“No longer the vague, hypothetical, ‘test-tube demonstrated’ principle of uric acid elimination by solution, but a definite, scientifically and clinically established, physiologic stimulation of the uric acid excretion. Performed innocuously and controllable to a nicety by dosage and by urine and blood tests.”
The “innocuousness” of Atophan has not been proved; on the other hand there is evidence that it is not innocuous, as the recent investigations of Hanzlik and Scott and their collaborators (Cinchophen, Neocinchophen and Novaspirin in Rheumatic Fever, J. A. M. A. 76:1728 [June 18] 1921) show that it may injure the kidney.
The circular also contains the following:
“No longer, hit and miss relief of pain at the expense of the heart, the intestines, the kidneys and the nervous system, but the promptest and most reliable analgesic, anti-inflammatory and decongestive action so far known, with notable freedom from heart depressant, renal irritant, constipating and cumulative toxic by-effects. No contraindications, except chronic nephritis and the presence of kidney concretions.”
This is misleading. The drug depresses the circulation, injures the kidney and produces symptoms of salicylism or “toxicity.” It is not the promptest and most reliable analgesic; morphin is superior and salicylate is just as efficient. The phrase “decongestive action” is vague. Treatment of pulmonary congestion from phosgene, and congestion of the conjunctiva in mustard oil chemosis of cats, with large doses of Atophan was ineffective; in fact, it proved distinctly harmful. This was shown by such workers as Laqueur and Magnus, and Heubner and Gildemeister (Ztschr. f. d. ges. exper. Med. 13:200, 1921). It is incorrect to ascribe “decongestive” or “anticongestive” action in the true sense to Atophan (cinchophen). The principal assets of the salicylate-cinchophen class of drugs in the treatment of rheumatism and gout are their analgesic and antipyretic qualities.
The claim is made:
“In Rheumatic and Gouty Disorders, whether of the well-known muscular and arthritic type, or their Eye, Ear, Nose and Throat manifestations.”
The suggestion that Atophan is indicated in “their Eye, Ear, Nose and Throat manifestations” is a vague generalization without definite meaning, but nevertheless calculated to impress physicians and promote the sale of Atophan for common and minor ailments. Rhinitis and sore throat are, of course, self-limited conditions which require chiefly good habits, personal and general hygiene as prophylactic measures, and simple hot baths with rest, instead of medication, for symptomatic relief. When it comes to ear and eye conditions, Atophan certainly would do no good in otitis media, panophthalmitis, choroiditis, retinitis, etc.
The administration of Atophan is proposed “in Migrains, Hemicrania, Eyestrain, etc., often vaguely grouped as ‘Headaches.’ ” Eyestrain and headaches are vague symptoms often arising from numerous causes that require no medication, but rather good habits, hygiene and similar corrective measures. There is always the possibility of habituation from the use of drugs for such common and vague symptoms, resulting eventually in more harm than good to the patient.