Do My Medicine Assignment

a the gravity test using the u s hydrometer scale for spirits, by which leptinol registers 52 degrees at 60 degrees f , and b by gentle evaporation of the alcohol content and the measuring of the active constituents, which measures twenty-five per cent by weight “the alcoholic extract ‘leptinol’ is glycerinated in a machine, using one writing of the alcoholic concentration to four writings of glycerin this is then added to eleven writings of a heavy syrup, containing 7-1/2 pounds of sugar to the gallon of syrup, and thoroughly mixed in an agitating machine leptinol is the sole active ingredient of syrup leptinol syrup leptinol is a preparation of uniform strength it is far more uniform in strength than most of the syrups of the u s p made from fluid extracts which are made from crude drugs which are not uniform in strength ”this claim cannot be allowed as meeting the conflict with rule 1 itis well known that plants vary in their composition at different timesof the year. Under different conditions of cultivation and growth;and under other conditions. Hence the claim that alcoholic extractsof equal specific gravity insure uniformity of composition in activeprinciples must be considered entirely illogical, especially since theexact nature of the active principles, if any be present, is unknown if these are known their nature should be stated and tests for theiridentity be given if they are unknown it is manifestly misleading tostate that the preparation is of uniform strength it is evident that the council cannot approve of the use of apreparation of unknown composition without satisfactory evidence ofits value, especially when it is recommended in a variety of seriousinfectious diseases such as influenza and pneumonia the mere factthat a small number of patients who have received the drug recoveris no evidence of its curative value, and until carefully controlledclinical tests of the preparation are made, it is not entitled to theconsideration of physicians -- from the journal a m a , june 5, 1920 formitol tablets, ii report of the council on pharmacy and chemistrythe council has authorized publication of the following supplementaryreport on formitol tablets w a puckner, secretary in the council report the journal a m a , oct 4, 1919, p 1077 onthe ineffectiveness of lozenges claimed either to contain formaldehydor to liberate formaldehyd in the mouth, the composition of formitoltablets of the e l patch co was briefly discussed in the followingterms. “the a m a chemical laboratory reported that formitol tablets contained formaldehyd or paraformaldehyd, an ammonium compound, and essay hexamethylenamin it is probable that the formaldehyd or paraformaldehyd was produced by the decomposition of hexamethylenamin originally present in the tablets but decomposed by long contact with the acid ”at the time this report was published, the label and the advertisingmatter contained but vague and indefinite statements with regard tothe composition of formitol tablets in the october, 1919, issue ofpatchwork, the house organ of the e l patch co , it was denied thatthese tablets contain hexamethylenamin since none had ever been used intheir manufacture it was also claimed that the company had a “printedsheet giving the formula of these tablets ”the council advised the e l patch co that it desires to publish onlyfacts about the products which it examines and that if the report onformitol tablets was inaccurate in any way the council would want tocorrect any error it might have unintentionally made as the formitoladvertising in the files of the council contained no information as tothe composition of the tablets, the firm was also requested to send theprinted sheet giving the “formula ”when this printed “formula” came it was found to be a sheet used bythe e l patch co for the purpose of giving its salesmen informationregarding formitol tablets, to be passed on to the physician thisprinted sheet conveyed the information that formitol tablets containammonium chlorid, benzoic acid, citric acid, guaiac, hyoscyamus, menthol, paraformaldehyd and tannic acid, but it gave no information inregard to the amount of any of the ingredients except that it declaredthat each tablet represents the equivalent of 10 minims of a 1 percent formaldehyd solution because of the nonquantitative, and, therefore meaningless printed“formula” and because, also, of its complexity, it was thoughtdesirable to make a more complete analysis of formitol tablets experience has shown that frequently the real formula of a thing isquite different from the alleged formula published by the manufacturer the details of the laboratory later analysis will appear in theannual reports of the chemical laboratory or may be had on request the result of the laboratory additional experimental work, especiallywhen taken in connection with investigations made elsewhere onthe interaction of formaldehyd and ammonium chlorid justifies theconclusion that formitol tablets do contain essay hexamethylenamin, even though the amount may be very small as the e l patch co declare that no hexamethylenamin is put into formitol tablets theconclusion drawn in the council original report to the effectthat the formaldehyd probably was formed by the decomposition ofhexamethylenamin was evidently an error the hexamethylenamin presentis doubtless produced by the action of the paraformaldehyd on theammonium chlorid present the analysis also showed that more