CINERARIA MARITIMA
Report of the Council on Pharmacy and Chemistry
Occasional inquiries in regard to the therapeutic value of Cineraria maritima caused the Council to consider the drug with reference to its fitness for inclusion in N. N. R. among non-official, non-proprietary remedies. The following report, having been submitted to the Council by a subcommittee, was adopted and its publication authorized.
W. A. Puckner, Secretary.
To the Council:—The juice of a plant referred to as Cineraria maritima was at one time supposed to be of value in the treatment of cataract and certain other affections of the eye. No scientific evidence is available to show that the drug is therapeutically active, and its value is no doubt correctly estimated by Dr. Casey Wood, who (“Ophthalmic Therapeutics,” p. 446; Cleveland Press, Chicago, 1909) says:
“Still, a few respectable names have been associated with its [Cineraria maritima] employment in that capacity and it only remains to be said that the instillation into the conjunctival sac of a preparation of this or any other member of the Senecio family has about as much effect on the resolution or dispersal of opacities due to organic changes in the lens as pouring the same down the back of the patient’s neck!”
The plant from which Cineraria maritima juice is claimed to be prepared is commonly referred to in literature as Cineraria maritima, but is more correctly described as Senecio cineraria, D. C.
It may be considered a matter of indifference whether a remedy like this be advertised for the treatment of such diseases as cataract, providing its application could do no harm, but it must be remembered that it is recommended also for other diseases of the eye in which its use, by postponing efficient treatment, would be the means of serious damage or even loss of vision.
Since there is no evidence to show that this drug is of any therapeutic value, it is recommended that it be not admitted to the list of non-official, non-proprietary remedies in N. N. R., and that the Council formally expresses its opinion that the drug, as judged by the evidence which is available, is without value in the treatment of cataract or similar diseases of the eye.
[Editorial Comment.—Cineraria maritima would long since have been relegated to the limbo of discarded and discredited drugs had it not been given a semiproprietary character by a St. Louis nostrum house—the Walker Pharmacal Company—which, like the Manola Chemical Company, is, we understand, practically a subsidiary concern of the Luyties Homeopathic Pharmacy Company. The Walker concern exploits this drug under the name Succus Cineraria Maritima (Walker). Its method of exploitation consists in publishing testimonials, which it dignifies with the name “clinical reports,” from men whom it designates as “representative physicians.” As indicative of what constitutes representative physicians, we find that of the seven testimonials given in their pamphlet the names of three of the signers are not to be found in any medical directory.
The exploitation of Succus Cineraria Maritima (Walker) is the oft-repeated story of the resurrection of discarded and worthless drugs for the purpose of creating proprietorship in a nostrum. Cineraria maritima is worthless; its therapeutic value is nil. By the prodigal use of printers’ ink, the medical profession—and through it the public—has been humbugged into believing that it possesses curative value.]—(From The Journal A. M. A., Nov. 11, 1911.)
HAGEE’S CORDIAL OF THE EXTRACT OF COD LIVER OIL COMPOUND [I]
Report of the Council on Pharmacy and Chemistry
This is one of the “oilless” cod liver cordials. Like other manufacturers of such extracts, the Katharmon Chemical Company, St. Louis, which owns Hagee’s Cordial, attempts to trade on the reputation long enjoyed by cod liver oil as a promoter of growth and nutrition. The following is the statement of composition furnished by the company:
“Each fluid ounce of Hagee’s Cordial of the extract of Cod Liver Oil Compound represents the extract obtainable from 1⁄8 fluid ounce of Cod Liver Oil (the fatty portion being eliminated), 6 grs. Calcium Hypophosphite, 3 grs. Sodium Hypophosphite, 1⁄2 gr. Salicylic Acid (made from Oil Wintergreen), with Glycerin and Aromatics.”
And here are some of the therapeutic claims:
“Tonic, Stimulant, Alterative, Reconstructive, Nutritive and Digestive.”
“Useful in phthisis pulmonalis, scrofula and all chronic pectoral complaints, coughs, colds, brain exhaustion, nervous debility, palsy, chronic cutaneous eruptions and impaired digestion.”
