TEKARKIN

“... the only remedy for the relief of cataract and other opacities of vision, which stands before the medical fraternity on a firm foundation of accomplished results....”“... possesses a specific power in removing the obstruction to vision.”“In this class of cases [cataract] physicians can place reliance on Succus Cineraria Maritima (Walker) which does not require the services of a specialist but is simply dropped into the eye with an ordinary medicine dropper twice daily....”“... has been used with success in cataract, both lenticular and capsular, pterygium and opacities of the cornea, softening the opaque deposits, causing dissolution, and by its stimulating properties, hastening absorption.”

“... the only remedy for the relief of cataract and other opacities of vision, which stands before the medical fraternity on a firm foundation of accomplished results....”

“... possesses a specific power in removing the obstruction to vision.”

“In this class of cases [cataract] physicians can place reliance on Succus Cineraria Maritima (Walker) which does not require the services of a specialist but is simply dropped into the eye with an ordinary medicine dropper twice daily....”

“... has been used with success in cataract, both lenticular and capsular, pterygium and opacities of the cornea, softening the opaque deposits, causing dissolution, and by its stimulating properties, hastening absorption.”

Succus Cineraria Maritima is advertised to the medical profession in true “patent medicine” style by means of testimonials from doctors, obscure and deceased. The preparation is valueless for the purposes for which it is sold and “has about as much effect on the dissolution or dispersal of opacities due to organic changes in the lens as pouring the same down the back of the patient’s neck!” More than five years ago the Council on Pharmacy and Chemistry reported on the worthlessness of the drug, Cineraria maritima, and, at the same time,The Journalpointed out that the drug would have been forgotten long ago had it not been for the prodigal use of printers’ ink by the Walker Pharmacal Company in advertising its Succus Cineraria Maritima.

These facts are given for the purpose of refreshing the memory of our readers and are but incidental to the object of this article. In due time the federal authorities proceeded against the Walker Pharmacal Company charging that Succus Cineraria Maritima was misbranded under the federal Food and Drugs Act. The government chemists reported that analysis “showed that the product was essentially an aqueous solution of glycerin, boric acid and vegetable drug extractives carrying tannin-like bodies.” The direct and inferential claims made in the advertising matter accompanying the trade package were quoted by the federal authorities, who pointed out that the Walker Pharmacal Company was selling the nostrum under claims thatwould create in the minds of the purchasers the belief that Succus Cineraria Maritima was a remedy for cataract and other opacities of the eye causing impaired vision and that it was a cure for senile cataract, trachoma, secondary opacities, etc. These claims the government charged were “false and fraudulent in that the same were applied to the article knowingly, and in reckless and wanton disregard of their truth or falsity,” because “in truth and in fact it was not, in whole or in part, composed of, and did not contain, such ingredients and medicinal agents” as would produce the therapeutic effects claimed.

Facsimile of a letter, dated October, 1916, suggesting the use of “Succus Cineraria Maritima” as a cure for cataract and other opacities of vision. Eight months previously (February, 1916), the Walker Pharmacal Company had pleaded guilty to the charge that the claims that “Succus Cineraria Maritima” was a cure for cataract and other eye opacities were false and fraudulent and applied knowingly and in reckless and wanton disregard of their truth or falsity. The federal Food and Drugs Act does not apply to claims made in circular letters or elsewhere than in the trade package.

These charges put the matter flatly up to the Walker Pharmacal Company. This company has for years been telling physicians that their stuffcouldandwoulddo just what the federal authorities insisted it cannotand willnotdo. Did the Walker Pharmacal Company attempt to defend its claims? Did it demonstrate that Succus Cineraria Maritima would cure cataract? Did it produce evidence of the numerous cases of recovery from blindness or partialblindness which must have been available if the preparation had the powers claimed for it? No! The Walker Pharmacal Company in February, 1916, pleaded guilty—and was fined a paltry $10 and costs.

This, however, is not the end of the story. The company was prosecuted because it had published the false and fraudulent claims in the trade package, thus bringing the claims within the purview of the federal Food and Drugs Act. Had the Walker Pharmacal Company confined its false statements to medical journal advertisements, to the circular letters sent to physicians or to any other advertising matter not part of the trade package, it could have snapped its fingers at the Food and Drugs Act.

It was in February, 1916, that the Walker Pharmacal Company pleaded guilty to the charge of making false and fraudulent claims for Succus Cineraria Maritima. In October, 1916, they were still sending out circular letters to physicians urging the use of Succus Cineraria Maritima in the treatment of cataract and enclosing the usual booklet of testimonials claiming cures for cataract and other opacities of the lens and cornea!

