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

Chapter XXII: Part III: Contributions From the Journal: Nostrums (3)

Text size

An examination of the advertising matter fails to show that R. W. Gardner makes any definite statement in regard to the nature or the composition of his Hypo-Quinidol. Certain statements made in the literature sound much as if the article might be some sort of a quinin hypophosphite preparation. But if this is true, its action would be the same as other salts of quinin and the extravagant claims made could not be substantiated. It is said to be a “non-toxic quinin.” It is safe to say that a quinin which will not produce the toxic symptoms--cinchonism--either is not absorbed in sufficient quantity or has been so changed that it no longer has the therapeutic properties of quinin. Altogether Hypo-Quinidol must be put down as a preparation the composition of which is kept secret and regarding which extravagant and highly improbable statements are made.--(_From The Journal A. M. A., Jan. 10, 1914._)

IODONUCLEOID

An Iodin Product Under a Misleading Name

Information has been frequently asked concerning Iodonucleoid, a product not included in New and Nonofficial Remedies. The Association Laboratory after investigating this preparation reported as follows:

This preparation was at one time considered for inclusion with New
and Nonofficial Remedies, and at that time was examined in this
laboratory. The examination showed that iodonucleoid contains:

Phosphorus 0.79 per cent.
Calcium 0.43 per cent.
(Equal to 0.6 per cent. CaO).
Iodin 24.2 per cent.

When 2 gm. was dissolved in tenth-normal potassium hydroxid
volumetric solution and acetic acid added until faintly acid, an
abundant, white, flocculent precipitate formed. This precipitate
was collected, washed with water, transferred to a beaker,
phenolphthalein added and tenth-normal potassium hydroxid volumetric
solution run in until a pink color was produced. This required
15 c.c. of tenth-normal alkali. Subtracting from the 2 gm. of
iodonucleoid the 24 per cent. iodin, leaves 1.52 gm.; this divided by
the c.c. of alkali used indicates an equivalent weight of 1013.

Authorities differ widely regarding the amount of phosphorus
contained in nuclein from different sources, the figures ranging
from 2.9 per cent. to as high as 10 per cent. If the nuclein from
which iodonucleoid purports to be made contained but 2.9 per cent.
phosphorus, the preparation, after allowing for 24 per cent. iodin,
should still contain 2.2 per cent. phosphorus instead of the 0.79 per
cent. found by analysis. A true nuclein should contain no calcium. If
iodonucleoid is a casein compound of iodin we might expect to find,
if the casein had been freed from milk by acidulation without further
purification, both calcium and phosphorus. The equivalent weight of
casein is given by Long (_Jour. Am. Chem. Soc._, 1906, xxviii, 372)
as 1124. This figure was obtained on a casein of high purity, and the
figure of 1013 given above agrees fairly well with Long’s figure for
casein. The evidence, therefore, indicates that iodonucleoid is a
compound of iodin and casein, and not a nuclein compound.

The findings of the laboratory were at that time submitted to Prof. John H. Long of Northwestern University, who said:

“We have also made a number of examinations of iodonucleoid. We
determined in it the iodin and found the amount 24.2 per cent. by
weight, which is a little more than that claimed by the manufacturer.
We have also tested the solubility of this substance and find it to
behave about as your laboratory did. As you know, we have been making
a number of preparations from casein, and recently we have determined
the combining power of casein with various acids, including hydriodic
acid. This acid when evaporated in moderately strong solution with
casein yields finally a hard, dry mass, which may be ground up to
a powder resembling very closely the preparation under discussion.
Various amounts of iodin may be combined here, depending on the
strength of the iodin solution used, and we have secured some
containing over 35 per cent. of iodin. Several of these preparations
resemble closely iodonucleoid, so far as solubility, appearance and
reaction with alkalies on titration are concerned. I am unable,
therefore, to distinguish this preparation from the casein compounds
which we are making.”

From this it would appear that iodonucleoid is not a compound of nuclein, as indicated by the name, but instead is a casein compound of iodin.

Iodonucleoid, then, seems to be another one of the many iodin “substitutes” which have been put on the market. Other iodin substitutes are Iodalbin, manufactured by Parke, Davis & Co.; Iodipin manufactured by E. Merck & Co., and Sajodin, manufactured by the Farbenfabriken of Elberfeld Co. As these products have been examined by the Council and found eligible for inclusion with New and Nonofficial Remedies, physicians who wish to use substitutes for potassium iodid would do well to use them instead of a product presented under a misleading name. Physicians should understand, however, that these organic iodin compounds are non-irritating because the iodin is held in such combination that it is much less active. It seems probable that they are therapeutically active only to the extent that the iodin content is dissociated from the organic compound and concerted into ionic iodin.

A discussion of a number of iodin substitutes is found in an article by von Notthafft (_Monatsh. f. prakt. Dermat._, Oct. 15, 1910, p. 343), which was abstracted and commented on in The Journal, March 4, 1911, p. 685. Von Notthafft believes that the lower degree of toxicity which these remedies exhibit has its basis in a feebler activity; either the substitutes evolve too little iodin or they split it off with greater difficulty. Physicians should, therefore, view with some distrust the claims of manufacturers that their products are not only non-irritating but at the same time possess unusual therapeutic efficiency. This will apply with especial force if there is any tendency to conceal the nature or origin of the combination.--(_The Journal A. M. A., July 22, 1911._)

IRIDIUM

Dr. C. A. Dexter, Columbus, Ga., asks for information concerning the use of iridium in the treatment of acute and chronic rheumatism. Iridium is a well-known element although we have not found that it has been used as a medicine; however, we presume our correspondent refers to “Iridium (Medicinal),” sold by the Platinum Company of America. We are not able to locate this company, but in their advertising circular “Iridium (Medicinal)” is said to be “an agent for the blood, a laxative, an alterative, indicated in all disorders of the stomach, in Jacksonian epilepsy,” and “a specific in rheumatism.” As to its origin, it is said in the circular, “the platinum sands are associated with and composed of iridium” and some other elements, so that as far as the circular gives information the nostrum is alleged to contain the element iridium.

