PEPTO-MANGAN (GUDE)
Report of the Council on Pharmacy and Chemistry
The following report was adopted by the Council and its publication authorized.
W. A. Puckner, Secretary.
About ten years ago the M. J. Breitenbach Company circulated what pretended to be an abstract of the report of a government commission for the investigation of the anemia then prevalent in Porto Rico. The company asserted that “this report alone would suffice to establish Pepto-Mangan at once as the foremost hematinic known.” Examination of the official report of the commission[67] revealed the fact that the administration of iron in hookworm anemia was considered of secondary importance, and that of the various preparations of iron, Blaud’s pill was found to be more efficient than Pepto-Mangan (Gude). A protest[68] was made at this time by the commission against the unwarranted use of its report by the Breitenbach Company.
Later the Breitenbach Company sent out a report pretending to prove that at the Infants Hospital, Randall’s Island, New York City, Pepto-Mangan (Gude) had been found a most superior preparation in the treatment of infantile anemia. Inspection of the hospital records and daily charts of the cases disclosed[69] a remarkable disparity between the claims of the Pepto-Mangan pamphlet and the real results of treatment. And so here, also, as well as in the Porto Rico commission’s report the trials, selected by the Breitenbach Company prove the limitations and non-superiority of Pepto-Mangan.
The preceding false reports, though no longer circulated, have never been definitely withdrawn and while it is now generally conceded that the good results in anemia are obtained by the administration of the various simple inorganic iron preparations the Breitenbach Company still attempts to convey the impression that Pepto-Mangan (Gude) is of most superior efficacy. Thus the present Pepto-Mangan circular attempts to discredit by obsolete and absurd or untrue statements the various preparations of iron which are in general use and to carry the impression that only iron and manganese, in the particular form and proportion in which they are contained in Pepto-Mangan—namely, 3 parts Fe to 1 part Mn—are useful for the treatment of anemia, chlorosis, etc. Thus contrary to general conceptions, the impression is given that the now generally accepted course of chlorosis is due to the three varieties of insufficiency of certain blood elements: (1) insufficiency of manganese, (2) insufficiency of iron, (3) insufficiency of iron and manganese; and that the administration of iron often fails because manganese is not supplied to the system at the same time and in sufficient amounts. The following statement is made:
“Doctor:
“If you have a case of ANAEMIA, CHLOROSIS, or AMENORRHOEA, that shows no visible sign of improvement, and you have exhausted the entire list of Nauseating Iron preparations with little or no effect, it is because the blood is deficient in that essential oxidizing constituent, MANGANESE, in a soluble, readily assimilable form, the best being in combination with iron.”
Another extravagant claim:
“Usually after taking it for a week its restorative influence on the functions of the stomach is felt; appetite reappears, and the general health is improved by the increase in bodily warmth, an effect directly due to manganese.”
The following statement implies that Pepto-Mangan is absorbed unchanged, for which there is no justification:
“As the ferruginous and manganic ingredients of Pepto-Mangan (Gude) exist in the form of organic peptonates, they have already undergone the changes necessary to insure prompt absorption and appropriation by the circulating fluid.”
The following declaration implies that it repairs the individual defective blood-cells which is, of course, also ridiculous:
“That Pepto-Mangan (Gude) quickly and efficiently builds up defective red blood cells, and generates, or at least potently encourages the formation of new ones, and materially increases their richness in hemoglobin, has been abundantly demonstrated....”
The M. J. Breitenbach Company is still trying to mislead physicians; it also aims to make use of them in its direct appeal to the physicians’ patients. For instance, the name “Pepto-Mangan (Gude)” blown in the bottle, the advertising circular suggesting Pepto-Mangan as the treatment for anemia, etc., and the recommendation to physicians that it be prescribed in “original bottles” all tend to encourage the use of Pepto-Mangan by the public with the likelihood that it will be depended on where good food and fresh air are of prime importance. The attempt to exploit it directly to the public is further attested by the advertisements of department-store drug departments.
It is evident from the foregoing that Pepto-Mangan (Gude) is in conflict with Rules 4 and 6 and therefore not eligible for admission to New and Nonofficial Remedies.—(From Reports Council Pharm. and Chem., 1914, p. 121.)
