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1 at the end of theduodenum. 2 at the end of the ilium. And 3 at the lower portionof the rectum. And an incision should be made with a pair of scissorsbetween these ligatures the jejunum and ilium should first be removedtogether by seizing the gut with the left hand, keeping it on thestretch, and cutting with a pair of scissors through the mesenteryclose to its intestinal attachment the cæcum, colon, and rectum shouldthen be removed in a similar manner the intestines being placed in large absolutely clean dishes, whichhave previously been rinsed with distilled water, are opened. Greatcare being taken that none of the intestinal contents are lost thesmall intestines should be opened in one dish and the large intestinein another a portion of the intestines where morbid appearances aremost likely to be seen in paper of poisoning are the duodenum, thelower writing of the ilium, and the rectum the comparative intensity ofthe appearances of irritation should be especially noted for example, if the stomach appears normal and the intestines are found inflamed thepossibility of poison from an irritant may be denied the intestines are opened along their detached border by theenterotome care should be taken to distinguish the post-mortemdiscolorations which are usually seen along the intestines from thoseproduced by disease the former are most marked in the dependentportions they are apt to occur in patches which can be readilyrecognized by stretching the wall of the gut the darkish brown orpurple discolorations which are essaytimes seen as the result ofdecomposition are due to the imbibition from the vessels of decomposedhæmoglobin much care and experience are necessary to tell the amountof congestion which is within normal limits and to recognize changes ofcolor produced by decomposition the pathological lesions ordinarily looked for in the examinationof the intestines are ulcers, perforation, hemorrhages, strictures, tumors, and the evidences of various inflammations to obtain anaccurate idea of the various portions of the mucous membrane of theintestines, it is essaytimes necessary to remove their contents whenvery adherent this should be done by allowing as small a portionof distilled water as possible to flow over their surface if anyabnormalities are noticed along the intestinal tract, an accuratedescription should be given of their situation and extent. As also theamount of congestion seen in different portions of the intestinal tract if possible the different portions of the intestines, as well as thestomach, should be examined immediately after being exposed to view, as under the influence of the air those writings which are pale maybecome red, and slight redness may become very pronounced in this wayonly can we estimate the degree of vascularity of the various writingsafter death however, in paper of suspected poisoning, when it isimpossible for the chemist to be present at the autopsy, the medicalexaminer should not open the stomach and intestines, but place themin sealed jars as soon as possible afterward, the chemist beingpresent, they should then be examined in the manner indicated whatmay be lost by waiting, in changes of color which have taken place, will be more than counterbalanced by the data which the chemist willobtain from observing the contents and mucous membrane of the stomachand intestines when they are first exposed the characteristic odorsof certain poisons are so evanescent that they quickly disappear afteropening of the stomach and intestines after a thorough examination of the intestines, they are to be put withtheir contents into wide-mouthed vessels, each writing by itself, andthe basins in which they were opened washed with distilled water andthe washings put into the same bottle as soon as the intestines aretransferred to the jars they should be sealed the stomach - the stomach and duodenum are removed together theyare opened by passing the enterotome into the duodenum and dividingit along its convex border, the incision being continued along thegreater curvature of the stomach as far as the œsophageal opening theyshould be opened in a large glass dish which has been carefully washedwith distilled water the chemist and medical examiner will carefullynote the quantity, odor, color, and reaction of the stomach contents;also whether luminous or not in the dark. The presence or absence ofcrystalline matter, foreign substances, undigested food or alcohol portions of the contents should be placed in a small glass bottle andsealed, so that at a future time they may be examined microscopically only in this way can an absolute knowledge of the character of thestomach contents be obtained in certain medico-legal paper the abilityto decide the character of the stomach contents is of the utmostimportance the mucous membranes of the stomach and duodenum must benext carefully examined for evidences of hemorrhages, erosions, tumors, and of acute or chronic inflammations the appearance of the rugæ andtheir interspaces, principally in the region of the greater curvature, should be noted. Because here traces of poison and its effects aremost frequently seen if the stomach is inflamed, the seat of theinflammation should be exactly specified, as also that of any unusualcoloration the condition of the blood-vessels are also noted vascularity orredness of the stomach after death should not be confounded with