Facsimile of some of the pages from the booklet that accompanied the letter reproduced herewith. The obvious intent of this booklet was to lead physicians to believe that Succus Cineraria Maritima will cure “Opacity of the Cornea,” “Opacity of the Lens,” “Senile Cataract,” “Incipient Cataract,” “Double Cataract,” etc.

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.

A few weeks agoThe Journalcalled attention to a flagrant case of fraud; and at that time it said, “It is justifiable to assume that when any man, whatever his business, admits in court that he has made fraudulent claims and then continues to make the same claims through channels that are not controlled by penal enactment, that man’s standard of business ethics is such that the public needs protection against it. There are many such men in the ‘patent medicine’ world. The only way in which the public may properly be protected against being defrauded in such cases is for the federal Food and Drugs Act to have its scope extended to coveralladvertising of the products coming under the purview of the act.”—(From The Journal A. M. A., March 17, 1917.)

From various parts of the countryThe Journalhas received a sixteen page pamphlet,Therapeutic Leaves. The publication, which has a saffron colored cover, is said to be published by the National Bio-Chemical Laboratory, Mount Vernon, N. Y. The National Bio-Chemical Laboratory seems to be a style used by Dr. Edward Percy Robinson. The “editorial offices” ofTherapeutic Leavesare given as “501 Knox Bldg., 5th Ave. at 40th St., New York,” which is a roundabout way of describing 452 Fifth Ave., the office address of Edward Percy Robinson. The first number (February, 1921) ofTherapeutic Leavesgives the names of the “editors” as “E. P. Robinson, M.D.,and W. A. Jenner, B.A.” In addition, there is “Assistant Editor, F. J. Geiger,” and “Gen’l Manager, Beverly K. Robinson.” The first and second numbers ofTherapeutic Leaves(February and March, 1921) are practically identical, being evidently printed from the same plates.Therapeutic Leavespurports to be a periodical published as “a medium for the dissemination of knowledge, pertaining to therapeusis.” Actually, it is an advertising medium dealing with the products of the National Bio-Chemical Laboratory: “Osmo-Calcic Solution,” “Tekarkin” and “Osmotic Mangano-Potassic Solution.”

These preparations are said to be the “formulas” of Dr. Edward Percy Robinson who lives in Mt. Vernon, N. Y., and has an office at 452 Fifth Ave., New York City. They are used by Dr. Robinson in the treatment of cancer. At an earlier stage they seem to have been known under different names: “Tekarkin” was first “Hypotonic Sal-Cella” and then “Neoanabolin-X;” “Osmo-Calcic Solution” was “Osmotonic Calcic” while “Osmotic Mangano-Potassic Solution” was “Osmotonic Drops.” The three solutions are put up in one package containing 4 c.c. (about 65 minims) of “Tekarkin” and 1 ounce each of the other preparations. The package sells for $10.00. “Remittance with order... We have no agents.”

Most of the material inTherapeutic Leavesis a rehash of four papers published by Edward Percy Robinson in the New YorkMedical Recordof various dates between September, 1917, and July, 1920. In these Robinson advances the theory that cancer is caused by an excess of sodium chlorid (table salt) in the blood and tissues and that it can be cured by administering a solution of potassium nitrate. Such a treatment sounds ideally simple. One might assume that all that was necessary was to make up a solution of potassium nitrate and inject it. One might further wonder how it would be possible to commercialize such a “treatment.” “Homemade solutions,” says Dr. Robinson, “are apt to be disappointing.” Their use is likely to cause “considerable swelling at the site of an injection, accompanied with tenderness and some heat.” Moreover, “a wide hyperemic area with red blotches has been observed in a number of instances.” In order to avoid “accidents of this sort” which would “bring discredit upon an excellent agent,” Dr. Robinson, “after considerable experimental work” has obtained “a solution of this chemical which would meet the ideal requirements.” This is availableunder the name “Tekarkin.” Dilute potassium nitrate solution sold under the name “Tekarkin” sells for $67 an ounce. The physician can make his own solution, of the purest and highest grade potassium nitrate on the market, at an expense, for the chemical, not exceeding 5 cents an ounce.

Therapeutic Leavesalso contains the usual number of those “clinical reports” which bulk so large in the literature of “cures” for cancer. Then there is a full page advertisement of a side-line of the National Bio-Chemical Laboratory: “Vitamines (Compressed) Tekarkin Brand;” “They have a meaty taste.”

