“The theories for the favorable action of Fellows Syrup of Hypophosphites have undergone several changes.”
“The theories for the favorable action of Fellows Syrup of Hypophosphites have undergone several changes.”
The same circular further maintains, however, that:
“... the fact has never been challenged that in Fellows Syrup of Hypophosphites we have one of the most efficient, most complete, most all-around tonics and roborants in the materia medica.”
“... the fact has never been challenged that in Fellows Syrup of Hypophosphites we have one of the most efficient, most complete, most all-around tonics and roborants in the materia medica.”
No attempt is made to base this assertion on the therapeutic action of the constituents. In other words, the old theory, which formed the basis for the popularity of Fellows’ Syrup, has been thrown overboard, but no substitute is deemed necessary; the momentum already acquired is apparently regarded as sufficient to insure its continued sale.
Fellows’ Syrup of Hypophosphites is a semisecret, unscientific preparation—an affront to sound therapy—exploited by means of extravagant and misleading statements.
Little information concerning this preparation seems to be furnished at present by the manufacturers, Arthur Peter & Co., Louisville, Ky. According to an old circular, it contains, in each fluidounce,
Grains“Hypophos. Potass.11⁄2Hypophos. Manganese1Hypophos. Lime1Hypophos. Iron11⁄2Hypophos. Quinin6⁄16Hypophos. Strichnin1⁄16“1⁄128grain Strychnia to Teaspoonful.”
“Hypophos. Potass.
Hypophos. Manganese
Hypophos. Lime
Hypophos. Iron
Hypophos. Quinin
Hypophos. Strichnin
Further, according to the same circular:
“The Hypophosphites are especially useful in all diseases where there is a lack of nutrition.... They are the best of all remedies in Rachitis, non-union of fractures, Osteomalacia and Syphilitic Periostitis.”
“The Hypophosphites are especially useful in all diseases where there is a lack of nutrition.... They are the best of all remedies in Rachitis, non-union of fractures, Osteomalacia and Syphilitic Periostitis.”
As for Syrupus Roborans itself:
“This elegant preparation is... the best general tonic and reconstructive known.”
“This elegant preparation is... the best general tonic and reconstructive known.”
The unwarranted therapeutic claims formerly made for it seem to be no longer circulated. Syrupus Roborans is an unscientific, shotgun mixture.
The Schlotterbeck & Foss Co., Portland, Maine, the manufacturers, say of their preparation:
“This solution contains 30 grains of the combined Hypophosphites of Lime and Soda to the ounce. It contains No Sugar, No Acid and it is Perfectly Neutral.”“Indications for use.—Galactostasis, Imperfect Metabolism, Neurasthenia, Nervous Dyspepsia, Insomnia, Convalescence, Acetonuria, Cyclic Vomiting in Infants, Diabetes, Starvation, Deficiency of Lime, Mother’s Teeth during Pregnancy, Dentition of Infants, Rachitis, Furunculosis, Vomiting of Pregnancy, Obesity.”“Migraine is often caused by conditions for which this Solution is one of the most satisfactory remedies:”“In Insomnia due to advancing age, it will often act as a hypnotic....”
“This solution contains 30 grains of the combined Hypophosphites of Lime and Soda to the ounce. It contains No Sugar, No Acid and it is Perfectly Neutral.”
“Indications for use.—Galactostasis, Imperfect Metabolism, Neurasthenia, Nervous Dyspepsia, Insomnia, Convalescence, Acetonuria, Cyclic Vomiting in Infants, Diabetes, Starvation, Deficiency of Lime, Mother’s Teeth during Pregnancy, Dentition of Infants, Rachitis, Furunculosis, Vomiting of Pregnancy, Obesity.”
“Migraine is often caused by conditions for which this Solution is one of the most satisfactory remedies:”
“In Insomnia due to advancing age, it will often act as a hypnotic....”
Of the hypophosphites the Schlotterbeck & Foss Company say:
“If ‘damning it with faint praise’ on the part of some of the leading medical authorities, or utterly condemning it as useless, on the part of others, would kill a medicine, the Hypophosphites would long since have disappeared as medicinal agents. Negative testimony in regard to the value of a drug does not settle anything.”
“If ‘damning it with faint praise’ on the part of some of the leading medical authorities, or utterly condemning it as useless, on the part of others, would kill a medicine, the Hypophosphites would long since have disappeared as medicinal agents. Negative testimony in regard to the value of a drug does not settle anything.”
Of their own preparation they say:
“When we get the results that ought to follow the administration of Hypophosphites, we have proved that Schlotterbeck’s Solution enters the system unchanged.”“This Solution is primarily a blood and nerve tonic and chemical food.”
“When we get the results that ought to follow the administration of Hypophosphites, we have proved that Schlotterbeck’s Solution enters the system unchanged.”
“This Solution is primarily a blood and nerve tonic and chemical food.”
Schlotterbeck’s Solution of Hypophosphites of Lime and Soda is a semisecret preparation marketed under claims that are both unwarranted and misleading.
According to the manufacturers, the Robinson-Pettet Company, Louisville, Ky., each fluidounce of this preparation contains:
“Hypophosphites Soda2gr.Hypophosphites Lime11⁄2gr.Hypophosphites Iron11⁄2gr.Hypophosphites Quinin3⁄4gr.Hypophosphites Strychnine1⁄16gr.”
