GOMENOL

A correspondent sends some advertising matter on Gomenol and calls attention to the number of diseases for which the preparation is recommended:

Gomenol is apparently a volatile oil. It is a proprietary said to come from France, and to be prepared from a species of cajuput (Melaleuca viridiflora, Gaertn.). This plant is closely related to the cajuput tree or swamp tea-tree (Melaleuca leucodendron, Linné) from which the official oil of cajuput is obtained. The oils from these two plants are very similar in composition and presumably in therapeutic properties. The oil of the first-named plant appears not to be marketed except in the form of the proprietary, Gomenol. It probably has no advantage over the official oil of cajuput, while in the form of Gomenol it costs about four times as much. The following are some of the claims made for Gomenol in the advertising circulars. They need no comment.

“A real specific for suppurations and catarrh.... It immunizes tissues, excites their vitality and favors the formation of new cells....

“The least trace of Gomenol prevents the growth in vitro of the streptococcus, the tuberculous bacillus and the gonococcus.”​—(From The Journal A. M. A., April 4, 1914.)

HEADACHE CURES[AL]

Harmful Effects of Acetanilid, Antipyrin and Acetphenetidin

The United States Department of Agriculture Bulletin[107] No. 126, issued July 3, 1909, sets forth the results of an investigation conducted by the Bureau of Chemistry with regard to the harmful effects of acetanilid, antipyrin and acetphenetidin. During recent years the use of these remedies and preparations containing them by the people at large, without the supervision of the physician, has increased rapidly and investigation has shown that coincidently there has been a marked increase in the number of cases of poisoning reported, in the number of fatalities, and in the number of instances of habitual use.

Since the passage of the Food and Drugs Act, June 30, 1906, the attention of the Department of Agriculture has been directed to this subject, particularly in connection with the branding of drug products containing one or more of these agents, and an attempt has been made to obtain full and reliable data with regard to their poisonous qualities with the object of furnishing information to the public which would enable them to understand that these remedies should be employed with caution in the absence of reliable medical advice.

The information obtained with regard to the number of an inquiry addressed to medical practitioners in the United States with regard to their personal experience with these drugs; and, second, the study of the cases of poisoning recorded in medical literature. Nearly a thousand letters, each containing eighteen questions, were addressed by the department to physicians throughout the country, the object being to secure information which would represent as closely as possible the conditions existing among the people at large so far as the harmful effects of the drugs in question are concerned. Four hundred replies were received.

The information obtained with regard to the number of instances quoted in medical literature in which poisoning, death, or habitual use has been known to result from the administration of acetanilid, antipyrin, and acetphenetidin is set forth in Section A of the accompanying table. The information summarized in Section B is based on the data submitted by physicians. Granting that the 525 physicians who did not reply had no cases to report, the question may profitably be asked, if 925 physicians have observed 814 cases of poisoning by these drugs, 28 deaths which are attributed to their use, and 136 instances of habitual use, how many such cases have in all probability been observed by the 125,000 physicians scattered throughout the United States? The summary, C, includes both the number of cases recorded in medical literature and those reported by physicians.

POISONING BY ACETANILID, ANTIPYRIN AND PHENACETIN

A.—Cases Recorded in Medical Literature

POISONING.DEATH.HABITUAL
USE.
Acetanilid2971332
Antipyrin48810..
Acetphenetidin7031
————
Total8552633

B.—Data Submitted by Physicians

POISONING.DEATH.HABITUAL
USE.
Acetanilid61416112
Antipyrin10557
Acetphenetidin95717
—————
Total81428136

C.—Total Number of Cases

POISONING.DEATH.HABITUAL
USE.
Acetanilid91129144
Antipyrin593157
Acetphenetidin1651018
——————
Total1,66954169

The bulletin contains information with regard to dosage, the extent to which these drugs are employed by physicians, poisoning and habitual use, the nature of the ill effects produced, etc. It also contains references to the recorded cases of poisoning, together with a brief abstract of each case.—(From The Journal A. M. A., July 31, 1909.)

Sanatoriums and the Acetanilid Habit

To the Editor:—I enclose herewith a “form” letter and question blank which I received recently from St. Louis. I may be entirely too wary but I am suspicious that this is a collection of “statistics” to combat the work of the medical profession in educating the physician and the laity in the harmfulness of acetanilid and similar preparations.

G. H. Benton, M.D., Chester, W. Va.
Sterling-Worth Sanitarium.

Comment: The letter which Dr. Benton encloses is in facsimile form and purports to come from Uriel S. Boone, M.D., of St. Louis, who states that he is “preparing an exhaustive article for publication in a leading medical journal” on the question, “Is acetanilid a habit-forming drug?” To obtain the necessary data Dr. Boone is “writing to every hospital and sanitarium in the United States.” Examination of the question blank which accompanies the form letter discloses the fact that information is wanted regarding not acetanilid alone, but also antipyrin and acetphenetidin (phenacetin). The last question asked runs as follows:

“If your records [of cases of habitual use of these drugs] are incomplete, would you allow a reputable physician to investigate the above-mentioned cases so that he could write with positiveness about them, and, if necessary, make oath to the truth of his report?” [Italics ours.—Ed.]

Dr. Boone opines that the recipients of his queries “may hesitate to answer” the question just quoted, but he trusts that its importance will be evident when he explains that “it is currently reported that the manufacturers of acetanilid, phenacetin, etc., have decided to prosecute all libelers of these drugs” [Italics again ours.—Ed.] and he wishes to make no statement that he “can not substantiate under oath.” Surely the life {of} the collector of medical statistics is unusually hazardous.

For the purpose of aiding Dr. Boone in his arduous search for truth on the “much mooted question, ‘Is acetanilid a habit-forming drug?’” we direct his attention to a work that should prove of invaluable assistance. We refer to Bulletin 126 of the Bureau of Chemistry, entitled “The Harmful Effects of Acetanilid, Antipyrin and Phenacetin.” This interesting study to which we have previously called attention records 112 cases of the acetanilid habit. Of this number at least 50, or 44.6 per cent. of the cases were those of patients who took proprietary preparations of the drug.

From this we would not wish to give any bias to Dr. Boone’s statistics. We hardly expect, however, that such will be the case. Dr. Boone’s name appears as the author of an article entitled “A Therapeutic Study of Antikamnia and Heroin Tablets”—​an article that has been very extensively “quoted” and has been sent out in its entirety by the Antikamnia Chemical Company. Under these circumstances we may be forgiven if we venture the opinion that Dr. Boone is not likely to be unduly prejudiced against “headache tablets” in general and fake “synthetic” coal-tar mixtures in particular. We await with breathless interest the appearance of Dr. Boone’s “exhaustive article” and we must confess to some degree of curiosity regarding the name of the “leading medical journal” in which these valuable data will appear.​—(Modified from The Journal A. M. A., Aug. 14, 1909.)