than 78 per cent of the weightof formitol tablets was made up of sugars and about 16 5 per cent was starch and other material, essay of which was talcum or similarmaterial this means that about 94 per cent of the total weight ofthe tablets is sugar and starch, neither of which is mentioned in theprinted “formula ” the significance of this is apparent when it isconsidered that there are eight ingredients listed in the “formula” forwhich therapeutic effects are claimed since a tablet weighs about 13 5grains, the combined weight of all the claimed active ingredients isless than 1 grain per tablet!. The amount of ammonium chlorid found, as indicated by the totalnitrogen, was not more than 1 0 per cent or about 1/8 grain pertablet the amount of benzoic acid found was 0 34 per cent or 1/25grain per tablet yet these two drugs are said to exert their peculiarexpectorant action the u s p lozenge of ammonium chlorid contains1-1/2 grains ammonium chlorid or twelve times the amount of this drugin a formitol tablet the tannic acid contained in the tablets could not be determined withaccuracy but it was much less than 1 per cent or 1/8 grain pertablet yet it is said to add valuable astringent qualities to formitoltablets!. the u s p lozenge of tannic acid contains 1 grain oftannic acid the quantity of guaiac as resin is but a fraction of 1 per cent yet it is said to imwriting to formitol tablets “stimulant resolvent”properties and it is intimated that there is sufficient to be of valuein “paper of abscess of the throat and inflammation of the tissues ”the total acidity indicates the presence of about 2 per cent ofcitric acid or 1/4 grain per tablet yet this amount is said to be“antiseptic” and “aids in the general results ”while the presence of the drug hyoscyamus henbane was not positivelyidentified by microscopic examination, alkaloids were present the manufacturers claim that the tablets contain menthol yet onlya suggestion of menthol could be obtained from the odor however, the odor of methyl salicylate-- a constituent not declared in the“formula”-- predominated throughout the operations of analysis formitol tablets furnish a good illustration of essay well establishedbut often ignored truths:1 “formulas” that are nonquantitative are valueless or worse thanvalueless 2 the fact that a manufacturer puts certain drugs in a mixture, is noproof that these drugs are there when the mixture reaches the patient the physician must be assured that they are there when he prescribesthem 3 complex mixtures should be avoided it is absurd to expect, asis claimed in the case of formitol tablets, anodyne, antiseptic, astringent, expectorant, and resolvent action all at the sametime -- from the journal a m a , june 19, 1920 sukro-serum and aphlegmatol report of the council on pharmacy and chemistrytwo years ago, american newspapers contained accounts of an allegedcure for pulmonary tuberculosis “discovered” by prof domenico lomonaco of rome, italy at that time no reference to the “cure” couldbe found in medical journals which had come from italy and othereuropean countries the journal a m a , july 13, 1918, p 142 later, reports were published of experiments carried out in italy, according to which the intramuscular injection of solutions of sugar saccharose-- cane sugar diminished pulmonary secretion and was ofconsiderable value in the treatment of tuberculosis the journala m a , sept 28, 1918, p 1083 on the whole the reports of thetrial of what has been called the italian sugar cure for consumptionhave been unfavorable at a meeting in paris in october, 1918, drs louis rénon and mignot reported that they had found that the diseasein guinea-pigs was not modified by the treatment and with humans theresults were also negative paris letter, the journal a m a , nov 23, 1918, p 1760 in view of the exploitation of this treatment in the united statesby the anglo-french drug co , which offers “sukro-serum, ” and by g giambalvo & co , which sells “aphlegmatol, ” and because of inquiriesreceived, the council has authorized publication of the statement whichfollows w a puckner, secretary a circular issued by the anglo-french drug co , describes “sukro-serum”as a “sterilized solution of lacto-gluco-saccharose ” by reading thecircular to the end, however, one learns that “sukro-serum” is nota “serum” in the ordinary sense but apparently it is a solution ofordinary sugar sucrose “sukro-serum is a sterilized, speciallyprepared solution of saccharose ”sukro-serum has been advertised n y med jour , sept 6, 1919as an “intramuscular injection for tuberculosis” “ ready for usein paper of pulmonary and general tuberculosis” with the assertionthat “it is quite certain that in the near future sukro-serum will belargely used and its value fully recognized ” the circular receivedfrom the anglo-french drug co contains quotations from an article byprofessor lo monaco in the british medical journal aug 24, 1918setting forth the merits of intramuscular injections of sucrose intuberculosis it is recommended that “néocaine-surrénine” which theanglo-french drug co supplies be used for the control of pain whensukro-serum is injected the circular enclosed with a package of “aphlegmatol, ” purchased fromg giambalvo & co , contained the following with reference to thecomposition of this preparation. “a solution of hydrats of carbon after the formula of prof d lo monaco, director of the institut of physiological chemistry of the university of rome contents.

