COTTON PROCESS ETHER

To the Editor:—Has anything been published on the efficacy of “Collosol Manganese” in malaria? I recently read the Council’s report which indicated the fakishness of the “Crooke’s Collosols,” but I also was told that the War Office of England had requested a study to be made of colloidal manganese in malaria.J. B., Columbus, Ohio.

J. B., Columbus, Ohio.

Answer.—Stephens, Yorke, Blacklock, Macfie, Cooper and Carter report in theAnnals of Tropical Medicine and Parasitology(Feb. 28, 1919, p. 345) the results of their investigation for the English government and conclude: “Collosol Manganese in the doses used is of no value in the treatment of simple tertian malaria.”—(Query in The Journal A. M. A., May 3, 1919.)

To the Editor:—Please let me know what information you have about the enclosed clipping?E. W. Carpenter, M.D., Greenville, S. C.To the Editor:—“Cotton Process Ether,” manufactured by the Du Pont Co., has been given considerable notoriety in the lay press. A letter of inquiry addressed to the firm elicits the information that “Cotton Process Ether is a very highly refined Di-ethyl Ether charged with Ethylene Gas.”... What is your opinion of the “Cotton Process Ether”? Has the Council on Pharmacy and Chemistry investigated this product?John L. Atlee, M.D., Lancaster, Pa.To the Editor:—I have been waiting for some reference to the new anesthetic referred to in the enclosed clipping, but if any has been made in the medical press I have failed to notice it. If there is anything of interest in connection with this item, and it is not too much trouble, I will thank you to put me in touch with the situation.Holman Taylor, M.D., Fort Worth, Tex.

To the Editor:—Please let me know what information you have about the enclosed clipping?

E. W. Carpenter, M.D., Greenville, S. C.

To the Editor:—“Cotton Process Ether,” manufactured by the Du Pont Co., has been given considerable notoriety in the lay press. A letter of inquiry addressed to the firm elicits the information that “Cotton Process Ether is a very highly refined Di-ethyl Ether charged with Ethylene Gas.”... What is your opinion of the “Cotton Process Ether”? Has the Council on Pharmacy and Chemistry investigated this product?

John L. Atlee, M.D., Lancaster, Pa.

To the Editor:—I have been waiting for some reference to the new anesthetic referred to in the enclosed clipping, but if any has been made in the medical press I have failed to notice it. If there is anything of interest in connection with this item, and it is not too much trouble, I will thank you to put me in touch with the situation.

Holman Taylor, M.D., Fort Worth, Tex.

Answer.—About January 20, the “News Service” of the “E. I. Du Pont De Nemours and Co., Inc.,” circularized the press of the country with what it was pleased to term a “good ‘filler’ ”; this particular piece of press agent work dealt with “The New Du Pont Ether.” To quote one paragraph from the “News Item”:

The new anesthetic, which is a highly refined di-ethyl ether, modified by the addition of gases, has the following characteristics: (1) the property of inducing and maintaining anesthesia with practical freedom from postoperative nausea, and (2) the property of inducing and maintaining analgesia (conscious insensibility to pain) as distinguished from anesthesia (insensibility to pain plus narcosis).

The Du Pont Ether and the claims made for it are seemingly based on the work of one man, “James H. Cotton, M.A., M.D., Toronto, Canada,” who published an article on “Cotton Process Ether and Ether Analgesia,” in theAmerican Journal of Surgeryfor April, 1919. However, Cotton did not give the composition of the “new” ether nor, so far as we are aware, has his work beencorroborated. In view of the inquiries received, the Secretary of the Council on Pharmacy and Chemistry asked the Du Pont Chemical Works for the composition of the new ether. From the firm’s reply we quote one paragraph:

“... The procedures of manufacture, and the exact composition of our ether, we regard as confidential information which we are entitled to retain unless a condition were to arise in which we were unable alone to satisfy the demand for this type of ether.”

It has been recognized—and incorporated in the “Principles of Medical Ethics”—that the use of a therapeutic agent of unknown composition is unscientific and contrary to the best interests of the medical profession and the public; but it is many times more serious for a physician to employ a secret or semisecret substance as an anesthetic. A physician using such a semisecret substance would have little defense if the patient should die.—(Query in The Journal A. M. A., Feb. 21, 1920.)

