Dr. Nascher takes exception to our statement that the treatment seems first to have been brought to notice through the printed slip sent to medical journals, and states that he has “referred to amorphous phosphorus repeatedly in medical articles appearing during the last three years.” His articles for 1912 and 1913 have been examined for the purpose of learning when the treatment as now presented to the profession was first announced. In his article “Errors in the Treatment of Senile Cases,” New York Medical Journal, Oct. 12, 1912, he speaks of the iodids in senile arteriosclerosis, but says nothing about amorphous phosphorus. It may be assumed, therefore, that the treatment had not been brought to general notice at that time. The new treatment is very briefly described in the New York Medical Journal, July 13, 1913, in an article whose title, “Longevity and Rejuvenescence” gave no indication that it dealt with amorphous phosphorus. Under the circumstances, it is not strange that its therapeutic value was not learned of until Dr. Nascher’s printed slips were sent out.
Dr. Nascher admits that his theory is based on empirical methods. Most of the serious errors in therapeutics have had their origin in this very method. It was on just such methods that physicians reported wonderful results in the use of alleged “lithia waters” that actually contained less lithium than ordinary river water! So unscientific is the empirical method that it is hardly worth taking the space to demonstrate its imperfections.
Neither is it worth while to discuss the question of a constant occurrence of a sediment of amorphous calcium phosphate in alkaline urine. If there are exceptions to this rule, they must be rare indeed.
In The Journal’s article authors were quoted to show that amorphous phosphorus is regarded as inert. It was not suggested that the authorities referred to were all that could be found. Dr. Nascher refers to Thornton, Shoemaker, Neuman, Blythe and Kobert, and asks whether the various statements on the subject, made by these men, are unscientific or were “omitted because they disproved” the contention that amorphous phosphorus is practically inert. Thornton’s article was omitted because it is unscientific in that he does not report experiments made by himself, but refers to an unpublished paper by one Kelly. Who Kelly is, or was, he does not tell us. Kelly’s report, therefore, should be and was disregarded, since it is the work of an unknown author and there is nothing in the article to indicate that Thornton was in any position to vouch for Kelly’s work. Incidentally, it may be said that Kelly’s report merely recorded subjective symptoms; Dr. Nascher himself indicates his distrust of Kelly’s alleged results by suggesting that an impure preparation was used!
Shoemaker’s report was not given, for a similar reason. Shoemaker says:
“Amorphous phosphorus is almost completely destitute of taste or odor, has no immediate caustic effect, and is claimed to be less toxic than white phosphorus; but in the form of matches [Italics ours.—Ed.] has caused many deaths and is known as the ‘servant girls’ poison.’”
It is well known that commercial amorphous phosphorus is usually impure, and it is more than probable that if toxic effects were produced by the ingestion of match-heads, these matches were made either of white phosphorus or of very impure red phosphorus. In any case, Shoemaker’s statement has no bearing whatever on the pharmacologic action of pure amorphous phosphorus.
The statement of Neuman quoted from Roscoe and Schorlemmer, as well as that of Nassé, referred to by Hatcher, had no bearing on the question at issue, as these men injected the material into the blood-stream. If, when the amorphous phosphorus is injected into the blood, it produces the ordinary symptoms of phosphorus poisoning, one would naturally expect the same symptoms when the substance is given by mouth—if amorphous phosphorus were soluble or absorbable. The fact that such symptoms are not produced when amorphous phosphorus is taken into the alimentary canal, sustains the views held by chemists, pharmacologists and physicians, that the drug is practically insoluble and unabsorbable—in other words, inert.
Dr. Nascher declares that he “never claimed that amorphous phosphorus will cure arteriosclerosis.” Yet he insists that amorphous phosphorus removes lime from the “abnormal lime deposits” that occur in arteriosclerosis. What is this but claiming curative action?
Summed up, Dr. Nascher’s own admissions amply confirm the main contentions of The Journal’s article. He admits that he has no experimental basis for the use of this remedy; he admits that his theory “is simply a theory without facts to prove it.” The only conclusions that can be reached from his reply coincide closely with the very statement made by The Journal, and which we here reiterate: