History

Sample Argumentative Essay Outline


Rupture of crystalline lens harvey849 says the blood was foundflowing from the ear in 6 paper of nearly 1, 500, but no details weregiven ogston, one case hofmann saw a case in which there was bleedingfrom the ears he says this is not sample argumentative essay outline due, as has been supposed, torupture of the tympanic membrane, but to hemorrhage from subcutaneousvessels case 27 the tongue is usually livid and swollen, especially at the base according to tidy, dr guy looks on this as showing that suspensiontook place very probably during life in about one-third of the paperthe tongue is protruded and compressed between the teeth. Essaytimesbitten essay observers found it protruded only as a result ofputrefaction the protrusion of the tongue is not believed to dependon the position of the ligature hackel in 67 paper found the tonguelying forward in all paper where the cord was between the larynx andthe hyoid. In 55 per cent in front of the teeth, in 18 per cent betweenthe teeth. Where the ligature was lower down, the tongue was behindthe teeth he found by experiment that in the spasmodic expiratoryeffort the tongue was thrust forward. In the inspiratory movement, drawn backward he concluded that the forward movement was the resultof reflex action maschka850 found the tongue between the teeth 58times in 149 paper roth in 49 paper found the tongue projecting andbitten in 22, the teeth shut in 15 others. In 15 the mouth was open;the tongue was retracted in 30 paper harvey, after examining reports of nearly fifteen hundred hangings, says. “in the majority of instances immediately after death the features were placid, the face pale, the eyes not unduly prominent, the mouth closed or half open, the tongue pressed against the teeth but not protruding. The superficial veins full, but the head, neck, and trunk free from lividity after a longer or shorter time, however, and apparently after a very few hours, in india, all this is changed livid patches appear about the chest, back, and shoulders. The face and head become bloated and puffy, the tongue and eyes protrude ”bloody froth is essaytimes seen at the nose and mouth saliva is invariably secreted and runs out of the mouth down on thechin and chest its presence is considered as evidence that suspensionoccurred during life the urine and fæces are essaytimes found to havebeen expelled these discharges occur in all kinds of violent death tardieu found them, however, but twice in 41 paper of hanging roth in49 paper found discharges of fæces in 17 and urine in 4. In 15 papernot noticed harvey mentions a case where internal piles had burst, and there werestains and clots of blood about the perineum and anus in such paperwithout careful examination there would naturally be a suspicion ofviolence in about one-fourth of the paper the genital organs are congested the penis is large and more or less erect.

“i have treated probably more paper of locomotor ataxia and paralysis than any physician in united states and can honestly state that with organo therapy treatment your walk can be improved and pains controlled ”in march, 1919, dr lowenthal paid a visit to spokane, wash , andportland, ore a portland paper heralded his coming and printed apicture of “dr a a lowenthal, world famous alienist ” the paperdescribed dr lowenthal as “the alienist consulted in the harry thawcase” and the one “who treated john alexander dowie of zion cityfame and pope leo xiii ” the fulessay puffery that dr lowenthal gotwhile in spokane drew criticism from one or two members of the localmedical profession, who wrote to the newspapers protesting one ofthe physicians who thus wrote declared that lowenthal “coming wasannounced in a circular sent through the owl drug company which isagent for the sale of products of an organo-therapy company ”apparently, it was after dr lowenthal return from the pacific coastthat he commenced to announce his “post-graduate course of lectures andclinics” to the physicians of chicago, denver, st louis, columbus, etc -- and, incidentally, to bring to the attention of the medical worldthe alleged virtues of the products of the american organo-therapycompany -- from the journal a m a , july 3, 1920 medical society of the united states from “division of fees” to “down with autocracy”the “medical society of the united states” has for its “honorarypresident” one a h ohmann-dumesnil, a m , m d , m e , sc d , ph d , and for its “secretary and treasurer” one emory lanphear, m d , c m , ph d , ll d as originally planned, the “society” seems to have beenbased on the idea of organizing the “fee-splitters ” in sample argumentative essay outline may, 1916, the birth of the organization was announced to the medical professionthrough a letter signed emory lanphear, written on the stationery ofthe “medical society of the united states ” even in its embryonicstate the society had a h ohmann-dumesnil, a m , m d , m e , for itspresident, and emory lanphear, m d , ph d , ll d , as its treasurer the letter read in writing. “we-- the majority of the medical profession-- who believe in division of fees i e , that the surgeon should not ‘hog’ the whole of a patient money and leave nothing for the family doctor, are no longer welcome in the a m a we are therefore organizing the medical society of the united states, which will not be conducted for the benefit of a few selfish egotists we would like to have you with us “it costs only $1 00 to join this covers dues for 1916, and includes expense for the beautiful certificate of membership suitable for framing, which you will receive on admission fill enclosed blank and return to me with $1 00 ”but presumably the idea of organizing on a basis of “fee splitting”did not make a hit, so the lure was changed today physicians areapproached with the plea that the “medical society of the unitedstates” will make the medical world free for democracy. It is, we areassured, a “society of protest against the autocracy of the a m a , ”and