The medical profession, naturally, is interested in knowing more about the physician who admits that he has discovered the cause and cure of cancer. According to our records, Edward Percy Robinson was born in 1871 and was graduated in 1897 by Bellevue Hospital Medical College. He was licensed in New York State the same year and has practiced in New York City continuously since that time. He is not, and apparently never has been, a member of his local medical society.

Reproduction (reduced) of some advertising matter issued in 1914 when Edward Percy Robinson was specializing in “facial contouring.”

In 1914 Robinson was specializing in “facial contouring.” One piece of advertising purports to be the reprint of an interview with “Dr. E. P. Robinson, Specialist, as he sat in his office at 116 West 39th Street, having questions fired at him by the reporter.” Thus Dr. Robinson:

“There are physicians everywhere who abandon the general, or family, practice of medicine, to devote their life to some specialty. My specialty is the improvement of the facial features and the beautifying of the shoulders, neck and arms. I round out hollow cheeks, build up the neck, eradicate wrinkles, make irregular noses perfect and remove defects by aprocess which is my own secret. I claim no superhuman power or ability; I have simply bent my whole professional study and energy to the one line of remodeling—so to speak—the human features, and I employ only scientific methods and aids in my operations.”

In another piece of advertising, a little booklet bearing Edward Percy Robinson’s name, we find the following:

“This is what I accomplish....“Remove all wrinkles and traces of age from the forehead, or about the eyes and mouth. Lift sag from cheeks and chin.“Round out hollow cheeks.“Remove depressions and defects from the chin.“Build up the neck and shoulders.“Build up and enlarge the bust.“Round out and give symmetry to unshapely arms and remove the lines of age from the hands.“Correct many of the defects not mentioned here, but which may be possessed by exceptional cases.”

“This is what I accomplish....

“Remove all wrinkles and traces of age from the forehead, or about the eyes and mouth. Lift sag from cheeks and chin.

“Round out hollow cheeks.

“Remove depressions and defects from the chin.

“Build up the neck and shoulders.

“Build up and enlarge the bust.

“Round out and give symmetry to unshapely arms and remove the lines of age from the hands.

“Correct many of the defects not mentioned here, but which may be possessed by exceptional cases.”

Still another advertising leaflet purports to be a reprint of an “editorial” from theMercantile and Financial Timesof March 11, 1914. It is a pretentious puff of Robinson, telling about his “scientific attainments” and his marvelous secret preparations used in “Youthifying the Face.” TheMercantile and Financial Timesis an utterly discredited sheet run for the purpose of selling what appear to be editorial comments. Such “editorial” puffs are paid for through the purchase of a certain number of copies of the paper by the party who desires the publicity. The Associated Advertising Clubs of the World exposed this publication in a special bulletin issued in June, 1919, and described it as an “example of publications that serve as convenient tools of fake promoters.” In 1911 theMercantile and Financial Timespublished an “editorial” endorsement of the consumption cure “Nature’s Creation.” It has done the same for a fakish device known as the “Ideal Sight Restorer.” It published a puff on the “Oxypathor,” a swindle so preposterous that the exploitation of this “gaspipe” fake was debarred from the U. S. mails and its exploiter was sent to the federal penitentiary.

Reproduction (reduced) of a testimonial for an obesity cure fake, “Get Slim.” The A. M. A. chemists reported that this “vegetable combination” consisted of baking soda and pink-tinted tartaric acid and sugar.

We also find in our files a testimonial signed E. P. Robinson, M.D., 1402 Broadway (Edward Percy Robinson’s address in 1912), extolling the virtues of a foolish piece of quackery, the obesity cure “Get Slim.” This nostrum was exposed inThe Journalsome years ago and was also exposed by Dr. Wiley inGood Housekeeping. The “Get Slim” concern suedGood Housekeepingfor libel but a jury decided thatGood Housekeepinghad told the truth. In the “Get Slim” testimonial Robinson is quoted as saying that he is “acquainted with the ingredients entering into its manufacture” and he describes it, as did the “Get Slim” concern, as “a purely vegetable combination.” The fact is the Association’s chemists found this “purely vegetable combination” to consist of sugar and tartaric acid, each colored pink, and baking soda.

And this is the gentleman who claims to have discovered the cause of, and offers for sale a cure for, one of the most baffling scourges known to modern medicine—cancer. Except for the articles that have been published during the past three years in theMedical Record, we are unable to find anywhere in representative medical literature anything to indicate that Edward Percy Robinson can lay any claim to special knowledge of, or skill in the treatment of, cancer. What we do find are advertisements describing Edward Percy Robinson’s alleged abilities as a “face beautifier,” puffs from utterly uncritical or discredited sources and a testimonial to the value of a preposterous “fat cure” fake.

