only separate for the use of the profession and the therapy furnished ,dr4 ,watkins she mixed as used40 ,this statement throws no light on the discrepancies in the statements with regard to the place of the iodinized oil in the treatment1 namely3 7a7 the original statement that the oil was to be given a week after the serum2 7b7 ,white's statement 7quoted earlier in this report7 that the oil 8is only an adjunct or side treatment0 and 8is not always used or indicated02 7c7 the statement in ,dr4 ,watkins' paper that the oil and the serum are given in combination4 ,the ,council declared the ,mark ,white ,goiter ,serum and ,mark ,white ,iodinized ,oil ineligible for ,new and ,nonofficial ,remedies and authorized publication of this report4 ,editorial ,note on the ,mark ,white 8,serum0 ,as some of our readers will remember1 on ,april #bf1 #aiac1 ,the ,journal called attention to the ,mark ,white preparation which at that time was being exploited from ,denver4 ,the ,propaganda ,department has in its files a number of letters sent out from the ,mark ,white concern at various times4 ,one mailed in ,may1 #aiaa1 on the embossed stationery of 8,the ,mark ,white ,goiter ,institute10 ,exchange ,building1 ,denver1 was evidently a general letter sent to physicians1 calling their attention to 8the most important medical discovery of the age40 8,dr4 ,mark ,white1 a graduate of the ,university of ,pennsylvania10 said the letter1 had discovered 8a simple and harmless remedy0 that would cure goiter4 8,because of the desire to preserve the secrecy of this remedy it is given only at the office here40 ,it was then suggested that the doctor might send those of his patients who were suffering from thyroidism to the 8,mark ,white ,goitre ,institute40 ,if he would do so he would be 8given a commission of #aj1 in cases of the #ej fee with the additional #e for each #ej increase40 ,it closed with some casuistic arguments1 presumably for the purpose of overcoming the physician's scruples1 summing up the matter with the statement3 8,no right thinking man will allow a narrow and self-seeking system of ethics to stand between him and his duty to the sick and suffering40 ,about #aiab the name of the concern seems to have been changed1 for we have in our files a letter addressed to a layman on the stationery of the 8,mark ,white ,goitre ,treatment ,company40 ,according to this letterhead the product this concern had for sale was 8,goitreine0 discovered by ,mark ,white1 8,president and ,general ,manager40 ,mr4 ,white's letter to the sufferer from goiter assured him that if he would take 8,goitreine0 he might 8be practically sure of an immediate and permanent cure40 8,goitreine10 according to ,white1 8has absolutely and permanently cured #ij per cent40 of all cases of goiter in which it has been used--8and the other ten showed remarkable improvement40 ,it was efficacious for all forms of goiter and 8cannot possibly harm40 ,the person who received this assurance might have had his confidence in it shaken had he seen a copy of the ,denver ,news for ,may #bc1 #aiaa1 in which was reported a case of collapse and death in a woman following an injection given in ,white's office4 ,the paper stated that the death certificate was signed by one ,w4 ,a4 ,gray and gave 8fatty degeneration of the heart and goiter0 as the cause of death4 ,gray1 it seems1 was the licensed physician employed by ,mark ,white to administer 8,goitreine0--if that is what ,white happened to be calling his product at that time4 ,for here it may be stated1 parenthetically1 that ,mark ,white is not a physician2 he is a veterinarian4 ,in ,february1 #aiac1 ,mark ,white sent a circular letter to a number of medical publications with the request that it be printed in full in the next issue1 8to cover one full page of space40 ,the letter ,white wanted printed was addressed to doctors offering to 8enter into a copartnership agreement0 with such physicians who would be willing to treat 8patients with goiter affections on a #ej per cent4 commission basis40 8,you would be expected to make a cash charge to the patient for the treatment1 remitting on the same day our #ej per cent4 to us1 when ordering the treatment1 giving the treatment in no cases for less than #ej4jj40 ,about the same time that ,mark ,white made this 8fifty-fifty0 offer1 he sent in an advertisement to be published in the classified column of ,the ,journal4 ,at that time he was told his advertisement was not acceptable2 we now reprint it1 however1 free of charge4 ,here it is3 8,,wanted--,,one ,,or ,,more ,,physicians in each vicinity to administer and represent our new medical treatment for ,,goiter4 ,good margin of profit4 ,write for copy of contract4 ,the ,mark ,white ,goitre ,treatment ,co41 ,denver1 ,colo40 ,in #aiad1 ,white moved to ,chicago4 ,at least the card which we reproduce so indicates4 ,at that time1 as will be seen1 8,dr4 ,mark ,white0 was 8personally associated0 with ,peter ,s4 ,clark1 ,m4,d4 ,according to the same card ,dr4 ,f4 ,d4 ,paul of ,rock ,island1 ,ill41 seems to have been his 8associate0 for that particular locality4 ,in this connection1 it is worth noting that a ,rock ,island paper1 in one of its issues during ,july1 #aiac1 devoted a good deal of space to 8,dr4 ,mark ,white0 who was at that time in ,rock ,island 8directing ,dr4 ,frank ,d4 ,paul in the administering of the treatment40 ,there was nothing to indicate that this notice was an advertisement or that the editorial appearing in the same issue puffing ,white's 8important cure10 was paid for4 ,illustration3 ,when exploited from ,denver the ,mark ,white 8goiter cure0 was advertised in the daily papers4 ,here is a photographic reproduction 7reduced7 of an advertisement that appeared in the ,denver ,post1 ,sept4 #a1 #aiab4 ,dr4 ,w4 ,a4 ,gray1 who has already been mentioned as ,white's associate in ,denver1 seems to have been doing business in ,illinois some time in #aiac and a ,princeton 7,ill47 paper had some uncomplimentary things to say about him4 ,finally in ,july1 #aiac1 this item appeared in a ,princeton paper4 8,dr4 ,w4 ,a4 ,gray1 the goiter specialist who operated last winter at ,princeton and ,walnut until he became embroiled with ,dr4 ,mark ,white1 a ,denver veterinary and originator of the cure1 over a division of the spoils1 has opened a goiter institute in ,chicago under his own name4 ,advertisements of the ,dr4 ,gray ,goiter ,institute appeared ,sunday morning in the ,chicago ,examiner and other morning papers4 ,dr4 ,gray and ,mark ,white broke off their relations after their disagreement at ,walnut1 and ,dr4 ,gray slightly changed the ingredients of the goiter cure and started off on his own hook40 ,one of ,gray's advertisements in ,chicago newspapers made the claim that 8,dr4 ,gray's ,new ,medical ,treatment removes the cause of goiter in seven days40 ,illustration3 ,photographic reproduction 7reduced7 of the 8professional0 card used by 8,dr4 ,mark ,white0 after he came to ,chicago4 ,the ,tulsa 7,okla47 associate of 8,dr40 ,white seems to have been ,dr4 ,j4 ,h4 ,morgan and the ,tulsa papers of ,june1 #aiad1 tell of 8,dr40 ,white's visit to that city 8for the purpose of instructing ,dr4 ,j4 ,h4 ,morgan in the technique of his new medical treatment for nervous disorders and goiter40 ,some months later--in ,december1 #aiae--the following little item appeared in a ,tulsa paper3 8,dr4 ,mark ,white was found guilty in the county court yesterday of practicing medicine without a license and was fined #ej4 ,doctor ,white is a goiter specialist40 ,in ,september1 #aiae1 ,mr4 ,thomas ,s4 ,hogan1 the efficient counsel for the ,illinois ,state ,board of ,health1 instituted action against ,mark ,white for practicing medicine without a license4 ,the case was tried ,oct4 #ae1 #aiae1 and the jury1 after being out four hours1 returned a verdict of 8not guilty40 ,attorney ,hogan attributes the failure to obtain a conviction to the testimony of ,dr4 ,rachel ,watkins1 who said she had a partnership arrangement with ,white in carrying on the medical business4 ,it was about this time that ,mark ,white seems to have issued some new letterheads4 ,these bore in their upper left hand corner the device 8,rachel ,watkins1 ,m4 ,d41 ,practice ,limited to ,goiter and ,other ,disorders of the ,thyroid ,glands10 while the upper right hand corner read 8,mark ,white1 ,goiter ,research40 ,on ,dec4 #i1 #aiae1 ,rachel ,watkins1 ,m4 ,d41 of ,chicago1 read a paper entitled 8,a ,serum ,treatment for ,physiologically ,defective ,thyroids1 ,with ,clinical ,reports0 before the ,stock ,yards ,branch of the ,chicago ,medical ,society4 ,the 8serum treatment0 discussed was ,mark ,white's 8,goitreine0 which1 in the course of its checkered career1 had lost its original name by the wayside4 ,this paper appeared in the ,december1 #aiae1 issue of the ,illinois ,medical ,journal4 ,probably emboldened by the ease with which a component part of the ,american ,medical ,association 8fell for0 a paper exploiting a 8goiter cure10 ,dr4 ,watkins requested that she be permitted to read a paper on the same subject before the ,section on ,pharmacology and ,therapeutics at the ,detroit meeting of the ,american ,medical ,association last ,june4 ,the request was refused4 ,dr4 ,watkins is apparently no longer connected with ,white and in fact has protested against the use of her name by ,white in connection with his 8goiter cure40 ,after the above was in type and ready for the pages of ,the ,journal1 attention was called to the ,official ,bulletin of the ,chicago ,medical ,society of ,sept4 #af1 #aiaf4 ,this ,bulletin contained a full page advertisement of the ,mark ,white 8goiter cure40 ,the advertiser referred to the preparation as having been 8announced to the ,chicago ,medical ,society0 and declared it to be 8an ethical therapeutic agent40 ,mark ,white was described as 8a medical research student0 but no hint was given that he is a veterinarian4 ,after again emphasizing that 8this therapy is ethically proven0 physicians were invited to 8visit our goats when convenient0 and the advertisement closed with the modest claim that 8this thyroid therapy has equal curative therapeutic value in these cases as quinin in malaria40 ,and this sort of pseudo-scientific claptrap is presented to a presumably learned profession through its own official ,bulletin--but what's the use of commenting6--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bc1 #aiaf47 ,,kora-,,konia ,report of the ,council on ,pharmacy and ,chemistry ,kora-,konia is a 8dusting powder0 which at present is advertised to the medical profession through medical journals1 circulars1 post cards and sample packages4 ,it is put out by the 8,house of ,mennen10 which sells various toilet preparations such as talcum powder1 shaving soap1 etc4 ,on the trade package is the statement3 8,indicated in the treatment of ,acne1 ,dermatitis1 ,eczema ,intertrigo2 in obstinate cases of chafing1 prickly heat1 nettle rash1 chicken pox1 measles1 scarlatina and irritations of the skin2 as a soothing absorbent and antiseptic dusting powder and as an umbilical dressing40 ,while a circular asserts that3 8,kora-konia is indicated in the treatment of acne1 dermatitis1 eczema and eczematous conditions of the utmost severity1444 eruptive fevers14440 ,what purports to be a physician's testimonial reads3 8,i used ,kora-,konia in a new born case of inherited syphilis and the eruption soon cleared up40 ,germicidal powers are claimed for ,kora ,konia in a medical journal advertisement4 ,in view of the various claims made and the fact that it is advertised to the medical profession1 the ,chemical ,laboratory of the ,american ,medical ,association was asked to analyze ,kora-,konia4 ,this was done and the chemists reported as follows3 ,,laboratory ,,report ,kora-,konia is a white powder1 slightly greasy to the touch4 ,qualitative tests showed the presence of boric acid1 zinc1 magnesium1 a solid fatty acid and material insoluble in hydrochloric acid containing magnesium and aluminum4 ,starch was not found4 ,quantitative determinations gave the following results3 ,acid-insoluble material 7talc7 #dh4c per cent4 ,magnesium 7,mg7 soluble in dilute acid #a4b per cent4 ,zinc 7,zn7 #d4e per cent4 ,stearic acid 7impure7 #ci4b per cent4 ,boric acid #c4j per cent4 ,carbon dioxide 7,,co7 #a4e per cent4 ,from this analysis it is concluded that ,kora-,konia has essentially the following composition3 ,zinc stearate ,u4 ,s4 ,p4 #dd per cent4 ,talc #dh per cent4 ,magnesium carbonate ,u4 ,s4 ,p4 #e4j per cent4 ,boric acid #c4j per cent4 ,essentially this dusting powder consists of the well-known substances talc and zinc stearate in about equal proportions to which small quantities of magnesium carbonate and boric acid have been added4 ,inasmuch as the claim is made1 by inference at least1 that ,kora-,konia represents original investigation carried out 8with the cooperation of the medical profession0 it should be stated that the preparation of commercial zinc stearate was described and recommended as a dusting and toilet powder nearly twenty-five years ago4#if #if ,proc4 ,am4 ,pharm4 ,a4 #dj3dhh1 #ahib4 ,there is nothing new or original in any one of these substances or in the combination4 ,the extravagant and unwarranted claims made for this simple dusting powder are undoubtedly leading the public as well as some thoughtless physicians1 to place undeserved confidence in it4 ,in view of the small amount of boric acid present in the powder1 its antiseptic powers must be slight and its germicidal powers almost nil4 ,the ,council declared ,kora-,konia ineligible for ,new and ,nonofficial ,remedies and authorized publication of this report4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #cj1 #aiaf47 ,,the ,,therapeutic ,,value ,,of ,,the ,,glycerophosphates ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,glycerophosphates are the salts of glycerophosphoric acid1 ,h,c,h7,,oh7,,po4 ,this acid is produced by the interaction of glycerin and phosphoric acid4 ,in general1 only sodium glycerophosphate1 ,na,c,h7,,oh7,,po #e-a_/b;,h,o1 and calcium glycerophosphate1 ,ca,c,h7,,oh7,,po ,h,o1 are used in medicine1 though the glycerophosphates of lithium1 potassium1 manganese1 magnesium1 iron1 quinin and strychnin are claimed as constituents of proprietary preparations4 ,at a time when certain disorders were assumed to be due to a deficiency of phosphorus in the nerve structure in the body1 glycerophosphates were introduced as 8nerve foods0 and 8tonics0 on the theory that they would be assimilated more readily than hypophosphites or ordinary phosphates4 ,what led to this assumption was the fact that the lecithins1 which form a part of the nerve structure1 were known to contain the glycerophosphate radical in the molecule4 ,the belief that inorganic phosphates cannot supply the body's need of phosphorus is implied or expressed in most of the 8literature0 devoted to proprietary phosphorus preparations4 ,thus1 ,schering and ,glatz quote ,g4 ,meillire as saying that 8the organism is incapable of assimilating inorganic forms of phosphorus40 ,again1 when exploiters of glycerophosphates admit that the body can synthesize its phosphorus compounds from inorganic phosphates1 they attempt to counterbalance the admission by contending that the use of organic compounds 8spares0 the system the necessity of making such synthesis4 ,this assumption rests on the theory that the organic phosphorus compounds are absorbed and stored as such4 ,this theory is contradicted by evidence which has been presented#ig that the organic phosphorus compounds are split up into inorganic phosphates before absorption4 #ig ,mc,collum and ,hart1 ,grosser and ,husler1 ,plimmer1 and ,bayliss and ,plimmer1 quoted by ,marshall 7,note #b74 ,the ,council requested ,e4 ,k4 ,marshall1 ,jr41 to review the evidence for and against the therapeutic value of organic phosphorus compounds4 ,marshall's study#ih brings out the following points3 #ih ,marshall1 ,e4 ,k43 ,the ,therapeutic ,value of ,organic ,phosphorus ,compounds1 ,j4 ,a4 ,m4 ,a41 ,feb4 #ac1 #aiae1 p4 #egc4 #a4 ,in various tissues of the animal body1 enzymes have been found which hydrolyze complex organic phosphorus compounds so as to liberate the phosphorus in the form of inorganic phosphates4 #b4 ,metabolism studies of the phosphorus balance with diets containing inorganic phosphorus compounds1 as compared with diets containing organically bound phosphorus1 are somewhat conflicting in their results4 ,the balance of evidence1 however1 is in favor of the view that there is no difference between organically combined phosphorus and inorganic salts with respect to the phosphorus balance4 #c4 ,experiments indicate that the organism thrives on and supplies its phosphorus needs quite as well from inorganic phosphorus compounds as from organically bound phosphorus4 ,marshall concludes3 8,we see that the evidence is very convincing of the view that the animal organism can synthesize its complex organic phosphorus constituents from inorganic phosphates1 and that organic phosphorus is of no more value as a food than inorganic40 ,in view of this report1 the ,council deemed it advisable to take up the consideration of certain glycerophosphate preparations on the market4 ,as the therapeutic claims are all similar1 it is not necessary to quote them extensively4 ,,tonols 7,,schering',s ,,glycerophosphates7 ,tonols 7,schering and ,glatz1 ,new ,york7 comprise iron1 lime1 lithium1 magnesium1 manganese1 potassium1 quinin1 sodium and strychnin 8,tonols0 or glycerophosphates2 also ,duotonol ,tablets1 said to contain equal parts of calcium and sodium glycerophosphates2 ,triotonol ,tablets1 each said to contain 8,sodium ,tonol #b-a_/b grains1 ,lime-,tonol #b-a_/b grains1 ,strychnine-,tonol #a_/fj grain02 ,quartonol ,tablets1 said to contain 8,sodium and ,lime-,tonols1 each #b-a_/d grains1 ,quinine ,tonol #a_/b grain1 ,strychnine-,tonol #a_/bjj grain02 ,sextonol ,tablets1 said to contain 8,sodium and ,lime-,tonols1 each #b grains1 ,iron-,tonol1 #a_/b grain1 ,manganese and ,quinine-,tonols1 each #a_/d grain1 ,strychnine-,tonol1 #a_/bjj grain40 ,the name 8,tonols0 is objectionable in that it is not only nondescriptive of the composition1 but also therapeutically 7and falsely7 suggestive4 ,the composition of the more elaborate ,tonols is particularly unscientific2 there is no justification for combining quinin1 strychnin1 iron1 manganese1 etc41 in one formula4 ,,phosphorcin ,,compound ,phosphorcin ,compound1 called 8,the ,elementary ,phosphorus indicated in all forms of ,nervous ,diseases0 and the 8,perfect ,formula10 is said to be manufactured by the ,organic ,products ,company1 ,wetzlar an der ,lahn1 ,germany1 and ,greenwich1 ,conn4 ,it is sold in the ,united ,states by ,eimer and ,amend1 ,new ,york1 according to whom3 8,each two fluidrachms contain3 8,acidulated ,bone ,phosphor ,o4 ,p4 ,co4 #b grains 8,calcium ,glycerinophosphate1 ,merck ,co4 #a-a_/b grains 8,magnesium ,glycerinophosphate1 ,merck ,co4 #a-a_/b grains 8,sodium ,glycerinophosphate1 ,merck ,co4 #b-a_/b grains 8,lactated ,pepsin #b grains 8,ignatia ,extract #a_/bj grain 8,c4 ,p4 ,glycerin 7,special ,process7 ,o4 ,p4 ,co4 #ej per cent4 8,acidulated bone phosphor0 presumably is acid phosphate of calcium4 ,this formula is an unscientific shotgun combination4 ,,robinol ,robinol1 manufactured by ,john ,wyeth and ,brother1 ,philadelphia1 is called a 8,universal ,tonic40 ,it is said to be3 8,a preparation of the glycerophosphates of lithium1 calcium1 sodium1 iron1 manganese1 quinine1 with #a-af gr4 strychnine glycerophosphate in each fluidounce40 ,this is a semisecret preparation1 since the quantities of most of the ingredients are not given and the vehicle is not named4 ,this complex combination1 too1 is unwarranted4 ,,phosphoglycerate ,,of ,,lime 7,,chapoteaut7 ,this is said to be prepared by the ,laboratories de ,pharmacologie ,gnrale1 ,dr4 ,ph4 ,chapelle1 ,paris and ,new ,york4 ,it is sold in this country by ,e4 ,fougera and ,co41 ,inc41 ,new ,york4 ,it is offered in several forms1 especially in that of wine1 which is called the 8,medicinal ,wine and ,tonic ,par ,excellence40 ,the alcohol is no doubt the constituent to which this preparation is indebted for such popularity as it has attained1 for it is much more freely advertised than the syrup1 capsules or granulated form4 ,the usual claims are made with regard to the efficacy of calcium glycerophosphate 8during convalescence1 in cases of enfeebled vitality1 and nervous affections associated with an excessive elimination of phosphates40 ,,elixir ,,glycerophosphates1 ,,nux ,,vomica ,,and ,,damiana ,this is manufactured by ,sharp and ,dohme1 ,baltimore4 ,the manufacturers' statement of composition is3 8,each fluidounce represents ,nux ,vomica #h grains1 ,damiana #fd grains1 combined with ,glycerophosphates of ,calcium and ,sodium40 8,alcohol #bj per cent40 ,sharp and ,dohme call this mixture a 8,reconstructive ,nerve ,stimulant1 ,aphrodisiac10 and claim that3 8,phosphorus in elemental form has long been prescribed under the title of ,elixir ,phosphorus1 ,nux ,vomica and ,damiana1 but due to the rapidity of chemical change occurring in preparations containing this form of ,phosphorus1 much of the ,physiologic action is lost4 ,the ,glycerophosphates present ,phosphorus in its most available form--the form in which it exists in the brain and nervous system4 ,they powerfully stimulate the functions of nutrition and are rapidly assimilated by the system4 8,nux ,vomica is a general ,nerve ,tonic4 ,damiana exerts a stimulant effect upon the sexual appetite and function40 ,the claim that the glycerophosphates may be substituted for elementary phosphorus is1 at least1 novel4 ,the elixir is an unscientific semisecret combination4 ,,recommendations ,all of the preparations mentioned violate ,rule #f 7unwarranted therapeutic claims74 ,in addition1 ,robinol and ,elixir ,glycerophosphates1 ,nux ,vomica and ,damiana violate ,rule #a 7secrecy of composition7 in that not all the quantities of the ingredients are declared2 ,tonols1 ,phosphorcin ,compound and ,robinol violate ,rule #h 7objectionable names74 ,it is recommended that the ,council endorse ,marshall's findings#ih and declare that ,tonols 7,schering and ,glatz71 ,phosphorcin ,compound 7,eimer and ,amend71 ,robinol 7,john ,wyeth and ,brother71 ,phosphoglycerate of ,lime ,chapoteaut 7,e4 ,fougera and ,co471 and ,elixir ,glycerophosphates1 ,nux ,vomica and ,damiana 7,sharp and ,dohme7 are ineligible for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #cj1 #aiaf47 ,,hydras ,report of the ,council on ,pharmacy and ,chemistry ,hydras1 sold by ,john ,wyeth and ,brother1 ,philadelphia1 is one of the many proprietary1 so-called 8uterine tonics40 ,it is said to contain 8,cramp ,bark1 ,helonias ,root1 ,hydrastis1 ,scutellaria1 ,dogwood and ,aromatics10 but as the amounts of the several ingredients are not given the statement regarding its composition is valueless4 ,the label declares the presence of #bd per cent4 alcohol4 ,the name 8,hydras10 taken in connection with the statement of composition1 would suggest that hydrastis 7golden-seal7 is an important constituent4 ,the report of the ,chemical ,laboratory of the ,american ,medical ,association1 however1 indicates that hydrastis is present in unimportant amounts3 8,the hydrastin content of ,hydras was determined by extraction with immiscible solvents 7,pharm4 ,review1 ,may1 #aijh1 p4 #acb74 ,twenty-five c4c4 was found to yield an alkaloid residue of #j4jafj gm4 ,the preparation contains1 therefore1 not more than #j4jfd gm4 #8hydrastin' per #ajj c4c4 ,inasmuch as hydrastis is required to contain about #b4e per cent4 #8hydrastin1' hydras contains an equivalent of not more than #b4ef gm4 hydrastis 7golden seal7 in #ajj c4c4 and the stated dose of ,hydras--one dessertspoonful 7#h c4c47--represents not more than #j4b gm4 or #a_/aj of the ,u4 ,s4 ,p4 average dose of hydrastis40 ,the label of a recently purchased bottle of ,hydras bears the following recommendations for its use3 8,indicated in treatment of ,dysmenorrhea1 ,menorrhagia ,anti-,abortive1 with anodyne and tonic properties40 8,for dysmenorrhea1 suppressed menses1 etc41 a dessertspoonful three times daily1 before or after meals40 8,to relieve pain due to uterine disorders1 a dessertspoonful every three hours1 or increased to a tablespoonful1 at the discretion of the attending physician40 ,a circular wrapped around the bottle declares that ,hydras is3 8,a valuable preparation to the physician in the treatment of dysmenorrhea1 colic1 cramps1 spasm1 palpitation incident to pregnancy1 and the various pains resulting from diseases of the female sexual organs40 ,it is further claimed that3 8,in the dysmenorrhea of young girls due to some mechanical difficulty1 as anteflexion or of a congestive character1 of suppressed menses from exposure to cold and other causes of a similar character1 ,hydras will prove efficient and can be administered freely without danger40 ,the value of hydrastis in the treatment of the diseases and conditions mentioned is problematical at best1 and the small amount present in ,hydras is wholly useless4 ,as for the other constituents1 cramp bark 7,viburnum opulus71 helonias 7false unicorn--,chamlirium luteum or ,helonias dioica7 and scutellaria 7skullcap--,scutellaria lateriflora7 are drugs which are practically ignored by most writers on materia medica and therapeutics4#ii ,dogwood 7,cornus florida7 is a mildly astringent aromatic bitter for the use of which there is no scientific evidence4#ajj #ii ,see reports of the ,council1 ,j4 ,a4 ,m4 ,a41 ,jan4 #i1 #aiae1 p4 #afe2 ,jan4 #bc1 #aiae1 p4 #cei2 ,nov4 #bg1 #aiai1 p4 #ahcf2 ,march #bg1 #aiae1 p4 #ajic4 #ajj ,see ,reports ,council ,pharm4 and ,chem41 #aiab1 p4 #cf4 ,to sum up3 ,of the five ingredients of ,hydras 7aside from alcohol and aromatics71 one 7hydrastis71 which apparently gives the preparation its name1 is present in unimportant amounts2 three 7cramp bark1 helonias and scutellaria7 are therapeutically unimportant2 the fifth 7dogwood7 has never been shown to have any specific action on the uterus4 ,the potent constituent1 therefore1 appears to be the alcohol4 ,but1 even if every one of the several drugs said to be contained in ,hydras were possessed of distinct therapeutic properties1 and if each were present in known and therapeutically active amounts1 still the combination in fixed proportion would be irrational4 ,no one could foresee the joint effect of the five drugs in the several conditions for which the mixture is advertised4 ,hydras is evidently meant to appeal to the thoughtless and to be used at random2 witness the suggestion made in the advertising that 8,owing to its palatability1 it is acceptable to patients with impaired digestion1 and will serve as a stomachic tonic1 promoting appetite and digestion40 ,a useless alcoholic nostrum 8administered freely0 to women and girls is as dangerous as the recommendation for such administration is reprehensible4 ,this preparation is semisecret4 ,the recommendations for its use in specified diseases which appear on the label and in the advertising accompanying the bottle are sure to lead to its ill-advised use by the public4 ,the claims made for its curative properties are exaggerated and unwarranted4 ,the name1 in view of the small content of hydrastis1 is misleading4 ,finally1 the combination of five drugs1 even if individually they were of therapeutic value1 is irrational4 ,hydras1 consequently1 is inadmissible to ,new and ,nonofficial ,remedies for conflict with ,rules #a1 #d1 #f1 #h and #aj1 and publication of this report is authorized4 ,editorial ,comment4--,products like 8,hydras0 are the bane of scientific medicine4 ,the physician who prescribes them could with just as much reason prescribe any of the various alcoholic 8patent medicines0 of the 8women's tonic0 type4 ,in fact1 his patients would be running less risk of contracting the alcohol habit if he prescribed the 8patent medicines10 as these nostrums usually have less alcohol than is contained in their 8ethical0 prototypes--and alcohol is the only really important drug in practically all of them4 ,whatever one may think of reputable pharmaceutical houses who put out products of the 8,hydras0 type1 the fault really lies with the profession which tolerates such therapeutic monstrosities4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #g1 #aiaf47 ,,bromin-,,iodin ,,compound ,report of the ,council on ,pharmacy and ,chemistry 8,bromin-,iodin ,compound10 according to the ,bromin-,iodin ,chemical ,company1 ,san ,diego1 ,calif41 has the following 8formula03 ,iodin ,gr4 #a ,bromin ,gr4 #a_/d ,phosphorus ,gr4 #a_/ajj ,thymol ,gr4 #b_/c ,menthol ,gr4 #b_/c ,sterilized ,oil ,gr4 #a ,the only statement regarding its method of preparation is the line 8,solution in ,cod ,liver ,oil1 ,norwegian40 ,according to the promoters1 8,bromin-,iodin0 is3 8,a ,powerful ,anti-,tubercular ,agent for ,hypodermic ,use in ,pulmonary and ,laryngeal ,tuberculosis4 ,useful in other forms of ,tubercular ,diseases1 and in ,non-,tubercular ,pulmonary ,diseases of a ,sub-,acute or ,chronic ,nature40 ,the 8formula10 in the form in which the manufacturers publish it1 is either impossible or meaningless1 according to the interpretation that may be given4 ,it is impossible if it is intended to indicate the actual composition of the product because that would mean that the oil is alleged to contain free or uncombined iodin1 bromin and phosphorus4 ,both on theoretical grounds and also in the light of the findings of the ,chemical ,laboratory of the ,american ,medical ,association1 it is not possible that all these constituents can be present in the free state4 ,the formula is meaningless if it is intended to convey the idea1 merely1 that iodin1 bromin1 phosphorus1 thymol1 menthol and sterilized oil are combined to form 8,bromin-,iodin40 ,in the absence of any details of the method of manufacture1 it is futile to attempt to pass judgment on the actual composition of the preparation4 ,the use of an almost identical product 7said1 however1 to contain only #a_/b grain iodin to each fluidram7 was described in #aijh by ,dr4 ,ingraham of ,binghamton1 ,n4 ,y41 in 8,five ,years ,successful ,experience with a ,special ,mode of ,treating ,pulmonary ,tuberculosis40 ,in #aiaj ,the ,journal#a characterized the preparation as 8one of the innumerable #8treatments' for pulmonary tuberculosis that have arisen1 had their day and1 more or less gracefully1 retired40 ,if the preparation had value for the purpose for which it is recommended1 its use during these twelve years should have secured its general recognition4 ,there is no satisfactory evidence of its therapeutic efficacy4 ,the ,council refused recognition to ,bromin-,iodin ,comp4 and1 after submitting this report to the ,bromin-,iodin ,chemical ,company1 authorized its publication4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #bc1 #aiaf47 ,,ammonium ,,hypophosphite ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,ammonium hypophosphite was admitted to ,new and ,nonofficial ,remedies in #aijh as a preliminary step in the consideration of a preparation containing it--8,gardner's ,syrup of ,ammonium ,hypophosphite0--because the ,council standardizes unofficial products before considering preparations or mixtures of these4 ,the therapeutic use of hypophosphites being irrational 7see1 8,the ,hypophosphite ,fallacy10 ,report of the ,council on ,pharmacy and ,chemistry1 ,the ,journal1 ,sept4 #b1 #aiaf1 p4 #gfj71 the salt1 ammonium hypophosphite1 deserves continued recognition only on condition that this salt of ammonium is superior to other salts from which may be obtained the effect of the ammonium radical4 ,it has been claimed that ammonium hypophosphite has a less objectionable taste than other ammonium salts used for similar purposes4 ,this claim would merit serious consideration if in addition to being less objectionable to the taste1 the effects of ammonium hypophosphite were equal to or more desirable than the official ammonium salts4 ,there is no evidence that this condition is met by the hypophosphite salt4 ,ammonium hypophosphite has long been known1 yet it is not official in the ,austrian1 ,belgian1 ,british1 ,french1 ,german1 ,hungarian1 ,italian1 ,swedish1 ,swiss or ,united ,states ,pharmacopeias4 ,neither is it mentioned in the leading textbooks on materia medica1 pharmacology or therapeutics4 ,in short it appears to be an instance of an obscure and superfluous salt selected for proprietary exploitation4 ,since the continued recognition of ammonium hypophosphite would tend to perpetuate the hypophosphite fallacy1 and because there is no evidence supporting its advantage as a means of securing the effect of ammonium salts the ,council directed its omission from ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #ea47 ,,alphozone ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following advertisement appeared in the ,new ,idea 7,september1 #aiaf71 a house organ of ,frederick ,stearns ,co41 the proprietors of ,alphozone3 ,illustration ,in the light of our present knowledge the claim that ,alphozone is a preventive of infantile paralysis is without warrant and the advice that the public depend on it for this purpose is reprehensible and dangerous4 ,therefore1 the ,council directed that ,alphozone be omitted from ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #ej47 ,,calcium ,,glycerophosphate ,,and ,,sodium ,,glycerophosphate ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,calcium glycerophosphate and sodium glycerophosphate were accepted for ,new and ,nonofficial ,remedies chiefly in order that these products might be standardized4 ,these mixtures now being defined in the new edition of the ,u4 ,s4 ,pharmacopeia1 this reason for including them in ,n4 ,n4 ,r4 no longer exists4 ,the report of ,marshall 7,the ,journal1 ,feb4 #ac1 #aiae1 p4 #egc7 which has the endorsement of the ,council 7,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcc7 shows that organic phosphorus compounds are split up into inorganic phosphates before absorption1 that the animal organism can synthesize its complex organic phosphorus constituents from inorganic phosphates and consequently that the glycerophosphates1 so far as their phosphorus value is concerned1 are not superior to other phosphates4 ,in fact1 sodium and phosphate are more effectively administered as neutral or acid phosphate4 ,it is evident that sodium glycerophosphate is a superfluous pharmaceutical preparation1 particularly when the difficulty of obtaining a pure product and its high price is considered4 ,so far as its calcium value is concerned1 calcium glycerophosphate has no advantages over such calcium salts as the carbonate1 phosphate1 lactate1 or chlorid4 ,in view of the foregoing1 the ,council directed that sodium glycerophosphate and calcium glycerophosphate be omitted from ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #eb47 ,,gardner',s ,,syrup ,,of ,,ammonium ,,hypophosphite ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,in recognition of the considerable revision of the therapeutic claims made by the manufacturer1 ,gardner's ,syrup of ,ammonium ,hypophosphite was retained in ,new and ,nonofficial ,remedies1 #aiaf1 and the proprietor advised of this provisional retention4 ,in the most recent advertising for this ammonium hypophosphite syrup the claim is made3 8,besides being an active expectorant ,syrup of ,ammonium ,hypophosphite 7,gardner7 is useful as an alterative and resolvent and by virtue of its phosphorus element1 which is in the form of a hypophosphite1 ,,ph,o1 has a tonic value40 ,as detailed in the report of the ,council 8,the ,hypophosphite ,fallacy0 7,the ,journal1 ,a4 ,m4 ,a41 ,sept4 #b1 #aiaf1 p4 #gfj7 careful studies show that the hypophosphites are devoid of the 8alterative0 and 8tonic0 actions claimed by the manufacturer of ,gardner's ,syrup of ,ammonium ,hypophosphite4 ,accordingly the ,council voted to omit ,gardner's ,syrup of ,ammonium ,hypophosphite from ,new and ,nonofficial ,remedies and authorized publication of this report4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #ee47 ,,gluten ,,products ,,made ,,by ,,the ,,kellogg ,,food ,,company ,report of the ,council on ,pharmacy and ,chemistry ,for over two years the ,council has had under consideration certain products offered for the use of diabetics by the ,kellogg ,food ,company of ,battle ,creek1 ,mich4 ,these are3 ,pure ,gluten ,biscuit4 ,pure ,gluten ,meal4 #dj per cent4 ,gluten ,biscuit4 #dj per cent4 ,gluten ,flour4 #dj per cent4 ,gluten ,meal4 #bj per cent4 ,gluten ,meal4 ,the ,council found these products ineligible for ,new and ,nonofficial ,remedies because the statements of composition 7particularly of starch content7 were insufficient and because the exploitation of the products to the laity was objectionable4 ,june #ba1 #aiae1 the company promised to place a statement of the starch content on the package of each gluten product1 to place on the gluten flour sacks a caution that diabetics use the flour only on the advice of their physicians1 and to revise its advertising in accordance with the suggestions of the ,council4 ,nothing further having been heard from the company1 in ,april1 #aiaf1 specimens of the product were obtained1 through a layman1 direct from the ,kellogg ,food ,company4 ,these specimens1 together with the advertising matter received at the same time1 and also a letter of advice from the company to another layman1 were sent to the ,council's referee1 whose report follows4 ,as will be seen1 the referee finds that the amounts of carbohydrates contained in ,pure ,gluten ,flour1 #dj per cent4 ,gluten ,flour and ,pure ,gluten ,meal are greater than the amounts claimed in the company's published analyses2 that in the two first mentioned the amounts of protein are less than the amounts claimed2 that exaggerated claims are made on all the labels and in the advertising literature1 and that the company prescribes directly to the patient4 ,the following report was sent to the ,kellogg ,food ,company for consideration4 ,in reply the firm stated that a revision of its advertising was under consideration but would make no statement as to how soon this revision would be carried into effect4 ,as the consideration had already consumed two years1 the ,council decided to give the profession the facts and authorized publication of the report4 ,at the same time the ,kellogg ,food ,company was advised that its products would be considered further whenever any submitted evidence warranted this4 ,w4 ,a4 ,puckner1 ,secretary4 ,referee's ,report ,i submit herewith my report on certain foods offered by the ,kellogg ,food ,company for the use of diabetics4 ,i shall discuss these products from the standpoint of the claims made on the label1 from the standpoint of the company toward nonmedical treatment as revealed in a letter to a layman1 and lastly1 on the basis of the claims made for the foods in the company's literature4 ,,claims ,,made ,,on ,,the ,,label ,,pure ,,gluten ,,biscuit ,referee ,company ,water #h4cj #e-aj ,ash #b4jd #a-b ,protein 7,n #e4g7 #gc4hg #ge-hj ,fiber #j4ab #b4d-c ,carbohydrates #ad4hd #j-e ,fat #j4ha #j4be-j4gj ,starch #d4jb #j-e ,the sample analyzed does not contain the amount of protein claimed for it4 ,it also contains more starch than one might suspect from the company's analysis4 ,a more conservative claim would be 8starch less than #e per cent40 ,the company makes the error of using the terms 8starch0 and 8carbohydrates0 as synonymous4 ,if the maximum figures of the company's analysis are used1 the carbohydrates would amount to #e per cent41 whereas ,i find #ad4hd per cent4 ,the claim on the label 8,guaranteed to contain less than #e per cent4 of carbohydrates0 is incorrect4 ,the next claim1 8,each ounce of this gluten contains #bc grams of protein and represents #ie calories0 is approximately correct1 as my analysis shows #bj4i grams of protein and #ajc calories4 ,the following remarks under 8,vegetable ,proteins0 are in my judgment exaggerated3 8,leading authorities are now agreed that meat1 fish1 eggs and other animal proteins are greatly inferior to vegetable proteins in diabetes1 often increasing the sugar output and the dangerous acidosis which leads to diabetic coma4444 ,after many years of experimentation1 we have succeeded in perfecting a process whereby the carbohydrates are excluded40 ,in this connection1 von ,noorden1 whom the company constantly quotes1 says3 8,in the slighter forms 7of diabetes71 the influence of meat albumins is not great and it is difficult to demonstrate the reaction of the patient to different forms of albumin4 ,it may be necessary to add more albumin than the patient can actually take before glycosuria indication is reacted4444 ,once a medium amount of albumin is exceeded1 say #gj to #hj grams1 the glycosuria increases1 no matter what the type of albumin is40 ,my analysis also shows that the carbohydrates are not excluded from this food as claimed above4 #dj ,,per ,,cent4 ,,gluten ,,biscuit ,referee ,water #h4ej ,ash #a4dh ,protein 7,n #e4g7 #da4ae ,fiber #j4jh ,carbohydrates #dg4ha ,fat #j4ih ,starch #cf4ih ,no analysis is supplied by the company1 but this may be called properly a 8#dj per cent4 ,gluten ,biscuit40 ,the company claims1 however1 that this is 8,best for ,diabetics10 which is not true4 ,here1 as in the case of 8#dj per cent4 ,gluten ,flour10 the company's label attributes to 8,dr4 ,wm4 ,osler in #8,practice of ,medicine1'0 the following quotation3 8,of ,gluten ,foods1 many are very unpalatable1 others are frauds4 ,a ,good ,gluten ,flour is made by the ,battle ,creek ,sanatarium ,co41 ,mich40 ,i have no way of knowing to which gluten flour of the company ,dr4 ,osler had reference4 ,the 8,pure ,gluten ,meal0 might be called properly a 8good gluten flour10 but this 8#dj per cent4 ,gluten ,flour0 is no better1 and no worse1 than the average gluten flour on the market4 ,the quotation from ,osler gives an entirely false impression4 #dj ,,per ,,cent4 ,,gluten ,,flour ,referee ,company ,water #h4fb #e-aj ,ash #j4hi #j4e-a ,protein 7,n #e4g7 #cc4fc #dj-de ,fiber #j4jh #a-c ,carbohydrates #ee4ce #dj-de ,fat #a4dc #j4b-j4e ,starch #dh4jd 444 ,my analysis shows #f4cg per cent4 less protein than the company's minimum1 and #aj4ce more carbohydrates than their maximum4 ,in past years ,i have found the protein in this brand to range from #ce4j to #db4i per cent4 7using the factor #e4g74 ,it is true that the manufacturer does not state what protein factor is used in his reported analysis1 but as in four other brands #e4g is used1 it is fair to assume that the same factor applies to this as well4 ,at least such should be the case1 as otherwise the manufacturer's analyses would be meaningless4 ,even using the factor #f4be this later sample contains only #cf4hh per cent4 of protein4 ,the following statement1 in my judgment1 as applied to a food containing over #dh per cent4 of starch1 does not hold water3 8,this food is of special service in cases of ,glycosuria and in the milder forms of ,diabetes40 ,with this brand as with 8#dj per cent4 ,gluten ,biscuit0 the manufacturer again uses the misleading quotation from ,osler4 #dj ,,per ,,cent4 ,,gluten ,,meal ,referee ,company ,water #g4cj #e-aj ,ash #a4cf #a-b ,protein 7,n #e4g7 #da4ee #dj-de ,fiber #j4aj #a-b ,carbohydrates #dh4eh #dj-de ,fat #a4aa #j4b-j4e ,starch #cf4ei #dj-de ,the claimed analysis is justified by my findings4 ,i must take exception1 however1 to the following statement3 8,prepared with great care from a good grade of ,spring ,wheat1 by our special process1 which preserves the natural food properties of the product40 ,the company evidently tries to carry water on both shoulders1 on the one hand claiming a reduction in the starch content1 while on the other claiming the preservation of all 8the natural food properties40 #bj ,,per ,,cent4 ,,gluten ,,meal ,referee ,company ,water #g4fe #e-aj ,ash #a4bb #a-b ,protein 7,n #e4g7 #bd4fh #bj-cj ,fiber #j4ab #a-b ,carbohydrates #fe4da #fe-gj ,fat #j4ib #a-b ,starch #ea4bd #fe-gj ,the company's analysis is confirmed4 ,as the company claims directly that this is 8,not ,a ,diabetic ,food10 any criticism of its use for that purpose is disarmed4 ,however1 again exception must be taken to the statement that 8the natural food properties of the product0 are preserved4 ,,pure ,,gluten ,,meal ,referee ,company ,water #d4fj #e-aj ,ash #j4if #a-b ,protein 7,n #e4g7 #gf4gh #ge-hj ,fiber #j4jh #a-c ,carbohydrates #af4gg #j-e ,fat #j4ha #j4be-j4gj ,starch #f4gg #j-e ,the minimum claim as to protein is justified4 ,again the company confuses carbohydrates and starch1 and the food instead of containing from #j to #e per cent4 of 8carbohydrates 7starch70 actually contains #af4gg per cent4 of carbohydrates1 of which #f4gg per cent4 is starch4 ,once more the statement that 8the natural food properties0 are preserved is untrue as applied to a wheat product deprived of most of its starch4 ,in justice to the company1 it should be noted that on the labels of 8,pure ,gluten ,biscuit0 and 8,pure ,gluten ,meal0 appears the warning3 8,every person suffering from diabetes should be under the care of an experienced physician10 and on the label of 8#dj per cent4 ,gluten ,meal10 8,persons suffering from diabetes should use this food only on the advice of a physician40 ,on the other hand1 the suggestion on the label of 8,pure ,gluten ,meal10 8,write for a copy of ,diabetic ,foods and ,how to ,use ,them0 is a more or less direct invitation to self-treatment4 ,moreover1 a letter dated ,may #i1 #aiaf1 apparently dictated for the ,kellogg ,food ,company by one ,ruth ,french1 in reply to an inquiry from a layman1 gives direct advice with no reference whatever to a physician4 ,,claims ,,made ,,in ,a ,,letter ,,to ,a ,,layman ,in addition to this inconsistent attitude the letter makes certain clear misstatements1 as follows3 8#dj per cent4 ,gluten ,flour actually contains #dj per cent4 of pure ,gluten1 making it a perfectly safe article of diet in all but the gravest cases of diabetes4 ,from our ,gluten ,flour excellent bread1 gems and puffs are made that perfectly satisfy the craving for bread with no harmful results40 ,this flour contains #cc4fc per cent4 of gluten1 not #dj per cent42 it is not 8a perfectly safe article of diet in all but the gravest cases of diabetes10 for if one reads the literature correctly1 starch restriction is more necessary in mild than in severe cases of diabetes4 ,furthermore1 the bread1 gems and puffs made from such a flour do not 8satisfy the craving for bread with no harmful results40 ,in the next paragraph of the letter1 undue emphasis is laid on the 8objectionable properties0 of flesh foods1 a statement only in accord with the tenets of extreme vegetarians4 ,i also doubt very much whether the statement is true that 8under a diet of our diabetic foods the thirst to which diabetics are so often subject is usually very much relieved40 ,in the next paragraph the assertion is made that 8,the diet indicated 444 is in keeping with the ideas of the highest medical authorities4444 ,meat is entirely excluded from the dietary40 ,my reading of the literature does not show that the leading authorities take any such position4 ,later on reference is made to von ,noorden's claim as to the superiority of vegetable over animal proteins1 which ,i have already discussed under 8,pure ,gluten ,biscuit40 7,certain detached sentences of von ,noorden might justify such a statement1 but a reading of all he says on the subject leads to a very different conclusion47 ,,claims ,,made ,,in ,,an ,,advertising ,,booklet ,the whole booklet is written from the standpoint of an extreme vegetarian1 and therefore is often misleading in its conclusions4 ,page #e4 8,the researches of ,ogata and others have shown that cane sugar is a less wholesome food than the natural sugars found in fruits and produced in the body by the digestion of starch1 that is1 fruit sugars and malt sugars40 ,in opposition to this ,i quote from von ,noorden1 their own authority1 8,die ,zuckerkrankheit und ihre ,behandlung10 ,berlin1 #aiaj1 page #bgj3 8,that levulose1 milk sugar and inulin are more useful than the other carbohydrates is a common opinion1 but the importance of their use in practice does not correspond with the theory4 ,in light cases the form of carbohydrates makes little difference2 in severe cases the advantage from using levulose1 milk sugar1 etc41 is only slightly greater than from using bread and flour4444 ,only in certain cases does it appear to me that the special form of carbohydrates possesses any particular significance40 ,on page #ib of the same work von ,noorden tells us that of the carbohydrates dextrose is the worst1 with maltose almost as bad 7in spite of the fact that ,kellogg exploits his 8,meltose10 the 8new carbohydrate10 as of special value for diabetics74 ,he also says that levulose increases glycosuria only about half as much as dextrose1 when used occasionally1 but with long use it is as bad as dextrose and starch4 ,page #e4 ,the company refers to sugar as 8possibly also causing diabetes40 ,sugar or any other carbohydrate may under diabetic conditions cause an increase of glucose in the urine1 but ,i do not believe that any food or any diet can cause diabetes4 ,page #g4 8,that the large use of meat and eggs is not only detrimental but positively dangerous in many cases of diabetes is now a well known and recognized fact40 ,the dietaries of well known authorities on diabetes are not in harmony with this statement4 ,page #ac4 8,it has been discovered that the complete suppression of carbohydrates from the dietary is not only unnecessary but is highly detrimental and even dangerous40 8,the complete suppression of carbohydrates from the dietary0 is the only means the physician has to determine the diabetic's carbohydrate tolerance4 ,if carbohydrate-poor foods are so 8highly detrimental and even dangerous10 why does the company exploit foods like 8,pure ,gluten ,flour0 and 8,pure ,gluten ,biscuit10 whose chief claim to excellence is their comparative freedom from carbohydrates8 ,page #ag4 8,cream is an emulsion1 and1 with the exception of egg yolk1 is the only form in which animal fat is found in an emulsified state40 ,milk1 ,nature's most wonderful emulsion1 is apparently overlooked4 ,page #ai4 8444 these foods 444 will be found of great value 444 especially as substitutes for the breads and meats which are the most objectionable features of the ordinary diet1 and which should1 as far as possible1 be interdicted in this class of cases40 ,this is simply special pleading for the ,kellogg vegetarian diet4 ,page #ai4 8,our glutens 444 are all thoroughly standardized1 so that in their use the physician and the patient know just the amount of starch eaten40 ,this standardization is largely mythical4 ,for instance1 8,pure ,gluten ,biscuit0 claims #j to #e per cent4 8carbohydrates 7starch710 whereas ,i find #ad4hd per cent4 carbohydrates with #d4jb per cent4 starch4 8#dj per cent4 ,gluten ,flour0 claims #dj per cent4 gluten and #dj to #de per cent4 carbohydrates1 whereas ,i find #cc4fc and #ee4ce per cent41 respectively4 8,pure ,gluten ,meal0 claims #j to #e per cent4 8carbohydrates 7starch70 whereas ,i find #af4gg per cent4 carbohydrates and #f4gg per cent4 starch4 ,i have a record of six analyses each of 8#dj per cent4 ,gluten ,flour0 and 8#dj per cent4 ,gluten ,biscuit10 which show the hollowness of this claim of 8standardization40 ,the flour showed #cc4f1 #ce4j1 #db4i1 #cf4h1 #ce4f1 and #dj4i per cent4 of protein1 with from #dj4h to #ee4d per cent4 of carbohydrates2 the biscuits #cb4g1 #cc4b1 #ci4e1 #dc4c1 #cc4i1 and #da4b per cent4 of protein1 with from #da4a to #ed4j per cent4 of carbohydrates4 ,in fact1 my experience shows that the ,kellogg products are more poorly 8standardized0 than most of the diabetic foods on the market4 ,page #bj4 8,may be made to carry a large amount of fat in the form of butter1 a most desirable thing in the treatment of diabetes10 while on page #af the company claims that in an experiment of ,minkowski on a dog1 butter 8passed through the body without change1 none being absorbed02 these are certainly contradictory statements4 ,the explanation is that on the one page the company is exploiting its biscuits1 and on the other its nut preparations4 ,page #bj4 ,again the incorrect claim is made for 8#dj per cent4 ,gluten ,flour0 that 8we believe this to be the only standardized gluten flour made40 ,page #ba4 ,the claim is made that flesh foods are 8objectionable on account of the large amounts of ptomains and toxins which they contain40 ,i was not aware that fresh meats contained any ptomains whatever4 ,on the same page the claim is again made that by the use of the ,kellogg nut foods 8diabetics lose their thirst10 a claim which ,i think is more than doubtful4 ,page #bb4 8,nuts are a whole food1 containing all the elements required for the perfect nutrition of the body40 ,a marked characteristic of nuts is that they are not 8a whole food10 as with the exception of a few varieties1 such as the chestnut1 they are extremely poor in carbohydrates1 which fact gives them their value in the diabetic diet4 ,page #bc4 8,with the exception of the potato1 the beet and the carrot1 vegetables contain little sugar or starch40 ,corn1 beans and peas are all vegetables which are relatively high in carbohydrates1 and for this reason are specifically excluded from the diabetic's dietary4 ,from the foregoing considerations ,i would recommend that the company's analyses of 8#dj per cent4 ,gluten ,biscuit10 8#dj per cent4 ,gluten ,meal10 and 8#bj per cent4 ,gluten ,meal0 be accepted as correct4 ,before the ,council can accept any of these products1 the following steps should be taken3 ,the company on all its labels should correct the impression that 8carbohydrates0 and 8starch0 are synonymous terms4 ,the labels of all the preparations examined should be changed in accordance with the criticisms given above4 ,in all cases in which analytic data are given1 it would be preferable to state only the minimum of protein and the maximum of carbohydrates4 ,the booklet1 8,practical ,suggestions ,about ,diet in ,diabetes10 should be radically changed along the lines noted above4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #ef47 ,,iodo-,,mangan ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,iodo-,mangan1 made by the ,chemische ,fabrik ,helfenberg ,a4 ,g41 near ,dresden1 ,germany1 and sold in the ,united ,states by the ,reinschild ,chemical ,company1 ,new ,york1 is a solution said to contain iron1 manganese and iodin in combination with peptone4 ,it is claimed to be a reconstructive tonic and blood-making adjuvant1 with favorable action in affections of the glandular system4 ,it was admitted to ,new and ,nonofficial ,remedies in #aijg1 before the ,council had adopted the present ,rule #aj1 which provides that no article shall be admitted to ,new and ,nonofficial ,remedies which1 because of its unscientific composition1 is useless or inimical to the best interests of the public or of the medical profession4 ,in #aiaa the ,council considered the question whether or not this product was still eligible and decided in the end to retain it as probably having some merit4 ,to determine if ,iodo-,mangan was eligible for ,new and ,nonofficial ,remedies1 #aiag1 the ,reinschild ,chemical ,company was requested to send in the current advertising matter4 ,as this advertising was not sent in and as apparently the product was not marketed at the present time1 the ,council on ,pharmacy and ,chemistry voted to omit ,iodo-,mangan from ,new and ,nonofficial ,remedies4 ,at the same time the ,reinschild ,chemical ,company was informed that the preparation might be submitted for reconsideration at any time4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #fd47 ,,liquid ,,albolene ,report of the ,council on ,pharmacy and ,chemistry ,as now marketed1 ,liquid ,albolene 7,mc,kesson and ,robbins1 ,new ,york71 is claimed to be made only from genuine ,russian oil and hence to possess distinct advantages over 8444 ,oils purporting to be ,russian1 most of which are imperfectly purified and many of which are positively dangerous for continued use40 ,on the other hand1 a short time ago1 ,mc,kesson and ,robbins claimed that ,liquid ,albolene was then available4 8444 ,of as high a quality as we had supplied before the ,european ,war4 ,thanks to the research and scientific achievement of ,our ,chemists1 we are now able to offer ,,liquid ,,albolene1 using as a base a specially refined ,domestic ,oil that is in every way suitable for medicinal purposes1 and having the same viscosity as ,russian ,oil40 ,the advertising matter suggests the promiscuous1 thoughtless and irrational use of ,liquid ,albolene and of a number of ,albolene preparations by extravagant claims1 such1 for example1 as the following3 8,albolene will never fail to bring a free1 easy stool1 no matter what condition may be present1 from obstinate atony of the bowel to fissure1 fistula1 or even malignant disease1 and in spite of the failure of ordinary purgatives to which the patient may have become habituated4444 8,aromatic ,liquid ,albolene is actually the first laxative presented to the medical profession that seems to have no drawback4444 8,it will not have been lost upon the physician who has read the remarks on the use of ,aromatic ,liquid ,albolene to regulate the bowels in surgical cases1 that there are many instances where it would prove equally valuable during the treatment of acute diseases4 ,in the exanthemata1 in pneumonia1 for example1 to cite only a few of the conditions where it may be used to advantage1 an absolutely reliable laxative that will not in any way weaken or distress the patient1 presents obvious superiority to any of the agents heretofore in common use40 ,the ,council held ,liquid ,albolene ineligible because the product is marketed in a way to encourage its indiscriminate and irrational use by the public 7,rule #d7 and because unwarranted therapeutic claims are made for it 7,rule #f74--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #fe47 ,,naphey',s ,,medicated ,,uterine ,,wafers ,report of the ,council on ,pharmacy and ,chemistry ,naphey's ,medicated ,uterine ,wafers were submitted to the ,council by the manufacturers1 ,naphey ,co41 some years ago and were rejected4 ,naphey ,co4 has recently requested reconsideration of the preparation1 and has submitted advertising matter1 trade packages and sample packages4 ,the label of the trade package contains the following3 8,naphey's ,wafers4 ,for the local treatment of diseases of women1 indicated in catarrhal conditions of the vagina1 and of the uterine cervix4 ,as a sic6 adjuvant for the physician to use in carrying out treatment of disease of the uterus40 8,zinc ,sulphate1 #c-c_/d gr41 ,sodium ,sulphate1 #c-a_/b gr41 ,sodium ,borate1 #d gr41 ,boric ,acid1 #c_/d gr40 8,naphey ,co41 ,warren1 ,pa41 ,u4 ,s4 ,a40 8,each box contains #be wafers1 sufficient for three months' treatment4 ,price per box1 #be;c40 ,in name1 composition1 and general appearance of the package1 ,naphey's ,medicated ,uterine ,wafers bear a strong resemblance to ,micajah's ,medicated ,uterine ,wafers 7,the ,journal1 ,a4 ,m4 ,a41 ,march #bf1 #aiaj1 p4 #ajgj74 ,an advertising pamphlet reads3 8,in every form of leucorrhea ,naphey's ,medicated ,uterine ,wafers are indicated 4440 8,what is true of leucorrhea is also true of all other functional troubles affecting the female genital canal2 they are all treated best by astringents and antiseptics4 ,and these1 to be effective1 must be applied in prolonged contact40 ,the implication that all 8functional troubles affecting the female genital canal0 are best treated by astringent tablets like ,naphey's ,medicated ,uterine ,wafers is an absurdity4 ,the naming of disease conditions on the label1 the manifestly unwarranted and exaggerated therapeutic claims1 the name1 which is non-descriptive of composition but suggestive of use1 and the fixed formula1 which cannot rationally be expected to give uniformly satisfactory results in the wide range of conditions for which the product is recommended1 render ,naphey's ,medicated ,uterine ,wafers ineligible for ,new and ,nonofficial ,remedies under ,rules #d1 #f1 #h and #aj4 ,the report having been sent to ,naphey ,co41 the manufacturer offered1 on condition that the preparation be accepted1 to revise the advertising matter in minor particulars1 to remove disease names from the trade package and to adopt the name ,naphey's ,wafers or ,naphey's ,tablets4 ,the ,council advised ,naphey ,co4 that the proposed names do not conform to the requirements for acceptance in ,new and ,nonofficial ,remedies because they do not indicate the composition of this pharmaceutical mixture1 and moreover1 that the routine use of a complex formula such as that of these tablets is irrational4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #ff47 ,,nujol ,report of the ,council on ,pharmacy and ,chemistry ,nujol1 a liquid petrolatum 7,standard ,oil ,company of ,new ,jersey1 ,bayonne1 ,n4 ,j471 was submitted to the ,council by the manufacturers4 ,the ,council advised the company that1 before ,nujol could be made eligible for ,new and ,nonofficial ,remedies1 the advertising claims made for it must be revised to conform to the rules of the ,council and the term 8liquid petrolatum0 must be used in connection with the brand designation and given equal prominence on the labels1 advertisements and all circulars4 ,the company thereupon submitted a label on which the name 8,nujol0 appeared in large red letters and under it in small letters the words 8,liquid ,petrolatum40 ,this did not meet the ,council's requirement with regard to the name4 ,moreover1 ,nujol continued to be advertised to the public under exaggerated and unwarranted claims4 ,the foregoing report was sent to the ,standard ,oil ,company of ,new ,jersey1 which thereupon submitted revised advertising copy4 ,this copy was decidedly less objectionable than the previous advertising but still contained exaggerated statements4 ,the copy for use in lay journals particularly evidenced exaggeration4 ,observation on many occasions of a similar fact has convinced the ,council of the inexpediency of admitting to ,new and ,nonofficial ,remedies any article which is advertised to the public4#aja #aja ,since publication of this report the ,council on ,pharmacy and ,chemistry has revised its rule against recognition of articles advertised to the public so that this shall not apply 7a7 to disinfectants1 germicides and antiseptics1 provided the advertising be limited to conservative recommendations for their use as prophylactic applications to superficial cuts and abrasions of the skin and to the mucous surfaces of the mouth1 pharynx and nose1 and provided they are not advertised as curative agents1 and 7b7 to non-medicinal food preparations1 except when advertised in an objectionable manner4 ,the ,council held that conflict with ,rules #c1 #f and #h prevented the acceptance of ,nujol and authorized the publication of this report4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #fh47 ,,pulvoids ,,natrium ,,compound ,report of the ,council on ,pharmacy and ,chemistry ,pulvoids ,natrium ,compound was submitted to the ,council by the ,drug ,products ,company1 ,inc41 ,new ,york1 with the statement that each pulvoid 7coated tablet1 said to be made to dissolve in the intestinal tract7 represents the equivalent of3 ,potassium ,nitrate #b-a_/b grs4 ,sodium ,nitrite #a_/b gr4 ,sodium ,bicarbonate #b grs4 ,fl4 ,ext4 ,crataegus ,oxycantha #a min4 ,nitroglycerin #a_/bej gr4 ,according to the advertisements the tablets are 8indicated in the treatment of high blood pressure and all forms of hypertension of the cardio-vascular system40 ,it is claimed that the tablets 8will not irritate the kidneys40 ,the ,council1 having submitted its objections to the manufacturer and considered the firm's reply1 held that ,pulvoids ,natrium ,compound was inadmissible to ,new and ,nonofficial ,remedies for the following reasons3 #a4 ,the claim is made that the tablets disintegrate in the intestines2 experiments conducted by the ,council indicated that in most cases they would be broken up in the stomach4 ,it was found that the tablets were visibly changed immediately after being put into gastric juice or even into distilled water2 they disintegrated within from three to four hours1 not only in gastric juice 7obtained from a dog7 at #cg ,c41 but also in distilled water4 ,it is quite usual for solids to remain in the stomach for more than three hours4 ,if they make their way out of the stomach in less than that time the gastric movements must be so vigorous as further to hasten the disintegration of the tablets4 #b4 ,the rules of the ,council require that the name of a pharmaceutical mixture shall indicate the potent ingredients4 ,the name of this mixture does not indicate the presence of the nitrites1 the potassium nitrate1 the bicarbonate or the extract of hawthorne and the nondescriptive name is likely to lead physicians to use the tablets without fully realizing what they are giving4 #c4 ,no evidence was submitted that the tablets1 as found on the market1 contained the amount of sodium nitrite and nitroglycerin claimed4 ,that is1 it does not appear that the manufacturer checks the sodium nitrite and nitroglycerin content by analysis4 ,the ,council did not determine the nitrite content of the tablets4 ,it maintains that when a manufacturer places a product on the market the burden of proof is on that manufacturer to show that the facts are in accordance with his claims for his product4 ,further1 the examination by the ,council of one or several specimens of any commercial product 7particularly in the case of nitroglycerin preparations7 would not be a guarantee of the constancy of its composition so long as the manufacturer does not himself control the composition by analysis4 ,the necessity of such control of tablets containing nitroglycerin is evident from the report#ajb of ,l4 ,f4 ,kebler of the ,u4 ,s4 ,bureau of ,chemistry4 ,dr4 ,kebler said3 #ajb ,j4 ,a4 ,m4 ,a41 ,nov4 #b1 #aiab1 p4 #afjd4 8444 nitroglycerin tablets have in a majority of cases been found deficient in the nitroglycerin content declared40 8444 these commodities are manufactured largely by rule of thumb4 ,little checking obtains in their manufacture and generally no analyst is employed40 ,a further proof that nitroglycerin tablets are likely to be deficient in strength is contained in the convictions under the ,food and ,drugs ,act of manufacturers who sold tablets below the declared strength1 recorded from time to time 7,notices of ,judgments ,nos4 #cdje1 #bjei1 #ahdc1 #agii74 #d4 ,there is no good evidence1 experimental or clinical1 to justify the simultaneous administration in fixed proportion of two vasodilators like sodium nitrite and glyceryl trinitrate 7nitroglycerin74 ,also there is no rational excuse for combining extract of hawthorne1 which is said to have a tonic effect on the heart muscle1 with nitrites1 which cause relaxation of the vascular system1 or for the combination with these constituents of potassium nitrate or of sodium bicarbonate4 ,in the absence of evidence for the combination1 ,pulvoids ,natrium ,compound must be considered an irrational mixture1 the use of which is a detriment to sound drug therapy and1 hence1 not admissible to ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #fi47 ,,saloform ,report of the ,council on ,pharmacy and ,chemistry ,a referee submitted the following report of the ,american ,medical ,association ,chemical ,laboratory to the ,council3 ,,analysis ,,of ,,saloform ,saloform 7,flexner7 is advertised by the ,robinson-,pettet ,company of ,louisville1 ,ky4 ,in the advertisements for the product it is stated that3 8,saloform is a definite chemical compound the component parts of which are ,hexamethylene ,tetramine1 ,salicylic ,acid and ,lithia40 8,as a ,uric ,acid ,solvent it is indicated in ,rheumatism1 ,gout1 in ,phosphaturia1 in ,gravel1 and in ,renal ,colic40 8,as a ,genito-,urinary ,antiseptic it limits suppuration anywhere along the ,urinary ,tract1 from the ,kidneys down to the orifice of ,urethra40 ,as1 even after diligent search1 no description of a compound of hexamethylenamine 7hexamethylenetetramine71 salicylic acid and lithia was found in chemical literature1 it seemed probable that ,saloform is merely a mixture of hexamethylenamine and lithium salicylate4 ,accordingly the separation of ,saloform into its component parts by means of selected solvents was attempted4 ,by triturating the powder with chloroform1 filtering and evaporating the filtrate1 a residue was obtained which gave satisfactory tests for hexamethylenamine but contained only traces of salicylic acid or lithium salicylate4 ,the portion insoluble in chloroform was dissolved in water4 ,the solution gave satisfactory tests for lithium salicylate but not for hexamethylenamine4 ,from these tests it is evident that ,saloform is a simple mixture of hexamethylenamine and lithium salicylate4 ,quantitative examination indicated that the two ingredients1 hexamethylenamine and lithium salicylate1 are present in approximately equal amounts4 ,,referee',s ,,recommendation ,the report of our ,chemical ,laboratory shows that ,saloform is not a definite compound as claimed1 but a simple mixture of hexamethylenamin and lithium salicylate4 ,it is therefore in conflict with ,rule #a4 ,it is also in conflict with ,rule #f1 for neither hexamethylenamin1 lithium1 nor salicylate are therapeutically effective 8uric acid solvents02 nor would any of these have any effect on 8phosphaturia40 ,the mixture also conflicts with ,rule #aj2 for it is inadvisable to administer the ingredients in fixed1 but unknown proportions4 ,it is recommended that ,saloform be deemed inadmissible to ,n4 ,n4 ,r4 ,the ,council adopted the recommendation of the referee and authorized publication of this report4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #ga47 ,,secretogen ,report of the ,council on ,pharmacy and ,chemistry ,about a year ago the ,council declared ,secretogen1#ajc a product the active ingredient of which was stated to be 8pancreatic secretin0 and advertised as a remedy for certain conditions of defective digestion and assimilation1 to be ineligible for ,new and ,nonofficial ,remedies4 ,the reasons for this decision were stated at the time as follows3 #ajc ,j4 ,a4 ,m4 ,a41 ,may #a1 #aiae1 p4 #aeah4 8#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 8#b4 ,there is no evidence that secretin in any form is physiologically active when administered by mouth40 ,since ,secretogen was not the only so-called secretin preparation on the market1 and since the use of secretin preparations was recommended by certain writers1 notwithstanding the lack of evidence of its value1 the ,council caused an experimental investigation of the question to be made4 ,this was carried out by ,prof4 ,a4 ,j4 ,carlson of the ,university of ,chicago4 ,no secretin was found in the commercial products examined1 namely1 ,secretogen ,tablets1 ,secretogen ,elixir and ,duodenin4 ,furthermore1 ,carlson's results#ajd confirmed the ,council's previous conclusion as to the inertness of secretin administered by mouth4 ,the ,council endorsed ,professor ,carlson's findings4#aje #ajd ,carlson4 ,a4 ,j42 ,lebensohn1 ,j4 ,e41 and ,pearlman1 ,s4 ,j42 ,has ,secretin a ,therapeutic ,value8 ,j4 ,a4 ,m4 ,a41 ,jan4 #ae1 #aiaf1 p4 #agh4 ,reports ,council on ,pharm4 and ,chem41 #aiae1 p4 #ih4 #aje ,so-,called ,secretin ,preparations1 ,j4 ,a4 ,m4 ,a41 ,jan #ae1 #aiaf1 p4 #bjh2 ,reports ,council on ,pharm4 and ,chem41 #aiae1 p4 #if4 ,the ,g4 ,w4 ,carnrick ,company has replied to the publication of this report in the letter printed below4 7,a portion of this letter1 which consists of a communication from an unnamed correspondent of the ,g4 ,w4 ,carnrick ,company and the company's comment thereon1 has been omitted47 ,the ,council offered to publish this if the ,carnrick ,company would furnish the name of the writer4 ,this it has not done4 ,as will be seen1 the company now shifts ground1 abandoning entirely the claim that ,secretogen contains secretin4 ,the ,council has authorized publication of the letter 7omitting the part just mentioned71 together with the comment that follows4 ,w4 ,a4 ,,puckner1 ,secretary4 8,the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association4 8,gentlemen3--,the opinion of the ,council and the contribution by ,professor ,carlson which appeared in ,the ,journal of the ,american ,medical ,association for ,jan4 #ae1 #aiaf1 have been read by us with interest4 ,the column of ,current ,comment dealing with #8,tiger-,bone ,therapy and ,clinical ,experience' has appealed to our good nature and1 under the circumstances1 our sense of humor4 8,professor ,carlson seems to have quite well established that the so-called secretin preparations do not contain secretin to any appreciable extent1 and that they are inert in laboratory experiments on normal animals4 ,at the same time1 to do away with an apparent discrimination on the part of the management of the ,council1 it would have been well if ,professor ,carlson had included the so-called secretin preparations belonging to another well-known firm which markets such a product4 ,this discrimination has already been referred to by us4 8,had ,professor ,carlson stopped at the determination of the therapeutic availability of secretin given by mouth1 his work might have been accepted without comment1 even if we should have thought it advisable to object to the matter published by the ,council4 ,but the professor went beyond his province entirely when1 in commenting on the findings obtained by using ,secretogen clinically1 he said3 #8,it is1 perhaps1 impertinent for laboratory men to comment on these clinical results4' ,it is4 ,his point was well taken and it is a profound pity that ,professor ,carlson did not observe his own ruling4 8,in the words of a correspondent of ,the ,journal of the ,american ,medical ,association1 in discussing ,professor ,carlson's criticism of ,dr4 ,crile's #8,kinetic ,drive1' #8it behooves the laboratory man to be circumspect in his criticism of clinical theories1 since going beyond the bounds of well-established things weakens his position1 not merely with reference to the particular subject under discussion1 but with reference to clinical phenomena in general4' ,clinical results have definitely established the value of ,secretogen4 ,as the matter now stands this statement is beyond criticism4 8,when ,secretogen was first introduced we assumed that it depended on secretin for results produced4 ,in this assumption we were in good company1 as witnessed by the testimony of ,moore1 ,edie and ,abram when1 in the course of their investigations as to the value in diabetes of a secretin-bearing extract given by mouth1#ajf they said3 #8,in the majority of these cases 444 there has been no appreciable fall in the output of sugar 444 in some of these negative cases there has been noted1 however1 improvement in the digestion and1 in certain cases1 the patient's weight has increased4' ,they also state that the secretin-bearing product #8appears to stimulate the functional activity of the duodenum4'#ajf ,they give a most significant report4#ajg ,we quote from the paper as follows3 #ajf ,all italics are ours4 ,g4 ,w4 ,carnrick ,company4 #ajg ,bio-,chem4 ,jour4 #a3bh1 #aijf4 8#8,the patient had been under observation for six months before treatment and the sugar was not reducible by diet4 ,almost at once the dyspepsia from which he was suffering was relieved and his general nutrition improved to such an extent that he regained over eighteen pounds in weight1 which he had previously lost1 and this improvement was accompanied by complete recovery of his physical and mental energies4'#ajf 8,inasmuch as this improvement could not have been due to the contained secretin it must have been due to some other principle contained in the extract4 ,our experience and that of the physicians who have used ,secretogen establish the fact that ,moore1 ,edie and ,abram made no mistake when they came to the conclusion that what they termed a secretin-bearing extract stimulates the functional activity of the duodenum and improves the digestion4 8,when ,professor ,carlson was investigating ,secretogen he must have realized that he was dealing essentially with an extract of the duodenal mucosa4 ,it is1 therefore1 all the more surprising1 considering his extensive researches into the literature1 that he should have ignored the testimony of some of his own authorities1 particularly ,hallion1 as to the value of extracts of the duodenal mucosa in duodenal insufficiencies4 ,the meticulous carefulness with which this evidence was avoided is hardly worthy of the best traditions of physiology1 a science which has truth for its first and last aim4 8,hallion in his #8,la ,pratique de l',opothrapie' says that the #8aims of duodenal opotherapy are3 #a1 ,to supply deficient duodenal juice4 #b1 ,above all to stimulate and to relieve this organ--notably to aid the production of secretin#d--;and so profit by the stimulating action which duodenal extract exercises on the duodenal mucosa which action we1 ,enriquez and myself1 believe and have experimentally proved1 conforms to the general principles of opotherapy4 #c1 ,by means of the production of secretin1 to reinforce the biliary1 pancreatic and intestinal secretions4 #d1 ,to stimulate intestinal peristalsis4 8#8,principal indications3 ,intestinal dyspepsias1 intestinal autointoxications1 certain forms of constipation and duodenal insufficiency4' 8,at the ,international ,congress of ,medicine1 ,madrid1 #aijc1 ,hallion said that he felt justified in stating that duodenal opotherapy correctly carried out must be classed under the very best methods of treating dyspepsia4#ajf ,the results had been satisfactory and1 in many cases1 remarkable4 ,it had been nil in a few cases but it had never been harmful in any degree4 ,he pointed out that ,marfan was the first to employ this substance clinically4 ,marfan had had particularly excellent results in children of #ae months to #d years suffering with marked malnutrition1 anorexia and constipation4 ,marfan prescribed the duodenal extract given in milk4#ajf ,hallion further remarks that1 as he is not a practitioner1 he had had only one opportunity to test duodenal opotherapy clinically4 ,the case was that of a man of #bf years with obstinate intestinal dyspepsia and severe constipation which had persisted from childhood4 ,this patient had been treated by enemas1 laxatives1 diet1 etc4 ,treatment with duodenal extract resulted in a complete cure4#ajf ,hallion points out that the most satisfactory aspect of duodenal opotherapy is the permanent effect produced1#ajf which bears out his statement that these extracts have the power to aid in the restoration of function and structure of an organ4 8,this has been so well established that the principle is now embodied in a law which is frequently referred to as #8,hallion's ,law'3 #8,extracts of an organ exert on the same organ an exciting influence which lasts for a longer or shorter time4 ,when the organ is insufficient it is conceivable that this influence augments its action and1 when it is injured1 that it favors its restoration4' 8,in #8,la ,pratique de l',opothrapie' ,hallion points out that #8the opotherapeutic product which corresponds to the affected organ represents in some way the stimulating and elective food for that organ1 and if we supply the organ with a food which is more complete than it necessarily needs1 the affected organ can exercise its elective action and take up only those substances of which it is in need4' 8,hallion's observations on this point are beautifully borne out by the classic work of ,j4 ,w4 ,draper1 as reported in ,the ,journal of the ,american ,medical ,association1 ,sept4 #bf1 #aiad4 ,this report gives results in both laboratory and clinical experiments4 8,in order to show that fed jejunal and ileac epithelium exercise some special detoxicating power1 not yet understood but definitely recognizable1 ,draper fed a control series of dogs with intestinal obstruction1 experimentally produced1 on emulsified cells of liver1 spleen1 pancreas and muscle tissue4 ,these animals lived a few hours longer than not-fed controls1 but ,draper says that it is evident that these cells had either no detoxicating action1 or a very feeble one compared with intestinal epithelium4 ,he used jejunal and ileac epithelium clinically in two instances3 #ast1 ,in a female dog which had had #8chronic stomach trouble' for six months4 ,when ,draper saw her she had had complete intestinal obstruction for five days1 with symptoms of tachycardia1 extreme nervousness and great weakness in the hind legs4 ,draper removed a pebble from her intestine but her condition was still grave4 8,she was immediately put on small-intestine epithelium derived from two dogs of different breed4 ,draper says that from a long experience with duodenally obstructed dogs1 he should not have expected her to recover1 but the symptoms gradually subsided and she lived4 ,the second instance in which he used the epithelium therapeutically was in the case of a man who suffered from an annular cancer of the intestine with definite symptoms of obstruction4 ,after the operation1 and realizing that the patient was in a desperate condition1 he fed him an emulsion of intestinal epithelium from a dog4 ,the pulse improved and the patient lived4 8,some of ,draper's conclusions are as follows3 8#8,autotoxemia in intestinal obstruction undoubtedly arises from an interference with cellular reactions of the intestinal epithelium4444 ,when small-intestine epithelial cells of healthy animals are placed in the stomach#ajf of duodenally obstructed animals1 such animals have lived nearly twice as long as not-fed controlled animals4 ,this evidence is strongly opposed to the bacterial theory of origin of toxins4' 8,the point to be emphasized is this3 ,if this emulsion of intestinal epithelium had been fed to a normal dog and a normal man1 what would have happened8 ,absolutely nothing4 ,on the other hand1 given as it was to a dog and a man in desperate need it exercised a potent effect4 8,abundant clinical testimony can be cited in support of the opinions of ,moore1 ,edie and ,abram1 ,hallion1 ,marfan and ,draper as to the value of extracts of the intestinal mucosa given by mouth in pathological conditions4 ,we have previously cited the published favorable opinions of such gastroenterologists as ,anthony ,bassler1 ,lewis ,brinton1 ,g4 ,r4 ,lockwood1 and ,r4 ,c4 ,kemp1 so there is no need to recapitulate their experiences with what they honestly believed to be secretin-bearing extracts1 but which were essentially extracts of the duodenal mucosa4 8,supplementing the evidence of these men as to the value of these extracts we submit an excerpt from a letter from one of the best known physicians of ,edinburgh3 8#8,i can speak in very high praise of ,secretogen1 which ,i have used in both tablet form and as the elixir4 ,there is no doubt about its value in a certain class of intractable indigestion which refuses to be benefited by any other remedy4 ,on several occasions ,i have been much gratified by the definite relief obtained in this class of cases4 ,it hits the mark also in some types of obstinate constipation--,i think those cases where the trouble is wrapped up in impaired enervation of the intestine1 and where stasis occurs at certain segments of the canal4' 8,hallion very pertinently points out#ajh that it is now accepted that opotherapy is not substitutive1 but homostimulative and he remarks further that it is well to bear in mind that the so-called active substances which make the extract efficacious need not necessarily be the hormones4 #8,it may be the elements of tissue structure which may come to the aid of the injured organ4 ,the hormone should not therefore be looked on as the only active agent of opotherapy and1 while its action is important1 it need not necessarily be preponderant4 ,the chemical isolation of the hormones is1 of course1 of interest but may not be as vital to organotherapy as we have thought4' 4440 #ajh ,presse ,mdicale1 #aiab1 p4 #dcc4 ,,comment ,,by ,,the ,,council ,,on ,,pharmacy ,,and ,,chemistry ,the ,g4 ,w4 ,carnrick ,company1 which formerly claimed that ,secretogen was efficacious because it contained secretin1 now admits this claim to be unfounded4 ,notwithstanding1 the manufacturers still call their product ,secretogen and make for it practically the same therapeutic claims as before4 ,they now base these claims on vague 8principles of opotherapy0 and on so-called 8clinical testimony40 ,the burden of proof rests on them to show that these old claims1 already discredited but put forth again on new grounds1 are justified4 ,have they done so8 ,the 8clinical te stimony0 is not convincing4 ,so much of it as is definite enough to permit of criticism has already been dealt with4 ,the remainder consists of mere assertions2 it is not through reliance on such evidence that the ,council can discharge its trust4 ,on this side of the question there is nothing new to be said--reassertion of a refuted argument does not constitute fresh proof4 ,nor is the case better on the experimental side4 ,the statements of ,hallion1 ,enriquez1 ,zuelzer and others#aji as to the existence of a 8peristaltic hormone0 not only have failed of confirmation1 but also have been positively discredited4 ,with regard to ,draper's work1 which dealt with acute intestinal obstruction1 it is difficult to see what is its relevance to the present issue1 particularly since ,draper's results were obtained with a product derived from the mucosa of the jejunum and ileum and not with an extract of the duodenum such as ,secretogen purports to be4 #aji ,cf4 interal4 ,schagindweit1 ,e43 ,experimentelle ,versuche mit ,hormonal1 ,arch4 ,internat4 de ,pharmacod41 #aiac1 p4 #gg4 ,the innuendo that the ,council discriminates in favor of certain manufacturers1 is itself a confession of weakness4 ,in publishing this correspondence the ,council's sole object is to put the medical profession in possession of the exact facts of the case4 ,these may fairly be summed up as follows3 #a4 ,secretogen was originally marketed as a preparation containing secretin4 ,none was found in it4 #b4 ,notwithstanding proof of this fact1 the ,g4 ,w4 ,carnrick ,company retain the original name of the product1 knowing that1 by its association with their former erroneous assertions concerning ,secretogen1 this name must inevitably convey to a physician using the product the impression that he is administering secretin4 ,in the advertising literature no hint is given that this original statement was erroneous4 #c4 ,the product called 8,secretogen0 has not been shown1 either experimentally and by sound clinical evidence1 to possess useful therapeutic properties4 ,under these circumstances the ,council reaffirms its decision4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiaf1 p4 #gb47 ,,iron ,,citrate ,,green ,report of the ,council on ,pharmacy and ,chemistry ,h4 ,k4 ,mulford ,company and ,e4 ,r4 ,squibb and ,sons submitted to the ,council ampules containing solutions of iron citrate green4 ,it thus became necessary to consider the eligibility of iron citrate green itself for admission to ,new and ,nonofficial ,remedies4 ,as the rules of the ,council provide that nonessential modifications of official or nonproprietary preparations will not be recognized1 the above named firms were asked to state what advantages1 if any1 the so-called iron citrate green had over the official iron and ammonium citrate4 ,in reply the ,h4 ,k4 ,mulford ,company wrote that it had come to the conclusion that iron citrate green and ampules thereof would undoubtedly be considered by the ,council as a nonessential modification of an official product1 adding3 8,it seems to differ from the official ferric citrate so far as essentials go only in color1 but custom1 which is exceedingly hard to change in ,south ,america1 demands that this green variety of ampules be used in place of the official product40 ,in reply to a similar letter of inquiry ,e4 ,r4 ,squibb and ,sons wrote3 8,iron citrate green 7iron and ammonium citrate green7 differs from the ,u4 ,s4 ,p4 iron and ammonium citrate in that it contains less iron and more citric acid and more ammonium citrate than does the latter4 ,it is of course a modification of the official salt and is supplied to meet a real demand4 ,its reaction is quite decidedly acid and our present stock contains ,fe slightly below the ,u4 ,s4 ,p4 requirements for iron1 assaying #ae4gd per cent4 instead of #af per cent4 ,fe4 ,the tests used to control its quality are those for the official product except as before indicated1 it is always acid instead of neutral1 as the ,u4 ,s4 ,p4 requires for that salt40 ,the smaller iron content 7#ih per cent4 of the ,u4 ,s4 ,p4 requirement7 of the green variety referred to by ,e4 ,r4 ,squibb and ,sons is so small as to be negligible4 ,further1 the low iron content as well as the acidity of the green salt would appear to be detriments rather than advantages4 ,inasmuch as no evidence has been presented to show that iron citrate green is superior in any way to the well-known iron and ammonium citrate the ,council held that iron citrate green1 and with it the dosage forms1 was ineligible to ,n4 ,n4 ,r4 ,the preceding report was submitted to the ,mulford ,company and to ,e4 ,r4 ,squibb and ,sons for comment before publication4 ,the former firm replied that in the present case it felt bound to supply the existing demand1 the latter replied that1 to give the ,council its support in this matter1 the sale of iron citrate green and ampules thereof would be discontinued4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ac1 #aiag47 ,,aspirin ,report of the ,council on ,pharmacy and ,chemistry ,the referee's report on ,aspirin-,bayer which follows was submitted to the ,council and adopted by it and1 in accordance with the referee's recommendation1 was sent to the ,bayer ,company1 ,inc4 ,the company's reply contained nothing to warrant the continued recognition of this product by the ,council4 ,it was accordingly directed that ,aspirin-,bayer be omitted from ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,,referee',s ,,report ,the referee's attention has been called to the systematic campaign of advertising aspirin to the public4 ,he is informed that tablets have been marketed for some time in 8vest-pocket0 boxes1 bearing the name 8,aspirin0 permanently affixed1 which is in technical conflict with the ,council's rule against indirect advertising to the public4 ,more recently1 conspicuous advertisements have appeared in daily papers4 ,these are technically in conflict with the rule against direct advertising to the public4 ,in addition to the plain technical conflicts with the ,council's rules there is a feature of the case which has not hitherto been raised and which should be fully considered3 ,it may be remarked that the advertisements contain no therapeutic recommendation1 and do not1 on their face1 urge the public to employ aspirin but apparently merely tell the public how it may protect itself against sophistication4 ,in substance1 they say3 8,if you are a user of aspirin1 this is how you may obtain the genuine40 ,it might be said that this is not an attempt to increase the use or sale of aspirin--the ordinary object of advertising--but that the means of protection against adulteration is a 8subject on which the public should be instructed40 ,the principle of such exceptions is stated in the comments to ,rule #c 7,new and ,nonofficial ,remedies1 #aiaf1 p4 #ae72 and although the present case does not come under the exceptions specified under these comments1 it may be urged that the exceptions need to be increased as occasion arises4 ,the notorious adulteration of aspirin may well be urged as establishing a need for a similar exception in its use4 ,the general principle of protecting the public against fraud1 adulteration and substitution is directly in line with the objects of the ,council1 and deserves commendation and support4 ,it is obvious1 however1 that the means adopted for this end must be efficient1 that they must not open the door to other1 perhaps greater evils and that they must be used in good faith4 ,the policy of advertising 8,aspirin-,bayer0 must be examined in these respects4 ,in the first place1 the acceptance of a product by the ,council implies an agreement by the manufacturers or agents that they will adhere strictly to the ,council's rules and will not depart from the letter or spirit of these rules without notice to the ,council4 ,this principle has been grossly infringed in the present case4 ,there can be no doubt that the agents were aware that their advertisements conflicted1 at least with the letter of ,rule #c4 ,nevertheless1 they did not1 in any way1 inform the ,council of the change in policy4 ,in this respect1 at least1 they have not acted in good faith4 ,secondly1 the wording of the advertisement implies that only the tablets stamped with 8,the ,bayer ,cross0 are genuine4 ,this is misleading1 since every druggist has the right to make unstamped tablets of aspirin1 fully as genuine as those stamped with the cross4 ,thirdly1 the cross itself cannot be considered an efficient protection2 for people who imitate aspirin will not hesitate to imitate the stamp4 ,the remedy1 in either case1 and as with any other drug1 is the examination of trade samples1 and the vigorous prosecution of those guilty of violating the law4 ,fourthly1 the permanent affixing of the name 8,aspirin0 to the vest-pocket boxes is also inefficient as a protection1 and serves mainly as an advertisement4 ,fifthly1 whatever may have been the motives of the advertisers1 and however carefully the advertisements are worded1 they will inevitably tend to increase the use of aspirin by the public1 and this is directly against the interests of public health4 ,the public does not know1 as physicians do1 that headaches are merely symptoms of other1 sometimes very serious conditions2 and that they are often the signal for the need of a thorough physical examination and diagnosis4 ,it is true that they are often also the symptoms of very minor derangements1 which will right themselves spontaneously2 and that1 in such cases1 drugs like aspirin may give relief and may do no harm4 ,the patient1 however1 is not educated to distinguish one class from the other1 and therefore anything that tends to promote the indiscriminate use of such remedies as aspirin is detrimental to the public health4 ,furthermore1 aspirin itself is not always harmless4 ,alarming idiosyncrasies are sufficiently common that the use of the first doses1 at least1 should require medical supervision4 ,with these considerations in mind1 the referee is of the opinion that the direct and indirect advertising of aspirin is to be condemned4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bj1 #aiag47 ,,pil4 ,,cascara ,,compound-,,robins ,report of the ,council on ,pharmacy and ,chemistry ,a circular issued by the ,a4 ,h4 ,robins ,company of ,richmond1 ,va41 contains the following statement3 8,,pil4 ,,cascara ,,compound-,,robins is a rational therapeutic formula1 composed of ,,cascara1 ,,podophyllin1 ,,colocynth and ,,hyoscyamus1 which promotes a natural flow of secretions1 which is1 in turn1 the physiologic stimulant of peristalsis4 ,thus1 a normal evacuation is produced without subsequent inhibition4 8,they contain no ,mercury1 ,strychnia nor ,belladonna4 8,an ideal aid to any remedial agent1 when a ,mild1 ,medium or ,strong alimentary stimulant is needed sic4 8,made in two strengths1 the dosage may be easily regulated so as to obtain the effects of an ,anti-,dyspeptic1 ,aperient1 ,laxative or ,cathartic1 as desired4 ,they never cause discomfort unless given in larger dose than needed40 ,this preparation is another example of the innumerable mixtures of well-known drugs having nothing in the way of originality or of special therapeutic value to recommend them4 ,the advertising implies that this particular combination has a special action on the secretions of the gastro-intestinal tract2 otherwise it would be hard to explain the claim that the preparation is antidyspeptic1 if that means anything more than a laxative or cathartic4 ,the claim is made that this preparation contains no belladonna--yet it admittedly contains hyoscyamus6 ,this manifests either ignorance on the part of the manufacturers1 or an effort to impose on the medical profession4 ,both belladonna and hyoscyamus contain variable amounts of similar alkaloids1 chiefly hyoscyamin4 ,hyoscyamus is feebler than belladonna in its action1 as it contains less alkaloid4 ,the qualitative differences between the two drugs1 with reference to their use as laxatives1 is so slight as to make the company's claim for hyoscyamus appear either deliberately misleading or to be the result of crass ignorance4 ,promoting this mixture of well-known laxatives and cathartics as an 8ideal aid to any remedial agent when a mild1 medium or strong alimentary stimulant is needed0 is a slur on the intelligence of physicians4 ,pil4 ,cascara ,compound-,robins is not acceptable for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bg1 #aiag47 ,,casta-,,flora ,report of the ,council on ,pharmacy and ,chemistry ,casta-,flora is one of those complex preparations which are offered to the medical profession1 with plausible arguments in support of the claims made4 ,it is put out by the ,wm4 ,s4 ,merrell ,chemical ,co41 ,cincinnati4 ,each fluidounce is said to represent3 8,castanea1 fresh leaves1 #dj gr42 ,passiflora1 fresh plant1 #dj gr42 ,gelsemium1 green tincture1 #h minims2 ,inula1 represented by the camphoraceous stearoptene ,helenin1 #bj grs42 ,iodized ,lime1 #h grs42 ,menthol1 #a-d grs42 ,aromatic ,syrup ,yerba ,santa1 #fj minims40 ,it is said to be3 8,a new combination of well-tried remedies of especial value in pertussis and other spasmodic coughs4 ,it is composed of astringent1 antispasmodic1 sedative and expectorant agents1 that control the paroxysms1 relieve the irritation1 promote expectoration1 and give tone to mucous membranes involved40 ,still more exaggerated claims are made for the individual constituents of ,casta-,flora1 partly by direct statement1 partly by inference4 ,for example3 8,castanea is almost a specific in whooping cough and other spasmodic coughs4 8,passiflora is a narcotic1 sedative and antispasmodic without habit-forming properties1 nor does it lock up the secretions and upset digestion like opiates4 8,inula 7elecampane7 has been employed as a cough remedy in ,england for centuries4 ,its action is similar to guaiacol and creosote4 ,its active principle1 helenin1 is destructive of tubercle bacilli in dilutions of #a to #aj1jjj4 8,iodized ,lime1 ,menthol1 and ,yerba ,santa are too well known as expectorants and antiseptics to require more than passing mention40 ,that ,casta-,flora is a 8new0 combination may be admitted2 it is improbable that exactly this combination of obsolete drugs was ever before selected for any purpose whatever1 but the statement is misleading in that no new principle of therapeutics is involved4 ,on the contrary1 the combination is just what might be expected from haphazard choosing of discarded and nearly forgotten drugs4 ,it seems incredible that a reputable firm of manufacturing pharmacists would make the positive statement that castanea is almost a specific in whooping cough4 ,why not say it is a specific8 ,it would be about as true4 ,a specific or 8almost specific0 for this disease would rank among great medical discoveries2 but castanea is merely a slightly astringent drug neither better nor worse than scores of other astringent drugs that have been tried1 found valueless and discarded4 ,hardly less surprising are the statements regarding passiflora4 ,this herb has been on the market about three quarters of a century4 ,not only has it never established itself in scientific medicine1 but it is not even mentioned in modern standard works on therapeutics4 ,of all the statements made in the circular perhaps the most remarkable1 in that it is so dangerously misleading1 is that regarding helenin1 the active principle of elecampane4 ,the statement that this principle 7helenin7 is destructive of tubercle bacilli in dilutions of #a-aj1jjj can only mean that it is of extraordinary value in the treatment of tuberculosis2 in fact1 it is definitely stated that the action of elecampane is similar to that of guaiacol and creosote4 ,it is obvious that any drug which would destroy the tubercle bacilli in the human lungs without exerting a toxic action on the patient would be a great contribution to medicine4 ,but although elecampane may have been used for centuries it has proved to have little1 if any1 merit1 and even the ,national ,standard ,dispensatory1 p4 #hdh1 says3 8,elecampane was formerly employed as a tonic1 stimulant1 diuretic1 diaphoretic1 expectorant1 and emmenagogue1 but has now largely fallen into disuse40 ,one looks in vain in the standard textbooks on therapeutics for a description of the uses of inula 7or elecampane71 and of its so-called 8active principle10 helenin4 ,the circular to which reference has been made says1 referring to the use of castanea and passiflora in the treatment of whooping cough3 8,gelsemium1 when made from the fresh1 green plant--as is ,merrell's--is an excellent adjuvant to the above drugs1 and allays the nervous irritability so frequently present40 ,h4 ,c4 ,wood1 ,jr4 7,pharmacology and ,therapeutics1 #aiaf1 p4 #afj71 says of gelsemium3 8,gelsemium was originally employed as an arterial sedative and febrifuge in the malarial fevers of the ,south1 and subsequently in sthenic fevers4 ,it appears in some way to depress the bodily temperature1 but it does not appear probable that any advantage to be derived from it will counterbalance the danger attending its employment in the large doses required4 ,in asthma1 spasmodic laryngitis1 whooping cough1 and nervous cough it has been recommended by ,bartholow1 but is little used40 ,that is about as favorable a statement for the drug as is to be found in the textbooks1 and it serves to illustrate how little new there is in this mixture of obsolete drugs that ,merrell seeks to market as one possessing extraordinary therapeutic value4 ,even though the ingredients1 or certain of them1 were singly useful in the treatment of those conditions for which ,casta-,flora is recommended1 no one could possibly foresee the effect in any given case of such a jumble of drugs1 both active and inert1 as is said to be represented in this preparation4 ,the prescribing of such mixtures1 the action of which cannot in any way be foreseen1 is plain charlatanism4 ,in addition1 the various drugs in ,casta-,flora are present in such proportions that the dose of each of the several ingredients bears no relation to the commonly accepted dose4 ,casta-,flora is not acceptable for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bg1 #aiag47 ,,firwein ,report of the ,council on ,pharmacy and ,chemistry ,firwein is a product of ,the ,tilden ,company1 ,new ,lebanon1 ,n4 ,y4 ,it is sold under the claim that when swallowed it has a 8predilection0 both for the bronchial mucosa and also for the genito-urinary organs4 ,to quote3 8,expectorant1 ,sedative1 ,antispasmodic in the ,treatment of ,inflammations of the ,bronchial and ,genito-,urinary ,mucos40 8,firwein being a bland1 soothing balsam possesses a wide range of adaptability and increased potency because of its healing virtues and usefulness as an expectorant1 sedative and antispasmodic in bronchitis1 and inflammation and catarrh of nose1 throat and lungs40 8,firwein has a special predilection for mucos1 this being as marked in diseases of the genito-urinary system as it is in the respiratory organs4 ,in inflammatory diseases of the genito-urinary organs1 its bland1 curative properties are exerted in a gratifying degree4 ,in cystitis and uritis it is clearly indicated44440 ,little information is given concerning the composition of ,firwein4 ,an old circular says3 8,firwein contains ,phosphorus1 ,iodin and ,bromin finely blended with a balsameous elixir made from the fir tree40 ,from a more recent circular we quote3 8,firwein is prepared from the inside fresh green bark of the fir tree 4440 ,the label on the product reads3 8,firwein is pleasantly and effectively blended with salts of iodin and bromin1 held in solution with #bj per cent4 alcohol40 ,the therapeutic claims made for ,firwein and the mystery enshrouding its composition make it obvious that the product is intended to appeal to those who are either thoughtless or ignorant4 ,this is emphasized by the suggestion that ,firwein be combined with 7#a7 cod liver oil 7under the claim that it will 8promote the efficiency of the oil071 with 7#b7 whisky for the treatment of bronchorrhea of the aged1 and with 7#c7 syrup of hypophosphites for the treatment of persistent bronchitis4 ,as the composition of ,firwein is secret1 the therapeutic claims unwarranted1 and its use irrational1 the ,council declared it inadmissible to ,new and ,nonofficial ,remedies4--7,from ,journal ,a4 ,m4 ,a41 ,feb4 #ag1 #aiag47 ,,firolyptol ,,plain ,,and ,,firolyptol ,,with ,,kreosote ,report of the ,council on ,pharmacy and ,chemistry ,firolyptol1 another product of ,the ,tilden ,company1 is1 we are told1 composed of eucalyptol #aj drops1 cottonseed oil #a_/b ounce and ,firwein enough to make #a ounce4 ,as the composition of ,firwein is secret1 it is evident that the composition of ,firolyptol is also unknown1 except to the manufacturers4 8,firolyptol with ,kreosote0 is said to contain1 in addition to whatever may be the component parts of ,firolyptol1 #aj minims of creosote to each ounce4 ,according to an advertisement1 ,firolyptol with ,kreosote is 8antituberculous1 antistrumous0 and 8contains all the desired features of cod liver oil and is readily assimilated40 ,the advertisements of 8,firolyptol ,plain0 and 8,firolyptol with ,kreosote0 seem to have for their key-note the assertion that cottonseed oil is a particularly valuable nutriment and that when combined with constituents of ,firolyptol and ,firolyptol with ,kreosote becomes particularly valuable to the tuberculous4 ,to quote from an advertising circular3 8,now that the reconstructive properties of cottonseed oil are better appreciated by the profession1 the advantages that follow the administration of a palatable emulsion of this strengthening and fattening food product are being demonstrated in hundreds of cases where formerly reliance would have been placed in cod liver oil4444 ,a recent writer says that pure cottonseed oil is the greatest and purest vegetable oil known to chemistry1 and will do much toward revolutionizing the treatment of the ,,great ,,white ,,plague4444 ,if the treatment of tuberculosis could resolve itself into the administration of a fatty substance in a readily assimilated form1 there would be no need for any part of ,,firolyptol but the ,cottonseed ,oil4444 ,the toxic material constantly produced in the system by the germs of tuberculosis tend to expose it more and more to the ravages of the disease1 and the physiologic functions of the body suffer a constant depression4 ,to neutralize this germ activity with a consequent production of toxins it seems most logical to employ such agents as have demonstrated their suitability for such purposes1 for which reason ,eucalyptol and ,kreosote with ,firwein are incorporated in ,,firolyptol40 ,the assertion that cottonseed oil is an especially valuable form of fat is without warrant1 but even if it were true the fat is available in cheap and palatable forms in numerous other cottonseed oil products4 ,it is unnecessary to discuss the problematic value of creosote in the treatment of tuberculosis or the value of eucalyptol 7now generally abandoned71 or even of the secret mixture ,firwein4 ,food and fresh air1 not drugs1 constitute the fundamentals of the treatment of tuberculosis1 and it is both irrational and detrimental to the interests of the tuberculous to administer various potent agents in fixed and unknown amounts with such simple articles of food as cottonseed oil4 ,neither of these products is acceptable for ,new and ,nonofficial ,remedies4 ,editorial ,note4--,firwein#aaj has been advertised to physicians for twenty-five or thirty years and it is a sad commentary on the intelligence of our profession that a preparation sold under such obviously false and misleading1 not to say silly1 claims1 should still be in existence4 ,firwein is claimed to 8prevent waste of tissue0 in tuberculosis4 ,if it had this power1 it would have found its place long ago among the few great agents in drug therapy4 ,as a matter of fact1 ,firwein has gained virtually no recognition outside of the 8literature0 of the ,tilden concern4 ,the claims made for ,firwein are a peculiar mixture of studied candor--when the truth is not likely to hurt its sale--and inane vaporing--when the facts would not redound to its credit4 ,the ,tilden ,company declares that 8,firwein stands without a peer in its class40 ,but the company adds #aj drops of eucalyptol and some cottonseed oil to this peerless product and an improvement is born--8,firolyptol06 ,then1 to perfect the already perfectly perfected1 #aj drops of creosote are added to 8,firolyptol0 and the profession is offered 8,firolyptol with ,kreosote06 ,in just what verbal pyrotechnics the ,tilden ,company might indulge1 should it decide to add ten drops of something else to 8,firolyptol with ,kreosote10 one shudders to contemplate4 #aaj ,three other ,tilden products have been the subject of deserved and unfavorable comment in the ,j4 ,a4 ,m4 ,a3 8,narkine0 in the issue of ,oct4 #bd1 #aijh1 8,hydrocyanate of ,iron-,tilden0 in the issue of ,june #ai1 #aiji1 and 8,febrisol10 in the issue of ,june #bi1 #aiab4 ,the first two articles are reprinted in the latest 7#ith7 edition of 8,the ,propaganda for ,reform40 ,if we are accused of exhibiting undue levity in discussing a therapeutic problem1 we can only answer that it is impossible to consider seriously the ,charlie ,chaplins of the nostrum world4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ag1 #aiag47 ,,biniodol ,report of the ,council on ,pharmacy and ,chemistry ,in accordance with the usages of the ,council1 the report which appears below along with the reports of the clinical investigation by ,drs4 ,cole and ,keidel upon which the recommendations of the referee were based were sent to the manufacturer for comment4 ,the reply of the manufacturer contained no evidence which justified the ,council in modifying the action already taken4 ,publication of the report was therefore authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,biniodol was submitted to the ,council by the manufacturer1 ,charles ,c4 ,yarbrough1 ,memphis1 ,tenn4 ,the manufacturer claims the product is a solution of #a per cent4 of red mercuric iodid and #b4ge per cent4 of guaiacol in bland vegetable oil4 ,it is marketed with the implication that it is new and superior to other oil solutions of mercuric iodid4 ,for instance3 8444 it is a straight solution of this mercurial compound1 as no alkaline iodide or other chemical is used to bring about the solution40 8444 ,it is probably the first and only one-percent oil solution of straight mercury biniodide made in ,america44440 ,the manufacturer1 in a letter addressed to the secretary of the ,council1 explains3 8,by straight solution1 ,i mean that the solution of the red mercuric iodid is effected without the aid of any alkaline iodid or other chemicals4444 ,biniodol was first offered early in #aiab 4440 8,biniodol is1 therefore1 superior and much to be preferred to other mercurials used for like purposes4 ,it is highly active therapeutically1 producing the desired effects1 usually without the inevitable disadvantages of other mercurials4 ,it rarely causes salivation1 diarrhea1 or other symptoms of mercurial intolerance1 even when pushed to full therapeutic effect and when given for a considerable period of time4 ,nor does it produce anemia40 ,the ,chemical ,laboratory of the ,american ,medical ,association found that ,biniodol contained #a per cent4 of mercuric iodid and #b4e per cent4 of guaiacol2 hence the composition is essentially as claimed4 ,it is not true1 however1 that ,biniodol is the 8first and only one-percent solution of straight mercury biniodide made in ,america40 ,as shown in ,the ,journal ,a4 ,m4 ,a41 ,dec4 #i1 #aiad1 p4 #bbdg1 formulas by ,lemaire and ,dunning for making a 8straight0 solution of mercuric iodid were published in this country in #aiji and #aiaj1 respectively4 ,moreover1 a #a per cent4 solution of mercuric iodid in oil is on the market and is described in ,new and ,nonofficial ,remedies4 ,to determine whether or not ,biniodol is 8superior and much to be preferred to other mercurials used for like purposes10 the ,council secured the cooperation of the ,department of ,dermatology and ,syphilology of the ,western ,reserve ,university cooperating with the ,cleveland ,city ,hospital1 and of the ,johns ,hopkins ,hospital4 ,each received three samples1 labeled respectively1 #a1 #b and #c3 #a contained ,biniodol2 #b1 a #a per cent4 solution of mercuric iodid in oil2 #c1 a solution made up according to the formula of ,biniodol1 namely1 #a per cent4 of mercuric iodid and #b4e per cent4 of guaiacol in oil4 ,all the solutions were sterile4 ,the investigators were not informed which preparation was designated by the respective numbers1 but they were asked to use the preparations when intramuscular injections of a #a per cent4 oily solution of mercuric iodid were indicated1 and to note what differences1 if any1 were observed following the use of the different solutions regarding pain1 discomfort1 induration and any other evidences of effects of the medicaments4 ,the ,cleveland investigator reports that the patients were more or less confused in their replies to inquiries and gave rather indefinite and conflicting answers4 ,after carefully tabulating the replies1 however1 the following summary resulted3 #a was worse than #b or #c in #f cases4 #b was worse than #a or #c in #e cases4 #c was worse than #b or #a in #a case4 ,the report from ,johns ,hopkins records a series of #aag injections followed by the estimated reactions recorded below3 #a4 ,severe1 #ac2 mild1 #ad2 none1 #d2 unrecorded1 #h #ci #b4 ,severe1 #e2 mild1 #ae2 none1 #af2 unrecorded1 #e #da #c4 ,severe1 #g2 mild1 #be2 none1 #c2 unrecorded1 #b #cg ,that is1 when recorded in percentages3 #a4 7,biniodol7 severe1 #cc4c2 mild1 #ce4i2 none1 #aj4c2 unrecorded1 #bj4e4 #b4 7,without guaiacol7 severe1 #ab4b2 mild1 #cf4h2 none1 #ci4j2 unrecorded1 #ab4b4 #c4 7,with guaiacol7 severe1 #ah4i2 mild1 #fg4e2 none1 #h4a2 unrecorded1 #e4e4 ,the manufacturer of ,biniodol supplied the names of several physicians who have used that preparation in their practice4 ,correspondence with these elicited the following statements3 ,one had used ,biniodol in forty-eight cases and states that 8only a few patients complain of pain at all and then only of a general soreness in the muscle40 ,this physician reports a limited experience with the use of another manufacturer's 8mercury biniodide oil solution0 7apparently six cases71 but severe pain following the injections made it necessary to abandon that preparation4 ,another of these physicians named by the manufacturer1 without reference to any series of cases1 reports that 8,biniodol is superior to any oily solution of mercury biniodid that ,i have tried40 ,a third physician has 8used it ,biniodol a few times0 and is 8convinced that it has no special action or virtue0 over 8any red mercuric iodide in oil40 ,this evidence1 in its most favorable estimate1 shows ,biniodol to be a good #a per cent4 solution of mercuric iodid in oil1 but fails to justify attributing to the preparation any unique characteristics4 ,the preparations made in the laboratory were as satisfactory1 or better than the ,biniodol1 and the presence or absence of the guaiacol was of no consequence4 ,biniodol conflicts with ,rule #f1 since claims of superior therapeutic efficiency made for it are not established2 and with ,rules #h and #aj1 since it is an unessential modification of an established nonproprietary article marketed under a proprietary name4 ,in view of the foregoing1 the referee recommends that ,biniodol be not accepted for ,new and ,nonofficial ,remedies1 and that this report1 including the clinical investigations of ,drs4 ,cole and ,keidel1 be authorized for publication4 ,,comparative ,,symptoms ,,resulting ,,from ,,the ,,use ,,of ,,several ,,oily ,,suspensions ,,of ,,red ,,mercuric ,,iodid 7,,mercury ,,biniodid7 ,report of ,dr4 ,h4 ,n4 ,cole,c ,c ,from the ,department of ,dermatology and ,syphilology of the ,western ,reserve ,university and of the ,cleveland ,city ,hospital4 ,at the request of ,prof4 ,torald ,sollmann of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association1 we made a comparative study of several oily preparations of red mercuric iodid for intramuscular injections in syphilis4 ,the information1 concerning the preparations submitted to the investigators1 was as follows3 ,,oily ,,solution ,,of ,,red ,,mercuric ,,iodid 8,it is desired to ascertain whether there is any difference between three preparations1 each containing #a per cent4 of mercuric iodid1 as to pain1 discomfort1 induration1 etc4 ,the preparations will be labeled 8#a10 8#b0 and 8#c40 ,they will be sterile4 8,one of these preparations will be a plain solution in oil2 another will contain1 in addition1 #b4e per cent4 of guaiacol2 the third will be a proprietary preparation containing the guaiacol4 8,it is also desirable to know how the oily solution compares with the plain watery solution2 but this is of secondary importance40 ,the preparations all had the same appearance4 ,the patients were taken indiscriminately1 and we attempted to keep them on the injections as long as possible1 in order to compare symptoms4 ,owing1 however1 to discharge from hospital1 symptoms of mercury intoxication1 etc41 we were unable in all cases to give a thorough trial with each preparation4 ,in all1 eleven patients were treated and seventy-one injections given--by which time our experimental supply was exhausted4 ,in each case the drug was given intramuscularly in the buttocks and the patients carefully observed for subjective symptoms of pain and for objective symptoms of swelling1 induration1 abscess formation1 etc4 ,the details are given in ,table #a4 ,as will be noted1 in several of the cases the patients were more or less confused and gave rather indefinite and conflicting answers4 ,in attempting to compare the results from the different drugs1 by careful tabulation one finds that symptoms were more marked with the respective sample as follows3 ,preparation #a was worse than ,preparation #b or #c in six cases4 ,preparation #b was worse than ,preparation #a in two cases4 ,preparation #b was worse than ,preparation #c in five cases4 ,preparation #c was worse than ,preparations #b or #a in one case4 ,,table #a4--;,,details ,,of ,,investigation ,,by ,,dr4 ,,cole99 ,symptoms ,prepar-,dose1 ----------------------------- ,case,age,sex ,date ation ,grain ,induration-- ,objective ,pain ---------------------------------------- ------------------------ #a #be #f_/aa_/af #b #a_/e ,none ,still painful #f_/ab_/af #a #a_/d ,none ,none #f_/ac_/af #b #a_/e ,none ,quite painful #f_/ad_/af #b #a_/d ,hurt for some ,very tender time #f_/af_/af #b #a_/e ,hurt for some ,very tender time #f_/ag_/af #c #a_/e ,not so painful ,less tender than with ,prepar- ation #b4 #f_/ah_/af #c #a_/e ,not so painful ,can sit on ,discontinued area2 as 7salivation7 needle prick is only place that it hurts #f_/bb_/af #b #a_/d ,hurt1 but not ,slight indur- so long ation and slight tenderness #f_/bd_/af #b #a_/d ,hurt1 but not ,pain 8dead so long stinging0 lasts #a hour #f_/be_/af #a #a_/d ,not so bad ,about the same ---------------------------------------- ------------------------ #b #cb #f_/bd_/af #b #a_/d ,some pain ,no induration #f_/be_/af #a #a_/d ,more pain ,slight indur- ation ---------------------------------------- ------------------------ #c 44 #f_/ab_/af #a #a_/e ,no symptoms ,painful #f_/ac_/af #b #a_/d ,no symptoms ,painful #f_/ad_/af #b #a_/d ,says the last ,painful #f_/af_/af ,arseno- two have hurt benzol the more #f_/ag_/af #c #a_/e ,more pain than ,small painful previously area #f_/ag_/af #c #a_/e #f_/ah_/af #c #a_/e ,not so much ,some indur- pain3 in ation at site #f_/ai_/af #c #a_/e fact1 patient of injections #f_/bj_/af #c #a_/d says he is #f_/ba_/af #c #a_/d over it in a very short while2 com- plained of last one #f_/bb_/af #b #a_/d ,some pain ,considerable tenderness #f_/bd_/af #b #a_/d ,not so much as now after so previously many injec- #f_/be_/af #a #a_/d tions ---------------------------------------- ------------------------ #d #cf #f_/bb_/af #b #a_/d ,no pain ,no tenderness #f_/bd_/af #b #a_/d ,some pain ,some tender- ness #f_/be_/af #a #a_/d ,could not sleep,some tender- at night ness2 slight induration ---------------------------------------- ------------------------ #e #cb #f_/bj_/af #c #bj ,some pain ,no induration minims #f_/ba_/af #c #be ,some pain minims #f_/bc_/af #b #a_/d ,worse pain ,no induration #f_/bd_/af #b #a_/d ,worse pain #f_/be_/af #a #a_/d ,worse than any ,slight tender- ness ---------------------------------------- ------------------------ #f #bj #f_/ #h_/af #a #a_/f ,very little #f_/aj_/af #a #a_/e ,very little #f_/ac_/af #a #a_/d ,very little #f_/ad_/af #b #a_/d ,bothered more than others #f_/ag_/af #b #a_/e ,quite a little ,still some pain soreness #f_/ah_/af #b #a_/e ,quite a little ,still some pain soreness #f_/ai_/af #c #a_/d ,considerably ,very little less pain than tenderness #f_/bj_/af #c #a_/d with ,prepar- #f_/ba_/af #c #a_/d ation #b ---------------------------------------- ------------------------ #g #cj #f_/ab_/af #a #a_/e ,little pain ,none #f_/ac_/af #b #a_/d ,no pain #f_/ad_/af #b #a_/e ,some pain #f_/af_/af ,arseno- benzol #f_/ag_/af #c #a_/e ,not so much ,no tenderness #f_/ah_/af #c #a_/e ,not so much ,no tenderness #f_/ai_/af #c #a_/e ,very little ,only slight pain amount of #f_/bj_/af #c #a_/d induration #f_/ba_/af #c #a_/d #f_/bb_/af #b #a_/d ,some pain ,some little induration #f_/bd_/af #b #a_/d ,considerable ,some indura- pain tion #f_/be_/af #a #a_/d 8,fine0 ,slight indura- tion ---------------------------------------- ------------------------ #h #bh #f_/ac_/af #b #a_/e ,little pain ,little pain afterward #f_/ae_/af #b #a_/e ,little pain ,little pain afterward ---------------------------------------- ------------------------ #i #bh #f_/ag_/af #b #a_/e ,some complaint ,very little of pain4 induration #f_/ah_/af #b #a_/e ,fairly severe #f_/ai_/af #c #a_/e ,some pain2 says,very slight these have induration #f_/bj_/af #c #a_/d hurt very much #f_/ba_/af #c #a_/d less than others ---------------------------------------- ------------------------ #aj #cg #f_/ab_/af #a #a_/e ,no symptoms ,none #f_/ac_/af #a #a_/d ,no symptoms ,none #f_/ad_/af #a #a_/e ,no symptoms ,none #f_/ae_/af #c #a_/e ,no symptoms ,none #f_/af_/af ,arseno- benzol #f_/ag_/af #c #a_/e 8,much less pain,none than biniodid or grey oil0 #f_/ah_/af #c #a_/e ,no complaint ,none #f_/ai_/af #c #a_/e ,says he is over,some indura- #f_/bj_/af #c #a_/d it in one hour tion at site #f_/ba_/af #c #a_/d of injection ---------------------------------------- ------------------------ #aa #cj #f_/aa_/af #a #bj ,considerable2 ,considerable minims not so much pain and #f_/ab_/af #b #bj tenderness on minims palpation over area #f_/ac_/af #a #be ,not much pain ,indurated area minims at pt4 of each4 ,painful #f_/ad_/af #a #be ,not much pain ,slight indura- minims tion ---------------------------------------- ------------------------ 99 ,the diagnosis in ,case #e was primary syphilis1 and in the other cases1 secondary syphilis4 ,in this column1 indicates male1 and female4 ,in no case did ,wassermann become negative4 ,the criticism may be raised that the number of cases and of injections is too small to permit the drawing of any just conclusions4 ,even should we grant it1 the statistics certainly do not prove any marked superiority of any one of the preparations over the others4 ,we wish to thank ,dr4 ,sollmann for advising and directing us in this work1 and ,drs4 ,bailey1 ,bernstein1 ,markus and ,reycraft for assistance in carrying it out4 ,report of ,dr4 ,albert ,keidel ,twenty cases were chosen at random from the syphilitic patients attending the clinic4 ,they were given intramuscular injections of the three solutions1 in amounts varying from #a to #b c4c41 at intervals 7in most instances7 of two days4 ,the injections were invariably made into the gluteal muscles1 at depths of from #b to #b-a_/b inches1 and ordinary care exercised to preserve asepsis4 ,after injection the patient was allowed to depart1 and the result was recorded at the succeeding visit4 ,the result was determined from the patient's statement and our examination4 ,some patients received injections of only one solution2 some were treated with first one and later with another1 and one patient received all three at different times4 ,the solutions were never mixed for a single injection1 of course4 ,,table #b4--,,reactions ,,in ,,twenty ,,cases ,,reported ,,by ,,dr4 ,,keidel ,preparation ,reactions ,number of ,injections ,severe ,mild ,none ,undetermined #a #ac #ad #d #h #ci #b #e #ae #af #e #da #c #g #be #c #b #cg --- #aag ---------------------------------------- -------------------------- ,the solutions are understood to contain a #a per cent4 solution of red mercuric iodid in oil1 two of them containing in addition #b4e per cent4 of guaiacol1 one of these being a proprietary preparation4 ,the solutions are designated as ,preparations #a1 #b and #c1 respectively1 corresponding to the numbers on the labels of the bottles in which they were originally received4 ,the local reactions are recorded as 8severe0 7,s71 8mild0 7,m71 8none0 7,o7 and 8,undetermined0 7,u74 ,by 8severe0 is meant very severe pain lasting for from several hours to several days2 by 8mild0 is meant slight pain or numbness for several hours1 or less than an hour2 8none0 indicates that there was no local reaction1 and 8undetermined10 that the patient has failed to return after the last injection4 ,in ,table #c all the details of the investigation are recorded4 ,under 8,local ,reaction10 the letters represent the type of reaction after each injection1 in the order in which they were given2 when two solutions were used in the same case1 the letters represent the reactions following the solution opposite which they stand4 ,in the fifth column the plus and minus symbols indicate the ,wassermann reaction2 plus indicates a completely positive1 and minus a completely negative reaction4 ,when there is only one sign1 it refers to the reaction at the end of treatment2 when there are two1 to the reaction before and after4 ,the seventh column shows the clinical result at the end of treatment2 when no note is made1 it means that there was no change noted4 ,in the eighth column are noted any objective results observed at the time of examinations of the patients4 ,the injections were made and the result charted by ,dr4 ,e4 ,l4 ,zimmermann1 of my staff1 under my directions and supervision4--7,abstracted in ,the ,journal ,a4 ,m4 ,a41 ,feb4 #bd1 #aiag47 ,,table #c4--;,,details ,,of ,,investigation ,,by ,,dr4 ,,keidel ,total ,dura- ,effect ,case,no4,prepar- ,local ,amount tion on ,type of ,result ,general ation ,reaction ,solution of ,wasser- ,case ,remarks ,given1 ,treat- mann ,c4c4 ment ---------------------------------------- ------------------------------------ #a #c #b ,,ooo #c #f da4 ,latent #b #e #b ,,mosms #e4f #i da4 ,gummas4444,marked #c #g #a ,,mmm2 #i4e #c mo4- to ,latent improve- others ,u ment #c #b ,,uuu #d #a #b ,u #j4ge 444 ,latent #e #d #a ,,sssm #d4d #i da4 - ,gummas44444444444444,after #dth injection1 developed diarrhea2 melena #f #i #a ,,ooumsosmu #i4a #a mo4 - ,latent #g #b #c ,,mm #c4h #b da4 ,latent 4444444444,well tolerated #h #g #b ,,oooomou #i4f #ag da4 to ,primary444,primary healed #i #d #a ,,smmu #e4e #i da4 ,gumma44444,improved #aj #c #c ,,mss #c #f da4 ,palmar ,markedly syphilis2 improved tertiary #aa #g #c ,,msmmmmm #aj4f #ac da4 to ,latent #ab #c #b ,,mmo #e4d #ad da4 ,secondary ,rash ,developed #b #a ,,sm 7papular7 disap- toxic ery- pearing4 thema on thighs4 ,cleared up on stopping ,hg,cl and under local treatment #ac #aj #c ,,mmmmmmmm #ab4f #bj da4 to ,secondary ,rash ,small ,,mmu 7lichen not induration syph47 improved4 following injection of #a4b c4c4 #ad #f #b ,,oomsmm #g4b #ag da4 to ,old 4444444444,responded to #b #a ,,sm cerebro- doses of spinal #a c4c4 with syphilis salivation2 fever after injection of #a4b c4c4 #ae #d #a ,,soms #d4b #g da4 to ,secondary ,no 7condyl- improve- omas7 ment #af #i #c ,,omommsmso #aj4d #ab da4 ,secondary ,pustules ,slight #b #b ,,so 7pustular dried up2 gingivitis syph47 headache following and fever dose of gone #a4e c4c4 #ag #e #a ,,ssmsu #ac4c #ah da4 to ,tertiary2 ,general #b #b ,,ms aortitis4 condition #b #c ,,ms improved #ah #d #b ,,oomm #i4e #ac da4- to ,latent #b #a ,,mm ,markedly improved #ai #b #c ,,mu #b4e #e da4 ,gumma44444 #bj #e #b ,,mmmmo #i #ad da4 to ,latent4444,marked ,small #b #c ,,ms general induration improve- following ment ,no4 #c ---------------------------------------- ------------------------------------ ,,corpora ,,lutea 7,,soluble ,,extract71 ,,parke1 ,,davis ,,co4 ,report of the ,council on ,pharmacy and ,chemistry ,following inquiries1 the ,council took up for consideration 8,corpora ,lutea 7,soluble ,extract710 marketed by ,parke1 ,davis ,co4 in the form of ampules and proposed for hypodermic administration4 ,the report which appears below was submitted to the ,council by a committee1 and was adopted by the ,council4 ,corpora ,lutea 7,soluble ,extract7 was declared inadmissible to ,new and ,nonofficial ,remedies1 and publication of the report authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,corpora ,lutea 7,soluble ,extract7 has not been submitted by the manufacturer4 ,the information of the referee is based1 therefore1 on the claims made in the trade package1 and on the statements in the price list4 ,these show that the product is essentially secret and claims made for the actions and uses of the preparation do not make clear the essentially experimental status of the article1 and are therefore misleading4 ,conflict with ,rule #a4--,no definite statement of composition appears beyond the indefinite claim that it is an aqueous solution of 8soluble ,corpora ,lutea ,extract10 each ampule corresponding to #j4b ,gm4 of desiccated gland4 ,how these soluble products are obtained1 whether they represent all the water-soluble principles1 or whether some have been eliminated1 are questions that are not answered4 ,yet such information is essential to intelligent and scientific use1 for1 as there is no method of standardization1 the method of preparation is the only mark of identity4 ,for instance1 we do not know at this time whether proteins have anything to do with the supposed value of corpora lutea4 ,it is1 therefore1 essential to know whether or not the proteins have been eliminated4 ,conflict with ,rule #f4--,the circular in the package advises the hypodermic use of this extract1 not only in functional amenorrhea and the ordinary reflex consequences of physiologic or artificial menopause1 but also in3 8#8neurasthenic' symptoms during menstrual life02 8sterility1 not due to pyogenic infection or mechanical obstruction02 8repeated abortions1 not due to disease or mechanical factors02 8hyperemesis in the early months of pregnancy40 ,these are not stated merely as conditions in which various enthusiasts have tried corpus luteum1 but as conditions 8for which it will be found serviceable40 ,it is not necessary to inform the medical profession that this statement is calculated to raise expectations which cannot possibly be fulfilled4 ,even the manufacturers seem to realize this2 at least they speak somewhat indefinitely of 8suitable cases10 8good judgment10 8real indications10 etc4 ,but they proceed to nullify this warning--if it was intended as a warning--by their illustrations of unsuitable cases1 for instance1 8amenorrhea due to extreme anemia1 dysmenorrhea due to cervical stenosis10 etc4 ,finally1 they sum up the case3 8,therefore1 additional emphasis on the necessity for the proper selection of cases is essential in order that this useful preparation may not be unjustly discredited40 ,how these cases of sterility1 abortions1 etc41 are to be selected is not revealed4 ,in other words1 the restriction is no more than a convenient device by which every improvement is to be attributed to the medicine1 and every failure to the physician4 ,the referee recommends that ,corpora ,lutea 7,soluble ,extract71 ,parke1 ,davis ,co41 be held ineligible to ,n4 ,n4 ,r41 because it is a secret preparation advertised under extravagant claims4 ,editorial ,comment4--,was it not in ,weir ,mitchell's 8,adventures of ,franois0 that the itinerant promised to pull teeth without any pain1 if the patient would hold absolutely still8 ,and1 mirabile dictu1 the ones who suffered were those who had not held absolutely still6--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #g1 #aiag47 ,,wheeler',s ,,tissue ,,phosphates ,report of the ,council on ,pharmacy and ,chemistry ,the ,council held that the contribution from the ,a4 ,m4 ,a4 ,chemical ,laboratory1 8,wheeler's ,tissue ,phosphates10 demonstrates that this is a semisecret1 complex and irrational preparation1 sold with misleading claims concerning its medicinal constituents and therapeutic properties4 ,the ,council directed that the report be included with the ,annual ,council ,reports and declared ,wheeler's ,tissue ,phosphates in conflict with ,rules #a1 #f1 #h and #aj4 ,w4 ,a4 ,puckner1 ,secretary4 ,,wheeler',s ,,tissue ,,phosphates ,l4 ,e4 ,warren1 ,ph4,c41 ,b4,s4 8,wheeler's ,tissue ,phosphates10 known also as 8,compound ,elixir of ,phosphates and ,calisaya10 is advertised as a nerve food and a nutritive tonic4 ,the label states that it contains calcium1 iron1 sodium trihydrogen phosphates1 alkaloids of ,peruvian bark with #ab-a_/b per cent4 of alcohol4 ,the preparation is sold by the ,t4 ,b4 ,wheeler1 ,m4 ,d4 ,co41 of ,rouses ,point1 ,new ,york4 ,according to the manufacturer1 ,wheeler's ,tissue ,phosphates 8444 is an inorganic combination of the phosphates of iron and calcium and hydrogen 7phosphoric acid7 together with hydrochloric acid1 hydrocyanic acid1 and quinine1 cheerful coloring1 and a delicious1 cordial-like flavoring40 8444 ,the iron is the green1 inorganic phosphate and the calcium the simple white phosphate of your early student days44440 ,the preparation is a red liquid1 having an acid reaction1 a sweet-bitter taste and the odor of wild cherry4 ,qualitative tests indicated the presence of calcium1 iron1 a phosphate1 a chlorid1 a sulphate1 quinin or cinchona alkaloids1 alcohol1 sodium1 cochineal coloring and invert sugar4 ,ammonium salts1 glycerol1 citrates or lactates were not found4 ,from the quantitative values obtained the preparation may be taken to represent3 ,sp4 gr at #be;,c4_/#be;,c4 #a4ajhg ,alcohol 7per cent1 by volume7 #aa4ce ,gm4 per #ajj c4c4 ,calcium phosphate ,ca7,,po799 #j4cig ,iron phosphate 7,fe,p,o4#d;,h,o799 #j4jfh ,chlorid 7as hydrochloric acid7 #j4djg ,sodium sulphate 7,na,,so4#aj;,h,o7 #j4jdc ,quinin sulphate 7,u4 ,s4 ,p47 #j4jda ,sodium phosphate 7,na,,hpo4#ab;,h,o7 #j4jfe ,invert sugar #bf4hbd ,water1 cochineal and flavor1 to make #ajj c4c4 99 ,it should be understood that the calcium and iron salts are held in solution by the hydrochloric acid4 ,the dose of ,wheeler's ,tissue ,phosphates recommended by the manufacturer is a tablespoonful or about #ae c4c4 7#a_/b oz474 ,the total calcium in a dose of the preparation is equivalent to about one-sixth of an average dose of the official calcium chlorid1 and the total phosphate to each dose is equivalent to about one-fourth of a dose of the official diluted phosphoric acid4 ,each prescribed dose of the preparation contains about #j4ja gm4 7#b_/ac grain7 of iron phosphate or about one twenty-fifth of the average dose1 and to obtain a ,pharmacopeial dose of iron phosphate the patient would be obliged to take three-fourths of the contents of an entire bottle--or #ab ounces--of the preparation4 ,if it be assumed that all of the chlorid present is in the form of free hydrochloric acid1 each dose of the preparation contains the equivalent of about two-thirds of one ,pharmacopeial dose of diluted hydrochloric acid4 ,each dose of the preparation contains about #j4jjfb gm4 7#a_/aj grain7 of quinin sulphate1 or about one-sixteenth of the average tonic dose4 ,in other words1 to obtain the amount of quinin sulphate given in the ,u4 ,s4 ,pharmacopeia as the tonic dose1 the patient would be required to swallow #g-a_/b fluidounces of the proprietary preparation1 or the contents of nearly half a bottle4 ,the fallacy of prescribing ,wheeler's ,tissue ,phosphates either for its quinin or its iron content is apparent4 ,wheeler's ,tissue ,phosphates is1 then1 a mildly bitter flavored syrup which contains nearly #ab per cent4 of alcohol1 small quantities each of calcium phosphate and hydrochloric acid and insignificant amounts of iron and quinin salts4 ,in other words1 essentially it is a sweetened solution of small quantities of calcium phosphate in very dilute hydrochlorid acid together with #ab per cent4 of alcohol4 ,bearing in mind the analysis of the preparation1 how ludicrous some of the claims appear3 8,tissue ,phosphates is not a hypophosphite preparation2 it is not a combination of glycerophosphates or other organic salts1 or so-called peptonates and manganates1 all recently condemned by the best therapeutic opinion here and in ,europe1 as much slower and less active than the simpler salts4 ,the iron is the green1 inorganic phosphite and the calcium the simple white phosphate of your early student days4 ,nature takes these simple salts and builds them rapidly into lecithin1 bone1 and other tissue1 without the delay incurred by splitting up the organic salts before she can recombine them40 8,tissue phosphates is in fact a chemical food40 8,the formula1 suggested by ,professor ,dusart1 of ,paris1 combines in an easily assimilable and agreeable cordial2 medium medicinal doses of ,phosphorus1 the ,generator of ,nerve ,force2 ,calcium ,phosphate1 for ,cell ,development and ,nutrition2 ,sodium ,phosphate1 a stimulant of ,liver and ,pancreas and ,corrective of ,acid ,fermentation in the ,alimentary ,canal2 ,iron1 generating in the ,blood1 ,heat and ,motion1 ,phosphoric ,acid1 ,tonic in ,sexual ,debility2 ,alkaloids of ,calisaya1 ,antimalarial and ,antipyretic2 ,extract of ,wild ,cherry1 ,tonic1 yet ,calming ,irritation and ,diminishing ,nervous ,excitement2 ,ethyl ,alcohol #ab4e2 and ,aromatics40 ,although the claim is made that the 8formula0 of ,wheeler's ,tissue ,phosphates has been 8suggested by ,professor ,dusart10 such of ,dusart's papers as were available in this country#aaa failed to disclose any 8formula0 that was at all comparable to this product4 #aaa ,dusart1 ,l43 ,recherches exprimentales sur le rle physiologique et thrapeutique du phosphate de chaux1 ,paris1 #ahgj2 ,quel est l'acide du suc gastrique8 ,lille1 #ahgd1 unbound1 #h pages2 ,notice sur l'emploi et les propriets du lacto-phosphate de chaux1 ,clichy1 #ahfh1 unbound1 #h pages4 ,dusart and ,blache3 ,recherches sur l'assimilation du phosphate de chaux1 ,paris1 #ahfh1 unbound1 #ae pages4 ,editorial ,note4--,the investigation verifies facts that must be obvious to every physician who has given the matter thought4 8,wheeler's ,tissue ,phosphates0 is an unscientific1 shotgun mixture whose most active and powerful drug is the alcohol it contains4 ,that it was not years ago relegated to the realms of obsolete and discarded preparations is a commentary alike on the lack of scientific discrimination and the persuasive power of advertising4 ,while in the past 8,wheeler's ,tissue ,phosphates0 has been advertised extensively in medical journals1 it seems that now the chief1 if not the only beneficiary of the advertising appropriation for this product is the ,new ,york ,medical ,journal1 which weekly heralds the 8,delicious0 and 8,sustaining0 qualities of 8,the ,ideal ,tonic for ,fastidious ,convalescents40--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #e1 #aiag47 ,,the ,,claimed ,,galactagogue ,,effects ,,of ,,nutrolactis ,,and ,,goat',s ,,rue ,,not ,,substantiated ,report of the ,council on ,pharmacy and ,chemistry ,specific lactagogues--drugs which stimulate the secretion of milk--are unknown to science4 ,yet medical publications give space to advertisements of a proprietary--8,nutrolactis0--which is said to increase the milk supply of nursing mothers4 ,since dependence on a preparation of this kind is likely to cause neglect of the only means of increasing a scanty milk supply of nursing mothers--care of the general health and a sufficient quantity of proper food--this proprietary and the drug 8goat's rue10 7,galega officinalis7 which the proprietors hint as being the potent constituent1 were subjected to a critical study to determine their possible influence on milk secretion4 ,for this purpose the ,council secured the help of ,a4 ,j4 ,carlson1 ,ph4,d41 professor of physiology1 ,university of ,chicago4 ,dr4 ,carlson1 with the aid of ,a4 ,woelfel1 ,m4,d41 and ,marian ,lewis1 ,sc4,m41 undertook to estimate the effect of ,nutrolactis and of goat's rue on nursing dogs and goats with the intention of extending the study to nursing mothers if the animal experiments so warranted4 ,the contribution1 8,the ,alleged ,galactagogue ,action of ,galega and ,nutrolactis10 by ,marian ,lewis and ,a4 ,j4 ,carlson from the ,hull ,physiological ,laboratory of the ,university of ,chicago1 which appears below1 shows that ,nutrolactis and goat's rue are without influence on the milk secretion in nursing animals4 ,the ,council endorsed the work of ,lewis and ,carlson and held that the claimed galactagogue effects of ,nutrolactis and goat's rue are not substantiated4 ,w4 ,a4 ,puckner1 ,secretary4 ,,the ,,alleged ,,galactagogue ,,action ,,of ,,galega ,,and ,,nutrolactis,d ,marian ,lewis1 ,sc4,m41 and ,a4 ,j4 ,carlson1 ,ph4,d4 ,,chicago ,d ,from the ,hull ,physiological ,laboratory of the ,university of ,chicago4 ,d ,this investigation was begun in #aiae by ,drs4 ,a4 ,woelfel and ,a4 ,j4 ,carlson4 ,it is well established that the food best adapted to the energy and growth requirements of the infant is normal mother's milk4 ,any decrease in quantity or deterioration in quality of the maternal secretion is soon followed by a parallel impairment of growth1 loss of weight1 or lowered resistance to infection in the infant4 ,the widespread occurrence of deficient milk secretion is a matter of common knowledge4 ,the discovery of true lactagogues1 or specific substances which increase the quantity and quality of the milk on being administered to nursing mothers1 would therefore be of very great importance4 ,in view of this great medical and economic interest in true lactagogues it is not surprising to find that the medical and biologic literature records discoveries of lactagogues based on hope rather than demonstration1 and that spurious lactagogues are on the market4 ,some of the factors known to affect milk secretion are general health1 food supply1 psychic state1 and heredity4 ,the mechanism of secretion and the method by which these factors affect it are imperfectly understood4 ,in general it has been observed that milk yield improves both in quantity and in quality with improvement in general health1 better food supply1 and more favorable psychic state4 ,the influence of heredity is taken advantage of by dairymen who are well acquainted with the potential milk production of the different breeds of cattle4 ,among the substances which have been reported to stimulate milk secretion may be mentioned the extract of the posterior lobe of the hypophysis4 ,but pituitary extract is not a true lactagogue1 because its action is confined to the smooth musculature of the gland ducts1 causing a more or less complete ejection of the milk already formed2 it has no effect on the gland cells or the actual secretory process in the direction of increasing the milk yield4 ,extracts of thymus1 corpus luteum1 ovaries1 uterus1 placenta1 fetus1 and the mammary gland itself have also been reported to have a temporary stimulating effect on the quantity of milk secreted1 but when these extracts are given by mouth they are apparently without specific influence on the mammary gland4 ,galega1 or goat's rue 7,galega officinalis71 is an herb described in the ,national ,formulary as being slightly bitter and astringent4 ,in #ahgc1 ,gillet-,damotti1#aab in a communication to the ,french ,academy1 stated that this plant when fed to cows increases the secretion of milk from #ce to #ej per cent4 ,other ,french writers have affirmed that goat's rue is a lactagogue4 ,in ,germany1 ,fragner#aac made a preparation called ,galegal1 using galega as the active principle and combining it with lactose to give it a pleasant taste and make it soluble in water1 milk1 coffee1 and tea4 ,this preparation was reported on favorably by ,scherer1#aad who asserts that he obtained positive results in fifty-four of the eighty cases in which he used it4 #aab ,gillet-,damotti3 ,comp4 rend4 ,acad4 d4 ,sc41 ,july #g1 #ahgc4 #aac ,fragner3 ,wien4 med4 ,wchnschr4 #fj3ajcc-ajcf1 #aiaj4 #aad ,scherer3 ,wien4 med4 ,wchnschr4 #fj3ajcc-ajcf1 #aiaj4 ,more recently ,hut#aae tested the effects of ,theinhardt's ,hygiama lactogene on four lactating women4 ,this preparation is said to be composed of hygiama1#aaf galega and anise4 ,analysis showed that it contains albumins1 fat1 soluble and insoluble carbohydrates1 salts and water4 ,hut could not observe any influence from the use of this preparation1 either on the quantity or on the composition of the milk secreted4 #aae ,hut3 ,nederlandsch ,tijdschr4 v4 ,geneesk4 #a3acec-acgj1 #aiad4 #aaf ,hygiama is said to be a food consisting of condensed milk1 with 7fatless7 cocoa and cereals added to it 7,encyclopedia and ,dictionary of ,medicine and ,surgery1 #aijg74 ,nutrolactis#aag is a commercial preparation sold by the ,nutrolactis ,company of ,new ,york at #a a bottle4 ,the label states that it contains #e per cent4 of alcohol2 that it contains fluid extracts of the family of 8galactagogic plants10 and that it is intended to 8increase the supply of mother's milk40 ,it is recommended to maintain 8quality and quantity until the end of normal lactation40 ,nutrolactis is also recommended for a mother debilitated by lactation4 ,it is claimed that 8,nutrolactis does not force the secretion of milk but merely assists such secretion40 ,years ago ,millbank#aah reported good results from the use of ,nutrolactis4 ,after more than a year's use he concluded that it was more satisfactory than any other lactagogue hitherto employed by him1 which is not saying very much1 as specific lactagogues are as yet unknown4 ,nutrolactis is still 7#aiaf7 extensively advertised in various medical journals as a lactagogue4 #aag ,the ,north ,dakota ,agricultural ,experiment ,station has recently published 7,bulletin #bb1 #aiae1 p4 #chf7 a complete chemical analysis of ,nutrolactis4 ,it contains only #j4fj per cent4 solids 7including strychnin and emodin74 ,it has a bitter taste4 ,the alcohol content was #c4e per cent4 ,the report concludes3 8a little strychnin1 a little alcohol1 and a little laxative is about all there is to cause an increase in the milk secretion40 #aah ,millbank3 ,new ,york ,m4 ,j4 #ej3edd1 #ahhi4 ,,methods ,,of ,,investigation ,the alleged lactagogue action of galega and ,nutrolactis was tested on lactating dogs and goats4 ,in these animals the psychic factors1 or suggestion1 are largely eliminated4 ,if the results had been positive or had indicated lactagogue action1 the test would have been extended to nursing women4 ,the puppies and kids were weighed before and after nursing and a record kept of the amount of milk obtained at each nursing 7the animals nursing from three to five times daily74 ,the mothers were fed with varying doses of the drugs1 and the milk yield compared with that of a control period during which no drugs were administered4 ,an effort was made to keep the conditions of the experiments uniform throughout4 ,the galega was ground and mixed with the food4 ,the ,nutrolactis was mixed with food given by the stomach tube1 or in some cases with a spoon4 ,galega was tested on two goats and ,nutrolactis on one goat and nine dogs4 ,the results are given herewith3 ,,galega ,goat #a3 ,control period1 #a1fjj gm41 milk av4 daily yield for #g days4 ,galega period 7#cj gm4 galega mixed with oats71 #hfj gm41 milk av4 daily yield for #h days4 ,kids weaned at end of period4 ,goat #b3 ,control period1 #a1afa gm4 milk av4 daily yield for #i days4 ,galega period 7#cj gm4 galega mixed with oats71 #hfj gm4 milk av4 daily yield for #h days4 7#be gm4 galega in same way71 #haj gm4 milk av4 daily yield for #aj days4 ,control period1 #hif gm4 milk av4 daily yield for #f days4 ,,nutrolactis ,goat #c3 ,control period1 #hif gm4 milk av4 daily yield for #f days4 ,nutrolactis period 7#cj c4c4 ,nutrolactis mixed with oats71 #feh gm4 milk av4 daily yield for #i days4 ,control period1 #fff gm4 milk av4 daily yield for #e days4 ,dog #a3 ,control period1 #agf gm4 milk av4 daily yield for #g days4 ,nutrolactis period 7#h c4c4 ,nutrolactis by stomach tube71 #ee gm4 milk av4 daily yield for #ab days4 ,dog #b3 ,control period1 #ahi gm4 milk av4 daily yield for #f days4 ,nutrolactis period 7#h c4c4 ,nutrolactis by stomach tube71 #gb gm4 milk av4 daily yield for #aa days4 ,dog #c3 ,control period1 #ic gm4 milk av4 daily yield for #h days4 ,nutrolactis period 7#h c4c4 ,nutrolactis on bread71 #ag gm4 milk av4 daily yield for #e days4 ,dog #d3 ,control period1 #bh gm4 milk av4 daily yield for #g days4 ,nutrolactis period 7#h c4c4 ,nutrolactis by stomach tube71 #dg gm4 milk av4 daily yield for #f days4 7#aj c4c4 ,nutrolactis by stomach tube71 #dc gm4 milk av4 daily yield for #h days4 ,control period1 #da4e gm4 milk av4 daily yield for #f days4 ,nutrolactis period 7#aj c4c4 ,nutrolactis by stomach tube71 #cc4e gm4 milk av4 daily yield for #d days4 ,dog #e3 ,control period1 #fg gm4 milk av4 daily yield for #f days4 ,nutrolactis period 7#aj c4c4 ,nutrolactis on bread71 #ha gm4 milk av4 daily yield for #f days4 ,dog #f3 ,control period1 #dj gm4 milk av4 daily yield for #e days4 ,nutrolactis period 7#aj c4c4 ,nutrolactis by stomach tube71 #cc gm4 milk av4 daily yield for #h days4 ,control period1 #bf gm4 milk av4 daily yield for #d days4 ,dog #g3 ,control period1 #bhc gm4 milk av4 daily yield for #i days4 ,nutrolactis period 7#aj c4c4 ,nutrolactis by stomach tube71 #aee gm4 milk av4 daily yield for #ae days4 7#ae c4c4 ,nutrolactis by stomach tube71 #hb gm4 milk av4 daily yield for #f days4 ,control period1 #cc gm4 milk av4 daily yield for #c days4 ,dog #h3 ,control period1 #bch gm4 milk av4 daily yield for #h days4 ,nutrolactis period 7#bj c4c4 ,nutrolactis on bread71 #bbc gm4 milk av4 daily yield for #d days4 7#bj c4c4 ,nutrolactis on bread71 #df gm4 milk av4 daily yield for #f days4 ,dog #i3 ,control period1 #bbc gm4 milk av4 daily yield for #f days4 ,nutrolactis period 7#aj c4c4 ,nutrolactis on bread71 #agh gm4 milk av4 daily yield for #ae days4 7#ae c4c4 ,nutrolactis on bread71 #adf gm4 milk av4 daily yield for #e days4 ,,comment ,,and ,,conclusion ,goat #a had already been lactating for over two months1 and the yield was gradually decreasing at the time the observations were begun4 ,the administration of galega did not check this decrease4 ,goat #b should have been a very favorable subject1 for the kid was about a week old at the time the observations were begun4 ,both galega and ,nutrolactis caused a decrease in milk yield of this animal4 ,this decrease is perhaps partly due to the animal's distaste for the drugs and her consequent failure to eat as well as during the control periods4 ,administration of ,nutrolactis was accompanied by an increase in milk in only two animals1 ,dog #d and ,dog #e4 ,a detailed examination of the records of these two dogs shows that in both cases there was a progressive increase in milk yield during the control period and that administration of the drug failed to accelerate this increase4 ,on the contrary1 the curve for ,dog #e takes a sudden drop immediately after the first administration of the drug4 ,the records of ,dogs #f and #g show that the yield during the second control period is lower than that of the preceding periods4 ,although the administration of the drug in both cases was followed by a decrease in the yield1 it may be urged that the drug has some lactagogue action1 for its discontinuance was followed by a decrease in yield4 ,this effect1 however1 is also apparent rather than real1 for the data show a gradual falling off in yield during the period of administration of the drug1 which decrease was not accelerated by withdrawing the drug4 ,our data show that galega and ,nutrolactis1 when taken by mouth1 and the elements of suggestion excluded1 had no beneficial effect on lactation--at least in so far as the quantity of milk is concerned4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #bf1 #aiag47 ,,the ,,russell ,,emulsion ,,and ,,the ,,russell ,,prepared ,,green ,,bone ,report of the ,council on ,pharmacy and ,chemistry ,the following report on 8,the ,russell ,emulsion0 and 8,the ,russell ,prepared ,green ,bone10 marketed by the ,standard ,emulsion ,company1 was submitted to the ,council by a referee4 ,the ,council endorsed the report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,russell ,emulsion is put up in a neat package and advertised in an attractive pamphlet1 on the cover of which we are told3 8,truth ,always ,justifies ,the ,superlative ,degree40 ,as what follows in the booklet and in the printed circulars certainly does not lack superlatives1 this is doubtless a warning4 ,in addition to the pamphlet and circular advertising1 the product seems to be systematically boomed by a lecture scheme in which one ,dr4 ,hague talks before medical societies and distributes advertising matter4 ,the lecture is succeeded by a follow-up letter scheme through which matter is sent to members of the society4 ,hague ostensibly discusses 8lime starvation in tuberculosis10 but medical societies soon learned to estimate his work as essentially to advertise the ,russell products4 ,last ,april the ,medical ,society of the ,state of ,pennsylvania sent out a circular letter to its county organizations on the subject of the ,russell-,hague propaganda which opens in this way3 8,you have doubtless received a letter from ,dr4 ,william ,grant ,hague of ,new ,york1 offering to address your county society on ,tuberculosis4 ,after due investigation1 it is respectfully suggested that it may not be desirable to ask him to address your society44440 ,the statements in the pamphlet and circular published are typical of the whole method of exploitation4 ,for example1 can such claims as these be surpassed by the veriest quack8 8,,science cannot improve the means employed in producing ,,the ,,russell ,,emulsion40 8,,genius has not devised better methods than are used in manufacturing ,,the ,,russell ,,emulsion40 8,,money cannot buy better products than are used in ,,the ,,russell ,,emulsion40 8,,experience cannot suggest a more nutritious combination of fats than we use in ,,the ,,russell ,,emulsion40 ,the emulsion is said to be made of equal parts of beef-fat1 coconut1 peanut and cottonseed oils1 held in suspension by albumin4 ,the latter we are told is applied to each globule of the emulsion by an 8elaborate technical process0 devised by ,dr4 ,russell4 ,the mixture is everywhere spoken of as a 8physiological0 emulsion1 but the word is always in quotation marks4 ,why it is called 8physiological0 is not clear1 but the term may be counted on to impress the unthinking or the unscientific4 ,numerous false and exaggerated statements are made about this 8physiological0 emulsion with reference to food value4 ,for instance3 8,the nutritional value of fats differ2 the nutritional value of these fats and their increased efficiency by combination over all others have been determined by extensive clinical observation40 ,and also3 8,the ,russell ,emulsion is approximated in food value by no other emulsion or food product in existence40 8,a #8physiological' emulsion is a predigested food4 ,it is absorbed with little assistance from the digestive juices1 and with no waste of energy4 ,it is1 therefore1 the ideal food44440 ,these are sample statements found in the pamphlet and accompanying circular4 ,a dozen or more pathologic conditions are mentioned in which this 8ideal food0 is specifically indicated2 but we find1 also1 this curious statement3 8,patients can rarely take this dose speaking of the maximum dose of #b ounces night and morning for more than three or four weeks without showing symptoms of over-feeding40 ,this unguarded remark about an ingestion of #dh grams of fat daily prompts one to ask what is wrong with the 8ideal predigested food40 ,russell is wedded to the idea that 8lime starvation0 is the main factor in tuberculosis1 and insists on the importance of large amounts of fat for the 8lime starved40 8,dr4 ,russell was the original interpreter of the ,lime ,starved ,state and originated ,the ,lime ,starvation ,treatment in ,tuberculosis4 ,he also first pointed out and emphasized the therapeutic importance of regarding the combination of lime phosphate and casein1 as brought down by the rennet enzyme1 as a chemical union40 ,this overworked lime-starvation theory certainly lacks any tangible confirmation 7see in this connection a recent paper by ,halverson1 ,mohler and ,bergeim1 in ,the ,journal1 ,may #e1 #aiag71 and to urge it to promote the sale of a fat preparation is preposterous4 ,on the uninitiated the exaggerated pseudo-scientific language of the pamphlet and circular advertisement will probably make some impression4 ,unfortunately such things count not only with the layman who1 having no technical knowledge of physiology1 cannot be expected to weigh the evidence but also with those medical men who1 while scientifically educated1 are influenced by unscientific claims when plausibly presented4 ,the pamphlet is a striking example of a style which is dangerous because it smacks of science4 ,the ,russell ,company sells also a mixture called 8,prepared ,green ,bone10 said to be made by partially digesting ground chicken bones with hydrochloric acid and pepsin and adding glycerin at the end of the digestion4 ,the product is a sticky1 unappetizing looking mass1 put up in little earthenware boxes and advertised as a lime food1 apparently to go along with the fat emulsion4 ,the greater value of a few glasses of milk daily is evidently overlooked4 8,the ,russell ,emulsion0 and 8,the ,prepared ,green ,bone0 were declared inadmissible to ,new and ,nonofficial ,remedies4 ,editorial ,comment4--,there are always those who are ready to exploit the unfortunate tuberculous4 ,it is1 unfortunately1 a fact that many physicians accept as true1 statements clothed with obscure and voluminous quasi-scientific verbiage4 ,such men would laugh at the bald claim that the moon is made of green cheese2 when1 however1 one plausibly and with due solemnity1 affirms that the nocturnal luminous earthly satellite is composed of an infinite aggregation of molecules of bewildering and awe-compelling complexity1 built up from the recently discovered polypeptids1 the whole being of a verdant tint1 the person addressed looks impressed and opines that it sounds reasonable6 ,the advertising for ,the ,russell ,emulsion and ,the ,russell ,prepared ,green ,bone is dangerous because it appeals to the thoughtless--layman and physician1 alike4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #bc1 #aiag47 ,,brom-,i-,,phos ,report of the ,council on ,pharmacy and ,chemistry ,brom-,i-,phos 7,national ,drug ,company1 ,philadelphia7 was submitted to the ,council with a label bearing the following statement3 8#8,,alcohol #be ,,per ,,cent4' ,,composition--,per ,fluidounce ,iodin #a gr4 ,bromin #a gr4 ,phosphorus #h-ajj gr4 ,aromatic ,base q4 s40 ,a request for further information in regard to the composition of ,brom-,i-,phos was sent to the ,national ,drug ,company4 ,it was suggested that since the preparation cannot contain the stated amounts of free bromin1 free iodin and free phosphorus1 the form of combination in which these elements are present should be set forth4 ,in reply1 the firm said1 first1 that 8,brom-,i-,phos consists of ,bromin1 ,iodin1 ,phosphorus1 ,glycerin1 ,wine1 ,water and ,volatile ,oils4 ,the ,iodin is rubbed up with a small percentage of ,potassium ,iodid and #ie per cent4 ,alcohol1 which solution is mixed with a solution of ,bromine and ,spirits of ,phosphorus which are combined with the base and aromatics40 ,the manufacturer also admitted that phosphorus reacts with bromin and iodin and that other reactions might occur1 but maintained that it was 8justified in assuming the greater part1 if not all of these elements1 are actually existent in the nascent state10 and asserted that its 8printed formula complies with our working formula in point of quantities involved as well as existence of elements in an uncombined state40 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reported1 on the contrary1 that no free phosphorus1 free bromin or free iodin could be found in ,brom-,i-,phos1 and that no bromate or iodate could be found2 bromid and iodid were present4 ,the addition of silver nitrate to an acidulated portion1 diluted with water1 gave an amount of silver halid roughly agreeing with that which would be obtained had the claimed amount of bromin and iodin 7together with some potassium iodid7 been used in the preparation of ,brom-,i-,phos and in the process of manufacture become converted to bromid and iodid4 ,the ,council declared ,brom-,i-,phos inadmissible to ,new and ,nonofficial ,remedies1 for conflict with ,rules #a1 #d1 #f1 #h and #aj4 ,the statement of composition is unsatisfactory and misleading in that it suggests that the preparation contains bromin1 iodin and phosphorus in the free 7elementary7 state4 ,the presence of the potent elementary phosphorus is especially suggested by the small amounts of 8phosphorus0 declared4 ,the following statement on the label of the trade package constitutes an indirect advertisement to the public3 8,,indications3 ,scrofula1 ,coryza1 ,hay ,fever ,necrosis1 ,bronchial and ,throat ,affections1 ,catarrhal ,pneumonia1 ,glandular enlargements of the ,spleen1 ,thyroid1 and ,lymphatics1 ,rickets and ,syphilis40 ,the following claims are therapeutic exaggerations3 8,the ,ideal ,alterative0 8444 indicated in all cases where an alterative is desired 4440 8,the association of ,bromin with ,iodin in ,brom-,i-,phos materially enhances the product in the treatment of chronic affections of the skin1 depraved conditions of the mucous membranes1 tertiary syphilis1 glandular enlargements1 etc40 ,in that it suggests that the phosphorus in ,brom-,i-,phos is more readily assimilated than ordinary phosphate1 the following is misleading3 8,the ,phosphorus contained in ,brom-,i-,phos is readily assimilated and at once acts as a nutrient to the nervous and osseous structures of the body1 stimulates metabolism and increases mental activity40 ,the recommendation3 8,your specification of ,brom-,i-,phos in the treatment of ,syphilitic cases will immediately prove beneficial to the patient0 is not supported by evidence4 ,the name does not indicate that ,brom-,i-,phos is an alcoholic preparation with iodid as its essential constituent1 but suggests that phosphorus is an important constituent1 whereas the amount of phosphate or phosphite1 produced by the action of iodin on elementary phosphorus 7if the amount of phosphorus used in making the preparation is correctly stated7 is insignificant4 ,the combination of bromin1 iodin and phosphorus1 or bromid1 iodid and phosphate1 is irrational because these elements are not of mutual assistance to each other in the conditions for which ,brom-,i-,phos is advertised4 ,the ,council's report was submitted to the manufacturer of ,brom-,i-,phos for comment2 the reply contained nothing to permit a revision of the previous conclusions4 ,the ,council declared ,brom-,i-,phos inadmissible to ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #cj1 #aiag47 ,,creosote-,,delson ,,and ,,creofos ,report of the ,council on ,pharmacy and ,chemistry ,creosote-,delson and ,creofos1 or ,creosote with ,hypophosphites1 were submitted by the ,delson ,chemical ,co41 ,inc41 ,new ,york ,city4 ,creosote-,delson is said to be 8beechwood creosote from which the irritating and caustic properties are removed by fractional distillation40 ,it is claimed that ,creofos contains 8#b grains of ,creosote-,delson and #c-c_/e grains of the combined ,hypophosphites in each fluidrachm of the mixture or emulsion1 the lime salt predominating40 ,it is also claimed that 8the primary object of the hypophosphites in this preparation is that of maintaining the refined creosote in a pure1 unoxidized state1 and that no particular claim for therapeutic action on their part is advanced40 ,it is explained further1 however1 8the addition of the lime was prompted by the belief 444 that the fundamental cause of pulmonary tuberculosis is lime starvation44440 ,the assertions are made that ,creosote-,delson is superior to the official creosote because it can be taken 8abundantly and persistently without harm to or interference with stomach and kidneys0 and can be 8taken uninterruptedly and indefinitely10 while the dosage is 8unlimited by any former knowledge of ,creosote ,therapy40 ,creosote-,delson is not on the market except in the combination ,creofos1 although it is supplied on request4 ,creofos is advised in the treatment of tuberculosis1 whooping cough1 measles1 8,grippe and ,colds10 bronchitis1 asthma1 8,intestinal ,affections 7,colitis1 ,summer ,diarrhoea1 etc4710 while its use is suggested for the 8prevention of the spread of contagious diseases10 and for 8preventing contagion in minor contagious diseases at any rate1 in schools and families40 ,the following advertisement has recently appeared in the ,new ,york ,medical ,journal and in the ,therapeutic ,gazette3 ,,creofos ,,medication is the successful development of the most advanced practice in the treatment of infectious diseases4 ,it destroys completely the causative organisms by a bactericide many times more powerful than phenol1 yet absolutely harmless to animal life4 ,unlike serums1 its activity is not confined to any specific disease1 and its use insures against sequelae 7as pneumonia following grippe74 ,especially valuable in the treatment of infants and patients of delicate constitution and in cases where time is of importance4 ,the ,delson ,chemical ,co4 was requested to supply information regarding the identity of ,creosote-,delson and to support the claim that although it is 8the whole drug0 its dosage is 8unlimited by any former knowledge of ,creosote ,therapy40 ,the reply was virtually an admission that the toxic1 caustic1 phenolic components of creosote were present in ,creosote-,delson just as in the official creosote4 ,the referee of the ,committee on ,therapeutics in submitting his report to the ,council pointed out that it is difficult to discuss the pharmacologic merits of a semisecret preparation1 like ,creosote-,delson1 claimed to be more acceptable to the human organism than the official product it is intended to supplant1 when the action of the parent drug is still questioned or disputed by eminent clinicians4 ,absorption experiments have been carried out with creosote and creosote compounds1 such as creosote with hypophosphites or calcium or creosote carbonate1 chiefly by a study of the elimination products in the urine4 ,but any evidence so far offered that these combinations increase absorption and lessen the irritating1 caustic or toxic properties has been wholly inconclusive4 ,the evidence offered by the ,delson ,chemical ,co4 presented no control experiments with the official creosote and did not prove that either ,creosote-,delson or ,creofos was less toxic than a corresponding amount of ordinary beechwood creosote4 ,the referee concluded that no proof had been offered that these preparations are materially superior to ordinary creosote preparations from the pharmacologic or therapeutic standpoint1 and that the claims made for ,creosote-,delson and ,creofos are unwarranted in the light of our knowledge of the properties of creosote4 ,the advertisement quoted above is an example of unproved and unwarranted claims4 ,on the recommendation of the referee1 the ,council declared ,creosote-,delson and ,creofos inadmissible to ,new and ,nonofficial ,remedies1 for conflict with the rules as follows3 ,creosote-,delson3 ,the information so far available is not sufficient to define the nature1 or composition1 of ,creosote-,delson1 or to indicate in how far this product differs1 if at all1 from the official creosote 7conflict with ,rule #a74 ,no methods are furnished for determining the identity or composition of ,creosote-,delson 7conflict with ,rule #b74 ,the available information does not show that ,creosote-,delson has advantages over creosote 7conflict with ,rule #f74 ,creofos3 ,the composition of ,creosote-,delson not having been furnished1 the statement concerning the composition of ,creofos is also unsatisfactory 7conflict with ,rule #a74 ,the therapeutic claims are unsubstantiated and grossly exaggerated 7conflict with ,rule #f74 ,the name is not descriptive of its composition as is required for pharmaceutical mixtures 7conflict with ,rule #h74 ,there is no evidence that hypophosphites prevent decomposition of creosote 7if this occurs74 ,hence the inclusion of hypophosphites must be considered irrational 7conflict with ,rule #aj74 ,the ,council's report was sent to the ,delson ,chemical ,co4 for consideration4 ,the firm's reply contained nothing to warrant a revision of the report1 and the ,council voted that ,creosote-,delson and ,creofos were inadmissible to ,new and ,nonofficial ,remedies and authorized the publication of this report4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #g1 #aiag47 ,,triner',s ,,american ,,elixir ,,of ,,bitter ,,wine ,report of the ,council on ,pharmacy and ,chemistry ,triner's ,american ,elixir of ,bitter ,wine is a wine to which bitter drugs and laxatives have been added4 ,though evidently intended for public consumption1 it is also advertised to physicians1 and consequently the ,council publishes this report4 ,some recent advertisements read3 8,it ,acts ,well and ,is ,very ,palatable4 ,these are the reasons why so many physicians recommend ,,triner',s ,,american ,,elixir ,,of ,,bitter ,,wine4 ,free from any chemicals4 ,prepared from bitter herbs roots and barks of eminent medicinal value and pure natural red wine4 ,a safe relief in auto-intoxication1 constipation1 weakness1 etc4 ,price #a4jj4 ,at drug ,stores4 ,samples gratis upon request only to physicians40 8,a ,laxative ,tonic4 ,in cases of constipation and its sequel1 autointoxication1 weakness and nervousness you should try ,triner's ,american ,elixir of ,bitter ,wine4 ,this preparation consists of ,cascara ,sagrada1 ,dandelion1 ,gentian ,root1 with ,licorice in ,pure ,red ,wine as a base1 with ,aromatics40 ,triner's ,american ,elixir of ,bitter ,wine is put up in bottles said to hold #a pint1 #e-a_/c fluidounces4 ,the label declares the presence of from #af to #ah per cent4 alcohol by volume1 and states that 8no special tax is required by the laws of the ,u4 ,s4 for the sale of this medicinal preparation40 ,the circular contains the following recommendations for its use3 8444 ,it should be used in all cases calling for a safe evacuation of the bowels1 without weakening the body or causing any pain or other discomfort2 in loss of appetite1 nervousness and weakness40 8,triner's ,american ,elixir of ,bitter ,wine consists of two principal ingredients1 viz41 ,red ,wine and ,medicinal ,herbs40 8,red ,wine strengthens the intestines and regulates their work4 ,it also increases the appetite1 stimulates and strengthens the body40 8,use ,triner's ,american ,elixir of ,bitter ,wine always when a thorough cleaning out of the intestines is needed4 ,arrange the dose to suit your condition and habits40 8,in ,chronic ,constipation the dose of ,triner's ,american ,elixir of ,bitter ,wine should be increased or taken oftener40 8,many ,female ,troubles are caused or aggravated by constipation and ladies should always pay good attention to this fact40 ,in addition to ,triner's ,elixir of ,bitter ,wine1 the circular--in ,english1 ,polish1 ,russian1 ,spanish and other languages--advises the use of ,triner's ,angelica ,bitter ,tonic1 ,triner's ,red ,pills1 ,triner's ,liniment and ,triner's ,cough ,sedative4 ,the composition of this 8wine0--some bitter drugs1 a laxative and a tannin-containing1 constipating red wine--and advertising propaganda all tend to the continued use of this alcoholic stimulant and thus to the unconscious formation of a desire for alcoholic stimulation4 ,as the medical journal advertisements may lead physicians to prescribe this secret and irrational preparation and thus unconsciously lead to alcoholism1 the ,council authorized publication of this report4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #ad1 #aiag47 ,,trimethol ,report of the ,council on ,pharmacy and ,chemistry ,trimethol is the trade name for a substance said to be trimethyl-methoxy-phenol of the formula ,c,h7,,ch77,,och74,,oh--#a3b3d3e3f1 originated by ,j4 ,t4 ,ainslie ,walker4 ,it is sold as a nontoxic germicide1 having a ,rideal-,walker phenol-coefficient of #dj1 even in the intestinal canal4 ,it is described as insoluble in water and not to be decomposed in the alimentary tract1 and to be excreted unchanged in the feces4 ,trimethol itself is not obtainable4 ,pharmaceutical preparations--,trimethol ,syrup1 ,trimethol ,capsules and ,trimethol ,tablets1 said to contain ,trimethol--are prepared by ,the ,walker-,leeming ,laboratories and sold by ,thos4 ,leeming and ,co41 ,new ,york4 ,trimethol preparations are advertised for use in all conditions dependent on intestinal putrefaction4 ,the advertising claims made are very extensive and some of them give to 8,trimethol0 the scope of a panacea4 ,for example3 8,physicians are constantly reporting cases where ,trimethol has been especially efficient1 and describing conditions 7until recently not associated with intestinal infection7 which have been distinctly benefited by its use4 ,this would seem to bear out the contentions of ,charcot and ,metchnikoff that #ij of all human ailments have their origin in intestinal infection4 8,the careful practitioner1 when in doubt1 will bear this in mind1 now that we have a really efficient and non-toxic intestinal germicide--not a mere antiseptic40 ,the ,walker-,leeming ,laboratories have not formally requested the ,council to consider the ,trimethol preparations1 though in a personal letter to a member of the ,council ,j4 ,t4 ,ainslie ,walker invited an investigation of his compound4 ,for the investigation of ,trimethol and its preparation the ,council secured the aid of a bacteriologist who has given much attention to the study of the intestinal flora4 ,the ,walker-,leeming ,laboratories and ,j4 ,t4 ,ainslie ,walker were both asked to submit details of experimental studies and also to furnish a supply of the pure 8,trimethol40 ,but the only data sent that had any definiteness set forth the bacterial counts made of plate cultures of stools of one patient before and after the administration of ,trimethol ,capsules4 ,,refuse ,,to ,,furnish ,,trimethol ,the request for the pure substance was refused1 on the grounds that the substance was not used in the undiluted form4 ,the failure to furnish the chemical substance claimed as the essential constituent of the ,trimethol preparations is to be deprecated if indeed it has not greater significance4 ,at least it made it impossible for the ,council's expert to express his results in terms of absolute ,trimethol of established composition4 ,the data obtained apply only to the market preparations claimed to contain ,trimethol4 ,so far as the investigation and report go1 8,trimethol0 is a hypothetical substance4 ,clinical or animal tests of the asserted intestinal antiseptics have hitherto given equivocal results because it is impossible1 on the one hand1 to predict the course of any intestinal infection1 or1 on the other hand1 to determine what effect1 if any1 was produced by administration of the medicament4 ,it therefore seemed unwise to undertake this line of investigation until the more direct laboratory bacteriologic methods had been exhausted4 ,consequently the investigator checked1 in the first place1 the phenol coefficient of one of the ,trimethol preparations and then also determined its 8penetrability0 coefficient4 ,although by both methods ,trimethol was found to be a germicide1 the results did not indicate any remarkable potency or other properties suggesting that the drug possessed special therapeutic value4 ,from the results obtained it appeared inadvisable to proceed further with the work until more definite evidence of the nature and of the value of the substance should be at hand4 ,the report of the bacteriologic investigation follows3 ,,the ,,bacteriologist',s ,,report 8,i have made no attempt to study the effects of internal administration of ,trimethol on the intestinal flora4 ,the methods available at the present time of enumerating the numbers of viable bacteria in the feces are probably not accurate within #ajj per cent4 and the precision of such determinations is equally variable4 ,the physiologic factors involved are so complex that they would appear to make a really valuable assay a question of many months' careful study4 ,if it were possible to administer known amounts of ,trimethol1 as such1 the problem might be worth while2 inasmuch as the available reactive substance is not at present quantitatively assayable1 this phase of the investigation barely seems practicable4 8#8,trimethol ,syrup1' as such1 appears to be about #aj per cent4 as efficient in its germicidal value as carbolic acid4 ,if the assay1 #c_/d m4 ,trimethol per drm4 7as the label indicates71 is correct1 the substance would appear to possess germicidal merit provided enough could be administered1 if it is not influenced by passage through the stomach4 8,a package containing four four-ounce bottles labeled #8,trimethol1 ,a ,non-,toxic ,germicide ,,syrup ,representing #c_/d m4 ,trimethol per drm41 ,alcohol #a-a_/b per cent4' was received at the laboratory ,dec4 #ae1 #aiaf4 ,later a smaller package containing1 according to the label1 #ajj ,trimethol tablets1 each #e gr41 representing #a-a_/d m4 ,trimethol1 was received4 ,the tablets were apparently chocolate coated4 8,two separate series of tests were made upon the syrup4 7a7 ,,phenol ,,coefficient1 using the method outlined in ,bulletin ,no4 #hb1 ,hygienic ,laboratory1 ,method of ,standardizing ,disinfectants ,with and ,without ,organic ,matter4 7b7 ,a ,,penetrability ,,coefficient by the method of ,kendall and ,edwards1 ,journal of ,infectious ,diseases1 #h1 #bej4 8,the former method compares the viability of naked germs in a #a per cent4 carbolic acid solution as a standard1 with various dilutions of the germicide to be tested4 ,the latter measures the relative diffusibility and germicidal power of carbolic acid and various dilutions of the germicide to be tested upon ,bacillus coli suspended in #a4b per cent4 agar which is molded in cylinders of one centimeter diameter after infection with the organism4 8,the first method--phenol coefficient--possesses advantages and disadvantages which are well known and need no mention here4 ,it is worthy of notice1 however1 that as the death rate of the bacteria increases during the progress of the test1 it becomes increasingly difficult to maintain a uniform suspension of living organisms so that each loopful removed shall exactly represent the developmental potentiality of the residual organisms4 8,the second method theoretically covers the possibility because all the organisms are immobilized and are exposed to the germicide in direct proportion to its diffusibility until the center of the agar mass is reached1 where the residual viable bacteria are presumably located4 ,inasmuch as the penetrability of an intestinal mass is involved in a discussion of intestinal germicides1 the propriety of utilizing this #8penetrability coefficient' in this connection is obvious1 in spite of its patent shortcomings4 8,it is unnecessary to discuss the technique--the standard broth mentioned in the ,hygienic ,bulletin1 a temperature of #gj ,f41 a standard #d mm4 loop and careful attention to dilutions 7using distilled water7 were all observed4 ,the various dilutions of ,trimethol ,syrup were made with accurate volumetric pipettes1 measuring flasks and distilled water was used as a diluent4 8,the results of several determinations1 using ,trimethol ,syrup from three separate bottles1 were in sufficient accord to warrant the statement that a dilution of #a_/aj of ,trimethol ,syrup was equivalent to a #a_/ajj dilution of carbolic acid1 using ,bacillus typhosus as the test organism4 ,both solutions--the ,trimethol and phenol--killed the organism in the interval between #g-a_/b minutes and #aj minutes' exposure4 ,that is to say1 our observations indicate that under standard conditions as defined above1 a #aj per cent4 solution of ,trimethol ,syrup is equivalent in germicidal powers1 as defined by the phenol coefficient to a #a per cent4 solution of phenol4 ,naturally1 no predictions can be drawn from these observations indicative of the value as an intestinal germicide of ,trimethol itself4 8,the ,,penetrability ,,coefficient resulted as follows3 ,a #e per cent4 solution of phenol killed ,bacillus coli1 suspended uniformly throughout a cylinder of #a4b per cent4 agar in the interval between #fj and #ij minutes4 ,a #a per cent4 solution of phenol killed the same organisms under the same conditions in the interval between two and one half and three hours4 ,an undiluted solution of ,trimethol ,syrup killed the organisms in the interval between two and one half and three hours4 ,a #aj per cent4 solution 7nine volumes of distilled water to one volume of ,trimethol ,syrup7 failed to kill the organisms in four hours4 ,it would appear that undiluted ,trimethol ,syrup has the same combined penetrability and germicidal value as a #a per cent4 phenol solution4 8,the ,,phenol ,,coefficient3 ,a #aj per cent4 solution of ,trimethol ,syrup in distilled water 7nine volumes of distilled water to one volume of ,trimethol ,syrup7 possesses the same germicidal power as a #a per cent4 solution of carbolic acid4 ,this coefficient takes no cognizance of the actual amount of ,trimethol as such--it merely indicates the relative germicidal power of the ,trimethol ,syrup as sold40 ,the preceding report shows that ,trimethol ,syrup has a phenol coefficient of #a_/aj1 and1 assuming ,trimethol ,syrup contains the amount of ,trimethol declared1 the substance ,trimethol would have a phenol coefficient of #h-a_/c instead of #dj1 as is claimed4 ,according to ,kendall and ,edwards' method1 the penetrability-germicidal value of the syrup is equal to a #a per cent4 solution of phenol4 ,,walker',s ,,reply ,,to ,,criticism ,the report of the bacteriologist was submitted to ,the ,walker-,leeming ,laboratories for comment4 ,the following reply was received from ,j4 ,t4 ,ainslie ,walker3 7,may #bb1 #aiag7 8,in reply to your letter of the #aeth inst41 which has just been placed before me on my return to town1 ,i have to inform you that the potent constituent of ,trimethol ,tablets and ,trimethol ,syrup is not fully available as a bactericide until it comes in contact with the pancreatic fluid4 8,as you will see from the enclosed extracts from clinical reports1 the therapeutic value of ,trimethol has been well established4 8,as regards penetrability1 no claim has ever been made for ,trimethol in this connection2 and1 as ,i pointed out in my original paper 7,american ,medicine1 ,september1 #aiad71 when referring to the independent tests made by ,dr4 ,frederick ,sondern1 #8,no attempt was made to determine the bacterial content of the solid particles1 as in the opinion of the writer sterilization of the interior of these particles is not only absolutely impossible1 but wholly unnecessary4 ,the fact of the fluid contents of the canal being sterile may be taken to indicate that the exterior of all solid particles is in a like condition1 and therefore harmless4 ,it is the organisms in the fluid portions only that produce the deadly effects through the chemical substances they secrete2 those in the interior of the solid portions 7i4 e41 as evacuated7 may be disregarded1 as they are not available for good or evil4' 8,i must confess to no little surprise on learning that your investigator is still using the ,hygienic ,laboratory method of determining phenol coefficients4 ,i would respectfully suggest that you call his attention to the critical comparison of the ,hygienic ,laboratory and ,r4-,w4 ,tests1 which he will find in the enclosed reprint from the ,new ,york ,medical ,journal of ,march #aa1 #aiaf3 #8,instead of being an improvement upon the standard ,r4-,w4 ,test1 the so-called ,hygienic ,laboratory ,method is so defective as to be wholly unreliable1 and incapable of furnishing results of any scientific or practical value whatever4'0 ,as to the statement that the potent constituent of ,trimethol ,tablets and ,trimethol ,syrup is not fully available as a bactericide until it comes in contact with the pancreatic fluid1 attention is called to a leaflet1 which accompanies each bottle of ,trimethol ,syrup1 that reads3 8,trimethol is insoluble in water1 but when properly emulsified has a ,rideal-,walker co-efficient of #dj2 that is to say1 it is #dj times more efficient as a germicide than phenol 7pure carbolic acid740 ,the ,trimethol ,syrup which was used in the investigation1 when mixed with water produced an almost perfectly transparent solution1 which justifies the assumption that the proper physical conditions were observed and that this objection is not well founded4 ,as regards the relation of pancreatic fluid to bactericidal availability of ,trimethol1 there is little to say1 other than that the published statements in the advertising accompanying the packages make no mention of this point4 ,it would be interesting to know what1 if any1 relation the pancreatic fluid has to this substance1 in view of the statement that it 8has a ,rideal-,walker coefficient of #dj40 ,the ,trimethol 8literature0 does not throw light on the question1 ,what is the germicidal value of ,trimethol ,syrup as compared with phenol8 ,the only available method of determining the germicidal value of a liquid disinfectant is to make a direct comparison of the substance in question with phenol under similar conditions4 ,given parallel conditions1 not obviously prejudicial to the substance tested in contrast to the standard solution1 the results are comparable1 and furnish a basis for estimating the relative germicidal power of the two substances4 ,in the investigation1 ,trimethol ,syrup and phenol were thus compared4 ,as regards the contention that the bacteria within fecal masses are harmless1 this may be granted4 ,but it must also be admitted that these intestinal masses are constantly being reformed so that buried micro-organisms do not remain in the interior4 ,for this reason1 the determination of the penetrability coefficient of a germicide is pertinent4 ,regarding the respective merits of the old ,rideal-,walker and the newer ,u4 ,s4 ,hygienic ,laboratory method of determining the phenol coefficient1 the ,rideal-,walker method was found to possess certain drawbacks1 and in an attempt to overcome these the 8,lancet ,method0 was evolved2 this method in turn was improved in the ,u4 ,s4 ,hygienic ,laboratory and led to the ,united ,states ,public ,health ,service ,hygienic ,laboratory method for the determination of the phenol coefficient of disinfectants 7published in ,hygienic ,laboratory ,bulletin #hb74 ,in #aiac this method was formally adopted by the ,council for the valuation of disinfectants or germicides of the phenol type1 and the method is now in general use for this purpose in the ,united ,states4#aai ,in this connection ,hiss and ,zinsser may be quoted 7,ed4 #b1 page #hj73 8,the most precise method of standardizing disinfectants is that now in use in the ,united ,states ,public ,health ,service40 ,stitt1 director of the ,united ,states ,naval ,medical ,schools1 in his ,practical ,bacteriology1 ,blood ,work and ,parasitology 7,ed4 #d1 page #dgc7 says3 8,in the ,united ,states disinfectants are rated according to the ,hygienic ,laboratory ,phenol ,coefficient40 #aai ,those who are interested in the relative merits of the ,rideal-,walker1 the ,lancet and the ,hygienic ,laboratory methods for the valuation of disinfectants1 should read the following3 ,method of ,standardizing ,disinfectants with and without ,organic ,matter1 ,j4 ,a4 ,m4 ,a41 ,aug4 #bd1 #aiab1 p4 #ffg2 ,standardization of disinfectants1 ,report of the ,council on ,pharmacy and ,chemistry1 ,j4 ,a4 ,m4 ,a41 ,april #bf1 #aiac1 p4 #acaf2 ,standardizing ,disinfectants1 ,j4 ,a4 ,m4 ,a41 ,sept4 #cj1 #aiaf1 p4 #hhc4 ,the ,council adopted the recommendation of the ,committee on ,pharmacology to the effect that the claims made for ,trimethol are unsupported by acceptable evidence4 ,accordingly1 ,trimethol and the pharmaceutical preparations said to contain it--,trimethol ,syrup1 ,trimethol ,capsules1 and ,trimethol ,tablets--were held ineligible for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #aa1 #aiag47 ,,ferrivine1 ,,intramine ,,and ,,collosol ,,iodine ,report of the ,council on ,pharmacy and ,chemistry ,e4 ,fougera ,co41 ,inc41 ,new ,york1 acting as agent for ,the ,british ,drug ,houses1 ,ltd41 ,london1 advertise 8,ferrivine10 8,intramine0 and 8,collosol ,iodine0 to the medical profession4 ,a circular entitled 8,ferrivine1 ,the ,new ,anti-,syphilitic ,remedy0 begins3 8,,ferrivine is the name given to ferric tri-para-amino-benzene sulphonate4 ,this iron compound was first prepared by ,mr4 ,j4 ,e4 ,r4 ,mc,donagh1 ,f4 ,r4 ,c4 ,s41 by whom it has been both biologically and clinically tested4 ,it is slightly soluble in water1 the solution having an acid reaction4 8,,indications 8,according to ,mr4 ,j4 ,e4 ,r4 ,mc,donagh's researches1 the phases of the ,leucocytozoon syphilids are killed by the lipoid-globulin molecules of the serum1 which possess a stereochemical molecular configuration homologous to those of the lipoid-globulin molecules of the parasite4 ,the process is one of absorption1 a chemico-physical reaction which is in part dependent upon the supply of active oxygen4 ,active oxygen is formed directly by oxidation processes and the peroxide necessary for its formation directly by reducing processes4 ,oxidation is increased by metals and reduction by non-metals4 ,the non-metal which acts in the body as the normal reducing agent is sulphur1 hence the discovery of ,intramine 7see separate pamphlet74 ,the metal which acts in the body as the normal oxidising agent1 is iron1 hence the discovery of ,ferrivine40 ,a circular1 8,intramine1 a ,new ,non-,toxic ,compound for the ,treatment of ,protozoal and ,chronic ,bacterial ,diseases10 expounds ,mr4 ,mc,donagh's ideas of the treatment of syphilis with ,ferrivine and ,intramine by means of the oxidising action of ,ferrivine and the reducing action of ,intramine and asserts3 8,as the ultimate administration of oxidising and reducing agents will benefit almost any infection1 it may be said that ,intramine is indicated in all protozoal diseases1 and in all chronic bacterial diseases1 especially in tuberculosis1 presumably in leprosy and possibly in malignant disease cancer84 ,to the administration of ,intramine there are no contraindications40 ,we are also told that3 8,intramine is useful injected into the urethra4444 ,in cases of chronic urethritis and perifolliculitis 444 invaluable as a local application to chronic ulcers 4440 ,the ,intramine circular includes a 8,scheme of ,treatment for ,syphilis0 which advises1 in addition to ,intramine1 ,ferrivine or salvarsan1 mercury and iodids1 the use of another proprietary called 8,collosol ,iodine40 ,an inquiry addressed to ,fougera ,co4 in regard to the character and composition of this preparation1 brought the reply that the firm had no knowledge of its identity4 ,this 8scheme of treatment0 is objectionable in that it advises the 8stock0 treatment of a disease which demands individualization and further in that whatever beneficial effects may result from the use of mercury and iodid is likely to be ascribed to the preparations 8,intramine10 8,ferrivine0 and 8,collosol ,iodine40 ,the advertising for ,ferrivine and ,intramine sent out by ,fougera ,co4 contains no experimental or clinical data on which an estimate of their value may be based4 ,apparently in ,england1 where these products were originated1 little has been published regarding them4 ,there is1 however1 one report which may be accepted as a carefully controlled clinical trial4 ,in the ,lancet 7,june #ag1 #aiaf1 p4 #abad7 ,l4 ,w4 ,harrison1 ,d4,s4,o41 ,m4,b41 ,ch4,b4,glasg41 and ,c4 ,h4 ,mills1 ,m4,r4,c4,s41 ,l4,r4,c4,p4,lond41 report on 8,the ,effect of ,ferrivine and ,intramine on ,syphilis40 ,after briefly reviewing the theories which form the basis of ,mc,donagh's proposed treatment of syphilis with his discoveries 8,ferrivine0 and 8,intramine0 the authors point out3 8444 that ,mr4 ,mc,donagh's biological discoveries 444 have not been publicly confirmed by any biologist of standing 4440 ,while3 8444 eminent chemists have confessed themselves unable to understand his chemistry40 ,the authors explain3 8,recognizing that this might prejudice our practical tests of ,intramine and ,ferrivine1 we have taken particular care to guard against their influence1 cross-checking our observations and submitting them to others for confirmation or otherwise40 ,harrison and ,mills chose for a test three ordinary cases of secondary syphilis1 cases with well marked lesions1 the clinical progress of which could easily be watched and from which it was easy to obtain specimens for microscopic examination4 ,after a detailed account of the three cases--which records grave conditions resulting from the treatment and which shows the inefficiency of the drugs--they write3 8,from the above account it will be seen that the local and general reactions which follow the injection of these preparations are by no means pleasant4 ,in the case of ,intramine the pain is undiluted torture and lasts so for two or three days4 ,one of us had previously treated four cases with ,intramine and the same local reaction occurred in these4 ,in two of them abscesses have burst outwardly1 one of which is still discharging necrotic dbris1 ten weeks after the injection1 and will take many more weeks to close4 ,in those cases where no abscess has yet burst it is easy to feel by the gap in the muscles that considerable necrosis has occurred4 ,none of these effects can be ascribed to sepsis1 as most rigid aseptic precautions were taken4 ,further1 particular care was taken to make the injections strictly intramuscular4 ,the constitutional symptoms which follow immediately upon the injection of ,ferrivine are distinctly alarming1 and such as would cause one to hesitate before injecting this remedy into any but robust patients40 ,harrison and ,mills estimate the therapeutic effects of these drugs thus3 8#a4 ,that ,ferrivine entirely failed to cause ,s4 pallida to disappear from the lesions of three well-marked cases of secondary syphilis4 8#b4 ,after the failure of ,ferrivine to cause the disappearance of ,spirochaeta pallida from a mucous patch a single dose of #j4c gm4 salvarsan effected this in #ah hours1 and the patch1 which had hitherto been uninfluenced1 had healed within #dh hours4 8#c4 ,clinically we were unable to detect any influence of either or both these compounds on syphilitic lesions1 although each of them was of the variety which heals in a week or ten days under salvarsan treatment4 8#d4 ,further syphilitic lesions appeared immediately after the treatment in one of the two cases treated with both ,ferrivine and ,intramine4 ,a mucous patch appeared on one tonsil as well as further syphilitic papules from which spirochetes were obtained4 ,the other case developed nephritis1 with albumin and epithelial casts2 which was not present prior to the injections40 ,while from these cases the obvious conclusion was drawn that ,intramine and ,ferrivine 8have no specific effect on early syphilis10 these authors subsequently treated a case of tertiary syphilis with the drugs4 ,an ,intramine injection caused pain for several days but did not stop the progress of the disease4 ,ferrivine was then administered 8not without a feeling of grave responsibility0 in view of their previous experiences4 ,they state that 8the reaction which resulted in this instance was the most severe0 they ever experienced after an intravenous injection of any of the antisyphilitic remedies with which they had previously worked4 ,it is stated that 8for a period of some minutes there was grave doubt as to the patient's survival40 ,after resuscitation the patient passed a disturbed night1 and rigors which ensued lasted until the following afternoon4 ,the author's report that in this case also no clinical improvement occurred and that the ,intramine-,ferrivine treatment was replaced by a course consisting of salvarsan1 potassium iodid and mercurial inunction4 ,ferrivine1 ,intramine and ,collosol ,iodine were declared inadmissible to ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #h1 #aiag47 ,,eskay',s ,,neuro ,,phosphates ,report of the ,council on ,pharmacy and ,chemistry ,for the information of the profession the ,council has prepared and authorized for publication the following report on ,eskay's ,neuro ,phosphates4 ,w4 ,a4 ,puckner1 ,secretary4 ,eskay's ,neuro ,phosphates 7,smith1 ,kline ,french ,co41 ,philadelphia7 is offered to physicians under the claims that it contains alcohol1 #ag per cent41 and sodium glycerophosphate1 #b grains1 calcium glycerophosphate1 #b grains1 and strychnin glycerophosphate1 #a_/fd grain1 in each dessertspoonful4 ,it is called a 8,nerve ,tissue ,reconstructive10 and its advertising claims are based on the discredited theories that certain disorders are due to a deficiency of phosphorus in the nerve structure of the body1 and that glycerophosphates are assimilated more readily than ordinary phosphates4 ,this assumption was based on the knowledge that the lecithins1 which form a part of the nerve structure1 contained the glycerophosphate radical in the molecule4 ,in line with this1 ,smith1 ,kline ,french ,co4 aver3 8,eskay's ,neuro ,phosphates is of marked value in many acute and chronic conditions1 in nervous exhaustion following mental and physical strain1 neurasthenia1 paralysis1 anemia1 tuberculosis1 marasmus1 debility and wasting diseases generally1 and the nerve-weakness of the aged4 ,it is particularly useful in convalescence from acute diseases and in the nervous condition following la grippe40 ,in its report on 8,the ,therapeutic ,value of the ,glycerophosphates0 7,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcc7 the ,council pointed out that the therapeutic use of the glycerophosphates was based on the assumption that the inorganic phosphates cannot supply the body's needs of phosphorus or that the use of organic compounds 8spared0 the system the necessity of making such synthesis4 ,the report presented evidence to show that the glycerophosphates are not absorbed as such1 but that they are split into inorganic phosphates before absorption4 ,the ,council showed that there was convincing evidence that the animal organism synthesizes its complex organic phosphorus constituents from inorganic phosphates1 and that organic phosphorus is of no more value as a food than inorganic4 ,despite this the ,neuro ,phosphates advertising makes use of the fallacious assumption regarding the action of the glycerophosphates4 ,pleading for the particular mixture represented by the proprietary1 it is asserted that3 8,sodium glycerophosphate is of special value in neurasthenia1 ,addison's disease1 phosphaturia and phthisis40 and that calcium glycerophosphate 8is employed in bone fracture1 rachitis1 tuberculosis and various wasting diseases40 ,the phosphorus content of #a_/fd grain of strychnin glycerophosphate is ridiculously small4 ,yet it is asserted that this strychnin salt is of superior value because it combines the effects of strychnin with a 8food-like form of phosphorus40 ,eskay's ,neuro ,phosphates has an acid reaction which is capitalized1 thus3 8,experiments have shown that the acid glycerophosphates are more rapidly absorbed and are more efficient than the neutral salts40 ,and as a further illustration of extravagant claims3 8,as a glycerophosphoric acid in the form of lecithin is normally present in spermatozoids1 it is but natural that the glycerophosphates should exhibit aphrodisiac effects 7as has been observed71 but this result does not seem to obtain in all cases40 ,is this a clumsy attempt to exploit this 8nerve phosphate0 as a 8lost manhood0 cure8 ,the ,council held ,eskay's ,neuro ,phosphates ineligible for ,new and ,nonofficial ,remedies because unwarranted therapeutic claims are made for it and because the administration of strychnin1 calcium1 phosphate and alcohol is not conducive to rational therapeutics1 particularly when such a mixture is marketed under a name which indicates but one of its constituents4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bi1 #aiag47 ,k-,y ,,lubricating ,,jelly ,report of the ,council on ,pharmacy and ,chemistry ,because of inquiries received1 the ,council has authorized publication of the following report declaring ,k-,y ,lubricating ,jelly inadmissible to ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,k-,y ,lubricating ,jelly 7,van ,horn and ,sawtell1 ,new ,york71 originally advertised as a lubricant for instruments and the hands1 is now also recommended as a therapeutic agent4 ,if the claims for 8,k-,y0 were limited strictly to such effects as result from the purely mechanical properties of a lubricant1 it might be held that it would not come under the purview of the ,council4 ,the preparation1 however1 while introduced as a lubricant1 is now offered for a broader field of use1 and the manufacturers make claims which are not supported by any evidence available to the ,council4 ,evidence the following1 taken from a circular that accompanies the package3 8,k-,y allays smarting and burning at once through its pronounced soothing and cooling effects1 and thus makes an admirable dressing for burns40 8,many physicians make a practice of anointing the bodies of their measle and scarlet fever patients with #8,k-,y1' in this way affording gratifying relief from itching and irritation1 and effectively preventing dissemination of infectious material40 ,and this from another circular3 8,i had one of the most troublesome cases of pruritus vulv that ,i had ever seen4 ,i guess ,i must have tried everything and the case had been referred to me by another man1 who had previously tried everything1 including cauterization4 ,well1 one day ,i was examining her1 and of course ,k-,y on the speculum--the irritation seemed to quiet down1 and the following day she said she felt no effects from it at all4 ,then later on1 it returned1 and ,i couldn't imagine what had done so much good1 unless it could have been the lubricant1 so ,i told her to buy a tube1 which she did4 ,every once in a while she has a return of it slightly1 but she just applies ,k-,y and clears it all up40 ,the manufacturers state that they do not know why ,k-,y is so soothing1 but suggest3 8,possibly the cooling action of the combination1 and the effect of the #d boric acid contained1 are factors that enter4 ,be all that as it may1 the fact certainly remains that oftentimes1 after other local measures fail1 #8,k-,y' lubricating ,jelly gives relief40 ,elsewhere it is claimed to be germicidal1 and to give relief in other conditions1 thus3 8,diabetic and uremic irritations1 not only of the genitalia1 but of other parts1 have been found fully as amenable as pruritus vulvae to the soothing influence of #8,k-,y' ,lubricating ,jelly1 especially if the previous application is removed with water every time a new one is put on40 ,the foregoing citations are obviously intended largely for the public1 and make it plain that 8,k-,y0 ,jelly is not in the class of nonmedical and harmless external applications2 on the contrary1 these claims tend to create the impression that the spread of measles and scarlet fever can be prevented in the stage of desquamation4 ,to place such statements in the hands of the patient supported by the tacit endorsement of a prescription is to create a false and dangerous sense of security and to lead to a failure to observe other and more important means of preventing dissemination of these diseases4 ,the ,council held ,k-,y ,lubricating ,jelly in conflict with ,rules #a1 #d1 #f and #aj1 and authorized publication of this report4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bi1 #aiag47 ,,ziratol ,report of the ,council on ,pharmacy and ,chemistry ,ziratol 7,bristol-,myers ,company1 ,new ,york71 in compliance with the federal 8insecticide law10 is declared to contain #cb per cent4 water and #cj per cent4 glycerin as inert constituents4 ,regarding its active constituents the manufacturer makes the following and meaningless statement3 8,ziratol is prepared from ,phenols of the ,naphthalene series and consists of a solution of such ,phenols in a mixture of soap1 water and glycerin40 ,in response to inquiry1 the ,a4 ,m4 ,a4 ,chemical ,laboratory examined ,ziratol and reported that its essential constituent appears to be alpha-napthol1#abj and that it has1 essentially1 the following composition by weight3 ,alpha-napthol #ah per cent41 soap #bj per cent41 glycerin and water sufficient to make #ajj per cent4 #abj ,alpha-napthol was also found to be the basis of the nostrum ,benetol4 ,see ,the ,journal1 ,april #ae1 #aiaa1 p4 #aabh4 ,a ,ziratol advertising circular gives a tabulated report of germicidal tests1 said to have been made according to the method of the ,hygienic ,laboratory of the ,u4 ,s4 ,public ,health ,service4 ,when this work was done is not stated4 ,according to these tests ,ziratol possesses a phenol-coefficient of #ac4ff4 ,the claim that ,ziratol is ten times more efficient than carbolic acid 7phenol7 is evidently based on this report4 ,these claims of high germicidal value are contradicted by an examination made for the ,council4 ,a specimen purchased in the open market was examined independently by two operators1 to determine the ,hygienic ,laboratory phenol-coefficient4 ,one observer found the phenol coefficient to be #b4ed4 ,the other reported it to be #c4ji4 ,evidently the germicidal value of ,ziratol is greatly exaggerated in the advertising claims and1 in fact1 does not exceed that of the official compound solution of cresol 7,liquor ,cresolis ,compositus1 ,u4 ,s4 ,p47 for which a phenol-coefficient of about three has been established4 7,see ,new and ,nonofficial ,remedies1 #aiag1 p4 #hb47 ,the claim that ,ziratol is 8the ,universal ,antiseptic and ,germicide0 is manifestly an unwarranted exaggeration4 ,the referee in submitting this report to the ,council recommended that ,ziratol be held in conflict with ,rule #a 7secrecy of composition7 and ,rule #f 7unwarranted and exaggerated claims74 ,after the report had been submitted1 it was found that a new advertising circular1 accompanying a trade package1 no longer contained the claim that 8,ziratol is ten times more efficient than ,carbolic ,acid40 ,the older circular made the following statement3 8#a4 ,strong ,activity4--,compared with the bactericidal action of ,carbolic ,acid by the method of the ,hygienic ,laboratory of the ,marine ,hospital ,service1 ,,ziratol has the ,carbolic ,acid ,coefficient of more than ,,ten1 that is1 ,,ziratol is ,,ten times more efficient than ,carbolic ,acid1--a strength unapproached by any other of its class4 ,,ziratol in dilution of #a3adjj kills the ,typhoid ,bacillus in #b-a_/b minutes1 thus proving that it is strongly active even in very weak solutions40 ,the new advertising circular reads3 8#a4 ,strong ,activity--,extensive bacteriological investigations on many pathogenic organisms1 conducted in the ,lederle ,laboratories of ,new ,york1 prove conclusively the high bactericidal value of ,ziratol in extremely dilute solutions4 7,a copy of the complete report will be mailed upon request470 ,in response to a request1 the ,bristol-,myers ,company sent a copy of the bacteriologic investigations of ,ziratol1 said to have been made by the ,lederle ,laboratories4 ,the organisms employed for these tests were ,staphylococcus aureus1 ,staphylococcus albus1 ,streptococcus1 ,green pus bacillus1 ,b4 coli1 and saliva4 ,no tests are given with the typhoid bacillus4 ,the conclusion is reached that 8in all the tests the solutions of ,ziratol have several times greater killing efficiency than those of phenol40 ,the 8coefficients0 or comparative values which can be calculated from the results after exposure of #ae minutes to the disinfectants range from #b4j to #d4j4 ,this is in substantial accord with the referee's findings as regards the phenol-coefficient with ,b4 typhosus as the test object4 ,while the new advertising circular avoids the former claim that ,ziratol is ten times more efficient than carbolic acid1 in germicidal value1 it still makes the unwarranted claims that ,ziratol is the 8universal disinfectant40 ,the ,council declared ,ziratol inadmissible to ,new and ,nonofficial ,remedies 7#a7 because its composition is secret 7,rule #a72 7#b7 because the phenol coefficient1 determined according to the method of the ,hygienic ,laboratory1 ,u4 ,s4 ,p4 ,h4 ,s41 is not stated on the label 7,rule #b72 7#c7 because the label and the circular accompanying the trade package advises its use by the public as a 8vaginal douche0 7,rule #c72 and 7#d7 because the claim that ,ziratol is the 8universal disinfectant0 is exaggerated and unwarranted 7,rule #f74 ,before authorizing publication of the preceding report the ,council submitted it to the ,bristol-,myers ,company in order to give that company the opportunity of revising its method of marketing ,ziratol4 ,in reply the company enlarged on its withdrawal 7on 8our own initiative07 of the claim that ,ziratol had a phenol-coefficient of over ten when this claim was shown to be incorrect 8by authoritative sources40 ,one wonders whether this is a euphemistic reference to the proceedings of the federal authorities under the ,insecticide ,act against the ,bristol-,myers ,company1 just made public1#aba because of the false claims made for the germicidal efficiency of ,ziratol4 ,this prosecution resulted in the seizure and condemnation of two lots of this proprietary which had passed in interstate commerce4 #aba ,u4 ,s4 ,dept4 of ,agric41 ,insecticide and ,fungicide ,board1 ,service and ,regulatory ,announcements1 ,no4 #af1 issued ,aug4 #h1 #aiag4 ,no4 #bdd1 ,misbranding of 8,ziratol40 ,u4 ,s4 v4 #ajj bottles1 more or less1 of 8,ziratol02 consent decree of condemnation and forfeiture2 product ordered released on bond1 p4 #bdh4 ,no4 #bef1 ,misbranding of 8,ziratol40 ,u4 ,s4 v4 #icf bottles and #f jugs of ,ziratol1 consent decree of condemnation and forfeiture2 product ordered released on bond1 p4 #bfj4 ,the ,bristol-,myers ,company in replying to the ,council's report made no offer to declare the exact composition of ,ziratol1 to state the actual phenol-coefficient1 or to remove the other objections pointed out in the report of the ,council4 ,in other words1 the ,bristol-,myers ,company has abandoned a definite but false claim of high germicidal power--a claim which subjected the firm to federal prosecution--and has substituted therefor indefinite statements which do not define the actual germicidal efficiency of ,ziratol4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #f1 #aiag47 ,,gonosan ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following report on ,gonosan and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,gonosan 7,riedel and ,company1 ,inc41 ,new ,york ,city7 comes in the form of capsules1 each said to contain #e minims of a mixture composed of oil of sandalwood #hj per cent41 and #bj per cent4 of alpha- and beta-resin of kava1 isolated by a patent process4 ,the mixture1 as the name implies1 is intended for the treatment of gonorrhea4 ,this proprietary preparation was under consideration by the ,council at various times from #aije to #aiaj4 ,during this time1 the ,council agreed to accept the preparation if the suggestive name was changed1 the therapeutic exaggerations abandoned1 and the drug kava admitted to ,new and ,nonofficial ,remedies4 ,the name was not changed1 the other questions were left open1 and the preparation was not accepted4 ,recent and more objectionable advertising of ,gonosan makes it advisable for the ,council to take action and to publish a report4 ,the tone of this advertising is reflected by the following quotation from a recent advertising circular3 8,the old-established balsamic treatment of gonorrhea1 for some years neglected in favor of the local injection of organic silver and other germicidal salts1 has1 with the increasing knowledge and attention paid to the composition and purity of the balsams1 regained to a large extent the confidence formerly reposed in them4 8,it may now be said that the combined treatment with local injections and internal administration of natural balsamic products completely dominates modern gonorrheal therapy40 ,any one conversant with current medical literature and practice would stamp these statements as misleading exaggerations4 ,the balsams1 oleoresins and volatile oils may have some value as minor adjuvants in the treatment of gonorrhea1 but that is all4 ,the position in this respect has not changed materially in recent years4 ,these agents do not have a value equal to that of local treatment1 as the quoted statement implies4 ,the claims made for ,gonosan might with equal force be made for oil of santal alone4 ,kava kava1 the other constituent1 belongs to the pepper family2 it had a temporary vogue some two or three decades ago1 but has failed to maintain a place4 ,it has never been recognized officially4 ,there is no scientific evidence that it has any value either alone or as an adjuvant to sandal oil4 ,the 8clinical reports0 quoted in the advertising circulars1 rather curiously1 nearly all date back ten years or more1 viz41 to a period when the attitude of the profession toward proprietary remedies was less critical than it is now4 ,it would be interesting to know whether these authors still adhere to their opinion1 or whether any of them have subsequently had experiences similar to that of a correspondent who wrote3 8,gonosan1 at my hands1 did not prove to be of more essential value in the treatment of gonorrhea than any other sandalwood oil preparation4 ,the various claims made for ,gonosan1 that it possesses sedative and anesthetic properties1 that by its continuous use the urethral discharge disappears more rapidly and that1 if combined with appropriate diet and rest1 it is liable to prevent complications1 are1 according to my experience1 not corroborated by actual results40 ,the only experimental work quoted in support of ,gonosan1 that of ,pohl1 is not convincing4 ,the doses that ,pohl found necessary to influence experimental purulent pleurisy makes it impossible to transfer his work to the clinic4 7,he found a dosage of oil of santal corresponding to an ounce per day1 for man1 inefficient2 positive results were obtained only with #b ounces per day47 ,in order to learn the estimate placed on the therapeutic value of the 8balsams10 an inquiry was sent to the authors of the papers presented to the section of ,genito-,urinary ,diseases at the recent meeting of the ,american ,medical ,association in ,new ,york4 ,the inquiry read3 8,dear ,doctor3--,an advertising circular for ,gonosan #8,riedel' which is now being distributed begins thus3 #8,the old-established balsamic treatment of gonorrhea1 for some years neglected in favor of the local injection of organic silver and other germicidal salts1 has1 with the increasing knowledge and attention paid to the composition and purity of the balsams1 regained to a large extent the confidence formerly reposed in them4' #8,it may now be said that the combined treatment with local injections and internal administration of natural balsamic products completely dominates modern gonorrheal therapy4' 8,is the statement correct that the combined treatment with local injections and internal administration of natural balsamic products completely dominates modern gonorrheal therapy8 ,your reply to the above will be appreciated by the ,council40 ,seventeen replies were received4 ,they bear out the position that has been outlined4 ,only one writer considered the statement even approximately justified1 and this in the sense that 8the majority of cases receive no other treatment0 than a combination of local applications and systemic medication4 ,another stated that1 8in a general way their statement is true though a trifle too sweeping10 and then added that the field of the balsams is rather restricted4 ,with the exception of these qualified endorsements the remaining 7fifteen7 replies characterized the statement as incorrect and misleading4 ,the replies are a valuable contribution to the status of the 8balsam0 treatment of gonorrhea1 and extracts of them are appended to this report4 ,it is recommended that the ,council declare ,gonosan inadmissible to ,new and ,nonofficial ,remedies1 because the therapeutic claims are exaggerated 7,rule #f72 because there is no evidence that the combination of kava resin with oil of santal is superior to oil of santal alone 7,rule #aj72 and because the therapeutically suggestive name is conducive of indiscriminate and unwarranted use of the preparation both by the profession and the public 7,rules #d and #h74 ,appendix ,the extracts from replies received to the inquiry above referred to1 follow3 ,dr4 ,b41 ,penn41 wrote3 8,in my practice ,i have found that local injections are very valuable in the treatment of gonorrhea1 but ,i have never found that the internal administration of natural balsamics dominated modern gonorrheal therapy2 while it is an aid1 ,i consider the quoted statement to be very erroneous40 ,dr4 ,f41 ,d4 ,c41 wrote3 8,while it is doubtless true that acute urethritis1 gonorrheal1 is now generally treated by local injections of solutions of organic silver salts1 and that santal oil is often used1 it is not true1 as one would infer from the quotation1 that the balsams are now considered more efficacious than they were formerly4 ,so far as ,i know they have not lost or regained anything during the past dozen years in the way of confidence reposed in them4 ,the indications for their use is very definite and very limited40 ,dr4 ,b41 ,ga41 wrote3 8444 ,in recent years ,i have almost abandoned the use of balsams1 etc41 in the treatment of gonorrhea4 ,patients1 who are properly treated otherwise1 seem to get along as well without such drugs as with them1 in fact apparently better for they have no gastric disturbance4 ,it is important for patients to drink freely of water and when so doing the balsams are so diluted that ,i cannot conceive of their doing much good4 ,formerly my patients often lost weight during the treatment of gonorrhea2 now1 without balsams and with plenty of water1 they usually gain in weight40 ,dr4 ,s41 ,mich41 wrote3 8444 we believe that in a general way their statement is true though a trifle too sweeping4 ,we do not ordinarily use the balsams in uncomplicated anterior urethritis4 ,we do however1 find indication for their administration in from sixty to seventy five per cent4 of all cases of acute gonorrhea at some time during the course of the disease40 ,dr4 ,l41 ,mo41 wrote3 8,i would say that the statement that1 #8,the combined treatment with local injections and internal administration of natural balsamic products completely dominates modern gonorrheal therapy1' is far from representing the facts4 ,while the balsamics may occasionally have an indirect soothing effect on the mucous membranes involved1 the dominant factor is local treatment1 aiming at disinfection and restoration to normal of the inflamed tissues40 ,dr4 ,r41 ,mich41 wrote3 8,regarding your request although ,i am willing to reply it is difficult to do so because if ,i should do so in the affirmative that could apply only to certain acute cases without complication of any kind and such cases are rare4 ,in such1 however1 the advertiser is not far from right--since vaccine therapy has proven absolutely worthless we must fall back on antiseptics in acute urethritis when there are no objections to such treatment 4440 ,dr4 ,k41 ,ill41 wrote3 8,i am under the impression that the internal administration of balsamics is used only when complications arise1 such as acute posterior urethritis4 ,personally ,i use the balsamics very1 very rarely4 ,from my observation1 however1 ,i am led to believe that many men still use internal drugs in the treatment of gonorrhea1 and during the past few years1 ,i should say the use of hexamethylenamin has been on the increase1 and the use of the balsams on the decrease4 ,i do not believe that hexamethylenamin is of any value in the treatment of gonorrhea1 and am simply citing this as my observation of the widespread use of this drug in the treatment of gonorrhea40 ,dr4 ,t41 ,penn41 wrote3 8444 ,i believe that more men use salol or hexamethylenamin1 or no urinary antiseptic whatsoever1 than use the balsamics40 ,dr4 ,b41 ,ind41 wrote3 8444 ,the only systemic treatment that is considered necessary today is rest1 plenty of water and neutralize the acidity of the urine with bicarbonate of soda or some sodium salt40 ,dr4 ,y41 ,mass41 wrote3 8,sandal wood oil during the acute stage of gonorrhea certainly tends to make the patient more comfortable and undoubtedly does lend some 7tho ,i believe slight7 gonococcidal action4 ,that it plays any considerable part in actual cure ,i think is doubtful4 ,the statement as quoted is true in so far as it states that local treatment plus internal medication with a balsam comprises most of the modern treatment of gonorrhea but it is grossly misleading in that it lets one draw the inference that the balsam plays a large if not the principal part40 ,dr4 ,h41 ,new ,york1 wrote3 8,for a period of at least three years in my hospital1 dispensary and private practice1 ,i conscientiously tried out most of the balsamics on the market 7including ,gonosan1 which ,i favored for some time7 both alone1 and combined with local injections4 ,as a result of this study1 ,i have come to the conclusion that the balsamics have little1 if any value in the treatment of gonorrhea4 ,during the past few years ,i have relied almost entirely on local therapy1 and seldom prescribed any of the balsams in my private practice1 certainly in not more than #e per cent4 of the cases4 ,my results ,i find are just as satisfactory1 and my patients appreciate the fact that they are not loaded up with disagreeable medication4 ,instead of the balsamics1 ,i am using sodium bicarbonate more and more1 and feel convinced that the proper use of this drug is of more value than all of them combined40 ,dr4 ,k41 ,cal41 wrote3 8,the statement that the combined treatment with local injections and internal administration of natural balsamic products completely eliminates modern gonorrheal therapy1 would at present not be justifiable even with reference to the initial or acute stage of gonorrhea1 while in the subacute and chronic forms of the disease local injections and balsams play an almost insignificant rle as compared with various other recognized therapeutic measures40--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ac1 #aiag74 ,,alcresta ,,ipecac ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,in #aiae ,alcresta ,ipecac ,tablets 7,eli ,lilly and ,co47 were admitted to ,new and ,nonofficial ,remedies as a preparation of ipecac that is insoluble in the stomach but soluble in the intestines4 ,it was supposed that this property would permit the administration of ipecac without the accompanying nausea and vomiting1 and that this would be of especial advantage when using the drug in amebic dysentery4 ,the systemic effects1 of course1 would be those of ipecac4 ,more recently1 the manufacturers of ,alcresta ,ipecac have been advising its use in conditions which were not contemplated by the ,council when the preparation was accepted for ,new and ,nonofficial ,remedies4 ,they now claim that ipecac alkaloids have been shown to be useful in the treatment of typhoid fever1 flatulence1 diarrhea and constipation and that ,alcresta ,ipecac has these properties4 ,such a statement is misleading4 ,while it is true that at one time ipecac was used promiscuously against 8flatulence1 diarrhea and constipation0 there never has been and is not now any scientific evidence of its efficiency in such conditions except1 of course1 in diarrhea of the amebic type4 ,as to the alleged usefulness of ipecac in typhoid fever3 ,this has not even the sanction of tradition and the claim certainly should not be accepted until there is strong evidence to support it4 ,the advertising matter on ,alcresta ,ipecac also contained statements to the effect that ipecac alkaloids have a demonstrated usefulness in pyorrhea4 ,such an unequivocal statement is unwarranted4 ,in spite of the enthusiastic advocacy1 in the past1 of ipecac alkaloids as a specific in pyorrhea alveolaris the preponderance of scientific evidence indicates that ipecac is of questionable value in this condition4 ,neither is there any substantial evidence to warrant the claim that ipecac alkaloids1 when absorbed through the intestines1 are demonstrably useful in amebic infections of the tonsils4 ,the reputation of the best drugs1 whether unofficial or official1 is bound to suffer if extravagant claims for them are permitted to go unchallenged4 ,the referee of the ,council1 therefore1 believed it necessary to call the attention of the manufacturers of ,alcresta ,ipecac ,tablets to the statements made for the product and suggested that they submit evidence to substantiate the claims4 ,this the manufacturers have refused to do4 ,their attitude in the matter1 as well as their attitude toward the ,council's work is expressed in the following letter3 8,responding to your letter of ,march #ajth1 we beg to suggest that literature covering the different matters at issue are readily available to your referee1 and all statements emanating from us are made advisedly4 8,if you cannot satisfy yourselves that this preparation is a scientific product1 ethically advertised1 and a desirable advance in therapeutics1 you can only delete it from your next issue of ,new and ,nonofficial ,remedies40 ,it is to be regretted that ,eli ,lilly and ,co4 refuse either to withdraw or modify their claims or to substantiate these claims by scientific evidence4 ,the statements as they stand are exaggerated1 misleading and harmful4 ,as such they conflict with ,rule #f of the ,council and necessitate the omission of ,alcresta ,ipecac from ,new and ,nonofficial ,remedies4 ,the referee recommended the adoption and publication of this report4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bj1 #aiag47 ,,iodeol ,,and ,,iodagol ,report of the ,council on ,pharmacy and ,chemistry ,iodeol and ,iodagol 7formerly called ,iodargol7 are products of ,viel and ,company1 ,rennes1 ,france1 widely advertised in this country by ,david ,b4 ,levy1 ,incorporated1 ,new ,york4 ,the claim made for both preparations is that they depend on 8colloidal iodin0 for their action4 ,they are put up in a number of forms1 for instance3 8,iodeol ,ampoules each containing #a c4c4 7#bj centigrammes colloidal iodin in an oily vehicle740 8,iodeol ,external1 containing #ej per cent4 colloidal iodine40 8,iodagol ,ampoules1 each containing #b c4c4 7#ej centigrammes colloidal iodine in an oily vehicle740 ,the claim is1 that1 the iodin being in the colloidal state1 it has the properties of elementary iodin and thus the preparations may be used in concentrations and under conditions which would make the use of free iodin impossible4 ,the products have been extensively and extravagantly advertised for use in a wide range of conditions4 ,thus ,iodeol has been proposed in the treatment of3 8,pulmonary ,tuberculosis0 8,laryngeal ,tuberculosis10 8,glandular ,tuberculosis0 8,tuberculosis of the ,bones0 8,pneumonia1 ,broncho-pneumonia1 and ,congestive ,conditions0 8,whooping ,cough1 ,influenza1 ,asthma0 8,typhoid ,fever0 8,syphilis0 8,obesity40 ,iodagol1 which is for external use1 has been advised in the treatment of3 8,gonorrhea and its ,sequel0 8,cystitis0 8,tetanus0 8,wounds complicated by gaseous gangrene0 8,burns0 8,old ,suppurations1 ulcers1 abscesses1 etc40 8,articular rheumatism0 8,abscess ,alveolar0 8,pyorrhea ,alveolaris0 8,stomatitis 7,canker-,sores740 ,nearly two years ago the ,american agents requested the ,council to consider ,iodeol and ,iodagol for admission to ,new and ,nonofficial ,remedies4 ,the information submitted in regard to their character and composition was vague and indefinite1 the pharmacologic information practically nil and the clinical data as voluminous as it was unconvincing4 ,on the basis of chemical1 pharmacologic1 bacteriologic and clinical investigation carried out under the direction of the referee and a study of the submitted evidence1 the referee reported3 #a4 ,iodeol and ,iodagol do not contain the amount of iodin claimed4 #b4 ,the iodin is not present as elementary iodin1 but instead the preparations behave similarly to the well-known organic iodin compounds such as iodized fats4 #c4 ,the therapeutic claims made for the preparations are exaggerated and unwarranted4 ,in view of his findings he recommended that ,iodeol and ,iodagol be declared inadmissible to ,new and ,nonofficial ,remedies for conflict with ,rules #a and #b 7misleading statements regarding composition and identification7 and ,rule #f 7unwarranted therapeutic claims74 ,the ,council adopted the recommendation of the referee1 directing inclusion of the full report in the annual ,council reports after submission to the manufacturer1 and recommending publication of an abstract of this report in ,the ,journal4 ,this report was brought to the attention of the ,american agent1 ,david ,b4 ,levy1 ,inc41 and through them to the ,french manufacturers1 ,e4 ,viel and ,company4 ,the manufacturers have intimated that they will not file a reply to the report4 ,the firm of ,david ,b4 ,levy1 ,inc41 has decided to sever its connection with these products and to discontinue their sale4 ,w4 ,a4 ,puckner1 ,secretary4 ,summary of ,referee's ,report ,iodeol and ,iodagol were submitted to the ,council nearly two years ago as 8electro-colloidal iodine0 and with the claim that they produced all the antiseptic and other effects of ordinary iodin without any of its side actions4 ,the referee has done much work on the subject1 conducted a large amount of correspondence and has contended with long delays4 ,he feels that the consideration of these products should be brought to a conclusion and accordingly he submits this report of their consideration4 ,the following is a summary of the report1 which is appended3 ,i4 ,discrepancy in ,iodin ,percentage4--,the examination at the ,chemical ,laboratory of the ,american ,medical ,association1 as well as that of the referee1 shows that the various samples of ,iodeol and ,iodagol examined contained a little less than one-half of the total iodin claimed4 ,these facts were reported to the ,american agent4 ,after a lengthy delay a reply was received which presented a double excuse3 7#a7 that the full amount of iodin had been added1 whatever had become of it later2 7#b7 that the claims were made for 8colloidal iodin0 and that this is not elementary iodin in the colloidal state1 but a preparation of iodin containing only #ej per cent4 of real iodin4 ,neither explanation can be taken seriously1 as they are obvious quibblings4 ,the referee concludes that the preparations are falsely labeled as to iodin content4 ,,ii4 ,nature of the ,iodin ,compound in ,iodeol and ,iodagol4--,in the information sent the ,council1 ,iodeol and ,iodagol were defined as 8,a suspension of electro-chemical colloidal iodin in a vehicle of purified oil40 ,numerous inquiries have failed to elicit more specific information from the manufacturer or his agent4 ,the statement of composition can mean only that the preparations contain free iodin 7but in colloidal form7 suspended in oil4 ,no evidence to substantiate this claim has been submitted4 7,there is evidence that the preparations contain colloidal particles1 but it does not indicate if this colloidal material is iodin1 or a combination of iodin or indeed whether the colloidal component contains any iodin47 ,the recent statements of the agent seem to concede that what they call 8electro-colloidal iodin0 contains only about #ej per cent4 of real iodin1 in other words that it is not 8colloidal iodin0 at all1 but a mixture or combination of iodin with some other unnamed substance4 ,this1 of course1 is something very different4 ,certain results reported from the ,american ,medical ,association's ,chemical ,laboratory suggest that the so-called 8colloidal iodin0 of ,iodeol may be a combination of iodin with a volatile oil4 ,the investigations of the referee indicate that the iodin exists in a rather resistant form or combination behaving altogether differently from ordinary free iodin1 and rather resembling the behavior of iodin substitution products1 such as iodized fats or phenols4 ,briefly then the recent admissions of the agents indicate that ,iodeol does not contain 8colloidal iodin0 in a chemical sense1 and there are indications that it does contain its iodin in a rather firm 7chemical7 combination4 ,,iii4 ,chemical ,properties of ,iodeol4--,from a study of different specimens of ,iodeol1 the referee concludes that fresh specimens contain no free iodin and that old ones contain small amounts as a result of decomposition4 ,iodeol has the solubility characteristics of fats and fat-like compounds4 ,the examination1 as a whole1 shows that ,iodeol contains a peculiar and rather resistant form or combination of iodin4 ,there is nothing in the chemical data that suggests that it could act differently from ordinary iodin compounds1 such as iodized fats4 ,it would not act as ordinary iodin4 ,,iv4 ,pharmacologic ,data4--,the pharmacologic statements which were submitted were loose and apparently meaningless or misleading4 ,in reply to questions submitted by the referee1 the manufacturer finally had some work done and submitted a report by ,jean ,laumonnier4 ,the referee was unable to confirm some of this work1 and as a whole it does not appear materially to elucidate the action of ,iodeol4 ,from a consideration of the submitted evidence1 and as a result of his own work1 the referee concludes that ,iodeol does not behave like elementary iodin2 it does not coagulate proteins and therefore is not irritant4 ,it is presumably absorbed1 but quite probably after chemical change2 it is changed into iodid and1 like organic iodids1 is excreted somewhat more slowly than when inorganic iodids are administered1 but the difference does not appear important4 ,v4 ,antiseptic and ,bactericidal ,action4--,elementary iodin is considered a fairly powerful agent in these respects4 ,the activity is presumably due to changes in the proteins1 etc41 of the bacteria1 analogous to the effects which produce pain1 irritation and necrosis of the tissue cells4 ,since the latter effect is not produced by ,iodeol1 it seems highly improbable1 if not impossible1 that it should act on bacteria