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seat of the reflex arcs. The authors conclude the paper with the following suggestion: "The facts here collected are presented merely as suggestive, not as demonstrative or as representing final results. The main object in this branch of the communication is to direct attention to the importance of more complete and careful observations of the locations and the periods in which central growths affect the reflexes, with a view to furthering the final analysis of the cerebral reflex mechanism."
I. H. N.
BY DELOS LEONARD PARKER, PH. B., M. D., DETROIT, MICHIGAN.
LECTURER ON MATERIA MEDICA IN THE DETROIT COLLEGE OF MEDICINE.
THE SECRET NOSTRUM EVIL.
FOR some time unmistakable signs have appeared in medical journals and medical conversations that go to show that the medical profession is fast becoming wearied with unscientific therapeutics. No more telling sign of this kind has come to the notice of the profession at large than that exhibited by Frank Billings, M. D., of Chicago, in a paper entitled "The Secret Nostrum Evil," read before the American Medical Association, July, 1905, and published in the December 2, 1905, number of the association journal.
The doctor begins by saying that "proprietary medicine" does not necessarily stamp a preparation or remedy as a nostrum. Some propprietary medicines are patented, a process that causes their owners to file at the patent office their formulas and their mode of preparation. For a small fee any person can get from the patent office a copy of the information bearing on the remedies that have been recorded there. Whether or not the patented remedy or remedies are prepared in conformity with the information furnished the patent office is another story. Whether or not a patented remedy contains the same ingredients one year that it does another is also another story. Whatever the actual facts, however, the profession could easily get on without patented remedies and fare better with older and simpler combinations.
The so-called copyright preparations do not differ in any essential particular from "patent medicines." Both are protected by copyright for an indefinite period, and both, as a rule, are mixtures of several ingredients, prepared with the idea, not that they will correct disturbed functions of the body, but that they will sell and bring money to the coffers of somebody. Doctor Billings quotes Doctor H. C. Wood, Jr., as follows:
"A much more elusive and therefore dangerous evil lurks in the class of mixtures which attempt to cloak their secrecy with a deceptive show of frankness. I think you will grant that the physician is rarely justified in the use of remedies concerning which he has no knowledge, and I maintain that the publication by a drug firm, of whose integrity
the physician is absolutely ignorant, of a professed list of ingredients of some mixture is not sufficient knowledge to pardon or to warrant the uses of that remedy. In the first place, if the published formula be correct, it is not enough to know simply the composition of a mixture, the exact quantities must also be known; there is a vast difference between the effects of one grain and of one hundred grains of opium. Moreover, there is no means of knowing that the formula is a true one, for many of these corporations do not hesitate to pervert the truth."
Preparations of reliable manufacturing chemists, made up of known ingredients, and recommended to the profession simply for their palatability or convenience of form are not included in the list of preparations to be condemned.
Doctor Billings closes his paper as follows:
"What is the cause of the nostrum evil? There are several.
"(1) Pharmacology and therapeutics are neglected relatively by many of our medical schools. Anatomy, physiology, pathology, diagnosis, et cetera, are emphhasized and too often the usefulness and limitations of drugs are neglected. Too frequently drug nihilism is taught. If the student were fully taught the physiologic action of drugs, the art of prescribing, preferably single remedies or in simple combination, using if he desires the pharmacopeial preparations prepared by reliable manufacturing pharmacists, and at the same time if he were taught when not to rely on drugs, but frankly to prescribe for his patient a course of hygienic measures which alone would accomplish all that would be required, he would not be the willing dupe of the nostrum vendor, as he now is.
"(2) The reputable manufacturing pharmacists deserve great credit for the improvement they have made in pharmaceutical products. They have afforded us official preparations in the form of pills, tablets, syrups, tinctures, extracts, et cetera, which are elegant in appearance, often palatable and usually potent. For this advance in pharmacy, a distinct credit to our country, we owe them our thanks. Unfortunately, many of them have not stopped at this point, but have manufactured their own special mixtures which are just as objectionable as the products of the special manufacturers. They, too, have been active with their agents in visiting physicians and in distributing 'literature.' This encourages drug-giving in specific mixtures for special symptoms, and is wrong. With one hand they do good work, with the other much evil is done.
"(3) The nostrum makers at first copied the methods of the reliable manufacturing chemists, in exploiting their products, but they have gone a step farther and have reached a point where one may say that they have subsidized the medical press. I know I am on dangerous ground when I make this statement, but right here is the chief cause-and the remedy. How many of our so-called medical journals are subsidized by medicine manufacturers I do not know, but all physicians know as well as I that there are many, and I do not refer to the
so-called house organs. I unhesitatingly affirm that one-half of the medical journals of the country would be out of existence if it were not for the nostrum advertisements. Under the circumstances, therefore, can we expect these journals to say anything? Need we be surprised that scarcely a journal published the official report regarding the acetanilid mixtures, when the preparations hit were the best paying advertisements in the country?
"What is the remedy? Publicity. The enlightenment of the profession. The truth regarding not only what the preparations contain, but who makes them. Certainly no honest manufacturer will object to this last proposition, and no honest physician will put up with less than the former.
"The Council on Pharmacy and Chemistry has been created to investigate the nonofficial preparations, to find out the truth about them, and to publish its findings. It is not necessary to repeat here the results of the work already done by this body. All physicians have read, or may read all about it. In my opinion there has been no movement undertaken by the American Medical Association that will be so far reaching as this one to rid us of the blight of the nostrum evil. For the first time, we see the possibility of the elimination of a part, at least, of this curse to American medicine. It is the first practical solution offered of a most difficult problem."
