Chapter XV: Part I: Council Reports (10)

The examination, therefore, shows that Sulpho-Lythin is a mixture consisting mainly of sodium sulphate and sodium phosphate and sodium thiosulphate. The statement that it is a “sulpho-phosphite of sodium and lithium,” therefore, is not correct, and a statement that “it is entirely new and unique in its action” appears unwarranted and misleading. It is, therefore, recommended that the preparation be refused recognition. It is also recommended that an article be prepared for publication calling attention to the exaggerated claims made for Sulpho-Lythin.

The recommendations of the subcommittee were adopted by the Council and in accordance therewith the report is published with comments, substantially as follows: The formula means that it is a solution of well-known salts, some of them under partially disguised names. Every one knows what Glauber’s salts are good for. Disodium hydrogen phosphate is ordinary common sodium phosphate. Sodium thiosulphate is familiar as sodium hyposulphite, the “hypo” of the photographers. Every one knows, of course, that sodium chlorid is common salt. Examination and analysis of various specimens of this product demonstrated that its composition is not always the same. As an indication of the ignorance of the promoters of this nostrum it is interesting to note that the label on one of the bottles purchased states that it is a “sulphophosphate” instead of a sulphophosphite. Extravagant claims are made for this simple mixture of laxative salts, and these with the methods of using it are printed on the labels, and while it is claimed to be only advertised to the profession, the physician is repeatedly advised in the advertisements to “order always an original (six ounce) bottle to prevent substitution.” The natural result of this would be, of course, to put the patient in the way of prescribing it for himself and to spread the advertisement of the drug among the public. Difficulty has been experienced in finding out who the promoters of this nostrum are and the correspondence in regard to it is published. They seem to prefer to be known by their corporate title of Laine Chemical Company only. It is a sample of many other so-called ethical proprietary drugs, most of which are simple mixtures of well-known drugs which physicians are using every day and which require no skill in their compounding. Their proprietors not only presume to sell and advertise medicines but also to tell the physicians how to treat their patients.--(_Abstracted from The Journal A. M. A., Dec. 8, 1906._)

TAUROCOL

Report of the Council on Pharmacy and Chemistry

The Paul Plessner Company, Detroit, places on the market Taurocol Tablets and Taurocol Compound Tablets. The company makes a pretense of giving the formula--minus any quantities--thus:

“Taurocol is a combination of bile salts, extracts of cascara
sagrada, phenolphthalein and aromatics.”

The “formula” given for Taurocol Compound Tablets is:

“Taurocol (Bile Salts) Gramme .1296
Pepsin 1-3000 " .0324
Pancreatic Ext " .0324
Extract Nux Vomica (1/8 gr.) " .0081
Aromatics Q. S.”

A comparison of these two “formulas” with those furnished for Veracolate and Veracolate with Pancreatin and Pepsin shows that they are nearly the same.

The claims made for the Taurocol preparations are essentially those made for Veracolate preparations, as instance the following, which appears on a physician’s sample of Taurocol:

“For Hepatic Insufficiency, Intestinal Putrefaction, Habitual
Constipation.”

Likewise the following, found on a Taurocol circular, duplicates claims made for Veracolate:

“... Directly stimulates the liver cells, producing an abundant
flow of bile rich in cholates, solvent of cholesterin and a biliary
antiseptic.”

Taurocol is objectionable for the reasons that apply to Veracolate, and Taurocol Compound Tablets are subject to the objections that apply to Veracolate with Pepsin and Pancreatin. (See p. 216.) The Council therefore refused recognition to Taurocol and its preparations.--(_From The Journal A. M. A., April 24, 1915._)

TRI-IODIDES, THREE CHLORIDES AND MAIZO-LITHIUM

Report of the Council on Pharmacy and Chemistry

As an illustration of unreliability of claims and the unscientific character of proprietary mixtures, the Council has authorized publication of the following reports on Tri-Iodides, Three Chlorides and Maizo-Lithium, products of the Henry Pharmacal Co. (J. F. Ballard, proprietor).

W. A. Puckner, Secretary.

Tri-Iodides (Henry)

Tri-Iodides (Henry Pharmacal Co., St. Louis) is a nostrum whose ingredients apparently were selected at random. Since the effects of such a mixture cannot be predicted, no thoughtful physician would think of prescribing in any one condition all the drugs named in the formula of Tri-Iodides--if he had to write out the prescription. Yet because the misleading name of the preparation gives it the semblance of a therapeutic entity--and because it is advertised in medical journals--a certain number of physicians thoughtlessly prescribe this shotgun mixture.

LABORATORY REPORT

Regarding the composition of “Tri-Iodides” the Association’s Chemical Laboratory makes the following report:

A trade package of Henry’s Tri-Iodides purchased in 1910 bore the
following formula on the label:

“Colchicin, 1-20 grain,
“Phytolaccin, 1-10 grain,
“Solanin, 1-3 grain,
“Sodium Salicylate, C. P., 10 grains,
“Iodic Acid (equal to 7/32 gr. of Iodine) in two fluid drachms
of Aromatic Cordial.”

In the circular which was wrapped with the bottle the wording of the
formula differs somewhat from the foregoing, “iodic acid” of the
label being replaced by “hydro-iodic acid.” While the label on the
bottle named “phytolaccin” as one of the constituents the label on
the carton which contained the bottle gave “decandrin.” The following
formula appears on a trade package purchased June, 1914:

“Colchicine, 1-200 Grain,
“Phytolacca, 1 1-5 Grain,
“Mydriatic Alkaloids, 1-500 Grain.
“Sodium Salicylate, 3 1-2 Grain.
“Iodic Acid (equal to 7-125 Grain of Iodine) in two
fluid drachms.”

The differences between the formulas are striking. Colchicin has been
reduced from 1/20 grain to 1/200 grain; sodium salicylate from 10
grains to 3-1/2 grains; iodin (claimed to be present as iodic acid)
from 7/32 grain to 7/125 grain. “Phytolaccin” (“Decandrin”) has been
replaced by “Phytolacca” and “Solanin” by “Mydriatic Alkaloids.”
While the formula for the preparation has been changed, the circular
accompanying the package still refers to “solanin” (in some parts
of the circular wrongly spelled “salonin”) and “phytolaccin.” As no
principle having the characteristic effects of poke-root is known
to have been isolated the terms “decandrin” and “phytolaccin” are
meaningless.

