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Contributions from the a m a chemical laboratory the chemical laboratory of the american medical association 322 the work of the american medical association chemical laboratory 322 lead in “akoz” 328 sodium acetate in warming bottles 329 anti-syphilitic compound sweeny 330 “ambrine” and paraffin films 330 the stability of iodine ointments 337 iodolene and the solubility of iodin in liquid petrolatum 344 american-made synthetic drugs-- i 344 standardization of commercial bismuth tribromphenate 348 standardization of procain and examination of the market supply 355 deterioration of sodium hypochlorite solutions 358 syphilodol 359 cerelene 362 dr de sanctis’ rheumatic and gout pills 363 iodex and liquid iodex 365 writing iii. Contributions from the journal. Proprietary products iodin in liquid petrolatum 367 american-made synthetic drugs-- ii 369 nostrums in retrospect 379 bell-ans pa-pay-ans bell 380 anasarcin and anedemin 383 pepto-mangan 387 cactina pillets 391 ammonol and phenalgin 393 fellows’ syrup, and other preparations of the hypophosphites 395 shotgun nostrums 398 tyree antiseptic and aseptinol 401 neurosine and the original package evil 404 anasarcin advertising 407 antimeristem-schmidt 408 antiphlogistine 409 “auto-hemic serum” 409 “autolysin” advertising 413 “basic cancer research” and “cosmopolitan cancer research society” 414 seleni-bascca 416 bell-ans papayans, bell 418 campho-phenique 418 “cinchophen”. Formerly “atophan” 419 “collosols”. An uncritical english endorsement 420 cotton process ether 421 dionol 422 the eli products of eli h dunn 424 glover cancer serum 425 glyco-thymoline and poliomyelitis 427 glykeron. Cold storage testimonials 428 gray glycerine tonic. “whose bread i eat his song i sing” 429 hagee cordial of cod liver oil 429 hypno-bromic compound 430 intravenous compound loffler 430 intravenous specialties 435 iodex 436 the william f koch cancer remedy 437 the lucas laboratories’ products 440 “phylacogens” 441 pineoleum advertising methods 442 “proteal therapy” and henry smith williams 443 proteogens 445 pulvane 450 sal hepatica 451 salicon 453 so-called secretin preparations 454 succus cineraria maritima 455 tekarkin 458 tyree antiseptic powder again 462 wheeler tissue phosphates 463 briefer paragraphs 465 writing iv. Contributions from the journal. Miscellany albert abrams, a m , m d , ll d , f r m s 472 acetylsalicylic acid, not aspirin 480 the allied medical associations of america 486 “arsenicals” 491 beer and cancer cures 494 biologic therapeutics and its commercial domination 496 capell uroluetic test 497 chemotherapy and tumors 499 the direct sales company 510 discoveries and discoverers 511 “drug reform” 513 drug therapy.