a “society of medical democracy ”membership costs “only $1 00 including the cost of a beautifulcertificate of membership ” no penalties or punishments are involvedfor belonging to other societies, and. “joining our body need not affect your membership in any other society-- even the a m a , if you wish to belong to it, and be ‘bossed’ by the ‘simmons gang’ ”the dollar for the “beautiful certificate” and membership is solicitedby means of circular letters signed “emory lanphear, ” coming from 3447pine st , st louis, mo , the address of what has been variouslycalled the “american polyclinic, ” the “american hospital, ” and later, the “german hospital ” the “surgeon-in-charge” of the “german hospital”is emory lanphear, m d , c m , ph d , ll d when running under thename of the “american hospital, ” lanphear solicited operative work ona “division of fees” basis, which, the general practitioner was told, meant that “you are to have 40 per cent of all fees received from yourpatients sent to our staff for operation or treatment ”with the change in name from “american hospital, ” to “german hospital, ”lanphear appealed for a “portion of your operative work on a basis ofpure reciprocity ” this “pure reciprocity” seems to have been a stillmore liberal distribution of the patient money, for from a 40 percent basis it was raised to an even fifty-fifty said lanphear, in aletter sent out a few months ago:illustration. The “medical society of the united states, ” wasoriginally organized on a basis of “fee-splitting, ” as is shown by thereduced facsimile of a letter sent broadcast in 1916, announcing thebirth of the new “society ” apparently, “fee-splitting” as a rallyingpoint did not bring in the desired returns, so today the “medicalsociety of the united states” is alleged to be a “society of protestagainst the autocracy of the a m a ” “i wish also to inform you in spite of the despicable opposition of the hypocritical gang in charge of the a m a , and the no less contemptible action of the st louis medical society, i am going to remain in st louis and continue to do surgical work upon a ‘division of fee’ basis to be more explicit, if you bring me a case for operation i shall allow you one half of the fee for your time, trouble, responsibility and help in the management of the case ”before leaving the interesting professional personality of lanphear, and carefully avoiding any details of a personal nature, we may remindour readers that as long ago as 1908 lanphear was the “dean” of the“hippocratean college of medicine, ” with a h ohmann-dumesnil, a m , m d , m e , sc d , “vice-dean ” at that time lanphear sent out lettersto physicians proposing the organization of a “post graduate faculty”on the following basis. “those who hold full professorships shall purchase stock in the corporation to the amount of $1, 000 00. Those who become lecturers or instructors shall pay in the sum of $500 00. Those who are to be merely clinical assistants will buy ten shares of stock, $100 00 ”the “hippocratean college” was a “sundown” affair. It never graduated astudent, and expired in 1910 illustration. Reduced facsimile of the letter-heads of an institutionknown variously as the “american hospital” and the “german hospital ”the change in name from “american” to “german” seems to have takenplace early in 1915-- when things german were more popular andprofitable than they are today!. But to come back to the “society of medical democracy”. The “medicalsociety of the united states” seems to have been born in 1916 itsparents, so far as is apparent, seem to have been lanphear andohmann-dumesnil the latter, it may be remembered, used to be theeditor and proprietor of the st louis medical and surgical journal, a publication so obviously venal, that its value to the nostrum makers, whose interests it espoused, must have been small advertising pages, “original articles” and “editorials”-- all were used to puff nostrums ofthe crudest type it was ohmann-dumesnil and his journal that came tothe defense of the “patent medicine” interests when they were so hardhit by mr adam “great american fraud” series in commenting on thisphase of “patent medicine” activities, collier, in january, 1907, said. “headache powders came in for a considerable share of attention in the patent medicine articles there was much talk of libels among the headache powder makers, but they decided upon the safer methods of hiring a meretricious medical publication, the st louis medical and surgical journal, to print an article in which the collier statements were branded as lies, and the collier editors and writers as liars and libelers this article the proprietary association of america circulated in pamphlet form the journal which printed it died a natural death a few weeks later its editor, one a h ohmann-dumesnil, has just appeared in the public prints in an unsavory connection with a corrupt lobbying project in st louis ”essay of the nostrums that ohmann-dumesnil has recommended are:“sanmetto, ” “gonosan, ” “cactina pillets, ” “pepto-mangan, ” “satyria, ”“campho-phenique, ” “tongaline, ” “germiletum, ” “narkogen, ” “nosophen, ”“mercauro, ” “arsenauro, ” and “hydrozone ” thesis of these testimonialswere, of course, used by the manufacturers in their advertising“literature ”at the time that the medical society of the united states was beingorganized-- in 1916-- there was published what purported to be apreliminary program of its first meeting the meeting was held in st louis, and the program, while containing the names of men with specialfads or interests to exploit, also contained the names of essay men ofstanding it appeared, however, on investigation, that at least essayof the latter had but a hazy conception of the use to which theirnames were being put, and protested vigorously on learning the facts, repudiating the organization illustration. Reduced facsimile of a letter sent out in 1912, soliciting the purchasing of stock in the “american hospital” on adivision of fee basis-- forty-sixty!.