In the Query and Minor Notes department ofThe Journalof February 21, some inquiries from physicians relative to “Cotton Process Ether” were answered. In referring to the composition of this product it was stated that the secretary of the Council on Pharmacy and Chemistry had asked the manufacturers, the Du Pont Chemical Works, for information on this point and one paragraph from the firm’s reply was quoted. Another paragraph from the same letter was omitted; and to this omission the manufacturers took exception, expressing the opinion that by itThe Journalled its readers to infer that the concern had “refused to furnish any information whatever” regarding the composition of the ether. The following paragraph, italicized as in the original letter, is the one in question:

“Cotton Process Ether contains no components which do not occur in other anesthesia ethers.Its peculiar properties result from the thorough methods taken to exclude harmful impurities, such as aldehydes, peroxides, traces of acids, carbon monoxide, sulphur compounds, etc., and to include carefully regulated quantities of only such of the usual components as we have found to give distinctly beneficial properties to the ether. We are willing to state that in this class we consider properly prepared ethylene of greatest importance, but we have not announced which of the beneficial components of anesthesia ether we include in our ether, or the amount of such components.”

As the quotation shows, the paragraph is informative in a negative rather than in a positive way in that it states what Cotton Process Etheris notrather than what itis. Since that time, however, the manufacturers have notifiedThe Journalthat they have definitely decided to present Cotton Process Ether to the Council on Pharmacy and Chemistry for consideration and that in preparing the data required by the Council will define Cotton Process Ether as follows:

“An improved anesthesia ether consisting of highly refined diethyl oxid (C2H5)2O, plus approximately two volumes of ethylene (C2H4),1⁄2volume of carbon dioxide (CO2) and 1 per cent. by weight of ethyl alcohol.”—(From The Journal A. M. A., May 22, 1920.)

“Dionol” is advertised to physicians by the Dionol Company of Detroit. If one takes the word of the manufacturers, the therapeutic possibilities of Dionol are apparently limited only by the blue sky. Even the company admits that “the unprecedented range of action” of this marvel “may come as a surprise.” A glance over the published “case reports” confirms the inference. From “Bed Sores,” “Bubo,” “Catarrh” and “Circumcision” through “Croup,”“Deafness,” “Dysmenorrhea” and “Eczema,” including “Endometritis,” “Erysipelas,” “Gastritis” and “Hemorrhoids,” not omitting “Osteomyelitis,” “Otitis Media,” “Pneumonia” and “Ptomaine Poisoning,” down through the pathologic alphabet to “Quinsy,” “Sciatica,” “Spinal Curvature,” “Varicose Veins,” and “Whooping Cough” one concludes that here at last is a catholicon indeed.

What is Dionol? First it should be said that the preparation comes in two forms: as an ointment and as an emulsion. The ointment, so declare the manufacturers, “isalwaysrequired”; the emulsion may be used “as an auxiliary treatment.” The Dionol “literature” when stripped of the verbal camouflage with which it abounds may be said to propound the following theories and propositions: First, that the nerves of the body are electric conductors insulated from the surrounding tissues by the nerve sheaths; second, that inflammation breaks down the insulation with the resultant escape of the current and an interference with the normal metabolic action of the cells; third, that Dionol, when applied to the body, penetrates the tissues, “coating the cells and with them the nerve sheaths with a nonconducting layer which is sufficient to insulate the nerve sheaths and stop the leak.”

So much for the theory on which the alleged action of Dionol is based. Dionol itself is a sort of glorified petrolatum. Not, of course, that the manufacturers describe it in any such crude and understandable language. According to the company, Dionol is “composed of pure hydrocarbons, especially selected with regard to specific gravity, viscosity and other necessary physical properties” which has been “perfectlydeionizedby our special scientific process under the Baines Method.” It appears, from further reading, that ordinary petrolatum will not “turn the trick”; presumably because it does not overcome the human short circuits which the Dionol Company declare are always present in inflammation. When, however, the petrolatum has been subjected to the “Baines Method” it achieves, it seems, an esoteric value that puts to shame its plebeian origin.

The whole thing is very simple. To those physicians that like this sort of thing this preparation should make a strong appeal.—(From The Journal A. M. A., Jan. 26, 1918.)

An Indiana physician sends us in a batch of leaflets detailing the marvels of “Dionol” and thus comments:

“I received the enclosed in the mail today and I am puzzled, perplexed and astounded. I had formed the opinion that the profession was getting better; that it was more scholarly than formerly when the two course school was still in existence and any one could matriculate; that it was no longer possible for a ‘patent medicine’ manufacturer to palm off his wares on us. After reading this stuff and realizing that such methods must be remunerative, I am deeply humiliated. Is it possible that educated physicians respond to this kind of advertising? Or has some one perpetrated a joke on me? If the profession can be thus successfully exploited one can no longer wonder at the following which every new ‘ic’ and ‘ism’ acquires.”

