Part 4

The old claim is repeated that nothing enters into the production of Liquozone but gases, water and a little harmless coloring matter, and that the process requires large apparatus and from eight to fourteen days' time. I have seen the apparatus, consisting of huge wooden vats, and can testify to their impressive size. And I have the assurance of several gentlemen whose word (except in print) I am willing to take, that fourteen days' time is employed in impregnating every output of liquid with gas. The result, so far as can be determined chemically or medicinally, is precisely the same as could be achieved in fourteen seconds by mixing the acids with the water. The product is still sulphurous and sulphuric acid heavily diluted, that is all.

Will the compound destroy germs in the human body? This is, after all, the one overwhelmingly important point for determination; for if it will, all the petty fakers and forgery, the liquid oxygen and Professor Pauli and the mythical medical journalism may be forgiven. For more than four months now _Collier's_ has been patiently awaiting some proof of the internal germicidal qualities of Liquozone None has been forthcoming except specious generalities from scientific employés of the company--and testimonials. The value of testimonials as evidence is considered in a later article. Liquozone's are not more convincing than others. Of the chemists and bacteriologists employed by the Liquozone Company there is not one who will risk his professional reputation on the simple and essential statement that Liquozone taken internally kills germs in the human system. One experiment has been made by Mr. Schoen of Chicago, which I am asked to regard as indicating in some degree a deterrent action of Liquozone on the disease of anthrax. Of two guinea-pigs inoculated with anthrax, one which was dosed with Liquozone survived the other, not thus treated, by several hours. Bacteriologists employed by us to make a similar test failed, because of the surprising fact that the dose as prescribed by Mr. Schoen promptly killed the first guinea-pig to which it was administered. A series of guinea-pig tests was then arranged (the guinea-pig is the animal which responds to germ infection most nearly as the human organism responds), at which Dr. Gradwohl, representing the Liquozone Company, was present, and in which he took part. The report follows: {030}

LEDERLE LABORATORIES.

Sanitary, Chemical and Bacteriologic Investigations.

518 FIFTH AVENUE,

NEW YORK CITY.

October 21, 1905,

Anthrax Test. Twenty-four guinea-pigs were inoculated with anthrax bacilli, under the same conditions, the same amount being given to each. The representative of the Liquozone people selected the twelve pigs for treatment. These animals were given Liquozone is 5 c.c. doses for three hours. In twenty-four hours all pigs were dead--the treated and the untreated ones.

Second Anthrax Test. Eight guinea-pigs were Inoculated under the same conditions with a culture of anthrax sent by the Liquozone people. Four of these animals were treated for three hours with Liquozone as in the last experiment. These died also in from thirty-six to forty-eight hours, as did the remaining four.

Diphtheria Test. Six guinea-pigs were inoculated with diphtheria bacilli and treated with Liquozone. They all died in from forty-eight to seventy-two hours. Two out of three controls (i. e., untreated guinea-pigs) remained alive after receiving the same amount of culture.

Tuberculosis Test. Eight guinea-pigs were inoculated with tubercle bacilli. Four of these animals were treated for eight hours with 5 c.c. of a 20 per cent, solution of Liquozole. Four received no Liquozone. At the end of twenty-four days all the animals were killed.

Fairly developed tuberculosis was present in all.

To summarize, we would say that the Liquozone had absolutely no curative effect, but did, when given in pure form, lower the resistance of the animals, so that they died a little earlier than those not treated.

Lederle Laboratories.

By Ernst J. Lederle.

Dr. Gradwohl, representing the Liquozone Company, stated that he was satisfied of the fairness of the tests. He further declared that in his opinion the tests had proved satisfactorily the total ineffectiveness of Liquozone as an internal germicide.

But these experiments show more than that. They show that in so far as Liquozone has any effect, it tends to lower the resistance of the body to an invading disease. That is, in the very germ diseases for which it is advocated, _Liquozone may decrease the chances of the patient's recovery with every dose that is swallowed, but certainly would not increase them_.

