LIQUID COMBINATIONS CONTAINING PEPSIN AND PANCREATIN [Z]
Report of the Council on Pharmacy and Chemistry of the American Medical Association
The following report was submitted to the Council by a subcommittee:
To the Council on Pharmacy and Chemistry:—The U. S. Pharmacopeia, 8th revision, pages 334–5, states: “Pepsin and pancreatin in solution are incompatible with one another. If the solution be neutral or alkaline the pancreatin gradually destroys the pepsin, and if acid the pepsin destroys the pancreatin.” The correctness of this statement has been amply demonstrated by the reports which have been submitted to the Council from time to time on liquid preparations claimed to contain these two ferments.
Thus an elixir was investigated which was by the manufacturers claimed to contain “the five active agents of digestion, pepsin, veg. ptyalin, pancreatin, lactic and hydrochloric acids,” and to be “superior to all other remedies in dyspepsia and diseases arising from imperfect digestion,” and the committee which investigated the article in question reported that “it was impossible to establish the presence of either the proteolytic or the amylolytic ferment.”
Similarly, on another liquid preparation, which was said to contain “pancreatin, pepsin, lactic and muriatic acids, etc.” ... “the combined principles of digestion to aid in digesting animal and vegetable cooked food, fatty and amylaceous substances,” the committee reported “this product possessed only very slight proteolytic action and failed to digest 2 per cent. of its own weight of starch.”
Again, the report on still another preparation stated: “But while it was said to contain pancreatin, the U. S. P. test for the valuation of pancreatin failed to indicate this ferment.”
The report on yet another elixir, claimed to be “the only true digestant, because it contains the enzymes of all the glands which are necessary for digestion,” showed that this article did not contain “any appreciable enzyme activity, either amylolytic or proteolytic.”
The correctness of these findings of the committee of the Council was generally acknowledged by the manufacturers when their attention was called to the matter. Thus, one manufacturer of digestive ferments writes: “We will ask you to hold this matter up until you hear from us further on the subject. The reason for this request is that we have been going over our liquid preparations very carefully in order to be sure that after aging they would contain the ferments that we put into them. The pancreatic ferments in alcoholic liquids seem to lose their strength.”
The chemist for a large manufacturing house writes: “There are now on the market a number of preparations in which pepsin and pancreatin are combined in liquid form, and the result is that we have had numberless requisitions from our representatives that we also market such a preparation. As the result of this we have carried out a series of experiments no less than four or five times in order to determine whether pepsin, diastase, and pancreatin would retain their activity in the form of a syrup, wine or elixir. We have proved incontrovertibly that this cannot be done. While any two of these substances, or even all three of them, can be dispensed in the form of a liquid by the retail druggist and will retain their normal activity for as long a period as three to six weeks, yet if allowed to stand sufficiently long, they mutually destroy each other; so that in a combination of pancreatin and pepsin the pancreatic enzyme is lost and the pepsin greatly injured, and where diastase is present, both diastase and pepsin (or diastase and pancreatin) mutually destroy each other.”