Chapter XIII: Introduction: The Council on Pharmacy and Chemistry was established (6)

MCARTHUR’S SYRUP OF THE HYPOPHOSPHITES COMP. (LIME AND SODA)

So far as the recent literature and trade package are concerned, no information as to the composition of this product is furnished beyond what is conveyed in the name. The advertising for McArthur’s Syrup, like that for Fellows’ Syrup and Peters’ Syrupus Roborans, has been modified as time has passed. A few years ago it was advertised under such claims as the following:

“... Has Stood the Test during many years for unequaled efficacy
in the treatment of Tuberculosis.... Indicated also as a Tonic and
Tissue Builder in convalescence from Fevers, in Nervous Diseases,
Rickets, Senile Debility and Bronchitis.”

“Its use is indicated in ... diseases of the chest, chronic cough,
throat affections, general debility, brain exhaustion, cholera
infantum and wasting diseases of children.”

At present no definite claims seem to be made for it; the manufacturers evidently find the magic name of hypophosphites sufficient to evoke the spell for which the advertisement writer’s aid was once sought. A testimonial contained in a circular which seems to be still used illustrates both the kind of aura which surrounds hypophosphites in the minds of physicians who are still living in the past, and the kind of logic which has made the reputation of this and many other equally worthless preparations.

“Just about six years ago I had a severe attack of La Grippe which
almost killed me. Left me with Asthma (Catarrh) and a severe cough.
Did not get out of the house for three months. Took over a dozen
bottles McArthur’s Hypophos.--came out all right and since then
worked hard, but last Fall took another cold, but worked on, used
McArthur’s Hypophos., am using it now, am on my 12th bottle.

“I have five or six patients whom I have put on McArthur’s
Hypophos., but I do not prescribe the single bottle, but
_wholesale_ no less than half dozen bottles. One patient is on
his 24th bottle with orders to get another half dozen and keep it
up all winter. I have given the same order to all (keep it up all
winter) and I myself intend to do the same, for with its use I have
lost no time--rain or shine I am doing my work. I know what it has
done for me and what it is doing for my patients.”

It would be hard to find a more characteristic example of the naïve mental processes of the simple folk who in all good faith write testimonials for worthless medicines. This well-meaning practitioner (a homeopath, by the way), because he “came out all right” after an attack of grip, returns all praise to McArthur’s Hypophosphites, which he has taken “wholesale.” Not the faintest doubt of the validity of his _post hoc ergo propter hoc_ argument seems to glimmer across his consciousness.

McArthur’s Syrup of the Hypophosphites is an irrational preparation. While its faults are fewer and less glaring than those of some other proprietaries, the circulation of such a testimonial as the one just quoted is sufficient of itself to cast suspicion on the product.

BORCHERDT’S MALT OLIVE WITH HYPOPHOSPHITES, MALTZYME WITH
HYPOPHOSPHITES AND MALTINE WITH OLIVE OIL AND HYPOPHOSPHITES

These preparations are now described in the appendix to New and Nonofficial Remedies. Borcherdt’s Malt Olive with Hypophosphites (Borcherdt Malt Extract Company, Chicago) is said to contain in each 100 c.c., 0.64 gm. each of calcium and sodium hypophosphites, with malt extract, olive oil and glycerine. Maltzyme with Hypophosphites (Malt-Diastase Company, New York) is said to contain, in each 100 c.c., 0.4 gm. each of calcium, sodium and potassium hypophosphites and 0.005 gm. each of iron and manganese hypophosphites, with maltzyme. Maltine with Hypophosphites (Maltine Company, Brooklyn, N. Y.) is said to contain in each 100 c.c., 0.64 gm. each of calcium and sodium hypophosphites and 0.42 gm. of iron hypophosphite, with maltine. Maltine with Olive Oil and Hypophosphites (Maltine Company, Brooklyn, N. Y.) is said to contain, in each 100 c.c., 0.6 gm. each of calcium and sodium hypophosphites, with maltine and olive oil. In general, no therapeutic claims are made for these mixtures so far as the hypophosphites are concerned. The addition of hypophosphites to such mixtures is irrational and, since it tends to perpetuate the hypophosphite fallacy, detrimental to sound therapeutics.

THE COUNCIL’S ACTION

The Council endorsed the conclusions of the work of Dr. Marriott referred to above, and noted: (1) that the therapeutic use of hypophosphites (except possibly in some cases as a convenient means of administering the positive element in the salt, as ammonium in ammonium hypophosphite or calcium in calcium hypophosphite) is irrational; (2) that the merits of each hypophosphite salt submitted for consideration under the foregoing exception must be judged individually, and (3) that Fellows’ Syrup of Hypophosphites, Peters’ Syrupus Roborans, Schlotterbeck’s Solution Hypophosphites of Lime and Soda, Robinson’s Hypophosphites, the Eupeptic Hypophosphites of Nelson, Baker & Co., and McArthur’s Syrup of the Hypophosphites are ineligible for inclusion in New and Nonofficial Remedies, and that Borcherdt’s Malt Olive with Hypophosphites, Maltzyme with Hypophosphites, Maltine with Hypophosphites, and Maltine with Olive Oil and Hypophosphites be deleted from the appendix of N. N. R. Of these preparations, all are in conflict with Rule 10; Fellows’ Syrup, Schlotterbeck’s Solution, Robinson’s Hypophosphites and Nelson, Baker & Co.’s Eupeptic Hypophosphites are in conflict with Rule 6; the Fellows, Schlotterbeck, and Nelson, Baker preparations are also in conflict with Rule 1.--(_From The Journal A. M. A., Sept. 2, 1916._)

PULVOIDS CALCYLATES

Report of the Council on Pharmacy and Chemistry

Pulvoids Calcylates 5 grains was submitted by the Drug Products Company, Inc., New York, under the following claims as to composition:

“When ingested represents the following chemical formulas:
OH)
C₆H₄ COO)₂ Ca.2H₂O + Sr.(C₇H₅O₃)₂ + 2H₂O.”

“Strontium Di-Salicylate 2-1/2 grs. and our especially prepared
Salt of Calcium and Acid Salicylic adjusted in such nascent form,
that these pulvoids upon ingestion will promptly form Calcium
Neutral Di-Salicylate 2-1/2 gr.”

“A combination of Calcium and Strontium Di-Salicylate, in seemingly
true chemical union.”

These statements are rather vague, possibly because they are an attempt to mystify. The product, however, may be assumed to be a mixture (not a chemical combination) of calcium salicylate and strontium salicylate. The therapeutic claims made for the preparation are:

“Superior to ordinary salicylates. Can be taken continuously
and indefinitely without gastric irritation, insuring maximum
efficiency.”

