As strontium salicylate and lithium salicylate are now generally considered to differ but slightly, if at all, in their action from that of sodium salicylate, each dose of Thoxos, 1 teaspoonful or 4 c.c., may be considered the equivalent of 0.2 gm. or 3 grains of sodium salicylate with a fractional dose of colchicum. Hence this nostrum—for this is the correct definition—is a mixture of no more value than a prescription of sodium salicylate with a fractional dose of potassium iodid and colchicum, one that any doctor could write and any druggist dispense. Yet it is doubtless prescribed by physicians under the belief that it possesses some occult power not to be found in ordinary drugs and their combinations. To prescribe Thoxos is to prescribe a name, and the patient who takes it would be as well off if he went to the nearest drug store and purchased a bottle of any of the thousand and one rheumatism cures with which the country is flooded.—(From The Journal A. M. A., March 21, 1914.)
TRYPSOGEN
Besides exploiting a clay poultice—“Antithermoline”—the G. W. Carnrick Company appears to be chiefly concerned in the promotion of “internal secretion” specialties; a class of preparations the therapeutic value of which is problematical. Thus it markets the diabetes remedy, “Trypsogen” tablets, said to contain “the enzyme of the islands of Langerhans with the tryptic and amylolytic ferments of the pancreas” along with gold bromid and arsenic bromid; Secretogen Elixir, said to be “prepared from gastric secretin obtained from the pyloric antrum and pancreatic secretin from the duodenum, combined with the enzymes of the peptic glands, and one-twentieth of one per cent. HCl”; Secretogen Tablets, said to be “prepared from prosecretin and succus entericus obtained from the epithelial cells of the duodenum, combined with pancreatic extract”; Kinazyme, “a preparation of extract of spleen, reinforced with trypsin, amylopsin and calcium lactate.”
While great claims have been made for Trypsogen and while it has been most widely advertised, it is the consensus of opinion of the most eminent students of the question that pancreas is not really efficacious in diabetes. Were it of any value in this disease, it would have won world-wide recognition for itself ere now, in view of the great enthusiasm with which the discovery of the relation of the pancreas to diabetes was received and of the enormous amount of clinical, as well as animal, experimentation that followed. As the conditions of experiment in this question are extremely complex, it is not surprising that occasionally apparently positive results should have been obtained. Were it really useful, it should have yielded positive results much more uniformly.
Furthermore, if pancreas were really efficacious in the treatment of diabetes mellitus, the addition of arsenic, of gold, of bromid would be entirely unnecessary.
Even were it granted that pancreas extracts are valuable in the treatment of diabetes, and that gold and arsenic also have beneficial effects, it is our opinion that Trypsogen should be considered an unscientific shotgun mixture, because fixed combinations of remedies of different potencies, such as arsenic, gold, bromid and pancreas, are therapeutically erroneous, as they do not permit of that accurate adjustment of dosage of each ingredient that is indispensable to obtain maximum benefit with minimum danger of poisoning.
Antithermoline and Trypsogen were at one time described in New and Nonofficial Remedies. These preparations were omitted when the Council’s rules were revised some years ago.
When the Council was first organized it undertook only the correction of the most serious abuses that had become a part of the proprietary medicine business, and paid less attention to the therapeutic worth of a remedy; thus at that time it admitted both Antithermoline and Trypsogen to New and Nonofficial Remedies. Since then the Council has modified its rules to exclude unscientific mixtures marketed under names that are misleading or therapeutically suggestive. Accordingly it rescinded the acceptance of Antithermoline, which was essentially the official clay poultice, Cataplasma Kaolini, U. S. P. For similar reasons and because the therapeutic claims were held unwarranted Trypsogen has been omitted from New and Nonofficial Remedies.