The circular states that solanin is an alkaloid obtained from
the sprouts of _Solanum tuberosum_, but wrongly calls this plant
“bittersweet” instead of potato. At the market price the amount of
solanin claimed, according to the old formula, to be present in a
bottle of Tri-Iodides, would cost $1.60, although a bottle of the
preparation sold at wholesale for 67 cents.

Tri-Iodides is a dark brown, mobile liquid having a faint clove-like
odor and a mawkish, sweet taste. Salicylate was found in considerable
amounts. Traces of alkaloids were found, a portion of which appeared
to be colchicin. Iodic acid and its salts were absent, although
claimed by the formula to be present. Potassium iodid was present.
Determinations of the iodin by distillation with ferric ammonium
sulphate solution and sulphuric acid indicated the presence of about
1.68 gm. of iodin (equivalent to 2.18 gm. of potassium iodid) in each
100 c.c. of the preparation. This is equivalent to about 7.65 grains
of iodin per fluidounce, or more than thirty-four times the amount
claimed by the formula on the bottle. An approximate determination of
the salicylic acid by extraction of the acidified preparation with
ether and evaporation of the solvent indicated about 2.67 gm. in 100
c.c., equivalent to 3.09 gm. of sodium salicylate, or about 14.11
grains per fluidounce. Since the amount of sodium salicylate claimed
is 3.5 grains in 2 fluidrams or 14 grains in each fluidounce, the
amount found agrees essentially with the claims.

ABSURD CLAIMS

It should be unnecessary, after pointing out the conflict between the name and the published formula, between the formula and the actual composition, and between the composition and all established therapy, to discuss this heterogeneous and unscientific mixture further. A few specimen absurdities, however, may be quoted from the advertising “literature”:

“... Free of the Disagreeable Effects of the Alkaline Iodides.”

[Tri-Iodides, according to the laboratory report, depends for its iodin action on potassium iodid.]

“... we have an assimilable form of vegetable hydriodates.

“The hydriodates of these valuable vegetable alkaloids afford the
specific alterative action of iodine without such disagreeable
results as the iodism produced by the ordinary iodides.”

[“The hydriodates” is an obsolete term formerly applied to iodids of vegetable alkaloids. Iodids of vegetable alkaloids, if present at all in Tri-Iodides, are present in negligible amounts.]

“Containing Iodine in an available form, it is obvious that the
formula must be beneficial in the majority of syphilitic skin
lesions.”

The falsity of the first two of these claims and the mischievousness of the last are self-evident.

It would be possible, but is unnecessary, to produce an almost unlimited amount of evidence to show the transparent character of the deception by which this preparation is exploited.

The referee feels that the nostrum will have been sufficiently characterized when he has mentioned further that the name “Henry’s Tri-Iodides” is blown in the glass of the bottle, that the label contains the recommendation “For Gout, Rheumatism and other Diathetic Diseases,” and that the circular accompanying the bottle recommends the use not only of Tri-Iodides, but also of Three Chlorides, Maizo-Lithium, Campho-Phenique and Satyria in the treatment of many diseases.

Three Chlorides (Henry)

Three Chlorides (Henry) is advertised as:

“An oxygen-carrying ferruginous preparation, suitable for prolonged
treatment of children, adults and the aged. Indicated in anemia and
convalescence from acute diseases and surgical operations.”

The following report on the composition of Three Chlorides is submitted by the Association’s Chemical Laboratory:

LABORATORY REPORT

It is claimed that each fluidram of Henry’s Three Chlorides contains:

“Mercuric Bichlorid 1-72 Gr.
“Arsenic Chloride 1-40 Gr.
“Proto-Chloride Iron 2-25 Gr.
“ ... in a cordial of Calisaya Alkaloids.”

The preparation is a pale yellow, clear solution having an odor
of alcohol. The addition of potassium ferricyanid solution does
not produce any blue coloration, thus demonstrating the absence of
ferrous chlorid (iron protochlorid). Instead potassium ferrocyanid
solution produces at once an intense blue precipitate and potassium
sulphocyanate solution an intense red coloration, thus proving
the presence of iron in the ferric condition. It is obvious that
the claimed superiority of Three Chlorides over preparations
containing ferric iron is absurd. Since it contains iron in the
ferric condition, Three Chlorides decomposes soluble iodids with
the liberation of free iodin. The assertion that it is a suitable
“vehicle” for the administration of iodids is likely to lead the
physician unwittingly to administer free iodin.

As the laboratory report shows, the “formula” of Three Chlorides (Henry) is incorrect, for protochlorid of iron (ferrous chlorid) was absent from the preparation. There is, however, a more serious objection to the formula than the misstatement of fact. When the physician is dealing with conditions that call for mercury, arsenic or iron, it is irrational and unscientific to prescribe a preparation containing these three drugs in fixed proportions.

OBJECTIONABLE ADVERTISING

Three Chlorides is marketed in bottles having the name “Three Chlorides” blown in the glass, in a carton containing a circular extolling the curative powers of this and other proprietaries of the same concern. Thus a physician who prescribes Three Chlorides is likely to place in the hands of his patient the advice that

“Three Chlorides ... is suitable for the prolonged treatment of
children ...”

“In tertiary syphilis, with or without potassium iodide, it holds
first rank among remedies directed against the specific taint ...”

Further, that “Maizo-Lithium” is:

“A Genito-Urinary Sedative” and a “remarkable uric-acid solvent.”

Also that “Satyria” is:

“An Ideal Genito Tonic and Nerve Reconstituent.”

“Indicated in Prostatic trouble, Cystitis, Urethritis, Gonorrhea,
Gleet, Leucorrhea, Sexual Debility and Impotence.”

We are told that

“As a hematinic, the protochloride of iron justifies the confidence
of the medical profession.”

“The protochloride, more than any other salt of iron, stimulates
the paptic [_sic_] and hydrochloric glandular system of the
stomach, increasing the flow of acid gastric juice.”

It is unnecessary to discuss the truth or falsity of these assertions, since Three Chlorides does not contain the protochlorid of iron. For the same reason, it is obvious that the small amount of iron which it contains is the only possible justification for the claim that the preparation is

“... Non-Productive of ... Constipation or Teeth Discoloration.”

It is hardly necessary to point out that it is a therapeutic exaggeration to claim that Three Chlorides is of particular value in the treatment of tertiary syphilis, that in eczema it is “the most effective remedy,” that in any form of constipation it is “the remedy par excellence,” or that

“After arresting malarial attacks with quinine, the combination of
iron, arsenic and mercury with calisaya is an essential requisite.”