like elementary iodin4 ,it is entirely unjustifiable to credit the known antibacterial qualities of ordinary iodin to 8colloid0 iodin4 ,this misrepresentation is especially prominent in the circular 8,notable ,new ,therapeutic ,agents10 as will be seen1 for instance1 from the following citations3 8,iodine has long been universally recognized as an antiseptic of extraordinary potency4 ,not only is it rapid and certain in its germ-destroying action1 but it also possesses an attribute denied many other antiseptic agents1 namely1 the power to penetrate and impregnate the tissues4 ,other antiseptics1 as is well known1 act on the surface epithelium only40 8,according to ,kinnaman 7,j4 ,a4 ,m4 ,a41 ,aug4 #bf1 #aije71 iodine is far superior to bichloride of mercury1 a two per cent4 solution killing streptococcus pyogenes in two minutes4 ,iodine does not coagulate albumin1 and is very penetrating40 ,the citations imply that this 8colloidal iodin0 of ,iodeol and ,iodagol acts as an antiseptic like ordinary iodin1 except that it is claimed to be more efficient by 8diffusing0 more readily4 ,this is entirely unjustified and misleading4 ,if ,iodeol and ,iodagol are really antiseptic1 they must act by some other mechanism than that through which elementary iodin acts1 and such antiseptic action would have to be demonstrated by direct observation and not assumed from the known action of free iodin4 ,antiseptic and bactericidal effects are easily estimated by laboratory methods4 ,yet no evidence on this point appeared to have been available until the ,council called for this4 ,laumonnier then carried out some experiments which were in turn submitted to bacteriologic control4 ,the bacteriologist failed to obtain any results with some of the tests1 and considered the other data of little value4 ,the claim that ,iodeol and ,iodagol have the antiseptic and bactericidal action of free iodin lacks proof and must be considered unwarranted and misleading in the extreme4 ,,vi4 ,clinical ,trials4--,the manufacturers and agents of ,iodeol presented many letters from physicians2 but few1 if any1 of these gave evidence of careful1 critical1 controlled observations4 ,they could not1 therefore1 be considered as acceptable evidence4 ,the more important claims1 letters and published papers1 however1 were submitted to clinical specialists collaborating with the ,council1 with the request that they examine these and conduct some clinical trials1 if they considered it advisable4 ,the results obtained in these preliminary trials did not appear sufficient to warrant further experimentation4 ,from a consideration of the evidence presented1 the referee concludes that the claims made for ,iodeol and ,iodagol are unwarranted1 exaggerated and misleading4 ,he recommends that ,iodeol and ,iodagol be declared ineligible for ,new and ,nonofficial ,remedies for conflict with ,rules #a and #b 7misleading statements as to composition and identification7 and with ,rule #f 7unwarranted and misleading therapeutic claims74 ,he further recommends that the ,council authorize publication of the preceding summary of the consideration of ,iodeol and ,iodagol in ,the ,journal and inclusion of the full report in the annual ,council reports after submission to the manufacturer4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ag1 #aiag47 ,,capsules ,,bismuth ,,resorcinol ,,compound ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,in response to inquiries received1 the ,council took up the consideration of ,capsules ,bismuth ,resorcinol ,compound 7,the ,gross ,drug ,company1 ,inc41 ,new ,york ,city74 ,the label1 sent by the ,gross ,drug ,company1 bore the following3 ,,capsules ,,bismuth ,,resorcinol ,,compound ,bismuth ,subgallate #b grs4 ,resorcinol #a gr4 ,beta ,naphthol #a_/b gr4 ,creosote 7,beechwood7 #a m4 ,this combination is of acknowledged value in reducing the value in reducing the intes- tinal putrefaction and fermentation1 allaying the pain and discomfort of flatulent conditions in the intestinal tract4 ,,dose4--,one or two capsules before or after meals repeated in two hours if necessary4 ,the ,gross ,drug ,company1 ,inc4 #bj ,laight ,street1 ,new ,york ,the ,council held this preparation inadmissible to ,new and ,nonofficial ,remedies or the ,appendix1 because 7#a7 the claim 8acknowledged value in reducing the intestinal putrefaction and fermentation1 allaying the pain and discomfort of flatulent conditions in the intestinal tract0 is an unwarranted1 exaggerated and misleading claim of therapeutic value 7,rule #f72 because 7#b7 the name does not indicate the identity of the bismuth salt contained in the capsules1 nor declare the presence of betanaphthol and creosote 7,rule #h72 and because 7#c7 the combination of bismuth subgallate1 resorcinol1 betanaphthol and creosote in fixed proportions is irrational 7,rule #aj74--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #aci47 ,,dixon',s ,,tubercle ,,bacilli ,,extract ,,and ,,dixon',s ,,suspension ,,of ,,dead ,,tubercle ,,bacilli ,report of the ,council on ,pharmacy and ,chemistry ,new and ,nonofficial ,remedies1 #aiag1 contains general descriptions of ,dixon's ,tubercle ,bacilli ,extract and ,dixon's ,suspension of ,dead ,tubercle ,bacilli2 the products of these manufactured by the ,h4 ,m4 ,alexander ,company being listed as dosage forms4 ,it having become necessary to omit the preparations of the ,alexander ,company 7see page #ach7 the referee recommended that the general articles of 8,dixon's ,tubercle ,bacilli ,extract0 and 8,dixon's ,suspension of ,dead ,tubercle ,bacilli0 also be omitted4 ,he reported that no other firm appears to be marketing these products and that they had not been shown to be of special value4 ,the ,council accepted the recommendation and directed the omission as proposed4 ,in accordance with the procedure of the ,council1 these have been transferred to the annual ,council ,reports for reference and appear below4 ,w4 ,a4 ,puckner1 ,secretary4 ,dixon's ,tubercle ,bacilli ,extract4--,an extract of tubercle bacilli dissolved in normal saline solution4 7,see 8,fluid of ,dixon10 ,medical ,news1 ,jan4 #ag1 #ahia47 ,dixon's ,suspension of ,dead ,tubercle ,bacilli4--,a suspension in physiologic salt solution of dead tubercle bacilli which have been defatted by prolonged treatment with alcohol and ether4 7,see 8,possibility of ,establishing ,tolerance for ,tubercle ,bacilli10 ,medical ,news1 ,oct4 #ai1 #ahhi47--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #adj47 ,,formosol ,report of the ,council on ,pharmacy and ,chemistry ,sunshine's ,formosol 7,the ,formosol ,chemical ,company1 formerly the ,sunshine ,chemical ,company1 ,cleveland1 ,ohio7 is claimed to contain #ah per cent4 formaldehyd in a solution of soap4 ,it is therefore very similar to ,veroform ,germicide which was deleted from ,new and ,nonofficial ,remedies because of the low phenol coefficient reported by the ,hygienic ,laboratory of the ,united ,states ,public ,health ,service 7,the ,journal1 ,nov4 #bb1 #aiac1 p4 #aibj47 ,the ,council voted that in view of the ,hygienic ,laboratory's finding that formaldehyd has a low germicidal value1 the manufacturers of ,formosol be required to produce definite evidence of the degree of germicidal value for this product4 ,in submitting the preparation to the ,council1 it was claimed that ,formosol had 8all properties peculiar to ,formaldehyde40 ,this conservative tone was1 however1 not maintained in the form-letters submitted4 ,these contain the following unwarranted statements3 8,as the name implies1 ,,formosol is a formaldehyde preparation1 which embodies all the innate antiseptic merits and eliminates all the ill features of the world's greatest disinfectant40 8,the elimination of all the destructive elements and the incorporation of all the established therapeutic virtues of formaldehyde1 have been scientifically blended in ,,formosol40 8,,formosol is unique in the sphere of antisepsis because of its peculiar healing properties as diametrically opposed to irritation to the tissue of mucous membrane40 8,,formosol may be used for the thousand niceties of modern antisepsis1 but is specific in ,gynecology and ,obstetrics and is indicated in ,dermatology40 ,italics not in original4 8,the constant use of ,,formosol is to develop a habit sympathetic to ethics40 8,to prescribe ,,formosol is a great step toward ,personal ,hygiene1 a duty of the medical fraternity to the laity40 ,italics not in original4 ,the trade package recommends the use of ,formosol 8for cuts1 wounds1 ulcers1 abscesses 4440 ,this is a conflict with ,rule #d4 ,the ,council held ,formosol in conflict with ,rules #d and #f1 and advised the manufacturers that ,formosol is refused admission to ,new and ,nonofficial ,remedies until they submit evidence establishing the degree of antiseptic and germicidal efficiency1 and justify the quotations listed above2 or until these and any other existing conflicts with the ,rules have been removed4 ,after submission of this report to ,the ,formosol ,chemical ,company the ,council authorized its publication4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #ade47 ,,iodolene1 ,a ,,solution ,,of ,,iodin ,,in ,,liquid ,,petrolatum1 ,,inadmissible ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council was asked to consider a solution of iodin in liquid petrolatum1 said to be prepared from ,gulf ,coast petroleum by a special process4 ,it was to be marketed as 8,iodolen0 provided the ,council found the preparation admissible to ,new and ,nonofficial ,remedies4 ,the preparation was claimed to contain over #a4e per cent4 free iodin4 ,the following claims were made3 8,it is less irritating in its use on the skin1 or in wounds40 8,will kill pathogenic micro-organisms present40 8,is a suitable medium for cell proliferation40 8,will penetrate a useful distance into the walls of a wound40 8,facilitates an easier1 less painful and better method of dressing wounds or ulcers40 ,examination in the ,american ,medical ,association ,chemical ,laboratory showed a submitted sample to contain #a4cb per cent4 free iodin and to emit a strong odor of hydrogen sulphid4 ,a specimen of liquid petrolatum1 said to be composed chiefly of hydrocarbons of the naphthene series1 after saturation with iodin at room temperature was found to contain #a4db per cent4 free iodin4 ,another specimen of liquid petrolatum1 said to be composed chiefly of saturated hydrocarbons1 after saturation at room temperature was found to contain #a4cj per cent4 free iodin4 ,the preparation having been shown to be an unoriginal1 simple solution of iodin in liquid petrolatum1 the ,council declared the name 8,iodolene0 unacceptable 7,rule #h7 and the therapeutic claims made for the preparation unwarranted 7,rule #f74--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #adh47 ,,kalak ,,water ,report of the ,council on ,pharmacy and ,chemistry ,the following report1 submitted by a member of the ,council's committee on chemistry1 was endorsed by the committee and adopted by the ,council3 ,kalak ,water1 sold by the ,kalak ,water ,company1 ,inc41 ,new ,york1 is an artificial mineral water said to be made by adding certain salts to carbonated1 distilled water and supersaturating with the gas under pressure4 ,such merit as it may possess by virtue of sodium bicarbonate and sodium phosphate is quite insufficient to warrant the extravagant claims made in the advertising pamphlets4 ,according to the analysis furnished1 the water contains1 in #a1jjj1jjj parts 7milligrams per liter7 the following3 ,sodium carbonate #djdi4j ,sodium phosphate #bch4e ,sodium chloride #hjf4c ,calcium carbonate #egh4b ,magnesium carbonate #dh4i ,potassium chloride #dg4i ,among the many misleading statements found in the advertising pamphlet bearing the title 8,a ,brief for ,physiological ,alkalescence0 these may be quoted3 8,the calcium content of ,kalak is over #ajj greater than ever before placed in solution in any vehicle1 a fact of supreme importance when the unique alkalinizing power of the alkaline salts of this metal is considered2 the ratio of calcium metabolism to its enormous waste in pregnancy1 the diseases of infancy and childhood and the rapidly growing group of #8acidoses' make its availability in ,kalak of double value40 ,the first part of this statement is untrue2 the last part is muddled and without much meaning4 ,evidently the 8acidosis0 fad is to be overworked as was the old 8uric acid diathesis10 of unsavory memory4 ,again this3 8,one of the most important characteristics of ,kalak is the close approximation of its formula to the correlation of the contained salts as they occur in the human body1 together with its freedom from salts foreign to the human economy4 ,another is its almost unbelievable palatability1 considering its high degree of alkalinity1 it being eleven times greater than any other known mineral water1 artificial or natural40 ,these statements are false4 ,the salts dissolved here bear no discernible relation to the needs of the body1 as disclosed by the composition of the blood or solid tissues or as shown by the character of the urinary excretion4 ,the last statement concerning the high alkalinity is neither clear nor accurate4 ,then1 this warning and remedy3 8,it seems to be an unappreciated fact that the degree of urinary acidity1 checked with the acidity of the saliva1 is in direct ratio to the existing acid toxemia1 and a urine acid to methyl red should be the signal for immediate and adequate alkalinizing treatment4444 8,startling clinical results have been observed by physicians who have used ,kalak thoughtfully and sufficiently in the more serious types of acidosis associated with diabetes1 nephritis1 rheumatism1 gout and the acute infections4 ,there is also evidence of its good effect in acute alcoholism and the respiratory edemas2 in fact a certain few have hailed ,kalak as a possible solution of the annual hay fever problem4 ,of perhaps supreme importance1 however1 is the use of ,kalak throughout pregnancy as preventive medicine against the inevitable #8toxemia of pregnancy4'0 ,also this3 8,kalak has accomplished certain unexplainable things for the diabetic and nephritic1 and if1 in future years1 diabetes and nephritis should prove to be constitutional diseases1 based upon functionation or its lack1 ,kalak therapy1 the embodiment of physiological alkalescence may come into its own1 for if acidity retards1 alkalinity must normalize functionation40 ,it is not necessary to quote further4 ,in order to insure that everyone will recognize the great need of ,kalak it is advised to test the urine for acidity by means of a group of indicator solutions sent out to the physicians4 ,methyl red is one of these and any urine showing an acid reaction with this is said to be open to suspicion4 ,paranitrophenol is another of the indicators and the explanations given of the behavior of the two and the conclusions to be drawn are questionable4 ,the methyl red solution furnished is too concentrated for proper use and perfectly normal urines from normal individuals have given a rather marked color with it4 ,this indicator gives some color at ,h #a4b #aj-f and a strong reaction at #c #aj-c4 ,to condemn a urine on such a finding is entirely unwarranted4 ,sodium bicarbonate is the main constituent of the water4 ,the value of the phosphate in such a combination1 with so much calcium1 is problematical4 ,in case an alkaline reaction in the intestine is reached some of it would be left as insoluble phosphate4 ,a few grams of bicarbonate daily would have equal therapeutic value with this water4 ,the advice based on the indications of methyl red and the urine is bad4 ,the committee's report was sent to the ,kalak ,water ,company for comment4 ,the company promised to withdraw the advertising circular referred to in the report and disclaimed responsibility for the accuracy and value of the set of indicators which it sent out1 but1 on the whole1 the previous advertising claims were insisted on4 ,in view of the absurd and false claims made for the product the ,council declared ,kalak ,water inadmissible to ,n4 ,n4 ,r4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #adh47 ,,minson',s ,,soluble ,,iodin 8,,kelpidine0 ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,minson's ,soluble ,iodin 8,kelpidine0 was submitted to the ,council by ,j4 ,j4 ,minson1 ,washington1 ,d4 ,c41 trading as the ,kelpidine ,company1 with the statement that in future 8literature0 it was to be known as ,minson's ,soluble ,iodin1 only4 ,the following statement of composition was furnished3 8,minson's ,soluble ,iodin is somewhat of an indefinite character1 chemically4 ,its formula is1 ,iodin #d per cent41 ,distilled ,water #f per cent41 and ,absolute ,alcohol q4 s4 #ajj per cent4 ,by a process of chilling and heating an iodid of uncertain character is produced1 and because of the extreme sensitiveness of the product to chemical tests1 it is hard to determine4 ,so far as ,i have been able to judge1 however1 the result is about #c or #c-a_/b per cent4 free iodin and from #a_/b per cent4 to #a per cent4 iodid1 possibly ethyl and hydrogen iodid in combination40 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reports that the preparation is an alcoholic solution containing free iodin and iodid1 probably hydrogen iodid and ethyl iodid1 but that the free iodin content was only #b4fi gm4 per #ajj c4c4 ,it is claimed that the 8therapeutic indications0 of ,minson's ,soluble ,iodin are the 8same as those of all iodin and iodid preparations1 internally1 externally1 hypodermically and intravenously2 excepting1 however1 counter irritation40 ,it is admitted that there are no 8clinical reports0 as to the hypodermic and intravenous use1 but the belief is expressed 8that in an emergency it is a safe remedy under proper dilution40 ,it is further claimed that 8for all practical purposes it is nontoxic and nonirritating0 and that 8it has none of the undesirable features such as is the case with the iodids and the organic preparations of iodin1 proprietary or otherwise40 ,it was assigned for consideration to the ,committee on ,pharmacology1 whose referee reported3 8,according to the information submitted1 this is a tincture of iodin2 differing from the official tincture in that it is more dilute and in that hydrogen and ethyl iodid is the solvent in place of potassium iodid4 ,it is practically immaterial for internal administration1 whether the cation of the solvent iodid is hydrogen1 ethyl1 potassium or sodium4 ,it would certainly be inadvisable to inject a preparation containing free iodin hypodermically4 ,it is not #8a safe remedy' for intravenous injection and it would not be nonirritant4 ,the statement that #8it has none of the undesirable features' of other iodin compounds is inherently impossible4 ,apparent freedom of any iodin preparation from undesirable effects is generally due to the use of small doses4 ,such claims are plainly therapeutic exaggerations and therefore in conflict with ,rule #f4 ,even should these be removed1 the preparation must be held an unessential modification of the official tincture1 and therefore in conflict with ,rule #aj40 ,the report was agreed to by the committee and adopted by the ,council and ,minson's ,soluble ,iodin 8,kelpidine0 declared inadmissible to ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #aeb47 ,,nutone ,report of the ,council on ,pharmacy and ,chemistry ,nu,tone 7,nu,tone ,company1 ,lowell1 ,mass47 is a 8nutritive tonic0 said to have the following complex composition3 ,cod ,liver ,oil1 ,pure ,norwegian1 #be per cent4 ,malt ,extract1 #i-a_/c per cent4 ,beef juice1 ,glycerine1 ,hypophosphite ,lime1 ,hypophosphite ,soda1 ,chemically pure1 #a-a_/b grs4 each to the oz4 ,fl4 ,ext4 ,nux ,vomica1 #c_/fd of a minimum in each teaspoonful4 ,it is advertised with claims that will lead thoughtless physicians and a confiding public to depend on it in cases in which fresh air1 hygienic surroundings and nutritious food are of prime importance4 ,a sample package 7the phrase 8as recommended by your physician0 and other statements suggest that it is expected to be given the patient by the physician and thus effectively advertise ,nu,tone to the public7 describes ,nu,tone as an 8,agreeable ,concentrated ,nutritive ,tonic ,emulsion of ,malt ,extract1 ,beef ,juice and ,cod ,liver ,oil1 ,combined with ,nerve ,tonics and ,bone ,nutrients40 ,emphasizing the nutritive value of this 8,malt ,extract1 ,beef ,juice1 and ,cod ,liver ,oil0 preparation1 it is advised1 8,as ,nu,tone is rich in nutritive properties1 it is well to begin with one-fourth teaspoonful1 gradually increasing to regular dose1 which is3 ,adults1 #a to #b teaspoonfuls after meals and at bedtime4 ,children according to age40 ,it thus appears that adults are to take this preparation as a 8nutritive0 in doses which represent from #c to #ab grains of sugar 7on the assumption that malt extract may contain as much as #ej per cent4 sugar7 and #h to #cj minims of cod liver oil with unstated1 but probably equally small1 amounts of beef juice4 ,a consideration of the negligible food value of ,nu,tone as well as of the inefficiency of the other components and the claim that it is indicated in 8malnutrition10 8wasting diseases0 and 8incipient phthisis0 classes ,nu,tone with that large group of shotgun mixtures which do harm in that dependence is placed on them in conditions in which the patient will probably be restored to health if proper medical and hygienic measures are adopted in time4 ,the ,council declared ,nu,tone inadmissible to ,new and ,nonofficial ,remedies because it is an irrational shotgun mixture advertised indirectly to the public with unwarranted therapeutic claims and a nondescriptive therapeutically suggestive name4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #aed47 ,,tri-,,arsenole1 ,l4 ,o4 ,,compound ,,no4 #a ,,and ,l4 ,o4 ,,compound ,,no4 #b ,report of the ,council on ,pharmacy and ,chemistry ,tri-,arsenole4--,according to the advertising of the ,medical ,supply ,company of ,atlanta1 ,ga41 8,tri-,arsenole0 is 8,merco-,arseno-,benzo-,chloride10 and the claim is made3 8,this compound is the result of many years' research4 ,the toxicity has been fully tested upon animals before using clinically1 the latter having proven such complete success1 we take pleasure in presenting it to the public 4440 8,the manufacturers of ,,tri-,,arsenol1 before placing it upon the market1 tested it biologically40 ,tri-,arsenole is 8recommended and suitable for the treatment of primary1 secondary1 tertiary and hereditary syphilis4 ,it has also been found very useful in pellagra and malaria40 ,the preparation is supplied in ampules containing varying amounts of the dry substance4 ,it is to be dissolved in water and is to be administered intravenously4 ,in the advertising attention is called to the yellow color of ,tri-,arsenole2 this1 and the style of package suggest that it is a preparation similar to salvarsan4 ,in reply to a request sent the ,medical ,supply ,company for the quantitative composition and chemical formula of the compound 8,merco-,arseno-,benzo-,chloride0 and for the details of the biologic test by which its toxicity is claimed to have been determined and evidence for its efficiency1 the following statement was received3 8,tri-,arsenole ,no4 #a equals to each ,ampoule1 gr4 ,sodium chlorid #d-a_/b ,hydrarg chlor4-cor4 #a_/d ,arsenous acid #a_/d ,sodium benzoate #d ,hydrastin 7resinoid7 #b ,tri-,arsenole ,no4 #b equals to each ,ampoule1 ,sodium chlorid #d ,hydrarg chlor4-cor4 #a_/b ,arsenous acid #a_/b ,sodium benzoate #d ,hydrastin 7resinoid7 #b ,tri-,arsenole ,no4 #c equals to each ,ampoule1 ,sodium chlorid #c-a_/b ,hydrarg chlor4-cor4 #c_/d ,arsenous acid #c_/d ,sodium benzoate #d ,hydrastin 7resinoid7 #b ,tri-,arsenole ,no4 #d equals to each ,ampoule1 ,sodium chlorid #c ,hydrarg chlor4-cor4 #a ,arsenous acid #a ,sodium benzoate #d ,hydrastin 7resinoid7 #b ,the request for information regarding the animal experiments said to have determined the toxicity was ignored1 nor were references supplied to clinical reports demonstrating the value of the product4 ,the ,council declared ,tri-,arsenole inadmissible to ,new and ,nonofficial ,remedies because of conflict with the rules as follows3 ,in the absence of details of the method used1 the claim that the preparation has been tested biologically is in conflict with ,rule #b1 which requires that for preparations claimed to be physiologically standardized the method of testing must be published so as to permit of control by independent investigators4 ,the claims that 8,merco-,arseno-,benzo-,chloride0 is 8the result of many years research10 that its 8toxicity has been fully tested upon animals before using clinically0 and that clinical use has 8proven such complete success0 have not been substantiated by evidence and must be held as unwarranted4 ,the name is in conflict with ,rule #h1 which requires that pharmaceutical mixtures shall bear names descriptive of their composition4 ,further1 the name 8,tri-,arsenole0 by its similarity to ,diarsenol1 the ,canadian brand of arseno-phenolamin hydrochlorid1 suggests that this pharmaceutical mixture is a chemical compound similar to salvarsan4 ,moreover1 the danger of confusion is increased by the addition of the hydrastis preparation which imparts a yellow color like that of salvarsan to the solution obtained when the colorless mercury and arsenic compounds of the mixture are dissolved4 ,again1 the synonym 8,merco-,arseno-,benzo-,chloride0 conveys the false impression that ,tri-,arsenole is a definite chemical compound4 ,the label does not declare the poisonous constituents claimed to be contained in the mixture2 namely1 8arsenous acid0 and corrosive mercuric chlorid 7,rule #g74 ,there is no evidence that arsenous acid 7arsenic trioxid7 used intravenously is efficient and safe as a spirocheticide1 and the administration of this drug in conjunction with mercuric chlorid in fixed proportion is irrational and dangerous--particularly so because of the implied similarity of ,tri-,arsenole to arsenphenolamin hydrochlorid 7,salvarsan1 ,diarsenol7 7,rule #aj74 ,l4 ,o4 ,compound ,no4 #a and ,l4 ,o4 ,compound ,no4 #b4--;,in submitting these preparations to the ,council1 the ,medical ,supply ,company stated that 8,no4 #a0 was 8composed of the following ingredients2 chloral1 camphor1 menthol1 iodin1 and oil of gualtheria1 incorporated in a fatty base4 ,each ounce contains fifteen grains of chloral hydrate1 nine grains of resublimed iodine40 8,no4 #b0 was said to have the same composition as 8,no4 #a0 except that the oil of gaultheria had been omitted4 ,the ,medical ,supply ,company was informed that the rules of the ,council required declaration of the amounts of each therapeutic constituent of pharmaceutical mixtures and that1 therefore1 in addition to the information furnished the amounts of camphor1 menthol and oil of gualtheria should be given for 8,no4 #a0 and the amount of camphor and menthol for 8,no4 #b40 ,the following reply was received3 8,l4 ,o4 ,compound ,no4 #a equals to each ,tube1 ,chloral hydrate gr4 #ae ,camphor gr4 #bb ,menthol gr4 #g-a_/b ,iodin 7resublime7 gr4 #c-b_/c ,oil of gaultheria m4 #c ,petrolatum1 q4 s4 oz4 #a ,l4 ,o4 ,compound ,no4 #b1 ,the same as above formula for ,l4 ,o4 ,c4 ,no4 #a1 except the oil of gaultheria which is omitted40 ,it should be noted that when the preparations were submitted each ounce of the preparation was claimed to contain #i grains of iodin1 while in the subsequent letter the company declares that they contain only #c-b_/c grains to the ounce4 ,if it be assumed that the unit intended is the avoirdupois ounce1 the preparation should contain #b4jf per cent4 of iodin according to the first statement and #j4hd per cent4 of iodin according to the second statement4 ,while the dark color of the preparations suggested the presence of appreciable amounts of free iodin1 the ,a4 ,m4 ,a4 ,chemical ,laboratory reported that an examination of the specimens submitted by the ,medical ,supply ,company showed that 8,no4 #a0 and 8,no4 #b0 each contained but #j4jcc per cent4 of free iodin2 hence both preparations are in conflict with ,rule #a4 ,for both preparations the labels suggest their use for the treatment of 8septic wounds1 burns1 pustular processes of all varieties1 and especially bronchial troubles40 ,this constitutes a conflict with ,rule #d4 ,regarding ,no4 #a the advertising circular included with the trade package asserts3 8,its merits have been practically demonstrated in the following conditions4 ,we invite your especial attention to its use in diseases of the thoracic cavity1 especially ,bronchitis and ,pneumonia1 ,rheumatism1 ,lumbago1 ,migraine1 ,neuralgia1 ,orchitis1 ,balanitis1 enlarged glands or any disturbance of the lymphatic system1 anti-galactagogue1 or wherever analgesic action is required40 8,no4 #b0 is said to be especially adapted to the needs of the surgeon1 it 8can be applied in any wound either aseptic or infected40 ,it is asserted that the usual method of preparing patients for operation may be discarded and that patients may be operated on after application of this ointment3 8444 ,we have no other preparation to-day which serves the purpose of ,l4 ,o4 ,compound in operative and post operative treatment4 8,it is a powerful antiseptic and germicide combining anesthetic1 analgesic and alterative properties40 ,after attempting to discredit the approved methods of preparing the field for surgical operations1 the advertising circular continues3 8,method of today3 ,a liberal amount of ,l4 ,o4 ,compound ,no4 #b is applied to the intended area of operation1 massage thoroughly until absorption is complete4 ,patient is ready for operation 4440 ,both products are in conflict with ,rule #f4 ,further1 as the names of these pharmaceutical mixtures are not descriptive of their composition1 they also conflict with ,rule #h4 ,the use of complex mixtures such as these is irrational and leads to misplaced confidence on the part of the physician2 particularly when1 as in this case1 neither the label nor the advertising matter gives the necessary information regarding the composition of the preparations further than that1 in accordance with the requirements of the ,federal ,food and ,drugs ,act1 the amount of chloral is declared 7,rule #aj74 ,the ,council declared ,l4 ,o4 ,compound ,no4 #a and ,l4 ,o4 ,compound ,no4 #b inadmissible to ,new and ,nonofficial ,remedies for conflict with ,rules #a1 #d1 #f1 #h and #aj4 ,the ,council's consideration of ,tri-,arsenole1 ,l4 ,o4 ,compound ,no4 #a and ,l4 ,o4 ,compound ,no4 #b was based on information received from the ,medical ,supply ,company1 the correspondence being signed 8,medical ,supply ,co41 per ,dr4 ,h4 ,e4 ,pontius40 ,the findings having been sent to the ,medical ,supply ,company1 the following reply was received3 7,june #bg1 #aiag7 8,replying to your registered letter of this ,a4 ,m4 relative to the ,medical ,supply ,company's products1 will state that the party furnishing you with such information as you have in hand was misinformed4 ,he is no longer with this company and whereabouts unknown4 ,respectfully1 ,medical ,supply ,company1 7,signed7 ,w4 ,b4 ,lingo1 ,president40 ,the ,medical ,supply ,company then was asked to point out any statements occurring in the report1 as submitted1 which the company considered to be inaccurate2 but no reply has been received to this request4 ,the advertising sent out by the ,medical ,supply ,company during the last part of ,august contained essentially the same statements and claims as those to which reference is made in the preceding report4 ,a qualitative examination of ,tri-,arsenole made in the ,a4 ,m4 ,a4 ,chemical ,laboratory indicated the presence of sodium1 mercury1 arsenic1 chlorid1 benzoate and a hydrastis preparation4 ,quantitative determinations were not made as there was no guarantee that an analysis of the present supply would indicate the composition of that marketed later on4 ,in view of the statement of the president of the company1 that the information submitted in the letters from the ,medical ,supply ,company was inaccurate1 ,tri-,arsenole and ,l4 ,o4 ,compound must definitely be placed with preparations1 the composition of which is not divulged by their owners2 hence ,tri-,arsenole as well as ,l4 ,o4 ,compound ,no4 #a and ,l4 ,o4 ,compound ,no4 #b are in conflict with ,rule #a4--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #aef47 ,,unctol ,report of the ,council on ,pharmacy and ,chemistry ,unctol1 sold by the ,r4 ,r4 ,rogers ,chemical ,company1 ,san ,francisco1 is a paste stated to contain approximately #dj per cent4 of metallic mercury in a soap base4 ,it is claimed that a part of the mercury is 8precipitated mercury0 and a part 8mechanically comminuted mercury40 ,unctol is sold as a substitute for mercurial ointment and is to be rubbed into the skin with the aid of water4 ,the claim is made for ,unctol that 8,it is more active than blue ointment because the mercury in it 7#dj per cent47 is more finely divided and the lathering still further subdivides the mercury particles and hence promotes absorption40 ,no evidence was presented to the ,council in support of the claimed superior efficacy of mercury soap paste over the official mercurial ointment4 ,on the other hand1 a consultant of the ,council who has studied the absorption of mercury and mercury compounds1 when applied to the skin1 reported that he had used mercury preparations in which soap was the base1 and that in his opinion ,unctol could have no advantage over the official mercurial ointment from the standpoint of therapeutic effect4 ,moreover1 the ,council is advised that some trials with ,unctol at the skin clinic of ,leland ,stanford ,university ,junior ,school of ,medicine did not confirm the claim that ,unctol is more active than mercurial ointment4 ,the ,council declared ,unctol inadmissible to ,new and ,nonofficial ,remedies because3 #a4 ,the claim of superiority over mercurial ointment is not substantiated1 and constitutes an unwarranted therapeutic claim 7,rule #f74 #b4 ,the name does not indicate the composition of this pharmaceutical mixture 7,rule #h74 #c4 ,the circular wrapped with the trade package advertises proprietary preparations not accepted by the ,council 7,rule #d74--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #afb47 ,v-,e-,m 7,,schoonmaker ,,laboratories1 ,,inc47 ,report of the ,council on ,pharmacy and ,chemistry ,because of inquiry received1 the ,schoonmaker ,laboratories1 ,inc41 ,new ,york1 were requested to submit information in regard to the 8,v-,e-,m0 products4 ,according to information received1 these products have the following composition3 ,v-,e-,m ,unguentum ,eucalyptol ,compound ,menthol #e grs4 ,eucalyptol 7,sander's7 #ae gtts4 ,white ,vaseline #a oz4 ,v-,e-,m with ,ichthyol ,menthol #b-a_/b grs4 ,eucalyptol 7,sander's7 #ae gtts4 ,ichthyol #aj grs4 ,white ,vaseline #a oz4 ,v-,e-,m with ,stearate of ,zinc ,menthol #b-a_/b grs4 ,eucalyptol 7,sander's7 #ae gtts4 ,stearate of ,zinc #a drm4 ,white ,vaseline #a oz4 ,v-,e-,m with ,camphor ,camphor #ae grs4 ,eucalyptol 7,sander's7 #ae gtts4 ,white ,vaseline #a oz4 ,v-,e-,m with ,boric ,acid ,pulv4 ,boric ,acid #a_/b drm4 ,eucalyptol 7,sander's7 #ae gtts4 ,white ,vaseline #a oz4 ,in an advertising circular this claim is made3 8,v-,e-,m ,unguentum ,eucalyptol ,compound ,combining1 in well-balanced proportions1 the cooling1 soothing and healing virtues of ,menthol with the antiseptic and deodorizing properties of ,eucalyptol1 in a base of pure1 neutral white ,vaseline4 ,furnished in five formulas as follows3 8,v-,e-,m ,unguentum ,eucalyptol ,compound3 ,menthol1 ,eucalyptol 7,sander's71 ,white ,vaseline4 8,v-,e-,m with ,ichthyol3 ,menthol1 ,eucalyptol 7,sander's71 ,ichthyol1 ,white ,vaseline4 8,v-,e-,m with ,stearate of ,zinc3 ,menthol1 ,eucalyptol 7,sander's71 ,stearate of ,zinc1 ,white ,vaseline4 8,v-,e-,m with ,camphor3 ,camphor1 ,eucalyptol 7,sander's71 ,white ,vaseline4 8,v-,e-,m with ,boric ,acid3 ,pulv4 ,boric ,acid1 ,eucalyptol 7,sander's71 ,white ,vaseline4 8,for local application in the treatment of affections of the nose and throat4 8,the efficacy of these combinations of remedial agents is so well established as to preclude the necessity of more than passing mention4 ,what is obvious is that in acute coryza1 in chronic and acute nasal catarrh1 in dry catarrhal conditions especially1 in both forms of chronic rhinitis--atrophic and hypertrophic--in the latter stages of the prevailing grippe colds1 and even in hay fever1 ,v-,e-,m ,unguentum ,eucalyptol ,compound affords pronounced relief and proves a most grateful application44440 ,though the identity and purity of eucalyptol are provided for by the standards of the ,u4 ,s4 ,pharmacopeia1 the claim is made that the product contained in these preparations 8transcends in purity and efficiency all other brands40 ,a package of ,v-,e-,m ,unguentum ,eucalyptol ,compound1 recently sent to a physician1 contains the following3 8,if your head is all stuffed up to-night1 or you feel a cold coming on1 use ,v-,e-,m just before going to bed4 ,it will break up the cold1 and you'll wake up in the morning1 with your head clear and feeling fine all over4 8,if you suffer with chronic or acute catarrh1 use ,v-,e-,m regularly night and morning4 ,you'll be agreeably surprised at the relief it will give you in a short time4 8,there is nothing quicker1 nothing surer to alleviate rhinitis1 grippe-colds1 or hay fever4 8,in a word--,v-,e-,m is the best antiseptic ointment for all diseased conditions of the nose44440 ,the ,council declared these preparations in conflict with its rules because unwarranted therapeutic claims were made for them 7,rule #f72 because the public was advised to depend on them in the treatment of diseases 7,rule #d71 and because these combinations of ingredients1 in fixed proportions1 under proprietary names1 are irrational 7,rules #h and #aj74--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiag1 p4 #afc47 ,,hemo-,,therapin ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,hemo-,therapin has been adopted by the ,council1 and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,according to the ,hemo-,therapin ,laboratories of ,new ,york ,city3 8,hemo-,therapin is a combination of highly refined creosols and phenols 7which have been detoxicated by special processes7 with salts of iron1 potassium1 sodium1 phosphorus and calcium in minute but physiologic proportions--the solution as a whole being designed to approximately closely in various fundamental details the chemistry of the blood40 ,no statement is made as to the quantities of the several ingredients1 nor is any information given as to the identity of the 8creosols0 and 8phenols10 nor the nature of the processes whereby these are 8detoxicated40 ,it is further claimed that it is3 8444 ,the composite character of ,hemo-,therapin1 the relative proportion and balance of its several ingredients1 and the action of the compound as a whole1 to which its potency is due40 ,and it is suggested that3 8,it will be apparent that the ingredients which enter into the composition of ,hemo-,therapin1 a remedy used intravenously exclusively1 have been selected with the utmost care with the object of assuring not only maximum therapeutic potency but also absolute safety and freedom from all dangers of toxic or other unpleasant or harmful action40 ,italics in the original4 ,the advertising does not explain1 however1 why the complex preparation should be therapeutically efficient or why the intravenous administration of this mixture should be absolutely safe and free from toxic or harmful action4 ,of the origin of ,hemo-,therapin it is said3 8,for many years ,dr4 ,e4 ,b4 ,witte1 a prominent physician of ,trenton1 ,n4 ,j4 apparently owner of the ,hemo-,therapin ,laboratories has devoted himself to the study of the blood4 ,as a result of his researches1 he early determined that when the blood is close to normal standards1 the body is well nourished1 the natural waste products are properly eliminated1 an effective resistance is offered to the invasion of pathogenic bacteria1 and the various functions of the body are kept normally active4 ,but when1 for one reason or another1 the blood falls away from normal standards1 the nutrition of the body suffers1 the elimination of waste products is impaired1 the resistance to germ attack is weakened1 and the various functions of the body become sadly deranged and perverted4 ,in other words1 instead of the physiologic processes of the body being normally active1 as soon as the blood is depreciated1 they become depressed or deranged1 with a loss of the physiologic harmony or equilibrium that constitutes a state of health4 8,recognizing the relation of clinical conditions to these various phenomena1 ,dr4 ,witte reached the conclusion that the correction of many aberrant or diseased conditions depended on restoring the blood to as near to its normal state as possible4 ,he accordingly applied himself especially to investigation of the chemistry of the blood1 with the object of evolving a substance in liquid form that would so closely approximate normal blood in its essential chemical characteristics that when introduced into the circulation it would bring the blood nearer to the condition in which it exists in health40 ,after the usual 8many years of hard painstaking labor10 ,dr4 ,witte elaborated a 8fluid meeting the foregoing conditions0 and now the ,hemo-,therapin ,laboratories inform us that #e to #aj c4c4 of this synthetic blood administered once in one1 two or three days in 8acute affection0 and at longer intervals in 8chronic ills0--once a week is said to be usually sufficient--will restore blood to a normality and empower it to overcome most ills4 ,while disclaiming that 8,hemo-,therapin is an infallible panacea10 the medical profession is asked to believe that3 8,in erysipelas1 septicemia1 pyemia1 the acute fevers1 puerperal infection1 furunculosis1 carbuncles1 malaria1 acute rheumatism1 pneumonia1 typhoid fever1 and in various skin diseases1 such as eczema1 psoriasis1 herpes zoster1 etc41 the results have been prompt and gratifying40 ,it is 8no less effective0 in such 8chronic ailments0 as3 8444 diabetes1 chronic ,bright's disease1 goiter1 pulmonary tuberculosis1 chronic rheumatism1 the severe anemias1 arterio-sclerosis sic1 various nervous disorders1 locomotor ataxia1 varicose and indolent ulcers44440 ,evidence of the virtues of ,hemo-,therapin is submitted as a series of 8case reports0--unsigned--which bear a striking likeness to the testimonials of 8patent medicine0 almanacs4 ,a specimen of the 8case reports0 is the following3 8,blood ,poisoning due to ,snake ,bite4--,case #i43 ,mrs4 ----2 age1 #eb2 was bitten by a poisonous snake--a copperhead--seventeen years ago4 ,on the anniversary of the bite the arm would swell to more than twice its normal size and there would be pain1 chills and fever4 ,after a month of this the acute symptoms would disappear and the arm would show large scaly blotches which upon being removed would disclose a thin mucous liquid4 ,throughout the seventeen years pain was constant1 being particularly acute in midsummer around the anniversary of the bite4 ,this patient had consulted many physicians during the seventeen years of suffering without any relief4 ,large doses of narcotic remedies were necessary each day to subdue the pain4 ,twenty-four hours after the first injection of ,hemo-,therapin all pain was dissipated4 ,after four treatments the patient was considered well and there has been no return of any of the symptoms since the last treatment six months ago40 ,hemo-,therapin is sold in ampules3 #f for #e and #ab for #aj1 and a circular sent to a physician contained this typewritten note3 8,,fees4--,while the physician's fee is not regulated by this company1 the physicians who use ,hemo-,therapin get #e4jj and #aj4jj for each treatment40--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #e1 #aiah47 ,,venosal ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,venosal has been adopted by the ,council1 and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 8,venosal0 is one of the products of the ,intravenous ,products ,company1 ,denver1 ,colo4 ,its composition has been variously1 and obscurely1 described3 8,venosal is a sterile solution representing #a gm4 7#ae4d gr47 of salicylates in combination1 together with colchicum40 8,this is a product for intravenous use4 ,the composition of which is ,sodium ,salicylate1 #ae4d grs4 7#a gm471 ,iron ,salicylate a minute quantity and the equivalent of approximately #b grs4 ,dried ,colchicum ,root40 ,none of these 8formulas0 gives the quantity of the product containing the #a gm4 of salicylate1 etc41 but presumably it refers to the contents of #a ampule or #bj c4c4 ,this inference is in accord with the analysis of the product made in the ,chemical ,laboratory of the ,american ,medical ,association4 ,the analysis also brought out the fact that the amount of iron in a given ampule was #j4jjjh gm4 7about #a_/hj grain74 ,this trace of iron in the presence of salicylate gives the product a purple color4 ,venosal is recommended for the treatment of 8rheumatism10 meaning1 the context would indicate1 infectious rheumatic fever4 ,as colchicum has no special action on this disease and as there is no apparent reason for the employment of the trace of iron present1 these additions in fixed proportions are unscientific1 if not absurd4 ,according to the advertising matter3 8,venosal 444 eliminates unpleasant digestive disturbances which frequently forbid the use of salicylates by mouth and1 in addition1 insures their full therapeutic value40 ,the statement is misleading1 as the cases in which the oral administration of the salicylates is contraindicated are not 8frequent0 but exceptional and there is no evidence to justify the implication that the 8full therapeutic value0 of salicylates cannot readily be attained by their oral use4 ,still more astonishing is the following claim3 8,venosal is a combination carrying the true salicylates 7sodii7 in doses much larger than given by mouth4 ,with this preparation given intravenously1 there is no nausea or disagreeable digestive after-effects1 tinnitus aurium1 or the accumulating effects of the drug2 yet the specific action of the salicylates seems to be increased many-fold1 according to reports received40 ,what are the facts8 ,by mouth sodium salicylate is given in doses of from #c to #ae gm4 in a day2 whereas ,venosal is advised as #a gm41 in from one to three day intervals2 as a matter of elementary arithmetic it is plain that these doses of ,venosal are smaller instead of being 8much larger40 ,the absence of digestive ill effects1 tinnitus1 etc41 is explained by the small dosage4 ,that the specific action of the salicylates should be increased by intravenous administration is surprising when it is remembered that the drug is absorbed rapidly and completely from the intestines2 in fact1 the quoted statement is incredible4 ,the company further alleges that1 on the basis of 8clinical reports0 it has received1 it does not 8hesitate to recommend this product for routine use in all streptococcic infections40 ,such a therapeutic suggestion is1 to put it conservatively1 gross exaggeration4 ,the whole question of the justification of using salicylates intravenously is open to grave doubt4 ,since it is possible to obtain the salicylate effects promptly and certainly by oral administration1 the inherent dangers of intravenous medication render its routine employment unwarranted4 ,a further objection to ,venosal1 especially at this time when economy is a national policy1 is the unnecessarily high expense of ,venosal itself and of its administration4 ,the referee recommends that ,venosal be declared ineligible to ,new and ,nonofficial ,remedies because of conflicts with ,rule #a 7indefinite chemical composition71 ,rule #f 7therapeutic exaggerations7 and ,rule #aj 7unscientific composition74--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #e1 #aiah47 ,,secretin-,,beveridge ,,and ,,the ,u4 ,s4 ,,patent ,,law ,report of the ,council on ,pharmacy and ,chemistry ,two years ago the ,council published reports on two proprietary preparations said to contain secretin1 namely1 8,secretogen10 sold by the ,g4 ,w4 ,carnrick ,company 7,the ,journal ,a4 ,m4 ,a41 ,may #a1 #aiae1 p4 #aeah71 and 8,duodenin10 sold by ,armour and ,company 7,the ,journal ,a4 ,m4 ,a41 ,aug4 #ad1 #aiae1 p4 #fci74 ,these reports explained that there was no evidence to indicate that an insufficient amount of secretin was the cause of gastro-intestinal diseases1 and further that there was no evidence that secretin in any form was physiologically active when administered by the mouth4 ,subsequently1 ,a4 ,j4 ,carlson and his co-workers1 at the request of the ,council1 studied the question of the stability of secretin and demonstrated 7,the ,journal ,a4 ,m4 ,a41 ,jan4 #ae1 #aiaf1 pp4 #agh and #bjh7 that commercial secretin preparations contained no secretin and1 further1 that secretin given both by the mouth and even in enormous doses directly into the intestine is entirely inactive4 ,shortly after the publication of ,professor ,carlson's work the attention of the ,council was called to a ,u4 ,s4 patent issued1 ,may #b1 #aiaf1 to ,james ,wallace ,beveridge1 8,means for and ,method of ,stabilizing ,secretin40 ,in this patent ,beveridge claimed to have invented 8,the process of producing secretin in stable form as a commercial article for therapeutic use 4440 that is1 a process for preparing preparations which would contain secretin when they reach the consumer and in a form resisting destruction in its passage through the stomach4 ,in view of the demonstrated instability of secretin1 the ,council asked ,professor ,carlson to investigate the validity of the claims of the ,beveridge patent4 ,the study on 8,the ,question of the ,stability of ,secretin10 by ,a4 ,j4 ,carlson1 ,a4 ,e4 ,kanter and ,i4 ,tumpowski1 which appears below1 shows that the ,beveridge patent furnishes no process for the manufacture of commercially stable secretin preparations1 nor any means for preventing the destruction of secretin by the gastric juice when administered orally4 ,it further demonstrates that the preparation made by ,beveridge was devoid of secretin4 ,the ,council adopted the report of ,carlson and his co-workers1 and declared ,secretin-,beveridge inadmissible to ,new and ,nonofficial ,remedies4 ,the ,council directed that the report of ,carlson and his collaborators be sent to the ,commissioner of ,patents with a protest against the granting of patents without competent and thorough investigation of the claims advanced therein4 ,w4 ,a4 ,puckner1 ,secretary4 ,,the ,,question ,,of ,,the ,,stability ,,of ,,secretin ,a4 ,j4 ,carlson1 ,a4 ,e4 ,kanter and ,i4 ,tumpowski ,from the ,hull ,physiological ,laboratory of the ,university of ,chicago ,in a letters patent1 filed ,may #f1 #aiad1 the patent granted ,may #b1 #aiaf1 ,james ,w4 ,beveridge1 ,m4,d41 makes certain claims concerning the stability and physiologic activity of secretin prepared according to the method patented by him4 ,in brief1 ,dr4 ,beveridge claims that secretin prepared by digesting intestinal mucosa with a weak acid at a temperature slightly below boiling1 and mixed with #j4b per cent4 to #b per cent4 blood serum1 albumin or peptone 7#a7 remains active for at least six months1 7#b7 stimulates the pancreas when given by mouth1 and 7#c7 8may be injected intravenously in man1 if desired40 ,the only thing in the letters patent in support of these claims is the statement3 8,i have found out by actual tests that the preparation maintains its stability for five or six months40 ,here are the claims in detail3 8,for the source of secretin ,i preferably use that part of the alimentary tract of any lower animal--such as a hog or sheep--including the gastric pylorus1 the duodenum and the jejunum4 ,this part is split open and washed with a normal saline solution to clean the mucosa or mucous membrane of any detritus which may be present4 ,the mucosa with the epithelial cells is then removed or separated from the muscular wall by scraping with a blunt knife or in any other suitable way4 ,the scrapings or cuttings1 which contain the secretin1 are then macerated or broken up40 8,the macerated mass is placed in a suitable vessel and subjected to the action of an acid solution until digested4 ,the time for the digestion of the mass will1 of course1 depend upon the strength and temperature of the acid solution employed4 ,the stronger the solution and the higher the temperature1 the shorter the time necessary for complete digestion4 ,this period may vary from several minutes to several hours4 ,in my experiments ,i found that the best results were obtained with hydrochloric acid solution of one-tenth to five-tenths of one per cent4 in strength1 although as high as eight-tenths per cent4 might be used4 ,the mixture is brought to a temperature of approximately #baj ,f41 and it may even for a few moments exceed that temperature1 but it should be kept below the boiling point1 for excessive heat injures or breaks down the secretin molecule and impairs or destroys its activity4 ,although ,i prefer to use hydrochloric acid1 ,i would have it understood that other acids--both organic or inorganic--may be employed1 provided that the percentage of acidity is regulated to prevent a chemical change in the secretin1 and further provided1 of course1 that the acid has no injurious effect on the human system40 8,after the mass has been digested in the heated solution1 the decoction is decanted1 and after being allowed to cool is passed through a suitable filter until the filtrate is clear4 ,i found that by filtering the decoction from four to six times through a carbon filter1 ,i obtained a clear colorless filtrate4 ,this is a solution of secretin and the acid which was used1 and the clearness of the solution shows that it is practically free from albumoses1 gelatin and other impurities 7such as cell tissues1 etc47 present in the raw material under treatment40 8,to the solution of pure and active secretin prepared as above explained1 there is added a suitable quantity of blood serum--say from one-fifth to two per cent4 or any equivalent medium--such as albumin solution or a peptone solution--which will aid and sustain the activating power of secretin as provided by the blood4 ,that is to say1 any medium having the same power1 similar quality or chemical composition that the blood-stream possesses in combining with secretin to stimulate the pancreas4 ,the addition of such a medium to the active secretin solution increases the potency of the secretin and its degree of stability by preventing oxidation or deterioration thereof4 ,if this strengthening or fortifying medium1 as it may be properly termed1 is alkaline1 it performs the additional function of lowering the acidity of the secretin filtrate4 ,it is preferable that the final product be just faintly acid4 ,if desired1 the final product may be made into an elixir by the addition of aromatics40 8,any desired strength of secretin solution may be obtained according to the quantity of acid solution4 ,in my experiments ,i used from ten to fourteen duodena to a pint of acid solution40 8,the solution of secretin prepared as above described is characterized by its ability to resist oxidation or deterioration for a sufficient period of time to render the solution available as a commercial article1 and is furthermore characterized by freedom from poisonous and irritable chemical substances1 whereby the secretin is chemically adapted to the human system to stimulate the pancreas to increased secretion40 8,as previously stated1 the secretin prepared according to my method may be administered orally to produce the desired physiological action4 ,of course1 if desired1 the secretin might be injected intravenously1 but this more or less dangerous procedure is not at all necessary1 and ,i merely mention it here to point out that when ,i refer to the oral administration of my new secretin preparation1 ,i do not mean to exclude its administration by injection40 8,as to the commercial stability of the secretin prepared according to my method1 ,i may say that ,i have found by actual tests that the preparation maintains its stability for as long a period as five or six months4 ,when ,i refer to my product as being 8commercially stable10 ,i mean that it resists oxidation or deterioration for a sufficient period to render the same available as a commercial article4 ,this period may vary from several weeks to several months1 depending upon certain commercial factors well understood by the manufacturer4 ,so1 roughly speaking1 ,i should say that secretin is commercially stable when it retains its activity from one to six months4 ,i do not wish to be understood1 however1 as limiting myself to these exact figures40 ,that active secretin may be extracted from macerated intestinal mucosa by weak acids below the temperature of boiling is well known4 ,in fact1 weak acids at body temperature in contact with the duodenal mucosa lead to the formation of secretin4 ,the claims that secretin given by mouth reaches the blood and acts on the pancreas has been made for other preparations of secretin4 ,it has also been shown that these claims are erroneous4#abb ,thus it would appear that the only novel element in ,dr4 ,beveridge's patented secretin is the addition of serum1 soluble proteins or peptones4 ,what reason is there for believing that this will render the secretin stable for months1 and physiologically active when taken by mouth8 ,we do not believe ,dr4 ,beveridge ever injected his secretin--protein mixture--intravenously in man or animals not under anesthesia1 otherwise he would not have stated3 8,of course1 if desired1 the secretin may be injected intravenously40 #abb ,carlson1 ,lebensohn and ,pearlman1 ,the ,journal1 ,jan4 #ae1 #aiaf1 p4 #agh4 ,,beveridge',s ,,patented ,,secretin ,,is ,,not ,,stable ,i4 ,the ,samples of ,secretin ,sent ,us by ,dr4 ,beveridge4--,physiological tests were made on four quart bottles of the secretin kindly sent us by ,dr4 ,beveridge ,june #bf1 #aiaf4 ,according to a letter from ,dr4 ,beveridge of ,july #bj1 #aiaf1 those samples of secretin were prepared ,june #bj1 that is1 only six days before received by us4 ,the material came in dark colored bottles4 ,it was kept in the original bottles and placed in the ice box immediately on receipt4 ,dr4 ,beveridge stated the secretin 8should remain active until the month of ,november1 #aiaf1 at least40 ,tests were made on three out of the four bottles4 ,the fourth bottle was not opened1 as we desired to learn what change it might undergo in the way of protein precipitation and bacterial decomposition4 ,there is nothing in the ,beveridge method of preparation that insures a sterile secretin unless it is passed through a ,berkefeld filter4 ,in all our crucial experiments the animals 7dogs7 were kept under light ether anesthesia1 a cannula inserted into the pancreatic duct1 the blood pressure recorded from the carotid artery and the various secretin preparations injected intravenously4 ,when inactive secretin preparations were encountered1 control tests were always made with active solutions of secretin to eliminate possible individual peculiarities of the animal4 ,thus when the pancreas of a dog reacts to the injection of preparation ,a1 but not to preparation ,b1 it is evident that absence of response to ,b is due to this preparation and not to the animal or to the experimental conditions4 ,illustration3 ,fig4 #a4--,records of carotid blood pressure and secretion of pancreatic juice on intravenous injection of ,beveridge's secretin in dogs4 ,x1 injection of #aj c4c4 secretin2 b1 record of flow of pancreatic juice in drops4 ,tracing ,a1 injection of #aj c4c4 of one sample secretin 7ten days old7 furnished by ,dr4 ,beveridge4 ,tracing ,b1 injection of #aj c4c4 of second sample of secretin 7ten days old7 furnished by ,dr4 ,beveridge4 ,tracing ,c1 injection of #aj c4c4 of secretin 7twenty hours old7 made by us according to the ,beveridge method4 ,showing that the secretin preparations sent us by ,dr4 ,beveridge contained no secretin4 ,each of the three samples of secretin sent us by ,dr4 ,beveridge was tested in the above manner on five dogs4 ,the first tests were made ,june #bg1 #bh and #bi1 respectively1 that is1 within nine days of the preparation of these samples of secretin4 ,none of the samples was active 7,fig4 #a71 even when injected intravenously in quantities up to #ej c4c43 #dj-ej c4c4 of ,beveridge's secretin mixture may kill a dog by too great lowering of the blood pressure4 ,a good secretin preparation yields a copious secretion of pancreatic juice on intravenous injection of a few cubic centimeters4 ,it is not difficult to prepare a secretin1 by the original ,bayliss or ,starling method or by the ,beveridge method1 that retains some activity for a longer period than nine days4 ,hence we cannot account for the absolute inactivity of these preparations except on the assumption that they did not contain any secretin to start with2 that is1 faulty preparation and absence of physiologic standardization4 ,the sample kept intact in its original container for six months became gradually cloudy1 a large mass of amorphous precipitate settled to the bottom and the odor showed bacterial decomposition4 ,it is reprehensible1 to say the least1 to state concerning such a mixture3 8,of course1 if desired1 it may be injected intravenously40 ,the fact that ,beveridge's secretin may be rendered clear by filtering through carbon is not sufficient evidence that it is 8pure secretin10 free from bacteria and other injurious substances4 ,,ii4 ,beveridge ,secretin ,mixture ,is ,rapidly ,rendered ,inactive by ,human ,gastric ,juice4--,we prepared active secretin solutions by the ,beveridge method1 using #j4b per cent4 serum as the protein 8stabilizer0 7874 ,the addition of the serum does not appear to affect the activity of the fresh secretin preparation4 ,if ,beveridge's secretin is able to act on the pancreas when given by mouth1 it is obvious that it must run the gamut of gastric digestion1 except in cases of complete achlorhydria4 ,it has been repeatedly demonstrated that all other secretin preparations are rapidly destroyed by pepsin-hydrochloric acid digestion4 ,is ,beveridge's secretin an exception8 ,what is there in a little serum1 native albumin1 or peptones to protect secretin against gastric digestion8 ,the pure human gastric juice used in these tests was secured from the fistula case 7,mr4 ,f4 ,v47 that has been under observation in our laboratory for years4#abc #abc ,carlson3 ,the ,control of ,hunger in ,health and ,disease1 ,chicago1 #aiaf4 ,,beveridge',s ,,secretin ,,and ,,bayliss-,,starling ,,secretin ,,prepared ,sept4 #bi1 #aiaf ,response of ,pancreas 7,no4 of ,drops of ,secretin7 ,date of ,test ,quantity of ,secretin ,bayliss-,starling ,beveridge ,injected1 ,c4c4 ,secretin ,secretin ,sept4 #bi4 #aj #ge #gh ,oct4 #b4 #aj #fa #fa ,oct4 #f4 #aj #bh #ag ,oct4 #ac4 #aj #be #ca ,oct4 #bg4 #aj #e #f ,nov4 #c4 #aj #g #f ,nov4 #ag4 #aj #d #e ,nov4 #cj4 #aj #c #d ,dec4 #d4 #aj #b #b ,dec4 #bj4 #aj #j #j ---------------------------------------- ------------------------ ,two cubic centimeters of fresh gastric juice added to #h-aj c4c4 ,beveridge secretin1 the mixture being kept at body temperature 7#ch ,c471 renders the secretin completely inactive in from #e to #h minutes 7,fig4 #b74 ,there is no exception to this rule1 as we have repeated the test on many different secretin preparations and using different samples of human gastric juice4 ,the secretin of ,beveridge is just as vulnerable as the secretin of ,bayliss and ,starling to pepsin-hydrochloric acid digestion4 ,on what kind of tests does ,beveridge base his claim that his secretin mixture acts on the pancreas when given by mouth8 ,,iii4 ,the ,relative ,rate of ,deterioration of the ,secretin ,solutions ,prepared ,according to ,bayliss and ,starling and ,according to ,beveridge4--,six different preparations of the two kinds of secretin were made1 kept in dark stoppered bottles in the ice box1 and tested by intravenous injection in dogs under ether anesthesia from time to time until all influence on the pancreas had been lost4 ,one typical series of these tests is given by the way of illustration4 7,see ,table on page #abf47 ,illustration3 ,fig4 #b4--,records of carotid blood pressure and flow of pancreatic juice on intravenous injection of secretin prepared by us according to the ,beveridge method4 ,x1 injection of #aj c4c4 of the secretin2 b1 record of flow of pancreatic juice in drops4 ,tracing ,a1 the #aj c4c4 of ,beveridge's secretin injected had been digested for five minutes with #c c4c4 of human gastric juice4 ,tracing ,b1 injection of #aj c4c4 of the same secretin preparation not subjected to gastric digestion4 ,showing rapid and complete destruction of ,beveridge's secretin by human gastric juice4 ,it will be seen that the rate of deterioration 7oxidation or decomposition7 of the secretin is practically the same whether prepared according to ,bayliss and ,starling or according to ,beveridge 7,figure #c74 ,in both preparations the rate of deterioration is most rapid the first few days after preparation4 ,it is scarcely necessary to point out that secretin preparations not kept constantly at low temperature and in the dark1 as in the above experiments1 will deteriorate more rapidly4 ,illustration3 ,fig4 #c4--,records of carotid blood pressure and flow of pancreatic juice on intravenous injection of secretin preparations4 ,x1 injection of #aj c4c4 secretin2 b1 record of flow of pancreatic juice in drops4 ,tracing ,a1 secretin prepared according to the ,beveridge method ,september #cj4 ,i1 injection of #aj c4c4 ,october #b4 ,,ii1 injection of #aj c4c4 ,november #cj4 ,tracing ,b1 secretin prepared by the ,bayliss-,starling method ,september #cj4 ,,iii1 injection of #aj c4c4 ,october #b2 ,,iv1 injection of #aj c4c4 ,november #cj4 ,showing no greater stability of ,beveridge's secretion over that of ,bayliss and ,starling4 ,why can we hope that the addition of serum or any solution of protein will render secretin more stable8 ,in the intact man or animal under normal conditions of digestion1 secretin reaches the pancreas by way of the blood1 that is1 it is in solution in blood4 ,does that fact render the secretin stable8 ,by no means4 ,the reader is familiar with the fact that the response of the pancreas to a single intravenous administration of secretin is very transitory 7#e-ae min474 ,the cessation of activity is due1 not to fatigue of the pancreas1 as a second injection of secretin gives a prompt response of pancreatic secretion1 but to the disappearance of active secretin from the blood4 ,in fact1 secretin left in the test tube or in the bottle remains active over a much longer period of time than when introduced into the blood stream4 ,,iv4 ,beveridge's ,secretin ,given by ,mouth to the ,intact ,animal ,has ,no ,specific ,action on the ,pancreas4--,active secretin prepared according to the method of ,beveridge was fed on an empty stomach to a small dog 7#e kilo7 with permanent fistula of one of the pancreatic ducts4 ,on control days we gave the dog 7a7 equal quantities of n_/#aj ,h,cl1 and 7b7 bread and milk4 ,the ,beveridge secretin was prepared with #j4c per cent4 ,h,cl and the addition of #j4b per cent4 serum4 ,the results may be stated by the following summary3 ,,giving ,,beveridge',s ,,secretin ,,by ,,mouth ,secretin of the ,number of ,pancreas for ,three ,material ,fed ,tests ,hours ,following the ,feeding #aej c4c4 ,beveridge ,secretin #f #aj4b c4c4 #aej c4c4 n_/#aj ,h,cl #e #bb4g c4c4 ,bread soaked in milk #d #f4f c4c4 ---------------------------------------- ------------------------ ,the ,control experiments with pure hydrochloric acid show that the secretion of pancreatic juice following the introduction of ,beveridge's secretin into the stomach is due to the acid factor and the protein content4 ,,conclusions ,the patented secretin of ,beveridge is rendered inactive by gastric juice1 is without effect when given by mouth1 and exhibits no greater stability or keeping qualities than the secretin prepared according to ,bayliss and ,starling4 ,it has no merit as a therapeutic agent4 ,it should under no conditions be administered intravenously in man1 as it contains deleterious protein split products and living bacteria4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ab1 #aiah47 ,,need ,,for ,,patent ,,law ,,revision ,report of the ,committee on ,patent-,law ,revision of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association ,at the present critical time when the efficiency of this nation must be raised to the highest point1 it is essential that the ,united ,states government should lead in the efforts tending to such increased efficiency4 ,to bring this about the government must protect and stimulate science1 art and industry and at the same time curb or prevent waste of the country's resources4 ,in this field the ,united ,states ,patent ,office has unlimited power for good and evil--good1 in the issuance of patent grants for novel devices and substances which go to increase national efficiency2 evil1 in the granting of patent protection where such protection is not in the interest of national efficiency1 conservation of energy and material resources4 ,for years the ,american ,medical ,association1 in common with the national pharmaceutical bodies1 has been urging amendment of the law which governs the issuance of patents on medicinal preparations and more particularly revision of the procedure under which such patents are issued4 ,at the ,chicago 7#aijh7 meeting of the ,american ,medical ,association a special committee of five was appointed by the ,house of ,delegates to study the questions involved1 and to cooperate with the ,association's committee on medical legislation in preparing and securing the enactment of a bill which would correct the abuses connected with the enforcement of our patent laws 7,the ,journal ,a4 ,m4 ,a41 ,june #ac1 #aijh1 p4 #bjjc74 ,this committee presented a comprehensive report at the ,atlantic ,city 7#aiji7 meeting of the ,american ,medical ,association 7,the ,journal ,a4 ,m4 ,a41 ,june #ai1 #aiji1 p4 #bjfc74 ,a further report was presented at the ,st4 ,louis 7#aiaj7 meeting of the ,american ,medical ,association 7,the ,journal ,a4 ,m4 ,a41 ,june #ah1 p4 #bjgi74 ,in #aiaa 7,the ,journal ,a4 ,m4 ,a41 ,nov4 #be1 #aiaa1 p4 #aghj7 the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association issued a report which set forth the inadequacy of our patent laws as they are administered in relation to medical products particularly4 ,,against ,,public ,,interest ,since that time the ,council has continued its study of the ,u4 ,s4 ,patent law as it applies to medicine and has become convinced that in many instances the patent law or its enforcement is contrary to the best interest of the public1 both as concerns health and prosperity4 ,the ,council feels it a duty at this time to protest against the provisions of our patent law1 or the methods of its enforcement1 which permit the granting of patents without thorough and scientific investigation of the claims advanced in such letters patent4 ,as one means of improving conditions the ,council urges that the ,u4 ,s4 ,public ,health ,service1 the ,bureau of ,chemistry1 ,u4 ,s4 ,department of ,agriculture and other scientific departments of the ,united ,states government conversant with medicines and related subjects be consulted before the issuance of patents on medicinal preparations4 ,in support of the ,council's contention that the patent law procedure requires revision1 the following is offered3 ,in #aiab a ,u4 ,s4 ,patent 7,no4 #a1jca1iga7 was granted on a cresol derivative1 metacresyl acetate1 a product described in chemical literature in #aijc4 ,when the ,council inquired as to the grounds for the issuance of a patent for a substance known to science1 the ,patent ,office replied that it was not familiar with the publication in which metacresyl acetate had been described4 ,it seems evident that this patent would not have been issued had the application first been submitted to a government department familiar with chemical literature4 ,an illustration of the granting of a patent on the use of well-known chemical bodies which present no discovery or originality1 is the patent issued for the use of peroxids1 perborates and percarbonates as ingredients of tooth powders 7,u4 ,s4 ,patents ,nos4 #gfj1cig and #hjb1jii74 ,regarding these patents ,the ,journal of the ,american ,medical ,association 7,sept4 #bj1 #aiac1 p4 #igh7 commented3 8,the patents held by ,mc,kesson and ,robbins give this firm the exclusive right of manufacturing tooth powders containing peroxids1 perborates and percarbonates4 ,it is another illustration of the unfair monopolies that may be secured under our present patent laws40 ,,granting ,a ,,patent ,,to ,a ,,nostrum ,again in #aiac ,u4 ,s4 ,patent ,no4 #a1jha1jfi was granted to a citizen of ,switzerland 7a country which does not grant patents on medicinal preparations7 for a 8composition which is intended to be used internally and which confers to the organisms immunity against the following microbial infectious illnesses3 diphtheria1 pneumonia1 typhus1 scarlet fever1 influenza1 septic infections1 cerebral-spinal meningitis1 syphilis1 pest1 cholera and tuberculosis2 it is also effective in another kind of disease1 viz41 goiter40 7,italics not in original74 ,the patent specification states that 8,the principal of these substances is creatinin 44410 but offers no evidence whatever that this well-known chemical body has the extensive and miraculous powers claimed for it4 ,in publishing a notice of this patent ,the ,journal of the ,american ,medical ,association 7,jan4 #c1 #aiad1 p4 #ed7 explained3 8,it appears that the inventor is dead1 and that his estate took out the patent4 ,since this great benefactor should have been1 by the use of his preparation1 immune to practically all diseases1 he must have died of senility1 although this seems hardly to have been the case40 and held3 8,assuredly granting patents on such claims ought to be sufficient to show the need of a change in the methods of granting patents--at least of the methods governing the issuance of patents for medicinal products40 ,we submit1 that had the department of the government entrusted with the enforcement of the federal ,food and ,drugs ,act been consulted as to the claims of this patent1 it would probably have advised that1 if the absurd and palpably fraudulent claims set forth in this application for a patent were made on the label of a preparation of creatinin offered for sale in interstate commerce or in the ,district of ,columbia1 the vendor would be prosecuted4 ,in #aiad there was issued ,u4 ,s4 ,patent ,no4 #a1jhf1cci4 ,here the 8inventor0 declared3 8,it is the object of my invention to destroy parasitic micro-organisms1 particularly on living tissue without injuring the latter1 by progressively evolving sodium hydroxid contiguous to said tissue1 from and in a moist mixture of calcium hydroxid1 sodium carbonate1 aluminum sulfate and boric acid44440 ,in a word1 this patent apparently was granted for the production of sodium hydroxid by a chemical reaction which had been in use for several centuries4 ,because the patentee had twisted the granting of this patent into a quasi-endorsement of his nostrum1 the ,council's consideration of this preparation was sent the ,patent ,office as a protest against the present law which authorizes the granting of patents on unproved and improbable medical claims4 ,at that time the ,council was informed by the ,patent ,office that reforms in the issuance of patents for medicinal substances had been instituted1 and that 8the trouble will not be so pronounced in the future as it has been in the past40 ,,flavoring ,,epsom ,,salt ,a 8,,discovery0 ,there was issued early in #aiag ,u4 ,s4 ,patent ,no4 #a1bab1hhh for a method of flavoring ,epsom salt--yet this 8discovery0 is a procedure which has been practiced ever since the cathartic action of this bitter salt has been known4 ,not only does the patent describe a process long known to physicians and pharmacists1 but it sets forth claims that the flavored cathartic salt produced by the process cures flatulency1 indigestion1 sick and sour stomach1 colic and destroys worms4 ,in commenting on this patent ,the ,journal of the ,american ,medical ,association 7,june #bc1 #aiag1 p4 #aiad7 was constrained to remark3 8,the splendid conception of the framers of our constitution in providing a plan for promoting progress in science and useful arts by granting to inventors for a limited time the exclusive use of their inventions1 in exchange for the publication of full knowledge thereof1 is being debased4 ,no branch of our government is of greater importance to the progress of the country than the patent office1 provided that office is intelligently administered4 ,when the patent office is used1 however1 for an extension of the nostrum business1 founded on the abuse of patent and trade-mark laws1 it becomes a menace to the public health4 ,the objects of the patent law are being defeated by the practices of the patent office40 ,still further1 attention is called to ,u4 ,s4 ,patent ,no4 #a1bbf1cid for a process of making hexamethylenamin tetraiodid and on the product so produced4 ,this patent was issued after the ,council had notified the ,patent ,office that hexamethylenamin tetraiodid had been discovered in #ahhh and that a process identical in principle with that for which patent application appeared to have been made was published in #aiaf4 ,on the basis of claims for which no evidence is produced this patent is issued for a well-known substance on the ground that as previously produced it contained a little free iodin or that the known processes were less economical4 ,this patent appears to be an illustration of our patent procedure which obliged ,american users of acetylsalicylic acid to pay an exorbitant price because this country granted a patent which gave to the patentee1 a foreigner1 the exclusive right to the manufacture of the substance1 whereas no such patent was issued in the patentee's own country nor1 so far as we can learn1 in any other country4 ,it forcibly illustrates the need for a revision either of our patent laws or of their methods of enforcement or both4 ,,the ,,beveridge ,,patent ,in further justification of the ,council's protest against the provisions of our present law1 or the methods of its enforcement1 which permit the granting of patents without thorough and scientific investigation of the claims advanced in such letters patent1 the ,council calls attention to the report1 appearing above1 of an investigation made by ,a4 ,j4 ,carlson1 ,a4 ,e4 ,kanter and ,i4 ,tumpowski1 8,the ,question of the ,stability of ,secretin10 which relates to ,u4 ,s4 ,patent ,no4 #a1aha1dbd1 issued to ,james ,wallace ,beveridge4 ,whereas the regulations governing the issuance of patents demand that the processes shall be described in such detail that one versed in the sciences can confirm the claims made by the patentee1 no pretense whatever of fulfilling this requirement is made in the patent specifications of this patent4 ,the substance of the first three paragraphs of this patent has long been general knowledge4 ,nearly every sophomore medical student has himself performed1 or seen performed such 8experiments0 as are therein described4 ,the claims of novelty evidently are confined to the assertion that the preparation is able to 8resist oxidation or deterioration02 that it is free from 8poisonous and irritable chemical substances02 that it 8may be administered orally to produce the desired physiological action40 etc41 etc4 ,not the slightest hint is given as to how any person can substantiate these claims4 ,as a matter of fact1 the investigation of ,professor ,carlson and his co-workers has shown that a preparation having the properties claimed cannot be made by the process described in this patent4 ,any one familiar with the subject could have demonstrated readily that the applicant was withholding information concerning essential features of his process1 assuming that he had any information on the subject 7which he probably did not have7 and would have advised against the issuance of the ,beveridge patent4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ab1 #aiah47 ,,surgodine ,report of the ,council on ,pharmacy and ,chemistry ,the following report submitted by a referee was adopted by the ,council and authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,surgodine 7,sharp and ,dohme1 ,baltimore1 ,md471 according to an advertising pamphlet1 is a solution of #b-a_/d per cent4 of iodin in alcohol1 containing no alkaline iodid1 but miscible with water in all proportions4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reports that ,surgodine is an alcoholic liquid 7containing #ia4h per cent4 alcohol by volume7 containing free iodin1 combined iodin and free acid1 probably hydrogen iodid 7hydriodic acid74 ,quantitative estimations gave #b4ea gm4 free iodin per #ajj c4c4 and #a4gh gm4 combined iodin 7the greater part apparently was present as hydrogen iodid74 ,it is therefore similar to several other iodin preparations already considered by the ,council4 ,like these1 it is essentially similar to the official tincture of iodin1 except that it is considerably weaker1 and instead of potassium iodid it presumably contains hydrogen iodid and probably ethyl iodid to render the iodin water-soluble4 ,its composition1 however1 is secret4 ,there would be no objection to the use of ethyl iodid or hydrogen iodid1 except perhaps the acidity of the latter1 as a solvent agent rather than of potassium iodid4 ,but neither is there any important advantage1 and these preparations would have to be considered as unessential modifications of official preparations1 and therefore ineligible for ,new and ,nonofficial ,remedies4 ,the attempt to make these modifications commercially profitable1 however1 seems inevitably to lead to exaggerations and misstatements4 ,in an advertising pamphlet the following claims for ,surgodine are unsupported by any evidence3 8,but from the surgical viewpoint the addition of this potassium salt is most objectionable because when such solutions as the official tincture are used locally in the antiseptic treatment of open and often infected wounds the ,potassium ,iodide acts as an irritant to the wound and therefore produces a localized irritation which is not only objectionable from the surgical standpoint but also materially lessens the antiseptic power of the ,iodine itself40 8,it has been demonstrated repeatedly that ,iodine without the admixture of any alkaline iodide is much more efficient as a surgical antiseptic than any iodine solution that contains such an addition40 8,iodine does not produce #8iodism' as quickly as the alkaline iodides do because it is eliminated more quickly and more perfectly than the alkaline iodides40 ,the next statement intimates that iodin taken by mouth enters the intestinal tract unchanged and is there free to combine with various gases3 8,iodine in the presence of phosphorated or sulphurated gases in the gastro-intestinal tract unites with their hydrogen and thus breaks up these noxious compounds40 ,this is certainly untrue at least for ordinary doses4 ,it is recommended that ,surgodine be held inadmissible to ,new and ,nonofficial ,remedies because its composition is secret 7,rule #a72 because the therapeutic claims made for it are exaggerated and unwarranted 7,rule #f72 and because it is an unessential modification of the official tincture of iodin 7,rule #aj74 ,editorial ,comment4--,surgodine is a good illustration of the economic waste inseparable from most proprietary medicines4 ,a hospital pharmacist writes that whereas his hospital obtains tincture of iodin at less than #hb cents a pint1 ,surgodine costs #b4ac a pint4 ,this means that while the free-iodin strength of ,surgodine is only about one-third that of the official tincture1 its price is between two and three times as high4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bf1 #aiah7 ,,medeol ,,suppositories ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,medeol ,suppositories has been adopted by the ,council1 and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 8,medeol ,suppositories0 7,medeol ,company1 ,inc41 ,new ,york7 appear to be an imitation of 8,anusol ,suppositories0 which1 in #aijg1 were found to be inadmissible to ,new and ,nonofficial ,remedies4 ,a comparison of the composition and of the claims made for the two preparations will be of interest in the present consideration of ,medeol ,suppositories3 ,,anusol ,,suppositories 7#aiji7 ,,medeol ,,suppositories 7#aiag7 ,anusoli #g4e ,medeol #j4be ,zinc oxid #f4j ,zinc oxid #j4e ,balsam ,peru #a4e ,acid4 tannic #j4ae ,ol4 theobrom4 #ai4j ,bals4 ,peru #j4af ,ungt4 cerat4 #b4e ,cocoa butter and wax q4 s4 for #ab suppositories4 for #a suppository4 8,anusol0 was formerly said to be bismuth iodoresorcinsulphonate4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory published a report in #aiji showing that the suppositories contained only #a per cent4 of the iodin declared in the 8formula10 and were greatly deficient in bismuth and sulphur4 ,after the publication of the report the ,american agents for the product disclaimed that 8,anusol0 was a definite chemical compound4 ,today ,anusol ,suppositories are said to contain unstated amounts of the indefinite 8bismuth oxyiodid and resorcinsulphonate40 8,medeol0 is said to be 8resorcinated iodo bismuth10 but no information is vouchsafed as to the character or composition of the ingredient4 ,the therapeutic claims made for the two preparations are similar1 as the following1 taken from circulars1 show3 ,,anusol ,,suppositories ,an innocuous1 non-irritant remedy for anal1 rectal and vaginal inflammatory affections1 especially for ,,hemorrhoids6 ,the local medicinal treatment of hemorrhoidal and other inflammatory ano-rectal conditions has always been unsatisfactory4 ,the usual media cannot be applied in effective concentration without producing intense inflammatory reactions2 they are either ineffective or intolerable4444 ,anusol suppositories are absolutely free from narcotic1 caustic or other injurious ingredients and may unhesitatingly be used by both sexes1 at any age and under all conditions4 ,,medeol ,,suppositories ,an innocuous1 ,non-irritant1 ,efficient ,antiphlogistic for use in inflammatory diseases of the rectum1 anus and vagina especially in ,,hemorrhoids4 ,hitherto most of the local remedies used in these conditions have either been too irritating to be employed in sufficient concentration to be efficient or they have lacked efficiency per se4444 ,medeol suppositories do not contain any narcotic or any caustic or other constituent having violent action2 their blandness permits of their use in either sex and at all ages4 ,the claims made for these preparations--as for instance 8that surgical treatment 444 should rarely be undertaken until ,medeol ,suppositories have been given a thorough trial0--are misleading in that they create the inference that the limitations in the palliative treatment of piles have been overcome4 ,it is altogether untrue that these mixtures can be expected to 8relieve the most obstinate cases10 as stated in a ,medeol circular4 ,this1 from an ,anusol circular1 is equally misleading3 8,if dietetic and other requirements are complied with1 even the most obstinate chronic cases will frequently readily yield to treatment with ,anusol ,suppositories40 ,the ,council declared ,medeol ,suppositories inadmissible to ,new and ,nonofficial ,remedies because their composition is secret 7,rules #a and #b72 because unwarranted therapeutic claims are made for these 7,rule #f72 because the name is objectionable 7,rule #h71 and because the combination is unscientific 7,rule #aj74 ,in those cases of hemorrhoids in which palliative measures may be expected to enable the patient to avoid surgical interference and afford relief from attacks1 the object should be to secure cleanliness1 to avoid irritation1 whether it be by friction or irritating fecal matter1 to reduce inflammation by astringents and1 when necessary1 to relieve pain by analgesics4 ,if an antiseptic dusting powder is desired1 boracic acid in impalpable powder with talc may be employed2 if an astringent1 finely powdered oxid of zinc may be added2 if a local analgesic is necessary1 a little extract of belladonna may be incorporated with petrolatum or other ointment base4 ,the main reliance1 in any event1 should be to effect normal bowel movements by regulating the diet rather than by the use of purgatives2 the use of warm water to insure cleanliness2 the avoidance of irritation1 especially that caused by friction and secretions2 a mild astringent to reduce inflammation4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #i1 #aiah7 ,,guaiodine ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,guaiodine1 marketed by the ,intravenous ,products ,company1 ,denver1 has been adopted by the ,council and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,a referee of the ,committee on ,pharmacology1 in submitting to the ,council a report from the ,a4 ,m4 ,a4 ,chemical ,laboratory on ,guaiodine1 advises that the ,laboratory's examination shows that instead of containing free 8colloidal0 iodin as claimed1 the preparation is essentially an iodated fatty oil1 containing only combined iodin4 ,equally misleading1 in view of the ,laboratory's findings1 are the implied claims that the antiseptic action of ,guaiodine corresponds to that of free iodin4 ,guaiodine is advertised mainly for the treatment of gonorrhea4 ,while it may be true that the guaiacol contained in ,guaiodine has some beneficial effect1 especially when preceded by potassium permanganate irrigation as advised1 the advertised claim that 8,guaiodine acts as a specific for gonorrhea in a majority of cases0 is utterly false4 ,the 8case records0 offered to establish the therapeutic value of ,guaiodine are in themselves sufficient to condemn the 8evidence40 ,the following are fair samples3 8,the second boy came a day or so later with a slight discharge with the characteristic burning and itching1 and with symptoms of a beginning gonorrhea1 and judging from the source of the infection1 it was believed to be so4 ,two injections of ,guaiodine were given when the discharge ceased40 8,i have several cases that were completely cured in a very short time4 ,i note this1 that the first dose causes a cessation of the discharge and the second seems to increase the flow1 but the color is changed4 ,i give three doses1 and then use a mild wash1 and in ten days they are well4 ,i am very pleased with this preparation and very truly believe that it is the best there is to date for the positive cure of gonorrhea40 ,,report ,,of ,,the ,,chemical ,,laboratory ,guaiodine is manufactured by the ,intravenous ,products ,company1 ,denver1 ,colorado4 ,the 8literature0 which accompanies the product describes ,guaiodine as3 8444 an electro-chemically prepared iodin1 suspended in oil1 containing iodin1 the same strength as the ,u4 ,s4 ,p4 tincture of iodin1 or #g per cent41 together with a therapeutic dose of guaiacol40 ,the ,intravenous ,products ,company claims that ,guaiodine is made by an 8electro-chemical process of preparing colloidal iodine10 discovered by one ,e4 ,b4 ,page1 and that by this process the tendency of iodin to produce iodism has been 8overcome40 ,it is said to be 8pre-eminently an antiseptic and germicide40 ,guaiodine is a dark brown1 oily liquid with a specific gravity of #j4ihde at #ae4f ,c4 and an odor suggestive of guaiacol4 ,its solubilities were those of a fat4 ,free iodin was absent in the recently purchased specimen 7traces were present in an older one74 ,steam distillation indicated that the product consisted of volatile and nonvolatile constituents4 ,the volatile matter was concluded to consist1 in the main1 of guaiacol or some guaiacol-like body1 and the nonvolatile matter to be an iodized fatty oil4 ,quantitative determinations indicated that ,guaiodine contained about #g4be per cent4 of iodin in combination1 and that it is composed approximately of #c per cent4 volatile matter and #ig per cent4 nonvolatile matter4 ,hence ,guaiodine appears to be an iodized fatty oil to which a small amount of guaiacol or some guaiacol-like substance has been added4 ,,the ,,council',s ,,action ,on the recommendation of the referee1 the ,council voted that ,guaiodine be declared inadmissible to ,new and ,nonofficial ,remedies because of false statements as to composition and action4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #f1 #aiah47 ,,several 8,,mixed0 ,,vaccines ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the 8mixed0 vaccines which are discussed in the reports that follow were considered by the ,council during the past year because inquiries had been received in regard to them4 ,in publishing these reports it is desirable that the attitude of the ,council toward 8mixed0 vaccines again be stated4 ,in view of the rapid development of bacterial therapy1 the possibility for harm that attends the use of bacterial vaccines and the skepticism among experienced clinicians as to the value of vaccines representing a combination of organisms1 the ,council has felt that it should scrutinize the claims for such agents with exceptional care and that there should be admitted to ,new and ,nonofficial ,remedies only those vaccine mixtures for which there is acceptable evidence to indicate that the use of the particular mixtures is rational4 ,in considering the subject the ,council has borne in mind the fact that in many institutions in which cases are studied and the results of therapeutic measures carefully observed and controlled1 vaccines of any sort are practically never used--certainly here the stock mixed vaccine has no recognition4 ,experienced clinicians have generally come to the conclusion that mixed vaccines have no specific action and that any effect they may produce is due to a non-specific protein reaction4 ,as set forth in the reports1 in no case was the evidence submitted by the proprietors sufficient to establish the claims made for the preparations4 ,hence none was accepted for ,new and ,nonofficial ,remedies4 ,the preparations that form the basis for the accompanying reports are only a few of the many that are being made and sold by some biological houses4 ,doubtless many of those not dealt with in this report are equally irrational and sold under claims equally--or probably even more--unwarranted than those with which the present report deals4 ,w4 ,a4 ,puckner1 ,secretary4 ,mixed ,vaccines-,abbott ,in response to inquiry the ,council undertook a consideration of the following 8mixed0 vaccines sold by the ,abbott ,laboratories3 ,m4 ,catarrhalis-,combined-,bacterin1 said to contain killed ,micrococcus catarrhalis1 ,bacillus ,friedlnder1 ,pneumococci1 ,streptococci1 ,staphylococcus aureus and ,staphylococcus albus4 ,b4 ,coli-,combined-,bacterin1 said to contain killed ,streptococcus viridans1 ,streptococcus hemolyticus and ,bacillus coli4 ,pertussis-,combined-,bacterin1 said to contain killed ,bacillus pertussis1 ,pneumococci1 ,streptococci1 ,staphylococcus albus1 ,staphylococcus aureus and ,micrococcus catarrhalis4 ,streptococcus-,rheumaticus-,combined-,b acterin1 said to contain killed 8,streptococci 7,rheumaticus1 ,viridans1 etc470 and ,pneumococci4 ,streptococcus-,viridans-,combined-,bact erin1 said to contain killed ,streptococcus viridans1 ,streptococcus hemolyticus1 ,pneumococcus and ,staphylococcus albus4 ,the ,abbott ,laboratories were asked to assist in the investigation of these products and to submit evidence to establish their eligibility for admission to ,new and ,nonofficial ,remedies4 ,the manufacturer was informed that the ,council accepts 8mixed0 vaccines or bacterins1 provided the usefulness of these products is established by acceptable clinical evidence1 and references to the literature bearing on the value of the preparations were requested4 ,the ,abbott ,laboratories submitted specimens of the products1 the advertising matter therefor and a considerable list of references to current literature2 all of which was transmitted to the ,committee on ,serums and ,vaccines for consideration4 ,in due time a referee of the committee submitted the following report3 ,,the ,,committee',s ,,report ,the referee has studied the literature covered by the references submitted4 ,in general the articles are favorable to the use of vaccines1 though many of these papers do not consider 8mixed0 vaccines2 indeed1 a number of the articles do not discuss treatment at all1 but are devoted entirely to the consideration of etiology of the disease4 ,many of the papers are by those who are obviously overenthusiastic on the subject of the use of biologic preparations4 ,one paper--not included in the references submitted by the ,abbott ,laboratories--records an alarming reaction following a dose of mixed vaccine2 no claim is made that improvement followed4 ,the following comments on the submitted references are offered3 ,m4 ,catarrhalis-,combined-,bacterin4--,only four of the nine references given deal with the therapeutic use of the vaccine4 ,the reported results in general were favorable1 but sometimes in the discussion evoked by certain of the papers1 views the reverse of those expressed by the author were brought forward4 ,the enthusiasm of one writer is shown in his statement that following the use of vaccine in cases of carbuncle complicating diabetes the sugar in the urine disappeared or was reduced4 ,one observer1 who reports excellent results in nasal pharyngeal catarrh1 speaks of certain vaccines as 8bulk goods10 while another considers 8----'s ,no4 #g0 as the proper thing4 ,it is evident that the reports are not based on careful1 scientific data1 or such unscientific definition of the product employed would not be used4 ,b4 ,coli-,combined-,bacterin4--,in the references cited in support of this preparation the following general statements are noted3 ,one enthusiastic writer says1 8,it must be recognized that we have no satisfactory explanation of the action of vaccines1 and their use at present is empirical40 ,one author dwelt on the superiority of autogenous vaccines but admits that occasionally stock vaccines are indicated4 ,one vaccine therapist in concluding an article states1 8,it is simply impossible to practice modern urology without our modern biologic products40 ,yet it is a well-known fact that many successful and capable genito-urinary surgeons avoid the use of vaccines1 mixed or simple4 ,pertussis-,combined-,bacterin4--,these reports are uniformly favorable1 but are not controlled and their value is not to be compared with a recent report from the ,new ,york ,city ,department of ,health which indicates that the vaccine is practically valueless4 ,it is noted1 further1 that one of the articles cited which dealt rather fully with the treatment of pertussis did not mention vaccines4 ,streptococcus-,rheumaticus-,combined-,b acterin4--,the references cited in support of the preparations by the manufacturer give no support whatever for the use of mixed stock vaccines4 ,the first reference deals with the relation of ,streptococcus viridans to arthritis deformans and endocarditis and reports the following cases3 ,case #a4--,vaccine case--improvement after eight months4 ,case #b4--,slight improvement following use of vaccine4 ,case #c4--,slight improvement following use of vaccine4 ,case #d4--,marked improvement4 ,case #e4--,prompt improvement4 ,case #f4--,vaccine not mentioned4 ,case #g4--,vaccine followed by slight improvement4 ,in each of the cases other methods of treatment were used4 ,the paper shows the etiologic relation of ,streptococcus viridans rather than the value of vaccines4 ,there is no indication that stock vaccines were used1 though the paper is not clear on this point4 ,the second paper deals with the application of vaccine therapy in the treatment of arthritis4 ,this paper is by a man who is avowedly an enthusiast on vaccine therapy4 ,the indications are that he generally used a mixed autogenous vaccine1 but the reports of cases are not always clear4 ,this writer apparently makes no serious attempt at the classification of the joint conditions he treats4 ,the third reference is a purely experimental study and has no bearing on the use of vaccines in treatment4 ,the fourth article was admitted by the manufacturer to be 8negative as regards evidence40 ,the fifth reference specifically states that 8the vaccine must be autogenous40 ,the sixth reference deals with the experimental production of appendicitis by the use of diplococci1 and has not the most remote bearing on the use of vaccines in the treatment of rheumatism4 ,streptococcus-,viridans-,combined-,bact erin4--,the article which bears evidence of more care than the others admits that we are not in position to state the value of vaccines in pyorrhea but the author believes they may have value supplementary to local treatment4 ,it is not surprising that a large number of favorable reports can be accumulated when we appreciate how promptly men report what they consider to be their successes and how commonly they leave their failures unrecorded4 ,bearing in mind the fact that these stock mixed vaccines1 though before the profession for many years1 have not been used1 or continued in use1 in hospitals where work is rigidly controlled and that they are used practically not at all in the large government hospital service1 a candid critic must hold that there is no substantial evidence in favor of the therapeutic use of a mixed vaccine1 certainly not for stock 8goods0 and that probably there is but a limited field for the employment of autogenous vaccines4 ,the referee calls attention to a shift in the advertising matter on vaccines--the tendency to recommend vaccines to be used in conjunction with drugs4 ,a heading in the ,abbott booklet reads1 8,the ,biologics ,do ,not ,replace ,drugs02 and the paragraph speaks of serums and bacterins as 8new tools1 supplemental to those we already have1 but not replacing them40 444 8,we need them both40 ,the referee recommends that the several mixed vaccines discussed in this report be not accepted on the grounds that satisfactory evidence of their value is wanting4 ,having been endorsed by the ,committee on ,serums and ,vaccines the ,council adopted the report and declared ,m4 ,catarrhalis-,combined-,bacterin1 ,b4 ,coli-,combined-,bacterin1 ,pertussis-,combined-,bacterin1 ,streptococcus-,rheumaticus-,combined-,b acterin and ,streptococcus-,viridans-,combined-,bact erin ineligible for admission to ,new and ,nonofficial ,remedies4 ,catarrhal ,vaccine ,combined-,lilly and ,influenza ,mixed ,vaccine-,lilly ,because of inquiry received1 the ,council requested ,eli ,lilly and ,company to aid in determining the acceptability of the following products for ,new and ,nonofficial ,remedies3 8,catarrhal ,vaccine ,combined10 said to contain killed cultures of the ,bacillus of ,friedlnder1 ,micrococcus catarrhalis1 ,staphylococcus aureus and albus1 ,pneumococcus and ,streptococcus2 8,influenza ,mixed ,vaccine10 said to contain killed cultures of ,staphylococcus albus and aureus1 ,streptococcus1 ,pneumococcus1 ,micrococcus catarrhalis and ,bacillus influenzae4 ,lilly and ,company sent the circulars1 etc41 used in advertising these products4 ,a circular for 8,catarrhal ,vaccine ,combined0 contained the following claim3 8,catarrhal ,vaccine has been especially useful in many respiratory infections1 including bronchitis1 pharyngitis1 rhinitis1 chronic catarrh and in the mixed infections of pulmonary tuberculosis40 ,a circular for 8,influenza ,mixed ,vaccine0 contained the following3 8,the vaccine is useful in the treatment of influenza and ordinary colds1 and in any infection in which the ,bacillus influenzae is the causative agent40 ,an advertising pamphlet contained the following3 8,catarrh1 ,acute and ,chronic2 ,colds1 ,influenza4--,the micro-organisms capable of producing catarrhal conditions of the nose and pharynx and most commonly isolated are ,b4 ,friedlnder1 ,m4 catarrhalis1 staphylococcus1 pneumococcus 7in infections beginning in the larynx71 ,b4 influenza and streptococcus4 ,these organisms are found normally in the respiratory passages and acquire virulence only when resistance has been lowered through overwork1 exposure to cold1 etc4 8,the results following the use of ,catarrhal ,vaccine ,combined 7in the non-epidemic forms7 and influenza ,mixed ,vaccine 7in the epidemic types7 have been very satisfactory1 due to the great vascularity of the tissues4 ,acute attacks are aborted altogether or shortened in duration and the danger of complications greatly minimized40 ,no evidence was submitted which warrants the preceding claims nor is the ,council aware of any reliable testimony to indicate that the administration of the mixture here discussed is warranted or desirable4 ,on the recommendation of the ,committee on ,serums and ,vaccines the ,council voted that 8,catarrhal ,vaccine ,combined-,lilly0 and 8,influenza ,mixed ,vaccine-,lilly0 be not included in ,new and ,nonofficial ,remedies because satisfactory evidence of their value is wanting4 ,influenza ,serobacterin ,mixed-,mulford ,because of inquiry received1 the ,council took up the consideration of 8,influenza ,serobacterin ,mixed-,mulford10 and requested the ,mulford ,company to present evidence to establish the admissibility of the preparation to ,new and ,nonofficial ,remedies4 ,the ,mulford ,company sent specimens of the serobacterin in question1 an advertising circular and a letter by the director of its ,biologic ,laboratories4 ,according to the label on the package1 the preparation is made from the following organisms3 ,bacillus influenzae1 ,staphylococcus aureus1 ,staphylococcus albus1 ,streptococcus1 ,pneumococcus and ,micrococcus catarrhalis 7group74 ,this mixture is recommended by the manufacturer3 8,for the prophylaxis and ,treatment of ,common ,colds1 ,mixed ,infections of the ,respiratory ,mucous ,membranes1 ,acute and ,chronic ,catarrhal ,conditions of the ,nose1 ,throat and ,respiratory ,passages40 ,no evidence is submitted for this recommendation except that in 8colds and bronchitis and the other common infections of the upper respiratory passages 444 five or six bacteria are very commonly present--two or more of them are nearly always present 4440 and the letter by the director of the ,mulford ,biologic ,laboratories expressing the belief that in his own case the use of the mixed vaccine has aborted or prevented colds4 ,as regards the use of this complex biologic preparation3 ,first1 the cause of common colds is1 at the present time1 quite unknown4 ,one of the most striking things is that at the beginning of a cold the organisms to be cultivated from the nasal mucous membrane are very few in number and there is no uniformity in the type of organism found4 ,if someone of the well-known organisms 7,streptococcus1 ,staphylococcus1 ,pneumococcus1 ,micrococcus ,catarrhalis1 ,influenza ,bacillus1 etc47 were responsible1 we should expect to find one of them preponderating and in overwhelming numbers4 ,this is far from the case4 ,after the duration of the cold for a day or two with the increased production of mucus and apparently with the infection of a mucous membrane whose powers of resistance have been greatly lowered1 bacteria of all kinds are to be found in immense numbers4 ,there is considerable reason for believing that an ultramicroscopic organism is responsible for this condition 7,see ,foster1 ,journal of ,infectious ,diseases #ba3dea ,nov4 #aiag74 ,second1 there is no acceptable clinical evidence that vaccination with the influenza bacillus1 the ,streptococcus1 the ,pneumococcus or the ,micrococcus ,catarrhalis will influence the course of an infection due to one or the other of these organisms4 ,it has been repeatedly found that a staphylococcus vaccine is of a certain degree of value when the infection with the staphylococcus is localized1 but it is well known that general systemic infections with the staphylococcus are not at all benefited4 ,third1 the letter submitted as evidence by the ,mulford ,company is not convincing4 ,the ,council is not prepared to accept evidence of this sort unless it is in volume large enough to justify a definite conclusion4 ,holding that there is no evidence for the value of this mixture1 the ,council declared 8,influenza ,serobacterin ,mixed-,mulford0 inadmissible to ,new and ,nonofficial ,remedies because its use is illogical4 ,sherman's ,mixed ,vaccine ,no4 #dj ,because of inquiry received the ,council decided to consider this preparation and requested the manufacturer1 ,g4 ,h4 ,sherman1 ,detroit1 ,mich41 to submit evidence in support of the claims made for it4 ,this vaccine is said to be made from killed cultures of ,streptococcus1 ,pneumococcus1 ,micrococcus catarrhalis1 ,staphylococcus aureus1 and ,staphylococcus albus4 ,in the printed matter sent out by ,g4 ,h4 ,sherman this vaccine is recommended for hay-fever1 in which it is stated that some of the symptoms are due to bacterial invasion of the respiratory mucosa2 for tonsillitis1 both as a remedy and as a prophylactic against rheumatic and other sequelae2 for 8throat infections02 for rhinitis with the claims that acute coryza can be aborted within twenty-four hours2 for pneumonia in which it is advised for all stages2 for laryngitis1 for bronchitis1 and for asthma4 ,no acceptable evidence was submitted as to the value of the product in the treatment of any of the foregoing conditions4 ,in view of what is known about non-specific reactions1 it seems likely that any influence which this vaccine may have on the diverse conditions enumerated by the manufacturer1 is due to this1 rather than to the combination of organisms used in its preparation4 ,on the recommendation of the ,committee on ,serums and ,vaccines1 the ,council declared 8,sherman's ,mixed ,vaccine ,no4 #dj0 ineligible to ,new and ,nonofficial ,remedies because the therapeutic claims made for it are unwarranted 7,rule #f7 and because the combination1 in view of its complexity1 is irrational and detrimental to sound therapy 7,rule #aj74--7;,from ,the ,journal ,a4 ,m4 ,a41 ,june #bc1 #aiah47 ,,ophthalmol-,,lindemann ,report of the ,council on ,pharmacy and ,chemistry ,ophthalmol-,lindemann was taken up for consideration by the ,council because of inquiries received4 ,the following report1 declaring ,ophthalmol inadmissible to ,new and ,nonofficial ,remedies1 was adopted by the ,council and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,ophthalmol-,lindemann 7,innis1 ,speiden and ,co41 ,new ,york7 is advertised as a treatment for eye diseases by 8hyperemia40 ,the circular advertising the product is written somewhat in the style of 8patent medicine0 advertisements4 ,it contains testimonials of dubious value4 ,the principle underlying the use of ,ophthalmol is that employed to a considerable extent by ophthalmologists1 through the use of ethylmorphine 78dionin071 etc41 viz41 the production of conjunctival irritation in inflammatory eye diseases4 ,ophthalmol is1 therefore1 merely a special agent for the production of such ophthalmic irritation4 ,the advertising circular contains no evidence that ,ophthalmol is in any respect superior to the established agents for producing conjunctival hyperemia4 ,on the other hand1 there are obvious objections to the use in the eye of a substance of unknown and apparently indefinite composition and uncertain activity4 ,ophthalmol is said to be an oily solution of 8glandular extract of the fish ,cobitis ,fossilis40 ,cobitis fossilis is a small fish said to be common in ,germany4 ,according to ,kochs1 who analyzed ,ophthalmol 7,arb4 a4 d4 ,pharm4 ,inst4 d4 ,univ4 ,berl41 #d3adj1 #aijg71 this fish is popularly believed to predict weather1 but medical virtues are not ascribed to it4 ,this 8fishy0 extract is indefinite1 to say the least4 ,the activity of the preparation is described by the manufacturer thus3 8,it seems probable that the typical action of ,ophthalmol is due to certain organic acids which may have formed during manufacture through the decomposition of protein bodies contained in the crude material40 ,the profession is not told whether this important decomposition is1 or1 in fact1 can be controlled so as to produce a material of uniform activity4 ,kochs concluded from his analysis that ,ophthalmol had the properties of rancid olive oil containing about #f to #g per cent4 mineral oil4 ,the oil contained no nitrogen1 left no ash on ignition and though traces of iodin were claimed to be present1 no iodin could be found4 ,it is recommended that ,ophthalmol be rejected first1 because the use in the eye of an irritant of secret composition and uncertain activity is unscientific and against the interest of public health2 second1 because ,ophthalmol is of secret composition 7the composition claimed being practically meaningless71 and1 third1 because no evidence has been submitted to substantiate its claimed superiority over established methods of treatment4 ,the ,council declared ,ophthalmol inadmissible to ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #f1 #aiah47 ,,silvol ,,ineligible ,,for ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,silvol 7,parke1 ,davis ,company7 was adopted by the ,council and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,council took up the consideration of ,silvol 7,parke1 ,davis ,company7 because of inquiries received4 ,the following report was submitted by the referee in charge of silver preparations3 ,silvol 7,parke1 ,davis ,company7 is a silver-protein preparation of the ,argyrol type4 ,like ,argyrol1 it is said to contain about #bj per cent4 of silver4 ,the referee finds that1 like ,argyrol1 it is nonirritant to the nasal mucosa in a #aj per cent4 solution2 does not precipitate with chlorid2 dissolves in water readily2 a #be per cent4 solution has a high specific gravity 7,silvol1 #a4acg at #bj ,c42 ,argyrol1 #a4adg at #bj ,c471 and is not very viscid 7viscosity1 #a4be74 ,a #a3a1jjj solution of ,silvol is clear and about #ej per cent4 deeper in color than a solution of ,argyrol of the same strength4 ,silvol differs from ,argyrol mainly in that its solutions yield a fine precipitate with egg albumin 7under suitable conditions71 while ,argyrol is nonprecipitant2 and in that ,silvol solutions are not so effectively decolorized by ,lloyd's reagent4 ,the manufacturers did not reply to an inquiry with regard to the basis for the claims made for ,silvol 7see ,appendix74 ,the referee was therefore obliged to deduce these claims from the firm's advertising matter4 ,about the same claims are made for the local use of ,silvol as are generally made for ,argyrol4 ,these may be accepted without detailed evidence in view of the similarity of the two preparations4 ,its usefulness1 as suggested in the advertising1 when given by mouth 8in the treatment of acute or chronic gastritis1 gastric ulcer1 or gastro-enteritis10 or the efficacy of very dilute solutions 7#j4b per cent47 against dysentery1 etc41 is doubtful and requires substantiation by evidence4 ,the claims that ,silvol is astringent1 though nonirritant and noncoagulant1 that it is a 8powerful germicide0 or even that it is a 8powerful antiseptic10 and that it may be used with advantage wherever 8a silver salt is indicated10 need substantiation4 ,there is no proof of the assertions that ,silvol is 8the most efficacious of silver salts02 8the most efficient antiseptic10 and 8the most remarkable organic silver compound 4440 ,as the manufacturers have not presented any evidence for their highly improbable claims1 and as they have not signified any intention of making their claims agree with substantiated facts1 it is recommended that ,silvol be declared inadmissible to ,new and ,nonofficial ,remedies4 ,the ,council adopted the report of its referee and authorized its publication4 ,,appendix ,the following letter from the ,secretary of the ,council was sent to ,parke1 ,davis ,company1 ,march #bj1 #aiag4 ,no reply to it has been received3 ,the referee of the ,council who is conducting an investigation of silver preparations asked me to inquire if you are willing to submit your evidence for the following claims which are made in your circulars for ,silvol3 #a4 ,how it is possible for the solution to be astringent1 and at the same time nonirritant and noncoagulant8 #b4 ,that intestinal irrigation with a ,silvol solution containing #aj to #ae grains to the pint is sufficiently bactericidal to 8be used in the abortive treatment of such infectious processes as dysentery1 cholera infantum1 and colitis40 #c4 ,what evidence have you as to the degree of antiseptic and germicidal power of ,silvol solutions8 #d4 ,what evidence have you as to the degree of antiseptic and germicidal power of #e per cent4 ,silvol ,ointment8 ,a reply to the above questions and any other information in regard to ,silvol will receive careful consideration4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #ac1 #aiah47 ,,katharmon ,report of the ,council on ,pharmacy and ,chemistry ,following inquiries1 the ,council took up 8,katharmon0 for consideration and authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,katharmon ,chemical ,company of ,st4 ,louis in advertising its ,katharmon appeals especially to a profession whose members1 should they live up to their ethical code1 could not prescribe it4#abd ,in #ahic 7when the publication of 8a formula0 for proprietary preparations was thought to satisfy the requirements of scientific medicine7 an advertisement in ,the ,journal of the ,american ,medical ,association gave the following 8formula0 for ,katharmon3 #abd 8444 it is equally unethical to prescribe or dispense secret medicines or other secret remedial agents14440 ,sec4 #f1 ,art4 ,i1 ,chapter ,,ii1 ,principles of ,medical ,ethics4 8,hydrastis ,canadensis1 ,phytolacca ,decandra1 ,acid ,salicylous ,c4 ,p4 7from ,oil of ,wintergreen71 ,acid ,boric ,c4 ,p41 ,mentha ,arvensis1 ,thymus ,vulgaris1 ,dist4 ,ext4 ,hamamelis ,virg4 ,conc40 ,in #aijg an advertisement in the ,kansas ,city ,medical ,index-,lancet declared that3 8,katharmon represents in chemical combination the active principles of ,hydrastis ,canadensis1 ,gaultheria ,procumbens1 ,hamamelis ,virginica1 ,phytolacca ,decandra1 ,mentha ,arvensis1 ,thymus ,vulgaris1 with two grains ,c4 ,p4 ,boric ,acid to each fluid drachm40 ,now the advertisements which appear in some medical journals state3 8,,katharmon represents in combination ,hydrastis ,canadensis1 ,thymus ,vulgaris1 ,mentha ,arvensis1 ,phytolacca ,decandra1 #aj-a_/b grains ,acid ,borosalicylic1 #bd grains ,sodium ,pyroborate to each fluid ounce of ,pure ,distilled ,extract of ,witch ,hazel40 ,a comparison of these so-called formulas shows that they have not only varied from time to time1 but that in no instance was a quantitative statement with regard to all the asserted ingredients given4 ,the ,chemical ,laboratory of the ,a4 ,m4 ,a4 reports3 ,katharmon has an alkaline reaction and therefore cannot contain boric acid1 salicylic acid or 8borosalicylic acid0 7the latter is unknown to medical literature except as loosely applied to a simple mixture of boric and salicylic acids74 ,the solution gives tests for sodium1 borate1 and salicylate and therefore probably contains sodium borate and sodium salicylate4 ,examined by the methods used for the determination of hydrastin in goldenseal preparations1 a residue giving only a faint test for alkaloid was obtained2 if present at all1 hydrastis canadensis 7goldenseal7 is there only in very small amounts4 ,a circular wrapped with the trade package of ,katharmon contained the following1 palpably unwarranted1 claims3 8,,internally it is very useful in acute indigestion1 ,gastric ,catarrh1 ,diarrhoea and ,cholera ,infantum40 8444 it has demonstrated its remarkable curative effects1 not only in preventing unhealthy conditions of fresh wounds1 but also in correcting the decaying of putrefactive processes peculiar to the body under certain circumstances4 ,it has1 further1 a remarkable efficacy in surface inflammations1 whether produced by accident or disease1 and is an indispensable remedy in the affections of the mucous membranes of the nose1 mouth1 stomach1 bowels1 vagina1 uterus1 urethra1 bladder and rectum40 ,katharmon is in conflict with ,rules #a and #d of the ,council on ,pharmacy and ,chemistry because of its indefinite and secret composition and the method of advertising it indirectly to the public2 it is in conflict with ,rules #aj1 #f and #h1 in that it is an irrational shotgun mixture sold under unwarranted therapeutic claims and under a name nondescriptive of its composition4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #aj1 #aiah47 ,,iodinized ,,emulsion 7,,scott7 ,,and ,,creosotonic 7,,scott7 ,report of the ,council on ,pharmacy and ,chemistry 8,iodinized ,emulsion 7,scott70 and 8,creosotonic 7,scott70 are proprietary preparations of the ,dawson ,pharmacal ,company1 ,dawson ,springs1 ,ky4 ,the latter preparation used to be known as 8,iodinized ,emulsion 7,scott7 with ,hypophosphites1 ,guaiacol and ,creosote40 ,in #aijg these preparations were considered by the ,council and found inadmissible to ,new and ,nonofficial ,remedies4 ,examination of the preparations having been again requested1 the ,council considered them anew because the composition and claims had been changed somewhat and because at the previous consideration no report was published4 ,the reports which appear below were sent to the ,dawson ,pharmacal ,company for comment before publication4 ,in reply the company offered to revise its claims for the preparations4 ,the ,council replied that the report sent explained that both preparations are irrational mixtures1 and hence a revision of the claims would not make them eligible for ,new and ,nonofficial ,remedies4 ,it advised that publication of the report would be withheld sixty days and that it would be revised if new information or evidence was submitted permitting such revision4 ,after expiration of the stipulated postponement1 the ,dawson ,pharmacal ,company wrote that no new advertising matter had been prepared1 but that the old circulars were not being sent out4 ,as these irrational preparations were still sold and advertised to the medical profession and presumably used by some physicians1 the ,council directed publication of its report with this explanation4 ,w4 ,a4 ,puckner1 ,secretary4 ,iodinized ,emulsion 7,scott7 ,the label for ,iodinized ,emulsion 7,scott7 declares3 8,each fluidram contains3 ,alcohol1 m4 #d-c_/d2 ,rectified ,ol4 of ,turpentine1 m4 #c-a_/b2 ,iodin1 gr4 #a_/h2 ,phenol1 gr4 #a_/b2 ,glycerine and ,elixir ,lactated ,pepsin with ,aromatic ,oils in the form of a perfect emulsion40 ,a circular which gives what is asserted to be the composition of ,iodinized ,emulsion1 declares that1 among other ingredients1 each fluidram contains 8one and three quarters m4 ,tincture of ,iodine40 ,both the statement on the label that the preparation contains 8iodin0 and the one in the circular that tincture of iodin is present in the product are incorrect1 for the ,a4 ,m4 ,a4 ,chemical ,laboratory reports that no free iodin could be detected in the preparation1 and that it responded to tests for iodid instead4 ,an advertising circular for ,iodinized ,emulsion 7,scott7 makes unwarranted claims for the therapeutic properties of the constituents4 ,for example3 8444 the great usefulness of ,turpentine in diseases1 especially of the ,intestinal ,infection1 such as the ,meteorism and ,tympanites of ,typhoid40 ,and this absurdity3 8444 where ,turpentine1 ,carbolic ,acid or ,iodine or even ,pepsin is indicated1 that it will give satisfaction in each and every case40 ,iodinized ,emulsion 7,scott7 is not a 8pharmaceutical triumph02 it is an irrational mixture--a reminder of a decadent polypharmacy--sold under misleading and unwarranted claims4 ,it is inadmissible to ,new and ,nonofficial ,remedies for conflict with ,rules #a1 #f1 #h and #aj4 ,creosotonic 7,scott7 ,creosotonic 7,scott71 advertised as a 8reconstructive tonic0 for the tuberculous1 according to the label1 contains in each fluidram3 8,alcohol1 m4 #b-a_/b2 ,creosote and ,guaiacol sulphonates of each1 gr4 #a2 ,compound ,hypophosphites1 gr4 #a 7including ,quinine ,hypophosphites1 gr4 #a_/cf and ,strychnine ,hypophosphites1 gr4 #a_/bef71 with ,iodinized ,emulsion 7,scott7 m4 #cj40 ,as in the case of ,iodinized ,emulsion 7,scott71 the advertising makes exaggerated therapeutic claims for the individual constituents of the preparation and for the heterogeneous mixture of guaiacol and creosote sulphonates1 hypophosphites1 quinin1 strychnin1 turpentine1 phenol1 iodin1 8lactated pepsin10 etc4 ,thus1 while it is well established that in guaiacol sulphonate and creosote sulphonate the phenolic constituent is bound so firmly that1 when administered1 but very little is split off in the organism1 yet the advertising claims 8that the system can be saturated in a shorter time and with smaller doses of creosote and guaiacol sulphonates than with any other form of these drugs0 and that 7on the false premise that the guaiacol and creosote from these drugs will permeate the tissues of the lungs7 8they help to clear up the local infection and thus aid in returning to normal the diseased mucous membrane40 ,in the advertising pamphlet1 following a discussion of the effect of climate and food in the treatment of the tuberculous1 we read3 8,while admitting the great importance of the foregoing points1 we are firmly of the opinion that proper medication is a great aid in the treatment of pulmonary tuberculosis1 and1 with this in view1 we offer to the profession ,creosotonic 7,scott7 believing that in it we have a superior preparation for this purpose40 ,this is unwarranted4 ,of course suitable medication to meet special conditions is proper in the treatment of tuberculosis1 but the routine administration of a complex and irrational mixture such as ,creosotonic 7,scott7 is bound to cause inattention to the prime requisites for the proper treatment of the tuberculous--hygienic surroundings and good food4 ,creosotonic 7,scott7 is an irrational mixture1 sold under misleading and unwarranted claims4 ,it is inadmissible to ,new and ,nonofficial ,remedies for conflict with ,rules #a1 #f1 #h and #aj4--7;,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bd1 #aiah47 ,,campetrodin ,,and ,,campetrodin ,,no4 #b ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,campetrodin and ,campetrodin ,no4 #b has been adopted by the ,council and its publication authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,the following report of the ,a4 ,m4 ,a4 ,chemical ,laboratory on 8,campetrodin0 and 8,campetrodin ,no4 #b10 sold by the ,a4 ,h4 ,robins ,company1 ,richmond1 ,va41 was submitted to the ,council by a referee of the ,committee on ,pharmacology3 ,campetrodin and ,campetrodin ,no4 #b1 ,double ,strength1 are called 8ethical medicinal specialties0 by the ,a4 ,h4 ,robins ,company1 ,richmond1 ,va41 which sells them4 ,an advertisement in the ,maryland ,medical ,journal 7,december1 #aiag7 contains the following claim for composition3 8,,campetrodin 7,made in ,two ,strengths of ,iodine74 ,this preparation is an ,oleaginous ,solution of ,iodine in ,camphor40 ,a booklet describing the 8specialties0 of the ,robins ,company contains the following in reference to ,campetrodin3 8,composition3 ,camphor1 ,iodine ,element1 ,oleaginous ,solvent40 ,from this it appears that the preparations are claimed to contain elementary 7free7 iodine in an 8oleaginous solvent40 ,since free iodin1 as is well known1 readily combines with fats1 it was decided to determine the form in which the iodin was present in these preparations4 ,the examination demonstrated that both preparations contained but a trace of free iodin4 ,on steam distillation there was obtained from both preparations a distillate amounting to about #ce per cent4 by volume which had an odor strongly suggestive of turpentine1 while the residue contained the iodin and had the characteristics of an iodized fatty oil4 ,quantitative determinations indicated that ,campetrodin contained approximately #j4jc per cent4 of free iodin and #a4c per cent4 of iodin in combination with the fatty oil4 ,campetrodin ,no4 #b1 ,double ,strength1 contained approximately #j4jc per cent4 free iodin and #b per cent4 of iodin in combination with the fatty oil4 ,thus1 contrary to the published statements1 ,campetrodin is not a preparation of free 7elementary7 iodin and ,campetrodin ,no4 #b1 ,double ,strength1 does not contain twice as much iodin as ,campetrodin4 ,the report of the ,chemical ,laboratory shows that the statements made in regard to the composition of ,campetrodin and ,campetrodin ,no4 #b are incomplete in some respects and false in others4 ,in view of the ,laboratory's findings it appears superfluous to inquire into the therapeutic claims made for the preparations3 ,it is evident1 however1 that a solution containing practically no free iodin is not1 as claimed by the ,robins ,company1 8adapted for use wherever 444 iodin is indicated externally44440 ,it is recommended that ,campetrodin and ,campetrodin ,no4 #b be declared inadmissible to ,new and ,nonofficial ,remedies because of false statements as to chemical composition and therapeutic action1 constituting conflicts with ,rules #a and #f4 ,the ,council adopted the recommendation of the referee and authorized publication of this report4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #ba1 #aiah47 ,,carminzym ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following which explains why ,carminzym was not accepted for ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,carminzym is a tablet sold by ,fairchild ,bros4 and ,foster1 ,new ,york4 ,each tablet contains1 according to claims made1 approximately #cb mg4 of an extract of pancreas1 #ej mg4 sodium bicarbonate1 #agb mg4 prepared chalk1 #a4e mg4 powdered ipecac and 8aromatics q4 s40 ,without considering other possible conflicts with its rules1 the ,council held the preparation inadmissible to ,new and ,nonofficial ,remedies for conflict with ,rule #aj which holds that unscientific or useless articles are not acceptable products4 ,the ,council holds that complex mixtures of remedial agents are1 from every point of view1 inimical to therapeutic progress and therefore to the public welfare4 ,such mixtures are especially objectionable because it is impossible accurately to determine the effects which follow the simultaneous administration of a number of drugs having dissimilar actions2 because the practice of prescribing such mixtures tends to discourage careful consideration of the special needs of individual patients without which there can be no rational drug therapy4 ,on the contrary1 with the use of such mixture therapeutic treatment becomes haphazard and mere guesswork4 ,the ,council1 appreciating that long established customs cannot be changed at once1 has applied ,rule #aj concerning the recognition of mixtures with the greatest leniency compatible with consistency4 ,when there has been a reasonable doubt concerning the value of a mixture it has frequently directed that ,rule #aj should not apply pending further clinical trial of such mixture4 ,in no instance has subsequent experience shown that a strict interpretation of the rule would have worked hardship or injustice4 ,the ,council feels that there is no longer warrant for the admission of complex mixtures to ,new and ,nonofficial ,remedies or for the retention of any that have been admitted unless definite evidence of the therapeutic value of such combinations is available4 ,in accordance with this decision several mixtures now described in ,new and ,nonofficial ,remedies will be omitted at the expiration of the three year period for which articles are accepted4 ,reverting to the ,carminzym tablet3 ,when it is desired to obtain the effects of pancreatic extract by oral administration it must be administered with a view of preventing its destruction by the gastric fluid4 ,with this end in view an antacid should be administered to decrease the acidity of the gastric juice4 ,the amount of alkali may be supplied in the form of any of the official preparations1 but the amount must be adjusted to the individual patient for the reason that no two successive patients are likely to have the same degree of gastric acidity4 ,ipecac has a well defined though limited field of usefulness4 ,when it is used1 it should be given with a due regard to the amount needed by the patient and the frequency of the repetition of the dose4 ,there is no reason to suppose that any two successive patients will require ipecac and extract of pancreas in a fixed proportion and with equal frequency4 ,as a matter of fact1 the amount of ipecac in ,carminzym is so small that no definite therapeutic action can be assigned to it and its use in this combination is purely empirical4 ,in a word1 the employment of mixtures of pancreatic extract1 alkalis1 ipecac and carminatives in fixed proportion leads to slipshod treatment and irrational therapeutics4 ,carminzym is an irrational mixture the use of which is detrimental to therapy4 ,the preceding report was sent to ,fairchild ,bros4 and ,foster for comment in accordance with the ,council's usual procedure4 ,the following reply was received3 ,the long established custom of the use of mixtures of remedial agents rests upon considerations well known and generally accepted4 ,this is equally true of combinations of drugs of similar and dissimilar properties4 ,the drugs of these combinations1 especially those of marked therapeutic action1 are well known and used by themselves when indicated4 ,in fact1 dissimilarity of action is a cause of combination1 an essential of synergism4 ,drugs classed as similar are by no means alike in action2 laxatives1 tonics1 carminatives1 diuretics are combined with distinct advantage1 economy of dose1 enhanced effect1 potency not obtainable with the single drug4 ,your sweeping arbitrary conclusions that complex mixtures of remedial agents are from every point of view inimical to therapeutic progress is not1 it seems to us1 sustained by fact and experience4 ,there is therapeutic progress in the considerate use and observation of combinations as well as in the use of a single drug4 ,indeed1 in the production of a synthetic chemical substance as a therapeutic agent1 the combination of potent and dissimilar elements is worked out to mitigate and correct an objectionable side effect1 and promote desirable action4 ,as for ourselves1 at the very outset in our line of work we quite voluntarily declared our principles and our intentions as opposed to incompatible and therefore unstable or inert combinations of the enzymes2 and against the 8unnecessary multiplication of preparations0--see ,fairchild's ,hand-,book of the ,digestive ,ferments4 ,is not this after all the crux of the whole matter--does a combination contain the ingredients stated1 does it possess the demonstrable properties which are to be attributed to it in consequence of this composition2 and if for a certain purpose1 is it well designed therefor8 ,carminzym presents certain agents of well known properties1 not in the least of incompatible or antagonistic action1 but indeed especially suitable for the particular purpose designed2 its efficacy not to be measured and judged by theory or opinion as to the efficiency of a certain dosage of a particular drug by itself4 ,that the doses as contained are minimal and effective is distinctly advantageous4 ,the alkaline carbonates are in ,carminzym in stated quantities2 the physician adjusts the dosage to the individual patient and with obvious evidence of the efficiency of the adjustment4 ,as we understand it1 the employment of alkaline carbonates is not based on purely chemic considerations--a definite known quantity of acid of the gastric juice is to be neutralized2 the whole literature and practice dealing with the alkaline carbonates show them to be accredited with a much wider field of use and repute in gastro-intestinal disorders4 ,the pancreatic extract in ,carminzym is designed to be diffusible in the stomach1 the tablet is preferable to be crushed in the mouth before swallowing1 and we believe the pancreatic extract to be an effective constituent as administered in ,carminzym4 ,you comment as follows3 8,ipecac has a well defined though limited field of usefulness4 ,when it is used it should be given with due regard to the amount needed by the patient and the frequency of the repetition of the dose40 ,this in a sense may be said of any of the most useful drugs1 but not in the least special degree does it apply to ipecac1 which is1 on the contrary1 of quite characteristic1 peculiar range of therapeutic properties1 useful in varying combinations and in widely varying proportions and doses according to the purpose for which it is employed4 ,ipecac in well known official alkaline1 carminative1 laxative preparations occurs in the 8average dose0 in the varying quantities of #a_/ad1 #a_/aj1 #a_/h1 and #c_/af of a grain4 ,the ipecac in combination with the other ingredients in ,carminzym is designed for a tablet which shall carry a minimal quantity whilst capable of adequate remedial action1 thus admitting of increase of dosage or repetition as occasion requires4 ,the quantity of ipecac was not taken at random1 but chosen after long trial and consideration4 ,we believe that ,carminzym possesses carminative properties in a superior degree and that1 furthermore1 in consequence of its composition it directly stimulates the gland secretions and thus exerts a beneficial action upon the whole digestive functions4 ,carminzym is for use as occasion requires1 and this is to be especially noted4 ,thus it is not only of direct benefit1 but helpful in promoting systematic therapeutic measures and regimen4 ,the ,council takes the ground that complex mixtures of remedial agents are so wrong that there is no longer warrant for their admission into ,new and ,nonofficial ,remedies2 and that ,carminzym is an irrational mixture4 ,we hold that certain desirable therapeutic properties may rationally be attributable to ,carminzym2 and that these are manifested in practice4 ,during the time since the description was sent and the receipt of the statement of the action of the ,council1 some ten months1 ,carminzym has proved of constantly increasing service4 ,the statement in the letter of ,fairchild ,bros4 and ,foster 8,the long established custom of the use of mixtures of remedial agents rests on considerations well known and generally accepted0 might well be paraphrased to read3 ,the one-time prevalent custom of using ill-considered combinations of remedial agents has been thoroughly discredited and is generally abandoned by progressive practitioners4 ,such arguments as that 8laxatives1 tonics1 carminatives1 diuretics are combined with distinct advantage0 have led to the use of irrational mixtures such as the compound syrup of hypophosphites and the electuary of theriaca4 ,the ,council is confident that no one who has studied the causes and treatment of digestive disorders will find occasion to prescribe at one time all the ingredients stated to be contained in ,carminzym1 and certainly not in the fixed proportions present therein4 ,the comments in the ,council's report concerning ipecac certainly does apply to all active therapeutic agents4 ,ipecac was mentioned in the report because the several constituents of ,carminzym were under discussion and hence it was necessary to point out the futility of the small dosage of ipecac in this mixture4 ,the announcement that 8,carminzym has proved of constantly increasing service0 is not convincing4 ,the ,council does not know of a single clinical study of the action of ,carminzym under conditions which would have afforded satisfactory evidence of its therapeutic value4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bh1 #aiah47 ,,phillips' ,,phospho-,,muriate ,,of ,,quinine ,,comp4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,phillips' ,phospho-,muriate of ,quinine ,comp4 has been adopted by the ,council and authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,phillips' ,phospho-,muriate of ,quinine ,comp4#abe is sold by the ,charles ,h4 ,phillips ,chemical ,co41 ,new ,york4 ,according to the published formula1 each fluidram contains3 ,phosphoric ,acid #b minims ,potassium ,phosphate ,magnesium ,phosphate ,calcium ,phosphate #b-a_/d grains ,ferric ,phosphate ,quinin ,muriate 7equal to nearly #a_/b gr4 ,bi-,sulph47 #a_/d grain ,strychnin #a_/abj grain ,flavoring1 ,glycerin and ,syrup1 q4 s4 #abe ,the evolution of 8,phillips' ,phospho-,muriate of ,quinine ,comp40 from 8,phillips' ,wheat ,phosphates0 may be interesting4 ,every one knows that therapeutics tends to fashions1 and 8,phillips' ,wheat ,phosphates0 appears to have had its inception as the result of the observation that super-refined white flour contains less phosphates than the corresponding amount of wheat4 ,it was assumed that such flour must be deficient in an essential constituent1 and the ,wheat ,phosphates preparation was apparently designed to fill the want4 ,it was exploited for the relief of numerous conditions that were supposed1 without satisfactory evidence1 to result from this deficiency4 ,when iron1 quinin and strychnin mixtures became the vogue a quarter of a century ago1 it was only natural to ride on the wave of popularity and the already widely advertised 8,wheat ,phosphates0 was further enhanced--commercially--by the addition of the iron1 quinin and strychnin1 the amount of alkaloid added being practically negligible4 ,those who are not familiar with the various phases of the phosphorus1 phosphoric acid1 lactophosphate1 lecithin1 nuclein and glycerophosphate propaganda are referred to a report of the ,council on ,pharmacy and ,chemistry in ,the ,journal ,a4 ,m4 ,a41 ,sept4 #cj1 #aiaf1 p4 #ajcc4 ,some typical claims made for the preparation are3 8,with marked beneficial action upon the nervous system4 ,to be relied on where a deficiency of the phosphates is evident40 8444 brace those tired nerves and aid that worn stomach with ,phillips' ,phospho-,muriate of ,quinine40 8,the maintenance of a satisfactory blood pressure level free from intervals of depression may be accomplished by the use of ,phillips' ,phospho-,muriate of ,quinine ,compound in appropriate doses40 8,the quantities of quinin and strychnin in this preparation are so well balanced that they relieve the depression and fatigue from mental or physical exertion1 without the necessity of recourse to alcoholic stimulation40 8,the other ingredients of ,phillips' ,phospho-,muriate of ,quinine--phosphoric acid1 and the phosphates of potash1 magnesia1 lime1 and iron--are the most rational as well as convenient means of administering these tissue remedies1 and of introducing phosphorus--the vitalizing constituent of the nervous system--into the organism40 ,the action of such a mixture as a whole is practically that of the sum of the actions of its constituents4 ,the therapeutic action of strychnin and quinin are described in every text-book of therapeutics1 but it is necessary to distinguish carefully between the various conditions in which these alkaloids have been used without discrimination1 and those conditions in which they have been proved to be of value4 ,while both have been widely used in a great variety of conditions1 neither is of proved value in more than a distinctly limited range of diseases4 ,the manufacturers of ,phillips' ,phospho-,muriate of ,quinine ,comp4 seem to appeal to the less discriminating who use these alkaloids without any definite conception of exactly what they seek to accomplish with them4 ,quinin1 although used by the uncritical in a host of diseases1 has a definite field of usefulness in the treatment of malaria1 both prophylactic and curative1 but the required dose in the treatment of malaria is many times larger than that recommended in the ,phillips' preparation4 ,the claim that the 8strychnin and quinin in this preparation are so well balanced that they produce a mild1 buoyant effect1 so advantageous1 instead of alcoholic stimulation1 to relieve depression and fatigue from mental or physical exertion0 is nonsensical1 if1 indeed1 it is not mendacious balderdash4 ,calcium and potassium have important functions in the body1 but any deficiency that may arise is usually attributable to an inability of the body to utilize that which is supplied1 for there is seldom any deficiency of these salts in the food1 and when they are needed they are best supplied as simple solutions of the salts in appropriate doses without all of the other constituents of ,phillips' ,phospho-,muriate of ,quinine ,comp4 ,phosphoric acid exerts practically the same actions as other mineral acids1 hydrochloric being usually preferred for internal administration in certain forms of indigestion1 aside from which they are seldom used as such4 ,in the more recent literature for ,phillips' ,phospho-,muriate of ,quinine ,comp41 we find the attempt to utilize the well known craze about phosphorus1 which has been through so many phases1 every one of which has had its day and has been discarded4 ,the phosphoric acid and phosphates present in ,phillips' ,phospho-,muriate of ,quinine are of no more value in nervous diseases than is simple sodium phosphate which does not require the addition of a host of other ingredients for its action4 ,as a matter of fact1 the phosphates of calcium and potassium present in a dose of ,phillips' ,phospho-,muriate of ,quinine are probably devoid of appreciable effect in practically all conditions4 ,to pretend that one who suffers from physical and nervous exhaustion can be materially benefited by this mixture is sheer nonsense and is unworthy of a moment's consideration by a clinician who is called on to treat such patients4 ,iron is useful in anemia1 as every one knows4 ,iron has practically no other field of usefulness in therapeutics4 ,when it is indicated it should be administered in a simple form1 such as the pill of ferrous carbonate1 for example1 and not in a 8shotgun0 mixture that is quite as likely to do harm as good4 ,the claim that a satisfactory level of blood pressure can be maintained by ,phillips' ,phospho-,muriate of ,quinine is mentioned only to condemn as the limit of impudent therapeutic claims4 ,it is an insult to the intelligence of any practitioner to pretend that any known agent or combination of remedial agents can maintain a uniform blood pressure in any one of innumerable conditions4 ,in short1 ,phillips' ,phospho-,muriate of ,quinine ,comp4 is a complex and irrational mixture exploited by means of unwarranted claims4 ,it is a survival of the old days of therapeutic chaos when impossible and fantastic chemical formulas were gravely published and as solemnly accepted without question1 and also without the slightest understanding on the part of many2 when the most eminent of practitioners did not hesitate to give glowing testimonials for lithia waters that contained no more lithium than ordinary river water2 when no therapeutic claim was too preposterous to receive acceptance1 no theory too nonsensical to justify the use of all manner of claptrap mixtures for all manner of conditions4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ai1 #aiah47 ,b4 ,,iodine ,,and ,b4 ,,oleum ,,iodine ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report on 8,b4 ,iodine0 and 8,b4 ,oleum ,iodine10 together with the reply submitted by the manufacturer and a discussion thereon by the referee in charge of the preparations4 ,w4 ,a4 ,puckner1 ,secretary4 ,specimens of ,b4 ,iodine and ,b4 ,oleum ,iodine 7,b4 ,iodine ,chemical ,company7 and an advertising pamphlet were sent to the ,council by ,john ,bohlander1 ,a4,m41 ,m4,d41 with the declaration3 8,well knowing the value of ,iodin in surgical operations and dressings1 prompted me for the benefit of my fellow physicians as well as myself1 and for ,humanity's sake1 to make ,iodin my master-piece in chemistry4 8,after several years of diligent work in my private laboratory ,i succeeded in discovering a new product of ,iodin--,nitrogen1 hydrate of ,iodin40 ,while 8,b4 ,iodine0 is said to be nitrogen hydrate of iodin and 8,b4 ,oleum ,iodine0 a #e per cent4 solution thereof1 the examination made by ,prof4 ,a4 ,h4 ,clark of the ,university of ,illinois1 ,school of ,pharmacy 7working in the ,a4 ,m4 ,a4 ,chemical ,laboratory71 indicates that the first is a simple mixture of iodin and ammonium iodid1 and the second a solution of iodin in liquid petrolatum4 ,the ,council adopted the report of the ,a4 ,m4 ,a4 ,chemical ,laboratory 7which appears below7 and declared ,b4 ,iodine and ,b4 ,oleum ,iodine inadmissible to ,new and ,nonofficial ,remedies because3 #a4 ,the composition is incorrectly declared4 ,b4 ,iodine is not a newly discovered iodin compound1 8,nitrogen ,hydrate of ,iodine10 but a mixture of iodin and ammonium iodid4 ,b4 ,oleum ,iodine is not a #e per cent4 solution of ,b4 ,iodine as suggested by the statement on the label and in the advertising1 but a solution of iodin in liquid petrolatum containing about #j4he per cent4 of iodin4 #b4 ,since ,b4 ,iodine is a mixture of ,iodin and ammonium iodid1 its solution in water will have the properties of other solutions of iodin made by the aid of iodid1 such as a dilution of tincture of iodin or of compound solution of iodin 7,lugol's solution74 ,hence1 the therapeutic claim that ,b4 ,iodine 8being of a colloidal nature has the advantage of being more readily absorbed and taken up by all cellular structure1 thus getting a perfect cellular medication of ,iodine10 is unwarranted4 #c4 ,the names 8,b4 ,iodine0 and 8,b4 ,oleum ,iodine0 are not descriptive of the pharmaceutical mixtures to which they are applied4 #d4 ,b4 ,iodine and ,b4 ,oleum ,iodine are unessential modifications of established articles4 ,b4 ,iodine has no advantage over tincture of iodin or compound solution of iodin4 7,as more convenient of transportation1 the ,medical ,department of the ,u4 ,s4 ,army supplies its field hospitals with a mixture of iodin and iodid ready for solution in water1 either in tablet form or in powdered form in tubes47 ,solutions of iodin in liquid petrolatum may be readily prepared 7,reports ,council ,pharm4 and ,chem41 #aiag1 p4 #hh74 ,contribution from the ,a4 ,m4 ,a4 ,chemical ,laboratory ,b4 ,,iodine ,,products ,a4 ,h4 ,clark1 ,ph4,g41 ,b4,s4 8,b4 ,iodine0 products are marketed by the ,b4 ,iodine ,chemical ,company1 ,cincinnati1 ,ohio2 ,john ,bohlander1 ,a4,m41 ,m4,d41 is said to be the discoverer4 ,they consist of 8,b4 ,iodine10 8,b4 ,oleum ,iodine10 and 8,b4 ,aqua ,iodine40 ,b4 ,iodine and ,b4 ,oleum ,iodine were submitted to the ,council4 ,in a circular submitted by the ,b4 ,iodine ,chemical ,company1 ,b4 ,iodine is said to be 8,nitrogen ,hydrate of ,iodin40 ,it is claimed that 8coming in contact with water1 ,h,o1 a chemical change takes place forming ,hydro ,oxid of ,iodin1 the ,nitrogen of the ,nitrogen ,hydrate of ,iodin escaping1 the balance taking up one of oxygen of the water4 ,its companion1 the ,h1 escaping at the same time with the ,nitrogen then combining with the remainder of the water to form the solution of ,hydrogen ,oxid of ,iodin2 so you can readily see that you really have a pure water of ,iodin1 nothing but the ,h1 the ,o and the ,i40--7,from the ,journal ,a4 ,m4 ,a41 ,feb4 #a1 #aiai47 ,b4 ,,iodine ,according to the circular1 ,b4 ,iodine is soluble in alcohol1 chloroform1 and ether4 ,also it3 8,has odor1 taste1 melting and boiling point1 same as regular ,iodin1 has a great affinity for water and will respond to all the tests of ,iodin4 ,appears in a ,bluish ,black ,granulated mass or ,powder4 ,when heated in vaporating dish will throw off large purple volumes of ,iodin leaving a slight white crystalline precipitate1 which on continuous heating will entirely disappear4 ,with careful manipulation you can get prismatic needle point like crystals1 looking like spores of glass1 these dissolving in water will yield pure ,iodin coloring the water ,iodin4 8,,pharmacologic1 ,,therapeutical ,,and ,,physiological ,,action3 ,same as ,iodin1 being of a colloidal nature has the advantage of being more readily absorbed and taken up by all cellular structure1 thus getting a perfect cellular medication of ,iodin40 ,a sample of ,b4 ,iodine1 marked 8,nitrogen ,hydrate of ,iodin0 was submitted by the manufacturers and this sample was examined4 ,b4 ,iodine was found to be a granular powder1 almost black with a purple cast4 ,it has an odor of iodin and dissolves in water readily4 ,it is also quite soluble in alcohol1 but not entirely soluble in chloroform and ether4 ,ether quickly dissolves iodin from ,b4 ,iodine1 leaving a residue of a white granular substance4 ,chloroform acts the same as ether except that the iodin is dissolved out with some difficulty4 ,on heating ,b4 ,iodine1 vapors of iodin escape4 ,if the heating is done on a water bath1 a residue of a white granular substance1 subsequently identified as ammonium iodid1 remains4 ,if heated in a bunsen flame1 no residue remains4 ,these tests all indicate that iodin is held in the form of a simple mixture4 ,ammonia3 ,b4 ,iodine when mixed with an excess of sodium hydroxid and warmed1 evolves ammonia4 ,iodine3 #j4aefg gm4 ,b4 ,iodine dissolved in water required #e4hh c4c4 tenth-normal sodium thiosulphate solution indicating #dh4bh per cent4 iodin4 #j4cgba gm4 ,b4 ,iodine required #ad4ah c4c4 tenth-normal sodium thiosulphate solution indicating #dh4cg per cent4 iodin4 ,the average is #dh4cc per cent4 iodin4 ,ammonium ,iodide3 #j4cdec gm4 of the residue after heating ,b4 ,iodine on a water bath until all iodin had volatilized was dissolved in water1 acidulated with phosphoric acid1 and hydrogen dioxid solution added4 ,the liberated iodin was extracted with chloroform and titrated with tenth-normal sodium thiosulphate4 #bc4gh c4c4 were required indicating #j4cddg gm41 or #ii4hc per cent41 ammonium iodid4 ,a mixture of #e gm4 iodin and #e gm4 ammonium iodid has the properties of ,b4 ,iodine mentioned above4 ,the conclusion is that ,b4 ,iodine is essentially a mixture of iodin and ammonium iodid in equal parts1 the two substances being finely powdered and intimately mixed4 ,b4 ,,oleum ,,iodine ,the following regarding ,b4 ,oleum ,iodine is quoted from the circular submitted3 8,b4 ,,oleum ,,iodine3 ,iodine soluble in mineral oil #e and #aj for ,nasal1 ,pharyngeal1 ,laryngeal1 ,bronchial1 ,rectal1 etc41 and all meucoid affections and abnormal conditions of the mucous membrane40 ,a sample of ,b4 ,oleum ,iodine was submitted by the manufacturer and examined4 ,the label on the bottle states that it is #e per cent4 ,b4 ,oleum ,iodine in mineral oil4 ,this sample has the characteristics of a solution of iodin in liquid petrolatum4 ,it is oily and has the characteristic violet color4 ,ammonia3 ,b4 ,oleum ,iodine1 since it is presumed to be a solution of ,b4 ,iodine1 was examined for ammonium compounds4 ,a small quantity was mixed with an equal volume of strong sodium hydroxid solution and heated4 ,no ammonia was evolved4 ,a few crystals of ammonium chlorid were added to a little of ,b4 ,oleum ,iodine and treated as above4 ,ammonia was readily detected4 ,iodine3 #e4bee gm4 ,b4 ,oleum ,iodine was dissolved in chloroform and placed in a separator4 ,a solution of potassium iodid was added and the iodin titrated with a tenth-normal sodium thiosulphate solution4 ,it required #c4e c4c4 indicating #j4he per cent4 iodin4 ,the conclusion is that ,b4 ,oleum ,iodine is a simple solution of iodin in liquid petrolatum to the extent of #j4he per cent4 and not #e per cent4 as claimed4 ,furthermore1 it is not a solution of ,b4 ,iodine since no ammonium compound is present4 ,the preceding report was sent to the ,b4 ,iodine ,chemical ,company4 ,the following reply was received3 ,your letter of the #bast inst41 received and contents noted and cannot quite agree with your report4 ,reasons why3 ,,nh,i1 a ,nitro ,hydrate ,iodide2 ,,nh,i1 a ,nitro ,hydrate ,iodate2 and ,,nh,i,i1 ,per ,iodide1 a molecular compound1 which ,i claim1 they all being of a ,,nh group1 so what can be the objection of ,nitrogen ,hydrate of ,iodine8 ,of course when your chemist1 with the aid of heat1 drove off all the ,iodine1 he naturally brought it back to a ,,nh,i4 ,there's where he gets the ,a4,m44 ,i claim a molecular compound4 ,the ,oil of ,iodine ,i sent you by mistake was a #a per cent4 and not a #e per cent4 as marked4 ,i claim it is made from the resublimed ,iodine in mineral oil and not the ,b4 ,iodine4 ,i claim a #e per cent4 has heretofore never been accomplished1 so ,i therefore can claim something new4 ,tr4 ,iodine contains ,alcohol and ,potash as a base1 the alcohol a dehydrater and ,potash an escharotic1 and all other soluble ,iodines like the tincture have a metallic base4 ,mine has not4 ,my iodine is compatible almost with all the salts1 alkaloids1 tannates1 and even the metals4 ,you can't say that for the tincture or the others4 ,now why should mine not be superior to others8 ,preparations as yet are not on the market and a few pamphlets were printed to meet with the requirements of your rulings and approval and shall be corrected if we only can agree on a proper name as you may suggest4 ,yours very truly1 ,,the ,b4 ,,iodine ,,chemical ,,co4 ,by ,john ,bohlander1 ,a4,m1 ,m4,d4 ,p4,s4 ,we are sending you under separate cover another sample of the ,oil of ,iodine which is a #e per cent4 solution1 and allowing for deterioration will test at least four per cent4 ,the referee in charge of the preparations submitted the above letter to the ,council with the following comments3 ,the principal statements in the letter are essentially erroneous or misleading3 ,mixtures or double salts of ammonium iodid and iodin were not discovered by ,dr4 ,bohlander1 and are nothing new4 ,watery solutions of iodin by means of an iodid have long been known and used in the form of ,lugol's solution4 ,there is no evidence that ammonium iodid is less irritating than potassium iodid4 ,on the contrary1 ammonium salts are generally more irritating than the corresponding potassium salts4 ,b4 ,iodine is not compatible with alkaloids1 but behaves essentially like ,lugol's solution4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reports that the new sample of ,b4 ,oleum ,iodine contains only #a4b per cent4 of free iodin1 instead of the claimed amount4 ,it is therefore somewhat weaker than the iodin petrolatum prepared by the ,a4 ,m4 ,a4 ,chemical ,laboratory 7,reports ,council ,pharm4 and ,chem41 #aiag1 p4 #hh74 ,however good ,dr4 ,bohlander's intentions may be1 the statements that he makes about his products are misleading or erroneous1 and the products are ineligible for ,n4 ,n4 ,r4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #dd47 ,,antithyroid ,,preparations 7,,antithyroidin-,,moebius ,,and ,,thyreoidectin7 ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report explaining the omission from ,new and ,nonofficial ,remedies of antithyroid preparations 7,antithyroidin-,moebius and ,thyreoidectin7 has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,new and ,nonofficial ,remedies1 #aiah1 contains a discussion of 8antithyroid0 preparation and describes two of these3 ,antithyroidin-,moebius 7,e4 ,merck1 ,darmstadt1 ,germany7 and ,thyreoidectin 7,parke1 ,davis ,company1 ,detroit1 ,mich474 ,the referee reported that these 8antithyroid preparations0 evidently have not realized the expectations of their promoters1 and are viewed with skepticism by practically all critical clinicians4 ,consequently1 notwithstanding the cautiously worded statements of claims made by the manufacturers of ,thyreoidectin1 the ,council approved the recommendation that this preparation 7,thyreoidectin7 be omitted from ,new and ,nonofficial ,remedies for conflict with ,rule #f 7unwarranted therapeutic claims7 and ,rule #aj 7unscientific and useless articles7 7,antithyroidin-,moebius had already been omitted because it was off the market74 ,the ,council further directed that the general article 8antithyroid preparations0 be also omitted4 ,the ,council having adopted the recommendation of the referee1 ,thyreoidectin is omitted from ,n4 ,n4 ,r41 while the general article appears below1 as a matter of record3 ,antithyroid preparations are obtained from the blood or milk of animals1 after the removal of the thyroid glands4 ,the use of these preparations is based on the theory that the thyroid gland secretes products which are toxic1 but which neutralize and are neutralized by1 other toxic substances produced elsewhere in the body4 ,removal of the thyroid glands would then lead to the accumulation of these second toxic substances as evidenced by the phenomena of cachexia strumipriva and myxedema4 ,on the other hand1 the blood or milk of such animals is claimed to be capable of preventing the effects of hypersecretion of thyroid substance1 such as is supposed to occur in hyperthyroidism 7,basedow's or ,graves' disease--generally called exophthalmic goiter74 ,these views are largely hypothetical2 attempts to give to them a rational experimental basis have failed1 but some clinical observers report distinctly beneficial results in the milder forms of the diseases1 and in obscure nervous disorders which are supposedly connected with thyroid hypersecretion from the administration of the milk from thyroidectomized goats and also from the use of the proprietary blood preparations listed below4 ,the value of these preparations is very doubtful4 ,the reported improvements may only be psychical or due to associated measures1 as is often seen in this disease4 ,other measures of treatment should not be neglected4 ,improvement is said to occur in two or three weeks and to be indicated by an amelioration of the nervous symptoms1 tremor1 palpitation1 insomnia and excitability4 ,the administration must be long continued4 ,oral and hypodermic administration are said to be equally effective1 but the former is usually preferred4 ,these preparations are not known to be toxic1 even when very large doses are used4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #ej47 ,,cephaelin ,,and ,,syrup ,,cephaelin-,,lilly ,,omitted ,,from ,n4 ,n4 ,r4 ,,and ,,syrup ,,emetic-,,lilly ,,not ,,accepted ,report of ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report1 which explains the omission of cephaelin and ,syrup ,cephaelin-,lilly from ,new and ,nonofficial ,remedies and the non-acceptance of ,syrup ,emetic-,lilly4 ,w4 ,a4 ,puckner1 ,secretary4 ,new and ,nonofficial ,remedies1 #aiah1 describes cephaelin 7an alkaloid obtained from ipecacuanha root7 and lists ,syrup ,cephaelin-,lilly 7containing #j4jhh ,gm4 cephaelin hydrochlorid per #ajj ,cc47 as a pharmaceutical preparation of it4 ,the period of acceptance for ,syrup ,cephaelin-,lilly having expired1 ,eli ,lilly ,company were asked to send the current advertising and labels so that the ,council might determine if the acceptance of this preparation might be continued4 ,in reply the firm wrote3 8,we have changed the name ,syrup ,cephaeline to ,syrup ,emetic but the product remains the same as before4 ,we have no circulars describing ,syrup ,emetic and can only send copies of the label40 ,the new name 8,syrup ,emetic0 conflicts with the rules of the ,council in that it does not indicate the potent ingredient of this simple pharmaceutical preparation and in that it is therapeutically suggestive4 ,emetics are powerful agents1 and physicians should be given every opportunity of knowing what they prescribe for the purpose4 ,the name being in conflict with ,rule #h1 the ,council voted to omit ,syrup ,cephaelin-,lilly and not to accept ,syrup ,emetic-,lilly4 ,as the cephaelin syrup was the only preparation of cephaelin admitted to ,new and ,nonofficial ,remedies1 and as the alkaloid appears to have no important therapeutic field1 the ,council directed that the description of cephaelin also be omitted4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #eb47 ,,colalin ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report explaining the omission from ,new and ,nonofficial ,remedies of ,colalin has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,colalin is a bile salt preparation claimed to consist essentially of hyoglycocholic and hyotaurocholic acids4 ,it is manufactured by ,rufus ,crowell and ,company1 ,somerville1 ,mass41 and marketed by ,schieffelin and ,company1 ,new ,york4 ,an examination of the current advertising by the referee of the ,council in charge of bile salt preparations having revealed that claims were made for ,colalin which were not in harmony with the known action of bile preparations1 ,schieffelin and ,company were informed that in the opinion of the referee the ,colalin circular matter required radical revision4 ,in this communication the referee's objections to the claims were set forth in detail4 ,no reply to this letter was received1 and hence a copy of the letter was sent to ,schieffelin and ,company and also to ,rufus ,crowell and ,company with the explanation that unless the statements in the ,colalin advertising which the referee had questioned were substantiated by satisfactory evidence1 were suitably revised1 or else the advertising matter withdrawn pending revision1 the referee would be obliged to recommend to the ,council that ,colalin be omitted from ,new and ,nonofficial ,remedies4 ,in reply1 ,schieffelin and ,company wrote that they were not 8engaged actively in the introduction of ,colalin10 and agreed to the omission of ,colalin from ,n4 ,n4 ,r4 ,in view of the failure to substantiate the claims objected to or an agreement to discontinue them1 the ,council directed that ,colalin and ,colalin ,tablets be omitted from ,new and ,nonofficial ,remedies for conflict with ,rule #f 7unwarranted therapeutic claims74 ,the following are the claims which the referee questioned3 8,colalin embodies the physiological function of the bile in the intestinal canal and also possesses properties of its own which are intimately connected with the function of the liver40 ,the quotation implies that ,colalin has properties essentially different from those of bile salts1 a claim which requires substantiation4 8,in the liver its action seems to be that of a general stimulant of all the hepatic functions40 ,this is a claim which requires substantiation4 8,by the introduction of ,colalin it has therefore become possible to actually utilize the bile for therapeutic purposes40 ,this is an unwarranted claim1 for bile was used therapeutically before ,colalin was introduced4 8,as gall-stones are chiefly composed of cholesterin1 experiments were made to determine whether ,colalin would dissolve these concretions outside of the body4 ,these were completely successful and were then followed by an extensive series of clinical investigations on persons suffering with cholelithiasis1 which demonstrated that by the administration of ,colalin in many instances gall-stones were evacuated by the natural passages and their further formation prevented without resort to surgical intervention40 ,this is misleading in that the context shows that 8without surgical intervention0 is meant to imply a connection between the experiments showing the solvent power of ,colalin and the passage of concretions4 8444 ,colalin not only acts as a solvent of cholesterin calculi1 but prevents their further formation by removing the causes upon which their development depends40 ,this conveys the impression that such solvent action is exerted in the body1 that is1 that such concretions in the gallbladder may be dissolved and evacuated by the use of ,colalin4 ,for this claim there is no evidence4 8,to understand the value of ,colalin in intestinal disorders it is necessary to bear in mind the important functions of the bile in the intestinal canal1 namely1 its participation in the digestion of fats1 its antitoxic action1 and its influence upon the peristalsis40 8444 through its antiseptic influence inhibits the production of toxins in the intestines40 ,the referee believes that there is no satisfactory evidence that bile or bile salts can inhibit the production of toxins in that part of the intestine--the colon--in which they are commonly produced4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #eb47 ,,foral ,report of the ,council on ,pharmacy and ,chemistry ,the following report on ,foral1 a depilatory preparation1 has been authorized for publication by the ,council4 ,w4 ,a4 ,puckner1 ,secretary4 ,foral is sold by the ,foral ,products ,company1 ,pittsburgh1 ,pa41 as an 8antiseptic depilatory0 with the special claim for its use for the removal of hair prior to surgical operation or the dressing of wounds4 ,in addition to claims made for its hair dissolving action1 it is asserted that1 in removing the hair from an open wound1 ,foral acts as 8an antiseptic1 which guarantees against any infection40 ,it is also claimed that1 though hair will return after its use1 8by proper use it will diminish the growth of hair and cause the hair to grow much slower1 and unlike the razor1 the hair will not return coarser and thicker40 ,we are informed by the ,foral ,products ,company that their preparation is used in many hospitals and that 8444 one and all are well pleased and a great satisfaction to do away with the old style razor 4440 ,foral is stated to be made according to the following formula3 ,to manufacture seventy-five pounds of ,,foral ,starch #ce pounds ,barium-,sulphide #bj pounds ,zinc-,oxide #aj pounds ,calcium-,carbonated-,precip4 #aj pounds ,potassium-,permanganate #aj grams ,menthol-,crystallized #aj grams ,carbolic-,acid #a_/b ounce ,lilac or ,citronel oil #c ounces ,the four above chemicals are going to a heating process before mixing or sifting4 ,in consideration of the preceding1 the ,council declared ,foral inadmissible to ,new and ,nonofficial ,remedies for conflict with its rules1 thus3 #a4 ,foral is an unessential and irrational modification of an established article4 ,while its manufacturer states that ,foral has been on the market for eighteen years1 the following depilatory formula appears in a book published thirty-five years ago 7,a practical ,treatise on ,diseases of the ,skin1 ,louis ,a4 ,duhring1 ,ed4 #c1 #ahhc7 and is to be found in most books on dermatology3 ,barium ,sulphid #b drams ,zinc oxid #c drams ,starch #c drams ,permanganates and sulphids mutually destroy each other1 and therefore the addition of the small amount of potassium permanganate cannot serve any useful purpose4 ,the amounts of phenol1 menthol and 8,lilac or ,citronel oil0 are too small to exercise any effect 7other than that of a flavor7 and must be considered unessential additions4 #b4 ,foral is a pharmaceutical mixture marketed under a non-informing name4 ,whereas it is in the interest of rational medicine that physicians should know the composition of the preparations which they use1 the name of this pharmaceutical mixture fails to indicate that it contains the well-known and by no means always harmless barium sulphid4 #c4 ,foral is sold under exaggerated and unwarranted claims4 ,in view of the small amount of phenol present and the method of using the preparation1 the claim that the use of ,foral which1 when operating on open wounds1 8guarantees against any infection10 is evidently unwarranted4 ,there is no evidence for the claim that the use of depilatories such as ,foral retards the growth of hair or renders hair less coarse4 ,on the contrary1 the commonly prevailing opinion is that depilation1 like shaving1 makes the hair coarser4 ,to determine if 8one and all0 of those who had used ,foral were still using the preparation1 four of the testimonials1 appearing in an advertising pamphlet1 were investigated4 ,the pharmacist of the hospital from which the first of these testimonials was stated to have emanated replied that the person whose name appeared in connection with it had left the hospital about ten years ago and that no depilatory preparation has been used in this hospital for some time4 ,so far as he knew1 depilatories were not now in use in the surgical wards of the hospital4 ,in regard to the second testimonial1 the pharmacist of this hospital wrote that the hospital had not bought the preparation1 but that some of it had been obtained for an elderly deaconness1 who had personal use for a depilatory4 ,the physician signing the third testimonial replied that the preparation was effectual for the removal of hair from the scalp1 but that 8444 we have gotten out of the habit of using it40 ,in the case of the fourth testimonial1 its asserted author wrote 8444 if it is applied in too large a quantity or too concentrated1 or permitted to remain on too long1 it will vesicate4 ,it was for this reason chiefly that ,i discontinued its use4 ,it is a very bad smelling mixture and patients complain of it very bitterly40--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #ee47 ,,granular ,,effervescent ,,bromide ,,and ,,acetanilid ,,compound-,,mulford ,report of the ,council on ,pharmacy and ,chemistry ,the following report explaining the omission from ,new and ,nonofficial ,remedies of ,granular ,effervescent ,bromide and ,acetanilid ,compound-,mulford has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,council holds that complex mixtures of remedial agents are from every point of view inimical to therapeutic progress and therefore to the public welfare4 ,they are especially objectionable because it is impossible accurately to determine the effects which follow the simultaneous administration of a number of drugs having dissimilar actions1 and because the practice of prescribing such mixtures tends to discourage careful consideration of the special needs of the individual patients without which there can be no drug therapy4 ,on the contrary1 with the use of such mixtures1 therapeutic treatment becomes haphazard and mere guesswork4 ,the ,council1 appreciating that long established customs cannot be changed at once1 has applied ,rule #aj1 concerning the recognition of mixtures1 with the greatest leniency compatible with consistency4 ,when there has been a reasonable doubt concerning the value of a mixture1 it has frequently directed that ,rule #aj should not apply1 pending further clinical trial of such mixture4 ,in no instance has subsequent experience shown that a strict interpretation of the rule would have worked hardship or injustice4 ,the ,council feels that there is no longer warrant for the admission of complex mixtures to ,new and ,nonofficial ,remedies1 or for the retention of any that have been admitted1 unless definite evidence of the therapeutic value of such combinations is available4 ,in accordance with this decision1 several mixtures now described in ,new and ,nonofficial ,remedies will be omitted at the expiration of the three year period for which articles are accepted4 ,granular ,effervescent ,bromide and ,acetanilid ,compound-,mulford is listed in the ,appendix to ,new and ,nonofficial ,remedies4 ,each #ajj ,gm4 of the mixture contains sodium bromide1 #e ,gm41 and acetanilid1 #a4e ,gm4 ,according to the label1 an amount containing acetanilid1 #f4e grains1 and sodium bromide1 #bb grains1 is to be taken at a dose1 to be repeated in half an hour if necessary4 ,for 8children10 half this dose is advised4 ,the ,council has considered the available evidence for mixtures of this sort1 and has reached the conclusion that they are inimical to rational medicine and the public1 and therefore in conflict with ,rule #aj4 ,it holds that the use of mixtures of acetanilid and sodium bromide in fixed proportion is irrational and prone to induce their indiscriminate use by the public4 ,despite the perfectly frank declaration of the composition of this mixture that is made by the ,mulford ,company1 the 8directions0 will be followed blindly and the preparation will be given to 8children0 and 8repeated in half an hour1 if necessary0 in cases in which it would be held unwarranted to administer a dose of #c grains of acetanilid to a child4 ,the period of acceptance having expired for ,granular ,effervescent ,bromide and ,acetanilid ,compound-,mulford1 the ,council directed its omission from ,new and ,nonofficial ,remedies for conflict with ,rule #aj4--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #eh47 ,,holadin ,,and ,,bile ,,salt ,,mixtures ,holadin and ,bile ,salts-,fairchild2 ,capsules of ,bile ,salts1 ,succinate of ,soda and ,phenolphthalein-,fairchild2 ,capsules of ,holadin1 ,bile ,salts and ,phenolphthalein-,fairchild2 ,capsules of ,holadin1 ,succinate of ,soda and ,bile ,salts-,fairchild4 ,report of the ,council on ,pharmacy and ,chemistry ,to explain the omission from ,new and ,nonofficial ,remedies of certain mixtures1 the ,council has authorized publication of the matter which appears below4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,council holds that complex mixtures of remedial agents are from every point of view inimical to therapeutic progress and therefore to the public welfare4 ,they are especially objectionable because it is impossible accurately to determine the effects which follow the simultaneous administration of a number of drugs having dissimilar actions1 and because the practice of prescribing such mixtures tends to discourage careful consideration of the special needs of individual patients without which there can be no rational drug therapy4 ,on the contrary1 with the use of such mixtures1 therapeutic treatment becomes haphazard and mere guesswork4 ,the ,council1 appreciating that long established customs cannot be changed at once1 has applied ,rule #aj concerning the recognition of mixtures with the greatest leniency compatible with consistency4 ,when there has been a reasonable doubt concerning the value of a mixture it has frequently directed that ,rule #aj should not apply1 pending further clinical trial of such mixture4 ,in no instance has subsequent experience shown that a strict interpretation of the rule would have worked hardship or injustice4 ,the ,council feels that there is no longer any warrant for the admission of complex mixtures to ,new and ,nonofficial ,remedies or for the retention of any that have been admitted unless definite evidence of the therapeutic value of such combinations is available4 ,in accordance with this decision1 several mixtures now described in ,new and ,nonofficial ,remedies will be omitted as soon as the three year period for which articles are accepted has expired4 ,the following preparations are included in ,new and ,nonofficial ,remedies1 #aiah3 ,holadin and ,bile ,salts-,fairchild4--,a mixture of holadin1 #e parts1 with bile salts-,fairchild1 #a part1 put up in #c grain capsules4 ,capsules of ,bile ,salts1 ,succinate of ,soda and ,phenolphthalein4--,each capsule contains bile salts-,fairchild1 #j4jfe ,gm4 7#a grain72 sodium succinate exsiccated1 #j4b ,gm4 7#c grains71 and phenolphthalein1 #j4jc ,gm4 7#a_/b grain74 ,capsules of ,holadin1 ,bile ,salts and ,phenolphthalein4--,each capsule contains holadin1 #j4ac ,gm4 7#b grains72 bile salts-,fairchild1 #j4jc ,gm4 7#a_/b grain71 and phenolphthalein1 #j4jfe ,gm4 7#a grain74 ,capsules of ,holadin1 ,succinate of ,soda and ,bile ,salts4--,each capsule contains holadin1 #j4bj ,gm4 7#c grains72 sodium succinate exsiccated1 #j4bj ,gm4 7#c grains71 and bile salts-,fairchild1 #j4jc ,gm4 7#a_/b grain74 ,oxbile has long been credited with a cholagogue action1 which1 however1 has probably been greatly overestimated4 ,when pure bile salts were placed on the market some years ago1 they and their compounds were admitted to ,n4 ,n4 ,r4 ,holadin is said to represent all the constituents of the pancreas and to possess great potency in respect to the several enzymes1 trypsin1 amylopsin1 lipase1 and the milk-curdling ferment4 ,it is not clear when such a substance is indicated therapeutically4 ,while it may be useful when there is a deficiency of pancreatin and gastric secretion1 it should be used alone4 ,it is also quite possible that bile salts may have a distinct1 though limited1 field of usefulness when there is a deficiency of biliary secretion2 but the bile salts are best administered alone1 or in combination with such laxatives as may be deemed necessary by the physician while keeping in mind the fact that different patients show the widest difference in their reaction to laxatives1 making combinations of these agents in fixed proportion irrational4 ,phenolphthalein was popularized by nostrum makers2 and while it has some therapeutic value1 this has been greatly overestimated1 and it should be used only in amounts deemed necessary for each patient1 preferably alone4 ,succinate of sodium was introduced as a saline cathartic1 with the claim that it exerts an antiseptic action on the biliary passages and gallbladder4 ,there is no satisfactory evidence to substantiate this claim4 ,the ,council maintains a liberal attitude toward new preparations1 but it feels that it is impossible to determine the value of the several constituents of such complex mixtures when used as such2 it holds that these mixtures are superfluous and that the several substances of which they are composed should be used singly or at most with greater attention to the individual requirements of the patient than is possible when these fixed mixtures are prescribed4 ,despite the fact that these mixtures have been in use for more than nine years1 there is no satisfactory evidence that they possess any advantage over the simple laxatives or the preparations of bile or pancreatic extract4 ,they are therefore held to be in conflict with ,rule #aj1 and the ,council has directed that they be not included in ,n4 ,n4 ,r4 after ,dec4 #ca1 #aiah4 ,having adopted the preceding report1 the ,council1 in accordance with its regular procedure1 submitted this to ,fairchild ,bros4 and ,foster for comment4 ,the following reply was received3 ,we are entirely at variance with you in the arbitrary conclusion expressed concerning the inimical influence of mixtures on therapeutic progress1 the practice of medicine and the public welfare4 ,if the combinations of ,holadin and ,bile ,salts1 etc41 in capsules1 were ever properly within the scope of ,new and ,nonofficial ,remedies1 they should be retained4 ,if1 however1 complex mixtures are to be held as1 a priori1 unworthy of consideration1 the rejection of all would naturally be a logical proceeding4 ,we believe that the particular combination of ,holadin and ,bile ,salts etc41 have been clearly in the line of therapeutic progress--a natural evolution1 improvement and development4 ,for many years combinations of pancreatic extract and ox gall had naturally suggested themselves4 ,when we realized the fact that the bile salts were quite clearly the active principles of the bile1 and that they must necessarily exist in greatly varying percentages in the official inspissated or ox gall1 and also because these ox gall products of pharmacy were of extremely varying density1 even from that of treacle to resin--and of other objectionable character1 we undertook to prepare bile salts4 ,these combinations are now further justified in view of physiological considerations1 the simultaneous secretion of the pancreas and bile1 and the state of our knowledge of the function of bile salts1 and as co-ferments1 promoting and supplementing the pancreas enzymes4 ,the question suggested as to whether the cholagogic action of ox gall 7and bile salts7 has been overestimated seems to us no clear purport4 ,the bile salts are obviously employed as the means of administering and thus realizing whatever properties this secretion may have in medicine1 of which the cholagogic action is by no means the only consideration4 ,as for phenolphthalein1 which is credited with purely laxative properties1 we are at a loss to see any bearing in the remark that phenolphthalein was popularized by nostrum makers4 ,we cannot see that the physician's or chemist's estimate of phenolphthalein1 its properties and uses1 can be in the least degree influenced one way or the other by the statement that 8phenolphthalein has been popularized by nostrum makers40 ,the phenolphthalein and succinate of soda combinations were originally both prescribed1 and we have simply placed them at the service of the physician without other exploitation of them than that designed to call attention to their use in the conditions indicated4 ,these combinations are offered in a form which may be administered by the mouth with the best promise of introducing the substance more directly in the intestinal tract during the digestion period or at such interval after or prior to1 the digestion period1 as would best1 in the judgment of the physician1 meet the indications4 ,these particular combinations are especially desirable in these 8fixed forms0 since they are stable and reliable resources at the command of the physicians1 the enzymes retaining their stability and potency without material deterioration for many years1 and they naturally possess the advantages which are obviously due to the character of the particular pancreas and bile products used in the combinations4 ,furthermore1 the hygroscopic and soluble organic substances in admixture cannot extemporaneously be so prepared in sealed capsules as to be readily available under the practical requirements of prescribing and dispensing4 ,and we do not believe that those who practice medicine will be in accord with your view that the pancreas substance should necessarily be administered alone1 or the bile substance alone4 ,it now appears that these combinations are to be dropped from ,new and ,nonofficial ,remedies in consequence of the view1 so stated1 that in clinical experience 8for more than nine years there is no satisfactory evidence that they possess any advantage over the simple laxatives or preparations of bile or pancreatic extract40 ,in reply to this we would simply make the following comment3 ,during these 8nine years0 these combinations have inevitably been put to an informing clinical trial1 because of the fact that they have been employed with success in disorders of the pancreas and bile functions and often in chronic and serious cases where the clinical conditions were obvious and unmistakable4 ,the reports of these cases come to us from physicians widely separated and each of his own independent initiative4 ,it would seem gratuitous1 to say the least1 to state that the observers are 8disinterested10 since it is quite clear that there is no other interest than that of the practitioner and his patient4 ,it is not a case of a new drug or combinations of new remedies1 but simply resources which1 upon well grounded reasons1 both from a theoretical and material standpoint1 justify clinical trial1 and with results which would seem from any ordinary human standpoint to be satisfactory clinical evidence4 ,as to the interpretation of competent clinical evidence by the ,council1 we would1 in view of the circumstances and without comment1 ask to embody in this text this rule3 8,clinical ,evidence40--8,to be acceptable1 the clinical evidence must offer objective data with such citation of authority as will enable the ,council to confirm the facts and establish the scientific value of the conclusions drawn4 ,clinical data are worthless when the author is not cited4 ,the facts on which claims with regard to the value of a remedy are based must have been rendered accessible for investigation and confirmation by disinterested observers1 either through publication or through the records of a hospital or other institution40 ,to discredit these combinations would seem to us not only unjustified1 but sterile of any real advancement in medicine1 or of anything in the way of helpfulness to the patient in the class of cases in which these products have been resorted to with benefit2 this on no other ground really than the opinion 8that they have no advantage over the simple preparations themselves40 ,naturally we shall continue to prepare these products and shall continue to take such action as we deem best to bring them to the attention of the physician1 for the conduct of our business must remain in the hands of those who are personally responsible for it4 ,and it is now forty years since we took up this line of work and with the declared intention of devoting ourselves to the applied science of the digestive ferments and 8to their development and practical application in every useful purpose in medicine40 ,we have been consistently in sympathy with the fundamental purpose of the ,council1 which must first rest upon fact as to the character of the products offered as medicinal agents4 ,the weight of evidence justifies the position that these particular products rationally should be1 and as a matter of fact are1 of important special service in the utilization of these organic secretions in medicine4 ,as explained in the preceding report1 the ,council holds that complex mixtures of remedial agents are from every point of view inimical to therapeutic progress and therefore to the public welfare4 ,they are especially objectionable because it is impossible to determine accurately the effects which follow the simultaneous administration of a number of drugs having dissimilar actions1 and because such a practice tends strongly to discourage careful consideration of the special needs of individual patients without which there can be no therapeutic progress4 ,on the contrary1 with their use1 therapeutic treatment becomes haphazard and mere guesswork4 ,the dismissal of the holadin and bile salts mixtures does not involve the question of the usefulness of holadin or of bile salts alone2 on the contrary1 the possible usefulness of these preparations is admitted in the report4 ,it is the combination of holadin1 bile salts1 sodium succinate and phenolphthalein to which objection is made4 ,the statement of ,fairchild ,bros4 and ,foster that 8these combinations are now further justified in view of physiological considerations0 is somewhat misleading4 ,it is true that bile and the pancreatic secretion cooperate in intestinal digestion1 but there is no evidence that in every case in which there is a deficiency of one of these secretions there is also a deficiency of the other1 and it is an axiom of scientific therapeutics that no drug or remedial agent should be administered except to fill a definite want4 ,otherwise the practice of therapeutics becomes mere empiricism4 ,the properties of phenolphthalein are not in the least influenced by the manner of its introduction1 as ,messrs4 ,fairchild ,bros4 and ,foster emphasize2 but the important fact in this connection is that the popular conception of their actions is greatly influenced by the mode of introduction1 and phenolphthalein has been widely advertised in a variety of conditions1 so that the popular notion concerning it is not that of scientific therapeutics4 ,in short1 the entire argument of ,messrs4 ,fairchild ,bros4 and ,foster concerning the exploitation of these preparations may be summed up by saying that they have been used by clinicians who believe that good results have followed their use1 and that the firm will therefore continue to supply the demand4 ,the tendency of some to use anything brought to their notice1 and the readiness of manufacturers to market anything that physicians will use1 presents the greatest obstacle to therapeutic progress4 ,there was never a nostrum so irrational or worthless that honest but undiscriminating clinicians could not be found who reported wonderful results from its use4 ,according to ,fairchild ,bros4 and ,foster1 these holadin and bile salts mixtures have been in use for some nine years4 ,yet the ,council is not aware of any investigation of their merits that meets the requirements of scientific research4 ,the ,council is not acquainted with a single clinical investigation of their action under conditions which afford satisfactory evidence of their therapeutic value4 ,it is obviously wholly insufficient for a clinician to report that the use of a mixture was followed by good results4 ,the fallacy of such arguments was demonstrated long ago4 ,he must make a comparison of the results obtained with the remedial agent with those obtained in as nearly similar conditions as possible except for the use of the agent4 ,we are not aware that any such study of the mixtures in question has been made4 ,it is in the last degree irrational to hold that because bile salts are the active constituents of bile1 therefore such complex mixtures as these are necessary4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #ei7 ,,liquor ,,santaiva1 ,s4 ,d41 ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report explaining the omission from ,new and ,nonofficial ,remedies of ,liquor ,santaiva1 ,s4 ,d41 has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,so far the ,council has applied ,rule #aj concerning the recognition of mixtures with the greatest leniency compatible with consistency4 ,when there has been a reasonable doubt concerning the value of a mixture1 it has frequently directed that ,rule #aj should not apply1 pending further clinical trial of such mixture4 ,in no instance has subsequent experience shown that a strict interpretation of the rule would have worked hardship or injustice4 ,the ,council feels that there is no longer any warrant for the admission of complex mixtures to ,new and ,nonofficial ,remedies or for the retention of any that have been admitted1 unless definite evidence of the therapeutic value of such combinations is available4 ,the ,council being engaged in the annual revision of ,new and ,nonofficial ,remedies1 the referee in charge of santal preparations reported that the three year period of acceptance had expired for ,liquor ,santaiva 7,sharp ,dohme74 ,the referee held that ,liquor ,santaiva1 ,s4 ,d41 declared to be a solution of santal oil and copaiba with aromatic oils1 in a mixture of alcohol and water1 is plainly in conflict with the current interpretation of ,rule #aj1 because there was no sound evidence to indicate that any useful end is gained by the simultaneous administration of santal oil and copaiba in any proportion1 and that so1 of course1 there is no evidence of the special advantage in the fixed proportions represented by the mixture4 ,he pointed out that the formula is essentially a survival of the discredited shotgun gonorrhea mixtures and therefore recommended that its acceptance be not continued4 ,the ,council agreed to the recommendation of the referee and directed that ,liquor ,santaiva1 ,s4 ,d41 be omitted from ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #ff7 ,,maltzyme1 ,,maltzyme ,,with ,,cascara ,,sagrada1 ,,maltzyme ,,with ,,cod ,,liver ,,oil1 ,,maltzyme ,,ferrated ,,and ,,maltzyme ,,with ,,yerba ,,santa ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report explaining the omission from ,new and ,nonofficial ,remedies of the ,maltzyme preparations has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,in #aiaf1 the ,council voted to omit ,maltzyme with ,hypophosphites1 and ,maltzyme with ,phosphate of ,iron1 ,quinine and ,strychnine4 ,at that time the labels used on the ,maltzyme preparations still in ,new and ,nonofficial ,remedies contained a list of ,maltzyme combinations which included those which had been dismissed4 ,as the ,council does not permit an accepted article to be used as a means of advertising an article not accepted1 it voted to continue the following preparations for a period of three years on condition that reference to the deleted articles be omitted from the labels when those then in stock had been used up3 ,maltzyme1 ,maltzyme with ,cascara ,sagrada1 ,maltzyme with ,cod ,liver ,oil1 ,maltzyme ,ferrated and ,maltzyme with ,yerba ,santa4 ,while the ,maltzyme ,company made no definite agreement to revise its advertising propaganda in accordance with the ,council's requirements1 the ,maltzyme preparations were retained in the belief that in due time the required revision of the labels would be made4 ,the ,council being engaged in preparing the #aiai edition of ,new and ,nonofficial ,remedies1 the referee in charge of malt extracts reported that the ,maltzyme ,company had not revised its labels in accordance with the stipulation of the ,council4 ,the referee further reported he had become convinced that the claim that ,maltzyme is 8rich in malt enzymes0 is unwarranted and that the term 8,maltzyme0 7malt plus enzyme7 is misleading2 this because of the recognized instability of malt extracts 7,jour4 ,a4 ,m4 ,a41 ,march #cj1 #aiab1 p4 #ied7 and because the ,maltzyme ,company makes no definite statement with regard to the diastase 7malt enzyme7 content of its preparations4#abf ,for this reason it had been the referee's intention to propose the deletion of all ,maltzyme preparations when their period of acceptance expired in #aiai4 ,as1 however1 the present ,maltzyme preparations are in contravention with the ,council's requirements1 he recommended that the acceptance of these preparations be canceled now4 #abf ,manufacturers are warned by the ,department of ,agriculture1 through the ,bureau of ,chemistry1 that combinations claiming to contain digestive enzymes must be active when sold4 ,if preparations tend to deteriorate in a short time1 each lot should be dated and not sold after the period when they become inactive4 ,while every manufacturer must be considered innocent until proved guilty1 and ignorant until proved knowing1 it is a matter of knowledge that manufacturers have marketed their various digestive mixtures with full appreciation of their worthlessness4--7,jour4 ,a4 ,m4 ,a41 ,dec4 #ai1 #aiad1 p4 #bbcd47 ,the ,council agreed to the recommendation of the referee and directed that ,maltzyme1 ,maltzyme with ,cascara ,sagrada1 ,maltzyme with ,cod ,liver ,oil1 ,maltzyme ,ferrated1 and ,maltzyme with ,yerba ,santa be omitted from ,n4 ,n4 ,r4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #fg7 ,,methaform ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report explaining the omission from ,new and ,nonofficial ,remedies of ,methaform has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,methaform is the proprietary name applied by ,f4 ,stearns ,co4 to chlorbutanol4 ,being engaged in the annual revision of ,new and ,nonofficial ,remedies1 and the term of acceptance for ,methaform having expired1 a trade package was purchased to determine if the product was marketed in compliance with the rules of the ,council4 ,it was then found that a circular was wrapped with the trade package which advertised ,methaform ,inhalant1 a preparation not accepted for ,new and ,nonofficial ,remedies4 ,for obvious reasons1 the ,council does not countenance the use of an accepted article as a means of advertising an article not accepted4 ,accordingly ,f4 ,stearns ,co4 was advised that the ,council would be obliged to withdraw the acceptance of ,methaform unless the objectionable circular was omitted from the ,methaform packages4 ,stearns ,co4 did not give the requested assurance1 and therefore the ,council directed that ,methaform be omitted from ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #fh7 ,,pineal ,,gland1 ,,red ,,bone-,,marrow ,,and ,,thymus ,,gland ,,and ,,their ,,preparations ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report explaining the omission from ,new and ,nonofficial ,remedies of pineal gland1 red bone-marrow and thymus gland and their preparations has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,pineal gland1 red bone-marrow and thymus gland were admitted to ,new and ,nonofficial ,remedies when these products gave promise of having therapeutic value4 ,the term of acceptance for the preparations of pineal gland1 red bone-marrow and thymus gland having expired1 the referee in charge of animal organ preparations recommended in his report for the annual revision of ,n4 ,n4 ,r4 that these products and the general articles describing them be omitted from ,new and ,nonofficial ,remedies4 ,he held that the experimental and clinical experience with them leads to the conclusion that they are without value4 ,in accordance with the recommendation of the referee1 the ,council voted that the following preparations be omitted from ,new and ,nonofficial ,remedies3 ,desiccated ,pineal ,gland-,armour2 ,pineal ,gland ,tablets-,armour2 ,extract of ,red ,bone-,marrow-,armour2 ,desiccated ,thymus-,armour2 ,thymus ,tablets-,armour4 ,as a matter of record1 the descriptive articles for pineal gland1 red bone-marrow and thymus gland1 which appeared in ,new and ,nonofficial ,remedies1 #aiah1 are given below4 ,pineal ,gland ,the functions of this gland have not yet been established but there is some pathological and some experimental evidence that there is a relation between the gland and some processes of development and growth2 the nature of this relation is unknown4 ,adiposis is a frequent sign of disturbed pineal function1 but observers are not agreed whether to interpret this as indicating hypofunction or hyperfunction1 or possibly a concurrent disturbance of the pituitary4 ,in some instances intravenous injections of pineal extract have seemed to cause a distinct fall in blood pressure4 ,it has been inferred from observations in cases of pineal tumors in the young that the gland in young individuals furnishes a secretion which inhibits growth1 particularly the development of the reproductive glands1 but the results of experimental administration of pineal substance orally have led other observers to infer that the pineal secretion favors physical and possibly mental and sexual development4 ,it has been suggested that1 as all evidence points to the fact that the function of the pineal gland is one of early life1 extract of adult pineal glands might be expected to be inert4 ,experiment has also indicated greater activity in glands obtained from young animals than in those obtained from older ones4 ,the ,council has decided to admit preparations of pineal gland to ,new and ,nonofficial ,remedies simply for experimental purposes4 ,red ,bone-,marrow ,red bone-marrow consists largely 7more than #ij per cent47 of fat4 ,in new-born animals a third or more of this fat consists of lecithin4 ,the marrow of the bones of new-born animals contains iron 7up to #a per cent4 or more7 in various forms of organic combination4 ,both lecithin and iron decrease rapidly in the first weeks after birth4 ,the commercial preparations contain very variable amounts of these constituents4 ,actions and ,uses4--,red bone-marrow is supposed to stimulate the formation of red blood corpuscles2 whatever action it may have in this direction is probably due largely to the iron and lecithin which it contains4 ,it is said to be useful in simple and pernicious anemias4 ,thymus ,gland ,little is known as to the functions of the thymus1 but it is believed to have an important relation to growth4 ,there also seems to be some relation between the thymus and thyroid1 for the former is frequently abnormal in diseases involving the latter 7hyperthyroidism74 ,the use of thymus is purely empirical4 ,it has been employed in the treatment of hyperthyroidism1 rickets1 tuberculosis1 hemophilia1 and infantile marasmus and atrophy2 its use in the latter conditions is said to be the most promising4 ,it is claimed on very doubtful grounds to exert a somewhat favorable effect in certain cases of cancer4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #fi7 ,,piperazine ,,and ,,lycetol ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the following report explaining the omission from ,new and ,nonofficial ,remedies of ,piperazine and ,lycetol has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,piperazine 7diethylenediamene7 and ,lycetol 7a methyl derivative of diethylenediamene7 were accepted for ,new and ,nonofficial ,remedies in #aijf4 ,both ,piperazine and ,lycetol were asserted to be efficient uric acid solvents and efficacious remedies in the treatment of gout and rheumatism4 ,these products have been retained until now because there was no investigation which definitely showed their uselessness as uric acid solvents1 though their use is generally admitted to have been disappointing4 ,from an exhaustive and critical study of the available evidence1 ,hanzlik 7,jour4 ,lab4 ,clin4 ,med41 ,february1 #aiag7 concluded that scientific evidence1 though limited1 and clinical opinion indicate that ,piperazine is valueless in gout and that there is sufficient scientific evidence to indicate the worthlessness of ,lycetol4 ,the referee in charge of ,piperazine and ,lycetol recommended that these products be omitted from ,new and ,nonofficial ,remedies for the reason that they have been sufficiently tried to justify the conclusion that they are not of value4 ,the period of acceptance having expired1 the ,council directed that ,piperazine and ,piperazine ,tablets 7,the ,bayer ,company1 ,inc47 and ,lycetol 7,the ,bayer ,company1 ,inc47 be omitted from ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #gj47 ,,stanolind ,,liquid ,,paraffin ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,as explained in the report which follows1 8,stanolind ,liquid ,paraffin0 was omitted from ,new and ,nonofficial ,remedies at the request of the proprietors4 ,announcement of this omission was made in the preface to ,new and ,nonofficial ,remedies1 #aiah1 but publication of the ,council's report was postponed pending actual conflict with the rules4 ,the ,council now authorizes publication of the report because a circular indirectly advertising the product to the public was found enclosed with the trade package of ,stanolind ,liquid ,paraffin4 ,w4 ,a4 ,puckner1 ,secretary4 ,stanolind ,liquid ,paraffin was admitted to ,new and ,nonofficial ,remedies in #aiaf1 when its method of marketing conformed to the rules of the ,council4 ,this brand of liquid petrolatum1 by action of the ,council1 has been omitted from ,new and ,nonofficial ,remedies on request of the ,standard ,oil ,company of ,indiana1 its manufacturer1 who wrote to the ,secretary of the ,council stating that3 8,in order that our facilities for the manufacture of this oil shall be constantly engaged1 it will be necessary for us to find sales on a larger scale than in the past4 ,to do this under our present advertising and marketing arrangement we feel will be impossible40 ,this letter1 in addition1 suggested 8that physicians are not prescribing ,stanolind ,liquid ,paraffin in any considerable proportion of their orders0 and 8that the situation which now confronts us would not be materially helped if ,stanolind was specified in all such prescriptions40 ,further1 the ,council is asked to consider whether it 8might be willing to declare this preparation as not a ,council product10 on the alleged grounds that 8liquid paraffin is not medicinal in its action and passes through the digestive tract in practically unaltered condition40 ,the ,council holds that ,stanolind ,liquid ,paraffin is a drug1 and that1 therefore1 its direct advertising to the public is in contravention of the ,council's rules4 ,constipation should be treated by dietary and hygienic means4 ,evacuants are only temporary measures4 ,liquid petrolatum is medicinal2 it greatly modifies the intestinal flora2 it acts as a lubricant and emollient2 it modifies the absorptive powers of the intestinal mucous membrane2 it is capable of influencing the digestion of fats4 ,in short1 liquid petrolatum1 being a drug1 its indiscriminate and excessive use should not be encouraged4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #gb7 ,,westerfield',s ,,digitalis ,,tablets ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following report and authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,westerfield's ,digitalis ,tablets 7,the ,westerfield ,pharmacal ,co41 ,dayton1 ,ohio7 are claimed to represent a fat free tincture of digitalis and to be 8enteric coated40 ,it is claimed that because of this coating these tablets pass the stomach unchanged and dissolve in the intestine1 and that this obviates any possibility of gastric disturbance4 ,the circular which sets forth the asserted advantages of the tablets states that digitalis contains a fat which is an irritant to the gastric membrane4 ,it also contains the following3 8,we feel no hesitation in saying that if this remedy is given a fair trial where it is properly indicated1 the result obtained will be a gratifying surprise4 8,it is a common expression from physicians who have tried this remedy to say1 #8,surely ,i have never used ,digitalis before4'0 ,if these quotations mean anything1 they imply that these tablets present a distinct advance in digitalis therapy4 ,there is no warrant for such a claim4 ,the statement with reference to the occurrence of an oil in digitalis is partly false and partly misleading4 ,tincture of digitalis1 which the tablets are claimed to represent1 is fat free2 the fixed oil that is present in the drug is not soluble in #gj per cent4 alcohol1 the menstruum used for the preparation of the official tincture of digitalis4 ,furthermore1 a fairly large amount of this oil 7such as is present in #ajj therapeutic doses of the drug7 is incapable of causing gastric disturbance4 ,gastric disturbance is a side action that is inseparable from slight overdosage with all true digitalis bodies and is not in any way due to local gastric action4 ,the claim that such action is prevented by the use of enteric pills or tablets is obviously false and misleading4 ,the alleged 8common expression from physicians who have tried this remedy0 does not constitute acceptable evidence of the value of the preparation4 ,the ,council declared ,westerfield's ,digitalis ,tablets inadmissible to ,new and ,nonofficial ,remedies because unwarranted therapeutic claims are made for this product4 ,when the preceding report was submitted to the ,westerfield ,pharmacal ,co41 a reply was received indicating that the firm did not know that progressive manufacturers had discontinued the claim that 8fat free0 digitalis preparations were devoid of gastric effects4 ,it also submitted a revised circular1 which1 however1 reiterated the claim that the tablet presented a distinct advance in digitalis therapy in that it was 8fat free10 and coated to prevent disintegration in the stomach4 ,since tincture of digitalis and extract of digitalis are practically devoid of fatty material1 and since it is now well known that the fat does not cause gastric disturbance and that therapeutic doses of digitalis do not exert a local irritant action on the stomach1 the manufacturer's product and the claims made for it merely tend to perpetuate old errors4 ,the ,council declared ,westerfield's ,digitalis ,tablets inadmissible to ,new and ,nonofficial ,remedies on the ground that this presents an unessential modification of pills of an official substance4 ,it directed publication of its report with this explanation4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #ge7 ,,xeroform-,,heyden ,,and ,,bismuth ,,tribromphenate-,,merck ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report on ,bismuth ,tribromphenate-,merck and ,xeroform-,heyden4 ,these two products were found not to comply with the standards for bismuth tribromphenate adopted for ,new and ,nonofficial ,remedies1 and hence could not be retained4 ,as the manufacturers of both products announce that efforts toward the production of a satisfactory product are continued1 the omission of the two brands is without prejudice to their reacceptance when a satisfactory product becomes available4 ,w4 ,a4 ,puckner1 ,secretary4 ,the referee in charge of bismuth preparations submitted the following report of the ,a4 ,m4 ,a4 ,chemical ,laboratory which shows that ,xeroform-,heyden and ,bismuth ,tribromphenate-,merck do not comply with the adopted standards for bismuth tribromphenate4 ,some time ago a request was received from the ,medical ,section of the ,national ,council of ,defense for a report on a brand of bismuth tribromphenate4 ,in accordance with this request the firm's product was examined1 and at the same time and for comparison1 an examination was also made of a specimen of bismuth tribromphenate received from ,merck and ,company1 ,october1 #aiae1 and of another specimen of bismuth tribromphenate 8,xeroform-,heyden0 obtained from the ,chicago branch of the ,heyden ,chemical ,works in ,april1 #aiah4 ,the examination brought out that the bismuth tribromphenate submitted to the national ,council of ,defense contained a large amount of uncombined tribromphenol1 while the specimen of ,xeroform-,heyden contained an excessive quantity of bismuth4 ,when the latter finding was submitted to the ,heyden ,chemical ,works1 the firm stated3 8,the product had to be made in this country after importations from ,europe became impossible and the first lots were not fully up to the standard 4440 ,the firm stated that it could now furnish a product which it considered fully equal to that which was previously imported1 and offered to submit 8samples of the new material40 ,having been requested to do so1 a specimen of ,xeroform-,heyden was received from the ,heyden ,chemical ,works1 ,new ,york4 ,this and a second specimen1 purchased from a ,chicago wholesale drug house1 were examined4 ,whereas the standards for bismuth tribromphenate which had been formulated by the ,laboratory and accepted by the ,heyden ,chemical ,works required that the product should contain from #dj to #di per cent4 of bismuth and contain not more than #c4c per cent4 of uncombined tribromphenol1 the specimen purchased in ,chicago contained #fg4g per cent4 of bismuth1 while the specimen received direct from the ,heyden ,chemical ,works contained #bd per cent4 of uncombined tribromphenol4 ,when this result was reported to the ,heyden ,chemical ,works1 the firm replied3 8,it seems that we are not yet in a position to supply a product that answers a uniform standard and that we have to continue our efforts in this direction4 8,we will take this matter up with you again as soon as we have been successful 4440 ,at the time when the preceding examination was being made1 bismuth tribromphenate-,merck could not be obtained from the ,chicago wholesale houses4 ,a request sent to ,merck and ,company for a specimen of the market supply brought the information that the product was temporarily unavailable4 ,though unable to supply the product1 the firm gave valuable advice for a revision of the somewhat loosely drawn tests for bismuth tribromphenate in ,new and ,nonofficial ,remedies1 #aiah4 ,recently 7,november1 #aiah7 ,merck and ,company sent a specimen of its product labeled 8,bismuth ,tribromphenate-,merck0 8,merck and ,company1 ,new ,york1 ,distributors and ,guarantors10 and wrote 8444 ,you will notice this sample conforms in nearly all details to the tests we submitted with our letter of ,june #dth4 ,we have been able to produce better goods1 but just at present unsatisfactory starting material confronts us4 ,the sample conforms to ,n4 ,n4 ,r41 #aiah1 but will not meet the test for uncombined tribromphenol submitted by you in your letter of ,september #dth 4440 ,examination of the specimen demonstrated that it was soluble to a considerable extent in alcohol 7the ,n4 ,n4 ,r41 #aiah1 description provides that it should be only slightly soluble in alcohol7 and according to the standards adopted for ,new and ,nonofficial ,remedies1 #aiai1 contains #ah per cent4 uncombined tribromphenol 7more than five times the permitted amount74 ,in view of the ,laboratory's report1 the referee recommended that the acceptance of ,xeroform-,heyden and ,bismuth ,tribromphenate-,merck be withdrawn1 without prejudice to their reinstatement when satisfactory products are again offered for sale4 ,the ,council adopted the recommendation of the referee1 and accordingly ,xeroform-,heyden and ,bismuth ,tribromphenate-,merck are omitted from ,new and ,nonofficial ,remedies1 #aiai4 ,when the ,laboratory's findings with regard to ,xeroform-,heyden and the action of the ,council deleting the article from ,new and ,nonofficial ,remedies was reported to the ,heyden ,chemical ,works1 the firm expressed regret that efforts to produce a product equal to that formerly obtained from ,germany had so far not been successful and announced that it had decided to withdraw ,xeroform-,heyden from the market for the present4 ,when ,merck and ,company was advised in regard to the report of the ,laboratory and the ,council's action1 this firm questioned the feasibility of producing a product meeting the ,council's standards and suggested that the test for free tribromphenol be revised to permit as much as #ae per cent4 of this constituent4 ,when ,merck and ,company was reminded that its product1 submitted in #aiae1 essentially complied with the adopted standards and that the estimate of the therapeutic value of bismuth tribromphenate is based on a product essentially free from alcohol-soluble material1 the firm replied3 8,as stated in our letter of the #abth inst4 we do not wish to market the chemical unless it meets all legitimate requirements of the physicians that use it4 ,if1 therefore1 your standard proves to be good and it is commercially possible to make supplies conforming to it1 we shall do so4 ,we shall discontinue the article unless it is of suitable quality40 --7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #gf47 ,,cream ,,of ,,mustard ,,refused ,,recognition ,report of the ,council on ,pharmacy and ,chemistry ,cream of ,mustard1 ,the ,cream of ,mustard ,co41 ,south ,norwalk1 ,conn41 is said to be made by mixing #b drachms of oil of mustard and #b drachms of oil of turpentine with one pound of white petrolatum4 ,according to the label it is 8for ,tonsillitis1 ,rheumatism1 ,sore ,muscles1 ,croup1 ,pleurisy1 ,frosted ,feet1 ,sore ,throat1 ,neuralgia1 ,sprains1 ,bronchitis1 ,headache1 ,chilblains1 ,stiff ,neck1 ,congestion1 ,bruises1 ,asthma1 ,lumbago1 ,pains and ,aches1 ,colds in ,chest40 ,the ,council refused recognition to ,cream of ,mustard3 ,because it is a simple pharmaceutical mixture of well-known ingredients and has no advantage over established rubefacients which every physician knows how to prescribe and every pharmacist to compound4 ,incidentally1 the name 8,cream of ,mustard0 is misleading and not descriptive of the composition of this pharmaceutical of oils of mustard and turpentine4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiah1 p4 #gi7 8,,pluriglandular0 ,,mixtures ,caps4 ,adreno-,spermin ,comp41 ,caps4 ,antero-,pituitary ,comp41 ,caps4 ,placento-,mammary ,comp41 ,caps4 ,thyro-,ovarian ,comp41 ,caps4 ,hepato-,splenic ,comp41 ,caps4 ,pancreas ,comp41 and ,caps4 ,thyroid ,comp41 ,not ,admitted to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,after considering the evidence for the several 8pluriglandular0 mixtures described below1 the ,council declared them inadmissible to ,new and ,nonofficial ,remedies4 ,the ,council's action was communicated to the manufacturer1 ,henry ,r4 ,harrower1 in accordance with the usual procedure4 ,after giving due consideration to the manufacturer's reply the ,council authorized publication of the report which appears below4 ,w4 ,a4 ,puckner1 ,secretary4 ,with the offer 8to supply you with as much literature as may be necessary and as little of the actual remedies as may be desired0 if 8the prospects for the inclusion of these formulas in ,n4 ,n4 ,r4 are good10 ,henry ,r4 ,harrower sent the ,council a booklet descriptive of his preparations and labels for the following mixtures3 ,caps4 ,adreno-,spermin ,comp41 each said to contain 8,adrenal ,gland 7total7 gr4 #a_/d1 ,thyroid ,gland 7,u4 ,s4 ,p47 gr4 #a_/ab1 ,spermin ,extr4 7from ,gonads71 ,brain and ,spinal ,cord aa gr4 #a1 ,calc4 ,glycerophosphate q4 s4 ad gr4 #e40 ,caps4 ,antero-,pituitary ,comp41 each said to contain 8,anterior ,pituitary ,body gr4 #b1 ,thymus ,gland gr4 #a1 ,thyroid ,gland 7,u4 ,s4 ,p47 gr4 #a_/ab1 ,calcium-phosphorus ,comp4 q4 s4 ad gr4 #e40 ,caps4 ,placento-,mammary ,co41 each said to contain 8,desiccated ,placenta gr4 #b1 ,mammary ,substance gr4 #a-a_/b1 ,pituitary ,body 7total7 gr4 #a_/c1 ,calcium-phosphorus ,comp4 q4 s4 ad4 gr4 #e40 ,caps4 ,thyro-,ovarian ,comp41 each said to contain 8,desic4 ,corpora ,lutea ,ovarian ,substance gr4 #b-a_/b1 ,thyroid ,gland 7,u4 ,s4 ,p47 gr4 #a_/ab1 ,pituitary ,gland 7total7 gr4 #a_/h1 ,calcium-phosphorus ,comp4 q4 s4 ad gr4 #e40 ,caps4 ,hepato-,splenic ,comp41 each said to contain 8,liver ,parenchyma1 ,spleen ,substance aa gr4 #b1 ,powd4 ,bile ,salts gr4 #a_/b1 ,adreno-,spermin ,co4 7,no4 #a7 gr4 #a40 ,caps4 ,pancreas ,comp41 each said to contain 8,adrenal ,gland1 ,pituitary ,gland 7total7 aa gr4 #a_/b1 ,ovarian ,substance gr4 #a1 ,pancreas ,substance q4 s4 ad gr4 #e40 ,caps4 ,thyroid ,comp41 each said to contain 8,desic4 ,thyroid ,gland 7,u4 ,s4 ,p47 gr4 #a_/h1 ,calcium-phosphorus ,comp4 q4 s4 ad gr4 #e40 ,the ,council declared these preparations inadmissible to ,new and ,nonofficial ,remedies1 for reasons which follow3 #a4 ,each of the mixtures contains one ingredient or more1 which is neither recognized in the ,u4 ,s4 ,pharmacopeia nor admitted to ,new and ,nonofficial ,remedies1 namely3 8,spermin ,extract10 8,brain10 8,spinal ,cord10 8,desiccated ,placenta10 8,liver ,parenchyma10 8,spleen ,substance10 8,pancreas ,substance0 and 8,calcium ,phosphorus ,comp4 7,each #ajj gm4 represents ,magnes4 ,phos4 #a2 ,calc4 glycerophos4 #d2 ,potas4 bicarb4 #ae2 ,sod4 bicarb4 #bb and ,sod4 chlor4 q4 s4740 ,for obvious reasons the ,council does not accept a mixture containing an indefinite ingredient and hence it would be necessary as a preliminary for the consideration of any one of the mixtures that their unofficial ingredients be made eligible for ,new and ,nonofficial ,remedies by the submission of evidence that such ingredient is of uniform composition and that it is therapeutically valuable when given by mouth4 ,there is no evidence that many of these organs have any value whatever when administered by the mouth or in any other way4 #b4 ,in the light of our knowledge the administration of gland mixtures in the host of conditions enumerated in the advertising circular is irrational and on a par with the use of the shotgun mixtures once in vogue4 ,be it a pharmaceutical mixture1 a 8mixed0 vaccine1 or a 8pluriglandular0 product1 the combination of two medicinal ingredients in a mixture must be considered contrary to rational therapy unless a good reason exists for such combination4 ,such mixtures are held in conflict with ,rule #aj unless the manufacturer presents acceptable evidence for the value of his combination4 ,a physician may prescribe any mixture which he considers indicated in a given case1 but the marketing of mixtures of drugs in fixed proportions is in most instances irrational and a detriment to sound therapy4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ah1 #aiai7 ,,cerelene ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report declaring ,cerelene inadmissible to ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,cerelene1 a paraffin preparation for the treatment of burns1 was submitted to the ,council by the ,holliday ,laboratories1 with the statement that it was composed of #hd per cent4 paraffin1 #ae per cent4 myricyl palmitate1 and #a per cent4 purified elemi gum to which is added oil of eucalyptus #b per cent4 and betanaphthol #j4be per cent4 ,it was explained3 8,myricyl ,palmitate is a purified form of ,beeswax1 free from all impurities1 acids1 etc41 which is solely manufactured by this ,company44440 ,it was also stated that on 8special order0 ,cerelene has been made containing oil of eucalyptus and resorcin1 oil of eucalyptus and picric acid1 and picric acid alone4 ,the following report on the preparation was presented to the ,council by the referee to whom ,cerelene had been assigned3 ,cerelene is another compound wax for the treatment of burns4 ,according to the work of ,sollmann 7,j4 ,a4 ,m4 ,a41 #fh3agii1 #aiag7 it is highly improbable that compound mixtures have any advantage over simple paraffin of low melting point4 ,cerelene must therefore be considered as an unessential modification of paraffin1 and as in conflict with ,rule #aj2 unless definite evidence of superiority is submitted4 ,cerelene mixtures containing medicinal ingredients also appear unscientific since the evidence that the ingredients do not leave the wax has not been successfully contradicted4 ,finally1 the claims made for ,cerelene are rather extreme1 and would need some revision before they could be accepted4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reports3 ,the physical properties of ,cerelene are as follows3 ,melting point #ej4j ,c4 by ,u4 ,s4 ,p4 method4 ,ductility limit #cj4e ,c4 ,plasticity limit #bf4d ,c4 ,not strong at #ch ,c4 ,adheres moderately well2 detaches with 8pulling40 ,on heating1 readily loses eucalyptol1 and a small amount of resinous substance forms in the bottom of the beaker4 ,if ,cerelene is heated to #ade ,c4 and cooled1 the resulting product no longer has the properties of the original ,cerelene4 ,it is recommended that the preceding report be sent to the ,holliday ,laboratories1 and that unless its superiority over simple paraffins is demonstrated and the unwarranted claims abandoned1 ,cerelene be declared inadmissible to ,new and ,nonofficial ,remedies for conflict with ,rules #f and #aj4 ,this report was submitted to the ,holliday ,laboratories with the information that it had been adopted1 ,oct4 #c1 #aiag4 ,it was also explained that before ,cerelene could be accepted1 the unofficial and unstandardized constituent 8myricyl palmitate0 would have to be considered and accepted for ,new and ,nonofficial ,remedies since1 for obvious reasons1 the ,council does not accept a preparation which contains an unofficial and unstandardized substance not in ,n4 ,n4 ,r4 ,the ,holliday ,laboratories acknowledged receipt of the ,council's report and asked that the matter be held in abeyance until the requested evidence had been obtained4 ,later the ,council was advised that the advertising circulars for ,cerelene had been withdrawn with the exception of one giving directions for its use4 ,five months later1 the firm stated that experiments were being made 8to determine the actual strength of ,cerelene in comparison with other paraffin waxes44440 ,nothing further has been heard from the ,holliday ,laboratories and no reply has been received to an inquiry made ,oct4 #ab1 #aiah4 ,the ,council therefore authorizes publication of its report declaring ,cerelene inadmissible to ,new and ,nonofficial ,remedies4--7,from the ,journal ,a4 ,m4 ,a41 ,feb4 #ae1 #aiai74 ,,collosol ,,cocaine ,,not ,,admitted ,,to ,n4 ,n4 ,r ,report of the ,council on ,pharmacy and ,chemistry ,the report which appears below was adopted by the ,council and sent to the ,anglo-,french ,drug ,co41 ,ltd41 ,new ,york1 for comment in ,december1 #aiah4 ,no explanation has been received from the manufacturer4 ,for the information of the profession the ,council has now authorized publication of the report4 ,w4 ,a4 ,puckner1 ,secretary4 8,collosol ,cocaine0 was submitted to the ,council in ,october1 #aiah1 by the ,anglo-,french ,drug ,co41 ,ltd41 ,new ,york1 under the claim that it was an 8absolute colloid0 and that it contained 8#a per cent4 cocain40 ,the label on the submitted specimen declares3 8,collosol ,cocaine #a-ajj0 8444 the ,cocaine exists as the pure alkaloid in the ,colloidal state--the condition in which it is isomorphic with the protein of the body fluids4 ,the effect is more prolonged than that of a molecular ,cocaine ,solution and being non-toxic absorption presents no practical danger40 ,the product was assigned to the ,committee on ,pharmacology for consideration4 ,the following report was submitted and its adoption by the ,council recommended by the committee3 8,collosol ,cocaine0 is said to be a colloidal form of cocain and is alleged to possess a remarkably low toxicity4 ,the subjoined report of the ,a4 ,m4 ,a4 ,chemical ,laboratory1 however1 shows that the preparation does not have the composition claimed for it and it is1 in effect1 misbranded4 ,in fact1 the ,english manufacturers concede that it is not an 8absolute colloid0 and that the declaration with regard to the percentage of cocain is incorrect4 ,it is recommended that1 without considering other conflicts with the rules of the ,council at this time1 8,collosol ,cocaine0 be declared inadmissible to ,new and ,nonofficial ,remedies for conflict with ,rule #a which requires that the composition of an article must be correctly declared4 ,the report of the ,a4 ,m4 ,a4 ,chemical ,laboratory is appended4 ,,report ,,of ,,the ,a4 ,m4 ,a4 ,,chemical ,,laboratory ,simpson1 ,hewlett and ,eyre 7,lancet1 ,april #bh1 #aiag1 p4 #ffj7 reported 8,collosol ,cocaine0 to be much less toxic than cocain4 ,these writers1 however1 did not verify the statements as to the composition and in the light of subsequent chemical examination it is not to be wondered at that 8,collosol ,cocaine #a4j per cent40 was much less toxic than a solution containing #a4j per cent4 of cocain hydrochlorid4 ,barger1 ,dale and ,durham report from the ,department of ,biochemistry and ,pharmacology1 ,medical ,research ,committee 7,lancet1 ,dec4 #a1 #aiag1 p4 #hbe71 that they examined 8,collosol ,cocaine0 and found it to contain but #j4be per cent4 of cocain4 ,they also found that the cocain was not present in a colloidal form4 ,discussing the low toxicity claimed by the manufacturers1 these investigators state3 8,in the samples which we examined the toxicity was1 indeed1 much lower than that of an ordinary #a per cent4 solution of a cocain salt2 but the local anesthetic action was low to a corresponding degree1 and both actions corresponded satisfactorily with the proportion of cocain chemically recoverable from the solution40 ,stroud1 of the ,crookes ,laboratory 7which manufactures the preparation71 who apparently had been informed of this work in advance of publication1 admits the correctness of it1 and states 7,british ,medical ,journal1 ,nov4 #bd1 #aiah1 p4 #gaj7 that 8whilst the colloidal protective apparently absorbs a portion of the cocain1 the remainder is found not to exhibit the attributes of a colloid14440 ,the specimen of 8,collosol ,cocaine0 submitted to the ,council and labeled 8,collosol ,cocaine #a-ajj0 was found to contain at most #j4d per cent4 cocain4 ,the examination was made in accordance with the method used by ,barger1 ,dale and ,durham and calculated as cocain4 ,this method1 however1 probably would not distinguish between cocain and basic decomposition products1 but would include all as cocain in the amount found4 ,the specimen of 8,collosol ,cocaine0 examined was neutral or slightly acid1 a fact which tends to confirm the conclusion of the ,british investigators that 8,collosol ,cocaine0 contains cocain in noncolloidal form and precludes an increased physiologic effect due to alkalinity4 ,the ,council adopted both the report submitted by the committee and that of the ,a4 ,m4 ,a4 ,laboratory and declared 8,collosol ,cocaine0 inadmissible to ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ab1 #aiai47 ,,cuprase ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report on ,cuprase1 sold by the ,anglo-,french ,drug ,co41 ,ltd4 ,the ,council's criticisms of the advertising claims were sent to the firm1 ,december1 #aiah4 ,the firm made no reply and essentially the same claims are contained in recent advertisements4 ,w4 ,a4 ,puckner1 ,secretary4 8,cuprase0 is now being advertised and sold in the ,united ,states by the ,anglo-,french ,drug ,co41 ,ltd41 the firm which also markets it in ,england4 ,it is said to be 8prepared in the ,laboratories of ,f4 ,ducatte1 #h ,place de la ,medeleine1 ,paris40 ,according to an advertising circular entitled 8,the ,medical ,treatment of ,cancer0 8,cuprase0 is 8chemical colloidal copper02 in another place it is 8a colloidal copper hydroxid10 which is said to be obtained chemically by the reduction of salts of copper in the presence of albumosic acid4 ,a box 7price #h4ej less #aj per cent4 discount7 of 8,cuprase-,doctor ,gaube du ,gers0 was purchased recently from the ,anglo-,french ,drug ,co41 ,ltd4 ,it contained eight ampules each containing approximately #a #bc of a brownish fluorescent liquid4 ,no information of composition was given on the box1 except the line3 8,chaque ampoule contient3 #a #bc 4#jjaba de ,cuivre pur0 7,each ampule contains ,o4#jjaba gr4 of pure copper74 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reports that the preparation does contain a small amount of copper1 with some protein material and about #a per cent4 sodium chlorid4 ,the therapeutic claims in the advertising circular are those commonly made for cancer 8cures0 and are about equally convincing4 ,the publication of such statements and quotations as the following1 which appear in a pamphlet 8,the ,medical ,treatment in ,cancer10 cannot be too strongly condemned in a medicament that at best has only an experimental status3 8,a special preparation1 ,cuprase1 has been introduced into therapeutics which has been remarkably successful4 ,in the history of the therapeutics of cancer1 nothing has been found which can compare with the effects produced by means of ,cuprase4 ,clinical facts carry greater weight than theoretical deductions4 ,it follows1 from the clinical observations which ,i have collected1 that in the large majority of cases ,cuprase effects the diminution or disappearance of the pains1 an improvement in the general condition1 a diminution or arrest of the neoplasms1 and finally in certain cases1 a cure has been effected4 ,it should be remarked that all or nearly all the observations refer to inoperable cases in which the prognosis was unfavorable at an early date4 ,it is needless to emphasize the practical importance of a preparation capable of yielding such results1 even relative1 in the worst stages of a disease which has always been regarded as absolutely resisting the action of all internal remedies40 8,to sum up1 ,cuprase has given positive results in about #id per cent4 of the cases in which it has been employed for a sufficiently long period1 and some brilliant results in about #bj per cent4 of these cases4 ,therefore1 it may be affirmed1 that among the internal remedies for cancer1 ,cuprase is the one which has produced the most successful results1 and can1 under certain circumstances1 compete with surgical methods1 even1 so far as the rapidity of their results are concerned40 8,it is indicated3 7a7 apart from all operation1 and as a specific and curative remedy2 7b7 before an operation1 in order to give tone to the patient1 mobilise the tumor1 destroy its toxins2 7c7 after the operation1 as a tonic and anti-toxic1 and in order to avoid frequent relapses which are always possible40 ,essentially the same statements are made in the more recent advertisements 7f4 i4 ,urological and ,cutaneous ,review1 ,feb41 #aiai74 ,opposed to these loose statements are the results of ,richard ,weil 7,the ,journal ,a4 ,m4 ,a41 #aiac1 ,sept4 #bg1 p4 #ajcd2 ibid1 #aiae1 ,april #ag1 p4 #abhc74 ,weil avoided pitfalls of subjective impressions and used as the essential criterion of efficiency 8the demonstrable reduction in size of a tumor1 of a kind not to be attributed to the natural processes of evolution of that tumor or of its associated lesions0 7l4 c4 #aiae1 p4 #abhi74 ,the available evidence for ,cuprase is far from meeting this criterion4 ,that published by the manufacturers and agents presents only vague generalities1 and no definite data4 ,the evidence gathered by ,weil himself permits an estimate of the value of ,cuprase and it is entirely unfavorable4 ,he states 7l4c4 #aiae1 p4 #abhh73 8,colloidal copper has been used in recent time for the same purpose by ,gaube du ,gers and by others4 ,i have recently examined the effects of colloidal copper on malignant tumors in man1 and have been unable to find that it has any therapeutic value4 ,furthermore1 a study of the distribution of the copper in tumors obtained at operation or by necropsy from individuals so treated failed to show that the copper had been deposited therein40 ,in view of the extravagant and cruelly misleading therapeutic claims1 and the indefinite statements of composition1 the ,council voted ,cuprase ineligible to ,n4 ,n4 ,r41 and authorized the publication of this report4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ab1 #aiai47 ,,collosol ,,preparations ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted and authorized publication of the report which appears below declaring 8,collosol ,argentum10 8,collosol ,arsenicum10 8,collosol ,cocain10 8,collosol ,cuprum10 8,collosol ,ferrum10 8,collosol ,hydrargyrum10 8,collosol ,iodin10 8,collosol ,manganese10 8,collosol ,quinin0 and 8,collosol ,sulphur0 inadmissible to ,new and ,nonofficial ,remedies1 because their composition is uncertain 7conflict with ,rule #a74 ,in the few cases in which the therapeutic claims for these preparations were examined1 the claims were found to be so improbable or exaggerated 7conflict with ,rules #f and #aj7 as to have necessitated the rejection of these products4 ,w4 ,a4 ,puckner1 ,secretary ,the ,anglo-,french ,drug ,co41 ,ltd41 ,london and ,new ,york1 in ,november1 #aiah1 requested the ,council to consider the products 8,collosol ,argentum10 8,collosol ,arsenicum10 8,collosol ,cocain10 8,collosol ,cuprum10 8,collosol ,ferrum10 8,collosol ,hydrargyrum10 8,collosol ,iodin10 8,collosol ,manganese10 8,collosol ,quinin0 and 8,collosol ,sulphur40 ,the term 8,collosol0 appears to be a group designation for what are claimed to be permanent colloidal solutions1 marketed by the ,anglo-,french ,drug ,co41 ,ltd4 ,were this claim correct1 8,collosols0 should contain their active constituents in the form of microscopic or ultramicroscopic suspensions1 protected against spontaneous precipitation by the presence of proteins or some similar 8stabilizers40 ,according to the original patent specifications for ,collosols1 the metals are precipitated or treated with 8peptone10 which acts as the suspending or stabilizing agent4 ,the method of using the peptone makes it doubtful1 in the first place1 whether the major part of the metals is present in colloidal form1 or merely in the form of peptonates1 i4 e41 as ordinary salts4 ,moreover1 the later patents indicate that the products have been unsatisfactory2 8experience having shown that some metal colloids under certain conditions not yet fully understood have the tendency to break down after a certain period0 7,u4 ,s4 patent ,no4 #a1aaf1bdg74 ,phenol1 it is claimed has a tendency to counteract this decomposition1 and the patent covers the use of phenol for this purpose4 ,it is difficult to see how phenol could possibly have such action4 ,in fact1 it obviously does not1 for a number of the samples of ,collosols submitted to the ,council had separated4 ,for instance1 8,collosol ,hydrargyrum0 was not a colloidal solution at all1 but a suspension of a coarse powder4 ,the ampules of 8,collosol ,ferrum0 contained a considerable quantity of flocculent precipitate4 ,if either of these preparations were injected intravenously as directed1 death might result1 making the physician morally if not legally liable4 ,the recklessness of the claims is further illustrated by the advice that these indefinite mixtures of poisonous metals can be injected in unlimited quantities4 ,thus1 ,henry ,crookes stated 7,chemical ,news1 ,may #g1 #aiad1 p4 #bah7 that ,collosols 8contain so small a proportion of metal1 viz41 #a in #bjjj1 that even a poisonous body like arsenic can be used with impunity40 ,he stated that they may be applied as a lotion1 intramuscular or intravenous injection1 and that 8one pint or more can be injected intravenously40 ,in the case of 8,collosol ,cocain10 as was brought out in the ,council's report published in ,the ,journal1 ,april #ab1 #aiai1 the manufacturers have admitted that the product is not what they have claimed--and still claim--for it4 ,the report of the ,a4 ,m4 ,a4 ,chemical ,laboratory showed that 8,collosol ,cocain10 instead of containing #a per cent4 cocain as claimed1 contained1 in fact1 at most not more than #j4d per cent4 cocain4 ,the report of the ,a4 ,m4 ,a4 ,chemical ,laboratory on the ,collosol products was sent by the ,council to the ,new ,york office of the ,anglo-,french ,drug ,co41 ,ltd41 in duplicate in order to facilitate reference to the ,london office4 ,this was some months ago4 ,the information which the ,council requested has not yet been received1 nor has the ,anglo-,french ,drug ,co41 ,ltd41 indicated its intention of supplying such information4 ,on the other hand1 claims to which specific objection have been made1 continue to appear in current advertising4 ,accordingly1 the ,council authorizes publication of this report1 and declares the ,collosol preparations previously named ineligible to ,new and ,nonofficial ,remedies4 ,additional ,notes on ,collosol ,evidence ,in addition to the preceding the following notes of the referee on the evidence so far submitted were sent to the ,anglo-,french ,drug ,company1 ,ltd41 for consideration3 ,collosol ,iodine3 ,the leaflet which describes ,collosol ,iodine contains claims that are improbable1 not in accord with accepted facts nor substantiated by evidence2 for instance3 8,this preparation contains ,iodine in its most active form 4440 8,the disadvantages of #8iodism' and nausea frequently associated with iodides never occur with ,collosol ,iodine40 8,in the case of ,colloidal ,iodine the whole of the ,iodine is absorbed and enters into molecular combination with protein to form an iodo-amino acid and 444 exerts a reducing action on the lipoids producing a different condition of the blood--hence the use of ,iodine as an #8alterative'40 8,intravenously the action of ,collosol ,iodine is more rapid 444 in cases of pyemia 444 thus showing its absolute non-toxicity40 8#8,per se' ,colloidal ,iodine is only slightly parasitotropic and bacteriotropic but micro-organisms are very greatly influenced by its action1 and not only is the effect of a subsequently administered remedy greatly increased but also the insoluble colloidal protein of serum itself is reduced to smaller particles1 thus increasing its surface and adsorptive capacity and consequent germicidal power4 ,in some cases the serum1 thus aided1 is enabled to throw off a milk microbial invasion4 ,the above action can be readily demonstrated #8in vitro' by means of the ultramicroscope40 8,in ,cancer1 the intravenous injection of ,collosol ,iodine relieves pain1 even where large dosage of morphine is ineffective40 8,in ,rheumatism the ionic method of treatment with ,collosol ,iodine is strongly advised40 8,in ,recovery from ,alcoholism the internal administration of ,collosol ,iodine restores the normal condition of cell activity1 ensuring rapid recovery40 ,collosol ,hydrargyrum3 ,this is said to be a preparation of colloidal mercury and would therefore be similar to ,electromercurol 7,new and ,nonofficial ,remedies1 #aiai1 p4 #afg74 ,colloidal mercury preparations have been used to some extent2 they appear to have no decided advantage over other1 noncolloidal1 mercury compounds4 ,they differ sufficiently from them1 however1 to justify acceptance for ,new and ,nonofficial ,remedies1 providing that reasonable claims are made for them4 ,the leaflet advertising ,collosol ,hydrargyrum contains statements that cannot be accepted and require thorough revision to make them acceptable4 ,the following are instances3 8,although--especially locally--the action of mercurials is markedly antiseptic1 when taken internally or injected1 it has been stated by some of the best known authorities1 that their action is rather to increase the natural resisting power of the body to disease1 probably because of stimulation of the oxidases40 ,with the soluble mercurials 8considerable upset of the normal cell conditions of the tissues ensues whilst these soluble salts are being converted to a condition in which the body can make use of them40 8,the colloidal state 444 is stated by some authorities in the case of mercury to be invariably precedent to absorption4444 ,with the usual forms of mercury the danger of too great a dose per cell is considerable1 but in the case of colloidal mercury1 the diffusion is extremely rapid and chemical affinity low4 ,hence the danger to the individual leucocyte is minimized and the maximum effect obtained40 8444 absence of pain is usual in the administration of colloidal preparations and is due to their isomorphism with the colloidal lipoid and protein of the tissues and body fluids40 8,according to ,mc,donagh1444 mercury acts as an oxidizing agent and that the process of oxidation is more effective in the early stages of syphilis in producing the death of the causal organism44440 ,collosol ,manganese3 ,the circular submitted to the referee is a reprint of a paper by ,sir ,malcolm ,morris on 8,the ,treatment of ,furunculosis and ,other ,deep-,seated ,coccogenic ,infections by ,collosol ,manganese40 ,it reports four cases of furunculosis1 each of which cleared up after the intramuscular injection of a few doses of ,collosol ,manganese4 ,the author seems to attribute the cure to the manganese but the evidence is not convincing4 ,even the author admits that1 in the treatment of furunculosis in general 8when at last the dismal procession ends1 this often appears to be less the result of treatment than because the disease has run its natural course40 ,unless much better evidence is in existence1 the preparation must be considered to conflict with ,rule #f1 which requires therapeutic claims to be substantiated4 ,collosol ,argentum3 ,the evidence submitted as to actions consists of a single reprint by ,roe1 which is not convincing1 and this fantastic statement by ,boys3 8,a young girl1 aged #ah1 came to my house with acute inflammation of one eye with an ulcer on the cornea4 ,two drops of ,collosol ,argentum were dropped in the eye at #g p4 m41 and a pad placed over the eye4 ,when she came next morning the eye was quite well2 the ulcer had disappeared1 and there was no inflammation40 ,there is no evidence that this preparation acts as catalyzer and assists the natural resisting bodies of the tissues2 or that these are 8oxygen carriers40 ,unless the claims are supported by better evidence1 they1 in the opinion of the referee1 could not be accepted4 ,there have been submitted to the ,council samples of the following metallic ,collosols3 ,,collosol ,,argentum ,,collosol ,,ferrum ,,collosol ,,arsenicum ,,collosol ,,hydrargyrum ,,collosol ,,cuprum ,,collosol ,,manganese ,also ,collosols of ,iodine and ,sulphur1 and finally ,collosols of ,cocain and ,quinin4 ,of all the above1 except sulphur1 only three small ampules have been submitted4 ,this does not admit of any chemical examination but a statement of the physical appearance may be of interest4 ,collosol ,arsenicum1 #j4b per cent43 ,very turbid with large quantities of a lemon yellow flocculent precipitate4 ,on shaking does not become homogeneous and rapidly separates again4 ,collosol ,argentum1 #a-bjjj3 ,the liquid has a slight opalescence4 ,there is considerable deposit of a heavy black precipitate4 ,does not become homogeneous on shaking and the black substance quickly separates again4 ,collosol ,cuprum1 #j4e per cent43 ,dark red somewhat opalescent liquid4 ,no precipitate4 ,may be colloidal4 ,collosol ,ferrum1 #a-bjjj3 ,liquid clear4 ,large quantities of dark brown flocculent precipitate4 ,the precipitate is not distributed evenly when the mixture is shaken and settles out quickly on standing4 ,collosol ,hydrargyrum1 #e per cent43 ,milky liquid4 ,large quantities of white deposit mixed with considerable black4 ,the deposit mixes fairly well but the greater part settles out after standing an hour or two4 ,collosol ,manganese1 #b4e-ajjj3 ,clear reddish-brown liquid without deposit of any kind4 ,is not opalescent or fluorescent4 ,collosol ,iodin1 #a-ejj3 ,very pale straw colored liquid without deposit4 ,has a slight opalescence4 ,collosol ,sulphur1 #a-ajj3 ,liquid is opalescent4 ,there is some deposit of yellow particles4 ,a four ounce bottle was also submitted4 ,the liquid in this bottle is milky with considerable deposit of yellow crystals like ordinary crystalline sulphur4 ,collosol ,cocain1 #a-ajj3 ,transparent1 colorless liquid with no deposit4 ,chemical examination showed #j4d per cent4 of what may have been cocain4 ,this residue gave alkaloidal tests4 ,collosol ,quinin1 #a-ajj3 ,slightly opalescent1 colorless liquid1 with no deposit4 ,gives alkaloidal reactions4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #g1 #aiai47 ,,pulvoids ,,calcylates ,,compound ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report1 not so much because the preparation with which it deals is of any great importance1 but as a protest against the large number of similar irrational complex mixtures which are still offered to physicians4 ,w4 ,a4 ,puckner1 ,secretary4 ,pulvoids ,calcylates ,compound 7,the ,drug ,products ,co41 ,inc47 are tablets each of which is claimed to contain3 8,calcium and ,strontium ,disalicylate1 #e grs42 ,resin ,guaiac1 #a_/b gr42 ,digitalis1 #a_/d gr42 ,cochium colchicum8 ,seed1 #a_/d gr42 ,squill1 #a_/d gr42 ,cascarin1 #a_/af gr4 with aromatics40 8,pulvoids ,calcylates ,compound 7,sugar coated orange color70 is advertised 7,medical ,times1 ,january1 #aiai7 as being 8,analgesic-,antipyretic and ,diuretic10 and is included in the preparations designated by the advertiser as 8,approved ,remedies for ,la,grippe and #8,flu4'0 ,the claim that 8,their tolerance is remarkable0 refers not to the physicians who tolerate such products1 but to the alleged fact that ,pulvoids ,calcylates are tolerated remarkably well4 ,the advertisement continues3 8,may be given persistently and continuously without gastric disturbances40 8,they are uniformly efficient4 ,more certain in effect than the ordinary ,salicylates40 ,it would be difficult to find an advertisement of equal length containing a greater number of misleading or directly false statements than are found in this one4 ,the ,journal 7,april #bb1 #aiaf1 p4 #acjg7 has called attention to the lack of justification for this absurd mixture of drugs and has discussed the preparation with especial reference to its use in acute rheumatism1 in which the salicylates occupy a special field4 ,the advertisement just quoted mentions ,la ,grippe and 8,flu0 7or ,influenza7 as special fields of usefulness for this preparation4 ,this1 apparently1 is merely an attempt to spread the sail for any breeze4 ,salicylates have a field of usefulness in influenza in that they often afford relief from pain4 ,there is no reason to suppose that a mixture containing calcium and strontium salicylates--the 8,calcium and ,strontium ,disalicylate0 of ,pulvoids ,calcylates is probably a mixture of calcium and strontium salicylate#abg--;has any greater salicylic effect than an equal amount of sodium salicylate4 ,on the other hand1 it is worse than useless to give colchicum1 squill and digitalis for the relief of such pains4 #abg ,see report1 ,the ,journal1 ,sept4 #i1 #aiaf1 p4 #hbg4 ,should cardiac dilatation develop1 and digitalis medication be required it would be impossible to adjust the dose of such a mixture with special reference to the digitalis action1 which alone would be indicated for that condition4 ,no educated physician at present would think of giving resin of guaiac merely because his patient required digitalis1 nor would he administer 8cascarin10 whatever that may be1 in fixed doses1 every time he gave a dose of salicylate4 ,it is impossible to recognize the several effects induced by this therapeutic omneity1 and the medical profession should consider it an insult to be offered mixtures such as ,pulvoids ,calcylates ,compound4 ,pulvoids ,calcylates ,compound is1 per se1 of no great importance2 it is one of a type4 ,it has been selected as one of the utterly irrational and therefore potentially dangerous mixtures1 that may be found by the score or the hundred in the catalogues of practically every pharmaceutical manufacturing firm in the ,united ,states4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #ad1 #aiai47 ,,proteogens ,,of ,,the ,,wm4 ,s4 ,,merrell ,,company ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted and authorized publication of the statement which appears below1 declaring ,proteogen ,no4 #a 7,plantex7 for ,cancer1 ,proteogen ,no4 #b for ,rheumatism1 ,proteogen ,no4 #c for ,tuberculosis1 ,proteogen ,no4 #d for ,hay ,fever and ,bronchial ,asthma1 ,proteogen ,no4 #e for ,dermatoses1 ,proteogen ,no4 #f for ,chlorosis1 ,proteogen ,no4 #g for ,secondary ,anemia1 ,proteogen ,no4 #h for ,pernicious ,anemia1 ,proteogen ,no4 #i for ,goitre1 ,proteogen ,no4 #aj for ,syphilis1 ,proteogen ,no4 #aa for ,gonorrhea1 and ,proteogen ,no4 #ab for ,influenza and ,pneumonia inadmissible to ,new and ,nonofficial ,remedies because their composition is secret2 because the therapeutic claims made for them are unwarranted2 and because the secrecy and complexity of their composition makes the use of these preparations irrational4 ,the ,council took up the consideration of the ,merrell ,proteogens because of inquiries received1 and on ,january #bg invited the ,merrell ,company to aid in the proposed investigation by submitting information in regard to the composition of the preparations1 submitting the current advertising1 and presenting evidence for the claims that were made for the preparations4 ,while the ,merrell ,company agreed to submit the requested information1 this had not been received at the time the report of the referee to whom the products had been assigned 7,referee #a71 was adopted4 ,this report was sent to the company on ,april #d4 ,in reply the ,merrell ,company protested against the conclusions of the report and submitted considerable material in an attempt to support the claims made for the products4 ,this material was examined by the first referee and then transmitted to a second referee 7,referee #b7 for consideration4 ,the second referee concluded that the matter submitted offered no evidence that would justify the ,council in modifying the report first adopted1 and hence recommended that its publication be authorized4 ,in accordance with this recommendation 7report of ,referee #b7 the ,council authorized the publication of the reports of both the first and second referees4 ,w4 ,a4 ,puckner1 ,secretary4 ,report of ,first ,referee on ,proteogens 8,proteogens10 according to the ,william ,s4 ,merrell ,co41 are 8,polyvalent ,proteins of ,non-,toxic ,plant ,origin40 ,the subject of ,proteogens can best be approached by recalling the history of 8,autolysin10 an alleged remedy for cancer1 originated by ,a4 ,s4 ,horowitz1 ,ph4,d4 ,this was exploited some years ago1 and was finally shown to be worthless4 ,proteogens are said to be prepared 8under the personal supervision of the originator1 ,dr4 ,a4 ,s4 ,horowitz40 ,the composition of the different ,proteogens is essentially secret4 ,the assertion was made at one time1 but is not found in the present advertising matter1 that ,plantex--now called 8,proteogen ,no4 #a0--;is similar to ,autolysin4 ,now the ,proteogens are said to be 8prepared by a special process employing various combinations of plants40 ,further3 ,the biologic principles present are chlorophyll1 chromoplast1 lipoids and vitamines2 these are ferments or enzymes4 ,the vegetable acids1 metalloids and metals present in all plants in colloid form act biochemically4 ,among the metalloids are hydrogen1 carbon1 manganese1 oxygen1 sulphur1 phosphorus and chlorine2 the heavy metals are iron1 potassium1 sodium1 magnesium and copper4 ,these biochemic principles are always present in plants as colloids40 ,it is claimed by the ,merrell ,company that3 8,proteogens stimulate the cytogenic mechanism to higher activity2 therefore1 indirectly cleave the invading microorganism and eliminate their special toxins4 ,proteogens swing the disturbed metabolism back to normal and1 by natural processes1 build up effective defenses against recurrent bacterial attacks40 ,proteogen ,no4 #a was first introduced as 8,plantex10 and at that time the ,merrell ,company referred to a preparation that was the result of 8a series of studies0 carried out by a 8noted biologist0 with a view of 8evolving a ,cancer remedy0 that was 8to be autolytic in character10 and announced3 8,the ,house of ,merrell always interested in the progress of plant therapy1 began pharmacological experimentations to reproduce this same substance4 ,the qualitative and quantitative analysis of the substance as used in ,new ,york having been published simplified matters4 ,a somewhat similar remedy has now been prepared4 ,it consists of the following substances--,menyanthes trifoliata ,buckbean1 ,melilotus officinalis ,yellow sweet clover1 ,mentha crispa ,curled mint1 ,brassica alba ,white mustard1 ,anemone hepatica ,liver leaf1 ,viola tricolor ,pansy1 ,anthemis ,roman chamomile1 ,fructus colocynthidis ,colocynth1 ,lignum quassi ,quassia1 ,urtica dioica ,nettle1 ,radix rhei ,rhubarb root1 ,hedge hyssop4 ,these substances are in approximately equal proportions with the exception of the mustard which forms #bj per cent4 of the mixture1 and the colocynth fruit which is #e per cent40 ,with respect also to the other ,proteogens listed above1 study of medical literature revealed no evidence establishing their therapeutic value2 in fact1 no evidence was found other than that appearing in the advertising matter of the manufacturer4 ,the range of diseases in which ,proteogens are recommended is so wide as to make obvious the lack of scientific judgment which characterizes their exploitation4 ,a circular letter1 received ,january1 #aiai1 reminded the physician that about a year ago his attention had been directed to ,proteogen ,no4 #a for cancer1 that later developments enabled the firm to recommend for his consideration 8a series of ,proteogens 7,nos4 #b to #i710 and that now 8,in response to an insistent demand1 ,dr4 ,a4 ,s4 ,horowitz has prepared two new ,proteogens--,no4 #aj for ,syphilis and ,no4 #aa for ,gonorrhea40 ,a postscript to this circular letter announced another preparation1 8,proteogen ,no4 #ab for ,influenza and ,pneumonia10 a 8development out of the present influenza epidemic10 and admitted that 8,it has not had the clinical experimentation that precedes our introduction of a new product40 ,the introduction of ,no4 #ab was effected by means of a special bulletin which consists exclusively of clinical reports from seven physicians1 all from ,chicago save one1 and all purporting to show most favorable results from ,no4 #ab4 ,they describe cases which any physician with experience with influenza can duplicate without any special treatment4 ,it is difficult to give serious consideration to a set of alleged remedies when the only evidence is that furnished by the proponents of the alleged remedies4 ,this is particularly true when the alleged remedy does not make a sufficient appeal to one's sense of the rational in therapeutics to lead one to feel justified in asking a trial at the hands of careful clinical observers4 ,considering the grave nature of the diseases for which ,proteogens are recommended1 particularly cancer1 tuberculosis1 and pernicious anemia1 the want of a rational basis for the method of treatment and the general tenor of the advertising matter1 it appears safe to conclude that these agents do not represent any definite advance in therapeutics4 ,as the use of preparations1 secret in composition1 and of no established value1 is contrary to rational therapy1 it is recommended that the ,proteogen preparations be declared in conflict with ,rules #a1 #f and #aj4 ,report of ,second ,referee ,reviewing ,manufacturers' ,reply ,the report declaring the ,proteogens of the ,william ,s4 ,merrell ,company inadmissible to ,new and ,nonofficial ,remedies was adopted by the ,council1 but before publication it was sent to the ,merrell ,company for such comments as it might desire to make4 ,in due time the reply of the firm was received4 ,it consisted of two volumes bound in limp morocco1 each stamped in gold3 8,report ,proteogen ,therapy ,requested by the ,american ,medical ,association1 #aiai2 ,the ,wm4 ,s4 ,merrell ,company40 ,the first volume contained #gi pages of typewritten material2 the second volume contained #gf pages of typewritten material and a number of advertising booklets put out by the ,wm4 ,s4 ,merrell ,company1 exploiting the ,proteogens4 ,among the typewritten material was a #ad-page report on 8,proteogen ,therapy0 by its originator1 ,a4 ,s4 ,horowitz4 ,following this there are several pages devoted to what is termed 8a short qualitative description of the ingredients of major importance in ,proteogens40 ,then follows a page describing the advertising of ,proteogens1 and the remainder of the two books is devoted to testimonials1 lauding the benefit of ,proteogens in diseases such as cancer1 tuberculosis1 rheumatism1 asthma1 influenza1 enlarged prostate1 rheumatic endocarditis1 syphilis1 eczema1 psoriasis1 diabetes1 secondary anemia1 gonococcic infections1 etc4 ,finally1 there are attached samples of advertising pamphlets4 ,the dissertation by ,a4 ,s4 ,horowitz contains little actual information concerning these substances1 but is concerned principally with discussion of foreign proteins1 8antiferments10 8non-specific proteins10 8anti-virolins0 and speculations on their hypothetical actions and interactions on each other and on the organs of the body and on bacteria4 ,the report contains many questionable statements4 ,one finds in this report but few definite statements of facts which are known to be accurate or which could be accepted without question4 ,the qualitative description of the proteins and their components is as vague as the previous discussion4 ,the differentiation between the various ,proteogens is extremely indefinite2 that for ,tuberculosis1 ,no4 #c is described as 8polyvalent1 non-specific protein which rapidly attacks the acid-fast1 encapsulated tubercle bacilli02 ,proteogen ,no4 #aj for syphilis is said to be a combination of 8non-specific plant proteins and different chemicals which has the power to paralyze and destroy living spirochete40 ,it is stated that ,proteogens are scientific preparations based on standard ingredients and that the standardization is more accurate than in serums1 vaccines or toxins1 etc4 ,the report gives no proof of such statements4 ,the testimonials that are submitted are typical of 8reports0 that manufacturers are able to obtain from some physicians1 to prove the efficacy of almost any preparation in any disease4 ,each consists1 practically1 of the opinion of the individual who has employed the ,proteogens or the opinion of the patient who has been treated4 ,few data are given in these reports from which an impartial conclusion might be drawn4 ,a few of the testimonials presented by the ,william ,s4 ,merrell ,company follow4 ,the valuelessness of such material as scientific evidence is obvious3 ,,rheumatism3--,proteogen ,no4 #b4--,the ,doctor has one case being treated with ,no4 #b4 ,she has improved so rapidly she cannot express her pleasure1 and will continue for some time on the treatments4 ,she is a patient who was confined during the time she suffered from a rheumatic illness1 and it seemed to affect her mental condition4 ,this condition is clearing up also1 very much to the pleasure of both patient and doctor4--,november #bg1 #aiah4 ,,influenza3--,proteogen ,no4 #ab4--;,first day1 temperature #ajb1 gave #a c4c4 ,proteogen ,no4 #ab2 second day1 temperature #ajj1 gave #a c4c4 ,proteogen ,no4 #ab2 third day1 temperature #ih4h1 gave #a c4c4 ,proteogen ,no4 #ab1 and then discharged the case as recovered4--,october #ca1 #aiah4 ,,asthma3--,proteogen ,no4 #d4--,splendid results obtained from a sample of ,proteogen ,no4 #d4 ,three ampoules affected effected8 complete recovery4--,october #i1 #aiah4 ,,cancer3--,proteogen ,no4 #a4--,mrs4 ,b4 pronounced recovered from ,cancer by ,dr4 ,o4 ,w4 ,a41 of ,catlin1 after having injections of ,proteogen ,no4 #a for some time4--,october #d1 #aiah4 ,,eczema3--,proteogen ,no4 #e4--,tried ,no4 #e on a patient with eczema1 and with happy results4 ,have not done anything for him for about five months--and he is now at his business4 ,proteogen ,no4 #e also ,,relieved ,,him ,,of ,,constipation ,,and ,,what ,,he ,,claimed ,a ,,traumatic ,,stricture ,,of ,,the ,,lower ,,portion ,,of ,,sigmoid ,,flexure4 ,he is sure pleased and recommending them to his friends4 7,proteogens74--,february #ag1 #aiai4 ,,syphilis3--,proteogen ,no4 #aj4--;,i am getting such excellent results with the ,no4 #aj ,proteogen for ,syphilis that ,i am badly in need of more1 as ,i am treating so many cases4 ,please send me four dozen ,c4 ,o4 ,d4--,october #i1 #aiah4 ,,enlarged ,,prostate3--,proteogen ,no4 #a4--;,have used ,plantex in four cases1 with good results in each case4 ,one of them his father1 an elderly man4--,april #be1 #aiah4 ,,lobar ,,pneumonia3--,proteogen ,no4 #ab4--,the only case ,i have used ,proteogen ,no4 #ab1 was a man who had ,lobar ,pneumonia of left lung following ,influenza4 ,after crisis came1 patient continued to have slight rise in temperature1 cough1 and after using #aj doses of your ,proteogen ,no4 #ab1 temperature was normal1 cough very much better1 patient began to take on flesh and is still improving4--,december #bf1 #aiah4 ,,tuberculosis3--,proteogen ,no4 #c4--,the ,doctor writes3 ,the ,proteogen ,no4 #c sent me worked wonders in my patient4 ,the case came under my care when he was too far gone for anything to benefit him a great deal1 but the ,proteogen did for him more than anyone could have expected1 yet he died leaving me with a few ampoules to try on the next patient4--,september #bj1 #aiah4 ,,gonorrheal ,,cystitis3--,proteogen ,no4 #aa4--,my patient has taken two boxes of your ,proteogen ,no4 #aa given for gonorrheal cystitis of probably two years' standing and at this writing ,i consider her almost1 if not entirely1 cured which ,i think speaks very highly of your remedy4 ,i expect to use more of your preparations in the future4--,april #ab1 #aiai4 ,this testimonial1 either by clerical error1 or because the results were considered remarkable1 was repeated elsewhere in the material submitted by the ,merrell ,company4 ,,acute ,,gonorrhea3--,proteogen ,no4 #aa4--,mr4 ,a4 ,e4 ,r41 age #fe1 weight #adj pounds4 ,first attack4 ,had had no previous treatment4 ,came to me ,january #b1 #aiai4 ,had discharge1 all acute symptoms1 burning1 etc4 ,gave seventeen injections of ,proteogen ,no4 #aa1 also mild antiseptic urethral wash4 ,discharged on ,february #ae1 #aiai1 clinically cured4--,april #aa1 #aiai4 ,,epithelioma ,,of ,,buttock4--,proteogen ,no4 #a4--;,i used ,proteogen ,no4 #a on an epithelioma of buttock some six months ago with favorable results and no return of symptoms as yet4--,april #ac1 #aiai4 ,it is obvious that the ,proteogen preparations are in conflict with ,rules #a1 #f and #aj1 and should not be admitted to 8,new and ,nonofficial ,remedies40 ,it is recommended that the previous action of the ,council be allowed to stand and that publication of both reports be authorized4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #ab1 #aiai7 8,,arsenoven ,s4 ,s40 ,,and 8,,arseno-,,meth-,,hyd0 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council authorizes publication of the following report4 ,this report declares ,arsenoven ,s4 ,s4 of the ,s4 ,s4 ,products ,company and ,solution of ,arsenic and ,mercury 7formerly called ,arseno-,meth-,hyd7 of the ,new ,york ,intravenous ,laboratory1 inadmissible to ,new and ,nonofficial ,remedies4 ,the ,council takes this opportunity to repeat its warning against the abuses--often dangerous--to which patients are frequently subjected when 8intravenous therapy0 is employed4 ,w4 ,a4 ,puckner1 ,secretary4 ,because of inquiries received1 the ,council took up the consideration of ,arsenoven ,s4 ,s4 and ,arseno-,meth-,hyd 7now sold as ,solution of ,arsenic and ,mercury74 ,the preparations having been referred to a committee for consideration1 this committee reported3 ,,arsenoven ,s4 ,s4 8,arsenoven ,s4 ,s40 is a preparation put out by the ,s4 ,s4 ,products ,company1 ,philadelphia4 ,the claims are made that it is 8a simplified office treatment for syphilis0 and is 8a combination of arsenic and mercury for office use1 offering maximum efficiency1 safety and convenience40 ,according to the company1 8,arsenoven ,s4 ,s40 contains ,dimethylarsenin #ae4d grains1 ,mercury biniodid #a_/aj grain1 ,sodium iodid #a_/b grain4 ,with regard to the identity of 8dimethylarsenin0 the company claims3 8,this product is a compound of cacodylic acid similar to sodium cacodylate but with a more pronounced therapeutic action40 ,the committee recommends to the ,council that 8,arsenoven ,s4 ,s40 be declared inadmissible to ,new and ,nonofficial ,remedies because of unwarranted therapeutic claims4 ,,arseno-,,meth-,,hyd 8,arseno-,meth-,hyd10 is sold by the ,new ,york ,intravenous ,laboratory1 ,new ,york ,city1 for the treatment of syphilis4 ,it comes in three dosages1 #b gm41 #a4e gm41 and #j4g gm41 respectively4 ,the claim is made that 8,arseno-,meth-,hyd #b gm40 contains 8#b gm4 7#ca grains7 of ,sodium ,dimethylarsenate 7,cacodylate71 ,u4 ,s4 ,p44 and ,mercury ,iodid #e mg4 7#a_/ab grain70 in #e c4c4 of solution4 ,physicians are told3 8,in primary and early secondary case administer ,arseno-,meth-,hyd #b gm4 every sixth day and ,mercury ,oxycyanide 4#jjh 7#a_/h grain7 intravenously between each injection40 8,in ,tertiary cases and those of long standing alternate with intravenous injection of ,sodium ,iodid #b gm40 ,the following claims are made for the alleged effectiveness and safety of the cacodylate3 8,this methyl compound of arsenic has come into almost universal use for syphilis4 ,on account of lack of toxicity an aggressive routine can be carried on4 ,the simple technic and absence of reactions make it most desirable for the regular practitioner4 ,this large dose gives more uniform results both as healing manifestations and negative ,wassermann's40 8,much discussion has surrounded the use of ,methyl ,compounds of ,arsenic and it has been demonstrated beyond doubt that ,cacodylate of ,soda proves an effective remedy for syphilis provided that it is properly administered40 sic 8,the low toxicity of this ,methyl compound of arsenic is remarkable4 ,it is contraindicated only where a decided idiosyncrasy for even small doses of arsenic exists40 ,these statements are essentially false and misleading4 ,cacodylate has not come into universal use in the treatment of syphilis1 nor has its usefulness been 8demonstrated beyond doubt40 ,on the contrary1 ,h4 ,n4 ,cole 7,the ,journal1 ,dec4 #cj1 #aiaf1 p4 #bjab7 has shown that doses so large as to produce renal injury were almost totally ineffective against syphilis4 ,obviously1 8effective doses0 if such exist1 are not harmless4 ,the dosage advised for ,arseno-,meth-,hyd may not produce acute toxic symptoms2 nevertheless smaller doses have produced nephritic phenomena4 ,the 8,arseno-,meth-,hyd0 treatment includes the intravenous injection of about #a_/d grain of a mercury salt4 ,although this is less than the usual dose 7about #a grain per week71 the mercury is probably more effective than the cacodylate4 ,the committee recommends to the ,council that1 because of the unwarranted therapeutic claims1 8,arseno-,meth-,hyd0 be held inadmissible to ,new and ,nonofficial ,remedies4 ,the ,council adopted both reports of the committee and declared 8,arsenoven ,s4 ,s40 and 8,solution of ,arsenic and ,mercury0 78,arseno-,meth-,hyd07 inadmissible to ,new and ,nonofficial ,remedies4 ,the committee's reports on these two products impel the ,council again to call attention to the undesirable and dangerous abuses to which 8,intravenous ,therapy0 lends itself4 ,there is a distinct field for the intravenous administration of drugs in those cases in which immediate drug action is necessary1 or when the medicament is likely to be changed if absorbed through the ordinary channels4 ,unless such indications exist1 however1 intravenous administration involves not only inconvenience and expense to the patient1 but what is more important1 unnecessary danger4 ,the fact that indiscriminate intravenous administration is peculiarly profitable to certain manufacturing houses makes it all the more necessary for the medical profession to be on its guard in this matter4 ,in this connection it is well worth while to quote the closing paragraph from an editorial on 8,intravenous ,therapy0 that appeared in ,the ,journal1 ,nov4 #aa1 #aiaf4 ,it is as true today as when it appeared3 8,intravenous therapy will be most securely advanced if its employment is restricted to such well defined fields4 ,as those mentioned above4 ,these fields can be satisfactorily determined only by a scientific pharmacologic study of the action of these drugs when so administered in animals1 as well as in man1 under conditions in which the results are carefully controlled4 ,the intravenous method is an impressive one1 approaching in preparation almost to that which goes with a surgical operation4 ,the patient is usually interested and impressed by this new1 and1 to him1 mysterious method4 ,there is a psychic element in his reaction to the injection which is not a factor in his reaction to the same drug when given by mouth4 ,the intravenous injection of a complex mixture would appear to be particularly reprehensible4 ,little is known1 as has been stated1 of the results to be expected from intravenous therapy1 even with simple substances4 ,the use of complex mixtures will without doubt react against the proper use of the method40 ,after the report on ,arseno-,meth-,hyd had been presented to the ,council1 a letter was received from the ,new ,york ,intravenous ,laboratory announcing that the preparation 8,arseno-,meth-,hyd0 was now called 8,solution of ,arsenic and ,mercury0 and expressing a desire to have its products accepted for inclusion in ,new and ,nonofficial ,remedies4 ,in view of this letter1 the committee's report on 8,arseno-,meth-,hyd0 and the ,council's protest against promiscuous intravenous therapy were sent the ,new ,york ,intravenous ,laboratory for consideration4 ,the reply of the ,new ,york ,intravenous ,laboratory contained nothing which permitted a revision of the preceding report4 ,the change of the name of 8,arseno-,meth-,hyd0 to 8,solution of ,arsenic and ,mercury0 means little as the name still does not disclose the important fact that the arsenic is present as sodium cacodylate1 nor does it tell the character of the mercury compound4 ,the ,council voted that 8,solution of ,arsenic and ,mercury0 and 8,arsenoven ,s4 ,s40 be declared inadmissible to ,new and ,nonofficial ,remedies because the therapeutic claims advanced for them are unwarranted 7,rule #f7 and because the names of these pharmaceutical preparations are not descriptive of their composition 7,rule #h74 ,in filing its reply with the ,council1 the ,new ,york ,intravenous ,laboratory announced that that document would be circulated to the medical profession4 ,this is of course the firm's privilege4 ,the ,council notes1 however1 with interest1 that the reply is devoted almost entirely to points which were not raised by the ,council and that it fails to discuss the objections which were actually made4 ,the reply constantly confuses the efficiency of cacodylate in anemia and in syphilis4 ,the ,council's report on 8,arseno-,meth-,hyd0 does not discuss or even touch on the question of cacodylates in anemia4 ,it is confined to a discussion of the disappointing results obtained with cacodylates as such 7i4 e41 without mercury7 in the treatment of syphilis4 ,this attempt on the part of the ,new ,york ,intravenous ,laboratory to confuse the issue and to attribute to the ,council an opinion that it has never stated or held is an inexcusable misrepresentation4 ,the company in its reply said3 8,we believe that you have previously stated that a solution cacodylate of soda possesses no more action than so much water4 ,in other words1 it was inert4 ,now you try to show that it produces renal injury40 ,the ,council has never declared that cacodylates are inert4 ,in the report it is merely stated 8that doses so large as to produce renal injury were almost totally ineffective against syphilis40 ,neither has the ,council stated that cacodylate is 8peculiarly dangerous40 ,in fact the absolute toxicity of cacodylates is low but ,cole's results were quoted as a caution that 8effective0 doses are not harmless4 ,a great portion of the remainder of the reply is devoted to disparaging arsphenamin--a product that is not involved in this action of the ,council1 and one about which the physician is amply informed4 ,amongst other wholly extraneous matters1 the firm's 8reply0 tried to resurrect the pepsin pancreatin controversy4 ,this also has nothing to do with the efficiency or harmlessness of sodium cacodylate4 ,in order to dispose of the matter1 however1 it may be pointed out that the implications are entirely misleading4 ,the work which is quoted against the ,council was undertaken by the ,council itself1 to clarify obscurities in the older data4 ,the outcome of these new investigations showed the essential correctness of the deductions from the older work1 namely1 that pancreatin is destroyed by pepsin-hydrochloric acid4 ,dr4 ,long's work to which the firm's reply evidently refers1 showed that under favorable conditions1 namely1 when protected by an excess of protein1 some trypsin may escape destruction in the stomach2 but it fully confirmed the original conclusion that pepsin and pancreatin mixtures as ordinarily administered are practically worthless 7,j4 ,h4 ,long1 ,jour4 ,amer4 ,pharmaco4 ,assoc41 ,sept4 #ai1 #aiag74 ,as regards the editorial on intravenous therapy1 a concession may be made the ,new ,york ,intravenous ,laboratory3 intravenous injections are no longer quite as 8impressive0 as in #aiaf1 but that does not alter the fact that they should be used only when a distinct advantage is to be gained4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #b1 #aiai7 ,,hormotone ,,and ,,hormotone ,,without ,,post-,,pituitary ,report of the ,council on ,pharmacy and ,chemistry4 8,hormotone10 of the ,g4 ,w4 ,carnrick ,company1 is advertised as 8,a pluriglandular tonic for asthenic conditions40 8,hormotone ,without ,post-,pituitary0 is recommended for use 8in neurasthenic conditions associated with high blood pressure40 ,these preparations are sold in the form of tablets for oral administration4 ,the ,council declares these preparations inadmissible to ,new and ,nonofficial ,remedies because3 7#a7 ,their composition is semisecret 7,rule #a72 7#b7 the therapeutic claims are unwarranted 7,rule #f72 7#c7 they are sold under names not descriptive of their composition but suggestive of indiscriminate use as 8tonics0 7,rule #h72 7#d7 in the light of our present knowledge the routine administration of polyglandular mixtures is irrational 7,rule #aj74 ,in explanation of this action1 the ,council authorized publication of the report which appears below4 ,w4 ,a4 ,puckner1 ,secretary4 ,each tablet of 8,hormotone0 7,g4 ,w4 ,carnrick ,co41 ,new ,york ,city7 is said to contain #a_/aj grain of desiccated thyroid and #a_/bj grain of entire pituitary1 together with the hormones of the ovary and testes--the amounts and the form in which the latter are supposed to be present are not given4 ,from this it will be seen that the only definite information given to the medical profession regarding the composition of ,hormotone is that it is a weak thyroid and a still weaker pituitary preparation4 ,what results can be anticipated from one or two tablets three times daily 7the recommended dose of ,hormotone7 each containing #a_/aj grain of thyroid and #a_/bj grain entire pituitary8 ,such doses of thyroid may1 of course1 have a beneficial action in a limited number of cases of myxedema and cretinism4 ,an extract of the posterior lobe of the pituitary 7,liquor ,hypophysis1 ,u4 ,s4 ,p41 for example7 will1 when injected subcutaneously or intramuscularly1 have a pronounced effect on the parturient uterus2 its action on certain other forms of smooth muscle will be much less certain4 ,but the oral administration 7for which ,hormotone is recommended7 of the posterior lobe of the pituitary has not been shown to have any such effect4 ,the use of the anterior lobe in doses of #a to #d grains 7doses very many times larger than those recommended for the entire gland in ,hormotone7 is in the experimental stage and its only probable value seems to be in those cases of known gland deficiency4 ,as to the other alleged ingredients of ,hormotone--hormones of the ovary and testes1 amounts not stated3 all physicians know the uncertainties attending the use of ovarian preparations and the serious question as to whether testicular extracts have any therapeutic value4 ,whatever may be the physicians views as to the probable therapeutic value of these organs1 the first thing he desires to know is how much of the substance he is giving and from what part of the gland it is obtained4 ,so much for the facts2 yet the physician is asked to jump from this region of solid fact into a sea of hypothesis2 to believe that small amounts of the well-known drugs thyroid and pituitary1 plus an unknown amount of unknown hormones of the testes and ovary are of great value in conditions that in themselves are often purely hypothetical4 ,he is asked to believe that this combination has virtues in such conditions as 8hypofunction of the adrenal system10 neurasthenia1 the 8fatigue syndrome10 amenorrhea1 dysmenorrhea1 8natural and artificial menopause10 sexual neuroses1 cold extremities1 cardiac asthenia1 low blood pressure1 infantilism1 sterility1 melancholic conditions1 obesity1 anorexia1 anemia1 slow metabolism1 constipation1 psychasthenia1 lowered virility and the sexual neuroses of the unmarried1 hysteria following functional exhaustion of the nerve centers1 frigidity1 etc41 etc41 especially if he guesses that the trouble is due to a 8pluriglandular disturbance10 8glandular hypofunction10 an 8adreno-pituitary deficiency10 suboxidation1 etc4 ,the physician is invited to use ,hormotone because1 among other reasons1 each alleged constituent is said to be 8in physiologic sympathy and therapeutic harmony with the others10 and further1 because3 8,pluriglandular therapy has the endorsement of high authorities1 is both logical and effective and ,hormotone is a splendid example of it4 ,it will be seen at its best where the patient lacks snap and vim and vigor4 ,asthenic conditions necessarily indicate hypofunction of the adrenal system 4440 etc4 8,the use of gland extracts in the treatment of aplasias of the pluriglandular system has become an established therapeutic measure of miraculous potency 7,bayard ,holmes3 ,the ,internal ,secretory ,glands1 ,lancet-,clinic1 ,sept4 #ai1 #aiad740 ,the ,g4 ,w4 ,carnrick ,company also advertises a 8,hormotone ,without ,post-,pituitary10 each tablet of which is said to contain #a_/aj grain desiccated thyroid1 and to 8present0 8hormone bearing extracts of thyroid1 anterior pituitary1 ovary1 and testes40 ,this product is just as irrational as 8,hormotone40--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #af1 #aiai7 ,,formaldehyde ,,lozenges ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has voted ,hex-,iodin 7,daggett and ,miller ,co41 ,inc41 ,providence1 ,r4 ,i471 ,formitol ,tablets 7,e4 ,l4 ,patch ,co41 ,boston71 and ,cin-,u-,form ,lozenges 7,mc,kesson and ,robbins1 ,new ,york ,city7 inadmissible to ,new and ,nonofficial ,remedies1 and authorized publication of the report which appears below4 ,w4 ,a4 ,puckner1 ,secretary4 ,some years ago1 the ,council published 7,the ,journal ,a4 ,m4 ,a41 ,aug4 #bh1 #aiae1 p4 #haf7 a report on ,formamint1 a proprietary medicine widely exploited as a peculiar chemical compound of sugar of milk and formaldehyde4 ,the formaldehyde was said to be liberated slowly by the action of the saliva1 and because of this liberation of formaldehyde1 ,formamint was claimed to be a powerful germicide4 ,extravagant claims were made for its curative and prophylactic effects4 ,the ,council found that the therapeutic claims were grossly unwarranted and that its exploitation to the public was a public danger4 ,during the recent epidemic of influenza1 a variety of tablets or lozenges were advertised1 and are still being advertised1 having formaldehyde1 in some form or other1 as the nucleus around which revolve the therapeutic claims4 ,in some cases1 the advertising clearly indicates the character of the formaldehyde compound that is claimed to be present2 in others the statements are vague and indefinite or misleading4 ,it is hardly necessary to remind physicians that the use of tablets containing hexamethylenamin or other formaldehyde compounds can neither cure respiratory infections1 nor even confer protection against such infections4 ,to be effective1 formaldehyde would need to be supplied to the entire respiratory tract continuously for some time or else in concentrations that would be distinctly irritant and damaging to the tissues4 ,saliva-dissolved tablets1 obviously cannot reach the nasal or tracheal mucosae directly2 and the application of quickly acting concentrations of formaldehyde is out of the question4 ,this altogether aside from the fact that hexamethylenamin1 the basis of some of these tablets1 does not liberate formaldehyde in the mouth1 and for this reason alone would be quite useless for this purpose6 7,see ,hanzlik and ,collins1 ,archives of ,internal ,medicine1 ,november1 #aiac47 ,an inefficient antiseptic is more than merely useless2 it is a menace to public safety1 in that it tends to lead to the neglect of rational and effective protective measures4 ,it therefore seems advisable for the ,council again to call the attention of physicians to the subject4 ,accordingly1 three specimens of these products were purchased and examined in the ,association's ,chemical ,laboratory4 ,hex-,iodin ,hex-,iodin 7,hexamethylenetetramine and ,iodum7 ,lozenges are manufactured by ,daggett and ,miller ,company1 ,inc41 ,providence1 ,r4 ,i4 ,they weigh #ae-a_/b grs4 each1 are sweetened and are flavored with mint or menthol4 ,the package and circulars do not contain a definite statement of composition4 ,the rather indefinite synonyms 8,hexameth4 and ,iodine ,comp40 and 8,hexamethylenetetramine and ,iodum0 suggest that the lozenges contain hexamethylenamin and free iodin4 ,the further statement that they 8contain the combined medicinal antiseptic and prophylactic properties of ,hexamethylenetetramine and ,iodum0 is also rather indefinite4 ,the therapeutic action claimed for the lozenges1 however1 could only be produced by free iodin and by liberated formaldehyde4 ,it is unnecessary to discuss in detail the extravagant claims made for these lozenges4 ,the inefficiency of hexamethylenamin has already been referred to2 the limitations of iodin1 free or combined1 in lozenge form1 need not be discussed because the examination made in the ,a4 ,m4 ,a4 ,chemical ,laboratory showed that ,hex-,iodin lozenges contained no free iodin1 and only traces of combined iodin4 ,neither formaldehyde nor paraformaldehyde was present2 hexamethylenamin was present but1 the lozenges being neutral no formaldehyde is generated in contact with water or with the alkaline saliva4 ,thus ,hex-,iodin is shown to be worthless for the purpose for which it is advertised4 ,of the two important ingredients said to be present1 iodin and hexamethylenamin1 only traces could be found of the former while the latter1 as has been shown1 is incapable of exerting any effect when used as the manufacturers direct4 ,formitol ,tablets ,these tablets are prepared by the ,e4 ,l4 ,patch ,co41 ,boston4 ,each tablet weighs #ac-a_/b grs4 ,they have the odor of thymol or menthol and an acid taste and reaction4 ,they are1 according to the label3 8,for the throat and mouth4 ,soothing1 ,astringent1 ,antiseptic4 ,rapidly destroys germs of infection1 preventing and relieving sore throat and mouth40 ,in a circular1 it is stated1 that one of the qualities of ,formitol3 8444 is the generation of formaldehyde when in contact with water or the saliva40 8,besides generating formaldehyde1 ,formitol1 ,patch contains astringent1 demulcent and soothing ingredients which render the combination unusually effective40 ,a bacteriologic report is given in this circular in which it is stated that1 in #b-a_/b minutes one ,formitol ,tablet rendered sterile a plate culture of a 8characteristic throat micrococci40 ,the instructions are to dissolve a tablet in the mouth1 slowly1 once an hour or a half-tablet every half hour4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reported that ,formitol ,tablets contained formaldehyde 7or paraformaldehyde71 and ammonium compound1 and some hexamethylenamin4 ,it is probable that the formaldehyde 7or paraformaldehyde7 was produced by the decomposition of hexamethylenamin originally present in the tablets but decomposed by long contact with the acid4#abh #abh ,the ,e4 ,l4 ,patch ,company declares that 8no hexamethylenamine has ever been used in the manufacture of ,formitol tablets10 and that ammonium chloride and paraformaldehyde are among the ingredients used in the manufacture of these tablets4 ,the hexamethylenamine present in the tablets1 therefore1 must have been produced by interaction of the paraformaldehyde and ammonium chloride4 ,this does not alter the laboratory findings regarding the composition of the tablets1 namely1 that they 8contain formaldehyde 7or paraformaldehyde71 an ammonium compound and some hexamethylenamine40 ,these tablets differ from ,hex-,iodin in that they really contain active formaldehyde and1 therefore1 possibly produce antiseptic effect in test-tube cultures4 ,the conditions in the mouth1 however1 are very different from those in the test-tube1 since in the mouth the formaldehyde would be immediately 8bound0 or absorbed4 ,the claimed absence of irritation indicates sufficiently the absence of efficient quantities of formaldehyde under clinical conditions4 ,cin-,u-,form ,lozenges ,cin-,u-,form ,lozenges1 manufactured by ,mc,kesson and ,robbins1 ,new ,york ,city1 are marketed in bottles of #bd for #be cents4 ,they have a strong odor of cinnamon1 weigh #ae-a_/b grs4 each1 and are acid in taste and reaction4 ,the label states that they contain3 8,cinnamon1 ,eucalyptus1 ,formaldehyde and ,menthol--all powerful germicides against ,influenzal bacilli1 but not injurious to the system in this palatable form40 ,a circular contains the same statement as to composition and claims further that they3 8444 help to prevent the infection of ,spanish ,influenza1 ,pneumonia1 ,grip ,colds and to guard against ,sore ,throat1 ,tonsillitis1 ,pharyngitis1 etc40 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reported that ,cin-,u-,form ,lozenges contained some formaldehyde 7or paraformaldehyde7 and no hexamethylenamin4 ,it is obvious that the mouth and throat cannot be 8disinfected0 by these lozenges4 ,they would be totally ineffective against bacteria that enter through the nose2 they cannot prevent influenza1 pneumonia1 etc4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #d1 #aiai7 ,,lavoris ,report of the ,council on ,pharmacy and ,chemistry ,lavoris was considered by the ,council in #aiac1 and its proprietors--the ,lavoris ,chemical ,company--were advised that the preparation was inadmissible to ,new and ,nonofficial ,remedies because of conflict with ,rules #a1 #d1 #f1 #h and #aj4 ,no report was published at that time4 ,as the preparation is still widely advertised to physicians1 the ,council has again examined ,lavoris and authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,in recent years ,lavoris has been widely advertised as 8,,the ,,ideal ,,oral ,,antiseptic10 particularly to the dental profession4 ,a printed card sent out by the ,lavoris ,chemical ,company in #aiac read3 8,,lavoris1 the ,pyorrhea ,remedy4 ,the ,original ,,zinc ,,chloride ,mouth ,wash4 ,one grain zinc to each ounce40 ,the card also gave a 8formula0 to the effect that each pint of ,lavoris contained3 ,zinc ,chloride #a4jdj ,resorcin #j4ebj ,menthol #j4djj ,saccharin #j4aie ,formalin #j4aie ,ol4 ,cassia ,zeyl #j4ghj ,ol4 ,caryophyl #j4aie ,advertisements now appearing in medical journals repeat the older 8formula0 except that resorcin is omitted4 ,the formula while seemingly frank and open is in reality indefinite and misleading in that no denomination of weight is given for the various constituents4 ,it is uncertain1 for example1 if the figures in the formula are intended to represent grains1 grams or percentages of the several constituents4 ,in view of the indefinite statement of composition1 a chemical examination of ,lavoris was undertaken in the ,a4 ,m4 ,a4 ,chemical ,laboratory4 ,the report of the laboratory follows3 ,zinc4--,this was determined electrolytically4 ,fifty c4c4 gave #j4jbf gm4 zinc and #ajj c4c4 gave #j4jeca gm4 zinc4 ,the average is #j4jebf gm4 zinc in #ajj c4c4 ,this is equivalent to #j4aajb gm4 anhydrous zinc chlorid in #ajj c4c4 ,chlorid4--,after decolorizing some of ,lavoris with chlorid-free animal charcoal1 the chlorid was determined by the ,volhard method4 ,twenty-five c4c4 ,lavoris required #d4cbh c4c4 tenth-normal silver nitrate solution equivalent to #j4jaece gm4 chlorid 7chloridion7 or #j4jfad gm4 in #ajj c4c4 ,a second #be c4c4 of ,lavoris required #d4aab gm4 tenth-normal silver nitrate solution equivalent to #j4jadeh gm4 chlorid 7chloridion7 or #j4jehcb gm4 in #ajj c4c4 ,average is #j4jeihe gm4 ,this is equivalent to #j4aaej gm4 zinc chlorid in #ajj c4c4 ,this agrees closely with the foregoing zinc determination4 ,resorcin4--,the method of the ,u4 ,s4 ,pharmacopeia was used4 ,the total bromin absorption of #be c4c4 ,lavoris was #c4fh c4c4 tenth-normal bromin solution4 ,this would be equivalent to #j4jjfge gm4 resorcin in #be c4c4 or #j4jbgjj gm4 in #ajj c4c4 ,in a duplicate test1 #be c4c4 ,lavoris required #c4h c4c4 tenth-normal bromin solution equivalent to #j4jjfig gm4 resorcin or #j4jbghh gm4 in #ajj c4c4 ,since oil of cinnamon absorbs bromin1 #ej c4c4 of ,lavoris was boiled until very little or no odor of the oil was noted1 keeping the volume nearly constant by adding a little water from time to time1 and the bromin absorption then taken4 ,in one experiment1 #j4cf c4c4 of tenth-normal bromin solution was consumed1 and in a duplicate no bromin was absorbed4 ,this shows the absence of resorcin4 ,residue4--,on evaporating #be c4c4 ,lavoris on a steam bath and subsequent drying of the residue at #ajj ,c41 #j4jdee gm4 of residue was obtained4 ,this is equivalent to #j4ahbj gm4 in #ajj c4c4 ,saccharin4--,saccharin was detected in the residue and ether-extract of the residue by its intense sweet taste when a little sodium bicarbonate was added to it4 ,formaldehyd4--,this could be detected by the ,jarrison test4 ,the color was not very pronounced and the quantity of formaldehyd was small4 ,oil of ,cinnamon4--,the odor and taste of ,lavoris is characteristic of cinnamon4 ,menthol and ,oil of ,cloves4--,the odor of menthol and of oil of cloves could not be detected1 but no tests were made to demonstrate their presence4 ,the analysis thus indicates that the ,lavoris of today contains no resorcin but does contain a small amount of formaldehyd1 a little saccharin1 and oil of cinnamon 7menthol and oil of cloves could not be detected by the odor1 but were not tested for74 ,the analysis showed that the principal constituent of ,lavoris is zinc chlorid1 of which there is about #j4a gm4 per #ajj c4c4 7about #a_/b grain to the ounce74 ,the amount of zinc chlorid given in the published formula1 i4 e41 #a4jd1 is meaningless because the unit of weight or measure is not given2 furthermore1 the analysis shows that it is inaccurate for any unit of weight that might be assumed from the published figures4 ,since the amount of the most active medicinal ingredient is both indefinite and inaccurate1 the composition of the preparation is essentially secret4 ,lavoris is indirectly advertised to the public by having included in the package a circular giving a list of diseases for which the preparation was recommended4 ,the combination of zinc chlorid1 formaldehyd and oil of cinnamon 7assuming the menthol and oil of cloves to be present as flavors7 in a mixture is irrational and likely to lead its users to ascribe a false and exaggerated value to the preparation4 ,the name is objectionable in that it does not indicate the composition of the potent ingredients of the mixture1 but instead suggests its use as a mouth wash4 ,from a standpoint of public safety1 the most serious objection to ,lavoris1 however1 lies in the many unwarranted therapeutic claims and suggestions4 ,it is generally held that zinc chlorid solutions which possess a strength of from #a to #bjj up to #a to #ejj exercise a weak antiseptic action4 ,the strength of zinc chlorid in ,lavoris is approximately #a to #a1jjj4 ,the directions for its use recommend that ,lavoris should be diluted4 ,a dilution of #a to #d is recommended for a variety of mouth conditions while for cystitis irrigations and as a vaginal douche1 it is recommended that one tablespoonful be added to a quart of warm water or salt solution4 ,the strength of zinc chlorid in the last suggested dilution would approximate #a to #fd1jjj4 ,it is evident that no antiseptic action could be expected from such dilutions4 ,the recommendation that diluted ,lavoris be used for the treatment of coryza1 nasal catarrh1 hay fever1 inflamed eyes1 hemorrhoids and leucorrhea is objectionable and irrational4 ,especially dangerous is the recommendation that members of a family exposed to diphtheria or scarlet fever should use ,lavoris freely as a preventive4 ,such recommendations can but give a false sense of security and lead to the neglect of proved methods for preventing the spread of these diseases4 ,equally unwarranted is the recommendation that in gonorrhea one teaspoonful of ,lavoris to eight of warm water be used with a blunt end syringe4 ,the use of ,lavoris as recommended would not only prove valueless in many instances but might lead to serious consequences because really valuable methods of prevention or treatment might be neglected4 ,for these reasons the preparation is in conflict with ,rule #f4 ,the ,council declared ,lavoris ineligible for ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #a1 #aiai7 ,,medinal ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report on ,medinal 7,schering and ,glatz1 ,inc474 ,w4 ,a4 ,puckner1 ,secretary4 ,medinal is a proprietary name applied to barbital sodium 7sodium diethylbarbiturate7 the sodium salt of barbital 7diethylbarbituric acid74 ,the latter was first introduced as ,veronal4 ,medinal was deleted from ,new and ,nonofficial ,remedies in #aiaf because the advertising issued by ,schering and ,glatz 7who then acted as agents for ,chemische ,fabrik auf ,actien vorm4 ,e4 ,schering1 the ,german manufacturer7 contained misleading and unwarranted therapeutic claims4 ,the ,council did not publish its report because by the time the report was ready for publication the product was practically off the ,american market1 and it was hoped that when ,medinal again became available1 ,schering and ,glatz would revise the claims and thus permit its reacceptance4 ,medinal1 said to be manufactured in the ,united ,states1 is now marketed by ,schering and ,glatz1 ,inc4 ,in ,october1 #aiah1 the firm sent to the ,council a typewritten copy of a proposed circular for ,medinal4 ,the firm was informed that this leaflet was subject to the objections that had been raised when ,medinal was deleted from ,new and ,nonofficial ,remedies4 ,in ,april1 #aiai1 the firm submitted a printed circular which it was sending out4 ,this contained numerous misleading statements1 among them1 these3 8,,medinal removes its ,diethylbarbituric acid one objectionable feature--insufficient solubility--and thus fulfills the three prerequisites of a truly rational hypnotic3 ,quick absorption1 insuring prompt action1 rapid and complete excretion1 affording protection from cumulative toxic after effects1 and the choice of rectal and subcutaneous administration40 ,there is no justification for the claim that diethylbarbituric acid 7barbital7 has only one objectionable feature and that a minor matter of 8insufficient solubility40 ,the ,council has called the attention of ,schering and ,glatz1 ,inc41 to the fact that the difference in the time of absorption between ,medinal 7barbital sodium7 and barbital is1 at the most1 but one of minutes and that there is no evidence that ,medinal is excreted more rapidly than barbital4 ,hence the claims that the danger of toxic side-actions and that cumulative after-effects are avoided in this product1 are wholly unwarranted4 ,it is also claimed1 and the claim is unsupported by satisfactory evidence1 that ,medinal is useful in the insomnia of tuberculosis in which condition it is said to have a double advantage owing to its favorable effects on the night-sweats4 ,it is claimed that ,medinal is used in the withdrawal treatment of morphin addiction with great success2 there is no evidence that ,medinal has any special usefulness in this treatment of the morphin habit4 ,it is claimed further that success has been reported with ,medinal in the treatment of whooping cough4 ,the ,council knows of no satisfactory evidence to show that ,medinal is of special value in whooping cough2 on the contrary1 it is capable of doing a great deal of harm4 ,the recommendations that ,medinal be used for the control of labor pains and in acute neuralgic pains that resist other forms of treatment are wholly unwarranted as the value of the drug in such conditions is inherently improbable and until satisfactory evidence in support of them is forthcoming1 must be deemed misleading4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ae1 #aiai7 ,,omission ,,of ,,cotarnin ,,salts 7,,stypticin ,,and ,,styptol7 ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,salts of the base cotarnin have been used as local and systemic hemostatics4 ,the hydrochlorid was first introduced as 8,stypticin10 and is now in the pharmacopeia as cotarnin hydrochlorid 7,cotarninae ,hydrochloridum1 ,u4 ,s4 ,p474 ,the phthallic acid salt of cotarnin--cotarnin phthallate--was introduced as 8,styptol40 ,both ,stypticin and ,styptol were admitted to ,new and ,nonofficial ,remedies4 ,in #aiah the ,council voted to omit ,stypticin because the former ,american agents were no longer offering it for sale4 ,styptol was retained and is described in ,n4 ,n4 ,r41 #aiai4 ,as was pointed out in the description 7,n4 ,n4 ,r41 #aiah71 the evidence for the usefulness of the cotarnin salts has been contradictory and unsatisfactory2 but since the available data against the efficiency were at least equally unreliable1 the ,council deemed it best to retain them in ,n4 ,n4 ,r4 pending a thorough investigation of the subject4 ,this was undertaken by ,p4 ,j4 ,hanzlik1 at the suggestion of the ,therapeutic ,research ,committee of the ,council4 ,a reliable judgment of hemostatic efficiency can be formed only on a basis of strictly controlled conditions1 which can best be furnished in the laboratory4 ,hanzlik repeated the principal experiments published by previous investigators1 and applied a number of new or improved methods4 ,the results 7published in the ,journal of ,pharmacology and ,experimental ,therapeutics #aj3ebc1 #aiah2 #ab3ga1 #aiai7 show the following3 ,direct ,application to ,wounds4--,the widely quoted results of the gynecologist ,k4 ,abel1 on the footpad of cats1 were found to be quite unreliable4 ,when the experiment is properly controlled1 the results are either negative or the bleeding may be increased4 ,quantitative experiments on wounds of the footpad of dogs showed that cotarnin invariably increased the bleeding4 ,equally negative or unfavorable results were obtained with wounds to the comb of roosters1 and to the liver and spleen4 ,direct ,action on ,vessels4--,the results of perfusion experiments were variable1 but1 in general1 showed a vasodilation action instead of constriction4 ,this holds true also of the uterine vessels4 ,the vessels in the living animal 7rabbit's ear7 were also unaffected4 ,systemic ,administration4--,the bleeding from an irrigated wound was not modified directly by intravenous injection of cotarnin salts1 but varied merely with the state of the blood pressure4 ,the evidence for the inefficiency of cotarnin salts as hemostatics seemed so conclusive as to warrant the ,council in rescinding the acceptance of ,styptol1 and directing the omission of the general article on cotarnin salts and the description of ,styptol from ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bb1 #aiai7 ,,micajah',s ,,wafers ,,and ,,micajah',s ,,suppositories ,report of the ,council on ,pharmacy and ,chemistry 8,micajah's ,medicated ,wafers0 and 8,micajah's ,suppositories10 sold by ,micajah ,co41 ,warren1 ,pa41 are declared inadmissible to 8,new and ,nonofficial ,remedies0 because 7#a7 their composition is essentially secret 7,rule #a72 7#b7 name of neither of these mixtures is indicative of its composition 7,rule #h72 7#c7 of exaggerated and unwarranted therapeutic claims 7,rule #f71 and 7#d7 the therapeutic advice which accompanies the trade packages constitutes an indirect advertisement to the public 7,rule #d74 ,w4 ,a4 ,puckner1 ,secretary4 ,micajah's ,medicated ,wafers 7formerly called 8,micajah's ,medicated ,uterine ,wafers07 were analyzed in the ,a4 ,m4 ,a4 ,chemical ,laboratory in #aiaj4 ,they were found to consist essentially of dried 78burnt07 alum1 boric acid and borax1 in approximately the following proportions3 ,alum1 dried #ei4hf per cent4 ,borax1 dried #ae4fb per cent4 ,boric acid #e4fg per cent4 ,water of hydration #ah4he per cent4 ,there are a number of drugs that are more or less effective in the treatment of local lesions of mucous membranes and the skin4 ,they are classed as astringents4 ,among these are included alum1 borax and boric acid4 ,every physician has used them4 ,to say that a wafer consists of alum1 borax and boric acid inspires but little awe4 ,but there is something much more mysterious and impressive in declaring that a wafer 8consists of an astringent and antiseptic base1 in which are incorporated certain medicaments which both locally and after absorption1 contribute to the astringent1 antiphlogistic1 depletive1 soothing and healing action of the product40 ,this gives the impression that some powerful and almost incomprehensible factors are at work4 ,yet1 after all is said and done1 the substances contained in ,micajah's ,medicated ,wafers are just the homely old alum1 boric acid and borax4 ,in addition to 8,micajah's ,medicated ,wafers10 ,micajah ,co4 also put out 8,micajah's ,suppositories for ,hemorrhoids40 ,these have been examined in the ,a4 ,m4 ,a4 ,chemical ,laboratory and1 like the 8,medicated ,wafers0 have been found to contain alum1 boric acid and borax--and these substances practically alone--incorporated in cocoa butter4 ,the company claims that 8to these have been added ,ammonii ,ichthyosulphonate1 ,balsam of ,peru1 ,ext4 ,belladonae40 ,the ,a4 ,m4 ,a4 chemists report1 however1 that if extract of belladonna is present at all it is in amounts too small to be detected by the method commonly employed in the chemical examination of alkaloidal drugs4 ,the chemists report further that while ammonium ichthyosulphonate and balsam of ,peru both have a decided odor and are dark in color1 the suppositories have but little color and the odor of the cocoa butter that forms their base is not covered by these drugs2 obviously1 therefore1 if ammonium ichthyosulphonate and balsam of ,peru are present at all it is in amounts utterly insufficient to exert any therapeutic effect4 ,it would be hard to find better examples of mischievous proprietary medicines than these two products of the ,micajah ,company4 8,twins of ,efficiency10 they are called in an advertising pamphlet4 ,the composition is not stated4 ,a physician using the 8twins0 does so absolutely in the dark4 ,to him they are secret preparations4 ,he is encouraged to use them in a great variety of conditions in which other drugs are much more useful4 ,inevitably1 physicians using them will be likely to overlook1 or pass over1 new growths1 specific infections and diseases that require radical remedial measures4 ,in addition to misleading and exaggerated claims1 there is a reference to a report from the usual 8well-known and reliable bacteriological laboratory40 ,the excerpts published from this report of an unnamed laboratory are sufficiently vague to incriminate no one4 ,from time to time it is worth while to emphasize facts regarding proprietary medicines that while obvious are sometimes forgotten4 ,for this reason attention is directed to ,micajah's ,uterine ,wafers and ,micajah's ,suppositories4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bi1 #aiai7 ,,alkalithia ,report of the ,council on ,pharmacy and ,chemistry ,alkalithia was introduced at a time when it was believed that the administration of lithium salts served to remove uric acid from the system4 ,the product was considered by the ,council in #aijf1 and found ineligible for ,new and ,nonofficial ,remedies4 ,no report1 however1 was published at that time4 ,because of inquiries received1 the ,council examined the current claims for ,alkalithia1 and authorized publication of the report which appears below4 ,w4 ,a4 ,puckner1 ,secretary4 ,keasbey and ,mattison ,company's ,effervescent ,alkalithia is sold with the following statement of composition3 8,each dose or heaping teaspoonful contains #a grain of ,caffeine1 #aj grains each of ,bi-carbonates of soda and potash1 and #e grains of ,carbonate of ,lithia40 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reports that ,alkalithia is an effervescent mixture which contains alkaline carbonates and bicarbonates together with caffein1 free tartaric acid and free citric acid4 ,the major portion of the alkali carbonates and bicarbonates is converted into citrates and tartrates when the preparation is dissolved in water--as is done before it is taken4 ,an excess of alkali is present1 however1 as the solution has an alkaline reaction4 ,each 8heaping teaspoonful0 7which was found to be about #d4he ,gm47 contains about #j4jdd ,gm4 of caffein 7the manufacturers claim #j4jfdh ,gm4 per heaping teaspoonful74 ,as taken1 ,alkalithia1 therefore1 represents caffein in a solution of alkali tartrate1 citrate and bicarbonate containing free carbonic acid4 ,if it is assumed that all of the tartrate and citrate in ,alkalithia is converted into carbonate in the organism1 a 8heaping teaspoonful0 of ,alkalithia would represent about #b4i ,gm4 of sodium bicarbonate4 ,this assumption is1 however1 not correct1 for it is known that tartrates are not completely converted into carbonates in the organism4 ,according to the label on the bottle1 this mixture of caffein and alkali salts is 8a common sense remedy for the relief and treatment of conditions dependent upon perverted metabolism as manifested by neuralgic1 rheumatic1 cardiac and renal symptoms40 ,wrapped with a trade package is a circular in which is discussed the 8uric acid diathesis0 as 8a cause of ,rheumatism in its various forms1 ,calculus1 ,gravel and ,inflammation of the ,bladder and ,kidneys1 ,asthma1 ,hay ,fever1 ,catarrh1 ,quinsy and ,bronchitis1 ,eczema1 ,hives1 ,itching and ,burning of the ,skin1 ,palpitation of the ,heart and ,cold ,hands and ,feet1 ,dizziness1 ,mental ,depression1 ,melancholia1 ,neuralgia1 ,chorea1 ,hysteria1 ,numbness and a great variety of purely nervous symptoms40 ,the arguments for the use of ,alkalithia as 8a safe and scientific treatment for the uric acid diathesis0 found in the circular constitute an indirect appeal to the laity 7conflict with ,rule #d74 ,in the circular matter sent direct to the physicians1 ,keasbey and ,mattison claim that in rheumatism1 ,alkalithia is prescribed by the medical profession more often than any other remedy4 ,the claim is made that1 8,in five minutes the urine will be discolorized and analysis will show it to be loaded with urates40 ,the manufacturers further assert3 8,you can change the character of the urinary secretion in a few minutes completely0 by ,alkalithia1 and 8,in nine cases out of ten1 when the doctor prescribes #8,alkalithia' his patient greatly improves1 or gets well40 ,the firm advises that 8,renal ,insufficiency0 be determined by the old method of multiplying the ounces of urine in twenty-four hours by the last two numbers of the specific gravity1 adding #aj1 which gives the number of grains of solids excreted in the twenty-four hours4 ,if this is low1 no matter what the cause1 they advise ,alkalithia1 8that ideal eliminant40 ,the ,council declared ,alkalithia inadmissible to ,new and ,nonofficial ,remedies because the claims made on the label and the circular accompanying the trade package lead the public to its detriment to depend on this preparation 7,rule #d72 and because the therapeutic claims are unwarranted 7,rule #f74--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #fe7 ,,arhovin ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,arhovin is a solution of dephenylamine1 thymol benzoate and ethyl benzoate1 marketed by ,schering and ,glatz1 ,inc4 ,it was omitted from ,new and ,nonofficial ,remedies because the therapeutic claims made for the preparation were unwarranted and because the firm had refused to discontinue the distribution of the advertising which contained the objectionable claims prior to ,jan4 #a1 #aiai4 ,when the report which appears below explaining the dismissal was submitted to ,schering and ,glatz1 ,inc41 the firm again promised a revision of its advertising1 but refused discontinuance of the objectionable circular before ,jan4 #a1 #aibj4 ,since ,arhovin is still marketed with unwarranted therapeutic claims1 the ,council has authorized publication of this report4 ,w4 ,a4 ,puckner1 ,secretary4 ,the attention of the firm ,schering and ,glatz1 ,inc41 was called to misleading statements in its booklet for ,arhovin in #aiae1 and in #aiah the firm was informed that unless the misleading statements were withdrawn before ,jan4 #a1 #aiai1 ,arhovin would be omitted from ,new and ,nonofficial ,remedies4 ,the following quotations are taken from the circular in question1 and illustrate the character of the claims to which objection was made3 8,striking also is the antiphlogistic and anesthetic effect of ,arhovin on the inflamed mucosae1 an effect which1 as all authorities agree1 is far greater than that of all other internal anti-gonorrheaics40 8,under its influence vesical and prostatic complications1 gonorrheal arthritis1 endocarditis1 etc41 are rarely incurred40 ,references to the indexes of leading textbooks1 including those of ,meyer and ,gottlieb1 ,cushny1 ,sollman and ,bastedo1 fails to show that ,arhovin is so much as mentioned by those authors2 hence1 it is obviously false to state1 as is done in the first of the quotations above1 that all authors agree concerning the striking effects of ,arhovin4 ,many of the statements are objectionable by reason of the actions implied1 rather than stated directly4 ,the following are examples3 8,arhovin in ,gonorrheal ,infections of the ,male ,genito-,urinary ,organs4 ,anterior ,urethritis4 ,this is the class of cases in which the most favorable results from ,arhovin have been reported40 8,posterior ,urethritis4 8,here also the striking effects from ,arhovin medication1 both in acute and chronic cases1 are rapid decrease of discharge1 disappearance of gonococci from the secretion1 and cessation of subjective difficulties1 such as strangury40 ,while the firm did not agree to withdraw the objectionable advertising before ,jan4 #a1 #aiai1 which made necessary the omission of ,arhovin from ,new and ,nonofficial ,remedies1 #aiai1 it did submit a proposed folder in which the most objectionable of the claims are still made4 ,the following statement1 which was in the proposed 8folder0 and is included in an advertising pamphlet sent out during #aiai1 serves to illustrate those points3 8,its action is three-fold3 8,strong antiseptic and bactericidal effect upon the urethral and vesical mucosae1 highly conducive to shortening and palliation of the acute disease course40 ,no evidence has been presented that ,arhovin is capable of destroying the gonococcus in the urethra1 and consequently1 the ,council declared the recommendation for the use of ,arhovin in the treatment of gonorrhea1 by means of claims such as those just cited1 is both misleading and dangerous4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #ff7 ,,chloron1 ,,chlorax ,,and ,,number 8#c0 ,report of the ,council on ,pharmacy and ,chemistry ,the report which appears below was sent to the ,chlorine ,products ,company1 ,inc41 ,may #ad1 #aiai4 ,in reply to an inquiry sent the ,chlorine ,products ,company1 ,july #h1 the company wrote that it could send no reply because the medical director was still in ,france4 ,however1 ,chloron and ,chlorax are being advertised in medical journals2 also essentially the same advertising as that discussed in the report was recently received by a physician from the ,chlorine ,products ,company4 ,the preceding facts having been reported to the ,council1 publication of the report was authorized4 ,w4 ,a4 ,puckner1 ,secretary4 ,chloron1 ,chlorax and ,number 8#c0 are preparations of essentially similar composition put out by the ,chlorine ,products ,company1 ,inc41 ,new ,york4 ,chloron ,chloron1 according to the label1 is 8,a stable ,,chlorine remedy for the reduction of inflammation1 relief of pain and for all wounds1 burns1 scalds and every description of sores except cancer and lupus40 ,its composition is given as3 8,free chlorine1 #j4bjj per cent42 calcium chloride1 #j4aij per cent42 mercurous chloride1 #j4jcj per cent42 lithium chloride1 #j4jce per cent42 calcium hydrate1 #j4jaj per cent42 water to #ajj parts40 ,the ,council asked the manufacturers for further information in regard to the composition or preparation of ,chloron and received this reply3 8,chlorine gas is prepared in the usual way and purified and passed into water until a saturated solution is made4 8,water to the extent of three times the volume of the chlorine solution is used to dissolve the necessary amount of calcium chloride1 and the two solutions are mixed4 8,the necessary amounts of ,lithium and ,mercurous ,chloride are then intimately mixed and made into solution4 ,this solution is then added to the above and the whole is agitated for some minutes40 ,a specimen of ,chloron was examined in the ,a4 ,m4 ,a4 ,chemical laboratory and the chemists reported3 ,qualitatively the presence of the following constituents was confirmed3 calcium1 mercury1 lithium1 chlorid1 free chlorin4 ,the solution was alkaline4 ,of course1 the declaration that ,chloron contains mercurous chlorid 7calomel7 is obviously incorrect1 as mercurous chlorid cannot exist in a solution containing active 7free7 chlorin1 but is oxidized to mercuric chlorid 7corrosive sublimate74 ,as the solution was alkaline in reaction1 it seemed unlikely that all the active chlorin was present in the free state1 as declared on the label4 ,quantitative determination of free chlorin and of total active 78available07 chlorin gave3 free chlorin1 #j4jcf gm4 per hundred c4c42 total 8available0 chlorin1 #j4ccj gm4 per hundred c4c41 or #afe per cent4 of the claimed amount4 ,a comparison of the information sent to the ,council with the analytic findings leads to the conclusion that ,chloron is not of reliable composition4 ,as evidence of the therapeutic value of ,chloron1 the following 8case reports0 were submitted3 8,in a case of second degree burn involving the most of one leg from the middle of the calf down1 ,,chloron was the only dressing used4 ,the burn was a bad one and the patient in a rundown anaemic condition1 at no time was there any appearance of pus1 the surface looked clean and bright and the healing was accomplished with practically no scar whatever4 ,the burn was kept wet with the solution by hourly applications day and night4 ,the skin which has grown on the wound is clear1 healthy and firm4 ,in another case of ,varicose veins of long standing1 the result was surprising4 ,the patient told of two years vibrating from ,hospital to ,hospital and getting no real relief4 ,each leg had large open running sores1 the only dressing used was wet compresses of this solution4 ,the pus disappeared at once1 the wound began to cicatrise from the edges and in two weeks the man was discharged from the hospital practically cured40 8,,chloron was recently tried at the ---- and ---- ,hospital on cases presenting ulcers and other sores which did not readily yield to other methods1 with good results1 in fact were of an indolent type4 ,in these cases ,,chloron proved very valuable40 8,i have used ,,chloron on a series of cases 7surgical7 presenting pus foci and ,i have found the application very beneficial and healing1 the pus early disappearing4 ,in cases of ,osteomyelitis1 ,suppurating ,arthritis1 ,cellulitis and ,chronic ,ulcers1 ,,chloron is particularly valuable1 its good effects quickly observed and the time of restoration to health shortened40 ,in the first case report1 there is no evidence that ,chloron is more efficient in the treatment of burns than any other commonly used procedure might have been4 ,in the case of the varicose ulcers1 while there was some apparent benefit from ,chloron1 no credit is given to rest and the general treatment which is known to be important in the treatment of such conditions4 ,the evidence in the other case reports is quite inconclusive4 ,consideration of the 8case reports0 leads to the conclusion that clinical evidence for the value of ,chloron is lacking4 ,attention should be called to the fact that the amount of active chlorin1 claimed to be present in ,chloron as well as the amount found by the association laboratory1 is less than that considered effective by ,dakin1 ,dunham and others2 seemingly in preparing ,chloron no attention has been paid to the degree of alkalinity1 yet the importance of this factor is now generally recognized4 ,chloron fails to comply with the requirements for surgical solution of chlorinated soda 7,n4 ,n4 ,r41 #aiai1 p4 #acc71 yet the manufacturers make free use of the text of ,dakin and ,dunham's ,handbook of ,antiseptics in their advertising pamphlet4 ,thus3 ,from the ,chloron pamphlet3 8,this ideal antiseptic effects complete sterilization within its sphere of action without causing any damage to the cells or tissues4 ,an important method of judging the injurious action of antiseptics is to investigate their effects on the leucocytes4 ,from experiments in vitro by ,parry ,morgan and in vivo by ,col4 ,c4 ,j4 ,bond with the strength of antiseptics commonly used in surgery1 it has been found that ,chlorine antiseptics and mercury salts have little effect on phagocytosis in comparison with other germicides4 ,the activity of the leucocytes from wounds which have recently been treated with ,,chloron may be demonstrated experimentally40 8,in addition to its antiseptic action ,,chloron is a strong oxidizing agent and deodorant and possesses to a marked degree the property of decomposing toxins4 ,in this connection it is interesting and pertinent to note that ,dean1 by the regulated action of hypochlorous acid1 has prepared a nontoxic dysentery vaccine and it is now a common observation that the free use of ,,chloron may reduce the constitutional symptoms arising from septic processes and that they reappear on discontinuing the antiseptic treatment40 ,dakin and ,dunham ,handbook of ,antiseptics3 8,the ideal surgical antiseptic should effect complete sterilization within its sphere of action without causing any damage to animal cells4 ,at the moment such a substance does not appear likely to be found1 but on the other hand it is surprising to see how little damage may be done to animal tissues by some active antiseptics4 ,an important method of judging of the injurious action of antiseptics is to investigate the condition of the leucocytes in wounds recently treated with the substance under consideration4 ,in general it appears from experiments in vitro that1 with the strength of antiseptics commonly used in surgery1 mercury salts and hypochlorites have relatively little effect on phagocytosis as compared with phenol 7,parry ,morgan74 ,it is a regular phenomenon to observe activity of the leucocytes obtained from wounds which have been recently treated with hypochlorites4 ,ingenious methods for determining the influence in vivo of antiseptics on the activities of leucocytes have been worked out by ,col4 ,c4 ,j4 ,bond4 8,in addition to their disinfecting action1 the ,chlorine antiseptics are strong oxidizing agents and deodorants and moreover possess in high degree the property of decomposing toxins4 ,by the regulated action of hypochlorous acid1 ,dean has prepared a nontoxic dysentery vaccine and it is a common observation that the free use of hypochlorites may reduce the constitutional symptoms arising from septic processes and that they reappear on discontinuing the antiseptic treatment40 ,chlorax ,chlorax is said to be 8,a stable ,,chlorine solution for internal use10 in 8,kidney ,conditions10 8,diabetes10 8,acute ,infections10 8,blood ,dicrasias10 8,lithemias and ,rheumatism10 and 8,nervous ,conditions40 ,it is claimed to have the same composition as that of ,chloron with the addition of #j4jaf per cent4 of tincture of opium4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reported that the free chlorin in ,chlorax was #j4ja gm4 per hundred c4c4 and the total amount of active 78available07 chlorin was #j4be gm4 per hundred c4c41 or #abe per cent4 of the amount claimed4 ,the laboratory notes that though the chlorin content of ,chloron and ,chlorax is claimed to be the same1 that of ,chlorax actually is less4 ,this is not surprising when the presence in ,chlorax of reducing substances such as alcohol is borne in mind4 ,the laboratory concludes that ,chlorax is not of reliable composition4 ,the following is typical of the 8case reports0 submitted to show the value of ,chlorax3 8,in ,january last ,i used ,chlorax on a case of ,diabetes ,mellitus and with excellent results4 8,the patient had been suffering for about nine years and when first brought to my care ,toxemia had set in1 he was drowsy1 irritable and unable to leave the house4 ,i prescribed ,chlorax in teaspoonful doses four times a day and am pleased to say that in one week he showed marked improvement4 ,soon after he was able to leave the house and attend to his business and after two months' treatment resumed a normal diet and habits apparently without injurious effects4 8,i believe that in this case ,chlorax undoubtedly prolonged life40 ,no mention is made of the dietary or other measures used4 ,the wide variation in diabetes and its response to proper diet is so well known that the noncommittal statement concerning the beneficial effects of ,chlorax amounts to no evidence at all in favor of the preparation4 ,the other 8case reports0 furnished by the ,chlorine ,products ,company1 ,inc41 which concern the treatment of gastric ulcers1 acute alcoholic gastritis1 tonsillitis1 etc41 are equally unconvincing4 ,in fact1 no satisfactory evidence for the clinical value of ,chlorax has been presented4 ,the following from the advertising for ,chlorax is unwarranted and absurd3 8,mercurous chloride 7calomel7 is perhaps the most widely used internal antiseptic and alterative and has established itself in the therapy of constipation1 cholera1 dysentery1 cardiac dropsy1 pleurisy1 malignant fever1 malaria1 syphilis1 worms1 infectious diseases1 gout and rheumatism2 lithium chloride is particularly efficacious in acute and chronic parenchymatous nephritis and in various lithemic conditions2 while ,opium has no rival as an anodyne and can be used to stabilize and conserve the alkaline reserve of the body against the acidosing influence of infections40 ,further1 on page #ad we find3 8,in chills and fever malaria and other blood dicrasias1 ,,chlorax is indicated as an internal antiseptic and it exerts a beneficial effect on the course of these diseases40 ,the claims made for ,chlorax are exaggerated and misleading4 ,number 8#c0 ,according to the label1 ,number 8#c0 is 8,a ,,stable ,,chlorine remedy for the purification of the blood10 with the composition3 8,free ,chlorine1 #j4ce per cent42 ,calcium ,chloride1 #j4cj per cent42 ,mercurous ,chloride1 #j4jc per cent42 ,lithium ,chloride1 #j4jd per cent42 ,calcium ,hydrate1 #j4ja per cent42 ,opium1 #j4jb per cent42 ,ethyl ,alcohol1 #j4aj per cent42 water to #ajj parts40 ,it will be noticed that the composition claimed for ,number 8#c0 is essentially similar to that claimed for ,chloron4 ,it differs from ,chloron in that the amounts of some of the constituents are somewhat greater1 and in that1 like ,chlorax1 it contains some tincture of opium4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reports that the free chlorin in a specimen of ,number 8#c0 was #j4jbd gm4 in #ajj c4c4 and the total active 78available07 chlorin #j4agc gm4 per hundred c4c41 or about #ej per cent4 of the claimed amount4 ,the examination indicates that ,number 8#c0 is of unreliable composition4 ,the ,chlorine ,products ,company1 ,inc41 submitted no clinical evidence for ,number 8#c0 to which it refers as 8our ,syphilis remedy40 ,it stated that two physicians had used the preparation 8with good results10 and admitted that 8the company requires further evidence before pushing it40 ,the ,council declared 8,chloron10 8,chlorax0 and 8,number #8#c'0 in conflict with the rules governing admission to ,new and ,nonofficial ,remedies4 ,all are of unreliable composition 7conflict with ,rule #a74 ,the therapeutic claims made for the preparations are not substantiated by acceptable evidence and are unwarranted and misleading4 ,chloron is inferior as an antiseptic to the well-known surgical solution of chlorinated soda on account of its low chlorin content and uncontrolled reaction4 ,there is no warrant for the claim that ,chlorax is useful in the treatment of 8,kidney ,conditions10 8,diabetes10 8,acute ,infections10 8,blood ,dicrasias10 8,lithemias and ,rheumatism10 and 8,nervous ,conditions10 nor is there warrant for the claim that 8,number #8#c'0 is a remedy for the purification of the blood or a 8,syphilis remedy0 7conflict with ,rule #f74 ,the names of these pharmaceutical mixtures are not descriptive of their composition 7conflict with ,rule #h74 ,all three preparations are irrational4 ,no evidence has been furnished that the lithium salt is of value in the mixtures4 ,it is not rational to combine an active chlorin preparation and a mercury salt in one mixture1 nor is there evidence that the addition of opium to the preparations proposed for internal use is of value or rational4 ,experimentation with ,number 8#c0 as a 8,syphilis remedy0 is to be severely condemned in that those on whom it is used will in the meantime be deprived of efficient medication 7conflict with ,rule #aj74--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #gj7 ,,elarson ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report announcing the omission of ,elarson from ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,elarson1 now sold by the ,winthrop ,chemical ,company1 ,inc41 was formerly sold in the ,united ,states by the ,bayer ,co41 ,inc4 ,it was admitted to ,new and ,nonofficial ,remedies in #aiad4 ,the circular issued by the ,winthrop ,chemical ,co4 contains several statements markedly at variance with the results of an investigation made1 at the request of ,fischer1 by ,joachimoglu 7,arch4 f4 exper4 ,path4 u4 ,pharmakol4 #gh3aiad74 ,the circular states that ,elarson contains about #ac per cent4 arsenic4 ,joachimoglu found from #aj4h to #aa4a per cent4 to be present4 ,the circular states further3 8,the fact that ,elarson represents a lipoid-like chemical combination of arsenic has an important bearing upon its absorption and utilization in the system 444 there is good reason to believe that when arsenic is administered in a stable1 lipoid-like combination1 as in ,elarson1 it is more readily taken up by the cells and more completely utilized than when given in the customary manner40 8,as regards the behavior of ,elarson in the system1 it has been shown that its active constituent1 chlorarseno-behenol1 is almost completely absorbed in this form1 probably as a chlor-behenolate of sodium or potassium40 ,as a matter of fact1 ,joachimoglu found that very little arsenic was absorbed when ,elarson was given to dogs and rabbits2 most of it was recovered from the feces2 only traces were found in the liver and kidneys and none in the blood and brain4 ,the absence from the latter organs shows that the lipoid solubility does not obtain in the body4 ,it is claimed in the circular that ,elarson has the advantage over ,fowler's solution 8in that it is free from any irritating action upon the gastro-intestinal tract02 it is stated that as many as sixty tablets have been given to dogs daily without any toxic effects4 ,joachimoglu1 on the other hand1 found powdered ,elarson to be very irritating to the gastro-intestinal tract2 also that the dog could not stand sixty tablets at all 7gar nicht vertragen71 such doses causing vomiting1 diarrhea and intestinal hemorrhages2 on repeated administration the symptoms became progressively more severe4 ,joachimoglu also found that1 compared on the basis of arsenic content1 ,elarson1 given intravenously1 is from ten to twelve times as poisonous as arsenic trioxid4 ,elarson is recommended for the class of cases in which ,fowler's solution is used4 ,to sum up3 ,none of the special claims made for ,elarson--the arsenic content1 ready absorbability1 freedom from irritating action on the gastro-intestinal tract and its alleged better adaptation for continued administration--have been substantiated2 on the contrary1 they have been disproved as well as the theory of its mode of absorption proposed by ,fischer and ,klemperer4 ,furthermore1 ,joachimoglu found that when it actually got into the circulation 7intravenous injection7 in the form in which ,fischer and ,klemperer supposed it to be absorbed1 it was from ten to twelve times as toxic as arsenic trioxid4 ,the ,council voted to omit ,elarson from ,new and ,nonofficial ,remedies because it is sold under unproved and consequently unwarranted claims and because it is an unscientific and relatively useless article4 ,elarson has not been shown to have advantages over ,fowler's solution2 on the contrary1 in some respects at least1 it is inferior4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #ge47 ,,iodiphos ,report of the ,council on ,pharmacy and ,chemistry ,a report which appears below was sent ,charles ,l4 ,heffner for consideration4 ,no reply having been received1 the ,council authorized its publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,iodiphos1 marketed by ,charles ,l4 ,heffner1 ,brooklyn1 ,n4 ,y41 is declared to contain ferric citro-iodine1 #f grains2 calcium glycerophosphate1 #h grains2 sodium glycerophosphate1 #h grains1 and hypophosphorous acid1 #b minims in each fluidounce1 and to present 8the ,metallic and ,non-,metallic elements3 ,iron1 ,iodine1 ,phosphorous1 ,calcium and ,sodium 7each in separate ,basic combination740 ,according to the label1 ,iodiphos is 8,,alterative1 ,,tonic1 ,,nervine and ,,anti-,,tubercular0 and is 8,for ,treatment of ,,blood1 ,,nerves and ,,pulmonary ,,organs40 ,an advertising circular#abi asserts that 8,iodiphos exerts its ,physiological action rapidly in hardening of the ,arteries1 ,high ,blood ,pressure1 ,anaemia1 ,glandular ,swelling1 ,neurasthenia1 ,hypochondria1 ,phthisis1 ,bronchitis1 ,asthma1 ,pneumonia and as an ,intestinal ,antiseptic and ,appetizer10 and declares it to be 8,indispensable as a ,tonic and ,restorative40 #abi ,after publication of the foregoing report had been authorized by the ,council1 a letter was received from ,charles ,l4 ,heffner1 advising that the distribution of the circulars has been discontinued4 ,in the advertising circular it is averred that in the production of ,iodiphos 8,chemistry ,again ,aids the ,modern ,physician40 ,iodiphos is another instance when a decadent polypharmacy proposes haphazard medication and so obstructs the efforts of modern medicine to establish the use of single drugs to meet definite indications4 ,iodiphos is inadmissible to ,new and ,nonofficial ,remedies because it is an irrational mixture of drugs sold with therapeutic claims that are unwarranted1 and under a name which is not descriptive of its composition4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #ha47 ,,mervenol ,,and ,,armervenol ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the report which appears below declaring ,mervenol and ,armervenol1 marketed by the ,hille ,laboratories1 inadmissible to ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,mervenol is stated by the proprietors--,the ,hille ,laboratories1 ,chicago--to be a hydrosol 7colloidal suspension7 of the sulphides of mercury and copper1 containing sufficient sodium chloride to make it isotonic with blood serum1 and 8inert proteid0 and 8carbohydrate0 to stabilize the colloidal suspension3 each cubic centimeter is stated to contain #j4jje gm4 mercury1 #j4jjaf gm4 copper1 and #j4jjaf gm4 sulphur4 ,it is claimed that this preparation is of value in pneumonia1 influenza1 and other conditions and diseases requiring increased leukocytosis4 ,it is further claimed that the properties and therapeutic effects of this preparation are as follows3 8,practically non-irritant2 practically non-toxic2 lower temperature1 often crisis like2 lower pulse1 with better elimination2 greatly accelerated recovery from ,influenza2 fewer ,pneumonia complications2 lower mortality rate in ,influenza and ,pneumonia2 remarkable ,leucocyte stimulation40 ,administration by mouth and by intramuscular and intravenous injection are advocated4 ,in the recent influenza epidemic1 it is reported that therapeutic results of some value were obtained at the ,great ,lakes ,training ,station and at ,fort ,sheridan4 ,the reports of certain medical officers indicate that this preparation seemed to have some effect on the course of pneumonia and influenza1 on the temperature1 and on the leukocyte count4 ,but those conducting the experiments state that it was 8absolutely impossible0 to fulfil ideal conditions as to controls and other observations at the time the experiments were conducted4 ,so far as the ,council knows1 no effort has been made to determine the potent constituent1 or constituents1 of this preparation2 whether the mercury1 the copper1 or the protein in the mixture was responsible for the claimed benefits is an open question4 ,these reports were given careful consideration1 but it was decided not to accept this preparation because of 7#a7 exaggerated therapeutic claims1 conflicting with ,rule #f 7aside from the report of its use in influenza and pneumonia at the ,great ,lakes ,training ,station and the ,post ,hospital at ,fort ,sheridan1 which reports are of work done and observations made under conditions which did not permit careful controls1 no evidence has been presented to the ,council supporting the therapeutic claims7 and 7#b7 being an irrational mixture1 conflicting with ,rule #aj--;a mixture containing colloidal mercury1 copper and sulphur with proteins and carbohydrates in addition1 it is difficult to predict the changes which occur in such mixtures on standing4 ,samples of ,mervenol 7two #a-ounce bottles7 submitted by the manufacturer1 ,june #e1 #aiai1 were found when opened1 ,aug4 #ah1 #aiai1 to have undergone decomposition4 ,a very disagreeable odor had developed1 the liquid was turbid1 and a large amount of precipitate had formed4 ,armervenol is stated by the proprietors--,the ,hille ,laboratories1 ,chicago--to be a hydrosol 7colloidal suspension7 of 8mercury-copper-sulpharsenite0 containing sufficient sodium chlorid to make it isotonic with blood serum and 8inert proteid0 and 8carbohydrate0 to stabilize the solution3 each cubic centimeter is declared to contain #j4jjbe gm4 arsenic1 #j4jje gm4 mercury1 #j4jjaf gm4 copper1 and #j4jjcb gm4 sulphur4 ,the use of ,armervenol as advised by the ,hille ,laboratories is the same as that of ,mervenol1 and in addition its use in syphilis is emphasized4 ,the criticisms of this mixture are similar in every respect to those directed against ,mervenol--the addition of arsenic introduces still another factor of uncertainty4 ,after investigating these claims1 it was decided not to accept this preparation on the ground 7#a7 that the therapeutic claims are unproved and unwarranted1 conflicting with ,rule #f1 and 7#b7 that the mixture is an irrational one1 conflicting with ,rule #aj4--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #hb47 ,,normal ,,phenol ,,serum 7,,cano7 ,,and ,,methyl-,,phenol ,,serum 7,,cano7 ,,not ,,accepted ,,for ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following statement declaring ,normal ,phenol ,serum 7,cano7 and ,methyl-,phenol ,serum 7,cano7 ineligible to ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,no statement of the composition of these preparations was submitted to the ,council and none appears on the labels of the trade packages4 ,however1 the advertising circular contains statements such as3 8444 normal phenol serum--phenol with methyl blue dissolved in anaphylactic serum 4440 8444 a combination of human or horse serum with ,phenol and ,methylene-blue1 thereby forming a new chemico-biologic product which he termed ,methyl-phenol ,serum or1 chemically1 ,chloride of ,phenol ,thionin ,tetramethylene-,seric40 8,methyl-phenol ,serum is a chemico-biological product in which ,phenol is the chief factor4 ,each ampule of #aj c4c4 contains the therapeutic equivalent of #j4e gm4 7#g4e grains7 of ,phenol40 ,from the foregoing it appears that both preparations contain phenol and methylthionine chloride 7methylene blue7 and that the second does not contain methyl phenol 7cresol7 as the name would indicate4 ,no definite evidence for the value of these preparations is brought forward and even the manufacturer is constrained to caution1 8,we assume no responsibility for the therapeutic action of the serum44440 ,on the other hand there are a great many statements in the papers of ,cano and his colleagues to which exception must be taken4 ,of these1 from among many similar1 the following statements are to be cited and commented on3 8,accepting that the gonorrheal infection gives systemic toxemia from absorption of the toxins 4440 ,it is the general opinion that in the majority of instances there is no systemic toxemia4 8,the technique of intraprostatic injection1 while less simple than that of the intravenous1 is by no means so difficult or complicated as to place it exclusively in the category of the urologist40 ,this obviously is an attempt to encourage the general use of these preparations and to minimize the necessity for careful study and special skill in their employment4 ,it is most unwise for one to attempt intraprostatic injections unless he is specially trained in the technique of this procedure4 8,this injection to be performed after the #eth or #fth intravenous injection of ,methyl-phenol ,serum44440 ,intravenous injections have a place in sane therapy only when the medicament to be so administered is of known composition and when evidence is available which gives assurance that definite results shall follow its use4 ,in the absence of these conditions it is manifestly unwise and even unexcusable to employ any medicament in this manner1 and its repeated use is reprehensible4 8,intravenous injection of ,methyl-phenol ,serum alternating with intravenous injections of mercury should be given every #dh hours until infection is under control40 ,this quotation further emphasizes that the treatment1 as advised1 carries with it a certain element of danger4 8,methylene blue prevents the phenol from exerting its usual action upon the red blood corpuscles1 and ensures rapid elimination through healthy kidneys4 ,it preserves the antiseptic power of the phenol and prevents the phenol from interfering with the chemico-biological function of the white and red blood cells4 ,the serum component favors chemotaxis1 it strengthens bodily defense1 it prevents anaphylaxis even in debilitated patients1 and it replaces the resistance which has been impaired by the demands that have already been made upon it40 ,no evidence is submitted to substantiate these claims4 ,it seems strange that phenol should lose its power and that this should be restored by the methylene blue4 8,it has a refractory chemico-biological action1 and exercises no vicious effect on the red blood corpuscles in the circulation1 but1 on the contrary1 by its inoffensive presence1 it wholly preserves all of the physiological properties of the blood40 ,what 8a refractory chemico-biologic action0 is1 is not clear1 but there is no evidence that this preparation has any action which might be defined as 8refractory chemico-biological10 that its presence is inoffensive or that it wholly preserves all the physiologic properties of the blood4 8,the treatment of gonorrhea by ,cano's theory 444 is firmly based upon chemico-biological facts and accepted authoritative theories and bears the same relation to gonorrhea that intravenous injections of arsenicals bear to syphilis40 ,quite an exaggerated and unwarranted statement4 ,in the same way1 objection is taken to the following quotations3 8,phenol administered intravenously in combination with methylene blue1 to protect the red-blood globule1 undergoes no change1 and preserves all of its actual antiseptic effect on the gonococcus and its toxins as though employed in the test tube40 8,when thus introduced into the human body its elimination is unique1 effective1 antiseptic1 germicidal1 being completely and exclusively thrown off through the kidneys in a period varying from one-half to twelve hours without local injury or disturbance to the general economy40 8,combinations of phenol are unstable1 but they do have the advantage of mitigating direct action on the cells and globules4 ,it is also known that ordinary phenol has a coagulant action on the albumins and an oxidizing power on the tissues1 which power1 if permanent1 produces gangrene4 ,by virtue of this dual action it therefore acts as a modifier2 by its oxidizing power on the germ it is germicidal1 and prevents the growth of the gonococcus2 and by its coagulant power on the toxins it relieves paragonococcal lesions 7mono- and poly-arthritides7 and affections of the serous organs 7endo- and pericarditis1 meningitis71 and some definite systemic disturbances1 the pathology of which is often confused with that of other infections40 8,lymphocytosis is often persistent in some individuals in whom the internal secretions and the processes of assimilation and disassimilation are deficient2 and because of the lack of these the organic physiological ferments are insufficient for the mechanism of nutrition and the phenomena of hematopoiesis40 ,until proof is available showing that phenol1 administered intravenously in the quantities employed in ,cano's ,normal ,phenol ,serum and ,cano's ,methyl-,phenol ,serum1 acts as a germicide and methylthionine chloride 78methylene blue07 prevents the deleterious effects of phenol on the red blood corpuscles2 that repeated intravenous injections of phenol and mercury are without danger2 that there is no danger of anaphylaxis2 that the physiologic properties of the blood are preserved by these medicaments2 and1 finally1 that these preparations have an effect on gonorrhea and its complications1 these substances ,normal ,phenol ,serum 7,cano7 and ,methyl-,phenol 7,cano71 are inadmissible to ,new and ,nonofficial ,remedies4 ,the following quotations taken from the circular are admissions that these preparations are not innocuous3 8,that the economy will tolerate to a surprising degree substances directly introduced through the blood stream is now well known4 ,by the intravenous injection of #aj c4c4 of methyl-phenol serum we throw into the human body a massive dose of an alien substance4 ,the immediate effect of this injection is upon the central nervous system4 ,the recipient usually becomes either pale or suffused1 he has a ringing in his ears1 has a sensation of great altitude1 and occasionally has a dryness of the fauces and a metallic or a garlic taste40 8,in some patients secondary reactions occur in from one to four hours after injection4 ,the phenomena we have observed in these secondary reactions are pronounced chill and rigor 4440 ,there is no doubt that considerable harm may be done by the intravenous and by the intraprostatic administration of these preparations and until there is good evidence showing the therapeutic value of the treatment1 the routine use of these preparations1 except perhaps at hospitals in selected and well controlled and carefully guarded cases1 is to be strongly discouraged4 ,when the foregoing statement was sent to the ,mulford ,company for comment1 the firm submitted a letter from ,dr4 ,perry ,townsend to the ,mulford ,company in which he declared that the results obtained with the ,cano preparations had been satisfactory and without untoward results4 ,in this letter1 ,dr4 ,townsend proposed that a series of injections with these preparations be carried out under the observation of members of the ,council and the supervision of ,dr4 ,cano or himself4 ,the report of the ,council1 the letter from the ,mulford ,company and that of ,dr4 ,townsend were sent to a number of urologists for their opinion concerning this whole matter4 ,it was explained that the referee held that no reason had been presented which would warrant the ,council to depart from its customary procedure1 namely1 to require that clinical evidence be submitted in the form of published reports which permit investigation and verification by independent observers but that1 before making further recommendation to the ,council1 he desired the opinion of urologists of recognized standing concerning the report submitted to the ,mulford ,company4 ,all replies received approved the ,council's position4 ,the following is one of the replies received3 ,your letter in regard to ,normal ,phenol ,serum 7,cano7 and ,methyl-,phenol ,serum 7,cano7 received4 ,i wish to state that ,i have read the correspondence between the ,council and ,h4 ,k4 ,mulford ,co4 and in my opinion the referee and the ,council are quite correct in their attitude in the matter4 ,in my opinion ,i would emphasize the following3 7#a7 ,there is absolutely nothing about the remedies directed specifically against the gonococcus and no evidence to show that any action against them is obtained4 ,as we know there are certain states of normal serum which are highly toxic and any normal serum from another animal will produce disturbances in man when injected intravenously--particularly if repeated4 ,the addition of substances to serum normal or otherwise is apt to and frequently does render that serum highly toxic6 ,the substances added in the instances referred to--phenol and methylene blue are not in any way calculated to lessen the toxicity of serum4 ,the element of danger existing in the indiscriminate use of serums intravenously is1 in my opinion1 increased by the addition of the substances mentioned1 and it would be unwise to encourage the general use of any such remedies4 ,furthermore the products are condemned by the very evidence of the originators and their admissions are quite sufficient to deter anyone from using the products as they suggest4 ,as to the intraprostatic injections with the serums it does not at all meet my views2 although the introduction of serums by this route have been frequently advocated and ,i have personally carried this mode out ,i cannot allow the impression to go out that it could be done in a routine manner--nor that no ill results could follow--for ,i have seen otherwise4 ,furthermore from theoretical standpoint serums need not be given in this way4 ,in consideration of the opinion expressed by the ,council's consultants the referee recommended that ,normal ,phenol ,serum 7,cano7 and ,methyl-,phenol ,serum 7,cano7 be declared ineligible for ,new and ,nonofficial ,remedies because of conflict with ,rule #f 7unwarranted therapeutic claims7 without considering possible conflicts with other rules1 and that publication of the report be authorized4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #he47 ,,soamin ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,soamin is the name under which the firm of ,burroughs ,wellcome and ,company sells its brand of sodium arsanilate4 ,the ,council directed the omission of ,soamin from ,new and ,nonofficial ,remedies and authorized publication of the report which appears below after the proprietors of the product had declined to withdraw or suitably revise the unwarranted therapeutic claims which it made4 ,w4 ,a4 ,puckner1 ,secretary4 ,the proprietary brand 8,soamin0 of sodium arsanilate was admitted to ,new and ,nonofficial ,remedies several years ago at a time when the therapeutic value of arsanilic acid had not been definitely determined4 ,experience with this drug has shown that it is far more dangerous and also has a more limited field of usefulness than was at first recognized4 ,the proprietors of the ,soamin brand have continued to include in the list of conditions in which it 8would seem0 to be a 8very effective agent0 cerebrospinal meningitis and pellagra2 in fact1 meningitis is the first in the list of conditions mentioned1 syphilis the second and pellagra third4 ,in support of their belief in the efficacy of the remedy in meningitis1 three reports1 published from six to nine years ago1 are quoted4 ,in one of these it is stated that two patients 8were cured02 in another report1 seven of eight patients in whom the clinical1 but not the microscopic1 diagnosis of meningitis had been made were reported as having recovered2 in the third report1 fifty-six of ninety cases were reported cured2 in this larger series of cases the author neglects to state the method of administration4 ,the firm quotes but one paper 7which is a very uncritical report7 in regard to pellagra4 ,it seems to the ,council that the evidence of value of sodium arsanilate in these conditions 7which are now treated by more rational methods7 is too slight to justify the emphasis laid on it by the firm1 especially as sodium arsanilate is admittedly a dangerous agent1 several cases of blindness having been reported from its use4 ,for these reasons it was voted to omit ,soamin from ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #hi47 ,,some ,,mixed ,,vaccines ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,the consideration of the following 8mixed0 vaccines was requested by ,f4 ,i4 ,lackenbach1 ,san ,francisco3 ,special ,bacterial ,vaccine ,no4 #b 7,staph-,strep4 ,bacterin7 containing killed ,staphylococcus albus1 ,staphylococcus aureus and streptococcus4 ,special ,bacterial ,vaccine ,no4 #c 7,pneumo-,staph-,strep4 ,bacterin7 containing killed ,staphylococcus albus1 ,staphylococcus aureus1 streptococcus and pneumococcus4 ,special ,bacterial ,vaccine ,no4 #d 7,pneumo-,staph-,strep-,coli ,bacterin7 containing killed ,staphylococcus albus1 ,staphylococcus aureus1 ,staphylococcus citreus1 ,bacillus coli1 streptococcus and pneumococcus4 ,special ,bacterial ,vaccine ,no4 #e 7,influenza ,combined ,bacterin7 containing killed ,staphylococcus albus1 ,staphylococcus aureus1 ,bacillus ,friedlnder1 ,bacillus influenzae1 ,micrococcus catarrhalis1 streptococcus and pneumococcus4 ,special ,bacterial ,vaccine ,no4 #aa 7,pneumo-,strep4 ,bacterin7 containing killed streptococcus and pneumococcus4 ,special ,bacterial ,vaccine ,no4 #ae 7,combined ,whooping ,cough ,bacterin7 containing killed ,bacillus pertussis1 ,staphylococcus albus1 ,staphylococcus aureus1 ,micrococcus catarrhalis1 ,bacillus influenzae1 streptococcus and pneumococcus4 ,special ,bacterial ,vaccine ,no4 #af 7,mixed ,gonococcus ,bacterin7 containing killed gonococcus1 ,staphylococcus albus1 ,staphylococcus aureus1 ,bacillus coli1 diphtheroid bacillus1 streptococcus and pneumococcus4 ,mr4 ,lackenbach states that these bacterial mixtures were prepared for him by ,e4 ,r4 ,squibb ,sons4 ,their sale in interstate commerce is permitted under the license granted to the latter firm by the ,u4 ,s4 ,treasury ,department4 ,however1 no evidence of any kind was presented to the ,council proving the therapeutic efficacy of the several mixed vaccines4 ,as a mixture of two or more kinds of organisms is accepted for ,new and ,nonofficial ,remedies only if there is satisfactory evidence that its therapeutic use is rational1 the ,council declared the several vaccine mixtures ineligible for ,new and ,nonofficial ,remedies 7,rule #aj74--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #ij47 ,,somnoform ,report of the ,council on ,pharmacy and ,chemistry ,the ,council examined the available evidence for ,somnoform1 sold by ,stratford-,cookson ,company1 successors to ,e4 de ,trey and ,sons1 and found the preparation inadmissible to ,new and ,nonofficial ,remedies4 ,the ,council authorized publication of the report which appears below4 ,w4 ,a4 ,puckner1 ,secretary4 ,somnoform is sold in the ,united ,states by ,stratford-,cookson ,company1 successors to ,e4 de ,trey and ,sons4 ,according to the label on a package of ,somnoform sent the ,council4 8,this mixture contains ,chloride of ,ethyl1 #hc per cent42 ,chloride of ,methyl1 #af per cent42 ,bromide of ,ethyl1 #a per cent40 ,although ,somnoform has been on the market for a long time1 the published reports present no proof that it is superior to ethyl chlorid used alone4 ,moreover1 the published reports and statistics do not necessarily apply to the ,somnoform now sold for the reason that mixtures of varying composition have been sold as ,somnoform in the past4 ,thus1 when ,somnoform was considered by the ,council in #aiji1 it was claimed to be composed of chloride of ethyl1 #fj per cent42 chloride of methyl1 #ce per cent41 and bromide of ethyl1 #e per cent4 ,federal chemists found1 however1 that it contained no bromide of ethyl 7,notice of ,judgment ,no4 #ega74 ,it is a question1 therefore1 whether a given report applies to a mixture containing #e per cent4 bromide of ethyl1 #a per cent4 of this substance1 or none at all4 ,the present advertising booklet for ,somnoform does not present acceptable evidence of the therapeutic value of the preparation4 ,an ignorance concerning the elementary facts of physiology and pharmacology is evident in the second sentence3 when having stated that 8,somnoform is the result of several years of study and investigation by ,dr4 ,george ,rolland1 ,dean of the ,bordeau ,dental ,school10 the pamphlet continues3 8,he sought an anesthetic which would enter1 dwell in1 and leave the body in the same manner that oxygen does44440 ,the claim as to the value of the #a per cent4 of ethyl bromide in the mixture is highly improbable2 certainly no evidence in support of the claimed value of this constituent is available to the referee4 ,no evidence is submitted which proves the claim of superiority of ,somnoform over similar preparations1 asserted in the following3 8,the peculiar manner in which the elements are combined is what makes ,somnoform at once so efficient and so safe40 ,the ,council declared ,somnoform inadmissible to ,new and ,nonofficial ,remedies because1 in the absence of acceptable evidence showing its exceptional safety and value1 the claims are unwarranted 7,rule #f71 and because the name of the mixture is not descriptive of its composition 7,rule #h74--7;,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #ij47 ,,tablets ,,formothalates ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report which declares ,tablets ,formothalates 7,tailby-,nason ,company1 ,boston1 ,mass47 ineligible for ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,tablets ,formothalates are sold by ,tailby-,nason ,company1 ,boston1 ,mass4 ,on the label a formula is given3 8,constituents3 ,acetanilid #b gr42 phenolphthalein #a_/b gr4 ,in a balanced combination with ,hexamene a name sometimes applied to hexamethylenamin and ,oil of ,cinnamon4 ,indications3 ,influenza1 ,colds1 ,grippe1 ,headache1 ,neuralgia1 ,rheumatism40 ,the same formula is given in advertisements and in this advertisement it is claimed that they are 8,for ,influenza and ,grip0 and if 8given in the acute stage may avert a serious attack0 7,boston ,m4 ,s4 ,j41 ,oct4 #c1 #aiah74 ,the dose is given as one to two tablets at #f p4 m4 and repeat at bedtimes4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reported that the tablets weigh an average of #j4dhhb ,gm41 or #g-a_/b grains2 that they have the odor and taste of cinnamon2 and that they contain hexamethylenamin1 are neutral and therefore give up no formaldehyde in the presence of water alone4 ,the ,laboratory further reported that they contain phenolphthalein and acetanilid4 ,these tablets were directed to be taken internally and therefore their effect was not intended to be local4 ,the amount of hexamethylenamin was not determined1 but in any case could not exceed #e grains per tablet4 ,it is evident that #d grains of acetanilid and #aj grains of hexamethylenamin and #a grain of phenolphthalein 7in two tablets7 8if given in the acute stage0 of influenza would not 8avert a serious attack10 as claimed in the advertisements4 ,the ,council declared ,tablets ,formothalates inadmissible to ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #ib47 ,,triple ,,arsenates ,,with ,,nuclein ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has declared ,triple ,arsenates with ,nuclein ,no4 #a and ,triple ,arsenates with ,nuclein ,no4 #b1 tablets marketed by the ,abbott ,laboratories1 inadmissible to ,new and ,nonofficial ,remedies because unwarranted therapeutic claims 7,rule #f7 are made for them and because they present an illogical combination of drugs 7,rule #aj74 ,the publication of the following report has been authorized by the ,council4 ,w4 ,a4 ,puckner1 ,secretary4 ,the following claims are made for ,triple ,arsenates with ,nuclein3 8,puts #8pep' and strength back into that patient recovering from ,spanish ,influenza1 pneumonia1 typhoid1 or surgical operation4 ,an extremely powerful reconstructive tonic4 ,try it for that #8run down' feeling40 ,triple ,arsenates with ,nuclein is said to contain 8,strychnin ,arsenate gr4 #a_/abh1 ,quinin ,arsenate gr4 #a_/fd1 ,iron ,arsenate gr4 #a_/fd1 ,nuclein ,solution mins4 #d40 ,a second preparation1 of double strength--,triple ,arsenates with ,nuclein ,no4 #b--;is also advertised4 ,the ,council voted not to accept these preparations for ,new and ,nonofficial ,remedies on the following grounds3 ,the quantities of quinin1 iron and nuclein in the doses represented in these mixtures are negligible2 thus1 one tablet of ,triple ,arsenates with ,nuclein containing #a_/fd grain of quinin arsenate contains only about #a_/ij grain of anhydrous quinin2 the tablet containing #a_/fd grain of iron arsenate contains #a_/baj grain of iron2 #d minims of the nuclein solution 7assuming it to be the 8,nuclein ,solution-,abbott07 would contain but #b_/e of a grain of nuclein--a substance which even in large doses is of questionable therapeutic value4 ,the amounts of iron and nuclein contained in doses of this preparation are insignificant in comparison with the amounts present in ordinary foods4 ,the only substances present in even small therapeutic doses are strychnin and arsenic4 ,the effects of arsenic and strychnin are very different and there are comparatively few conditions in which they should be prescribed at the same time4 ,hence a preparation containing these two in fixed proportions is illogical4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiai1 p4 #ib47 8,,anti-,,pneumococcic ,,oil0 ,,and ,,the ,,use ,,of ,,camphor ,,in ,,pneumonia ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted and authorized publication of the report which appears below4 ,this report declares 8,anti-,pneumococcic ,oil0 7a solution of camphor in oil sold by ,eimer and ,amend1 ,new ,york7 ineligible for ,new and ,nonofficial ,remedies because 7#a7 the recommendations for its use in pneumonia are not warranted by the evidence1 7#b7 the name is not descriptive of its composition but is therapeutically suggestive1 and 7#c7 the sale of a solution of camphor in oil under a name nondescriptive of its composition is unscientific and a hindrance to therapeutic progress4 ,w4 ,a4 ,puckner1 ,secretary4 ,the ,council having decided to consider ,anti-,pneumococcic ,oil 7,eimer and ,amend1 ,new ,york71 the preparation was assigned to the ,committee on ,therapeutics for report4 ,the report that follows was made by a member of this committee3 ,according to the advertising1 ,anti-,pneumococcic ,oil is a 8twenty-five per cent4 solution of camphor in a thin oil0 which was 8originated0 by ,august ,seibert1 ,m4,d4 ,the following directions are given for its use3 8#aj c4c4 7#aej minims7 to every #ajj pounds of body weight1 to be injected hypodermically every eight to twelve hours in pneumococcic pneumonia1 as soon after the initial chill as possible40 ,it is claimed that the prescribed dose one hour before general anesthesia begins1 8safeguards against postoperative pneumonia10 and1 that 8animals can so be immunized against later and otherwise fatal intravenous pneumococcic infection 7,boehnke1 ,institute for ,experimental ,therapy1 ,frankfort740 ,the advice is given3 8,in pneumococcic meningitis1 endocarditis and pleuritis1 #c of salicylic acid should be added to this oil40 ,in an article by ,seibert1 8,camphor and ,pneumococci0 7,medical ,record1 ,april #bj1 #aiab71 a reprint of which is used to advertise ,anti-,pneumococcic ,oil1 previous work 7,mnchen1 med4 ,wchnschr41 ,no4 #cf1 #aiji7 is mentioned as the starting point for the use of camphor in pneumonia4 ,in this article1 the author reports his first case1 that of a young woman who entered ,st4 ,francis' ,hospital on the third day after the initial chill 8with the symptoms of severe toxemia 7unconscious1 temperature #aje4e ,f41 pulse #acj1 and respiration #dj7 and involvement of both lower lobes40 8,large doses of camphor10 #ab c4c4 of a #bj per cent4 solution1 were injected hypodermically 8every twelve hours1 resulting in gradual improvement and recovery by the fourth day1 without a crisis40 ,seibert reports success in its use in twenty-one cases1 but gives no case histories or protocols4 ,he admits1 however1 that in four out of sixteen cases1 following the first twenty-one so reported certain 8limitations of this treatment were observed10 and a 8sudden rise of temperature in two patients on the second and third days of treatment1 respectively1 proved to be due to pneumococcic nephritis1 promptly subdued by appropriate doses of urotropin1 while the camphor injections were continued and resulting in speedy recovery40 ,he further admits that empyema occurs1 and states3 8,this proves that the camphor brought into the blood cannot prevent the as yet living organisms1 constantly entering the blood current from the affected alveoli1 from colonizing in the renal and pleural tissue40 ,he reports1 among thirty-seven patients treated in this manner1 one death1 that of a man #fh years old1 weighing #bjj pounds1 with a fatty heart4 ,heart failure was the real cause of death4 ,seibert also reports some very incomplete experimental work2 ,dr4 ,hensel1 assistant and pathologist of the ,german ,hospital1 found that 8#a_/aj1jjj part of camphor added to the usual culture media inhibited the growth of pneumococci1 while the controls all thrived02 ,dr4 ,j4 ,c4 ,welch1 pathologist of the ,lying-in ,hospital1 found that rabbits infected with lethal doses of pneumococcus cultures intravenously were saved by large doses of camphorated oil2 fragmentary protocols are given4 ,the assistant pathologist of ,st4 ,francis' ,hospital carried on the experimental work1 adding salicylic acid to the camphor4 ,no blood cultures are reported4 ,the conclusion reached by ,dr4 ,seibert is that salicylic acid up to #c per cent41 added to the camphorated oil1 is effective in preventing pleural infection4 ,in the article by ,dr4 ,seibert1 there appear most sketchy reports of cases1 recovery being reported without crisis in from three to nine days4 ,the referee has made a careful search of the literature1 with the following results3 ,boehnke 7,berl4 klin4 ,wchnschr4 #ej3hah1 #aiac71 using white mice1 failed to confirm the experiments reported in ,seibert's paper1 unless camphorated oil were given before the pneumococci1 and even then1 he felt that the results were too irregular to be of great significance4 ,when given with anti-pneumococcic serum1 however1 he felt that there was some benefit to be seen by the administration of camphor2 his protocols1 however1 are not detailed4 ,there is no report of blood cultures1 etc4 ,another worker1 ,h4 ,leo 7,deutsch4 med4 ,wchnschr4 #ci3fij1 #aiac71 reported that camphor water given intravenously prolonged the lives of thirty-eight rabbits inoculated with pneumococci4 ,here again there were no adequate protocols and very little evidence of careful experimental work appears4 ,in the literature of the past ten years1 there appear sketchy clinical articles on the value of huge doses of camphor in pneumonia4 ,markevitch 7,russk4 ,vrach1 ,june #bg1 #aiad2 abstr41 ,the ,journal1 ,dec4 #e1 #aiad1 p4 #bjha7 treated #bbf cases of pneumonia with #e c4c4 of camphorated oil hypodermically four times daily1 at the same time giving digitalis 7amount not stated71 with a mortality of #f4f per cent41 whereas1 in #cbb cases untreated1 there was a mortality of #ac4c per cent4 ,he reports #acc grave cases2 sixty-six received no camphor2 #dh per cent4 died4 ,of sixty-seven treated with camphor1 only #bb per cent4 died4 ,he reports temperature falling by lysis when camphor is used1 and comments on the symptomatic improvement following its use4 ,with the great variation in the clinical course of pneumonia1 the above figures1 though suggestive1 certainly need further support before the routine use of camphor as recommended by ,seibert can be sanctioned4 ,later articles found on the subject refer to it in a very cursory way1 giving no protocols and no cases1 and giving the referee the feeling that the conclusions were very impressionistic4 ,r,,sum ,after a careful search of the literature1 the referee concludes that3 ,huge doses of camphor1 to #bej grains in twenty-four hours1 may be given to man without serious results4 ,no satisfactory evidence1 however1 appears that camphor has a specific germicidal action on pneumococci 7similar to that of ethylhydrocuprein74 ,the clinical evidence1 as found in the literature1 is certainly of very little value4 ,it appears that the sale of a simple solution of camphor in oil under the guise of 8,anti-,pneumococcic ,oil0 is to be deplored 7a #bj per cent4 solution of camphor in cottonseed oil is official in the ,u4 ,s4 ,pharmacopeia as camphor liniment74 ,it is recommended that the preparation be held inadmissible to ,new and ,nonofficial ,remedies because exaggerated therapeutic claims are advanced for it1 and because the name is not descriptive of the composition1 but is1 instead1 therapeutically suggestive4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #c1 #aibj47 ,,dial 8,,ciba0 ,report of the ,council on ,pharmacy and ,chemistry ,dial 8,ciba0 has not been accepted for 8,new and ,nonofficial ,remedies0 because1 as the report which follows shows1 unwarranted claims are made for the product4 ,it is a definite new chemical compound which might be made eligible for ,n4 ,n4 ,r4 if misleading therapeutic claims were eliminated4 ,the ,council directed that ,dial 8,ciba0 be included with ,articles ,described but ,not ,accepted1 so that physicians might be informed with regard to its character and properties4 ,w4 ,a4 ,puckner1 ,secretary4 ,dial 8,ciba0 is a hypnotic manufactured by the ,society of ,chemical ,industry of ,basle1 ,switzerland1 and is sold in the ,united ,states by ,a4 ,klipstein and ,company1 ,inc41 ,new ,york4 ,chemically1 ,dial 8,ciba0 is diallylbarbituric acid and is1 therefore1 closely related to diethylbarbituric acid or barbital 78veronal074 ,the claims made for ,dial 8,ciba0 are 7#a71 that the 8allyl0 group in its molecule makes it more readily decomposed by oxidizing agents than barbital1 which contains the 8ethyl0 group2 7#b7 that because of this ease of oxidation1 it is more readily decomposed in the body and more rapidly and completely eliminated1 and 7#c7 that because of its alleged rapid elimination1 it is devoid of the after effects of barbital and other hypnotics4 ,the ,council took up the substance in ,february1 #aiah1 and referred the matter to the referee in charge of barbital preparations4 ,the referee considered unwarranted the claim that ,dial 8,ciba0 did not have the after-effects of other hypnotics due to its alleged total decomposition in the body4 ,the ,american agents1 ,a4 ,klipstein and ,company1 were informed of the referee's objections4 ,their attention was also called to the fact that1 notwithstanding the claimed absence of after-effects in one part of the advertising1 other parts of the same advertising admitted certain post-hypnotic effects of the product4 ,it was pointed out also that while it was claimed in one of the advertising circulars that lowering of the blood pressure is never observed after administration of ,dial 8,ciba10 yet two of the authors quoted in the same circular definitely stated that a lowering of the blood pressure followed even small doses of the drug and these authors warn against this very danger in certain conditions4 ,a year later1 a circular letter sent out by ,a4 ,klipstein and ,company reiterated the claim that the asserted decomposition of ,dial 8,ciba0 in the body prevents after-effects1 the drug being still contrasted with barbital 78veronal074 ,in view of the reiteration of this highly improbable claim1 the referee undertook to study the comparative action of ,dial 8,ciba0 as compared with other hypnotics4 ,it was found that the actions of ,dial 8,ciba0 are not distinguishable1 qualitatively1 from those of barbital1 there being no perceptible difference in the after-effects or in the nature of the side actions4 ,in toxic doses1 both caused profound depression with the temperature falling to that of the room 7or about one degree above71 the respiration being extraordinarily slow and shallow as one would expect with lowering of the temperature4 ,there were also the same evidences of nausea that are so frequently seen after toxic doses of the various hypnotics of this group4 ,in view of these results1 the ,council declared that it is unwarranted to claim freedom from after-effects for ,dial 8,ciba40 ,the ,council held that the following statement is unwarranted3 8,the therapeutic field for ,dial #8,ciba1' as shown by tests on rabbits1 is just as broad as the field for ,diethylbarbituric ,acid40 ,tests on rabbits do not and cannot show the breadth of the therapeutic field for a hypnotic4 ,the ,council also declared the following statement improbable1 and contrary to the evidence obtained by the referee3 8,in dogs1 the increase of dosage beyond the therapeutic dose to the point of death is decidedly in favor of ,dial #8,ciba1' which required a larger dose than diethylbarbituric acid to produce death40 ,the referee's experiments on cats show that ,dial 8,ciba0 is several times as toxic as hydrated chloral1 and more than twice as toxic as diethylbarbituric acid 7barbital74 ,since the circular to which objection was made in #aiah was still being sent out in ,december1 #aiai1 the ,council held ,dial 8,ciba0 inadmissible to ,n4 ,n4 ,r4 and voted that report of its action in the matter be authorized for publication4 ,the ,council further directed that ,dial 8,ciba0 be included with ,articles ,described but ,not ,accepted4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bd1 #aibj47 ,,apothesine ,report of the ,council on ,pharmacy and ,chemistry ,apothesine is a synthetic drug for producing local anesthesia1 made by ,parke1 ,davis ,company4 ,in the fall of #aiag the ,council wrote to ,parke1 ,davis ,company offering its aid in establishing the identity1 purity and therapeutic efficiency of this synthetic local anesthetic with the ultimate object of accepting the product for inclusion in ,new and ,nonofficial ,remedies should the facts warrant such acceptance4 ,the ,council's letter was never acknowledged4 ,after ,apothesine was put on the market the ,council desired to accept it for inclusion in ,new and ,nonofficial ,remedies but1 unfortunately1 was unable to do so because some of the claims made for the product were not justified by acceptable evidence4 ,the manufacturers were notified of the ,council's desire to admit this product to ,n4 ,n4 ,r4 and the wish was expressed that the company would either so modify its claims as to make the product acceptable under the ,council's rules or else would submit evidence to the ,council in proof of the claims made and thus permit the ,council to revise its conclusions4 ,parke1 ,davis ,company were1 apparently1 either unwilling or unable to submit evidence that would sustain their claims2 neither did they offer to modify the claims themselves4 ,the product1 therefore1 is ineligible to inclusion in ,new and ,nonofficial ,remedies2 it will1 however1 be listed in the 8,described ,but ,not ,accepted0 department of ,new and ,nonofficial ,remedies4 ,the report on ,apothesine that follows has been authorized for publication4 ,w4 ,a4 ,puckner1 ,secretary4 ,apothesine1 8the hydrochlorid of diethyl-amino-propyl-cinnamate10 is an efficient local anesthetic4 ,it belongs to the procain rather than to the cocain type1 that is1 it belongs to that type which1 while effective for injection anesthesia 7especially when combined with epinephrin7 is relatively inefficient when applied to mucous membranes4 ,apothesine may also be used for spinal anesthesia4 ,its absolute toxicity is less than that of cocain 7as #bj is to #ae1 see table below7 but about twice that of procain 7as #bj is to #dj1 see table below74 ,it is non-irritant1 is easily soluble and makes a stable solution so that it may readily be sterilized4 ,the ,council took exception to certain claims made by ,parke1 ,davis ,company for their product on the ground that these claims were not supported by acceptable scientific evidence4 ,one of the claims was that ,apothesine is applicable in any case in which any other local anesthetic is used4 ,this statement1 made in many advertisements1 is distinctly misleading as used4 ,when applied to mucous membranes ,apothesine is far inferior to cocain and to some other local anesthetics1 yet the claim obviously suggests that ,apothesine is an efficient substitute for any local anesthetic4 ,the manufacturers claimed1 too1 that ,apothesine is as potent as cocain4 ,the claim would lead the physician to think that ,apothesine had the same anesthetic potency as cocain in solution of equal strength4 ,this statement1 so far as it refers to the drug when applied to mucous membranes1 is not in accord with the facts and is true for injection anesthesia only when stronger solutions are used4 ,the only support for the claim of equal efficiency appears to be the experiments with intracutaneous injections made by ,h4 ,c4 ,hamilton#acj in ,parke1 ,davis ,company's laboratory4 ,these differed considerably from the results of ,sollmann4#aca ,a further series of experiments were made by ,sollmann to compare still further the diverse results previously reported by him and ,hamilton4 ,the latest series1 while showing considerable variations in the susceptibility of different skin areas1 especially toward ,apothesine1 demonstrated in every case that the efficiency of ,apothesine is unmistakably lower than that of cocain1 being at best one half4 ,the series also showed that the potency of ,apothesine was never greater than procain and averaged considerably below it4 #acj ,the ,comparative ,values of ,some ,local ,anesthetics by ,h4 ,c4 ,hamilton1 ,detroit1 ,mich41 from the ,research ,laboratory of ,parke1 ,davis ,co41 ,j4 ,lab4 ,clin4 ,m4 #d3fj 7,nov47 #aiah4 #aca ,comparative ,efficiency of ,local ,anesthetics1 ,v1 by ,t4 ,sollmann1 from the ,pharmacological ,laboratory of the ,school of ,medicine1 ,western ,reserve ,university1 ,j4 ,pharmacol4 ,exper4 ,therap4 #aa3fi 7,feb47 #aiah4 ,another claim made for ,apothesine which the ,council holds is not supported by evidence is that of superior safety4 ,this claim is made on the basis of hypodermic injections in guinea-pigs carried out in the laboratory of ,parke1 ,davis ,company4 ,such experiments prove little because of the fact--well known to laboratory workers--that the use of rodents in toxicity tests made by injecting a drug into the subcutaneous tissues does not give a reliable index of the relative toxicity of such a drug for man4 ,this is due partly to the peculiar resistance of rodents to poisons and partly to the great importance of the rate of absorption4 ,the organism destroys most local anesthetics so rapidly that the rate of absorption is more important than the absolute dose4 ,the absorption from hypodermic injections into guinea-pigs differs1 of course1 from that in clinical accidents1 especially where the drug has been applied to mucous membranes4 ,one cannot1 therefore1 reliably estimate the degree of clinical danger on animals4 ,it has been shown that when toxicity tests of local anesthetics are made on cats these animals seem to respond to the drugs in a manner more closely approximating humans and it is a suggestive fact that the more toxic of local anesthetics1 as shown by tests on cats1 have been found the most dangerous in clinical use4 ,the absolute toxicity of ,apothesine has been measured by ,eggleston and ,hatcher#acb by the intravenous injection in cats4 ,the fatal doses1 in terms of milligrams per kilogram ranged as follows3 ,alypin1 ,holocain #aj ,beta ,eucain #ab4e ,cocain #ae ,apothesine #bj ,tropacocain #bj-be ,stovain #be-cj ,nirvanin #cj-ce ,procain #dj-de #acb ,a ,further ,contribution to the ,pharmacology of the ,local ,anesthetics by ,eggleston and ,hatcher1 from the ,department of ,pharmacology1 ,cornell ,university ,medical ,college1 ,new ,york ,city1 ,j4 ,pharmacol4 ,exper4 ,therap4 #ac3dcc 7,aug47 #aiai4 ,the absolute toxicity of ,apothesine is1 therefore1 only a little lower than that of cocain1 and is twice as great as that of procain4 ,the clinical dangers cannot be predicted by either method1 since clinical accidents depend1 in most instances1 on idiosyncrasies1 or the technic of application4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bd1 #aibj47 ,,eumictine ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted and authorized publication of the report which appears below4 ,this report declares 8,eumictine0 ineligible for ,new and ,nonofficial ,remedies because 7#a7 it conflicts with ,rule #aj in that it is unscientific1 7#b7 it conflicts with ,rule #f in that it is sold under unwarranted therapeutic claims1 7#c7 it conflicts with ,rule #d against indirect advertising to the public in that the name 8,eumictine0 is blown in the bottle for the obvious purpose of bringing the product to the attention of the public when it is prescribed in the original package1 and 7#d7 because the name is therapeutically suggestive and not in any way descriptive of its composition4 ,w4 ,a4 ,puckner1 ,secretary4 ,eumictine is a preparation from the laboratory of ,maurice ,le ,prince1 ,paris1 ,france1 and is marketed in this country by ,george ,j4 ,wallau1 ,inc41 ,new ,york4 ,it is claimed that the product is 8a balsamo-antiseptic preparation composed of ,santalol1 ,salol1 and ,hexamethylene-,tetramine1 in the form of gluten-coated capsules40 ,nowhere in the advertising are the amounts of the ingredients given4 ,according to the ,american agent1 however1 8each capsule is supposed to contain #bj centigrams of ,santalol1 #e centigrams of ,salol1 #e centigrams of ,hexamethylene-,tetramine40 ,eumictine is advised 8in treating genito-urinary diseases 7urethritis1 cystitis1 prostatitis1 pyelitis1 etc4740 ,it is claimed to be 8both an antiphlogistic modifying agent1 a well-tolerated diuretic0 which 8may be administered for long periods without ill effects40 ,the ,council declares ,eumictine ineligible for ,new and ,nonofficial ,remedies because it is exploited in conflict with the following rules3 ,it is unscientific 7,rule #aj74 ,eumictine is composed of hexamethylenamin1 salol and sanalol in fixed proportions4 ,hexamethylenamin may serve a useful purpose in some forms of infection of the urinary tract1 but neither it nor salol is of any considerable value in gonorrhea4 ,it is now known that the balsamic preparations1 formerly so widely used1 do not have the curative effects in gonorrhea and associated conditions that used to be ascribed to them4 ,to combine three substances1 none of which has any distinct therapeutic value in the conditions for which ,eumictine is proposed1 does not enhance their value4 ,there is nothing original in the combination used in ,eumictine1 or in the manner of dispensing it4 ,it is sold under unwarranted therapeutic claims 7,rule #f74 ,these claims are made not only for the components of ,eumictine but for the combination itself4 ,though santalol has certain advantages over the somewhat variable oil of santal and other balsamic resins1 it is not true that santalol 8does not cause congestion of the renal epithelium0 or that it does not 8produce exanthema as do copaiba1 cubebs1 and the ordinary santal oil40 ,it is not true that salol is 8devoid of toxicity40 ,neither is it correct to say that salol 8asepticizes and disinfects the bladder1 the prostate and the urethra40 ,the claim that hexamethylenamin 8is of value when any acute symptoms or tendency to inflammation subsist0 is not justified4 ,the claim that hexamethylenamin 8renders soluble the uric acid and urates0 is also without foundation4 ,the following paragraph is characteristic of the claims made for ,eumictine3 8,anti-gonorrhoic by its ,santalol1 diuretic1 urolytic and analgetic by its hexamethylenetetramin 7,urotropin7 antiseptic and antipyretic by its ,salol1 ,eumictine represents a real therapeutic advance in the scientific treatment of diseases of the urinary passages40 ,instead of being 8a real therapeutic advance0 in the treatment of diseases of the urinary passages1 ,eumictine presents one of the complex combinations that have long retarded the scientific treatment of these diseases4 ,eumictine also conflicts with ,rules #d and #h of the ,council4--7,from ,the ,journal ,a4 ,m4 ,a4 ,feb4 #ba1 #aibj47 ,,platt',s ,,chlorides ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report on 8,platt's ,chlorides40 ,it also declares the preparation inadmissible to ,new and ,nonofficial ,remedies because its composition is uncertain and indefinite and because the claims made for it are exaggerated and misleading4 ,w4 ,a4 ,puckner1 ,secretary 8,platt's ,chlorides10 marketed by ,henry ,b4 ,platt1 ,new ,york1 is sold as a disinfectant and germicide4 ,only incomplete and contradictory statements have been made in regard to its composition4 ,many years ago 7about #ahii7 the composition of ,platt's ,chlorides was given as 8,the ,chlorids of ,zn #dj per cent41 ,pb #bj1 ,ca #ae1 ,al #ae1 ,mg #e1 ,k #e40 ,the statement that the preparation contained #bj per cent4 of lead chlorid is interesting1 in view of the fact that lead chlorid is soluble in water at ordinary temperatures to the extent of less than #a per cent4 ,in a booklet1 also issued a number of years ago1 the following 8,formula of ,platt's ,chlorides0 was given3 8,a saturated solution of ,metallic ,chlorids combined in the following proportions3 8,sol4 ,zinc ,chlorid #dj per cent4 8,sol4 ,aluminum ,chlorid #ae per cent4 8,sol4 ,lead ,chlorid #bj per cent4 8,sol4 ,calcium ,chlorid #ae per cent4 8,sol4 ,magnesium ,chlorid #e per cent4 8,sol4 ,potassium ,chlorid #e per cent40 ,the label on a bottle purchased in #aiaa1 describes ,platt's ,chlorides as3 8,a ,highly ,concentrated ,solution of the ,chlorids of ,aluminum1 ,calcium1 ,lead1 ,zinc1 etc40 ,the label of a bottle purchased in #aiai reads3 8,contains ,inert ,material3 ,water #hd4j4 ,sodium ,chlorid #d4h4 ,calcium ,chlorid #j4c40 ,this statement is obviously made to meet the requirements of the federal ,insecticide ,act4 ,this law requires either that the identity and the amounts of potent ingredients in disinfecting preparations be declared or else that the percentage of the inert ingredients of such preparations be given4 ,the omission from the label of all statements with regard to the potent ingredients of the preparation and the absence of such a statement in recent advertising matter suggests either that the older statements about its composition were false or else that the composition has been changed4 ,tscheppe published 7,pharmaceutische ,rundschau #h3aji1 #ahij7 an analysis of ,platt's ,chlorides which has been quoted in other publications as indicating the composition of the preparation4 ,he reported that he found each quart of the preparation to contain aluminum sulphate #f ounces1 zinc chlorid #a-a_/c ounces1 sodium chlorid #b ounces1 calcium chlorid #c ounces4 ,some years ago 7about #aiaa7 the company made the following statement relative to the germicidal power 7phenol co-efficient7 of ,platt's ,chlorides3 8444 for some time the carbolic acid co-efficiency of our output has been from #b4e to #d4c1 the average being about #c2 namely about three times stronger than pure carbolic acid40 ,in #aiab1 the ,u4 ,s4 ,public ,health and ,marine ,hospital ,service reported 7,bulletin #hb1 ,public ,health and ,marine ,hospital ,service1 p4 #fi7 that the phenol coefficient of a sample of ,platt's ,chlorides was so low that it could not be determined and also that the sample was found to contain some mercuric chlorid4 ,in #aiac1 the ,north ,dakota ,agricultural ,experiment ,station reported 7,bulletin1 ,july1 #aiac1 p4 #bib71 that ,platt's ,chlorides contained principally zinc chlorid1 also some aluminum chlorid1 calcium chlorid1 and traces of mercuric chlorid4 ,the phenol coefficient1 determined by the ,hygienic ,laboratory method1 was found to be #j4je4 ,the preceding suggests that the composition of ,platt's ,chlorides had been changed 7without notice to the consumer7 and that it had been fortified by the addition of mercuric chlorid4 ,years ago part of the advertising of this product was a testimonial from a health official which declared that1 for disinfection1 8bichlorid of mercury is useless in disinfecting sputum or discharges from the bowels1 being rendered inert by the albumin present0 and it lauded ,platt's ,chlorides as devoid of such drawbacks4 ,,recent ,,analyses ,,of ,,platt',s ,,chlorides ,to determine the present composition of ,platt's ,chlorides and to compare it with that sold formerly1 the ,a4 ,m4 ,a4 ,chemical ,laboratory has made an analysis of a specimen purchased in #aiai and also of one purchased in #aiaa and since kept unopened in the files of the ,council on ,pharmacy and ,chemistry4 ,the following table contains the results of these analyses 7all quantities given are ,gm4 per #ajj c4c473 #aiaa ,,specimen #aiai ,,specimen ,color ,colorless ,straw ,color ,odor ,none ,none ,specific ,gravity at #be ,cc4 #a4abbi #a4acac ,total ,solids 7residue at #ajj ,cc47 #af4di #ah4cc ,chlorid 7,cl-7 #g4fj #aj4gd ,sulphate 7,,so--7 #a4aa 4#af ,aluminum 7,al7 4#bb 4#ij ,calcium 7,ca7 4#ai 4#ac ,zinc 7,zn7 #e4aa #c4ic ,lead 7,pb7 4#jdf ,traces ,mercury 7,hg7 44 4#jjhf ,sodium 7,na7 #a4ja #a4ci ,these quantities transposed to hypothetical combinations would indicate that ,platt's ,chlorides has the following composition3 #aiaa ,specimen #aiai ,specimen ,aluminum ,sulphate #a4cb 4#ah ,aluminum ,chlorid 4#jg #d4bi ,calcium ,chlorid 4#ed 4#cg ,zinc ,chlorid #aj4ff #h4ai ,lead ,chlorid 4#jf ,traces ,mercury ,chlorid 44 4#jaaf ,sodium ,chlorid #b4eg #d4ha ,hydrogen ,chlorid 4#dc ,none ,in the past1 the advertising has suggested1 more or less directly1 that1 as chlorinated lime 7bleaching powder7 may be made to give off chlorin gas which disinfects1 so the air in a room may be disinfected by evaporating ,platt's ,chlorides4 ,thus the label of the #aiaa specimen contains the following3 8,,for ,,store ,,rooms1 ,refrigerators1 and ,closets1 keep a sponge saturated with the pure liquid in a saucer on an upper shelf40 ,on the label of the #aiai specimen1 the statement reads3 8,,refrigerators ,,and ,,storerooms--,as a disinfectant wash regularly with one part ,chlorides to eight of water4 ,as a deodorant1 keep in an open vessel a sponge or cloth saturated with the ,chlorides full strength40 ,that the owner of ,platt's ,chlorides really believes that the vapors of the preparation have disinfecting properties is seen from a letter over the name of ,henry ,b4 ,platt printed in the ,new ,york ,tribune in #aiaf4 ,this read1 in part3 8444 by keeping in a dish or saucer on radiators ,platt's ,chlorides diluted one-half1 the hot solution will evaporate and purify the air1 thus destroying the grip germ which is the cause of all the trouble40 ,from the analysis of ,platt's ,chlorides1 it is evident that when the preparation is evaporated1 water vapor only escapes4#acc ,whatever disinfecting or germicidal action the preparation may possess is exercised only when the solution is brought in direct contact with the substance to be disinfected4 #acc ,it is well known that when a solution of mercuric chlorid in water is evaporated1 mercuric chlorid passes off with the water vapors1 but under any condition the amount is but a fraction of the whole4 ,as in ,platt's ,chlorides other metallic chlorids are present1 the formation of complex mercuric compounds which is bound to have occurred1 should retard or prevent the volatilization of mercuric chlorid4 ,that this actually occurs was confirmed by the following experiment3 ,when #a gm4 mercuric chlorid was dissolved in #a liter of water and the solution distilled1 the distillate contained a very small amount of mercury4 ,then the experiment was repeated after adding sodium chlorid to the solution to simulate the conditions in ,platt's ,chlorides4 ,in this case no mercury was found in the distillate4 ,even were all the mercury in a bottle of ,platt's ,chlorides volatilized in a room #aj by #ab by #i feet1 this would be equivalent to only about #a_/ejj grain mercuric chlorid per cubic foot4 ,the aluminum and zinc salts present may be useful as deodorants but they are not effective as germicides4 ,the presence of mercuric chlorid in a concentration of #a to #aj1jjj is hardly to be considered as materially increasing the efficiency4 ,the directions recommend the use of a mixture of #a part of ,platt's ,chlorides to #aj parts of water for rinsing the hands1 and a mixture of #a part to #d parts of water for the disinfection of discharges4 ,it is further stated that #a quart makes #b gallons sufficiently strong for general use4 ,it is evident that such dilutions decrease considerably the feeble germicidal action of the original fluid4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #bg1 #aibj47 ,,anti-,,tuberculous ,,lymph ,,compound 7,,sweeny7 ,,and ,,anti-,,syphilitic ,,compound 7,,sweeny7 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the reports which appear below1 declaring ,anti-,tuberculous ,lymph ,compound 7,sweeny7 and ,anti-,syphilitic ,compound 7,sweeny7 ineligible for ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,anti-,tuberculous ,lymph ,compound 7,sweeny7 8,anti-,tuberculous ,lymph ,compound 7,sweeny70 is put out by the ,national ,laboratories of ,pittsburgh1 ,dr4 ,gilliford ,b4 ,sweeny1 8,medical ,director40 ,sweeny has claimed at different times that he became interested in the subject of von ,behring's efforts to immunize cattle to tuberculosis at a time when he was an assistant in von ,behring's laboratory4 ,he claims to have conceived the idea while there of transferring bovine immunity to tuberculosis to the human subject and later to have evolved his 8treatment0 at the ,pasteur ,institute in ,paris4 ,just how ,anti-,tuberculous ,lymph ,compound is made today is not stated--at least so far as one is able to learn from recent advertising4 ,some years ago ,sweeny declared that his 8,anti-,tubercular ,lymph0 7as it was then called7 was derived from a bullock which had been immunized to tuberculosis4 ,then3 8,the immunized animal having been slaughtered1 the contents of the lymph reservoirs are carefully collected and an aqueous extract is made from the grey cerebral substance1 spinal cord and the lymph glands4 ,it is then filtered under high pressure and de-albuminized by succussion4 ,to this1 the lymph1 together with a definite proportion 7#ej per cent471 of the naturally phosphorized brain fats is added1 with a small amount of chloride of gold 7about #a-fj gr4 to the dose71 the latter as a preservative40 ,it is a fair assumption that however the preparation may have been made originally1 it is not now made in such a manner as to bring it under the federal laws governing the preparation of serums and similar preparations4 ,the claims made for ,anti-,tuberculous ,lymph ,compound are of the usual uncritical and unscientific type4 ,mainly1 of course1 they are of the testimonial class4 ,the physician is told that the preparation has been carefully tested by men whose judgment is worthy of consideration2 that the verdict has been altogether favorable to the 8,compound40 ,thus3 8444 the remedy was submitted to a selected body of skilled physicians1 recognized for their skill and care in making therapeutic observations4 ,these men represented widely varying conditions1 climatic and otherwise4 ,those who said ten years ago that ,anti-,tuberculous ,lymph ,compound has a specific immunizing influence upon the tuberculosis patient1 find the same to be true today40 ,careful reading of the matter just quoted will reveal its ambiguity and inherent lack of frankness4 ,the inference conveyed is that the 8selected body of skilled physicians0 have unqualifiedly endorsed ,anti-,tuberculous ,lymph ,compound 7,sweeny7--but it does not say so6 ,it is the history of all such preparations1 introduced to the medical profession with the usual blare of trumpets1 that a certain number of favorable testimonials can be obtained4 ,it is also the history of such products that one has but to wait a few years and the physicians who had written most enthusiastically regarding the preparation--in the first flush of their optimism following its use and the perusal of the manufacturers' literature--will acknowledge that they were mistaken in their original estimate and are no longer using the agent4 ,in this connection an investigation of some of the old testimonials for ,anti-,tuberculous ,lymph ,compound by the ,propaganda department of ,the ,journal is instructive4 ,in a somewhat elaborate booklet published in #aijg by ,sweeny1 an ,indiana physician was said to have reported favorable results following the administration of the 8lymph40 ,a letter written to this physician in ,october1 #aiai1 asking for his present opinion on the product brought this reply1 in part3 8444 it being twelve years since using the serum and no reference or repeated orders since should surely suffice as evidence of my lack of faith in the serum44440 ,an ,illinois physician was reported in the same booklet to have described a case of a young man with an active tuberculosis1 who was given injections of the 8lymph0 in ,february1 #aijg4 ,the patient1 it was claimed1 showed immediate improvement and the ,sweeny booklet 7published in ,august1 #aijg7 stated that 8improvement in this case continued and terminated in complete recovery40 ,a letter written to the physician in ,october1 #aiai1 brought out the fact that the young man in question1 after receiving 8,anti-,tuberculous ,lymph ,compound0 and other treatment was removed 8on a stretcher0 8to ,new ,mexico1 where he remained for three or four years0 and recovered4 ,the doctor adds3 8,i do not think that the ,anti-,tuberculous ,lymph had anything to do with the man's recovery1 although ,i realize the difficulty of definitely analyzing just what did effect the cure4 ,i did since that time use that preparation in several other cases without beneficial results so that ,i gave it up a good many years ago adding it to that large heap of pharmaceutical material #8weighed and found wanting4'0 ,a physician in ,texas also reported in the #aijg booklet as having had very satisfactory results with the ,anti-,tuberculous ,lymph ,compound in one case of pulmonary tuberculosis was written to in ,october1 #aiai4 ,he replied3 8,i will state that subsequent use of this compound did not bear out the apparent good results from its use in the first case or two40 ,in a 8,bulletin0 issued by the ,sweeny concern in #aiab1 a ,pennsylvania physician was quoted as having treated three cases with ,anti-,tuberculin ,lymph ,compound with resultant cures4 ,this physician was written to in ,october1 #aiai1 and he replied3 8,i have no knowledge of the use of my name by any ,pittsburgh concern and know nothing of a lymph of the name of ,sweeny2 neither do ,i recollect ever curing three cases of tuberculosis with any lymph40 ,the same 8,bulletin0 quoted the alleged statement by a ,delaware physician to the effect that he believed ,anti-,tuberculous ,lymph ,compound to be the most successful treatment of tuberculosis extant4 ,this in #aiab4 ,to an inquiry sent in ,october1 #aiai1 this physician briefly replied3 8,am not using it now40 ,the result of the ,propaganda department's questionnaire was what might have been expected4 ,every physician who answered the inquiry regarding his previous and present opinions of ,anti-,tuberculous ,lymph ,compound 7,sweeny7 declared1 in effect1 that he had long since ceased to have faith in its value or efficacy4 ,according to claims made in ,sweeny literature1 8,anti-,tuberculous ,lymph ,compound exercises its immunizing power through a specific action upon the blood cells40 ,the statement that 8it destroys the tuberculosis germ when this is present in the system of the patient0 is untrue4 ,the facts are1 no serum or lymph has thus far been proved to have any value in the treatment of tuberculosis even when fortified by 8a small proportion of chloride of gold and soda0 as one circular tells us the 8lymph0 is4 ,in spite of research by competent investigators1 we are still without any aid in the form of a serum in the treatment of tuberculosis4 ,anti-,tuberculous ,lymph ,compound 7,sweeny7 is one of those preparations that need no elaborate laboratory tests1 nor even exact therapeutic research1 to convince any clear-thinking person that it is patently and obviously worthless4 ,one would hesitate before asking any reputable clinician to test a preparation of this sort4 ,it is a constant source of surprise that some physicians allow themselves to be persuaded by advertising literature that is obviously uncritical and unscientific1 to use preparations which have no more reasonable foundation than this one4 ,the ,council declares ,anti-,tuberculous ,lymph ,compound 7,sweeny7 not acceptable for ,new and ,nonofficial ,remedies4 ,anti-,syphilitic ,compound 7,sweeny7 ,this preparation also is made by or under the direction of the same ,dr4 ,gilliford ,b4 ,sweeny whose researches 787 led to the production and evolution of the ,anti-,tuberculous ,lymph ,compound 7,sweeny74 ,according to the data at hand1 this preparation is made by suspending benzoate of mercury in lymph from the bullock4 ,case reports are given of alleged cures of syphilis after two months of treatment2 indeed1 the circular exploiting the agent makes the statement that it is seldom necessary to continue the treatment beyond two months1 which1 if one chose to be credulous1 would indicate extraordinary power for the mercury4 ,mercury of course has a proper place in the treatment of syphilis1 but that any physician could be induced to place his trust in this preparation is almost unthinkable though testimonials--which the 8,national ,laboratories0 claim to have received from physicians--are published4 ,they all stamp the writers as not only gullible but also incompetent4 ,the tenor of the claims is on a par with those made for the ,anti-,tuberculous ,lymph ,compound2 they do not justify the time required for detailed consideration4 ,the ,council declares ,anti-,syphilitic ,lymph ,compound 7,sweeny7 not acceptable for ,n4 ,n4 ,r4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #c1 #aibj47 ,,syrup ,,leptinol 7,,formerly ,,syrup ,,balsamea7 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report on 8,syrup ,leptinol0 7formerly 8,syrup ,balsamea074 ,the product is inadmissible to 8,new and ,nonofficial ,remedies10 first1 because the manufacturers fail to give the profession information regarding either the amount of the potent ingredient or the method of determining its identity and uniformity2 second1 because of the unwarranted recommendation for its use in such infectious diseases as pneumonia and epidemic influenza and for lack of satisfactory supporting evidence of its alleged therapeutic efficacy in other diseases and1 third1 because the recommendations for its use appearing on and in the trade package constitute an indirect advertisement to the public4 ,w4 ,a4 ,puckner1 ,secretary4 ,syrup ,leptinol is sold by the ,balsamea ,co4 of ,san ,francisco4 ,it was first introduced as ,syrup ,balsamea4 ,in recent advertising1 ,syrup ,leptinol is also referred to simply as 8,leptinol40 ,according to the statements of the ,balsamea ,co41 ,syrup ,leptinol is prepared from the root of a species of ,leptotaenia 7a plant belonging to the parsnip family7 which grows in ,nevada and which has heretofore not been used in medicine4 ,the manufacturer states that the botanists who have been consulted have been unable to agree on the botanical classification of the plant4 ,the dried root of this unclassified species of ,leptotaenia is extracted with alcohol and from the extract so obtained the syrup is made1 but no information has been furnished to show how the alcohol-soluble material is incorporated in the syrup4 ,further1 the manufacturer has not announced tests whereby the identity and uniformity of the finished preparation may be determined4 ,a booklet contains the following3 8,the species of ,leptotaenia from which ,,leptinol is produced was first used in medicine by ,dr4 ,e4 ,t4 ,krebs1 who1 after thorough laboratory investigation and clinical application over a period of several months1 which resulted in the perfecting of ,,leptinol1 prescribed the preparation for ,influenza during the epidemic of that disease in #aiah with remarkably good results4 ,since this first use1 ,,leptinol has been exhaustively tested by clinicians in private practice and in hospitals in the treatment of ,pneumonia1 ,influenza ,bronchitis1 etc41 and has been universally endorsed40 ,in a circular letter it is asserted that the use of 8,leptinol0 during the 8influenza epidemic0 of #aiah-aiai 8demonstrated its almost specific action in respiratory affections02 that 8during this epidemic it proved to be five times as efficacious as any other treatment in pneumonia 44402 and that 8it is now as firmly fixed in the mind of many doctors for respiratory diseases as quinine is for malaria and the salicylates for rheumatism40 ,in the booklet it is further stated that the therapeutic action of the preparation is primarily that of a 8stimulating expectorant0 and secondarily as a 8sedative expectorant02 that 8its antiseptic action in the respiratory tract is prompt02 that it 8is an effectual cardiac tonic where the tone of the heart muscle is impaired by fever02 that 8in acute pulmonary conditions it effectively improves the respiratory action and allays cerebral irritation due to fever and toxins02 that it acts 8as a vital stimulant and nerve sedative02 that 8it stimulates the excretion of acid by the skin and in fever it has a strongly diaphoretic and antipyretic action without depressing the circulation or the central nervous system02 that it is 8mildly diuretic0 and 8slightly augments the biliary flow0 and that 8it increases the gastric and intestinal secretions and allays intestinal fermentation40 ,no evidence has been presented to the ,council which shows that ,syrup ,leptinol has the actions ascribed to it4 ,the reports of clinical trial are little more than chance observations and lack all control4 ,this applies also to the following1 stated to be a quotation from the report of the ,tonopah ,mines ,hospital ,association3 8,in the spring of #aiai a recurrence of the ,influenza epidemic of the previous winter was experienced4 ,during the first period of this second epidemic1 prior to ,april #aeth1 there were treated one hundred sixteen cases of ,influenza1 fourteen of which developed ,influenzal ,pneumonia1 with six deaths4 ,the ,pneumonia was of the very virulent type which prevails in this high altitude4444 ,after ,april #aeth1 when the clinical use of ,leptinol was inaugurated1 three hundred and sixty-eight cases of ,influenza were treated and not a single case developed ,pneumonia4 ,twenty-two cases of ,influenzal ,pneumonia were received and treated with ,,leptinol1 with a consequent one hundred per cent4 recovery4444 8,in the cases where ,,leptinol was used the treatment was the same as had been previously followed1 as to diet1 fresh air1 etc41 but the medication was confined to ,,leptinol4 ,syrup ,,leptinol was started immediately in one-dram doses at one-hour intervals1 in cases with high temperatures1 and this was continued until temperature and pulse subsided4 ,it was then used in one-dram doses at three-hour intervals as recovery progressed4 ,on admission to the hospital1 calomel in #a_/d grain doses1 was given at fifteen minute intervals for eight doses4 ,the last calomel was followed in six hours by #a_/b ounce ,magnesium ,sulphate in saturated solution4 ,the second day #a_/aj grain of calomel was given at one-hour intervals for ten doses44440 ,medical journals are replete with reports of remarkable results obtained with the most varied forms of treatment instituted at the time that the 8influenza epidemic0 had been reached4 ,in these cases it is more than probable that the lessened virulence of the causative factor of the disease1 the gradually established resistance of those stricken with it in the latter period and the improved management resulting from experience deserve the credit for the successful outcome of the treatment1 rather than the particular form of medication employed4 ,the report of the ,tonopah ,mines ,hospital ,association directly implies that ,syrup ,leptinol prevents the development of pneumonia in practically all cases of influenza in which it would develop and that it entirely abolishes the mortality of that disease4 ,however1 it is well known that innumerable remedies have been recommended as specifics in the treatment of pneumonia on the basis of the treatment of a limited number of cases which recovered1 and that eventually these asserted specifics have been discarded as of little value4 ,in the present instance1 the recovery of twenty-two cases in succession afford prima facie evidence that those cases were not the virulent type of pneumonia in which the death rate is very high under any methods of treatment4 ,while no effort appears to have been made to determine the nature of the infecting organism1 the records show fairly conclusively that they belonged to those causing the milder type of pneumonia4 ,the ,council finds ,syrup ,leptinol 7formerly ,syrup ,balsamea7 inadmissible to ,new and ,nonofficial ,remedies because3 7#a7 the information in regard to composition does not state the amount of potent ingredient1 nor permit the determination of its identity and uniformity2 7#b7 the recommendation for its use in such infectious diseases as pneumonia and epidemic influenza is unwarranted and its claimed therapeutic efficacy in other diseases is without satisfactory supporting evidence2 and 7#c7 the recommendations for its use which appear on the label and the circular wrapped with the trade package constitute an indirect advertisement to the public4 ,the ,council accepts the explanation of the manufacturer that he has been unable to obtain a satisfactory classification of the plant from which ,syrup ,leptinol is made4 ,it would be undesirable to exclude from therapeutic use a valuable drug simply because its botanical character has not been determined or because an exhaustive chemical examination had so far not been made4 ,however1 in the absence of such information the manufacturer should give full information with regard to the preparation or standardization of his remedy and the therapeutic claims made for it should be accompanied by indisputable1 thoroughly controlled clinical evidence4 ,in the case of ,syrup ,leptinol1 there is no satisfactory evidence available showing that the preparation has any value in the treatment of epidemic influenza1 pneumonia1 whooping cough1 etc4 ,while it is probable that a balsamic syrup1 such as ,syrup ,leptinol1 has palliative properties in coughs1 such action does not at all justify the claim that it is useful in the contagious diseases for which it is proposed4 ,the ,council cannot recognize a syrup presenting an unknown plant in uncertain proportions which is recommended in a variety of dangerous contagious diseases in which it ultimately may be harmful1 even though in early stages of these diseases it may serve to allay some of the milder symptoms4 ,concerning the composition of the plant from which ,syrup ,leptinol is prepared1 the ,balsamea ,company states that it contains 8,alkaloids1 acids1 glucosides1 volatile and fixed oils1 gums and resins40 ,this information is valueless1 since no information is given concerning the character1 amounts or pharmacologic action of the ingredients4 ,further1 it is unreliable as far as the presence of alkaloids is concerned since the ,a4 ,m4 ,a4 ,chemical ,laboratory has been unable to find any alkaloids in the specimen of the crude drug furnished by the manufacturers4 ,in accordance with its regular procedure1 the ,council submitted the preceding statement to the manufacturer4 ,in reply the ,balsamea ,company stated that it is more than ever of the belief that ,syrup ,leptinol is deserving of recognition by the ,council1 basing this opinion on further clinical experience with it in the treatment of influenza4 ,the manufacturer stated that the use of the words 8,leptinol0 and 8,syrup ,leptinol0 interchangeably was due to an oversight and promised to limit the use of the word 8,leptinol0 to an alcoholic extract of the plant4 ,concerning the method of preparation of this alcoholic extract and the amount used in the preparation of ,syrup ,leptinol the ,balsamea ,company replied as follows3 8,the alcoholic extract of the ,leptotaenia1 which we have termed #8,leptinol' is a preparation of definite and uniform strength1 as determined by two methods3 7a7 the gravity test using the ,u4 ,s4 ,hydrometer ,scale for spirits1 by which ,leptinol registers #eb degrees at #fj degrees ,f41 and 7b7 by gentle evaporation of the alcohol content and the measuring of the active constituents1 which measures twenty-five per cent4 by weight4 8,the alcoholic extract #8,leptinol' is glycerinated in a machine1 using one part of the alcoholic concentration to four parts of glycerin4 ,this is then added to eleven parts of a heavy syrup1 containing #g-a_/b pounds of sugar to the gallon of syrup1 and thoroughly mixed in an agitating machine4 ,leptinol is the sole active ingredient of ,syrup ,leptinol4 ,syrup ,leptinol is a preparation of uniform strength4 ,it is far more uniform in strength than most of the syrups of the ,u4 ,s4 ,p4 made from fluid extracts which are made from crude drugs which are not uniform in strength40 ,this claim cannot be allowed as meeting the conflict with ,rule #a4 ,it is well known that plants vary in their composition at different times of the year2 under different conditions of cultivation and growth2 and under other conditions2 hence the claim that alcoholic extracts of equal specific gravity insure uniformity of composition in active principles must be considered entirely illogical1 especially since the exact nature of the active principles1 if any be present1 is unknown4 ,if these are known their nature should be stated and tests for their identity be given4 ,if they are unknown it is manifestly misleading to state that the preparation is of uniform strength4 ,it is evident that the ,council cannot approve of the use of a preparation of unknown composition without satisfactory evidence of its value1 especially when it is recommended in a variety of serious infectious diseases such as influenza and pneumonia4 ,the mere fact that a small number of patients who have received the drug recover is no evidence of its curative value1 and until carefully controlled clinical tests of the preparation are made1 it is not entitled to the consideration of physicians4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #e1 #aibj47 ,,formitol ,,tablets1 ,,ii ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following supplementary report on ,formitol ,tablets4 ,w4 ,a4 ,puckner1 ,secretary4 ,in the ,council report 7,the ,journal ,a4 ,m4 ,a41 ,oct4 #d1 #aiai1 p4 #ajgg7 on the ineffectiveness of lozenges claimed either to contain formaldehyd or to liberate formaldehyd in the mouth1 the composition of ,formitol ,tablets of the ,e4 ,l4 ,patch ,co4 was briefly discussed in the following terms3 8,the ,a4 ,m4 ,a4 ,chemical ,laboratory reported that ,formitol ,tablets contained formaldehyd 7or paraformaldehyd71 an ammonium compound1 and some hexamethylenamin4 ,it is probable that the formaldehyd 7or paraformaldehyd7 was produced by the decomposition of hexamethylenamin originally present in the tablets but decomposed by long contact with the acid40 ,at the time this report was published1 the label and the advertising matter contained but vague and indefinite statements with regard to the composition of ,formitol ,tablets4 ,in the ,october1 #aiai1 issue of ,patchwork1 the house organ of the ,e4 ,l4 ,patch ,co41 it was denied that these tablets contain hexamethylenamin since none had ever been used in their manufacture4 ,it was also claimed that the company had a 8printed sheet giving the formula of these tablets40 ,the ,council advised the ,e4 ,l4 ,patch ,co4 that it desires to publish only facts about the products which it examines and that if the report on ,formitol ,tablets was inaccurate in any way the ,council would want to correct any error it might have unintentionally made4 ,as the ,formitol advertising in the files of the ,council contained no information as to the composition of the tablets1 the firm was also requested to send the printed sheet giving the 8formula40 ,when this printed 8formula0 came it was found to be a sheet used by the ,e4 ,l4 ,patch ,co4 for the purpose of giving its salesmen information regarding ,formitol tablets1 to be passed on to the physician4 ,this printed sheet conveyed the information that ,formitol ,tablets contain ammonium chlorid1 benzoic acid1 citric acid1 guaiac1 hyoscyamus1 menthol1 paraformaldehyd and tannic acid1 but it gave no information in regard to the amount of any of the ingredients except that it declared that each tablet represents the equivalent of #aj minims of a #a per cent4 formaldehyd solution4 ,because of the nonquantitative1 and1 therefore meaningless printed 8formula0 and because1 also1 of its complexity1 it was thought desirable to make a more complete analysis of ,formitol ,tablets4 ,experience has shown that frequently the real formula of a thing is quite different from the alleged formula published by the manufacturer4 ,the details of the laboratory's later analysis will appear in the ,annual ,reports of the ,chemical ,laboratory or may be had on request4 ,the result of the laboratory's additional experimental work1 especially when taken in connection with investigations made elsewhere on the interaction of formaldehyd and ammonium chlorid justifies the conclusion that ,formitol ,tablets do contain some hexamethylenamin1 even though the amount may be very small4 ,as the ,e4 ,l4 ,patch ,co4 declare that no hexamethylenamin is put into ,formitol ,tablets the conclusion drawn in the ,council's original report to the effect that the formaldehyd probably was formed by the decomposition of hexamethylenamin was evidently an error4 ,the hexamethylenamin present is doubtless produced by the action of the paraformaldehyd on the ammonium chlorid present4 ,the analysis also showed that more than #gh per cent4 of the weight of ,formitol ,tablets was made up of sugars and about #af4e per cent4 was starch and other material1 some of which was talcum or similar material4 ,this means that about #id per cent4 of the total weight of the tablets is sugar and starch1 neither of which is mentioned in the printed 8formula40 ,the significance of this is apparent when it is considered that there are eight ingredients listed in the 8formula0 for which therapeutic effects are claimed4 ,since a tablet weighs about #ac4e grains1 the combined weight of all the claimed active ingredients is less than #a grain per tablet6 ,the amount of ammonium chlorid found1 as indicated by the total nitrogen1 was not more than #a4j per cent4 or about #a_/h grain per tablet4 ,the amount of benzoic acid found was #j4cd per cent4 or #a_/be grain per tablet4 ,yet these two drugs are said to exert their peculiar expectorant action4 7,the ,u4 ,s4 ,p4 lozenge of ammonium chlorid contains #a-a_/b grains ammonium chlorid or twelve times the amount of this drug in a ,formitol ,tablet47 ,the tannic acid contained in the tablets could not be determined with accuracy but it was much less than #a per cent4 7or #a_/h grain per tablet7 yet it is said to add valuable astringent qualities to ,formitol ,tablets6 7,the ,u4 ,s4 ,p4 lozenge of tannic acid contains #a grain of tannic acid47 ,the quantity of guaiac 7as resin7 is but a fraction of #a per cent4 ,yet it is said to impart to ,formitol ,tablets 8stimulant resolvent0 properties and it is intimated that there is sufficient to be of value in 8cases of abscess of the throat and inflammation of the tissues40 ,the total acidity indicates the presence of about #b per cent4 of citric acid or #a_/d grain per tablet4 ,yet this amount is said to be 8antiseptic0 and 8aids in the general results40 ,while the presence of the drug hyoscyamus 7henbane7 was not positively identified by microscopic examination1 alkaloids were present4 ,the manufacturers claim that the tablets contain menthol yet only a suggestion of menthol could be obtained from the odor4 ,however1 the odor of methyl salicylate--a constituent not declared in the 8formula0--predominated throughout the operations of analysis4 ,formitol ,tablets furnish a good illustration of some well established but often ignored truths3 #a4 8,formulas0 that are nonquantitative are valueless or worse than valueless4 #b4 ,the fact that a manufacturer puts certain drugs in a mixture1 is no proof that these drugs are there when the mixture reaches the patient4 ,the physician must be assured that they are there when he prescribes them4 #c4 ,complex mixtures should be avoided4 ,it is absurd to expect1 as is claimed in the case of ,formitol ,tablets1 anodyne1 antiseptic1 astringent1 expectorant1 and resolvent action all at the same time4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #ai1 #aibj47 ,,sukro-,,serum ,,and ,,aphlegmatol ,report of the ,council on ,pharmacy and ,chemistry ,two years ago1 ,american newspapers contained accounts of an alleged cure for pulmonary tuberculosis 8discovered0 by ,prof4 ,domenico ,lo ,monaco of ,rome1 ,italy4 ,at that time no reference to the 8cure0 could be found in medical journals which had come from ,italy and other ,european countries 7,the ,journal ,a4 ,m4 ,a41 ,july #ac1 #aiah1 p4 #adb74 ,later1 reports were published of experiments carried out in ,italy1 according to which the intramuscular injection of solutions of sugar 7saccharose--cane sugar7 diminished pulmonary secretion and was of considerable value in the treatment of tuberculosis 7,the ,journal ,a4 ,m4 ,a41 ,sept4 #bh1 #aiah1 p4 #ajhc74 ,on the whole the reports of the trial of what has been called the ,italian ,sugar ,cure for ,consumption have been unfavorable4 ,at a meeting in ,paris in ,october1 #aiah1 ,drs4 ,louis ,rnon and ,mignot reported that they had found that the disease in guinea-pigs was not modified by the treatment and with humans the results were also negative 7,paris ,letter1 ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bc1 #aiah1 p4 #agfj74 ,in view of the exploitation of this treatment in the ,united ,states by the ,anglo-,french ,drug ,co41 which offers 8,sukro-,serum10 and by ,g4 ,giambalvo ,co41 which sells 8,aphlegmatol10 and because of inquiries received1 the ,council has authorized publication of the statement which follows4 ,w4 ,a4 ,puckner1 ,secretary4 ,a circular issued by the ,anglo-,french ,drug ,co41 describes 8,sukro-,serum0 as a 8,sterilized ,solution of lacto-gluco-saccharose40 ,by reading the circular to the end1 however1 one learns that 8,sukro-,serum0 is not a 8serum0 in the ordinary sense but apparently it is a solution of ordinary sugar 7sucrose74 8,sukro-,serum is a sterilized1 specially prepared solution of ,saccharose40 ,sukro-,serum has been advertised 7,n4 ,y4 ,med4 ,jour41 ,sept4 #f1 #aiai7 as an 8,,intramuscular ,,injection ,,for ,,tuberculosis0 8444 ready for use in cases of ,pulmonary and general ,tuberculosis0 with the assertion that 8,it is quite certain that in the near future ,sukro-,serum will be largely used and its value fully recognized40 ,the circular received from the ,anglo-,french ,drug ,co4 contains quotations from an article by ,professor ,lo ,monaco in the ,british ,medical ,journal 7,aug4 #bd1 #aiah7 setting forth the merits of intramuscular injections of sucrose in tuberculosis4 ,it is recommended that 8,nocaine-,surrnine0 7which the ,anglo-,french ,drug ,co4 supplies7 be used for the control of pain when ,sukro-,serum is injected4 ,the circular enclosed with a package of 8,aphlegmatol10 purchased from ,g4 ,giambalvo ,co41 contained the following with reference to the composition of this preparation3 8,a solution of ,hydrats of ,carbon ,after the formula of ,prof4 ,d4 ,lo ,monaco1 ,director of the ,institut of ,physiological ,chemistry of the ,university of ,rome4 ,contents3 ,sucrose 7,c,h,o7 ,glucose and ,galactose 7,c,h,o740 ,the package contained ampules of thin1 fragile1 brown colored glass1 containing approximately #b-a_/b c4c4 of light1 clear1 amber colored1 thick1 sticky fluid1 having a distinct caramel odor4 ,reaction p,h #e4j4 ,a reducing substance 7probably glucose7 amounting to #g4d per cent4 was found by using ,benedict's method for estimating glucose quantitatively2 after hydrolysis with hydrochloric acid1 #ee4e per cent4 glucose was found4 ,there was no reaction for albumin4 ,no attempt was made to identify the sugars1 as it seemed probable that in the preparation caramel had been produced4 ,the circular which accompanied the package of ,aphlegmatol contained the following information 7spelling and composition as in original7 about its use and effects3 ,to be emploied where a large bronchial secretion is present in the respiratory branches disease4 ,the secretion will diminish and1 in non complicated cases1 it will completely disappear4 ,fever1 cough1 hemottisis1 night perspiration1 vomiting and difficulty of breathing are1 in the meantime1 diminuished4 ,aphlegmatol acts also as a riconstituent1 being itself a nurrishing composition1 improves the digestive function of the body and increases the arterial pressure4 #e c4c4 7#b ,phials7 of ,aphlegmatol per day must be injected intramuscularly in the ,gluteus4 ,if the patient wishes two injections may be made1 one at the right immediately followed by a second one at the left4 ,the cure must not be interrupted untill sometime after expectoration has disappeared1 which result may be obtained only after fifty or sixty days1 in the meantime the patient must be controlled by his home physician1 especialy when thermal elevation of the body takes place4 ,improvement will be manifested on or about the tenth day of the first injection4 ,in the advertising circular1 which is apparently intended for general distribution1 much the same information is given as in the sheet enclosed with the ampules1 except that in the directions we find3 8,if the injections are painful--especially in cases where patients are very emaciated--physicians are advised to inject together with ,aphlegmatol1 as an anesthetic1 a vial with #a c4c4 solution of ,stovain at #c40 ,the advertising for ,aphlegmatol contains many misspelled words and appears to be the work of those ignorant of the ,english language4 ,tuberculosis is a widespread disease and a majority of the uninformed are only too willing and ready to try such a 8cure40 ,the preparations appear to be nothing more than concentrated solutions of sugar4 ,it is probable that a small amount of the cane sugar might be inverted to glucose and fructose1 but experiments have shown that cane sugar subcutaneously administered in the small amounts used in this instance is largely excreted in the urine unchanged4 ,less is known about galactose1 but the evidence available would indicate that galactose is largely excreted in the urine unchanged when given subcutaneously4 ,glucose would be absorbed as such1 and in the amounts under consideration1 used by the system much the same as when given by mouth4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ba1 #aibj47 ,,supsalvs ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report declaring ,supsalvs 7,anglo-,french ,drug ,company7 inadmissible to ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,supsalvs are advertised by the ,anglo-,french ,drug ,company as 8stable suppositories of #8#fjf' 7of ,french manufacture70 with the claim that by the rectal administration of these suppositories the effects of arsphenamine may be obtained4 ,the asserted efficacy of ,supsalvs medication is based in part on the claim that for these suppositories an excipient was found which mixes with the cocoa butter base 8to form an assimilable emulsion40 8,the active principle and the vehicle being bound to one another1 the mucous membrane is able to absorb both simultaneously and progressively in the form of an organic emulsion40 ,as no information was furnished the ,council by the ,anglo-,french ,drug ,company on the origin or quality of the arsphenamine used in the preparation of ,supsalvs or the character of the vehicle which was 8bound0 to the arsphenamine in such a way as to permit the absorption of this combination in the form of an 8organic emulsion10 the firm was requested to furnish3 7#a7 ,evidence that the arsphenamine used in ,supsalvs complies with the ,n4 ,n4 ,r4 standards and that deterioration of it does not occur in the preparation of the suppositories or on keeping4 7#b7 ,the identity of the ingredients composing the suppository4 ,the ,anglo-,french ,drug ,company did not supply the requested evidence and consequently the ,council judged the preparation on the basis of the information received from the company1 and that contained in the available advertising and circulars4 ,it found ,supsalvs inadmissible to ,new and ,nonofficial ,remedies1 first because the quality of the medicament contained in the suppositories has not been established1 and second because the claimed efficacy of this preparation as a means of securing the effects of arsphenamine lacks substantiating proof4 ,during the past few years some ,french physicians have reported favorably on the intrarectal administration of arsphenamine4 ,boyd and ,joseph at ,panama published 7,the ,journal1 ,aug4 #ag1 #aiah1 p4 #eba7 an enthusiastic report on intrarectal injection of arsphenamine but did not refer to its use in the form of suppositories4 ,in a comprehensive report1 on the 8,treatment of ,syphilis0 7,quarterly ,journal of ,medicine1 ,july1 #aiag7 ,l4 ,w4 ,harrison stated that arsphenamine 7,salvarsan7 in the shape of an enema is definitely less effective than intravenously and that 8,neisser and the vast majority of workers can see no value in the rectal method40 ,schamberg and ,hirschler 7,a ,safe and ,efficient ,intensive ,method of ,treating ,syphilis1 ,therapeutic ,gazette1 ,november1 #aiai1 p4 #gfa7 have given a rather thorough trial of this method2 the results were most disappointing3 8,a certain or rather uncertain amount of arsphenamine is absorbed into the blood1 but the quantity is obviously too small to be at all comparable in its effect with the intravenous administration4 ,our conclusions are that the rectal administration of arsphenamine or neoarsphenamine is an extremely feeble method of administering these drugs40 ,the report of the ,special ,committee on the ,manufacture1 ,biological ,history and ,clinical ,administration of ,salvarsan and ,other ,substances of the ,british ,national ,health ,insurance ,medical ,research ,committee contains the following3 8,the rectal method of administration1 either in the form of solution or as suppositories1 has been advocated by a few observers mainly for cases in which there is difficulty in the adoption of the intravenous method4 ,the experiments made by ,mills at ,rochester ,row show that three enemata of #8#fjf' 7#j4f ,gm4 in each7 on successive days failed to produce any effect on the spironemes in the lesions4 ,the general opinion of experienced workers is that the rectal method is ineffective1 and in this view the ,committee concur40--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #cj1 #aibj47 ,,hypodermic ,,solution ,,no4 #ac1 ,,iron1 ,,arsenic ,,and ,,phosphorus ,,compound ,,not ,,accepted ,,for ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,hypodermic ,solution ,no4 #ac1 ,iron1 ,arsenic and ,phosphorus ,compound 7,burdick-,abel ,laboratory7 is said to contain in each c4c43 ,ferrous citrate #j4jf ,gm4 ,sodium cacodylate #j4jf ,gm4 ,sodium glycerophosphate #j4a ,gm4 ,chloretone #j4jje ,gm4 ,the preparation is advertised as 8the old reliable hematinic0 which is 8indicated in all forms of anemia1 where both red and white cells are low40 ,it is for hypodermic or intramuscular administration4 ,the product is inadmissible to ,new and ,nonofficial ,remedies because3 #a4 ,it does not contain ferrous citrate as claimed4 ,instead the iron is in the ferric condition1 apparently in the form of the unofficial and unstandardized 8iron citrate green0 for which there is no evidence of superiority over the official iron and ammonium citrate4#acd #acd ,iron ,citrate ,green1 ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ab1 #aiag1 p4 #ace2 ,reports ,council ,pharm4 and ,chem41 #aiaf1 p4 #db4 #b4 ,its name gives no information on the form in which the iron1 the arsenic and the phosphorus occur therein4 ,the term 8arsenic0 does not indicate whether the mild cacodylate or the potent arsenous oxid is being administered nor does the term 8phosphorus0 tell the physician that he is administering the practically inert sodium glycerophosphate4#ace--7;,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ac1 #aibj47 #ace ,glycerophosphates1 ,the ,journal ,a4 ,m4 ,a41 ,sept4 #cj1 #aiaf1 p4 #ajcc2 ,reports ,council ,pharm4 and ,chem41 #aiaf1 p4 #cb4 ,sodium glycerophosphates4 ,reports ,council ,pharm4 and ,chem41 #aiaf1 p4 #eb4 ,,parathesin ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,the local anesthetic ethyl paraminobenzoate was first introduced as 8,anesthesin0 or 8,ansthesin40 ,ethyl paraminobenzoate is not patented in the ,united ,states and it may be manufactured1 therefore1 by any firm which chooses to do so4 ,in order that a common name by which to designate the drug might be available1 the ,council coined the name 8,benzocaine10 as being short and easily remembered1 but yet suggestive of its composition and character 78benzo0 to indicate its derivation from benzoic acid and 8caine0 to indicate its cocaine-like properties74 ,as the term 8anesthesin0 had become a common name for the drug1 the ,council recognized this as a synonym for benzocaine4 ,one of the accepted brands for benzocaine is 8,anesthesin10 manufactured by the ,h4 ,a4 ,metz ,laboratories1 ,inc4 7see ,new and ,nonofficial ,remedies1 #aibj1 p4 #cc74 ,however1 on ,april #ai1 #aibj1 the ,metz ,laboratories requested that its product be recognized under the designation of 8,parathesin40 ,as the use of one substance under several names causes confusion and retards rational therapeutics1 the ,council's rules provide against the recognition of proprietary names for nonproprietary1 established drugs4 ,in view of this and because the legitimate interests of the manufacturer may be safeguarded by appending his name or initials to the common name1 benzocaine or anesthesin1 the ,council voted not to recognize the designation 8,parathesin40--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ac1 #aibj47 ,,chlorlyptus ,report of the ,council on ,pharmacy and ,chemistry ,the condensed report on ,chlorlyptus which follows and also a complete detailed report was sent to the proprietor1 ,jan4 #i1 #aibj4 ,in reply he requested that publication be postponed pending the submission of further clinical evidence4 ,as after nine months this evidence had not been received the ,council has authorized publication of its report4 ,w4 ,a4 ,puckner1 ,secretary4 ,chlorlyptus is manufactured by ,chas4 ,a4 ,weeks1 trading as the ,weeks ,chemical ,company1 ,philadelphia4 ,it is prepared by chlorinating eucalyptus oil until it has bound #cj per cent4 of chlorin1 the chlorin being in relatively stable combination4 ,it is claimed that ,chlorlyptus is a new 8chlorinated antiseptic10 highly efficient as a wound antiseptic and at the same time nonirritant and nontoxic4 ,chlorlyptus is offered for use in the treatment of local infections of all types1 as well as of burns1 and also as an antiseptic in the alimentary and genito-urinary tracts4 ,the claims were based largely on reports of investigations made by ,philip ,b4 ,hawk and his collaborators4 ,these reports the referee of the committee in charge of ,chlorlyptus considered incomplete and unconvincing4 ,being advised of this ,mr4 ,weeks caused further investigations to be made4 ,some of the information was checked and extended by the ,a4 ,m4 ,a4 ,chemical ,laboratory and by the referee4 ,the laboratory side of the investigation may now be considered as complete4 ,the results show that ,chlorlyptus is a feeble antiseptic of the aromatic oil type1 considerably weaker than eucalyptus oil1 both as to therapeutic and toxic qualities4 ,the chlorin contained in it is bound too firmly to have any action2 in fact1 the chlorination appears to have accomplished nothing more than a considerable destruction or weakening of the eucalyptus oil4 ,as far as the referee can judge1 this object could have been accomplished just as effectively by diluting ordinary eucalyptus oil with some indifferent solvent4 ,the manufacturer of ,chlorlyptus contends that if the experimental findings are against his product1 it should be judged by the clinical data4 ,the clinical evidence1 however1 is not decisive4 ,it shows that wounds healed and infections were prevented or successfully combated in cases in which ,chlorlyptus was used in combination with good surgery1 but it does not show how much of the result was due to the surgery and how much1 if any1 to the use of ,chlorlyptus4 ,even if it were granted as probable that the ,chlorlyptus contributed to the favorable outcome1 it would still be a question whether it equals other established antiseptics1 or whether it possesses any material advantages over diluted eucalyptus oil4 ,until these points are established the clinical reports cannot offset the unfavorable results of the laboratory investigation4 ,the manufacturer has endeavored to obtain more convincing clinical reports1 but the lack of success in this direction during the past nine months gives little encouragement that acceptable clinical evidence will be available within a reasonable time4 ,believing that the information which has been obtained should be made available to the profession1 the ,council authorized publication of this statement and also of the detailed report4 ,the ,council voted not to accept ,chlorlyptus for ,new and ,nonofficial ,remedies because of the unfavorable results of the laboratory investigation1 but with the agreement that the product would receive further consideration should more convincing clinical data become available4 ,i4 ,,detailed ,,reports ,summarized ,reports ,,chemical ,,nature ,,of ,,chlorlyptus ,chlorlyptus is prepared by chlorinating eucalyptus oil until it has bound #cj per cent4 of chlorin4 8,chlorlyptol0 is prepared in an analogous manner from eucalyptol4 ,there has been some confusion as to the composition2 but the principal constituent is now stated to be 8a dichloride of eucalyptus oil10 to which the formula ,c,h,o,cl has been assigned4 ,it differs from the 8chlorinated eucalyptus oil10 as ordinarily used for making dichloramin-,t solutions1 and which contains only #b_/c per cent4 of chlorin4 ,,availability ,,of ,,chlorin ,,in ,,chlorlyptus ,the chlorin content of chlorlyptus is almost entirely firmly bound1 and therefore not 8available10 in contrast to the group of so-called chlorinated antiseptics 7i4 e41 the hypochlorite and chloramin type74 ,for instance1 it does not directly liberate iodin from iodid4 ,it contains a very small quantity of free hydrochloric acid1 or perhaps some acid esters1 and liberates a little more on prolonged contact with water2 but the total quantity liberated under reasonable conditions is very small4 ,according to ,hawk's data1 they correspond only to #a_/h per cent4 ,h,cl even after standing with water overnight and to only #a_/e per cent4 of ,h,cl after two weeks4 ,the referee has shown that this quantity of acid has no therapeutic significance4 ,the 8bound0 chlorin of chlorlyptus1 being chemically inactive1 would have no more practical significance than the bound chlorin in common salt4 ,the 8ozone0 said to be used during the preparation1 to expel the ,h,cl1 has also practically disappeared1 to judge by the slowness with which iodin is liberated from potassium iodid4 ,,acid ,,formation ,some constituents of chlorlyptus hydrolyze slowly and to a slight degree with the liberation of a trace of free hydrochloric acid4 ,according to the data of ,hawk's report1 the free acidity1 in term of ,h,cl1 is #a_/ab per cent4 ,on standing with water over night1 this increases to #a_/h per cent4 ,on this basis1 ,hawk proposed a theory that the claimed antiseptic effects of chlorlyptus are due to the continuous liberation of hydrochloric acid4 ,experiments by the referee show this to be untenable4 ,the traces of acid are neutralized and absorbed by the tissues so rapidly that an acid reaction is not maintained4 ,these experiments are described in the appendix4 ,they were submitted to the manufacturers1 who in the name of ,mr4 ,weeks 7,may #i1 #aiai7 concede this conclusion and state that 8there is no doubt that the referee's statements as to action in mouth1 contact with living tissue and improbability that the acidity is effectively antiseptic is correct1 and ,i am willing to accept the referee's statement as conclusive in this respect40 ,,bacterial ,,culture ,,experiments ,mr4 ,weeks submitted a statement by ,hawk to the effect that chlorlyptus has a phenol coefficient of #b4f1 determined by the standard ,hygienic ,laboratory procedure4 ,he also quotes ,rockefeller ,war ,hospital that chlorlyptus kills ,staphylococcus aureus in concentra of #a dram3 #a gallon 7about #a3a1jjj71 but not in more dilute solutions4 ,more recently1 he presented a more comprehensive report by ,rivas1 which is reproduced in the appendix4 ,the essential results are tabulated herewith4 ,this tabulation shows that chlorlyptus fails to kill the organisms after an hour's exposure of the following concentrations3 ,typhoid in bouillon1 #aj per cent4 of chlorlyptus4 ,staphylococci in pus1 #e per cent4 of chlorlyptus4 ,staphylococci in serum1 #a per cent4 of chlorlyptus4 ,it seems to the referee that a substance that is ineffective with an hour's exposure to these concentrations is not at all likely to kill or check bacteria under clinical conditions4 ,in other words1 it is not an antiseptic in the ordinary sense4 ,the referee is not impressed by the superior power attributed by ,rivas to chlorlyptus in the presence of pus4 ,inefficiency of #aj per cent4 for one-half hour or of #e per cent4 for two hours seems a failure rather than a success4 ,the referee also notes the absence of any data as to the relative efficiency of chlorlyptus against staphylococci in pus and in bouillon4 ,the data on serum indicate that chlorlyptus is much weaker than phenol and show that it is less effective in the presence of pus than in other mediums4 ,the referee fails to grasp the bearing of the oil experiments on any clinical condition4 ,moreover1 the inconstant results mentioned by ,rivas suggest the possibility that the incorporation of the bacteria in oil may have prevented their effective distribution in the culture medium4 ,if any significance is to be attached to these experiments1 they should be checked by controls1 without antiseptics4 ,,summary ,,of ,,rivas' ,,in ,,vitro ,,experiments ,minimal ,maximal ,germicidal ,not ,germicidal ,concentrations ,concentrations ,typhoid ,bacilli in ,bouillon3 ,chlorlyptus 7,exp4 #c7 #aj1 #b to #d hours #aj for #a hour #e for #b hours ,eucalyptus oil 7,exp4 #a7 #e within #e minutes ,no data ,phenol 7,exp4 #e7 #a within #aj min4 ,no data ,streptococci and ,staphylococci in ,olive ,oil3 ,chlorlyptus 7,exps4 #g and #h7 #a1 almost at once1 ,no data sometimes ,eucalyptus oil ,no data ,no data ,phenol 7,exps4 #i and #aj7 #a1 almost at once1 ,no data ,staphylococci in ,pus3 ,chlorlyptus 7,exp4 #aa7 #aj for #a hour #aj for #a_/b hour #e for #b hours ,eucalyptus oil ,no data ,no data ,phenol ,no data ,no data ,staphylococci in ,human ,blood ,serum3 ,chlorlyptus 7,exp4 #ab7 #e in #a hour #a in #a hour ,eucalyptus oil ,no data ,no data ,phenol #e almost at once #a in #a hour ---------------------------------------- ---------------------------- ,,infection ,,experiments ,,in ,,vivo ,dr4 ,rivas reports two series of experiments1 in each of which three guinea-pigs received staphylococcus suspensions in the peritoneum4 ,one guinea-pig in each series was left untreated2 the others received injections of chlorlyptus into the peritoneum at various intervals4 ,the following results were obtained3 ,chlorlyptus ,results ,exp4 #ai1 ,no4 #a ,none ,survived ,exp4 #bj1 ,no4 #a ,none ,died ,exp4 #ai1 ,no4 #b ,at once ,died ,exp4 #ai1 ,no4 #c ,after #bd hours ,survived ,exp4 #bj1 ,no4 #b ,after #ah hours ,died ,exp4 #bj1 ,no4 #c ,after #bd hours ,died ---------------------------------------- ------------ ,this shows mortalities of3 #a in #b1 i4 e41 #ej per cent41 without chlorlyptus4 #c in #d1 i4 e41 #ge per cent41 with chlorlyptus4 ,it is doubtful whether so small a series of experiments on so variable a phenomenon as is infection should receive any serious consideration4 ,so far as they go1 they would indicate that chlorlyptus is useless or worse4 ,,toxicity ,the referee determined the acute toxicity of chlorlyptus by hypodermic injection of oily solutions into white rats4 ,comparative experiments were made with ordinary eucalyptus oil4 ,the details are given in the appendix4 ,the end-results may be summarized as follows3 ,survived ,chlorlyptus ,eucalyptus ,oil #a4ef c4c4 #c4ge c4c4 #e4jj c4c4 #f4be c4c4 #a4be c4c4 #h4fe c4c4 #b4e c4c4 7#c days7 ,died 7in days7 #ab4e c4c4 7#a day7 #c4ge c4c4 7#c days7 #ab4e c4c4 7#a day7 #e4jj c4c4 7#c days7 #ah4ge c4c4 7#a day7 #f4be c4c4 7#a-a_/b days7 ,m4 ,f4 ,d4 #h4ge to #ab4e c4c4 per kg4 #a4be to #b4e c4c4 per kg4 ---------------------------------------- -------------------------- ,fatality4--,the doses are calculated for cubic centimeters of the undiluted drugs per kilogram of rat4 ,dr4 ,rivas reports a series of toxicity experiments on guinea-pigs4 ,assuming a uniform weight of #djj gm4 per animal1 his results 7details in appendix7 may be summarized as3 ,minimal ,maximal ,fatal ,dose ,survived ,dose ,c4c4 per ,kg4 ,c4c4 per ,kg4 ,chlorlyptus1 peritoneal 7,exp4 #ad7 #g4e c4c4 #e4j c4c4 ,chlorlyptus1 pleural 7,exp4 #ae7 #e4j c4c4 #b4e c4c4 ,eucalyptus oil1 peritoneal 7,exp4 #af7 #b4e c4c4 ,no ,data ,eucalyptus oil1 pleural 7,exp4 #af7 #a4be c4c4 ,no ,data ,dichloramin-,t1 peritoneal 7,exp4 #af7 #a4be c4c4 ,no ,data ---------------------------------------- -------------------------- ,the comparative toxicity in the various series is therefore approximately as follows3 ,chlorlyptus 3 ,eucalyptus ,referee1 rats1 hypodermic #a_/e 3 #a ,rivas guinea-pig1 peritoneal #a_/c 3 #a ,rivas guinea-pig1 pleural #a_/d 3 #a ---------------------------------------- ---------------- ,evidently1 the toxicity of chlorlyptus is about one-fourth of that of eucalyptus oil4 ,the difference is considerable1 but not fundamental4 ,moreover1 the symptoms of chlorlyptus resemble the characteristics of eucalyptus oil4 ,according to the tabulation of ,barker and ,rowntree1#acf the mean fatal dose of eucalyptus oil for man1 in the twenty-nine clinical cases reported in the literature1 is about #bj c4c4 ,if the toxicity ratio of the two substances were the same as for the rat experiments 7a rather hazardous assumption71 the fatal dose of chlorlyptus for man would be about #hj c4c4 #acf ,barker and ,rowntree 7,bull4 ,johns ,hopkins ,hospital #bi3bae1 #bba ,oct4 #aiah7 obtained the following results with eucalyptus oil3 ,cat1 hypodermic2 survived #c c4c4 per kg42 killed by #e4e c4c4 per kg4 ,cat1 intraperitoneal2 killed by #e c4c4 per kg4 ,dog1 hypodermic2 survived #a4c c4c4 per kg4 ,they quote from ,browning that the following doses1 c4c4 per kilogram1 are not fatal3 frogs1 #j4e2 rabbits1 #a to #e2 guinea-pigs1 #a4 ,,irritation ,rivas's ,experiment #ad shows that chlorlyptus gives very definite irritation1 apparently similar to that produced in ,experiment #af by eucalyptus oil in one-fourth the dose4 ,incidentally1 the referee may add from personal experience that the 8chlorlyptus oil1 #e per cent4 ,cl0 is markedly irritating in the nostrils1 although marked 8non-irritating0 on the label4 ,,ii4 ,,appendix3 ,,special ,,reports ,a4 ,,comparison ,,of ,,chlorlyptus ,,with ,,chlorinated ,,eucalyptol ,from the ,chemical ,laboratory of the ,american ,medical ,association ,according to the label1 8,chlorlyptus0 is a 8,synthatized ,chlorinated ,oil of ,eucalyptos1 with ,acid ,reaction1 containing approximately #cj per cent4 ,chlorine and possesses excellent ,germicidal ,properties1 when made under our special process40 ,it is manufactured by the ,weeks ,chemical ,company1 ,philadelphia1 ,pa4 ,this product was submitted to the ,council on ,pharmacy and ,chemistry by the manufacturers1 and in turn the ,laboratory was asked to examine it with the idea of comparing it with the nonproprietary brands of 8chlorinated eucalyptol0 7used as a solvent for dichloramine-,t2 see ,new and ,nonofficial ,remedies1 #aiai1 p4 #gj74 ,in the submission1 certain tests were described1 most of which were followed4 ,among the statements given under the chemical properties of chlorlyptus are3 8,on distillation1 chlorlyptus begins to boil at about #ajj ,c4 ,the temperature rises as the distillation continues1 accompanied by the decomposition of the chlorlyptus and the evolution of hydrochloric acid and chlorine40 8,when brought into contact with water1 chlorlyptus undergoes a process of hydrolysis 4440 ,notwithstanding the foregoing the statement is made on the label that chlorlyptus 8is a ,stable ,compound1 not affected by heat1 light or water40 ,the following comparisons of chlorlyptus1 chlorinated eucalyptol-,abbott and chlorinated eucalyptol-,squibb were made3 ,chlorlyptus is a viscous1 dark brown liquid1 with an acrid odor and having a specific gravity of #a4bjih4 ,chlorinated eucalyptol-,abbott is a mobile1 light yellow liquid1 with a eucalyptus odor1 having a specific gravity of #j4icag4 ,chlorinated eucalyptol-,squibb is a mobile1 colorless liquid1 and its specific gravity is #j4icjc4 ,an alcoholic solution of silver nitrate added to an alcoholic solution of chlorlyptus yields a heavy precipitate of silver chloride4 ,in the case of the ,abbott chlorinated eucalyptol a slight turbidity is caused by this test2 the ,squibb product shows no reaction4 ,a #aj per cent4 solution of potassium iodide is overlaid with an equal volume of chlorlyptus4 ,iodine is slowly liberated1 being noticeable in one-half hour4 ,with chlorinated eucalyptol-,abbott1 a trace of free iodine is discernible after four hours1 while with chlorinated eucalyptol-,squibb there is no free iodine present4 ,when the respective products are shaken with an alcoholic solution of potassium iodide1 no iodine is immediately liberated1 thus showing the absence of 8active chlorine0 7difference from the hypochlorite derivatives74 ,when chlorlyptus is dissolved in concentrated sulphuric acid1 some blackening occurs and the odor of hydrogen chloride is very noticeable4 ,both the ,abbott and ,squibb brands of chlorinated eucalyptol give a reddish mixture1 with no perceptible evolution of hydrogen chloride1 and still retain the characteristic eucalyptol odor4 ,on heating1 chlorlyptus decomposes and begins to boil at from #ajc to #aje ,c4 ,then a higher fraction comes over at #agh ,c4 ,the distillate has a sharp odor1 is acid1 and frees very little iodine from potassium iodide4 ,chlorinated eucalyptol-,abbott does not seem to decompose4 ,some gaseous substance is given off at #hj ,c1 but the liquid distills at #agc ,c4 ,the distillate has no acid odor1 is neutral1 and liberates no iodine from potassium iodide4 7,in both cases the distillation was not carried to completion1 approximately only about half of the volume being distilled over47 ,,preliminary ,,tests ,,on ,,chlorlyptus ,,and ,,chlorinated ,,eucalyptol ,chlorinated ,chlorinated ,chlorlyptus ,eucalyptol-,abbot ,eucalyptol-,squibb ,odor ,acrid ,like eucalyptus ,like eucalyptus ,density and ,dark brown2 ,light yellow2 ,colorless2 color viscous1 mobile2 lighter mobile2 lighter heavier than water than water than water ,ag,n,o added ,heavy ppt4 ,slight turbidity ,clear to alcoholic solution ,equal parts ,gives free ,gives free iodin ,no free iodin with ,,ki iodin slowly1 in #d hours2 in #d hours solution noticeable not much in #a_/b hour ,equal parts ,much iodin ,small amount of ,no free iodin with #aj ,,ki1 immediately free iodin in in #c hours #aj ,,kio few numbers2 solution does not noticeably increase ,equal parts ,some blackening2 ,reddish mixture2 ,same with conc4 odor of ,h,cl no ,h,cl2 ,h,,so eucalyptol odor ,alcohol ,,ki ,no iodin ,same ,same as ,abbott liberated product ,heating ,decomposes and ,apparently does not boils at decompose2 some #ajc-aje ,c42 gas given off then higher when ,t#hj2 the fraction comes liquid distilled over at #agh ,c42 at #agc ,c42 the distillate has distillate did sharp odor1 is not have much acid1 but frees odor2 no ,h,cl very little gas detected2 ,i from ,,ki2 no ,i from distillation ,,ki2 distillate not completed was neutral 7distillation not completed7 ---------------------------------------- ------------------------------ ,the addition of chlorlyptus to a mixture of #aj per cent4 potassium iodide1 #aj per cent4 potassium iodate solution1 brings about the liberation of iodine1 increasing perceptibly on standing4 ,this shows that the hydrogen chloride is gradually split off1 and in time will cause a solution having a considerable degree of acidity4 ,when this test is carried out on chlorinated eucalyptol-,abbott1 a small amount of iodine is liberated in a few minutes but does not increase1 showing a slight initial acidity without further hydrolysis4 ,chlorinated eucalyptol-,squibb yields no free iodine after standing three hours4 ,when the chlorine content of chlorlyptus is determined according to the method of ,carius1 the amount is found to be #bi4f per cent4 7,the manufacturers give a method of determining chlorine by ,hunter's fusion method4 ,it is believed that in this method hydrogen chloride may be lost1 and this opinion is substantiated by the firm's statement1 8,chlorlyptus analyzed in this manner shows approximately #be per cent4 of chlorine407 ,the chlorine content of chlorinated eucalyptol-,abbott is found to be #j4fg per cent41 and that of the ,squibb brand to be #j4fb per cent4 7about one-fiftieth as much as in chlorlyptus74 ,to sum up3 ,chlorlyptus differs from chlorinated eucalyptol in odor1 color1 density1 in reaction to silver nitrate1 potassium iodide1 sulphuric acid and the aqueous solution of potassium iodate and potassium iodide4 ,the distillation of the two products occurs differently4 ,chlorlyptus contains nearly #cj per cent4 of chlorine1 which is approximately fifty times as much as in chlorinated eucalyptol4 ,thus it appears to have considerable chlorine in the negative form 7,cl-7 which may be relatively easily split off as hydrogen chloride4 ,b4 ,,the ,,persistence ,,of ,,the ,,acid ,reaction of ,chlorlyptus in the ,body ,,by ,,the ,,referee ,this 8chlorinated ozonized eucalyptus oil0 is distinctly acid to litmus paper4 ,it is claimed that further quantities of acid are liberated on contact with water4 ,this is credited with producing a continuous acid reaction on the surface of tissues to which the oil may be applied and this in turn is stated to be antiseptic or germicidal4 ,this theoretical speculation does not take into account the large quantity of reserve alkali in the body by which it combats attempts to alter its normal reaction4 ,it is therefore not convincing1 unless it is supported by direct evidence4 ,in the absence of such data on the part of the promoters of the preparation1 experiments were made to determine whether the oil preserves its acid reaction in contact with mucous and serous membranes4 ,the answers were clearly in the negative4 ,in the mouth1 the reaction becomes neutral within ten or fifteen minutes2 in the pleura and peritoneum within half an hour1 and probably in much shorter periods4 ,more detailed data follow3 ,,series ,a3 ,,behavior ,,in ,,the ,,mouth2 ,,homo ,,experiment4--,chlorlyptus and to less extent ,chlorlyptus ,oil1 are acid to litmus4 ,they are applied3 7a7 ,drop to litmus paper and this to gums4 7b7 ,several drops directly to tongue4 7c7 ,same to gums4 ,the reaction to litmus paper is tried from time to time4 ,,results4--7a7 ,applied to gums on litmus paper3 ,chlorlyptus3 ,red color becomes gradually feebler and does not spread on the paper4 ,chlorlyptus ,oil3 ,turns blue in a few minutes4 7b7 ,dropped on tongue3 ,chlorlyptus3 ,acid taste at once4 ,does not increase1 but on contrary1 becomes less4 ,litmus applied after ten minutes3 not acid4 ,litmus applied after five minutes3 distinctly acid4 7c7 ,dropped on inside of cheek3 ,chlorlyptus1 #a_/c c4c43 ,after six minutes1 litmus very red4 ,after ten minutes1 faintly red4 ,after fifteen minutes1 blue4 ,chlorlyptus ,oil1 #a c4c4 ,after three minutes1 faintly red4 ,after eight minutes1 neutral4 ,,conclusions4--,on contact with living tissues1 the acid of chlorlyptus is rapidly neutralized and absorbed4 ,the surface is neutral within ten or fifteen minutes4 ,it is therefore very improbable that the acidity is effectively antiseptic4 ,a comparison of chlorlyptus with dilute acetic acid shows that the chlorlyptus does not maintain the acidity even as well as #a per cent4 acetic acid4 ,acetic ,acid ,chlorlyptus ,tongue1 a drop of #e per cent42 still ,neutral between five slightly acid to litmus after ten minutes2 and ten minutes taste almost gone in two minutes ,gums1 a few drops between cheeks and gums3 ,neutral between ten ,five per cent4 still strongly acid in and fifteen minutes twelve minutes2 distinctly acid in seventeen minutes4 ,one per cent4 still strongly acid in twenty-one minutes ---------------------------------------- ----------------------------- ,,chlorlyptus3 ,,reaction 7,,litmus ,,paper7 ,,on ,,contact ,,with ,,tissue ,serial ,when ,quantity1 ,time ,blue ,symptoms or ,no4 ,animal ,injected ,c4c4 of ,death ,litmus ,toxicity #a ,rat ,pleura #a #a_/b hour ,remains blue ,none2 killed2 pleura not congested2 lung spec4 #ba2 slight congestion #b ,rat ,pleura #a #a hour ,remains blue ,negative #c ,rat ,pleura #a #bc min4 ,remains blue ,almost at once bad gasping respiration and died in #bc m42 heart distend42 possibly injection penetrated lung ,peritoneum #a #bc min4 ,turns red #d ,rabbit ,pleura #a 4444 444444 ,died overnight #e ,dog ,pleura #a #a_/d hour ,remains blue #bj m4 p4 m4 ,peritoneum #a #a_/d hour ,remains blue #bj m4 p4 m4 #f ,dog ,pleura #a #c min4 ,remains blue #de m4 p4 m4 ,peritoneum #a #c min4 ,remains blue #de m4 p4 m4 #g ,dog ,pleura #a #bj min4 ,remains blue #bj m4 p4 m4 ,peritoneum #a #bj min4 ,remains blue #bj m4 p4 m4 ,,series ,b3 ,,serous ,,membranes ,in these experiments1 #a c4c4 of chlorlyptus was injected into the pleura or peritoneum4 ,after a stated time1 the animal was killed1 and the reaction of the pleural or peritoneal surface was tested with blue litmus paper4 ,the results are shown in the table4 ,c4 ,,toxicity ,,experiments ,by the ,referee ,,technic ,white rats were injected hypodermically with chlorlyptus or with eucalyptus oil1 diluted with olive oil in the ratio of #a3d4 ,the larger doses were divided between two or more sites of injection4 ,,detailed ,,protocols ,hypodermic injections in white rats4 ,drugs diluted with #c parts of olive oil4 ,doses are given as cubic centimeters of pure drug per kilogram of rat4 ,a4 ,,eucalyptus ,,series ,,experiment #a4--a4be c4c42 injected ,,vii4#i4ai3 ,active2 walks about4 ,no depression at any time4 ,,vii4#aj4ai4 ,appears normal4 ,,experiment #b4--b4e c4c42 injected ,,vi4#cj4ai3 ,quiet--not very depressed1 reflexes good 7six hours74 ,,vii4#a4ai--;,active--reflexes good1 eats moderately4 ,,vii4#b4ai--;,animal acts normal--eats moderately1 reflexes good2 active 7a4m474 ,later in day1 depressed4 ,,vii4#d4ai--;,died during night of ,,vii4#c4ai4 ,,experiment #c4--c4ge c4c42 injected ,,vi4#bd4ai3 ,quiet2 depressed2 pain reflex diminished4 ,animal lay on ventral surface1 not supported by legs4 ,will get on to feet very sluggishly if turned on side 7twenty-four hours74 ,does not eat4 ,,vi4#bf4ai--;,depressed slightly2 pain reflex present4 ,,vi4#bg4ai--;,fairly active2 eats a little4 ,,vi4#bh4ai--;,depressed4 ,died during night of ,,vi4#bi4ai 7three days74 ,,experiment #d4--e c4c42 injected ,,vi4#bd4ai3 ,quiet2 markedly depressed 7one hour74 ,does not get on feet when turned on side2 ataxia well marked4 ,slight watery secretion in eyes4 ,reflexes diminished4 ,does not eat 7twenty-four hours74 ,,vi4#bf4ai--;,heart slowed and arrhythmic4 ,animal lies on side4 ,unable to walk2 markedly depressed4 ,,vi4#bg4ai--,lies on side2 does not eat4 ,died during night of ,,vi4#bg4ai 7three days74 ,,experiment #e4--f4be c4c42 injected ,,vi4#bd4ai3 ,quiet2 very markedly depressed4 ,heart and respiration greatly slowed4 ,lies on side2 tears in eyes2 does not eat 7twenty-four hours74 ,,vi4#be4ai--,temperature subnormal2 cold to touch2 tail stiffened and straight4 ,died during night of ,,vi4#be4ai 7one and one-half days74 ,postmortem3 ,lungs congested4 ,liver pale in color4 ,spleen very dark red4 ,kidneys normal4 ,other organs normal4 ,b4 ,,chlorlyptus ,,experiments ,,experiment #a4--a4ef c4c42 injected ,,vi4#bd4ai3 ,rather restless for an hour4 ,active during next four hours and following twenty-four4 ,eats well1 reflexes good4 ,acts normal on ,,vii4#a4ai and since ,,vi4#bf4ai4 ,,experiment #b4--c4ge c4c42 injected ,,vi4#bd4ai3 ,more quiet2 active during next twenty-four hours4 ,reflex all right4 ,eats well2 normal ,,vii4#a4ai1 since ,,vi4#bf4ai4 ,,experiment #c4--e c4c42 injected ,,vi4#bd4ai3 ,quiet2 defecation in four hours4 ,rather quiet for six hours4 ,eats well4 ,reflexes good2 normal ,,vii4#a4ai1 since ,,vi4#bf4ai4 ,,experiment #d4--f4be c4c42 injected ,,vi4#bd4ai3 ,quiet and breathing labored in four hours2 active after twenty-four hours4 ,eats well4 ,somewhat depressed on ,,vi4#bf4ai2 pain reflex present4 ,on ,,vi4#bf4ai1 eats well and fairly active4 ,active and eats1 ,,vi4#bg4ai4 ,appears normal1 ,,vii4#a4ai4 ,,experiment #e4--h4ge c4c42 injected ,,vi4#cj4ai3 ,rather quiet during next two hours4 ,morning of ,,vii4#a4ai1 lies on stomach2 quiet2 does not eat very much4 ,pain reflexes good4 ,,vii4#b4ai1 still depressed2 does not eat4 ,appears normal1 ,,vii4#c4ai4 ,,experiment #f4--ab4e c4c42 injected ,,vi4#be4ai3 ,quiet1 but reflexes good2 more quiet and depressed after several hours4 ,some loss of oil from wound4 ,died night of ,,vi4#be4ai 7one day74 ,tail stiff4 ,temperature low4 ,postmortem3 ,lungs markedly congested4 ,spleen and liver dark red4 ,one kidney congested4 ,other viscera normal4 ,,experiment #g4--ab4e c4c42 injected ,,vii4#i4ai3 ,quiet for one-half hour2 #a4e hours twitching of muscles of whole body1 lies on side1 ataxia present4 ,died night of ,,vii4#i4ai 7one day74 ,,experiment #h4--ah4ge c4c42 injected ,,vi4#be4ai3 ,quiet2 reflexes good 7three hours74 ,some loss of oil4 ,depressed and turns on side 7six hours74 ,died night of ,,vi4#be4ai 7one day74 ,postmortem3 ,lungs congested4 ,spleen and liver very dark red4 ,right kidney much darker red4 ,viscera normal4 ,d4 ,,report ,,of ,,dr4 ,d4 ,,rivas ,the following are the results of experiments conducted by me1 during the past four months1 on the germicidal action of chlorlyptus 7chlorinated oil of eucalyptus1 principal constituent ,c,h,o,cl7 in vitro and in vivo1 and comparison also with carbolic acid1 oil of eucalyptus and dichloramine in test for irritation and toxicity4 ,germicidal ,action4--,based on the results obtained1 chlorlyptus when used in a #e per cent4 paraffin oil solution was found to be a mild germicidal against typhoid ,b1 streptococcus and staphylococcus when these organisms were suspended in ordinary bouillon culture or sterile salt solutions4 ,the germicidal action was found stronger when these micro-organisms were suspended in a sterile oily or lipoid substance1 such as olive oil4 ,the results of these experiments were not constant1 owing probably to the imperfect suspension of the bacteria4 ,thus1 while in some of the experiments chlorlyptus in #a per cent4 oil solution destroyed these micro-organisms1 in other cases the same strength solution failed to give same result in same time4 ,the increased germicidal action of chlorlyptus on bacterial suspensions in olive oil may be accounted for by the fact that chlorlyptus is soluble in olive oil and not an admixture1 as in the case of paraffin oil4 ,chlorlyptus is not a coagulant1 as are germicides of the phenol or hypochlorite types1 and the germicidal action is therefore not strictly comparable4 ,the germicidal action of chlorlyptus oil solution1 on pathogenic bacteria1 on streptococcus and staphylococcus1 suspended in pus1 was found to be stronger than when these micro-organisms were suspended in ordinary bouillon culture or sterile salt solution4 ,in one of the experiments1 similar results were obtained when these micro-organisms were suspended in olive oil1 chlorlyptus showing marked germicidal action4 ,irritation and ,toxicity4--,the irritating action was found to be relatively mild in tests on laboratory animals4 ,thus1 from #j4e to #a c4c4 of chlorlyptus in paraffin oil #e per cent4 solution1 injected into peritoneal or pleural cavities of guinea-pigs weighing #djj gm4 was found to be without any appreciable disturbance in the health of the animal1 and in some cases the injection of as much as #b c4c4 did not kill the animal4 ,therapeutic ,action4--,guinea-pigs were inoculated with purulent material containing streptococcus1 staphylococcus and ,b4 coli in peritoneal and pleural cavities respectively1 and after six hours #a c4c4 of chlorlyptus #e per cent4 in paraffin oil solution was injected4 ,other infected animals were similarly treated twenty-four hours after inoculation1 and another series forty-eight hours after inoculation4 ,in some of these cases the animals died from shock but in a clearly defined series in which the injection of #a c4c4 of the chlorlyptus solution was made in the peritoneum of the guinea-pigs twenty-four hours after the inoculation1 the animals lived4 ,the control animal1 inoculated with the purulent material and not treated with chlorlyptus oil solution1 died4 ,in consideration that the injection of chlorlyptus oil solution sic1 referee were made 8 referee in the peritoneal cavity this substance is apt to affect the vital organs in the abdominal cavity4 ,it is my belief that in case of wall abscess of chronic inflammation1 by limiting the action of chlorlyptus to the infected area1 preventing at the same time the infection of the vital organs1 chlorlyptus1 because of its non-irritating quality1 can be used effectively as an antiseptic4 ,,conclusions #a4 ,chlorlyptus is a mild and relatively nonirritating antiseptic of marked action on pus and suppuration4 #b4 ,when bacteria were suspended in olive oil or in pus1 chlorlyptus showed marked germicidal action4 #c4 ,chlorlyptus can be injected into the peritoneum or the pleural cavities of guinea-pigs in the proportion of #a c4c4 per #djj gm4 of body weight without detriment to the animal4 #d4 ,chlorlyptus in #e per cent4 oil solution 7taking ,clause #c as comparison7 can perhaps be injected in man as an antiseptic agent when there is a walled-in abscess in the peritoneum or pleural cavity where there is drainage1 in the proportion of #j4e to #a c4c4 per pound of body weight with good result4 ,,report ,,on ,,the ,,germicidal ,,action ,,of ,,chlorlyptus ,,on ,,pathogenic ,,bacteria ,,in ,,vitro ,,and ,,in ,,vivo ,,experiment #a4--,the germicidal action of eucalyptus oil4--,typhoid bacillus was destroyed in less than five minutes when exposed to the action of a #e per cent4 suspension of oil of eucalyptus4 ,the exposure for four hours in a #e per cent4 suspension of chlorlyptus in paraffin oil was without effect on typhoid bacillus4 ,it requires an exposure of two to four hours in a #aj per cent4 suspension of chlorlyptus in paraffin oil to destroy typhoid bacillus4 ,,experiment #b4--;,bacilliary action of chlorlyptus on the growth of pathogenic bacteria4--,typhoid and anthrax bacilli were selected for the experiment4 ,two series of five tubes each were made4 ,the culture medium used was nutrient bouillon4 ,chlorlyptus was added in the following proportions3 ,tube #a1 #a3aj2 ,tube #b1 #a3ajj2 ,tube #c1 #a3a1jjj2 ,tube #d1 #a3aj1jjj1 and ,tube #e1 #a3ajj1jjj4 ,one series was inoculated with typhoid bacillus4 ,all tubes were incubated for three days at #cg ,c4 ,chlorlyptus inhibited the growth of typhoid bacillus when added to the bouillon in the proportions of #a3aj4 ,the growth of anthrax bacillus was inhibited by chlorlyptus when it was added in the proportions of #a3aj1 #a3ajj and #a3a1jjj1 as shown in the accompanying table4 ,the table was not submitted4--,ed4 ,in one instance the growth was markedly inhibited by chlorlyptus when added in the proportion of #a3aj1jjj4 ,,experiment #c4--;,germicidal action of chlorlyptus on typhoid bacillus4--,bouillon cultures of typhoid bacillus forty-eight hours old1 and a suspension of forty-eight-hour agar cultures of typhoid bacillus in sterile salt solution were used for the experiment4 ,chlorlyptus was added in the proportion of #a3a1jjj2 #a3a1ejj2 #a3ajj2 #b per cent42 #c per cent42 #d per cent42 #e per cent4 and #aj per cent41 respectively4 ,inoculations were made in trypsinized peptone bouillon after the addition of chlorlyptus at different intervals1 namely3 at once1 after five minutes1 after ten minutes1 after fifteen minutes1 after thirty minutes1 after one hour and after two hours1 and tubes incubated at #cg ,c4 for forty-eight hours4 ,result3 ,growth was shown in all tubes except those in which chlorlyptus was added in the proportion of #aj per cent4 and after the action of the antiseptic for two hours or longer4 ,,experiment #d4--;,inhibitory action of chlorlyptus in the growth of typhoid bacillus4--,chlorlyptus was added to sterile bouillon in the proportion of #a3ajj1 #a3a1jjj1 #a3aj1jjj and #a3ajj1jjj1 and incubated for forty-eight hours at #cg ,c4 to eliminate any possible contamination of the bouillon during the manipulations4 ,all tubes were found sterile and inoculated with typhoid bacillus4 ,result3 ,all tubes were found sterile again after being inoculated with typhoid bacillus and incubated at #cg ,c4 for