DRUGGING IN MEDICAL PRACTICE.
I firmly believe that if the whole materia medica as now used
could be sunk to the bottom of the sea, it would be all the better
for mankind, and all the worse for the fishes.
- OLIVER WENDELL HOLMES.
There are but few people who have not at some time had use for
the services of a doctor. Some are loud in praise of one school
and equally loud in abuse of another. They take some medicine prescribed
by their favorite doctor who practices their adopted system, get
well, and attribute all to the merits of the drug administered,
as they believe, with so much skill. As a matter of fact, the drugs
may have had nothing whatever to do with their recovery; truly,
they may have recovered in spite of the evil effects of the medicine.
How else can the fact that drugs that have been declared to be almost
opposite in their effects produce the same results, and drug schools
find little of merit in the medication of each other? Their theories
are radically opposed, and they sometimes criticize each other as
bitterly as they do the osteopaths.
OPPOSING SCHOOLS OF DRUG PRACTICE.
The following appeared in the Journal of the American Medical Association
for April 26, 1899. The writer evidently had not much respect for
much of the work of his own school, or a very exalted opinion of
homeopathy; but expresses a well-known truth when he gives that
school credit for revolutionizing the practice of medicine:
"I trust it has been made clear that I do not regard all homeopaths
with an unfriendly eye. There are different kinds of 'disciples,'
you know. St. John was one kind, and the disciple who liked silver
was another. According to Professor Hale, less than one per cent
of Hahnemann's disciples are of the same class as St. John, and
more than 99 per cent are disciples for revenue only.
"Name one of the Hahnemannic precepts and I will name twenty
disciples - representative men –leaders - who have repudiated
it. The law of similars is just where Father Hippocrates left it.
There is no more difference of opinion between representative 'new
school' and 'old school' physicians in relation to this question
today than exists between individual adherents of either school
concerning the germ theory of disease.
"And what does the difference relate to anyway? A mere theory
of the mode of action of medicines in curing disease. That is all.
Think of it! A theory - speculation - wind! A mere difference of
opinion as to the way medicines produce their effects, is, in the
year of our Lord, 1899, and in free America, the ostensible reason
why a profession that is called 'liberal' should be divided into
discordant elements! Oh, what a shame upon us all! What a shame
"Homeopathy has done a noble work; it has served its purpose
well. Look back a hundred years to the time of its birth and contrast
the methods of practice then in vogue with those which are in favor
today, and tell me whether a stupendous revolution has not been
wrought, and largely through the instrumentality of Samuel Hahnemann.
Then the practice of medicine, as it appears to us now, was almost
senseless savagery. Bleeding, bleeding, bleeding, for everything.
Blistering, purging, vomiting, salivating the sick to death. Doctors
were fined and imprisoned in those days for allowing a sick man
to die without bleeding him. Brissot is said to have been driven
from Paris, not because he ever failed to bleed a patient, not because
he questioned the universal applicability of the lancet, but because
he had the audacity to propose a new method of bleeding. The traditions
of Hippocrates and Galen had to be duly honored in those days. It
is related of Achilles that when sick he consulted the oracle and
was informed that he must lose thirty pints of blood and then be
plunged into the icy waters of the river! But Achilles made a dive
for the back door and with electricity in his heels departed from
that place at a rate of a mile a minute, and never looked back until
he reached the plains of Troy. I can imagine him now backing up
with glowering earnestness the sentiment of Chimmie Fadden –
T’ ‘ell with the doctors!'
"Look at the prescriptions of those times and you will find
that many of them include from ten to sixty ingredients. Ask my
own students whether they would rather be bled, blistered, puked,
purged, and salivated, and then be compelled to swallow a pint of
some decoction every two hours till dead, or take their chances
with calcarea carbonica, high?"
A prominent homeopath, Dr. C. E. Walton, has paid his compliments
to his allopathic brethren in the following language, and at the
same time showed some misgivings as to his own school:
"Much has been heard in the last seventy or eighty years about
the 'regular' and 'irregular' physician. The first prescribes without
any rule (except that of limitation), and is consequently 'regular;'
the second tries to prescribe only by rule, and hence is conspicuously
'irregular.' At the present day we are not infrequently treated
to the paradox of the allopath prescribing by the rule of both homeopathic
selection and dose, and he is the irregular; while the homeopath,
with his large doses of drugs furnished by the manufacturing chemists,
lays himself quite liable to the charge of being regular. Does this
mean that the homeopathic lamb is preparing to rise up within the
allopathic lion, after the manner of a post-historic millennial
scheme, or is the Kilkenny cat style of amalgamation working out
another example of the 'survival of the fittest?"'
The following cases are cited by the same eminent authority:
"The case is that of a wealthy European whose attending physicians
disagreed over his disease, whereupon he resolved to consult several
physicians and to take their treatment if any course was perfectly
agreed upon by three. He consulted many keeping an exact account
of every consultation in a book for the purpose, resembling a ledger
in large folio. But he did not succeed in finding any two who agreed
respecting his case. Accordingly he did not follow any advice, but
remained without treatment. The number of physicians he consulted
was 477, and the number of prescriptions was 832, containing in
all 1,097 remedies.
"A similar case occurred in this country about ten years ago.
Twelve of the leading physicians of each school were sent a description
of a case with an urgent request to name the remedies indicated,
inclosing the usual consultation fee, with the result that no two
of the allopaths prescribed alike; in fact, each sent a widely different
prescription from the others, while all the homeopaths, without
an exception, prescribed the same remedy."
The following is taken from a book written for the laity by one
of the ablest exponents of the Eclectic school, Dr. Scudder:
"A certain class of physicians claim to be regulars, and the
direct descendants of AEsculapius. They further claim to possess
all the science and literature of the profession, and to be par
excellence. To hear them talk or to read their works, it would be
supposed that they were the embodiment of perfection, and that it
would be impossible for any persons outside of their ranks to know
anything of the healing art. Yet it was these same men that, twenty
or thirty years ago, gave calomel by the teaspoonful, and in every
disease, and that bled in almost every acute affection.
"There has been a very marked change for the better in this
school. They have been forced by public sentiment to almost entirely
discard mercury, antimony, and the lancet, and to adopt other and
milder means of treatment. It is true, many hold on to their old
errors with great tenacity, and others have discarded them under
protest, and not as yet become acquainted with better means. But
the change is going on, and they will be forced to complete it.
"Our old school brethren are noted for their illiberality,
their self-esteem, and their antipathy to change. Ever ready to
investigate anything that is stamped as legitimate, born within
the ranks and that does not conflict with their prejudices, they
reject with contempt anything that comes to them from without. They
have changed greatly within the last twenty years, and the change
is still going on, and we hope that the errors will be forsaken
in twenty years more.
"May we not reasonably and justly conclude that the attenuated
form of medication the infinitesimal doses - often receive credit
when none should be awarded to it; that their influence is imaginary,
and not real; that they exercise no positive curative agency in
many, perhaps not in any case in which they are administered, but
in which it is ascribed to them; that the effects are negative,
and that the powerful influences, benefits, and advantages claimed,
to follow from the exhibition of the millionth or decillionth part
of a grain of charcoal, common sell, or of silex (and all other
agents when administered in a form so attenuated), and carried out
according to the doctrines of Hahnemann, are but an imposition on
the credulity of the people, which must be apparent to any one who
investigates the subject? Does it not seem to be a mere placebo
the bread pills, or colored-water exhibited in a new form ? To believe
that a dose of the most simple agent, so minute that it is entirely
beyond the conception of the human mind, exercises such a powerful
control over the human system when in a state of disease, requires
an imagination so acute (it seems to us) as it falls to a lot of
but few mortals to possess. As well may we imagine that the millionth
or decillionth part of a grain of our daily sustenance, taken three
times a day, will be sufficient to sustain life; that it will support
the wants of the animal economy, and maintain all the varied processes
of secretion, excretion, and innervation, as that a similar amount
of salt, charcoal, etc., will effect great sanative changes upon
the human body when in a state of disease."
WIDESPREAD USE OF DRUGS.
Since the advent of Osteopathy drug medication has grown less popular
with great rapidity. The sick want to be cured, and those who grow
steadily worse under long-standing approved methods, readily accept
Osteopathy, because it appeals to their judgment and has verifiable
records of cures. The medical profession, with an ardor commendable
in a more worthy cause, has held to many exploded notions among
which drug medication is the most prominent. The rejection of drugs
by some of the ablest practitioners has led many to believe that
they are used less frequently and in less drastic doses than hitherto.
While this is true in the practice of the most progressive drug
doctors, it is not apparent that the total amount of drugs consumed
per capita is less than formerly. On the other hand the large volume
of business of the drug manufacturer and the pharmacist do not point
to the immediate abandonment of the drug habit. Furthermore the
prominence given to drug medication in all medical colleges shows
that the method occupies a more prominent place in the mind of those
who are making the doctors of the future than all other methods
combined. Evidence of this fact is to be found in the published
course of study of almost every medical college in the United States
and in the testimony of the graduates of those schools.
The growing habit of resorting to the use of "patent medicines"
is also evidence that the use of drugs is far from being obsolete.
And the capital involved in the manufacture and distribution of
both patent and proprietary medicines lends assurance to the assumption
that the business end of the proposition will receive increased
attention. We may therefore expect that the drug habit will increase
rather than decrease until a time when the people shall have become
aware of the impositions put upon them by the practice, and throw
off the shackles that are binding them soul and body with a merciless
The rapid increase in the use of stimulants, narcotics, and sedatives
is becoming a menace to our national life. We hear more of the effects
of alcoholic beverages than of other forms of dissipation because
the use of alcohol in some form is much more general and its symptoms
are more apparent. The more subtle influences of morphine, cocaine,
chloral, etc., and the greater secrecy maintained in their use,
make their effects less noticeable than those of alcohol and tobacco;
and the excuse for their use for medical purposes gives them a charm
which makes them more enticing than the better known sources of
Almost every one knows that nearly all drug doctors administer
drugs on the slightest occasion. The custom is so nearly universal
that one feels instinctively that he must "take something"
when ailing. It is not necessary to cite instance to show that medicine
as practiced by the old schools is first, last, and always, the
administration of drugs. The people have been taught that, and custom
warrants the conclusion. The treatment of the late President Wm.