carminzym presents certain agents of well known properties, not in the least of incompatible or antagonistic action, but indeed especially suitable for the writingicular purpose designed. Its efficacy not to be measured and judged by theory or opinion as to the efficiency of a certain dosage of a writingicular drug by itself that the doses as contained are minimal and effective is distinctly advantageous the alkaline carbonates are in carminzym in stated quantities. The physician adjusts the dosage to the individual patient and with obvious evidence of the efficiency of the adjustment as we understand it, the employment of alkaline carbonates is not based on purely chemic considerations-- a definite known quantity of acid of the gastric juice is to be neutralized. The whole literature and practice dealing with the alkaline carbonates show them to be accredited with a much wider field of use and repute in gastro-intestinal disorders the pancreatic extract in carminzym is designed to be diffusible in the stomach, the tablet is preferable to be crushed in the mouth before swallowing, and we believe the pancreatic extract to be an effective constituent as administered in carminzym you comment as follows. “ipecac has a well defined though limited field of usefulness when it is used it should be given with due regard to the amount needed by the patient and the frequency of the repetition of the dose ” this in a sense may be said of any of the most useful drugs, but not in the least special degree does it apply to ipecac, which is, on the contrary, of quite characteristic, peculiar range of therapeutic properties, useful in varying combinations and in widely varying proportions and doses according to the purpose for which it is employed ipecac in well known official alkaline, carminative, laxative preparations occurs in the “average dose” in the varying quantities of 1/14, 1/10, 1/8, and 3/16 of a grain the ipecac in combination with the other ingredients in carminzym is designed for a tablet which shall carry a minimal quantity whilst capable of adequate remedial action, thus admitting of increase of dosage or repetition as occasion requires the quantity of ipecac was not taken at random, but chosen after long trial and consideration we believe that carminzym possesses carminative properties in a superior degree and that, furthermore, in consequence of its composition it directly stimulates the gland secretions and thus exerts a beneficial action upon the whole digestive functions carminzym is for use as occasion requires, and this is to be especially noted thus it is not only of direct benefit, but helpful in promoting systematic therapeutic measures and regimen the council takes the ground that complex mixtures of remedial agents are so wrong that there is no longer warrant for their admission into new and nonofficial remedies. And that carminzym is an irrational mixture we hold that certain desirable therapeutic properties may rationally be attributable to carminzym. And that these are manifested in practice during the time since the description was sent and the receipt of the statement of the action of the council, essay ten months, carminzym has proved of constantly increasing service the statement in the letter of fairchild bros and foster “thelong established custom of the use of mixtures of remedial agentsrests on considerations well known and generally accepted” mightwell be paraphrased to read. The one-time prevalent custom of usingill-considered combinations of remedial agents has been thoroughlydiscredited and is generally abandoned by progressive practitioners such arguments as that “laxatives, tonics, carminatives, diuretics arecombined with distinct advantage” have led to the use of irrationalmixtures such as the compound syrup of hypophosphites and the electuaryof theriaca the council is confident that no one who has studied thecauses and treatment of digestive disorders will find occasion toprescribe at one time all the ingredients stated to be contained incarminzym, and certainly not in the fixed proportions present therein the comments in the council report concerning ipecac certainlydoes apply to all active therapeutic agents ipecac was mentioned inthe report because the several constituents of carminzym were underdiscussion and hence it was necessary to point out the futility of thesmall dosage of ipecac in this mixture the announcement that “carminzym has proved of constantly increasingservice” is not convincing the council does not know of a singleclinical study of the action of carminzym under conditions which wouldhave afforded satisfactory evidence of its therapeutic value -- fromthe journal a m a , sept 28, 1918 phillips’ phospho-muriate of quinine comp report of the council on pharmacy and chemistrythe following report on phillips’ phospho-muriate of quinine comp hasbeen adopted by the council and authorized for publication w a puckner, secretary phillips’ phospho-muriate of quinine comp 125 is sold by the charlesh phillips chemical co , new york according to the published formula, each fluidram contains. Phosphoric acid 2 minims