LIQUID PETROLATUM OR “RUSSIAN MINERAL OIL” [AA]
Report of the Council on Pharmacy and Chemistry
The following report was submitted to the Council by a referee and its publication authorized by the Council.
W. A. Puckner, Secretary.
Petroleum has been in use as a medicine from time immemorial. It was known to Herodotus 400 years before Christ and is mentioned by Plutarch, Dioscorides, Pliny and other early writers. It was extensively used by the Arabians and evidently played an important part in the practice of medicine in India, being known to the Bengalese as Muthe Katel. The raw product was the substance used in earlier times and differed much in character and composition, as obtained from different sources.
As an internal remedy it was early employed in chronic pulmonary affections, in obstinate skin diseases, in rheumatism, and for the expelling of tapeworms. It was extensively used for these several purposes in France under the name of “Oleum Gabianum” and in North America as “Seneka oil.”
The internal use of the refined product may be traced to a patent granted to Robert A. Chesebrough of New York, in June, 1872, for the manufacture of a “new and useful product from petroleum, named vaseline.” This name was originally applied only to a semisolid preparation, but later a liquid product known as liquid vaseline was marketed and for a time exploited as a cure for coughs, colds, consumption and a number of other diseases and conditions.
The liquid petrolatum has since become known under a variety of names, proprietary and otherwise, in addition to being used as a substitute or an adulterant for other, more costly, fats and oils. Some of the names applied to the product are:
| Adepsine oil | Neutralol |
| Amilee | Olo |
| Atoleine | Paraffin Oil |
| Atolin | Paroline |
| Blandine | Petralol |
| Crysmalin | Petro |
| Deeline | Petrolax |
| Glyco | Petrolia |
| Glycoline | Petronol |
| Glymol | Petrosio |
| Heavy petroleum oil | Rock Oil |
| Liquid Albolene | Russian liquid petrolatum |
| Liquid Cosmoline | Russian mineral oil |
| Liquid Fossiline | Russian paraffin oil |
| Liquid Geoline | Russol |
| Liquid Paraffin | Saxol |
| Liquid Petrolatum | Terraline |
| Liquid Saxoline | Terralbolia |
| Liquid Vaseline | Usoline |
| Mineral Glycerin | Water-white mineral oil |
| Mineral Oil | White paraffin oil. |
A preparation similar to that official in the Pharmacopeia of the United States as liquid petrolatum has been included in many, if not all, of the foreign pharmacopeias, the official titles under which this preparation is recognized being as follows:
Petrolatum Liquidum, U. S. Pharmacopeia; Paraffinum Liquidum, pharmacopeias of Great Britain, Germany, the Netherlands, Japan, Belgium, Austria, Denmark, Switzerland, Sweden, Servia, Italy, Hungary and Russia; Oleum Paraffinae, Spanish Pharmacopeia; Vaselinum Liquidum, French Pharmacopeia, and Oleum Vaselini (as a synonym) pharmacopeias of Denmark and Russia.
The requirements of the several pharmacopeias differ somewhat and the specific gravity as given is as follows:
| U. S. P. VIII, 1905 | 0. | 870 | to 0.940 | at 25° |
| Ph. Brit. IV, 1895 | 0. | 885 | to 0.890 | at 15.5° |
| B. P. C. II, 1911, usually | 0. | 875 | or lower | at 15° |
| Ph. Germ. V, 1910, at least | 0. | 885 | at 15° | |
| Ph. Ross. VI, 1910 | 0. | 880 | to 0.885 | at 15° |
| Ph. Hung. III, 1909 | 0. | 88 | to 0.89 | at 15° |
| Ph. Ital. III, 1909 | 0. | 875 | to 0.890 | at 15° |
| Ph. Fr. V, 1908, about | 0. | 875 | at 15° | |
| Ph. Serb. II, 1908, about | 0. | 880 | at 15° | |
| Ph. Svec. IX, 1908 | 0. | 88 | to 0.90 | at 15° |
| Ph. Helv. IV, 1907 | 0. | 880 | to 0.885 | at 15° |
| Ph. Dan. VII, 1907, at least | 0. | 880 | at 15° | |
| Ph. Austr. VIII, 1906, at least | 0. | 880 | at 15° | |
| Ph. Belg. III, 1906, not below | 0. | 880 | at 15° | |
| Ph. Japon. III, 1906 | 0. | 875 | to 0.945 | at 15° |
| Ph. Ndl. IV, 1905, not below | 0. | 860 | at 15° | |
| Ph. Hisp. VII, 1905 | 0. | 840 | at 15° |
For pharmaceutical purposes, liquid petrolatum may be divided into two grades, the lighter or more limpid oil, used extensively as a vehicle for oil sprays, and the heavier, more viscid oil generally recognized in European pharmacopeias and used as an ingredient of ointments and more recently as a remedy in the treatment of intestinal stasis.
