Chapter XIX: Conclusion

By chemical analysis the active ingredients of Uriseptin are shown to be hexamethylenamin, approximately 5.5 gm. per 100 c.c. (about 25 gr. to each fluidounce), and lithium benzoate, approximately 0.70 gm. per 100 c.c. (about 11 grains to each fluidounce), neither of which compounds is mentioned in the advertising matter on the label or in the so-called “analysis” on the label. The statements concerning the composition of Uriseptin are false and appear to be a deliberate attempt to mislead physicians.

Comment.--Investigation of the various “patent” and so-called “ethical proprietaries” advertised to the public and to the medical profession shows that those that have any value as therapeutic agents depend for that value on some well known drug or drugs. Hence, while many proprietaries have some virtue, the ingredients which are of any value are so concealed by the coined and “near-scientific” names applied to them that these drugs are usually unrecognizable. The many and various acetanilid mixtures furnish examples of this class of proprietaries. And now we find another example in that much advertised nostrum, Uriseptin.

According to our chemists, the chief ingredients of Uriseptin are hexamethylenamin and lithium benzoate. Hexamethylenamin is a valuable so-called urinary antiseptic--probably one of the best we have. It is a pity that more physicians do not know the value of this drug in and of itself; it is a common ingredient of many proprietaries, and yet too seldom prescribed under its true name. There is no reason for its being given in the form of a nostrum; it requires no skill in compounding, for it is best given in its powdered form, either in capsules or otherwise. So that, like acetanilid, the old argument of the nostrum men that the preparation needs skill in compounding will not hold. If a physician wants to prescribe hexamethylenamin let him prescribe it in its simplest and best form, and thus know exactly what he is giving.

Lithium benzoate also has its rightful place in the materia medica, but not hidden in a proprietary mixture to be prescribed unknowingly. It is hard to conceive of any one thing that operates more disastrously against scientific therapeutics than the vicious practice of marketing under proprietary names standard and valuable drugs, with their identity purposely concealed. Yet how frequently it is done. Well-known drugs of unquestioned worth are combined with those that are little known and of doubtful value, or more likely absolutely worthless, the mixture is put on the market under a high-sounding name and it is exploited through physicians as a panacea for all kinds of diseases.

In this, as in so many other instances, an “analysis” made to order is given to lend an air of apparent respectability and scientific standing to the preparation or to its exploiters, with the object, of course, of misleading physicians into thinking they are reading unbiased testimony. In addition, the “literature” accompanying the preparation is usually a jargon of pseudo-scientific verbiage put in to serve the same purpose as the analysis--that of catching the careless physician.

This state of affairs will continue just so long as the medical profession will tolerate it--and no longer. So long as members of our profession will prescribe proprietaries on the statements of their owners--as to both their composition and their therapeutic value--just so long will pseudo-chemical and pseudopharmaceutical companies fatten at the expense of the medical profession and to the detriment of the public health.--(_From The Journal A. M. A., Aug. 29, 1908._)

ZEMACOL

W. A. Puckner and W. S. Hilpert

Attention has been called to the vague and mysterious statements regarding a preparation called Zemacol, manufactured by the Norwich Pharmacal Co., Norwich, N. Y. Because of the unsatisfactory statements regarding the composition of the preparation, it was considered of sufficient interest to make an analysis and determine its chemical constituents. Accordingly specimens of the preparation were obtained and examined.

The preparation Zemacol (Norwich Pharmacal Co.), as found on the market, is a thick, pink, mucilaginous liquid, highly perfumed and having besides a suggestion of a phenolic odor. The bottle bears a label on which appear the following statements:

“A colloidal emollient containing extract of the rete mucosum
of the healthy yearling lamb, combined with glycerin, salicylic
acid and other antiseptic and aromatic oils. Useful in eczema and
diseases of the integument where cell destruction is a prominent
factor.”

In the advertising matter the following claims are made:

“An advance in animal therapy....”

“... increases the nutritive activity of the cell tissue of the
skin through the absorbable extract of the rete mucosum.”

“... clinical tests show its efficacy in both the so-called moist
and dry eczematous conditions of all parts of the cutaneous
surfaces.”

“... rich in animal cells.”

Since nothing could be found in the literature regarding the therapeutic action of an extract of the rete mucosum of the sheep, it was thought possible that the statements on the label were given simply as a vague and mysterious means of indicating the presence of wool-fat (lanolin), and tests were made to determine the presence or absence of the latter substance. A substance was isolated from Zemacol which had the physical properties of, and responded to some of the chemical tests for, wool-fat; but it was found in such small quantities as to indicate that it was not present as an active constituent. Since there are no definite tests for the detection of serums or animal extracts the presence or absence of these could not be demonstrated. Further examination indicated the presence of salicylic acid, a gummy material, having the properties of tragacanth and glycerin. It is practically free from inorganic matter. By distillation a small quantity of oil was isolated, which possesses the characteristic odor of the preparation.

Quantitative estimations[103] indicated the presence of the above-mentioned constituents in approximately the following quantities:

[103] Details of this analysis appear in the annual report for 1910 of the Chemical Laboratory of the American Medical Association.

