THE WORKING BULLETIN SYSTEM AND BOARD OF CONTROL-A PLAN FOR COLLECTING EVIDENCE CONCERNING THE NEWER

MATERIA MEDICA. F. E. Stewart, Ph. G., M. D., Philadelphia. URING the past thirty years, tens sired to exploit it dishonestly for of thousands of alleged new reme- financial gain the profession virtually dies have been introduced by ad- went into the same business. The

vertising and not more than one- public is at fault because it did not tenth of one per cent of them have pass and enforce proper laws to make proved of any therapeutic value.

such exploitation of the sick impossiThis introduction represents hun- ble. dreds of thousands of useless experi- The remedy is not to be found in ments upon the sick by physicians in throwing the materia medica overprivate and hospital practice, and board and resorting to drugless cults. many times that number by the self- It is to be found in standardizing the medicating public. No one has profited materia medica and rendering drugs by this so-called "new remedy" busi- instruments of precision. ness, except the manufacturers and How shall this be accomplished ? the press -medical, pharmaceutical, The answer is, by a co-operative insecular and religious. The public, vestigation in which the medical and disgusted by this state of affairs, has pharmaceutical press take part. lost faith in doctors and drugs and is "Not so," immediately opposes a turning to drugless systems of therapy certain class of objectors. “Persons for relief.

interested in the sale of drugs cannot The medical and pharmaceutical be competent observers. This work professions have been impoverished by must be done by the universities." it and their prestige seriously injured This objection is untenable. Such in public esteem. The public has suf- an investigation to be of any great fered by it in health and finance. value as a remedy for the present deThere is no use of trying to put the plorable state of affairs must have blame on anybody for all parties to the the support of the medical and phartransaction are at fault. The medical maceutical press and the manufacturprofession is at fault because this con- ing houses engaged in the materia dition of affairs could never have oc- medica supply business. curred if the profession as custodians “But the manufacturers are comof the materia medica had been true to mercial," say the objectors. "They its obligations toward the public. The are engaged in the sale of drugs; their pharmaceutical profession is at fault money is invested in the business; because instead of making a vigorous they are therefore biased in favor of protest against the invasion of the drugs; they are especially biased in pharmaceutic field by persons who de- favor of the drugs they commercially

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control and introduce by advertising. maceutical colleges, universities and They are not in position to co-operate journals. in the working of any fair method of But this knowledge cannot be investigation for it would injure their taught until it is acquired. How then, commercial interests."

is it to be acquired? Yes, the manufacturing houses are

The knowledge of medicine is to be commercial. So is the medical press acquired by the practice of the medi- . accepting advertisements of new ma

cal arts and by the publication of the teria medica products; so are the pub- results of experience by those engaged lishers of books on materia medica;

in that practice. so are the editors and authors who de

Progress in the knowledge of marive an income from the sale of the

teria medica is dependent upon the journals and books; so are physicians practice of those engaged in the pracwho accept fees for services rendered; tice of pharmacognosy, pharmacy, so are teachers in universities who re- pharmacodynamics, therapydynamics ceive salaries. The question is a com

and pharmacotherapy. mercial one and what we want is hon

"Yes, that is true," admit the obest commercialism on the part of all jectors. "But those practitioners parties concerned. Honest commer

who obtain an income from the sale of cialism and co-operation is wanted be- the goods are incompetent to investitween all concerned in solving a most gate their merits in an impartial manimportant commercial problem-a ner. What they say is of little value problem affecting the practice of med- as evidence in obtaining verdicts. The icine and pharmacy – affecting the

work must be done by university proteaching of universities and colleges- fessors. They may be commercial so affecting the public health-co-opera

far as accepting salaries is concerned, tion in solving this problem honestly

but they are not dependent upon the is what we want and must have before sale of drugs.” the problem can be solved.