“Reports show surprisingly good results, even where the sodium salt
fails.”

As there is no evidence to show that strontium salicylate, calcium salicylate or a mixture of the two salts has any advantage over sodium salicylate, these claims cannot be accepted. The name and the statement of composition are objectionable in that they do not reveal the identity of the drugs in “Calcylates” and in suggesting that this preparation possesses radical advantages over salicylates in other forms.

The Drug Products Company was told that the facts just mentioned rendered “Pulvoids Calcylates” ineligible for New and Nonofficial Remedies. The company in its reply objected to the Council’s conclusions, and in support of its position submitted testimonials from a number of physicians. The reply of the company embodied no facts or arguments which had not been considered by the Council’s referee, and the testimonials from physicians contained no evidence to show that the combination has any real advantage over sodium salicylate.

The Council therefore declared “Pulvoids Calcylates” ineligible for New and Nonofficial Remedies for the following reasons: Unwarranted therapeutic claims are made for the mixture (Rule 6); the name does not describe the composition (Rule 8), and the mixture is an unessential modification of an established remedy (sodium salicylate) (Rule 10).--(_From The Journal A. M. A., Sept. 9, 1916._)

SULFURYL MONAL

Report of the Council on Pharmacy and Chemistry

Sulfuryl Monal is said to be manufactured by Monal Frères, manufacturing chemists of Nancy, France. It is sold in the United States by George J. Wallau, Inc., New York City. According to the label:

{Contains: Sulfuryl (combined polysulphurets)
{ = 0.35 centigr.”
“Each Pastille {
{Liberates: Nascent sulphurretted Hydrogen
{ = 2 cub. cent.”

The Chemical Laboratory of the American Medical Association was requested to check the amount of available hydrogen sulphid. An original bottle of Sulfuryl Monal was used; this contained tablets having the taste of licorice extract and an odor of hydrogen sulphid. The tablets were found to liberate about 6 c.c. hydrogen sulphid to each tablet.

Among the claims made for the preparation are:

“Dissolved by the saliva, Sulfuryl Monal reaches the stomach
where, under the influence of the gastric juice, it generates
nascent sulphuretted hydrogen. Professor Albert Robin’s remarkable
researches have proven that it is in the nascent state that drugs
produce the greatest effect with the smallest dose.... Being thus
eliminated by the entire respiratory tract: the lungs, bronchi and
the throat, the sulphurretted hydrogen passes from the interior to
the exterior, that is to say, goes right through these organs which
are, as a consequence, thoroughly cleansed, antisepticized and
freed of the pathogenic micro-organisms.... Then, again, part of
the sulphuretted hydrogen, liberated in the stomach, is eliminated
by the mouth and acts as an antiseptic and disinfectant of the
mucous membranes of the throat and mouth. Hence Sulfuryl Monal is a
perfect protective agent against contagious diseases.... Numerous
clinical tests have demonstrated its real efficacy in diseases of
the throat and of the respiratory tract: laryngitis, pharyngitis,
hoarseness, granulations, tonsillitis, colds, bronchitis, pulmonary
catarrh, asthma, emphysema, grippe, whooping cough, simple
and infectious pneumonia, and in the first stage of pulmonary
tuberculosis.”

The sulphids are practically ignored in modern textbooks. There is a rather extensive clinical literature on the subject, particularly in connection with sulphur waters; this, however, offers no good evidence for the therapeutic value of sulphids. Probably the tradition in their favor is largely due to the old popular idea that a disagreeable taste or odor is a mark of a good remedy.[95]

[95] Liquid Sulphur--Sulphume, J. A. M. A., Dec. 2, 1911, p. 1853.

When hydrogen sulphid is introduced into the body, the small amounts that appear in the expired air are insufficient for quantitative demonstration and it is highly improbable that the amount thus excreted has any germicidal action, or that enough is excreted in the lungs to cause irritation and a reaction. The claim that Sulfuryl Monal is “a perfect protective agent against contagious diseases” is unwarranted; the recommendation for its use in “simple and infectious pneumonia, and in the first stage of pulmonary tuberculosis” is dangerous and vicious. The Council declared Sulfuryl Monal ineligible for New and Nonofficial Remedies and authorized publication of this report.

[Editorial Note..--With one exception, this product does not appear to be advertised in medical journals. We find, however, in the gallery of nostrums that grace the advertising pages of the _International Journal of Surgery_, that Sulfuryl Monal has its place. According to an advertisement that has been running some months in this publication, “affections of the throat and respiratory organs respond promptly” to Sulfuryl Monal whose “effects are rapid and certain” even in “incipient tuberculosis.” This preposterous pronouncement is no worse than many others appearing in the same journal, but it is bad enough to indicate how uncritical must be the physicians who support--by subscription or contribution--publications that are still debasing scientific medicine.]--(_From The Journal A. M A., Sept. 16, 1916._)

MARK WHITE GOITER SERUM AND MARK WHITE IODINIZED OIL

Report of the Council on Pharmacy and Chemistry

The “Mark White Goiter Serum Laboratories” of Chicago asked the Council to consider its products “Mark White Goiter Serum” and “Mark White Iodinized Oil.” The “serum” was claimed to be an “antibody blood serum from a goat with thyroidosis” while the “Iodinized Oil” was said to contain “about 4 grains of iodin” to “each c.c.” The therapeutic indications for the treatment were given as:

“Simple or Exophthalmic Goiter, Hyperthyroidism-dosis, Thyrosis,
Thyroidosis, Thyrotoxicosis, Dementia.”

An ampule (2 c.c.) of the “serum” is to be injected into the thyroid to be followed one week later by an ampule (2 c.c.) of the “Iodinized Oil.” Repetition of this “treatment” once or twice a month is advised.

The Council asked for more specific information as to the composition of the remedies, particularly as to the preparation and nature of the serum; it also asked for evidence of the therapeutic value of the preparations. In reply, Mark White wrote:

“All that I can say regarding the serum is that it is made from the
blood of goats with thyroid affection, and it has been found that
the serum from these goats has antibodies which control, or has
curative effect upon thyroid affections when injected into thyroid
glands of either humans or animals. As to the iodinised oil, it
is only an adjunct or side treatment which is not always used or
indicated, and will only be furnished to the physician for use in
case in his judgment his patient needs it. We shall also advise the
use of quinin ... when indicated....”

