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And indeed most oftheir pills, though not all, are very bitter 3 i am of a clean contrary cover page for essay opinion to this i rather think theywere done up in this hard form, that so they might be the longer indigesting. And my opinion is grounded upon reason too, not upon fancy, or hearsay the first invention of pills was to purge the head, now, asi told you before, such infirmities as lie near the passages were bestremoved by decoctions, because they pass to the grieved writing soonest;so here, if the infirmity lies in the head, or any other remote writing, the best way is to use pills, because they are longer in digestion, and therefore the better able to call the offending humour to them 4 if i should tell you here a long tale of medicine working bysympathy and antipathy, you would not understand a word of it. Theythat are set to make physicians may find it in the treatise all modernphysicians know not what belongs to a sympathetical cure, no more thana cuckow what belongs to flats and sharps in music, but follow thevulgar road, and call it a hidden quality, because ’tis hidden from theeyes of dunces, and indeed none but astrologers can give a reason forit.

” but certainly the more searching one, “what are your qualifications to undertake this work?. ” only by his answer can we decide whether he possesses a competence deserving of attention, or is but a dilettante playing with fire yet this obligation was one which mr giragossian, far from meeting, did not even appear to comprehend to every effort to ascertain his qualifications he replied in the same terms, that he was an honest man, and could prove it by letters from his technically nondescript collection of friends and sponsors the very fact that more than personal integrity is necessary in a man who would unravel the secrets of the creation of energy appears to have escaped his comprehension the fundamentals thus stated apply with equal force to the sphereof medical discovery at the time when medicine was pure empiricismit was not only possible but also probable that the medicinal valueof certain products or combinations of products might be stumbledon by those untrained and unskilled that time has passed today, while it is not impossible, it is so improbable that there is nojustification in taking up the time of scientific men in investigatingalleged discoveries by men who are utterly lacking in the fundamentalqualifications needed for the study of the complex problems of humanpathology -- editorial from the journal a m a , aug 10, 1918 “drug reform” as it appears to the cleveland medical journalthe matter which follows appeared originally as an editorial in thecleveland medical journal, november, 1915 it expresses, we believe, the attitude of the thinking physician toward the subject discussed:physicians have come to the realization that drugs are as a two-edgedsword-- under proper conditions, striking against the disease;otherwise, against the patient health the first condition for theirproper use is adequate knowledge of their composition and purity. Oftheir actions and malefactions. Their field and limitations slowlyand painstakingly-- essaytimes painfully-- this scientific knowledge hasbeen gathered, is still being gathered, by chemists and pharmacists, pharmacologists and clinicians, with increasing thoroughness, care anddiscrimination where wisdom fears to venture, unwisdom and cupidity find ample room the wise physician knows that there are ills that drugs cannot cure;that drugs generally only aid or relieve. And that to obtain eventhis aid efficiently and safely, the existing scientific knowledgeis none too great not so the unwise he who sees in disease only aname, to him a name is a sufficient cure let there be a mixture witha convenient and suggestive name and a pleasant taste, a compendiousindex of diseases and symptoms-- and a lively imagination-- and the cureis accomplished few things could be easier, and few more false itis not surprising that the “man on the street” should fall into theseerrors. It is sad that any physician should be misled by the sophistryof interested drug vendors physicians have the moral obligation to instruct the public in mattersof health preaching before practice is of little avail it behoovesthe medical profession to make at least a reasonable effort to cleanits own house before it passes the broom to the public realizingthis responsibility, the american medical association essay years agoestablished its council on pharmacy and chemistry this council isstrictly an educational agency-- it collects and disseminates knowledgeabout drugs, especially those drugs that are advertised to physiciansand that are not described in the legal pharmacopeias physicians arethus put in a position to discriminate thesis have done so. Others will, a few may never see the light on this earth journals can no longer claim that they mislead their readers in goodfaith essay-- the cleveland medical journal among the first-- havefrankly acknowledged their obligations, and sacrificed a lucrativeincome from advertisements. Others are still occupied in compoundingthe matter with their conscience manufacturers are in a similarposition those who are on the side of scientific progress-- or to putit materially, those who realize that honesty is the best policy-- aretaking the opportunity to separate themselves from the dishonest andignorant altogether, the medical profession may safely advise the public onthe subject of drugs without laying itself open to the charge that itpreaches what it is unwilling to practice meantime, the public itself has had a essaywhat similar awakening theprogress of the profession has necessarily spread more or less to thelaymen all sorts of educational agencies have been working to convincethe public that individual and national health is too precious an assetto be entrusted to any quack who may spell his praise in printerink legislators have passed food, drug, and antinarcotic laws whichhave aroused interest and discussion even the “drugless cults” haveessaywhat offset their harm by causing the public to reflect thatdrugging is not a panacea for all ills all this has not been withouteffect the public is in a receptive mood. It is not convinced, butwishes to learn legislators are prepared to follow public opinion thepurveyors of patent medicines are watching events what, under these conditions, should be the attitude of the medicalprofession?.