There is some truth in what the And, unless the medical and phar- university professors say, but it is not maceutical professions, including the

the whole truth. Two classes of inmanufacturers and press, unite to

vestigators are necessary. One class, solve the problem, it will be solved for

viz., pharmacists and manufacturers, them by the public in a manner by no

engaged in the materia medica supply means conducive to the interests of

business and publishing the results of those most directly concerned.

the investigations and experiences of

its members and, another class acting As already stated, the solution of in a judicial capacity. the problem is not to be found in

At the present time the university throwing the materia medica over

professors have organized a pharmaboard and resorting to drugless ther- cologic society. To assure its judicial apy. It is to be found in materia character the society has a rule that medica standardization and the render- no member shall directly or indirectly ing of drugs of precision.

engage in commercial materia medica Drug standardization consists of fix- work. ing a nomenclature for drugs and pre- If it can be shown that the profesparations; it consists of determining sional men in the employ of manufacmethods for insuring uniformity in turing houses are so influenced by composition and physiological action commercial connections that they canand therapeutic affect; it consists in not express a judicial opinion, memadjusting finished products to fixed bership in any professional society standards and in devising means for should be denied. If, on the other keeping them there for a sufficient hand, these men are left perfectly free length of time to permit their proper in their scientific work, they are application as therapeutic agents; it eligible to scientific recognition as consists in reducing this knowledge any other independent investigators. to law and embodying it in system and To deny professional recognition in then teaching it in medical and phar- the latter case is to take advantage

a

as

of the merest quibble, for the value with the view of founding at Washof scientific investigation must always ington a comprehensive materia medirest absolutely upon its merits, and ca collection with knowledge concernnever upon the place where such work ing the same derived from unscientific happens to be performed.

as well as scientific sources, such The time is coming, and now is, knowledge to be confirmed or disproved when scientific men connected with by the verification work of the medimanufacturing houses are recruited cal and pharmaceutical professions. from the graduate schools of our great Included in my plan was the founduniversities.

ing of “Scientific Departments" by the We have also many other classes of great manufacturing houses, the same practitioners engaged in work affect- to be maned by pharmacognocists, ing the materia medica either directly pharmacists, biologists, and chemists, or indirectly-botanists, chemists, thus bringing the manufacturers into physiologists, agriculturists and many co-operation with the professions of others who are not necessarily inter- medicine and pharmacy, and bringing ested in medicine or pharmacy, who both professions into close and harmoare constantly contributing to the nious relations. knowledge of materia medica sub- I found that Prof. Baird was al. stances by their valuable researches. ready engaged in making a materia All of this work must be taken into medica collection which was intrusted account in any comprehensive system to Dr. Flint of the U. S. Navy as curof materia medica investigation. ator. He became immediately inter

Our knowledge of drugs and chemi- ested in my plan, which he said was cals as therapeutic agents has been one of the most important ones ever derived principally from the researches suggested to the Smithsonian Instiand experiences of physicians at the tution, and said that he would adopt bedside. “Such knowledge,” say the it, and if we could secure an approprilaboratory men, is of very little ation from Congress, he would collect scientific value. It consists largely of the drugs and information, publish the opinions unsupported by conclusive latter in "working bulletins' and evidence. The observations of clini- send the bulletins to the medical and cians should be confirmed by labora- pharmaceutical professions for verifitory experiments before they can be cation of claims. accepted as scientific in character." It is not my intent at this time to

Laboratory findings are certainly of give a complete history of the plan great value as evidence, but without for investigating the materia medica, clinical verification, they are of no but to give due credit to Prof. Baird's greater value than clinical observation memory for his suggestion. This without laboratory confirmation. Evi- plan, so far as the Smithsonian Instidence of both kinds is necessary for tution was concerned, was abandoned obtaining therapeutic verdicts.

for lack of appropriation. It was op

posed by the so-called “proprietary” THE WORKING BULLETIN SYSTEM OF COL

interests on the ground that its adopLECTIVE MATERIA MEDICA INVESTI.

tion by the government would be folGATION.

lowed in time by the adoption of plans I devised the working bulletin sys- for controlling the patent medicine tem of materia medica investigation business. in 1881. It was suggested by a re- But that part of the plan relating mark made by Prof. Spencer F. to the founding of scientific departBaird, the Honorable Secretary of the ments and the publication of working Smithsonian Institution. I had just bulletins, either under that name or proposed to him a plan for investigat- under the names "monograph” or “diing the materia medica of the world gest" was adopted by several large under the auspices of the United

the United manufacturing houses. States Government, to ascertain what The Working Bulletin System insubstances were being used as medi- cludes the collection of evidence for cines by various nations and tribes, and against the drug, chemical or