History

Sat Essay Sample


And having done so, i set myself to study thereason of them i knew well enough the whole world, and every thingin it, was formed of a composition of contrary elements, and in sucha harmony as must needs show the wisdom and power of a great god iknew as well this creation, though thus composed of contraries, was oneunited body, and man an epitome of it. I knew those various affectionsin man, in respect of sickness and health, were caused naturally though god may have other ends best known to himself by the variousoperations of the microcosm. And i could not be ignorant, that as thecause is, so must the cure be.

And none know this better than the makers of nostrums aproprietary individuality is obtained by giving essay special form tothe tablets and package or a special coloring to the capsules “specify‘phenalgin pink top capsules’” so as to indicate the identity of theproducts in such a way that the patient may in the future procure themwithout the advice or sat essay sample warning of the physician when a proprietarypreparation with the name or initials stamped on it or attached toit is prescribed, the patient immediately is aware of the fact, andhis respect for the physician intelligence and wisdom is naturallylessened the physician should never place such dangerous drugs as acetanilid andacetphenetidin, or ready made mixtures of them, in the hands of thepatient in such a way that they can be employed without his supervisionor control he should never prescribe more than is needed at the timeand should not form the habit of using fixed doses or combinationsof drugs without a special reference to the writingicular needs of theindividual certain forms of headache yield more readily to a mixture of caffeinand acetanilid or caffein and acetphenetidin than to either acetanilidor acetphenetidin alone when the physician wishes to prescribe sucha mixture he may combine 1 grain of caffein or 2 grains of citratedcaffein with 3 grains of acetanilid or 4 grains of acetphenetidin ina powder or capsule under supervision such a dose may be repeatedat intervals of from two to four hours if necessary to control pain it is necessary to remember, however, that when small doses fail togive relief, increase in the dose is useless this fact is especiallyimportant, and disregard or ignorance of it has been responsible forthesis paper of poisoning further, it should be remembered that while itwas taught for thesis years that the admixture of caffein with acetanilidlessened the effect of the latter drug on the heart, hale has shownthat this is not the case and such mixtures must be used with specialcaution -- from the journal a m a , feb 2, 1918 article vi fellows’ syrup, and other preparations of the hypophosphiteswe hope that it is clear to those who have read the several articlesof this series that their purpose is to present evidence that willenable the reader to form a correct estimate of the literatureemployed in the exploitation of various nostrums the distinctionbetween mere assertion-- however plausible, and from however eminentan authority-- and evidence should again be emphasized satisfactoryevidence rests on careful observation by those who are capable ofaccurately determining to what extent any changes that may be observedare due to the therapeutic agent employed and not mere accompanimentsof such treatment when the council on pharmacy and chemistry was organized in 1905, the greater writing of the literature of the nostrums was so palpablymisleading, the statements often so ludicrously false, that it was onlynecessary to call attention to this fact to have those claims collapse as a result of the council work, the exploiters of worthless nostrumshave developed a greater degree of shrewdness in avoiding the easilyexploded falsehoods this has made it increasingly difficult to pointout the exact statements on which thesis of the false claims now rest, even though the exploitation as a whole is as inherently dishonest asbefore if a nostrum is worthless, any exploitation must be false andmisleading in effect, even though not one single false direct statementis made a platitude may be given an appearance of importance if uttered in animpressive manner, and it may be employed to suggest far more than itcategorically affirms these two facts are appreciated by thesis nostrumexploiters and we find that they have adopted the impressive manner tosecure attention, and the platitude to suggest far more than they coulddefend in direct statement thus we have the “lie with circumstance ” fellows’ syrupa full page advertisement, which has been appearing regularly forabout a year and which must represent a good deal of money, is used togive an appearance of importance to a few words which, if printed inordinary type, would either pass wholly unnoticed or would lead one toassume that essaything essential to the full meaning had been omitted the statement, in full reads. “fellows’ syrup differs from other preparations of the hypophosphites leading clinicians in all writings of the world have long recognized this important fact have you?. to insure results, prescribe the genuine ℞ syr hypophos comp fellows’ reject cheap and inefficient substitutes reject preparations ‘just as good ’”the only direct statement contained in the advertisement is to theeffect that thesis clinicians have observed that fellows’ syrup and otherpreparations of the hypophosphites are not alike in truth, fellows’is not like the better preparations of this type, since after standingit contains a muddy looking deposit that any pharmaceutical tyro wouldbe ashamed of technically, then, the statement is true, but it ishardly credible that the manufacturer is paying for an entire page in amedical journal to make this statement without any attempt to suggestessaything else the advertising pages of six medical journals were examined in theorder in which they chanced to come to hand in five of these, theentire advertisement of fellows’ syrup was in the words just quoted;not a single word more in one there was the further statement. “not a new-born prodigy or an untried experiment, but a remedy whose usefulness has been fully demonstrated during half a century of clinical application ”these advertisements show that the exploiters of fellows’ syrup arespending a great deal of money to induce physicians to prescribe thepreparation, and it is equally evident that they wish to convey theimpression that the preparation has essay therapeutic value since wefind nothing directly false, in the first mentioned advertisement atleast, we must take the evident intent for consideration