PART IV

CONTRIBUTIONS FROM THE JOURNAL: MISCELLANEOUS MATTER

ACETPHENETIDIN AND PHENACETIN--THEIR RELATIVE PURITY

Until six years ago the chemical product known as phenacetin was patented both as to process and to product. As the patent ran out at that time, anyone, of course, could manufacture it. It was placed in the Pharmacopeia under the name “acetphenetidin.” It is on the market now under both names, “phenacetin” and “acetphenetidin.” The price of the former is five times[130] that of the latter, hence it is rather important to know whether or not one is, in any way, better or purer than the other. The original patentees or manufacturers, the Farbenfabriken of Elberfeld Company, market the product under the name “phenacetin” and also under the official name “acetphenetidin,” the former at about 33 cents an ounce and the latter at about 6 or 7 cents an ounce. Evidently these people believe that acetphenetidin is all right since their price-list says: “Our product is of the highest standard of purity,” and in another place: “On account of the low price of acetphenetidinum, U. S. P., it is especially suitable for the manufacture of medicinal specialties, such as headache powders, etc.” Remember that it is the manufacturers of phenacetin who say this.

[130] Phenacetin is listed at 33 cents an ounce, acetphenetidin at 98 cents a pound in quarter-pound lots.

The question arose whether or not phenacetin differs from acetphenetidin. If it does, then physicians should know it. An inquiry was addressed to Farbenfabriken of Elberfeld Company and also to Lehn & Fink, two firms which market the product in this country under both names, asking in what respect the two products differ. No answer was received from either firm. With the object of answering the question our chemists have investigated the preparations on the market, both those sold under the name “phenacetin” and those under the official title “acetphenetidin.” The following is a summary of their report:[131]

[131] Full details of analysis are published in Volume V of the annual report of the Chemical Laboratory.

THE CHEMISTS’ REPORT

_Physical Appearance._--All the specimens were found to be fine white crystalline powders, differing somewhat in appearance as follows: Four specimens--Acetphenetidin (Farbenfabriken), Phenacetin (Specimen 1[132]--Farbenfabriken), Phenacetin (Specimen 2[132]--Farbenfabriken) and Acetphenetidin (Squibb)--appeared very much alike, each being a very fine crystalline powder, differing only slightly as to fineness. Five other specimens--Phenacetin (Lehn & Fink), Acetphenetidin, U. S. P. (Lehn & Fink), Acetphenetidin (Merck), and two specimens of Acetphenetidin (Powers-Weightman-Rosengarten), had the same general appearance, each consisting of a fine crystalline powder containing a considerable proportion of large rectangular plates. Three specimens--Acetphenetidin (Mallinckrodt) and two specimens of Acetphenetidin (Powers-Weightman-Rosengarten)--had the same general appearance, being a moderately fine and homogeneous crystalline powder. When examined microscopically with a low-power lens the Mallinckrodt product appeared to consist principally of rectangular prisms and the Powers-Weightman-Rosengarten product to be made up largely of plates.

[132] “Specimen 1” is a specimen of the product regularly sold in this country. “Specimen 2” is a specimen of a product sold in England and whose resale in this country was prohibited by the manufacturers.

_Identity._--All of the specimens when tested side by side responded to and complied with the identity tests of the United States, British, German, Swiss, Dutch, Swedish, Spanish, and Danish pharmacopeias. The reactions given by the several specimens were all the same, showing no difference in any case.

_Melting-Points._--As a further proof of identity and similarity the melting-points of the different specimens were taken and found to be: Acetphenetidin (Farbenfabriken), 134.2 C.; Phenacetin (Specimen 1--Farbenfabriken) 133.7 C.; Phenacetin (Lehn & Fink), 134.7 C.; Acetphenetidin (Lehn & Fink) 134.9 C.; Acetphenetidin (Powers-Weightman-Rosengarten), (1) 134.3 C., (2) 133.6 C., (3) 134.7 C., (4) 134.7 C.; Acetphenetidin (Squibb) 134.2 C.; Acetphenetidin (Merck), 134.8 C., and Acetphenetidin (Mallinckrodt), 134.2 C. The melting-point is given as 135 C. in the British, French and Spanish pharmacopeias, and as 134 to 135 C. in the United States, German, Swiss, Danish, Swedish and Dutch pharmacopeias. Thus all comply with the standard given in our pharmacopeia and most foreign pharmacopeias with two exceptions and those respectively only 0.3 C. and 0.4 C. low.

_Absence of Acetanilid._--The absence of acetanilid in all the specimens was indicated by the bromin test of the United States, British, German, Swiss, Dutch, Swedish and Danish pharmacopeias.

_Absence of Carbonizable Matter._--The absence of carbonizable matter was shown in all specimens by the sulphuric acid test of the United States, British, German, French, Swiss, Dutch, Swedish and Spanish pharmacopeias.

_Water-Soluble Matter._--All specimens when tested for excess of water-soluble matter came well within the limit (0.50 per cent.) set by the French pharmacopeia, the greatest amount being 0.20 per cent.

_Ash._--When heated, all the specimens were found to yield practically no ash, the residues from 1 gm. samples weighing in no case more than 0.0004 gm.

_Absence of Paraphenetidin._--When tested by the methods of the United States, British, German and French pharmacopeias, the absence of an impurity of paraphenetidin was shown in all specimens, with the exception of one specimen obtained from Powers-Weightman-Rosengarten Co., which gave a positive, though not strong, reaction and two other specimens of the same firm which reacted still more faintly.

TABLE SHOWING RESULTS OF ANALYSES OF VARIOUS SPECIMENS OF ACETPHENETIDIN AND PHENACETIN[BG]

COLUMN HEADINGS: A = Melting Point (Corr.) C. B = Water-Soluble Matter in, per Cent. C = Ash, per Cent. D = Paraphenetidin, U. S. P. Test[BH] E = Paraphenetidin, Swiss Test[BH] ================+==================+=======+======+======+=====+==== | Physical | | | | | Name | Appearance | A | B | C | D | E ----------------+------------------+-------+------+------+-----+---- Acetphenetidin | Very fine | 134.2 | 0.17 | 0.02 | - | + (Farbenfabriken)| homogeneous | | | | | (1) | crystalline | | | | | | powder | | | | | | | | | | | Phenacetin | Very fine | 133.7 | 0.06 | 0.00 | - | + (Farbenfa- | homogeneous | | | | | briken) | crystalline | | | | | | powder | | | | | | | | | | | Phenacetin | Fine crystalline | 134.7 | 0.11 | 0.02 | - | + (Lehn & Fink) | powder, not | | | | | | uniform | | | | | | | | | | | Acetphenetidin | Fine crystalline | 134.8 | 0.13 | 0.00 | - | + (Lehn & Fink) | powder, not | | | | | | uniform | | | | | | | | | | | Acetphenetidin | Homogeneous | 134.3 | 0.19 | 0.03 | + | + (P. W. R.) (1) | crystalline | | | | | | powder | | | | | | | | | | | Acetphenetidin | Homogeneous | 134.7 | 0.16 | 0.02 | + | + (P. W. R.) (2) | crystalline | | | | | | powder | | | | | | | | | | | Acetphenetidin | Homogeneous | 134.7 | 0.14 | 0.02 | + | + (P. W. R.) (3) | crystalline | | | | | | powder | | | | | | | | | | | Acetphenetidin | Fine crystalline | 133.6 | 0.20 | 0.01 | - | - (P. W. R.) (4) | powder | | | | | | | | | | | Acetphenetidin | Fine crystalline | 134.3 | 0.19 | 0.00 | - | + (Squibb) | powder | | | | | | | | | | | Acetphenetidin | Fine crystalline | 134.8 | 0.15 | 0.03 | - | - (Merck) | powder | | | | | | | | | | | Acetphenetidin | Fine crystalline | 134.2 | 0.11 | 0.01 | - | - (Mallinckrodt) | powder | | | | | ----------------+------------------+-------+------+------+-----+----

[BG] In all cases identity was confirmed; acetanilid was absent; carbonizable matter was absent.

[BH] In this column plus indicates presence; minus, absence.

While this firm’s product alone gave any reaction whatever when the U. S. P. test for paraphenetidin was applied with the test of the Swiss pharmacopeia, all but Acetphenetidin (Mallinckrodt), Acetphenetidin (Merck) and one specimen of Powers-Weightman-Rosengarten Co. gave positive, though very faint, reactions, indicating that the majority of specimens, including those of the original manufacturer, contain a minute trace of this impurity.

Our findings regarding the product of Powers-Weightman-Rosengarten Co. having been communicated to this firm, their correctness was acknowledged. At the same time the firm wrote: “All that we have on hand now gives negative tests for paraphenetidin, and we believe our present records are correct when we state that all lots which we are supplying now, and have been supplying for some time past, answer all U. S. P. requirements.”

This examination appears to demonstrate that the chemical substance, para-acetphenetidin, whether sold as acetphenetidin, U. S. P., or as phenacetin, is practically identical. The impurity of the product of some of the specimens coming from Powers-Weightman-Rosengarten Co. is too slight to be considered dangerous. Furthermore, a comparison of the “lot numbers” indicates that this firm has been improving its product steadily so that in the future its assurances of an unimpeachable product may be relied on. Inasmuch, therefore, as acetphenetidin complies with all the pharmacopeial requirements as to identity and purity, in just the same way as phenacetin, which sells for as high as five times the price of acetphenetidin, physicians need not hesitate in using the title of the U. S. P. “acetphenetidin” when prescribing this produce.--(_From The Journal A. M. A., March 16, 1912._)

Acetphenetidin and Phenacetin

A physician-pharmacist writes: “If a prescription calls for ‘phenacetin,’ should the pharmacist dispense ‘phenacetin-Bayer’--that is, the phenacetin manufactured by the original patentee--or would he be justified in dispensing the official acetphenetidin, manufactured by any reliable chemical or pharmaceutical house?”

Unless the pharmacist happens to know that the physician in writing the prescription desired the Bayer brand, he would be justified in dispensing acetphenetidin, U. S. P. As a general thing, physicians use the word “phenacetin” without intending to prescribe any particular brand or make, simply because they are familiar with this word and are not familiar with the official term “acetphenetidin.” They will doubtless continue to use the term “phenacetin” and we know of no sufficient reason for doing otherwise. During the life of the patent the word “phenacetin” became a familiar one, and the product became generally known by this term. But a coined name for a patented article loses its proprietary character and becomes the common name of the article when the patent expires. In other words, when the patent expires, not only the product but also the name itself becomes common property. This principle has been recognized by the courts. Those who formerly controlled the product and the name “phenacetin” evidently recognized this principle, for they have taken no steps to prosecute a firm in this country which sells the product openly under the name “phenacetin.” It might be added that the preparation is official in most foreign pharmacopeias under the name “phenacetin.” In agreement also with this principle the Council on Pharmacy and Chemistry (The Journal, April 27, p. 1298) lists in New and Nonofficial Remedies such products as “lanolin,” “phenacetin,” “sulphonal” and “trional” as non-proprietary names applied to Adeps lanæ hydrosus, U. S. P., Acetphenetidinum, U. S. P., Sulphonmethanum, U. S. P., and Sulphonethylmethanum, U. S. P., respectively.

In view of these facts--and also bearing in mind the findings of the Association’s Chemical Laboratory (The Journal, March 16, p. 801) that the preparations on the market under the title “acetphenetidin” are of equal quality with the preparations sold under the name “phenacetin”--the pharmacist should recognize that acetphenetidin is identical with phenacetin, is prescribed, provided, of course, that no special brand of phenacetin is ordered.

It is the physician’s privilege, of course, to specify the goods of a particular manufacturer, but in view of the fact brought out above that all brands of this chemical have tested up to the U. S. P. standard, it is placing an unnecessary burden on the pharmacist to require him to have on hand many different brands of one substance. The physician should save this privilege for use when prescribing some product that differs materially in its various forms on the market, as for example in the case of certain fluidextracts.

Physicians will doubtless find that the above comments will interest their local pharmacists. It is of mutual value for physicians to talk these matters over with their pharmacists.--(_From The Journal A. M. A., Oct. 5, 1912_).

CLEAN ADVERTISING

It is individual effort that counts for most in every movement for better things--socially, economically or politically. Realizing this, The Journal repeatedly urges physicians who write regarding various fraudulent advertisements to enter their individual, personal protest against the continuation of such advertisements.

Within the past few months The Journal has had brought to its attention a good example of what may be accomplished by personal effort in cleaning up the advertising pages of a fraternal publication. _The Royal Neighbor_, official organ of a fraternal organization, until comparatively recently, carried numerous fraudulent medical advertisements. Fake liquor cures, rheumatism cures, tapeworm expellers, tobacco-habit cures, asthma and hay-fever cures, epilepsy cures, etc., disgraced its advertising pages. These called forth protests from Dr. E. A. Hall, Henry, Ill., who addressed letters to the official physicians of the fraternal order that the _Royal Neighbor_ represents, objecting to such advertisements. These letters in turn reached the advertising manager, and it was not long before the board of managers took the matter up for consideration and decided to eliminate this class of advertising from their official organ. By December, 1913, the _Royal Neighbor_ came to its readers clean. There is no doubt that the same results can be duplicated in similar cases. Whether they are will depend on the amount of active work done by individuals interested in the question of clean advertising.--(_From The Journal A. M. A., Feb. 14, 1914._)

LIPPINCOTT’S MAGAZINE

Its Advertising--a Protest and an Excuse

A few days ago a physician wrote to The Journal enclosing two advertisements taken from the current issue of _Lippincott’s_ magazine. One of these was a half-page advertisement of that outrageous fraud, the “Oxydonor;” the other was a full-page advertisement of J. B. Lippincott Company, Philadelphia, calling for salesmen “to present standard medical books to physicians only.”

The physician sending in this material asked us to send to _Lippincott’s_ a pamphlet showing the fraudulence of the Oxydonor. Instead of doing so, we sent the pamphlet to the physician and suggested that he write a personal letter in the belief that individual missionary work is the most effective way of fighting fraud. Accordingly the doctor wrote to _Lippincott’s_ and received in reply this letter from the advertising department of that publication:

“Your letter of the 23d received, and in reply beg to say that we do not approve of fraudulent advertising, and we have never before been advised that the advertisement to which you call our attention was objectionable. _In fact, we know nothing whatever about it._ [Italics ours.--Ed.] It came to us, as do most of the others, through an advertising agency, and while we do not willingly publish anything that is fraudulent or objectionable, _it is not our custom to verify the claims of advertisers_ [Italics, again, ours.--Ed.] especially when the same copy is being run in almost every other high-grade publication.

“We have a very high regard for the American Medical Association, and they undoubtedly are doing a splendid work in ridding the country of fake medical preparations, but the mere fact that they condemn some of our advertisers is hardly sufficient proof for us to refuse the advertising, because, _if the advertiser desires to do so, he can make us prove in the courts that he is a faker, or claim damages from us for refusing to publish his advertisement_. [Our italics.--Ed.] If the American Medical Association will guarantee to protect the publishers against loss from damage suits brought by advertisers whose business they refuse to accept, then, we believe that the publishers would gladly reject them, but not many of the publishers are in a position to investigate the merits of all the advertising that is offered, especially when the claims are backed up by affidavits of reputable people who believe themselves to have been cured by the preparation.

“We certainly do not wish to jeopardize our medical publications by advertising fake schemes or propositions of any kind, and we thank you for writing us concerning the matter and will now look into this particular case.”

This letter discloses the workings of the brain of an advertising man of the old school. The principles enunciated therein are those that dominated the advertising field until quite recently. They represent the _laissez faire_ doctrine as applied to advertising. At that time the only unacceptable advertising copy was that which would debar the publication using it from the United States mails. This was the yardstick by which all advertising was measured at that time.

The economic conscience has since awakened. There are few reputable magazines today, we venture to believe, that would be willing to go on record to the effect that it is not their “custom to verify the claims of advertisers.” The modern, progressive advertising man recognizes not only the responsibilities his profession imposes, but also realizes that, from the narrower view of enlightened self-interest, the greatest menace to the future of modern advertising is the fraudulent advertisement.

The claims on the part of the advertising department of _Lippincott’s_ that it dares not refuse to accept fraudulent advertisements because the advertiser might bring suit against it for refusing to accept his advertisement is a statement whose falsity is exceeded only by its silliness. Equally preposterous is the statement that _Lippincott’s_ will willingly refuse to accept fraudulent advertisements provided the American Medical Association will guarantee to protect the Lippincott Company against loss from damage suits that may be brought by the exploiters of the frauds whose advertisements are refused.

It may be news to _Lippincott’s_ to learn that there are a score and more of newspapers and magazines that are accepting the findings of the American Medical Association on medical frauds and rejecting advertisements of such frauds. There are many newspapers that send us the medical advertising “copy” submitted to them and ask for an opinion on it. When that opinion is unfavorable, these papers refuse such advertisements. This is being done daily. We have yet to hear of any “patent medicine” faker or quack even threatening to bring suit because his advertisements have been rejected.

The advertising department of _Lippincott’s_ may therefore take heart. When an advertisement of an outrageous fake like the Oxydonor is submitted to it, instead of accepting the money for it, meantime muttering an inaudible protest at the unfortunate position in which it has been placed, it may look the fraud in the eye and say Boo! The faker will not bite.

Before leaving the subject, we are constrained to refer to Lippincott’s medical publication, the _Annals of Surgery_. We begin to realize now why that journal offers a welcome haven to such products as Sal Hepatica, Bromidia, Papine, Gray’s Glycerin Tonic, Fellows’ Syrup of Hypophosphites, et al. Presumably the same “custom” obtains in the acceptance of advertising for the _Annals of Surgery_ as for _Lippincott’s_, namely that the Lippincott Company does “not verify the claims of advertisers.” Possibly the _Annals of Surgery_ is afraid that, should it reject the Sal Hepatica advertisement, for instance, it might he haled into court! Let us trust, for their peace of mind, that the publishers of the _Annals of Surgery_ do not receive an advertisement from Old Doc Hartman for a full page display of Peruna. The mental anguish they would undergo in reluctantly accepting this advertisement--under the fear that Hartman would “claim damages” if it were rejected--is painful to contemplate.--(_From The Journal A. M. A., Feb. 7, 1914._)

MEDICAL JOURNAL ADVERTISING

And Methods of Obtaining Paid-Up Subscribers

Time was when the postal authorities were lenient with publishers. The names of individuals who had ever subscribed for publications of a certain class were carried on the books indefinitely, whether they paid their subscriptions or not. This permitted a padding of the circulation figures. Of late years, however, the postoffice department requires publishers to have bona-fide paid-up subscriptions if they wish their publications to be carried at the low second-class rate. Certain medical journals have been hard put to it to get a circulation that would be at all attractive to the advertisers, on whose money they depend for continued existence.

Many and various have been the schemes devised whereby the dwindled circulation might be “boosted.” Subscriptions could not be given away because the postal laws forbade it. One ingenious method of obviating this difficulty is worked in this fashion: Dr. John Doe writes an article that appears in a reputable medical journal. A few days after its appearance, Dr. Doe receives a letter from the editor and publisher of a medical journal that is in need of a subscription list. He is told that the editor has read his article with much interest and would appreciate receiving from Dr. Doe a brief abstract of it. He does not expect the doctor to go to the trouble of making this abstract for nothing. He will, therefore, on receipt of the abstract credit Dr. Doe with three years’ subscription for himself or for one year for himself and one year for each of any other two doctors he may name. For every doctor that bites on this scheme the publisher increases his circulation by three copies and the federal officials are assured that they are paid-up subscriptions--not paid for in cash, it is true, but in “abstracts.”

All of this preliminary to a letter recently received:

_To the Editor_:--Enclosed find letter which speaks for itself. Now what I should like to know from you is the following: Is the _Charlotte Medical Journal_ all it should be? Should a doctor contribute to a journal--thereby adding to its prestige and circulation--that carries questionable matter in the advertising pages? If the above journal is off color, does that act as a bar for good men to contribute?

Very truly yours, L. J. Genella, M.D., New Orleans, La.

The letter which our correspondent encloses is on the stationery of the _Charlotte Medical Journal_ and signed by the editor of that journal. Here it is:

“My Dear Doctor Genella:--I have just looked over an article of yours published in the _New Orleans Medical and Surgical Journal_ entitled ‘Clinical Studies in Pituitary Irritation, with Report of Case.’ I would be very glad indeed to have you send me a manuscript or article for the _Charlotte Medical Journal_. Your style of writing is very attractive.

“If you will send me an article for the journal, I will be glad to publish same and will place your name on my complimentary mailing list. Under separate cover I am sending you a copy of the journal.

“Of course I will expect the article to be typewritten.”

Whether or not this is a modification of the “abstract” scheme or an attempt to boost the circulation of the _Charlotte Medical Journal_ are questions we shall not attempt to answer. As to the questions propounded by our correspondent, they have been answered many times in these pages. We turn to one of the recent copies of the _Charlotte Medical Journal_ and examine its advertising pages. On one of the first we find Anasarcin, a product whose fraudulent character was described at some length in The Journal, May 4 and 11, 1907. On another page we find Tongaline, which has also come in for a fair share of attention (see The Journal, Sept. 23, 1906, and May 10, 1913). A little farther over we find a half-page advertisement of Bannerman’s Intravenous Solution, a nostrum first exploited as a “consumption cure” and now as a cure-all (see The Journal, May 31, 1913). Cactina Pillets (see The Journal, March 12, 1910), Hagee’s Cordial of the Extract of Cod-Liver Oil (see The Journal, Oct. 13, 1906), Burnham’s Soluble Iodin (see The Journal, March 28, 1908), Ecthol (see The Journal, March 13, 1909), Bromidia (see The Journal, April 21, 1906), Papine (see The Journal, April 29, 1911), Phenalgine--two advertisements (see The Journal, Jan. 13, and 27, 1906, and Jan. 27, 1912) and Sal Hepatica (see The Journal, March 26, 1910) are some more products which have attained unenviable notoriety but found a safe haven in the advertising pages of the _Charlotte Medical Journal_. Neither must we fail to refer to the advertisement of Duffy’s Malt Whiskey (see The Journal, Nov. 23, 1912), which looks thoroughly at home.

Does our correspondent--in fact, does any conscientious physician having the interest of scientific medicine at heart--want to do anything that will tend to perpetuate therapeutic fraud? Subscribing for or contributing to medical journals whose income is largely derived from nostrums that are as vicious as many of the “patent medicines” advertised in the daily press hampers the medical profession in its fight for honesty in therapeutics and renders largely abortive its fight against fraudulent “patent medicines.” So long as the accredited organs of the medical profession tolerate fraudulent “ethical proprietaries” in their advertising pages, just so long will the protests of physicians against the swindling advertisements of “patent medicines” in the daily press fall largely on deaf ears--and justly so.--(_From The Journal A. M. A., Oct. 11, 1913._)

A Physician Places the Responsibility for Fraudulent Advertising Where It Belongs

“_To the Editor_:--The Journal has had much to say in recent years regarding the ethics, or lack of same, in advertising matter exploited by its contemporaries. It has been criticized by many for the stringency of its attack; it has been criticized by very few because it did not go far enough. Is it not about time to get to the root of the matter?

“In the last number [see p. 426, this book] dissatisfaction is expressed with the advertising policy of the _Medical Times_. Nothing finer! Go to it! But is the method of attack right? I have before me a sample copy of the _American Journal of Surgery_. Among other articles is one on diseases of joints and the bone marrow by a man very favorably known in Denver. He was ‘ethical’ enough to be accorded a place on the program in the Section on Medicine at Minneapolis. Another contributor from Baltimore remarks that he took a patient to the University Hospital. Can it be possible that Johns Hopkins is admitting men to its wards and clinics that are below par in professional morals? Another article appears from a well-known orthopedic man of Washington, D. C. Personally, I see very little to commend in the advertising columns of the _American Journal of Surgery_.

“I, who confess to a state bordering on youth, may be very wrong; but I believe that the trouble will be solved only when men who claim to have any professional distinction refuse to contribute to journals whose pages are not clean from cover to cover. Pardon the presumption, Mr. Editor, but were you ever tempted to print anything like this:

“‘Last week’s issue of the _New York Medical Squall_ contains an article on “Duodenal Ulcer” by John Doe, the well-known Chicago surgeon. Dr. Doe doubtless knows as well as any one the disreputable character of the _Squall’s_ advertising matter, but like most of our great men, is unable to restrain his appetite for journalistic publicity.’

“Physicians read medical journals because they contain literature that is worth while. Jump on your erring editorial brethren, Mr. Editor, but please remember that the problem of eliminating bogus advertisements will be solved when the so-called leaders of our profession show enough manhood to refuse literary support to publications whose columns are in disrepute. While castigating the little sinner, please don’t let the big sinner go scot free.

“Clinton E. Harris, M.D., Grinnell, Iowa.”

Dr. Harris sums up the situation correctly. No small degree of responsibility rests on the prominent members of the medical profession who lend their support either as subscribers for or contributors to those medical journals whose advertising pages are a stench in the nostrils of thinking physicians. Dr. Harris asks why The Journal does not condemn the advertising columns of the _American Journal of Surgery_. The Journal has done so more than once and in no uncertain terms, both in the Propaganda department and editorially. At one time it said:

“In circular letters and in an editorial announcement in its December issue, the _American Journal of Surgery_ ‘features’--to use a newspaper term--some of the contributors to its January issue. The list comprises men who hold, or have held, high offices in the American Medical Association. Presidents, vice-presidents, chairmen, secretaries and members of sections of the Association--these are some of the men whose names appear as contributors to this nostrum-promoting publication. Is it any wonder that the proprietors of the _American Journal of Surgery_ assume an attitude of indifference to the class of proprietary preparations which they admit to the pages of their publication?”

What was the result of The Journal thus directing the attention of its readers to the _American Journal of Surgery_? In the next issue of the _American Journal of Surgery_ appeared a seven-column editorial tirade, entitled “An Unwarranted Attack on the President and Other Eminent Members of the American Medical Association and on the Leading Medical Journals of the Country.”

On many and various occasions has The Journal called attention to the very evils that Dr. Harris deplores, and for the benefit of those who care to look up the matter these references to some of the articles are appended:

“The Mote and the Beam,” editorial, Nov. 18, 1911.

“Activity or Passivity--Sympathy or Sacrifice,” editorial, Dec. 9, 1911.

“Cui Bono,” editorial, Dec. 16, 1911.

“Medical Journals and the Great American Fraud,” Propaganda Department, Dec. 16, 1911.

“The Profession Must Apply the Penalty,” editorial, Jan. 13, 1912.

“Fraudulent Advertising in High-Class Medical Journals,” editorial, Jan. 4, 1913.

“Demand Clean Advertising,” editorial, Jan. 4, 1913.

“Medical Journals and the Great American Fraud,” editorial, Jan. 18, 1913.

“A Good Principle to Apply,” editorial, May 13, 1913.

“Medical Journal Advertising,” Propaganda Department, Oct. 11, 1913.

“Medical Journals and the Great American Fraud,” Propaganda Department, Oct. 18, 1913.

“Medical Journals and the Great American Fraud,” Propaganda Department, Nov. 1, 1913.

“The Medical Times’ Advertisements,” Propaganda Department, Nov. 8, 1913.

In another letter on the same subject its writer says: “I think the time has arrived when we have a right to expect real leadership from the ‘big men’ of the profession.”--(_From The Journal A. M. A., Nov. 22, 1913._)

MEDICAL JOURNALS AND THE GREAT AMERICAN FRAUD

How the Medical Times Aids and Abets Quackery, with the Moral Support of Members of the Medical Profession

Two letters have been received, both from physicians. One comes from New York City and the other from Alexandria, Va. Each letter contained an advertisement of the Kellam Hospital, Richmond, Va., cut from the _Medical Times_. Here is the New York letter:

“_To the Editor_:--I am enclosing an advertisement clipped from the _Medical Times_. It seemed to me an especially flagrant example of what may happen in the absence of proper supervision of the advertising pages of a medical magazine. The condition would seem all the worse in this instance as among the ‘Board of Contributing Editors’ are listed men like Howard Lilienthal of New York and Almuth C. Vandiver, who is Counsel for the Medical Society of the County of New York. The _Medical Times_ is sent to two of the physicians who live at this address without charge and without solicitation. Many advertisements of proprietary preparations are inserted in type indistinguishable from that of the body of the magazine and it is of course possible that its financial backing comes entirely from the manufacturers of these drugs.”

And this is from Virginia:

“_To the Editor_:--The statements made in the advertisement of the Kellam Hospital in the October number of the _Medical Times_ are so out of the ordinary that I ask you to tell us something if you can of their institution and its methods of cure. Can such things as are stated in this advertisement be true? ‘Physicians Treated Free?’ ‘Endorsed by the Senate and Legislature of Virginia?’ What can all this mean to the sufferer from cancer? If true, let the whole world of sufferers know the glorious news.”

_Collier’s_ paid its respects to the Kellam concern some time ago and we cannot do better than quote from its pages. Thus:

“Grief is the portion of the Kellam Cancer Hospital, of Richmond, Virginia, because in these editorials it has been grouped with other exemplars of the Great American Fraud. It offers the invariable and hollow mockery of testimonials and endorsements, which, as has been repeatedly shown, can be wheedled, browbeaten or bribed out of the victims of any form of quackery. It, of course, courts the fullest investigation, and desires that we send a representative to investigate whether its claims are not well founded. Unsuspected by the Messrs. Kellam, our representative has already investigated their claims, notably their statement that they are endorsed by the Legislature of the State of Virginia. Upon request for a copy of the endorsement they forwarded a weak subterfuge, and finally, on pressure, admitted that they could not produce the proof they had boasted. For their further consideration we present a brief parallel:

FROM THE KELLAM CIRCULAR FROM A KELLAM LETTER

The Cancer is removed without We do not claim to “_cure them the use of the knife or X-Ray all_.” We go further, and on ... No roots or fibers left; our part, we agree to treat, free _hence it can not return_. of charge, any patient _who suffers a recurrence after having been treated by our method_.

“The italics are our own, but we cheerfully present them for elucidation to the Kellam Hospital. A little careful thought devoted to reconciling the irreconcilable may help them to forget their woe. Meanwhile, they make themselves out worse than they really are by pretending to withhold from the bitter need of humanity a true, non-surgical cure for cancer. If this were true; if, indeed, they had solved the problem which has baffled the greatest minds of modern science; if, having a genuine cure for the dreadful ailment which claims its increasing thousands of tortured victims yearly, they secrete their discovery for the sake of a few paltry dollars, then they are as cold-hearted as the sailors who pass within fair hail of the naked island on which some shipwrecked crew is starving, and keep their stony eyes on the compass. They have not even the excuse of the fanatical among the Christian Scientists who, denying the existence of pain, refuse to take measures to ease the cancer victim’s suffering even at the last. Human nature is seldom so callous.”