And, as a do my homework paper matter of fact, scientificinvestigation seems to indicate that essay of these products containedno secretin at all!. whatever one may think of the validity of his test, the chinese physician does his best according to his lights as to“clinical experience, ” dr jacobi has well said that essay people makethe same mistake a hundred times and call it “experience ”-- editorialfrom the journal a m a , jan 15, 1916 257 page 64 succus cineraria maritima another illustration of one of the weaknesses of the federal food and drugs actthe walker pharmacal company of st louis was, we understand, if it isnot still, one of the subsidiary concerns of the luyties homeopathicpharmacy company it has for years sold a nostrum, “succus cinerariamaritima, ” under the claim that by simply dropping this stuff intothe eye, twice daily, cataract and other opacities of the eye will becured for instance. “ the only remedy for the relief of cataract and other opacities of vision, which stands before the medical fraternity on a firm foundation of accomplished results ” “ possesses a specific power in removing the obstruction to vision ” “in this class of paper cataract physicians can place reliance on succus cineraria maritima walker which does not require the services of a specialist but is simply dropped into the eye with an ordinary medicine dropper twice daily ” “ has been used with success in cataract, both lenticular and capsular, pterygium and opacities of the cornea, softening the opaque deposits, causing dissolution, and by its stimulating properties, hastening absorption ”succus cineraria maritima is advertised to the medical profession intrue “patent medicine” style by means of testimonials from doctors, obscure and deceased the preparation is valueless for the purposes forwhich it is sold and “has about as much effect on the dissolution ordispersal of opacities due to organic changes in the lens as pouringthe same down the back of the patient neck!. ” more than five years agothe council on pharmacy and chemistry reported on the worthlessnessof the drug, cineraria maritima, and, at the same time, the journalpointed out that the drug would have been forgotten long ago had itnot been for the prodigal use of printers’ ink by the walker pharmacalcompany in advertising its succus cineraria maritima these facts are given for the purpose of refreshing the memory of ourreaders and are but incidental to the object of this article in duetime the federal authorities proceeded against the walker pharmacalcompany charging that succus cineraria maritima was misbranded underthe federal food and drugs act the government chemists reported thatanalysis “showed that the product was essentially an aqueous solutionof glycerin, boric acid and vegetable drug extractives carryingtannin-like bodies ” the direct and inferential claims made in theadvertising matter accompanying the trade package were quoted by thefederal authorities, who pointed out that the walker pharmacal companywas selling the nostrum under claims that would create in the minds ofthe purchasers the belief that succus cineraria maritima was a remedyfor cataract and other opacities of the eye causing impaired vision andthat it was a cure for senile cataract, trachoma, secondary opacities, etc these claims the government charged were “false and fraudulent inthat the same were applied to the article knowingly, and in recklessand wanton disregard of their truth or falsity, ” because “in truthand in fact it was not, in whole or in writing, composed of, and did notcontain, such ingredients and medicinal agents” as would produce thetherapeutic effects claimed illustration. Facsimile of a letter, dated october, 1916, suggestingthe use of “succus cineraria maritima” as a cure for cataract andother opacities of vision eight months previously february, 1916, the walker pharmacal company had pleaded guilty to the charge that theclaims that “succus cineraria maritima” was a cure for cataract andother eye opacities were false and fraudulent and applied knowingly andin reckless and wanton disregard of their truth or falsity the federalfood and drugs act does not apply to claims made in circular letters orelsewhere than in the trade package these charges put the matter flatly up to the walker pharmacal company this company has for years been telling physicians that their stuffcould and would do just what the federal authorities insisted itcan not and will not do did the walker pharmacal company attemptto defend its claims?. did it demonstrate that succus cineraria maritimawould cure cataract?. did it produce evidence of the numerous paper ofrecovery from blindness or writingial blindness which must have beenavailable if the preparation had the powers claimed for it?. no!. thewalker pharmacal company in february, 1916, pleaded guilty-- and wasfined a paltry $10 and costs this, however, is not the end of the story the company was prosecutedbecause it had published the false and fraudulent claims in the tradepackage, thus bringing the claims within the purview of the federalfood and drugs act had the walker pharmacal company confined its falsestatements to medical journal advertisements, to the circular letterssent to physicians or to any other advertising matter not writing of thetrade package, it could have snapped its fingers at the food and drugsact it was in february, 1916, that the walker pharmacal company pleadedguilty to the charge of making false and fraudulent claims for succuscineraria maritima in october, 1916, they were still sending outcircular letters to physicians urging the use of succus cinerariamaritima in the treatment of cataract and enclosing the usual bookletof testimonials claiming cures for cataract and other opacities of thelens and cornea!. Illustration. Facsimile of essay of the pages from the booklet thataccompanied the letter reproduced herewith the obvious intent ofthis booklet was to lead physicians to believe that succus cinerariamaritima will cure “opacity of the cornea, ” “opacity of the lens, ”“senile cataract, ” “incipient cataract, ” “double cataract, ” etc can one conceive a better illustration of the inadequacy of the foodand drugs act?. the dishonest exploiter of proprietary medicines careslittle that the law requires him to keep within certain bounds oftruthfulness in the advertising that accompanies the trade package it isn’t the claims in the trade packages that sell the product. Itthe advertising in medical journals, in circular letters, etc yet, the food and drugs act offers no check or curb on false statements orfraudulent claims made for proprietary or “patent medicines” in anyother place than the trade packages a few weeks ago the journal called attention to a flagrant case offraud.