The Council was referred for further information to a paper by Rachel Watkins, M.D., published in the _Illinois Medical Journal_. It is to be noted, incidentally, that the letterheads used by White in his correspondence bore in one corner the notation “Rachel Watkins, M.D., Practice Limited to Goiter and Other Disorders of the Thyroid Glands,” and in the other, “Mark White, Goiter Research.”

The information regarding the composition of this goiter treatment, as furnished in Dr. Watkins’ paper, was to this effect:

“The medical treatment consists of the administration of a blood
serum derived from a thyrodized goat. Formula: Iodine 0.16 grams
[according to a correction by Mark White, this should read 0.26
gm.], oil 0.25 c.c., serum q. s. 1 c.c.”

This description of the treatment differs from that furnished to the Council by Mark White in that here the iodin and oil appear to be combined with the serum. Dr. Watkins’ “formula” implies that the iodin is a routine medication, thus contradicting White’s statement, which, in turn, is at variance with the statements made in submitting the treatment.

The Council does not accept any biologic product until its sale in interstate commerce has been authorized by the secretary of the treasury in accordance with the federal law regulating the sale of viruses, serums, toxins and analogous products. The sale of the Mark White Goiter Serum has not been so authorized; consequently even if the preparation complied with other rules of the Council it could not be accepted.

In addition, however, this treatment conflicts with other Council rules. The statements regarding its composition are indefinite and contradictory (Rule 1); the evidence presented to support the therapeutic claims is insufficient in itself and does not appear to have been checked by any disinterested authority (Rule 6). Moreover, the recognized variation in the morphology and pathology of the types of goiter render it impracticable to treat cases of goiter by any routine procedure.

The foregoing report was submitted to the Mark White Goiter Serum Laboratory. In reply, a letter signed “Mark White, V.M.D.,” was received, which read, in part:

“... we hope at some future time to be able to give you more
detailed information, but as you possibly appreciate that we
have experienced for some time a demand on the part of many
physicians that we furnish to them our therapy, which necessitates
us furnishing it before all the detailed work has yet been
accomplished, and I trust that you will be so kind as to bear
patiently with us until we are better in a position to make a
complete scientific application and report to you.”

White wrote further:

“The serum and iodized oil may be mixed for immediate use, but
could not be put up only separate for the use of the profession and
the therapy furnished Dr. Watkins she mixed as used.”

This statement throws no light on the discrepancies in the statements with regard to the place of the iodinized oil in the treatment, namely: (_a_) the original statement that the oil was to be given a week after the serum; (_b_) White’s statement (quoted earlier in this report) that the oil “is only an adjunct or side treatment” and “is not always used or indicated”; (_c_) the statement in Dr. Watkins’ paper that the oil and the serum are given in combination.

The Council declared the Mark White Goiter Serum and Mark White Iodinized Oil ineligible for New and Nonofficial Remedies and authorized publication of this report.

Editorial Note on the Mark White “Serum”

As some of our readers will remember, on April 26, 1913, The Journal called attention to the Mark White preparation which at that time was being exploited from Denver. The Propaganda Department has in its files a number of letters sent out from the Mark White concern at various times. One mailed in May, 1911, on the embossed stationery of “The Mark White Goiter Institute,” Exchange Building, Denver, was evidently a general letter sent to physicians, calling their attention to “the most important medical discovery of the age.” “Dr. Mark White, a graduate of the University of Pennsylvania,” said the letter, had discovered “a simple and harmless remedy” that would cure goiter. “Because of the desire to preserve the secrecy of this remedy it is given only at the office here.” It was then suggested that the doctor might send those of his patients who were suffering from thyroidism to the “Mark White Goitre Institute.” If he would do so he would be “given a commission of $10, in cases of the $50 fee with the additional $5 for each $50 increase.” It closed with some casuistic arguments, presumably for the purpose of overcoming the physician’s scruples, summing up the matter with the statement:

“No right thinking man will allow a narrow and self-seeking system
of ethics to stand between him and his duty to the sick and
suffering.”

About 1912 the name of the concern seems to have been changed, for we have in our files a letter addressed to a layman on the stationery of the “Mark White Goitre Treatment Company.” According to this letterhead the product this concern had for sale was “Goitreine” discovered by Mark White, “President and General Manager.” Mr. White’s letter to the sufferer from goiter assured him that if he would take “Goitreine” he might “be practically sure of an immediate and permanent cure.” “Goitreine,” according to White, “has absolutely and permanently cured 90 per cent.” of all cases of goiter in which it has been used--“and the other ten showed remarkable improvement.” It was efficacious for all forms of goiter and “cannot possibly harm.”

The person who received this assurance might have had his confidence in it shaken had he seen a copy of the Denver _News_ for May 23, 1911, in which was reported a case of collapse and death in a woman following an injection given in White’s office. The paper stated that the death certificate was signed by one W. A. Gray and gave “fatty degeneration of the heart and goiter” as the cause of death. Gray, it seems, was the licensed physician employed by Mark White to administer “Goitreine”--if that is what White happened to be calling his product at that time. For here it may be stated, parenthetically, that Mark White is not a physician; he is a veterinarian.

In February, 1913, Mark White sent a circular letter to a number of medical publications with the request that it be printed in full in the next issue, “to cover one full page of space.” The letter White wanted printed was addressed to doctors offering to “enter into a copartnership agreement” with such physicians who would be willing to treat “patients with goiter affections on a 50 per cent. commission basis.”

“You would be expected to make a cash charge to the patient for the
treatment, remitting on the same day our 50 per cent. to us, when
ordering the treatment, giving the treatment in no cases for less
than $50.00.”

About the same time that Mark White made this “fifty-fifty” offer, he sent in an advertisement to be published in the classified column of The Journal. At that time he was told his advertisement was not acceptable; we now reprint it, however, free of charge. Here it is:

“WANTED--ONE OR MORE PHYSICIANS
in each vicinity to administer and represent our new medical
treatment for GOITER. Good margin of profit. Write for copy of
contract. The Mark White Goitre Treatment Co., Denver, Colo.”

In 1914, White moved to Chicago. At least the card which we reproduce so indicates. At that time, as will be seen, “Dr. Mark White” was “personally associated” with Peter S. Clark, M.D. According to the same card Dr. F. D. Paul of Rock Island, Ill., seems to have been his “associate” for that particular locality. In this connection, it is worth noting that a Rock Island paper, in one of its issues during July, 1913, devoted a good deal of space to “Dr. Mark White” who was at that time in Rock Island “directing Dr. Frank D. Paul in the administering of the treatment.” There was nothing to indicate that this notice was an advertisement or that the editorial appearing in the same issue puffing White’s “important cure,” was paid for.