McKinley is a case in point. It excited a great deal of interest
and provoked much criticism at the tinge, and is destined to become
a subject of as much dispute as was that of Washington more than
one hundred years ago. The report of the medical staff attending
him appeared in the New York Medical Journal, October 19, 1901.
The skill with which the report evades a clear statement as to the
cause of death is noteworthy. One reputable authority said the doctors
killed him; another said it was a pity that they did not have a
physician who knew the cumulative effect of drugs, naming digitalis.
The case is mentioned here, not to criticize the eminent physicians
in charge of the case, but to show that the "regular"
school of practice depends very largely upon the use of drugs even
in surgical cases. It is evident that many of the drugs used were
antagonistic to nature, and that nature had but slight chance to
get in her work. The report shows that there were eight surgeons
in attendance, two assistants, and seven nurses. Below is given
the drugs administered in different ways, exclusive of those used
purely as antiseptics.
He was shot at 4:07 P. M., September 6, 1901. Morphine and strychnine
were given almost immediately, and ether for the anesthetic. Following
the operation and before midnight, strychnine, brandy, morphine
sulphate, and a saline enema. Second day, saline enema, digitalis,
and morphine. Third day, digitalis, strychnine, Epsom salts, glycerine,
sweet oil, soap, and whiskey. Fourth day, codeine, calomel, and
oxgall. Fifth day, soap and water, and codeine phosphate. Sixth
day, strychnine. Seventh day, whiskey, castor oil, digitalis, strychnine,
calomel, oxgall, "atimulants" freely, and salt solution.
Eighth day, strychnine, whiskey, camphoretted oil, "stimulants"
more freely, liquid peptonoids, adrenalin, salt solution, nitroglycerin,
camphor, brandy, oxygen, and morphine. He died at 2:15 A. M., September
REACTION AGAINST DRUGS.
Humanity owes Dr. George S. Keith, of Scotland, a debt of gratitude
for the bold stand he has taken against present-day medical practices.
His "Plea for a Simpler Life" and "Fads of an Old
Physician" are classics. His arguments are so convincing that
only those who are wedded to their idols can fail to be convinced.
In speaking of the treatment of influenza - grip - in a communication
which, I understand, first appeared in the British Medical Journal
in 1902, he says:
"The after-effects are too well known to need mention, and
the deaths from them have been much more frequent after a more or
less prolonged period than were those from the original attack.
These deaths are not returned as from influenza, but from the diseases
resulting from it - notably from pneumonia and other chest affections.
For myself, I have all along treated cases of influenza on the old
method of leaving them absolutely to nature, and so far as my memory
goes, I do not remember the loss of a single case. Certainly for
twenty-five years after my late colleague and successor joined me,
we did not lose a single case.
"I have invariably found that influenza wisely treated leaves
the patient in better health than before."
This is in line with osteopathic experience. Bad after-effects
are practically eliminated in cases treated osteopathically; and
we are naturally led to suspect that most of the terrors of grip
are due to drugging and other irrational methods of treatment. The
same is true of many other diseases, such as pneumonia, typhoid
Physicians often lay too much stress upon the effects of drugs
upon normal animals in testing them to determine their therapeutic
value. "One man's meat is another man's poison." Every
individual is a law unto himself. Even the same individual is not
at all times equally susceptible to the effects of a drug. Every
one knows that even food may produce sickness, and has often noticed
that some articles of diet may be relished at one time and may act
as a poison, at least as an irritant, at another. We have all seen
cases where strawberries or oysters, or even eggs, would always
produce a deathly sickness. A quarter of a grain of quinine is more
dangerous in some cases than twenty grains in others. Many times
a drug doctor has to be warned against the use of certain drugs
to prevent his risking the life of his patient by dangerous experiments.
The American Journal of Physiology for July, 1903, has a valuable
contribution as to the effects of drugs, etc., from which the following
quotation is taken:
"Nor our knowledge of the effects of all drugs, alkaloids,
noxions or metabolic products, is mostly derived from a study upon
normal animals or organs. Are the effects the same when the organs
are deprived of their normal innervation? As far as we know this
question has as yet hardly been seriously raised. Our experiments
have demonstrated that the effect on pathological organs can be
diametrically opposite to that on the normal one."
A few choice quotations are given below from an article in International
Clinics, which appeared in January, 1905, by George Hayem, M. D.,
Professor in the Paris Faculty of Medicine.
"The oldest drugs endowed with undeniable therapeutic effect
were bequeathed to us by empiricism; they are the so-called specifies:
mercury, iodine, and quinine. A curious fact concerning them is
that, in spite of the time that has elapsed since their discovery,
contemporary science has not yet been able to ascertain precisely
how they act.
"And yet the science of chemistry, constantly progressing,
has introduced a large number of substances into therapeutics without
our being able to find a single specific.
"Serum therapeutics, however, has so far given rather meager
results and has proved richer in promises than in accomplishments.
Although there is reason to hope that it has a brilliant future
before it, it has disappointed us in many cases, and particularly
in the attempts that have been made with it in tuberculosis, the
greatest of our enemies.
"So, while awaiting the dawn of new specifics, or the discovery
of further active serums, we are standing with arms at rest, so
to speak, having as weapons, the endless number of substances furnished
by modern therapeutics."
After citing several cases in which he shows that the patients
are suffering more from the effects of the drugs taken than from
the original disease, Dr. Hayem continues:
"But, it will be objected, you cite only exceptional instances.
I only wish it were so, but unfortunately these are every-day occurrences,
and are met with at every step. I could mention analogous cases
by the hundred. It is true that I see mostly chronic cases, and
I hasten to say that in acute complaints instances are much rarer
in which our medical action is productive of harm.
"In chronic disorders that run a long course, the physician's
part is really very difficult. The patients demand prescriptions,
which, as they are generally useless, have to be replaced by others,
and these in turn by others still, and so on for years. In many
instances, again, the patients continue, without medical advice
to take for long periods of time a preparation that they look on
as harmless. But even the most inoffensive drugs become harmful,
when taken indefinitely. By introducing a certain degree of variety
in prescriptions, and by frequently changing a treatment, as I find
is usually done, the harm done is in no wise diminished; its effects
are simply rendered more complex. So that it is scarcely necessary
for me to repeat what I have already said on former occasions; slow
intoxication by drugs is the greatest danger that a patient with
some chronic disorder runs.
After denouncing, in no uncertain terms, the bad habit of dyspeptics
stuffing themselves with sodium bicarbonate and alkaline mineral
waters, he says:
"In this connection I may remark that alkaline saturation,
so far from lessening the production of free HCl [hydrochloric acid],
produces the most marked and typical hyperchlorhydria that can be
seen. That effect is sometimes so intense that the gastric juice
becomes a sort of solution of free UCI.
"When we see gastric patients growing steadily weaker and
thinner, although eating a sufficient amount of food, it is rare
that the disturbance of the general nutrition is not the result
of medicinal intoxication."
Similar facts are observed in other chronic disorders, and especially
in tubercular patients. What occurs with the latter class of patients
when we endeavor to stimulate nutrition, and to treat cough, pyrexia,
or sweats by medicinal prescriptions? The therapeutic agents, powerless
to hinder the evolution of the disease, soon lessen the appetite
and produce harmful digestive disorders.
"Pure air, sunlight, the thermic agents, and food are the
normal stimulants of the system and the sources from which we derive
our elements of maintenance and activity. These agents, called hygienic,
are also those which suit a diseased system struggling against a
never-ceasing cause of increased expenditure and loss of strength."
MENACE OF THE MANUFACTURING DRUGGIST.
Notwithstanding the fact that many people have lost faith in drugs,
and that many of the ablest M. D.'s have shown the fallacies of
their use, thousands, yes millions, believe they possess a magic
power to cure diseases. What better evidence of this fact than the
vast amount of medicine sold either with or without a prescription
from a doctor, or even the recommendation of a druggist? An article
in Leslie's for January, 1904, states that in Detroit there are
manufactured over 1,700 varieties of pills. It says:
"If Detroit's crop of pills for a single year was made of
any deadly poison, one-half of them would be sufficient to depopulate
the entire globe, but this would so injure the pill business that
it is not likely to occur.
"If the annual pill harvest of Detroit was strung on thread,
like Christmas popcorn, the rope of pills would reach twice around
the earth, with enough over to tie in a bow knot. If this string
of pills was cut in pieces each of the 36,000,000 women and girls
in America could have a different necklace of pills for every day
in the year, with an extra long one for each Sunday.
"Detroit produces 4,000,000,000 pills each year, and yet this
tremendous number is only about sixty per cent of the total quantity
of pills made, so that to get a fair idea of the growth of modern
civilization and the pill-eating mania the sum must be multiplied
by two or thereabouts."
The article shows how more than $20,000 were spent in one expedition
in South America in search of new poisons from plants and animals
that could be used in the preparation of medicines, and adds: "Since
then that expenditure of $20,000 has given a return of many times
The manufacturing druggist is a close competitor with the patent
medicine proprietor in the sales of his wares. An item appeared
in the public prints about two years ago stating that eight proprietary
drug houses in the United States spent over $500,000 each annually
in advertising their business. These were not 'patent medicines"
that were advertised, but "proprietary medicines," sold
only upon prescription of doctors. Concerning this growing evil,
and the disgrace it is bringing upon the medical profession, Dr.