Under petrolatum liquidum the U. S. P. recognizes a mixture of hydrocarbons, chiefly of the methane series, which occurs as a colorless or very slightly yellowish, oily, transparent liquid without odor or taste and having a specific gravity of about 0.870 to 0.940 at 25 C. For the U. S. P. IX, it is proposed to change this requirement somewhat so as to have it apply to a transparent liquid free from fluorescence, without odor or taste and having a specific gravity of from 0.845 to 0.940 at 25 C.
Such a requirement would include all of the available paraffin oils irrespective of origin. The now commonly available commercial liquid petrolatum, used for pharmaceutical purposes, is practically colorless and all of the better grades are free from odor or taste. The specific gravity varies from 0.855 to 0.895. The lighter oils, having a specific gravity of from 0.860 to 0.870, are usually preferred in the making of oil sprays or solutions of substances to be used as local applications. The product having a specific gravity above 0.875 evidently contains a considerable amount of dissolved solid paraffin which separates out at temperatures at or below 0 C., but readily dissolves again at temperatures above 10 C.
There is considerable difference in the chemical composition of the paraffin oils obtained from various sources. The American oil consists largely of hydrocarbons of the methane series, while the Russian oil contains naphthenes or hydrocarbons of the benzene series, having the empirical composition of ethylene, (CnH2n) which may be considered as hydrogenated aromatic hydrocarbons, though they behave with reagents very much in the same way as do the hydrocarbons of the methane series.
Mineral oils with a naphthene base are best suited for making white petrolatum, and at the present time the production of the colorless water-white liquid petrolatum appears to be confined largely or almost exclusively to the crude product of the Baku district of Russia, though it is asserted that it is now also made from the Hanover (Germany) crude oil and that some is being produced by “cracking” the white solid paraffin.
It is also said that the American oil can be made water white but that it is not being so produced at present for economic reasons; the yellowish oil, free from fluorescence, having a very wide sale, both as a lubricant and as a substitute for lard oil and other of the more costly lubricating oils.
From a pharmaceutical point of view it would appear important to note the physical characteristics of the oil and to insist on absence of color, absence of odor and taste, absence of acid and of alkali and a specific gravity in harmony with the purposes for which the oil is to be used.
During the past year or two liquid petrolatum has attracted considerable attention as a remedy in the treatment of intestinal stasis or chronic constipation, the practice of using it having been developed largely through its recommendation by Sir W. Arbuthnot Lane and his associates. This use of liquid petrolatum and of petrolatum products generally is by no means novel. N. A. Randolph[70] of Philadelphia was among the first to suggest its use for this purpose in an article published in 1885. Randolph also appears to have been the first to experiment with petrolatum and to determine its non-absorbability from the intestinal tract. In an article[71] in 1884 he concludes that “pure petrolatum while entirely unirritating to the digestive tract is valueless as a foodstuff.”
The experiments recorded by Randolph were evidently prompted by the fact that vaseline and a number of imitation products then on the market were being sold as substitutes for lard and butter, and opinions regarding the food value of petroleum products appear to have differed very materially. Following the experiments of Randolph, Robert Hutchison in 1899 made a series of experiments to demonstrate that petroleum, petrolatum, paraffin and related products were absolutely unassailable by any of the digestive fluids, despite the “large vogue that had of late years been given to various petroleum emulsions, chiefly by ingenious and unterrified advertising.” He came to practically the same conclusions arrived at by Randolph fifteen years earlier and pointed out that “liquid paraffin in one sense may be regarded as an artificial intestinal mucus and might in that way have some value on certain forms of constipation.”