Dr. W. A. Gray, who has already been mentioned as White’s associate in Denver, seems to have been doing business in Illinois some time in 1913 and a Princeton (Ill.) paper had some uncomplimentary things to say about him. Finally in July, 1913, this item appeared in a Princeton paper.

“Dr. W. A. Gray, the goiter specialist who operated last winter
at Princeton and Walnut until he became embroiled with Dr. Mark
White, a Denver veterinary and originator of the cure, over a
division of the spoils, has opened a goiter institute in Chicago
under his own name. Advertisements of the Dr. Gray Goiter Institute
appeared Sunday morning in the Chicago _Examiner_ and other morning
papers. Dr. Gray and Mark White broke off their relations after
their disagreement at Walnut, and Dr. Gray slightly changed the
ingredients of the goiter cure and started off on his own hook.”

One of Gray’s advertisements in Chicago newspapers made the claim that “Dr. Gray’s New Medical Treatment removes the cause of goiter in seven days.”

The Tulsa (Okla.) associate of “Dr.” White seems to have been Dr. J. H. Morgan and the Tulsa papers of June, 1914, tell of “Dr.” White’s visit to that city “for the purpose of instructing Dr. J. H. Morgan in the technique of his new medical treatment for nervous disorders and goiter.” Some months later--in December, 1915--the following little item appeared in a Tulsa paper:

“Dr. Mark White was found guilty in the county court yesterday of
practicing medicine without a license and was fined $50. Doctor
White is a goiter specialist.”

In September, 1915, Mr. Thomas S. Hogan, the efficient counsel for the Illinois State Board of Health, instituted action against Mark White for practicing medicine without a license. The case was tried Oct. 15, 1915, and the jury, after being out four hours, returned a verdict of “not guilty.” Attorney Hogan attributes the failure to obtain a conviction to the testimony of Dr. Rachel Watkins, who said she had a partnership arrangement with White in carrying on the medical business. It was about this time that Mark White seems to have issued some new letterheads. These bore in their upper left hand corner the device “Rachel Watkins, M. D., Practice Limited to Goiter and Other Disorders of the Thyroid Glands,” while the upper right hand corner read “Mark White, Goiter Research.”

On Dec. 9, 1915, Rachel Watkins, M. D., of Chicago, read a paper entitled “A Serum Treatment for Physiologically Defective Thyroids, With Clinical Reports” before the Stock Yards Branch of the Chicago Medical Society. The “serum treatment” discussed was Mark White’s “Goitreine” which, in the course of its checkered career, had lost its original name by the wayside. This paper appeared in the December, 1915, issue of the _Illinois Medical Journal_.

Probably emboldened by the ease with which a component part of the American Medical Association “fell for” a paper exploiting a “goiter cure,” Dr. Watkins requested that she be permitted to read a paper on the same subject before the Section on Pharmacology and Therapeutics at the Detroit meeting of the American Medical Association last June. The request was refused. Dr. Watkins is apparently no longer connected with White and in fact has protested against the use of her name by White in connection with his “goiter cure.”

[After the above was in type and ready for the pages of The Journal, attention was called to the _Official Bulletin of the Chicago Medical Society_ of Sept. 16, 1916. This _Bulletin_ contained a full page advertisement of the Mark White “goiter cure.” The advertiser referred to the preparation as having been “announced to the Chicago Medical Society” and declared it to be “an ethical therapeutic agent.” Mark White was described as “a medical research student” but no hint was given that he is a veterinarian. After again emphasizing that “this therapy is ethically proven” physicians were invited to “visit our goats when convenient” and the advertisement closed with the modest claim that “this thyroid therapy has equal curative therapeutic value in these cases as quinin in malaria.” And this sort of pseudo-scientific claptrap is presented to a presumably learned profession through its own official Bulletin--but what’s the use of commenting!]--(_From The Journal A. M. A., Sept. 23, 1916._)

KORA-KONIA

Report of the Council on Pharmacy and Chemistry

Kora-Konia is a “dusting powder” which at present is advertised to the medical profession through medical journals, circulars, post cards and sample packages. It is put out by the “House of Mennen,” which sells various toilet preparations such as talcum powder, shaving soap, etc. On the trade package is the statement:

“Indicated in the treatment of Acne, Dermatitis, Eczema Intertrigo;
in obstinate cases of chafing, prickly heat, nettle rash, chicken
pox, measles, scarlatina and irritations of the skin; as a soothing
absorbent and antiseptic dusting powder and as an umbilical
dressing.”

While a circular asserts that:

“Kora-konia is indicated in the treatment of acne, dermatitis,
eczema and eczematous conditions of the utmost severity,...
eruptive fevers,...”

What purports to be a physician’s testimonial reads:

“I used Kora-Konia in a new born case of inherited syphilis and the
eruption soon cleared up.”

Germicidal powers are claimed for Kora Konia in a medical journal advertisement. In view of the various claims made and the fact that it is advertised to the medical profession, the Chemical Laboratory of the American Medical Association was asked to analyze Kora-Konia. This was done and the chemists reported as follows:

LABORATORY REPORT

Kora-Konia is a white powder, slightly greasy to the touch. Qualitative tests showed the presence of boric acid, zinc, magnesium, a solid fatty acid and material insoluble in hydrochloric acid containing magnesium and aluminum. Starch was not found. Quantitative determinations gave the following results:

Acid-insoluble material (talc) 48.3 per cent.
Magnesium (Mg++) soluble in dilute acid 1.2 per cent.
Zinc (Zn++) 4.5 per cent.
Stearic acid (impure) 39.2 per cent.
Boric acid 3.0 per cent.
Carbon dioxide (CO₂)   1.5 per cent.

From this analysis it is concluded that Kora-Konia has essentially the following composition:

Zinc stearate U. S. P. 44 per cent.
Talc 48 per cent.
Magnesium carbonate U. S. P. 5.0 per cent.
Boric acid 3.0 per cent.

Essentially this dusting powder consists of the well-known substances talc and zinc stearate in about equal proportions to which small quantities of magnesium carbonate and boric acid have been added. Inasmuch as the claim is made, by inference at least, that Kora-Konia represents original investigation carried out “with the cooperation of the medical profession” it should be stated that the preparation of commercial zinc stearate was described and recommended as a dusting and toilet powder nearly twenty-five years ago.[96]

[96] Proc. Am. Pharm. A. =40=:488, 1892.

