PHENOLPHTHALEIN

Phenolphthalein has long been used as an indicator in chemical reactions, but its use as a therapeutic agent[115] is comparatively new. When its laxative properties were first discovered it was exploited as a proprietary in Germany, and it was not long before the enterprising manufacturers in this country saw in it a potential gold mine and now nearly every proprietary drug manufacturer in this country has coined a proprietary name for it and is exploiting it, either alone or in combination with one or more other laxatives, and with more or less unwarranted claims.

Phenolphthalein itself has certain pretty well defined properties, but when a little of some other drug has been added wonderful therapeutic possibilities are claimed for the combination. The drug also has a definite market value and the pure substance in the form of powder, tablets or pills could not be sold at a price greatly in excess of the market value. Thus manufacturers, from business policy, add to it other drugs. There are now on the market numerous more or less secret and “fancy” preparations of phenolphthalein for which a price is charged out of all proportion to the value of the preparation. Among these are:

Phenolphthalein Laxative (El Zernac Co.).
Exurgine (Bischoff & Co.).
Probilin (Schering & Glatz).
Prunoids (Sultan Drug Co.).
Laxine (Columbus Pharmacal Co.).
Phenolax Wafers (Upjohn Co.).
Laxaphen (Parke, Davis & Co.).
Phenalein (Pax Chemical Co.).
Thalosen (Abbott Alkaloidal Co.).
Laxothalen Tablets (Pitman-Myers Co.).
Veracolate (Marcy Co.).

And additional preparations are still coming out! Some of the preparations contain only the phenolphthalein with a coined non-descriptive proprietary name attached, but most of them contain in addition one or more of such drugs as cascara, sulphur, prune, senna, salicylic acid, ipecac and aromatics. The exploitation of phenolphthalein in this way gives opportunity to the manufacturers to make all sorts of strong claims, some of them directly contradictory, for their preparations. For instance, Phenolax, which is said to contain phenolphthalein and cane sugar, is claimed to be “a great success for all forms of constipation, intestinal atony and hepatic torpor.” Of Laxothalen, which is said to contain phenolphthalein, aromatics and sugar, it is stated that “its action is confined to the bowel and it has practically no hepatic action.” Of Prunoids, which is said to contain phenolphthalein, cascara, de-emetized ipecac and prunes, we have the old familiar statement that “the harmonious blending of the several ingredients will give results that cannot be obtained through their use separately, nor will their use be followed by after-constipation.”

At the time phenolphthalein was beginning to be exploited in this country The Journal[116] suggested that physicians who wished to try the remedy should prescribe it under its own name and not under fancy, coined names. Since phenolphthalein occurs in the form of an insoluble and tasteless powder there is no reason why special pharmaceutical preparations of it should be placed on the market. It can be prescribed in powder form, in pills, capsules or tablets. Thus given, the true therapeutic action of the drug would be apparent and its actual value arrived at.

The vice of this unscientific habit of prescribing names instead of drugs is stated in a forcible way in a letter received from Dr. V. E. Simpson, a teacher of materia medica and therapeutics in the medical department of the University of Louisville. He says:

“Recently P. D. & Co.’s representative left on my desk a sample labeled ‘Laxaphen.’ The formula given is: phenolphthalein, gr. viii; salicylic acid, gr. 3⁄5, in each fluidounce, ‘incorporated in a palatable chocolate base.’ Now, in the first place, this name is one that the public will easily learn and will soon call for; in the second place, it is not a name that carries with it even a suggestion of its contents; and, finally, the physician acquires the habit of mechanically prescribing names instead of drugs, and in the burdening of his memory with the myriad of fantastic labelings he finds it impossible to remember even the drugs any one contains, much less the exact proportions of those drugs. Then suppose that a consultation is had; the consultant asks what is being given and the attendant answers that he is giving ‘laxaphen.’ The consultant, perhaps, has not been sampled and inquires about it; the attendant must answer. ‘Oh, it contains some phenolphthalein and a salicylate, but I have forgotten the exact proportions. I have the literature on my desk.’ Had he used U. S. P. and N. F. remedies, which the consultant and every other doctor in the land has access to and should have some knowledge of, this embarrassment would not occur.”

All of the above should remind the physician that he should write simple prescriptions, for drugs whose action he knows, adapted to the particular case and not for money-making combinations under fanciful, non-descriptive names exploited by the proprietary manufacturers. In this way he will not only save money for himself and his patients, but he will be giving them exact and effective treatment, he will know exactly what he is giving and learn for himself its effect, and he will be following the only method which entitles him to be called a scientific physician.​—(From The Journal A. M. A., April 30, 1910.)