Council on Pharmacy and Chemistry

“ On exactly the same principle, the government has the right and the duty to protect the uninformed public against the flagrant evil of the patent medicine traffic—and the patent medicine traffic as now carried on is a flagrant evil and series of evils. The government should protect the public against advertisements that are framed to suggest or create imaginary ailments, with their attendant miseries; it should protect the public against being deluded by false promises of cure; against the specious relief that merely hides the disease and blinds the patient to its dangers ”

“ Whatever may be the physicians views as to the probable therapeutic value of these organs, the first thing he desires to know is how much of the substance he is giving and from what part of the gland it is obtained.
So much for the facts; yet the physician is asked to jump from this region of solid fact into a sea of hypothesis; to believe that small amounts of the well-known drugs thyroid and pituitary, plus an unknown amount of unknown hormones of the testes and ovary are of great value in conditions that in themselves are often purely hypothetical. ”

“ Why should the firm have any such deep interest in seeing that an original bottle gets to the patient? Why should it be necessary to do anything more than see that the genuine mixture reaches the patient? ”

“ Thus estimates of the value of a farm crop and cattle fodder are made to do service as testimonials to its therapeutic merit for human beings! Has the “patent medicine” promoter ever dared to insult the intelligence of his patrons by a cruder absurdity? Yet it is not to the nontechnical and unscientific public, but to a profession presumably scientifically trained in pharmacology and therapeutics that this concern presumes to offer its fodder tincture on the basis of testimony to the agricultural value of the fodder plant. ”

“ Should we take the meaningless statement of a nostrum maker, who does not submit evidence of any therapeutic value of his preparation—unless one can call certain careless habits of prescribing evidence—and assume the responsibility of prescribing a nostrum that according to all scientific evidence available is useless, and of no more effect than a few teaspoonfuls of milk, so far as its hypo­phosphite content is concerned? ”

“ Physicians have come to the realization that drugs are as a two-edged sword—under proper conditions, striking against the disease; otherwise, against the patient’s health. The first condition for their proper use is adequate knowledge of their composition and purity; of their actions and malefactions; their field and limitations. Slowly and painstakingly—sometimes painfully—this scientific knowledge has been gathered, is still being gathered, by chemists and pharmacists, pharmacologists and clinicians, with increasing thoroughness, care and discrimination. ”

“ Having learned the name of the remedy that has been prescribed for sleeplessness, let us say, he proceeds to use it whenever he imagines that he needs it; and that need, real or imaginary, has a way of increasing in frequency. As a result, the patient takes far more Neurosine than the physician would think of permitting if the matter had not passed entirely beyond his control.
Not only has the patient acquired a dangerous habit of self-prescribing, but he takes especial delight in recommending his favorite remedy to friends whose symptoms, real and imaginary, seem to resemble his own. ”

“ My profession is the practice of medicine, and the policy of my practice is not controlled by the editorial department of the journal. I am progressive, and a firm believer that legitiment medicine and surgery can not be practiced if the physician be governed by a set of medical clerks, who disdainfully boast that they control, and govern the healing art through out the breadth of the land, with a sceptre that is biased and steeped in the unadulterated commercialism of a certain medical clique. ”

“ Can one conceive a better illustration of the inadequacy of the Food and Drugs Act? The dishonest exploiter of proprietary medicines cares little that the law requires him to keep within certain bounds of truthfulness in the advertising that accompanies the trade package. It isn’t the claims in the trade packages that sell the product; it’s the advertising in medical journals, in circular letters, etc. Yet, the Food and Drugs Act offers no check or curb on false statements or fraudulent claims made for proprietary or “patent medicines” in any other place than the trade packages. ”

“ We do not pretend that even the best studied drug has not much to be learned about it; but the nostrum maker who exploits a complex mixture either knows practically nothing of the side actions that it will exert, or, if he knows, he conceals that knowledge. He knows that massive doses of hydrated chloral combined with various narcotics can be relied on to cause unconsciousness in nearly all cases, but he prefers to speak of this as a hypnotic action. This is plain gambling with human life. When the patient dies, it is difficult to prove that death was caused by the mixture alone. ”

“ Many times The Journal has been chided, even by its friends, for failing to take seriously preposterous claims made for alleged discoveries in medicine by well-meaning but self-deluded enthusiasts or by shrewd and conscienceless charlatans. Far too often the attitude is that any alleged discovery in medicine, no matter how bizarre or how humanly improbable, should be taken up in all seriousness and subjected to the tests of modern laboratory methods. ”

“ When a physician prescribes a dose of Epsom salt to be taken in one of the official aromatic waters, he does not produce or create a new invention by so doing. Of course, in one sense every prescription is an invention—an invention to meet the conditions presented by the patient—but such inventions are not patentable, because they represent the ordinary skill of a physician in carrying on his vocation. ”

“ As indicated in the Council’s report, Gray’s Glycerine Tonic Comp.—and what an absurd name!—is simply a mixture of ordinary drugs, requiring no skill whatever in compounding. If there is a physician living who cannot write a prescription offhand as good as this formula, that physician should either go back to a medical school or change his vocation. There is, and can be, no excuse for prescribing such a ready-made mixture, for every cross-roads drugstore has the ingredients and any pharmacist worthy of the name could compound it. ”