and determinewhat therapeutic value, if any, this preparation has, and whether it isadvisable for physicians to employ it in any case the preparation, according to the statement just cited, has been inuse for fifty years as the exploiter of any preparation cites themost convincing evidence in his possession in support of his views, this claim may be assumed to be the strongest available, and if thisevidence fails we must reject the contention as not proved herewe face a dilemma, for examination of the literature used in theexploitation of fellows’ syrup fails to disclose any evidence of thekind that we have described as satisfactory. And we are, therefore, forced to conclude that none has ever been found by this it is notto be implied that no reputable physician has ever reported favorablyconcerning the therapeutic effects of this preparation it is quitepossible that an extensive literature of that sort might be found ifone examined the older medical journals but the day has passed whenevery improvement that follows the administration of a preparation isblindly attributed to the drug in question clinical research today isfar more exacting we will assume that the reader who has investigated the question withan open mind will have come to the decision that the contention thatfellows’ syrup is of especial therapeutic value is not proved we mightrest with that assumption and ask the clinician whether he is preparedto use a nostrum that has been before the medical profession for halfa century without any satisfactory evidence having been gained thatit possesses therapeutic value we might ask him whether he would bewilling to tell his patients that he was prescribing such a nostrumfor them in the face of the absence of any such evidence of its value the inertness of the hypophosphitesbut we prefer to go even further and show him that not only is therean entire absence of any evidence of its therapeutic value so far aswe have been able to learn, but in addition there is an abundance ofevidence that the hypophosphites are devoid of any such therapeuticeffect as they were formerly reputed to have, and that, in fact, they are, so far as any effect based on their phosphorus content isconcerned, singularly inert while we have thus far taken the fellows’ preparation as the subjectof the discussion, we may take a broader view and examine the subjectof the hypophosphites in general, and the substitutes containingphosphorus that have been introduced from time to time it hardly needsto be said that if the hypophosphites are without therapeutic value, itis impossible to give them value by combining them in a muddy-looking, ill-made preparation such as fellows’ syrup such evidence wassubmitted to the medical profession in a report of the council onpharmacy and chemistry j a m a 67:760 sept 2 1916. And wewould strongly advise any one who is disposed to act on the suggestioncontained in the advertisements of fellows’, and other hypophosphitepreparations, to read that report in full and to think the matter overbefore prescribing one of these nostrums quoting briefly from thereport in question. “although the overwhelming weight of evidence was against the probability that the hypophosphite preparations are of value as therapeutic agents, the council thought it well to investigate the subject dr w mckim marriott of baltimore was therefore requested to review the evidence for and against the therapeutic usefulness of the hypophosphites and to conduct such experiments as seemed necessary ”the council was not content to rest on the mere absence of evidencefor the value of these preparations or any one of them, but soughtto obtain evidence that would fulfil the conditions mentioned above, and in pursuance of this plan it secured the cooperation of a trainedinvestigator, one who would work under the best of conditions forlearning the truth the results of dr marriott investigation werepublished in the journal, feb 12, 1916, p 486, and should be read byeveryone who has any interest in the problem lest essay of our readersmay fail to refer to the original of marriott paper, we will quotebriefly from it. “none of the subjects of the experiment experienced any effect whatsoever from the administration of the drug almost all of the ingested hypophosphite is eliminated unchanged “these experiments forbes demonstrate conclusively that the hypophosphites possess no specific value as a source of phosphorus for the body it is doubtful if there are any conditions in which the body suffers from lack of phosphorus even should such conditions exist, phosphorus, in the form that it occurs in the ordinary foods, or as phosphates, is more efficient in supplying the deficit than hypophosphites that must be oxidized before utilization and which are only about 15 per cent oxidized if at all for example, half a glass of milk contains more available phosphorus than three large doses of hypophosphites of 15 grains each, as great a dosage as is usually given “what then, is the therapeutic value of hypophosphites?. there is no reliable evidence that they exert a physiologic effect. It has not been demonstrated that they influence any pathologic process. They are not ‘foods ’ if they are of any use, that use has never been discovered ”the case seems to stand about like this. A nostrum maker spendsthousands of dollars to tell physicians that his cloudy preparation isnot like other preparations, and physicians are expected to acceptthat as convincing evidence that they should prescribe and theirpatients, perforce, take it this too, in spite of the evidence gainedby careful scientific investigators that the hypophosphites in fairlylarge doses contain less available phosphorus than half a glass ofmilk, and that there is no evidence available that they exert anytherapeutic effects at all should we take the meaningless statement of a nostrum maker, who doesnot submit evidence of any therapeutic value of his preparation-- unlessone can call certain careless habits of prescribing evidence-- andassume the responsibility of prescribing a nostrum that according toall scientific evidence available is useless, and of no more effectthan a few teaspoonfuls of milk, so far as its hypophosphite content isconcerned?. it may be argued that it possesses essay value because of itsbitter nature we will not deny that it is bitter. So is strychnin, sois quinin, so are scores of simple drugs, but what physician would careto admit to his patients that he did not know how to prescribe a simplebitter, such as nearly every layman can select for himself, withoutrecourse to a preparation such as fellows’ syrup?.

