BRIEFER PARAGRAPHS
Laxol and Lysol—The Short and Catchy Proprietary Name
A laborer went to a Brooklyn physician for treatment and was given three prescriptions. One of the prescriptions, according to the Food and Drug Bulletin of the Department of Health, City of New York, called for “Laxol,” the word being written on a piece of blank paper without directions. The drug clerk misread the prescription and dispensed an “original” bottle of “Lysol” which bore the usual poison label with skull and cross bones. The man drank the entire 3 ounces of Lysol and died half an hour later. The case is now in the hands of the District Attorney, the drug clerk being held under $10,000 bail. “Laxol,” as our readers know, is castor oil sweetened with saccharin and flavored with peppermint. There is no excuse for prescribing the product. The official Aromatic Castor Oil (Ol. Ricin. Arom.) of the National Formulary would answer every purpose served by the proprietary preparation.—(Editorial from The Journal A. M. A., May 29, 1920.)
Look Up Its Rating
Modern business has become so complex that it is no longer possible for those engaged in trade to know, offhand, the financial responsibility of their prospective customers. The commercial agency is a natural development; it aims to supply the technical (financial) information which the conservative business man needs but is otherwise unable to get. When John Doe & Co. contemplates entering into business arrangements with Henry Roe & Son to a degree that involves financial obligations, it looks up Roe in the rating book of Dun or Bradstreet and probably calls for a special commercial report on the concern. These facts are so elemental and obvious as to be trite. The complexity of modern medicine, especially in the pharmacologic field, has made it a physical impossibility for physicians to know the scientific status of scores of pharmaceutical products put out under proprietary or brand names. It was recognition of this fact that brought about the creation by the American Medical Association of the Council on Pharmacy and Chemistry. This body of experts, serving without remuneration and reporting without fear or favor on the newcomers to the pharmaceutical world, places at the disposal of physicians unbiased information, free alike from prejudice or prepossession. As the commercial agency reports on the commercial probity of individuals and firms, so the Council on Pharmacy and Chemistry reports on what might be called the scientific probity of proprietary and unofficial pharmaceutical products. The commercial agency issues, at no small expense to its customers, rating books; the council on Pharmacy and Chemistry issues, at a nominal price, “New and Nonofficial Remedies.” The commercial agency, for a substantial fee, will furnish reports on business concerns; the Council on Pharmacy and Chemistry will, without any expense to the profession, furnish reports on proprietary products used for the relief or cure of human ailments. The careful business man avails himself of the services of the commercial agency; there are financial interests at stake. The conscientious physician will avail himself of the services of the Council; there are, it may well be, lives at stake.—(Editorial from The Journal A. M. A., April 24, 1920.)
The Medical Profession and Commercial Interests
Last week The Journal published a letter received by a physician in Milwaukee from a firm of lawyers representing the Farbwerke-Hoechst Company. In this communication the physician was threatened with suit if he published further unfavorable reports regarding that firm’s preparation. Quoting from the attorney’s letter:
“Mr. Metz directs us to inform you that the publication of this article and the statements therein were seriously damaging to the Farbwerke-Hoechst Company, and directs us to say further to you that he and the corporation will hold you personally responsible for any repetition, oral or written, of the same or of similar statements to the same effect.”
We were under the impression that the time had passed when a proprietary medicine manufacturer would presume to threaten a physician for making an honest report of his results with any therapeutic agent. Such condition did exist once, before the Council on Pharmacy and Chemistry undertook its work. Now comes Mr. Metz to revive this relic of an historic but infamous period in the history of American proprietary medicine manufacturing. Even Mr. Vanderbilt regretted that he ever said “The public be d——.” One of the elementary principles in the practice of medicine is that the individual physician shall let others know his results, whether good or bad, in any line of treatment. It is by such interchange of knowledge and experience that progress in medicine is possible. Yet Mr. Metz would interfere with the diffusion of such knowledge and experience when it applies to proprietary medicines. His legal threat against Dr. Sargent is “terrorism” applied to the medical profession.—(Editorial from The Journal A. M. A., June 8, 1918.)
Rabbit-Foot Therapy
Few but ignorant darkies have any great faith in the therapeutic efficacy of the left hind foot of a rabbit caught in the churchyard in the dark of the moon. In the light of modern therapeutics one is tempted to believe, however, that had some one person or firm an exclusive proprietary right to this particular brand of rabbits’ feet, there would be many intelligent people—and not all of them laymen—ready to swear by rabbits’ foot therapy. In medical journals (whose advertising pages set forth the virtues of the pedal extremities of Lepus sylvaticus) many solemnly scientific articles would probably appear relating the success that the writers had had with this form of therapy in the treatment of some distressing stubborn conditions that had failed to respond to all previous efforts. Is it ubiquity that has saved the homely cotton-tail from being a therapeutic hero?—(Editorial from The Journal A. M. A., Sept. 29, 1917.)
Secret Remedies and the Principles of Ethics
Many hundreds, possibly thousands, of inquiries are received each year by The Journal from physicians asking for information on, or an opinion of certain proprietary remedies. In many instances the preparations in question are essentially secret in composition, although advertised to the profession under a fair-seeming exterior of apparent frankness. There are on the market today—and used by members of the American Medical Association—dozens, yes scores, of widely advertised proprietaries that are, to all intents and purposes, secret. The physicians who prescribe them do not know and cannot know what they are giving their patients. On this point Section 6 of Chapter II of the Principles of Medical Ethics of the American Medical Association says:
“... it is ... unethical to prescribe or dispense secret medicines or other secret remedial agents, or manufacture or promote their use in any way.”
The inherent and basic reasonableness of the various requirements of the Principles of Medical Ethics needs no exposition or defense. A large number of proprietary remedies which at present degrade medicine would be wiped out of existence or, at any rate, go over to the “patent medicine” class, where they belong, if physicians would live up to Section 6, Chapter II, of the Principles.—(Editorial from The Journal A. M. A., Sept. 27, 1919.)
“Sterling Violet Ray Generator”
To the Editor:—I am curious to learn the value of the violet ray in the treatment of disease. The violet ray seems to be much in evidence in Canada at the present time in various towns. It is well advertised, not in the same way as a “patent medicine” would be, but as a genuine form of treatment. The enclosed booklet gives a brief outline of what the agents for the “Sterling Violet Ray Generator” claim it will do. The reason I am troubling you about the matter is that I feel if there is anything in it as is claimed, it should be better known. It also seems that if this treatment is not capable of doing what is claimed for it, it is a rather serious thing for a person who may defer calling a physician.
J. A. G.
Answer.—The “Sterling Violet Ray Generator” is a small high frequency apparatus with some vacuum and possibly other electrodes. There is a violet color in these vacuum electrodes when they are energized. The apparatus is not one for producing violet or ultraviolet rays in the scientific meaning of those words. The apparatus certainly will not do the things claimed for it in the booklet which includes the treatment of practically every ailment known to mankind.—(Correspondence in The Journal A. M. A., April 14, 1917.)
Strontium Salicylate Not Superior to Sodium Salicylate
Sodium salicylate is a valuable drug. It is official and cheap; it is the compound generally relied on when salicylate effects are desired. And there is no mystery about it. With the other salicylates, mystery begins. For this reason, such studies as that of Blankenhorn on strontium salicylate are of special value. Blankenhorn shows that strontium salicylate possesses no advantages over sodium salicylate, as regards either therapeutic efficacy or freedom from undesirable by-effects. He calls attention to the fact that “the salicyl content of strontium salicylate is about four-fifths that of sodium salicylate based on the amount of available anion.” The question naturally arise whether this smaller salicylate content may not contribute to the notion that strontium salicylate is less likely to cause salicylism. The impression as to the greater freedom of this salt from undesirable by-effects may have arisen in part also from the fact that the more expensive preparations are more likely to be given in small doses than is the cheaper sodium salicylate. As Blankenhorn suggests, when once such a tradition gains currency, it will be “lugged along” from one textbook to another, with little or no attempt at critical examination.—(Editorial from The Journal A. M. A., Jan. 29, 1916.)
Vaccine As a Prophylactic in Influenza
To the Editor:—I am chief surgeon for a large steel industry in Canton, and desire to do all in my power to prevent the threatened recurrence of influenza. What is the status of the various vaccines as a preventive or prophylactic measure? Would you advise their use as a preventive measure, to immunize the workers in the industries?
M.D., Canton, Ohio.
Answer.—The status of vaccine therapy as a prophylactic for influenza may be ascertained from the two articles appearing in The Journal, Aug. 9, 1919: that of E. C. Rosenow and B. F. Sturdivant entitled “Studies in Influenza and Pneumonia: Further Results of Prophylactic Inoculations,” and that of G. W. McCoy, director, Hygienic Laboratory, U. S. Public Health Service, on “Status of Prophylactic Vaccination Against Influenza.” In brief, the conclusion of Rosenow and Sturdivant is: “It appears from all of the facts at hand that by the use of a properly prepared vaccine it is possible to rob influenza of some of its terrors.” On the other hand, McCoy states: “The general impression gained from uncontrolled use of vaccines is that they are of value in the prevention of influenza; but, in every case in which vaccines have been tried under perfectly controlled conditions, they have failed to influence in a definite manner either the morbidity or the mortality.” To make a conservative statement: The use of vaccine as a prophylactic in influenza is an experiment.—(Query in The Journal A. M. A., Sept. 27, 1919.)
Vaccines for “Colds”
To the Editor:—Has there been work done of sufficient extent to be of value in justifying use of mixed “shotgun” vaccines to abort or immunize “common colds,” that is, rhinitis, pharyngitis, acute bronchitis, coryza, etc.?
Charles E. Bennett, M.D., Aneta, N. D.
Answer.—We know of no investigation which demonstrates that the use of the commercial mixed vaccines are of value in the prevention or treatment of “common colds” or of similar affections. The Council on Pharmacy and Chemistry accepts for New and Nonofficial Remedies mixed vaccines only on condition that their usefulness has been established by acceptable clinical evidence; so far it has not admitted any of the “influenza” or “catarrhal” mixed vaccines.—(Correspondence in The Journal A. M. A., Nov. 10, 1917.)
To the Editor:—Please advise me of the latest and best vaccine for common colds.
L. J. Smith, M.D., Wilson, N. C.
Health Officer, City and County Health Department.
Answer.—There is no scientific evidence that common colds can be prevented by the use of vaccines, despite the glowing recommendations of vaccine makers and the patter of the detail man. Colds characterized by catarrhal inflammation of the mucous membranes of the nose and throat are caused by various organisms, including a number of the commoner cocci and the bacillus of Pfeiffer. They are contagious, and spread rapidly from one person to another by the transfer of the bacteria concerned, so that small epidemics of colds are continually occurring in homes and communities. The organism concerned in one small epidemic may be different from that in another, and it is impossible to anticipate what organism is about to invade the household or community. The inoculation of mixed vaccines in the hope of providing against a number of possible invaders fails to produce immunity sufficient to prevent the infection of mucous membranes. Where completely controlled experiments have been made with large numbers of persons, colds have occurred among the inoculated in as large proportion as among the uninoculated. During the war, some evidence was obtained which indicated that preventive inoculation of troops with a vaccine containing large numbers of pneumococci reduced the incidence and mortality of pneumonia. In the case of superficial infection of the nasal and pharyngeal mucous membranes with diverse etiology, less can be expected, and practical results indicate that this skepticism based on theoretical considerations is well founded.—(Query in The Journal A. M. A., Nov. 13, 1920.)