“Whenever gastric troubles and digestive disturbances furnish a
contra-indication to iron, this contra-indication disappears when
the iron is combined with arsenic.”

“The simultaneous exhibition of small doses of arsenic and
bichloride of mercury, besides augmenting the effect of iron upon
the red blood-cells, completely obviates the tendency to vascular
congestion and hemorrhage.”

Finally, the suggestion that by the use of Three Chlorides iodids may be prevented from causing iodism is absurd.

In short, whatever may be the advisability of prescribing iron, arsenic or mercury in any given case, it is irrational to prescribe them in fixed proportions. A physician who is induced by the exaggerated advertising claims to prescribe these drugs in a proprietary mixture, under a non-informative name, does grave injustice to his patients.

Maizo-Lithium

Maizo-Lithium (Henry Pharmacal Co., St. Louis) is one of the many proprietary lithium preparations based on the disproved theory that lithium dissolves uric acid deposits in the body. The label on a trade package states that:

“Maizo-Lithium promptly facilitates the elimination of the uric and
phosphatic deposits from the system.”

As might be expected, the promoter of Maizo-Lithium ascribes a long list of ills to “uric and phosphatic deposits,” and argues that, therefore, Maizo-Lithium is the proper treatment:

“In lithemia, hematuria, incipient diabetes, cystitis, urethritis,
pyelitis and ALL inflamed conditions requiring a non-irritating
diuretic.”

“Inflamed conditions,” naturally, include almost all of the real or imaginary ills of kidney, bladder, etc.

Maizo-Lithium is distinguished from its congeners chiefly by the claim that it contains a mythical or problematical compound, maizenate of lithium.

LABORATORY REPORT

The following report on the composition of Maizo-Lithium has been submitted by the Chemical Laboratory of the American Medical Association:

The promoter of Maizo-Lithium makes the following statement on the
label concerning the composition of the preparation:

“Each fluid drachm contains two grains maizenate of lithium.”

The following is also found in a circular which is enclosed with the trade package of Maizo-Lithium:

“Maizo-Lithium, the remarkable uric acid solvent, is a nascent
chemic union of maizenic acid, obtained from green corn silk, with
the alkaline base lithium forming maizenate lithium, of which the
mother liquid carries two grains to each drachm.”

Standard works on organic chemistry and pharmacology, such as Beilstein’s Organische Chemie and Cushny’s Pharmacology and Therapeutics, do not mention maizenic acid. Neither is it mentioned in comprehensive bibliographies of phyto-chemical investigations, such as Huseman-Hilger’s Die Pflanzenstoffe or Wehmer’s Die Pflanzenstoffe. The first to use the term appears to have been a Dr. Vautier (_Arch. méd. belg._), but his publication is not available to the laboratory. Rademacher and Fischer (_Amer. Jour. Pharm._, 1886, lviii, 369) claim to have isolated the substance from green corn-silk, but the record of their work is unsatisfactory and indefinite and therefore their results could not be verified; it seems unlikely, however, that they isolated a pure proximate principle.

Examination of Maizo-Lithium demonstrated the absence of bromids, chlorids, phosphates, sulphates, acetates, benzoates, salicylates and tartrates--combinations in which lithium might be expected to be present. The presence of a citrate, however, was shown by the usual tests. Lithium and sodium were present. Free acid was absent. Determination of lithium citrate and of sodium citrate indicated the presence of a total of about 3.7 gm. of these two salts in each 100 c.c. of the preparation, or about 2.1 grains in each fluidram. About 25 per cent. of the total salts appeared to be lithium citrate. The examination, therefore, does not demonstrate the presence of “maizenate of lithium,” but does show that Maizo-Lithium contains a mixture of lithium citrate and sodium citrate. Tests for citric acid and citrates were made on a commercial specimen of fluidextract of corn-silk. The results were negative, although the preparation had an acid reaction to litmus. The presence of maizenate of lithium in Maizo-Lithium--in fact, its actual existence--thus failed of demonstration. In view of this fact, it was felt that the burden of proof rested on the promoter of Maizo-Lithium to supply some satisfactory evidence with regard to this substance. The following letter was therefore, sent to James F. Ballard:

“According to the label on a recently purchased bottle of
Maizo-Lithium, each fluidram of this preparation contains 2
grains of ‘maizenate of lithium.’ From an examination made in
this laboratory we are inclined to conclude that this statement
is not in accordance with the facts. A search of chemical and
pharmaceutical publications does not reveal that such a compound
as ‘maizenate of lithium’ has ever been isolated and described,
and we are very much inclined to question its existence. We should
be pleased to receive from you any evidence which you may care to
send in substantiation of your claim in regard to the content of
‘maizenate of lithium’ in Maizo-Lithium--particularly a specimen of
‘maizenate of lithium’ or the method by which it is produced.”

While this letter was sent Oct. 13, 1914, no evidence has been submitted up to date (January, 1915) to substantiate the asserted presence of maizenate of lithium in Maizo-Lithium.

The report just given shows that the manufacturer has found it expedient to surround his worthless nostrum with a cloak of mystery. A discussion of the jumble of uncritical claims, baseless assertions and evident falsehoods presented in favor of Maizo-Lithium would seem a waste of time when the secrecy of this nostrum is all-sufficient for its condemnation.

[Editorial Note.--When the Council on Pharmacy and Chemistry was started we announced that we did not see any clear line of demarcation between “patent medicines” and many so-called “ethical proprietaries.” Time has not caused us to change our opinion. As we have already shown, and as we shall have occasion to show in the future, not a few of the “ethical proprietaries” offered to physicians are being advertised by those who are pushing the rankest of “patent medicines.” The three preparations mentioned above are sold--and presumably manufactured--by Mr. Ballard, of St. Louis. Mr. Ballard is the promoter of Ballard’s Snow Liniment, Brown’s Iron Bitters, Herbine, Dr. Herrick’s Vegetable Liver Pills, Swaim’s Panacea, Renne’s Pain Killing Oil, etc. He is also the promoter of Campho-Phenique, exposed in The Journal some eight years ago.[89] The spectacle is not an edifying one. A manufacturer with one hand offers the public a profusion of cure-alls, while with the other he endeavors to foist on the medical profession preparations which are just as fraudulent. Some day our profession will awake to the disgrace of it all. It will also awake to the fact, which should have been evident ere this, that the nostrum business would cease if physicians would refuse to accept into their offices, even as a gift, the nostrum-promoting medical journals that live off this trade. Fraudulent “patent medicines” will continue to thrive just so long as newspapers will publish “patent medicine” advertisements; fraudulent “ethical proprietaries” will continue to exist just so long as medical journals will advertise such proprietaries. As the better class of newspapers are rejecting “patent medicine” advertising on their own volition, so are the better class of medical journals rejecting advertisements of fraudulent proprietaries. Some newspapers will continue to carry nostrum advertising until their subscribers raise a protest that will cause the business department to take notice; so, too, some medical journals will continue to share the profits with the nostrum exploiters until an outraged medical profession repudiates such publications.]--(_From The Journal A. M. A., Feb. 6, 1915._)

[89] The Journal A. M. A., April 20, 1907, reprinted in “Propaganda for Reform,” 8th Edition.