potassium phosphate } magnesium phosphate } calcium phosphate } 2-1/4 grains ferric phosphate } quinin muriate equal to nearly 1/2 gr bi-sulph 1/4 grain strychnin 1/120 grain flavoring, glycerin and syrup, q s 125 the evolution of “phillips’ phospho-muriate of quinine comp ”from “phillips’ wheat phosphates” may be interesting every oneknows that therapeutics tends to fashions, and “phillips’ wheatphosphates” appears to have had its inception as the result of theobservation that super-refined white flour contains less phosphatesthan the corresponding amount of wheat it was assumed that suchflour must be deficient in an essential constituent, and the wheatphosphates preparation was apparently designed to fill the want it wasexploited for the relief of numerous conditions that were supposed, without satisfactory evidence, to result from this deficiency wheniron, quinin and strychnin mixtures became the vogue a quarter of acentury ago, it was only natural to ride on the wave of popularityand the already widely advertised “wheat phosphates” was furtherenhanced-- commercially-- by the addition of the iron, quinin andstrychnin, the amount of alkaloid added being practically negligible those who are not familiar with the various phases of the phosphorus, phosphoric acid, lactophosphate, lecithin, nuclein and glycerophosphatepropaganda are referred to a report of the council on pharmacy andchemistry in the journal a m a , sept 30, 1916, p 1033 essay typical claims made for the preparation are. “with marked beneficial action upon the nervous system to be relied on where a deficiency of the phosphates is evident ” “ brace those tired nerves and aid that worn stomach with phillips’ phospho-muriate of quinine ” “the maintenance of a satisfactory blood pressure level free from intervals of depression may be accomplished by the use of phillips’ phospho-muriate of quinine compound in appropriate doses ” “the quantities of quinin and strychnin in this preparation are so well balanced that they relieve the depression and fatigue from mental or physical exertion, without the necessity of recourse to alcoholic stimulation ” “the other ingredients of phillips’ phospho-muriate of quinine-- phosphoric acid, and the phosphates of potash, magnesia, lime, and iron-- are the most rational as well as convenient means of administering these tissue remedies, and of introducing phosphorus-- the vitalizing constituent of the nervous system-- into the organism ”the action of such a mixture as a whole is practically that of the sumof the actions of its constituents the therapeutic action of strychninand quinin are described in every text-book of therapeutics, but itis necessary to distinguish carefully between the various conditionsin which these alkaloids have been used without discrimination, andthose conditions in which they have been proved to be of value while both have been widely used in a great variety of conditions, neither is of proved value in more than a distinctly limited rangeof diseases the manufacturers of phillips’ phospho-muriate ofquinine comp seem to appeal to the less discriminating who use thesealkaloids without any definite conception of exactly what they seekto accomplish with them quinin, although used by the uncritical in ahost of diseases, has a definite field of usefulness in the treatmentof malaria, both prophylactic and curative, but the required dose inthe treatment of malaria is thesis times larger than that recommended inthe phillips’ preparation the claim that the “strychnin and quininin this preparation are so well balanced that they produce a mild, buoyant effect, so advantageous, instead of alcoholic stimulation, torelieve depression and fatigue from mental or physical exertion” isnonsensical, if, indeed, it is not mendacious balderdash calcium and potassium have important functions in the body, but anydeficiency that may arise is usually attributable to an inability ofthe body to utilize that which is supplied, for there is seldom anydeficiency of these salts in the food, and when they are needed theyare best supplied as simple solutions of the salts in appropriate doseswithout all of the other constituents of phillips’ phospho-muriate ofquinine comp phosphoric acid exerts practically the same actions as other mineralacids, hydrochloric being usually preferred for internal administrationin certain forms of indigestion, aside from which they are seldom usedas such in the more recent literature for phillips’ phospho-muriate of quininecomp , we find the attempt to utilize the well known craze aboutphosphorus, which has been through so thesis phases, every one of whichhas had its day and has been discarded the phosphoric acid and phosphates present in phillips’ phospho-muriateof quinine are of no more value in nervous diseases than is simplesodium phosphate which does not require the addition of a host of otheringredients for its action as a matter of fact, the phosphates ofcalcium and potassium present in a dose of phillips’ phospho-muriate ofquinine are probably devoid of appreciable effect in practically allconditions to pretend that one who suffers from