The Propaganda for Reform in Proprietary Medicines, Vol. 1 of 2

Chapter XVIII: Part II: Contributions From the Chemical Laboratory (2)

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“Psora, the Syphilis Specific,” is a shot-gun mixture said to be “the scientific combination of the soluble Triple Iodids with the active principles of Echinacea, Cascara amagra, Berberis aquif., and Phytolacca rad.,” and is claimed to make “the syphilitic lesions disappear and fail to return.”

“Rectoids--Cones for the treatment of all rectal trouble,” are said to be “a combination of Rectin (Pix) compounded from Buckeye, Collinsonia, Hamamelis, Belladonna, Pix Cresol.”

“Tablets for the Female--Pix Cresol Uterettes,” it is said, “for sanitary purposes may be continued forever ...”

When one realizes that this sort of pseudo-scientific twaddle is accepted by many physicians at its face value, the outlook for therapeutics seems dark, indeed. So long as the existence of such concerns is tolerated by the medical profession, so long will there be a crying need for a “Propaganda for Reform in Proprietary Medicines.”--(_From The Journal A. M. A., June 10, 1911._)

SALIODIN

W. A. Puckner and A. H. Clark

[The Council on Pharmacy and Chemistry refused recognition to Saliodin because it conflicts with Rules 1 and 6, and directed publication of the following.

W. A. Puckner, Secretary.]

Saliodin is sold by the Saliodin Chemical Co., Scranton, Pa. In the literature and on the trade package the following “formula” is given:

This formula being indefinite and vague, the examination of saliodin was taken up in the Association laboratory.

From the analysis we calculate the composition of saliodin to be
approximately equivalent to a mixture of:

Sodium salicylate 57.54
Potassium iodid 1.18
Potassium acetate 30.00
Matter volatile at 130° (oil of anise, oil of
gaultheria, moisture, etc.) 8.10
Undetermined (extractive?) 3.18
------
100.00

The analysis shows that the formula is not only indefinite and vague,
but incorrect and false.

To emphasize the incorrectness of the published formula the following
comment on its first two items is offered:

In the “formula” it is stated that 20 grains of saliodin contain
approximately “salicylic acid (aceto-salicylate) Grs. XV.” The
statement is not clear, but conveys the impression that 20 grains
of saliodin contain an amount of aceto-salicylate, a salt of
acetyl-salicylic acid (aspirin), equivalent to 15 grains of salicylic
acid. But the chemical examination shows that it contains neither
acetyl-salicylic acid, nor salt of acetyl-salicylic acid, nor even
salicylic acid itself. In the place of these, the analysis shows that
over half of saliodin is the common, every-day sodium salicylate.

+---------------------------------------------------------------+
| It is an “Iodated, Aceto-Salicylate with Adjuvants,” and the |
| SPECIFIC treatment for every form of URIC ACID DIATHESIS. |
| “Saliodin” is a SOLVENT and ELIMINANT of URIC ACID and is a |
| happy combination of ℞ Salicylic Acid, Iodine, Acetic Acid, |
| Aconite, Bryonia, Colchicum, Capsicum and Gaultheria and |
| chemically appears in the form of a PINK, GREYISH POWDER |
| soluable in water 1 to 3--dose grs. X to grs. XXX; for the |
| EXCLUSIVE USE OF PHYSICIANS--put up in one ounce bottles; |
| price PER OUNCE $1.50. Is manufactured ONLY by the Saliodin |
| Chemical Co. “SALIODIN is SPECIFICALLY indicated in |
| RHEUMATISM, GOUT NEURALGIA, MALARIA and LA GRIPPE; is |
| ANALGESIC, ANTIPYRETIC; an INTESTINAL ANTISEPTIC, DIAPHORETIC,|
| DIURETIC, EXPECTORANT, DEOBSTRUENT, SIALAGOGUE, CHOLAGOGUE, |
| EMMENAGOGUE, ANTI-SYPHILITIC, GONOCOCOCIDAL, PARASITICIDAL, |
| ASEPTIC, BACTERICIDAL and ALTERATIVE. Doctor, you may |
| prescribe Saliodin with confidence wherever IODINE or a |
| SALICYLATE is indicated. Used both internally and externally. |
+---------------------------------------------------------------+

Reproduction (much reduced) of a paragraph in the advertising
pamphlet on Saliodin. Note the twenty-one indications for Saliodin.
Lest some condition might be overlooked, we are advised to use it
“internally and externally.” Isn’t this scientific therapy?]