A few statements quoted from the circular will show that the person who wrote it knows nothing about medicine and cannot correctly use the English language: “The qualifications of Medicinal Iridium are its simplicity, purity, harmless under prolonged use, easily borne by the stomach.” “It has been observed that when Medicinal Iridium acts as a laxative, it will regulate the same.” “Called the family group, Iridium and Osmium are destined to become the world’s benefactors in medicinal properties, thereby creating a new chapter in medical science.” The circular quotes some supposed “excerpts from hundreds of letters on file, written by physicians, in the hope that they may attract your attention,” which bear marks of having been written by the same person who wrote the circular. Note the quality of the following statements: “Iridium has a power, purity and simplicity that pleases me; now I can make progress.” “I say to you frankly, Iridium is my standard. I can get results and make progress. I am confident it aids the fibrin in the blood.” “Dr. X is pushing Iridium on five or six cases.” It is not explained who Dr. X is, but it has this to say about him: “Dr. X is an eminent practitioner. He has made a remarkable record with Iridium and has so far never failed on cases of Jacksonian epilepsy; experimental tests have shown that Iridium increases blood-corpuscles.”

The man who signs himself president of the Platinum Company of America is said to be a lawyer, but is not working at it, and was formerly a promoter, fiscal agent, etc. It should not be difficult for the physician to fix the status of iridium under this sort of exploitation.--(_From The Journal A. M. A., April 23, 1910._)

IRON TROPON

The composition of Iron Tropon seems to have varied from time to time. The manufacturers formerly stated that it contained fat, sugar, pepsin and iron in organic combination with albumin, and its use was advocated both as a food and as a medicine. It was not claimed to contain over 1 per cent. of pepsin, but tests failed to show that it contained any pepsin, or if any, such a small amount that there was not sufficient to digest the albumin in Iron Tropon itself. It was also claimed that the iron, being in organic combination with the albumin, possessed advantages over the widely used aromatic fluid preparations of iron. Tests, however, showed that the iron was not in organic combination, though even had it been, late investigations fail to demonstrate the superiority of the organic over inorganic iron compounds.

The manufacturers state in their later “literature” that Iron Tropon is a tonic and a food; that it is a compound of the food albumin tropon, 2.5 per cent. of iron in its most assimilable form, and enough chocolate to flavor it agreeably. It will be noted that they now make no claim for pepsin, nor do they state that it contains iron in organic form. In the dose recommended, a teaspoonful three times a day for an adult, the patient gets something over a grain of iron, and he might as well take an equivalent quantity of Blaud’s mass, the value of which has been proved.

As a food, Iron Tropon, weight for weight, is about equal to beans and a little better than flour, although it contains a larger percentage of protein than either. In the dose stated, an invalid would get about 50 calories, or about 1/40 the necessary nourishment for a day. Tests have also shown that the albumin is difficult of digestion. In spite of this fact, the advertisement of Iron Tropon states: “A patient who takes Iron Tropon receives not only the benefit of iron medication, but at the same time his economy is supplied with perfectly assimilable albumin in sufficient quantity.” It will thus be seen that the claim for pepsin in this preparation has been abandoned, that the statement as to the iron being in organic form has been modified, and that the food value of the albumin is exaggerated; but perhaps the manufacturers do not expect the physician to apply his arithmetic to such problems.--(_From The Journal A. M. A., April 23, 1910._)

KUTNOW’S POWDER

Which Is It, a “Proprietary” or a “Patent Medicine”?

The term “patent medicine” has been applied, rather loosely, to those nostrums sold and exploited directly to the public, while the name “proprietary” has been given such preparations as are advertised only to the medical profession. As has been many times exemplified by reports in The Journal, the distinction is often a very fine one and the dividing line frequently reaches the vanishing point.

It is not unusual, for instance, for “proprietary” preparations to be foisted on the medical profession until a certain number of testimonials (of doubtful value, it is true, but still testimonials) have been ingeniously wheedled out of physicians and the product rather generously prescribed. When this objective point has been reached the manufacturer comes into the open and advertises the nostrum to the public direct and the testimonials previously given for the “proprietary” are used as advertising assets for the “patent medicine.”

Then again there are certain preparations which are “proprietaries” or “patent medicines” according to the location. On one side of the Atlantic the product is advertised to physicians only, while on the other side it runs indiscriminately on the billboards and in the newspapers. One of the best examples of this last class is Kutnow’s Powder. In England, where it originated, this preparation, which “dissolves and eliminates uric acid,” is consistently lined up with Beecham’s Pills and Pink Pills for Pale People. Full-page newspaper advertisements announce the fact that free samples will be

+----------------------------+
| “SENT TO ALL APPLICANTS” |
+----------------------------+

In the United States, however, Kutnow’s have learned from their wide advertising experience that a cheaper and surer way of introducing a nostrum to the public is to advertise it to the medical profession only. By means of advertisements in medical journals (whose space is much less expensive than that of the daily papers) and the liberal distribution of samples which are

+----------------------------------+
| “SENT FREE TO PHYSICIANS ONLY” |
+----------------------------------+

the medical profession becomes the unpaid “barker” for the nostrum manufacturer. At present, therefore, Kutnow’s Powder is--in the United States--an ethical (!) “proprietary.”