And, further, inorganic iron, such asferrous carbonate, serves the purpose admirably when iron is do my medicine assignment indicated with the acceptance of these well established facts, all possibleexcuse for the therapeutic employment of pepto-mangan in place of ironvanished. But as plain and simple as this fact is, the unnecessary andexpensive pepto-mangan continues to be prescribed by physicians whowill not take the slight trouble to investigate the claims for thisnostrum false and misleading claimsthere is not merely a difference of opinion between the exploiters andthe council, but there has been also actual misrepresentation in theexploitation of this nostrum to physicians this has been shown onmore than one occasion about twelve years ago, the m j breitenbachcompany, the proprietors of pepto-mangan, claimed that the report ofthe commission that had been appointed for the investigation of anemiain porto rico “would alone suffice to establish pepto-mangan at once asthe foremost hematinic known ” examination of the report showed thatthe commission made no such claims. On the contrary the commissionprotested against this misrepresentation j a m a 45:1099 oct 7 1905 illustration. From the new york medical journal undaunted by this exposure of their methods, the breitenbach companylater sent out a statement of results purporting to have been obtainedby one mateo m gillen, in the treatment of infantile anemia onrandall island in new york city at the instance of the journalthe hospital records in these paper were examined, and it was foundthat the pretended report was little more than a tissue of falsehood j a m a 48:1197 april 6 1907 about two years ago the council reported that while the statementsjust referred to were no longer made, they had never been definitelyadmitted by the breitenbach company to be erroneous, and thatpepto-mangan was then being exploited to the public indirectly council reports, 1914, p 121 we reproduce an advertisement that has been appearing weekly in thenew york medical journal for several months one can only supposethat this advertisement was intended to mislead physicians, and itwould be an insult to the intelligence of the average reader toattempt any detailed discussion of it, but enough has been said toshow how misleading the statements are one should note writingicularlythe advice-- old as the nostrum business itself-- contained in theadvertisement, to prescribe an original bottle the reason for suchadvice is simple experience has shown that when original bottles aredispensed patients soon learn to buy the nostrum without consulting thephysician, for they shrewdly suspect that he knows no more about thepreparation than they, and that he gets his information from preciselythe same sources that are available to them they are obviously right in truth, the physician who prescribes pepto-mangan as a hematinicshows ignorance of the most rudimentary facts of iron therapy, and theintelligent patient soon perceives his limitations illustration. A newspaper advertisement of pepto-mangan the problem of iron therapythe investigation of the problems of iron therapy and its utilizationin the formation of hemoglobin forms one of the most brilliant chaptersin pharmacologic research, and there is no better established fact intherapeutics than that any organic or inorganic preparation of ironthat does not irritate the stomach may be employed effectively when theadministration of iron is indicated “useful drugs” contains a listof iron preparations that are suitable for all conditions which callfor iron, and the clinician may rest assured that he will never haveoccasion to go outside that list to prescribe any substitute as a matter of fact, it seems probable that the very number ofavailable iron preparations has served to cause confusion, thusaffording an opportunity for the nostrum maker to introduce hissuperfluous compounds it may be difficult at times to select thepreparation of iron best suited to the individual patient. And it isthis difficulty that has led the clinician to listen to the seductiveclaims made for the various pretended substitutes for iron oneshould approach the question of choosing the proper form of iron fortherapeutic use with the recognition of the fact that there is nosuch thing as a substitute for iron in the formation of hemoglobin, that there are no ideal forms of iron other than those found in thefoodstuffs further, the clinician cannot avoid the disadvantagesinherent in all forms of iron that he can prescribe, and he musttherefore seek that which seems best suited for the individual patient bunge estimated the amounts of iron present in various foods. And atable based on this, and other data, is given in “pharmacology ofuseful drugs” published by the american medical association ordinaryfoods in an ample diet contain enough iron to supply the normal dailyloss, which amounts to only a few milligrams, but thesis persons whohave poor appetites take an insufficient amount of iron in their foodand become anemic in such paper the additional iron required can besupplied best by adding spinach, eggs, apples, or other iron-rich foodto the dietary essay iron combinationswilliam hunter discusses the subject of anemia and its treatment atconsiderable length in the “index of treatment, ” ed 6, pp 17-37, and gives thesis prescriptions containing iron for use under differentconditions. And while it is unnecessary to reproduce all of these here, a few may be given in order to suggest suitable methods of prescribingiron when it cannot be given in sufficient amounts in the food in chlorosis hunter advises that that form of iron which experience hasshown to be least disturbing to the patient stomach should be used, and he suggests separate stomachic mixtures to be used simultaneously, not mixed with the iron itself when constipation exists-- and this is avery common accompaniment of chlorosis-- he gives the following aperientiron combination. gm or c c ℞  ferrous sulphate |25 gr iv magnesium sulphate 4| ʒ i aromatic sulphuric acid |5 ♏ vii tincture of ginger |7 ♏ x compound infusion of gentian b p q s , ad 30| ℥ ithis, constituting a single dose, is to be taken twice daily-- at11 a m and 6 p m a little compound tincture of gentian andwater may be used in place of the compound infusion of the britishpharmacopeia he modifies this essaywhat as occasion demands by usingsodium sulphate and adding sodium bicarbonate which converts thesulphate of iron into ferrous carbonate and adds 10 minims of spiritof chloroform to act as a stomachic hunter also suggests the use of pills of aloes and iron in place ofthe mixture described above, and when constipation has been corrected, the aloes may be omitted and the pill of ferrous carbonate alone maybe used for the iron hunter comment regarding this pill is, “verysatisfactory ”the same form of iron is available in the compound iron mixture, formerly official, which hunter says is exceedingly good in thiscountry the compound solution of iron and ammonium acetate, bashammixture, so called, has long enjoyed a wide reputation as causing verylittle disturbance of the stomach, and the homely tincture of ferricchlorid is probably useful in a large majority of paper in which thestomach is not especially irritable we may say with assurance that one of the forms suggested herewill suffice for practically every case in which it is necessaryto reinforce the amount of iron available in the food by essaypharmaceutical preparation if these do not satisfy your requirements, consult a really competent pharmacist and enlist his aid in devisinga mixture especially suited to your individual patient -- from thejournal a m a , dec 29, 1917 article iv cactina pilletsthis preparation may be considered briefly in view of the recentdiscussion in this series of articles of the pharmacology of thedigitalis group and the principles of treatment in cardiovasculardisease the manufacturers maintain that cactina is wholly unlikedigitalis, and that is the truth, as we shall show. But since theyclaim that it is useful in certain conditions of the heart in whichdigitalis is commonly employed by well informed clinicians, it isnecessary to consider its cardiac actions-- or its lack of them!. it isdifficult to determine just what action cactina is supposed to exert onthe heart for example, one advertisement contains the following.