THIALION

Report of the Council on Pharmacy and Chemistry

The following report was submitted to the Council by a subcommittee which examined Thialion (Vass Chemical Company):

_To the Council on Pharmacy and Chemistry_:--We beg leave to report
on Thialion as follows:

Thialion is sold by the Vass Chemical Co., Danbury, Conn. In
the literature supplied to physicians and in the advertisements
in medical journals, Thialion is stated to be “a laxative salt
of lithia” with the chemical formula “3Li_{2}O.NaO.SO_{3}.7HO.”
“Sodio-trilithic anhydrosulphate” is given as a synonym. An elaborate
graphic or structural formula is also given.

According to analyses, this preparation is a mixture consisting
chiefly of sodium sulphate and sodium citrate with very small
amounts of lithium, the average of several estimations indicating the
following composition:

Sodium citrate 58.6
Sodium sulphate, anhydrous 26.6
Sodium chlorid 3.3
Lithium citrate, anhydrous 1.8
Water 9.7

Thus, the advertising literature is a deliberate misrepresentation
of the facts. It is, therefore, recommended that the preparation be
refused recognition, and that this report be published.

The recommendations of the subcommittee were adopted by the Council and in accordance therewith the above report is published.

W. A. Puckner, Secretary.

In publishing the above report, the Council is presenting to the medical profession another object lesson, and one that illustrates how easily our profession is being humbugged. There are several things that we may learn from the report on this nostrum, but at this time we will take up only one phase of the lesson. Many of the scientific chemical compounds and derivatives given us by the German chemists have been distinct advancements and have proved to be valuable additions to our therapeutic agents; further, they were received with so much favor by physicians that they have been profitable for those who made them. It is not strange, therefore, that imitators should appear. One of the first was our old friend, Antikamnia (which was introduced as a “new synthetical” compound). This was followed by Ammonol, Phenalgin, Salacetin, and a host of others having acetanilid as their principal ingredient.

This picturesque “graphic formula” for Thialion appears with many of the advertisements. To most of us it looks formidable, wonderfully and deeply scientific and non-understandable; to a chemist it looks absurd.]

But there are hundreds of other so-called “new chemical” compounds among the “ethical” proprietaries on the market aside from the acetanilid mixtures. These wonderful compounds, by the mysterious union of their ingredients, possess therapeutic properties different from, or more powerful for good than the drugs from which they are made. At least, this is what we are told, and this is what many believe or they would not sell so well.

There is another factor worth noticing connected with this subject: When to the claim that the mixture is a “chemical compound” is added a complex chemical formula, it prevents the impertinent question, “What is it?” For isn’t the “formula” there, and is not the information given without the asking? Most of us have been so overcome by the display of the chemical knowledge of the nostrum maker that we have been afraid to expose our ignorance by asking for information or explanation. And thus the promoter avoids perplexing questions, which, if answered truthfully, would spell bankruptcy.

To a chemist the formula of Thialion furnished by the Vass Chemical Company signifies nothing. To a physician who possesses but little knowledge of chemistry, it will seem impressive, and he may absorb the idea that it stands for a preparation that is the result of exhaustive scientific research. To the chemist, this formula will appear as a jumble of symbols and numbers that mean nothing.

It is not worth while to call attention to the simplicity of this simple mixture of ordinary salts, for it is too self-evident. As to the remarkable therapeutic qualities of Thialion, the reader is referred to that ably edited “scientific” periodical, the _Uric Acid Monthly_, and to the mass of “literature” relating to this wonderful remedy.

While there is a ridiculous side to this business, there is also a serious one. Those who have been making money out of us undoubtedly laugh in their sleeves at our gullibility, but to us as members of a presumably learned and intelligent profession, it is not a laughing matter. The whole nostrum business is a shame and a disgrace.--(_Modified from The Journal A. M. A., Nov. 3, 1906._)

UNGUENTUM SELENIO VANADIC (V. ROEMER)

Report of the Council on Pharmacy and Chemistry

Unguentum Selenio Vanadic (v. Roemer) is an ointment manufactured by A. von Roemer, Brooklyn, N. Y., and put on the market by Schering and Glatz, New York. It is claimed to contain 1 per cent. of selenium oxycyanid and 1 per cent. of vanadium chlorid “so prepared and incorporated into a modified lanolin base as to insure complete absorption.” The preparation is recommended in the later stages of inoperable carcinoma, sarcoma, epithelioma and other malignant tumors, as a substitute for morphin and other narcotics to control pain, as a modifying (ante-operative) treatment in the middle stage of malignant cases presenting the characteristics of being inoperable, and as a prophylactic treatment of recurrences and metastases following excision of malignant tumors. It is also recommended for use in slow-healing surgical wounds, abscesses, tuberculous and mixed septic and gangrenous processes, etc., in lupus, acne, eczema, psoriasis, scabies, erythemata, adenomata, angiomata, papillomata, etc. The use of the ointment is further recommended by systemic inunction in septicemia, pneumonia, erysipelas, cerebrospinal meningitis, septic rheumatism, septic neuritis, etc. The Council voted that the preparation be not accepted for inclusion with New and Nonofficial Remedies because no evidence has been submitted that the vanadium and selenium are absorbed or that they produce any of the effects claimed.

When the preceding report was sent to Schering and Glatz, the firm expressed surprise that evidence of the absorption of selenium and vanadium should be requested. On June 8 the firm wrote that within a few days one or more tests would be sent by which the presence of selenium and vanadium in the urine could be demonstrated. These tests were not received. So far (November, 1914) no evidence of the value of the preparation either in carcinoma or in any of the very long list of other diseases in which it is recommended has been submitted, and, the pharmacologic evidence that such a preparation would be of value in such conditions being practically nil, the Council authorized publication of this report.--(_From The Journal A. M. A., Nov. 21, 1914._)

UNICORN ROOT, WILD YAM AND WILD INDIGO

Report of the Council on Pharmacy and Chemistry

The Council has voted that recognition be refused to the following: Unicorn Root (_Aletris farinosa_), Wild Yam (_Dioscorea villosa_), and Wild Indigo (_Baptisia tinctoria_) and has authorized the publication of the following statements.

