MICAJAH’S MEDICATED UTERINE WAFERS
W. A. Puckner and W. S. Hilpert
Evidently touched by the generosity of the manufacturer in sending him a sample and literature, but not too favorably impressed by the claims made for the preparation referred to, a correspondent writes:
I enclose a valuable sample and literature just received. Such a palpable humbug as Micajah’s Uterine Wafers would hardly seem to need notice were it not probably true that many practitioners habituated to the use of samples are still influenced by the glowing accounts of cures wrought; especially when attested by such a name and title as “Elmore Palmer, M.D., Ex-President Western New York Medical Society.” This secret gynecologic medicament is recommended for anything from “Pruritis Vulvæ,” “Enlargement of the Womb,” “Displacements,” “Cystocele and Rectocele,” to the “Menopause.”
Following the definition that by her “stomach” a woman means anything from her chin to her knees, the ex-president with truly noble impartiality has with the wonderful Micajah wafers wrought lightning cures all the way from “stone-bruise” of the heel to nasal polyp and influenza, and some of them are male patients too.
With the foregoing as an impetus to investigate the nature of this much advertised nostrum, the wafers were submitted to analysis by the Association laboratory. The report follows:
LABORATORY FINDINGS
Trade packages of the wafers purchased on the open market bear the name of the preparation and that of the manufacturers, Micajah & Co., Warren, Pa. The label states that the nostrum is a:
“Disinfectant, astringent and local alterative of the greatest virtue. A remedy for the local treatment of the diseases of women. Inflammation, engorgement and prolapse of the womb, vaginitis, leucorrhea, menstrual derangements and the disturbances incidental to the menopause. Also highly recommended for affections of the mucous membranes in general, particularly those of the nose, the throat, the rectum, and for gonorrhea, cystitis, etc.”
“This box contains wafers for three months’ treatment.”
“Price per box $1.00.”
The box contained 25 tablets, and a circular entitled, “Hints on the treatment of diseases of women,” in which directions for the treatment of many diseases are given. It ends with a paragraph which contains the following statement:
“There is no doubt that the field of usefulness of Micajah’s Wafers can be indefinitely enlarged by the ingenuity and therapeutic skill of the physician.”
Much of the advertising “literature” is in the form of leaflets, brochures and small pamphlets full of testimonials by physicians.
Micajah’s uterine wafers as found on the market are white, hexagonal tablets, odorless and possessing an astringent taste. The wafers are soluble in water with extreme difficulty. Hot hydrochloric acid and alkali hydroxids dissolve the powdered tablets readily, leaving a slight residue which under the microscope and by physical tests was identified as lycopodium.
The acid solution of the wafers responded to qualitative tests which indicated the presence of potassium, sodium, aluminum sulphate, borate and a mere trace of a fatty material. Quantitative estimation of boric acid, aluminum sulphate, sodium and potassium were made, which indicated that Micajah’s Uterine Wafers consist of alum more or less anhydrous or “burnt,” boric acid and borax in approximately the following proportions:[97]
| Alum, dried | 59.86 | per cent. |
| Borax, dried | 15.62 | per cent. |
| Boric acid | 5.67 | per cent. |
| Water of hydration | 18.85 | per cent. |
The average weight of the tablets is 0.7791 gm (11.8 grains) and allowing for the fact that the quantity of water present in commercial exsiccated alum varies, each tablet would contain approximately 0.4986 gm. (7.8 grains) burnt alum; 0.2337 gm. (3.6 grains) crystallized borax, and 0.0467 gm. (0.7 grain) boric acid.
COMMENT
Judging from the “literature” that goes with the packages of this nostrum, one might imagine that it was put up absolutely for the layman, but this is not the case. It is advertised only in medical journals and not directly to the public. But direct advertising to the public is not necessary; for every physician who prescribes these wafers at the same time places in the hands of his patient advertising matter intended to influence that patient—and it usually does. As a result this preparation is being bought by the public direct. To what extent we do not know, but physicians are responsible for it. Probably if physicians realized that the same interests that control Piso’s Consumption Cure also control Micajah’s Medicated Uterine Wafers they would not be so ready to act as the unpaid agents for the concern.
That such simple astringents and feeble antiseptics as alum, borax and boric acid could have such remarkable curative effects on uterine diseases is absurd. The serious aspect of the matter is, that, by the encouragement given them in the advertising literature to treat themselves, women may neglect proper surgical or medical attention in the early stages of serious diseases such as cancer or dangerous pelvic infections, until they get beyond the hope of proper management. But when nostrum promoters urge the use of such inefficient remedies in the treatment of gonorrhea, it is time to look at the matter seriously. Considering the vital social significance of the venereal diseases, the employment of useless remedies can only favor the spread of these infections, which cause such a large proportion of the diseases which afflict women particularly.