According to the “formula,” each 20 grains of saliodin contains
“iodin (iodate), equivalent to iodid potass. Grs. XV.” This
statement, too, is vague, but conveys the impression that 20 grains
of saliodin contain an amount of iodin, in combination as an iodate,
which corresponds in iodin content to 15 grains of potassium iodid.
But the analysis shows that the product does not contain any iodate
whatever, and that the amount of iodin contained in it is sufficient
to account for only 1/4 grain of potassium iodid in each 20 grains of
saliodin.

COMMENTS

The above report is published simply as another example of the “ethical proprietaries” that physicians are asked to prescribe. It is not unique. It is neither better nor worse than hundreds of others.

To show what absurdities appear in the “literature” (?) that is sent to physicians, we reproduce a paragraph from an advertising pamphlet. The promoters’ statement as to the composition of the product is absurd, but not more so than are the claims made for it as a therapeutic agent. There is not a “patent medicine” on the market for which any more blatant, extravagant and ridiculous claims are made.

The manner of exploiting saliodin is another illustration of the tendency on the part of nostrum-makers to advertise their wares through pseudo-scientific articles published in a certain class of medical journals. In the pamphlet sent out by the Saliodin Company appears a reprint of an article from the Philadelphia _Medical Summary_ of February, 1905. It is entitled “A Similarity in the Etiologic Factors of Rheumatism and Malaria,” and was written by J. C. Denston, M.D. In it occurs this statement: “The manufacturers (of saliodin) publish their formula and, _I think_, distribute samples and literature on request.” The charming ingenuousness of this statement is fully realized when it is understood that J. C. Denston is the president of the Saliodin company. This is also another illustration of what is now a common occurrence, viz.: men who are engaged in manufacturing proprietary products and who have an M.D. degree use that degree as a commercial asset, and by this means the average reader is led to think that articles written by them in praise of their own products are spontaneous tributes from practicing physicians.--(_From The Journal A. M. A., Oct. 26, 1907._)

THEOBROMIN SODIUM SALICYLATE VERSUS “DIURETIN”: THE ECONOMICAL ASPECT

W. A. Puckner and Paul N. Leech

The following inquiry is from Dr. Reid Hunt, recently appointed professor of pharmacology at Harvard Medical School:

“Have you ever made an examination of the theobromin sodium
salicylates on the market to determine if they are identical with
‘Diuretin?’ The description of theobromin sodium salicylate in
New and Nonofficial Remedies agrees with the statements as to the
composition of Diuretin, but I wondered if, at times at least,
the theobromin sodium salicylate on the market might be a simple
mixture of theobromin and sodium salicylate just as the Caffeinae
Sodio-Salicylas, N. F., seems to be a simple mixture. Diuretin is
quoted in current price-lists at $1.75 an ounce, whereas the price
of theobromin sodium salicylate is only 35 cents an ounce. Many
hospitals use diuretin, and both physicians and students often have
only hazy ideas as to what it is. If the preparations of theobromin
sodium salicylate now on the market are identical with Diuretin they
should certainly be used, not only because they are less expensive,
but because the descriptive name will continually remind the
physicians of what they are using.”

Theobromin for some time has been regarded as a valuable therapeutic agent. The obstacle to its use has been its insolubility and the consequent uncertainty of the degree of its absorption. For this reason a soluble salt of theobromin, theobromin sodium salicylate, first introduced and advertised under the proprietary name “Diuretin,” has come to be used to a considerable extent.