Dan Millikin, in his presidential address before the Ohio State
Medical Association a few years ago, spoke in no uncertain terms;
but the evil has been increasing most alarmingly ever since he uttered
his warning. He said:
"There is now raging in our profession a pestilence which
is somewhat analogous to the nostrum-frenzy among the laity. If
it were manly to shuffle and find excuses for this, we might cite,
as the inducing cause, the greed of manufacturing druggists, who
are not content with legitimate profits, and who are by many devices
cultivating the notion that they each have a monopoly of the knowledge
requisite for the compounding of some 'special preparation.'
"This abominable infection is growing. Only a short time ago
a very able physician asked me if a patient we had been treating
in common had not better take a ferruginous tonic for a short time.
I agreed, and asked him his preference; he lightly said, 'Oh, give
him some one of the newer forms of iron.' I inquired further, and
found that he had a quack preparation in mind, and when I spoke
lightly of it, he looked on your president pityingly, as one looks
on an imbecile. A bright young doctor sent me word of one of my
old patients, who is slowly dying with a senile heart; he is treating
the old gentleman as well as he can, for he is giving him somebody's
'elixir of three chlorides,' though neither he nor I know what three
chlorides, nor what the dose may be, nor what the three several
indicators may be. He is one of the thousands, for it is not too
strong a statement to say that the whole American medical profession
has gone daft over these preparations of the manufacturing pharmacists,
sold by pure impudence, and bought by the doctors through pure credulity.
St. Louis is the headquarters of this shameful traffic, but every
city and many of the small towns have their firms, all intent on
getting rich through mystery and loud pretense.
"It is the special object of this address to call your attention
to the fact that these so-called special preparations do not differ
in any regard from the patent medicines which are swallowed in such
quantities by the laity to feed the inextinguishable laughter of
the doctors. It is not in order for you or me to sneer at the girl
who buys love-powders in the kitchen, or madame who buys subscription
books in the parlor, if we, snickering in the office, are seduced
by the dru=er's smooth tongue into the purchase and use of secret
"The advertising of this sort of stuff has become a curse
almost unbearable. The impudence of the advertisers rises to its
superb climax when they put forth what appears to be journals, and
send out broadcast, as 'sample numbers,' postage free!
"Aye, and let us confess that the legitimate medical press
is not without taint. I can show you whole issues of the best journals
of our land containing no clean advertisements, such as should accost
the physician, with the exception of here and there a call to drink
pale ale, to buy trusses or artificial legs, or to go to a private
lunatic asylum. All other space is evidently for sale to the highest
bidder with the lowest notions of our work; and I shame to say that
this low fellow with the long purse buys editorial notices of his
secret preparations along with other spaces."
The evils mentioned by Dr. Millikin are recognized by the profession
at large. The two following recommendations appeared in the report
of the proceedings of the American Medical Association at New Orleans,
in May, 1903. It is not necessary to read between the lines to see
that the profession itself is responsible for the deplorable state
of affairs. The layman will also see that he must take what the
"regular" physician prescribes, with all "the lack
of knowledge on the part of medical graduates," because "no
medical preparation," etc., no matter how efficient "is
entitled to the patronage of physicians."
"That inasmuch as the primary cause of the proprietary medicine
evils is the lack of knowledge on the part of medical graduates,
the course in materia medics should be supplemented during the last
year in connection with therapeutics by a course in pharmacy especially
designed to qualify the student to formulate his own prescriptions
in the most eligible manner.
"That the Committee on National Legislation be asked to consider
the feasibility of the introduction in the next House of Representatives
of an interstate measure prohibiting or limiting the sale of poisonous
and dangerous patent medicines.
"That no medicinal preparation for internal use, as distinguished
from antiseptics, disinfectants, cosmetics, and dietetics, advertised
as a remedy or cure to the laity, is entitled to the patronage of
physicians, nor should such be admitted to the pages of the medical
journals, nor to the exhibitions of the American Medical Asociation."
An article in the New York and Philadelphia Medical Journal, April
30, 1904, by John H. Neal, M. D., gives warning of the same danger.
Meantime, commercialism increases, the trade goes merrily on, the
manufacturers become rich, the people pay the bills, and the grave
swallows up the victims. Dr. Neal says:
"There is one other question which I will mention, and then
I have done. I refer to the dispensing of drugs. It seems to me
that the profession has very largely drifted into a most unscientific
and expensive habit; one which is expensive, not only to the doctors,
but also to their patients, in more ways than one. Many physicians
are allowing the manufactures of pharmaceutical products, so called,
to do practically all the prescribing of drugs. Their salesmen make
their regular tours, presenting samples of their products to the
physicians, of the nature, quality, and strength of which they know
nothing. They have a prescription in some form or other to meet
every indication. A specific for every disease; yes, every symptom.
Their principal argument is their cheapness. And, in many instances,
they could not enlarge upon that in one respect. These concerns
have the audacity to send to physicians, in many cases, their preparations
in containers, on which are found labels stating the indications
for their use, the doses, and how administered, but not stating
the amount of, and in some cases, the ingredients themselves. I
cannot conceive of an act more audacious. And it is, in my opinion,
one of the most serious charges that can be brought against the
profession, that it stands this abuse. These concerns can not be
blamed for this condition of affairs. It has been brought about
by the consent of the profession, which can also change the condition
at its will."
THE DRUG AND APPLIANCE BUSINESS,
Some drug companies, possibly all, are composed of a large number
of M. D.'s who are owners of stock and who are pledged to use the
goods manufactured by the company in which they are interested.
I was assured recently by one who is interested in such a company,
that its average net profit on its goods is eighty percent. Whether
such companies are a less menace to the health of the people than
many of the patent medicine companies, I leave to the thoughtful
man of affairs to decide. The enormous profits upon drugs to the
druggist who fills the prescription, the manufacturer who prepares
the ingredients, and often to the doctor who writes the prescription,
stimulate the business, so that the welfare of the patient is often
lost sight of in the grasp for money.
A circular letter from a prominent firm of "manufacturing
chemists," bearing date of June 16, 1904, says:
"We want you to know that Tablet ______ are in every way as
efficient and unobjectionable in the treatment of rheumatism, neuralgias,
and litheomic headaches as the _________ are in indigestion; and
that our records show that we sold over three hundred millions of
the latter tablets (thirty-Seven thousand to our most prominent
local bacteriologist alone) in 1903; and that more than seventy
thousand physicians are now either dispensing or prescribing these
Is it any wonder that those who may find temporary relief by the
use of such means soon find themselves victims of the drug habit
or their natural functions so impaired that hope gives way to despair,
even if half we are told about the quantity of drugs consumed is
The business end of drug medication is also in evidence by the
amount of advertising in reputable medical journals. An examination
of several reveals the fact that seventy to ninety per cent of the
advertisements exploiting curative agents are in the interests of
drugs; and that twenty to forty per cent of the entire contents
of the journals is given over to the same business. It is evident
the doctors prescribe these drugs, the patients pay for them, and
the drug gist receives his profit, or they would not be presented
to the profession through this perfectly legitimate source.
Suppose we admit that pure drugs are harmless, the evils of drug
medication are not eliminated. There is money in the business to
several parties, and if the profits cannot be made sufficiently
large to satisfy the greedy, adulteration or "substitution"
is resorted to. Read the following from an editorial in the Lancet
Clinic, December 31, 1904:
"Some weeks ago the Illinois State Board of Pharmacy, for
the purpose of investigating the numerous reports that had been
brought to their attention, sent to various druggists to be filled
130 prescriptions. These were then subjected to expert chemical
analysis, and it was found that in 23 there was no trace of the
drug prescribed, 66 contained 80 per cent of impurities; 10, 20
per cent; and but 31 could be regarded as pure - that is to say,
containing exactly what was ordered.
"This statement almost staggers human belief. While much has
been written of substitution in medical journals and physicians
have in a hazy sort of way become cognizant of the fact that such
an evil does exist, no one has imagined for a moment that it has
reached such awful proportions. But 31 pure prescriptions out of
a total of 130! It is a discovery calculated to cause the gravest
alarm in the minds of both profession and laity."
Manufacturers of appliances have also been drawn into this frightful
maelstrom of greed. A circular before me from a surgical and dental
supply company contains the following: "Liberal commission
allowed to physicians on all business sent us on elastic stockings,
trusses, braces, and abdominal supporters." The "liberal
discount" is about twenty-five per cent. A factory claiming
to be the largest in the United States seems to be owned by the
profession. Its circular says: "A share of stock in this company
gives you a discount, ninety days' time, and a dividend on what
others buy." Thus in addition to the fee to which the doctor
is justly entitled from a professional standpoint, he can trace
his profits back to the factory. From the large number of these
devices placed upon the market it is hard to escape the conviction
that many of them are prescribed for "profit only;" rather
than the good of the one that must pay the bill with profits to
so many financially interested in the sale.
In this connection another fact should be recorded, namely, the
paying of commissions on cases referred to them by other doctors.
Through a decoy letter, a number of Chicago physicians were found,
in the autumn of 1904, who paid such commissions. It seems the practice
is quite common and has been growing steadily during the past five
years. A dispatch to the Commercial Tribune, October 18, 1904, reports
Dr. John B. Murphy as saying:
"The paying of commissions is the most vicious, pernicious,
and outrageous practice to which a doctor can resort. It is unfortunate
that we can not stamp out this evil among ourselves, but publicity
seems to be the only method of checking it. The public would soon
lose confidence in a physician who was known to be paying commissions
for the treatment of patients.
"The practice means that the patient is being betrayed by
the one in whom he has implicit confidence - the family physician.
It means that his life is being auctioned off to the man who will
pay the highest premium."
CHANGES IN FASHION.