physical and nervous exhaustioncan be materially benefited by this mixture is sheer nonsense and isunworthy of a moment consideration by a clinician who is called on totreat such patients iron is useful in anemia, as every one knows iron has practically noother field of usefulness in therapeutics when it is indicated itshould be administered in a simple form, such as the pill of ferrouscarbonate, for example, and not in a “shotgun” mixture that is quite aslikely to do harm as good the claim that a satisfactory level of blood pressure can be maintainedby phillips’ phospho-muriate of quinine is mentioned only to condemnas the limit of impudent therapeutic claims it is an insult to theintelligence of any practitioner to pretend that any known agent orcombination of remedial agents can maintain a uniform blood pressure inany one of innumerable conditions in short, phillips’ phospho-muriate of quinine comp is a complex andirrational mixture exploited by means of unwarranted claims it isa survival of the old days of therapeutic chaos when impossible andfantastic chemical formulas were gravely published and as solemnlyaccepted without question, and also without the slightest understandingon the writing of thesis. When the most eminent of practitioners did nothesitate to give glowing testimonials for lithia waters that containedno more lithium than ordinary river water.

Then put to thema pint of oil of trotters or sheep feet. Let them boil a good while, still stirring them well. Which being strained, anoint the grievedplace therewith, warm against the fire, rubbing it well with one hand:and bind also essay of the herb if you will to the place, and, withgod blessing, it will help it in three times dressing chick-pease, or cicers descript the garden sorts whether red, black, or white, bringforth stalks a yard long, whereon do grow thesis small and almost roundleaves, dented about the edges, set on both sides of a middle rib;at the joints come forth one or two flowers, upon sharp foot stalks, pease-fashion, either white or whitish, or purplish red, lighter ordeeper, according as the pease that follow will be, that are containedin small, thick, and short pods, wherein lie one or two pease, moreusually pointed at the lower end, and almost round at the head, yet alittle cornered or sharp. The root is small, and perishes yearly place and time they are sown in gardens, or fields as pease, beingsown later than pease, and gathered at the same time with them, orpresently after government and virtues they are both under the dominion of venus they are less windy than beans, but nourish more. They provoke urine, and are thought to increase sperm. They have a cleansing faculty, whereby they break the stone in the kidneys to drink the cream ofthem, being boiled in water, is the best way it moves the bellydownwards, provokes women courses and urine, increases both milk andseed one ounce of cicers, two ounces of french barley, and a smallhandful of marsh-mallow roots, clean washed and cut, being boiled inthe broth of a chicken, and four ounces taken in the morning, andfasting two hours after, is a good medicine for a pain in the sides the white cicers are used more for meat than medicine, yet have thesame effect, and are thought more powerful to increase milk and seed the wild cicers are so much more powerful than the garden kinds, byhow much they exceed them in heat and dryness. Whereby they do moreopen obstructions, break the stone, and have all the properties ofcutting, opening, digesting, and dissolving. And this more speedily andcertainly than the former cinquefoil, or five-leaved grass. Called in essay counties, five-fingered grass descript it spreads and creeps far upon the ground, with longslender strings like straw berries, which take root again, and shootforth thesis leaves, made of five writings, and essaytimes of seven, dentedabout the edges, and essaywhat hard the stalks are slender, leaningdownwards and bear thesis small yellow flowers thereon, with essay yellowthreads in the middle, standing about a smooth green head, which, whenit is ripe, is a little rough, and contains small brownish seeds theroot is of a blackish brown colour, as big as one little finger, butgrowing long, with essay threads thereat. And by the small string itquickly spreads over the ground place it grows by wood sides, hedge sides, the path-way in fields, and in the borders and corners of them almost through all this land time it flowers in summer, essay sooner, essay later government and virtues this is an herb of jupiter, and thereforestrengthens the writing of the body it rules. Let jupiter be angular andstrong when it is gathered. And if you give but a scruple which is buttwenty grains, of it at a time, either in white wine, or in white winevinegar, you shall very seldom miss the cure of an ague, be it whatague soever, in three fits, as i have often proved to the admirationboth of myself and others. Let no man despise it because it is plainand easy, the ways of god are all such it is an especial herb used inall inflammations and fevers, whether infectious or pestilential. Oramong other herbs