Of course, these absurd claims hark back to the time of the prevalence of the now discarded theory that the valuable properties of cod liver oil reside, not in the fat, but in certain nitrogenous, alkaloid-like constituents present in infinitesimal amounts. Further “playing up” this theory:
“The prescriber may know that in our preparation he is getting, in easily assimilable and palatable form, the very properties that make cod liver oil the best of reconstructives.
“When you prescribe cod liver oil you are after the active principles—why not give the active principles themselves.”
Proprietary manufacturers usually ignore scientific investigations which establish facts adverse to proprietary claims; but the same proprietary manufacturers are quick to seize on any theory that can be twisted into support of their interests. Thus, recent investigations having shown that cod liver oil, like butter and egg yolk, possesses certain growth-promoting properties not found in some other fats, the promoters of Hagee’s Cordial claim these properties of cod liver oil for their extract. They assert:
“Recent Chemical Investigations of Cod Liver Oil show that the active principles contain the nutritive qualities attributed to the whole oil.”
The Council has previously expressed the opinion[19] that the preponderance of evidence indicates that whatever therapeutic value cod liver oil may have depends chiefly, if not entirely, on its fat (oil). There never was any evidence or scientific authority for the theory that the therapeutic value of cod liver oil was independent of its fat content. The fact that the fat is the growth-promoting element has already been shown, and J. P. Street, chemist for the Connecticut Agricultural Experiment Station (The Journal A. M. A., Feb. 20, 1915, p. 638), in a series of experiments on a number of the so-called extracts of cod liver or cod liver oil (including Hagee’s Cordial) has conclusively demonstrated that the growth-promoting properties of the oil are not to be found in the extracts. Street placed rats on a ration not sufficient to maintain normal nutrition and growth for an extended period. After the rats had been on this ration for some time and a failure to maintain weight was indicated, an amount of dealcoholized Hagee’s Cordial was substituted for a portion of the lard contained in the ration. Later Hagee’s Cordial was replaced by cod liver oil.
Street says:
“None of the four rats did well on Hagee’s Cordial; in fact, they lost 1.2 to 15.4 gm. during feeding periods of from seven to fourteen days.”
“The rats failed so quickly when put on Hagee’s Cordial that in two cases the animals did not recover even when put on the full cod liver oil ration.”
“... the four rats during the Hagee period, instead of gaining the normal 24 gm., actually lost 36.2 gm., while during the cod liver oil period instead of gaining 114 gm., they gained 156.4 gm.”
“The inferiority of Hagee’s Cordial as a reconstructive and a nutrient compared with ordinary cod liver oil is apparent.”
Hagee’s Cordial of the Extract of Cod Liver Oil Compound has neither the nutritive qualities nor the reconstructive efficacy of cod liver oil. This mixture is worthless for the conditions for which it is advertised, and is marketed under misleading and unwarranted claims. It is recommended that Hagee’s Cordial be held ineligible for New and Nonofficial Remedies.—(From The Journal A. M. A., April 10, 1915.)
WAMPOLE’S PERFECTED AND TASTELESS PREPARATION OF AN EXTRACT OF COD LIVER [J]
Report of the Council on Pharmacy and Chemistry
Wampole’s Preparation is another of the oil-free “extracts” of cod liver. The following formula (which, be it observed, is non-quantitative and therefore practically worthless) is published by the owners, Henry K. Wampole & Co., Inc.:
“Contains a solution of an extractive obtainable from fresh cod livers, the oily or fatty portion being afterward eliminated. This extractive is combined with Liquid Extract of Malt, Fluid Extract of Wild Cherry and Compound Syrup of Hypophosphites (containing Calcium, Sodium, Potassium, Iron, Manganese, Quinin and Strychnin).”
An alcohol content of 17 per cent. is declared on the label. The following claims are typical of those made for the preparation:
“This grease, or oil, is not present in Wampole’s Preparation of the Extract, which is palatable and, at the same time, very efficient as a stimulant to the centers of nutrition and assimilation. It is unsurpassed as a reconstructive tonic ...”
“[Cases] with a marked tendency to pulmonary troubles,... if a timely impulse be given them will easily shake off the impending evil. Wampole’s Preparation gives that timely impulse ...”
In the Council’s opinion, as previously expressed,[20] such therapeutic value as there may be in cod liver oil is chiefly, if not altogether, due to the fat (oil). Lately, the investigations of J. P. Street of the Connecticut Agricultural Experiment Station have definitely disproved the claims made for the Wampole’s and similar preparations. In Street’s experiments, rats were placed on a ration insufficient for normal nutrition and growth. After the rats had been on the ration for a time long enough for inability to maintain weight to become evident, dealcoholized Wampole preparation was substituted for a portion of the lard contained in the ration. Later the Wampole preparation was replaced by cod liver oil. From these experiments it appears that, although the Wampole preparation is said to contain malt extract and sugar, it does not show the advantage over ordinary cod liver oil as a source of nutriment which is claimed for it by the manufacturers. Street emphasizes that the Wampole preparation does not possess to any marked degree the reconstructive properties of cod liver oil, butter fat and egg yolk, on which foods rats gain weight rapidly and steadily after having been on a deficient diet. Street calls attention to the fact that the amount of alcohol consumed daily by the user of the Wampole preparation (the equivalent of 0.7 fluidounces of whiskey) explains to a considerable extent the asserted tonic virtues of the preparation.
Though offered as an efficient substitute for cod liver oil, Wampole’s “Perfected and Tasteless Preparation of an Extract of Cod Liver” lacks both the nutritive and the reconstructive properties and is marketed under an indefinite name and unwarranted and untrue claims. It is recommended that Wampole’s Preparation be held ineligible for New and Nonofficial Remedies.—(From The Journal A. M. A., April 10, 1915.)
WATERBURY’S METABOLIZED COD-LIVER OIL COMPOUND [K]
Report of the Council on Pharmacy and Chemistry and Laboratory Contribution on Which It Is Based
The following report has been adopted by the Council and its publication directed
W. A. Puckner, Secretary.
To the Council:—Your committee on pharmacology has read with interest the contribution from the Association’s laboratory on Waterbury’s Metabolized Cod-Liver Oil Compound. The report shows that misleading and false statements are made in regard to the composition of the product and also that exaggerated and unwarranted claims are made for its therapeutic value. In view of the attempt of the Waterbury Chemical Co. to create a false impression in regard to the therapeutic value of the composition of its product, it is recommended that the following report be adopted and published:
The Council believes that there is a preponderance of evidence to indicate that whatever therapeutic value cod-liver oil has, that value depends chiefly, if not entirely, on its fat (oil). In the opinion of the Council, the word cod-liver oil should not be used in connection with any preparation unless it consists to a large extent (25 per cent. or more) of cod-liver oil. Since Waterbury’s Metabolized Cod-Liver Oil Compound contains no appreciable quantity of cod-liver oil, the name is incorrect and misleading, and as a cod-liver oil preparation it is believed to be wholly valueless. The Council has previously voted that Waterbury’s Cod-Liver Oil Compound be refused recognition because of conflict with Rules 1 and 6.—(From The Journal A. M. A., Oct. 9, 1909.)
[Contribution from the Chemical Laboratory of the American Medical Association]
Waterbury’s Metabolized Cod-Liver Oil Compound
W. A. Puckner and L. E. Warren
A full page advertisement of Waterbury’s Metabolized Cod-Liver Oil Compound appeared in the Iowa Medical Journal, March 15, 1909, in the form of a letter purporting to give the results of an analysis of the product made for the firm by a Chicago chemist. In this letter-advertisement the chemist states at the outset that the results of his examination “are somewhat at variance with the statements made in The Journal.” These statements he quotes as follows:
1. It is a clear liquid and no globules of oil are seen under the microscope. It is therefore not an emulsion.
2. It is of acid reaction when mixed with water and remains clear when strongly acidified. Hence it does not contain a soap, and is not a saponification of fat.