There is nothing new or original in any one of these substances or in the combination. The extravagant and unwarranted claims made for this simple dusting powder are undoubtedly leading the public as well as some thoughtless physicians, to place undeserved confidence in it. In view of the small amount of boric acid present in the powder, its antiseptic powers must be slight and its germicidal powers almost nil. The Council declared Kora-Konia ineligible for New and Nonofficial Remedies and authorized publication of this report.--(_From The Journal A. M. A., Sept. 30, 1916._)

THE THERAPEUTIC VALUE OF THE GLYCEROPHOSPHATES

Report of the Council on Pharmacy and Chemistry

The Council has adopted the following report and authorized its publication.

W. A. Puckner, Secretary.

Glycerophosphates are the salts of glycerophosphoric acid, H₂[C₃H₅(OH)₂]PO₄. This acid is produced by the interaction of glycerin and phosphoric acid. In general, only sodium glycerophosphate, Na₂[C₃H₅(OH)₂]PO₄ + 5-1/2H₂O, and calcium glycerophosphate, Ca[C₃H₅(OH)₂]PO₄ + H₂O, are used in medicine, though the glycerophosphates of lithium, potassium, manganese, magnesium, iron, quinin and strychnin are claimed as constituents of proprietary preparations. At a time when certain disorders were assumed to be due to a deficiency of phosphorus in the nerve structure in the body, glycerophosphates were introduced as “nerve foods” and “tonics” on the theory that they would be assimilated more readily than hypophosphites or ordinary phosphates. What led to this assumption was the fact that the lecithins, which form a part of the nerve structure, were known to contain the glycerophosphate radical in the molecule. The belief that inorganic phosphates cannot supply the body’s need of phosphorus is implied or expressed in most of the “literature” devoted to proprietary phosphorus preparations.

Thus, Schering and Glatz quote G. Meillière as saying that “the organism is incapable of assimilating inorganic forms of phosphorus.”

Again, when exploiters of glycerophosphates admit that the body can synthesize its phosphorus compounds from inorganic phosphates, they attempt to counterbalance the admission by contending that the use of organic compounds “spares” the system the necessity of making such synthesis. This assumption rests on the theory that the organic phosphorus compounds are absorbed and stored as such.

This theory is contradicted by evidence which has been presented[97] that the organic phosphorus compounds are split up into inorganic phosphates before absorption.

[97] McCollum and Hart, Grosser and Husler, Plimmer, and Bayliss and Plimmer, quoted by Marshall (Note 2).

The Council requested E. K. Marshall, Jr., to review the evidence for and against the therapeutic value of organic phosphorus compounds. Marshall’s study[98] brings out the following points:

[98] Marshall, E. K.: The Therapeutic Value of Organic Phosphorus Compounds, J. A. M. A., Feb. 13, 1915, p. 573.

1. In various tissues of the animal body, enzymes have been found which hydrolyze complex organic phosphorus compounds so as to liberate the phosphorus in the form of inorganic phosphates.

2. Metabolism studies of the phosphorus balance with diets containing inorganic phosphorus compounds, as compared with diets containing organically bound phosphorus, are somewhat conflicting in their results. The balance of evidence, however, is in favor of the view that there is no difference between organically combined phosphorus and inorganic salts with respect to the phosphorus balance.

3. Experiments indicate that the organism thrives on and supplies its phosphorus needs quite as well from inorganic phosphorus compounds as from organically bound phosphorus.

Marshall concludes:

“We see that the evidence is very convincing of the view that the animal organism can synthesize its complex organic phosphorus constituents from inorganic phosphates, and that organic phosphorus is of no more value as a food than inorganic.”

In view of this report, the Council deemed it advisable to take up the consideration of certain glycerophosphate preparations on the market. As the therapeutic claims are all similar, it is not necessary to quote them extensively.

TONOLS (SCHERING’S GLYCEROPHOSPHATES)

Tonols (Schering and Glatz, New York) comprise iron, lime, lithium, magnesium, manganese, potassium, quinin, sodium and strychnin “Tonols” or glycerophosphates; also Duotonol Tablets, said to contain equal parts of calcium and sodium glycerophosphates; Triotonol Tablets, each said to contain “Sodium Tonol 2-1/2 grains, Lime-Tonol 2-1/2 grains, Strychnine-Tonol 1/60 grain”; Quartonol Tablets, said to contain “Sodium and Lime-Tonols, each 2-1/4 grains, Quinine Tonol 1/2 grain, Strychnine-Tonol 1/200 grain”; Sextonol Tablets, said to contain “Sodium and Lime-Tonols, each 2 grains, Iron-Tonol, 1/2 grain, Manganese and Quinine-Tonols, each 1/4 grain, Strychnine-Tonol, 1/200 grain.”

The name “Tonols” is objectionable in that it is not only nondescriptive of the composition, but also therapeutically (and falsely) suggestive. The composition of the more elaborate Tonols is particularly unscientific; there is no justification for combining quinin, strychnin, iron, manganese, etc., in one formula.

PHOSPHORCIN COMPOUND

Phosphorcin Compound, called “The Elementary Phosphorus indicated in all forms of Nervous Diseases” and the “Perfect Formula,” is said to be manufactured by the Organic Products Company, Wetzlar an der Lahn, Germany, and Greenwich, Conn. It is sold in the United States by Eimer and Amend, New York, according to whom:

“Each two fluidrachms contain:
“Acidulated Bone Phosphor O. P. Co. 2 grains
“Calcium Glycerinophosphate, Merck & Co. 1-1/2 grains
“Magnesium Glycerinophosphate, Merck & Co. 1-1/2 grains
“Sodium Glycerinophosphate, Merck & Co. 2-1/2 grains
“Lactated Pepsin 2 grains
“Ignatia Extract 1/20 grain
“C. P. Glycerin (Special Process) O. P. Co. 50 per cent.

“Acidulated bone phosphor” presumably is acid phosphate of calcium. This formula is an unscientific shotgun combination.

ROBINOL

Robinol, manufactured by John Wyeth and Brother, Philadelphia, is called a “Universal Tonic.” It is said to be:

“A preparation of the glycerophosphates of lithium, calcium,
sodium, iron, manganese, quinine, with 1-16 gr. strychnine
glycerophosphate in each fluidounce.”

This is a semisecret preparation, since the quantities of most of the ingredients are not given and the vehicle is not named. This complex combination, too, is unwarranted.