Per Cent.
Gummy matter having the properties of tragacanth 2.02
Salicylic acid 0.67
Matter having the general properties of wool-fat
(lanolin) 0.20
Glycerin 5.50
Volatile matter (water and alcohol) 91.00
Aromatic oils and phenol-like bodies Trace

The results of the above analysis, together with advertising matter regarding Zemacol, were submitted to Dr. William Allen Pusey, professor of dermatology and clinical dermatology, College of Physicians and Surgeons, Chicago, and past chairman of the Section on Dermatology of the American Medical Association, with the inquiry whether or not there was any record of investigations regarding the therapeutic value of an extract of the rete mucosum of the sheep and whether in his opinion the claims made for Zematol would be warranted. The following reply was received:

“So far as I know, nobody ever thought of or proposed the use of
an extract of rete mucosum as a therapeutic agent and if a serious
suggestion of that sort had ever been made I believe I would know it.
I can conceive of no service which such an extract could render and
I think the suggestion of it is a highly fantastic idea. From the
analysis which you furnish I should say that the mixture described
is substantially the ordinary 2 per cent. solution of tragacanth in
glycerin and water with a little antiseptic added to keep it from
decomposing. That is a commonly known lotion, modifications of which
are used in practically every hospital as a hand lotion, and has no
magical virtues whatever. Incidentally, I should think it cost, aside
from the labor, about twenty cents a gallon to make it.”--(_From The
Journal A. M. A., May 14, 1910._)

ZYME-OID

W. A. Puckner and W. S. Hilpert

Zyme-oid, manufactured by the Oxychlorine Chemical Company of Chicago, is advertised as “a powerful gastro-intestinal antiferment” which will “arrest and prevent bacterial fermentation in any portion of the intestinal tract, whether the media be acid or alkaline.” These extravagant statements, like many others made regarding the properties of zyme-oid, are very similar in character to those made in the circulars accompanying the preparation oxychlorine, manufactured by the same firm and exposed in The Journal, July 6, 1907, page 54. (See page 147 of this book.)

As examples, several parallel statements help to show this similarity. The formula (?) of oxychlorine, as expounded on the label, is given in full, while in the case of zyme-oid only a hint is given as to its composition, but still sufficient to point to a similarity between the two:

OXYCHLORINE ZYME-OID

“Oxychlorine is a tetraborate “Zyme-Oid is a double borate
of sodium and potassium com- salt.”
bined with oxychlorid of boron,
thus: (6NaKB_{4}O_{7}) BOCl_{3}.”

In the matter of claims for chemical stability the two seem to be very closely allied:

Oxychlorine is “a stable salt Zyme-oid is “a product which is
under all conditions until stable enough for keeping pur-
brought in contact with sub- poses, but which readily yields
oxygenated organic matter.” nascent oxygen in the presence of
bacterial products.”

The therapeutic properties attributed to these sister products are even more similar, for we find that:

“Oxychlorine is adapted to all “Zyme-oid is a powerful gastro-
morbid and abnormal fermentative intestinal antiferment.”
alimentary states.”

Many more statements and claims could be quoted to show a similarity between, amounting almost to an identity of, oxychlorine and zyme-oid.

With these facts in mind, the analysis of zyme-oid was undertaken in order to compare it with the previously examined oxychlorine and to determine to what extent the claims made for zyme-oid are upheld by its composition. The analysis indicated, as was expected, that zyme-oid is essentially the same as oxychlorine as is shown in the following, quoted from the report of the analysis of each:

ANALYSIS OF OXYCHLORINE ANALYSIS OF ZYME-OID
Potassium (K) 12.26 Potassium (K) 13.50
Sodium (Na) 8.20 Sodium (Na) 9.84
Chlorate (ClO_{3}) 25.32 Chlorate (ClO_{3}) 27.50
Nitrate (NO_{3}) 21.70 Nitrate (NO_{3}) 24.22
Boric acid anhydrid Boric acid anhydrid
(B_{2}O_{3}) 18.63 (B_{2}O_{3}) 13.42
Water, calculated 13.29 Water, calculated 10.42

Assuming that the chlorate in zyme-oid is present as potassium chlorate and the nitrate is present as sodium nitrate, the figures obtained by analysis correspond to a mixture approximately as follows:

Potassium chlorate (KClO_{3}) 40.43
Sodium Nitrate (NaNO_{3}) 33.22
Potassium tetraborate (K_{2}B_{4}O_{7}) 1.60
Sodium tetraborate (Na_{2}B_{4}O_{7}) 3.31
Boric acid 21.14

From the results of the analysis and from the physical properties of zyme-oid we conclude, just as was done in the case of oxychlorine, that the preparation is not a definite chemical compound, but is essentially a mixture of alkali chlorate and nitrate with boric acid, probably produced by fusing together the constituents.

COMMENT

An examination of the claims made for the firm’s two products, while, as already proved, disclosing many points of similarity, will also show one remarkable difference. We refer to the skilful indefiniteness that pervades the claims made for zyme-oid and which defies scientific refutation. This verbal obscurity is becoming daily more common in the “literature” of firms marketing nostrums. Since the Council has analyzed many of the much-advertised articles and proved the unreliability of the pseudo-scientific claims made for them, the more cautious of the nostrum-mongers have modified the matter descriptive of their products. They have called to their aid the principle that words were given to man to conceal thought rather than to express it, and they have reduced equivocation to a fine art. Wherever it was possible to put forward claims by implication rather than by expression this has been done.

To substantiate further the claims made by the manufacturers of zyme-oid for their product, a laboratory report is brought in evidence. This report, which is written more in the style of a peruna testimonial than that of a conservative scientific statement, fails to verify the claim that zyme-oid is a “double borate salt,” but confines itself to a statement of its harmlessness and its anti-fermentative properties. In passing, it seems regrettable that scientific laboratories should, for a pecuniary consideration, be willing to jeopardize their reputations by lending their names to the furtherance of nostrum exploitation. The results of the examination of zyme-oid demonstrate that the product is no more worthy of the physician’s consideration than its close, and equally worthless, relative, oxychlorine.--(_From The Journal A. M. A., May 23, 1908._)