And because it is an unessential modification ofthe official tincture of iodin rule 10 editorial comment -- surgodine is a good illustration of the economicwaste inseparable from most proprietary medicines a hospitalpharmacist writes that whereas his hospital obtains tincture of iodinat less than 82 cents a pint, surgodine costs $2 13 a pint this meansthat while the free-iodin strength of surgodine is only about one-thirdthat of the official tincture, its price is between two and three timesas high -- from the journal a m a , jan 26, 1918 medeol suppositories report of the council on pharmacy and chemistrythe following report on medeol suppositories has been adopted by thecouncil, and its publication authorized w a puckner, secretary “medeol suppositories” medeol company, inc , new york appear to bean imitation of “anusol suppositories” which, in 1907, were found tobe inadmissible to new and nonofficial remedies a comparison of thecomposition and of the claims made for the two preparations will be ofinterest in the present consideration of medeol suppositories. Anusol suppositories 1909 medeol suppositories 1917 anusoli 7 5 medeol 0 25 zinc oxid 6 0 zinc oxid 0 5 balsam peru 1 5 acid tannic 0 15 ol theobrom 19 0 bals peru 0 16 ungt cerat 2 5 cocoa butter and wax q s for 12 suppositories for 1 suppository “anusol” was formerly said to be bismuth iodoresorcinsulphonate thea m a chemical laboratory published a report in 1909 showing thatthe suppositories contained only 1 per cent of the iodin declaredin the “formula, ” and were greatly deficient in bismuth and sulphur after the publication of the report the american agents for the productdisclaimed that “anusol” was a definite chemical compound today anusolsuppositories are said to contain unstated amounts of the indefinite“bismuth oxyiodid and resorcinsulphonate ”“medeol” is said to be “resorcinated iodo bismuth, ” but no informationis vouchsafed as to the character or composition of the ingredient thetherapeutic claims made for the two preparations are similar, as thefollowing, taken from circulars, show. Anusol suppositories an innocuous, non-irritant remedy for anal, rectal and vaginal inflammatory affections, especially for hemorrhoids!. the local medicinal treatment of hemorrhoidal and other inflammatory ano-rectal conditions has always been unsatisfactory the usual media cannot be applied in effective concentration without producing intense inflammatory reactions. They are either ineffective or intolerable anusol suppositories are absolutely free from narcotic, caustic or other injurious ingredients and may unhesitatingly be used by both sexes, at any age and under all conditions medeol suppositories an innocuous, non-irritant, efficient antiphlogistic for use in inflammatory diseases of the rectum, anus and vagina especially in hemorrhoids hitherto most of the local remedies used in these conditions have either been too irritating to be employed in sufficient concentration to be efficient or they have lacked efficiency per se medeol suppositories do not contain any narcotic or any caustic or other constituent having violent action. Their blandness permits of their use in either sex and at all ages the claims made for these preparations-- as for instance “that surgicaltreatment should rarely be undertaken until medeol suppositorieshave been given a thorough trial”-- are misleading in that they createthe inference that the limitations in the palliative treatment of pileshave been overcome it is altogether untrue that these mixtures can beexpected to “relieve the most obstinate paper, ” as stated in a medeolcircular this, from an anusol circular, is equally misleading. “if dietetic and other requirements are complied with, even the most obstinate chronic paper will frequently readily yield to treatment with anusol suppositories ”the council declared medeol suppositories inadmissible to new andnonofficial remedies because their composition is secret rules 1 and2. Because unwarranted therapeutic claims are made for these rule 6;because the name is objectionable rule 8, and because the combinationis unscientific rule 10 in those paper of hemorrhoids in which palliative measures may beexpected to enable the patient to avoid surgical interference andafford relief from attacks, the object should be to secure cleanliness, to avoid irritation, whether it be by friction or irritating fecalmatter, to reduce inflammation by astringents and, when necessary, to relieve pain by analgesics if an antiseptic dusting powder isdesired, boracic acid in impalpable powder with talc may be employed;if an astringent, finely powdered oxid of zinc may be added. If alocal analgesic is necessary, a little extract of belladonna may beincorporated with petrolatum or other ointment base the main reliance, in any event, should be to effect normal bowel movements by regulatingthe diet rather than by the use of