There exists in this country, as most of our readers know, an organization of “patent medicine” manufacturers whose “reason for being” is to get full value received for the $40,000,000 paid annually in advertising nostrums in the newspapers of the country. This organization is known as the Proprietary Association of America. The now familiar “red clause” in the advertising contracts by which the newspaper forfeits its contract if state laws are enacted that are inimical to the “patent medicine” interests, is a creation of this organization and has been most effective in making the newspapers the unpaid lobbyists of the nostrum interests. The “silence clause” is another “joker” in the contracts by which the agreement is canceled if matter detrimental to the nostrum “is permitted to appear in the reading columns” of the paper. It is little wonder that with such weapons the “patent medicine” manufacturer has assumed an arrogance that is as disgusting as it is serious.

Great Britain, too, has its “patent medicine” men’s organization, which is known as the Proprietary Articles Trades Association. Of both these honorable bodies Mr. S. Kutnow of Kutnow Brothers, Ltd., is, or was, a conspicuous member. At a recent meeting of the British organization, Mr. Kutnow worked himself into a fine frenzy of indignation because of some articles that had appeared in the _Pharmaceutical Journal_ of London on the subject of “Secret Remedies and Proprietaries.” As these articles did not specifically mention Kutnow’s Powder, and as evidence was directed against only those preparations as were most disreputable, it is evident that Mr. Kutnow now appraises his own product at its face value. He gave his opinion of the _Pharmaceutical Journal_ and told the meeting that when the advertising man for that journal solicited advertising he refused to have any more dealings with him owing to the articles that had appeared in the _Pharmaceutical Journal_. He declared that he was quite independent of any newspaper or journal, and was able to take care of himself.

Therein Mr. Kutnow is mistaken; he is not independent of newspapers and journals. On the contrary, he and others of his ilk are most subserviently dependent on them. Let reputable papers and medical journals refuse, for but one year, to carry the high-flown advertisements of his Anglo-American Patent-Proprietary, and his firm would perforce seek some worthier, if less profitable, line of business.

The editor of the _Pharmaceutical Journal_ resents Mr. Kutnow’s “implied assumption that by inserting paid announcements in the advertising columns of a newspaper, he or any one else, can dictate the policy of that organ.”

The _Pharmaceutical Journal_, it should be said, is the official organ of the Pharmaceutical Society of Great Britain, and is the most influential organ of the drug trade in the British Isles. It is refreshing to note, in these days of “canned” editorials and paid “write-ups” masquerading as original articles, that there is still to be found a journal that can not be bought.

One wonders whether a large experience in the advertising world, and especially his membership in the Proprietary Association of America, has unconsciously led Mr. Kutnow to assume that muzzling the press is one of the perquisites of the large purchasers of advertising space.--(_From The Journal A. M. A., Aug. 31, 1907._)

LYMPH COMPOUND R-H AND ORCHITIC FLUID TABLETS

A physician wrote The Journal:

“I have under my care a patient with chronic parenchymatous
nephritis. Microscopic examination shows occasional epithelial casts,
with hyaline and granular casts. The patient feels well and appears
to enjoy the best of health. Please give me your opinion on the
use, in such a case, of the lymph injections put out by the Animal
Therapy Company of Chicago, from whom I have just received a supply
of literature.”

The Journal replied as follows:

“The Council on Pharmacy and Chemistry took up for consideration
the ‘Lymph Compound R-H,’ and ‘Orchitic Fluid Tablets,’ sold by the
Animal Therapy Company and refused them recognition.

“The treatment of a case of chronic parenchymatous nephritis is a
task requiring the best judgment and the greatest knowledge that the
physician can command. From the first his aim should be to do no
harm, and with this in view he will recognize that since we do not
know the cause of this disease, and since we are unable to influence
the essential process in the kidney, the administration of a remedy
capable of doing harm should be undertaken only under the clearest
indications. It is probable that the remedy proposed, containing,
it is asserted, a mixture of foreign proteins, might injure healthy
kidneys, to say nothing of sick ones. It is well known that foreign
proteins, such as the white of egg, if they enter the circulation
unchanged, are excreted by the kidney and are liable to produce
serious irritation, which in the case of parenchymatous nephritis
might easily aggravate the existing condition and frustrate all
other efforts at a cure. More especially is it imperative to do no
harm when, as in the case reported by our correspondent, the patient
appears to be in good health. Two questions should be raised in that
case. First, is there any evidence that the occasional excretion
of a few casts, whatever may be their variety, is actually doing
the patient any harm? And second, since there are no symptoms, what
possible improvement could be expected from treatment? It is admitted
that we have no remedy which can affect an essential change in the
condition of the diseased kidney. What must be done in such a case
is to spare the kidney--to require of it the minimum of functional
activity. In such a case, the physician who introduces an animal
protein, foreign to the human system, would be taking a serious
responsibility. The chances are that it would do harm; how great,
no one can tell. If the physician can really make up his mind to
experiment at the risk of the life of his patient, this case appears
to be one unusually favorable to the manufacturer of the serum.
There are chances that the diagnosis may be incorrect and that such
a condition of the urine does not indicate a serious condition of
the kidney. It is frequently the case after an acute infection, or
some similar irritation, that the kidney continues for some time
to excrete albumin and casts, but the condition eventually clears
up. In such a case, if the serum did no harm it would be given the
credit of curing the patient, who recovers in spite of it. It is a
little unfortunate, however, for the purpose of such demonstration
that the patient is said to feel well. If only he could be persuaded
that he has a serious disease so that he might be somewhat depressed
mentally, the effect of the cure would be more remarkable!

