INTESTINAL ANTISEPTIC W-A

Report of the Council on Pharmacy and Chemistry

The Council voted that Intestinal Antiseptic W-A be refused recognition, and that the publication of the following report be authorized.

W. A. Puckner, Secretary.

The Abbott Alkaloidal Company advertises “Intestinal Antiseptic W-A” as

“... A scientifically blended and physiologically adjusted mixture, of the pure sul­pho­car­bo­lates of calcium, sodium and zinc, grs. 5, with bismuth subsalicylate, gr. 1-4 and aromatics.”

This formula is in conflict with Rule 1 in that it does not state in what proportion the sul­pho­car­bo­lates are present.

The name “Intestinal Antiseptic W-A” is in conflict with Rules 4 and 8, since it is therapeutically suggestive.

The preparation is in conflict with Rules 6 and 10, in that exaggerated claims are made for it, no evidence being submitted to prove the superior value of the mixture.

The most serious of these conflicts consists in the exaggerated and misleading therapeutic claims. The advertisements say:

“This combination has no equal as an antiseptic and inhibitive agent in typhoid fever, diarrhea, dysentery,” etc.

“Numerous cleverly devised and scientifically constructed intestinal antiseptics have been introduced to the profession, but not one of them has ever rivaled for one moment these salts in popularity.”

“... we are convinced that no small share of the credit for the reduction of the death rate in infantile diarrheas is due to the widespread application of this general method of treatment, associated of course with the calomel clean-out and the regulation of diet, now known to be essential.”

“But the use of the sul­pho­car­bo­lates is not restricted to diseases of the alimentary canal, although in the summer diarrheas, gastric fermentation, intestinal indigestion, typhoid fever, dysentery—​indeed in all alimentary disturbances—​it is the one essential remedy. It is also indicated in practically all infectious diseases.”

“Typhoid Fever (in this disease the W-A Intestinal Antiseptic is of great value; used early, with the proper synergistic cleanout, it will often cut short the disease).”

These extreme claims exceed the limits of permissible optimism, unless they are supported by strong dependable evidence. They contrast sharply with the low esteem in which the phe­nol­sul­pho­nates (sul­pho­car­bo­lates) are generally held. To accept these claims, and to justify encouraging physicians to rely on them, it would be necessary to establish:

First, that feasible concentrations have a distinct antiseptic action on cultures of intestinal bacteria. This experiment could be easily made, but the claims do not seem to be based on evidence of this kind.

Second, that the preparation actually checks putrefaction in the intestines. There are several methods by which this proof may be attempted; but the claims do not appear to be based on evidence of this kind.

Third, that the preparation actually has a favorable influence on the progress of diseases. This sort of evidence is exposed to so many fallacies that it would have to be gathered very carefully and critically, duly discounting the effect of other treatment; for instance, by comparison with similar cases which do not receive this preparation. This is especially important; and yet we find directions to use this preparation in conjunction with active cathartic treatment, which in itself has considerable influence on the conditions for which this preparation is recommended. No evidence of this kind is presented.

The testimonials contained in the advertisements cannot be considered as serious evidence. None present any indication of accurate record or proper control of conditions, or of the performance of control observations. They are superficial impressions, to which little or no weight can be attached.

It is recommended that Intestinal Antiseptic W-A be considered ineligible for New and Nonofficial Remedies.​—(From The Journal A. M. A., Dec. 19, 1914.)