The medical profession for the most part has become mentally calloused to the exaggerated claims of the nostrum makers and does not make sufficient effort to condemn them. There may be some physicians, however, who use such preparations as these wafers in their practice, as is indicated by the circulars wherein the manufacturers suggest that their “usefulness can be indefinitely enlarged by the ingenuity and therapeutic skill of the physician.” It is only occasionally that a physician voices his indignation as to these humbugs, as in the case of the physician whose letter is quoted above.—(From the Journal A. M. A., March 26, 1910.)
The Firm Replies
To the Editor:—We have read with interest the report of your committee on pharmacology recently published in The Journal, on the subject of Micajah’s Medicated Uterine Wafers, and your comments thereon.
We are of the opinion that, in your laudable efforts to reform the practice of pharmacology, it is not your desire or intention to act other than justly and fairly, and therefore, with this belief, we submit the following statements for your consideration, with the hope that you will see fit to publish them.
1. We do not seek by word or deed the patronage of the laity, and what few sales are made to the public are not of our contriving, nor should we be held responsible for them, any more than is the manufacturer of quinin to be blamed for the universal use of that drug.
2. Our literature should not be considered extravagant, for it is for the most part made up of clinical reports received from physicians and based on the unsolicited testimonials in our possession from hundreds of practitioners, many of whom have used Micajah’s Wafers in practice from five to twenty years and they are therefore as well grounded as are the clinical reports concerning any preparation.
3. In the past year we have endeavored to place our preparation on a higher ethical basis by stating in our advertisements what our wafers contain, and by eliminating whatever seems to us open to criticism.
4. That the ingredients of the preparation are “simple” is no reason for considering them valueless. H. A. Kelly, in his work on medical gynecology, page 266, recommends these ingredients in a variety of conditions. Bandler also made important recommendations bearing on this subject in his “Medical Gynecology,” 1909 edition, page 472. We feel we have the right to recommend this preparation for these and similar conditions, especially when our statements are backed up by the clinical experience of numerous general practitioners.
5. That the owner of Micajah’s Wafers holds stock in a corporate firm which manufactures proprietary medicines and toilet articles, advertised to the laity, should not militate for or against our right to market a meritorious preparation on strictly ethical lines to the medical profession, inasmuch as many of the largest drug houses cater to both the doctor and the proprietary interests, and several are actively engaged in exploiting so-called nostrums.
6. We enclose a recent advertisement which has been accepted after investigation of our methods by careful medical journals, and we now believe we are conducting our business in entire conformity with the best interests of the medical profession and we feel certain of the true merits of our article.
Micajah & Company, Warren, Pa.
[Comment: This letter brings out still more strongly the points raised in the article which appeared in The Journal, March 26, 1910. Being unable to analyze motives we must perforce, accept Micajah & Co.’s statement that they “do not seek by word or deed the patronage of the laity.” In the comments on the laboratory’s report it was very explicitly stated that this nostrum was advertised only in medical journals and not directly to the public. Inasmuch, however, as the container in which this product comes has printed on it the various diseases in which the “wafers” are indicated, as, moreover, within the container there is a leaflet which describes in detail the use of the preparation in a list of pathologic states varying from “enlargement of the womb” to “gonorrhea in the male,” and, finally, as the name “uterine wafers” would seem in itself to be a plain bid to the public, we still maintain that “one might imagine that is was put up absolutely for the layman.”
The proposition that advertising matter should not be considered extravagant because it is largely “made up of clinical reports received from physicians” is an argument that is as old as the nostrum business itself—and as fallacious as it is old. Unfortunately, as our files show, the most extravagant statements made for proprietary products frequently emanate from men who legally are entitled to write M.D. after their name. The fact that it is not the manufacturer but a Buffalo physician who tells of the marvelous results he obtained from the use of Micajah’s Medicated Uterine Wafers in forty-three cases comprising no fewer than thirty-six pathologic conditions from “otitis media” to “injured toe,” and from “bunion” to “ophthalmia neonatorum” does not exempt the firm that prints such stuff from the charge that its “literature” is not merely extravagant, but ridiculously so.
As Micajah & Co. say, because the ingredients of their preparation are simple is no reason for considering them valueless. On the contrary, if the “wafers” were truthfully exploited for what they are and what they will do, their very simplicity would be a virtue. But such has not been done. And therein lies the viciousness of nostrums. Simple mixtures of well-known drugs are foisted on the medical profession with no hint as to their composition and with claims made that are not only false, but would immediately be recognized as absurd, if their actual composition were known.
That a mixture of borax and alum may be of value in some of the simple ailments of the female genital tract can easily be granted. That relief might follow the use of suppositories made of these ingredients—especially when supplemented by an increased attention to simple cleanliness—can also be admitted. To say, however, that such medicaments will quickly and permanently cure gonorrhea, urethritis, endometritis, etc., is foolish, false and vicious.]—(From the Journal A. M. A., April 16, 1910.)