In its own field Liquozone is _sui generis_. On the ethical side, however, there are a few "internal germicides," and one of these comes in for mention here, not that it is in the least like Liquozone in its composition, but because by its monstrous claims it challenges comparison.

Since the announcement of this article, and before, _Collier's_ has been in receipt of much virtuous indignation from a manufacturer of remedies which, he claims, Liquozone copies. Charles Marchand has been the most active enemy of the Douglas Smith product. He has attacked the makers in print, organized a society, and established a publication mainly devoted to their destruction, and circulated far and wide injurious literature (most of it true) about their product. Of the relative merits of Hydrozone, Glycozone (Marchand's products); and Liquozone, I know nothing; but I know that the Liquozone Company has never in its history put forth so shameful an advertisement as the one reproduced on page 28, [IMAGE ==>] {028} signed by Marchand, and printed in the New Orleans _States_ when the yellow-fever scare was at its height. {031}

And Hydrozone is an "ethical" remedy; its advertisements are to be found in reputable medical journals.

The Same Old Fake.

Partly by reason of Marchand's energy, no nostrum in the country has been so widely attacked as the Chicago product. Occasional deaths, attributed (in some cases unjustly) to its use, have been made the most of, and scores of analyses have been printed, so that in all parts of the country the true nature of the nostrum is beginning to be understood. The prominence of its advertising and the reckless breadth of its claims have made it a shining mark. North Dakota has forbidden its sale. San Francisco has decreed against it; so has Lexington, Ky., and there are signs that it will have a fight tor its life soon in other cities. It is this looming danger that impelled Liquozone to an attempted reform last summer. Yet, in spite of the censorship of its legal lights, in spite of the revision of its literature by its scientific experts, in spite of its ingenious avoidance of specifically false claims in the advertising which is being scattered broadcast to-day, Liquozone is now what it was before its rehabilitation, a fraud which owes its continued existence to the laxity of our public health methods and the cynical tolerance of the national conscience.

IV--THE SUBTLE POISONS.

Reprinted from Collier's Weekly, Dec. 2, 1006. {032}

Ignorance and credulous hope make the market for most proprietary remedies. Intelligent people are not given largely to the use of the glaringly advertised cure-alls, such as Liquozone or Peruna. Nostrums there are, however, which reach the thinking classes as well as the readily gulled. Depending, as they do, for their success on the lure of some subtle drug concealed under a trademark name, or some opiate not readily obtainable under its own label, these are the most dangerous of all quack medicines, not only in their immediate effect, but because they create enslaving appetites, sometimes obscure and difficult of treatment, most often tragically obvious. Of these concealed drugs the headache powders are the most widely used, and of the headache powders Orangeine is the most conspicuous.

Orangeine prints its formula. It is, therefore, its proprietors claim, not a secret remedy. But to all intents and purposes it is secret, because to the uninformed public the vitally important word "acetanilid" in the formula means little or nothing. Worse than its secrecy is its policy of careful and dangerous deception. Orangeine, like practically all the headache powders, is simply a mixture of acetanilid with less potent drugs. Of course, there is no orange in it, except the orange hue of the boxes and wrappers which is its advertising symbol. But this is an unimportant deception. The wickedness of the fraud lies in this: that whereas the nostrum, by virtue of its acetanilid content, thins the blood, depresses the heart and finally undermines the whole system, it claims _to strengthen the heart and to produce better blood_. Thus far in the patent medicine field I have not encountered so direct and specific an inversion of the true facts.