“Hypophosphites Soda
Hypophosphites Lime
Hypophosphites Iron
Hypophosphites Quinin
Hypophosphites Strychnine
It is claimed to be
“Nutritive, Tonic Alterative. A Standard Remedy in the treatment of Pulmonary Phthisis, Bronchitis, Scrofulous Taint, General Debility, etc. Stimulates Digestion, promotes Assimilation.”
“Nutritive, Tonic Alterative. A Standard Remedy in the treatment of Pulmonary Phthisis, Bronchitis, Scrofulous Taint, General Debility, etc. Stimulates Digestion, promotes Assimilation.”
The declared composition of the preparation is unscientific, and the therapeutic claims are unwarranted.
Nelson, Baker & Co., Detroit, Mich., who market Eupeptic Hypophosphites, call this preparation:
“A superior combination containing the Hypophosphites of Potassium, Calcium, Iron and Manganese, and the bitter tonics, Quinin and Strychnin, agreeably associated with natural digestive ferments of the pancreatic secretion. It is thus a general reconstructive tonic.... The remedy is of especial value in the treatment of mental and nervous affections.... It is indicated in pulmonary tuberculosis, in all wasting diseases, in debilitated conditions generally and in all exhaustion from over work.”
“A superior combination containing the Hypophosphites of Potassium, Calcium, Iron and Manganese, and the bitter tonics, Quinin and Strychnin, agreeably associated with natural digestive ferments of the pancreatic secretion. It is thus a general reconstructive tonic.... The remedy is of especial value in the treatment of mental and nervous affections.... It is indicated in pulmonary tuberculosis, in all wasting diseases, in debilitated conditions generally and in all exhaustion from over work.”
On the basis of the manufacturer’s statement, Eupeptic Hypophosphites must be regarded as a semisecret, unscientific, shotgun preparation, exploited through unwarranted therapeutic claims.
So far as the recent literature and trade package are concerned, no information as to the composition of this product is furnished beyond what is conveyed in the name. The advertising for McArthur’s Syrup, like that for Fellows’ Syrup and Peters’ Syrupus Roborans, has been modified as time has passed. A few years ago it was advertised under such claims as the following:
“... Has Stood the Test during many years for unequaled efficacy in the treatment of Tuberculosis.... Indicated also as a Tonic and Tissue Builder in convalescence from Fevers, in Nervous Diseases, Rickets, Senile Debility and Bronchitis.”“Its use is indicated in... diseases of the chest, chronic cough, throat affections, general debility, brain exhaustion, cholera infantum and wasting diseases of children.”
“... Has Stood the Test during many years for unequaled efficacy in the treatment of Tuberculosis.... Indicated also as a Tonic and Tissue Builder in convalescence from Fevers, in Nervous Diseases, Rickets, Senile Debility and Bronchitis.”
“Its use is indicated in... diseases of the chest, chronic cough, throat affections, general debility, brain exhaustion, cholera infantum and wasting diseases of children.”
At present no definite claims seem to be made for it; the manufacturers evidently find the magic name of hypophosphites sufficient to evoke the spell for which the advertisement writer’s aid was once sought. A testimonial contained in a circular which seems to be still used illustrates both the kind of aura which surrounds hypophosphites in the minds of physicians who are still living in the past, and the kind of logic which has made the reputation of this and many other equally worthless preparations.
“Just about six years ago I had a severe attack of La Grippe which almost killed me. Left me with Asthma (Catarrh) and a severe cough. Did not get out of the house for three months. Took over a dozen bottles McArthur’s Hypophos.—came out all right and since then worked hard, but last Fall took another cold, but worked on, used McArthur’s Hypophos., am using it now, am on my 12th bottle.“I have five or six patients whom I have put on McArthur’s Hypophos., but I do not prescribe the single bottle, butwholesaleno less than half dozen bottles. One patient is on his 24th bottle with orders to get another half dozen and keep it up all winter. I have given the same order to all (keep it up all winter) and I myself intend to do the same, for with its use I have lost no time—rain or shine I am doing my work. I know what it has done for me and what it is doing for my patients.”
“Just about six years ago I had a severe attack of La Grippe which almost killed me. Left me with Asthma (Catarrh) and a severe cough. Did not get out of the house for three months. Took over a dozen bottles McArthur’s Hypophos.—came out all right and since then worked hard, but last Fall took another cold, but worked on, used McArthur’s Hypophos., am using it now, am on my 12th bottle.
“I have five or six patients whom I have put on McArthur’s Hypophos., but I do not prescribe the single bottle, butwholesaleno less than half dozen bottles. One patient is on his 24th bottle with orders to get another half dozen and keep it up all winter. I have given the same order to all (keep it up all winter) and I myself intend to do the same, for with its use I have lost no time—rain or shine I am doing my work. I know what it has done for me and what it is doing for my patients.”
It would be hard to find a more characteristic example of the naïve mental processes of the simple folk who in all good faith write testimonials for worthless medicines. This well-meaning practitioner (a homeopath, by the way), because he “came out all right” after an attack of grip, returns all praise to McArthur’s Hypophosphites, which he has taken “wholesale.” Not the faintest doubt of the validity of hispost hoc ergo propter hocargument seems to glimmer across his consciousness.
McArthur’s Syrup of the Hypophosphites is an irrational preparation. While its faults are fewer and less glaring than those of some other proprietaries, the circulation of such a testimonial as the one just quoted is sufficient of itself to cast suspicion on the product.
These preparations are now described in the appendix to New and Nonofficial Remedies. Borcherdt’s Malt Olive with Hypophosphites (Borcherdt Malt Extract Company, Chicago) is said to contain in each 100 c.c., 0.64 gm. each of calcium and sodium hypophosphites, with malt extract, olive oil and glycerine. Maltzyme with Hypophosphites (Malt-Diastase Company, NewYork) is said to contain, in each 100 c.c., 0.4 gm. each of calcium, sodium and potassium hypophosphites and 0.005 gm. each of iron and manganese hypophosphites, with maltzyme. Maltine with Hypophosphites (Maltine Company, Brooklyn, N. Y.) is said to contain in each 100 c.c., 0.64 gm. each of calcium and sodium hypophosphites and 0.42 gm. of iron hypophosphite, with maltine. Maltine with Olive Oil and Hypophosphites (Maltine Company, Brooklyn, N. Y.) is said to contain, in each 100 c.c., 0.6 gm. each of calcium and sodium hypophosphites, with maltine and olive oil. In general, no therapeutic claims are made for these mixtures so far as the hypophosphites are concerned. The addition of hypophosphites to such mixtures is irrational and, since it tends to perpetuate the hypophosphite fallacy, detrimental to sound therapeutics.
The Council endorsed the conclusions of the work of Dr. Marriott referred to above, and noted: (1) that the therapeutic use of hypophosphites (except possibly in some cases as a convenient means of administering the positive element in the salt, as ammonium in ammonium hypophosphite or calcium in calcium hypophosphite) is irrational; (2) that the merits of each hypophosphite salt submitted for consideration under the foregoing exception must be judged individually, and (3) that Fellows’ Syrup of Hypophosphites, Peters’ Syrupus Roborans, Schlotterbeck’s Solution Hypophosphites of Lime and Soda, Robinson’s Hypophosphites, the Eupeptic Hypophosphites of Nelson, Baker & Co., and McArthur’s Syrup of the Hypophosphites are ineligible for inclusion in New and Nonofficial Remedies, and that Borcherdt’s Malt Olive with Hypophosphites, Maltzyme with Hypophosphites, Maltine with Hypophosphites, and Maltine with Olive Oil and Hypophosphites be deleted from the appendix of N. N. R. Of these preparations, all are in conflict with Rule 10; Fellows’ Syrup, Schlotterbeck’s Solution, Robinson’s Hypophosphites and Nelson, Baker & Co.’s Eupeptic Hypophosphites are in conflict with Rule 6; the Fellows, Schlotterbeck, and Nelson, Baker preparations are also in conflict with Rule 1.—(From The Journal A. M. A., Sept. 2, 1916.)
Pulvoids Calcylates 5 grains was submitted by the Drug Products Company, Inc., New York, under the following claims as to composition:
“When ingested represents the following chemical formulas: C6H4OHCOO2Ca.2H2O + Sr.(C7H5O3)2+ 2H2O.”“Strontium Di-Salicylate 21⁄2grs. and our especially prepared Salt of Calcium and Acid Salicylic adjusted in such nascent form, that these pulvoids upon ingestion will promptly form Calcium Neutral Di-Salicylate 21⁄2gr.”“A combination of Calcium and Strontium Di-Salicylate, in seemingly true chemical union.”
“When ingested represents the following chemical formulas: C6H4OHCOO2Ca.2H2O + Sr.(C7H5O3)2+ 2H2O.”
“Strontium Di-Salicylate 21⁄2grs. and our especially prepared Salt of Calcium and Acid Salicylic adjusted in such nascent form, that these pulvoids upon ingestion will promptly form Calcium Neutral Di-Salicylate 21⁄2gr.”
“A combination of Calcium and Strontium Di-Salicylate, in seemingly true chemical union.”
These statements are rather vague, possibly because they are an attempt to mystify. The product, however, may be assumed to be a mixture (not a chemical combination) of calcium salicylate and strontium salicylate. The therapeutic claims made for the preparation are:
“Superior to ordinary salicylates. Can be taken continuously and indefinitely without gastric irritation, insuring maximum efficiency.”“Reports show surprisingly good results, even where the sodium salt fails.”
“Superior to ordinary salicylates. Can be taken continuously and indefinitely without gastric irritation, insuring maximum efficiency.”
“Reports show surprisingly good results, even where the sodium salt fails.”
As there is no evidence to show that strontium salicylate, calcium salicylate or a mixture of the two salts has any advantage over sodium salicylate, theseclaims cannot be accepted. The name and the statement of composition are objectionable in that they do not reveal the identity of the drugs in “Calcylates” and in suggesting that this preparation possesses radical advantages over salicylates in other forms.
The Drug Products Company was told that the facts just mentioned rendered “Pulvoids Calcylates” ineligible for New and Nonofficial Remedies. The company in its reply objected to the Council’s conclusions, and in support of its position submitted testimonials from a number of physicians. The reply of the company embodied no facts or arguments which had not been considered by the Council’s referee, and the testimonials from physicians contained no evidence to show that the combination has any real advantage over sodium salicylate.
The Council therefore declared “Pulvoids Calcylates” ineligible for New and Nonofficial Remedies for the following reasons: Unwarranted therapeutic claims are made for the mixture (Rule 6); the name does not describe the composition (Rule 8), and the mixture is an unessential modification of an established remedy (sodium salicylate) (Rule 10).—(From The Journal A. M. A., Sept. 9, 1916.)
