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therapeutic action. Many of these preparations contain from tive to twenty different drugs.
Turn to the advertising columns of our journals, and a thinking man is astonished at the brazen announcements made. Let me call your attention to some of these from our leading medical periodicals (so-called). For the prevention and cure of pulmonary phthisis (formulae) morphia sul, atropia sulphate, codeia, antimony tartrate, aconite, ipecac, pulsatilla, dulcamara, causticum, graphite, rhus tox, and lachesis, to be taken in one dose (for the single symptom of cough) and followed by a dose consisting of arsenicuru precipitate carb. of iron, phosphate lime, carb., lime, silica, and the other ultimate constituents, according to physiological chemistry (normally) in the human organism, together with caraccas coca and sugar ; being twenty drugs in two doses, besides the other ultimate constituents, etc. (whatever that may be). On the next page we find (formulae), glycerine, sherry wine, gentian, taroxicum, phosphoric acid with carminatives. This, we are assured, will cure phthisis, bronchitis, throat affection, nervous prostration, anemia convulsions, and is a general tonic. Another cure for consumption and a dozen other diseases is : Cod liver oil, distilled water, soluble pancreatin, soda and salicylic acid. Another entire page is taken up with Amick's
cure of consumption, which the company claims to have the confidence and · support of 50,000 physicians and 7,000 patients that it will perform a cure in thirty days' time.
There are hundreds of other remedies and medicines with unique patent or trade mark names, the formulae of which are given in part only, for example : Cafetonique for dyspepsia; alkalithia for rheumatism; sal aperient for constipation; bromo-caffein for headache, and so on.
In addition to this, we have innumerable compound prescriptions of renowned and obscure physicians, each pharmacist giving a separate name to the preparation, thus multiplying the confusions of the busy practitioner. Listerine put up by a dozen manufacturers under a dozen different names. The elixirs and compounds of viburnum with as many more names, and the same is true with a large number of other medicines.
In these cases, we find each proprietor claiming his to be the only genuine and efficient preparation, all others being frauds and imitations. Thus we find those upon whom we depend for our means of relief and care of our patients, accusing each other of fraud and deception.
These are but a tithe of the same class of ads, that fill the colums of our journals, and many of them appear in a score of publications at the same time.
Verily the advertising matter of the medical journal of today puts to shame the patent medicine man's almanac; for these ads. are addressed to the
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educated and intelligent physician, and he is the patron of the manufacturer of these preparations.
Turn now to the editorial columns of these same papers and you will find long tirades against the patent medicine vender, the drug clerk counterprescriber, and the quack; at the same time begging its reader to peruse carefully all the ads. in this journal, with the astounding announcement that nothing but reliable matter is permitted to appear in this journal.
My hearers may say we use none of these nostrums (for this is the proper name for them), but it is evident that many do, for the manufacturer and pharmacist are paying out money by the thousands and tens of thousands of dollars in calling the attention of the profession to their wonderful preparations, each ad. ending with the alluring offer of “free sample to any physician," and testimonials and literature on application, and the editor says be sure and mention our journal in your correspondence. Now write to them and they will crowd your mail with testimonials from M. D.'s from every state and every nation on the globe, from the pen of the humblest practitioner in the backwoods hamlet to the professor of our best colleges. And in many instances a glowing endorsement and flattering praise is given by the doctor, on trial of a single sample in a single case. Others will write long articles for publication, citing cases of marvelous cure from the use of some of these nondescript articles. The manufacturer seizes upon the reprints and circulates this statement as advertisement of his goods. The facts are that our pharmacists and our medical journals are entirely two commercial in their dealings with us. They are caring little for the true value of their preparations. “Any thing that will sell,” seems to be their motto.
They are still asking us every day to try some some new and wonderful remedy or medicine, the properties of which they themselves know nothing. Asking us to experiment continually on our patients and make them pay exorbitant prices for the article used, for every new medicine must be made to pay the enormous expense of advertising and introduction to the medical profession and to pay postage and stationery for the tens of thousands of circulars sent broadcast over the land.
To such an extent has this craze for new medicines run that our old tried materia medica is being burned with rubbish. We are forgetting the tried and reliable means we have.
The young as well as the old men in the profession are becoming imbued with the idea that anything that is worth their while to look into, must be new. That anything or any method that has been in use since their grandfather's day, is surely old fogyism.
Not many years ago, within the memory of some of us here, the man who dared to prescribe a medicine not official (then called officinal) would at once be set upon as a quack, and he would be very careful that his brother practitioner should not know the fact.
This was perhaps too dogmatic, but we are rushing with such mad speed to the other extreme, that it seems to me that we must call a halt or we shall be swamped and shipwrecked in the mire of experimental materia medica and therapeutics.
The kind of materia medica that we are drifting into is not only making empirics of the present generation of physicians, but is opening the gates and paving the way for quackery to every man and woman who possesses an ordinary amount of tact and shrewdness. All they have to do is to make themselves and the people believe that they can distinguish one disease from another, then turn to the advertising columns of our medical journals and select the certain and sure specific of which they will find a vast number for every disease; all prepared with full directions for administration. This is the strand toward which we are being driven and on which we shall surely flounder unless we change our course.
