BRIEFER PARAGRAPHS
Alcresta Lotion
To the Editor:—What is the composition of Alcresta Lotion?
L. T. A. Hotten, M.D., Paris, Idaho.
According to a circular in our files, “Alcresta Dental Lotion-Libby” contains “Emetin, the active amebicidal principle of Ipecac, together with Benzoic Acid, Thymol, Eucalyptol and Aromatics.” The theory that emetin is an active amebicide against pyorrhea alveolaris has been exploded. In this connection, it is interesting to note that the firm does not list the product in the latest catalogue in our files.—(Query from The Journal A. M. A., Oct. 29, 1921.)
Calcidin Tablets (Abbott)
To the Editor:—What is the composition of calcidin tablets (Abbott) and what is their value?
J. S.
Answer.—Calcidin is claimed to be a mixture of iodin, lime and starch. In contact with water, the iodin and lime react to form calcium iodid and calcium iodate. By the acid of the gastric juice, the calcium iodid and calcium iodate are decomposed with liberation of free iodin. The administration of calcidin tablets amounts to giving free (elementary) iodin. In the past, the advertising for calcidin has contained the unwarranted claim more or less directly that it was the most effective and only noninjurious preparation of iodin for internal use, and that it possesses all of the valuable properties of the iodin with all of the objectionable effects left out. So far as we know, the effects produced by the administration of free iodin do not differ from those produced by the administration of iodids and, therefore, calcidin has no advantage over the iodids, such as sodium iodid.—(Query in The Journal A. M. A., Sept. 25, 1920.)
Di-Crotalin Treatment of Epilepsy
To the Editor:—Do you have any literature or information relative to the Di-Crotalin treatment for epilepsy? I will be very grateful if you can furnish information as to method of preparation, rationale of the treatment, etc.
R. C. Decker, Captain, M. R. C.,
U. S. Soldiers’ Home, Washington, D. C.
Answer.—Di-Crotalin is a rattlesnake venom preparation sold by the Swan-Myers Company of Indianapolis as a “Treatment for Epilepsy, Chorea, Bronchial Asthma, Chronic or Hereditary Nervous Headache, Nervous Prostration Incident to Change of Life, Hysteria-Mania, Insomnia, Neurasthenia, etc.” Dr. Thomas J. Mays of Philadelphia advocated the use of rattlesnake venom for tuberculosis. Later his former assistant, Dr. R. H. Spangler, used the same material in the treatment of epilepsy. That any measure of success sufficient to justify the adoption of the rattlesnake venom or crotalin treatment for epilepsy has resulted is not to be concluded from the available reports. Still less evidence is there for the use of rattlesnake venom in the list of conditions for which the Swan-Myers Company has recommended its preparation. There are a number of good reasons why a cautious physician will shun the administration of this treatment and advise against it. J. F. Anderson, working in the hygienic laboratory of the United States Public Health Service, reported a death from the crotalin treatment in consequence of infection, and reports that the market supply of crotalin solution and crotalin tablets is highly contaminated. He also found both crotalin and crotalin solution to vary in activity. The use of rattlesnake venom was discussed in The Journal, March 15, 1913, p. 850.—(Query in The Journal A. M. A., Aug. 17, 1918.)
Estivin
To the Editor:—What is “Estevin,” or something like that? It is said to be good in hay-fever.
Constant Reader.
Answer.—The product called “Estivin” is sold by Schieffelin and Company, New York. A request for a statement of the composition of this preparation sent to Schieffelin and Company by the Council on Pharmacy and Chemistry brought the indefinite and, therefore, meaningless statement that “ ‘Estivin’ is an extract of Rosa Gallica containing no alcoholic or foreign ingredients.”—(Query from The Journal A. M. A., Nov. 12, 1921.)
Iron Arsenite
To the Editor:—Can you inform me how iron arsenite can be prepared for subcutaneous injection? A commercial firm furnishes physicians with ampules of arsenite of iron. Is this really arsenite of iron?