The belief is general that drugs are prescribed by doctors much
less than formerly. While the total amount consumed is doubtless
increasing daily, the amount used by the most intelligent and the
most conscientious doctors is constantly decreasing. Dr. John Maddens,
of Milwaukee, spoke as follows in American Medicine for February
"Each year sees more than one time-honored remedy become limited
in its use or else fall into complete desuetude. A quarter of a
century ago the student loaded the pages of his note book with complex
formulas, each containing from two to ten different ingredients,
to be cherished until the time should come when he would be a giver
of drugs. These formulas were definite instruments that the fathers
in the profession used to cure disease. Each disease had its treatment
indicated in sets of formulas, some to be given if it ran an uncomplicated
course, others to be given to meet complications and crises.
"Just glance over the pages of any comprehensive Practice
of Medicine, published fifteen or sixteen years ago, and note the
drugs used in, or recommended for, yellow fever - emetics, purgatives,
sudorifies, ipecac, castor oil, calomel, the salines, jaborandi,
mustard, quinine, as much as twenty grains at a single dose, with
a half dram of tincture of opium; mucilages, linseed, slippery elm,
gum arabic, opium, potassium bromid, chloral, external applications
of ammonia, camphor, and common salt, embrocations of turpentine,
gelseminum, digitalis, aconite, veratrum veride, ergot, turpentine
(internally), gallic acid, tincture of chloride of iron, sodium
bicarbonate, morphine, creosote, seltzer, apollinaris, champagne,
chloroform, and cantharides"
Dr. Oliver Wendell Holmes, poet, scholar, doctor, spent much of
a long and useful life trying to lessen the drug evil. The following
often misquoted statement appeared in a lecture before the Massachusetts
Medical Society in 1801, and twenty three years later he defended
his position in Note C, mentioned in the quotation. There is much
in Dr. Holmes's volume of "Medical Essays," as well as
in his poems, that will interest the intelligent reader.
"Presumptions are of vast importance in medicine, as in law.
A man is presumed innocent until he is proved guilty. A medicine
that is a noxious agent, like a blister, a seton, an emetic, or
a cathartic - should always be presumed to be hurtful. It always
is directly hurtful; it may sometimes be indirectly beneficial.
If this presumption were established, and disease always assumed
to be the innocent victim of circumstances, and not punishable by
medicines, that is, noxious agents, or poisons, until the contrary
was shown, we should not so frequently hear the remark commonly,
perhaps, erroneously, attributed to Sir Astley Cooper, but often
repeated by sensible persons, that on the whole, more harm than
good is done by medication. Throw out opium, which the Creator Himself
seems to prescribe, for we often see the scarlet poppy growing in
the cornfield, as if it were foreseen that wherever there is hunger
to be fed there must also be pain to be soothed; throw out a few
specifics which our art did not discover, and is hardly needed to
apply (Note C); throw out wine, which is a food, and the vapors
which produce the miracle of anaesthesia, and I firmly believe that
if the whole materia medica as now used could be sunk to the bottom
of the sea, it would be all the better for mankind, - and all the
worse for the fishes."
Dr. Holmes did not live to see the good work of opposition to the
promiscuous use of drugs finished. Many other M. D.'s have battled
in the same cause; but they are as one against ten thousand. Dr.
Wm. Osler has done much towards puncturing the fads of modern methods.
Note what he says about germs in the first paragraph quoted below,
pneumonia in the second, and present medical practices in what follows.
From the last sentence the reader will see that this great doctor's
mind seems to be fixed upon the use of a few drugs; but he does
not seem to be able to live up to his idea of treating even typhoid
fever, if we are to believe the statement of the papers as to his
treatment of the late Senator Hanna. Here are a few of the good
things Dr. Osler says in his famous address on Medicine in "The
Progress of the Century."
"They [bacteria] give to the farmer the good quality of his
crops, to the dairyman superior butter and cheese; they assist in
large measure in freeing our rivers and lakes from harmful pollutions.
Here it should be strongly emphasized that those bacteria which
cause disease are only of a few species, all others contributing
to our welfare in countless ways.
"We know the cause of the disease [pneumonia]; we know only
too well its symptoms, but the enormous fatality (from twenty to
twenty-five per cent) speaks only too plainly of the futility of
our means of cure, and yet in no disease has there been so great
a revolution in treatment. The patient is no longer drenched to
death with drugs, or bled to a point where the resisting powers
of nature are exhausted.
"The century has witnessed a revolution in the treatment of
disease, and the growth of a new school of medicine. The old schools
- regular and homeopathic - put their trust in drugs, to give which
was the Alpha and the Omega of their practice. For every symptom
there were a score or more of medicines - vile, nauseous compounds
in one case; bland, harmless dilutions in the other. The new school
has a firm faith in a few good, well-tried drugs, little or none
in the great mass of medicines still in general use. Imperative
drugging - the ordering of medicine in any and every malady - is
no longer regarded as the chief function of the doctor. Naturally,
when the entire conception of the disease was changed, there came
a corresponding change in our therapeutics. In no respect is this
more strikingly shown than in our present treatment of fever -say,
of the common typhoid fever. During the first quarter of the century
the patients were bled, blistered, purged, and vomited, and dosed
with mercury, antimony, and other compounds to meet special symptoms.
During the second quarter, the same, with variations in different
countries. After 1850 bleeding became less frequent, and the experiments
of the Paris and Vienna schools began to shake the belief in the
control of fever by drugs. During the last quarter sensible doctors
have reached the conclusion that typhoid fever is not a disease
to be treated with medicines, but that in a large proportion of
all cases diet, nursing, and bathing meet the indications. There
is active, systematic, careful, watchful treatment, but not with
drugs. The public has not yet been fully educated to this point,
and medicines have sometimes to be ordered for the sake of the friends,
and it must be confessed that there are still in the ranks antiques
who would insist on a dose of some kind every few hours.
"The battle against poly-pharmacy, or the use of a large number
of drugs (of the action of which we know little, yet we put them
into bodies of the action of which we know less), has not been fought
to a finish. There have been two contributing factors on the side
of progress - the remarkable growth of the skeptical spirit fostered
by Paris, Vienna, and Boston physicians, and, above all, the valuable
lesson of homeopathy, the infinitesimals of which certainly could
not do harm, and quite as certainly could not do good; yet nobody
has ever claimed that the mortality among homeopathic practitioners
was greater than among those of the regular school. A new school
of practitioners has arisen which cares nothing for homeopathy and
less for so-called allopathy. It seeks to study, rationally and
scientifically, the action of drugs, old and new. It is more concerned
that a physician shall know bow to apply the few great medicines
which all have to use, such as quinine, iron, mercury, iodide of
Potassium opium, and digitalis, rather than a multiplicity of remedies,
the action of which is extremely doubtful."
THE CRY FOR RELIEF.
The cry going up everywhere for relief from the thraldom of drugs
is heard here and there by the drug doctor; and he is forced by
the impetus of public sentiment to acknowledge the mere "psychical
effect" of most drugs and the "poisoning effect of many
of the popular drugs and nostrums in common use." An article
by J. K. P. Bowen, M. D., entitled "A Plea for the Use of Less
Drugs in the Treatment of Typhoid Fever," in the Philadelphia
Medical Journal for April 11, 1903, is well worth perusing. Among
other good things, he says:
"Psychotherapy, or every-day practical suggestion, is an important
factor in the treatment of most diseases, for aside from the psychical
influence, but little of the drugs taken result in good. How frequently
the physician is tempted to prescribe a medicine in treatment for
his drug-believing patient for its psychical effect.
"The Americans take four times the amount of drugs taken by
Europeans, and our death rate is greater, especially from acute
diseases. How many of the peculiar symptoms, universal complications
and fatal terminations are due to the treatment! The statistics
of the last few years show conclusively that physiological treatment
with only an occasional medicinal auxiliary gives decidedly the
best results. Physiological therapeutics utilizes vital forces,
aids in cell growth, strengthens vital resistance, and promotes
natural elimination and not the corroding, depressing and poisoning
effect of many of the popular drugs and nostrums in common use.
Many mild cases of most any acute disease will recover under any
kind of medicinal treatment in spite of the diseased condition and
the drugs, too, and occasionally, the effect of the drug is left
on the system permanently, or the drug habit is acquired, which
is one of the most appalling and unfortunate circumstances that
could befall human form."
Drug doctors have endeavored more than once to stay the constantly
increasing tendency on the part of the thoughtless to use drugs,
except when prescribed by one of their own school. But the people
were taught that habit by the drug doctors themselves. Drug medication
is the foundation rock upon which their system is builded; hence,
it will take years, perhaps generations, to undo the evils growing
out of the practice. The following quotation is from the Cleveland
Medical Journal, January, 1902. The same issue contained an article
which every osteopath would sanction, advocating the passage of
a bill requiring "the makers of patent medicines to print the
true formulas of their nostrums on all labels." It also gave
three pages against the osteopathic bill then pending before the
legislature (Chapter IV); thus trying to prevent the people from
using non-drug methods and at the same time trying to compel them
to patronize only those who administer drugs and incidentally only
those who prescribe for a fee and require the patient, in having
the prescription filled, to contribute to the profits of at least
two or three parties to the transaction.
"The newspapers of this city recently and very properly have
been agitating against the general sale of cocaine, which is reported
to be going on. Cocaine wholesales at six dollars an ounce, and
one druggist here is reputed to buy the drug in one hundred pound
lots! But the newspapers miss the real source of danger, which lies
in the multitude of patent medicines bought freely by the public
and containing as their only active agents morphine, cocaine, and
other narcotic drugs. It is these which give to many unfortunates
their first taste for 'nerve tickling' and soul-destroying drugs."
WEDDED TO THEIR IDOLS.