theeffects of poison or the marks of disease it may occur in everyvariety of degree or character and still be within normal limits vascularities which we might call normal are seen in the posterior writingof the greater end and in the lesser curvature, and may cover spacesof various extent rigot and trosseau have proven by experiment thatvarious kinds of pseudo-morbid redness may be formed which cannot bedistinguished from the varieties caused by inflammation. That theseappearances are produced after death and often not until five or eighthours afterward, and that they may be made to shift their place andappear where the organ was previously healthy, merely by altering theposition of the stomach ulcers, or perforations of the stomach as theresults of disease, as also the digestion of the stomach after death, have been mistaken for the effects of irritant poisons when perforation of the stomach is the result of caustic poisons, theedges of the opening are very irregular, and are of the same thicknessas the rest of the organ the writings not perforated are more or lessinflamed, and traces of the action of the caustic are found in themouth, pharynx, and œsophagus this is the opposite condition to thatseen in spontaneous perforation in considering perforation of the stomach the following points given bytaylor are well to remember. 1 a person may have died from perforation of the stomach and not frompoisoning 2 a person laboring under disease may be the subject of poison 3 a person laboring under disease may have received blows orinjuries on the abdomen, and it will be necessary to state whether theperforation did or did not result from the violence 4 the perforation of the stomach from post-mortem changes may bemistaken for perforations from poison corrosives, if they do not produce perforation of stomach, willgenerally cause intense inflammation accompanied by softening of theinner coat, essaytimes ending in gangrene the inflammation varies as toits extent and intensity, essaytimes affecting principally the mouth andœsophagus, but generally the changes are more pronounced in the stomachand duodenum, while in rare paper the inflammatory process may extendthrough the whole alimentary canal the mucous membranes are essaytimesbright red with longitudinal or transverse patches of a blackish color, formed by extravasated blood between the coats carbolic acid oftenproduces in the stomach and œsophagus white patches when these patchesare carefully examined, an ulcerated surface beneath them is generallyseen narcotic poisons - it is a common but mistaken idea that thesepoisons produce essay mark or characteristic effect upon the stomachwalls.

Beingboiled with wine, it is good to wash inflammations, and takes away theblack and blue spots and marks that come by strokes, bruises, or falls, being applied with warm water it is an excellent medicine for thequinsy, or swellings in the throat, to wash and gargle it, being boiledin figs. It helps the tooth-ache, being boiled in vinegar and gargledtherewith the hot vapours of the decoction taken by a funnel in at theears, eases the inflammations and singing noise of them being bruised, and salt, honey, and cummin seed put to it, helps those that are stungby serpents the oil thereof the head being anointed kills lice, andtakes away itching of the head it helps those that have the fallingsickness, which way soever it be applied it helps to expectorate toughphlegm, and is effectual in all cold griefs or diseases of the chestsor lungs, being taken either in syrup or licking medicine the greenherb bruised and a little sugar put thereto, doth quickly heal any cutor green wounds, being thereunto applied hops these are so well known that they need no description. I mean themanured kind, which every good husband or housewife is acquainted with descript the wild hop grows up as the other doth, ramping upontrees or hedges, that stand next to them, with rough branches andleaves like the former, but it gives smaller heads, and in far lessplenty than it, so that there is scarcely a head or two seen in a yearon divers of this wild kind, wherein consists the chief difference place they delight to grow in low moist grounds, and are found inall writings of this land time they spring not until april, and flower not until the latterend of june. The heads are not gathered until the middle or latter endof september government and virtues it is under the dominion of mars this, inphysical operations, is to open obstructions of the liver and spleen, to cleanse the blood, to loosen the belly, to cleanse the reins fromgravel, and provoke urine the decoction of the tops of hops, as wellof the tame as the wild, works the same effects in cleansing the bloodthey help to cure the french diseases, and all manner of scabs, itch, and other breakings-out of the body. As also all tetters, ringworms, and spreading sores, the morphew and all discolouring of the skin thedecoction of the flowers and hops, do help to expel poison that any onehath drank half a dram of the seed in powder taken in drink, killsworms in the body, brings down women courses, and expels urine asyrup made of the juice and sugar, cures the yellow jaundice, eases thehead-ache that comes of heat, and tempers the heat of the liver andstomach, and is profitably given in long and hot agues that rise incholer and blood both the wild and the manured are of one property, and alike effectual in all the aforesaid