forty-eight hours1 which shows chlorlyptus inhibited and the growth of typhoid bacillus in bouillon when this antiseptic was added in the proportions of #a3ajj to #a3ajj1jjj4 ,remarks3 ,in another experiment made1 chlorlyptus showed a weaker inhibitory action on the growth of typhoid bacillus4 ,,experiment #e4--;,germicidal action of carbolic acid4--,the technic was the same as that outlined in ,experiment #a4 except that carbolic acid was used instead of chlorlyptus4 ,result3 ,carbolic acid showed a distinct germicidal action on typhoid bacillus in the proportions of #a per cent4 in ten minutes4 ,,experiment #f4--;,action of nitrogen gas on the growth of typhoid bacillus in bouillon and nutrient agar when chlorlyptus was added to this culture medium4--,chlorlyptus was added to the bouillon in the proportions of #a3ajj1 #a3a1jjj1 #a3aj1jjj and #a3ajj1jjj1 as outlined in ,experiment #b2 also to agar kept melted at #de ,c4 ,tubes were inoculated with typhoid bacillus2 plates were made of the inoculated agar tubes2 all plates and tubes were incubated at #cg ,c4 for forty-eight hours in an atmosphere of nitrogen gas4 ,duplicate experiments were made with cultures of typhoid bacillus as above in bouillon and agar plates containing the same amount of chlorlyptus and incubated at #cg ,c4 in ordinary atmosphere as control4 ,result3 ,nitrogen gas did not show any appreciable increase of the germicidal action of typhoid bacillus when grown in medium containing chlorlyptus4 ,growth was about the same in cultures supplied with nitrogen gas as in those growing in ordinary atmosphere4 ,,experiment #g4--;,germicidal action of chlorlyptus on pyogenic bacteria suspended in an oily medium4--,experiment with streptococcus3 ,cultures of streptococcus in blood agar three days old were suspended in olive oil 7sterile71 and chlorlyptus was added in the proportions of #a1 #e and #aj per cent4 and inoculated in trypsinized bouillon at different intervals1 namely3 at once1 after five minutes1 after ten minutes1 after fifteen minutes1 after thirty minutes1 and after one hour4 ,tubes were incubated at #cg ,c4 for forty-eight hours4 ,result3 ,all tubes remained sterile4 ,the germicidal action of chlorlyptus on streptococcus suspended in oil was almost at once and with certainty after five minutes when added in the proportion of #a1 #e and #aj per cent4 ,,experiment #h4--;,germicidal action of chlorlyptus on staphylococcus1 suspended in sterile olive oil4--,the technic employed was the same as in ,experiment #e1 except that a culture of staphylococcus was used4 ,result3 ,all tubes remained sterile4 ,the germicidal action of chlorlyptus was almost at once in the proportions of #a1 #e and #aj per cent4 ,remarks3 ,by repeating this experiment the result showed some variations4 ,the discrepancy was probably due to an imperfect suspension of the micro-organism in the oil4 ,,experiment #i4--;,germicidal action of carbolic acid on streptococcus suspended in olive oil4--,the technic employed was the same as in ,experiment #e1 except that carbolic acid was used instead of chlorlyptus4 ,result3 ,the germicidal action of carbolic acid of streptococcus suspended in olive oil was almost at once in the proportions of #a1 #e and #aj4 ,,experiment #aj4--;,germicidal action of chlorlyptus on staphylococcus4--,the technic employed was the same as in ,experiment #f except that the carbolic acid was used instead of chlorlyptus4 ,result3 ,the germicidal action of carbolic acid on staphylococcus suspended in olive oil was almost at once1 in proportions of #a1 #e and #aj per cent4 ,,experiment #aa4--;,germicidal action of chlorlyptus on pyogenic bacteria suspended in pus4--,chlorlyptus was added to sterile pus in the proportions of #a1 #e and #aj per cent41 and then inoculated with staphylococcus and cultures were made in bouillon at once1 after five minutes1 after ten minutes1 after fifteen minutes1 after thirty minutes1 after one hour and after two hours1 respectively1 and tubes incubated for forty-eight hours at #cg ,c4 ,result3 ,growth was shown in all tubes except those inoculated from tubes in which chlorlyptus was added in the proportions of #aj per cent4 after one hour4 ,,experiment #ab4--;,germicidal action of chlorlyptus on streptococcus suspended in sterile human blood serum4--,staphylococcus culture in agar forty-eight hours old was suspended in sterile human blood serum1 and to the suspension chlorlyptus #e per cent4 in paraffin oil was added in the proportions of #a1 #e and #aj per cent4 ,inoculations were made at intervals1 at once1 after five minutes1 after ten minutes1 after fifteen minutes and after one hour in trypsinized bouillon4 ,tubes were incubated at #cg ,c4 for forty-eight hours4 ,result3 ,chlorlyptus showed inhibitory action on the growth of staphylococcus in the strength of #aj per cent41 but did not produce complete sterilization4 ,similar results were shown with the #e per cent41 and in the #a per cent4 chlorlyptus did not show any inhibitory action at all4 ,,experiment #ac4--;,germicidal action of carbolic acid on staphylococcus suspended in human blood serum 7sterile74--,the technic employed was the same as in ,experiment #aj except that carbolic acid was used instead of chlorlyptus4 ,result3 ,carbolic acid produced a complete sterilization in the strength of #aj per cent4 almost at once1 and with certainty after five minutes4 ,similar results were produced with the #e per cent4 ,the #a per cent4 carbolic acid did not show any appreciable germicidal action on staphylococcus4 ,,experiment #ad4--,toxic and irritant action of chlorlyptus4--,six normal guinea-pigs were used for the experiment4 ,guinea-,pig #a was injected peritoneally with #a c4c4 of chlorlyptus1 ,guinea-,pig #b with #b c4c4 of chlorlyptus1 ,guinea-,pig #c with #c c4c4 of chlorlyptus1 ,guinea-,pig #d with #d c4c4 and ,guinea-,pig #e with #e c4c4 #e per cent4 respectively4 ,guinea-,pig #f was used as a control and not injected4 ,result3 ,guinea-,pigs #a and #b did not show any appreciable disturbance4 ,guinea-,pig #c was sick for four days1 after which it gradually recovered but it became sick again after one week and died ten days after the injection4 ,guinea-,pig #d died over night4 ,guinea-,pig #e died six hours after injection4 ,guinea-,pig #e was injected at #aa3cj with #e c4c4 chlorlyptus4 ,ten minutes after the injection it was lying relaxed1 respiration and heart normal1 conjunctive reflex present4 ,one hour after the injection the animal seemed to present symptoms resembling those of narcosis3 respiration and heart were normal4 ,after four hours there was no change in the condition of the guinea-pig except that the respiration was irregular4 ,five and a half hours after it showed prostration with irregular respiration and heart action4 ,six hours after injection the animal was dead4 ,autopsy3 ,the peritoneum showed a congestion and a fibrinous exudation1 amount of liquid increased1 some part of which was probably chlorlyptus unabsorbed4 ,spleen about normal1 liver congested1 kidney about normal1 suprarenal glands about normal1 lungs normal1 pleural cavity obtained no exudation1 heart soft1 flabby and congested4 ,,experiment #ae4--,toxic and irritant action of chlorlyptus when injected into the pleural cavity4--,six normal guinea-pigs used for the experiment4 ,chlorlyptus was injected in the pleural cavity as follows3 ,guinea-,pig #a1 #j4e c4c42 ,guinea-,pig #b1 #a c4c42 ,guinea-,pig #c1 #b c4c42 ,guinea-,pig #d1 #c c4c41 and ,guinea-,pig #e1 #d c4c4 ,guinea-,pig #f was used as a control4 ,result3 ,guinea-,pigs #a and #b recovered about four hours after injection4 ,guinea-,pig #c died three days after and ,guinea-,pigs #d and #e four and two hours after1 respectively4 ,conclusions3 ,guinea-pigs weighing on the average of #djj gm4 may be injected peritoneally with one or two c4c4 or intrapleurally with #j4e to #a c4c4 of chlorlyptus without having fatal results from the injection4 ,,experiment #af4--,toxic and irritant action of eucalyptus oil4--,three normal guinea-pigs were used for the experiment4 ,guinea-,pig #a was injected with #a c4c4 of oil of eucalyptus in the peritoneum1 and ,guinea-,pig #b with #j4e c4c4 in the pleural cavity4 ,guinea-,pig #c was used as a control4 ,result3 ,guinea-,pig #a died about three hours after injection1 and ,guinea-,pig #b about two hours after the injection4 ,autopsy3 ,both guinea-pigs showed marked congestion and a moderate degree of exudate in the peritoneum4 ,,experiment #ag4--,toxic and virulent action of eucalyptus4--,three normal guinea-pigs were selected for the experiment1 as in ,experiment #af4 ,the injection was made in the pleural cavity4 ,guinea-,pig #a was injected with #j4e c4c4 and ,guinea-,pig #b with #a c4c4 of eucalyptus oil4 ,result3 ,guinea-,pig #a died the following day1 and ,guinea-,pig #b one hour after the injection4 ,,experiment #ah4--,toxic and irritant action of dichloramin-,t1 #j4e per cent4 in chlorcozane4--,one guinea-pig was used for each experiment4 ,guinea-,pig #a was injected with #j4e c4c4 and ,guinea-,pig #b with #a c4c4 of dichloramin-,t peritoneally4 ,result3 ,both animals became restless immediately after the injection1 and died twelve hours after of acute hemorrhagic peritonitis4 ,,experiment #ai4--;,effect of chlorlyptus on staphylococcus suspended in salt solution and one of that solution injected into the peritoneum of the guinea-pig4--,three guinea-pigs were used for the experiment4 ,guinea-,pig #a was injected with #j4e c4c4 of staphylococcus suspension as control4 ,guinea-,pig #b was given the same1 and immediately after received #a c4c4 of chlorlyptus4 ,guinea-,pig #c was injected with the same amount1 and chlorlyptus was injected twenty-four hours after injection4 ,results3 ,guinea-,pig #a was sick and weak with loss of appetite for some days1 but gradually recovered4 ,guinea-,pig #b died over night4 ,autopsy3 ,there was a large amount of exudate in the peritoneal cavity1 irritation of the intestine1 and other signs of acute inflammation4 ,a moderate degree of congestion2 spleen not enlarged2 liver showed cloudy swelling and fibrinous exudate2 lungs and heart about normal except for a moderate degree of congestion but no exudate4 ,guinea-,pig #c was sick for some days1 but recovered gradually one week after4 ,,experiment #bj4--;,effect of chlorlyptus in vivo on staphylococcus4--,the experiment was conducted in the same way as in ,experiment #ag1 but #b c4c4 were used instead of #a c4c4 ,result3 ,guinea-,pig #a was injected with #b c4c4 staphylococcus suspension and died over night4 ,autopsy showed that the animal died of acute peritonitis4 ,the peritoneum showed some fibrinous exudate and mesenteric vessels4 ,guinea-,pig #b was injected with #b c4c4 of staphylococcus1 and eighteen hours after was injected with #a c4c4 of chlorlyptus4 ,the animal died two weeks after injection4 ,guinea-,pig #c was injected with #b c4c4 staphylococcus suspension1 and twenty-four hours after with #a c4c4 of chlorlyptus4 ,the ,guinea-,pig died ten days after4 ,autopsy revealed bronchopneumonia of the left lung and acute miliary abscess in the liver4 --7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bg1 #aibj1 with additions47 ,,aquazone 7,,oxygen ,,water7 ,report of the ,council on ,pharmacy and ,chemistry ,aquazone is stated by the ,aquazone ,laboratories1 ,inc41 ,los ,angeles1 ,california1 to be a supersaturated solution of oxygen in water1 carrying approximately five and one-half times as much dissolved oxygen as ordinary water4 ,in an advertising booklet1 it is suggested that ,aquazone is of value in the treatment of influenza1 pneumonia1 typhoid1 ,bright's disease and kindred disorders4 ,it was also stated therein that in the treatment of fevers it lowers the temperature1 and that the administration of three bottles of ,aquazone 7representing #j4jcc gm4--#a-a_/b grain--of oxygen7 is of value for 8preventive and tonic purposes40 ,the evidence which the ,aquazone ,laboratories submitted did not show that the effects were other than those which might be obtained from the administration of ordinary potable water4 ,the ,council declared ,aquazone inadmissible to ,new and ,nonofficial ,remedies1 because the therapeutic claims made for it were unwarranted1 and because its use is irrational for the reason that oxygen given by stomach in this way is of little or no value4--7,abstracted from ,reports of ,council on ,pharmacy and ,chemistry1 #aibj1 p4 #ej47 ,,coagulen-,,ciba ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report announcing the deletion of ,coagulen-,ciba from ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,coagulen-,ciba1 a product of the ,society of ,chemical ,industry1 ,basle1 ,switzerland1 was admitted to ,new and ,nonofficial ,remedies in #aiae4 ,it is stated to be an extract prepared from blood platelets and to contain thromboplastic substances 7cytozym1 thrombokinase1 thrombozym7 mixed with lactose4 ,extensive clinical reports appeared to justify its acceptance for ,new and ,nonofficial ,remedies with ,fibrin ,ferments and ,thromboplastic substances4 ,in #aiah1 ,dr4 ,arthur ,d4 ,hirschfelder reported to the ,council that of a number of specimens of ,coagulen-,ciba examined by him1 failed to accelerate the coagulation time of blood4 ,in view of ,dr4 ,hirschfelder's findings1 the ,therapeutic ,research ,committee of the ,council invited ,dr4 ,p4 ,j4 ,hanzlik to undertake an exhaustive investigation of thromboplastic substances1 the ,council1 in the meantime temporarily retaining ,coagulen in ,new and ,nonofficial ,remedies until the investigation was completed4 ,the following report on the eligibility of ,coagulen-,ciba was made to the ,council by ,dr4 ,hanzlik3 ,object3 ,to test the claims of thromboplastic and hemostatic activities4 ,claims3 ,coagulen is alleged to be a 8physiological styptic prepared from the natural coagulants of animal food contained in the blood platelets4 ,it has the characteristics of a lipoid40 7,if cephalin is meant it is difficult to understand why platelets should be selected in preference to other abundantly supplied organs such as brains74 8,coagulen is indicated in all cases of external and internal hemorrhage due to a deficiency of the coagulating power of the blood3 epistaxis1 hemophilia1 hemorrhage from gastric or duodenal ulcer1 melaena neonatorum1 hemorrhage from the gums1 the lungs1 the bladder1 the uterus1 hemorrhage during or after operations 7turbinectomy1 tonsillectomy74 ,it has also been used as a prophylactic before operations1 likely to produce severe hemorrhage40 8,in cases of true hemophilia one application of #e grains of coagulen usually suffices to control the hemorrhage40 8,in gastric and intestinal hemorrhage the internal administration of coagulen will be found effective40 8,in bonegrafting1 plastic surgery1 dentistry and nose and throat surgery the application of a #aj per cent4 solution of ,coagulen will be found to be of valuable assistance in controlling hemorrhage and oozing40 8,it is a non-toxic and non-irritating powder to which a certain amount of sugar has been added1 with a view to ensuring its prompt solution in water or physiological sodium chloride solution40 ,description3 8,coagulen is a yellowish granular powder with but slight odor1 a sweet taste and is readily soluble in water or a normal salt solution40 ,the dry ,coagulen obtained corresponds to the description claimed4 ,old specimens show the presence of dark brown particles4 ,coagulen is marketed in #c forms3 7#a7 as dry powder containing lactose1 which1 it is claimed1 facilitates solution in water2 7#b7 as #c per cent4 sterile solution in ampoules2#acg 7#c7 tablets4 #acg ,an ampoule labeled as follows3 8,coagulen-,ciba1 #bj c4c4 in sterile solution ready for use4 ,to be shaken4 ,import de ,suisse4 ,op4 ,no4 #ifh0 was found to measure only #ae c4c4 ,another ampoule with the same label and ,op4 ,no4 #ifda contained considerable sediment4 ,methods of ,study3 ,the alleged thromboplastic activity was tested by the method of ,howell and a modification of this method by ,fenger as described in 8,new and ,nonofficial ,remedies40 ,in the ,howell method dog or cat blood is used1 while beef blood at body temperature is used in ,fenger's method4 ,in other respects the methods are essentially the same4 ,briefly these consist of noting the acceleration of coagulation time in a mixture of equal parts of serum and the thromboplastic agent to which about an equal part of oxalate plasma is added4 ,under these conditions cephalin causes clotting in about #a minute or even less as compared with #bj to #cj minutes or more of the control4 ,the effects were compared with freshly prepared cephalin and other thromboplastic agents1 using saline 7#j4i per cent4 ,na,cl7 as control4 ,the effect of different concentrations was also studied4 ,the literature of the manufacturers claims that ,coagulen is harmless4 ,this was tested by making intravenous and subcutaneous injections into guinea-pigs1 using saline and cephalin as controls4 ,bloods of #d different species were used1 namely1 cat1 dog1 beef and human4 ,dog's peptonized blood and plasma were also tried4 ,the #ae different tests that were made in vitro were carried out with #c different samples of fresh dry ,coagulen 7from manufacturer71 #b old samples 7one from ,council on ,pharmacy and ,chemistry and one of our own71 #c fresh specimens of sterile solution in ampoules 7from manufacturer71 one old specimen and #d small ampoules 7,council on ,pharmacy and ,chemistry74 ,the tablets were not tested since these are made from dry ,coagulen and the results would hardly be expected to show anything different4 ,results3 ,the results obtained may be briefly summarized as follows3 7#a7 #j4a per cent4 to #e per cent4 ,coagulen did not accelerate the coagulation time of blood and oxalate plasmas in the majority of tests any more than the controls of saline1 while #j4a per cent4 cephalin was found to shorten the coagulation time from #a_/c to #a_/b4 7#b7 ,there was no difference between the behavior of old and fresh specimens4 7#c7 ,no acceleration of coagulation in vitro was observed even with the highest concentrations tried1 namely #be and #ej per cent4 7#d7 ,irrigations made with fresh dry coagulen in solution and sterile solution in ampoules on superficial bleeding from the foot-pads of #c normal and peptonized dogs and local application to hemorrhages from dissected femoral arteries and bone and liver wounds of #c dogs showed that coagulen was no more active than normal saline4 ,toxicity3 ,subcutaneous and intravenous injections of different doses of ,coagulen solutions 7fresh ampoules7 and dry ,coagulen in solution in #h guinea-pigs produced definite anaphylactoid symptoms with injury to the circulatory and respiratory systems as indicated by cardiac dilatation1 abdominal congestion and pulmonary hemorrhages1 congestion1 distention and sometimes thrombi4 ,on the other hand1 the control animals injected with saline and cephalin remained practically unharmed4 ,conclusions3 ,the results obtained justify the following conclusions3 7#a7 ,coagulen is entirely inactive as a thromboplastic and hemostatic agent4 7#b7 ,coagulen is distinctly injurious when injected systemically4 7#c7 ,the claims of hemostatic efficiency and harmlessness for ,coagulen by the manufacturer appear exaggerated and unjustified4 ,recommendations3 ,because of its uncertain composition1 the possible dangers when injected systemically1 and its inactivity as a thromboplastic and hemostatic agent when tested by several different methods1 ,coagulen merits no recognition as a therapeutic agent for inclusion in ,new and ,nonofficial ,remedies4 ,the detail evidences used as the basis of this brief report concerning ,coagulen will be published shortly in the ,journal of ,pharmacology1#ach together with the results with other thromboplastic agents4 #ach ,since the report was sent to the manufacturers1 the results have been published4 ,hanzlik1 ,p4 ,j41 and ,weidenthal1 ,c4 ,m41 ,plasma and ,blood ,clotting ,efficiency of ,thromboplastic ,agents in ,vitro and their ,stability1 ,j4 ,pharmacol4 and ,exper4 ,therap4 #ad3aeg 7,october7 #aiai2 ,hanzlik1 ,p4 ,j41 ,karsner1 ,h4 ,t41 and ,fetterman1 ,j41 ,anaphylactoid ,conditions1 ,j4 ,pharmacol4 and ,exper4 ,therap4 #ad3ahi 7,oct47 #aiai2 ,hanzlik1 ,p4 ,j41 ,karsner1 ,h4 ,t41 and ,fetterman1 ,f41 ,anaphylactoid ,phenomena from ,thromboplastic ,agents1 ,j4 ,pharmacol4 and ,exper4 ,therap4 #ad3bbi 7,nov47 #aiai4 ,the preceding report was sent to the ,american agent for the ,society of ,chemical ,industry1 ,sept4 #h1 #aiai4 ,in reply the ,american agent1 ,ciba ,co41 ,inc41 on ,march #bb1 #aibj1 sent the ,council 8some additional clinical reports on the use of ,coagulen-,ciba in the treatment of ,hemorrhages supporting our claims of the merits of ,coagulen-,ciba40 ,the material submitted by the ,ciba ,co41 contains no objective evidence for or against the efficiency of ,coagulen-,ciba but merely opinions4 ,as a rule these opinions are favorable though conditional and hedging and quite unconvincing4 ,nothing was submitted to offset or challenge the findings of ,dr4 ,hanzlik's report4 ,since the evidence indicates that ,coagulen-,ciba has little1 if any1 efficacy as a hemostatic1 the ,council directed its omission from ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aibj1 p4 #ec47 ,,ferric ,,cacodylate ,,omitted ,,from ,,new ,,and ,,nonofficial ,,remedies ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the report which appears below1 explaining the omission of ferric cacodylate from ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,iron cacodylate1 the ferric salt of cacodylic acid1 was admitted to ,new and ,nonofficial ,remedies in #aiag4 ,it is required to contain from #ci4g to #dd4i per cent4 of arsenic 7,as74 ,the following statement of the action1 uses and dosage of iron cacodylate appears in the #aibj edition of ,new and ,nonofficial ,remedies3 8,actions and ,uses4--,ferric ,cacodylate has the properties of iron salts and of arsenic4 ,its use has been proposed in conditions in which the effects of iron and the mild arsenic action of cacodylates is desired4 8,dosage4--from #j4jae to #j4a ,gm4 7#a_/d to #a-a_/b grains740 ,the period for which the iron cacodylate preparations now in ,new and ,nonofficial ,remedies were accepted coming to an end with the close of #aibj1 the ,council decided to determine if sufficient evidence for the value of ferric cacodylate has accumulated to warrant its continued recognition4 ,the following is the report of the referee of the ,committee on ,therapeutics to whom the matter was assigned3 8,as far as the ,referee knows1 the only claim that ,iron ,cacodylate has as a therapeutic agent is that it forms a convenient method for the administration of ,iron and ,cacodylate 7while there is no reason why a drug should not be given by mouth1 usually intramuscularly1 and apparently it has recently been given intravenously74 ,the effects to be expected from its use are those of iron and arsenic4 8,granted that iron and arsenic are valuable therapeutic agents1 ,iron ,cacodylate is not a satisfactory preparation in which to administer these drugs for the following reasons3 8#a4 ,it would appear that ,cacodylates are not the best form in which to administer arsenic4 ,cacodylates in therapeutic doses exert but a feeble action4 ,small quantities may be reduced to cacodyl 7,,ch7,as1 and varying amounts to inorganic arsenic4 ,the amount transformed to arsenic is apparently unknown and probably varies in different individuals4 ,on these grounds alone the use of the cacodylates where an arsenic effect is desired seems dubious4 8#b4 ,the amounts of iron and cacodylates contained in the doses recommended are small when compared with the usual doses of either iron or cacodylate4 ,the amount of iron in the ,iron ,cacodylate preparations is small1 about 4#jjcf gram per dose1 while the preparations admitted to #8,useful ,drugs' contain much larger amounts per dose recommended4 ,the list follows3 ,massa ,ferri ,carbonates ,fe per dose 4#jdb gm4 ,pilulae ,ferri ,carbonates 4#jeh gm4 ,tinctura ,ferri ,chloride 4#jbb gm4 ,ferri et ,ammonii ,citrae 4#jdb gm4 8,the approximate amount of arsenic in ,iron ,cacodylate in the commonly recommended doses varies from 4#jab gm4 to #j4jbd gm41 while the amount of arsenic in ,sodium ,cacodylate in the recommended doses varies between 4#jba and 4#ce gms4 ,it would seem that a much more rational method of administration of these two drugs would be separately1 in which case a better control over the dosage is possible4 8#c4 ,the ,referee has been unable to secure reliable clinical evidence that ,iron ,cacodylate is a serviceable preparation4 ,a search of the available literature for the past fifteen years has been made1 also ,drs4 ,edsall1 ,longcope1 ,stengel1 ,hoover1 ,phillips and ,miller have been consulted4 ,these physicians know nothing of its use4 8#d4 ,in view of the above1 it appears to the ,referee that ,iron ,cacodylate is an irrational and useless method of the administration of iron and arsenic40 ,the ,council adopted the report of the referee and directed that iron cacodylate be omitted from the #aiba edition of ,new and ,nonofficial ,remedies4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aibj1 p4 #fb47 ,,libradol ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized for publication the following report which explains why ,libradol was found ineligible for ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,libradol is manufactured by ,lloyd ,bros41 ,cincinnati4 ,according to a circular 7a 8readily removable0 label7 which accompanies the trade package1 its 8uses0 are3 8,in colds1 croup and acute bronchitis4 ,in local congestions2 in lung trouble1 in acute inflammations of this or any other organ1 especially if pain or soreness be present4 ,in lumbago1 sciatica1 or in rheumatic pains of the joints or muscles4 ,applied to the forehead1 it induces sleep40 ,libradol is offered in two forms1 8,libradol ,mild0 for infants and supersensitive persons which is said to be 8destitute of drug energy0 and ,libradol 8,regular0 which is 8highly medicated10 the 8constituents0 being 8,,dracontium1 ,,sanguinaria1 ,,cephaelis1 ,,melaleuca1 ,,lobelia1 ,,laurus1 ,,capsicum1 ,,tobacco40 ,according to a circular1 8,the sanitary plasma ,libradol0 is a 8homogeneous1 highly medicated1 and exceedingly potent compound1 in plastic form10 which 8carries the energies of its drug constituents and the high antiseptic qualities of ,laurus ,camphora and ,melaleuca40 ,it is stated3 8,the ,drug ,influence of ,libradol is necessarily different from that of any known single member of the ,materia ,medica4 ,but yet1 no mystery either in medicine or of pharmacy is claimed as a part of its composition or process of manufacture4 ,it is a thing peculiar to itself1 the result of the study of the drugs from which it is derived and compounded4 ,these drugs may be studied at leisure by whoever cares to do so44440 ,the following information bearing on the composition of ,libradol was furnished by ,lloyd ,brothers in response to a request from the ,council to aid in the consideration of the preparation3 8#8,compound ,lobelia ,powder' has been1 since #aheb1 official in the ,american ,dispensatory1 in the first edition of which 7#aheb7 its formula is given1 as follows3 8#8,take of ,lobelia1 in powder1 twelve ounces2 ,bloodroot and ,skunk ,cabbage1 in powder1 of each1 six ounces2 ,ipecacuanha1 eight ounces2 ,capsicus1 in powder1 two ounces4 ,mix them4' 8,this preparation came increasingly into demand with the ,eclectic profession1 the principal use for which it was first employed 7as an emetic71 being finally displaced by its local application in bronchial pneumonia troubles1 when sprinkled on a greased cloth and applied to the chest40 8,in #ahih1 ,dr4 ,finley ,ellingwood petitioned ,lloyd ,brothers to make for him1 in plasma form1 ready for application1 a compound carrying the ingredients of the old #8,compound ,lobelia ,powder1' strengthened by the addition of ,melaleuca leucadendron1 ,laurus camphora and ,nicotiana tabacum4 ,experiments not very encouraging in a pharmaceutical sense were made1 and it was not until repeated requests had been made that a product was at last satisfactorily prepared and forwarded to ,dr4 ,ellingwood 7#aijj71 with no thought other than that of serving him personally in his practice4 ,this product he used and commended to his professional friends1 and under his commendation it came into professional demand40 ,an examination of the information submitted by ,lloyd ,brothers showed ,libradol to be in conflict with the principles and rules that govern in the acceptance of articles for ,new and ,nonofficial ,remedies as follows3 ,composition 7,rule #a74--,the information which has been received gives little idea of the actual composition of the preparation2 for example1 the statement that ,libradol 8carries the energies of its drug constituents and the high antiseptic qualities of ,laurus ,camphora and ,melaleuca0 gives no indication as to the part or parts of the ,laurus ,camphora or ,melaleuca employed4 ,if the statement is correct1 that ,libradol 8is a homogeneous1 highly medicated1 and exceedingly potent compound10 it is essential that the several potent ingredients be stated clearly and not merely hinted at by their qualities4 ,other conflicts with ,rule #a might be enumerated1 but the foregoing citations state the direct conflict2 and this has not been removed1 although an inquiry was sent to ,lloyd ,brothers for a statement of the amount of each potent ingredient in a given quantity of ,libradol4 ,indirect ,advertising 7,rule #d74--,the recommendation for the use of ,libradol in the treatment of colds1 bronchitis1 lumbago1 sciatica and rheumatic pains1 which accompanies the trade package1 is prone to lead the public to depend on it in cases where definite treatment is imperative4 ,unwarranted ,therapeutic ,claims 7,rule #f74--,libradol is recommended in a great variety of conditions and is especially claimed not only to relieve pain1 but to remove the cause of pain4 ,this is explained as follows3 8,in the study of the physiological action of many drugs1 it was found that the constituent remedies in this combination exercised a most salutary influence1 not only upon the sensibility of the nerves involved1 but upon the capillary circulation within the diseased area1 the muscular structures therein included1 and1 subsequently1 upon the course of the advancement of the congestive and inflammatory processes1 and upon secretion1 exudation1 adhesion1 induration1 hypertrophy1 suppuration and excretion40 ,granting1 for the sake of argument1 that carefully controlled experimental clinical evidence were available to substantiate this statement with reference to a single case of pain1 the statement would be misleading when considered as a general explanation of the preparation's relieving pain by removing the cause of pain when taken in connection with the conditions for which it is recommended and in which pain is even a minor symptom4 ,still1 if pain were relieved in these cases by removing the cause1 the patient would be cured of the conditions which give rise to the pain1 and these include3 8,acute pain in the chest2444 acute inflammation in the chest2444 persistent local pain24440 7,this might be interpreted as including tuberculosis2 pneumonia2 cancer1 and appendicitis47 8lumbago2 sciatica2 articular rheumatism0 7gonorrheal infections874 ,name 7,rule #h74--,the name1 derived from ,dolar and ,liber1 suggests the claimed action of the preparation 7the relief of pain7 rather than the drugs said to be presented by it4 ,irrational ,composition 7,rule #aj74--;,it is quite possible that ,libradol will relieve pain in certain instances and that the drug constituents present in ,libradol 8,regular0 make this more effective than 8,libradol ,mild0 which is 8destitute of drug energy02 this1 however1 is no justification for the use by physicians of a cataplasm containing or made from skunk cabbage1 bloodroot1 ipecac1 melaleuca 7oil of cajeput871 lobelia1 laurus comphora 7camphor871 capsicum and tobacco4 ,the combination is thoroughly irrational and a reminder of a past century4 ,further1 the ,council knows of no evidence to support the following claims3 8,as a stimulant ,capsicum has the power of neutralizing depressant remedies like ,lobelia and ,tobacco40 8,our association of its desirable constituents with those of ,lobelia1 in connection with the modifying influence of ,capsicum1 ,melaleuca1 and ,laurus ,camphora1 permits a more free use in ,libradol than would be possible were it to be employed alone40 8,capsicum1 ,melaleuca1 and ,laurus ,camphora in ,libradol tend to counteract the excessive relaxative and depressant effects of ,lobelia40 8,the great value of ,melaleuca in ,libradol is its quality of modifying and controlling the action of the associated energetic constituents of the drugs ,tobacco and ,lobelia1 which reduce congestion and inflammation1 but which would1 unsupported1 be too depressant40 ,libradol is inadmissible to ,new and ,nonofficial ,remedies because its composition is complex1 irrational and semi-secret1 and because its name and the unwarranted therapeutic recommendations made for it will lead to its ill-advised use4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aibj1 p4 #fe47 ,,helmitol ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,helmitol is hexamethylenamin methylencitrate4 ,it was introduced with the claim that it was superior to hexamethylenamin--which acts in acid fluids only--in that it is equally efficient whether the urine is alkaline or acid4 ,in #aiah ,the ,bayer ,company1 which then marketed the product in the ,united ,states1 was notified that the ,council questioned the claims made for ,helmitol and desired evidence to substantiate them4 ,in #aiai the same notification was sent the ,winthrop ,chemical ,company1 which in the meantime had secured control of the product4 ,pending the submission of the evidence1 the ,council continued the acceptance of ,helmitol for ,new and ,nonofficial ,remedies with the statement that the actions and uses of hexamethylenamin anhydromethylencitrate were those of hexamethylenamin4 ,w4 ,a4 ,puckner1 ,secretary4 ,the following report on ,helmitol was made by the referee in charge of hexamethylenamin compounds and preparations1 adopted by the ,council and sent the ,winthrop ,chemical ,company3 8,helmitol is a compound of anhydromethylencitric acid and hexamethylenamin4 ,it was introduced with the claim that it would be antiseptic even in alkaline urine4 ,the ,council did not entirely trust the evidence1 but continued to list ,helmitol in ,n4 ,n4 ,r41 merely as a salt of hexamethylenamin1 until satisfactory data should become available4 ,these have now been furnished by ,hanzlik 7,journal of ,urology #d3ade7 who has shown that3 8#a4 ,the alkalinity required to split off formaldehyd from anhydromethylencitric acid is greater than exists in the urine1 even in advanced ammoniacal fermentation4 8#b4 ,even if any formaldehyd were liberated in ammoniacal fermentation1 it would at once become inactive by combining with ammonia4 8#c4 ,urine after the administration of anhydromethylencitric acid actually putrefies readily4 8#d4 ,less than #e per cent4 of the anhydromethylencitric radical reaches the urine1 the remainder being destroyed in the body4 8,the only reason for the existence of ,helmitol was this claim of antiseptic action in alkaline and putrefying urines4 ,since this has been disproved1 there remains no reason for retaining ,helmitol in ,n4 ,n4 ,r42 on the contrary1 its retention would only tend to continue the fallacy on which it is based4 8,it is1 therefore1 recommended that ,helmitol be no longer listed with ,new and ,nonofficial ,remedies1 and that this report be published1 after the usual submission to the manufacturers40 ,in accordance with the recommendation of the report1 the ,council has directed the omission of ,helmitol from ,new and ,nonofficial ,remedies and has authorized the publication of this report4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bb1 #aiba47 ,,spirocide ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 8,spirocide0 7,the ,spirocide ,corporation of ,new ,york7 is advertised as a new and successful treatment of syphilis by fumigation and inhalation4 ,according to the information presented to the ,council1 ,spirocide is a mechanical mixture of metallic mercury #be per cent41 copper sulphate #be per cent41 cypress cones #bj per cent41 henna #bj per cent41 nut gall #e per cent41 and dried pomegranate #e per cent4 ,it is supplied in the form of greenish-gray tablets weighing about #aj gm4 each1 and containing1 therefore1 about #b4e gm4 7about #ch grains7 of mercury4 ,it is sold in packages of six tablets4 ,the following directions for its use are contained in a pamphlet recently distributed3 8,spirocide is administered by means of fumigation and inhalation4 ,the patient is disrobed to the waist and placed in a light chair1 preferably with arms4 ,a pastil or tablet of ,spirocide is placed on a small plate1 or open receptacle1 after being ignited by holding in a gas or alcohol flame for a minute or so until it begins to smoulder4 ,the plate with the burning ,spirocide is then placed on the floor between the patient's feet or just under the chair4 ,a small shelf or platform between the lower rounds of the chair is an excellent location for the plate containing the burning mass4 ,when all is in position a sheet should be thrown over the patient and arranged to enclose the whole4 ,the patient should breathe naturally and inhale the vapor1 which will rise and fill the canopy surrounding him4 ,the treatment will require #ae to #cj minutes1 or until the ,spirocide is burned up4 ,the patient may complain at first of a slight choking sensation1 and there may be some tendency to cough4 ,this can be removed by raising the sheet long enough to let in a little clear air4 ,the eyes should be closed or lightly bandaged to avoid smarting40 ,experiments conducted in the ,a4 ,m4 ,a4 ,chemical ,laboratory show that ,spirocide1 when ignited1 burns slowly with consequent volatilization of mercury4 ,the several organic constituents serve as fuel and the copper sulphate possibly acts as a regulator of the combustion4 ,during the burning process the cypress cones1 henna1 etc41 are consumed but most1 if not all1 the copper remains behind1 the mercury only being vaporized4 ,it is asserted in the advertising pamphlet that ,spirocide is indicated in all stages of syphilis1 primary1 secondary and tertiary1 and in all its complications or sequelae4 ,in these varying conditions one tablet daily or every other day is recommended until six treatments have been taken1 though it is stated that 8occasionally1 depending on the severity or the duration of the disease1 it may be wise to give nine treatments1 the last three at intervals of two1 three or more days40 ,some of the results which it is claimed are obtained with ,spirocide are3 8,at the completion of this course of treatment with ,spirocide1 all signs or evidences of syphilis are removed1 and in ten days to three months all ,wassermann tests prove negative4 ,any further treatments than the original course of fumigations are rarely needed4 ,wassermann's will be found uniformly negative after a period which1 according to the patient1 may vary from ten days to three months4 ,these results have been obtained in cases in which ,salvarsan and kindred preparations have been employed without the slightest benefit40 ,in a letter to the ,council the 8scientific observer0 of the ,spirocide ,corporation declared3 8,we do not claim that the vaporization method is new4 ,we do claim1 however1 that this combination of mercury produces more rapid volatilization1 certain absorption and undoubted effect than any form of mercury administered by any method known to science without the usual danger4 ,that this is so we are willing to prove by comparison with other methods both by ourselves and many observers scattered over the ,united ,states44440 ,to determine the validity of the claims made for ,spirocide1 the ,corporation was asked to present the evidence which it offered4 ,in reply1 the corporation's 8scientific observer10 ,dr4 ,j4 ,lewengood1 submitted #hc case reports from a number of different observers1 including those from military hospitals and a state institution1 and also a reprint of an article published by him in the ,new ,york ,medical ,journal1 ,feb4 #ba1 #aibj1 wherein were reported eight cases which received 8,spirocide ,treatment40 ,in no case were controls with other methods of mercury administration carried out4 ,this material the ,council sent to two recognized syphilographers for an opinion4 ,one of the consultants reported that of the #hc cases1 #bj dealt with patients who had also received arsphenamin medication and1 therefore1 these #bj cases could not be considered as evidence concerning the value of ,spirocide4 ,as to the remaining cases1 he found on the whole that the history and data furnished were far from sufficient to warrant the claims made4 ,in many of the cases emphasis was laid on the ,wassermann test1 as though this test were the only thing to be considered in a case of syphilis4 ,he pointed out that in one case the reaction changed from negative to strongly positive after six treatments and that in several cases the phenomena reported cannot be explained by anything else than a desire to get a negative blood test4 ,for example1 one case had ,spirocide treatment and a ,wassermann1 #a plus1 #ee days after2 the author then reports that #ai days later the reaction had become negative and1 therefore1 the change must be due to ,spirocide4 ,in several of the cases reported it is even questionable if the patients were syphilitic4 ,the consultant concluded that the evidence submitted by the ,spirocide ,corporation failed to prove the claims made for ,spirocide4 ,he pointed out on the other hand that patients readily become salivated from the use of ,spirocide1 often after #h or #aj treatments4 ,the second consultant replied that in his opinion the claim that ,spirocide produces more 8undoubted effect than any form of mercury administered by any method known to science without the usual danger10 was not substantiated4 ,he believed that it was not as effective as some other methods1 that the dosage is not as exact1 and1 therefore1 it is not as free from danger when the drug is pushed4 ,the ,council's two consultants were also asked whether or not1 in their opinion1 the administration of mercury by inhalation is a method which the ,council should endorse to the extent of recognizing a preparation based on this principle4 ,this inquiry was also sent to the members of the editorial board of the ,archives of ,dermatology and ,syphilology4 ,five replies were received4 ,one advised a thorough study of the different methods of administering mercury by inhalation4 ,the other four were opposed to such recognition on the ground that as the dosage is not exact the effects1 therefore1 are not certain4 ,in consideration of the opinions expressed by its consultants1 the ,council declared ,spirocide inadmissible to ,new and ,nonofficial ,remedies because 7#a7 the claims made for it are unproved and unwarranted1 7#b7 the routine use of an inexact method for the administration of mercury is detrimental to sound therapy and 7#c7 the name is not descriptive of its composition1 thus failing to remind the physician who uses these pastils that he is administering metallic mercury4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bb1 #aiba47 ,,digifolin-,,ciba ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized the publication of the following report1 declaring ,digifolin-,ciba inadmissible to ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,digifolin-,ciba is a product of the ,society of ,chemical ,industry of ,basle1 ,switzerland4 ,it is marketed in the ,united ,states by the ,ciba ,company1 #ia ,barclay ,street1 ,new ,york ,city4 ,it is claimed that ,digifolin-,ciba is 8a preparation of digitalis leaves that has been freed from the useless and harmful principles such as ,digitonin 7saponin71 coloring and inert matter1 etc41 but does contain all the really valuable1 therapeutically active constituents of the leaves1 namely3 digitoxin and digitalein in their natural proportions40 ,there is no evidence that digifolin contains all of the glucosides of digitalis as they exist in the leaf1 and it is extremely improbable that this is the case because one cannot remove saponin without altering the other active principles of digitalis4 ,the ,ciba ,company sends out the following pamphlets relating to ,digifolin3 8#8,concerning ,digifolin-,ciba1 ,a ,new ,preparation of ,digitalis1' by ,c4 ,hartung1 ,m4,d41 ,ph4,d4 ,extracts from the work #8,ueber ,digifolin1 ,ein ,neues ,digitalis-,praeparat' in the ,munich ,medical ,weekly1 ,no4 #cf1 page #aidd1 #aiab40 8#8,digitoxin ,contents of ,digifolin-,ciba1' by ,c4 ,hartung1 ,m4,d41 ,ph4,d41 ,basle1 ,switzerland4 ,reprints from the ,pharmaceutical ,post1 #aiac4 ,no4 #cd1 page #ceg4 ,no4 #dj1 page #dca40 8#8,pharmacological ,tests of ,digitalis1' by ,m4 ,j4 ,chevalier1 ,chef ,des ,travaux ,pratiques de ,pharmacologie et ,matiere ,medicale1 ,faculte ,de ,medecine ,de ,paris4 ,report ,presented to the ,societe de ,therapeutique at ,their ,meeting1 ,may #bh1 #aiac40 ,in the reprint 8,concerning ,digifolin1 #8,ciba4'0 ,hartung lays stress on the presence of harmful and inert substances present in the leaf and galenical preparations with the direct or implied statement that digifolin has an advantage in that these are absent from it4 ,this is misleading4 ,it is true that ,boehm whom ,hartung cites1 found saponin to be irritating1 but ,boehm states that it required #ajj mg4 per kilogram of body weight to induce vomiting after its oral administration4 ,furthermore1 saponin is present in traces only in infusion of digitalis1 so that the therapeutic dose contains a wholly negligible amount of it4 ,the following occurs in 8,pharmacological ,tests of ,digitalis10 by ,m4 ,j4 ,chevalier3 8,hartung's ,digifolin merits our attention1 especially because it seems to possess all the pharmacodynamic properties of galenic preparations of digitalis without showing any of their disadvantages40 ,this claim scarcely needs comment1 since it is well established that the chief 8disadvantages0 of digitalis are inherent in the principles which produce the desired effects of digitalis and may be avoided to a large extent by a carefully regulated dosage of any digitalis preparation4 ,in short1 the advertising for ,digifolin asserts that this digitalis preparation has all the advantages of digitalis itself1 but none of its disadvantages4 ,this claim has been refuted so frequently that manufacturers must be aware that it is untenable4 ,further the claims now made for ,digifolin are essentially those made nearly four years ago at which time the attention of the ,american agent was called to their unwarranted character4 ,the ,council declared ,digifolin-,ciba inadmissible to ,new and ,nonofficial ,remedies because the therapeutic claims advanced for it are misleading and unwarranted4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #b1 #aiba47 ,,some ,,of ,,loeser',s ,,intravenous ,,solutions ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized the publication of the following report on 8,loeser's ,intravenous ,solution of ,hexamethylenamin10 8,loeser's ,intravenous ,solution of ,hexamethylenamin and ,sodium ,iodid10 8,loeser's ,intravenous ,solution of ,sodium ,salicylate10 8,loeser's ,intravenous ,solution of ,salicylate and ,iodid10 8,loeser's ,intravenous ,solution of ,sodium ,iodid0 and 8,loeser's ,intravenous ,solution of ,mercury ,bichlorid10 put out by the ,new ,york ,intravenous ,laboratory1 ,inc4 ,w4 ,a4 ,puckner1 ,secretary4 ,the intravenous solutions of 8,hexamethylenamin10 8,hexamethylenamin and ,sodium ,iodid10 8,sodium ,salicylate10 8,sodium ,salicylate and ,sodium ,iodid10 8,sodium ,iodid0 and 8,mercuric ,chlorid0 marketed by the ,new ,york ,intravenous ,laboratory1 ,inc41 are solutions of official substances sold under their official names4 ,they would1 therefore1 be outside the scope of the ,council1 were it not that special and general therapeutic claims are made for them4 ,such special claims1 for instance1 are contained in an advertisement in the ,illinois ,medical ,journal for ,oct4 #bj1 #aibj1 which gives1 under the various drugs1 a list of diseases in which the drugs are said to be 8indicated40 ,the ,council is unable to agree with some of these recommendations4 ,the fundamental objection1 however1 is the general claim of superiority and safety of the intravenous method4 ,the intravenous solutions named above would naturally have little sale if such special claims were not made for them4 ,while the claims may not be made directly1 they are carried by such display phrases as 8,for the progressive physician seeking improved clinical results0 and 8,a safe practical office technique40 ,the ,council continues to hold that intravenous medication1 generally1 is not as safe as oral medication even with relatively harmless substances 7a fact again illustrated by the results of ,hanzlik and ,karsner1 #aibj1 ,journal ,pharmacology and ,experimental ,therapeutics1 #ad1 #cgi71 and that it does not give 8improved clinical results0 except under rather narrowly confined circumstances--namely1 if the drug undergoes decomposition in the alimentary tract1 if it is not absorbed1 if it causes serious direct local reaction or if time is an urgent element4 ,each intravenous preparation for which advantage over oral administration is claimed1 directly or by implication1 must be examined from these points of view4 ,the ,council has recognized intravenous preparations which satisfied these requirements4 ,it is evident1 however1 that hexamethylenamin1 sodium iodid and sodium salicylate do not4 ,when given orally they do not undergo material decomposition in the digestive tract1 they are rapidly absorbed1 they cause no direct local reaction1 and in the conditions in which they are used the hour or so which is required for absorption is immaterial1 especially as they are used continuously for some time4 ,mercuric chlorid does indeed produce some local irritation1 but there is as yet no convincing evidence that its intravenous injection causes less injury than oral administration4 ,more experience under controlled conditions is needed before the intravenous use of mercuric chlorid can be approved4 ,especially objectionable are the fixed proportion mixtures of sodium iodid with sodium salicylate and with hexamethylenamin4 ,the dosage of all three drugs has to be adapted to individual conditions4 ,this is impossible when giving them in fixed proportions4 ,the ,council voted not to accept 8,loeser's ,intravenous ,solution of ,hexamethylenamin10 8,loeser's ,intravenous ,solution of ,hexamethylenamin and ,sodium ,iodid10 8,loeser's ,intravenous ,solution of ,sodium ,salicylate10 8,loeser's ,intravenous ,solution of ,salicylate and ,iodid10 8,loeser's ,intravenous ,solution ,sodium ,iodid0 and 8,loeser's ,intravenous ,solution of ,mercury ,bichlorid0 for ,new and ,nonofficial ,remedies because they are sold under misleading claims regarding their alleged safety and efficiency4 ,in view of this fundamental objection the individual claims for each preparation were not passed on4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #af1 #aiba47 8,,national ,,iodine ,,solution0 ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 8,national ,iodine ,solution0 is a proprietary sold by the ,national ,drug ,co41 ,philadelphia1 ,pa4 ,from inquiries received by the ,council on ,pharmacy and ,chemistry it is evident that the product is extensively brought to the attention of physicians by means of circulars4 ,the name implies that it is a solution of iodin and the inference is given that it has the advantages of iodin without the disadvantages4 ,,composition ,in view of the foregoing1 the ,council took up the investigation of 8,national ,iodine ,solution10 and in turn asked the ,a4 ,m4 ,a4 ,chemical ,laboratory to analyze it4 ,the chemist's report follows3 ,according to the label of ,national ,iodine ,solution1 8each fluidounce represents three grains ,proteo-albuminoid compound of iodin 7,national702 also an alcohol declaration of #g per cent4 is made4 ,otherwise no information is given as to the composition either of the 8solution0 or of 8,proteo-albuminoid compound of ,iodine40 ,each bottle contained about #aae c4c4 7nearly #d ounces7 of a yellowish solution1 acid in reaction1 having an odor resembling witch hazel2 its specific gravity at #be ,c4 was #j4ihfj4 ,qualitative tests indicated the presence of zinc1 alcohol1 sulphate1 an iodin compound 7the solution gave tests which indicated a very small amount of free iodin2 most of the iodin was in the form of ordinary iodid71 a small amount of vegetable extractives1 and traces of aluminum and potassium4 ,if any protein was present1 it was in amounts too small to be identified1 though a small amount of a nitrogenous compound was present4 ,the amount of solids in 8,national ,iodine ,solution0 was equivalent to #j4gb per cent1 and the amount of ash1 to #j4b per cent4 ,quantitative estimations yielded the following3 ,alcohol 7by volume7 #g4j per cent4 ,zinc 7,zn7 #j4jif per cent4 ,iodin 7free and combined7 #j4jbi per cent4 ,sulphate 7,,so--7 #j4adf per cent4 ,protein 7,n #f4cf7 #j4jab per cent4 ,the above findings indicate that each #ajj c4c4 contains about #g c4c4 of alcohol1 #j4e gram of zinc sulphate ,u4 ,s4 ,p4 7,zn,s,o#g;,h,o471 #j4jc gram of iodin1 #j4ja gram of protein 7calculated as such from nitrogen times the factor #f4cf7 and some hamamelis water4 ,expressed in equivalent apothecary terms1 each fluidounce contains essentially3 ,zinc sulphate #b-a_/c grains ,iodin 7free and combined7 #a_/h grain ,protein #a_/be grain ,alcohol #cd minims ,this amount of alcohol is equivalent to about #c-a_/b fluidrams of witch hazel water4 ,although the label states that each fluidounce contains three grains of 8proteo-albuminoid compound of iodine10 yet the sum of the protein 7calculated from nitrogen content7 and iodin components is equivalent to less than #a_/e grain4 8,national ,iodine ,solution0 appears to be very similar to 8,gonocol0 7,the ,national ,drug ,co41 ,philadelphia1 ,pa471 which was analyzed by the ,bureau of ,chemistry of the ,u4 ,s4 ,department of ,agriculture4 ,the bureau stated that 8it ,gonocol consisted essentially of an aqueous solution of zinc sulphate1 hamamelis water1 a small amount of alcohol1 #j4ch grain of iodin1 and #j4cf grain of protein per fluidounce40 ,it is evident that 8,national ,iodine ,solution0 is not a solution of free elementary iodin as the name suggests2 instead it appears to be a solution of zinc sulphate in witch hazel water containing less than #j4jc per cent4 of combined iodin and not more than a trace of free iodin4 8,national ,iodine ,solution0 is one more to be added to that already long list of proprietaries which makes capital of the high esteem in which physicians hold iodin4 ,,the ,,claims ,an advertising circular sent to physicians begins3 8,dear ,doctor3 ,we beg to suggest a line of treatment while using ,national ,iodine ,solution which our many years of experience has proven to us to give the best and quickest results in the treatment of inflammation of the urethral tract 4440 ,in it are given directions for the treatment of 8acute gonorrhea1 male10 8anterior urethritis10 8anterior-posterior urethritis10 8ardor urin and chordee10 etc41 by means of ,national ,iodine ,solution and other proprietaries of the ,national ,drug ,company's make4 ,in fact the solution is claimed to be 8,indicated in ,all ,conditions of ,urethra ,accompanied by a ,discharge40 ,,comment ,,and ,,conclusions ,the therapeutic claims made for 8,national ,iodine ,solution0 are unwarranted4 ,such a solution is not indicated in all conditions of the urethra accompanied by discharge4 ,the advice contained in the circular is equivalent to mail-order treatment of gonorrhea4 ,it is of interest to note that the claims for an identical or a similar solution prepared by the ,national ,drug ,company as a treatment for gonorrhea and intended for use by the laity1 has been adjudged misbranded by the federal authorities 7,notice of ,judgment ,no4 #haej1 issued ,jan4 #be1 #aiba7 in that it misled and deceived the purchaser or purchasers thereof in the statements regarding the therapeutic or curative effects of the article1 which falsely and fraudulently represent it to be indicated in all conditions of the urethra accompanied with a discharge1 8whereas in truth and in fact it was not40 ,the ,council would emphasize that if physicians give heed to advertising such as that sent out by the ,national ,drug ,company for this preparation the medical profession cannot with good grace protest against the routine treatment of venereal diseases by quacks and 8patent medicine0 venders4--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #d1 #aiba47 ,,mon-,,arsone ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report4 ,w4 ,a4 ,puckner1 ,secretary4 ,mon-,arsone is offered by the ,harmer ,laboratories ,company as 8a new and non-toxic arsenical for the treatment of syphilis40 ,in the advertisements for ,mon-,arsone it has been claimed that with this drug 8the toxic1 corrosive and uncertain reactions attending the use of arsphenamine have been entirely eliminated0 and that 8it has a therapeutic value equal to arsphenamine1 but extensive case reports fail to record the slightest toxic reaction following its use40 ,according to the manufacturers1 ,mons-,arsone is disodiumethylarsonate1 the sodium salt of ethylarsonic acid1 derived from arsenic acid by replacement of one hydroxyl group by the ethyl group--,as,o7,,ch,,ch77,,oh74 ,mons-,arsone is related to sodium cacodylate1 which is the sodium salt of dimethyl-arsenic acid--,as,o7,,ch7,,oh--derived from arsenic acid by replacement of two hydroxyl groups by two methyl groups4 ,ethylarsonic acid and its potassium salt were described by ,la ,coste#aci more than thirty-five years ago1 and the use of the sodium salt of methylarsonic acid was proposed in ,france some years ago4 ,the ,harmer ,laboratories ,company claims originality for ,mons-,arsone in that it was the first to prepare the sodium salt of ethylarsonic acid and to propose its therapeutic use4 #aci ,la ,coste3 ,annalen der ,chemie 7,liebig's7 #bjh3 #cd4 ,it was reported several years ago by ,castelli#adj that sodium cacodylate and the sodium salt of methyl arsenic acid were devoid of effect on experimental trypanosomiasis and spirochete infections4 ,careful clinical observations in this country by ,h4 ,j4 ,nichols#ada and ,h4 ,n4 ,cole#adb have demonstrated the inefficacy of sodium cacodylate in the treatment of human syphilis4 #adj ,castelli1 ,g43 ,arch4 f4 ,schiffs- u4 ,tropen-,hyg4 #af3 #fje1 #aiab4 #ada ,nichols1 ,h4 ,j43 ,salvarsan and ,sodium ,cacodylate1 ,j4 ,a4 ,m4 ,a4 #ef3 #dib 7,feb4 #ah7 #aiaa4 #adb ,cole1 ,h4 ,n43 ,a ,study of ,sodium ,cacodylate in the ,treatment of ,syphilis1 ,j4 ,a4 ,m4 ,a4 #fg3 #bjab 7,dec4 #cj7 #aiaf4 ,animal experiments carried out in the ,u4 ,s4 ,hygienic ,laboratory by ,voegtlin and ,smith#adc show that ,mon-,arsone is devoid of any practical trypanocidal action4 ,thus the 8therapeutic ratio0 7the ratio of the minimal effective dose to the lethal dose7 was about #a1 that is1 it was effective therapeutically only in approximately fatal doses2 the therapeutic ratio for arsphenamine in similar conditions was #ag1 and that of neoarsphenamine1 #bh4 #adc ,voegtlin1 ,carl1 and ,smith1 ,h4 ,w43 ,j4 ,pharmacol4 and ,exper4 ,therap4 #af3 #ddi1 #aiba4 ,the findings that sodium dimethylarsenate 7sodium cacodylate71 sodium methylarsenate1 and sodium ethylarsenate are devoid of any practical trypanocidal action and the conclusion that sodium cacodylate is inefficient in the treatment of human syphilis does not prove that ,mon-,arsone is without effect on the disease4 ,these findings1 however1 certainly demand convincing therapeutic evidence to warrant the recommendation for the use of the drug in the treatment of syphilis--particularly because the drug is proposed as a substitute for arsphenamine1 the value of which is established4 ,when the ,council first took up the consideration of ,mon-,arsone1 the only evidence for the claim that it 8has a therapeutic value at least equal to that of arsphenamine0 consisted1 with one exception1 of reports from those who had experimented with the drug for the ,harmer ,laboratories ,company1 including a report by ,b4 ,l4 ,wright1 ,l4 ,a4 ,kennell1 and ,l4 ,m4 ,hussey1#add the latter of the ,harmer ,laboratories ,company4 ,these reports appeared to show that the administration of ,mon-,arsone caused less reaction than arsphenamine1 and that the immediate effects1 judged by clinical symptoms and the response to the ,wassermann test1 appeared to be good4 ,these trials extended over too short a period of time to permit judgment as to the permanence of the results4 ,a report by an independent observer seemed to indicate that ,mon-,arsone does not have the sterilizing action on syphilitic lesions which it is usually believed arsphenamine exercises4 #add ,wright1 ,b4 ,l42 ,kennell1 ,l4 ,a41 and ,hussey1 ,l4 ,m43 ,m4 ,rec4 #ig3 #fjg 7,april #aj7 #aibj4 ,after examining the available evidence1 the ,council advised the ,harmer ,laboratories ,company that the claim that ,mon-,arsone has a therapeutic value equal to arsphenamine appeared unwarranted2 that1 in the opinion of the ,council1 ,mon-,arsone should not be used except under conditions that justify the experimental trial of an unproved drug1 and should not be used in a routine way until the permanence of its effects has been established2 and consequently any advertising propaganda for the drug by the ,harmer ,laboratories ,company was to be deprecated4 ,in its reply the ,harmer ,laboratories ,company admitted that its advertising claim1 that ,mon-,arsone was at least equal to arsphenamine therapeutically1 had been based on reports on fifty cases and on additional reports that were beginning to come in at that time4 ,the ,harmer ,laboratories ,company submitted a list of hospitals and physicians using ,mon-,arsone4 ,a letter of inquiry sent by the ,council to those who1 according to the names in the list supplied by the ,harmer ,laboratories ,company1 had used ,mon-,arsone1 brought seven replies4 ,the clinical evidence contained in these replies was to the effect that ,mon-,arsone had been used in the various types of syphilis and that there was a certain beneficial effect1 both clinically and as shown by the ,wassermann reaction4 ,in certain instances the ,wassermann reaction changed from a four plus to a negative reaction4 ,the reports showed that the efficiency of ,mon-,arsone as compared with that of arsphenamine preparations has not been adequately studied4 ,one physician who has used ,mon-,arsone extensively reports that in many of the cases treated there seemed to be nearly as good results from the use of ,mon-,arsone as is frequently obtained in the use of arsphenamine4 ,he reports1 however1 that it was necessary in eleven out of one hundred cases to change from ,mon-,arsone to neoarsphenamine4 ,in view of the fact that there is definite lack of evidence to show that ,mon-,arsone is the equal of arsphenamine therapeutically1 and because of the reports that in some cases it is inferior1 ,mon-,arsone should not be used in the treatment of syphilis generally until its therapeutic status has been more rigidly investigated and conclusive evidence of its superiority to arsphenamine preparations obtained4 ,the ,council voted not to admit ,mon-,arsone to ,new and ,nonofficial ,remedies and reaffirmed its conclusion that the claim that ,mon-,arsone has a therapeutic value equal to that of arsphenamine is premature and unwarranted2 that ,mon-,arsone should not be used except under conditions that justify the experimental trial of an unproved drug2 and that the advertising propaganda for the drug by the ,harmer ,laboratories ,company is to be deprecated4 99 99 99 99 99 ,when the preceding report was sent to the ,harmer ,laboratories ,company1 the firm submitted a reply in which it was stated3 #a4 ,that in certain instances patients improved under ,mon-,arsone who1 previously1 had not improved under arsphenamine1 and that this should be taken to offset the report of the one hundred cases in which the use of ,mon-,arsone had to be abandoned in #aa per cent4 of the cases4 #b4 ,that the ,harmer ,laboratories ,company has abandoned the claim that ,mon-,arsone is therapeutically equal to arsphenamine and that it now furnishes the drug to such men as care to use it simply on the basis of its special and useful characteristics4 ,the ,council heartily endorses the recent warning against the use of untried medicaments which was issued by the ,u4 ,s4 ,public ,health ,service4#ade #ade ,j4 ,a4 ,m4 ,a4 ,june #ab1 #aibj1 p4 #afed4 ,since the ,council's report was prepared a report on the effects of ,mon-,arsone on experimental syphilis has been published by ,nichols1#adf from the ,division of ,laboratories1 ,army ,medical ,school1 which concludes3 #a4 ,disodium-ethylarsinate1 or mon-arsone1 tested on rabbits infected with syphilis shows no spirocheticidal power4 ,the tissues are fatally poisoned as soon as or before the spirochetes are affected4 8#b4 ,for its practical use in syphilis there is no such germicidal basis as exists in case of the arsphenamine group40--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #ah1 #aiba47 #adf ,nichols1 ,h4 ,j43 ,the ,spirocheticidal ,value of ,disodium ,ethyl ,arsenate 7,mon-,arsone71 ,j4 ,a4 ,m4 ,a4 #gf3 #acce 7,may #ad7 #aiba4 ,,oxyl-,,iodide ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry 8,oxyl-,iodide0 7,eli ,lilly and ,co47 is said to be the hydroiodid of cinchophen and the claim is made that it exerts the effects of cinchophen and of iodid4 ,because of inquiries which have been received the ,council decided to determine the eligibility of 8,oxyl-,iodide0 for ,new and ,nonofficial ,remedies4 ,dr4 ,p4 ,j4 ,hanzlik--formerly ,associate ,professor of ,pharmacology at ,western ,reserve ,university ,school of ,medicine1 now ,professor of ,pharmacology at ,leland ,stanford ,junior ,university ,medical ,school--who has made a study of the action of salicylates and cinchophen1 was asked to report on the therapeutic value and the rationality of 8,oxyl-,iodide40 ,this he consented to do and his report appears below4 ,after considering ,doctor ,hanzlik's report1 the ,council declared 8,oxyl-,iodide0 inadmissible to ,new and ,nonofficial ,remedies because it is an irrational combination1 marketed under claims that are unproved and consequently unwarranted4 ,w4 ,a4 ,puckner1 ,secretary4 8,oxyl-,iodide10 marketed by ,eli ,lilly ,co41 is claimed to be the hydroiodid of phenylcinchoninic acid1 containing #cc per cent4 of iodin and #fg per cent4 of phenylcinchoninic acid 7cinchophen74 ,its solubility resembles that of cinchophen1 being low in water and acid mediums1 and higher in the presence of alkalis4 ,whether 8oxyl-iodide0 is decomposed into its constituents in the presence of alkalis does not appear to have been determined4 ,however1 if this were the case1 the intestine1 after administration of 8oxyl-iodide10 would contain cinchophen and sodium iodid in the same forms as if these agents were administered individually so that nothing would be gained by administering 8oxyl-iodide40 ,being1 like cinchophen1 practically insoluble in acid mediums1 8oxyl-iodide0 would have no advantage over the latter so far as gastric irritation is concerned4 ,,dosage ,the dosage advised is from one to three tablets containing #c grains 7#j4b gm47 each of 8oxyl-iodide40 ,the total dosage would depend on the condition to be treated4 ,in rheumatic fever1 which requires a full therapeutic or so-called1 8toxic0 dose of cinchophen1 about #ab to #ac gm4 would be administered intensively4 ,since each tablet of 8oxyl-iodide0 contains #j4ac gm4 of cinchophen1 the total number of tablets of 8oxyl-iodide0 required would be #ajj1 or two and one-half bottles of forty tablets each4 ,at the same time the patient would receive #f4f gm4 of iodin 7as iodid74 ,this might be distinctly objectionable because of the production of the disagreeable symptoms of iodism in some persons1 and indicates that the fixed proportion of the iodin constituent would be objectionable4 ,even a smaller dosage1 such as #e gm4 of cinchophen1 which gives partial relief in rheumatism and similar conditions1 would still require a patient to take a full bottle1 or forty tablets1 of 8oxyl-iodide10 and at the same time about #b4g gm4 of iodin would have to be ingested4 ,furthermore1 rheumatic fever1 the arthritides1 gout and related conditions in which cinchophen is indicated do not require iodid4 ,therefore1 8oxyl-iodide0 would not be the remedy of choice in these conditions1 and its use would be irrational and illogical4 ,,actions ,no data on the pharmacologic actions of 8oxyl-iodide0 are presented in the manufacturer's literature4 ,presumably1 the compound would exhibit the actions of its individual components1 i4 e41 cinchophen and iodin 7as iodid71 though probably less efficiently1 owing to its low solubility4 ,this is also indicated by the following statements of the manufacturer3 8,the analgesic action of #8oxyl-iodide' is gradual4 ,a word of caution is necessary to those who may expect immediate relief from pain40 ,therefore1 why use 8oxyl-iodide0 in place of more dependable analgesics1 such as salicylate or cinchophen4 ,the following statements appear far-fetched3 8,there is a stimulation of the endocrines which is perhaps more marked in the thyroid gland1 although it is probably shared by the pituitary and other glands which function in a chain-like control4444 ,there is stimulation of cells with increased flow of secretion1 visibly demonstrated by the nasal mucous membrane after #8oxyl-iodide' has been taken for some time4 ,the general action on mucous membranes favors elimination of toxins and waste products40 ,it is probable that 8oxyl-iodide0 acts as a uric acid eliminant1 though there is no reason to suppose that it is more effective than cinchophen alone4 ,no data are given for this in the manufacturer's literature4 ,,uses ,successful use of 8oxyl-iodide0 is claimed in brachial and sciatic neuritis1 lumbago1 muscular rheumatism1 arthritis deformans1 chronic arthritis 78444 in some instances were apparently cured071 subacute bronchitis1 circumflex neuritis1 traumatic orchitis1 eczema and rheumatism4 ,however1 a careful reading of the protocols of seven cases1 representing these conditions1 gives an unfavorable impression as to the real contribution to the recovery by1 or value received from1 8oxyl-iodide40 ,summarized1 the opinions as quoted by the manufacturers in support of their claims for 8oxyl-iodide0 are briefly as follows3 ,case #a4 8,of course1 the case is not complete yet1 but ,i am looking for continued betterment40 ,case #b4 8,for two weeks past her improvement has been marvelous40 ,case #c4 8,the joints are still enlarged and we do not hope to clear them entirely44440 ,case #d4 8,undoubtedly1 removal of the kidney had much to do with improvement40 ,case #e4 8,i think ,i have gotten very good results40 ,case #f4 8,some apparent benefit40 ,case #g4 8,she is practically free from pain1 and the muscle and joint stiffness is now slight40 ,these inconclusive opinions certainly do not agree with the favorable impression which other portions of the manufacturer's literature create4 ,if the factor of natural recovery in the conditions represented by these seven cases is given due weight1 little1 if anything1 is left to the credit of 8oxyl-iodide40 ,such clinical evidence as is supplied by the manufacturer indicates that the therapeutic efficiency of 8oxyl-iodide0 is doubtful1 and not an improvement over either cinchophen or iodid4 ,,iodism ,iodism cannot be avoided by the use of 8oxyl-iodide10 for the manufacturer's literature states that 8the dosage of #8oxyl-iodide' may be pushed to iodism as manifested by skin symptoms4444 ,to avoid iodism there should be an occasional interruption of treatment40 8,oxyl-iodide10 therefore1 has no advantage over ordinary sodium iodid to avoid iodism4 ,usually1 the conditions which require cinchophen do not require the simultaneous administration of iodids1 and vice versa4 ,if administration of iodid and cinchophen together should be indicated or desirable1 these can be given separately with the added advantage that the iodid can be easily reduced or withdrawn in case iodism supervenes1 and the cinchophen could be continued if necessary4 ,since conditions do not arise frequently enough to warrant the use of iodid and cinchophen together1 the existence of such a product as 8oxyl-iodide0 is unwarranted4 ,finally1 the manufacturer himself recognizes that phenylcinchoninic acid 7cinchophen7 can take the place of 8oxyl-iodide40 ,under 8dosage10 the circular states3 8,a few patients may be idiosyncratic to the iodides and find they cannot take #8oxyl-iodide4' ,for the latter chloroxyl1 the hydrochloride of phenylcinchoninic acid1 is recommended40 ,the action of the hydrochlorid of phenylcinchoninic acid does not differ1 of course1 from that of cinchophen4 ,the difficulties of assigning a clear-cut1 definite1 therapeutic rle to 8oxyl-iodide0 in order to justify its existence1 alongside well-known and tried remedies are self-evident4 ,,conclusion 8,oxyl-iodide0 is pharmacologically and therapeutically an illogical1 irrational and unjustified substitute for cinchophen and iodids4 ,the conditions which require the administration of cinchophen do not as a rule require the administration of iodid and vice versa4 ,if it is desirable to secure the effects of iodid and cinchophen together1 these can be more conveniently and advantageously administered as separate agents1 permitting in that way a better control of their actions4 ,this cannot be accomplished with 8oxyl-iodide10 in which the proportion of iodid and cinchophen are fixed4 ,symptoms of iodism cannot be avoided by the administration of 8oxyl-iodide40 ,the objective evidences for its actions and uses are totally lacking2 and the clinical opinions concerning its therapeutic benefits in different disease conditions are inconclusive and hedging1 and1 if anything1 contradictory to the favorable impressions which the language of the advertising matter is likely to create4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #b1 #aiba47 ,,quassia ,,compound ,,tablets ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report1 declaring that ,quassia ,compound ,tablets 7,flint1 ,eaton and ,company7 are inadmissible to ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,quassia ,compound ,tablets1 marketed by ,flint1 ,eaton and ,company1 ,decatur1 ,ill41 according to the label on a trade package submitted to the ,council1 contain in each tablet3 ,quassia #c_/d grain ,aloin #a_/d grain ,chionanthus #a grain ,ipecac #a_/af grain ,wahoo #c_/d grain ,podophyllin #a_/d grain ,nux ,vomica #a_/b grain ,gingerine q4 s4 ,cascara #a_/c grain ,in the advertising the 8,cascara0 of the label is replaced by the indefinite term 8,cascarin0 and the 8,gingerine q4 s40 by 8,carminative ,antigripe q4 s40 ,flint1 ,eaton and ,company informed the ,council that 8,carminative ,antigripe is ,c4 ,p4 ,sodium ,sulphite of which each tablet contains #a_/d grain40 ,the tablets were treated with dilute hydrochloric acid and the odor of sulphur dioxid became apparent4 ,this shows that the company's statement to the ,council1 that the tablets contain a sulphite1 is correct and the formula on the label is incorrect4 ,in the advertising for this preparation we read3 8,a careful study of this formula which formula8 ,that on the label or that in the general advertising8--,,council will reveal the outstanding fact that1 while there are several drugs employed1 each ingredient is there for a purpose and all do splendid teamwork4 ,if your patient is constipated because the stomach is not sufficiently energetic1 the ,quassia stimulates that organ to an increased secretion of digestive fluids and sets it to working normally4 ,if the liver be sluggish1 the ,chionanthus and ,wahoo prompt it to increased activity4 ,chionanthus has no superior for producing a sustained healthy hepatic condition4 ,should the bowels be slow and uncertain1 the small doses of ,aloin1 ,cascarin and ,podophyllin stimulate to free peristaltic action1 while the ,nux ,vomica sets the nervous system right4 ,we use an effective ,antigripe so that there is no griping40 ,it is absurd to suppose that a complex mixture of drugs in fixed proportions can have the actions claimed for ,quassia ,compound ,tablets4 ,as regards the claim that 8,chionanthus has no superior for producing a sustained healthy hepatic condition10 it was brought out in a report of the ,council on 8,some ,unimportant ,drugs0 7,reports of ,council on ,pharmacy and ,chemistry1 #aiab1 p4 #cf7 that the 8claims for this remedy ,chionanthus are not supported by experimental evidence and the clinical reports of its use fail to show indications of discriminating critical observation4 ,it is not noticed by most pharmacologic authorities40 ,of ,wahoo 7,euonymus ,n4 ,f47 the 8,epitome of the ,u4 ,s4 ,p4 and ,n4 ,f40 says3 8,actions and ,uses4--,obsolete cathartic2 toxic digitalis effects4 ,caption3 the uncertain absorption of this drug makes its use inadvisable40 ,quassia ,compound ,tablets 7,flint1 ,eaton and ,company7 are inadmissible to ,new and ,nonofficial ,remedies because 7#a7 they contain drugs of unproved value2 7#b7 their composition is needlessly complex1 and1 therefore irrational2 7#c7 unwarranted therapeutic claims are made for them2 7#d7 the name is misleading and not descriptive of their composition1 and 7#e7 the statement of their composition is indefinite and incorrect4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #i1 #aiba47 ,,toxicide ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized the publication of the following report3 ,w4 ,a4 ,puckner1 ,secretary4 ,toxicide 7,toxicide ,laboratories1 ,chicago7 is alleged to be a remedy which 8increases systemic resistance10 is 8used for immunizing against septic infections0 and 8is indicated in any case of septic infection1 capable of inducing inflammation and pus formation1 regardless of location or kind of tissue involved40 ,the following statements bearing on the composition of the preparation are furnished by the manufacturers3 8,toxicide contains ,lachesis #ab,x1 ,tarantula #f,x1 ,psorinum 7special7 #ae,x1 ,silicia #f,x and ,excipient q4 s4 7the excipient is sweet milk74 8,these remedies are combined in the sweet milk and put through a process of development1 which produces the curative agent which we call #8,toxicide' 444 8,put up in tablet form1 sugar coated and colored red40 ,no information is given as to the proportions1 either relative or actual1 of the ingredients4 ,neither is any information given regarding the 8process of development0 to which the mixture is subjected1 nor the amount of the finished mixture which is contained in ,toxicide tablets4 ,the ,toxicide ,laboratories present the following 8theory03 8,in combining these remedies and processing with milk1 we develop a latent immunizing active principle1 which usually controls the most virulently1 active1 septic infections promptly40 ,illustration3 ,photographic reproduction 7reduced7 of an advertisement of the 8originator0 of ,toxicide2 it ran for many months in the program of a burlesque theater located in ,ruckel's neighborhood4 ,there is no evidence1 however1 that any effort has been made to demonstrate the presence of a 8latent immunizing active principle0 by scientific methods of modern immunology4 ,the following claims for the use of ,toxicide appear on the label3 8,acne1 boils1 carbuncles1 furuncles and abscesses of the most virulent types usually begin to show improvement within #d to #ab hours after beginning administration4 8,in badly infected wounds1 ,toxicide will check the further destruction of live tissue and should always be given for a few days before and after operations on pus cases4 8,for gunshot wounds and other conditions difficult to sterilize or drain1 ,toxicide is the ideal remedy4 8,for abscesses existing or threatened in any obscure location1 the middle ear1 the mastoid1 the frontal or any accessory sinuses1 ,toxicide is of inestimable value4 8,if administered early1 in fractures1 compound or simple1 or for laceration and other injuries1 inflammation1 swelling1 soreness and destruction of tissue will be greatly mitigated40 ,in support of these claims there are offered letters from physicians who have used ,toxicide with good results4 ,none of these testimonials present evidence that the reported effects were due to ,toxicide4 ,the asserted--and highly improbable--action of ,toxicide could be determined only by an extensive series of carefully controlled clinical trials--and such evidence is entirely lacking4 ,in fact1 the claims appear to have no better basis than the coincidence which is stated to have led to the discovery of the 8remedy02 namely1 that a boil on the neck disappeared shortly after the administration of ,toxicide6 ,the ,council finds ,toxicide inadmissible to ,new and ,nonofficial ,remedies because 7#a7 the identity and amount of the potent constituent or constituents have not been furnished2 7#b7 the preparation is advertised indirectly to the public2 7#c7 the name 8,toxicide0 is therapeutically suggestive1 and 7#d7 the therapeutic claims1 being unsubstantiated by evidence1 are unwarranted4 ,illustration3 ,photographic reproduction 7greatly reduced7 of an advertising circular used some time ago describing the marvels 7alleged7 of ,toxicide4 ,editorial ,comment4--,it seems rather preposterous that a scientific body1 such as the ,council on ,pharmacy and ,chemistry1 should have to waste its time in investigating and reporting on such an obviously unscientific product as 8,toxicide40 ,so long1 however1 as there are physicians who will take preparations of this sort seriously1 the ,council feels that it is its duty to report on such products4 ,the problem1 in fact1 was well stated in a letter addressed to the editor some months ago by the secretary of a county medical society who had just received a visit from a representative of the ,toxicide ,laboratories and who sent to ,the ,journal some of the advertising matter that he had received from the same source4 ,this physician wrote3 8,i do not wish to trouble you with this kind of material1 usually deposited safely in my waste paper basket1 but the enclosed was handed to me today by a #8bird' who is calling on all the doctors and making strong statements4 ,when he claimed that #8,toxicide' is being used in the ,presbyterian ,hospital1 ,chicago1 and that the ,council on ,pharmacy and ,chemistry is considering it seriously1 etc41 etc41 ,i wish to know whether ,i am missing any real good thing4 ,if it has any real virtue1 ,i would like to know about it1 but if it has not1 it seems to me that something ought to be done to head him off as some doctors are sure to fall for some of it40 ,the ,toxicide ,laboratories is1 apparently1 merely a trade name used by the alleged originator of 8,toxicide10 ,j4 ,f4 ,ruckel1 ,m4,d4 ,according to our records1 ,ruckel was born in #ahfj and was graduated by the ,chicago ,homeopathic ,medical ,college in #ahhf4 ,he claims to have originated ,toxicide about twenty years ago and to have prescribed it 8in over #c1jjj cases40 ,in addition to ,toxicide1 the ,toxicide ,laboratories also put out 8,dianasiac for ,nymphomania and ,satyriasis0 and 8,somnosine for ,insomnia40--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #h1 #aiba47 ,,pil4 ,,mixed ,,treatment 7,,chichester7 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report3 ,w4 ,a4 ,puckner1 ,secretary4 8,pil4 ,mixed ,treatment 7,chichester70 is a proprietary preparation of the ,hillside ,chemical ,co41 ,newburgh1 ,n4 ,y4 ,it is sold in the form of pills1 each said to contain #a_/bj grain of mercuric iodid and #e grains of potassium iodid4 ,in #aijg the ,council examined the therapeutic claims advanced for this preparation and found that they were unwarranted1 exaggerated and misleading4 ,it found1 also1 many misleading statements in regard to the product itself4 ,furthermore1 the ,a4 ,m4 ,a4 ,chemical ,laboratory found the pills to be 8short weight0 in potassium iodid content4 ,at the time that the ,council examined ,pil4 ,mixed ,treatment 7,chichester71 a dermatologist of recognized standing1 to whom the 8literature0 for this product had been submitted for an opinion1 made the following report3 8,assuming that this pill contains what is claimed for it1 one-twentieth 7#a_/bj7 of a grain of biniodid of mercury and five 7#e7 grains of potassium iodid1 it presents neither an original nor a very useful formula4 8,the literature furnished by the company abounds in suggestions that the mixture1 as they prepare it1 represents some unusual potency which is not possessed by the ordinary mixture of these same drugs in the same proportion4 ,these suggestions may of course be dismissed without consideration4 ,there is nothing mysterious in a mixture of potassium iodid and biniodid of mercury and this formula is no more entitled to special consideration than any other pill or tablet of the same composition prepared by any reputable pharmaceutical firm4 8,the formula of this pill1 however1 does not represent a good combination4 ,it is offered for use both during the active secondary period of syphilis and for tertiary lesions4 ,the pill does not contain enough mercury to be an efficient remedy for secondary syphilis and not enough potassium iodid to be satisfactory in the treatment of tertiary lesions4 ,it is neither fish1 flesh1 fowl1 nor good red herring4 ,a patient with secondary syphilis should not be dosed all the time with potassium iodid and for the treatment of tertiary lesions he should have a very much larger quantity of potassium iodid than can be given in these pills without giving toxic doses of mercury4 8,the statement that this pill #8does not impair the appetite nor disturb digestion and is well borne by patients who cannot tolerate iodids otherwise administered' is a bald claim which cannot be justified by experience4 ,the most unsatisfactory way of administering potassium iodid is in solid form4 ,a patient who can stand potassium iodid in pill form1 as it is furnished in this preparation1 can stand it in any form in which it is ever administered4 8,in short this preparation is neither agreeable nor efficient4 ,the greatest objection to it is its inefficiency1 for it is offered as an adequate preparation for the treatment of syphilis in all of its stages1 whereas it is neither satisfactory for the treatment of secondary syphilis nor of tertiary lesions40 ,during the fourteen years which have elapsed since the ,council's first examination of ,pil4 ,mixed ,treatment 7,chichester71 arsphenamin has been added to the syphilographer's armamentarium and much has been learned about syphilis and its treatment4 ,while there exist differences of opinion as to the exact value of arsphenamin in the treatment of syphilis and there are even some who desist from the use of arsenic compounds of any kind1 no syphilographer of standing countenances the routine treatment of syphilis with a fixed combination of mercuric iodid and potassium iodid4 ,the use of ,pil4 ,mixed ,treatment 7,chichester7 is on a par with the use of certain 8blood purifiers0 which were advocated at a time when the treatment of syphilis was a baffling problem4 ,,present ,,day ,,claims ,the present advertising1 which reads as if it had been written in the heyday of proprietary license1 is1 in effect1 an invitation to treat syphilis in its various stages and manifestations with ,pil4 ,mixed ,treatment 7,chichester74 ,if heeded by those who read the advertising of the ,hillside ,chemical ,co41 it will result in much harm to the public and the profession4 ,for this reason1 the present report of the ,council is published as a protest against any advertising propaganda advocating the routine treatment of a disease which requires that each case be studied carefully so that prompt and efficient measures may be applied to the various manifestations of the disease4 ,the following advertisement appeared recently in several medical journals3 8,medicine is an ,exact ,science--on ,paper ,only60 ,every general practitioner of medicine is called upon to treat ,syphilis occasionally4 ,he cannot depend upon the use of arsenicals alone4 ,in most cases1 8mixed treatment0 the giving of mercury and iodides is required to get satisfactory results4 ,,pil4 ,,mixed ,,treatment 7,,chichester7 accurately and successfully meets the indications and assures definite action4 ,important advantages3 ,ready solubility of mercury in combination with ,potassium ,iodide4 ,avoidance of gastric1 buccal or intestinal disturbance4 ,easy administration1 can be taken at any time1 anywhere4 ,economical1 both drugs in one combination4 ,accurate adjustment of dosage to each individual case4 ,full physiological action--assured by purity of content4 ,secrecy--patient or friends do not know nature of medicine4 ,pil ,mixed ,treatment 7,chichester7 has been time tested and trial proven4 ,it needs no introduction to the thousands of physicians who prescribe or dispense it4 ,while the advertisement does not directly so advise1 yet it is a subtle invitation to the general practitioner to use ,pil4 ,mixed ,treatment 7,chichester7 and thus save himself and his patient the time and inconvenience which the rational treatment of syphilis imposes4 ,a circular 8,the ,treatment of ,syphilis ,simplified and ,improved0 begins3 8,no therapeutic fact is more conspicuously and decisively established than that a radical cure of syphilis can be effected by the continuous administration1 from the period of development1 of a proper combination of mercury with iodine40 ,continuing1 it is admitted that mercury is the most efficacious drug in the primary and secondary stages of syphilis and iodin in the tertiary stage1 but it is asserted that3 8444 it is now granted by all syphilologists that the antiluetic action of these drugs is immeasurably augmented by properly combining them1 and that the best results are obtained when they are conjunctively administered throughout the entire course of the disease40 ,arguing along the same lines1 this circular continues3 8444 it was not until mercury and iodine in the form of ,pil4 ,mixed ,treatment 7,chichester7 was evolved that the marked advantages of the combined employment of these drugs in the various stages of syphilis became a scientific certainty40 ,further we are asked to believe that3 8,because of the greatly increased potency of mercury and iodine when combined1 as in ,pil4 ,mixed ,treatment 7,chichester71 the foremost syphilologists are now agreed that the employment of these drugs in such form should be enjoined as soon as the disease develops1 and should be thus continued until a cure has been effected2 in other words1 ,pil4 ,mixed ,treatment 7,chichester7 should be made the sole antisyphilitic medication throughout all stages of the disease40 ,the circular illustrates the extent to which our knowledge of drugs may be distorted and misrepresented and the public health jeopardized in the exploitation of a proprietary medicine4 ,illustration3 ,one reason scientific medicine lags4 ,uncritical medical journals perpetuate--for a price--the use of nostrums4 ,,proprietary ,,claims ,in its advertising1 the ,hillside ,chemical ,co4 claims that ,pil4 ,mixed ,treatment 7,chichester7 both as to formula and method of preparation 8in the incapsulated powder form0 was 8brought to the notice of the profession by ,dr4 ,w4 ,r4 ,chichester of ,new ,york1 an eminent ,syphilographer and recognized authority in the therapeutics of ,syphilis40 ,it is claimed that this pill 8is perfectly soluble1 tasteless1 nonirritant1 and therefore well adapted to a sensitive stomach40 ,it is claimed that the pill 8is always preferable to one extemporaneously prepared1 which1 even if identical in composition1 often gives negative results40 ,an examination made in the chemical laboratory of the association to determine if the product now marketed contains the claimed amount of potassium iodid indicated that this was the case4 ,the chemist who made this examination commented as follows on the claim that in this pill1 potassium iodid is rendered tasteless1 that the pill is 8perfectly soluble0 and that extemporaneous pills of 8identical 444 composition often give negative results40 8,that the potassium iodid has been rendered tasteless is false1 naturally2 the pills when placed in the mouth1 after removal of the coating1 have the characteristic taste of alkali iodids4 ,the claim that the pills are entirely soluble is incorrect2 they contain a large amount of insoluble material1 probably kaolin4 ,the assertion that an extemporaneous compound prescription even if identical in composition with the ,chichester pill is often inert1 is absurd and a reprehensible attack by suggestion of the ideal that the physician shall write his prescription to meet the individual needs of his patient and that the pharmacist shall compound the prescriptions of the physician as they are required4 ,it should also be pointed out that while much is said about the potassium iodid in the ,chichester pill being in powdered form1 the pill mass is solid and very slowly soluble and the claim of being in powdered form is1 if immaterial1 also incorrect40 ,as to the asserted standing of the alleged discoverer of the formula for ,pil4 ,mixed ,treatment3 ,dr4 ,william ,r4 ,chichester appears to have lived and practiced in ,new ,york since #ahhf or longer1 but the claim that he is an 8eminent syphilographer0 seems to have originated with the exploiters of 8,pil4 ,mixed ,treatment40 ,search failed to show the name of ,w4 ,r4 ,chichester among authors of textbooks of syphilis or any other branch of medicine or among authors of contemporary literature in the ,index ,medicus from #aijg down to the present2 nor did a search of the catalogue to the ,surgeon-,general's ,library reveal ,w4 ,r4 ,chichester as ever having published anything on syphilis or any other subject4 ,pil4 ,mixed ,treatment 7,chichester7 is sold under therapeutic claims which are unwarranted and misleading4 ,the preparation well illustrates the abuses which are connected with the exploitation as proprietaries of established drugs or mixtures of established drugs4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bb1 #aiba47 ,,atophan ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report explaining why ,atophan has been omitted from ,new and ,nonofficial ,remedies4 ,schering and ,glatz1 ,inc41 the firm which markets this brand of cinchophen in the ,united ,states1 has refused to place either the ,u4 ,s4 ,pharmacopeial name1 8,phenylcinchoninic ,acid 7,acidum ,phenylcinchoninicum70 or the ,n4 ,n4 ,r4 name1 8,cinchophen10 on the label and in the advertising matter so as to make the identity of the product clear to physicians4 ,furthermore1 the product is sold under therapeutic claims which the ,council holds to be exaggerated and unwarranted4 ,w4 ,a4 ,puckner1 ,secretary4 ,,commercial ,,history ,,of ,,cinchophen ,the substance1 #b-phenyl-quinolin-#d-;carboxylic acid1 was described by ,doebner and ,gieseke in #ahhg 7,ann4 d4 ,chem4 ,liebig's #bdb3bia74 ,the therapeutic properties of this compound were described by ,nicolaier and ,dohrn in #aijh 7,deutsch4 ,arch4 f4 klin4 ,med4 #ic3cca74 ,subsequently the product was placed on the market and extensively advertised by the ,chemische ,fabrik auf ,actien 7vorm4 ,e4 ,schering71 ,berlin1 ,germany4 ,this firm also took out a patent in the ,united ,states on its production and in #aiaa secured a ,u4 ,s4 trademark on the name 8,atophan40 ,in #aiab ,atophan was passed on by the ,council and admitted to ,new and ,nonofficial ,remedies4 ,when the government of the ,united ,states took charge of ,german-owned patents during the ,world ,war1 the ,federal ,trade ,commission1 and later the ,chemical ,foundation1 ,inc41 issued licenses to ,american firms whereby these were authorized to manufacture the compound4 ,in the meantime1 ,schering and ,glatz1 ,inc41 who had been the ,u4 ,s4 representatives for the ,chemische ,fabrik auf ,actien1 also undertook to supply the drug1 but did not obtain a license from the boards in charge of ,german patents4 ,also1 this firm secured1 in #aiai1 a trademark of the word 8,atophan10 apparently after the ,german-owned trademark had been canceled4 ,the drug 8,atophan0 was admitted to the ,u4 ,s4 ,pharmacopeia as 8,phenylcinchoninic ,acid 7,acidum ,phenylcinchoninicum740 ,as this name proved too cumbersome1 the ,council on ,pharmacy and ,chemistry coined the abbreviated name 8,cinchophen0 for it1 and this name is now used by all the firms which are marketing the product in the ,united ,states1 with the exception of ,schering and ,glatz1 ,inc41 who use the term 8,atophan10 first owned by the ,chemische ,fabrik auf ,actien4 ,,atophan1 ,a ,,brand ,,of ,,cinchophen ,because of the confusion which is bound to arise from giving various names to one drug1 the ,council selects a common name and provides standards of identity1 purity and strength for any drug which1 by reason of the absence or lapse of patent rights or for other reason1 is open to manufacture by more than one firm4 ,the ,council1 then1 will accept such article only if it is marketed under the title adopted for ,new and ,nonofficial ,remedies4 ,the rules provide1 however1 that when the ,council adopts a common name for an article that has been admitted under another name1 such article will be retained in ,new and ,nonofficial ,remedies under the older name if the ,council name is given prominence on the label and in the circulars and advertisements1 in order to avoid confusion4 ,accordingly1 when the period of acceptance for ,atophan in ,new and ,nonofficial ,remedies was about to expire1 ,schering and ,glatz were notified that ,atophan could be retained in that publication only on condition that the name1 8,cinchophen10 or else the pharmacopeial name1 8,phenylcinchoninic ,acid 7,acidum ,phenylcinchoninicum70 be placed on the label and used in the circulars and advertising4 ,,unwarranted ,,therapeutic ,,claims ,,for ,,atophan ,at the time that the ,council asked ,schering and ,glatz to adopt cinchophen or phenylcinchoninic acid as a synonym for ,atophan1 the firm was also requested to omit from future advertising a number of therapeutic claims to which the ,council was obliged to take exception4 ,schering and ,glatz refused the first request and made no definite promise with regard to the second4 ,the ,council1 therefore1 directed the omission of ,atophan from ,new and ,nonofficial ,remedies1 #aiba4 ,the advertising to which the ,council took exception does not appear to be distributed at present4 ,a pamphlet has been sent out1 however1 which is equally objectionable4 ,it contains unwarranted therapeutic claims and suggests that ,atophan be used in conditions in which it is not indicated4 ,for instance3 8,no longer the vague1 hypothetical1 #8test-tube demonstrated' principle of uric acid elimination by solution1 but a definite1 scientifically and clinically established1 physiologic stimulation of the uric acid excretion4 ,performed innocuously and controllable to a nicety by dosage and by urine and blood tests40 ,the 8innocuousness0 of ,atophan has not been proved2 on the other hand there is evidence that it is not innocuous1 as the recent investigations of ,hanzlik and ,scott and their collaborators 7,cinchophen1 ,neocinchophen and ,novaspirin in ,rheumatic ,fever1 ,j4 ,a4 ,m4 ,a4 #gf3 #agbh ,june #ah #aiba7 show that it may injure the kidney4 ,the circular also contains the following3 8,no longer1 hit and miss relief of pain at the expense of the heart1 the intestines1 the kidneys and the nervous system1 but the promptest and most reliable analgesic1 anti-inflammatory and decongestive action so far known1 with notable freedom from heart depressant1 renal irritant1 constipating and cumulative toxic by-effects4 ,no contraindications1 except chronic nephritis and the presence of kidney concretions40 ,this is misleading4 ,the drug depresses the circulation1 injures the kidney and produces symptoms of salicylism or 8toxicity40 ,it is not the promptest and most reliable analgesic2 morphin is superior and salicylate is just as efficient4 ,the phrase 8decongestive action0 is vague4 ,treatment of pulmonary congestion from phosgene1 and congestion of the conjunctiva in mustard oil chemosis of cats1 with large doses of ,atophan was ineffective2 in fact1 it proved distinctly harmful4 ,this was shown by such workers as ,laqueur and ,magnus1 and ,heubner and ,gildemeister 7,ztschr4 f4 d4 ges4 exper4 ,med4 #ac3bjj1 #aiba74 ,it is incorrect to ascribe 8decongestive0 or 8anticongestive0 action in the true sense to ,atophan 7cinchophen74 ,the principal assets of the salicylate-cinchophen class of drugs in the treatment of rheumatism and gout are their analgesic and antipyretic qualities4 ,the claim is made3 8,in ,rheumatic and ,gouty ,disorders1 whether of the well-known muscular and arthritic type1 or their ,eye1 ,ear1 ,nose and ,throat manifestations40 ,the suggestion that ,atophan is indicated in 8their ,eye1 ,ear1 ,nose and ,throat manifestations0 is a vague generalization without definite meaning1 but nevertheless calculated to impress physicians and promote the sale of ,atophan for common and minor ailments4 ,rhinitis and sore throat are1 of course1 self-limited conditions which require chiefly good habits1 personal and general hygiene as prophylactic measures1 and simple hot baths with rest1 instead of medication1 for symptomatic relief4 ,when it comes to ear and eye conditions1 ,atophan certainly would do no good in otitis media1 panophthalmitis1 choroiditis1 retinitis1 etc4 ,the administration of ,atophan is proposed 8in ,migrains1 ,hemicrania1 ,eyestrain1 etc41 often vaguely grouped as #8,headaches4'0 ,eyestrain and headaches are vague symptoms often arising from numerous causes that require no medication1 but rather good habits1 hygiene and similar corrective measures4 ,there is always the possibility of habituation from the use of drugs for such common and vague symptoms1 resulting eventually in more harm than good to the patient4 ,the use of ,atophan is proposed 8,in ,influenza 7,grippe7 for the ready alleviation of the respiratory congestion1 pain and stiffness of limbs and back40 ,probably the entire claim is without warrant1 since influenza is a self-limited disease4 ,atophan might relieve pain in the joints1 reduce the fever1 etc41 but at the same time it would tend to impair the functional efficiency of the heart1 which may be impaired already by the disease4 ,cardiac failure is one of the causes of death in influenza4 ,the recommendation for 8alleviating respiratory congestion0 is certainly without warrant1 since in actual trial in pulmonary congestion by ,magnus et al41 ,atophan was found to be deleterious and not beneficial4 ,phosgenized cats are probably as good a test object for the alleged decongestive action of ,atophan as anything could be1 since1 according to ,underhill and ,ringer 7,j4 ,a4 ,m4 ,a4 #ge3aeca1 #aibj7 the pathological physiology of the circulation and respiration in phosgene poisoning and influenza are nearly identical4 ,further1 ,atophan is recommended 8,in ,pyorrhea ,alveolaris as a systemic support to local and specific measures40 ,atophan is not indicated here4 ,pyorrhea requires local medication1 if anything at all4 ,it could exert no local beneficial effects in this condition2 indeed1 the employment of ,atophan might lead to irritation4 ,good dental treatment is more essential than medication4 ,finally1 ,schering and ,glatz advise ,atophan 8,in ,eczema1 ,pruritus and similar irritant and itching ,skin ,diseases with lowered blood alkalinity40 ,the assumption that blood alkalinity is lowered in irritant and itching disease is unsupported by evidence in medical literature and the recommendation is incorrect and misleading4 ,neither does ,atophan alter the reaction of the blood4 ,amelioration in these capricious conditions occurs without medication so that any relief that might be obtained could not be attributed to ,atophan4 ,the entire paragraph is misleading and will undoubtedly tend to extend the use of ,atophan in conditions for which it is not suited4--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiba1 p4 #h47 ,,urotropin ,,omitted ,,from ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,urotropin is a proprietary name applied to the substance which is known in chemical literature as hexamethylenetetramin and which is designated hexamethylenamine in the ,u4 ,s4 ,pharmacopeia4 ,the ,council has authorized publication of the following report explaining that ,urotropin was omitted from ,new and ,nonofficial ,remedies because ,schering ,glatz1 ,inc4 7the firm that markets this brand of hexamethylenamin in the ,united ,states71 refused to place the ,u4 ,s4 ,pharmacopeia name ,hexamethylenamine 7hexamethylenamina7 on the label and in its advertising so as to make clear to physicians the identity of the product1 and1 furthermore1 because it was sold under therapeutic claims which the ,council held unwarranted4 ,w4 ,a4 ,puckner1 ,secretary4 ,commercial ,history of ,hexamethylenamin ,this substance which is generally referred to in chemical literature as hexamethylenetetramin1 the cyclic condensation product of formaldehyd and ammonia1 appears to have been described first in #ahfj 7,butlerow3 ,ann4 d4 ,chem4 #aae3cbb1 #ahfj74 ,subsequently1 numerous references to the preparation1 properties and constitution of the substance appeared in chemical literature4 ,hexamethylenetetramin is said to have been first used for therapeutic purposes by ,g4 ,bardet1 who1 in #ahid1 reported to the ,socit de ,thrapeutique that he believed this substance to be a uric acid solvent4 ,at about the same period1 ,a4 ,nicolaier1 who gave ,bardet credit for suggesting the use of hexamethylenetetramin as a uric acid solvent1 announced the discovery of its antiseptic action 7,centralbl4 f4 d4 med4 ,wissensch4 #cb3hig1 #ahid2 ,deutsche med4 ,wchnschr4 #ba3eda1 #ahie74 ,shortly thereafter as a result of ,nicolaier's publication1 the ,chemische ,fabrik auf ,aktien vorm4 ,e4 ,schering1 ,berlin1 ,germany1 began to offer the product to the medical profession under the trademarked and nondescriptive name 8,urotropine40 ,in the ,united ,states1 it was marketed by ,schering and ,glatz1 who then were acting as ,american agents for the ,schering works of ,germany4 ,it soon became evident that hexamethylenetetramin was a valuable drug4 ,as the substance was introduced at a time when new 8synthetic0 drugs were rapidly appearing and when unlimited and uncritical confidence was placed in them1 and before the medical profession became skeptical of the claims advanced by manufacturers for their respective 8discoveries10 it was not long before this new drug was placed on the market by many firms1 each applying its own name and often keeping the chemical character of it in the background4 ,some of the names which were thus applied to hexamethylenamin were ,cystogen1 ,aminoform1 ,formin1 ,uritone1 ,urisol1 and ,cystamine4 ,in #aijg the late ,prof4 ,j4 ,o4 ,schlotterbeck1 then a member of the ,council1 protested against the confusion caused by the marketing of a given drug under different names4 ,he stated that it was not uncommon for a physician to prescribe two or more of these identical substances in the same mixture1 expecting to get the combined action of different urinary antiseptics2 also1 that patients had been treated first with hexamethylenamin under one name and later by the same substance under another name 7,the ,journal1 ,jan4 #ai1 #aijg1 p4 #bda74 ,hexamethylenetetramin was admitted to the eighth revision of the ,u4 ,s4 ,pharmacopeia4 ,in part because of this official recognition and standardization and in part because the extravagant reports of its virtues had been largely discounted1 physicians have in general prescribed the drug by its pharmacopeial name1 with one notable exception3 ,urotropin4 ,one reason for this is that ,urotropin was the first proprietary brand of hexamethylenetetramin introduced1 a second reason is that through the extensive and persistent advertising of the proprietary name under which the substance was introduced1 it has become firmly fixed in the minds of many physicians4 ,the other is that the product was claimed to be of greater purity than the product sold under the pharmacopeial or other name although no evidence confirmatory of this claim has ever been published4 ,on the other hand1 ,daniel ,base1 as long ago as #aijg1 found that hexamethylenamin sold under its pharmacopeial name is just as pure as when sold under proprietary names4 ,when1 in #aijg1 urotropin was admitted to ,new and ,nonofficial ,remedies1 the published description showed that it was manufactured by the ,chemische ,fabrik auf ,aktien vorm4 ,e4 ,schering1 ,berlin1 and that ,schering and ,glatz were the ,united ,states agents4 ,in #aiai1 the description was revised to show that ,schering and ,glatz were no longer selling the ,german product4 ,as it is the general practice to omit articles that are admitted to the ,u4 ,s4 ,pharmacopeia for the reason that their quality is guaranteed under the federal ,food and ,drugs ,act and because pharmacopeial nonproprietary articles are rarely advertised with claims that require the ,council's control1 yet1 in the case of ,urotropin1 it was retained because it was sold under a name not recognized in the pharmacopeia and because special 7proprietary7 claims were made for it4 ,urotropin ,marketed ,under ,unwarranted ,therapeutic ,claims ,the period for which ,urotropin stood 8,accepted0 expired with the close of #aiba4 ,to determine its continued eligibility for ,new and ,nonofficial ,remedies1 the ,council examined the labels and circular matter sent by ,schering and ,glatz for the purpose and also a booklet 8,urotropin10 subsequently sent by the firm to physicians4 ,it was found that the pamphlet contained a number of unwarranted statements4 ,particularly objectionable are the claims made for the use of ,urotropin as an antiseptic in body fluids that are alkaline1 such as the cerebrospinal fluid1 bile1 aqueous humor of the eye1 saliva1 the excretions caused by middle ear infection and other excretions of the nasal1 bronchial1 laryngeal and mucous membranes4 ,the lack of efficacy of hexamethylenamin in alkaline secretions is generally admitted and the clinical references to the use of hexamethylenamin in the pamphlet are obsolete4 ,in the introduction to the pamphlet1 ,schering and ,glatz state that they are well acquainted with the scientific research work discrediting the efficiency of hexamethylenamin in nonacid mediums1 but that they feel that the accumulated evidence for its efficacy in such conditions should not be 8brushed aside40 ,however1 the pamphlet is not made up of quotations1 but of unqualified statements4 ,with one exception1 all references to the antiseptic properties of the drug in alkaline mediums are previous to #aiac1 that is1 before the importance of reaction of the medium was fully appreciated4 ,to quote these earlier articles without regard to the later work1 which in most eyes discredited them1 constitutes in effect an exploitation of this brand of hexamethylenamin under unwarranted therapeutic claims4 ,urotropin a ,brand of ,hexamethylenamine1 ,u4 ,s4 ,p4 ,in consideration of the confusion which arises from the application of different names to an identical article1 the rules of the ,council provide that when an article which has been accepted for ,new and ,nonofficial ,remedies is admitted to the ,u4 ,s4 ,pharmacopeia under another name1 it will be retained1 provided the official name is given prominence on the label and in the advertising of such article4 ,neither the label nor the advertising for ,urotropin gives prominence to the pharmacopeial name as a synonym nor indeed does it bring out the fact that ,urotropin is a brand of hexamethylenamine1 ,u4 ,s4 ,p4 ,schering and ,glatz1 ,inc41 was advised that ,urotropin could be retained in ,new and ,nonofficial ,remedies only on condition that the objections to the therapeutic recommendations were removed and on agreement that the ,u4 ,s4 ,p4 name appear on the labels and circular matter4 ,the firm did not offer to make the product eligible for continued recognition2 accordingly the ,council directed the omission of ,urotropin because of conflict with ,rule #f 7,unwarranted ,therapeutic ,claims7 and with ,rule #h 7,objectionable ,names74--7,from ,reports of ,council on ,pharmacy and ,chemistry1 #aiba1 p #ga47 ,,styptysate ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report1 declaring ,styptysate 7,ernst ,hischoff ,co41 ,inc47 inadmissible to ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 ,styptysate1 according to the advertisement of ,ernst ,bischoff ,co41 ,inc41 ,new ,york1 is 8obtained by dialysis from ,bursa ,pastoris 7,sheppard's sic6 ,purse740 ,it is claimed to be 8,the ,remedy ,for ,hemorrhages10 to be 8,superior to ,ergot and ,hydrastis10 8of particular advantage in ,menorrhagia and ,metrorrhagia0 and to have been 8found of great value in vesical hemorrhages and hemorrhages from mucous membranes in general40 ,the ,styptysate label bears the synonym 8,dialysate ,herba ,bursa ,pastoris02 the statement that it contains 8alcohol #aa per cent40 and that it is 8made in ,germany40 ,no other statement of the composition or strength of 8,styptysate0 is furnished nor is the name of the ,german manufacturer disclosed4 ,in an advertising circular entitled 8,styptysate1 a ,new ,reliable ,hemostatic10 it is declared that in recent years the plant1 ,shepherd's ,purse 7,capsella bursa pastoris71 8has been submitted to clinical tests in the form of a concentrated dialysate1 known as ,styptysate1 by ,loewy1 ,oppenheim1 ,krummacher and others1 and that their reports coincide in regard to ,styptysate as a hemostatic par excellence1 particularly in uterine hemorrhages1 even in cases where ergot and hydrastis had failed to produce satisfactory results40 ,the circular also reprints some 8short clinical reports0 without reference to their authorship2 one ascribed to ,krummacher and two ascribed to 8,b4,h4,m41 ,kansas ,city1 ,mo410 and the following references3 8,a4 ,krummacher1 ,m4,d41 ,monthly ,review for ,obstetrics and ,gynecology1 ,berlin1 ,vol4 ,,xlix1 #d1 and ,vol4 ,,lii40 8,h4 ,oppenheim1 ,m4,d41 ,medical ,clinic1 ,berlin1 #aibj1 #ce40 ,shepherd's ,purse is a weed common in the ,united ,states and in ,europe4 ,like most other herbs1 it has some reputation as a folk medicine4 ,it is used by eclectics and homeopaths1 being included in the ,homeopathic ,pharmacopeia of the ,united ,states4 ,shepherd's ,purse receives no consideration at the hands of the authors of standard works on materia medica1 pharmacology or therapeutics4 ,from an examination of recent ,german medical publications1 it appears that the use of ,shepherd's ,purse was proposed as a substitute for ergot and hydrastis1 when the latter drugs became scarce in ,germany4 ,these publications1 in the main1 emanate from those in the employ of pharmaceutical firms and deal with proprietary preparations or they are written by physicians who used these proprietary preparations at the solicitation of the manufacturers4 ,for this reason the reported results must be accepted with reserve4 ,one of the proprietary preparations discussed in the ,german publications is ,styptysate1 manufactured by ,isalfabrik ,johannes ,buerger1 ,wernigerode4 ,it is said to be produced by submitting the juice of fresh ,shepherd's ,purse to dialysis and preserving the dialysate by the addition of alcohol4 ,there is no statement as to the drug strength or the chemical or biological standards1 if any1 used in its manufacture2 hence1 the preparation is essentially a secret one4 ,as first produced1 the preparation seems to have been fortified by the addition of cotarnin3 the dose was then given as ten to fifteen drops4 ,later1 as the cost of cotarnin went up1 this drug was omitted1 and the drug strength increased2 the dose of the new preparation is given as twenty-five to thirty drops4 ,just what relation1 if any1 the ,styptysate of ,ernst ,bischoff ,co41 ,inc41 bears to that of the ,isalfabrik ,johannes ,buerger1 ,wernigerode1 cannot be determined from the ,bischoff advertising4 ,if it has any relationship the announcement that no narcotic order is required when ordering ,styptysate would indicate that the new preparation is supplied2 the old one with its addition of cotarnin would require a narcotic order4 ,on the other hand1 the recommended dose of the cotarnin-free preparation is twenty-five to thirty-drops1 whereas the product sold by ,bischoff and ,co4 is to be given in doses of ten to fifteen drops--that is1 in the amount proposed for the cotarnin-fortified product4 ,what justification is there for the claim that ,styptysate has been submitted to clinical tests by ,loewy1 ,oppenheim and ,krummacher and found to be a hemostatic par excellence and efficient even where ergot had failed to give satisfactory results8 ,loewy 7,zentralblatt fr ,gyncologie #db3ibj1 #aiba7 made some pharmacologic tests on guinea-pigs with the cotarnin-containing preparation1 but reported no clinical trials4 ,hans ,oppenheim 7,medizinische ,klinik1 ,aug4 #bi1 #aibj1 p4 #ijf7 reported that he was agreeably surprised at the excellent results 7vorzueglichem ,erfolg7 obtained with the drug but he did not assert that it is superior to ergot4 ,krummacher reported on thirteen cases of profuse menstruation in which the patients were treated with ,styptysate1 using for a part1 the preparation containing cotarnin and for the other a preparation without cotarnin4 ,he reported as good results with the cotarnin-free preparation in larger dosage1 as with the cotarnin-containing preparation in smaller dosage4 ,krummacher did not compare ,styptysate with ergot4 ,some of ,krummacher's cases are quoted1 with some typographical errors1 in the ,bischoff circular4 ,on the assumption that the product discussed in ,german publications is the ,styptysate marketed in the ,united ,states1 the best that can be said for it is1 that during a shortage of ergot it was used in place of that established drug4 ,there is no evidence to warrant the use of this indefinite proprietary in place of the biologically standardized fluidextract of ergot or other standardized ergot preparations4 ,styptysate 7,ernst ,bischoff and ,co41 ,inc47 is inadmissible to ,new and ,nonofficial ,remedies because its composition is semisecret and indefinite and there is no evidence that its uniformity and strength is controlled 7,rules #a and #b72 further1 it is inadmissible because the therapeutic claims advanced for it are exaggerated and unwarranted 7,rule #f7 and because there is no evidence that it possesses any advantage over established drugs such as the biologically standardized fluidextract of ergot or the definite ergot preparations admitted to ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #aa1 #aibb47 ,,lipoidal ,,substances 7,,horovitz7 ,,not ,,admitted ,,to ,n4 ,n4 ,r4 ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has authorized publication of the following report declaring ,lipoidal ,substances 7,horovitz7 inadmissible to ,new and ,nonofficial ,remedies because its composition is essentially secret and because the curative claims made for it are unsubstantiated and1 therefore1 unwarranted4 ,w4 ,a4 ,puckner1 ,secretary4 ,in the advertising of the ,horovitz ,biochemic ,laboratories ,co4 7,a4 ,s4 ,horovitz1 president7 we read3 8,horovitz proves by careful paralleled investigations of normal and of pathological tissues1 both in addiction disease and in other diseases1 that in patients suffering from narcotic addiction disease there is an inactivity of the lymph-glands due to the use of the drug and that the system is not supplied with the necessary fats40 8,horovitz further found that the lipoidal content of the cerebro-spinal system varies in strict accordance with the pathological processes introduced by infection or by alkaloids4 ,furthermore1 he has found that the lipoids of various other organs1 as well as those of the ,t,h,e,r,m,o,rnervous system1 may be extracted and consumed by the administration of narcotic alkaloids40 ,it is further stated in the advertising that3 8,after a long and very careful research investigation1 ,dr4 ,horovitz worked out a method of rational treatment for narcotic addiction disease which involves the restoration of the lipoids1 which have been lost through the action of the drug1 and of the toxins1 by means of a combination of lipoidal substance from various plant lipoids in the form of a sterile solution4 ,this preparation not only replaces the lipoids lost by the tissues1 but also protects the nerve tissues1 from attacks by the toxins elaborated during the use of narcotics1 and1 this by detoxicating the tissues1 brings about permanent freedom from the craving of narcotics1 instead of the temporary relief afforded by other methods of treatment40 ,the 8combination of lipoidal substance of various plant lipoids0 which was worked out by ,horovitz1 the ,horovitz ,biochemic ,laboratories offer as 8,lipoidal ,substances40 ,this preparation is supplied in ampoules said to contain #a c4c4 of solution4 ,the treatment with 8,lipoidal ,substances0 consists1 first1 in the complete withdrawal of the narcotic2 second1 in free catharsis2 and third1 in the intramuscular injection of the preparation4 ,the initial dose is given as #h to #ab minims repeated with increase of #c to #d minims every three hours during the first day4 ,on the second1 third and fourth day #af minims is to be given twice a day and 8from the fifth day until the medication is stopped 7usually #bh to #ce days7 it will be necessary usually to give but #a injection of #af minims each day40 ,in a request for the admission of its preparation to ,new and ,nonofficial ,remedies1 the ,horovitz ,biochemic ,laboratories ,co4 stated3 8,the composition of ,lipoidal ,substance is 7a7 ,lipoids of plant origin1 7b7 ,vitamines 7water soluble7 of plant origin1 7c7 ,non-specific plant proteins1 7d7 ,preservatives--,none40 ,while the communication abounded in generalities1 it gave neither the identity nor character of the lipoids1 of the vitamins nor of the nonspecific protein1 nor their quantities or methods for their control4 ,the firm presented no evidence that the injection of 8,lipoidal ,substances0 produced any effect other than by suggestion4 ,also1 while a long list of references to publications bearing on lipoids was submitted 7many of which had no bearing on the subject under consideration7 there was no reference to the work of ,horovitz quoted in the firm's advertising4 ,after examining the information which had been submitted1 the ,council requested the manufacturer to supply3 #a4 ,information as to the character 7identity7 of the several ingredients contained in the preparation that it marketed1 the amount of each ingredient so far as known and the method used for their control4 #b4 ,evidence that the administration of 8,lipoidal ,substances0 is of value in the treatment of drug addiction4 #c4 ,evidence for the claims that the 8researches0 of ,horovitz have proved that 8in patients suffering from narcotic addiction disease there is an inactivity of the lymph-glands 444 and the system is not supplied with the necessary fats0 and that 8lipoidal content of the cerebro-spinal system varies in strict accordance with the pathological processes introduced by infection or by alkaloids0 and that 8the lipoids of various other organs as well as those of the nervous system1 may be extracted and consumed by the administration of narcotic alkaloids40 ,the ,horovitz ,biochemic ,laboratories replied that the requested information would be supplied in about two weeks4 ,at the expiration of three months the promised information and evidence had not been received2 neither had any reports to show the value of the treatment come to the attention of the ,council4 ,the ,council1 accordingly1 declared 8,lipoidal ,substances0 7,horovitz ,biochemic ,laboratories7 inadmissible to ,new and ,nonofficial ,remedies because the composition is essentially secret and because the curative claims are unsubstantiated and unwarranted4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #be1 #aibb47 ,,yeast ,,preparations ,,and ,,vitamin ,b ,,concentrates ,report of the ,council on ,pharmacy and ,chemistry ,the ,council has adopted the following principles as a guide in the consideration of yeast preparations and vitamin ,b concentrates for ,new and ,nonofficial ,remedies4 ,w4 ,a4 ,puckner1 ,secretary4 #a4 ,the claim that deficiency of vitamin ,b and diseases resulting therefrom are common conditions in the ,united ,states is not at this time supported by adequate acceptable evidence4 #b4 ,the claim that yeast preparations or extracts are1 in principle or in general1 essentially more effective or more practical or more available means of administering vitamins than the commonly available vitamin-containing foods is not at this time supported by adequate acceptable evidence4 7,any claims for superiority made for such products proposed for inclusion in ,new and ,nonofficial ,remedies must be presented in detail and passed on specially by the ,council47 #c4 ,the claim that therapy with yeast or yeast preparations has as yet more than an experimental status is not at this time supported by adequate acceptable evidence4 ,preparations for which such claims are made1 directly or by implication or in one-sided quotations1 in advertisements or letters or by salesmen1 cannot be admitted to or retained in ,new and ,nonofficial ,remedies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ae1 #aibb47 ,,part ,,ii ,,contributions ,,from ,,the ,a4 ,m4 ,a4 ,,chemical ,,laboratory ,,foreword ,,the ,,chemical ,,laboratory ,,of ,,the ,,american ,,medical ,,association ,the ,chemical ,laboratory of the ,american ,medical ,association was established in #aijf to assist the ,council on ,pharmacy and ,chemistry in the investigation of proprietary remedies4 ,in accordance with the principle of its foundation1 the ,laboratory examines and checks the claims made for the composition and chemical properties of the products under examination by the ,council1 and when these are admitted to ,new and ,nonofficial ,remedies1 it insures the establishment of tests and standards whereby the identity and purity of these products may be controlled4 ,in addition1 the ,laboratory supplies information1 secured by reference to chemical and pharmaceutical literature or by actual analytic work1 in regard to proprietary and unofficial medicines1 either for publication in ,the ,journal of the ,american ,medical ,association or through direct correspondence4 ,those portions of the ,laboratory's activities which are of special interest to physicians and which were not included in the ,reports of the ,council on ,pharmacy and ,chemistry were included in the ,propaganda for ,reform in ,proprietary ,medicines1 ninth edition 7#aiaf71 so far as they had been published up to the time when the edition was issued2 those made during the last five years are included in ,part ,,ii of this volume4 ,for a detailed report of the ,laboratory's work1 the reader is referred to the article that follows on 8,the ,work of the ,american ,medical ,association ,chemical ,laboratory40 ,those who are interested in the analysis of drugs are referred to the ,reports of the ,chemical ,laboratory issued annually for the details of the analyses which have been made by the ,laboratory4 ,,the ,,work ,,of ,,the ,,american ,,medical ,,association ,,chemical ,,laboratory,e ,w4 ,a4 ,puckner1 ,phar4,d4 ,e ,read before the ,section on ,pharmacology and ,therapeutics at the ,sixty-,seventh ,annual ,session of the ,american ,medical ,association1 ,detroit1 ,june1 #aiaf4 ,the ,american ,medical ,association ,chemical ,laboratory was established nearly ten years ago--in fall of #aijf4 ,the reason for its existence was primarily the fact that the ,council on ,pharmacy and ,chemistry found it difficult to secure from outside sources such help as it needed in checking up the composition and properties of proprietary medicines under investigation4 ,medical schools and similar institutions were found ready to lend their assistance in pharmacologic and medical investigations2 but the chemical investigation required the establishment of a laboratory under the control of the ,american ,medical ,association4 ,as years have passed1 the scope of the laboratory has been extended3 ,its services have been requisitioned by ,the ,journal in various ways4 ,thus1 when requested1 the laboratory reviews and verifies the chemical data contained in editorials and original contributions4 ,the laboratory is often called on for information as to the character and composition of quack treatments and so-called 8patent medicines40 ,through the columns of ,the ,journal and through direct correspondence1 the laboratory responds to requests of physicians with information regarding the composition of medicines which they prescribe or in which they are interested4 ,the laboratory attempts to be to the members of the ,american ,medical ,association what the prescription pharmacist is1 or should be1 to the prescribing physician--a storehouse of chemical and pharmaceutical information4 ,in the belief that an insufficient familiarity with the chemistry and pharmacy of drugs constitutes the chief reason for the extensive use of unscientific1 worthless or fraudulent proprietary remedies1 this service is rendered by the laboratory as a contribution to the cause of rational therapy4 ,since the efficiency of the ,american ,medical ,association ,chemical ,laboratory will increase as its activities are better known1 the following more detailed statement of its work is offered3 ,,the ,,laboratory ,,and ,,the ,,council ,as stated in the rules of the ,council on ,pharmacy and ,chemistry1 it is 8manifestly impossible for the ,council to investigate the composition of every complex pharmaceutical mixture 44402 8it can only give an unbiased judgment on the available evidence40 ,in line with this1 the laboratory does not undertake to prove the composition of constitution of all new synthetics1 nor does it attempt to determine the individual composition of proprietary mixtures4 ,it checks all claims that seem doubtful1 however1 and uses its best endeavors to secure correction of misstatements with regard to proprietary remedies and improvement in the quality of these products4 ,further1 it reexamines1 when this seems desirable1 the products which have been admitted by the ,council to ,new and ,nonofficial ,remedies1 and thus determines1 from time to time1 their dependability4 ,the fact that no product admitted to ,new and ,nonofficial ,remedies has later been shown to be untrue to its claimed composition is1 it is believed1 an indication that in this respect the laboratory has succeeded in performing the work for which it was primarily created4 ,in this connection the question may be asked1 ,are many proprietary medicines exploited to the medical profession with false claims in regard to their composition8 ,also it may be asked1 ,has the number of proprietaries marketed with false statements of composition decreased since the ,council and the laboratory began their work8 ,answering the latter question first3 ,there is no doubt that today fewer proprietary medicines are being sold with false claims as to composition than there were ten years ago4 ,when the ,council began its work1 medical journal advertising teemed with statements regarding the composition of medicines which any chemist familiar with medicine would not hesitate at sight to brand as untrue4 ,today such manifestly false claims are rare4 ,coming to the former question3 ,many false statements regarding the identity and composition of remedies have been made in ignorance4 ,this is not surprising when it is remembered that the most ignorant may and do engage in the manufacture of medicine4 ,besides ignorance1 however1 an accommodating conscience on the part of the manufacturer and a failure on the part of the medical profession to appreciate the danger which lies in the use of medicines of unknown composition unquestionably have greatly encouraged the marketing of falsely declared medicines4 ,a glaring illustration of the ignorance of manufacturers--for it is hard to believe that any business concern would deliberately court prosecution by the federal authorities through false statements on labels--is the fact that nearly thirty years ago ,a4 ,b4 ,lyons published a report#adg pointing out that the proprietary ,iodia was falsely declared as to composition and that in #aiad when the ,council examined this preparation such incorrect declaration appeared on the label4#adh ,that many physicians do not recognize the danger to their patients and their reputation in the use of medicines1 the composition of which they do not know1 is illustrated by the fact1 disclosed by inquiries sent to the laboratory1 that physicians were found willing to employ an arsenical preparation 7,venarsen71 advertised for intravenous use1 although its promoters vouchsafed no information in regard to the nature of the arsenic compound contained therein4 #adg ,lyons1 ,a4 ,b43 ,detroit ,lancet1 #ahhb1 #f1 #aeg4 #adh ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ba1 #aiad1 p4 #ahga4 ,,unreliability ,,of ,,little ,,used ,,drugs ,the purpose of the federal ,food and ,drugs ,act is to secure the prosecution and punishment of all who sell medicines which are adulterated or misrepresented as to composition4 ,as a matter of fact1 the wording of the law relating to the adulteration and misbranding of drugs is such that the federal authorities have been able to do little more than to require that the drugs for which standards are provided in the ,pharmacopeia shall when sold comply with those standards4 ,similarly1 those states which attempt to improve the quality of drugs sold within their borders--few states do efficient work along these lines--limit their work to the enforcement of the ,pharmacopeial standards4 ,this leaves the vast number of unofficial drugs and medicaments beyond the control of federal or state authorities4 ,while most of these drugs are relatively unimportant1 and while the amounts of them which are used are not great individually1 the total consumption of them is large4 ,with a view of furnishing to physicians standards for drugs of this sort the ,council has described in ,new and ,nonofficial ,remedies not only distinctly proprietary drugs1 but also some of the unofficial drugs which are apparently of therapeutic value and used to a considerable extent4 ,aiding the ,council in this line of endeavor1 the laboratory has attempted to establish standards for these little used drugs1 and ,new and ,nonofficial ,remedies1 #aiaf1 provides standards for such unofficial and non-proprietary drugs as quinin and urea hydrochlorid quinin1 tannate1 sodium acid phosphate1 and sodium perborate4 ,an example of work which furnished much needed standards for an unofficial article is the investigation of zinc permanganate by ,w4 ,s4 ,hilpert4#adi ,reference to the published reports of the laboratory will give an idea of the amount of work such standardization entails4 ,a reference to the new ,u4 ,s4 ,pharmacopeia1 when this comes from the press1 will show that a considerable number of unofficial articles described in ,new and ,nonofficial ,remedies have been admitted to the ,pharmacopeia along with the standards worked out in this laboratory4 #adi ,zinc permanganate1 ,j4 ,a4 ,m4 ,a41 ,feb4 #f1 #aiji1 p4 #dhh2 ,reports ,chem4 ,lab4 #b3ae1 #aiji4 ,while in a way the work done in connection with these less important drugs has attracted little attention from the medical profession1 it has had an effect on pharmaceutical manufacturers4 ,in the past1 pharmaceutical houses1 ever anxious to market something new1 on the slightest provocation have placed on the market1 in the form of pills1 powder1 elixir1 ampule1 etc41 every drug for which some sort of medical recommendation could be found4 ,in marketing these dosage forms1 the manufacturer has too often been little concerned about the quality of the drugs used4#aej ,just at present1 for instance1 some interest is being shown in iron cacodylate2 but while manufacturers appear to be most ready to take advantage of this interest by offering the drug in the form of ampules1 etc41 they have given little help toward the establishment of standards for this arsenic compound4 ,manufacturers are ever ready to sell drugs of all sorts1 but in view of the small demand they cannot or will not safeguard the identity and purity of such drugs4 ,a further illustration of the unreliability of unofficial drugs is the recent report by ,levy and ,rowntree#aea showing not only that the various dosage forms of emetin hydrochlorid obtained from different manufacturers varied from manufacturer to manufacturer1 but also that the product of the same manufacturer was variable and that the supply furnished by one pharmaceutical firm was so toxic as to make its use dangerous4 #aej ,the ,unreliability of ,unimportant ,medicaments1 ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bh1 #aiab1 p4 #aaef4 #aea ,levy1 ,r4 ,l41 and ,rowntree1 ,l4 ,g43 ,on the ,toxicity of ,various ,commercial ,preparations of ,emetin ,hydrochlorid1 ,arch4 ,int4 ,med41 ,march1 #aiaf1 p4 #dbj4 ,,the ,,analysis ,,of 8,,patent ,,medicines0 ,in the preface to the first annual report of the chemical laboratory it was stated that the laboratory 8occasionally takes up the examination of #8patent medicines' 4440 ,at that time it was felt that the widespread use by the medical profession of irrational and even secret medicines made it necessary to devote the laboratory's attention to the correction of this evil4 ,as the years have passed on1 these conditions have been remedied to some extent1 at least so far as chemical analysis can correct them4 ,on the other hand1 public opinion has been aroused to the many evils connected with the exploitation of 8patent medicines10 and has more and more insistently demanded that the medical profession aid in the correction of this evil4 ,accordingly1 the laboratory has paid much attention to the analysis of 8patent medicines0 during the last few years4 ,as the chief asset of 8patent medicines0 is the element of secrecy which surrounds their composition1 it is hoped that the laboratory's analysis of such widely used 8patent medicines0 as ,nature's ,creation1#aeb ,mayr's ,wonderful ,stomach ,remedy1#aec ,sanatogen1#aed ,eckman's ,alterative1#aee ,tonsiline1#aef and ,bromo-,quinin#aeg has been worth the labor4 ,in addition1 the work of this laboratory has been published1 including not only the results of its analyses1 but also the methods which are used4 ,in view of the dearth of published reports regarding the methods used in the analysis of 8patent medicines10 it is hoped that this feature of the laboratory's work has been of aid to chemists engaged in similar work4 #aeb ,the ,journal ,a4 ,m4 ,a41 ,march #e1 #aiaj1 p4 #hjf4 #aec ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ai1 #aiaa1 p4 #fga4 #aed ,the ,journal ,a4 ,m4 ,a41 ,april #bj1 #aiab1 p4 #abaf4 #aee ,the ,journal ,a4 ,m4 ,a41 ,april #bg1 #aiab1 p4 #abih4 #aef ,the ,journal ,a4 ,m4 ,a41 ,april #d1 #aiad1 p4 #aaji4 #aeg ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bg1 #aiae1 p4 #aicb4 ,the laboratory's activities along these lines have done much to discount the claim of proprietary manufacturers that chemical analysis is unable to determine the character of 8patent medicines40 ,the recent ,wine of ,cardui trial has brought it out prominently that chemical analysis can determine the presence of potent constituents1 and that 8patent medicines0 which fail to reveal such potent ingredients to the analyst may safely be put down as worthless4 ,the demonstration that the essential composition of medicinal preparations may be determined by chemical analysis should also prove an effective answer to the manufacturers in their protest against the requirement1 now being urged for enactment into law in various states1 that the medicinal ingredients of their wares must be declared on the label4 ,manufacturers have held that this would lay them open to competition with imitations and substitutions4 ,the possibility of chemical identification proves1 however1 that secrecy of composition1 though it prevents consumers from knowing the character of a 8patent medicine10 will not be a hindrance to the imitator and substitutor4 ,,identity ,,of ,,drugs ,,used ,,in ,,investigations ,in the past1 much of the experimental work in medicine has seriously suffered in that the identity of the material used in such investigations was not established4 ,in view of this the laboratory has watched the contributions submitted to ,the ,journal1 and whenever necessary and feasible has urged the authors to identify their material before publication of the findings4 ,for instance1 a number of staining agents--so-called 8anilin dyes0--have been found to possess therapeutic action4 ,since the identity of many of these staining agents is today essentially secret1 the laboratory has urged through ,the ,journal that those who experiment with these substances make an effort to determine their identity whenever possible and to give preference to those the chemical identity of which is known4 ,the need for such identification has been discussed in the reports of the laboratory4#aeh ,the amount of work involved in the chemical identification of drugs used for experimental work is illustrated in a contribution entitled 8,an ,examination of ,several ,commercial ,specimens of ,opium ,alkaloids or ,their ,salts40#aei by ,l4 ,e4 ,warren1 in which was determined the identity of the various opium products used in an investigation by ,d4 ,i4 ,macht1 carried out under a grant of the ,therapeutic ,research ,committee4 #aeh ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiab1 v1 #ajb4 #aei ,am4 ,jour4 ,pharm41 #aiae1 #hg1 #dci4 ,,the ,,laboratory ,,and ,,pharmaceutical ,,literature ,in the past much of the information in regard to the composition and properties of medicines which has appeared in pharmaceutical journals has not become available to medicine4 ,in many cases medical journals could not afford to publish such data because this would have been contrary to the interest of their advertisers1 and hence the publications regarding the irrational character of ,lactopeptine1 of ,bromidia1 etc41 which appeared in the pharmaceutical journals did not become a matter of common medical knowledge4 ,through the laboratory an attempt has been made to keep the medical profession informed in regard to pharmaceutical literature4 ,the laboratory has a good working pharmaceutical and chemical library1 and subscribes to the important ,american and foreign pharmaceutical and chemical publications4 ,the discussion of new remedies1 such as medinal and sodium veronal1#afj salvarsan1 atoxyl and arsacetin1#afa and neosalvarsan#afb soon after their introduction1 illustrates the work of the laboratory along these lines4 #afj ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bc1 #aiji1 p4 #caa4 #afa ,the ,journal ,a4 ,m4 ,a41 ,dec4 #ca1 #aiaj1 pp4 #bcjc and #bcad4 #afb ,the ,journal ,a4 ,m4 ,a41 ,oct4 #e1 #aiab1 p4 #abie4 ,,the ,,laboratory',s ,,efforts ,,toward ,,rational ,,prescribing ,the laboratory naturally is in thorough sympathy with the present day efforts toward a more rational use of drugs1 as exemplified in the ,council's publication 8,useful ,drugs40 ,two recent contributions of the laboratory may be cited as a further support of the movement for limiting prescribing to the more widely used drugs4 ,in line with the general tendency of manufacturers to put out all sorts of modifications and asserted improvements over official substances1 there have been placed on the market a number of preparations said to represent some improvement over the pharmacopeial ,blaud pills4 ,the report1 8,the ,quality of ,commercial ,blaud's ,pills10#afc by ,l4 ,e4 ,warren1 shows that the ordinary pharmacopeial ,blaud pill is in every way the equal of the semiproprietary preparations claimed to be improvements4 ,further1 the examination of the various brands of sodium and theobromin salicylate as compared with the preparation diuretin by ,p4 ,n4 ,leech#afd shows that the former preparations1 sold at #ce cents per ounce at the time the examination was made1 are fully the equal of the proprietary ,diuretin1 which then cost the druggist #a4ge per ounce4 #afc ,the ,journal ,a4 ,m4 ,a41 ,april #ag1 #aiae1 p4 #acdd4 #afd ,the ,journal ,a4 ,m4 ,a41 ,april #d1 #aiad1 p4 #aajh4 ,,the ,,laboratory ,,as ,,an ,,information ,,bureau ,it is generally admitted that the proprietary medicine business1 particularly the exploitation of complex mixtures1 attained the extensive vogue which it has or had because instruction in medical schools was deficient in materia medica1 pharmacy and chemistry4 ,as a result of lack of knowledge along these lines1 the young graduate after some trial became fearful of formulating his own prescriptions1 and in time became dependent on pharmaceutical firms which provided him with medicines ready to dispense4 ,that physicians have been insufficiently trained in regard to the pharmacy and chemistry of drugs has often been emphasized in pharmaceutical journals where prescriptions containing incompatible drugs are reported and where even plans are brought forward whereby the pharmaceutical profession may aid in remedying this difficulty4 ,during my pharmaceutical experience ,i was often sorely vexed as to what to do when prescriptions contained drugs which on mixing would undergo decomposition which the physician surely did not anticipate4 ,i remember well a prescription directing that potassium permanganate be made into pills with extract of gentian and other things1 and how1 the physician having spurned the suggestion to modify the prescription so as to avoid decomposition of the permanganate1 ,i was obliged to select a mortar1 gently triturate the drugs until a conflagration was started1 and to finish the prescription after the combustion had subsided4 ,however1 in my pharmaceutical experience ,i generally found the physician most ready to receive suggestions from the pharmacist which would prevent incompatibilities1 improve the palatability and appearance of his prescriptions1 and protect the patient from unnecessary expense4 ,similarly it has been my experience since the establishment of the ,association's laboratory that physicians are anxious to receive information in regard to the materia medica1 pharmacy and chemistry of drugs4 ,as the druggist earns the respect and support of the physician when he makes available to him the pharmaceutical knowledge and experience which he has1 so this laboratory has aimed to gain the endorsement of the ,american ,medical ,association membership by furnishing to physicians information in regard to the composition1 chemistry and pharmacy of drugs through replies in the ,query and ,minor ,notes ,department of ,the ,journal as well as through direct correspondence4 ,it has been most gratifying to the laboratory that ,the ,journal receives an increasing number of inquiries both as regards the chemical and pharmaceutical questions involved in the writing of prescriptions and as regards the composition of secret and semisecret proprietaries 7often because they are prescribed by the inquirer's colleague7 and 8patent medicines0 7which are taken by his patient74 ,the laboratory has tried its best to answer the many inquiries received4 ,many of the questions which come in can be answered by a pharmacist or chemist without hesitation4 ,others1 particularly as to the composition of medicines1 the laboratory has been able to answer by reference to its library and its extensive card index4 ,still others have required experimentation and chemical analysis4 ,while1 as stated a moment ago1 the laboratory has encouraged the sending of inquiries and has earnestly striven to furnish the information asked for1 it is obvious that the amount of chemical work which can be done is limited4 ,the small size of the laboratory force1 consisting of three chemists engaged in actual analytical work1 makes it necessary to select for investigation those problems which shall be of general interest to the medical profession4 ,as the ,american ,medical ,association is national in its scope1 the laboratory has held that it can do analytical work only when such work will be of general interest to physicians and of value both to the medical profession and the public4 ,in view of this it has refrained from undertaking analyses which would benefit only the physician making the inquiry and possibly his patient4 ,the laboratory further has not felt justified in undertaking work of merely local interest2 instead it has used its endeavors to secure the investigation of such local problems by municipal or state authorities4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #be1 #aiaf47 ,,lead ,,in 8,,akoz0 ,akoz is a mineral product sold by the ,natura ,company of ,san ,francisco1 and said to possess most remarkable medicinal properties4 ,a circular issued by the ,natura ,company begins thus3 8,while scientists have been striving through the centuries to compound remedies for man's various ills1 ,nature1 greatest chemist of them all1 has been working wonders in her crucibles and has achieved results far beyond man's greatest expectation40 8,nature's chief handicap has been the difficulty of placing her gifts in the hands of those whom she would benefit4 ,by accident or fate1 as you will1 one of ,nature's greatest medicinal products has just been discovered4 ,it is the mineral given the name of ,akoz by ,john ,d4 ,mackenzie1 president and manager of the ,natura ,company of ,san ,francisco1 which is now giving this rare remedy of ,nature to the public40 ,the circular then describes how the power of the 8rare remedy0 to cure rheumatism is claimed to have been discovered and asserts that3 8,akoz was subjected to every known scientific test before being presented to the public4 ,it was practically determined that the ore contained a new element having radium-like qualities but containing nothing poisonous or harmful40 8,after the curative virtues of ,akoz for rheumatism1 stomach trouble1 eczema1 catarrh1 piles1 ulcers and numerous other ailments had been fully established in chemical laboratory1 hospital clinic1 and the private practice of physicians in various parts of the world1 ,mr4 ,mackenzie effected the organization of the ,natura ,company40 ,this product1 put up in the form of 8,akoz ,medicinal ,mineral ,water1 ,akoz ,ointment1 ,akoz ,powder and ,akoz ,suppositories10 was submitted to the ,council on ,pharmacy and ,chemistry for consideration some years ago with the claims that 8,akoz0 itself consists essentially of zinc sulphid1 barium sulphate and aluminum oxid4 ,the submitted analysis did not declare the presence of lead or of uranium though 8special tests0 for the latter had been 8run40 ,without checking the claimed composition1 the ,council at that time refused recognition to ,akoz because there was no evidence submitted for the very extravagant and altogether improbable therapeutic claims4 ,after the ,council had concluded the consideration of ,akoz a letter was received from a ,california physician stating that according to an analysis submitted to him ,akoz contained #j4cd per cent4 of lead in the form of lead sulphate4 ,the correspondent held that1 while the lead sulphate did not pass into solution1 persons drinking the supernatant liquid from ,akoz 7the 8medicinal mineral water0 is made by adding ,akoz to ordinary water7 might inadvertently swallow some of the powder4 ,he was inclined to believe that this might account for a case of lead poisoning which had been observed in a patient who had been taking ,akoz4 ,inasmuch as it has been demonstrated by ,carlson and ,woelfel 7,carlson1 ,a4 ,j41 and ,woelfel1 ,a43 ,solubility of ,lead ,sulphate and ,basic ,lead ,carbonate in ,human ,gastric ,juice4444 ,in ,hygiene of the ,painter's ,trade by ,alice ,hamilton1 ,bull4 of ,u4 ,s4 ,bureau of ,labor ,statistics ,no4 #abj1 ,may #ac1 #aiac1 pp4 #bb-cb7 that even small quantities of lead sulphate when taken into the system for a long time1 have produced lead poisoning1 the laboratory deemed it important that the products be examined for lead4 ,a specimen of 8,akoz ,powder0 submitted to the ,council by the ,natura ,company and contained in a sifter-top can was taken for analysis4 ,the contents of the can were thoroughly mixed4 ,to determine the presence of lead some of the powder was extracted with ammonium acetate solution4 ,details of ,analysis ,qualitative tests showed the presence of lead and sulphate in the ammonium acetate solution4 ,the presence of lead was demonstrated by the black precipitate with hydrogen sulphid1 the yellow precipitate with potassium chromate and the typical yellowish crystalline precipitate with potassium iodin4 ,the presence of sulphates in the ammonium acetate solution was shown by the formation of a precipitate with barium chlorid solution and acetic acid4 ,two #b gm4 samples 7,a and ,b7 were taken for the quantitative determination of lead4 ,each was treated repeatedly with a saturated solution of ammonium acetate until the filtered ammonium acetate solution gave no appreciable precipitate with potassium chromate solution4 ,the ammonium acetate extractions from each specimen were combined and treated with hydrogen sulphid1 the precipitated lead sulphid filtered off and washed1 and ignited with sulphuric acid at a low heat4 ,the crucible with the residue of lead sulphate was cooled and weighed4 ,a yielded #j4jdfi gm41 or #b4cd per cent41 lead sulphate4 ,b yielded #j4jddj gm41 or #b4bj per cent41 lead sulphate4 ,while the laboratory has no evidence to show that the amount of lead-sulphate thus found to be present is likely to prove harmful1 the following cautionary letter was sent to the ,natura ,company3 8,according to information which you sent to the ,council on ,pharmacy and ,chemistry your product 8,akoz0 does not contain lead4 ,in view of reports received ascribing symptoms1 resulting from the internal use of ,akoz1 to chronic lead poisoning1 an examination of a specimen of ,akoz ,powder1 which you sent to the ,council1 was made4 ,this examination indicates the presence in ,akoz ,powder of about #b4b per cent4 lead sulphate4 ,in view of the disastrous results likely to follow the internal use of products containing even small amounts of lead1 the above is submitted to you for your consideration40 ,no reply to the foregoing was received from the ,natura ,company4--7,from ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiaf1 p4 #ajc47 ,,sodium ,,acetate ,,in ,,warming ,,bottles ,recently the laboratory's attention was called to the 8,thermo,r ,waterless ,hot ,bottle10 manufactured by the ,royal ,thermophor ,sales ,co41 ,new ,york4 ,the following claims appear in one of the advertising pamphlets3 8,there is moist heat40 8,rubber hot-water 78 8 87 naturally give a moist heat40 ,it 7,thermo,r7 gives a dry heat4 8,the #8,,thermor' ,bottle is not a hot-water bottle--it acts on a principle that is entirely different and new40 8444 gives you first1 last and all the time a fixed degree of dry usable heat--a heat that holds steadily at #abe degrees for fully twelve hours--you will easily see why it is that #8,,thermor' relieves and cures where hot-water bottles fail40 ,the bottle was nickel plated1 #h-c_/h inches in diameter and #a-a_/b inches thick1 and in appearance resembled an exaggerated closed ,ingersoll watch4 ,the bottle is not flexible and weighs #c-a_/b pounds4 ,the contents consisted essentially of sodium acetate4 ,this salt melts when heated4 ,when it cools the temperature inside the bottle is relatively constant1 as it will remain at the 8freezing point0 until all of the sodium acetate has solidified4 ,the duration of the time that it remains warm when well wrapped is simply in inverse proportion to the conductivity of the surrounding environment4 ,when two ordinary towels were carefully arranged about it1 the air between the bottle and the wrappings was maintained at a temperature of #dj-ej ,c4 7#ajd-abb ,f47 for a period of eight hours4 ,the company's implication that the heat given out by the ,thermor bottle differs from that given out by an ordinary hot-water bottle is an absurdity4 ,the use of sodium acetate in the preparation of warming bottles has been in practice many years1 and is not 8a principle that is entirely different and new40 ,furthermore1 the therapeutic claims are extravagant4--7,from ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiaf1 p4 #aje47 ,,anti-,,syphilitic ,,compound 7,,sweeny7 ,a specimen of ,anti-,syphilitic ,compound 7,sweeny71 sold by ,the ,national ,laboratories of ,pittsburgh1 was received from a physician4 ,the package 7#a ounce size7 has been opened by the sender and about three fourths of the contents removed4 ,from the rather indefinite statements in the literature of the manufacturer it is gathered that the preparation is claimed to be a 8sterile1 oily emulsion0 which contains #a_/bj grain of mercuric benzoate in each #e minims1 together with some sodium chlorid4 ,according to information furnished by the ,laboratory's correspondent1 the price asked for the preparation is #ae an ounce4 ,the quantity of the preparation received was too small to permit a complete examination1 but1 from the tests which it was possible to make1 the preparation appears to be an aqueous solution containing some suspended matter and small quantities of mercuric benzoate and a chlorid1 presumably sodium chlorid4 ,there was no evidence of the presence of an 8oily emulsion40 ,quantitative tests indicated the presence of a mercuric salt1 equivalent to about #j4bghc gm4 of crystallized mercuric benzoate per #ajj c4c4 ,this corresponds to about #j4jjjhf gm4 in each #e minims1 or about #bf4e per cent4 of the amount claimed4--7,from ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiaf1 p4 #ajf47 8,,ambrine0 ,,and ,,paraffin ,,films,f ,paul ,nicholas ,leech1 ,ph4,d4 ,f ,contribution from the ,chemical ,laboratory of the ,american ,medical ,association4 ,in the last year or so1 the hot-wax or paraffin treatment of burns has been widely discussed both in medical and lay periodicals4 ,although the treatment is simply a modification of the well-known use of oil and ointments1 it has received unusual attention1 owing to the widespread sensationalism following the exploitation in ,france of a secret and therefore mysterious mixture1 8,ambrine10 the formula of ,dr4 ,barthe de ,sandfort4 ,owing to this publicity1 it seemed desirable to investigate the chemical composition1 and to compare its physical properties with other waxlike substances4 8,ambrine0 is promoted as a dressing for burns1 frostbites1 neuritis1 varicose ulcers1 phlebitis1 neuralgia1 rheumatism1 sciatica1 gout1 etc4 ,it is a smoky-appearing substance1 resembling paraffin in consistency and without odor4 ,for application1 8,ambrine0 is melted and applied to the wound either with a brush or with a specially devised atomizer4 ,it cools quickly1 and leaves a solid1 protecting film4 ,illustration3 - - - - - - - - - - - - - - - - - ,,hyperthermality ,a ,,reality4 ,hyperthermality is a fact1 however1 through the agency of a keri-resinous product which has been used in ,france since #aijj under the name of ,l',ambrine4 ,hyperthermine1 as the remedial agent will be known in this country1 is a combination of several kinds of waxes and resins1 scientific- ally blended and containing no medicinal elements whatever4 ,it comes in the form of waxy flakes4 ,it melts at #abd and on cooling resembles a dark colored wax4 ,hyperthermine is the discovery of ,dr4 ,barthe de ,sandfort1 an eminent retired ,french naval surgeon and a member of numerous foreign medical societies4 ,he - - - - - - - - - - - - - - - - - 8,ambrine0 has been exploited in the ,united ,states for some time4 ,to physicians it was sold under the name 8,hyperthermine40 ,above is a photographic reproduction 7reduced7 of a portion of a booklet describing 8,hyperthermine10 which has been in ,the ,journal office for some years4 ,illustration3 - - - - - - - - - - - - - - - - - ,,hyperthermine',s ,,field4 ,hyperthermine can be used in practically all in- flammatory conditions4 ,during the past ten years1 under the name of ,l',ambrine1 our product has been widely used in the hospitals in ,france1 as well as in private practice1 and we have very many clinical reports on a variety of subjects4 ,its greatest use has been in such conditions as sciatica1 lumbago1 articular and muscular rheumatism1 gout1 arthritis1 burns of all degrees1 pneumonia1 bronchitis1 orchit- is1 buboes1 soft chancres1 peritonitis1 dysmenor- rhea1 adenitis1 mastitis1 periostitis1 synovitis1 conjunctivitis1 iritis1 irido-choroiditis1 abscess- es1 bruises1 furuncles1 whitlow1 paronychia1 car- buncles1 moist eczema and similar dermatological affections1 and varicose and tubercular ulcers4 - - - - - - - - - - - - - - - - - ,photographic reproduction 7reduced7 from the 8,hyperthermine0 78,ambrine07 booklet recommending it for use in rheumatism1 gout1 pneumonia1 buboes1 dysmenorrhea1 eczema1 tuberculous ulcers1 etc4 ,it is said that de ,sandfort 8stumbled on this treatment by accident40#afe ,being a sufferer from rheumatism1 he had been benefited by hot mud baths2 on returning home he sought a substitute1 and finally made a mixture of paraffin1 oil of amber and amber resin4 ,this was applied hot1 serving as a firm poultice4 8,years later1 he went on service to a railway in ,china and was in ,yunnan at the time of the incendiary insurrection1 and many badly burned ,chinese were brought in for treatment4 ,remembering that ,ambroise ,par treated such cases with hot oil1 he tried the effect of covering the burn with his melted ambrine1 which at once glazes over1 forming a coat impervious to the air1 and his patients ceased to suffer40#aff #afe ,the ,outlook1 ,jan4 #ag1 #aiag1 p4 #ajj4 #aff ,med4 ,rec41 ,new ,york1 ,jan4 #bg1 #aiag1 p4 #afj4 8,ambrine0 has been sold in ,america under two names3 8,hyperthermine10 as exploited to physicians1 and 8,thermozine10 as advertised to the public4 ,physical comparison alone shows that ,ambrine as now sold differs from 8,hyperthermine0 of a few years ago2 the probable reason is that 8,ambrine0 has changed its formula4 ,this is borne out by ,matas1#afg who states that de ,sandfort 8admitted that ,ambrine was a compound of paraffin1 oil of sesame and resins1 but was not at liberty to divulge its exact composition1 as the formula and manufacture of this substance was now the property of a private corporation1 which was exploiting it as a proprietary and secret remedy40 ,the later formula differs from the original4 #afg ,matas1 ,rudolph3 ,burns ,treated with ,paraffin ,mixtures1 ,new ,orleans ,med4 and ,surg4 ,jour41 ,april1 #aiag1 p4 #fha4 ,besides the foregoing paraffin preparations1 two others have recently been placed on the ,american market1 8,parresine0 7nonsecret7 and 8,mulene0 7secret74 ,,analysis ,,of ,,ambrine 8,ambrine0 comes in rectangular cakes1 about #a-a_/b inches wide1 #f inches long and #a_/b inch thick4 ,it is moderately soft1 but somewhat brittle at ordinary room temperature4 ,a black substance is present1 which evidently settles out during the compounding1 as in one side of the cake these particles can be clearly discerned by holding it up to the light2 in the other side there are no suspended particles4 ,when melted1 the solution is not clear1 and a sediment forms4 ,the melting point 7,u4 ,s4 ,p4 method2 see later7 is #dh4d ,c4 ,the plasticity and ductility#afh are #bg and #cj4e1 respectively4 ,it is pliable and strong at body temperature4 ,the saponification number and acid number are both very low1 but a fatty oil is present4 ,tests indicated oil of sesame4 ,ninety-eight per cent4 of 8,ambrine0 is soluble in ether2 this soluble portion may be treated with low-boiling ligroin 7petroleum ether71 out of which1 on standing1 a black asphalt-like substance separates4 ,of the ether-insoluble substance1 #fe per cent4 is soluble in chloroform4 ,the remaining insoluble substance contains a small amount of silica and vegetable fiber4 ,the paraffin obtained from 8,ambrine0 melted at #dh4f ,c4 ,as a result of various experiments1 it appears that the composition of 8,ambrine0 is essentially as follows3 ,paraffin 7,m4 ,p4 #dh4f ,c47 #ig4j per cent4 ,fatty oil 7sesame87 #a4e per cent4 ,asphalt-like body #j4e per cent4 ,coloring matter1 and undetermined #a4j per cent4 ----- #ajj4j #afh ,these determinations will be described later4 ,,other ,,proprietary ,,films ,a cursory examination of 8,mulene10 manufactured by the ,mulene ,company1 ,pittsburgh1 was also made4 ,this appears to contain paraffin1 beeswax1 a fat-soluble red dye and considerable rosin4 ,when heated carefully in a beaker1 the rosin 8sticks0 to the bottom1 and does not go into solution readily4#afi #afi ,when the sample was first obtained1 this feature was not observed4 8,paresine10#agj according to the manufactures1 is a mixture composed of paraffin1 #id to #if per cent42 gum elemi1 #j4bj to #j4be per cent42 ,japan wax1 #j4dj to #j4ej per cent42 asphalt1 #j4bj to #j4be per cent41 and eucalyptol1 #b per cent41 the whole being colored with alkannin and gentian violet4#aga #agj ,made by the ,abbott ,laboratories1 ,chicago1 and accepted by the ,council on ,pharmacy and ,chemistry for ,new and ,nonofficial ,remedies1 ,the ,journal1 ,may #ab1 #aiag1 p4 #adjf4 #aga ,no chemical examination was made4 ,,formula ,,for ,,paraffin ,,film ,in a recent article1 ,sollmann#agb presented various suggestions for the compounding of paraffin films4 ,some of the formulas were promising and others were not1 but all were simple4 ,he did not try to imitate 8,ambrine40 ,lieut4-,col4 ,a4 ,j4 ,hull#agc of the ,royal ,army ,medical ,corps1 after experimenting with different combinations1 concluded that a mixture of 8#a part resorcin1 #b parts eucalyptus oil1 #e parts olive oil1 #be parts soft paraffin petrolatum#agd and #fg parts hard paraffin0 served the purpose as well as 8,ambrine40 ,the following formula1 which might be called ,asphalt-,paraffin ,no4 #ba1 much more closely resembles 8,ambrine10 and it seems to have certain advantages1 due to the use of a more suitable grade of paraffin3 ,paraffin#age 7,m4 ,p4 by ,u4 ,s4 ,p4 method #dg4b ,c47 #ig4e gm4 ,asphalt from #c to #e drops ,olive oil #a4e c4c4 #agb ,sollmann1 ,torald3 ,suggested ,formulas for ,paraffin ,films1 ,the ,journal ,a4 ,m4 ,a41 ,april #g1 #aiag1 p4 #ajcg4 #agc ,hull1 ,a4 ,j43 ,the ,treatment of ,burns by ,paraffin1 ,brit ,med4 ,jour41 ,jan4 #ac1 #aiag1 p4 #cg2 ,the ,treatment of ,burns by ,paraffin1 ,therapeutics1 ,the ,journal ,a4 ,m4 ,a41 ,feb4 #c1 #aiag1 p4 #cgc4 #agd ,the 8soft paraffin0 of the ,british ,pharmacopeia resembles petrolatum1 ,u4 ,s4 ,p41 ,queries and ,minor ,notes1 ,the ,journal ,a4 ,m4 ,a41 ,april #bh1 #aiag1 p4 #abha4 #age ,the paraffin used in this formula was supplied by the ,standard ,oil ,company of ,indiana2 the melting point given by the manufacturers is from #abj to #abb ,f41 which1 according to the ,american ,standard of taking melting points1 gives higher results than the method described in the pharmacopeia4 ,illustration3 - - - - - - - - - - - - - - - - - inception4 ,where the ,dry ,wax ,poultice has been used ,thermozine known in ,france as l',ambrine1 has been used in the following ,parisian hospitals1 with #ib of cures3 ,hospital de la ,pitie1 services of ,drs4 ,lion1 ,darier - - - - - - - - - - - - - - - - - ,photographic reproduction from a booklet on 8,thermozine0 showing that it is identical with 8,ambrine40 ,about #aj c4c4 of 8asphalt varnish0 7,b4 ,asphaltum7#agf is placed in a beaker and heated on the steam bath for one-half hour4 ,from #c to #e drops1 delivered from a #a c4c4 pipet1 are then placed in a casserole1 and #a4e c4c4 of olive oil added4 ,the mixture is heated and stirred for a few minutes until perfect solution is effected4 ,to this is then added1 with stirring1 the paraffin1 which has been previously melted4 ,when it is cooled1 a brown solid is obtained4#agg ,the physical factors of this paraffin mixture are1 melting point #de4d ,c4 7,u4 ,s4 ,p4 method72 plasticity1 #bh4e2 ductility1 #bi2 it is very pliable and strong at #ch ,c41 and adheres exceedingly well to the skin1 although it detaches easily4 ,this mixture1 which is easy to prepare1 is inexpensive1 the cost of the materials being approximately #aj cents a pound4 #agf ,the 8,asphalt ,varnish0 used was obtained from ,remien ,kuhnert ,company1 ,chicago4 #agg ,while needless1 a color resembling 8,ambrine0 may be obtained by the addition of coloring agents4 ,both ,hull and ,sollmann noticed that tarlike substances and melted paraffin do not mix well4 ,this is noticeable in 8,ambrine10 which cannot be called an 8elegant0 preparation4 ,the difficulty may be overcome by first mixing hot olive oil and asphalt2 the asphalt will then go into solution4 ,it is interesting to note that the suggested formula 7as well as others which were also prepared7 is not as plastic as the paraffin itself4#agh ,this is also true of 8,ambrine40 ,on the other hand1 the melting point of the paraffin is higher4 ,the important point1 however1 in compounding all paraffin preparations1 is to select a proper grade of paraffin as elaborated below4 #agh ,in a personal communication ,dr4 ,sollmann expressed the opinion that the synthetic preparation is inferior to the paraffin used in the formula1 basing the view on the greater plasticity of the paraffin4 ,for practical purposes1 the paraffin will most probably serve as well as the mixture1 especially when it is held in place by bandages1 but ,i believe that the mixture is more adhesive4 ,,examination ,,of ,,paraffins ,,and ,,paraffin ,,preparations ,illustration3 ,photographic reproduction 7greatly reduced7 of a full page magazine advertisement of 8,thermozine10 the name under which 8,ambrine0 was sold to the public4 ,the name 8paraffin0 generally applies to a colorless and tasteless waxlike substance that is solid at ordinary temperature4 ,it is composed of saturated hydrocarbons1 that is1 they are unable to take up any more hydrogen1 and thereby are quite stable2 the hydrocarbons in paraffin have the general formula of ,cn,h#bn#b1 ranging as high as ,c,h to ,c,h4 ,paraffin may be found in crude form in coal1 from which source the first paraffin candles were made4 ,it may be produced from the distillation of brown coal1 as in ,germany1 or from bituminous shale4 ,in ,america1 it is obtained chiefly from the distillation of crude petroleum1 being in the residue after the distillation of such products as naphtha 7gasoline71 kerosene and the lubricating oils4 ,the residue is treated by one of a number of processes causing the unpurified solid paraffin to be made available4 ,the crude paraffin is either sold as such1 or is refined4 ,paraffin or 8paraffin waxes0#agi are designated in the trade by their melting points 7which in the 8,american standard0 is expressed in ,fahrenheit degrees71 and as to their state of refinement as 8crude10 8semirefined0 and 8fully refined0 paraffin4 ,there are certain chemical and physical differences so that two refined waxes having the same melting point would not have the same plasticity4 ,the higher melting point varieties of paraffin are hard and tough at room temperature3 when melted1 paraffin expands and forms a thin mobile liquid4 #agi ,paraffin is sometimes spoken of as 8white wax40 ,this is unfortunate1 as 8white wax0 is an official name for 8,white ,beeswax1 ,u4 ,s4 ,p40 ,the term 8white wax0 is also often applied to 8,chinese wax10 which is formed from an insect living on the tree ,ligustrum lucidum4 ,illustration3 ,photographic reproduction from a booklet on 8,thermozine0 giving the conditions in which the stuff was alleged to be 8very useful40 ,the significant requirements of paraffin for surgical dressings are that it should be solid at body temperature1 at the same time having flexibility and adhesiveness1 together with a certain amount of strength4 ,a number of brands of paraffin are sold in the ,united ,states1 so that it seemed advisable to examine some of them and compare them with certain paraffin-film preparations4 ,they were tested as to their melting points1 plasticity1 ductility1 strength of film1 etc4 ,melting ,point ,determination4--,the melting point was determined by the method of the ,u4 ,s4 ,pharmacopeia ,,ix1 p4 #eif4 ,the melting point as obtained by this method is lower than the melting point used by manufacturers of paraffin 7after conversion to ,fahrenheit74 ,pliability and ,ductility1 ,limit ,temperature4#ahj--;,a little of the melted wax was poured from a teaspoon on the surface of the water at about #dj ,c41 in a tin pan 7bread mold74 ,this formed a fairly thin film4 ,the temperature of the water was then lowered by the addition of cold water4 ,at each temperature the pliability and ductility were tested thus3 #ahj ,i am indebted to ,dr4 ,torald ,sollmann for these methods4 ,pliability ,test4--,the film1 immersed in water1 was doubled on itself1 note being taken whether or not it broke4 ,ductility ,test4--,the film was pulled under water1 note being taken whether it stretched on being pulled and broke with a ragged fracture2 or whether it broke sharp without stretching4 ,it is desirable that the pliability and ductility be preserved at as low a temperature as possible4 ,cotton ,films1 ,adhesives and ,detachability4#ahj--,the melted wax was applied as it would be for burns2 namely1 a thin layer was painted on the inner surface of the forearm with a camel's hair brush1#aha a transverse strip about an inch wide being made4 ,this was covered with a very thin layer of absorbent cotton1 and over this another layer of melted wax was painted4 ,as soon as this had cooled a little1 it was covered by a few layers of bandage and left on for at least an hour4 ,at the end of that time1 the bandage was removed4 ,the cotton film should be found at the place at which it was applied1 showing that it is sufficiently adherent4 ,it should detach without 8pulling0 the skin4 #aha ,when painting a surface with a paraffin film1 ,i found that the temperature of the paraffin should not be too close to the melting point1 but several degrees above2 otherwise it does not 8set0 well4 ,illustration3 ,photographic reproduction 7greatly reduced7 of the carton in which 8,ambrine0 is now sold4 ,the results of these tests are given in the accompanying table4 ,it can be seen that nearly all the paraffins examined have properties which would make them useful1 the notable exceptions being ,nos4 #h1 #ae and #af4 ,the more satisfactory products would be those having a melting point about #dg ,c41 ductility of #cj or below1 and plasticity of #bh or below4 ,the paraffin described in the ,u4 ,s4 ,pharmacopeia is not so satisfactory1 the required melting point being between #ej and #eg ,c4 ,the use of paraffin bandages has been suggested by ,fisher#ahb and ,sollmann4#ahc ,in such cases1 it may very likely be that a paraffin of higher melting point would be more satisfactory1 owing to its greater resistance and tougher fiber4 #ahb ,fisher1 ,h4 ,e43 ,nonadhering ,surgical ,gauze1 ,the ,journal ,a4 ,m4 ,a41 ,march #be1 #aiaf1 p4 #ici4 #ahc ,sollmann1 ,torald3 ,paraffin-,covered ,bandages1 ,the ,journal ,a4 ,m4 ,a41 ,april #ba1 #aiag1 p4 #aagh4 ,,summary #a4 8,ambrine0 is essentially paraffin in which a small amount of fatty and asphalt-like body is incorporated2 like most secret mixtures1 its composition varies4 #b4 ,a simple formula for a paraffin film1 similar in chemical composition but superior in physical properties to 8,ambrine10 is that described as ,formula #ba4 ,the superiority is due to using a grade of paraffin that is better adapted to the purpose4 ,the cost of materials is about #aj cents a pound4 #c4 ,the properties of the paraffin used for a surgical dressing are important4 ,a number of different grades have been examined1 in order to determine the ones that appear most promising4 ,paraffins ,nos4 #c1 #d1 #aj1 #aa and #be are the best in the table1 and surpass 8,ambrine0 itself4 #d4 ,it is exceedingly probable that further experience will show that for most purposes simple paraffin will serve just as well as the mixtures--if1 indeed1 not better4 ,addenda 7,reprinted from the ,annual ,report of the ,chemical ,laboratory of ,the ,american ,medical ,association1 ,vol4 #aj 7#aiag71 p4 #cb7 ,since the foregoing was published1 two other products--8,cerelene0 and 8,stanolind ,surgical ,wax0--were submitted to the ,council on ,pharmacy and ,chemistry for investigation as to their acceptability for inclusion in ,new and ,nonofficial ,remedies4 ,in this connection the ,laboratory was requested to examine them4 8,cerelene0 is manufactured by the ,holliday ,laboratories1 ,pittsburgh4 ,according to the manufacturers1 8,cerelene0 is a compound composed of #hd per cent4 paraffin1 #ae per cent4 myricyl palmitate and #a per cent4 elemi gum4 ,as ordinarily marketed1 8,cerelene0 contains the following materials3 ,to the beeswax is added ,oil of ,eucalyptus1 ,u4 ,s4 ,p41 #b per cent41 and ,betanaphthol1 ,u4 ,s4 ,p41 #j4be per cent4 ,the manufacturer further states that the myricyl palmitate is a purified form of beeswax1 free from all impurities1 acids1 etc41 which is solely manufactured by this company and for which patents are pending4 ,the properties described for 8,cerelene0 were as follows3 ,when cold1 ,cerelene is a solid wax-like cake of a fine yellow brown color4 ,on exposure to air for long periods1 the amber color darkens to some extent4 ,it is entirely free from solids1 odorless and tasteless2 does not separate or change when melted repeatedly1 and cannot in the melted state be separated by fractional crystallization4 ,it is entirely neutral to indicators being perfectly free from both acids and bases4 ,tests3 ,melting ,point1 ,u4 ,s4 ,p4 method1 #abf ,f4 ,density1 ,u4 ,s4 ,p4 method1 #j4ijg4 ,iodin value1 #j4e4 ,saponification number1 #j4i4 8,stanolind ,surgical ,wax0 is manufactured by the ,standard ,oil ,company of ,indiana4 ,in the submission of the product to the ,council on ,pharmacy and ,chemistry1 it was stated that the product was a specially prepared paraffin 8free from dirt or other deleterious matter4444 ,it has been steamed and resteamed to drive out any free oil and repeatedly filtered40 ,the examination of the foregoing products yielded the figures described in ,table 8,b40--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ai1 #aiag47 ,,the ,,stability ,,of ,,iodine ,,ointments ,l4 ,e4 ,warren1 ,ph4,c41 ,b4,s4 ,in general1 the literature on the keeping qualities of iodine ointment1 and on the stability of iodine if mixed with ointment bases1 is confusing4 ,the recorded evidence is often contradictory4 ,the attention of the writer was brought to this condition by studies of several proprietary preparations1 ,iodex1#ahd ,iod-,izd-,oil1#ahe ,iocamfen1 and ,iocamfen ,ointment4#ahf #ahd ,rep4 ,chem4 ,lab41 ,a4 ,m4 ,a41 #aiae1 #h1 #hi4 #ahe ,rep4 ,chem4 ,lab41 ,a4 ,m4 ,a41 #aiae1 #h1 #ajf4 #ahf ,rep4 ,chem4 ,lab41 ,a4 ,m4 ,a41 #aiaf1 #i1 #aah4 ,iodex was sold under the claim that it is 8444 an embodiment of vaporized iodine1 in an organic base1 reduced and standardized at #e per cent4 by incorporation with a refined petroleum product40 ,the exact composition of ,iodex is a trade secret4 ,analysis showed that it contains petrolatum-like substances and combined iodine1 the latter probably in combination with oleic acid4 ,tests for free iodine were made in five specimens of ,iodex4 ,in one of these no free iodine was present2 in the others the merest traces were found4 ,two years ago a preparation called 8,iod-,izd-,oil0 was examined4 ,this was claimed to contain #b per cent4 of free iodine in liquid petrolatum4 ,at the time of the examination the age of the preparation was not known1 but it had been obtained just prior to the analysis1 and was thought not to be very old4 ,the analysis showed that it contained but about #j4dc per cent4 of iodine1 all of which was in a free state4 ,the fact that all of the iodine present was in the free state appeared to indicate that iodine is relatively stable in liquid petrolatum solutions4 ,iocamfen is a liquid composed of iodine1 camphor and phenol4 ,it was claimed to contain #aj per cent4 of free iodine4 ,analysis showed that it contained #i4c per cent4 of total iodine 7of which #g4e per cent4 was present in an uncombined state71 #ff4a per cent4 of camphor and #ai4g per cent4 of phenol4 ,after storing for several months a second assay of ,iocamfen showed no appreciable loss in iodine content4 ,this would indicate that iodine is relatively stable in presence of phenol and camphor1 although immediately after mixing there is some loss of free iodine4 ,the ,iocamfen ,ointment was supposed to contain #ej per cent4 of ,iocamfen 7equivalent to #e per cent4 of free iodine7 in a lard-wax-cacaobutter base4 ,the analysis showed that the ointment contained but #j4d per cent4 of free iodine1 the balance being in combination4 ,from the results of the examination1 and from correspondence with the manufacturers 7,schering and ,glatz71 it became evident that the only plausible explanation for the loss of free iodine in the preparation of ,iocamfen ,ointment from ,iocamfen lay in the combination of the free iodine with the ingredients of the ointment base4 ,it seems likely that the free iodine originally present in ,iocamfen for the most part had gradually gone into combination with the fatty substances after the ointment had been prepared4 ,the literature was then examined to determine the consensus of opinion concerning the stability of iodine in iodine ointment4 ,in the older literature the belief that iodine ointment is unstable appears to be quite general4 ,such statements as the following are typical3 ,the ointment should be prepared only when wanted for use1 for it undergoes change if kept1 losing its deep1 orange-brown color1 and becoming pale upon its surface4#ahg #ahg ,u4 ,s4 ,disp41 ed4 #ai1 p4 #acae4 ,it is better to prepare it only as it is required for use4#ahh #ahh ,am4 ,disp41 ed4 #b1 p4 #bjbb4 ,this ointment must not be dispensed unless it has recently been prepared4#ahi #ahi ,u4 ,s4 ,pharmacopeia1 ,,ix1 p4 #dha4 ,in #aiji ,lythgoe1#aij of the ,massachusetts ,board of ,health laboratory1 reported an examination of four samples of iodine ointment4 ,three were found to be pure1 the fourth was low in iodine4 ,experiments showed that iodine ointment deteriorates rapidly2 consequently1 no further collections of samples were made4 #aij ,rep4 ,mass4 ,bd4 ,health1 #aiji1 #da1 #dgg4 ,in #aiab ,pullen#aia reported that he had prepared two specimens of iodine ointment according to the ,british ,pharmacopeia1 one being from new lard and the other from a specimen of lard at least #b years old4 ,assays for free iodine were carried out immediately after the preparations were made1 and at intervals afterward up to four months4 ,the following values were found3 #aia ,pharm4 ,jour41 #aiab1 #hi1 #faj4 ,sample ,i ,sample ,,ii ,ointment from ,ointment from new lard1 old lard1 per cent4 per cent4 ,iodine introduced #d4j #d4j ,iodine found immediately after making #c4ie #c4ch ,iodine found after twenty-four hours #c4cj #c4ae ,iodine found on the third day #c4ah #b4fb ,iodine found on the seventh day #c4ae #b4df ,iodine found on the fourteenth day #c4jj #b4de ,iodine found after one month #c4jj #b4ci ,iodine found after two months #b4ij #b4ca ,iodine found after four months #b4ib #b4bf ,pullen found that the loss in free iodine could be accounted for by the iodine which had gone into combination with the fats of the ointment base4 ,pullen also found that if the potassium iodide and glycerin were omitted in the preparation of the ointment1 the loss in free iodine was very rapid1 the preparation containing practically no free iodine 7only #a_/bj7 after a few hours4 ,he concludes that the use of potassium iodide and glycerin is necessary for the preservation of the ointment4 ,he obtained specimens of iodine ointment in drug stores1 and assayed them for free iodine4 ,it is to be presumed that the ages of the several specimens were not known4 ,the results are found in the following table3 ,specimen ,no4 #a #b4gd per cent4 ,specimen ,no4 #b #b4he per cent4 ,specimen ,no4 #c #b4fb per cent4 ,specimen ,no4 #d #b4dh per cent4 ,specimen ,no4 #e #b4ec per cent4 ,specimen ,no4 #f #b4gi per cent4 ,fried#aib prepared iodine ointment according to the ,u4 ,s4 ,p4 ,,viii formula1 and assayed it at intervals4 ,his results are tabulated herewith3 #aib ,pharm4 ,jour41 #aiab1 #hi1 #faj4 ,per cent4 ,iodine introduced #d4jj ,iodine found immediately after making #c4hi ,iodine found one hour after making #c4ea ,iodine found one day after making #c4dh ,iodine found five days after making #c4jf ,iodine found ten days after making #b4hd ,iodine found thirty days after making #b4ha ,iodine found ninety days after making #b4ha ,iodine found eight months after making #b4ha ,iodine ointment has been official in the ,u4 ,s4 ,pharmacopeia since #ahgj4 ,briefly1 the method now used for making the preparation is as follows3 ,four gm4 of iodine1 #d gm4 of potassium iodide and #ab gm4 of glycerin are weighed into a tared mortar and the mixture triturated until the iodine and potassium iodide are dissolved and a dark1 reddish-brown1 syrupy liquid is produced4 ,eighty gm4 of benzoinated lard are then added in small portions and with trituration after each addition4 ,the mass is then triturated until of uniform consistence4#aic #aic ,the time required to complete the process after the initial portion of lard has been added should be about twenty minutes4 ,,paraffins ,,and ,,paraffin ,,preparations--,,table ,a ,,key3 ,a3 ,formula ,b3 ,substance ,c3 ,melting ,point1 ,u4 ,s4 ,p4 ,d3 ,ductility ,limit ,e3 ,plasticity ,limit ,f3 7a7 ,adhesiveness and ,detachability 7b7 ,strength of ,film at #ch ,c4 ,a ,b ,c ,d ,e ,f #a 8,parowax10 #ej4h #cb4e #bi4j 7a7 ,adheres and ,stand4 ,oil ,co4 of ,ind4 detaches well2 rather hard 7b7 ,pliable and strong #c 8,paraffin #aah-abj ,f410 #df4h #bh4e #bd4e 7a7 ,does not adhere ,stand4 ,oil ,co4 of ,ind4 well2 detaches easily 7b7 ,pliable but not strong #d 8,paraffin #abj-abb ,f410 #dg4b #bi4j #bd4e 7a7 ,adheres well2 ,stand4 ,oil ,co4 of ,ind4 detaches well 7b7 ,pliable and fairly strong #e 8,paraffin #abc-abe ,f410 #dh4h #ca4e #bh4e ,same as #d ,stand4 ,oil ,co4 of ,ind4 #f 8,paraffin #abh-acj ,f410 #eb4j #cc4j #cj4j 7a7 ,adheres well2 ,stand4 ,oil ,co4 of ,ind4 detaches not so easily 7b7 ,pliable and strong #g 8,texwax10 ,texas ,co41 #ea4b #cb4e #bi4h ,same as #f ,port ,arthur1 ,texas #h 8,paraffin ,wax #abb-abd ,f410 #ej4f #cf4j #cd-ce 7a7 ,unsatisfactory2 ,warren ,refining ,co41 does not adhere ,warren1 ,pa4 7b7 ,only slightly pliable2 too tough #i 8,paraffin ,no4 #iaj10 #dg4j #cj4e #bf-bg 7a7 ,adheres well2 ,waverly ,oil ,works1 detaches well ,pittsburgh 7b7 ,pliable and strong #aj 8,paraffin ,no4 #ibj10 #dd4d #bg4e #be4j 7a7 ,adheres well2 ,waverly ,oil ,works1 detaches well ,pittsburgh 7b7 ,pliable and fairly strong #aa 8,hard ,paraffin10 #dh4j #bh4e #bd4e-be4e 7a7 ,adheres well2 ,rob't ,stevenson ,co41 detaches well ,chicago 7b7 ,pliable and strong #ab 8,paraffin10 #dg4b #cc4j #cb4e ,not quite as good ,island ,petroleum ,co41 as #aa ,chicago #ac 8,paraffin #abb ,f410 #df4h #cj4e #bg4e-bh 7a7 ,does not adhere ,gulf ,refining ,co41 so well2 ,pittsburgh detaches well 7b7 ,very pliable #ad 8,paraffin #abe ,f410 #ej4j #cb4j #ca4j ,about as #ac ,gulf ,refining ,co41 ,pittsburgh #ae 8,paraffin #acb ,f410 #ed4h #ce4e #cd4j 7a7 ,does not adhere ,gulf ,refining ,co41 well ,pittsburgh 7b7 ,not very pliable1 but strong #af 8,paraffin ,no4 #cja10 #ej4b #cc4j #cb-cb4e 7a7 ,does not adhere ,national ,refining ,co41 well ,cleveland 7b7 ,not very pliable #ah ,paraffin recovered #dh4f #cj4e #bh-bh4e 7a7 ,adheres well2 from 8,ambrine0 detaches well 7b7 ,pliable but not strong #ai 8,hyperthermine0 #di4d #cc4e #cj4e-ca 7a7 ,does not adhere well2 detaches well 7b7 ,very pliable and strong #bj 8,ambrine0 #dh4d #cj4e #bg4j 7a7 ,adheres well2 detaches well 7b7 ,very pliable and strong #ba ,paraffin #abj-abb ,f4 #de4d #bi4j #bh4e 7a7 ,adheres 7see #c71 #ig4e2 excellently2 olive oil1 #a4e2 detaches well asphalt1 #d drops 7b7 ,very pliable and strong #bb 8,parowax0 7see #a71 #ig4e2 #di4b #cb4j #cj4e 7a7 ,adheres well2 olive oil1 #a4e2 detaches well asphalt1 #d drops 7b7 ,pliable and strong #bc 8,mulene0 #ea4j #cf4j #bh4j 7a7 ,adheres but detaches with difficulty 7b7 ,pliable but not strong #bd 8,parresine10 #df4j #bi4e #bf4j 7a7 ,adheres well2 ,abbott ,laboratories1 detaches easily 7b7 ,pliable and fairly strong #be 8,paraffin #aah-aba ,f410 #de4h #bf4d #bc4b 7a7 ,adheres well2 ,the ,atlantic ,refining detaches easily ,co41 ,philadelphia 7b7 ,pliable and ,chicago fairly strong ,,table ,b #bf 8,cerelene10 #ej4j #cj4e #bf4e 7a7 ,adheres well2 ,holliday ,lab4199 detaches with ,pittsburgh pulling 7b7 ,not strong at #ch ,c4 #bg 8,stanolind0 ,surgical #dg4j #bh4h #be4j 7a7 ,adheres well2 ,wax1 ,standard detaches easily ,oil ,co4 of ,ind4 7b7 ,fairly strong at #ch ,c4 99 ,on being heated1 it readily loses eucalyptol1 and a small amount of resinous substance forms in the bottom of the beaker4 ,if 8,cerelene0 is heated to #ade ,c4 and cooled1 the resulting product no longer has the properties of the original 8,cerelene40 ,accepted by the ,council on ,pharmacy and ,chemistry for inclusion in ,new and ,nonofficial ,remedies4 ,iodine ointment is officialized also in several foreign pharmacopeias1 although the iodine strength of the several preparations is not uniform4 ,the formula in the ,british ,pharmacopeia is exactly like that in the ,u4 ,s4 ,pharmacopeia except that pure lard is directed to be used instead of benzoinated lard4 ,some of the foreign pharmacopeias also specify that the preparation must be freshly prepared when wanted4 ,in the earlier editions the ,u4 ,s4 ,pharmacopeia directed the ointment to be prepared by using water as the solvent for the potassium iodide4 ,in the ,u4 ,s4 ,pharmacopeia ,,viii the formula was changed so as to employ glycerin1 and that solvent is now official4 ,water is still prescribed as the potassium iodide solvent by the ,pharmacopeias of the ,netherlands and of ,france4 ,from the examination of the literature it seems probable that iodine ointments which contain petrolatum products only as the ointment bases are apt to be relatively stable1 so far as the content of free iodine is concerned4 ,on the other hand1 ointments the bases of which contain fats of the unsaturated fatty acid series1 such as oleic acid1 do not satisfactorily preserve the iodine in the free state4 ,in the latter class it seems likely that the iodine enters into combination with the unsaturated fatty acids4 ,accordingly1 on theoretical grounds1 an ointment base composed of pure stearin 7if such substance were available7 but softened by an admixture of liquid petrolatum would preserve the iodine satisfactorily4 ,cocoanut oil 7iodine ,no4 #h7 ought to be suitable also if mixed with hard paraffin4 ,since the literature was not sufficiently concordant to warrant positive conclusions concerning the stability of ointments containing free iodine1 it seemed worth while to conduct experiments with preparations of known origin4 ,accordingly1 a number of preparations containing free iodine were made under varying conditions and each was assayed for its free iodine content immediately after its manufacture and from time to time later4 ,leaf lard of the best quality obtainable was purchased from a butcher4 ,this was rendered in an open dish on the steam bath4 ,the preparation was of a fine color1 and uniform consistence and had a faint but not unpleasant odor4 ,two specimens of lard were furnished by the research department of ,armour and ,company4 ,an effort was made to procure specimens of lard having iodine absorption numbers as far apart as possible1 i4 e41 one with a low and the other with a high iodine value4 ,this was done in order to determine whether the keeping qualities of the ointments prepared from the two would be alike4 ,one of the specimens 7a7 was described as 8,natural lard2 iodine value1 #eg4a4 ,leaf lard used exclusively for butterine and benzoinated lard40 ,the other specimen was described as 8,prime steam lard4 ,good1 commercial grade of lard for general use2 iodine value1 #fi4j40 ,the iodine absorption numbers of the three specimens were determined by the ,u4 ,s4 ,p4 process to be as follows3 ,laboratory rendered specimen #eg4a ,armour specimen 7a7 #eg4fe ,armour specimen 7b7 #fg4ee ,each specimen was benzoinated according to the process described in the ,u4 ,s4 ,p4 ,,ix and #ajj gm4 of iodine ointment were prepared from each according to the ,u4 ,s4 ,p4 process4 ,another specimen was made from benzoinated lard and iodine only#aid without the addition of either glycerin or potassium iodide4 ,this was made to contain #d per cent4 of iodine4 #aid ,in order to facilitate the incorporation of the iodine with the fatty base the iodine was first powdered by trituration with alcohol and drying the powder in the air4 ,immediately after preparation each of these iodine ointments was assayed for free iodine1 and each was reassayed at intervals later4 ,the method for the determination of iodine in the ointment was that employed in this laboratory for the determination of iodine in ,iocamfen ,ointment4#aie ,it is essentially the same as was employed by ,pullen for the determination of uncombined iodine in iodine ointment4#aif ,as carried out in this laboratory for iodine ointment it is as follows3 #aie ,rep4 ,chem4 ,lab41 ,a4 ,m4 ,a41 #aiaf1 #i1 #aah4 #aif ,pharm4 ,jour41 #aiab1 #hi1 #faj4 ,from #e to #h gm4 of the ointment were weighed in a small porcelain capsule1 the capsule and contents placed in a #af oz4 salt mouth bottle together with #bj c4c4 of chloroform1 #aj c4c4 of potassium iodide solution and #dj c4c4 of water4 ,tenth-normal sodium thiosulphate was slowly added with agitation until the pink color of the chloroform layer had nearly disappeared4 ,a little soluble starch was then added and the titration continued until a blue color in the aqueous layer could no longer be obtained by repeated shaking4 ,the findings for the several assays are tabulated herewith3 ,u4 ,s4 ,p4 ,u4 ,s4 ,p4 ,u4 ,s4 ,p4 ,ointment ,ointment ,ointment ,ointment from ,age at from from from lard and time laboratory commercial commercial iodine only of rendered lard lard 7laboratory assay lard ,grade ,i ,grade ,,ii rendered lard7 7 ,i7 7 ,i7 7 ,i7 7 ,i7 ,freshly made #c4cb #c4bf #c4cj #j4cb ,after #c days #c4be 4444 4444 #j4bc ,after #g days #b4ii #c4ag #c4ae 4444 ,after #c weeks #c4ja #c4ai #c4jg 4444 ,after #g weeks #c4ab99 #c4aj #c4jb 4444 ,after #c months #b4ih #b4hh #b4hh 4444 99 ,this slight rise in iodine content followed by a fall could not be accounted for4 ,the specimen was believed to have been very thoroughly mixed at the time of manufacture4 ,that the fatty constituents of the ointment contained iodine after the preparation had been made for some time was demonstrated4 ,some of the material was examined as follows3 ,a portion of the ointment which had been made for nearly three months was shaken in a separator with chloroform and a dilute mixture of potassium iodide and sodium thiosulphate solutions4 ,after all of the free iodine had been removed the chloroformic solution of the fats was washed several times with a very dilute solution of sodium thiosulphate4 ,the chloroformic solution was filtered1 evaporated and the residue dried over sulphuric acid4#aig #aig ,the resultant fatty residue was of a brownish-green color4 ,it no longer had either the taste1 color or odor of lard4 ,it was noted that the fats1 after removal by this method from the freshly prepared ointment1 were nearly white4 ,as the ointment aged the fat became successively darker in color4 ,the separated fat was then tested for iodine by ,kendall's method4#aih ,it was found to contain iodine in considerable amounts1 but quantitative determinations were not made4 #aih ,the method depends upon the conversion of all of the iodine compounds into iodate by fusion with sodium hydroxide and oxidation with potassium nitrate4 ,the melt is dissolved in water1 a little sodium bisulphite added1 the solution cooled and neutralized with phosphoric acid1 using methyl orange as indicator4 ,an excess of bromine water is added1 and the mixture boiled to expel carbon dioxid and bromine4 ,a little sodium salicylate is added1 the solution cooled1 an excess of potassium iodid added1 and the liberated iodine titrated with tenth-normal sodium thiosulphate in the usual way4 ,one sixth of the iodine found is obtained from the material assayed1 the balance being furnished by the potassium iodide added4--,jour4 ,biochem41 #aiad1 #ai1 #bea4 ,the ,pharmacopeia of the ,netherlands directs that iodine ointment shall contain #c per cent4 of potassium iodide and #b per cent4 of iodine instead of equal proportions 7#d per cent4 of each7 as prescribed by the ,u4 ,s4 ,pharmacopeia4 ,likewise the ,french ,pharmacopeia directs that #aj per cent4 of potassium iodide and only #b per cent4 of iodine shall be used4 ,both of these pharmacopeias use water instead of glycerin as the solvent4 ,loose combinations of iodine and potassium iodide1 such as are represented by the compound having the formula ,,ki1 have been described4 ,the quantity of potassium iodide prescribed by the ,u4 ,s4 ,pharmacopeia for the preparation of iodine ointment is not sufficient to form such a compound as ,,ki with all of the iodine directed to be used4 ,since some of the pharmacopeias use larger proportions of potassium iodide 7more than sufficient to form the compound1 ,,ki71 it seemed worth while to determine whether an ointment containing a greater proportion of potassium iodide than that required by the ,u4 ,s4 ,pharmacopeia would be more stable than the official article4 ,accordingly a specimen was prepared to contain #d per cent4 of iodine1 #h per cent4 of potassium iodide 7twice the ,u4 ,s4 ,p4 requirement71 #ab per cent4 of glycerin and #gf per cent4 of lard4 ,this was assayed for its free iodine content immediately after preparation1 and found to contain #c4fh per cent4 ,nine days later it contained #c4gj per cent4 ,another specimen of the same iodine strength prepared from grade ,no4 #b of commercial lard assayed #c4fi per cent4 at the initial assay1 and seven days later #c4dj per cent4 ,from these experiments it seems likely that the free iodine content of the ,u4 ,s4 ,pharmacopeia iodine ointment could be raised somewhat by increasing the proportion of potassium iodide4 ,the results of these studies confirm the findings of ,pullen and of ,fried in all essential particulars4 ,it appears that during the process of manufacture of iodine ointment about #bj per cent4 of the free iodine goes into combination with the fatty constituents of the ointment4 ,on standing for a month approximately an additional #e per cent4 goes into combination1 after which there is practically no loss in free iodine content4 ,in other words iodine ointment which is a month old is a relatively stable preparation4 ,it appears to make no noticeable difference upon the rate and amount of iodine absorption whether the lard from which the ointment is made has a high or a low iodine absorption value4 ,the composition of iodine ointment1 which has been made sufficiently long to have reached equilibrium1 is approximately as follows3 ,free iodine #c per cent4 ,iodine combined with fat #a per cent4 ,potassium iodide #d per cent4 ,benzoinated lard 7containing iodine7 #hj per cent4 ,the ,u4 ,s4 ,pharmacopeia requirement that iodine ointment shall be freshly prepared when wanted appears to be unnecessary4 ,probably most pharmaceutical manufacturers are aware of this1 for many of them include the preparation in their trade lists4 ,the presence of an iodide appears to be necessary1 to prevent practically all of the iodine from entering into combination with the fat4#aii--7;,from the ,american ,journal of ,pharmacy1 ,august1 #aiag47 #aii ,in order to determine whether the iodine which is in combination with fat is absorbed through the skin1 a few experiments were carried out4 ,the dark-colored iodine-containing fat 7obtained from the ointment and washed free from potassium iodide by the method described above7 was rubbed thoroughly into the skin of the forearm4 ,it was allowed to remain for four hours1 after which the limb was scoured with soap suds4 ,beginning at the time of the application the urine was collected for forty-eight hours4 ,this was evaporated to small bulk and the residue tested for iodine by ,kendall's method4 ,small amounts of iodine were found4 ,these findings were taken to indicate that the iodine-containing fat is absorbed to some extent by the skin4 ,it is generally believed that potassium iodide is not absorbed by the unbroken skin4 ,therefore it seems reasonable to suppose that the principal iodine effects obtainable from iodine ointment are those due to the free iodine contained in the preparation1 supplemented to a slight extent by the iodine which is contained in the fatty ointment base4--,jour4 ,biochem41 #aiad1 #ai1 #bea4 ,,iodolene ,,and ,,the ,,solubility ,,of ,,iodin ,,in ,,liquid ,,petrolatum ,the ,council on ,pharmacy and ,chemistry was asked to examine a preparation submitted with the statement that it was 8iodin crystals incorporated in a petroleum product40 ,the name 8,iodolene0 was proposed by the promoters1 providing the product was found eligible for ,new and ,nonofficial ,remedies4 ,iodolene was stated to have been prepared by treating a liquid petrolatum1 obtained from ,gulf ,coast petroleum1 with an excess of iodin2 the mixture was subsequently 8placed in an oven for three hours40 ,the claim was made that this method of procedure produced a preparation containing more iodin than market specimens which had been examined1 namely3 8over #a4ej per cent4 free iodine40 ,two specimens of the product were submitted1 one stated to have been unfiltered1 and the other filtered4 ,both of the specimens emitted a strong odor of hydrogen sulphide upon removing the stopper from the respective containers4 ,iodin ,content of ,iodolene4--,the iodin content of the filtered specimen was determined thus3 ,a weighed amount--#c to #e gm4--was transferred to a separator by means of #bj c4c4 of ligroin1 used in portions4 ,twenty c4c4 of #aj per cent4 potassium iodid solution was added and the free iodin titrated with tenth-normal sodium thiosulphate solution 7with agitation71 the end point being the absence of a yellow color in the aqueous layer4 ,the amount of free iodin was found to be #a4cb per cent4 ,the ,solubility of ,iodin in ,liquid ,petrolatum4--,to determine the solubility of iodin in ,liquid ,petrolatum1 #bjj c4c4 of ,liquid ,petrolatum-,squibb 7said to be composed of hydrocarbons of the naphthene series7 and #bjj c4c4 of ,stanolind ,liquid ,paraffin 7said to be composed chiefly of marsh gas hydrocarbons7 were each treated with #e gm4 of iodin crystals4 ,the two mixtures were maintained for a week at a temperature somewhat above that of the room and agitated occasionally4 ,each was then cooled to room temperature 7about #bb ,c471 agitated for a day and then filtered4 ,the amount of iodin in the preparation made with ,liquid ,petrolatum-,squibb was found to be #a4db per cent4 ,the iodin content of the preparation made with ,stanolind ,liquid ,paraffin was #a4cj per cent4 ,in view of these findings the prospective manufacturer was advised that the ,council cannot countenance a proprietary name for an unofficial1 simple solution of iodin in liquid petrolatum4--7,from ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiag1 p4 #hg47 ,,american-,,made ,,synthetic ,,drugs--,i ,examination of ,american-,made ,acetylsalicylic ,acid ,paul ,nicholas ,leech1 ,ph4,d4 ,at the request of the ,council on ,pharmacy and ,chemistry1 the ,a4 ,m4 ,a4 ,chemical ,laboratory has undertaken examinations of ,american-made synthetic drugs4 ,the most extensively used synthetic is acetylsalicylic acid and hence an investigation of this product was deemed expedient4 ,for seventeen years acetylsalicylic acid was protected by a ,united ,states ,patent 7the proprietors were not given a patent in other countries7 and sold under the name 8,aspirin40 ,in ,february1 #aiag1 the patent expired1 and since then a number of firms have engaged in the manufacture of acetylsalicylic acid1 selling it either as such or as aspirin1 modified1 of course1 by a distinctive firm designation4 ,during this period the former manufacturers 7,the ,bayer ,co41 ,new ,york1 in past years called ,farbenfabriken of ,elberfeld ,co41 ,new ,york7 have been extensively advertising1 both to physicians and the public1 the alleged superior qualities of their product4 ,the chemical examination1 therefore1 was concerned chiefly with tests of purity1 and the comparison of the ,american brands with the formerly patented product4 ,in ,european countries1 acetylsalicylic acid#bjj is described in the various pharmacopeias as a condensation product of acetic anhydride or acetyl chloride with salicylic acid 7o-hydroxybenzoic acid74 ,generally the test of identification is hydrolysis of acetylsalicylic acid and qualitative tests for acetic acid and salicylic acid4 ,for purposes of purity the requirements are essentially that the specimen should have a certain melting point1 should show absence of salicylic acid by means of ferric chloride 7the manipulations for the tests are variously described7 and leave no appreciable ash4 ,the two tests of purity most generally employed1 however1 are the melting point and the reaction with ferric chloride4 #bjj ,unfortunately1 the nondescriptive name 8aspirin0 has been used extensively in ,european literature and has even got into ,european pharmacopeias1 instead of the scientific name 8acetylsalicylic acid40 ,,melting ,,point ,the melting point of acetylsalicylic acid has been given at various temperatures from #aah to #acg ,c4#bja2 the ,british ,pharmacopeia describes the melting point at #acc to #ace ,c42 the ,german ,pharmacopeia 8about #ace ,c420 the ,french ,pharmacopeia at #ace ,c42 ,new and ,nonofficial ,remedies1 #aiag1 #acd to #acf ,c4 ,the ,bayer ,company1 in the patent trial at ,chicago a number of years ago1 gave among the 8four infallible tests0 a melting point of 8about #ace ,c40 ,several men have carefully determined the melting point in recent years4 ,emery and ,wright#bjb in #aiab found that 8,aspirin1 ,bayer0 melted at #acj4e to #aca ,c4 ,in ,france1 ,franois#bjc has determined the melting point of pure acetylsalicylic acid1 which1 according to his method1 is #acb ,c4 ,when various samples of acetylsalicylic acid were examined in this laboratory1 it was found that the melting point of none was as high as that described in ,new and ,nonofficial ,remedies or the ,british1 ,french1 or ,german pharmacopeias when taken according to the general method of the ,u4 ,s4 ,pharmacopeia1 ,vol4 #i1 p4 #eif4 ,on critical observation1 it may be seen that the melting point of acetylsalicylic acid is preceded and accompanied by decomposition4 ,if the sample in the melting tube is heated from the original room temperature of the bath to #abj ,c41 the temperature of melting will be lower than if the bath is first heated to #abj ,c4 and the melting-point tube then placed in the bath4#bjd ,thus the melting point of acetylsalicylic acid1 like so many organic compounds which decompose and do not melt sharply1 is unsatisfactory and cannot be taken as an 8infallible test0 of purity1 especially when determined by different operators who do not give their method in detail4 ,after making a large number of melting-point determinations of acetylsalicylic acid1 alone and in parallel with other operators1 it was decided to use the method described in the ,u4 ,s4 ,pharmacopeia modified by first heating the bath to #abj ,c4 before attaching the melting-point tube to the thermometer4 #bja ,for reference to older literature see ,beilstein1 ,,ii1 #adif 7#hhi74 #bjb 8,the ,melting ,temperature of ,aspirin and ,salicylic ,acid ,mixtures10 ,proc4 ,assoc4 ,off4 ,agr4 ,chem41 #aiab2 ,bureau of ,chemistry1 ,department of ,agriculture1 ,bull4 #afb4 #bjc 8,assay of ,aspirin10 ,j4 ,pharm4 ,chem41 #ae 7#aag71 ,no4 #g1 #bac4 #bjd ,similar observations were made by ,emery and ,wright1 who state3 8,an accurate determination of the melting temperature in this way 7the rate of heating was such as to give a rise in temperature of about #a per minute7 is rendered difficult by the fact that #8aspirin' decomposes on heating1 as evidenced in the depression of the melting temperature of the pure substance of about #a for every five minutes' heating just below its melting temperature40 ,the melting point of purified acetylsalicylic acid was found to be #aca4e to #acb4e ,c4 7corr474#bje ,with the exception of one specimen1 which was obviously impure1 the various specimens examined melted between #abh and #acc ,c4 as may be seen in the accompanying table4 ,it would appear that this range of melting points would be more acceptable and reliable than the melting points described in various standards4 #bje ,isolated crystals attached to the walls of the melting-point tube1 apart from the bulk acetylsalicylic acid1 melted at a lower temperature4 ,,presence ,,or ,,absence ,,of ,,free ,,salicylic ,,acid ,it is generally conceded that the presence of salicylic acid in amounts more than traces is deleterious4 ,furthermore1 the amount of salicylic acid is a good index of the purity of the acetylsalicylic acid1 because the test is so delicate that1 under favorable conditions1 mere traces may be determined and1 as a rule1 the better the product1 the less the amount of free salicylic acid4 ,the tests appearing in various pharmacopeias for salicylic acid as an impurity in acetylsalicylic acid do not give concordant results1 different workers interpreting the results differently1 nor are they detailed in such a manner as to yield maximum delicacy4 ,after experimentation1 it was decided to establish a 8limit0 test of approximately #j4a per cent4 free salicylic acid1 when carried out according to the following method3 #j4a gm4 of the substance was placed in a dry colorimeter tube and #a c4c4 of alcohol1#bjf previously distilled over ,na,o,h1 was added4 ,after the acetylsalicylic acid had dissolved1 #dh c4c4 of water and #a c4c4 of fresh #j4a per cent4 ferric chloride 7,fe,cl4#f;,h,o7 solution were added4 ,at the same time a control was run by treating #a c4c4 of a 8standard0 salicylate solution the same as above4#bjg ,if within two minutes the color given by acetylsalicylic acid is not more intense than the color given by the 8standard10 the presence of not more than #j4a per cent4 free salicylic acid is proved4#bjh #bjf ,an excess of alcohol destroys or lessens the color when only a very minute amount of salicylic acid is present4 #bjg ,the control should be made each time as standing in the air changes its tinctorial power4 #bjh ,the presence of pure acetylsalicylic acid does not seem to affect the iron 7,fe7 salicylic acid coloration4 ,the small amount of acetic acid was added to the sodium salicylate control solution 7#a7 to stimulate an acidity approximating the acidity of the acetylsalicylic acid1 and 7#b7 since acetylsalicylic acid gives by hydrolysis both acetic acid and salicylic acid1 it was thought advisable to add acetic acid to the standard4 ,if there is any free acetic acid in a sample of acetylsalicylic acid containing salicylic acid 7which ,i believe is generally the case when salicylic acid is present7 then it would modify the color given by the same amount of salicylic acid alone4 ,for this reason it was thought to be more comparable to have the standard contain a slight amount of acetic acid4 ,the solutions used were prepared as follows3 ,redistilled alcohol was treated with a small amount of sodium hydroxide for twenty-four hours1 then again distilled4 ,the color standard was made by dissolving #j4aaf gm4 of dried sodium salicylate in water1 adding #a minim of glacial acetic acid1 and making up to #a1jjj c4c4 ,each c4c4 represents #j4a mg4 of salicylic acid4#bji #bji ,this standard is somewhat similar to the one proposed by ,t4 ,w4 ,thoburn and ,paul ,j4 ,hanzlik1 ,j4 ,biol4 ,chem41 #bc1 #age4 ,the ferric chloride solution was made by diluting #a c4c4 ferric chloride 7,fe,cl4#f;,h,o7 test solution ,u4 ,s4 ,p4 with #ii c4c4 of water4 ,the diluted solution must be freshly prepared each day4 ,with one exception1 all of the commercial specimens examined responded satisfactorily to the above test showing less than #a part salicylic acid in #a1jjj parts acetylsalicylic acid4 ,the individual results are given in the accompanying table4 ,,melting ,,point ,,and ,,salicylic ,,acid ,,determinations ,melting ,point ,free ,salicylic ,acid ,,brand ,corrected ,colorimetrically ,acetylsalicylic acid1 #acj4j-aca4j ,colored1 but showing ,p4 ,w4 ,r4#a less than #j4a per cent4 ,acetylsalicylic acid1 #acj4j-aca4j ,no color ,millikin#b ,acetylsalicylic acid1 #abi4j-acj4j ,no color ,millikin#b #e-;grain capsules ,acetylsalicylic acid1 #abh4j-abi4j 7a7 ,colored1 but showing less ,millikin1#a than #j4a per cent4 7a7 #e-;grain capsules#c #abe4e-abf4e 7b7 ,considerably more than #j4a per cent4 7b7 ,acetylsalicylic acid1 #aca4j-acb4j ,no color ,squibb#b ,acetylsalicylic acid #aca4j-acb4j ,no color 7,aspirin71#a ,monsanto ,acetylsalicylic acid1 #acj4e-aca4e ,colored1 but showing less ,m4 ,c4 ,w4#a than #j4a per cent4 ,acetylsalicylic acid1 #aca4e-acb4e ,colored1 but showing less ,m4 ,c4 ,w4#a than #j4a per cent4 ,acetylsalicylic acid1 #aca4j-acb4j ,colored1 but showing less ,m4 ,c4 ,w4#a than #j4a per cent4 ,aspirin1 ,bayer#a 7before patent #aca4e-acb4e ,no color expired7 ,aspirin1 ,bayer#a #d 7after patent #abh4e-abi4e ,colored1 but showing less expired7 than #j4a per cent4 ,aspirin1 ,bayer#a #d 7after patent #abi4e-acj4e ,colored1 but showing less expired7 than #j4a per cent4 ,aspirin1 ,lehn #acj4e-aca4e #j4a per cent4 and ,fink#b ,aspirin1 ,lehn #acj4e-aca4e ,colored1 but showing less and ,fink#b than #j4a per cent4 ,aspirin1 ,lehn #aca4j-acb4j ,colored1 but showing less and ,fink#a than #j4a per cent4 #a ,obtained on the open market4 #b ,obtained from manufacturer4 #c ,one-third of the capsules 7a7 contained a white powder2 two-thirds of the capsules 7b7 contained a pink powder having strong odor of acetic acid and not complying with the tests4 #d ,not described in 8,new and ,nonofficial ,remedies1 #aiag02 the other products are4 ,,other ,,tests ,new and ,nonofficial ,remedies1 #aiag1 requires that acetylsalicylic acid shall form a clear solution with warm sodium carbonate solution2 that sulfates1 chlorides and heavy metals shall be absent2 that #j4e gm4 shall leave no weighable ash4 ,all the brands reported in this paper complied with these requirements4 ,so far there has been no satisfactory quantitative estimation of acetylsalicylic acid4 ,true1 various methods have been proposed1 but they are objectionable4 ,it was thought that hydrolysis of acetylsalicylic acid and then titrating the solution by comparing the color formed by ferric chloride with that of a standard control might yield interesting results1 providing that the conditions were alike4 ,for this purpose #a gm4 of acetylsalicylic acid was dissolved in #aj c4c4 of alcohol and diluted to #a1jjj c4c4 ,the solution was then heated at #ih to #ajj ,c4 for two hours1 allowing the alcohol to evaporate1 then allowed to stand at room temperature 7#bb ,c47 for twenty-two hours4 ,after adding water sufficient to make #a1jjj c4c41 it was compared colorimetrically for salicylic acid strength4 ,the amount of hydrolysis varied so with different samples under the same conditions1 that it was realized that an approximate assay by this method was unreliable4 ,if the assay were made under more exact conditions1 quantitative comparisons might be possible4 ,in one experiment1 after sixty days the hydrolysis of the acetylsalicylic acid was #fa per cent41 which is in rough agreement with the work of ,tsaklatos and ,horsh4#baj #baj ,apoth4 ,ztg41 #aiae1 p4 #bdg2 ,bull4 soc4 chem41 #ag 7#aiae71 #dja4 8,studies of the decomposition of aspirin determined by titrametric methods and by conductivity measurements indicate that the reaction is exceedingly complex10 ,t4 and ,h4 ,chem4 ,abs41 #aj1 #eia4 ,,discussion ,apart from the proposed revision of the standards for the melting point and limit of salicylic acid in acetylsalicylic acid1 the examination shows that there is no appreciable difference between the various brands of acetylsalicylic acid examined1 all of them with one exception 7acetylsalicylic acid1 ,millikin1 #e-;grain capsules1 purchased on the open market7 complying with the tests described in this paper4 ,the ,journal of the ,american ,medical ,association1 in past years1 has protested repeatedly against the monopoly given to the ,bayer ,company for their 8,aspirin10 contending that acetylsalicylic acid 7aspirin7 was not new1 and that 8,aspirin1 ,bayer0 was simply a good brand of acetylsalicylic acid which could be bought in foreign countries at much lower prices than here4 ,although the patent in the ,united ,states has expired1 8,aspirin1 ,bayer0 is still being retailed at higher prices than other products which are now enjoying the privilege of ,american manufacture4 ,mr4 ,paul ,bakewell1#baa in an opinion answering the warning circular of the ,bayer ,co4 in reference to the use of the word 8aspirin0 by firms other than ,bayer1 argues very ably that acetylsalicylic acid1 before the patent was granted1 meant the impure substance which was not used therapeutically1 while 8aspirin0 was designated as the improved product 7a new article of manufacture1 the particular acetylsalicylic acid made under the ,hoffman patent7 and 8is the substance now known in pharmacy as aspirin0 7statement made by an officer of the ,farbenfabriken of ,elberfeld ,co4 in ,u4 ,s4 ,circuit ,court1 #aiji74 ,the products reported in this paper are 7with the one exception7 the same as described in the ,hoffman patent1 and1 in the sense of ,mr4 ,bakewell's argument1 are 8aspirin40 ,however1 it would seem better if the name acetylsalicylic acid1 instead of aspirin1 were used1 especially by physicians in their prescriptions because 7#a7 it is a generic1 scientific name2 7#b7 8,aspirin1 ,bayer0 is sold at higher prices than other products1 whereas chemically equivalent products sold under the descriptive name may be purchased at a lower price4 ,finally1 the manufacture of acetylsalicylic acid in this country is another example of the fact that ,american chemists can produce the drug synthetics1 and at the same time make products as good as1 if not better than1 those of ,german origin4 #baa 8,in the ,matter of ,aspirin4 ,answer to the warning circular of the ,bayer ,co4 of ,june #a1 #aiag10 by ,mr4 ,paul ,bakewell1 ,monsanto ,chemical ,works4 ,i express my appreciation to ,dr4 ,w4 ,a4 ,puckner for his kind interest4--7,from the ,journal of ,industrial and ,engineering ,chemistry1 ,april1 #aiah47 ,,the ,,standardization ,,of ,,commercial ,,bismuth ,,tribromphenate ,william ,rabak1 ,ph4,g41 ,sc4,b4 ,this work was begun in view of a request received by the ,council on ,pharmacy and ,chemistry from the ,medical ,section of the ,council of ,national ,defense for a report on the quality of bismuth tribromphenate1 offered to the government by a certain firm4 ,in submitting a specimen of its product1 8,bismuth ,tribromphenolate10 the firm claimed that 8it is of high character1 matching exactly the ,german product formerly imported into this country10 and expressed the belief that it would be found to conform to the standards for this preparation in ,new and ,nonofficial ,remedies4 ,later a second specimen was received from the same company1 with the request that this be substituted for that first received4 ,it was explained that the first had been taken from an experimental lot1 and that the second1 taken from the regular factory output1 was identical with the first except that it was free from odor because of the more thorough washing to which it had been subjected4 ,accordingly1 the examination which is reported below refers to the second specimen only4 ,new and ,nonofficial ,remedies1 #aiah1 defines bismuth tribromphenate as basis bismuth tribromphenate having the formula ,bi7,c,h,br,o7,,oh4,bi,o1 and it is required to yield not less than #di4e per cent4 of bismuth oxid 7the chemical formula requires #df4b per cent4 bismuth1 or #ea4f per cent4 bismuth oxid1 ,bi,o1 and #di4b per cent4 tribromphenate1 ,c,h,br4,,oh74 ,it describes it as a 8fine1 yellow1 nearly odorless and tasteless powder1 neutral in reaction10 and 8only slightly soluble in water1 alcohol1 chloroform1 liquid petrolatum and vegetable oils40 ,it is required to yield tribromphenol 7to which a melting point of #ie ,c4 is assigned7 when decomposed by alkali and the alkali tribromphenate decomposed by acid1 the separated tribromphenol purified and dried4 ,as the ,new and ,nonofficial ,remedies description appeared loosely drawn--it had been based on information furnished for the product ,xeroform when this1 because of patent protection1 was the only bismuth tribromphenate on the market--it was decided to include in the examination also specimens of the two brands of ,bismuth ,tribromphenate included in ,new and ,nonofficial ,remedies1 namely1 ,bismuth ,tribromphenate-,merck 7,merck and ,company7 and ,xeroform-,heyden 7,the ,heyden ,chemical ,works74 ,the ,merck specimen had been received by the ,council from ,merck and ,company in #aiae1 while the ,heyden preparation was obtained direct from the firm's ,chicago branch in ,april1 #aiah4 ,at this time ,bismuth ,tribromphenate-,merck could not be obtained from the ,chicago wholesale houses4 ,all three specimens were nearly odorless4 ,two of the specimens 7the ,research ,council ,specimen and ,merck products7 were of a lemon-yellow color1 while the ,heyden preparation was of a grayish color4 ,,bismuth ,,determination ,four methods for the determination of the bismuth content of the specimens were tried3 7,a74 ,direct ,ignition to ,bismuth ,oxid4--,this method was abandoned because of the tendency to ignite suddenly during the incineration and the consequent loss of material4 7,b74 ,the ,method of the ,japanese ,pharmacopeia1 ,third ,revised ,edition1 ,translated by the ,pharmaceutical ,society of ,japan4--,the method consists in treatment of the product with nitric acid1 evaporation and subsequent heating to bismuth oxid4 ,this method also was abandoned because of tendency toward sudden ignition with loss of material4 7,c74 ,the ,method of ,kollo 7,apotheker ,zeitung1 #aiaj1 p4 #ii74--,the method consists in decomposition of the product by heating on water bath with normal sodium hydroxid solution1 with formation of soluble sodium tribromphenate and insoluble bismuth hydroxid4 ,the bismuth hydroxid is collected on a filter1 washed with hot water until a few drops of the filtrate no longer turn litmus paper blue1 dried and heated to constant weight and weighed as bismuth oxid4 7,d74 ,a4 ,m4 ,a4 ,method 7,reports ,a4 ,m4 ,a4 ,chem4 ,lab41 #aiaa1 p4 #ah74--,this method consists in dissolving the product in hot1 strong hydrochloric acid1 diluting1 filtering and precipitating by saturation with hydrogen sulphid4 ,the bismuth sulphid obtained is dissolved in nitric acid and from the solution obtained the bismuth is precipitated by addition of an excess of ammonium hydroxid and ammonium carbonate4 ,the precipitate is collected and converted to bismuth oxid by heat4 ,the following tabulation shows the results obtained by ,methods 8,c0 and 8,d03 ,,table #a4--;,,bismuth ,,content ,,of ,,bismuth ,,tribromphenate ,gm4 of ,gm4 of ,per ,cent4 ,method ,salt ,bi,o of ,bi,o ,no4 #a ,research ,council ,spec ,c #b4acab #a4aged #ee4a ,no4 #a ,research ,council ,spec ,d #j4eaea #j4bggb #ej4jc ,no4 #b 7,merck ,company7 ,c #b4jbhg #a4bedc #fa4h ,no4 #b 7,merck ,company7 ,d #j4ejfd #j4bfcd #eb4ja ,no4 #c 7,heyden ,chem4 ,works7 ,c #b4jdgb #a4fjbj #gh4b ,no4 #c 7,heyden ,chem4 ,works7 ,d #j4ebbg #j4cedf #fg4h ,it is seen from the tabulation that the results obtained by the ,kollo method 7,method ,c7 are higher than those by the sulphid method 7,method ,d7 and that duplicate determinations show a rather wide variation4 ,the results by the sulphid method are somewhat lower than those by the ,kollo method1 but duplicates agree fairly well4 ,in view of the fact that the ,kollo method will give excessive results if impurities such as talcum1 etc41 are present and in consideration of the satisfactory results obtained in previous work with the sulphid method1 the figures obtained by this method are taken as indicative of the bismuth content of the specimens examined4 ,calculating the per cent4 of bismuth oxid obtained to bismuth 7,bi71 the following values are obtained3 ,bismuth ,tribromphenolate1 ,research ,council ,specimen3 ,bismuth1 #dd4h per cent4 ,bismuth ,tribromphenate-,merck1 ,merck ,co43 ,bismuth1 #df4f per cent4 ,xeroform1 ,heyden ,chemical ,works3 ,bismuth1 #fj4g per cent4 ,,total ,,tribromphenol ,the content of tribromphenate radical1 ,c,h,br,o-1 was determined by the method of ,kollo 7,apotheker ,zeitung1 #aiaj1 p4 #ii74 ,it consists in titrating the filtrate of the bismuth oxid determination of ,kollo1 described under 8,c0 7bismuth determinations71 with normal hydrochloric acid1 using phenolphthalein as an indicator4 ,the cubic centimeters of normal alkali consumed multiplied by the theoretical factor #j4cca gives the weight of tribromphenol 7combined and free7 contained in the specimen4 ,the following results were obtained3 ,,table #b4--;,,determination ,,of ,,total ,,tribromphenol ,,in ,,bismuth ,,tribromphenate ,gm4 ,tribromphenol ,gm4 of ,calculated from ,per ,cent4 ,salt ,theoretical of ,total ,taken ,factor ,tribromphenol ,no4 #a 7,research ,council ,spec47 #a4ghag #a4jeib #ei4dd ,no4 #b 7,merck ,co47 #j4igdc #j4efbg #eg4ge ,no4 #c 7,heyden ,chem4 ,works7 #b4jddj #j4dcjc #ba4jd ,,uncombined ,,tribromphenol ,the definite chemical formula given in ,new and ,nonofficial ,remedies for bismuth tribromphenate and the statement that it is 8only slightly soluble in 444 alcohol 4440 requires the absence of uncombined tribromphenol1 but no method for its detection or determination is provided4 ,in the ,u4 ,s4 ,patent #eaf1ceh 7expired ,march #ac1 #aiaa71 issued to ,bruno ,richard ,seifert1 assignor to ,dr4 ,f4 ,von ,heyden1 for 8,phenol ,bismuth ,compound0 the freedom from uncombined tribromphenol was provided for by the direction to wash with alcohol the product obtained4 ,in the ,swiss ,pharmacopeia the permissible content of uncombined tribromphenol is limited thus3 8,if #j4e gm4 be shaken with #e c4c4 of alcohol and #a c4c4 of the filtrate be diluted with #ae c4c4 of water1 neither a turbidity nor a flocculent precipitate should appear44440 ,when this test was applied to the three specimens under examination1 the ,merck and ,heyden specimens complied1 while the ,research ,council specimen did not comply1 with this requirement4 ,method #a4--;,about #a gm4 of bismuth tribromphenate was placed in a flask1 #bj c4c4 of #ie per cent4 alcohol added and shaken for fifteen minutes1 after which it was filtered by suction through a ,gooch filter into an ,erlenmeyer flask4 ,the flask was rinsed with #aj c4c4 of alcohol and finally the filter was washed with #aj c4c4 of alcohol1 #be c4c4 of tenth-normal sodium hydroxid solution were added to the alcoholic filtrate 7which was nearly but not perfectly clear7 containing the tribromphenol1 and the residual alkali titrated with tenth-normal hydrochloric acid4 ,the number of cubic centimeters of tenth-normal alkali consumed multiplied by #j4cca gave the weight of tribromphenol 7,table #c74 ,,table #c4--;,,determination ,,of ,,free ,,tribromphenol ,gm4 ,tribromphenol ,calculated from ,per ,cent4 ,gm4 of ,theoretical ,free ,salt ,taken ,factor ,tribromphenol ,research ,council ,spec4 #b4ccea #j4chjf #af4ca ,merck ,co4 #j4gihj #j4jcfd #d4ef ,heyden ,chemical ,works #a4idfj #j4jacb #j4fh ,method #b4--;,about #b gm4 of bismuth tribromphenate were placed in a glass stoppered ,erlenmeyer flask1 #ajj c4c4 of alcohol were measured in and shaken during one-half hour and allowed to stand over night4 ,fifty c4c4 of the supernatant liquid were then removed by means of a pipet1 a slight excess of tenth-normal sodium hydroxid added and the residual alkali titrated with tenth-normal ,h,cl4 ,table #d gives results obtained4 ,,table #d4--,,per ,,cent4 ,,of ,,tribromphenol ,,by ,,method #b ,gm4 ,tribromphenol ,calculated from ,per ,cent4 ,gm4 of ,theoretical ,free ,salt ,taken ,factor ,tribromphenol ,research ,council ,spec4 #b4jgab #j4cije #ah4he ,merck ,co4 #a4idag #j4jgfj #c4ib ,heyden ,chemical ,works #b4jddj #j4jaih #j4ig ,table #e gives a comparison of the results obtained by the two methods4 ,,table #e4--;,,comparison ,,of ,,results ,,by ,,methods #a ,,and #b ,method #a ,method #b ,research ,council ,spec4 #af4ca #ah4he ,merck ,co4 #d4ef #c4ib ,heyden ,chemical ,works #j4fh #j4ig ,the results obtained in ,method #a 7the percolation method7 apparently are reliable and1 as the method is the more simple1 may be given preference4 ,,combined ,,tribromphenol 7,,tribromphenate7 ,the amount of tribromphenol existing in the specimen in combination was calculated by subtracting from the per cent4 of total tribromphenol determined1 the per cent4 of free tribromphenol found by ,method #a4 ,the figures obtained are given in ,table #f4 ,,table #f4--,,the ,,tribromphenate ,,content ,,of ,,bismuth ,,tribromphenate ,per ,cent4 of ,combined ,tribromphenol ,research ,council ,specimen #dc4ac ,merck ,co4 #ec4ai ,heyden ,chemical ,works #bj4cf ,,summary ,from the foregoing the specimens examined contain the percentages shown in ,table #g of bismuth 7,bi71 combined tribromphenate and free tribromphenol4 ,,table #g4--,,percentages ,,of ,,bismuth ,,and ,,of ,,combined ,,tribromphenate ,,and ,,free ,,tribromphenol ,per ,cent4 ,per ,cent4 ,per ,cent4 ,combined ,free ,bismuth ,tribromphenate ,tribromphenol ,research ,council ,specimen #dd4h #dc4ac #af4ca ,merck ,co4 #df4f #ec4ai #d4ef ,heyden ,chemical ,works #fj4g #bj4cf #j4fh ,this examination shows3 #a4 ,the ,bismuth ,tribromphenolate submitted to the ,council of ,national ,defense1 does not correspond to the description of bismuth tribromphenate in ,new and ,nonofficial ,remedies4 #b4 ,as now supplied1 ,xeroform-,heyden does not meet the requirements for bismuth tribromphenate1 nor does its composition correspond to that of the product formerly supplied4 #c4 ,the description in ,new and ,nonofficial ,remedies of bismuth tribromphenate should provide an upper1 as well as a lower1 limit for the bismuth content2 it should provide tests for the absence of adulterants1 and also set a limit of permissible uncombined tribromphenol4 ,report to ,council of ,national ,defense ,the results of this examination with reference to the ,research ,council specimen having been submitted to the ,council on ,pharmacy and ,chemistry1 this body advised the ,medical ,section of the ,council of ,national ,defense as follows3 #a4 ,the specimen of 8,bismuth ,tribromphenolate0 sent to the ,council of ,national ,defense complies with the ,new and ,nonofficial ,remedies description for bismuth tribromphenate1 except that it contains considerable amounts 7approximately #af per cent47 of alcohol-soluble1 uncombined tribromphenol4 ,revision of ,n4 ,n4 ,r4 ,standards ,the results of the examination of the three specimens were sent to the ,heyden ,chemical ,works and to ,merck and ,co4 7in each case disclosing the identity of the particular firm's product71 asking aid in the standardization of the product4 ,after ,merck and ,co4 had submitted valuable advice for a revision of the somewhat loosely drawn standards for bismuth tribromphenate in ,n4 ,n4 ,r41 #aiah1 the inquiry whether the following proposed revision of the description of bismuth tribromphenate in ,new and ,nonofficial ,remedies was acceptable1 was submitted to both firms3 ,,bismuth ,,tribromphenate4--,bismuthi ,tribromphenas4--,bismuth ,tribromphenol4--,xeroform4--,a basic bismuth tribromphenate of variable composition4 ,an amorphous1 yellow1 nearly odorless and tasteless powder1 neutral to moistened litmus paper4 ,it is only slightly soluble in water1 alcohol1 chloroform1 liquid petrolatum and vegetable oils4 ,alkalies and strong acids decompose it4 ,it is stable at temperatures below #abj ,c4 ,when about #a gm4 of the salt is boiled with #aj c4c4 of sodium hydroxide test solution1 the liquid filtered1 and the filtrate acidulated with sulphuric acid1 the white curdy precipitate produced1 when washed and dried1 melts at #ij to #ie ,c4 7tribromphenol74 ,the contents of the filter dissolve completely in dilute hydrochloric acid 7insoluble inert material74 ,boil #a gm4 of bismuth tribromphenate with #bj c4c4 of a mixture of equal parts of acetic acid and distilled water1 cool the solution and filter4 ,free the filtrate from bismuth by the addition of hydrogen sulphide1 boil the mixture and again filter4 ,the latter filtrate leaves not more than #j4jje gm4 of residue on evaporation and gentle ignition 7alkalies and alkali earths74 ,shake for one minute in a separatory funnel1 #b gm4 of bismuth tribromphenate1 #bj c4c4 of ether1 and #bj c4c4 of a mixture of equal volumes of hydrochloric acid and distilled water4 ,draw off the aqueous portion and concentrate to about #d c4c42 pour it into #ajj c4c4 distilled water1 filter1 evaporate the filtrate on the water bath to #cj c4c41 again filter and divide this filtrate into portions of #e c4c4 each4 ,mix one portion with an equal volume of dilute sulphuric acid2 it does not become cloudy 7lead74 ,treat another portion with a slight excess of ammonia water2 the supernatant liquid does not exhibit a bluish tint 7copper74 ,another portion is not immediately affected by barium nitrate test solution 7sulphate74 ,heat gently a mixture of about #j4b gm4 of bismuth tribromphenate with #e c4c4 of potassium hydroxide test solution and about #j4b gm4 of aluminum wire2 the vapors evolved do not turn red litmus blue 7nitrates74 ,shake #a gm4 of bismuth tribromphenate frequently during fifteen minutes with #cj c4c4 of alcohol 7#ie per cent471 filter and rinse flask with two separate #aj c4c4 portions of alcohol1 allowing the washings to run through filter4 ,to the combined filtrate and washings add #bj c4c4 of tenth-normal sodium hydroxide and a few drops of phenolphthalein solution and determine the excess of alkali with tenth-normal hydrochloric acid4 ,not more than #a c4c4 of tenth-normal sodium hydroxide should have been consumed by the alcoholic liquid 7free tribromphenol74 ,add #b c4c4 of nitric acid to #b gm4 of bismuth tribromphenate in a porcelain crucible1 carefully evaporate to dryness on a sand bath and incinerate4 ,dissolve the residue in #e c4c4 of concentrated hydrochloric acid and add to the solution #aj c4c4 of a saturated solution of stannous chloride in concentrated hydrochloric acid4 ,the mixture should not darken on standing thirty minutes 7arsenic74 ,mix #j4e gm4 of the salt with #aj c4c4 of a mixture of equal parts of hydrochloric acid1 ,u4 ,s4 ,p41 and distilled water4 ,no effervescence should occur 7carbonate74 ,to about #j4e gm4 of bismuth tribromphenate1 accurately weighed1 add #bj c4c4 of hydrochloric acid and digest on water bath4 ,add #aej c4c4 of distilled water and filter4 ,rinse the beaker with #cj c4c4 of distilled water and allow the washings to run through the filter4 ,saturate the combined filtrate and washings with hydrogen sulphide1 filter off the bismuth sulphide1 wash and dissolve in hot dilute nitric acid4 ,add a slight excess of ammonia water followed by #b c4c4 of ammonium carbonate test solution4 ,allow to stand thirty minutes1 filter off the precipitated bismuth hydroxide and heat to constant weight at dull red heat4 ,the residue of bismuth oxide 7,bi,o7 should not be less than #de per cent4 nor more than #ee per cent4 of the original weight of bismuth tribromphenate taken1 corresponding to not less than #dj per cent4 nor more than #di per cent4 of bismuth4 ,the ,heyden ,chemical ,works accepted the proposed monograph4 ,regarding the ,laboratory's findings1 the firm stated that 8the product had to be made in this country after importations from ,europe became impossible and the first lots were not fully up to the standard40 ,later the firm stated that it could furnish a product which it considered equal to that which was previously imported and offered to submit 8samples of the new material40 ,merck and ,co4 acknowledged the receipt of the monograph but made no statement as to its acceptance or suggestions for its revision4 ,as the new monograph was accepted by the ,heyden ,chemical ,works and as ,merck and ,co4 offered no objections1 it was adopted for ,n4 ,n4 ,r41 #aiai1 by the ,council on ,pharmacy and ,chemistry4 ,in ,november1 #aiah1 ,merck and ,co4 sent a specimen labeled 8,bismuth ,tribromphenate-,merck10 8,merck and ,co41 ,new ,york1 ,distributors and ,guarantors0 and wrote3 8,you will notice this sample conforms in nearly all details to the tests submitted with our letter of ,june #d4 ,we have been able to produce better goods1 but just at present unsatisfactory starting material confronts us40 ,examination of the specimen demonstrated that it was soluble to a considerable extent in alcohol 7the ,n4 ,n4 ,r41 #aiah1 description provides that it should be only slightly soluble in alcohol7 and1 according to the standards adopted for ,new and ,nonofficial ,remedies1 #aiai1 contained #ah per cent4 of uncombined tribromphenol 7more than five times the permitted amount74 ,in ,december1 #aiah1 ,merck and ,co4 submitted another specimen and said3 8,we believe this is a better grade than we have been able to make in the recent past4 ,it seems to meet all the tests for ,n4 ,n4 ,r41 #aiai1 with two exceptions3 these are 7a7 solubility in alcohol1 and 7b7 the test for uncombined tribromphenol40 ,when the two recent samples of bismuth tribromphenate-,merck and two samples of ,xeroform-,heyden were examined according to the new monograph the results given in ,table #h were obtained4 ,,table #h4--;,,examination ,,of ,,tribromphenate ,,and ,,xeroform #a4 ,,bismuth4 ,weight of ,per ,cent4 ,weight ,bi,o of ,brand and ,date ,received ,taken1 ,obtained1 ,bismuth1 ,gm4 ,gm4 ,gm4 ,xeroform-,heyden 7from mfr47 ,july1 #aiah #j4fged #j4cefe #dg4b ,xeroform-,heyden 7open market7 ,july1 #aiah #j4hbei #j4faef #ff4g ,bismuth tribromphenate-,merck ,nov41 #aiah #j4dhhb #j4beab #df4a ,bismuth tribromphenate-,merck ,dec41 #aiah #j4hhfi #j4ddie #de4e #b4 ,,uncombined ,,tribromphenol4 ,no4 ,c4c4 ,per ,cent4 ,weight of ,tenth- of ,free ,brand and ,date ,received ,taken1 ,normal ,na,o,h ,tribrom- ,gm4 ,consumed1 phenol ,c4c4 ,xeroform-,heyden 7from mfr47 ,july1 #aiah #a #g4d #bd4e ,xeroform-,heyden 7open market7 ,july1 #aiah #a #j4g #b4c ,bismuth ,tribromphenate-,merck ,nov41 #aiah #a #e4g #ah4h ,bismuth ,tribromphenate-,merck ,dec41 #aiah #a #e #af4e ,in view of the laboratory's report the referee of the ,council on ,pharmacy and ,chemistry in charge of bismuth tribromphenate recommended that the acceptance of ,xeroform-,heyden and bismuth tribromphenate-,merck be withdrawn1 but that this should be without prejudice to their reinstatement when satisfactory products are again offered for sale4 ,the ,council adopted the recommendation of the referee and accordingly ,xeroform-,heyden and bismuth tribromphenate-,merck are omitted from ,new and ,nonofficial ,remedies1 #aiai4 ,when the laboratory's findings with regard to ,xeroform-,heyden and the action of the ,council deleting the article from ,new and ,nonofficial ,remedies was reported to the ,heyden ,chemical ,works1 the firm expressed regret that efforts to produce a product equal to that formerly obtained from ,germany had so far not been successful and announced that it had decided to withdraw ,xeroform-,heyden from the market for the present4 ,when ,merck and ,co4 was advised in regard to the report of the laboratory and ,council's action1 this firm questioned the feasibility of producing a product meeting the ,council's standards and suggested that the test for free tribromphenol be revised to permit as much as #ae per cent4 of this constituent4 ,when ,merck and ,co4 was reminded that its product submitted in #aiae essentially complied with the adopted standards 7an old sample of ,xeroform-,heyden was also found to comply7 and that the estimate of the therapeutic value of bismuth tribromphenate is based on a product essentially devoid of free tribromphenol1 the firm replied3 8,as stated in our letter of the #abth inst41 we do not wish to market the chemical unless it meets all legitimate requirements of the physicians that use it4 ,if1 therefore1 your standard proves to be good and it is commercially possible to make supplies conforming to it1 we shall do so4 ,we shall discontinue the article unless it is of suitable quality40--7,from ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiah1 p4 #ic47 ,,the ,,standardization ,,of ,,procain ,,and ,,examination ,,of ,,the ,,market ,,supply ,procain1 which chemically is the mono-hydrochlorid of para-amino-benzoyldiethyl-amino-ethanol1 is the nonproprietary name selected by the ,federal ,trade ,commission as the official designation for the drug previously known under the proprietary name 8novocaine40 ,before the war procain was obtainable in this country only through the ,farbwerke ,hoechst ,co41 the ,american representative of the ,german establishment1 ,farbwerke1 vorm1 ,meister1 ,lucius and ,bruening1 under the name 8novocaine40 ,this monopoly on 8novocaine0 was exercised by virtue of ,united ,states patent ,no4 #habeed1 which was issued to ,alfred ,einhorn1 ,munich1 ,germany1 assignor to ,farbwerke1 vorm1 ,meister1 ,lucius and ,bruening1 ,hoechst a4 ,m41 in #aijf4 ,with the outbreak of hostilities1 ,congress passed the ,trading with the ,enemy ,act1 and under this1 the ,federal ,trade ,commission took charge of the novocain patent with a view of securing the production of this product in the ,united ,states4 ,to ensure an adequate supply of the drug1 the ,federal ,trade ,commission on recommendation of the ,committee on ,synthetic ,drugs of the ,national ,research ,council1 in addition to issuing a license to the ,farbwerke ,hoechst ,company 7which license was later transferred to the ,h4 ,a4 ,metz ,laboratories7 granted authority to the ,abbott ,laboratories and the ,rector ,chemical ,company to manufacture it under the ,u4 ,s4 patent after specimens submitted by these firms had been found satisfactory in the ,association's laboratory and at the ,cornell ,pharmacologic ,laboratory4 ,when the first specimen of ,american made procain was sent to the ,american ,medical ,association ,chemical ,laboratory it was necessary to work out adequate standards4 ,the standards were formulated on the basis of the novocain monograph in the ,german ,pharmacopeia1 #aiaj1 ,ed4 #e1 p4 #cfc1 ,remedia 8,hoechst10 p4 #bdb1 and ,new and ,nonofficial ,remedies1 #aiah1 p4 #cb1 and the work carried out in this laboratory4 ,the following description has been adopted for ,new and ,nonofficial ,remedies1 #aiai1 and all specimens of procain were subjected to these tests3 ,procain occurs in small colorless and odorless crystals1 or a crystalline powder which if placed on the tongue produces a transient sense of numbness4 ,it melts at #aec-aee ,c4#bab #bab ,u4 ,s4 patent number #hab1eed--the novocain patent--declares that the salt melts at #aef ,c4 ,evidently based on this1 the ,german ,pharmacopoeia ,remedia 8,hoechst0 and past editions of ,new and ,nonofficial ,remedies give this melting point4 ,two specimens of ,german made novocain obtained from our files1 stated to be manufactured by ,farbwerke-,hoechst vorm4 ,meister1 ,lucius and ,bruening1 ,hoechst a4,m4 were found to melt1 respectively1 between #aed and #aee ,c4 and between #aec4e and #aed4e ,c4 when the melting point was determined according to the directions of the ,u4 ,s4 ,pharmacopoeia1 #ith revision4 ,the various specimens examined at that time melted between #aec and #aee ,c4 and it was decided to permit this range4 ,one gm4 of procain is soluble in #j4g c4c4 of water and in #bj c4c4 of alcohol ,u4 ,s4 ,p4 7#ie per cent47 at #bj ,c4 ,from the aqueous solution1 which is neutral1 alkali hydroxids and carbonates precipitate the free base in the form of a colorless oil1 which soon congeals to a crystalline mass1 but solutions of sodium bicarbonate are miscible with solutions of procain without producing precipitations or turbidity4 ,dissolve #a gm4 of procain in water4 ,separate portions of the solution yield a white precipitate with potassium mercuric iodid solution1 a white precipitate with mercuric chlorid test solution1 a brown precipitate with iodin test solution and a yellow precipitate with picric acid test solution4 ,acidify a portion with dilute nitric acid4 ,a white curdy precipitate is thrown down on the addition of silver nitrate test solution4 ,dissolve about #j4a gm4 of procain in #e c4c4 of water1 add #b drops of dilute hydrochloric acid and #b drops of sodium nitrite solution 7#aj per cent47 and mix with a solution of #j4b gm4 of betanaphthol in #aj c4c4 of sodium hydroxid solution 7#aj per cent474 ,a scarlet red precipitate is thrown down4 ,to a solution of about #j4a gm4 of procain in #e c4c4 of water add #c drops of dilute sulphuric acid and mix with #e drops of potassium permanganate test solution4 ,the violet color of the latter disappears immediately 7distinction from cocain74 ,dissolve about #j4a gm4 procain in #a c4c4 sulphuric acid ,u4 ,s4 ,p4 ,the solution is colorless 7organic impurities74 ,dissolve #j4a gm4 of the salt in #aj c4c4 of water and saturate with hydrogen sulphid4 ,no coloration or precipitation occurs 7salts of the heavy metals74 ,incinerate about #j4e gm4 of procain accurately weighed4 ,not more than #j4a per cent4 of residue remains4 ,to obtain specimens representing the market supply1 orders for the three brands of procain were placed with pharmaceutical firms in ,new ,york1 ,baltimore and ,san ,francisco4 ,the ,baltimore and ,san ,francisco firms supplied specimens of procain-novocain brand and procain-,rector brand but reported that the ,abbott brand was not procurable4 ,the ,new ,york correspondent was able to supply procain-,rector only4 ,as the entire output of the ,abbott ,laboratories was stated to go to the government1 specimens of this product were obtained through the surgeon-general of the army from the general purchasing office1 ,medical ,dept41 ,u4 ,s4 ,army4 ,the following specimens were obtained and examined3 #a4 ,procain-,abbott1 #f specimens3 ,the first specimen bore no serial number but the five later specimens were designated respectively1 ,no4 #hiiii1 ,no4 #hiiih1 ,no4 #hiiig1 ,no4 #hiiif1 and ,no4 #hajiie1 representing batches from which shipments are to be made on contracts placed by the general purchasing office1 ,medical ,department1 ,u4 ,s4 ,army1 with the ,abbott ,laboratories of ,chicago4 #b4 ,procain-novocain brand1 #d specimens3 ,these were designated respectively1 ,a#ef1 ,a#eg1 ,a#fc1 and ,a#fg4 ,the first two specimens were labeled 8,manufactured by the ,farbwerke-,hoechst ,co4 at the ,h4 ,a4 ,metz ,laboratories40 ,the third specimen 7not in original container7 was labeled 8,h4 ,a4 ,metz ,laboratories0 and the fourth was marked 8,manufactured by the ,h4 ,a4 ,metz ,laboratories40 #c4 ,procain-,rector1 #c specimens3 ,each bore the statement 8,manufactured by the ,rector ,chemical ,company0 but had no 8lot number40 ,from this examination it appears that all the specimens of procain received complied satisfactorily with all tests of identity and purity with the following exceptions3 7#a7 ,one specimen of procain-,abbott had a melting point slightly below the permitted range2 however1 the last five specimens had the required melting point4 7#b7 ,five specimens of procain-,abbott and the last three specimens of procain-,rector were not entirely colorless1 but had a yellow or light brown tinge4 ,the toxicity experiments1 which were carried out by ,dr4 ,r4 ,a4 ,hatcher of the ,cornell ,pharmacologic ,laboratory1 were reported as being satisfactory4 ,when the ,council on ,pharmacy and ,chemistry referred the matter of the discolored specimens of procain to the ,rector ,chemical ,company for explanation1 the firm wrote that for a short time for some unexplainable reason its procain had been slightly yellowish in color1 but that every batch had been carefully tested and found to answer all chemical requirements4 ,the firm stated that the product which it had sent out for some time past had been white and yielded a colorless solution4 ,to a like inquiry from the ,council the ,abbott ,laboratories replied that the five samples which were found discolored were products manufactured by the ,rector ,chemical ,company and represented goods which it had purchased to assist in filling delayed orders1 because the firm had found itself unable to keep pace with the demand on account of delay in securing needed apparatus4 ,the firm submitted protocols to show that the procain made by it1 by ,rector and by ,metz were of equal toxicity4 ,in the accompanying table the results of the examination are given4 ,for comparison the findings for the specimens examined previously are included4 ,date ,melting ,ash ,brand ,received ,color ,point1 ,c4 ,procain 7,abbott71 from ,committee on ,synthetic ,drugs #ab_/ba_/ag ,white #aed-aee ,none ,procain 7,abbott71 submitted to ,council ,p4 and ,c #a_/bi_/ah ,white #aec4e-aed4e ,none ,procain 7,abbott71 ,gen4 ,pur4 ,off4 ,u4 ,s4 ,army #h_/ca_/ah ,white #aeb4e-aec4e ,none ,procain 7,abbott71 ,gen4 ,pur4 ,slight ,off4 ,u4 ,s4 ,army1 ,no4 #hiiii #i_/cj_/ah brownish #aec4e-aed4e ,none tint ,procain 7,abbott71 ,gen4 ,pur4 ,slight ,off4 ,u4 ,s4 ,army1 ,no4 #hiiih #i_/cj_/ah brownish #aec-aed4e #j4jje tint ,procain 7,abbott71 ,gen4 ,pur4 ,slight ,off4 ,u4 ,s4 ,army1 ,no4 #hiiig #aj_/ #h_/ah brownish #aec-aed ,none tint ,procain 7,abbott71 ,gen4 ,pur4 ,slight ,off4 ,u4 ,s4 ,army1 ,no4 #hiiif #aa_/ #d_/ah brownish #aec4e-aed4e ,none tint ,procain 7,abbott71 ,gen4 ,pur4 ,slight ,off4 ,u4 ,s4 ,army1 ,no4 #hajiie #aa_/ #d_/ah brownish #aec4e-aed4e ,none tint ,procain 7,farbwerke ,hoechst ,co471 submitted to ,council #aj_/bd_/ag ,white #aec-aed ,none ,procain 7,farbwerke ,hoechst ,co471 submitted to ,council #ab_/aj_/ag ,white #aec-aed4e ,none ,procain 7,farbwerke ,hoechst ,co471 submitted to ,council1 market spec4 8,a#ef0 #h_/ #i_/ah ,white #aec4e-aed4e ,none ,procain 7,farbwerke ,hoechst ,co471 submitted to ,council1 market spec4 8,a#eg0 #i_/ #i_/ah ,white #aec4e-aed4e ,none ,procain 7,h4 ,a4 ,metz ,lab471 market spec4 8,a#fc0 #h_/bc_/ah ,white #aec-aed ,none ,procain 7,h4 ,a4 ,metz ,lab471 market spec4 8,a#fg0 #i_/bc_/ah ,white #aec-aed #j4jah ,procain 7,rector71 from ,com4 on ,synthetic ,drugs #ab_/ah_/ag ,white #aec-aed4e ,none ,procain 7,rector71 market ,slight spec4 #h_/bj_/ah brownish #aec-aee ,none tint ,procain 7,rector71 market ,slight spec4 #h_/bc_/ah brownish #aec-aee ,none tint ,procain 7,rector71 market ,slight spec4 #h_/bc_/ah brownish #aec-aed4e ,none tint ---------------------------------------- ---------------------------- ,so far as the evidence goes1 there was nothing to indicate that the yellowish or brownish colored specimens of procain were seriously impure4 ,on the contrary1 the compliance with the chemical and toxicologic tests indicated that the color was due to an insignificant trace of some colored substance produced in the manufacturing process4 ,in view of this1 the ,council considered the use of the discolored product to be justified in the present emergency1 although it urged that the future supply of procain should be free from color and also comply to the tests of purity4 ,it made this request in the interest of the medical and dental professions1 which use the drug1 and also in a desire that in the manufacture of synthetic drugs1 the ,united ,states should occupy a high place4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #aa1 #aiai1 with additions47 ,,deterioration ,,of ,,sodium ,,hypochlorite ,,solutions 78,chlorinated ,soda0 ,solutions7 ,the following note on two hypochlorite solutions is published as a slight addition to the inconclusive available information concerning the rate of deterioration of solutions containing sodium hypochlorite3 ,hyclorite4--,this is a solution of chlorinated soda1 #ajj gm4 of which is said to contain sodium hypochlorite #d4je gm41 sodium chlorid #c4bj gm41 calcium hydroxid #j4be gm41 inert ingredients #j4ib gm4 ,it is declared to contain1 when placed on the market1 not less than #c4he per cent4 of available chlorin1 and to deteriorate at the rate of about #ab per cent4 per year4 ,in order that the available chlorin content at the time of use may be judged1 the date of bottling is stamped on each package4 ,the solution is prepared by decomposing chlorinated lime suspended in water with sodium carbonate and adding to the solution obtained a freshly prepared solution of electrolyzed sodium chlorid4 ,the composition and keeping qualities of hyclorite were reported on by this laboratory 7,ann4 ,rep4 ,chem4 ,lab41 ,a4 ,m4 ,a4 #i3abc1 #aiaf74 ,hyclorite is fully described in ,new and ,nonofficial ,remedies1 #aiah1 p4 #aec4 ,to further check the keeping qualities of hyclorite1 a specimen received from the manufacturer in ,june1 #aiah1 and said to have been bottled in ,april1 #aiah1 was examined in ,september1 #aiah4 ,it was found to contain #c4f per cent1 8available chlorin0 7equivalent to #c4gi gm4 sodium hypochlorite in #ajj gm474 ,this indicated a loss of #f4b per cent4 during five months 7equivalent to #ad4i per cent4 per year7 on the assumption that it contained the amount of 8available chlorin0 declared on the label4 ,concentrated ,solution ,sodium ,hypochlorite-,mulford4--,this is described as a #e per cent1 aqueous solution of sodium hypochlorite containing free chlorin equivalent to from #j4b to #a per cent4 sodium hypochlorite4 ,it is prepared by treating a solution of sodium carbonate and sodium bicarbonate with chlorinated lime4 ,the solution is filtered and standardized by determining the 8available chlorin0 and adjusting it to contain the equivalent of #e per cent4 of sodium hypochlorite4 ,it is proposed for use in the irrigation treatment of infected wounds after dilution with nine times its volume of water and the addition of a determined amount 7stated on the label of each bottle7 of boric acid to render it neutral to phenolphthalein4 ,the manufacturer has found that development of a red color 7due to formation of permanganate from the manganese contained in the chlorinated lime7 is indicative of deterioration1 and therefore warns against any solution which has become pink4 ,a specimen of concentrated solution of sodium hypochlorite-,mulford was sent the ,council on ,pharmacy and ,chemistry in ,june1 #aiag1 with a view of having the product admitted to ,new and ,nonofficial ,remedies4 ,at that time it was found to contain #d4ah per cent4 8available chlorin0 7equivalent to #d4d gm4 sodium hypochlorite in #ajj gm474 ,another specimen received at the same time and kept unopened in a dark place1 was examined in ,september1 #aiah1 and was found to contain #b4hh per cent4 available chlorin 7equivalent to #c gm4 sodium hypochlorite per #ajj gm474 ,on the assumption that the second specimen contained1 at the time of its receipt1 the amount of 8available chlorin0 found in the first1 this second specimen lost #ca per cent4 of its 8available chlorin0 during fifteen months4 ,at the time the specimens were received from the ,mulford ,company1 the firm reported experiments which were under way to determine the keeping qualities of the solution4 ,these experiments indicated marked deterioration of the specimens1 which had become red from permanganate formation1 and also that one specimen1 which had not become red1 had lost #e per cent4 of its available chlorin in one month4 ,the ,mulford ,company explained that when sufficient data had been accumulated1 a decision would be made either as to placing a time limit on the solution or making a claim as to the rate of deterioration4 ,when the extreme deterioration found by this laboratory was reported to the ,mulford ,company1 the firm replied that this was a much greater loss than the average deterioration found in its chemical laboratory1 namely1 an average of #aj or #ab per cent4 per year4 ,it advised that because of the instability of concentrated solution of sodium hypochlorite1 its manufacture had been discontinued4--7,from ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiah1 p4 #ha47 ,,syphilodol ,the shortage of arsphenamin 7salvarsan7 has made the sale of substitutes a profitable business4 ,in many of these substitutes the earmarks of dishonesty have been obvious1 so that detection of their falsity was relatively simple4 ,in the case of 8,syphilodol0 marketed by the ,french ,medicinal ,company1 ,inc41 ,new ,york1 the deception has been practiced more skilfully4 ,in the circular announcing their preparations1 we read3 8,it seems fitting at this time1 when the ,american physicians are doing so much for ,france1 that there should be a reciprocation in some way4 8,attempting to enhance somewhat this mutual interchange1 we are presenting some of those scientific products1 which have been so successfully used in ,france1 ----0 8,the effect of ,,syphilodol is very similar to salvarsan and neosalvarsan1 but it has the advantage of being more lasting in its results and more pleasing in the manner of its preparations1 in that it is put up in the form of tablets1 and1 also1 in hermetically closed glass syringes or ampules1 so that it may be administered either by the mouth1 intravenously or intramuscularly1 at the discretion of the physician4 ,patients averse to the use of the hypodermic needle may be treated expeditiously by the use of the tablet form of the medicine40 ,in addition to ,syphilodol1 the ,french ,medicinal ,co4 also sells 8,vichi ,fruti10 a combination of salts1 8,urodol10 an 8alkaline salt of the famous ,european ,springs which is noted for breaking up and dissolving uric acid rapidly0 and 8,syloiodol10 8,french ,preventive10 which is described as 8a solution of iodol incorporated into bougie40 8,syphilodol10 we are told1 is 8a synthetic chemical product of silver1 arsenic and antimony1 scientifically prepared after the formula of the late ,dr4 ,alfred ,fournier of ,paris40 7,italics ours--,ed474 ,it is also claimed that 8,prof4 ,metchnikoff and other noted ,french scientists have made exhaustive tests of syphilodol and found it superior to the other products1 in the treatment of syphilis40 ,in the advertisements1 ,fournier and ,metchnikoff are the only names given of alleged endorsers2 both of these men are dead and cannot protest4 ,true1 ,fournier did considerable work on a legitimate synthetic of antimony1 silver and arsenic having a general chemical constitution similar to arsphenamin1 but so far as we are aware1 there has been no publication by these men on 8,syphilodol40 ,it would seem that the valuable work and high reputation of ,fournier and ,metchnikoff are being capitalized by the ,french ,medicinal ,company in their endeavor to foist a nostrum on the medical profession of this country4 8,syphilodol0 comes in two forms--ampules and tablets4 ,an order for two #j4d ampules brought an elaborate case1 much like those used to hold the popular style safety razors4 ,the ampule itself was a 8classy0 affair evidently made by a glass expert2 the hypodermic needle was enclosed in a novel sealed glass device4 ,the price of each ampule is #c4 ,no such fancy garnishments came with the tablets1 although they are listed at #d4ej for twenty-five--#ah cents a tablet6 ,in the 8,syphilodol0 advertising it is emphasized that both the tablets and ampules are to be administered4 ,for example3 8,syphilodol is dispensed in the form of tablets and also hermetically closed glass syringes or ampules so that it may be used either by the mouth1 intravenously or intramuscularly at the discretion of the physician4 ,an advantage of the tablets is that they can and should be given during the interim between the injections40 ,,laboratory ,,report ,,on ,,syphilodol ,several samples of 8,syphilodol0 were sent to the ,american ,medical ,association ,chemical ,laboratory by readers of ,the ,journal4 ,an original bottle of tablets was ordered direct from the ,french ,medicinal ,company4 ,the bottle contained #be yellow tablets1 having an average weight of #j4bgf gm4 7#d-a_/d grains74 ,after being powdered1 8,syphilodol0 was found to be only partially soluble in water 7the excipient is soluble7 and to be neutral in reaction4 ,these findings contradict the claims on the circular accompanying the bottle to the effect that 8,syphilodol is a yellow powder1 soluble in water1 and has an acid reaction40 ,qualitative tests indicated the presence of mercury1 sucrose 7cane sugar71 iodid1 calcium1 sulphate1 fatty material1 a trace of silver1 a trace of arsenic and a very minute trace of antimony2 a red dye was also present4 ,both qualitative and quantitative data showed that the mercury was present in the form of mercurous iodid 7yellow iodid of mercury--hydrargyri iodidum flavum74 ,quantitative estimations yielded the following3 ,silver 7,ag7 #j4jja per cent4 ,mercury 7,hg7 #aa4a per cent4 ,iodid 7,i-7 #g4h per cent4 ,sucrose 7cane sugar7 #gb4j per cent4 ,ash 7calcium sulphate7 #b4e per cent4 ,ether-soluble material 7fatty material--petrolatum7 #c4e per cent4 ,thus each tablet of 8,syphilodol0 contains approximately1 #c_/d grain of mercurous iodid4 ,an ampule of 8,syphilodol10 labeled #j4d gram1 contained approximately #a4e c4c4 of a liquid which after evaporation on a water-bath left a residue weighing #j4h mg41 or #a_/hj grain4 ,a second ampule held about #b c4c4 of liquid1 which contained a trace of arsenic 7less than #j4jjjja gm41 or #a_/fjjj grain72 a very small amount of mercury was indicated but not definitely established4 ,the liquid had the physical characteristics of water4 ,accompanying 8,syphilodol0 advertising sent to physicians is a circular letter inviting the doctor to become a member in the 8,united ,states ,bacteriological and ,research ,institute40 ,the 8institute0 seems to be a means of suggesting that the physician have bacteriologic1 pathologic and serologic examinations made on behalf of his patients4 ,in view of the fact that it is to the commercial interest of the ,french ,medicinal ,company to have as many users of 8,syphilodol0 as possible1 it would be interesting to know what proportion of the ,wassermann tests are reported negative4 ,shorn of its mystery1 ,syphilodol the 8synthetic chemical product of silver1 arsenic and antimony0 is essentially mercurous iodid--yellow iodid of mercury4 ,details of ,analysis ,,syphilodol ,,tablets ,in ,france there has been on the market for some time a synthetic compound of silver1 arsenic and antimony having the general structure of arsphenamin4 ,structurally1 the formula as given by ,bonard1 ,danyss and ,tournier is 7,c,h,n,as7 #b;,ag,br,sb,o 7,h,,so7--dioxy diamino arsenobensolstibicosilver sulphate4 ,as the advertising matter for 8,syphilodol0 referred to the synthetic compound of silver1 antimony and arsenic1 and also to its use in syphilis by ,fournier1 the above compound was first suspected4 ,however1 the general characteristics of syphilodol tablets1 such as partial solubility in water1 but not soluble in sodium hydroxid1 sodium bicarbonate or acids1 threw doubt on the hypothesis4 ,when a small amount of the powdered tablets was treated with water1 a yellow residue could be filtered off2 the filtrate was pink1 opalescent1 which on standing gave a clear pink solution1 and a small yellow precipitate4 ,the residue1 when allowed to remain in sulphuric acid solution 7#bj per cent47 over night became red2 on boiling1 the red precipitate with sulphuric acid1 the precipitate volatilized and could be condensed in a watch glass4 ,adding a pinch of manganese dioxid to the hot sulphuric acid mixture caused an evolution of iodin fumes4 ,a small amount of powdered syphilodol tablets was placed in the sunlight2 they turned from yellow to black4 ,all these reactions are typical of mercurous iodid--yellow iodid of mercury4 ,,mercury1 ,,silver1 ,,arsenic1 ,,antimony ,i4 ,mercury4--,two methods were used to determine the mercury3 7a7 #a4dece gm4 of powdered syphilodol was treated with #aj c4c4 of a #ej per cent4 sodium sulphid solution4 ,the solution was then transferred with washings 7about #bj c4c47 to a cathode cup1 previously weighed with its contained mercury4 ,the mercury compound was electrolyzed by a current of about #h volts and #c amperes1 using a rotating anode4 ,the solution 7and some sulphur suspension7 was removed by siphon1 pouring in water until the amperage of the current was close to zero 7,u4 ,s4 ,p41 ,,ix1 p4 #ehg74 ,the increased weight in mercury was #j4afab gm4 ,,ii4 ,to serve as a check on the foregoing method1 mercury was also determined in the following method1 which also allowed systematic tests for silver1 antimony and arsenic4 7b7 #a4ajbc gm4 of the sample was placed in an ,erlenmeyer flask1 #ej c4c4 of water1 #ej c4c4 of sodium hydroxid solution 7#aj per cent47 and #bj c4c4 of formaldehyd solution1 ,u4 ,s4 ,p41 added4 ,the solution was boiled for ten minutes and maintained at temperature of steam bath for two hours4 7,this reduces the mercury salt to mercury and any silver salt to silver2 antimony would probably be likewise reduced47 ,the precipitated mercury was transferred by water1 and concentrated nitric acid added4 7,the nitric acid solution is boiled to oxidize all mercurous nitrate to mercuric nitrate47 ,a small white precipitate was obtained at this point which seemed to be insoluble in aqua regia 7calcium sulphate74 ,the filtrate from this precipitate1 which was washed well1 was tested with one or two drops of dilute hydrochloric acid and a faint precipitate formed2 this was filtered off through extra fine filter paper and washed repeatedly4 ,the paper and precipitate was heated with potassium cyanid solution over night1 filtered and the filtrate electrolyzed in a platinum dish4 ,the increase in weight of the dish was #j4jjjah gm41 or #j4jja per cent4 ,into the platinum dish some nitric acid was poured1 then diluted1 and a drop of hydrochloric acid added4 ,a turbidity was produced which cleared on the addition of excess of ammonium hydroxid solution 7silver74 ,the filtrate from the nitric acid treatment was electrolyzed1 this time in a platinum dish1 and the liquid carefully removed1 washed carefully with redistilled alcohol and ether4 ,the mercury1 which could be seen easily by the naked eye1 weighed #j4abjj gm41 equivalent to #aj4hi per cent4 of mercury4 ,,iii4 ,arsenic and ,antimony4--,about #c gm4 of the powdered specimen was digested with sulphuric acid in a ,kjeldahl flask4 ,one-half portion 7which was evaporated almost to dryness and treated with #e c4c4 of concentrated hydrochloric acid7 was submitted to treatment with hydrogen sulphid1 diluted1 and saturated with hydrogen sulphid4 ,the precipitate was treated in the usual manner of the group separation with warm ammonium sulphid solution4 ,the filtrate from this treatment was acidulated with hydrochloric acid1 the precipitate removed1 and treated with concentrated hydrochloric acid4 ,the substance insoluble in hydrochloric acid was treated with more concentrated hydrochloric acid and a crystal of potassium chlorate4 ,the solution was tested after the ,gutzeit method of the ,pharmacopeia ,,ix1 for arsenic4 ,a very small amount was indicated4 ,the hydrogen sulphid test was not indicative4 ,the solution which might contain the antimony was tested with hydrogen sulphid4 ,in one case only was a slight orange coloration produced4 ,no antimony was deposited on platinum foil in the presence of granulated zinc4 ,these tests were run in triplicate4 ,iodid4--,iodid was determined by the ,carius method 7a7 #j4gdab gm4 yielded #j4aaab gm4 silver iodid1 equivalent to #h4ji per cent42 7b7 #j4ecai gm4 yielded #j4jgea gm41 equivalent to #g4hj per cent4 ,the iodid and mercury were in proportions comparable to mercurous iodid4 ,ash4--7a7 #j4iaei gm4 when ignited to constant weight yielded #j4jbcb gm41 equivalent to #b4eb per cent4 ash2 7b7 #a4cjjh gm4 treated with water and the residue filtered on a ,gooch filter and ignited4 ,the ash of the residue was #b4ea per cent4 7the mercurous iodid volatilized74 ,the ash was calcium sulphate4 ,sucrose4--#a4cjjh gm4 of the sample was treated with water and filtered by suction through a ,gooch crucible4 ,the filtrate and washing were carefully transferred to #ejj c4c4 volumetric flask1 and allowed to stand one week2 #ej c4c4 portions were used to determine sugar according to the ,daufresne-,o',sullivan method4 ,the weights of cupric oxid averaged #baj mg41 or #gb per cent4 ,ether ,soluble ,material4--#a4fiih gm4 of the powdered specimen was extracted with ether and the ether extract evaporated to dryness4 ,the residue weighed #j4jfjj gm41 equivalent to #c4ec per cent4 ,,syphilodol ,,ampules ,water4--,the liquid from one ampule was distilled over very carefully4 ,the freezing point of the liquid was #j4a ,c41 and it was neutral to methyl orange and phenolphthalein4 ,arsenic4--,the contents of one ampule was placed in a small florence flask1 #bj c4c4 of concentrated sulphuric acid added and heated to #gj ,c42 #j4e gm4 of potassium permanganate was added in small amounts4 ,the procedure was then carried on as described by ,engelhardt and ,winters in ,j4 ,am4 ,pharm4 ,assn41 #aiae1 p4 #adfi4 ,to the mixture from #e to #aj c4c4 of hydrogen peroxid solution were added drop by drop until the color had disappeared4 ,the liquid was diluted with #bj c4c4 of water1 boiled fifteen minutes1 diluted again and boiled fifteen minutes1 then cooled and made up to exactly #ajj c4c4 ,a blank was also run alongside4 ,five c4c4 of this solution was then tested quantitatively for arsenic according to the ,u4 ,s4 ,p4 ,,ix method1 using all precautions4 ,comparisons of stains showed less than #j4jjjja gm4 of arsenic 7,as74--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ah1 #aiah47 ,,cerelene ,cerelene1 a paraffin preparation for the treatment of burns1 was submitted to the ,council by the ,holliday ,laboratories1 with the statement that it was composed of #hd per cent4 paraffin1 #ae per cent4 myricyl palmitate1 and #a per cent4 purified elemi gum to which is added oil of eucalyptus #b per cent4 and betanaphthol #j4be per cent4 ,it was explained3 8,myricyl ,palmitate is a purified form of ,beeswax1 free from all impurities1 acids1 etc41 which is solely manufactured by this ,company44440 ,it was also stated that on 8special order0 ,cerelene has been made containing oil of eucalyptus and resorcin1 oil of eucalyptus and picric acid1 and picric acid alone4 ,the following report on the preparation was presented to the ,council by the referee to whom ,cerelene had been assigned3 ,cerelene is another compound wax for the treatment of burns4 ,according to the work of ,sollmann 7,j4 ,a4 ,m4 ,a4 #fh3agii1 #aiag7 it is highly improbable that compound mixtures have any advantage over simple paraffin of low melting point4 ,cerelene must therefore be considered as an unessential modification of paraffin1 and as in conflict with ,rule #aj1 unless definite evidence of superiority be submitted4 ,cerelene mixtures containing medicinal ingredients also appear unscientific since the evidence that the ingredients do not leave the wax has not been successfully contradicted4 ,finally1 the claims made for ,cerelene are rather extreme1 and would need some revision before they could be accepted4 ,the ,a4 ,m4 ,a4 ,chemical ,laboratory reports3 ,the physical properties of ,cerelene are as follows3 ,melting point by ,u4 ,s4 ,p4 method #ej4j ,c4 ,ductility limit #cj4e ,c4 ,plasticity limit #bf4d ,c4 ,not strong at #ch4j ,c4 ,adheres moderately well2 detaches with 8pulling40 ,on heating1 readily loses eucalyptol1 and a small amount of resinous substance forms in the bottom of the beaker4 ,if ,cerelene be heated to #ade ,c4 and cooled1 the resulting product no longer has the properties of the original ,cerelene4 ,after two years' delay on the part of the manufacturer1 the ,council authorized publication declaring ,cerelene inadmissible for ,new and ,nonofficial ,remedies because its superiority over single paraffins had not been demonstrated and the unwarranted claims had not been abandoned4--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ae1 #aiai47 ,,dr4 ,,de ,,sanctis' ,,rheumatic ,,and ,,gout ,,pills ,dr4 ,de,sanctis' ,rheumatic and ,gout ,pills are sold by ,edward ,cleaver1 #ac ,clerkenwell ,road1 ,london1 ,england4 ,the ,american agents are ,e4 ,fougera and ,co41 ,inc41 ,new ,york4 ,the package is a round pill box and contains twelve pills and a circular1 which directs that one pill be taken every eight hours until relieved4 ,in the package there is also a circular advertising ,dr4 ,de,sanctis' ,gout and ,rheumatic ,paint1 with directions for its use4 ,on the cover of a box1 which contained six of the retail packages1 is the statement that these pills have been in general use for nearly #ajj years1 and that their sale has been built up without advertising4 ,de,sanctis' pills are round1 uncoated1 and have a light brown color4 ,there was some variation in the color of different lots1 one lot in particular being gray rather than brown4 ,a little arrowroot starch was found in each box1 this evidently having been used as a dusting powder4 ,the pills were very hard1 rather brittle1 but quite difficult to powder4 ,the pills were not readily disintegrated by water or diluted acids1 even when warmed1 but when warmed with a dilute sodium hydroxid solution they readily disintegrated4 ,ten pills weighed #c4bac gm41 an average of #j4cbac gm41 or #e grains4 ,the arrowroot starch used as a dusting powder was removed as completely as possible by rolling the pills in a cloth4 ,several dozen pills were then powdered and the powder thus obtained used for the analysis4 ,a microscopic examination of the powder showed powdered colchicum seed in abundance and also traces of arrowroot starch1 no doubt from that used as the dusting powder4 ,since colchicum seed was so abundant1 the powder was assayed by the ,u4 ,s4 ,pharmacopeial method for colchicum seed 7,u4 ,s4 ,p4 ,,ix1 p4 #abj71 slightly modified so that less of the powdered pills than directed there could be used4 ,in one assay #c4ge gm4 gave #j4jbjd gm4 of colchicin or #j4ed per cent4 ,in a duplicate1 #e gm4 gave #j4jbcd gm4 of colchicin or #j4dg per cent42 average #j4e per cent4 ,the alkaloid obtained had the characteristic appearance and odor of colchicin when separated from the seed under these conditions4 ,the solution in water and acid was yellow2 the aqueous solution was intensely bitter1 and the yellow color intensified with acids4 ,the dry residue became intensely yellow with concentrated sulphuric acid2 with nitric acid it became violet turning to yellow1 and with concentrated sulphuric acid and potassium nitrate it gave a yellowish green color1 turning to violet and finally to a wine color4 ,all these reactions are typical of colchicin4 ,from #a gm4 of the powdered pills there was obtained #j4jdbe gm4 of ash1 or #d4be per cent4 ,when the powdered pills were extracted with chloroform in a ,soxhlet apparatus1 a very uniform quantity of extract was obtained4 ,from #e gm4 there was obtained1 in one case1 #j4eha gm42 in another1 #j4egee gm41 and in a third1 #j4ehh gm41 the average being #j4ehae gm4 or #aa4fc per cent4 ,on still further extracting with alcohol1 a small amount of extractive was obtained1 the amount depending on the length of time the extraction was continued4 ,on extracting with hot water the residue left after exhaustion with chloroform and with alcohol1 a further extract was obtained4 ,in one case1 it amounted to #j4dgfc gm4 or #i4ec per cent41 and in another case it amounted to #j4dgj gm41 or #i4dj per cent42 average #i4dg per cent4 ,in attempting to dry the pills or the above-mentioned chloroformic extract at #ajj ,c41 a crystalline sublimate was obtained which had the odor of benzoic acid4 ,the crystals were acid1 their neutral solution gave a flesh-colored precipitate with ferric chlorid1 and they melted at #abj-aba ,c4 ,this crystalline substance appeared to be benzoic acid4 ,the quantity of benzoic acid in this extract was determined by heating it to about #adj ,c4 ,a current of air was drawn through the flask and the sublimed benzoic acid collected in a cooled tube4 ,the benzoic acid was washed out of the tube with neutral alcohol1 and the solution was titrated with tenth normal potassium hydroxid4 ,in one case1 #aa4be c4c4 of tenth-normal alkali was used1 indicating #j4acgc gm1 of benzoic acid2 in another1 #ab4bg c4c41 indicating #j4adih gm4 of benzoic acid2 average #j4adcf gm41 or #b4hg per cent4 ,in a third case the temperature reached #bej ,c41 and there was some decomposition of the fat in the flask and some colored material distilled over4 ,for this sublimate #ae4ed c4c4 of tenth-normal alkali were required4 ,after evaporating the alcohol and acidulating the solutions obtained in the previous experiments1 the benzoic acid was extracted with chloroform4 ,in the first case1 #j4achc gm4 was obtained2 in the second1 #j4aeda gm42 average #j4adfb gm41 or #b4ib per cent4 of benzoic acid4 ,when the original chloroformic extract was heated until all of the benzoic acid had been driven off1 the residue had the appearance of a semisolid fat4 ,it compared quite closely in color1 odor1 etc41 with the fatty material obtained by extracting colchicum seed with chloroform1 although the odor was more suggestive of oleic or stearic acid4 ,it was distinctly acid1 which is also true of the fatty material obtained from a sample of colchicum seed4 ,the extract obtained with hot water was light yellow2 gummy1 at first1 but dried to a glass-like brittle mass4 ,it had a slight burned-sugar odor and taste1 and was neutral in reaction4 ,it was strongly dextrogyrate and at once reduced ,fehling's solution as well as alkaline silver nitrate solution4 ,on boiling with potassium hydroxid solution1 it turned deep red4 ,it also gave the ,molisch carbohydrate reaction1 and the ozazone test in seventeen minutes as described in ,mulliken 7,identification of ,pure ,organic ,compounds1 ,ed4 #a1 #aije1 p4 #bf74 ,these are all characteristic reactions of lactose or milk sugar4 ,from this examination we conclude that ,de,sanctis' pills contain powdered colchicum seed1 benzoic acid1 and sugar of milk4 ,there is also present fatty material which resembles the fat of colchicum seed1 but may be1 in part1 added fatty acid4 ,the percentage of colchicin found 7#j4ej7 is about that of a good quality of colchicum seed1 the ,u4 ,s4 ,pharmacopeial standard being not less than #j4de per cent4 ,since the pills contain material other than colchicum seed1 this assay would indicate a colchicum seed of high alkaloidal content1 or the possible reinforcement of the pills with colchicum extract or colchicin4 ,the amount of benzoic acid1 #b4ib per cent41 or about #a_/g grain per pill1 is insignificant from a therapeutic standpoint1 since an average dose is #j4e gm41 or #h grains4 ,fatty acids1 and the fatty matter from colchicum seed are inert1 at least in the quantities found here4 ,the only office which fatty acids might perform1 would be to give the pills an enteric quality1 preventing their absorption until they reach the intestine4 ,the sugar of milk1 about #aj per cent41 or #a_/b grain per pill1 no doubt is simply an excipient4 ,de,sanctis' pills are therefore essentially #e grain doses of powdered colchicum seed1 of which the average dose is #j4b gm41 or #c grains 7,u4 ,s4 ,p4 ,,ix1 p4 #abj74 ,the ,journal in presenting the facts contained in the above report made the following comments3 8,here then1 we have sold for self-medication an extremely poisonous drug1 with no warning of the risk the public runs in using it4 ,while the directions call for 8one pill every eight hours until relieved10 it is notorious that the public takes the attitude toward 8patent medicines0 that1 if a little is good1 more is better1 and the average user of remedies for self-treatment is likely1 unless there is some warning1 to use his own discretion as to the amount taken4 8,the individual dose is above that of the average recommended in the ,united ,states ,pharmacopeia4 ,colchicum or its alkaloids--or for that matter1 any drug as toxic as colchicum--have no place in preparations of the home-remedy type4 ,in the case of all 8patent medicines10 public interest demands that the full quantitative formula of the therapeutically active ingredients should be given on the label1 for when the public prescribes for itself1 it has a right to know what it is taking4 ,unfortunately1 public interest clashes with vested interests and1 as usual1 vested interests get the better of it4 ,in the case of such dangerous preparations as ,de,sanctis' pills1 if their sale is to be permitted at all1 not only should the names and quantities of all therapeutically active ingredients in the mixture be given1 but the law should require that the word ,poison be plainly printed on the label40--7,abstracted from ,the ,journal ,a4 ,m4 ,a41 ,july #ai1 #aiai47 ,,iodex ,,and ,,liquid ,,iodex ,the ,a4 ,m4 ,a4 ,chemical ,laboratory examined ,iodex in #aiae4bac ,the claims made1 at that time1 by the exploiters1 ,menley ,james1 were shown to be contrary to facts in that ,iodex contained only traces of free iodin while they claimed 8#e per cent4 ,therapeutically ,free ,iodin40 ,even the total quantity of iodin was shown to be only about one half of the #e per cent4 claimed to be present as free iodin4 #bac ,annual ,reports of the ,chem4 ,lab4 of the ,a4 ,m4 ,a41 #aiae1 p4 #hi4 ,an examination of the advertising matter sent out by ,menley ,james in #aiai showed that substantially the same claims were being made as in #aiae4 ,this at once suggested the inquiry3 ,since the claims are the same as previously made1 have the manufacturers altered the composition to conform to the claims8 ,the answer is found in the results of the analysis of two samples purchased in the open market early in #aiai4 ,this analysis shows conclusively that ,iodex is essentially the same as in #aiae1 that is1 that it contains no free iodin and only about three fifths of the total amount of iodin claimed4 ,it would seem that ,iodex 7,ung4 ,iodi41 ,m4 ,j47 is in obvious conflict with ,section #g of the ,food and ,drugs ,act4 ,while it is sold under a name recognized by the ,u4 ,s4 ,pharmacopeia1 namely1 ,ung4 ,iodi41 it does not conform to the standards of the ,u4 ,s4 ,pharmacopeia for that product4 ,iodin ointment ,u4 ,s4 ,p4 is made with #d per cent4 of free iodin1 #d per cent4 of potassium iodid1 #ab per cent4 of glycerin1 and a benzoinated lard base4 ,it should then contain approximately #g per cent4 of total iodin4 ,it has been shown by ,warren#bad that about #ge per cent4 of the iodin in the ,u4 ,s4 ,p4 ointment remains in the free state even after months of standing4 ,ung4 ,iodi41 ,u4 ,s4 ,p41 then1 should contain about #c per cent4 of free iodin4 ,iodex contains no free iodin1 or but traces1 and no potassium iodid4 ,furthermore1 the ,iodex label declares the presence of #e per cent4 of 8therapeutically free0 iodin4 ,as a matter of fact1 the amount of iodin is variable1 the highest amount found being #c4e per cent4 and samples containing as low as #b4fc per cent4 have been examined4 #bad ,warren1 ,l4 ,e43 ,iodin ,ointment1 ,am4 ,j4 ,pharm41 ,august1 #aiag1 p4 #cci4 ,it would seem further that ,iodex is misbranded under the ,sherley amendment in that it is said that it 8may be used externally with advantage in all cases where the action of iodin is desired40 ,since it contains no iodin as such this cannot possibly be true4 ,it is also stated in a circular accompanying the trade package that 8,thirty minutes after inunction iodin can be found in the urine40 ,this statement has also been shown to be untrue4--7,annual ,reports ,a4 ,m4 ,a4 ,chem4 ,lab41 #aiae1 p4 #hi47 ,details of ,analysis ,iodex4--,this is a rather soft ointment1 almost black but with a decided greenish cast in thin layers4 ,it is soluble in chloroform but is only partly saponified and dissolved by alcoholic potassium hydroxid4 ,iodex has a distinct odor like oleic acid4 ,free ,iodin4--,when examined by the method previously used#bae only minute traces of free iodin were found4 #bae ,ibid41 p4 #ij4 ,total ,iodin4--,the methods employed were as follows3 #a4 ,iodex was saponified by boiling for from two to three hours with alcoholic potassium hydroxid4 ,the alcohol was then evaporated and the iodin determined by the method described in the ,u4 ,s4 ,pharmacopeia for thymol iodid4 #b4 ,the same as ,method #a1 except that after ignition of the saponified mixture the halogen was determined by weighing as silver iodid4 #c4 ,the ,carius method4 ,it should be noted that ,methods #b and #c determine chlorin and bromin should any be present with the iodin4 ,when #e gm4 of ,sample #a was assayed by ,method #a1 it required #gc4ef c4c4 of tenth-normal sodium thiosulphate1 equivalent to #c4aa per cent4 of iodin4 ,in a duplicate1 #b4gefe gm4 of ,iodex required #ch c4c4 of tenth-normal sodium thiosulphate1 equivalent to #b4ib per cent4 of iodin2 average of the two1 #c4jb per cent4 of iodin4 ,a weight of #b4ehjj gm4 of ,sample #a1 assayed by ,method #b1 gave #j4aehb gm4 of silver halid1 equivalent to #j4jhee gm4 of iodin1 or #c4ca per cent4 ,a weight of #j4ehh gm4 of ,sample #b1 assayed by the ,carius method1 gave #j4jchh gm4 of silver halid1 indicating #j4jbjif gm4 of iodin1 or #c4eb per cent4 ,in a duplicate1 #j4ecdb gm4 gave #j4jcch gm4 of silver halid1 indicating #j4jahbf gm4 of iodin1 or #c4db per cent42 average1 #c4di per cent4 of iodin4 ,liquid ,iodex4--,this is sold by ,menley ,james1 ,ltd41 the firm selling ,iodex ,ointment4 ,according to a circular in a trade package 8the valuable properties of ,free ,iodine are available in ,liquid #8,iodex' in a state of greatly enhanced activity2 but the irritating1 corrosive and hardening drawbacks of ordinary solutions of the drug are absent40 ,the label on a bottle reads as follows3 8,liquid #8,iodex' 7,liq4 ,iodi4 ,m4 ,j474 ,a nonirritant preparation of iodine 7#b-a_/b7 444 ,this product contains ,free ,iodine44440 ,the sample of ,liquid ,iodex purchased on the open market was found to be a reddish liquid with an odor like oleic acid4 ,it dissolved completely in chloroform4 ,free ,iodin4--,a weight of #f4bicf gm4 was dissolved in chloroform and the solution shaken with #be c4c4 of a solution of potassium iodid4 ,the iodin which passed into the potassium iodid solution was titrated with tenth-normal sodium thiosulphate1 #j4ha c4c4 being required4 ,this indicates #j4jajbb gm4 of iodin1 or #j4af per cent4 ,total ,iodin4--,total iodin was determined by ,method #a as given above under ,iodex4 ,a weight of #d4dff gm4 required #cb4ic c4c4 of tenth-normal sodium thiosulphate1 equivalent to #j4jfifd gm4 of iodin1 or #a4ee per cent4 ,in a duplicate1 #e gm4 of material required #cc4c c4c4 of tenth-normal sodium thiosulphate1 equivalent to #j4gjdc gm4 of iodin1 or #a4da per cent42 average1 #a4dh per cent4 of iodin4 ,liquid ,iodex1 then1 contains but little 7#j4af per cent47 free iodin and only about three fifths of the total iodin claimed4 ,i4 ,g4 ,o4 ,i4 ,g4 ,o4 is an iodin ointment4 ,it is said to be made by ,dr4 ,h4 ,s4 ,lambdin1 ,peru1 ,kansas4 ,in a circular distributed by the manufacturer1 it is stated that 8,i4 ,g4 ,o4 is a saturated solution of ,iodine ,gas in petrolatum at #acj degrees with oil of eucalyptus4 ,the heat of the body liberates the iodine and it is absorbed as free iodine40 ,a sample of ,i4 ,g4 ,o41 received from a physician1 was examined4 ,it was found to be a black ointment1 green in thin layers1 with a slight odor like crude petroleum4 ,by the methods used for the examination of ,iodex1 ,i4 ,g4 ,o4 was found to contain #j4ei per cent4 of free iodin4--7,from ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiai1 p4 #ajd47 ,,iodin ,,in ,,liquid ,,petrolatum ,a4 ,h4 ,clark1 ,ph4,g41 ,sc4,b4 ,of all the things used in medicine nothing seems to have attracted the attention of all classes of users as has iodin4 ,perhaps more romantic schemes for the cure of all the ills which afflict mankind have centered in iodin therapy than in any other one drug4 ,iodin is being used in every conceivable way from crystals to colloid2 in vapor2 combined as iodid1 iodate and the like2 organic1 inorganic1 simple and complex2 internal1 external and by injection1 and yet there seems to be no end to the ingenious schemes for its exploitation4 ,one of these schemes1 and one so simple that it seems at first sight to be hardly worth serious consideration1 is that of a solution of iodin in liquid petrolatum4 ,solutions of this kind have frequently been offered to physicians and the laity4 ,the thing of particular interest is the claim made as to the percentage of free iodin4 ,five per cent4 is frequently claimed4 ,examination of some of these products in the chemical laboratory of the ,a4 ,m4 ,a4#baf revealed the fact that they did not contain the claimed amount of free iodin4 ,these questions at once arose3 ,was the low free iodin content due to intentional fraud1 the result of carelessness1 or of ignorance8 ,was it impossible to prepare a solution containing #e per cent41 or did the iodin slowly combine with the oil and disappear8 #baf ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiae1 p4 #ajf2 ,ibid41 #aiag1 p4 #hg4 ,several years ago the ,a4 ,m4 ,a4 ,chemical ,laboratory#bag conducted some experiments on the solubility of iodin in liquid petrolatum1 which indicated that a saturated solution would contain about #a4d per cent4 ,these experiments did not show conclusively that no iodin was absorbed by the petrolatum during the process of solution4 ,for this reason1 further experiments were conducted with the view of determining both the solubility in and the extent to which iodin is absorbed 7disappears as free iodin71 if at all1 by liquid petrolatums of various kinds4 ,theoretically such hydrocarbons should not absorb iodin4 ,the results of these experiments are here given4 #bag ,ibid41 #aiag1 p4 #hg4 ,a sample of iodin was prepared by sublimation from a mixture with potassium iodid4 ,this sample when dried over sulphuric acid assayed #ii4ih per cent4 of iodin4 ,portions of this sample were used in all of the subsequent experiments4 ,to prepare solutions of definite concentrations1 in all cases expressed as percentage by weight1 an accurately weighed quantity of iodin was placed in a glass-stoppered bottle and an accurately weighed quantity of liquid petrolatum added4 ,the mixture was subjected to treatment as indicated in the various experiments and from the weights of iodin and petrolatum used the percentage of iodin was calculated4 ,the method of assay employed was as follows3 ,a weighed quantity of the iodin solution was transferred to a bottle or flask by means of several small amounts of chloroform1 about #ej c4c4 in all4 ,to this was added about #be c4c4 of potassium iodid solution4 ,the mixture was then titrated with tenth-normal sodium thiosulphate until on thorough shaking no iodin passed into the aqueous layer4 ,to #b4abdh gm4 of iodin was added #aii4c gm4 of liquid petrolatum4 ,the mixture was shaken frequently each day and after forty days there seemed to be still a few particles of iodin undissolved4 ,the supernatant solution was assayed1 however1 and found to contain #a4jch per cent4 of iodin4 ,the iodin added was #a4jee per cent4 ,six months later #a4jbe per cent4 of iodin was found4 ,to #e4ahcb gm4 of iodin was added #aii4e gm4 of liquid petrolatum4 ,the mixture was heated to #ajj ,c4 for four hours with frequent shaking4 ,the iodin was in perfect solution4 ,the per cent4 of iodin would then be #d4ie4 ,upon cooling1 iodin in abundance crystallized out4 ,after standing a few hours1 with frequent shaking1 the iodin in solution was determined4 ,this was found to be #a4dbe per cent4 ,these two experiments indicate3 ,first1 that the previous findings of the ,a4 ,m4 ,a4 ,chemical ,laboratory are correct in that only about #a4d per cent4 of free iodin is retained in solution in liquid petrolatum at room temperature4 ,second1 that the quantity of iodin absorbed by liquid petrolatum at room temperature1 in seven months at least1 is practically none4 ,third1 that iodin dissolves rather slowly in liquid petrolatum at room temperature4 ,in the experiments1 the results of which are tabulated below1 the iodin and liquid petrolatum were heated at #ajj ,c4 for about four hours1 shaking frequently to hasten solution4 ,after cooling1 the specimens were assayed and were again assayed at intervals as indicated in the table4 ,date of ,per ,per ,kind of ,manufac- ,weight ,per ,per ,cent4 ,cent4 ,liquid ture and ,cent4 ,cent4 ,iodin ,iodin ,petrolatum ,first ,iodin ,petrolatum ,iodin ,iodin ,nov4 #ag1 ,nov4 #ai1 ,used ,assay ,used ,found #aiah #aiai ,stanolind #aj_/ag_/ah #b4jhi #ahh4d #a4jif #a4jhe #a4jfh #a4jfg ,squibb #aj_/ad_/ah #a4iefi #ahf4gh #a4jcjf #a4jbcb #a4jac #a4jji ,unknown1 bulk99 #aj_/bh_/ah #a4idig #aeh4b #a4bbe #a4acc #a4jge #a4jie ,parke1 ,davis #aj_/bd_/ah #b4jhfi #afg4dc #a4bda #a4bdhh #a4aia #a4ahj ,co 99 ,considerable dark sediment formed in this sample during the heating process4 ,it should be pointed out here that while every sample showed some absorption1 the amount1 with the exception of the unknown bulk1 is so small that it might even be accounted for on the basis of 8experimental error40 ,every ordinary precaution was taken to insure accuracy1 but since about #ae gm4 of the solution was used for each determination1 it is seen that an error of #j4c c4c4 in the titration would indicate a greater absorption of iodin than that noted4 ,conclusions3 ,these experiments show3 ,a solution of iodin in liquid petrolatum is saturated when it contains about #a4d per cent4 of iodin4 ,the amount of iodin absorbed 7disappearing as free iodin7 by liquid petrolatum1 when in contact at room temperature for as long as seven months1 or in contact at #ajj ,c4 for four hours1 or both1 is relatively insignificant4 ,also all the absorption seems to take place during the heating and in the first month of contact4--7,from ,reports ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiai1 p4 #ba47 ,,american-,,made ,,synthetic ,,drugs--,,ii ,examination of ,procain 7,novocain71 ,barbital 7,veronal71 ,phenetidyl- ,acetphenetidin 7,holocain71 ,cinchophen or ,phenylcinchoninic ,acid 7,atophan71 ,manufactured ,under ,federal ,trade ,commission ,licenses,g ,paul ,nicholas ,leech1 ,ph4,d42 ,william ,rabak1 ,ph4,g41 ,sc4,b41 and ,a4 ,h4 ,clark1 ,ph4,g41 ,sc4,b4 ,g ,from the ,chemical ,laboratory of the ,american ,medical ,association4 ,g ,the first article of this series dealt with the purity of acetylsalicylic acid4 ,leech1 ,p4 ,n43 ,examination of ,american-,made ,acetylsalicylic ,acid1 ,j4 ,indust4 ,engin4 ,chem41 ,april1 #aiah1 p4 #bhh4 8,what's in a ,name80 ibid41 p4 #bee4 ,acetylsalicylic ,acid1 or 8,what's in a ,name80 ,editorial1 ,j4 ,a4 ,m4 ,a4 #gj3 #ajig 7,april #ac7 #aiah4 ,before ,european hostilities1 the ,united ,states was so dependent on ,germany for synthetic drugs that the dependence was considered a necessity2 this was strikingly manifested by the precipitous rise in prices immediately after the embargo was declared against ,germany4 ,since then the shortage of ,german-made synthetics has caused two important results3 #a4 ,the physician can do without most of the ,german drugs1 because the prewar demand had been stimulated artificially4 #b4 ,those few synthetics1 which were in great need1 are being rapidly replaced by the ,american-made drugs4#bah ,in connection with the second result1 the ,chemical ,laboratory of the ,american ,medical ,association has endeavored to contribute its services4 #bah ,stieglitz1 ,julius3 ,synthetic ,drugs ,,ii1 ,j4 ,a4 ,m4 ,a4 #gj3 #fhh 7,march #i7 #aiah4 ,leech1 ,p4 ,n43 ,the ,vindication of the ,american ,chemist2 ,synthetic ,drugs1 ,chicago ,chem4 ,bull4 ,january1 #aiah1 p4 #bcj4 ,in ,september1 #aiag1 it was announced#bai that the ,a4 ,m4 ,a4 ,chemical ,laboratory would make studies of ,american-made synthetics4 ,just prior to this announcement1 the ,national ,research ,council established a committee on synthetic drugs#bbj 8to facilitate the manufacture of synthetic drugs in this country and thus to relieve shortage and reduce the exorbitant prices which have resulted from the war40#bba ,also during this time ,congress was considering the 8trading with enemy0 act1 first known as the ,adamson bill--the purpose of which was to confer authority on the ,president to license ,american firms to use ,u4 ,s4 patents owned by ,german subjects4 ,the act became law1 ,september #bh2 the ,federal ,trade ,commission was designated by the ,president to carry out the provisions of the law as it referred to enemy-owned patents4 ,as a result of a conference1 ,oct4 #cj1 #aiag1bbb with various agencies1 the ,federal ,trade ,commission decided to consider licenses for manufacturers of synthetic drugs1 after recommendations had been made by the ,committee on ,synthetic ,drugs of the ,national ,research ,council2 this committee in turn invoked the aid of the ,a4 ,m4 ,a4 ,chemical ,laboratory in testing the manufacturer's products4 ,the essence of the laboratory's work up to ,july #a1 #aiai1 is reported in this paper4 #bai ,the ,quality of ,american-,made ,synthetics1 ,j4 ,a4 ,m4 ,a4 #fi3 #ajah 7,sept4 #bb7 #aiag4 #bbj ,this committee is composed of ,julius ,stieglitz1 chairman1 professor of chemistry1 ,university of ,chicago2 ,w4 ,a4 ,puckner1 secretary of the ,council on ,pharmacy and ,chemistry1 ,american ,medical ,association1 and ,moses ,gomberg1 professor of chemistry1 ,university of ,michigan4 #bba ,stieglitz1 ,julius3 ,shortage of ,synthetic ,remedies1 ,j4 ,a4 ,m4 ,a4 #fi3 #djj 7,aug4 #d7 #aiag4 #bbb ,foreign ,patents to ,be ,open to ,american ,manufacturers1 ,j4 ,a4 ,m4 ,a4 #fi3 #aeej 7,nov4 #c7 #aiag4 ,,the ,,naming ,,of ,,licensed ,,drugs 8,partly in order to help insure to licensees a market for their products after the war1 in larger part inspired by the idea of encouraging the establishment of a permanent ,american industry in these important articles1 the ,federal ,trade ,commission wisely decided that ,american houses should be put on the same footing as competing foreign houses for after-the-war competition1 by imposing on all licensees the obligation to use new official names for the articles1 names which after the war will be open to all competitors1 domestic and foreign40#bbc #bbc ,for an interesting discussion1 see ,stieglitz1 ,julius3 ,synthetic ,drugs1 ,j4 ,a4 ,m4 ,a4 #gj3 #ecf 7,feb4 #bc72 #fhh 7,march #i72 #ibc 7,march #cj7 #aiah4 ,bracken1 ,l4 ,l43 ,federal ,trade ,commission ,requests ,use of ,official ,names1 ibid4 #gj3 #eeh 7,feb4 #bc7 #aiah4 ,the new ,american names are3 ,arsphenamin#bbd 7contracted from the scientific name arsenphenolamin7 for salvarsan1 arsenobenzol1 diarsanol1 arsaminol4 #bbd ,the testing and standardizing of arsphenamin is being done by the ,hygienic ,laboratory1 ,u4 ,s4 ,public ,health ,service4 ,for chemical tests see reprint #dgb1 ,public ,health ,reports4 ,for a review of the patent literature see article by ,h4 ,f4 ,lewis1 ,j4 ,indust4 ,engin4 ,chem41 ,feb4 #a1 #aiai1 p4 #ada4 ,barbital 7contracted from the scientific name diethyl-barbituric acid7 for veronal4 ,barbital-sodium 7the sodium salt of barbital7 for 8veronal-sodium0 and 8medinal40 ,cinchophen for atophan or phenylcinchoninic acid 7the ,u4 ,s4 ,p4 ,,ix name74 ,procain for novocain hydrochlorid 7from 8pro0 and 87co7caine074 ,procain nitrate for novocain nitrate4 ,,examination ,,of ,,synthetic ,,drugs ,in testing chemically the products which had been submitted to the ,federal ,trade ,commission1 the aims were that the product should conform to a high degree of purity2 at the same time the candidate for license should not be inflicted with undue hardships in making the product1 such as an unnecessarily high degree of purity4 ,it was insisted that the purity of the drugs should be equal to1 if not greater than1 that of the respective former ,german-made products1 in order to uphold the name and reputation of the ,american manufacturers in the after-the-war competition4 ,consequently1 in the chemical work the ,american product was always examined parallel with the ,german-made product1 authentic samples of the latter of which the laboratory had in its possession4 ,whenever possible1 the tests described in books of standards were carried out4 ,,barbital 7,,veronal7 ,barbital was introduced into medicine under the proprietary name 8veronal10 and was manufactured in ,germany by ,friedr4 ,bayer ,co41 ,leverkusen1 and ,e4 ,merck ,co41 ,darmstadt1 ,germany4 ,barbital is described in ,new and ,nonofficial ,remedies1 #aiai1bbe as diethylbarbituric acid 7diethylmalonyl urea7 having the formula3 ,,nh--,,co ,c,h _/ _/ ,,oc ,c _/ ,,nh--,,co ,c,h #bbe ,new and ,nonofficial ,remedies1 #aiai1 published by ,the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association1 p4 #hb4 ,it is official in the ,british ,pharmacopeia under the name 8barbitone10 and in the ,german ,pharmacopeia as 8acidum diethylbarbituricum40 ,barbital 8may be prepared by the interaction of esters of diethylmalonic acid with urea in the presence of metallic alcoholates4444 ,it is also obtained by condensation of diethylcyanacetic ester with urea by means of sodium alcoholate40 ,barbital is used in medicine chiefly as a hypnotic4 ,the different brands of barbital which were submitted to the laboratory were subjected to the tests given in the books referred to above4#bbf ,the products were3 #bbf ,the pharmaceutic monograph on barbital has been omitted4 ,it was published in the #aiah edition of the ,annual ,reports of the ,chemical ,laboratory of the ,american ,medical ,association4 #a4 ,barbital 7,abbott7 ,sample ,a1 to ,federal ,trade ,commission4 #b4 ,barbital 7,abbott7 ,sample ,b1 to ,federal ,trade ,commission4 #c4 ,barbital 7,abbott7 ,sample ,c1 to ,red ,cross4 #d4 ,barbital 7,antoine ,chiris71 to ,federal ,trade ,commission4 #e4 ,barbital 7,v4 ,halter71 to ,federal ,trade ,commission4 #f4 ,barbital 7,rector ,chemical ,company7 to ,federal ,trade ,commission4 #g4 ,diethylbarbituric acid 7,merck71 to ,council4 #h4 8,veronal10 manufactured by ,farb4 vorm ,fried4 ,bayer ,co41 ,germany4 ,all responded satisfactorily to the tests4 ,in ,table #a are given the respective melting points and percentages of ash found4 7,the melting point of a mixture of the sample with the original 8veronal0 was always taken47 ,,table #a4--,,melting ,,point ,ash ,ash #a #ahh4e-ahi4j #j4ja #e #ahh4j-ahh4e #j4ja #b #ahh4e-ahi4j #j4ja #f #ahh4j-ahh4e #j4ja #c #ahh4j-ahh4e #j4ja #g #ahh4j-ahh4e #j4ja #d #ahh4j-ahh4e #j4jd #h #ahh4j-ahh4e #j4jb ,barbital does not seem to form an insoluble salt with chlorplatinic acid2 nor an ether-insoluble hydrochlorid or oxalate2 nor an insoluble barium salt4 ,it does not respond to many urea tests1 and is not affected by urease as would be expected in light of the extensive investigations made on this enzyme by ,van ,slyke and ,cullen4 ,as barbital is also sold in the form of tablets or mixtures1 a reliable method for its quantitative determination in the presence of other substances is needed4 ,some experiments in this direction were made1 but the press of other work did not permit their continuation4 ,when time permits1 this work will be resumed4 ,at the time of writing this article1 licenses for manufacture had been granted by the ,federal ,trade ,commission to the ,abbott ,laboratories1 to ,antoine ,chiris ,company1 and to the ,rector ,chemical ,company4 ,,barbital ,,sodium 7,,medinal ,,or ,,veronal-,,sodium7 ,barbital sodium1 formerly sold under the proprietary names 8veronal-sodium0 and 8medinal10 is1 as the former name suggests1 the sodium salt of diethylbarbituric acid4 ,its therapeutic advantages are stated to be that more rapid results are obtained because of its increased solubility over barbital alone4#bbg ,barbital sodium should yield1 according to theory1 #aa4ai per cent4 of sodium and #hi4ca per cent4 of diethylbarbituric acid4 ,a number of years ago1 when 8veronal-sodium0 and 8medinal0 were being introduced1 ,puckner and ,hilpert#bbh found that these products yielded results corresponding closely to the theoretical amounts of sodium and diethylbarbituric acid4 ,a recent examination of veronal-sodium1 ,merck1 made for the ,council on ,pharmacy and ,chemistry1 showed it to be of the same composition as that previously reported4 #bbg ,new and ,nonofficial ,remedies1 #aiah1 p4 #if4 #bbh ,puckner1 ,w4 ,a41 and ,hilpert1 ,w4 ,s43 ,veronal-,sodium and ,medinal1 ,j4 ,a4 ,m4 ,a4 #eb3caa 7,jan4 #bc7 #aiji2 ,rep4 ,a4 ,m4 ,a4 ,chemical ,lab41 #b3ac4 ,only one firm's product has been submitted to the laboratory through the ,committee on ,synthetic ,drugs1 but because of the unsatisfactory results1 it was not recommended for license1 nor1 as far as we are aware1 has the firm investigated its anomalies4#bbi ,the amount of moisture in this specimen was #j4jd per cent4 ,it yielded #aj4id and #aj4ig per cent1 of sodium4 ,puckner and ,hilpert found #aa4jb per cent4 of sodium in 8medinal10 and #aa4ja per cent4 of sodium in 8veronal-sodium40 ,the theoretical amount1 according to the formula given for medinal by the proprietors 7,c,h7 ,c,c,o,n,na,c,o,n,h,c,o is #aa4ai per cent4 ,when an aqueous solution of barbital sodium was acidified1 and the diethylbarbituric acid extracted with ether1 it was found that theamount of freed acid extracted varied directly with the length of time after acidification4 #bbi ,since this was written1 the ,council on ,pharmacy and ,chemistry has also accepted 8,barbital-,sodium ,abbott40 ,it is possible that in preparing the sodium salt of diethylbarbituric acid1 the ring opens up1 forming a compound not so easily affected by dilute mineral acids4 ,,table #b4--;,,extraction ,,of ,a ,,sample ,,of ,,barbital-,,sodium ,diethylbarbituric ,acid ,length of ,time per ,cent4 a4 ,immediately #ge4e a#a4 #c_/d hour #hb4j b4 ,immediately #hb4j c4 #a-a_/b hours #hj4e d4 #d hours #hb4hb e4 #d hours #hc4ef f4 #d hours #hc4da g4 #de-a_/b hours #hd4hi h4 #de-a_/b hours #hd4gc ,theory 44444444 #hi4ca ,veronal-,sodium 7,puckner and ,hilpert7 #hi4ja 7average7 ,medinal 7,puckner and ,hilpert7 #hh4ie 7average7 ,,phenetidyl-,,acetphenetidin ,,hydrochlorid#bcj 7,,holocain ,,hydrochlorid7 ,phenetidyl-acetphenetidin hydrochlorid was introduced in the ,united ,states under the name of 8holocain hydrochloride0 by ,farbwerke1 vorm ,meister ,lucius and ,bruening1 ,hoechst a4 ,m4 ,germany2 the product apparently had not been patented in this country1 although it was protected in ,germany under patents ,no4 #ghhfh and #hjefh4 ,new and ,nonofficial ,remedies1 #aiah1 describes 8holocain hydrochlorid0 as ethenyl-paradiethoxy-diphenyl-amidin hydrochlorid ,,ch37,,nc,h,,oc,h77,,nhc,h,,oc,h7,h,cl4 ,it is used as a local anesthetic for the eye4 #bcj ,no short1 scientific name has been given for this substance although several are under consideration4 ,the standards1 such as had been described1 were meager and unsatisfactory4 ,hence when the first specimen of ,american-made phenetidyl-acetphenetidin was sent to the ,a4 ,m4 ,a4 ,chemical ,laboratory through the agency of the ,federal ,trade ,commission and the ,committee on ,synthetic ,drugs1 it was necessary for the laboratory to work out adequate standards4#bca ,as a result of the chemical work1 a rather comprehensive monograph was drawn up1 which was published in the #aiah ,laboratory ,reports4 ,a summary of the products examined1 with some of the chemical data1 is given in ,table #c4 ,it will be seen that one specimen had a deficiency of about #b per cent4 of free base4 #bca ,certain chemical tests are described by ,e4 ,h4 ,rankin1 ,indian ,j4 ,m4 ,res4 #d3bcg1 #aiaf2 also ,chem4 ,abst4 #aj3ebd4 ,other references are ,schmidt3 ,pharmazeutische ,chemie #b3iij1 ,beilstein ,,ii1 7#djc74 ,arends1 ,g43 ,neue ,arzneimittel und pharmazeutische ,spezialitten1 ,ed4 #d1 #aiac1 p4 #bga4 ,,table #c4--;,,data ,,on ,,phenetidyl-,,acetphenetidin ,,hydrochlorid table split by transcriber to fit small screen ,melting ,phosphorus ,manufacturer ,appearance ,moisture ,point ,compounds ,phenetidin99 ,john ,t4 ,white #e4ac #aia4e to #aib ,absent ,negative ,milliken ,co4 crystalline powder ,synthetic ,white #b4ij #aib to #aib4e ,absent ,negative ,products ,co4 crystalline powder ,h4 ,a4 ,metz ,white #d4ii #aib to #aib4e ,absent ,negative ,laboratories1 crystalline ,inc4 powder ,farbwerke- ,slightly #e4ji #aij to #aia ,absent ,negative ,hoechst ,co4 pink 7,german crystal specimen7 ---------------------------------------- ------------------------------ ,per ,per ,per ,cent4 ,cent4 ,cent4 ,melting ,platinum in ,indol ,base by ,base by ,point ,platinum ,manufacturer ,reaction ,ash ,weight ,titration of ,base ,salt ,john ,t4 ,milliken ,co4 ,positive #j4jj #hi4af #hi4af #aaf to #aag #ai4jb ,synthetic ,products ,co4 ,positive #j4ac #hg4di #hg4bf #aaf to #aag #ai4c ,h4 ,a4 ,metz ,laboratories1 ,positive #j4jj #hi4ad #hh4ee #aag #ai4cd ,inc4 ,farbwerke- ,hoechst ,co4 ,positive #j4af #hi4fe #hi4fd #aaf to #aag #ai4jj 7,german specimen7 ---------------------------------------- ------------------------------ 99 ,the phenetidin test is not very sensitive4 ,the melting point of the free base is given by a number of writers at #aba ,c4 ,although ,kennert#bcb stated it to be #aag ,c4 and not #aba ,c41 his findings seemingly went unheeded4 ,it will be noted that our work shows the melting point to be in accord with that announced by ,kennert4 #bcb ,kennert3 ,chem4 ,zentralbl4 #b3eef1 #ahig4 ,the ,federal ,trade ,commission has not issued any licenses for the manufacture of 8holocain hydrochlorid40 ,the ,john ,t4 ,milliken ,company has withdrawn its application4 ,the ,h4 ,a4 ,metz ,laboratories 7,successor to ,farbwerke ,hoechst ,company1 ,new ,york7 are making the product in this country4 ,,cinchophen 7,,phenylcinchoninic ,,acid1 ,u4 ,s4 ,p42 ,,atophan7 ,cinchophen 7phenylcinchoninic acid7 was introduced in the ,united ,states as a medicine under the proprietary name 8atophan10 by ,schering and ,glatz1 ,new ,york ,city1 who before the war were the ,american agents for the ,german manufacturers 8,chemische ,fabric auf ,actien von ,e4 ,schering1 ,berlin40 ,phenylcinchoninic acid 7#b phenyl-quinolin-#d carboxylic acid7 was first described by ,doebner and ,gieseke#bcc in #ahhg1 who prepared it by warming together pyro-racemic acid1 benzaldehyd and anilin in alcoholic solution2 it has the structural formula3 ,,cooh ,n #bcc ,doebner and ,gieseke3 ,ann4 d4 ,chem4 7,liebigs7 #bdj3bia1 #ahhg4 ,the chief use of phenylcinchoninic acid is as an antiuric acid agent1 especially indicated in gout4 ,in #aiac1 the ,german house of ,schering was made the assignee of patent #ajdegei granted by the ,united ,states government#bcd for the manufacture of phenylcinchoninic acid3 at about the same time the product was admitted to the ,u4 ,s4 ,pharmacopeia ,,ix1 under very loosely constructed standards4 #bcd ,the validity of this patent is to be doubted4 ,some time after the beginning of the ,european war the proprietary 8atophan0 became scarce in ,america4 ,in #aiag1 however1 ,schering and ,glatz1 ,new ,york1 placed ,american-made atophan on the market and submitted it to the ,council on ,pharmacy and ,chemistry4 ,later1 other firms began to manufacture the product and also submitted specimens4 ,during the time it was investigating these products1 the ,federal ,trade ,commission decided that a license was needed to manufacture phenylcinchoninic acid under the patent just referred to1 so that altogether the laboratory had a number of specimens to examine4 ,in making the examinations for the ,council1 the laboratory was practically confined1 by virtue of the ,food and ,drugs ,law1 to limit its requirements of purity to those of the ,pharmacopeia4 ,practically1 the only tests were melting point1 ash and solubility4 ,according to the ,u4 ,s4 ,pharmacopeia the melting point is 8about #baj40 ,in ,new and ,nonofficial ,remedies1 #aiah1 it was explained that atophan 8complies with the standards for phenylcinchoninic acid1 ,u4 ,s4 ,p41 but melts between #bjh and #bab ,c40 ,the ,u4 ,s4 ,pharmacopeia requires that no weighable ash remains on incinerating about #j4e gm4 of phenylcinchoninic acid4 ,considerable variations1 especially in melting points1 were found1 as can be seen from ,table #d4 ,,table #d4--,,melting ,,points ,,and ,,ash ,product ,manufacturer ,melting ,ash1 ,no4 ,point1 ,c4 #a ,abbott ,laboratories1 ,chicago #bjh4e-baj4e #j4je #b ,abbott ,laboratories1 ,chicago #bab-bac #j4je #a ,calco ,chem4 ,co41 ,bound ,brook #bji-baj4e #j4jg #a ,morgenstern1 ,new ,york #bjd4e-bjg4e #b4h #b ,morgenstern1 ,new ,york #bjh4e-baa4e ,none #a ,schering and ,glatz1 ,new ,york #bjf-bjh ,none #b ,schering and ,glatz1 ,new ,york #bji-baa ,none #c ,schering and ,glatz1 ,new ,york #bjh4e-baj #j4ag #d;a ,schering and ,glatz1 ,new ,york 7#a7 #bjh4e-baj #j4b #d;b ,schering and ,glatz1 ,new ,york 7#b7 #bjh4e-bji4e #j4c #d;c ,schering and ,glatz1 ,new ,york 7#c7 #bjh4e-baj #j4jbe #a ,wm4 ,h4 ,sweet and ,co41 ,columbus #bjd-bjh ,none #b ,wm4 ,h4 ,sweet and ,co41 ,columbus #bji4e-baa4e #j4jd #a ,german specimen from ,schering and ,glatz #baj-bab ,none ,by referring to this table on melting points and ash content it will be noted that the production of a better grade of products resulted after the respective firms had submitted samples to the ,a4 ,m4 ,a4 ,chemical ,laboratory for criticism1 and from a chemical standpoint1 the last products examined were found to be as satisfactory as the ,german-made 8atophan40 ,solubility of ,cinchophen 7,phenylcinchoninic ,acid74--,as methods of determining impurities1 or estimating the degree of purity of phenylcinchoninic acid were not described in the ,u4 ,s4 ,pharmacopeia1 it was decided to try extraction methods4#bce ,this in turn led to the question of solubilities4 ,the ,u4 ,s4 ,pharmacopeia gives the solubility of phenylcinchoninic acid only in general terms2 hence it was deemed advisable to determine its solubilities and describe them in more definite terms4 ,the sample of phenylcinchoninic acid employed to determine the solubility was obtained by repeated recrystallization from alcohol of a commercial specimen4 ,solubilities were determined in water2 #ie4j per cent4 alcohol2 #dh4e per cent4 alcohol2#bcf chloroform and ethyl acetate4#bcg ,complete saturation of the solvent was attained according to the ,u4 ,s4 ,p4 ,,ix method 7p4 #eii74 ,the bath was maintained at a temperature of #be ,c41 with a range of #j4b degrees4 ,the solution was analyzed by the method of ,seidell4#bch ,the data obtained for the solubility of phenylcinchoninic acid are given in ,table #e4 ,,table #e4--,,solubility ,,of ,,cincophen ,gm4 per ,hundred ,solubility1 ,gm4 of ,parts by ,solvent ,sat4 ,solution ,weight ,distilled water #j4jafj #a in #f1baf4j #ie per cent4 ethyl alcohol #j4hcdc #a in #aai4j ,dilute ethyl alcohol #j4jhge #a in #a1adb4f ,chloroform1 #j4ajge #a in #ibi4g ,ethyl acetate #a4daea #a in #gj4f #bce ,attempts were made to make salts of phenylcinchoninic acid with metals such as copper1 mercury1 barium and calcium1 and also the chloroplatinic acid or periodid addition products4 ,reliable quantitative results could not be obtained4 #bcf ,this corresponds to 8diluted alcohol1 ,u4 ,s4 ,p40 #bcg ,the ethyl acetate was ,merck's product 7redistilled71 stated to contain #ha4f per cent4 of ethyl acetate1 #aj per cent4 alcohol and alcohol derivatives4 #bch ,seidell1 ,a43 ,bull4 #fg1 ,hyg4 ,lab41 ,u4 ,s4 ,p4 ,h4 ,s41 p4 #aa4 ,the ,abbott ,laboratories1 ,chicago1 have been licensed by the ,federal ,trade ,commission to manufacture cinchophen4 ,other firms1 however1 have decided to manufacture it without the formality of obtaining a license1 evidently considering the ,german-obtained patent not to be valid4#bci #bci ,very recently the ,chemical ,foundation1 ,inc41 has undertaken to grant licenses for cinchophen4 ,the ,calco ,chemical ,company has obtained one4 ,,procain 7,,novocain7 ,procain was introduced in medicine under the proprietary name 8novocain10 and before the war was obtainable in this country only through the ,farbwerke ,hoechst ,company1 the ,american representative of the ,german establishment1 ,farbwerke vorm ,meister ,lucius ,bruening1 ,hoechst a4 ,m4 ,chemically it is the mono-hydrochlorid of para-amino-benzoyl-diethyl-amino-ethanol 1 having the structural formula3 ,illustration3 ,,nh--7benzene ring7,,coo-,,ch-,,ch--,n7,c,h74,h,cl ,it is prepared according to ,u4 ,s4 patent ,no4 #habeed 7issued to ,alfred ,einhorn1 ,munich1 ,germany7 by treating para-nitro-benzoylchlorid with ethylene chlorhydrin and diethylamin with subsequent reduction of the nitro groups1 the resulting product being purified by recrystallization4 ,procain is employed largely in infiltration anesthesia4 ,it is less toxic than cocain1 but its anesthetic action is not sustained4 ,this drawback is overcome by the simultaneous injection of epinephrin1 and for this reason procain is often compounded with epinephrin in tablets1 thus obviating the necessity of separate solutions4 ,when the first specimens of the ,american-made product were submitted through the channels of the ,federal ,trade ,commission1 it was necessary to compile a monograph4#bdj ,this was prepared from descriptions in the available literature1 mostly from tests described in ,new and ,nonofficial ,remedies1 #aiah1 and the ,german ,pharmacopeia ,v4 #bdj ,the monograph appears in ,new and ,nonofficial ,remedies1 #aiai4 ,the submitted products were found satisfactory chemically4 ,the toxicity determinations made by ,dr4 ,r4 ,a4 ,hatcher1 with the assistance of ,dr4 ,carey ,eggleston#bda indicated that none of the specimens are to be considered dangerous when used in ordinary dosage for normal individuals4 ,therefore the ,federal ,trade ,commission1 on recommendation of the ,committee on ,synthetic ,drugs of the ,national ,research ,council 7aided by the ,a4 ,m4 ,a4 ,chemical ,laboratory71 issued licenses for the manufacture of procain to the ,farbwerke-,hoechst ,company 7which license was later transferred to the ,h4 ,a4 ,metz ,laboratories71 to the ,abbott ,laboratories1 to the ,calco ,chemical ,company and to the ,rector ,chemical ,company4 #bda ,the report of these and subsequent toxicity experiments on procain appeared in the report of the ,council on ,pharmacy and ,chemistry1 ,j4 ,a4 ,m4 ,a4 #gb3 #acf 7,jan4 #aa7 #aiai4 ,subsequently the products of the licensed firms were submitted to the ,council on ,pharmacy and ,chemistry1 which in turn invoked the aid of the ,a4 ,m4 ,a4 ,chemical ,laboratory and the ,cornell ,university ,pharmacologic ,laboratory4 ,later the ,council asked the laboratory to examine the market supply4 ,altogether1 therefore1 a number of products were examined which were found to respond satisfactorily to the tests outlined 7,table #f74 ,,table #f ,date ,melting ,ash1 ,brand ,received ,color ,point1 ,c499 ,procain 7,abbott71 #ab_/ba_/ag ,white #aed-aee ,none from ,committee on ,synthetic ,drugs ,procain 7,abbott71 #a_/bi_/ah ,white #aec4e-aed4e ,none submitted to ,coun- cil ,p4 and ,c4 ,procain 7,abbott71 #h_/ca_/ah ,white #aeb4e-aec4e ,none ,gen4 ,pur4 ,off4 ,u4 ,s4 ,army ,procain 7,abbott71 #i_/cj_/ah ,slight #aec-aed4e ,none ,gen4 ,pur4 ,off4 brownish ,u4 ,s4 ,army1 tint ,no4 #hiiii ,procain 7,abbott71 #i_/cj_/ah ,slight #aec-aed4 #j4jje ,gen4 ,pur4 ,off4 brownish ,u4 ,s4 ,army1 tint ,no4 #hiiih ,procain 7,abbott71 #aj_/h_/ah ,slight #aec-aed ,none ,gen4 ,pur4 ,off4 brownish ,u4 ,s4 ,army1 tint ,no4 #hiiig ,procain 7,abbott71 #aa_/d_/ah ,slight #aec4e-aed4e ,none ,gen4 ,pur4 ,off4 brownish ,u4 ,s4 ,army1 tint ,no4 #hiiif ,procain 7,abbott71 #aa_/d_/ah ,slight #aec4e-aed4e ,none ,gen4 ,pur4 ,off4 brownish ,u4 ,s4 ,army1 tint ,no4 #hajiie ,procain 7,calco71 #b_/g_/ah ,white #aec4e-aed4e ,none from ,committee on ,synthetic ,drugs ,procain 7,farbwerke- #aj_/bd_/ah ,white #aec-aed ,none ,hoechst ,co471 sub- mitted to ,council ,procain 7,farbwerke- #ab_/aj_/ag ,white #aec-aed4e ,none ,hoechst ,co471sub- mitted to ,council ,procain 7,farbwerke- #h_/i_/ah ,white #aec4e-aed4e ,none ,hoechst ,co471 sub- mitted to ,council1 market spec4 8,a #ef0 ,procain 7,farbwerke- #i_/i_/ah ,white #aec4e-aed4e ,none ,hoechst ,co471 sub- mitted to ,council1 market spec4 8,a #eg0 ,procain 7,h4 ,a4 ,metz #h_/bc_/ah ,white #aec-aed ,none ,lab471 market spec4 8,a #fc0 ,procain 7,h4 ,a4 ,metz #i_/bc_/ah ,white #aec-aed ,none ,lab471 market spec4 8,a #eg0 ,procain 7,rector71 #ab_/ah_/ag ,white #aec-aed4e ,none from ,committee on ,synthetic ,drugs ,procain 7,rector71 #e_/b_/ah ,white #aeb4e-aec ,none from ,committee on ,synthetic ,drugs ,procain 7,rector71 #h_/bj_/ah ,slight #aec-aee ,none market spec brownish tint ,procain 7,rector71 #h_/bc_/ah ,slight #aec-aee ,none market spec brownish tint ,procain 7,rector71 #h_/bc_/ah ,slight #aec-aed4e ,none market spec brownish tint ---------------------------------------- --------------------- 99 ,u4 ,s4 ,patent #hab1eed--the novocain patent--declares that the salt melts at #aef ,c4 ,evidently based on this1 both the ,german ,pharmacopeia and past editions of ,new and ,nonofficial ,remedies give this melting point4 ,two specimens of ,german-made novocain obtained from our files1 stated to be manufactured by ,farbwerke-,hoechst vorm4 ,meister1 ,lucius and ,bruening1 ,hoechst a4 ,m41 were found to melt1 respectively1 between #aed and #aee ,c4 and between #aec4e and #aed4e ,c4 when the melting point was determined according to the direction of the ,u4 ,s4 ,pharmacopeia1 ninth revision4 ,the various specimens examined at that time melted between #aec and #aee ,c41 and it was decided to permit this range4 ,an examination of some ,american-made procain-suprarenin tablets was also made4 ,the procain was determined by liberation of the alkaloid with ammonia water1 extraction with chloroform1 evaporation of the chloroform1 dissolving the alkaloid in one hundredth normal sulphuric acid solution and titrating excess acid with one hundredth normal sodium hydroxid solution4 ,the epinephrin was determined according to the method employed by ,seidell1#bdb with slight modifications4 ,the tablets contained the claimed amounts of ingredients4 #bdb ,seidell3 ,j4 ,biol4 ,chem4 #ad3 #ai1 #aiac4 ,,the ,,synthetic ,,drug ,,situation ,before the war1 the ,american physician was literally bombarded with new and wonderful 787 coal-tar synthetics1 most of which were originated in ,germany4 ,in fact1 it seemed that if a by-product in the manufacture of dyes could not be used for a dye per se1 then a place might be found for it in the ever increasing lists of medicaments4 ,by clever advertising and propaganda among physicians1 an artificial stimulation for coal-tar drugs was created which evidently yielded lucrative financial returns4 ,as a result of the war1 it is interesting to observe that of all the synthetic drugs imported into this country from ,germany and on which the ,american patents were controlled by the ,germans 7up to the time of our entrance into the war71 the demand was really sufficient enough to warrant the commercial manufacture of only four of them by ,american firms4 ,of course1 a larger number of nonpatented drugs1 also imported from ,germany1 are now being made in sufficient quantities in this country2 many of the drugs in this class were never patented or are the ones which have survived after the patent had expired1 such as acetanilid1 acetphenetidin1 and acetylsalicylic acid4 ,in view of the agitation to found an institute for cooperative research as an aid to the ,american drug industry under the auspices of the ,american ,chemical ,society1 it will be well for the medical profession to be on its guard against too enthusiastic propaganda on the part of those engaged in the laudable enterprise of promoting ,american chemical industry4 ,unless it is1 it may be inflicted in the future1 as in the past1 with a large number of drugs that are either useless1 harmful or unessential modifications of well-known pharmaceuticals4 ,it will be well also for the chemists--those engaged in this enterprise--to be sure that the product is of therapeutic value before asking its use as a medicine4 ,the ,american medical profession has learned that relatively few of the many ,german synthetics were really valuable or decided improvements over established drugs4 ,if ,american chemists desire to retain their prestige with the medical profession1 they should earnestly endeavor to see that the advantages derived from the war and from such an institute as proposed are not abused in the worthy desire to popularize chemistry both educationally and commercially4 ,they should realize that physicians are in no receptive mood for a flood of synthetics1 even though 8,american-made40 ,on the other hand1 the constructive possibilities of chemistry in the service of medicine should serve as a stimulus for ,american research4 ,notwithstanding all the pharmaceutical shrubbery which ,germany sent to us1 still it did contain some synthetics that were worth while4 ,as therapeutics has been benefited by these organic chemicals1 it is logical to reason by analogy that there remain other synthetics to be discovered which will occupy places of equal distinction in the modern materia medica4 ,for example1 vaccines are of undoubted merit in the field of immunology1 but their action is1 in the end1 chemical2 as soon as chemical technic is refined by medicochemical research1 it is quite possible that a definite chemical agent 7synthetic7 will supersede the indefinite bacterial vaccine4 ,obviously the ,american chemist has the opportunity of showing his resourcefulness in aiding the public health of ,america and the world4 ,in this connection1 a cooperative institute devoted to purely scientific drug research1 and governed in such a manner as to inspire confidence in its humanitarianism and unbiased judgment1 should serve a most commendable purpose4 ,the hopes of ,american men of science are for a monumental research institution--cooperative with all the allied professions--and1 as the ,chicago ,chemical ,bulletin stated1 8,stripped of all professional or commercial pettishness and not dominated by any one group of scientists40#bdc #bdc ,proposed ,institute for ,drug ,research1 editorial ,chicago ,chem4 ,bull41 ,april1 #aiai1 p4 #fg4 ,,conclusions ,as for the results of the work so far1 they can be summed up in two sentences4 #a4 ,american chemists are producing synthetic drugs formerly controlled by ,germany1 and thus have declared their independence of ,german chemicals4 #b4 ,judging from the evidence at hand1 we can feel assured that the quality of ,american synthetics will be second to none4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #f1 #aiai47 ,,part ,,iii ,,contributions ,,from ,,the ,,journal3 ,,proprietary ,,products ,,nostrums ,,in ,,retrospect ,a ,series of ,nine ,articles ,reviewing ,worthless or ,unscientific ,proprietary ,mixtures ,previously ,criticized ,s4 ,q4 ,lapius1 ,m4,d4 ,,foreword4--,it is more than twelve years since the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association was created4 ,since then there have been but few issues of ,the ,journal that have not called the attention of the medical profession to the debasing influence on scientific medicine of unscientific or worthless proprietary mixtures advertised to physicians for their use in prescribing4 ,the ,council on ,pharmacy and ,chemistry has investigated and shown many of these preparations to be fraudulent in one way or another1 and these reports have been published in ,the ,journal4 ,in spite of this1 these preparations have been advertised continuously to physicians1 through medical journals and otherwise1 and prescribed by a large number of physicians4 ,one reason for this is that there are many physicians who have never seen these reports--who were not in active practice at the time1 or who were not reading ,the ,journal4 ,we probably have among our readers at the present time #ce1jjj or #dj1jjj physicians who were not among the readers of ,the ,journal twelve years ago4 ,it is desirable1 then1 that we should take up1 in more or less detail1 several of the more widely advertised products that have been the subjects of previous reports4 ,it has been repeatedly stated in ,the ,journal that many of the proprietary mixtures--the so-called ethical proprietaries advertised to physicians--were no better and no worse than 8patent medicines0 advertised to the public4 ,every physician who has the welfare of medicine at heart should put these questions squarely to himself if he has not already taken a firm stand on this whole problem3 ,what is my attitude toward the work of the ,council8 ,are its reports worthy of acceptance8 ,am ,i upholding the ,council in its efforts to place therapeutics on a rational basis1 not by blind faith alone1 but by an honestly critical attitude toward it8 ,am ,i following the path of indolence by taking the advice of nostrum makers without any serious effort to determine whether they are true or false8 ,in a word1 am ,i really practicing medicine1 or am ,i an unpaid agent and a dupe of nostrum makers8 ,there are other revolutions than political4 ,the public can be wronged just as certainly by the abuse of its confidence in clinicians as by the usurpers of political power1 and when the public is thoroughly aroused the heavy hand of retribution is not likely to be too discriminating4 ,that the sins of clinicians are standing out plain for any one who wishes to read is becoming more and more evident4 ,there is but one short and ugly word that properly characterizes the physician who accepts a fee for prescribing that about which he has no more knowledge than has the one for whom he prescribes it4 ,are you with the nostrum makers or with decent medicine8 ,the article below is the first of a series written for ,the ,journal by one who is thoroughly conversant with the work of the ,council on ,pharmacy and ,chemistry and can speak authoritatively on questions dealing with the action of drugs and the treatment of diseases4 ,we believe that these articles will prove of interest and profit and that they will help physicians to answer the questions just propounded4 ,,article ,i ,bell-,ans 7,pa-,pay-,ans ,bell7,h ,h ,see also 88884sic ,bell-ans1 for years advertised only in medical journals under the name 8,pa-pay-ans 7,bell710 is now advertised in newspapers as a remedy that 8,absolutely ,removes ,indigestion40 ,as it is still being advertised to physicians1 we propose to analyze the claims made for it with as much care as would be exercised in the discussion of the newest discovery in medicine1 because we believe that it is desirable to show the trend of exploitation of a certain type of preparation in the medical press4 ,in the ,new ,york ,medical ,journal the following advertisement recently appeared on the front cover3 ,illustration3 ---------------------------------------- --------------------- ,acute ,indigestion ,yesterday a great soldier and today the head of a big trust succumbed to an attack of ,acute ,indigestion1 and every day we hear from some physician of some case he has saved with ,,bell-,,ans by giving ,,six 7#f7 tablets dissolved in a glass of hot water and repeating if necessary4 ,can any doctor who reads this fail to provide himself with the free supply of ,,bell-,,ans which we will gladly send for his emergency case8 ,bell ,co4 7,inc47 ,mfg4 ,chemists ,orangeburg ,new ,york ,u ,s ,a ---------------------------------------- --------------------- ,typical of ,bell-ans advertisements as appearing in medical journals4 ,a recently purchased package of ,bell-ans contained a circular in which it was stated that ,bell-ans removes flatulence1 vertigo1 weakness and other symptoms of indigestion quickly and pleasantly2 that it aids the digestion of food and tends to restore the digestive tract to a normal condition2 that it relieves vomiting in pregnancy1 alcoholism1 seasickness and cholera morbus1 besides being pleasant1 harmless and effective for colic1 sour stomach1 feverishness1 and wakefulness of infants and children4 ,the circular contained paragraphs purporting to be taken from various medical journals1 including the ,new ,york ,medical ,journal1 ,wisconsin ,medical ,recorder1 the ,lancet ,clinic1 ,international ,journal of ,surgery1 and ,massachusetts ,medical ,journal4 ,no exact references were given to permit verification or to determine whether or not the quotations were from 8reading notices0 7advertisements7 or from the scientific part of the journals in question4 ,to quote one of the statements given3 8,the results from the use of ,bell-ans 7,pa-,pay-ans ,bell7 in the treatment of indigestion are so prompt and so generally good--and the evidence of this fact is accumulating so rapidly and from such reliable sources--that we venture to suggest to our readers who have not tried this remedy that they prescribe one original sealed package of ,bell-ans 7,pa-pay-ans ,bell7 and that they carefully note the results from its use4 8,we suggest an original sealed package because the preparation is widely and badly imitated1 and unless such a package is specified an imitation of little value may be substituted and the experiment be thus rendered useless40 ,it is possible that ,bell-ans has been imitated1 but it is not true that it is widely imitated1 for no such imitation has ever been called to our attention1 and we strongly suspect that the main reason for desiring that an original package be dispensed is that the patient may see for himself the name ,,bell-,,ans plainly blown in the glass4 ,the circular in question states that there is no derangement of the digestive organs on which the proper dose of ,bell-ans will not act quickly and pleasantly6 ,these are samples of the claims made for ,bell-ans4 ,let us inquire into the nature of the conditions for which the preparation is recommended and the treatment advised by well known clinicians4 ,the subject of indigestion is discussed by ,robert ,hutchison and ,robert ,saundby under the general title of dyspepsia in the 8,index of ,treatment by ,various ,writers10 ,edition #f1 #aiab1 pp4 #bfj-bfe4 ,hutchison says3 8,in the first place it must be remembered that in many patients who complain of #8indigestion' the seat of the trouble is not in the stomach at all40 ,illustration3 ---------------------------------------- ------------------------- ,a ,philadelphia ,doctor writes3 8,your ,,bell-,,ans for ingestion do just what you claim and more too4 ,i1 personally1 had a bad case of intestinal indigestion with gastric vertigo4 ,i had taken almost everything and got no relief1 until ,i commenced to take ,,bell-,,ans--four to six tablets in a large glassful of hot water after each meal4 ,you have my permission to use this statement1 with my name and address if you wish4 ,i prescribe ,,bell-,,ans constantly0 ,,bell-,,ans ,,for ,,indigestion #be;c package at every drug store in the ,u4 ,s4 ---------------------------------------- ------------------------- ,newspaper advertisement of ,bell-ans1 capitalizing the statements of physicians4 ,the general principles to be observed in the treatment of functional dyspepsia1 as given by ,hutchison1 are3 7#a7 to remove the cause2 7#b7 to adapt the diet to the impaired functional power of the stomach2 7#c7 to administer such drugs as are calculated to stimulate or correct the particular function or functions which happen to be impaired1 or disordered4 ,proper diet1 proper mastication of food1 hygiene of the mouth1 and constipation are enumerated as deserving attention4 ,careful attention to securing a proper diet is essential4 ,the choice of drugs depends1 of course1 on the conditions that give rise to indigestion1 and he calls attention to the necessity of avoiding all routine treatment and compiling one's prescription with an eye to the special disorder or disorders of function1 whether secretory1 motor or sensory1 believed to be present4 ,hutchison gives the following typical prescriptions to illustrate the use of drugs in the different disorders of function3 ,,for ,,hypersecretion 7,,hyperchlorhydria1 ,,acid ,,dyspepsia1 ,,etc47 ,sodium bromid #aj grains ,bismuth subcarbonate #ae grains ,chloroform water #a_/b ounce ,this mixture to be taken before meals4 ,sodium bicarbonate4 ,bismuth subcarbonate4 ,heavy magnesium carbonate1 of each equal parts4 ,a small teaspoonful of the powder to be taken mixed with a little water or milk about two hours after meals4 ,,for ,,deficient ,,secretion 7,,hypochylia1 ,,achylia1 ,,gastritis1 ,,etc47 ,sodium bicarbonate #aj grains ,tincture of nux vomica #aj minims ,spirit of chloroform #h minims ,compound infusion of gentian #a_/b ounce ,this mixture to be taken before meals4 ,dilute hydrochloric acid and glycerin1 of each #ae minims with enough water to make half an ounce1 to be taken about twenty minutes after meals4 ,,for ,,defective ,,motility 7,,atonic ,,dyspepsia1 ,,gastroptosis1 ,,etc47 ,hutchison recommends the use of #aj minims of tincture of nux vomica in an aromatic vehicle1 such as infusion of quassia and compound tincture of cardamom2 but another aromatic bitter1 such as the compound tincture of gentian1 will serve quite as well1 of course4 ,this is to be taken before each meal1 and for the flatulence that often accompanies this trouble he gives menthol1 aromatic spirit of ammonia and spirit of chloroform1 as may be needed4 ,,for ,,acid ,,dyspepsia ,robert ,saundby recommends the following to be used before each meal for the relief of acid dyspepsia3 sodium bicarbonate1 bismuth subcarbonate1 magnesium carbonate1 of each #aj grains2 mucilage of tragacanth #ae minims1 and enough peppermint water to make an ounce4 ,these are only a few of the conditions that are discussed by ,hutchison and ,saundby1 but they serve to show that the treatment of indigestion by a single prescription or combination is wholly irrational4 ,bell-ans1 both under its present name and under its older name1 8,pa-pay-ans 7,bell710 has always been alleged by its manufacturers to contain papain or to be a preparation of the digestive juice from the fruit of ,carica papaya 7papaw7 with other substances4 ,various chemists have attempted to find papain present and to determine the digestive power of the tablets1 but without success4 ,for this reason ,the ,journal suggested that the change of name from 8,pa-pay-ans 7,bell70 to 8,bell-ans0 was probably not made entirely for euphonious reasons1 as alleged1 especially when one considers that the name of a nostrum is its most valuable asset4 ,it is much more likely that as analyses indicated there was not and probably never had been any papain present in the product1 the name was changed for fear that some day the misleading term 8,pa-pay-ans0 might bring the preparation in conflict with the federal ,food and ,drugs ,act4 ,pa-pay-ans 7,bell7 was examined for the ,council on ,pharmacy and ,chemistry in #aiji and the tablets were found to consist of charcoal1 sodium bicarbonate1 ginger1 saccharin and oil of gaultheria4 ,no digestive ferment could be detected in the tablets4 ,sodium bicarbonate is antacid and serves to dissolve mucus2 ginger1 if in sufficient amount1 causes the expulsion of flatus1 and charcoal1 while an absorbent in the dry state1 is probably useless for any therapeutic purpose whatever after it becomes saturated with gastric juice4 ,bell-ans1 then1 has all of the virtues1 which are few1 and all of the limitations1 which are many1 of a tablet of sodium bicarbonate and ginger4 ,its value in the treatment of acute indigestion would be limited to the value of a tablet of such a composition4 ,it is absurd to suppose that it could have the slightest value in the far more serious conditions attended with intestinal indigestion1 with the toxemia and autointoxication to which they give rise4 ,bell-ans is now advertised directly to the public--but it is no less valuable on that account4 ,true1 it is a 8patent medicine0 in the commonly accepted sense of the term1 but it is no more a 8patent medicine0 today than it was fifteen years ago when it reached the public1 not through the direct medium of the newspapers but the more indirect route of the medical journals and undiscriminating physicians4 ,it is true that1 in view of the serious nature of many conditions which are loosely spoken of by the public as 8indigestion10 its present method of exploitation is likely to make it just that much more dangerous because of the larger publicity that will be given4 ,the point to be borne in mind is that ,bell-ans is now in fact what it has always been in essence1 a 8patent medicine40 ,illustration3 - - - - - - - ,,business ,,notice ,,bell-,,ans ,absolutely ,removes ,indigestion4 ,one package proves it4 #be;c at all druggists4 - - - - - - - ,typical of ,bell-ans advertisements as appearing in newspapers4 ,again we ask the question3 ,how do you wish to be classified1 ,doctor--among those who follow blindly the lead of a firm of nostrum makers1 or among the intelligent members of the profession who study their cases carefully and prescribe intelligently8 ,the manufacturers of ,bell-ans claim that #ajj1jjj ,american physicians now prescribe ,bell-ans1 and that #fjj1jjj1jjj of the tablets are sold annually4 ,if this is even approximately true it is a serious reflection on the medical profession1 for the ,council examined ,bell-ans and reported its findings nearly eight years ago 7,j4 ,a4 ,m4 ,a4 #ec3efi ,aug4 #ad #aiji71 and the statements made in that report are as incontrovertible today as they were then4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bd1 #aiag47 ,,article ,,ii ,anasarcin and ,anedemin 8,anasarcin0 and 8,anedemin0 are the twin nostrums of cardiac pseudotherapy4 ,they are dubbed 8twin nostrums0 not so much because of any similarity in their formulas1 that being a minor consideration in the average nostrum1 but because of the close similarity in their methods of exploitation1 the therapeutic claims made for them1 and the time and place of their birth4 ,it may be remembered that they both claim ,winchester1 ,tenn41 as their birthplace1 and they appeared on the market at about the same time2 furthermore1 a comparison of the claims formerly made for both of them indicated that one mind conceived the main idea that lies back of their exploitation4 ,while ,anasarcin is especially dealt with in this article1 much of the discussion applies with equal force to ,anedemin4 ,a ,,lush ,,field ,,for ,,nostrums ,cardiac disease1 with its resultant renal involvement1 is frequently encountered2 and running1 as it does1 a chronic course1 it offers an almost ideal field of exploitation for the typical nostrum vender4 ,by a typical nostrum vender we mean one whose knowledge of his product is far below that of his appreciation of a certain element of human character4 ,on this element rests the whole secret of the nostrum vender's success4 ,it is variously termed credulity1 gullibility and childlike simplicity1 but it is that which often causes even the most conscientious clinician to turn aside from the use of the best known and most dependable drugs at his command1 in the face of disappointment and failure1 and employ some vaunted mixture which1 in his saner moments1 he scorns to use4 ,anedemin is said to consist of a 8,scientific ,combination of three of the more recently investigated members of the ,digitalis ,series1 with ,sambucus02 that is1 of apocynum1 strophanthus and squill with elder4 ,it is difficult to know just what idea the statement that it is a 8scientific combination0 of these drugs is intended to convey1 for it is unscientific to mix three drugs of this group for use in fixed proportion in a wide range of conditions1 if indeed1 there is ever any indication for their use4 ,the great disadvantages of strophanthus and apocynum pertain to the extreme uncertainty of their absorption from the gastro-intestinal tract4 ,strophanthus is occasionally absorbed promptly1 sometimes so slowly that the therapeutic effects are not induced until an amount equal to several times that which would prove fatal if all of it were absorbed into the circulation has been administered1 and1 unfortunately1 one cannot control the absorption which may continue until a fatal effect is induced4 ,this is true to an even greater degree of apocynum1 and it was due to the recognition of this fact that apocynum was not admitted to the ,u4 ,s4 ,pharmacopeia ,,ix1 the committee on dosage having agreed that no safe and effective dose could be given4 ,,the ,,council',s ,,previous ,,findings ,in #aijg the ,council on ,pharmacy and ,chemistry examined the literature used in the exploitation of ,anasarcin and ,anedemin and published its report4 ,anasarcin tablets1 it was pointed out1 were said to contain the active principles of ,oxydendron arboreum 7sour wood71 ,sambucus canadensis 7elder7 and ,urginea scilla 7squill71 and the following claims were made for the nostrum3 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 and permanent cure of dropsies40 8,unrivaled heart tonic40 8,the most powerful agent known40 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 appetite 4440 8,this treatment is to be continued without cessation until all symptoms of dropsy have disappeared40 ,a comparison of the earlier claims with those now being made 7see advertisement reproduced from the ,new ,york ,medical ,journal7 illustrates one of the results of the work of the ,council4 ,today the nostrum exploiter avoids the cruder forms of obvious misstatement1 but continues to make1 by inference1 claims that are equally misleading4 ,it will be observed in this case that a more cautious pen worded the later advertisement1 but there is still evident the intent to convince the reader that ,anasarcin is superior to the official drugs in the treatment of cardiovascular diseases4 ,the facts are that ,anasarcin is at best a dangerous remedy in the hands of the average clinician in the treatment of such conditions1 and its use is at all times to be condemned4 ,no competent investigator has ever investigated the pharmacology of sour wood 7,oxydendron arboreum71 and it appears to have no therapeutic value other than that due to a slight acidulousness4 ,elder 7,sambucus canadensis7 contains a trace of a volatile oil as its most important constituent1 according to the ,british ,pharmaceutical ,codex of #aiaa 7p4 #ijh71 but it is difficult to explain why a trace of volatile oil should be considered important4 ,elder may be dismissed without further consideration in connection with ,anasarcin tablets4 ,,the ,,pharmacology ,,of ,,squill ,this leaves only squill among the constituents of ,anasarcin for consideration4 ,sollmann 7,manual of ,pharmacology1 #aiag1 p4 #dji7 in discussing the advantages claimed for squill over other drugs of the digitalis group1 says3 8,dixon1 #aijf1 points out that any superiority is outweighed by its disadvantages3 uncertain absorption2 strong gastro-intestinal irritation40 ,squill was formerly used as an expectorant and diuretic1 the activity having been attributed to two amorphous glucosids1 scillipicrin and scillitoxin1 but ,ewins1 #aiaa1 found these to be impure mixtures4 ,a later investigator claimed to have isolated two glucosidal agents from squill1 but similar claims have often been made only to be disproved later1 and we know of no confirmation of the claims regarding the isolation of any pure principles from squill having any true typical digitalis action4 ,the statement quoted from ,sollmann is accepted by practically all pharmacologists1 and we may say with certainty that squill is decidedly inferior to digitalis in the treatment of cardiovascular1 and cardiorenal diseases1 and certainly no active principles of squill were known to the scientific world at a time that the remarkable claims were first made for ,anasarcin by an obscure pharmacist of ,winchester1 ,tenn4 ,indeed1 if ,anasarcin were all that it was claimed to be1 its discovery would have made ,winchester as famous as a certain ,wisconsin city was said to have been made by a popular beverage4 ,it has been abundantly demonstrated1 and it is now almost universally accepted among well informed pharmacologists and clinicians1 that all digitalis principles exert the same kind of action on the heart after they enter the circulation in effective doses1 though they differ to an extraordinary degree in the intensity of their action and in their undesired sideactions1 such as nausea and vomiting4 ,when the use of ,anasarcin 7squill7 is followed by immediate improvement after digitalis has failed1 it merely shows that the dosage of digitalis was insufficient or that it was discontinued and the squill mixture was substituted before the full therapeutic effects of the digitalis developed4 ,,when ,,the ,,digitalis ,,group ,,is ,,contraindicated ,if the administration of a sufficient dose of digitalis is not followed by improvement in the circulation1 it shows that the heart is incapable of responding to such treatment and the further use of any of the drugs of this group is distinctly contraindicated4 ,this is confirmed by the experience of nearly every competent observer of digitalis therapy1 and numerous fatalities have resulted from the failure to appreciate this fact and further administer some other member of the group1 such as strophanthus or squill4 ,it is now well known that the cardiac effects of toxic doses of squill1 and other members of the group1 resemble closely those of cardiac disease1 and it is often impossible to determine whether the behavior of the heart in a given case is attributable to insufficient dosage1 to excessive dosage1 or to the progress of the cardiac disease itself4 ,if this occurs when one uses the best known members of the group1 it is certain that it occurs even more frequently when others that are less understood are employed4 ,in the light of this knowledge of the dangers attending the incautious use of any member of the digitalis group1 and more especially the use of impure principles1 such as are commonly obtained from squill1 it is impossible to condemn sufficiently the recommendation that the use of ,anasarcin should be continued without cessation until all symptoms of dropsy have disappeared4 ,digitalis bodies are not suited for the treatment of all cardiac disturbances1 and it is1 of course1 self-evident that a time must come in the treatment of chronic cardiac disease when the heart is incapable of responding to any form of treatment with improvement4 ,but1 unfortunately1 it never loses its response to toxic doses1 and to push the administration of any drug or mixture containing any drug of the entire digitalis group--and especially those1 like squill1 in which the side actions are most prominent--beyond the point of tolerance is to court certain disaster4 ,,the ,,treatment ,,of ,,cardiac ,,dropsy ,while it is quite certain that many lives have been sacrificed to the failure to understand this phase of cardiac therapy1 it is equally certain that many lives have been sacrificed because of insufficient dosage1 and one can steer a safe course between these dangers only by using the best known preparation available2 and in the present state of our knowledge it is indisputable that digitalis and the tincture of digitalis are best suited for the treatment of cardiac disease except in those few cases in which intramuscular or intravenous administration must be employed temporarily for immediate effect4 ,illustration ,the secret of prescribing successfully for the relief of dropsy in cardiac disease consists in understanding the effects of digitalis on the heart1 in administering it until these effects indicate that the desired object has been obtained1 and stopping1 or interrupting1 the administration at that point until the effects begin to wear off4 ,cumulation1 so called1 is a positive advantage in such cases4 ,it merely means that the desired therapeutic effects once induced persist for a time1 and that further medication is unnecessary during such persistence of action4 ,eggleston has recently shown 7,arch4 ,int4 ,med4 #af3a ,july #aiae2 abstr41 ,j4 ,a4 ,m4 ,a4 #dd3dei ,july #ca #aiae7 that the full therapeutic effects of digitalis can be induced in suitable cases within a few hours even with oral administration4 ,we are not aware of a single publication in which a careful1 detailed clinical study of ,anasarcin has been reported4 ,the claims made for ,anasarcin1 past and present1 indicate either a deliberate purpose to mislead or crass ignorance of the rudiments of pharmacology and therapeutics4 ,the exploiters of the nostrum claim that thousands of physicians have found ,anasarcin tablets of unsurpassed remedial value in the treatment of disorders of the circulatory system and of ascitic conditions4#bdd ,it must be admitted that too many physicians have prescribed ,anasarcin1 otherwise the manufacturers would not have continued to spend thousands of dollars in advertising it in medical journals during a period of more than ten years4 #bdd ,former estimates of the number of physicians who prescribed ,anasarcin appear to have been too high1 possibly based on the ratio obtaining in ,winchester1 ,tenn4 ,inquiry at five fairly busy drug stores in a large eastern city showed that in no instance was the pharmacist even acquainted with the name4 ,one pretended to be1 and manifested pity for the inquirer's ignorance in supposing that it could be imported during the war6 ,he was obviously merely less honest than the others1 who frankly admitted they had never heard of it4 ,doctor1 this article is meant to be a candid discussion with you1 whether you use ,anasarcin or not1 because every clinician is vitally interested in the customs that obtain in the practice of medicine1 and we wish to put a hypothetic question to you4 ,answer it1 at least to yourself1 in exactly the spirit in which it is put4 ,suppose that you prescribe ,anasarcin for a patient who is critically ill with cardiac disease4 ,he dies4 ,are you willing to tell the relatives frankly just what you used and the nature of the evidence on which you based your choice of this nostrum8 ,let the supposition be carried further and say that the case was hopeless1 and agree that digitalis and all other drugs would have been equally ineffective4 ,granting all this1 would your explanation satisfy8 ,would you in all candor dare to offer such an explanation8 ,try it as a hypothetic case before you are forced to apply it4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #h1 #aiag47 ,,article ,,iii ,pepto-,mangan ,it would be interesting1 and even instructive1 to know how many educated physicians1 if any1 are now prescribing ,pepto-,mangan 7,gude73 interesting as indicating the number who have neglected to avail themselves of the work of the ,council on ,pharmacy and ,chemistry1 especially the earlier work2 instructive in that it would show how many are still prescribing by the rule of thumb1 and who are taking their therapeutic instructions from purely commercial sources instead of striving to learn how to choose those drugs that are most effective in the treatment of disease4 ,it has been pointed out many times in the pages of ,the ,journal that many nostrums are advertised first to physicians1 and that after physicians have served as the unpaid agents of the manufacturers in introducing the preparations1 their exploitation is then commonly continued by means of advertisements in the public press4 ,this plan has been followed successfully in so many cases that we have now come to look on it as the regular course4 ,it is in keeping with this rule that we find ,pepto-,mangan now advertised in the public press1 the physicians having served the manufacturer's purpose4 ,,discarded ,,theories ,,of ,,iron ,,medication ,it will be recalled that many years ago the theory was held that hydrogen sulphid 7sulphureted hydrogen7 interfered with the absorption of the iron of the food1 and that the administration of medicinal iron prevented this interference by neutralizing the hydrogen sulphid 7sulphureted hydrogen74 ,it was only a short step to argue that manganese might replace the medicinal iron in combining with the hydrogen sulphid1 permitting the food iron to be absorbed1 and it was held that only food iron could be utilized in the formation of hemoglobin4 ,it is hardly necessary to remind the reader that this theory rests on numerous fallacies4 ,there is no hydrogen sulphid worth mentioning in the small intestine where iron is absorbed2 food iron cannot be utilized directly in the formation of hemoglobin but must be broken into simple forms for absorption2 and1 further1 inorganic iron1 such as ferrous carbonate1 serves the purpose admirably when iron is indicated4 ,with the acceptance of these well established facts1 all possible excuse for the therapeutic employment of ,pepto-,mangan in place of iron vanished2 but as plain and simple as this fact is1 the unnecessary and expensive ,pepto-,mangan continues to be prescribed by physicians who will not take the slight trouble to investigate the claims for this nostrum4 ,,false ,,and ,,misleading ,,claims ,there is not merely a difference of opinion between the exploiters and the ,council1 but there has been also actual misrepresentation in the exploitation of this nostrum to physicians4 ,this has been shown on more than one occasion4 ,about twelve years ago1 the ,m4 ,j4 ,breitenbach ,company1 the proprietors of ,pepto-,mangan1 claimed that the report of the commission that had been appointed for the investigation of anemia in ,porto ,rico 8would alone suffice to establish ,pepto-,mangan at once as the foremost hematinic known40 ,examination of the report showed that the commission made no such claims2 on the contrary the commission protested against this misrepresentation 7,j4 ,a4 ,m4 ,a4 #de3ajii ,oct4 #g #aije74 ,illustration3 ,from the ,new ,york ,medical ,journal4 ,undaunted by this exposure of their methods1 the ,breitenbach ,company later sent out a statement of results purporting to have been obtained by one ,mateo ,m4 ,gillen1 in the treatment of infantile anemia on ,randall's ,island in ,new ,york ,city4 ,at the instance of ,the ,journal the hospital records in these cases were examined1 and it was found that the pretended report was little more than a tissue of falsehood 7,j4 ,a4 ,m4 ,a4 #dh3aaig ,april #f #aijg74 ,about two years ago the ,council reported that while the statements just referred to were no longer made1 they had never been definitely admitted by the ,breitenbach ,company to be erroneous1 and that ,pepto-,mangan was then being exploited to the public indirectly4 7,council ,reports1 #aiad1 p4 #aba47 ,we reproduce an advertisement that has been appearing weekly in the ,new ,york ,medical ,journal for several months4 ,one can only suppose that this advertisement was intended to mislead physicians1 and it would be an insult to the intelligence of the average reader to attempt any detailed discussion of it1 but enough has been said to show how misleading the statements are4 ,one should note particularly the advice--old as the nostrum business itself--contained in the advertisement1 to prescribe an original bottle4 ,the reason for such advice is simple4 ,experience has shown that when original bottles are dispensed patients soon learn to buy the nostrum without consulting the physician1 for they shrewdly suspect that he knows no more about the preparation than they1 and that he gets his information from precisely the same sources that are available to them4 ,they are obviously right4 ,in truth1 the physician who prescribes ,pepto-,mangan as a hematinic shows ignorance of the most rudimentary facts of iron therapy1 and the intelligent patient soon perceives his limitations4 ,illustration3 ,a newspaper advertisement of ,pepto-,mangan4 ,,the ,,problem ,,of ,,iron ,,therapy ,the investigation of the problems of iron therapy and its utilization in the formation of hemoglobin forms one of the most brilliant chapters in pharmacologic research1 and there is no better established fact in therapeutics than that any organic or inorganic preparation of iron that does not irritate the stomach may be employed effectively when the administration of iron is indicated4 8,useful ,drugs0 contains a list of iron preparations that are suitable for all conditions which call for iron1 and the clinician may rest assured that he will never have occasion to go outside that list to prescribe any substitute4 ,as a matter of fact1 it seems probable that the very number of available iron preparations has served to cause confusion1 thus affording an opportunity for the nostrum maker to introduce his superfluous compounds4 ,it may be difficult at times to select the preparation of iron best suited to the individual patient2 and it is this difficulty that has led the clinician to listen to the seductive claims made for the various pretended substitutes for iron4 ,one should approach the question of choosing the proper form of iron for therapeutic use with the recognition of the fact that there is no such thing as a substitute for iron in the formation of hemoglobin1 that there are no ideal forms of iron other than those found in the foodstuffs4 ,further1 the clinician cannot avoid the disadvantages inherent in all forms of iron that he can prescribe1 and he must therefore seek that which seems best suited for the individual patient4 ,bunge estimated the amounts of iron present in various foods2 and a table based on this1 and other data1 is given in 8,pharmacology of ,useful ,drugs0 7published by the ,american ,medical ,association74 ,ordinary foods in an ample diet contain enough iron to supply the normal daily loss1 which amounts to only a few milligrams1 but many persons who have poor appetites take an insufficient amount of iron in their food and become anemic4 ,in such cases the additional iron required can be supplied best by adding spinach1 eggs1 apples1 or other iron-rich food to the dietary4 ,,some ,,iron ,,combinations ,william ,hunter discusses the subject of anemia and its treatment at considerable length in the 8,index of ,treatment10 ,ed4 #f1 pp4 #ag-cg1 and gives many prescriptions containing iron for use under different conditions2 and while it is unnecessary to reproduce all of these here1 a few may be given in order to suggest suitable methods of prescribing iron when it cannot be given in sufficient amounts in the food4 ,in chlorosis ,hunter advises that that form of iron which experience has shown to be least disturbing to the patient's stomach should be used1 and he suggests separate stomachic mixtures to be used simultaneously1 not mixed with the iron itself4 ,when constipation exists--and this is a very common accompaniment of chlorosis--he gives the following aperient iron combination3 ,gm4 or c4c4 ,ferrous sulphate #be gr4 iv ,magnesium sulphate #d i ,aromatic sulphuric acid #e vii ,tincture of ginger #g x ,compound infusion of gentian 7,b4 ,p47 q4 s41 ad #cj i ,this1 constituting a single dose1 is to be taken twice daily--at #aa a4 m4 and #f p4 m4 ,a little compound tincture of gentian and water may be used in place of the compound infusion of the ,british ,pharmacopeia4 ,he modifies this somewhat as occasion demands by using sodium sulphate and adding sodium bicarbonate 7which converts the sulphate of iron into ferrous carbonate7 and adds #aj minims of spirit of chloroform to act as a stomachic4 ,hunter also suggests the use of pills of aloes and iron in place of the mixture described above1 and when constipation has been corrected1 the aloes may be omitted and the pill of ferrous carbonate alone may be used for the iron4 ,hunter's comment regarding this pill is1 8very satisfactory40 ,the same form of iron is available in the compound iron mixture1 formerly official1 which ,hunter says is exceedingly good4 ,in this country the compound solution of iron and ammonium acetate1 ,basham's mixture1 so called1 has long enjoyed a wide reputation as causing very little disturbance of the stomach1 and the homely tincture of ferric chlorid is probably useful in a large majority of cases in which the stomach is not especially irritable4 ,we may say with assurance that one of the forms suggested here will suffice for practically every case in which it is necessary to reinforce the amount of iron available in the food by some pharmaceutical preparation4 ,if these do not satisfy your requirements1 consult a really competent pharmacist and enlist his aid in devising a mixture especially suited to your individual patient4--7,from the ,journal ,a4 ,m4 ,a41 ,dec4 #bi1 #aiag47 ,,article ,,iv ,cactina ,pillets ,this preparation may be considered briefly in view of the recent discussion in this series of articles of the pharmacology of the digitalis group and the principles of treatment in cardiovascular disease4 ,the manufacturers maintain that cactina is wholly unlike digitalis1 and that is the truth1 as we shall show2 but since they claim that it is useful in certain conditions of the heart in which digitalis is commonly employed by well informed clinicians1 it is necessary to consider its cardiac actions--or its lack of them6 ,it is difficult to determine just what action cactina is supposed to exert on the heart4 ,for example1 one advertisement contains the following3 8,cactina ,pillets4 ,a gentle cardiac tonic that supports and sustains the heart through its capacity to improve cardiac nutrition40 ,just how the cardiac nutrition is to be improved without an improved coronary circulation is not explained4 ,it would be interesting to know in what other way this is to be accomplished1 and how an improved coronary circulation can be induced without acting on the heart or vessels4 ,but that is what digitalis does1 and you should remember that cactina is so very different from digitalis6 ,then again3 8,cactina ,pillets4 ,a remedy that steadies and strengthens the heart by imparting tone to the heart muscle40 ,that is a pretty direct statement1 but digitalis imparts tone2 and we must not forget that 8cactina0 is wholly unlike digitalis1 and we are told that 8cactina0 is3 8,invaluable in all functional cardiac disorders such as tachycardia1 palpitation1 arrhythmia1 and whenever the heart's action needs regulating or support40 ,if these are merely functional disorders of the heart1 it is highly desirable to know what are the symptoms of really serious cardiac disease6 ,since the manufacturers give us no information concerning the mode of action of 8cactina0 we will turn to the literature of disinterested observers4 ,if one attempts to discover the origin of 8cactina10 he will probably meet with disappointment1 for various bibliographies fail to mention the name of ,sultan1 who is said to have isolated 8cactina0 from ,cactus grandiflorus4 ,it seems that ,sultan worked with ,cactus1 or some other plant1 when a student of pharmacy1 and it is to be remembered that ,cactina ,pillets are manufactured by the ,sultan ,drug ,company4 ,it is doubtful whether ,sultan actually worked with genuine ,cactus grandiflorus2 and1 in fact1 there is good reason for thinking that he did not1 for all subsequent workers who have taken pains to secure genuine ,cactus grandiflorus have failed to detect the presence of any active principle1 except possible traces that are of no therapeutic importance whatever4 ,,what ,,the ,,council ,,found ,the ,council on ,pharmacy and ,chemistry examined the literature relating to cactus and certain proprietary preparations1 including ,cactina ,pillets1 alleged to be made from cactus1 and has reported the results of its investigation 7,j4 ,a4 ,m4 ,a4 #ed3hhh ,march #ab #aiaj7 and we will quote from that report4 8,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 8,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 drug are set out below40 ,illustration3 ,typical advertisements of 8,cactina ,pillets0 from the ,medical ,record and ,new ,york ,medical ,journal1 respectively4 ,the report then proceeds to analyze the work of ,o4 ,h4 ,myers1 ,r4 ,a4 ,hatcher1 ,boinet and ,boy-,teissier1 ,sayre1 ,gordon ,sharp1 ,s4 ,a4 ,matthews1 ,p4 ,w4 ,williams1 ,aulde and ,ellingwood1 and comes to conclusions that are set forth as follows1 in brief3 #a4 ,it is uncertain what part of the plant contains the active principle1 if any such principle exists4 #b4 ,part of the experimental and clinical work has been published under proprietary auspices4 #c4 ,the value of clinical evidence when unsupported by 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 ,in other words1 the literature does not afford a report of a single piece of careful painstaking work the results of which lend support to the claims made for ,cactina ,pillets as stated above1 for it is obvious that if ,cactus grandiflorus contains no active principle1 no active principle can be extracted from it4 ,some time after the report of the ,council was published1 ,hatcher and ,bailey secured genuine ,cactus grandiflorus directly from a competent botanist1 ,dr4 ,c4 ,a4 ,purpus1 of ,vera ,cruz1 ,mexico1 and studied it experimentally4 ,they reported 7,j4 ,a4 ,m4 ,a4 #ef3bf ,jan4 #g #aiaa7 in part as follows3 8,we have been unable to obtain any evidence that the true ,mexican ,cactus grandiflorus possesses any pharmacologic action whatever2 but1 on the contrary1 it appears to be a singularly inert substance when administered either by the mouth or by the vein40 ,when colossal doses of ,cactus grandiflorus are given by the vein1 they sometimes--but not always--appear to exert an extremely feeble action on the heart2 but this action is so slight that its nature could not be determined4 ,even the most colossal doses of ,cactus grandiflorus administered by the mouth to cats1 dogs and frogs exert no perceptible effect4 ,sollmann thus satirizes the absurd claims made by the exploiters of proprietary forms of cactus3 8,should the heart be too slow1 cactus quickens it2 if the heart is too fast1 cactus slows it2 should the heart be too weak1 cactus strengthens it2 if the heart is too strong1 cactus weakens it2 does the heart wobble1 cactus steadies it2 if the heart is normal1 cactus does not meddle with it0 7,j4 ,a4 ,m4 ,a4 #ea3eb ,july #d #aijh74 ,will physicians continue to accept the statements of an interested nostrum vender--who submits not a shred of evidence to support his claims1 but who has a financial interest in convincing them--even when his statements are diametrically opposed to all the evidence that the ,council on ,pharmacy and ,chemistry has been able to secure8--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ai1 #aiah47 ,,article ,v ,ammonol and ,phenalgin ,at the time that synthetic chemical drugs were coming into fame and when every manufacturer who launched a new headache mixture claimed to have achieved another triumph in synthetic chemistry1 ,ammonol and ,phenalgin were born4 ,of course1 these twins of analgesic pseudotherapy were claimed to be synthetics and were duly christened with 8formulas40 ,they were among the first of the nostrums examined for the ,council on ,pharmacy and ,chemistry1 and the false claims made for them were exposed4 ,the analyses made for the ,council showed that ,ammonol and ,phenalgin were simple mixtures1 having the following composition3 ,,acetanilid ,,sodium ,,bicarbonate ,,ammonium ,,carbonate ,,ammonol #ej #be #bj ,,phenalgin #eg #bj #aj ,the reports of the ,council on1 and numerous references to1 these two nostrums may be found in ,the ,journal of various dates4#bde ,the reports will prove interesting to those who are not familiar with1 or have forgotten1 the methods of nostrum exploiters at the time the ,council was formed4 ,following the ,council's exposure of the false claims made by the manufacturers of ,phenalgin1 the ,medical ,record published an advertisement of that nostrum in which an attempt was made to discredit the ,council's report4 ,the editor of the ,medical ,record was requested by the ,council to publish the facts in the case but he refused to do so4 #bde ,j4 ,a4 ,m4 ,a4 #dd3 #agia 7,june #c7 #aije2 ibid4 #dd3 #aiig 7,june #bd7 #aije2 ibid4 #de3 #ice 7,sept4 #bc7 #aije2 ibid4 #df3 #acd 7,jan4 #ac7 #aijf2 ibid4 #df3 #bij 7,jan4 #bg7 #aijf2 ibid4 #eh3 #bhj 7,jan4 #bg7 #aiab4 ,long after the death of ,dr4 ,cyrus ,edson1 the claim was made that ,phenalgin was made under his direction and that it was his 8discovery40 ,as a matter of fact1 ,dr4 ,edson had favored the use of ,ammonol at one time1 and when the ,council exposed the false claims then being made for ,phenalgin1 ,the ,journal charged that a fraud was being perpetrated on the medical profession4 ,despite the exposure of the methods used in exploiting ,ammonol and ,phenalgin1 one finds just as glaringly false statements made in the advertisements of ,phenalgin today as were made in its unsavory past4 ,this would seem to indicate either that physicians have short memories or that they are strangely indifferent to the welfare of their patients1 to their own reputations and to the good name of medicine4 ,the ,new ,york ,medical ,journal of ,dec4 #bb1 #aiag1 contained an advertisement of ,phenalgin--it has been running for months--from which the following is quoted3 8,for the relief of ,,pain the #8logical supplanter of opium and other habit-forming drugs' is ,,phenalgin4 ,no matter how severe or where located pain is promptly and satisfactorily controlled by this effective anodyne--and without disturbing the digestion1 suppressing the secretions1 causing constipation or inducing a drug habit4 8,this is why ,phenalgin has superseded opium and its derivatives for relieving ,,headaches1 ,,rheumatism1 ,,gout1 ,,la ,,grippe1 ,,lumbago1 ,,neuralgia1 ,,disorders ,,of ,,the ,,female1 ,,dysmenorrhea1 ,,and ,,painful ,,conditions ,,generally4 ,to thousands of physicians ,phenalgin #8is the one dependable analgesic--the logical supplanter of opium4'0 ,if we are to suppose that the composition of ,phenalgin is today essentially the same as when it was examined1 the claims just quoted are obviously false for1 of course1 such a mixture must have the properties of acetanilid with all of its drawbacks and limitations4 ,we may contrast the statements made in the advertisement just quoted with those made in ,bulletin #abf of the ,bureau of ,chemistry of the ,u4 ,s4 ,department of ,agriculture4 ,this bulletin on 8,the ,harmful ,effects of ,acetanilid1 ,antipyrin and ,phenacetin0 summarizes the replies received from #djj physicians to whom a questionnaire had been sent4 ,the information thus gained was tabulated and the figures that follow are from these tables4 ,there were reported no fewer than #fad cases of poisoning by acetanilid with #af deaths and #aab cases of its habitual use4 ,the larger number of cases of poisoning followed the administration of the drug1 by physicians1 in doses larger than those now regarded as fairly safe4 ,this large number reported by only #djj physicians indicated an excessively large number in the whole country4 ,since the questionnaire was sent to nearly a thousand physicians1 of whom about #ejj failed to reply1 it may be assumed that had it been sent to the entire #acj1jjj physicians in the country1 at least #ge1jjj cases of poisoning would have been reported4 ,prior to the passage of the federal ,food and ,drugs ,act 7the 8,pure ,food ,law07 many nostrum makers had declared that their preparations contained no acetanilid4 ,when that law went into effect1 some of these manufacturers triumphantly pointed to the fact that they were still able to make the same claim without conflicting with the requirements of the law4 ,this was accomplished in fact by changing the formula and substituting acetphenetidin 7phenacetin7 for the acetanilid4 ,while acetphenetidin is somewhat less toxic than acetanilid1 bulk for bulk1 the toxicity and therapeutic activity of the two drugs are nearly proportional4 ,the claim made by many proprietary medicine manufacturers that they are 8strictly ethical0 because they advertise only to physicians is mere verbal camouflage4 ,there may be no more certain way of insuring the continued use of a nostrum by the public than to have it prescribed by physicians2 and none know this better than the makers of nostrums4 ,a proprietary individuality is obtained by giving some special form to the tablets and package or a special coloring to the capsules 78,specify #8,phenalgin ,pink ,top ,capsules'07 so as to indicate the identity of the products in such a way that the patient may in the future procure them without the advice or warning of the physician4 ,when a proprietary preparation with the name or initials stamped on it or attached to it is prescribed1 the patient immediately is aware of the fact1 and his respect for the physician's intelligence and wisdom is naturally lessened4 ,the physician should never place such dangerous drugs as acetanilid and acetphenetidin1 or ready made mixtures of them1 in the hands of the patient in such a way that they can be employed without his supervision or control4 ,he should never prescribe more than is needed at the time and should not form the habit of using fixed doses or combinations of drugs without a special reference to the particular needs of the individual4 ,certain forms of headache yield more readily to a mixture of caffein and acetanilid or caffein and acetphenetidin than to either acetanilid or acetphenetidin alone4 ,when the physician wishes to prescribe such a mixture he may combine #a grain of caffein or #b grains of citrated caffein with #c grains of acetanilid or #d grains of acetphenetidin in a powder or capsule4 ,under supervision such a dose may be repeated at intervals of from two to four hours if necessary to control pain4 ,it is necessary to remember1 however1 that when small doses fail to give relief1 increase in the dose is useless4 ,this fact is especially important1 and disregard or ignorance of it has been responsible for many cases of poisoning4 ,further1 it should be remembered that while it was taught for many years that the admixture of caffein with acetanilid lessened the effect of the latter drug on the heart1 ,hale has shown that this is not the case and such mixtures must be used with special caution4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #b1 #aiah47 ,,article ,,vi ,fellows' ,syrup1 and ,other ,preparations of the ,hypophosphites ,we hope that it is clear to those who have read the several articles of this series that their purpose is to present evidence that will enable the reader to form a correct estimate of the literature employed in the exploitation of various nostrums4 ,the distinction between mere assertion--however plausible1 and from however eminent an authority--and evidence should again be emphasized4 ,satisfactory evidence rests on careful observation by those who are capable of accurately determining to what extent any changes that may be observed are due to the therapeutic agent employed and not mere accompaniments of such treatment4 ,when the ,council on ,pharmacy and ,chemistry was organized in #aije1 the greater part of the literature of the nostrums was so palpably misleading1 the statements often so ludicrously false1 that it was only necessary to call attention to this fact to have those claims collapse4 ,as a result of the ,council's work1 the exploiters of worthless nostrums have developed a greater degree of shrewdness in avoiding the easily exploded falsehoods4 ,this has made it increasingly difficult to point out the exact statements on which many of the false claims now rest1 even though the exploitation as a whole is as inherently dishonest as before4 ,if a nostrum is worthless1 any exploitation must be false and misleading in effect1 even though not one single false direct statement is made4 ,a platitude may be given an appearance of importance if uttered in an impressive manner1 and it may be employed to suggest far more than it categorically affirms4 ,these two facts are appreciated by many nostrum exploiters and we find that they have adopted the impressive manner to secure attention1 and the platitude to suggest far more than they could defend in direct statement4 ,thus we have the 8lie with circumstance40 ,,fellows' ,,syrup ,a full page advertisement1 which has been appearing regularly for about a year and which must represent a good deal of money1 is used to give an appearance of importance to a few words which1 if printed in ordinary type1 would either pass wholly unnoticed or would lead one to assume that something essential to the full meaning had been omitted4 ,the statement1 in full reads3 8,fellows' ,syrup differs from other preparations of the hypophosphites4 ,leading clinicians in all parts of the world have long recognized this important fact4 ,have you8 ,to insure results1 prescribe the genuine ,syr4 ,hypophos4 ,comp4 ,fellows'4 ,reject cheap and inefficient substitutes4 ,reject preparations #8just as good4'0 ,the only direct statement contained in the advertisement is to the effect that many clinicians have observed that ,fellows' syrup and other preparations of the hypophosphites are not alike4 ,in truth1 ,fellows' is not like the better preparations of this type1 since after standing it contains a muddy looking deposit that any pharmaceutical tyro would be ashamed of4 ,technically1 then1 the statement is true1 but it is hardly credible that the manufacturer is paying for an entire page in a medical journal to make this statement without any attempt to suggest something else4 ,the advertising pages of six medical journals were examined in the order in which they chanced to come to hand4 ,in five of these1 the entire advertisement of ,fellows' syrup was in the words just quoted2 not a single word more4 ,in one there was the further statement3 8,not a new-born prodigy or an untried experiment1 but a remedy whose usefulness has been fully demonstrated during half a century of clinical application40 ,these advertisements show that the exploiters of ,fellows' ,syrup are spending a great deal of money to induce physicians to prescribe the preparation1 and it is equally evident that they wish to convey the impression that the preparation has some therapeutic value4 ,since we find nothing directly false1 in the first mentioned advertisement at least1 we must take the evident intent for consideration and determine what therapeutic value1 if any1 this preparation has1 and whether it is advisable for physicians to employ it in any case4 ,the preparation1 according to the statement just cited1 has been in use for fifty years4 ,as the exploiter of any preparation cites the most convincing evidence in his possession in support of his views1 this claim may be assumed to be the strongest available1 and if this evidence fails we must reject the contention as not proved4 ,here we face a dilemma1 for examination of the literature used in the exploitation of ,fellows' ,syrup fails to disclose any evidence of the kind that we have described as satisfactory2 and we are1 therefore1 forced to conclude that none has ever been found4 ,by this it is not to be implied that no reputable physician has ever reported favorably concerning the therapeutic effects of this preparation4 ,it is quite possible that an extensive literature of that sort might be found if one examined the older medical journals4 ,but the day has passed when every improvement that follows the administration of a preparation is blindly attributed to the drug in question4 ,clinical research today is far more exacting4 ,we will assume that the reader who has investigated the question with an open mind will have come to the decision that the contention that ,fellows' syrup is of especial therapeutic value is not proved4 ,we might rest with that assumption and ask the clinician whether he is prepared to use a nostrum that has been before the medical profession for half a century without any satisfactory evidence having been gained that it possesses therapeutic value4 ,we might ask him whether he would be willing to tell his patients that he was prescribing such a nostrum for them in the face of the absence of any such evidence of its value4 ,,the ,,inertness ,,of ,,the ,,hypophosphites ,but we prefer to go even further and show him that not only is there an entire absence of any evidence of its therapeutic value so far as we have been able to learn1 but in addition there is an abundance of evidence that the hypophosphites are devoid of any such therapeutic effect as they were formerly reputed to have1 and that1 in fact1 they are1 so far as any effect based on their phosphorus content is concerned1 singularly inert4 ,while we have thus far taken the ,fellows' preparation as the subject of the discussion1 we may take a broader view and examine the subject of the hypophosphites in general1 and the substitutes containing phosphorus that have been introduced from time to time4 ,it hardly needs to be said that if the hypophosphites are without therapeutic value1 it is impossible to give them value by combining them in a muddy-looking1 ill-made preparation such as ,fellows' ,syrup4 ,such evidence was submitted to the medical profession in a report of the ,council on ,pharmacy and ,chemistry 7,j4 ,a4 ,m4 ,a4 #fg3gfj ,sept4 #b #aiaf72 and we would strongly advise any one who is disposed to act on the suggestion contained in the advertisements of ,fellows'1 and other hypophosphite preparations1 to read that report in full and to think the matter over before prescribing one of these nostrums4 ,quoting briefly from the report in question3 8,although the overwhelming weight of evidence was against the probability that the hypophosphite preparations are of value as therapeutic agents1 the ,council thought it well to investigate the subject4 ,dr4 ,w4 ,mc,kim ,marriott of ,baltimore was therefore requested to review the evidence for and against the therapeutic usefulness of the hypophosphites and to conduct such experiments as seemed necessary40 ,the ,council was not content to rest on the mere absence of evidence for the value of these preparations or any one of them1 but sought to obtain evidence that would fulfil the conditions mentioned above1 and in pursuance of this plan it secured the cooperation of a trained investigator1 one who would work under the best of conditions for learning the truth4 ,the results of ,dr4 ,marriott's investigation were published in ,the ,journal1 ,feb4 #ab1 #aiaf1 p4 #dhf1 and should be read by everyone who has any interest in the problem4 ,lest some of our readers may fail to refer to the original of ,marriott's paper1 we will quote briefly from it3 8,none of the subjects of the experiment experienced any effect whatsoever from the administration of the drug 444 ,almost all of the ingested hypophosphite is eliminated unchanged4444 8,these experiments 7,forbes7 demonstrate conclusively that the hypophosphites possess no specific value as a source of phosphorus for the body4444 ,it is doubtful if there are any conditions in which the body suffers from lack of phosphorus4 ,even should such conditions exist1 phosphorus1 in the form that it occurs in the ordinary foods1 or as phosphates1 is more efficient in supplying the deficit than hypophosphites that must be oxidized before utilization and which are only about #ae per cent4 oxidized if at all4 ,for example1 half a glass of milk contains more available phosphorus than three large doses of hypophosphites of #ae grains each1 as great a dosage as is usually given4 8,what then1 is the therapeutic value of hypophosphites8 ,there is no reliable evidence that they exert a physiologic effect2 it has not been demonstrated that they influence any pathologic process2 they are not #8foods4' ,if they are of any use1 that use has never been discovered40 ,the case seems to stand about like this3 ,a nostrum maker spends thousands of dollars to tell physicians that his cloudy preparation is not like other preparations1 and physicians are expected to accept that as convincing evidence that they should prescribe and their patients1 perforce1 take it4 ,this too1 in spite of the evidence gained by careful scientific investigators that the hypophosphites in fairly large doses contain less available phosphorus than half a glass of milk1 and that there is no evidence available that they exert any therapeutic effects at all4 ,should we take the meaningless statement of a nostrum maker1 who does not submit evidence of any therapeutic value of his preparation--unless one can call certain careless habits of prescribing evidence--and assume the responsibility of prescribing a nostrum that according to all scientific evidence available is useless1 and of no more effect than a few teaspoonfuls of milk1 so far as its hypophosphite content is concerned8 ,it may be argued that it possesses some value because of its bitter nature4 ,we will not deny that it is bitter2 so is strychnin1 so is quinin1 so are scores of simple drugs1 but what physician would care to admit to his patients that he did not know how to prescribe a simple bitter1 such as nearly every layman can select for himself1 without recourse to a preparation such as ,fellows' ,syrup8 ,we have felt that it is not wholly satisfactory to discourage the use of a given nostrum without making an effort to assist the physician in choosing wisely in the treatment of the condition for which the nostrum is claimed to be useful4 ,in the present instance1 however1 we fear that would prove a task beyond our powers1 for the hypophosphites have been used in such a variety of conditions that the discussion would have to include nearly the whole materia medica if we were to follow our usual procedure4--7,from the ,journal ,a4 ,m4 ,a4 ,feb4 #af1 #aiah47 ,,article ,,vii ,shotgun ,nostrums ,formerly it was customary to prescribe mixtures of many drugs on the assumption that if one of the ingredients missed the mark another might be expected to hit it1 just as a poor marksman is more likely to hit a target at short range with a blunderbuss than with a high powered rifle4 ,increased precision in every branch of science has become the outstanding feature of civilization4 ,the soldier today must shoot straight with a rifle that sends a single ball4 ,there is none of the disposition to rely on chance as when the blunderbuss was used4 ,a capable physician directs his drug straight at the seat of the trouble1 and we now have many drugs that can be depended on to exert definite actions4 ,the complex mixture is just as preposterous in modern therapeutics as the blunderbuss would be on a modern battlefield4 ,every drug exerts undesired side actions1 and it is the aim of the modern physician to try to select the one which will have a maximum of therapeutic with a minimum of undesired actions4 ,when a complex mixture is employed1 it is obvious that only the best is utilized1 whereas all the undesired side actions come into play4 ,we do not pretend that even the best studied drug has not much to be learned about it2 but the nostrum maker who exploits a complex mixture either knows practically nothing of the side actions that it will exert1 or1 if he knows1 he conceals that knowledge4 ,he knows that massive doses of hydrated chloral combined with various narcotics can be relied on to cause unconsciousness in nearly all cases1 but he prefers to speak of this as a hypnotic action4 ,this is plain gambling with human life4 ,when the patient dies1 it is difficult to prove that death was caused by the mixture alone4 ,the ,council on ,pharmacy and ,chemistry has expended a great deal of time and energy in combating the 8shotgun0 nostrum evil4 ,it is easy to understand the disadvantages of such mixtures but it is not so easy to demonstrate the misleading character of the claims made1 with an entire disregard of the truth1 for these mixtures4 ,no one believes that a pot of gold lies at the end of the rainbow1 but no one has actually gone there to see for himself4 ,,bromidia ,there are many types of 8shotgun0 nostrum4 ,some are dangerous1 as in the case of 8,bromidia02 some are preposterous1 therapeutic monstrosities which excite the contempt of educated physicians1 as in the case of 8,tongaline02 some are merely useless mixtures of well known drugs1 sold under grotesquely exaggerated claims1 as in the case of 8,peacock's ,bromides40 ,various formulas have been given for ,bromidia4 ,the manufacturers appear to be more cautious under those circumstances in which falsehood might lead them into collision with the federal authorities1 than when giving reign to fancy and considering only the best means of winning the favor of the physician4 ,it is said to consist of hydrated chloral1 potassium bromid1 ,indian cannabis1 and hyoscyamus4 ,it is impossible to determine from the published formulas just how much hydrated chloral and potassium bromid it contains1 but is probable that there are about #ae grains of each of these two drugs to the fluidram1 and variable amounts of ,indian cannabis and a small amount of either extract or tincture of hyoscyamus4 ,this much is certain3 ,bromidia is a distinctly dangerous mixture for indiscriminate use4 ,the claim of the manufacturers1 implied1 rather than directly stated1 that it is superior to an extemporaneously prepared mixture of those drugs is especially reprehensible because it tends to create the impression that the nostrum is safer in effective doses1 conducing to a false sense of security on the part of those who are deluded into prescribing it in larger doses than they would a mixture of the same drugs prepared extemporaneously4 ,a report of the ,council on ,pharmacy and ,chemistry published in ,the ,journal1 ,may #af1 #aiad1 p4 #aegc1 mentions three instances in which death is reported to have followed the use of ,bromidia4 ,the manufacturers of ,bromidia have no magic power to render hydrated chloral harmless1 while it retains its hypnotic action4 ,it depresses the central nervous system1 and it is nothing less than monstrous for any one to pretend to rob this drug of its dangerous properties while it retains its hypnotic effects4 ,if the patient requires a hypnotic1 the physician should choose that one which his judgment and experience dictate as the best for that particular patient4 ,if he needs hydrated chloral1 the physician should prescribe exactly as much as he believes the patient needs4 ,if the effect is slightly greater or slightly less than anticipated1 no harm is done and the physician has gained experience that will be valuable in future prescribing4 ,if ,bromidia is prescribed and unexpected effects are induced1 it is impossible to know whether these were due to the hydrated chloral or to one of the other narcotics or to a synergistic action2 and there is nothing to guide in the further use of the nostrum1 for mixtures of narcotics commonly have much less uniformity of action than a single drug4 ,the irritant action of hydrated chloral on the stomach can be avoided by the use of bland fluids or dilute solutions4 ,the following serves as an example of the way in which it may be prescribed conveniently3 ,gm4 or c4c4 ,hydrated chloral #bf gr4 xl ,syrup of orange peel ,water of each #cj fl i ,a tablespoonful 7#ae4j c4c47 of this mixture1 containing #aj grains 7#j4fe gm47 of hydrated chloral1 will often induce sleep in the absence of severe pain or serious disturbance1 and seldom does this dose have to be repeated more than once in such simple cases4 ,hydrated chloral is often used in somewhat smaller doses in combination with potassium bromid1 which may be prescribed in a mixture such as the following3 ,gm4 or c4c4 ,hydrated chloral #ac gr4 xx ,potassium bromid #ci gr4 lx ,syrup of orange peel ,water of each #cj fl i ,in producing sleep when severe pain is absent this is as effective as the preceding1 in similar doses4 ,the use of repeated doses of hydrated chloral in such a mixture as this1 or in the form of ,bromidia or other nostrum when sleeplessness is due to severe pain is highly dangerous4 ,it should be remembered that while hydrated chloral is an effective hypnotic in case of simple sleeplessness1 it is not actively analgesic except in distinctly dangerous doses4 ,bromidia in repeated doses will induce sleep even in the presence of pain1 of course2 but any active narcotic does that1 and it is correspondingly dangerous4 ,small doses of morphin given alone are preferable when sleeplessness is due to severe pain4 ,,tongaline 8,tongaline0 is an example of the type of 8shotgun0 nostrum that would be merely ludicrous if we could look on anything that degrades therapeutics so lightly4 ,a report was made to the ,council on ,pharmacy and ,chemistry1 and published in ,the ,journal1 ,july #ag1 #aiae1 p4 #bfi1 and in this report it is stated that ,tongaline is said to consist of tonga1 cimicifuga racemosa1 sodium salicylate1 colchicum1 and pilocarpin4 ,whether the formula was cut short just there because the office boy ran out of breath at that point1 or because the discoverers of this wonderful combination had not heard of the eminently potent substances that the witches added to their cauldron1 we can leave to the reader's imagination1 for it is manifestly impossible to present an orderly discussion of the pharmacology and therapeutics of such a preposterous jumble of drugs4 ,,peacock,s ,,bromides 8,peacock's ,bromides0 belongs to a slightly different class4 ,it is said to consist of the bromids of sodium1 potassium1 ammonium1 calcium and lithium4 ,in the absence of a logical explanation of the pretended superiority of this mixture over one that is made extemporaneously1 the exploiters seem to have been driven to the necessity of pretending that its freedom from contaminating chlorids explains its claimed advantages over mixtures of the official or commercial bromids4 ,the truth is that the chlorids are used as antidotes in bromid poisoning4 ,disregard the claims made for ,peacock's ,bromides1 and ask yourself the question whether you have ever actually seen any ill results following the use of the official bromids that you could reasonably attribute to contaminating chlorids4 ,furthermore1 carefully consider the relative advantage of a single bromid 7say the bromid of potassium1 or bromid of sodium1 if you prefer it71 with the opportunity of observing its effects and adjusting the dose in accordance with the results of your experience1 and a mixture such as ,peacock's ,bromides1 the composition of which you do not know1 and which the manufacturer can alter to suit his own convenience4 ,while it is true that the therapeutic art will not degenerate in its entirety merely because some physicians continue to use the most fraudulent and worthless nostrums1 yet1 on the other hand1 to the extent that a physician continues to be guided by the false teachings of nostrum venders who have no therapeutic training1 he is plunged into therapeutic chaos4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #b1 #aiah47 ,,article ,,viii ,tyree's ,antiseptic and ,aseptinol ,it may seem paradoxic to say that recent progress in the medical sciences has made therapeutic chaos possible1 but it is true nevertheless4 ,revolutions are sometimes slow and orderly1 sometimes sudden and attended with confusion4 ,the revolutionary changes in the medical sciences have been so numerous and so rapid that the general practitioner has been unable to keep pace with them1 and in the resulting confusion the nostrum maker has seen his opportunity for exploiting his useless1 dangerous or unscientific preparations4 ,the greater the confusion1 the greater his opportunity2 and it is no exaggeration to say that he has been the most potent factor in maintaining the chaos of therapeutics4 ,the majority of our readers would probably say that the existing scientific medical literature insures the permanence of established beliefs1 but every one who has delved into the literature has found instances of truths that had been established and forgotten--buried under the ever-increasing avalanche of contributions to that literature4 ,illustration3 ,typical half-page ,tyree advertisement appearing in medical journals4 ,rapid advances are still being made in the medical sciences and unless constant vigilance is exercised therapeutics will return to the chaotic condition from which it has so recently emerged4 ,it was in recognition of these facts--the danger of this return to chaos1 and the difficulty1 in fact1 impossibility1 of any individual's keeping pace with all of the medical sciences--that the ,american ,medical ,association secured the cooperation of men in various branches of medicine in the ,council on ,pharmacy and ,chemistry1 in order that it may place the results of therapeutic progress before the readers of ,the ,journal in an impartial manner4 ,are you profiting by this work1 or are you still depending on your unaided efforts to distinguish the false teachings of the nostrum venders from that of scientific medicine8 ,are you prescribing 8,antikamnia0 and 8,ammonol0 or a simple member of the group1 such as acetanilid or phenacetin8 ,are you depending on 8,tyree's ,antiseptic10 so called1 or are you using an antiseptic about which there is no mystery1 for which no false claims are made1 and one which is really effective8 ,in short1 are you using drugs of unquestioned value1 such as are described in 8,useful ,drugs10 or are you taking your therapeutic instructions from nostrum makers' circulars8 ,perhaps you have been led to believe that the ,council on ,pharmacy and ,chemistry is composed of 8theorists0 and that the nostrums represent the work of 8practical men40 ,every one should strive to be practical1 of course1 and it is worth while to inquire whether scientific experimenters1 who so largely mold medical literature1 should be termed theorists1 or practical men4 ,a practical man practices that which is useful in the treatment of the sick1 and he must determine who is capable of furnishing him with a better materia medica4 ,a perusal of medical literature will convince any unbiased mind that medical science progresses only by means of experiment1 hence experimenters must be considered the really practical men while those who cling to outworn theories are really the 8theorists40 ,illustration3 ,typical ,aseptinol advertisement4 ,when ,lister introduced antiseptic methods into surgery he inaugurated a veritable revolution1 which afforded the nostrum makers opportunities for reaping rich harvests through the exploitation--under extraordinary claims--of cheap mixtures of little1 or no1 value4 ,there is no lack of antiseptics of extraordinary activity in the test tube that are practically harmless to man1 and it would seem natural to suppose that such antiseptics could be used to control the development of bacteria in such diseases as typhoid fever1 but1 unfortunately1 such hopes have not been fulfilled4 ,ehrlich experimented with many phenol derivatives that showed decided antiseptic activity in the test tube1 in the hope that he might find some that could be used to combat such common diseases as diphtheria and typhoid fever1 but while many of these are of low toxicity for man1 he was unable to find even one that could be used effectively in the treatment of any of these diseases4 ,his discovery of arsphenamin 78salvarsan07 resulted from quite another type of investigation4 ,many practitioners lose sight of the essential difference between antiseptics and disinfectants and employ antiseptics in cases in which only a disinfectant action would be of value4 ,an antiseptic does not destroy bacteria1 it merely inhibits their growth2 and when it is diluted too much1 it loses its effects and the bacteria may begin to multiply as though no antiseptic had been used4 ,this is especially true after the use of weak antiseptics in the mouth4 ,these are soon diluted or removed by the saliva1 and the bacteria continue to multiply with only a momentary interruption at best2 hence to advise the use of an oral antiseptic as an effective means of treating diphtheria is little short of criminal4 8,tyree's ,antiseptic ,powder0 was submitted to the ,council nearly twelve years ago4 ,the label on the package stated3 8,this preparation is a scientific combination of borate of sodium1 alumen1 carbolic acid1 glycerin and the crystallized principles of thyme1 eucalyptus1 gaultheria and mentha in the form of a powder40 ,illustration3 ,one of the older newspaper advertisements of ,tyree's ,antiseptic ,powder4 ,a leaflet issued several years ago by the ,aseptinol ,manufacturing ,company states that 8,pulv4 ,aseptinol ,comp40 combines in an elegant form boric acid1 the salts of aluminum1 crystallized phenol1 and the active crystalline principles of thymus1 mentha and gaultheria4 ,a comparison of these formulas would justify the designation of the two preparations as twins1 but even one twin may have a wart where the other lacks it4 ,the formula of ,pulv4 ,aseptinol ,comp4 given in the leaflet also includes ,hydrastis canadensis1 but we believe that a wart should be quite as much of an addition to the anatomy of man as the hydrastis is to this already preposterous formula4 ,similar as the formulas of these two nostrums were said to be1 the general methods of exploiting them were even more similar4 ,a partial list of the diseases for which each has been recommended by its exploiters shows the similarity of methods pursued3 ,,tyree',s ,,was ,,said ,,to ,,be ,,useful ,,pulv4 ,,aseptinol ,,comp4 ,,was ,,said ,,to ,,in ,,the ,,treatment ,,of3 ,,be ,,useful ,,in ,,the ,,treatment ,,of3 ,leucorrhea ,leucorrhea ,gonorrhea ,gonorrhea ,vaginitis ,vaginal inflammation ,pruritus ,pruritus ,ulcerated conditions of ,ulceration of vagina or the mucous membrane cervix ,scrofulous ulcers ,chronic ulcers ,syphilitic ulcers ,prophylactic against specific disease ,disinfecting offensive ,cleansing pus cavities cavities ,deodorant ,deodorant ,profuse and offensive ,checks abnormal secretion perspiration ,we stated that the formula furnished by ,tyree was that given above1 but the ,council was never able to learn when ,tyree actually employed the formula except for advertising purposes2 and analysis of the powder showed that ,tyree's ,antiseptic ,powder was essentially a mixture of boric acid and zinc sulphate1 with insignificant amounts of odorous principles4 ,a remarkable fact brought out in the course of the consideration of the preparation by the ,council was that ,tyree admitted that he had changed the formula without having published the new one4 ,the ,council then showed that a specimen of the 8antiseptic0 that had been kept in a retail drug store for several years was essentially similar to that sold at the later date4 ,thus it would seem that ,mr4 ,tyree had been making his powder by one formula and publishing an entirely different one for years before the ,council published the facts in the case4 ,if ,tyree found it necessary to change the formula of his powder--if indeed1 he ever used the published formula--why did the ,aseptinol ,manufacturing ,company adopt it1 or one so closely resembling it8 ,it is obvious that both of these twin nostrums are utterly unfit for treating the various conditions for which they are or have been recommended2 and in view of the misrepresentation in one case1 it is difficult to understand why it should be taken as the model for the other4 ,do physicians believe that a simple mixture of boric acid and zinc sulphate1 or a mixture such as that given in the formula of 8,aseptinol0 powder1 is in any way superior to a prescription such as any physician could write8 ,there is a far more important question to consider than the relative merits of such nostrums and a prescription of the physician's own devising4 ,that question is whether the medical profession is going to help perpetuate the chaotic conditions that the use of such nostrums fosters or to assist in therapeutic progress by maintaining its independence of such false teachers1 and seeking to aid in the establishment of a rational use of drugs and remedial measures4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #cj1 #aiah47 ,,article ,,ix ,neurosine and the ,original ,package ,evil ,we called attention recently to the skill which the nostrum vender displays in avoiding the particular thorn that pricks him1 and his development of the art of impressively saying1 8,nothing in ,general10 as exemplified in the advertisements of ,fellows' ,syrup4 ,nostrum sellers are more canny than original2 and when once an idea finds lodgment with one of them1 it is made to serve many masters4 ,formerly exploiters of either vicious or worthless nostrums were wont to boast that their preparations were exploited in a 8strictly ethical manner40 ,recent perusal of as choice a lot of advertisements as can be found in the most degraded of medical journals failed to disclose this claim in a single instance1 although the claim that a preparation is 8advertised only to physicians0 is still common4 ,the advertisement of 8,neurosine10 which we reproduce1 was the first one which came to our attention when we searched through some medical journals for one that would illustrate a discussion of the 8original package0 evil4 ,this is the only reason for selecting ,neurosine rather than another4 ,such half page advertisements and others of similar size in various medical journals cost a good deal of money and they presuppose that the ,dios ,chemical ,company is interested in having original bottles of ,neurosine dispensed every time that nostrum is prescribed4 ,why should the firm have any such deep interest in seeing that an original bottle gets to the patient8 ,why should it be necessary to do anything more than see that the genuine mixture reaches the patient8 ,does it seem within the bounds of reason that substitution is so commonly practiced by pharmacists that this firm must go to large expense to prevent the substitution of spurious mixtures for its product8 ,is dishonesty the rule among pharmacists8 ,common sense rejects the plea as placing too great a strain on one's credulity4 ,obviously1 then1 the advertisement does not tell the whole truth1 though it does indeed tell exactly what the nostrum maker wishes to have done1 that is1 to have only original bottles dispensed when physicians prescribe that nostrum4 ,the fact we have2 the reason is not far to seek4 ,illustration ,when the pharmacist puts up an ordinary1 nonproprietary prescription1 the patient gets no clue from the package as to the nature of the prescription employed4 ,but when an original bottle of ,neurosine is dispensed1 even though the pharmacist puts his own prescription label on it1 the patient sees the difference at once and knows just why the usual prescription bottle was not employed4 ,he also knows that he can get the medicine with its original wrapper or label by merely showing the bottle to the druggist1 for the words 8,neurosine0 and 8,dios ,chemical ,co40 are blown in the glass4 ,here1 then1 may be a plausible reason for desiring that only original bottles be dispensed4 ,you may ask1 8,what difference does it make if the patient does learn the name of the nostrum1 he must go to his physician for advice concerning its use80 ,having learned the name of the remedy that has been prescribed for sleeplessness1 let us say1 he proceeds to use it whenever he imagines that he needs it2 and that need1 real or imaginary1 has a way of increasing in frequency4 ,as a result1 the patient takes far more ,neurosine than the physician would think of permitting if the matter had not passed entirely beyond his control4 ,not only has the patient acquired a dangerous habit of self-prescribing1 but he takes especial delight in recommending his favorite remedy to friends whose symptoms1 real and imaginary1 seem to resemble his own4 ,this offers him an opportunity to prescribe with an air of authority4 ,it was prescribed for him by ,dr4 ,blank1 and it gave relief1 ergo it may be depended on to give relief to others6 ,thus is the basis laid for its general use by the laity1 when this process is multiplied sufficiently4 ,the statement is susceptible of easy proof by any one who cares to investigate the matter for himself4 ,there is probably no physician worthy of the name who will attempt to deny that the promiscuous use of hypnotics and narcotics is dangerous1 and certainly no careful physician will deliberately place a narcotic in the hands of patients to be used freely and without control4 ,since we have selected ,neurosine at random1 so far as this particular discussion is concerned1 it is worth while to inquire into its composition1 the claims that have been made for it and the evidence1 if any exists1 for or against its therapeutic value4 ,even the most active of hypnotics are worse than useless if they are inferior to other readily available hypnotics1 or if they have undesired side-actions that outweigh any advantages that they might otherwise have4 ,the ,council on ,pharmacy and ,chemistry investigated the literature relating to ,neurosine and published its report in ,the ,journal1 ,jan4 #i1 #aiae1 p4 #afe4 ,according to this report the manufacturers of ,neurosine claimed that each fluidounce contained3 ,bromid of potassium1 ,c4 ,p4 #dj grains ,bromid of sodium1 ,c4 ,p4 #dj grains ,bromid of ammonium1 ,c4 ,p4 #dj grains ,bromid of zinc #a grain ,extract lupulin #cb grains ,cascara sagrada1 fl4 ex4 #dj minims ,extract henbane #j4jge grain ,extract belladonna #j4jge grain ,extract cannabis indica #j4fj grain ,oil bitter almonds #j4fj grain ,aromatic elixir ,this chemical blunderbuss was recommended for use in insomnia1 hysteria1 neurasthenia1 migraine1 neuralgia1 delirium tremens1 epilepsy and many other conditions4 ,also it was called an ideal calmative for children suffering from chorea1 the exploiters claiming that 8,all authorities recommend the bromids1 hyoscyamus and cannabis indica in this disease40 ,oliver ,t4 ,osborne1 professor of therapeutics in ,yale ,medical ,school1 does not mention one of these three drugs in his discussion of the ,medicinal ,treatment of ,chorea1 in the ,handbook of ,therapy1 though he quotes several authorities in this article4 ,indeed1 he does not mention one of the ten drugs included in the above formula of ,neurosine in connection with the treatment of this disease4 ,it is a curious fact that ,osborne gives the greatest prominence to the use of that drug which is claimed to be wanting in the formula of ,neurosine1 namely1 hydrated chloral4 ,perhaps you may have seen temporary relief follow the administration of ,neurosine in chorea1 and may argue that theorizing is of little value in the face of personal experience4 ,we shall not deny that some may have had that experience1 for ,osborne calls attention to the fact that the success of any medicinal treatment must be judged in the light of the fact that chorea is self-limited1 and the intensity of the symptoms will abate in from two to four weeks4 ,in view of this1 we would hardly dispute the claim that one may administer narcotics1 such as those contained in ,neurosine1 and the symptoms of chorea may abate in spite of such mistreatment4 ,in all the years that ,neurosine has been exploited to physicians with such remarkable claims1 we have never seen a report of a careful clinical study in which the product has been used under the conditions which scientific investigation demands4 ,would you prescribe any nonproprietary preparations which had never been studied clinically1 if a horse-shoer or grocer's boy told you it would cure epilepsy or malaria8 ,according to an editorial note appended to the report of the ,council on ,neurosine1 the ,dios ,chemical ,company consisted at that time 7#aiae7 of ,j4 ,h4 ,chambers1 his wife and two sons4 ,it appeared that ,chambers never claimed to have any special knowledge of chemistry1 pharmacy or medicine1 yet we find that he arrogated to himself or to his employees the right to offer therapeutic advice to the medical profession1 and even to direct them as to how they should prescribe a given mixture4 ,we sometimes fail to see the forest because of the trees4 ,it may help us to obtain a better perspective1 in a problem that concerns us intimately1 by resorting to a hypothetic case1 if a close analogy is maintained4 ,in order that we may see ourselves as others see us in such a situation1 let us consider the following imaginary case3 ,you become involved in a lawsuit in which an effort is made to deprive you of your property and your liberty4 ,you seek what you had reason to believe was competent legal advice2 but1 nevertheless1 you lose your case and find yourself deprived of your property and your liberty4 ,now let us suppose further that you discover1 when too late to permit you to correct your mistake1 that your legal adviser 7we can hardly call such a man a lawyer7 had been acting all along under the guidance of a plumber who made no pretense of knowing anything about law4 ,how would you feel regarding that pretended lawyer8 ,would you feel that you had been treated fairly8 ,would you feel disposed to speak with all charity of him1 to recommend him to those in need of legal advice8 ,you would probably feel toward such a lawyer as patients must feel toward physicians who prescribe proprietary nostrums based on information and advice offered by those who1 though without any special knowledge of chemistry1 pharmacy or medicine1 will be benefited financially if their information and advice are accepted and acted on4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bg1 #aiah47 ,,anasarcin ,,advertising,i ,i ,see index for other articles on ,anasarcin4 ,to the ,editor3--,as an old ,fellow of the ,a4 ,m4 ,a4 ,i beg to present the following facts to you1 and to ask if anything can be done by you to expose the methods of these people3 ,a concern calling itself 8,the ,anasarcin ,chem4 ,co40 of ,winchester1 ,tenn41 has caused to be sent to physicians a chart on the subject of 8,diagnostics of ,renal ,diseases40 ,this chart contains eighteen plates1 which were all taken without knowledge or permission of either myself or my publishers1 ,william ,wood ,co41 from the third edition of my book on 8,urinary ,analysis and ,diagnosis40 ,the plates are partly composite plates1 but mostly portions of plates1 exactly reproduced from my book4 ,i at once caused my publishers to write to the ,anasarcin ,company2 and a few days ago ,i received a letter from a ,dr4 ,h4 ,elliott ,bates of #aah ,east ,twenty-,eighth ,street1 ,new ,york1 whose letterhead says1 8,medical ,advertising40 ,in this letter the writer says that it was he who suggested the sending of such a chart1 and admits that all the plates were taken from my book4 ,in this letter he offers to have a letter sent to every physician of the country 8in which it is explicitly stated that the cuts on the chart were taken from your book1 and that complete information regarding the matters treated on the chart can be found in your book40 ,in other words he offers to advertise my book free of cost to me1 so that ,i should take no further steps in the matter4 ,i consider this entire matter an outrage1 and thought it best to write to you for advice1 since my publishers seem to think that in spite of the violation of the copyright nothing can be done4 ,besides the cuts1 some of the text on the chart is bodily taken from my book1 while some of the other text1 not taken from my book1 but apparently compiled from different articles1 is in part entirely wrong1 so much so that ,i must be ashamed of its being associated with any of my own work4 ,by giving this letter your early consideration1 and advising me what you think it best for me to do1 you would greatly oblige ,louis ,heitzman1 ,m4,d41 ,new ,york4 ,comment4--,readers of ,the ,journal are1 of course1 familiar with the articles#bdf that have been published on 8,anasarcin10 the 8dropsy cure06 ,knowing the standard of ethics that the ,anasarcin concern adopts in the exploitation of its ridiculous squill mixture1 our readers will not be surprised at the standard of commercial ethics which would justify the appropriation of copyrighted scientific material for nostrum advertising purposes4 ,the statement of ,dr4 ,heitzmann's publishers that 8in spite of a violation of copyright nothing can be done0 is1 of course1 incorrect4 ,something can be done by those who hold the copyright4--,ed4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ah1 #aiai47 #bdf ,j4 ,a4 ,m4 ,a4 #df3bhh 7,jan4 #bg7 #aijf2 ibid4 #dh3aece 7,may #d7 #aijg2 ibid4 #dh3afad 7,may #aa7 #aijg1 and ibid4 #di3aiib 7,dec4 #h7 #aiag4 ,,antimeristem-,,schmidt ,some1 possibly many1 of our readers have received a letter from ,cologne1 ,germany1 from the 8,bakteriologisch-,chemisches ,laboratorium ,wolfgang ,schmidt40 ,the letter contains a circular directing the attention of ,american physicians to 8,antimeristem-,schmidt40 ,it also contains some advertising leaflets4 ,one physician in sending this material to ,the ,journal writes3 8,a copy of the enclosed circulars has been sent to many of the physicians in this city1 and probably elsewhere4 ,perhaps it has already been called to your attention4 ,let us be as liberal as possible with our recent enemies4 ,the sooner the old channels of scientific communication are re-opened1 the better4 ,but let us not allow such blatant commercialism from a foreign country to go unprotested1 any more than we should if it were from our own40 ,it should be noted in passing that the envelop in which the ,wolfgang ,schmidt letter came has on its face a rubber-stamped impress to the effect3 8,concerns ,cancer ,treatment40 ,the circular letter declares that by means of ,antimeristem-,schmidt 8either a cure or improvement has been effected in numerous inoperable cases0 of malignant tumors4 ,american physicians are asked 8to employ the preparation when occasion arises0 and are assured that 8every medical man in city or country will be able to carry out treatment without preliminary knowledge40 ,with the letter are two leaflets discussing the use and administration of the product2 one contained what was called a 8,synopsis of some of the more recent publications regarding the employment of ,antimeristem-,schmidt in inoperable malignant tumors40 ,the 8recent0 publications comprised three articles published in #aiaj and one published in #aiab6 ,antimeristem-,schmidt was rather widely exploited some six or seven years ago4 ,as was explained in ,the ,journal1 ,march #h1 #aiac1 p4 #gff1 it is a preparation claimed to be useful in the treatment of inoperable cancer and as a supplementary treatment after operations for cancer4 ,the treatment is founded on a theory advanced by one ,o4 ,schmidt that the cause of cancer is found in a fungus1 ,mucor racemosus1 which1 ,schmidt at first asserted1 carried a protozoon which he regarded as the real cause of the disease4 ,the vaccine is said to be prepared from cultures from this fungus4 ,while ,schmidt claims that he has been able to produce cancer by means of the organism1 scientific research has not verified his claims4 ,extensive clinical trials have shown the treatment to be without effect4 ,the ,journal also advised its readers on ,april #ai1 #aiac1 that no license for the sale of ,antimeristem-,schmidt had been granted by the ,treasury ,department and1 therefore1 its importation into this country was prohibited4 ,neither the therapeutic nor the legal status of the product has been changed since then4--7,from ,the ,journal ,a4,m4,a41 ,dec4 #f1 #aiai47 ,,antiphlogistine ,to the ,editor3--,last ,september1 my chief1 ,dr4 ,j4 ,s4 ,millard1 received a letter from the ,denver ,chemical ,mfg4 ,co41 manufacturers of 8,antiphlogistine40 ,this letter purported to quote many large commercial concerns as testifying to the value of ,antiphlogistine4 ,recently1 ,i doubted the veracity of these claims and wrote to some of those quoted4 ,i quote from the original letter of the ,antiphlogistine company3 8,the surgeon to the electric light and electric railroad company in ,new ,orleans says that ,antiphlogistine is the finest thing he has ever used in burns1 especially flash and brush burns4 8,the physician to the ,new ,york ,edison ,co4 makes a similar statement4 ,he says that the application gives speedy relief and the burns heal quickly without scars40 ,i wrote to ,dr4 ,john ,woodman1 the physician to the ,new ,york ,edison ,co41 who replied in part as follows3 8,the ,denver ,chemical ,manufacturing ,company have no authority to quote me4444 ,i gave ,antiphlogistine a thorough trial1 and found it had a very limited use1 and ,i cannot recommend it for burns44440 ,again1 the ,antiphlogistine letter said3 8,it may be of interest to you to know that at the emergency hospital of the ,ford ,automobile ,co4 in ,detroit1 ,antiphlogistine is carried in stock and is used extensively by the three physicians in burns1 bruises1 infected wounds1 sprains and other traumatic conditions which are constantly arising in such a plant44440 ,i wrote to ,dr4 ,mead who replied as follows3 8,in answer to your letter of ,january #beth1 will state that no ,antiphlogistine has been purchased or used in this hospital for years past1 and ,i cannot imagine why the representative of the ,denver ,chemical ,company should make such a statement as attributed to him44440 ,he adds that 8,antiphlogistine has never been used0 in his department 8on an open wound1 abrasion or burn40 ,is there not some way that such exploitation of our large companies can be prevented8 ,a4 ,g4 ,gould1 ,m4,d41 ,akron1 ,ohio4 ,plant ,physician1 the ,goodyear ,tire ,rubber ,co4-7,from the ,journal ,a4,m4,a41 ,feb4 #bc1 #aiah47 8,,auto-,,hemic ,,serum0 ,a ,cure for ,laziness1 ,ugliness1 ,frigidity and ,many ,other ,things ,the following letters are typical of many that have been received asking for information regarding ,dr4 ,l4 ,d4 ,rogers and his 8,auto-,hemic ,serum40 ,this from a physician in ,new ,york state3 8,can you give me any information in reference to ,dr4 ,rogers of ,chicago1 ,ill41 who has an ,auto-,hemic ,institute80 ,and this from ,kansas3 8,just received a letter from a ,dr4 ,l4 ,d4 ,rogers1 #bhab ,north ,clark ,st41 who is anxious to sell me a course in #8,auto-,hemic ,therapy4' ,would you kindly inform me what he has to sell8 ,he did not tell me what it consisted of2 am inclined to believe it is a rank fake4 ,kindly let me know what ,the ,journal thinks about it4 ,just what is it8 ,in the letter they claim that it is practically a panacea for every blood disease40 ,this from ,maine3 8,what is ,auto-,hemic ,therapy8 ,i have a handsome red and yellow circular from the ,ideal ,life ,extension ,press1 #bhab ,north ,clark ,st41 ,chicago1 soliciting subscriptions to their publication1 offering as a bonus this book1 #8,auto-,hemic ,therapy' by ,l4 ,d4 ,rogers1 ,a4,m41 ,m4,d41 ,,ll4,d41 ,chicago1 and membership in the ,american ,medical ,union40 ,,the ,,national ,,medical ,,university ,in order better to appreciate the probable scientific status of 8,auto-,hemic ,serum10 it is well briefly to sketch some of the previous activities of its discoverer1 ,dr4 ,l4 ,d4 ,rogers4 ,for many years ,rogers was the head and chief owner of the ,national ,medical ,university of ,chicago1 a low-grade school of the 8sun-down0 variety4 ,the 8university0 is now out of existence and for some time before it went out of existence was not recognized either by the board of health of the state in which it operated or by the boards of the majority of the other states in the ,union4 ,the report of the ,carnegie ,foundation on medical education had this to say about the laboratory facilities of ,rogers' school3 8,the school occupies a badly lighted building1 containing nothing that can be dignified by the name of equipment4 ,there has been no dissecting thus far 7,october to the middle of ,april1 #aiji71 anatomy being didactically taught4 ,persistent inquiry for the #8dissecting-room' was1 however1 finally rewarded by the sight of a dirty1 unused1 and almost inaccessible room containing a putrid corpse1 several of the members of which had been hacked off4 ,there is a large room called the chemical laboratory1 its equipment #8locked up1' the tables spotless4 #8,about ten' oil-immersion microscopes are claimed--also #8locked up in the storeroom4' ,there is not even a pretense of anything else4 ,classes in session were all taking dictation40 ,dr4 ,rogers is1 or was1 if he is not still1 8,permanent ,secretary0 of the 8,national ,association of ,panpathic ,physicians0--whatever that is4 ,in fact1 one of ,dr4 ,rogers' specialties seems to be the founding of quasimedical organizations--organizations1 apparently1 which may prove useful in the promulgation of such projects as he may1 at the time1 be interested in4 ,a few years ago1 ,rogers was exploiting a 8cancer serum0 and1 presto1 the 8,american ,cancer ,research ,society0 came into being1 ,l4 ,d4 ,rogers1 president4 ,soon thereafter certain members of the profession were circularized urging them to purchase shares in the 8,cancer ,research ,laboratory and ,hospital10 par value #aj4 ,apparently1 the profession did not invest4 ,a few years ago1 also1 ,l4 ,d4 ,rogers' name appeared on the 8,faculty0 list of the 8,american ,post-,graduate ,school10 a concern which granted--on the mail-order plan--a long line of sonorous degrees and an equally complete line of ornate diplomas4 ,,the ,,japanese ,,consumption ,,cure ,then1 in #aiae1 there appeared in the classified columns of certain newspapers the following advertisement3 ,,tuberculosis--,new ,japanese treatment2 to prove merits and give discovery quick publicity will send #aj days' treatment free4 ,,dr4 ,,rogers1 #edf ,surf ,st41 ,chicago4 ,so far as we have been able to learn1 ,rogers1 for some unexplained reason1 did not call into existence out of the vastly deep a 8,japanese-,american ,tuberculosis ,research ,society40 ,this consumption cure apparently died of inanition4 ,then came the 8,auto-,hemic ,serum0 with its inevitable sequel1 the 8,national ,society of ,auto-,hemic ,practitioners40 ,another adjunct to the serum exploitation is the ,north ,american ,journal of ,homeopathy1 the official organ of the 8,auto-,hemic ,practitioners0 and of the 8,american ,medical ,union0 and possibly of some other 8societies0--but not representative of homeopathy6 ,,what ,,is ,,auto-,,hemic ,,therapy ,what is this new therapy8 ,according to a very lurid poster1 it is described as 8,the ,missing ,link in ,medicine0--possibly referring to the ease with which one may make monkeys of certain physicians4 ,more specifically1 although still vaguely1 we learn3 8,it consists in giving the patient a solution made by attenuating1 hemolizing1 incubating and potenizing a few drops of his or her own blood1 and administering it according to a refined technic developed by the author40 ,elsewhere it is said to consist3 8444 in taking five drops 7or some multiple of five7 of blood from a vein and putting it into nineteen times as much sterilized1 distilled water1 and incubating it at fever temperature for twenty-four hours1 and then making further dilutions according to the needs of the case1 as can be determined only by a physician skilled in its use40 ,neither of these statements1 of course1 describes the 8refined technic0 of those 8skilled in its use10 but those who are interested can1 by sending ,dr4 ,l4 ,d4 ,rogers1 8,one ,hundred ,dollars cash-in-advance0 get a mail-order course in this new marvel4 ,but if it is rather expensive to learn just how to use 8,auto-,hemic ,serum10 it does not cost so much to learn what the 8serum0 will do4 ,rogers has written a book on the subject1 8,auto-,hemic ,therapy10 which is used as a premium for subscriptions to the ,north ,american ,journal of ,homeopathy1 price #e4jj per year1 payable in advance4 ,in the book ,dr4 ,rogers modestly assures his readers that he considers his discovery more important than that of ,alexis ,carrel1 winner of a ,nobel ,prize4 ,a ,,cure ,,for ,,laziness ,one of the chief virtues claimed for this serum is that of developing in the patient who takes it an unbounded energy that1 apparently1 makes him want to work himself to death4 ,in some sensational articles that have appeared in ,sunday editions of newspapers on ,rogers' serum1 the stuff has been described as 8,lazy ,serum40 ,one of the first cases described in the ,rogers book is that of a young waiter1 8a good-for-nothing lazy fellow who would not work and would not pay for medical services0 and who was turned over to ,dr4 ,rogers' free clinic4 ,he was given the serum on ,thursday and was told to report ,saturday4 ,he did not return until ,monday1 his excuse being that 8he worked all day ,saturday until midnight and all day ,sunday and felt as if he could work all day and all night without rest40 ,the 8case report0 ends3 8444 finally remarking1 #8,i feel like a bird' he flew out of the classroom and we never saw him again40 ,,housewives ,,take ,,notice ,the next case described is that of a servant girl who had not worked for a year2 within a week after taking the 8,auto-,hemic ,serum10 8she voluntarily beat carpets till she blistered her hands40 ,then there was the rooming house keeper who had spent more than half of each day in bed4 ,after an 8,auto-,hemic0 injection she 8discharged her maid and janitor 444 and did all the work of her twelve room house herself1 beating rugs1 firing furnace and carrying out ashes besides doing some of the laundry40 8,case ,no4 #gagf0 is interesting3 ,a man1 generally considered the laziest person in his community and with a habit of 8drinking thirty whiskies a day10 took 8,auto-,hemic ,serum40 ,he stopped drinking1 shaved himself and changed from 8a 8bum0 to that of a sober1 clean1 wholesome1 bright and honest workman40 ,then there was the case of the 8lady physician0 who 8took the serum one evening and the next morning reported that she had the #8giggles' all day02 also she became 8more magnetic40 ,more remarkable still was the case of the young woman clerk in a retail store who1 after taking the serum1 8astonished her employer by volunteering to work overtime40 ,in the chapter dealing with 8,ills ,peculiar to ,women0 ,dr4 ,rogers details the moving story of a man to whom the 8serum0 was given and who reported that 8about the third twenty-four hours after taking it his bowels moved forty times0--nevertheless1 8he felt no exhaustion40 ,in all phases of human activity the serum seems to work wonders4 8,the cases are numerous in which the frigidity of both sexes have sic melted after ,auto-,hemic treatment40 ,a young married woman with a morbid dislike for her husband took the serum and within a week 8became normal40 ,the discoverer suggests that in some cases there is no doubt that this serum 8would prevent divorce40 ,a #dj year old woman who could not endure to wear any waists but white or black was able1 it seems1 after taking the serum to tolerate a veritable ,jacob's coat4 ,is1 then1 8,auto-,hemic ,serum0 good for everything8 ,let ,dr4 ,rogers answer3 8,briefly stated1 without any great exaggeration1 this new modified serum treatment is good for anything that is the matter with you1 provided the cause is not organic1 mechanical or bacterial40 ,one infers that in the inorganic1 mental1 spiritual and nonbacterial spheres the stuff is supreme4 ,but it has its limitations4 ,for instance1 ,dr4 ,rogers states that he once had 8a very troublesome cough which lasted several weeks1 but did not yield to this serum40 ,reaching the conclusion that some other treatment was necessary 8he had the bones of his neck #8adjusted' and got immediate relief40 ,,as ,a ,,complexion ,,beautifier ,the serum 8cannot be made up by the barrel and sold at wholesale or retail03 8,if it could be bottled and stored and sold at retail like a patent medicine1 the demand for it as a complexion beautifier alone would net the proprietor millions4 ,more than one person a few days after taking the treatment has been wrongly accused of painting40 ,should any of ,the ,journal readers decide to take the #ajj mail-order course in 8,auto-,hemic ,therapy0 he should realize that even after he has done so there are certain restrictions in the practice of this 8therapy40 ,in no case must he administer 8a course of ,auto-,hemic ,treatment0 for 8less than #ajj1 paid in advance40 ,the only exceptions to this rule are 8cases of absolute charity1 expectant mothers and to persons positively unable to pay that amount40 ,furthermore1 ,dr4 ,rogers says that for the reputation of his method1 as well as for the good of all concerned1 8,i insist that the entire fee be paid in advance and that the course extend over a period of one year whether the patient needs few or many treatments40 ,,dollars ,,and ,,cents ,for those who do not wish to take the mail-order course1 ,rogers offers to prepare individual specimens of the 8serum0 from blood that is sent to him by the physician4 ,the cost of this 8serum0 is #e4jj1 8in advance10 of course4 ,still emphasizing the commercial side1 8,auto-,hemic ,therapy0 is especially recommended to 8the general practitioner growing old and the physician who is ambitious to build up a creditable and lucrative practice0 because 8the health of four people out of five 7old or young1 whether they consider themselves sick or well7 taken at random can be improved by this method of treatment06 ,an ,ohio physician was said to have doubled his #c1jjj practice in two years after starting the 8,auto-,hemic0 method4 ,a ,virginia physician is alleged to have 8increased his income #aj1jjj a year40 ,a ,pennsylvania physician urged by ,rogers to send #aej4jj for the mail-order course1 was assured that this 8is merely a nominal amount1 as most of the doctors have been able to get this amount back the first month40 ,but enough4 ,the story1 were it not for the tragic element that forms the background1 would be amusing4 ,but it is tragic6--7,from ,the ,journal ,a4,m4,a41 ,feb4 #ad1 #aibj47 8,,autolysin0 ,,advertising ,to the ,editor3--,enclosed is a little booklet ,i received today from the ,goodhue ,publishing ,co41 of ,new ,york1 exploiting the ,horowitz-,beebe cure-all for cancer1 which1 were it not for certain obvious serious features1 would make humorous reading4 ,what psychologic explanation can be made of the fact that there are always sufficient numbers of suckers to make such pseudoscientific adventures profitable8 ,h4 ,c4 ,dodge1 ,m4,d41 steamboat ,springs1 ,colo4 ,to the ,editor3--,in my professional life ,i have been flooded with the usual number of insults to intelligence both by mail and by the softspoken detail man4 ,as a result1 ,i have no doubt1 of the active propaganda for reform carried on by ,the ,journal1 these insults have lost a certain quality of 8rawness0 and become much more cleverly done4 ,one of these has just been perpetrated on the profession which will probably hold the championship pennant for #aiaf1 although ,i admit that it is early in the year to begin prophecy4 ,a very modestly bound1 well printed volume comes to my desk with the compliments of the publishers4 ,at the end of the volume is a group of highly ethical advertisements of other books of the author4 ,so far1 so good4 ,the last four pages1 however1 contain the advertisement of a forthcoming book on the 8autolysin0 treatment of inoperable cancer4 ,perhaps we might forgive this were it not for the following paragraph3 8,this book tells how the general practitioner 444 may take an active hand in fighting the malady4 ,the weapons he requires are an ordinary hypodermic syringe and some ampules of ,autolysin4 ,the syringe he already possesses4 ,autolysin he may secure1 if he is a legally qualified practitioner1 by writing10 etc4 ,incidentally1 the book is advertised to the ,intelligent ,layman4 ,isn't it beautiful8 ,too bad the lamented ,f4 ,f4 ,f4 with his mock turtles or those prominent eugenists of scopolamin-morphin fame could not take a lesson in advertising4 ,it was not very long ago that we were invited to come ,east and learn how to use 8autolysin10 or else pay the rather heavy fee for an imported tutor4 ,now all we need is a 8gun0 and some of the 8dope40 ,all this is interesting in view of the recent article on the failure of 8autolysin0 in mouse tumor4 ,it is a foregone conclusion that a lot of 8autolysin0 will be used1 so cancer patients1 who have been told that they have cancer1 will get better through suggestion1 and a lot of enthusiastic reports will pour in from medical brethren who have never studied psychology4 ,then the thing will slump and we shall all be ready for the next fad4 ,nevertheless1 each one of these things furnishes us with a text for another sermon on ethics of medical advertising1 so ,i suppose they do not live in vain4 ,j4 ,w4 ,force1 ,m4,d41 ,berkeley1 ,calif4 ,assistant ,professor of ,epidemiology1 ,university of ,california4 ,comment4--,with each of the foregoing communications is a circular letter from the ,goodhue ,company1 advertising ,dr4 ,henry ,smith ,williams' book on 8,the ,autolysin ,treatment of ,cancer40 ,with this circular is a booklet entitled 8,notes on the ,treatment of ,inoperable ,cancer with the ,new ,remedy ,,autolysin 7,horowitz-,beebe7 ,issued by the ,autolysin ,laboratory40 ,similar circular letters and pamphlets have been sent to ,the ,journal from various parts of the country4 ,the ,goodhue ,company1 publishers1 therefore are apparently killing two birds with one stone--advertising the book as well as 8,autolysin40 ,the ,journal has been informed that ,henry ,smith ,williams in some of his magazine articles uses the pen name 8,stoddard ,goodhue10 and that ,henry ,smith ,williams is a part owner of the ,goodhue ,publishing ,company4 ,articles on 8,autolysin0 will be found in ,the ,journal1 ,nov4 #f1 #aiae1 pp4 #afda1 #afdg and #affb4 ,the article on 8,action of #8,autolysin' on ,mouse ,tumors10 by ,dr4 ,francis ,carter ,wood1 appeared in ,the ,journal1 ,jan4 #h1 #aiaf1 p4 #id4-- ,ed4--7,correspondence in ,the ,journal ,a4,m4,a41 ,jan4 #bi1 #aiaf47 8,,basic ,,cancer ,,research0 ,,and 8,,cosmopolitan ,,cancer ,,research ,,society0 ,medical journals1 and some other technical publications1 have received recently what purport to be items of news value sent out by the 8,medical ,news ,bureau10 #gg ,seventh ,ave41 ,brooklyn1 ,new ,york4 ,the 8manager0 of this alleged bureau is given as ,d4 ,e4 ,woolley4 ,these 8news items0 are undated but are marked3 87,for immediate release70 ,one of these starts with the statement1 attributed to ,mme4 ,curie1 that cancer can be cured by radium and then continues3 8,cancer can be cured by the use of selenium and tellurium1 more plentiful and less costly elements10 says ,f4 ,w4 ,humphreys of ,brooklyn1 an ,american born student of chemistry and science who has devoted years to the study of the cause of cancer and the discovery of methods for relief4444 8,for the purpose of further developing methods of control and treatment of disease by the use of selenium and tellurium discovered by a number of local scientists1 chemists and physicians1 the ,basic ,cancer ,research has been organized and an efficient laboratory established at #hdg ,union ,street1 ,brooklyn44440 8,through the education of the people and special instruction to physicians it is hoped it may soon be possible to gain control of and eradicate the disease which now appears so great a menace4 ,mr4 ,f4 ,w4 ,humphrey1 one of the organizers of the new institution1 estimates that within ten years1 or perhaps less time1 cancer will no longer be considered a fatal disease40 ,evidently the joker here is the 8,basic ,cancer ,research0 of #hdg ,union ,street1 ,brooklyn6 ,newspapers are approached from a different angle4 ,they receive free publicity matter on stationery reading 8,cosmopolitan ,cancer ,research ,society0 7,d4 ,e4 ,woolley1 secretary71 #hdg ,union ,st41 ,brooklyn1 ,n4 ,y4 ,with this matter is a letter from ,woolley addressed to the editor of the paper to which the stuff is sent and asking3 8,in the interest of suffering humanity will you please give space to the enclosed8 8,no object of greater importance has ever been presented for your helpful consideration4 ,thousands are dying whom you can help save40 ,according to the 8news item0 that accompanies this letter the 8,cosmopolitan ,cancer ,research ,society0 has been founded for the purpose of 8investigating and developing methods0 by which cancer 8may be successfully combated and eventually eradicated40 ,it states further that the 8society0 will 8disseminate information concerning symptoms1 diagnosis1 treatment and methods of prevention0 of cancer4 ,furthermore1 the membership of the society 8includes physicians1 scientists and chemists of prominence1 laymen of means1 and the sympathetically inclined from all walks of life40 ,nor is this all6 8,doctor ,frederick ,klein the eminent authority on urinology and the chemistry of cancer1 has evolved a new colorimetric test which is a most wonderful and valuable discovery in the diagnosis of cancer and various other diseases4 ,this test will be particularly valuable in all life extension work because it determines1 even in children the possibility of predisposition toward any particular disease1 whether tuberculosis1 cancer1 diabetes or any of the diseases which in later life may become fatal4 ,it determines also the vitality of the subject enabling the physician to accurately determine the condition of any of the vital organs40 ,we learn in closing that memberships in the 8society0 are 8graduated from #a4jj upwards according to the ability and disposition of those who may be interested40 ,located at #gg ,seventh ,avenue1 from which the press agent material of the 8,medical ,news ,bureau0 is sent1 is the 8,basic ,chemical ,corporation of ,america40 ,according to such information as we have been able to get1 the president of this concern is ,f4 ,w4 ,humphreys1 the 8student of chemistry and science who has devoted years to the study of the cause of cancer and the discovery of methods of relief40 ,we are informed that ,mr4 ,humphreys was for a while in the employ of a 8chemical company0 of ,philadelphia1 and has been in the photographic line down in ,virginia and later was connected with a real estate concern in ,brooklyn4 ,another officer of the ,basic ,chemical ,corporation is said to have been in the grocery line in a small village in ,missouri1 selling out and later coming to ,brooklyn and entering the insurance business4 ,still another officer1 it seems1 was in the fish business4 ,in addition to these three officers1 there are two directors1 one of whom is in the fancy grocery line1 and the other is a local practicing physician whose name we find in the ,propaganda department's testimonial file under ,sanmetto and ,arsenauro4 ,the ,dr4 ,frederick ,klein1 who is described as the 8eminent authority on urinology and the chemistry of cancer10 is not a physician but claims a ,ph4,d4 from ,munich1 ,bavaria4 ,klein claims to have developed certain urinary tests4 ,one of these1 according to him1 8indicates the body ,vitality with great accuracy10 another proves the presence of cancer1 a third is the 8syphilis test0 and a fourth is the 8pregnancy test40 ,and these are not all6 ,those who read the reports of the ,council on ,pharmacy and ,chemistry may remember that ,frederick ,klein is the gentleman who made 8,sulfo-,selene10 which the ,council1 in refusing it recognition1 described as a 8mixture containing a selenium compound of undetermined composition produced by reduction of nitro-selenous acid with sulphurous acid1 mixed with bile salts and diluents40 ,sulfo-,selene was widely exploited in the newspapers in #aiaf as a remedy for cancer1 and ,klein got a good deal of publicity at that time4 ,just what product the ,basic ,chemical ,corporation of ,america is putting1 or is about to put1 on the market we do not know4 ,from the rather vague talk about selenium and ,frederick ,klein's marvelous diagnostic discoveries1 it might be inferred that 8,sulfo-,selene0 was to be resurrected4 ,be that as it may1 it seems fairly obvious that the material being sent out by ,d4 ,e4 ,woolley--whether as 8,manager0 of the 8,medical ,news ,bureau0 or as 8,secretary0 of the 8,cosmopolitan ,cancer ,research ,society0--is advertising matter in the guise of news4 ,in this connection it is worth noting that the ,american ,newspaper ,publishers' ,association1 in a special bulletin issued in #aiji1 published a very complete list of press agents and the interests these agents represented4 ,this list contains the name ,d4 ,e4 ,woolley1 who then was sending out press notices for the ,national ,association of ,piano ,dealers of ,america4 ,is this the gentleman who is now acting as press agent for the ,basic ,chemical ,corporation of ,america8 ,if it is1 it may be that the slump in the piano trade has caused ,mr4 ,woolley to turn from musical instruments to cancer cures4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #c1 #aiba47 ,seleni-,bascca ,in the issue of ,september #c ,the ,journal called attention to a campaign of free publicity that was being instituted by a ,brooklyn concern that1 apparently1 had for sale an alleged remedy for cancer4 ,the press agent material was of two kinds--for medical journals and for newspapers4 ,that which went to the medical journals was sent out on the stationery of the 8,medical ,news ,bureau10 #gg ,seventh ,ave41 ,brooklyn4 ,the 8manager0 of the bureau was given as ,d4 ,e4 ,woolley4 ,the items sent out to medical journals stated that the 8,basic ,cancer ,research0 had been organized to develop a treatment of cancer by the use of selenium and tellurium4 ,the material received by newspapers was sent out by the 8,cosmopolitan ,cancer ,research ,society10 #hdg ,union ,st41 ,brooklyn 7the same address as the 8,basic ,cancer ,research074 ,the 8,secretary0 of the 8,cosmopolitan ,cancer ,research0 was ,d4 ,e4 ,woolley6 ,the name of one 8,dr4 ,frederick ,klein0 loomed large in the matter sent out by the 8,cosmopolitan ,cancer ,research ,society40 ,klein1 we were told1 is 8the eminent authority on urinology and the chemistry of cancer40 ,the ,journal called attention to the fact that ,frederick ,klein's name was not unknown in the ,propaganda files1 as he was the gentleman who manufactured 8,sulfo-,selene10 a product that was widely heralded in the newspapers in #aiaf as a remedy for cancer4 ,it was also brought out that ,klein1 who is not a physician1 claims to have evolved certain remarkable urinary diagnostic tests whereby the presence of cancer1 syphilis1 etc41 may be determined4 ,more than a month after the publication of ,the ,journal's article1 a letter was received 7,october #h7 from ,frederick ,klein4 ,to quote literally from part of the letter3 8,in the above ,journal dated ,sept4 #cth1 ,vol4 #gg1 on page #hje1 regarding the #8,cosmopolitan ,cancer ,research ,society' you have amongst others1 mentioned my name ,dr4 ,frederick ,klein4 8,i wish to inform you that ,i have given my legal adviser the order to write a note to the above ,cosmopolitan ,cancer ,research ,society1 #hdg ,union ,st41 ,brooklyn1 forbidden them to the effect that my name should not be used by above society in any form or writing in any of their transactions1 this has been done some time ago to prevent unethical conceptions concerning myself40 ,shortly after the article of ,september #c another item appeared in the newspapers throughout the country to the effect that the ,cancer ,research ,society was offering a 8#ajj1jjj ,cancer ,prize0 for a 8medicinal cure for cancer40 ,many of the newspapers of the country seemed to bite on this piece of free publicity4 ,this was in the first week of ,october4 ,in the third week of the same month a ,brooklyn paper announced that #c1jjj people had submitted formulas for curing cancer to the ,cosmopolitan ,cancer ,research ,society4 ,the article containing this announcement gave interesting descriptions of some of the 8cures0 submitted and closed with the statement that the ,cosmopolitan ,cancer ,research ,society was establishing 8clinics0 in various cities4 ,it ended with the statement3 8,all treatments are confidential4 ,in this respect the society had the cooperation of the ,brooklyn ,bureau of ,charities4 ,it also has the cooperation of the ,american ,medical ,association40 ,the closing sentence is1 of course1 unequivocally false4 ,at the time of ,the ,journal's article the name of the particular preparation which the ,basic ,chemical ,corporation of ,america was putting out was unknown4 ,shortly after the article appeared it was learned that the product was on the market as 8,seleni-,bascca40 ,a physician1 himself a sufferer from carcinoma1 after reading the article of ,september #c1 sent ,the ,journal some correspondence he had received from the ,cosmopolitan ,cancer ,research ,society regarding the alleged cure4 ,one piece was a letter signed 8,f4 ,w4 ,humphrey1 ,acting ,director2 ,dictated by ,dr4 ,george ,d4 ,barney10 which read in part3 8,our claim is a very simple one indeed1 namely that the use of a proper preparation of ,selenium 7,seleni-,bascca7 restores the ,sulphur metabolism to normal2 we claim that cancer cannot exist in any form1 when the ,sulphur metabolism is normal1 the results from the proper use of ,seleni-,bascca in cases of ,carcinoma are quick and lasting1 the ,medical ,profession can hardly realize that in this modest treatment a remedy for the ,dreaded ,carcinoma has been discovered4 8,seleni-,bascca in its colloidal form is quickly taken up by the blood stream1 reaches the finest tissues and almost immediately resists the further growth of the disease4 ,the research work has been going on since #aija1 under the direction of ,dr4 ,frederick ,klein1 in connection with ,medical ,men who have proved to their own satisfaction that ,seleni-,bascca should be used as a treatment in every case of malignancy40 ,seleni-,bascca comes in small vials containing fifty tablets4 ,each vial bears a label reading3 8,,selenibascca4 ,a mixture of ,colloidal ,selenium in tablet form4 ,recommended in the internal treatment of ,carcinoma and some other cases of faulty metabolism40 ,some of the preparation was turned over to the ,a4 ,m4 ,a4 ,chemical ,laboratory with the request that the tablets be examined to determine whether or not they contained1 as claimed1 selenium in colloidal form4 ,the laboratory report follows3 ,,chemical ,,report 8,an original vial of #8,seleni-,bascca' 7,basic ,chemical ,corporation of ,america7 was examined in the ,a4 ,m4 ,a4 ,chemical ,laboratory to determine whether or not the substance contained colloidal selenium4 ,the bottle contained #ej tablets weighing approximately #j4a gm4 7about #a-a_/b gr47 each4 ,the major portion of the tablet was soluble in hot water4 ,qualitative tests indicated the presence of chlorid1 sulphate1 small amount of nitrate1 potassium1 sodium1 starch1 talc and selenium4 ,tellurium was not found to be present4 ,the ash was equivalent to #e4e per cent42 over one-half of the ash consisted of a talc-like substance4 ,the amount of selenium present in the specimen examined was only about #a4c per cent4 8,in the literature sent out by ,the ,basic ,chemical ,corporation1 #8,dr4 ,frederick ,klein' is mentioned as chemist4 ,several years ago1 the ,council on ,pharmacy and ,chemistry investigated #8,sulfo-,selene1' a cancer remedy1 with which the same #8,dr4 ,klein' was connected4 ,the alleged composition of #8,sulfo-,selene1' as given to the ,council1 was3 8,selenium 4#be 8,sulphur 7partially in colloidal 4#aj and partially in crystalloid state7 8,potassium carbonate 4#aj 8,nitrogen 4#je 8,bile ,salts 4#ej 8,to which is added an inert base or vehicle2 as sugar of milk or amylum40 8,it was claimed that #8,sulfo-,selene' was prepared by reducing nitro-selenious acid with sulphurous acid1 neutralizing with potassium bicarbonate and then adding bile salts4 ,assuming that the composition claimed for #8,sulfo-,selene' was correct the analysis of #8,seleni-,bascca' shows that the two products resemble each other4 ,the tests1 however1 failed to reveal in #8,seleni-,bascca' the presence of the bile salts claimed to have been present in #8,sulfo-,selene4'0 8,the product is not colloidal as claimed as the selenium can be removed by ordinary filtration40--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ai1 #aiba47 ,repudiated by the ,brooklyn ,bureau of ,charities ,to the ,editor3--,my attention has been called to the fact that there appears in a recent issue of ,the ,journal of the ,american ,medical ,association a statement that the ,cosmopolitan ,cancer ,research ,society1 located at #hdg ,union ,street1 ,brooklyn1 has the cooperation of the ,brooklyn ,bureau of ,charities4 ,in reply may ,i say that the ,bureau of ,charities has no connection1 understanding1 or relationship whatever1 with the ,cosmopolitan ,cancer ,research ,society1 and has never sent a patient to them4 ,t4 ,j4 ,riley1 ,brooklyn4 ,secretary1 ,brooklyn ,bureau of ,charities4--,correspondence from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #bd1 #aiba4 ,,bell-,,ans 7,,papayans1 ,,bell7,j ,as the ,new ,york ,tribune's 8,ad-,visor0 ,sees ,it ,j ,see index for additional article on ,bell-,ans4 8,why avoid draughts8 ,sit by an open window if you want to6 ,just take a few drops of ,sneeze-o before you go into the draught and after you come out of it1 and you'll never catch cold4 8,don't be afraid of contagion4 ,kiss your ,uncle ,ebenezer1 even if he's dying of tuberculosis6 ,just fortify yourself with a sip of ,lungicide before you go to his bedside1 and another when you come away1 and you'll be taking no risk4 8,are you going to sit there and let the other folks eat up all the good things just because you are afraid to pitch in1 when #b or #c ,bell-,ans taken before and after the meal would enable you to enjoy your share of all that's coming without a bit of discomfort or distress8 ,bell-,ans has restored the pleasures of the table to thousands who say3 #8,i can now eat anything and plenty of it1 too4'0 8,the first two blurbs are ,the ,ad-,visor's4 ,the third is a bona fide advertisement of ,bell-,ans1 aimed to catch the holiday trade4 ,they are all patterned after the same style and the first two are no more lacking in logic than the last4 ,overeat--deliberately court indigestion--invite gout--don't be a gourmet1 be a gourmand--be an anti-,hoover and eat a lot of food1 whether you need it or not2 than take ,bell-,ans4 ,if it doesn't #8absolutely remove indigestion1' your druggist will give you back your money6 ,could anything be fairer than that8 8,such copy as this is not limited in its evil effects to the misguided individual who eats lobster and ice cream at midnight and trusts to ,bell-,ans to atone for his indiscretion4 ,the most serious effect of such reckless advice is the example which the advertising sets to other advertisers40 ,the comments just quoted are from the ,ad-,visor department of the ,new ,york ,tribune of ,feb4 #g1 #aiah4 ,they are respectfully referred to the ,new ,york ,medical ,journal1 the ,international ,journal of ,surgery and the ,woman's ,medical ,journal--three presumably scientific publications that through their advertising pages urge physicians to prescribe ,bell-ans4--7,from ,the ,journal ,a4,m4,a41 ,feb4 #bc1 #aiah47 ,,campho-,,phenique ,appealing to the ,new ,fledged ,graduate4 ,the secretary of the ,harvard ,university ,medical ,school received from the ,campho-,phenique ,company of ,st4 ,louis a letter that1 presumably1 has been sent to most of the medical colleges of the country4 ,it read3 8,we wish to supply the senior class of all ,medical ,colleges with physicians' samples of ,,campho-,,phenique ,liquid and ,,campho-,,phenique ,powder1 and ,ointment for #aiah4 8,we will thank you very kindly if you will send us a communication stating the number of students in your graduating class1 and if possible1 we would like the name of each and every student1 that we may send him personally a sample of ,,campho-,,phenique4 ,in this way1 we are sure the party receives the sample40 ,presumably1 the ,campho-,phenique concern believes in following the old advice3 ,catch 'em young6 ,in this connection1 it may be well briefly to call to the attention of fourth-year medical students the results of the investigation of the ,council on ,pharmacy and ,chemistry of ,campho-,phenique4 ,the ,council's findings on ,campho-,phenique ,liquid were to the effect that the preparation1 which was exploited under a false 8formula10 was1 essentially1 a solution of camphor and phenol in liquid petrolatum1 substances well known in medicine and none of which under its own name has been credited with possessing any superlative virtues4 ,the ,council's verdict on ,campho-,phenique ,powder was that 8for all practical purposes it is essentially a camphorated talcum powder0 containing1 apparently1 sufficient camphor and phenol to give the talcum powder an odor4 ,it was further brought out in the ,council's report that the ,campho-,phenique ,company was in effect one of the numerous trade names adopted by one ,james ,f4 ,ballard of ,st4 ,louis4 ,mr4 ,ballard seems to market a number of 8patent medicines10 most of them sold direct to the public1 but some1 as in the case of ,campho-,phenique1 exploited to the public via the medical profession4 8,herbine10 a 8marvelous preparation0 that 8puts the liver in healthy condition02 8,ballard's ,snow ,liniment0 that when applied to wounds performs 8a perfect cure that leaves no scar02 8,dr4 ,t4 ,l4 ,stephens' ,chemical ,eye ,salve0 which 8acts quickly in all cases0 and cures 8failing vision10 are some of the numerous 8patent medicines0 made and sold by ,ballard4 8,collins ,ague ,remedy10 8,swaim's ,panacea10 8,swayne's ,panacea0 and 8,renne's ,pain ,killing ,oil0 are four more of ,mr4 ,ballard's products1 for each of which he has pleaded guilty in the federal courts to making false and fraudulent claims knowingly and wantonly4 ,if medical colleges of the better class were turning out graduates today who could be caught by free samples of such nostrums as ,campho-,phenique1 then1 indeed1 would the outlook for the future of scientific medicine be a gloomy one4 ,but they are not4 ,the young man or woman who goes out today from a reputable medical college is imbued with the scientific spirit1 has developed habits of straight thinking and will not1 we believe1 be so uncritical as to accept at their face value claims made for nostrums of the ,campho-,phenique type4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #i1 #aiah47 8,,cinchophen03 ,,formerly 8,,atophan0 ,it will be remembered that the ,federal ,trade ,commission adopted the names arsphenamin and neoarsphenamin for the drugs first introduced as 8salvarsan0 and 8neosalvarsan10 respectively2 the terms barbital and barbital sodium for the substances first introduced as 8veronal0 and 8veronal sodium10 and the word procain as the name for the compound first marketed as 8novocain40 ,in issuing licenses for the use of the patents on these drugs1 the commission stipulated that the drugs should be sold under the new ,american title unless the firm desired to use a new trade designation1 in which case the titles chosen by the commission should be given equal prominence4 ,the ,council on ,pharmacy and ,chemistry has cooperated with the ,federal ,trade ,commission and has adopted the new names as the descriptive names which appear in ,new and ,nonofficial ,remedies4 ,the ,chemical ,foundation1 ,inc41 which has purchased some #d1ejj ,german-owned patents1 many of them for synthetic drugs1 proposes to continue the wise policy of the ,federal ,trade ,commission by requiring that those who receive licenses for the use of patents for synthetic drugs must use a common designation for each drug selected by the foundation4 8,cinchophen0 has been selected as the designation for the substance introduced as 8atophan0 7also described in the ,u4 ,s4 ,pharmacopeia under 8phenylcinchoninic acid074 ,in consideration of this action on the part of the ,chemical ,foundation1 and also because physicians found it difficult to use the pharmacopeia name 8phenylcinchoninic acid10 the ,council on ,pharmacy and ,chemistry has recognized the contracted term 8cinchophen0 as a name for the drug introduced as 8atophan40 ,it is hoped that physicians will support this simplified and nonproprietary nomenclature in the same spirit with which they adopted the terms 8arsphenamin10 8barbital0 and 8procain40--7,editorial from ,the ,journal ,a4,m4,a41 ,aug4 #i1 #aiai47 8,,collosols03 ,,an ,,uncritical ,,english ,,endorsement ,under the auspices of the ,british ,association for the ,advancement of ,science1 there has just appeared a report on the present status of colloid chemistry4#bdg ,the work has been recognized as sufficiently important to receive the endorsement of the government ,department of ,scientific and ,industrial ,research4 ,of particular interest to physicians is the chapter on 8,administration of ,colloids in ,disease0 written by ,alfred ,b4 ,searle1 8consulting chemist1 ,sheffield40 ,after a somewhat academic generalization of colloidal drugs1 the 8thesis0 is devoted largely to the 8,collosols0--proprietary preparations made by the ,crookes ,laboratories4 ,the 8scientific0 evidence presented by ,searle for colloids in medicine reads as if the advertising literature of the ,crookes concern had been considered ample source of information4 ,thus3 8,colloidal ,manganese10 besides having been 8used with remarkable and surprising results in the treatment of coccogenic skin diseases1444 gives excellent results in impetigo1 chronic seborrheic eczema and acute folliculitis when employed in conjunction with intramine06 ,the grave danger of the intramine therapy has been known for more than two years1 both here and abroad1#bdh in fact1 one author stated that in cases of intramine injections1 8the pain is undiluted torture40 ,in a style as bombastic and verbose as the usual house-organ write-up1 the report recklessly details all sorts of conditions in which so-called colloids--and particularly the 8,collosol0 brand--have been recommended1 but derogatory findings are conspicuous by their omission4 ,even ,sir ,malcolm ,morris is quoted as lending his name 7and title7 to the endorsement of 8,collosols40 #bdg ,british ,association for the ,advancement of ,science4 ,second ,report on ,colloid ,chemistry4 ,published for the ,department of ,scientific and ,industrial ,research by ,his ,majesty's ,stationery ,office4 #bdh ,ferrivine1 ,intramine and ,collosol ,iodine1 ,j4,a4,m4,a4 #fi3hda 7,sept4 #h7 #aiag4 ,in the ,united ,states the medical profession has created a means whereby physicians need not be misled by such 8high0 authorities as evidently has been the case with our ,english confrres4 ,once more the value of the ,council on ,pharmacy and ,chemistry is strikingly manifested4 ,what are the facts about 8,collosols08 ,the ,council has reported that a number of the 8,collosol0 preparations were not colloids at all1 and 8if 444 injected intravenously as directed1 death might result1 making the physician morally if not legally liable02#bdi that in the cases in which the therapeutic claims were examined1 the claims were found to be either exceedingly improbable or exaggerated2 furthermore1 that the ,a4 ,m4 ,a4 ,chemical ,laboratory found 8,collosol ,cocaine10 on analysis1 to contain only #dj per cent4 of the claimed amount of cocain4#bej #bdi ,collosol ,preparations1 ,j4,a4,m4,a4 #gb3afid 7,june #g7 #aiai4 #bej ,collosol ,cocaine ,not ,admitted to ,n4 ,n4 ,r41 ,j4 ,a4 ,m4 ,a4 #gb3 #ajid 7,april #ab7 #aiai4 ,such are the findings which have been presented to the ,american physician4 ,but the ,british physician is now being made the object of an intensive advertising campaign for 8,collosols10 based in part on an uncritical1 pseudogovernmental endorsement4 ,just so long as the ,english profession will not protect itself by creating a competent board to examine and judge proprietary medicines and to control methods of exploitation1 just so long will such extravagant and even cruelly misleading claims continue to impede scientific progress in therapeutics4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ah1 #aiai47 ,collosol ,manganese ,to the ,editor3--,has anything been published on the efficacy of 8,collosol ,manganese0 in malaria8 ,i recently read the ,council's report which indicated the fakishness of the 8,crooke's ,collosols10 but ,i also was told that the ,war ,office of ,england had requested a study to be made of colloidal manganese in malaria4 ,j4 ,b41 ,columbus1 ,ohio4 ,,answer4--,stephens1 ,yorke1 ,blacklock1 ,macfie1 ,cooper and ,carter report in the ,annals of ,tropical ,medicine and ,parasitology 7,feb4 #bh1 #aiai1 p4 #cde7 the results of their investigation for the ,english government and conclude3 8,collosol ,manganese in the doses used is of no value in the treatment of simple tertian malaria40--7,query in ,the ,journal ,a4 ,m4 ,a41 ,may #c1 #aiai47 ,,cotton ,,process ,,ether ,to the ,editor3--,please let me know what information you have about the enclosed clipping8 ,e4 ,w4 ,carpenter1 ,m4,d41 ,greenville1 ,s4 ,c4 ,to the ,editor3--8,cotton ,process ,ether10 manufactured by the ,du ,pont ,co41 has been given considerable notoriety in the lay press4 ,a letter of inquiry addressed to the firm elicits the information that 8,cotton ,process ,ether is a very highly refined ,di-ethyl ,ether charged with ,ethylene ,gas40 444 ,what is your opinion of the 8,cotton ,process ,ether08 ,has the ,council on ,pharmacy and ,chemistry investigated this product8 ,john ,l4 ,atlee1 ,m4,d41 ,lancaster1 ,pa4 ,to the ,editor3--,i have been waiting for some reference to the new anesthetic referred to in the enclosed clipping1 but if any has been made in the medical press ,i have failed to notice it4 ,if there is anything of interest in connection with this item1 and it is not too much trouble1 ,i will thank you to put me in touch with the situation4 ,holman ,taylor1 ,m4,d41 ,fort ,worth1 ,tex4 ,,answer4--,about ,january #bj1 the 8,news ,service0 of the 8,e4 ,i4 ,du ,pont ,de ,nemours and ,co41 ,inc410 circularized the press of the country with what it was pleased to term a 8good #8filler'02 this particular piece of press agent work dealt with 8,the ,new ,du ,pont ,ether40 ,to quote one paragraph from the 8,news ,item03 ,the new anesthetic1 which is a highly refined di-ethyl ether1 modified by the addition of gases1 has the following characteristics3 7#a7 the property of inducing and maintaining anesthesia with practical freedom from postoperative nausea1 and 7#b7 the property of inducing and maintaining analgesia 7conscious insensibility to pain7 as distinguished from anesthesia 7insensibility to pain plus narcosis74 ,the ,du ,pont ,ether and the claims made for it are seemingly based on the work of one man1 8,james ,h4 ,cotton1 ,m4,a41 ,m4,d41 ,toronto1 ,canada10 who published an article on 8,cotton ,process ,ether and ,ether ,analgesia10 in the ,american ,journal of ,surgery for ,april1 #aiai4 ,however1 ,cotton did not give the composition of the 8new0 ether nor1 so far as we are aware1 has his work been corroborated4 ,in view of the inquiries received1 the ,secretary of the ,council on ,pharmacy and ,chemistry asked the ,du ,pont ,chemical ,works for the composition of the new ether4 ,from the firm's reply we quote one paragraph3 8444 ,the procedures of manufacture1 and the exact composition of our ether1 we regard as confidential information which we are entitled to retain unless a condition were to arise in which we were unable alone to satisfy the demand for this type of ether40 ,it has been recognized--and incorporated in the 8,principles of ,medical ,ethics0--that the use of a therapeutic agent of unknown composition is unscientific and contrary to the best interests of the medical profession and the public2 but it is many times more serious for a physician to employ a secret or semisecret substance as an anesthetic4 ,a physician using such a semisecret substance would have little defense if the patient should die4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ba1 #aibj47 ,a ,note from the ,manufacturers ,in the ,query and ,minor ,notes department of ,the ,journal of ,february #ba1 some inquiries from physicians relative to 8,cotton ,process ,ether0 were answered4 ,in referring to the composition of this product it was stated that the secretary of the ,council on ,pharmacy and ,chemistry had asked the manufacturers1 the ,du ,pont ,chemical ,works1 for information on this point and one paragraph from the firm's reply was quoted4 ,another paragraph from the same letter was omitted2 and to this omission the manufacturers took exception1 expressing the opinion that by it ,the ,journal led its readers to infer that the concern had 8refused to furnish any information whatever0 regarding the composition of the ether4 ,the following paragraph1 italicized as in the original letter1 is the one in question3 8,cotton ,process ,ether contains no components which do not occur in other anesthesia ethers4 ,its peculiar properties result from the thorough methods taken to exclude harmful impurities1 such as aldehydes1 peroxides1 traces of acids1 carbon monoxide1 sulphur compounds1 etc41 and to include carefully regulated quantities of only such of the usual components as we have found to give distinctly beneficial properties to the ether4 ,we are willing to state that in this class we consider properly prepared ethylene of greatest importance1 but we have not announced which of the beneficial components of anesthesia ether we include in our ether1 or the amount of such components40 ,as the quotation shows1 the paragraph is informative in a negative rather than in a positive way in that it states what ,cotton ,process ,ether is not rather than what it is4 ,since that time1 however1 the manufacturers have notified ,the ,journal that they have definitely decided to present ,cotton ,process ,ether to the ,council on ,pharmacy and ,chemistry for consideration and that in preparing the data required by the ,council will define ,cotton ,process ,ether as follows3 8,an improved anesthesia ether consisting of highly refined diethyl oxid 7,c,h7,o1 plus approximately two volumes of ethylene 7,c,h71 #a_/b volume of carbon dioxide 7,,co7 and #a per cent4 by weight of ethyl alcohol40--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #bb1 #aibj47 ,,dionol 8,dionol0 is advertised to physicians by the ,dionol ,company of ,detroit4 ,if one takes the word of the manufacturers1 the therapeutic possibilities of ,dionol are apparently limited only by the blue sky4 ,even the company admits that 8the unprecedented range of action0 of this marvel 8may come as a surprise40 ,a glance over the published 8case reports0 confirms the inference4 ,from 8,bed ,sores10 8,bubo10 8,catarrh0 and 8,circumcision0 through 8,croup10 8,deafness10 8,dysmenorrhea0 and 8,eczema10 including 8,endometritis10 8,erysipelas10 8,gastritis0 and 8,hemorrhoids10 not omitting 8,osteomyelitis10 8,otitis ,media10 8,pneumonia0 and 8,ptomaine ,poisoning10 down through the pathologic alphabet to 8,quinsy10 8,sciatica10 8,spinal ,curvature10 8,varicose ,veins10 and 8,whooping ,cough0 one concludes that here at last is a catholicon indeed4 ,what is ,dionol8 ,first it should be said that the preparation comes in two forms3 as an ointment and as an emulsion4 ,the ointment1 so declare the manufacturers1 8is always required02 the emulsion may be used 8as an auxiliary treatment40 ,the ,dionol 8literature0 when stripped of the verbal camouflage with which it abounds may be said to propound the following theories and propositions3 ,first1 that the nerves of the body are electric conductors insulated from the surrounding tissues by the nerve sheaths2 second1 that inflammation breaks down the insulation with the resultant escape of the current and an interference with the normal metabolic action of the cells2 third1 that ,dionol1 when applied to the body1 penetrates the tissues1 8coating the cells and with them the nerve sheaths with a nonconducting layer which is sufficient to insulate the nerve sheaths and stop the leak40 ,so much for the theory on which the alleged action of ,dionol is based4 ,dionol itself is a sort of glorified petrolatum4 ,not1 of course1 that the manufacturers describe it in any such crude and understandable language4 ,according to the company1 ,dionol is 8composed of pure hydrocarbons1 especially selected with regard to specific gravity1 viscosity and other necessary physical properties0 which has been 8perfectly deionized by our special scientific process under the ,baines ,method40 ,it appears1 from further reading1 that ordinary petrolatum will not 8turn the trick02 presumably because it does not overcome the human short circuits which the ,dionol ,company declare are always present in inflammation4 ,when1 however1 the petrolatum has been subjected to the 8,baines ,method0 it achieves1 it seems1 an esoteric value that puts to shame its plebeian origin4 ,the whole thing is very simple4 ,to those physicians that like this sort of thing this preparation should make a strong appeal4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bf1 #aiah47 ,glorified ,petrolatum ,an ,indiana physician sends us in a batch of leaflets detailing the marvels of 8,dionol0 and thus comments3 8,i received the enclosed in the mail today and ,i am puzzled1 perplexed and astounded4 ,i had formed the opinion that the profession was getting better2 that it was more scholarly than formerly when the two course school was still in existence and any one could matriculate2 that it was no longer possible for a #8patent medicine' manufacturer to palm off his wares on us4 ,after reading this stuff and realizing that such methods must be remunerative1 ,i am deeply humiliated4 ,is it possible that educated physicians respond to this kind of advertising8 ,or has some one perpetrated a joke on me8 ,if the profession can be thus successfully exploited one can no longer wonder at the following which every new #8ic' and #8ism' acquires40 ,it is a pity that the medical profession generally does not react to the ,dionol and similar advertising as does our correspondent4 ,as the concern continues to do business1 the presumption is that at least some physicians are using ,dionol4 ,as was pointed out in ,the ,journal of ,jan4 #bf1 #aiah1 ,dionol seems to be a glorified and esoteric form of petrolatum4 ,the exploitation of ,dionol is based on the following theory3 7#a7 ,the brain is a generator of neuro-electricity2 7#b7 the nerves are the conductors of this electricity2 7#c7 the nerve sheaths are the insulator2 7#d7 wherever there is local inflammation the nerves are short circuited1 due to a breaking down of the insulation resistance of the nerve sheath2 7#e7 this results in 8an escape of neuro-electricity20 7#f7 ,dionol coats the nerve sheaths with a nonconducting layer and this restores the insulation and 8stops the leak40 ,whether this ingenious theory was invented to lend an air of verisimilitude to an otherwise bald and unconvincing tale and give a 8reason for being0 for ,dionol or whether ,dionol was first invented and it became necessary to evolve a theory that would give some plausibility to the claims made for this etheralized petrolatum1 we are unable to say4 ,in any case the theory and the product are exploited together4 ,among the material sent in by a correspondent are some 8,dionol ,case ,reports40 ,neither the names nor the addresses of the physicians making these reports are given1 but the company states that they may be had 8on request40 ,one special 8report0 is featured under the heading 8,infected ,wound4 ,striking ,results ,after ,united ,states and ,french ,government ,army ,surgeons ,failed0 is signed 8,dr4 ,w40 ,it is dated ,july #ai1 #aiai4 ,a few months ago the ,dionol ,company was sending out this same testimonial with the full name and address of the 8doctor0 giving it4 ,investigation showed that the 8doctor0 in question was an osteopath whose specialties1 according to his advertisement in his local newspaper1 are 8,catarrhal ,deafness and ,hay ,fever1 ,acute and ,chronic ,diseases06 ,in this connection it is worth noting that investigation of some of the earlier testimonials sent out by the ,dionol concern and alleged to have been given by 8doctors0 showed that the gentlemen in question were 8drugless healers40 ,as a 8true indication of the value which the medical profession is placing on ,dionol0 the ,dionol ,company has published the names of some physicians who1 it is alleged1 have used the preparation4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #g1 #aibj47 ,,the ,,eli ,,products ,,of ,,eli ,h4 ,,dunn ,physicians are receiving some miscellaneous advertising matter from a concern that seems to operate under various names such as 8,e4 ,h4 ,dunn ,co410 8,eli ,h4 ,dunn10 8,eli ,laboratory10 etc4 ,the concern is located at #chbj ,main ,st41 ,kansas ,city1 ,mo4 ,one ,journal reader1 who is evidently not greatly impressed by this material1 forwards the stuff to us with the laconic request3 8,will you please give me your opinion on this junk80 ,the 8junk0 referred to comprised1 in part1 an advertising leaflet on 8,eli #fjf ,capsules10 another leaflet on 8,eli ,vaginal ,capsules10 still another on 8,eli #8,vim' ,restorative20 then there was reference to the inevitable nostrum for intravenous use3 8,ampoules ,eli ,venhydrarsen40 ,a four-page leaflet1 headed in large and very black letters 8,confidential ,guide to ,live ,wire ,physicians ,only10 expressed its key-note in the opening paragraph3 8,how to make ,,money as well as ,,reputation in the treatment of all ,,chronic ,,ailments and all types1 forms and sequella of ,,venereal diseases40 ,the 8,eli #8,vim' ,restorative0 is said to be a 8tonic aphrodisiac40 ,the 8action0 of the product is to 8,arouse ,sexual ,ardor and ,desire4 ,influx blood supply to the genital organs40 ,a postscript to the 8,guide0 urges physicians3 8,if you do not already use ,intravenous ,serums1 by all means get an outfit1 if for no other reason than to meet the popular ,,demand40 ,a 8,special ,note0 in the 8,confidential ,guide0 advises physicians who 8have to deal with ,hysteria0 to 8write the ,author of this ,guide1 who will explain by personal letter a method of cooperation by which such ,convulsions may be ,at ,once and forever stopped4444 ,there will be #ajj for ,you from every case treated40 ,one physician wrote to the 8,author of this ,guide0--,eli ,h4 ,dunn1 ,m4,d4--asking for further information on this treatment for hysteria4 ,he received in reply two letters both signed ,eli ,h4 ,dunn2 one was to be shown to the patient1 the other was for the doctor's own information4 ,the letter for the patient to see described the marvelous effects of 8,dunn's ,intravenous and ,restorative ,treatment0 in hysteria and recommended it 8with the utmost confidence in every case able to pay you the fee commensurate with the service you render40 ,then followed these two paragraphs3 8,the cost of the treatment when administered by yourself is #cjj ,,cash ,,with ,,orders which includes one complete outfit and technique for administering4 8,should you call me personally in consultation an additional fee of #aej per diem covering the time ,i am away from my ,kansas ,city office2 fees to be collected and held until ,i arrive40 ,the letter that was intended only for the doctor's eye declared3 8,you are to have #ajj of the fee and #ej of the per diem40 ,it explained that the 8complete outfit0 referred to in the 8patient's letter0 would 8consist in part of a tube of intravenous medication0 and doses of 8,restorative ,capsules0 and 8,eli #fjf ,capsules40 ,eli ,h4 ,dunn seems to have had a somewhat varied and spectacular career4 ,after being graduated in #ahhe he apparently started practice in ,orion1 ,ill4 ,during the nineties he was practicing at ,elma1 ,iowa1 and about #aijj he seems to have moved to ,kansas ,city1 ,mo4 ,during #aijf and #aijh1 he also had an additional office at ,denver1 ,col4 ,about this time he was exploiting 8,dunn's ,uterine ,evacuant0 which was 8a strictly legitimate0 product which could 8be injected within the uterus with perfect safety and immediate effect40 ,this stuff was advertised both from the ,kansas ,city and the ,denver offices4 ,the 8,personal ,column0 of a ,kansas ,city paper in #aiaj carried the message to 8,ladies0 that 8,dr4 ,dunn0 was a 8,regular physician for women only10 ,dunn's violation of the postal laws in #aiaa and of the federal ,food and ,drugs ,act in #aiab need not be gone into at this time4 ,the ,journal would feel like apologizing for devoting space to such a preposterous scheme were it not for the fact that physicians1 being human1 sometimes 8fall for0 preposterous schemes4 ,some1 we know1 have nibbled at ,dunn's bait2 others may do so4 ,the gross commercialism that permeates the advertising matter sent out by ,dunn again emphasizes the fact that the fad for intravenous medication offers an attractive field for those who would exploit our profession4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bb1 #aiai47 ,,glover',s ,,cancer ,,serum ,scores of letters have reached--and are reaching--,the ,journal office similar in effect to the following3 8,i am enclosing #8literature' received from the #8,t4 ,j4 ,glover ,research ,laboratory4' ,though purporting to come from ,toronto1 where the #be4jj are to be sent1 if you please1 the envelope bears the #ddh ,new ,york postmark40 ,the above is from ,new ,jersey while the two following are from ,michigan and ,illinois1 respectively3 8,have you any information in regard to this party and his treatment for cancer8 ,this is the first ,i have heard of any such work having been done4 ,one wonders if it is presented in good faith or if the money god has overcome the gentleman's scientific spirit40 8,is this just one more of them8 ,why a roan horse8 ,some people might want serum from a nice bay or calico cow pony40 ,the literature referred to comes in an envelop bearing the name of 8,t4 ,j4 ,glover1 ,research ,laboratory1 ,toronto1 ,canada10 but mailed1 apparently1 from ,new ,york ,city4 ,the enclosures are a single sheet circular signed ,thomas ,joseph ,glover and entitled 8,etiology of ,cancer10 a 8,directions0 slip and a card quoting prices4 ,in the circular ,dr4 ,glover states that he has prepared a serum from immunized horses1 8between ages of seven and nine years1 of the roan type10 and has injected this intramuscularly 8into patients in the advanced stages of cancer and noticed that it has a specific action on every known type of cancer40 ,further3 8,up to the present time ,i have apparently cured cancer of the face1 eye1 nose1 lip1 mouth1 tongue1 stomach1 bowel1 bladder1 breast and uterus40 ,in addition to the circular1 was a small leaflet giving directions for the injection of the serum and also a card bearing ,dr4 ,glover's name and ,toronto address and reading3 ---------------------------------------- -------------------- ,this is to advise you that ,,dr4 ,t4 ,j4 ,,glover',s ,serum for the treatment of cancer can now be had by application to office at above address4 ,,price ,,five ,,dollars ,,per ,,treatment4 ,,five ,,treatments ,,minimum ,,number ,,sent ,,at ,,one ,,time4 ,send money by ,post-,office ,money ,order or ,certified ,cheque4 ,,directions ,,for ,,treatment ,,with ,,each ,,order4 ---------------------------------------- -------------------- ,this advertising material1 which is evidently being widely circulated in the ,united ,states1 would indicate that the ,glover ,research ,laboratory had received a permit from the ,united ,states ,public ,health ,service licensing the interstate sale of this serum in the ,united ,states4 ,no such license has been issued4 ,the ,journal briefly reported in the department of ,medical ,news1 ,oct4 #cj1 #aibj1 that the ,academy of ,medicine of ,toronto had appointed a committee to investigate the claims made for the ,glover 8cancer serum40 ,in the meantime1 the most charitable thing that can be said is that the 8treatment0 is in the experimental stage and the reported results have not been corroborated by independent investigators4--7,from ,the ,journal ,a4,m4,a41 ,jan4 #a1 #aiba47 ,the ,toronto ,academy of ,medicine ,reports ,unfavorably on ,glover's ,cancer ,serum ,the method of exploitation of the alleged cancer serum being put out by ,dr4 ,t4 ,j4 ,glover of ,toronto1 ,canada1 was briefly discussed in this department of ,the ,journal for ,january #a4 ,at that time it was pointed out that the medical profession of the ,united ,states was being widely circularized by ,dr4 ,glover and that1 while the letters purported to come from ,toronto1 they were1 in fact1 mailed from ,new ,york ,city4 ,since this article appeared the circularization seems to have continued undiminished and physicians in various parts of the ,united ,states have sent in the ,glover advertising material4 ,oddly enough1 the matter now sent out1 while identical in every respect with that dealt with in the previous article1 bears a different return address on the back of the envelop4 ,the envelops are the same2 but the legend 8,t4 ,j4 ,glover ,research ,laboratory1 #ech ,jarvis ,st41 ,toronto1 ,canada10 has been crudely crossed out and there has been substituted by means of a rubber stamp the legend 8,,mrs4 ,,stewart1 #cji ,w4 #edth ,st41 ,new ,york40 ,still later letters have been modified to the extent that the letters 8,,rs0 of 8,,mrs40 have been cut out of the stamp and it now reads 8,m 4 ,,stewart40 ,there has now come to hand a report just published by a special committee appointed by the council of the ,academy of ,medicine1 ,toronto1 to investigate the ,glover ,serum4 ,the report of this committee may be summed up by one of its closing paragraphs1 which reads3 8,the data which your committee has been able to obtain have not convinced it that the results of treatment obtained by the use of ,dr4 ,glover's serum are better than those obtained by similar methods introduced by others1 and which have ultimately disappointed the hopes entertained of them40 ,the committee's report deals with the claims that ,dr4 ,glover has made for his serum1 both experimental and clinical4 ,it seems that ,dr4 ,glover has claimed that1 experimentally1 he had 7#a7 cultured cancer cells and from these cells had isolated and cultured an organism which he declared was confined to1 and present in1 every type of cancer2 7#b7 produced cancer in a number of animals by inoculation with these cells and organisms2 7#c7 obtained a serum--from a horse that had been injected with cultures of these cells and organisms--which1 when injected into experimental animals rendered them immune to inoculation1 and 7#d7 produced improvement or cure in cases of human cancer by the injection of his serum4 ,the committee reported that it was unable to obtain any evidence to substantiate ,dr4 ,glover's claims on the experimental aspect of the question as ,dr4 ,glover had refused to permit representatives of the committee to visit his laboratory2 had refused the request of the committee to be allowed to examine his cultures and experimental material2 had not acceded to the request of the committee that he demonstrate his ability to culture cancer cells and organisms and to produce cancer by inoculation or to immunize animals against it4 ,the committee attempted also to collect information which would enable it to pass on the clinical claims made by ,dr4 ,glover1 first1 as to whether he has succeeded in producing cures1 either regularly or occasionally1 in cases definitely established as cancer and1 second1 to enable the committee to decide whether his serum in cases definitely established as cancer produces improvement beyond that which occasionally occurs spontaneously or under palliative measures4 ,on both of these points1 the committee reported that it found no evidence to warrant the hope that a specific cure for cancer has been discovered by ,dr4 ,glover or that the serum had produced a cure in any case definitely established as cancer4 ,it should be understood1 that the committee's investigations and findings were completed before the present advertising campaign of the ,glover serum was initiated4--7,from ,the ,journal ,a4,m4,a1 ,feb4 #e1 #aiba47 ,,glyco-,,thymoline ,,and ,,poliomyelitis ,one characteristic of the 8patent medicine0 business is that it trades on fear4 ,should an epidemic occur the market is flooded with new nostrums purporting to cure or prevent the disease in question1 while the manufacturers of older 8patent medicines0 revamp their advertising so as to make it appear that their preparations are all that stand between the scourge and the public4 ,one has but to remember 8,peruna's0 exploitation of the yellow fever epidemic in ,new ,orleans some years ago and the way in which the exploiters of 8,pond's ,extract0 played on the fears of the public at the time of the former meningitis epidemic in ,new ,york ,city4 ,at present the public is much exercised over the epidemic of infantile paralysis4 ,anticipating that the nostrum fraternity would attempt to reap a golden harvest from the public distress1 the federal officials issued a bulletin of warning on the subject4 ,naturally1 the bulletin was addressed to the lay public1 the government assuming that physicians knew enough to avoid being misled by any such advertising campaigns4 ,apparently1 the assumption is too broad4 ,at any rate1 the manufacturers of 8,glyco-,thymoline0 are circularizing physicians1 one of whom writes as follows3 ,to the ,editor3--,i am enclosing circular letter that ,i received this morning which seems to me almost a crime4 ,i do not suppose that there is any way to prevent anything of this sort1 but it is certainly a shame to attempt to deceive people in this way4 ,as ,i recollect1 ,glyco-,thymoline is almost inert1 practically no more efficient than ,dobell's ,solution4 ,e4 ,fletcher ,ingals1 ,m4,d41 ,chicago4 ,the circular letter referred to was on the stationery of ,kress ,owen ,company1 manufacturers of ,glyco-,thymoline4 ,it read3 ,dear ,doctor3--,regarding ,infantile ,paralysis1 it is conceded that the source of infection is through the ,nose1 ,mouth and ,throat4 ,taking this measure to be correct1 we believe that there is no safer prophylactic measure than the use of ,glyco-,thymoline1 with three parts of water1 as a mouth1 tooth and nasal wash1 by means of the ,k4 ,o4 ,nasal ,douche and the toothbrush4 ,glyco-,thymoline tends to promote exosmosis1 and prevents the absorption of the germ or toxic matter4 ,we would be glad to send you samples of both ,glyco-,thymoline and the ,douche should you so desire4 ,with best wishes1 we beg to remain1 ,yours very truly1 ,kress ,owen ,company4 ,glyco-,thymoline has been discussed in these pages4 ,a report of the ,council on ,pharmacy and ,chemistry pointed out that this 8patent medicine0 is simply a weak antiseptic1 so feeble that even in full strength it does not kill ,staphylococcus aureus in four hours and is of little1 if any1 greater therapeutic value than sterile salt solution4 ,yet1 ,glyco-,thymoline has been recommended by its manufacturers1 either directly or inferentially1 for such diseases as diphtheria1 ophthalmia neonatorum and consumption4 ,today its manufacturers put it forward as one of the safest prophylactic measures against infantile paralysis and have the effrontery to make this suggestion1 not to the uninstructed public but to the medical profession4 ,presumably1 as a business organization1 the concern believes it will convince a sufficient number of physicians of the therapeutic efficacy of its product to pay for the cost of this advertising campaign4 ,if it appraises the situation correctly there need no longer be any wonder expressed that in the recent suit against ,the ,journal1 8patent medicine0 makers were able to enlist the help of medical men4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #af1 #aiaf47 ,,glykeron3 ,,cold ,,storage ,,testimonials,k ,k ,glyco-,heroin ,the law which limits the length of time that food products may be kept in cold storage could with advantage have its scope extended to include 8patent medicine0 testimonials4 ,physicians recently received through the mails--at a time when the mails were frightfully congested with ,christmas business--a sixteen page pamphlet sent out in a plain envelop as first class matter4 ,the caption of the pamphlet reads3 8,cough and ,its ,treatment in ,pulmonary and ,laryngeal ,tuberculosis3 ,by ,henry ,levien1 ,m4,d41 ,while ,medical ,director and ,physician-in-,charge of the ,liberty ,sanitarium1 ,liberty1 ,n4 ,y4 ,from the ,buffalo ,medical ,journal40 ,the pamphlet is devoted to the alleged virtues of that dangerous and widely advertised nostrum1 8,glyco-,heroin 7,smith710 whose more recent and less descriptive name is now 8,glykeron40 ,physicians might assume1 and doubtless will assume1 from the pamphlet that this reprint represents a recent pronouncement on the subject with which it deals4 ,the facts are that the 8,liberty ,sanitarium0 has1 apparently1 been out of existence for at least fifteen years1 while the article itself originally appeared more than eighteen years ago--,september1 #aija4 ,one of many physicians who sent in the copies received called attention to the fact that he had left the address to which the pamphlet was directed1 more than six years ago4 ,even at that1 the mailing lists of the concern that sells this heroin-containing nostrum are more than twelve years ahead of its 8clinical reports40--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ag1 #aibj47 ,,gray',s ,,glycerine ,,tonic3 8,,whose ,,bread ,i ,,eat ,,his ,,song ,i ,,sing0 ,last ,september the ,united ,states ,department of ,agriculture issued a press bulletin describing the work of the ,bureau of ,chemistry in prosecuting the venders or manufacturers of fraudulently exploited 8patent medicines40 ,at the end of the bulletin was a tabulated list of 8other preparations against which the government's charge that they were falsely or fraudulently labeled was sustained by the federal courts40 ,tucked away in the list was a product often euphemistically described as an 8ethical proprietary0 but none the less essentially a 8patent medicine0--8,gray's ,glycerine ,tonic40 ,the editor of the ,atlanta ,journal of ,medicine1 apparently not having read the bulletin with any great degree of care1 published it verbatim4 ,thus it was that the ,atlanta ,journal-,record of ,medicine for ,september1 #aiae1 presented the interesting sight of a half-page advertisement of 8,gray's ,glycerine ,tonic0 in the same issue that contained the government's article classifying 8,gray's ,glycerine ,tonic0 among the false and fraudulent products6 ,what happened8 ,in the very next issue the ,atlanta ,journal-,record of ,medicine apologized thus editorially3 8,in our ,september issue1 ,gray's ,glycerine ,tonic ,comp4 was inadvertently included in a list that seemed to be under the ban of the ,government and very likely an injustice has been done the ,purdue ,frederick ,company which we desire to undo as far as possible40 ,did the editor mean by 8inadvertently included10 that he would have omitted 8,gray's ,glycerine ,tonic0 from the government's list had he noticed it in time8 ,if so1 on what grounds8 ,it is a fact that 8,gray's ,glycerine ,tonic0 was one of the 8,fifty ,falsely ,labeled ,medicines02 it is also a fact that it is one of the products that government officials and the federal courts have declared to be sold under claims that are 8false1 fraudulent and misleading40 ,if 8,gray's ,glycerine ,tonic0 was fraudulently exploited--and the government and the courts have so declared it--why is it necessary for the editor of a medical journal to apologize to his subscribers for having told them so8--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #a1 #aiaf47 ,,hagee',s ,,cordial ,,of ,,cod ,,liver ,,oil 8,under the deceptive heading #8,making ,cod ,liver ,oil ,palatable1' the ,charlotte ,medical ,journal in its ,december issue prints a boost for #8,cord4 ,ext4 ,ol4 ,morrhuae ,comp4 7,hagee71' or1 as it is generally known to the drug trade1 #8,hagee's ,cordial of ,cod ,liver ,oil4' 8,the boost intimates that this is a preparation in which cod liver oil has in some way been rendered palatable1 and then goes on to say that this is a cod liver oil product which has not suffered the least loss of those essential elements which make the crude oil such a high-class reconstructive4 8,at first sight one might question whether a cod liver oil product which contains absolutely no cod liver oil had not suffered the loss of essential elements4 ,but a closer reading discloses a significant qualification1 namely1 the phrase1 #8those elements which make the crude oil such a high-class reconstructive4' 8,the boost is misleading from beginning to end4 ,the manufacturers have not succeeded in this preparation in #8making cod liver oil palatable1' nor does their preparation in any way possess the virtues of cod liver oil4 ,these claims have again and again been refuted1 but they continue to be published--at a price but rarely in reputable medical journals40 ,the above is quoted from the ,weekly ,bulletin of the ,department of ,health of the ,city of ,new ,york4 ,the ,bulletin is issued for the enlightenment of the public4--7,from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #h1 #aiaf47 ,,hypno-,,bromic ,,compound ,a physician in ,vermont writes3 8,this is simply a word of inquiry--and of possible warning to other practitioners--regarding a preparation known as ,hypno-,bromic ,compound manufactured by ,h4 ,k4 ,wampole ,co4 ,this compound is dispensed by druggists without prescription and contains in each ounce3 8,cannabis indica #a gr4 8,morphin #a_/d gr4 8,potassium bromid #dh gr4 8,hyoscyamus #a gr4 8,chloral hydrate #if gr4 8,i have at the present time three young women who are addicts to this preparation as the result of thoughtless prescriptions from physicians4 ,this mixture evades the working of the ,harrison ,act and may be dispensed freely at the discretion of the druggist and1 as a result1 these three cases of mine have been able1 by visiting at the various drug stores in town1 to keep an ample supply on hand at all times40 8,hypno-,bromic ,compound0 is more than an unscientific mixture2 it is a dangerous product and should not be sold indiscriminately over the drug counter4 ,before the ,harrison ,narcotic ,law went into effect1 8,hypno-,bromic ,compound0 contained half a grain of morphin sulphate to the ounce instead of its present one-fourth grain4 ,physicians remember that ,section #f of the ,harrison law contains a joker--put over by the 8patent medicine0 interests--that exempts proprietary remedies containing one-fourth grain of morphin or less to the ounce from the restrictions of that act4 ,while it is illegal for a physician to write a prescription which contains morphin1 no matter how small the amount1 unless he conforms in all ways to the requirements of the ,harrison ,narcotic ,law1 8patent medicine0 concerns can sell indiscriminately nostrums containing morphin up to this amount and the public can buy them without let or hindrance4 ,no reputable druggist would sell a layman over #gjj grains of chloral hydrate or #b grains of morphin or #h grains of extract of cannabis indica1 without a prescription1 yet1 the druggist may hand over #h ounce bottles of ,hypno-,bromic ,compound which contain #gfh grains of choral hydrate1 #b grains of morphin sulphate1 #h grains of extract of cannabis indica1 #h grains of hyoscyamus and #chd grains of potassium bromid6 ,physicians who prescribe such products as ,hypno-,bromic ,compound and druggists who indiscriminately sell such stuff are disgracing two honorable professions4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #g1 #aibj47 ,,intravenous ,,compound 7,,loffler7 ,its ,composition and the ,peculiar ,methods by ,which ,it ,is ,exploited ,for some time past inquiries have been received regarding ,charles ,lyman ,loffler1 his ,post-graduate ,course in ,intravenous ,therapy and especially relative to 8,intravenous ,compound 7,loffler740 ,for instance1 a physician writes3 8,can you tell me anything about the ,physicians ,drug ,syndicate4444 ,they are pushing the sale of ,thymozene and offering ,one ,hundred ,dollars' worth of stock fully paid and non-assessable1 free to those sending in their order1 and also a copy of ,dr4 ,loffler's ,lectures on the ,blood40 ,and from another physician3 8,what do you know of ,charles ,loffler1 ,m4,d41 and his ,intravenous ,compound8 ,a few evenings ago a man who appeared to be about #dj years old came to my office and tried to interest me in the above-mentioned article2 he claimed to be ,dr4 ,charles ,loffler of ,chicago4 ,with him was a young lady whom he introduced as ,miss ,b----4 ,miss ,b---- said that she had been with ,dr4 ,x---- a physician of high standing in ,los ,angeles for two months and that he was using the ,intravenous ,compound2 also quoted other physicians4444 ,his whole layout looks quackish1 and were it not for the fact that he showed me a letter that appeared to be from ,dr4 ,x----1 ,i should not have given him a second thought40 ,and this also3 8,charles ,loffler1 ,m4,d41 or his agent was traveling around inducing one ,m4,d4 in each town to take up his methods of blood examination and treatment and with a little advertising of blood examinations free the doctor selected gets quite a run of patronage40 ,another physician writes3 8,my attention has been called by another physician to ,loffler's ,intra-,venous ,compound4 ,may ,i trouble you to give me any information that you may have with regard to its composition and its value as a therapeutic agent80 ,c4 ,l4 ,loffler does business from ,rooms #aaja-aajb1 ,venetian ,bldg41 ,chicago1 the location of the 8,intravenous ,chemical ,co410 the 8,physicians ,drug ,syndicate0 and the 8,ma-,oze ,chemical ,co40 ,of these1 more later4 ,the ,journal has in its files a large amount of material regarding ,loffler4 ,a brief rsum of that part of the material dealing with ,loffler's professional activities will be given for the purpose of allowing physicians to evaluate the scientific status of ,loffler's 8,lectures10 8,post-,graduate ,courses10 his therapeutic 8discoveries0 and his products4 ,it seems that ,loffler was reared in ,yankton1 ,s4 ,d4 ,in #ahih-ahii1 ,loffler was a senior student at ,john ,creighton ,medical ,college1 but1 for reasons that need not be gone into here1 he was never graduated4 ,he received a diploma from ,barnes ,medical ,college in #aijj1 and in the same year was licensed to practice in ,south ,dakota4 ,in #aijb he was at ,le ,mars1 ,iowa2 in #aijd his name appears in the medical directory1 under ,sioux ,falls1 ,s4 ,d41 as 8,specialist in ,chronic ,troubles40 ,,the ,,intravenous ,,company ,,in ,,colorado ,charles ,l4 ,loffler's 8specialty0 is 8,intravenous ,medication40 ,in #aiab and #aiac1 as the ,intravenous ,company of ,colorado ,springs1 he was sending out a booklet entitled 8,consumption40 ,this described the alleged marvelous results to be obtained in the treatment of tuberculosis by the use of 8,intravenous ,compound02 there was also a side line1 8,the ,loffler ,internal ,bath ,plate40 ,at that time the administration of 8,intravenous ,compound0 was recommended intravenously1 hypodermically1 by rectum1 by mouth and even by insufflation4 ,when the stuff was to be given by rectum1 the recommendation was made3 8,first wash out the bowels with a preliminary injection of two or three quarts of warm water1 using for this purpose the ,loffler ,internal ,bath40 ,in #aiac ,loffler sought a larger field for his peculiar talents and left ,colorado ,springs4 ,after a short stay in ,denver he is next found in ,minneapolis1 where he was also 8engaged in the practice of intravenous therapy0 and1 incidentally1 seems to have been an organizer and manager of a common law concern known as the ,automatic ,thrasher ,co4 ,,the ,,physicians' ,,drug ,,syndicate ,in #aiai we find ,loffler in ,chicago as president of the 8,physicians ,drug ,syndicate40 ,this concern--another common law organization--had for its vice president one ,a4 ,e4 ,erling1 ,m4,d41 and for its secretary and treasurer1 ,arthur ,c4 ,hanson4 ,erling was discussed#bea in an article that appeared in ,the ,journal1 ,july #e1 #aiai1 on the egregious 8,allied ,medical ,association of ,america0 of which organization ,c4 ,l4 ,loffler was 8,president0 in #aiah4 #bea ,here is what ,the ,journal published on ,erling3 ,a4 ,e4 ,erling according to the stationery1 is 8,chairman0 of 8,censors40 ,our records fail to show that ,erling ever graduated in medicine4 ,the ,health ,department of ,milwaukee1 however1 says that ,erling1 when interviewed1 claimed to have 8a diploma from the ,german ,medical ,college of ,chicago1 but refused to show or present the same40 ,the ,american ,medical ,directory has this item3 ,german ,medical ,college1 ,chicago4 ,chartered ,dec4 #bh1 #ahia1 by ,johann ,malok4 ,fraudulent4 ,extinct4 ,a few years ago ,erling was in ,la ,crosse1 ,wis41 and in #aijh a circular letter bearing his name and picture was sent out1 from which the following extracts are taken4 ,capitalization as in the original3 8,dear ,friend3--,permit me to call your attention to the fact that ,dr4 ,a4 ,e4 ,erling1 the eminent specialist1 after many years of travel1 practice and medical research1 has given up his extensive road practice and severed his connection with the several medical institutes which have heretofore occupied considerable of his attention4444 ,dr4 ,erling's success in the treatment of all ,,chronic ,,diseases ,,is ,,truly ,,remarkable4 ,,nervousness1 ,,all ,,blood ,,diseases1 ,,rheumatism1 ,,diseases ,,peculiar ,,to ,,women2 ,,catarrh1 ,,deafness1 ,,chronic ,,constipation 444 ,,appendicitis 444 ,,piles1 ,,stomach ,,troubles1 ,,partial ,,paralysis1 etc41 give way as if by magic under his skilful method of treatment4444 ,understand1 please1 that ,dr4 ,erling ,,does ,,not ,,accept ,a ,,case ,,for ,,treatment unless he can ,,promise ,a ,,speedy ,,and ,,positively ,,permanent ,,cure40 ,the ,journal also has in its files advertisements 7vintage of #aiae71 from some ,wisconsin country newspapers2 which notify the afflicted that 8,drs4 ,erling and ,karass1 the expert ,german ,specialists10 could be seen in their offices in the 8,schlegel ,hotel10 the 8,schlitz ,hotel10 etc41 as the case might be4 ,whether one of these 8,german ,specialists0 was ,dr4 ,arnold ,e4 ,erling1 ,the ,journal does not know4 ,official medical records fail to show1 at least1 that there is any other ,erling in the state of ,wisconsin4 ,hanson1 the secretary and treasurer of the ,physicians ,drug ,syndicate1 is said to have hailed originally from ,minot1 ,n4 ,d41 where he was in the drug business4 ,his name appears in the ,propaganda files as the manager of the ,ma-,oze ,chemical ,co4 of ,minneapolis1 which1 in ,october1 #aiai1 was advertising in a daily paper of that city3 8,protect yourself against influenza4 ,don't let the germs get a foothold in your system4 ,kill them with ,ma-,oze ,antiseptic ,powder4 ,use it as a gargle4 ,it is 444 sure death to all kinds of disease germs40 ,in a preliminary statement sent out by ,hanson in the early part of #aiai it seems that the ,physicians ,drug ,syndicate was conceived 8primarily to supply physicians with a product to be used in ,leucorrhea and personal cleanliness of women40 ,this product1 apparently1 was the ,ma-,oze of influenza fame in ,minneapolis4 ,it was to be put out1 however1 under the name of 8,thymozene10 which1 8packed in #d ounce unlabeled carton for dispensing10 would 8show nearly #ajj per cent4 profit to the organization over the profit which you make if you dispense your own drug40 ,,thymozene1 ,,free ,,stock--,,and ,,everything ,in ,october1 #aiai1 the ,physicians ,drug ,syndicate was circularizing physicians in ,iowa trying to get them to send in #f for 8#a ,dozen ,thymozene #d oz40 ,for this #f the doctors were to get1 in addition to the marvelous ,thymozene1 the following rights1 privileges and emoluments3 #a4 ,a free ,post-,graduate ,course in ,intravenous ,therapy by ,dr4 ,charles ,loffler4 #b4 ,a gift of #ajj worth of stock in the ,physicians ,drug ,syndicate4 #c4 ,a copy of ,dr4 ,loffler's ,lectures on ,blood4 #d4 ,the privilege of purchasing future supplies of ,thymozene 8at wholesale prices less discount of #cc-a_/c per cent40 ,the letter making these offers mentioned incidentally3 8,besides our product ,thymozene we have been forced to add a ,uterine ,wafer to be used in connection with hot ,thymozene douches in ,leucorrhea4 ,these wafers are simply miracle workers40 ,in addition to this circular letter there was a membership blank leaflet detailing the marvels of 8,thymozene40 ,there was another leaflet headed in very large1 black type 8,influenza0 and recommending 8,ma-,oze ,antiseptic ,powder0 or 8,thymozene0 for this condition4 ,still another leaflet accompanying it lauded 8,intravenous ,compound 7,loffler70 and reprinted laudatory puffs of this preparation that were credited to ,h4 ,h4 ,witherstine1 ,m4,d41 ,rochester1 ,minn41 ,joseph ,b4 ,klinehans1 ,m4,d41 ,chicago1 and the 8,loring ,park ,sanatorium0 of ,minneapolis4 ,in addition to the ,intravenous ,compound 7,loffler7 there is1 of course1 certain 8apparatus for the giving of the treatment0 which the ,intravenous ,chemical ,co4 supplies4 ,the 8compound0 must be given just so1 and the ,intravenous ,chemical ,co4 8reserves the right to refuse to supply any physician with ,intravenous ,compound 7,loffler7 who1 either through lack of proper apparatus or proper care in preparation of solution1 or for any reason1 uses it in such a manner that will cast discredit upon it40 ,the complete apparatus1 including #b ounces of ,intravenous ,compound 7,loffler71 sells for #bd4 ,what is ,intravenous ,compound8 ,apparently1 nobody knows except ,charles ,l4 ,loffler1 who asks physicians to inject--and we regret to say some are injecting--this nostrum of unknown composition into the veins of their patients4 ,to a physician who had raised the point of secrecy ,loffler wrote in part3 8,i am sure that you will agree with me that it is far better to place this treatment in the hands of competent physicians1 such as ,dr4 ,witherstine1 and many more whose names ,i will gladly send you1 and to protect the honest and competent doctor who investigates and takes up the work1 than to publish the formula and give to the unscrupulous a chance to try to make the product and no doubt to claim to cure disease that is beyond hope4 ,the formula is not kept secret for profit 444 but is so kept upon the advice of a number of good men who have the interest of the doctor at heart4444 ,i am willing and anxious to place the product and the results in thousands of cases before the ,a4 ,m4 ,a4 on the one condition that the formula shall be kept secret for the benefit of the reputable physician40 ,in another letter written more recently to a physician who called attention to the secrecy of the nostrum1 ,loffler wrote3 8,the ,intravenous ,compound contains approximately #eh per cent4 oxygen1 #ab per cent4 chlorine1 #af per cent4 potassium1 #i per cent4 sodium and #e per cent4 boron4 ,i have no hesitancy in giving it1 and it was due to an incompetent man in this office that this was not given fully in the booklet4 ,he made the changes without my consent and has caused me to answer many inquiries by physicians40 ,a seeming frankness is a trick as old as nostrum exploitation itself4 ,loffler's 8formula0 is meaningless4 ,a quack who was putting out a mixture of #a part baking soda and #b parts common salt might with equal frankness say that his marvelous combination contained approximately #ce4d per cent4 sodium1 #d4h per cent4 carbon1 #ai per cent4 oxygen1 #dj4d per cent4 chlorin1 and #j4d per cent4 hydrogen4 ,in order that the profession might know more about this product a specimen was turned over to the ,a4 ,m4 ,a4 ,chemical ,laboratory for analysis4 ,here is what the chemists report3 ,,chemists' ,,report 8,one original #b ounce bottle of #8,intravenous ,compound 7,loffler7 for ,intravenous ,use' was submitted to the ,association's ,chemical ,laboratory for examination4 ,according to the label1 the product is sold by the #8,intravenous ,chemical ,co41 ,chicago4' ,the bottle contained a white granular substance1 which appeared as if the ingredients had been fused together4 ,the product responded to tests for sodium1 potassium1 chlorate1 borate and nitrate4 ,as this same set of chemical radicals was found by ,puckner and ,hilpert 7,j4 ,a4 ,m4 ,a41 ,may #bb1 #aijh1 p4 #agjf7 to be present in #8,oxychlorin' and #8,zyme-oid1' a quantitative comparison of #8,intravenous ,compound 7,loffler7' was made4 8,the analysis indicated that all three products are essentially the same3 ,,intravenous ,,oxychlorin1 ,,zyme-,,oid1 ,,compound1 ,per ,cent4 ,per ,cent4 ,per ,cent4 ,potassium 7,k7 #ab4bf #ac4ej #ac4gi ,sodium 7,na7 #h4bj #i4hd #i4hb ,boric acid anhydride 7,b,o7 #ah4fc #ac4db #ae4bj ,chlorate 7,cl,o-7 #be4eb #bg4ec #bf4dd ,nitrate 7,,no-7 #ba4gj #bd4bb #bc4ge ,water calculated #ac4bi #aj4db #aa4gb 8,assuming that the chlorate in #8,intravenous ,compound 7,loffler7' is present as potassium chlorate and the nitrate is present as sodium nitrate1 the figures obtained by the analysis correspond to a mixture approximately as follows3 ,potassium chlorate 7,k,cl,o7 #ch4f per cent4 ,sodium nitrate 7,na,n,o7 #cb4f per cent4 ,potassium borate 7,k,b,o7 #d4i per cent4 ,sodium borate 7,na,b,o7 #d4j per cent4 ,boric acid #ba4a per cent4 8,from the results of the examination it is concluded that this preparation is a mixture of alkali chlorate and nitrate and boric acid1 probably produced by fusing together the constituents4 ,it is practically the same mixture as ,oxychlorine and ,zyme-oid as analyzed nearly fourteen years ago in the ,a4 ,m4 ,a4 ,chemical ,laboratory40 ,throughout the advertising of 8,intravenous ,compound 7,loffler70 the physician is reminded of the financial returns that the product offers4 8444 ,the financial return will prove as interesting to yourself as results are to the patients40 8,and lastly but not less interesting1 the financial returns are commensurate with results40 8444 the instruction given me in the use of your ,intravenous ,compound and the opportunity presented adds four to five hundred dollars per month to my bank account40 8444 will not only give you more positive results than have ever obtained in chronic and progressive diseases but a very remunerative business40 8,intravenous ,compound 7,loffler7 is supplied in granular form1 #b ounces to a bottle1 at #b per bottle4 ,an ounce will average fifteen treatments and treatments are at from #c to #e each1 according to the ability of the patient to pay40 ,a physician whose name the ,intravenous ,chemical ,company had given as a user of ,intravenous ,compound 7,loffler7 was written to by another physician who was interested in the matter and he was asked frankly for his opinion4 ,he replied in part3 8,the treatment makes a profound impression on the recipient and is usually followed by a marked improvement mentally1 and ,i have not been keen enough to draw the line of just how far the physical or material improvement went and when the psychical began4 8,for the office #8specialist' of the advertising type this would be a boon1 but ,i am not entirely satisfied that its use completely justifies its claims40 ,,summary ,intravenous ,compound 7,loffler7 stands revealed as a nostrum of secret composition which physicians are asked to inject into the veins of their patients4 ,it must be purchased in connection with some supplementary material1 8a complete set of apparatus10 sold by the same concern4 ,its successful administration is said to depend on following a technic detailed either in a booklet sent out by ,loffler or given by ,loffler in a 8,post-graduate ,course0 which costs physicians #ej unless they have purchased six dollars' worth of another nostrum1 8,thymozene40 ,the intravenous administration of drugs is impressive4 ,to the patient the technic is mysterious and its psychic effect striking4 ,its dangers--infection1 air embolism1 intravascular clotting1 sudden death--are matters of record4 ,every conservative physician will admit that there is no excuse for the intravenous administration of even those drugs that are well known and whose effects have been carefully studied1 except when distinct advantages are to be secured4 ,as ,the ,journal has stated before1 8,little is known of the results to be expected from intravenous therapy even with simple substances40 ,what1 then1 can be said of the physician who subjects his patients to the intravenous injection--8at from #c to #e each1 according to the ability of the patient to pay0--of a preparation of whose composition he is as ignorant as he must be of its effects8 ,intravenous ,compound 7,loffler7 has been on the market ten years2 it is unmentioned in the literature of scientific medicine4 ,the name of its exploiter1 while not unknown in the twilight zone of professionalism as the exploiter of a nostrum1 as a 8,specialist0 in 8,chronic ,troubles0 and 8,intravenous ,therapy10 as well as in other capacities even less savory1 is equally unknown to scientific medicine4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ab1 #aiba47 ,,intravenous ,,specialties ,to the ,editor3--,there is a salesman here in ,salt ,lake ,city making extravagant claims about the medicines advertised in the enclosed pamphlet4 ,would you kindly advise me as to your opinion of it8 ,w4 ,c4 ,schulte1 ,m4,d41 ,salt ,lake ,city4 ,to the ,editor3--,i am interested in knowing the attitude of the ,council on ,pharmacy and ,chemistry regarding the products of the ,intravenous ,products ,company of ,america1 #aba ,madison ,avenue1 ,new ,york ,city4 ,if the ,council has already reported1 please refer me to the appropriate number of ,the ,journal4 ,if it has not1 please give me any information available4 ,h4 ,b4 ,gessner1 ,m4,d41 ,new ,orleans4 ,,answer4--,the ,intravenous ,products ,company of ,america has not requested the ,council on ,pharmacy and ,chemistry to examine any of its intravenous specialties1 nor have they been discussed in ,the ,journal or examined in the ,american ,medical ,association ,chemical ,laboratory4 ,the firm's list of specialties bears a striking resemblance to those of other 8intravenous specialty0 firms4 ,endoarsan1 like ,venarsen of the ,intravenous ,products ,company of ,denver1 is stated to contain a cacodylate 7dimethylarsenate7 along with mercury and iodid4 ,venarsen was reported on unfavorably by the ,council 7,the ,journal1 ,may #bb1 #aiae1 p4 #aghj71 the inferior efficacy of sodium cacodylate was discussed 7,the ,journal1 ,march #be1 #aiaf1 p4 #igh7 and the worthlessness of sodium cacodylate as a spirocheticide confirmed by ,h4 ,n4 ,cole 7,the ,journal1 ,dec4 #cj1 #aiaf1 p4 #bjab71 ,william ,g4 ,ward 7,the ,journal1 ,feb4 #c1 #aiag1 p4 #cij71 and ,r4 ,l4 ,sutton 7,the ,journal1 ,feb4 #ag1 #aiag1 p4 #eff74 ,endosal1 like ,venosal of the ,intravenous ,products ,company of ,denver1 is said to contain salicylate and a colchicum preparation 7the latter is also said to contain iodids74 ,venosal was found unacceptable for ,new and ,nonofficial ,remedies by the ,council on ,pharmacy and ,chemistry4 ,like other 8intravenous0 firms1 this company advertises the intravenous administration of drugs such as sodium iodid and hexamethylenamin4 ,the objections to and the dangers of indiscriminate administration of drugs intravenously was recently emphasized in a report of the ,council on ,pharmacy and ,chemistry 8,some of ,loeser's ,intravenous ,solutions0 7,the ,journal1 ,april #af1 #aiba1 p4 #aabj74--7,query from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #aj1 #aiba47 ,,iodex ,at fairly frequent intervals physicians receive through the mail free samples of 8,iodex10 a black ointment sent out in small1 circular aluminum boxes4 ,iodex is sold by ,menley and ,james1 ,ltd41 ,new ,york ,city1 under the claim that it is a preparation of free iodin1#beb minus the objectionable features that go with free iodin4 ,the preparation was examined in the ,a4 ,m4 ,a4 ,chemical ,laboratory in #aiae1 and found practically devoid of free iodin4 ,the laboratory also reported that when #a or #b grams of ,iodex was rubbed on the skin of the forearm on several subjects and the urine collected and tested for iodin1 the results were negative4 ,this disproved the claim that 8thirty minutes after inunction with ,iodex iodine can be found in the urine40 #beb 8,free0 or elementary iodin 7such as the tincture of iodin7 is used externally for its local irritant and antiseptic effects4 8,combined iodin0 7e4 g41 iodid of potassium71 does not produce these effects2 and when preparations containing iodin in combined form are used1 it is with the expectation of obtaining the systemic 78alterative07 effects such as are produced by iodids4 ,the findings of the laboratory1 which were summed up in a report 7,the ,journal1 ,june #ai1 #aiae7 of the ,council on ,pharmacy and ,chemistry on ,iodex1 were essentially as follows3 #a4 ,the composition is incorrectly stated2 the actual iodin content is only about half of that claimed4 #b4 ,the action of ,iodex is not essentially that of free iodin1 although that is the impression conveyed by the advertising4 #c4 ,the assertion that iodin may be found in the urine shortly after ,iodex has been rubbed on the skin has been experimentally disproved4 ,at the time the laboratory reported its findings1 it pointed out the obvious contradiction in the claim that ,iodex is not only an 8effective free iodine application without drawbacks0 but also a means of 8really efficient external iodine therapy without stain or irritation40 ,it is impossible to have free iodin present in sufficient quantities to be therapeutically efficient and not get skin stains and irritation4 ,in a recent issue of the house organ1 ,pharmacal ,advance1 there was a large display advertisement of ,iodex under the heading3 8,for prophylaxis and to #8,double ,cross' ,disease10 with the claims3 8,free ,iodine40 8,rub ,through ,skin40 8,does ,not ,irritate nor ,stain40 ,on other pages of the same issue these claims appeared3 8,there is no therapeutic virtue in ,iodex which is not inherent--though often latent--in ,free ,iodine2 and there is no virtue in ,free ,iodine which is not available in ,iodex40 8,in ,iodex all the beneficent properties of ,iodine are emphasized and all its disadvantages are eliminated--in a word1 ,iodex is ,pure ,free ,iodine presented therapeutically active and efficient1 ready for use in all conditions1 with all the well-known powers of ,free ,iodine1 but without the sequel of unpleasant effects1 as irritation1 corrosion1 desquamation1 staining1 etc41 which defeat the ends of treatment when ordinary preparations of ,iodine are used4 ,the fact that ,free ,iodine in the form of ,iodex can now be used in rectal and vaginal treatment1 without irritation1 speaks volumes for its penetrability and bland action40 ,these quotations are sufficient to show that the manufacturers of ,iodex still persist in their claim that the product contains free iodin4 ,in view of this1 the ,a4 ,m4 ,a4 ,chemical ,laboratory has again examined ,iodex1 having recently purchased specimens on the open market4 ,it reports that ,iodex gives no test for free iodin1 or at most1 but minute traces4 ,an interesting side-light on the methods of ,menley and ,james is also brought out in the issue of ,pharmacal ,advance just quoted4 ,under a 8department0 misnamed 8,book ,reviews0 the following appears3 8,,the ,,actions ,,of ,,drugs4--,torald ,sollmann1 ,m4,d4 ,published by ,w4 ,b4 ,saunders ,co41 ,philadelphia4 ,this is a book of lectures designed for students in pharmacy and deals with the subject in plain and simple language4 ,the author in his introduction has brought out the fact that over-counter prescribing is baneful both to the public and to the pharmacist himself4 ,among some of the interesting points brought out that ,pharmacol ,advance has always maintained1 namely1 that #8,potassium iodid is not absorbed efficiently by the skin2 hence the ointment of potassium iodid is unscientific4' 8,we would especially call attention to ,ungt4 ,iodi ,u4 ,s4 ,p41 containing ,potassium ,iodid1 used as a solvent for its iodin content4 ,accepting ,sollmann's statement1 it is to be assumed that ,ungt4 ,iodi ,u4 ,s4 ,p4 has not #ajj per cent4 efficiency40 ,garbling statements from scientific works for the purpose of puffing proprietaries is not unusual in nostrum exploitation4 ,the facts are that the statement in ,sollmann's book1 introduced in the ,menley and ,james house organ under the guise of a book review1 appeared in a discussion of iodin compounds4 ,in this the author points out that to obtain systemic iodid effects1 it is irrational to apply iodin preparations externally4 ,so far as the free iodin content of the official ointment of iodin is concerned1 ,l4 ,e4 ,warren 7,reports of the ,a4 ,m4 ,a4 ,chemical ,laboratory1 #aiag7 has shown that even after more than six months this ointment still contains about #ge per cent4 of the free iodin originally added4 ,the official ointment 7,unguentum ,iodi1 ,u4 ,s4 ,p471 therefore1 so far as its free iodin content is concerned1 is far superior to ,iodex1 which contains no iodin in its free state4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #c1 #aiai47 ,,the ,,william ,f4 ,,koch ,,cancer ,,remedy ,a number of inquiries have been received of which those that follow are typical4 ,this from a ,philadelphia physician3 8,would you give me any information you have about one so-called #8,dr4 ,w4 ,s4 ,koch1' ,detroit1 ,michigan8 ,this man is said to claim to have in his possession a cure for cancer1 the nature of which ,i do not know4 ,i know1 however1 that he obtained a very large fee not very long ago in treating a case1 but without success 4440 ,while a ,chicago physician writes3 8,i have at hand a pamphlet from ,wm4 ,f4 ,koch1 ,m4,d41 ,ph4,d41 of ,detroit1 ,mich41 which is supposed to be a reprint from the ,medical ,record of ,oct4 #cj1 #aibj1 entitled #8,a ,new and ,successful ,diagnosis and ,treatment of ,cancer4' ,will you kindly advise me what you know about this man's work on this subject and how much stock ,i can put in the claims he makes in this article80 ,and this from a physician in ,seattle1 received a few days ago3 8,has your office any knowledge of the cancer cure devised by ,dr4 ,william ,f4 ,koch1 ,ph4,d41 ,m4,d41 of ,detroit8 ,he published an article on it in the ,medical ,record1 ,oct4 #cj1 #aibj4444 ,i enclose copy of letter received by one of our patients from his #8western representative' which reads like pure quackery4 ,i do not find ,dr4 ,koch's name in either the ,a4 ,m4 ,a4 or ,polk's medical directories40 ,the letter referred to in the last inquiry as coming from ,dr4 ,koch's 8western representative0 was addressed to a woman who had written to ,dr4 ,koch with reference to his alleged cancer cure4 ,the letter1 dated ,jan4 #ai1 #aiba1 was signed 8,chas4 ,l4 ,tisdale1 #ahih ,geary ,street1 ,san ,francisco40 ,it read3 8,dear ,madam3--,your letter of ,january #ajth written to ,dr4 ,koch of ,detroit in reference to his cancer cure has been sent to me by ,dr4 ,koch4 ,i am the western representative of ,dr4 ,koch and am giving the treatments with his remedy4 ,i am now treating #ad cases here with some most wonderful results4 ,the amount of the remedy that ,dr4 ,koch can supply me with is limited and it is a very expensive substance4 ,none of it can be sent to ,seattle or any other place for ,i have only enough to treat the cases that are constantly presenting themselves here4 ,if you could come to ,san ,francisco and have the money to pay a reasonable fee1 say enough to pay for the remedy1 ,i would be very glad to do everything ,i can for you4 8,the results that have already shown in many of these cases warrant me in believing that almost any case of cancer can be cured if the treatment is persisted in40 ,according to our records1 ,dr4 ,william ,f4 ,koch of ,detroit was born in #ahhe4 ,some years ago he graduated in chemistry and for some time held the position of professor of physiology and physiologic chemistry at the ,detroit ,college of ,medicine and ,surgery4 ,in #aiah1 ,dr4 ,koch received his degree in medicine from this same college4 ,less than a year after his graduation1 ,dr4 ,koch declared that he had 8developed a real specific cure for cancer40 ,in the ,detroit ,medical ,journal for ,july1 #aiai1 there appeared a brief article by ,william ,f4 ,koch1 entitled 8,a ,new and ,successful ,treatment and ,diagnosis of ,cancer40 ,a more extensive article bearing the same title was published in the ,new ,york ,medical ,journal of ,oct4 #cj1 #aibj4 ,as a result of the publicity that was given the ,koch treatment1 the ,wayne ,county 7,detroit7 ,medical ,society appointed a committee to investigate the treatment4 ,its first report appeared in the ,bulletin of the society for ,dec4 #bb1 #aiai4 ,briefly1 this report said that the ,board of ,health of ,detroit had placed at the disposal of the committee twelve beds in a local hospital with the necessary special nurses and everything else required free of charge4 ,the committee sent certain patients to the hospital2 and there were also some other patients recommended by different physicians as proper cases for treatment4 ,there were nine altogether4 ,after going over the cases carefully1 the committee found some in which the diagnosis was doubtful4 ,there were five cases1 however1 of undoubted cancer1 a positive diagnosis having been made from specimens and microscopic examination4 ,the management and treatment of these patients were turned over to ,dr4 ,koch4 ,dr4 ,koch seems to have raised certain objections and to have made certain criticisms4 ,he also insisted that he ought to have some representative on the committee4 ,the committee offered to put on any and all he would name4 ,he failed to name any4 ,the committee reported further that ,dr4 ,koch was very negligent in his treatment of the patients and finally1 on ,november #bf1 the committee met with ,koch and went over all the cases with him4 ,at that time he gave the patients injections and promised to attend to the treatment regularly in the future4 ,according to the report1 he saw the patients only once more 7three days later7 and then did not come near them again4 ,as the patients became disgusted with the neglect1 some of them left and the committee sent the rest home and closed its connections with the investigation of the subject4 ,in the same issue of the ,bulletin of the county society in which this committee's report was published1 the editor of the ,bulletin stated that from all sections of the country inquiries were coming relative to the treatment and 8from long distances patients are coming to ,detroit to be #8cured' of cancer40 ,the editor further stated3 8,it is reported that ,dr4 ,koch is treating many patients1 promising much and charging well40 ,to this ,dr4 ,koch retorted that only about #cj per cent4 of his patients had 8contributed40 ,the rest were treated free4 ,the ,wayne ,county ,medical ,society ,bulletin for ,jan4 #e1 #aibj1 was devoted almost exclusively to another discussion of ,dr4 ,koch's 8cancer cure40 ,it was there stated that a second committee had been appointed to gather what information could be obtained from outside sources relative to cases treated by ,dr4 ,koch4 ,this committee reported that of fifty-six cases of which it was able to obtain data1 only three of the patients showed clinical improvement2 twenty-one of the patients were dead4 ,three more patients treated both by the ,koch injections and by operation were reported as clinically improved4 ,the condition of eighteen of the patients was reported as stationary1 or unimproved4 ,in eleven of the cases1 the results were unknown but the surgeons reported unfavorably4 ,the committee reported further that ,dr4 ,koch's records were incomplete and that he had submitted no proof that his injections have any particular merit and the committee concluded that the study 8is entirely experimental and improperly supervised40 ,evidently1 the most that can be said of ,dr4 ,koch's alleged 8cure0 for cancer is that the claims made for it have not been supported by independent investigators4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ab1 #aiba47 ,further ,comment ,last week some space was given to the alleged cure for cancer put out by ,dr4 ,william ,f4 ,koch of ,detroit4 ,incidentally1 it should be mentioned that ,dr4 ,koch's article of ,oct4 #cj1 #aibj1 to which reference was made1 appeared not in the ,new ,york ,medical ,journal1 as stated1 but in the ,new ,york ,medical ,record4 ,the following correspondence throws additional light on the subject3 ,to the ,editor3--,to the number of inquiries which you have received regarding the alleged cure of cancer by ,dr4 ,koch1 permit me to add the following personal experience4 ,on ,july #a1 #aibj1 ,i was asked to examine an ex-patient of mine whom ,i had not seen professionally for many years4 ,her husband frankly told me that for several months his wife had been treated by ,dr4 ,w4 ,f4 ,koch for inoperable carcinoma of the pelvic organs1 that he wished ,dr4 ,koch to retain charge of the treatment but hoped ,i would give my opinion regarding certain nervous manifestations in the patient which were causing him 7her husband7 much concern4 ,at the same time1 he showed me a letter written by ,dr4 ,koch purporting to explain the symptoms and offering suggestions regarding treatment4 ,i called on the patient and found her in the last stages of generalized carcinomatosis4 ,simple palpation of the abdomen revealed multiple nodules involving both lower and upper abdominal quadrants4 ,i did not feel justified in making a pelvic examination but noted a profuse foul-smelling discharge on the vulvar pad4 ,my prognosis did not meet with the deluded husband's approval4 ,the patient died within a week and a necropsy confirmed the clinical picture of carcinomatosis4 ,enclosed is ,dr4 ,koch's letter2 the patient's name should1 of course1 be omitted if you see fit to publish this note4 ,george de ,tarnowsky1 ,m4,d41 ,chicago4 ,the letter from ,dr4 ,koch which ,dr4 de ,tarnowsky enclosed with his own1 follows4 ,we have1 of course1 deleted the name of the patient4 ,dear ,doctor3 ,mrs4 ---- has absorbed and is still absorbing some killed tumor tissue4 ,she has absorbed some three pounds1 ,i judge4 ,the results of the absorption are intoxication quite general 7nervous1 muscular1 perhaps nephritic74 ,the myocardium at present shows no signs of poisoning but the skeletal muscles and nerve do4 ,the important toxin liberated by the killed tissue is methyl cyanimide which combines ammonia 7,,nh7 from the amino acids1 and thus becomes methyl guanidine4 ,this latter has produced in my patients an intoxication varying in similarity to3 idiopathic tetany in children1 chorea in children1 eclampsia in women1 and has even been so severe as tetanus in some of the muscle spasms2 a toxic albuminuria has resulted in some of my cases4 ,all of my cases have cleaned up so far4 ,of course1 ,i cannot predict in any individual case1 except that when the absorption has been completed and the toxin all eliminated1 everything should return to normal1 unless the toxin has destroyed tissue beyond physiological repair4 ,my suggestions as to treatment would be elimination1 saving the kidneys as much as possible1 by whatever methods you find best and necessary4 ,at present ,i am treating symptomatically thus--atropin as a guanidine antidote1 arsenic as a chorea coupled antidote as a prevention to the production of guanidine from the cyanimide1 the use of dilute hydrochloric acid has proven successful to me4 ,even a urine boiling solid--albumen has cleared up in one case in three days just by taking large quantities of #a_/b per cent ,h,cl4 ,i am explaining the factors ,i have contended with in these cases1 but do not want to influence your plan of treatment when your judgment finds me insufficient4 ,sincerely1 ,wm4 ,f4 ,koch4 ,i shall have a publication out very soon on the treatment of these tetanics and eclampsia with ,h,cl4 ,it is worth noting that this letter of ,dr4 ,koch's was written ,june #bh1 just three days before ,dr4 de ,tarnowsky saw ,mrs4 ---- and less than a week before she died of generalized carcinoma4 ,not the least important element in the story which these two letters tell is the optimism engendered in the husband of the poor cancer patient by the widely vaunted treatment of ,koch4 ,and herein lies one of the most pernicious features connected with the exploitation of alleged cures for cancer1 tuberculosis1 etc4 ,all such remedies1 whether fraudulent both in their inception and exploitation or those which while equally worthless are at least honestly put forward and are based on a certain amount of scientific investigation1 produce a profound and marked temporary change in the patient's condition4 ,it is this that tends to warp the judgment not only of the unscientific layman1 but also of the physician4 ,the psychic element in cancer has been well described by ,weil3 8,it is1 indeed1 very remarkable that a patient who has been consigned to death as a victim of a hopeless malady1 should regain his spirits and his appetite1 when he is again confronted with the hope of a cure1 and of the eradication of his disease8 ,it is a phenomenon well known to every student of the disease that a large proportion of cases responds in just this manner to any treatment which is offered them4 ,osler has described a case of cancer of the stomach in which the mere visit to a consultant of sanguine temperament1 though poor judgment1 whose assurance of the patient that there was no possibility of cancer1 resulted in the disappearance of all the symptoms and a gain of #ah pounds in weight4 ,it is this psychic influence1 which has occasionally deluded the honest student of cancer cure1 and which has also so generously played into the hands of the dishonest40--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ai1 #aiba47 ,,the ,,lucas ,,laboratories' ,,products ,the ,journal has received several inquiries about the products put out by the ,lucas ,laboratories1 ,incorporated1 of ,new ,york ,city4 ,a typical inquiry is that received from ,dr4 ,f4 ,a4 ,jewett of ,brooklyn1 who writes3 8,the enclosed circular is sent out to the medical profession by ,dr4 ,william ,lucas1 #bhg ,w4 #gjth ,st41 ,new ,york4 ,what do you know of this man and his methods80 ,william ,h4 ,lucas was graduated by the ,medical ,college of ,ohio in #ahie and was licensed in #ahig4 ,he is not a member of his local medical society4 ,the products put out by the ,lucas ,laboratories are for intravenous use1 and their method of exploitation indicates that the concern is less interested in the science of therapeutics than it is in taking commercial advantage of the present fad for intravenous medication4 ,the ,journal has protested editorially against the unnecessary use of the intravenous administration of drugs1 and the abuse of this method of drug giving prompted the ,council on ,pharmacy and ,chemistry recently to emphasize the danger of indiscriminate intravenous medication4 ,the products of the ,lucas ,laboratories1 ,inc41 have not been examined either by the ,a4 ,m4 ,a4 ,chemical ,laboratory or by the ,council on ,pharmacy and ,chemistry4 ,the composition of these products is essentially secret1 which in itself should be sufficient to deter physicians from using them4 ,of course1 in accordance with all the tenents of orthodox nostrum exploitation1 8formulas0 are furnished4 ,even the crude hieroglyphics that used to be palmed off on the medical profession by nostrum exploiters under the guise of 8graphic formulas0 are outdone by the ,lucas ,laboratories in publishing the alleged formulas of its preparations4 ,if we1 as physicians1 knew more chemistry1 the ,lucas ,laboratories would not find it profitable to publish such ineffable nonsense as that which characterizes their 8literature40 ,for instance3 8#8,luvein' ,arsans 7,plain70 is said to be3 8,di hypo sodio calcio phosphite hydroxy arseno mercuric iodid40 ,the first part of this 8formula0 might stand for sodium and calcium hypophosphite4 ,the remainder is meaningless except that it suggests 7but does not insure7 the presence of arsenic and mercury iodide4 8#8,luvein' ,arsans1 ,nos4 #a1 #b and #c40--8,meta hydroxy iodide sodio arsano mercuric dimethyl benzo sodio arsenate1 ai oxy sodio tartaria sulpho disheuyl hydrazin40 ,who can venture even a conjecture as to the possible significance of this8 8#8,luvein' ,creosophite40--8,ammonio hydroxy calcio sodio hypo-phosphite arsenous pentoxy iodide40 ,while the name suggests creosote1 the 8formula0 gives no hint of this4 ,it might refer to hypophosphites of ammonium1 calcium and sodium with iodide of arsenic4 ,whether arsenous 7trivalent arsenic7 or arsenic 7pentavalent arsenic7 iodide or both are intended1 is a question4 8#8,luvein' ,hexacol40--8,hexa methylenepyro catechin mono methyl amino ether glycerite40 ,by moving these syllables around like the old 8fifteen puzzle0 they can be arranged to represent hexamethylenamin and monomethyl-ether of pyrocatechin1 or guaiacol1 having the 8glycerite0 left over4 ,it is futile to discuss the therapeutic claims made for the various preparations put out by the ,lucas ,laboratories4 ,one might as profitably discuss the therapeutic claims made for 8,peruna0 or 8,paine's ,celery ,compound0 for the exploitation of the latter products is on just as high a scientific plane as the exploitation of the 8,luvein0 nostrums4 ,the proposition offered to physicians by the ,lucas ,laboratories1 ,inc41 is an insult to the intelligence of the medical profession4 ,not that the products themselves are necessarily any worse or any better than many offered for intravenous use2 the selling methods are more crude1 that is all4 ,the facts are1 we have entered a new cycle of nostrum development4 ,the unscientific mixtures for oral administration that characterized so large and disreputable a part of the proprietary medicine business of the past two or three decades are giving way to equally unscientific mixtures for intravenous use4 ,the dangers of the older nostrums are accentuated in the newer by the added element of risk that is inseparable from intravenous therapy4 ,add to this the temptation to the physician in the way of more substantial fees which1 legitimately enough1 may be charged when intravenous administration is called for1 and the menace of the new style nostrum becomes evident4 ,the ,journal can only reiterate the warning that intravenous therapy should be employed only when most positively indicated4 ,further1 because of the danger that is inseparable from this method of drug administration1 physicians should be doubly careful to see that products employed for intravenous use come from firms of unquestioned scientific standing4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bj1 #aiai47 8,,phylacogens0,l ,l ,this matter was largely reprinted in the ,propaganda for ,reform1 eighth and ninth editions4 ,a physician in ,florida writes3 8,i am enclosing a copy of a circular letter just received from ,parke1 ,davis ,company1 and will call your attention to a marked paragraph in this letter on which ,i would like to have an expression of your opinion40 ,the circular letter which the doctor forwards is devoted to singing the praises of 8,pneumonia ,phylacogen40 ,it opens with the statement3 8,influenza1 we learn1 has appeared in your section40 ,the paragraph marked by our correspondent reads3 8,pneumonia ,phylacogen has been found to be a dependable means of preventing and treating pneumonic complications of ,influenza4 ,in one large city it became a routine measure to give all persons affected with ,influenza an injection of ,pneumonia ,phylacogen as a prophylactic of pneumonia4 ,the results were remarkable4 ,not only did the cases improve rapidly1 but in a great majority of them the pneumonia did not occur40 ,the 8,phylacogens0 were repeatedly discussed in ,the ,journal during #aiac and #aiad when these products were being pushed with much vigor by the manufacturers4 ,we know of no evidence that calls for a revision of the statements then made regarding them4 ,the injection of phylacogens is simply the administration of a mixture of the filtered products of several bacterial species4 ,the results which follow represent the reaction of the bacterial protein--a reaction for good or evil4 ,there is no scientific evidence to show that they possess any specific prophylactic virtue4 ,to recommend their use in cases of influenza1 as a prophylactic against pneumonia1 is unwarranted1 and the physician who acts on the advice of the manufacturer must assume the responsibility for the results4 ,in case of mishap he cannot fall back on the manufacturer2 he will find no scientific evidence to support him4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ae1 #aiai47 ,,pineoleum ,,advertising ,,methods ,capitalizing the ,name and ,position of the ,president of the ,american ,medical ,association ,to the ,editor3--,enclosed is a postal card which a physician in ,oklahoma has sent me together with thirty-six cents in stamps4 ,the envelop was addressed to me at the address of the ,pineoleum ,company4 ,the postoffice corrected the address and sent it to me4 ,it is evident1 therefore1 that the physician in ,oklahoma thought ,i was sending these postals as an employee of the ,pineoleum ,company1 or1 at least1 was endorsing their products4 ,illustration3 ---------------------------------------- ----------------------------- ,,treatment ,,of ,,influenza #djh-aj-ab ,west #acth ,street ,by ,a4 ,,lambert1 ,m4 ,d41 ,new ,york4 ,pres4 ,a4 ,m4 ,a4 ,new ,york ,city ,dear ,doctor3 8,the #8,flu' is coming back in ,october to scourge the whole world4 ,i expect the plague to come back as soon as people begin to live indoors again4 ,the death toll ,will be serious1 but ,i do not expect it will be as bad as it was last winter40 --,dr4 ,royal ,s4 ,copeland1 ,chief of the ,new ,york ,health ,department4 8,the persistent spraying of the nose and pharynx with some form of silver salt1 or some form of mild disinfectant1 materially aids in confining the infection in its early stages to the upper passages1 and this procedure gives the impression1 when tried in a large number of patients1 that it prevents in many cases the spread down- ward into the bronchi and thus limits pulmonary complications40 --,extract from 8,the ,treatment of ,influenza10 by ,a4 ,lambert1 ,m4,d41 in the ,journal of the ,american ,medical ,association1 ,august #bnd1 #aiai4 ,we have letters from a large number of physicians confirming the above extract1 and with the further statement that as a preventive and relieving agent there is no combination before the profession today so satisfactory as ,pineoleum4 ,if you have not received recently1 a complimentary ,outfit1 return this card with #cf cents in stamps and we will forward a regular #a4jj package by prepaid ,parcels ,post4 ,,the ,,pineoleum ,,company ---------------------------------------- ----------------------------- ,postal card capitalizing the name and position of the ,president of the ,american ,medical ,association4 ,kindly do me the favor to publish this letter in ,the ,journal as a protest against the dishonesty of this method of advertising4 ,what is quoted from an article that ,i wrote appeared originally in the ,new ,york ,state ,journal of ,medicine and was abstracted in ,the ,journal of the ,american ,medical ,association of ,august #b1 #aiai4 ,the obvious inference to be drawn from this postal is that ,i referred to the products of the ,pineoleum ,company in that article4 ,i did not have the products of the ,pineoleum ,company in my mind4 ,i never have used their products and never prescribed them4 ,this form of advertising is done with intent to deceive and did deceive the doctor in ,oklahoma4 ,it was therefore a successful falsehood1 its success depending on the false use of the name of the ,president of the ,american ,medical ,association to bolster up the sale of the product4 ,i resent the use of my name in connection with the quack advertising of nostrum venders4 ,the low1 vulpine cunning of the method used is on the same level as the deceit and dishonesty which use this form of advertising to the injury of my name and reputation4 ,as ,president of the ,american ,medical ,association ,i must insist that you protect me by publishing this letter in ,the ,journal1 giving it as widespread publicity as possible4 ,alexander ,lambert4 ,comment4--8,pineoleum0 is a 8patent medicine0 advertised in the cheapest and most effective way--by the aid of the easy going and complacent physician4 ,in #aijf ,pineoleum was being marketed by the ,winslow ,laboratory of ,new ,york ,city1 which also put out three or four other nostrums--8,morumalt10 8,egeriol10 8,digestylin10 and 8,ford's ,nucleo-,peptone40 ,pineoleum was advertised to the public then as it is advertised now1 via the medical profession4 ,physicians are circularized and are offered a petty graft in the form of a cheap nebulizer and a sample bottle of ,pineoleum4 ,some time ago the company seems to have developed a scheme whereby physicians could make money 8dispensing ,pineoleum nebulizer outfits at more than #adj per cent4 profit40 ,the ,pineoleum concern for years has also polluted the stream at its source by attempting to get the secretary of the senior class of every medical school to distribute its free nebulizer outfits to members of the class and receive therefor #e cents for each outfit distributed6 ,the life history of ,pineoleum is that of the typical nostrum4 ,epidemics1 of course1 are utilized as opportunities for pushing the product4 ,in #aiaa a card was sent out featuring 8,a ,special ,la,grippe ,offer02 in #aiaf the profession was circularized recommending ,pineoleum as 8,the ,ideal ,prophylactic0 in infantile paralysis2 during the past year influenza has again been the selling point4 ,the case described by ,dr4 ,lambert is not the first example of the misuse of names and statements of physicians4 ,last ,december the ,pineoleum concern was sending out an advertising card in which ,dr4 ,mc,coy of the ,united ,states ,public ,health ,service was quoted as recommending ,pineoleum as the 8bulwark of prevention0 and 8battery of relief0 in influenza4 ,of course1 ,dr4 ,mc,coy never said anything of the sort4 ,a protest against this particular falsehood resulted in another card being sent out several months later by the ,pineoleum people purporting to explain and apologize for the misquotations and putting the blame on the printer4 ,the 8apology0 ended with a postscript 7in larger and bolder face type than the body of the card7 that urged physicians to 8secure our liberal introductory advertising proposition on improved oil nebulizer outfits40 ,from the standpoint of publicity for ,pineoleum1 the 8explanation and apology0 was doubtless as good an advertisement as the original card of misrepresentation4--,ed4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #a1 #aiai47 8,,proteal ,,therapy0 ,,and ,,henry ,,smith ,,williams ,to the ,editor3--,will you please advise as to the success and safeness in using the ,proteal treatment for tuberculosis by ,henry ,smith ,williams1 ,m4,d41 ,,ll4,d41 #ajd ,east #djth ,street1 ,new ,york8 ,c4 ,p4 ,burchard1 ,alamogordo1 ,n4 ,m4 ,to the ,editor3--,kindly send me any available information on 8,the ,proteal ,treatment for ,cancer40 ,an article by ,dr4 ,henry ,smith ,williams1 #abj ,west #cb ,street1 ,new ,york ,city1 in ,april ,hearst's has caused relatives to request its use in a case of carcinoma of the liver under my care4 ,m4 ,m4 ,reppard1 ,middlebourne1 ,w4 ,va4 ,to the ,editor3--,i am enclosing a leaflet1 mailed to me on request1 by ,dr4 ,henry ,smith ,williams of ,new ,york ,city1 who published a series of articles during the last year in ,hearst's ,magazine on 8,proteal ,therapy40 ,if you have investigated this man and his proteal treatment1 ,i should like to know the result of your findings4 ,i am a consumptive and am1 therefore1 particularly interested in its alleged benefactions for the treatment of tuberculosis4 ,michael ,a4 ,long1 ,glen ,lake ,sanitarium1 ,hopkins1 ,minn4 ,to the ,editor3--,what information can you give me regarding ,henry ,smith ,williams1 ,m4,d41 ,,ll4,d41 #ajd ,east ,fortieth ,street1 ,new ,york1 and the therapeutic value of the 8,proteal ,therapy0 that he has originated8 ,m4 ,d4 ,baker1 ,m4,d41 ,san ,jose1 ,calif4 ,the above letters are selected from many received on the subject4 ,henry ,smith ,williams is better known in the journalistic world than in the field of scientific medicine4 ,he was graduated by the ,chicago ,medical ,college in #ahhd4 ,in the thirteen issues of medical directories of the ,united ,states that have been published during the past thirty years ,dr4 ,williams' name does not appear--except for the issues of #ahij and #ahic--until the #aiad edition4 ,so far as we have been able to find1 ,dr4 ,williams had not until #aiae contributed any articles to medical journals4 ,the catalog of the ,surgeon ,general's ,library contains no reference to any articles of ,dr4 ,williams except those that have appeared in popular magazines4 ,the volumes of the ,index ,medicus from #aijg until #aiad1 inclusive1 also contain no references to any articles by him in medical journals4 ,the ,journal#8s author index to current medical literature from #aijj to #aiad1 inclusive1 fails to record any articles by ,dr4 ,williams in medical journals4 ,dr4 ,williams' articles1 however1 in popular magazines have been voluminous and numerous4 ,sometimes his articles have been under his own name and sometimes under the nom de plume1 8,stoddard ,goodhue1 ,m4,d40 ,under the latter name the ,cosmopolitan published articles on 8,adding ,years to ,your ,life10 8,battle of the ,microbes10 8,do ,you ,choose ,your ,children80 and 8,what is the ,matter ,with ,your ,brain80 ,under his own name articles have appeared in popular magazines on such subjects as 8,burbank's ,way with ,flowers10 8,every ,woman ,her ,own ,burbank10 8,why ,not ,live ,forever80 8,science of ,breeding ,kings10 8,new ,cancer ,treatment0 and 8,new ,hope for ,rheumatism ,sufferers40 ,in addition1 ,dr4 ,williams has published books on such subjects as 8,history of the ,art of ,writing10 8,historians' ,history of the ,world10 8,story of ,nineteenth ,century ,science10 8,luther ,burbank10 8,twilight ,sleep0 and others4 ,the ,goodhue ,company of ,new ,york ,city1 which publishes some of ,dr4 ,williams' books has1 we understand1 for its president1 ,dr4 ,henry ,smith ,williams1 for its vice president1 ,dr4 ,williams' wife1 and for its secretary-treasurer1 ,dr4 ,williams' daughter4 ,readers of ,the ,journal will remember the publicity given in #aiae and #aiaf to an alleged treatment for cancer1 sometimes called the 8,horowitz-,beebe ,autolysin ,treatment40 ,the method was heralded widely both in a certain portion of the medical press and in popular magazines and newspapers4 ,a popular article by ,henry ,smith ,williams on 8,the ,new ,cancer ,treatment0 appeared in the ,illustrated ,world for ,october1 #aiae1 with pictures of ,dr4 ,horowitz1 ,dr4 ,beebe1 etc4 ,a month or two later1 physicians received1 gratis1 from the ,goodhue ,company a neatly bound little book on 8,alcohol ,hygiene and ,legislation10 by ,e4 ,h4 ,williams1 ,m4,d4 7brother of ,henry ,smith ,williams74 ,enclosed with it was a letter from the ,goodhue ,company asking physicians to accept the book4 ,the body of the letter was devoted to calling the attention of physicians to an 8important work0 by ,dr4 ,henry ,smith ,williams on 8,the ,autolysin ,treatment of ,cancer0 that the ,goodhue ,company was publishing4 ,with the letter1 there was a small advertising pamphlet 8,issued by the ,autolysin ,laboratory0 and advertising that product4 ,in addition1 the last thirteen pages of the book on 8,alcohol ,hygiene0 contained advertisements of the ,goodhue ,company's publications with particular emphasis 7four pages of it7 on the 8,autolysin ,treatment of ,cancer10 by ,henry ,smith ,williams4 ,in ,may1 #aiag1 physicians in the ,west received a letter from the 8,ellison-,white ,chautauqua ,system0 informing them that ,dr4 ,henry ,smith ,williams was to lecture at 8your ,chautauqua0 and reminding them that 8he has recently issued two volumes1 #8,the ,autolysin ,treatment of ,cancer' which he believes will be his greatest contribution to medical science40 ,the present 8,proteal0 treatment appears to be a modification of the 8,autolysin0 treatment4 ,dr4 ,williams1 in attempting to justify the use of his 8,proteal0 in tuberculosis1 cancer1 rheumatism1 etc41 takes advantage of certain investigations bearing on the nonspecific reactions resulting from the parental injection of foreign proteins4 ,so far as we can discover1 there is no scientific evidence to indicate that the 8,proteal0 treatment expounded by ,williams is of value in the treatment of cancer1 tuberculosis or the other numerous diseases for which the 8,proteals0 are recommended4 ,it is a question whether such articles as those on 8,the ,proteal ,treatment of ,cancer10 8,new ,hope for ,rheumatism ,sufferers10 etc41 published in popular magazines or newspapers serve any useful public purpose4 ,may they not1 on the contrary1 by raising false hopes1 cause much mental suffering and do scientific medicine great harm8--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #f1 #aiah47 ,,proteogens ,commercial ,therapeutics,m ,m ,see index for additional articles on proteogens4 ,a report of the ,council on ,pharmacy and ,chemistry that appears elsewhere#bec in this book deals with another attempt to foist on our profession a series of essentially secret preparations whose therapeutic value has not been scientifically demonstrated4 ,grotesquely extravagant claims are advanced as to the therapeutic potency and range of action of substances of whose nature and effects we have no trustworthy information4 ,physicians are advised to use--and many undoubtedly are using--these alleged remedies in the treatment of diseases in which delay in the proper kind of treatment may be of the greatest danger to the patient4 ,as stated1 there is available no reliable information regarding the effects of these substances when they are introduced in the human body4 ,they may have no effect whatever1 or they may produce more or less direct injury2 in either case1 there is the chance that damage1 even irreparable to the patient1 may result because rational treatment is withheld4 #bec ,page #bbg4 ,if we accept the statement that the preparations are largely vegetable proteins1 it is a fair inference that1 under certain conditions1 they may cause a febrile reaction of the same general nature as that caused by other foreign proteins when injected into the body4 ,we know that such reactions are not without danger and that the treatment of certain infections by induced reactions to foreign proteins is strictly an experimental procedure to be undertaken only under very special conditions4 ,there is1 therefore1 no known valid reason why a physician should assume the responsibility for using these alleged remedies in the treatment of his patients2 there is a very obvious reason why he should not--the therapeutic instructions of 8the ,house of ,merrell1 always interested in the progress of plant therapy0 to the contrary notwithstanding4 ,it is the old story of exploiting physicians through commercial pseudoscience2 of trading on the credulity of the profession to the detriment of the public4 ,as ,osler#bed recently protested so vigorously3 #bed ,advance pages1 the ,oxford ,medicine1 #aiai1 ,vol4 #a1 ,part4 #c1 p4 #bde4 ,some time ago a pamphlet came from ,x and ,company1 characterized by brazen therapeutic impudence1 and indicating a supreme indifference to anything that could be called intelligence on the part of the recipients4 ,that these firms manufacturing pharmacists have the audacity to issue such trash indicates the state of thraldom in which they regard us4 ,and ,i would protest against the usurpation on the part of these men of our function as teachers4 ,why1 for example1 should ,y and ,company write as if they were directors of large genito-urinary clinics instead of manufacturing pharmacists8 ,it is none of their business what is the best treatment for gonorrhea--by what possibility could they ever know it1 and why should their literature pretend to the combined wisdom of ,neisser and ,guyon8 ,what right have ,z and ,company to send on a card directions for the treatment of anemia and dyspepsia1 about which subjects they know as much as an unborn babe1 and1 if they stick to their legitimate business1 about the same opportunity of getting information8 ,for years the profession has been exploited in this way1 until the evil has become unbearable1 and we need as active a crusade against the pseudoscience in the profession as has been waged of late against the use of quack medicines by the public4 ,we have been altogether too submissive1 and have gradually allowed those who should be our willing helpers to dictate terms and to play the rle of masters4 ,,far ,,too ,,large ,a ,,section ,,of ,,the ,,treatment ,,of ,,disease ,,is ,,today ,,controlled ,,by ,,the ,,big ,,manufacturing ,,pharmacists1 ,,who ,,have ,,enslaved ,,us ,,in ,a ,,plausible ,,pseudoscience4 ,what shall the profession do to protect itself against this humiliation--to throw off the credulity that extols pseudoscience and makes commercialized empiricism financially profitable8 ,osler says the remedy is obvious3 8,give our students a firsthand acquaintance with disease1 and give them a thorough practical knowledge of the great drugs1 and we will send out independent1 clear-headed1 cautious practitioners who will do their own thinking and be no longer at the mercy of the meretricious literature1 which has sapped our independence40 ,excellent6 ,but must humanity wait a generation8 ,why not stop this evil at once8 ,the ,american ,medical ,association has provided the means whereby this can be done1 if physicians will only make use of it--the ,council on ,pharmacy and ,chemistry4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,july #ab1 #aiai47 ,an ,alleged ,endorsement of ,proteogens ,repudiated ,to the ,editor3--,i note in the issue of ,the ,journal for ,july #ab1 a statement regarding the so-called 8,proteogens0 manufactured by the ,wm4 ,s4 ,merrell ,company of ,cincinnati4 ,my attention has been called to the fact that salesmen of this company have been exhibiting a letter purporting to show that this department has endorsed their products in the treatment of venereal diseases4 ,the letter in question was written by a physician employed in one of the clinics conducted jointly by this department and the ,u4 ,s4 ,public ,health ,service1 and the stationery of the department was used without authority4 ,the physician in question has made numerous efforts to recall the letter1 but the ,merrell people profess an inability to control its use4 ,i need not add that this department has not endorsed and will not endorse these products1 and has no evidence that they are of any value whatsoever4 ,allen ,w4 ,freeman1 ,m4,d41 ,commissioner of ,health1 ,state of ,ohio1 ,state ,department of ,health4 --7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,july #bf1 #aiai47 ,the ,manufacturer's ,protest and a ,reply ,to the ,editor3--,allow us to direct your attention to several misstatements which appear in the letter signed1 8,allen ,w4 ,freeman1 ,m4,d41 ,commissioner of ,health1 ,state of ,ohio10 published in ,the ,journal of the ,american ,medical ,association for ,july #bf4 #a4 ,salesmen of this company have not been exhibiting a 8letter purporting to show that this department has endorsed their products in the treatment of venereal diseases10 as stated by ,dr4 ,freeman4 #b4 ,the author of the letter has not 8made numerous efforts to recall the letter1 but the ,merrell people profess an inability to control its use10 as stated by ,dr4 ,freeman4 ,a physician employed in one of the clinics used our ,proteogens ,nos4 #aj and #aa extensively and is still using them to a large extent in his private practice4 ,he is a man of standing in the community in which he practices and is also a professor in one of the leading medical colleges in the state4 ,the letter in question cites the case of a man who had been under treatment for three years with #fjf1 #iad and most of the other treatments in general use1 and on ,august #ca1 a year ago1 still gave a ,wassermann test plus #d4 ,he was given ,proteogen ,no4 #aj1 and by the middle of ,december the ,wassermann was negative and the man was discharged as cured4 ,while this letter was written on the stationery of the ,bureau of ,venereal ,diseases of the ,department of ,health1 ,state of ,ohio1 it was written in the first person1 and made no pretension in any way to being official nor was any such pretense made or authorized by the ,merrell ,company4 ,the author of the letter has not made 8numerous efforts to recall the letter10 nor has the ,merrell ,company 8professed an inability to control its use40 ,the physician did ask that the letter be returned to him1 and his request was complied with promptly4 ,then follows the full text of the letter in question4 ,as its contents have no bearing on the question under discussion1 it is omitted4--,ed4 ,in over ninety-one years of honorable service as manufacturers of medicinal preparations1 the ,wm4 ,s4 ,merrell ,company has never endeavored to advance its interests through misrepresentation4 ,the ,wm4 ,s4 ,merrell ,company1 ,chas4 ,g4 ,merrell1 ,pres4 ,the letter above was submitted to ,dr4 ,allen ,w4 ,freeman1 ,commissioner of ,health of the ,state of ,ohio4 ,dr4 ,freeman's comments appear below4--,ed4 ,to the ,editor3--,the plain issue of veracity raised in the communication of the ,merrell ,company must be settled on the evidence1 which is unfortunately too voluminous to be published in full in ,the ,journal4 ,copies of the correspondence in the case have been furnished the editor1 and the originals are on file in the office of the state department of health in ,columbus4 #a4 ,whether or not the photographic reproduction of a letter written on the letter head of this department1 and the distribution of copies to salesmen for display to physicians1 was a conscious effort on the part of the firm in question to create the impression that the letter was an official one is perhaps a matter of inference4 ,that it did create such an impression is evidenced by the letters of inquiry received from physicians who saw it4 #b4 ,the statement that the ,merrell ,company refused to return the letter is perhaps erroneous4 ,they did apparently return the original letter but not the photographic copies which had been distributed to their salesmen4 ,on ,may #bb the firm wrote as follows3 8,a number of physicians who are in cooperation with both state and national bureaus of venereal diseases have been using our ,proteogens with marked success and there are doubtless many letters carried by our salesmen--reports from some of these physicians40 ,this was interpreted to mean that the firm had no method of knowing what letters were carried by their salesmen and was not responsible for them4 ,whether or not this interpretation is correct is again1 perhaps1 a matter of opinion4 ,the purpose of the original communication was to make plain to those of the profession who have already seen or might subsequently see the letter referred to that the communication was the expression of an individual and not of the ,department4 ,a4 ,w4 ,freeman1 ,commissioner4 --7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,sept4 #f1 #aiai47 ,details of the ,alleged ,endorsement of ,proteogens ,our readers will remember the recent correspondence published in ,the ,journal of ,july #bf and ,september #f1 by ,dr4 ,a4 ,w4 ,freeman1 ,commissioner of ,health of the ,state of ,ohio and the ,wm4 ,s4 ,merrell ,co4 ,the letters dealt with the use that had been made by the ,wm4 ,s4 ,merrell ,co4 of a letter1 written on the official stationery of the ,bureau of ,venereal ,diseases of the ,state ,department of ,health of ,ohio1 puffing one of the company's proprietary remedies--,proteogen ,no4 #aj4 ,dr4 ,freeman wrote to ,the ,journal calling the attention of the profession to the use of this letter and explaining that the letter was merely the expression of opinion of an individual1 and not an expression from the ,state ,department of ,health4 ,the ,wm4 ,s4 ,merrell ,co4 took exception to certain inferences made in ,dr4 ,freeman's letter and in the course of a letter to ,the ,journal regarding this1 incorporated the contents of the testimonial letter4 ,the ,journal1 in publishing the ,merrell letter1 omitted this testimonial on the ground that the contents of the letter had no bearing on the question under discussion4 ,we have now received a letter from the company protesting against this omission4 ,the ,journal1 therefore1 takes this opportunity of briefly restating such facts as it has been able to get regarding the entire matter and publishing the letter4 ,the facts are as follows3 #a4 ,in ,february of this year a ,cincinnati physician1 ,dr4 ,c4 ,j4 ,broeman1 wrote to ,dr4 ,a4 ,s4 ,horovitz relative to alleged results with ,proteogen ,no4 #aj4 ,the letter was written--without authority--on the official stationery of the ,bureau of ,venereal ,diseases of the ,state ,department of ,health of ,ohio4 #b4 ,the ,wm4 ,s4 ,merrell ,co4 had linen mounted photographs made of ,dr4 ,broeman's letter and distributed them to their ,proteogen detail men4 ,accompanying these photographic copies was a communication to these detail men describing the photographed letter as one written by3 8444 a ,cincinnati physician who is now ,acting ,assistant ,surgeon1 ,u4 ,s4 ,public ,health ,service1 cooperating with the ,bureau of ,venereal ,diseases of the ,department of ,health of the ,state of ,ohio40 #c4 ,the right hand top corner of the official stationery1 as can be seen by the reproduction1 bore the name of 8,james ,d4 ,bauman1 ,deputy ,commissioner40 ,dr4 ,broeman's signature was rather illegible and could easily be mistaken1 by those not knowing the handwriting of either man1 for the signature of ,deputy ,commissioner ,bauman4 ,in at least one instance it was so mistaken1 and the physician who was misled wrote to the ,director of the ,bureau asking whether the testimonial for ,proteogen ,no4 #aj which had been shown him by the ,merrell detail man was really an official communication4 #d4 ,on ,may #ae1 #aiai1 ,commissioner of ,health ,freeman wrote to the ,merrell ,co4 stating that he had been informed that one of the ,merrell representatives was using as an advertisement a letter bearing the letterhead of the ,bureau of ,venereal ,diseases of the ,state ,department of ,health and what purported to be a report signed by 8,mr4 ,bauman1 ,deputy ,commissioner40 #e4 ,on ,may #ai1 the ,wm4 ,s4 ,merrell ,co4 wrote ,dr4 ,freeman that he was certainly mistaken in regard to the use of any 8report signed by ,mr4 ,bauman40 ,dr4 ,freeman then sent to the company the letter he had received from the physician who had mistaken ,broeman's letter for an official letter by ,bauman4 ,although it would seem that this letter and ,commissioner ,freeman's protest should have made plain to the ,wm4 ,s4 ,merrell ,co41 the fact that the letter1 incorrectly referred to as ,mr4 ,bauman's1 was in reality ,dr4 ,broeman's1 the company remained silent regarding its use of the ,broeman letter and1 on ,may #bb1 merely reiterated that there had been 8no letter circulated by this company containing a testimonial of your ,mr4 ,bauman40 ,on ,may #bh 7six days later7 the ,merrell company sent to its ,proteogen detail men another general letter1 8for personal use of agents10 in which it again called their attention to the 8photographic copy mounted on linen0 of ,dr4 ,broeman's letter4 ,this communication to the detail men also declared that it 8has been suggested that the further use of ,dr4 ,broeman's letter might antagonize the ,state ,department of ,health0 and1 therefore the detail men were told to 8discontinue using the photographic copy in question0 and to return the photographs to the head office4 ,illustration3 ,reproduction 7reduced7 of one of the photographic copies sent out by the ,wm4 ,s4 ,merrell ,co4 to its ,proteogen detail men to be shown to physicians4 ,while the letter is a private one1 it was written 7without authority7 on official stationery4 ,some physicians were misled into thinking it was an official endorsement of ,proteogens4 ,the ,merrell concern denied any intention to mislead and claimed that it was interested only in bringing to the attention of physicians the contents of the letter6 ,here1 briefly are the bald facts in the case4 ,the essential point at issue is whether these photographic copies of ,dr4 ,broeman's letter would or would not be likely--whether or not they were so intended--to mislead physicians into believing that the endorsement was an official one by the ,state ,board of ,health rather than an individual one4 ,one can but wonder why1 if1 as the ,merrell company so vehemently asserts1 there was no intention of misleading physicians on this point1 the company should have gone to the trouble and expense of photographing the entire letter1 including the letterhead1 rather than making typewritten or mimeographed copies of the contents of the letter4--7,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bg1 #aiai47 ,dr4 ,broeman's ,final ,report on ,proteogens ,to the ,editor3--,in the ,september #bg issue of ,the ,journal my name was mentioned in connection with the ,merrell ,chemical ,company's 8,proteogens0 in the treatment of syphilis4 ,the ,merrell ,chemical ,company promised not to use my name at any time in connection with their 8,proteogens0 injection and they know that the use of my name has been distinctly against my wishes4 ,i feel that in justice to myself1 as well as the public1 ,i should report the result of my experiments with their 8,proteogens0 in private practice4 ,in explanation ,i might say that ,i began the use of their 8,proteogens0 in ,april1 #aiah1 and ,i feel that ,i now have enough data to give a complete report4 ,i might say that all my results have been practically nil2 particularly is this true in my cases of syphilis1 which all had a four plus ,wassermann reaction when ,i discontinued using this form of treatment4 ,very truly yours1 ,c4 ,j4 ,broeman1 ,m4,d41 ,cincinnati4 --7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,oct4 #aa1 #aiai47 ,,pulvane ,in a twelve-page pamphlet1 sent out by the ,pulvane ,laboratories1 ,inc41 of ,des ,moines1 ,iowa1 and purporting to deal with 8,the ,therapy of ,pulvane1 an advanced method for the treatment of ,respiratory ,diseases10 we are told that ,pulvane 8was developed in a ,united ,states ,army ,general ,hospital by officers of the ,medical ,department40 ,pulvane 8originally was intended only for its germicidal action upon tubercle bacilli in the lung10 but it is now also recommended for asthma1 hay fever1 bronchitis1 rhinitis1 laryngitis and 8other affections of the air passages40 ,of the alleged action of ,pulvane on tuberculosis we read3 8,it destroys the spores of the bacilli as well as the germs themselves4 ,it prevents infection of new areas by aspiration1 gravity or surface contact4 8,in cases where sputum is positive it is a very noteworthy fact that shortly after treatment is begun1 the bacilli begin to disappear1 gradually diminish in number1 and finally the sputum becomes negative40 ,pulvane is administered1 by inhalation1 at the offices of the ,pulvane ,laboratories1 ,inc4 ,its 8discoverer0 chanced on a method of 8introducing into solution and volatizing a certain germicide1 extremely rare in its usage because of its resistance heretofore to attempts to bend it to scientific will40 ,this 8rare0 medicament is alpha naphthol6 ,but since the discovery of this volatizing method 8three other ingredients of high therapeutic value have been added40 ,what are these other ingredients8 8,they would be named were it not that ,pulvane requires special technique in its preparation and administration4 ,our medical directors do not consider it advisable to identify them here because of the possibility of incompetent hands attempting their use4 ,the medical directors1 however1 will be glad to name every ingredient of ,pulvane for any reputable member of the profession4 ,pulvane ,laboratories reserve only the method of compounding40 ,presumably1 therefore1 if physicians desire to know what ,pulvane is1 the ,pulvane ,laboratories1 ,inc41 8will be glad to name every ingredient of ,pulvane40 ,it is worth noting that nothing is said about quantities4 ,it is also worth remembering that 8,peruna0 and some other 8patient medicines0 have for years printed on the label the names of the alleged ingredients4 ,how much longer is the medical profession going to be fooled with the trick of nostrum exploiters pretending a frankness that means nothing8 ,from a recent issue of a ,des ,moines newspaper we learn that the ,pulvane ,laboratories are about to establish a sanatorium where the ,pulvane treatment can be given4 ,this announcement is said to be made by ,john ,p4 ,mosher1 the alleged discoverer of ,pulvane4 ,mosher is not a physician4 ,the newspaper article states1 further1 that ,mosher's experiments were tried out 8under the observation of ,major ,sharpe10 commander at ,fort ,des ,moines4 ,it appears also that an ex-newspaper reporter is connected with the ,pulvane ,laboratories4 ,the value of having a good publicity man is obviously recognized4 ,there also seems to be connected with the concern a ,dr4 ,harry ,p4 ,hall4 ,we find in the records reference to one ,harry ,p4 ,hall who was graduated by the ,medical ,department of ,drake ,university of ,des ,moines1 ,iowa1 in #ahid1 and was licensed in ,iowa in #ahif4 ,our records indicate that he has not been in practice for some years4 ,we also find in our files some newspaper clippings regarding a ,dr4 ,harry ,p4 ,hall who1 in #aiad1 pleaded guilty to a charge of using the mails to defraud and was fined in the federal courts4 ,whether there is any connection between these two names1 we do not know4 ,reverting to the claims made by the ,pulvane ,laboratories that ,pulvane was 8developed in a ,united ,states ,army ,general ,hospital by officers of the ,medical ,department0 the following statement has recently been received by ,the ,journal from ,surgeon-,general ,ireland of the ,united ,states ,army3 8,it has been brought to my attention that a concern in ,des ,moines1 ,iowa1 known as the ,pulvane ,laboratories1 has issued a pamphlet in which statements are made which would naturally lead medical men to believe that the experiments1 etc41 referred to therein were made with the approval of and more or less under the direction of the ,medical ,department of the ,army4 ,i wish to say that this is not so2 that the ,medical ,department had nothing whatever to do with the matter and that it thoroughly disapproves of the methods used by the promoters of this concern4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #aa1 #aibb47 ,,sal ,,hepatica ,sal ,hepatica is a saline laxative sold by the ,bristol-,myers ,company of ,new ,york4 ,little information is given1 or1 apparently1 ever has been given1 concerning the composition of this product4 ,many years ago the stock medical journal advertisement contained this statement3 8,composition4--,sal ,hepatica contains all of the ,tonic1 ,alterative and ,laxative ,salts of the celebrated #8,bitter ,waters' of ,europe1 especially those of ,bohemia1 as determined by actual chemical analysis of these waters1 and fortified by the addition of ,lithium and ,sodium ,phosphates40#bee #bee ,some of the ,sal ,hepatica advertising has claimed that it 8is a saline combination with the addition of ,sodium ,phosphate and ,lithia ,citrate60 ,sal ,hepatica no longer 8contains all the tonic1 alterative and laxative salts 44410 etc41 for the label on a package recently purchased reads3 8,,sal ,,hepatica is an effervescent saline combination possessing medicinal properties similar to the natural #8,bitter ,waters' of ,europe1 and fortified by the addition of ,sodium ,phosphate40 ,in #aiji1 the ,druggists ,circular published an analysis of ,sal ,hepatica which showed that the preparation contained only #j4jd per cent4 of lithium phosphate4 ,by referring to the two quotations just given it will be noticed that today the manufacturers make no claim that their preparation is fortified with any salt of lithium4 ,a circular accompanying recent trade packages states3 8,sal ,hepatica is composed solely of harmless salts1 being absolutely free from ,acetanilid1 ,phenacetin1 ,caffein1 ,calomel1 opium or coal tar derivatives40 ,since neither the names nor the amounts of the 8harmless salts0 are mentioned1 the composition of ,sal ,hepatica is secret4 ,it is a trick of the nostrum exploiter1 old but ever popular1 to mention numerous drugs which his preparation does not contain2 it helps to distract attention from the fact that he does not tell what the preparation does contain6 ,in the old-time medical journal advertisements1 one reads1 8,sal ,hepatica is the most powerful solvent of ,uric ,acid known40 7,the same advertisement as it appeared in those days in ,the ,journal shows that claim toned down to1 8,sal ,hepatica is a powerful solvent of ,uric ,acid407 ,in those easy going days1 the ,bristol-,myers ,company declared that 8diabetes is treated with decided advantage by means of ,sal ,hepatica 444 it 444 possesses the property of arresting the secretion of sugar in the liver40 ,in the old days1 too1 ,sal ,hepatica was recommended in the treatment of cirrhosis of the liver1 ,bright's disease1 gravel1 phthisis1 etc4 ,the present advertising circular recommends ,sal ,hepatica as an eliminant1 laxative or cathartic in gout1 autointoxication1 8,bilious ,attacks10 rheumatism1 acute indigestion1 catarrhal conditions of the stomach1 pyorrhea1 headache1 dizziness1 heart burn1 8,summer ,complaints10 8,derangements of the ,stomach and ,liver10 skin diseases1 colic1 alcoholic excesses1 and as a 8preventive of ,seasickness40 ,in #aiad the ,council on ,pharmacy and ,chemistry published#bef a report on ,sal ,hepatica declaring it secret in composition and sold under exaggerated and unwarranted claims4 #bef ,j4 ,a4 ,m4 ,a41 ,feb4 #g1 #aiad1 p4 #dgb4 ,in view of the inquiries which ,the ,journal continues to receive it seemed worth while to make a chemical examination of the present-day product4 ,accordingly specimens were purchased and analyzed in the ,a4 ,m4 ,a4 ,chemical ,laboratory4 ,the report that follows was submitted by the chemists3 8,sal ,hepatica is a white1 granular1 odorless powder4 ,it effervesces on the addition of water in which it eventually dissolves4 ,the aqueous solution1 after boiling to remove carbon dioxid1 has an acid reaction to litmus4 8,since a great many medicinal substances are sold in effervescent form1 and since practically no information is given by the manufacturer concerning the composition of ,sal ,hepatica1 it became necessary to test for a considerable number of therapeutic agents4 ,the absence of acetanilid1 acetphenetidin1 alkaloids1 ammonium salts1 benzoates1 caffein1 citrates1 heavy metals1 hexamethylenamin1 magnesium1 potassium1 salicylates and sugars was demonstrated by appropriate tests4 ,the presence of a carbonate 7probably in the form of a bicarbonate71 a phosphate1 a sulphate1 a chlorid1 tartaric acid1 sodium and traces of lithium was shown by qualitative tests4 8,quantitative analysis indicated that the composition of the specimens examined was essentially as follows3 ,sodium phosphate1 anhydrous #d4d per cent4 ,sodium sulphate1 anhydrous #bf4e per cent4 ,sodium tartrate1 anhydrous #ab4g per cent4 ,sodium bicarbonate #ai4e per cent4 ,tartaric ,acid1 free #bj4h per cent4 ,sodium chlorid #h4i per cent4 ,lithium phosphate trace ,water of hydration 7by difference7 #g4b per cent4 8,from the results of the analysis1 it appears probable that the composition of the mixture before #8granulation' was approximately as follows3 ,sodium phosphate #d per cent4 ,sodium sulphate #be per cent4 ,sodium bicarbonate #cj per cent4 ,tartaric ,acid #cj per cent4 ,sodium chlorid #h per cent4 ,lithium phosphate trace ,water of hydration 7by difference7 #c per cent4 8,sal ,hepatica1 therefore1 is essentially an effervescing mixture of dried sodium sulphate 7,glauber's salt7 and sodium tartrate with a little dried sodium phosphate and table salt added4 ,it is similar to the effervescent artificial ,carlsbad ,salt described in the ,national ,formulary4 8,in #aiji the ,druggists ,circular published the following analysis of ,sal ,hepatica3 ,sodium phosphate #bi4hj parts ,sodium sulphate 7,glauber's salt7 #bf4bg parts ,sodium bicarbonate 7baking soda7 #ah4jj parts ,sodium chlorid 7salt7 #ac4je parts ,lithium phosphate #j4jd parts ,citric and tartaric acids 7to make #ajj7 #ab4hd parts 8,a comparison of the recent analysis with the earlier one would seem to indicate that considerable changes have been made in the formula since the first examination4 ,the proportions of sodium phosphate have been greatly reduced1 while the sodium bicarbonate and tartaric acid have been increased and the citric acid entirely eliminated40 ,sal ,hepatica1 then1 is a simple effervescent saline laxative1 essentially secret in composition and sold under claims that would be laughed at were the full formula of the product a matter of public knowledge4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bi1 #aiba47 ,,salicon 8,salicon0 is marketed by the ,k4 ,a4 ,hughes ,company1 ,boston1 as 8an improved aspirin40 ,in a circular sent out to the public a little over a year ago the following claims were made for it3 8,we rendered aspirin absolutely harmless and yet retained all its virtues as a medicine40 8,it positively will not depress the heart nor upset the stomach no matter how large amounts of it are taken40 8444 the ,massachusetts state medical authorities 444 adopted its use at all the state camps for fighting the ,spanish influenza44440 ,the first two statements quoted above are obviously false4 ,the third statement might have been true although it seemed unlikely4 ,a letter was1 therefore1 written to the ,department of ,public ,health of the ,commonwealth of ,massachusetts and the claim of the ,k4 ,a4 ,hughes ,company relative to the adoption of ,salicon in all the state camps by the 8state medical authorities0 was brought to their attention4 ,the reply of the department on this point was emphatic3 8,the ,state ,department of ,health of ,massachusetts did not endorse the use of ,salicon for any purpose40 ,some ,salicon was purchased on the open market and submitted to the ,a4 ,m4 ,a4 ,chemical ,laboratory for analysis4 ,here is the chemists' report4 8,one original bottle of #8,salicon' 7,k4 ,a4 ,hughes ,company1 ,boston7 was submitted by the ,propaganda department of ,the ,journal to the ,association's ,chemical ,laboratory for examination4 ,the bottle contained #ajj white tablets having an average weight of #j4djg gram 7#f4c grains71 each4 ,the amount of ash was #bj4i per cent4 ,qualitative tests indicated the presence of magnesium1 carbonate1 starch1 acetylsalicylic acid and a trace of calcium2 a very small amount of a petrolatum-like substance was present4 ,alkaloids and drugs used for a laxative effect were not found4 ,the amount of acetylsalicylic acid extracted by chloroform was #ej4g per cent4 ,the amount of magnesium present as magnesium oxid was #ad4c per cent4 ,the amount of magnesium oxid derived from magnesium carbonate ,u4 ,s4 ,p4 is variable2 but calculating on the lowest limit1 #ad4c per cent4 of magnesium oxid is equivalent to at least #ce4e per cent4 of magnesium carbonate4 ,this figure agreed closely with that obtained from the ,u4 ,s4 ,p41 method of assay4 ,the acetylsalicylic acid was not combined with the magnesium4 ,from the above1 it may be stated that each tablet consisted essentially of a mixture of #c4b grains of acetylsalicylic acid 7aspirin71 #b4b grains of magnesium carbonate and some starch4 ,although labeled #e grains1 each tablet did not contain #e grains of the most active ingredient1 acetylsalicylic acid40 ,the same old story4 ,an ordinary mixture of well known drugs put on the market as a new discovery and foisted on the public under false and misleading claims4--7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,feb4 #e1 #aiba47 ,,so-,,called ,,secretin ,,preparations ,in ,china the administration of powdered tiger-bone is--or was--a favorite form of treatment in cases of supposed cardiac weakness4 ,the theory is1 presumably1 that the cardiac strength of the tiger would be a good thing for the patient to acquire4 ,since many patients have recovered after taking tiger-bone1 and no one has proved that they might not have died had they failed to take it1 8clinical experience0 stands back of the treatment2 and where is the skeptic so rash as to challenge that8 ,the ,chinese physician believes in his tiger-bone therapy1 and1 with the best interests of his patient at heart1 insists on obtaining absolutely true and authentic tiger-bone4 ,not satisfied with the assertions of the dealers1 the conscientious ,chinese physician subjects his tiger-bone to a kind of physiologic standardization4 ,he offers the bone in question to a dog6 ,if it is an ox-bone--a frequent form of substitution--the dog will seize and eagerly gnaw it1 whereas1 according to all the teachings of ,chinese pharmacognosy1 if it is a tiger-bone the dog will depart hurriedly with his tail between his legs4 ,very foolish8 ,yes6 ,but before we smile superciliously at the ,chinese medical man1 let us turn to the report of the ,council on ,pharmacy and ,chemistry on 8,so-,called ,secretin ,preparations40#beg ,after reading this report let us put to ourselves1 squarely and honestly1 the question3 ,has the attitude toward secretin therapy1 of a certain portion of those who represent ,western modern medicine1 really been much more scientific than that of the ,chinese medical profession toward tiger-bone therapy8 ,on the basis of a hypothesis scarcely less crude and unsubstantiated than that which assumes that tiger-bone is of value in heart disease1 it has been assumed that secretin is of value in gastro-intestinal diseases4 ,on the ground of 8clinical evidence0 scarcely more critical than that exhibited by our confrres in the antipodes1 it has been asserted that alleged secretin preparations actually are efficious4 ,indeed1 in one respect the methods of the ,chinese physician appear more scientific than those of his ,western brethren4 ,to the best of his ability1 the ,oriental at least makes sure that he is administering genuine tiger-bone2 he does not rely on the unverified word of his dealer alone4 ,the ,american physician has not been making the least effort to ascertain whether his supposed secretin preparations are truly such2 and1 as a matter of fact1 scientific investigation seems to indicate that some of these products contained no secretin at all6 ,whatever one may think of the validity of his test1 the ,chinese physician does his best according to his lights4 ,as to 8clinical experience10 ,dr4 ,jacobi has well said that some people make the same mistake a hundred times and call it 8experience40--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ae1 #aiaf47 #beg ,page #fd4 ,,succus ,,cineraria ,,maritima ,another ,illustration of ,one of the ,weaknesses of the ,federal ,food and ,drugs ,act ,the ,walker ,pharmacal ,company of ,st4 ,louis was1 we understand1 if it is not still1 one of the subsidiary concerns of the ,luyties ,homeopathic ,pharmacy ,company4 ,it has for years sold a nostrum1 8,succus ,cineraria ,maritima10 under the claim that by simply dropping this stuff into the eye1 twice daily1 cataract and other opacities of the eye will be cured4 ,for instance3 8444 the only remedy for the relief of cataract and other opacities of vision1 which stands before the medical fraternity on a firm foundation of accomplished results44440 8444 possesses a specific power in removing the obstruction to vision40 8,in this class of cases cataract physicians can place reliance on ,succus ,cineraria ,maritima 7,walker7 which does not require the services of a specialist but is simply dropped into the eye with an ordinary medicine dropper twice daily44440 8444 has been used with success in cataract1 both lenticular and capsular1 pterygium and opacities of the cornea1 softening the opaque deposits1 causing dissolution1 and by its stimulating properties1 hastening absorption40 ,succus ,cineraria ,maritima is advertised to the medical profession in true 8patent medicine0 style by means of testimonials from doctors1 obscure and deceased4 ,the preparation is valueless for the purposes for which it is sold and 8has about as much effect on the dissolution or dispersal of opacities due to organic changes in the lens as pouring the same down the back of the patient's neck60 ,more than five years ago the ,council on ,pharmacy and ,chemistry reported on the worthlessness of the drug1 ,cineraria maritima1 and1 at the same time1 ,the ,journal pointed out that the drug would have been forgotten long ago had it not been for the prodigal use of printers' ink by the ,walker ,pharmacal ,company in advertising its ,succus ,cineraria ,maritima4 ,these facts are given for the purpose of refreshing the memory of our readers and are but incidental to the object of this article4 ,in due time the federal authorities proceeded against the ,walker ,pharmacal ,company charging that ,succus ,cineraria ,maritima was misbranded under the federal ,food and ,drugs ,act4 ,the government chemists reported that analysis 8showed that the product was essentially an aqueous solution of glycerin1 boric acid and vegetable drug extractives carrying tannin-like bodies40 ,the direct and inferential claims made in the advertising matter accompanying the trade package were quoted by the federal authorities1 who pointed out that the ,walker ,pharmacal ,company was selling the nostrum under claims that would create in the minds of the purchasers the belief that ,succus ,cineraria ,maritima was a remedy for cataract and other opacities of the eye causing impaired vision and that it was a cure for senile cataract1 trachoma1 secondary opacities1 etc4 ,these claims the government charged were 8false and fraudulent in that the same were applied to the article knowingly1 and in reckless and wanton disregard of their truth or falsity10 because 8in truth and in fact it was not1 in whole or in part1 composed of1 and did not contain1 such ingredients and medicinal agents0 as would produce the therapeutic effects claimed4 ,illustration3 ,facsimile of a letter1 dated ,october1 #aiaf1 suggesting the use of 8,succus ,cineraria ,maritima0 as a cure for cataract and other opacities of vision4 ,eight months previously 7,february1 #aiaf71 the ,walker ,pharmacal ,company had pleaded guilty to the charge that the claims that 8,succus ,cineraria ,maritima0 was a cure for cataract and other eye opacities were false and fraudulent and applied knowingly and in reckless and wanton disregard of their truth or falsity4 ,the federal ,food and ,drugs ,act does not apply to claims made in circular letters or elsewhere than in the trade package4 ,these charges put the matter flatly up to the ,walker ,pharmacal ,company4 ,this company has for years been telling physicians that their stuff could and would do just what the federal authorities insisted it can not and will not do4 ,did the ,walker ,pharmacal ,company attempt to defend its claims8 ,did it demonstrate that ,succus ,cineraria ,maritima would cure cataract8 ,did it produce evidence of the numerous cases of recovery from blindness or partial blindness which must have been available if the preparation had the powers claimed for it8 ,no6 ,the ,walker ,pharmacal ,company in ,february1 #aiaf1 pleaded guilty--and was fined a paltry #aj and costs4 ,this1 however1 is not the end of the story4 ,the company was prosecuted because it had published the false and fraudulent claims in the trade package1 thus bringing the claims within the purview of the federal ,food and ,drugs ,act4 ,had the ,walker ,pharmacal ,company confined its false statements to medical journal advertisements1 to the circular letters sent to physicians or to any other advertising matter not part of the trade package1 it could have snapped its fingers at the ,food and ,drugs ,act4 ,it was in ,february1 #aiaf1 that the ,walker ,pharmacal ,company pleaded guilty to the charge of making false and fraudulent claims for ,succus ,cineraria ,maritima4 ,in ,october1 #aiaf1 they were still sending out circular letters to physicians urging the use of ,succus ,cineraria ,maritima in the treatment of cataract and enclosing the usual booklet of testimonials claiming cures for cataract and other opacities of the lens and cornea6 ,illustration3 ,facsimile of some of the pages from the booklet that accompanied the letter reproduced herewith4 ,the obvious intent of this booklet was to lead physicians to believe that ,succus ,cineraria ,maritima will cure 8,opacity of the ,cornea10 8,opacity of the ,lens10 8,senile ,cataract10 8,incipient ,cataract10 8,double ,cataract10 etc4 ,can one conceive a better illustration of the inadequacy of the ,food and ,drugs ,act8 ,the dishonest exploiter of proprietary medicines cares little that the law requires him to keep within certain bounds of truthfulness in the advertising that accompanies the trade package4 ,it isn't the claims in the trade packages that sell the product2 it's the advertising in medical journals1 in circular letters1 etc4 ,yet1 the ,food and ,drugs ,act offers no check or curb on false statements or fraudulent claims made for proprietary or 8patent medicines0 in any other place than the trade packages4 ,a few weeks ago ,the ,journal called attention to a flagrant case of fraud2 and at that time it said1 8,it is justifiable to assume that when any man1 whatever his business1 admits in court that he has made fraudulent claims and then continues to make the same claims through channels that are not controlled by penal enactment1 that man's standard of business ethics is such that the public needs protection against it4 ,there are many such men in the #8patent medicine' world4 ,the only way in which the public may properly be protected against being defrauded in such cases is for the federal ,food and ,drugs ,act to have its scope extended to cover all advertising of the products coming under the purview of the act40--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #ag1 #aiag47 ,,tekarkin ,edward ,percy ,robinson's 8,cure0 for ,cancer ,from various parts of the country ,the ,journal has received a sixteen page pamphlet1 ,therapeutic ,leaves4 ,the publication1 which has a saffron colored cover1 is said to be published by the ,national ,bio-,chemical ,laboratory1 ,mount ,vernon1 ,n4 ,y4 ,the ,national ,bio-,chemical ,laboratory seems to be a style used by ,dr4 ,edward ,percy ,robinson4 ,the 8editorial offices0 of ,therapeutic ,leaves are given as 8#eja ,knox ,bldg41 #eth ,ave4 at #djth ,st41 ,new ,york10 which is a roundabout way of describing #deb ,fifth ,ave41 the office address of ,edward ,percy ,robinson4 ,the first number 7,february1 #aiba7 of ,therapeutic ,leaves gives the names of the 8editors0 as 8,e4 ,p4 ,robinson1 ,m4,d41 and ,w4 ,a4 ,jenner1 ,b4,a40 ,in addition1 there is 8,assistant ,editor1 ,f4 ,j4 ,geiger10 and 8,gen'l ,manager1 ,beverly ,k4 ,robinson40 ,the first and second numbers of ,therapeutic ,leaves 7,february and ,march1 #aiba7 are practically identical1 being evidently printed from the same plates4 ,therapeutic ,leaves purports to be a periodical published as 8a medium for the dissemination of knowledge1 pertaining to therapeusis40 ,actually1 it is an advertising medium dealing with the products of the ,national ,bio-,chemical ,laboratory3 8,osmo-,calcic ,solution10 8,tekarkin0 and 8,osmotic ,mangano-,potassic ,solution40 ,these preparations are said to be the 8formulas0 of ,dr4 ,edward ,percy ,robinson who lives in ,mt4 ,vernon1 ,n4 ,y41 and has an office at #deb ,fifth ,ave41 ,new ,york ,city4 ,they are used by ,dr4 ,robinson in the treatment of cancer4 ,at an earlier stage they seem to have been known under different names3 8,tekarkin0 was first 8,hypotonic ,sal-,cella0 and then 8,neoanabolin-,x20 8,osmo-,calcic ,solution0 was 8,osmotonic ,calcic0 while 8,osmotic ,mangano-,potassic ,solution0 was 8,osmotonic ,drops40 ,the three solutions are put up in one package containing #d c4c4 7about #fe minims7 of 8,tekarkin0 and #a ounce each of the other preparations4 ,the package sells for #aj4jj4 8,remittance with order 444 ,we have no agents40 ,illustration ,most of the material in ,therapeutic ,leaves is a rehash of four papers published by ,edward ,percy ,robinson in the ,new ,york ,medical ,record of various dates between ,september1 #aiag1 and ,july1 #aibj4 ,in these ,robinson advances the theory that cancer is caused by an excess of sodium chlorid 7table salt7 in the blood and tissues and that it can be cured by administering a solution of potassium nitrate4 ,such a treatment sounds ideally simple4 ,one might assume that all that was necessary was to make up a solution of potassium nitrate and inject it4 ,one might further wonder how it would be possible to commercialize such a 8treatment40 8,homemade solutions10 says ,dr4 ,robinson1 8are apt to be disappointing40 ,their use is likely to cause 8considerable swelling at the site of an injection1 accompanied with tenderness and some heat40 ,moreover1 8a wide hyperemic area with red blotches has been observed in a number of instances40 ,in order to avoid 8accidents of this sort0 which would 8bring discredit upon an excellent agent10 ,dr4 ,robinson1 8after considerable experimental work0 has obtained 8a solution of this chemical which would meet the ideal requirements40 ,this is available under the name 8,tekarkin40 ,dilute potassium nitrate solution sold under the name 8,tekarkin0 sells for #fg an ounce4 ,the physician can make his own solution1 of the purest and highest grade potassium nitrate on the market1 at an expense1 for the chemical1 not exceeding #e cents an ounce4 ,therapeutic ,leaves also contains the usual number of those 8clinical reports0 which bulk so large in the literature of 8cures0 for cancer4 ,then there is a full page advertisement of a side-line of the ,national ,bio-,chemical ,laboratory3 8,vitamines 7,compressed7 ,tekarkin ,brand20 8,they have a meaty taste40 ,the medical profession1 naturally1 is interested in knowing more about the physician who admits that he has discovered the cause and cure of cancer4 ,according to our records1 ,edward ,percy ,robinson was born in #ahga and was graduated in #ahig by ,bellevue ,hospital ,medical ,college4 ,he was licensed in ,new ,york ,state the same year and has practiced in ,new ,york ,city continuously since that time4 ,he is not1 and apparently never has been1 a member of his local medical society4 ,in #aiad ,robinson was specializing in 8facial contouring40 ,one piece of advertising purports to be the reprint of an interview with 8,dr4 ,e4 ,p4 ,robinson1 ,specialist1 as he sat in his office at #aaf ,west #cith ,street1 having questions fired at him by the reporter40 ,thus ,dr4 ,robinson3 8,there are physicians everywhere who abandon the general1 or family1 practice of medicine1 to devote their life to some specialty4 ,my specialty is the improvement of the facial features and the beautifying of the shoulders1 neck and arms4 ,i round out hollow cheeks1 build up the neck1 eradicate wrinkles1 make irregular noses perfect and remove defects by a process which is my own secret4 ,i claim no superhuman power or ability2 ,i have simply bent my whole professional study and energy to the one line of remodeling--so to speak--the human features1 and ,i employ only scientific methods and aids in my operations40 ,in another piece of advertising1 a little booklet bearing ,edward ,percy ,robinson's name1 we find the following3 8,this is what ,i accomplish4444 8,remove all wrinkles and traces of age from the forehead1 or about the eyes and mouth4 ,lift sag from cheeks and chin4 8,round out hollow cheeks4 8,remove depressions and defects from the chin4 8,build up the neck and shoulders4 8,build up and enlarge the bust4 8,round out and give symmetry to unshapely arms and remove the lines of age from the hands4 8,correct many of the defects not mentioned here1 but which may be possessed by exceptional cases40 ,illustration3 ,reproduction 7reduced7 of some advertising matter issued in #aiad when ,edward ,percy ,robinson was specializing in 8facial contouring40 ,still another advertising leaflet purports to be a reprint of an 8editorial0 from the ,mercantile and ,financial ,times of ,march #aa1 #aiad4 ,it is a pretentious puff of ,robinson1 telling about his 8scientific attainments0 and his marvelous secret preparations used in 8,youthifying the ,face40 ,the ,mercantile and ,financial ,times is an utterly discredited sheet run for the purpose of selling what appear to be editorial comments4 ,such 8editorial0 puffs are paid for through the purchase of a certain number of copies of the paper by the party who desires the publicity4 ,the ,associated ,advertising ,clubs of the ,world exposed this publication in a special bulletin issued in ,june1 #aiai1 and described it as an 8example of publications that serve as convenient tools of fake promoters40 ,in #aiaa the ,mercantile and ,financial ,times published an 8editorial0 endorsement of the consumption cure 8,nature's ,creation40 ,it has done the same for a fakish device known as the 8,ideal ,sight ,restorer40 ,it published a puff on the 8,oxypathor10 a swindle so preposterous that the exploitation of this 8gaspipe0 fake was debarred from the ,u4 ,s4 mails and its exploiter was sent to the federal penitentiary4 ,illustration3 - - - - - - - - - - - - - - - - - - - ,the ,jean ,downs ,co41 ,new ,york ,my dear ,mrs4 ,downs1 ,the package of your 8,get ,slim0 remedy for obesity has been given to a patient of mine with beneficial results4 ,in observing the action of the remedy ,i noted no laxative effect on the bowels1 or any disturbance of the stomach4 ,in fact there were no physical sensations that any remedy had been taken1 and there was a very satisfactory reduction in weight4 8,get ,slim0 remedy1 being a purely vegetable combination is not fraught with any risk to the individual's health1 and may be safely given4 ,i would not hesitate to prescribe it for a child suffering from obesity4 ,this statement is based on the fact that ,i am acquainted with the ingredients entering into its manufacture4 ,i would add that this remedy for obesity might be intro- duced to the regular physicians with some advantage to you4 ,yours truly1 ,e ,p ,,robinson ,m ,d #adjb ,broadway ---------------------------------------- ------------------- ,reproduction 7reduced7 of a testimonial for an obesity cure fake1 8,get ,slim40 ,the ,a4 ,m4 ,a4 chemists reported that this 8vegetable combination0 consisted of baking soda and pink-tinted tartaric acid and sugar4 ,we also find in our files a testimonial signed ,e4 ,p4 ,robinson1 ,m4,d41 #adjb ,broadway 7,edward ,percy ,robinson's address in #aiab71 extolling the virtues of a foolish piece of quackery1 the obesity cure 8,get ,slim40 ,this nostrum was exposed in ,the ,journal some years ago and was also exposed by ,dr4 ,wiley in ,good ,housekeeping4 ,the 8,get ,slim0 concern sued ,good ,housekeeping for libel but a jury decided that ,good ,housekeeping had told the truth4 ,in the 8,get ,slim0 testimonial ,robinson is quoted as saying that he is 8acquainted with the ingredients entering into its manufacture0 and he describes it1 as did the 8,get ,slim0 concern1 as 8a purely vegetable combination40 ,the fact is the ,association's chemists found this 8purely vegetable combination0 to consist of sugar and tartaric acid1 each colored pink1 and baking soda4 ,and this is the gentleman who claims to have discovered the cause of1 and offers for sale a cure for1 one of the most baffling scourges known to modern medicine--cancer4 ,except for the articles that have been published during the past three years in the ,medical ,record1 we are unable to find anywhere in representative medical literature anything to indicate that ,edward ,percy ,robinson can lay any claim to special knowledge of1 or skill in the treatment of1 cancer4 ,what we do find are advertisements describing ,edward ,percy ,robinson's alleged abilities as a 8face beautifier10 puffs from utterly uncritical or discredited sources and a testimonial to the value of a preposterous 8fat cure0 fake4 ,with the best brains of the world at work on the problem of cancer1 it is reasonable to assume that any man who has found out even a little more than has previously been discovered or is able to accomplish even a little better results than the average in the treatment of this dreaded disease1 would be well known to scientific medicine4 99 99 99 99 99 ,after this article was in type physicians began sending in ,no4 #c 7,april1 #aiba7 of ,therapeutic ,leaves4 ,this is still another reprint of ,nos4 #a and #b1 with minor changes4 ,in the first two1 ,tekarkin is described as 8a solution of potassium nitrate of special strength20 in ,no4 #c it becomes 8a special solution containing potassium nitrate40 ,in ,nos4 #a and #b1 ,robinson described an alleged case of 8,cancer of the ,rectum ,treated with ,tekarkin40 ,in ,no4 #c this becomes 8,medicinal ,treatment ,cures ,cancer of the ,rectum40 ,in ,no4 #c the names of the editors1 assistant editor and general manager are eliminated4 ,illustration ,the inside back cover of ,no4 #c contains an advertisement of ,tekarkin1 in which physicians are warned that 8,cancer of the ,lung ,may ,present ,diagnostic ,signs of ,tuberculosis40 ,it contains the further startling information that the particular micro-organism responsible for pulmonary tuberculosis is the ,klebs-,loeffler bacillus6 ,thus3 8,the ,klebs-,loeffler bacillus may find a suitable habitat in a malignant area of lung tissue and thrive therein4 ,the presence of the bacillus does not necessarily exclude the presence of cancer4 ,a chronic cough with blood-streaked sputum may be the result of tuberculosis and cancer40--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #bh1 #aiba47 ,,tyree',s ,,antiseptic ,,powder ,,again ,the 8,ethical and ,commercial ,requirements0 of the ,drug ,business 8,i am fond of the retail drug business and follow it every day of my life4 ,i know and observe to the fullest extent its ethical and commercial requirements40 ,this from a circular letter recently received by physicians1 and signed ,j4 ,s4 ,tyree1 who asks that he be forgiven for writing you personally1 but there are several reasons why he thinks the circumstances warrant it4 ,all of which is preliminary to calling attention to an enclosure1 which accompanies the circular letter1 and is described as a 8short memorandum0 submitted for 8your consideration40 ,the 8memorandum0 is a four-page leaflet of which three pages are devoted to 8,tyree's ,antiseptic ,powder40 ,one of these three pages is a reproduction of a letter on the stationery of the ,surgeon ,general's ,office of the ,war ,department1 and signed 8,w4 ,m4 ,gray1 ,m4,d41 ,microscopist1 ,army ,medical ,museum2 ,pathologist to ,providence ,hospital40 ,the letter describes a series of 8bacteriological and comparative tests0 made by ,dr4 ,gray with ,tyree's ,antiseptic ,powder4 ,the entire second page of the circular is given over to the results of these bacteriologic tests which compare various strengths of ,tyree's ,antiseptic ,powder with 8mercuric bichlorid10 phenol and formaldehyde4 ,the physicians who received this advertising material in ,april1 #aiai1 might easily overlook the fact that ,dr4 ,gray has been dead several years1 that the letter which is reproduced is dated ,jan4 #c1 #ahij1 and that the bacteriologic tests were made in #ahhi--thirty years ago6 ,the ,council on ,pharmacy and ,chemistry in #aijfbeh published the results of an analysis of ,tyree's ,antiseptic ,powder which showed that although the stuff was advertised as a mixture of borax and alum1 it was in fact essentially a mixture of zinc sulphate and boric acid4 ,the publication of the ,council's report in #aijf1 showing the falsity of the formula1 brought out the admission that the composition had recently been changed4 ,certain it is1 however1 that for at least a decade past1 the ,tyree product has been a zinc sulphate-boric acid preparation4 ,yet1 according to the manufacturer's own statement1 ,tyree's ,antiseptic ,powder in #ahhi1 when ,dr4 ,gray made his bacteriologic tests1 was an entirely different substance from the present mixture4 #beh ,at this time ,tyree's ,antiseptic ,powder was an 8ethical proprietary0--heaven save the mark6--and advertised only to physicians4 ,later1 as ,the ,journal has shown1 it entered the 8patent medicine0 field as 8ideal for douche0 and the 8best preventative known40 ,the articles on this nostrum are reprinted in the ninth edition of 8,the ,propaganda for ,reform40 ,here then we have a manufacturer publishing in #aiai1 in behalf of a certain product1 tests that were made in #ahhi with a product of different composition1 although of the same name6 ,is this observing 8to the fullest extent0 the 8ethical and commercial requirements0 of the 8retail drug business08 ,there is no scientific excuse for such a mixture as ,tyree's ,antiseptic ,powder4 ,if1 however1 physicians feel that they must use an irrational conglomeration such as this1 why not prescribe ,pulvis ,antisepticus1 ,n4 ,f48 ,like the ,tyree product1 this1 too1 is essentially a mixture of zinc sulphate and boric acid1 with minute amounts of phenol1 eucalyptol1 menthol and thymol1 to say nothing of a dash of salicylic acid4 ,this official article has at least the virtue of constancy of strength1 composition and purity assured under the federal ,food and ,drugs ,act4--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #ag1 #aiai47 ,,wheeler',s ,,tissue ,,phosphates 8,the ,commissioner of ,health directs me to call to your attention the enclosed advertisement issued by ,t4 ,b4 ,wheeler1 ,m4,d41 ,company1 ,montreal1 ,canada1 in which the name of the ,association's ,journal is being used40 ,accompanying this brief note to ,the ,journal from the secretary of ,dr4 ,haven ,emerson1 ,commissioner of the ,department of ,health of the ,city of ,new ,york1 was a four page leaflet devoted to the exploitation of 8,wheeler's ,tissue ,phosphates40 ,the trend of the circular is to lead the average reader to infer that ,the ,journal of the ,american ,medical ,association has endorsed ,wheeler's ,tissue ,phosphates4 ,for example1 in describing the preparation one reads3 8,it embodies 444 the best recent scientific opinion concerning the treatment of the disease 7tuberculosis7 as stated 444 by the official ,journal ,a4 ,m4 ,a40 ,elsewhere in the circular ,the ,journal's criticisms of the hypophosphites and the glycerophosphates 7proprietary preparations which are competitors of the ,wheeler product7 are quoted and twisted into a tribute to the ingredients of ,wheeler's ,tissue ,phosphates4 ,garbling quotations1 distorting statements1 separating phrases from their contexts and omitting qualifying clauses1 all for the purpose of making out a case for some proprietary remedy is a trick as old as quackery itself4 ,that it should be used in advertising ,wheeler's ,tissue ,phosphates is entirely fitting4 ,obviously1 the ,t4 ,b4 ,wheeler1 ,m4,d41 ,company esteems the opinion of ,the ,journal on pharmacologic matters4 ,this being the case1 it should1 in the interest of truth and scientific accuracy1 publish in its advertising circulars just what ,the ,journal has said about ,wheeler's ,tissue ,phosphates4 ,it could not do this better than by quoting from a recent editorial note which commented on a report of the ,chemical ,laboratory on this preparation4 ,here is part of the ,the ,journal's comment3 8#8,wheeler's ,tissue ,phosphates' is an unscientific shotgun mixture whose most active and powerful drug is the alcohol it contains4 ,that it was not years ago relegated to the realms of obsolete and discarded preparations is a commentary alike on the lack of scientific discrimination and on the power of advertising40 ,here we have 8,wheeler's ,tissue ,phosphates0 stripped of the verbal camouflage with which its exploiters have invested it4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bb1 #aiag47 ,,briefer ,,paragraphs ,alcresta ,lotion ,to the ,editor3--,what is the composition of ,alcresta ,lotion8 ,l4 ,t4 ,a4 ,hotten1 ,m4,d41 ,paris1 ,idaho4 ,according to a circular in our files1 8,alcresta ,dental ,lotion-,libby0 contains 8,emetin1 the active amebicidal principle of ,ipecac1 together with ,benzoic ,acid1 ,thymol1 ,eucalyptol and ,aromatics40 ,the theory that emetin is an active amebicide against pyorrhea alveolaris has been exploded4 ,in this connection1 it is interesting to note that the firm does not list the product in the latest catalogue in our files4--7,query from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bi1 #aiba47 ,calcidin ,tablets 7,abbott7 ,to the ,editor3--,what is the composition of calcidin tablets 7,abbott7 and what is their value8 ,j4 ,s4 ,,answer4--,calcidin is claimed to be a mixture of iodin1 lime and starch4 ,in contact with water1 the iodin and lime react to form calcium iodid and calcium iodate4 ,by the acid of the gastric juice1 the calcium iodid and calcium iodate are decomposed with liberation of free iodin4 ,the administration of calcidin tablets amounts to giving free 7elementary7 iodin4 ,in the past1 the advertising for calcidin has contained the unwarranted claim more or less directly that it was the most effective and only noninjurious preparation of iodin for internal use1 and that it possesses all of the valuable properties of the iodin with all of the objectionable effects left out4 ,so far as we know1 the effects produced by the administration of free iodin do not differ from those produced by the administration of iodids and1 therefore1 calcidin has no advantage over the iodids1 such as sodium iodid4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,sept4 #be1 #aibj47 ,di-,crotalin ,treatment of ,epilepsy ,to the ,editor3--,do you have any literature or information relative to the ,di-,crotalin treatment for epilepsy8 ,i will be very grateful if you can furnish information as to method of preparation1 rationale of the treatment1 etc4 ,r4 ,c4 ,decker1 ,captain1 ,m4 ,r4 ,c41 ,u4 ,s4 ,soldiers' ,home1 ,washington1 ,d4 ,c4 ,,answer4--,di-,crotalin is a rattlesnake venom preparation sold by the ,swan-,myers ,company of ,indianapolis as a 8,treatment for ,epilepsy1 ,chorea1 ,bronchial ,asthma1 ,chronic or ,hereditary ,nervous ,headache1 ,nervous ,prostration ,incident to ,change of ,life1 ,hysteria-,mania1 ,insomnia1 ,neurasthenia1 etc40 ,dr4 ,thomas ,j4 ,mays of ,philadelphia advocated the use of rattlesnake venom for tuberculosis4 ,later his former assistant1 ,dr4 ,r4 ,h4 ,spangler1 used the same material in the treatment of epilepsy4 ,that any measure of success sufficient to justify the adoption of the rattlesnake venom or crotalin treatment for epilepsy has resulted is not to be concluded from the available reports4 ,still less evidence is there for the use of rattlesnake venom in the list of conditions for which the ,swan-,myers ,company has recommended its preparation4 ,there are a number of good reasons why a cautious physician will shun the administration of this treatment and advise against it4 ,j4 ,f4 ,anderson1 working in the hygienic laboratory of the ,united ,states ,public ,health ,service1 reported a death from the crotalin treatment in consequence of infection1 and reports that the market supply of crotalin solution and crotalin tablets is highly contaminated4 ,he also found both crotalin and crotalin solution to vary in activity4 ,the use of rattlesnake venom was discussed in ,the ,journal1 ,march #ae1 #aiac1 p4 #hej4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ag1 #aiah47 ,estivin ,to the ,editor3--,what is 8,estevin10 or something like that8 ,it is said to be good in hay-fever4 ,constant ,reader4 ,,answer4--,the product called 8,estivin0 is sold by ,schieffelin and ,company1 ,new ,york4 ,a request for a statement of the composition of this preparation sent to ,schieffelin and ,company by the ,council on ,pharmacy and ,chemistry brought the indefinite and1 therefore1 meaningless statement that 8#8,estivin' is an extract of ,rosa ,gallica containing no alcoholic or foreign ingredients40--7,query from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ab1 #aiba47 ,iron ,arsenite ,to the ,editor3--,can you inform me how iron arsenite can be prepared for subcutaneous injection8 ,a commercial firm furnishes physicians with ampules of arsenite of iron4 ,is this really arsenite of iron8 ,s4 ,h4 ,kempner1 ,m4,d41 ,new ,york4 ,,answer4--,ferric arsenite 7iron arsenite7 is in itself relatively insoluble in water1 but may be treated with ammonium citrate1 the resulting product thus being soluble2 the latter substance was at one time described in ,new and ,nonofficial ,remedies as 8,ferric ,arsenite1 ,soluble0 and is sometimes sold as a solution in ampule form4 ,in #aiab1 the ,council on ,pharmacy and ,chemistry deleted 8,ferric ,arsenite1 ,soluble0 from ,new and ,nonofficial ,remedies because 8one cannot1 in administering ,ferric ,arsenite1 ,soluble1 give a useful dose of iron without giving too much arsenic2 and1 vice versa1 one cannot give a safe dose of arsenic without giving too little iron40 ,the ,council1 therefore1 held the preparation to be irrational and unscientific4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ai1 #aiba47 ,k-,y ,lubricating ,jelly ,to the ,editor3--#a4 ,what is the composition of 8,k-,y ,lubricating ,jelly08 #b4 ,can you furnish a formula for a simple nongreasy lubricating jelly8 ,s4 ,t4 ,,answer4--#a4 ,the composition of 8,k-,y ,lubricating ,jelly0 has not been divulged4 ,examination of the advertising matter reveals only meaningless statements1 such as3 8,this is a judicious combination of vegetable products 444 ,combined in well balanced proportions with non-irritating antiseptics 44410 8,it incorporates a sufficient quantity of mild antiseptics 7of the ,thymol class7 4440 and 8444 contains ,,no formaldehyde40 #b4 ,probably a simple tragacanth jelly1 which can be made cheaply1 will produce the same effects as those of the proprietary preparation4 ,the following formula was published by ,mr4 ,j4 ,k4 ,thum1 apothecary at the ,german ,hospital1 ,philadelphia 7,druggists ,circular1 ,september1 #aiae1 p4 #ehf73 ,,lubricating ,,jelly ,tragacanth1 whole #c gm4 ,glycerin #be c4c4 ,phenol #a4e gm4 ,distilled water1 a sufficient quantity to make #cjj c4c4 ,the tragacanth is broken in small pieces1 and put into a wide-mouthed bottle2 the other ingredients are added and the bottle frequently shaken4 ,in regard to this formula1 ,mr4 ,thum writes3 ,it has been used in our gynecologic department for years4444 ,for the last six years we have been dispensing it in collapsible tubes throughout the hospital for general work4--7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,may #ab1 #aiag47 8,nikalgin0 ,to the ,editor3--,collier's has a special article this week on 8,nikalgin40 ,have you any information on this subject8 ,it sounds like nostrum stuff4 ,p4 ,r4 ,minahan1 ,m4,d41 ,fond du ,lac1 ,wis4 ,,answer4--8,nikalgin0 is said to be the 8invention0 of ,gordon ,edwards1 an engineer4 ,large claims for its anesthetic and antiseptic virtues have been made4 ,while no very definite information seems to be forthcoming regarding the preparation1 it has been said to be 8composed of quinin1 hydrochloric acid and urea40 ,this would indicate that 8,nikalgin0 may be nothing more wonderful than the well known local anesthetic1 quinin and urea hydrochlorid1 the ,quininae et ,ureae ,hydrochloridum of the ,u4 ,s4 ,pharmacopeia1 or a modification of it4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bb1 #aiag47 ,pertussin and ,syrup of ,thyme ,to the ,editor3--,a short time ago ,i received a sample of 8,pertussin0 and used some in an obstinate case of bronchitis with excellent results4 ,i have since received a catalog from a pharmaceutical firm1 which advertises syrup of thyme4 ,i have searched for a formula to make my own syrup of thyme1 but have not been able to find one4 ,will you publish one8 ,e4 ,f4 ,benner1 ,m4,d41 ,salfordville1 ,pa4 ,,answer4--,the subjoined formula yields a product very similar to 8,pertussin0 in taste1 flavor1 composition1 and probably in activity as well3 ,fluidextract of thyme #ae c4c4 ,glycerin #ae c4c4 ,syrup to make #ajj c4c4 ,the original ,german preparation contained #a4e gm4 of sodium bromid in each hundred cubic centimeters1 and this might be added to the foregoing formula with advantage1 so far as action is concerned4 ,however1 a sample of 8,pertussin0 purchased in the open market in the ,united ,states failed to respond to tests for bromids4 ,as fluidextract of thyme is not official1 this formula is presented as furnishing an acceptable preparation3 ,thyme1 in ,no4 #fj powder #ajj gm4 ,moisten with a mixture of3 ,water #be c4c4 ,alcohol #ae c4c4 ,glycerin #aj c4c4 ,after standing five hours1 pack in a percolator4 ,exhaust with a menstruum of alcohol1 #a volume1 and water1 #c volumes4 ,reserve the first #he c4c4 of percolate4 ,concentrate the weak percolate to a soft extract and dissolve in the reserved portion4 ,make up to #ajj c4c4 by addition of a mixture of alcohol1 #a volume1 and water1 #c volumes4 ,other aromatic expectorants1 such as terebene1 terpin hydrate or creosote1 might be expected to have similar but greater effect in chronic bronchitis4 7,query in ,the ,journal1 ,a4 ,m4 ,a41 ,march #bg1 #aibj47 ,quinin and ,urea ,hydrochlorid ,to the ,editor3--,could you tell me why quinin and urea hydrochlorid has not become more popular for local anesthesia8 ,is it less efficacious or more toxic than other preparations8 ,if it is useful1 can you name some trustworthy firm or brand8 ,please omit my name in answering4 ,l4 ,f4 ,c41 ,m4,d41 ,mexico4 ,,answer4--,quinin and urea hydrochlorid 8has the actions of quinin4 ,when injected hypodermically it exerts an anesthetic action much more prolonged than that of cocain0 7,useful ,drugs1 ,ed4 #d1 #aibj1 p4 #abg74 ,it has been pointed out editorially in ,the ,journal 7,feb4 #ad1 #aibj1 p4 #dfb7 that quinin has been regarded for more than half a century by toxicologists as a protoplasmic poison capable of destroying various forms of animal and vegetable cells1 and hence it need not be surprising that tissue necrosis may be produced by strong solutions of the quinin salts4 ,that this deleterious reaction actually does occur and has militated against the general use of quinin and urea hydrochlorid is confirmed by the report of the ,committee on the ,advantages and ,disadvantages of ,local ,anesthesia in ,nose and ,throat ,work 7,the ,journal1 ,july #ca1 #aibj1 p4 #cae74 ,to quote3 ,the only local anesthetic that produces edema and sloughing is quinin and urea hydrochlorid4 ,so many statements were found in the literature that this anesthetic has been abandoned in other fields of medicine because of edema and sloughing1 that writers who had presented favorable reports in nose and throat operations were communicated with by your committee4 ,one writer who had recorded #cij cases of tonsillectomies extolling this anesthetic1 which he had used for four years and is still so recorded1 now states that he has not used it in two years1 although no publication has been made retracting his former endorsement4 ,still another writer1 who stated that quinin-urea came nearest the ideal local anesthetic1 now states that he has ceased using it4 ,your committee finds that as far as nose and throat operations are concerned1 this drug has practically gone into 8innocuous desuetude40 ,the anesthesia produced by this drug at the time of operation is good and the recovery of the patient might often be enhanced by its use if it did not have the serious drawback4 ,the product is official in the ,u4 ,s4 ,pharmacopeia1 and may be obtained from any reputable pharmaceutical house4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ba1 #aibj47 ,ricord ,pills and ,house ,organ ,therapeutics ,to the ,editor3--,my mail is frequently cluttered with pseudo-scientific data from various manufacturers of proprietary remedies which contain as much real scientific information as the ,police ,gazette4 ,i am enclosing a sample page of such a periodical4 ,the article has been so cleverly worded in the first paragraph1 as to impress the unthinking with the idea that sodium cacodylate is superior to arsphenamin1 when we know in reality that sodium cacodylate has been proved practically worthless in syphilis 7vide 8,venarsen074 ,one case is reported1 in which twenty injections of sodium cacodylate were administered intravenously1 from ,october #bc to ,december #ad4 ,on ,december #ah1 a ,wassermann test proved negative1 it had been strongly positive on ,october #bj1 but during the same interval from ,october #bc to ,december #ad1 the patient had been taking by mouth 8,ricord pills0 each containing half a grain of yellow iodid of mercury2 granted that he had taken these pills regularly1 during all that time1 it might well be that the ,wassermann would be sharply influenced by them4 ,again1 a negative ,wassermann in the midst of treatment proves little2 it might be positive again in a few days4 ,the article stimulates the further use of a product of known worthlessness in the treatment of syphilis4 ,how any one can use sodium cacodylate in preference to arsphenamin in syphilis is beyond me4 ,if ,i mistake not1 the ,propaganda ,department has not taken up the matter of these various pamphlets of the drug companies1 such as the ,doctor's ,factotum1 ,therapeutic ,notes1 etc41 lauding to the skies such articles as 8,seng10 8,cactina ,pillets10 etc41 ad nauseam4 ,the saddest part of the whole thing is that it must bring returns from the unthinking1 otherwise they would soon disappear1 which would be a great relief for the scrubwomen who empty our waste baskets4 ,paul ,e4 ,bechet1 ,m4,d41 ,new ,york4 ,comment4--,the 8sample page0 sent by ,dr4 ,bechet is from the ,march-,april1 #aiah1 number of ,parke1 ,davis ,company's ,therapeutic ,notes4 ,it contains an 8,original ,communication0 on 8,the ,treatment of ,syphilis with ,sodium ,cacodylate1 by ,adolph ,lappner1 ,m4,d41 ,detroit1 ,mich40 ,the 8article10 while nominally devoted to the praise of sodium cacodylate1 is virtually a puff for 8,ricord ,pills40 a ,parke1 ,davis ,co4 product4--7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,july #ac1 #aiah47 ,stannoxyl ,to the ,editor3--,i am very anxious to know whether tin or stannous oxid 7,sn,o7 has or has had any place among useful drugs4 ,i have seen such a prescription given in the treatment of mucous colitis1 and would be very glad to learn what its use may be4 ,carlos ,manuel ,garcia1 ,m4,d41 ,havana1 ,cuba4 ,,answer4--,recently1 on the assumption that tin workers are less troubled with boils than the average person1 two ,french investigators proposed the use of tin compounds in the treatment of staphylococcic infections4 ,based on their work1 a proprietary preparation--,stannoxyl--has been placed on the market which is claimed to be 8composed of stannous oxide and specially purified metallic tin40 ,absurd claims are made for the product3 for instance1 8444 ,we have no hesitation in offering ,,stannoxyl--in ,tablets or ,cachets--as the only true specific for diseases of ,staphylococcus origin40 ,the available evidence is unconvincing and in no way warrants such exaggerated statements4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,march #f1 #aibj47 ,to the ,editor3--,i was much interested in your answer to a query about ,stannoxyl 7,the ,journal1 ,march #f1 p4 #fbi74 ,i submit the following experience as a confirmatory note3 ,while serving with the ,royal ,army ,medical ,corps in ,egypt1 ,i for some time had charge of the medical division of a hospital in which most of the skin diseases occurring among soldiers in the district were treated4 ,the most common conditions were boils and septic sores1 chiefly due to staphylococcal infection1 though several of the latter cases were diphtheritic4 ,the treatment adopted was that in ordinary use1 namely1 incision and evacuation of pus1 application of antiseptic dressings1 and in most cases employment of the specific vaccine4 ,it was possible to judge of the efficacy of any variations of treatment1 as there were always plenty of cases undergoing the usual treatment with which the results could be controlled4 ,an available supply of ,stannoxyl1 a proprietary remedy consisting of a mixture of metallic tin and tin oxid1 enabled me to give it a fair trial in full doses in eight cases of boils of average severity1 in which culture revealed the infecting organism to be ,staphylococcus aureus4 ,the boils were treated locally as usual1 but no vaccine was given4 ,no improvement could be demonstrated in these cases that could not be shown in other cases similarly treated with the omission of ,stannoxyl2 in fact1 three of the treated cases were much longer in clearing up than the untreated controls4 ,eight cases do not constitute a very large series from which to draw conclusions2 but if the preparation were as good as the descriptive literature would lead one to believe1 one should have expected an evident result in at least one of these cases4 ,it has been stated that ,stannoxyl does not inhibit the growth of staphylococci1 but only renders the growth less virulent4 ,it is known that a certain amount of tin may be absorbed from the intestine1 and ,salant1 ,rieger and ,treuhardt have shown that in certain cases tin may be retained for some time in the skin2 but it is questionable whether1 when preparations of tin are given by mouth1 any reaches the staphylococci in the boils1 or at any rate enough materially to influence their growth or virulence4 ,in the cases treated by me1 the results did not at all suggest that ,stannoxyl was a 8specific for diseases of staphylococcal origin40 ,j4 ,w4 ,c4 ,gunn1 ,m4,a41 ,m4,b41 ,ch4,b41 ,cape ,town4 ,professor of ,pharmacology1 ,university of ,cape ,town4 --7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bj1 #aibj47 ,syphilodol ,to the ,council on ,pharmacy and ,chemistry3--,if you have not already done so1 will you kindly examine and report on 8,syphilodol0 advertised in the enclosed pamphlet8 ,b4 ,c4 ,pedersen1 ,m4,d41 ,new ,york4 ,to the ,editor3--,have you any information concerning the enclosed half page advertisement of ,syphilodol from the ,urologic and ,cutaneous ,review8 ,edward ,s4 ,newell1 ,m4,d41 ,pelham1 ,n4 ,y4 ,to the ,editor3--,i am enclosing an advertisement for a substance called 8,syphilodol0 manufactured in ,new ,york4 ,am not familiar with this article nor have ,i seen it advertised in the higher class journals4 ,can you tell me whether ,the ,journal's department of ,new and ,nonofficial ,remedies has passed on this article or whether you have any data concerning it8 ,it looks a trifle fishy to me4 ,louis ,leroy1 ,m4,d41 ,memphis1 ,tenn4 ,to the ,editor3--,i am sending the enclosed correspondence ,syphilodol letters to you as it looks as if it might have some interesting features from the point of view of your nostrum department4 ,isadore ,dyer1 ,new ,orleans1 ,la4 ,,answer4--,these are but some of the inquiries that have been received on this subject and it is encouraging to note the scientifically critical attitude of physicians toward new therapeutic agents4 ,according to the ,french ,medicinal ,company1 ,inc41 which markets this product1 8,syphilodol is a synthetic chemical product of silver1 arsenic and antimony44440 ,nowhere in the advertising matter is there any more definite statement as to the composition of this new 8synthetic0 than that just quoted4 ,the product is now under examination in the ,association's laboratory and when this is completed a more detailed report will doubtless be forthcoming4 ,at present the work has progressed sufficiently to show that ,syphilodol tablets contain considerable quantities of mercury6 ,although the advertising leaflets claim that the preparation is 8the formula of the late ,dr4 ,alfred ,fournier of ,paris0 and had been exhaustively tested by ,metchnikoff1 who is alleged to have found it superior to salvarsan and neosalvarsan1 yet1 strange to say1 a careful search of ,french medical journals fails to show any reports on ,syphilodol4 ,verb4 sap4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,feb4 #bc1 #aiah47 ,thialion ,to the ,editor3--,kindly inform me regarding thialion1 manufactured by the ,vass ,chemical ,company1 ,danbury1 ,conn4 ,please omit my name and address in answering in ,the ,journal4 ,h4 ,c4 ,w4 ,,answer4--,thialion is an heirloom of the days when lithium salts were supported to be nature's antidote for all kinds of ailments1 supposedly due to excess of uric acid4 ,it was advertised as a uric acid eliminant and therefore good for all kinds of diseases4 ,the ,council on ,pharmacy and ,chemistry published a report on thialion in ,the ,journal1 ,nov4 #c1 #aijf4 ,at that time thialion was advertised by the ,vass ,chemical ,company as a 8laxative salt of lithia0 with the chemical formula 8#c,li,o4,na,o4,,so4#g;,,ho10 and an elaborate structural formula was also furnished4 ,the ,council reported that the product was not a definite chemical compound1 but a mixture consisting chiefly of sodium sulphate1 sodium citrate and small amounts of lithia4 ,in recent advertisements1 thialion is referred to as 8,a ,non-,effervescing ,lithiated ,laxative ,salt10 8a non-hygroscopic1 non-deliquescent1 granular salt of lithia10 etc41 but the chemical formula does not appear1 nor is any definite statement of composition furnished4 ,according to this advertisement1 the 8indications0 for thialion are3 8gout1 rheumatism1 uric acid diathesis1 constipation1 acute and chronic1 sluggish liver1 ,bright's disease1 albuminuria of pregnancy1 asthma1 incontinence of urine1 gravel1 cystitis1 chronic lead poisoning1 headache1 neuralgia1 neurasthenia and lumbago1 ,hay fever1 etc40--7,query in ,the ,journal ,a4 ,m4 ,a41 ,dec4 #f1 #aiai47 ,venarsen ,to the ,editor3--,the following is a copy of a letter sent to the ,intravenous ,products ,company1 which needs no explanation3 ,june #h1 #aiag4 ,the ,intravenous ,products ,co41 ,denver1 ,colo4 ,gentlemen3--,in reply to your circular letter under date of ,june #c1 may ,i say that after using a great quantity of ,venarsen both in clinical and private cases1 ,i can see no more effect upon these cases than if so much water had been administered4 ,this is also the report of ,don ,r4 ,black1 pathologist for ,bell ,memorial ,hospital1 ,university of ,kansas4 ,in our experiments all bloods were tested before and after each administration of this product4 ,william ,a4 ,wilson1 ,m4,d41 ,kansas ,city1 ,mo4 7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,july #g1 #aiag47 ,,part ,,iv ,,contributions ,,from ,,the ,,journal3 ,,miscellany ,,albert ,,abrams1 ,a4,m41 ,m4,d41 ,,ll4,d41 ,f4,r4,m4,s4 8,spondylotherapy10 8,electronic ,reactions10 the 8,oscilloclast10 the 8,electrobioscope10 ,etc4 ,for some time ,the ,journal has received inquiries of which the following recent examples are typical4 ,this from an ,ohio physician3 8,please give me some information concerning ,dr4 ,abrams and his diagnostic and therapeutic devices known as reflexaphore and oscilloclast4 ,if this is published please withhold my name40 ,a physician in ,massachusetts writes3 8,can you give me any information concerning ,dr4 787 ,san ,francisco1 ,california1 who reports himself able to diagnose syphilis from a drop of blood sent him on a blotting paper8 ,he has caused a patient of mine a great deal of needless worry40 ,and from ,rhode ,island a physician facetiously inquires3 8,i am interested to know of the #8,reactions of ,abrams4' ,have you any information that you can give me in regard to this matter8 ,they apparently do wonderful things in the ,west40 ,while a ,new ,york physician acknowledges his failure to keep up with the times thus3 8,to-day ,i had occasion to see a patient who mentioned having an ,abrams test for gonorrheal infection of the prostate4 ,he also stated he wished to have ,abrams' treatment for the same condition4 ,could you enlighten me as to what these are8 ,i thought ,i had kept myself up to date as to all new tests and treatments in my line2 but evidently ,i have been delinquent40 ,according to our records1 ,albert ,abrams1 ,a4,m41 ,m4,d41 ,,ll4,d41 ,f4,r4,m4,s41 was born in ,san ,francisco in #ahfd4 ,he was graduated in medicine by the ,university of ,heidelberg1 ,germany1 in #ahhb4 ,dr4 ,abrams is a member of his local medical society and through that holds fellowship in the ,american ,medical ,association4 ,dr4 ,abrams has written voluminously4 ,in #aiaj1 his book on 8,spondylotherapy0 78,physio-,therapy of the ,spine07 was reviewed in ,the ,journal4 8,spondylotherapy0 is a neologic creation of ,dr4 ,abrams4 ,according to its disciples1 it concerns itself 8only with the excitation of the functional centers of the spinal cord0 and has been called 8the science of evoking the reflexes of the body both to diagnose and to cure disease40 ,in bringing its review of ,abrams' book on 8,spondylotherapy0 to a close1 ,the ,journal said3 8444 one wonders whether this is an attempt to explain osteopathy and chiropractic to the understanding of the regular practitioner1 or to exploit the very ingenious percussion devices of the author1 or whether it is really true that medical men really know practically nothing about the cure of disease through treatment of the spine4 ,let us hope that it is the latter and that a careful study of this unique volume may open new avenues of therapy heretofore undreamed of40 ,while the review was obviously critical1 yet in advertising the book1 the publisher picked out part of the closing sentence1 omitted the context1 and quoted ,the ,journal as having said3 8,let us hope that a careful study of this unique volume may open new avenues of therapy heretofore undreamed of40 ,when this matter was brought to the attention of ,dr4 ,abrams1 he replied1 8,i fail to see any real difference in the two quotations0 and 8only one 444 with an astigmatic mentality0 could 8see any incongruity between the context and the concluding sentence40 ,yet1 in this same letter which attempted to justify the garbling of a quotation so as to make a critical review appear a laudatory one1 ,dr4 ,abrams declared that the review in question was 8conceived and executed in a malicious spirit40 ,between #aiab and #aiad ,dr4 ,abrams gave 8clinical courses0 on 8,spondylotherapy0 in various parts of the country--price #ej4 ,these 8courses0 were widely advertised by an ,ohio concern that seems to make a specialty not only of handling the advertising campaigns of those members of the medical profession who have unusual or bizarre methods to exploit1 but also of acting as an agent for the sale of such devices and publications as may be necessary to the proper practice of the particular brand of therapy that is being exploited4 ,at the time this concern was featuring ,abrams' course it called attention to the alleged fact that 8no class were sic6 so busy as those employing mechanical treatment such as ,osteopathy1 ,chiropractic1 ,mechanotherapy1 etc40 ,says ,dr4 ,abrams3 8,despite the fury of tongue or the truculence of the pen1 the osteopath and chiropractor are inspiring the confidence of the community with their systems4 ,right or wrong in their theory1 they are1 in vulgar parlance1 #8delivering the goods4' ,spondylotherapy was a product of necessity--the translation of an ignored field of medicine from a chaotic to a scientific basis40 ,possibly the following testimonial published by ,dr4 ,abrams as typical of many received1 and credited to 8,dr4 ,henry ,stacy ,dodge1 ,richmond1 ,va410 may explain the field that 8,spondylotherapy0 is to cover4 ,incidentally 8,dr40 ,dodge is listed in the ,richmond telephone directory as a chiropractor3 8,i have been in practice for fifteen years in ,chiropractic and ten years an ,osteopath and ,i wish to say that during the last three years ,i have received more genuine and sincere satisfaction from the application of ,spondylotherapy than all other methods combined4 ,my success in gastrology alone is worth many times the cost of the information40 ,more recently1 ,dr4 ,abrams has advertised that he gives a 8course0 in ,spondylotherapy in ,san ,francisco1 beginning on the first of each month4 ,the course last four weeks4 8,the honorarium for this course is #bjj4jj40 ,in #aiab an organization was created devoted to this new therapeutic method3 the 8,american ,association for the ,study of ,spondylotherapy40 ,later ,dr4 ,abrams was made ,honorary ,president4 ,whether the organization is still viable we do not know4 ,,electronic ,,reactions ,,of ,,abrams ,in addition to 8,spondylotherapy10 ,dr4 ,abrams has also evolved what he calls the 8,electronic ,reactions of ,abrams40 ,these are said to make possible long-distance diagnoses1 it being necessary only to send a few drops of blood taken from the patient and allowed to dry on a slide4 ,there are1 it seems1 certain instruments and devices used in the performance of these diagnostic feats4 ,by means of the 8,electronic ,reactions0 ,dr4 ,abrams 7while admitting the protective factor of vaccination against smallpox7 has discovered that practically all the vaccines obtained from reliable firms yield the reaction 78electronic tests07 of congenital syphilis1 and that many of them also yield the reaction of tuberculosis and of streptococci and staphylococci4 ,further1 8from the cicatrices of all vaccinated persons1 one can always elicit a reaction of congenital syphilis and in early scars a tuberculous reaction40 ,dr4 ,abrams also declares that exposing vaccine virus for ten minutes to blue light will destroy the syphilitic1 streptococcic and staphylococci reactions and exposing it for the same period to yellow light will destroy the tuberculous reaction4 ,one of ,dr4 ,abrams' disciples--,sir ,james ,barr--frequently quoted with evident satisfaction1 declares that from a fresh sample of blood spread over four square inches of white blotting paper1 8,dr4 ,abrams can diagnose the sex1 race and disease of the patient40 ,however1 there are certain precautions that must be taken3 ,the patient should face ,west1 8the blood should be taken in a subdued light and there should be no strong red or yellow coloring material in the room40 ,in various places ,dr4 ,abrams has asseverated that 8if splancho-diagnosis is approached with a prejudiced mind1 it is better not to attempt it1 for there are #8none so blind as those that will not see4'0 ,dr4 ,abrams founded and edits ,physico-,clinical ,medicine4 ,it is published by 8,physico-,clinical ,co40 at #bace ,sacramento ,st41 ,san ,francisco--the address1 according to the telephone directory1 of ,dr4 ,abrams' residence4 ,it is a quarterly 8,devoted to the ,study of the ,electronic ,reactions of ,abrams and the ,visceral reflexes of ,abrams1 in the ,diagnosis1 ,treatment and ,pathology of ,disease40 ,single copies1 one dollar2 by the year1 two dollars4 ,the publication is1 apparently1 not entered as second class matter1 in fact1 presumably1 it could not be1 as it seems obviously to be an advertising affair4 ,each issue contains material dealing with 8,spondylotherapy10 8,splanchno-,diagnosis10 8,electronic ,reactions0 and other discoveries and theories of ,dr4 ,abrams4 ,in it also is published a list of 8,some recent visitors at ,dr4 ,abrams' laboratory10 the names and addresses of the 8,lessees of ,oscilloclast0 7about which more later71 testimonials for ,dr4 ,abrams1 etc4 ,of course1 it carries advertisements of ,dr4 ,abrams' 8,physico-,clinical ,laboratory0 7also at #bace ,sacramento ,st47 and his 8,practical ,courses in ,spondylotherapy and ,electronic ,diagnosis and ,treatment0 7#bjj in advance74 ,some of the devices of ,dr4 ,abrams are also advertised4 8,no apparatus sold on credit4 ,terms cash40 ,among these are3 8,dr4 ,abrams' ,electrodes for ,electronic ,diagnosis #f4jj 8,biodynamometer #cf4jj 8,dr4 ,abrams' ,reflex ,set #cf4jj 8,dr4 ,abrams' ,electro-,concusser #abj4jj0 ,,the ,,oscilloclast ,but what seems to be the outstanding piece of apparatus1 devised or invented by ,dr4 ,abrams1 the pice de resistance1 as it were1 of physicoclinical diagnosis and treatment1 is the 8,oscilloclast40 ,this device is not for sale4 ,it can be had only on lease4 ,the first payment is #bjj or #bej1 according to whether it is wired for alternating or direct current4 ,then there is a monthly payment of #e4 ,dr4 ,abrams publishes a list of more than #acj men who have leased one or more 8,oscilloclasts40 ,sir ,james ,barr's name heads the list4 ,according to ,dr4 ,abrams1 the 8,oscilloclast0 owes its conception to the therapeutic principles he advocates4 ,these1 in part1 are3 8#a4 ,physiologic phenomena are manifestations of electronic energy4 8#b4 ,pathologic phenomena are manifestations of perturbed electronic energy4 8#c4 ,the energy in health and disease has an invariable and definite rate of vibration 7determinable by the electronic reactions74 8#d4 ,specific drugs possess a like vibratory rate as the diseases for which they are effective4 8,these like vibratory rates 7hemovibrations7 of drugs owe their efficiency to their inherent radioactivity4 ,thus1 an obsolete drug like gamboge painted on the chest in incipient tuberculosis will effect a symptomatic cure within a few weeks4 ,gamboge possesses the same vibratory rate as tuberculosis4 ,our conception that drug action is dependent on direct cellular contact is thus demolished4444 8#e4 ,all forms of energy whether derived from heat1 electricity or magnetism may be made to yield different rates of vibration and these rates corresponding to the diseases are utilized for their destruction40 ,if one accepts one of ,dr4 ,abrams' theories1 the possibilities of such a piece of machinery as the 8,oscilloclast0 would seem to loom large1 not only in therapeutics1 but also in economics4 ,all one needs to do1 according to ,dr4 ,abrams1 is to ascertain 8the vibration rate of a drug0 and then to substitute the same vibration as produced by the 8,oscilloclast40 ,thus1 if one substitutes the 8vibratory rate of atropin0 for the drug itself 8the mouth dries or the subject feels as if it were puckered40 ,conversely1 if you switch the 8,oscilloclast0 to the pilocarpin vibratory rate1 there is a copious flow of saliva4 ,,therapeutic ,,results ,,with ,,oscilloclast ,what some of the lessees of the oscilloclast are accomplishing 7if we are to believe the clinical reports published in ,physico-,clinical ,medicine7 may be gathered from the following quotations3 8,woman1 ,age #eb4--;,diagnosis of acquired syphilis made by one of our most eminent clinicians4 787 ,abrams test showed tuberculosis of the apex of the right lung4 ,no syphilis4 ,fourteen treatments with the ,oscilloclast at #e4 ,patient gained fourteen pounds in three weeks4 ,now in perfect health40 8,mechanic1 ,age #bb4--;,acute acquired syphilis4 ,general eruption1 throat1 mouth symptoms and chancre4 ,thirteen treatments with the ,oscilloclast at #c1 and splenic sterilization only4 ,complete abatement of all symptoms40 8,woman1 ,age #db4--,strep infection of the second upper cuspid tooth of three years' standing4 ,well developed sinus4 ,regular discharge of pus4 ,eight treatments with the ,oscilloclast at #b4 ,clinically cured40 8,cancer of the pylorus and pylorectomy executed at the ,mayo ,clinic4 ,later1 vomiting1 severe pains1 loss in weight1 etc4 ,after the third treatment with 8,oscilloclast0 pains ceased and1 after #ad treatments1 she was well and continued so when ,i last saw her40 8,cancer of uterus4 ,inoperable4 ,severe uterine hemorrhages4 ,electrode of ,oscilloclast to cervix and hemorrhage ceased after second treatment4 ,after #ad treatments the patient declared she was well4 ,another case of the same character was followed by equally good results40 ,,economic ,,results ,,with ,,oscilloclast ,it also seems to be a great business-getter1 as the following testimonials published by ,dr4 ,abrams show3 8,the ,oscilloclast has doubled my business40--,s4 ,king1 ,m4,d4 7,pa474 8,i am doing good work with the ,oscilloclast in ,t4 ,b4 and when ,i get more room ,i shall want another machine40--,h4 ,michener 7,kas474 8,we are swamped with work and our three cord ,oscilloclast is working to full capacity4 ,we are still astonishing the incredulous and keeping busy4 ,we must have another ,oscilloclast at once for there are so many here who demand treatment40--,w4 ,p4 ,myers1 ,m4,d4 7,cal474 ,,the ,,electrobioscope ,more recently1 ,dr4 ,abrams has extended his observations and experiments1 using what apparently is a modification of the old fashioned pith ball suspended by a silk thread from a rubber rod with which we all experimented during our high school days4 ,this device ,dr4 ,abrams has called the 8,electrobioscope40 ,it is for sale by the ,physico-,clinical ,co4 ,the 8,electrobioscope10 in addition to doing many other things1 has demonstrated 7to ,dr4 ,abrams7 the 8sexuality of numbers and sounds40 ,thus1 if the pith ball is charged negatively and the numbers #a to #i are marked on a narrow board and the vowels and consonants are marked on another board1 it will be found--still according to ,dr4 ,abrams--that even numbers repel the pith ball while odd numbers attract it4 ,vowels repel and consonants attract4 8,a female hair repels and a male hair attracts40 ,from these data ,dr4 ,abrams deduces that 8even numbers and vowels are female and odd numbers and consonants are male40 ,the value of music as a therapeutic agent is briefly touched on by ,dr4 ,abrams and we are told that the overture of 8,tannhuser0 will increase the pulse rate whereas 8,meditation0 diminishes blood pressure and pulse rate4 8,in dogs1 music augments elimination of carbonic acid and increases the consumption of oxygen40 ,love1 says ,dr4 ,abrams1 8is dependent upon matter in vibration and the passional component has a wave metric index of #ad in both sexes40 ,in referring to legendary lore1 ,dr4 ,abrams apparently assigns a scientific basis for the belief among the bucolic that carrying around a potato has therapeutic virtue4 ,thus3 8,a cut potato 7carried on the person7 prevents elicitation of the stomach reflex when the negative pole of a bar-magnet is presented to the stomach region whereas the positive pole will evoke dulness40 ,it seems also that the 8rheumatic rings0 of iron 8when worn yield a neutral energy which prevents the elicitation of the stomach reflex by either pole of a bar-magnet40 ,we learn1 too1 that the divining rod 8no longer belongs to occultism but is entitled to consideration as a scientific fact40 ,dr4 ,abrams also has investigated methods whereby the sex of the fetus may be diagnosed4 ,in the human these investigations have1 apparently1 been so limited as to permit only tentative conclusions4 ,in the case of eggs of the domestic fowl1 ,dr4 ,abrams reports that with four eggs that yielded negative polarity1 the result of incubation was four hens4 ,of five eggs yielding a positive polarity only two hatched1 one was a hen and one a rooster1 giving an 8error in observation40 ,three eggs tested yielded neutral polarity and 8as predicted the eggs were sterile40 ,in case of an egg yielding a negative 7female7 polarity 8an attempt was made to reverse the sex by painting one end of the egg with a yellow coloring material40 ,the result was a rooster4 ,much more might be written about what one of our correspondents calls the wonderful things they are doing in the ,west1 but space forbids4 8,neither the fury of tongue10 says ,dr4 ,abrams in the preface to his book1 ,new ,concepts in ,diagnosis and ,treatment1 8nor the truculence of pen can discredit the author's observations which are capable of analyzation and demonstration40 ,if there is any scientific foundation for the marvels that ,dr4 ,abrams so picturesquely features1 the scientific world has not yet found it out6--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #be1 #aibb47 ,dr4 ,abrams' ,graduation ,in this department of ,the ,journal for ,march #be appeared an article on ,dr4 ,albert ,abrams and some of his discoveries4 ,we have now received a letter from a physician1 who asks that his name be not published1 reading3 8,to the ,editor3--,i notice in your article on ,albert ,abrams the statement that he was born in #ahfd and received his degree of ,m4,d4 in ,heidelberg #ahhb2 if these data are furnished by himself and not a typographical error--though ,i find the same data in the ,american ,medical ,directory for #aiaf--then it is high time that some board of censors should make a careful examination of his credentials4 8,anybody1 like myself1 who is acquainted with medical matters in ,germany knows that it is preposterous to assume that anybody could obtain the degree of ,m4,d4 in any ,german university at the age of #ah years4 ,m4 ,d41 ,leipzig40 ,eighteen is rather young to receive an ,m4,d4 degree from ,heidelberg6 ,by again going over the various sources of information available the following data were collected3 ,in ,polk's ,medical ,directory for #ahhf ,dr4 ,abrams' name appears as a graduate of the ,university of ,heidelberg1 #ahhb1 and of ,cooper ,medical ,college in #ahhc4 ,the records we have from these two institutions confirm these dates4 ,the year of ,dr4 ,abrams' birth seems less clear4 ,in the early part of #aijb the ,american ,medical ,association sent ,dr4 ,abrams a blank for him to fill out for a permanent record4 ,this was returned in due course and1 according to it1 ,dr4 ,abrams was born in ,san ,francisco ,dec4 #h1 #ahfc4 ,this same date appears in various editions of 8,who's ,who in ,america40 ,a blank sent by the ,a4 ,m4 ,a4 ,directory ,department to ,dr4 ,abrams in #aijh asking for a personal biographical report was returned ,aug4 #bj1 #aijh2 it gave ,dr4 ,abrams' date of birth as ,dec4 #h1 #ahfd4 ,a similar blank sent in the earlier part of #aiji was returned giving the same birth date4 ,we learn1 however1 that an affidavit executed in #aiag states that ,albert ,abrams was born in ,san ,francisco ,dec4 #h1 #ahfb4 ,just how long ,dr4 ,abrams attended ,heidelberg ,university before he was granted the ,m4,d4 degree1 we do not know4 ,apparently1 at that time the standards for admission to that institution were not especially severe and the length of time one would have to attend before being admitted to an examination seems to have depended on the educational credentials that the matriculant offered4 ,what credentials ,dr4 ,abrams submitted1 we do not know4 ,assuming that the earliest date 7#ahfb7 represents ,dr4 ,abrams' date of birth1 he could have been but twenty years old when he received his ,m4,d4 from ,heidelberg4 ,this indicates a precocity that might have forecast ,dr4 ,abrams' later achievements4 ,throughout the records of ,dr4 ,abrams' educational credentials there appears the statement that he also graduated from the 8,university of ,portland0 in #ahib1 receiving the degree of ,a4,m4 ,from references available we have been unable to find any record of a 8,university of ,portland40--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #h1 #aibb47 ,a ,defense by ,upton ,sinclair ,a somewhat voluminous letter has been received from ,mr4 ,upton ,sinclair1 which is a defense of ,dr4 ,albert ,abrams of ,san ,francisco4 ,we publish ,mr4 ,sinclair's letter because we believe it is written in honesty and sincerity--and because ,the ,journal readers will enjoy it6 ,it is worth mentioning in this connection that ,mr4 ,sinclair in his latest book devotes a few pages to a eulogy of ,dr4 ,abrams and his methods4 ,this material has not only been reproduced by ,dr4 ,abrams in his 8house organ0 ,physico-,clinical ,medicine but is reprinted in leaflet form and is being distributed by some of the individuals who are exploiting the ,abrams methods4 ,such reprints have been sent to this office by both laymen and physicians4 ,,mr4 ,,sinclair',s ,,letter ,to the ,editor4--,a few weeks ago you published an article dealing with the discoveries or claims of ,dr4 ,albert ,abrams of ,san ,francisco4 ,i happen to be attending ,dr4 ,abrams' clinic at the time and have discussed this article with him at some length4 ,dr4 ,abrams follows the policy of ignoring attacks on his work1 taking the view that in the long run1 the man who cures disease makes his way in the world in spite of all opposition4 ,however1 it is easy to see that he has been deeply hurt by this attack on his reputation1 and as one of his friends and most ardent admirers ,i am taking the liberty of addressing a letter to you4 ,i do not know if the rules of your publication permit intervention in medical affairs by a mere layman4 ,permit me to introduce myself as a layman who for some twenty years tried faithfully to be cured of various diseases by many doctors of the best reputation in many parts of the world1 and failed2 and who1 therefore1 was compelled1 as a matter of self-protection1 to look into the question of health for himself4 ,i have read so many different kinds of books on health and made so many experiments of my own that nowadays when ,i meet with a group of physicians ,i find that before long they come to accept me as one of themselves4 ,you may not go that far1 but at least you may be so generous as to allow me to tell you a little of what ,i have seen during the time ,i have spent in the clinic of ,dr4 ,albert ,abrams4 ,i observe that in the course of your two page article dealing with this subject1 you nowhere have anything to charge against ,dr4 ,abrams1 nor do you show that you have investigated his work4 ,you consider that all you have to do is to quote ,dr4 ,abrams' own words as to what he can do1 and that these words refute themselves4 ,italics our4--,ed44 ,also you quote ,dr4 ,abrams' schedules of prices1 and imply that his motives are mercenary4 ,i will take up these two questions one at a time4 ,,what ,,dr4 ,,abrams ,,can ,,do ,first1 as to what ,dr4 ,abrams can do3 ,i have been here and have seen him do all that he claims to do4 ,therefore1 you will understand that this portion of your argument does not produce much impression on me4 ,i merely say to you1 why do you not come and see1 or why do you not send some reliable representative to see--before you take it for granted that ,abrams is a knave or a lunatic8 ,this man is not merely a colleague of yours2 he is a fellow of the ,royal ,medical ,society of ,great ,britain ,we know of no such society4--,ed4 and surely he was entitled to a little elementary courtesy from you4 ,why did you not at least write to him and permit him to put before you a little of his evidence on the genuineness of his work8 ,you admit that he is a graduate of the ,universities of ,heidelberg and ,stanford2 ,dr4 ,abrams is not a graduate of 8,stanford40--,ed4 you admit that he was graduated from ,heidelberg at the age of twenty4 ,it happens that this was the youngest and remains the youngest age at which any man has taken a ,doctor's ,degree at that ,university in a hundred years4 ,if you had inquired further you might have learned that ten years ago ,abrams was one of the most respected physicians in ,san ,francisco4 ,what has he done since to forfeit the honors of a lifetime8 ,all that he has done is to shut himself up in his laboratory and make the most revolutionary discoveries of this or any other age2 and now when he emerges and offers this work to the world1 you can think of nothing to do but jeer at him4 ,i spent two weeks in his clinic2 then ,i took six months to write to his physicians all over the country1 and to experiment with his cures on a great number of my friends4 ,italics again ours4--,ed4 ,now ,i am spending another two weeks in his clinic1 and ,i venture to stake whatever reputation ,i have1 or hope to have in this world1 upon the statement that ,albert ,abrams has discovered the great secret of the diagnosis and cure of all the major disease4 ,again we must italicize4--,ed4 ,he has proven by diagnosing with the taps of his own sensitive finger tips over #ae1jjj people1 and my investigation convinces me that he has cured over #ie per cent4 of these who have taken his treatments4 ,moreover1 he has taught his method to #bjj or #cjj other physicians1 and some #hj per cent4 of these have submitted to me answers to a questionnaire in which they claim thousands of cures4 ,you may say1 perhaps1 that ,i am not competent to judge of cures4 ,for the sake of argument1 ,i will grant that2 but ,i assert that ,i am competent to judge of physicians1 for ,i have tested several score of them1 and if ,i ever knew a devoted scientist and a great humanitarian1 it is ,albert ,abrams4 ,in his clinic ,i have met perhaps a hundred physicians1 and ,i venture to assert that a number of these are men both of integrity and capacity1 and when ,i asked them why they came1 ,i got invariably one answer3 8,because ,i sent him blood specimens and ,i found that invariably he sent me a correct diagnosis40 ,not once1 but at least two score times1 ,i have seen ,albert ,abrams take a blood specimen brought to him1 without even the name of the patient1 and heard him diagnose cancer or sarcoma1 and from the blood specimen locate the growth ,,precisely ,,to ,,an ,,inch4 ,italics fail one here6--,ed4 ,then ,i have seen the patient1 an entire stranger to ,abrams1 brought into the clinic and examined1 not merely by ,abrams1 but by a score of other physicians1 and the growth found precisely at the spot indicated4 7,this was done twice between the time when this letter was dictated and the time when it was transcribed47 ,three times1 yesterday1 ,i saw a diagnosis made of syphilis and the patient brought in1 and all the standard reactions demonstrated4 ,i have seen1 not once1 but hundreds of times1 tubercular lesions diagnosed and located from the blood specimen and the patient brought in and the condition demonstrated by percussion4 ,all these things are going on day after day4 ,they are being done in other clinics in several score of cities1 and you may have the addresses for the asking4 ,why do you not ask8 ,we have some such addresses in the ,propaganda files4--,ed4 ,,the ,,economic ,,element ,i take up the second criticism1 that ,albert ,abrams is mercenary4 ,he charges #bjj4jj for the clinical course1 which may last as long as the physician wishes4 ,it seems to me that that price is to be judged somewhat in relation to what he has to teach4 ,he maintains a large establishment2 he has need of many assistants1 and expensive apparatus for his research work4 ,he charges for the use of his oscilloclast a deposit of #bej4jj1 and a rental of #e4jj per month4 ,the former item covers the cost of manufacturing the machine1 and the second item must be compared with the fact that a great number of physicians who are using this instruments are today enjoying incomes of from #a1jjj4jj to #b1jjj4jj per week4 ,once more1 italics6--,ed4 ,a few weeks ago ,i visited a physician who told me he had treated thirty-two patients that day with his one instrument1 and that his income was over #a1cjj4jj for that week1 and ,i could name several who have given similar accounts4 ,it may be1 of course1 that you will say they should not charge so much4 ,the average charge is about #bjj4jj for a guaranteed cure of such diseases as syphilis1 tuberculosis1 cancer and sarcoma4 ,italics our again4--,ed44 ,do you know anyone who will guarantee to cure a cancer or sarcoma at any price8 ,no6--,ed4 ,i am sure you will agree with me that it would be possible to find physicians who would be willing to put up many hundreds of dollars to guarantee that neither cancer nor sarcoma can at the present time be cured except by operation4 ,and ,i can recall many cases in my lifetime when ,i paid hundreds and even thousands of dollars to be cured of diseases by the medical profession1 and ,i am unable to recall a single case where ,i was ever cured of anything4 ,still this need not be an indictment of scientific medicine4--,ed4 ,finally1 as regards to the subject of mercenary motives1 permit me to state that ,i have in my possession a letter from ,dr4 ,abrams stating that what he desires is to have established an institute for the purpose of making his work known to the world1 and that if such an institute is established he is prepared to give up all his other work and devote all his time1 without compensation1 to the institute4 ,furthermore1 he is willing to furnish his instruments without charge to any medical institution which requests them4 ,within the last few days1 on account of the enormous number of blood specimens brought into his clinic1 ,dr4 ,abrams has signed in my presence1 and is prepared to issue a statement to the effect that his charge for examining blood specimens is to be raised from #aj4jj to #be4jj and all checks are to be made payable to a ,trust ,fund which is to be immediately established1 for the purpose of founding the institution above referred to4 ,i do not see how the medical profession can ask for more than this2 but if you do1 ,i should be pleased to receive your suggestions and transmit them to my friend4 ,,an ,,old ,,story ,now1 this failure to recognize a great medical discovery is an old story4 ,it was the experience of ,harvey ,we knew poor ,harvey would be dragged into this4--,ed41 of ,jenner and of ,lister4 ,but the world moves on1 and men's brains should improve1 and it should be possible to shorten the time of persecution which the great pioneers of science have to suffer4 ,i put to you this simple proposition3 ,send a reliable man of science to the clinic of ,albert ,abrams1 and let him stay there as long as he pleases and see all that he wishes to see1 and then send you a report1 and if it indicates that you have blundered in your condemnation1 be honest and say so1 and save your profession from another black mark against its name4 ,upton ,sinclair1 ,pasadena1 ,cal4 ,comment ,a testimonial is of value to the extent that the person giving it is an authority on the subject on which he testifies4 ,when ,mr4 ,sinclair testifies on socialism we may listen respectfully1 believing him competent to express an opinion2 but when ,mr4 ,sinclair gives a testimonial on certain bizarre methods of interpreting difficult and obscure problems in medicine1 he leaves us cold4 ,mr4 ,sinclair says that he has spent time in ,dr4 ,abrams' clinic and is wonderfully impressed with ,dr4 ,abrams' achievements4 ,so is the small boy impressed with the marvelous facility with which the magician extracts the white rabbit from the silk hat4 ,mr4 ,sinclair is convinced 8that ,albert ,abrams has discovered the great secret of the diagnosis and cure of all the major diseases40 ,the small boy is equally convinced that the prestidigitator has solved the mystery of producing snow white bunnies from airy nothings4 ,great store seems to be placed by ,mr4 ,sinclair on the favorable reports that he obtained from those who are relieving the public--of from #a1jjj to #b1jjj a week--by the ,abrams methods of diagnosis and treatment4 ,what kind of evidence did he expect to get from such obviously ex parte sources8 ,mr4 ,sinclair's navet may be childlike1 but it is not scientific4 ,while the significance of the statement may not be apparent to ,mr4 ,sinclair1 it is a fact that when the names of the one hundred or more lessees of the ,abrams 8,oscilloclast0 were checked up it was found that a number of these individuals were already in the ,propaganda files in some other connection4 ,that these disciples of ,abrams1 who are 8enjoying incomes of from #a1jjj to #b1jjj a week10 should speak favorably of the ,abrams method was inevitable6 ,some years ago ,upton ,sinclair wrote a book on his 7at that time7 panacea for human ailments4 ,it was the 8,fasting ,cure40 ,at that time he told of individual acquaintances suffering from various ailments3 one was 8dying of kidney trouble02 another was 8in the hospital from nervous breakdown02 still another had 8only a year to live10 while a fourth was 8a nervous wreck1 craving for death40 ,of these ,mr4 ,sinclair said at the time3 8,and there is not one of these people whom ,i could not cure if ,i had him alone for a couple of weeks40 ,,mr4 ,,sinclair ,,and ,,the ,,medical ,,profession ,at that time ,mr4 ,sinclair was greatly perturbed at the attitude of the medical profession toward his dictum that 8the fast is ,nature's remedy for all diseases40 ,there was just one physician 8who was really interested40 ,this man lived 8in an out of the way town in ,arkansas0 and asked ,sinclair to 8let him print several thousand copies of the article in the form of a pamphlet to be distributed among his patients40 ,as ,mr4 ,sinclair said at the time1 8one single mind among all the #adj1jjj physicians1 open to a new truth60 ,and this 8open mind10 that of a man who was practicing in a small town in ,arkansas and needed 8several thousand copies0 of the ,sinclair article to distribute to his patients6 ,after his 8fasting cure0 experience1 ,mr4 ,sinclair had the 8raw food0 fad--also abandoned in due time4 ,in one of his recent books 78,the ,brass ,check07 he refers to his outgrown fads in the following words3 8,i 444 was willing to try anything in the hope of solving the health problem1 which ,i have since realized is insolvable--there being no diet or system of any sort which will permit a man to overwork with impunity40 ,he states further in this same connection3 8,i look back in retrospect and have not a little fun over my #8monkey diet' days40 ,who shall say that ten years hence ,mr4 ,sinclair may not be able to look back1 good humoredly1 in retrospect1 to another time when he was 8monkeying0 with a subject that was beyond his ken8--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #bi1 #aibb47 ,,acetylsalicylic ,,acid1 ,,not ,,aspirin ,the ,council on ,pharmacy and ,chemistry publishes a report in this issue giving its reasons for deleting 8,aspirin-,bayer0 from ,new and ,nonofficial ,remedies4 ,in order that a standard may be provided1 the drug acetylsalicylic is retained#bei in ,n4 ,n4 ,r4 under its scientific name1 acetylsalicylic acid1 aspirin appearing as a synonym4 ,the attempt on the part of the ,bayer ,company to perpetuate the monopoly it has had for seventeen years in the ,united ,states was briefly discussed editorially in ,the ,journal1 ,aug4 #ab1 #aiaf4 ,we quoted from ,printers' ,ink1 a magazine devoted to advertising1 in part as follows3 #bei ,see index for additional article4 8,the manufacturers of aspirin are about to launch an extensive advertising campaign to clinch the market as far as possible before the expiration of their patent rights next year4444 ,the purpose of the campaign is to identify the product with the trademark of the ,bayer ,company and to this extent hamper competition after the expiration of the patent40 ,it is worth while reminding physicians of the privileges the ,bayer ,company has enjoyed for so many years1 owing largely to our inequitable and crude patent laws1 or to their construction4 ,first1 it should be remembered that practically no other country in the world1 not even the original home of the preparation1 would grant a patent on either acetylsalicylic acid1 the product1 or on the process for making that product4 ,the ,united ,states granted both6 ,as a result1 for seventeen years it has been impossible in this country for anybody except the ,bayer ,company to manufacture or sell acetylsalicylic acid1 either under its chemical name or under any other name4 ,neither was it possible for individuals1 hospitals or any other institutions to import it1 legally1 for their own use4 ,needless to say1 the ,american people have been made to pay exorbitantly for the monopoly our patent office granted this firm4 ,three or four years ago ,the ,journal1 through the ,american consuls1 obtained information regarding the price at which acetylsalicylic acid was sold in foreign countries4 ,at that time1 acetylsalicylic acid1 as 8aspirin10 was costing ,american druggists--and of course the ,american public had to pay still more for it--#dc cents an ounce4 ,just across the border in ,canada it sold for one-third the price asked here4 ,in some of the foreign countries1 acetylsalicylic acid under its scientific name could be purchased by the druggists of those countries at from one-sixth to less than one-tenth the price that it cost ,american druggists4 ,here are some of the figures3 ,austria-,hungary #d cents an ounce ,holland #d cents an ounce ,british ,isles #f cents an ounce ,norway #d cents an ounce ,denmark #d cents an ounce ,sweden #d cents an ounce ,france #d cents an ounce ,united ,states #dc cents an ounce ,germany #d cents an ounce ,not content with the iron-bound monopoly which it had been granted through our patent laws1 the company attempted further to clinch its exclusive rights by giving the preparation a fancy name1 8aspirin10 and getting a trademark on this name4 ,the patent on acetylsalicylic acid expires next month 7,february1 #aiag74 ,after its expiration the product1 and its method of manufacture1 become common property4 ,american manufacturers will now be able to do what manufacturers in other countries1 other than the patentees1 have long been doing--make and sell acetylsalicylic acid4#bfj #bfj ,the ,bayer people may try to convey the impression that 8,aspirin0 is pure and reliable whereas other brands are not4 ,since acetylsalicylic acid is a definite chemical compound1 there is no more likelihood of this being sophisticated than there is of quinin being adulterated4 ,furthermore1 the ,council in accepting acetylsalicylic acid for ,new and ,nonofficial ,remedies has provided standards of purity which will insure a uniform product4 ,the brand of one firm--,powers-,weightman-,rosengarten ,co41 of ,philadelphia--has been accepted by the ,council on ,pharmacy and ,chemistry for inclusion in ,new and ,nonofficial ,remedies1 #aiag4 ,unfortunately1 it is extremely improbable that any ,american manufacturer will market acetylsalicylic acid under the name aspirin1 although we believe they would have a legal right to do so4 ,the courts have held in related instances that when a patented article has been known during the life of the patent under a trademarked name1 with the expiration of the patent the name as well as the product becomes common property4 ,the classical 8,singer ,sewing ,machine0 decision and the lanolin case are in point4 ,the ,bayer ,company1 through a widespread newspaper advertising campaign1 seems to be attempting to perpetuate its seventeen-year monopoly by leading the public to believe that there can be only one brand of genuine acetylsalicylic acid on the market--that made by the ,bayer ,company4 ,the firm will1 of course1 continue to manufacture and advertise the product under the name 8,aspirin-,bayer10 and will probably charge high prices for it1 as was the case with phenacetin 7acetphenetidin74 ,in any event1 physicians hereafter should do what for a long time we have been advising should be done1 namely1 prescribe the compound under its scientific name1 acetylsalicylic acid4 ,they should do this if for no other reason than that they would be using the name which carries with it a reminder of the composition of the preparation4 ,of course1 for those who have been writing 8aspirin0 it will be rather difficult to write 8acetylsalicylic acid10 just as a quarter of a century ago it was difficult for the physician of that day who had been using the copyright name 8antifebrin0 to write 8acet-anilid10 a name which nowadays is easy1 even for laymen4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bj1 #aiag47 8,what's in a ,name80 ,under the caption 8,what's in a ,name80 the current 7,april7 issue of the ,journal of ,industrial and ,engineering ,chemistry has an editorial dealing with the nomenclatures--common and proprietary--of acetylsalicylic acid4 ,the editorial was prompted by an article by ,dr4 ,leech printed in the same issue4 ,replying to its own question3 8,the answer to this question so far as it applies to acetylsalicylic acid 7popularly known as aspirin7 is the difference between eighty-eight cents1 the price the druggist must pay for every one hundred tablets of ,bayer aspirin1 and forty cents1 the cost of an equally pure ,american product4 ,naturally1 this difference in cost is passed on to the individual consumer4 8,that no scientific justification exists for this difference in cost is clearly shown in the contribution by ,dr4 ,paul ,nicholas ,leech1 of the ,chemical ,laboratory of the ,american ,medical ,association1 page #bhh of this issue4 8,on the other hand1 the excess profit fully warrants the extensive and shrewdly-worded advertising campaign now in progress1 a campaign which must eventually fail1 because in the first place1 it is contrary to the prevailing spirit of modern advertising1 the motive of which is constructive rather than destructive1 and1 in the second place1 it appeals merely to the temporary ignorance of the public at large1 and has no basis in fact4 8,we have been informed that the ,custodian of ,alien ,enemy ,property has taken charge of the stock interests of alien enemies in the company conducting this propaganda4 ,surely the ,custodian will not care1 even in a trustee capacity1 to continue as a participant in a misleading campaign whose sole purpose is the perpetuation of a monopoly hitherto enjoyed under full patent protection40 ,the article to which the editorial refers is a somewhat technical one giving the findings of an examination made1 at the request of the ,council on ,pharmacy and ,chemistry1 in the ,chemical ,laboratory of the ,american ,medical ,association by ,paul ,nicholas ,leech1 ,ph4,d41 of various ,american brands of acetylsalicylic acid 7aspirin74 ,the result of the investigation may be summed up briefly in the statement that there are on the ,american market1 made by ,american firms1 several brands of acetylsalicylic acid that are just as good as1 if not better than1 the ,bayer product4 ,the ,journal has called attention to the misleading propaganda on the part of the ,bayer ,company 7,farbenfabriken vorm4 ,friedr4 ,bayer ,co471 in its attempt to perpetuate the monopoly granted under our inequitable patent laws4 ,this is done by conveying the inference that the only pure acetylsalicylic acid on the market is that known as 8,aspirin-,bayer40 ,physicians should again be reminded of the facts in the case of aspirin3 ,practically no other country in the world1 and certainly not ,germany1 the original home of aspirin1 would grant a patent either on acetylsalicylic acid1 itself1 or the process for making it4 ,the ,united ,states granted both6 ,as a result no one in this country except the ,bayer ,company could for seventeen years manufacture or sell acetylsalicylic acid either under its chemical name or under any other name4 ,nor was it permissible for hospitals or individuals to import it4 ,while the monopoly held1 the ,american people were compelled to pay from six to ten times as much for acetylsalicylic acid as were the people of ,great ,britain1 ,france1 ,germany1 ,austria-,hungary1 ,denmark1 ,holland1 ,norway or ,sweden4 ,at a time when ,american druggists were compelled to pay #dc cents an ounce for acetylsalicylic acid as aspirin1 just across the border in ,canada it sold for about one-third the price4 ,about a year ago1 the ,council on ,pharmacy and ,chemistry announced that 8,aspirin-,bayer0 had been deleted from ,new and ,nonofficial ,remedies while the scientific term acetylsalicylic acid was retained along with standards to insure its quality4 ,the necessity for a standard becomes evident when it is remembered that acetylsalicylic acid is not yet an official drug1 and its purity1 therefore1 is not subject to the control of the federal ,food and ,drugs ,act4 ,it is worth while at this time to remind physicians that several brands of acetylsalicylic acid 7aspirin7 have been found to comply with the standards set by the ,council on ,pharmacy and ,chemistry and have been admitted to ,new and ,nonofficial ,remedies4#bfa ,these1 of course1 are thereby subject to the control of the federal law to conform to the standard to which they profess4 #bfa ,the following brands of acetylsalicylic acid conform to the standards of the ,council and are in ,new and ,nonofficial ,remedies3 8,aspirin-- ,l4 and ,f403 ,lehn ,fink1 ,new ,york4 8,acetylsalicylic ,acid-- ,squibb03 ,e4 ,r4 ,squibb ,sons1 ,new ,york4 8,acetylsalicylic ,acid-- ,merck03 ,merck ,co41 ,new ,york4 8,acetylsalicylic ,acid-- ,milliken03 ,john ,t4 ,milliken ,co41 ,st4 ,louis4 8,acetylsalicylic ,acid-- ,m4 ,c4 ,w403 ,mallinckrodt ,chemical ,works1 ,st4 ,louis4 8,acetylsalicylic ,acid-- ,monsanto03 ,monsanto ,chemical ,works1 ,st4 ,louis4 8,acetylsalicylic ,acid-- ,p4 ,w4 ,r403 ,powers-,weightman-,rosengarten ,company1 ,philadelphia4 ,leech's report gives still greater weight to the suggestion that has been made for some time1 viz41 that physicians should describe acetylsalicylic acid under its scientific name rather than its proprietary name1 even though1 in the opinion of ,the ,journal1 the proprietary name1 aspirin1 has become common property since the expiration of the acetylsalicylic acid patent4 ,every consideration of public interest1 of patriotism and of ordinary common sense should prompt physicians to specify acetylsalicylic acid in writing prescriptions4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,april #ac1 #aiah47 ,advertising ,principles--,lay and ,medical ,the ,journal has received two letters1 one from a physician who had written to the ,new ,york ,tribune protesting against an advertisement of 8,aspirin 7,bayer70 that appeared in the rotogravure supplement of a ,sunday edition and the other the ,new ,york ,tribune's answer to the protest4 ,the two letters make an editorial in themselves4 ,here is the letter of the physician--,dr4 ,edwin ,h4 ,shepard of ,syracuse1 ,n4 ,y4--which was addressed to the editor of ,the ,journal3 8,when a great daily newspaper takes a stand for honest advertising it seems worthy that acknowledgement should be made4 ,on ,april #ad the illustrated ,sunday supplement of the ,new ,york ,tribune1 together with many of the other papers of the country1 published a duplicate of the enclosed advertisement of #8,aspirin4' ,your own instructive editorial on #8,acetylsalicylic ,acid1 or ,what's in a ,name8' had appeared in the copy of ,the ,journal of the day preceding4 8,believing in the sincerity of the ,tribune in its effort for honest advertising1 ,i sent them a copy of your editorial together with the page of advertisement1 also calling attention to the statements in the advertisement which seemed questionable4 ,among the questionable matters in the advertisement were the statements1 #8,the one genuine ,aspirin1' #8,no other is genuine1' #8,that which is genuine possesses qualities of excellence never found in imitations1' #8,for your protection 444 every package and tablet is marked with the ,bayer cross1' #8,your guarantee of purity1' and #8,refuse substitutes as they may prove ineffective and harmful4' 8,the ,tribune was requested to investigate into the standing of the ,bayer company and its product4 ,a few days later the enclosed letter was received from the paper's ,bureau of ,investigations40 ,and here is the ,new ,york ,tribune's answer1 signed by ,r4 ,r4 ,baer1 assistant director of that paper's ,bureau of ,investigations3 8,we have your letter of ,april #adth1 which was acknowledged on the #bbnd1 in re ,aspirin4 ,for your information3 ,our rotogravure supplement is printed a number of days in advance of the ,sunday paper4 ,when these copies which have already been printed are used1 no further ,aspirin copy will appear4 ,this means a loss of some four pages40 ,how many of the numerous medical journals that are still carrying the 8,aspirin 7,bayer70 advertising would make such a financial sacrifice for mere principle8--7,from ,the ,journal ,a4 ,m4 ,a41 ,may #be1 #aiah47 8,aspirin0--,a ,common ,name 8,aspirin0 as a trademark will no longer exist if the recommendation of the ,examiner of ,interferences of the ,united ,states ,patent ,office is upheld1 as it probably would be1 should the matter be taken to the courts4 ,the opinion of the ,patent ,office was the result of a petition by the ,united ,drug ,company in the case of that company against the ,bayer ,company1 or1 as it was called at the time the suit was brought1 the ,farbenfabriken of ,elberfeld ,company4 ,the stand taken by the ,patent ,office is directly in line with that that has been held in this and other cases by ,the ,journal1 which has for years insisted that it was against public policy to permit patentees to extend the seventeen-year monopoly1 which the patent laws grant1 to a perpetual monopoly by the simple device of obtaining a trademark for the name of the thing patented4 ,it is a fundamental principle in law that 8no one can have a monopoly in the name of anything40 ,this1 of course1 has been recognized and admitted even by those manufacturers who have attempted to invoke the trademark laws to obtain an unwarranted advantage4 ,the manufacturers of aspirin have held that the chemical name 8monoaceticacidester of salicylic acid0 was the true name of the patented article1 and was the only name which became public property when the patent right expired4 ,the ,patent ,office points out1 however1 that for years the only name that the public ever saw on the brand of monoaceticacidester of salicylic acid made by the holders of the patent on this product was 8,aspirin40 ,the ,examiner of ,interferences in his decision points out that1 previous to #aiae1 the ,bayer ,company sold no tablets to the retail-purchasing public1 but marketed its product as a powder2 further1 that it did sell vast quantities of the powder to tablet-makers1 who sold 8,aspirin ,tablets10 and that the consuming public knew the product only by the name 8,aspirin40 ,this name1 then1 had a significance to the purchaser1 similar to that of the word 8quinin0 on a package of quinin tablets1 or the word 8calomel0 on a package of calomel tablets4 ,as the ,patent ,office says3 8,in other words1 the prima facie significance of this word #8,aspirin' to such purchasers was that of a name0--and as a name it is 8necessarily incapable of exclusive use by any one40 ,the ,patent ,office's decision also brings out the fact that1 until the owners of the aspirin patent commenced making tablets themselves1 the aspirin tablets on the market were not uniform1 and that this lack of uniformity was a fraud on the public which the owners of the aspirin patent should have prevented4 ,the concern did prevent it when it began to make the tablets itself1 but maintained in its contention against the ,united ,drug ,company that it was unable to control the matter previously--a contention to which the ,patent ,office gives short shrift4 ,it is further pointed out that the ,bayer ,company evidently recognized the weakness of its contention by the emphasis it placed through its advertising on the 8,bayer ,cross40 ,when the ,bayer ,company began manufacturing its own aspirin tablets1 it made a pretense of complying with the letter of the law1 while violating its spirit1 by placing on the label under the word 8,aspirin10 the statement that 8the monoaceticacidester of salicylic acid in these tablets is the reliable ,bayer manufacture40 ,says the ,patent ,office3 8,with regard to the expression #8monoaceticacidester of salicylic acid1' a mere inspection of it is sufficient to apprise any one of its inherent unsuitability for use as a name by the lay purchasing public40 ,this attempt on the part of the company to 8beat the devil around a stump0 tended1 in the opinion of the ,patent ,office decision1 8to show that the respondent was familiar with the methods of some modern traders to meet the trend of the law40 ,and1 discussing such methods1 the ,examiner of ,interferences says3 8,a very popular one is for a trader to seemingly bend to the necessity of the situation by placing on the label a notation which in theory1 but not in practice1 may be used by the public to identify the article after the monopoly has expired4 ,to the examiner this practice seems to be merely a manifestation of that keen commercial instinct which endeavors to keep just ahead of the law4 ,this instinct is fairly common in traders1 and is clearly disclosed in trademark infringement cases40 ,summed up1 the decision is to the effect that1 as in any case prior to #aiae1 the public had been driven to look on the word 8,aspirin0 as the name of a thing1 and as the ,bayer ,company had not used the word as a 8trademark0 within the meaning of the law1 the ,patent ,office recommends that the registration of 8,aspirin0 as a trademark be canceled4 ,if no appeal is taken from this decision1 or in case an appeal is taken1 should the opinion be sustained1 the attempt on the part of the patentees of aspirin to get a perpetual monopoly on their product through the trademark laws will have been definitely defeated4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #aa1 #aiai47 8,aspirin ,bayer0 and the ,sterling ,products ,company ,a correspondent1 who asks that his name be not published1 writes3 8,your editorial on #8,aspirin or ,acetylsalicylic ,acid--,an ,important ,court ,decision' is timely4 ,too often1 ,i fear1 physicians forget #8what's in a name4' ,i have been told that the ,sterling ,products ,co41 the present owners of the ,aspirin-,bayer rights1 are manufacturers of other #8patent medicines4' ,are they interested in the ,winthrop ,chemical ,company1 which firm seems to be using the much vaunted #8,bayer ,cross' on the labels of the products formerly imported from ,germany by #8,the ,bayer ,company'8 ,if you answer this in ,the ,journal1 kindly omit my name40 ,the recent history of ,bayer ,co41 is somewhat as follows3 ,shortly after the ,united ,states entered the war1 the ,alien ,property ,custodian took over the property of ,bayer ,co4 7,inc47 and its subsidiary1 the ,synthetic ,patents ,co4 ,in his report to congress the ,custodian said3 8,the stock of ,bayer ,co4 7,inc47 and of ,synthetic ,patents ,co4 was sold by me at public auction1 the successful bidder being the ,sterling ,products ,co41 a ,west ,virginia corporation dealing in proprietary medicines4 ,this company had previously agreed to dispose of the dye plant and patents1 in case it secured the property1 to ,grasselli ,chemical ,co41 one of the largest makers of heavy chemicals in the country4 ,the price paid was #e1caj1jjj1 plus back taxes and other obligations of many hundred thousands more40 ,after the ,sterling ,products ,company had acquired the pharmaceutical end of the business1 the ,winthrop ,chemical ,co4 was incorporated in the state of ,new ,york4 ,this concern seemingly secured control of all the ,bayer pharmaceutical specialties except 8,aspirin40 ,the ,bayer ,co41 it was announced1 had been merged with the ,sterling ,products ,co41 and 8,aspirin-,bayer0 added to the latter firm's list of 8patent medicines03 ,cascarets1 ,danderine1 ,pape's ,diapepsin1 ,california ,syrup of ,figs1 ,neuralgine and ,dodson's ,livertone4 ,the business is apparently a paying one financially as witness the following excerpt from a recent announcement in a drug journal3 8,stockholders of the ,sterling ,products ,co41 ,inc41 of ,wheeling1 manufacturers of ,neuralgine1 ,cascarets1 ,bayer's ,aspirin1 and other well known products1 and the largest proprietary medicine organization in the world1 at their annual meeting received a report of ,manager ,w4 ,e4 ,weiss1 which showed that the company did a #aj1jjj1jjj business in #aibj4 ,the total profits were #b1ajj1jjj1 while a total of #a1jhj1jjj was paid out in dividends40 ,just what relationship exists between the ,winthrop ,chemical ,co41 and the ,sterling ,products ,co41 we do not know4 ,as our correspondent points out1 the 8,bayer ,cross0 is used on the label of the ,winthrop products4 ,the advertising campaign of 8,aspirin1 ,bayer0 since it entered the 8patent medicine0 field has been typical of that field4 ,by half truths and inferential falsehoods the public has been led to believe that the only genuine aspirin on the market is that put out under the ,bayer name4 ,the facts are1 of course1 that the aspirin of any reputable firm is just as good as the aspirin put out by the makers of ,livertone1 ,danderine and ,cascarets4 ,there is one point1 however1 that is of vital importance to the medical profession2 ,the decision recently rendered in the ,united ,states ,district ,court of ,southern ,new ,york makes it obligatory for druggists1 when filling a physician's prescription calling for 8aspirin10 to dispense the ,bayer product4 ,when the public buys aspirin on its own responsibility--without specifying any particular brand--the druggist may give the purchaser any make of acetylsalicylic acid he sees fit4 ,to repeat what was said in ,the ,journal's comment on this decision3 8,unless a physician wishes to cater to the concern owning the ,bayer rights and to aid in perpetuating what was a monopoly for seventeen years1 he should be careful to prescribe the drug under the term #8acetylsalicylic acid1' ,the court now places the responsibility directly on the medical profession4 ,avoid #8aspirin'--write #8acetylsalicylic acid4'--7,from ,the ,journal ,a4 ,m4 ,a41 ,june #aa1 #aiba47 ,,the ,,allied ,,medical ,,associations ,,of ,,america ,another ,rocket in the ,pyrotechnics of ,quasimedical ,organizations ,it was once said1 in the days when diploma mills flourished1 that it seemed easier to start a 8university0 than it was to open a grog shop4 ,a study of quasimedical organizations convinces one that it is easier to found a 8medical society0 than it is to establish a peanut stand4 ,most reputable practitioners of medicine who care to affiliate themselves with medical organizations are members of the ,american ,medical ,association1 its component societies1 or similar scientific bodies4 ,it is not surprising then1 that those who live and move in the twilight zone of professionalism1 from visionaries riding bizarre medical hobbies to those who have special interests to exploit1 should create and make use of hybrid medical organizations4 ,such organizations multiply as rapidly as rabbits4 ,they flourish for a while1 obtain more or less newspaper and other publicity--usually more1 because of the sensational methods of those controlling them--then1 having served the purpose of those who brought them into being1 they lapse into innocuous desuetude4 ,the official accouchement of the ,allied ,medical ,associations of ,america occurred1 according to that organization's report1 ,may #ah1 #aiah4 ,on the official stationery of the ,allied ,medical ,associations of ,america in use in ,may1 #aiai1 we find the names of the 8,officers10 8,censors10 etc4 ,these constitute1 presumably1 the more prominent members of this organization4 ,we give briefly1 some data regarding some of these so that a rational perspective may be obtained3 ,l4 ,m4 ,ottofy1 ,m4,d41 ,st4 ,louis1 ,mo4--,dr4 ,ottofy seems to have been the chief organizer1 if not1 indeed1 the founder4 ,he has been its 8,secretary-,treasurer0 since its inception2 he is also 8editor0 of its journal4 ,ottofy1 according to our records1 was born in #ahfe at ,budapest1 ,hungary1 and was graduated in #ahhh by the ,homeopathic ,medical ,college of ,missouri4 ,in ,polk's ,medical ,directories for #aiad and #aiag1 ,ottofy has those extended notices which any physician can obtain who cares to pay for them4 ,according to these notices1 ,ottofy is1 or has been1 affiliated with the following 8societies03 ,president of the ,international ,cancer ,research ,society4 ,ex-,president of the ,st4 ,louis ,society of ,medical ,research4 ,second ,vice ,president of the ,missouri ,institute of ,homeopathy4 ,general ,secretary of the ,american ,association of ,progressive ,medicine4 ,chairman of the ,board of ,censors of the ,missouri ,institute of ,homeopathy4 ,member of the ,american ,institute of ,homeopathy4 ,member of the ,southern ,homeopathic ,association4 ,member of the ,american ,association of ,orificial ,surgeons4 ,member of the ,southern ,homeopathic ,medical ,society4 ,member of the ,kansas ,city ,society of ,medical ,research4 ,honorary member of the ,chicago ,society of ,medical ,research4 ,in ,december1 #aiaa1 numerous newspaper clippings show that ,dr4 ,ottofy was obtaining much publicity relative to his antivaccination activities4 ,at that time the papers reported that ,ottofy was suing the ,st4 ,louis ,board of ,education for #be1jjj damages1 because the board would not admit to the schools of the city a child he had 8internally0 vaccinated4 ,in ,november1 #aiac1 the ,st4 ,louis ,republic reported that ,ottofy had claimed to have discovered a serum for the cure of cancer1 and quoted ,ottofy as claiming 8a record of #gb per cent4 of cures0 in 8selected cases40 ,in ,february1 #aiad1 the newspapers reported that ,ottofy was making a trip east 8on the trail of radium for use in his practice in the cure of cancer0 and quoted him as stating1 8,i have learned on good authority that there is radium in ,missouri1 and just where ,i refuse to divulge at this time40 ,in ,january1 #aiae1 the ,st4 ,louis ,republic reported that ,ottofy1 at a meeting of the 8,st4 ,louis ,society of ,medical ,research10 had announced that he had perfected a serum treatment for cancer1 which 8is curing patients who have been pronounced incurable by so-called #8cancer experts4'0 ,in ,january1 #aiaf1 the ,st4 ,louis ,star reported that ,ottofy had sought an injunction against the ,board of ,education of ,st4 ,louis to restrain it from using its funds for 8the maintenance of a ,board of ,hygiene40 ,in ,july1 #aiaf1 ,st4 ,louis papers recorded that ,ottofy1 who was then running for coroner1 had been cited to appear before the prosecuting attorney to explain a charge of passing out1 at a political meeting1 a card alleged to have borne an indecent drawing of ,president ,wilson4 ,the prosecuting attorney was said to have instructed ,ottofy to bring the plates from which the cards were printed to his office4 ,two days later the papers stated that ,ottofy had sent the cards and plates by messenger to the prosecuting attorney's office4 ,n4 ,la ,doit ,johnson1 ,m4,d41 ,chicago4--,dr4 ,johnson's name appears as the 8,first ,vice-,president0 of the ,allied ,medical ,associations of ,america4 ,a few years ago1 ,dr4 ,johnson's name also appeared as the 8,dean of the ,faculty0 of the 8,american ,post ,graduate ,school40 ,this 8school0 was a mail-order concern which1 according to the 8,annual ,announcement10 would grant diplomas and confer degrees as follows3 8,master of ,surgery10 8,bachelor of ,medicine10 8,bachelor of ,science10 8,master of ,electro-,therapy10 8,doctor of ,osteopathy10 8,doctor of ,psychology10 8,master of ,massage10 etc4 ,h4 ,m4 ,goehring1 ,d4,o41 ,m4,d41 ,pittsburgh1 ,pa4--,the 8,second ,vice-,president10 according to the letterheads of the 8,association0 carries the letters ,d4,o41 ,m4,d41 after his name4 ,so far as our records show1 and they are most complete and based on official data1 ,h4 ,m4 ,goehring is an osteopath1 but not a doctor of medicine4 ,a4 ,e4 ,erling1 ,m4,d41 ,milwaukee1 ,wis4--,a4 ,e4 ,erling1 according to the stationery1 is 8,chairman0 of 8,censors40 ,our records fail to show that ,erling ever graduated in medicine4 ,the ,health ,department of ,milwaukee1 however1 says that ,erling1 when interviewed1 claimed to have 8a diploma from the ,german ,medical ,college of ,chicago1 but refused to show or present the same40 ,the ,american ,medical ,directory has this item3 ,german ,medical ,college1 ,chicago4 ,chartered ,dec4 #bh1 #ahia1 by ,johann ,malok4 ,fraudulent4 ,extinct4 ,a few years ago ,erling was in ,la ,crosse1 ,wis42 and in #aijh a circular letter bearing his name and picture was sent out from which the following extracts are taken4 ,capitalization as in the original3 8,dear ,friend3--,permit me to call your attention to the fact that ,dr4 ,a4 ,e4 ,erling1 the eminent specialist1 after many years of travel1 practice and medical research1 has given up his extensive road practice and severed his connection with the several medical institutes which have heretofore occupied considerable of