With the best brains of the world at work on the problem of cancer, it is reasonable to assume that any man who has found out even a little morethan has previously been discovered or is able to accomplish even a little better results than the average in the treatment of this dreaded disease, would be well known to scientific medicine.

After this article was in type physicians began sending in No. 3 (April, 1921) ofTherapeutic Leaves. This is still another reprint of Nos. 1 and 2, with minor changes. In the first two, Tekarkin is described as “a solution of potassium nitrate of special strength;” in No. 3 it becomes “a special solution containing potassium nitrate.” In Nos. 1 and 2, Robinson described an alleged case of “Cancer of the RectumTreatedwith Tekarkin.” In No. 3 this becomes “Medicinal TreatmentCuresCancer of the Rectum.” In No. 3 the names of the editors, assistant editor and general manager are eliminated.

The inside back cover of No. 3 contains an advertisement of Tekarkin, in which physicians are warned that “Cancer of the Lung May Present Diagnostic Signs of Tuberculosis.” It contains the further startling information that the particular micro-organism responsible for pulmonary tuberculosis is the Klebs-Loeffler bacillus! Thus:

“The Klebs-Loeffler bacillus may find a suitable habitat in a malignant area of lung tissue and thrive therein. The presence of the bacillus does not necessarily exclude the presence of cancer. A chronic cough with blood-streaked sputum may be the result of tuberculosis and cancer.”—(From The Journal A. M. A., May 28, 1921.)

“I am fond of the retail drug business and follow it every day of my life. I know and observe to the fullest extent its ethical and commercial requirements.” This from a circular letter recently received by physicians, and signed J. S. Tyree, who asks that he be forgiven for writing you personally, but there are several reasons why he thinks the circumstances warrant it. All of which is preliminary to calling attention to an enclosure, which accompanies the circular letter, and is described as a “short memorandum” submitted for “your consideration.”

The “memorandum” is a four-page leaflet of which three pages are devoted to “Tyree’s Antiseptic Powder.” One of these three pages is a reproduction of a letter on the stationery of the Surgeon General’s Office of the War Department, and signed “W. M. Gray, M.D., Microscopist, Army Medical Museum;Pathologist to Providence Hospital.” The letter describes a series of “bacteriological and comparative tests” made by Dr. Gray with Tyree’s Antiseptic Powder. The entire second page of the circular is given over to the results of these bacteriologic tests which compare various strengths of Tyree’s Antiseptic Powder with “mercuric bichlorid,” phenol and formaldehyde.

The physicians who received this advertising material in April, 1919, might easily overlook the fact that Dr. Gray has been dead several years, that the letter which is reproduced is dated Jan. 3, 1890, and that the bacteriologic tests were made in 1889—thirty years ago!

The Council on Pharmacy and Chemistry in1906258published the results of an analysis of Tyree’s Antiseptic Powder which showed that although the stuff was advertised as a mixture of borax and alum, it was in fact essentially a mixture of zinc sulphate and boric acid. The publication of the Council’s report in 1906, showing the falsity of the formula, brought out the admission that the composition had recently been changed. Certain it is, however, that for at least a decade past, the Tyree product has been a zinc sulphate-boric acid preparation. Yet, according to the manufacturer’s own statement, Tyree’s Antiseptic Powder in 1889, when Dr. Gray made his bacteriologic tests, was an entirely different substance from the present mixture.

Here then we have a manufacturer publishing in 1919, in behalf of a certain product, tests that were made in 1889 with a product of different composition, although of the same name! Is this observing “to the fullest extent” the “ethical and commercial requirements” of the “retail drug business”?

There is no scientific excuse for such a mixture as Tyree’s Antiseptic Powder. If, however, physicians feel that they must use an irrational conglomeration such as this, why not prescribe Pulvis Antisepticus, N. F.? Like the Tyree product, this, too, is essentially a mixture of zinc sulphate and boric acid, with minute amounts of phenol, eucalyptol, menthol and thymol, to say nothing of a dash of salicylic acid. This official article has at least the virtue of constancy of strength, composition and purity assured under the federal Food and Drugs Act.—(From The Journal A. M. A., May 17, 1919.)

“The Commissioner of Health directs me to call to your attention the enclosed advertisement issued by T. B. Wheeler, M.D., Company, Montreal, Canada, in which the name of the Association’sJournalis being used.”