W. A. Puckner, Secretary.

Unicorn Root--Aletris Farinosa

Unicorn Root (_Aletris farinosa_) contains a bitter principle and starch. Remarkable powers as a uterine tonic have been ascribed to it but have not been realized by reliable observers, the drug being practically valueless in these conditions. It enters into the composition of a number of nostrums. As a bitter it is superfluous and it should not be included among non-official drugs.

Wild Yam--Dioscorea Villosa

Wild Yam (_Dioscorea villosa_) has been little used in medicine. It contains a saponin and an acrid resin, and is said to possess expectorant, diaphoretic and--in large doses--emetic properties. It has been recommended as a remedy in biliary colic and in muscular rheumatism. Its value in such conditions has not been verified to an extent entitling it to consideration as a useful remedy.

Wild Indigo--Baptisia Tinctoria

Wild Indigo (_Baptisia tinctoria_) has been in use--chiefly by the eclectics--for about three-quarters of a century, but there is no satisfactory evidence that it has any therapeutic value. The following text-books on pharmacology do not even mention wild indigo: Cushny, Brunton, Dixon, Binz, Sollmann. It is not official in the United States or other leading pharmacopeias.

A preparation of wild indigo is advertised with extravagant claims for its therapeutic action, but these claims are not supported by any substantial evidence. Other virtues ascribed to wild indigo are its properties as a cardiac and hepatic stimulant and its value in sepsis, particularly in typhoid fever. It actually has emetic and cathartic properties, but even these are inferior to those possessed by many other drugs.

It is very evident that a drug possessing the extraordinary merits that have been claimed for wild indigo would not have remained unnoticed by the leading authorities on pharmacology and therapeutics, especially after its prolonged use in medicine. Owing, therefore, to the lack of substantial evidence of its usefulness, baptisia is not considered as of sufficient importance to warrant its inclusion in the list of non-official drugs. It is probably entirely superfluous.--(_From The Journal A. M. A., Jan. 22, 1910._)

PROPRIETARY VANADIUM PREPARATIONS

Report of the Council on Pharmacy and Chemistry on Products of
Vanadium Chemical Co.: Vanadiol, Vanadioseptol,
Phospho-Vanadiol, Vanadoforme, etc.

Vanadiol and preparations thereof, the products of the Vanadium Chemical Company, were submitted to the Council. After thorough investigation it was concluded that the company has not, and never has had, any reliable evidence for the therapeutic claims it has presented to the medical profession regarding these products. Accordingly the Council voted that the several products under consideration be not accepted for inclusion with New and Nonofficial Remedies. The findings of the Council having been submitted to the Vanadium Chemical Company and its reply considered, the Council authorized publication of the report which appears below.

W. A. Puckner, Secretary.

The Vanadium Chemical Company, Pittsburgh, Pa., submitted to the Council on Pharmacy and Chemistry for inclusion in New and Nonofficial Remedies the following products: Vanadiol, Vanadioseptol, Phospho-Vanadiol, Vanadium Solution for Intravenous and Hypodermic Use and Vanadoforme. At the same time, the company submitted statements and “literature” regarding the composition and therapeutic value of these products. The committee to which the matter was referred, after carefully considering both the matter presented and certain modifications in the advertising matter to which the company consented, reported that the evidence, especially that relating to the therapeutic value of the preparations, was insufficient to warrant the acceptance of the articles. Since the validity of therapeutic claims can be determined to a certain extent by experimental investigation, the Council decided to postpone final action until sufficient dependable evidence as to the therapeutic value had been submitted.

Accordingly, a series of questions was sent to the Vanadium Chemical Company for the purpose of learning on what pharmacologic evidence the therapeutic claims were based. After waiting several months, the information requested not being furnished, the Council took final action on the products. This action was based both on the evidence originally submitted and on the advertising matter being sent out by the company at the time.

Briefly, Vanadiol is said to contain a compound of vanadium with oxygen and chlorin, which gives up its oxygen to readily oxidizable substances, such as the blood. In addition to this compound it contains an oxidizing agent (sodium chlorate) which is said to serve as a source of oxygen, so that, according to the theory of the promoters, Vanadiol acts in the animal system as an oxygen-carrier.

The following is quoted from an advertising circular:

“Most thorough and conclusive physiological tests were made on
guinea-pigs and other animals, which established undoubted evidence
as to the truth of this theory.

“INFLUENCE

“Under the influence of Vanadiol and the other derivatives, the
appetite is increased, there is greater ability to peptonize ingested
proteid material, and, through the improvement in the assimilative
powers and the checking of abnormal fermentations, leads to an
increase in weight. A greater excretion of urea follows their use.
Phagocytic action is promoted by an increase in the leucocytes. All
phases of the elimination of waste materials are favored by the
positive increase in the number of red blood corpuscles and the
percentage of hemoglobin, hematogenesis being thereby rendered more
perfect. The beneficent effect of nascent (active) oxygen, upon the
red corpuscles and upon tissue cells of low vitality are matters of
common knowledge. The results obtained from the vanadium derivatives
are not drug effects, but are due to improved metabolism, which in
turn is due to the removal of microbian toxins, and the general
stimulation of cell activity.

“In a tubercular organism, the action of Vanadiol is two-fold.
First, it acts as an antiseptic and antitoxin, combating the Koch
bacilli and neutralizing their poison. Second, as a reconstituent of
the economy, to which it furnishes nascent oxygen, fortifying the
defenseless cells by the very element that is necessary to make them
healthy and resistant.”

“In Anemia and Chlorosis, the blood cells lack oxygen, and in
Neurasthenia the nerve cells are deficient. Vanadiol brings both
blood and nerve cells from a condition of weakness and decay into
vital energy, by furnishing them with active oxygen in a manner that
had not been possible by any other medicine.”

“Vanadiol accelerates the work of digestion by producing HCl in
small doses; it does not hinder the peptonization of albuminoids as
do beta-naphthol, salicylic acid, boric acid, etc., when used as a
stomachal antiseptic, but on the contrary it favors, by hydrochloric
acid, the transformation of albuminoids into peptone without the
assistance of pepsin. Thus, Vanadiol, when given to consumptives,
favors the digestion of large amounts of proteid materials and
causes oxidation of toxins of the stomach. The stomachic action is
reflected in other parts of the organism by the stimulation of the
chief functions; the pulse becomes stronger and muscular strength
increases; and, last, but of greatest importance, is the tremendous
increase which will be noted in the hemoglobin and the red cell
count.”