diseases by all thesetestimonies beer appears to be better than ale mars owns the plant, and then dr reason will tell you how it performsthese actions horehound there are two kinds of horehound, the white and the black the blacksort is likewise called hen-bit. But the white one is here spoken of descript common horehound grows up with square hairy stalks, half ayard or two feet high, set at the joints with two round crumpled roughleaves of a sullen hoary green colour, of a reasonable good scent, buta very bitter taste the flowers are small, white, and gaping, set in arough, hard prickly husk round about the joints, with the leaves fromthe middle of the stalk upward, wherein afterward is found small roundblackish seed the root is blackish, hard and woody, with thesis strings, and abides thesis years place it is found in thesis writings of this land, in dry grounds, andwaste green places time it flowers in july, and the seed is ripe in august government and virtues it is an herb of mercury a decoction ofthe dried herb, with the seed, or the juice of the green herb takenwith honey, is a remedy for those that are short-winded, have a cough, or are fallen into a consumption, either through long sickness, orthin distillations of rheum upon the lungs it helps to expectoratetough phlegm from the chest, being taken from the roots of iris ororris it is given to women to bring down their courses, to expel theafter-birth, and to them that have taken poison, or are stung or bittenby venemous serpents the leaves used with honey, purge foul ulcers, stay running or creeping sores, and the growing of the flesh overthe nails it also helps pains of the sides the juice thereof withwine and honey, helps to clear the eyesight, and snuffed up into thenostrils, purges away the yellow-jaundice, and with a little oil ofroses dropped into the ears, eases the pains of them galen saith, itopens obstructions both of the liver and spleen, and purges the breastand lungs of phlegm. And used outwardly it both cleanses and digests adecoction of horehound saith matthiolus is available for those thathave hard livers, and for such as have itches and running tetters the powder hereof taken, or the decoction, kills worms the greenleaves bruised, and boiled in old hog grease into an ointment, healsthe biting of dogs, abates the swellings and pains that come by anypricking of thorns, or such like means. And used with vinegar, cleansesand heals tetters there is a syrup made of horehound to be had at theapothecaries, very good for old coughs, to rid the tough phlegm. Asalso to void cold rheums from the lungs of old folks, and for thosethat are asthmatic or short-winded horsetail of that there are thesis kinds, but i shall not trouble you nor myselfwith any large description of them, which to do, were but, as theproverb is, to find a knot in a rush, all the kinds thereof beingnothing else but knotted rushes, essay with leaves, and essay without take the description of the most eminent sort as follows descript the great horsetail at the first springing has headsessaywhat like those of asparagus, and afterwards grow to be hard, rough, hollow stalks, jointed at sundry places up to the top, a foothigh, so made as if the lower writings were put into the upper, where growon each side a bush of small long rush-like hard leaves, each writingresembling a horsetail, from whence it is so called at the tops of thestalks come forth small catkins, like those of trees the root creepsunder ground, having joints at sundry places place this as most of the other sorts hereof grows in wetgrounds time they spring up in april, and their blooming catkins in july, seeding for the most writing in august, and then perish down to theground, rising afresh in the spring government and virtues the herb belongs to saturn, yet is veryharmless, and excellently good for the things following. Horsetail, thesmoother rather than the rough, and the leaves rather than the bare, ismost physical it is very powerful to staunch bleeding either inward oroutward, the juice or the decoction thereof being drank, or the juice, decoction, or distilled water applied outwardly it also stays allsorts of lasks and fluxes in man or woman, and bloody urine. And healsalso not only the inward ulcers, and the excoriation of the entrails, bladder, &c but all other sorts of foul, moist and running ulcers, andsoon solders together the tops of green wounds it cures all rupturesin children the decoction thereof in wine being drank, provokes urine, and helps the stone and stranguary. And the distilled water thereofdrank two or three times in a day, and a small quantity at a time, also eases the bowels, and is effectual against a cough that comes bydistillations from the head the juice or distilled water being warmed, and hot inflammations, pustules or red wheals, and other breakings-outin the skin, being bathed therewith, doth help them, and doth no lessthe swelling heat and inflammation of the lower writings in men and women houseleek or sengreen both these are so well known to my countrymen, that i shall not need towrite any description of them place it grows commonly upon walls and house-sides, and flowers injuly government and virtues it is an herb of jupiter, and it is reportedby mezaldus, to preserve what it grows upon from fire and lightning our ordinary houseleek is good for all inward heats as well asoutward, and in the eyes or other writings of the body.

Inwardly it is given tengrains at a time against bloody-fluxes raw-silk, heats and dries, cheers the heart, drives away sadness, comforts all the spirits, both natural, vital and animal belonging to the sea sperma cœti, is well applied outwardly to eating ulcers, the markswhich the small pox leaves behind them. It clears the sight, provokessweat. Inwardly it troubles the stomach and belly, helps bruises, and stretching of the nerves, and therefore is good for women newlydelivered amber-grease, heats and dries, strengthens the brain and nervesexceedingly, if the infirmity of them come of cold, resists pestilence sea-sand, a man that hath the dropsy, being set up to the middle init, it draws out all the water red coral, is cold, dry and binding, stops the immoderate flowing ofthe menses, bloody-fluxes, the running of the reins, and the fluoralbus, helps such as spit blood, it is an approved remedy for thefalling sickness also if ten grains of red coral be given to a childin a little breast-milk so soon as it is born, before it take any otherfood, it will never have the falling-sickness, nor convulsions thecommon dose is from ten grains to thirty pearls, are a wonderful strengthener to the heart, encrease milkin nurses, and amend it being naught, they restore such as are inconsumptions. Both they and the red coral preserve the body in health, and resist fevers the dose is ten grains or fewer. More, i suppose, because it is dear, than because it would do harm amber, viz yellow amber heats and dries, therefore prevailsagainst moist diseases of the head. It helps violent coughs, helpsconsumption of the lungs, spitting of blood, the fluor albus. It stopsbleeding at the nose, helps difficulty of urine. You may take ten ortwenty grains at a time the froth of the sea, it is hot and dry, helps scabs, itch, andleprosy, scald heads, &c it cleanses the skin, helps difficulty ofurine, makes the teeth white, being rubbed with it, the head beingwashed with it, it helps baldness, and trimly decks the head with hair metals, minerals, and stones gold is temperate in quality, it wonderfully strengthens the heart andvital spirits, which one perceiving, very wittily inserted these verses. For gold is cordial. And that the reason, your raking misers live so long a season however, this is certain, in cordials, it resists melancholy, faintings, swoonings, fevers, falling-sickness, and all such likeinfirmities, incident either to the vital or animal spirit alum heats, binds, and purges. Scours filthy ulcers, and fastensloose teeth brimstone, or flower of brimstone, which is brimstone refined, andthe better for physical uses. Helps coughs and rotten flegm. Outwardlyin ointments it takes away leprosies, scabs, and itch. Inwardly ithelps yellow jaundice, as also worms in the belly, especially beingmixed with a little salt-petre.