While many physicians are trying honestly to check the giving of
drugs, others are not only wedded to their idols but try to force
all to worship at the same shrine. A medical formulary issued in
1901, "comprises over 1,600 formulas in actual use by medical
practitioners and covering also the newest remedies of recognized
merit." In another "will be found 2,600 prescriptions
collected from the practice of physicians of experience, American
and foreign, nine hundred and twenty-two American and foreign authorities
being represented." The two formulas given below are for "colds
in the head." The first is from one of the formularies mentioned
above; the second is from Anders' "Practice of Medicine,"
a standard work. When we learn that Fowler's Solution "is a
1 percent solution, prepared by boiling together Arsenous Acid [white
arsenic, 'ratsbane'] 1; Potassium Bicarbonate, 2; Compound Tincture
of Lavender, 3; and Distilled Water to 100;" and that Seidlitz
powder has "of Potassium and Sodium Tartrate 120 grains; of
Sodium Bicarbonate 40 grains, mixed in one paper; and of Tartaric
Acid 35 grains in another paper," we get a clearer idea of
the complexity of drug medication, even for a bad cold.
Here are the prescriptions:
Euquinine, - - - - 20 grains.
Fowler's Solution, - - - 10 grains.
Solution Atropine (1 percent), 4 minims.
Extract Gentian, - - - 20 grains.
Powder Acacia, - - - for 12 pills.
One every 3 or 4 hours.
"At the outset a purge consisting of calomel (gr. ij - 0.129
), or a pill of blue mass (gr. v - 4.324) at night, followed by
a Seidlitz powder in the morning, is advisable. To children a dose
of castor oil may be given. The early administration of a diaphoretic,
such as Dover's powder (gr. v-x -0.324. - 0.345) at night may arrest
the complaint, and quinine in a large dose (gr. xij-xv - 0.77 -0.992)
at night may cut short the cause of the disease. When the above
mentioned abortive measures fail, the following tablet produces
Quinin sulphat., - - - - gr. ijas (0.162)
Extr. balladonnua fl., - - - - injss (0.099)
Sodii salicylatis,- - - gr. xxx (1.944)
Camphorae. - - - - gr. ijss (0.162)
M. et ft. tablet No. x,
Sig - One tablet every hour or two.
"For the fever aconite may be employed, and, if the throat
is involved, bryonia may be given in conjunction."
The frightful destruction of morals, health, and life by the use
of opium and morphine, often administered under other names, is
appalling. The scores of preparations that are always depressant,
as headache powders, are also getting in their deadly work. As is
well known., cocaine is one of the most dangerous drugs used by
the medical profession. It destroys both soul and body. Its victim
disregards truth and ignores property rights. In other words, he
will lie and steal without any compunctions of conscience. His bodily
functions also soon become impaired beyond all hope of recovery.
Recently there has been an epidemic of crime among the negroes in
Cincinnati which the police authorities attribute to the use of
cocaine. Who is responsible for this new menace to health and morality?
The druggist is held up as the chief offender for" selling
it "without a prescription." But is not he who gives the
prescription in the first place the original and primary offender?
Here is what the Alkaloidal Clinic for May, 1904, had to say on
"While many of these and other forms of drug habit are directly
blamable to thoughtless and careless members of the medical profession,
who all too quickly give to neurasthenic patients prescriptions
for narcotics, yet it is our friend, the druggist, who, for purely
mercenary reasons, continues to fill and refill these prescriptions
till the sufferer degenerates into a ten cent cocaine habitue or
morphine fiend, on whom the bulk of the burden rests. Doctor, you
should think more than once or Twice before you give a prescription
for a narcotic. And, brother Drug-man, you should never refill such
a prescription. If it should be repeated let the doctor take the
blame and write a new one. Better both cut it out."
The dangers from the use of alleged catarrh cures are well known
to all intelligent physicians. The people have been warned many
times, but the diabolical traffic does not seem to have diminished.
The following clear statement as to their evil effects appeared
in a recent issue of The Medical World:
"It is well known that many secret catarrh cures contain cocaine.
The object is to get the patient in the habit of taking the catarrh
snuff with every prospect that he will continue it indefinitely.
Other secret nostrums advertise to cure catarrh, asthma, hay fever,
bronchitis, consumption, etc., to be taken internally, are launched
on the same basis and for the same purpose.
"Inducements are made to take 'a full month's treatment,'
and then instructions are given how to order, and the victim is
told that the goods will bear no external marks. The reasons are
obvious; the plan is transparent to those who will open their eyes.
Doctors should explain this to the laity whenever occasion offers.
If we had a law like that of Germany, requiring the formula on every
bottle or package, the ignorant could not be so easily entrapped
into the slavery of drug habits. That such should exist in the 'land
of the free' is an outrage."
None are more fully aware of the passing of drugs as curative agents
than some of the doctors themselves. They deplore the situation
and begin to realize that they are confronted by a condition, not
a theory. Occasionally we hear the cry of despair because of the
ruthless demolition of the idols of the profession by scientists
in their own ranks. The following appeared in American Medicine,
November 23, 1901, in an article by W. W. Van Denberg, M. D., on
"Has the Use of Drugs Become Obsolete?"
"An analysis of the papers presented during the late meeting
of the New York State Medical Association at the Academy of Medicine
in New York, offers some interesting features in connection with
one of the most representative bodies in this country. Besides the
president's address, there are forty-eight papers on the program.
The larger percentage of these are able documents, and fairly represent
the whole. Diagnosis may be credited with eleven, or about fourteen
per cent; etiology with four, or about eight percent; mixed papers
in which there may be some allusion to the use of drugs, though
this is by no means certain, three papers - six percent; special
therapeutics (not drugs), one paper; special idiosyncrasy, one paper;
and last on the program, on the final day of the meeting, 'Brief
Comments on the Materia Medica, Pharmacy, and Therapeutics of the
Year Ending July 1, 1901.'
"So it seems that therapeutics, by the use of drugs, received
a trifle over two percent of the time of this meeting, and this
only at the end, after interest has subsided and most of the members
have gone home.
"Was this the ease in the days of our fathers in the days
of Alfred Stifle and his compeers?
"Do our associates, when making out the program, consider
that ninety-five percent of all the cases with which the practitioner
has to deal are medical cases? Why then this pitiful less than two
The statement made before a Chicago Medical Society in January,
1904, by Dr. A. D. Bevan, that "drug treatment is useless in
cases of pneumonia," might be expected to cause some surprise
to the laity, but should not have aroused such a discussion in the
profession as it did. Such well-known writers on medicine as Hilton,
Keith, Hughes, Anders, Osler, Billings, and others had already said
enough to convince the profession that drugs in such cases were
useless, if not positively harmful. But the teachings of centuries
are not easily set aside and the prejudices of ignorance must not
be overlooked. Give drugs for their "moral effect," as
suggested by doctors who protested against Dr. Bevan's statement.
The following account of the controversy appeared in the press reports,
and is not denied by the medical journals; but it made some of them
"'Drug treatment is useless in cases of pneumonia. The medical
profession, so far as medicines are concerned, can be of no assistance
in the light against this disease. The sooner the profession will
acknowledge this to the public and set to work to discover some
specific to save pneumonia patients, the better for all concerned'
"This startling statement by Dr. Arthur D. Bevan, who stands
high in the profession, has stirred up the members of the Chicago
Medical Society at their meeting.
"Several physicians sprang to their feet to protest against
this arraignment. All had to admit, however, that there is no definite
remedy known, and they based their protests solely on the contention
that they might influence the patient favorably by easing him somewhat
and by the moral effect of their presence."
The Osteopathic Physician, February, 1904, contained the following
caustic comment upon the above incident.
"So they go on admitting that the 5,000 drugs already listed
in the United States Dispensatory are of no service in this and
that ill, while they are a positive harm in some other one, but
still multiplying trouble by inventing new drugs, led on by the
ignis fatuus that some day inert matter will be found in cunning
formulae which will solve the mystery of creative life and actually
impart vitality to vitiated protoplasm.
"Alas, vain search ! Alas, futile alchemy worse than the attempts
at transmutation of lead to gold in the olden time! Worse than the
search for a Fountain of Immortal Youth because not alchemists,
not romanticists, not poets, not devotees of superstition, but men
of science engage in this child-like bootless task!
"We feel sorry for our benighted brethren of regular medicine.
It may be a bit Pharisaical to admit it, but we can't help it. They
seem to us to be fetich-worshipers, pure and simple, in this blind
searching for panaceas of life's myriad ills. Knowing as much as
they do of all the co-ordinate branches of a liberal scientific
education, it seems inexplicable to us that they should make such
poor use of their knowledge and talents. Truly, it is not what men
know, but how they use it, that counts in medicine."
GROPING IN THE DARK.
It has been only a few months since the X-ray and radium were heralded
as sure cures for cancer. The present writer said then to a very
sick patient that she would live to see those medical fads things
of the past, just as scores of others that had been relegated to
the therapeutic waste-basket are now known only to history. The
prediction is already verified according to expert witnesses. P.
J. M. McCourt, M. D., in an article in the Medical Review of Reviews,
April, 1904, makes the following statement:
"Aside from operative procedures, the only assumed remedies
for carcinoma at present are the 'X-rays' and the radium rays. It
is laudable that these and all available agents should be studied
and subjected to crucial - not commercial - tests; but it is noxious
that we should be deluded by the extravagant claims of undignified
enthusiasts of 'cures' which are wholly chimerical. I would not
depreciate the rational work of others; we are or should be - seekers
for the truth in our own way. But the only therapeutic result thus
far produced by the Roentgen and radium rays has been the occasional
temporary suppression of epithelioma, soon to be followed by local
recurrence, metastasis, or general diffusion throughout the system.
And in view of the apparent causation of carcinoma, no other results
could have been anticipated. The unknown has a fascination for many,
sometimes even for logicians; and of these rays we as yet know practically
nothing - except their dangers."