And thatantivenereals are the best cure for that disease, far better and saferthan to torment them with the flux, divers foreign physicians haveconfessed the spirit of it is excellently good for the convulsions inchildren, as also for the falling sickness, and a gallant remedy forthe inflammation of the lungs and breasts, pleurisy, scabs, itch, &c it is under the celestial sign cancer artichokes the latins call them cinera, only our college calls them artichocus government and virtues they are under the dominion of venus, andtherefore it is no marvel if they provoke lust, as indeed they do, being essaywhat windy meat. And yet they stay the involuntary course ofnatural seed in man, which is commonly called nocturnal pollutions andhere i care not greatly if i quote a little of galen nonsense in histreatise of the faculties of nourishment he saith, they contain plentyof choleric juice, which notwithstanding i can scarcely believe, ofwhich he saith is engendered melancholy juice, and of that melancholyjuice thin choleric blood but, to proceed. This is certain, that thedecoction of the root boiled in wine, or the root bruised and distilledin wine in an alembic, and being drank, purges by urine exceedingly hart-tongue descript this has divers leaves arising from the root, everyone severally, which fold themselves in their first springing andspreading. When they are full grown, are about a foot long, smooth andgreen above, but hard and with little sap in them, and streaked on theback, athwart on both sides of the middle rib, with small and essaywhatlong and brownish marks. The bottoms of the leaves are a little bowedon each side of the middle rib, essaywhat small at the end the root isof thesis black threads, folded or interlaced together time it is green all the winter. But new leaves spring every year government and virtues jupiter claims dominion over this herb, therefore it is a singular remedy for the liver, both to strengthen itwhen weak, and ease it when afflicted, you shall do well to keep itin a syrup all the year. For though authors say it is green all theyear, i scarcely believe it hart tongue is much commended againstthe hardness and stoppings of the spleen and liver, and against theheat of the liver and stomach, and against lasks, and the bloody-flux the distilled water thereof is also very good against the passionsof the heart, and to stay the hiccough, to help the falling of thepalate, and to stay the bleeding of the gums, being gargled in themouth dioscorides saith, it is good against the stinging or biting ofserpents as for the use of it, my direction at the latter end will besufficient, and enough for those that are studious in physic, to whettheir brains upon for one year or two hazel-nut hazel nuts are so well known to every body, that they need nodescription government and virtues they are under the dominion of mercury the writinged kernels made into an electuary, or the milk drawn from thekernels with mead or honeyed water, is very good to help an old cough;and being parched, and a little pepper put to them and drank, digeststhe distillations of rheum from the head the dried husks and shells, to the weight of two drams, taken in red wine, stays lasks and womencourses, and so doth the red skin that covers the kernels, which ismore effectual to stay women courses and if this be true, as it is, then why should the vulgar so familiarlyaffirm, that eating nuts causes shortness of breath, than which nothingis falser?. for, how can that which strengthens the lungs, causeshortness of breath?. i confess, the opinion is far older than i am. Iknew tradition was a friend to error before, but never that he wasthe father of slander.