A QUICK MEANS OF PRESERVING MILK.
THE fertility of milk as a culture medium for bacteria, as evidenced by the rapidity with which organisms increase in the liquid and the consequent putrefaction, has prompted many efforts by scientists to discover some ready means for preserving this excellent nutritive article without altering the character of its composition. Experiments have demonstrated that in the short space of one hour one cubic centimeter of milk may provide for the generation of over six thousand organisms, and that after the lapse of twenty-four hours this growth. may increase to the magnitudinous proportions of about eleven million. These observations were made with milk procured under ideal conditions, and obviously the number of microbes would be decidedly greater were the milk secured from an unhygienic dairy. Refrigeration affords an admirable means of checking the growth of bacteria, but since this process is not always convenient its impracticability for general purposes is apparent, and indeed the same may be said of the various other preservative measures known to science.
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It therefore seems appropriate to chronicle a relatively simple method employed with great success by Renard, a Frenchman, which,
while not intended as a preservative for long periods, has given prime results in checking bacterial growth for from two to three days, or even longer time. An interesting feature in the preservation is that no antiseptics, such as formol, salicylic acid, or borax, are employed, the mere admixture of the milk with oxygenized water sufficing to retard the growth of organisms through decomposition of the water, the milk being unaffected and absolutely pure and sweet at the termination of the process. In experiments recently conducted at Rouen, the investigator obtained excellent results by pouring a two-per-cent solution of water, oxygenized at twelve volumes, into the milk. The results already achieved indicate the unadvisability of employing the water in stronger than three-per-cent solution, since the decomposition of a more powerful solution in the milk may lead to undesirable outAfter treatment with a three-per-cent solution, milk was preserved at a temperature of 11° centigrade, without the slightest trace of acidity for ninety-five hours, while preservation could be maintained. for only thirty-two hours at a temperature of twenty degrees.
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That milk preserved by the above method is absolutely pure was demonstrated in one of the dispensaries at Rouen, where fifty-seven infants were fed on the product with uniformly good effect. The results obtained with boiled milk were not favorable, since the oxygenized water forms certain combinations with the elements of the milk which have undergone change in boiling. Experiments conducted by Nicolle and Duclaux upon the comma bacillus, the bacillus of cholera, the bacillus coli, and certain pus-producing organisms demonstrate that the oxygenized water process does not destroy pathogenic bacteria with any degree of certainty. The question may be asked, then, why is not Pasteurization a more acceptable method, since it insures the destruction of all organisms, with the possible exception of the tubercle bacillus? So far as the destruction of bacteria is concerned the Pasteur method is ideal, but it does not insure preservation, and the milk, after being subjected thereto, is devoid of many of its nutritive properties.
STUDIES IN SIMIAN VERNACULAR.
PROFESSOR GARNER, the eminent scientist, who is the discoverer of the monkey language, is to undertake a second expedition into the wilds of Western Africa to further his studies in simian vernacular. The professor carries with him a green cage in which, while making observations, he is secure from the ravages of the serpent and ferocious beasts of the jungle. By means of intricate apparatus he was enabled, on a former expedition, to record certain inarticulate sounds from afar, which observation taught him to decipher. By means of definite
articulation he was able to put to flight an entire monkey horde, and with equal dexterity could assemble the quadrumana by imitating their expression for "all is well." He learned to recognize their sound for food and water and for many other things, and could in course of time converse, so to speak, with the tribe. The contemplated expedition will doubtless be more fruitful in its results, however, as Garner will take with him the most perfect phonographs ever produced, that record may be made of the language of the wild.
THEORIES APPERTAINING TO APPENDICITIS.
MAHLER, in a German periodical, discusses appendicitis and theorizes on the factors leading to its causation. The French theory that particles of porcelain from cooking utensils are responsible for the affection must be abandoned, since in one thousand operations Kremmer found no trace of such substance in the appendix. According to Mahler, heredity undoubtedly plays an important rôle in the causation of the disease, as is evidenced by repeated attacks in the same family. This author ventures the suggestion, however, that meat may be a provocative factor, and cites the prevelance of appendicitis in America, England, and the city of Hamburg, where meat is the chief food staple, in support of this idea. The fact that appendicial attacks occur more generally among people of wealth in Europe is further emphasized, as the economic conditions existing abroad preclude the poorer classes from meat indulgence.
OBSERVATIONS IN ANIMAL OPTICS.
DOCTOR LINDSAY JOHNSON, the English ophthalmologist, who has been studying the optic apparatus of various animals, has made some valuable discoveries which, according to Lankester, the noted zoologist, will require the entire rearrangement of one section of zoology. That man bears a close relationship to the lower forms is reiterated in Johnson's findings. The similarity of the eye of man and that of the anthropoid apes, according to this investigator, is suggestive of the Darwinian theory. Each is equipped with a highly complex arterial and venous system, and parallel vision is characteristic of both. The observations disclose the probability that the canine family is a product of two ancestries, since in the dog may be found both the round- and oval-eyed types. The first species is undoubtedly the result of an admixture of hyena blood. The eye of animals exposed to the chasethe squirrel, hare, et cetera-is so situated that the vision is unlimited, the animal being able to see in all directions, without altering position. The fact was likewise observed that all rodents squint, but the significance of this peculiarity remains unascertained. The parallel vision is especially typical of the higher forms, and the lower in the scale of development the animal is classified the less liability is there to this optical adjustment. Perhaps the most interesting feature of Johnson's