Still Further Duplicity
When the Food and Drugs Act went into effect the manufacturers of this preparation, instead of continuing to put out the same mixture as they had been doing radically changed the composition by substituting acetphenetidin (phenacetin) for acetanilid. By doing this the company avoided the disagreeable necessity for acknowledging on the label that the nostrum contained acetanilid, as was shown by the analysis published in The Journal, June 3, 1905. In addition to stating that the package of Antikamnia contained acetphenetidin, the company also stated that it contained no “acetanilid, antifebrin, antipyrin, alcohol, morphin, opium, codein, heroin, cocain, strychnin, chloroform, cannabis indica, or chloral hydrate.” Knowing that the nostrum was being advertised in Great Britain and Canada as well as in the United States, The Journal obtained some Antikamnia from London, and it was analyzed in the Association’s laboratory. As was suspected, the analysis showed that Antikamnia as sold abroad has the same composition now as it had in the United States before the Food and Drugs Act went into force, viz.: Acetanilid, 67.75 per cent.; caffein, 4.88 per cent., and citric acid and sodium bicarbonate, by difference, 25.36 per cent. This corresponds with the analysis previously made and published in The Journal, June 3, 1905. The Antikamnia on the market in this country was also analyzed and it was found to contain: acetphenetidin (phenacetin), 72.05 per cent.; caffein, 13.95 per cent.; citric acid and sodium bicarbonate, 14 per cent. The preparation sold as “Antikamnia and Quinin” was also analyzed, and it was found that starch had been substituted for the bicarbonate of sodium which is found in the Antikamnia itself. The details of the analyses are given with the following comments: “The above are brief statements of bald facts. Two of these should be emphasized: (1) When the Food and Drugs Act went into force, January, 1907, the manufacturers of Antikamnia, rather than acknowledge the truth of the past—we can imagine no other reason—materially and radically changed the composition of their preparation, and did this without notifying the medical profession or intimating in any way, so far as we can learn, that such a change had been made. We have no doubt they believed they had a right to do as they pleased with their own; that it was nobody’s business but theirs what they did with their own preparation, or how they changed it. As they never had told physicians what it contained, there was no reason why they should do so now. This is logical and we cannot blame the manufacturers so long as the medical profession is willing to be humbugged. (2) For the same reason, we presume, they claim that they have a right to continue to use acetanilid in the product for the foreign market. The Food and Drugs Act applies only to the United States, of course, and acetanilid being cheaper, why not use it? What is the difference if one is more dangerous than the other? The fact that the Antikamnia sold abroad differs from that sold in this country some may say is of no special interest to us. Still this fact is worth noting: The dose of acetphenetidin—phenacetin—(71⁄2 grains) is nearly double that of acetanilid (4 grains): one becoming accustomed to a certain dosage of the nostrum as sold in this country might, while abroad, unwittingly be led to take a double dose of acetanilid.—(Abstracted from The Journal A. M. A., Feb. 8, 1908.)
Samples, Form Letters and “Prescriptions” Sent to the Laity
To the Editor:—The enclosed “literature” is being sent broadcast to the laity by the Antikamnia people and still a great many of the physicians throughout the country are prescribing the preparation thus advertised. Will the time ever come when the medical fraternity will awaken to the fact that it has been humbugged by a great many manufacturing concerns? I certainly hope so.
J. W. DuVal, M.D., Wichita Falls, Texas.
Comment:—The “literature” referred to by our correspondent consists of a form letter and a small pamphlet. The letter was similar to the one reproduced herewith.
The pamphlet accompanying the letter is entitled “Practical Prescriptions,” and contains a list of diseases and morbid states arranged alphabetically from “Alcoholism,” “Asthma” and “Backache,” to “Wind,” “Women’s Pains” and “Worry.” For the one hundred and twenty-two conditions listed, “Antikamnia,” “Antikamnia and Codein” or “Laxative Antikamnia and Quinin” are prescribed, demonstrating that the “prescriptions” are more “practical” than scientific.
In many respects the methods of the proprietors of “headache powders” and “anti-pain pills” are less offensive to one’s sense of professional decency than the course pursued by the Antikamnia people. The former have at least never recommended their products as “ethical proprietaries”; they have not used medical men as their unpaid agents; the claims made for their products have been no more exaggerated; and they have not found it necessary, from the requirements of the Food and Drugs Act, to substitute acetphenetidin for acetanilid to avoid giving the lie to their former claims.
As to the query propounded by our correspondent: We are optimistic enough to believe that the time he longs for is already here. The fact that the proprietors of nostrums of the Antikamnia type are finding it necessary to advertise to the laity is, in itself, evidence of the diminishing demand for such products on the part of the medical profession.—(From The Journal A. M. A., April 18, 1908.)