It is a pity that the medical profession generally does not react to the Dionol and similar advertising as does our correspondent. As the concern continues to do business, the presumption is that at least some physicians are using Dionol. As was pointed out inThe Journalof Jan. 26, 1918, Dionol seems to be a glorified and esoteric form of petrolatum. The exploitation of Dionol is based on the following theory: (1) The brain is a generator of neuro-electricity; (2) the nerves are the conductors of this electricity; (3) the nerve sheaths are the insulator; (4) wherever there is local inflammation the nerves are short circuited, due to a breaking down of the insulation resistance of the nerve sheath; (5) this results in “an escape of neuro-electricity;” (6) Dionol coats the nerve sheaths with a nonconducting layer and this restores the insulation and “stops the leak.”

Whether this ingenious theory was invented to lend an air of verisimilitude to an otherwise bald and unconvincing tale and give a “reason for being” for Dionol or whether Dionol was first invented and it became necessary to evolve a theory that would give some plausibility to the claims made for this etheralized petrolatum, we are unable to say. In any case the theory and the product are exploited together.

Among the material sent in by a correspondent are some “Dionol Case Reports.” Neither the names nor the addresses of the physicians making these reports are given, but the company states that they may be had “on request.” One special “report” is featured under the heading “Infected Wound. Striking Results After United States and French Government Army Surgeons Failed” is signed “Dr. W.” It is dated July 19, 1919. A few months ago the Dionol Company was sending out this same testimonial with the full name and address of the “doctor” giving it. Investigation showed that the “doctor” in question was an osteopath whose specialties, according to his advertisement in his local newspaper, are “Catarrhal Deafness and Hay Fever, Acute and Chronic Diseases”! In this connection it is worth noting that investigation of some of the earlier testimonials sent out by the Dionol concern and alleged to have been given by “doctors” showed that the gentlemen in question were “drugless healers.”

As a “true indication of the value which the medical profession is placing on Dionol” the Dionol Company has published the names of some physicians who, it is alleged, have used the preparation.—(From The Journal A. M. A., Feb. 7, 1920.)

Physicians are receiving some miscellaneous advertising matter from a concern that seems to operate under various names such as “E. H. Dunn & Co.,” “Eli H. Dunn,” “Eli Laboratory,” etc. The concern is located at 3820 Main St., Kansas City, Mo. OneJournalreader, who is evidently not greatly impressed by this material, forwards the stuff to us with the laconic request: “Will you please give me your opinion on this junk?”

The “junk” referred to comprised, in part, an advertising leaflet on “Eli 606 Capsules,” another leaflet on “Eli Vaginal Capsules,” still another on “Eli ‘Vim’ Restorative;” then there was reference to the inevitable nostrum for intravenous use: “Ampoules Eli Venhydrarsen.” A four-page leaflet, headed in large and very black letters “Confidential Guide to Live Wire Physicians Only,” expressed its key-note in the opening paragraph:

“How to make MONEY as well as REPUTATION in the treatment of all CHRONIC AILMENTS and all types, forms and sequella of VENEREAL diseases.”

The “Eli ‘Vim’ Restorative” is said to be a “tonic aphrodisiac.” The “action” of the product is to “Arouse Sexual Ardor and Desire. Influx blood supply to the genital organs.” A postscript to the “Guide” urges physicians:

“If you do not already use Intravenous Serums, by all means get an outfit, if for no other reason than to meet the popular DEMAND.”

A “Special Note” in the “Confidential Guide” advises physicians who “have to deal with Hysteria” to “write the Author of this Guide, who will explain by personal letter a method of cooperation by which such Convulsions may be At Once and forever stopped.... There will be $100 for You from every case treated.” One physician wrote to the “Author of this Guide”—Eli H. Dunn, M.D.—asking for further information on this treatment for hysteria. He received in reply two letters both signed Eli H. Dunn; one was to beshown to the patient, the other was for the doctor’s own information. The letter for the patient to see described the marvelous effects of “Dunn’s Intravenous and Restorative Treatment” in hysteria and recommended it “with the utmost confidence in every case able to pay you the fee commensurate with the service you render.” Then followed these two paragraphs:

“The cost of the treatment when administered by yourself is $300 CASH WITH ORDERS which includes one complete outfit and technique for administering.“Should you call me personally in consultation an additional fee of $150 per diem covering the time I am away from my Kansas City office; fees to be collected and held until I arrive.”

“The cost of the treatment when administered by yourself is $300 CASH WITH ORDERS which includes one complete outfit and technique for administering.

“Should you call me personally in consultation an additional fee of $150 per diem covering the time I am away from my Kansas City office; fees to be collected and held until I arrive.”

The letter that was intended only for the doctor’s eye declared:

“You are to have $100 of the fee and $50 of the per diem.”