“ Among the scores of nostrums that disgrace the medical profession of this country, none is more typical of all that is inimical to scientific medicine, to the medical profession and above all to the public—for, after all is said, it is the public that ultimately is humbugged. ”

“ The Tilden Company declares that “Firwein stands without a peer in its class.” But the company adds 10 drops of eucalyptol and some cottonseed oil to this peerless product and an improvement is born—“Firolyptol”! Then, to perfect the already perfectly perfected, 10 drops of creosote are added to “Firolyptol” and the profession is offered “Firolyptol with Kreosote”! In just what verbal pyrotechnics the Tilden Company might indulge, should it decide to add ten drops of something else to “Firolyptol with Kreosote,” one shudders to contemplate. ”

“ What right have Z and Company to send on a card directions for the treatment of anemia and dyspepsia, about which subjects they know as much as an unborn babe, and, if they stick to their legitimate business, about the same opportunity of getting information? For years the profession has been exploited in this way, until the evil has become unbearable, and we need as active a crusade against the pseudoscience in the profession as has been waged of late against the use of quack medicines by the public. ”

“ Permit me to introduce myself as a layman who for some twenty years tried faithfully to be cured of various diseases by many doctors of the best reputation in many parts of the world, and failed; and who, therefore, was compelled, as a matter of self-protection, to look into the question of health for himself. I have read so many different kinds of books on health and made so many experiments of my own that nowadays when I meet with a group of physicians I find that before long they come to accept me as one of themselves. ”

“ Scientific discovery, once an open field for all comers, is today becoming more and more a matter calling for the most intensive special qualifications. As the body of human knowledge broadens and deepens, it becomes increasingly difficult to make any material addition to it. Any one undertaking such a task must of necessity bring to it a long and careful training, acquired either in the refined atmosphere of the laboratory, or in the rougher school of close contact with the operation of apparatus constructed by those who have already qualified. ”

“ The intravenous administration of drugs is impressive. To the patient the technic is mysterious and its psychic effect striking. Its dangers—infection, air embolism, intravascular clotting, sudden death—are matters of record. Every conservative physician will admit that there is no excuse for the intravenous administration of even those drugs that are well known and whose effects have been carefully studied, except when distinct advantages are to be secured. As The Journal has stated before, “Little is known of the results to be expected from intravenous therapy even with simple substances.” ”

“ When a therapeutic measure not only lacks a positive basis in physiology and pathology but runs contrary to all the well-established experimental facts in these fundamental medical sciences, is it too much to ask that positive clinical findings be subjected to more than usual critical analysis before acceptance? “Clinical tests,” it is said, “covering a period of several years have proved that neither the condition in the stomach during digestion nor those in the intestine prevent the secretin from entering intact into the circulation.” ”

“ By a typical nostrum vender we mean one whose knowledge of his product is far below that of his appreciation of a certain element of human character. On this element rests the whole secret of the nostrum vender’s success. It is variously termed credulity, gullibility and childlike simplicity, but it is that which often causes even the most conscientious clinician to turn aside from the use of the best known and most dependable drugs at his command, in the face of disappointment and failure, and employ some vaunted mixture which, in his saner moments, he scorns to use. ”

“ In view of the agitation to found an institute for cooperative research as an aid to the American drug industry under the auspices of the American Chemical Society, it will be well for the medical profession to be on its guard against too enthusiastic propaganda on the part of those engaged in the laudable enterprise of promoting American chemical industry. Unless it is, it may be inflicted in the future, as in the past, with a large number of drugs that are either useless, harmful or unessential modifications of well-known pharmaceuticals. ”

“ When the pharmacist puts up an ordinary, nonproprietary prescription, the patient gets no clue from the package as to the nature of the prescription employed. But when an original bottle of Neurosine is dispensed, even though the pharmacist puts his own prescription label on it, the patient sees the difference at once and knows just why the usual prescription bottle was not employed. He also knows that he can get the medicine with its original wrapper or label by merely showing the bottle to the druggist, for the words “Neurosine” and “Dios Chemical Co.” are blown in the glass. ”

“ At the time when medicine was pure empiricism it was not only possible but also probable that the medicinal value of certain products or combinations of products might be stumbled on by those untrained and unskilled. That time has passed. Today, while it is not impossible, it is so improbable that there is no justification in taking up the time of scientific men in investigating alleged discoveries by men who are utterly lacking in the fundamental qualifications needed for the study of the complex problems of human pathology.— (Editorial from The Journal A. M. A., Aug. 10, 1918.) ”

“ It is true that bile and the pancreatic secretion cooperate in intestinal digestion, but there is no evidence that in every case in which there is a deficiency of one of these secretions there is also a deficiency of the other, and it is an axiom of scientific therapeutics that no drug or remedial agent should be administered except to fill a definite want. Otherwise the practice of therapeutics becomes mere empiricism. ”