But the author has his own method of treating this loathsome disease,
which may have biased his mind against other methods. The injection
of blood serum from a diseased horse as au antidote for diphtheria,
and the pus from the sores on a diseased cow for small-pox, is refinement
compared with the dosing of the cancer toxins prepared as described
below. Note the results. Only fourteen percent, "apparently
restored to their former condition of health." The results
upon the whole do not appear to be as successful as the do-nothing
method. A. F. Jones, M. D., in the Journal of the American Medical
Association, May 9, 1903, after giving four cases, says: "In
two of our cases the neoplasm disappeared spontaneously, the disappearance
depending, no doubt, on some form of katabolism not yet understood."
Katabolism is the tearing down act in the process of nutrition,
and is quite well understood. Are we to infer that Dr. Jones believes
in a special "form" of katabolism for each disease? Here
is Dr. Me Court's method and its results
"The cancer-tissue is pressed and triturated in purest vegetable
glycerine, and the juices thus obtained are separated until micro-organisms
are no longer found. The resultant fluid contains all the ptomaines
or alkaloids of the cancer virus, as well as those of other materiae
morbosa - syphilis, scrofula, tuberculosis, erysipelas, malaria,
etc. - associated with them in the subject from whom the virus was
"'In five percent - the advanced and extremely malignant -
the toxins were found to be entirely valueless. In ninety percent,
relief from pain, foetar, hemorrhage, insomnia, vesical and rectal
tenesmus, etc., has been marked and life materially prolonged. And
in fourteen percent, indurated glands have become normal, ulcers
have healed, body weight has increased, a complete cessation of
all objective and subjective symptoms has ensued, and the patients
are, apparently, restored to their former condition of health.
"Whether this relief is permanent can be answered only by
time. Even hope must be in abeyance until years of attentive and
anxious observation have passed. Meantime, I have not told the whole
truth on behalf of the cancer toxins."
THE SERUM FALLACY.
The serum method seems to be the most natural successor to the
drug method of treating diseases. Many of the drugs used in common
practice are obtained from diseases of plants or animals. Serums
are always secured from animals diseased artificially. The animal
is inoculated with the desired disease, as diphtheria, tuberculosis,
or tetanus, and the serum of the blood which contains the antitoxin
to the products of the disease germs with which the animal was inoculated
is prepared for the market. Only a few years ago it was hailed as
the open sesame for the cure of all germ diseases. Many kinds of
serums have been prepared, and still the profession is at work along
that line. The serum for tuberculosis has proven to be an absolute
failure, and the profession has even lost faith in its use for diagnostic
purposes. That tetanus (lockjaw) has been increased by the use of
the serum is now quite generally conceded. But the profession as
a whole still claims that the serum treatment is the only one for
diphtheria, and it is little less than suicide for a drug doctor
to express doubts as to its success. For the laity or an "irregular"
to question the correctness of the statistics that show the positive
benefits to be derived from the serum treatment of diphtheria is
to have his honesty or sanity questioned; and the look of contempt,
or even scorn, with which he is met, is apt to make him wonder whether
truth is truth or falsehood. Occasionally old school medical authorities
will speak the truth as they see it, even though all their professional
brethren seem to be against them. An article by Boucher, entitled
"Extraordinary Gravity of Diphtheria since the Introduction
of the Behring and the Roux Serums," appeared in the Journal
de Medicine de Paris, April 3, 1904. A translation by Dr. T. C.
Minor, a regular, is found in the Eclectic Medical Journal, June,
1904. Statistics to prove the fatal results due to the administration
of antitoxin for diphtheria are given. The following quotations
contain the pith of the article:
"Every day, in the great public press, editors as ignorant
as Pasteur of the great principles of our science, proclaim with
conviction that hydrophobia is vanquished by the divine and immortal
chemist, and that diphtheria has been conquered by Disciple Roux.
For hydrophobia it is now well known, well demonstrated, and positively
proved that fatal cases have doubled since Pasteur's invention.
Then, too, we have statistics, coming from all sides, that the mortality
from diphtheria has also increased since the introduction of Behring
serums, recopied by the eminent Roux.
"The study of the mortality of Basle leads one to the same
conclusion. In fact, according to the works of Lotz that appeared
in Correspondent Blatt fur Setweizer Artz, 1898, it is shown that
in the ten years between 1885 and 1894-that is to say, before the
serotherapeutic epoch - an annual mortality of 29 cases is noted;
and in the years that follow the mortality was raised to 45, and
even reached 69. Let it be understood meantime that there are always
periods of lowering in morbidity and mortality from all causes.
It would be illogical to assume that temporary periods of lower
mortality were due to serum.
"Such are the indisputable facts observed in more than fifty
thousand cases. Meantime many medical confreres who might be considered
as good practitioners and even as clinical observers, claim that
their patients have been aided by serums with truly excel lent results.
"How explain this medical mirage, and make these propositions
appearing antinomical, agree? To my mind it is a very simple matter.
To make false membranes disappear, which, for all the world represent
a material expression, one of the disease - these false membranes
that choke the patient, and by suppuration give the malady its very
frightful character - such is the pursuit and attempt of the physician.
For, if the false membrane is made to disappear, hope for the recovery
of the patient is reborn, and the dawn of the cure appears. If,
later on, complications follow, if the kidneys, bronchi, lungs,
or heart are attacked, if death terminates the sad scene, the practitioner
himself is put beyond blame by the family, for did he not cause
the visible signs of the malady to disappear before the patient's
death? was the suppuration not stopped? Yes, he did his best. Now
the inoculation of anti-diphtheritic serum makes the false membrane
fall off rapidly, not because of any specificity it is supposed
to contain, but purely through mechanical action. We know that artificial
blood serum will produce the same results. For the augmentation
of sanguinary pressure, caused by the ingestion into vascular system
of a certain quantity of a liquid, is certain to reach the point
of inflammation; that is to say, the spot where the inflammation
is most considerable, a serous transudalion occurs that permits
the false membrane to become easily detached. I imagine that this
hyper-pressure can not occur without exercising a profound repercussion
on the heart, even up to the point of inducing cardiac collapse.
Sommers' observations leave no doubt on this point. On the other
hand, if I report the account rendered by the works presented to
the Congress of Nancy by learned bacteriologists, these indicate
that the inoculation of serum is often followed by ulbuminuria and
that nerve trouble is the result, expressed at times by attacks
of auria or nephritic hemorrhage. I have thus the right to conclude
that the inoculation of anti-diphtheritic serum gives a natural
explanation of diphtheria attacking the heart or kidneys, being
the direct cause of these complications.
"All my confreres who have observed the progress usual to
this affection agree with me, I are sure, that these rapid deaths,
absolutely abnormal, were occasioned by complications induced by
the serum. I make this remark in order to answer a young official,
chief of a clinic, who assured me in a patronizing manner, that
serum never induces accidents. In reality the Roux serum never exercised
any beneficial action on diphtheria; and if a number of sincere
practitioners affirm its efficacy, it is because they have been
misled by the fad of the moment, and forgot the true proportion
of deaths from diphtheria before the era of Pasteur, and besides
have considered simple cases of angina diphtheria, simply because
they showed a bacillus; so they used the serum as a cure, when the
same cases would have recovered with any simple treatment.
"Are we then wise in concluding, once and for all, that Roux's
serum is absolutely murderous and a danger to the public health
? So why, under the pretext of spreading confidence, giving convolutions,
and boasting, like some editors of the public press, will thinking
men indorse a remedy that not only poisons but kills."
Elmer Lee, M. D., New York, commented on- the above article from
the French journal in the following language, as printed in the
New York Tribune in the summer of 1944:
"The claims that are seductively held out that cases treated
early by antitoxin would recover, have utterly failed. The claim
subsequently that cases treated by antitoxin recover more quickly
than those not so treated has utterly failed to be true. The claim
that the death rate would be lessened has proved to be a disappointment.
The claim that antitoxin was harmless has been proved to the contrary
by many fatal terminations. It is not the purpose to impute insincerity
or lack of intelligent experimenting on the part of the profession
concerned in experimenting with antitoxin, but the promises of better
results through its use have unfortunately failed to be substantiated.
The human system, when laboring under morbid influences, needs rather
those elements which can add strength and vigor to the vital resistance.
"The records of the cases treated in the Willard Parker Hospital
of New York City, prove that antitoxin is dangerous and even fatal.
The statistics of that hospital establish that the further use of
antitoxin is unjustifiable. Dr. Joseph E. Winters, of New York,
has sought diligently to establish the value of antitoxin, but the
clinical experiences have forced him, unwillingly, to condemn its
use. Professor Lennox Browne, of London, patiently and earnestly
sought for clinical reasons, to further the interests of antitoxin.
His conclusions are emphatic and pronounced against it. Dr. Welch,
of Philadelphia, also deprecates the use of antitoxin in the Municipal
Hospital of that city."
The testimony of another eminent authority is cited to the same
effect. This is from The Medical Brief, April, 1905. It is published
in St. Louis, where thirteen children were killed by antitoxin within
a month in 1902:
"Suppose you stop and think about this serum question a moment.
"If you should take the serum of a dead man, which, as you
know, is highly poisonous, and add enough carbolic acid or trikresol
to make it absolutely inert, it would be safe for you to inject
it into a living man. If, now, this man were suffering from a disease,
and good results followed the injection, would you not ascribe the
improvement to the antiseptic rather than to the inert serum? How
can it be the serum, when that has been killed, its identity destroyed,
by the action of the antiseptic?
"This is precisely the condition antitoxin is in today, and
in spite of the money invested in its manufacture, and the various
interests tied up in it, the serum idea is on the decline, and no
power on earth can stop its passing out of use in the course of
HARM IN DRUGGING.
Physicians cannot deny that their prescriptions are often neither
more nor less than the preparations sold in the form of patent medicines.
Druggists will tell you that compounds sold as patent medicines
are often dispensed upon the prescription plan. The medicine is,
of course, removed from the original package and the, label is not
allowed to reveal its identity. It is truly unfortunate that such
things are done, and doubly unfortunate for many poor victims of
disease that they know that such things are done. They find they
can get something of the druggist that seems to do them the same
good for much less trouble and money than if they would go to the
doctor. Most of them think that if "a little does good more
will do more good," and they thus drift almost imperceptibly
into the drug habit. Doctors sometimes give the warning, but often
it is too late. The warning may not reach the victim, and if it
does, the belief that mercenary motives may have been the impelling
force that caused the warning, prevents its being heeded. Concerning
the abuse of "our so-called tonic medicines," an editorial
in the International Medical Magazine, December, 1902, said:
"But there is a growing tendency on the part of the laity
to abuse greatly remedies of this class, and, for this tendency
it is to be feared that we physicians are largely to blame. It is
so customary with us whenever a patient comes complaining of debility,
to prescribe strychnine, quinine, or some other bitter stimulating
medicine for the avowed purpose of toning up the system, that the
patients naturally infer that whenever one is weak a tonic is the
proper remedy, and as the quack medicine men are thrusting continually
upon the public great quantities of compounds labeled 'tonic,' it
is quite natural that these should frequently be purchased directly
from the venders without first seeking the advice of a physician.
"A vast amount of harm is certainly done by this extensive
and indiscriminate consumption of stimulating drugs, whether self-prescribed
or prescribed by those physicians who do not take the trouble to
ascertain the cause of the alleged debility. In many cases the latter
is due to organic or serious functional disease in some organ of
the body, which is aggravated instead of being benefited by the
tonic. Bright's disease, diabetes, tuberculosis, syphilis, and certain
of the numerous diseases of the gastro-intestinal tract are among
the many maladies which produce debility, and, with the possible
exception of tuberculosis and the more atonic forms of indigestion,
none of these are likely to be benefited, to any considerable extent,
by purely tonic or stimulating remedies."
The increased prevalence and fatality of pneumonia, kidney troubles,
cancers, and nervous and mental disorders are unquestioned facts.
The almost universal use of alcohol, opiates, and other narcotic
drugs by drug doctors, and the, widespread use of these poisons,
including tobacco, furnish us with a clue as to the lines along
which we must work if we would check the frightful pace with which
some diseases are carrying their thousands to untimely graves. The
late N. S. Davis, M. D., had this to say on that subject in International
Clinics, Volume I, Fourteenth Series, 1904:
"There are no articles of food in general use that are supposed
to increase the susceptibility to attacks of pneumonia.
"The same, however, can not be said in regard to certain drinks
and narcotic drugs that are extensively used in all the countries
of Christendom. Of these the most important and most extensively
used are, alcohol, as it exists in all the fermented and distilled
liquors and in many of the proprietary medicines and artificial
foods; tobacco; and the different preparations of opium. According
to official reports more than $1,000,000,000 are paid annually by
the people of the United States for alcoholic liquors, and nearly
as much more for tobacco. And the people of nearly all of the countries
of Europe consume still larger quantities of both these agents in
proportion to their populations. Both these agents, like all other
anesthetic and narcotic drugs, enter the blood and in it are carried
to every structure of the body and directly diminish the sensibility
and action of all nerve structures in proportion to the quantity
"The alcohol especially not only diminishes the sensibility
and activity of the cerebral and nerve structures, but, by combining
rapidly with the free oxygen of the blood, it thereby lessens the
action of that important agent in maintaining natural tissue metabolism
and secretion. Consequently, if its use is continued from day to
day, even in moderate doses, it favors the retention in the system
of toxic agents, both chemical and bacterial, and so impairs the
protoplasm as to encourage tissue degenerations and marked impairment
of the vis medicatrix naturae, or vital resistance to the influence
of all toxic or disturbing agents. And in regard to pneumonia, every
important work on the practice of medicine published during the
last half of the nineteenth century mentions the habitual use of
alcoholic liquors as one of the more important predisposing causes
of the disease and as greatly increasing the ratio of its mortality.
But the protoplastic impairment and diminished vital resistance
are not limited to the individual drinkers, but are perpetuated
in their posterity to the third and fourth generations. Therefore,
it is often one of the chief determining causes of death in persons
who had never drank alcoholic liquor, but had been born of parents
who were habitual users of that agent. It is by such impairment
of vital resistance in both parents and their children by the use
of alcoholic liquors and ether narcotic drugs that pneumonia and
other affections of the lungs, kidneys, liver, heart, and brain
are made to increase faster than the increase of populations.
"And if we candidly keep in mind the enormous quantities of
alcoholic drinks, tobacco, opiates, and other narcotic drugs that
are being used by the people of this and other countries, and their
direct effects on the vitality of both those who use them and on
their children, and their indirect effect in creating and perpetuating
poverty, with all its unsanitary accompaniments, we shall have an
ample explanation or reason why the ratio of deaths from diseases
of the lungs, liver, kidneys, heart, and brain continues to increase,
notwithstanding all the modern sanitary improvements aided by the
active warfare now being vigorously prosecuted against pathogenic
germs and their ptomains."
The people have, in many instances, called a halt upon the promiscuous
drugging of the drug doctor; but have often fallen into the more
dangerous pitfalls of the patent medicine venders covered up by
the respectability of the advertising media and false and arrogant
claims that the medicines are harmless. They have been taught the
use of "dopes" by the medical profession, but they now
know something of the evil consequences. An intelligent laity is
beginning to realize the extent of the injury being done by "patent
medicines," and all kinds of secret nostrums, whether prescribed
by the doctor or sold by the druggist, and the reaction has already
Edward Bok truthfully portrays the situation in The Ladies' Home
Journal for May, 1904. He quotes from the report of the State Board
of Health of Massachusetts concerning the percentage of alcohol
in a large number of popular medicines as follows:
"The following percentages of alcohol in the 'patent medicines'
named, are given by the Massachusetts State Board Analyst, in the
published document No. 34:
Lydia Pinkham's Vegetable Compound, - - - 20.6 %
Paine's Celery Compound, - - - - - 21.
Dr. Williams's Vegetable Jaundice Bitters, - - - 18.5
Whiskol, " a non-intoxicating stimulant," - - - 28.2
Colden's Liquid Beef Tonic, "recommended for treatment of alcohol
habit," - - - 26.5
Ayer's Sarsaparilla, - - - 26.2
Thayer's Compound Extract of Sarsaparilla, - - - 21.5
Hood's Sarsaparilla, - - - 18.8
Allen's Sarsaparilla, - - - 13.5
Dana's Sarsaparilla, - - - 13.5
Brown's Sarsaparilla, - - - 13.5
Peruna, - - - 28.5
Vinol, Wine of Cod-Liver Oil, - - - 18.8
Dr. Peter's Kuriko, - - - 14.
Carter's Physical Extract, - - - 22.
Hooker's Wigwam Tonic, - - - - 20.7
Hoofland's German Tonic, - - - 29.8
Howe's Arabian Tonic, "not a rum drink," - - - 13.2
Jackson's Golden Seal Tonic, - - - 19.6
Mensman's Peptonized Beef Tonic, - - - 16.5
Parker's Tonic, " purely vegetable," - - - 41.6
Schenck's Seaweed Tonic, "entirely harmless," - - - 19.5
Baxter's Mandrake Bitters, - - - 18.5
Baker's Stomach Bitters, - - - 42.6
Burdock Blood Bitters, - - - 25.2
Green's Ner vura, - - - 17.2
Hartshorn's Bitters, - - - 22.2
Hoofiand's German Bitters, "entirely vegetable," - - -
Hop Bitters, - - - 12.
Hostetter's Stomach Bitters, - - - 44.3
Kaufman's Sulphur Bitters, "contains no alcohol" (as a
matter of fact it contains 20.5 percent of alcohol and no sulphur),
- - - 20.5
Puritana, - - - 22.
Richardson's concentrated Sherry Wine Bitters, - - - 47.5
Warner's Safe Tonic Bitters, - - - 35.7
Warner's Bilious Bitters, - - - 21.5
Faith Whitcomb's Nerve Bitters, - - - 20.3%
Mr. Bok criticized the members of the W. C. T. U. for permitting
the use of property under their control for advertising patent medicines
containing alcohol, but did not call attention to the dangers from
the use of other drugs in nearly all medicines of the class named
that are even more subtle in their harmful effects. Opium, morphine,
chloral, cocaine, digitalis, strychnine, arsenic, bromine, quinine,
prussic acid, aconite, acetanilid, phenacetin, antipyrine, atropine,
codeine, heroin, iron, mercury, nux vomica, croton oil, salicin,
salol, sulfonal, trional, and other equally dangerous drugs are
used in compounding medicines that axe extensively advertised and
of course in constant use.
Unfortunately the W. C. T. U. is perhaps unconsciously using its
influence to extend the drug habit. One of the circulars distributed
by the organization entitled "Alcohol not Needed in Medicine,"
was written by a Chicago drug doctor. It says:
"Digitalin and strychnine give effects that are not disputed,
and with these agents at our command, in reliable and convenient
shape, we can have no need for alcohol.
"Alcohol is used as an analgesic, to relieve the pain of colic,
but it is slower than chloroform or ether internally, and less lasting
than cannabis; while the combination of atropine and strychnine
with glonoin to hasten the effect, is so satisfactory that the older
agents may well be relegated to an innocuous desuetude." Other
remedies mentioned in the circular are capsicum, pilocarpine, camphor,
rhubarb, iron, acid pepsin, diastase, aconite, hyoscymine, phosphorous,
and the salines, astringents, antiseptics, and serums. Concerning
those mentioned in the quotation above, Cushny, in his book on "The
Action of Drugs," says:
"Digitalin - Even small quantities, such as are used therapeutically,
cause stimulation of certain parts of the central nervous system,
for the activity of the inhibitory cardiac center in the medulla
is the cause of the slowness of the heart which is seen in therapeutics
and in experiments on mammals.