William Duffield Robinson[72] reports on the use of a perfectly refined colorless and odorless petrolatum, supposedly of American origin. He was able to show that all of the product passed unchanged through the intestinal tract and could be regained from the feces. In his conclusions he expressed the belief that the effect of the administration of these petroleum products is far more than as a simple intestinal lubricant. In over fifty selected cases in which nutrition, digestion and body-weight were impaired, and the purest oil administered in 1- or 2-dram doses each day for a period of from four to six months, there was in every instance an improvement of weight, health and feeling of well-being. The administration of refined paraffin oil gave no discomfort in any instance, even in cases in which nearly a pint was given in a few hours.
William Ewart[73] suggests liquid paraffin as a safe agent for the local treatment of the lesions in typhoid fever. He says in part: “Mineral oil, such as petrolatum or paraffin, is neither absorbed nor dissolved; therefore, after all absorbable ingestions are taken up by the lacteals, it will still remain in the bowel. In this way pure liquid paraffin is valuable, precisely because it is inert; moreover, it might some day, perhaps, be made the vehicle for effective topical remedies.”
A. D. Schmidt[74] quotes Stubenrath as having given liquid paraffin in the treatment of chronic constipation, and he himself gave as much as 20 gm. of liquid paraffin to adults without observing any injurious effect whatever. He says, “As a result of the administration of liquid paraffin, the feces are softened considerably and are found under the microscope to contain numerous minute globules of paraffin.” He was, however, unable to recover from the feces the entire quantity of paraffin administered and believes that a certain portion of it, probably the fractions with a low boiling-point, are absorbed or possibly oxidized in the organism.
Maurice Vejux Tyrode[75] also refers to the use of liquid petroleum in the treatment of constipation.
Sir W. Arbuthnot Lane in his recommendations of liquid petrolatum calls it an ideal remedy for stasis, but cautions against the use of the lighter oil as extensively prescribed in this country as a vehicle for sprays in nose and throat work.
Paraffin oil is not absorbed from the alimentary tract and so far as known exerts no deleterious influence. It is usually given in quantities of from 10 to 20 c.c. half an hour or an hour before meals or in larger doses, from 30 to 50 c.c., at one time on retiring. From available evidence it appears that comparatively huge doses may be administered without the production of any untoward results. According to many observers, liquid paraffin should not be given with or after meals because of the inhibiting influence that it may have on the digestion of food. It is not soluble in water or the ordinary solvents and therefore cannot be diluted. The denser oils are preferably slightly warmed or drunk with warm water so as to obviate the disagreeable slimy sensation that persists when taken cold.
Volatile oils may be used in moderate amounts to give a distinctive taste to the otherwise rather insipidly tasteless paraffin oil. Among the more desirable oils to be used for this purpose would be oil of peppermint, oil of cinnamon, oil of betula or methyl salicylate and oil of cloves. From 2 to 10 drops of any of these oils can be added to a pint of the oil. When larger doses of the oil are to be given at one time, it would, of course, be advisable to use a comparatively smaller quantity of the volatile oil as a flavor.[76]
From the foregoing it would appear that apart from the Pharmacopeia of the United States, practically all other known pharmacopeias describe a water-white mineral oil under the title “Paraffinum Liquidum” or “Liquid Paraffin” as a colorless, odorless, tasteless, non-fluorescent, oily liquid, free from acids, alkalies and organic impurities. As explained before, the specific gravity of the preparation as recognized in other countries and as offered on the American market at the present time varies considerably, and there appears to be some difference of opinion as to the exact nature of the product that is preferable for use for different purposes. This matter requires further investigation.
Since the definition of liquid petrolatum in the U. S. Pharmacopeia permits the use of fluorescent products of widely varying specific gravities, it is recommended that physicians who desire the water-white non-fluorescent (Russian) mineral oil should use the term “Petrolatum Liquidum, Grave,” or “Paraffinum Liquidum, B. P.,” if the heavy product recommended by Lane is desired, and “Petrolatum Liquidum, Leve” if the light varieties are required. It is further recommended that under the foregoing names, manufacturers and pharmacists be requested to dispense the products, in accordance with the following descriptions:
Petrolatum Liquidum, Grave.—Heavy (Russian) Liquid Petrolatum.—Paraffinum Liquidum, B. P., liquid paraffin.—A transparent, colorless, tasteless, non-fluorescent, oily liquid, odorless when cold but giving off a faint petroleum odor on heating. This preparation should correspond to the requirements of the British Pharmacopeia for liquid paraffin and have a specific gravity of about 0.885 to 0.890 at 15 C. It is insoluble in water or alcohol but soluble in boiling absolute alcohol and readily soluble in ether, chloroform, carbon disulphid, petroleum benzin, benzene and fixed and volatile oils. It serves as a solvent for volatile oils and related substances like camphor, menthol and thymol.