Theobromin sodium salicylate--also called theobromin and sodium salicylate--is prepared by interaction, in molecular proportions, of theobromin, sodium hydroxid and sodium salicylate, the theobromin first being treated with sodium hydroxid in the presence of a suitable solvent, then the sodium salicylate added and the whole brought to dryness. The soluble compound which is formed is generally considered to be a double salt of theobromin sodium and sodium salicylate.

Theobromin sodium salicylate is described in New and Nonofficial Remedies and in several foreign pharmacopeias. It is also to be described in the forthcoming United States Pharmacopeia.

Although the product is not controlled by patents of any kind, and although it is offered for sale under its chemical name by the leading chemical manufacturers at from 35 to 45 cents per ounce, the proprietary product, Diuretin, sells for $1.75 an ounce. This is probably because the manufacturers think that those who have been using it under its chemically non-descriptive but therapeutically suggestive title, Diuretin, will remain ignorant of the fact that the same product is on the market under its chemical name. In view of these conditions, emphasized by Dr. Hunt’s letter, it was deemed important to examine the market-supply of theobromin sodium salicylate and to compare the several specimens with the proprietary brand Diuretin.

The following specimens, purchased in 1-ounce original packages, were examined:

Diuretin, “Knoll,” Knoll & Co.

Theobromine and Sodium Salicylate, Mallinckrodt Chemical Works.

Theobromine and Sodium Salicylate, Merck & Co.

Theobromine and Sodium Salicylate Powder, Powers-Weightman-Rosengarten Co.

Theobromine and Sodium Salicylate, “Roche,” Hoffmann-La Roche Chemical Works.

Theobromine and Sodium Salicylate, Squibb, E. R. Squibb & Sons.

The theobromin content prescribed for theobromin sodium salicylate by the various standards ranges from 45 to 50 per cent., that of New and Nonofficial Remedies being the highest. A requirement of not less than 46.5 per cent. theobromin in the dried powder has been proposed for the new U. S. Pharmacopeia.

The methods of quantitative estimation laid down by the various authorities are all very similar and consist, in the main, of a determination of water, of the sodium hydroxid, free and in combination with theobromin, and of the theobromin itself. For the theobromin estimation the following method was employed:

A weighed sample (about 2 gm) which had previously been dried, under slightly reduced pressure, over sulphuric acid, to constant weight, was dissolved in five times its weight of warm water. Two drops of phenolphthalein were added, and the solution titrated with normal hydrochloric acid. To the neutral solution, 1 drop of 10 per cent. ammonium hydroxid solution was added, and the mixture allowed to stand, with occasional stirring, for three and one-half hours at the temperature of 15 C. The precipitate was filtered on a weighed Gooch crucible, washed with just ten times the weight (of the original sample taken) of water (temperature 15 C.) and the precipitate dried at from 100 to 104. To the weight obtained, a correction factor (proved satisfactory by quantitative extraction experiments on the filtrate) of 0.13 gm. was added, for every 2 grams of the original sample taken.

The full details of the examination will be published in the 1914 Reports of the A. M. A. Chemical Laboratory. The results of the examination have been abstracted and are compiled in the accompanying table:

SUMMARY OF ANALYSIS
============+==========+=======+=====+=====+========+========+========
| |Gm. in |Price|Mois-|Alkalin.|Theo- |Theo-
|Physical |1-Ounce|per |ture,|as NaOH |bromin. |bromin.
|Appearance|Bottle |Ounce|Per |on Dry |in Dry |in Orig.
| [AQ] | | |Cent.|Powder |Powder |Specimen
| | | | |[AR] Per|[AR] Per|[AR] Per
| | | | |Cent. |Cent. |Cent.
------------+----------+-------+-----+-----+--------+--------+--------
Diuretin | 3 | 28.5 |$1.75| 0.01| 10.44 | 48.61 | 48.61
|Pure White| | | | | |
| | | | | | |
Theo. | 3 | | | | | |
Sod. Sal. |Pure White| 27.5 | 0.35| 1.89| 9.95 | 46.11 | 45.24
M. C. W | | | | | | |
| | | | | | |
Theo. | 1 | | | | | |
Sod. Sal. |Pure White| 29.0 | 0.35| 0.48| 10.38 | 47.87 | 47.58
Merck | | | | | | |
| | | | | | |
Theo. | 3 |
Sod. Sal. |Pure White| 29.1 | 0.35| 2.46| 10.30 | 47.57 | 46.39
P. W. R. Co.| | | | | | |
| | | | | | |
Theo. | 3 | | | | | |
Sod. Sal. | Pink | 28.6 | 0.35| 2.27| 9.92 | 49.05 | 47.92
Roche | |
| | | | | | |
Theo. | 1 | | | | | |
Sod. Sal. |Pure White| 26.8 | 0.45| 0.39| 9.97 | 46.82 | 46.63
Squibb | | | | | | |
------------+----------+-------+-----+-----+--------+--------+--------

[AQ] In this column, 1, 2 and 3 denote the following:

1. Quite crystalline, under microscope.

2. Fairly crystalline, under microscope.

3. Not crystalline, under microscope.

[AR] Average of determinations.

While the results show some variation in the moisture content and also in the actual theobromin content of the dried specimens, the variation is unimportant. The products in their original state (undried), as compared in relation to the theobromin content (the highest percentage of theobromin being 48.61, the lowest 45.24), reveal a variation of only about 3 per cent.--a variation which is negligible in the case of drugs such as theobromin.

From the preceding investigation, it is concluded that (1) practically there is no difference between the non-proprietary brands of “theobromin sodium salicylate” and “Diuretin;” (2) the several specimens examined were not simple mixtures of “theobromin” and “sodium salicylate”; (3) essentially all the brands complied with the standards laid down and can be rated as satisfactory; (4) “Diuretin,” though sold at an exorbitant price, is not superior to the product supplied under the descriptive term “theobromin sodium salicylate,” and (5) “Diuretin” sells wholesale for $1.75 an ounce, against 35 cents for the “theobromin sodium salicylate,” and therefore its employment cannot be interpreted otherwise than as a useless and unnecessary expense.--(_From The Journal A. M. A., April 4, 1914._)

UNGUENTINE

W. A. Puckner and A. H. Clark

Attention has been called at various times to the fact that the value of a published “formula” to a proprietary remedy is in direct ratio to the reliability of the manufacturer publishing it. When medical journals first insisted on their advertisers letting physicians know the contents of the remedies they wished to sell them, medical literature reeked with formulas--some of them of weird and wonderful design. Since the advent of the Food and Drugs Act, which requires that labels shall approximate truthfulness, and particularly since the Council on Pharmacy and Chemistry has investigated a number of proprietary remedies, the publication of “formulas” is not so common.

Unguentine, manufactured by the Norwich Pharmacal Co., is one of those remedies whose advertisement for years always included “a formula”; more recently, however, this is not in evidence. In an advertisement which appeared about ten years ago, the “formula” given is:

“Carbolic acid 2 per cent.
“Ichthyol 5 per cent.
“Alum 15 to 16 per cent.”

It was claimed that, by a special process of their own, the manufacturers had eliminated most of the astringent properties of the alum, rendering it non-irritant. It was also stated that “the base of Unguentine is pure petrolatum.” Later the manufacturers seem to have changed the composition of their product, or at least the “formula” given in the advertisements was changed. Thus it appeared:

“Alum 15 per cent.
“Zinc oxid 5 per cent.
“Carbolic acid 2 per cent.
“Ichthyol 5 per cent.
“Aromatics and antiseptic oils with specially
prepared petrolatum and animal fat base.”