Recent years have added to the mortality records of our cities a surprising and alarming number of sudden deaths from heart failure. In the year 1902 New York City alone reported a death rate from this cause of 1.34 per thousand of population; that is about six times as great as the typhoid fever death record. It was about that time that the headache powders were being widely advertised, and there is every reason to believe that the increased mortality, which is still in evidence, is due largely to the secret weakening of the heart by acetanilid. Occasionally a death occurs so definitely traceable to this poison that there is no room for doubt, as in the following report by Dr. J. L. Miller, of Chicago, in the _Journal of the American Medical Association_, on the death of Mrs. Frances Robson:

"I was first called to see the patient, a young lady, physically sound, who had been taking Orangeine powders for a number of weeks for insomnia. The rest of the family noticed that she was very blue, and for this reason I was called. When I saw the patient she complained of a sense of faintness and inability to keep warm. At this time she had taken a box of six Orangeine powders within about eight hours. She was warned of the danger of continuing the indiscriminate use of the remedy, but insisted that many of her friends had used it and claimed that it was harmless. The family promised to see that she did not obtain any more of the remedy. Three days later, however, I was called to the house and found the patient dead. The family said that she had gone to her room the evening before in her usual health. The next morning, the patient not appearing, they investigated and found her dead. The case was reported to the coroner, and the coroner's verdict was: 'Death was from the effect of an overdose of Orangeine {033}powders administered by her own hand, whether accidentally or otherwise, unknown to the jury.'"

Last July an 18-year-old Philadelphia girl got a box of Orangeine powders at a drug store, having been told that they would cure headache. There was nothing on the label or in the printed matter inclosed with the preparation warning her of the dangerous character of the nostrum. Following the printed advice, she took two powders. In three hours she was dead. Coroner Dugan's verdict follows:

"Mary A. Bispels came to her death from kidney and heart disease, aggravated by poisoning by acetanilid taken in Orangeine headache powders."

Prescribing Without Authority.

Yet this poison is being recommended every day by people who know nothing of it and nothing of the susceptibility of the friends to whom they advocate it. For example, here is a testimonial from the Orangeine booklet:

"Miss A. A. Phillips, 60 Powers street, Brooklyn, writes: 'I always keep Orangeine in my desk at school, and through its frequent applications to the sick I am called both "doctor and magician."'"

If the school herein referred to is a public school, the matter is one for the Board of Education; if a private school, for the Health Department or the county medical society. That a school teacher should be allowed to continue giving, however well meaning her foolhardiness may be, a harmful and possibly fatal dose to the children intrusted to her care seems rather a significant commentary on the quality of watchfulness in certain institutions.

Obscurity as to the real nature of the drug, fostered by careful deception, is the safeguard of the acetanilid vender. Were its perilous quality known, the headache powder would hardly be so widely used. And were the even more important fact that the use of these powders becomes a habit, akin to the opium or cocain habits, understood by the public, the repeated sales which are the basis of Orangeine's prosperity would undoubtedly be greatly cut down. Orangeine fulfills the prime requisite of a patent medicine in being a good "repeater." Did it not foster its own demand in the form of a persistent craving, it would hardly be profitable. Its advertising invites to the formation of an addiction to the drug. "Get the habit," it might logically advertise, in imitation of a certain prominent exploitation along legitimate lines. Not only is its value as a cure for nervousness and headaches insisted on, but its prospective dupes are advised to take this powerful drug as a _bracer_.

"When, as often, you reach home tired in body and mind... take an Orangeine powder, lie down for thirty minutes' nap--if possible--anyway, relax, then take another."

"To induce sleep, take an Orangeine powder immediately before retiring. When wakeful, an Orangeine powder will have a normalizing, quieting effect."

It is also recommended as a good thing to begin the day's work on in the morning--that is, take Orangeine night, morning and between meals!

These powders pretend to cure asthma, biliousness, headaches, colds, catarrh and grip (dose: powder every four hours during the day for a week!--a pretty fair start on the Orangeine habit), diarrhea, hay fever, insomnia, influenza, neuralgia, seasickness and sciatica.

Of course, they do not cure any of these; they do practically nothing but give temporary relief by depressing the heart. With the return to normal conditions of blood circulation comes a recurrence of the nervousness, {034}headache, or what not, and the incentive to more of the drug, until it becomes a necessity. In my own acquaintance I know half a dozen persons who have come to depend on one or another of these headache preparations to keep them going. One young woman whom I have in mind told me quite innocently that she had been taking five or six Orangeine powders a day for several months, having changed from Koehler's powders when some one told her that the latter were dangerous! Because of her growing paleness her husband had called in their physician, but neither of them had mentioned the little matter of the nostrum, having accepted with a childlike faith the asseverations of its beneficent qualities. Yet they were of an order of intelligence that would scoff at the idea of drinking Swamp-Root.