Accompanying this brief note toThe Journalfrom the secretary of Dr. Haven Emerson, Commissioner of the Department of Health of the City of New York, was a four page leaflet devoted to the exploitation of “Wheeler’s Tissue Phosphates.” The trend of the circular is to lead the average reader to infer thatThe Journalof the American Medical Association has endorsed Wheeler’s Tissue Phosphates. For example, in describing the preparation one reads:

“It embodies... the best recent scientific opinion concerning the treatment of the disease (tuberculosis) as stated... by the officialJournal A. M. A.”

Elsewhere in the circularThe Journal’s criticisms of the hypophosphites and the glycerophosphates (proprietary preparations which are competitors of the Wheeler product) are quoted and twisted into a tribute to the ingredientsof Wheeler’s Tissue Phosphates. Garbling quotations, distorting statements, separating phrases from their contexts and omitting qualifying clauses, all for the purpose of making out a case for some proprietary remedy is a trick as old as quackery itself. That it should be used in advertising Wheeler’s Tissue Phosphates is entirely fitting. Obviously, the T. B. Wheeler, M.D., Company esteems the opinion ofThe Journalon pharmacologic matters. This being the case, it should, in the interest of truth and scientific accuracy, publish in its advertising circulars just whatThe Journalhas said about Wheeler’s Tissue Phosphates. It could not do this better than by quoting from a recent editorial note which commented on a report of the Chemical Laboratory on this preparation. Here is part of theThe Journal’s comment:

“ ‘Wheeler’s Tissue Phosphates’ is an unscientific shotgun mixture whose most active and powerful drug is the alcohol it contains. That it was not years ago relegated to the realms of obsolete and discarded preparations is a commentary alike on the lack of scientific discrimination and on the power of advertising.”

Here we have “Wheeler’s Tissue Phosphates” stripped of the verbal camouflage with which its exploiters have invested it.—(Editorial from The Journal A. M. A., Sept. 22, 1917.)

To the Editor:—What is the composition of Alcresta Lotion?L. T. A. Hotten, M.D., Paris, Idaho.

To the Editor:—What is the composition of Alcresta Lotion?

L. T. A. Hotten, M.D., Paris, Idaho.

According to a circular in our files, “Alcresta Dental Lotion-Libby” contains “Emetin, the active amebicidal principle of Ipecac, together with Benzoic Acid, Thymol, Eucalyptol and Aromatics.” The theory that emetin is an active amebicide against pyorrhea alveolaris has been exploded. In this connection, it is interesting to note that the firm does not list the product in the latest catalogue in our files.—(Query from The Journal A. M. A., Oct. 29, 1921.)

To the Editor:—What is the composition of calcidin tablets (Abbott) and what is their value?J. S.

To the Editor:—What is the composition of calcidin tablets (Abbott) and what is their value?

J. S.

Answer.—Calcidin is claimed to be a mixture of iodin, lime and starch. In contact with water, the iodin and lime react to form calcium iodid and calcium iodate. By the acid of the gastric juice, the calcium iodid and calcium iodate are decomposed with liberation of free iodin. The administration of calcidin tablets amounts to giving free (elementary) iodin. In the past, the advertising for calcidin has contained the unwarranted claim more or less directly that it was the most effective and only noninjurious preparation of iodin for internal use, and that it possesses all of the valuable properties of the iodin with all of the objectionable effects left out. So far as we know, the effects produced by the administration of free iodin do not differ from those produced by the administration of iodids and, therefore, calcidin has no advantage over the iodids, such as sodium iodid.—(Query in The Journal A. M. A., Sept. 25, 1920.)

To the Editor:—Do you have any literature or information relative to the Di-Crotalin treatment for epilepsy? I will be very grateful if you can furnish information as to method of preparation, rationale of the treatment, etc.R. C. Decker, Captain, M. R. C.,U. S. Soldiers’ Home, Washington, D. C.

R. C. Decker, Captain, M. R. C.,U. S. Soldiers’ Home, Washington, D. C.

Answer.—Di-Crotalin is a rattlesnake venom preparation sold by the Swan-Myers Company of Indianapolis as a “Treatment for Epilepsy, Chorea, Bronchial Asthma, Chronic or Hereditary Nervous Headache, Nervous Prostration Incident to Change of Life, Hysteria-Mania, Insomnia, Neurasthenia, etc.” Dr. Thomas J. Mays of Philadelphia advocated the use of rattlesnake venom for tuberculosis. Later his former assistant, Dr. R. H. Spangler, used the same material in the treatment of epilepsy. That any measure of success sufficient to justify the adoption of the rattlesnake venom or crotalin treatment for epilepsy has resulted is not to be concluded from the available reports. Still less evidence is there for the use of rattlesnake venom in the list of conditions for which the Swan-Myers Company has recommended its preparation. There are a number of good reasons why a cautious physician will shun the administration of this treatment and advise against it. J. F. Anderson, working in the hygienic laboratory of the United States Public Health Service, reported a death from the crotalin treatment in consequence of infection, and reports that the market supply of crotalin solution and crotalin tablets is highly contaminated. He also found both crotalin and crotalin solution to vary inactivity. The use of rattlesnake venom was discussed inThe Journal, March 15, 1913, p. 850.—(Query in The Journal A. M. A., Aug. 17, 1918.)