The introduction of zinc oxid, aromatic and antiseptic oils and animal fat was a new feature. Somewhat later, and particularly since the passage of the national Food and Drugs Act, no formula or other statement regarding the composition seems to have appeared in the advertisements in the medical press. In the 1906 price-list (p. 170) the following formula appears:

“Unguentine represents:
“Alum (non-irritating) 15 per cent.
“Phenol 2 per cent.
“Ichthyol 5 per cent.
“Zinc oxid 5 per cent.
“Aromatic and antiseptic oils, with especially
prepared petrolatum and purified animal fat.”

In the price-list issued for 1908--after the Food and Drugs Act went into effect--the following appears:

“Unguentine represents:
“Alum compound (non-irritating)
“Phenol,
“Ichthyol,
“Zinc oxid,
“Aromatic and antiseptic oils, with especially
prepared petrolatum and purified animal fat.”

Thus the proportions are omitted, and alum becomes “alum compound,” whatever that may mean.

In view of the conflicting statements made by the Norwich Pharmacal Company, in regard to their leading specialty, Unguentine, and especially because much stress was laid on the filing of their “guarantee” under the Food and Drugs Act, it was decided to ascertain of what Unguentine really consists.

From our analysis we conclude that Unguentine contains not alum but aluminum acetate (small amounts of alum may be present as impurities in the aluminum acetate), zinc oxid, or more probably impure zinc carbonate, and that the entire quantity of both does not exceed 5 per cent. It contains no ichthyol, or if any but the merest traces, and less than 1 per cent. of phenol. The aromatic oils amount to not more than approximately 1 per cent. in all. The ointment-base is, in the main, petrolatum.

In Unguentine we have, therefore, another proprietary “specialty,” regarding the composition of which indefinite, false or misleading statements have been made--this irrespective of protestation of honesty by the firm.--(_From The Journal A. M. A., March 27, 1909._)

URICEDIN

W. A. Puckner and A. H. Clark

In view of the results of investigations by Zernik of Uricedin as sold in Germany, and because it is being advertised to physicians in this country, an examination of this product was made in the laboratory of the American Medical Association. Zernik’s report shows how this remedy has varied in its composition as put on the market in Germany. From their analysis the authors find that Uricedin is not a definite chemical compound as is claimed, but is a simple mixture whose composition is approximately:

Sodium sulphate (anhydrous) 61.52 per cent.
Sodium citrate (anhydrous) 29.62 per cent.
Sodium chlorid 2.13 per cent.
Citric acid (anhydrous) 3.25 per cent.
Moisture 2.53 per cent.
Undetermined 0.95 per cent.
------
100.00

Uricedin, therefore, is not a definite chemical compound as claimed, but a simple mixture which consists essentially of sodium sulphate (dried Glauber salt) 2/3, and sodium citrate 1/3. It is, therefore, a typical nostrum, and, as it appears, one the composition of which is changed from time to time to suit the whim of the manufacturer. The therapeutic claims made for it are of the usual extravagant character. According to a recent advertisement it is “used successfully for Gouty Diathesis, urinary Calculi, Rheumatoid Arthritis,” “useful in Migraine, Occipital Headache, Epilepsy, Hay Fever, Asthma,” etc. If such a simple mixture will do all that this one is claimed to do, let us use it, but prescribe its ingredients under their proper names. Such a mixture would cost only a few cents a pound, but this nostrum is listed at $1.25 a bottle of five ounces, or probably $1.75 at retail, and this for the benefit of its foreign manufacturers and their agents.--(_Abstracted from The Journal A. M. A., Nov. 23, 1907._)

URISEPTIN

W. A. Puckner and W. S. Hilpert

“Uriseptin,” manufactured by the Gardner-Barada Chemical Co. of Chicago and claimed to be a “urinary antiseptic, uric acid solvent and diuretic,” was examined in the laboratory of the American Medical Association to determine to what extent the claims made for it are justified.

The preparation as purchased in the open market bears a label which presents the claims of the manufacturers, emphasized by the chemical analysis duly signed by an analyst and attested by a notary. Accompanying is a reproduction of part of the label.