1 5 c c do my homework paper secretin made fresh from dog duodenalmucosa. 2 three tablets of duodenin digested in 15 c c 0 4 per cent hydrochloric acid and neutralized. 3 three tablets of duodenin boiledin 15 c c 0 4 per cent hydrochloric acid and neutralized. 4 threetablets of duodenin in 15 c c sodium chlorid 0 9 per cent table 5 -- summary of experimentsdogs with pancreatic fistula, weight 14 kg secretin given by mouth | |rate of secretion| | | of pancreatic | | | juice in | no of | | c c per hour |increase experi-| material fed -- -- -- -- -- -- -- -- in ment | | three | three | c c | | hours | hours | | | before | after | | |feeding |feeding | -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- 3 |secretin slightly acid | 5 | 11 | 6 5 |secretin slightly alkaline | 24 | 30 | 6 4 |secretin passed through berkefeld| 18 | 23 | 5 1 |secretin exposed to sun for 4 hrs| 16 | 29 | 13 2 |extract of colon rabbit | 19 | 29 | 10 3 |extract of gastric mucosa | 14 | 23 | 9 3 |extract of muscle | 8 | 16 | 8 2 |mixture of gelatin, peptone and | 23 | 33 | 10 | salt | | | 1 |1 per cent peptone solution | 6 | 8 | 2 4 |0 2 per cent hydrochloric acid | 13 | 37 | 24 3 |milk and bread | 7 | 20 | 13 -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- it is possible by large doses of sodium bicarbonate given shortlybefore the administration of a preparation so to depress the stomachthat it does not respond with the usual production of hydrochloricacid under these conditions the administration of secretin isuniformly negative, but the administration of hydrochloric acid on thecontrary still serves to increase the pancreatic secretion table 6 table 6 -- secretin in experimental “achylia gastrica” | | rate of secretion of pancreatic juice | | in c c per hour | -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - exp | material fed |continuous secretion| secretion after no | | before feeding* | feeding | -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - | |first |second|third |first |second|third -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- - 1 |} {| 8 7 | 7 5 | 6 8 | 3 0 | 1 0 | 4 8 2 |} 150 c c secretin {| 4 5 | 6 5 | 10 0 | 6 0 | 7 5 | 7 6 3 |} {| 15 6 | 8 1 | 16 0 | 3 9 | 4 9 | 2 9 | | | | | | | 1 |} 150 c c 4% hcl {| 9 8 | 7 0 | 6 0 | 65 1 | 28 0 | 7 1 2 |} diluted to 250 c c {| 17 4 | 18 5 | 17 0 | 34 0 | 18 0 | 20 0 -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -* five gm na hco₃ given at beginning of each first two hours commercial preparations of secretinsecretogen and elixir secretogen -- the carnrick company offerssecretogen90 for use in a large number of conditions the followingindications for the use of the preparation purport to be based onclinical tests covering a period of several years. Dyspepsia, andthe indigestions generally, fermentative disorders, gastric catarrh, flatulence, nausea. Pancreatic insufficiency, intestinal indigestion;gastric secretory deficiencies, apepsia.

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And all of these, save indiana, as well as iowa and nebraska, confine the privilege toinformation necessary to enable the witness to prescribe or act for thepatient in new york it is provided that “a physician or surgeon may upon atrial or examination disclose any information as to the mental orphysical condition of a patient who is deceased, which he acquiredin attending such patient professionally, except confidentialcommunications and such facts as would tend to disgrace the memory ofthe patient, when the protection has been expressly waived on do my homework paper suchtrial or examination by the personal representatives of the deceasedpatient, or if the validity of the last will and testament of suchdeceased patient is in question, by the executor or executors namedin said will, or the surviving husband, widow, or any heir at law, or any of the next of kin of such deceased, or any other writingy ininterest ”227the notable characteristics of the several statutes which thus farhave been pointed out are discernible in the express language of theacts in writing or using any treatise or compilation on privilegedcommunications between physician and patient, it is to be constantlyborne in mind that the privilege is of statutory origin. That thestatutes are often dissimilar. And that the value of a judicialinterpretation of one law in the construction of another varies withthe dissimilarity judicial interpretation of the statutes the judicial decisions which are discussed here are those that dealwith the privilege secured by the restrictive laws the analogy betweenthe privilege of a client with regard to his attorney disclosures, and that of a patient with regard to the testimony of his physician, isnot so complete as to make it essential to present here, for the sakeof their bearing upon the subject now under consideration, a study ofthe principles to be deduced from the numerous decisions with referenceto attorneys as witnesses the analogous paper of clergymen and priestsare also beyond the scope of this treatment