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And although the present case doesnot come under the exceptions specified under these comments, it may beurged that the exceptions need to be increased as occasion arises thenotorious adulteration of aspirin may well be urged as establishing aneed for a similar exception in its use the general principle of protecting the public against fraud, adulteration and substitution is directly in line with the objects ofthe council, and deserves commendation and support it is obvious, however, that the means adopted for this end must be efficient, that they must not open the door to other, perhaps greater evilsand that they must be used in good faith the policy of advertising“aspirin-bayer” must be examined in these respects in the first place, the acceptance of a product by the council impliesan agreement by the manufacturers or agents that they will adherestrictly to the council rules and will not dewriting from the letter orspirit of these rules without notice to the council this principle hasbeen grossly infringed in the present case there can be no doubt thatthe agents were aware that their advertisements conflicted, at leastwith the letter of rule 3 nevertheless, they did not, in any way, inform the council of the change in policy in this respect, at least, they have not acted in good faith secondly, the wording of the advertisement implies that only thetablets stamped with “the bayer cross” are genuine this is misleading, since every druggist has the right to make unstamped tablets ofaspirin, fully as genuine as those stamped with the cross thirdly, the cross itself cannot be considered an efficient protection;for people who imitate aspirin will not hesitate to imitate thestamp the remedy, in either case, and as with any other drug, is theexamination of trade samples, and the vigorous prosecution of thoseguilty of violating the law fourthly, the permanent affixing of the name “aspirin” to thevest-pocket boxes is also inefficient as a protection, and servesmainly as an advertisement fifthly, whatever may have been the motives of the advertisers, andhowever carefully the advertisements are worded, they will inevitablytend to increase the use of aspirin by the public, and this is directlyagainst the interests of public health the public does not know, asphysicians do, that headaches are merely symptoms of other, essaytimesvery serious conditions. And that they are often the signal for theneed of a thorough physical examination and diagnosis it is true thatthey are often also the symptoms of very minor derangements, which willright themselves spontaneously. And that, in such paper, drugs likeaspirin may give relief and may do no harm the patient, however, isnot educated to distinguish one class from the other, and thereforeanything that tends to promote the indiscriminate use of such remediesas aspirin is detrimental to the public health furthermore, aspirinitself is not always harmless alarming idiosyncrasies are sufficientlycommon that the use of the first doses, at least, should requiremedical supervision with these considerations in mind, the referee isof the opinion that the direct and indirect advertising of aspirin isto be condemned -- from the journal a m a , jan 20, 1917 pil cascara compound-robins report of the council on pharmacy and chemistrya circular issued by the a h robins company of richmond, va , contains the following statement. “pil cascara compound-robins is a rational therapeutic formula, composed of cascara, podophyllin, colocynth and hyoscyamus, which promotes a natural flow of secretions, which is, in turn, the physiologic stimulant of peristalsis thus, a normal evacuation is produced without subsequent inhibition “they contain no mercury, strychnia nor belladonna “an ideal aid to any remedial agent, when a mild, medium or strong alimentary stimulant is needed sic “made in two strengths, the dosage may be easily regulated so as to obtain the effects of an anti-dyspeptic, aperient, laxative or cathartic, as desired they never cause discomfort unless given in larger dose than needed ”this preparation is another example of the innumerable mixtures ofwell-known drugs having nothing in the way of originality or of specialtherapeutic value to recommend them the advertising implies that this writingicular combination has a specialaction on the secretions of the gastro-intestinal tract. Otherwiseit would be hard to explain the claim that the preparation isantidyspeptic, if that means anything more than a laxative or cathartic the claim is made that this preparation contains no belladonna-- yetit admittedly contains hyoscyamus!.

Choked to death by lumbricoid worm passing from pharynx into rightbronchus specimen 7, 737 suicide 56 sankey. Brit med jour , 1883, i , p 88 - epileptic. Found deadin bed, lying on his back a round pebble in each nostril. Strip offlannel rolled up and stuffed in throat 57 macleod. Ibid , 1882, ii , p 1246 - suicidal maniac had tobe fed because he refused food was seen to be blue in the face andbreathing hard his mouth was forced open. Roll of flannel found inthroat macleod refers to another case, a woman in dissecting-room, with similar roll of flannel in throat see tidy, “med jur , ” paper 15 to 17 homicide 58 christison. Edin med jour , 1829, xxxi , pp 236-250 - thefamous burking case a woman was struck down to a sitting posture burke then threw himself on her, kept her down by the weight ofhis body, covered her mouth and nose with one hand and placed hisother hand under the chin for ten to fifteen minutes, till she died necroscopy showed a severing of the posterior ligamentous connectionsof the third and fourth cervical vertebræ, with blood in spinal canalbut not under the dura mater. Cord not injured christison madeexperiments to ascertain if the injury to spine had been made duringlife 59 hackel.

Attempted strangulation by her husband there need help writing a narrative essay were slightecchymoses on each side of neck under angle of jaw, most marked onleft side. When seen, she complained of lassitude and lively pain inhypochondria and region of lower ribs antero-laterally. No sign oflesion she stated that she was awakened from sleep by pressure on neckand chest and feeling of suffocation. She soon lost consciousness andso remained for essay hours her statements were corroborated by othertestimony laennec considered the case one of prolonged syncope frompressure on carotids 18 lancet, ii , 1841-42, p 129 - woman, found dead, her clothingon fire and lower writing of her body burnt necroscopy showed face andneck swollen as low as thyroid cartilage, and purple. Eyes prominentand congested. Mouth closed.

Or if you would stay it in its place, apply it to the navel, and that is one good way to stay the child in it the burdock leavesare cooling, moderately drying, and discussing withal, whereby it isgood for old ulcers and sores a dram of the need help writing a narrative essay roots taken with pinekernels, helps them that spit foul, mattery, and bloody phlegm theleaves applied to the places troubled with the shrinking of the sinewsor arteries, gives much ease the juice of the leaves, or rather theroots themselves, given to drink with old wine, doth wonderfully helpthe biting of any serpents. And the root beaten with a little salt, andlaid on the place, suddenly eases the pain thereof, and helps thosethat are bit by a mad dog the juice of the leaves being drank withhoney, provokes urine, and remedies the pain of the bladder the seedbeing drank in wine forty days together, doth wonderfully help thesciatica the leaves bruised with the white of an egg, and applied toany place burnt with fire, takes out the fire, gives sudden ease, andheals it up afterwards the decoction of them fomented on any frettingsore, or canker, stays the corroding quality, which must be afterwardsanointed with an ointment made of the same liquor, hog-grease, nitre, and vinegar boiled together the roots may be preserved withsugar, and taken fasting, or at other times, for the same purposes, andfor consumptions, the stone, and the lask the seed is much commendedto break the stone, and cause it to be expelled by urine, and is oftenused with other seeds and things to that purpose cabbages and coleworts i shall spare labour in writing a description of these, since almostevery one that can but write at all, may describe them from his ownknowledge, they being generally so well known, that descriptions arealtogether needless place they are generally planted in gardens time their flower time is towards the middle, or end of july, andthe seed is ripe in august government and virtues the cabbages or coleworts boiled gentlyin broth, and eaten, do open the body, but the second decoction dothbind the body the juice thereof drank in wine, helps those that arebitten by an adder, and the decoction of the flowers brings downwomen courses. Being taken with honey, it recovers hoarseness, orloss of the voice the often eating of them well boiled, helps thosethat are entering into a consumption the pulp of the middle ribs ofcoleworts boiled in almond milk, and made up into an electuary withhoney, being taken often, is very profitable for those that are puffyand short winded being boiled twice, an old cock boiled in the brothand drank, it helps the pains and the obstructions of the liver andspleen, and the stone in the kidneys the juice boiled with honey, anddropped into the corner of the eyes, clears the sight, by consumingany film or clouds beginning to dim it. It also consumes the cankersgrowing therein they are much commended, being eaten before meat tokeep one from surfeiting, as also from being drunk with too much wine, or quickly to make a man sober again that was drunk before for asthey say there is such an antipathy or enmity between the vine and thecoleworts, that the one will die where the other grows the decoctionof coleworts takes away the pain and ache, and allays the swelling ofsores and gouty legs and knees, wherein thesis gross and watery humoursare fallen, the place being bathed therewith warm it helps also oldand filthy sores, being bathed therewith, and heals all small scabs, pushes, and wheals, that break out in the skin the ashes of colewortstalks mixed with old hog-grease, are very effectual to anoint thesides of those that have had long pains therein, or any other placepained with melancholy and windy humours this was surely chrysippusgod, and therefore he wrote a whole volume on them and their virtues, and that none of the least neither, for he would be no small fool. Heappropriates them to every writing of the body, and to every disease inevery writing. And honest old cato they say used no other physic i knownot what metal their bodies were made of. This i am sure, cabbages areextremely windy, whether you take them as meat or as medicine. Yea, as windy meat as can be eaten, unless you eat bag-pipes or bellows, and they are but seldom eaten in our days. And colewort flowers areessaything more tolerable, and the wholeessayr food of the two the moonchallenges the dominion of this herb the sea coleworts descript this has divers essaywhat long and broad large and thickwrinkled leaves, essaywhat crumpled about the edges, and growing eachupon a thick footstalks very brittle, of a greyish green colour, fromamong which rises up a strong thick stalk, two feet high and better, with essay leaves thereon to the top, where it branches forth much. Andon every branch stands a large bush of pale whitish flowers, consistingof four leaves a-piece.

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In fact, the quoted statement isincredible the company further alleges that, on the basis of “clinical reports”it has received, it does not “hesitate to recommend this product forroutine use in all streptococcic infections ” such a therapeuticsuggestion is, to put it conservatively, gross exaggeration the whole question of the justification of using salicylatesintravenously is open to grave doubt since it is possible to obtainthe salicylate effects promptly and certainly by oral administration, the inherent dangers of intravenous medication render its routineemployment unwarranted a further objection to venosal, especially atthis time when economy is a national policy, is the unnecessarily highexpense of venosal itself and of its administration the referee recommends that venosal be declared ineligible to new andnonofficial remedies because of conflicts with rule 1 indefinitechemical composition, rule 6 therapeutic exaggerations and rule10 unscientific composition -- from the journal a m a , jan 5, 1918 secretin-beveridge and the u s patent law report of the council on pharmacy and chemistrytwo years ago the council published reports on two proprietarypreparations said to contain secretin, namely, “secretogen, ” soldby the g w carnrick company the journal a m a , may 1, 1915, p 1518, and “duodenin, ” sold by armour and company the journala m a , aug 14, 1915, p 639 these reports explained that therewas no evidence to indicate that an insufficient amount of secretin wasthe cause of gastro-intestinal diseases, and further that there wasno evidence that secretin in any form was physiologically active whenadministered by the mouth subsequently, a j carlson and his co-workers, at the request ofthe council, studied the question of the stability of secretin anddemonstrated the journal a m a , jan 15, 1916, pp 178 and 208that commercial secretin preparations contained no secretin and, further, that secretin given both by the mouth and even in enormousdoses directly into the intestine is entirely inactive shortly after the publication of professor carlson work the attentionof the council was called to a u s patent issued, may 2, 1916, to james wallace beveridge, “means for and method of stabilizingsecretin ” in this patent beveridge claimed to have invented “theprocess of producing secretin in stable form as a commercial articlefor therapeutic use ” that is, a process for preparing preparationswhich would contain secretin when they reach the consumer and in a formresisting destruction in its passage through the stomach in view of the demonstrated instability of secretin, the councilasked professor carlson to investigate the validity of the claims ofthe beveridge patent the study on “the question of the stability ofsecretin, ” by a j carlson, a e kanter and i tumpowski, whichappears below, shows that the beveridge patent furnishes no process forthe manufacture of commercially stable secretin preparations, nor anymeans for preventing the destruction of secretin by the gastric juicewhen administered orally it further demonstrates that the preparationmade by beveridge was devoid of secretin the council adopted the report of carlson and his co-workers, anddeclared secretin-beveridge inadmissible to new and nonofficialremedies the council directed that the report of carlson and his collaboratorsbe sent to the commissioner of patents with a protest against thegranting of patents without competent and thorough investigation of theclaims advanced therein w a puckner, secretary the question of the stability of secretin a j carlson, a e kanter and i tumpowski from the hull physiological laboratory of the university of chicagoin a letters patent, filed may 6, 1914, the patent granted may 2, 1916, james w beveridge, m d , makes certain claims concerning the stabilityand physiologic activity of secretin prepared according to the methodpatented by him in brief, dr beveridge claims that secretin prepared by digestingintestinal mucosa with a weak acid at a temperature slightly belowboiling, and mixed with 0 2 per cent to 2 per cent blood serum, albumin or peptone 1 remains active for at least six months, 2stimulates the pancreas when given by mouth, and 3 “may be injectedintravenously in man, if desired ” the only thing in the letters patentin support of these claims is the statement. “i have found out byactual tests that the preparation maintains its stability for five orsix months ”here are the claims in detail. “for the source of secretin i preferably use that writing of the alimentary tract of any lower animal-- such as a hog or sheep-- including the gastric pylorus, the duodenum and the jejunum this writing is split open and washed with a normal saline solution to clean the mucosa or mucous membrane of any detritus which may be present the mucosa with the epithelial cells is then removed or separated from the muscular wall by scraping with a blunt knife or in any other suitable way the scrapings or cuttings, which contain the secretin, are then macerated or broken up ” “the macerated mass is placed in a suitable vessel and subjected to the action of an acid solution until digested the time for the digestion of the mass will, of course, depend upon the strength and temperature of the acid solution employed the stronger the solution and the higher the temperature, the shorter the time necessary for complete digestion this period may vary from several minutes to several hours in my experiments i found that the best results were obtained with hydrochloric acid solution of one-tenth to five-tenths of one per cent in strength, although as high as eight-tenths per cent might be used the mixture is brought to a temperature of approximately 210 f , and it may even for a few moments exceed that temperature, but it should be kept below the boiling point, for excessive heat injures or breaks down the secretin molecule and impairs or destroys its activity although i prefer to use hydrochloric acid, i would have it understood that other acids-- both organic or inorganic-- may be employed, provided that the percentage of acidity is regulated to prevent a chemical change in the secretin, and further provided, of course, that the acid has no injurious effect on the human system ” “after the mass has been digested in the heated solution, the decoction is decanted, and after being allowed to cool is passed through a suitable filter until the filtrate is clear i found that by filtering the decoction from four to six times through a carbon filter, i obtained a clear colorless filtrate this is a solution of secretin and the acid which was used, and the clearness of the solution shows that it is practically free from albumoses, gelatin and other impurities such as cell tissues, etc present in the raw material under treatment ” “to the solution of pure and active secretin prepared as above explained, there is added a suitable quantity of blood serum-- say from one-fifth to two per cent or any equivalent medium-- such as albumin solution or a peptone solution-- which will aid and sustain the activating power of secretin as provided by the blood that is to say, any medium having the same power, similar quality or chemical composition that the blood-stream possesses in combining with secretin to stimulate the pancreas the addition of such a medium to the active secretin solution increases the potency of the secretin and its degree of stability by preventing oxidation or deterioration thereof if this strengthening or fortifying medium, as it may be properly termed, is alkaline, it performs the additional function of lowering the acidity of the secretin filtrate it is preferable that the final product be just faintly acid if desired, the final product may be made into an elixir by the addition of aromatics ” “any desired strength of secretin solution may be obtained according to the quantity of acid solution in my experiments i used from ten to fourteen duodena to a pint of acid solution ” “the solution of secretin prepared as above described is characterized by its ability to resist oxidation or deterioration for a sufficient period of time to render the solution available as a commercial article, and is furthermore characterized by freedom from poisonous and irritable chemical substances, whereby the secretin is chemically adapted to the human system to stimulate the pancreas to increased secretion ” “as previously stated, the secretin prepared according to my method may be