FRAUD AND DECEPTION IN PREPARATIONS OF COD-LIVER OIL.
The Journal of the American Medical Association, October 13, 1906, exposes the fraud and deception practised by certain proprietary firms in putting on the market preparations purporting to contain cod-liver oil, when, in fact, they contain no oil at all. It is conceded by pharmacologists that the value of these remedies depends on the nutritive power of the fat, and any preparation which contains fat must respond to simple tests which the physician can personally apply. The preparations claiming to represent cod-liver oil are in liquid form, and if they contain oil it must be in one of the following forms:
(1) An emulsion of the oil which may be miscible with water, but from which the fat tends to separate and rise to the top. In this form the fat can be seen as globules under the microscope.
(2) A solution, resulting from the saponification of the oil, containing a soap which usually will be alkaline in reaction, especially when mixed with water, and from which fatty acids are separated as a precipitate when the solution is acidified.
(3) A solution of fatty acids. This will be acid in reaction and will be precipitated by the addition of water, in which the fatty acids are not soluble.
An examination of one of these preparations, e. g., Waterbury’s Metabolized Cod-Liver Oil, which, it is claimed, “contains the metabolized product obtained by the action of ferments on cod-liver oil,” shows that it is neither an emulsion, a solution of soap, nor a solution of fatty acids, and more careful analysis shows that it contains no fat or fat acids (except the merest traces). No intelligent physician should be misled by the extravagant and unfounded claims made for this preparation.
Hagee’s Cordial of Cod-Liver Oil is a representative of a class of preparations which claim to “represent the oil, but contain no fat,” and are therefore practically worthless. The claims of therapeutic value for such preparations can not be substantiated. Some such remedies are advertised as extracts of cod-liver oil, when, in fact, they are made from cod livers, but not from cod-liver oil. These preparations, if honestly made, might be worthy of a trial, but they are not preparations of cod-liver oil, and should not be so termed. So far as we know, however, no satisfactory evidence is forthcoming that such extractives have any therapeutic value.
The attempt to modify cod-liver oil for therapeutic purposes may be pronounced a failure and the large variety and extensive sale of these preparations appear to be owing to the fact that physicians do not recall the ordinary facts of chemistry, but accept too readily the statements of the manufacturers.
PROGRESS IN PHARMACY.
A QUARTERLY REVIEW OF SOME OF THE MORE IMPORTANT ADVANCES IN PHARMACY AND MATERIA MEDICA.
By M. I. Wilbert,
Apothecary at the German Hospital, Philadelphia, Pa.
The Food and Drugs Act, June 30, 1906, continues to be the leading topic for discussion in pharmaceutical journals and in pharmaceutical circles generally. In many of the larger cities special meetings have been held at which the probable effect of the law, directly as well as indirectly, on the several branches of pharmacy have been discussed at length.
Wholesale druggists and manufacturing pharmacists appear to be heartily in favor of the underlying principles and of the general provisions of the Federal pure food and drug law, despite the fact that it has imposed an enormous amount of additional work and expense for which they can scarcely expect to be adequately recompensed.
The proposition to endorse the Federal law, by corresponding laws in the several States, has aroused considerable opposition on the part of retail pharmacists, who appear to be either indifferent or else fearful lest the additional obligations that would be imposed on them might be too exacting or else involve an undue amount of work or expense to comply with.
In this connection we should remember that pharmacists, as such, have taken little or no part in securing the enactment of the Federal pure food and drug law, and that, as a consequence, they have thus sacrificed no little of their professional independence and prestige.
This apathy on the part of pharmacists is even now being taken advantage of by members of boards of health, Food and Dairy Commissioners and well-meaning but frequently misinformed reformers who are actively at work to secure food and drug legislation along the lines of the National law.
In by far the greater number of State legislatures, now in session, bills for laws of this kind have been introduced, and whether enacted into laws or not, will tend to show the wants or desires of retail pharmacists, and, if opposed or ignored, will seriously reflect on the ability and professional disinterestedness of pharmacists themselves.
Retail pharmacists should, and if they desire to maintain their standing in the community they must, favor pure food and drug legislation that is designed to protect the public. By themselves taking an active interest in the securing of legislation along these lines they could readily prevent the enactment of ill-advised measures that would tend to hamper or restrict them in the pursuance of their business.
That the medical profession in all sections of the country is clearly in favor of pure food and drug legislation was plainly evidenced at the Conference of the Committee on Medical Legislation, of the American Medical Association, with the National Legislative Council, held at Washington, D.C., December 13th to 15th inclusive.
State legislation was discussed at some length and the representatives of the several State Medical Associations who were present expressed themselves in no uncertain way as being in favor of the individual States endorsing the Federal Food and Drugs Act.