It explained that the “complete outfit” referred to in the “patient’s letter” would “consist in part of a tube of intravenous medication” and doses of “Restorative Capsules” and “Eli 606 Capsules.”

Eli H. Dunn seems to have had a somewhat varied and spectacular career. After being graduated in 1885 he apparently started practice in Orion, Ill. During the nineties he was practicing at Elma, Iowa, and about 1900 he seems to have moved to Kansas City, Mo. During 1906 and 1908, he also had an additional office at Denver, Col. About this time he was exploiting “Dunn’s Uterine Evacuant” which was “a strictly legitimate” product which could “be injected within the uterus with perfect safety and immediate effect.” This stuff was advertised both from the Kansas City and the Denver offices. The “Personal Column” of a Kansas City paper in 1910 carried the message to “Ladies” that “Dr. Dunn” was a “Regular physician for women only,” Dunn’s violation of the postal laws in 1911 and of the federal Food and Drugs Act in 1912 need not be gone into at this time.

The Journalwould feel like apologizing for devoting space to such a preposterous scheme were it not for the fact that physicians, being human, sometimes “fall for” preposterous schemes. Some, we know, have nibbled at Dunn’s bait; others may do so. The gross commercialism that permeates the advertising matter sent out by Dunn again emphasizes the fact that the fad for intravenous medication offers an attractive field for those who would exploit our profession.—(From The Journal A. M. A., Nov. 22, 1919.)

Scores of letters have reached—and are reaching—The Journaloffice similar in effect to the following:

“I am enclosing ‘literature’ received from the ‘T. J. Glover Research Laboratory.’ Though purporting to come from Toronto, where the $25.00 are to be sent, if you please, the envelope bears the New York postmark.”

The above is from New Jersey while the two following are from Michigan and Illinois, respectively:

“Have you any information in regard to this party and his treatment for cancer? This is the first I have heard of any such work having been done. One wonders if it is presented in good faith or if the money god has overcome the gentleman’s scientific spirit.”“Is this just one more of them? Why a roan horse? Some people might want serum from a nice bay or calico cow pony.”

“Is this just one more of them? Why a roan horse? Some people might want serum from a nice bay or calico cow pony.”

The literature referred to comes in an envelop bearing the name of “T. J. Glover, Research Laboratory, Toronto, Canada,” but mailed, apparently, fromNew York City. The enclosures are a single sheet circular signed Thomas Joseph Glover and entitled “Etiology of Cancer,” a “Directions” slip and a card quoting prices. In the circular Dr. Glover states that he has prepared a serum from immunized horses, “between ages of seven and nine years, of the roan type,” and has injected this intramuscularly “into patients in the advanced stages of cancer and noticed that it has a specific action on every known type of cancer.” Further:

“Up to the present time I have apparently cured cancer of the face, eye, nose, lip, mouth, tongue, stomach, bowel, bladder, breast and uterus.”

In addition to the circular, was a small leaflet giving directions for the injection of the serum and also a card bearing Dr. Glover’s name and Toronto address and reading:

This is to advise you thatDr. T. J. Glover’sSerum for the treatment of cancer can now be had by application to office at above address.PRICE FIVE DOLLARS PER TREATMENT. FIVE TREAT-MENTS MINIMUM NUMBER SENT AT ONE TIME.Send money by Post-Office Money Order or Certified Cheque.DIRECTIONS FOR TREATMENT WITH EACH ORDER.

This is to advise you thatDr. T. J. Glover’sSerum for the treatment of cancer can now be had by application to office at above address.

PRICE FIVE DOLLARS PER TREATMENT. FIVE TREAT-MENTS MINIMUM NUMBER SENT AT ONE TIME.

Send money by Post-Office Money Order or Certified Cheque.

DIRECTIONS FOR TREATMENT WITH EACH ORDER.

This advertising material, which is evidently being widely circulated in the United States, would indicate that the Glover Research Laboratory had received a permit from the United States Public Health Service licensing the interstate sale of this serum in the United States. No such license has been issued.

The Journalbriefly reported in the department of Medical News, Oct. 30, 1920, that the Academy of Medicine of Toronto had appointed a committee to investigate the claims made for the Glover “cancer serum.” In the meantime, the most charitable thing that can be said is that the “treatment” is in the experimental stage and the reported results have not been corroborated by independent investigators.—(From The Journal A.M.A., Jan. 1, 1921.)