This is the type of preparation used by Sir W. Arbuthnot Lane, and his associates for internal administration. It is also used as a basis for ointments and salves and as a local application to wounds, ulcers and in certain forms of skin diseases in which a simple protective is desired.
Petrolatum Liquidum, Leve.—Light (Russian) Liquid Petrolatum.—A transparent, colorless, tasteless, non-fluorescent, oily liquid, odorless when cold, but giving off a faint petroleum odor on heating. In other respects this preparation should correspond to the pharmacopeial tests for liquid petrolatum and have a specific gravity of about 0.860 to 0.875 at 15 C. Like the heavy variety of liquid petrolatum, it is insoluble in water and alcohol, but soluble in boiling absolute alcohol and rapidly soluble in ether, chloroform, carbon disulphid, petroleum benzin, benzene and fixed and volatile oils. It serves as a solvent for volatile oils and related substances like camphor, menthol and thymol.
This is a type of preparation extensively used as a vehicle for the oily sprays in nose and throat work. It is also being used as one of the constituents in the now popular paraffin oil cold cream and has been used to some extent for internal administration in the treatment of chronic stasis. Being more limpid than the preparation preferred by Lane, it is more readily taken, though greater care must be exercised in securing a sample devoid of the lighter fractions of petroleum distillates.—(From The Journal A. M. A., May 30, 1914.)
CLINICAL EXPERIENCE WITH LIQUID PARAFFIN (LIQUID PETROLATUM) [AB]
A Comparative Investigation Made Under the Auspices of the Council on Pharmacy and Chemistry [AC]
W. A. Bastedo, M.D., New York
During the past three or four years, “mineral oil” has come into extensive use in the treatment of constipation. Preparations of the Russian and the American oil, both heavy and light, have appeared on the market, but there have been no satisfactory data on which to base a selection of oil for use. Therefore, in order to obtain reliable clinical information concerning the relative efficiency of the different oils, the Therapeutic Research Committee of the Council on Pharmacy and Chemistry of the American Medical Association submitted samples of the oils to various clinicians for testing. The following is a synopsis of the investigation, which I have prepared at the request of the committee.
The collaborators were advised that specimens of the best obtainable light Russian liquid petrolatum, heavy Russian liquid petrolatum and an American brand of liquid petrolatum would be sent out, but that, to avoid bias, these specimens would be distinguished only by numbers or letters. The oils sent out were (1) a light “Russian” liquid petrolatum having a specific gravity of 0.860 at 20 C., (2) a heavy “Russian” liquid petrolatum having a specific gravity of 0.885 at 20 C., and (3) an “American” liquid petrolatum having a specific gravity of 0.857 at 20 C. and being markedly fluorescent. The collaborators were advised that the reports should furnish information as to size and frequency of dose, the agreeableness to the taste, the effect on the stomach, the number and character of the stools, the degree of admixture of the oil with the other ingredients of the stool, the degree of leakage of oil about the anus, and the need of other cathartic measures.
Reports have been received from Drs. L. F. Barker, W. A. Bastedo, J. B. Champion, Henry A. Christian with C. K. Drinker and F. A. Hatch, Alfred Stengel and R. L. Wilbur.
CONCLUSIONS
The conclusions to be drawn from the clinical reports are:
Dosage.—Half an ounce to 3 ounces a day. In the same patient, the same amount of each of the oils was required.
Frequency of Dose.—The same amount daily seemed as efficient when given in one dose as when given in divided doses two or three times a day.
Agreeableness to the Taste.—There is a difference of opinion in this regard. Two reports favored the heavy Russian oil. One report favored the light Russian petrolatum. But the taste of any of the samples was so slight as to be a negligible quantity after the patient had taken the remedy for two or three days.