Sulfuryl Monal is said to be manufactured by Monal Frères, manufacturing chemists of Nancy, France. It is sold in the United States by George J. Wallau, Inc., New York City. According to the label:
“Each PastilleContains: Sulfuryl (combined polysulphurets)= 0.35 centigr.”Liberates: Nascent sulphurretted Hydrogen= 2 cub. cent.”
The Chemical Laboratory of the American Medical Association was requested to check the amount of available hydrogen sulphid. An original bottle of Sulfuryl Monal was used; this contained tablets having the taste of licorice extract and an odor of hydrogen sulphid. The tablets were found to liberate about 6 c.c. hydrogen sulphid to each tablet.
Among the claims made for the preparation are:
“Dissolved by the saliva, Sulfuryl Monal reaches the stomach where, under the influence of the gastric juice, it generates nascent sulphuretted hydrogen. Professor Albert Robin’s remarkable researches have proven that it is in the nascent state that drugs produce the greatest effect with the smallest dose.... Being thus eliminated by the entire respiratory tract: the lungs, bronchi and the throat, the sulphurretted hydrogen passes from the interior to the exterior, that is to say, goes right through these organs which are, as a consequence, thoroughly cleansed, antisepticized and freed of the pathogenic micro-organisms.... Then, again, part of the sulphuretted hydrogen, liberated in the stomach, is eliminated by the mouth and acts as an antiseptic and disinfectant of the mucous membranes of the throat and mouth. Hence Sulfuryl Monal is a perfect protective agent against contagious diseases.... Numerous clinical tests have demonstrated its real efficacy in diseases of the throat and of the respiratory tract: laryngitis, pharyngitis, hoarseness, granulations, tonsillitis, colds, bronchitis, pulmonary catarrh, asthma, emphysema, grippe, whooping cough, simple and infectious pneumonia, and in the first stage of pulmonary tuberculosis.”
“Dissolved by the saliva, Sulfuryl Monal reaches the stomach where, under the influence of the gastric juice, it generates nascent sulphuretted hydrogen. Professor Albert Robin’s remarkable researches have proven that it is in the nascent state that drugs produce the greatest effect with the smallest dose.... Being thus eliminated by the entire respiratory tract: the lungs, bronchi and the throat, the sulphurretted hydrogen passes from the interior to the exterior, that is to say, goes right through these organs which are, as a consequence, thoroughly cleansed, antisepticized and freed of the pathogenic micro-organisms.... Then, again, part of the sulphuretted hydrogen, liberated in the stomach, is eliminated by the mouth and acts as an antiseptic and disinfectant of the mucous membranes of the throat and mouth. Hence Sulfuryl Monal is a perfect protective agent against contagious diseases.... Numerous clinical tests have demonstrated its real efficacy in diseases of the throat and of the respiratory tract: laryngitis, pharyngitis, hoarseness, granulations, tonsillitis, colds, bronchitis, pulmonary catarrh, asthma, emphysema, grippe, whooping cough, simple and infectious pneumonia, and in the first stage of pulmonary tuberculosis.”
The sulphids are practically ignored in modern textbooks. There is a rather extensive clinical literature on the subject, particularly in connection with sulphur waters; this, however, offers no good evidence for the therapeutic value of sulphids. Probably the tradition in their favor is largely due to the old popular idea that a disagreeable taste or odor is a mark of a good remedy.95
When hydrogen sulphid is introduced into the body, the small amounts that appear in the expired air are insufficient for quantitative demonstration and it is highly improbable that the amount thus excreted has any germicidal action, or that enough is excreted in the lungs to cause irritation and a reaction. The claim that Sulfuryl Monal is “a perfect protective agent against contagious diseases” is unwarranted; the recommendation for its use in “simple and infectious pneumonia, and in the first stage of pulmonary tuberculosis” is dangerous and vicious. The Council declared Sulfuryl Monal ineligible for New and Nonofficial Remedies and authorized publication of this report.
[Editorial Note..—With one exception, this product does not appear to be advertised in medical journals. We find, however, in the gallery of nostrums that grace the advertising pages of theInternational Journal of Surgery, that Sulfuryl Monal has its place. According to an advertisement that has been running some months in this publication, “affections of the throat and respiratory organs respond promptly” to Sulfuryl Monal whose “effects are rapid and certain” even in “incipient tuberculosis.” This preposterous pronouncement is no worse than many others appearing in the same journal, but it is bad enough to indicate how uncritical must be the physicians who support—by subscription or contribution—publications that are still debasing scientific medicine.]—(From The Journal A. M A., Sept. 16, 1916.)
The “Mark White Goiter Serum Laboratories” of Chicago asked the Council to consider its products “Mark White Goiter Serum” and “Mark White Iodinized Oil.” The “serum” was claimed to be an “antibody blood serum from a goat with thyroidosis” while the “Iodinized Oil” was said to contain “about 4 grains of iodin” to “each c.c.” The therapeutic indications for the treatment were given as:
“Simple or Exophthalmic Goiter, Hyperthyroidism-dosis, Thyrosis, Thyroidosis, Thyrotoxicosis, Dementia.”
“Simple or Exophthalmic Goiter, Hyperthyroidism-dosis, Thyrosis, Thyroidosis, Thyrotoxicosis, Dementia.”
An ampule (2 c.c.) of the “serum” is to be injected into the thyroid to be followed one week later by an ampule (2 c.c.) of the “Iodinized Oil.” Repetition of this “treatment” once or twice a month is advised.