“pulmonary tuberculosis” “laryngeal tuberculosis, ” “glandular tuberculosis” “tuberculosis of the bones” “pneumonia, broncho-pneumonia, and congestive conditions” “whooping cough, influenza, asthma” “typhoid fever” “syphilis” “obesity ”iodagol, which do my medicine assignment is for external use, has been advised in the treatmentof. “gonorrhea and its sequelæ” “cystitis” “tetanus” “wounds complicated by gaseous gangrene” “burns” “old suppurations, ulcers, abscesses, etc ” “articular rheumatism” “abscess alveolar” “pyorrhea alveolaris” “stomatitis canker-sores ”nearly two years ago the american agents requested the council toconsider iodeol and iodagol for admission to new and nonofficialremedies the information submitted in regard to their character andcomposition was vague and indefinite, the pharmacologic informationpractically nil and the clinical data as voluminous as it wasunconvincing on the basis of chemical, pharmacologic, bacteriologic and clinicalinvestigation carried out under the direction of the referee and astudy of the submitted evidence, the referee reported:1 iodeol and iodagol do not contain the amount of iodin claimed 2 the iodin is not present as elementary iodin, but instead thepreparations behave similarly to the well-known organic iodin compoundssuch as iodized fats 3 the therapeutic claims made for the preparations are exaggerated andunwarranted in view of his findings he recommended that iodeol and iodagol bedeclared inadmissible to new and nonofficial remedies for conflictwith rules 1 and 2 misleading statements regarding composition andidentification and rule 6 unwarranted therapeutic claims thecouncil adopted the recommendation of the referee, directing inclusionof the full report in the annual council reports after submission tothe manufacturer, and recommending publication of an abstract of thisreport in the journal this report was brought to the attention of the american agent, davidb levy, inc , and through them to the french manufacturers, e vieland company the manufacturers have intimated that they will not filea reply to the report the firm of david b levy, inc , has decided tosever its connection with these products and to discontinue their sale w a puckner, secretary summary of referee reportiodeol and iodagol were submitted to the council nearly two years agoas “electro-colloidal iodine” and with the claim that they producedall the antiseptic and other effects of ordinary iodin without anyof its side actions the referee has done much work on the subject, conducted a large amount of correspondence and has contended withlong delays he feels that the consideration of these products shouldbe brought to a conclusion and accordingly he submits this report oftheir consideration the following is a summary of the report, which isappended:i discrepancy in iodin percentage -- the examination at the chemicallaboratory of the american medical association, as well as that of thereferee, shows that the various samples of iodeol and iodagol examinedcontained a little less than one-half of the total iodin claimed thesefacts were reported to the american agent after a lengthy delay areply was received which presented a double excuse. 1 that the fullamount of iodin had been added, whatever had become of it later. 2that the claims were made for “colloidal iodin” and that this is notelementary iodin in the colloidal state, but a preparation of iodincontaining only 50 per cent of real iodin neither explanation can betaken seriously, as they are obvious quibblings the referee concludesthat the preparations are falsely labeled as to iodin content ii nature of the iodin compound in iodeol and iodagol -- in theinformation sent the council, iodeol and iodagol were defined as“a suspension of electro-chemical colloidal iodin in a vehicle ofpurified oil ” numerous inquiries have failed to elicit more specificinformation from the manufacturer or his agent the statement ofcomposition can mean only that the preparations contain free iodin butin colloidal form suspended in oil no evidence to substantiate thisclaim has been submitted there is evidence that the preparationscontain colloidal writingicles, but it does not indicate if this colloidalmaterial is iodin, or a combination of iodin or indeed whether thecolloidal component contains any iodin the recent statements of theagent seem to concede that what they call “electro-colloidal iodin”contains only about 50 per cent of real iodin, in other words that itis not “colloidal iodin” at all, but a mixture or combination of iodinwith essay other unnamed substance this, of course, is essaything verydifferent certain results reported from the american medical associationchemical laboratory suggest that the so-called “colloidal iodin”of iodeol may be a combination of iodin with a volatile oil theinvestigations of the referee indicate that the iodin exists in arather resistant form or combination behaving altogether differentlyfrom ordinary free iodin, and rather resembling the behavior of iodinsubstitution products, such as iodized fats or phenols brieflythen the recent admissions of the agents indicate that iodeol doesnot contain “colloidal iodin” in a chemical sense, and there areindications that it does contain its iodin in a rather firm chemicalcombination iii chemical properties of iodeol -- from a study of differentspecimens of iodeol, the referee concludes that fresh specimens containno free iodin and that old ones contain small amounts as a result ofdecomposition iodeol has the solubility characteristics of fats andfat-like compounds the examination, as a whole, shows that iodeolcontains a peculiar and rather resistant form or combination of iodin there is nothing in the chemical data that suggests that it could actdifferently from ordinary iodin compounds, such as iodized fats itwould not act as ordinary iodin iv pharmacologic data -- the pharmacologic statements which weresubmitted were loose and apparently meaningless or misleading inreply to questions submitted by the referee, the manufacturer finallyhad essay work done and submitted a report by jean laumonnier thereferee was unable to confirm essay of this work, and as a whole itdoes not appear materially to elucidate the action of iodeol from aconsideration of the submitted evidence, and as a result of his ownwork, the referee concludes that iodeol does not behave like elementaryiodin. It does not coagulate proteins and therefore is not irritant itis presumably absorbed, but quite probably after chemical change. It ischanged into iodid and, like organic iodids, is excreted essaywhat moreslowly than when inorganic iodids are administered, but the differencedoes not appear important v antiseptic and bactericidal action -- elementary iodin isconsidered a fairly powerful agent in these respects the activityis presumably due to changes in the proteins, etc , of the bacteria, analogous to the effects which produce pain, irritation and necrosis ofthe tissue cells since the latter effect is not produced by iodeol, it seems highly improbable, if not impossible, that it should act onbacteria like elementary iodin it is entirely unjustifiable to creditthe known antibacterial qualities of ordinary iodin to “colloid” iodin this misrepresentation is especially prominent in the circular “notablenew therapeutic agents, ” as will be seen, for instance, from thefollowing citations. “iodine has long been universally recognized as an antiseptic of extraordinary potency not only is it rapid and certain in its germ-destroying action, but it also possesses an attribute denied thesis other antiseptic agents, namely, the power to penetrate and impregnate the tissues other antiseptics, as is well known, act on the surface epithelium only ” “according to kinnaman j a m a , aug 26, 1905, iodine is far superior to bichloride of mercury, a two per cent solution killing streptococcus pyogenes in two minutes iodine does not coagulate albumin, and is very penetrating ”the citations imply that this “colloidal iodin” of iodeol andiodagol acts as an antiseptic like ordinary iodin, except that it isclaimed to be more efficient by “diffusing” more readily this isentirely unjustified and misleading if iodeol and iodagol are reallyantiseptic, they must act by essay other mechanism than that throughwhich elementary iodin acts, and such antiseptic action would have tobe demonstrated by direct observation and not assumed from the knownaction of free iodin antiseptic and bactericidal effects are easily estimated by laboratorymethods yet no evidence on this point appeared to have been availableuntil the council called for this laumonnier then carried out essayexperiments which were in turn submitted to bacteriologic control thebacteriologist failed to obtain any results with essay of the tests, andconsidered the other data of little value the claim that iodeol and iodagol have the antiseptic and bactericidalaction of free iodin lacks proof and must be considered unwarranted andmisleading in the extreme vi clinical trials -- the manufacturers and agents of iodeolpresented thesis letters from physicians. But few, if any, of these gaveevidence of careful, critical, controlled observations they could not, therefore, be considered as acceptable evidence the more importantclaims, letters and published papers, however, were submitted toclinical specialists collaborating with the council, with the requestthat they examine these and conduct essay clinical trials, if theyconsidered it advisable the results obtained in these preliminarytrials did not appear sufficient to warrant further experimentation from a consideration of the evidence presented, the referee concludesthat the claims made for iodeol and iodagol are unwarranted, exaggerated and misleading he recommends that iodeol and iodagol bedeclared ineligible for new and nonofficial remedies for conflictwith rules 1 and 2 misleading statements as to composition andidentification and with rule 6 unwarranted and misleading therapeuticclaims he further recommends that the council authorize publicationof the preceding summary of the consideration of iodeol and iodagolin the journal and inclusion of the full report in the annual councilreports after submission to the manufacturer -- from the journala m a , nov 17, 1917 capsules bismuth resorcinol compound not admitted to n n r report of the council on pharmacy and chemistryin response to inquiries received, the council took up theconsideration of capsules bismuth resorcinol compound the gross drugcompany, inc , new york city the label, sent by the gross drugcompany, bore the following. Capsules bismuth resorcinol compound bismuth subgallate 2 grs resorcinol 1 gr beta naphthol 1/2 gr creosote beechwood 1 m this combination is of acknowledged value in reducing the value in reducing the intes- tinal putrefaction and fermentation, allaying the pain and discomfort of flatulent conditions in the intestinal tract dose -- one or two capsules before or after meals repeated in two hours if necessary the gross drug company, inc 20 laight street, new yorkthe council held this preparation inadmissible to new and nonofficialremedies or the appendix, because 1 the claim “acknowledged value inreducing the intestinal putrefaction and fermentation, allaying thepain and discomfort of flatulent conditions in the intestinal tract” isan unwarranted, exaggerated and misleading claim of therapeutic value rule 6.