+--------------------------------------------------+
| ANALYSIS |
| |
| Sample of “Uriseptin” manufactured by the |
| Gardner-Barada Chemical Co., Chicago. Ill., |
| was found to contain: |
| |
| Specific Gravity at 15.5 C 1.0716 |
| Total Solids 20.42 p.c. |
| Alcohol (Ethyl) 7.66 p.c. |
| Water (by Difference) 71.92 p.c. |
| Total Ash 1.46 p.c. |
| Lithium Oxide 0.50 p.c. |
| Formaldehyde 5.62 p.c. |
| Acidity 100 cc equals 6.4 cc Normal Alkali. |
| |
| Sugars Present |
| Couch Grass Extract Present |
| Corn Silk Extract Present |
| |
| The Total Solids consist mainly of the sugars |
| and extract of corn silk and couch grass. The |
| couch grass and corn silk extracts were |
| determined by taste and smell in comparison |
| with authentic samples of same products. The |
| Lithium Oxide and the Formaldehyde are in |
| combination in the Uriseptin and together |
| represent 26.77 grains per liquid oz. I remain, |
| Yours very truly, |
| (Signed) Dr. Edwd. Gudeman. |
| |
| State of Illinois} _ss._ |
| County of Cook } |
| |
| Subscribed and sworn to before me this 13th |
| day of May, 1905. |
| (Signed) Paul E. Buedefeldt, |
| Notary Public. |
+--------------------------------------------------+

Reduced photographic reproduction of part of the Uriseptin label.]

Before the examination had extended very far it was found that discrepancies existed between facts and claims, and by the time the analysis was complete Uriseptin was found to be in the same class as many other proprietary remedies that have been discussed in these columns.

Our examination shows that the most misleading statement is that concerning the “lithium-formaldehyd” compound the presence of which is claimed, more or less directly, by both the manufacturers and the analyst employed by the manufacturers. Although the chemical properties of lithium and formaldehyd indicate in themselves that the existence of such a compound would be most improbable, yet considerable time was spent in searching the chemical literature for such a compound. Thorough search, however, demonstrated that no such compound, nor any that even approximated it, has been described.

The question then arose as to the form in which the lithium and the formaldehyd are present. The statements regarding its properties as a urinary antiseptic and the fact that the preparation is said to liberate formaldehyd slowly in the bladder point strongly to the presence of hexamethylenamin.

Tests[102] were applied to demonstrate whether the formaldehyd was present as a lithium compound, and if not, whether it existed in the form of hexamethylenamin. By these the presence of hexamethylenamin was proved and the absence of formaldehyd in other combinations demonstrated. This fact alone shows that the preparation is deliberately marketed under a false claim, and it shows further that the analysis on the label is worthless. The quantitative method of analysis demonstrated the presence of 5.51 gm. hexamethylenamin per 100 c.c. (25.15 grains per fluidounce).

[102] These appear in the annual report for 1908 of the Chemical Laboratory of the American Medical Association; they were also published in full in Jour. Am. Chem. Soc., September, 1908; an outline of the analysis appeared in The Journal A. M. A., Aug. 29, 1908.

Besides the hexamethylenamin, Uriseptin contains lithium and a benzoate. Concerning the latter nothing is said in the analysis, whose worthlessness is again demonstrated. By quantitative methods Uriseptin was found to contain lithium and a benzoate in such proportions as would indicate that the lithium and the benzoate radicle exist as lithium benzoate. This fact is further indicated by the claims made for the preparation regarding its properties as a uric acid solvent, for which purpose lithium benzoate is often used. Again, the demonstration that the formaldehyd present is in combination as hexamethylenamin precluded any possible chemical combination between lithium and formaldehyd and adds another strong point in support of the conclusion that the lithium and benzoic acid are in combination as lithium benzoate.

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The Propaganda for Reform in Proprietary Medicines, Vol. 1 of 2Chapter XVIII: Part II: Contributions From the Chemical Laboratory (2)

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