The leaves, flowers, and seed, all sat essay sample or any of them, are good toexpel pensiveness and melancholy. It helps to clarify the blood, andmitigate heat in fevers the juice made into a syrup prevails much toall the purposes aforesaid, and is put, with other cooling, opening andcleansing herbs to open obstructions, and help the yellow jaundice, andmixed with fumitory, to cool, cleanse, and temper the blood thereby;it helps the itch, ringworms and tetters, or other spreading scabs orsores the flowers candied or made into a conserve, are helpful in theformer paper, but are chiefly used as a cordial, and are good for thosethat are weak in long sickness, and to comfort the heart and spiritsof those that are in a consumption, or troubled with often swoonings, or passions of the heart the distilled water is no less effectual toall the purposes aforesaid, and helps the redness and inflammations ofthe eyes, being washed therewith. The herb dried is never used, butthe green. Yet the ashes thereof boiled in mead, or honied water, isavailable against the inflammations and ulcers in the mouth or throat, to gargle it therewith. The roots of bugloss are effectual, being madeinto a licking electuary for the cough, and to condensate thick phlegm, and the rheumatic distillations upon the lungs blue-bottle it is called syanus, i suppose from the colour of it.

“we have sat essay sample been unable to obtain any evidence that the true mexican cactus grandiflorus possesses any pharmacologic action whatever. But, on the contrary, it appears to be a singularly inert substance when administered either by the mouth or by the vein ”when colossal doses of cactus grandiflorus are given by the vein, they essaytimes-- but not always-- appear to exert an extremely feebleaction on the heart. But this action is so slight that its naturecould not be determined even the most colossal doses of cactusgrandiflorus administered by the mouth to cats, dogs and frogs exertno perceptible effect sollmann thus satirizes the absurd claims made by the exploiters ofproprietary forms of cactus. “should the heart be too slow, cactusquickens it. If the heart is too fast, cactus slows it. Should theheart be too weak, cactus strengthens it. If the heart is too strong, cactus weakens it. Does the heart wobble, cactus steadies it. If theheart is normal, cactus does not meddle with it” j a m a 51:52july 4 1908 will physicians continue to accept the statements of an interestednostrum vender-- who submits not a shred of evidence to support hisclaims, but who has a financial interest in convincing them-- even whenhis statements are diametrically opposed to all the evidence that thecouncil on pharmacy and chemistry has been able to secure?. -- from thejournal a m a , jan 19, 1918 article v ammonol and phenalginat the time that synthetic chemical drugs were coming into fame andwhen every manufacturer who launched a new headache mixture claimedto have achieved another triumph in synthetic chemistry, ammonol andphenalgin were born of course, these twins of analgesic pseudotherapywere claimed to be synthetics and were duly christened with “formulas ”they were among the first of the nostrums examined for the council onpharmacy and chemistry, and the false claims made for them were exposed the analyses made for the council showed that ammonol and phenalginwere simple mixtures, having the following composition. Acetanilid sodium bicarbonate ammonium carbonate ammonol 50 25 20 phenalgin 57 20 10the reports of the council on, and numerous references to, these twonostrums may be found in the journal of various dates 245 the reportswill prove interesting to those who are not familiar with, or haveforgotten, the methods of nostrum exploiters at the time the councilwas formed following the council exposure of the false claims madeby the manufacturers of phenalgin, the medical record published anadvertisement of that nostrum in which an attempt was made to discreditthe council report the editor of the medical record was requestedby the council to publish the facts in the case but he refused to do so 245 j a m a 44.