to cool and temper the blood and humours in the body as also for all lotions, gargles, infections, and the like, for soremouths, ulcers, cancers, fistulas, and other corrupt, foul, or runningsores the juice hereof drank, about four ounces at a time, for certaindays together, cures the quinsey and yellow jaundice. And taken forthirty days together, cures the falling sickness the roots boiled inmilk, and drank, is a most effectual remedy for all fluxes in man orwoman, whether the white or red, as also the bloody flux the rootsboiled in vinegar, and the decoction thereof held in the mouth, easesthe pains of the toothach the juice or decoction taken with a littlehoney, helps the hoarseness of the throat, and is very good for thecough of the lungs the distilled water of both roots and leaves, isalso effectual to all the purposes aforesaid. And if the hands be oftenwashed therein, and suffered at every time to dry in of itself withoutwiping, it will in a short time help the palsy, or shaking in them the root boiled in vinegar, helps all knots, kernels, hard swellings, and lumps growing in any writing of the flesh, being thereto applied;as also inflammations, and st anthony fire, all imposthumes, andpainful sores with heat and putrefaction, the shingles also, and allother sorts of running and foul scabs, sores and itch the same alsoboiled in wine, and applied to any joint full of pain, ache, or thegout in the hands or feet, or the hip gout, called the sciatica, andthe decoction thereof drank the while, doth cure them, and eases muchpain in the bowels the roots are likewise effectual to help rupturesor bursting, being used with other things available to that purpose, taken either inwardly or outwardly, or both. As also bruises or hurtsby blows, falls, or the like, and to stay the bleeding of wounds in anywritings inward or outward essay hold that one leaf cures a quotidian, three a tertain, and four aquartan ague, and a hundred to one if it be not dioscorides. For he isfull of whimsies the truth is, i never stood so much upon the numberof the leaves, nor whether i give it in powder or decoction.

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There is no evidence that medinal has any special usefulnessin this treatment of the morphin habit it is claimed further thatsuccess has been reported with medinal in the treatment of whoopingcough the council knows of no satisfactory evidence to show thatmedinal is of special value in whooping cough. On the contrary, it iscapable of doing a great deal of harm the recommendations that medinalbe used for the control of labor pains and in acute neuralgic painsthat resist other forms of treatment are wholly unwarranted as thevalue of the drug in such conditions is inherently improbable and untilsatisfactory evidence in support of them is forthcoming, must be deemedmisleading -- from the journal a m a , nov 15, 1919 omission of cotarnin salts stypticin and styptol from n n r report of the council on pharmacy and chemistrythe council has authorized publication of the following report w a puckner, secretary salts of the base cotarnin have been used as local and systemichemostatics the hydrochlorid was first introduced as “stypticin, ”and is now in the pharmacopeia as cotarnin hydrochlorid cotarninae hydrochloridum, u s p the phthallic acid salt ofcotarnin-- cotarnin phthallate-- was introduced as “styptol ” bothstypticin and styptol were admitted to new and nonofficial remedies in1918 the council voted to omit stypticin because the former americanagents were no longer offering it for sale styptol was retained and isdescribed in n n r , 1919 as was pointed out in the description n n r , 1918, the evidencefor the usefulness of the cotarnin salts has been contradictory andunsatisfactory. But since the available data against the efficiencywere at least equally unreliable, the council deemed it best to retainthem in n n r pending a thorough investigation of the subject thiswas undertaken by p j hanzlik, at the suggestion of the therapeuticresearch committee of the council a reliable judgment of hemostatic efficiency can be formed only on abasis of strictly controlled conditions, which can best be furnished inthe laboratory hanzlik repeated the principal experiments publishedby previous investigators, and applied a number of new or improvedmethods the results published in the journal of pharmacologyand experimental therapeutics 10:523, 1918. 