Stomach Effects.—In about 20 per cent. of the patients, the oil produced a slight degree of nausea or tended to repeat. This is most likely in patients who have gastric stagnation with retarded emptying of the stomach. All the oils acted the same in this regard. Vomiting was reported in two cases.
Number of Stools.—To produce one or two copious stools a day the dose required varied considerably, but there was no difference noted on account of difference in the specific gravity or character of the oils.
Character of Stools.—The stools were soft, usually formed, sometimes mushy, obviously greasy. They had a peculiar odor described as sour. Their consistency varied with the dose, but was the same for the different kinds of oil.
Admixture of Oil with Other Ingredients of Stool.—Generally well mixed, but from time to time a patient would have a stool of free oil. This occurred with all varieties of oil. (It necessitated reduction of the dose, and if then the bowels were not active enough, the administration in addition of cascara, aloin, etc.)
Leakage About the Anus.—A disagreeable feature complained of by many is that when they take enough of the oil to move the bowels, there is sufficient leakage from the anus to keep the neighboring skin continually in a greasy condition, and sometimes to stain the clothes. That there is any difference in this regard between the oils has not been determined.
In the reports, one clinician noted no differences that were not negligible. Another was slightly in favor of No. 2 (heavy Russian) as regards taste. A third reporter did not make comparative tests. A fourth is slightly in favor of “B” (heavy Russian) as regards taste and general suitability. All of the findings of this investigation are based on hospital cases. A fifth reporter favored No. 1 (light Russian petrolatum). He considered it the most prompt in its effect, the most uniform in results, and the most prone to give a satisfactory admixture of the oil with the other materials. The difference, however, from the other oils was not marked. Another reporter noted no special differences.
SUMMARY
The results of this clinical investigation appear to warrant the conclusion that so far as therapeutic results are concerned the differences in the action of the three varieties of liquid petrolatum, namely, light Russian liquid petrolatum, heavy Russian liquid petrolatum and American liquid petrolatum, are too slight to be of importance. Hence the choice between the lighter and the heavier oils, and between the Russian and the American is an open one, to be determined not by therapeutic differences, but by palatability, dependent on the degree to which the refinement of the oil is carried out. The U. S. Pharmacopeia, the revision of which is now nearing completion, no doubt will furnish standards which will insure a suitable product. From the findings of the foregoing report it would appear that a satisfactory standard might permit the use of either Russian or American oil, if suitably refined so as to be as nearly as possible devoid of odor and taste.—(From The Journal A. M. A., March 6, 1915.)
ANGIER’S EMULSION[AD]
Report of the Council on Pharmacy and Chemistry
Angier’s Emulsion is essentially a petroleum product. When it was first put on the market commercial interests had been fostering the idea that petroleum products had food-value, and the manufacturers of Angier’s Emulsion, making use of the idea, advertised it as a “food-medicine” and an “ideal substitute for cod-liver oil.” The impression thus created has been kept alive through persistent advertising in spite of scientific proof to the contrary. To-day many who know that petroleum products have no food-value are still likely unconsciously to class Angier’s Emulsion among nutrients. Although the manufacturers now advertise this product as “purely mechanical in its action,” they yet show a disposition to profit by the old misapprehension, since, so far from expressly disavowing the old claims as erroneous, they mingle with the new ones vague claims of “tonic and reconstructive merits” apparently designed to sustain, in those who do not take time to consider the evidence carefully, the old faith in the claimed nutritive qualities of the preparation.
While the Council judges a preparation by the claims made for it at present, and not by any past misstatements when these have been thoroughly corrected, the past advertising of Angier’s Emulsion so instructively illuminates the scientific worthlessness of proprietary therapeutic claims in general, and the whole course of its history is so typical that the referee has thought it well to review the subject briefly. The Council has authorized the publication of the following report.
W. A. Puckner, Secretary.
Angier’s Petroleum Emulsion was brought out in 1881—that is to say, before the food-value of petroleum products had been experimentally disproved. Its advertising history well illustrates the weed-like vitality of a financially profitable therapeutic fallacy. The shifting claims made for this preparation are such good examples of the generally unreliable therapeutic pretensions of proprietary medicines—whether of the “patent medicine” or of the “ethical proprietary” type—that it has been deemed advisable to present a brief review of the conflicting claims made for it at various times.
