GLYCEROPHOSPHATES
Physicians who prescribe on definite principles must often be puzzled by the number and variety of glycerophosphates on the market. All available evidence indicates that, as sources of phosphorus to the animal organism, the glycerophosphates possess no advantages over the ordinary inorganic phosphates.[290] The glycerophosphates are split up in the intestine, and liberate inorganic phosphates. In this form they are absorbed and utilized, if they are utilized at all. There is no evidence that glycerophosphates have any pharmacologic action to warrant the belief that they are of use as therapeutic agents. The theory that organic phosphorus compounds are more readily assimilable than inorganic compounds and hence a better means of introducing phosphorus into the system is still kept alive in the promotion of certain proprietary mixtures, in spite of the scientific evidence that the organism can assimilate phosphorus quite as readily from inorganic as from organic phosphorus compounds.[291] The glycerophosphates will continue to be manufactured until physicians refuse to prescribe them. A chemist in the “research laboratory” of a well known manufacturing firm has recently given a rather interesting reason for the use of glycerophosphates—from the manufacturers’ point of view. He is quoted as saying: “On account of the instability of phosphorus in elixir of phosphorus, nux vomica and damiana we have quite recently replaced the phosphorus by glycerophosphates. Such a preparation is apparently equally as effective, for we continue to have a great demand for it.” This is doubtless a sufficient reason for the substitution from the manufacturers’ point of view; but how about the patient, who, after all, is the one to be considered? Is it not a matter of considerable importance to the patient whether he receives phosphorus, one of the most powerful drugs known, or the inert glycerophosphates? The chemist’s statement seems to imply that it is not. It may be of interest to recall that a member of the firm whose chemist gives this “reason” for the use of glycerophosphates, in a recent address, was rather severe in his condemnation of institutions of learning, hospitals, etc., for their lack of cooperation with manufacturers: he said that “they should welcome an opportunity to let any manufacturer try out or test his products in their clinics, laboratories, etc.” A test as to whether there is a difference between the action of glycerophosphates and ordinary poisonous yellow phosphorus, especially when the former are mixed with extracts of nux vomica and damiana, would not be likely to appeal to many hospitals and laboratories as a very promising field of research at this day since, as has been stated, the scientific evidence at present available does not furnish any warrant for the therapeutic use of glycerophosphates.—(Editorial from The Journal A. M. A., April 15, 1916.)
INFLUENZA VACCINES
With the appearance of the epidemic of influenza, reports began to appear, chiefly in newspapers, as to new serums, vaccines, drugs and other methods for checking and even for curing the disease. A few samples of such as have come to The Journal appear in our Tonics and Sedatives Department this week. In Massachusetts, Commissioner E. R. Kelly appointed two committees to investigate the value of influenza vaccines as a preventive agent and as a treatment of the disease. The first committee, a special board for scientific investigation, consisting of Dr. M. J. Rosenau, chairman, and Frederick P. Gay and George W. McCoy, was appointed to consider the evidence available on the prophylactic and therapeutic use of vaccines against influenza. This committee presented the following conclusions:
1. The evidence at hand affords no trustworthy basis for regarding prophylactic vaccination against influenza as of value in preventing the spread of the disease, or of reducing its severity. The evidence from the present epidemic, though meager, suggests that the incidence of the disease among the vaccinated is smaller than among the nonvaccinated. The board, therefore, concludes that further experimental evidence should be collected.
2. The evidence at hand convinces the board that the vaccines we have considered have no specific value in the treatment of influenza.
3. There is evidence that no unfavorable results have followed the use of the vaccines.
The second committee, known as the Special Board of Statistical Investigation, consisted of Dr. George C. Whipple, chairman, William H. Davis and F. C. Crum. This committee reported:
1. The weight of such statistical evidence as we have been able to accumulate indicates that the use of the influenza vaccine which we have investigated is without therapeutic benefit. Exceptional cases where apparent benefit has resulted from the use of the vaccine can be matched by other cases where similar recoveries have been made without vaccination.