To the Editor:—What is “Estevin,” or something like that? It is said to be good in hay-fever.Constant Reader.

To the Editor:—What is “Estevin,” or something like that? It is said to be good in hay-fever.

Constant Reader.

Answer.—The product called “Estivin” is sold by Schieffelin and Company, New York. A request for a statement of the composition of this preparation sent to Schieffelin and Company by the Council on Pharmacy and Chemistry brought the indefinite and, therefore, meaningless statement that “ ‘Estivin’ is an extract of Rosa Gallica containing no alcoholic or foreign ingredients.”—(Query from The Journal A. M. A., Nov. 12, 1921.)

To the Editor:—Can you inform me how iron arsenite can be prepared for subcutaneous injection? A commercial firm furnishes physicians with ampules of arsenite of iron. Is this really arsenite of iron?S. H. Kempner, M.D., New York.

S. H. Kempner, M.D., New York.

Answer.—Ferric arsenite (iron arsenite) is in itself relatively insoluble in water, but may be treated with ammonium citrate, the resulting product thus being soluble; the latter substance was at one time described in New and Nonofficial Remedies as “Ferric Arsenite, Soluble” and is sometimes sold as a solution in ampule form. In 1912, the Council on Pharmacy and Chemistry deleted “Ferric Arsenite, Soluble” from New and Nonofficial Remedies because “one cannot, in administering Ferric Arsenite, Soluble, give a useful dose of iron without giving too much arsenic; and, vice versa, one cannot give a safe dose of arsenic without giving too little iron.” The Council, therefore, held the preparation to be irrational and unscientific.—(Query in The Journal A. M. A., Feb. 19, 1921.)

To the Editor:—1. What is the composition of “K-Y Lubricating Jelly”? 2. Can you furnish a formula for a simple nongreasy lubricating jelly?S. T.

To the Editor:—1. What is the composition of “K-Y Lubricating Jelly”? 2. Can you furnish a formula for a simple nongreasy lubricating jelly?

S. T.

Answer.—1. The composition of “K-Y Lubricating Jelly” has not been divulged. Examination of the advertising matter reveals only meaningless statements, such as: “This is a judicious combination of vegetable products... Combined in well balanced proportions with non-irritating antiseptics...,” “It incorporates a sufficient quantity of mild antiseptics (of the Thymol class)...” and “... containsNOformaldehyde.”

2. Probably a simple tragacanth jelly, which can be made cheaply, will produce the same effects as those of the proprietary preparation. The following formula was published by Mr. J. K. Thum, apothecary at the German Hospital, Philadelphia (Druggists Circular, September, 1915, p. 586):

LUBRICATING JELLY

Tragacanth, whole3gm.Glycerin25c.c.Phenol1.5gm.

Tragacanth, whole

Glycerin

Phenol

Distilled water, a sufficient quantity to make 300 c.c. The tragacanth is broken in small pieces, and put into a wide-mouthed bottle; the other ingredients are added and the bottle frequently shaken.

In regard to this formula, Mr. Thum writes:

It has been used in our gynecologic department for years.... For the last six years we have been dispensing it in collapsible tubes throughout the hospital for general work.—(Correspondence in The Journal A. M. A., May 12, 1917.)

To the Editor:—Collier’shas a special article this week on “Nikalgin.” Have you any information on this subject? It sounds like nostrum stuff.P. R. Minahan, M.D., Fond du Lac, Wis.

To the Editor:—Collier’shas a special article this week on “Nikalgin.” Have you any information on this subject? It sounds like nostrum stuff.

P. R. Minahan, M.D., Fond du Lac, Wis.

Answer.—“Nikalgin” is said to be the “invention” of Gordon Edwards, an engineer. Large claims for its anesthetic and antiseptic virtues have been made. While no very definite information seems to be forthcoming regarding the preparation, it has been said to be “composed of quinin, hydrochloric acid and urea.” This would indicate that “Nikalgin” may be nothing more wonderful than the well known local anesthetic, quinin and urea hydrochlorid, theQuininae et Ureae Hydrochloridumof the U. S. Pharmacopeia, or a modification of it.—(Query in The Journal A. M. A., Sept. 22, 1917.)