“If the physician to whom such a patient comes for advice, instead
of taking the wise course of seeking reliable information, were to
take at their face value the statements of interested commercial
manufacturers--if he were to administer this unknown and dangerous
remedy, the effects of which he cannot predict--he would commit a
breach of trust more culpable than the most vicious attempts of the
nostrum-maker to mislead the physician and the public.”--(_From the
Journal A. M. A., Dec. 14, 1912._)

LYSOL-THE EVOLUTION OF A PROPRIETARY

Regarding certain proprietary preparations and their equivalents found in the pharmacopeias or other standard works of reference, it is often questioned whether the proprietary is the original and the official preparation the imitation, or vice versa. As a general proposition, medicinal compounds and preparations are not born but evolved, as in the case of epinephrin, in which the credit of discovery belongs to no one person, but to several.[108] So it is often the case that the proprietary and official preparations may be based one on the other, while both are usually based on some preparation which antedates them. This is well illustrated by the proprietary preparation Lysol, the practical equivalent of which--liquor cresolis compositus--is official in the United States Pharmacopeia. After the discovery of phenol (carbolic acid) and the recognition of its germicidal value, it was gradually learned that other phenolic compounds occurring in the crude distillates from tar and wood were more efficient and less poisonous than phenol (carbolic acid). When this was discovered, attempts of course were made to utilize these higher and more efficient phenols, which meant that their insolubility in water had to be overcome. In these attempts there were efforts to form new compounds as well as a search for simple solvents. While the first failed, because these compounds were less efficient than the phenol from which they were made, a simple solvent was found in soap. The first attempt to utilize the solvent power of soap gave creolin, a mixture of the so-called crude carbolic acid (really containing but little phenol and consisting largely of higher phenols along with inert hydrocarbons) with soap. This was followed in 1884 by Schenkel’s discovery that a portion of this “crude carbolic acid” could be made soluble in water by treatment with soap. Schenkel was refused a patent on the ground that any soap manufacturer should be permitted to add phenol to his soap, but in 1889 a patent for a cresol-soap solution was granted to Damann, who used cresol, a constituent of “crude carbolic acid.” The preparation was put on the market and has since been widely advertised under the proprietary name “Lysol.”[109] It is thus seen that Lysol is a good example of the way in which manufacturers appropriate the discoveries of others, develop them and turn them to proprietary use.

[108] The Journal A. M. A., March 25, 1911, pp. 901, 910.

[109] Pharm. Ztg., Oct. 14, 1908, p. 817.

The ill-deserved patent protection for Lysol happily expired long ago and the product can now be made by anyone. In view of the non-descriptive character of the name “Lysol” and the danger in using such names in connection with potent and poisonous remedies, this cresol-soap solution has been admitted to pharmacopeias, not under the original name “Lysol,” but under descriptive names such as that in the United States Pharmacopeia--“liquor cresolis compositus.”--(_From The Journal A. M. A., Dec. 14, 1912._)

THOMPSON’S MALTED FOOD COMPANY

And Its Blood, Nerve and Tissue Builder, “Hemo”

During the past eighteen months The Journal has received inquiries from physicians in various parts of the country asking for information regarding “Thompson’s Malted Food Company” of Waukesha, Wis., which for some time has been selling and trying to sell its stock to physicians and others. In reply The Journal called attention to the fallacy of any concern trying to induce people to purchase its stock on the ground that the Bromo-Seltzer company, the Postum Cereal company and others had been successful.

The earlier name for the Thompson concern was “American Malted Food Company” and originally it had its office and factory in Milwaukee. Its products are “Malted Milk,” “Malted Beef-Peptone” and “Hemo.” As long ago as 1911 the company was sending out glowing descriptions of the money that might be expected to be made by investing in the concern, which was then known as the American Malted Food Company. According to the company’s booklet it was estimated that in the United States and Canada alone $20,000,000 worth of dry malt food products were consumed annually. Further:

“On the most conserving estimate the American Malted Food Company
will supply 5 per cent. of the demand or $1,000,000 of the
consumption from the very outset....”

At the time this was written (1911) the company claimed that its stock had “been advanced over 100 per cent. in one year’s time” and that even then it had “found it advisable to curtail the sale of stock so as not to exceed the prescribed number of shares to any one person.” In 1914, however, the company still had its representatives in the field offering stock for sale.

In November, 1913, one physician wrote that three years previously he had purchased stock in the company and _at that time_ (1910) was given to understand that dividends would be paid in at least a year! He has received no dividends to date. Other physicians have written that the company’s agents in attempting to sell stock have given the impression that the concern either is paying dividends or is about to pay dividends. Still other physicians say that the agents made no claim to them that the concern was paying dividends. To quote from a few of many letters together with the date of the communications:

“Alluring promises of big profits in the near future have been held
out by the canvassers....” (September, 1913).

“No actual promise was made but it was ‘estimated’ that dividends
would be declared ‘about the first of the year’” (November, 1913).

“After I said I wouldn’t buy any stock was told the company was
already paying dividends and I was turning down a good thing.”
(March, 1914).

“The agent gave me to understand that the profits of the company
were enormous and that large dividends would be paid in the near
future.” (March, 1914).

“Mr. ---- [the agent] told me the company expected to pay dividends
as soon as all the stock had been sold.” (May, 1914.)

“The agent gave me to understand that they were about to pay very
generous dividends and that it was a chance to get in on the ground
floor on a good thing.” (May, 1914).

The price asked for stock during the past year or more has been $1.50 a share, the par value of the stock being held at $1.00. At various times, however, the stock seems to have been purchasable from other sources at a much lower figure. A physician writing September, 1913, stated that he had just been solicited to purchase stock in the Thompson Malted Food Company at $1.50 a share, and that immediately he wrote to two firms, one in Chicago and one in Milwaukee, that sell unlisted securities, asking the price of Thompson’s Malted Food Company stock. Both brokers expressed the opinion, according to the physician, that at 90 cents a share the stock would be a “good buy,” and both offered to undertake to secure stock at that price. One of the concerns sent a circular to the physician offering the stock at 80 cents. The physician thereon canceled his order for stock which he had made at $1.50 and declared that if he bought at all he would buy from other sources.