administered orally to produce the desired physiological action of course, if desired, the secretin might be injected intravenously, but this more or less dangerous procedure is not at all necessary, and i merely mention it here to point out that when i refer to the oral administration of my new secretin preparation, i do not mean to exclude its administration by injection ” “as to the commercial stability of the secretin prepared according to my method, i may say that i have found by actual tests that the preparation maintains its stability for as long a period as five or six months when i refer to my product as being “commercially stable, ” i mean that it resists oxidation or deterioration for a sufficient period to render the same available as a commercial article this period may vary from several weeks to several months, depending upon certain commercial factors well understood by the manufacturer so, roughly speaking, i should say that secretin is commercially stable when it retains its activity from one to six months i do not wish to be understood, however, as limiting myself to these exact figures ”that active secretin may be extracted from macerated intestinal mucosaby weak acids below the temperature of boiling is well known in fact, weak acids at body temperature in contact with the duodenal mucosa leadto the formation of secretin the claims that secretin given by mouthreaches the blood and acts on the pancreas has been made for otherpreparations of secretin it has also been shown that these claims areerroneous 122 thus it would appear that the only novel element indr beveridge patented secretin is the addition of serum, solubleproteins or peptones what reason is there for believing that thiswill render the secretin stable for months, and physiologically activewhen taken by mouth?. we do not believe dr beveridge ever injected hissecretin-- protein mixture-- intravenously in man or animals not underanesthesia, otherwise he would not have stated. “of course, if desired, the secretin may be injected intravenously ”122 carlson, lebensohn and pearlman, the journal, jan 15, 1916, p 178 beveridge patented secretin is not stablei the samples of secretin sent us by dr beveridge -- physiologicaltests were made on four quart bottles of the secretin kindly sent us bydr beveridge june 26, 1916 according to a letter from dr beveridgeof july 20, 1916, those samples of secretin were prepared june 20, thatis, only six days before received by us the material came in darkcolored bottles it was kept in the original bottles and placed inthe ice box immediately on receipt dr beveridge stated the secretin“should remain active until the month of november, 1916, at least ”tests were made on three out of the four bottles the fourth bottlewas not opened, as we desired to learn what change it might undergoin the way of protein precipitation and bacterial decomposition there is nothing in the beveridge method of preparation that insuresa sterile secretin unless it is passed through a berkefeld filter in all our crucial experiments the animals dogs were kept underlight ether anesthesia, a cannula inserted into the pancreatic duct, the blood pressure recorded from the carotid artery and the varioussecretin preparations injected intravenously when inactive secretinpreparations were encountered, control tests were always made withactive solutions of secretin to eliminate possible individualpeculiarities of the animal thus when the pancreas of a dog reacts tothe injection of preparation a, but not to preparation b, it isevident that absence of response to b is due to this preparation andnot to the animal or to the experimental conditions illustration. Fig 1 -- records of carotid blood pressure and secretionof pancreatic juice on intravenous injection of beveridge secretinin dogs x, injection of 10 c c secretin. B, record of flow ofpancreatic juice in drops tracing a, injection of 10 c c of onesample secretin ten days old furnished by dr beveridge tracingb, injection of 10 c c of second sample of secretin ten daysold furnished by dr beveridge tracing c, injection of 10 c c of secretin twenty hours old made by us according to the beveridgemethod showing that the secretin preparations sent us by dr beveridgecontained no secretin each of the three samples of secretin sent us by dr beveridge wastested in the above manner on five dogs the first tests were madejune 27, 28 and 29, respectively, that is, within nine days of thepreparation of these samples of secretin none of the samples wasactive fig 1, even when injected intravenously in quantities up to50 c c. 40-50 c c of beveridge secretin mixture may kill a dog bytoo great lowering of the blood pressure a good secretin preparationyields a copious secretion of pancreatic juice on intravenous injectionof a few cubic centimeters it is not difficult to prepare a secretin, by the original bayliss orstarling method or by the beveridge method, that retains essay activityfor a longer period than nine days hence we cannot account for theabsolute inactivity of these preparations except on the assumptionthat they did not contain any secretin to start with.