“ a cincinnati physician who is now acting assistant surgeon, u s public health service, cooperating with the bureau of venereal diseases of the dewritingment of health of the state of ohio ”3 the right hand top corner of the official stationery, as can beseen by the reproduction, bore the name of “james d bauman, deputycommissioner ” dr broeman signature was rather illegible and couldeasily be mistaken, by those not knowing the handwriting of eitherman, for the signature of deputy commissioner bauman in at least oneinstance it was so mistaken, and the physician who was misled wrote tothe director of the bureau asking whether the testimonial for proteogenno 10 which had been shown him by the merrell detail man was really anofficial communication 4 on may 15, 1919, commissioner of health freeman wrote to themerrell co stating that he had been informed that one of the merrellrepresentatives was using as an advertisement a letter bearing theletterhead of the bureau of venereal diseases of the state dewritingmentof health and what purported to be a report signed by “mr bauman, deputy commissioner ”5 on may 19, the wm s merrell co wrote dr freeman that he wascertainly mistaken in regard to the use of any “report signed bymr bauman ” dr freeman then sent to the company the letter he hadreceived from the physician who had mistaken broeman letter for anofficial letter by bauman although it would seem that this letterand commissioner freeman protest should have made plain to the wm s merrell co , the fact that the letter, incorrectly referred toas mr bauman, was in reality dr broeman, the company remainedsilent regarding its use of the broeman letter and, on may 22, merelyreiterated that there had been “no letter circulated by this companycontaining a testimonial of your mr bauman ” on may 28 six dayslater the merrell company sent to its proteogen detail men anothergeneral letter, “for personal use of agents, ” in which it again calledtheir attention to the “photographic copy mounted on linen” of dr broeman letter this communication to the detail men also declaredthat it “has been suggested that the further use of dr broemanletter might antagonize the state dewritingment of health” and, thereforethe detail men were told to “discontinue using the photographic copy inquestion” and to return the photographs to the head office illustration. Reproduction reduced of one of the photographiccopies sent out by the wm s merrell co to its proteogen detail mento be shown to physicians while the letter is a private one, it waswritten without authority on official stationery essay physicianswere misled into thinking it was an official endorsement of proteogens the merrell concern denied any intention to mislead and claimed thatit was interested only in bringing to the attention of physicians thecontents of the letter!. Here, briefly are the bald facts in the case the essential point atissue is whether these photographic copies of dr broeman letterwould or would not be likely-- whether or not they were so intended-- tomislead physicians into believing that the endorsement was an officialone by the state board of health rather than an individual one one canbut wonder why, if, as the merrell company so vehemently asserts, therewas no intention of misleading physicians on this point, the companyshould have gone to the trouble and expense of photographing theentire letter, including the letterhead, rather than making typewrittenor mimeographed copies of the contents of the letter -- from thejournal a m a , sept 27, 1919 dr broeman final report on proteogensto the editor:-- in the september 27 issue of the journal my namewas mentioned in connection with the merrell chemical company“proteogens” in the treatment of syphilis the merrell chemical companypromised not to use my name at any time in connection with their“proteogens” injection and they know that the use of my name has beendistinctly against my wishes i feel that in justice to myself, as wellas the public, i should report the result of my experiments with their“proteogens” in private practice in explanation i might say that i began the use of their “proteogens”in april, 1918, and i feel that i now have enough data to give acomplete report i might say that all my results have been practicallynil. Writingicularly is this true in my paper of syphilis, which all hada four plus wassermann reaction when i discontinued using this form oftreatment very truly yours, c j broeman, m d , cincinnati -- correspondence in the journal a m a , oct 11, 1919 pulvanein a twelve-page pamphlet, sent out by the pulvane laboratories, inc , of des moines, iowa, and purporting to deal with “the therapy ofpulvane, an advanced method for the treatment of respiratory diseases, ”we are told that pulvane “was developed in a united states army generalhospital by officers of the medical dewritingment ”pulvane “originally was intended only for its germicidal actionupon tubercle bacilli in the lung, ” but it is now also recommendedfor asthma, hay fever, bronchitis, rhinitis, laryngitis and “otheraffections of the air passages ” of the alleged action of pulvane ontuberculosis we read. “it destroys the spores of the bacilli as well as the germs themselves it prevents infection of new areas by aspiration, gravity or surface contact “in paper where sputum is positive it is a very noteworthy fact that shortly after treatment is begun, the bacilli begin to disappear, gradually diminish in number, and finally the sputum becomes negative ”pulvane is administered, by inhalation, at the offices of the pulvanelaboratories, inc its “discoverer” chanced on a method of “introducinginto solution and volatizing a certain germicide, extremely rare inits usage because of its resistance heretofore to attempts to bend itto scientific will ” this “rare” medicament is alpha naphthol!. butsince the discovery of this volatizing method “three other ingredientsof high therapeutic value have been added ” what are these otheringredients?. “they would be named were it not that pulvane requires special technique in its preparation and administration our medical directors do not consider it advisable to identify them here because of the possibility of incompetent hands attempting their use the medical directors, however, will be glad to name every ingredient of pulvane for any reputable member of the profession pulvane laboratories reserve only the method of compounding ”presumably, therefore, if physicians desire to know what pulvane is, the pulvane laboratories, inc , “will be glad to name every ingredientof pulvane ” it is worth noting that nothing is said about quantities it is also worth remembering that “peruna” and essay other “patientmedicines” have for years printed on the label the names of thealleged ingredients how much longer is the medical profession going tobe fooled with the trick of nostrum exploiters pretending a franknessthat means nothing?. From a recent issue of a des moines newspaper we learn that the pulvanelaboratories are about to establish a sanatorium where the pulvanetreatment can be given this announcement is said to be made by john p mosher, the alleged discoverer of pulvane mosher is not a physician the newspaper article states, further, that mosher experiments weretried out “under the observation of major sharpe, ” commander at fortdes moines it appears also that an ex-newspaper reporter is connectedwith the pulvane laboratories the value of having a good publicityman is obviously recognized there also seems to be connected with theconcern a dr harry p hall we find in the records reference to oneharry p hall who was graduated by the medical dewritingment of drakeuniversity of des moines, iowa, in 1894, and was licensed in iowa in1896 our records indicate that he has not been in practice for essayyears we also find in our files essay newspaper clippings regarding adr harry p hall who, in 1914, pleaded guilty to a charge of using themails to defraud and was fined in the federal courts whether there isany connection between these two names, we do not know reverting to the claims made by the pulvane laboratories that pulvanewas “developed in a united states army general hospital by officersof the medical dewritingment” the following statement has recently beenreceived by the journal from surgeon-general ireland of the unitedstates army. “it has been brought to my attention that a concern in des moines, iowa, known as the pulvane laboratories, has issued a pamphlet in which statements are made which would naturally lead medical men to believe that the experiments, etc , referred to therein were made with the approval of and more or less under the direction of the medical dewritingment of the army i wish to say that this is not so. That the medical dewritingment had nothing whatever to do with the matter and that it thoroughly disapproves of the methods used by the promoters of this concern -- from the journal a m a , march 11, 1922 sal hepaticasal hepatica is a saline laxative sold by the bristol-myers company ofnew york little information is given, or, apparently, ever has beengiven, concerning the composition of this product thesis years ago thestock medical journal advertisement contained this statement. “composition -- sal hepatica contains all of the tonic, alterative and laxative salts of the celebrated ‘bitter waters’ of europe, especially those of bohemia, as determined by actual chemical analysis of these waters, and fortified by the addition of lithium and sodium phosphates ”255255 essay of the sal hepatica advertising has claimed that it “is asaline combination with the addition of sodium phosphate and lithiacitrate!. ”sal hepatica no longer “contains all the tonic, alterative and laxativesalts , ” etc , for the label on a package recently purchased reads. “sal hepatica is an effervescent saline combination possessing medicinal properties similar to the natural ‘bitter waters’ of europe, and fortified by the addition of sodium phosphate ”in 1909, the druggists circular published an analysis of sal hepaticawhich showed that the preparation contained only 0 04 per cent oflithium phosphate by referring to the two quotations just givenit