The method of exploitation of the alleged cancer serum being put out by Dr. T. J. Glover of Toronto, Canada, was briefly discussed in this department ofThe Journalfor January 1. At that time it was pointed out that the medical profession of the United States was being widely circularized by Dr. Glover and that, while the letters purported to come from Toronto, they were, in fact, mailed from New York City. Since this article appeared the circularization seems to have continued undiminished and physicians in various parts of the United States have sent in the Glover advertising material. Oddly enough, the matter now sent out, while identical in every respect with that dealt with in the previous article, bears a different return address on the back of the envelop. The envelops are the same; but the legend “T. J. Glover Research Laboratory, 538 Jarvis St., Toronto, Canada,” has been crudely crossed out and there has been substituted by means of a rubber stamp the legend “MRS. STEWART, 309 W. 54th St., New York.” Still later letters have been modified to the extent that the letters “RS” of “MRS.” have been cut out of the stamp and it now reads “M . STEWART.”

There has now come to hand a report just published by a special committee appointed by the council of the Academy of Medicine, Toronto, to investigatethe Glover Serum. The report of this committee may be summed up by one of its closing paragraphs, which reads:

“The data which your committee has been able to obtain have not convinced it that the results of treatment obtained by the use of Dr. Glover’s serum are better than those obtained by similar methods introduced by others, and which have ultimately disappointed the hopes entertained of them.”

The committee’s report deals with the claims that Dr. Glover has made for his serum, both experimental and clinical. It seems that Dr. Glover has claimed that, experimentally, he had (1) cultured cancer cells and from these cells had isolated and cultured an organism which he declared was confined to, and present in, every type of cancer; (2) produced cancer in a number of animals by inoculation with these cells and organisms; (3) obtained a serum—from a horse that had been injected with cultures of these cells and organisms—which, when injected into experimental animals rendered them immune to inoculation, and (4) produced improvement or cure in cases of human cancer by the injection of his serum. The committee reported that it was unable to obtain any evidence to substantiate Dr. Glover’s claims on the experimental aspect of the question as Dr. Glover had refused to permit representatives of the committee to visit his laboratory; had refused the request of the committee to be allowed to examine his cultures and experimental material; had not acceded to the request of the committee that he demonstrate his ability to culture cancer cells and organisms and to produce cancer by inoculation or to immunize animals against it.

The committee attempted also to collect information which would enable it to pass on the clinical claims made by Dr. Glover, first, as to whether he has succeeded in producing cures, either regularly or occasionally, in cases definitely established as cancer and, second, to enable the committee to decide whether his serum in cases definitely established as cancer produces improvement beyond that which occasionally occurs spontaneously or under palliative measures. On both of these points, the committee reported that it found no evidence to warrant the hope that a specific cure for cancer has been discovered by Dr. Glover or that the serum had produced a cure in any case definitely established as cancer.

It should be understood, that the committee’s investigations and findings were completed before the present advertising campaign of the Glover serum was initiated.—(From The Journal A.M.A, Feb. 5, 1921.)

One characteristic of the “patent medicine” business is that it trades on fear. Should an epidemic occur the market is flooded with new nostrums purporting to cure or prevent the disease in question, while the manufacturers of older “patent medicines” revamp their advertising so as to make it appear that their preparations are all that stand between the scourge and the public. One has but to remember “Peruna’s” exploitation of the yellow fever epidemic in New Orleans some years ago and the way in which the exploiters of “Pond’s Extract” played on the fears of the public at the time of the former meningitis epidemic in New York City.

At present the public is much exercised over the epidemic of infantile paralysis. Anticipating that the nostrum fraternity would attempt to reap a golden harvest from the public distress, the federal officials issued a bulletin of warning on the subject. Naturally, the bulletin was addressed to the lay public, the government assuming that physicians knew enough to avoid beingmisled by any such advertising campaigns. Apparently, the assumption is too broad. At any rate, the manufacturers of “Glyco-Thymoline” are circularizing physicians, one of whom writes as follows:

To the Editor:—I am enclosing circular letter that I received this morning which seems to me almost a crime. I do not suppose that there is any way to prevent anything of this sort, but it is certainly a shame to attempt to deceive people in this way. As I recollect, Glyco-Thymoline is almost inert, practically no more efficient than Dobell’s Solution.E. Fletcher Ingals, M.D., Chicago.

E. Fletcher Ingals, M.D., Chicago.

The circular letter referred to was on the stationery of Kress & Owen Company, manufacturers of Glyco-Thymoline. It read:

Dear Doctor:—Regarding Infantile Paralysis, it is conceded that the source of infection is through the Nose, Mouth and Throat.Taking this measure to be correct, we believe that there is no safer prophylactic measure than the use of Glyco-Thymoline, with three parts of water, as a mouth, tooth and nasal wash, by means of the K. & O. Nasal Douche and the toothbrush.Glyco-Thymoline tends to promote exosmosis, and prevents the absorption of the germ or toxic matter.We would be glad to send you samples of both Glyco-Thymoline and the Douche should you so desire.With best wishes, we beg to remain,Yours very truly,Kress & Owen Company.