[IMAGE ==>] {034}

An Acetanilid Death Record.

This list of fatalities is made up from statements published in the newspapers. In every case the person who died had taken to relieve a headache or as a bracer a patent medicine containing acetanilid, without a doctor's prescription. This list does not include the case of a dog in Altoona, Pa., which died immediately on eating some sample headache powders. The dog did not know any better.

Mrs. Minnie Bishop, Louisville, Ky.; Oct. 16, 1903. Mrs. Mary Cusick and Mrs. Julia Ward, of 172 Perry Street, New York City; Nov. 27, 1903. Fred. P. Stock, Scranton, Pa.; Dec. 7, 1903. C. Frank Henderson, Toledo, 0.; Dec. 13, 1903. Jacob E. Staley, St. Paul, Mich.; Feb. 18, 1904. Charles M. Scott, New Albany, Ind.; March 15, 1904. Oscar McKinley, Pittsburg, Pa.; April 13, 1904. Otis Staines, student at Wabash College; April 13, 1904. Mrs. Florence Rumsey, Clinton, la.; April 23, 1904. Jenny McGee, Philadelphia, Pa.; May 26, 1904. Mrs. William Mabee, Leoni, Midi.; Sept. 9, 1904. Mrs. Jacob Friedman, of South Bend, Ind.; Oct. 19, 1904. Miss Libbie North, Rockdale, N. Y.; Oct. 26, 1904. Margaret Hanahan, Dayton, O.; Oct. 29, 1904. Samuel Williamson, New York City; Nov. 21, 1904. George Kublisch, St. Louis, Mo.; Nov. 24, 1904. Robert Breck, St. Louis, Mo.;'Nov. 27, 1904. Mrs. Harry Haven, Oriskany Falls, N. Y.; Jan. 17, 1905. Mrs. Jennie Whyler, Akron, 0.; April 3, 1905. Mrs. Augusta Strothmann, St. Louis, Mo.; June 20, 1905. Mrs. Mary A. Bispels, Philadelphia, Pa.; July 2, 1905. Mrs. Thos. Patterson, Huntington, W. Va.; Aug. 15, 1905.

Some of these victims died from an alleged overdose; others from the prescribed dose. In almost every instance the local papers suppressed the name of the fatal remedy, {035}Peruna. That particular victim had the beginning of the typical blue skin pictured in the street-car advertisements of Orangeine (the advertisements are a little mixed, as they put the blue hue on the "before taking," whereas it should go on the "after taking"). And, by the way, I can conscientiously recommend Orangeine, Koehler's powders, Royal Pain powders and others of that class to women who wish for a complexion of a dead, pasty white, verging to a puffy blueness under the eyes and about the lips. Patient use of these drugs will even produce an interesting and picturesque, if not intrinsically beautiful, purplish-gray hue of the face and neck.

[IMAGE ==>] {035}

Drugs That Deprave.

Another acquaintance writes me that he is unable to dissuade his wife from the constant use of both Orangeine and Bromo-Seltzer, although her {036}health is breaking down. Often it is difficult for a physician to diagnose these cases because the symptoms are those of certain diseases in which the blood deteriorates, and, moreover, the victim, as in opium and cocain slavery, will positively deny having used the drug. A case of acetanilid addiction (in "cephalgin," an ethical proprietary) is thus reported:

"When the drug was withheld the patient soon began to exhibit all the traits peculiar to the confirmed morphine-maniac--moral depravity and the like. She employed every possible means to obtain the drug, attempting even to bribe the nurse, and, this failing, even members of the family." Another report of a similar case (and there are plenty of them to select from) reads:

"Stomach increasingly irritable; skin a grayish or light purplish hue; palpitation and slight enlargement of the heart; great prostration, with pains in the region of the heart; blood discolored to a chocolate hue. The patient denied that she had been using acetanilid, but it was discovered that for a year she had been obtaining it in the form of a proprietary remedy and had contracted a regular 'habit.' On the discontinuance of the drug the symptoms disappeared. She was discharged from the hospital as cured, but soon returned to the use of the drug and applied for readmission, displaying the former symptoms."