HEMO

At the present time the product that Thompson’s Malted Food Company seems to be “pushing” is a product it calls “Hemo.” According to advertisements, Hemo is “the food that builds up weak stomachs.” Hemo, we are told, contains “the iron of spinach, the juices of prime beef, the tonic properties of selected malt in powdered form and the richest sweet milk.” Furthermore, “Hemo contains the active principle of selected barley malt ...”--whatever the “active principle” of barley malt may be.

According to the Thompson Malted Food Company “80 per cent. of the American citizens” are “troubled with anemia” and it is for them that “Hemo has been especially prepared.” In a sentence:

“It is a well-known fact that organic iron can be obtained from
animal life as well as from vegetable life, and as the digestive
organs of a majority of the people are not equal to the task
of supplying their bodies with a sufficient amount of organic
iron to maintain a supply of a good quality blood, the lack of
which results in numerous nervous ailments--insomnia, diabetes,
rheumatism, anemia, tuberculosis, etc., it has been found necessary
to secure for mankind organic iron in a form that will be
concentrated, palatable and most easily assimilated.”

This is a sample of the farrago of pseudo-scientific nonsense sent out by this concern in its attempt to sell “Hemo.” To continue the quotation:

“With this object in view, the laboratories of Thompson’s Malted
Food Company have successfully produced and successfully tried out
Hemo on the most desperate cases.”

In a letter addressed to a physician-stockholder, the statement is made: “Our Hemo-Malted Milk has never had and never will have an equal as a builder of blood, nerve and tissue ... it will build tissue, nerve and blood in less time than any other food heretofore known.”

Disregarding the question whether or not this is a stock jobbing scheme or whether the purchase of the stock is a good investment, there is another side to the matter. It must be evident that the public is not getting a square deal when physicians are financially interested in the products they prescribe for, or recommend to, the sick. Whatever the value of the Thompson products, the method of exploitation and the attempts on the part of the company to get physicians financially interested in its ventures, are to be deprecated. If laymen of a speculative turn of mind wish to invest in the stock of companies putting out “bottled energy,” “blood builders” and “nerve repairers” that is their business, but it is certainly neither conducive to the scientific practice of medicine nor to the interest of the public for physicians to be financially interested in products of this sort.--(_From The Journal A. M. A., Oct. 24, 1914._)

MANOLA

Physicians as Unpaid Pedlers of Nostrums

One of the most disheartening features of the fight against the proprietary evil within the profession is the slowness with which physicians awake to their responsibilities in the matter. It is a notorious fact, familiar to physicians against advertising men alike, that the simplest and cheapest way to introduce a nostrum to the public is through the instrumentality of the medical profession. Ever since the birth of the proprietary evil in this country, shrewd manufacturers have persuaded doctors to act as unpaid pedlers for their wretched nostrums and to become _particeps criminis_ in the exploitation of such wares.

Manola is an alcoholic nostrum with just enough more or less inert medicinal products added to exempt it from the internal revenue tax, but not enough to prevent its being used as a tipple by those who object to taking their “toddy” in a simpler form. It is prepared by the Luyties Pharmacy Company of St. Louis, a homeopathic concern whose hahnemannian leanings are not so strong but that it is willing to cater to the various sectarian schools of medicine as well as to the regular profession. Since the promoters realize, doubtless, that to put this stuff out under a homeopathic label might not be conducive to stimulating physicians’ confidence, Manola is labeled: “Prepared only by the Manola Company, St. Louis.” In other words, it is the old dodge of forming subsidiary companies for the purpose of hiding the identity of the real owners. In this connection, it is worth reminding our readers, incidentally, that the Walker Pharmacal Company, St. Louis, is another subsidiary concern of the Luyties Pharmacy Company, created for the purpose of pushing another nostrum--Hymosa.

Manola is seldom advertised in medical journals. Instead the Luyties Pharmacy Company has discovered a more effective method of “putting one over” on physicians and druggists. The method which has been pursued for years and which, under the same title and subtitle that head this article, was exposed in The Journal as long ago as May 6, 1905, consists in sending to physicians a letter containing three postcards--unstamped, of course. With the postcard there is a slip that reads:

INSTRUCTION FOR OBTAINING
3 BOTTLES OF MANOLA FREE

_Dear Doctor_: Fill out the attached cards Nos. 1 and 2. Mail No.
1 to _us_ and hand Nos. 2 and 3 to _your druggist_. Impress upon
him the necessity of mailing postal card No. 3 _direct_ to us, and
_not_ to his jobber.

Yours truly,
THE MANOLA COMPANY.

The postcards are numbered, respectively, 1, 2 and 3. Here is No. 1:

Dr Ezymark writes the name of his druggist on Card 1, puts a stamp on it and mails it to the Manola Company, alias Luyties Pharmacy Co.

Card 2, addressed to his druggist, also is filled out by Dr. Ezymark. Here it is:

Then the doctor, acting the part of errand-boy, delivers Card 2 and also Card 3 to his druggist. Here is Card 3:

This, Mr. Goat, the druggist, has to fill out, affix a stamp and send to the Manola Company. In return for all this, Mr. Goat has his shelves loaded up with a dozen bottles of Manola and, for that privilege pays $8 out of his own pocket. Dr. Ezymark gets three free bottles. Incidentally, he also gets the contempt of his druggist--and of such patients as learn of it.