PHOSPHOGLYCERATE OF LIME (CHAPOTEAUT)

This is said to be prepared by the Laboratories de Pharmacologie Générale, Dr. Ph. Chapelle, Paris and New York. It is sold in this country by E. Fougera and Co., Inc., New York. It is offered in several forms, especially in that of wine, which is called the “Medicinal Wine and Tonic Par Excellence.” The alcohol is no doubt the constituent to which this preparation is indebted for such popularity as it has attained, for it is much more freely advertised than the syrup, capsules or granulated form. The usual claims are made with regard to the efficacy of calcium glycerophosphate “during convalescence, in cases of enfeebled vitality, and nervous affections associated with an excessive elimination of phosphates.”

ELIXIR GLYCEROPHOSPHATES, NUX VOMICA AND DAMIANA

This is manufactured by Sharp and Dohme, Baltimore. The manufacturers’ statement of composition is:

“Each fluidounce represents Nux Vomica 8 grains, Damiana 64 grains,
combined with Glycerophosphates of Calcium and Sodium.”

“Alcohol 20 per cent.”

Sharp and Dohme call this mixture a “Reconstructive Nerve Stimulant, Aphrodisiac,” and claim that:

“Phosphorus in elemental form has long been prescribed under the
title of Elixir Phosphorus, Nux Vomica and Damiana, but due to the
rapidity of chemical change occurring in preparations containing
this form of Phosphorus, much of the Physiologic action is lost.
The Glycerophosphates present Phosphorus in its most available
form--the form in which it exists in the brain and nervous system.
They powerfully stimulate the functions of nutrition and are
rapidly assimilated by the system.

“Nux Vomica is a general Nerve Tonic. Damiana exerts a stimulant
effect upon the sexual appetite and function.”

The claim that the glycerophosphates may be substituted for elementary phosphorus is, at least, novel.

The elixir is an unscientific semisecret combination.

RECOMMENDATIONS

All of the preparations mentioned violate Rule 6 (unwarranted therapeutic claims). In addition, Robinol and Elixir Glycerophosphates, Nux Vomica and Damiana violate Rule 1 (secrecy of composition) in that not all the quantities of the ingredients are declared; Tonols, Phosphorcin Compound and Robinol violate Rule 8 (objectionable names). It is recommended that the Council endorse Marshall’s findings[98] and declare that Tonols (Schering and Glatz), Phosphorcin Compound (Eimer and Amend), Robinol (John Wyeth and Brother), Phosphoglycerate of Lime Chapoteaut (E. Fougera and Co.), and Elixir Glycerophosphates, Nux Vomica and Damiana (Sharp and Dohme) are ineligible for New and Nonofficial Remedies.--(_From The Journal A. M. A., Sept. 30, 1916._)

HYDRAS

Report of the Council on Pharmacy and Chemistry

Hydras, sold by John Wyeth and Brother, Philadelphia, is one of the many proprietary, so-called “uterine tonics.” It is said to contain “Cramp Bark, Helonias Root, Hydrastis, Scutellaria, Dogwood and Aromatics,” but as the amounts of the several ingredients are not given the statement regarding its composition is valueless. The label declares the presence of 24 per cent. alcohol.

The name “Hydras,” taken in connection with the statement of composition, would suggest that hydrastis (golden-seal) is an important constituent. The report of the Chemical Laboratory of the American Medical Association, however, indicates that hydrastis is present in unimportant amounts:

“The hydrastin content of Hydras was determined by extraction with immiscible solvents (_Pharm. Review_, May, 1908, p. 132). Twenty-five c.c. was found to yield an alkaloid residue of 0.0160 gm. The preparation contains, therefore, not more than 0.064 gm. ‘hydrastin’ per 100 c.c. Inasmuch as hydrastis is required to contain about 2.5 per cent. ‘hydrastin,’ hydras contains an equivalent of not more than 2.56 gm. hydrastis (golden seal) in 100 c.c. and the stated dose of Hydras--one dessertspoonful (8 c.c.)--represents not more than 0.2 gm. or 1/10 of the U. S. P. average dose of hydrastis.”

The label of a recently purchased bottle of Hydras bears the following recommendations for its use:

“Indicated in treatment of Dysmenorrhea, Menorrhagia Anti-Abortive,
with anodyne and tonic properties.”

“For dysmenorrhea, suppressed menses, etc., a dessertspoonful three
times daily, before or after meals.”

“To relieve pain due to uterine disorders, a dessertspoonful every
three hours, or increased to a tablespoonful, at the discretion of
the attending physician.”

A circular wrapped around the bottle declares that Hydras is:

“A valuable preparation to the physician in the treatment of
dysmenorrhea, colic, cramps, spasm, palpitation incident to
pregnancy, and the various pains resulting from diseases of the
female sexual organs.”

It is further claimed that:

“In the dysmenorrhea of young girls due to some mechanical
difficulty, as anteflexion or of a congestive character, of
suppressed menses from exposure to cold and other causes of
a similar character, Hydras will prove efficient and can be
administered freely without danger.”

The value of hydrastis in the treatment of the diseases and conditions mentioned is problematical at best, and the small amount present in Hydras is wholly useless. As for the other constituents, cramp bark (_Viburnum opulus_), helonias (false unicorn--_Chamælirium luteum_ or _Helonias dioica_) and scutellaria (skullcap--_Scutellaria lateriflora_) are drugs which are practically ignored by most writers on materia medica and therapeutics.[99] Dogwood (_Cornus florida_) is a mildly astringent aromatic bitter for the use of which there is no scientific evidence.[100]

[99] See reports of the Council, J. A. M. A., Jan. 9, 1915, p. 165; Jan. 23, 1915, p. 359; Nov. 27, 1919, p. 1836; March 27, 1915, p. 1093.

[100] See Reports Council Pharm. and Chem., 1912, p. 36.

To sum up: Of the five ingredients of Hydras (aside from alcohol and aromatics), one (hydrastis), which apparently gives the preparation its name, is present in unimportant amounts; three (cramp bark, helonias and scutellaria) are therapeutically unimportant; the fifth (dogwood) has never been shown to have any specific action on the uterus. The potent constituent, therefore, appears to be the alcohol.

But, even if every one of the several drugs said to be contained in Hydras were possessed of distinct therapeutic properties, and if each were present in known and therapeutically active amounts, still the combination in fixed proportion would be irrational. No one could foresee the joint effect of the five drugs in the several conditions for which the mixture is advertised. Hydras is evidently meant to appeal to the thoughtless and to be used at random; witness the suggestion made in the advertising that

“Owing to its palatability, it is acceptable to patients with
impaired digestion, and will serve as a stomachic tonic, promoting
appetite and digestion.”