The proceedings of this conference have been published in pamphlet form, comprising sixty-eight pages of closely printed material. This pamphlet contains much that is of interest to pharmacists, and may be obtained from the Secretary of the Bureau of Medical Legislation of the American Medical Association, 103 Dearborn Avenue, Chicago, Ill.
The available literature on pure food and drug legislation is rapidly assuming huge proportions. In addition to the liberal space that is devoted to the question in the current numbers of pharmaceutical journals, a number of reprints of material of this kind have appeared. Not the least interesting of these reprints is a pamphlet of sixty-four pages entitled:—
The Food and Drug Act as it relates to drugs, examined and explained in connection with the rules and regulations for its enforcement. This pamphlet is published by the National Druggist, St. Louis, Mo., and contains in addition to the law itself and the regulations pertaining to it, a number of interesting decisions and much additional material bearing more or less directly on the proper interpretation of the Food and Drugs Act.
Digest of National Food and Drugs Act and Regulations, by Mahlon N. Kline, is the title of a pamphlet containing upwards of seventy-two pages that has recently been sent out with the compliments of the Smith, Kline, French Company, Philadelphia. In addition to a transcript of the Food and Drugs Act, and of the rules and regulations for the enforcement of the same, this pamphlet also contains a number of additional opinions, replies and explanations that have been published from time to time; also a legal exposition of the Food and Drugs Act by George L. Douglas, attorney for the Proprietary Association of America; extracts from the recently published “Standard of Purity for Food Products,” and much additional information of interest to retail pharmacists.
The Ladies’ Home Journal Bill, or a corresponding measure to regulate the manufacture and sale of so-called patent medicines, has been introduced in upwards of ten of the State legislatures now in session. This bill, originally published in the Ladies’ Home Journal about a year ago, is essentially a formula on the label bill and provides, in addition, that preparations containing one or more of certain specified drugs be labeled poison.
Anti-narcotic legislation is also receiving a fair proportion of attention. The most drastic of these measures is probably the one that has been introduced into the legislature of the State of New York, at the instance of the Evening Journal. This bill prohibits the sale of opium, chloral, cocaine, eucaine or acetanilid, or any preparation containing them, except on the original written prescription of a physician, dentist or veterinarian.
In several States, notably Texas and Missouri, bills are pending that are designed to improve or to revise the laws governing the practice of pharmacy.
Patent Reform Bill.—Representative Currier, Chairman of the House Committee on Patents, has introduced a bill to substitute the much discussed Mann bill. This bill, popularly known as the Currier bill, is practically a revival of the reciprocity feature of the original Mann bill, but is not restricted to medicine, or medicinal products and includes patents of all kinds.
The Currier bill provides: “That any patent issued to a citizen or subject of a foreign country, shall be upon the same conditions and for the same term as are patents issued by such country to citizens of the United States.”
This single provision, it is said, would effectually correct the evils arising from our present system of process and product patents, but would be contrary to the terms of the International Convention for the protection of industrial property and will no doubt be vigorously opposed on this ground.
Incorporation of the Public Health Defense League. A bill has been introduced into the Legislature of the State of New York providing for the incorporation of the Public Health Defense League, under a special charter patterned after that of the Red Cross Society.
The object of this new society is announced as being an organized movement against medical and surgical quacks, frauds in patent medicines or nostrums, and an effort to obtain and to disseminate accurate information concerning practices and conditions of every kind that are dangerous to the public health and morals. (Journal A. M. A., 1907, page 236.)
Sunday Rest in France.—Pharmacists in France are not alone adapting themselves to the recently enacted Sunday Rest Law, but are even going farther and are adopting earlier hours for closing during the week.
At Grenoble, where Sunday closing has been in vogue for some time, the pharmacists have decided to close at 8 P.M. daily and to organize a night service by rotation.
The syndicate of Paris pharmacists recommends that its members adopt 9 P.M. as the hour for closing during the week and to close from midday till the following morning on Sundays and bank holidays. (Chem. and Drug., 1906, page 775.)
Popularity of Pasteur in France.—The Petit Parisien has taken a rather interesting plebiscite as to who is thought to be the greatest of nineteenth century Frenchmen. In the voting Pasteur took the lead from the first, followed by Victor Hugo, Gambetta, Napoleon I, Thiers and Lazare Carnot, in the order named. (Chem. and Drug., 1907, page 6.)
Doses in the Codex.—The Codex Revision Committee has decided to include a list of maximum doses in a supplement to the Codex, and has delegated the work of drawing up such a list to a special committee including MM. Laudouszy, Marty, Bourquelot, Gilbert and Yvon. (Chem. and Drug., Dec., 1906, page 884.)