[IMAGE ==>] {036}

NEW YORK STATE'S NEW POISON LABEL.

On a cocain-laden medicine.

Where I have found a renegade physician making his millions out of Peruna, or a professional promoter trading on the charlatanry of Liquozone, it has seemed superfluous to comment on the personality of the men. They are what their business connotes. With Orangeine the case is somewhat different. Its proprietors are men of standing in other and reputable spheres of activity. Charles L. Bartlett, its president, is a graduate of Yale University and a man of some prominence in its alumni affairs. Orangeine is a side issue with him. Professionally he is the western representative of Ivory Soap, one of the heaviest of legitimate advertisers, and he doubtless learned from this the value of skillful exploitation. Next to Mr. Bartlett, the largest owner of stock (unless he has recently sold out) is William Gillette, the actor, whose enthusiastic indorsement of the powders is known in a personal sense to the profession which he follows, and in print to hundreds of thousands of theater-goers who have read it in their programs. Whatever these gentlemen may think of their product (and I understand that, incredible as it may seem, both of them are constant users of it and genuine believers in it), the methods by which it is sold and the essential and mendacious concealment of its real nature illustrate the {037}level to which otherwise upright and decent men are brought by a business which can not profitably include either uprightness or decency in its methods.

Orangeine is less dangerous, except in extent of use, than many other acetanilid mixtures which are much the same thing under a different name. A friend of mine with a weak heart took the printed dose of Laxative Bromo Quinin and lay at the point of death for a week. There is no word of warning on the label. In many places samples of headache powders are distributed on the doorsteps. The St. Louis Chronicle records a result:

"Huntington, W. Va., Aug. 15, 1905.--While Mrs. Thomas Patterson was preparing supper last evening she was stricken with a violent headache and took a headache powder that had been thrown in at her door the day before. Immediately she was seized with spasms and in an hour she was dead."

That even the lower order of animals is not safe is shown by a canine tragedy in Altoona, Pa., where a prize collie dog incautiously devoured three sample tablets and died in an hour. Yet the distributing agents of these mixtures do not hesitate to lie about them. Rochester, N. Y., has an excellent ordinance forbidding the distribution of sample medicines, except by permission of the health officer. An agent for Miniature Headache Powders called on Dr. Goler with a request for leave to distribute 25,000 samples.

"What's your formula?" asked the official.

"Salicylate of soda and sugar of milk," replied the traveling man.

"And you pretend to cure headaches with that?" said the doctor. "I'll look into it."

Analysis showed that the powders were an acetanilid mixture. The sample man didn't wait for the result. He hasn't been back to Rochester since, although Dr. Goler is hopefully awaiting him.

Bromo-Seltzer is commonly sold in drug stores, both by the bottle and at soda fountains. The full dose is "a heaping teaspoonful." A heaping teaspoonful of Bromo-Seltzer means about ten grains of acetanilid. The United States Pharmacopeia dose is four grains; five grains have been known to produce fatal results. The prescribed dose of Bromo-Seltzer is dangerous and has been known to produce sudden collapse.

Megrimine is a warranted headache cure that is advertised in several of the magazines. A newly arrived guest at a Long Island house party brought along several lots and distributed them as a remedy for headache and that tired feeling. It was perfectly harmless, she declared; didn't the advertisement say "leaves no unpleasant effects"? As a late dance the night before had left its impress on the feminine members of the house party, there was a general acceptance of the "bracer." That night the local physician visited the house party (on special "rush" invitation), and was well satisfied to pull all his patients through. He had never before seen acetanilid poisoning by wholesale. A Chicago druggist writes me that the wife of a prominent physician buys Megrimine of him by the half-dozen lots secretly. She has the habit.