will be noticed that today the manufacturers make no claim thattheir preparation is fortified with any salt of lithium a circularaccompanying recent trade packages states. “sal hepatica is composed solely of harmless salts, being absolutely free from acetanilid, phenacetin, caffein, calomel, opium or coal tar derivatives ”since neither the names nor the amounts of the “harmless salts” arementioned, the composition of sal hepatica is secret it is a trickof the nostrum exploiter, old but ever popular, to mention numerousdrugs which his preparation does not contain. It helps to distractattention from the fact that he does not tell what the preparationdoes contain!. In the old-time medical journal advertisements, one reads, “salhepatica is the most powerful solvent of uric acid known ” the sameadvertisement as it appeared in those days in the journal showsthat claim toned down to, “sal hepatica is a powerful solvent ofuric acid ” in those easy going days, the bristol-myers companydeclared that “diabetes is treated with decided advantage by meansof sal hepatica it possesses the property of arresting thesecretion of sugar in the liver ” in the old days, too, sal hepaticawas recommended in the treatment of cirrhosis of the liver, brightdisease, gravel, phthisis, etc the present advertising circular recommends sal hepatica as aneliminant, laxative or cathartic in gout, autointoxication, “biliousattacks, ” rheumatism, acute indigestion, catarrhal conditions ofthe stomach, pyorrhea, headache, dizziness, heart burn, “summercomplaints, ” “derangements of the stomach and liver, ” skin diseases, colic, alcoholic excesses, and as a “preventive of seasickness ”in 1914 the council on pharmacy and chemistry published256 a reporton sal hepatica declaring it secret in composition and sold underexaggerated and unwarranted claims 256 j a m a , feb 7, 1914, p 472 in view of the inquiries which the journal continues to receive itseemed worth while to make a chemical examination of the present-dayproduct accordingly specimens were purchased and analyzed in thea m a chemical laboratory the report that follows was submitted bythe chemists:“sal hepatica is a white, granular, odorless powder it effervesces onthe addition of water in which it eventually dissolves the aqueoussolution, after boiling to remove carbon dioxid, has an acid reactionto litmus “since a great thesis medicinal substances are sold in effervescent form, and since practically no information is given by the manufacturerconcerning the composition of sal hepatica, it became necessary totest for a considerable number of therapeutic agents the absence ofacetanilid, acetphenetidin, alkaloids, ammonium salts, benzoates, caffein, citrates, heavy metals, hexamethylenamin, magnesium, potassium, salicylates and sugars was demonstrated by appropriatetests the presence of a carbonate probably in the form of abicarbonate, a phosphate, a sulphate, a chlorid, tartaric acid, sodiumand traces of lithium was shown by qualitative tests “quantitative analysis indicated that the composition of the specimensexamined was essentially as follows. Sodium phosphate, anhydrous 4 4 per cent sodium sulphate, anhydrous 26 5 per cent sodium tartrate, anhydrous 12 7 per cent sodium bicarbonate 19 5 per cent tartaric acid, free 20 8 per cent sodium chlorid 8 9 per cent lithium phosphate trace water of hydration by difference 7 2 per cent “from the results of the analysis, it appears probable that thecomposition of the mixture before ‘granulation’ was approximately asfollows. Sodium phosphate 4 per cent sodium sulphate 25 per cent sodium bicarbonate 30 per cent tartaric acid 30 per cent sodium chlorid 8 per cent lithium phosphate trace water of hydration by difference 3 per cent “sal hepatica, therefore, is essentially an effervescing mixture ofdried sodium sulphate glauber salt and sodium tartrate with alittle dried sodium phosphate and table salt added it is similar tothe effervescent artificial carlsbad salt described in the nationalformulary “in 1909 the druggists circular published the following analysis ofsal hepatica. Sodium phosphate 29 80 writings sodium sulphate glauber salt 26 27 writings sodium bicarbonate baking soda 18 00 writings sodium chlorid salt 13 05 writings lithium phosphate 0 04 writings citric and tartaric acids to make 100 12 84 writings“a comparison of the recent analysis with the earlier one would seem toindicate that considerable changes have been made in the formula sincethe first examination the proportions of sodium phosphate have beengreatly reduced, while the sodium bicarbonate and tartaric acid havebeen increased and the citric acid entirely eliminated ”sal hepatica, then, is a simple effervescent saline laxative, essentially secret in composition and sold under claims that would belaughed at were the full formula of the product a matter of publicknowledge -- from the journal a m a , oct 29, 1921 salicon“salicon” is marketed by the k a hughes company, boston, as “animproved aspirin ” in a circular sent out to the public a little over ayear ago the following claims were made for it.