The Druggists’ Circular has rounded out a half century of its existence. The January, 1907, number of this journal constitutes a fiftieth anniversary number and comprises a total of 320 pages. The 190 or more pages that are devoted to reading matter contain quite an exhaustive review of American pharmacy during the past fifty years. All of the more interesting articles are liberally illustrated and the number itself will no doubt be appreciated as an album of men who have contributed, or are now contributing, to the development of the science of pharmacy in America.
Incompatibility of Pepsin and Pancreatin in liquid preparations.—A report of the Council on Pharmacy and Chemistry of the American Medical Association (Journal American Medical Association, February 2, 1907, p. 434) calls renewed attention to the generally well-known fact that despite the frequently made statement that pepsin and pancreatin must be incompatible in liquid preparations a number of such mixtures are still being offered by manufacturers or retail pharmacists and are used by physicians.
The Council has investigated a number of preparations of this type and has invariably found them to be practically inert in at least some of the claims made for them. Having demonstrated that pepsin and pancreatin cannot exist in one and the same solution for any reasonable length of time and that preparations that are said to contain these two ferments are sold under impossible claims, the Council recommends:
(1) That the Council on Pharmacy and Chemistry refuse to approve liquid preparations that are claimed to contain both pepsin and pancreatin.
(2) That the medical profession through the Journal of the American Medical Association be advised of the fallacy of employing such combinations.
(3) That the attention of manufacturers be called to the worthlessness of such incompatible liquid preparations of pepsin and pancreatin and that they be urged to cease offering such products to the profession.
(4) That since the National Formulary has recognized a preparation of this kind under the title “Elixir Digestivum Compositum” the American Pharmaceutical Association be requested to instruct its committee on the National Formulary to omit this preparation from the next edition.
Acetanilid Mixtures.—The mixtures of acetanilid and other ingredients that formerly were exploited as definite chemical compounds are now being marketed as mixtures, and, in some cases at least, have had their composition changed so as to be totally unrecognizable.
Antikamnia, under the regulations of the Pure Food and Drugs Act, is being marketed as a mixture containing 350 grains of acetphenetidin in each ounce. Pharmacists who are in the habit of filling prescriptions for physicians calling for “antikamnia” in solution will now experience the additional difficulty of being obliged to explain why the new antikamnia differs from the old in its physical properties.
Ammonol.—This preparation is said to be Ammoniumphenylacetamid on one portion of its label and directly under it is said to contain 240 grains of paracetyl-phenetidin in each ounce.
Phenalgin, marketed as an ammoniated phenylacetamide, is labeled as containing 50 per cent. of acetanilidum.
Benzosalin.—Methyl benzoyl salicylate occurs as a white crystalline powder having a slight aromatic odor and taste. The substance melts at from 84 to 85° C. It is nearly insoluble in water, but is soluble in 35 parts of alcohol and is readily soluble in chloroform but somewhat less so in ether. (Phar. Centralh., 1906, p. 1053.)
Borovertin.—This is the name that has been applied to hexamethylene tetramine triborate. The substance occurs as a yellowish white powder readily soluble in water and having a distinctly bitter taste. It may be given in doses of from 1 to 4 grammes daily. (Phar. Centralh., 1906, p. 928.)
Castor oil in form of powder.—A recently issued German patent describes a process for preparing a supposedly active preparation of castor oil in powder form. This is accomplished by the addition of light calcined magnesia to an emulsion of castor oil, or by adding a specific quantity of castor oil to the same weight of calcined magnesia that has been moistened with distilled water, and drying the resulting mixture and powdering the residue. (Phar. Centralh., 1907, p. 65.)
Cystopurin.—This is said to be a combination of one molecule of hexamethylene tetramine with two molecules of sodium acetate. It occurs as white, nearly tasteless crystals that are readily soluble in either hot or cold water. Cystopurin may be administered in doses of 1 or 2 grammes three times a day. (Phar. Zeit., 1907, page 48.)
Forgenin.—This is said to be tetra methyl ammonium formiate and responds to all of the known reactions for formic acid compounds. It is being recommended, in small doses, as a heart tonic. (Phar. Zeit., 1907, page 48.)
Levurinose is a name given to a yeast that has been desiccated by means of a current of cold air so as to preserve the individual yeast cells intact. This preparation has been recommended to be used in affections of the skin, such as acne, eczema, furunculosis, urticaria, etc. (Phar. Zeit., 1907, page 47.)
