In brief, then, it appears from the statements of the Anasarcin Company that the action of the remedy is that of squill and that the other ingredients are a mere blind. It is, of course, well known that squill can be used as a substitute for digitalis in cardiac dropsy, although it is generally considered very inferior to the latter drug. Rose Bradford, for instance, states: “Squill is not used to any extent in the treatment of cardiac disease and cardiac dropsy, digitalis being a far more efficient and less toxic substance.” However, it has been frequently observed that digitalis occasionally fails, and it may then be replaced successfully by another member of the group. At all events, it is very likely that squill is a fairly efficient substitute for digitalis, especially when it is supplemented by a very free course of Epsom salts and by potassium nitrate (the active ingredient of Anasarcin Elixir), both of which are stated to be essential adjuvants to the Anasarcin (or squill) tablets. There can be no objection to the use of squill when it is indicated; but any one who wishes to use it should do so with his eyes open, knowing what substance he is using and how much (which he does not in Anasarcin); knowing also that it has the same indications and limitations as digitalis. He should not be misled by such statements as the following:
“Does what dropsy medicaments have hitherto failed to accomplish.”
“Superior to digitalis, strophanthus, scoparius, squills, acetate of potash and the hydragogue cathartics all put together.”
“The only known relief [how modest!] and permanent cure of dropsies.”
“Unrivaled heart tonic.” “The most powerful agent known.”
Any one wishing to use squill should take the trouble to acquaint himself with the results obtained by competent and independent observers, and not rely on it in eclampsia, septicemia, “vices of civilization,” all forms of neurasthenia, as “an active eliminator of uric acid in rheumatism,” in hepatic cirrhosis, dyspepsia, asthma, obesity, cystitis (!), lumbago, exophthalmic goiter, etc.
He should also learn the contra-indications to the use of squill, deducible from the fact that it causes vasoconstriction and raises the blood-pressure (prohibiting its use in Bright’s disease and arteriosclerosis), and that it produces marked gastric irritation, consequently nausea and depression, that it is a very toxic agent, and that the dangers of cumulative action must be borne in mind. In respect to these the advertisements of the Anasarcin people are little short of criminal, for these state:
“Safe in administration.” “Non-toxic as ordinarily administered.” “Will nauseate some persons,” but “the reaction from the temporary depression is prompt.” “In Bright’s disease, both the interstitial and parenchymatous forms of nephritis, acute or chronic, no remedy ... to equal it in efficacy.” “Without increasing the debility of the patient or interfering with nutrition by producing loss of appetite....” “This treatment is to be continued without cessation until all symptoms of dropsy have disappeared.”
Physicians who are inclined to disregard this warning, and who follow the advice of the Anasarcin people, should remember that their patients—or their friends—will put the blame for the results, which are bound to follow sooner or later, on the prescribers, and not on the deceptive advertisements of the Anasarcin Chemical Company.