History

John Proctor Essay


And so intense is this conviction thatin every civilized community the retention by a judge of presents fromsuitors visits him not only with disqualification but disgrace henceit is that, awriting from the writingisan character of their opinions, theirutterances, now that they have as a class become the retained agentsof the writingies, have lost all judicial authority and are entitled onlyto the weight which sound and consistent criticism will award to thetestimony itself in making this criticism a large allowance must bemade for the bias necessarily belonging to men retained to advocatea cause, who speak not as to fact but as to opinion, and who areselected, on all moot questions, either from their prior advocacy ofthem or from their readiness to adopt the opinion to be proved in thissense we may adopt the strong language of lord kenyon, that skilledwitnesses come with such a bias on their minds to support the causein which they are embarked, that hardly any weight should be given john proctor essay totheir evidence ”this author then proceeds to show that under the civil law system theconclusions of experts were formerly treated as unassailable facts, but under the english and american common law system this is not thecase, but their testimony is to be weighed by the court he says:“the grounds on which the conclusion is reached may be asked for. Theexpert capacity for drawing conclusions, as well as his premises, may be assailed paper of conflict are to be determined, not by thenumber of witnesses, but by the weight of their testimony, and thoughthe opinion of an expert of high character may be entitled to greatrespect, yet if questioned, its authority must ultimately rest upon thetruth, material and formal, of the reasoning on which it depends ”judge davis, of the supreme court of maine, in neil case citedin wharton and stille “medical jurisprudence, ” vol i , section294, said. “if there is any kind of testimony that is not only of novalue, but even worse than that, it is in my judgment that of medicalexperts they may be able to state the diagnosis of a disease morelearnedly, but upon the question whether it had at a given time reacheda stage that the subject of it was incapable of making a contract, orirresponsible for his acts, the opinions of his neighbors, of men ofgood common sense, would be worth more than that of all the experts inthe country ”such stinging criticisms as these, and others which might be cited, of a like character, may not be always merited it is certain thatmedical experts’ opinions, if fully enlightened by scientific researchand free from writingisan bias, ought to occupy a position like thatof judicial opinions in weight and decisiveness upon the questionssubmitted to them such was the position occupied in the publicestimation, and in that of judges and counsel, by the great dr casparin gerthesis, and foedere or pinel, and others since their time, infrance but this position was acquired chiefly because of the factalready mentioned, that under the system of administration of justicewhich prevails in those countries these great men were regarded, andacted, as a component writing of the judicial system they were calledin as officers of the law to assist the court in forming a judgment, and determining disputed questions of fact, in paper involving lifeand death, or the devolution of property, where scientific experience, knowledge and skill, not possessed by judges or by counsel, wasnecessary for the determination of the questions involved the rootof the evil in america is, as already pointed out, to be found inthe system which allows writingies to retain and pay their own expertswithout any substantial restrictions sooner or later, among the otherreforms in our judicial system, it will be found necessary to reformthis evil by the enactment of laws requiring that the witnesses inmedico-legal paper, writingicularly those in which a crime is allegedto have been committed, shall be designated by the court, or by essaypublic authority, and paid from the public treasury instead of bythe writingies such experts would then occupy their proper position ofspecial counsel, advising and assisting the legal counsel and thecourt, but they would not be taken out of this sphere and put in theutterly inconsistent one of witnesses their status and their dutieswould be as clearly distinguished from that of expert witnesses as nowknown, as the status and duty of the lawyer are from the status andduty of the judge the present system has been said to be very muchlike putting a lawyer, who has just argued his client case, on thebench to decide it whether experts should be appointed as permanentgovernment officials, like our judges, or should be selected speciallyfor each case like juries, referees, or arbitrators, and in the latterevent whether they should be nominated by the writingies and selected bythe court from such nominees, or otherwise, are all questions of detail our judges and lawyers seem slow to recognize the fact that the dutiesof experts are judicial, or at least quasi-judicial. To pass uponcertain facts which neither the court nor the jury can understandwithout their aid but, as we have seen from the citations just given, judges and lawyers have fully recognized the unreliability of experttestimony, produced as it now is in england and in this country atthe whim and selection of the writingies and paid for, much or little, according to the means of the writingies 181method of preliminary examination of experts on medical questions alicensed physician presumed competent - as the system exists here, theonly power that the court has over the selection of an expert, is todetermine, in advance of his testimony and of the elucidation of hisopinions, whether or not he is competent as an expert but this poweraffords little or no check or restriction, because in the effort to getall the light that is possible upon the questions under consideration, and to avoid unduly interfering with counsel in the conduct of thecase at bar, the practice has become universal, and is recognized inthe decisions and text writers, of permitting any medical man who hasa license to practise his profession, to testify as an expert, and togive his opinion as such on any question cognate to his profession this is so without regard to the amount of study and experience hemay have had in the writingicular matter under consideration the nakedfact that he is licensed to practise is enough he then that is, after testifying that he is a practising physician is clothed withthe garment of authority the only way in which his knowledge can betested is by cross-examination as to his experience and skill, andpossibly by contrasting him as he appears upon the witness-stand andhis history as he gives it, with other and more or less experienced andskilful men who follow him the rule is, that when a witness is produced to give an opinion on amedical question, he is interrogated by the counsel who produces himas to his qualifications at this point, before he is allowed to givehis opinion, it is proper and customary that the counsel upon the otherside of the case should be allowed an opportunity to cross-examineas to his competency, and then the court determines whether or nothe is a competent witness if the court pronounces him competent, ahypothetical question is put to him stating the facts of the case, asthe counsel interrogating him claims them to be established by theevidence, and the expert is then asked to give his opinion on thequestion at issue, based upon an assumption that the facts stated aretruly stated then the opposing counsel has the right to cross-examine, and to ask his views and opinions upon the same question at issue, butassuming as true other and different facts or premises, as he claimsthem to be established by the evidence this often involves a test ofwit and intelligence, and of forensic acumen, between the counsel andthe witness, which serves very little useful purpose, except perhaps toelucidate more strongly than has been here stated the defects of thesystem which now obtains it is also not unusual, and in fact is theresult of the workings of human nature, that under the manipulations ofcounsel skilled in cross-examination, skilled in methods of indirectionin stating facts, and armed with the powerful weapon of the rulewhich permits them to insist upon a categorical yes-or-no answer to aquestion, the jury and the court become confused, the witness loseshis temper, or becomes affected more strongly than ever before by biasagainst his persecutors, as he feels them to be, and the examinationends in a farce this is not always the case, and the illustrationgiven is an extreme one like the citations from judicial criticism ofexpert testimony which have been given, these matters are only advertedto here as danger signals, a warning to both professions, and with anearnest suggestion of the necessity of reform experts, how summoned into court they must obey the summons and appear and be sworn in general theyneed not give their opinions unless duly compensated - an expertwitness is brought into court like an ordinary witness by the usualprocess of the court this process is, under the american system, anordinary subpœna, and, being process of the court, whether or not hehas been paid or promised compensation for giving his opinion he mustobey the process to the extent at least of appearing in court whencalled, to be sworn interesting questions have been raised as to hisobedience to the subpœna to the extent of testifying when he has notbeen compensated it has been argued, and the argument is sustainedby the decisions of courts of high authority in essay states, thathis knowledge and skill, acquired by study and by experience, is hisproperty, of which he cannot be deprived without just compensation, under his constitutional rights guaranteed to him by the organic lawof this country on the other hand, in essay other states it has beenheld that he is so far a necessary writing of the judicial system that hemay be called upon to give the results of his experience, knowledge, and skill forming his opinion, without payment other than the ordinarycompensation to witnesses it is believed, however, that the betteropinion is the former.

As also pains andtorments in the bowels bawm water distilled in may, restores memory, it quickens all thesenses, strengthens the brain, heart, and stomach, causes a merry mindand a sweet breath the water of comfrey solders broken bones, being drank, helpsruptures, outwardly it stops the bleeding of wounds, they being washedwith it wormwood water distilled cold, about the end of may, heats andstrengthens the stomach, helps concoction, stays vomiting, kills wormsin the stomach and bowels, it mitigates the pains in the teeth, and isprofitably given in fevers of choler mint water strengthens the stomach, helps concoction and staysvomiting, distil it in the latter end of may, or beginning of june, asthe year is in forwardness or backwardness, observe that in all therest chervil water distilled about the end of may, helps ruptures, breaksthe stone, dissolves congealed blood, strengthens the heart and stomach the water john proctor essay of mother of time strengthens the brain and stomach, gets aman a good stomach to his victuals, provoke urine and the menses, heatsthe womb it is in its prime about the end of june the water of marigold flowers is appropriated to most cold diseasesof the head, eyes, and stomach. They are in their vigour when the sunis in the lion the distilled water of centaury comforts a cold stomach, helps infever of choler, it kills worms, and provokes appetite maudlin and costmary water distilled in may or june, strengthens theliver, helps the yellow jaundice, opens obstructions, and helps thedropsy water-cresses distilled in march, the water cleanses the blood, andprovokes urine exceedingly, kills worms, outwardly mixed with honey, itclears the skin of morphew and sunburning distil nettles when they are in flower, the water helps coughs andpains in the bowels, provokes urine, and breaks the stone saxifrage water provokes urine, expels wind, breaks the stone, cleanses the reins and bladder of gravel, distil them when they are inflower the water of pellitory of the wall, opens obstructions of the liverand spleen, by drinking an ounce of it every morning. It cleanses thereins and bladder, and eases the gripings of the bowels coming of wind distil it in the end of may, or beginning of june cinquefoil water breaks the stone, cleanses the reins, and is ofexcellent use in putrified fevers distil it in may the water of radishes breaks the stone, cleanses the reins and bladder, provokes the menses, and helps the yellow jaundice elicampane water strengthens the stomach and lungs, provokes urine, and cleanses the passages of it from gravel distil burnet in may or june, the water breaks the stone, cleansesthe passages of urine, and is exceeding profitable in pestilentialtimes mugwort water distilled in may, is excellent in coughs and diseasesproceeding from stoppage of the menses, it warms the stomach, and helpsthe dropsy distil penny-royal when the flowers are upon it. The water heats thewomb gallantly, provokes the menses, expels the afterbirth. Cuts, andcasts out thick and gross humours in the breast, eases pains in thebowels, and consumes flegm the water of lovage distilled in may, eases pains in the head, andcures ulcers in the womb being washed with it. Inwardly taken it expelswind, and breaks the stone the tops of hops when they are young, being distilled, the watercleanses the blood of melancholy humours, and therefore helps scabs, itch, and leprosy, and such like diseases thence proceeding. It opensobstructions of the spleen, helps the rickets, and hypochondriacmelancholy the water of borrage and bugloss distilled when their flowers areupon them, strengthens the heart and brain exceedingly, cleanses theblood, and takes away sadness, griefs and melancholy dodder water cleanses the liver and spleen, helps the yellow jaundice tamarisk water opens obstructions, and helps the hardness of thespleen, and strengthens it english tobacco distilled, the water is excellently good for such ashave dropsy, to drink an ounce or two every morning. It helps ulcers inthe mouth, strengthens the lungs, and helps such as have asthmas the water of dwarf elder, hath the same effects thus you have the virtues of enough of cold waters, the use of which isfor mixtures of other medicines, whose operation is the same, for theyare very seldom given alone. If you delight most in liquid medicines, having regard to the disease, and writing of the body afflicted by it, these will furnish you with where withal to make them so as will pleaseyour pallate best compounds spirit and compound distilled waters culpeper before i begin these, i thought good to premise a fewwords.

Digitoxin and digitalein in their natural proportions ” thereis no evidence that digifolin contains all of the glucosides ofdigitalis as they exist in the leaf, and it is extremely improbablethat this is the case because one cannot remove saponin withoutaltering the other active principles of digitalis the ciba company sends out the following pamphlets relating todigifolin. “‘concerning digifolin-ciba, a new preparation of digitalis, ’ by c hartung, m d , ph d extracts from the work ‘ueber digifolin, ein neues digitalis-praeparat’ in the munich medical weekly, no 36, page 1944, 1912 ” “‘digitoxin contents of digifolin-ciba, ’ by c hartung, m d , ph d , basle, switzerland reprints from the pharmaceutical post, 1913 no 34, page 357 no 40, page 431 ” “‘pharmacological tests of digitalis, ’ by m j chevalier, chef des travaux pratiques de pharmacologie et matiere medicale, faculte de medecine de paris report presented to the societe de therapeutique at their meeting, may 28, 1913 ”in the reprint “concerning digifolin, ‘ciba ’” hartung lays stresson the presence of harmful and inert substances present in the leafand galenical preparations with the direct or implied statement thatdigifolin has an advantage in that these are absent from it this ismisleading it is true that boehm whom hartung cites, found saponin tobe irritating, but boehm states that it required 100 mg per kilogramof body weight to induce vomiting after its oral administration furthermore, saponin is present in traces only in infusion ofdigitalis, so that the therapeutic dose contains a wholly negligibleamount of it the following occurs in “pharmacological tests of digitalis, ” by m j chevalier. “hartung digifolin merits our attention, especially because it seems to possess all the pharmacodynamic properties of galenic preparations of digitalis without showing any of their disadvantages ”this claim scarcely needs comment, since it is well established thatthe chief “disadvantages” of digitalis are inherent in the principleswhich produce the desired effects of digitalis and may be avoidedto a large extent by a carefully regulated dosage of any digitalispreparation in short, the advertising for digifolin asserts that thisdigitalis preparation has all the advantages of digitalis itself, butnone of its disadvantages this claim has been refuted so frequentlythat manufacturers must be aware that it is untenable further theclaims now made for digifolin are essentially those made nearly fouryears ago at which time the attention of the american agent was calledto their unwarranted character the council declared digifolin-ciba inadmissible to new and nonofficialremedies because the therapeutic claims advanced for it are misleadingand unwarranted -- from the journal a m a , april 2, 1921 essay of loeser intravenous solutions report of the council on pharmacy and chemistrythe council has authorized the publication of the following reporton “loeser intravenous solution of hexamethylenamin, ” “loeserintravenous solution of hexamethylenamin and sodium iodid, ” “loeserintravenous solution of sodium salicylate, ” “loeser intravenoussolution of salicylate and iodid, ” “loeser intravenous solution ofsodium iodid” and “loeser intravenous solution of mercury bichlorid, ”put out by the new york intravenous laboratory, inc w a puckner, secretary the intravenous solutions of “hexamethylenamin, ” “hexamethylenaminand sodium iodid, ” “sodium salicylate, ” “sodium salicylate and sodiumiodid, ” “sodium iodid” and “mercuric chlorid” marketed by the new yorkintravenous laboratory, inc , are solutions of official substances soldunder their official names they would, therefore, be outside the scopeof the council, were it not that special and general therapeutic claimsare made for them such special claims, for instance, are contained inan advertisement in the illinois medical journal for oct 20, 1920, which gives, under the various drugs, a list of diseases in which thedrugs are said to be “indicated ” the council is unable to agree withessay of these recommendations the fundamental objection, however, isthe general claim of superiority and safety of the intravenous method the intravenous solutions named above would naturally have little saleif such special claims were not made for them while the claims may notbe made directly, they are carried by such display phrases as “for theprogressive physician seeking improved clinical results” and “a safepractical office technique ”the council continues to hold that intravenous medication, generally, is not as safe as oral medication even with relatively harmlesssubstances a fact again illustrated by the results of hanzlik andkarsner, 1920, journal pharmacology and experimental therapeutics, 14, 379, and that it does not give “improved clinical results” exceptunder rather narrowly confined circumstances-- namely, if the drugundergoes decomposition in the alimentary tract, if it is not absorbed, if it causes serious direct local reaction or if time is an urgentelement each intravenous preparation for which advantage over oraladministration is claimed, directly or by implication, must be examinedfrom these points of view the council has recognized intravenous preparations which satisfiedthese requirements it is evident, however, that hexamethylenamin, sodium iodid and sodium salicylate do not when given orally they donot undergo material decomposition in the digestive tract, they arerapidly absorbed, they cause no direct local reaction, and in theconditions in which they are used the hour or so which is required forabsorption is immaterial, especially as they are used continuously foressay time mercuric chlorid does indeed produce essay local irritation, but there is as yet no convincing evidence that its intravenousinjection causes less injury than oral administration more experienceunder controlled conditions is needed before the intravenous use ofmercuric chlorid can be approved especially objectionable are thefixed proportion mixtures of sodium iodid with sodium salicylate andwith hexamethylenamin the dosage of all three drugs has to be adaptedto individual conditions this is impossible when giving them in fixedproportions the council voted not to accept “loeser intravenous solution ofhexamethylenamin, ” “loeser intravenous solution of hexamethylenaminand sodium iodid, ” “loeser intravenous solution of sodiumsalicylate, ” “loeser intravenous solution of salicylate and iodid, ”“loeser intravenous solution sodium iodid” and “loeser intravenoussolution of mercury bichlorid” for new and nonofficial remedies becausethey are sold under misleading claims regarding their alleged safetyand efficiency in view of this fundamental objection the individualclaims for each preparation were not passed on -- from the journala m a , april 16, 1921 “national iodine solution” not admitted to n n r report of the council on pharmacy and chemistrythe council has authorized publication of the following report w a puckner, secretary “national iodine solution” is a proprietary sold by the national drugco , philadelphia, pa from inquiries received by the council onpharmacy and chemistry it is evident that the product is extensivelybrought to the attention of physicians by means of circulars the nameimplies that it is a solution of iodin and the inference is given thatit has the advantages of iodin without the disadvantages compositionin view of the foregoing, the council took up the investigation of“national iodine solution, ” and in turn asked the a m a chemicallaboratory to analyze it the chemist report follows:according to the label of national iodine solution, “each fluidouncerepresents three grains proteo-albuminoid compound of iodin national”. Also an alcohol declaration of 7 per cent is made otherwise no information is given as to the composition either of the“solution” or of “proteo-albuminoid compound of iodine ”each bottle contained about 115 c c nearly 4 ounces of a yellowishsolution, acid in reaction, having an odor resembling witch hazel. Itsspecific gravity at 25 c was 0 9860 qualitative tests indicated thepresence of zinc, alcohol, sulphate, an iodin compound the solutiongave tests which indicated a very small amount of free iodin. Mostof the iodin was in the form of ordinary iodid, a small amount ofvegetable extractives, and traces of aluminum and potassium if anyprotein was present, it was in amounts too small to be identified, though a small amount of a nitrogenous compound was present the amountof solids in “national iodine solution” was equivalent to 0 72 percent, and the amount of ash, to 0 2 per cent quantitative estimationsyielded the following. Alcohol by volume 7 0 per cent zinc zn 0 096 per cent iodin free and combined 0 029 per cent sulphate so₄--    0 146 per cent protein n × 6 36 0 012 per cent the above findings indicate that each 100 c c contains about 7 c c ofalcohol, 0 5 gram of zinc sulphate u s p znso₄7h₂o , 0 03 gramof iodin, 0 01 gram of protein calculated as such from nitrogen timesthe factor 6 36 and essay hamamelis water expressed in equivalentapothecary terms, each fluidounce contains essentially. Zinc sulphate 2-1/3 grains iodin free and combined 1/8 grain protein 1/25 grain alcohol 34 minimsthis amount of alcohol is equivalent to about 3-1/2 fluidrams of witchhazel water although the label states that each fluidounce containsthree grains of “proteo-albuminoid compound of iodine, ” yet the sum ofthe protein calculated from nitrogen content and iodin components isequivalent to less than 1/5 grain “national iodine solution” appears to be very similar to “gonocol” thenational drug co , philadelphia, pa , which was analyzed by the bureauof chemistry of the u s dewritingment of agriculture the bureau statedthat “it gonocol consisted essentially of an aqueous solution of zincsulphate, hamamelis water, a small amount of alcohol, 0 38 grain ofiodin, and 0 36 grain of protein per fluidounce ”it is evident that “national iodine solution” is not a solution offree elementary iodin as the name suggests.

Calcium chloride, 0 190 per cent. Mercurous chloride, 0 030 per cent. Lithium chloride, 0 035 per cent. Calcium hydrate, 0 010 per cent. Water to 100 writings ”the council asked the manufacturers for further information in regardto the composition or preparation of chloron and received this reply. “chlorine gas is prepared in the usual way and purified and passed into water until a saturated solution is made “water to the extent of three times the volume of the chlorine solution is used to dissolve the necessary amount of calcium chloride, and the two solutions are mixed “the necessary amounts of lithium and mercurous chloride are then intimately mixed and made into solution this solution is then added to the above and the whole is agitated for essay minutes ”a specimen of chloron was examined in the a m a chemical laboratoryand the chemists reported:qualitatively the presence of the following constituents was confirmed:calcium, mercury, lithium, chlorid, free chlorin the solution wasalkaline of course, the declaration that chloron contains mercurouschlorid calomel is obviously incorrect, as mercurous chlorid cannotexist in a solution containing active free chlorin, but is oxidizedto mercuric chlorid corrosive sublimate as the solution was alkalinein reaction, it seemed unlikely that all the active chlorin was presentin the free state, as declared on the label quantitative determinationof free chlorin and of total active “available” chlorin gave. Freechlorin, 0 036 gm per hundred c c. Total “available” chlorin, 0 330 gm per hundred c c , or 165 per cent of the claimed amount a comparison of the information sent to the council with the analyticfindings leads to the conclusion that chloron is not of reliablecomposition as evidence of the therapeutic value of chloron, the following “casereports” were submitted. “in a case of second degree burn involving the most of one leg from the middle of the calf down, chloron was the only dressing used the burn was a bad one and the patient in a rundown anaemic condition, at no time was there any appearance of pus, the surface looked clean and bright and the healing was accomplished with practically no scar whatever the burn was kept wet with the solution by hourly applications day and night the skin which has grown on the wound is clear, healthy and firm in another case of varicose veins of long standing, the result was surprising the patient told of two years vibrating from hospital to hospital and getting no real relief each leg had large open running sores, the only dressing used was wet compresses of this solution the pus disappeared at once, the wound began to cicatrise from the edges and in two weeks the man was discharged from the hospital practically cured ” “chloron was recently tried at the -- -- and -- -- hospital on paper presenting ulcers and other sores which did not readily yield to other methods, with good results, in fact were of an indolent type in these paper chloron proved very valuable ” “i have used chloron on a series of paper surgical presenting pus foci and i have found the application very beneficial and healing, the pus early disappearing in paper of osteomyelitis, suppurating arthritis, cellulitis and chronic ulcers, chloron is writingicularly valuable, its good effects quickly observed and the time of restoration to health shortened ”in the first case report, there is no evidence that chloron is moreefficient in the treatment of burns than any other commonly usedprocedure might have been in the case of the varicose ulcers, whilethere was essay apparent benefit from chloron, no credit is given torest and the general treatment which is known to be important in thetreatment of such conditions the evidence in the other case reports isquite inconclusive consideration of the “case reports” leads to theconclusion that clinical evidence for the value of chloron is lacking attention should be called to the fact that the amount of activechlorin, claimed to be present in chloron as well as the amount foundby the association laboratory, is less than that considered effectiveby dakin, dunham and others. Seemingly in preparing chloron noattention has been paid to the degree of alkalinity, yet the importanceof this factor is now generally recognized chloron fails to comply with the requirements for surgical solution ofchlorinated soda n n r , 1919, p 133, yet the manufacturers makefree use of the text of dakin and dunham handbook of antiseptics intheir advertising pamphlet thus. From the chloron pamphlet. “this ideal antiseptic effects complete sterilization within its sphere of action without causing any damage to the cells or tissues an important method of judging the injurious action of antiseptics is to investigate their effects on the leucocytes from experiments in vitro by parry morgan and in vivo by col c j bond with the strength of antiseptics commonly used in surgery, it has been found that chlorine antiseptics and mercury salts have little effect on phagocytosis in comparison with other germicides the activity of the leucocytes from wounds which have recently been treated with chloron may be demonstrated experimentally ” “in addition to its antiseptic action chloron is a strong oxidizing agent and deodorant and possesses to a marked degree the property of decomposing toxins in this connection it is interesting and pertinent to note that dean, by the regulated action of hypochlorous acid, has prepared a nontoxic dysentery vaccine and it is now a common observation that the free use of chloron may reduce the constitutional symptoms arising from septic processes and that they reappear on discontinuing the antiseptic treatment ” dakin and dunham handbook of antiseptics. “the ideal surgical antiseptic should effect complete sterilization within its sphere of action without causing any damage to animal cells at the moment such a substance does not appear likely to be found, but on the other hand it is surprising to see how little damage may be done to animal tissues by essay active antiseptics an important method of judging of the injurious action of antiseptics is to investigate the condition of the leucocytes in wounds recently treated with the substance under consideration in general it appears from experiments in vitro that, with the strength of antiseptics commonly used in surgery, mercury salts and hypochlorites have relatively little effect on phagocytosis as compared with phenol parry morgan it is a regular phenomenon to observe activity of the leucocytes obtained from wounds which have been recently treated with hypochlorites ingenious methods for determining the influence in vivo of antiseptics on the activities of leucocytes have been worked out by col c j bond “in addition to their disinfecting action, the chlorine antiseptics are strong oxidizing agents and deodorants and moreover possess in high degree the property of decomposing toxins by the regulated action of hypochlorous acid, dean has prepared a nontoxic dysentery vaccine and it is a common observation that the free use of hypochlorites may reduce the constitutional symptoms arising from septic processes and that they reappear on discontinuing the antiseptic treatment ” chloraxchlorax is said to be “a stable chlorine solution for internal use, ” in“kidney conditions, ” “diabetes, ” “acute infections, ” “blood dicrasias, ”“lithemias and rheumatism, ” and “nervous conditions ” it is claimed tohave the same composition as that of chloron with the addition of 0 016per cent of tincture of opium the a m a chemical laboratory reported that the free chlorin inchlorax was 0 01 gm per hundred c c and the total amount of active “available” chlorin was 0 25 gm per hundred c c , or 125 per cent of the amount claimed the laboratory notes that though the chlorincontent of chloron and chlorax is claimed to be the same, that ofchlorax actually is less this is not surprising when the presence inchlorax of reducing substances such as alcohol is borne in mind thelaboratory concludes that chlorax is not of reliable composition the following is typical of the “case reports” submitted to show thevalue of chlorax. “in january last i used chlorax on a case of diabetes mellitus and with excellent results “the patient had been suffering for about nine years and when first brought to my care toxemia had set in, he was drowsy, irritable and unable to leave the house i prescribed chlorax in teaspoonful doses four times a day and am pleased to say that in one week he showed marked improvement soon after he was able to leave the house and attend to his business and after two months’ treatment resumed a normal diet and habits apparently without injurious effects “i believe that in this case chlorax undoubtedly prolonged life ”no mention is made of the dietary or other measures used the widevariation in diabetes and its response to proper diet is so well knownthat the noncommittal statement concerning the beneficial effects ofchlorax amounts to no evidence at all in favor of the preparation the other “case reports” furnished by the chlorine products company, inc , which concern the treatment of gastric ulcers, acute alcoholicgastritis, tonsillitis, etc , are equally unconvincing in fact, nosatisfactory evidence for the clinical value of chlorax has beenpresented the following from the advertising for chlorax is unwarranted andabsurd. “mercurous chloride calomel is perhaps the most widely used internal antiseptic and alterative and has established itself in the therapy of constipation, cholera, dysentery, cardiac dropsy, pleurisy, malignant fever, malaria, syphilis, worms, infectious diseases, gout and rheumatism. Lithium chloride is writingicularly efficacious in acute and chronic parenchymatous nephritis and in various lithemic conditions. While opium has no rival as an anodyne and can be used to stabilize and conserve the alkaline reserve of the body against the acidosing influence of infections ”further, on page 14 we find. “in chills and fever malaria and other blood dicrasias, chlorax is indicated as an internal antiseptic and it exerts a beneficial effect on the course of these diseases ”the claims made for chlorax are exaggerated and misleading number “3”according to the label, number “3” is “a stable chlorine remedy for thepurification of the blood, ” with the composition. “free chlorine, 0 35 per cent.

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Nederlandsch tijdschr v geneesk 1:1353-1370, 1914 116 hygiama is said to be a food consisting of condensed milk, with fatless cocoa and cereals added to it encyclopedia and dictionary ofmedicine and surgery, 1907 nutrolactis117 is a commercial preparation sold by john proctor essay the nutrolactiscompany of new york at $1 a bottle the label states that it contains5 per cent of alcohol. That it contains fluid extracts of the familyof “galactagogic plants, ” and that it is intended to “increase thesupply of mother milk ” it is recommended to maintain “quality andquantity until the end of normal lactation ” nutrolactis is alsorecommended for a mother debilitated by lactation it is claimed that“nutrolactis does not force the secretion of milk but merely assistssuch secretion ” years ago millbank118 reported good results from theuse of nutrolactis after more than a year use he concluded that itwas more satisfactory than any other lactagogue hitherto employed byhim, which is not saying very much, as specific lactagogues are as yetunknown nutrolactis is still 1916 extensively advertised in variousmedical journals as a lactagogue 117 the north dakota agricultural experiment station has recentlypublished bulletin 22, 1915, p 386 a complete chemical analysisof nutrolactis it contains only 0 60 per cent solids includingstrychnin and emodin it has a bitter taste the alcohol content was3 5 per cent the report concludes. “a little strychnin, a littlealcohol, and a little laxative is about all there is to cause anincrease in the milk secretion ”118 millbank. New york m j 50:544, 1889 methods of investigationthe alleged lactagogue action of galega and nutrolactis was testedon lactating dogs and goats in these animals the psychic factors, or suggestion, are largely eliminated if the results had beenpositive or had indicated lactagogue action, the test would have beenextended to nursing women the puppies and kids were weighed beforeand after nursing and a record kept of the amount of milk obtained ateach nursing the animals nursing from three to five times daily the mothers were fed with varying doses of the drugs, and the milkyield compared with that of a control period during which no drugswere administered an effort was made to keep the conditions of theexperiments uniform throughout the galega was ground and mixed with the food the nutrolactis wasmixed with food given by the stomach tube, or in essay paper with aspoon galega was tested on two goats and nutrolactis on one goat andnine dogs the results are given herewith:galega goat 1. Control period, 1, 600 gm , milk av daily yield for 7 days galega period 30 gm galega mixed with oats, 860 gm , milk av daily yield for 8 days kids weaned at end of period goat 2. Control period, 1, 161 gm milk av daily yield for 9 days galega period 30 gm galega mixed with oats, 860 gm milk av daily yield for 8 days 25 gm galega in same way, 810 gm milk av daily yield for 10 days control period, 896 gm milk av daily yield for 6 days nutrolactis goat 3. Control period, 896 gm milk av daily yield for 6 days nutrolactis period 30 c c nutrolactis mixed with oats, 658 gm milk av daily yield for 9 days control period, 666 gm milk av daily yield for 5 days dog 1.