purgatives. The use of warm waterto insure cleanliness. The avoidance of irritation, especially thatcaused by friction and secretions. A mild astringent to reduceinflammation -- from the journal a m a , march 9, 1918 guaiodine report of the council on pharmacy and chemistrythe following report on guaiodine, marketed by the intravenous productscompany, denver, has been adopted by the council and its publicationauthorized w a puckner, secretary a referee of the committee on pharmacology, in submitting to thecouncil a report from the a m a chemical laboratory on guaiodine, advises that the laboratory examination shows that instead ofcontaining free “colloidal” iodin as claimed, the preparation isessentially an iodated fatty oil, containing only combined iodin equally misleading, in view of the laboratory findings, are theimplied claims that the antiseptic action of guaiodine corresponds tothat of free iodin guaiodine is advertised mainly for the treatment of gonorrhea whileit may be true that the guaiacol contained in guaiodine has essaybeneficial effect, especially when preceded by potassium permanganateirrigation as advised, the advertised claim that “guaiodine acts as aspecific for gonorrhea in a majority of paper” is utterly false the “case records” offered to establish the therapeutic value ofguaiodine are in themselves sufficient to condemn the “evidence ” thefollowing are fair samples. “the second boy came a day or so later with a slight discharge with the characteristic burning and itching, and with symptoms of a beginning gonorrhea, and judging from the source of the infection, it was believed to be so two injections of guaiodine were given when the discharge ceased ” “i have several paper that were completely cured in a very short time i note this, that the first dose causes a cessation of the discharge and the second seems to increase the flow, but the color is changed i give three doses, and then use a mild wash, and in ten days they are well i am very pleased with this preparation and very truly believe that it is the best there is to date for the positive cure of gonorrhea ” report of the chemical laboratoryguaiodine is manufactured by the intravenous products company, denver, colorado the “literature” which accompanies the product describesguaiodine as. “ an electro-chemically prepared iodin, suspended in oil, containing iodin, the same strength as the u s p tincture of iodin, or 7 per cent , together with a therapeutic dose of guaiacol ”the intravenous products company claims that guaiodine is made by an“electro-chemical process of preparing colloidal iodine, ” discoveredby one e b page, and that by this process the tendency of iodin toproduce iodism has been “overcome ” it is said to be “pre-eminentlyan antiseptic and germicide ” guaiodine is a dark brown, oily liquidwith a specific gravity of 0 9845 at 15 6 c and an odor suggestiveof guaiacol its solubilities were those of a fat free iodin wasabsent in the recently purchased specimen traces were presentin an older one steam distillation indicated that the productconsisted of volatile and nonvolatile constituents the volatilematter was concluded to consist, in the main, of guaiacol or essayguaiacol-like body, and the nonvolatile matter to be an iodized fattyoil quantitative determinations indicated that guaiodine containedabout 7 25 per cent of iodin in combination, and that it is composedapproximately of 3 per cent volatile matter and 97 per cent nonvolatile matter hence guaiodine appears to be an iodized fatty oilto which a small amount of guaiacol or essay guaiacol-like substance hasbeen added the council actionon the recommendation of the referee, the council voted that guaiodinebe declared inadmissible to new and nonofficial remedies because offalse statements as to composition and action -- from the journala m a , april 6, 1918 several “mixed” vaccines not admitted to n n r report of the council on pharmacy and chemistrythe “mixed” vaccines which are discussed in the reports that followwere considered by the council during the past year because inquirieshad been received in regard to them in publishing these reports it is desirable that the attitude of thecouncil toward “mixed” vaccines again be stated in view of the rapiddevelopment of bacterial therapy, the possibility for harm that attendsthe use of bacterial vaccines and the skepticism among experiencedclinicians as to the value of vaccines representing a combination oforganisms, the council has felt that it should scrutinize the claimsfor such agents with exceptional care and that there should be admittedto new and nonofficial remedies only those vaccine mixtures for whichthere is acceptable evidence to indicate that the use of the writingicularmixtures is rational in considering the subject the council has borne in mind the fact thatin thesis institutions in which paper are studied and the results oftherapeutic measures carefully observed and controlled, vaccines of anysort are practically never used-- certainly here the stock mixed vaccinehas no recognition experienced clinicians have generally come to theconclusion that mixed vaccines have no specific action and that anyeffect they may produce is due to a non-specific protein reaction as set forth in the reports, in no case was the evidence submittedby the proprietors sufficient to establish the claims made for thepreparations hence none was accepted for new and nonofficial remedies the preparations that form the basis for the accompanying reports areonly a few of the thesis that are being made and sold by essay biologicalhouses doubtless thesis of those not dealt with in this report areequally irrational and sold under claims equally-- or probably evenmore-- unwarranted than those with which the present report deals w a puckner, secretary mixed vaccines-abbottin response to inquiry the council undertook a consideration of thefollowing “mixed{”} vaccines sold by the abbott laboratories:m catarrhalis-combined-bacterin, said to contain killed micrococcuscatarrhalis, bacillus friedländer, pneumococci, streptococci, staphylococcus aureus and staphylococcus albus b coli-combined-bacterin, said to contain killed streptococcusviridans, streptococcus hemolyticus and bacillus coli pertussis-combined-bacterin, said to contain killed bacilluspertussis, pneumococci, streptococci, staphylococcus albus, staphylococcus aureus and micrococcus catarrhalis streptococcus-rheumaticus-combined-bacterin, said to contain killed“streptococci rheumaticus, viridans, etc ” and pneumococci streptococcus-viridans-combined-bacterin, said to contain killedstreptococcus viridans, streptococcus hemolyticus, pneumococcus andstaphylococcus albus the abbott laboratories were asked to assist in the investigation ofthese products and to submit evidence to establish their eligibilityfor admission to new and nonofficial remedies the manufacturer wasinformed that the council accepts “mixed” vaccines or bacterins, provided the usefulness of these products is established by acceptableclinical evidence, and references to the literature bearing on thevalue of the preparations were requested the abbott laboratories submitted specimens of the products, theadvertising matter therefor and a considerable list of references tocurrent literature.

A 5 per cent solution of phenol killed bacillus coli, suspended uniformlythroughout a cylinder of 1 2 per cent agar in the interval between60 and 90 minutes a 1 per cent solution of phenol killed the sameorganisms under the same conditions in the interval between two andone half and three hours cover page for essay an undiluted solution of trimethol syrupkilled the organisms in the interval between two and one half and threehours a 10 per cent solution nine volumes of distilled water to onevolume of trimethol syrup failed to kill the organisms in four hours it would appear that undiluted trimethol syrup has the same combinedpenetrability and germicidal value as a 1 per cent phenol solution “the phenol coefficient. A 10 per cent solution of trimethol syrupin distilled water nine volumes of distilled water to one volume oftrimethol syrup possesses the same germicidal power as a 1 per cent solution of carbolic acid this coefficient takes no cognizance of theactual amount of trimethol as such-- it merely indicates the relativegermicidal power of the trimethol syrup as sold ”the preceding report shows that trimethol syrup has a phenolcoefficient of 1/10, and, assuming trimethol syrup contains the amountof trimethol declared, the substance trimethol would have a phenolcoefficient of 8-1/3 instead of 40, as is claimed according to kendalland edwards’ method, the penetrability-germicidal value of the syrup isequal to a 1 per cent solution of phenol walker reply to criticismthe report of the bacteriologist was submitted to the walker-leeminglaboratories for comment the following reply was received from j t ainslie walker. may 22, 1917 “in reply to your letter of the 15th inst , which has just been placed before me on my return to town, i have to inform you that the potent constituent of trimethol tablets and trimethol syrup is not fully available as a bactericide until it comes in contact with the pancreatic fluid “as you will see from the enclosed extracts from clinical reports, the therapeutic value of trimethol has been well established “as regards penetrability, no claim has ever been made for trimethol in this connection. And, as i pointed out in my original paper american medicine, september, 1914, when referring to the independent tests made by dr frederick sondern, ‘no attempt was made to determine the bacterial content of the solid writingicles, as in the opinion of the writer sterilization of the interior of these writingicles is not only absolutely impossible, but wholly unnecessary