Dr. Boerhaave, nearly two hundred years ago, in speaking of the soure of heat of the body, that the ancients thought to be located in the heart itself, said: "If they had considered the circumstances they would have assigned the cause and seat of the blood's heat not to the heart itself, but to the determinate velocity with which the blood moves through the heart. But who would have suspended their judgment on this affair from the time of Hippocrates down to our day, the space of 2200 years? That would have been declaring himself ignorant in one of the most considerable articles of his profession; yet it is what he ought to have done, and with such patients only can physic be purged from its errors and established upon the most true and certain principles. Therefore, when a difficulty of this nature offers itself, not accountable for but upon hypotheses, we should refrain our judgment and leave the doubt to be solved by our posterity, when they shall have attaine:1 light enough from experiments which have escaped us. It therefore behooves us to defer our opinions about the use of the spleen and some other parts of anatomy, with the virtues of many plants, the causes of contagious diseases from poison, etc., till time shall bring the truth to light. By this means physic, it is true, will be reduced to a small compress, but then it will be true, certain and always the same. But while, from the imperfect ideas of many experiments, we attempt to deduce theories and establish opinion it is impossible that physic should be free from fallacy and errors. Such speculations are fitter for the lucubra
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tions and entertainments of the learned than to direct the practice of a physician, who being misled by some such spacious but false theory in a city might turn out to be of the most fatal consequence to its inhabitants.”
While this quotation may seem to be an extreme caution, one which it is not necessary for us, at this time, in these days of rapid progress, to follow, it is well for us to check our headlong speed and to go slow and more carefully.
We should at least require of every man, be he doctor, chemist or pharmacist, who asks us to use a new and unknown medicine, to at least give us a true and fair physiological history of the article. This can be done upon the healthy man and upon animals; it can be done without risk to human life.
It is enough to ask our patients to bear the burden of the therapeutic test alone, and even this we should do with extreme caution and good judgment.
We should be very careful in arriving at our conclusions in regard to the true therapeutic action of any remedy, and not base a judgment on a single case, nor attribute every thing that follows the administration of medicine to the remedy alone, for there is a vital force at work in every disease which does far more toward the restoration to health than all our treatments combined, and we should not lose sight of this important fact. I do not wish to seem to be a pessimist in medicine, but I do think our tendency is strongly toward the optimist.
Not long since an article appeared in one of our journals, from the pen of Dr. J. M. DeCosta, on the use of Guaiacol externally applied over the right illiac region in cases of typhoid fever, he cited several cases in which the treatment had been tried in one of the hospitals in Philadelphia, and from this experiment he came to the conclusion that it reduced the temperature without any untoward symptoms. There was no increased debility, no delirium, nor indeed any manifest disturbance of nerve function. That in many cases it was preferable to the cold water bath, and far superior to other antipyretics.
But a few months later came an article from Dr. W. S. Thayer, of Baltimore, with nearly the same number of cases treated in the same manner in Prof. Osler's ward, at the John S. Hopkins hospital, but the conclusions arrived at were entirely opposite. Dr. Thayer's conclusion was that the fall in temperature (which was slight in some cases) was usually followed by disagreeable, profuse sweating, and marked chill and weakness. That its action is exactly similar to the older medicines, creosote and carbolic acid. Now when men of so high eminence in the profession come to diametrically
opposite conclusions from almost identical circumstances, it behooves us to be very cautious of expressing opinions that are not well four:ded on undoubted facts.
The number of articles in our materia medica are outgrowing all bounds of reason. If one-half of "our physics were thrown to the dogs” the physician and the patient would be better off. Turn to the therapeutic index of the National Dispensatory, and you will find under amenorrhea 86 articles; bronchitis 226; colic 94; constipation 80; diarrhea 150; dyspepsia 150; neuralgia 140; rheumatism 175; skin diseases 150, and whooping cough 70, and so on.
Could a man live to be as old as Methuselah, he could not become familiar with all the articles of our materia medica of today. The remedy for this growing evil lays to a great extent in our own hands. Let us he less ready to jump at the alluring bate of the commercial pharmacist. Let us admonish our medical journals that we have no use for the thousand and one nondescript preparations that they are aiding the projectors in bringing into use.
Let us cease to experiment with every new remedy that is presented, and be conservative in forming and expressing our opinions, reserving our judgment and endorsement until we know we are right, even if it takes a hundred years.
Let us eradicate, as far as we can, the weeds and tares that have already sprung up in our materia medica. Let us make it our duty as individuals and organized societies to put our stamp of disapproval on this wild course of continuous and unprofitable experiment. Let us return to slower and more scientific methods, and our true progress in materia medica will be greater, and the good to ourselves, our patients and to our posterity will be much increased
Professor Billroth. — Although the great Austrian surgeon had an immense practice, and might, had he thought proper, have employed his talents in the accumulation of money to an unlimited extent, he nevertheless died so poor that a special pension of 2,000 florins had been conferred for life upon his widow. In order that this might be done a special Imperial decree was necessary, the ordinary pension limit in Austria being 600 florins (1.60).
The Identification of Criminals.---The Royal Commission, appointed last year to inquire into the mode of identification of habitual criminals, having reported favorably on the Bertillon system, the Commissioners of Prisons have decided to adopt the anthropometrical system of measurement of criminals. The system will be worked in conjunction with the present system of identification Officers from various prisons have already been ordered to attend at Penton ville Prison to receive instruction from Dr. Garson.-- Provincial Med. Jour.