The Council asked for more specific information as to the composition of the remedies, particularly as to the preparation and nature of the serum; it also asked for evidence of the therapeutic value of the preparations. In reply, Mark White wrote:
“All that I can say regarding the serum is that it is made from the blood of goats with thyroid affection, and it has been found that the serum from these goats has antibodies which control, or has curative effect upon thyroid affections when injected into thyroid glands of either humans or animals. As to the iodinised oil, it is only an adjunct or side treatment which is not always used or indicated, and will only be furnished to the physician for use in case in his judgment his patient needs it. We shall also advise the use of quinin... when indicated....”
“All that I can say regarding the serum is that it is made from the blood of goats with thyroid affection, and it has been found that the serum from these goats has antibodies which control, or has curative effect upon thyroid affections when injected into thyroid glands of either humans or animals. As to the iodinised oil, it is only an adjunct or side treatment which is not always used or indicated, and will only be furnished to the physician for use in case in his judgment his patient needs it. We shall also advise the use of quinin... when indicated....”
The Council was referred for further information to a paper by Rachel Watkins, M.D., published in theIllinois Medical Journal. It is to be noted, incidentally, that the letterheads used by White in his correspondence bore in one corner the notation “Rachel Watkins, M.D., Practice Limited to Goiter and Other Disorders of the Thyroid Glands,” and in the other, “Mark White, Goiter Research.”
The information regarding the composition of this goiter treatment, as furnished in Dr. Watkins’ paper, was to this effect:
“The medical treatment consists of the administration of a blood serum derived from a thyrodized goat. Formula: Iodine 0.16 grams [according to a correction by Mark White, this should read 0.26 gm.], oil 0.25 c.c., serum q. s. 1 c.c.”
“The medical treatment consists of the administration of a blood serum derived from a thyrodized goat. Formula: Iodine 0.16 grams [according to a correction by Mark White, this should read 0.26 gm.], oil 0.25 c.c., serum q. s. 1 c.c.”
This description of the treatment differs from that furnished to the Council by Mark White in that here the iodin and oil appear to be combined with the serum. Dr. Watkins’ “formula” implies that the iodin is a routine medication, thus contradicting White’s statement, which, in turn, is at variance with the statements made in submitting the treatment.
Photographic reproductions (greatly reduced) of some of the letterheads used by the Mark White concern during the past five years.
Photographic reproductions (greatly reduced) of some of the letterheads used by the Mark White concern during the past five years.
The Council does not accept any biologic product until its sale in interstate commerce has been authorized by the secretary of the treasury in accordance with the federal law regulating the sale of viruses, serums, toxins and analogous products. The sale of the Mark White Goiter Serum has not been so authorized; consequently even if the preparation complied with other rules of the Council it could not be accepted.
In addition, however, this treatment conflicts with other Council rules. The statements regarding its composition are indefinite and contradictory (Rule 1); the evidence presented to support the therapeutic claims is insufficient in itself and does not appear to have been checked by any disinterested authority (Rule 6). Moreover, the recognized variation in the morphology and pathology of thetypes of goiter render it impracticable to treat cases of goiter by any routine procedure.
The foregoing report was submitted to the Mark White Goiter Serum Laboratory. In reply, a letter signed “Mark White, V.M.D.,” was received, which read, in part:
“... we hope at some future time to be able to give you more detailed information, but as you possibly appreciate that we have experienced for some time a demand on the part of many physicians that we furnish to them our therapy, which necessitates us furnishing it before all the detailed work has yet been accomplished, and I trust that you will be so kind as to bear patiently with us until we are better in a position to make a complete scientific application and report to you.”
“... we hope at some future time to be able to give you more detailed information, but as you possibly appreciate that we have experienced for some time a demand on the part of many physicians that we furnish to them our therapy, which necessitates us furnishing it before all the detailed work has yet been accomplished, and I trust that you will be so kind as to bear patiently with us until we are better in a position to make a complete scientific application and report to you.”
White wrote further:
“The serum and iodized oil may be mixed for immediate use, but could not be put up only separate for the use of the profession and the therapy furnished Dr. Watkins she mixed as used.”
“The serum and iodized oil may be mixed for immediate use, but could not be put up only separate for the use of the profession and the therapy furnished Dr. Watkins she mixed as used.”
This statement throws no light on the discrepancies in the statements with regard to the place of the iodinized oil in the treatment, namely: (a) the original statement that the oil was to be given a week after the serum; (b) White’s statement (quoted earlier in this report) that the oil “is only an adjunct or side treatment” and “is not always used or indicated”; (c) the statement in Dr. Watkins’ paper that the oil and the serum are given in combination.
The Council declared the Mark White Goiter Serum and Mark White Iodinized Oil ineligible for New and Nonofficial Remedies and authorized publication of this report.
As some of our readers will remember, on April 26, 1913,The Journalcalled attention to the Mark White preparation which at that time was being exploited from Denver. The Propaganda Department has in its files a number of letters sent out from the Mark White concern at various times. One mailed in May, 1911, on the embossed stationery of “The Mark White Goiter Institute,” Exchange Building, Denver, was evidently a general letter sent to physicians, calling their attention to “the most important medical discovery of the age.” “Dr. Mark White, a graduate of the University of Pennsylvania,” said the letter, had discovered “a simple and harmless remedy” that would cure goiter. “Because of the desire to preserve the secrecy of this remedy it is given only at the office here.” It was then suggested that the doctor might send those of his patients who were suffering from thyroidism to the “Mark White Goitre Institute.” If he would do so he would be “given a commission of $10, in cases of the $50 fee with the additional $5 for each $50 increase.” It closed with some casuistic arguments, presumably for the purpose of overcoming the physician’s scruples, summing up the matter with the statement:
“No right thinking man will allow a narrow and self-seeking system of ethics to stand between him and his duty to the sick and suffering.”
