Suppose some fellow should get up a scheme to exploit a mixture of quinin and some cheap, harmless substance, say, starch—equal parts of each. Suppose he gives it a fanciful name, puts it on the market at a high price, say $1.25 an ounce, and announces it as a new synthetic with wonderful therapeutic qualities. Suppose that the schemer then adopts the nostrum vender’s methods of fooling physicians into using his product by getting some to give testimonials, others to furnish write-ups, and then subsidizes medical journals through liberal advertising to print both the testimonials and the write-ups. The preparation would, of course, prove to be a good thing if it were used in liberal quantities where quinin would ordinarily be used, and some patients using it would get well even if quinin were not indicated. Then with the psychologic effect of the testimonials, the write-ups, and good, strong claims rightly pushed, unthinking physicians would do the rest. And then, after a while, when the schemer had gotten to the point where, each year, he was making a fortune out of his preparation, suppose some “self-appointed chemists” should examine into the preparation and discover that it was nothing but quinin and starch, and so announce to the doctors of the country; what would the doctors say? That it makes little difference “provided it is just what he has always found it to be!”
This analogy is not far-fetched, for it is practically what has been done with Phenalgin. One difference is that since quinin costs as much per ounce as acetanilid does per pound, the profits on the acetanilid mixture would be sixteen times greater than that of our imaginary preparation. Another difference is that acetanilid is really a dangerous drug, unless used with care, both in its immediate and in its remote effects; quinin is far less so.
“Little difference” indeed, whether we are being buncoed or not! Evidently!
In conclusion, we charge the Etna Chemical Company with intentionally misleading and deceiving the members of the medical profession, in that the said company has in its literature and its advertisements conveyed the impression (whether directly stated or not): First, that its preparation, Phenalgin, is a synthetic compound; second, that Phenalgin requires special skill in its preparation; third, that Phenalgin has therapeutic values which it does not possess; and, fourth, that Phenalgin is non-toxic.
We also charge that on account of these and other misrepresentations, this company has inveigled physicians into prescribing and using a simple mechanical mixture of common well-known cheap drugs—for which an extravagantly high price is charged—under the supposition that this combination of cheap drugs is a chemical compound of special and peculiar merit as a therapeutic agent, and, therefore, worthy of their confidence.
Our object in again giving space to this preparation—and practically all we have said applies to the other acetanilid mixtures that are exploited under fictitious names or as chemical compounds (such as ammonol, antikamnia and salacetin or sal-codeia—Bell)—is to impress on physicians, by a typical example, the shamefulness of the deceptions practiced on them by nostrum manufacturers to the great injury of the public and of the medical profession.
A Pharmaceutical Secret Which Should Not Be Lost
Dr. Gregory Costigan, New York City, writes under date of January 21, as follows:
“I have been carefully reading and enthusiastically approving your articles on the nostrum evil, and have been impressed more than usual on the existence of quack advertising in medical journals as set forth in last paragraph and quotation on page 206, bottom of first column, of your issue of Jan. 20, 1906.
“In Merck’s Archives, page 11, we are told in an advertisement on ‘Phenalgin’ that it ‘is a compound of peculiar character which cannot be extemporaneously made from powdered drug’ and ‘our process of manufacturing tablets is coincident with the manufacture of Phenalgin and is the result of a long series of careful experiments by which we are able to produce tablets of Phenalgin in a friable condition without losing any of its volatile constituents or undergoing chemical changes from heat or moisture’! Inasmuch as Phenalgin tablets are not covered with a waterproof coating I think this is a remarkable statement to make, and the manufacturing of a drug coincident with the manufacture of a tablet must be a very remarkable performance, especially because it ‘retains the full therapeutic value of the drug unimpaired’ while the advertisement asserts that no other manufacturer is cognizant of this wonderful method. This ad. is for the perusal of physicians only. The Etna Chemical Company owes it to the medical and pharmaceutical world not to let this secret die with the company’s dissolution. It owes it as a duty to the coming generations of science immediately to jot down the full data of this wonderful performance, to put it away in an age-proof safe and not allow it to be lost to humanity as were a great many other arts that were well known to the ancients. Let them keep it secret now and profit by it, but do not let it be lost to posterity.”—(From The Journal A. M. A., Jan. 13, 1906, and Jan. 29, 1906.)