A PETROLEUM PRODUCT
Angier’s Emulsion is described by the manufacturers as containing, in addition to “our specially purified Petroleum,” “the combined hypophosphites of lime and soda, chemically pure glycerine, and the necessary emulsifying agents.” So far as the hypophosphites are concerned, it is probably unnecessary to remark that the latest researches bring to light no evidence that they influence metabolism in the slightest degree. The Angier Chemical Company apparently accepts this view, for in its advertising stress is laid exclusively on the merits of the emulsion as a petroleum product. It is therefore proper to consider it from this point of view.
The history of the internal use of liquid petrolatum was sketched in a recent Council report.[77] As mentioned at that time, a number of petroleum products were put on the market some thirty years ago as substitutes for lard and butter. Contemporary opinions regarding the food value of such products differed widely.
There never was any scientific evidence to support the view that petroleum and its derivatives are assimilable by the animal organism. In fact, so far as we can learn, there was no scientific investigation of the problem until Randolph’s experiments in 1884. These were probably the first to demonstrate the non-absorbability of petroleum and its valuelessness as a foodstuff.
In 1899 Robert Hutchison conclusively demonstrated by experiment that petrolatum, paraffin and related products were absolutely unassailable by any of the digestive fluids, and therefore could not possibly have any food value. Various investigators later confirmed these findings.
FIRST ADVERTISED AS A “FOOD-MEDICINE”
Let us now take up the advertising history of this nostrum. In 1895 it was sold under these claims:
“... a ‘Food-Medicine’ that is far more than a substitute for cod-liver oil”;
“... a Food-Medicine that is readily assimilated and helps to digest other foods.”
In 1897 it was an:
“Ideal Substitute for Cod Liver Oil.”
In 1899 it:
“... conserves heat and energy by furnishing more material for oxidation.”
In 1902 it:
“... supplants tissue waste by tissue reconstruction.”
The promoters of Angier’s Emulsion thus for some time ignored the status definitely assigned to petroleum products by the experiments of Randolph, Hutchison and others. This was only natural. If petrolatum was absolutely inert in the alimentary canal (and this was now proved beyond controversy) then an emulsion prepared from it most certainly was not a “food-medicine,” could not “supplant tissue waste,” or “conserve heat and energy.” All the credit which previous “unterrified and ingenious advertising” (to quote Hutchison) had accumulated for Angier’s Emulsion was bound up with the view that petroleum products were foodstuffs.
LATER ADVERTISED AS NON-ABSORBABLE
The non-absorbability of liquid petrolatum, however, suggested to Robinson, Schmidt, Lane and others, a new therapeutic use for it in the treatment of chronic constipation. This method has rapidly gained popularity and it is not surprising, therefore, that the promoters of Angier’s Emulsion changed their claims accordingly, and now began to base their advertising chiefly on the proved properties of petrolatum. In 1910 the emulsion was advertised for the treatment of chronic diarrhea on these grounds:
“... given by the mouth, it passes to the lowermost portions of the intestines without changing its identity; hence it exerts antiseptic, soothing and demulcent properties upon every inch of the intestinal tract, from the duodenum to the rectum.”
The old claims, however, were not discarded altogether, for in 1911 the preparation was recommended for children’s diseases as:
“... an aid to appetite and digestion and a splendid tonic and builder.”
Before long the attempt was made to weave together the claims based on opposed and mutually incompatible properties. In 1912 we find Angier’s Emulsion recommended because it:
“... corrects digestive disturbance and promotes normal action of the bowels. At the same time it has a most invigorating tonic influence upon the general health.”
In 1914 medical men are advised through the advertising pages of the British Medical Journal of the:
“... tonic and reconstructive merits of Angier’s Emulsion.”
A pamphlet on “Constipation,” which is “Presented to Physicians with Compliments of the Angier Chemical Company” (copyright, 1913; still distributed in 1914) informs physicians that Angier’s Emulsion is:
“... purely mechanical in its action.”