“No right thinking man will allow a narrow and self-seeking system of ethics to stand between him and his duty to the sick and suffering.”
About 1912 the name of the concern seems to have been changed, for we have in our files a letter addressed to a layman on the stationery of the “Mark White Goitre Treatment Company.” According to this letterhead the product this concern had for sale was “Goitreine” discovered by Mark White, “President and General Manager.” Mr. White’s letter to the sufferer from goiter assured him that if he would take “Goitreine” he might “be practically sure of an immediate and permanent cure.” “Goitreine,” according to White, “has absolutely and permanently cured 90 per cent.” of all cases of goiter in which it has been used—“and the other ten showed remarkable improvement.” It was efficacious for all forms of goiter and “cannot possibly harm.”
The person who received this assurance might have had his confidence in it shaken had he seen a copy of the DenverNewsfor May 23, 1911, in which was reported a case of collapse and death in a woman following an injection given in White’s office. The paper stated that the death certificate was signed by one W. A. Gray and gave “fatty degeneration of the heart and goiter” as the cause of death. Gray, it seems, was the licensed physician employed by Mark White to administer “Goitreine”—if that is what White happened to be calling his product at that time. For here it may be stated, parenthetically, that Mark White is not a physician; he is a veterinarian.
In February, 1913, Mark White sent a circular letter to a number of medical publications with the request that it be printed in full in the next issue, “to cover one full page of space.” The letter White wanted printed was addressed to doctors offering to “enter into a copartnership agreement” with such physicians who would be willing to treat “patients with goiter affections on a 50 per cent. commission basis.”
“You would be expected to make a cash charge to the patient for the treatment, remitting on the same day our 50 per cent. to us, when ordering the treatment, giving the treatment in no cases for less than $50.00.”
“You would be expected to make a cash charge to the patient for the treatment, remitting on the same day our 50 per cent. to us, when ordering the treatment, giving the treatment in no cases for less than $50.00.”
About the same time that Mark White made this “fifty-fifty” offer, he sent in an advertisement to be published in the classified column ofThe Journal. At that time he was told his advertisement was not acceptable; we now reprint it, however, free of charge. Here it is:
“WANTED—ONE OR MORE PHYSICIANSin each vicinity to administer and represent our new medical treatment forGOITER. Good margin of profit. Write for copy of contract. The Mark White Goitre Treatment Co., Denver, Colo.”
In 1914, White moved to Chicago. At least the card which we reproduce so indicates. At that time, as will be seen, “Dr. Mark White” was “personally associated” with Peter S. Clark, M.D. According to the same card Dr. F. D. Paul of Rock Island, Ill., seems to have been his “associate” for that particular locality. In this connection, it is worth noting that a Rock Island paper, in one of its issues during July, 1913, devoted a good deal of space to “Dr. Mark White” who was at that time in Rock Island “directing Dr. Frank D. Paul in the administering of the treatment.” There was nothing to indicate that this notice was an advertisement or that the editorial appearing in the same issue puffing White’s “important cure,” was paid for.
When exploited from Denver the Mark White “goiter cure” was advertised in the daily papers. Here is a photographic reproduction (reduced) of an advertisement that appeared in the DenverPost, Sept. 1, 1912.
When exploited from Denver the Mark White “goiter cure” was advertised in the daily papers. Here is a photographic reproduction (reduced) of an advertisement that appeared in the DenverPost, Sept. 1, 1912.
Dr. W. A. Gray, who has already been mentioned as White’s associate in Denver, seems to have been doing business in Illinois some time in 1913 and a Princeton (Ill.) paper had some uncomplimentary things to say about him. Finally in July, 1913, this item appeared in a Princeton paper.
“Dr. W. A. Gray, the goiter specialist who operated last winter at Princeton and Walnut until he became embroiled with Dr. Mark White, a Denver veterinary and originator of the cure, over a division of the spoils, has opened a goiter institute in Chicago under his own name. Advertisements of the Dr. Gray Goiter Institute appeared Sunday morning in the ChicagoExaminerand other morning papers. Dr. Gray and Mark White broke off their relations after their disagreement at Walnut, and Dr. Gray slightly changed the ingredients of the goiter cure and started off on his own hook.”
“Dr. W. A. Gray, the goiter specialist who operated last winter at Princeton and Walnut until he became embroiled with Dr. Mark White, a Denver veterinary and originator of the cure, over a division of the spoils, has opened a goiter institute in Chicago under his own name. Advertisements of the Dr. Gray Goiter Institute appeared Sunday morning in the ChicagoExaminerand other morning papers. Dr. Gray and Mark White broke off their relations after their disagreement at Walnut, and Dr. Gray slightly changed the ingredients of the goiter cure and started off on his own hook.”
One of Gray’s advertisements in Chicago newspapers made the claim that “Dr. Gray’s New Medical Treatment removes the cause of goiter in seven days.”
Photographic reproduction (reduced) of the “professional” card used by “Dr. Mark White” after he came to Chicago.
Photographic reproduction (reduced) of the “professional” card used by “Dr. Mark White” after he came to Chicago.