As for the _Medical Times_: This publication for years contained comparatively little advertising. Then it came into the hands of Romaine Pierson, who also owns the _Practical Druggist_. Mr. Pierson is not a physician and to him the medical profession is but a commercial problem. He is publishing a medical journal for the money there is in it, and for this he is not to be censured. Questions of advertising policy, in such circumstances, are determined on a commercial basis. When an advertising contract is submitted, for a product that physicians would know to be fraudulent, the question that arises is, “Can it be put over?” Manifestly, a medical journal published purely as a business venture would not dare long to fly in the face of the opinions of those from whom it received its support--its subscribers and contributors. If our correspondents will go through the advertising columns of the _Medical Times_ they will find many, many other frauds, less cruel perhaps than the Kellam advertisement, but no less disreputable or discreditable to the medical profession.

After all is said and done, it is enlightened public opinion that is causing publishers of lay magazines and newspapers to eliminate fraudulent “patent medicine” and quack advertisements. Until the medical profession takes an equally enlightened stand, physicians may expect to be afflicted with such commercial medical journals as the _Medical Times_, the _International Journal of Surgery_, the _American Journal of Surgery_, _American Medicine_, and several other papers that are published primarily in the interest of the advertiser. When such journals as these find they cannot get a circulation among physicians so long as they carry advertisements similar to many now appearing in their pages, these advertisements will be eliminated, but not before. Many physicians are receiving such journals at a nominal price or, as one of our correspondents notes, free. The physician who permits such journals to come to his office must share with the paid subscribers the responsibility for the low standard of medical journalism.--(_From the Journal A. M. A., Oct. 18, 1913._)

Two Physicians Express Themselves on the Ethics of Medical Journalism

After the preceding article was in type, we received, in the same mail, two letters that are so apropos that we reproduce them. The first was from a town in Illinois, and was dated October 11. Here it is:

_To the Editor_:--About two weeks ago, a representative of the Surgery Publishing Company, New York, N. Y., came to ---- Ill. soliciting subscriptions for the _American Journal of Surgery_. Together with numerous others I subscribed--chiefly on the strength of the contributors whose articles appeared in the sample numbers shown by the agent.

Since receiving the first number (October) one look at the advertising pages has shown me why the subscription price for a year and a quarter is one dollar. Anasarcin, Tongaline, Cactina Pillets, Hagee’s Cordial of Ext. Cod Liver, Burnham’s Soluble Iodin, Papine, Phenalgine, Anusol, etc., etc.

I have written to the Surgery Publishing Company, telling them in no uncertain language that there is no room on my reading desk for such. Have you ever exposed this journal, and the attitude of our big, brilliant, eminent men in permitting their articles--presumably original--to fill space in such a journal? [Yes! The Journal, Dec. 16, 1911, pp. 2,000 and 2,013.] This letter is not for publication--at least not with name of city. Keep up the good work....

The other, dated October 10, follows:

_To the Editor_:--That little story about medical journal advertising and methods of obtaining paid-up subscribers, in this week’s Journal makes me blush (p. 422, this book). I am guilty. Unlike Dr. Genella, I swallowed the bait--but the bait was even more tempting in my case; the flattering “editor” offered me twenty-five subscriptions to distribute among my friends, all for an “abstract.” Thank goodness, I only accepted five subscriptions, but worse luck, I sent them to young men by preference. So I am a deep-dyed offender indeed. Extenuating circumstances affected my susceptibility somewhat, however. I have noticed that prominent men like Beverly Robinson, A. Rose, Tom A. Williams, Wayne Babcock, and Morris--the latter, at least, a really able man and a brilliant writer--contribute to these peanut journals occasionally. If they do, why not I? There’s nothing like being in big company, you know.

So far as I know, my “abstract” has not yet been published. On looking over the sample copy of this monthly I found an advertisement printed right in the list of contents--in fact, it was the second “original article” in the issue, as brave and respectable as you please! Then, with characteristic Hibernian impetuosity I got out my machine and pounded that editor a strong protest with a dire command not to use my “abstract” in his miserable organ. But I have never received the manuscript, nor any reply to my stern rebuke. I wish I had been cautious like Dr. Genella.

Wm. Brady, M.D., Elmira, N. Y. --(_From The Journal A. M. A., Oct. 18, 1913._)

The Responsibility of Physicians

The responsibility of medical journals for the continued existence of at least a part of the “great American fraud,” has been referred to in these pages many times. Within the past few weeks The Journal has called attention to the inconsistency of reputable physicians of high ideals lending their moral, and often financial, support to those medical journals whose advertising pages are a disgrace to the profession. Specifically, the _Medical Times_--originally a homeopathic medical journal--has been referred to, among others, as an example of this type of journalism. It must, however, be regarded simply as a type, for it is no better and no worse than many other medical journals. Several letters have been received on the subject, some of which we reproduce. The first one is from Dr. George G. Ross of Philadelphia:

“I was very much jarred on receiving the last issue of The Journal to find under the Propaganda for Reform an article concerning the _Medical Times_, among the list of whose contributing editors my name appears. I enclose you herewith a copy of my letter of resignation to the _Medical Times_. I have a very dim recollection of what occurred at the time that I was asked to give my name as a contributing editor. As I recollect it, however, at that time the journal was a respectable and ethical publication. I had been asked by a friend of mine to write an article giving my opinion of the effects of college athletics on undergraduates. This was at the time that Dr. Stokes had issued his order about athletics at Annapolis. I want personally to thank you and the committee for the exposure of this journal and for having drawn my attention to the fact that I was unwittingly aiding and abetting such a journal. I trust that if you have space in some future number of The Journal, you will do me the justice to publish all or part of this letter.”

Because he feels that he has “unwittingly been put in an unfavorable light,” Dr. James A. Babbitt, also of Philadelphia, sends The Journal a copy of a letter written by him to the editor of the _Medical Times_. Here it is:

“For reasons of which you are probably cognizant, I deem it advisable to resign from the board of contributing editors of the _Medical Times_, and desire that this resignation be accepted at once and my name not appear in further issues.”

What shall be done, asks Dr. Sidney Thompson of Humboldt, Tennessee, in such cases as the following? Says Dr. Thompson:

“In the Propaganda for Reform, in The Journal, October 18, 1913, in closing your article on ‘Medical Journals and the Great American Fraud,’ you say: ‘The physician who permits such journals to come to his office must share with the paid subscribers the responsibility for the low standard of medical journalism.’ Now I agree with you in everything you have said about the _Medical Times_, but what I want to know is how to keep such journals from coming into your office. The _Medical Times_ has been coming to me for a number of years with repeated duns for the subscription price. I have written to them several times that I did not want the journal and never expected to pay for it, but still it comes. I have a vague recollection that I bit at an offer to send it three or four months free, not knowing what it was, but I never authorized them to enter my name as a regular subscriber.”

The simplest course in such a case as that described by Dr. Thompson, is to write on the unwelcome publication the word “refused” and either drop it in the nearest mail-box or hand it back to the postman. The courts have held that a person who continues to accept publications is legally liable for the payment of such publications. The postoffice department, however, has ruled that a magazine--either monthly or weekly--may not be sent at second-class rates for more than one year after the expiration of a bona fide subscription. At the expiration of that time, stamps must be affixed and the publications sent at third-class postal rates.--(_From The Journal A. M. A., Nov. 1, 1913._)

Medical Journals and Sanatogen[BI]

[BI] See also Sanatogen, p. 358.

We have frequently referred to the inquiries that are received by this office from newspaper and magazine editors asking for information about products whose advertisements they have been offered. One of the greatest difficulties in the way of accomplishing the good that such inquiries otherwise might lead to is the lack of uniform action on the part of the medical press of the country. A specific instance may be given. A layman wrote to a high-glass weekly magazine published in New York City protesting against an advertisement of Sanatogen which the magazine was carrying, and sending a reprint of The Journal’s article on this product. The advertising manager of the magazine in question wrote back that he had seen The Journal’s article, but had sought further information regarding the preparation from the editor of a medical journal in his city. The medical editor recommended that the magazine accept the Sanatogen advertisement, so the advertising manager said, and in view of this, the manager suggested that possibly the article published by the American Medical Association in its journal was inspired by some “personal prejudice.” Giving weight to the probability that the advertising manager went for his information to a source that he knew would be favorable to the acceptance of the advertisement, the fact remains that it is a disgraceful state of affairs when editors of medical journals will give vicious advice in matters on which they are supposedly competent to pass. The probability is, of course, that the medical journal whose editor was questioned contained the self-same advertisement that the lay magazine was carrying. And the advertising manager of the magazine was willing to accept--because such information coincided with his wishes--information that on its face must be biased, and rejected advice--that did not meet his approval--because of a purely supposititious “personal prejudice.” It is probably asking too much to expect advertising managers not to go to sources that are likely to be favorable for information about products whose advertisements are offered to them. But we have a right to expect that physicians, editors of medical journals, should no longer be _participes criminis_ in the furtherance of the great American fraud. If our strictures on Sanatogen are unfair, if the Council on Pharmacy and Chemistry rejected the product in mere pique, if the opinions of such men as Billings, Cabot, Hektoen and Lusk are to be brushed aside as “personal prejudice,” if this mixture of cottage cheese and glycerophosphates really is the marvelous product which its exploiters claim--then indeed not only have the editors of medical journals a right to praise it, but it is also their duty to proclaim these wonders in their editorial pages. If, on the other hand, this much-vaunted preparation is a very ordinary mixture sold at an extraordinary price, if indigent consumptives and others are being inveigled into spending dollars for a preparation whose food value could be duplicated for a few cents--then in the name of humanity and common decency let the editors of medical journals proclaim these facts, and not let their scientific judgment be blinded by the glitter of advertising contracts.--(_Modified from The Journal A. M. A., Jan. 18, 1913._)

THE ARMY AND NAVY MEDICAL RECORD

A Fraudulent Publication Whose Editorial Opinions Are for Sale

Whenever a business assumes certain proportions, subsidiary businesses spring up to cater to the needs of the larger enterprise. For some years the nostrum business has grown so large that it has furnished a more or less precarious life for many individuals who have catered to it. There are, for instance, men whose trade it is to obtain testimonials; others, claiming a long string of imposing degrees, will furnish fake reports and bogus analyses; still others issue at irregular intervals publications with high-sounding names which sell editorial indorsement to the products of concerns such as are willing to pay the price asked. “Journals” of this type have been called to the attention of our readers at different times; the _New York Health Journal_ and the _United States Health Reports_ come to mind at this moment. Both of these had their day and died a natural death, as all such publications must when once the public is cognizant of their true character.

TWO LETTERS

More recently the attention of _The Journal_ has been called to a publication calling itself the _Army and Navy Medical Record_. A physician in the South sends a letter he has received from the _Army and Navy Medical Record_ reading as follows:

“We have had many favorable reports reach us relative to your most excellent institution, and, as you are doubtless aware, we come in direct contact with a large number of Army and Navy and other government attachés who have sons that they desire to provide with a medical education combined with the higher course included in your up-to-date laboratory methods and the sciences incidental to clinical medical practice.

“If you will regard the proposition as confidential, we will agree to carry a one-fourth page advertisement of your university at the nominal rate of $38 per year, provided this amount is forwarded in advance at the time copy is furnished; and _we will further promise to editorially indorse and recommend your school and its methods without qualification or exception_. [Our italics.--Ed.] This article you should be able to use (and are authorized to do so) after publication for advertising purposes.

“We will also be able, and are willing, to furnish you with a desirable list of probable candidates from time to time.

“Kindly let us hear from you at once, if interested, and oblige,

“Yours with best wishes, “The Army and Navy Medical Record, “Arthur G. Lewis, Managing Editor.”

The physician to whom this was addressed made a notation on the letter to the effect that “this looks crooked.” A few weeks later, Dr. V. C. Vaughan, dean of the University of Michigan, Department of Medicine and Surgery, sent in a letter from the _Army and Navy Medical Record_ which he had received in his official capacity at the university. Here is the letter; again the italics are ours:

“We are gratified to advise you that in our efforts to select a strictly ethical and high-grade institution of medicine that this magazine could consistently indorse and recommend, we have decided on the University of Michigan, Department of Medicine and Surgery, as the institution in your territory to whom our special publicity concession will be made this year.

“You are doubtless aware that we come in direct contact with a very large number of Army and Navy and other government attachés, also physicians in private practice who have sons that they desire to provide with a medical education, combined with the higher courses included in your up-to-date methods.

“For personal reasons we are particularly anxious to favor your institution, and frankly believe that we can prove of material service to you. The special proposition, to be regarded by you as strictly confidential, is that we will publish a full one-half page announcement of your institution for the term of one year, you to merely pay a nominal expense charge of $38 for the year’s service. As our regular rate is $125 per annum for this service, _the necessity of regarding the matter between ourselves is apparent_. [Transparently so.--Ed.] We further propose, without expense to you, to editorially indorse and recommend your institution and its methods without qualification or exception. An electrotype illustration may be used, without charge.

“It is important, however, that we hear from you promptly. Awaiting your immediate reply, we are, with best wishes,

“Yours faithfully, “The Army and Navy Medical Record, “Arthur G. Lewis, Managing Editor.”

Dr. Vaughan, in forwarding the matter to The Journal, wrote that on receipt of the offer just given, he “was uncertain whether its writer was a knave or a fool.” After inquiring into the matter somewhat thoroughly, he concluded that “the managing editor of the _Army and Navy Medical Record_ is both a knave and a fool.”

THE ARMY AND NAVY MAGAZINE

The Journal had the _Army and Navy Medical Record_ under investigation before these two letters were received and, as a result, the following facts seem to be pretty well substantiated. Herbert C. Lewis, with his brother, Arthur G., conducted from Washington, D. C., a publication called the _Army and Navy Magazine_. In The Journal’s nostrum file there is a booklet put out by the Renova Distributing Company describing the wonderful virtues of its product, “Anti-Jag,” which, as its name might intimate, is a “liquor cure” of the fake variety. One page of this booklet is given over to what purports to be “A Letter from a Great Magazine Editor.” The letter is dated June 19, 1900, from Washington, D. C., and says that “the editor of the _Army and Navy Magazine_ takes pleasure in stating that from his own personal knowledge he has found ‘Anti-Jag’ to be one of the most reliable medicines ever introduced for the permanent cure of drunkenness.” And more to the same effect. The letter is signed “Herbert C. Lewis, editor.”

The publishing offices of the _Army and Navy Magazine_ are at 606 F Street, N. W., Washington, D. C. The building at this address is known as the Baltic Building. Herbert C. Lewis is said to be a printer by trade.

The _Army and Navy Medical Record_ seems to have been started within the last few months by Arthur G. Lewis. It does business from two addresses, the Baltic Building, Washington, D. C., and the Maple Villa Sanitarium, Hammonton, N. J. Lewis is said to have purchased the Maple Villa Sanitarium recently, but apparently his chief source of income is the _Army and Navy Medical Record_. He is alleged to have claimed that some medical officials of the government are interested with him in this publication but that these officials do not wish their names known. We do not blame them.

ADVERTISEMENTS AS EDITORIALS

A glance through two issues of the _Army and Navy Medical Record_ makes perfectly plain the character of the publication. The January-February, 1913, number leads off with articles by well-known medical officers in the Army, the Navy and the Public Health Service. These have been copied from other publications. Then comes an editorial entitled “A Much Needed Dietary Reform,” devoted to the laudation of “Postum,” the widely advertised coffee substitute. Following this is an editorial on “The Philosophy of Hypnotics” in which aconitine, saline laxative and digitalin are each given a “boost.” Then comes an “original article” (save the mark!) entitled “The Physiological Pathology of Consumption.” This is by “Alfred S. Gubb, M.D., L.R.C.P., London, M.R.C.S., Eng., D.P.H., etc. etc., Aix-les-Bains, Savoie, France.” Two pages are devoted to this. The “joker” appears in the third paragraphs from the end--Fellows’ Syrup of Hypophosphites. Dioxogen receives more than three pages of editorial mention under the caption “The Sterilization of Milk with Dioxogen.” Under “Another New Electrical Wonder--Magnified Sound,” the “Acousticon” is given a two-and-a-quarter page write-up. “What Wise Men Wear” is the title of a four-page article--unsigned--devoted to the laudation of suspensories in general and the “O-P-C Suspensory” in particular. Dr. H. F. Boatman, Los Angeles, contributes a short article on “A Case of Advanced Pulmonic Tuberculosis Treated with Injections of Dioradin,” while our good old friend Willard H. Morse, M.D., “F.S.Sc. (Lond.),” the champion fake-testimonial-giver of the country, writes more or less entertainingly on “Putting on a Mustard Plaster.” The article has nothing to do with mustard plasters but has a good deal to do with “Zumota,” a nostrum recommended as a substitute for the mustard plaster. These are but a few of the nostrums to which the editorial and reading pages of the _Army and Navy Medical Record_ are devoted.

In the June-July issue, Arthur G. Lewis becomes bolder. The leading article is entitled “First Aid in the Navy,” by C. F. Stokes, Surgeon-General, United States Navy. There is nothing to indicate that this article was not contributed to the _Army and Navy Medical Record_ by its author. As a matter of fact, it originally appeared in an official publication, the _United States Naval Medical Bulletin_ for January, 1913, and was reprinted by Lewis without credit and without permission. Following the article by Dr. Stokes is another, unsigned, entitled “The Passing of ‘The Pie Habit.’” This describes the surprise of the students of Harvard University at being served breakfast cereals instead of pie at their noonday meal and suggests that “Shredded Wheat Biscuits” make a “delicious dessert.” A two-and-a-half page article on the “Danger of Corrosive Sublimate in Vaginal Douche” is reprinted from the _Lancet-Clinic_ of September, 1903. The reason for resurrecting this ten-year-old article becomes apparent before one gets half through it. It deals not so much with the danger of corrosive sublimate as with the marvelous--alleged--properties of Tyree’s Antiseptic Powder. Dr. Claude C. Keeler, Denver, has a three-page article on the “Medical Treatment of Pulmonary Tuberculosis.” The “medical treatment” referred to is Waterbury’s Compound. An editorial entitled “One Notch Ahead of Morphin” is devoted to that vicious morphin solution sold under the proprietary name “Papine.” Another on “The Treatment of Catarrh by Palliatives and Curatives” deals with a widely advertised “patent medicine,” “Kondon’s Catarrhal Jelly.” What appears to be a contributed article by Charles Wardell Stiles of the United States Public Health Service on “Country Schools and Rural Sanitation” has really been “lifted” from an official publication without credit and, needless to say, without Dr. Stiles’ permission.

But medicinal preparations are not the only things to which the _Army and Navy Medical Record_ gives editorial indorsement. All advertising matter, apparently, is grist to its mill. Sandwiched in between articles on “Public Health Administrations” and “Important Army Medical Lectures” is a dissertation on “The Millennium of Shirt Construction,” in which are sung the virtues of the tailless shirt! A little farther along the Hawaiian pineapple is extolled, while the last pages of the issue are devoted to various banking concerns.

In addition to the advertisements appearing throughout the reading and editorial pages of these two issues of the _Army and Navy Medical Record_, there are a number of display advertisements. There is no reason to suppose, at least in the majority of cases, that the advertisers had the slightest reason to suspect the nature of the _Army and Navy Medical Record_. Several pages are devoted to financial advertisements, there being more than forty banks that have “fallen for” the wiles of Arthur G. Lewis. In view of the letters received by the deans of medical colleges and other educational institutions, the display advertisements of schools and colleges have a special interest to physicians. Schools for girls, polytechnics, colleges of music, veterinary, dental and medical schools--all are to be found in this cosmopolitan publication.

Among the therapeutic products advertised--in the advertising pages--are:

Fellows’ Syrup of Hypophosphites 1 cover page Kondon’s Catarrhal Jelly 1/2 page Expurgo Anti-Diabetes 1/2 page Laxol 1/2 page Campho-Phénique 1/2 page Palpebrine 1/2 page Zumota 1/2 page Sanmetto 1/4 page

While in the reading pages the following products are puffed:

Tyree’s Antiseptic Powder. Waterbury’s Compound. Papine. Kondon’s Catarrhal Jelly. Ranier Natural Soap. Iodia (Battle). Creo-Derma. Fellows’ Syrup of Hypophosphites. Tannalbin. Expurgo Anti-Diabetes. Zumota. Sulfothen. Dioxogen. Palpebrine. Bannerman’s Intravenous Solution. Daniel’s Concentrated Tincture of Passiflora. Peacock’s Bromides. Aletris Cordial Rio. Gonosan. Digipuratum. Dioradin. Pepto-Fer. Lactol. Campho-Phénique.

Summed up: The _Army and Navy Medical Record_ is but another of the parasites of quackery. It is not entered as second-class matter and it has probably no bona-fide circulation. While it is claimed to be “Devoted to the Interest of the Medical and Surgical Corps of the Army and Navy, the Public Health Marine Hospital Service and the Red Cross Society” it is actually devoted to none of these. It is devoted to the exploitation of the advertising public for the special financial benefit of the man who calls himself its editor--Arthur G. Lewis. Advertising contracts are obtained under false and fraudulent pretenses. In brief, Arthur G. Lewis is using the good name of the various medical services of the United States government to further his swindling operations. He has written letters to honorable physicians making dishonest and insulting propositions to deceive and defraud the public. Editorial indorsements of the _Army and Navy Medical Record_ mean nothing except that money has been paid for them. In short, the _Army and Navy Medical Record_ is a fraud, and its “editor,” Arthur G. Lewis, a faker.--(_From The Journal A. M. A., Oct. 25, 1913._)

THE MEDICAL TIMES ADVERTISEMENTS

In Which Are Discussed Some “Oversights” and the Ethics of Journalism

Two or three weeks ago we published letters from two physicians calling attention to an advertisement of a “cancer cure” hospital appearing in the _Medical Times_. As a result of The Journal’s comments, some of the physicians who were listed as “contributing editors” of the _Medical Times_ wrote that they had requested that their names be withdrawn from this list. In reply to at least some of these letters, the editor of the _Medical Times_ wrote asking them to reconsider their decision and offering as an excuse the statement that the appearance of the “cancer cure” hospital advertisement was an oversight. In this connection the following letter from the _Medical Times_, addressed to The Journal of the American Medical Association, is pertinent:

“_Gentlemen_:--We note in your issue of October 18 an article calling attention to an advertisement which appears in the columns of this journal, and to which your editor rightly objects.

“The advertisement in the _Times_ was the result of an oversight, and it will not reappear.

“While we are indebted to you for thus bringing the matter to our attention, we cannot but feel that a letter written to us would have been more in keeping with the ethics of journalism.

“Very truly yours, The Medical Times.”

It will be noticed that this letter, like the letters sent to other physicians, ignores altogether the most important point made by The Journal in its criticism of that publication’s advertising policy. The Journal said in this connection:

“If our correspondents will go through the advertising columns of the _Medical Times_ they will find many, many other frauds, less cruel perhaps than the Kellam advertisement, but no less disreputable or discreditable to the medical profession.”

The _Medical Times_ apologizes for the advertisement of the Kellam Cancer Cure Hospital but ignores altogether the fact that the hospital advertisement was but one of many equally discreditable. We turn to recent issues of the _Medical Times_ and we find it fairly reeking with advertisements of proprietary preparations that are a disgrace to the medical profession, many of them having been repeatedly exposed in The Journal. We find, for instance, a quarter-page advertisement of the Expurgo Manufacturing Company. “Expurgo Anti-Diabetes,” we are solemnly told in the pages of the _Medical Times_ is:

“The only reliable and thoroughly tested remedy for the cure of Diabetes Mellitus and Insipidus.”

This wretched fraud, which also is advertised in true “patent medicine” style direct to the public, is presented to a presumably intelligent profession as a “cure” for a disease which so far has baffled the best brains in the scientific world.

“Expurgo Lapis” we are told, also via the _Medical Times_ is:

“The only known cure for gall-stones, kidney and bladder stones, gravel and all kidney trouble arising from uric-acid origin.”

Did Kilmer’s Swamp-Root ever claim more? “Diabetes is no longer an incurable disease” runs the advertisement of the Jireh Diabetic Food Company, yet the editor of the _Medical Times_ must know that in The Journal[133] and in the reports of state chemists the Jireh diabetic foods have been shown time and again to be among the most dangerous and fraudulently exploited products sold to the unfortunate diabetic.

[133] The Journal A. M. A., Dec. 14, 1912, March 22, 1913, and April 5, 1913; see also p. 451, this book.

Phenalgin,[134] twin brother to the Antikamnia fraud, shouts its inferential falsehoods in a half-page display. Micajah’s Wafers,[135] the alum-borax mixture long advertised as a cure for gonorrhea, endometritis, etc., may also be found, as well as many other preparations exposed at various times by The Journal. For example: Anasarcin,[136] Campho-Phenique,[137] Papine,[138] Bromidia,[139] Cactina Pillets,[140] Pluto Water,[141] Prunoids,[142] Sanatogen[143] and Sal Hepatica.[144]

[134] Pages 10 and 335, this book.

[135] Page 240, this book.

[136] Page 11, this book.

[137] Page 40, this book.

[138] Page 330, this book.

[139] Nostrums and Quackery, Ed. 2, p. 589; page 31, this book.

[140] Page 36, this book.

[141] The Journal, March 29, 1913, p. 1013.

[142] Page 178, this book.

[143] Nostrums and Quackery, Ed. 2, p. 470; page 358, this book.

[144] Nostrums and Quackery, Ed. 2, p. 639; page 179, this book.

What excuse can the _Medical Times_ offer for the presence of these frauds in its pages? Are these, too, “the result of an oversight”? Presumably for thus bringing to its attention these various other disreputable advertisements, The Journal will be accused again of violating “the ethics of journalism.” If calling attention to fraudulent advertisements is out of keeping with the ethics of journalism, what, pray, must be said of publications that are willing to share in the profits of such fraudulent exploitation? But, and we cannot repeat it too often, the _Medical Times_ is but one of a class, neither worse nor better than many other medical journals whose financial support comes from the proprietary interests rather than from the medical profession. The responsibility for the existence of these journals really rests not on the business men who conduct them on a commercial basis, but on the physicians who tolerate or encourage them in any way.--(_From The Journal A. M. A., Nov. 8, 1913._)

CAUSE FOR OPTIMISM

A Clean Medical Journal--the South Texas Medical Record

Fortunately, there are forces at work in the medical profession that make for optimism. An editorial in the last issue--April, 1915--of the _South Texas Medical Record_, the official organ of the South Texas District Medical Association, is especially significant. While not a large journal, the _South Texas Medical Record_ could well stand as an example to medical publications of a much more pretentious character. Its advertising pages are above reproach and the journal is a credit alike to its editors and to those members of the profession whose support makes its existence possible. In the editorial referred to, entitled, “Honest Advertising--Let Us Cleanse Our Own Linen First,” the editor-in-chief, Dr. W. Burton Thorning, says:

“A recent editorial, entitled ‘Honest Advertising,’ in a daily newspaper, furnished the occasion for an editorial comment in the January number of the _Southwestern Hospital Reporter_. The latter, while taking the ground that the newspaper was inconsistent in uttering high editorial sentiments and in adjoining columns printing patent medicine advertisements, implied that newspaper men should be allowed some latitude in the matter of accepting advertising, on the plea of being laymen and therefore not expected to possess the same amount of information concerning patent ‘dope’ that medical men have.

“It would appear to be a fair assumption that a layman, even though a highly educated and able editor of a great newspaper, does not know, and cannot be expected to know, the depth of depravity to which the consumption cure faker and the cancer quack can descend.

“Granting that the newspaper man accepts the advertisements through ignorance of the facts concerning their possibilities for evil, what can be offered in defense of the medical editor who accepts advertising matter equally pernicious in its influence?

“Indeed, it is not so many years since many of the so-called ethical medical journals carried the ads of some of the most notorious quacks this country has ever known.

“Doubtless there are few, if any, who do so at the present time, but, on the other hand, there are only a few who do not advertise unethical institutions, and questionable proprietary medicines. As a matter of fact some of the most widely advertised patent medicines of today were formerly advertised as ethical proprietaries in medical periodicals, the great majority of which are still serving as a sort of preparatory school for advertisements that will presently appear in the lay press.

“What shall be offered in defense of the medical publication which continues to publish the advertising matter of hundreds of proprietaries which the Council on Pharmacy and Chemistry of the American Medical Association has shown to be either generally worthless or an out and out fake?

“Can the medical editor plead ignorance? Hardly. To do so would be to admit utter incapacity. There is only one inference to be drawn; the publication needs the money and is not overparticular regarding its source.

“There is a remedy, however, a remedy absolutely certain in its results. If every physician in the United States for a period of three months would positively refuse to receive at his desk a medical journal containing questionable advertising, this blotch on medical journalism could be erased.

“It is true that many of them would sink, never to rise again, but the profession would be better off without those whose existence depends upon ‘phoney’ advertising. There are, unfortunately, several American journals whose reading pages are well and carefully edited and a credit to medical literature, whose advertising pages carry such undesirable matter that the educated physician can only feel a sense of disgust.

“Such journals could very well succeed on the quality of their reading matter and undoubtedly would increase their circulation enough to more than offset the loss in advertising.”--(_From The Journal A. M. A., May 29, 1915._)

THE COMPARATIVE NUTRIENT VALUE OF COD LIVER OIL AND COD LIVER OIL CORDIALS[BJ]

John Phillips Street, M.S. Chemist, Connecticut Agricultural Experiment Station NEW HAVEN, CONN.

[BJ] See also reports on Hagee’s Cordial, pp. 51, 289; Wampole’s Preparation, pp. 52, 442, and Waterbury’s Compound, pp. 54, 57, 291.

For a long time cod liver oil has been recognized as an easily assimilable nutrient and reconstructive and of special value in wasting diseases. The unpalatability of the oil, however, has led to various devices to make it tasteless or to render it more acceptable to the stomach. Emulsions containing the oil in mixture with other substances were exploited, and doubtless served a useful purpose. The oil, however, but imperfectly concealed, was still disagreeable to many, and other preparations began to appear on the market, which claimed to retain the therapeutic virtues of cod liver oil without its disagreeable characteristics. This practice has been carried so far that now we find for sale cod liver oil preparations from which the oil has been removed in its entirety, and only the name remains. Certain of these products claim to “represent” the oil and to retain all its virtues; others are said to contain oil, while still others claim “all the valuable constituents” of the oil without the oil itself.