Mistura Strzyzowski is the formidable name, applied in Austria, to a mixture containing ferric pyrophosphate, quinine hydrochloride and sodium bromide. This mixture is directed to be prepared as follows:—
Sodium bromide 8·00 is dissolved in distilled water, 40·00; syrup of orange peel, 20·00; alcohol, 10·00. Mix and add a solution of quinine hydrochloride, 1·00 in distilled water, 40·00; and syrup of orange peel, 20·00. Mix, and then add the following, prepared by slightly warming: Ferric pyrophosphate with ammonium citrate, 4·00 in distilled water, 40·00. Mix, and add syrup of orange peel, 40·00.
Dose, one to two teaspoonfuls, with water, two or three times a day.
Novaspirin is the name applied to methyl citric acid ester of salicylic acid. It occurs as a white powder having a slightly acid taste. It is nearly insoluble in water but is readily soluble in alcohol. Novaspirin may be given in doses of 1 gramme three times a day. (Phar. Zeit., 1907, page 9.)
Quinine Phytinate.—Anhydro oxymethylene diphosphate of quinine occurs as a yellow powder, very soluble in water but almost insoluble in alcohol, ether, benzin or chloroform. The substance contains 57 per cent. of quinine and has an intensely bitter taste.
Scarlatin Marpman is an antitoxin preparation that, given internally, is being used as a prophylactic for scarlet fever. It is said to be produced by inoculating animals with infectious material from scarlet fever patients and inoculating other animals with the serum taken from the first. The serum from the blood of the second animal is used to immunize other animals, and it is from these immunized animals that the antitoxin serum is prepared.
Scarlatin is a yellowish, opalescent liquid having a slight odor and a salty taste. The substance has a specific gravity of from 1·012 to 1·013, is neutral in reaction and gives a copious precipitate with reagents for albumin. (Phar. Centralh., 1907, page 69.)
Solubility of Salicin.—D. B. Dott (Phar. Jour., 1907, page 79) finds that the solubility of salicin, as given in the British Pharmacopœia (1 in 28) is practically correct, while that of the U. S. P. (1 in 21 at 25° C.) is too high.
Using pure salicin, that melted at 201° C., he finds that it has a solubility of 1 in 24 at 25° C., or very nearly that called for by the British Pharmacopœia at ordinary temperatures.
Substitutes for Cocaine.—Dr. Hugo Wintersteiner (Wiener Mea. Wochensch., 1906, page 1339) reports a comprehensive comparative study of the use of cocaine and its various substitutes in eye work. Of the numerous substances that have been proposed from time to time he describes tropococain, holocain, eucain, stovain, alypin and novocain at some length and concludes that while it is true that these substances are relatively more stable than cocain, and are therefore more readily sterilized, the numerous objectionable features, such as unreliability, irritating properties and the production of a hyperemia, are so much more objectionable that cocaine must be admitted to be by far the most satisfactory as well as the safest local anesthetic in all varieties of eye work.
Tannisol is a reddish-brown, odorless and tasteless powder that is insoluble in water, ether or benzine, but is soluble in alcohol and in dilute solutions of alkalies or of the alkaline carbonates. It is directed to be used internally in cases of intestinal catarrh, and externally for a variety of inflammatory conditions of the skin. Internally it may be given in doses of 0·50 gramme (Phar. Centralh., 1906, page 1006).
Theolactin.—This name has been applied to a double salt of theobromin sodium and sodium lactate. It occurs as a white hygroscopic powder, readily soluble in water and having a distinctly bitter taste. It is said to be an active diuretic, but is not free from occasional side effects in the form of gastric disturbances. (Phar. Zeit., 1907, page 49.)
Tinctura olea Europeae.—A tincture made with 60 per cent. alcohol from the dried leaves of the European olive has been used as a febrifuge as well as a general tonic in place of the tincture of cinchona bark.
Triacetyl morphin.—This substance has been isolated from a mixture of acetyl derivatives of morphin. Triacetyl morphin melts at from 206 to 208° C., is only slightly soluble in water or cold alcohol, but is readily soluble in acids. With hydrochloric acid it forms a salt that crystallizes in the form of long needles. (Phar. Centralh., 1906, page 928.)
Tulaselactin is the name given by Behring to a substance that is expected to immunize infants against tuberculosis. (Phar. Centralh., 1907, page 24.)
Tulase (A. J. P., 1906, page 582) is the name given by Behring to his immunizing and curative serum for tuberculosis.
This preparation is said to contain all of the constituents of the Koch bacillus. It occurs as a clear fluid which has the general outward characteristics of thin honey. It may be given subcutaneously, intravenously or by mouth. The mixture of tulase with milk, mentioned above, is the form in which it may be administered to infants.
Tulase is now being used in an experimental way, but Behring himself warns against too much reliance being placed on the curative properties of the substance.