The only one who profits by all this is the Luyties Pharmacy Co., alias the Manola Co., alias the Walker Pharmacal Company.

Evidently this method of exploitation pays; that it does pay is a disgrace to the medical profession. To those physicians who have in the past acted as pedlers for Manola we would say: If your patients really need sherry wine let them purchase it under its own name and at the ordinary market price. You will then know what they are getting and you will be able to retain not only your own self-respect but also the respect of your druggist and the public.

The Composition of Manola

Examination of Manola in the Association laboratory indicates that its composition is consistent with its origin, for its medicinal ingredients are present in truly homeopathic quantities. The laboratory report follows:

An examination of an original bottle of Manola gave the following
results:

Specific gravity at 25 C. 1.0329
Alcohol 18.00 per cent. by vol.
Non-volatile matter
(residue on evaporation) 15.93 gm. in 100 c.c.
Ash .96 gm. in 100 c.c.
Phosphoric pentoxid (P_{2}O_{5}) .0668 gm. in 100 c.c.
Total alkaloids .0047 gm. in 100 c.c.
Calcium Traces.
Magnesium Traces.
Iron Traces.
Sodium Traces.
Arsenic Traces.

Manola is a light amber colored liquid having the odor and taste of sherry wine. The above analysis indicates that it is nothing more than wine, fortified with alcohol and a slight amount of medicinal substances added. The non-volatile matter appears to be nearly all sugar, glycerin, or some similar substance and the presence of less than one gram of ash to 100 c.c. excludes the presence of more than a small amount of organic salts. From the amount of phosphorus found there appears to be about one dose of phosphoric acid to a twenty-ounce bottle. Arsenic is present in such small amounts that the ordinary hydrogen sulphid test failed to show its presence and the delicate Gutzeit’s test had to be used to detect it.--(_Modified from The Journal A. M. A., April 2, 1910._)

MERCOL

R. Hunt and A. Seidell, Washington, D. C., report the result of an examination of a preparation called Howell’s Mercol, manufactured by H. B. Howell & Co., Ltd., New Orleans, and claimed to be a 1 per cent. solution of mercuric iodid in a non-irritating neutral menstruum, and recommended for hypodermic use in the treatment of syphilis. Their examination indicates, as they say, “that although the manufacturers of Mercol may have used a mercuric iodid in its preparation, they have not succeeded in obtaining a 1 per cent. solution of this compound in their ‘non-irritating neutral menstruum.’ It is furthermore evident that the sample examined as above outlined contains none, or at most only traces, of biniodid of mercury.” It is stating it mildly to say that a manufacturer is careless who claims to make an efficient preparation of what is almost a specific for one of the most serious of diseases but which contains practically none of the essential active ingredient.--(_Abstracted from The Journal A. M. A., Jan. 16, 1909._)

The Component Parts and the Finished Product

After the appearance of the first article, a physician wrote stating he had seen Mercol manufactured, following the process in detail and had himself weighed out a sufficient quantity of mercuric iodid to produce a 1 per cent. solution. He protested that the firm “had no desire to foist on the medical profession or the public a fraud.” With his letter he sent a sample of the particular batch of Mercol which he had seen manufactured. This sample was analyzed with the same care and thoroughness that the previous sample had been, and the practical absence of mercuric iodid was again demonstrated. While The Journal does not question the honesty and good faith of either the manufacturers or the physician, it maintains that claims for remedial agent should be based on the finished product rather than on the component parts used in its manufacture. Without attempting to explain what has become of the mercuric iodid, it insists that the important fact, and the one that vitally concerns both patient and physician, is that the finished product fails to contain it. If the manufacturer has made an honest mistake in supposing he could produce a 1 per cent. solution of mercuric iodid in liquid petrolatum, he will doubtless see that the mistake is corrected. If, on the other hand, he is governed by commercial considerations only, the misrepresentation will probably be perpetuated.--(_From The Journal A. M. A., May 15, 1909._)

MIDOL AND NURITO

Pyramidon Entering the Patent-Medicine Field

Repeated warnings to the public of the dangers of acetanilid, antipyrin and acetphenetidin and the requirement in the Food and Drugs Act which makes it obligatory to declare the presence of acetanilid and acetphenetidin on the labels of “patent medicines,” have been responsible for the growing unpopularity of nostrums containing these drugs.

MIDOL

During the past few months advertisements have appeared in the newspapers of a new “headache cure,” the advertising slogan of which is that it “contains no acetanilid or phenacetin.”

The name of this preparation is Midol and it is sold under the following claims:

“Instantly relieves headache, neuralgia, toothache.”

“Has no depressing effect.”

“More effective than antipyrin, acetanilid, phenacetin or similar
pain-relieving products.”

“Midol is the one safe-to-take aid of sufferers of headache.”

“Quickly relieves pain of whatever nature.”

“There is no cumulative action.”

“No bad effect upon the heart or other organs.”

An original package of Midol was purchased and examined in the Association laboratory. The chemists’ report follows:

“Midol is sold in the form of white tablets each weighing, on an
average, 0.425 gm. or about six and one-half grains. The tablets are
soluble in water, chloroform or benzene to the extent of about 80 per
cent. The soluble portion appeared to be largely composed of starch,
with about 4.5 per cent. of some inorganic matter, probably talc. The
chloroform soluble portion was found to consist chiefly of pyramidon,
chemically known as dimethyl-dimethylamino-pyrazolon. Besides
pyramidon, the chloroform soluble matter contained a small quantity
of caffein and may have contained small amounts of other substances.

“From examination it is concluded that Midol depends essentially on
pyramidon for its therapeutic effect.”