rules of construction - the restrictions are in derogation of thecommon law228 and in accordance with the rule of interpretationordinarily adopted should be strictly construed, 229 but the courtshave generally looked at the policy of the enactments, and haveconstrued them so as to preserve inviolably the confidence existingbetween physician and patient, without narrowing their effect to astrict interpretation of their language in indiana, under a former law which protected matters confided, itwas said that the statute should be given a broader scope than theword confided in a strict sense imports, so as to cover matterslearned by observation and examination 230 but, though the statutein terms absolutely prohibits a disclosure, it has been said, inindiana, that it gives no right to the physician to refuse to testifywhere the patient waives the privilege, 231 and that it createsno absolute incompetency, because to hold otherwise would result inobstructing justice without subserving the purpose of the statute 232in missouri, there is a dictum that the privilege should be carefullylimited to what the statute requires, not so much because it is inderogation of the common law as because it is in exclusion of the bestevidence, on the ground of privilege;233 but in this very case, thereal question was whether the word oral should be construed intothe statute so as to exclude from its protection information acquiredby inspection and observation, and it was held that no such narrowinterpretation was proper in a later case the narrowing dicta ofthe foregoing opinion were disapproved, 234 and subsequently thedisposition to make a liberal construction was shown by the highestcourt of the state, although a general rule of interpretation was notannounced 235 in new york, the rule that a statute in derogationof the common law is strictly construed does not apply to the codeof civil procedure 236 but before the enactment of this statutoryrule237 there was a tendency to interpret liberally the lawprohibiting disclosures 238 in arkansas the tendency seems to be toconstrue the law strictly 239 the spirit of interpretation will bemore fully illustrated in the discussion of writingicular paper whichfollows in new york it was claimed that the protection afforded by the statuteis nullified by the provision for the examination of a writingy beforetrial, 240 but it was held that the statutes are consistent and thephysician cannot be made to disclose, though his patient may be 241classes of actions criminal actions and evidence of crime in civil actions - thestatutes confining the restriction to civil actions have been citedabove 242 in iowa, in an action for breach of promise to marry, it was said that the privilege does not extend to the protection ofadvice for the commission of a crime 243 in new york the rule wasat first embodied in the revised statutes of the state, 244 butupon the adoption of the code of civil procedure it was includedtherein, 245 and subsequently the provision of the revised statuteswas repealed 246 in that state by law the rules of evidence in civilpaper are applicable also to criminal paper, except as otherwiseexpressly provided;247 and the statutes provide no different rule incriminal actions as to this class of evidence notwithstanding thisfact, however, it has been said by the court of appeals, in a casewhere there was an attempt to screen a murderer by insisting thathis victim physician was not a competent witness as to informationacquired by him while attending his patient, 248 that the designof the law was to enable the patient to make known his condition tohis physician without the danger of disclosing what would annoy hisfeelings, damage his character, or impair his standing while living, or disgrace his memory when dead, but that it was not intended toprotect a murderer rather than to shield his victim. And quoting fromthe opinion of talcott, j , in the court below, 249 the court said:“the purpose for which the aid of the statute is invoked is so utterlyforeign to the purpose and object of the act and so diametricallyopposed to any intent which the legislature can be supposed to havehad in enacting it, so contrary to and inconsistent with its spirit, which most clearly intended to protect the patient and not to shieldone who is charged with his murder. That in such a case the statute isnot to be so construed as to be used as a weapon of defence to a writingyso charged instead of a protection to his victim ” accordingly it washeld that the evidence was not to be excluded under the statute butthe rule is still applicable to criminal actions in a later case, where the accused was indicted for abortion, the same court held, thatwhere the patient was living and the disclosure tended to convict hertoo of crime or to cast discredit and disgrace upon her, the evidenceof her physician as to information acquired by him in attendanceupon her was inadmissible in the trial of the man charged with thecrime 250 in a still later case, 251 the general term of the supremecourt