12:71, 1919 show thefollowing:direct application to wounds -- the widely quoted results of thegynecologist k abel, on the footpad of cats, were found to be quiteunreliable when the experiment is properly controlled, the resultsare either negative or the bleeding may be increased quantitativeexperiments on wounds of the footpad of dogs showed that cotarnininvariably increased the bleeding equally negative or unfavorableresults were obtained with wounds to the comb of roosters, and to theliver and spleen direct action on vessels -- the results of perfusion experiments werevariable, but, in general, showed a vasodilation action instead ofconstriction this holds true also of the uterine vessels the vesselsin the living animal rabbit ear were also unaffected systemic administration -- the bleeding from an irrigated wound wasnot modified directly by intravenous injection of cotarnin salts, butvaried merely with the state of the blood pressure the evidence for the inefficiency of cotarnin salts as hemostaticsseemed so conclusive as to warrant the council in rescinding theacceptance of styptol, and directing the omission of the generalarticle on cotarnin salts and the description of styptol from new andnonofficial remedies -- from the journal a m a , nov 22, 1919 micajah wafers and micajah suppositories report of the council on pharmacy and chemistry“micajah medicated wafers” and “micajah suppositories, ” sold bymicajah & co , warren, pa , are declared inadmissible to “new andnonofficial remedies” because 1 their composition is essentiallysecret rule 1. 2 name of neither of these mixtures is indicativeof its composition rule 8. 3 of exaggerated and unwarrantedtherapeutic claims rule 6, and 4 the therapeutic advice whichaccompanies the trade packages constitutes an indirect advertisement tothe public rule 4 w a puckner, secretary micajah medicated wafers formerly called “micajah medicateduterine wafers” were analyzed in the a m a chemical laboratory in1910 they were found to consist essentially of dried “burnt” alum, boric acid and borax, in approximately the following proportions. Alum, dried 59 86 per cent borax, dried 15 62 per cent boric acid 5 67 per cent water of hydration 18 85 per cent there are a number of drugs that are more or less effective in thetreatment of local lesions of mucous membranes and the skin theyare classed as astringents among these are included alum, boraxand boric acid every physician has used them to say that a waferconsists of alum, borax and boric acid inspires but little awe butthere is essaything much more mysterious and impressive in declaringthat a wafer “consists of an astringent and antiseptic base, in whichare incorporated certain medicaments which both locally and afterabsorption, contribute to the astringent, antiphlogistic, depletive, soothing and healing action of the product ” this gives the impressionthat essay powerful and almost incomprehensible factors are at work yet, after all is said and done, the substances contained in micajahmedicated wafers are just the homely old alum, boric acid and borax in addition to “micajah medicated wafers, ” micajah & co also put out“micajah suppositories for hemorrhoids ” these have been examined inthe a m a chemical laboratory and, like the “medicated wafers” havebeen found to contain alum, boric acid and borax-- and these substancespractically alone-- incorporated in cocoa butter the company claimsthat “to these have been added ammonii ichthyosulphonate, balsam ofperu, ext belladonae ” the a m a chemists report, however, that ifextract of belladonna is present at all it is in amounts too small tobe detected by the method commonly employed in the chemical examinationof alkaloidal drugs the chemists report further that while ammoniumichthyosulphonate and balsam of peru both have a decided odor and aredark in color, the suppositories have but little color and the odor ofthe cocoa butter that forms their base is not covered by these drugs;obviously, therefore, if ammonium ichthyosulphonate and balsam of peruare present at all it is in amounts utterly insufficient to exert anytherapeutic effect it would be hard to find better examples of mischievous proprietarymedicines than these two products of the micajah company “twinsof efficiency, ” they are called in an advertising pamphlet thecomposition is not stated a physician using the “twins” does soabsolutely in the dark to him they are secret preparations he isencouraged to use them in a great variety of conditions in which otherdrugs are much more useful inevitably, physicians using them will belikely to overlook, or pass over, new growths, specific infections anddiseases that require radical remedial measures in addition to misleading and exaggerated claims, there is a referenceto a report from the usual “well-known and reliable bacteriologicallaboratory ” the excerpts published from this report of an unnamedlaboratory are sufficiently vague to incriminate no one from time to time it is worth while to emphasize facts regardingproprietary medicines that while obvious are essaytimes forgotten forthis reason attention is directed to micajah uterine wafers andmicajah suppositories -- from the journal a m a , nov 29, 1919 alkalithia report of the council on pharmacy and chemistryalkalithia was introduced at a time when it was believed that theadministration of lithium salts served to remove uric acid from thesystem the product was considered by the council in 1906, and foundineligible for new and nonofficial remedies no report, however, waspublished at that time because of inquiries received, the council examined the current claimsfor alkalithia, and authorized publication of the report which appearsbelow w a puckner, secretary keasbey and mattison company effervescent alkalithia is sold with thefollowing statement of composition. “each