Dear Doctor:—Regarding Infantile Paralysis, it is conceded that the source of infection is through the Nose, Mouth and Throat.

Taking this measure to be correct, we believe that there is no safer prophylactic measure than the use of Glyco-Thymoline, with three parts of water, as a mouth, tooth and nasal wash, by means of the K. & O. Nasal Douche and the toothbrush.

Glyco-Thymoline tends to promote exosmosis, and prevents the absorption of the germ or toxic matter.

We would be glad to send you samples of both Glyco-Thymoline and the Douche should you so desire.

With best wishes, we beg to remain,

Yours very truly,

Kress & Owen Company.

Glyco-Thymoline has been discussed in these pages. A report of the Council on Pharmacy and Chemistry pointed out that this “patent medicine” is simply a weak antiseptic, so feeble that even in full strength it does not killStaphylococcus aureusin four hours and is of little, if any, greater therapeutic value than sterile salt solution. Yet, Glyco-Thymoline has been recommended by its manufacturers, either directly or inferentially, for such diseases as diphtheria, ophthalmia neonatorum and consumption. Today its manufacturers put it forward as one of the safest prophylactic measures against infantile paralysis and have the effrontery to make this suggestion, not to the uninstructed public but to the medical profession. Presumably, as a business organization, the concern believes it will convince a sufficient number of physicians of the therapeutic efficacy of its product to pay for the cost of this advertising campaign. If it appraises the situation correctly there need no longer be any wonder expressed that in the recent suit againstThe Journal, “patent medicine” makers were able to enlist the help of medical men.—(From The Journal A. M. A., Sept. 16, 1916.)

The law which limits the length of time that food products may be kept in cold storage could with advantage have its scope extended to include “patent medicine” testimonials. Physicians recently received through the mails—at a time when the mails were frightfully congested with Christmas business—a sixteen page pamphlet sent out in a plain envelop as first class matter. The caption of the pamphlet reads: “Cough and Its Treatment in Pulmonary and Laryngeal Tuberculosis: By Henry Levien, M.D., While Medical Director and Physician-in-Charge of the Liberty Sanitarium, Liberty, N. Y. From theBuffalo Medical Journal.” The pamphlet is devoted to the alleged virtues of that dangerous and widely advertised nostrum, “Glyco-Heroin (Smith),” whose more recent and less descriptive name is now “Glykeron.” Physicians might assume, and doubtless will assume, from the pamphlet that this reprint represents a recent pronouncement on the subject with which it deals. The factsare that the “Liberty Sanitarium” has, apparently, been out of existence for at least fifteen years, while the article itself originally appeared more than eighteen years ago—September, 1901. One of many physicians who sent in the copies received called attention to the fact that he had left the address to which the pamphlet was directed, more than six years ago. Even at that, the mailing lists of the concern that sells this heroin-containing nostrum are more than twelve years ahead of its “clinical reports.”—(Editorial from The Journal A. M. A., Jan. 17, 1920.)

Last September the United States Department of Agriculture issued a press bulletin describing the work of the Bureau of Chemistry in prosecuting the venders or manufacturers of fraudulently exploited “patent medicines.” At the end of the bulletin was a tabulated list of “other preparations against which the government’s charge that they were falsely or fraudulently labeled was sustained by the federal courts.” Tucked away in the list was a product often euphemistically described as an “ethical proprietary” but none the less essentially a “patent medicine”—“Gray’s Glycerine Tonic.” The editor of theAtlanta Journal of Medicine, apparently not having read the bulletin with any great degree of care, published it verbatim. Thus it was that theAtlanta Journal-Record of Medicinefor September, 1915, presented the interesting sight of a half-page advertisement of “Gray’s Glycerine Tonic” in the same issue that contained the government’s article classifying “Gray’s Glycerine Tonic” among the false and fraudulent products! What happened? In the very next issue theAtlanta Journal-Record of Medicineapologized thus editorially:

“In our September issue, Gray’s Glycerine Tonic Comp. was inadvertently included in a list that seemed to be under the ban of the Government and very likely an injustice has been done the Purdue Frederick Company which we desire to undo as far as possible.”