held, where the accused was on trial for murder and he hadconfided to a physician what he had done, that the physician could notdisclose the confidence the rule deducible from these decisions seemsto be that in new york the privilege extends to criminal actions, eventhough they be trials for murder, and even though the person accusedbe the patient, but that the statute will be applied only for theprotection of the patient, and where it is apparent that no injury canpossibly be done to the patient or his memory by the admission of theevidence, and the interests of justice demand the disclosure, for thepunishment of a person for an injury done to the patient involving aviolation of the criminal law, and the patient is not alive to waivethe privilege, that the disclosure is not forbidden in new york efforts have been made to exclude from the operation ofthe statute other classes of actions, to which it has been urged thatthe reasons for the enactment do not apply, or in which the mischiefalleged to be wrought by its enforcement has been suggested as groundfor believing that the legislature could not have intended to includethem of these, actions for divorce on the ground of adultery are oneclass. But it has been held that they constitute no exception 252testamentary causes - in new york it was long supposed that thepolicy of the law excepted probate proceedings. It was so held bythe surrogate of new york city;253 and also by the general termof the supreme court, 254 by which it was stated that the practicehad prevailed for a half-century in will paper, 255 but the courtof appeals, 256 has decided that testamentary paper constitute noexception to the rule, the judge who delivered the opinion statingthat there is no more reason for allowing secret ailments of a patientto be brought to light in a contest over his will than in any othercase, and that if mischief be wrought by the law the remedy lies withthe legislature and not with the courts the legislature has sinceafforded the remedy, 257 but not to the extent of adopting the rule ofthe earlier paper in indiana, in an action to set aside a will, thetestimony of the testator physician has been excluded 258 and inmichigan and missouri it seems that testamentary paper are no exceptionto the general rule 259lunacy and habitual drunkenness - it has been claimed in new yorkthat inquisitions of lunacy are an exception, and recently it has beenheld that the alleged lunatic physician may testify as to his mentalcondition because no one is better qualified to testify, 260 but thisdecision seems to be at variance with the principle of the decisionsof the court of appeals with reference to testamentary paper, andpresents no satisfactory reason for a distinction in a similar case inthe supreme court, chambers, it was held that a medical attendant at anasylum could not testify 261 it has also been held that a physiciancannot make an affidavit as to the appearance and condition of hispatient to support a petition for the appointment of a committee forhim as an habitual drunkard 262fraud - still another class of actions in which contending principleshave been invoked to make an exception in the law of privilege, isactions on life-insurance contracts the contract of insurance isuberrimæ fidei, and the defence of fraud in the application isfrequently interposed to defeat a claim under a policy medicaltestimony would often be the most satisfactory evidence to establishthe fraud, and efforts have been made to introduce it under thatexcuse, but without avail in the case of dilleber vs home lifeinsurance company, in the supreme court of new york at generalterm, 263 the question seems to have been directly before thecourt, and davis, p j , dissenting, insisted that the suppressionof a physician testimony ought not to be permitted so as to coverup a fraud, but the majority of the court held otherwise. The casewas subsequently overruled, but not on the ground urged by justicedavis 264 the number of insurance paper in which the rule has beenenforced seems to leave it beyond question that it will not be relaxedfor the purpose of establishing fraud, 265 although that announcementhas not been specifically made there seems no reason that the ruleshould be relaxed in that regard when it is not relaxed to establishthe crime of the patient. Though the mischief that may be done in suchpaper is apparent 266the witness - the statutory provisions as to the professionalstatus of the witness whose testimony is excluded have already beenshown 267 the facts which establish the relation of physicianand patient will be treated later 268 the witness is a member ofa profession, but there is very little discussion in the paper asto what constitutes a physician or surgeon 269 the language ofthe statutes as well as their policy and intent has been said toplainly embrace a physician who casually or in any way attends andprescribes for a patient, whether he be a family physician or the usualmedical attendant or not 270 the spirit of the acts would protectcommunications