A useless alcoholic nostrum “administered freely” to women and girls is as dangerous as the recommendation for such administration is reprehensible.

This preparation is semisecret. The recommendations for its use in specified diseases which appear on the label and in the advertising accompanying the bottle are sure to lead to its ill-advised use by the public. The claims made for its curative properties are exaggerated and unwarranted. The name, in view of the small content of hydrastis, is misleading. Finally, the combination of five drugs, even if individually they were of therapeutic value, is irrational. Hydras, consequently, is inadmissible to New and Nonofficial Remedies for conflict with Rules 1, 4, 6, 8 and 10, and publication of this report is authorized.

[Editorial Comment.--Products like “Hydras” are the bane of scientific medicine. The physician who prescribes them could with just as much reason prescribe any of the various alcoholic “patent medicines” of the “women’s tonic” type. In fact, his patients would be running less risk of contracting the alcohol habit if he prescribed the “patent medicines,” as these nostrums usually have less alcohol than is contained in their “ethical” prototypes--and alcohol is the only really important drug in practically all of them. Whatever one may think of reputable pharmaceutical houses who put out products of the “Hydras” type, the fault really lies with the profession which tolerates such therapeutic monstrosities.]--(_From The Journal A. M. A., Oct. 7, 1916._)

BROMIN-IODIN COMPOUND

Report of the Council on Pharmacy and Chemistry

“Bromin-Iodin Compound,” according to the Bromin-Iodin Chemical Company, San Diego, Calif., has the following “formula”:

Iodin Gr. 1
Bromin Gr. 1/4
Phosphorus Gr. 1/100
Thymol Gr. 2/3
Menthol Gr. 2/3
Sterilized Oil Gr. 1

The only statement regarding its method of preparation is the line “Solution in Cod Liver Oil, Norwegian.” According to the promoters, “Bromin-Iodin” is:

“A Powerful Anti-Tubercular Agent for Hypodermic Use in Pulmonary
and Laryngeal Tuberculosis. Useful in other forms of Tubercular
Diseases, and in Non-Tubercular Pulmonary Diseases of a Sub-Acute
or Chronic Nature.”

The “formula,” in the form in which the manufacturers publish it, is either impossible or meaningless, according to the interpretation that may be given. It is impossible if it is intended to indicate the actual composition of the product because that would mean that the oil is alleged to contain free or uncombined iodin, bromin and phosphorus. Both on theoretical grounds and also in the light of the findings of the Chemical Laboratory of the American Medical Association, it is not possible that all these constituents can be present in the free state. The formula is meaningless if it is intended to convey the idea, merely, that iodin, bromin, phosphorus, thymol, menthol and sterilized oil are combined to form “Bromin-Iodin.” In the absence of any details of the method of manufacture, it is futile to attempt to pass judgment on the actual composition of the preparation.

The use of an almost identical product (said, however, to contain only 1/2 grain iodin to each fluidram) was described in 1908 by Dr. Ingraham of Binghamton, N. Y., in “Five Years Successful Experience with a Special Mode of Treating Pulmonary Tuberculosis.” In 1910 The Journal[1] characterized the preparation as “one of the innumerable ‘treatments’ for pulmonary tuberculosis that have arisen, had their day and, more or less gracefully, retired.” If the preparation had value for the purpose for which it is recommended, its use during these twelve years should have secured its general recognition. There is no satisfactory evidence of its therapeutic efficacy. The Council refused recognition to Bromin-Iodin Comp. and, after submitting this report to the Bromin-Iodin Chemical Company, authorized its publication.--(_From The Journal A. M. A., Dec. 23, 1916._)

AMMONIUM HYPOPHOSPHITE OMITTED FROM N. N. R.

Report of the Council on Pharmacy and Chemistry

Ammonium hypophosphite was admitted to New and Nonofficial Remedies in 1908 as a preliminary step in the consideration of a preparation containing it--“Gardner’s Syrup of Ammonium Hypophosphite”--because the Council standardizes unofficial products before considering preparations or mixtures of these.

The therapeutic use of hypophosphites being irrational (see, “The Hypophosphite Fallacy,” Report of the Council on Pharmacy and Chemistry, The Journal, Sept. 2, 1916, p. 760), the salt, ammonium hypophosphite, deserves continued recognition only on condition that this salt of ammonium is superior to other salts from which may be obtained the effect of the ammonium radical. It has been claimed that ammonium hypophosphite has a less objectionable taste than other ammonium salts used for similar purposes. This claim would merit serious consideration if in addition to being less objectionable to the taste, the effects of ammonium hypophosphite were equal to or more desirable than the official ammonium salts. There is no evidence that this condition is met by the hypophosphite salt.

Ammonium hypophosphite has long been known, yet it is not official in the Austrian, Belgian, British, French, German, Hungarian, Italian, Swedish, Swiss or United States Pharmacopeias. Neither is it mentioned in the leading textbooks on materia medica, pharmacology or therapeutics. In short it appears to be an instance of an obscure and superfluous salt selected for proprietary exploitation.

Since the continued recognition of ammonium hypophosphite would tend to perpetuate the hypophosphite fallacy, and because there is no evidence supporting its advantage as a means of securing the effect of ammonium salts the Council directed its omission from New and Nonofficial Remedies.--(_From Reports of Council on Pharmacy and Chemistry, 1916, p. 51._)

ALPHOZONE OMITTED FROM N. N. R.

Report of the Council on Pharmacy and Chemistry

The following advertisement appeared in the _New Idea_ (September, 1916), a house organ of Frederick Stearns & Co., the proprietors of Alphozone:

In the light of our present knowledge the claim that Alphozone is a preventive of infantile paralysis is without warrant and the advice that the public depend on it for this purpose is reprehensible and dangerous. Therefore, the Council directed that Alphozone be omitted from New and Nonofficial Remedies.--(_From Reports of Council on Pharmacy and Chemistry, 1916, p. 50._)

CALCIUM GLYCEROPHOSPHATE AND SODIUM GLYCEROPHOSPHATE
OMITTED FROM N. N. R.