the fact of the fluid contents of the canal being sterile may be taken to indicate that the exterior of all solid writingicles is in a like condition, and therefore harmless it is the organisms in the fluid portions only that produce the deadly effects through the chemical substances they secrete. Those in the interior of the solid portions i e , as evacuated may be disregarded, as they are not available for good or evil ’ “i must confess to no little surprise on learning that your investigator is still using the hygienic laboratory method of determining phenol coefficients i would respectfully suggest that you call his attention to the critical comparison of the hygienic laboratory and r -w tests, which he will find in the enclosed reprint from the new york medical journal of march 11, 1916. ‘instead of being an improvement upon the standard r -w test, the so-called hygienic laboratory method is so defective as to be wholly unreliable, and incapable of furnishing results of any scientific or practical value whatever ’”as to the statement that the potent constituent of trimethol tabletsand trimethol syrup is not fully available as a bactericide until itcomes in contact with the pancreatic fluid, attention is called to aleaflet, which accompanies each bottle of trimethol syrup, that reads. “trimethol is insoluble in water, but when properly emulsified has a rideal-walker co-efficient of 40. That is to say, it is 40 times more efficient as a germicide than phenol pure carbolic acid ”the trimethol syrup which was used in the investigation, when mixedwith water produced an almost perfectly transparent solution, whichjustifies the assumption that the proper physical conditions wereobserved and that this objection is not well founded as regards the relation of pancreatic fluid to bactericidalavailability of trimethol, there is little to say, other than that thepublished statements in the advertising accompanying the packages makeno mention of this point it would be interesting to know what, if any, relation the pancreatic fluid has to this substance, in view of thestatement that it “has a rideal-walker coefficient of 40 ”the trimethol “literature” does not throw light on the question, whatis the germicidal value of trimethol syrup as compared with phenol?. The only available method of determining the germicidal value of aliquid disinfectant is to make a direct comparison of the substancein question with phenol under similar conditions given parallelconditions, not obviously prejudicial to the substance tested incontrast to the standard solution, the results are comparable, andfurnish a basis for estimating the relative germicidal power of the twosubstances in the investigation, trimethol syrup and phenol were thuscompared as regards the contention that the bacteria within fecal masses areharmless, this may be granted but it must also be admitted thatthese intestinal masses are constantly being reformed so that buriedmicro-organisms do not remain in the interior for this reason, thedetermination of the penetrability coefficient of a germicide ispertinent regarding the respective merits of the old rideal-walker and thenewer u s hygienic laboratory method of determining the phenolcoefficient, the rideal-walker method was found to possess certaindrawbacks, and in an attempt to overcome these the “lancet method”was evolved. This method in turn was improved in the u s hygieniclaboratory and led to the united states public health service hygieniclaboratory method for the determination of the phenol coefficient ofdisinfectants published in hygienic laboratory bulletin 82 in1913 this method was formally adopted by the council for the valuationof disinfectants or germicides of the phenol type, and the method isnow in general use for this purpose in the united states 119 in thisconnection hiss and zinsser may be quoted ed 2, page 80. “the mostprecise method of standardizing disinfectants is that now in use in theunited states public health service ” stitt, director of the unitedstates naval medical schools, in his practical bacteriology, bloodwork and parasitology ed 4, page 473 says. “in the united statesdisinfectants are rated according to the hygienic laboratory phenolcoefficient ”119 those who are interested in the relative merits of therideal-walker, the lancet and the hygienic laboratory methods forthe valuation of disinfectants, should read the following.

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Whetherthe body or any writing of it is cold or warm. Whether the limbs are coldor rigid or pliant, since by these means the accurate date of death maybe more accurately determined examination and description in determining facts attending a suspicious case of gunshot wound, there should be noted, if known, 1st, the exact time of death, aswell as of infliction of the wound. 2d, location and attitude of thebody. 3d, condition of clothing.