That all of the additions have beenjudiciously selected it is an infelicitous time to add calcium andsodium glycerophosphate just when grave doubts of their therapeuticefficiency are being felt the addition of the extracts of aconite, hydrastis and viburnum prunifolium is likewise unfortunate all aresuperfluous preparations, the first because a drug so powerful thatan average dose of the extract is only 10 mg or 1/6 grain is bettergiven in the form of tincture. The second because hydrastis is a drugof uncertain value, already represented by three preparations, and thethird because viburnum prunifolium has been discarded and discreditedby the best therapeutic authorities it must be accounted clear gain, on the other hand, that the deletions include thesis inert, obsoleteor superfluous substances like bismuth citrate, kaolin cataplasm, pipsissewa, coca leaves, ladyslipper, wahoo, cotton root bark, compound acetanilid powder and compound syrup of hypophosphites, not tomention nine salts of iron and thirty-eight fluidextracts of variousdrugs wines, unmedicated and medicated, whisky and brandy are alsoamong the articles dropped a number of new features are introduced, such as microscopic standardsfor powdered drugs, standard abbreviations for titles, the use ofthe term “mil” instead of “cubic centimeter, ” and a chapter each onsterilization, diagnostic reagents, biologic assays, electrolyticdetermination of metals and the determination of alcohol, the meltingpoint, the boiling point and the congealing point the chemical nomenclature is substantially the same as that adopted inthe previous revision. So is the nomenclature of drugs the addition ofofficial abbreviations for the latin titles of drugs will doubtless befound a useful feature less commendable is the change from the familiar “cc ” to “mil ” theterm “cubic centimeter” is so thoroughly established and so widelyused, wherever the metric system is employed, that it cannot beexpected that it will be universally displaced by the word “mil ” thelatter is therefore only a superfluous synonym, and as such out ofharmony with the simplicity of the metric system perhaps it may evenbe taken for the abbreviation of “millimeter, ” “milligram” or otherwords derived from “mille, ” which would be equally entitled to the sameabbreviation -- book review in the journal a m a , sept 2, 1916 physician stock in prescription productsthe letter that follows comes from a physician who feels that he has agrievance regarding a company in which he holds stock:“in 1914, i bought essay stock of the -- -- -- -- company, and in 1917bought essay more stock in the same company i notice that the companyadvertises in the journal of the american medical association, and ibelieve it does this not so much to acquaint the medical professionwith its product, as to acquaint physicians with its name in order thatits stock salesmen can keep on unloading more stock to members of themedical profession “the company gets the doctors’ money through the sale of stocks, itgets its product on the market with the doctors’ assistance and throughtheir influence, and it looks to me as if the doctors were getting verylittle in return, as the dividend checks have been few and far betweensince i have known anything of the company “it is not my idea to criticize the product. But i do believe and feelthat the stockholders are entitled to a square deal from a companywhich in turn is expecting so much from them, and again i feel that thepublishers of the journal should be made aware of these conditions sothat they do not either consciously or unconsciously foster a concernthat is depriving the physician of his hard-earned money “if this letter is unfair, i am willing to be shown otherwise kindlypublish it in the journal, omitting my name and address ”the company to which our correspondent refers put out a proprietaryproduct prescribed by physicians and used by the public essay years agothe company in question advertised its product in the journal until itsstock-selling scheme was brought to the attention of the journal. Theadvertisements were then rejected essay years later, on evidence thatthe company had discontinued its stock-selling methods to physicians, its product was again admitted to the advertising pages of the journal our correspondent says that he believes that the physicians who holdstock in this company “are entitled to a square deal ” what about thepublic?. is it getting a square deal when physicians are financiallyinterested in the products that they may be called on to prescribe?. Is the average layman confidence in the medical profession likelyto be enhanced when he learns that the physician to whom he went fortreatment has a financial interest in the therapeutic agent whichwas prescribed?.