“Phospho-Vanadiol, a combination of Vanadiol with an easily
assimilable organic phosphorus, is an active accelerator of general
nutrition with a special action on the nervous system.”

Such remarkable statements as these are past credence, certainly, unless they are supported by scientific evidence. And evidence, either in support or in contradiction of the claims made, could be obtained; for many of these actions, at least, are capable of proof by animal experimentation. The Vanadium Chemical Company was asked to furnish such proof but failed to do so. The inference is plain! The committee has concluded that the company has not, and never has had, any reliable evidence on which to base the therapeutic claims it has presented to the medical profession.

Here another fact should be noted. It is the connection shown in The Journal, June 22, 1912, of the general manager of the Vanadium Chemical Company, F. M. Turner, with a fraudulent obesity cure concern, the Dr. Turner Company of Syracuse, N. Y.

It seems, moreover, by all the evidence available, that F. M. Turner is not authorized to use the title M.D.; yet, under this title his name appeared on cards representing the Vanadium Chemical Company and under this title, also, he published an article in a medical journal recommending to the medical profession the use of Vanadiol. Later this article was distributed as an advertising circular by the Vanadium Chemical Company. Turner’s connection with the Dr. Turner Company is known and acknowledged by the Vanadium Chemical Company, yet it still retains him as general manager!

While there is not necessarily any direct relation between the personnel of a proprietary manufacturing company and the value of that company’s product, it is natural that the medical profession should view with distrust any concern managed by one who has previously been connected with such a fraud as the Turner obesity cure.

The committee therefore recommends that the preparations of the Vanadium Chemical Company be refused recognition, and that this report be authorized for publication.--(_From The Journal A. M. A., Jan. 18, 1913._)

VENARSEN

Report of the Council on Pharmacy and Chemistry

The report which appears below was sent to the Intravenous Products Company for consideration. Having considered the firm’s reply, the Council has authorized publication of its report along with the explanation sent by the Intravenous Products Company in reference to the variable composition reported for Venarsen, namely, that “only the first few experimental ampules, sent to the doctors for clinical tests, were made without the Mercuric Iodide.”

W. A. Puckner, Secretary.

This product is prepared by the Intravenous Products Company, Denver. The advertising circulars contain inconsistent statements as to its composition. According to one circular Venarsen is

“... a comparatively non-toxic organic arsenic compound, 0.6 Gm.
representing 247 Mg. (3-3/4 grains) of metallic arsenic in chemical
combination....”

According to another circular Venarsen is

“... a comparatively non-toxic organic arsenic compound, 0.6 Gm.,
representing 247 Mg. (3-3/4 grains) of metallic arsenic and .78 Mg.
(3/250 grain) metallic mercury in chemical combination.”

Neither one of these statements gives any information as to the actual composition of the product. Inquiry addressed to the manufacturers elicited the reply that:

“Venarsen contains in each 5 c.c. 0.6 Gm. Sodium Dimethyl Arsenate,
.0016 grams of Mercuric Iodide, .0048 grams of Sodium Iodide in
solution in a suitable vehicle for intravenous administration.”

The following report of the examination of Venarsen is submitted by the Association’s Chemical Laboratory:

LABORATORY REPORT

Three ampules of Venarsen were examined. The first ampule was labeled

“A comparatively non-toxic organic arsenic compound, representing
247 Mg. (3-3/4 grs.) of metallic arsenic in chemical combination. 5
c.c.--0.6 Gm.”

Practically the same statement appeared in an advertising circular wrapped around the ampule. The second and third ampules bore labels identical with the first. The circulars differed from that accompanying the first ampule in that the presence of mercury is also announced, thus:

“Venarsen is a comparatively non-toxic organic arsenic compound,
0.6 Gm., representing 247 Mg. (3-3/4 grains) of metallic arsenic
and .78 Mg. (3/250 grain) metallic mercury in chemical combination
and is so prepared and enhanced as to present the ingredients to
the blood in their most acceptable form.”

Thus, although the potent elements said to be contained in Venarsen are named, its chemical character (the combination in which the elements occur) is not disclosed.

The ampules contained a transparent, odorless solution, possessing the yellow color of salvarsan solution (an aqueous solution of sodium cacodylate, mercuric iodid and sodium iodid in the amounts said to be present in Venarsen is colorless). Qualitative tests demonstrated the presence in each of the three ampules of sodium cacodylate (sodium dimethyl arsenate), and the absence of arsenites, arsenates, phosphates, arsanilates (atoxyl, soamin) and arsenphenolamins (salvarsan, neosalvarsan). Titrated with normal hydrochloric acid, using methyl orange as indicator (as outlined in New and Nonofficial Remedies, 1915, p. 40), the three ampules were found to contain the equivalent of respectively, 0.219, 0.253 and 0.216 Gm., or an average of 0.244 Gm. arsenic. (According to statements of the firm each 5 c.c. of Venarsen contains 0.6 Gm. sodium dimethyl arsenate [sodium cacodylate], equivalent to 0.247 Gm. arsenic or 41.66 per cent. Sodium dimethyl arsenate, as described in New and Nonofficial Remedies, contains 3 molecules of water and 35 per cent. arsenic. This indicates that the sodium dimethyl arsenate used in Venarsen contains less water of crystallization than the N. N. R. product).

Neither mercury nor iodid could be found in the first ampule. (The company has since explained that mercury was absent only from the first experimental samples.) The second and third ampules contained iodid and mercury in small amount. The exact quantity was not determined because, on the basis of the mercury content declared, a single accurate mercury estimation would have required the purchase of something like 25 to 100 ampules. As each ampule sells for two dollars, the cost of the material was considered prohibitive.

From the foregoing we conclude that the first ampule examined consisted essentially of a solution containing 0.625 Gm. of sodium cacodylate, N. N. R., while the second and third ampules contained 0.722 Gm. and 0.617 Gm. sodium cacodylate, respectively, and in addition, a mercury compound, probably mercuric iodid, dissolved by sodium iodid.

In other terms, Venarsen as now marketed is a simple solution containing approximately 9 grains of sodium cacodylate, 1/40 grain of mercury “biniodide” and 3/4 grain of sodium iodid to each full dose.