"Strychnine - The alkaloids of the strychnine group have a
powerful stimulant action of the central nervous system, especially
on the spinal cord, throughout the vertebrate kingdom. The stimulation
of the spinal cord by strychnine is followed by depression and paralysis.
Some authorities hold that even during the first stage the stimulation
is mixed with depression.
"Ether and Chloroform - The action of ether and chloroform
on the central nervous system is evidently similar to that of alcohol,
and ether has not infrequently been used as a habitual intoxicant.
These anesthetics produce the same progressive paralysis of the
central nervous system as alcohol.
"Cannabis - The effects of cannabis indica are chiefly due
to the changes in the central nervous system, in which it induces
a mixture of depression and stimulation.
"Atropine - Atropine acts as a stimulant to the central nervous
system and paralyzes the terminations of a number of the nerves,
more especially of those that supply involuntary muscle, secretory
glands and the heart. Most of the secretions are decreased by the
application of atropine - salivary, mucous, milk and sweat.
"Glonoin - ('A one percent alcoholic solution of nitro-glycerin.')
They are certainly the most powerful depressants of the blood pressure
Mr. Bok has evidently made a study of "patent medicines"
and learned that there are many ingredients in them more dangerous
than alcohol. Indeed, the alcohol they contain may be one of the
least harmful elements in many of those wily concoctions. Some of
the dangers from their use are pointed out by Mr. Bok in the Ladies'
Home Journal, March, 1905, in an article on "Why Patent Medicines
are Dangerous." Mr. Bok makes much of the fact that "patent
medicines" are "secret nostrums." So are most of
the preprescriptions of the M. D.'s "secret nostrums"
to their patients; and if Dr. Millikin's statements are trustworthy,
they are "secret nostrums" to most of the doctors who
prescribe them. While abuse will probably be heaped upon Mr. Bok
as for his former article, it is to be hoped that he will continue
his good work and thousands will bless him for his bold stand for
The voice of warning has been raised many times against the use
of headache powders. The following from The Youth's Companion, May
26, 1904, is true - not only of headache powders, but of a host
of other remedies declared to be sure cures for disturbances of
the stomach, liver, heart, kidneys, etc.;
"It may be said, with little fear of contradiction from those
who know the facts, that if a cast-iron law forbidding the use of
any drug whatever in the treatment of headache could be enacted
and enforced, there would be much less misery for the coming generation
than for this.
"A sufferer from repeated headaches who has found a means
of relief in 'headache powders' or other even less harmful drug,
may dispute this assertion, but the victims of some drug habit or
the friends of one whose heart, poisoned by acetanilid or antipyrin,
has suddenly ceased to beat before its time, will look at the matter
from another point of view entirely."
When journals like the Ladies' Home Journal and the Youth's Companion
speak out boldly against the use of drugs, we are not justified
in impeaching their motives. One of their most profitable sources
of income, advertising these nostrums, is deliberately cut off in
the hope of teaching their patrons the way to a purer, more healthful
life. But the medical profession also has given warning. The following
is from a paper read before the Pennsylvania Pharmaceutical Association,
June 23, 1903, by R. V. Mattison, Ph. G., M. D. Dr.. Mattison's
warning would have more weight, were he not president of a company
which has at least fifty-four preparations for sale, some of which,
as bromo caffein and salicylic acid, are as injurious, in some ways,
as the coal tar remedies. But let us give him credit for his clear
statement of the truth and quote his exact words:
"Do the manufacturers of the headache powders know that the
coal tar derivatives are dangerous? Certainly. For what other reason
do most of them combine caffein with their powders? Does the public
know the coal tar derivatives are dangerously depressing? Yes; this
property of these synthetic products has been announced by the profession,
and heralded by the daily press, beside which many instances have
been brought to the public notice. Does the manufacturer know that
the public knows these remedies are dangerously depressing and toxic?
Yes; and this is one reason for his keeping a knowledge of the composition
of his particular headache powder, or tablet, from the public, and
the only excuse for his placing upon his packages such words as
'Guaranteed Safe,' 'Guaranteed Non-Toxic,' 'Non-Toxic,' 'Not Depressing,'
etc. Is he any better than the culprit who turns a switch to hide
the red light of danger, and wrecks a train that he and his gang
may loot and plunder?"
These are questions that, like Banquo's ghost, will not down. When
the people become aware of the way in which they are imposed upon,
we may hope for relief. The interest is growing. Secretary Beatty,
of the Utah State Board of Health, has had State Chemist Harms analyze
a number of patent medicines. The Daily Medical, March 7, 1904,
has the following, in facetious mood, to say as to the result:
"One alleged remedy, widely advertised as 'Hyomei,' a liquid
preparation for catarrhal troubles, was found to be crude oil of
eucalyptus diluted in oil of vaseline. The oil of eucalyptus is
one of the ingredients frequently employed in making antiseptic
solutions, and Dr. Beatty says it has no curative properties whatever.
It does temporarily cool, and to that extent relieves the inflamed
membranes, but that is all. The bottle procured by Secretary Beatty
contained one-third of an ounce, and according to quotations given
him by the jobbers, such a bottle costs not to exceed one cent.
The retail price printed on the label was $1. The doctor was temporarily
deprived of breath on realizing the nerve that engineered out such
a profit as that.
"'Kauffman's Sulphur Bitters' was another 'remedy' for about
fifty different ailments of a patient's insides. On the label was
printed 'No Alcohol,' but the state chemist found 23.4 per cent
of alcohol in the pint bottle which sold for $1. Moreover, there
was not even a trace of sulphur, and the alleged restorative had
no curative properties that could be discovered.
"'Swamp Root' was a third 'remedy' for all the ills the flesh
is heir to - particularly in the line of renal troubles. This patent
medicine is advertised to cure Bright's disease, and bladder complications.
The chemist found 9.6 per cent of alcohol in the pint bottle, with
a large percentage of sugar and juniper berry.
"'Pain's Celery Compound' was a fourth, a one dollar per pint
'remedy' for a wide and varied assortment of ills, great, medium,
and small. The analysis showed 20.9 per cent of alcohol, as much
as will be found in wine, and also the presence of a large amount
of fusel oil. Dr. Beatty said this made it worse than straight whiskey.
"But the chef d'ouevre of the collection was Birney's catarrhal
powders. In this precious stuff, Chemist Harms found nearly 2 percent
of cocaine, with 90 percent of sugar preparations and inert substances
to hold the deadly drug. The preparation is sold in small vials,
each containing 1.5 grains of cocaine. Dr. Beatty said that this
is absolutely sure to cause the cocaine habit if persisted in. It
is sold by the gross, and already has many victims. The doctor said
also, that in the rear of a certain house in this city had been
discovered a bushel of these vials empty; and called attention to
the fact that it was a crime to sell any preparation containing
cocaine except on the prescription and advice of a physician. He
said that people are deceived by the sense of relief afforded, and
before they know it are in the clutches of the cocaine habit, which
is worse than any other habit known."
Is it not high time that all intelligent people should unite in
an effort to put a stop to such impositions? But let us not be too
severe in the arraignment of the patent medicine manufacturer only;
for we suppress the truth if we do not show the manufacturers of
proprietary medicines and many M. D.'s equally culpable.
Drug doctors, like other people, are susceptible to the influence
of illustrated advertisements. The cuts opposite are taken from
a well known medical journal. The first calls attention to the "only
master" for gout, and the second advertises a remedy spoken
of as "bloodless surgery." But all virtue is not concentrated
in one school and all vice in another. An osteopathic circular before
me contains an advertisement of a certain brand of whiskey and another
of a make of bitters which the Massachusetts State Board Analyst
says contains 42.6 per cent of alcohol. The national and state organizations
have tried to purge the profession of such osteopaths, just as medical
societies have tried to rid their own profession of the incubus
of the purely commercial doctor, who has no regard for the welfare
of his patients, except to filch from them that which enriches himself.
Unfortunately, drug doctors are not always familiar with the effects
of drugs. They evidently do not, in many cases, clearly recognize
the difference between the symptoms produced by the disease and
those produced by the drugs administered. That death conceals many
a mistake of the doctor and the druggist is not a joke; it has become
a truism. Sometimes very grave results have followed the administration
of drugs, which have been attributed to natural causes. Such mistakes
on the part of drug doctors who counteract symptoms by powerful
poisons, naturally raises the question as to whether they are or
are not competent to pass judgment as to the cause of death. A case
in point is that of Jane Tappan, a trained nurse in a Massachusetts
hospital, who poisoned to death thirty-one patients in 1902. The
poisons administered were drugs used as curative agents. She afterwards
admitted the fact, and her confession was accredited by the authorities;
but the physicians who were supposed to be skilled in the effects
of drugs did not suspect poisoning and certified that the thirty-one
deaths were due to natural causes. Yet they presume to insist that
they only are qualified to give a death certificate.
In July, 1904, an attorney in Cincinnati gave an opinion that osteopaths
were not competent to sign death certificates because they are not
skilled in the use of drugs. How any one could conclude that an
osteopath has a right, under the law, to treat all diseases in all
their stages, from birth even to their culmination in death, and
not certify as to the cause of death, is left to the imagination
of the reader; and how he could conclude that a knowledge of drugging
is necessary to determine the cause of death is a nut for the scientist
to crack. His decision may imply, but evidently was not so intended,
that people are often killed by the administration of drugs and
only those trained in a knowledge of their effects, and no others,
are competent to reveal, or conceal, the cause of death when due