To the Editor:—A short time ago I received a sample of “Pertussin” and used some in an obstinate case of bronchitis with excellent results. I have since received a catalog from a pharmaceutical firm, which advertises syrup of thyme. I have searched for a formula to make my own syrup of thyme, but have not been able to find one. Will you publish one?E. F. Benner, M.D., Salfordville, Pa.

E. F. Benner, M.D., Salfordville, Pa.

Answer.—The subjoined formula yields a product very similar to “Pertussin” in taste, flavor, composition, and probably in activity as well:

Fluidextract of thyme15 c.c.Glycerin15 c.c.Syrupto make100 c.c.

Fluidextract of thyme

Glycerin

Syrup

The original German preparation contained 1.5 gm. of sodium bromid in each hundred cubic centimeters, and this might be added to the foregoing formula with advantage, so far as action is concerned. However, a sample of “Pertussin” purchased in the open market in the United States failed to respond to tests for bromids.

As fluidextract of thyme is not official, this formula is presented as furnishing an acceptable preparation:

Thyme, in No. 60 powder100 gm.

Thyme, in No. 60 powder

Moisten with a mixture of:

Water25c.c.Alcohol15c.c.Glycerin10c.c.

Water

Alcohol

Glycerin

After standing five hours, pack in a percolator. Exhaust with a menstruum of alcohol, 1 volume, and water, 3 volumes. Reserve the first 85 c.c. of percolate. Concentrate the weak percolate to a soft extract and dissolve in the reserved portion. Make up to 100 c.c. by addition of a mixture of alcohol, 1 volume, and water, 3 volumes.

Other aromatic expectorants, such as terebene, terpin hydrate or creosote, might be expected to have similar but greater effect in chronic bronchitis.—(Query in The Journal, A. M. A., March 27, 1920.)

To the Editor:—Could you tell me why quinin and urea hydrochlorid has not become more popular for local anesthesia? Is it less efficacious or more toxic than other preparations? If it is useful, can you name some trustworthy firm or brand? Please omit my name in answering.L. F. C., M.D., Mexico.

L. F. C., M.D., Mexico.

Answer.—Quinin and urea hydrochlorid “has the actions of quinin. When injected hypodermically it exerts an anesthetic action much more prolonged than that of cocain” (Useful Drugs, Ed. 4, 1920, p. 127). It has been pointed out editorially inThe Journal(Feb. 14, 1920, p. 462) that quinin has been regarded for more than half a century by toxicologists as a protoplasmic poison capable of destroying various forms of animal and vegetable cells, and hence it need not be surprising that tissue necrosis may be produced by strong solutions of the quinin salts. That this deleterious reaction actually does occur and has militated against the general use of quinin and urea hydrochlorid is confirmed by the report of the Committee on the Advantages and Disadvantages of Local Anesthesia in Nose and Throat Work (The Journal, July 31, 1920, p. 315). To quote:

The only local anesthetic that produces edema and sloughing is quinin and urea hydrochlorid. So many statements were found in the literature that this anesthetic has been abandoned in other fields of medicine because of edema and sloughing, that writers who had presented favorable reports in nose and throat operations were communicated with by your committee. One writer who had recorded 390 cases of tonsillectomies extolling this anesthetic, which he had used for four years and is still so recorded, now states that he has not used it in two years, although no publication has been made retracting his former endorsement. Still another writer, who stated that quinin-urea came nearest the ideal local anesthetic, now states that he has ceased using it. Your committee finds that as far as nose and throat operations are concerned, this drug has practically gone into “innocuous desuetude.”

The anesthesia produced by this drug at the time of operation is good and the recovery of the patient might often be enhanced by its use if it did not have the serious drawback. The product is official in the U. S. Pharmacopeia, and may be obtained from any reputable pharmaceutical house.—(Query in The Journal A. M. A., Aug. 21, 1920.)