Did the editor mean by “inadvertently included,” that he would have omitted “Gray’s Glycerine Tonic” from the government’s list had he noticed it in time? If so, on what grounds? It is a fact that “Gray’s Glycerine Tonic” was one of the “Fifty Falsely Labeled Medicines”; it is also a fact that it is one of the products that government officials and the federal courts have declared to be sold under claims that are “false, fraudulent and misleading.” If “Gray’s Glycerine Tonic” was fraudulently exploited—and the government and the courts have so declared it—why is it necessary for the editor of a medical journal to apologize to his subscribers for having told them so?—(Editorial from The Journal A. M. A., Jan. 1, 1916.)

“Under the deceptive heading ‘Making Cod Liver Oil Palatable,’ theCharlotte Medical Journalin its December issue prints a boost for ‘Cord. Ext. Ol. Morrhuae Comp. (Hagee),’ or, as it is generally known to the drug trade, ‘Hagee’s Cordial of Cod Liver Oil.’

“The boost intimates that this is a preparation in which cod liver oil has in some way been rendered palatable, and then goes on to say that this is a cod liver oil product which has not suffered the least loss of those essential elements which make the crude oil such a high-class reconstructive.

“At first sight one might question whether a cod liver oil product which contains absolutely no cod liver oil had not suffered the loss of essential elements. But a closer reading discloses a significant qualification, namely, thephrase, ‘those elements which make the crude oil such a high-class reconstructive.’

“The boost is misleading from beginning to end. The manufacturers have not succeeded in this preparation in ‘making cod liver oil palatable,’ nor does their preparation in any way possess the virtues of cod liver oil. These claims have again and again been refuted, but they continue to be published—at a price but rarely in reputable medical journals.”

The above is quoted from theWeekly Bulletinof the Department of Health of the City of New York. The Bulletin is issued for the enlightenment of the public.—(From The Journal A. M. A., Jan. 8, 1916.)

A physician in Vermont writes:

“This is simply a word of inquiry—and of possible warning to other practitioners—regarding a preparation known as Hypno-Bromic Compound manufactured by H. K. Wampole & Co. This compound is dispensed by druggists without prescription and contains in each ounce:

“Cannabis indica1gr.“Morphin1⁄4gr.“Potassium bromid48gr.“Hyoscyamus1gr.“Chloral hydrate96gr.

“Cannabis indica

“Morphin

“Potassium bromid

“Hyoscyamus

“Chloral hydrate

“I have at the present time three young women who are addicts to this preparation as the result of thoughtless prescriptions from physicians. This mixture evades the working of the Harrison Act and may be dispensed freely at the discretion of the druggist and, as a result, these three cases of mine have been able, by visiting at the various drug stores in town, to keep an ample supply on hand at all times.”

“Hypno-Bromic Compound” is more than an unscientific mixture; it is a dangerous product and should not be sold indiscriminately over the drug counter. Before the Harrison Narcotic Law went into effect, “Hypno-Bromic Compound” contained half a grain of morphin sulphate to the ounce instead of its present one-fourth grain. Physicians remember that Section 6 of the Harrison law contains a joker—put over by the “patent medicine” interests—that exempts proprietary remedies containing one-fourth grain of morphin or less to the ounce from the restrictions of that act. While it is illegal for a physician to write a prescription which contains morphin, no matter how small the amount, unless he conforms in all ways to the requirements of the Harrison Narcotic Law, “patent medicine” concerns can sell indiscriminately nostrums containing morphin up to this amount and the public can buy them without let or hindrance. No reputable druggist would sell a layman over 700 grains of chloral hydrate or 2 grains of morphin or 8 grains of extract of cannabis indica, without a prescription, yet, the druggist may hand over 8 ounce bottles of Hypno-Bromic Compound which contain 768 grains of choral hydrate, 2 grains of morphin sulphate, 8 grains of extract of cannabis indica, 8 grains of hyoscyamus and 384 grains of potassium bromid! Physicians who prescribe such products as Hypno-Bromic Compound and druggists who indiscriminately sell such stuff are disgracing two honorable professions.—(From The Journal A. M. A., Feb. 7, 1920.)

For some time past inquiries have been received regarding Charles Lyman Loffler, his Post-graduate Course in Intravenous Therapy and especially relative to “Intravenous Compound (Loffler).” For instance, a physician writes:

“Can you tell me anything about the Physicians Drug Syndicate.... They are pushing the sale of Thymozene and offering One Hundred Dollars’ worth of stock fully paid and non-assessable, free to those sending in their order, and also a copy of Dr. Loffler’s Lectures on the Blood.”

And from another physician:

“What do you know of Charles Loffler, M.D., and his Intravenous Compound? A few evenings ago a man who appeared to be about 40 years old came to my office and tried to interest me in the above-mentioned article; he claimed to be Dr. Charles Loffler of Chicago. With him was a young lady whom he introduced as MissB——. MissB——said that she had been with Dr.X——[a physician of high standing in Los Angeles] for two months and that he was using the Intravenous Compound; also quoted other physicians.... His whole layout looks quackish, and were it not for the fact that he showed me a letter that appeared to be from Dr.X——, I should not have given him a second thought.”