In the past, cod liver oil has been considered a food rather than a medicine, and its value attributed to the easily digestible and metabolizable oil it contains. This position, however, has been disputed. By some its therapeutic value has been attributed to the small amount of iodin present in the oil, but in recent years the suggestion has been made that its special potency depends on its peculiar fatty acids. In this connection the U. S. Dispensatory[145] says:

[145] U. S. Dispensatory, Ed. 19, p. 860.

“Other oleaginous substances, certainly not less nutritious, have not been equally efficient, though taken in much larger quantities. If this be the true explanation, persons living chiefly on milk, which abounds in oil, or on fat pork, ought to show a special exemption from scrofulous complaints. The probability appears to us to be that, in consequence of some peculiar principle or principles it contains, it exercises a stimulant and alterative influence on the processes of assimilation and nutrition, thereby aiding in the production of healthy tissue.”

Indeed, Osborne and Mendel[146] have shown in their experiments on albino rats that by substituting cod liver oil for a portion of the lard in their standard diets, growth was resumed after failure on foods containing commercial lard alone as the source of fat. Similar results were secured with butter-fat and egg yolk fat.

[146] Osborne, T. B., and Mendel, L. B.: Jour. Biol. Chem., 1914, xvii, 401.

In the light of the theories advanced for the therapeutic value of cod liver oil, and the results secured by Osborne and Mendel with the oil itself; it seemed a profitable study to examine some of the prominent “oilless” preparations on the market to determine whether or not the claims made for them as nutrients were justified. Certain of the so-called cod liver oil preparations are termed “extracts” of cod liver oil, and are not made from the oil, but from the cod livers instead. As has been well said,[147] “They are preparations, which, if honestly made, might be worthy of trial, but they are improperly called ‘extracts’ of cod liver oil, since they do not contain the fat, which is the active constituent of the oil, but the extractives from the liver, which may or may not possess therapeutic virtues. So far as we know, however, no satisfactory evidence is forthcoming to indicate that such extractives have any therapeutic value.”

[147] Fraud and Deception Connected with So-Called Cod Liver Oil Preparations, The Journal A. M. A., Oct. 13, 1906, p. 1207.

It was with preparations of this class that our experiments were made. Four of the more extensively advertised brands were selected, as they represent rather distinct types of this class of products, as the following claims of their label will show:

_Hagee’s Cordial of the Extract of Cod Liver Oil, Compound._--“Tonic, stimulant, alterative, reconstructive, nutritive and digestive.” “Each fluid ounce represents the extract obtainable from 1/3 fluid ounce of cod liver oil (the fatty portion being eliminated), 6 grs. calcium hypophosphite, 3 grs. sodium hypophosphite, 1/2 gr. salicylic acid (made from oil wintergreen), with glycerin and aromatics.”

_Vinol._--“The modern tonic reconstructor containing the medicinal extractives of fresh cod livers with peptonate of iron.” “When the blood is poor, when more fresh blood is needed, when the weak need strength, when the throat and lungs are affected, TAKE VINOL.”

_Wampole’s Perfected and Tasteless Preparation of an Extract of Cod Liver._--“Contains a solution of an extractive obtainable from fresh cod livers, the oily or fatty portion being afterward eliminated. This extractive is combined with liquid extract of malt, fluid extract of wild cherry and compound syrup of hypophosphites (containing calcium, sodium, potassium, iron, manganese, quinine and strychnine).”

_Waterbury’s Compound, Plain._--“Made from cod liver oil, digestive ferments, malt extract unfermented, hypophosphites comp. special, ext. cherry, eucalyptus, aromatics, etc.”

Thus we have represented in our experiments an “extract” with hypophosphites, one with peptonate of iron, one with malt extract and hypophosphites and the alkaloids quinin and strychnin, and one with malt extract and hypophosphites without alkaloids.

In order to prepare a dry ration of suitable keeping properties, it was necessary to remove the alcohol and water from the various preparations. This was done by evaporation under reduced pressure at from 40 to 55 C. (104 to 131 F.). In the case of Hagee’s Cordial it was claimed that one fluidounce of the preparation represented 1/3 fluidounce of cod liver oil, and in the subsequent substitution for cod liver oil in our rations, this ratio was used for all four products.... These are very dissimilar preparations, the alcohol ranging from 7.50 to 18.69 per cent., the extract from 8.72 to 39.53 per cent. (10.81 of the 13.18 gm. of extract in Hagee’s Cordial being glycerin), the ash from 0.305 to 1.967 per cent., the reducing sugars from 1.35 to 17.10 per cent., and the glycerin from a trace to 10.81 per cent. Wampole’s contained quinin and strychnin, the others no alkaloids; salicylates were present in all but Wampole’s; saccharin in Hagee’s. The Pettenkoffer test for biliary acids gave a negative result in Hagee’s and Wampole’s; in Vinol and Waterbury’s, small amounts of fatty acids were obtained, amounting to 0.016 and 0.032 gm. per hundred c.c., respectively, quite insignificant amounts.

The feeding experiments were made on albino rats of both sexes, which were placed, when about 6 weeks old, on a standard ration, No. 7, and after several months, when a failure to maintain weight was indicated,[148] an amount of dealcoholized cordial extract equivalent to 18 per cent. of cod liver oil was substituted for a portion of the lard, the cordial extract later being replaced by an equivalent amount of cod liver oil.

[148] Osborne and Mendel have shown (Jour. Biol. Chem., 1913, xv, 311) that mixtures of purified protein, lard, starch and protein-free milk have been singularly efficient for a time in promoting growth of young rats. In from sixty to 100 days or more, however, normal growth stops; the animals may remain at constant weight for a few days, or grow very slowly, and then suddenly decline and die unless a change is made in the diet. The substitution of butter-fat, egg yolk fat, or cod liver oil for a portion of the lard in the ration, in the experiments of these authorities, brought prompt recovery and continuation of normal growth.

SUMMARY

Table 11 gives a summary of the actual gains of the fifteen rats on the four rations, compared with the gains shown by cod liver oil and those shown by normal rats at the same period of their life history.

TABLE 11.--SUMMARY OF RESULTS[BK]

=====================+========+========+=========+========= | Total | Total | Average | Average Rations | Normal | Actual | Normal | Actual | Gain, | Gain, | Gain, | Gain, | Gm. | Gm. | Gm. | Gm. ---------------------+--------+--------+---------+--------- Hagee ration | 24 | -36.2 | 6 | -9.1 Cod liver oil ration | 114 | 156.4 | 28.5 | 39.1 | | | | Vinol ration | 42 | -1.5 | 10.5 | -0.4 Cod liver oil ration | 42 | 87.5 | 10.5 | 21.9 | | | | Wampole ration | 83 | 51.4 | 20.8 | 12.9 Cod liver oil ration | 62 | 81.5 | 15.5 | 20.4 | | | | Waterbury ration | 32 | 0.3 | 10.7 | 0.1 Cod liver oil ration | 42 | 87.4 | 14 | 29.1 ---------------------+--------+--------+---------+---------

[BK] In this table are given the totals and averages of the figures already presented in Tables 4, 6, 8 and 10.

In considering the effect of these preparations as general medicines, their alcohol content must not be overlooked. Hagee’s Cordial contains 7.50 per cent. of alcohol by volume, Vinol 18.60 per cent., Wampole’s Preparation 16.59 per cent., and Waterbury’s Compound 11.25 per cent. Full strength whisky contains 50 per cent. of alcohol by volume. By following the doses prescribed by the manufacturers of these preparations, the user would consume daily the following equivalents of full strength whisky:

In Hagee’s Cordial 0.24 fluidounce In Vinol 0.8 fluidounce In Wampole’s Preparation 0.7 fluidounce In Waterbury’s Compound 0.6 fluidounce

These amounts of alcohol are by no means negligible and doubtless explain to a considerable extent the source of the alleged tonic virtues of these preparations.

The results of the experiments may be summarized as follows:

Hagee’s Cordial failed to sustain rats during periods of seven and fourteen days, the rats showing a loss in weight of 36.2 gm., instead of the normal gain of 24 gm.

Vinol in two cases sustained and in two cases failed to sustain growth during periods of from eleven to thirty-five days, the net loss in weight of the four rats being 1.5 gm., instead of the normal gain of 42 gm.

Wampole’s Preparation in three Cases sustained and in one case promoted growth in rats during periods of eighteen and thirty-nine days, showing, however, only 51.4 gm. gain in weight instead of the normal 83 gm.

Waterbury’s Compound in two cases sustained and in one case failed to sustain rats during periods of fourteen and thirty days, the net gain in weight, however, being but 0.3 gm. instead of the normal 32 gm.

Cod liver oil showed a gain of 42.4 gm. over the normal, while with the same rats Hagee’s Cordial showed a loss of 60.2 gm. Cod liver oil showed a gain of 45.5 gm. over the normal, while with the same rats Vinol showed a net loss of 43.5 gm. Cod liver oil showed a gain of 19.5 gm. over the normal, while with the same rats Wampole’s Preparation showed a loss of 31.6 gm. Cod liver oil showed a gain of 45.4 gm. over the normal, while with the same rats Waterbury’s Compound showed a net loss of 31.7 gm.

_Not only did cod liver oil show a marked superiority as a source of nutriment over Hagee’s Cordial, Vinol, Wampole’s Preparation and Waterbury’s Compound, but it also showed a remarkable reconstructive and recuperative power in its ability to enable rats to gain weight rapidly and steadily after having suffered from a deficiency in nutriment when fed the four preparations named above._--(_Abbreviated from The Journal A. M. A., Feb. 20, 1915._)

DIABETIC FOODS OFFERED FOR SALE IN THE UNITED STATES

A Preliminary Report

John Phillips Street, M.S. Chemist, Connecticut Agricultural Experiment Station NEW HAVEN, CONN.

Recent references in The Journal to gluten flours and certain other foods offered for the use of diabetics suggest that a preliminary report of an investigation just about completed in my laboratory by Prof. L. B. Mendel and myself might be useful to many diabetics and to physicians who are called on to arrange their dietaries.

In 1906 this laboratory, then under the direction of Dr. A. L. Winton, who is now with the Department of Agriculture, made its first examination of commercial diabetic foods. In nearly every year since it has analyzed various other brands as they appeared on the market. The demand for the reports on these foods and the many inquiries directed to us have led us to make a more extensive review of the situation, and to collect as far as possible all information as to the quality of the so-called “diabetic” foods offered to the American public. That the present state of the market is unsatisfactory is well known, and the inferiority (from the diabetic’s point of view) of many of the products at present offered is unfortunately familiar to all careful dietitians. The most dangerous feature of the present situation is that the unsuspecting patient is led to purchase foods, generally at an exorbitant price, which are not only misrepresented but which may be positively harmful to him. In this day of self-medication this condition is all the greater menace to the diabetic.

Without any attempt to suggest methods of treatment for diabetes, which is the province of the physician, I may say that it is well recognized that diabetes is primarily a disturbance of nutrition, in which the normal ability of the body to make use of carbohydrates is more or less completely impaired. All recent authorities agree in placing the chief emphasis on the role of diet in the management of this disease. Janeway, Benedict, Joslin, Futcher, Falta, Strauss, von Noorden and other writers on diabetes could be quoted at length in support of this view. The importance of a restriction of the carbohydrates in certain cases and certain aspects of diabetes is admitted by practically all competent authorities. In order to prescribe a starch-free and sugar-free dietary, which at times is necessary, and to know accurately the actual amount of these carbohydrates contained in the various available foods, the physician must rely on the cooperation of the chemist to furnish this requisite information. This is our excuse, if any be needed, for our present investigation.

There seems to be some uncertainty as to what sort of preparation is entitled to be sold as a “diabetic” food. Granting the desirability of feeding the patient all the carbohydrate he can tolerate, and recognizing the possible value of the oatmeal, potato, rice and other treatments, in which a relative abundance of carbohydrate is fed for a limited period, it would seem that a low percentage of carbohydrates should be a requisite for a “diabetic” food. Certainly no special food containing nearly as much carbohydrate as a normal food of the same class should be entitled to this appellation. Flours, breads, biscuits, chocolates, breakfast-foods, macaroni, etc., containing only a slightly lowered percentage of carbohydrates, are no more entitled to be called “diabetic” foods than the normal foods themselves. It is true that, when a patient’s carbohydrate tolerance is well established, the use of foods containing 20, 25 and even 35 per cent. of carbohydrates might be permissible, when used under the direction of a competent physician; but when a strict diet is necessary, such as is required to determine this tolerance, even these relatively low percentages are objectionable, if not dangerous.

It has been our purpose to include in this investigation, as nearly as possible, all available data on the composition of all diabetic foods sold in America. Our report, therefore, will be in part compiled, but in greater part will consist of our original analyses. It will show 539 analyses of about 400 brands, 200 of which are our own new analyses and 110 those made in this laboratory in previous years.

While the purpose of this preliminary note is to call attention to the better preparations rather than to emphasize those which are obviously objectionable and fraudulent, it may not be out of place to summarize briefly our findings in general. The full details of the investigation are now being prepared for publication and will shortly be issued as a report from the Connecticut Agricultural Experiment Station.

One hundred and eight samples of sixty-eight brands of flours and meals are included in the report. Sixty-seven of these were sold as “gluten” flours, twenty of which did not even satisfy the low government standard of 35 per cent. protein. Twelve samples contained less than 13 per cent. carbohydrates, while the remaining gluten flours ranged from 28 to 76 per cent.

The soy bean flours contained from 23 to 26 per cent. of carbohydrates, the almond meals 17 per cent., and a cotton-seed flour 21 per cent. Other “diabetic” flours, not specifically sold as “gluten” flours, contained from 67 to 80 per cent.

The purchaser of gluten flours at the present time may obtain preparations containing from 87 to 11 per cent. of protein and from 4 to 76 per cent. of carbohydrates, at a cost of from 9 cents to $1.56 per pound.

In view of the government’s low standard for gluten flour, and because of the wide variations in composition found in the brands at present on the market, proper protection of the diabetic demands that the manufacturers of these flours should be required to state on the label the guaranteed percentages of both protein and carbohydrates.

Three samples of American soft gluten breads contained from 35 to 37 per cent. of carbohydrates; two other brands contained 49 and 54 per cent., little, if any, lower than found in ordinary wheat bread.

One hundred and forty-eight analyses of 112 brands of hard breads, biscuits, rusks, cakes and other bakery products are included. Eight brands of _Luftbrot_, or aerated bread, are reported; two of these contained from 9 to 12 per cent. of carbohydrates, one 20 per cent., two from 31 to 33, and the other three from 44 to 54 per cent.

A number of the brands of rolls, biscuits, breads, etc., showed satisfactorily low percentages of carbohydrates, thirty-five samples containing from 1 to 25 per cent., forty-four samples containing from 35 to 55 per cent., and forty-one over 55 per cent., seven of the latter exceeding 72 per cent.

The cost of the _Luft_ breads ranged from 71 cents to $2.33 per pound. Biscuits, containing 11 per cent. or less of carbohydrates, cost from 72 cents to $3 per pound. A number of brands, containing from 43 to 77 per cent., cost from $3 to $3.60 per pound. Even the cheaper preparations, containing from 50 to 77 per cent., no better, and in some cases even worse, for the diabetic’s use than ordinary bread, cost from 30 to 41 cents per pound.

Fourteen samples of breakfast-foods were analyzed, five of which contained from 44 to 54 per cent. of carbohydrates, somewhat lower percentages than normal. Seven of the ten brands of recommended macaroni, noodles, etc., contained over 70 per cent. of carbohydrates, the other three from 42 to 51 per cent.

The analyses are given of fourteen samples of peanut butter, five of almond paste and butter, two of pine-nuts, one of almonds and ten of miscellaneous nut foods. As was to be expected, most of these preparations proved to be suitable diabetic foods. The peanut butters contained from 12 to 20 per cent. of carbohydrates, with an average of 15 per cent. The three almond pastes contained from 30 to 40 per cent., one showing an addition of 11 per cent. cornstarch. The two almond butters contained only 7 and 8 per cent., the pine-nuts from 3 to 8 per cent., and the almonds 16 per cent. The other nut preparations contained from 6 to 44 per cent. carbohydrates.

Seven brands of diabetic chocolates contained from 10 to 50 per cent. carbohydrates, while four cocoas contained from 21 to 51 per cent. The chocolates cost from $1.63 to $2.06 per pound, and the cocoas were similarly expensive.

Two sugar-free milks were examined which were true to name, containing only the merest traces of carbohydrates. One “diabetic” baking-powder examined contained no starch, another brand from 14 to 16 per cent. Various jams, preserves and other fruit products were examined which contained from 1.24 to 7 per cent. of invert sugar, percentages far below the normal. A currant-juice contained only 0.85 per cent. of invert sugar. Four of the fruit preparations were artificially colored with a coal-tar dye--a permitted color to be sure, but seemingly quite out of place in foods intended primarily for the use of invalids.

As already stated, the main purpose of this investigation was not so much to detect fraud as to secure information which would be of benefit to the diabetic and to the physician who seeks foods suitable for a low carbohydrate diet. In the accompanying tabulations a summary is given of the brands, _sold as diabetic foods_, which showed less than 35 per cent. of carbohydrates, arranged in the order of their carbohydrate[149] content. A date in parentheses following a brand name signifies that the brand named showed variations in different years; in other cases, in which the agreement was close, the results have been averaged.

[149] In the tables “carbohydrates” is used as synonymous with “nitrogen-free extract.”

BRANDS SHOWING UNDER 5 PER CENT. OF CARBOHYDRATES

Per Cent. Casoid Baking Powder .0 Dr. Bouma Sugar-Free Fat-Milk .0 Whiting’s Sugar-Free Milk .0 Rademann’s Currant Juice “ohne Zucker” 0.9 Kalaria Batons (1909) 0.9 Glidine 1.0 Casoid Sugarless Marmalade 1.2 Casoid Sugarless Jam 1.5 Kalari Biscuit 1.7 Casoid Dinner Rolls 2.1 Casoid Flour 2.2 Jireh Diatetic Pine Nuts 3.4 Rademann’s Preserved Fruits, “entzuckert” 3.5 Kellogg’s Protose 3.6 Barker’s Gluten Food “A” 4.1 Kellogg’s Pine Nuts 4.2 Kellogg’s 80 Per Cent. Gluten Biscuit 4.4 Bischof’s Gluten Flour 5.0

BRANDS SHOWING FROM 5 TO 10 PER CENT. OF CARBOHYDRATES

Per Cent. Casoid Biscuits No. 2 5.6 Rademann’s Preserved Fruits “in eigenen Saft” 5.7 Barker’s Gluten Food “B” 5.9 Kellogg’s Nuttolene 6.3 Nashville Sanitarium Nutcysa 6.3 Huntley and Palmer’s Akoll Biscuit 6.5 Nashville Sanitarium Nutfoda 6.8 Rademann’s Preserved Fruits “ohne Zucker” 7.0 Muller’s Tomatoes für Diabetiker 7.3 Barker’s Gluten Food “C” 7.7 Kalari Batons (1913) 7.7 Casoid Biscuits No. 3 7.8 Kellogg’s 80 Per Cent. Gluten (1912) 7.9 Casoid Biscuits No. 1 8.0 Kellogg’s Almond Butter 8.2 Fromm’s Uni Bread 9.0 Metcalf’s Vegetable Gluten (1913) 9.8

BRANDS SHOWING FROM 10 TO 15 PER CENT. OF CARBOHYDRATES

Per Cent. Kellogg’s Pure Gluten Biscuit (1906) 10.2 Health Food Pure Washed Gluten Flour (1913) 11.1 Health Food Alpha Diabetic Wafers 11.3 Loeb’s Imported Gluten Flour 11.8 Health Food No. 1 Proto Puffs 11.9 Kellogg’s Potato Gluten Biscuit (1906, 1909) 11.9 Kellogg’s Nut Meal 12.1 Kellogg’s 80 Per Cent. Gluten (1909) 12.5 Nashville Sanitarium Nut Butter 13.0 Kellogg’s Nut Butter 13.9 Bischof’s Diabetic Gluten Bread 14.3 Jireh Diabetic Baking Powder 15.0 Peanut Butter (range from 12 to 20) 15.0

BRANDS SHOWING FROM 15 TO 20 PER CENT. OF CARBOHYDRATES

Per Cent. Casoid Chocolate Almonds 16.1 California Paper Shell Almonds 16.3 Callard’s Cocoanut Biscuit 16.4 Rademann’s Diabetiker-Chokolade 16.9 Health Food Almond Meal 16.9 Callard’s Ginger Biscuit 18.1 Callard’s Prolactic Biscuit 19.3

BRANDS SHOWING FROM 20 TO 25 PER CENT. OF CARBOHYDRATES

Per Cent. Callard’s Almond Shortbreads 20.7 Callard’s Casoid Rusks 20.8 Rademann’s Diabetiker-Makronen 20.8 Health Food Protosoy Diabetic Wafers 21.2 Jireh Patent Cotton-Seed Flour 21.3 Casoid Lunch Biscuit 21.6 Rademann’s Diabetiker-Chokolade Biscuit 21.9 Cereo Soy Bean Gruel Flour 23.7 Health Food Salvia Sticks 24.0 Health Food Protosoy Soy Flour 24.5 Metcalf’s Soja Bean Meal 25.0

BRANDS SHOWING FROM 25 TO 35 PER CENT. OF CARBOHYDRATES

Per Cent. Jireh Soja Bean Meal 25.8 Brusson Chocolat with Added Gluten 26.4 Rademann’s Diabetiker-Stangen 27.0 Rademann’s Diabetiker-Dessert-Gebäck 27.5 Nashville Sanitarium Malted Nut Food 27.5 Metcalf’s Vegetable Gluten (1906) 28.1 Health Food Pure Washed Gluten Flour (1906) 29.5 Fromm’s Luft Bread 30.7 Spencer’s Almond Paste 31.6 Fromm’s Conglutin-Diabetiker-Schokolade 32.7 Health Food No. 2 Proto Puffs 33.3 Ferbuson Gluten Bread 33.6 Gum Gluten Breakfast Food 34.2

--(_From The Journal A. M. A., June 28, 1913._)

THE JIREH DIABETIC FOOD COMPANY

The Company Rises to Explain in a Brief Note of One Thousand Words

Exploiters of fraudulent and dangerous pharmaceutical products have no love for The Journal. When such products are exposed in these pages, their manufacturers seldom reply to the criticisms except through indirect channels. Then the replies are frequently replete with billingsgate and denunciation of The Journal and its editor, the Association and the medical profession generally.

We have, at different times, had to call the attention of the public and the medical profession to the fraudulence and dangers of some of the products of the Jireh Diabetic Food Company. We have shown that the Jireh company lied boldly and directly so long as it could do so without getting into the courts, and that it lies inferentially still; we have shown that Jireh flour had practically as much carbohydrate as ordinary flour; we have shown that, probably to escape prosecution under the Food and Drugs Act, the Jireh concern has coined the word “diatetic” and substituted it for the word “diabetic,” which used to appear in its advertisements; we have shown that the claim made for the Jireh products that they are “starch-changed” was a false one, and that the company has modified this to “starch-treated,” presumably to avoid being haled into the courts under the “pure food law;” we have shown, in short, the unreliability both of the Jireh concern and of its products.

Two or three weeks ago a New York physician wrote to The Journal for information regarding the Jireh products. We sent him such matter as had been published on the subject, and he showed this material to a patient who was using the Jireh products. The patient, in turn, expressed her opinion of the product to the retailer from whom she had been purchasing it. A day or two later she received a letter from the Jireh Diabetic Food Company, which, in spite of its length and discursiveness, we publish in full, so that physicians may know just what this company thinks of them. The letter, which is dated Nov. 20, 1913, really belongs in the “Knocks and Boosts” department, but its length prevents its use there. Here it is:

“We learned through Mess. Cushman Co. that you are a constant user of Jireh Foods for some time past, and that recently a certain derogatory statement was brought to your attention relative to our product. We feel an explanation is due you for two reasons.

“First, because we want you to continue using Jireh Foods and thus receive the benefits of the same; and second, that the remarks called to your attention are not only libelous, but are in no way pertinent enough to detract from the value of our product. In the first place, we want to state that the particular journal in question has been endeavoring to injure our business for some time past and that we are not the only descent [_sic_] manufacturers of foods that are suffering in this way at the hands of the editors of this particular magazine. Since you are interested in the Jireh Foods, you may be more interested to learn why this particular magazine is so anxious to injure our reputation. The reason is very obvious if you will take into account the fact that this magazine is the official journal of the medical association of this country which is known as the backer of the medical trust. It is very clear to you, no doubt, that there are some physicians, particularly those that are associated with the magazine, who are anxious to stamp out of existance [_sic_] such concerns that offer a bona fide product, a meritorious product which actually produces the required results, without the aid of medicine.

“For the particular maladies for which we offer our foods, we have been very successful, consequently the antagonism on the part of this particular journal is the logical thing. In addition to this, however, and perhaps more important to us, is the fact that the editors of this magazine have made it known to us that they will not approve of our product until such time that we care to be dominated by the moving influence of the magazine in question. They want us to supply them with the private formula which we use for manufacturing our foods and to enlighten them and show them the various processes applied to our products to produce the required results. As a bona fide and ethical business house, we absolutely and unqualifiedly refuse to comply with this wish, and will always refuse to do so, no matter how often they may attack us. We stand strictly on principle in this matter and propose to run our business in our own way, and will not, under any circumstances, allow a magazine or anybody else dictate to us under what conditions we are allowed to do our business.

“The remarks which they make would perhaps hurt us some if they emanated from a source that was qualified to judge the merits of our food. The absurd side of the issue, and perhaps the comical side of it, is the fact that the honorable gentlemen who assume to condemn a product, know less about the disease for which the product is offered, and much less about diet and foods than the average layman. Consequently, we consider it simply absurd to allow them to step into our business and dictate policy to us. This is the jist [_sic_] of the discontent that prevails between the magazine editors and ourselves, and as long as we refuse to comply with their wish, we certainly cannot expect them to speak well of us. It has become a notorious fact in the medical profession that their criticisms are almost valueless, inasmuch as they stop at nothing in order to create sensationalism, and have attacked not only ourselves, but every bona fide manufacturer of foods and drugs in this country who has refused to fall in line with them.

“This explanation, we trust, will appeal to your good judgment and will convince you of what is said about us is untrue. Furthermore, our business has grown to colossal proportions, notwithstanding their endeavors to crush us. We call your attention to a most peculiar fact: that is, that they make no comment whatsoever as to the product and its therapeutic value in the treatment of diabetes. You notice they make an awful play on our literature, which was changed merely to suit conditions in business. We also wish to call your attention to another peculiar fact, and that is that a great majority of the physicians who are in with this magazine readily recommended our foods, and we also believe that your physician, after reading this letter, will feel the same way as most physicians do in relation to our foods. We believe that your physician is perfectly willing to be convinced that our foods are as represented to be, and the very best clinical evidence as this is the effect our foods have had upon you. Finally, if the foods are palatable and wholesome and have alleviated the annoying symptoms of Diabetes, then why should you be guided by the opinions of demagogues and yellow journalists?

“You may be pleased to learn that our foods have received the attention of Dr. Wiley, the well-known chemist and food scientist of this country, and we have now in our possession his reports showing the very high standard of our foods. This, in our opinion, is of more consequence than all the harangue which those venerable gentlemen of the magazine may indulge in.

“We want to convince you without an atom of doubt that we are honest and bona fide in everything we say, and we extend to you a hearty invitation to call at the first opportunity and shall be glad to tell you anything you may wish to know. Thus awaiting the pleasure of this visit, we beg to remain

“Yours very truly, “Jireh Diabetic Food Co.”

We learn from this letter that The Journal’s “remarks” on the Jireh product are “libelous.” We have made them many times and for several years past; if libelous, the manufacturer has excellent grounds for damages. We learn, too, that our remarks “are in no way pertinent enough to detract from the value” of the Jireh products. Why, then, take any notice of them? We learn, moreover, for the hundred-and-first time, that The Journal is the official organ of the “medical trust,” and we are told that “there are some physicians” that are opposed to the Jireh Foods because these products cure diabetes without the use of medicine! The Journal, so the company says, wants the Jireh Diabetic Food Company to supply its “private formula” and to show the “various processes” by which the Jireh products are made. Such statements indicate that the Jireh Diabetic Food Company does not confine its mendacity to the mere advertising of its product, where the necessity for lying is naturally great.

The ambiguous remarks regarding Dr. Wiley are evidently intended to convey the idea that the doctor approves of the Jireh products. Dr. Wiley was sent a copy of the Jireh letter and his attention directed to the statements appearing therein regarding himself. He replied:

“In regard to the Jireh products and their claims that our reports show the very high standing of their foods, I would say that I consider such a claim entirely false.... We did examine five or six products in our own laboratory, however, and found them to be of very fair composition per se, but _not of a composition that afforded any legitimate basis for their claims_. _We entirely disapproved ... three of the products making special claim as to their fitness for diabetics._ [Italics ours.--Ed.] These were the Wheat Nuts, the Jireh Flour and the Patent Barley. Two of the other products were passed with a non-committal rating, which means that they are not actually disapproved, but the star marking is not accorded. These products were the dietetic Rusks and the Macaroni. For the latter especially no specific claims seem to be made. We called attention, however, to the generally objectionable juggling of terms indulged in by this company....”

The Jireh concern says that in spite of the efforts of The Journal to “crush” it, “our business has grown to colossal proportions.” Of this the New York physician who sends us the letter says: “Their ‘colossal proportions’ must have received a slight jar or they would not have taken time to write such a letter.”--(_From The Journal A. M. A., Dec. 20, 1913._)

THE NAME “EPINEPHRIN” VERSUS THE NAME “ADRENALIN”[BL]

[BL] A reprint of the letter from Parke, Davis & Co. referred to in this article, together with the discussion thereof, will be sent on receipt of a 2-cent stamp.

There are thirty or more different brands of the blood-pressure-raising principle of the suprarenal gland on the market, five being in this country alone. These products are identical so far as their chief constituent is concerned; they differ, however as to the solvent and preservative used. The processes of manufacture of some of them are patented; all of them are sold under trade names.

Until two years ago there was no common name applicable to this active principle; whenever reference was made to it a trade name had to be used. At that time the Council on Pharmacy and Chemistry, realizing the need of a generic term, adopted “epinephrin” as such a term. This name was selected in part because Abel had adopted it in 1899; in part because, so far as could be discovered, it was the name under which, through Abel’s publications, the substance first appeared in medical literature; and in part because it seemed to be the only suitable one not already appropriated by some commercial firm.

After the publication of the Council’s report, The Journal began gradually to use the term in those cases in which it seemed clear that the proprietary term was used in a generic sense. The substitution of the name “epinephrin” for “adrenalin” in the abstracts of certain foreign articles caused Parke, Davis & Co. to write a letter of protest which called forth the discussion appearing in the Propaganda Department of this issue.

The amount of space devoted to this matter may be criticized and considered unwarranted by those who do not realize the importance of the subject. The criticism is to a certain degree, just. The somewhat inordinate length of the article is due in part to the unfortunate fact that, in availing themselves of the courtesy extended by The Journal, Parke, Davis & Co., in their reply, have injected into the discussion side-issues, such as the priority of discovery, the superiority of their product, etc., whereas the question under discussion is simply that which relates to the name. It is, however, not altogether a matter for regret that the discussion has been thus broadened, for it brings before our readers many facts regarding the discovery of an important medicinal agent that are not generally known, at least by physicians.

Whether or not “adrenalin” is superior to “adrin,” “suprarenalin,” “suprarenin,” “adnephrin,” or to any other of the preparations is entirely immaterial in this connection. The point is that the active principle of the suprarenal gland is on the market under various trade names, and that a name common to all has been selected to be used when no particular brand is referred to. The fact that “adrenalin” is regarded by many, both here and abroad, as a common, generic name does not alter the fact that it is claimed as a trade name by a commercial house and, therefore, presumably at least, cannot be used except as such.

Among the facts brought out in this discussion, one stands out clearly: that Abel deserves as much credit for the discovery as any other man, if not more. Credit belongs to Takamine for making use of reactions which were already well known. His work was a step in the progress of knowledge of the substance, but it was a step which he could not have taken but for what others, Abel especially, had accomplished and published. Abel’s magnificent work, covering several years, deserves as much credit, to say the least, as that of Takamine. And it should be kept in mind that the former worked in the interest of science, and published his results for the benefit of all. He had no hope of pecuniary reward, asked for none, and received none.

Let us repeat, however, that these are side issues; the question is simply that of name. It cannot be too strongly emphasized that “epinephrin” is a true scientific name for the active principle of the suprarenal gland, and that it should be used on all occasions when the active principle and not some particular firm’s make is referred to.--(_From The Journal A. M. A., March 25, 1911._)

THE HORD SANITARIUM

“_Propaganda for Reform Department_:--One often hears it declared that the present time is the worst ever known for a young man to make a fortune or get a start to one.

“All a mistake, as the enclosed letter from the Hord Skinatarium will certify. At $25 this equals $2,500 for 100 cases, $25,000 for 1,000 cases, and all any young doctor needs is a little push to be as rich as J. D. in a few months. If you know of any cases send ’em in and get your $25. “K. T. Crossen, M.D., Carbondale, Ohio.”

With his letter Dr. Crossen encloses a circular letter from the Hord Sanitarium, “For Liquor and Drug Habits, A Cure Positively Guaranteed,” and an unsigned check on the Farmers National Bank, Shelbyville, Indiana, for $25 payable to himself. Printed on the check in large red letters is the statement:

“THIS CHECK WILL BE COUNTERSIGNED UPON YOU BRINGING OR SENDING US A PATIENT.”

The Journal has received these circular letters and unsigned checks by the hundreds from physicians who have expressed very frankly their contempt of the kind of business the Hord Sanitarium is engaged in. These correspondents seem to have overlooked the fact that The Journal has already commented editorially on this particular insult to the medical profession. For this reason we reprint the editorial note, “Ethics!” from The Journal, Sept. 27, 1913:

“We will pay you $25 for each patient that you bring or send us.” Thus, to physicians, writes the Hord Sanitarium of Shelbyville, Indiana, and continues: “We have a perfect and an absolute cure for all liquor and drug addictions.” Fearing doubtless that those to whom these offers are made may be disgusted with the first proposition and will realize the evident falsity of the second, the concern encloses a list of references “showing the high moral and professional standing of our sanitarium.” The Hord Sanitarium emphasizes further that it does a strictly “no cure no pay” business. Suspiciously similar is the offer made by the Mizer Sanatorium of Coshocton, Ohio, Blake V. Mizer, manager. Not many months ago Mr. Mizer was running the Hord Sanitorium (the concern’s own spelling), which at that time advertised “the only guaranteed cure.” Now, Mr. Mizer hurls invectives at those concerns that make “unreasonable guarantees” and adds virtuously that “we resort to no such unethical and pretended guarantee in order to do business.” Nevertheless, in small type in the northwest corner of his stationery, Mr. Mizer admits that his “proposition” is no cure no pay. The fees of the Mizer Sanatorium “are $125 to $250, depending on the room.” The physician’s rake-off is “20 per cent. of the above.” “This,” explains Mr. Mizer blandly, “is simply a matter between ourselves and does not concern the patient in any way.” Of course not. All the patient has to do is to pay the bills. And the Mizer Sanatorium is “conducted along ethical ... lines”--Mr. Mizer says so. The Mizer Sanatorium has odd ideas of what constitutes ethics, medical or otherwise, for not long ago it advertised, in such medical journals as would accept its “copy,” that “medical ethics prevents the statement here of the whole truth about the Mizer treatment.” Of course medical ethics never prevented truthful statements of any kind. A dirty business; no other words express it. When the Hord Sanitarium and the Mizer Sanatorium claim to cure all cases of drug or liquor addiction, they make claims that are false--cruelly false. When these concerns try to drum up trade by offering secret commissions to physicians they insult an honorable profession. The fact that they send out this sort of advertising matter is presumptive proof that there are some physicians who will patronize them. Such as do so are unfair to their patients and untrue to the ideals of medicine.--(_From The Journal A. M. A., Jan. 31, 1914._)

THE GERMAN PROPAGANDA FOR REFORM

Appreciation by a German Lay Publication

Of all those interested in the reform of the proprietary drug business, the patient has the most at stake--and the public is beginning to understand this fact. If physicians are slow in recognizing the necessity for improvement, laymen will eventually demand reform in their own interests. The movement, therefore, will not be halted by the indifference of the unprogressive element of the medical profession. New evidence of this fact is furnished by a recent editorial comment by the German lay periodical, _Wohlfahrt und Wirtschaft_ (Public Welfare and Economics), on the Arzneimittel-Kommission, a German organization resembling in purpose if not in scope the Council on Pharmacy and Chemistry of the American Medical Association.

“One would suppose,” says this lay journal, “that medicinal preparations which did not win the approval of scientific medicine would not be used by any physician, but the contrary is the case. In fact, those new medicinal preparations or old ones with new names that flood the market far surpass the actual demand according to the judgment of all authorities. The impartial advisers in this field, practitioners and members of medical faculties, demand, as a matter of public welfare that this overproduction should be regulated in the interests of the sick, the consumers; but, unfortunately, a medical man, like any one else, is impressed by the suggestion from advertising done on a large scale.”

The movement for reform, _Wohlfahrt und Wirtschaft_ goes on to explain, is not exclusively a medical one. It is a part of the reaction of “economic common sense” against a too individualistic commercial system which leads to overproduction. In other words, it is a reaction against the system of making things because they can be sold rather than because they are needed. The interests of producers need to be harmonized with those of consumers, not merely in the drug trade alone, but throughout the commercial world. _Wohlfahrt und Wirtschaft_ quotes with unqualified approval the ArzneimittelKommission’s statement of its position: An industry which serves the science of healing must be guided by that science. (_Eine Industrie die der Heilwissenschaft dient, hat sich nach der Heilwissenschaft zu richten._)

The movement for reform in Germany has apparently gathered sufficient impetus among the laity to go on of its own momentum, even though, with one exception, German medical journals, reluctant to lose the advertising of drug houses by publishing criticisms of their wares, have become lukewarm, if not antagonistic, to the efforts of the ArzneimittelKommission. The one exception is the _Therapeutische Monatshefte_, which, in its May issue, quotes in full the editorial just referred to and makes the following comment: “These lines reveal such intimate knowledge and correct judgment of existing conditions that the suggestions advanced in regard to possible reforms deserve serious consideration. For us physicians the editorial is important in that it recognizes that the efforts of the profession to accomplish the reforms aimed at are rational and beneficial from the standpoint of general economics and the public welfare.”--(_From The Journal A. M. A., June 13, 1914._)

THE GERMAN COUNCIL ON PHARMACY AND CHEMISTRY

At the meeting of the German Congress for Internal Medicine in 1911, a German council on pharmacy and chemistry, Die Arzneimittelkommission des Kongresses für innere Medizin, was organized, with purposes similar to those for which the Council on Pharmacy and Chemistry of the American Medical Association was created. As practically nothing has been done to restrict the advertising of proprietaries in Germany, the task of the commission was tremendous. Its work has been noted in The Journal from time to time.[150] A review of what has been done up to the present is given by Heubner,[151] and indicates some differences between conditions in Germany and this country. The members of the commission found confronting them the same evils that met the early efforts of the American council, namely, dominant proprietary interests, a subservient and financially interested medical press and an indifferent profession. Moreover, the pecuniary interest of the editors of German medical journals in the profits of advertising seems to be more direct and more important than in America. The German commission, in Heubner’s opinion, was placed at a disadvantage compared with the American council from the first. Funds for investigation were lacking, and the commission had no journal in which its objects could be presented to the medical profession. At the beginning of its work the commission established rules very similar to those of the American Council on Pharmacy and Chemistry. It listed the articles advertised in German medical journals in three groups: (1) those which conformed to the rules of the commission in the method of advertising; (2) those which violated the rules, and (3) those whose classification could not be determined. This amounted to an attack on advertising in medical journals and was undoubtedly premature. It aroused at once the antagonism not only of the proprietary interests but also of the medical press.

[150] A German Council on Pharmacy and Chemistry, Propaganda, The Journal A. M. A., July 27, 1912, p. 291; Current Comment, Aug. 10, 1912, p. 452. Reform in the Advertising of Proprietary Medicinal Articles, Berlin Letter, Dec. 7, 1912, p. 2081. Heubner, W.: Wünsche zur Reform des Arzneivertriebes, Therap. Monatsh., 1912, xxvi, No. 11; abstr., The Journal A. M. A., Dec. 14, 1912, p. 2195.

[151] Heubner: Die Arzneimittelkommission des deutschen Kongresses für innere Medizin, Therap. Monatsh., 1914, xxviii, 185.

“The establishment of the lists of medicines encountered opposition or hindrance from three sources,” says Heubner, “first, from the pharmaceutical and chemical manufacturing interests; second, from the medical press, and third, from the medical profession itself. The ‘trade’ naturally was irritated at any attempt to interfere with ‘business,’ and brought forward a number of reasons why the procedure adopted by the commission was especially calculated to injure the ‘general welfare.’ This opposition was to be expected and might be disregarded. The extent to which the medical press was dependent on the drug trade, however, had not been foreseen. The same journals in which for many years all sorts of articles on the evils in the trade in medicines had appeared showed themselves decidedly cool or emphatically critical toward the accomplished fact of the ‘lists of remedies.’ In hastily written articles a whole series of mistakes in general and in particular were published.... One thing, however, was not explicitly stated--namely, that in any event the lists of remedies must be rejected, and for this the cogent reason was anxiety in regard to advertisements. The editors had been sufficiently warned. The _Therapeutische Monatshefte_, which had not submitted to the wish of a great industrial firm in another matter, was punished for this offense by the withdrawal of all its advertisements. None of the other publishers wanted to risk such a reduction in income, and none of the editors was willing to undertake the risk to the extent of a conflict with his publisher. Curiously, the idea does not seem to have arisen that if the threatened publishers had made common cause they might have freed their editors from the distressing burden of improper advertisements with scarcely any risk at all.”

Heubner believes that another motive influencing the editors was the fact that their efforts in behalf of reform, sporadic and ineffective at the best, had been replaced by the propaganda of the commission. It seems clear that the opposition from the press was due not to principle chiefly but to financial pressure. The editors, however unworthy their motives, nevertheless exerted, as in other cases, a powerful influence on public opinion. Among the medical public, opposition was encountered because many physicians were interested--sometimes financially--in one or more of the discredited remedies. The mass of the profession either were not interested or misunderstood the position of the council.

Despite the obstacles encountered and the difficulties involved, the council and the Congress of Internal Medicine have not wavered. Heubner, however, sums up the work of the council in a rather pessimistic tone, as follows:

“What are the results of the great amount of labor, self-sacrifice, hopeful courage and wasted money? Two journals pretend to be doing wonders in that they are eliminating some of the worst misstatements, distortions, obscurations and concealments of truth in the advertisements. Physicians at certain intervals receive lists of preparations, the manufacturers of which as a rule do not need to pay any attention to the council because their dealings are directly with the public, because their advertisements are usually made to physicians by word of mouth, or their preparations have already a sufficient reputation--no matter for what reason....

“There is little doubt that the results have not paid for the efforts expended. There is no doubt that the whole enterprise will amount to nothing more than a splash in the water if the work is not extended, just as a preliminary skirmish must remain without effect unless followed up by the main army. The main army in this case is the German medical profession. However gratifying the progressive attitude of some individuals and, in fact, of some associations, such as that of Wurtemburg, may be, the fact remains that the profession [in Germany] is not advancing but rather tends to retrograde. The support which the executive committee of the Aerztevereinsbund at first accorded to the efforts of the council was later limited. All further progress depends on the developments of the near future. Will sufficient power be given to the German medical profession after settlement with the insurance societies to permit them to follow the example of their American colleagues?

“It should be made perfectly clear,” Heubner insists, “that we are concerned with questions of importance for the standing and influence of the medical profession among the people, and, consequently, for the conditions of its future existence. But even now the consequences of the prevailing indifference to the traffic in nostrums are making themselves felt. The prevalence of self-medication, which was lately recognized by a Berlin court as the normal for ‘slight’ affections and which has already been made an argument against the extension of the compulsory prescription law, is merely a result of the great evil based on the loss of control by the medical profession of the remedies it employs. Only centralized and energetic measures on the part of the organized profession can secure a reformation of the intolerable conditions that prevail in the field of modern industry in medicine and foodstuffs. The American Medical Association and the German Arzneimittelkommission have shown that a little sacrifice and energy can secure a condition in which the medical profession becomes a powerful factor, able to dictate in the field of the trade in medicine instead of letting itself be dictated to.”--(_From The Journal A. M. A., April 18, 1914._)

GRAND PRIX AND GOLD MEDALS FOR SALE

Max Kaiser Offers to Procure “Awards of Merit” at Various International Exhibitions--Price, Four Hundred Dollars

There was a time when the manufacturer who could point to the “Grand Prix” or the “Gold Medal” his product had been awarded at some exhibition was considered to have a valuable advertising asset. Possibly there was a time when medals and prizes were awarded with an eye single to the excellencies of the goods and bore no relation to the amount of money paid by exhibitors to the organizers of the exhibition. Possibly there are, even today, occasional awards made on a basis of pure merit, but they are probably few and far between. The matter which follows throws an interesting light on this subject. Within the past two months manufacturers have received a letter on the stationery of the “International Exhibition, Paris, 1914.” The letter came from the “Commissioner-General” of the exhibition, one Max Kaiser, 24 Holborn, London, E. C. Here it is:

“_Dear Sirs_:--I beg to draw your attention to the great INTERNATIONAL EXHIBITION of Alimentation, Pure Food, Hygiene, Beverages, Drugs and allied trades, which will be held at Paris in March, 1914, inviting you to partake with your manufacture at this INTERNATIONAL EXHIBIT. I beg to point out that the aim of this Exhibition is to introduce Foreign Manufactured Goods, Proprietary Articles, Patents, etc., to the French and Foreign Markets, and to open up or extend new channels for such goods.

“A Commercial Office at the Exhibition Building, under the Commissioner General’s own supervision, with a well-trained staff, will do everything required in the interest of Exhibitors, such as effect sales by circularizing, or inviting prominent buyers to call at your particular stall to judge for themselves the merits of your Exhibit, and in this way bring the American Manufacturers in direct touch with the Foreign Markets and the Buying Public.

“This Commercial Office will also negotiate with the Representatives on your behalf: at the same time undertaking to arrange your Exhibit, supply all necessary fittings, decoration, the display, maintenance, repacking and returning of the Exhibit, and also to represent you before the Public and Jury in such a manner as to make certain that your Exhibit shall be awarded first honors (GRAND PRIZE OR GOLD MEDAL).

“You will understand that such an award obtained at this INTERNATIONAL EXHIBITION means an everlasting advertisement as an official acknowledgment and convincing proof to the Superior Quality of your goods, and will certainly put you in front of your competitors on the home market, and naturally increase your sales considerably.

“I might mention here that many a big business has been built up and small concerns been prominently brought to the notice of the Public by Exhibiting. In many cases I have been able to interest Authorities and Reigning Houses in Exhibits under my care, and I have opened up or extended markets for firms Exhibiting under my direction.

“I enclose herewith a list containing some of the most prominent American and English Firms whom I have represented at European Exhibitions and for whom I achieved splendid results.

“I could arrange your Exhibit for the amount of $400, to be paid one-half on allotment and the balance on receipt of an award (Grand Prize or Gold Medal).

“Trusting that this will be of interest to you, I shall be pleased to receive your reply by return mail, and give you any further particulars you may desire. Yours faithfully,

The Commissioner General. (Signed) Max Kaiser.

“I can also accept Exhibits on exactly the same terms for the INTERNATIONAL EXHIBITION, Rome, 1914.”

The list Mr. Kaiser enclosed with his letter was a printed sheet, giving the names of a number of American and British manufacturers whom Kaiser claims to have “represented” at various “International Exhibitions.” The majority of the concerns named are breweries, but there is a good sprinkling of “patent medicine” companies and a few miscellaneous manufacturers. In the American list there are two nostrum concerns named that will be more or less familiar to our readers. They are:

_Alonzo O. Bliss Company_, Washington, D. C. This company sells “the Great Blood Purifier, Kidney and Liver Regulator” known as “Bliss’ Native Herbs.” According to Max Kaiser, the Alonzo O. Bliss Company obtained one Grand Prize and one Gold Medal.

_Waterbury Chemical Company_, Des Moines, Iowa. This company exploits what used to be known as “Waterbury’s Cod-Liver Oil Compound,” which, from its lack of cod-liver oil,[152] was impelled to change its name to “Waterbury’s Compound.” Kaiser states that the Waterbury Chemical Company received four Grand Prix and four Gold Medals.

[152] See Waterbury’s Compound, pp. 54, 57 and 291.

Briefly the proposition submitted by Max Kaiser is this: For $400 he will make all arrangements for a manufacturers’ exhibit at one of the numerous “International Exhibitions.” Further, he practically guarantees that this exhibit will receive either a “grand prize” or a “gold medal”; in fact, the manufacturer need not complete the payment of Kaiser’s charges until the prize or medal has been awarded!

The value of “awards” obtained in this way is, of course, evident. As the public becomes better informed on the subject of international exhibitions, the grand prix, gold medals, and other “awards” made at such exhibitions will be appraised at their true value.--(_From The Journal A. M. A., March 14, 1914._)

THE HYPOPHOSPHITE FALLACY

An Example of the Perpetuation of a False Theory by Advertising

A false therapeutic notion born of speculation soon dies a natural death if exposed unsupported to the cold world of facts, but when nursed by commercial interests it may be kept alive for generations. Interesting examples of this, to name but two or three, are the misconceptions perpetuated during the past half century concerning “lithia,” the “natural” salicylates and the hypophosphites.

Take, for instance, the lithia delusion. The supposed solvent powers of lithium compounds for uric acid were soon disproved to the satisfaction of scientists, but proprietors of lithia waters and nostrums for gout and rheumatism still harp on the old string and utilize long-exploded theories. Take, again, the alleged superiority of “natural” to “synthetic” salicylates. In spite of experimental proof to the contrary, proprietary interests have been able for twenty years to persuade a large part of the medical profession that the effects of pure salicylic acid made artificially differ from the effects of the same substance obtained from natural sources.

The altogether undeserved continued popularity of hypophosphites affords a striking example of the influence of advertising in perpetuating therapeutic error, for hypophosphites are given on a theory long since disproved. It may be interesting to trace the origin and history of the theory on which the practice of prescribing the hypophosphites is founded. The early part of the last century was prolific in chemical discoveries, and, as a corollary, in chemical theories of disease. Many of the theories arose from the hasty application of the chemical properties of new elements and compounds to the explanation of the processes in the living body, without due consideration of the conditions prevailing in the animal organism.

THE ELEMENT PHOSPHORUS

The element phosphorus is eager for oxygen and readily oxidizable. When taken into the system it acts as a violent poison, and, in view of this, it was at first supposed--although the supposition was based on no scientific data--that it would prove to be a powerful therapeutic agent when given in minute doses. In its elementary form, phosphorus is difficult to handle, and therefore not convenient for use. Hence it was natural that a compound should be sought which could be used as a substitute for the element.

Broadly speaking, phosphorus forms three classes of salts varying in the degree of oxidation: the phosphates, containing the most oxygen, the phosphites, containing less, and the hypophosphites, least of the three. The phosphates, being saturated with oxygen, undergo little change in the body, and because of this were thought to be of little value in therapeutics. The phosphites contain less oxygen, are unstable and are not used in medicine. The hypophosphites, containing still less oxygen, stand nearest to elementary phosphorus and are easily decomposed and readily oxidized to phosphates. Hence the theory that the hypophosphites would furnish an admirable source from which to obtain the action of the element phosphorus.

CHURCHILL’S THEORY

The hypophosphites were introduced into medicine about 1855, as a substitute for elementary phosphorus by a Dr. Churchill of Paris, and later of London, who advocated their use as a specific remedy for consumption. Churchill conceived the theory that phthisis is caused by a lack of oxygen in the tissues; he therefore sought an agent capable of increasing oxidation. He was led to the use of hypophosphites for this purpose on the supposition that phosphorus exists in the organism as a biologic element in a lower degree of oxidation than the phosphate. He supposed that this form of phosphorus acts by its chemical affinity as an initiatory agent in attracting and utilizing the inspired oxygen. He believed that when this form of phosphorus, which he called the “phosphide element,” is deficient in quantity (because it had been oxidized into phosphate, or because the supply from natural sources was deficient), the degree of oxidation of the tissues is less than normal. Therefore he advocated the use of hypophosphites to supply the lacking oxidizing constituent. He believed this “phosphide element” not only to be essential for the oxidation of the tissues, but also to be the source of energy of the nervous system.

THE FACTS

The theory was a pretty one; the facts, however, did not support it. Subsequent investigations indicate that instead of consumption being due to a lack of oxygen, there is in that disease really an increased oxidation; in other words, the respiratory exchanges in this disease are exaggerated. The existence in the system of a form of phosphorus less highly oxidized than the phosphates is unproved. No evidence has been produced to show that phosphorus acts as an energizer of oxidation. There is no proof that the hypophosphites enter into general metabolism or affect disease processes in any way. Not only is there no scientific evidence for the utility of the hypophosphites, but science has long since demonstrated their worthlessness.

In 1895 Boddaert[153] published researches showing that hypophosphites are rapidly eliminated through the kidneys unchanged. Similar results have been reached by Paquelin and Joly, who attributed to the hypophosphites only the action of diuretics. In 1901 Massol and Gamel[154] found by animal experimentation that the hypophosphites did not act as diuretics, but that the hypophosphorous acid was completely eliminated in the form of sodium hypophosphite. The urea was not increased and the relation of urea to total nitrogen remained the same. Their results indicated no increase of oxidizing actions within the system. Finally, Massol and Gamel examined the urine of patients taking hypophosphites and found the same conditions: the results were the same as in the experiments on animals.

[153] Boddaert: Arch. de pharmacod., 1895, 2.

[154] Massol and Gamel: Jour. de pharm. et de chem., 1901, xiv, 337.

PROPRIETARY THERAPEUTICS

In spite of these facts the hypophosphites continue to be employed by many practitioners. Why? Because the theory, being plausible at the time when such chemical theories were popular, gained a certain recognition and was accepted without scientific investigation. Thus the hypophosphites came into use. It was not long before they were taken up by certain manufacturers, and the theory on which their use was based became a commercial asset. As a result the theory, which uncommercialized would have died of inanition, was kept alive by continued advertisement.

The manufacturer of proprietaries having settled on a plausible theory on which to sell his products has no further need for science. Thus, while these theories are no longer to be found in accredited text-books, they are still preached by the proprietary interests. An elaborate pamphlet on “Iodine and Phosphorus,” containing statements which are known to be false, is one firm’s text-book supplied to physicians to-day, and contains long quotations from Dr. Churchill’s writings of sixty years ago. This book contains no intimation that these theories have been overthrown. It is poor economy to waste money in changing literature when the old theories and the old plausible reasoning will sell goods just as well. Consequently the old errors are drummed into those physicians who are willing to read their physiology from the neat monographs of proprietary literature and to sit at the feet of glib salesmen who expound to them the proprietary theory of therapeutics.--(_From The Journal A. M. A., April 25, 1914._)

BUFFALO LITHIA WATER

Contains One-Fifth as Much Lithium as Potomac River Water

Some years ago, Alexander Haig evolved the theory that most diseases are due to uric acid. The data on which he founded his theory were not corroborated by scientific men, and investigation showed that his methods were unreliable. In spite of the fact that Haig’s theories are utterly discredited, and have been for years, the uric acid fallacy still persists, although it is now largely confined to the public. Shrewd business men, especially those who are more intent on making money than they are concerned with the manner in which that money is made, owe much to Haig’s theory. As a business proposition, uric acid has been one of the best-paying fallacies on the market--and possibly still is. It is only necessary to refer to The Journal’s recent article[155] on the Turnock mail-order medical fraud to emphasize this fact.

[155] The Journal A. M. A., May 23, 1914, p. 1675.

Contemporary with, and to a certain extent a corollary of, the uric acid fallacy was another, _viz._, that lithium would eliminate uric acid. This at once gave a good working principle for the proprietary men. Uric acid, we were told, causes disease; lithium, we were also told, would eliminate uric acid; therefore, lithium is the new elixir of life! Could anything be simpler?

Accepting this theory, it was inevitable that mineral waters containing lithium salts should become highly popular. Many exploiters of mineral waters began to place most emphasis on the lithium salts in their waters even in those cases in which lithium was present in such infinitesimal amounts as to render its detection impossible by any but spectroscopic methods.

One of the best known, because most widely advertised, of the so-called lithia waters is Buffalo Lithia Water--or what used to be called Buffalo Lithia Water. After the Federal Food and Drugs Act came into effect, by which falsification on the label was penalized, the name of Buffalo Lithia Water was changed to Buffalo Lithia Springs Water. The reason for this change was that when Buffalo Lithia Water was subjected to examination by the government chemists it was found to contain so little lithium that the amount present was unweighable--it could be demonstrated only by the spectroscope. It was evidently, therefore, not a lithia water in that it did not contain--at least in quantities that could be consumed--an amount of lithium that would give the therapeutic effects of lithium: Possibly the company imagined that by changing the name from “Buffalo Lithia Water” to “Buffalo Lithia Springs Water” it had cleverly evaded the federal law. Their argument was to this effect: The springs from which this water is taken are known as Buffalo Lithia Springs; therefore, it is not a misstatement of facts to call this Buffalo Lithia Springs Water.

WHAT IS A LITHIA WATER?

The Supreme Court of the District of Columbia, holding a district court, has recently given an opinion on the Buffalo Lithia Springs Water case. The findings of the court are refreshingly simple, and characterized by that broad commonsense view that is becoming increasingly more common among modern jurists. Read Judge Gould’s opinion as to what constitutes a lithia water:

“Speaking generally, and as an individual of average intelligence and information, it would seem that if one were offered a water which the vendor told him was a ‘lithia’ water, one would have the right to expect enough lithium in the water to justify its characterization as such, thus differentiating it from ordinary potable water; and this amount would reasonably be expected to have some effect on the consumer of the water by reason of the presence of the lithium.”

Certainly a reasonable attitude, and one which the man in the street not only can understand but will agree with. Then came the question as to the actual lithium content of Buffalo Lithia Springs Water, and the court said:

“For a person to obtain a therapeutic dose of lithium by drinking Buffalo Lithia Water he would have to drink from one hundred and fifty thousand to two hundred and twenty-five thousand gallons of water per day. It was further testified, without contradiction, that Potomac River water contains five times as much lithium per gallon as the water in controversy.”

SOME TESTIMONIALS

Here, then, is a water that has for years been advertised first, in medical journals, and later, in lay publications, as a “lithia water” yet, actually, it contains less lithium, five to one, than is to be found in ordinary river water. This is a point for physicians to ponder well over. Turn to the back volumes of medical journals and read, both in the advertising and reading pages, the elaborate testimonials, given by men high in the medical profession, on the marvelous effects obtained by the use of Buffalo Lithia Water. Read the following in light of the fact that the water from the Potomac River contains five times as much lithium as Buffalo Lithia Water:

“In the class of cases in which lithia, soda and potash are regarded as most specially indicated, I have obtained far better results from the Buffalo Lithia Waters than from any of the preparations of the lithium salts of the Pharmacopeia.” (_Statement by a member of the Faculty of Medicine of Paris, France_, _etc._)

“Its [Buffalo Lithia Water] therapeutic effects, in my practice, have been vastly superior to those obtained from Lithia Tablets or other Lithia preparations.” (_Statement by an ex-president of the University College of Medicine, Richmond, Va._, _etc._)

“It [Buffalo Lithia Water] is strikingly superior to emergency solutions of lithia tablets and pure water, even where the said solution is an exceedingly strong one.” (_Statement by a former Professor of Clinical Medicine of the College of Physicians and Surgeons, New York, and vice-president of the American Medical Association_, _etc._)

“When Lithia is indicated, I prescribe Buffalo Lithia Water in preference to the Salts of Lithia, because it is therapeutically superior to laboratory preparations of Lithia.” (_Statement by a former professor in the Medical College of Virginia and ex-president of the Medical Society of Virginia_, _etc._)

“Buffalo Lithia Water ... by its richness of composition of Lithia, is of marvelous efficacy, in cases of gout, of chronic, articular, and muscular rheumatism ...” etc. (_Statement by former Physician in Ordinary to the Pope; Member of Academy of Rome_, _etc._)

“I have tried carbonate of lithia dissolved in water in various proportions; but it certainly does not have the same effect as Buffalo Lithia Water.” (_Statement by a former Surgeon-General of the U. S. Army_, _etc._)

These are but a few of many testimonials from physicians that might be quoted. They are interesting from many points of view. They show the worthlessness of testimony of this sort--no matter from what source--and the fallacy of that based on so-called clinical evidence.

To go back to the court’s findings: In the case of the government against Buffalo Lithia Springs Water, one other judicial opinion is worthy of attention, that referring to the attempt on the part of the exploiters of the water to circumvent, on a technicality, the evident intent of the Food and Drugs Act. Said Judge Gould:

“The argument seems to be that if Buffalo Lithia Springs are falsely named, being called ‘Lithia’ Springs, when they do not flow water containing lithium, therefore the proprietors have the right to sell the product as being Buffalo Lithia Springs Water, thus perpetuating on the public the misnomer connected with the origin of the water. It is not apparent how the deceit practiced on the public by the label is mitigated by carrying it back to the designation of the spring from which the water comes.”

For years no one, apparently, ever criticized the claims made for this product. Finally, we got the Food and Drugs Act and the federal officials, acting under the authority vested in them by that law, in December, 1910, declared Buffalo Lithia Water misbranded. Thus this old established vested interest was attacked. The company, of course, fought. It first demurred to the charge brought, and in April, 1912, the demurrer was sustained. At the same time an amended libel was filed by the government, which the company again demurred to. This demurrer was overruled in June, 1912, whereon the company in December, 1912, filed an answer denying that the water was misbranded. The question has now (1914) been finally decided by the court sitting as a jury, the matter having been submitted by agreement to the court.

Buffalo Lithia Water has been sold since 1878. During this period undoubtedly many physicians have prescribed enormous quantities of this water, and many more laymen have taken the water on their own initiative, based on the advertised claims made for it. Practically all who purchased the water, whether directly or on the advice of physicians, did so in the belief that they were getting lithium. Had they known that, to get a therapeutic dose of lithium they would have had to drink 200,000 gallons of Buffalo Lithia Water, they would have felt, and rightly so, that they were the victims of an expensive hoax.--(_From The Journal A. M. A., June 13, 1914._)

MEAT EXTRACTS AND MEAT JUICES[BM]

Their Composition and Relative Values

[BM] See Report of the Council on Pharmacy and Chemistry on “Meat and Beef Juices,” p. 123.

The Bureau of Chemistry of the Department of Agriculture has recently given in Bulletin No. 114 much new and valuable data regarding the commercial meat products. The work contained in this bulletin is practically an elaboration or continuation of that published in The Journal of May 11, 1907, p. 1612. It was taken up to determine the condition and quality of meat preparations in general and from the results obtained to prepare tentative standards for the preparation and composition of such meat preparations. The results as well as the methods of analysis of many meat products are given, showing the composition and relative value of the various preparations. The comments of many investigators regarding the food value of such products is also a valuable contribution to the knowledge of meat extracts, and will help in deciding the real value of the preparations.

The preparations taken up are divided into three general classes (1) Solid and Fluid Meat Extracts; (2) Meat Juices; (3) Miscellaneous Preparations. For each of these the tentative standards submitted by the Committee on Food Standards of the Association of Official Agricultural Chemists are given along with the tabulated results of the chemical analysis. The preparations examined showed, for the most part, that they conformed to the standards, and only those which are at variance in one or more particulars will be mentioned in this review.

SOLID MEAT EXTRACTS

For solid meat extracts the following are the requirements:

“Meat extract is the product obtained by extracting meat with boiling water and concentrating the liquid portion by evaporation after removal of fat, and contains not less than 75 per cent. total solids of which not over 27 per cent. is ash and not over 12 per cent. is sodium chlorid (calculated from the total chlorin present), not over 0.6 per cent. is fat and not less than 7 per cent. is nitrogen. The nitrogenous compounds contain not less than 40 per cent. of meat bases and not less than 10 per cent. of kreatin.”

With the above as the standard, several of the solid meat extract preparations examined were not up to grade on one or more points, though in some cases it is true they were very slightly below the standard set. The following products were found wanting in some respects and the requirements which they failed to meet are given:

“REX” BRAND BEEF EXTRACT (Cudahy Packing Co., Omaha) contained 26.50 per cent. water instead of the standard 25 per cent.

EXTRACT OF BEEF PREMIER (Libby, McNeil & Libby, Chicago) contained 30.92 per cent. of ash instead of the standard 27 per cent.; 18.32 per cent. of sodium chlorid (standard, 12 per cent.); 6.02 nitrogen (standard, 7 per cent.).

BEEF EXTRACT (Swift & Co., Chicago) contained 13.51 per cent. sodium chlorid (standard, 12 per cent.); 6.60 per cent. nitrogen (standard, 7 per cent.).

BEEF EXTRACT, COIN SPECIAL (G. H. Hammond Co., Hammond, Ind.) contains 13.25 per cent. of sodium chlorid (standard, 12 per cent.); and 6.86 per cent. nitrogen (standard, 7 per cent.).

With these few exceptions, the solid meat extracts were found to comply with the standards given.

FLUID MEAT EXTRACTS

For fluid meat extract the following standards have been suggested:

“Fluid meat extract is identical with meat extract except that it is concentrated to a lower degree and contains not more than 75 per cent. and not less than 50 per cent. of total solids.”

According to this standard all excepting one of the fluid meat extracts examined were found to be below grade in one respect, that of solids. The following are preparations examined and the percentage of solids found:

Per cent. CONCENTRATED FLUID BEEF EXTRACT (Armour & Co., Chicago) 42.25 MEAT JUICE (Valentine’s Meat Juice Co., Richmond, Va.) 42.36 BEEF JUICE (John Wyeth & Bro., Philadelphia) 41.16 VIGORAL (Armour & Co., Chicago) 50.06 “REX” FLUID BEEF EXTRACT (Cudahy Packing Co., Omaha) 44.01 FLUID EXTRACT OF BEEF (Cibilis Co., New York) 35.37 FLUID BEEF JELLY (Mosquera-Julia Food Co., Detroit) 31.03

Special notice is directed to the price of some of these preparations, which in spite of their large water content, are higher priced than some of the solid meat extracts.

MEAT JUICES

The following is given as the standard for preparations of meat juice:

“Meat juice ... is the fluid portion of muscle fiber obtained by pressure or otherwise, and may be concentrated by evaporation at a temperature below the coagulating point of the soluble proteids. The solids contain not more than 15 per cent. of ash, not more than 2.5 per cent. of sodium chlorid (calculated from the total chlorin present), not more than 4 per cent. nor less than 2 per cent. of phosphoric acid (P_{2}O_{5}), and not less than 12 per cent. of nitrogen. The nitrogenous bodies contain not less than 35 per cent. of coagulable proteids and not more than 40 per cent. of meat bases.”

It is especially noticeable among the meat juices, so called, that none shows any appreciable amount of coagulable proteids. Valentine’s Meat Juice and Wyeth’s Beef Juice, besides being below the standard in total solids as fluid extracts, are misbranded when called meat or beef juices, as can readily be seen by comparing the results of the analyses and the standard.

Wyeth’s Beef Juice is advertised as containing “all the albuminous principles of beef in an active and soluble form” and “in an unaltered form”--two statements that are on the face of them untrue and misleading. To say that all the albuminous principles of meat are present is to say that not only the juice of the meat but all the fiber is present, which evidently is not true. Then again, to say that it is present in an unaltered form is far from the facts, for, as is stated on page 18 of the Bulletin: “It appears impracticable to prepare a true meat juice for market, as the temperature necessary for the preservation of food products in hermetically sealed packages coagulates the proteids and changes the nature of the product.” On page 55: “When prepared under the best possible conditions a commercial meat extract is, of necessity, in order that it may not spoil, deprived of the greater part of the coagulable proteids, which constitute the chief nutritious elements of the juice.”

On examining the tables of analysis, it is seen that Wyeth’s Beef Juice contains but 23 per cent. of its total proteids in a coagulable form, while the standard calls for 35 per cent., thus showing it to be no more valuable as a food product than any other so-called meat juice, the statements of the manufacturers to the contrary notwithstanding.

In the case of Valentine’s Meat Juice we note a large discrepancy between the standard requirements and the results of the government analysis, for instead of the proteid matter containing 35 per cent. in the coagulable form, it contains but 1.6 per cent. These figures show, then, that Valentine’s preparation contains practically no coagulable proteids, and since the quantity of these measures the food value of such preparations, the conclusion must be drawn that Valentine’s Meat Juice has practically no value as a food and should certainly not be classed as a meat juice.

Bovinine, another widely advertised meat preparation, which, according to statements on “The Bovinine Co.’s” letter head, is “a concentrated beef juice” and “the only perfect food in the world” was analyzed and found below the standard set for meat juices, since it contains only 3.38 per cent. of coagulable proteids. Yet in spite of this discrepancy, the manufacturers of Bovinine persist in exploiting it as a food, stating it to be “... a concentrated easily assimilable, nitrogenous food,” and in another place it is stated that Bovinine “is an ideal food.” As it is deficient in coagulable proteids and thus below the requirements as a food, it is misbranded when called a food of any sort, for to quote again the Bulletin, page 55: “... meat extracts ... must not be looked on as representing in any notable degree the food value of the beef or other meat from which they are derived”; and, again: “They are not, however, concentrated foods, having, on the contrary, but comparatively little nutritive value.”

Taken individually or as a class, meat extracts are not to be considered foods, and should, therefore, not be advertised as such, a conclusion which the government officials have come to and voiced in the conclusion of the Bulletin as follows:

VALUE AND LIMITATIONS

“It seems to be the consensus of opinion among scientific investigators who have studied this question that the food value of these meat extracts is rather limited, and although they are a source of energy to the body they must not be looked on as representing in any notable degree the food value of the beef or other meat from which they are derived. When prepared under the best possible conditions a commercial meat extract is of necessity, in order that it may not spoil, deprived of the greater part of the coagulable proteids, which constitute the chief nutritious elements of the juice.”--(_From The Journal A. M. A., Jan. 23, 1908._)

PHARMACEUTICAL MANUFACTURERS AND THE GREAT AMERICAN FRAUD

At various times we have given more or less complete accounts of the prosecutions the United States Government has brought against nostrum exploiters under the Food and Drugs Act. One of the more recent of these, while of comparatively little interest _per se_, is of importance to the medical profession, because of certain elements connected with it. The case is known technically as “Notice of Judgment No. 284” and deals with the “Alleged Misbranding of Danderine.” The gist of the case is as follows: Casks of Danderine--a widely advertised “hair tonic”--were shipped in carload lots from Michigan to West Virginia, where the product was bottled, labeled and put in condition to be retailed. Danderine contains a percentage of alcohol which, while given on the labels of the bottles in which it is sold, was not stated on the casks in which the preparation was shipped in bulk. The government sought to confiscate, under the Food and Drugs Act, sixty-five casks thus shipped because the quantity or proportion of alcohol in the casks was not stated. The Knowlton Danderine Company resisted the confiscation and the court upheld the company’s claim.

The point in this case which is--or should be--of interest to the medical profession is to be found in the “statement of facts” presented by the Knowlton Danderine Company in its own defense. Here it is said that: “Parke, Davis & Co., who are mentioned in the said libel as shippers ... are under contract with the said Knowlton Danderine Company ... to compound the said formula ...” Elsewhere it is stated: “Parke, Davis & Co. were ... the manufacturing agents, under contract, of the owner, the Danderine Company ...”

This evidently means that Parke, Davis & Co., who are generally supposed to manufacture only “ethical” preparations--proprietary or otherwise--and as such to desire the respect and good wishes of the medical profession, are in the business of furnishing the supplies for nostrum venders. What Danderine is, it is hardly necessary to specify. The widely distributed advertisements of this “hair tonic” nostrum with the slogan: “Danderine Grows Hair and We Can Prove It” are sufficiently well-known to all who read to make a lengthy disquisition on the product unnecessary.

It is interesting in this connection to note that according to newspaper dispatches the Danderine Company has absorbed the Sterling Remedy Company, which exploits “Cascarets.” Three years ago a physician, who is also a pharmacist, wrote to the _Medical World_ regarding the manufacture of Cascarets:

“... I have positive evidence, which I will gladly submit, that P., D. & Co., make all of them [Cascarets], and that they have a contract with the Cascaret people not to make anything similar for any one else.”

In the circular which comes in the Danderine packages two other “specialties” are advertised: “Neuralgine” for “sick, weak, tired nerves” and “Drake’s Palmetto Compound” for “weak stomachs, sluggish livers, disordered kidneys,” and various other derangements of the system. The question naturally arises, are these, too, shipped in casks from Parke, Davis & Co., and merely bottled and labelled in West Virginia?

Not that the Danderine case is the first one in which Parke, Davis & Co. have been exposed as manufacturers of nostrum supplies. “Vitaopathy” a method of “treatment” practiced by the notorious New York Institute of Physicians and Surgeons in the person of “Prof.” Adkin and apparently consisting of “absent treatment” and pills, was finally put out of business by a fraud-order from the post office department. The concern used to advertise:

“In Professor Adkin’s laboratory, his chemists are daily engaged in extracting the life-and-health-giving principle from rare vegetables, fruits and plants.”

“Prof.” Adkin had no laboratory; his chemists, according to the government report, were Parke, Davis & Co., from whom he purchased the tablets which formed part of his stock-in-trade of quackery.

The Nutriola Company of Chicago was declared fraudulent by the postal authorities and a full account of the methods of this fake medical concern appeared in The Journal, April 28, 1906. Nutriola was advertised as:

“The greatest Chemical-Medical Preparation ever prepared by the skill of man.”

“Nutriola and Nature are the only invincible conquerors of diseases ever known.”

The promoter of this scheme was one Edward F. Hanson, who was questioned by the government inspectors regarding the manufacture of the Nutriola nostrum. Quoting from the government report:

“_Q._ Please name the chemists who now manufacture the remedies of the Nutriola Company.”

“_A._ Parke, Davis & Company, Detroit; E. L. Patch Manufacturing Company, Stoneham, Mass.; Seabury & Johnson, New York.”

Not that the course pursued by Parke, Davis & Co. is by any means an exceptional one in the pharmaceutical world. It may be recalled that The Journal has previously referred to the fact that Sharp & Dohme are reported to make or to have made the “Getwell Tablets” for the “patent medicine” concern which exploits the nostrum; and that Frederick Stearns & Co. make or did make the widely advertised “cures” Shac and Zymole Trokeys also has been mentioned. That Seabury & Johnson made preparations for a fake medicine concern was brought to light by Mr. Adams in the “Great American Fraud” series. And unquestionably there are many others. The attitude taken by such houses seems to be that they are willing to furnish anything in the pharmaceutical line that anyone is willing to pay for, whether it is for legitimate use of the physician or pharmacist or for furthering the business by which the ignorant or gullible sick are humbugged and defrauded.--(_From The Journal A. M. A., July 2, 1910._)

DOWD’S PHOSPHATOMETER

Dowd’s Phosphatometer, according to its inventor, is a device “for taking the phosphatic index or pulse of the nervous system.” Its originator, J. Henry Dowd, M.D., Buffalo, N. Y., writes enthusiastically of his instrument:

“Physicians who use the Phosphatometer are sending 50 per cent. less patients away for consultation, getting 75 per cent. better results at home, because the Phosphatometer tells the cause and what to do, and the Comp. Phosphorus Tonic gives results in 80 per cent. of all conditions of illness.”

The “Comp. Phosphorus Tonic” referred to in the above quotation is a sideline of Dr. Dowd’s, put out by the Richardson Company, of Buffalo. The stationery of the Richardson Company gives its address as 334 Franklin Street, but directs that all communications be addressed to 40 North Pearl Street, which is the private address of J. Henry Dowd. According to the Buffalo directories, 334 Franklin Street is the drug store of Arthur E. Reimann.

To those who read the Dowd “literature,” the Phosphatometer will appear to be either one of the wonders of the age or an unscientific absurdity. To the thinking man it will be the latter. It pretends to determine the amount of phosphates in the system. This is accomplished--alleged--by taking the second urine passed in the morning and mixing a portion of it in the instrument with a solution which is the well-known magnesia mixture. The height to which the crystals settle in ten minutes determines, according to Dowd, the amount of phosphates! Was ever a test devised that violated more of the first principles of quantitative chemical analysis? If so, we never heard of it. Dowd’s system does not require any determination of the amount of urine passed in twenty-four hours or even of the amount passed at the second micturition in the morning.

If a patient whose urine was being “tested” by the Dowd method, should drink two cups of coffee for breakfast instead of one, his urine might be so dilute that the phosphates would fall below the “normal” mark. Dowd says that his Phosphatometer “takes the pulse of the nervous system.” What about the patient who eats several eggs or consumes a sweetbread or other nuclein-containing articles of diet? The increased amount of phosphates in such a diet might easily lead to an apparent excess in the urine. Every physician, nay, every sophomore medical student, knows that the amount and kind of food ingested governs almost entirely the amount of phosphates excreted in the urine.

What actually does “Dowd’s Phosphatometer,” when used according to instructions, show? It shows the _presence_ of phosphates in the urine; it permits a guess--with not the slightest claim to accuracy--as to the amount in the specimen tested; it gives no possible clue to the normal or abnormal relation of the phosphates in the urine or as to whether the source of the crystals precipitated is the nerve tissue or the food. Yet here are some of the claims made for it:

“The Phosphatometer shows nervous metabolism the same as the ureometer shows muscular; the former errs in about 3 per cent.; the latter in 40 per cent.”

“The Phosphatometer shows the amount of nerve food being used and present in the nerve cells.”

“Over 50 per cent. of pain and human suffering is due to the nerves crying for food; the Phosphatometer will show the true cause in ten minutes.”

“The Index not only tells the present condition, but foretells the future, thus preventing serious complications which might arise.”

“The Phosphatometer measures the amount of phosphorus in the system.”

“The Dowd Phosphatometer not only takes blood-pressure, it tells how to regulate it.”

“The Phosphatometer measures the amount of phosphorus in the nerve cells; it is as positive in nerve troubles as the x-ray in fractures.”

These claims are essentially false. As a matter of fact, a simple examination of the urine for phosphates cannot tell us the condition of the nervous system. This must be evident from the fact that only a portion of the phosphates is excreted in the urine, a very considerable part passing out with the feces. Further, the bulk of the phosphorus excreted comes from the food and only a small portion from the waste of the nervous system. The amount excreted by the urine which comes from torn-down nerve tissue is so small that it is practically impossible to estimate variations in it even by the most careful analytic methods.

In brief, Dowd’s “scientific method” is nothing more than unscientific humbug.--(_From The Journal A. M. A., Dec. 20, 1913._)

AMORPHOUS PHOSPHORUS[BN]

A Practically Inert Substance Introduced as a Valuable Therapeutic Agent

[BN] The so-called amorphous phosphorus is in reality a crystalline body and is more correctly called red phosphorus to distinguish it from the ordinary or yellow phosphorus. It is the ordinary or yellow phosphorus which is official as “Phosphorus.”

Amorphous phosphorus is a chemical anomaly contrasting markedly with ordinary phosphorus in its physical, chemical and pharmacologic properties. Ordinary phosphorus is soluble in certain solvents, such as oil; amorphous phosphorus is insoluble. Ordinary phosphorus is poisonous; amorphous phosphorus is not poisonous. Ordinary phosphorus has been regarded as of some therapeutic value; amorphous phosphorus, because of its insolubility and other physical properties, has never been so regarded. Pharmacologists, therefore, have paid very little attention to it. Some of them do not even mention it, though there are a few accounts of experimental work.

Noé,[156] in experiments on the action of phosphorus with yeast, found that yeast acted on ordinary phosphorus, producing PH_{3} (hydrogen phosphid), but on amorphous phosphorus it had no action. His experiments show that amorphous phosphorus was not toxic to animals.

[156] Noé, J.: Action comparée du phosphore blanc et du phosphore rouge sur la matière vivante, Compt. rend. Soc. de biol., 1899, 105, i, 380.

Thornton[157] quotes Reese as publishing a report of a case in which 30 grains of amorphous phosphorus were taken by a young woman with suicidal intent, but no toxic symptoms were manifested. Thornton found it non-toxic to animals.

[157] Thornton, E. Q.: The Advantages of Amorphous Phosphorus over the Official Form, Therap. Gaz., 1894, xxxv, 19. Tr. Pan. Am. Med. Congress, 1893, Washington, 1895, p. 1,438.

Witthaus and Becker (Medical Jurisprudence, Forensic Medicine and Toxicology, iv, 635) say: “The form of phosphorus is practically non-poisonous, probably by reason of its insolubility. It has been administered to dogs to the extent of 200 gm. (nearly half a pound) in twelve days without causing poisoning.”

C. D. F. Phillips (Materia Medica, Pharmacology and Therapeutics, Inorganic Substances, Ed. 3, p. 46) makes the following statement: “Amorphous phosphorus has been, by some observers, credited with physiologic activity. Thus, Bednar used it for a long period in small doses, and observed symptoms of excitation, trembling and clonic convulsions; but as much as 1 ounce has been given to dogs without perceptible effect. Thompson, in twelve carefully observed cases, found its action nil, and plausibly attributes its supposed powers to a slight admixture of ordinary phosphorus (_Pharm. Jour., 1875_). I believe it is practically inert.”

HOW INTRODUCED

The foregoing represents our scientific knowledge as to the action of amorphous phosphorus. Now, however, comes Dr. I. L. Nascher and introduces amorphous phosphorus as a remedy of remarkable value for the arteriosclerosis of old age. The method of introduction is somewhat peculiar. The treatment seems first to have been brought to notice through a printed slip sent to medical journals generally. This slip consisted of an extract from Nascher’s book on old age, which at the time had not been published! Nascher also published an article on this subject in an obscure journal, the _American Practitioner_, for December, 1913. Neither the matter copied from his book nor the article referred to contain a single scientific fact that would warrant the claims made for it as a therapeutic agent. No record is given of animal experiments, and the clinical evidence presented certainly cannot be regarded as scientific.

As already stated, this form of phosphorus has not been previously used and has been regarded as without effect on the human system because of its insolubility in any of the liquids of the body. Nascher himself has not been able to find any new way to dissolve it. He says: “I made a number of experiments to find a solvent. The only substance which appears to dissolve it is serum, but I am still uncertain whether it is a solution or a very fine suspension. The phosphorus is precipitated in a few days, but the serum remains tinged.” The fact that it separates from the serum on standing is quite conclusive evidence that it is insoluble in that liquid. Since no way of making it soluble has been discovered, there is no reason for expecting it to have any effect on the system. An insoluble and non-absorbable substance can produce no general systemic effect; if, when ingested, it produces any effect whatever, this effect must be local and will be shown by symptoms of gastro-intestinal disturbance. Nascher, however, took 15 grains, and no symptoms of gastro-intestinal disturbance followed. Hence, we must conclude that it is without effect on the gastro-intestinal mucous membrane. While Nascher records no experiments on animals which is much to be regretted, he did experiment on himself and says:

“Ten grains produced a frontal headache, restlessness, excessive mental stimulation, ideas arising with such vividness as to appear as actual occurrences. There was a sense of weight or oppression in the stomach and priapism, the latter probably psychic, as I was looking for such a result. These symptoms passed away in a few hours.”

Without doubt his explanations of the priapism can be applied to the whole experience; whatever symptoms there were, they were unquestionably psychic. The consideration of these subjective symptoms may be dismissed, since it is reasonable to assume that an insoluble, unabsorbable substance which produces no disturbance of the gastro-intestinal tract will have no effect on the rest of the organism.

Amorphous phosphorus did not produce such symptoms as Nascher relates in experiments similar to his made by us. The drug was taken in 10-grain doses by six different individuals. In no case did the symptoms described by Nascher follow; in fact, there were no symptoms whatever.

NASCHER’S THEORY

Nascher, after relating his subjective experiences and those of his patients, proceeds to build a theory to account for the unproved action of amorphous phosphorus in disease, especially in arteriosclerosis. It would have been more appropriate if before advancing the theory, he had made some experiments to prove that the substance has some action. But we give his theory as found in the quotation from his book, sent to medical journals, as already referred to. Here it is:

“Amorphous Phosphorus in Senile Arteriosclerosis: The author has used the red amorphous phosphorus in senile arteriosclerosis for several years. Given originally as a substitute for ordinary phosphorus in senile debility, it was found that it was eliminated as amorphous phosphate of lime and that the lime elimination was thereby increased. Weil’s experiments showed that the lime elimination in arteriosclerosis was diminished. Phosphorus has the property of combining with lime and increasing the lime assimilation. In the small doses which can be given when the ordinary phosphorus is employed, the phosphorus will combine with the lime of the food and increase the amount of lime salts in the body. When given as amorphous phosphorus, the dose is 2 grains or more several times a day, and with a lime-free diet the lime required for the combination necessary to secure the elimination of the phosphorus excess is drawn from the abnormal lime deposits. This appears to be the rationale of the treatment and explains the good results obtained from its use. From ‘Diseases of Old Age,’ by I. L. Nascher, M.D., to be published shortly.”

Thus, according to Nascher, the phosphorus, after being oxidized to phosphoric acid, catches the calcium and drags it out of the system! What are the facts? The human body contains a large store of phosphates which are excreted in the urine in combination with sodium and potassium--and yet these do not draw the calcium from the blood, brain and bones! To be blunt, Nascher’s theory is absurd. The calcium in its various deposits in the body is already combined with phosphoric acid. Why should the phosphorus introduced take calcium from the phosphate radical with which it is already in combination? Nascher asserts that the phosphorus which is introduced as amorphous phosphorus is excreted as amorphous phosphate of lime within twenty-four hours. How does he know it is? It is, of course, very appropriate that amorphous phosphorus should form the amorphous phosphate of lime, but, unfortunately, phosphates made from the ordinary phosphorus also are precipitated in the amorphous condition. By what private mark does Dr. Nascher identify the amorphous phosphate produced by his amorphous phosphorus? Is it not a fact that he found the urine alkaline and detected a precipitate of amorphous calcium phosphate--always present in alkaline urine--and concluded that this must be his particular amorphous phosphorus in combination with calcium?

Dr. Nascher makes no record of examinations of the feces, although a great part--sometimes the greater part--of ingested phosphorus is found in the feces in experimental work on phosphorus metabolism. If he had examined the feces he would doubtless have found the total quantity of amorphous phosphorus unchanged.

Nascher refers to several cases in which he has used this remedy and states that he had the most gratifying results. So far as we can learn, the benefit was entirely in the subjective symptoms of the patient. It seems evident, therefore, that his claims for the value of this remedy rest on no better foundation than an unproved theory without experimental basis.

ITS COMMERCIALIZATION

Thus far we have considered only the scientific aspects of amorphous phosphorus therapy. It is unfortunate that we cannot stop here. Some of our readers will have seen in recent medical journals half-page advertisements of amorphous phosphorus reading:

The striking physical and chemical properties possessed by common phosphorus, together with the fact that phosphorus is one of the constituents of nerve-tissue, are probably responsible for the reputation which this element acquired generations ago as a remedy for sexual impotence and mental decay. Among scientific men this reputation was a fleeting one, for, when put to the test, the product failed. Like so many products with a similar history, the unearned reputation it obtained from medical men survived in the minds of the laity, and, as is always the case, the survival has been taken advantage of by quacks. Among charlatans and nostrum makers phosphorus is still in vogue. “Weak men’s specialists” and venders of “lost manhood” and alleged aphrodisiac drugs “play up” the phosphorus fallacy for all it is worth.

It is worth noting that the present exploitation of amorphous phosphorus is following along somewhat similar lines. The asserted actions of amorphous phosphorus are such as may be calculated to appeal to the sexual neurasthenic. There is no doubt that the Sharp & Dohme advertisements will bring about an extensive use of this remedy, especially by the uncritical. The psychic element--which plays so large a part in the sexual neurasthenic--will result in favorable reports being given on the drug. Articles may be expected to appear in a certain class of medical journals, telling of the marvelous results that Dr. John Doe has had in the use of “Pill Phosphorus Amorphous S. & D.” A luxuriant crop of testimonials may be expected to follow, and the _tout ensemble_ will go far to sustain the Sharp & Dohme propaganda.

We are prompted to believe that Messrs. Sharp & Dohme do not fully realize the potentialities for harm that lie in their present exploitation of amorphous phosphorus. It hardly seems possible that a firm of standing would knowingly put on the market and advertise a worthless drug with an appeal to susceptible, infirm old men. The function of introducing new remedies to the medical profession is a responsible one, and a firm that assumes it should have among its officers some one sufficiently conversant with pharmacologic science to prevent such unscientific absurdities as that exhibited in the marketing of amorphous phosphorus, especially under such claims as those contained in the advertisements.--(_From The Journal A. M. A., March 7, 1914._)

Dr. Nascher’s Reply to The Journal’s Article--Comments

_To the Editor_:--Regarding the article on Amorphous Phosphorus in the March 7 issue of The Journal of the American Medical Association, I want first of all to clear myself of the implied charge of commercialism in connection with the marketing of the Pill Phosphorus Amorphous by Sharpe & Dohme. I have never had anything to do with the manufacture or sale of those pills, never had any business dealings with Sharpe & Dohme and I have no commercial interest whatsoever in either this or any other drug or drug house. I knew nothing about the advertisement which you reproduced until I saw it in the medical journals. I immediately protested against this unwarranted use of my name and was assured that the statement “Made under the direction of Doctor I. L. Nascher, New York,” was not made for the purpose of misleading and that the ad. would be immediately withdrawn. I gave my approval to the pills made by this firm as I would give my approval to the pills made by any other reliable house for I claim the right to endorse any drug or preparation which I believe to be of value whether it is approved by the Council of [on] Pharmacy and Chemistry or not.

In your general charge of commercialism you make it appear that the exploitation of amorphous phosphorus had the ulterior purpose of appealing to the sexual neurasthenic along the lines of the “lost manhood” ads. So far as this relates to Sharpe & Dohme, I have no interest, but you have included me in your general denunciation. The only reference I ever made to aphrodisiac effects of Amorphous Phosphorus, in all my writings, is contained in these words in the four-page article in the _American Practitioner_, “In a few cases aphrodisiac effects were noticed.” I have never recommended amorphous phosphorus as an aphrodisiac and in the chapters on “Impotence and Neurasthenia” in my book on “Diseases of Old Age,” I have not mentioned amorphous phosphorus at all.

You say “the treatment seems first to have been brought to notice through a printed slip sent to medical journals generally.” This slip containing an extract from my book which was then in press was sent out about four months ago while I have referred to amorphous phosphorus repeatedly in medical articles during the past three years. In my paper on Senile Debility, _Medical Record_, Jan. 21, 1911, I said amorphous phosphorus had no effect, as I was then looking for the usual effects of the ordinary phosphorus. In a paper on Senile Mentality, _International Clinics_, Vol. 4, 21st series, I said I was using amorphous phosphorus but had not yet determined its value. I recommended it in several of my papers, articles and lectures in 1912 and 1913 after I had found that under its use in some cases of senile arteriosclerosis, symptoms were relieved. I sent these slips to the medical journals as a general reply to many inquiries I received about amorphous phosphorus and I stated this in the letters I sent with the slips to some editors. Further inquiries for more information led me to write the paper which appeared in the December issue of that “obscure journal” the _American Practitioner_. I felt that a medical journal which carried articles by Sir James Barr, ex-president of the British Medical Association, Sir R. W. Philip, R. Murray Leslie, Halliday Sutherland, and such American authorities as Adami, Hare, Brooks, Hirschberg, Knopf, Starkey, Ely, Bissell, Wilcox, Col. Maus, U. S. A., etc., was a representative high class journal and I was pleased to have my paper in it.

To take up the scientific criticism of amorphous phosphorus, permit me to say at the outset that I am a general practitioner, specially interested in geriatrics, and more concerned about obtaining favorable clinical results in my cases than in solving laboratory problems. Nevertheless I have tried for years to obtain the cooperation of expert laboratory workers to help me determine the properties, chemical, physical and physiological, of amorphous phosphorus. In 1909 or 1910 the Rockefeller Institute, in reply to my request for permission to experiment there with amorphous phosphorus, said it did not accept volunteer workers. Four heads of college laboratories could not spare the time. I asked the Council on Pharmacy and Chemistry last November to take up its investigation and was informed that it could not do so at present. I have been perforce compelled to depend mainly on empirical methods with such little experimentation as the facilities of the physician’s office permitted and such little literature as I could find.

You reject empirical methods as being unscientific notwithstanding the fact that most of our therapeutic knowledge is based on empiricism. (I use the terms empirical and empiricism here in the sense of knowledge obtained from experience and observation, not in the bad sense in which they might be construed.) It would therefore be folly on my part to argue with you that I have obtained beneficial results from amorphous phosphorus in many cases of senile arteriosclerosis. I did not obtain such results from a single dose, but gave it in some cases for many weeks or months. It is unfair to judge of the value of a drug from a single dose or several doses unless it is a drug which is expected to show immediate effects. It would be greater folly on my part to pit my knowledge of pharmacy and chemistry against the knowledge of your staff of experts. I can but repeat what I have said on many occasions that under the persistent use of amorphous phosphorus in cases of senile arteriosclerosis symptoms were frequently relieved. I never claimed that amorphous phosphorus will cure arteriosclerosis. In the chapter on Arteriosclerosis in my book I say: “Senile arteriosclerosis being a natural, normal condition, is incurable in the sense that it can be neither prevented nor removed. The best that we can hope for is to retard its progress and relieve disagreeable symptoms, etc.”

You say in reference to the elimination of the amorphous phosphorus as amorphous phosphate of calcium, “Is it not a fact that he (I) found the urine alkaline and detected a precipitate of amorphous calcium phosphate--always present in alkaline urine--and concluded that this must be his particular amorphous phosphorus in combination with calcium?” No. The specimens of urine were examined in reliable laboratories and I have reports showing acid and neutral urine as well as alkaline urine having the amorphous phosphate precipitate. Nor is the amorphous phosphate “always present in alkaline urine.”

As for the theory I advanced, it is simply a theory based on reasoning without facts to prove it. If I had facts to prove it, it would no longer be a theory or open for discussion. Being a theory, it is the province of the wise man to ridicule it and call it absurd. I will confess that your criticism of it is not clear to me and I still do not see its absurdity. I don’t see what relation your argument, that the phosphates of sodium and potassium do not draw the calcium from the blood, brains and bones, has to the theory I advanced. It is true that I have no private mark by which I can identify the amorphous phosphate produced by amorphous phosphorus, but such argument is puerile. When medical science has so far progressed that the physician will be able to put his tag on the molecule of drug substance and follow it through the various metabolic processes to its final elimination we will not need any Council on Pharmacy and Chemistry to decry what it cannot understand. Let me say here that scientific criticism does not stoop to ridicule for ridicule is usually based on animus or bias.

The conclusive proof of the value of a drug is not its action on the healthy dog, frog or guinea-pig but its action on the individual patient, and no amount of animal experimentation can dispose of the personal factor which is so marked in senile cases. This is no criticism of animal experimentation as a whole but of the insistence on animal experimentation to determine the value of a drug in a class of cases for which the healthy animal can furnish no comparison.

You say amorphous phosphorus is practically inert and quote Noé, Witthaus and Becker, Thornton and Phillips. The quotations of the first three are little more than statements that amorphous phosphorus is non-toxic. Phillips makes two references, one of which is to Badner who obtained decided effects from its prolonged use. Thornton, whom you quote in your contention that amorphous phosphorus is inert, says that on prolonged use in doses of 3/10 grains every two hours it produced headache, vertigo, mental excitement, priapism, etc. (See footnote under Phosphorus, U. S. Dispensatory). Shoemaker’s Materia Medica and Therapeutics says it is toxic and is called the servant-girl’s poison. Phillips suggested that Badner probably used an impure drug. I suggested that Thornton probably used an impure drug. On the other hand, Badner and Thornton obtained positive results from prolonged use, not from the single dose.

You say it has not been used on account of its insolubility in any of the liquids of the body. Roscoe and Schorlemmer, quoting Neuman, said if injected into the blood the usual symptoms of phosphorus poisoning appear. In a letter from Dr. Hatcher he says Nassé injected 0.2 gm. of the purest amorphous phosphorus into a rabbit’s vein and the animal presented the usual symptoms of phosphorus poisoning. There are also references to amorphous phosphorus action in Kobert’s _Lehrbuch der Intoxicationen_, in Blythe’s Poisons, etc.

You say of your four quotations, “the foregoing represents our scientific knowledge as to the action of amorphous phosphorus.” Did you not know of these other authorities, or are their statements unscientific, or were they omitted because they disprove your contention that amorphous phosphorus is practically inert?

Your denunciation of ordinary phosphorus has no bearing on the subject as I do not recommend the amorphous phosphorus as a substitute for the other.

I have worked for eight years to arouse medical and public interest in the aged and their ailments and I cannot afford charges of commercialism, foisting worthless drugs as aphrodisiacs or other unethical conduct to stand against me. As for the charge of unscientific work, I can only point to my work on Diseases of Old Age, and my medical papers, and express the hope that others better equipped for laboratory research will take up the laboratory investigation of amorphous phosphorus. I have faith in its therapeutic value and believe competent clinical observers will have favorable results from it in suitable cases.

I. L. Nascher, M.D., New York.

Comment.--Accompanying the preceding letter was a note from Dr. Nascher in which he says: “I want this published in full without elision or change. If you do not intend to publish it as written, I want it returned and enclose postage.” The letter therefore is given in full in spite of the fact that much of it is irrelevant to the question discussed.

Dr. Nascher’s protest to Sharpe and Dohme against the “unwarranted use” of his name in connection with “Pill Phosphorus Amorphous, S & D” seems to have resulted in various modifications of the phrases connecting his name with the exploitation of this pill. What was apparently the original advertisement, contained the phrase:

“Made under the direction of Dr. I. L. Nascher, New York.”

Later advertisements, while identical in all other respects with the first, had this phrase modified to read:

“Made at the suggestion of Dr. I. L. Nascher, New York.”

Still other advertisements, also identical with the first in other respects, are modified to read:

“Made with the approval of Dr. I. L. Nascher, New York.”

That Dr. Nascher was directly or indirectly connected with the commercializing of this product, The Journal has never suggested, inferentially or otherwise. That the exploitation of amorphous phosphorus by Sharpe and Dohme is one that appeals to the sexual neurasthenic, no one who has read the advertisements can deny. As a matter of fact, it would be difficult to sell phosphorus in any form as a medicament, without appealing to the sexual neurasthenic. The word “phosphorus” has become, in the minds of both laymen and physicians, more or less synonymous with the treatment of so-called sexual weakness and it is a practical impossibility to divorce the word from the idea suggested. How true this is, Dr. Nascher himself unwittingly admits when he tells that the result of his first experiment on himself with amorphous phosphorus was a priapism that he acknowledges was “probably psychic, as I was looking for such a result.” But the Sharpe and Dohme advertisements plainly state that the amorphous phosphorus pill they are marketing is a “new and successful method of treatment for ... functional and senile impotence....”

Dr. Nascher’s explanation of how he came to send out the slip regarding amorphous phosphorus to medical journals leaves him the victim of an unfortunate coincidence. It is at least unusual for authors to send out advance extracts from books that are about to be published, especially when such extracts deal wholly with a drug that is coincidently being introduced as a new proprietary product by some enterprising pharmaceutical house.

Dr. Nascher takes exception to our statement that the treatment seems first to have been brought to notice through the printed slip sent to medical journals, and states that he has “referred to amorphous phosphorus repeatedly in medical articles appearing during the last three years.” His articles for 1912 and 1913 have been examined for the purpose of learning when the treatment as now presented to the profession was first announced. In his article “Errors in the Treatment of Senile Cases,” _New York Medical Journal_, Oct. 12, 1912, he speaks of the iodids in senile arteriosclerosis, but says nothing about amorphous phosphorus. It may be assumed, therefore, that the treatment had not been brought to general notice at that time. The new treatment is very briefly described in the _New York Medical Journal_, July 13, 1913, in an article whose title, “Longevity and Rejuvenescence” gave no indication that it dealt with amorphous phosphorus. Under the circumstances, it is not strange that its therapeutic value was not learned of until Dr. Nascher’s printed slips were sent out.

Dr. Nascher admits that his theory is based on empirical methods. Most of the serious errors in therapeutics have had their origin in this very method. It was on just such methods that physicians reported wonderful results in the use of alleged “lithia waters” that actually contained less lithium than ordinary river water! So unscientific is the empirical method that it is hardly worth taking the space to demonstrate its imperfections.

Neither is it worth while to discuss the question of a constant occurrence of a sediment of amorphous calcium phosphate in alkaline urine. If there are exceptions to this rule, they must be rare indeed.

In The Journal’s article authors were quoted to show that amorphous phosphorus is regarded as inert. It was not suggested that the authorities referred to were all that could be found. Dr. Nascher refers to Thornton, Shoemaker, Neuman, Blythe and Kobert, and asks whether the various statements on the subject, made by these men, are unscientific or were “omitted because they disproved” the contention that amorphous phosphorus is practically inert. Thornton’s article was omitted because it is unscientific in that he does not report experiments made by himself, but refers to an unpublished paper by one Kelly. Who Kelly is, or was, he does not tell us. Kelly’s report, therefore, should be and was disregarded, since it is the work of an unknown author and there is nothing in the article to indicate that Thornton was in any position to vouch for Kelly’s work. Incidentally, it may be said that Kelly’s report merely recorded subjective symptoms; Dr. Nascher himself indicates his distrust of Kelly’s alleged results by suggesting that an impure preparation was used!

Shoemaker’s report was not given, for a similar reason. Shoemaker says:

“Amorphous phosphorus is almost completely destitute of taste or odor, has no immediate caustic effect, and is claimed to be less toxic than white phosphorus; but in the _form of matches_ [Italics ours.--Ed.] has caused many deaths and is known as the ‘servant girls’ poison.’”

It is well known that commercial amorphous phosphorus is usually impure, and it is more than probable that if toxic effects were produced by the ingestion of match-heads, these matches were made either of white phosphorus or of very impure red phosphorus. In any case, Shoemaker’s statement has no bearing whatever on the pharmacologic action of pure amorphous phosphorus.

The statement of Neuman quoted from Roscoe and Schorlemmer, as well as that of Nassé, referred to by Hatcher, had no bearing on the question at issue, as these men injected the material into the blood-stream. If, when the amorphous phosphorus is injected into the blood, it produces the ordinary symptoms of phosphorus poisoning, one would naturally expect the same symptoms when the substance is given by mouth--if amorphous phosphorus were soluble or absorbable. The fact that such symptoms are not produced when amorphous phosphorus is taken into the alimentary canal, sustains the views held by chemists, pharmacologists and physicians, that the drug is practically insoluble and unabsorbable--in other words, inert.

Dr. Nascher declares that he “never claimed that amorphous phosphorus will cure arteriosclerosis.” Yet he insists that amorphous phosphorus removes lime from the “abnormal lime deposits” that occur in arteriosclerosis. What is this but claiming curative action?

Summed up, Dr. Nascher’s own admissions amply confirm the main contentions of The Journal’s article. He admits that he has no experimental basis for the use of this remedy; he admits that his theory “is simply a theory without facts to prove it.” The only conclusions that can be reached from his reply coincide closely with the very statement made by The Journal, and which we here reiterate:

“It seems evident, therefore, that his claims for the value of this remedy rest on no better foundation than an unproved theory without experimental basis.”--(_From The Journal A. M. A., March 28, 1914._)

INDEX

(Including References to Articles Not Contained in This Book)

The following is an index (1) to topics discussed in this volume, and (2) to products discussed in reports and other articles not included here:

1. The references to topics discussed or mentioned in this volume are printed in CAPITALS.

2. The references to articles published elsewhere are printed in small letters. These references include papers published in The Journal of the American Medical Association, papers published in the “Annual Reports of the Council on Pharmacy and Chemistry” and a few published in the “Annual Reports of the Chemical Laboratory of the American Medical Association.” A number of these papers have appeared both in The Journal and in the Council Reports. In such cases, for the benefit of those who may not have access to files of both The Journal and the Council Reports, references are given to both sources. Some of this matter is also issued in reprint form.

PAGE

ABBOTT ALKALOIDAL COMPANY, 37, 103, 344

ABICAN, 47

ACETANILID, HARMFUL EFFECTS OF, 305

ACETANILID MIXTURES, 9

ACETPHENETIDIN AND PHENACETIN--THEIR RELATIVE PURITY, 414

ACETPHENETIDIN, HARMFUL EFFECTS OF, 305

ACOUSTICON, 436

ADEPSINE OIL, 161

ADKIN, “PROFESSOR”, 475

ADRENALIN, NAME, VERSUS THE NAME EPINEPHRIN, 454

ADVERTISING, CLEAN, 418

AGAR-LAC AND AGAR-LAC, INC., 10

Agmel (Maguey Products Co.), The Journal, Oct. 12, 1912, p. 1392.

Agurin Tablets (Bayer Co.), Reports Council Pharm. & Chem., 1915, p. 162.

AKOLL BISCUIT, 449

ALBOLENE, LIQUID, 161

Alborum (Whitehouse Chemical Co., Inc.), The Journal, Dec. 12, 1914, p. 2148; Reports Council Pharm. & Chem., 1914, p. 129.

Aletrin, The Journal, Nov. 13, 1909, p. 1655; Reports Council Pharm. & Chem., 1909, p. 135.

Aletris Compound, Elixir (Parke, Davis and Co., Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46.

ALETRIS CORDIAL, 46

ALETRIS FARINOSA, 208

Alfatone (Norwich Pharmacal Company), The Journal, Aug. 7, 1915, p. 548; Reports Council Pharm. & Chem., 1915, p. 62.

ALIENIST AND NEUROLOGIST, ADVERTISING IN, 31

Alkaline Digestine (Parke, Davis and Co.), Reports Council Pharm. & Chem., 1912, p. 44.

Alkalol (Alkalol Company), The Journal, Nov. 6, 1915, p. 1665.

ALLEOTONE, 264

ALMOND PREPARATIONS, VARIOUS DIABETIC, 450

AMERICAN JOURNAL OF CLINICAL MEDICINE, ADVERTISING IN, 303, 304, 342

AMERICAN JOURNAL OF OBSTETRICS, ADVERTISING IN, 342

AMERICAN JOURNAL OF SURGERY, ADVERTISING IN, 31, 49, 342, 424, 429

AMERICAN MALTED FOOD COMPANY, 319

AMERICAN MEDICINE, ADVERTISING IN, 31, 49, 131, 304, 342, 429

VON AMERONGEN, E. M., 299

AMILEE, 161

Amolin Deodorant Powder (Amolin Chemical Co.), The Journal, Feb. 22, 1908, p. 626; Reports Chem. Lab., 1909, p. 63.

AMMONOL, 9

AMMONOL CHEMICAL COMPANY, 338

AMORPHOUS PHOSPHORUS, 478

ANADOL, 246

ANALGESIC BALM, BENGUÉ’S, 267

ANALGESIC CREAM, STEARNS’, 267

ANALGINE-LABORDINE, 117

Analutos and Analutos Tablets (Royal Pharmaceutical Works, Meppel, Holland), The Journal, Feb. 20, 1915, p. 684; Reports Council Pharm. & Chem., 1915, p. 135.

ANASARCIN, 11, 12

ANASARCIN CHEMICAL COMPANY, 11, 18

ANDERTON, DR. T. B., 18

ANEDEMIN, 11, 12, 16

ANEDEMIN CHEMICAL COMPANY, 12, 16, 18

ANGIER CHEMICAL COMPANY, 170

ANGIER’S PETROLEUM EMULSION, 169

ANGIER’S THROAT TABLETS, 173

ANGLO-AMERICAN PHARMACEUTICAL COMPANY, LTD., 58

ANIMAL THERAPY COMPANY, 317

Anistamina (M. Olivetti), Reports Council Pharm. & Chem., 1915, p. 162.

ANNALS OF SURGERY, ADVERTISING IN, 35, 421

ANODYNE BALM, P-M COMPANY, 267

ANTIDIABETICUM-BAUER, 267

ANTI-JAG, 434

ANTIKAMNIA, 9, 268, 307

Antikamnia and Quinin (Antikamnia Chemical Co.), The Journal, July 1, 1905, p. 55.

ANTIKAMNIA CHEMICAL COMPANY, 277, 279, 307

Antimeristem-Schmidt (Laboratorium W. Schmidt), The Journal, March 8, 1913, p. 766.

ANTI-NEURALGIC OINTMENT, 267

Antiphlogistine (Denver Chemical Manufacturing Company), The Journal, June 1, 1907, p. 1875.

ANTIPYRIN, HARMFUL EFFECTS OF, 305

ANTISEPTIC POWDER, MAIGNEN, 19

ANTISEPTIC POWDER, TYREE’S, 21, 404, 436

Antiseptic Tablets, Clover (Sharp & Dohme), The Journal, Aug. 26, 1911, p. 755.

ANTISEPTIC W-A, INTESTINAL, 103

ANTITHERMOLINE, 403

ANUSOL HEMORRHOIDAL SUPPOSITORIES, 227, 280, 281

APERGOLS, 26

Arbor Vitae, Reports Council Pharm. & Chem., 1912, p. 38.

ARCHIVES OF PEDIATRICS, ADVERTISING IN, 31

ARMOUR & CO., 133, 472

ARMY AND NAVY MAGAZINE, 434

ARMY AND NAVY MEDICAL RECORD, 292, 300, 432

ARNOLD’S ZYMOTOID AND ARNOLD’S ZYMOTOID COMPANY, 412

AROMATIC DIGESTIVE TABLETS, 229

ASEPTIKONS, 26

ASPIRO-LITHINE, 281

ASPIROPHEN, 85

ATLANTA JOURNAL-RECORD OF MEDICINE, ADVERTISING IN, 31, 35, 296

ATOLEINE, 161

ATOLIN, 161

AUBERGIER’S SYRUP OF LACTUCARIUM, 399

Autolysin (Autolysin Laboratory), The Journal, July 24, 1915, p. 336; Nov. 6, 1915, pp. 1647, 1662.

Avenin Compound Tablets (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 44.

Baby Taeniafuge Grape (Grape Capsule Co.), Reports Council Pharm. & Chem., 1915, p. 174.

Bacillicide (Prophytol Products Co.), The Journal, Nov. 14, 1914, p. 1778; Reports Council Pharm. & Chem., 1914, p. 125.

BAKING POWDER, CASOID, 449

BAKING POWDER, JIREH DIABETIC, 450

Bakurol (Sharp & Dohme), The Journal, July 10, 1915, p. 175.

BALLARD, J. F., 112, 198

BALLARD-SNOW LINIMENT COMPANY, 43

BALLARD’S SNOW LINIMENT, 205

Baneberry, Reports Council Pharm. & Chem., 1912, p. 38.

Baptisin, The Journal, Nov. 13, 1909, p. 1655; Reports Council Pharm. & Chem., 1909, p. 135.

BANNERMAN, WM., & CO., AND BANNERMAN’S INTRAVENOUS SOLUTION, 105

BAPTISIA TINCTORIA, 209

BARKER’S GLUTEN FOODS, 449, 450

BATTLE & CO., 31, 81, 108, 330

BAUER, CHARLES, 299

BAUER, LUDWIG, 267

BAUER CHEMICAL COMPANY, 366

BAUME ANALGÉSIQUE BENGUÉ, 267

Bee, Honey, Reports Council Pharm. & Chem., 1912, p. 38.

BEEF EXTRACTS, JUICES AND PREPARATIONS, 123, 133, 471, 472

BELL & CO., 151, 282, 356

BELL-ANS (PA-PAY-ANS, BELL), 151, 282

Benetol (Northern Chemical Assn.), The Journal, April 15, 1911, p. 1128; Reports Chem. Lab., 1911, p. 82.

BETUL-OL, 27

BEYER, CHARLES AND FRANK, 299

BIOSOL, 284

BISCHOF’S DIABETIC GLUTEN BREAD, 450

BISCHOF’S GLUTEN FLOUR, 449

BISCHOFF & CO., 293, 344

BISCUIT, VARIOUS DIABETIC, 449, 450

Bismuth Iodo-Resorcin Sulphonate, The Journal, Feb. 11, 1911, p. 441; Reports Chem. Lab., 1911, p. 14.

Bismuth, Opium and Phenol Tablets (Hance Bros. & White, Wm. S. Merrell Chemical Co., Parke, Davis & Co., Sharp & Dohme, F. Stearns & Co., Truax, Greene & Co., H. K. Wampole & Co., Wm. R. Warner & Co.), The Journal, July 25, 1908, p. 330; Dec. 17, 1910, p. 2169; May 6, 1911, p. 1344; Reports Chem. Lab., 1909, p. 28; 1910, p. 85; 1911, p. 22.

Bitter Bark, Reports Council Pharm. & Chem., 1912, p. 39.

Bladder Wrack, Reports Council Pharm. & Chem., 1912, p. 39.

BLANDINE, 161

Blandine Laxative, Mulford (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1914, p. 136.

Blaud Capsules and Blaud Arsenic and Strychnine Capsules, Frosst’s (C. E. Frosst & Co.), Reports Council Pharm. & Chem., 1915, p. 164.

BLISS, ALONZO O., COMPANY, 463

Blood Tonic, Alterative (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 47.

Blue Cohosh, The Journal, Sept. 11, 1915, p. 972.

BOATMAN, H. F., 436

Boneset, Tall, Reports Council Pharm. & Chem., 1912, p. 45.

BOONE, URIEL S., 307

Borolyptol (Palisade Mfg. Co.), The Journal, Nov. 15, 1913, p. 1812.

BOUMA, DR., SUGAR-FREE FAT-MILK, 449

BOVININE, 123, 125, 126

BOVININE COMPANY, 123

BRADBURY’S ECZEMA LOTION, 245

BRANT, J. W., COMPANY, LTD, 411

BREADS, VARIOUS DIABETIC, 450

BREAKFAST FOOD, GUM GLUTEN, 450

BREITENBACH, M. J., COMPANY, 159

BRISTOL-MYERS COMPANY, 87, 179

Brobor (Gaynor-Bagstad Co.), Reports Council Pharm. & Chem., 1915, p. 164.

Bromides with Cypripedium Compound (Truax, Greene & Co.), Reports Council Pharm. & Chem., 1912, p. 43.

BROMIDES, PEACOCK’S, 28

BROMIDIA, 31

BROMIN-IODIN CHEMICAL COMPANY AND BROMIN-IODIN COMPOUND, 285

Bromo-Mangan (Reinschild Chemical Company), Reports Council Pharm. & Chem., 1915, p. 165.

Broom Corn, Reports Council Pharm. & Chem., 1912, p. 39.

BROWN’S IRON BITTERS, 205

BROWN’S IRON BITTERS COMPANY, 43

Bruschettini Curative Vaccine (A. Bruschettini), Reports Council Pharm. & Chem., 1915, p. 176.

BRUSSON CHOCOLATE WITH ADDED GLUTEN, 450

BUCHU AND HYOSCYAMUS COMP., TYREE’S ELIXIR, 407

Buchu and Hyoscyamus Compound, Tyree’s Elixir of (J. S. Tyree), Reports Council Pharm. & Chem., 1915, p. 167.

Buchu and Pareira Compound Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 46.

Buchu, Juniper and Acetate Potassium, Elixir of (Pitman-Moore Co.), Reports Council Pharm. & Chem., 1915, p. 166.

Budwell’s Emulsion of Cod-Liver Oil, Nos. 1 and 2 (Budwell Pharmacal Company), The Journal, Feb. 20, 1915, p. 684; Reports Council Pharm. & Chem., 1915, p. 135.

BUFFALO LITHIA WATER, 467

BUFFALO MEDICAL JOURNAL, ADVERTISING IN, 31, 35, 300

BURNHAM’S SOLUBLE IODINE, 110, 233

BURNHAM’S SOLUBLE IODINE COMPANY, 110

BUTTERS, VARIOUS DIABETIC, 450

CACTIN (NOW CACTOID), 37

Cactin (The Abbott Laboratories) and Cactina (Sultan Drug Company), The Journal, Sept. 21, 1907, p. 1021; March 21, 1908, p. 956; April 4, 1908, p. 1140; Aug. 6, 1910, p. 455.

CACTINA, 36

CACTINA PILLETS, 37

CACTUS GRANDIFLORUS, 36

Cactus Grandiflorus, The Journal, Sept. 21, 1907, p. 1021; Jan. 7, 1911, p. 26.

Calcidin Abbott and Calcidin Tablets (The Abbott Laboratories), The Journal, Sept. 7, 1907, p. 865; Reports Chem. Lab., 1909, p. 7.

CALCREOSE, 40

CALLARD’S PREPARATIONS FOR DIABETICS, 450

CALMINE, 286

CAMPHENOL, 287

CAMPHO-PHENIQUE, 40, 205

CAMPHO-PHENIQUE COMPANY, 40, 42

CAMPHO-PHENIQUE POWDER, 41

CANADA LANCET, ADVERTISING IN, 279, 300

CANADIAN MEDICAL ASSOCIATION JOURNAL, ADVERTISING IN, 300

CANADIAN PRACTITIONER AND REVIEW, ADVERTISING IN, 300

CANCER HOSPITAL (KELLAM), 426

Cannabis Compound, Syrup of (Pitman-Moore Co.), Reports Council Pharm. & Chem., 1915, p. 168.

Captol (Mülhens & Kropff), The Journal, Sept. 10, 1910, p. 959; Reports Chem. Lab., 1910, p. 70.

CARNINE, 123, 125, 128

CARNINE COMPANY, 123

CARNRICK, G. W., COMPANY, 185, 403

Caroid and Essence of Caroid (Mead, Johnson & Co.), Reports Council Pharm. & Chem., 1914, p. 109.

CARPANUTRINE, 133

Casca-Aletris (Pullen-Richardson Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46.

CASCARANS (BELL), 154

CASCARETS, 475

CASOID DIABETIC PREPARATIONS, 449, 450

Caviblen (A. Grimme), Reports Council Pharm. & Chem., 1915, p. 176.

Cedron Seed, Reports Council Pharm. & Chem., 1912, p. 40.

CELERINA, 43

CELLARIUS COMPANY, 85

Celery and various Elixirs of Celery (Hance Bros. & White, Nelson, Baker Co., Parke, Davis & Co., Ray Chemical Co., Smith, Kline & French Co., F. Stearns & Co.), Reports Council Pharm. & Chem., 1912, p. 40.

Cellasin (Mead Johnson & Co.), The Journal, Sept. 12, 1908, p. 931; Oct. 30, 1909, p. 1496; Reports Council Pharm. & Chem., 1905-8, p. 198; 1909, p. 118.

CEREO SOY BEAN GRUEL FLOUR, 450

CHAMAELIRIUM LUTEUM, 84

CHAMBERLAIN, C. S., 81

CHAMBERS, ARTHUR AND LESLIE T., 147

CHAMBERS, J. H. AND M. E., 146

CHAPOTEAUT’S WINE, 60

CHARLOTTE MEDICAL JOURNAL, ADVERTISING IN, 31, 35, 422

CHEMISCHE FABRIK FALKENBERG, 85

CHESEBROUGH, ROBERT A., 161

CHICAGO MEDICAL RECORDER, ADVERTISING IN, 31

CHINOSOL, 248

CHINOSOL COMPANY, 26, 248

Chiodrastis (H. K. Wampole & Co.), Chionacea (Nelson, Baker & Co., Inc.), Elixir Chionanthus Compound (Ray Chemical Co.), and Elixir Chionanthus (Special) (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 42.

CHIONIA, 30

CHLORO-PHENIQUE, 42

CHOCOLATE, PROPRIETARY DIABETIC, 450

CHOLOGEN, 288

Chologestin (F. H. Strong Co.), The Journal, Dec. 11, 1915, p. 2108.

Chromiac Tablets (Maltbie Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44.

CIBILIS COMPANY, 472

CINERARIA MARITIMA, 49

Citarin (The Bayer Company, Inc.), The Journal, Feb. 20, 1915, p. 685; Reports Council Pharm. & Chem., 1914, p. 135.

CITROCOLL, 85

CLAUSEL, HENRY, & CO., 221

Clover Compound, Syrup Red (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, p. 40.

COCILLANA COMPOUND, SYRUP OF, 396

Cod Liver Ext., Stearns’ Wine of, with Peptonate of Iron (Frederick Stearns & Co.). Reports Council Pharm. & Chem., 1915, p. 177.

COD LIVER OIL AND COD LIVER OIL CORDIALS, COMPARATIVE NUTRIENT VALUE OF, 442

Cod-Liver Oil, Budwell’s Emulsion of, Nos. 1 and 2 (Budwell Pharmacal Co.), The Journal, Feb. 20, 1915, p. 684; Reports Council Pharm. & Chem., 1915, p. 135.

COD LIVER OIL PREPARATIONS, 51, 52, 54, 57, 289, 442

Cohosh, Blue, and Fluidextract Blue Cohosh Compound (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 40.

Colchi-Methyl Capsules (H. K. Wampole & Co.), Reports Council Pharm. & Chem., 1915, p. 169.

COLCHI-SAL, 58

COLLYRIUM-WYETH, 292

COLUMBUS PHARMACAL COMPANY, 344

COMAR & CO., 401

Compound, Waterbury’s (Waterbury Chemical Co.), The Journal, March 20, 1915, p. 1016; Reports Council Pharm. & Chem., 1915, p. 138.

Condurango, Reports Council Pharm. & Chem., 1911, p. 54.

CONLEY, WILLIAM W., 49

CONSOLIDATED COLOR AND CHEMICAL WORKS, 328

COPELAND, B. F., 266

Corydalis Compound, Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 47.

COSMOLINE, LIQUID, 161

Coto and Cotoin, Reports Council Pharm. & Chem., 1913, p. 39.

COTTON-ROOT BARK, 84

COUDREY, H. M., 119

CRAMP BARK COMPOUND, FLUID EXTRACT OF, 410

CRAWLEY, M., 119

CRYSMALIN, 161

Cuprase (in “Chemotherapy and Tumors”), The Journal, April 17, 1915, p. 1283; Reports Council Pharm. & Chem., 1915, p. 28.

CUDAHY PACKING COMPANY, 471, 472

Curare and Curarin, The Journal, Jan. 15, 1910, p. 219; Reports Council Pharm. & Chem., 1910, p. 7.

CYPRIDOL CAPSULES, 59

Cystitis Tablet (Parke, Davis & Co., Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, p. 45.

CYSTOGEN, CYSTOGEN APERIENT, CYSTOGEN-LITHIA AND CYSTOGEN CHEMICAL COMPANY, 60

CYSTO-SEDATIVE, 61

DAD CHEMICAL COMPANY, 136

Damiana, Allan’s Compound Extract of (Allan-Pfeiffer Chemical Co.), The Journal, July 19, 1913, p. 211.

DANDERINE, 474

DANIEL, JOHN B., 332

DANIEL’S CONCENTRATED TINCTURE OF PASSIFLORA, 156, 332

DARPIN, 47

DAWSON, JAMES P., 49

DEELINE, 161

DENSTON, J. C., 251

DENVER MEDICAL TIMES AND UTAH MEDICAL JOURNAL, ADVERTISING IN, 31, 35, 49

DETROIT MEDICAL JOURNAL, ADVERTISING IN, 300

Diabetic Biscuit and Flour and other Foods, Jireh (Jireh Diabetic Food Company), The Journal, March 22, 1913, p. 922, and Dec. 14, 1912, p. 2174.

DIABETIC FOODS OFFERED FOR SALE IN THE UNITED STATES, 446

Dianol I, Dianol II and Dianol III (Kalle & Co.), Reports Council Pharm. & Chem., 1913, p. 34.

Diastos, Liquor (H. K. Mulford Co.), The Journal, Feb. 9, 1907, p. 533.

DIATUSSIN, 293

DIGALEN, 68

DIETETIC AND HYGIENIC GAZETTE, ADVERTISING IN, 342

DIGESTIVE TABLETS, AROMATIC, 229

Digestive Tonic (Truax, Greene & Co.), Reports Council Pharm. & Chem., 1912, p. 44.

Digitalis preparations, proprietary, The Journal, Dec. 4, 1915, p. 2024; Reports Council Pharm. & Chem., 1915, p. 89.

Digitalone (Parke, Davis & Co.), The Journal, June 12, 1909, p. 1938; Dec. 7, 1912, p. 2074; Jan. 11, 1913, p. 143.

Digitalysatum (E. Bischoff & Co.), The Journal, Feb. 15, 1913, p. 499; Jan. 8, 1916, p. 135; Reports Council Pharm. & Chem., 1915, p. 93.

DIORADIN, 73, 436

DIOS CHEMICAL COMPANY, 41, 139, 146

DIOSCOREA VILLOSA, 208

Dioscorea, various elixirs of (H. K. Mulford Co., Parke, Davis & Co., Ray Chemical Co., F. Stearns & Co.), Reports Council Pharm. & Chem., 1912, pp. 41, 46.

DIOVIBURNIA, 139, 141, 410

DIOXOGEN, 436

DIURETIN, 251

Diurol (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912, p. 45.

DODGE, JOHN L., 155

Dogwood, Flowering, Reports Council Pharm. & Chem., 1912, p. 41.

DOMINION MEDICAL MONTHLY, ADVERTISING IN, 300

DOWD, J. HENRY, AND DOWD’S PHOSPHATOMETER, 476

DRAKE’S PALMETTO COMPOUND, 475

DUBLIN JOURNAL MEDICAL SCIENCE, ADVERTISING IN, 279

Duodenin-Armour (Armour & Co.), The Journal, Aug. 4, 1915, p. 639; Jan. 15, 1916, p. 178; Reports Council Pharm. & Chem., 1915, pp. 99, 151.

Dyspepsia Compound, Elixir (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1912, p. 44.

Dyspepsia, Elixir Atonic, Phenolated (Wm. S. Merrell Chemical Company), The Journal, Feb. 9, 1907, p. 533.

ECHAFOLTA, 80

ECHINACEA, 79, 80

ECHITONE, 81

ECHTISIA, 81

ECLECTIC MEDICAL JOURNAL, ADVERTISING IN, 31, 35, 49, 342

ECTHOL, 80, 81

ECZEMA LOTION, DR. BRADBURY’S, 245

Edema Tablet (Parke, Davis & Co., Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, pp. 41, 45.

EDSON, DR. CYRUS, 336

EIMER AND AMEND, 113

EL ZERNAC COMPANY, 344

Elder, Reports Council Pharm. & Chem., 1912, p. 41.

Electro-Selenium (in “Chemotherapy and Tumors”), The Journal, April 17, 1915, p. 1283; Reports Council Pharm. & Chem., 1915, p. 28.

ELLINGWOOD’S THERAPEUTIST, ADVERTISING IN, 31, 35

Emulsio Minerolein and Emulsio Phen-Oleum (T. R. D. Barse Co.), Reports Council Pharm. & Chem., 1915, p. 169.

Endotin (Morgenstern & Co.), Reports Council Pharm. & Chem., 1914, p. 136.

Enesol (Fougera & Co.), The Journal, July 26, 1913, p. 293.

ENTERONOL AND ENTERONOL COMPANY, 294

Eosin-Selenium (in “Chemotherapy and Tumors”), The Journal, April 17, 1915, p. 1283; Reports Council Pharm. & Chem., 1915, p. 28.

EPINEPHRIN, NAME, VERSUS THE NAME ADRENALIN, 454

Episan (Gaynor-Bagstad Co.), Reports Council Pharm. & Chem., 1915, p. 164.

ERGOAPIOL, 82

Ergone (Parke, Davis & Co.), The Journal, Oct. 7, 1911, p. 1211; Oct. 14, 1911, p. 1302.

Ergotole (Sharp & Dohme), The Journal, Oct. 7, 1911, p. 1211; Oct. 14, 1911, p. 1302.

ERPIOL (DR. SCHRADER), 83

Eryngo, Water, Reports Council Pharm. & Chem., 1912, p. 47.

ESTILL, FLOYD, 18

ETNA CHEMICAL COMPANY, 225, 335

Eunatrol (C. Bischoff & Co.), The Journal, Feb. 22, 1908, p. 627.

EUSOMA, 80

Eusoma (Eusoma Pharmaceutical Co.), Reports Council Pharm. & Chem., 1912, p. 38.

EUSOMA PHARMACEUTICAL COMPANY, 81

EXPURGO ANTI-DIABETES AND EXPURGO MANUFACTURING COMPANY, 299

EXPURGO LAPIS, 439

Expurgo Lapis (Expurgo Manufacturing Co.), The Journal, Nov. 8, 1913, p. 1733.

EXURGINE, 344

FALSE UNICORN, 84

FARBENFABRIKEN OF ELBERFELD COMPANY, 311, 414

Febrisol (Tilden Co.), The Journal, June 29, 1912, p. 2043.

Febri-Tone (Arthur Veter & Co.), The Journal, Feb. 1, 1908, p. 379.

FELLOWS’ SYRUP OF HYPOPHOSPHITES, 436

FERBUSON GLUTEN BREAD, 450

Fermenlactyl (Anglo-American Pharmacal Co., Ltd.), The Journal, Jan. 30, 1909, pp. 372, 397.

Ferric Arsenite, Soluble, Reports Council Pharm. & Chem., 1912, p. 30.

Figwort, Reports Council Pharm. & Chem., 1912, p. 42.

Filudine (Geo. J. Wallau, Inc.), The Journal, Sept. 18, 1915, p. 1045; Reports Council Pharm. & Chem., 1915, p. 156.

FLOURS, VARIOUS DIABETIC, 449, 450

FOODS, DIABETIC, OFFERED FOR SALE IN THE UNITED STATES, 446

FOODS, MEDICINAL, 131

FORMAMINT, 303

Formamint (A. Wulfing Co.), The Journal, Aug. 28. 1915, p. 816; Reports Council Pharm. & Chem., 1915, p. 64.

Formidin (Parke, Davis & Co.), The Journal, Sept. 5, 1908, p. 818; Reports Council Pharm. & Chem., 1905-8, p. 192.

FORMUROL, 85

FORTOSSAN, 178

FOSSILINE, LIQUID, 161

FOUGERA, E. & CO., 10, 27, 58, 59, 115, 123

FRANCO-AMERICAN FERMENT COMPANY, 120

FRASER TABLET COMPANY, 232

FRAUD, GREAT AMERICAN, AND PHARMACEUTICAL MANUFACTURERS, 474

FREDERICK, PURDUE, COMPANY, 100

Friedmann’s Vaccine (Standard Distributing Co.), Reports Council Pharm. & Chem., 1914, p. 136.

Fringe Tree, Reports Council Pharm. & Chem., 1912, p. 42.

FROMM’S DIABETIC BREADS AND CHOCOLATE, 450

Frosst’s Blaud Capsules and Frosst’s Blaud, Arsenic and Strychnine Capsules (C. E. Frosst & Co.), Reports Council Pharm. & Chem., 1915, p. 164.

G. G. Phenoleum Disinfectant (G. G. Chemical Co., Inc.), The Journal, Jan. 30, 1915, p. 456; Reports Council Pharm. & Chem., 1915, p. 131.

Galactagogue (Eli Lilly & Co.), Reports Council Pharm. & Chem., 1912, p. 43.

GAMBLE, D. E., 119

GARDNER, R. W., 310

GARDNER-BARADA CHEMICAL COMPANY, 256

GARDNER’S SYRUP OF HYDRIODIC ACID, 97

GASTROGEN TABLETS, 87

Gelsemine Hydrochlorid and Gelseminine, Reports Council Pharm. & Chem., 1911, p. 57.

GENERAL DRUG COMPANY, 328

Genitone (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44.

GEOLINE, LIQUID, 161

GERMAN COUNCIL ON PHARMACY AND CHEMISTRY, 459

GERMAN PROPAGANDA FOR REFORM, 458

GERMILETUM, 139, 143

GERO, LOUIS, LTD., 74

GETWELL TABLETS, 476

Ginseng, Reports Council Pharm. & Chem., 1912, p. 42; The Journal, Oct. 24, 1914, p. 1486.

Ginseng Compound, Elixir (H. K. Mulford Co.), and Ginseng Compound (Special), Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 42.

GLASGOW MEDICAL JOURNAL, ADVERTISING IN, 279

GLIDINE, 449

Glidine (Menley & James), The Journal, June 28, 1913, p. 2037.

Globeol (Geo. J. Wallau, Inc.), The Journal, Sept. 18, 1915, p. 1046; Reports Council Pharm. & Chem., 1915, p. 157.

GLUTEN PRODUCTS, VARIOUS, FOR DIABETIC USE, 450

Glutol-Schleich (Schering & Glatz), Reports Council Pharm. & Chem., 1915, p. 170.

GLYCERIN, MINERAL, 161

Glycerine Tonic Comp., Gray’s (Purdue Frederick Co.), The Journal, July 10, 1915, p. 189; Reports Council Pharm. & Chem., 1915, p. 56.

Glycero-Lecithin, Pill (Westerfield Pharmacal Co.), Reports Council Pharm. & Chem., 1915, p. 170.

Glycerole of Lecithin (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1915, p. 123.

GLYCO, 161

GLYCO-HEROIN, SMITH, 88

GLYCOLINE, 161

GLYCO-THYMOLINE, 92

GLYCOZONE, 95

GLYMOL, 161

Goat’s Rue, Reports Council Pharm. & Chem., 1912, p. 42.

GOMENOL, 304

Gonococcide (Cox Chem. Co.), The Journal, Aug. 24, 1907, p. 708.

GORDON, 18

GOSSYPIN, 84

GRAND PRIX AND GOLD MEDALS FOR SALE, 462

Gray’s Glycerine Tonic Comp. (Purdue Frederick Co.), The Journal, July 10, 1915, p. 189; Reports Council Pharm. & Chem., 1915, p. 56.

GRISARD, A. F., B. A., DR. JOHN P. AND DR. JOHN W., 18

Guaialin (Organic Chemical Mfg. Co.), The Journal, Sept. 5, 1908, p. 818; May 8, 1909, p. 1511; Reports Council Pharm. & Chem., 1905-8, p. 166; Reports Council Pharm. & Chem., 1909, p. 76.

Guarana and Celery, various Elixirs of (Hance Bros. & White, Parke, Davis & Co., and Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 40.

GUBB, ALFRED S., 436

GUDE’S PEPTO-MANGAN, 159

GUM GLUTEN BREAKFAST FOOD, 450

H-M-C; see Hyoscin-Morphin Cactin.

HAGEE’S CORDIAL OF COD-LIVER-OIL, 51, 289, 443

Hair Cap Moss, Reports Council Pharm. & Chem., 1912, p. 43.

HAMMOND, G. H., COMPANY, 472

HANCE BROS, AND WHITE, 175

HANSON, EDWARD F., 476

HAYDEN’S VIBURNUM COMPOUND, 218, 409

HAYDEN, W. R., 218

HEADACHE “CURES”, 305

HEADACHE POWDERS, KOEHLER’S, 10

“HEALTH FOOD” DIABETIC PREPARATION, 450

HECTINE, 308

HELONIAS DIOICA, 84

Helonias, elixirs and fluidextracts of, various (Hance Bros. & White, H. K. Mulford Co., Parke, Davis & Co., Ray Chemical Co. and Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, pp. 41, 46.

Helonin Comp., Mist. (Schlotterbeck & Foss), The Journal, Dec. 18, 1915, p. 2186.

HEMO, 319, 322

HEMORRHOIDAL SUPPOSITORIES, ANUSOL, 227, 280

HENRY PHARMACAL COMPANY, 198

HERBINE, 205

HERRICK’S PILLS, 43, 205

Hexa-co-sal-in (Hexa-Co-Sal-In Company), The Journal, Oct. 2, 1915, p. 1203; Reports Council Pharm. & Chem., 1915, p. 159.

Hex-a-lith (Smith-Dorsey Company), The Journal, Feb. 14, 1914, p. 555.

HILLE, H., 284

HOFFMANN-LA ROCHE CHEMICAL WORKS, 68, 252

HOGE, W. M., 328

HORD SANITARIUM, 456

Horse Nettle, Reports Council Pharm. & Chem., 1912, p. 43.

HOSPITAL BULLETIN OF THE UNIVERSITY OF MARYLAND, ADVERTISING IN, 35

HOWELL, H. B. & CO., LTD., 326

HUNTLEY AND PALMER’S AKOLL BISCUIT, 449

HURLEY, H. O., 351

Hydragogin (C. Bischoff & Co.), The Journal, Jan. 27, 1906, p. 288; The Journal, Sept. 4, 1915, p. 894; Reports Council Pharm. & Chem., 1915, p. 154.

Hydrangea and Lithia, Elixir (Hance Bros. & White), Reports Council Pharm. & Chem., 1912, p. 45.

Hydrangea, Lithiated (Lambert Pharmacal Co.), Reports Council Pharm. & Chem., 1912, p. 42.

HYDRASTIS AND CRAMP BARK COMPOUND, HYDRASTIS AND VIBURNUM COMPOUND, ELIXIR OF, 410

HYDRIODIC ACID, GARDNER’S SYRUP OF, 97

HYDROCYANATE OF IRON, TILDEN, 235

Hydroleine (Charles N. Crittenton Company), Reports Council Pharm. & Chem., 1915, p. 171.

Hydron (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44.

HYDRONAPHTHOL, 308

Hydropsin (Ernst Bischoff Co.), The Journal, Jan. 8, 1916, p. 135; Reports Council Pharm. & Chem., 1915, p. 94.

HYDROZONE, 96, 309

HYMOSA, 238, 323

Hyoscin-Morphin Cactin (now Hyoscin-Morphin-Cactoid) (Abbott Laboratories), The Journal, Dec. 21, 1907, p. 2103.

HYPEROL, 100

HYPOPHOSPHITE FALLACY, 464

HYPOPHOSPHITES, FELLOWS’ SYRUP OF, 436

HYPOQUINIDOL, 310

Ichthynate (Mallinckrodt Chemical Works), Reports Chem. Lab., 1912, p. 110.

INDIANAPOLIS MEDICAL JOURNAL, ADVERTISING IN, 31, 35, 300

INDIGO, WILD, 209

INGLUVIN, 101

INGRAHAM, C. W., 285

Interol (Van Horn & Sawtell), The Journal, July 10, 1915, p. 175.

INTERNATIONAL JOURNAL OF SURGERY, ADVERTISING IN, 31, 49, 342, 429

INTERSTATE MEDICAL JOURNAL, ADVERTISING IN, 49

INTESTINAL ANTISEPTIC W-A., 103

Intravenin P-H (Intravenin Products Co.), Reports Council Pharm. & Chem., 1915, p. 120.

INTRAVENOUS PRODUCTS COMPANY, 212, 214

INTRAVENOUS SOLUTION, BANNERMAN’S, 105

IODALIA, 106

IODEX, 107

IODIA, 108

Iodin Petrogen (John Wyeth & Bro.), The Journal, Nov. 30, 1912, p. 1992.

_Iodine, Burnham’s Soluble and Burnham’s Soluble Iodine Tablets_, 110, 233

Iodival (Knoll & Co.), The Journal, March 4, 1911, p. 685.

Iodo-Bromide of Calcium Comp. “Without Mercury” and “With Mercury,” Elixir of (Tilden Co.), The Journal, Nov. 6, 1915, p. 1662; Reports Council Pharm. & Chem., 1915, p. 160.

Iodomuth (Organic Chemical Mfg. Co.), The Journal, Sept. 5, 1908, p. 818; May 8, 1909, p. 1511; Reports Council Pharm. & Chem., 1905-8, p. 166; Reports Council Pharm. & Chem., 1909, p. 75.

IODONUCLEOID, 310

IODOTONE, 113

IODOVASOGEN, 408

Iodum-Miller and Iod-Izd-Oil, Miller’s (Iodum-Miller Co.), The Journal, Oct. 2, 1915, p. 1202; Reports Council Pharm. & Chem., 1915, p. 76.

IOSALINE, 113

IOSALINE COMPANY, 114

IOWA MEDICAL JOURNAL, ADVERTISING IN, 35, 300

IRIDIUM (MEDICINAL), 312

IRON, HYDROCYANATE OF, TILDEN, 235

Iron Solution for Intravenous Therapy--Perkins and Ross (Perkins and Ross), The Journal, Nov. 14, 1914, p. 1778; Reports Council Pharm. & Chem., 1914, p. 125.

IRON TROPON, 313

Isopral (Farbenfabriken of Elberfeld Co.), The Journal, Aug. 8, 1908, p. 487; Reports Council Pharm. & Chem., 1905-8, p. 119.

Jaroma (Jaroma Company), The Journal, Sept. 2, 1911, p. 835; Reports Chem. Lab., 1913, p. 103.

JAROS, A. L., 225

Jireh Diabetic (Diatetic) Biscuit, Flour and other foods (Jireh Diabetic Food Company), The Journal, March 22, 1913, p. 922; Dec. 14, 1912, p. 2174.

JIREH DIABETIC (DIATETIC) FOOD PRODUCTS, 449, 450

JIREH DIABETIC FOOD COMPANY, 451

JOHNS, L. D., COMPANY AND DR. JOHN’S TABLETS, 154

JOHNSON AND JOHNSON, 287

JOURNAL OF NERVOUS AND MENTAL DISEASES, ADVERTISING IN, 35

JOURNAL TROPICAL MEDICINE AND HYGIENE, ADVERTISING IN, 279

Jubol (Geo. J. Wallau, Inc.), The Journal, Aug. 14, 1915, p. 639; Reports Council Pharm. & Chem., 1915, p. 152.

Juglandin, The Journal, Nov. 13, 1909, p. 1655; Reports Council Pharm. & Chem., 1909, p. 135.

KAISER, MAX, 462

KALARI BATONS, 449, 450

KALARI BISCUIT, 449

KANSAS CITY MEDICAL RECORD, ADVERTISING IN, 296

KATHARMON CHEMICAL COMPANY, 51

KEELER, CLAUDE C., 436

Kefilac (Kefilac Co.), The Journal, Jan. 30, 1909, pp. 372, 397.

KELLAM [CANCER] HOSPITAL, 426

KELLOGG’S DIABETIC PRODUCTS, 449, 450

KENNEDY’S PINUS CANADENSIS, LIGHT AND DARK, 47

KENNER, ROBERT C., 300

Keratin, Reports Council Pharm. & Chem., 1911, p. 58.

Kinazyme (G. W. Carnrick Co.), The Journal, Nov. 1, 1913, p. 1649.

KLIPSTEIN, A., & CO., 178

KNOLL & CO., 252

KNOWLTON DANDERINE COMPANY, 474

KOECHL, VICTOR, & CO., 135, 328

KOEHLER’S HEADACHE POWDERS, 10

Kola Compound, Elixirs (H. K. Mulford Co., Parke, Davis & Co. and Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 40.

Kolynos (Kolynos Co.), The Journal, Nov. 15, 1913, p. 1812.

KOMMANDANTAN APOTHEKE, 334

Koyol (Koyol Co.), Reports Council Pharm. & Chem., 1915, p. 172.

KRESS AND OWEN COMPANY, 92

KUTNOW BROTHERS, LTD., AND S. KUTNOW, 316

KUTNOW’S POWDER, 314

Kutnow’s Powder (Kutnow Bros.), The Journal, Nov. 9, 1907, p. 1619.

LABORDINE, 115

LABORDINE PHARMACAL COMPANY, 116, 119

LACTOBACILLINE, 120

Lactone (Parke, Davis & Co.), The Journal, Jan. 30, 1909, pp. 372, 397.

LACTOPEPTINE, 121

Lactopeptine and Elixir Lactopeptine (New York Pharmacal Association), The Journal, Oct. 23, 1915, p. 1477; Reports Council Pharm. & Chem., 1915, p. 79.

LACTUCARIUM, AUBERGIER’S SYRUP OF, 399

LAINE CHEMICAL COMPANY, 196

LANCET, ADVERTISING IN, 279

LANCET-CLINIC, ADVERTISING IN, 31, 342

LARYNGOSCOPE, ADVERTISING IN, 35

LAXAPHEN, 344

LAXINE, 344

LAXOTHALEN TABLETS, 344

Lecibrin (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1915, p. 123.

Lecithin, Reports Council Pharm. & Chem., 1915, p. 122.

Lecithin Solution (Fairchild Bros. & Foster), Reports Council Pharm. & Chem., 1915, p. 123.

Lecithol (Armour & Co.), Reports Council Pharm. & Chem., 1915, p. 123.

LEHN AND FINK, 414, 415

Lettuce Calmative (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, p. 43.

Lettuce, Wild, Reports Council Pharm. & Chem., 1912, p. 43.

LEWIS, ARTHUR G., 433

LEWIS, HERBERT C., 434

LIBBY, MCNEIL & LIBBY, 471

LILLY, ELI, & CO., 133, 195, 410

LIPPINCOTT’S MAGAZINE, ADVERTISING IN, 419

LIQUID PEPTONES, 133

LIQUID PETROLATUM, 161

LIQUID TAKA-DIASTASE, 62

LIQUOZONE, 413

Lithia and Broom Corn Compound, Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 39.

Lithia and Hydrangea, Elixirs (Parke, Davis & Co., Ray Chemical Co. and Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, p. 45.

Lithiated Sorghum Compound (Sharp & Dohme), Reports Council Pharm. & Chem., 1912, p. 39.

LITHIA WATER, BUFFALO, 467

LITTLETON, J. M. , 18

Liver Leaf, Reports Council Pharm. & Chem., 1912, p. 43.

LOEB’S IMPORTED GLUTEN FLOUR, 450

LOUISVILLE MONTHLY JOURNAL OF MEDICINE AND SURGERY, ADVERTISING IN, 31, 35, 300

LOUISVILLE PHARMACAL WORKS, 410

LUYTIES’ HOMEOPATHIC PHARMACY COMPANY, 50, 240, 323

LYMPH COMPOUND R-H, 317

LYNCH, J. J. , 18

Lysoform and Lysoform, Crude (Lysoform Gesellschaft), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 126.

LYSOL, 318

MAGISTRAL CHEMICAL COMPANY, 328

MAIGNEN ANTISEPTIC POWDER AND MAIGNEN INSTITUTE FOR THE STUDY OF BACTERIAL DISEASES, 19

MAIGNEN, P. J. A. , 20

Maizavena (William S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 44.

MAIZININ COMPOUND, 249

MAIZO-LITHIUM, 198, 203

MALLINCKRODT CHEMICAL WORKS, 119, 252, 415

Malt Extract with Pepsin and Pancreatin (Wm. S. Merrell Chemical Co., Parke, Davis & Co.), The Journal, Feb. 9, 1907, p. 533.

Malt, Williams’ Syrup of (American Malt Extract Co.), The Journal, Sept. 4, 1915, p. 895; Reports Council Pharm. & Chem., 1915, p. 155.

MALTBIE CHEMICAL COMPANY, 40

MALTED BEEF-PEPTONE, 319

MALTED MILK, 319

Manaca and various manaca preparations (Hance Bros. & White, William S. Merrell Chemical Co., H. K. Mulford Co., Nelson, Baker & Co., Parke, Davis & Co., Pullen-Richardson Chemical Co., Ray Chemical Co., Sharp & Dohme, Smith, Kline & French Co., F. Stearns & Co. and Truax, Greene & Co.), Reports Council Pharm. & Chem., 1912, pp. 43, 44.

MANOLA, 323

MANOLA CHEMICAL COMPANY, 50, 240, 323

MARCHAND, CHARLES, 95, 309

MARCY COMPANY, 216, 344

MARIANI & CO. AND MARIANI’S WINE, 221

Marienbad Tablets (J. Sieke), The Journal, July 18, 1908, p. 237.

MARMALADE, CASOID SUGARLESS, 449

MARMOLA, 348

MARYLAND MEDICAL JOURNAL, ADVERTISING IN, 31, 35

MASSACHUSETTS MEDICAL JOURNAL, ADVERTISING IN, 35, 49, 300

Matico Compound, Elixir (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 45.

MAYFIELD MEDICINE MFG. COMPANY, 43

MCKESSON AND ROBBINS, 281, 401

MEAT EXTRACTS AND MEAT JUICES, 123, 470

MEDICAL BRIEF, ADVERTISING IN, 31, 35, 49, 300

MEDICAL CENTURY, ADVERTISING IN, 49, 342

MEDICAL COUNCIL, ADVERTISING IN, 49

MEDICAL FORTNIGHTLY, ADVERTISING IN, 31, 300

MEDICAL HERALD, ADVERTISING IN, 31, 35, 300

MEDICAL JOURNALS AND THE GREAT AMERICAN FRAUD, 426

MEDICAL JOURNAL ADVERTISING, 422

MEDICAL PRESS AND CIRCULAR, ADVERTISING IN, 279

MEDICAL RECORD, ADVERTISING IN, 31, 303, 304, 342

MEDICAL REVIEW, ADVERTISING IN, 35, 300

MEDICAL REVIEW OF REVIEWS, ADVERTISING IN, 31, 35, 49, 300, 304

MEDICAL SENTINEL, ADVERTISING IN, 31, 35, 49

MEDICAL STANDARD, ADVERTISING IN, 31, 35, 49, 300, 342

MEDICAL SUMMARY, ADVERTISING IN, 31, 300

MEDICAL TIMES, ADVERTISING IN, 31, 35, 131, 300, 424, 426, 430, 438

MEDICAL WORLD, ADVERTISING IN, 31, 35, 131

MEDICINAL FOODS, 131

Med-O-Lin (Waverly Oil Works Co.), Reports Council Pharm. & Chem., 1915, p. 172.

MEISTER, LUCIUS & BRUNING, 135

MEMPHIS MEDICAL MONTHLY, ADVERTISING IN, 35

MENLEY AND JAMES, LTD., 107

MERCK & CO., 252, 311, 415

MERCK’S ARCHIVES, ADVERTISING IN, 35

MERCOL, 326

Mercury Sozoiodolate and Mercury Sozoiodolate Solution, The Journal, Feb. 13, 1909, p. 573.

MERRELL, WM. S., CHEMICAL CO., 81, 83, 133, 231

METCALF’S DIABETIC PRODUCTS, 450

METHYL SALICYLATE OINTMENT, 267

Methyl-Santal (H. K. Mulford Co.), Reports Council Pharm. & Chem., 1915, p. 173.

METROPOLITAN PHARMACAL CO., 188

METZ, HERMAN A., 328

MEYER, DR. H. F. C., AND MEYER’S BLOOD PURIFIER, 80

MICAJAH, & CO., 241, 243

MICAJAH’S MEDICATED UTERINE WAFERS, 240

MICROBE KILLER, RADAM’S, 413

MIDOL, 327

MIGRAININ, 135

MILK, SUGAR-FREE, 449

Miller’s Iod-Izd-Oil (Iodum Miller Co.), The Journal, Oct. 2, 1915, p. 1202; Reports Council Pharm. & Chem., 1915, p. 77.