In the past the preparation has been in conflict--especially serious because of the potent character of the drug--with Rule 1 (secrecy of composition). The manufacturers have removed this conflict by furnishing a statement of composition; and it is to be expected that they will likewise take steps to remove the manifestly erroneous impression now likely to be gathered from the circulars, namely, that the preparation is rather analogous to salvarsan. These conflicts, however, call for comment, since physicians have doubtless used the material under misapprehensions.

As to therapeutic claims, the preparation is said to be effective and safe in syphilis; “lower toxicity and greater spirochaetacidal power than other known arsenic compounds” are among the claims. No real evidence for either of these claims is presented. Sodium cacodylate has been tried as an antisyphilitic, but with indifferent success; certainly the results have not been comparable to those of salvarsan. The mercury could conceivably enhance its effect, but the dosage appears too small and the course too short for this influence to be pronounced. Moreover, a careful physician would not give arsenic and mercury in fixed proportions.

The claim of comparative non-toxicity is probable enough from what is known about the cacodylate. No physician should feel “safe,” however, when injecting intravenously 0.6 gm. of sodium cacodylate every four to six days. Aside from the grave dangers of intravenous injection in general, the possibility of idiosyncrasies to arsenicals should always be borne in mind.

Finally, Venarsen is claimed to be “indicated” in pellagra, tuberculosis, anemia, etc. No evidence is presented on which to base an opinion as to its efficiency in pellagra. Those who have studied that disease would not be likely to resort to this treatment. In tuberculosis and anemia, there is no sufficient advantage in giving the cacodylate intravenously.

To summarize, Venarsen treatment consists essentially in the intravenous injection of large doses of sodium cacodylate. The other ingredients, as well as the name, merely constitute so much mystification. While the cacodylate probably has some effect on the conditions for which it is advised, there is no evidence that its value even approaches that of salvarsan in syphilis, or that the intravenous use is preferable to the ordinary methods. The dangers are manifest, although they may not be so great as with salvarsan. No justification has been established for its use in tuberculosis and pellagra.

Physicians who wish to try intravenous cacodylate administration should have a full realization of the dangers of such treatment, and in order to avoid further risks, will do well to refrain from combining other drugs with the cacodylate in fixed proportions.

It is recommended that Venarsen be held in conflict with Rule 6 (unwarranted therapeutic claims), Rule 7 (poisonous ingredients not stated on label), Rule 8 (name does not express the chemical composition) and Rule 10 (unscientific combination) and that this report be published.--(_From The Journal A. M. A., May 22, 1915._)

VENODINE

Report of the Council on Pharmacy and Chemistry

Venodine (The Intravenous Products Co., Denver), according to information sent to the Council, is “an Intravenous Iodine Compound” put up in ampules each of which contains “28 grains of Sodium Iodide, 1/8 grain each of Beechwood Creosote and Guaiacol in a suitable vehicle, and excipients to enhance its compatibility with the circulating blood.”

The “Therapeutic Indications” include “infectious diseases, such as syphilis, tuberculosis, bronchitis, bacteraemias associated with chronic and acute nephritis (Bright’s disease), and other infections.” The Council held as unwarranted and grossly exaggerated the following therapeutic claims: (1) that the full therapeutic value of iodin medication cannot be readily obtained except by intravenous injection; (2) that Venodine is “of exceptional value in tuberculosis”; (3) that in pneumonia Venodine “combines the anaesthetic properties of creosote and guaiacol with the germicidal value of iodine”; (4) that “Venodine (or its iodine component) has long enjoyed an exceptional reputation” as of great value in many infectious diseases including bacteremias. The facts on these points are the following:

1. Since iodids are easily absorbed from the mucous membrane of the gastro-intestinal tract and are usually well tolerated by the stomach, there is no reason for resorting to intravenous injection in their administration.

2. The indiscriminate administration of iodids for pulmonary tuberculosis is strongly to be condemned. The cases in which they can be given to tuberculous patients without doing harm must be very carefully selected.

3. There is no evidence either that creosote is excreted by the lungs in sufficient quantity to exert an anesthetic influence or that iodin is present in the circulation of the lungs or in the bronchial secretions in a form which is capable of exerting any germicidal action whatever.

4. It is generally held that the systemic administration of iodin compounds in bacteremias is useless.

The Council also held the name “Venodine” objectionable in that it fails to indicate the chief ingredient (sodium iodid) of this simple pharmaceutical mixture. The statement in a circular that “Venodine is a sterile solution representing 1.54 Gm. (24 grains) of iodine in chemical combination together with creosote and guaiacol” is likely to lead physicians to use the preparation without considering that its chief constituent is the well-known substance sodium iodid, particularly so since no reference to sodium iodid is made in the circular.

Furthermore, the Council held that the combination of two such similar substances as creosote and guaiacol (the second a constituent of the first) as given in the published formula, stamps Venodine as unscientific; it adds mystery to the preparation, but does not increase its efficiency, and is therefore against the best interests of the public.

The Council voted that Venodine be held ineligible for conflict with Rules 6, 8 and 10.

This report having been submitted to the manufacturers, in accordance with the Council’s custom, and the reply affording no reason for modifying the findings, its publication has now been authorized.--(_From The Journal A. M. A., June 26, 1915._)

VERACOLATE[AM]

Report of the Council on Pharmacy and Chemistry

[AM] For report on a similar compound, see Taurocol, p. 198.

“Veracolate (plain),” “Veracolate with Pancreatin and Pepsin” and “Veracolate with Iron, Quinine and Strychnine” are proprietary tablets marketed by the Marcy Company, Boston.

“_Veracolate_ (_plain_).”--For this the following non-quantitative formula is given:

“A compound containing the bile acids, sodium glycocholate, sodium
taurocholate with cascara sagrada and phenolphthalein.”

The dose is three tablets. Examination in the Chemical Laboratory of the American Medical Association of a specimen of “Veracolate (plain)” indicated that there was about 20 mg. (1/3 grain) of phenolphthalein to each tablet. One dose, therefore (three tablets), would contain 1 grain of phenolphthalein--an average dose.

“_Veracolate with Pepsin and Pancreatin._”--The following “formula” is given for this mixture:

“Veracolate 1-1/4 grain
“Pure Pancreatin 1 grain
“Pepsin aseptic (1:3,000) 1/2 grain
“Oil peppermint 1/10 min.”

(Note the presence of two mutually incompatible digestive ferments.)