S. H. Kempner, M.D., New York.
Answer.—Ferric arsenite (iron arsenite) is in itself relatively insoluble in water, but may be treated with ammonium citrate, the resulting product thus being soluble; the latter substance was at one time described in New and Nonofficial Remedies as “Ferric Arsenite, Soluble” and is sometimes sold as a solution in ampule form. In 1912, the Council on Pharmacy and Chemistry deleted “Ferric Arsenite, Soluble” from New and Nonofficial Remedies because “one cannot, in administering Ferric Arsenite, Soluble, give a useful dose of iron without giving too much arsenic; and, vice versa, one cannot give a safe dose of arsenic without giving too little iron.” The Council, therefore, held the preparation to be irrational and unscientific.—(Query in The Journal A. M. A., Feb. 19, 1921.)
K-Y Lubricating Jelly
To the Editor:—1. What is the composition of “K-Y Lubricating Jelly”? 2. Can you furnish a formula for a simple nongreasy lubricating jelly?
S. T.
Answer.—1. The composition of “K-Y Lubricating Jelly” has not been divulged. Examination of the advertising matter reveals only meaningless statements, such as: “This is a judicious combination of vegetable products ... Combined in well balanced proportions with non-irritating antiseptics...,” “It incorporates a sufficient quantity of mild antiseptics (of the Thymol class) ...” and “... contains NO formaldehyde.”
2. Probably a simple tragacanth jelly, which can be made cheaply, will produce the same effects as those of the proprietary preparation. The following formula was published by Mr. J. K. Thum, apothecary at the German Hospital, Philadelphia (Druggists Circular, September, 1915, p. 586):
LUBRICATING JELLY
| Tragacanth, whole | 3 | gm. |
| Glycerin | 25 | c.c. |
| Phenol | 1.5 | gm. |
Distilled water, a sufficient quantity to make 300 c.c. The tragacanth is broken in small pieces, and put into a wide-mouthed bottle; the other ingredients are added and the bottle frequently shaken.
In regard to this formula, Mr. Thum writes:
It has been used in our gynecologic department for years.... For the last six years we have been dispensing it in collapsible tubes throughout the hospital for general work.—(Correspondence in The Journal A. M. A., May 12, 1917.)
“Nikalgin”
To the Editor:—Collier’s has a special article this week on “Nikalgin.” Have you any information on this subject? It sounds like nostrum stuff.
P. R. Minahan, M.D., Fond du Lac, Wis.
Answer.—“Nikalgin” is said to be the “invention” of Gordon Edwards, an engineer. Large claims for its anesthetic and antiseptic virtues have been made. While no very definite information seems to be forthcoming regarding the preparation, it has been said to be “composed of quinin, hydrochloric acid and urea.” This would indicate that “Nikalgin” may be nothing more wonderful than the well known local anesthetic, quinin and urea hydrochlorid, the Quininae et Ureae Hydrochloridum of the U. S. Pharmacopeia, or a modification of it.—(Query in The Journal A. M. A., Sept. 22, 1917.)
Pertussin and Syrup of Thyme
To the Editor:—A short time ago I received a sample of “Pertussin” and used some in an obstinate case of bronchitis with excellent results. I have since received a catalog from a pharmaceutical firm, which advertises syrup of thyme. I have searched for a formula to make my own syrup of thyme, but have not been able to find one. Will you publish one?
E. F. Benner, M.D., Salfordville, Pa.
Answer.—The subjoined formula yields a product very similar to “Pertussin” in taste, flavor, composition, and probably in activity as well:
Fluidextract of thyme | 15 c.c. | |
Glycerin | 15 c.c. | |
Syrup | to make | 100 c.c. |
The original German preparation contained 1.5 gm. of sodium bromid in each hundred cubic centimeters, and this might be added to the foregoing formula with advantage, so far as action is concerned. However, a sample of “Pertussin” purchased in the open market in the United States failed to respond to tests for bromids.