To the Editor:—My mail is frequently cluttered with pseudo-scientific data from various manufacturers of proprietary remedies which contain as much real scientific information as thePolice Gazette. I am enclosing a sample page of such a periodical. The article has been so cleverly worded in the first paragraph, as to impress the unthinking with the idea that sodium cacodylate is superior to arsphenamin, when we know in reality that sodium cacodylate has been proved practically worthless in syphilis (vide“Venarsen”). One case is reported, in which twenty injections of sodium cacodylate were administered intravenously, from October 23 to December 14. On December 18, a Wassermann test proved negative, it had been strongly positive on October 20, but during the same interval from October 23 to December 14, the patient had been taking by mouth “Ricord pills” each containing half a grain of yellow iodid of mercury; granted that he had taken these pills regularly, during all that time, it might well be that the Wassermann would be sharply influenced by them. Again, a negative Wassermann in the midst of treatment proves little; it might be positive again in a few days. The article stimulates the further use of a product of known worthlessness in the treatment of syphilis. How any one can use sodium cacodylate in preference to arsphenamin in syphilis is beyond me. If I mistake not, the Propaganda Department has not taken up the matter of these various pamphlets of the drug companies, such as theDoctor’s Factotum,Therapeutic Notes, etc., lauding to the skies such articles as “Seng,” “Cactina Pillets,” etc.,ad nauseam. The saddest part of the whole thing is that it must bring returns from the unthinking, otherwise they would soon disappear, which would be a great relief for the scrubwomen who empty our waste baskets.

Paul E. Bechet, M.D., New York.

[Comment.—The “sample page” sent by Dr. Bechet is from the March-April, 1918, number of Parke, Davis & Company’sTherapeutic Notes. It containsan “Original Communication” on “The Treatment of Syphilis with Sodium Cacodylate, by Adolph Lappner, M.D., Detroit, Mich.” The “article,” while nominally devoted to the praise of sodium cacodylate, is virtually a puff for “Ricord Pills.” a Parke, Davis & Co. product.]—(Correspondence in The Journal A. M. A., July 13, 1918.)

To the Editor:—I am very anxious to know whether tin or stannous oxid (SnO) has or has had any place among useful drugs. I have seen such a prescription given in the treatment of mucous colitis, and would be very glad to learn what its use may be.Carlos Manuel Garcia, M.D., Havana, Cuba.

Carlos Manuel Garcia, M.D., Havana, Cuba.

Answer.—Recently, on the assumption that tin workers are less troubled with boils than the average person, two French investigators proposed the use of tin compounds in the treatment of staphylococcic infections. Based on their work, a proprietary preparation—Stannoxyl—has been placed on the market which is claimed to be “composed of stannous oxide and specially purified metallic tin.” Absurd claims are made for the product: for instance, “... We have no hesitation in offering STANNOXYL—in Tablets or Cachets—as the only true specific for diseases of Staphylococcus origin.” The available evidence is unconvincing and in no way warrants such exaggerated statements.—(Query in The Journal A. M. A., March 6, 1920.)

To the Editor:—I was much interested in your answer to a query about Stannoxyl (The Journal, March 6, p. 629). I submit the following experience as a confirmatory note:

While serving with the Royal Army Medical Corps in Egypt, I for some time had charge of the medical division of a hospital in which most of the skin diseases occurring among soldiers in the district were treated. The most common conditions were boils and septic sores, chiefly due to staphylococcal infection, though several of the latter cases were diphtheritic. The treatment adopted was that in ordinary use, namely, incision and evacuation of pus, application of antiseptic dressings, and in most cases employment of the specific vaccine. It was possible to judge of the efficacy of any variations of treatment, as there were always plenty of cases undergoing the usual treatment with which the results could be controlled.

An available supply of Stannoxyl, a proprietary remedy consisting of a mixture of metallic tin and tin oxid, enabled me to give it a fair trial in full doses in eight cases of boils of average severity, in which culture revealed the infecting organism to beStaphylococcus aureus. The boils were treated locally as usual, but no vaccine was given. No improvement could be demonstrated in these cases that could not be shown in other cases similarly treated with the omission of Stannoxyl; in fact, three of the treated cases were much longer in clearing up than the untreated controls. Eight cases do not constitute a very large series from which to draw conclusions; but if the preparation were as good as the descriptive literature would lead one to believe, one should have expected an evident result in at least one of these cases.

It has been stated that Stannoxyl does not inhibit the growth of staphylococci, but only renders the growth less virulent. It is known that a certain amount of tin may be absorbed from the intestine, and Salant, Rieger and Treuhardt have shown that in certain cases tin may be retained for some time in the skin; but it is questionable whether, when preparations of tin are given by mouth, any reaches the staphylococci in the boils, or at any rate enough materially to influence their growth or virulence.

In the cases treated by me, the results did not at all suggest that Stannoxyl was a “specific for diseases of staphylococcal origin.”

J. W. C. Gunn, M.A., M.B., Ch.B.,Cape Town.Professor of Pharmacology, University of Cape Town.

—(Correspondence in The Journal A. M. A., Nov. 20, 1920.)

Back to Index Next