Chapter V: Part 5

The sale of so-called patent medicines by pharmacists is a continual irritant to doctors. Their objections have the same basis as in the preceding case, namely, that apothecaries ought not to encourage the people to prescribe for themselves. A distinguished physician once said that drugs do more harm than good—a statement which will not be disputed by those most conversant with the facts. But this is no argument against the employment of medicinal remedies in any proper way. Drugs taken by advice of educated, competent physicians do an immense amount of good; the injury comes almost altogether from their administration independently of the recommendation of qualified medical men. Concocted, not to benefit humanity, but to enrich their manufacturers, advertised as positive cures of diseases which the utmost skill of the medical profession cannot control, sometimes inert, sometimes dangerous from the poisons which they contain, pressed upon the attention of the people with impudent persistence and colossal mendacity, the infamous compounds, called patent medicines, are purchased by the credulous public in almost incredible amounts. Nobody knows as well as the pharmacist what quantities of drugs are sold in this form; nobody knows as fully as the physician the enormously baneful effects which they produce. If apothecaries would refuse to handle this class of goods, they would confer a wonderful blessing on humanity, by demonstrating their belief in the injuriousness of these articles, and thus bringing them into disrepute; and they would vastly dignify their profession by displaying its sense of moral obligation, even at the sacrifice of a lucrative part of its business.

Apothecaries complain that, to meet the demands of prescriptions, they are obliged, at great expense, to keep in stock a large number of whimsical preparations, and also many brands of the same standard medicines, when really one is practically as eligible as another. There is force in this complaint. As a rule, the former class of preparations has but an ephemeral popularity, and, as for the latter, there cannot often be need of specifying the goods of a particular manufacturer; for a worldly-wise, not to say honorable, pharmacist certainly may be trusted to furnish only fine articles, that he may keep the favor of those upon whose good-will his legitimate business depends. If a special brand is deemed necessary by the doctor, he can request a convenient apothecary to procure a quantity, and then can send to his shop the patients who require this article. Thoughtful consideration of this grievance will dictate some such course and effect its redress.

Occasionally, in places where apothecaries are accessible, physicians furnish their patients with medicines. This the pharmacist rightly regards with disfavor, as diminishing his legitimate business. The truly wise physician shuns this practice, perceiving that he cannot be as competent a pharmacist as is one who is nothing else, and furthermore, preferring to avoid the suspicion of administering medicines unnecessarily for the purpose of making a profit on them. Enlightened selfishness prompts him to encourage scientific pharmacy as a specialty.

BROOKLYN VITAL STATISTICS FOR JUNE, 1888.

By J. S. YOUNG, Dep. Commissioner of Health.

_Data of comparison_:

Population, estimated on July 1st, 1888 793,960 Inhabited houses, about 93,000

Average birth-rate per 1,000 for ten years (returns incomplete).

In the month of June, 1888, there were 1,513 deaths, the rate of
mortality being 23.78 in every 1,000 of the population.

The number of births reported was 937 The number of marriages reported was 531 The number of still-births reported was 113

The mortality by classes and by certain of the more important diseases was as follows:

_Causes_:

1. Zymotic 434
2. Constitutional 251
3. Local 644
4. Developmental 121
5. Violence 63
Measles 6
Croup 8
Diphtheria 82
Scarlet Fever 45
Typhoid Fever ———
Whooping Cough 5
Malarial Diseases 4
Diarrhœal Diseases (all ages) 244
Diarrhœal Diseases (under 5 years) 233
Phthisis 137
Bronchitis 45
Pneumonia 80
All Respiratory Diseases 149
Bright’s Diseases 35
Puerperal Diseases 17
Old Age 17
Suicide 10

Reported cases:

Diphtheria 214
Scarlet Fever 255
Measles 128
Typhoid Fever ———

During the month 13 cases of small-pox were reported, of which number 13 were confirmed as small-pox. 13 cases of small-pox were sent to hospital. No deaths from small-pox occurred in the city and 2 in the hospital.

Deaths by sex, color, and social condition were as follows:

Male 846 Female 667
White —— Colored 21
Native 1102 Foreign 411
Married 328 Single 1006
Widows, Widowers, and not stated 179

Still-births (excluded from list of deaths) were as follows:

Males 60
Females 53
Total 113
Deaths in public institutions 115
Deaths in tenement houses 745
Inquest cases 156
Homicides ———
Suicides 10

_Age Periods_:

Deaths under 1 year 496
Deaths under 5 years 253
Total deaths under 5 years 749
Total deaths 5 to 20 126
Total deaths 20 to 40 223
Total deaths 40 to 60 233
Total deaths 60 and upwards 182

Certain foreign and American cities show the following death-rate for the month of June:

Brooklyn 23.78
New York 26.86
Philadelphia 18.98
Berlin 19.40
Dublin 23.58
Vienna 31.50
Paris 21.68
London 16.10
Glasgow 22.98

NEW INSTRUMENTS.

This is a bulletin of inventions and improvements of interest to the physician and surgeon, and is published quarterly by Leach and Greene, Boston, Mass. It is mailed free to any address.

ANTIFEBRINE.

Antifebrine as a proprietary name is controlled by patents, and when bought under this name it costs about thirty cents per ounce. The name acetanilide, for exactly the same substance, is not and cannot be controlled in any way, and under this name it can be bought for about fifteen cents per ounce. As acetanilide is about one-eighth the price of antipyrine, and effective in half the dose, it is far more economical to the patient.—_Pittsburgh Medical Review._

ENEMA LESIONS.

“Dr. Achilles Nordmann, of Basle,” says the _Lancet_, “has published a description of twenty-five bowel lesions due to the operation of administering enemata. They include three complete perforations and ulcers, and wounds of various depths and sizes. The causes of these lesions seem to have been the use of defective instruments, ignorance of the direction of the rectum, catching of the transverse fold on the tube, extreme irritation of the mucous membrane of the bowel, and obstructions caused by certain conditions of the uterus, the fœtal head, or an enlarged prostate. As a rule, these lesions are to be found on the anterior wall of the rectum, from one to seven centimetres from the anus. They are not always easy to diagnose, as other foreign bodies or caustics may produce similar appearances. Tubercular and hæmorrhoidal ulcers may be mistaken for them; these are, however, generally higher up. A perforating wound gives rise to paraproctitis, but this is not necessarily fatal, though a stricture generally results.”—_N. Y. Medical Journal._

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TRANSCRIBER’S NOTES

1. Silently corrected typographical errors and variations in spelling. 2. Anachronistic, non-standard, and uncertain spellings retained as printed. 3. Enclosed italics font in _underscores_.