“_Veracolate with Iron, Quinine and Strychnine._”--This is stated to have the following “formula”:

“Veracolate 1-1/8 grain
“Reduced Iron 1 grain
“Quinine Sulphate 3/8 grain
“Strychnine Sulphate 1/100 grain”

It will be noticed that these mixtures increase in complexity until a combination of seven diverse ingredients, a veritable shotgun mixture, is evolved. In none of the “formulas” are the proportions of the purgative drugs in Veracolate stated. In the second “formula,” the digestants might as well be omitted, for the pancreatin is destroyed by peptic digestion and hence cannot pass the stomach while the pepsin is useless without hydrochloric acid, and, at any rate, of no value in the intestine. If one is indicated, the other is not. Yet this unscientific and complex combination of purgatives, mutually incompatible digestive ferments, and oil of peppermint is called:

“A scientific Blending of Digestive Ferments, Cholagogues and
Carminatives.”

“... for all forms of indigestion and dyspepsia.”

And the third, an equally irrational and complex combination, is termed “The Ideal Cholagogic Tonic”!

_Extravagant and Misleading Claims._--True to type, the claims are magnified in accordance with the number of ingredients. For instance, of “Veracolate (plain),” we are told:

“Veracolate is a true cholagogue and biliary disinfectant as it
_directly_ stimulates the liver cells producing an increased flow
of limpid bile. Although not a purgative, it moves the bowels and
is definite and dependable in its action.”

“The action of Veracolate is to bring about a profuse flow of
healthy bile which prevents bile stasis. As the flow of bile is
stimulated so antiseptic action ensues, calculi softened and the
concretion and mucous eliminated. Mucosal swelling is diminished
and the infection which is usually present is antagonized. Relief
is in plain evidence. As a result of the treatment the skin,
eyes and urine become normal in appearance in a short time, the
appetite and digestion improve and soreness in the region of the
gall-bladder is entirely relieved.”

Similarly, it is said of “Veracolate with Pancreatin and Pepsin” that:

“It causes a natural flow of bile which checks fermentation,
prevents the absorption of toxines and causes the food elements
to be emulsified and thus rendered easy of assimilation. All this
conduces to a natural movement of the bowels. Digestion is at once
improved and the epigastric pain, nervous symptoms and headache
disappear.”

“Veracolate with Iron, Quinine and Strychnine” is said to be indicated in:

“Hepatic Torpor accompanied by Anemia, Chlorosis, Debility,
Neurasthenia and Neuroses.”

And the physician is asked to believe that it will:

“... give gratifying results in all _nervous, anemic_, and ‘run
down’ conditions in which the liver function is usually subnormal.”

The objections to “Veracolate (plain)” are that it is semi-secret in composition, unscientific in combination and exploited under unwarranted claims. The same criticisms hold with reference to “Veracolate with Pancreatin and Pepsin” and “Veracolate with Iron, Quinine and Strychnine.”

These products are discreditable to the medical and pharmaceutical profession alike and their use is against the public good. The Council therefore refused recognition to Veracolate and its preparations.--(_From The Journal A. M. A., April 24, 1915._)

HAYDEN’S VIBURNUM COMPOUND[AN]

Report of the Council on Pharmacy and Chemistry

[AN] See also report on Dioviburnia, p. 141, and article on Viburnum Compound and Other Nostrums, p. 409.

The following report on Hayden’s Viburnum Compound was prepared by a member of the Council’s Committee on Therapeutics. The Council held the preparation in conflict with its rules and authorized publication of the referee’s report.

W. A. Puckner, Secretary.

Hayden’s Viburnum Compound, according to the advertising circulars, was first compounded in 1860 by W. R. Hayden. The medical profession is told that W. R. Hayden

“... found by his experiments that a combination of the active
principles of _Viburnum Opulus, Dioscorea Villosa_, combined with
aromatics, proved a valuable remedy for _Spasmodic Dysmenorrhea_.”

As in 1860 W. R. Hayden was not a physician (he received a diploma from the Eclectic Medical College, New York, in 1867), and, so far as we can learn, he was not a pharmacist or chemist, one wonders what kind of “experiments” he made. Hayden’s Viburnum Compound is put on the market by the New York Pharmaceutical Company of Bedford Springs, Mass. The name of this concern may sound imposing, until it is realized that it is merely a trade name adopted by Hayden in exploiting his nostrum.

The advertising matter formerly claimed that Scutellaria (skull-cap) was one of the ingredients of Hayden’s Viburnum Compound. As this is no longer mentioned, it is fair to assume that even the manufacturer does not consider the composition to be of vital importance. Stress is laid on the superior efficacy of viburnum opulus in the conditions for which the preparation is recommended; it is emphasized that it is viburnum opulus, and not viburnum prunifolium, that is the important ingredient of Hayden’s Viburnum Compound. The label, in accordance with the requirements of the Food and Drugs Act, declares that the preparation contains 50 per cent. alcohol. The claim is made:

_“It is free from all narcotics and leaves no unpleasant
after-effects.”_

The medical profession is told that Hayden’s Viburnum Compound is a remedy in:

“Hysteria, Bilious Colic, Cramps of Cholera Morbus, Muscular
Cramps,... Nervous Diseases of Pregnancy, Threatened Abortion,
Post-Partum Pains, Puerperal Convulsions, Rigid Os, Dysmenorrhea,
Menorrhagia.”

DISCUSSION OF ALLEGED INGREDIENTS

_Viburnum Opulus_ (_Cramp Bark_).--Botanists and pharmaceutical chemists declare that this drug has not been on the American market for many years, if ever, and that the drug used and even described as viburnum opulus is really the bark of another plant. Viburnum opulus and its preparations are therefore to be dropped from the next United States Pharmacopeia. The principal constituents of viburnum opulus are stated to be a glucosid, viburnin, a bitter resin, and a little tannin, with small amounts of earthy carbonates and phosphates and organic acids (Culbreth, Ed. 4, 1906, p. 591). The glucosid and resin being bitter, the drug might have a slight stomachic action (if, indeed, any such effect is actually produced by “bitters”); the small amount of tannin might make it slightly astringent; its fruit acids (citric and malic) might make it slightly diuretic. Even if viburnum opulus were present in Hayden’s Viburnum Compound there is no clinical or laboratory proof that it, if given alone--without alcohol or other drug--has any antispasmodic or nervous sedative action.

_Dioscorea Villosa_ (_Wild Yam_).--This drug contains a saponin and an acrid, irritant resin. It has never been proved clinically or experimentally that this drug has any action whatever except that its irritant resin might, if taken in sufficient quantity, cause irritation of the stomach and vomiting.