made to any person attending the patient in the acceptedcapacity of physician or surgeon wherever that might have happened, though the letter would confine it in essay instances to duly authorizedor duly licensed persons it does not seem to have been establishedwhether such authority or license must have been granted under thelaws of the state where the trial is conducted, nor how the severalstatutes apply to communications made elsewhere, especially in statesor countries where authority or license to practise is not required bylaw it has been said with reference to the new york law that it isabsolutely necessary that the witness should be a duly qualifiedphysician;271 and it has been held that the words “duly authorized”mean those persons who are not prohibited by the penal code frompractising, so that an unlicensed physician may be compelled todisclose confidential communications 272 whether the same rule wouldbe applied with reference to information obtained in another state bya physician duly authorized to practise there although prohibited frompractising in new york, is a question that is suggested as a casewithin the reason of the law but outside of its letter, and one whichdoes not seem to have been answered in new york, in an action by a physician for compensation for hisservices, it was held that a person who merely answered for a physicianat his office in his absence, and was not himself a physician, is not awitness whose testimony is privileged 273in missouri it has been held that a drug and prescription clerk isnot a privileged witness 274 the question arose in the same state, whether a dental surgeon is forbidden to testify under the statute, butits determination was not essential to the judgment and it was leftunanswered 275to establish the privilege it is necessary that the person who insistsupon it to exclude testimony should show by competent evidence that thewitness belongs to the class privileged under the law 276 but wherethe physician testified that he was a regular practising physician andattended in that capacity, and he was not examined further as to hisdue authority, it was held that a failure to produce his license couldnot be urged on appeal as reason for compelling him to testify 277the court said that if the privilege were the physician he might, ifthe objection were taken, be required to prove by the best evidencethat he was duly authorized, but as it is the patient privilege, inthe absence of objection to the sufficiency of the proof, the patientis entitled to the benefit of the presumption that the physician hadthe license which the law requires to entitle him to practise waiver of the privilege who may waive - those states in which the law provides for a waiverhave been enumerated;278 in others the courts have determined thatthe privilege of waiving is implied in the reason for the law inindiana it has been held that although the statute contains in termsan absolute prohibition, it creates no absolute incompetency andthe privilege may be waived by the person for whose benefit it ismade or his legal representative 279 under the michigan law itwas claimed that the physician is forbidden to reveal confidenceseven though he have his patient consent, but it has been held thatthe law only creates a privilege on the same footing with otherprivileged communications, which the public has no interest insuppressing when there is no desire for suppression on the writing ofthe person concerned 280 in missouri too the patient may waive theprivilege 281the protection vouchsafed by the law is designed for the benefit of thepatient, and therefore the physician himself cannot waive it 282 thepatient can disclose his own physical condition if he so desires 283but the physician cannot refuse to testify if the patient waives theprivilege 284the patient can waive the privilege during his life 285as it existed prior to 1891 the new york law provided that theprohibition should operate unless it was expressly waived upon thetrial or examination by the patient 286 this was interpreted to meanthat the patient himself was the only person who could make a waiver;and that, therefore, the possibility of waiver ceased with the deathof the patient, while the privilege of secrecy continued unabated, so that those claiming under the deceased patient could not waivethe privilege, nor insist upon the testimony of the physician, eventhough their interests were in jeopardy on account of his silence 287it seems, however, that a patient can during his lifetime waive theprivilege, the waiver to take effect after his death 288 the expresswaiver required by the statute may be given by the patient attorney, because of the nature of the attorney agency in conducting an actionfor the patient 289none of the other statutes are in the exact terms of the new yorkstatute, but those of california, colorado, idaho, minnesota, montana, nevada, north dakota, ohio, oregon, south dakota, utah, washington, and wyoming provide that the testimony shall not be given unless thepatient consent.