And this also:

“Charles Loffler, M.D., or his agent was traveling around inducing one M.D. in each town to take up his methods of blood examination and treatment and with a little advertising of blood examinations free the doctor selected gets quite a run of patronage.”

Another physician writes:

“My attention has been called by another physician to Loffler’s Intra-Venous Compound. May I trouble you to give me any information that you may have with regard to its composition and its value as a therapeutic agent?”

C. L. Loffler does business from Rooms 1101–1102, Venetian Bldg., Chicago, the location of the “Intravenous Chemical Co.,” the “Physicians Drug Syndicate” and the “Ma-Oze Chemical Co.” Of these, more later.The Journalhas in its files a large amount of material regarding Loffler. A brief résumé of that part of the material dealing with Loffler’s professional activities will be given for the purpose of allowing physicians to evaluate the scientific status of Loffler’s “Lectures,” “Post-Graduate Courses,” his therapeutic “discoveries” and his products.

It seems that Loffler was reared in Yankton, S. D. In 1898–1899, Loffler was a senior student at John Creighton Medical College, but, for reasons that need not be gone into here, he was never graduated. He received a diploma from Barnes Medical College in 1900, and in the same year was licensed to practice in South Dakota. In 1902 he was at Le Mars, Iowa; in 1904 his name appears in the medical directory, under Sioux Falls, S. D., as “Specialist in Chronic Troubles.”

Charles L. Loffler’s “specialty” is “Intravenous Medication.” In 1912 and 1913, as the Intravenous Company of Colorado Springs, he was sending out a booklet entitled “Consumption.” This described the alleged marvelous results to be obtained in the treatment of tuberculosis by the use of “Intravenous Compound”; there was also a side line, “The Loffler Internal Bath Plate.” At that time the administration of “Intravenous Compound” was recommended intravenously, hypodermically, by rectum, by mouth and even by insufflation. When the stuff was to be given by rectum, the recommendation was made: “First wash out the bowels with a preliminary injection of two or three quarts of warm water, using for this purpose the Loffler Internal Bath.”

In 1913 Loffler sought a larger field for his peculiar talents and left Colorado Springs. After a short stay in Denver he is next found in Minneapolis, where he was also “engaged in the practice of intravenous therapy” and, incidentally, seems to have been an organizer and manager of a common law concern known as the Automatic Thrasher Co.

In 1919 we find Loffler in Chicago as president of the “Physicians Drug Syndicate.” This concern—another common law organization—had for its vice president one A. E. Erling, M.D., and for its secretary and treasurer, Arthur C. Hanson. Erling wasdiscussed251in an article that appeared inThe Journal, July 5, 1919, on the egregious “Allied Medical Association of America” of which organization C. L. Loffler was “President” in 1918.

Hanson, the secretary and treasurer of the Physicians Drug Syndicate, is said to have hailed originally from Minot, N. D., where he was in the drug business. His name appears in the Propaganda files as the manager of the Ma-Oze Chemical Co. of Minneapolis, which, in October, 1919, was advertising in a daily paper of that city:

“Protect yourself against influenza. Don’t let the germs get a foothold in your system. Kill them with Ma-Oze Antiseptic Powder. Use it as a gargle. It is... sure death to all kinds of disease germs.”

In a preliminary statement sent out by Hanson in the early part of 1919 it seems that the Physicians Drug Syndicate was conceived “primarily to supply physicians with a product to be used in Leucorrhea and personal cleanliness of women.” This product, apparently, was the Ma-Oze of influenza fame in Minneapolis. It was to be put out, however, under the name of “Thymozene,” which, “packed in 4 ounce unlabeled carton for dispensing,” would “show nearly 100 per cent. profit to the organization over the profit which you make if you dispense your own drug.”

In October, 1919, the Physicians Drug Syndicate was circularizing physicians in Iowa trying to get them to send in $6 for “1 Dozen Thymozene 4 oz.” For this $6 the doctors were to get, in addition to the marvelous Thymozene, the following rights, privileges and emoluments:

1. A free Post-Graduate Course in Intravenous Therapy by Dr. Charles Loffler.

2. A gift of $100 worth of stock in the Physicians Drug Syndicate.

3. A copy of Dr. Loffler’s Lectures on Blood.

4. The privilege of purchasing future supplies of Thymozene “at wholesale prices less discount of 331⁄3per cent.”

The letter making these offers mentioned incidentally:

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