his attention 444 ,dr4 ,erling's success in the treatment of all ,,chronic ,,diseases is truly remarkable4 ,,nervousness1 all ,,blood ,,diseases1 ,,rheumatism1 ,,diseases ,,peculiar ,,to ,,women1 ,,catarrh1 ,,deafness1 ,,chronic ,,constipation 444 ,,appendicitis 444 ,,piles1 ,,stomach ,,troubles1 ,,partial ,,paralysis1 etc41 give way as if by magic under his skillful method of treatment 444 ,understand please1 that ,dr4 ,erling ,,does ,,not ,,accept ,a ,,case ,,for ,,treatment unless he can ,,promise ,a ,,speedy ,,and ,,positively ,,permanent ,,cure40 ,the ,journal also has in its files advertisements 7vintage of #aiae71 from some ,wisconsin country newspapers1 which notify the afflicted that 8,drs4 ,erling and ,karass1 the expert ,german ,specialists10 could be seen in their offices in the 8,schlegel ,hotel10 the 8,schlitz ,hotel10 etc41 as the case might be4 ,whether one of these 8,german ,specialists0 was ,dr4 ,arnold ,e4 ,erling1 ,the ,journal does not know4 ,official medical records fail to show1 at least1 that there is any other ,erling in the state of ,wisconsin4 ,w4 ,w4 ,fritz1 ,m4,d41 ,philadelphia4--,another of the 8,censors40 ,this presumably is ,w4 ,wallace ,fritz1 ,m4,d41 ,d4,d4,s41 ,n4,d41 ,d4,o41 ,d4,c41 who was the 8,dean0 of the 8,american ,college of ,neuropathy10 and 8,professor of ,neuropathy0 at the same institution4 ,according to newspaper reports published when the 8dean0 of the ,american ,college of ,neuropathy was called into court to testify regarding the 8school10 ,fritz admitted that when he became dean of this 8college10 the 8college0 had three students and thirty 8,faculty ,members06 ,fritz1 it should be mentioned in passing1 is a member of the ,philadelphia ,county ,medical ,society and by virtue of this membership he has qualified as a ,fellow of the ,american ,medical ,association6 ,recently ,fritz's name appeared in connection with the formation of a new organization1 founded1 it appears1 for the laudable purpose of fighting the 8,medical ,trust40 ,fritz1 according to the newspaper reports1 is treasurer of this new organization1 which has adopted the inspiring title1 8,constitutional ,liberty ,league of ,america0 and seems to be a later edition of the mushroom 8,national ,league for ,medical ,freedom40 ,quoting from the newspaper report3 8,dr4 ,w4 ,wallace ,fritz1 a member of the ,american ,medical ,association1 created a profound impression when he said that all health laws were written by agents of1 or members of1 the ,american ,medical ,association1 and that this organization was at once the most powerful and the most baneful of all the ,american ,trusts4 ,dr4 ,fritz then went on to say3 #8,most of the drugs administered are worthless4 ,most of the doctors who prescribe them are incompetent1 but both the injurious drug and the ignorant prescriber are protected1 in and out of court1 by the ,american ,medical ,association1 which trust is now raising a vast fund with which to drive all drugless healers out of the profession4 ,medicine is the camouflage used to conceal the most alert1 the most rapacious and the least patriotic of all the trusts milking the ,american people4 ,the tyranny of the ,medical ,trust is unbelievable4 ,it is also un-,american4'0 ,the ,philadelphia ,sunday ,transcript of ,may #d1 #aiai1 had a five column article under the name of ,w4 ,wallace ,fritz4 ,it is a most vituperative affair1 and reeks with fire and brimstone4 ,it is directed chiefly against the ,american ,medical ,association1 and physicians are dubbed 8,prescription ,writing ,drug ,peddlers ,who ,prosper ,through ,monopolistic ,laws ,rather than by the ,practice of an ,exact ,science40 ,in the course of this diatribe we read3 8,the members of the ,american ,medical ,association are manifesting an unwarranted interest in the dear people1 who1 in their assumption1 need quinin and mercurial guardian2 who under this class legislation confines us to this monopoly of the big and little pill1 is trying by hook and crook to shut out the natural and rational methods of cure which are driving the drug monopoly from the face of the earth4 ,diagnosis and consultation consist in four or five medical doctors1 whose faces denote death1 sitting around a sick man and guessing what ails him4 ,after that has been performed they guess at what will cure him1 and that is generally a sure sign the undertaker will follow40 ,c4 ,o4 ,linder1 ,m4,d41 ,spokane1 ,wash4--,this gentleman 7another 8,censor071 seems to be an osteopath1 who some years ago was 8,assistant ,secretary0 of the 8,washington's ,physicians' ,association10 founded apparently by rebels within the osteopathic ranks who denounced the ,washington ,osteopathic ,association as a 8professional trust06 ,linder apparently claims graduation in #aije from the 8,thompsonian ,medical ,college0 of ,allentown1 ,pa4 ,the following item from the ,american ,medical ,directory regarding this school is of interest3 8,thompsonian ,medical ,college1 ,allentown4 ,organized in #aijd4 ,fraudulent4 ,no evidence to show classes were ever held40 ,a4 ,h4 ,flower1 ,m4,d41 ,boston4--,still another 8,censor40 ,flower1 according to the notice that appears in ,polk's ,directory for #aiag1 claims graduation in #ahhh from the 8,american ,health ,college0 of ,cincinnati1 and in #ahid from the 8,american ,health ,university0 of ,chicago4 ,quoting again from the ,american ,medical ,directory1 here is what we find regarding the former 8college03 8,american ,health ,college1 ,cincinnati4 ,organized in #ahgd and re-organized in #ahgf4 ,conducted by a ,dr4 ,campbell who originated and copyrighted the so-called #8,vitapathic ,system1' ,fraudulent4 ,extinct about #ahhh40 ,we have no record of an 8,american ,health ,university0 of ,chicago1 although there was an 8,illinois ,health ,university0 of ,chicago1 one of the numerous diploma-mill swindles operated by ,armstrong4 ,it was declared fraudulent by the federal authorities and its charter was revoked in #ahig4 ,flower1 according to the notice in ,polk's ,directory1 is3 ,ex-,president ,maine ,eclectic ,society4 ,ex-,president ,new ,england ,eclectic ,medical ,association4 ,member ,national ,eclectic ,medical ,association4 ,member ,american ,progressive ,medical ,society4 ,member ,massachusetts ,eclectic ,medical ,society4 ,z4 ,l4 ,baldwin1 ,m4,d41 ,kalamazoo1 ,mich4--,possibly the data just given concerning some of those whose names appeared on the organization's stationery are more than sufficient for the average physician to get a perspective of the ,allied ,medical ,associations of ,america4 ,still1 it is worth mentioning that in a letter recently sent out by ,ignatz ,mayer1 extending an invitation to the annual convention of the ,allied ,medical ,associations of ,america1 ,mayer took the opportunity of incorporating in his letter a letter which one of the members of the 8association0 had been sending out1 urging individuals to join4 ,the member in question was ,dr4 ,z4 ,l4 ,baldwin of ,kalamazoo1 ,mich4 ,dr4 ,baldwin1 as some of our readers may remember1 is the gentleman who1 a few years ago1 was exploiting an 8,intravenous ,treatment0 for the cure of tuberculosis4 ,according to the claims made at that time3 8444 for the first time in the history of medicine1 we have a successful treatment for tuberculosis4 8444 we are able to kill the germs of the disease in the body1 thoroughly ridding it of all tubercular infection1 destroying the germ and its poisons likewise40 ,this was a few years ago4 ,whether ,dr4 ,baldwin is still specializing in consumption we do not know2 apparently not1 as we notice that at the first meeting of the ,allied ,medical ,associations1 ,baldwin's name was on the program for the 8,cure of ,goiter by ,adjustment of ,lenses40 ,george ,starr ,white1 ,m4,d41 ,f4,s4,sc41 ,lond41 ,los ,angeles1 ,calif4--,a letter received by a physician a few days before the recent convention of the ,allied ,medical ,associations1 held out as an inducement to be present the fact that 8,geo4 ,s4 ,white will show you how to diagnose disease by means of dif4 colored lights and the reaction of the body to the magnetic meridian40 ,dr4 ,george ,starr ,white was the 8,second ,vice-,president0 of the ,allied ,medical ,associations in #aiah4 ,white1 according to our records1 was graduated in #aijh when he was forty-two years old1 by the ,new ,york ,homeopathic ,medical ,college and ,hospital4 ,he was licensed in ,new ,york in #aijh1 in ,california1 ,connecticut and ,nevada in #aiac1 and in ,michigan in #aiaf4 ,he seems to have been one of the proponents of 8spondylotherapy10 8zonetherapy10 etc41 and in #aiae it was announced that he would give one week courses in 8,spondylotherapy0 in ,chicago1 ,kansas ,city and ,denver1 respectively4 ,in his advertisement he emphasized that he was a ,fellow of the ,american ,medical ,association1 which1 while true at the time1 is no longer true1 as on ,feb4 #d1 #aiaf1 he was expelled from membership in the ,los ,angeles ,county ,medical ,association4 ,in ,may1 #aiae1 ,white was arrested in ,chicago and fined #ajj and costs for practicing medicine without a license4 ,dr4 ,white's specialty seems to be what is ponderously known as 8,bio-,dynamo-,chromatic ,diagnosis40 ,this has been described by one of its enthusiastic adherents as 8,diagnosis by ,sympathetic ,vagal-,reflex40 ,to obtain the 8,sympathetic ,vagal-,reflex0 it seems the patient must face east or west and have his bare abdomen percussed until a dull area is located4 ,the patient is then faced north or south and again percussed4 ,then1 it seems1 different colored lights are thrown on the patient1 the location of the areas of dullness being determined meanwhile4 ,a combination of ruby and blue lights 8will cause a reflex in cases of gonorrhea10 a 8green light will cause a reflex in cases of liver or gallbladder trouble10 while the color for carcinoma is orange red6 ,during the height of the influenza epidemic last winter1 ,white seems to have put on the market 8,valens ,essential ,oil ,tablets0 which were for 8,gripping the ,flu out of ,influenza10 and were also said greatly to benefit or cure incipient tuberculosis1 hay-fever1 asthma1 and 8catar40 ,the letters 8,f4,s4,sc41 ,lond40 after ,dr4 ,white's name look well1 sound well1 and have an air of erudition and mystery that is well worth what they cost4 ,they mean 8,fellow of the ,incorporated ,society of ,science1 ,letters and ,arts of ,london1 ,ltd40 ,the 8,fellowship0 costs one guinea4 ,not a few 8patent medicine0 exploiters in the ,united ,states carry these mystic letters after their names4 ,the society in question was a seriocomic concern that was exposed by ,london ,truth some years ago and was also dealt with in ,the ,journal of ,may #bi1 #aiji1 in connection with the 8,aicsol ,consumption ,cure0 expos4 ,so much for the ,allied ,medical ,associations of ,america4 ,at their recent meeting in ,new ,york ,city they got much newspaper publicity because of their action on the prohibition question4 ,according to the newspaper reports1 the organization adopted a resolution declaring that 8properly brewed lager beer is absolutely essential in the treatment of certain cases40 ,they were further reported as endorsing the manufacture of light wines and of beer containing not to exceed #b4ge per cent4 alcohol4 ,as a piece of publicity work this resolution was all that its sponsors could expect4 sc,the ,journal_/sc office was flooded with telegrams and letters from physicians1 temperance workers1 congressmen1 church organizations1 and others1 asking1 in effect1 ,what is the ,allied ,medical ,associations of ,america8 ,this is our apology for giving the amount of space necessary to a proper understanding of this organization4 ,today the rocket of the ,allied ,medical ,associations of ,america is blazing a more or less erratic course across the sky of publicity4 ,the stick will be down anon6 ,any resolution or expression of opinion by this organization1 or others of its type1 when dealing with the broader problems of public health1 is wholly without scientific significance1 whether such resolutions are good1 bad or indifferent4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #e1 #aiai47 8,,arsenicals0 ,the ,september issue of the ,archives of ,dermatology and ,syphilology presents a number of significant features regarding the use of arsphenamin and related compounds that are at present being widely employed in the treatment of syphilis4 ,to one who studies these statements of laboratory and clinical investigators in the special field involved there must come the conviction that many therapeutic perplexities still remain at the end of nearly a decade of trial for the types of compounds which ,ehrlich introduced4 ,it is well for the practitioner to realize this1 especially when expert workers still make an appeal for conservative interpretations4 ,stokes forcefully summarized the situation when he stated at the ,new ,orleans session of the ,american ,medical ,association3 ,too short a time has elapsed since the discovery of these drugs1 and too little is as yet known about the ultimate problems of the pathology1 immunology and parasitology of syphilis1 to justify the announcing of new infallibilities4 ,the necropsy pathologist of the next fifty years may well1 like ,warthin1 upset our most plausible generalizations of today4 ,seasoned tradition and conservatism are still the wisest guides in our interpretation of clinical cure4 ,arsphenamin has made it apparently possible and even probable1 but only to the inexperienced has cure been made absolute and inevitable4 ,it is recognized that the exact composition of arsphenamin in its available form is not fully determined4 ,as has been emphasized again1 the quantitative determination of arsenic alone in arsphenamin is insufficient to estimate its purity2 in fact1 the interstate sale of arsphenamin is controlled by toxicity tests on guinea-pigs made by the ,hygienic ,laboratory of the ,united ,states ,public ,health ,service4 ,consequently1 practical medicine must be on its guard to employ a product which is carefully controlled by such toxicity tests as well as by other criteria4 ,it will not do to charge untoward results offhand solely to idiosyncrasy of the patient1 faulty administration or other errors in technic4 ,the drug itself still has inherent dangers4 ,it should be borne in mind also that neo-arsphenamin behaves differently in the animal organism from arsphenamin1 and should not be regarded simply as arsphenamin in a convenient form for administration4 ,it is gratifying to learn from a government expert that after the long struggle to produce satisfactory products1 arsphenamin preparations made in the ,united ,states are generally less toxic than those of foreign manufacture4 ,neo-arsphenamin preparations made in the ,united ,states compare favorably1 and in certain instances are decidedly less toxic than most of the foreign products4 ,timely presentations of the faults and dangers as well as the undisputed advantages of current therapy in the management of syphilis should be welcomed4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #i1 #aibj47 ,pharmacology of ,arsenicals ,the ,public ,health ,service some time ago#bfb warned against the use in syphilis of new arsenicals which are not related to arsphenamin2 it was stated that a number of such were being sold with unwarranted claims as to their value4 ,at least three such arsenicals have in recent years been the subject of some exploitation for use in this disease3 sodium cacodylate1 the sodium salt of methyl arsenic acid 78,arrhenal07 and the sodium salt of ethyl arsenic acid 78,mon-,arsone074#bfc ,as regards the first two1 ,castelli showed several years ago that neither has any action on experimental trypanosomiasis and spirochete infections2 careful clinical observations in this country have confirmed the inefficacy of sodium cacodylate in human syphilis4#bfd ,voegtlin and ,smith#bfe of the ,hygienic ,laboratory have now shown in animal experiments that ethyl arsenic acid 78,mon-,arsone07 is devoid of any practical trypanocidal action4 ,thus the 8therapeutic ratio0 7the ratio of the minimal effective dose to the lethal dose7 was about #a1 that is1 it was effective therapeutically only in approximately fatal doses1 the therapeutic ratio for arsphenamin in similar conditions was #ag1 and that of neo-arsphenamin1 #bh4 ,in fact1 the conditions with ethyl arsenic acid were no more favorable than were those with arsenous acid 7the active constituent of solution of potassium arsenite71 although it was far less poisonous4 ,the validity of such experiments in determining the probable value of drugs in human syphilis cannot be questioned3#bff it was by such experiments that ,ehrlich and his co-workers found two or three of six hundred and six arsenic preparations studied to be of value1 and of the next three hundred or more studied only one 7neo-arsphenamin7 worthy of trial in human medicine4 ,the time has passed when a high arsenic content of a compound and a low toxicity1 and a number of cases of apparent clinical improvement1 can be assumed to indicate that a drug has any real value in the treatment of syphilis4 ,many organic compounds of arsenic as well as other drugs may cause temporary or apparent improvement in syphilis1 but to date only those related to arsphenamin have proved of real value and comparatively safe4 ,others which had some real value proved to have dangerous side effects2 readers will recall the history of arsanilic acid 78,atoxyl0 or 8,soamin07 and its acetyl derivative 78,arsacetin074--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #bf1 #aiba47 #bfb ,warning ,against ,untried ,medicaments1 ,j4 ,a4 ,m4 ,a4 #gd3afed 7,june #ab7 #aibj4 #bfc ,wright1 ,b4 ,l42 ,kennell1 ,l4 ,a41 and ,hussey1 ,l4 ,m43 ,med4 ,rec4 #ig3fjg 7,april #aj7 #aibj4 #bfd ,nichols1 ,h4 ,j43 ,salvarsan and ,sodium ,cacodylate1 ,j4 ,a4 ,m4 ,a4 #ef3dib 7,feb4 #ah7 #aiaa4 #bfe ,voegtlin1 ,carl1 and ,smith1 ,h4 ,w43 ,j4 ,pharmacol4 ,exper4 ,therap4 #af3ddi1 #aiba4 #bff ,compare ,schamberg1 ,j4 ,f42 ,kolmer1 ,j4 ,a41 and ,raiziss1 ,g4 ,w43 ,am4 ,j4 ,m4 ,sc4 #aej3be 7,july7 #aibj4 ,salvarsan3 ,abrogate the ,patent ,the ,journal has already commented on the difficulty in securing salvarsan1 on the moral and ethical question as to whether or not it is justifiable for one person to control the output of a drug necessary to public health4 ,this week we publish an account of the action of the ,st4 ,louis and ,chicago medical societies1 which are calling on the medical profession to appeal to their senators and congressmen to abrogate this patent4 ,the ,journal believes that this patent should be abrogated1 not alone because the patentees have not supplied the demand1 not alone because they have dictated to the medical profession who should have the drug and how much a physician might have1 not alone because of the war with ,germany1 not alone because of the special needs of the government at this time for the control of venereal diseases1 not alone because1 as some claim1 the patent at ,washington does not correctly describe the product1 but also because the people who are supplying this product are charging prices that are exorbitant compared to the price at which others in this country can supply it4 ,the fact is that the salvarsan one can obtain today costs #d4ej per ampule of #j4f gram1 whereas the same dose of arsenobenzol--a preparation identical with1 if not better than1 salvarsan--costs #b4jj at retail1 and as ,dr4 ,schamberg says3 8,if we are permitted to continue marketing the same drug after the war1 we can sell it at #a4jj or less per tube40 ,to abrogate this patent would be doing an injury to no one4 ,certainly the patentees of salvarsan have already reaped their harvest--and a pretty rich one4 ,the supply of salvarsan at a reasonable price in proportion to its actual cost of production is in the interest of the health of the entire population of the country1 whereas to let matters rest as they are1 is to the benefit of one man4 ,while we are emphasizing here the cost1 there is after all a greater question1 and that is the supply necessary to help control the ravages of one of the most serious diseases which afflict humanity today4 ,it is the duty of ,congress to abrogate the patent on this preparation and1 incidentally1 on all medicinal preparations of importance4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,april #ba1 #aiag47 ,end the ,monopoly ,the ,adamson ,bill1 known as the 8trading with the enemy act10 has recently been passed by the ,house of ,representatives1 is now before the ,senate1 and will doubtless be enacted into a law4 ,one of its clauses confers authority on the ,federal ,trade ,commission to grant licenses to citizens of this country to operate patents owned by enemy aliens4 ,physicians are interested in the bill primarily because it includes the salvarsan situation4 ,the manner in which salvarsan has been supplied in this country has been so arbitrary and the prices charged so tremendously above the actual cost1 that we should not be satisfied unless the monopoly is ended so that the drug can be supplied at least at a fairly moderate figure1 and the old methods eliminated4 ,it is to be hoped1 therefore1 that the ,federal ,trade ,commission will not grant exclusive control--that is1 exclusive license--to any one person or firm4 ,to do so would simply perpetuate the old monopoly and the old conditions4 ,england has adopted a law1 which1 in principle1 is similar to the ,adamson ,bill1 and there several concerns have been licensed to manufacture the product4 ,the same should be done here4 ,the ,dermatologic ,research ,laboratories of ,philadelphia announce that they can supply arsenobenzol at #a4ej a tube1 and that there is immediately available a supply sufficient for any demand that may be made4 ,the same laboratories have announced also that in a few months they will be able to supply hospitals for #a4jj a tube4 ,considerable responsibility rests on the ,federal ,trade ,commission in this matter1 for it is not only a question of monopoly1 but also a question of scientific qualifications and ability to make the product on the part of some who may make application4 ,undoubtedly the commission will secure the cooperation of the ,united ,states ,public ,health ,service1 under whose supervision these drugs should be manufactured no matter who shall be licensed to make the product4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,july #ba1 #aiag47 ,arsphenamin ,no1 this is not a new chemical2 it is simply the name adopted by the ,federal ,trade ,commission for the hydrochlorid of #c-;diamino-#d-;dihydroxy-#a-;arsenobenz ene--in other words1 salvarsan4 ,as our readers already have been informed three firms have been licensed to manufacture and sell arsphenamin2 but1 while each manufacturer may have his own trade name on the label1 the official name must be the prominent one on all packages4 ,hence1 physicians should at once make it a point to learn and use the name 8arsphenamin0 in place of salvarsan4 ,at first sight1 arsphenamin looks formidable4 ,in reality1 it is just as easy to familiarize oneself with the word 8arsphenamin0 as it was to learn to use the terms 8salvarsan10 8arsenobenzol0 or any other of the trade names4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ai1 #aiah47 ,,beer ,,and ,,cancer ,,cures ,did the ,brewing ,interests ,advertise ,autolysin8 ,our readers may remember that an article appeared in this department of ,the ,journal for ,july #f1 #aiah1 under the title 8,henry ,smith ,williams and #8,proteal ,therapy4'0 8,proteal ,therapy0 is a treatment exploited by ,henry ,smith ,williams1 ,m4,d41 of ,new ,york1 for use in tuberculosis1 cancer1 rheumatism1 etc4 ,it is apparently a modification of the 8,autolysin0 cancer 8cure0 which ,williams had previously puffed in ,heart's ,magazine4 ,the ,journal's article pointed out that ,henry ,smith ,williams1 although entitled to write 8,m4,d40 after his name1 is essentially a journalist4 ,he has written voluminously for some years in lay publications on various subjects1 both under his own name and under his nom de plume1 8,stoddard ,goodhue1 ,m4,d40 ,in addition1 ,williams runs a publishing concern called the ,goodhue ,company1 which issues a number of books1 many of them being reprints of ,williams' own articles4 ,closely associated with ,henry ,smith ,williams is his brother1 ,edward ,huntington ,williams1 who also is a prolific writer4 ,the ,journal's previous article called attention to the fact that there had been sent broadcast to physicians a neat little cloth-bound book1 entitled1 8,alcohol1 ,hygiene and ,legislation40 ,this book1 which evidently cost somebody a good deal of money to distribute gratis1 was published by the ,goodhue ,company1 and was written by ,edward ,huntington ,williams4 ,enclosed with the book was an advertising leaflet on the 8,autolysin0 cancer cure and also a letter from the ,goodhue ,company1 asking physicians to accept it 8with our compliments and the compliments of the author40 ,the letter was chiefly devoted to calling attention to ,henry ,smith ,williams' 8new book1 the ,autolysin ,treatment of ,cancer40 ,the last thirteen pages of the book 8,alcohol1 ,hygiene and ,legislation0 contained advertisements of the ,goodhue ,company's publications1 particular emphasis being placed on the 8,autolysin ,treatment of ,cancer10 by ,henry ,smith ,williams4 ,so much by way of retrospect4 ,now comes information that may throw an interesting side-light on the matter just presented4 ,there is at present being conducted by a committee of the ,united ,states ,senate1 an investigation relative to the purchase of a ,washington 7,d4 ,c47 newspaper with money alleged to have been furnished by those interested in the brewing industry4 ,at the opening hearing before the ,senate ,committee1 ,tuesday1 ,november #ai1 the secretary of the ,united ,states ,brewers' ,association1 after admitting that brewers' propaganda had been published in the ,international ,monthly1 edited by ,viereck 7of the ,fatherland71 also declared that the ,publication ,committee of the brewers' association employed writers to 8write up certain subjects0 relating to the brewers' trade4 ,one of the writers mentioned in this connection was1 according to the newspaper reports1 8,dr4 ,edward ,h4 ,williams1 author of articles published in medical and other journals40 ,with this fact before us1 it seemed worth while to go through the book that had been distributed so lavishly to physicians with the compliments of the ,goodhue ,company and ,dr4 ,edward ,huntington ,williams1 in the exploitation of 8,autolysin10 and ,henry ,smith ,williams' book on the subject4 ,the first chapter of 8,alcohol1 ,hygiene and ,legislation0 consists of a reprint of an article from the ,new ,york ,medical ,journal of ,may #h1 #aiae4 ,the article is a skilful presentation of the case for the defenders of the lighter alcoholic beverages1 especially beer4 ,this chapter and all succeeding chapters of the book attempt to discredit prohibitory legislation1 and argue that prohibition drives the public to the use of the more ardent alcoholic beverages1 while preventing the use of the milder beverages1 such as beer1 which one is led to infer is not particularly harmful4 ,throughout the book1 also1 the state of ,kansas is held up as an example of the harm done by prohibition1 and the theme is developed that insanity and the use of cocain and other habit-forming drugs follows in the wake of prohibition4 ,the following extracts are from ,chapter ,i3 ,the evil effects of beer and wine1 for example1 are greatly less than those produced by spirituous liquors4444 ,italics ours4--,ed4 ,if our theory of immunity is correct we should expect to find that the older beverages1 such as beer and wine1 which have been used for thousands of years1 are less productive of alcoholic insanity1 for example1 than the spirituous liquors which are recent innovations4 ,in point of fact we find this to be the case3 the spirituous liquors are almost wholly responsible for all forms of alcoholic insanity4 ,italics ours4--,ed4 ,chapter ,,ii is a reprint of an article that appeared in ,everybody's ,magazine1 ,august #aiad1 and deals with 8,legislation from a ,medical ,viewpoint40 ,it is to the effect that drug addiction and insanity1 together with special forms of mental disease directly attributable to alcoholism1 seem to flourish best in prohibition territory4 ,chapter ,,iii deals with 8,the ,peace and ,war ,footing of ,alcohol10 and is a reprint from the ,medical ,record1 ,aug4 #g1 #aiae4 ,it1 too1 sings the praises of the 8lighter beverages10 while deprecating the use of 8ardent spirits40 ,for instance3 ,an overwhelmingly large proportion of persons who develop alcoholic psychoses in ,america are drinkers of whisky1 or some corresponding ardent spirit1 whereas this condition is seldom seen in beer and wine drinkers4 ,italics ours4--,ed4 ,thus we find the highest percentage of alcohol psychoses among the whisky drinkers who come from western ,europe1 while the wine and beer drinking races of central and southern ,europe show a distinctly lower percentage1 in some instances only about one-fourth as many per thousand4 ,italics ours4--,ed4 ,chapter ,,iv deals with 8,some ,aspects of ,liquor ,legislation40 ,like ,chapter ,,ii it is an indictment of prohibition1 and the ,united ,states ,census ,bureau's reports are called on to sustain this thesis4 ,quotations1 too1 are made from the writings of ,henry ,smith ,williams further to prove the point4 8,dry0 ,kansas and 8wet0 ,nebraska are frequently compared1 to the detriment of the former4 ,one who accepts the statements in this chapter will get the impression that ,kansas has more lawlessness1 illiteracy1 pauperism1 and insanity than ,nebraska4 ,chapter ,v deals with 8,the ,problem of ,legislation40 ,it is based on the premise that 8prohibition does not prevent the consumption of liquor10 but on the contrary1 8prohibitive legislation induces the consumption of the most harmful form of liquors40 ,stated in another way1 it is equivalent to charging that prohibition is hard on the brewers1 but beneficial to the distillers4 ,in fact1 ,e4 ,h4 ,williams1 in another book 78,the ,question of ,alcohol0--,goodhue ,co47 which also champions the case for the milder alcoholics1 quotes ,henry ,smith ,williams as saying1 relative to prohibitory legislation3 8,in general1 it would appear that1 if our legislators of recent years had been in league with the distiller1 they could not have served his purpose better40 ,whether or not ,edward ,h4 ,williams' or ,henry ,smith ,williams' conception of the alcohol problem is good1 bad or indifferent1 need not at this time concern us4 ,the medical profession1 however1 has a right to ask two questions3 ,first1 ,is the ,dr4 ,edward ,huntington ,williams who wrote 8,alcohol1 ,hygiene and ,legislation0 the 8,dr4 ,edward ,h4 ,williams0 who was employed by the brewers to write propaganda favorable to the brewing interests8 ,second1 ,was the cloth-bound book1 8,alcohol1 ,hygiene and ,legislation10 which was distributed by the ,williams brothers1 paid for1 wholly or in part1 by the ,united ,states ,brewers' ,association8 ,for those who wish to read ,dr4 ,edward ,huntington ,williams' opinion on the alcohol question1 the following bibliography may be of service3 8,liquor ,legislation and ,insanity03 ,medical ,record #hd3gia1 #aiac4 8,the ,liquor ,question in ,medicine03 ,medical ,record #he3fab1 #aiad4 8,inebriety as a ,medical ,problem03 ,post-,graduate #bi3fjc1 #aiad4 8,the ,problem of ,inebriety03 ,n4 ,y4 ,medical ,journal #aja3idj1 #aiae4 8,aspects of ,inebriety in ,alcohol03 ,british ,journal of ,inebriety #ac3i1 #aiae-aiaf4 8,the ,peace and ,war ,footing of ,alcohol03 ,medical ,record #hh3bbf1 #aiae4 8,alcohol and ,therapeutics03 ,medical ,record #ib3fff1 #aiag4--7;,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #cj1 #aiah47 ,,biologic ,,therapeutics ,,and ,,its ,,commercial ,,domination ,the danger of commercialized therapeutics has been enormously increased by the introduction of biologic products4 ,these substances offer a rich field for the commercially minded1 first1 because of the remarkable results which seem to have followed the use of certain products of this type2 second1 because the field is new and the mode of action of these substances not readily understood and1 third--and most important--because1 by the very nature of the problems involved1 few physicians are well informed concerning them4 ,the influenza epidemic of last year was widespread and fatal in character4 ,it stimulated earnest research in methods of prevention and cure4 ,we were all in a frame of mind to grasp at any straw4 ,here and there some worker would cry 8,eureka0--only to be disappointed when his product was actually put to the test4 ,however1 there were more than enough manufacturers ready to place any product on the market with specious claims that could not be positively denied4 ,vaccines1 serums1 proteins--all were advanced with such glowing statements as to their properties that only those physicians who kept their feet firmly on solid ground could resist the appeal4 ,now we have had another epidemic--mild1 it is true--but the memories of last year make the average physician ready to accept anything which promises hope1 and the manufacturers 8make hay while the sun shines40 ,physicians have been and are being deluged with literature on the prophylaxis and treatment of influenza4 ,so far as we know1 few publications have contained any word of warning on these matters4 ,one exception has just come to notice3 the ,medico-,military ,review1 a semimonthly mimeographed publication sent to medical officers of the ,army by the ,surgeon ,general's ,office4 ,this says3 ,,you ,,are ,,reminded that so far a comprehensive analysis of results obtained by the use of monovalent and polyvalent vaccines in the prevention of influenza has not demonstrated their value4 ,much carefully controlled experimental work is now being carried out on this subject both in civil institutions and in the ,army1 and any worthwhile advances will be reported in the ,review from time to time4 ,if a prospective vaccine is developed1 it will be prepared at the ,army ,medical ,school for general distribution and all medical officers will be duly notified4 ,the general use of the present commercial polyvalent protective against influenza is not considered desirable4 ,numerous telegrams and other requisitions are being received for influenza vaccine4 ,in view of the fact that no prophylactic influenza vaccine is available1 such requisitions should be discontinued4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #ad1 #aibj47 ,,capell',s ,,uroluetic ,,test ,u4 ,s4 ,marine ,hospital1 ,chicago4 ,to the ,editor3--,a member of the consultant staff of this hospital recently referred to us a 8,doctor0 ,h4 ,f4 ,matthews1 who was supposed to give demonstrations of a new test for syphilis--8,capell's #8,uroluetic' ,test40 ,the test was to be made of the urine of the patient4 ,the above mentioned consultant was under the impression that the said 8,doctor0 ,matthews was a graduate physician4 8,doctor0 ,matthews came to the hospital according to the appointment made by the consultant1 and proceeded to give his demonstration4 ,several of the junior officers and interns were present to witness it4 ,he was asked questions in an attempt to determine the scientific status of the test which he was demonstrating4 ,his answers were always vague and indefinite and not clothed in scientific words4 ,we became suspicious of him1 and he was asked if he was a graduate physician4 ,he admitted that he was not4 ,he was further asked if he had studied chemistry and bacteriology2 he stated that he had in #ahhh4 ,inquiry was made as to where2 he replied that it was at the ,university of ,illinois4 ,he was further asked if he was familiar with the ,wassermann reaction4 ,he stated that he was not4 ,this man is going around representing himself as a physician who has a new test which he claims is superior to1 and more delicate than1 the ,wassermann test2 yet he knows nothing whatever of the technic of the ,wassermann reaction4 ,in one case1 we gave him the same specimen of urine in four different containers4 ,he read a different degree of reaction for each of them4 ,in other words1 in a specimen from the same patient1 his four different tests showed1 respectively1 a 1 a 1 a and a reaction4 ,it occurred to me that it might be well to inform you of this man's methods1 as he told us that he had been to a good many institutions1 and ,i am sure he will soon start a plan to systematically force his pseudoscientific test on credulous physicians everywhere4 ,j4 ,o4 ,cobb1 ,m4,d41 ,senior ,surgeon in ,charge4 ,the ,propaganda ,department has in its files a business card reading3 8,capell's ,laboratories1 ,room #aeaj ,masonic ,temple1 ,chicago4 ,dr4 ,h4 ,f4 ,matthews1 ,special ,representative40 ,capell's ,laboratory has its headquarters in ,omaha1 and is apparently conducted by ,dr4 ,w4 ,l4 ,capell1 who1 for many years1 seems to have been more or less interested in proprietary medicines4 ,some years ago he was connected with a concern known as 8,acneine ,pharmacal ,company10 which1 apparently1 was dissolved some time in #aiaj2 and soon thereafter a new company was organized known as the ,le,roy ,drug ,company4 ,in #aiag ,w4 ,l4 ,capell was connected with the ,capell1 ,cameron ,co41 ,inc41 of ,lincoln1 ,neb41 which was selling 8,capell's ,uroluetic ,test01 8,capell's ,treatment for ,syphilis0 and other remedies4 ,the 8,treatment for ,syphilis0 was said to be 8,painless1 ,pleasant1 ,harmless1 ,efficacious1 and requires usually from #cj to #ij days only to eradicate the disease40 ,the name of the treatment is 8,mercarodin0--earlier it was called 8,camit0--and it is now being sold from 8,capell's ,laboratory10 ,omaha4 ,in addition1 ,capell's ,laboratory sells ,acneine1 which apparently is the same product that was sold in #aijf and #aijg under the name of 8,sambu-,co0 by the ,holtman-,stringer ,co4 of ,omaha and later was put out by the ,acneine ,pharmacal ,company of ,omaha4 ,while ,capell's ,laboratory sells proprietary remedies1 it is the 8,uroluetic ,test0 which the concern now seems to be featuring4 ,the claims made for this are3 8,this test requires no expert knowledge1 is inexpensive1 and can be made in a few minutes1 and is so plain that it cannot be mistaken40 ,the idea of being able to determine the absence or presence of syphilis by a simple color test of the urine is a fascinating one4 ,the present reliable diagnostic tests are1 as ,capell's ,laboratory so plausibly emphasizes1 somewhat involved1 and call for rather delicate technic4 ,but there are no short-cuts to knowledge4 ,a physician who ordered ,capell's ,uroluetic ,test some weeks ago received with the bill the letter that follows3 ,it is given not so much for what it says1 as for how it says it4 ,it is copied verbatim et literatim3 8,your letter received1 and we have mailed you as per your letter #a ,doz4 of ,capell's #8,uroluetic' ,tests4 ,in close find statement and instructions1 for same4 8,the #8,uroluetic' ,test is meeting a far greater approval from the ,medical profession than we had expected1 while we do not claime that it is perfect1 yet we have only received one unfavorable report1 and we daily feel incuraged in its efficacy4 8,you know ,doctor that there are two dangerous elements in this world1 one is the extreme pessimist and the other is the extreme optimist4 ,the immoral ,lincoln said1 #8,that there was nothing that was wholly good or wholly evil1' and we presume that this is equally true of the #8,uroluetic' test4 ,but we want the truth no matter what it is40 8,capell's ,uroluetic ,test0 would be 8important if true40 ,unfortunately1 its scientific value to the sufferer is negligible compared with its economic value to the exploiter4 ,it is not so much a test for lues in the patient as of credulity in the doctor4--7,from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bc1 #aiai47 ,another ,urinary ,test for ,syphilis ,to the ,editor3--,will you kindly inform me whether the test in the enclosed 8literature0 is what it is represented to be8 ,charles ,m4 ,thomas1 ,m4,d41 ,sunbury1 ,pa4 ,,answer4--,the 8literature0 referred to by ,dr4 ,thomas dealt with the 8,uri-,na ,test0 sold by the ,standard ,appliance ,company of ,philadelphia4 ,there seems to be a strong family resemblance between this alleged test and that known as 8,capell's ,uroluetic ,test10 which was discussed in the ,propaganda ,department of ,the ,journal1 ,aug4 #bc1 #aiai4 ,of that ,the ,journal said3 8,unfortunately1 its scientific value to the sufferer is negligible compared with its economic value to the exploiter4 ,it is not so much a test for lues in the patient as of credulity in the doctor40 ,the same may be said of the 8,uri-,na ,test40 ,the facts are1 there is no method at present known by which the absence or presence of syphilis may be determined by a simple color test of the urine4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bb1 #aiai47 ,,chemotherapy ,,and ,,tumors,n ,richard ,weil1 ,m4,d41 ,new ,york ,n ,from the ,cancer ,research ,service of the ,general ,memorial ,hospital1 ,new ,york4 ,n ,this critical discussion of the status of chemotherapy in tumors was prepared at the request of the ,council on ,pharmacy and ,chemistry of the ,american ,medical ,association4 ,within the last three years a number of reports have appeared in the medical press which bear on the treatment of malignant growths in human beings by chemical preparations4 ,the most persuasive and the most insistent claims have been made in connection with the colloidal solutions of certain metalloids and metals1 notably selenium1 vanadium and copper4 ,at the same time a number of drug houses1 both in this country and abroad1 have placed on the market proprietary preparations of these substances in various forms1 for which the claim is made that they produce striking therapeutic effects and sometimes even cures in malignant neoplasms4 ,the impulse toward the use and production of this type of preparation is directly traceable to a series of scientific experiments on the tumors of animals1 which date back no farther than the year #aiaa4 ,in that year ,wassermann and his co-workers#bfg published a report on the treatment of rat tumors by means of the intravenous injection of selenium compounds4 ,this paper received wide notoriety through its enthusiastic diffusion by the lay press4 ,shortly afterward ,neuberg and his co-workers#bfh published their observations upon the therapeutic effects of certain metallic compounds4 ,the clinical application of the encouraging results obtained by these authors in animal tumors followed rapidly1 and up to the present time a number of papers have appeared in which the claim is made that human tumors also may be favorably influenced through the constitutional use of substances similar to those used by ,wassermann or ,neuberg4 ,in some cases1 use has been made of colloidal solutions of the heavy metals1 such as copper2 in others1 selenium compounds have been used1 while in a third set of observations the therapeutic agent represents an attempt to combine the virtues of these two types of therapy by employing selenium in colloidal form4 ,as an example of the first class1 may be cited the cuprase of ,gaube du ,gers2#bfi of the second1 the seleniovanadic ointment of ,roemer and the sulpho-selene of ,walker2 of the third1 seleniol and electro-selenium4 #bfg ,wassermann1 ,keysser and ,wassermann3 ,deutsch4 med4 ,wchnschr4 #cg3bchi1 #aiaa4 ,wassermann and ,hansemann3 ,berl4 klin4 ,wchnschr4 #di3d1 #aiab4 #bfh ,neuberg and ,caspari3 ,deutsch4 med4 ,wchnschr4 #ch3cge1 #aiab4 ,neuberg1 ,caspari and ,lhe3 ,berl4 klin4 ,wchnschr4 #di3adje1 #aiab4 #bfi ,gers1 ,gaube du3 ,la cuprase et le cancer1 ,paris1 #aiac4 ,inasmuch as this new type of cancer therapy derives its origin1 its justification and its support1 in very large measure1 from the laboratory results obtained in animals1 it is a matter of considerable importance to examine those results with care1 in order to determine whether they furnish a satisfactory basis for human therapy1 and whether they justify the hopes to which they have given rise4 ,it is safe to assert that the application of chemotherapy to the treatment of tumors practically dates from the publications of ,wassermann4 ,he stated the principle that a rational therapy of tumors must be based on constitutional treatment4 ,it appears evident that local treatment can have only local effects4 ,the lymphatic extensions of tumorous growths1 and the often unsuspected metastases in distant organs must of necessity escape the effects of purely local treatment4 ,hence1 ,wassermann reached the conclusion that all treatment of cancer which was to be effective1 and not merely palliative1 must be carried to all parts of the body by means of the blood stream4 ,he therefore introduced the use of intravenous injections in the experimental therapy of rat and mouse tumors4 ,an accidental observation led him to believe that selenium was a substance possessing a high degree of affinity for tumor cells4 ,in order to insure the penetration of the tumor in the live animal by this substance1 however1 he considered it essential to combine it with some other highly diffusible substance4 ,this type of substance1 which was to act as a carrier of the selenium1 he described under the name 8cytotrochin10 from the ,greek word trochia1 meaning road4 ,for this purpose he selected eosin4 ,the eosin and the selenium were then combined by a method and in a form the details of which have never been published4 ,all that we know of this preparation is contained in the statement that it is very difficult to produce1 and that it is extremely unstable and difficult to keep4 ,mice can be given amounts of from #b to #c mg4 of this substance in solution4 ,wassermann experimented with mice inoculated with transplanted tumors of the types of carcinoma and sarcoma4 ,after from three to five intravenous injections of the drug1 he noted that the tumors become softer and fluctuate4 ,after still further injections the fluid mass undergoes absorption1 and the tumor gives the impression of an empty sac4 ,if it is possible to carry the injections up to the number of ten or twelve1 recovery ensues4 ,in such cured animals there remain only the unabsorbed portions of the fibrous capsule4 ,recurrences were not observed in the cured animals4 ,wassermann further stated that two spontaneous tumors in mice which had been treated by this method presented favorable results4 ,wassermann's original presentation gave few experimental details1 and has not been followed by the promised scientific report4 ,from his article it is impossible to determine what proportion of his animals were cured and what proportion failed to survive the treatment4 ,from a later paper by ,keysser#bgj we learn that by far the larger portion of the animals perished during the treatment in the stage of softening1 so that a cure was accomplished in from only #c to #e per cent4 of the animals4 ,this is a point of great importance1 inasmuch as it furnishes an indication of the highly dangerous character of this mode of treatment4 ,fatal results are attributed by ,keysser to the absorption of toxic products from the tumor4 ,this contention1 however1 is supported by no observations1 and it is certainly equally fair to assume that death results from the toxic effects of the compound4 ,a microscopic study of tumors taken from animals undergoing treatment was made by ,hansemann4 ,he found that the death of the cells was the result of nuclear destruction4 #bgj ,keysser3 ,wien4 klin4 ,wchnschr4 #bf3affd1 #aiac4 ,within a very few months after ,wassermann's publication1 ,neuberg and ,caspari#bfh published a paper which was the first of a series of studies on the therapeutic effects of the heavy metals on the animal tumors4 ,they used zinc1 platinum1 tin1 selenium1 copper1 silver and cobalt in the form of certain complex organic compounds1 the composition of which is not revealed4 ,owing to the fact that intravenous injections of these compounds produced a specific effect on the tumors1 they are described as 8tumoraffin0 substances4 ,immediately after the intravenous injection of these preparations1 there followed a marked hyperemia of the tumor1 whereas the remainder of the mouse's body appeared markedly anemic4 ,the hyperemia was often attended by hemorrhage into the tumor4 ,this first stage was succeeded by liquefaction and absorption followed by recovery in favorable cases4 ,the authors failed to state in what proportion of their experiments the animals died1 and in what proportion recovery ensued4 ,the second paper on this subject is by ,neuberg1 ,caspari and ,lhe1#bfh in which further details are vouchsafed4 ,they state that with the compounds used by them the toxic and the therapeutic doses approximate very closely1 from which it follows that the treatment1 as with the ,wassermann method1 results in a very high mortality4 ,smaller doses produce no therapeutic effect2 on the contrary1 they seem to act as a stimulus to the tumor1 accelerating the normal rate of growth4 ,spontaneous tumors show similar effects1 but no cures are recorded4 ,only in tumors in which autolysis is active intra vitam does the method exert any effect4 ,consequently the benign primary tumors of animals1 such as fibromas1 are not influenced by it4 ,neuberg and ,caspari are to a great extent responsible for the colloidal theory of treatment in tumors4 ,accepting the observations of ,petri and others that the autolytic ferments in tumors are quantitatively greater and qualitatively different from those present in the normal tissues of the body1 they venture the assumption that the process of recovery in the experimental tumors of animals is due to the self-digestion of the tumor by these ferments4 ,ascoli and ,izar#bga had shown that such ferments are materially stimulated by the presence of metals1 and more especially of metals in colloidal form4 ,this contention is apparently in harmony with the well-established fact that certain colloidal metals of themselves are capable of acting under certain circumstances as ferments4 ,neuberg and ,caspari were at first of the belief that the compounds produced by them circulate in colloidal form4 ,subsequently they stated that these compounds were crystalline substances1 but they assumed1 under the influence of the theoretical consideration mentioned above1 that these substances are broken up in the tumor and there undergo transformation into the colloid state4 #bga ,izar3 ,ztschr4 f4 ,immunittsforsch41 #aiac4 ,izar and ,basile3 ,berl4 klin4 ,wchnschr41 #aiac1 p4 #acab4 ,in connection with the preceding observations there are certain other experimental results which require mention4 ,izar#bga succeeded in curing rat tumors by means of injection of colloidal sulphur4 ,c4 ,lewin#bgb cured subcutaneous mouse tumors with various preparations of gold4 ,werner and ,szcsi#bgc produced similar results through a combination of selenium-vanadium with cholin-borate2 in these experiments the selenium-vanadium was supposed to be present in colloidal form4 #bgb ,lewin1 ,carl3 ,berl4 klin4 ,wchnschr41 #aiac1 p4 #adg2 ,berl4 klin4 ,wchnschr41 #aiac1 p4 #eda4 #bgc ,werner and ,szcsi3 ,ztschr4 f4 ,chemotherap41 #aiac1 ,orig41 i1 #ceh4 ,szcsi3 ,ibid41 ref41 #aiac1 ii1 #ajfj4 ,within a comparatively brief period of time1 therefore1 it fell to the lot of a number of observers1 using strikingly different substances1 to produce therapeutic effects amounting in a certain percentage of cases even to cure in the experimental tumors of the lower animals4 ,the various procedures have little in common4 ,both metals and nonmetallic substances have been employed either in colloidal form or in combination with organic radicals4 ,in some instances a diffusible carrier is combined with the basic substances2 in others not4 ,all of the preparations appear to possess a high degree of toxicity1 although adequate data on this very essential feature are almost invariably withheld4 ,wassermann's results with eosin-selenium were soon critically examined by other observers4 ,uhlenhuth#bgd and ,contamin#bge were unable to confirm his observations1 but their negative results are attributed by ,keysser to the fact that they were not in possession of the proper formula for the preparation of the eosin-selenium compounds as used by ,wassermann4 ,apolant1#bgf however1 in ,ehrlich's name confirmed ,wassermann's findings4 #bgd ,uhlenhuth1 ,dold and ,bindseil3 ,ref41 ,mnchen4 med4 ,wchnschr41 #aiab1 p4 #aghb4 #bge ,contamin1 ,detoeuf and ,thomos3 ,bull4 de l'assn4 fran4 pour l'tude du cancer1 vi1 #fb4 #bgf ,apolant1 ,h43 ,,vi ,tag4 der freien ,vereinigung fr ,mikrobiologie41 ,berlin1 #aiab4 ,ref4 ,mnchen4 med4 ,wchnschr41 #aiab1 p4 #fei4 ,the most important critique of eosin-selenium has been contributed by the subsequent investigations of one of ,wassermann's original collaborators1 ,f4 ,keysser4#bgg ,keysser's publication contains a large number of very careful observations on the various forms of eosin supplied by the ,german manufacturers1 as well as on other matters which cannot here be considered in detail4 ,he finally reached the conclusion that the eosin furnished by the manufacturing house of ,sandoz was the most effective for his purposes1 inasmuch as it combined the lowest grade of toxicity with the highest capacity for discoloring the tissues4 ,the selenium he used in the form of selenio-vanadium furnished by ,clin of ,paris1 which was the identical preparation used by ,werner and ,szcsi in combination with borcholin4 ,the maximum dose of this selenio-vanadium is #j4jf c4c4 for each gram of mouse4 ,eosin1 #j4ja gm41 dissolved in #j4e c4c4 of physiologic salt solution1 is mixed with #j4e c4c4 of the selenio-vanadium4 ,this mixture is then used for intravenous injections4 ,the results produced by the injection of this mixture are to all intents and purposes similar to those obtained by ,wassermann1 except that ,keysser induced cure in a larger proportion of animals1 namely1 from #f to #h per cent4 ,it is evident from his careful description of his experiments that the treatment is extremely toxic to the animals4 ,the therapeutic dose is considerably greater than one-half the toxic dose4 ,this accounts for the fact that an extremely large proportion of the animals perish during the course of the treatment4 ,the tumors failed to be influenced unless the dose given fell very little short of the fatal amount4 ,moreover1 in order to accomplish a complete cure1 at least eight to ten injections must be given1 and in some instances not less than fourteen4 #bgg ,keysser1 ,f43 ,ztschr4 f4 ,chemotherap41 #aiad1 ,orig41 ii1 #ahh4 ,keysser's most important conclusions1 however1 were obtained by following an altogether different line of procedure4 ,it has been pointed out by ,carl ,lewin#bgb that the therapeutic results obtained from subcutaneous mouse tumors1 however encouraging1 could not be logically applied to the treatment of human cancers4 ,the subcutaneous transplanted tumors1 as is well known1 are as a rule limited by a distinct capsule and show no tendency to infiltrative growth4 ,in this particular they present a most striking difference when compared with human tumors4 ,on the other hand1 the metastases of mouse tumors in the internal organs present an infiltrative mode of growth and thus approximate very much more closely to the human type of tumors4 ,keysser1 therefore1 determined to test the therapeutic effectiveness of his compounds on tumors implanted in various organs4 ,he developed a technic which enabled him to implant tumors in the liver1 the spleen1 the kidneys and other parts of the mouse by means of injection through special needles1 often without the assistance of a cutting operation4 ,the tumors so implanted grew rapidly1 and within from two to three weeks reached the size of cherry pits4 ,the growth was characteristically infiltrative4 ,animals with these tumors were then submitted to intravenous injection of the therapeutic agents in exactly the same fashion as the animals carrying subcutaneous tumors4 ,the results1 however1 were absolutely different4 ,whereas the subcutaneous tumors invariably showed a much more intense discoloration than the other tissues of the mouse1 this feature was entirely lacking in the case of the internal tumors4 ,softening and liquefaction1 which almost invariably follows on the third or fourth injection in the case of subcutaneous tumors1 and which is the first symptom of cure1 never presented itself in the case of the internal tumors4 ,their consistency throughout the treatment was indistinguishable from that of the tumors of control animals4 ,the treatment1 in fact1 appeared to exercise not the slightest influence on internal tumors4 ,there was neither cessation nor retardation in growth1 but the tumors continued their normal rate of destructive increase with the production of metastases1 leading eventually to the death of the animal either during the course of the treatment or shortly thereafter4 ,microscopic changes1 such as had been observed by ,hansemann in the case of subcutaneous tumors1 were entirely lacking4 ,no matter in what organ the tumors were implanted1 these results remained the same4 ,no matter what type of tumor was employed1 whether carcinoma1 adenocarcinoma or sarcoma1 the therapeutic outcome was regularly and consistently nil4 ,these results induced ,keysser to determine whether or not eosin-selenium could actually be shown to exercise a deleterious effect on cancer cells outside the body4 ,in order to do this he made a suspension of mouse tumor cells in salt solution and mixed this with the eosin-selenium-vanadium1 using the latter in amounts equivalent to three times the fatal dose for a mouse4 ,after the mixture had stood from one to three hours1 it was injected either subcutaneously or intravenously into mice in order to test the vitality of the cells4 ,in every instance the injections resulted in the production of tumors which could be in no way distinguished from the tumors produced by untreated cancer cells4 ,in other words1 the therapeutic preparation had absolutely no effect on the tumor cells4 ,in the same way ,keysser carried out experiments along the lines inaugurated by ,neuberg1 using a combination of glycocoll and copper4 ,he also tested the combination of borcholin with selenium-vanadium used by ,werner and ,szcsi4 ,he was able to confirm the fact that both of these substances produced an unmistakable therapeutic effect on subcutaneous tumors4 ,on the other hand1 they were absolutely without influence on the internal tumors4 ,in this respect1 therefore1 they were entirely comparable with the eosin-selenium compound4 ,the theoretical basis constructed by ,neuberg1 which rests on the assumption that the metallic compounds stimulate autolytic processes in the tumors1 was also subjected by ,keysser to destructive criticism4 ,finally1 ,keysser showed that none of these therapeutic agents were effective even in the case of subcutaneous tumors1 unless the latter had reached at least the size of cherry pits4 ,if a therapeutic injection were made immediately after inoculation of the tumors1 no effect was observed4 ,the tumors grew exactly as in the control animals1 and the injected animals died in about the same period of time as they4 ,all of these facts1 which taken together constitute a very remarkable and convincing piece of scientific investigation1 permit of but one conclusion4 ,it is quite clearly established that none of the preparations of which the therapeutic effectiveness has hitherto been proclaimed exercise any direct influence on the life or development of the tumor4 ,under certain very definite and restricted conditions1 however1 they do appear to produce certain changes in the tumors1 and in a small proportion even cures4 ,these results1 however1 are obtained only in the case of tumors which are subcutaneous in location and not smaller than a cherry pit in size4 ,keysser's interpretation of the striking differences between tumors is of interest in this connection4 ,he believes that the constant palpation and examination of the subcutaneous tumors1 which is prompted by interest in the experiment1 produces circulatory changes with hyperemia and hemorrhage4 ,these circulatory changes are responsible for the increased tendency of the injected substances to lodge in the tumors1 thereby possibly increasing the tendency to autolysis which the circulatory changes have inaugurated4 ,it is1 of course1 questionable whether this explanation can be regarded as final4 ,in a series of experiments which ,i performed many years ago1 ,i was able to show that sodium iodid when injected intravenously accumulates in tumors in larger amounts than in any other tissue of the body in rats4 ,a similar observation has been recorded by ,wells1 ,de ,witt and ,corper4#bgh ,in the same way ,i found that various dyes1 such as ,congo red1 when injected intravenously1 could be demonstrated in tumors long after the rest of the body had recovered its normal color2 the liver alone vied with the tumors in this respect4 ,the dyestuff was invariably sharply localized in the necrotic portions of the tumor4 ,the conclusion seemed obvious that1 owing to circulatory conditions or possibly even to chemical conditions1 the dye was retained longest in the necrotic parts of the tumor4 ,this effect was unquestionably not due to handling1 inasmuch as the animals in my experiments were not palpated from the time of injection until death4 #bgh ,wells1 ,h4 ,g41 ,de ,witt1 and ,corper3 ,ztschr4 f4 ,chemotherap41 #aiad1 ,orig41 ii1 #aaj4 ,i have1 however1 had an even more striking demonstration of the same fact4 ,i have given intravenous injections of dyes to patients suffering with various forms of internal tumors1 as1 for example1 cancer of the breast1 in the hope of favorably influencing the growths4 ,at operation1 the picture presented by the tumor is striking in the extreme4 ,it presents areas of various size which are intensely discolored by the dye4 ,these areas1 both to the naked eye and under the microscope1 are the necrotic parts of the tumor4 ,the actively growing areas of tumor tissue and all the normal tissues of the organ present their normal color4 ,all of these observations lead to the conclusion that the necrotic areas in tumors either possess a higher affinity for sodium iodid and for the dyes than do the normal tissues1 or that these substances are more slowly absorbed from the necrotic areas owing to the circulatory deficiency4 ,whichever of these explanations is accepted1 it is quite reasonable to believe that necrotic areas might well undergo liquefaction under the influence of the various substances which have been used for therapeutic injection4 ,such a result is1 of course1 without direct effect on the growth or vitality of the living part of the tumor4 ,this fact is quite clearly evidenced by the experimental data1 which show that the internal portions of the tumor might undergo liquefaction and yet the tumors were not cured4 ,indeed1 ,lhe1 who made microscopic examinations of the tumors treated by ,caspari and ,neuberg1 states particularly1 with reference to a tumor which had been subjected to treatment1 that 8the central portion of the tumor showed softening1 while the external margin was composed of actively growing cells40 ,the central portions of implanted tumors are1 of course1 those which first undergo spontaneous necrosis4 ,it still remains to explain the small percentage of cures achieved by ,wassermann and by ,keysser4 ,it does not appear to me that this problem presents any insuperable difficulties4 ,the fact must be emphasized that practically #ie per cent4 of the animals die under the treatment1 which sufficiently indicates the toxic effects of the agent used4 ,we must remember that transplanted tumors are under all circumstances at a certain disadvantage as compared with the normal tissues of the body4 ,after all1 they are implanted on a foreign soil4 ,their blood supply is impoverished and imperfect4 ,they have a natural tendency to undergo necrosis1 and in many cases spontaneous retrogression4 ,it is not strange1 therefore1 that they should prove in slight degree more susceptible to toxic effects than are the normal tissues of the body4 ,if we remember that the various therapeutic agents introduced in all probability reach a somewhat higher degree of concentration in the necrotic areas of the tumor than in the normal tissues of the body1 an assumption which is entirely in accord with the facts as observed in the case of sodium iodid and of various dyes1 we may be quite prepared to believe that this factor is sufficient to induce the destruction of the marginal healthy and living cells of the tumor4 ,the fact that small subcutaneous tumors were found by ,keysser to be entirely refractory to the treatment is entirely in accord with this assumption1 in view of the fact that tumors of this size present practically no central necrosis4 ,the same explanation holds of the observation previously cited from ,caspari that the primary spontaneous tumors of animals do not yield to the treatment4 ,indeed1 he himself states that the treatment is effective only in tumors in which autolysis takes place during life4 ,the word autolysis1 however1 in this connection is a misnomer and represents a gratuitous assumption2 as an actual fact1 one is entitled to say only that such tumors undergo central necrosis1 in all probably owing to defective circulatory supply4 ,the process is exactly similar to the coagulation necrosis described in the case of tubercles by ,weigert4 ,if autolysis occurs1 it is only secondary to the preceding necrosis4 ,this explanation1 however1 is confronted by the fact that the internal tumors produced by ,keysser showed no tendency to effect a localization of the dyes1 and correspondingly no tendency to be affected by the therapeutic agents4 ,one might be permitted to inquire whether these internal tumors had undergone any necrosis4 ,keysser unfortunately makes no mention of this matter4 ,it is certainly true that the infiltrative mode of growth of the internal tumors1 which is entirely different from that of the subcutaneous implantations1 is associated with a much better blood supply and a lessened tendency to undergo necrosis4 ,that such tumors can undergo necrosis1 however1 is evidenced by certain illustrations given by ,carl ,lewin in his paper on internal tumors4 ,but such changes usually occur only in advanced stages4 ,to judge from his plates1 ,keysser worked with relatively small tumors1 an assumption which is rendered even more likely by the fact that his injections were undertaken in a fairly early stage of their growth4 ,in this connection ,i may quote certain experiments of my own on internal tumors4#bgi ,the implantations made in my experiments were produced by intravenous injections of a tumor suspension into the jugular vein of rats4 ,such injections resulted almost invariably in the production of a large number of tumors in the lungs1 which1 as is well shown in the figures accompanying the original article1 differed very markedly in size4 ,the smaller of these tumors are composed throughout of actively growing cells1 while the large tumors present an area of central necrosis exactly as do the subcutaneous tumors4 ,if such an animal be given an intravenous injection of a dye such as ,congo red1 it will be found that the larger tumors present an area of central discoloration corresponding to the area of previous necrosis1 while the smaller tumors1 like normal tissues1 are not colored4 ,thus1 it is clear that the internal tumors implanted in animals are subject to the same laws concerning the distribution of dyes and1 of course1 other substances as are the subcutaneous tumors4 ,as ,i have stated previously1 an exactly analogous observation has been made in a human breast tumor4 ,in the absence of any contradictory evidence1 therefore1 ,i think that it is perfectly justifiable to assume that ,keysser failed to achieve a result in the internal growths simply owing to the fact that those growths presented practically no areas of necrosis at the time of his injection4 #bgi ,j4 ,m4 ,research1 #aiac1 p4 #dig4 ,another theoretical question which bears closely on the recent therapeutic investigations in human beings concerns the rle of colloids1 as such1 in the procedure4 ,it is quite clear from what has already been said that all experiments with animal tumors have been largely influenced by the belief that metals in the colloidal form exercise a peculiar and characteristic influence on the destruction of tumors4 ,even when the therapeutic agents have been introduced in crystalline form1 as by ,neuberg and ,caspari1 the authors find themselves compelled to assume that the metals are reduced to colloidal form within the tumors4 ,for the latter assumption there is absolutely no evidence2 it is due simply to the influence of the colloidal theory4 ,if one critically examines the data on which this theory is based1 one is forced to the conclusion that it has practically no established claim to validity4 ,if we grant that colloidal metals have been shown to stimulate autolysis in the test tube1 the same fact must be admitted of metals in noncolloidal solution4 ,the experiments1 however1 are very far from establishing either of these facts satisfactorily4 ,but even were this the case1 it is an unjustifiable inference that living tumor cells would be influenced in anything like the same manner as are the dead cells observed in test tube experiments4 ,as an actual fact1 we know from the work of ,evans and ,schulemann that only the 8scavenger cells0 of the body take up foreign colloids1 and to this class the tumor cells do not belong4 ,moreover1 the form in which metals are introduced into the circulation is not necessarily or even probably the form in which they act on the tissues4 ,colloidal solutions of the metals are certainly subject to precipitation and other changes on entering the blood4 ,this fact ,i have shown experimentally in a previous study on colloidal copper4#bhj ,in the same way it is probable1 as has been pointed out by ,wells1 that metals when introduced in crystalloid form may rapidly be altered so that they are carried throughout the body in colloidal form4 ,all of these considerations indicate how unjustifiable is the assumption that colloidal metals exercise a peculiar action on growing tumors4 ,it is hardly surprising that their empiric use has failed to measure up to expectations based on so slim a foundation of fact4 #bhj ,weil1 ,richard3 ,the ,effects of ,colloidal ,copper with an ,analysis of the ,therapeutic ,criteria in ,human ,cancer1 ,j4 ,a4 ,m4 ,a4 #fa3ajcd 7,sept4 #bg7 #aiac4 ,,clinical ,,observation ,clinicians have not been slow in following the lead suggested by the therapeutic experiments in animals4 ,it is perfectly proper that this should be the case4 ,in dealing with a disease of the character of cancer1 in many instances entirely beyond our power to influence1 no one can question the advisability of trying any and every agent which holds out the slightest promise4 ,unfortunately1 a closer analysis of the animal experiments fails to vindicate even that degree of faith4 ,when one considers the facts which have been analyzed in the preceding discussion1 it would appear not only futile but actually dangerous to attempt to benefit cancer sufferers by means of any of the agencies which have been employed in animal experimentation4 ,nevertheless1 the fact remains that a variety of preparations have been used in the human clinic4 ,the various types of preparations may be satisfactorily grouped under four classes1 namely3 #a4 ,the crystalline salts of selenium4 #b4 ,selenium in colloidal solution4 #c4 ,other metals in colloidal solution4 #d4 ,compounds of metals with organic radicals4 ,these substances have been administered by injection or by the mouth4 ,in the case of injection1 the injections have been made either into the subcutaneous tissues1 intramuscularly1 or intravenously1 or finally1 directly into the tumors4 ,before passing to a further consideration of this subject in detail1 it may be well to recall the fact that in the experimental tumors of animals1 no matter what preparation has been used1 it has been possible to accomplish therapeutic effects only by the use of relatively enormous doses of the medicament1 of doses1 in fact1 which were scarcely lower than the lethal dose4 ,certain experimenters have noted that smaller doses actually stimulated the growth of the tumors4 ,in the second place1 it has almost invariably been found necessary to administer the treatment intravenously1 inasmuch as the other modes of administration failed of therapeutic effect4 ,it is quite apparent that a procedure in human beings in any degree analogous to that pursued in animals is entirely impossible4 ,the doses used1 with one notable exception to be subsequently mentioned1 have invariably been relatively small4 ,hence it is apparent at the outset that at least one fundamental condition of success in the treatment of animal tumors has been necessarily excluded in the clinical application4 ,the salt used by ,wassermann is not stated in his original publication4 ,wolff#bha speaks of it as a sodium salt1 whereas ,keysser says that it was a combination with potassium cyanid4 ,in only one instance1 as far as ,i am aware1 has the sodium salt been used therapeutically in human beings4 ,delbet#bhb states that he employed this salt intravenously in one case1 and that its use was shortly followed by death4 ,unquestionably the salts of selenium are very much too toxic to be used in this way4 #bha ,wolff3 ,die ,lehre von der ,krebs ,krankheit #c3aiac4 #bhb ,delbet1 ,p43 ,bull4 de l',assn4 fran4 pour l'tude du cancer #e3aba1 #aiab2 ibid4 #f3he1 #aiac4 ,the majority of those who have worked with selenium have used it in colloidal form1 either preparing it themselves or employing one of the preparations put on the market by the pharmaceutic firms4 ,of the latter the best known are the electro-selenium of ,clin1 and the ,seleniol of ,couturieux4 ,of those who have made use of selenium in these forms may be mentioned ,cade and ,girard1#bhc ,bougeaut and ,galliot1#bhd ,blumenthal1#bhe ,thiroloix and ,lancien1#bhf ,delbet1 ,laurent and ,bohec1#bhg and most extensively of all1 ,m4 ,touche4#bhh ,all of these authors have described cases of malignant new growths of the most varied character which were treated by these preparations4 #bhc ,cade and ,girard3 ,bull4 ,soc4 md4 d4 hp4 de ,lyon #aa3cig1 #aiab4 #bhd ,bougeaut and ,galliot3 ,clinique1 ,paris #g3eja1 #aiab4 #bhe ,blumenthal1 ,a43 ,jour4 md4 de ,bruxelles1 #aiab1 #ag3cbe2 ,presse md4 belge #fe3iai1 #aiac4 #bhf ,thiroloix and ,lancien1 ,a3 ,bull4 et mm4 ,soc4 md4 d4 hp4 de ,paris #cc3aig1 #aiab4 #bhg ,laurent1 ,m41 and ,bohec1 ,j43 ,med4 ,press and ,circular #id3dfa1 #aiab4 #bhh ,touche1 ,m43 ,bull4 et mm4 ,soc4 md4 d4 hp4 de ,paris #ce3dea1 #aiac4 ,the results obtained are fairly concordant4 ,the intravenous injection of the preparation produces but slight disturbance4 ,there is leukocytosis1 a moderate rise of temperature1 and not infrequently a chill4 ,otherwise the substance seems to possess no toxicity4 ,the effects produced on the tumors have almost invariably been described as encouraging4 ,touche1 who treated twenty-seven cases in this way and has described each case in detail1 states that under the treatment the surface of the tumors1 if ulcerated1 became cleaner and healthier2 the tumors became softer2 the rate of growth was arrested1 and there was relief of pain and of the accompanying functional disturbances2 often1 too1 there was a gain in weight and an improvement in general well-being4 ,touche concludes his article with the statement that 8it is certain that the effect is not curative but it is actually palliative40 ,delbet1 on the other hand1 states that he has seen no beneficial effects from the use of colloidal selenium injected intravenously4 ,in the discussion on ,delbet's paper1 ,ledoux-,lebard states that he has observed nothing from selenium further than the temporary improvement which is shown by almost all cancer cases on the application of any new therapeutic measure4 ,in one or two instances the claim is made in the literature of an actual cure of malignant growth through the use of selenium4 ,such1 for example1 is the case described by ,blumenthal4 ,from the clinical description this might have been a cancer of the tongue1 and was judged to have been such in view of the negative ,wassermann reaction4 ,no microscopic examination was made4 ,arsphenamin was given4 ,the patient recovered4 ,it is clear that instances of this type cannot be accepted as beyond criticism1 and it is safe to say that nothing more convincing in the way of actual cure is offered in the rather voluminous literature on the use of selenium4 ,numerous compounds of selenium1 some of them claiming to circulate in colloidal form1 have been described1 and have been put on the market for use in malignant disease4 ,such are ,walker's sulpho-selene1 and selenio-vanadium1 which has been prepared in the form of an ointment by ,schering and ,glatz4 ,these preparations lay claim to the same palliative effects which have been previously described for colloidal selenium4 ,of the other metals in colloidal form1 chiefly silver and copper have come into use4 ,colloidal silver was first recommended for malignant growths by ,vogel4 ,it is obtainable on the market in proprietary form under the name of fulmargin1 and also as electrargol4 ,recently ,rohdenburg#bhi has made a careful study of the effects of colloidal silver in experimental and in human tumors1 and finds that they have no value4 ,colloidal copper has been used in recent times for the same purpose by ,gaube du ,gers and by others4 ,i have recently examined the effects of colloidal copper on malignant tumors in man1 and have been unable to find that it has any therapeutic value4 ,furthermore1 a study of the distribution of the copper in tumors obtained at operation or by necropsy from individuals so treated failed to show that the copper had been deposited therein4 #bhi ,rohdenburg1 ,h43 ,j4 ,m4 ,research #bf3cca1 #aiae4 ,finally1 preparations similar to those used by ,werner and by ,caspari in animals have also been used in human beings4 ,in these cases also the authors have been able to record palliative effects on the tumor1 but in no instance cures4 ,we have seen that it has been quite impossible to duplicate in human beings the therapeutic technic employed in animal experiments4 ,we have seen further that the use of a modified technic in animal experimentation has never been productive of favorable results even at the hands of enthusiastic adherents4 ,in striking contrast to these conclusions are the observations made in human therapeutics4 ,for every type of preparation described in the preceding paragraphs1 the claim has been made practically without exception that it exercises a markedly beneficial effect on malignant diseases in the human being4 ,not only are the subjective symptoms alleviated1 but also the tumors appear to become cleaner and softer2 the rate of growth is retarded2 necrosis and metastasis are prevented1 and inoperable tumors become operable4 ,how are we to interpret these observations8 ,how are we to explain the fact that they are the almost invariable accompaniment of the most diverse methods of treatment8 ,i have already quoted the statement of ,ledoux-,lebard that every therapeutic novelty appears to exercise a favorable effect on cancer cases4 ,the same fact has been observed in a variety of other diseases1 such as locomotor ataxia4 ,in order to arrive at a safe and reliable estimate as to the value of any new or experimental procedure in cases of cancer1 it seems advisable to accept certain definite therapeutic criteria by which the cases are to be judged4 ,in the absence of such a method1 alterations in symptoms which are actually of no real value or importance receive undue emphasis4 ,the natural course of the disease is associated with such fluctuations that a sanguine therapeutist can gain some encouragement from even the most hopeless cases4 ,hence it follows that every mode of treatment has found adherents4 ,the market is flooded with cancer drugs1 and cancer charlatans flourish in the most highly educated communities4 ,unfortunately1 even well trained1 honest and reputable physicians have fallen victims to this fallacy1 and have lent their names to the support of modes of treatment which in reality produce no determinable effect on the natural evolution of the disease4 ,it was the desire to combat this unfortunate tendency which led me some time ago to attempt to establish a reliable set of criteria of therapeutic effects in cancer4 ,these were embodied in an article#bhj which appeared two years ago1 and ,i may be here permitted to quote them in extenso3 ,,criteria ,,of ,,therapeutic ,,effects ,in determining the effects of any given mode of treatment on a tumor1 a variety of criteria may be relied on4 ,circulatory changes in the tumor1 the relief of pain and the restoration of a secondarily impaired function are certain of the criteria on which stress has been laid by the majority of observers in the past4 ,important as are these criteria in determining the progress of purely inflammatory processes1 it is unquestionable that their value in judging of the effects of therapeutic methods when applied to malignant disease is open to criticism4 ,it is a curious and interesting fact that almost every therapeutic claim made in recent years in connection with cancer has included among its virtues the relief of pain4 ,this is true of vaccination with cancer tissue1 of ,hodenpyl's method and of many others4 ,in view of this very general effect1 not much stress can be laid on this symptom1 and it is probably fair to assume that in the great majority of these cases the result is in no small measure psychic4 ,the improvement of function is also largely a subjective phenomenon1 and as such requires most careful criticism4 ,osler relates that he has known a patient with gastric cancer to be relieved of digestive disturbances and to gain #ah pounds in weight as the result simply of the visit of a sanguine consultant who denied the presence of a tumor4 ,improvement in the ability to chew food1 to articulate words or to move a limb are phenomena familiar to those who attempt to treat cases of cancer4 ,the victims of this disease seem to be in a very high degree 8suggestible0 and impressionable and respond nobly to every therapeutic effort4 ,circulatory changes in tumors offer an interesting group of clinical symptoms4 ,the observation has often been made1 especially in ulcerated new growths1 that treatment is associated with swelling1 peripheral hyperemia1 and an altered character of the discharge4 ,in spite of the fact that there is no reasonable relationship between this congeries of symptoms and the actual cure of the tumor1 they generally receive considerable emphasis and are cited as an indication of the specific local action of the agent employed4 ,it is also true1 however1 that the growth may continue to advance in spite of their presence4 ,it is of some importance to inquire into the mechanism which produces these circulatory changes and into their clinical interpretation4 ,it is a well known fact that many drugs1 when introduced into the body either by the mouth or through the skin1 are excreted not only by the normal channels of elimination1 such as the kidney or the intestine1 but also from such ulcerated surfaces as may be present on the body4 ,this is easily shown to be true1 for example1 of certain of the anilin dyes1 which1 when introduced by way of the veins1 produce an intense discoloration of the dressings over ulcers4 ,it is likewise true of certain of the metals1 such as arsenic4 ,in order to understand the series of events previously enumerated it is therefore only necessary to assume that the therapeutic agent is excreted from the ulcerated surface of tumors4 ,if an irritant1 it will tend to produce hyperemia of the margins of the ulcer1 and an increase of the secretions4 ,if an astringent1 however1 it may produce just the opposite of these effects4 ,such a result1 however striking1 is purely accidental1 and has no necessary bearing on the growth or destruction of the tumor itself4 ,it constitutes a symptom on which no reliance should be placed4 ,excluding from consideration all of these secondary factors1 we may conclude that the observation of the size of the tumor itself is the sole criterion on which we can place reliance in judging of the effect of therapeutic measures4 ,this implies1 in the first place1 that a tumor must be accessible to fairly accurate measurement4 ,tumors of the uterus1 for example1 and intra-abdominal growths will only exceptionally fall into this class4 ,in the second place1 indirect evidence of a decrease in the size of tumors1 such as is afforded by the increased permeability of obstructed passages1 as in the case of tumors of the esophagus1 pylorus or intestine1 must be accepted only with great reserve4 ,remissions in the obstructive symptoms characteristic of such tumors are a frequent feature of the normal evolution of the clinical history of such growths4 ,the relief of obstruction1 however1 may be due either to necrosis of the obstructing portions of the tumor1 while the remainder continues to grow progressively1 or to a relief of the accompanying muscular spasm4 ,finally1 evidence of decrease afforded by the roentgenogram is not sufficiently exact in most cases to afford ground for so important a conclusion as that at present in question4 ,not only must there be unquestionable evidence1 however1 of the diminution in size of the tumor1 but this diminution must be of a kind not ordinarily attributable to the natural evolution of the tumor4444 ,it is safe to say that multiple tumors offer enormous difficulties in the matter of interpreting therapeutic results4 ,at present we have in the wards of the hospital a patient with multiple metastatic carcinomas of the skin4 ,for several months we have at intervals made accurate measurements of certain of these tumors and have found that some have undergone retrogression1 others have entirely disappeared1 while still others have continued to grow steadily4 ,in the case which afforded the ascitic fluid used in ,hodenpyl's experiments1 many of the lymphatic metastases underwent complete retrogression1 while the metastatic process in the liver1 as was demonstrated at necropsy1 increased progressively1 and ultimately almost destroyed that organ4 ,thus1 in multiple carcinosis1 the retrogression of individual nodules is no indication that therapeutic intervention has produced an improvement4 ,i shall not delay to emphasize those variations in the size of solid tumors which accompany hemorrhage and its absorption1 edematous swelling1 necrosis in the depths1 and other familiar factors which clinically simulate1 or induce1 the softening and the reduction that are so often attributed to therapeutic interference4 ,but it is important to draw attention to a similar feature in that type of superficial epithelioma known as rodent ulcer4 ,these new growths not infrequently advance at one point of the periphery1 while they recede at another1 and thus cicatrization and contracture may simulate a partial recovery4 ,this effect is due in part to alterations not in the growth itself1 but in the accompanying ulcerative process4 ,the secretions from the growths1 especially if confined under dressings1 may have eroded and destroyed the surrounding skin1 and it is tempting to interpret a recession of the associated ulcerative disease as an indication of a favorable effect on the new growth4 ,it is unquestionably this aspect of rodent ulcers which plays so generously into the hands of the numerous venders of nostrums for this disease4 ,in brief1 the demonstrable reduction in size of a tumor1 of a kind not to be attributed to the natural processes of evolution of that tumor or of its associated lesions1 is the one essential feature of effective therapeutic intervention4 ,when the various methods of treatment which have been discussed in this paper are judged by the standard advocated above1 it is apparent that none of them can lay claim to therapeutic effectiveness4 ,the modifications of the disease attributed to them are modifications which occur spontaneously in a very large proportion of cases as a result of the natural evolution of the disease process4 ,this is a fact which cannot be too strongly emphasized4 ,owing unfortunately to the hopeless character of cancer1 men are not prone to study with care all the lesser changes which the disease and the patient present under ordinary conditions2 but when a 8cure0 is under investigation1 the patient and his medical attendant note every apparent improvement with painstaking attention and enthusiasm4 ,as a result1 some evidence of improvement in treatment is entered on the books4--7,from ,the ,journal ,a4 ,m4 ,a41 ,april #ag1 #aiae47 ,,the ,,direct ,,sales ,,company ,during the past four or five years1 ,the ,journal has had inquiries similar in effect to this1 just received from ,dr4 ,e4 ,p4 ,jewett of ,gardner1 ,mass43 8,will you kindly inform me regarding a drug manufacturing company by the name of the ,direct ,sales ,company1 ,buffalo1 ,new ,york8 ,are their products standard and reliable so far as you know80 ,the ,direct ,sales ,company1 ,inc41 ,buffalo1 has1 according to its letterhead1 the following officers3 ,geo4 ,j4 ,dotterweich1 ,president and ,treasurer1 ,c4 ,k4 ,dotterweich1 ,vice-,president1 ,louis ,b4 ,seufert1 ,secretary4 ,this concern circularizes physicians and emphasizes that it sells 8,only by ,mail40 ,it also features a 8profit sharing rebate0 scheme1 whereby purchasers receive a coupon representing #aj per cent4 of the invoice value of each purchase4 ,after #ajj worth of merchandise has been purchased the #aj worth of coupons when 8presented for redemption at one time0 will be 8honored as cash0--presumably on the purchase of additional goods4 ,the ,direct ,sales ,company catalogues have for some years1 carried a guaranty1 which reads1 in part3 8,we absolutely guarantee all preparations to be in exact accordance with the ,national ,pure ,food and ,drugs ,act1 ,june #cj1 #aijf4 8,we also absolutely guarantee all preparations bearing our label to be equal1 if not superior1 to any on the market40 ,in one of the ,quarterly ,bulletins of the ,state ,board of ,health of ,new ,hampshire1 issued last year1 this paragraph appeared3 8,the ,direct ,sales ,company1 ,inc41 ,buffalo1 ,n4,y41 is a pharmaceutical concern which until recently has done business direct with ,new ,hampshire physicians4 ,in two or three instances complaints have been received by this department that the preparations sold seemed to be lacking in potency4 ,some time ago a physician sent us a specimen of codein sulphate tablets1 one-fourth grain1 concerning which he was suspicious1 admission being made that the price paid was very much less than current quotations4 ,the amount of codein sulphate actually found per tablet proved to be but one-sixteenth grain4 ,later on1 having subsequently received a new lot from this source1 the same physician sent us a second sample1 the composition of which was found to be practically identical with the first4 ,acting under the federal law1 #ejj lot packages of the following preparations were next purchased of the company direct1 the analytical results indicating serious deficiency in every case1 as follows3 8,tablets salicylic acid1 #e grains 444 #a4gb grains found4 8,tablets acetylsalicylic acid1 #e grains 444 #b4ca grains found4 8,tablets acetanilid1 #c grains 444 #a4hh grains found4 8,tablets codein sulphate1 #a_/d grain 444 #a_/ae grain found4 8,tablets nux and pepsin ,no4 #b1 claiming pepsin #a grain1 extract nux vomica1 #a_/aj grain1 found to have a gross average weight per tablet of only #a4ag grains1 #j4ed grains of which was represented by sugar and other medicinally inert material4 8,tablets ,infant's ,anodyne 7,waugh7 showed serious discrepancy from formula40 ,the ,bulletin added the statement that1 as the company could not be reached under the ,new ,hampshire laws1 the federal authorities were appealed to4 ,the result of this appeal appeared in ,chemical ,supplement #ed1 issued ,aug4 #ba1 #aiah1 by the ,bureau of ,chemistry of the ,u4 ,s4 ,department of ,agriculture4 ,this government bulletin contained ,notice of ,judgment ,no4 #faic1 which describes cases of adulteration and misbranding of some of the drugs put out by the ,direct ,sales ,company4 ,briefly1 it may be said that some #b grain acetanilid tablets sold by this concern were found by the government chemists to contain1 roughly1 about #a-b_/c 7#a4fa7 grains2 some #a_/d grain calomel tablets were found to contain only about #a_/f 7#j4afc7 grain2 some #a grain quinin sulphate tablets were found to have only about #b_/c 7#j4fc7 grain2 some #b-a_/b grain salol tablets contained only about #a-a_/c 7#a4ci7 grain2 some #e grain sodium salicylate tablets contained less than half that amount 7#b4cb grain74 ,in addition1 the federal chemists found that some ,elixir of ,iron pyrophosphate ,quinin and ,strychnin 7,elix4 ,ferr4 ,pyrophos4 ,quin4 et ,strych4 ,n4 ,f47 fell considerably below the standard of strength laid down by the ,national ,formulary by having less than one-eighth the amount of quinin sulphate which the official standard calls for1 and only about one-fifth the amount of sugar1 saccharine1 which is not a normal ingredient of the official preparation1 having been substituted for part of the sugar4 ,the chemists found1 too1 that some hydriodic acid sold by the same concern1 instead of containing1 as the label declared and as the ,united ,states ,pharmacopeia requires1 #a per cent4 of absolute hydriodic acid1 contained less than one half of #a per cent4 ,the ,direct ,sales ,company pleaded guilty in this case and was fined #gjj4--7;,from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bg1 #aiai47 ,,discoveries ,,and ,,discoverers ,in spite of the wonderful achievements of modern science1 it seems impossible to get the public to think in scientific terms4 ,this is doubtless due to a fundamental weakness in our educational system4 ,the tendency still is to think in terms of the eighteenth century rather than of the twentieth4 ,many times ,the ,journal has been chided1 even by its friends1 for failing to take seriously preposterous claims made for alleged discoveries in medicine by well-meaning but self-deluded enthusiasts or by shrewd and conscienceless charlatans4 ,far too often the attitude is that any alleged discovery in medicine1 no matter how bizarre or how humanly improbable1 should be taken up in all seriousness and subjected to the tests of modern laboratory methods4 ,it was only a few years ago that a quack of unsavory antecedents brought forth an alleged cure for consumption--a disease that for years has been the subject of study by the best brains in the world--and a medical college spent thousands of dollars 8investigating0 the 8cure10 thereby giving it a standing that it would never have received otherwise and incidentally obtaining for the school an amount of publicity that may or may not have been desired4 ,as ,the ,journal said at the time1 it would have been just as pertinent for a body of astronomers to determine by scientific methods whether or not the moon is really made of green cheese4 ,the point we would make is that the strides made by modern science have practically eliminated the possibility of men without training or special knowledge evolving any epoch-making discovery4 ,in this connection an editorial in the ,scientific ,american of recent date1 dealing with the mechanical sciences rather than the medical1 is well worth quoting in part4 ,the editorial discussed the 8,garabed0 incident4 8,garabed10 as ,our readers know1 was a name given to a device which one ,garabed ,t4 ,k4 ,giragossian claimed to have developed and which1 so far as could be learned from the generalities in which ,mr4 ,giragossian indulged1 would take energy out of the cosmos and transfer it directly into mechanical motion4 ,mr4 ,giragossian would give no details regarding his 8engine10 but was so able to hypnotize ,congress into a belief that he had something worth looking into that it passed a joint resolution calling for the appointment of five scientists to pass on the claims for ,garabed4 ,the investigation proved1 as might have been expected1 that the thing was unsound in principle and nonoperative as a device4 ,the methods by which ,garabed was brought before the public savored strongly of those used by quacks in the medical world1 the one difference being that ,giragossian was apparently perfectly sincere and unequivocally honest4 ,the point that we bring out1 however1 and which1 as we have said before1 was so well expressed by the ,scientific ,american1 is the utter futility of wasting the time of scientific men on alleged inventions or discoveries by men without training who substitute secrecy and glittering generalities for facts and accomplishments4 ,quoting the ,scientific ,american3 ,scientific discovery1 once an open field for all comers1 is today becoming more and more a matter calling for the most intensive special qualifications4 ,as the body of human knowledge broadens and deepens1 it becomes increasingly difficult to make any material addition to it4 ,any one undertaking such a task must of necessity bring to it a long and careful training1 acquired either in the refined atmosphere of the laboratory1 or in the rougher school of close contact with the operation of apparatus constructed by those who have already qualified4 ,in particular1 he must possess a carefully developed power of making accurate observations and drawing correct conclusions4 ,it is rather the habit to point to men like ,edison and ,maxim in refutation of these necessities2 but they are not to be so refuted4 ,these men are examples1 raised to the nth power1 of the great inventor who has qualified in the ,university of ,hard ,knocks and ,long ,experience4 ,on these grounds1 when a man comes before us in the self-assigned rle of a great inventor1 it is incumbent upon him to answer1 not necessarily the bald question 8,who are you80 but certainly the more searching one1 8,what are your qualifications to undertake this work80 ,only by his answer can we decide whether he possesses a competence deserving of attention1 or is but a dilettante playing with fire4 ,yet this obligation was one which ,mr4 ,giragossian1 far from meeting1 did not even appear to comprehend4 ,to every effort to ascertain his qualifications he replied in the same terms1 that he was an honest man1 and could prove it by letters from his technically nondescript collection of friends and sponsors4 ,the very fact that more than personal integrity is necessary in a man who would unravel the secrets of the creation of energy appears to have escaped his comprehension4 ,the fundamentals thus stated apply with equal force to the sphere of medical discovery4 ,at the time when medicine was pure empiricism it was not only possible but also probable that the medicinal value of certain products or combinations of products might be stumbled on by those untrained and unskilled4 ,that time has passed4 ,today1 while it is not impossible1 it is so improbable that there is no justification in taking up the time of scientific men in investigating alleged discoveries by men who are utterly lacking in the fundamental qualifications needed for the study of the complex problems of human pathology4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #aj1 #aiah47 8,,drug ,,reform0 ,as ,it ,appears to the ,cleveland ,medical ,journal ,the matter which follows appeared originally as an editorial in the ,cleveland ,medical ,journal1 ,november1 #aiae4 ,it expresses1 we believe1 the attitude of the thinking physician toward the subject discussed3 ,physicians have come to the realization that drugs are as a two-edged sword--under proper conditions1 striking against the disease2 otherwise1 against the patient's health4 ,the first condition for their proper use is adequate knowledge of their composition and purity2 of their actions and malefactions2 their field and limitations4 ,slowly and painstakingly--sometimes painfully--this scientific knowledge has been gathered1 is still being gathered1 by chemists and pharmacists1 pharmacologists and clinicians1 with increasing thoroughness1 care and discrimination4 ,where wisdom fears to venture1 unwisdom and cupidity find ample room4 ,the wise physician knows that there are ills that drugs cannot cure2 that drugs generally only aid or relieve2 and that to obtain even this aid efficiently and safely1 the existing scientific knowledge is none too great4 ,not so the unwise4 ,he who sees in disease only a name1 to him a name is a sufficient cure4 ,let there be a mixture with a convenient and suggestive name and a pleasant taste1 a compendious index of diseases and symptoms--and a lively imagination--and the cure is accomplished4 ,few things could be easier1 and few more false4 ,it is not surprising that the 8man on the street0 should fall into these errors2 it is sad that any physician should be misled by the sophistry of interested drug vendors4 ,physicians have the moral obligation to instruct the public in matters of health4 ,preaching before practice is of little avail4 ,it behooves the medical profession to make at least a reasonable effort to clean its own house before it passes the broom to the public4 ,realizing this responsibility1 the ,american ,medical ,association some years ago established its ,council on ,pharmacy and ,chemistry4 ,this ,council is strictly an educational agency--it collects and disseminates knowledge about drugs1 especially those drugs that are advertised to physicians and that are not described in the legal pharmacopeias4 ,physicians are thus put in a position to discriminate4 ,many have done so2 others will1 a few may never see the light on this earth4 ,journals can no longer claim that they mislead their readers in good faith4 ,some--the ,cleveland ,medical ,journal among the first--have frankly acknowledged their obligations1 and sacrificed a lucrative income from advertisements2 others are still occupied in compounding the matter with their conscience4 ,manufacturers are in a similar position4 ,those who are on the side of scientific progress--or to put it materially1 those who realize that honesty is the best policy--are taking the opportunity to separate themselves from the dishonest and ignorant4 ,altogether1 the medical profession may safely advise the public on the subject of drugs without laying itself open to the charge that it preaches what it is unwilling to practice4 ,meantime1 the public itself has had a somewhat similar awakening4 ,the progress of the profession has necessarily spread more or less to the laymen4 ,all sorts of educational agencies have been working to convince the public that individual and national health is too precious an asset to be entrusted to any quack who may spell his praise in printer's ink4 ,legislators have passed food1 drug1 and antinarcotic laws which have aroused interest and discussion4 ,even the 8drugless cults0 have somewhat offset their harm by causing the public to reflect that drugging is not a panacea for all ills4 ,all this has not been without effect4 ,the public is in a receptive mood2 it is not convinced1 but wishes to learn4 ,legislators are prepared to follow public opinion4 ,the purveyors of patent medicines are watching events4 ,what1 under these conditions1 should be the attitude of the medical profession8 ,plainly1 it should continue to be what it always has been3 to stand aggressively for the protection of the public health1 without any compromise4 ,in doing so1 it is true1 physicians will expose themselves to the imputation of selfish motives4 ,selfishly commercial minds cannot or will not understand the unselfish ideals of a profession--that is their loss4 ,physicians1 however1 must be careful not to give a semblance of reason to the charge2 for that would diminish the effect of their attitude4 ,they must confine themselves to informing the public of the facts2 and to guarding the health of the public at large1 and of their own patients in particular4 ,no one1 in a free country1 can force a diseased individual to seek effective treatment or prevent him from using an ineffective treatment1 unless his disease imperils the health of others4 ,at that point1 and not before1 the government can and should take personal measures4 ,however1 it is a well recognized function of the government to protect individuals against their own ignorance4 ,it does this when it forces the child to go to school2 it does this when it places the swindler in jail4 ,on exactly the same principle1 the government has the right and the duty to protect the uninformed public against the flagrant evil of the patent medicine traffic--and the patent medicine traffic as now carried on is a flagrant evil and series of evils4 ,the government should protect the public against advertisements that are framed to suggest or create imaginary ailments1 with their attendant miseries2 it should protect the public against being deluded by false promises of cure2 against the specious relief that merely hides the disease and blinds the patient to its dangers2 against drugs that may and do work positive harm2 against the veil of mystery that makes these abuses possible4 ,the individual layman cannot protect himself against these dangers1 and has a right to expect that the government will prohibit the indiscriminate sale of any medicine that may be harmful to him4 ,he has a right to expect1 when the government permits the sale of a patent medicine1 that the medicine will do him no harm2 just as he has a right to expect that any physician whom the government permits to practice1 should be competent4 ,these are some of the reasons why physicians oppose patent medicines as they are now exploited2 and for these reasons1 physicians should take an absolutely uncompromising attitude1 and use every opportunity to educate the public4 ,the patent medicine interests naturally try to obscure the issue4 ,by the art in which they are so skilful1 they aim to suggest to the public that physicians are opposed to patent medicines1 in order to drive patients to their offices4 ,they 8forget0 to mention that physicians have never conducted a 8campaign0 against really efficient preventive public-health measures1 no matter how many prospective patients were involved4 ,no physician has ever refused to give diphtheria antitoxin because this would diminish the number of his visits4 ,a short memory is a very convenient asset for self-interested persons4 ,it is not so convenient for the public--but it is all too frequent4 ,physicians must1 therefore1 make it plain that their stand is not against patent medicines1 but for the protection of the health of the public4--7,from ,the ,journal ,a4 ,m4 ,a41 ,march #d1 #aiaf47 ,,drug ,,therapy3 ,,the ,,fallibility ,,of ,,textbooks ,until very recently1 we were compelled to acknowledge that little1 if any1 progress was being made in internal medicine so far as drug therapy was concerned4 ,everybody knows of the progress made in other branches--in bacteriology1 in pathology1 in biologic chemistry1 in surgery1 in etiology and in application of technical methods to diagnosis4 ,recently1 however1 pharmacologic research and the application of scientific methods in the study of the physiologic action of drugs are resulting in definite1 positive progress4 ,an important lesson1 incidentally learned through this scientific investigation1 is the fallibility of the drug therapy described in textbooks4 ,the explanation is1 of course1 that many of these textbooks are mere compilations containing false statements1 unproved theories1 and unverified clinical evidence representing the guesswork of ancient uncritical observers4 ,many drugs have been1 and still are1 vaunted in textbooks as valuable in a variety of conditions1 whereas scientific investigation and controlled clinical observation have proved them to be totally worthless2 others are proving to be of value in an extremely limited number of conditions4 ,the sooner writers of textbooks realize this fact and enter into the spirit of the new era1 the better for the public and for scientific medicine4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,may #bg1 #aiaf47 ,,thomas ,,webster ,,edgar ,tired ,rabbits for ,diabetes2 ,ring-,tailed ,monkeys for ,sex ,stimulation ,during the last two or three years ,the ,journal has received inquiries regarding one ,thomas ,webster ,edgar1 ,m4,d41 of ,new ,york ,city1 first1 relative to his alleged treatment for diabetes and more recently about his 8monkey gland0 treatment for sex stimulation4 ,here is one from a physician in ,washington3 8,have you any knowledge of the efficacy of a serum made from the pancreas of rabbits for the relief or cure of diabetes8 ,it is made by ,dr4 ,t4 ,w4 ,edgar of #gff ,west ,end ,ave41 ,new ,york ,city40 ,and this from a layman in ,pennsylvania3 8,last year there was published in the ,new ,york ,herald an account of the new treatment for diabetes in which a serum was injected in the veins and as a result it was claimed that over sixty-five per cent4 of the treatments made were successful4 ,the account further stated that they proposed to establish some sort of a sanitarium in ,new ,york ,city used especially for the treatment4 ,the writer having mislaid the account1 wrote the ,new ,york ,herald as to the doctor who had charge of it and in return was given the name and address4 ,dr4 ,edgar in a letter under date of last year stated that the cost of the treatment was #cjj4jj1 payable beginning of the treatment1 and he gave very little information as to the success of it1 with the exception that if the treatment did not give the desired effect after the end of three months1 it would be continued without any further cost4 ,the writer wrote and asked him the names of one or two of the patients who had been cured1 because it seemed rather unusual that if the treatment were a success1 it was necessary for a patient to pay the cost of the treatment in advance4 ,to that letter ,i have never received a reply40 ,while a physician from ,illinois writes3 8,i am enclosing a clipping from a ,chicago paper relative to ,dr4 ,thomas ,webster ,edgar of ,new ,york and his operation for transplanting the glands of ring-tailed monkey4 ,i note that he is a member of the ,new ,york ,county ,medical ,society6 ,what is there to this8 ,i have seen no mention of these wonders in ,the ,journal40 ,thomas ,webster ,edgar was born in #ahhi4 ,the records show that he was graduated in medicine by the ,university and ,bellevue ,hospital ,medical ,college in #aiac1 and was licensed to practice medicine in the ,state of ,new ,york the same year4 ,in ,march1 #aiai1 an article by ,t4 ,webster ,edgar appeared in the ,new ,york ,medical ,journal on 8,diabetes ,mellitus40 ,in this ,edgar gave a theory of the cause of diabetes mellitus and stated that he had 8treated successfully1 twenty cases of definite diabetes40 ,in the article he spoke positively of the successful results he had obtained by the 8intramuscular injections of my diabetic serum40 ,no information was given regarding this serum except that he mentioned vaguely that it was 8prepared from normal blood after the animal is exercised to the point of fatigue40 ,illustration3 ,photographic reproduction 7reduced7 of a few of the newspaper items that appeared in various parts of the country regarding ,thomas ,webster ,edgar's alleged serum for diabetes4 ,a few days after the appearance of this article in the ,new ,york ,medical ,journal1 newspaper articles appeared regarding a cure for diabetes perfected by 8,dr4 ,thomas ,webster ,edgar1 #gff ,west ,end ,avenue1 ,new ,york ,city40 ,according to these reports1 ,edgar said3 8,i tried the blood of rabbits and found what ,i wanted4 ,in obtaining the blood ,i first put the rabbit upon a treadmill and keep it there until it reaches a stage of fatigue4 ,then ,i draw the blood1 and after heating it to #fj degrees centigrade separate the corpuscles from the serum4 ,when the serum has been treated after the method ,i have discovered1 ,i inject it immediately subcutaneously4 8,i have attained success in #fe per cent4 of my cases and ,i have had #ajj cases4 ,i do not say that the cure is infallible1 but ,i am now certain that it will work in most cases1 particularly when the patient observes the rules laid down and undergoes faithful treatment40 ,in ,april1 #aiai1 a physician in ,kansas wrote to ,edgar at the request of a diabetic patient asking for information about the 8serum40 ,edgar replied that it would be impossible to send the physician any of the serum for administration unless the 8patient is willing to pay me for the cost of same1 which will be approximately the sum of #be40 ,he stated further that1 in a few months' time1 he hoped to be able to manufacture the serum in larger quantities which would 8more than cut the expense in half40 ,in the same month a layman in ,chicago who read the newspaper story wrote to ,edgar and asked for details regarding terms and the arrangements that would have to be made to take the 8treatment40 ,edgar replied that he expected to be in ,chicago in a few weeks' time and would see the man in consultation with his regular physician1 that he would administer the first injection and give instructions to the physician as to subsequent injections4 ,edgar added3 8,my custom is to have all fees paid in advance and my charge is #bjj4jj by certified cheque or money-order40 ,a layman in one of the smaller cities of ,new ,york wrote to ,edgar in ,may1 #aiai1 and received a reply from ,edgar's secretary stating that the treatment extends 8over a period of three months1 cost #aej40 ,he was also told that the serum could be sent to his physician for administration 8for the sum of #be prepaid by money-order40 ,the letter closed with the statement that ,edgar 8has been very successful with the serum40 ,illustration3 ,photographic reproduction 7greatly reduced7 of small portion of the publicity that has been given to ,edgar relative to his operation for 8sex stimulation0 by the transplantation of the glands of ring-tailed monkeys6 ,a layman in ,south ,carolina who wrote to ,edgar in ,june1 #aiai1 was told that the treatment as administered by ,edgar 8extends over a period of two months2 fee #cjj0 and that if he wanted the serum administered by his own physician the cost would be 8#ej prepaid40 ,in ,may1 #aibj1 ,edgar had another article on diabetes1 also in the ,new ,york ,medical ,journal4 ,in this1 too1 he refers to his serum in the following words3 8,in conclusion ,i may state that ,i have been able to produce some rather startling results by the use of my serum1 which is prepared from the blood of rabbits after they have undergone a series of maneuvres capable of activating the various internal secretory glands to increased action4 ,the serum contains the internal secretions in hormone form40 ,gradually the newspaper publicity on ,edgar's diabetic 8serum0 died down4 ,then1 in ,november1 #aibj1 there appeared--again in the ,new ,york ,medical ,journal--an article by ,edgar on 8,sterility1 ,sex ,stimulation and ,endocrines40 ,edgar there stated that he wished to place himself 8on record as being interested in sex stimulation0 and that he wanted to notify the profession that he had another serum which he was using 8with success in the treatment of this condition40 ,thus3 8444 ,i feel entitled to state that ,i have a distinctly beneficial serum for the alleviation of presenile and senile deficiency2 and that my product is capable of producing a new lease of life in those whose functions have been reduced to a minimum40 ,how long ,edgar has been featuring his 8serum0 for 8sex stimulation0 it is difficult to determine1 but during the last year the newspapers have carried sporadic reports of alleged remarkable results produced by 8,dr4 ,thomas ,webster ,edgar of #gff ,west ,end ,ave41 ,new ,york10 through the transplantation of the 8interstitial gland0 taken from 8a special species of orangoutang40 ,a layman who wrote ,edgar some months ago regarding this 8gland implantation0 received a letter from ,edgar's secretary stating that the treatment 8has been most successful in all cases0 and assuring him that 8the experimental stage had been passed1 and the operation is advised in all cases presenting symptoms of presenility or age40 ,a week later the same man received a letter written by ,edgar himself in which he reiterated the claim that all of the operations had been successful4 ,edgar added that he was now treating all cases 8by operation instead of the serum10 and that 8the fee for operation is #ejj1 inclusive of the sanitarium10 the patients remaining in the 8sanitarium0 8for from two to three days40 ,a month or two later the prospective patient received another letter signed1 8,thomas ,webster ,edgar1 ,m4,d410 assuring him that 8the effect is permanent1 and does not wear off4 ,no ill effects can possibly result40 ,commencing1 ,oct4 #a1 #aiba1 a series of sensational articles appeared regarding one of ,edgar's alleged monkey gland implantations performed on an individual described as 8one time lawyer and then a writer40 ,these articles purport to be written partly by one of the newspaper staff1 partly by the man undergoing the 8operation0 and at least one by ,thomas ,webster ,edgar4 ,the material is played up in the style typical of yellow journalism4 ,in addition to repeated pictures of the individual who is being operated on1 there also are given pictures of ,thomas ,webster ,edgar and one of his 8ring-tailed monkeys40 ,doubtless the 8story0 has sold many newspapers4 ,its sensational character1 the element of mystery and above all its sex slant will appeal to that large class of newspaper readers that hunger for stuff of this sort4 ,doubtless1 too1 it has proved a large advertising asset for ,thomas ,webster ,edgar4 ,the statement that appears in the series to the effect that ,edgar 8is a member of the ,county ,medical ,society of ,new ,york0 is incorrect4 ,edgar is not a member4 ,the further newspaper claim that ,edgar is 8an authority on glandular transplantation0 should also be accepted with reservations4 8,authorities0 are created with ease in the pages of newspapers4 ,edgar may possibly be termed an authority in a newspaper or1 shall we say1 ,pickwickian sense4--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ae1 #aiba47 ,the ,journal ,receives a ,letter ,denouncing 8,medical ,clerks0 and 8,biased ,sceptres0 ,the ,journal recently published in this department some inquiries regarding ,thomas ,webster ,edgar1 ,m4,d41 of ,new ,york ,city1 relative to some alleged serums that ,dr4 ,edgar had developed for diabetes and sex stimulation1 respectively1 and relative also to the newspaper publicity given ,dr4 ,edgar in connection with the alleged transplantation of glands from 8ring-tailed monkeys40 ,we are in receipt of a letter signed1 8,thomas ,webster ,edgar1 ,m4,d410 and reading as follows4 ,it is given verbatim et literatim3 8,gentlemen3--,i have read with great interest your editorial regarding the publicity given my work in metabolism1 and gland implantation4 8,your pseudo1 expose1 and distinctly libelous insinuations are unjust1 and they lead me to believe that you are going to be called to account at a very early date4 8,my profession is the practice of medicine1 and the policy of my practice is not controlled by the editorial department of the journal4 ,i am progressive1 and a firm believer that legitiment medicine and surgery can not be practiced if the physician be governed by a set of medical clerks1 who disdainfully boast that they control1 and govern the healing art through out the breadth of the land1 with a sceptre that is biased and steeped in the unadulterated commercialism of a certain medical clique4 8,aside from the fact that ,i am an associate editor on a medical publication1 it is disgraceful1 as well as unjust that you have written such an editorial with out first investigating the therapeutic value of my serum1 and implantation operation4 8,the psychology of your editorial1 only reflects on your editorial department1 and will tend to belittle some of the greatest surgeons in the country4 8,it may be to your advantage to know1 that this very afternoon1 ,i was on the program with the following men4 8,dr4 ,lewis ,gregory ,cole--,new ,york 8,dr4 ,charles ,h4 ,mayo--,rochester1 ,minn4 8,dr4 ,john ,b4 ,deaver--,philadelphia 8,dr4 ,charles ,peck--,new ,york4 8,my paper was entitled--,senility1 its etiology and treatment by gland implantation4 ,i am sure the above mentioned gentlemen are thoroughly ashamed of your actions in the matter1 as well as thoroughly disgusted with the baby like attitude you have displayed4 ,you have no sense of fair play1 and if it is with in my power to undue the wrong which you have wrought me1 ,i shall endeavor to vindicate myself in the eyes of the clear thinking members of the profession4 8,i sincerely trust you will publish this communication1 in order that my brethren shall understand and appreciate that your thrust has not gone unnoticed4 8,it is my hope that the various medical societies through out the country1 will call upon me to read a paper on my work1 so that ,i may be able to offer substantial evidence to the fact that you have done me an injustice4 8,very truly yours1 ,,twe_/,,ael ,signed 8,thomas ,webster ,edgar1 ,m4,d40 ,dr4 ,edgar's statement that he had been on the program with ,drs4 ,cole1 ,mayo1 ,deaver and ,peck was sufficiently startling to prompt further investigation4 ,it was found that the program in question was that of the annual meeting of the ,new ,york and ,new ,england ,association of ,railway ,surgeons4 ,it was further found that ,edgar's name did appear on some of the printed programs but not on others4 ,it was rather naturally assumed that the name had been put on the program before the officers of this organization had seen the crude publicity to which ,the ,journal recently called attention4 ,it was found1 however1 that after several hundred programs had been printed about #aej more were needed and 8in the meantime1 ,dr4 ,edgar had come into the limelight0 in his ring-tailed monkey gland transplantation rle and 8was invited to read a paper on the subject40 ,while he accepted this invitation the secretary of the organization tells us that ,edgar did not read his paper but1 when the paper was called1 declined1 saying it was time for him to be in his office6 ,as for the rest of ,dr4 ,edgar's communication1 ,the ,journal appreciates that courtesy is due 8an associate editor on a medical publication0--referring doubtless to the ,western ,medical ,times4 ,dr4 ,edgar's pronouncement that 8legitimate medicine and surgery can not be practiced if the physician be governed by a set of medical clerks0 seems reasonable--if cryptic4 ,but it is when he charges that these 8clerks0 govern the healing art 8with a sceptre that is biased and steeped in the unadulterated commercialism of a certain medical clique10 that he really shines4 ,whatever opinion one may hold of ,dr4 ,edgar's ability to compound serums1 surely no one can question his skill as a mixer of metaphors4 ,his reference to 8sceptres0 deserves to be embalmed in every textbook on rhetoric with the classic of the ,hibernian statesman who passionately declared3 8,i smell a rat6 ,i see it floating in the air6 ,but1 mark you1 ,sir1 ,i shall nip it in the bud60--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #c1 #aiba47 ,,glycerophosphates ,physicians who prescribe on definite principles must often be puzzled by the number and variety of glycerophosphates on the market4 ,all available evidence indicates that1 as sources of phosphorus to the animal organism1 the glycerophosphates possess no advantages over the ordinary inorganic phosphates4#bij ,the glycerophosphates are split up in the intestine1 and liberate inorganic phosphates4 ,in this form they are absorbed and utilized1 if they are utilized at all4 ,there is no evidence that glycerophosphates have any pharmacologic action to warrant the belief that they are of use as therapeutic agents4 ,the theory that organic phosphorus compounds are more readily assimilable than inorganic compounds and hence a better means of introducing phosphorus into the system is still kept alive in the promotion of certain proprietary mixtures1 in spite of the scientific evidence that the organism can assimilate phosphorus quite as readily from inorganic as from organic phosphorus compounds4#bia ,the glycerophosphates will continue to be manufactured until physicians refuse to prescribe them4 ,a chemist in the 8research laboratory0 of a well known manufacturing firm has recently given a rather interesting reason for the use of glycerophosphates--from the manufacturers' point of view4 ,he is quoted as saying3 8,on account of the instability of phosphorus in elixir of phosphorus1 nux vomica and damiana we have quite recently replaced the phosphorus by glycerophosphates4 ,such a preparation is apparently equally as effective1 for we continue to have a great demand for it40 ,this is doubtless a sufficient reason for the substitution from the manufacturers' point of view2 but how about the patient1 who1 after all1 is the one to be considered8 ,is it not a matter of considerable importance to the patient whether he receives phosphorus1 one of the most powerful drugs known1 or the inert glycerophosphates8 ,the chemist's statement seems to imply that it is not4 ,it may be of interest to recall that a member of the firm whose chemist gives this 8reason0 for the use of glycerophosphates1 in a recent address1 was rather severe in his condemnation of institutions of learning1 hospitals1 etc41 for their lack of cooperation with manufacturers3 he said that 8they should welcome an opportunity to let any manufacturer try out or test his products in their clinics1 laboratories1 etc40 ,a test as to whether there is a difference between the action of glycerophosphates and ordinary poisonous yellow phosphorus1 especially when the former are mixed with extracts of nux vomica and damiana1 would not be likely to appeal to many hospitals and laboratories as a very promising field of research at this day since1 as has been stated1 the scientific evidence at present available does not furnish any warrant for the therapeutic use of glycerophosphates4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,april #ae1 #aiaf47 #bij ,organic ,phosphorus ,compounds1 ,editorial1 ,j4 ,a4 ,m4 ,a4 #dj3 #aieh 7,june #ba7 #aiac4 ,marshall1 ,e4 ,k43 ,the ,therapeutic ,value of ,organic ,phosphorus ,compounds1 ,j4 ,a4 ,m4 ,a4 #dd3 #egc 7,feb4 #ac7 #aiae4 #bia ,marshall1 ,e4 ,k43 ,the ,therapeutic ,value of ,organic ,phosphorus ,compounds1 ,j4 ,a4 ,m4 ,a4 #dd3 #egc 7,feb4 #ac7 #aiae4 ,,influenza ,,vaccines ,with the appearance of the epidemic of influenza1 reports began to appear1 chiefly in newspapers1 as to new serums1 vaccines1 drugs and other methods for checking and even for curing the disease4 ,a few samples of such as have come to ,the ,journal appear in our ,tonics and ,sedatives ,department this week4 ,in ,massachusetts1 ,commissioner ,e4 ,r4 ,kelly appointed two committees to investigate the value of influenza vaccines as a preventive agent and as a treatment of the disease4 ,the first committee1 a special board for scientific investigation1 consisting of ,dr4 ,m4 ,j4 ,rosenau1 chairman1 and ,frederick ,p4 ,gay and ,george ,w4 ,mc,coy1 was appointed to consider the evidence available on the prophylactic and therapeutic use of vaccines against influenza4 ,this committee presented the following conclusions3 #a4 ,the evidence at hand affords no trustworthy basis for regarding prophylactic vaccination against influenza as of value in preventing the spread of the disease1 or of reducing its severity4 ,the evidence from the present epidemic1 though meager1 suggests that the incidence of the disease among the vaccinated is smaller than among the nonvaccinated4 ,the board1 therefore1 concludes that further experimental evidence should be collected4 #b4 ,the evidence at hand convinces the board that the vaccines we have considered have no specific value in the treatment of influenza4 #c4 ,there is evidence that no unfavorable results have followed the use of the vaccines4 ,the second committee1 known as the ,special ,board of ,statistical ,investigation1 consisted of ,dr4 ,george ,c4 ,whipple1 chairman1 ,william ,h4 ,davis and ,f4 ,c4 ,crum4 ,this committee reported3 #a4 ,the weight of such statistical evidence as we have been able to accumulate indicates that the use of the influenza vaccine which we have investigated is without therapeutic benefit4 ,exceptional cases where apparent benefit has resulted from the use of the vaccine can be matched by other cases where similar recoveries have been made without vaccination4 #b4 ,the statistical evidence1 as far as it goes1 indicates a probability that the use of this influenza vaccine has some prophylactic value4 #c4 ,there is also some evidence to the effect that other methods of protection1 such as open-air treatment and the use of proper masks1 are effective in protecting exposed attendants1 and the use of vaccine should not be taken as an excuse for omitting such safeguards4 ,as a result1 the following recommendations were made3 ,that the state encourage the distribution of influenza vaccine intended for prophylactic use1 but in such manner as will secure scientific evidence of the possible value of the agent4 ,the use of such vaccine is to be regarded as experimental4 ,that the state shall neither furnish nor endorse any vaccine at present in use for the treatment of influenza4 ,these reports are conservative1 and offer to other health commissioners and their communities a reliable guide as to procedures that should be adopted before subjecting or trying out on the public any method of prevention or treatment that may be offered4 ,these matters are the domain of medical science1 and medical scientists of recognized ability should be called on to make the decision4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ai1 #aiah47 ,serums and ,vaccines ,with respect to serums and vaccines in influenza1 there are certain simple facts and considerations that physicians will do well to keep in mind at this times4 ,the main point to keep always in sight is that unfortunately we as yet have no specific serum or other specific means for the cure of influenza1 and no specific vaccine or vaccines for its prevention4 ,such is the fact1 all claims and propagandist statements in the newspapers and elsewhere to the contrary notwithstanding4 ,this being the case1 efforts at treatment and prevention by serums and vaccines1 now hurriedly undertaken1 are simply experiments in a new field1 and the true value of the results cannot be predicted by any one4 ,indeed1 the exact results can be determined if at all only after a time1 in most cases probably not until the epidemic is past and all the returns fully canvassed4 ,consequently1 the physician must keep his head level and not allow himself to be led into making more promises than the facts warrant4 ,this warning applies especially to health officers in their public relations4 ,as to serum treatment1 the only noteworthy new method so far is the injection in severe cases of influenzal pneumonia of the serum of patients who have recovered from such pneumonia4#bib ,the principle of this method is rational2 analogous procedures have given seemingly good results in scarlet fever and other diseases2 and the results reported in influenzal pneumonia appear promising4 ,further trial of this treatment under proper conditions consequently seems to be warranted4 ,it should be borne in mind1 however1 that ,mc,guire and ,redden#bib made their observations in the declining phase of the epidemic when the organism or organisms concerned appeared to be losing virulence4 ,for this and other reasons1 the expectations as to what may be accomplished by this method must be kept within reasonable bounds4 ,influenza is a self-limited disease with variable complications and of variable severity in different places1 thus offering great difficulties in the way of evaluation of different methods of treatment4 #bib ,mc,guire1 ,l4 ,w41 and ,redden1 ,w4 ,r43 ,treatment of ,influenza ,pneumonia by the ,use of ,convalescent ,human ,serum3 ,preliminary ,report1 ,j4 ,a4 ,m4 ,a4 #ga3acaa 7,oct4 #ai7 #aiah4 ,at least two kinds of vaccine are in use in the hope that they may have preventive effects4 ,one consists solely of killed influenza bacilli2 it being extensively used in the ,east4 ,we have as yet no decisive figures as to its effects1 but there is an impression that it may have some value4 ,the other vaccine is a mixed vaccine of the more important bacteria in the respiratory tract in influenza1 principally pneumonococci1 streptococci and influenza bacilli4 ,it appears that vaccines of this nature are in extensive use1 but we have no evidence that any benefit will be derived from them4 ,to say that thousands have been vaccinated with apparently good results means nothing at all1 simply because we are still in the midst of the outbreak1 in many places even in the earlier stages4 ,how slender the basis of this anti-influenzal vaccination when it is considered that the real nature of influenza is still unknown6 ,in any event1 it will require many carefully elaborated and controlled observations before anything definite may be learned in regard to the effect of these vaccines1 and it is probably safe to say that nothing on which to rely in the future can be learned from the indiscriminate vaccination now going on4 ,there is1 therefore1 no basis on which promise of protection from vaccines may be made4 ,they may be harmless1 and they may or may not be of preventive value4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bf1 #aiah47 ,,intravenous ,,therapy ,the intravenous administration of drugs is a new departure in therapy1 but one which is rapidly increasing in use4 ,among its reputed advantages are that it is the quickest means of obtaining the effects of a drug1 the effects are obtained with a certainty not obtained by other methods1 and they are so marked that they cannot fail to impress the observer4 ,these advantages in many cases are apparent rather than real2 but even were they real advantages1 they should not blind us to the various and serious dangers which this method involves4 ,the technic1 although not difficult1 must be thoroughly mastered1 or undue pain1 infection1 air embolism1 or even death may result4 ,such accidents1 however1 are ordinarily easily avoided1 and should be considered quite inexcusable4 ,more serious is the fact that the drugs given intravenously reach the system1 and especially the heart1 in a different manner and concentration from that to which physicians are accustomed with ordinary methods of administration4 ,pharmacologists have long practiced intravenous administration1 when studying acute effects of drugs1 and they have observed that frequently the immediate result of such injections is a prompt fall of blood pressure1 not obtained when the same drugs are given by mouth or even hypodermically4 ,this fall in blood pressure is commonly attributed to irritation of the endocardium4 ,it is usually of short duration1 but is certainly undesirable and sometimes may have serious results4 ,it has also been observed that several drugs1 for instance1 quinin and potassium1 depress the cardiac muscle when given intravenously much more than when given in other ways4 ,furthermore1 any substance which tends to precipitate proteins must be injected slowly and with extreme caution1 or it will produce intravascular clotting and sudden death4 ,deaths have resulted not only from a lack of knowledge of the technic of intravenous therapy1 but also from a lack of knowledge of drugs which may be so administered4 ,sudden death has been reported following the injection of an iron preparation containing peptone1 and also following intravenous injection of ether4 ,intravenous injections1 while sometimes superior to the slower methods1 are distinctly inferior when a continuous1 rather than a sudden1 action is desired4 ,drugs leave the blood system with great rapidity1 and therefore their action on the circulation will cease promptly unless they are continuously supplied4 ,it would be undesirable to inject intravenously such drugs as iodids1 nitrites1 iron or salicylates4 ,with these dangers and disadvantages in mind1 it seems unwise to resort to promiscuous intravenous medication until the effects of this method have been studied in detail for the drugs employed1 and unless there are distinct advantages to be secured4 ,this is the case when an immediate action is necessary in emergencies1 as in the use of strophanthin for cardiac collapse1 quinin in pernicious malaria1 etc41 or if the drug would be destroyed in the stomach or tissues as in the case of salvarsan1 or when the drug is not adequately absorbed by any other channel1 as in the case of epinephrin4 ,intravenous therapy will be most securely advanced if its employment is restricted to such well defined fields4 ,these fields can be satisfactorily determined only by a scientific pharmacologic study of the action of these drugs when so administered in animals1 as well as in man1 under conditions in which the results are carefully controlled4 ,the intravenous method is an impressive one1 approaching in preparation almost to that which goes with a surgical operation4 ,the patient is usually interested and impressed by this new1 and to him1 mysterious method4 ,there is a psychic element in his reaction to the injection which is not a factor in his reaction to the same drug when given by mouth4 ,the intravenous injection of a complex mixture would appear to be particularly reprehensible4 ,little is known1 as has been stated1 of the results to be expected from intravenous therapy1 even with simple substances4 ,the use of complex mixtures will without doubt react against the proper use of the method4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #aa1 #aiaf47 ,,iodin ,,fumes ,one of the important factors connected with therapeutics as a science is the method of administration of medicinal substances4 ,drugs may be given by mouth1 by hypodermic or intravenous injection1 by inhalation1 by inunction or1 less frequently1 by the use of other entrances into the body4 ,in choosing a method1 the physical characters of the substance to be administered and the immediate effects of the substance on the body tissues with which it may come in contact must be especially taken into consideration4 ,these factors apply particularly in the case of substances like iodin1 arsenic1 mercury or the biologic products in which the mode of administration radically modifies the action4 ,for some time1 manufacturers have urged substitutes for tincture of iodin1 claiming that their substitutes were free from the undesirable properties of the tincture1 and1 at the same time1 possessed special virtues which the tincture could not possess4 ,more recently1 attention has been directed to the administration of iodin in the form of vapor4 ,the diffusing and penetrating powers of gases have particularly attracted the attention of therapeutists1 since by this method drugs may be applied to rather inaccessible portions of the body1 such as the lining of the lungs1 the throat and the mucous membranes of the genito-urinary tract4 ,furthermore1 it has been asserted that iodin in the form of fumes has increased combining powers1 and is thus far more potent in effect than iodin administered by any other route4 ,there do not seem to have been any adequate scientific investigations of the subject1 however1 until the recently published results of ,luckhardt and his collaborators#bic at the ,university of ,chicago4 ,in their experiments1 both on man and on animals1 accurately determined quantities of iodin were vaporized in a special device1 and the fumes applied to the skin4 ,at the same time1 the tincture was applied to the skin of other persons as a control4 ,iodin was also applied to the skin of dogs with hyperplastic thyroid glands2 and the effects on the gland1 before and after administration1 studied4 ,dogs were also used to determine whether iodin fumes were absorbed from the lungs4 ,as a result of these investigations1 which are reported in great detail1 it was found that iodin1 when deposited on the skin in the form of fumes1 is absorbed4 ,more iodin was recovered from the urine1 following the application of the tincture1 than was recovered following the use of the fumes4 ,this result is explained by the authors on the ground that probably more iodin was actually applied1 and that the iodin so deposited was held in combination with the protein during the process of coagulation of the latter by the alcohol of the tincture1 leading to a state of continuous absorption4 ,it is probable1 furthermore1 that the iodin deposited on the skin in the form of fumes is revaporized to some extent by the heat of the body4 #bic ,luckhardt1 ,a4 ,b42 ,koch1 ,f4 ,c42 ,schroeder1 ,w4 ,f42 and ,weiland1 ,a4 ,h43 ,the ,physiological ,action of ,fumes of ,iodin1 ,j4 ,pharmacol ,exper4 ,therap4 #ae3 #a 7,march7 #aibj4 ,most important were the effects of iodin administered intratracheally in the forms of fumes4 ,iodin given in this way seems to be rapidly and completely absorbed2 but it was found that the administration of the fumes of iodin by inhalation through the respiratory passages1 even in small quantities1 is fraught with great danger4 ,such administration induces dyspnea2 and when it is given in large quantities1 acute and fatal pulmonary edema ensues within twenty-four hours4 ,when respiratory disorders are present at the time of administration1 the fatal edema supervenes very quickly4 ,thus far1 no device designed to deliver fumes controls the dosage4 ,it is interesting to consider1 as do the authors1 the fact that the fumes of iodin have the same effect as those of two other halogens1 bromin and chlorin4 ,the results of these experiments with iodin fumes on the dog1 as shown by necropsy findings1 are practically identical with those reported by military surgeons as found in soldiers gassed with chlorin during the war4 ,the results of these researches are additional evidence as to how scientific research may confirm or deny conclusions based on empiric therapeutic observations4 ,the work may well serve as a model for similar experiments1 now being made1 on the therapeutic use1 intravenously1 of such substances as nonspecific proteins or organic preparations of toxic drugs4 ,the patient should at least have the chance that is afford him by preliminary experiments1 scientifically performed on animals in the research laboratory4--7,editorial from ,the ,journal ,a4,m4,a41 ,may #bi1 #aibj47 ,,italian ,,physico-,,chemical ,,company ,many and various are the letters received by ,the ,journal asking for information about an alleged scientific organization in ,italy styled l',acadmie ,physico-,chimique ,italienne4 ,this ,italian ,physico-,chemical ,academy is operated from ,palermo1 ,italy4 ,here is the scheme3 ,dr4 ,john ,doe1 an ,american physician receives an imposing-looking letter bearing the ,palermo1 ,sicily1 postmark and addressed to 8,monsieur le ,docteur ,john ,doe1 ,mdecin40 ,on opening the letter 8,monsieur le ,docteur0 finds that the 8,council0 of l',acadmie ,physico-,chimique ,italienne has nominated him 8,honorary ,member of this ,academy0 and furthermore has bestowed on him 8a ,first ,class ,medal for technical work and scientific merit40 ,all this1 8in consideration of your many dignities and great learning40 ,dr4 ,doe is told that as soon as he will write an acceptance of this honor 8in conformity with ,section #ai and #bb of the ,constitution0 he will be sent 8the ,medal1 ,diploma and all the other documents relating to the title accorded40 ,the joker in the scheme lies in the necessity for ,dr4 ,john ,doe 8conforming0 with 8,section #ai and #bb of the ,constitution40 ,here are the sections3 ,illustration3 ,reduced photographic reproduction of the stock letter sent to ,american physicians by the ,italian ,physico-,chemical ,academy4 ,the 8joker0 lies in the requirement around which we have drawn a line4 8,sec4 #ai4--,the entrance fee to cover office and postal expenses1 including postage of diploma is #e ,dollars1 and is payable once at the admission to the ,academy by special bulletin filled up1 stamped and signed40 8,sec4 #bb4--,those to whom medals are awarded and who wish to possess them must pay for their coinage #aj ,dollars as the ,academy does not1 at present1 possess the necessary funds for this purpose44440 ,in short the whole thing means that if ,dr4 ,doe is willing to send #ae in good ,american money he will receive in due time from the academy a 8diploma0 and a gilt 7not gold7 medal4 ,about four years ago when the 8,academy0 seemed to be making a particularly heavy bid for ,american dollars the member of ,the ,journal staff in charge of the ,propaganda ,department wrote to the 8,academy10 on his personal stationery1 asking about the cost of membership in the 8,academy0 and asking also for a copy of the 8prospectus40 ,and that was all4 ,in reply he received a letter stating that 8in consideration of0 his 8many dignities and great learning0 he had been nominated 8an officer of this academy0 and had been awarded 8la mdaille de premire classe0 for humanitarian work and scientific merit4 ,in order to obtain these tokens of the 8,academy's0 regard it would be necessary to inform the 8,academy0 of acceptance 8in conformity with ,section #ai and #bb 4440 ,as the ,propaganda ,department did not consider the diploma and gilt medal worth #ae even as exhibit for its museum of fakes1 the 8,form of ,acceptance0 was not filled in and returned 8in accordance with ,section #ai and #bb40 ,illustration3 ,photographic reproduction 7reduced7 of the 8,form of ,acceptance0 to 8membership0 in the 8,italian ,physico-,chemical ,academy40 ,filling out this blank and sending it with #ae4jj to the 8,academy0 will bring the gilt medal and 8diploma40 ,the leading spirits in the operation of this diploma and medal mill are ,d4 and ,g4 ,bandiera1 who1 so far as we can learn1 are neither physicians nor pharmacists nor have any scientific standing4 ,the 8,academy0 has been referred to at various times#bid by ,the ,journal4--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #bf1 #aiaf47 #bid ,j4 ,a4 ,m4 ,a4 #dh3 #baif 7,june #bi7 #aijg2 ,editorial #eg3 #acgc1 ,berlin letter1 p4 #achj 7,oct4 #ba7 #aiaa2 #eh3 #adee 7,may #aa7 #aiab2 #fj3 #ggj 7,march #h7 #aiac2 #fj3 #adhj 7,may #aj7 #aiac2 #fa3 #agcg 7,nov4 #h7 #aiac4 ,,what ,,is ,,liquid ,,petrolatum8 ,the use of liquid petrolatum in chronic constipation1 which has recently become the vogue1 has naturally been commercialized2 as a result1 also naturally1 claims of superiority of one brand over another have been made4 ,some of these claims may have been well founded2 others certainly are not4 ,some have claimed superiority for those products made from ,russian oil over those made from ,american oils4 ,as naphthene hydrocarbons predominate in ,russian crude petroleums1 and paraffin hydrocarbons in many or most ,american crude petroleums1 it was assumed that the petrolatums derived from these sources differed from one another in like manner4 ,both the naphthenes and the paraffins are chemically inert2 but some unexplained therapeutic superiority has been assumed to reside in the naphthenes4 ,consequently1 it has been urged that the ,american liquid petrolatums should not be used internally4 ,so far these claims and counterclaims have been based on much theory and little fact4 ,the ,journal publishes this week a contribution by ,benjamin ,t4 ,brooks1 ,senior ,fellow in charge of petroleum investigations at ,mellon ,institute1 ,pittsburgh4 ,brooks calls attention to the fact that ,marcusson1 in #aiac1 pointed out that most of the so-called 8mineral oils0 used for therapeutic purposes contain no paraffin hydrocarbons whatever2 that they consist solely of naphthenes and polynaphthenes4 ,brooks confirms this statement so far as ,american liquid petrolatums are concerned4 ,he states that many ,american petroleums1 such as most of those from the ,gulf region1 are like the ,russian in containing no paraffin2 and that1 in the case of those petroleums that do contain it1 the customary refinery method of removing paraffin is sufficient to produce true naphthene and polynaphthene petrolatums4 8,the claim that only ,russian oils belong in this class10 he says1 8has no basis in fact and has been advanced presumably for business reasons40 ,the name 8paraffin oil0 applied to these liquid petrolatums1 then1 is a misnomer4 ,the new name1 8white naphthene oils10 suggested by ,brooks1 seems superfluous1 however1 since the pharmacopeial title1 8liquid petrolatum10 is subject to no such objection4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #a1 #aiaf47 ,,the ,,lowenthal ,,postgraduate ,,course ,which ,tells ,how to ,make ,diagnoses ,accurately1 ,scientifically ,check the ,christian ,scientists and ,increase ,your ,earning ,power ,during the past year ,the ,journal has received letters from physicians in various cities asking for information regarding the 8,post ,graduate ,course of ,lectures and ,clinics on ,nervous and ,mental ,diseases0 which was going to be given in their respective cities by ,dr4 ,albert ,a4 ,lowenthal of ,chicago4 ,the following inquiries are typical3 8,to the ,editor4--,please note the enclosed letter from the ,american ,organotherapy ,company which appears to be conducted by ,lowenthal4 ,the proposition of conducting these clinics impresses me as a piece of colossal gall which is amazing even in these days4 ,do you know anything about this matter80 8,to the ,editor4--,who the dickens is ,albert ,a4 ,lowenthal1 ,m4,d48 ,note the circular enclosed4 ,i have blue circled the remarks he evidently thinks will attract40 ,in ,may1 #aiai1 ,chicago physicians received a form letter1 signed1 and on the stationery of1 ,albert ,a4 ,lowenthal1 notifying them that ,dr4 ,lowenthal was about to 8give a ,post ,graduate ,course of ,lectures and ,clinics on nervous and mental diseases0 in the 8,banquet ,hall1 ,morrison ,hotel40 ,enclosed was a 8,programme and ,reservation ,card0 and a self-addressed envelop for physicians to notify ,dr4 ,lowenthal that they would be present4 ,in addition to showing physicians 8how to make diagnoses accurately10 ,dr4 ,lowenthal offered to 8explain fully how to scientifically check the ,christian ,scientists and increase your earning power60 ,and all for nothing6 ,at later dates similar letters were received by physicians in other cities1 on the stationery of the 8,american ,organotherapy ,company1 ,room #ijb1 #ca ,north ,state ,st41 ,chicago40 ,dr4 ,lowenthal1 whose ,chicago office is ,room #ija1 #ca ,north ,state ,st41 is1 apparently1 president1 treasurer and practical owner of this company4 ,enclosed with each of these letters--which offered the same inducements1 free--was an envelop addressed to ,albert ,a4 ,lowenthal in care of the hotel at which ,dr4 ,lowenthal would stay while in that city4 ,there was also a 8,programme and ,reservation ,card0 as in the case of the letters sent to ,chicago physicians4 ,according to our records1 ,dr4 ,albert ,a4 ,lowenthal was born in ,chicago in #ahgd and was graduated by the ,college of ,physicians and ,surgeons1 ,chicago1 in #ahie1 receiving his license the same year4 ,in a leaflet issued some time ago by ,albert ,a4 ,lowenthal1 ,m4,d41 8for the sole purpose of enlightening ,prospective ,patients in regard to the therapeutic value of the ,organo ,therapy ,treatment for ,nervous ,diseases10 we learn that ,dr4 ,lowenthal is1 or was3 8,professor ,nervous and ,mental ,diseases1 ,chicago ,hospital ,college of ,medicine40 8,formerly ,professor ,nervous and ,mental ,diseases1 ,dearborn ,medical ,college1 ,jenner ,medical ,college40 8,adjunct ,professor on ,neurology and ,psychiatry1 ,university of ,illinois ,college of ,medicine40 8,formerly ,physician ,illinois ,eastern ,hospital for the ,insane40 8,formerly ,supt41 ,riverview ,hospital for ,nervous ,diseases1 ,kankakee1 ,ill40 8,formerly on ,advisory and ,associated ,attending ,staff ,cook ,county ,hospital40 ,in ,polk's ,medical ,directory for #aijd1 ,dr4 ,albert ,a4 ,lowenthal's name appeared1 under ,chicago1 at #iaj-iab ,chicago ,opera ,house ,building4 ,he was described as 8,superintendent of ,lowenthal's ,sanitarium40 ,in the same issue of the directory1 there was a display advertisement of the ,lowenthal ,sanitarium1 which1 while located at ,kankakee1 ,ill41 had its 8main offices0 at #iab ,chicago ,opera ,house ,bldg41 ,chicago4 ,the advertisement was headed 8,,goat ,,lymph ,,treatment10 and read in part3 8,goat ,lymph has revolutionized medicine1 and has been adopted by the scientific medical world as the only therapeutical agent that will absolutely bring about positive results in chronic conditions1 such as ,neurasthenia1 ,nervous ,collapse1 ,paralysis1 ,locomotor ,ataxia1 ,brain ,fag1 ,oncoming ,insanity1 ,chronic ,stomach ,disorders1 in fact such diseases needing cell stimulation40 ,it mentioned further that ,dr4 ,albert ,lowenthal 8introduced ,goat ,lymph to the medical world as a curative agent40 ,a few years ago a ,chicago concern1 known as the 8,american ,animal ,therapy ,co410 put out such products as 8,lymphoid ,compound 7,lowenthal710 8,ova ,mammoid 7,lowenthal710 8,prostoid 7,lowenthal710 etc4 ,the ,american ,animal ,therapy ,co4 had for its manager ,james ,m4 ,rainey4 ,rainey also operated the 8,rainey ,medicine ,co410 a mail-order 8patent medicine0 concern that sold 8,vitaline10 a 8general debility cure40 ,the ,rainey 8,vitaline0 quackery was exposed in ,the ,journal1 ,oct4 #a1 #aiaj1 and the matter appears in 8,nostrums and ,quackery40 ,when the ,american ,animal ,therapy ,company was operating from #hd ,adams ,st41 ,chicago1 it claimed to have a hospital and laboratory at ,kankakee4 ,at the same time letters were being sent out on the stationery of 8,the ,lymph ,hospital10 signed ,albert ,a4 ,lowenthal1 ,m4,d4 ,although this 8hospital0 was at ,kankakee1 ,ill41 the address on the stationery was #hd ,adams ,st41 ,chicago1 and its telephone number was that of the ,american ,animal ,therapy ,company4 ,according to the stationery1 the 8,medical ,department0 of the ,lymph ,hospital was 8under the personal direction of ,dr4 ,albert ,a4 ,lowenthal1 who introduced the ,lymph ,compound and ,lymphoid ,compound to the ,scientific ,medical ,world as a curative agent in ,chronic ,nervous conditions40 ,a layman received a letter from the 8,lymph ,hospital0 urging him to take 8,lymphoid ,compound40 ,later he received a 8follow-up0 letter1 from which the following extracts are made4 ,capitals used as in the original3 ,illustration3 ,some letterheads 7greatly reduced7 of concerns in which ,dr4 ,albert ,a4 ,lowenthal has been interested4 8,do you know that the doctors of this country are using the ,,lymphoid ,,compound ,,exclusively in all cases1 where the nervous system is greatly involved1 with the most ,,marvelous ,,results4 ,,isn',t ,,that ,,sufficient ,,proof as to the merit of the remedy80 8444 ,nobody can tell you there is something just as good1 because ,,there ,,is ,,nothing ,,just ,,as ,,good ,,as ,,the ,,lymph--in fact ,,it ,,is ,,the ,,only ,,thing ,,that ,,can ,,be ,,depended ,,upon40 8444 ,our ,dr4 ,lowenthal gives his personal attention to all cases at the ,hospital and devotes a portion of his time advising by mail those persons under treatment who are unable to come to the ,hospital4 ,he is a man of ,,world ,,wide ,,reputation ,,in ,,treating ,,nervous ,,diseases--,,his ,,advice ,,on ,,cases ,,like ,,yours ,,is ,,worth ,,everything ,,to ,,you40 8,think this over and if you do1 you will write an order today for the ,lymphoid ,compound4 ,the home treatment costs #i4ej for thirty three days--think of that4 ,you have our physician's advice and care free of charge--could anybody ofter more to you80 ,in #aijh ,dr4 ,lowenthal appeared as a witness for ,edward ,r4 ,hibbard1 who was being prosecuted by the federal authorities4 ,hibbard operated a 8men's specialist0 office in ,chicago2 it had two entrances and a different name for each entrance--the 8,boston ,medical ,institute0 and the 8,bellevue ,medical ,institute40 ,hibbard was found guilty of fraud in the operation of this concern and was fined #a1ejj4 ,the transcript of the testimony in the ,hibbard case records that ,dr4 ,albert ,a4 ,lowenthal1 when on the stand1 claimed to 8have treated as many nerve patients as any nerve specialist in ,chicago40 ,he further declared1 according to the transcript1 that physicians who make a specialty of nervous diseases 8mature in about ten years0 and that after that time most of them become nervous wrecks or insane4 ,this was in #aijh4 ,in this connection it is worth noting that in letters sent out by ,lowenthal in ,may1 #aiai1 he claimed3 8,in the past twenty-five years ,i have limited my work to neurological and psychological cases44440 ,in #aijh also1 ,dr4 ,lowenthal was sending out letters to ,illinois physicians in his capacity as secretary of the 8,physicians' ,league of ,illinois40 ,the 8league0 issued a 8report on candidates for governor and members of legislature10 giving the names of the various political candidates for office whom 8the members of the league can safely support40 ,there were no 8membership0 fees and a physician who wrote asking 8who foots the bills0 received no reply4 ,in #aiae ,albert ,a4 ,lowenthal1 whose 8valuable discoveries in the domains of ,organo ,therapy1 ,neurology and ,pediatrics1 have given him an international reputation as a ,neurologist1 ,alienist and ,climatological ,expert of high standing10 was 8,medical ,superintendent0 of the 8,national ,sanitarium ,information ,bureau40 ,this purported to represent the 8,leading ,sanitariums and ,health ,resorts in the ,u4 ,s40 ,the 8,bureau0 expected to make its 8profit from the #aj per cent4 honorarium received on every referred patient40 ,the 8,business ,manager0 of this concern was one ,hubert ,miller1 ,m4,d4 ,the following advertisement appeared in the classified department of the ,st4 ,louis ,post ,dispatch in #aiae3 ,illustration ,a layman who wrote in answer to this advertisement received a letter from ,dr4 ,lowenthal in which he said that it was his intention to take about thirty patients south with him for four months--cost of trip #ejj1 which includes medical treatment1 board1 etc4 ,dr4 ,lowenthal stated further3 8,i have treated probably more cases of ,locomotor ,ataxia and ,paralysis than any ,physician in ,united ,states and can honestly state that with ,organo ,therapy ,treatment your walk can be improved and pains controlled40 ,in ,march1 #aiai1 ,dr4 ,lowenthal paid a visit to ,spokane1 ,wash41 and ,portland1 ,ore4 ,a ,portland paper heralded his coming and printed a picture of 8,dr4 ,a4 ,a4 ,lowenthal1 ,world famous alienist40 ,the paper described ,dr4 ,lowenthal as 8the alienist consulted in the ,harry ,thaw case0 and the one 8who treated ,john ,alexander ,dowie of ,zion ,city fame and ,pope ,leo ,,xiii40 ,the fulsome puffery that ,dr4 ,lowenthal got while in ,spokane drew criticism from one or two members of the local medical profession1 who wrote to the newspapers protesting4 ,one of the physicians who thus wrote declared that ,lowenthal's 8coming was announced in a circular sent through the ,owl ,drug ,company which is agent for the sale of products of an organo-therapy company40 ,apparently1 it was after ,dr4 ,lowenthal's return from the ,pacific ,coast that he commenced to announce his 8,post-,graduate ,course of ,lectures and ,clinics0 to the physicians of ,chicago1 ,denver1 ,st4 ,louis1 ,columbus1 etc4--and1 incidentally1 to bring to the attention of the medical world the alleged virtues of the products of the ,american ,organo-,therapy ,company4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #c1 #aibj47 ,,medical ,,society ,,of ,,the ,,united ,,states ,from 8,division of ,fees0 to 8,down with ,autocracy0 ,the 8,medical ,society of the ,united ,states0 has for its 8,honorary ,president0 one ,a4 ,h4 ,ohmann-,dumesnil1 ,a4,m41 ,m4,d41 ,m4,e41 ,sc4,d41 ,ph4,d41 and for its 8,secretary and ,treasurer0 one ,emory ,lanphear1 ,m4,d41 ,c4,m41 ,ph4,d41 ,,ll4,d4 ,as originally planned1 the 8society0 seems to have been based on the idea of organizing the 8fee-splitters40 ,in ,may1 #aiaf1 the birth of the organization was announced to the medical profession through a letter signed ,emory ,lanphear1 written on the stationery of the 8,medical ,society of the ,united ,states40 ,even in its embryonic state the society had ,a4 ,h4 ,ohmann-,dumesnil1 ,a4,m41 ,m4,d41 ,m4,e41 for its president1 and ,emory ,lanphear1 ,m4,d41 ,ph4,d41 ,,ll4,d41 as its treasurer4 ,the letter read in part3 8,we--the majority of the medical profession--who believe in division of fees 7i4 e41 that the surgeon should not #8hog' the whole of a patient's money and leave nothing for the family doctor71 are no longer welcome in the ,a4 ,m4 ,a4 ,we are therefore organizing the ,medical ,society of the ,united ,states1 which will not be conducted for the benefit of a few selfish egotists4 ,we would like to have you with us4 8,it costs only #a4jj to join4 ,this covers dues for #aiaf1 and includes expense for the beautiful certificate of membership 7suitable for framing71 which you will receive on admission4 ,fill enclosed blank and return to me with #a4jj40 ,but presumably the idea of organizing on a basis of 8fee splitting0 did not make a hit1 so the lure was changed4 ,today physicians are approached with the plea that the 8,medical ,society of the ,united ,states0 will make the medical world free for democracy2 it is1 we are assured1 a 8,society of ,protest ,against the ,autocracy of the ,a4 ,m4 ,a410 and a 8,society of ,medical ,democracy40 ,membership costs 8only #a4jj 444 including the cost of a beautiful certificate of membership40 ,no penalties or punishments are involved for belonging to other societies1 and3 8,joining our body need not affect your membership in any other society--even the ,a4 ,m4 ,a41 if you wish to belong to it1 and be #8bossed' by the #8,simmons ,gang'40 ,the dollar for the 8beautiful certificate0 and membership is solicited by means of circular letters signed 8,emory ,lanphear10 coming from #cddg ,pine ,st41 ,st4 ,louis1 ,mo41 the address of what has been variously called the 8,american ,polyclinic10 the 8,american ,hospital10 and later1 the 8,german ,hospital40 ,the 8,surgeon-in-,charge0 of the 8,german ,hospital0 is ,emory ,lanphear1 ,m4,d41 ,c4,m41 ,ph4,d41 ,,ll4,d4 ,when running under the name of the 8,american ,hospital10 ,lanphear solicited operative work on a 8division of fees0 basis1 which1 the general practitioner was told1 meant that 8you are to have #dj per cent4 of all fees received from your patients sent to our staff for operation or treatment40 ,with the change in name from 8,american ,hospital10 to 8,german ,hospital10 ,lanphear appealed for a 8portion of your operative work on a basis of pure reciprocity40 ,this 8pure reciprocity0 seems to have been a still more liberal distribution of the patient's money1 for from a #dj per cent4 basis it was raised to an even fifty-fifty4 ,said ,lanphear1 in a letter sent out a few months ago3 ,illustration3 ,the 8,medical ,society of the ,united ,states10 was originally organized on a basis of 8fee-splitting10 as is shown by the reduced facsimile of a letter sent broadcast in #aiaf1 announcing the birth of the new 8society40 ,apparently1 8fee-splitting0 as a rallying point did not bring in the desired returns1 so today the 8,medical ,society of the ,united ,states0 is alleged to be a 8,society of ,protest ,against the ,autocracy of the ,a4 ,m4 ,a40 8,i wish also to inform you in spite of the despicable opposition of the hypocritical gang in charge of the ,a4 ,m4 ,a41 and the no less contemptible action of the ,st4 ,louis ,medical ,society1 ,i am going to remain in ,st4 ,louis and continue to do surgical work upon a #8division of fee' basis4 ,to be more explicit1 if you bring me a case for operation ,i shall allow you one half of the fee for your time1 trouble1 responsibility and help in the management of the case40 ,before leaving the interesting professional personality of ,lanphear1 and carefully avoiding any details of a personal nature1 we may remind our readers that as long ago as #aijh ,lanphear was the 8,dean0 of the 8,hippocratean ,college of ,medicine10 with ,a4 ,h4 ,ohmann-,dumesnil1 ,a4,m41 ,m4,d41 ,m4,e41 ,sc4,d41 8,vice-,dean40 ,at that time ,lanphear sent out letters to physicians proposing the organization of a 8,post ,graduate ,faculty0 on the following basis3 8,those who hold full professorships shall purchase stock in the corporation to the amount of #a1jjj4jj2 those who become lecturers or instructors shall pay in the sum of #ejj4jj2 those who are to be merely clinical assistants will buy ten shares of stock1 #ajj4jj40 ,the 8,hippocratean ,college0 was a 8sundown0 affair2 it never graduated a student1 and expired in #aiaj4 ,illustration3 ,reduced facsimile of the letter-heads of an institution known variously as the 8,american ,hospital0 and the 8,german ,hospital40 ,the change in name from 8,american0 to 8,german0 seems to have taken place early in #aiae--when things ,german were more popular and profitable than they are today6 ,but to come back to the 8,society of ,medical ,democracy03 ,the 8,medical ,society of the ,united ,states0 seems to have been born in #aiaf4 ,its parents1 so far as is apparent1 seem to have been ,lanphear and ,ohmann-,dumesnil4 ,the latter1 it may be remembered1 used to be the editor and proprietor of the ,st4 ,louis ,medical and ,surgical ,journal1 a publication so obviously venal1 that its value to the nostrum makers1 whose interests it espoused1 must have been small4 ,advertising pages1 8original articles0 and 8editorials0--all were used to puff nostrums of the crudest type4 ,it was ,ohmann-,dumesnil and his journal that came to the defense of the 8patent medicine0 interests when they were so hard hit by ,mr4 ,adam's 8,great ,american ,fraud0 series4 ,in commenting on this phase of 8patent medicine0 activities1 ,collier's1 in ,january1 #aijg1 said3 8,headache powders came in for a considerable share of attention in the patent medicine articles4 ,there was much talk of libels among the headache powder makers1 but they decided upon the safer methods of hiring a meretricious medical publication1 the ,st4 ,louis ,medical and ,surgical ,journal1 to print an article in which the ,collier's statements were branded as lies1 and the ,collier's editors and writers as liars and libelers4 ,this article the ,proprietary ,association of ,america circulated in pamphlet form4 ,the journal which printed it died a natural death a few weeks later4 ,its editor1 one ,a4 ,h4 ,ohmann-,dumesnil1 has just appeared in the public prints in an unsavory connection with a corrupt lobbying project in ,st4 ,louis40 ,some of the nostrums that ,ohmann-,dumesnil has recommended are3 8,sanmetto10 8,gonosan10 8,cactina ,pillets10 8,pepto-,mangan10 8,satyria10 8,campho-,phenique10 8,tongaline10 8,germiletum10 8,narkogen10 8,nosophen10 8,mercauro10 8,arsenauro10 and 8,hydrozone40 ,many of these testimonials were1 of course1 used by the manufacturers in their advertising 8literature40 ,at the time that the ,medical ,society of the ,united ,states was being organized--in #aiaf--there was published what purported to be a preliminary program of its first meeting4 ,the meeting was held in ,st4 ,louis1 and the program1 while containing the names of men with special fads or interests to exploit1 also contained the names of some men of standing4 ,it appeared1 however1 on investigation1 that at least some of the latter had but a hazy conception of the use to which their names were being put1 and protested vigorously on learning the facts1 repudiating the organization4 ,illustration3 ,reduced facsimile of a letter sent out in #aiab1 soliciting the purchasing of stock in the 8,american ,hospital0 on a division of fee basis--forty-sixty6 ,now1 in #aiah1 another drive is on for membership2 letters signed 8,emory ,lanphear0 are being sent to various selected groups of physicians4 ,for example1 the ,eclectics are being coaxed by a letter which commences3 8,we want every reputable ,eclectic practitioner in this country to join our society of protest against the iniquities of the ,a4 ,m4 ,a40 ,an identical letter has been addressed to ,homeopaths1 the words 8,homeopathic practitioner0 being substituted for 8,eclectic practitioners40 ,in all of the letters the 8beautiful certificate of membership0 is emphasized1 and the trivial cost--8only #a4jj a year0--is referred to1 while the plea3 8surely you are willing to help to that amount to #8down' the #8gang' in charge of the ,a4 ,m4 ,a410 is featured4 ,another group of letters has gone out to the graduates of the ,barnes ,medical ,college4 ,this commences3 8,most graduates of #8,old ,barnes' have joined our society of protest against the iniquities of the ,a4 ,m4 ,a4 ,why should you also not come in8 ,it costs only #a4jj to become a member1 including the cost of a beautiful certificate of membership40 ,still another group appeal is based on sex2 thus ,lanphear3 8,we want every reputable #8lady physician' in this country to join our society of protest against the iniquities of the ,a4 ,m4 ,a40 ,and yet another3 8,you formerly belonged to the ,tri-,state ,medical ,society1 of which ,i was ,treasurer for #bj years4 ,it is now dead4 ,i wish you would join our new society which has superseded ,tri-,state in this territory40 ,with these various letters is enclosed a 8preliminary program0 of the #aiah meeting which is to be held ,october #h and #i in ,chicago4 ,as might be expected1 many of the names on the program are characteristic of the organization and an interesting 8story0 might be made from the material in ,the ,journal's files on the individuals4 ,such names are of men1 who1 professionally speaking1 range from faddists1 who ride grotesque and bizarre medical hobbies1 to those who with special interests to exploit and unable to use reputable medical organizations for that purpose1 take refuge in such hybrid conglomerations as the ,medical ,society of the ,united ,states4 ,not that the program contains the names of crude quacks1 or obvious medical swindlers4 ,it is representative1 rather1 of that twilight zone of professionalism1 the penumbra1 in whose uncertain light it is difficult to distinguish between the unbalanced visionary1 with a fad1 and the more sinister near-quack1 with a 8scheme40--7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #e1 #aiah47 ,,the ,,national ,,formulary--,a ,,review ,,of ,,the ,,fourth ,,edition ,the fourth edition of the ,national ,formulary appears simultaneously with the ,u4 ,s4 ,pharmacopeia ,,ix1 and is to become official at the same time 7,september #a74 ,the principles which determine its scope1 as frankly set forth in the preface1 are apparently the same as those applied1 though more faint-heartedly1 in the compilation of the ,pharmacopeia4 ,a statement in the preface of the new ,national ,formulary runs3 8,the scope of the present ,national ,formulary is the same as in previous issues1 and is based on medical usage rather than on therapeutic ideals4 ,the committee consists entirely of pharmacists1 or of men with a pharmaceutical training1 and it cannot presume either to judge therapeutic practice or to follow any particular school of therapeutic practice4 ,the question of the addition or deletion of any formula was judged on the basis of its use by physicians and its pharmaceutical soundness4 ,the considerable use by physicians of any preparation was considered sufficient warrant for the inclusion of its formula in the book1 and a negligible or diminishing use as justifying its exclusion40 ,part ,i of the volume contains formulas1 good1 bad and indifferent1 including the equivalents of a large number of shotgun proprietaries4 ,part ,,ii contains descriptions of drugs4 ,this is a new feature4 ,the purpose is to provide standards for those drugs not described in the ,pharmacopeia but used in ,n4 ,f4 preparations4 ,many of these drugs were described in the ,u4 ,s4 ,pharmacopeia ,,viii1 but have not been included in the ninth revision4 ,practically all are either worthless or superfluous4 ,part ,,iii contains descriptions of special tests and reagents4 ,among the therapeutically useful formulas are those for aromatic castor oil1 emulsion of castor oil1 sprays or nebulae1 solution of aluminum acetate1 solution of aluminum subacetate and wine of antimony4 ,the two last named are also included in 8,useful ,drugs40 ,several formulas for new classes of preparations which may or may not be found superior to old forms are paste pencils for the application of medicaments to limited areas of the skin1 mulls1 which are ointments spread like plasters1 and fluidglycerates1 which are fluidextracts in which glycerin takes the place of alcohol4 ,it should be noted also that1 as a result of criticism1 the alcohol content of some preparations has been reduced4 ,as a whole1 the present edition of the ,national ,formulary1 like its predecessors1 is 8pharmaceutically useful but not a therapeutic necessity40 ,to say that it is not a therapeutic necessity is to state the matter mildly1 since most of the formulas and almost all of the drugs described have been discarded long since by rational therapeutists4 ,so long as there are physicians who prescribe therapeutic monstrosities1 however1 the druggist should have the aid that is furnished by this book in compounding them4 ,from the pharmacist's point of view1 therefore1 the book is a valuable one4 ,physicians who have a scientific training in the pharmacology of drugs will not want it2 others will be better off without the temptations offered by its many irrational formulas4--7,book ,review in ,the ,journal ,a4 ,m4 ,a41 ,sept4 #b1 #aiaf47 ,,nonspecific ,,protein ,,therapy ,the treatment by nonspecific methods in a series of cases of influenzal pneumonia has been the subject of two recent papers4#bie ,these methods are a development of the work of ,ichikawa1 ,kraus1 ,ldke1 ,jobling and ,petersen1 and others on the treatment of typhoid fever and of ,miller and ,lusk's work on arthritis4 ,in the original work in this field it was recognized that there were certain inherent dangers in the method and that wide application would be permissible only with the greatest caution and under careful control4 #bie ,roberts1 ,dudley1 and ,cary1 ,e4 ,g43 ,bacterial ,protein ,injections in ,influenzal ,pneumonia1 ,j4 ,a4 ,m4 ,a4 #gb3ibb 7,march #bi7 #aiai4 ,cowie1 ,d4 ,m41 and ,beaven1 ,p4 ,w43 ,nonspecific ,protein ,therapy in ,influenzal ,pneumonia1 ,j4 ,a4 ,m4 ,a4 #gb3aaag 7,april #ai7 #aiai4 ,when vaccines and other toxic protein substances are injected intravenously a train of reactions takes place that includes3 7a7 a primary leukopenia1 followed by a leukocytosis2 7b7 a primary lessening of the coagulability of the blood1 followed after some interval by a reduction of the coagulation time2 7c7 a pronounced lymphagogue effect1 the flow of lymph from the thoracic duct being increased threefold2 7d7 a hyperperistalsis of the intestinal tract1 and 7e7 a marked splanchnic engorgement with a resulting lowering of the systemic blood pressure4 ,the alteration of the coagulability of the blood1 together with the vascular engorgement of the splanchnic area and the coincident increase in motility of the intestinal tract that follow the therapeutic injection1 all tend to increase the possibility of intestinal hemorrhage4 ,protein therapy is therefore not a safe procedure in this particular disease4 ,that we are able to terminate a certain number of cases of typhoid fever by crisis by means of such injections is of very great interest from a theoretical point of view4 ,in the treatment of arthritis1 the results seem much more satisfactory4 ,the work of ,miller and ,lusk#bif has been confirmed by a number of observers1 among them ,culver1 ,cecil1 ,snyder1 ,cowie and ,calhoun2 and there seems little doubt that we may be able to give prompt relief and even permanent freedom from symptoms in a considerable percentage of cases of acute and subacute arthritis1 especially those classed as of rheumatic origin--and this with practically no risk to the patient4 #bif ,miller1 ,j4 ,l41 and ,lusk1 ,f4 ,b43 ,the ,treatment of ,arthritis by the ,intravenous ,injection of ,foreign ,protein1 ,j4 ,a4 ,m4 ,a4 #ff3 #agef 7,june #c7 #aiaf2 ,the ,use of ,foreign ,protein in the ,treatment of ,arthritis1 ibid4 #fg3 #bjaj 7,dec4 #cj7 #aiaf4 ,as with other new therapeutic measures1 there is still some uncertainty as to the proper dosage1 which is a matter of considerable importance1 in order to arrive at a just estimate of the relative advantage or danger in the treatment4 ,typhoid vaccines have been extensively used because they are readily procured and give a prompt and sharp reaction4 ,however1 they have the disadvantage of inexactitude in the bacterial count1 as well as being of varying degrees of toxicity1 the latter factor depending not only on the use of different strains of bacteria in their preparation but on the age of the vaccine4 ,synder1#big as well as other workers1 is of the opinion that the primary dose should be small--from five to ten million organisms--and that the dose of typhoid bacilli injected should never exceed two hundred and fifty million4 ,while a sharp reaction on the part of the patient is apparently a desideratum1 a sufficient response can usually be elicited with a relatively small dose4 ,there is no object in subjecting the patient to the risk of the profound depression that follows occasionally in the wake of large doses4 ,indeed1 the only serious results so far ascribed as due to this form of therapy have followed very large doses or the use of relatively large doses in moribund patients2 or such unreasonable procedures as the intravenous injection of milk4 ,it is true that milk injections were recommended by some of the ,german investigators1 but they were always used intramuscularly4 #big ,snyder1 ,r4 ,g43 ,a ,clinical ,report of ,nonspecific ,protein ,therapy in the ,treatment of ,arthritis1 ,arch4 ,int4 ,med4 #bb3 #bbd 7,aug47 #aiah4 ,in the treatment of pneumonia1 ,roberts and ,cary#d have employed a vaccine made up of #ajj million of each of the following organisms per cubic centimeter3 influenza bacilli1 pneumococci1 staphylococci and streptococci4 ,of this vaccine they injected1 intravenously1 first #j4e c4c41 later #a c4c4 ,in the series of #bjj patients so treated there was no evidence of injury to the patients in any way4 ,the mortality in this series was #i4e per cent42 in a series of eighty-six patients not treated with vaccine1 the mortality was #ca4b per cent4 ,in the untreated series1 #bj per cent4 recovered by crisis2 in the treated1 #cf per cent4 so recovered4 ,before any reliance is placed on such statistics they should be analyzed and compared carefully according to age periods1 as the death rate may vary at different ages4 ,cowie and ,beaven#bih used typhoid vaccine in the treatment of their patients1 and they consider the vaccine shock as indicated only in the early stages of pneumonia4 #bih ,report of ,international ,health ,board1 ,social ,medicine1 ,medical ,economics and ,miscellany1 ,j4 ,a4 ,m4 ,a4 #gb3 #gea 7,march #h7 #aiai4 ,before applying the treatment to such diseases as pneumonia it would seem that prudence would demand a thorough familiarity with the range of the reaction and the degree of toxicity of the preparation it is intended to use by first employing it in some arthritic cases4 ,in pneumonia we must ever keep before us the vital factor of cardiac impairment2 and certainly we must not undertake any measure that may depress the function of the heart4 ,in arthritis this danger is largely a negligible one2 and1 with proper precaution1 nonspecific therapy is not only without risk but indeed frequently followed by gratifying clinical improvement4 ,only in the light of experience gained in the manner indicated would it seem permissible for us to attempt to extend this form of therapy to more acute infections4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,may #ag1 #aiai47 ,,willard ,,ealon ,,ogden ,a 8,specialist in ,proctology0 and ,his 8,clinics0 ,within the past few weeks a number of inquiries have reached ,the ,journal from physicians in ,ohio1 ,indiana and ,pennsylvania4 ,those that follow are typical3 8,i am in receipt of literature from ,h4 ,l4 ,roberts1 #aabf ,masonic ,temple1 ,chicago1 advertising clinic in ,cleveland by ,dr4 ,willard ,e4 ,ogden who claims to be a member of the ,chicago ,medical ,society and the ,a4 ,m4 ,a4 ,what can you say of this man and his methods80 8,i am enclosing a folder received a short time ago4 ,i would be glad to know if ,dr4 ,ogden is a member of the ,a4 ,m4 ,a4 as he claims to be40 8,the enclosed folder has been sent to many doctors in ,indiana4 ,the purpose is plain4 ,the attached post card on this one was returned to him for further literature40 ,illustration3 ,photographic reproduction of one of ,ogden advertisements in ,chicago newspapers at the time he was at #cf ,w4 ,randolph ,street4 ,in each case the correspondents send in a four-page folder bearing the title 8,proctology1 ,a ,clinic4 ,who8 ,where8 ,why80 ,three of the four pages purport to answer the interrogations given on the title page4 ,under 8,who80 we read3 ,,dr4 ,,willard ,e4 ,,ogden ,chicago1 ,ill4 ,,specialist ,,in ,,proctology ,member ,chicago ,medical ,society and ,a4 ,m4 ,a4 ,author of 8,improved ,method of ,treating ,rectal ,diseases0 ,formerly associated with ,drs4 ,burleson ,burleson ,grand ,rapids1 ,mich4 ,under the question 8,where80 there appears the statement that 8,dr4 ,ogden ,will ,hold a ,clinic for ,the ,treatment of ,rectal ,diseases0 and the name of the city and the dates of the 8clinic0 are inserted with a typewriter4 ,under 8,why80 we read3 8,dr4 ,ogden does not use the usual surgical methods4 ,his many years of experience in the treatment of ,rectal ,diseases 7during which time he has been associated with the leading ,proctologists of ,america7 have enabled him to develop a system of office treatment which is not taught by any other practitioner4 8,tear off1 sign and mail attached postcard and ,i will send you a booklet giving you full particulars as to the course4 ,yours truly1 ,h4 ,l4 ,roberts1 ,business ,manager4 8,eighty-three per cent4 of the people have some ,rectal trouble4 ,,this ,,is ,,the ,,day ,,of ,,specialists4 ,why not fit yourself to specialize in ,proctology80 ,the fourth page is a post card addressed to 8,h4 ,l4 ,roberts1 ,room #aabf1 ,masonic ,temple1 ,chicago40 ,on the reverse side there is a printed statement which the recipient is expected to sign to the effect that he is interested in 8,dr4 ,ogden's ,clinic0 and wishes to have 8full particulars of the course40 ,a visit to ,room #aabf1 ,masonic ,temple1 failed to disclose the name of ,h4 ,l4 ,roberts1 either on the door 7or doors1 for there are two rooms having this number7 or on the office building directory board4 ,in fact1 ,rooms #aabf seem to contain a somewhat miscellaneous assortment4 ,the signs1 either on the door or on the directory board1 show that there is a public stenographer 7who operates a 8,mailing ,service10 and does 8,addressing1 ,mailing1 ,multigraphing1 ,mimeographing071 a bookstore1 a chocolate company1 a publishing company1 a lumber company1 and one or two other concerns2 but the name of 8,h4 ,l4 ,roberts0 does not appear4 ,incidentally1 no 8,h4 ,l4 ,roberts0 is to be found listed in the ,chicago telephone directory4 ,a few yards away from ,rooms #aabf and on the same floor there appears the name1 8,dr4 ,willard ,e4 ,ogden0 on ,room #aajb4 ,according to our records1 ,willard ,ealon ,ogden was born in #ahff4 ,before taking up the study of medicine he seems to have been a preacher4 ,in #ahii he was graduated by the ,saginaw ,valley ,medical ,college1 ,saginaw1 ,mich4 ,he was licensed in ,michigan in #aijj1 in ,illinois and ,indiana in #aiac1 and in ,wisconsin in #aiba4 ,from #aijj until #aijd he practiced in ,lyons1 ,mich42 from #aijf until #aiaa he was at ,ionia1 ,mich4 ,in #aiaa1 he was in ,grand ,rapids1 ,mich41 and was associated with ,burleson and ,burleson1 an advertising pile cure concern4 ,from some of the voluminous ,burleson advertising on file1 we learn that they 8cure all diseases of the rectum 7except cancer720 and claim to have 8the most successful method ever discovered10 and to have cured 8many desperate cases that have been given up to die40 ,furthermore1 they 8guarantee to cure in every case or make no charge40 ,on ,jan4 #a1 #aiad1 ,ogden was sending out a card to physicians in which he stated that he had removed from ,grand ,rapids1 ,mich41 and ,la,porte1 ,ind41 to #cf ,w4 ,randolph ,st41 ,chicago1 and that he would limit himself 8exclusively to the treatment of diseases of the rectum40 ,later1 ,ogden was sending out an advertising booklet filled with testimonials4 ,in #aiad1 ,ogden was carrying display advertisements in ,chicago papers reading1 in part1 in large back-faced type3 8,piles ,cured ,absolutely ,without ,knife1 ,anesthetics1 ,pain or ,loss of ,time4444 ,cure ,guaranteed or ,money ,refunded40 ,in ,march1 #aiah1 he became a member of the ,chicago ,medical ,society and qualified for ,fellowship in the ,american ,medical ,association1 ,august1 #aiah4 ,in #aiba1 ,ogden had a copyrighted mail-order course on the 8,treatment of ,rectal ,diseases by ,improved ,method40 ,this 8course0 consisted of thirty-eight pages of foolscap printed on one side in imitation typewriting4 ,the material abounded in typographical errors4 ,among the proprietary products recommended in this 8course0 as 8essential0 to those taking it1 was 8,mecca ,ointment40 ,this nostrum1 made by a ,chicago concern1 was declared misbranded in #aiaf because of false and fraudulent claims made knowingly1 recklessly and wantonly4 ,the 8course0 was divided into ten parts1 and with it1 apparently1 came ten consecutively numbered sealed envelops1 and the purchaser was instructed to open these envelops1 one at a time1 as he completed the corresponding part in the 8course40 ,he would there find questions which were to be answered and returned to ,ogden4 ,this1 according to the description1 was to enable ,ogden to determine whether it was necessary to 8enter more into detail upon that particular subject10 which1 he stated1 he would gladly do if necessary4 ,illustration3 ,photographic reproduction 7reduced7 of the first page of a booklet ,ogden was sending out in the latter part of #aiad4 ,furthermore1 the purchaser had the privilege of asking questions of ,ogden relative to symptoms1 diagnosis and treatment for a period of six months after the purchase of the 8course40 ,although1 in ,ogden's opinion1 8you should have the subject well understood long before that time40 ,the charge for this course and 8services as outlined0 was #bjj1 but in order to show his confidence in the ability of those who purchased it1 ,ogden was willing to take #ajj down and the other #ajj paid in 8five per cent4 of monies received from ,,cured patients0 until the balance was paid4 ,reverting to the present 8post-graduate course0 and 8clinic03 ,those who send in the postal card to 8,h4 ,l4 ,roberts0 receive a form-letter1 signed 8,h4 ,l4 ,roberts0 in facsimile handwriting1 stating that information was enclosed 8regarding ,,the ,,ogden ,,methods0 and stating that ,dr4 ,ogden would be in ,indianapolis or ,cleveland or ,pittsburgh1 as the case might be1 on a certain date and that the fee for the 8clinic0 would be #ajj4 ,with this letter is an eight-page pamphlet entitled 8,some ,facts ,concerning the ,ogden ,method of ,treating ,rectal ,diseases40 ,the first page is headed in black-faced type3 8,about ,references and ,endorsements40 ,it then states that the 8usual references and endorsements are omitted from this booklet40 ,further3 8,as to ,dr4 ,willard ,e4 ,ogden3 ,the professional and social standing of ,dr4 ,ogden is such that he does not need to offer any4 8,as to #8,,the ,,ogden ,,method' and its value to you in your professional work3 ,what others say or think has little if any weight4 ,you are your own man4 ,you do your own thinking4 ,you decide for yourself--,do you not80 ,illustration3 ,photographic reproduction 7greatly reduced7 of an advertisement of the ,burleson concern with which ,ogden was connected previous to #aiad1 and which connection he is capitalizing in his present advertising4 ,the booklet gives an outline of the 8,course of ,instruction10 which is almost identical1 word for word1 with the outline given in the letter advertising the mail-order course previously referred to4 ,the booklet further states that 8,,the ,,ogden ,,method has entirely eliminated the use of cautery1 the ligature or any injections1 in the treatment of hemorrhoids10 but that 8the use of the electric current has proved to be the very correct method in such cases1 as will be demonstrated at the clinic40 ,the booklet reiterates the statement that ,ogden's association with the ,burleson and ,burleson concern at ,grand ,rapids makes him 8eminently well qualified to instruct members of the medical profession in this important branch of the medical science60 ,in addition to this booklet there is a four-page advertising leaflet illustrating and describing the 8,ogden ,rectal ,cabinet0 and also the 8,ogden ,rectal ,table and ,stool40 ,there is also a little postcard--addressed1 of course1 to 8,h4 ,l4 ,roberts0--for the physician to fill in stating that 8you may enroll me as intending to attend ,dr4 ,ogden's ,clinic in ,proctology1 to be held at----40 ,should the recipient not fill in and mail this enrolment card he gets another form letter calling attention to the fact that the enrolment card has not been received and stating further that 8available hotel facilities make it necessary to limit our enrolment to twenty students40 ,careful search fails to disclose that ,dr4 ,willard ,ealon ,ogden has ever distinguished himself in the practice of the specialty in which he now wishes to instruct physicians4 ,equally careful search fails to show that ,dr4 ,ogden has ever published a paper either on any proctologic subjects or on any other phase of medicine or surgery4 ,neither does there seem to be any evidence for the claim that ,dr4 ,ogden 8has been associated with the leading ,proctologists of ,america40--7,from ,the ,journal ,a4 ,m4 ,a41 ,feb4 #d1 #aibb47 8,,patents0 ,patent ,laws and ,patent ,office ,practice ,the inequity of our patent laws1 or possibly it would be more correct to say1 of the interpretation of our patent laws1 has been commented on many times in ,the ,journal4 ,the ,journal also has had occasion to call attention to patents that have been issued for obviously unscientific and quackish devices and preparations4 ,the cases of the preposterous gas-pipe fake 8,oxydonor0 and the creatinin mixture for the alleged conferring of immunity against diphtheria1 pneumonia1 scarlet fever1 syphilis1 tuberculosis1 etc41 are cases in point4 ,in a patent issued the early part of this year for the 8discovery0 of a method of flavoring ,epsom salt1 the patent office has1 in fatuity1 piled ,pelion on ,ossa4 ,the 8inventor0 declares that his invention relates to a pharmaceutical preparation and a special method of treatment of the medicinal agents whereby said agent will be rendered much more efficient in character4 ,he further avows that the 8prime object0 of his 8invention0 is to 8disguise the normal taste and impart an agreeable odor or smell to salts commonly employed as a cathartic40 ,parenthetically it may be said that probably not a day passes that some physician in the ,united ,states does not do substantially the same thing when writing a prescription4 ,the 8inventor0 further claims that the object of his 8invention0 is to utilize the salts as a vehicle to carry an antiseptic and anesthetic agent whereby the salts when administered as a cathartic 8will also act beneficially on the entire digestive tract0 and 8whereby cramped and spasmodic conditions are at once relieved with a resulting cure of flatulency1 indigestion1 sick and sour stomach1 colic and the destruction of worms1 etc40 ,such claims are so absurd that the only excuse for commenting on them is the effect they have on the public mind4 ,the layman reading the specifications of this patent would naturally conclude that an invention of great importance had been made--of such importance as to warrant the government in rewarding its inventor by granting him a seventeen-year monopoly on the sale of his invention4 ,the law requires that1 to be patentable1 inventions shall be new and useful and shall show a higher degree of skill in their inception than is naturally to be expected from those who are skilled in the arts to which the inventions belong4 ,it has been decided again and again that physicians' prescriptions are not patentable because it is assumed that an educated physician will utilize his knowledge of pharmacy in devising proper compounds of medicines to meet the indications of disease4 ,when a physician prescribes a dose of ,epsom salt to be taken in one of the official aromatic waters1 he does not produce or create a new invention by so doing4 ,of course1 in one sense every prescription is an invention--an invention to meet the conditions presented by the patient--but such inventions are not patentable1 because they represent the ordinary skill of a physician in carrying on his vocation4 ,if the patent office goes on granting patents for such 8inventions0 as flavored ,epsom salt1 and it should be found financially profitable to secure such patents and place the products on the market1 it will only be a matter of time before the materia medica will be so restricted that a physician will be unable to write a prescription without infringing on somebody's patent4 ,the splendid conception of the framers of our constitution in providing a plan for promoting progress in science and useful arts by granting to inventors for a limited time the exclusive use of their inventions1 in exchange for the publication of full knowledge thereof1 is being debased4 ,no branch of our government is of greater importance to the progress of the country than the patent office1 provided that office is intelligently administered4 ,when the patent office is used1 however1 for an extention of the nostrum business1 founded on the abuse of patent and trade-mark laws1 it becomes a menace to the public health4 ,the objects of the patent law are being defeated by the practices of the patent office4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,june #bc1 #aiag47 ,our ,archaic ,patent ,laws ,in this issue we publish two reports of the ,council on ,pharmacy and ,chemistry which illustrate the weaknesses of the present working of the ,united ,states patent laws4 ,in the first report the ,council presents an investigation of a recently granted patent1 and shows that the patent was issued on the mere claims of the applicant and without the presentation of any evidence for such claims4 ,the second report--8,need for ,patent ,law ,revision0--is an appeal to the ,patent ,office for a more enlightened administration of the patent law1 and it presents a few illustrations of the unfair protection which has been granted by the ,patent ,office4 ,the protest of the ,council appears at an opportune time4 ,in ,science#bii the 8,patent ,office ,society10 an association of employees of the ,u4 ,s4 ,patent ,office1 announces that a committee has been created on request of the ,national ,research ,council to make a study of the ,u4 ,s4 ,patent ,office and its service to science and arts4 ,it states that this committee will meet in ,washington shortly to consider the adequacy of the present ,patent ,office equipment and the simplification of procedure as well as responsiveness to present national and international requirements4 ,the committee also hopes to coordinate1 in the interest of an improved public service1 the endeavors of the various national societies1 manufacturing interests1 patent bar associations and all others aiming at genuine patent reform4 ,unquestionably1 there is a growing conviction that in the case of medicines the monopoly given by the patent laws1 if granted at all1 should be granted with greater consideration of the public welfare4 ,too often the ,united ,states ,patent ,law has been used to obtain an unfair monopoly on a medicament or to abet quackery4 ,there is no question that one of two things is needed3 either a radical change in the patent law itself or the application of more brains in its administration4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #ab1 #aiah47 #bii ,dec4 #bh1 #aiag1 p4 #fbi4 ,patents ,perpetuated by ,trade ,names ,the patent on aspirin#cjj 7acetylsalicylic acid71 controlled by the ,bayer ,company1 ,american representative of the ,farbenfabriken of ,elberfeld ,company1 will expire next year 7#aiag74 ,the ,journal has previously stated that the grant of this patent was regrettable and worked injustice to ,american citizens4 ,it is unnecessary again to go into the grounds for this statement2 neither in the ,farbenfabriken's home country1 ,germany1 nor in any other country except in the ,united ,states1 has a patent been granted for this product4 ,owing to their monopoly1 the manufacturers have been able to exact a much higher price for acetylsalicylic acid1 or aspirin1 in this country1 than elsewhere4 ,naturally1 the ,bayer ,company1 the ,american agents1 view with disfavor the prospect of being compelled to share this rich field with competitors4 ,the foregoing furnishes the answer to inquiries which have reached us from all over the country with regard to the campaign of publicity which the ,bayer ,company has inaugurated in the lay press4 ,a presumably authentic and apparently candid exposition of the methods used and the motives behind the aspirin advertising is furnished in ,printers' ,ink3#cja #cjj ,granted ,feb4 #bg1 #aijj4 #cja ,printers' ,ink1 ,june #bi1 #aiaf1 p4 #ahi2 ,july #ac1 #aiaf1 p4 #ajj4 8,the manufacturers of aspirin are about to launch an extensive advertising campaign to clinch the market as far as possible before the expiration of their patent rights next year4444 ,the purpose of the campaign is to identify the product with the trademark of the ,bayer ,company and to this extent hamper competition after the expiration of the patent40 ,the business of the ,bayer ,company1 the article goes on to say1 has been hurt by the sale of worthless or even harmful imitations put on the market by irresponsible and unauthorized persons when the present war stopped importations from ,germany4 8,the public knew aspirin1 but did not know who made it italics ours4444 ,when the ,bayer ,company1 ,inc41 took over the manufacture of aspirin in this country1 the first steps were taken to identify the product with the firm who made it4444 ,of course1 there are good reasons why the makers were loth to advertise the product or to exploit their trademark4 ,as every one knows1 the advertising of a medical proposition is an extremely ticklish subject4444 ,it is easy to make a misstep4 ,aspirin is one of those proprietary drugs that are extensively prescribed by physicians4 ,if anything were done that might possibly associate this drug with the patent medicines that are in disfavor with the profession1 the valuable influence and cooperation of thousands of doctors might be lost4 ,it is believed that this knotty phase of the question is being answered in the present advertising4444 ,since nothing is mentioned about #8medicine1' #8cures' or #8ailments1' it is anticipated that there will be but little objection to the copy4 ,all that the advertising attempts to do is to link up the name #8,bayer' with aspirin4444 ,the nearest the copy gets to medical talk is in this sentence in very small type at the bottom of the advertisement1 #8,the trademark 8,aspirin0 7,reg4 ,u4 ,s4 ,patent ,office7 is a guarantee that the monoacetic acid ester of salicylic acid in these tablets is of the reliable ,bayer manufacture4'0 ,from this it appears that1 not content with seventeen years of monopoly1 the aspirin people are attempting to retain a hold on the market in perpetuo by associating the name of the company with the trade name 8aspirin40 ,there can be no better time than the present1 therefore1 for the medical profession to substitute1 for the nondescriptive name 8aspirin10 the descriptive and correct name acetylsalicylic acid4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ab1 #aiaf47 ,patenting ,therapeutic ,agents ,in the past1 therapeutic agents and apparatus have been controlled by patents and trademarks for profit4 ,if there have been exceptions1 they have been rare4 ,the ,principles of ,medical ,ethics of the ,american ,medical ,association contain this statement3 8,it is unprofessional to receive remuneration from patents for surgical instruments or medicines40 ,this does not mean that the patenting is wrong in itself2 there are occasions when it is wise1 if not necessary1 to obtain a patent in the interest of the public1 and1 in the case of surgical instruments and medicines1 of the medical profession4 ,in certain instances it is absolutely necessary that the article produced shall maintain a definite standard of quality and purity--and1 it may be added1 shall be sold at a reasonable price4 ,enterprising pharmaceutical manufacturers have usually been ready to appropriate the results of scientific research by investigators or therapeutic measures suggested by practicing physicians4 ,not infrequently1 in such instances1 the desire for financial gain has caused the marketing of such products with extravagant1 if not false1 claims as to their value4 ,yet the patent laws may be used so as to protect and benefit the public and the medical profession4 ,in research laboratories1 work is being carried on resulting in the production of new therapeutic agents4 ,it is important that these agents shall be so controlled that they may be made available without subordination to commercial interests4 ,it has become practically necessary1 therefore1 for research workers to protect their products in the interest of the public welfare and scientific medicine4 ,it has not been an easy matter to decide how best to bring about the desired results4 ,this question has been before the ,board of ,trustees of the ,american ,medical ,association2 and1 in #aiad1 the ,house of ,delegates passed a resolution authorizing the board to accept at its discretion patents for medical and surgical instruments and appliances2 as trustees1 for the benefit of the profession and the public1 provided that neither the ,association nor the patentee should receive remuneration from these patents4 ,the ,rockefeller ,institute for ,medical ,research has solved the problem in a similar manner4 ,in connection with the report of the discovery of several new arsenic compounds1 ,jacobs and ,heidelberger1#cjb working in the ,rockefeller ,institute1 say3 #cjb ,jacobs1 ,w4 ,a41 and ,heidelberger1 ,m43 ,aromatic ,arsenic ,compounds1 ,,ii1 ,the ,amides and ,alkyl ,amides of ,n--,arylglycine ,arsonic ,acids1 ,j4 ,am4 ,chem4 ,soc4 #da3aehg 7,oct47 #aiai4 ,it may be appropriate to mention here that this substance and related compounds1 described in the present and following papers of the series1 are covered by ,u4 ,s4 ,patents ,nos4 #abhjaai-bg4 ,patents have also been applied for in foreign countries4 ,all discoveries made at the ,rockefeller ,institute are made freely available to the public1 in accordance with the philanthropic purposes of the institution4 ,in order to insure purity of product and protection against exploitation1 it has been deemed necessary in certain instances to protect the discoveries by patents4 ,it is the purpose of the institute to permit any drugs which may prove of practical therapeutic value to be manufactured under license by suitable chemical firms and under conditions of production which will insure the biological qualities of the drugs and their marketing at reasonable prices4 ,other than through the issuance of license1 the ,rockefeller ,institute does not participate in any way in the commercial preparation or sale of the manufactured chemicals2 and it receives no royalties or other pecuniary benefits from the licenses it issues4 ,here we have medicine at its best4 ,the altruism of pure science operating for the benefit of the general public3 scientific therapeutics freed from commercial domination4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ah1 #aiai47 ,,pharmaceutical ,,barnums ,does the public love to be humbugged8 ,we doubt it4 ,that we1 whether sage or fool1 are humbugged is undeniable4 ,we are humbugged just to the extent that we are ignorant4 ,there lies one of the most powerful factors operating to the advantage of the 8patent medicine0 maker and the quack4 ,the layman's ignorance of the possibilities and limitations of drugs is wide and deep4 ,hence the ease with which he is fooled on this subject4 ,a seeming frankness in advertising being the order of the day1 the nostrum maker makes a pretense of telling what is in his stuff without disclosing any facts that will tend to lift the veil of mystery and thus destroy his greatest asset4 ,so the exploiter of nostrums to the medical profession1 realizing that at least a pretense must be made of giving the composition of medicaments offered to the physician1 declares that his clay poultice has for its base 8anhydrous and levigated argillaceous mineral40 ,this sounds much more imposing than dry and finely powdered clay1 and satisfies by its very sonorousness4 ,now comes a product exploited chiefly to members of the dental profession but also1 it seems1 to physicians4 ,tablets1 8activated tablets10 if you please6 ,they are 8an anodyne1 analgesic febrifuge sedative1 exorcising sic6 antineuralgic and antirheumatic action40 ,and their composition8 ,simply 8an activated1 balanced combination of the mono-acetyl-derivative of para-amidophenetol together with a feebly basic substance in the alkaloidal state from the ,thea-,sinensis40 ,as clear as the ,missouri ,river6 ,some day some dentist or physician is going to investigate and find that this awe-inspiring1 polysyllabic example of exuberant verbosity means nothing more mysterious than our old friends acetphenetidin 7phenacetin7 and caffein4 ,in the meantime1 the exploiters may smile softly and murmur1 8,barnum was right60--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #a1 #aiba47 ,,the ,,pharmacopeia ,the ,ninth ,decennial ,revision ,the ninth revision of the ,united ,states ,pharmacopeia became official this week1 ,sept4 #a1 #aiaf4 ,it is more fully reviewed elsewhere2#cjc here we desire merely to call attention to two points2 what the book is and what it is not4 ,it is a book of standards for drugs2 it is not a book of standard remedies4 ,the ,committee of ,revision of the ,pharmacopeia included physicians and pharmacists 7retail1 wholesale and manufacturing71 but the pharmacists were in the majority and in control4 ,the majority of the representatives of the medical profession on this committee would have preferred to see the bulk of the ,pharmacopeia reduced and its value as a work of reference enhanced by the rejection of therapeutically worthless drugs4 ,the representatives of commercial interests1 on the other hand1 argued that it was necessary for the ,pharmacopeia to provide standards for drugs in more or less general use1 whether worthless or otherwise4 ,the force of this argument is somewhat impaired by the fact that the ,national ,formulary1 which has also been made a book of legal standards1 now includes individual drugs as well as combinations2 the new edition of the ,formulary1 in fact1 contains a large number of drugs which had been dropped from the ,u4 ,s4 ,pharmacopeia ,,viii4 ,the principle of making use the sole criterion for admission to the ,pharmacopeia1 however1 on the whole carried the day4 ,it has not been strictly observed2 good results from the efforts of the medical contingent are to be observed here and there1 as in the deletion of elixir of the phosphates of iron1 quinin and strychnin and of emulsion of cod liver oil with hypophosphites4 ,that these instances were not expressions of policy on the part of the ,committee on ,revision1 but merely deviations from policy1 may be seen by a glance at the contents of the new ,pharmacopeia4 ,these include substances which have been shown to be inert1 like the hypophosphites 7calcium1 potassium and sodium hypophosphites71 complex and obsolete mixtures1 like the compound syrup of sarsaparilla1 and drugs which have been tried and found wanting1 like saw palmetto berries4 ,even substances seldom used by the medical profession1 but chiefly or altogether by the public1 like sassafras1 hops and peppermint 7the herb71 are standardized and made official4 ,it seems difficult to discover any principle by which the sphere of the ,pharmacopeia may be definitely marked off from that of the ,national ,formulary4 ,there is one great advantage in specifying ,u4 ,s4 ,p4 drugs and preparations3 ,physicians who do so invoke legal standards of purity and identity4 ,the only way to be sure of obtaining substances of therapeutic efficiency1 however1 is to exercise discrimination4 ,the ,pharmacopeia is no guide4 ,being prepared mainly by pharmacists to meet the needs of pharmacists1 the ,pharmacopeia of course contains much matter of little interest to physicians and entirely foreign to scientific medicine4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #b1 #aiaf47 #cjc ,j4 ,a4 ,m4 ,a4 #fg3gfd 7,sept4 #b7 #aiaf4 ,review of ,ninth ,revision ,the ninth revision of the ,united ,states ,pharmacopeia1 which has been in the hands of the ,committee of ,revision for more than six years1 has just appeared4 ,as was to be expected1 the desire of medical men on the ,committee of ,revision to have therapeutic value made a requirement for admission to the ,pharmacopeia has not been fully realized2 it remains a book of standards for therapeutically good1 bad and indifferent remedies4 ,among the drugs of little or no therapeutic importance or value are musk1 arnica1 eriodictyon1 quassia1 pumpkin seed1 saw palmetto berries1 sarsaparilla and couch grass4 ,many superfluous drugs and preparations are included4 ,for instance1 of the nine forms of quinin described 7quinin alkaloid1 bisulphate1 dihydrochlorid1 hydrobromid1 hydrochlorid1 salicylate1 sulphate and tannate1 and quinin and urea hydrochlorid71 at least four might well have been eliminated4 ,two insoluble forms 7the alkaloid and the tannate71 two soluble forms 7the hydrochlorid and quinin and urea hydrochlorid71 and a moderately soluble form 7the sulphate7 are all that could reasonably be demanded by even the most extreme partisans of the doctrine of 8pharmaceutic necessity40 ,further1 the use of quinin salicylate for its salicylic acid content and of quinin hydrobromid for its bromid content is unscientific4 ,the inclusion of these salts in the ,pharmacopeia is regrettable4 ,those interested in the promotion of rational therapy will also regret the inclusion of a number of fluidextracts of violently toxic drugs1 such as aconite and gelsemium 7dose #a_/b minim each71 belladonna root1 digitalis1 nux vomica and ipecac 7dose #a minim each71 and lobelia 7dose #b-a_/b minims74 ,the more diluted forms1 the tinctures1 of these drugs are preferable4 ,the inclusion of such fluidextracts in the ,pharmacopeia is playing into the hands of certain pharmaceutical manufacturers1 who recommend the tincture be prepared from fluidextracts--an unscientific procedure4 ,the efforts of the medical members of the committee1 however1 have not been entirely fruitless4 ,of the articles described in the ,u4 ,s4 ,pharmacopeia ,,viii1 #bdc have been deleted2 sixty-seven new articles have been added4 ,the loss of #afg titles may be set down as a gain4 ,moreover1 most of the new substances give promise of therapeutic usefulness4 ,thirty-six are taken over from ,new and ,nonofficial ,remedies2 nineteen are substances which are in the edition of ,useful ,drugs now in the press4 ,it cannot be said1 however2 that all of the additions have been judiciously selected4 ,it is an infelicitous time to add calcium and sodium glycerophosphate just when grave doubts of their therapeutic efficiency are being felt4 ,the addition of the extracts of aconite1 hydrastis and viburnum prunifolium is likewise unfortunate4 ,all are superfluous preparations1 the first because a drug so powerful that an average dose of the extract is only #aj mg4 or #a_/f grain is better given in the form of tincture2 the second because hydrastis is a drug of uncertain value1 already represented by three preparations1 and the third because viburnum prunifolium has been discarded and discredited by the best therapeutic authorities4 ,it must be accounted clear gain1 on the other hand1 that the deletions include many inert1 obsolete or superfluous substances like bismuth citrate1 kaolin cataplasm1 pipsissewa1 coca leaves1 ladyslipper1 wahoo1 cotton root bark1 compound acetanilid powder and compound syrup of hypophosphites1 not to mention nine salts of iron and thirty-eight fluidextracts of various drugs4 ,wines1 unmedicated and medicated1 whisky and brandy are also among the articles dropped4 ,a number of new features are introduced1 such as microscopic standards for powdered drugs1 standard abbreviations for titles1 the use of the term 8mil0 instead of 8cubic centimeter10 and a chapter each on sterilization1 diagnostic reagents1 biologic assays1 electrolytic determination of metals and the determination of alcohol1 the melting point1 the boiling point and the congealing point4 ,the chemical nomenclature is substantially the same as that adopted in the previous revision2 so is the nomenclature of drugs4 ,the addition of official abbreviations for the ,latin titles of drugs will doubtless be found a useful feature4 ,less commendable is the change from the familiar 8,cc40 to 8mil40 ,the term 8cubic centimeter0 is so thoroughly established and so widely used1 wherever the metric system is employed1 that it cannot be expected that it will be universally displaced by the word 8mil40 ,the latter is therefore only a superfluous synonym1 and as such out of harmony with the simplicity of the metric system4 ,perhaps it may even be taken for the abbreviation of 8millimeter10 8milligram0 or other words derived from 8mille10 which would be equally entitled to the same abbreviation4--7,book ,review in ,the ,journal ,a4 ,m4 ,a41 ,sept4 #b1 #aiaf47 ,,physician',s ,,stock ,,in ,,prescription ,,products ,the letter that follows comes from a physician who feels that he has a grievance regarding a company in which he holds stock3 8,in #aiad1 ,i bought some stock of the ---- ---- ,company1 and in #aiag bought some more stock in the same company4 ,i notice that the company advertises in ,the ,journal of the ,american ,medical ,association1 and ,i believe it does this not so much to acquaint the medical profession with its product1 as to acquaint physicians with its name in order that its stock salesmen can keep on unloading more stock to members of the medical profession4 8,the company gets the doctors' money through the sale of stocks1 it gets its product on the market with the doctors' assistance and through their influence1 and it looks to me as if the doctors were getting very little in return1 as the dividend checks have been few and far between since ,i have known anything of the company4 8,it is not my idea to criticize the product2 but ,i do believe and feel that the stockholders are entitled to a square deal from a company which in turn is expecting so much from them1 and again ,i feel that the publishers of ,the ,journal should be made aware of these conditions so that they do not either consciously or unconsciously foster a concern that is depriving the physician of his hard-earned money4 8,if this letter is unfair1 ,i am willing to be shown otherwise4 ,kindly publish it in ,the ,journal1 omitting my name and address40 ,the company to which our correspondent refers put out a proprietary product prescribed by physicians and used by the public4 ,some years ago the company in question advertised its product in ,the ,journal until its stock-selling scheme was brought to the attention of ,the ,journal2 the advertisements were then rejected4 ,some years later1 on evidence that the company had discontinued its stock-selling methods to physicians1 its product was again admitted to the advertising pages of ,the ,journal4 ,our correspondent says that he believes that the physicians who hold stock in this company 8are entitled to a square deal40 ,what about the public8 ,is it getting a square deal when physicians are financially interested in the products that they may be called on to prescribe8 ,is the average layman's confidence in the medical profession likely to be enhanced when he learns that the physician to whom he went for treatment has a financial interest in the therapeutic agent which was prescribed8 ,our correspondent's complaint against the company seems to be1 not that the company sold stock to physicians1 but that 8the dividend checks have been few and far between10 the assumption being that had the dividends come regularly1 there would have been no complaint4 ,it cannot be too often emphasized that it is against public interest and scientific medicine for physicians to be financially interested in the sale of products which they may be called on to prescribe for the sick4 ,it is perfectly true that there are many physicians who would not consciously permit financial considerations to warp their judgment2 but it is not humanly possible to remain unbiased in cases of this sort4 ,it is conceivable that a judge on the bench might make every effort to dispense impartial justice in a suit in which one of the parties was a firm in which he1 the judge1 had financial interest4 ,nevertheless1 it would be obviously improper for such a judge to try a case of this kind4 ,yet1 in this supposititious case the only harm that could result would be of a financial nature4 ,in the case of the physician1 the harm is not to the public's purse but to the public's health4--7,from ,the ,journal ,a4 ,m4 ,a41 ,dec4 #aa1 #aibj47 ,,pituitary ,,gland ,,preparations ,the importance of the standardization of preparations of the posterior1 or infundibular1 lobe of the pituitary gland 7the liquor hypophysis of the new ,united ,states ,pharmacopeia1 pituitary solution1 pituitary extract1 etc47 is exemplified by a recent publication of ,roth4#cjd ,as is well known1 the active constituent or constituents of this gland have not been isolated1 and there is no chemical method of determining the activity and therapeutic value of various preparations4 ,there are1 however1 certain physiologic methods by which the activity of such preparations may be determined with a considerable degree of exactness4 ,the last revision of the ,pharmacopeia1 recognizing that the best attested field of usefulness for such preparations is in obstetrics1 adopted as a test their activity on the uterus of the guinea-pig2 the details of the method adopted by the ,pharmacopeia are those described by ,roth4#cje ,roth now reports on the activity of seven samples of commercial infundibular extracts1 the products of five ,american manufacturing pharmacists4 ,four of these samples were found to be of ,pharmacopeia strength2 the other three were much weaker4 ,of the latter1 one had but one tenth1 another but one fifth and the third but one fourth of the required activity4 ,those preparations which had been accepted by the ,council on ,pharmacy and ,chemistry for inclusion in ,new and ,non-official ,remedies corresponded to the ,pharmacopeia requirements4 ,roth also compared the activity of these seven preparations on the blood pressure1 another method by which it has been proposed to standardize infundibular extracts4 ,the four preparations which were equally active on the uterus were found to be equally active on the blood pressure2 the other three were much weaker4 ,roth points out1 however1 that the results of the two methods are not necessarily parallel2 in one instance1 for example1 two samples caused equal rises of blood pressure1 but one was twice as active as the other on the uterus4 ,hence it is evident that the blood pressure test is not a satisfactory method for determining the activity of a preparation on the uterus1 and vice versa4 #cjd ,roth1 ,g4 ,b43 ,pituitary ,standardization1 ,bull #aji1 ,hyg4 ,lab41 ,u4 ,s4 ,p4 ,h4 ,s41 #aiag4 #cje ,roth1 ,g4 ,b43 ,bull #ajj1 ,hyg4 ,lab41 ,u4 ,s4 ,p4 ,h4 ,s4 ,the subject of pituitary standardization1 or perhaps it may be said the application of the present method is1 however1 in need of further study4 ,thus the statement has recently been made#cjf that commercial preparations are on the market which have from three to five times the activity of the ,pharmacopeia standard2 this was not the case1 however1 with the preparations examined by ,roth4 ,it is probable that some have used for comparison a weaker standard than that proposed by the ,pharmacopeia2 this1 of course1 would lead to the conclusion that the commercial preparations were stronger than the ,pharmacopeia standard4 ,roth suggests that the employment of standards of unequal activity by the various supply houses could easily be eliminated by having a central laboratory distribute material for use as a standard4 ,it will be recalled that before the ,united ,states ,public ,health ,service established and began the distribution of standards for diphtheria and tetanus antitoxins1 the commercial preparations of these varied even more in activity than do those of the pituitary extracts at present4 #cjf ,pittenger1 ,p4 ,s41 and ,vanderkleed1 ,c4 ,e43 ,jour4 ,am4 ,pharm4 ,assn4 #f3aca1 #aiag4 ,it is unnecessary to emphasize the importance of this subject2 this is sufficiently evident to those who have followed the recent clinical literature on the use of pituitary extracts in obstetrics4 ,these preparations are used in times of emergency2 a weak preparation is valueless1 whereas overdosage1 either from too strong a preparation or from too free use of a preparation of the official strength1 is often followed by disaster to the mother or child or both4 ,roth cites a number of cases of ruptured uterus and other injuries resulting from their use4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,may #e1 #aiag47 ,,proprietorship ,,in ,,medicine ,to the ,editor3--,i am enclosing a reprint of my article on the 8,present ,status of ,pituitary ,extract in ,labor10 which appeared in ,the ,journal1 ,june #b1 #aiag1 p4 #afja1 and also the ,september issue of ,parke1 ,davis and ,company's ,therapeutic ,notes1 on page #hi of which they quote this article1 that you may compare the two4 ,the ,therapeutic ,notes article is ostensibly a copy1 but as a matter of fact1 it gives it only in part1 which seems to me to be a gross misrepresentation1 and one which ,i do not think should go unnoticed4 ,joseph ,j4 ,mundell1 ,m4,d41 ,anacostia1 ,d4 ,c4 ,comment4--,therapeutic ,notes is one of the house organs of ,parke1 ,davis and ,company4 ,a part of each issue is usually devoted to 8excerpts0 from current literature4 ,the ,therapeutic ,notes may be judged from the manner of 8excerpting0 the article of ,dr4 ,mundell4 ,naturally the interest of ,parke1 ,davis and ,company is in those sections of the article which may be expected to promote the use of ,parke1 ,davis and ,company's proprietary preparation of pituitary extract--pituitrin4 ,the following passages from the article of ,dr4 ,mundell were not among those 8excerpted0 in ,therapeutic ,notes3 8,used here in properly selected cases1 after due consideration by one who has good obstetric judgment1 its results are usually happy1 and it is a boon to the tired mother and her attendants40 8,to step beyond these narrow confines of indications is indeed entering on dangerous territory4 ,especially is this true as regards the life of the baby4 ,it is recommended in small doses by some good authorities and is frequently used in cases of slight contraction at the brim with sometimes very good results if the birth occurs within a few minutes1 but frequently with disastrous results to the baby if delivery is delayed4 ,in such cases1 forceps are urgently indicated4 ,its use in such cases is risky beyond question4 ,pituitary extract is recommended in cases of postpartum hemorrhage1 but ergot is undoubtedly to be preferred40 8,all means should be exhausted to arrive at a definite diagnosis1 and the dangers of its use should be fully appreciated and due consideration given before its administration in any case1 for such a powerful drug1 used indiscriminately1 will surely produce sad results to mother or child or both40 8,during the past two years a number of untoward effects and consequences of severe character have arisen4 ,as far as the maternal accidents and complications are concerned1 ,i firmly believe that were the slogan of the hour 8safety first0 borne in mind1 a number of them could have been prevented1 for beyond question this drug has been greatly abused1 as it has been given in too large doses1 in cases in which its use was strongly contraindicated1 and often1 ,i am sorry to say1 for no reason other than the accoucheur's expediency4 ,its use has been reckless and careless4 ,the many reports of its rapid and safe action have been one of the greatest dangers4 ,de,lee says1 #8,it provides for the physician and his brother gynecologist a lot of chronic sufferers1 often incurable1 even after mutilating operations4'0 8,an analysis of the detailed reports of all these cases of ruptured uterus with one or two exceptions reveals the fact that pituitary extract was abused1 being given to patients who should not have had it4 ,to my mind1 to give a dose of pituitary extract to a woman who has a contracted pelvis1 mild or severe1 when the head has not passed through the pelvis1 is criminal and1 if the obstetrician is not aware of the contraction1 he is still little short of being a criminal40 ,in the latter part of his article in ,the ,journal1 ,dr4 ,mundell analyzes the reports of twelve cases of rupture of the uterus1 thirty-four cases of fetal deaths1 and forty-one cases of asphyxia pallida in which 8resuscitation was effected only after prolonged and vigorous efforts40 ,these also were not excerpted4--,ed4--7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bd1 #aiag47 ,the ,manufacturer's ,protest ,to the ,editor3--,the article in ,the ,journal1 ,november #bd1 page #ahah1 on proprietorship in medicine does us a gross injustice1 and in reply thereto we beg leave to submit the following3 ,for reasons which every publisher 7yourself included7 understands1 it is not practicable for us to reproduce in full1 in the columns of ,therapeutic ,notes1 all the clinical papers to which we wish to direct the attention of our readers4 ,but that the article of ,dr4 ,mundell was not garbled to make capital for ,parke1 ,davis ,co4 is quite apparent on comparison of the omitted portions with a previous paper by the same author1 reprinted in the ,january 7#aiag7 issue of the ,notes1 and herewith submitted together with clippings from other issues of the ,notes which prove that we have not hesitated to present to our readers the dangers incidental to the misuse of ,pituitrin as well as the advantages of its proper use4 ,therapeutic ,notes1 in quoting other journals1 puts into its readers' hands the means of investigating the fairness of its quotations4 ,it is a house organ--true enough2 but the organ of a house which has always appealed to the honor as well as to the progressiveness of the medical profession4 ,its publishers could not afford to resort to deception in advertising their products1 through this or any other medium4 ,the profession is indebted to ,parke1 ,davis ,co4 for ,pituitrin 7among other medicaments71 and it is to the profession that the manufacturers look for the ultimate verdict4 ,the contraindications are quite as important as the indications1 and1 as the excerpts submitted show1 we have taken account of these1 not only in forming our own estimate1 but in presenting the evidence to the readers of ,therapeutic ,notes4 ,we cite these facts that you may give us a square deal in an early issue of ,the ,journal if so disposed4 ,parke1 ,davis ,co41 ,detroit4 ,comment4--,the ,journal has no desire to discuss ,parke1 ,davis and ,company's motives in omitting certain parts of ,dr4 ,mundell's paper4 ,what ,the ,journal did was to publish those parts of ,dr4 ,mundell's paper on the 8,present ,status of ,pituitary ,extract in ,labor0 that ,parke1 ,davis and ,company left out of their circular4 ,that it is not practicable1 as ,parke1 ,davis and ,company points out1 for the manufacturers of proprietary products to reproduce in full all clinical papers dealing with such products is obvious4 ,it is not so obvious why such concerns in abstracting or quoting papers of this kind should delete those parts that are unfavorable to the products dealt with rather than those that are favorable4 ,curiously1 however1 whenever an author is quoted only in part those parts are almost invariably those favorable to the product4--,ed4--7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,dec4 #h1 #aiag47 ,why ,proprietaries ,flourish ,to the ,editor3--,the following experiences seem to add one more to the many reasons offered to explain why proprietaries and ready-made preparations flourish at the expense of the official drugs and preparations3 ,a few days ago ,i prescribed ,troches of ,ammonium ,chloride1 ,u4 ,s4 ,p41 for a patient of exceptional perseverance4 ,the next day he had not yet secured the troches and told me that he had submitted the prescription to seven pharmacies1 including the largest1 and three of the best known and admittedly the best equipped in ,new ,york4 ,all told him that these troches were 8not being made any more10 and that they were therefore unable to supply him4 ,he thereupon communicated with one of the largest wholesale manufacturing pharmaceutical houses in ,america and received precisely the same answer4 ,i then took the matter up with a first class pharmacist whom ,i knew and induced him to prepare this difficult 767 troche1 for which the ,u4 ,s4 ,pharmacopeia gives the following directions3 8,rub the powders together until they are thoroughly mixed2 then form a mass with syrup of tolu and divide 4440 ,seven pharmacists declined to fill a prescription for an official preparation because they could not buy the preparation from a wholesaler1 and it required some persuasion to get the eighth to make the preparation4 ,but even worse1 several of the pharmacists offered my patient some ready-made troche more or less resembling the official1 or offered compressed tablets of ammonium chlorid4 ,that this is not an isolated example of what often poses as pharmacy is shown by the fact that ,i have found it extremely difficult to find a pharmacist who would extemporaneously coat pills with gelatin4 ,most want the physician to alter his prescription so that one of the ready-made gelatin coated pills can be dispensed1 if a gelatin coating is necessary4 ,some gelatin1 hot water1 a large cork1 and a few domestic sewing needles are all that is required for very satisfactory coating of pills with gelatin1 yet few pharmacists seem willing to perform this simple procedure4 ,two other illustrations1 not so recent1 have come to me from a colleague4 ,a few years ago he was unable to obtain from either of two pharmacists an emulsion of cod liver oil without the hypophosphites because1 as both said1 8,it does not come without hypophosphites40 ,on another occasion four of the best drug stores in ,boston were asked for the ,compound ,laxative ,pill1 ,u4 ,s4 ,p41 then official in the ,pharmacopeia4 ,in every case he was told that he must have meant the compound cathartic pill1 which in no way resembles the pill he sought4 ,with this attitude on the part of the men supposed to be serving the public and the medical profession by the practice of pharmacy1 is it any wonder that it is difficult to induce the medical profession to prescribe official preparations or combinations of official drugs in place of ready-made commercial substitutes largely drawn from among the proprietaries or specialties8 ,real pharmacy by real pharmacists is a necessity if we are to succeed in combating the proprietary evil4 ,cary ,eggleston1 ,m4,d41 ,new ,york4 --7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ba1 #aibj47 ,,philip ,,rahtjen ,,and ,,his ,,discoveries ,recent newspaper reports regarding the alleged 8discovery of the ,germ of ,pernicious ,anemia0 and the development of 8an antitoxin and serum0 by ,dr4 ,philip ,rahtjen of ,pasadena1 ,california1 have brought inquiries of which the two that follow are typical4 ,this from a physician in ,indiana3 8,please let me know about the supposed recent discovery of ,dr4 ,philip ,rahtjen concerning pernicious anemia4 ,the information ,i have is from a newspaper clipping of ,october #ba1 ,pasadena1 ,california4 ,kindly omit my name40 ,a ,new ,york physician writes3 8,if you could send me any information as to the enclosed ,i would appreciate it4 ,the article impresses one as absolutely inconclusive4 ,however1 ,i promised the patient ,i would investigate the matter40 ,the enclosures referred to consisted of a reprint and a letter from 8,ph4 ,rahtjen1 ,m4,a41 ,ph4,d410 ,pasadena1 ,calif41 both of which had been sent to a layman who had written to ,rahtjen4 ,the reprint was a translation of a brief article by ,rahtjen 8,on the ,etiology of ,idiopathic ,anemia10 translated from the ,centralblatt fr ,bakteriologie ,parasitenkunde und ,infektionskrankheiten4 ,rahtjen's letter to the layman read3 8,your inquiry relative to my isolation and classification of the ,germ of ,anemia received4 8,i herein enclose my paper published in ,august in the ,central ,magazine of ,bacteriology4 8,i have succeeded in immunizing goats against the ,germ therein described4 ,five thousand injections of the ,serum have been given4 ,three hundred cases diagnosed as ,anemia and ,chlorosis were treated under observation4 ,six cases of ,pernicious ,anemia were observed under treatment4 ,all responded favorably4 8,the ,serum is at your disposal from my laboratory here for the use of your physician4 ,the price is five dollars for twelve ampoules each containing #a ccm41 the amount of one injection4 8,the treatment consists of intramuscular injection every second day accompanied with a nitrogenous free diet1 preferably milk diet4 ,your attending physician should very easily give them40 ,just what ,rahtjen's serum is we do not know4 ,nor have we been able to find any information on the subject in any available medical literature4 ,in fact1 a rather careful search of ,american medical literature for some years past fails to reveal any article by ,rahtjen on any subject4 ,philip ,rahtjen is not a physician4 ,in the ,propaganda files is a circular issued in #aiag by the 8,rahtjen ,tuberculosis ,sanatorium0 of ,san ,francisco1 ,calif4 ,this exploits 8,the ,rahtjen ,cure for ,tuberculosis0 and tells of 8,the ,discovery of ,dr4 ,philip ,rahtjen40 ,the circular states that3 8,dr ,rahtjen studied in ,heidelberg1 ,berlin1 ,munich1 ,marburg1 and ,rostock1 ,germany1 from which latter school in #aijd1 he graduated in chemical pathology as ,doctor of ,philosophy4 ,he became assistant professor of pathology at the ,imperial ,biological ,station at ,heligoland1 and was later appointed assistant to ,dr4 ,piorkowsky1 head of the ,deutsche ,schutz und ,heilserum ,gesellschaft40 ,the same circular summarizes the potentialities of 8,rahtjen's ,cure for ,tuberculosis0 thus3 8,the remedy seems to cure tuberculosis in all its forms with equal celerity and certainty4 ,the evidences indicate that it does not matter how far the disease has progressed1 if there be tissue of the attacked organ remaining sufficient to sustain life1 the disease can be wholly eradicated and the patient restored to health4 ,this is indicated alike in tuberculosis of the lungs1 of the throat1 of the bladder1 of the kidneys40 ,the booklet stated further that patients might be treated at one of two places3 at the offices of the sanatorium in the city of ,san ,francisco1 or at the sanatorium itself near ,glenwood4 ,the cost of treatment at the sanatorium was to be #a1jjj1 which would entitle 8the patient to residence and attention there for four months40 ,according to the leaflet1 8,this is regarded as a period sufficient to restore the patient to health whatever be the stage of his disease2 provided only1 as we remark1 that he has enough left of the infected organ to sustain life with the ,t4 ,b4 expelled40 8,at the end of four months the patient is sent to his home1 not alone relieved of his disease1 but in a highly vigorous state of health40 ,all this1 as stated previously1 was in #aiag4 ,and yet people are still dying of tuberculosis6 ,in ,march1 #aibj1 ,rahtjen 7so the newspapers have it7 was offering a 8,new-,life ,fluid40 ,according to a ,san ,francisco paper1 ,dr4 ,philip ,rahtjen 8announces the discovery that by the injection of secretions from the ductless glands the human body may be reinvigorated40 ,the paper described the discovery 8as a long step forward in the fight to counteract old age0 and stated that a syndicate was being formed by ,rahtjen and others to 8produce the extract in such quantity that it may be available for every one40 ,the newspaper article showed the learned doctor in a laboratory apron in the characteristic pose of the newspaper 8scientist0 pouring something from a beaker into a test tube--and gazing intently at the camera while doing it6 ,this was in ,march1 #aibj2 yet people still grow old4 ,within the last month the ,los ,angeles ,examiner has heralded some more wonderful accomplishments of ,rahtjen4 ,according to this paper ,rahtjen has3 #a4 ,isolated the 8germ of pernicious anemia40 #b4 ,found the 8serum0 for the cure of this disease4 #c4 ,discovered the secret of human virility4 #d4 ,evolved a fluid 8from the glands of selected bulls and cows0 which will 8restore #8pep' for worn-out human bodies6 ,give added weight1 clearer eyes1 brighter minds1 quicker bodies and a generally #8firmer grip' on oneself60 ,this 8amazing discovery0 was1 according to the ,los ,angeles paper1 the culmination of 8five years of continuous study0 and had only just been revealed by ,rahtjen4 8,dr4 ,rahtjen has for years been working silently in a bio-chemical laboratory in ,pasadena1 surrounded by microscopes1 scales1 test-tubes1 acids1 alkalis1 reagents and all the accompanying stage settings that spell bio-chemical science40 ,all of these wonders might still have been a closed book to the public had not 8friends0 of ,dr4 ,rahtjen brought the matter to the attention of the ,examiner4 8,dr4 ,rahtjen yesterday1 with the usual reserve of the ethical scientist1 was disinclined to talk of his work until publication of it in a scientific journal40 ,fortunately for a palpitating public1 the ,los ,angeles ,examiner 8was able to learn the essence of his study0 and pass the information on4 ,it seems from this newspaper report that ,rahtjen first made his extracts from the glands of goats and sheep but these extracts 8were found to be too strong40 ,as a result 8,dr4 ,rahtjen is now using the glands of specially selected ,mexican bulls and cows40 ,the male patients who are 8weak1 uninterested in life1 unable to concentrate in thought0 are given the extract of bull2 the female patients who are in a similarly deplorable condition receive an 8injection of the cow gland extract40 ,we have not yet learned whether the ,los ,angeles ,examiner has deprecated ,dr4 ,rahtjen's use of ,mexican bovines4 ,remembering the attitude of the ,hearst papers toward all things ,mexican1 one may look for the suggestion that ,mr4 ,rahtjen use #ajj per cent4 ,american bull4--7,from ,the ,journal ,a4 ,m4 ,a41 ,nov4 #bf1 #aiba47 ,,sodium ,,cacodylate ,,in ,,syphilis ,to the ,editor3--,i was much interested in the study of this subject by ,dr4 ,h4 ,n4 ,cole 7,the ,journal1 ,dec4 #cj1 #aiaf1 p4 #bjab47 ,in #aiac ,i treated a series of cases of syphilis with sodium cacodylate2 but1 not getting the desired results1 ,i discontinued its use4 ,in #aiae1 ,i became interested again because of the writings of ,dr4 ,j4 ,b4 ,murphy1 and applied it in three cases in which the patients had initial lesions3 ,,case #a4--;,j4 ,m41 man aged #ba1 single1 shoeworker1 came to me with an initial lesion of the penis to the right of the frenum4 ,i began intramuscular injections of sodium cacodylate1 #e grains1 in ampules made by ,parke1 ,davis ,co41 every day for ten days4 ,then ,i halted for ten days and repeated ten more injections4 ,the sore on the penis entirely disappeared about the ninth day4 ,there was a slight1 faintly macular eruption of the forearms and abdomen1 which soon disappeared4 ,there was no alopecia4 ,when he returned1 after the last series of ten injections1 there were mucous patches in the throat and some involvement of the left tonsil4 ,i put the patient on mixed treatment1 which cleared his throat4 ,he had1 at end of twenty doses of #e grains of sodium cacodylate each1 a positive ,wassermann reaction4 ,after mercury and potassium iodid for two months there was a positive ,wassermann reaction4 ,to date1 after three salvarsan treatments intravenously there have been two negatives4 ,,case #b4--;,f4 ,s41 man1 aged #bh1 married1 machinist1 had an initial lesion on the penis4 ,treatment with sixty injections of #e grains of sodium cacodylate gave results as follows3 ,the initial sore on the penis disappeared in ten injections2 there were severe mucous patches of the mouth2 the tonsils were badly infected4 ,there was a positive ,wassermann reaction4 ,there were syphilids of both arms and shins2 marked papular eruption2 malaise1 and a slight trace of albumin in the urine4 ,i placed the patient on mercurials and at last give him three salvarsan injections three weeks apart4 ,the result was a negative ,wassermann reaction1 the skin was clear and the patient felt fine4 ,,case #c4--;,d4 ,c41 woman1 aged #ba1 single1 seamstress1 had an initial lesion on the left side of the cervix1 and a macular eruption on the face1 neck and shoulders1 and also1 though faint1 on the forearms4 ,thirty injections of sodium cacodylate of #e grains each were given4 ,the initial lesion disappeared in one week4 ,mucous patches of the mouth appeared and persisted4 ,the ,wassermann reaction was positive4 ,i gave mercurials and potassium iodid for seven months1 and salvarsan once4 ,the ,wassermann reaction is now negative4 ,my conclusion after two trials of the use of sodium cacodylate in small or large doses is that it has no effect toward curing the condition2 in fact1 the throat symptoms were seemingly increased in severity by its use4 ,it has no effect on syphilids of the forearms and shins1 and if anything makes them worse4 ,it improves the appetite1 as one would expect4 ,it has some effect on the kidneys1 as noted in ,case #b2 it has some effect in healing the initial lesion1 as noted in all three of this series2 why1 ,i do not know4 ,i am entirely satisfied that it has no beneficial effect on syphilitics and have discontinued its use entirely in my practice4 ,i am glad to have read ,cole's excellent article1 as it shows me that ,i was correct in my decision not to use it again1 as it was worthless4 ,william ,g4 ,ward1 ,m4,d41 ,lynn1 ,mass4 ,to the ,editor3--,dr4 ,william ,g4 ,ward's letter 7,the ,journal1 ,feb4 #c1 #aiag1 p4 #cij71 and the recent admirable article by ,dr4 ,harold ,n4 ,cole 7,the ,journal1 ,dec4 #cj1 #aiaf1 p4 #bjab7 recall to mind ,dr4 ,j4 ,b4 ,murphy's clinical note on the use of sodium cacodylate in the treatment of syphilis 7,the ,journal1 ,sept4 #bd1 #aiaj1 p4 #aaac71 and the experimental work of ,cap4 ,h4 ,j4 ,nichols1 ,u4 ,s4 ,army 7,the ,journal1 ,feb4 #ah1 #aiaa1 p4 #dib74 ,the results of ,nichols' work conclusively proved1 at least from a laboratory standpoint1 that this drug was of very little value as a spirocheticide in combating syphilis4 ,prior to the publication of ,dr4 ,murphy's letter ,i had employed sodium cacodylate extensively as a remedy in psoriasis1 and ,i still continue to use it in selected cases of the disease4 ,adopting ,dr4 ,murphy's suggestion1 ,i gave the agent an extensive trial in syphilis in all stages of the disease4 ,the results were extremely disappointing1 from both clinical and serologic points of view4 ,more recently1 during the scarcity of salvarsan1 ,i gave the drug a second trial1 employing it in large dosage in the hope that the previous failure had been due to the employment of insufficient amounts4 ,the results were not tabulated1 but1 judging roughly from my experience in a score of cases1 its therapeutic value as an antisyphilitic was nil4 ,a few of the patients underwent a temporary improvement1 probably owing to the tonic effect of the drug1 but in every instance the serologic findings were unaffected4 ,r4 ,l4 ,sutton1 ,m4,d41 ,kansas ,city1 ,mo4 --7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,feb4 #c1 #aiag47 ,,tablets3 ,,dependability ,,of ,,dosage ,the tablet form of administering medicines is popular among many physicians because of its convenient availability and dosage4 ,there is no doubt about the convenience of tablets1 but the accuracy of the dosage content is not always to be depended on4 ,one reason for this is that the demand for palatable and convenient 8medicaments has led manufacturers to attempt to produce in tablet form mixtures which1 from the nature of the case1 are not suited to that method of compounding40 ,in a series of painstaking experiments#cjg on bismuth1 opium and phenol tablets1 conducted a number of years ago in the ,a4 ,m4 ,a4 ,chemical ,laboratory1 it was shown that no tablets on the market then contained the amount of phenol the label indicated1 the variation being from #ab4c to #aab4e per cent4 ,similarly1 the laboratory found that in the case of several different brands of ,aromatic ,digestive ,tablets1#cjh the amount of hydrochloric acid present in these absurd combinations was true to label in only one half of the specimens1 notwithstanding the fact that the amounts claimed to be present were ridiculously small2 in two specimens1 there was no hydrochloric acid whatever present1 while a third contained only a trace4 ,these examples illustrated clearly the very evident unwisdom of attempting the pharmaceutically impossible merely for the sake of convenience or pharmaceutical 8elegance40 #cjg ,puckner1 ,w4 ,a41 and ,clark1 ,a4 ,h43 ,examination of ,tablets of ,bismuth1 ,opium and ,phenol1 ,the ,journal ,a4 ,m4 ,a41 ,july #be1 #aijh1 p4 #ccj4 ,puckner1 ,w4 ,a41 and ,hilpert1 ,w4 ,s43 ,tablets of ,bismuth1 ,opium and ,phenol1 ,dec4 #ag1 #aiaj1 p4 #bafi1 ,may #f1 #aiaa1 p4 #acdd4 ,unreliable ,pharmaceutical ,products1 editorial1 ,may #f1 #aiaa1 p4 #acce4 #cjh ,puckner1 ,w4 ,a41 and ,warren1 ,l4 ,e43 ,aromatic ,digestive ,tablets1 ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bj1 #aiaj1 p4 #gaj4 ,another reason for doubting the accuracy of dosage1 irrespective of the characteristics of the drugs composing the tablets1 has been the manifest lack of care in their manufacture4 ,in #aiad1 ,kebler#cji reported the results of a far-reaching investigation of tablet compounding in which he pointed out that tablets on the market were not as uniform or accurate as was generally believed1 the variations being 8unexpectedly large in numbers and amount40 ,during the past year1 the ,connecticut ,agricultural ,experiment ,station#caj undertook the examination of tablets--proprietary and nonproprietary--taken from the stock of dispensing physicians4 ,the variations found in weights of the tablets were strikingly similar to those reported by ,kebler4 #cji ,kebler1 ,l4 ,f43 ,the ,tablet ,industry1 ,jour4 ,am4 ,pharm4 ,assn41 #aiad1 #c1 #hbj1 #icg1 #ajfb4 #caj ,bull4 #bjj1 ,connecticut ,agricultural ,station1 ,food and ,drug ,products1 #aiag1 p4 #afa4 ,,variation ,,in ,,weights ,,of ,,tablets ,kebler ,connecticut ,variation ,per ,cent4 ,per ,cent4 ,less than #aj per cent4 #dc #dd ,more than #aj per cent4 #eg #ef ,more than #ab per cent4 #dd #ce ,more than #ae per cent4 #bh #bf ,more than #bj per cent4 #i #aj ,the determinations of the composition of the tablets when compared with that claimed for them showed wide variation--from #ed per cent4 above to #gj4e per cent4 below2 in almost two thirds of the tablets examined1 the variation amounted to more than #aj per cent42 in three fifths of the tablets1 the variation was more than #ae per cent42 in one fourth1 more than #bj per cent41 and in one twentieth1 more than #ej per cent42 only in one eighth of the tablets was the variation less than #e per cent4 ,the ,connecticut investigators substantiate once again the work previously reported1 namely1 that there are a number of firms who are either incompetent or careless4 ,for tablets of simple composition1 a variation from the declaration of #aj per cent4 should be amply sufficient to compensate for the errors of careful manufacture4 ,it may be added that the best tablets originate generally from firms having competent chemical control4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #bg1 #aiah47 ,,therapeutic ,,evidence3 ,,its ,,crucial ,,test,o ,torald ,sollmann1 ,m4,d41 ,cleveland ,o ,read before the ,section on ,pharmacology and ,therapeutics at the ,sixty-,eighth ,annual ,session of the ,american ,medical ,association1 ,new ,york1 ,june1 #aiag4 ,o ,this article clearly states the difficulties experienced by the ,council in estimating the merits of a proprietary medicinal product and clearly defines the method which has been found to be practical in judging of the therapeutic value of such preparations4 ,the ,council has approved this discussion of the subject and has directed that the paper be published in the annual ,council reports4 ,w4 ,a4 ,puckner1 ,secretary4 ,according to the good old truism1 the last and crucial proof of the pudding is in the eating thereof2 and so1 the last and crucial test of a therapeutic agent is its consumption by a patient4 ,there is1 however1 one essential difference3 ,when the pudding is eaten1 with a sense of satisfaction1 we know that it was a good1 or at least an eatable1 pudding4 ,if the patient improves after taking a remedy1 we do not yet know that he improved on account of the remedy4 ,the post hoc type of reasoning or logic is not respectable2 but it is all too apt to creep in unawares1 unless one takes great precautions indeed4 ,clinical evidence needs especially to be on its guard against this pitfall1 for the conditions of disease never remain constant2 nor is it possible to foresee with certainty the direction which they are going to take4 ,it is just this point which makes the clinical evidence so much more difficult to interpret than laboratory evidence1 in which the conditions can be more or less exactly controlled1 and any changes foreseen4 ,it is on this account1 also1 that clinical experiments must be surrounded with extra painstaking precautions4 ,in brief1 while the 8proof0 of a remedy is on the patient1 that is not the whole story1 but merely an introduction4 ,the real problem is to establish the causative connection between the remedy and the events4 ,the imperfect realization of this has blocked therapeutic advance1 has disgusted critical men to the point of therapeutic nihilism1 and has fertilized the ground for the commercial exploitation of drugs that are of doubtful value or worse4 ,this has been impressed on me particularly by my service on the ,council on ,pharmacy and ,chemistry4 ,in the course of its work of passing on the claims advanced for commercial remedies1 this ,council is forced to inquire critically into the basis of the claims of manufacturers4 ,it is interesting to note the qualitative differences in the evidence for the various kinds of claims3 ,the chemical data are usually presented in such a form that it is possible to tell at a glance whether or not they are based on demonstrated facts1 which could usually be verified or refuted without special difficulty4 ,the deductions are usually such as can be legitimately drawn from the data1 or else they are obviously absurd4 ,all this agrees with the relatively exact status of chemical science4 ,in passing to data and deductions from animal experiments1 a distinct change is noticeable3 ,not only are the data less reliable1 and less worthy of confidence1 but they are more often stated in a less straightforward manner4 ,the presentation of the data often shows evidence of manipulation of the results1 so as to make them most favorable to a preconceived conclusion that would recommend the drug4 ,this is not always intentional1 but is partly due to the less exact nature of animal experimentation1 which leaves a wider play to the arbitrary interpretation of the reporter4 ,a certain amount of this is unavoidable4 ,no serious objection can be raised1 provided the experimenter presents all the essential data1 and discusses fairly all of the interpretations that would apply to them4 ,on the whole1 it is usually possible to form a fairly definite estimate of the value of experimental data4 ,when one comes to the clinical evidence1 an entirely different atmosphere obtains4 ,when the ,council demands evidence of the usefulness of a remedy1 the manufacturers generally respond with every sign of enthusiasm4 ,they may have ready a series of articles already published1 or they instruct their agents to bring in letters from physicians4 ,the last method seems to meet the most cordial response1 judging from the deluge of letters and opinions that floods the ,council4 ,the quality of the published papers is a fair reflection of the deficiencies of what is still the common type of clinical evidence4 ,a little thought suffices to show that the greater part cannot be taken as serious evidence at all4 ,some of the data are merely impressions--usually the latest impressions of an impressionable enthusiast--the type of man who does not consider it necessary to present evidence for his own opinions2 the type of man who does not even realize that scientific conclusions must be based on objective phenomena4 ,some of the papers masquerade as 8clinical reports10 sometimes with a splendid disregard for all details that could enable one to judge of their value and bearing1 sometimes with the most tedious presentation of all sorts of routine observations that have no relation to the problem4 ,the majority of reports obtained by the agents belong to these classes1 notwithstanding the fact that they are often written for the special use of the ,council1 and therefore with the realization that they are likely to be subjected to a thorough examination1 and therefore presumably representing the best type of work of which the reporter is capable4 ,so1 at least1 one would suppose4 ,it is also possible1 however1 that some of these reports are written merely out of thoughtlessness1 or perhaps often to get rid of an importunate agent4 ,this is illustrated by the following correspondence1 taken literally from the files of the ,council4 ,a letter from a prominent physician 8,a10 endorsing a certain preparation 8,d10 having been submitted to the ,council1 the secretary was directed to write to ,dr4 ,a as follows3 ,dear ,dr4 ,a3--,the ,b ,company of ,c has requested the ,council on ,pharmacy and ,chemistry to admit its preparation ,d to ,new and ,nonofficial ,remedies4 ,as part evidence for the value of the preparation1 the company submitted a letter from you which contains the following3 ,so far as my experience has thus far gone1 they are certainly superior to a number of other iodine compounds now on the market1 and ,i should judge that they ought to take a superior place in therapy involving the use of iodine4 ,the referee of the ,council in charge of ,d writes that he was interested by your letter and asks that ,i inquire3 ,as compared with sodium or potassium iodid1 what would you say are the differences between1 and real advantages of1 ,d and the alkaline iodids8 ,did you make any comparative experiments and keep a record of them8 ,if so1 the referee would like to receive an account of your trials4 ,in what direction could ,d be expected to occupy a superior place in iodin therapy8 ,i hope that you can give the information asked by the referee and thus aid the ,council in arriving at a correct estimate regarding the value of ,d4 ,the following reply was received from the physician in response to the foregoing3 ,dear ,professor ,puckner3--,in reply to yours of ,january #ai1 ,i did not proceed far enough in the investigation of ,d to draw conclusions of any particular value for the purpose of the ,council on ,pharmacy and ,chemistry2 and ,i so stated in my letter to the proprietors of that remedy4 ,answers to the questions you put in your letter require an amount of investigation of the remedy far beyond anything ,i undertook4 ,as a matter of fact1 ,i returned about five sixths of the capsules sent me1 because of lack of time and opportunity to carry out the extensive clinical experiments that ,i plainly saw would be required to give an opinion at all worth while4 ,i believe you had better not consider me in the matter at all4 ,the report was furnished by a physician for whom ,i have a high personal regard4 ,i introduce it here1 not so much in a spirit of criticism1 but as a justification of the opinion that ,i have formed of clinical evidence obtained by manufacturers through their clinical adjutors4 ,when commercial firms claim to base their conclusions on clinical reports1 the profession has a right to expect that these reports should be submitted to competent and independent review4 ,when such reports are kept secret1 it is impossible for any one to decide what proportion of them are trustworthy1 and what proportion thoughtless1 incompetent or accommodating4 ,however1 if this were done it is quite possible that such firms would find much more difficulty in obtaining the reports4 ,those who collaborate should realize frankly that under present conditions they are collaborating1 not so much in determining the scientific value1 but rather in establishing the commercial value of the article4 ,often the best type of clinical reports--those in which the observations are directed to the significant events and not to mere side lines1 and in which the significant events are correctly and adequately reported--generally lack one important essential1 namely1 an adequate control of the natural course of the disease4 ,since this cannot be controlled directly1 it must be compensated indirectly4 ,for this purpose1 there are available two methods3 ,the first is the statistical method1 in which alternate patients receive or do not receive the treatment4 ,this method can usually only be of value when a very large series of patients is available4 ,even then1 its value is limited or doubtful1 because it cannot take sufficient account of the individuality of cases4 ,the second method consists in the attempt to distinguish unknown preparations by their effects--the method that might be called the 8comparative method0 or the 8blind test40 ,in this1 the patient1 or a series of patients1 is given the preparation which is to be tested1 and another preparation which is inactive1 and the observer aims to distinguish the two preparations by their effects on the patient4 ,surely if the drug has any actions at all it will be possible to select correctly in a decided majority of the administrations4 ,the same principle can be applied in distinguishing the superiority of one preparation over another4 ,in this case1 the two preparations would be given alternately to different patients1 and the observer would try to distinguish them by their effects4 ,here again1 if one drug is really superior or otherwise different from another1 to a practically important extent1 the observer will surely be able to make the distinction4 ,this method is really the only one that avoids the pitfalls of clinical observation2 it is the only method that makes the results purely objective1 really independent of the bias of the observer and the patient4 ,it is the only method1 therefore1 which determines whether it was really the pudding that was eaten and not some other dessert4 ,in principle this method does not usually offer any very great difficulties4 ,it is1 of course1 necessary that the two preparations to be compared shall resemble each other so closely or shall be flavored1 etc41 so that they cannot be distinguished by their physical properties4 ,this is usually not a very difficult matter4 ,the method does not jeopardize the interests of the patient1 for it is understood that no drug would be tested in this way unless there is some reason to believe that it has a value4 ,when the patient's condition is such as to demand treatment1 then he would be receiving either the standard drug or the drug which the experimenter believes may be superior to the standard4 ,,conclusions ,the final and crucial test of a remedy is on the patient2 but the test must be framed so as to make it really crucial4 ,most clinical therapeutic evidence falls far short of this4 ,the 8blind test0 is urged to meet the deficiencies4--7,from ,the ,journal ,a4 ,m4 ,a41 ,july #ba1 #aiag47 8,,vaccines ,,in ,,toxic ,,conditions0 ,commercialized ,propaganda in the ,guise of ,science ,under the title 8,vaccines in ,toxic ,conditions10 what purports to be a scientific contribution appears in the original department of the official organ of a state medical society4#caa ,the apparent purpose of the article is to overcome any hesitancy on the part of practitioners to use vaccines in toxic infectious conditions for fear that they might thereby cause harm4 ,such a thesis is interesting and might be important--if true4 ,two outstanding facts1 however1 give pause4 ,first1 the theory promulgated is contrary to the experience of those who have studied the subject2 second1 the man who writes the article is in the business of making and selling vaccines6 ,the former fact is a matter of fairly general knowledge among the better informed members of the medical profession2 the latter fact is nowhere made evident in the article1 which the reader might infer came from a disinterested investigator in the realms of immunology4 #caa ,sherman1 ,g4 ,h43 ,vaccines in ,toxic ,conditions1 ,illinois ,m4,j4 #ch3 #cad 7,oct47 #aibj4 ,the article purports to prove that the special investigations carried on by its author show that there is no basis for the well-grounded fear that vaccines might be harmful to a patient suffering from toxic infectious conditions4 ,thus3 ,from a closer study of these infective processes we find that this toxic condition is due to the rapid multiplication of the infecting organisms with the incidental production of ferments which the germs secrete to digest the food on which they live4 ,these toxic ferments have a distinct destructive tendency on tissue cells1 without any marked influence in stimulating tissue cells for antibody production4 ,the crying need1 however1 in these extensive acute infections is rapid antibody formation to neutralize these germ-produced poisons and to eliminate the germs4 ,now vaccines1 we are informed1 are not toxic and so stimulate the production of antibodies4 ,in other words1 the same organism that in the body is toxic and without marked antigenic properties becomes nontoxic and actively antigenic when converted into a vaccine4 ,the details of the experiments of the 8closer study0 made by the author of this paper 7and the manufacturer of vaccines7 which give such definite and convincing results are not published4 ,possibly the article is a preliminary contribution1 and future issues of the same publication will carry further articles on the same subject4 ,the follow-up system is well recognized in the advertising world4 ,at all events1 this 8closer study0 has convinced the author of the article that3 444 even in extreme toxic conditions1 in acute infections1 bacterial vaccines may be employed without the least fear of doing any harm4 ,in fact1 we find that in extreme acute infections1 bacterial vaccines not only give the best clinical results1 but they may also be given in larger doses at shorter intervals with less reactions than in minor or chronic infections and the earlier they are given the better the results4 ,here again no details are given2 there are no comparative results of the careful study of a series of cases4 ,the sum and substance of this remarkable contribution to a scientific publication is to the effect 7#a7 that the organism that in the body is toxic becomes nontoxic when introduced in vaccine form2 7#b7 that the organism that in the body is but little antigenic becomes when introduced in vaccine form actively antigenic1 and 7#c7 that 8in extreme acute infections0 when the body is affected profoundly by the infectious agent and its product1 the oftener and the more one injects of these very materials1 the better the results6 ,and this astounding plea for the use of vaccines in conditions in which vaccines are generally held to be contraindicated1 or even injurious1 is made by one whose business is the manufacture of vaccines and selling them to the medical profession6--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #bc1 #aibj47 ,,vitamins3 ,,their ,,distribution ,our knowledge of the accessory food factors1 commonly spoken of as vitamins1 is so recent1 comparatively speaking1 and the exact nature of these factors still so enveloped in mystery1 that it was inevitable that the public's lack of knowledge on the subject should be capitalized4 ,it is not surprising that there are on the market a number of preparations of the 8patent medicine0 type that are being sold under the claim that they are rich in vitamins--although the exploiters of these fail to explain which1 if any1 of the three accessory food factors their products contain4 ,the renaissance of yeast as a therapeutic agent has given an opportunity to the manufacturers of this product of unduly stressing the fact that yeast is particularly rich in the antineuritic vitamin 7water-soluble ,b74 ,because milk and certain milk products are rich in the fat-soluble ,a factor1 the dairy interests would apparently have the public believe that this particular vitamin is to be obtained only from their products4 ,thus1 a journal devoted to the dairy interests recently claimed that those who want vitamins must get them in their milk1 butter1 cheese and other milk products4 ,the truth is1 the accessory food factors are so well distributed throughout the dietary of modern man that1 generally speaking1 the individual who uses ordinary judgment in selecting his food is in no danger of suffering from a deficiency of any of these three factors4 ,it would be well if every physician might read the excellent monograph on the present state of knowledge concerning accessory food factors written by a committee appointed jointly by the ,lister ,institute and ,medical ,research ,committee4 ,in this report the distribution of the vitamins in our common foodstuffs is thus briefly summarized3 8444 broadly speaking it is safe to say that the individual always finds sufficient supply of vitamins in his food so long as that food is reasonably varied and has received no artificial or accidental separation into parts1 and so long as no destructive influence has been applied to it40 ,at the end of the committee's report is a table 7reproduced on page #efb7 which shows the distribution of the three accessory factors in the commoner foodstuffs4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,aug4 #ac1 #aiba474 ,,distribution ,,of ,,three ,,accessory ,,factors ,,in ,,commoner ,,foodstuffs ,classes ,fat-,soluble ,a ,water-,soluble ,b ,anti- of or ,anti- or ,antineuritic scorbutic ,foodstuff rachitic 7,antiberiberi7 ,factor ,factor ,factor ,fats and ,oils3 ,butter ,cream ,cod-liver oil ,mutton fat ,beef fat or suet ,peanut oil ,fish oil1 whale oil1 etc4 ,margarin prepared ,value in from animal fat proportion to amount of animal fat contained ,nut butters ,meat1 ,fish1 etc43 ,lean meat 7beef1 mutton1 etc47 ,liver ,kidneys ,heart ,brain ,sweetbreads ,fish1 white very slight1 if any ,fish1 fat 7salmon1 herring1 etc47 very slight1 if any ,fish roe ,canned meats 8 very slight ,milk1 ,cheese1 etc43 ,milk1 cow's whole1 raw ,milk1 skim1 raw ,milk1 dried whole less than less than ,milk1 boiled1 whole undetermined less than ,milk1 condensed1 sweetened less than ,cheese1 whole milk ,eggs3 ,fresh 8 ,dried 8 ,cereals1 ,pulses1 etc43 ,wheat1 maize1 rice1 whole grain ,wheat germ ,wheat1 maize1 bran ,linseed1 millet ,dried peas1 lentils1 etc4 ,soy beans1 haricot beans ,germinated pulses or cereals ,vegetables and ,fruits3 ,cabbage1 fresh 7raw7 ,cabbage1 fresh 7cooked7 ,cabbage1 dried very slight ,cabbage1 canned very slight ,swede 7rutabaga7 raw expressed juice ,lettuce ,spinach 7dried7 ,carrots1 fresh raw ,carrots1 dried very slight ,beetroot1 raw1 expressed juice less than ,potatoes1 raw ,potatoes1 cooked ,beans1 fresh1 scarlet runners1 raw ,onions1 cooked at least ,lemon juice1 fresh ,lemon juice1 preserved ,lime juice1 fresh ,lime juice1 preserved very slight ,orange juice1 fresh ,raspberries ,apples ,bananas very slight ,tomatoes 7canned7 ,nuts ,miscellaneous3 ,yeast1 dried ,yeast1 extract and autolyzed 8 ,malt extract in some specimens ,our ,knowledge of ,vitamins ,commenting on the trend of medical research concerning vitamins1 the latest report of the ,british ,medical ,research ,council says3 ,the present situation is a curious one1 upon which posterity will probably look back with great interest4 ,we still have almost no knowledge of the nature of these elusive food substances or of their mode of action1 but we have gained empiric knowledge already of the greatest practical value for the prevention of scurvy and of other grave diseases and for the promotion of health and beauty in the population4 ,this statement1 it will be noted1 emphasizes the foundation on which rests our present use of vitamins4 ,from time to time ,the ,journal has commented on our lack of actual knowledge of these mysterious substances1 emphasizing particularly the generally accepted fact that the taking of a well-balanced diet results in providing the individual with such vitamins as are necessary to his growth and nutrition4 ,last week appeared a brief report of a meeting of the ,chicago ,medical ,society devoted to this subject1 and it was gratifying to have the conservative view which ,the ,journal has emphasized substantiated by many of those who took part in the discussion4 ,moreover1 the ,british ,medical ,journal1 in its leading editorial for ,february #aa1 reiterates that an abundant supply of vitamins exists in all fresh vegetables1 and that a considerable quantity occurs in milk and meat1 provided the latter substances are obtained from animals fed on fresh foods4 8,a normal adult10 it says1 8living on an ordinary diet containing a reasonable proportion of fresh vegetables is1 therefore1 certain of obtaining a plentiful supply of vitamins40 ,of all the mass of evidence which has accumulated relative to these substances1 this fact is the point of greatest importance4 ,it is1 however1 very unfortunately1 the one point which those commercially inclined are unwilling to recognize4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,march #aa1 #aibb47 ,the ,demand for ,vitamins ,thus the ,british ,medical ,journal in its current issue3 ,in spite of the fact that ordinary fresh foods are the simplest1 cheapest and richest sources of vitamins1 the public apparently demands to be supplied with vitamins in the form of medicinal products4 ,the public 8demands0 vitamins in pill form6 ,why8 ,for the same reason that the public1 lay or medical1 demands many things today that it does not need--because the whole trend of modern advertising is toward creating demands1 rather than supplying needs4 ,vitamin concentrates are being 8demanded0 by the public because shrewd and forward-looking 8patent medicine0 exploiters are using all the subtle arts of modern advertising to convince the public that it is in serious danger of vitamin starvation1 and that the only hope lies in buying these alleged concentrates to make up a hypothetical deficiency4 ,it seems inconceivable that a rational man would pay a tremendously high price for certain food factors which are already present in his ordinary diet4 ,but he will2 and advertising is the reason4 ,advertising campaigns such as these of the vitamins constitute a vicious circle2 an artificial demand is created and then the manufacturer excuses his business on the ground that he is merely supplying a demand6 ,as our ,british contemporary says1 8ordinary fresh foods are the simplest1 cheapest and richest sources of vitamins40--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,march #ah1 #aibb47 ,,the ,,william ,a4 ,,webster ,,co4 ,,and ,,the ,,direct ,,pharmaceutical ,,co4 ,the following letter from a ,detroit physician was received a few days ago4 ,to the ,editor3--,i have just received a letter from the ,direct ,pharmaceutical ,co4 of ,st4 ,louis1 ,mo41 quoting prices on drugs which are not more than one half what the leading manufacturers are quoting on the same drugs4 ,i have received previous literature from this company but have not done business with them4 ,i would be unwilling to prescribe their drugs unless ,i were satisfied that they are what is claimed for them4 ,i would be glad to receive any information regarding this firm that may be available4 ,the ,journal has also received some letters from physicians regarding the ,william ,a4 ,webster ,co4 of ,memphis1 ,tenn41 relative to a letter the concern was sending physicians in the form of a testimonial 7reproduced in miniature on this page7 and alleged to be from ,dr4 ,f4 ,w4 ,p4 ,butler of ,columbia1 ,s4 ,c4 ,typical letters on the ,webster advertising follow3 ,to the ,editor3--,is there not some way through which the dignity of the medical profession can be protected from the circulation of such idiotic drivel as the enclosures display8 ,to the ,editor3--,i am sending you an example of the sort of 8evidence0 which some so-called ethical pharmaceutical houses expect physicians to take for scientific proof4 ,it is pathetic that there are some in our profession who 8fall for0 such rot4 ,i trust you will continue your campaign for honest and intelligent medicine4 ,the 8evidence0 to which one of the correspondents refers and which another characterizes as 8idiotic drivel0 is reproduced on the following page in miniature4 ,it is a testimonial for ,william ,a4 ,webster ,company's 8,ferritonic-,woods40 ,our readers may wonder why we are discussing in one article the ,william ,a4 ,webster ,company of ,memphis1 ,tenn41 and the ,direct ,pharmaceutical ,co4 of ,st4 ,louis4 ,the reason is that the ,direct ,pharmaceutical ,co4 of ,st4 ,louis is apparently merely a sales agency for the ,william ,a4 ,webster ,company of ,memphis4 ,it appears that orders sent in to the ,direct ,pharmaceutical ,co4 go to ,memphis to be filled4 ,the following information regarding some of the products that have in the past been put out by the ,william ,a4 ,webster ,company should be of interest to the profession4 ,in government bulletins issued by the ,department of ,agriculture in ,october1 #aiac1 there were reported some cases of adulteration and misbranding on the part of the ,william ,a4 ,webster ,co41 of ,memphis1 ,tenn4 ,a 8,pure ,concentrated ,extract of ,lemon0 shipped by this concern was found by the federal chemists to be colored with a coal-tar dye 8whereby inferiority was concealed10 and while purporting to be a concentrated lemon extract1 8in fact1 it was not a concentrated lemon extract40 ,some 8,pure ,concentrated ,extract of ,banana0 was found to have mixed with it an imitation banana flavor and an artificial color so as to 8injuriously affect its quality and strength0 and so that 8its inferiority was concealed40 8,pure ,concentrated ,extract of ,pineapple0 was found to have had mixed with it 8an imitation extract of pineapple artificially colored40 8,pure ,concentrated ,extract of ,strawberry0 had been mixed with 8an imitation strawberry extract artificially colored40 ,the same bulletins described the case of the government against a shipment of 8,syrup ,iron ,iodide0 made by the ,webster concern in which the amount of iron iodid was less than half that claimed on the label4 ,in each of the cases just described1 the company pleaded guilty and was fined4 ,illustration3 ,reproduction 7reduced7 of a testimonial letter sent to physicians by ,william ,a4 ,webster ,company of ,memphis1 ,tenn4 ,those who operate this concern also have a sales agency in ,st4 ,louis1 ,mo41 known as the ,direct ,pharmaceutical ,co4 ,in a similar bulletin issued ,august1 #aiad1 there were recorded several more cases of adulteration and misbranding charged against the ,william ,a4 ,webster ,company4 ,some 8,wine ,coca ,leaves0 was held adulterated in that the amount of alcohol present was wrongly declared on the label2 it was held misbranded in that while it contained cocain1 the label failed to bear any statement regarding the quantity of proportion of this drug4 ,tablets of 8,acetanilid and ,sodium ,bromid ,compound0 were found deficient in strength4 8,anti-,vomit ,tablets10 8,aspirin ,tablets10 8,bismuth and ,calomel ,tablets10 8,quinin ,laxative ,tablets10 8,salol ,tablets10 8,sodium ,salicylate ,tablets10 8,neuralgic ,tablets10 8,diarrhea ,calomel ,pills0 and 8,morphin ,sulphate ,hypodermic ,tablets0 were also misbranded in that the amount of certain ingredients found in them failed to tally with the amount declared on the label4 ,in all of these cases also the ,william ,a4 ,webster ,company pleaded guilty and was fined4 ,in a government bulletin issued in ,june1 #aiag1 the same company was charged with adulterating and misbranding a quantity of ,aspirin tablets which1 instead of containing #e grains as labeled1 contained only a fraction over #a grain4 ,in this case1 too1 the company pleaded guilty and was fined4 ,the table that follows briefly summarizes some of the cases just referred to3 ,amount ,claimed ,amount ,found 8,syrup ,iron ,iodid1 ,u4 ,s4 ,p40 ,ferrous ,iodid #aj #d4f 8,acetanilid and ,sodium ,bromid ,tablets0 ,acetanilid #c4ej gr4 #b4id gr4 8,anti-,vomit ,tablets0 ,bismuth subnitrate #b4ej gr4 #a4gf gr4 ,cerium ,oxalate #b4ej gr4 #a4gh gr4 ,cocain ,hydrochl4 #j4jhcc gr4 #j4jfcg gr4 8,aspirin ,tablets0 #e4j gr4 #c4hb gr4 8,bismuth and ,calomel ,comp4 ,tablets0 ,bismuth subnitrate #j4a gr4 #j4bb gr4 ,calomel #j4a gr4 #j4bb gr4 8,quinin ,laxative ,tablets0 ,acetanilid #b4j gr4 #a4fi gr4 8,salol ,tablets0 #b4ej gr4 #b4je gr4 8,sodium ,calicylate ,tablets0 #e4j gr4 #c4hh gr4 8,neuralgic ,pills0 ,morphin sulphate #j4je gr4 #j4jae gr4 8,diarrhea ,calomel ,pills0 ,morphin sulphate #j4jfb gr4 #j4je gr4 8,morphin ,sulphate ,hypodermic ,tablets0 #j4be gr4 #j4ba gr4 8,aspirin ,tablets0 #e4jj gr4 #a4ac gr4 ,x_/ --7,from ,the ,journal ,a4 ,m4 ,a41 ,oct4 #ah1 #aiai47 ,,yeast ,from time to time yeast has attained a transitory popularity as a therapeutic agent4 ,its use in this way in practical medicine has been based essentially on empiric considerations4 ,yeast is rich in nucleic acid1 but this has not found any special applications4 ,the fatlike substances obtainable from yeast have been recommended in certain alimentary conditions1 without finding any widespread acceptance4 ,more recently yeast has acquired interest from somewhat different angles4 ,in these days of food shortage and enforced conservation1 it has come to be realized that the minute yeast cells are endowed with a remarkable capacity of synthesizing one of the most valued nutrients1 namely1 protein4 ,this substance can be built up out of the simplest forms of nitrogenous compounds by yeasts1 in contrast with the incapacity of the higher organisms to construct protein out of anything less complex than the ready made aminoacids4 ,it is reported that in ,europe yeast has actually been grown on a large scale in solutions of sugar1 salt and simple nitrogenous compounds for the sake of securing the much desired proteins4 ,the utilization of yeast protein for cattle feeding is a current practice abroad2 and the satisfactory digestibility and availability of the same product by the human organism has repeatedly been announced since the beginning of the war4 ,in this country the yeast which is produced as a by-product of the brewing industry is for the most part discarded as waste2 in the distilleries it becomes a part of the distillers' grains that are extensively employed as feeds in the dairy industry4 ,still newer is the indication that yeast is comparatively rich in at least one of the as yet unidentified accessory factors in nutrition now popularly spoken of as vitamins4 ,hopkins of the ,university of ,cambridge1 ,england1 first directed attention to this unique property of yeast4 ,it has been verified by ,funk and ,macallum1 and recently ,osborne and ,mendel have given substantial evidence of the potency of yeast to render a diet not otherwise capable of inducing maintenance effective in nutrition4 ,yeast has been used1 like extracts of rice polishings1 to cure the experimental polyneuritis induced in birds by a diet of polished rice4 ,from the experiments of ,osborne and ,mendel it appears that less than #b per cent4 of dried brewers' yeast suffices to induce small experimental animals to grow on artificial food mixtures on which alone they fail to thrive4 ,how the use of yeast as an adjuvant to otherwise inadequate food mixtures exerts its beneficial effect is not yet made clear4 ,satisfactory growth in these cases is promoted by liberal eating4 ,anything which renders food more palatable may stimulate one to eat more liberally of it4 ,this can scarcely be the explanation of the potency of the yeast as it is effective even when fed apart from the rest of the food4 ,it may have a favorable effect on the metabolism and thus improve the general condition so that more food is consumed4 ,small quantities of milk and extracts of many of the common plant foods1 such as the cereal grains1 have been found to act in the same way4 ,there seems to be little doubt1 therefore1 that yeast also contains something comparable with the so-called water-soluble vitamins of the diet4 ,a specific need for yeast can scarcely be predicated on this fact1 however2 for any well selected human dietary containing the usual variety of animal and vegetable foods is not likely to be devoid of the widely distributed water-soluble type of vitamin4 ,we mention this to check premature enthusiasm for a new vitamin4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #h1 #aiag47 ,yeast and ,its ,uses ,to the ,editor3--,is there available information concerning the medicinal use of yeast8 ,how is it taken8 ,i should like to know whether the use of it would cause any digestive disturbance1 and whether the flesh gained is normal and permanent4 ,s4 ,e4 ,l41 ,bridgeport1 ,conn4 ,,answer4--,yeast is one of those remedies that have undergone alternating cycles of use and of disuse2 just at present it appears again to be in its ascendency4 ,no doubt1 the reason for these cycles has been excessive praise and uncritical use1 followed by disappointment and consequent discard4 ,hawk and his associates 7,hawk1 ,p4 ,b42 ,knowles1 ,f4 ,c42 ,rehfuss1 ,m4 ,e41 and ,clarke1 ,j4 ,a43 ,the ,use of ,bakers' ,yeast in ,diseases of the ,skin and of the ,gastro-,intestinal ,tract1 ,the ,journal1 ,oct4 #ac1 #aiag1 p4 #abdc7 have recently called renewed attention to its laxative qualities4 ,when from one-half to one cake of yeast was given three times daily before meals1 it produced regular bowel movements in a number of patients suffering from constipation4 ,that this result is not due to any vital processes in the yeast is shown by the fact that yeast killed by boiling water was employed with success4 ,it is suggested that such yeast might be preferred for patients troubled with flatulence4 ,aside from the tendency of living yeast to produce diarrhea1 and the possibility that it may aggravate flatulence1 no digestive disturbance has been charged against it4 ,aaron1 in his 8,diseases of the ,digestive ,organs10 speaks favorably of its use in atonic constipation4 ,the much debated question whether yeast may serve as a food can be answered in the affirmative in view of such work as that of the ,germans on 8,nhrhefe0--yeast food 7,schottelius1 ,deutsch4 med4 ,wchnschr41 ,july #h1 #aiae1 p4 #hag7 and ,boruttau 7ibid41 ,july #bi1 #aiae1 p4 #ibd7 and of ,hawk and his associates4 ,there is no reason to assume that weight gained under its use would be more readily lost than weight gained from any other food4 ,however1 in view of its laxative action1 the average individual can ingest only from #a to #b gm4 of nitrogen a day in this form4 ,this obviously greatly limits its value as a food4 ,owing to its high nuclein content1 it is contraindicated in gout4 ,as a source of water soluble growth promoting as well as antineuritic vitamin1 yeast has become thoroughly established as the result of the recent works of numerous investigators4 ,however1 as such common foods as milk1 rice1 wheat1 oats and beans also contain such vitamin1 there is little likelihood of its proving of therapeutic value on that account4 ,in other words1 yeast and other vitamin containing foods have specific growth promoting qualities only when the stunting is due to lack of vitamin4 ,a minute amount of this substance suffices to produce maximal results4 ,more is of no use4 ,hess 7,proc4 ,soc4 ,exper4 ,biol4 ,med4 #ac3ade1 #aiaf7 found yeast of no value in infantile scurvy4 ,the most important question in connection with yeast therapy is to what extent it is endowed with 8antibiotic0 power1 that is1 to what degree it is capable of inhibiting the growth of other organisms4 ,that this frequently occurs in cultures in vitro is shown by the fact that yeast contamination may practically eradicate the growth of certain other organisms4 ,that1 on the other hand1 this is not true for all forms of bacterial life is shown by the fact that there is definite symbiosis between yeast and lactic acid bacilli 7,northrup3 ,soc4 ,tech4 ,bull4 #ae1 ,mich4 ,agr4 ,expa4 ,sta41 #aiab74 ,that its 8antiseptic power is1 on the whole insignificant0 has been shown by ,palier 7,diet4 ,hyg4 ,gaz41 ,march1 #aijf71 who found commercial yeasts commonly contaminated with numerous bacteria1 the most frequent being ,bacillus coli-communis or one of its congeners4 ,an antagonistic action by yeast is claimed against ,staphylococcus pyogenes1 and on the strength of this1 ,buchholtz 7,ueber ,acne und eine neue erfolgreiche ,behandlung derselben1 ,berl4 klin4 ,wchnschr41 ,feb4 #b1 #aiad1 p4 #bae7 employed it locally in the treatment of acne and obtained a positive but temporary effect4 ,he believes that the effect is improved by the combination of yeast with an equal quantity of boric acid4 ,he employed this as a dusting powder applied freely to the skin once daily1 after the application of a thin layer of a boric acid salve 7boric acid powder from #dj to #ej1 glycerin and water1 of each #ajj7 to make it stick better4 ,in cases in which the nose was markedly involved1 he also used this as a snuff4 ,yeast poultices have been employed with asserted great benefit in the treatment of wound infection of all kinds 7,kempf1 ,e4 ,j43 ,ind4 ,m4 ,j41 ,september1 #aijd1 p4 #ig74 ,the use in leukorrhea was recommended by ,hippocrates ,abraham 7,mon4 ,geb4 ,sym41 #aiaj7 and many others report favorable results from yeast in the treatment of gonorrheal vaginitis4 ,in various gastro-intestinal infections1 yeast has been lauded by many1 among others1 ,thiercelin and ,chevrey4 ,it has been given by mouth1 but most especially in high rectal enemas4 ,still more from a theoretical standpoint is the reassertion of the curative value of the oral administration of yeast in various cutaneous disorders4 ,thus ,hawk and his collaborators report cure or improvement in all of seventeen cases of acne vulgaris and eight cases of acne rosacea4 ,they also report seventeen cases of furunculosis1 in all but one of which there was cure or improvement from yeast treatment4 ,they are unable to decide whether the result is due to the laxative action1 the production of leukocytosis1 or to other influences4 ,yeast is probably best taken incorporated in food4 ,hawk and his associates found that yeast may well be incorporated in wheat biscuits1 and that in this way a yeast-wheat combination of most agreeable flavor was produced3 that1 in fact1 the biscuits with the yeast tasted better than those without it4 ,they found by tests that in bread making as much as #bj per cent4 of the flour might be replaced by dry yeast1 and that thereby a loaf would be produced that was excellent in every way and possessed of an attractive flavor4 ,the dry yeast was prepared by desiccating compressed yeast at #aje ,c4 in a current of air1 and then milling it to produce a flour of the approximate fineness of ordinary wheat flour4 ,they also found that yeast may be added to meat preparations1 such as ,hamburger steak1 to the extent of #b4e per cent41 yielding a preparation of very satisfactory taste4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,aug4 #bc1 #aiai47 ,,briefer ,,paragraphs ,laxol and ,lysol--,the ,short and ,catchy ,proprietary ,name ,a laborer went to a ,brooklyn physician for treatment and was given three prescriptions4 ,one of the prescriptions1 according to the ,food and ,drug ,bulletin of the ,department of ,health1 ,city of ,new ,york1 called for 8,laxol10 the word being written on a piece of blank paper without directions4 ,the drug clerk misread the prescription and dispensed an 8original0 bottle of 8,lysol0 which bore the usual poison label with skull and cross bones4 ,the man drank the entire #c ounces of ,lysol and died half an hour later4 ,the case is now in the hands of the ,district ,attorney1 the drug clerk being held under #aj1jjj bail4 8,laxol10 as our readers know1 is castor oil sweetened with saccharin and flavored with peppermint4 ,there is no excuse for prescribing the product4 ,the official ,aromatic ,castor ,oil 7,ol4 ,ricin4 ,arom47 of the ,national ,formulary would answer every purpose served by the proprietary preparation4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,may #bi1 #aibj47 ,look ,up ,its ,rating ,modern business has become so complex that it is no longer possible for those engaged in trade to know1 offhand1 the financial responsibility of their prospective customers4 ,the commercial agency is a natural development2 it aims to supply the technical 7financial7 information which the conservative business man needs but is otherwise unable to get4 ,when ,john ,doe ,co4 contemplates entering into business arrangements with ,henry ,roe ,son to a degree that involves financial obligations1 it looks up ,roe in the rating book of ,dun or ,bradstreet and probably calls for a special commercial report on the concern4 ,these facts are so elemental and obvious as to be trite4 ,the complexity of modern medicine1 especially in the pharmacologic field1 has made it a physical impossibility for physicians to know the scientific status of scores of pharmaceutical products put out under proprietary or brand names4 ,it was recognition of this fact that brought about the creation by the ,american ,medical ,association of the ,council on ,pharmacy and ,chemistry4 ,this body of experts1 serving without remuneration and reporting without fear or favor on the newcomers to the pharmaceutical world1 places at the disposal of physicians unbiased information1 free alike from prejudice or prepossession4 ,as the commercial agency reports on the commercial probity of individuals and firms1 so the ,council on ,pharmacy and ,chemistry reports on what might be called the scientific probity of proprietary and unofficial pharmaceutical products4 ,the commercial agency issues1 at no small expense to its customers1 rating books2 the council on ,pharmacy and ,chemistry issues1 at a nominal price1 8,new and ,nonofficial ,remedies40 ,the commercial agency1 for a substantial fee1 will furnish reports on business concerns2 the ,council on ,pharmacy and ,chemistry will1 without any expense to the profession1 furnish reports on proprietary products used for the relief or cure of human ailments4 ,the careful business man avails himself of the services of the commercial agency2 there are financial interests at stake4 ,the conscientious physician will avail himself of the services of the ,council2 there are1 it may well be1 lives at stake4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,april #bd1 #aibj47 ,the ,medical ,profession and ,commercial ,interests ,last week ,the ,journal published a letter received by a physician in ,milwaukee from a firm of lawyers representing the ,farbwerke-,hoechst ,company4 ,in this communication the physician was threatened with suit if he published further unfavorable reports regarding that firm's preparation4 ,quoting from the attorney's letter3 8,mr4 ,metz directs us to inform you that the publication of this article and the statements therein were seriously damaging to the ,farbwerke-,hoechst ,company1 and directs us to say further to you that he and the corporation will hold you personally responsible for any repetition1 oral or written1 of the same or of similar statements to the same effect40 ,we were under the impression that the time had passed when a proprietary medicine manufacturer would presume to threaten a physician for making an honest report of his results with any therapeutic agent4 ,such condition did exist once1 before the ,council on ,pharmacy and ,chemistry undertook its work4 ,now comes ,mr4 ,metz to revive this relic of an historic but infamous period in the history of ,american proprietary medicine manufacturing4 ,even ,mr4 ,vanderbilt regretted that he ever said 8,the public be d----40 ,one of the elementary principles in the practice of medicine is that the individual physician shall let others know his results1 whether good or bad1 in any line of treatment4 ,it is by such interchange of knowledge and experience that progress in medicine is possible4 ,yet ,mr4 ,metz would interfere with the diffusion of such knowledge and experience when it applies to proprietary medicines4 ,his legal threat against ,dr4 ,sargent is 8terrorism0 applied to the medical profession4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,june #h1 #aiah47 ,rabbit-,foot ,therapy ,few but ignorant darkies have any great faith in the therapeutic efficacy of the left hind foot of a rabbit caught in the churchyard in the dark of the moon4 ,in the light of modern therapeutics one is tempted to believe1 however1 that had some one person or firm an exclusive proprietary right to this particular brand of rabbits' feet1 there would be many intelligent people--and not all of them laymen--ready to swear by rabbits' foot therapy4 ,in medical journals 7whose advertising pages set forth the virtues of the pedal extremities of ,lepus sylvaticus7 many solemnly scientific articles would probably appear relating the success that the writers had had with this form of therapy in the treatment of some distressing stubborn conditions that had failed to respond to all previous efforts4 ,is it ubiquity that has saved the homely cotton-tail from being a therapeutic hero8--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bi1 #aiag47 ,secret ,remedies and the ,principles of ,ethics ,many hundreds1 possibly thousands1 of inquiries are received each year by ,the ,journal from physicians asking for information on1 or an opinion of certain proprietary remedies4 ,in many instances the preparations in question are essentially secret in composition1 although advertised to the profession under a fair-seeming exterior of apparent frankness4 ,there are on the market today--and used by members of the ,american ,medical ,association--dozens1 yes scores1 of widely advertised proprietaries that are1 to all intents and purposes1 secret4 ,the physicians who prescribe them do not know and cannot know what they are giving their patients4 ,on this point ,section #f of ,chapter ,,ii of the ,principles of ,medical ,ethics of the ,american ,medical ,association says3 8444 it is 444 unethical to prescribe or dispense secret medicines or other secret remedial agents1 or manufacture or promote their use in any way40 ,the inherent and basic reasonableness of the various requirements of the ,principles of ,medical ,ethics needs no exposition or defense4 ,a large number of proprietary remedies which at present degrade medicine would be wiped out of existence or1 at any rate1 go over to the 8patent medicine0 class1 where they belong1 if physicians would live up to ,section #f1 ,chapter ,,ii1 of the ,principles4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bg1 #aiai47 8,sterling ,violet ,ray ,generator0 ,to the ,editor3--,i am curious to learn the value of the violet ray in the treatment of disease4 ,the violet ray seems to be much in evidence in ,canada at the present time in various towns4 ,it is well advertised1 not in the same way as a 8patent medicine0 would be1 but as a genuine form of treatment4 ,the enclosed booklet gives a brief outline of what the agents for the 8,sterling ,violet ,ray ,generator0 claim it will do4 ,the reason ,i am troubling you about the matter is that ,i feel if there is anything in it as is claimed1 it should be better known4 ,it also seems that if this treatment is not capable of doing what is claimed for it1 it is a rather serious thing for a person who may defer calling a physician4 ,j4 ,a4 ,g4 ,,answer4--,the 8,sterling ,violet ,ray ,generator0 is a small high frequency apparatus with some vacuum and possibly other electrodes4 ,there is a violet color in these vacuum electrodes when they are energized4 ,the apparatus is not one for producing violet or ultraviolet rays in the scientific meaning of those words4 ,the apparatus certainly will not do the things claimed for it in the booklet which includes the treatment of practically every ailment known to mankind4--7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,april #ad1 #aiag47 ,strontium ,salicylate ,not ,superior to ,sodium ,salicylate ,sodium salicylate is a valuable drug4 ,it is official and cheap2 it is the compound generally relied on when salicylate effects are desired4 ,and there is no mystery about it4 ,with the other salicylates1 mystery begins4 ,for this reason1 such studies as that of ,blankenhorn on strontium salicylate are of special value4 ,blankenhorn shows that strontium salicylate possesses no advantages over sodium salicylate1 as regards either therapeutic efficacy or freedom from undesirable by-effects4 ,he calls attention to the fact that 8the salicyl content of strontium salicylate is about four-fifths that of sodium salicylate based on the amount of available anion40 ,the question naturally arise whether this smaller salicylate content may not contribute to the notion that strontium salicylate is less likely to cause salicylism4 ,the impression as to the greater freedom of this salt from undesirable by-effects may have arisen in part also from the fact that the more expensive preparations are more likely to be given in small doses than is the cheaper sodium salicylate4 ,as ,blankenhorn suggests1 when once such a tradition gains currency1 it will be 8lugged along0 from one textbook to another1 with little or no attempt at critical examination4--7,editorial from ,the ,journal ,a4 ,m4 ,a41 ,jan4 #bi1 #aiaf47 ,vaccine ,as a ,prophylactic in ,influenza ,to the ,editor3--,i am chief surgeon for a large steel industry in ,canton1 and desire to do all in my power to prevent the threatened recurrence of influenza4 ,what is the status of the various vaccines as a preventive or prophylactic measure8 ,would you advise their use as a preventive measure1 to immunize the workers in the industries8 ,m4,d41 ,canton1 ,ohio4 ,,answer4--,the status of vaccine therapy as a prophylactic for influenza may be ascertained from the two articles appearing in ,the ,journal1 ,aug4 #i1 #aiai3 that of ,e4 ,c4 ,rosenow and ,b4 ,f4 ,sturdivant entitled 8,studies in ,influenza and ,pneumonia3 ,further ,results of ,prophylactic ,inoculations10 and that of ,g4 ,w4 ,mc,coy1 director1 ,hygienic ,laboratory1 ,u4 ,s4 ,public ,health ,service1 on 8,status of ,prophylactic ,vaccination ,against ,influenza40 ,in brief1 the conclusion of ,rosenow and ,sturdivant is3 8,it appears from all of the facts at hand that by the use of a properly prepared vaccine it is possible to rob influenza of some of its terrors40 ,on the other hand1 ,mc,coy states3 8,the general impression gained from uncontrolled use of vaccines is that they are of value in the prevention of influenza2 but1 in every case in which vaccines have been tried under perfectly controlled conditions1 they have failed to influence in a definite manner either the morbidity or the mortality40 ,to make a conservative statement3 ,the use of vaccine as a prophylactic in influenza is an experiment4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,sept4 #bg1 #aiai47 ,vaccines for 8,colds0 ,to the ,editor3--,has there been work done of sufficient extent to be of value in justifying use of mixed 8shotgun0 vaccines to abort or immunize 8common colds10 that is1 rhinitis1 pharyngitis1 acute bronchitis1 coryza1 etc48 ,charles ,e4 ,bennett1 ,m4,d41 ,aneta1 ,n4 ,d4 ,,answer4--,we know of no investigation which demonstrates that the use of the commercial mixed vaccines are of value in the prevention or treatment of 8common colds0 or of similar affections4 ,the ,council on ,pharmacy and ,chemistry accepts for ,new and ,nonofficial ,remedies mixed vaccines only on condition that their usefulness has been established by acceptable clinical evidence2 so far it has not admitted any of the 8influenza0 or 8catarrhal0 mixed vaccines4--7,correspondence in ,the ,journal ,a4 ,m4 ,a41 ,nov4 #aj1 #aiag47 ,to the ,editor3--,please advise me of the latest and best vaccine for common colds4 ,l4 ,j4 ,smith1 ,m4,d41 ,wilson1 ,n4 ,c4 ,health ,officer1 ,city and ,county ,health ,department4 ,,answer4--,there is no scientific evidence that common colds can be prevented by the use of vaccines1 despite the glowing recommendations of vaccine makers and the patter of the detail man4 ,colds characterized by catarrhal inflammation of the mucous membranes of the nose and throat are caused by various organisms1 including a number of the commoner cocci and the bacillus of ,pfeiffer4 ,they are contagious1 and spread rapidly from one person to another by the transfer of the bacteria concerned1 so that small epidemics of colds are continually occurring in homes and communities4 ,the organism concerned in one small epidemic may be different from that in another1 and it is impossible to anticipate what organism is about to invade the household or community4 ,the inoculation of mixed vaccines in the hope of providing against a number of possible invaders fails to produce immunity sufficient to prevent the infection of mucous membranes4 ,where completely controlled experiments have been made with large numbers of persons1 colds have occurred among the inoculated in as large proportion as among the uninoculated4 ,during the war1 some evidence was obtained which indicated that preventive inoculation of troops with a vaccine containing large numbers of pneumococci reduced the incidence and mortality of pneumonia4 ,in the case of superficial infection of the nasal and pharyngeal mucous membranes with diverse etiology1 less can be expected1 and practical results indicate that this skepticism based on theoretical considerations is well founded4--7,query in ,the ,journal ,a4 ,m4 ,a41 ,nov4 #ac1 #aibj47 ,,index ,,and ,,bibliography ,see ,closing ,paragraph to ,preface1 ,page ,,iv4 ,,page ,abbott ,laboratories-- ,b4 ,coli-,combined-,bacterin1 #ahe ,barbital1 #cga ,calcidin ,tablets1 #dfe ,m4 ,catarrhalis-,combined-,bacterin1 #ahd ,neuro-,lecithin1 #ec ,pertussis-,combined-,bacterin1 #ahe ,procain-,abbott1 #cef ,streptococcus-,rheumaticus-,combined-,b acterin1 #ahe1 #ahf ,streptococcus-,viridans-,combined-,bact erin1 #ahe1 #ahf ,triple ,arsenates with ,nuclein1 #bef ,abrams1 ,albert1 #dgb ,abrams1 ,albert1 defense of1 by ,upton ,sinclair1 #dgg ,acetanilid and ,sodium ,bromid ,tablets1 #eff ,acetanilid ,compound1 ,mulford1 #bjf ,acet-,phenetidin ,compound1 ,p4-,m4 ,co41 ,tablets 7,pitman-,moore ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #gc4 ,acetylsalicylic ,acid3 ,see also ,aspirin4 ,acetylsalicylic ,acid1 ,american-made1 examination of1 #cdd ,acetylsalicylic ,acid 7,aspirin7 ,monsanto1 #cdg ,acetylsalicylic ,acid1 ,m4 ,c4 ,w1 #cdg ,acetylsalicylic ,acid1 ,millikin1 #cdg ,acetylsalicylic ,acid1 not ,aspirin1 #dhj ,acetylsalicylic ,acid1 ,p4 ,w4 ,r1 #cdg ,acetylsalicylic ,acid1 ,squibb1 #cdg ,acetylsalicylic ,acid--8,what's in a ,name401 #dhb ,adreno-,spermin ,comp41 ,caps1 #bai ,advertising by means of 8original0 articles in medical journals1 #efj ,advertising principles--lay and medical1 #dhc ,agar-lac 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,nov4 #ad1 #aiad1 p4 #aggg2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abd2 ,propaganda1 ed4 #i1 p4 #aj4 ,agmel 7,maguey ,products ,co471 ,the ,journal1 ,oct4 #ab1 #aiab1 p4 #acib4 ,akoz1 lead in1 #cbh ,akoz ,medicinal ,mineral ,water1 #cbh ,akoz ,ointment1 #cbh ,akoz ,powder1 #cbh ,akoz ,suppositories1 #cbh ,albolene1 ,liquid1 #ajf ,albolene1 ,liquid 7,mc,kesson ,robbins71 ,the ,journal1 ,july #bf1 #aiac1 p4 #bif2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #fe4 ,alborum 7,the ,whitehouse ,chemical ,co41 ,inc471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abi4 ,alcohol1 ,hygiene and ,legislation1 #die ,alcresta ,dental ,lotion-,lilly 7,eli ,lilly ,co471 ,the ,journal1 ,oct4 #bi1 #aiba1 p4 #adda4 ,alcresta ,ipecac1 #aec ,alcresta ,ipecac 7,eli ,lilly ,co471 ,the ,journal1 ,oct4 #bj1 #aiag1 p4 #acgc2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #fb4 ,alcresta ,lotion1 #dfe ,aletrin1 ,the ,journal1 ,nov4 #ac1 #aiji1 p4 #afee2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #ace4 ,aletris ,compound1 ,elixir 7,parke1 ,davis ,co42 ,ray ,chemical ,co472 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,aletris ,cordial 7,rio ,chemical ,co471 ,the ,journal1 ,oct4 #ag1 #aiad1 p4 #adaa2 ,feb4 #ac1 #aiae1 p4 #fjf2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ii2 ,propaganda1 ed4 #i1 p4 #dc4 ,alexander1 ,h4 ,m41 ,company-- ,dixon's ,tubercle ,bacilli ,extract and ,dixon's ,suspension of ,dead ,tubercle ,bacilli1 #aeh ,alfatone1 #bh ,alfatone 7,norwich ,pharmacal ,company71 ,the ,journal1 ,aug4 #g1 #aiae1 p4 #edh2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #fb4 ,alkaline ,digestine 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,alkalithia1 #bdb ,alkalithia 7,keasbey and ,mattison ,company71 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #fe4 ,alkalol 7,alkalol ,co471 ,the ,journal1 ,nov4 #f1 #aiae1 p4 #affe2 ,reports ,chem4 ,lab41 #aiae1 p4 #aaj4 ,alleotone 7,b4 ,f4 ,copeland71 ,the ,journal1 ,feb4 #a1 #aijh1 p4 #cgi2 ,propaganda1 ed4 #i1 p4 #bfd4 ,allied ,medical ,associations of ,america1 #dhf ,alphozone1 #ii ,alphozone 7,frederick ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ej4 ,ambrine1 analysis of1 #ccb 8,ambrine0 and ,paraffin ,films1 #ccj ,ambrine1 ,the ,journal1 ,april #g1 #aiag1 p4 #ajeg2 ,may #ai1 #aiag1 p4 #adig2 ,reports ,chem4 ,lab41 #aiag1 p4 #bj4 ,american ,animal ,therapy ,co1 #ebh ,american ,elixir of ,bitter ,wine1 ,triner's1 #aci ,american-made synthetic drugs1 #cdd1 #cfi ,american ,medical ,association ,chemical ,laboratory1 foreword1 #cbb ,american ,medical ,association ,chemical ,laboratory1 work of1 #cbb ,american ,medical ,association ,council on ,pharmacy and ,chemistry1 delays in passing on products1 #bj ,american ,medical ,association ,council on ,pharmacy and ,chemistry1 foreword1 #a ,american ,medical ,association ,council on ,pharmacy and ,chemistry offers services similar to ,dun and ,bradstreet1 #egj ,american ,medical ,association ,council on ,pharmacy and ,chemistry1 official rules of1 #c ,american ,medical ,association ,council on ,pharmacy and ,chemistry1 present and future1 #ab ,american ,medical ,association ,council on ,pharmacy and ,chemistry endorsed by ,the ,journal of the ,missouri ,state ,medical ,association1 #ai ,american ,organotherapy ,company1 #ebg ,ammonium ,chloride1 ,troches of1 druggists refuse to supply1 #eeb ,ammonium ,hypophosphite1 #ih ,ammonium ,hypophosphite1 ,gardner's ,syrup of1 #ajj ,ammonium ,hypophosphite1 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ea4 ,ammonol1 #cic ,ammonol 7,ammonol ,chemical ,co471 ,the ,journal1 ,june #c1 #aije1 p4 #agia2 ,feb4 #b1 #aiah1 p4 #ccg2 ,reports ,council ,pharm4 ,chem41 #aije1 #aijh1 p4 #g2 ,propaganda1 ed4 #i1 p4 #i4 ,amolin ,deodorant ,powder 7,amolin ,chemical ,co471 ,the ,journal1 ,feb4 #bb1 #aijh1 p4 #fbf2 ,reports ,chem4 ,lab41 #aiji1 p4 #fc4 ,anadol 7,wheeler ,chemical ,works71 ,the ,journal1 ,may #ba1 #aiaj1 p4 #agjd2 ,propaganda1 ed4 #i1 p4 #bde4 ,analutos and ,analutos ,tablets 7,royal ,pharmaceutical ,works1 ,meppel1 ,holland71 ,the ,journal1 ,feb4 #bj1 #aiae1 p4 #fhd2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ace2 ,reports ,chem4 ,lab41 #aiae1 p4 #aca4 ,anasarcin1 #chc ,anasarcin advertising1 #djg ,anasarcin 7,anasarcin ,chemical ,co471 ,the ,journal1 ,may #d1 #aijg1 p4 #aece2 ,dec4 #h1 #aiag1 p4 #aiib2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #ed2 ,propaganda1 ed4 #i1 p4 #aa4 ,anderson ,system for ,treatment of ,alcoholism 7,the ,anderson ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ea4 ,anedemin1 #chc ,anedemin 7,anedemin ,chemical ,co471 ,the ,journal1 ,may #d1 #aijg1 p4 #aece2 ,dec4 #h1 #aiag1 p4 #aiib2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #ed2 ,propaganda1 ed4 #i1 p4 #aa4 ,anesthesin1 #bgf ,angier's ,emulsion 7,angier ,chemical ,co471 ,the ,journal1 ,sept4 #ab1 #aiad1 p4 #ifb2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #dh2 ,reports ,chem4 ,lab41 #aiad1 p4 #ee2 ,propaganda1 ed4 #i1 p4 #afi4 ,anglo-,french ,drug ,co41 ,ltd4-- ,collosol ,cocaine1 #bba ,collosol preparations1 #bbc ,cuprase1 #bbb ,sukro-,serum1 #bgc ,supsalvs1 #bgd ,anistamina 7,m4 ,olivetti71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afb4 ,antero-,pituitary ,comp41 ,caps1 #bai ,antidiabeticum1 ,bauer 7,sanin-,gesellschaft71 ,the ,journal1 ,july #cj1 #aiaj1 p4 #dah2 ,propaganda1 ed4 #i1 p4 #bfg4 ,antidysenteric ,serum 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,antikamnia 7,antikamnia ,chemical ,co471 ,the ,journal1 ,june #c1 #aije1 p4 #agia2 ,feb4 #h1 #aijh1 p4 #dfg2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #g2 ,reports ,chem4 ,lab41 to #aiji1 p4 #fj2 ,propaganda1 ed4 #i1 pp4 #i1 #bfh1 #cjg4 ,antikamnia and ,quinin 7,antikamnia ,chemical ,co471 ,the ,journal1 ,july #a1 #aije1 p4 #ee4 ,anti-,malta ,fever ,serum 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #acf4 ,antimeristem-,schmidt1 #djh ,antimeristem-,schmidt 7,laboratorium ,w4 ,schmidt71 ,the ,journal1 ,march #h1 #aiac1 p4 #gff2 ,dec4 #f1 #aiai1 p4 #aghg4 ,antiphlogistine1 #dji ,antiphlogistine 7,denver ,chemical ,mfg4 ,co471 ,the ,journal1 ,june #a1 #aijg1 p4 #ahge2 ,feb4 #bc1 #aiah1 p4 #eeg4 ,anti-,pneumococcic ,oil 7,eimer and ,amend71 ,the ,journal1 ,jan4 #c1 #aibj1 p4 #df2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #eb4 8,anti-,pneumococcic ,oil0 and the use of camphor in pneumonia1 #beg ,antipneumococcus ,serum 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,antiseptic ,powder1 ,maignen 7,maignen ,institute71 ,the ,journal1 ,nov4 #ad1 #aiad1 p4 #aggh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #eg2 ,propaganda1 ed4 #i1 p4 #ai4 ,antiseptic ,powder1 ,tyree's1 #dfb ,antiseptic ,powder1 ,tyree's 7,j4 ,s4 ,tyree71 ,the ,journal1 ,oct4 #bj1 #aijf1 p4 #acaf2 ,aug4 #bd1 #aiab1 p4 #fff2 ,march #cj1 #aiah1 p4 #idi2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #bb2 ,propaganda1 ed4 #i1 pp4 #ba1 #djd2 ,may #ag1 #aiai1 p4 #adhb4 ,antiseptic ,tablets ,clover 7,sharp ,dohme71 ,the ,journal1 ,aug4 #bf1 #aiaa1 p4 #gee4 ,antiseptic1 ,tyree's1 #dja ,antistaphylococcus ,serum 7,burroughs ,wellcome ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #acg4 ,antistreptococcus ,serum1 ,aronson's 7,schering ,glatz1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,antistreptococcus ,serum 8,hoechst0 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,anti-,syphilitic ,compound 7,sweeny71 #bfh1 #ccj ,anti-,syphilitic ,compound ,sweeny 7,national ,laboratories of ,pittsburgh71 ,the ,journal1 ,april #c1 #aibj1 p4 #ife2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #ab4 ,antithermoline 7,g4 ,w4 ,carnrick ,co471 ,the ,journal1 ,nov4 #a1 #aiac1 p4 #afdi4 ,antithyroid ,preparations 7,antithyroidin-,moebius and ,thyreoidectin71 #bjb ,antithyroid ,preparations1 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ej4 ,antithyroidin-,moebius 7,merck ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ej4 ,antithyroidin-,moebius and ,thyreoidectin1 ,antithyroid ,preparations1 #bjb ,anti-,tuberculous ,lymph ,compound 7,sweeny71 #bff ,anti-,tuberculous ,lymph ,compound1 ,sweeny 7,national ,laboratories of ,pittsburgh71 ,the ,journal1 ,april #c1 #aibj1 p4 #ife2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #ab4 ,anti-,vomit ,tablets1 #eff ,anusol ,suppositories1 #ahb ,anusol ,suppositories 7,schering ,glatz1 ,inc471 ,the ,journal1 ,oct4 #b1 #aiji1 p4 #aaab2 ,oct4 #aa1 #aiac1 p4 #acib2 ,jan4 #ca1 #aiad1 p4 #cie2 ,march #i1 #aiah1 p4 #gai2 ,reports ,chem4 ,lab41 #aiji1 p4 #cb2 ,propaganda1 ed4 #i1 pp4 #bbg1 #bhj1 #bha4 ,apergols 7,h4 ,k4 ,wampole ,co41 ,inc471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badi2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #fd2 ,propaganda1 ed4 #i1 p4 #bf4 ,aphlegmatol1 #bgc ,aphlegmatol 7,g4 ,giambalvo ,co471 ,the ,journal1 ,aug4 #ba1 #aibj1 p4 #eef2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #bc4 ,apothesine1 #bfj ,aquazone 7,oxygen ,water71 #bij ,aquazone 7,oxygen ,water7 7,aquazone ,laboratories1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #ej4 ,arbor ,vitae1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ch4 ,arhovin1 #bdc ,arhovin 7,schering ,glatz1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ff4 ,armervenol1 #bdi ,armervenol 7,hille ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #hb4 ,armour and ,company-- ,duodenin1 #gf ,lecithol1 #ec ,pineal ,gland ,preparations1 #bac ,red ,bone-,marrow ,preparations1 #bac ,thymus ,gland ,preparations1 #bad 8,arrhenal01 #dib ,arrhenal 7,e4 ,fougera ,co47 ,the ,journal1 ,feb4 #bf1 #aiba1 p4 #eie4 ,arsenates1 ,triple1 with ,nuclein1 #bef ,arsenic and ,mercury1 ,solution of1 #bca ,arsenic and ,mercury1 ,solution of 7,new ,york ,intravenous ,laboratory71 ,the ,journal1 ,aug4 #b1 #aiai1 p4 #cec2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #bf4 ,arsenic1 ,iron and ,phosphorus ,compound1 ,hypodermic ,solution ,no4 #ac1 #bge 8,arsenicals01 #dia ,arsenicals1 pharmacology of1 #dib ,arseno-,meth4 ,hyd43 ,see ,arsenic and ,mercury1 ,solution of4 8,arsenoven1 ,s4 ,s401 #bca ,arsenoven1 ,s4 ,s4 7,s4 ,s4 ,products ,co471 ,the ,journal1 ,aug4 #b1 #aiai1 p4 #cec2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #bf4 ,arsphenamin1 #dia1 #did ,aseptikons 7,chinosol ,co471 ,the ,journal1 ,nov4 #ad1 #aiad1 p4 #aggh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abd2 ,propaganda1 ed4 #i1 p4 #bf4 ,aseptinol1 #dja ,aseptinol 7,aseptinol ,mfg4 ,co471 ,the ,journal1 ,march #cj1 #aiah1 p4 #idi4 ,aspirin3 ,see also ,acetylsalicylic ,acid4 ,aspirin1 #aaf1 #edd ,aspirin 7,the ,bayer ,co41 ,inc471 ,the ,journal1 ,jan4 #bj1 #aiag2 ,april #ac1 #aiah1 p4 #ajig2 ,june #ab1 #aibj1 p4 #affd2 ,may #ad1 #aiba1 p4 #acef2 ,june #aa1 #aiba1 p4 #afig2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #dc4 ,aspirin--a common name1 #dhd ,aspirin1 ,acetylsalicylic ,acid not ,aspirin1 #dhj ,aspirin advertisements1 #dhc ,aspirin ,bayer1 #aaf1 #cdg1 #dhj 8,aspirin ,bayer0 and the ,sterling ,products ,company1 #dhe ,aspirin1 ,lehn and ,fink1 #cdg ,aspirin ,tablets1 #eff ,aspiro-,lithine 7,mc,kesson ,robbins71 ,the ,journal1 ,may #bh1 #aiaj1 p4 #ahjc2 ,propaganda1 ed4 #i1 p4 #bha4 ,atlanta ,journal-,record of ,medicine and ,gray's ,glycerine ,tonic1 #dbi ,atophan1 #cac1 #cgc1 #dai ,atophan 7,phenylcinchoninic ,acid1 ,u4,s4,p471 ,cinchophen1 #cgc 8,auto-,hemic ,serum01 #dji ,auto-,hemic ,serum 7,l4 ,d4 ,rogers71 ,the ,journal1 ,feb4 #ad1 #aibj1 p4 #dgg4 ,autolysin 7,autolysin ,laboratory71 ,the ,journal1 ,july #bd1 #aiae1 p4 #ccf2 ,nov4 #f1 #aiae1 pp4 #afdg1 #affb4 8,autolysin0 advertising1 #dac ,b4 ,coli-,combined-,bacterin1 #ahe ,b4 ,coli-,combined-,bacterin 7,the ,abbott ,laboratories71 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,b4 ,iodine1 #aih ,b4 ,iodine 7,b4 ,iodine ,chemical ,co471 ,the ,journal1 ,feb4 #a1 #aiai1 p4 #cfe2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #dd4 ,b4 ,iodine ,product1 #aii ,b4 ,oleum ,iodine1 #aih ,b4 ,oleum ,iodine 7,b4 ,iodine ,chemical ,co471 ,the ,journal1 ,feb4 #a1 #aiai1 p4 #cfe2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #dd4 ,baby ,taeniafuge-,grape 7,grape ,capsule ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agd4 ,bacilli ,emulsion1 ,bovine 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,bacilli ,emulsion1 ,koch's 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,bacillicide 7,prophytol ,products ,co471 ,the ,journal1 ,nov4 #ad1 #aiad1 p4 #aggh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abe4 ,bacillus ,acidophilus ,cultures1 ,the ,journal1 ,dec4 #bj1 #aiai1 p4 #ahie2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ea4 ,bacillus ,vaccine1 ,friedlnder4 ,see ,friedlnder ,bacillus ,vaccine4 ,bacterial ,vaccine1 ,special1 ,nos4 #b1 #c1 #d1 #e1 #aa1 #ae and #af1 #bed ,bakurol 7,sharp ,dohme71 ,the ,journal1 ,july #aj1 #aiae1 p4 #age4 ,baldwin1 ,z4 ,l41 and the ,allied ,medical ,associations of ,america1 #dij ,balsamea ,co4--,syrup ,leptinol 7formerly ,syrup ,balsamea71 #bfh ,baneberry1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ch4 ,baptisin1 ,the ,journal1 ,nov4 #ac1 #aiji1 p4 #afee2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #ace4 ,barbital 7,abbott71 #cga ,barbital 7,antoine ,chiris71 #cga ,barbital 7,halter71 #cga ,barbital 7,rector ,chemical ,company71 #cga ,barbital 7,veronal71 #cgj ,barbital ,sodium 7,medinal or ,veronal-,sodium71 #cga 8,basic ,cancer ,research01 #dad ,baume ,analgesique1 ,bengu 7,thos4 ,leeming ,co471 ,the ,journal1 ,dec4 #ad1 #aiab1 p4 #bagc2 ,propaganda1 ed4 #i1 p4 #bfg4 ,bayer ,company1 ,inc4-- ,aspirin1 #aaf1 #cdg1 #dhj ,helmitol1 #bie ,lycetol1 #bad ,piperazine1 #bad ,bee1 ,honey1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ch4 ,beef ,extract 7,swift ,co471 ,the ,journal1 ,jan4 #bc1 #aiji1 p4 #caa2 ,propaganda1 ed4 #i1 p4 #dga4 ,beef ,extract1 ,coin ,special 7,g4 ,h4 ,hammond ,co471 ,the ,journal1 ,jan4 #bc1 #aiji1 p4 #caa2 ,propaganda1 ed4 #i1 p4 #dgb4 ,beef ,extract1 ,concentrated ,fluid 7,armour ,co471 ,the ,journal1 ,jan4 #bc1 #aiji1 p4 #caa2 ,propaganda1 ed4 #i1 p4 #dga4 ,beef ,extract1 ,fluid 7,cibilis ,co471 ,the ,journal1 ,jan4 #bc1 #aiji1 p4 #caa2 ,propaganda1 ed4 #i1 p4 #dgb4 ,beef ,extract1 ,fluid1 8,rex0 7,cudahy ,packing ,co471 ,the ,journal1 ,jan4 #bc1 #aiji1 p4 #caa2 ,propaganda1 ed4 #i1 p4 #dga4 ,beef1 ,extract of1 ,premier 7,libby1 ,mc,neil ,libby71 ,the ,journal1 ,jan4 #bc1 #aiji1 p4 #caa2 ,propaganda1 ed4 #i1 p4 #dga4 ,beef ,juice1 ,wyeth's 7,john ,wyeth ,bro471 ,the ,journal1 ,nov4 #bj1 #aiji1 p4 #aged2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #acg2 ,propaganda1 ed4 #i1 p4 #abc4 ,beer and cancer cures1 #did ,bell ,co41 ,inc4--,bell-,ans 7,pa-,pay-,ans ,bell71 #chj1 #dah ,bell-,ans 7,bell ,co471 ,the ,journal1 ,aug4 #bd1 #aiji1 p4 #efi2 ,may #i1 #aiad1 p4 #adib2 ,nov4 #bd1 #aiag1 p4 #ahae2 ,feb4 #bc1 #aiah1 p4 #eeg2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #ajh2 ,propaganda1 ed4 #i1 pp4 #aea1 #bhb4 ,bell-,ans 7,pa-,pay-,ans ,bell71 #chj1 #dah ,benetol 7,northern ,chemical ,assn471 ,the ,journal1 ,april #ae1 #aiaa1 p4 #aabh2 ,reports ,chem4 ,lab41 #aiaa1 p4 #hb4 ,betul-ol 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #fb2 ,reports ,chem4 ,lab41 #aiad1 p4 #gd2 ,propaganda1 ed4 #i1 p4 #bg4 ,beveridge1 ,james ,wallace--,secretin-,beveridge1 #agj ,bile ,salt and ,holadin ,mixtures1 #bjg ,bile ,salts1 ,holadin and ,phenolphthalein1 ,capsules of1 #bjh ,bile ,salts1 ,succinate of ,soda and ,holadin1 ,capsules of1 #bjh ,bile ,salts1 ,succinate of ,soda and ,phenolphthalein1 ,capsules of1 #bjh ,bile ,salts1 ,succinate of ,soda and ,phenolphthalein1 ,capsules of1 ,fairchild 7,fairchild ,bros4 ,foster71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ei4 ,biniodol1 #aba ,biniodol 7,charles ,c4 ,yarbrough71 ,the ,journal1 ,feb4 #bd1 #aiag1 p4 #fej2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aj2 ,reports ,chem4 ,lab41 #aiaf1 p4 #ajh4 ,biologic therapeutics and its commercial domination1 #dif ,biosol 7,vito ,chemical ,laboratories71 ,the ,journal1 ,march #h1 #aiac1 p4 #gfg2 ,propaganda1 ed4 #i1 p4 #bhd4 ,bischoff1 ,c41 ,co4--,hydragogin1 #da ,bischoff1 ,ernst1 ,company1 ,inc4-- ,digitalysatum1 #fc ,hydropsin1 #fa ,styptysate1 #cah ,bismon 7,kalle ,color and ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ab4 ,bismuth and ,calomel ,comp4 ,tablets1 #eff ,bismuth and ,iron ,citrate ,soluble 7,wellcome ,brand7 7,burroughs ,wellcome ,co471 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #ea4 ,bismuth and ,lithium ,citrate ,soluble 7,wellcome ,brand7 7,burroughs ,wellcome ,co471 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #ea4 ,bismuth ,iodo-,resorcin ,sulphonate1 ,the ,journal1 ,feb4 #aa1 #aiaa1 p4 #dda2 ,reports ,chem4 ,lab41 #aiaa1 p4 #ad4 ,bismuth1 ,opium and ,phenol ,tablets1 ,the ,journal1 ,july #be1 #aijh1 p4 #ccj2 ,dec4 #ag1 #aiaj1 p4 #bafi2 ,may #f1 #aiaa1 p4 #acdd2 ,reports ,chem4 ,lab41 to #aiji1 p4 #bh2 #aiaj1 p4 #he2 #aiaa1 p4 #bb4 ,bismuth1 ,opium and ,phenol ,tablets 7,hance ,bros4 ,white2 ,wm4 ,s4 ,merrell ,chemical ,co42 ,sharp ,dohme2 ,f4 ,stearns ,co42 ,truax1 ,greene ,co42 ,h4 ,k4 ,wampole ,co41 ,inc42 ,wm4 ,r4 ,warner ,co471 ,the ,journal1 ,july #be1 #aijh1 p4 #ccj2 ,dec4 #ag1 #aiaj1 p4 #bafi2 ,may #f1 #aiaa1 p4 #acdd2 ,reports ,chem4 ,lab41 to #aiji1 p4 #bh2 #aiaj1 p4 #he2 #aiaa1 p4 #bb4 ,bismuth1 ,resorcinol ,compound1 ,capsules1 #aeg ,bismuth ,resorcinol ,compound1 ,capsules 7,gross ,drug ,co41 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aci4 ,bismuth ,tribromphenate-,merck1 #baf1 #cdi ,bismuth ,tribromphenate1 standardization of1 #cdh ,bismuth ,tribromphenolate1 report to ,council of ,national ,defense1 #ceb ,bi-,taride ,tablets 7,germicidal ,products ,corporation71 ,the ,journal1 ,sept4 #af1 #aiaf1 p4 #hie2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ba4 ,bitter ,bark1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,bitter ,wine1 ,triner's ,american ,elixir of1 #aci ,bladder ,wrack1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,blandine ,laxative1 ,mulford 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #acf4 ,blaud1 ,arsenic and ,strychnine ,capsules1 ,frosst's1 #ef ,blaud1 ,arsenic and ,strychnine ,capsules1 ,frosst's 7,c4 ,e4 ,frosst ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afd4 ,blaud ,capsules1 ,frosst's1 #ef ,blaud ,capsules1 ,frosst's 7,c4 ,e4 ,frosst ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afd4 ,blaud's ,pills1 ,the ,journal1 ,april #ag1 #aiae1 p4 #acdd2 ,reports ,chem4 ,lab41 #aiae1 p4 #g4 ,blood ,tonic1 ,alterative 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,blue ,cohosh1 ,the ,journal1 ,sept4 #aa1 #aiae1 p4 #igb4 ,borcherdt's ,malt ,olive with ,hypophosphites1 #hd ,borolyptol 7,palisade ,mfg4 ,co471 ,the ,journal1 ,nov4 #ae1 #aiac1 p4 #ahab4 ,borotetramine 7,takamine ,laboratories71 ,the ,journal1 ,feb4 #ai1 #aiba1 p4 #ech2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ac4 ,bovinine 7,the ,bovinine ,co471 ,the ,journal1 ,nov4 #bj1 #aiji1 p4 #aged2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #acg2 #aiad1 p4 #aje2 ,propaganda1 ed4 #i1 p4 #abc4 ,breitenbach1 ,m4 ,j41 ,company--,pepto-,mangan1 #chg ,bristol-,myers ,company-- ,sal ,hepatica1 #dea ,ziratol1 #adh ,brobor3 ,see ,episan4 ,broeman1 ,c4 ,j4--,final report on ,proteogens1 #dej ,bromide and ,acetanilid ,compound-,mulford1 ,granular ,effervescent 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #eh4 ,bromide1 ,granular ,effervescent and ,acetanilid ,compound-,mulford1 #bjf ,bromides1 ,peacock's1 #djj ,bromides1 ,peacock's 7,peacock ,chemical ,co471 ,the ,journal1 ,april #c1 #aiae1 p4 #aagg2 ,march #b1 #aiah1 p4 #fdc2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #bd2 ,propaganda1 ed4 #i1 p4 #bh4 ,bromides with ,cypripedium ,compound 7,truax1 ,greene ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,bromidia1 #cii ,bromidia 7,battle ,co471 ,the ,journal1 ,may #af1 #aiad1 p4 #aegc2 ,march #b1 #aiah1 p4 #fdb2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ae2 ,propaganda1 ed4 #i1 p4 #ca4 ,bromin-,iodin ,compound1 #ig ,bromin-,iodin ,compound 7,bromin-,iodin ,chemical ,co471 ,the ,journal1 ,june #d1 #aiaj1 p4 #ahhd2 ,dec4 #bc1 #aiaf1 p4 #aief2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #dj2 ,propaganda1 ed4 #i1 p4 #bhe4 ,brom-,i-,phos1 #acf ,brom-,i-,phos 7,the ,national ,drug ,co471 ,the ,journal1 ,june #cj1 #aiag1 p4 #bjja2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #cb2 ,reports ,chem4 ,lab41 #aiag1 p4 #dc4 ,bromo-,mangan 7,reinschild ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afe4 ,broom ,corn1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,bruschettini ,curative ,vaccine3 ,see ,curative ,vaccine1 ,bruschettini4 ,buchu and ,hyoscyamus ,compound1 ,tyree's ,elixir of1 #eg ,buchu and ,hyoscyamus ,compound1 ,elixir of1 ,tyree's 7,j4 ,s4 ,tyree71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afg4 ,buchu and ,pareira ,compound1 ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,buchu1 ,juniper and ,acetate ,potassium1 ,elixir 7,pitman-,moore ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afg4 ,budwell's ,emulsion of ,cod-,liver ,oil1 ,nos4 #a and #b1 #bb ,burdick-,abel ,laboratory--,hypodermic ,solution ,no4 #ac1 ,iron1 ,arsenic and ,phosphorus ,compound1 #bgf ,burroughs ,wellcome and ,company--,soamin1 #bec ,cacodylate1 ,ferric1 #bib ,cactin1 now ,cactoid 7,the ,abbott ,laboratories71 ,the ,journal1 ,sept4 #ba1 #aijg1 p4 #ajba2 ,march #ba1 #aijh1 p4 #ief2 ,april #d1 #aijh1 p4 #aadj2 ,march #ab1 #aiaj1 p4 #hhh2 ,aug4 #f1 #aiaj1 p4 #dee2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #da2 ,propaganda1 ed4 #i1 p4 #cg4 ,cactina 7,sultan ,drug ,co471 ,the ,journal1 ,sept4 #ba1 #aijg1 p4 #ajba2 ,march #ba1 #aijh1 p4 #ief2 ,april #d1 #aijh1 p4 #aadj2 ,march #ab1 #aiaj1 p4 #hhh2 ,aug4 #f1 #aiaj1 p4 #dee2 ,jan4 #ai1 #aiah1 p4 #ahe2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #da2 ,propaganda1 ed4 #i1 p4 #cg4 ,cactina ,pillets1 #cia ,cactus ,compound ,pills 7,heart ,tonic71 ,the ,journal1 ,april #bi1 #aiaf1 p4 #achg4 ,cactus ,grandiflorus1 ,the ,journal1 ,sept4 #ba1 #aijg1 p4 #ajba2 ,march #ab1 #aiaj1 p4 #hhh2 ,jan4 #g1 #aiaa1 p4 #bf2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #dj2 ,propaganda1 ed4 #i1 p4 #cf4 ,calcidin ,abbott 7,the ,abbott ,laboratories71 ,the ,journal1 ,sept4 #g1 #aijg1 p4 #hfe2 ,reports ,chem4 ,lab41 to #aiji1 p4 #g4 ,calcidin ,tablets 7,abbott71 #dfe ,calcidin ,tablets 7,the ,abbott ,laboratories71 ,the ,journal1 ,sept4 #be1 #aibj1 p4 #hib4 ,calcium ,comp41 ,elixir ,iodo-,bromide of1 8,without ,mercury0 and 8,with ,mercury01 #eb ,calcium ,glycerophosphate and ,sodium ,glycerophosphate1 #ii ,calcium ,glycerophosphate1 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #eb4 ,calcylates ,compound1 ,elixir1 ,the ,journal1 ,april #bb1 #aiaf1 p4 #acjg4 ,calcylates ,compound1 ,pulvoids1 #bbf ,calcylates ,compounds1 ,pulvoids 7,the ,drug ,products ,co471 ,the ,journal1 ,june #ad1 #aiai1 p4 #aghd2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ai4 ,calcylates1 ,pulvoids1 #he ,calmine 7,the ,abbott ,laboratories71 ,the ,journal1 ,jan4 #ad1 #aiaa1 p4 #acg2 ,propaganda1 ed4 #i1 p4 #bhf4 ,calomel and ,bismuth ,comp4 ,tablets1 #eff ,campetrodin and ,campetrodin ,no4 #b1 #aic ,campetrodin and ,campetrodin ,no4 #b 7,a4 ,h4 ,robins ,company71 ,the ,journal1 ,sept4 #ba1 #aiah1 p4 #iic2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #bg4 ,camphenol 7,johnson ,johnson71 ,the ,journal1 ,nov4 #e1 #aiaj1 p4 #affb2 ,reports ,chem4 ,lab41 #aiaj1 p4 #aab2 ,propaganda1 ed4 #i1 p4 #bhg4 ,campho-,phenique1 #dah ,campho-,phenique 7,campho-,phenique ,co471 ,the ,journal1 ,april #bj1 #aijg1 p4 #acfe2 ,feb4 #i1 #aiah1 p4 #djh2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #ea2 ,propaganda1 ed4 #i1 p4 #dj4 ,campho-,phenique ,powder 7,campho-,phenique ,co471 ,the ,journal1 ,april #bj1 #aijg1 p4 #acfe2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #ea2 ,propaganda1 ed4 #i1 p4 #dj4 ,camphor in pneumonia1 #beg ,cancer cures and beer1 #did ,cancer1 ,edward ,percy ,robinson's 8,cure0 for 7,tekarkin71 #deh ,cancer ,remedy1 ,koch's 7,wm4 ,f4 ,koch71 ,the ,journal1 ,feb4 #ab1 #aiba1 p4 #dff2 ,feb4 #ai1 #aiba1 p4 #ecg4 ,cancer ,remedy1 ,william ,f4 ,koch's1 #dcg ,cancer ,research1 ,basic1 and ,cosmopolitan ,cancer ,research ,society1 #dad ,cancer ,serum1 ,glover's1 #dbe ,cancer ,serum1 ,glover's 7,t4 ,j4 ,glover71 ,the ,journal1 ,jan4 #a1 #aiba1 p4 #eb2 ,feb4 #e1 #aiba1 p4 #cif4 ,cannabis ,compound1 ,syrup 7,pitman-,moore ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afh4 ,cano's ,methyl-,phenol ,serum1 #bea ,cano's ,normal ,phenol ,serum1 #bea ,capell's ,uroluetic ,test3 ,see ,uroluetic ,test1 ,capell's4 ,caps4 ,adreno-,spermin ,comp4 7,henry ,r4 ,harrower71 ,the ,journal1 ,jan4 #ah1 #aiai1 p4 #bac2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #db4 ,caps4 ,antero-,pituitary ,comp4 7,henry ,r4 ,harrower71 ,the ,journal1 ,jan4 #ah1 #aiai1 p4 #bac2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #db4 ,caps4 ,folio ,digitalis 7,upsher ,smith71 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #eb4 ,caps4 ,hepato-,splenic ,comp4 7,henry ,r4 ,harrower71 ,the ,journal1 ,jan4 #ah1 #aiai1 p4 #bac2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #db4 ,caps4 ,pancreas ,comp4 7,henry ,r4 ,harrower71 ,the ,journal1 ,jan4 #ah1 #aiai1 p4 #bac2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #db4 ,caps4 ,placento-,mammary ,comp4 7,henry ,r4 ,harrower71 ,the ,journal1 ,jan4 #ah1 #aiai1 p4 #bac2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #db4 ,caps4 ,thyroid ,comp4 7,henry ,r4 ,harrower71 ,the ,journal1 ,jan4 #ah1 #aiai1 p4 #bac2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #db4 ,caps4 ,thyro-,ovarian ,comp4 7,henry ,r4 ,harrower71 ,the ,journal1 ,jan4 #ah1 #aiai1 p4 #bac2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #db4 ,capsules ,bismuth ,resorcinol ,compound1 #aeg ,captol 7,mhlens ,kropff71 ,the ,journal1 ,sept4 #aj1 #aiaj1 p4 #iei2 ,reports ,chem4 ,lab41 #aiaj1 p4 #gj4 ,carminzym1 #aid ,carminzym 7,fairchild ,bros4 ,foster71 ,the ,journal1 ,sept4 #bh1 #aiah1 p4 #ajha2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #bh4 ,carnick1 ,g4 ,w41 ,co4-- ,elixir ,secretogen1 #ge ,hormotone and ,hormotone without ,post-,pituitary1 #bcd ,secretin-,beveridge1 #agj ,secretogen1 #ge1 #aaj ,carnine 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,nov4 #bj1 #aiji1 p4 #aged2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #acg2 ,propaganda1 ed4 #i1 p4 #abc4 ,caroid 7,mead ,johnson ,co471 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #aji4 ,caroid1 ,essence of 7,mead ,johnson ,co471 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #aji4 ,carpanutrine 7,john ,wyeth ,bro471 ,the ,journal1 ,may #aa1 #aijg1 p4 #afab2 ,reports ,council ,pharm4 ,chem41 #aije-h1 opp4 p4 #fd2 ,propaganda1 ed4 #i1 p4 #acc4 ,casca-,aletris 7,pullen-,richardson ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,cascara1 ,compound-,robins1 ,pil41 #aag ,cascara ,sagrada1 with ,maltzyme1 #baa ,cascarans1 ,bell 7,bell ,co471 ,the ,journal1 ,aug4 #ad1 #aiji1 p4 #efi2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #aaa2 ,propaganda1 ed4 #i1 p4 #aed4 ,casta-,flora1 #aah ,castaflora 7,the ,wm4 ,s4 ,merrell ,chemical ,co471 ,the ,journal1 ,jan4 #bg1 #aiag1 p4 #cjc2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #de4 ,castrox 7,purdue ,newberry ,co471 ,the ,journal1 ,dec4 #bc1 #aiaf1 p4 #aief2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #da4 ,catarrhal ,vaccine ,combined-,lilly1 #ahg ,catarrhal ,vaccine ,combined-,lilly 7,eli ,lilly ,co471 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,caviblen 7,a4 ,grimme71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agf4 ,cedron ,seed1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,celerina 7,rio ,chemical ,co471 ,the ,journal ,oct4 #ag1 #aiad1 p4 #adaa2 ,feb4 #ac1 #aiae1 p4 #fjf2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj2 #aiad1 p4 #ii2 ,propaganda1 ed4 #i1 p4 #dc4 ,celery1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,celery and ,guarana ,compound1 ,elixir 7,ray ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,celery and ,guarana1 ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,celery ,compound1 ,elixir 7,nelson1 ,baker ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,celery ,compound1 ,elixir 7,ray ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,celery ,compound1 ,elixir 7,smith1 ,kline ,french ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,celery ,compound1 ,elixir 7,f4 ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,celery1 ,elixir ,guarana and 7,hance ,bros4 ,white71 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,cellasin 7,mead ,johnson ,co471 ,the ,journal1 ,sept4 #ab1 #aijh1 p4 #ica2 ,oct4 #cj1 #aiji1 p4 #adjf2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #aih2 #aiji1 p4 #aah4 ,cephaelin1 #bjc ,cephaelin1 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #eb4 ,cerelene1 #bai1 #ccg1 #cfb ,cerelene 7,holliday ,laboratories71 ,the ,journal1 ,feb4 #ae1 #aiai1 p4 #eac2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #dh4 ,chapoteaut's ,wine3 ,see ,wine1 ,chapoteaut's4 ,chemical ,laboratory of the ,american ,medical ,association3 ,see ,american ,medical ,association4 ,chemotherapy and tumors1 #dii ,chichester1 ,pil4 ,mixed ,treatment1 #caj ,chiodrastis 7,h4 ,k4 ,wampole ,co41 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,chionacea 7,nelson1 ,baker ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db2 ,the ,journal1 ,june #ad1 #aiai1 p4 #aghg4 ,chionanthus ,compound1 ,elixir 7,ray ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,chionanthus 7,special71 ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,chionia 7,peacock ,chemical ,co471 ,the ,journal1 ,april #c1 #aiae1 p4 #aagg2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db2 #aiae1 p4 #bd2 ,propaganda1 ed4 #i1 p4 #bh4 ,chlorax1 #bdd1 #bdf ,chlorax 7,chlorine ,products ,company1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #gj4 ,chlorides1 ,platt's1 #bfc ,chlorinated ,eucalyptol1 compared with ,chlorlyptus1 #bha 8,chlorinated ,soda0 ,solutions1 deterioration of1 #ceh ,chlorine ,products ,company1 ,inc4--,chloron1 ,chlorax and ,number 8#c01 #bdd ,chlorlyptus1 #bgg ,chlorlyptus 7,weeks ,chemical ,co471 ,the ,journal1 ,nov4 #bg1 #aibj1 p4 #aeab2 ,reports ,chem4 ,lab41 #aibj1 p4 #ge2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #bh4 ,chlorlyptus1 comparison of1 with chlorinated eucalyptol1 #bha ,chlorlyptus1 persistence of acid reaction of1 in body1 #bhc ,chlorlyptus1 report of ,dr4 ,d4 ,rivas on1 #bhf ,chlorlyptus toxicity experiments1 #bhe ,chloron1 #bde ,chloron 7,chlorine ,products ,company1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiai4 p4 #gj4 ,chologen 7,leonard ,a4 ,seltzer71 ,the ,journal1 ,feb4 #a1 #aiac1 p4 #chc2 ,propaganda1 ed4 #i1 p4 #bhh4 ,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 ,ciba ,company-- ,coagulen-,ciba1 #bij ,digiolin-,ciba1 #bih 8,cinchophen30 formerly 8,atophan01 #dai ,cinchophen 7,phenylcinchoninic ,acid1 ,u4 ,s4 ,p42 ,atophan71 #cgc1 #dai ,cineraria ,maritima1 ,the ,journal1 ,nov4 #aa1 #aiaa1 p4 #afcj2 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #dh2 ,propaganda1 ed4 #i1 p4 #di4 ,cin-,u-,form ,lozenges1 #bcg ,cin-,u-,form ,lozenges 7,mc,kesson and ,robbins71 ,the ,journal1 ,oct4 #d1 #aiai1 p4 #ajgg2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ce4 ,citarin 7,the ,bayer ,company1 ,inc471 ,the ,journal1 ,feb4 #bj1 #aiae1 p4 #fhe2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ace4 ,citrocoli 7,cellarius ,co471 ,the ,journal1 ,jan4 #ba1 #aiaa1 p4 #baj2 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #g2 ,propaganda1 ed4 #i1 p4 #he4 ,cleveland ,medical ,journal1 8drug reform0 as it appears to1 #eac ,clover ,compound1 ,syrup ,red 7,nelson1 ,baker ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,coagulen-,ciba1 #bij ,coagulen-,ciba 7,society of ,chemical ,industry1 ,basle1 ,switzerland71 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #ec4 ,cod-,liver1 ,extract of1 ,wampole's ,perfected ,tasteless ,preparation of 7,h4 ,k4 ,wampole ,co41 ,inc471 ,the ,journal1 ,april #e1 #aiac1 p4 #ajic2 ,april #aj1 #aiae1 p4 #abfb2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #adj2 ,propaganda1 ed4 #i1 p4 #eb4 ,cod-,liver ,oil1 ,budwell's ,emulsion of1 ,nos4 #a and #b1 #bb ,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 ,compound1 ,hagee's ,cordial of the ,extract of 7,katharmon ,chemical ,co471 ,the ,journal1 ,oct4 #ac1 #aijf1 p4 #abjh2 ,april #aj1 #aiae1 p4 #abfb2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ach2 ,propaganda1 ed4 #i1 pp4 #ea1 #bhi4 ,cod-,liver ,oil ,compound1 ,waterbury's ,metabolized 7,waterbury ,chemical ,co471 ,the ,journal1 ,oct4 #i1 #aiji1 p4 #abja2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #aae2 ,propaganda1 ed4 #i1 p4 #bia4 ,see also ,compound1 ,waterbury's4 ,cod-,liver ,oil1 ,hagee's ,cordial of1 #dbi ,cod-,liver ,oil with ,maltzyme1 #baa ,cohosh1 ,blue1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,colalin1 #bjc ,colalin 7,schieffelin ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #eb4 ,colchi-,methyl ,capsules 7,h4 ,k4 ,wampole ,co41 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afi4 ,colchi-,sal 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,march #bj1 #aiae1 p4 #ajaf2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #acf2 ,propaganda1 ed4 #i1 p4 #eh4 8,colds10 ,vaccines for1 #egc ,colloid ,solution ,materials for ,intravenous ,transfusion1 ,hogan's 7,e4 ,r4 ,squibb ,sons71 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adg4 ,colloidine 7,boracol ,chemical ,co471 ,the ,journal1 ,march #aa1 #aiaf1 p4 #hca2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #g2 ,reports ,chem4 ,lab41 #aiae1 p4 #abg4 ,collosol ,argentum1 #bbc1 #bbe1 #bbf ,collosol ,arsenicum1 #bbc1 #bbf ,collosol ,cocaine1 #bba1 #bbc1 #bbf ,collosol ,cocain 7,anglo-,french ,drug ,co41 ,ltd471 ,the ,journal1 ,april #ab1 #aiai1 p4 #ajid2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #h4 ,collosol ,cuprum1 #bbc1 #bbf ,collosol ,ferrum1 #bbc1 #bbf ,collosol ,hydrargyrum1 #bbc1 #bbe1 #bbf ,collosol ,iodin1 #add1 #bbc1 #bbd1 #bbf ,collosol ,iodine 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,sept4 #h1 #aiag1 p4 #hda2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #di4 ,collosol ,manganese1 #bbc1 #bbe1 #dba ,collosol ,preparations1 #bbc ,collosol ,preparations 7,collosol ,argentum1 ,collosol ,arsenicum1 ,collosol ,cuprum1 ,collosol ,ferrum1 ,collosol ,hydrargyrum1 ,collosol ,iodin1 ,collosol ,manganese1 ,collosol ,quinin1 and ,collosol ,sulphur7 7,anglo- ,french ,drug ,co41 ,ltd471 ,the ,journal1 ,june #g1 #aiai1 p4 #afid2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ad4 ,collosol ,quinin1 #bbc1 #bbf 8,collosols30 an uncritical ,english endorsement1 #dbj ,collosol ,sulphur1 #bbc1 #bbf ,collyrium1 ,wyeth 7,john ,wyeth ,bro471 ,the ,journal1 ,may #ag1 #aiac1 p4 #aeeg2 ,propaganda1 ed4 #i1 p4 #bib4 ,compound ,elixir of ,phosphates and ,calisaya3 ,see ,tissue ,phosphates1 ,wheeler's4 ,compound1 ,waterbury's 7,waterbury ,chemical ,co471 ,the ,journal1 ,march #bj1 #aiae1 p4 #ajaf2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ach2 ,propaganda1 ed4 #i1 p4 #eg4 ,concentrated ,solution ,sodium ,hypochlorite-,mulford1 #ceh ,condurango1 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #ed4 ,cooperation of the ,pharmaceutical ,houses1 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #ef4 ,copper ,phenolsulphonate 7,the ,abbott ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ed4 ,cordial of ,cod ,liver ,oil1 ,hagee's1 #dbi ,corpora ,lutea 7,soluble ,extract7 ,parke1 ,davis ,co1 #abh ,corpora ,lutea 7,soluble ,extract7 7,parke1 ,davis ,co471 ,the ,journal1 ,april #g1 #aiag1 p4 #ajef2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #bj4 ,corydalis ,compound1 ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 8,cosmopolitan ,cancer ,research ,society0 and ,basic ,cancer ,research1 #dad ,cotarnin ,salts 7,stypticin and ,styptol71 #bdj ,cotarnin ,salts1 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ci4 ,coto1 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #ci4 ,cotoin1 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #ci4 ,cotton ,process ,ether1 #dba ,council on ,pharmacy and ,chemistry3 ,see ,american ,medical ,association4 ,cream of ,mustard1 #bah ,cream of ,mustard 7,the ,cream of ,mustard ,co41 ,south ,norwalk1 ,conn471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #gi4 ,cream of ,sulphur1 ,o',grady's ,medicated ,mineral 7,john ,h4 ,o',grady1 ,minneapolis71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ha4 ,creo ,ferrum 7,the ,gross ,drug ,co41 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #af4 ,creofos1 #acg ,creofos 7,delson ,chemical ,co471 ,the ,journal1 ,july #g1 #aiag1 p4 #eh2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #cd4 ,creosote-,delson1 #acg ,creosote-,delson 7,delson ,chemical ,co471 ,the ,journal1 ,july #g1 #aiag1 p4 #eh2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #cd4 ,creosotonic 7,scott71 #aib1 #aic ,creosotonic 7,scott7 7,dawson ,pharmacal ,co471 ,the ,journal1 ,aug4 #bd1 #aiah1 p4 #fhj2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #be4 ,crittenton ,company1 ,charles ,n4--,hydroleine1 #eh ,crookes ,laboratories--,collosols1 #dbj ,croustils1 ,simple ,no4 #a 7,oaten ,bread7 7,la,porte ,gauthier71 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ag4 ,croustils1 ,no4 #b 7,dechloridised and ,lactosed7 7,la,porte ,gauthier71 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ag4 ,croustils1 ,no4 #c 7,glutinized7 7,la,porte ,gauthier71 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ag4 ,cu-,co-,ba ,tarrant 7,the ,tarrant ,co471 ,the ,journal1 ,sept4 #be1 #aibj1 p4 #hia4 ,cuprase1 #bbb ,cuprase 7,anglo-,french ,drug ,co41 ,ltd471 ,the ,journal1 ,april #ab1 #aiai1 p4 #ajie2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #aj4 ,curare1 ,the ,journal1 ,jan4 #ae1 #aiaj1 p4 #bai2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #g4 ,curarin1 ,the ,journal1 ,jan4 #ae1 #aiaj1 p4 #bai2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #g4 ,curative ,vaccine1 ,bruschettini1 #eh ,curative ,vaccine1 ,bruschettini 7,a4 ,bruschettini71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agf4 ,cypridol ,capsules 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,dec4 #ai1 #aiad1 p4 #bbdg2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #gg2 ,propaganda1 ed4 #i1 p4 #ei4 ,cystogen 7,cystogen ,chemical ,co471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ff2 ,propaganda1 ed4 #i1 p4 #fj4 ,cystogen ,aperient 7,cystogen ,chemical ,co471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ff2 ,propaganda1 ed4 #i1 p4 #fj4 ,cystogen ,lithia 7,cystogen ,chemical ,co471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badh2 ,reports ,pharm4 ,chem41 #aiad1 p4 #ff2 ,propaganda1 ed4 #i1 p4 #fj4 ,cysto-,sedative 7,strong1 ,cobb ,co471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #acj2 ,propaganda1 ed4 #i1 p4 #fa4 ,daggett and ,miller ,company1 ,inc4--,hex-,iodin1 #bcf ,damiana1 ,allen's ,compound ,extract of 7,allen-,pfeiffer ,chemical ,co471 ,the ,journal1 ,july #ai1 #aiac1 p4 #baa4 ,darpin 7,rio ,chemical ,co471 ,the ,journal1 ,feb4 #ac1 #aiae1 p4 #fjf2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ii2 ,propaganda1 ed4 #i1 p4 #dc4 ,dawson ,pharmacal ,company--,iodonized ,emulsion 7,scott7 and ,creosotonic 7,scott71 #aib ,delson ,chemical ,co41 ,inc4--,creosote-,delson and ,creofos1 #acg ,denver ,chemical ,mfg4 ,co4--,antiphlogistine1 #dji ,de ,sanctis' ,rheumatic and ,gout ,pills1 #cfc ,desiccated ,pineal ,gland--,armour1 #bac ,desiccated ,thymus--,armour1 #bac ,diabetic ,biscuit 7,jireh ,diabetic ,food ,co471 ,the ,journal1 ,march #bb1 #aiac1 p4 #ibb4 ,diabetic ,flour1 ,jireh 7,jireh ,diabetic ,food ,co471 ,the ,journal1 ,march #bb1 #aiac1 p4 #ibb4 ,diabetic ,food1 ,jireh 7,jireh ,diabetic ,food ,co471 ,the ,journal1 ,dec4 #ad1 #aiab1 p4 #bagd4 ,dial 8,ciba01 #bei ,dianol ,i1 ,dianol ,,ii1 and ,dianol ,,iii 7,kalle ,co471 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #cd2 ,reports ,chem4 ,lab41 #aiac1 p4 #ge4 ,diarrhea ,calomel ,pills1 #eff ,diastos1 ,liquor 7,h4 ,k4 ,mulford ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,diatussin 7,e4 ,bischoff ,co471 ,the ,journal1 ,may #ag1 #aiac1 p4 #aeeg2 ,propaganda1 ed4 #i1 p4 #bic4 ,di-,crotalin 7,swan-,myers ,co471 ,the ,journal1 ,aug4 #ag1 #aiah1 p4 #eib4 ,di-,crotalin treatment of epilepsy1 #dfe ,diethylbarbituric ,acid 7,merck71 #cga ,digalen 7,hoffmann-,la,roche ,chemical ,works71 ,the ,journal1 ,sept4 #e1 #aiad1 p4 #hha2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #cc2 ,propaganda1 ed4 #i1 p4 #fh4 ,digestive ,tablets1 ,aromatic 7,fraser ,tablet ,co42 ,wm4 ,s4 ,merrill ,chemical ,co42 ,h4 ,k4 ,mulford ,co42 ,parke1 ,davis ,co42 ,sharp ,dohme71 ,the ,journal1 ,aug4 #bj1 #aiaj1 p4 #gaj2 ,reports ,chem4 ,lab41 #aiaj1 p4 #fg2 ,propaganda1 ed4 #i1 p4 #bcb4 ,digestive ,tonic 7,truax1 ,greene ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,digifolin-,ciba1 #bih ,digifolin-,ciba 7,ciba ,company1 ,inc471 ,the ,journal1 ,april #b1 #aiba1 p4 #ieb2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #bj4 ,digitalis ,tablets1 ,westerfield's1 #bae ,digitalis ,tablets1 ,westerfield's 7,westerfield ,pharmacal ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ge4 ,digitalone 7,parke1 ,davis ,co471 ,the ,journal1 ,june #ab1 #aiji1 p4 #aich2 ,dec4 #g1 #aiab1 p4 #bjgd2 ,jan4 #aa1 #aiac1 p4 #adc4 ,digitalysatum1 #fc ,digitalysatum 7,e4 ,bischoff ,co471 ,the ,journal1 ,feb4 #ae1 #aiac1 p4 #dii2 ,jan4 #h1 #aiaf1 p4 #ace2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ic4 ,dionol1 #dbb ,dionol 7,dionol ,company71 ,the ,journal1 ,jan4 #bf1 #aiah1 p4 #beg2 ,feb4 #g1 #aibj1 p4 #daj4 ,dioradin 7,dioradin ,co471 ,the ,journal1 ,oct4 #bf1 #aiab1 p4 #aeef2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #bc2 #aiac1 p4 #cg2 ,propaganda1 ed4 #i1 p4 #gc4 ,dios ,chemical ,company--,neurosine1 #djd ,dioscorea ,compound1 ,elixir 7,h4 ,k4 ,mulford ,co42 ,parke1 ,davis ,co42 ,ray ,chemical ,co42 ,f4 ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,dioviburnia 7,dios ,chemical ,co471 ,the ,journal1 ,aug4 #ca1 #aiab1 p4 #gce2 ,jan4 #i1 #aiae1 p4 #aff2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df2 #aiad1 p4 #hf2 ,propaganda1 ed4 #i1 pp4 #aci1 #daj4 ,diphtheria ,antitoxin 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,diphtheria ,antitoxin1 ,concentrated 7,national ,vaccine and ,antitoxin ,institute71 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #bc4 ,diphtheria ,bacillus ,vaccine1 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ed4 ,direct ,pharmaceutical ,co4 and ,william ,a4 ,webster ,co41 #efd ,direct ,sales ,company1 #eaj ,discoveries and ,discoverers1 #eaa ,diuretin 7,knoll ,co471 ,the ,journal1 ,april #d1 #aiad1 p4 #aajh2 ,reports ,chem4 ,lab41 #aiad1 p4 #g2 ,propaganda1 ed4 #i1 p4 #bea4 ,diurol 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,dixon's ,suspension of ,dead ,tubercle ,bacilli1 #aeh ,dixon's ,suspension of ,dead ,tubercle ,bacilli1 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adj4 ,dixon's ,tubercle ,bacilli ,extract1 #aeh ,dixon's ,tubercle ,bacilli ,extract2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adj4 ,dogwood1 ,flowering1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,dosage1 dependability of tablet dosage1 #eef ,dotterweich1 ,g4 ,j41 and ,c4 ,k41 ,officers of ,direct ,sales ,company1 #eaj ,drug ,products ,co41 ,inc4-- ,pulvoids ,calcylates1 #he ,pulvoids ,calcylates ,compound1 #bbf ,pulvoids ,natrium ,compound1 #ajh 8,drug ,reform0 as it appears to the ,cleveland ,medical ,journal1 #eac ,drug ,therapy3 the fallibility of textbooks1 #eae ,drugs1 crucial test of therapeutic evidence1 #eeg ,dunn1 ,eli ,h41 ,eli products of1 #dbd ,duodenin1 #gf ,duodenin1 ,armour 7,armour ,co471 ,the ,journal1 ,aug4 #ad1 #aiae1 p4 #fci2 ,jan4 #ae1 #aiaf1 pp4 #agh1 #bjh2 ,reports ,council ,pharm4 ,chem41 #aiae1 pp4 #if1 #ii1 #aea2 #aiaf1 p4 #gb4 ,duotonol ,tablets1 #id ,duotonol ,tablets 7,schering ,glatz1 ,inc471 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcc2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #cd4 ,du ,pont ,de ,nemours1 ,e4 ,i4 and ,co41 ,inc4--,cotton ,process ,ether1 #dba ,dysentery ,bacterin-,mulford 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #ada4 ,dyspepsia ,compound1 ,elixir 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,dyspepsia1 ,elixir ,atonic1 ,phenolated 7,wm4 ,s4 ,merrell ,chemical ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,echinacea1 ,the ,journal1 ,nov4 #bg1 #aiji1 p4 #ahcf2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #add2 ,propaganda1 ed4 #i1 p4 #gi4 ,echitone 7,strong1 ,cobb ,co471 ,the ,journal1 ,jan4 #b1 #aiae1 p4 #ga2 ,july #ag1 #aibj1 p4 #aic2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #hj2 ,propaganda1 ed4 #i1 p4 #ha4 ,echthol 7,battle ,co471 ,the ,journal1 ,march #ac1 #aiji1 p4 #ijd2 ,jan4 #b1 #aiae1 p4 #ga2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #add2 #aiab1 p4 #ch2 #aiad1 p4 #hj2 ,propaganda1 p4 #ha4 ,echtisia 7,wm4 ,s4 ,merrell ,chemical ,co471 ,the ,journal1 ,jan4 #b1 #aiae1 p4 #ga2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #hj2 ,propaganda1 ed4 #i1 p4 #ha4 ,edema ,improved1 ,tablet 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,edema ,tablet 7,parke1 ,davis ,co42 ,smith1 ,kline ,french ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,edgar1 ,thomas ,webster1 #eae ,edgar1 ,thomas ,webster1 ,journal receives a letter denouncing 8,medical ,clerks0 and 8,biased ,sceptres01 #eah ,edward ,percy ,robinson's 8,cure0 for ,cancer1 #deh ,eimer and ,amend-- 8,anti-,pneumococcic ,oil01 #beg ,phosphorcin ,compound1 #id ,elarson1 #bdh ,elarson 7,winthrop ,chemical ,company1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ge4 ,elder1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,electrobioscope1 #dgb ,electrargol 7,e4 ,fougera ,co471 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #eh4 ,electronic ,reactions1 #dgb ,eli products of ,eli ,h4 ,dunn1 #dbd ,eli #fjf ,capsules1 #cbd1 #dbe ,eli ,vaginal ,capsules1 #dbd ,eli ,vim ,restorative1 #dbd ,elixir ,glycerophosphates1 ,nux ,vomica and ,damiana1 #ie ,elixir ,glycerophosphates1 ,nux ,vomica and ,damiana 7,sharp ,dohme71 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcd2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ce4 ,elixir ,iodo-,bromide of ,calcium ,comp4 8,without ,mercury0 and 8,with ,mercury01 #eb ,elixir ,lactopeptine1 #dc ,elixir ,novo-,hexamine 7,upsher ,smith71 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adb2 ,reports ,chem4 ,lab41 #aiag1 p4 #gj4 ,elixir of ,bitter ,wine1 ,triner's ,american1 #aci ,elixir of ,bitter ,wine1 ,triner's ,american 7,jos4 ,triner71 ,the ,journal1 ,july #ad1 #aiag1 p4 #aci2 ,reports ,council ,pharm4 ,chem41 p4 #cf4 ,elixir of ,buchu and ,hyoscyamus ,compound1 ,tyree's1 #eg ,elixir ,secretogen1 #ge ,empyroform 7,schering ,glatz1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ee4 ,emulsio ,minerolein 7,t4 ,r4 ,d4 ,barse ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afi4 ,emulsio ,phen-,oleum 7,t4 ,r4 ,d4 ,barse ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afi4 ,endoarsan1 #dce ,endosal1 #dce ,endotin 7,morgenstern ,co471 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #acf4 ,enesol 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,july #bf1 #aiac1 p4 #bic4 ,enteronol 7,enteronol ,co471 ,the ,journal1 ,march #ba1 #aijh1 p4 #igg2 ,reports ,chem4 ,lab41 #aiji1 p4 #fd2 ,propaganda1 ed4 #i1 p4 #bid4 ,epilepsy1 ,di-,crotalin treatment1 #dfe ,episan 7,gaynor-,bagstad ,co47 ,the ,journal1 ,sept4 #be1 #aiae1 p4 #aacj2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afd4 ,epsom ,salt ,flavoring a 8discovery01 #agi ,ergoapiol 7,martin ,h4 ,smith ,co471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badi2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #fd2 ,propaganda1 ed4 #i1 p4 #hb4 ,ergone 7,parke1 ,davis ,co471 ,the ,journal1 ,oct4 #g1 #aiaa1 p4 #abaa2 ,oct4 #ad1 #aiaa1 p4 #acjb4 ,ergotole 7,sharp ,dohme71 ,the ,journal1 ,oct4 #g1 #aiaa1 p4 #abaa2 ,oct4 #ad1 #aiaa1 p4 #acjb4 ,erling1 ,a4 ,e41 and the ,allied ,medical ,associations of ,america1 #dhh ,erling1 ,a4 ,e41 and the ,physicians' ,drug ,syndicate1 #dcb ,erpiol1 ,dr4 ,schrader 7,wm4 ,s4 ,merrell ,chemical ,co471 ,the ,journal1 ,june #c1 #aiaa1 p4 #afgj2 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #ah2 ,propaganda1 ed4 #i1 p4 #hc4 ,eskay's ,neuro ,phosphates1 #adf ,estivin1 #dff ,estivin 7,schieffelin and ,company71 ,the ,journal1 ,nov4 #ab1 #aiba1 p4 #aeie4 ,ether1 ,anesthesia 7,cotton ,process7 7,du ,pont ,chemical ,works71 ,the ,journal1 ,feb4 #ba1 #aibj1 p4 #edd2 ,may #bb1 #aibj1 p4 #adgd4 ,ether1 ,cotton ,process1 #dba ,ethics1 secret remedies and the principles of1 #ega ,eucalyptol1 ,chlorinated1 comparison of ,chlorlyptus with1 #bha ,eucalyptus1 toxicity experiments1 #bhe ,euca-,mul 7,the ,edward ,g4 ,bintz ,co471 ,the ,journal1 ,oct4 #bi1 #aiba1 p4 #adch4 ,eumictine1 #bfb ,eumictine 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,feb4 #ba1 #aibj1 p4 #edb2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #g4 ,eunatrol 7,c4 ,bischoff ,co471 ,the ,journal1 ,feb4 #bb1 #aijh1 p4 #fbg4 ,eupeptic ,hypophosphites1 #hc ,eupeptic ,hypophosphites 7,nelson1 ,baker ,co471 ,the ,journal1 ,sept4 #b1 #aiaf1 p4 #gfa2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ae4 ,eusoma 7,eusoma ,pharmaceutical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ch4 ,expurgo ,anti-,diabetes 7,expurgo ,mfg4 ,co471 ,the ,journal1 ,jan4 #bd1 #aiad1 p4 #cab2 ,reports ,chem4 ,lab41 #aiad1 p4 #bg2 ,propaganda1 ed4 #i1 p4 #bii4 ,expurgo ,lapis 7,expurgo ,mfg4 ,co471 ,the ,journal1 ,nov4 #h1 #aiac1 p4 #agcc4 ,extract of ,red ,bone ,marrow 7,armour71 #bac ,fairchild ,bros4 ,foster-- ,carminzym1 #aid ,holadin and ,bile ,salt ,mixtures1 #bjg ,lecithin1 #ec ,false ,unicorn1 ,the ,journal1 ,nov4 #bg1 #aiji1 p4 #ahcf2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #adf2 ,propaganda1 ed4 #i1 p4 #hd4 ,farbwerke-,hoechst ,co4-- ,procain 7,novocain71 #cee1 #ceg1 #cge ,threatens physician with suit for publishing unfavorable report of its product1 #egj1 #ega ,febrisol 7,the ,tilden ,co471 ,the ,journal1 ,june #bi1 #aiab1 p4 #bjdc4 ,febri-,tone 7,arthur ,peter ,co471 ,the ,journal1 ,feb4 #a1 #aijh1 p4 #cgi4 ,fellows' ,syrup and other preparations of ,hypophosphites1 #cie ,fellows' ,syrup of ,hypophosphites1 #hb ,fermenlactyl 7,anglo-,american ,pharmacal ,co41 ,ltd471 ,the ,journal1 ,jan4 #cj1 #aiji1 pp4 #cgb1 #cig4 ,ferric ,arsenite1 ,soluble1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #cj4 ,ferric ,cacodylate1 #bib ,ferric ,cacodylate1 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #fb4 ,ferritonic-,woods 7,william ,a4 ,webster ,company71 ,the ,journal1 ,oct4 #ah1 #aiai1 p4 #abca4 ,ferrivine1 #add ,ferrivine 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,sept4 #h1 #aiag1 p4 #hda2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #di4 ,figwort1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,filudine1 #da ,filudine 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,sept4 #ah1 #aiae1 p4 #ajde2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aef4 ,firolyptol ,plain1 #abj ,firolyptol ,plain 7,the ,tilden ,co474 ,the ,journal1 ,feb4 #ag1 #aiag1 p4 #efd2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #h4 ,firolyptol with ,kreosote1 #abj ,firolyptol with ,kreosote 7,the ,tilden ,co471 ,the ,journal1 ,feb4 #ag1 #aiag1 p4 #efd2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #di4 ,firwein1 #aai ,firwein 7,the ,tilden ,co471 ,the ,journal1 ,feb4 #ag1 #aiag1 p4 #efd2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #g4 ,flint1 ,eaton and ,company--,quassia ,compound ,tablets1 #cjf ,flower1 ,a4 ,h41 and the ,allied ,medical ,associations of ,america1 #dhi ,foral1 #bjd ,foral 7,foral ,products ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ee4 ,formaldehyde ,lozenges1 #bce ,formaldehyde ,lozenges1 ,the ,journal1 ,oct4 #d1 #aiai1 p4 #ajgg2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #cb4 ,formamint1 #cc ,formamint 7,a4 ,wulfing ,co471 ,the ,journal1 ,jan4 #bg1 #aiab1 p4 #bie2 ,feb4 #bd1 #aiab1 p4 #egb2 ,aug4 #bh1 #aiae1 p4 #haf2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #fd2 ,propaganda1 ed4 #i1 p4 #cjc4 ,formic ,acid1 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #be4 ,formicin 7,kalle ,color ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #gf4 ,formidin 7,parke1 ,davis ,co471 ,the ,journal1 ,sept4 #e1 #aijh1 p4 #hah2 ,reports ,council ,pharm4 ,chem41 #aije-h1 pp4 #afd1 #aib2 #aiab1 p4 #dh4 ,formitol ,tablets1 #bcf1 #bga ,formitol ,tablets 7,e4 ,l4 ,patch ,co471 ,the ,journal1 ,oct4 #d1 #aiai1 p4 #ajgg2 ,june #ai1 #aibj1 p4 #agcj2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #cd2 #aibj1 p4 #bj2 ,reports ,chem4 ,lab41 #aibj1 p4 #dj4 ,formosol1 #aeh ,formosol1 ,sunshine's 7,the ,formosol ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #ade4 ,formothalates1 ,tablets1 #bef ,formothalates1 ,tablets 7,tailby ,nason ,company71 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ib4 ,formurol 7,cellarius ,co471 ,the ,journal1 ,jan4 #ba1 #aiaa1 p4 #baj2 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #g2 ,propaganda1 ed4 #i1 p4 #he4 ,fortossan 7,a4 ,klipstein ,co471 ,the ,journal1 ,jan4 #cj1 #aiae1 p4 #def2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aca2 ,propaganda1 ed4 #i1 p4 #agh4 ,fougera ,e41 and ,co41 ,inc4-- ,collosol ,iodine1 #add ,dr4 ,de ,sanctis' ,rheumatic and ,gout ,pills1 #cfc ,ferrivine1 #add ,intramine1 #add ,phosphoglycerate of ,lime 7,chapoteaut71 #ie ,freeman1 ,allen ,w41 protests regarding advertising methods used by manufacturers of ,proteogens1 #dde1 #ddf ,french ,medicinal ,company1 ,inc4--,syphilodol1 #cei1 #dgj ,friedlnder ,bacillus ,vaccine1 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #gh4 ,fringe ,tree1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,fritz1 ,w4 ,w41 and the ,allied ,medical ,associations of ,america1 #dhh ,frosst's ,blaud ,capsules3 ,see ,blaud ,capsules4 ,frutosen 7,the ,frutosen ,drug ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #bf4 ,g4 ,g4 ,phenoleum ,disinfectant 7,g4 ,g4 ,phenoleum ,co41 ,inc471 ,the ,journal1 ,jan4 #cj1 #aiae1 p4 #def2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aca4 ,galactagogue action of ,galega and ,nutrolactis1 #aca ,galactagogue1 alleged ,galactagogue effects of ,nutrolactis and ,goat's ,rue not substantiated1 #aca ,galactagogue 7,eli ,lilly ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,galega and ,nutrolactis1 alleged ,galactagogue action of1 #aca ,gardner's ,syrup of ,ammonium ,hypophosphite1 #ajj ,gastrogen ,tablets 7,bristol-,myers ,co471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badi2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #aca2 ,propaganda1 ed4 #i1 p4 #hg4 ,gelesmine ,hydrochlorid1 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #eg4 ,gelseminine1 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #eg4 ,genitone 7,wm4 ,s4 ,merrell ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,genoform 7,c4 ,bischoff ,co471 ,the ,journal1 ,feb4 #bf1 #aiaf1 p4 #fgf4 ,germaseptic ,lubricant 8,bing0 7,chas4 ,m4 ,griswold1 ,st4 ,petersburg1 ,fla471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #gi4 ,germiletum 7,dios ,chemical ,co471 ,the ,journal1 ,jan4 #i1 #aiae1 p4 #afe2 ,reports ,council ,pharm ,chem41 #aiad1 p4 #hf2 ,reports ,chem4 ,lab41 #aiaj1 p4 #aa2 ,propaganda1 ed4 #i1 p4 #aci4 ,giambalvo1 ,g41 ,co4--,aphlegmatol1 #bgc ,ginseng1 ,the ,journal1 ,oct4 #bd1 #aiad1 p4 #adhf2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,ginseng ,compound1 ,elixir 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,ginseng ,compound 7,special71 ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,glidine 7,menley ,james71 ,the ,journal1 ,june #bh1 #aiac1 p4 #bjcg4 ,globeol 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,sept4 #ah1 #aiae1 p4 #ajdf2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aeg4 ,glover's ,cancer ,serum1 #dbe ,gluten ,biscuit1 ,pure 7,kellogg ,food ,company71 ,reports ,council ,pharm4 ,chem41 #aiaf1 pp4 #ef1 #eg4 ,gluten ,biscuit1 #dj per cent4 7,kellogg ,food ,company71 ,reports ,council ,pharm4 ,chem41 #aiaf1 pp4 #ef1 #eh4 ,gluten ,flour1 #dj per cent4 7,kellogg ,food ,company71 ,reports ,council ,pharm4 ,chem41 #aiaf1 pp4 #ef1 #ei4 ,gluten ,meal1 ,pure 7,kellogg ,food ,company71 ,reports ,council ,pharm4 ,chem41 #aiaf1 pp4 #ef1 #fj4 ,gluten ,meal1 #bj per cent4 7,kellogg ,food ,company71 ,reports ,council ,pharm4 ,chem41 #aiaf1 pp4 #ef1 #fj4 ,gluten ,meal1 #dj per cent4 7,kellogg ,food ,company71 ,reports ,council ,pharm4 ,chem41 #aiaf1 pp4 #ef1 #ei4 ,gluten products made by the ,kellogg ,food ,company1 #ajj ,glutol-,schleich 7,schering ,j4 ,glatz1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agj4 ,glycerinated ,vaccine ,virus 7,national ,vaccine and ,antitoxin ,institute71 ,reports ,council ,pharm4 ,chem44 #aiba1 p4 #bc4 ,glycerine ,tonic1 ,gray's1 #bd1 #dbi ,glycerine ,tonic1 ,gray's 7,purdue ,frederick ,co471 ,the ,journal1 ,july #aj1 #aiae1 p4 #ahi2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ef4 ,glycero-,lecithin1 ,pill 7,westerfield ,pharmacal ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agj4 ,glycerole of ,lecithin1 #ec ,glycerole of ,lecithin 7,fairchild ,bros1 and ,foster71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #abb4 ,glycerophosphate ,comp4 ,no4 #a1 ,mulford1 ,ampuls 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #di4 ,glycerophosphate ,comp1 ,ampuls1 #a ,cc4 ,squibb 7,e4 ,r4 ,squibb ,sons71 ,the ,journal1 ,feb4 #c1 #aiag2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #dh4 ,glycerophosphate1 ,sodium1 #ii ,glycerophosphates1 #ebj ,glycerophosphates1 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcc2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #cb4 ,glycerophosphate1 ,calcium1 #ii ,glycerophosphates1 ,elixir1 ,nux ,vomica and ,damiana1 #ie ,glycerophosphates1 ,schering's 7,tonols71 #id ,glycerophosphates1 therapeutic value of1 #ic ,glycerosal 7,rhm ,haas71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #eg4 ,glyco-,heroin1 ,smith 7,martin ,h4 ,smith ,co471 ,the ,journal1 ,june #f1 #aiad1 p4 #ahbf2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #bi2 ,propaganda1 ed4 #i1 p4 #hh4 ,glyco-,thymoline 7,kress ,owen ,co471 ,the ,journal1 ,march #ad1 #aiad1 p4 #hfh2 ,oct4 #aj1 #aiad1 p4 #acab2 ,sept4 #af1 #aiaf1 p4 #hie2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ed2 ,propaganda1 ed4 #i1 p4 #ib4 ,glyco-,thymoline and poliomyelitis1 #dbg ,glycozone 7,drevet ,mfg4 ,co471 ,the ,journal1 ,june #e1 #aiji1 p4 #ahea2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #ajc2 ,propaganda1 ed4 #i1 p4 #ie4 ,glykeron3 cold storage testimonials1 #dbh ,goat ,lymph ,treatment1 #ebh ,goat's ,rue1 claimed ,galactagogue effects of1 not substantiated1 #aca ,goat's ,rue1 ,the ,journal1 ,may #bf1 #aiag1 p4 #aegj2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db2 #aiag1 p4 #bd4 ,goehring1 ,h4 ,m41 and the ,allied ,medical ,associations of ,america1 #dhh ,goiter ,serum1 ,mark ,white1 #hg ,goiter ,serum1 ,mark ,white 7,mark ,white ,serum ,laboratories71 ,the ,journal1 ,sept4 #bc1 #aiaf1 p4 #ifg2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #bc4 ,goitreine1 #hh ,gomenol 7,charles ,r4 ,bard71 ,the ,journal1 ,april #d1 #aiad1 p4 #aaaj2 ,propaganda1 ed4 #i1 p4 #cjd4 ,gonococcic ,vaccine 7,national ,vaccine and ,antitoxin ,institute71 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ec4 ,gonococcide 7,cox ,chemical ,co471 ,the ,journal1 ,aug4 #bd1 #aijg1 p4 #gjh4 ,gonococcus ,bacterin1 ,mixed1 ,special ,bacterial ,vaccine ,no4 #af1 #bed ,gonosan1 #aej ,gonosan 7,riedel ,co41 ,inc471 ,the ,journal1 ,oct4 #ac1 #aiag1 p4 #abhg2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #eg4 ,gossypin1 ,the ,journal1 ,june #c1 #aiaa1 p4 #afgj2 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #ai2 ,propaganda1 ed4 #i1 p4 #hd4 ,gout and ,rheumatic ,pills1 ,dr4 ,de ,sanctis'1 #cfc ,granular ,effervescent ,bromide and ,acetanilid ,compound-,mulford1 #bjf ,granular ,effervescent ,sodium ,phosphate ,compound 7,squibb7 7,e4 ,r4 ,squibb ,sons71 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #fc4 ,gray's ,glycerine ,tonic1 #bd1 #dbi ,green ,bone1 ,russell ,prepared1 #acd ,gross ,drug ,company1 ,inc4--,capsules ,bismuth ,resorcinol ,compound1 #aeg ,guiaialin 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 #gf4 ,guaiodine1 #ahc ,guaiodine 7,intravenous ,products ,co471 ,the ,journal1 ,april #f1 #aiah1 p4 #ajbf2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #i4 ,gude's ,pepto-,mangan1 #chg ,h-,m-,c43 ,see ,hyoscin-,morphin-,cactin4 ,hagee's ,cordial of ,cod ,liver ,oil1 #dbi ,hair ,cap ,moss1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,hanson1 ,a4 ,c41 and the ,physicians' ,drug ,syndicate1 #dcb ,harmer ,laboratories ,company--,mon-,arsone1 #cjb ,harrower1 ,henry ,r4--8,pluriglandular0 ,mixtures3 ,caps4 ,adreno-,spermin ,comp41 ,caps4 ,antero-,pituitary ,comp41 ,caps4 ,placento-,mammary ,comp41 ,caps4 ,thyro-,ovarian ,comp41 ,caps4 ,hepato-,splenic ,comp41 ,caps4 ,pancreas ,comp41 and ,caps4 ,thyroid ,comp1 #bah ,havens' ,wonderful ,discovery 7,e4 ,c4 ,havens71 ,the ,journal1 ,march #bb1 #aiai1 p4 #hhc2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #g4 ,hay ,fever ,fall ,pollen ,extract-,mulford 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #de4 ,hay ,fever ,spring ,pollen ,extract-,mulford 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #de4 ,hectine 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,aug #h1 #aiad1 p4 #ejb1 ,propaganda1 ed4 #i1 p4 #cjh4 ,heffner1 ,charles ,l4--,iodiphos1 #bdi ,hlnin and ,globules of 8,hlnin ,de ,korab0 7,de ,korab ,bojemski71 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #gh4 ,helmitol1 #bie ,helmitol 7,winthrop ,chemical ,co471 ,the ,journal1 ,jan4 #bb1 #aiba1 p4 #bfj2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #di4 ,helonias ,compound1 ,cordial1 ,elixir 7,ray ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,helonias ,compound1 ,elixir 7,hance ,bros4 ,white2 ,h4 ,k4 ,mulford ,co42 ,parke1 ,davis ,co42 ,smith1 ,kline ,french ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,helonias ,compound1 ,fluidextract 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,hemaboloids 7,palisade ,manufacturing ,co471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #hj4 ,hemaboloids ,arseniated with ,strychnia 7,the ,palisade ,mfg4 ,co471 ,the ,journal1 ,dec4 #bg1 #aiac1 p4 #bcjf4 ,hemo 7,thompson's ,malted ,food ,co471 ,the ,journal1 ,oct4 #bd1 #aiad1 p4 #adid2 ,propaganda1 ed4 #i1 p4 #cai4 ,hemo-,therapin1 #afh ,hemo-,therapin 7,hemo-,therapin ,laboratories71 ,the ,journal1 ,jan4 #e1 #aiah1 p4 #dh2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aaf4 ,hepatico ,tablets 7,david ,laboratories1 ,inc471 ,the ,journal1 ,oct4 #bj1 #aiag1 p4 #agcd2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #fd4 ,hepato-,splenic ,comp41 ,caps1 #bai ,hexa-,co-,sal-,in 7,hexa-,co-,sal-,in ,co471 ,the ,journal1 ,oct4 #b1 #aiae1 p4 #abjc2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aei2 ,reports ,chem4 ,lab41 #aiae1 p4 #ajg4 ,hexalet 7,riedel ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #bg4 ,hex-a-lith 7,smith-,dorsey ,co471 ,the ,journal1 ,feb4 #ad1 #aiad1 p4 #eee4 ,hexamethylenamin1 commercial history of1 #caf ,hexamethylenamin ,methylencitrate3 ,see ,helmitol4 ,hex-,iodin1 #bcf ,hex-,iodin 7,daggett and ,miller ,co41 ,inc471 ,the ,journal1 ,oct4 #d1 #aiai1 p4 #ajgg2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #cc4 ,heyden ,chemical ,works--,xeroform-,heyden1 #baf1 #cdi1 #ceb ,hille ,laboratories--,mervenol and ,armervenol1 #bdi ,hillside ,chemical ,co4--,pil4 ,mixed ,treatment 7,chichester71 #caj ,hogan's ,colloid ,solution ,materials for ,intravenous ,transfusion4-- ,see ,colloid ,solution ,materials for ,intravenous ,transfusion1 ,hogan's4 ,holadin and ,bile ,salts--,fairchild1 #bjg ,holadin and ,bile ,salts1 ,fairchild 7,fairchild ,bros1 and ,foster71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ei4 ,holadin1 ,bile ,salts and ,phenolphthalein1 ,capsules of1 #bjh ,holadin1 ,bile ,salts and ,phenolphthalein1 ,capsules of1 ,fairchild 7,fairchild ,bros1 and ,foster71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ei4 ,holadin1 ,succinate of ,soda and ,bile ,salts1 ,capsules of1 #bjh ,holadin1 ,succinate of ,soda and ,bile ,salts1 ,capsules of1 ,fairchild 7,fairchild ,bros4 ,foster71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ei4 ,holliday ,laboratories--,cerelene1 #bai1 #ccg1 #cfb ,holocain ,hydrochlorid1 #cgb ,hormotone1 #bcd ,hormotone 7,g4 ,w4 ,carnrick ,co471 ,the ,journal1 ,aug4 #af1 #aiai1 p4 #edi2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #cj4 ,hormotone without ,postpituitary1 #bce ,hormotone ,without ,postpituitary 7,g4 ,w4 ,carnrick ,co471 ,the ,journal1 ,aug4 #af1 #aiai1 p4 #edi2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #cj4 ,horovitz ,biochemic ,laboratories ,co--,lipoidal ,substances1 #cbj ,horowitz-,beebe--8,autolysin01 #dac ,horse ,nettle1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,hughes1 ,k4 ,a41 ,company--,salicon1 #dec ,hyclorite1 #ceh ,hydragogin1 #da ,hydragogin 7,c4 ,bischoff ,co471 ,the ,journal1 ,jan4 #bg1 #aijf1 p4 #bhh2 ,sept4 #d1 #aiae1 p4 #hid2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aed4 ,hydrangea and ,lithia1 ,elixir 7,hance ,bros4 ,white71 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,hydrangea1 ,lithiated 7,lambert ,pharmacal ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,hydras1 #if ,hydras 7,john ,wyeth and ,bro471 ,the ,journal1 ,oct4 #g1 #aiaf1 p4 #aajg2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #cf2 ,reports ,chem4 ,lab41 #aiaf1 p4 #bi4 ,hydrastis and ,cramp ,bark ,compound1 ,elixir 7,parke1 ,davis ,co471 ,the ,journal1 ,aug4 #ca1 #aiab1 p4 #gce2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd2 ,propaganda1 ed4 #i1 p4 #daj4 ,hydrastis and ,viburnum ,compound1 ,elixir of 7,smith1 ,kline ,french ,co471 ,the ,journal1 ,aug41 #ca1 #aiab1 p4 #gce2 ,propaganda1 ed4 #i1 p4 #daj4 ,hydrocyanate of ,iron1 ,tilden 7,the ,tilden ,co471 ,the ,journal1 ,june #ai1 #aiji1 p4 #bjjh2 ,reports ,chem4 ,lab41 #aiji1 p4 #bg2 ,propaganda1 ed4 #i1 p4 #bce4 ,hydroleine1 #eh ,hydroleine 7,charles ,n4 ,crittenton ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aga4 ,hydron 7,wm4 ,s4 ,merrell ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,hydronaphthol 7,seabury ,johnson71 ,the ,journal1 ,sept4 #c1 #aiaj1 p4 #hgh2 ,reports ,chem4 ,lab41 #aiaj1 p4 #ajh2 ,propaganda1 ed4 #i1 p4 #cjh4 ,hydropsin1 #fa ,hydropsin 7,e4 ,bischoff ,co41 ,inc471 ,the ,journal1 ,jan4 #h1 #aiaf1 p4 #ace2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #id4 ,hydrozone 7,charles ,marchand71 ,the ,journal1 ,sept4 #bc1 #aije1 p4 #icf2 ,propaganda1 ed4 #i1 p4 #cji4 ,hymosa 7,walker ,pharmacal ,co471 ,the ,journal1 ,june #aa1 #aiaj1 p4 #aiee2 ,reports ,chem4 ,lab41 #aiaj1 p4 #ea2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd2 ,propaganda1 ed4 #i1 p4 #bch4 ,hyoscin-,morphine-,cactin1 now ,hyoscin-,morphin-,cactoid 7,the ,abbott ,laboratories71 ,the ,journal1 ,dec4 #ba1 #aijg1 p4 #bajc4 ,hyoscyamus ,compound1 ,tyree's ,elixir of ,buchu and ,hyoscyamus ,compound1 #eg ,hyperol 7,purdue ,frederick ,co471 ,the ,journal1 ,april #ah1 #aiad1 p4 #abga2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ab2 ,propaganda1 ed4 #i1 p4 #ajj4 ,hyperthermine1 #cca ,hyperthermine 7,pasteur ,chemical ,co471 ,the ,journal1 ,may #ai1 #aiag1 p4 #adig4 ,hypno-,bromic ,compound1 #dcj ,hypodermic ,solution ,no4 #ac1 ,iron1 ,arsenic1 and ,phosphorus ,compound1 #bge ,hypodermic ,solution ,no4 #ac1 ,iron1 ,arsenic and ,phosphorus ,compound 7,burdick-,abel ,laboratory71 ,the ,journal1 ,nov4 #ac1 #aibj1 p4 #aceh2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #bg4 ,hypophosphite1 ,the ,journal1 ,sept4 #b1 #aiaf1 p4 #gfj2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #aa4 ,hypophosphite1 ,ammonium1 #ih ,hypophosphite1 ,ammonium1 ,gardner's ,syrup of1 #ajj ,hypophosphite ,fallacy1 #hj ,hypophosphites1 ,borcherdt's ,malt ,olive with1 #hd ,hypophosphites ,comp4 7,lime and ,soda7--,mc,arthur's ,syrup of1 #hd ,hypophosphites1 ,eupeptic1 #hc ,hypophosphites1 ,fellows' ,syrup and other ,preparations of1 #cie ,hypophosphites1 ,fellows' ,syrup of1 #hb ,hypophosphites1 inertness of1 #cig ,hypophosphites1 ,maltine with ,olive ,oil and1 #hd ,hypophosphites1 ,maltzyme with1 #hd ,hypophosphites of ,lime and ,soda1 ,schlotterbeck's ,solution 7,liq4 ,hypophosphitum1 ,schlotterbeck's71 #hc ,hypophosphites1 ,preparations of1 #cie ,hypophosphites1 ,robinson's1 #hc ,hypophosphites1 ,robinson's 7,robinson-,pettet ,company71 ,the ,journal1 ,sept4 #b1 #aiaf1 p4 #gfa2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ae4 ,hypophosphites1 ,syrup1 ,comp4 with ,quinin1 ,strychinin and ,manganese1 ,syrupus ,roborans1 #hb ,hypoquinidol 7,r4 ,w4 ,gardner71 ,the ,journal1 ,jan4 #aj1 #aiad1 p4 #adh2 ,propaganda1 ed4 #i1 p4 #caj4 ,i4 ,g4 ,o41 #cfg ,ichthynate 7,mallinckrodt ,chemical ,works71 ,reports ,chem4 ,lab41 #aiab1 p4 #aaj4 ,ichthytar 7,szel ,import ,export ,co471 ,the ,journal1 ,march #aj1 #aiag1 p4 #gif2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #ah4 ,influenza ,combined ,bacterin 7,special ,bacterial ,vaccine ,no4 #e71 #bed ,influenza ,mixed ,vaccine-,lilly1 #ahg ,influenza ,mixed ,vaccine-,lilly 7,eli ,lilly ,co471 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,influenza ,prophylactic-,lederle 7,lederle ,antitoxin ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ha4 ,influenza ,serobacterin ,mixed-,mulford1 #ahg ,influenza ,serobacterin ,mixed-,mulford 7,h4 ,k4 ,mulford ,co471 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,influenza1 ,serums and ,vaccines1 #eba ,influenza1 vaccine as a prophylactic in1 #egb ,influenza ,vaccines1 #ebj ,ingluvin 7,wm4 ,r4 ,warner ,co471 ,the ,journal1 ,july #aa1 #aijh1 p4 #adb2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #aaf2 ,propaganda1 ed4 #i1 p4 #aja4 ,innis1 ,speiden ,co4--,ophthalmol-,lindemann1 #ahi ,interol 7,van ,horn ,sawtell71 ,the ,journal1 ,july #aj1 #aiae1 p4 #age4 ,intestinal ,antiseptic ,w-,a 7,the ,abbott ,laboratories71 ,the ,journal1 ,dec4 #ai1 #aiad1 p4 #bbdg2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #gh2 ,propaganda1 ed4 #i1 p4 #ajc4 ,intramine1 #add ,intramine 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,sept4 #h1 #aiag1 p4 #hda2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #di4 ,intravenin ,p-,h 7,intravenin ,products ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #abj4 ,intravenous ,compound 7,loffler71 #dcj ,intravenous ,compound 7,loffler7 7,charles ,lyman ,loffler71 ,the ,journal1 ,nov4 #ab1 #aiba1 p4 #aeia4 ,intravenous ,products ,company of ,america-- ,endoarsan1 #dce ,endosal1 #dce ,venosal1 #dce ,intravenous ,products ,company of ,denver-- ,guaiodine1 #ahc ,intravenous ,specialties1 #dce ,venarsen1 #dga ,venosal1 #afi ,intravenous ,solution1 ,bannerman's 7,william ,bannerman71 ,the ,journal1 ,may #ca1 #aiac1 p4 #agbd2 ,jan4 #b1 #aiae1 p4 #gj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #aca2 ,propaganda1 ed4 #i1 p4 #aje4 ,intravenous ,solution of ,hexamethylenamin1 ,loeser's1 #bii ,intravenous ,solution of ,hexamethylenamin1 ,loeser's 7,new ,york ,intravenous ,laboratory1 ,inc471 ,the ,journal1 ,april #af1 #aiba1 p4 #aabj2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #dc4 ,intravenous ,solution of ,hexamethylenamin and ,sodium ,iodid1 ,loeser's1 #bii ,intravenous ,solution of ,hexamethylenamin and ,sodium ,iodid1 ,loeser's 7,new ,york ,intravenous ,laboratory1 ,inc471 ,the ,journal1 ,april #af1 #aiba1 p4 #aabj2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #dc4 ,intravenous ,solution of ,sodium ,iodid1 ,loeser's1 #bii ,intravenous ,solution of ,mercury ,bichlorid1 ,loeser's1 #bii ,intravenous ,solution of ,mercury ,bichlorid1 ,loeser's 7,new ,york ,intravenous ,laboratory1 ,inc471 ,the ,journal1 ,april #af1 #aiba1 p4 #aabj2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #dc4 ,intravenous ,solution of ,salicylate and ,iodid1 ,loeser's1 #bii ,intravenous ,solution of ,salicylate and ,iodid1 ,loeser's 7,new ,york ,intravenous ,laboratory1 ,inc471 ,the ,journal1 ,april #af1 #aiba1 p4 #aabj2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #dc4 ,intravenous ,solution of ,sodium ,iodid and ,sodium ,salicylate1 ,loeser's 7,new ,york ,intravenous ,laboratory1 ,inc471 ,the ,journal1 ,april #af1 #aiba2 page #aabj2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #dc4 ,intravenous ,solution ,sodium ,salicylate1 ,loeser's1 #bii ,intravenous ,solutions1 ,loeser's1 #bii ,intravenous ,specialties1 #dce ,intravenous ,therapy1 #ebb ,iocamfen1 #cch ,iocamfen ,ointment1 #cch ,iodagol1 #aed ,iodagol 7,david ,b4 ,levy1 ,inc471 ,the ,journal1 ,nov4 #ag1 #aiag1 p4 #agbe2 ,reports ,council ,pharm4 ,chem41 #aiag1 pp4 #fe-aaf2 ,reports ,chem4 ,lab41 #aiag1 p4 #hj4 ,iodalia 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badi2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #fi2 ,reports ,chem4 ,lab41 #aiad1 p4 #ge2 ,propaganda1 ed4 #i1 p4 #ajf4 ,iodeol1 #aed ,iodeol 7,david ,b4 ,levy1 ,inc471 ,the ,journal1 ,nov4 #ag1 #aiag1 p4 #agbe2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #fe-aaf2 ,reports ,chem4 ,lab41 #aiag1 p4 #hj4 ,iodex1 #cch1 #cfe1 #dcf ,iodex 7,menley ,james71 ,the ,journal1 ,nov4 #cj1 #aiab1 p4 #aiib2 ,june #ai1 #aiae1 p4 #bjhe2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #add2 ,reports ,chem4 ,lab41 #aiae1 p4 #hi2 #aiai1 p4 #ajd2 ,propaganda1 ed4 #i1 p4 #ajg2 ,the ,journal1 ,may #c1 #aiai1 p4 #acae4 ,iodex1 ,liquid1 #cfe ,iodex1 ,liquid 7,menley and ,james71 ,reports ,chem4 ,lab41 #aiai1 p4 #ajd4 ,iodia 7,battle ,co471 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahga2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #fj2 ,reports ,chem4 ,lab41 #aiad1 p4 #eh2 ,propaganda1 ed4 #i1 p4 #ajh4 ,iodin1 ,burnham's ,soluble 7,burnham ,soluble ,iodin ,co471 ,the ,journal1 ,march #bh1 #aijh1 p4 #ajee2 ,may #ae1 #aiae1 p4 #afgc2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ej2 ,reports ,chem4 ,lab41 to #aiji1 p4 #cj2 ,propaganda1 ed4 #i1 pp4 #aaj1 #bcc4 ,iodin ,fumes1 #ebc ,iodin in liquid petrolatum1 #cfg ,iodin ,petrogen 7,john ,wyeth ,bro471 ,the ,journal1 ,nov4 #cj1 #aiab1 p4 #aiib4 ,iodin1 solubility of1 in liquid petrolatum1 #cdd1 #cfg ,iodin ,tablets1 ,burnham's ,soluble 7,burnham ,soluble ,iodin ,co471 ,the ,journal1 ,march #bh1 #aijh1 p4 #ajee2 ,reports ,chem4 ,lab41 to #aiji1 p4 #cb2 ,propaganda1 ed4 #i1 p4 #bcc4 ,iodine1 ,b4 ,iodine1 #aih ,iodine1 ,b4 ,iodine ,products1 #aii ,iodine1 ,b4 ,oleum ,iodine1 #aih ,iodine ointments1 stability of1 #ccg ,iodine ,solution1 ,national1 #cjj ,iodinized ,emulsion 7,scott71 #aib ,iodinized ,emulsion 7,scott7 7,dawson ,pharmacal ,co471 ,the ,journal1 ,aug4 #bd1 #aiah1 p4 #fhj2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #be4 ,iodinized ,oil1 ,mark ,white1 #hg ,iodinized ,oil1 ,mark ,white 7,mark ,white ,laboratories71 ,the ,journal1 ,sept4 #bc1 #aiaf1 p4 #ifg2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #bc4 ,iodinol 7,toledo ,pharmacal ,co471 ,the ,journal1 ,aug4 #bj1 #aiba1 p4 #fcg4 ,iodiphos1 #bdi ,iodiphos 7,charles ,l4 ,heffner71 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ha4 ,iodival 7,knoll ,co471 ,the ,journal1 ,march #d1 #aiaa1 p4 #fhe4 ,iod-,izd-,oil1 #cch ,iod-,izd-,oil 7,miller's71 #di ,iod-,izd-,oil 7,miller's7 7,iodum ,miller ,co471 ,the ,journal1 ,oct4 #b1 #aiae1 p4 #abjb2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #gf2 ,reports ,chem4 ,lab41 #aiae1 p4 #ajf4 ,iodo-,bromide of ,calcium ,comp4 8,without ,mercury0 and 8,with ,mercury10 ,elixir1 #eb ,iodo-,bromide of ,calcium ,comp41 8,without ,mercury0 and 8,with ,mercury10 ,elixir 7,the ,tilden ,co471 ,the ,journal1 ,nov4 #f1 #aiae1 p4 #affb2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afj4 ,iodolene and solubility of iodin in liquid petrolatum1 #cdd ,iodolene1 a solution of iodin in liquid petrolatum1 #aei ,iodo-,mangan1 #ajf ,iodo-,mangan 7,reinschild ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #fd4 ,iodomuth 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 #ge4 ,iodonucleoid 7,dinet ,delfosse ,pharm4 ,co471 ,the ,journal1 ,july #bb1 #aiaa1 p4 #cji2 ,reports ,chem4 ,lab41 #aiaa1 p4 #ib2 ,propaganda1 ed4 #i1 p4 #caj4 ,iodotone 7,eimer ,amend71 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #badi2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #gb2 ,propaganda1 ed4 #i1 p4 #aac4 ,iodovasogen 7,lehn ,fink71 ,the ,journal1 ,feb4 #ac1 #aiji1 p4 #ege2 ,propaganda1 ed4 #i1 p4 #djh4 ,iodum-,miller1 #di ,iodum-,miller 7,iodum-,miller ,co471 ,the ,journal1 ,oct4 #b1 #aiae1 p4 #abjb2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #gf2 ,reports ,chem4 ,lab41 #aiae1 p4 #ajb4 ,iosaline 7,iosaline ,co471 ,the ,journal1 ,march #ae1 #aiac1 p4 #hdi2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #ac2 ,propaganda1 ed4 #i1 p4 #aac4 ,ipecac1 ,alcresta1 #aec ,iridium ,medicinal 7,platinum ,company of ,america71 ,the ,journal1 ,april #bc1 #aiaj1 p4 #achi2 ,propaganda1 ed4 #i1 p4 #cab4 ,iron1 ,arsenic1 and ,phosphorus ,compound1 ,hypodermic ,solution ,no4 #ac1 #bge ,iron ,arsenite1 #dff ,iron ,citrate ,green1 #aae ,iron ,citrate ,green1 ,the ,journal1 ,jan4 #ac1 #aiag1 p4 #ace2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #db4 ,iron ,solution for ,intravenous ,therapy--,perkins and ,ross 7,perkins ,ross71 ,the ,journal1 ,nov4 #ad1 #aiad1 p4 #aggh2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abe4 ,iron ,tropon 7,tropon ,works71 ,the ,journal1 ,april #bc1 #aiaj1 p4 #achi2 ,propaganda1 ed4 #i1 p4 #cac4 ,isopral 7,the ,bayer ,company1 ,inc471 ,the ,journal1 ,aug4 #h1 #aijh1 p4 #dhg2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #aai4 ,italian ,physico-,chemical ,company1 #ebd ,ittiolo 7,guiseppi ,w4 ,guidi71 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #fd4 ,jaroma 7,jaroma ,co471 ,the ,journal1 ,sept4 #b1 #aiaa1 p4 #hce2 ,reports ,chem4 ,lab41 #aiaa1 p4 #ajc4 ,johnson1 ,n4 ,la ,doit1 and the ,allied ,medical ,associations of ,america1 #dhh ,jubol1 #ca ,jubol 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,aug4 #ad1 #aiae1 p4 #fci2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aeb4 ,juglandin1 ,the ,journal1 ,nov4 #ac1 #aiji1 p4 #afee2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #ace4 ,kal ,pheno ,tooth ,paste 7,kal ,pheno ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #da4 ,kal ,pheno ,tooth ,powder 7,kal ,pheno ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #da4 ,kalak ,water1 #afj ,kalak ,water 7,kalak ,water ,co41 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adh4 ,katharmon1 #aia ,katharmon 7,katharmon ,chemical ,co471 ,the ,journal1 ,aug4 #aj1 #aiah1 p4 #dhg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #bc4 ,keasbey and ,mattison ,company--,alkalithia1 #bdb ,kefilac 7,kefilac ,co471 ,the ,journal1 ,jan4 #cj1 #aiji1 pp4 #cgb1 #cig4 ,kellogg ,food ,company--,gluten products1 #ajj ,kelpidine3 ,see ,minson's ,soluble ,iodin4 ,keratin1 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #eh4 ,kinazyme 7,g4 ,w4 ,carnrick ,co471 ,the ,journal1 ,nov4 #a1 #aiac1 p4 #afdi4 ,klein1 ,frederick1 #dae ,klipstein1 ,a41 and ,company1 ,inc4--,dial 8,ciba01 #bei ,koch1 ,william ,f41 ,cancer ,remedy1 #dcg ,kola ,compound1 ,elixir 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,kola ,compound1 ,elixir 7,ray ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,kolynos 7,kolynos ,co471 ,the ,journal1 ,nov4 #ae1 #aiac1 p4 #ahab4 ,kora-,konia1 #ib ,kora-,konia 7,gerhard ,mennen ,chemical ,co471 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcd2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ca2 ,reports ,chem4 ,lab41 #aiaf1 p4 #bf4 ,koyol 7,the ,koyol ,co471 ,reports ,council ,pharm4 ,chem41 #ahae1 p4 #agb4 ,kress ,owen ,company--,glyco-,thymoline1 #dbg ,kutnow's ,powder 7,kutnow ,bros471 ,the ,journal1 ,nov4 #i1 #aijg1 p4 #afai2 ,propaganda1 ed4 #i1 p4 #cad4 ,k-,y ,lubricating ,jelly1 #adg1 #dff ,k-,y ,lubricating ,jelly 7,van ,horn ,sawtell71 ,the ,journal1 ,may #ab1 #aiag1 p4 #adcj2 ,sept4 #bi1 p4 #aajb2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #ec4 ,labordine 7,labordine ,pharmacal ,co471 ,the ,journal1 ,march #cj1 #aijg1 p4 #aaba2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #de2 #aiab1 p4 #dj2 ,propaganda1 ed4 #i1 p4 #aae4 ,lackenbach1 ,f4 ,i4-- ,special ,bacterial ,vaccine1 ,nos4 #b1 #c1 #d1 #e1 #aa1 #ae1 #af1 #bed ,lacteol 7,dr4 ,boucar1 ,paris71 ,the ,journal1 ,dec4 #ba1 #aiaf1 p4 #aiei4 ,lactobacilline 7,the ,franco-,american ,ferment ,co471 ,the ,journal1 ,april #ag1 #aiae1 p4 #acdf2 ,sept4 #ah1 #aiae1 p4 #ajdi2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #adc2 ,propaganda1 ed4 #i1 p4 #abj4 ,lactone 7,parke1 ,davis ,co471 ,the ,journal1 ,jan4 #cj1 #aiji1 pp4 #cgb1 #cig4 ,lactopeptine 7,new ,york ,pharmacal ,association71 ,the ,journal1 ,march #af1 #aijg1 p4 #iei2 ,aug4 #b1 #aiac1 p4 #ceh2 ,oct4 #bc1 #aiae1 pp4 #adff1 #adfg1 #adgg2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #dc2 #aiac1 p4 #ba2 #aiae1 p4 #gi2 ,propaganda1 ed4 #i1 p4 #aba4 ,lactopeptine and ,elixir ,lactopeptine1 #dc ,lactopeptine1 ,elixir 7,new ,york ,pharmacal ,association71 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc2 ,oct4 #bc1 #aiae1 pp4 #adff1 #adfg1 #adgg2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #gi4 ,lactucarium1 ,aubergier's ,syrup of 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,nov4 #i1 #aiab1 p4 #agcb2 ,feb4 #ae1 #aiac1 p4 #ech2 ,propaganda1 ed4 #i1 p4 #cii4 ,lambdin's ,i4 ,g4 ,o41 #cfg ,lambert1 ,alexander--protest regarding ,pineoleum advertising methods1 #ddc ,lanphear1 ,emory--and the ,medical ,society of the ,united ,states1 #eca ,lavoris1 #bcg ,lavoris 7,lavoris ,chemical ,company71 ,the ,journal1 ,nov4 #a1 #aiai1 p4 #achj2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ce4 ,laxaphen 7,parke1 ,davis ,co471 ,the ,journal1 ,april #cj1 #aiaj1 p4 #adeh1 ,propaganda1 ed4 #i1 p4 #cdd4 ,laxine 7,columbus ,pharmacal ,co471 ,the ,journal1 ,april #cj1 #aiaj1 p4 #adeh2 ,propaganda1 ed4 #i1 p4 #cdd4 ,laxol and ,lysol1 the short and catchy proprietary name1 #egj ,laxothalen ,tablets 7,pitman-,moore ,co471 ,the ,journal1 ,april #cj1 #aiaj1 p4 #adeh2 ,propaganda1 ed4 #i1 p4 #cdd4 ,lecibrin1 #ec ,lecibrin 7,fairchild ,bros4 and ,foster71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #abb4 ,lecithin1 ,glycerole of1 #ec ,lecithin ,preparations1 #ec1 #ed ,lecithin1 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #abb4 ,lecithin ,solution1 #ec ,lecithin ,solution 7,fairchild ,bros4 ,foster71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #abb4 ,lecithine1 ,gare's ,granular 7,gare ,pharmacal ,co471 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ef4 ,lecithol1 #ec ,lecithol 7,armour ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #abb4 ,leeming1 ,thos41 and ,co--,trimethol1 #adj ,lehn and ,fink--,aspirin1 #cdg ,leptinol1 ,syrup 7formerly ,syrup ,balsamea71 #bfh ,lettuce ,calmative 7,nelson1 ,baker ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,lettuce1 ,wild1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,leucocytic ,extract1 ,archibald's 7,the ,western ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #fe4 ,levy1 ,david ,b41 ,inc4--,iodeol and ,iodagol1 #aed ,libby's ,alcresta ,lotion1 #dfe ,libradol1 #bic ,libradol 7,lloyd ,bros471 ,reports ,council ,pharm4 ,chem41 #aij1 p4 #fe4 ,lilly1 ,eli1 and ,co4-- ,alcresta ,ipecac1 #aec ,catarrhal ,vaccine ,combined-,lilly1 #ahg ,cephaelin1 #bjc ,influenza ,mixed ,vaccine-,lilly1 #ahg ,oxyl-,iodide1 #cjd ,rheumalgine1 #bc ,syrup ,cephaelin-,lilly1 #bjc ,syrup ,emetic-,lilly1 #bjc ,linder1 ,c4 ,o41 and the ,allied ,medical ,associations of ,america1 #dhi ,lipoidal ,substances 7,horovitz71 #cbj ,liquid ,albolene1 #ajf ,liquid ,iodex1 #cfe ,liquid ,peptone 7,eli ,lilly ,co42 ,stevenson ,jester ,co471 ,the ,journal1 ,may #aa1 #aijg1 p4 #afab2 ,reports ,council ,pharm4 ,chem41 #aije-h1 opp4 p4 #fd2 ,propaganda1 ed4 #i1 p4 #acc4 ,liquid ,peptones with ,creosote 7,eli ,lilly ,co471 ,the ,journal1 ,may #aa1 #aijg1 p4 #afab2 ,reports ,council ,pharm4 ,chem41 #aije-h1 opp4 p4 #fd2 ,propaganda1 ed4 #i1 p4 #acc4 ,liquid ,petrolatum1 #ebf ,liquid ,petrolatum1 ,iodolene and the solubility of ,iodin in1 #cdd ,liquid ,petrolatum1 proprietary names for1 #ee ,liquor ,santaiva1 ,s4 ,d41 #baa ,liquor ,santaiva1 ,s4 ,d4 7,sharp ,dohme71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ff4 ,lithia and ,hydrangea1 ,elixir 7,parke1 ,davis ,co42 ,ray ,chemical ,co42 ,smith1 ,kline ,french ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,lithiated ,sorghum ,compound 7,sharp ,dohme71 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,liver ,leaf1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dh4 ,lloyd ,bros4--,libradol1 #bic ,l4 ,o4 ,compound ,no4 #a and ,l4 ,o4 ,compound ,no4 #b1 ,tri-,arsenole1 #afc ,l4 ,o4 ,compound ,no4 #a and ,no4 #b 7,medical ,supply ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aef4 ,loeser's ,intravenous ,solutions1 #bii ,loeser's ,intravenous ,solution of ,hexamethylenamin1 #bii ,loeser's ,intravenous ,solution of ,mercury ,bichloride1 #bii ,loeser's ,intravenous ,solution of ,salicylate and ,iodid1 #bii ,loeser's ,intravenous ,solution of ,sodium ,iodid1 #bii ,loeser's ,intravenous ,solution of ,sodium ,salicylate1 #bii ,loffler's ,intravenous ,compound1 #dcj ,lowenthal ,postgraduate ,course1 #ebg ,lubricating ,jelly1 ,k-,y1 #adg1 #dff ,lucas ,laboratories' ,products1 #ddj ,lucas ,laboratories' ,products 7,lucas ,laboratories1 ,inc471 ,the ,journal1 ,sept4 #bj1 #aiai1 p4 #ibg4 ,luvein ,arsans1 ,nos4 #a1 #b and #c1 #dda ,luvein ,arsans 7,plain71 #ddj ,luvein ,arsans 7,plain7 7,lucas ,laboratories1 ,inc471 ,the ,journal1 ,sept4 #bj1 #aiai1 p4 #ibg4 ,luvein ,arsans1 ,nos4 #a1 #b and #c 7,lucas ,laboratories1 ,inc471 ,the ,journal1 ,sept4 #bj1 #aiai1 p4 #ibg4 ,luvein ,creosophite1 #dda ,luvein ,creosophite 7,lucas ,laboratories1 ,inc471 ,the ,journal1 ,sept4 #bj1 #aiai1 p4 #ibg4 ,luvein ,hexacol1 #daa ,luvein ,hexacol 7,lucas ,laboratories1 ,inc471 ,the ,journal1 ,sept4 #bj1 #aiai1 p4 #ibg4 ,luytie's ,homeopathic ,pharmacy--,succus ,cineraria ,maritima1 #dee ,lycetol1 #bad ,lycetol 7,the ,bayer ,co41 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #gj4 ,lymph ,compound ,r-,h 7,new ,animal ,therapy ,co471 ,the ,journal1 ,dec4 #ad1 #aiab1 p4 #bagf2 ,propaganda1 ed4 #i1 p4 #cag4 ,lymphoid ,compound 7,lowenthal71 #ebh ,lysoform 7,lysoform ,gesellschaft71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abf4 ,lysoform1 ,crude 7,lysoform ,gesellschaft71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abf4 ,lysol 7,lehn ,fink71 ,the ,journal1 ,dec4 #ad1 #aiab1 p4 #bagc2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ec2 ,propaganda1 ed4 #i1 p4 #cah4 ,lysol and ,laxol--the short and catchy proprietary name1 #egj ,mc,arthur's ,syrup of ,hypophosphites ,comp4 7,lime and ,soda71 #hd ,mc,kesson and ,robbins-- ,cin-,u-,form ,lozenges1 #bcg ,liquid ,albolene1 #ajf ,maizavena 7,wm4 ,s4 ,merrell ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,maizo-,lithium 7,henry ,pharmacal ,co471 ,the ,journal1 ,feb4 #f1 #aiae1 p4 #ebh2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #i2 ,reports ,chem4 ,lab41 #aiad1 p4 #fe2 ,propaganda1 ed4 #i1 p4 #aih4 ,malt ,extract with ,alteratives1 ,borcherdt's 7,borcherdt ,malt ,extract ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ea4 ,malt ,extract with ,pepsin and ,pancreatin 7,wm4 ,s4 ,merrell ,chemical ,co42 ,parke1 ,davis ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,malt ,extract with ,yerba ,santa1 ,borcherdt's 7,borcherdt ,malt ,extract ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #ach4 ,malt ,olive1 ,borcherdt's1 with ,hypophosphites1 #hd ,malt ,peptonates with ,arsenic1 ,borcherdt's 7,borcherdt ,malt ,extract ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #ach4 ,malt-,diastase ,company--,maltzyme with ,hypophosphites1 #hd ,maltine with ,olive ,oil and ,hypophosphites1 #hd ,maltzyme1 #baa ,maltzyme 7,maltzyme ,company71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fg4 ,maltzyme ,ferrated1 #baa ,maltzyme ,ferrated 7,maltzyme ,company71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fg4 ,maltzyme with ,cascara ,sagrada1 #baa ,maltzyme with ,cascara ,sagrada 7,maltzyme ,company71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fg4 ,maltzyme with ,cod ,liver ,oil1 #baa ,maltzyme with ,cod ,liver ,oil 7,maltzyme ,company71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fg4 ,maltzyme with ,hypophosphites1 #hd ,maltzyme with ,yerba ,santa1 #baa ,maltzyme with ,yerba ,santa 7,maltzyme ,company71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fg4 ,mammary ,gland1 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #dd4 ,manaca1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,manaca and ,salicylates ,compound1 ,elixir 7,hance ,bros4 ,white2 ,wm4 ,s4 ,merrell ,chemical ,co42 ,h4 ,k4 ,mulford ,co42 ,nelson1 ,baker ,co42 ,parke1 ,davis ,co42 ,ray ,chemical ,co42 ,smith1 ,kline ,french ,co42 ,sharp ,dohme2 ,f4 ,stearns ,co42 ,truax1 ,greene ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,manaca and ,salicylates ,compound1 ,elixir 7,sharp ,dohme71 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,manacaline 7,pullen-,richardson ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,manola 7,manola ,co471 ,the ,journal1 ,april #b1 #aiaj1 p4 #aaed2 ,reports ,chem4 ,lab41 #aiaj1 p4 #aje2 ,propaganda1 ed4 #i1 p4 #cbc4 ,marienbad ,tablets 7,j4 ,sicke71 ,the ,journal1 ,july #ah1 #aijh1 p4 #bcg4 ,mark ,white ,goiter ,serum1 #hg ,mark ,white ,iodinized ,oil1 #hg ,meat ,extract1 8,rex0 ,brand 7,cudahy ,packing ,co471 ,the ,journal1 ,jan4 #bc1 #aiji1 p4 #caa2 ,propaganda1 ed4 #i1 p4 #dgb4 ,meat ,juice1 ,valentine's 7,valentine's ,meat ,juice ,co471 ,the ,journal1 ,nov4 #bj1 #aiji1 p4 #aged2 ,may #b1 #aiad1 p4 #adai2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #acg2 #aiad1 p4 #ad2 ,propaganda1 ed4 #i1 pp4 #abc1 #abi1 #dgb4 ,medeol ,suppositories1 #aha ,medeol ,suppositories 7,medeol ,company1 ,inc471 ,the ,journal1 ,march #i1 #aiah1 p4 #gai2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #g4 ,medical ,society of the ,united ,states1 #eca ,medical ,supply ,company--,tri-,arsenole1 ,l4 ,o4 ,compound ,no4 #a and ,l4 ,o4 ,compound ,no4 #b1 #afc ,medinal1 #bci1 #cga ,med-,o-,lin 7,waverly ,oil ,works ,co471 ,the ,journal1 ,july #aj1 #aiae1 p4 #age2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agb4 ,mellier ,drug ,company-- ,ponca ,compound1 #bf ,tongaline1 #bf ,tongaline ,tablets1 #bg ,meningococcus ,serum 8,hoechst0 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,menley and ,james1 ,ltd4--,iodex and ,liquid ,iodex1 #cfe1 #dcf ,mennen1 ,house of--,kora-,konia1 #ib ,merck and ,company-- ,antithyroidin-,moebius1 #bjb ,barbital-,sodium 7,medinal or ,veronal-,sodium71 #cga ,bismuth ,tribromphenate1 #baf1 #cdi1 #ceb ,diethylbarbituric ,acid1 #cga ,mercol1 ,howell's 7,h4 ,b4 ,howell ,co41 ,ltd471 ,the ,journal1 ,jan4 #af1 #aiji1 p4 #bbe2 ,may #ae1 #aiji1 p4 #aeie2 ,propaganda1 ed4 #i1 p4 #cbf4 ,mercuric ,iodid1 ,red1 7,mercury ,biniodid7 comparative symptoms resulting from use of several oily suspensions of1 #abc ,mercury ,biniodid1 comparative symptoms resulting from use of several oily suspensions of red mercuric iodid1 #abc ,mercury ,sozoiodolate1 ,the ,journal1 ,feb4 #ac1 #aiji1 p4 #egc2 ,reports ,chem4 ,lab41 #aiji1 p4 #ai4 ,mercury ,sozoiodolate ,solution1 ,the ,journal1 ,feb4 #ac1 #aiji1 p4 #egc2 ,reports ,chem4 ,lab41 #aiji1 p4 #ai4 ,merrell1 ,w4 ,s41 ,chemical ,co4-- ,casta-,flora1 #aah ,proteogens1 #bbg1 #dde ,mervenol1 #bdi ,mervenol 7,hille ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #hb4 ,methaform1 #bab ,methaform 7,f4 ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fh4 ,methyl-,phenol ,serum 7,cano71 #bea ,methyl-,phenol ,serum 7,cano7 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #he4 ,methyl-,santal 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agc4 ,metz1 ,h4 ,a41 ,laboratories1 ,inc4-- ,anesthesin1 #bgf ,parathesin1 #bgf ,phenetidyl-,acetphenetidin ,hydrochlorid 7,holocain ,hydrochlorid71 #cgb ,procain-,novocain brand1 #cef ,micajah's ,suppositories1 #bda ,micajah's ,suppositories 7,micajah ,co471 ,the ,journal1 ,nov4 #bi1 #aiai1 p4 #agae2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #di4 ,micajah's ,wafers1 #bda ,micajah's ,wafers 7,micajah ,co471 ,the ,journal1 ,nov4 #bi1 #aiai1 p4 #agae2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #di4 ,micrococcus ,catarrhalis-,combined-,bacterin1 #ahd ,micrococcus ,catarrhalis-,combined-,bacterin 7,the ,abbott ,laboratories71 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,micrococcus ,neoformans ,vaccine1 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aeb4 ,migrainin 7,farbwerke-,hoechst ,co471 ,the ,journal1 ,june #e1 #aiji1 p4 #ahea2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #aje2 ,propaganda1 ed4 #i1 p4 #ace4 ,miller's ,iod-,izd-,oil1 #di ,millikin's ,acetylsalicylic ,acid1 #cdg ,minson's ,soluble ,iodin 8,kelpidine01 #afa ,minson's ,soluble ,iodin 8,kelpidine0 7,j4 ,j4 ,minson71 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aeb4 ,mist4 ,helonin ,comp4 7,schlotterbeck ,foss71 ,the ,journal1 ,dec4 #ah1 #aiae1 p4 #bahf4 ,mitchella ,compound 7,dr4 ,j4 ,h4 ,dye ,medical ,institute71 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,mixed ,vaccine ,no4 #dj1 ,sherman's1 #ahh ,mixed ,vaccine ,no4 #dj1 ,sherman's 7,g4 ,h4 ,sherman71 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,mon-,arsone1 #cjb1 #dib ,mon-,arsone 7,the ,hammer ,laboratories ,co471 ,the ,journal1 ,feb4 #bf1 #aiba1 p4 #eie2 ,june #ah1 #aiba1 p4 #agha2 ,reports ,chem4 ,labs41 #aibj1 p4 #fg2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #dg4 ,monsanto's ,acetylsalicylic ,acid 7,aspirin71 #cdg ,morphin ,sulphate ,hypodermic ,tablets1 #eff ,morphine ,meconate1 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #hd4 ,mother's ,cordial 7,eli ,lilly ,co471 ,the ,journal1 ,aug4 #ca1 #aiab1 p4 #gce2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df2 ,propaganda1 ed4 #i1 p4 #daj4 ,mother's ,cordial 7,ray ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,motherwort1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,mucol ,powder 7,mucol ,co41 ,inc471 ,the ,journal1 ,nov4 #ae1 #aiac1 p4 #ahab2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #dc2 ,propaganda1 ed4 #i1 p4 #cbi4 ,mulene1 #ccb ,mulene 7,mulene ,co471 ,the ,journal1 ,may #ai1 #aiag1 p4 #adig4 ,mulford1 ,h4 ,k41 ,company-- ,acetanilid ,compound--,mulford1 #bjf ,concentrated ,solution ,sodium ,hypochlorite1 #ceh ,granular ,effervescent ,bromide1 #bjf ,influenza ,serobacterin ,mixed--,mulford1 #ahg ,iron ,citrate ,green1 #aae ,mustard1 ,cream of1 #bah ,muthol 7,demuth's ,laboratories71 ,the ,journal1 ,july #aj1 #aiae1 p4 #age4 ,mystic ,chemical ,company--,olio-,phlogosis1 #gi ,naphey's ,medicated ,uterine ,wafers1 #ajg ,narkine 7,the ,tilden ,co471 ,the ,journal1 ,oct4 #bd1 #aijh p4 #adci2 ,propaganda1 ed4 #i1 p4 #cbi4 ,national ,bio-,chemical ,laboratory 7,therapeutic ,leaves71 #deh ,national ,drug ,company-- ,brom-,i-,phos1 #acf 8,national ,iodine ,solution01 #cjj ,national ,formulary--a review of the fourth edition1 #ece 8,national ,iodine ,solution01 #cjj ,national ,iodine ,solution 7,national ,drug ,co471 ,the ,journal1 ,june #d1 #aiba1 p4 #aeib2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ej4 ,national ,laboratories of ,pittsburgh-- ,anti-,syphilitic ,compound 7,sweeny71 #bff1 #bfh1 #ccj ,anti-,tuberculous ,lymph ,compound 7,sweeny71 #bff ,national ,medical ,university1 #daj ,natrium ,compound1 ,pulvoids4 ,see ,pulvoids ,natrium ,compound4 ,natura ,company--8,akoz01 #cbh ,nazol 7,nazol ,antiseptic ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ha4 ,neisser ,serobacterin ,mixed 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #fg4 ,nelson1 ,baker ,co4--,eupeptic ,hypophosphites1 #hc ,nephritin 7,reed ,carnrick ,co471 ,the ,journal1 ,oct4 #e1 #aijg1 p4 #aaih2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #gi4 ,nephroson 7,wm4 ,s4 ,merrell ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,nerve ,vitalizer1 ,wheeler's 7,j4 ,w4 ,brant ,co41 ,ltd471 ,the ,journal1 ,april #aa1 #aijh1 p4 #abjf2 ,reports ,chem4 ,lab41 to #aiji1 p4 #ff2 ,propaganda1 ed4 #i1 p4 #daa4 ,neuralgic ,pills1 #eff ,neurilla 7,dad ,chemical ,co471 ,the ,journal1 ,march #bg1 #aiae1 p4 #ajic2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #bj2 ,propaganda1 ed4 #i1 p4 #acf4 ,neurocaine 7,schieffelin ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agc4 ,neuro-,lecithin1 #ec ,neuro-,lecithin-,abbott 7,the ,abbott ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #abb4 ,neuro ,phosphates1 ,eskay's1 #adf ,neuro ,phosphates1 ,eskay's 7,smith1 ,kline ,french ,co471 ,the ,journal1 ,sept41 #bi1 #aiag1 p4 #aajb2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #eb4 ,neurosine 7,dios ,chemical ,co471 ,the ,journal1 ,jan4 #i1 #aiae1 p4 #afe2 ,april #bg1 #aiah1 p4 #abea2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #hf2 ,propaganda1 ed4 #i1 p4 #aci4 ,neurosine and the original package evil1 #djd ,new ,york ,intravenous ,laboratory-- ,arseno-,meth-,hyd1 #bca ,loeser's ,intravenous ,solutions1 #bii ,new ,york ,pharmacal ,association--,lactopeptine and ,elixir ,lactopeptine1 #dc 8,nikalgin01 #dfg ,noitol 7,wheeler ,chemical ,works71 ,the ,journal1 ,may #ba1 #aiaj1 p4 #agjd2 ,reports ,chem4 ,lab41 #aiaj1 p4 #de2 ,propaganda1 ed4 #i1 p4 #bde4 ,normal ,horse ,serum1 ,sterile 7,national ,vaccine and ,antitoxin ,institute71 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ec4 ,normal ,phenol ,serum 7,cano71 #bea ,normal ,phenol ,serum 7,cano7 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #he4 ,noron 7,the ,heron ,company71 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ec4 ,norwich ,pharmacal ,company--,alfatone1 #bh ,nose-,ions 7,nose-,ions ,company71 ,the ,journal1 ,dec4 #d1 #aiae1 p4 #bjbf2 ,reports ,chem4 ,lab41 #aiae1 p4 #abc4 ,nostrums in retrospect1 #cgi ,nostrums1 ,shotgun1 #cih ,nourry ,wine 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,dec4 #ab1 #aiad1 p4 #baej2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #gd2 ,propaganda1 ed4 #i1 p4 #aae4 ,novocain1 ,procain1 #cge ,novocaine1 #cee ,nuclein1 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ed4 ,nuclein1 ,triple ,arsenates with1 #bef ,nucleinic ,acid1 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ed4 ,nujol1 #ajh ,nujol 7,standard ,oil ,co4 of ,new ,jersey71 ,the ,journal1 ,july #aj1 #aiae1 p4 #age2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #fh4 ,number 8#c01 #bdd1 #bdg ,number 8#c0 7,chlorine ,products ,company1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #gj4 ,nutone1 #afb ,nu,tone 7,nu,tone ,company71 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aed4 ,nutrient ,wine of ,beef ,peptone 7,armour ,co471 ,the ,journal1 ,may #aa1 #aijg1 p4 #afab2 ,reports ,council ,pharm4 ,chem41 #aije-h1 opp4 p4 #fd2 ,propaganda1 ed4 #i1 p4 #acc4 ,nutritive ,liquid ,peptone 7,parke1 ,davis ,co471 ,the ,journal1 ,may #aa1 #aijg1 p4 #afab2 ,reports ,council ,pharm4 ,chem41#aije-h1 opp4 p4 #fd2 ,propaganda1 ed4 #i1 p4 #acc4 ,nutrolactis1 #aca ,nutrolactis 7,the ,nutrolactis ,co471 ,the ,journal1 ,may #bf1 #aiag1 p4 #aegj2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #bd4 ,nuxated ,iron 7,dae ,health ,laboratories71 ,the ,journal1 ,oct4 #ba1 #aiaf1 p4 #abdd2 ,oct4 #bh1 #aiaf1 p4 #acji2 ,nov4 #d1 #aiaf1 p4 #acgf2 ,feb4 #bd1 #aiag1 p4 #fdb2 ,reports ,chem4 ,lab41 #aiaf1 p4 #bi4 ,oats1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,ogden1 ,willard ,ealon1 and his cure for piles1 #ech ,ohio ,state ,department of ,health protests use of name in advertisements of ,proteogens1 #ddf ,ohmann-,dumesnil1 ,a4 ,h41 #eca ,oleum ,iodine1 ,b4 oleum iodine1 #aih ,olio-,phlogosis1 #gi ,olio-,phlogosis 7,mystic ,chemical ,company71 ,the ,journal1 ,aug4 #ai1 #aiaf1 p4 #fca2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #aj4 ,olive ,oil and ,hypophosphites1 ,maltine with1 #hd ,ophthalmol-,lindemann1 #ahi ,ophthalmol-,lindemann 7,innis1 ,speiden ,co471 ,the ,journal1 ,july #f1 #aiah1 p4 #ei2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ba4 ,orchitic ,fluid ,tablets 7,new ,animal ,therapy ,co471 ,the ,journal1 ,dec4 #ad1 #aiab1 p4 #bagf2 ,propaganda1 ed4 #i1 p4 #cag4 ,orsudan 7,burroughs ,wellcome ,co471 ,the ,journal1 ,april #af1 #aiaj1 p4 #acbc4 ,oscilloclast1 #dgb ,osmium ,tetroxide1 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ee4 ,ottofy1 ,l4 ,m41 and ,the ,allied ,medical ,associations of ,america1 #dhg ,ova ,mammoid 7,lowenthal71 #ebh ,oxychlorine 7,oxychlorine ,co471 ,the ,journal1 ,july #f1 #aijg1 p4 #ed2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #fh2 ,propaganda1 ed4 #i1 p4 #adg4 ,oxydendron ,compound1 ,fluidextract 7,nelson1 ,baker ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,oxygen ,water1 ,aquazone1 #bij ,oxyl-,iodide1 #cjd ,oxyl-,iodide 7,eli ,lilly and ,co471 ,the ,journal1 ,july #b1 #aiba1 p4 #eg2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ef4 ,oxyntin 7,fairchild ,bros4 and ,foster71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agd4 ,palmetto ,compound 7,wm4 ,s4 ,merrell ,chem4 ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd4 ,palpebrine 7,dios ,chemical ,co471 ,the ,journal1 ,jan4 #i1 #aiae1 p4 #afg2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #hf2 ,propaganda1 ed4 #i1 p4 #aci4 ,pam-ala 7,pam-,ala ,co471 ,the ,journal1 ,feb4 #bh1 #aiad1 p4 #gae2 ,propaganda1 ed4 #i1 p4 #adi4 ,pancreas ,comp41 ,caps1 #bai ,pancreopepsin1 ,liquid 7,wm4 ,r4 ,warner ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,pan-peptic ,elixir 7,sharp ,dohme71 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,papain1 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ebb4 ,pa-pay-ans1 ,bell 7,bell ,co473 ,see ,bell-ans4 ,papine 7,battle ,co471 ,the ,journal1 ,april #bi1 #aiaa1 p4 #abgh2 ,reports ,chem4 ,lab41 #aiaa1 p4 #hb2 ,propaganda1 ed4 #i1 p4 #ccj4 ,para ,coto1 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #ci4 ,paracotoin1 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #ci4 ,paraffin ,films1 #ccj ,paraffin ,films1 formula for1 #ccc ,paraffin1 ,stanolind ,liquid1 #bad ,paraffins and paraffin preparations1 examination of1 #ccd ,parathesin1 #bgf ,parathesin 7,h4 ,a4 ,metz ,laboratories1 ,inc471 ,the ,journal1 ,nov4 #ac1 #aibj1 p4 #aceh2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #bg4 ,parke1 ,davis ,company-- ,apothesine1 #bfj ,corpora ,lutea 7,soluble ,extract71 #abh ,phylacogens1 #dda ,pituitary ,extract1 #eej ,pituitrin1 #eej ,ricord ,pills1 #dfh ,silvol1 #ahi ,therapeutic ,notes1 #eej ,thyreoidectin1 #bjb ,parresine1 #ccb ,pasadyne 7,john ,b4 ,daniel71 ,the ,journal1 ,march #h1 #aiac1 p4 #gff2 ,propaganda1 ed4 #i1 p4 #ccb4 ,pas-,avena 7,pas-,avena ,chemical ,company71 ,the ,journal1 ,march #g1 #aijh1 p4 #ghc2 ,reports ,chem4 ,lab41 to #aiji1 p4 #fi2 ,propaganda1 ed4 #i1 p4 #ccc4 ,pasiflora1 ,the ,journal1 ,march #ai1 #aiaj1 p4 #ihc2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ch2 ,propaganda1 ed4 #i1 p4 #aef4 ,pasiflora ,incarnata1 ,daniel's ,concentrated ,tincture of 7,john ,b4 ,daniel71 ,the ,journal1 ,march #ai1 #aiaj1 p4 #ihc2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #dd2 #aiab1 p4 #ch2 ,propaganda1 ed4 #i1 p4 #aef4 ,pasteur ,chemical ,company--,thermozine1 #ccd ,patch1 ,e4 ,l41 ,co4--,formitol ,tablets1 #bcf1 #bga ,patent-,law ,revision1 need for1 #agg ,patent ,laws and ,patent ,office ,practice1 #edb ,patent ,laws1 archaic1 #edc ,patent medicine1 physicians not against patent medicine but for protection of public1 #eac ,patenting therapeutic agents1 #edd ,patents perpetuated by trade names1 #edd ,pautauberge's ,solution 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,march #g1 #aiaj1 p4 #aefj4 ,peacock's ,bromides1 #djj ,pepsin and ,pancreatin ,compound1 ,elixir 7,eli ,lilly ,co471 ,the ,journal1 ,feb4 #f1 #aijg1 p4 #ecc4 ,pepsin and ,pancreatin ,compound1 ,tablets 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,pepsin and ,pancreatin1 ,elixir 7,eli ,lilly ,co42 ,sharp ,dohme2 ,smith1 ,kline ,french ,co42 ,f4 ,stearns ,co42 ,wm4 ,r4 ,warner ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,pepsin and ,pancreatin with ,caffein1 ,elixir 7,eli ,lilly ,co42 ,parke1 ,davis ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,pepsin1 ,bismuth and ,pancreatin1 ,elixir 7,parke1 ,davis ,co42 ,sharp ,dohme2 ,smith1 ,kline ,french ,co42 ,f4 ,stearns ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,pepsin1 ,bismuth1 ,strychnin and ,pancreatin1 ,elixir 7,parke1 ,davis ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,pepsin1 ,elixir ,lactated 7,h4 ,k4 ,mulford ,co42 ,parke1 ,davis ,co42 ,f4 ,stearns ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,pepsin1 ,pancreatin and ,bismuth1 ,elixir 7,eli ,lilly ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,pepsin1 ,pancreatin1 ,bismuth and ,strychnin1 ,elixir 7,eli ,lilly ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,pepsin1 ,strychnin1 ,bismuth and ,pancreatin1 ,elixir 7,sharp ,dohme71 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,peptenzyme1 ,elixir 7,reed ,carnrick ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc2 ,oct4 #e1 #aijg1 p4 #aaih2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #gi4 ,peptenzyme ,powder 7,reed ,carnrick ,co471 ,the ,journal1 ,oct4 #e1 #aijg1 p4 #aaih2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #gi4 ,peptic ,digestant 7,columbus ,pharmacal ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,peptic ,essence ,comp41 ,peters' 7,arthur ,peters ,co471 ,the ,journal1 ,feb4 #i1 #aijg1 p4 #ecc4 ,pepto-,mangan1 #chg ,pepto-,mangan 7,m4 ,j4 ,breitenbach ,co471 ,the ,journal1 ,sept4 #bc1 #aije1 p4 #icd2 ,april #f1 #aijg1 p4 #aaig2 ,dec4 #bi1 #aiag1 p4 #bbjb2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #aba2 ,propaganda1 ed4 #i1 p4 #aei4 ,peptone1 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #da4 ,peptonic ,elixir 7,wm4 ,s4 ,merrell ,chemical ,co471 ,the ,journal1 ,may #aa1 #aijg1 p4 #afab2 ,reports ,council ,pharm4 ,chem41 #aije-h1 opp4 p4 #fd2 ,propaganda1 ed4 #i1 p4 #acc4 ,perfection ,liquid ,food 7,perfection ,liquid ,food ,co471 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #dd2 ,reports ,chem4 ,lab41 #aiac1 p4 #hj4 ,pertussin1 #dfg ,pertussin 7,lehn ,fink71 ,the ,journal1 ,march #h1 #aiac1 p4 #gff2 ,propaganda1 ed4 #i1 p4 #ccd4 ,pertussis-,combined-,bacterin1 #ahe ,pertussis-,combined-,bacterin 7,the ,abbott ,laboratories71 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,peter1 ,arthur1 ,co4--,syrupus ,roborans 7,syrup ,hypophosphites ,comp4 with ,quinin1 ,strychnin and ,manganese71 #hb ,petrolatum1 ,liquid1 #ebf ,petrolatum1 ,liquid1 ,iodin in1 #cfg ,petrolatum1 ,liquid1 proprietary names for1 #ee ,petrolatum1 liquid1 solubility of ,iodin in1 #cdd ,pharmaceutical ,barnums1 #ede ,pharmacopeia1 the ,ninth ,decennial ,revision1 #edf ,phecolates 7,f4 ,waldo ,whitney71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abg2 ,propaganda1 ed4 #i1 p4 #agd4 ,phecolax 7,f4 ,waldo ,whitney71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abg2 ,propaganda1 ed4 #i1 p4 #agd4 ,phecotones 7,f4 ,waldo ,whitney71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abg2 ,propaganda1 ed4 #i1 p4 #agd4 ,phecozymes 7,f4 ,waldo ,whitney71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abg2 ,propaganda1 ed4 #i1 p4 #agd4 ,phenalein 7,pax ,chemical ,co471 ,the ,journal1 ,april #cj1 #aiaj1 p4 #adeh2 ,propaganda1 ed4 #i1 p4 #cdd4 ,phenalgin1 #cic ,phenalgin 7,etna ,chemical ,co471 ,the ,journal1 ,june #c1 #aije1 p4 #agia2 ,jan4 #bg1 #aiab1 p4 #bic2 ,feb4 #h1 #aiah1 p4 #ccg2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #h2 ,propaganda1 ed4 #i1 pp4 #aj1 #cce4 ,phenetidyl-,acetphenetidin ,hydrochlorid 7,holocain ,hydrochlorid71 #cgb ,pheno-,bromate 7,pheno-,bromate ,co471 ,the ,journal1 ,july #ad1 #aijf1 p4 #abe2 ,april #ah1 #aijh1 p4 #abhb2 ,propaganda1 ed4 #i1 p4 #cdc4 ,phenol1 ,methyl-,phenol ,serum 7,cano71 #bea ,phenol ,serum1 ,normal 7,cano71 #bea ,phenol ,sodique 7,hance ,bros4 ,white71 ,the ,journal1 ,nov4 #i1 #aijg1 p4 #afag2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #ii2 ,propaganda1 ed4 #i1 p4 #age4 ,phenolax ,wafers 7,upjohn ,co471 ,the ,journal1 ,april #cj1 #aiaj1 p4 #adeh2 ,propaganda1 ed4 #i1 p4 #cdd4 ,phenolphthalein ,laxative 7,el ,zernac ,co471 ,the ,journal1 ,april #cj1 #aiaj1 p4 #adeh2 ,propaganda1 ed4 #i1 p4 #cdd4 ,phenylcinchoninic ,acid1 ,u4 ,s4 ,p41 #cgc ,phillips' ,phospho-,muriate of ,quinine ,comp41 #aig ,phosphates1 ,wheeler's ,tissue1 #abi1 #dfc ,phosphoglycerate of ,lime 7,chapoteaut71 #ie ,phosphoglycerate of ,lime 7,chapoteaut7 7,e4 ,fougera and ,co41 ,inc471 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcd2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ce4 ,phospho-,muriate of ,quinine ,comp41 ,phillips'1 #aig ,phospho-,muriate of ,quinine ,comp4-,phillips 7,charles ,h4 ,phillips ,chemical ,co471 ,the ,journal1 ,oct4 #ai1 #aiah1 p4 #acce2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #cb4 ,phosphorcin ,compound1 #id ,phosphorcin ,compound 7,organic ,products ,company71 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcc2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #cd4 ,phosphorus1 ,amorphous1 ,the ,journal1 ,march #g1 #aiad1 p4 #gic2 ,march #bh1 #aiad1 p4 #ajcc2 ,propaganda1 ed4 #i1 p4 #dgh4 ,phosphorus1 ,amorphous1 ,pill1 ,s4 ,d4 7,sharp ,dohme71 ,the ,journal1 ,march #g1 #aiad1 p4 #gic2 ,march #bh1 #aiad1 p4 #ajcc2 ,propaganda1 ed4 #i1 #dgh4 ,phosphorus ,compound1 ,iron and ,arsenic1 ,hypodermic ,solution ,no4 #ac1 #bge ,phosphorus ,tonic1 ,compound1 ,dowd's 7,the ,richardson ,company71 ,the ,journal1 ,dec4 #bj1 #aiac1 p4 #bbeh2 ,propaganda1 ed4 #i1 p4 #dgf4 ,phospho-,vanadiol 7,vanadium ,chemical ,co471 ,the ,journal1 ,jan4 #ah1 #aiac1 p4 #bbe2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #g2 ,propaganda1 ed4 #i1 p4 #bji4 ,phylacogens1 #dda ,phylacogens 7,parke1 ,davis ,co471 ,the ,journal1 ,feb4 #a1 #aiac1 p4 #chd2 ,feb4 #bb1 #aiac1 pp4 #fjb1 #fae2 ,march #ae1 #aiac1 p4 #hdi2 ,aug4 #bi1 #aiad1 p4 #ghe2 ,nov4 #ae1 #aiai1 p4 #aedb2 ,propaganda1 ed4 #i1 p4 #cdf4 ,physicians' ,drug ,syndicate--,thymozene1 #dcb ,physician's ,league of ,illinois1 #ebi ,physician's stock in prescription products1 #edh ,phytin 7,a4 ,klipstein ,co471 ,the ,journal1 ,jan4 #cj1 #aiae1 p4 #def2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aca2 ,propaganda1 ed4 #i1 p4 #agh4 ,pil4 ,cascara ,compound-,robins1 #aag ,pil4 ,cascara ,comp4-,robins 7,a4 ,h4 ,robins ,co471 ,the ,journal1 ,jan4 #bg1 #aiag1 p4 #cjc2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #dg4 ,pil4 ,mixed ,treatment 7,chichester71 #caj ,pil4 ,mixed ,treatment 7,chichester7 7,hillside ,chemical ,co471 ,the ,journal1 ,oct4 #bb1 #aiba1 p4 #acee2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #fj4 ,pineal ,gland-,armour1 ,desiccated 7,armour ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fi4 ,pineal ,gland1 ,desiccated1 ,armour1 #bac ,pineal ,gland1 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fi4 ,pineal ,gland ,tablets--,armour1 #bac ,pineoleum advertising methods1 #ddb ,pineoleum 7,the ,pineoleum ,company71 ,the ,journal1 ,nov4 #a1 #aiai1 p4 #achj4 ,pinus ,canadensis1 ,kennedy's1 ,dark3 ,see ,darpin4 ,piperazine1 #bad ,piperazine 7,the ,bayer ,co41 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #gj4 ,piperazine ,water 7,lehn ,fink71 ,the ,journal1 ,feb4 #bi1 #aijh1 p4 #gjd4 ,pituitary ,extract in labor1 #eej ,pituitary ,gland ,preparations1 #edi ,pituitrin1 #eej ,pix ,cresol 7,pix ,cresol ,chemical ,co471 ,the ,journal1 ,june #aj1 #aiaa1 p4 #agch2 ,reports ,chem4 ,lab41 #aiaa1 p4 #cg2 ,propaganda1 ed4 #i1 p4 #bdg4 ,placento-,mammary ,comp41 ,caps1 #bai ,plantex1 ,proteogen ,no4 #a 7,plantex7 for cancer1 #bbg ,plasmon 7,plasmon ,milk ,products ,co471 ,reports ,chem4 ,lab41 #aiad1 p4 #hh4 ,platt's ,chlorides1 #bfc ,platt's ,chlorides 7,henry ,b4 ,platt71 ,the ,journal1 ,march #bg1 #aibj1 p4 #ijc2 ,reports ,chem4 ,lab41 #aibj1 p4 #bh2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #h4 ,plurasav1 ,young's 7,the ,plurasav ,co41 ,columbus1 ,ohio71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #hb4 8,pluriglandular0 mixtures1 #bah ,pluto ,spring ,water1 ,concentrated 7,french ,lick ,springs ,hotel ,co471 ,the ,journal1 ,march #bi1 #aiac1 p4 #ajac4 ,pneumonia1 camphor in1 #beg ,pneumo-,staph-,strep4 ,bacterin1 ,special ,bacterial ,vaccine ,no4 #c1 #bed ,pneumo-,staph-,strep-,coli ,bacterin1 ,special ,bacterial ,vaccine ,no4 #d1 #bed ,pneumo-,strep4 ,bacterin1 ,special ,bacterial ,vaccine ,no4 #aa1 #bed ,pneumo-,strep-,serum 7,h4 ,k4 ,mulford ,co471 ,the ,journal1 ,jan4 #ca1 #aibj1 p4 #cdb4 ,pollantin1 ,fall 7,fritzsche ,bros471 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #fi4 ,pollantin ,powder1 ,fall 7,fritzsche ,bros471 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #fi4 ,pollen ,antigen 7,lederle ,antitoxin ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fe4 ,pollen ,antigen-,lederle 7,fall ,type7 7,lederle ,antitoxin ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #de4 ,pollen ,antigen-,lederle 7,spring ,type7 7,lederle ,antitoxin ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #de4 ,ponca ,compound1 #bh ,ponca ,compound 7,mellier ,drug ,co471 ,the ,journal1 ,july #ag1 #aiae1 p4 #bfi2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df2 #aiad1 p4 #eh4 ,poslam 7,emergency ,laboratories71 ,the ,journal1 ,may #bb1 #aiji1 p4 #afgh2 ,reports ,chem4 ,lab41 #aiji1 p4 #be4 ,potassium ,iodo-,resorcin ,sulphonate1 ,the ,journal1 ,feb4 #aa1 #aiaa1 p4 #dda2 ,reports ,chem4 ,lab41 #aiaa1 p4 #ba4 ,prepared ,green ,bone1 ,russell1 #acd ,prescription products1 physician's stock in1 #edh ,probilin ,pills 7,schering ,glatz1 ,inc471 ,the ,journal1 ,aug4 #bd1 #aijg1 p4 #gjb2 ,nov4 #b1 #aijg1 p4 #aeda2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #gj2 ,propaganda1 ed4 #i1 p4 #cdd4 ,procain-,abbott1 #cef1 #cgg ,procain 7,calco71 #cgg ,procain 7,farbwerke-,hoechst ,co471 #ceg1 #cgg ,procain 7,metz71 #cgg ,procain 7,novocain71 #cge ,procain-,novocain brand1 #cef ,procain ,rector1 #cef1 #cgg ,procain1 standardization of1 and examination of market supply1 #cee ,proprietaries1 why they flourish1 #eeb ,proprietary medicine1 secret remedies and the principles of ethics1 #ega ,prostoid 7,lowenthal71 #ebh ,proteal ,therapy1 #did 8,proteal ,therapy0 and ,henry ,smith ,williams1 #ddc ,proteals 7,henry ,smith ,williams71 ,the ,journal1 ,july #f1 #aiah1 p4 #eh4 ,protein ,therapy1 ,nonspecific1 #ecf ,proteogen ,no4 #a 7,plantex7 for cancer1 #bbg ,proteogen ,no4 #b for rheumatism1 #bbg ,proteogen ,no4 #c for tuberculosis1 #bbg ,proteogen ,no4 #d for hay fever and bronchial asthma1 #bbg ,proteogen ,no4 #e for dermatoses1 #bbg ,proteogen ,no4 #f for chlorosis1 #bbg ,proteogen ,no4 #g for secondary anemia1 #bbg ,proteogen ,no4 #h for pernicious anemia1 #bbg ,proteogen ,no4 #i for goitre1 #bbg ,proteogen ,no4 #aj for syphilis1 #bbg ,proteogen ,no4 #aa for gonorrhea1 #bbg ,proteogen ,no4 #ab for influenza and pneumonia1 #bbg ,proteogens1 #bbf1 #dde ,proteogens 7,wm4 ,s4 ,merrell ,co471 ,the ,journal1 ,july #ab1 #aiai1 pp4 #aji and #abh2 ,july #bf1 #aiai1 p4 #bhh2 ,sept4 #f1 #aiai1 p4 #gha2 ,sept4 #bg1 #aiai1 p4 #ajjj2 ,oct4 #aa1 #aiai1 p4 #aaeb2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #bj4 ,proteogens1 alleged endorsement repudiated1 #ddf ,proteogens1 ,dr4 ,broeman's final report on1 #dej ,protonuclein1 #ei ,protonuclein 7,reed ,carnrick ,co471 ,the ,journal1 ,oct4 #e1 #aijg1 p4 #aaih2 ,oct4 #bd1 #aijh1 p4 #achh2 ,jan4 #a1 #aiaf1 p4 #dh2 ,reports ,council ,pharm4 chem41 #aije-h1 p4 #gi2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ij2 ,propaganda1 ed4 #i1 p4 #cdh4 ,protonuclein ,beta1 #ei ,protonuclein ,beta 7,reed ,carnrick ,co471 ,the ,journal1 ,jan4 #a1 #aiaf1 p4 #dh2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ij4 ,prunoids 7,sultan ,drug ,co471 ,the ,journal1 ,april #cj1 #aiaj1 p4 #adeh2 ,jan4 #b1 #aiae1 p4 #ga2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #acc2 ,reports ,chem4 ,lab41 #aiad1 p4 #fc2 ,propaganda1 ed4 #i1 pp4 #agh1 #cdd4 ,psora 7,pix ,cresol ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,pulvane1 #dej ,pulvoids1 ,calcylates1 #he ,pulvoids1 ,calcylates 7,drug ,products ,company71 ,the ,journal1 ,sept4 #i1 #aiaf1 p4 #hbg2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ah4 ,pulvoids ,calcylates ,compound1 #bbf ,pulvoids ,calcylates ,compound 7,the ,drug ,products ,co41 ,inc471 ,the ,journal1 ,june #ad1 #aiai1 p4 #aghd2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ai4 ,pulvoids ,natrium ,compound1 #ajh ,pulvoids ,natrium ,compound 7,drug ,products ,company1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #fi4 ,purdue ,frederick ,company--,gray's ,glycerine ,tonic1 #bd ,purgen 7,lehn ,fink71 ,the ,journal1 ,jan4 #e1 #aijg1 p4 #fd2 ,sept4 #ad1 #aijg1 p4 #ied2 ,propaganda1 ed4 #i1 p4 #cdi4 ,pyo-atoxin 7,h4 ,o4 ,hurley71 ,the ,journal1 ,feb4 #ad1 #aiad1 p4 #eeb2 ,reports ,chem4 ,lab41 #aiad1 p4 #cb2 ,propaganda1 ed4 #i1 p4 #cej4 ,pyocyaneus ,bacillus ,vaccine1 ,the ,journal1 ,may #ah1 #aiah1 p4 #adhf2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,pyxol 7,barrett ,mfg4 ,co471 ,the ,journal1 ,feb4 #bc1 #aiah1 p4 #eei4 ,quartonol ,tablets1 #id ,quartonol ,tablets 7,schering and ,glatz1 ,inc471 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcc2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #cd4 ,quassia ,compound ,tablets1 #cjf ,quassia ,compound ,tablets 7,flint1 ,eaton and ,company71 ,the ,journal1 ,july #i1 #aiba1 p4 #ada2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #fd4 ,queen of the ,meadow1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,quina ,la,roche 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,march #ba1 #aijh1 p4 #igh4 ,quinin and ,urea ,hydrochlorid1 #dfg ,quinin ,arsenate1 ,the ,journal1 ,july #af1 #aiaj1 p4 #cbe2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #gc4 ,quinin ,glycerophosphate1 ,reports ,chem4 ,lab41 #aiab1 p4 #ajg4 ,quinin ,laxative ,tablets1 #eff ,quinine ,comp41 ,phillips' ,phospho-,muriate of1 #aig ,rabbit-,foot ,therapy1 #ega ,radelium and ,radelium ,generator 7,radio-,active ,water ,company71 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #abh4 ,radio-,rem1 #gi ,radio-,rem ,outfit ,no4 #b1 ,no4 #c 7,schieffelin ,co471 ,the ,journal1 ,aug4 #ai1 #aiaf1 p4 #fca2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #i4 ,radio-,rem ,outfit ,c 7,schieffelin ,co471 ,the ,journal1 ,aug4 #ai1 #aiaf1 p4 #fca2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #i4 ,radium ,solution for ,intravenous ,use1 ,standard 7,radium ,chemical ,co471 ,the ,journal1 ,june #bf1 #aiae1 p4 #baef2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #adg4 ,rahtjen1 ,philip1 and his discoveries1 #eec ,rainey1 ,james ,m41 #ebh ,rattlesnake-,venom1 ,the ,journal1 ,march #ae1 #aiac1 p4 #hej2 ,march #bi1 #aiac1 p4 #ajja2 ,june #g1 #aiac1 p4 #ahaa4 ,rector ,chemical ,company-- ,barbital1 #cga ,procain-,rector1 #cef1 #cgg ,red ,bone-,marrow--,armour1 ,extract of1 #bac ,red ,bone-,marrow1 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fi4 ,red ,bone-,marrow--,armour1 ,extract of 7,armour ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fi4 ,red ,mercuric ,iodid 7,mercury ,biniodid7 comparative symptoms resulting from use of several oily suspensions of1 #abc ,redintol 7,johnson ,johnson71 ,the ,journal1 ,july #bh1 #aiag1 p4 #cjf4 ,reed and ,carnrick--,protonuclein and ,protonuclein ,beta1 #ei ,reinschild ,chemical ,company--,iodo-,mangan1 #ajf ,resinol 7,resinol ,chemical ,co471 ,the ,journal1 ,nov4 #f1 #aiji1 p4 #aegh2 ,propaganda1 ed4 #i1 p4 #ceb4 ,resor-,bisnol 7,resor-,bisnol ,chemical ,co471 ,the ,journal1 ,june #a1 #aiab1 p4 #agjf2 ,reports ,chem4 ,lab41 #aiab1 p4 #he2 ,propaganda1 ed4 #i1 p4 #cec4 ,respirazone 7,the ,tilden ,company71 ,the ,journal1 ,june #ad1 #aiac1 p4 #ahii4 ,restorative ,capsules1 #dbe ,rheumalgine1 #bc ,rheumalgine 7,eli ,lilly ,co471 ,the ,journal1 ,june #bf1 #aiae1 p4 #baef2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #adh4 ,rheumatic and ,gout ,pills1 ,de ,sanctis'1 #cfc ,rheumatic ,bacterin 7,mixed71 7,no4 #dg71 ,swan's 7,swan-,myers ,co471 ,the ,journal1 ,nov4 #f1 #aiae1 p4 #affb2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #afj4 ,rheume ,olum 7,rheumeolum ,chemical ,co471 ,the ,journal1 ,march #ag1 #aiag1 p4 #hfe2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #ai4 ,ricinol-,grape ,tape-,worm ,remedy 7,grape ,capsule ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agd4 ,ricord ,pills and house organ therapeutics41 #dfh ,riedel and ,company1 ,inc4--,gonosan1 #aej ,robinol1 #ie ,robinol 7,john ,wyeth ,bro471 ,the ,journal1 ,july #f1 #aiad1 p4 #di2 ,sept4 #cj1 #aiaf1 p4 #ajcd2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #cd2 ,propaganda1 ed4 #i1 p4 #cec4 ,robins1 ,a4 ,h41 ,company-- ,campetrodin and ,campetrodin ,no4 #b1 #aic ,pil1 ,cascara ,compound--,robins1 #aag ,robinson-,pettet ,company-- ,robinson's ,hypophosphites1 #hc ,saloform1 #aaj ,robinson's 8,cure0 for ,cancer--,tekarkin1 #deh ,robinson's ,hypophosphites1 #hc ,roborans1 ,syrupus1 7,syrup ,hypophosphites ,comp4 with ,quinin1 ,strychnin and ,manganese71 #hb ,rogers1 ,l4 ,d4--,auto-,hemic ,serum1 #dji ,rogers1 ,r4 ,r41 ,chemical ,company--,unctol1 #aff ,royal ,thermophor ,sales ,co4--,thermor ,waterless ,hot ,bottle1 #cbi ,russell ,emulsion1 #acd ,russell ,emulsion 7,the ,standard ,emulsion ,co471 ,the ,journal1 ,june #bc1 #aiag1 p4 #aica2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #bi4 ,russell ,prepared ,green ,bone1 #acd ,russell ,prepared ,green ,bone 7,the ,standard ,emulsion ,co471 ,the ,journal1 ,june #bc1 #aiag1 p4 #aica2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #bi4 ,sal-,codeia1 ,bell 7,bell ,co471 ,the ,journal1 ,nov4 #d1 #aije1 p4 #adbb2 ,propaganda1 ed4 #i1 p4 #ceg4 ,sal ,hepatica1 #dea ,sal ,hepatica 7,bristol-,myers ,co471 ,the ,journal1 ,march #bf1 #aiaj1 p4 #ajga2 ,feb4 #g1 #aiad1 p4 #dbg2 ,april #ab1 #aiai1 p4 #ajgh2 ,oct4 #bi1 #aiba1 p4 #adch2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #g2 ,propaganda1 ed4 #i1 p4 #agi4 ,sal ,hyl 7,new ,york ,salesthyl ,corporation71 ,the ,journal1 ,feb4 #bj1 #aiae1 p4 #fhd2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #acd4 ,salacetin 7,bell ,co471 ,the ,journal1 ,june #c1 #aije1 p4 #agia2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #h2 ,propaganda1 ed4 #i1 p4 #aeb4 ,salen 7,a4 ,klipstein ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aee4 ,salenal 7,a4 ,klipstein ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aee4 ,salesthyl 7,new ,york ,salesthyl ,corporation71 ,the ,journal1 ,feb4 #bj1 #aiae1 p4 #fhd2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #acd4 ,salicon1 #dec ,salicylic ,acid1 8,natural10 ,the ,journal1 ,sept4 #bj1 #aiac1 p4 #igi2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #bc4 ,saliodin 7,saliodin ,chemical ,co471 ,the ,journal1 ,oct4 #bf1 #aijg1 p4 #adec2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #ie2 ,propaganda1 ed4 #i1 p4 #bdi4 ,salit 7,heyden ,chemical ,works71 ,the ,journal1 ,june #e1 #aiji1 p4 #aheb2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #ajf4 ,saloform1 #aaj ,saloform 7,robinson-,pettet ,company71 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ga2 ,reports ,chem4 ,lab41 #aiaf1 p4 #cf4 ,salol ,tablets1 #eff ,salvarsan3 abrogate the patent1 #dic ,sanatogen 7,bauer ,chemical ,co471 ,the ,journal1 ,april #bj1 #aiab1 p4 #abaf2 ,dec4 #f1 #aiac1 p4 #bjhe2 ,march #bh1 #aiad1 p4 #ajce2 ,sept4 #bf1 #aiad1 p4 #aabg2 ,reports ,chem4 ,lab41 #aiab1 p4 #ga2 ,propaganda1 ed4 #i1 pp4 #ceh1 #cgh1 #che4 de ,sandfort's ,ambrine1 #ccj ,sanmetto 7,the ,od ,chemical ,co471 ,the ,journal1 ,july #h1 #aije1 p4 #aaf2 ,march #ac1 #aiae1 p4 #ibf2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ag2 ,propaganda1 ed4 #i1 p4 #ahb4 ,sanol 7,expurgo ,mfg4 ,co471--,see ,expurgo ,anti-,diabetes4 ,santaiva1 ,s4 ,d4 ,liquor1 #baa ,santal ,midy ,capsules 7,e4 ,fougera ,co471 ,the ,journal1 ,oct4 #i1 #aibj1 p4 #ajaf4 ,saphanol ,aromatic 7,saphanol ,products ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ff4 ,saphanol ,concentrate 7,saphanol ,products ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #ff4 ,schering and ,glatz1 ,inc4-- ,arhovin1 #bdc ,atophan1 #cac ,cinchophen 7,phenylcinchoninic ,acid1 ,u4 ,s4 ,p42 ,atophan71 #cgc ,medinal1 #bci ,tonols 7,schering's ,glycerophosphates71 #id ,urotropin1 #caf ,schieffelin and ,company-- ,colalin1 #bjc ,estivin1 #dff ,radio-,rem1 #gi ,schlotterbeck's ,solution ,hypophosphites of ,lime and ,soda 7,liq4 ,hypophosphitum1 ,schlotterbeck's71 #hc ,schmidt's ,antimeristem1 #djh ,schoonmaker ,laboratories1 ,inc4--,v-,e-,m1 #aff ,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 ,scott ,creosotonic1 #aib1 #aic ,scott ,iodinized ,emulsion1 #aib ,scullcap ,compound1 ,fluidextract 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc4 ,secretin-,beveridge 7,james ,wallace ,beveridge71 ,the ,journal1 ,jan4 #ab1 #aiah1 p4 #aaf2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #abj4 ,secretin-,beveridge and the ,u4 ,s4 ,patent ,law1 #agj ,secretin-,beveridge1 question of stability of1 #aga ,secretin1 commercial preparations of1 #ge ,secretin1 has it a therapeutic value81 #fe ,secretin ,preparations1 ,so-called1 #fd1 #ded ,secretogen1 #ge1 #aaj ,secretogen ,elixir 7,g4 ,w4 ,carnrick ,co471 ,the ,journal1 ,nov4 #a1 #aiac1 p4 #afdi2 ,may #a1 #aiae1 p4 #aeah2 ,sept4 #i1 #aiaf1 p4 #hbh2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #df2 #aiaf1 p4 #gb2 ,propaganda1 ed4 #i1 p4 #ahe4 ,secretogen ,tablets 7,g4 ,w4 ,carnrick ,co471 ,the ,journal1 ,nov4 #a1 #aiac1 p4 #afdi2 ,may #a1 #aiae1 p4 #aeah2 ,jan4 #ae1 #aiaf1 pp4 #agh1 #bjh2 ,sept4 #i1 #aiaf1 p4 #hbh2 ,reports ,council ,pharm4 ,chem41 #aiae1 pp4 #df1 #if1 #ii2 #aiaf1 p4 #gb2 ,propaganda1 ed4 #i1 p4 #ahe4 ,sedobrol 8,roche0 7,hoffmann-,la,roche ,chemical ,works71 ,the ,journal1 ,jan4 #b1 #aiae1 p4 #ga2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #acd4 ,seleni-,bascca1 #daf ,seleni-,bascca 7,cosmopolitan ,cancer ,research ,society71 ,the ,journal1 ,nov4 #ai1 #aiba1 p4 #afgb4 ,selenium in cancer1 #ejf ,semprolin 7,w4 ,browning ,co471 ,the ,journal1 ,july #aj1 #aiae1 p4 #age4 ,seng1 #ee ,seng 7,sultan ,drug ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db2 #aiae1 p4 #abi4 ,serum ,vaccine1 ,bruschettini 7,r4 ,g4 ,berlingieri71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abg4 ,serums1 #eba ,seufert1 ,l4 ,b41 ,secretary1 ,direct ,sales ,company1 #eaj ,seven-,bark1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,sevetol 7,john ,wyeth ,bro471 ,the ,journal1 ,july #f1 #aiad1 p4 #di2 ,propaganda1 ed4 #i1 p4 #cec4 ,sextonol ,tablets1 #id ,sextonol ,tablets 7,schering ,glatz1 ,inc471 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcc2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #cd4 ,sharp and ,dohme-- ,elixir ,glycerophosphates1 ,nux ,vomica and ,damiana1 #ie ,liquor ,santaiva1 #baa ,surgodine1 #ahj ,sherman1 ,g4 ,h41 on vaccines in toxic conditions1 #efj ,sherman's ,mixed ,vaccine ,no4 #dj4 ,see ,mixed ,vaccine ,no4 #dj1 ,sherman's4 ,shotgun ,nostrums1 #cih ,silvol1 #ahi ,sinclair1 ,upton1 defense of ,abrams by1 #dgg ,sinkina 7,metropolitan ,pharmacal ,co471 ,the ,journal1 ,sept4 #bg1 #aiac1 p4 #ajef2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #bd2 ,propaganda1 ed4 #i1 p4 #ahh4 ,sirolin 7,sirolin ,co471 ,the ,journal1 ,june #ba1 #aiac1 p4 #aigd4 ,smith1 ,kline ,french ,co4--,eskay's ,neuro ,phosphates1 #df ,soamin1 #bec ,soamin ,tabloid 7,burroughs ,wellcome ,co471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #hi4 ,sodium ,acetate in warming bottles1 #cbi ,sodium ,cacodylate in syphilis1 #eee ,sodium ,carbonate and ,sodium ,chloride ,mixture for making ,fisher's ,hypertonic ,alkaline ,solution 7,e4 ,r4 ,squibb ,sons71 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adg4 ,sodium ,glycerophosphate1 #ii ,sodium ,glycerophosphate1 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #eb4 ,sodium ,hypochlorite-,mulford1 ,concentrated ,solution1 #ceh ,sodium ,hypochlorite ,solutions 78,chlorinated ,soda0 ,solutions71 ,deterioration of1 #ceh ,sodium ,salicylate1 8,natural10 ,the ,journal1 ,sept4 #bj1 #aiac1 p4 #igi2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #bc4 ,sodium ,salicylate1 ,strontium ,salicylate not superior to1 #egb ,sodium ,salicylate ,tablets1 #eff ,sofos 7,general ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #fg4 ,solution ,hypophosphites of ,lime and ,soda 7,liq4 ,hypophosphitum1 ,schlotterbeck's71 #hc ,solution ,hypophosphites of ,lime and ,soda1 ,schlotterbeck's 7,liq4 ,hypophosphitum1 ,schlotterbeck's71 7,schlotterbeck and ,foss ,co471 ,the ,journal1 ,sept4 #b1 #aiaf1 p4 #gfa2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ad4 ,somnoform1 #bee ,somnoform 7,stratford-,cookson ,co471 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ij4 ,somnos 7,h4 ,k4 ,mulford ,co471 ,the ,journal1 ,sept4 #ae1 #aijf1 pp4 #hfc1 #hgb2 ,sept4 #bi1 #aijf1 p4 #ajcc2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #ab2 ,propaganda1 ed4 #i1 p4 #aic4 ,sourwood1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,sourwood ,compound1 ,elixir 7,eli ,lilly ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,sourwood ,compound1 ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,sourwood ,compound 7,special71 ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,special ,bacterial vaccine ,nos4 #b1 #c1 #d1 #e1 #aa1 #ae1 and #af1 #bed ,spermin1 ,poehl 7,prof4 ,dr4 v4 ,poehl ,soehne71 ,the ,journal1 ,april #ae1 #aiaa1 p4 #aacb2 ,propaganda1 ed4 #i1 p4 #cie4 ,spirocide1 #bif ,spirocide 7,the ,spirocide ,corp471 ,the ,journal1 ,jan4 #bb1 #aiba1 p4 #bei2 ,july #cj1 #aiba1 p4 #cid2 ,reports ,chem4 ,lab41 #aibj1 p4 #eh2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #df4 ,spondylotherapy1 #dgb ,squaw-,vine1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #de4 ,squaw-,vine and ,black-,haw ,compound1 ,elixir 7,eli ,lilly ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,squaw-,vine ,compound1 ,syrup 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,squibb1 ,e4 ,r41 and ,sons-- ,acetylsalicylic ,acid1 #cdg ,iron ,citrate ,green1 #aae ,s4 ,s4 ,products ,company--,arsenoven ,s4 ,s41 #bca ,standard ,appliance ,company--,uri-,na ,test1 #dih ,standard ,emulsion ,company-- ,russell ,emulsion and ,russell ,prepared ,green ,bone1 #acd ,standard ,oil ,company of ,indiana-- ,stanolind ,liquid ,paraffin1 #bad ,stanolind ,surgical ,wax1 #ccg ,standard ,oil ,company of ,new ,jersey--,nujol1 #ajh ,stannoxyl1 #dfi ,stannoxyl 7,e4 ,fougera ,co471 ,the ,journal1 ,march #f1 #aibj1 p4 #fib4 ,stanolind ,liquid ,paraffin1 #bad ,stanolind ,liquid ,paraffin 7,standard ,oil ,company of ,ind471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #gb4 ,stanolind ,surgical ,wax1 #ccg ,staph-,strep4 ,bacterin1 ,vaccine ,no4 #b1 ,special ,bacterial1 #bed ,stearns1 ,frederick ,co4-- ,alphozone1 #ii ,methaform1 #bab ,stearns' ,wine1 #ei ,stearns' ,wine1 #ei ,sterling ,products ,company and 8,aspirin ,bayer01 #dhe 8,sterling ,violet ,ray ,generator01 #egb ,stillingia ,compound1 ,elixir 7,hance ,bros4 ,white2 ,ray ,chemical ,co42 ,smith1 ,kline ,french ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,stillingia ,compound1 ,fluidextract 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,stillingia ,compound1 ,syrup 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #db4 ,stock1 ,physician's1 in ,prescription ,products1 #edh ,stone ,root1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,stratford-,cookson ,company--,somnoform1 #bee ,streptococcus-,rheumaticus-,combined-,b acterin1 #ahe1 #ahf ,streptococcus-,rheumaticus-,combined-,b acterin 7,the ,abbott ,laboratories71 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,streptococcus-,viridans-,combined-,bact erin1 #ahe1 #ahf ,streptococcus-,viridans-,combined-,bact erin 7,the ,abbott ,laboratories71 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,strontium ,salicylate not superior to ,sodium ,salicylate1 #egb ,strychnin ,arsenate1 ,the ,journal1 ,sept4 #bd1 #aiaj1 p4 #aabh2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #gd4 ,stypticin1 #bdj ,stypticin1 ,the ,journal1 ,nov4 #bb1 #aiai1 p4 #afbh2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #dh4 ,styptol1 #bdj ,styptol 7,e4 ,bilhuber71 ,the ,journal1 ,nov4 #bb4 #aiai1 p4 #afbh2 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #dh4 ,styptysate1 #cah ,succinate of ,soda1 ,bile ,salts and ,phenolphthalein1 ,capsules of1 #bjh ,succinate of ,soda1 ,holadin and ,bile ,salts1 ,capsules of1 #bjh ,succinolac 7,succinolac ,company71 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #gi4 ,succus ,alterans 7,eli ,lilly ,co471 ,the ,journal1 ,june #bf1 #aiji1 p4 #baae2 ,reports ,council ,pharm4 ,chem41 #aiji1 p4 #ajg2 ,propaganda1 ed4 #i1 p4 #aie4 ,succus ,cineraria ,maritima1 #dee ,succus ,cineraria ,maritima1 ,walker 7,walker ,pharmacal ,co471 ,the ,journal1 ,nov4 #aa1 #aiaa1 p4 #afcj2 ,march #ag1 #aiag1 p4 #hfd2 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #dh2 ,propaganda1 ed4 #i1 p4 #ej4 ,sukro-,serum1 #bgc ,sukro-,serum 7,anglo-,french ,drug ,co471 ,the ,journal1 ,aug4 #ba1 #aibj1 p4 #eef2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #bc4 ,sulfo-,selene1 #dag ,sulfuryl ,monal1 #hf ,sulfuryl ,monal 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,sept4 #af1 #aiaf1 p4 #hie2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #bb2 ,reports ,chem4 ,lab41 #aiaf1 p4 #bc4 ,sulpho-,lythin 7,laine ,chemical ,co471 ,the ,journal1 ,dec4 #h1 #aijf1 p4 #aicj2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #cd2 ,propaganda1 ed4 #i1 p4 #aif4 ,sulpho-,selene 7,c4 ,h4 ,walker71 ,the ,journal1 ,april #ag1 #aiae1 p4 #abhc2 ,dec4 #af1 #aiae1 p4 #ahfd2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #bh2 #aiaf1 p4 #hj4 ,sultan ,drug ,co4-- ,cactina ,pillets1 #cia ,seng1 #ee ,supsalvs1 #bgd ,supsalvs 7,anglo-,french ,drug ,co474 ,the ,journal1 ,oct4 #cj1 #aibj1 p4 #abai2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #be4 ,surgodine1 #ahj ,surgodine 7,sharp ,dohme71 ,the ,journal1 ,jan4 #bf1 #aiah1 p4 #beg2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #acd2 ,reports ,chem4 ,lab41 #aiag1 p4 #ei4 ,swan-,myers ,company--,di-,crotalin1 #dfe ,sweeny1 ,anti-,tuberculous ,lymph ,compound1 #bff ,sweeny's ,anti-,syphilitic ,compound1 #bfh1 #ccj ,synthetic drugs1 ,american-,made1 #cdd1 #cfi ,synthetic drug situation1 #cgf ,syphilis1 sodium cacodylate in1 #eee ,syphilodol1 #cei1 #dgj ,syphilodol 7,french ,medicinal ,company1 ,inc471 ,the ,journal1 ,may #ah1 #aiah1 p4 #adhe4 ,syrup ,balsamea1 #bfh ,syrup ,cephaelin-,lilly1 #bjc ,syrup ,cocillana ,compound 7,parke1 ,davis ,co471 ,the ,journal1 ,march #ah1 #aiaa1 p4 #hcd2 ,feb4 #ae1 #aiac1 p4 #ecg2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dc2 ,propaganda1 ed4 #i1 p4 #cif4 ,syrup ,emetic-,lilly1 #bjc ,syrup ,emetic-,lilly 7,eli ,lilly ,co474 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #eb4 ,syrup1 ,fellows'1 of ,hypophosphites1 #hb ,syrup1 ,gardner's1 of ,ammonium ,hypophosphite1 #ajj ,syrup of ,ammonium ,hypophosphite1 ,gardner's1 #ajj ,syrup of ,ammonium ,hypophosphite1 ,gardner's 7,r4 ,w4 ,gardner71 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ee4 ,syrup of ,hydriodic ,acid1 ,gardner's 7,r4 ,w4 ,gardner71 ,the ,journal1 ,nov4 #ad1 #aijh1 p4 #agab2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #bjj2 ,propaganda1 ed4 #i1 p4 #ig4 ,syrup of ,hypophosphites ,comp4 7,lime and ,soda7 ,mc,arthur's1 #hd ,syrup of the ,hypophosphites ,comp4 7,lime and ,soda71 ,mc,arthur's 7,mc,arthur ,hypophosphite ,co471 ,the ,journal1 ,sept4 #b1 #aiaf1 p4 #gfa2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #af4 ,syrup of ,hypophosphites1 ,fellow's1 #hb ,syrup of ,hypophosphites1 ,fellows' 7,fellows ,medical ,mfg4 ,co471 ,the ,journal1 ,sept4 #b1 #aiaf1 p4 #gfj2 ,feb4 #af1 #aiah1 p4 #dgh2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ac4 ,syrup ,iron ,iodid1 ,u4 ,s4 ,p41 #eff ,syrup ,leptinol 7,balsamea ,co471 ,the ,journal1 ,june #e1 #aibj1 p4 #aeia2 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #ae4 ,syrup ,leptinol 7formerly ,syrup ,balsamea71 #bfh ,syrup of ,malt ,williams' 7,american ,malt ,extract ,co471 ,the ,journal1 ,sept4 #d1 #aiae1 p4 #hie2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aee4 ,syrup of ,thyme1 #dfg ,syrupus ,roborans 7,syrup ,hypophosphites ,comp4 with ,quinin1 ,strychnin and ,manganese71 #hb ,syrupus ,roborans 7,syrup ,hypophosphites ,comp4 with ,quinin1 ,strychnin and ,manganese7 7,arthur ,peter ,co471 ,the ,journal1 ,sept4 #b1 #aiaf1 p4 #gfj2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ad4 ,tablets3 dependability of dosage1 #eef ,tablets ,formothalates1 #bef ,tablets ,formothalates 7,tailby-,nason ,company71 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ib4 ,tablogestin 7,f4 ,h4 ,strong ,co471 ,the ,journal1 ,dec4 #aa1 #aiae1 p4 #bajh4 ,tailby-,nason ,company--,tablets ,formothalates1 #bef ,taka-,diastase 7,parke1 ,davis ,co471 ,the ,journal1 ,july #aa1 #aijh1 p4 #adj2 ,july #f1 #aiab1 p4 #ej2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #aaj2 #aiab1 p4 #ad2 ,propaganda1 ed4 #i1 p4 #fb4 ,taka-,diastase1 ,liquid 7,parke1 ,davis ,co471 ,the ,journal1 ,july #aa1 #aijh1 p4 #adj2 ,july #f1 #aiab1 p4 #ej2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #aaj2 #aiab1 p4 #ad2 ,propaganda1 ed4 #i1 p4 #fb4 ,tannyl 7,charles ,goslar71 ,reports ,chem4 ,lab41 #aiab1 p4 #ajh4 ,tartarlithine 7,tartarlithine ,co41 ,mc,kesson ,robbins71 ,the ,journal1 ,april #ac1 #aijg1 p4 #abhd2 ,propaganda1 ed4 #i1 p4 #dja4 ,taurocol ,compound ,tablets 7,paul ,plessner ,company71 ,the ,journal1 ,april #bd1 #aiae1 p4 #adda2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #adc2 ,propaganda1 ed4 #i1 p4 #aih4 ,taurocol ,tablets 7,paul ,plessner ,company71 ,the ,journal1 ,april #bd1 #aiae1 p4 #adda2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #adc2 ,propaganda1 ed4 #i1 p4 #aih4 ,tekarkin1 #deh ,tekarkin 7,national ,bio-,chemical ,laboratory71 ,the ,journal1 ,may #bh1 #aiba1 p4 #aead2 ,nov4 #ai1 #aiba1 p4 #afge4 ,terpin ,hydrate with ,codein ,sulphate1 ,elixir1 ,the ,journal1 ,april #ae1 #aiaf1 p4 #aaii4 ,textbooks1 fallibility of1 #eae ,thalosen 7,the ,abbott ,laboratories71 ,the ,journal1 ,april #cj1 #aiaj1 p4 #adeh2 ,propaganda1 ed4 #i1 p4 #cdd4 ,therapeutic evidence3 its crucial test1 #eeg ,therapeutic ,leaves1 #deh ,therapeutic ,notes1 #eej ,therapeutic ,notes1 ,ricord ,pills written up in1 #dfh ,thermor ,waterless ,hot ,bottle1 #cbi ,thermozine1 #ccb1 #ccd ,thermozine 7,pasteur ,chemical ,co471 ,the ,journal1 ,may #ai1 #aiag1 p4 #adig4 ,thialion1 #dgj ,thialion 7,vass ,chemical ,co471 ,the ,journal1 ,nov4 #c1 #aijf1 p4 #aejj2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #bf2 ,propaganda1 ed4 #i1 p4 #bje4 ,thioform 7,otto ,hann ,bro71 ,reports ,chem4 ,lab41 to #aiji1 p4 #gi4 ,thiosinamine and ,thiosinamine ,compounds1 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #fh4 ,thoxos 7,john ,wyeth ,bro471 ,the ,journal1 ,march #ba1 #aiad1 p4 #idi2 ,reports ,chem4 ,lab41 #aiad1 p4 #da2 ,propaganda1 ed4 #i1 p4 #djb4 ,three ,chlorides 7,henry71 7,henry ,pharmacal ,co471 ,the ,journal1 ,feb4 #f1 #aiae1 p4 #ebh2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #i2 ,reports ,chem4 ,lab41 #aiad1 p4 #fe2 ,propaganda1 ed4 #i1 p4 #aih4 ,thyme1 ,syrup of1 #dfg ,thymozene1 #dcb ,thymus1 ,desiccated1 ,armour1 #bac ,thymus ,gland1 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fi4 ,thymus-,gland-,armour1 ,desiccated 7,armour ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #fi4 ,thymus ,tablets--,armour1 #bac ,thyreoidectin1 #bjb ,thyreoidectin 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #ej4 ,thyroid ,comp41 ,caps1 #bai ,thyroid ,preparations 7,antithyroidin-,moebius and ,thyreoidectin71 #bjb ,thyro-,ovarian ,comp41 ,caps1 #bai ,tilden ,company-- ,elixir ,iodo-,bromide of ,calcium ,comp4 8,without ,mercury0 and 8,with ,mercury01 #eb ,firolyptol ,plain and ,firolyptol with ,kreosote1 #abj ,firwein1 #aai ,tincture of ,digitalis 7,upsher ,smith71 ,reports ,council ,pharm4 ,chem41 #aibj1 p4 #eb4 ,tissue ,phosphates1 ,wheeler's1 #abi1 #dfc ,tissue ,phosphates1 ,wheeler's 7,t4 ,b4 ,wheeler1 ,m4,d41 ,company71 ,the ,journal1 ,may #e1 #aiag1 p4 #accf2 ,sept4 #bb1 #aiag1 p4 #ajaj2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #ba2 ,reports ,chem4 ,lab41 #aiag1 p4 #ac4 ,tonga1 ,the ,journal1 ,may #aj1 #aiac1 p4 #adgg2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,tonga and ,salicylates1 ,elixir 7,sharp ,dohme71 ,the ,journal1 ,may #aj1 #aiac1 p4 #adgh2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,tonga ,compound1 ,elixir 7,hance ,bros4 ,white2 ,eli ,lilly ,co42 ,nelson ,baker ,co42 ,ray ,chemical ,co42 ,f4 ,stearns ,co471 ,the ,journal1 ,may #aj1 #aiac1 p4 #adgh2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,tonga ,compound1 ,elixir 7,wm4 ,s4 ,merrell ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,tonga ,compound1 ,elixir 7,parke1 ,davis ,co42 ,wm4 ,r4 ,warner ,co471 ,the ,journal1 ,may #aj1 #aiac1 p4 #adgh4 ,tonga ,compound 7,special71 ,elixir 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,tonga ,salicylates1 ,elixir 7,wm4 ,s4 ,merrell ,chemical ,co471 ,the ,journal1 ,may #aj1 #aiac1 p4 #adgh4 ,tongaline1 #bf1 #djj ,tongaline 7,mellier ,drug ,co471 ,the ,journal1 ,may #aj1 #aiac1 p4 #adgg2 ,july #ag1 #aiae1 p4 #bfi2 ,march #b1 #aiah1 p4 #fdc2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg2 #aiae1 p4 #eh4 ,tongaline and ,quinine ,tablets 7,mellier ,drug ,co471 ,the ,journal1 ,july #ag1 #aiae1 p4 #bfi4 ,tongaline ,tablets1 #bg ,tonga-,salicyl 7,h4 ,k4 ,wampole ,co471 ,the ,journal1 ,may #aj1 #aiac1 p4 #adgh2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,tonic ,beef1 ,s4 ,d4 7,sharp ,dohme71 ,the ,journal1 ,may #aa1 #aijg1 p4 #afab2 ,reports ,council ,pharm4 ,chem41 #aije-h1 opp4 p4 #fd2 ,propaganda1 ed4 #i1 p4 #acc4 ,tonols 7,schering's ,glycerophosphates71 #id ,tonols 7,schering's ,glycerophosphates71 7,schering ,glatz1 ,inc471 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcc2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #cd4 ,toxicide1 #cjg ,toxicide 7,toxicide ,laboratories1 ,chicago71 ,the ,journal1 ,oct4 #h1 #aiba1 p4 #aaig2 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #fh4 ,toxinol 7,hughes ,chemical ,co471 ,the ,journal1 ,dec4 #b1 #aiaf1 p4 #afhg2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci2 #aiaf1 p4 #ch4 ,trade ,names1 ,patents perpetuated by1 #edd ,tri-,arsenole 7,medical ,supply ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aef4 ,tri-,arsenole1 ,l4 ,o4 ,compound ,no4 #a and ,l4 ,o4 ,compound ,no4 #b1 #afc ,trifolium ,compound1 ,extract 7,wm4 ,s4 ,merrell ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,trifolium ,compound1 ,fluidextract 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,trifolium ,compound1 ,syrup 7,hance ,bros4 ,white2 ,eli ,lilly ,co42 ,h4 ,k4 ,mulford ,co42 ,parke1 ,davis ,co42 ,ray ,chemical ,co42 ,f4 ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci1 #dj4 ,trifolium ,compound with ,cascara ,syrup 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dj4 ,tri-,iodides 7,henry7 7,henry ,pharmacal ,co471 ,the ,journal1 ,feb4 #f1 #aiae1 p4 #ebh2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #i2 ,reports ,chem4 ,lab41 #aiad1 p4 #fe2 ,propaganda1 ed4 #i1 p4 #aih4 ,trilene ,tablets1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #ci4 ,trimethol1 #adj ,trimethol 7,thos4 ,leeming ,co471 ,the ,journal1 ,aug4 #aa1 #aiag1 p4 #dhe2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #dc4 ,triner's ,american ,elixir of ,bitter ,wine1 #aci ,triotonol ,tablets1 #id ,triotonol ,tablets 7,schering ,glatz1 ,inc471 ,the ,journal1 ,sept4 #cj1 #aiaf1 p4 #ajcc2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #cd4 ,triple ,arsenates with ,nuclein1 #bef ,triple ,arsenates with ,nuclein 7,abbott ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiai1 p4 #ib4 ,troches of ,ammonium ,chloride1 druggists refuse to supply1 #eeb ,trophenine 7,reed ,carnrick ,co471 ,the ,journal1 ,oct4 #e1 #aijg1 p4 #aaih2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #gi4 ,trypsogen 7,g4 ,w4 ,carnrick ,co471 ,the ,journal1 ,nov4 #a1 #aiac1 p4 #afdi2 ,propaganda1 ed4 #i1 p4 #djc4 ,tubercle ,bacilli1 ,dixon's ,suspension of ,dead1 #aeh ,tubercle ,bacilli ,emulsion1 ,polygeneous 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tubercle ,bacilli ,extract1 ,dixon's1 #aeh ,tubercle ,bacilli1 ,triturated 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tubercle ,germs1 ,dried ,dead 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tubercle ,vaccine1 ,sherman's ,non-,virulent 7,g4 ,h4 ,sherman7 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abh4 ,tuberculin1 ,bovine 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculin1 ,bovine1 ,t4 ,r4 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculin1 8,koch0 ,new 7,t4 ,r47 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculin 8,koch0 7,old7 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculin ,old1 ,bovine 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculin-,rosenbach 7,kalle ,color ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #afa4 ,tuberculin ,test ,plate1 ,keller's 7,a4 ,h4 ,keller71 ,the ,journal1 ,dec4 #ai1 #aiad1 p4 #bbej4 ,tuberculin ,t4 ,o4 ,a4 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculin1 ,vacuum 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculin1 ,vacuum ,bovine 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculoids 7,columbus ,pharmacal ,co471 ,the ,journal1 ,feb4 #bb1 #aijh1 p4 #gjd4 ,tuberculosis-,diagnostic 8,hoechst0 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculosis-,diagnostic 8,hoechst0 ,dry in ,tubes 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculosis-,diagnostic 8,hoechst0 7#j4a per cent47 ,solution 7,farbwerke- ,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #adf4 ,tuberculosis ,serum ,vaccine 8,hoechst0 7,farbwerke-,hoechst ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #afa4 ,tubo-,arg 7,tubo ,pharmacal ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #age4 ,tumors and ,chemotherapy1 #dii ,turkey ,corn1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,tyree's ,antiseptic1 #dja ,tyree's ,antiseptic ,powder1 #dfb ,tyree's ,elixir of ,buchu and ,hyoscyamus ,compound1 #eg ,ulax ,salt 7,f4 ,h4 ,strong ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #age4 ,unctol1 #aff ,unctol 7,r4 ,r4 ,rogers ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #afb4 ,unguentine 7,norwich ,pharmacal ,co471 ,the ,journal1 ,march #bg1 #aiji1 p4 #ajdg2 ,july #ag1 #aiae1 p4 #bgb2 ,reports ,chem4 ,lab41 #aiji1 p4 #ba2 ,propaganda1 ed4 #i1 p4 #bed4 ,unguentum ,selenio ,vanadic 7v4 ,roemer7 7,a4 von ,roemer71 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #abi2 ,propaganda1 ed4 #i1 p4 #bjg4 ,unicorn ,root1 ,the ,journal1 ,jan4 #bb1 #aiaj1 p4 #cjd2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #aj2 ,propaganda1 ed4 #i4 p4 #bjh4 ,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 ,urea1 ,hydrochlorid and ,quinin1 #dfg ,uricedin 7,fischer ,chemical ,importing ,co471 ,the ,journal1 ,nov4 #bc1 #aijg1 p4 #aghh2 ,reports ,chem4 ,lab41 #aiji1 p4 #bj2 ,propaganda1 ed4 #i1 p4 #bef4 ,uricsol1 #cj ,uricsol 7,uricsol ,chemical ,co471 ,the ,journal1 ,aug4 #ad1 #aiae1 p4 #fch2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #adi2 ,reports ,chem4 ,lab41 #aiae1 p4 #if4 8,uri-,na ,test01 #dih ,uriseptin 7,gardner-,barada ,chemical ,co471 ,the ,journal1 ,aug4 #bi1 #aijh1 p4 #ggc2 ,reports ,chem4 ,lab41 to #aiji1 p4 #dj2 ,propaganda1 ed4 #i1 p4 #bef4 ,urodonal1 #cb ,urodonal 7,geo4 ,j4 ,wallau1 ,inc471 ,the ,journal1 ,aug4 #ad1 #aiae1 p4 #fci2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #aec4 ,uroluetic ,test1 ,capell's1 #dig ,uroluetic ,test1 ,capell's 7,capell's ,laboratory71 ,the ,journal1 ,aug4 #bc1 #aiai1 p4 #fbf4 ,uron 7,uron ,chemical ,co471 ,the ,journal1 ,nov4 #c1 #aijf1 p4 #aejj2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #bf4 ,urotropin1 #caf ,urotropin a brand of hexamethylenamin1 ,u4 ,s4 ,p41 #cah ,urotropin marketed under unwarranted therapeutic claims1 #cag ,uterine ,sedative1 ,elixir 7,eli ,lilly ,co471 ,the ,journal1 ,aug4 #ca1 #aiab1 p4 #gce2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd2 ,propaganda1 ed4 #i1 p4 #daj4 ,uterine ,tonic1 ,buckley 7,the ,abbott ,laboratories71 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,uterine ,tonic1 ,girard 7,girard ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,uterine ,tonic 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,uterine ,tonic1 ,elixir 7,f4 ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,uterine ,tonic 7,tablet71 7,maltbie ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,uterine ,wafers1 ,micajah's 7,micajah ,co471 ,the ,journal1 ,march #bf1 #aiaj1 p4 #ajgj2 ,sept4 #be1 #aiae1 p4 #aabh2 ,reports ,council ,pharm4 ,chem41 #aiaf1 p4 #ff2 ,reports ,chem4 ,lab41 #aiaj1 p4 #ah2 #aiae1 p4 #ajj2 ,propaganda1 ed4 #i1 p4 #bdj4 ,uterine ,wafers1 ,naphey's ,medicated1 #ajg ,utero ,tonic 7,nelson1 ,baker ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,utros 7,h4 ,k4 ,mulford ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,vaccine as a prophylactic in influenza1 #egb ,vaccine1 ,b4 ,coli-,combined-,bacterin1 #ahe ,vaccine1 ,catarrhal ,vaccine ,combined-,lilly1 #ahg ,vaccine1 ,curative ,vaccine1 ,bruschettini1 #eh ,vaccine1 ,friedmann's 7,standard ,distributing ,co474 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #acf4 ,vaccine-,lilly1 ,influenza ,mixed1 #ahg ,vaccine1 ,m4 ,catarrhalis-,combined-,bacterin1 #ahd ,vaccine1 ,non-,virulent ,tubercle ,bacillus 7,g4 ,h4 ,sherman74-- ,see ,tubercle ,vaccine1 ,sherman's ,non-,virulent4 ,vaccine1 ,no4 #b 7,staph-,strep4 ,bacterin71 ,special ,bacterial1 #bed ,vaccine ,no4 #c 7,pneumo-,staph-,strep4 ,bacterin71 ,special ,bacterial1 #bed ,vaccine ,no4 #d 7,pneumo-,staph-,strep-,coli ,bacterin71 ,special ,bacterial1 #bed ,vaccine ,no4 #e 7,influenza ,combined ,bacterin71 ,special ,bacterial1 #bed ,vaccine ,no4 #aa 7,pneumo-,strep4 ,bacterin71 ,special ,bacterial1 #bed ,vaccine ,no4 #ae 7,combined ,whooping ,cough ,bacterin71 ,special ,bacterial1 #bed ,vaccine ,no4 #af 7,mixed ,gonococcus ,bacterin71 ,special ,bacterial1 #bed ,vaccine1 ,no4 #dj1 ,sherman's ,mixed1 #ahh ,vaccine1 ,pertussis-,combined-,bacterin1 #ahe ,vaccine1 ,streptococcus-,rheumaticus-,combined-,b acterin1 #ahe ,vaccines-,abbott1 ,mixed1 #ahd ,vaccines and ,serums1 #eba ,vaccines for 8,colds01 #egc 8,vaccines0 in toxic conditions1 #efj ,vaccines1 ,influenza1 #ebj ,vaccines1 ,mixed1 ,the ,journal1 ,june #bb1 #aiah1 p4 #aifg2 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #aa4 ,see also3 ,b4 ,coli-,combined-,bacterin2 ,catarrhal ,vaccine-,combined-,lilly2 ,influenza ,mixed ,vaccine-,lilly2 ,influenza ,serobacterin ,mixed-,mulford2 ,m4 ,catarrhalis-,combined ,bacterin2 ,mixed ,vaccine ,no4 #dj1 ,sherman's2 ,pertussis-,combined- ,bacterin2 ,streptococcus-,rheumaticus-,combined-,b acterin2 ,streptococcus-,viridans-,combined-,bact erin4 ,vaccines1 ,several 8,mixed01 #ahd ,van ,horn and ,sawtell--,k-,y ,lubricating ,jelly1 #adg ,vanadic ,acid1 ,the ,journal1 ,may #i1 #aijh1 p4 #aedh2 ,july #bd1 #aiji1 p4 #cji4 ,vanadiol 7,vanadium ,chemical ,co471 ,the ,journal1 ,jan4 #ah1 #aiac1 p4 #bbe2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #g2 ,propaganda1 ed4 #i1 p4 #bji4 ,vanadioseptol 7,vanadium ,chemical ,co471 ,the ,journal1 ,jan4 #ah1 #aiac1 p4 #bbe2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #g2 ,propaganda1 ed4 #i1 p4 #bji4 ,vanadium1 ,the ,journal1 ,june #c1 #aiaa1 p4 #afdh4 ,vanadium ,solution for ,intravenous and ,hypodermic ,use 7,vanadium ,chemical ,co471 ,the ,journal1 ,jan4 #ah1 #aiac1 p4 #bbe2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #g2 ,propaganda ed4 #i1 p4 #bji4 ,vanadoforms 7,vanadium ,chemical ,co471 ,the ,journal1 ,jan4 #ah1 #aiac1 p4 #bbe2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #g2 ,propaganda1 ed4 #i1 p4 #bji4 ,vapo-,cresolene 7,vapo-,cresolene ,co471 ,the ,journal1 ,april #d1 #aijh1 p4 #aace2 ,reports ,chem4 ,lab41 to #aiji1 p4 #fe2 ,propaganda1 ed4 #i1 p4 #djh4 ,vasogen 7,lehn ,fink71 ,the ,journal1 ,feb4 #ac1 #aiji1 p4 #ege2 ,propaganda1 ed4 #i1 p4 #djh4 ,vass ,chemical ,company--,thialion1 #dgj ,v-,e-,m 7,schoonmaker ,laboratories1 ,inc471 #aff ,v-,e-,m ,unguentum ,eucalyptol ,compound1 #afg ,v-,e-,m ,unguentum ,eucalyptol ,compound 7,schoonmaker ,laboratories1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #afc4 ,v-,e-,m with ,boric ,acid1 #afg ,v-,e-,m with ,boric ,acid 7,schoonmaker ,laboratories1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #afc4 ,v-,e-,m with ,camphor1 #afg ,v-,e-,m with ,camphor 7,schoonmaker ,laboratories1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #afc4 ,v-,e-,m with ,ichthyol1 #afg ,v-,e-,m with ,ichthyol 7,schoonmaker ,laboratories1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #afc4 ,v-,e-,m with ,stearate of ,zinc1 #afg ,v-,e-,m with ,stearate of ,zinc 7,schoonmaker ,laboratories1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #afc4 ,venarsen1 #dga ,venarsen 7,intravenous ,products ,co471 ,the ,journal1 ,may #bb1 #aiae1 p4 #aghj2 ,march #be1 #aiaf1 p4 #igh2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #eb2 ,reports ,chem4 ,lab41 #aiae1 p4 #hb2 ,propaganda1 ed4 #i1 p4 #bab4 ,vencalxodine 7,intravenous ,products ,co471 ,the ,journal1 ,feb4 #af1 #aiah1 p4 #dha4 ,venodine 7,intravenous ,products ,co474 ,the ,journal1 ,june #bf1 #aiae1 p4 #baee2 ,march #be1 #aiaf1 p4 #bgh2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ade2 ,propaganda1 ed4 #i1 p4 #bad4 ,venomer 7,intravenous ,products ,co471 ,the ,journal1 ,march #be1 #aiaf1 p4 #igh4 ,venosal1 #afi1 #dce ,venosal 7,intravenous ,products ,co471 ,the ,journal1 ,jan4 #e1 #aiah1 p4 #dh2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #aah2 ,reports ,chem4 ,lab41 #aiag1 p4 #eg4 ,veracolate 7,marcy ,co471 ,the ,journal1 ,april #cj1 #aiaj1 p4 #adeh2 ,aug4 #a1 #aiad1 p4 #dbj2 ,april #bd1 #aiae1 p4 #addj2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ada2 ,propaganda1 ed4 #i1 pp4 #baf1 #cdd4 ,veracolate with ,iron1 ,quinine and ,strychnine 7,marcy ,co471 ,the ,journal1 ,april #bd1 #aiae1 p4 #addj2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ada4 ,veracolate with ,pepsin and ,pancreatin 7,marcy ,co471 ,the ,journal1 ,april #bd1 #aiae1 p4 #addj2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #ada4 ,veroform ,germicide 7,veroform ,hygienic ,co471 ,the ,journal1 ,nov4 #bb1 #aiac1 p4 #aibj2 ,reports ,council ,pharm4 ,chem41 #aiac1 p4 #bi4 ,veronal1 #cga ,veronal 7,barbital71 #cgj ,veronal-,sodium1 #cga ,viburn-,ovaro 7,ray ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,viburnum ,compound1 ,hayden's 7,new ,york ,pharmacal ,co471 ,the ,journal1 ,aug4 #ca1 #aiab1 p4 #gce2 ,jan4 #bc1 #aiae1 p4 #cei2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #ie2 ,propaganda1 ed4 #i1 pp4 #bah1 #dji4 ,viburnum ,compound1 ,elixir 7,nelson1 ,baker ,co471 ,the ,journal1 ,aug4 #ca1 #aiab1 p4 #gce2 ,propaganda1 ed4 #i1 p4 #daj4 ,viburnum ,compound 7,tablets71 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #da4 ,viburnum ,compound 7,tablet7 7,uterine ,tonic71 7,parke1 ,davis ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,viburnum ,compound 7,tablet7 7,smith1 ,kline ,french ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,viburnum ,sedative 7,fraser ,tablet ,co471 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df4 ,viburnumal 7,louisville ,pharmacal ,works71 ,the ,journal1 ,aug4 #ca1 #aiab1 p4 #gce2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dd2 ,propaganda1 ed4 #i1 p4 #daj4 ,vibutero 7,f4 ,stearns ,co471 ,the ,journal1 ,aug4 #ca1 #aiab1 p4 #gce2 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #df2 ,propaganda1 ed4 #i1 p4 #daj4 ,vigoral 7,armour ,co471 ,the ,journal1 ,jan4 #bc1 #aiji1 p4 #caa2 ,propaganda1 ed4 #i1 p4 #dgb4 ,vin ,mariani 7,mariani ,co471 ,the ,journal1 ,nov4 #bd1 #aijf1 p4 #agea2 ,reports ,council ,pharm4 ,chem41 #aije-h1 p4 #bi2 ,propaganda1 ed4 #i1 p4 #bba4 ,vinum ,extract ,morrhuae1 ,stearns1 #ei ,violet ,ray ,generator1 ,sterling1 #egb ,virol 7,etna ,chemical ,co471 ,the ,journal1 ,feb4 #bj1 #aiae1 p4 #fhc2 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #acb2 ,propaganda1 ed4 #i1 p4 #bbe4 ,vitamin ,b ,concentrates and ,yeast ,preparations1 #cba ,vitamins3 their distribution1 #efa ,vitaphos 7,the ,grain ,chemical ,company1 ,inc471 ,reports ,council ,pharm4 ,chem41 #aiba1 p4 #gd4 ,walker ,pharmacal ,company--,succus ,cineraria ,maritima1 #dee ,wallau1 ,george ,j41 ,inc4-- ,eumictine1 #bfb ,filudine1 #da ,jubol1 #ca ,sulfuryl ,monal1 #hf ,urodonal1 #cb ,wampole1 ,h4 ,k41 ,co4--,hypno-,bromic ,compound1 #dcj ,warming bottles1 ,sodium ,acetate in1 #cbi ,water1 ,buffalo ,lithia ,springs 7,buffalo ,lithia ,springs ,water ,co471 ,the ,journal1 ,sept4 #ab1 #aijh1 p4 #ica4 ,water ,eryngo1 ,reports ,council ,pharm4 ,chem41 #aiab1 p4 #dg4 ,webster ,co41 ,william ,a4 and the ,direct ,pharmaceutical ,co41 #efd ,weeks ,chemical ,company--,chlorlyptus1 #bgg ,westerfield's ,digitalis ,tablets1 #bae ,wheeler's ,tissue ,phosphates1 #abi1 #dfc ,white1 ,g4 ,s41 and the ,allied ,medical ,associations of ,america1 #dij ,white1 ,mark1 ,goiter ,serum ,laboratories--,mark ,white ,goiter ,serum and ,mark ,white ,iodinized ,oil1 #hg ,white ,sulphur ,salts 7,white ,sulphur ,springs1 ,inc471 ,the ,journal1 ,nov4 #ba1 #aiad1 p4 #ahgj2 ,reports ,council ,pharm4 ,chem41 #aiad4 p4 #abh4 ,whiteruss 7,lubric ,oil ,co471 ,the ,journal1 ,july #aj1 #aiae1 p4 #age4 ,whooping ,cough ,bacterin1 ,combined1 ,special ,bacterial ,vaccine ,no4 #ae1 #bed ,wild ,indigo1 ,the ,journal1 ,jan4 #bb1 #aiaj1 p4 #cjd2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #ai2 ,propaganda1 ed4 #i1 p4 #bjh4 ,wild ,yam1 ,the ,journal1 ,jan4 #bb1 #aiaj1 p4 #cjd2 ,reports ,council ,pharm4 ,chem41 #aiaj1 p4 #aj2 ,propaganda1 ed4 #i1 p4 #bjh4 ,william ,f4 ,koch ,cancer ,remedy1 #dcg ,williams1 ,henry ,smith1 and 8,proteal ,therapy01 #ddc1 #did ,wine1 ,chapoteaut's 7,e4 ,fougera ,co41 ,inc471 ,the ,journal1 ,dec4 #ai1 #aiad1 p4 #bbdg2 ,reports ,council ,pharm4 ,chem41 #aiad1 p4 #gg2 ,propaganda1 ed4 #i1 p4 #fj4 ,wine1 ,stearns' 7,f4 ,stearns ,co471 ,reports ,council ,pharm4 ,chem41 #aiae1 p4 #agg4 ,winslow ,laboratory--,pineoleum advertising methods1 #ddb ,winthrop ,chemical ,company1 ,inc4-- ,elarson1 #bdh ,helmitol1 #bie ,woolley1 ,d4 ,e41 ,manager of ,cosmopolitan ,cancer ,research ,society1 #dad ,worlds ,wonder ,remedy 7,w4 ,w4 ,remedy ,co41 ,superior1 ,wis471 ,reports ,council ,pharm4 ,chem41 #aiah1 p4 #hb4 ,wulfing1 ,a41 ,company--,formamint1 #cc ,wyeth1 ,john1 and ,brother-- ,hydras1 #if ,robinol1 #ie ,xanol 7,wm4 ,s4 ,merrell ,chemical ,co471 ,reports ,council ,pharm4 ,chem41 #aiaa1 p4 #fd4 ,xeroform1 #ceb ,xeroform-,heyden1 #baf1 #cdi ,yarbrough1 ,charles ,c4--,biniodol1 #aba ,yeast1 #eff ,yeast ,preparations and ,vitamin ,b ,concentrates1 #cba ,yerba ,santa1 ,maltzyme with1 #baa ,yogurt 7,yogurt ,co471 ,the ,journal1 ,jan4 #cj1 #aiji1 pp4 #cgb1 #cig4 ,yohimbin ,spiegel 7,lehn ,fink71 ,the ,journal1 ,march #cj1 #aijg1 p4 #aabg4 ,zemacol 7,norwich ,pharmacal ,co471 ,the ,journal1 ,may #ad1 #aiaj1 p4 #afbf2 ,reports ,chem4 ,lab41 #aiaj1 p4 #db2 ,propaganda1 ed4 #i1 p4 #bei4 ,ziratol1 #adh ,ziratol 7,bristol-,myers ,co471 ,the ,journal1 ,oct4 #f1 #aiag1 p4 #aaia2 ,reports ,council ,pharm4 ,chem41 #aiag1 p4 #ee2 ,reports ,chem4 ,lab41 #aiag1 p4 #ea4 ,zyme-oid 7,oxychlorin ,chemical ,co471 ,the ,journal1 ,may #bc1 #aijh1 p4 #agjf2 ,reports ,chem4 ,lab41 to #aiji1 p4 #cd2 ,propaganda1 ed4 #i1 p4 #bfa4 ,zymotoid1 ,arnold's 7,zymotoid ,co471 ,the ,journal1 ,april #f1 #aiab1 p4 #ajcj2 ,reports ,chem4 ,lab41 #aiab1 p4 #fh2 ,propaganda1 ed4 #i1 p4 #dab4 ,spelling variations3 amenorrhea_/amenorrhoea ampoule_/ampule_/ampul anaemia_/anemia analgetic_/analgesic any one_/anyone arsenphenolamin_/arseno-phenolamin arsphenamin_/arsphenamine bromid_/bromide cerebral-spinal_/cerebro-spinal_/cerebro spinal chlorid_/chloride cocain_/cocaine ,cod-,liver ,oil_/,cod ,liver ,oil diethylenediamene_/diethylene-diamine dioxid_/dioxide drams_/drachms dulness_/dullness envelop_/envelope every one_/everyone extention_/extension formaldehyd_/formaldehyde golden-seal_/goldenseal gonorrhoic_/gonorrheaic ,grip_/,grippe guaranty_/guarantee ,heitzman_/,heitzmann hexamethylenetetramin_/hexamethylenetetr amine_/hexamethylene-tetramine_/ hexamenthylenetetramin iodid_/iodide iodin_/iodine melena_/melaena oxid_/oxide ,parresine_/,paresine pharmacopeia_/pharmacopoeia post-graduate_/postgraduate sanatarium_/sanitarium_/sanatorium selenio-vanadium_/selenium-vanadium sequel_/sequelae_/sequella sulphurated_/sulphureted_/sulphuretted_/ sulphurretted technique_/technic vitamines_/vitamins ,spelling corrections3 accompanished -- accomplished accurtely -- accurately acethphenetidin -- acetphenetidin advertiseing -- advertising advertisments -- advertisements aluminium -- aluminum ,amercan -- ,american amples -- ampules an ypure -- any pure and -- an and -- on ,anelgesic -- ,analgesic anitseptic -- antiseptic anodoyne -- anodyne anohter -- another aortis -- aortitis artifically -- artificially asosciated -- associated ,assimiliation -- ,assimilation at -- as atttention -- attention authenic -- authentic author -- authors ,bacilus -- ,bacillus baillus -- bacillus ,barbitol -- ,barbital beeen -- been benefical -- beneficial betanaphtol -- betanaphthol betwen -- between bibliograpy -- bibliography ,binghampton -- ,binghamton binodide -- biniodide ,botazzi -- ,bottazzi carbonic -- carbolic carodylate -- cacodylate carrer -- carrier carthartic -- cathartic characteristc -- characteristic ,chautaqua -- ,chautauqua chefly -- chiefly ,chemisty -- ,chemistry ,chlorilyptus -- ,chlorlyptus ,choron -- ,chloron cities -- cites claims -- claim clipping -- clippings clorless -- colorless coeffiecient -- coefficient ,collosal -- ,collosol compained -- complained compaint -- complaint compatable -- compatible ,compond -- ,compound compostion -- composition ,concernng -- ,concerning conditons -- conditions conection -- connection coneentrated -- concentrated confrres -- confrres connenction -- connection constitutent7s7 -- constituent7s7 ,contro -- ,control convicition -- conviction corespondence -- correspondence corpuscules -- corpuscles crystaline -- crystalline davantages -- advantages deparment -- department destroyes -- destroys develope -- develop diehylbarbituric -- diethylbarbituric ,diethylbarbiutric -- ,diethylbarbituric digtalis -- digitalis dirctory -- directory distate -- distaste distils -- distills does -- doses dulness -- dullness dystentery -- dysentery ,ehlrich -- ,ehrlich ,electobioscope -- ,electrobioscope emipric -- empiric employe -- employee entiled -- entitled eperiments -- experiments esesntially -- essentially essentally -- essentially eucalytpus -- eucalyptus examation -- examination extravant -- extravagant exurberant -- exuberant ,farbkerke-,hoechst -- ,farbwerke-,hoechst ,farbwercke-,hoechst -- ,farbwerke-,hoechst ,farbwerke-,hochest -- ,farbwerke-,hoechst ,farbwerke-,hoechest -- ,farbwerke-,hoechst ,farkwerke -- ,farbwerke ,ferbwerke -- ,farbwerke finsh -- finish ,firwin -- ,firwein fitrate -- filtrate flgrant -- flagrant fluorish -- flourish ,,fom -- ,,from form -- from fradulent -- fraudulent ,fritsche -- ,fritzsche gactric -- gastric galactogogic -- galactagogic galactogogue -- galactagogue ,galatagogue -- ,galactagogue ,giesecke -- ,gieseke ,glyecrin -- ,glycerin ,goering -- ,goehring gonoccoccus -- gonococcus gualtheria -- gaultheria guiacol -- guaiacol habtual -- habitual ,hallon -- ,hallion ,hcl -- ,h,cl he -- be ,heath -- ,health hexamenthylenamin -- hexamethylenamin ,hexamenthylenetetramin -- ,hexamethylenetetramin ,hexamethylentetramine -- ,hexamethylenetetramine ,higienic -- ,hygienic hundrance -- hundrance ,hussy -- ,hussey hydiodic -- hydriodic hydochloric -- hydrochloric hyerplastic -- hyerplastic hyocyamus -- hyocyamus hyoscymus -- hyoscymus idodin -- iodin idosyncrasy -- idiosyncrasy inections -- injections ingorance -- ignorance insommia -- insomnia intractions -- interactions intramuscuarly -- intramuscularly itme -- time jubject -- subject lechithin -- lecithin liklihood -- likelihood lisited -- listed ,,lypmh -- ,,lymph ,maganese -- ,manganese ,magnesim -- ,magnesium manufacturer -- manufacturers ,mazazine -- ,magazine mecurial -- mercurial mecuric -- mercuric medicince -- medicine ,metorrhagia -- ,metrorrhagia ,meyers -- ,myers minimum -- minim mixutre -- mixture monoceticacidester -- monoaceticacidester monoply -- monopoly ,naphtol -- ,naphthol napthal -- napthol ,napthol -- ,naphthol neuralga -- neuralgia nirtic -- nitric ,nutrolactic -- ,nutrolactis ,o4 ,h4 -- ,a4 ,h4 odide -- iodide ,ophtalmol -- ,ophthalmol or -- of orginal -- original pag -- page pamphet -- pamphlet parffin -- paraffin parminobenzoate -- paraminobenzoate particuarly -- particularly pasticity -- plasticity patent -- patient pharmaceptical -- pharmaceutical ,pharmacopia -- ,pharmacopeia pharmactists -- pharmactists pharmceutical -- pharmaceutical phoshite -- phosphite ,phram4 -- ,pharm4 physicial -- physical ,pineolum -- ,pineoleum ,pinoleum -- ,pineoleum ,pitsburgh -- ,pittsburgh pituiary -- pituitary ,plurig andular -- ,pluriglandular ,pneumocci -- ,pneumococci ,pneumococccus -- ,pneumococcus pnuemonia -- pneumonia popularily -- popularly populary -- popularly postive -- positive ,power -- ,powder precipiate -- precipitate prefare -- preface preparatons -- preparations prescibed -- prescribed prevous -- previous prinicple -- principle procedues -- procedures profesion -- profession proper ties -- properties proponderant -- preponderant ,protier -- ,portier ,protogen -- ,proteogen puporting -- purporting pyrogenic -- pyogenic qestions -- questions quantiatively -- quantitatively ,querry -- ,query ,quine -- ,quinine radicle -- radical ,rathjen -- ,rahtjen recomendation -- recommendation recommmend -- recommend recommmended -- recommended refree -- referee rememebered -- remembered ,reparts -- ,reports ressistance -- resistance restrospect -- retrospect reults -- results ,rhatjen -- ,rahtjen saccarine -- saccharine same -- some santorium -- sanatorium scientfic -- scientific seleninum -- selenium seleno-vanadium -- selenio-vanadium series -- serious ,shering -- ,schering simiplicity -- simplicity specifially -- specifically ,staphylococus -- ,staphylococcus submited -- submitted submittted -- submitted substaneous -- subcutaneous supernatent -- supernatant suport -- support syphilus -- syphilis ,syracue -- ,syracuse teasponful -- teaspoonful tehnic -- technic tetraoidid -- tetraiodid that -- than thearapeutic -- therapeutic thiomethylarsniate -- thiomethylarsinate ,thyroidectin -- ,thyroidectin tisssues -- tissues tisues -- tissues to -- too travenous -- intravenous treament -- treatment tremely -- extremely troat -- throat tubercuclosis -- tuberculosis unbeliveable -- unbelievable vasty -- vastly vially -- vitally ,wulflng -- ,wulfing #bdj3b'a1 #ahhg4 -- #bdj3bia1 #ahhg4