VIBURNUM COMPOUND—AND OTHER NOSTRUMS
A number of drugs have some reputation for therapeutic value without there being any particular evidence to substantiate the claims. Viburnum, concerning which we recently received the following letter, is one of these drugs:
To the Editor:—Have you made an analysis of Viburnum Compound? Extravagant claims are being made for it and I cannot put my hand on any data. A patient has asked me concerning it and I wish to advise her honestly. I do not know but that there may be several “viburnum compounds.” I rarely use any of these “put-up” preparations, and hence know but little about them.
A. J. Hesser, M.D., Pittsburgh, Pa.
No analysis of Hayden’s Viburnum Compound, to which our correspondent refers, has been made in the Association laboratory. According to advertising circulars, the preparation contains American skullcap (Scutellaria lateriflora), cramp-bark (Viburnum opulus) and wild yam (Dioscorea villosa). Since these drugs contain no well-defined therapeutically active ingredients, an analysis of the preparation would necessarily be unsatisfactory.
A number of drugs have in some way obtained a reputation as being valuable in the treatment of diseases of women, without their therapeutic claims ever having been proved. It is said that some were used by the aborigines for such affections and we find a considerable number of them combined in various nostrums (sometimes with therapeutically active drugs) and exploited for the cure of female disorders, under most extravagant and usually absurd claims. Thus “Pierce’s Favorite Prescription” is advertised as containing black cohosh, blue cohosh, goldenseal, lady’s-slipper and false unicorn-root; “Dioviburnia” (Dios Chemical Co.) as containing American skullcap, cramp-bark, wild yam, blue cohosh, black haw, star-grass, trailing arbutus and false unicorn-root; “Viburnumal” (Louisville Pharmacal Works) as containing American skullcap, cramp-bark, wild yam, star-grass and motherwort.
Most pharmaceutical houses, following the lead of nostrum-makers, put similar mixtures on the market; for example: “Elixir of Viburnum Compound” (Nelson, Baker & Co.) is said to contain cramp-bark, American skullcap and wild yam; “Elixir of Hydrastis and Viburnum Compound” (Smith, Kline & French Co.), cramp-bark, goldenseal, Jamaica dogwood and pulsatilla; “Elixir of Hydrastis and Cramp Bark Compound” (Parke, Davis & Co.), cramp-bark, hydrastis, Jamaica dogwood and pulsatilla; “Fluid Extract of Cramp Bark Compound” (H. K. Mulford Co.), American skullcap, cramp-bark and wild yam; “Mother’s Cordial” (Eli Lilly & Co.), cramp-bark, blue cohosh, false unicorn and squaw vine; “Uterine Sedative Elixir” (Eli Lilly & Co.), cramp-bark, goldenseal, Jamaica dogwood and pulsatilla; “Vibutero” (Fred. Stearns & Co.), cramp-bark, wild yam, black haw, squaw vine, Jamaica dogwood, saw palmetto and pulsatilla. Practically all of these drugs except goldenseal are ignored in the standard works on pharmacology. Further, the results of careful examination by the Council on Pharmacy and Chemistry of the therapeutic claims made for most of them shows that these claims are not sustained by reliable clinical experience.
The fact is that the popularity of preparations of this kind is purely an artificially created one. A nostrum containing, let us say, extractives of some little-used or worthless drugs is put on the market and heavily advertised. Should it be advertised in a manner to make it sell, a host of imitations appear and the large pharmaceutical houses put out substitutes for it. The uncritical physician does the rest. He prescribes it indiscriminately in the class of cases for which it is advertised. Naturally, a certain proportion of the patients who take it recover, and the recoveries are credited to the nostrum. A vicious circle is thus established and the demand for the stuff increases. Its sale, together with the sale of similar products, continues until the overwhelming experience of those who have prescribed it proves its uselessness. In the meantime the manufacturers have reaped a harvest, at the expense both of the public and of the medical profession. And the manufacturers’ excuse for putting such absurd “specialties” on the market is that physicians prescribe them!—(From The Journal A. M. A., Aug. 31, 1912.)