MILWAUKEE MEDICAL JOURNAL, ADVERTISING IN, 296

MINERAL OIL, MINERAL GLYCERINE, 161

Mist. Helonin Comp. (Schlotterbeck & Foss), The Journal, Dec. 18, 1915, p. 2186.

Mitchella Compound (Dr. J. H. Dye Medical Institute), Reports Council Pharm. & Chem., 1912, pp. 41, 46.

MIZER, BLAKE V., AND MIZER SANATORIUM, 457

MONTHLY CYCLOPEDIA AND MEDICAL BULLETIN, ADVERTISING IN, 35

MORSE, WILLARD H., 436

MOSQUERA-JULIA FOOD CO., 472

MOTHER’S CORDIAL, 410

Mother’s Cordial (Eli Lilly & Co., Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46.

Motherwort, Reports Council Pharm. & Chem., 1912, p. 44.

MU-COL AND MU-COL CO. (INC.), 329

MULFORD, H. K. CO., 193, 230, 267, 410

MULLER’S TOMATOES FÜR DIABETIKER, 450

Muthol (Demuth’s Laboratories), The Journal, July 10, 1915, p. 175.

Narcophin (Merck and Co.), The Journal, Nov. 21, 1914, p. 1872.

NARKINE, 329

NASCHER, I. L., 479

NASHVILLE JOURNAL OF MEDICINE AND SURGERY, ADVERTISING IN, 31, 35

NASHVILLE SANITARIUM DIABETIC FOOD PRODUCTS, 449, 450

NELSON BAKER & CO., 267, 410

Nephritin (Reed & Carnrick Co.), The Journal, Oct. 5, 1907, p. 1198; Reports Council Pharm. & Chem., 1905-8, p. 79.

Nephroson (William S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1912, pp. 39, 45.

NERVE VITALIZER, WHEELER’S, 411

NEURALGINE, 475

NEURILLA, 136

Neuro-Lecithin-Abbott (Abbott Laboratories), Reports Council Pharm. & Chem., 1915, p. 123.

Neurocaine (Schieffelin & Co.), Reports Council Pharm. & Chem., 1915, p. 173.

NEUROSINE, 139, 140

NEUTRALOL, 161

NEW ORLEANS MEDICAL AND SURGICAL JOURNAL, ADVERTISING IN, 31, 35

NEW YORK HEALTH JOURNAL, 433

NEW YORK INSTITUTE OF PHYSICIANS AND SURGEONS, 475

NEW YORK MEDICAL JOURNAL, ADVERTISING IN, 31, 303, 304, 342

NEW YORK PHARMACEUTICAL ASSOCIATION, 121

NOITOL, 245

NORWICH PHARMACAL CO., 254, 259

Nose-Ions (Nose-Ions Company), The Journal, Dec. 4, 1915, p. 2026.

NOURRY WINE, 115

Nujol (Standard Oil Co. of New Jersey), The Journal, July 10, 1915, p. 175.

NURITO, 327, 328

NUTRIENT WINE OF BEEF PEPTONE, 133

NUTRIOLA CO., 475

NUTRITIVE LIQUID PEPTONE, 133

NUT PRODUCTS, VARIOUS DIABETIC, 449, 450

O-P-C SUSPENSORY, 436

Oats, Reports Council Pharm. & Chem., 1912, p. 44.

OD CHEMICAL CO., 182

OLD DOMINION JOURNAL OF MEDICINE AND SURGERY, ADVERTISING IN, 131

OLEUM GABIANUM, 161

OLO, 161

ORANGEINE, 10

ORCHITIC FLUID TABLETS, 317

Orsudan (Burroughs, Wellcome & Co.), The Journal, April 16, 1910, p. 1323.

OXYCHLORINE AND OXYCHLORINE CHEMICAL CO., 147, 261

Oxydendron Compound, Fluidextract (Nelson, Baker & Co.), Reports Council Pharm. & Chem., 1912, pp. 43, 45.

OXYDONOR, 419

Oxyntin (Fairchild Brothers & Foster), Reports Council Pharm. & Chem., 1915, p. 174.

OXYTONIC, 413

PACIFIC MEDICAL JOURNAL, ADVERTISING IN, 31, 279, 342

Palmetto Compound (William S. Merrell Chem. Co.), Reports Council Pharm. & Chem., 1912, p. 44.

PALPEBRINE, 139, 145

PAM-ALA, 149

PAM-ALA CO., 150

PANCREATIN AND PEPSIN MIXTURES, 157, 229

Pancreatin and pepsin preparations, various (Eli Lilly & Co., H. K. Mulford Co., Parke, Davis & Co., Sharp & Dohme, Smith, Kline & French Co., F. Stearns & Co. and William R. Warner & Co.), The Journal, Feb. 9, 1907, p. 533.

Papain, The Journal, Feb. 9, 1907, p. 522.

PAPAYANS BELL, 151, 282

PAPINE, 330

Para Coto and Paracotoin, Reports Council Pharm. & Chem., 1913, p. 39.

PARAFFIN, LIQUID, PARAFFIN OIL, 161

PARKE, DAVIS & CO., 62, 133, 231, 267, 311, 344, 396, 410, 474, 476

PAROLINE, 161

PASADYNE, 156, 332

PAS-AVENA AND PAS-AVENA CO., 333

PASSIFLORA, 156

PATCH, E. L., MANUFACTURING CO., 476

Pautauberge’s Solution (Geo. J. Wallau), The Journal, March 7, 1910, p. 1560.

PAX CHEMICAL CO, 344

PEACOCK CHEMICAL CO. AND PEACOCK’S BROMIDES, 28

PEARSON & CO., 408

PEDIATRICS, ADVERTISING IN, 131, 296, 342

PEPSIN AND PANCREATIN MIXTURES, 157, 229

Pepsin and pepsin and pancreatin preparations, various (Columbus Pharmacal Co., Eli Lilly & Co., H. K. Mulford Co., Parke, Davis & Co., Arthur Peters & Co., Sharp & Dohme, Smith, Kline & French Co., F. Stearns & Co. and William R. Warner & Co.), The Journal, Feb. 9, 1907, p. 533.

Peptenzyme, Elixir and Powder (Reed & Carnrick Co.), The Journal, Feb. 9, 1907, p. 533; Oct. 5, 1907, p. 1198; Reports Council Pharm. & Chem., 1905-8, p. 79.

PEPTO-MANGAN (GUDE), 159

Peptone, Reports Council Pharm. & Chem., 1913, p. 41.

PEPTONES, LIQUID, AND PEPTONIC ELIXIR, 133

Perfection Liquid Food (Perfection Liquid Food Co.), Reports Council Pharm. & Chem., 1913., p. 44.

PERTUSSIN, 334

PETRALOL, PETRO, NAMES FOR LIQUID PETROLATUM, 161

PETROLATUM, LIQUID, CLINICAL EXPERIENCES WITH, 167

PETROLATUM LIQUIDUM, GRAVE, AND LEVE, DESCRIPTION OF, 166

PETROLAX, PETROLIA, PETRONOL, PETROSIO, NAMES FOR LIQUID PETROLATUM, 161

PETROLEUM EMULSION, ANGIER’S, 169

PHARMACEUTICAL MANUFACTURERS AND THE GREAT AMERICAN FRAUD, 474

PHECOLATES, PHECOLAX, PHECOTONES AND PHECOZYMES, 174

PHENACETIN AND ACETPHENETIDIN, THEIR RELATIVE PURITY, 414

PHENALEIN, 344

PHENALGIN, 10, 335

PHENO-BROMATE AND PHENO-BROMATE CO., 343

PHENOL SODIQUE, 175

PHENOLAX WAFERS, 344

PHENOLPHTHALEIN, 343

PHENOLPHTHALEIN LAXATIVE, 344

PHILLIPS, I. G., 18

PHOSPHATOMETER, DOWD’S, 476

PHOSPHORUS, AMORPHOUS, 478

PHOSPHORUS AMORPHOUS, PILL, S. & D., 482

PHOSPHORUS TONIC, COMP., 476

PHOSPHO-VANADIOL, 209

PHYLACOGENS, 346

PHYTIN, 178

PIERCE’S FAVORITE PRESCRIPTION, 410

PIERSON, ROMAINE, 428

PINKERTON, E. D., 49

PINUS CANADENSIS, KENNEDY’S, 47

Piperazine Water (Lehn & Fink), The Journal, Feb. 29, 1908, p. 704.

PISO’S CONSUMPTION CURE, 242

PITMAN-MYERS CO., 267, 344

PIX CRESOL AND PIX CRESOL CHEMICAL CO., 247

Plasmon (Plasmon Milk Products Co.), Reports Chem. Lab., 1914, p. 88.

PLATINUM CO. OF AMERICA, 312

PLESSNER, PAUL, CO., 198

Pluto Spring Water, Concentrated (French Lick Springs Hotel Co.), The Journal, March 29, 1913, p. 1013.

POEHL’S SPERMIN, 395

Ponca Compound (Mellier Drug Co.), The Journal, July 17, 1915, p. 269; Reports Council Pharm. & Chem., 1915, p. 60.

Poslam (Emergency Laboratories), The Journal, May 22, 1909, p. 1678; Reports Chem., Lab., 1909, p. 25.

Potassium Iodo-Resorcin Sulphonate, The Journal, Feb. 11, 1911, p. 441; Reports Chem. Lab., 1911, p. 21.

POWERS-WEIGHTMAN-ROSENGARTEN CO., 252, 415

PRACTICAL DRUGGIST, 428

PRACTITIONER, ADVERTISING IN, 279

PROBILIN, 344

PROCTOLOGIST, ADVERTISING IN, 296

PROTO PUFFS, HEALTH FOOD NOS. 1 AND 2, 450

PROTONUCLEIN, 348

Protonuclein and Protonuclein Beta (Reed & Carnrick), The Journal, Jan. 1, 1916, p. 48; Reports Council Pharm. & Chem., 1915, p. 90.

PROTONUCLEIN SPECIAL, 349

PROTOSE, KELLOGG’S, 449

PROTOSOY DIABETIC FLOUR AND WAFERS, 450

PRUNOIDS, 178, 344

PSORA, 249

Pulsatilla, Reports Council Pharm. & Chem., 1912, p. 44.

PURDUE FREDERICK CO, 100

PURGEN, 349

PYO-ATOXIN, 350

PYRAMIDON IN PATENT MEDICINES, 327

Queen of the Meadow, Reports Council Pharm. & Chem., 1912, p. 45.

Quina LaRoche (E. Fougera & Co.), The Journal, March 21, 1908, p. 978.

Quinin Arsenate, The Journal, July 16, 1910, p. 235; Reports Council Pharm. & Chem., 1910, p. 73.

Quinine Glycerophosphate, Reports Chem. Lab., 1912, p. 107.

RADAM’S MICROBE KILLER, 413

Radelium and the Radelium Generator (Radio-Active Water Company), Reports Pharm. & Chem., 1915, p. 128.

RADEMANN’S DIABETIC PREPARATIONS, 449, 450

Radium Solution for Intravenous Use, Standard (Radium Chemical Co.), The Journal, June 26, 1915, p. 2156; Reports Council Pharm. & Chem., 1915, p. 147.

Rattlesnake-Venom, The Journal, March 15, 1913, p. 850; March 29, 1913, p. 1001; June 7, 1913, p. 1811.

RECTOIDS, 249

REIMANN, ARTHUR E., 477

RENGO, 348

RENNE’S PAIN KILLING OIL, 205

RENOVA DISTRIBUTING CO., 434

RESINOL, 352

RESOR-BISNOL, 353

Respirazone (Tilden Company), The Journal, June 14, 1913, p. 1899.

REX BRAND BEEF EXTRACT, 471, 472

Rheumalgine (Eli Lilly & Co.), The Journal, June 26, 1915, p. 2156; Reports Council Pharm. & Chem., 1915, p. 148.

Rheumatic Bacterin (Mixed) No. 47, Swan’s (Swan-Myers Co.), The Journal, Nov. 6, 1915, p. 1662; Reports Council Pharm. & Chem., 1915, p. 160.

RICHARDS, JOHN MORGAN, AND SONS, 121

RICHARDSON CO., 476

RICHARDSON’S LIFE-PRESERVING BITTERS, 43

Ricinol-Grape Tape-Worm Remedy and Baby Taeniafuge-Grape (Grape Capsule Co.), Reports Council Pharm. & Chem., 1915, p. 174.

RIGAUD & CHAPOTEAUT, 59

RIO CHEMICAL COMPANY, 43, 49

ROBINOL, 353, 354

ROCK OIL, 161

ROEMER, A. VON, 207

ROYAL NEIGHBOR, CLEAN ADVERTISING IN, 418

RUF, FRANK A., 276

RUSKS, CALLARD’S CASOID, 450

RUSSIAN MINERAL OIL, RUSSIAN PARAFFIN OIL, 161

ST. PAUL MEDICAL JOURNAL, ADVERTISING IN, 35

SALACETIN (BELL), 10, 152, 356

SAL-CODEIA (BELL), 152, 357

SAL HEPATICA, 87, 179

Salesthyl and Sal-Hyl (New York Salesthyl Corporation), The Journal, Feb. 20, 1915, p. 684; Reports Council Pharm. & Chem., 1915, p. 134.

SALIODIN AND SALIODIN CHEMICAL CO., 249

Salit (Heyden Chemical Works), The Journal, June 5, 1909, p. 1852; Reports Council Pharm. & Chem., 1909, p. 106.

SANATOGEN, 358, 378, 385

SANATOGEN AND MEDICAL JOURNALS, 431

Sanguinarine Nitrate, Reports Council Pharm. & Chem., 1911, p. 59.

SANMETTO, 182

SANOL ANTI-DIABETES AND SANOL MANUFACTURING CO., LTD. , 299

SATYRIA, 202

SAXOL, LIQUID SAXOLINE, 161

SCHERING & GLATZ, 207, 227, 344

Scopolamin-Morphin Mixtures, The Journal, Feb. 5, 1910, p. 446; Feb. 12, 1910, p. 516; June 7, 1913, p. 1814; Reports Council Pharm. & Chem., 1910, p. 11.

SCROFONOL, 43

Scullcap Compound, Fluidextract (Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 43.

SEABURY & JOHNSON, 308, 476

SECRETOGEN ELIXIR AND TABLETS, 185

Secretogen and Elixir Secretogen (G. W. Carnrick Co.), The Journal, Jan. 15, 1916, p. 178; Reports Council Pharm. & Chem., p. 99.

Sedobrol “Roche” (Hoffman-LaRoche Chemical Works), The Journal, Jan. 2, 1915, p. 71; Reports Council Pharm. & Chem., 1914.

Selenium compounds (in “Chemotherapy and Tumors”), The Journal, April 17, 1915, p. 1283; Reports Council Pharm. & Chem., 1915, p. 28.

Semprolin (W. Browning & Co.), The Journal, July 10, 1915, p. 175.

SENEKA OIL, 161

Seng (Sultan Drug Co.), Reports Council Pharm. & Chem., 1915, p. 129.

SEPTICIDE, 413

Serum Vaccine, Bruschettini (R. G. Berlingieri), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 127.

Seven-Bark, Reports Council Pharm. & Chem., 1912, p. 45.

SEVETOL, 353, 355

SHAC, 476

SHARP & DOHME, 133, 231, 476

SINKINA, 149, 150, 151, 188

Sirolin (Sirolin Co.), The Journal, June 21, 1913, p. 1974.

SMITH BILE BEANS CO. AND SMITH’S BILE BEANS, 43

SMITH, CHARLES B., 155

SMITH, KLINE AND FRENCH CO., 410

SMITH, MARTIN H., CO., 82, 88

SOCIETY OF CHEMICAL INDUSTRY, 178

SOJA BEAN MEALS, 450

SOMNALGESINE, 333

SOMNOS, 193

Sourwood and Sourwood Elixirs (Eli Lilly & Co. and Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 45.

SOUTH TEXAS MEDICAL RECORD, CREDITABLE ADVERTISING IN, 440

SOUTHERN PRACTITIONER, ADVERTISING IN, 31, 35, 279

SOUTHWEST JOURNAL OF MEDICINE AND SURGERY, ADVERTISING IN, 300

SOY FLOURS, 450

SPENCER’S ALMOND PASTE, 450

SPERMINUM POEHL, 395

Squaw Root, Reports Council Pharm. & Chem., 1912, p. 40.

Squaw-vine and squaw-vine preparations (Eli Lilly & Co., Parke, Davis & Co.), Reports Council Pharm. & Chem., 1912, p. 45.

SQUIBB, E. R., & SONS, 252, 415

Standard Radium Solution for Intravenous Use (Radium Chemical Co.), The Journal, June 26, 1915, p. 2156; Reports Council Pharm. & Chem., 1915, p. 147.

STEARNS, FREDERICK, & CO., 267, 410, 476

Stearns’ Wine (Frederick Stearns & Co.), Reports Council Pharm. & Chem., 1915, p. 177.

STERLING REMEDY CO., 475

STEVENSON & JESTER CO., 133

Stillingia preparations, various (Hance Bros. & White, H. K. Mulford Co., Parke, Davis & Co., Ray Chemical Co. and Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, pp. 42, 47.

Stone Root, Reports Council Pharm. & Chem., 1912, p. 46.

STRONG, COBB & CO., 61, 81

Strychnin Arsenate, The Journal, Sept. 24, 1910, p. 1128; Reports Council Pharm. & Chem., 1910, p. 74.

SUCCUS ALTERANS, 195

SUCCUS CINERARIA MARITIMA (WALKER), 50

Sugar Cane, Chinese, Reports Council Pharm. & Chem., 1912, p. 39.

SULPHO-LYTHIN, 196

SULTAN DRUG COMPANY, 37, 178, 344

SUSPENSORY, O-P-C, 436

SWAIM’S PANACEA, 205

SWAIN’S ALL-HEALING OINTMENT AND SWAIN’S LABORATORY, 43

Swan’s Rheumatic Bacterin (Mixed) No. 47 (Swan-Myers Co.), The Journal, Nov. 6, 1915, p. 1662; Reports Council Pharm. & Chem., 1915, p. 160.

SWIFT & CO., 471

SYNERGIA, 231

SYRUP OF COCILLANA COMPOUND, 396

SYRUP OF HYDRIODIC ACID, GARDNER’S, 97

SYRUP OF LACTUCARIUM, AUBERGIER’S, 399

Syrup of Malt, Williams’ (American Malt Extract Co.), The Journal, Sept. 4, 1915, p. 895.

SZENDEFFY, DR. R. DE, 74

Tablogestin (F. H. Strong Co.), The Journal, Dec. 11, 1915, p. 2108.

TAKA-DIASTASE AND LIQUID TAKA-DIASTASE, 62

Tannyl (Charles Goslar), Reports Chem. Lab., 1912, p. 108.

TARTARLITHINE AND TARTARLITHINE CO., 401

TAUROCOL TABLETS AND COMPOUND TABLETS, 198

TENNANT, GEORGE C., 155

TERRALBOLIA, TERRALINE, NAMES FOR LIQUID PETROLATUM, 161

TEXAS MEDICAL JOURNAL, ADVERTISING IN, 31, 35, 49

TEXAS MEDICAL NEWS, ADVERTISING IN, 31, 35

THALOSEN, 344

THEOBROMIN SODIUM SALICYLATE VERSUS DIURETIN, 251

THERAPEUTIC GAZETTE, ADVERTISING IN, 31, 35

THERAPEUTIC RECORD, ADVERTISING IN, 279, 300

THIALION, 205

Thiocol and Syrup Thiocol-Roche (Hoffmann-La Roche Chemical Works), The Journal, June 21, 1913, p. 1974; Reports Council Pharm. & Chem., 1913, p. 16.

Thioform (Otto Hann & Bro.), Reports Chem., Lab., 1909, p. 79.

THOMPSON’S MALTED FOOD CO., 319

THOXOS, 402

THREE CHLORIDES (HENRY), 198, 201

TILDEN CO., 235, 329

TOLEDO MEDICAL AND SURGICAL REPORTER, ADVERTISING IN, 296

Tonga and various tonga preparations (Hance Bros. & White, Eli Lilly & Co., William S. Merrell Chemical Co., Nelson, Baker & Co., Parke, Davis & Co., Ray Chemical Co., Sharp & Dohme, F. Stearns & Co., William R. Warner & Co. and H. K. Wampole & Co.), The Journal, May 10, 1913, p. 1478; Reports Council Pharm. & Chem., 1912, p. 46.

Tongaline and Tongaline Tablets (Mellier Drug Co.), The Journal, July 17, 1915, p. 269; Reports Council Pharm. & Chem., 1915, p. 58.

TONIC BEEF, S. & D., 133

Toxinol (Hughes Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 39.

TRI-IODIDES, 198, 199

Trifolium preparations, various (Hance Bros. & White, Eli Lilly & Co., William S. Merrell Chemical Co., H. K. Mulford Co., Parke, Davis & Co., Ray Chemical Co. and F. Stearns & Co.), Reports Council Pharm. & Chem., 1912, pp. 39, 40.

Trilene Tablets, Reports Council Pharm. & Chem., 1912, p. 39.

Trophonine (Reed & Carnrick Co.), The Journal, Oct. 5, 1907, p. 1198; Reports Council Pharm. & Chem., 1905-8, p. 79.

TRUAX, GREENE & CO., 231

TRYPSOGEN, 403

Tubercle Vaccine, Non-Virulent, Sherman’s (G. H. Sherman), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914, p. 128.

Tuberculin Test Plate, Keller’s (A. H. Keller), The Journal, Dec. 19, 1914, p. 2250.

Tuberculoids (Columbus Pharmacal Company), The Journal, Feb. 22, 1908, p. 704.

Tubo-Arg (Tubo Pharmacal Co.), Reports Council Pharm. & Chem., 1915, p. 175.

Turkey Corn, Reports Council Pharm. & Chem., 1912, p. 47.

TURNER, F. M., AND THE DR. TURNER CO., 211

TYREE, J. S., 21, 405

TYREE’S ANTISEPTIC POWDER, 21, 404

TYREE’S ELIXIR BUCHU AND HYOSCYAMUS COMP., 407

Tyree’s Elixir of Buchu and Hyoscyamus Compound (J. S. Tyree), Reports Council Pharm. & Chem., 1915, p. 167.

Ulax Salt (F. H. Strong Co.), Reports Council Pharm. & Chem., 1915, p. 175.

UNGUENTINE, 254

UNGUENTUM SELENIO VANADIC (V. ROEMER), 207

UNICORN ROOT, 208

UNITED STATES HEALTH REPORTS, 433

UPJOHN CO., 344

Uranoblen (A. Grimme), Reports Council Pharm. & Chem., 1915, p. 176.

Urasol (Organic Chemical Mfg. Co.), The Journal, Sept. 5, 1908, p. 818; May 8, 1909, p. 1511; Reports Council Pharm. & Chem., 1905-8, p. 166; 1909, p. 64.

URIC ACID MONTHLY, 207

URICEDIN, 256

Uricsol (Uricsol Chemical Co.), The Journal, Aug. 14, 1915, p. 638; Reports Council Pharm. & Chem., 1915, p. 149.

URISEPTIN, 256

Urodonal (Geo. J. Wallau, Inc.), The Journal, Aug. 14, 1915, p. 639; Reports Council Pharm. & Chem., 1915, p. 153.

Uron (Uron Chemical Company), The Journal, Nov. 3, 1906, p. 1500; Reports Council Pharm. & Chem., 1905-8, p. 26.

USOLINE, 161

UTERINE SEDATIVE ELIXIR, 410

Uterine Sedative, Elixir (Eli Lilly & Co.), The Journal, Aug. 31, 1912, p. 735; Reports Council Pharm. & Chem., 1912, p. 44.

Uterine tonics, various (Abbott Alkaloidal Co., Girard Chemical Co., Maltbie Chemical Co., H. K. Mulford Co., Nelson, Baker & Co., Parke, Davis & Co. and F. Stearns & Co.), Reports Council Pharm. & Chem., 1912, pp. 41, 46.

UTERINE WAFERS, MICAJAH’S MEDICATED, 240

Vaccine, Curative, Bruschettini (A. Bruschettini), Reports Council Pharm. & Chem., 1915, p. 176.

Vaccine, Friedmann’s (Standard Distributing Co.), Reports Council Pharm. & Chem., 1914, p. 136.

VACCINE, MIXED, 346

Vaccine, Non-Virulent Tubercle Bacillus (G. H. Sherman), The Journal, Sept. 20, 1913, p. 979.

VALENTINE, M. J., 123

VALENTINE’S MEAT JUICE, 123, 125, 129

VALENTINE’S MEAT JUICE CO., 472

Vanadic Acid, The Journal, May 9, 1908, p. 1548; July 24, 1909, p. 309.

VANADIOL, VANADIOSEPTOL AND VANADIUM SOLUTION FOR INTRAVENOUS AND HYPODERMIC USE, 209

Vanadium, The Journal, June 3, 1911, p. 1648.

VANADIUM CHEMICAL CO., 201, 211

VANADOFORME, 210

VAPO-CRESOLENE, 408

VASELINE, LIQUID, 161

VASOGEN, 408

VASS CHEMICAL CO., 205

VENARSEN, 212

VENODINE, 214

VERACOLATE, 216, 344

VERMONT MEDICAL MONTHLY, ADVERTISING IN, 35

Veroform Germicide (Veroform Hygienic Co.), The Journal, Nov. 22, 1913, p. 1920.

VIAL, NEW YORK LABORATORIES OF, 59

Viburn-Ovaro (Ray Chemical Co.), Reports Council Pharm. & Chem., 1912, p. 46.

VIBURNUM COMPOUND, ELIXIR OF, 410

VIBURNUM COMPOUND, HAYDEN’S, 218, 409

Viburnum preparations, various (Fraser Tablet Co., Parke, Davis & Co. and Smith, Kline & French Co.), Reports Council Pharm. & Chem., 1912, p. 46.

VIBURNUMAL, 410

VIBUTERO, 410

VIGORAL, 472

VIN MARIANI, 221

VINOL, 443

Vinum Ext. Morrhuae, Stearns (Frederick Stearns & Co.), Reports Council Pharm. & Chem., 1915, p. 177.

VIRGINIA MEDICAL SEMI-MONTHLY, ADVERTISING IN, 131

VIROL AND VIROL, LTD., 225

VITAOPATHY, 475

WALKER PHARMACAL CO., 50, 238, 240

WALKER, WILL E., 18

WALLAU, GEORGE J., INC., 106

WAMPOLE, HENRY K., & CO., INC., 26, 52

WAMPOLE’S PERFECTED AND TASTELESS PREPARATION OF AN EXTRACT OF COD LIVER, 52, 443

WARNER, W. R., & CO., 101

Water Eryngo, Reports Council Pharm. & Chem., 1912, p. 47.

WATERBURY CHEMICAL CO., 54, 57, 463

WATERBURY’S COMPOUND, 54, 57, 291, 443

WESTERN CANADA MEDICAL JOURNAL, ADVERTISING IN, 300

WHEELER CHEMICAL WORKS, 245

WHEELER’S NERVE VITALIZER, 411

Whiteruss (Lubric Oil Co.), The Journal, July 10, 1915, p. 175.

White Sulphur Salts (White Sulphur Springs, Inc.), The Journal, Nov. 21, 1914, p. 1870; Reports Council Pharm. & Chem., 1914.

WHITING’S SUGAR-FREE MILK, 449

WHITNEY, F. WALDO, 174

WILD INDIGO, 209

WILD YAM, 208

Williams’ Syrup of Malt (American Malt Extract Co.), The Journal, Sept. 4, 1915, p. 895; Reports Council Pharm. & Chem., 1915, p. 155.

WINE, CHAPOTEAUT’S, 60

Wine of Cod Liver Ext. with Peptonate of Iron, Stearns’ (Frederick Stearns & Co.), Reports Council Pharm. & Chem., 1915, p. 177.

WISCONSIN MEDICAL RECORDER, ADVERTISING IN, 31, 35

WOMAN’S MEDICAL JOURNAL, ADVERTISING IN, 31, 49

WYETH’S BEEF JUICE, 123, 125, 126

WYETH, JOHN, & BROTHER, 123, 133, 259, 292, 354, 402, 472

Xanol (Wm. S. Merrell Chemical Co.), Reports Council Pharm. & Chem., 1911, p. 64.

YAM, WILD, 208

Yogurt (Yogurt Co.), The Journal, Jan. 30, 1909, pp. 372, 397.

ZEMACOL, 259

ZYMOTOID, 412

ZYME-OID, 261

ZYMOLE TROKEYS, 476

ZUMOTA, 436

Spelling inconsistencies:

quinin/quinine soluble/solubile/soluable glucosid/glucoside peroxid/peroxide oxid/oxide Hydrastin/Hydrastine small-pox/smallpox protochlorid/protochloride narcotin/narcotine anilpyrine/anilipyrine vender/vendor chemic/chemical strychnin/strychnine pseudo-scientific/pseudoscientific semi-secret/semisecret beta-naphthol/betanaphthol to-day/today acetyl-salicylic/acetysalicylic indorse/endorse indorsement/endorsement gm./Gm.

Spelling corrections:

folowing —> following wafer —> water Amedemin —> Anedemin Prepration —> Preparation he —> the decription —> description administation —> administration oven —> even test —> tests constitutent —> constituent iutensive —> intensive accurary —> accuracy Helionas —> Helonias Phamacopeia —> Pharmacopeia cancerns —> concerns repiration —> respiration commitee —> committee ampoules —> ampules fradulent —> fraudulent Thp —> The Diastate —> Diastase diminshed —> diminished acetphenentidin —> acetphenetidin 1,169 —> 1,669 (in table) effciency —> efficiency that —> than thought —> bought Furthemore —> Furthermore bareley —> barley acetphentidin –> acetphenetidin prramidon —> pyramidon valuless —> valueless containg —> containing American —> America article —> articles nessary —> necessary out —> our strotium —> strontium sercretin —> secretin radicles —> radicals Speciment —> Specimen atained —> attained wo —> woe wounders —> wonders lives —> livers matiére —> matière Geseundhitslehrer —> Geseundheitslehrer readibly —> readily alkoloids —> alkaloids is —> it methol —> menthol amyolytic —> amylolytic