dose or heaping teaspoonful contains 1 grain of caffeine, 10 grains each of bi-carbonates of soda and potash, and 5 grains of carbonate of lithia ”the a m a chemical laboratory reports that alkalithia is aneffervescent mixture which contains alkaline carbonates andbicarbonates together with caffein, free tartaric acid and free citricacid the major portion of the alkali carbonates and bicarbonatesis converted into citrates and tartrates when the preparation isdissolved in water-- as is done before it is taken an excess of alkaliis present, however, as the solution has an alkaline reaction each“heaping teaspoonful” which was found to be about 4 85 gm containsabout 0 044 gm of caffein the manufacturers claim 0 0648 gm perheaping teaspoonful as taken, alkalithia, therefore, representscaffein in a solution of alkali tartrate, citrate and bicarbonatecontaining free carbonic acid if it is assumed that all of thetartrate and citrate in alkalithia is converted into carbonate inthe organism, a “heaping teaspoonful” of alkalithia would representabout 2 9 gm of sodium bicarbonate this assumption is, however, notcorrect, for it is known that tartrates are not completely convertedinto carbonates in the organism according to the label on the bottle, this mixture of caffein andalkali salts is “a common sense remedy for the relief and treatmentof conditions dependent upon perverted metabolism as manifested byneuralgic, rheumatic, cardiac and renal symptoms ” wrapped with a tradepackage is a circular in which is discussed the “uric acid diathesis”as “a cause of rheumatism in its various forms, calculus, gravel andinflammation of the bladder and kidneys, asthma, hay fever, catarrh, quinsy and bronchitis, eczema, hives, itching and burning of the skin, palpitation of the heart and cold hands and feet, dizziness, mentaldepression, melancholia, neuralgia, chorea, hysteria, numbness and agreat variety of purely nervous symptoms ” the arguments for the useof alkalithia as “a safe and scientific treatment for the uric aciddiathesis” found in the circular constitute an indirect appeal to thelaity conflict with rule 4 in the circular matter sent direct to the physicians, keasbey andmattison claim that in rheumatism, alkalithia is prescribed by themedical profession more often than any other remedy the claim is madethat, “in five minutes the urine will be discolorized and analysis willshow it to be loaded with urates ” the manufacturers further assert. “you can change the character of the urinary secretion in a few minutes completely” by alkalithia, and “in nine paper out of ten, when the doctor prescribes ‘alkalithia’ his patient greatly improves, or gets well ”the firm advises that “renal insufficiency” be determined by the oldmethod of multiplying the ounces of urine in twenty-four hours by thelast two numbers of the specific gravity, adding 10, which gives thenumber of grains of solids excreted in the twenty-four hours if thisis low, no matter what the cause, they advise alkalithia, “that idealeliminant ”the council declared alkalithia inadmissible to new and nonofficialremedies because the claims made on the label and the circularaccompanying the trade package lead the public to its detriment todepend on this preparation rule 4. And because the therapeutic claimsare unwarranted rule 6 -- from reports of council on pharmacy andchemistry, 1919, p 65 arhovin omitted from n n r report of the council on pharmacy and chemistryarhovin is a solution of dephenylamine, thymol benzoate and ethylbenzoate, marketed by schering and glatz, inc it was omitted fromnew and nonofficial remedies because the therapeutic claims made forthe preparation were unwarranted and because the firm had refused todiscontinue the distribution of the advertising which contained theobjectionable claims prior to jan 1, 1919 when the report whichappears below explaining the dismissal was submitted to schering andglatz, inc , the firm again promised a revision of its advertising, but refused discontinuance of the objectionable circular before jan 1, 1920 since arhovin is still marketed with unwarranted therapeuticclaims, the council has authorized publication of this report w a puckner, secretary the attention of the firm schering and glatz, inc , was called tomisleading statements in its booklet for arhovin in 1915, and in 1918the firm was informed that unless the misleading statements werewithdrawn before jan 1, 1919, arhovin would be omitted from new andnonofficial remedies the following quotations are taken from the circular in question, andillustrate the character of the claims to which objection was made. “striking also is the antiphlogistic and anesthetic effect of arhovin on the inflamed mucosae, an effect which, as all authorities agree, is far greater than that of all other internal anti-gonorrheaics ” “under its influence vesical and prostatic complications, gonorrheal arthritis, endocarditis, etc , are rarely incurred ”references to the indexes of leading textbooks, including thoseof meyer and gottlieb, cushny, sollman and bastedo, fails to showthat arhovin is so much as mentioned by those authors.