The Tulsa (Okla.) associate of “Dr.” White seems to have been Dr. J. H. Morgan and the Tulsa papers of June, 1914, tell of “Dr.” White’s visit to that city “for the purpose of instructing Dr. J. H. Morgan in the technique of his new medical treatment for nervous disorders and goiter.” Some months later—in December, 1915—the following little item appeared in a Tulsa paper:
“Dr. Mark White was found guilty in the county court yesterday of practicing medicine without a license and was fined $50. Doctor White is a goiter specialist.”
“Dr. Mark White was found guilty in the county court yesterday of practicing medicine without a license and was fined $50. Doctor White is a goiter specialist.”
In September, 1915, Mr. Thomas S. Hogan, the efficient counsel for the Illinois State Board of Health, instituted action against Mark White for practicing medicine without a license. The case was tried Oct. 15, 1915, and the jury, after being out four hours, returned a verdict of “not guilty.” Attorney Hogan attributes the failure to obtain a conviction to the testimony of Dr. Rachel Watkins, who said she had a partnership arrangement with White in carrying on the medical business. It was about this time that Mark White seems to have issued some new letterheads. These bore in their upper left hand corner the device “Rachel Watkins, M. D., Practice Limited to Goiter and Other Disorders of the Thyroid Glands,” while the upper right hand corner read “Mark White, Goiter Research.”
On Dec. 9, 1915, Rachel Watkins, M. D., of Chicago, read a paper entitled “A Serum Treatment for Physiologically Defective Thyroids, With Clinical Reports” before the Stock Yards Branch of the Chicago Medical Society. The“serum treatment” discussed was Mark White’s “Goitreine” which, in the course of its checkered career, had lost its original name by the wayside. This paper appeared in the December, 1915, issue of theIllinois Medical Journal.
Probably emboldened by the ease with which a component part of the American Medical Association “fell for” a paper exploiting a “goiter cure,” Dr. Watkins requested that she be permitted to read a paper on the same subject before the Section on Pharmacology and Therapeutics at the Detroit meeting of the American Medical Association last June. The request was refused. Dr. Watkins is apparently no longer connected with White and in fact has protested against the use of her name by White in connection with his “goiter cure.”
[After the above was in type and ready for the pages ofThe Journal, attention was called to theOfficial Bulletin of the Chicago Medical Societyof Sept. 16, 1916. ThisBulletincontained a full page advertisement of the Mark White “goiter cure.” The advertiser referred to the preparation as having been “announced to the Chicago Medical Society” and declared it to be “an ethical therapeutic agent.” Mark White was described as “a medical research student” but no hint was given that he is a veterinarian. After again emphasizing that “this therapy is ethically proven” physicians were invited to “visit our goats when convenient” and the advertisement closed with the modest claim that “this thyroid therapy has equal curative therapeutic value in these cases as quinin in malaria.” And this sort of pseudo-scientific claptrap is presented to a presumably learned profession through its own official Bulletin—but what’s the use of commenting!]—(From The Journal A. M. A., Sept. 23, 1916.)
Kora-Konia is a “dusting powder” which at present is advertised to the medical profession through medical journals, circulars, post cards and sample packages. It is put out by the “House of Mennen,” which sells various toilet preparations such as talcum powder, shaving soap, etc. On the trade package is the statement:
“Indicated in the treatment of Acne, Dermatitis, Eczema Intertrigo; in obstinate cases of chafing, prickly heat, nettle rash, chicken pox, measles, scarlatina and irritations of the skin; as a soothing absorbent and antiseptic dusting powder and as an umbilical dressing.”
“Indicated in the treatment of Acne, Dermatitis, Eczema Intertrigo; in obstinate cases of chafing, prickly heat, nettle rash, chicken pox, measles, scarlatina and irritations of the skin; as a soothing absorbent and antiseptic dusting powder and as an umbilical dressing.”
While a circular asserts that:
“Kora-konia is indicated in the treatment of acne, dermatitis, eczema and eczematous conditions of the utmost severity,... eruptive fevers,...”
“Kora-konia is indicated in the treatment of acne, dermatitis, eczema and eczematous conditions of the utmost severity,... eruptive fevers,...”
What purports to be a physician’s testimonial reads:
“I used Kora-Konia in a new born case of inherited syphilis and the eruption soon cleared up.”
“I used Kora-Konia in a new born case of inherited syphilis and the eruption soon cleared up.”
Germicidal powers are claimed for Kora Konia in a medical journal advertisement. In view of the various claims made and the fact that it is advertised to the medical profession, the Chemical Laboratory of the American Medical Association was asked to analyze Kora-Konia. This was done and the chemists reported as follows:
Kora-Konia is a white powder, slightly greasy to the touch. Qualitative tests showed the presence of boric acid, zinc, magnesium, a solid fatty acid and material insoluble in hydrochloric acid containing magnesium and aluminum.Starch was not found. Quantitative determinations gave the following results:
Acid-insoluble material (talc)48.3 per cent.Magnesium (Mg++) soluble in dilute acid1.2 per cent.Zinc (Zn++)4.5 per cent.Stearic acid (impure)39.2 per cent.Boric acid3.0 per cent.Carbon dioxide (CO2)1.5 per cent.
Acid-insoluble material (talc)
Magnesium (Mg++) soluble in dilute acid
Zinc (Zn++)
Stearic acid (impure)
Boric acid
Carbon dioxide (CO2)
From this analysis it is concluded that Kora-Konia has essentially the following composition:
Zinc stearate U. S. P.44 per cent.Talc48 per cent.Magnesium carbonate U. S. P.5.0 per cent.Boric acid3.0 per cent.