Report of the Council on Pharmacy and Chemistry

Calcium glycerophosphate and sodium glycerophosphate were accepted for New and Nonofficial Remedies chiefly in order that these products might be standardized. These mixtures now being defined in the new edition of the U. S. Pharmacopeia, this reason for including them in N. N. R. no longer exists. The report of Marshall (The Journal, Feb. 13, 1915, p. 573) which has the endorsement of the Council (The Journal, Sept. 30, 1916, p. 1033) shows that organic phosphorus compounds are split up into inorganic phosphates before absorption, that the animal organism can synthesize its complex organic phosphorus constituents from inorganic phosphates and consequently that the glycerophosphates, so far as their phosphorus value is concerned, are not superior to other phosphates. In fact, sodium and phosphate are more effectively administered as neutral or acid phosphate. It is evident that sodium glycerophosphate is a superfluous pharmaceutical preparation, particularly when the difficulty of obtaining a pure product and its high price is considered. So far as its calcium value is concerned, calcium glycerophosphate has no advantages over such calcium salts as the carbonate, phosphate, lactate, or chlorid. In view of the foregoing, the Council directed that sodium glycerophosphate and calcium glycerophosphate be omitted from New and Nonofficial Remedies.--(_From Reports of Council on Pharmacy and Chemistry_, 1916, p. 52.)

GARDNER’S SYRUP OF AMMONIUM HYPOPHOSPHITE OMITTED FROM N. N. R.

Report of the Council on Pharmacy and Chemistry

In recognition of the considerable revision of the therapeutic claims made by the manufacturer, Gardner’s Syrup of Ammonium Hypophosphite was retained in New and Nonofficial Remedies, 1916, and the proprietor advised of this provisional retention.

In the most recent advertising for this ammonium hypophosphite syrup the claim is made:

“Besides being an active expectorant Syrup of Ammonium
Hypophosphite (Gardner) is useful as an alterative and resolvent
and by virtue of its phosphorus element, which is in the form of a
hypophosphite, PH₂O₂, has a tonic value.”

As detailed in the report of the Council “The Hypophosphite Fallacy” (The Journal, A. M. A., Sept. 2, 1916, p. 760) careful studies show that the hypophosphites are devoid of the “alterative” and “tonic” actions claimed by the manufacturer of Gardner’s Syrup of Ammonium Hypophosphite. Accordingly the Council voted to omit Gardner’s Syrup of Ammonium Hypophosphite from New and Nonofficial Remedies and authorized publication of this report.--(_From Reports of Council on Pharmacy and Chemistry, 1916, p. 55._)

GLUTEN PRODUCTS MADE BY THE KELLOGG FOOD COMPANY

Report of the Council on Pharmacy and Chemistry

For over two years the Council has had under consideration certain products offered for the use of diabetics by the Kellogg Food Company of Battle Creek, Mich. These are:

Pure Gluten Biscuit.
Pure Gluten Meal.
40 per cent. Gluten Biscuit.
40 per cent. Gluten Flour.
40 per cent. Gluten Meal.
20 per cent. Gluten Meal.

The Council found these products ineligible for New and Nonofficial Remedies because the statements of composition (particularly of starch content) were insufficient and because the exploitation of the products to the laity was objectionable. June 21, 1915, the company promised to place a statement of the starch content on the package of each gluten product, to place on the gluten flour sacks a caution that diabetics use the flour only on the advice of their physicians, and to revise its advertising in accordance with the suggestions of the Council. Nothing further having been heard from the company, in April, 1916, specimens of the product were obtained, through a layman, direct from the Kellogg Food Company. These specimens, together with the advertising matter received at the same time, and also a letter of advice from the company to another layman, were sent to the Council’s referee, whose report follows. As will be seen, the referee finds that the amounts of carbohydrates contained in Pure Gluten Flour, 40 per cent. Gluten Flour and Pure Gluten Meal are greater than the amounts claimed in the company’s published analyses; that in the two first mentioned the amounts of protein are less than the amounts claimed; that exaggerated claims are made on all the labels and in the advertising literature, and that the company prescribes directly to the patient.

The following report was sent to the Kellogg Food Company for consideration. In reply the firm stated that a revision of its advertising was under consideration but would make no statement as to how soon this revision would be carried into effect. As the consideration had already consumed two years, the Council decided to give the profession the facts and authorized publication of the report. At the same time the Kellogg Food Company was advised that its products would be considered further whenever any submitted evidence warranted this.

W. A. Puckner, Secretary.

Referee’s Report

I submit herewith my report on certain foods offered by the Kellogg Food Company for the use of diabetics. I shall discuss these products from the standpoint of the claims made on the label, from the standpoint of the company toward nonmedical treatment as revealed in a letter to a layman, and lastly, on the basis of the claims made for the foods in the company’s literature.

CLAIMS MADE ON THE LABEL

PURE GLUTEN BISCUIT
Referee Company
Water 8.30 5-10
Ash 2.04 1-2
Protein (N × 5.7) 73.87 75-80
Fiber 0.12 2.4-3
Carbohydrates 14.84 0-5
Fat 0.81 0.25-0.70
Starch 4.02 0-5

The sample analyzed does not contain the amount of protein claimed for it. It also contains more starch than one might suspect from the company’s analysis. A more conservative claim would be “starch less than 5 per cent.” The company makes the error of using the terms “starch” and “carbohydrates” as synonymous. If the maximum figures of the company’s analysis are used, the carbohydrates would amount to 5 per cent., whereas I find 14.84 per cent. The claim on the label “Guaranteed to contain less than 5 per cent. of carbohydrates” is incorrect. The next claim, “Each ounce of this gluten contains 23 grams of protein and represents 95 calories” is approximately correct, as my analysis shows 20.9 grams of protein and 103 calories.

The following remarks under “Vegetable Proteins” are in my judgment exaggerated:

“Leading authorities are now agreed that meat, fish, eggs and
other animal proteins are greatly inferior to vegetable proteins
in diabetes, often increasing the sugar output and the dangerous
acidosis which leads to diabetic coma.... After many years of
experimentation, we have succeeded in perfecting a process whereby
the carbohydrates are excluded.”

In this connection, von Noorden, whom the company constantly quotes, says:

“In the slighter forms (of diabetes), the influence of meat
albumins is not great and it is difficult to demonstrate the
reaction of the patient to different forms of albumin. It may be
necessary to add more albumin than the patient can actually take
before glycosuria indication is reacted.... Once a medium amount of
albumin is exceeded, say 70 to 80 grams, the glycosuria increases,
no matter what the type of albumin is.”

My analysis also shows that the carbohydrates are not excluded from this food as claimed above.

40 PER CENT. GLUTEN BISCUIT
Referee
Water 8.50
Ash 1.48
Protein (N × 5.7) 41.15
Fiber 0.08
Carbohydrates 47.81
Fat 0.98
Starch 36.98

No analysis is supplied by the company, but this may be called properly a “40 per cent. Gluten Biscuit.” The company claims, however, that this is “Best for Diabetics,” which is not true.