Pyramidon is a proprietary preparation derived from, and having the antipyretic and anodyne properties of, antipyrin. While some observers have asserted that it is more likely to cause collapse than are either antipyrin or acetphenetidin there is no positive evidence of this assertion. That the use of pyramidon has been until recently practically restricted to physicians may account for the fact that its toxic effects are not as well known as are those of antipyrin, acetphenetidin, acetanilid, etc., which for some years have been indiscriminately used by the public. As the use of pyramidon as a “patent medicine” now bids fair to become as general as the better known antipyretics, it is probable that its toxicology will become better known.

It is interesting to note that pyramidon in the form of Midol is put on the American market by the General Drug Company, which also acts as a distributor of salvarsan (“606”). The General Drug Company is said to have for its president, W. M. Hoge, who was formerly employed in the comptroller’s office during the administration of Herman A. Metz, and the latter being employed by the Consolidated Color and Chemical Works and being president of Victor Koechl & Co. The General Drug Company, in its price list to physicians, lists the “ethical proprietary” pyramidon, but contains no mention of its “patent medicine” Midol.

NURITO

Midol is not the only “patent medicine” in which pyramidon is the essential drug. Nurito, which is advertised as “not a patent medicine but a proprietary preparation,” is a nostrum put on the market by the Magistral Chemical Co., New York. Here are some of the claims:

“Only U. S. P. ingredients are used in Nurito.”

“Guaranteed to relieve or your money refunded, Rheumatism,
Sciatica, Neuritis.”

“There is no compound known in medicine that so rationally,
scientifically and effectively removes waste and poisons from the
human system as Nurito.”

The Association’s laboratory recently analyzed a specimen of Nurito. The report follows:

A dollar-size package of Nurito was purchased and found to contain
seven powders. The powders ranged in weight from 9 to 12 grains, the
average weight being nearly 11 grains. The presence of pyramidon,
phenolphthalein and milk sugar was demonstrated. Alkaloids,
acetanilid, acetphenetidin, chlorids, bromids, iodids, heavy metals,
starch and sulphates were absent. Quantitative examination indicated
that the composition of Nurito is essentially as follows:

Milk sugar 34 per cent.
Phenolphthalein 6 per cent.
Pyramidon 60 per cent.

Each powder, therefore, contains about 2-2/3 grains of milk sugar,
2/3 of a grain of phenolphthalein and 6-2/3 grains of pyramidon.

What was said of pyramidon in the preceding article applies equally well here. The claim that Nurito is composed of “U. S. P. ingredients” is evidently a falsehood. The chief therapeutic ingredients are pyramidon and phenolphthalein, neither of which is described in the United States Pharmacopeia.--(_From the Journal A. M. A., Aug. 10, 1912._)

MU-COL

Salt and Borax as Wonder-Workers

“Mu-col, for Cleansing Mucous Membranes” is a nostrum put on the market by the Mu-col Company (Inc.), Buffalo, New York. As a specimen of the claims made for the preparation, the following is typical:

“Mu-col obtains most gratifying results in catarrhal inflammations
of the mucous membranes. Leucorrhea, Tonsillitis, Sore Throat,
Cystitis, Internal Hemorrhoids, Nasal Catarrh and Pus Cases respond
at once to irrigation with Mu-col solution. Strong solutions of
Mu-col have proven of sterling value in treating Hives, Prickly
Heat, Ivy Poison, Sunburn, Eczema, Typhoid and Scarlet Fever.”

This, and much more Mu-col will do--according to its manufacturers! No wonder physicians want to know the composition of Mu-col. As the manufacturers do not give this information the aid of the Association’s Laboratory was invoked. Let the chemists speak:

LABORATORY REPORT

“The specimen examined was a white powder, and from the odor,
thymol, eucalyptol, camphor and oil of wintergreen could be
recognized. Qualitatively sodium, chlorid and borate were found.
Zinc, benzoate, phenolsulphonate and sulphate could not be found.
The solution was alkaline to litmus. Gravimetric determination of
chlorid as silver chlorid and titration of borax by Thompson’s
method indicated sodium chlorid (NaCl) 47.2 per cent., sodium borate
(Na_{2}B_{4}O_{7}+10H_{2}O) 50.1 per cent.

“It thus appears that Mu-col is a mixture of ordinary salt and borax
in equal parts with the addition of a small amount of aromatic
substances.”

Mu-col will do just what a solution of salt and borax will do--no more, no less. And yet, it is claimed:

“Mu-col has been successfully used since the year 1900 by more than
50,000 physicians, which has proven it to be the most Efficient,
Economical and acceptable, preparation in its field.”--(_From The
Journal A. M. A., Feb. 7, 1914._)

NARKINE

The Intangible Product of the Tilden Laboratory

A little book, published by the _Druggists Circular_, and called “Modern Materia Medica,” gives in dictionary form the information regarding new remedies which that journal publishes in its monthly issues. Such information is not always acceptable to the manufacturers of various preparations of doubtful value. A case in point is brought to notice with reference to a remedy called Narkine, put out by the Tilden Company of St. Louis. In this little book the following appears:

“Narkine is described as ‘an opium preparation from which all
deleterious qualities have been eliminated’; an unsupportable claim,
as all opiates and other hypnotics are essentially deleterious.”

The Tilden Company wrote to the _Druggists Circular_, stating that they guaranteed Narkine “to be absolutely free from coal-tar or opium derivatives,” yet the “literature” of the company describes it as

“a specially prepared product of opium devoid of the nauseating and
disagreeable properties of this drug, yet possessing the anodyne
and soporific principles of same in the highest degree.”

To remove from opium all its derivatives and yet retain the anodyne and soporific principles attached to nothing in particular, indicates a degree of pharmaceutical skill seldom attained. One is irresistibly reminded of the Cheshire cat in “Alice in Wonderland,” whose smile remained long after the cat had vanished.