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Control period, 238 gm milk av daily yield for 8 days nutrolactis period 20 c c nutrolactis on bread, 223 gm milk av daily yield for 4 days 20 c c nutrolactis on bread, 46 gm milk av daily yield for 6 days dog 9. Control period, 223 gm milk av daily yield for 6 days nutrolactis period 10 c c nutrolactis on bread, 178 gm milk av daily yield for 15 days 15 c c nutrolactis on bread, 146 gm milk av daily yield for 5 days comment and conclusiongoat 1 had already been lactating for over two months, and the yieldwas gradually decreasing at the time the observations were begun theadministration of galega did not check this decrease goat 2 shouldhave been a very favorable subject, for the kid was about a week oldat the time the observations were begun both galega and nutrolactiscaused a decrease in milk yield of this animal this decrease isperhaps writingly due to the animal distaste for the drugs and herconsequent failure to eat as well as during the control periods administration of nutrolactis was accompanied by an increase in milkin only two animals, dog 4 and dog 5 a detailed examination of therecords of these two dogs shows that in both paper there was aprogressive increase in milk yield during the control period and thatadministration of the drug failed to accelerate this increase on thecontrary, the curve for dog 5 takes a sudden drop immediately after thefirst administration of the drug the records of dogs 6 and 7 show that the yield during the secondcontrol period is lower than that of the preceding periods althoughthe administration of the drug in both paper was followed by a decreasein the yield, it may be urged that the drug has essay lactagogue action, for its discontinuance was followed by a decrease in yield thiseffect, however, is also apparent rather than real, for the data show agradual falling off in yield during the period of administration of thedrug, which decrease was not accelerated by withdrawing the drug our data show that galega and nutrolactis, when taken by mouth, and the elements of suggestion excluded, had no beneficial effecton lactation-- at least in so far as the quantity of milk isconcerned -- from the journal a m a , may 26, 1917 the russell emulsion and the russell prepared green bone report of the council on pharmacy and chemistrythe following report on “the russell emulsion” and “the russellprepared green bone, ” marketed by the standard emulsion company, wassubmitted to the council by a referee the council endorsed the reportand authorized its publication w a puckner, secretary the russell emulsion is put up in a neat package and advertised in anattractive pamphlet, on the cover of which we are told. “truth alwaysjustifies the superlative degree ” as what follows in the booklet andin the printed circulars certainly does not lack superlatives, this isdoubtless a warning in addition to the pamphlet and circular advertising, the product seemsto be systematically boomed by a lecture scheme in which one dr haguetalks before medical societies and distributes advertising matter the lecture is succeeded by a follow-up letter scheme through whichmatter is sent to members of the society hague ostensibly discusses“lime starvation in tuberculosis, ” but medical societies soon learnedto estimate his work as essentially to advertise the russell products last april the medical society of the state of pennsylvania sent outa circular letter to its county organizations on the subject of therussell-hague propaganda which opens in this way:“you have doubtless received a letter from dr william grant hague ofnew york, offering to address your county society on tuberculosis after due investigation, it is respectfully suggested that it may notbe desirable to ask him to address your society ”the statements in the pamphlet and circular published are typical ofthe whole method of exploitation for example, can such claims as thesebe surpassed by the veriest quack?. “science cannot improve the means employed in producing the russell emulsion ” “genius has not devised better methods than are used in manufacturing the russell emulsion ” “money cannot buy better products than are used in the russell emulsion ” “experience cannot suggest a more nutritious combination of fats than we use in the russell emulsion ”the emulsion is said to be made of equal writings of beef-fat, coconut, peanut and cottonseed oils, held in suspension by albumin the latterwe are told is applied to each globule of the emulsion by an “elaboratetechnical process” devised by dr russell the mixture is everywherespoken of as a “physiological” emulsion, but the word is always inquotation marks why it is called “physiological” is not clear, but theterm may be counted on to impress the unthinking or the unscientific numerous false and exaggerated statements are made about this“physiological” emulsion with reference to food value for instance. “the nutritional value of fats differ. The nutritional value of these fats and their increased efficiency by combination over all others have been determined by extensive clinical observation ”and also. “the russell emulsion is approximated in food value by no other emulsion or food product in existence ” “a ‘physiological’ emulsion is a predigested food it is absorbed with little assistance from the digestive juices, and with no waste of energy it is, therefore, the ideal food ”these are sample statements found in the pamphlet and accompanyingcircular a dozen or more pathologic conditions are mentioned in whichthis “ideal food” is specifically indicated.