As fluidextract of thyme is not official, this formula is presented as furnishing an acceptable preparation:
| Thyme, in No. 60 powder | 100 gm. |
Moisten with a mixture of:
| Water | 25 | c.c. |
| Alcohol | 15 | c.c. |
| Glycerin | 10 | c.c. |
After standing five hours, pack in a percolator. Exhaust with a menstruum of alcohol, 1 volume, and water, 3 volumes. Reserve the first 85 c.c. of percolate. Concentrate the weak percolate to a soft extract and dissolve in the reserved portion. Make up to 100 c.c. by addition of a mixture of alcohol, 1 volume, and water, 3 volumes.
Other aromatic expectorants, such as terebene, terpin hydrate or creosote, might be expected to have similar but greater effect in chronic bronchitis.—(Query in The Journal, A. M. A., March 27, 1920.)
Quinin and Urea Hydrochlorid
To the Editor:—Could you tell me why quinin and urea hydrochlorid has not become more popular for local anesthesia? Is it less efficacious or more toxic than other preparations? If it is useful, can you name some trustworthy firm or brand? Please omit my name in answering.
L. F. C., M.D., Mexico.
Answer.—Quinin and urea hydrochlorid “has the actions of quinin. When injected hypodermically it exerts an anesthetic action much more prolonged than that of cocain” (Useful Drugs, Ed. 4, 1920, p. 127). It has been pointed out editorially in The Journal (Feb. 14, 1920, p. 462) that quinin has been regarded for more than half a century by toxicologists as a protoplasmic poison capable of destroying various forms of animal and vegetable cells, and hence it need not be surprising that tissue necrosis may be produced by strong solutions of the quinin salts. That this deleterious reaction actually does occur and has militated against the general use of quinin and urea hydrochlorid is confirmed by the report of the Committee on the Advantages and Disadvantages of Local Anesthesia in Nose and Throat Work (The Journal, July 31, 1920, p. 315). To quote:
The only local anesthetic that produces edema and sloughing is quinin and urea hydrochlorid. So many statements were found in the literature that this anesthetic has been abandoned in other fields of medicine because of edema and sloughing, that writers who had presented favorable reports in nose and throat operations were communicated with by your committee. One writer who had recorded 390 cases of tonsillectomies extolling this anesthetic, which he had used for four years and is still so recorded, now states that he has not used it in two years, although no publication has been made retracting his former endorsement. Still another writer, who stated that quinin-urea came nearest the ideal local anesthetic, now states that he has ceased using it. Your committee finds that as far as nose and throat operations are concerned, this drug has practically gone into “innocuous desuetude.”
The anesthesia produced by this drug at the time of operation is good and the recovery of the patient might often be enhanced by its use if it did not have the serious drawback. The product is official in the U. S. Pharmacopeia, and may be obtained from any reputable pharmaceutical house.—(Query in The Journal A. M. A., Aug. 21, 1920.)
Ricord Pills and House Organ Therapeutics
To the Editor:—My mail is frequently cluttered with pseudo-scientific data from various manufacturers of proprietary remedies which contain as much real scientific information as the Police Gazette. I am enclosing a sample page of such a periodical. The article has been so cleverly worded in the first paragraph, as to impress the unthinking with the idea that sodium cacodylate is superior to arsphenamin, when we know in reality that sodium cacodylate has been proved practically worthless in syphilis (vide “Venarsen”). One case is reported, in which twenty injections of sodium cacodylate were administered intravenously, from October 23 to December 14. On December 18, a Wassermann test proved negative, it had been strongly positive on October 20, but during the same interval from October 23 to December 14, the patient had been taking by mouth “Ricord pills” each containing half a grain of yellow iodid of mercury; granted that he had taken these pills regularly, during all that time, it might well be that the Wassermann would be sharply influenced by them. Again, a negative Wassermann in the midst of treatment proves little; it might be positive again in a few days. The article stimulates the further use of a product of known worthlessness in the treatment of syphilis. How any one can use sodium cacodylate in preference to arsphenamin in syphilis is beyond me. If I mistake not, the Propaganda Department has not taken up the matter of these various pamphlets of the drug companies, such as the Doctor’s Factotum, Therapeutic Notes, etc., lauding to the skies such articles as “Seng,” “Cactina Pillets,” etc., ad nauseam. The saddest part of the whole thing is that it must bring returns from the unthinking, otherwise they would soon disappear, which would be a great relief for the scrubwomen who empty our waste baskets.
Paul E. Bechet, M.D., New York.
[Comment.—The “sample page” sent by Dr. Bechet is from the March-April, 1918, number of Parke, Davis & Company’s Therapeutic Notes. It contains an “Original Communication” on “The Treatment of Syphilis with Sodium Cacodylate, by Adolph Lappner, M.D., Detroit, Mich.” The “article,” while nominally devoted to the praise of sodium cacodylate, is virtually a puff for “Ricord Pills.” a Parke, Davis & Co. product.]—(Correspondence in The Journal A. M. A., July 13, 1918.)
Stannoxyl
To the Editor:—I am very anxious to know whether tin or stannous oxid (SnO) has or has had any place among useful drugs. I have seen such a prescription given in the treatment of mucous colitis, and would be very glad to learn what its use may be.
Carlos Manuel Garcia, M.D., Havana, Cuba.
Answer.—Recently, on the assumption that tin workers are less troubled with boils than the average person, two French investigators proposed the use of tin compounds in the treatment of staphylococcic infections. Based on their work, a proprietary preparation—Stannoxyl—has been placed on the market which is claimed to be “composed of stannous oxide and specially purified metallic tin.” Absurd claims are made for the product: for instance, “... We have no hesitation in offering STANNOXYL—in Tablets or Cachets—as the only true specific for diseases of Staphylococcus origin.” The available evidence is unconvincing and in no way warrants such exaggerated statements.—(Query in The Journal A. M. A., March 6, 1920.)
To the Editor:—I was much interested in your answer to a query about Stannoxyl (The Journal, March 6, p. 629). I submit the following experience as a confirmatory note:
While serving with the Royal Army Medical Corps in Egypt, I for some time had charge of the medical division of a hospital in which most of the skin diseases occurring among soldiers in the district were treated. The most common conditions were boils and septic sores, chiefly due to staphylococcal infection, though several of the latter cases were diphtheritic. The treatment adopted was that in ordinary use, namely, incision and evacuation of pus, application of antiseptic dressings, and in most cases employment of the specific vaccine. It was possible to judge of the efficacy of any variations of treatment, as there were always plenty of cases undergoing the usual treatment with which the results could be controlled.
An available supply of Stannoxyl, a proprietary remedy consisting of a mixture of metallic tin and tin oxid, enabled me to give it a fair trial in full doses in eight cases of boils of average severity, in which culture revealed the infecting organism to be Staphylococcus aureus. The boils were treated locally as usual, but no vaccine was given. No improvement could be demonstrated in these cases that could not be shown in other cases similarly treated with the omission of Stannoxyl; in fact, three of the treated cases were much longer in clearing up than the untreated controls. Eight cases do not constitute a very large series from which to draw conclusions; but if the preparation were as good as the descriptive literature would lead one to believe, one should have expected an evident result in at least one of these cases.
It has been stated that Stannoxyl does not inhibit the growth of staphylococci, but only renders the growth less virulent. It is known that a certain amount of tin may be absorbed from the intestine, and Salant, Rieger and Treuhardt have shown that in certain cases tin may be retained for some time in the skin; but it is questionable whether, when preparations of tin are given by mouth, any reaches the staphylococci in the boils, or at any rate enough materially to influence their growth or virulence.
In the cases treated by me, the results did not at all suggest that Stannoxyl was a “specific for diseases of staphylococcal origin.”
J. W. C. Gunn, M.A., M.B., Ch.B., Cape Town.
Professor of Pharmacology, University of Cape Town.
—(Correspondence in The Journal A. M. A., Nov. 20, 1920.)
Syphilodol
To the Council on Pharmacy and Chemistry:—If you have not already done so, will you kindly examine and report on “Syphilodol” advertised in the enclosed pamphlet?