3. It mixes with water without precipitation, hence, it can not contain more than traces of a fatty acid.
The chemist admits in his letter to the firm that his analyses verify statements 1 and 3, but regarding statement 2 he says: “I find that your preparation is acid in reaction, but when strongly acidified gives a distinct turbidity within 10 minutes and a voluminous precipitate within 1 hour. This precipitate is shown to consist of fatty acids of cod-liver oil, which are thrown down by the splitting of the soaps, on acidifying either with sulphuric or hydrochloric acid.” From these results he states that to him it seems that the “preparation does not deserve the statement that it contains no soap, as there is no question whatever of the presence of cod-liver oil.”
While in the letter published in this advertisement the chemist claims to have demonstrated the presence in the product of “saponified cod-liver oil,” he omits to mention the quantities of the soap present. In the article that originally appeared in The Journal (Oct. 13, 1906), in addition to the three paragraphs quoted by the chemist, the following statements were made:
“By these simple tests a physician is easily able to demonstrate that the preparation does not contain cod-liver oil. It is therefore valueless for the purpose of nutrition for which we give the oil. More careful analysis confirms the results of these tests and shows that it contains no fat or fatty acids (except the merest traces)....”
At the time these statements were published in The Journal, the St. Paul Medical Journal, October, 1906, contained an advertisement for Waterbury’s Metabolized Cod-Liver Oil Compound, which contained this statement:
“The only tasteless preparation on the market which contains Cod-Liver Oil in its entirety. The metabolized product is obtained by the action of digestive ferments on pure Cod-Liver Oil.”
In the Ohio Medical Journal of Feb. 15, 1907, there appeared in the form of an advertisement what purported to be an analysis of Waterbury’s Metabolized Cod-Liver Oil Compound by Prof. C. N. Kinney of Drake University. While Professor Kinney made a quantitative analysis of the preparation, the quantities were omitted from the analysis as published. A footnote added by the Waterbury Chemical Company called attention to this fact and closed as follows:
“Any physician who is not satisfied with the analysis we will be only too glad to furnish the complete analysis by our representatives.”
If this weirdly constructed sentence meant anything, it meant that the complete analysis would be furnished on request. Such requests to the company, however, from various sources failed to elicit the information required nor was the “complete analysis” forthcoming. The inference to be drawn is fairly plain.
In a circular accompanying the product as sold at present, this statement occurs:
WATERBURY’S METABOLIZED COD LIVER OIL COMPOUND With Creosote and Guaiacol or Plain
As previous examination disclosed only the merest traces of cod-liver oil in the product though claims were made that it “represents cod-liver oil in its entirety,” and in view of the fact, too, that present advertisements emphatically declare that cod-liver oil is present in the preparation as now sold, it was thought best to examine some of the preparation with especial reference to the quantities of fatty acids from cod-liver oil.
OLD LABEL |
NEW LABEL | |
| It is interesting in this connection to note that this product isno longer being sold under the name “Metabolized Cod Liver Oil Compound.”See the illustrations of the old and new labels. | ||
The results of the examination are briefly as follows: The total quantity of acids isolated amounted to about 0.3 per cent., and of this amount about two-thirds was salicylic acid. Thus it appears from the examination of the specimens bought on the open market that the preparation contains at most but 0.1 per cent. of the fatty acids from cod-liver oil, a totally insignificant quantity.
Notwithstanding the protestations by the manufacturers, in the form of published analyses and circulars, it is seen that the statements published in The Journal, Oct. 13, 1906, p. 1207, are essentially substantiated; it is further evident that the product does not deserve to be designated as a cod-liver oil preparation. To obtain a medicinal dose of cod-liver oil the patient would be compelled to swallow the contents of a bottle of this mixture, and as the product contains 11 per cent. alcohol the patient who did so would probably experience a degree of exhilaration not referable to cod-liver oil.—(From The Journal A. M. A., Oct. 9, 1909.)
Declared Misbranded
This product of the Waterbury Chemical Company, of Des Moines, Iowa, was exposed in The Journal of the American Medical Association, October 9, 1909. In May, 1910, the United States Government issued a notice of judgment in which it was declared that Waterbury’s Metabolized Cod Liver Oil Compound was misbranded. The court rendered its decree of condemnation and forfeiture.—[Notice of Judgment, No. 303.]