Zinc stearate U. S. P.
Talc
Magnesium carbonate U. S. P.
Boric acid
Essentially this dusting powder consists of the well-known substances talc and zinc stearate in about equal proportions to which small quantities of magnesium carbonate and boric acid have been added. Inasmuch as the claim is made, by inference at least, that Kora-Konia represents original investigation carried out “with the cooperation of the medical profession” it should be stated that the preparation of commercial zinc stearate was described and recommended as a dusting and toilet powder nearly twenty-five years ago.96
There is nothing new or original in any one of these substances or in the combination. The extravagant and unwarranted claims made for this simple dusting powder are undoubtedly leading the public as well as some thoughtless physicians, to place undeserved confidence in it. In view of the small amount of boric acid present in the powder, its antiseptic powers must be slight and its germicidal powers almost nil. The Council declared Kora-Konia ineligible for New and Nonofficial Remedies and authorized publication of this report.—(From The Journal A. M. A., Sept. 30, 1916.)
The Council has adopted the following report and authorized its publication.
W. A. Puckner, Secretary.
Glycerophosphates are the salts of glycerophosphoric acid, H2[C3H5(OH)2]PO4. This acid is produced by the interaction of glycerin and phosphoric acid. In general, only sodium glycerophosphate, Na2[C3H5(OH)2]PO4+51⁄2H2O, and calcium glycerophosphate, Ca[C3H5(OH)2]PO4+H2O, are used in medicine, though the glycerophosphates of lithium, potassium, manganese, magnesium, iron, quinin and strychnin are claimed as constituents of proprietary preparations. At a time when certain disorders were assumed to be due to a deficiency of phosphorus in the nerve structure in the body, glycerophosphates were introduced as “nerve foods” and “tonics” on the theory that they would be assimilated more readily than hypophosphites or ordinary phosphates. What led to this assumption was the fact that the lecithins, which form a part of the nerve structure, were known to contain the glycerophosphate radical in the molecule. The belief that inorganic phosphates cannot supply the body’s need of phosphorus is implied or expressed in most of the “literature” devoted to proprietary phosphorus preparations.
Thus, Schering and Glatz quote G. Meillière as saying that “the organism is incapable of assimilating inorganic forms of phosphorus.”
Again, when exploiters of glycerophosphates admit that the body can synthesize its phosphorus compounds from inorganic phosphates, they attempt to counterbalance the admission by contending that the use of organic compounds “spares” the system the necessity of making such synthesis. This assumption rests on the theory that the organic phosphorus compounds are absorbed and stored as such.
This theory is contradicted by evidence which has beenpresented97that the organic phosphorus compounds are split up into inorganic phosphates before absorption.
The Council requested E. K. Marshall, Jr., to review the evidence for and against the therapeutic value of organic phosphorus compounds. Marshall’sstudy98brings out the following points:
1. In various tissues of the animal body, enzymes have been found which hydrolyze complex organic phosphorus compounds so as to liberate the phosphorus in the form of inorganic phosphates.
2. Metabolism studies of the phosphorus balance with diets containing inorganic phosphorus compounds, as compared with diets containing organically bound phosphorus, are somewhat conflicting in their results. The balance of evidence, however, is in favor of the view that there is no difference between organically combined phosphorus and inorganic salts with respect to the phosphorus balance.
3. Experiments indicate that the organism thrives on and supplies its phosphorus needs quite as well from inorganic phosphorus compounds as from organically bound phosphorus.
Marshall concludes:
“We see that the evidence is very convincing of the view that the animal organism can synthesize its complex organic phosphorus constituents from inorganic phosphates, and that organic phosphorus is of no more value as a food than inorganic.”
In view of this report, the Council deemed it advisable to take up the consideration of certain glycerophosphate preparations on the market. As the therapeutic claims are all similar, it is not necessary to quote them extensively.
Tonols (Schering and Glatz, New York) comprise iron, lime, lithium, magnesium, manganese, potassium, quinin, sodium and strychnin “Tonols” or glycerophosphates; also Duotonol Tablets, said to contain equal parts of calcium and sodium glycerophosphates; Triotonol Tablets, each said to contain “Sodium Tonol 21⁄2grains, Lime-Tonol 21⁄2grains, Strychnine-Tonol1⁄60grain”; Quartonol Tablets, said to contain “Sodium and Lime-Tonols, each 21⁄4grains, Quinine Tonol1⁄2grain, Strychnine-Tonol1⁄200grain”; Sextonol Tablets, said to contain “Sodium and Lime-Tonols, each 2 grains, Iron-Tonol,1⁄2grain, Manganese and Quinine-Tonols, each1⁄4grain, Strychnine-Tonol,1⁄200grain.”
The name “Tonols” is objectionable in that it is not only nondescriptive of the composition, but also therapeutically (and falsely) suggestive. The composition of the more elaborate Tonols is particularly unscientific; there is no justification for combining quinin, strychnin, iron, manganese, etc., in one formula.
Phosphorcin Compound, called “The Elementary Phosphorus indicated in all forms of Nervous Diseases” and the “Perfect Formula,” is said to bemanufactured by the Organic Products Company, Wetzlar an der Lahn, Germany, and Greenwich, Conn. It is sold in the United States by Eimer and Amend, New York, according to whom: