COTTON PROCESS ETHER
To the Editor:—Please let me know what information you have about the enclosed clipping?
E. W. Carpenter, M.D., Greenville, S. C.
To the Editor:—“Cotton Process Ether,” manufactured by the Du Pont Co., has been given considerable notoriety in the lay press. A letter of inquiry addressed to the firm elicits the information that “Cotton Process Ether is a very highly refined Di-ethyl Ether charged with Ethylene Gas.” ... What is your opinion of the “Cotton Process Ether”? Has the Council on Pharmacy and Chemistry investigated this product?
John L. Atlee, M.D., Lancaster, Pa.
To the Editor:—I have been waiting for some reference to the new anesthetic referred to in the enclosed clipping, but if any has been made in the medical press I have failed to notice it. If there is anything of interest in connection with this item, and it is not too much trouble, I will thank you to put me in touch with the situation.
Holman Taylor, M.D., Fort Worth, Tex.
Answer.—About January 20, the “News Service” of the “E. I. Du Pont De Nemours and Co., Inc.,” circularized the press of the country with what it was pleased to term a “good ‘filler’ ”; this particular piece of press agent work dealt with “The New Du Pont Ether.” To quote one paragraph from the “News Item”:
The new anesthetic, which is a highly refined di-ethyl ether, modified by the addition of gases, has the following characteristics: (1) the property of inducing and maintaining anesthesia with practical freedom from postoperative nausea, and (2) the property of inducing and maintaining analgesia (conscious insensibility to pain) as distinguished from anesthesia (insensibility to pain plus narcosis).
The Du Pont Ether and the claims made for it are seemingly based on the work of one man, “James H. Cotton, M.A., M.D., Toronto, Canada,” who published an article on “Cotton Process Ether and Ether Analgesia,” in the American Journal of Surgery for April, 1919. However, Cotton did not give the composition of the “new” ether nor, so far as we are aware, has his work been corroborated. In view of the inquiries received, the Secretary of the Council on Pharmacy and Chemistry asked the Du Pont Chemical Works for the composition of the new ether. From the firm’s reply we quote one paragraph:
“... The procedures of manufacture, and the exact composition of our ether, we regard as confidential information which we are entitled to retain unless a condition were to arise in which we were unable alone to satisfy the demand for this type of ether.”
It has been recognized—and incorporated in the “Principles of Medical Ethics”—that the use of a therapeutic agent of unknown composition is unscientific and contrary to the best interests of the medical profession and the public; but it is many times more serious for a physician to employ a secret or semisecret substance as an anesthetic. A physician using such a semisecret substance would have little defense if the patient should die.—(Query in The Journal A. M. A., Feb. 21, 1920.)
A Note from the Manufacturers
In the Query and Minor Notes department of The Journal of February 21, some inquiries from physicians relative to “Cotton Process Ether” were answered. In referring to the composition of this product it was stated that the secretary of the Council on Pharmacy and Chemistry had asked the manufacturers, the Du Pont Chemical Works, for information on this point and one paragraph from the firm’s reply was quoted. Another paragraph from the same letter was omitted; and to this omission the manufacturers took exception, expressing the opinion that by it The Journal led its readers to infer that the concern had “refused to furnish any information whatever” regarding the composition of the ether. The following paragraph, italicized as in the original letter, is the one in question:
“Cotton Process Ether contains no components which do not occur in other anesthesia ethers. Its peculiar properties result from the thorough methods taken to exclude harmful impurities, such as aldehydes, peroxides, traces of acids, carbon monoxide, sulphur compounds, etc., and to include carefully regulated quantities of only such of the usual components as we have found to give distinctly beneficial properties to the ether. We are willing to state that in this class we consider properly prepared ethylene of greatest importance, but we have not announced which of the beneficial components of anesthesia ether we include in our ether, or the amount of such components.”
As the quotation shows, the paragraph is informative in a negative rather than in a positive way in that it states what Cotton Process Ether is not rather than what it is. Since that time, however, the manufacturers have notified The Journal that they have definitely decided to present Cotton Process Ether to the Council on Pharmacy and Chemistry for consideration and that in preparing the data required by the Council will define Cotton Process Ether as follows:
“An improved anesthesia ether consisting of highly refined diethyl oxid (C2H5)2O, plus approximately two volumes of ethylene (C2H4), 1⁄2 volume of carbon dioxide (CO2) and 1 per cent. by weight of ethyl alcohol.”—(From The Journal A. M. A., May 22, 1920.)