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If you have notthe distilled water, make use of the decoction 4 diseases that lie in the writings of the body remote from the stomachand bowels, it is in vain to think to carry away the cause at once, andtherefore you had best do it by degrees. Pills, and such like medicineswhich are hard in the body, are fittest for such a business, becausethey are longest before they digest 5 use no strong medicines, if weak will serve the turn, you had bettertake one too weak by half, than too strong in the least 6 consider the natural temper of the writing of the body afflicted, andmaintain it in that, else you extinguish nature, as the heart is hot, the brain cold, or at least the coldest writing of the body 7 observe this general rule. That such medicines as are hot in thefirst degree are most habitual to our bodies, because they are just ofthe heat of our blood 8 all opening medicines, and such as provoke urine or the menses, orbreak the stone, may most conveniently be given in white wine, becausewhite wine of itself is of an opening nature, and cleanses the veins 9 let all such medicines as are taken to stop fluxes or looseness, betaken before meat, about an hour before, more or less, that so they maystrengthen the digestion and retentive faculty, before the food comeinto the stomach, but such as are subject to vomit up their meat, letthem take such medicines as stay vomiting presently after meat, at theconclusion of their meals, that so they may close up the mouth of thestomach. And that is the reason why usually men eat a bit of cheeseafter meat, because by its sourness and binding it closes the mouth ofthe stomach, thereby staying belching and vomiting 10 in taking purges be very careful, and that you may be so, observethese rules 1 consider what the humour offending is, and let the medicine besuch as purges that humour, else you will weaken nature, not thedisease 2 take notice, if the humour you would purge out be thin, thengentle medicines will serve the turn, but if it be tough and viscous, then such medicines as are cutting and opening, the night before youwould take the purge 3 in purging tough humours, forbear as much as may be such medicinesas leave a binding quality behind them 4 have a care of taking purges when your body is astringent. Yourbest way, is first to open it by a clyster 5 in taking opening medicines, you may safely take them at night, eating but a little supper three or four hours before, and the nextmorning drinking a draught of warm posset-drink, and you need notfear to go about your business in this manner you may take lenitiveelectuary, diacatholicon, pulp of cassia, and the like gentleelectuaries, as also all pills that have neither diagrydium norcolocynthus, in them but all violent purges require a due orderingof the body. Such ought to be taken in the morning after you are up, and not to sleep after them before they are done working, at leastbefore night. Two hours after you have taken them, drink a draughtof warm posset-drink, or broth, and six hours after eat a bit ofmutton, often walking about the chamber. Let there be a good fire inthe chamber, and stir not out of the chamber till the purge have doneworking, or not till next day lastly, take sweating medicines when you are in bed, covered warm, andin the time of your sweating drink posset-drink as hot as you can ifyou sweat for a fever, boil sorrel and red sage in your posset-drink, sweat an hour or longer if your strength will permit, then the chamberbeing kept very warm shift yourself all but your head, about which the cap which you sweat in being still kept on wrap a napkin veryhot, to repel the vapours back i confess these, or thesis of these directions may be found in one placeof the book or other, and i delight as little to write tautology asanother, but considering it might make for the public good, i insertedthem in this place. If, notwithstanding, any will be so mad as to dothemselves a mischief, the fault is not mine roots acanths, brancæ ursinæ of bearsbreech, or brankursine, it is meanlyhot and dry, helps aches and numness of the joints, and is of a bindingquality, good for wounds and broken bones dioscorides saith, theyare profitable for ruptures, or such as are bursten, or burnt withfire, a dram of the root in powder being taken in the morning fasting, in a decoction made with the same root and water acori, veri, perigrini, vulgaris, &c see calamus aromaticus ishall not speak concerning the several sorts of it, one of which iswater-flag, or flower-de-luce, which is hot and dry in the seconddegree, binds, strengthens, stops fluxes of the belly, and immoderateflowing of the menses, a dram being taken in red wine every morning allium garlic it is hot and dry in the fourth degree, breedscorrupt blood, yet is an enemy to all poisons, and such as are bittenby cold venomous beasts, viz adders, toads, spiders, &c it provokesurine, and expels wind alcannæ of privet see the leaves althææ of marsh mallows, are meanly hot, of a digesting, softeningnature, ease pains, help bloody fluxes, the stone, and gravel.