Notwithstanding this, we are told later on in the same pamphlet that it:
“... facilitates, hastens and assists the processes of digestion and assimilation.” ... “is a most efficacious remedy in Pulmonary Tuberculosis because it not only maintains normal nutrition, but also exerts a well-defined specific palliative influence upon the cough and other symptoms of the disease.”
Evidently the advertisement is written in the hope that in one paragraph a claim based on the proved properties of petroleum products may be substantiated, while in another a totally different and inconsistent claim may be glibly insinuated in vague phrases designed to lull thought and thus perform the remarkable feat of securing credence for two contradictory statements.
UNWARRANTED AND MISLEADING CLAIMS
Further evidence that Angier’s Emulsion is at present exploited both to the medical profession and to the public under claims that are unwarranted and misleading, if not as palpably untrue as the claims made in the past, is found on the wrapper of a trade package purchased in 1914 and in the circular accompanying it. Note the following:
“Indicated in Diseases of the Throat and Lungs and of the Digestive Apparatus. Useful in General Debility and Wasting Diseases, Especially when due to Faulty Nutrition. The antiseptic properties of the Emulsion particularly adapt it to the treatment of diseases of septic or bacterial origin.”
“Angier’s Petroleum Emulsion is indicated in affections of the throat, lungs and intestinal tract—both subacute and chronic. In diseases of the digestive apparatus due to catarrhal, ulcerative or tuberculous conditions, its peculiar soothing, healing and aseptic properties make its use especially beneficial. Wasting diseases, particularly when due to faulty nutrition, are greatly benefited by its use, one of the most noticeable effects being a prompt and decided increase in weight.”
It is, of course, unnecessary to point out that, since petroleum is non-absorbable, Angier’s Emulsion contains no ingredient capable of affecting the respiratory mucous membrane except by local application, for which, indeed, this preparation is evidently not intended.
COMPOSITION AND FORMULAS
According to a circular which was contained in a trade package recently purchased
“Each fluidounce of Angier’s Petroleum Emulsion with hypophosphites contains: 331⁄3 per cent. of our specially purified Petroleum; 9 grains of the combined hypophosphites of lime and soda, chemically pure glycerin and the necessary emulsifying agents.”
As regards the nature of the product referred to under the indefinite term “petroleum” the circular states that Angier’s Emulsion is:
“... prepared with refined petroleum specially purified for the purpose. By a process peculiarly our own the crude petroleum, obtained from special wells is so purified that all taste and odor and all objectionable and irritating properties are removed, while the full medicinal value of the oil is retained....”
The composition assigned to Angier’s Emulsion in an advertising pamphlet “The Petroleum Idea,” issued in 1907 differs in that it is said to contain “specially purified crude petroleum” and that each fluidounce is said to contain 2.84 grains of benzoate of sodium. While these quotations convey the impression that certain medicinal constituents of the “specially purified” product obtained from “special wells” are “retained,” a pamphlet recommending the use of Angier’s Emulsion for the treatment of constipation assures us that it produces the “mechanical effects of the purest petroleum” and that it is “purely mechanical in its action.”[78]
LABORATORY REPORT
The statements regarding the identity of the “petroleum” are so unsatisfactory and contradictory (in one place “refined petroleum specially purified for the purpose,” in another “specially purified crude petroleum”—in one place “medicinal” and in another “purely mechanical in its action”) that the help of the Chemical Laboratory of the Association was invoked to establish the character of the petroleum product and to determine the presence or absence of sodium benzoate, at one time declared by the manufacturers to be present but later omitted from the formula. The Association’s chemists reported:
“From a specimen of Angier’s Emulsion recently purchased there was separated by the customary methods of analysis, a yellow fluorescent, unsaponifiable, semi-solid residue which has all the properties of ordinary yellow petrolatum of a consistence somewhat softer than the product described in the Pharmacopeia. It was much more dense than the colorless, non-fluorescent liquid petrolatum now in vogue as a laxative. The preparation contained benzoate, both in the form of free benzoic acid and also in the form of a water-soluble salt probably sodium benzoate.”
The petroleum product contained in the emulsion was thus shown to be intermediate between the ordinary (solid) and the liquid petrolatum. It also appears that a benzoate is still present, though no longer mentioned in the formula.—(From The Journal A. M. A., Sept. 12, 1914.)