B. C. Pedersen, M.D., New York.
To the Editor:—Have you any information concerning the enclosed half page advertisement [of Syphilodol] from the Urologic and Cutaneous Review?
Edward S. Newell, M.D., Pelham, N. Y.
To the Editor:—I am enclosing an advertisement for a substance called “Syphilodol” manufactured in New York. Am not familiar with this article nor have I seen it advertised in the higher class journals. Can you tell me whether The Journal’s department of New and Nonofficial Remedies has passed on this article or whether you have any data concerning it? It looks a trifle fishy to me.
Louis Leroy, M.D., Memphis, Tenn.
To the Editor:—I am sending the enclosed correspondence [Syphilodol letters] to you as it looks as if it might have some interesting features from the point of view of your nostrum department.
Isadore Dyer, New Orleans, La.
Answer.—These are but some of the inquiries that have been received on this subject and it is encouraging to note the scientifically critical attitude of physicians toward new therapeutic agents. According to the French Medicinal Company, Inc., which markets this product, “Syphilodol is a synthetic chemical product of silver, arsenic and antimony....” Nowhere in the advertising matter is there any more definite statement as to the composition of this new “synthetic” than that just quoted. The product is now under examination in the Association’s laboratory and when this is completed a more detailed report will doubtless be forthcoming. At present the work has progressed sufficiently to show that Syphilodol tablets contain considerable quantities of mercury! Although the advertising leaflets claim that the preparation is “the formula of the late Dr. Alfred Fournier of Paris” and had been exhaustively tested by Metchnikoff, who is alleged to have found it superior to salvarsan and neosalvarsan, yet, strange to say, a careful search of French medical journals fails to show any reports on Syphilodol. Verb. sap.—(Query in The Journal A. M. A., Feb. 23, 1918.)
Thialion
To the Editor:—Kindly inform me regarding thialion, manufactured by the Vass Chemical Company, Danbury, Conn. Please omit my name and address in answering in The Journal.
H. C. W.
Answer.—Thialion is an heirloom of the days when lithium salts were supported to be nature’s antidote for all kinds of ailments, supposedly due to excess of uric acid. It was advertised as a uric acid eliminant and therefore good for all kinds of diseases. The Council on Pharmacy and Chemistry published a report on thialion in The Journal, Nov. 3, 1906. At that time thialion was advertised by the Vass Chemical Company as a “laxative salt of lithia” with the chemical formula “3Li2O.NaO.SO3.7HO,” and an elaborate structural formula was also furnished. The Council reported that the product was not a definite chemical compound, but a mixture consisting chiefly of sodium sulphate, sodium citrate and small amounts of lithia. In recent advertisements, thialion is referred to as “A Non-Effervescing Lithiated Laxative Salt,” “a non-hygroscopic, non-deliquescent, granular salt of lithia,” etc., but the chemical formula does not appear, nor is any definite statement of composition furnished. According to this advertisement, the “indications” for thialion are: “gout, rheumatism, uric acid diathesis, constipation, acute and chronic, sluggish liver, Bright’s disease, albuminuria of pregnancy, asthma, incontinence of urine, gravel, cystitis, chronic lead poisoning, headache, neuralgia, neurasthenia and lumbago, Hay fever, etc.”—(Query in The Journal A. M. A., Dec. 6, 1919.)
Venarsen—To the Editor:—The following is a copy of a letter sent to the Intravenous Products Company, which needs no explanation:
June 8, 1917.
The Intravenous Products Co., Denver, Colo.
Gentlemen:—In reply to your circular letter under date of June 3, may I say that after using a great quantity of Venarsen both in clinical and private cases, I can see no more effect upon these cases than if so much water had been administered.
This is also the report of Don R. Black, pathologist for Bell Memorial Hospital, University of Kansas. In our experiments all bloods were tested before and after each administration of this product.
William A. Wilson, M.D., Kansas City, Mo.
(Correspondence in The Journal A. M. A., July 7, 1917.)