ROBINOL AND SEVETOL

Revamping Discarded Theories for Commercial Purposes

It is astonishing how rapidly medical hypotheses become theories and theories are accepted for established facts, when such alleged facts are favorable to commercial enterprise. Yet, as a matter of fact, the manufacturers of proprietary preparations are under a moral obligation, at least, to tell the truth with reference to the scientific basis for their claims. To draw from exploded theories reasons for the use of proprietary preparations is reprehensible, not only because it may lead physicians to use preparations which are worthless, but also because it tends to confirm in the physician’s mind opinions which science has discarded.

Robinol

John Wyeth and Brother put up a mixture of glycero­phos­phates which they call Robinol. In their description of the properties of this mixture they say:

“Phosphorus exists in the brain, nervous system, and vital organs as lecithin, of which glycero­phosphoric acid is the most important constituent and is essential to the vital processes for the reproduction of life and maintenance of metabolism in old age, impotence, etc.”

The first impression on reading this sentence is that it suggests that glycero­phos­phates are essential to the vital processes, although the statement strictly applies to phosphorus. The next sentence confirms this impression and the mind glissades from the accepted fact of the existence of phosphorus in nervous tissue to the unfounded hypothesis that the glycero­phos­phates are necessary to supply the essential element. In the next sentence the circular continues:

“In nervous and general debility the glycero­phos­phates as exhibited in Robinol, are preferable to the mineral phosphates as they contribute the essential constituent of nerve tissue and are absorbed by the cells more readily than any phosphate of vegetable or inorganic origin.”

This statement is utterly unfounded. It is in direct opposition to the conclusions of pharmacologists. The glycero­phosphoric acid radical is, to be sure, found in the lecithin of nervous tissues, but its source is not known. There is no evidence either that it must be present in the food or that it must be taken as medicine in order that the brain and nervous tissues shall be nourished. When the glycero­phos­phates are taken there is no evidence that they enter into the composition of the brain or nervous tissue. They are excreted in the urine and feces as phosphates. It has never been shown that glycero­phos­phates are absorbed any more readily than other phosphates.

But the advertising circular has still more information to impart to physicians:

“In that group of maladies characterized by faulty nutrition, due to the excessive elimination of phosphorus from the body, as is evidenced by the fatigue and weakness following acute attacks and present in many chronic affections, during the course of fevers and in the later stages of phthisis and all diseases of the nervous system, physicians will find the tonic chalybeate properties of the glycero­phos­phates of great value.”

Physicians know, if the nostrum makers do not, how difficult it is to determine whether there is an excessive elimination of phosphorus from the body. The bulk of the phosphates found in the urine are derived from the food and so little comes from the metabolism of the nervous system that it is not easy to prove that any disease is due to excessive elimination of phosphorus from the body. That fatigue and weakness are due to such a loss of phosphorus is mere assumption, a convenient theory for the exploiters of glycerophosphates. But admitting that nervous waste or faulty nutrition is characterized by the loss of phosphorus, it is easier, cheaper and more rational to supply such loss by the use of phosphorus-containing foods, such as milk and eggs, and there is not the slightest evidence that the loss of phosphorus will be influenced in any way by giving a supply in the form of glycero­phos­phates. Thus, in order to bolster up the sale of a simple solution of glycero­phos­phates, vague theories and improbable hypotheses are dressed in all the dignity of scientific facts.

Sevetol

There was a time, perhaps a generation ago, when physiologists taught that fats were absorbed into the blood in the form of a fine emulsion. This theory has been definitely disproved and it is now known that fats enter the blood only after a chemical splitting into glycerol and fatty acids, the latter being, to a large extent, combined with alkalies in the form of soaps.

“Sevetol,” another Wyeth preparation, is presented to the profession under the claim that it is a very fine emulsion of fats, every portion of which “is readily absorbed through the intestinal wall.” To quote:

“The administration of Sevetol, therefore, does not tax the digestive power of the patient, for it is absorbed with very little effort on the part of the digestive apparatus; and even if the organs of digestion be involved, neither the weakness of the patient nor the severity of the symptoms necessarily contra-indicates its use. The amount ingested is limited only by the power of assimilation exhibited in the tissues, and it may be given in large doses for a continued period of time, or until symptoms of overfeeding are produced, such as coated tongue, anorexia, constipation, headache and lassitude. When these symptoms appear, the administration of Sevetol should be temporarily discontinued and a mild but effective laxative given for several days, after which its use may be resumed.”

While the language just quoted is a little more exalted and dignified than that found in typical “patent medicine” advertisements, the thought it expresses qualifies it for a place in the “Lydia Pinkham” or “Peruna” class. Every sophomore medical student knows, if he gives the matter any thought, that Sevetol must undergo the same process of digestion as any other fat. It must be broken up into a fatty acid and glycerol, and saponified before it can be absorbed. It is plainly evident that the amount of Sevetol which can be taken is limited not only by the power of assimilation, but also by the power of digestion. The symptoms mentioned in the advertisement and ascribed to overfeeding, are the symptoms, not of a system saturated with absorbed fat, but of digestive organs rebelling against an unusual diet.

The exploitation of Sevetol is but one more case of turning to commercial account an exploded theory. Isn’t it about time that our profession demanded that the purveyors of medicinal products tell the truth? And isn’t it time, too, that we cease taking our pharmacology and therapeutics from proprietary manufacturers?​—(From The Journal A. M. A., July 4, 1914.)