The absurdity of the thing, however, has apparently not occurred to many physicians, for these disembodied spirits of the pharmacologic world are evidently being prescribed.

The _Druggists Circular_ is to be congratulated on exposing this latest pharmaceutical freak. It does so in a rather striking manner by means of photographic reproductions of the claims of the Tilden Company.--(_From The Journal A. M. A., Oct. 24, 1908._)

PAPINE

A Disguised Morphin Solution

To the thinking physician it should be evident that a preparation containing morphin must possess not only all of the valuable properties of this drug, but also all of the objectionable ones. There are still some physicians, apparently, who give credence to the assertions of the manufacturers concerning the morphin preparation from which, it is claimed, all of the undesirable morphin effects have been removed. The following query from a correspondent illustrates this fact:

“Will you inform me as to the contents of ‘Papine’? I have a case of
chronic interstitial nephritis, and my consultant insists on giving
this preparation. I asked him if he knew what drugs it contained
and his answer was ‘one-eighth of a grain of morphin with the
objectionable parts of the drug removed.’”

The query was referred to the Association Laboratory, which submitted the following report:

For many years Papine has been advertised by its makers, Battle
& Company, St. Louis, as an anodyne. In the circulars Papine is
described in part as follows:

“Papine represents in pharmaceutical form the purely anodyne
principles of opium freed from the narcotic and tetanising
constituents.”

“Papine is the anodyne or pain-relieving principle of opium, the
narcotic and convulsive elements being eliminated. One fluid drachm
is equal in anodyne power to one-eighth grain of morphin.”

“Through special methods of preparation, the anodyne and analgesic
principles of _Papaver somniferum_ are so extracted as to free
them of the narcotic and convulsive elements that ever have been,
and must ever continue to be serious objections to the use of
opium and its common derivatives.... No demand is more regularly
made on the physician than that for the relief of pain, and to be
able to afford it promptly and completely, without the slightest
deleterious action, is an advantage that cannot be overestimated.”

“Unlike most derivatives and preparations of opium, Papine neither
nauseates nor constipates; nor does it inhibit the secretory
functions of the body.”

“In conditions of extreme nervousness, especially in women,
recourse to morphin is attended by the very real danger of the
formation of a habit. Lastly, opium and its alkaloids must not be
administered to persons whose kidneys are not in good working order
on account of the risk of toxic accumulation.”

“No such restriction exists in respect of Papine, its action being
exerted exclusively on the element pain; in other words, it is
purely anodyne.”

“Papine does not nauseate, constipate nor create a habit.”

From these statements the incautious physician might be led to infer that Papine is a preparation analogous or similar to the official tincture of deodorized opium. Formerly in the manufacture of the latter preparation, in addition to removal of the odorous substances, narcotin, then thought to be the principal convulsive alkaloid,[110] was also removed. By the process for the manufacture of this tincture, which is now official in the United States Pharmacopeia, most of the narcotine is found in the finished preparation. While it is a comparatively simple matter to remove the narcotin from opium and its preparations, thus eliminating most of the commonly reputed “convulsive elements,”[111] to remove the “narcotic elements” from opium would result in destroying the integrity of the product. The reasons for this are that morphin is the most powerful narcotic substance found in opium, and it is present in the largest proportion of any of the alkaloidal constituents. Its removal from an opium preparation would, therefore, render that preparation practically valueless.

[110] Narcotin is now known to possess very little physiologic effect.

[111] Of the opium alkaloids, laudanin and thebain possess the most powerfully tetanizing properties, but they are present in opium in too small quantities to produce any noticeable effect. Neither of these alkaloids is removed by the usual processes for “denarcotizing” opium.

From Papine, however, the morphin has not been removed, for _since the passage of the Food and Drugs Act_ the label has to admit that Papine contains 1 grain of morphin in each ounce!

A specimen of Papine was examined and found to be nothing more than a simple aqueous-alcoholic solution of morphin, containing glycerin. The preparation is flavored to imitate cherry and colored with cochineal. With the exception of morphin, neither narcotin, codein nor other opianic alkaloids were found, while meconic acid, a characteristic constituent of opium, was absent. Since Papine is claimed not to cause constipation, and as is well known, this condition is frequently produced by morphin, it seemed possible that Papine might contain laxative substances. On examination, however, no cascara, rhubarb, phenolphthalein or laxative salts were found.

While Battle & Co. have persistently exploited Papine as being an opium preparation having none of the objectionable qualities of opium, the analysis shows that the paradoxical claims made for it cannot be substantiated. In prescribing morphin there is an abundance of official preparations to choose from, and there certainly is no necessity or excuse for resorting to the much more expensive and in no way superior Papine.--(_From The Journal A. M. A., April 29, 1911._)

PASADYNE[AW]

[AW] See also report on Passiflora and Daniel’s Tincture, p. 156.

A physician asks: “Can you tell me the formula of a preparation on the market called Pasadyne, put up by John B. Daniel, Atlanta, Georgia?”

According to the manufacturer Pasadyne is a tincture of passion-flower. Formerly this nostrum was sold under the title “Daniel’s Concentrated Tincture of Passiflora Incarnata.” While the manufacturer claims marvelous virtues for this preparation, made from “the fruit, roots and vines of the passion-flower or May-pop,” passiflora (passion flower) is now generally recognized as being of little if any value.

A circular makes the following absurd statement:

Previous Next

Comments

The Propaganda for Reform in Proprietary Medicines, Vol. 1 of 2Chapter XXII: Part III: Contributions From the Journal: Nostrums (3)

0%36 min left in chapter