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Infact, the throat symptoms were seemingly increased in severity by itsuse it has pay someone to do assignments university no effect on syphilids of the forearms and shins, and ifanything makes them worse it improves the appetite, as one would expect it has essay effect onthe kidneys, as noted in case 2. It has essay effect in healing theinitial lesion, as noted in all three of this series. Why, i do notknow i am entirely satisfied that it has no beneficial effect on syphiliticsand have discontinued its use entirely in my practice i am glad to have read cole excellent article, as it shows me that iwas correct in my decision not to use it again, as it was worthless william g ward, m d , lynn, mass to the editor:-- dr william g ward letter the journal, feb 3, 1917, p 390, and the recent admirable article by dr harold n cole the journal, dec 30, 1916, p 2012 recall to mind dr j b murphyclinical note on the use of sodium cacodylate in the treatment ofsyphilis the journal, sept 24, 1910, p 1113, and the experimentalwork of cap h j nichols, u s army the journal, feb 18, 1911, p 492 the results of nichols’ work conclusively proved, at leastfrom a laboratory standpoint, that this drug was of very little valueas a spirocheticide in combating syphilis prior to the publication ofdr murphy letter i had employed sodium cacodylate extensively as aremedy in psoriasis, and i still continue to use it in selected paperof the disease adopting dr murphy suggestion, i gave the agent an extensive trialin syphilis in all stages of the disease the results were extremelydisappointing, from both clinical and serologic points of view morerecently, during the scarcity of salvarsan, i gave the drug a secondtrial, employing it in large dosage in the hope that the previousfailure had been due to the employment of insufficient amounts theresults were not tabulated, but, judging roughly from my experience ina score of paper, its therapeutic value as an antisyphilitic was nil afew of the patients underwent a temporary improvement, probably owingto the tonic effect of the drug, but in every instance the serologicfindings were unaffected r l sutton, m d , kansas city, mo -- correspondence in the journal a m a , feb 3, 1917 tablets. Dependability of dosagethe tablet form of administering medicines is popular among thesisphysicians because of its convenient availability and dosage thereis no doubt about the convenience of tablets, but the accuracy of thedosage content is not always to be depended on one reason for thisis that the demand for palatable and convenient “medicaments has ledmanufacturers to attempt to produce in tablet form mixtures which, fromthe nature of the case, are not suited to that method of compounding ”in a series of painstaking experiments307 on bismuth, opium andphenol tablets, conducted a number of years ago in the a m a chemical laboratory, it was shown that no tablets on the market thencontained the amount of phenol the label indicated, the variationbeing from 12 3 to 112 5 per cent similarly, the laboratory foundthat in the case of several different brands of aromatic digestivetablets, 308 the amount of hydrochloric acid present in these absurdcombinations was true to label in only one half of the specimens, notwithstanding the fact that the amounts claimed to be present wereridiculously small. In two specimens, there was no hydrochloricacid whatever present, while a third contained only a trace theseexamples illustrated clearly the very evident unwisdom of attemptingthe pharmaceutically impossible merely for the sake of convenience orpharmaceutical “elegance ”307 puckner, w a , and clark, a h. Examination of tablets ofbismuth, opium and phenol, the journal a m a , july 25, 1908, p 330 puckner, w a , and hilpert, w s. Tablets of bismuth, opiumand phenol, dec 17, 1910, p 2169, may 6, 1911, p 1344 unreliablepharmaceutical products, editorial, may 6, 1911, p 1335 308 puckner, w a , and warren, l e. Aromatic digestive tablets, the journal a m a , aug 20, 1910, p 710 another reason for doubting the accuracy of dosage, irrespective ofthe characteristics of the drugs composing the tablets, has been themanifest lack of care in their manufacture in 1914, kebler309reported the results of a far-reaching investigation of tabletcompounding in which he pointed out that tablets on the market werenot as uniform or accurate as was generally believed, the variationsbeing “unexpectedly large in numbers and amount ” during the past year, the connecticut agricultural experiment station310 undertook theexamination of tablets-- proprietary and nonproprietary-- taken from thestock of dispensing physicians the variations found in weights ofthe tablets were strikingly similar to those reported by kebler 309 kebler, l f. The tablet industry, jour am pharm assn , 1914, 3, 820, 937, 1062 310 bull 200, connecticut agricultural station, food and drugproducts, 1917, p 161 variation in weights of tablets kebler connecticut variation per cent per cent less than 10 per cent 43 44 more than 10 per cent 57 56 more than 12 per cent 44 35 more than 15 per cent 28 26 more than 20 per cent 9 10the determinations of the composition of the tablets when comparedwith that claimed for them showed wide variation-- from 54 per cent above to 70 5 per cent below. In almost two thirds of the tabletsexamined, the variation amounted to more than 10 per cent. In threefifths of the tablets, the variation was more than 15 per cent.