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THE MEDICAL WORLD

The knowledge that a man can use is the only real knowledge; the only knowledge that has life and growth in it and converts itself into practical power. The rest hangs like

dust about the brain, or dries like raindrops of the stones.-FROUDE.

The Medical World

C. F. TAYLOR, M.D., Editor and Publisher

A. L. RUSSELL, M.D., Assistant Editor

securing the general adoption of the suggested amendments -IRVING SHEPARD, Secretary."

We feel it a duty to recognize the above tendency, and to adopt it in a reasonable degree. We are also disposed to add enu! (enough) to the above list, and to conservativly adopt the follow ing rule recommended by the American Philological Association :

Drop final "e" in such words as “ definite," " infinite," "favorite," etc., when the preceding vowel is short. Thus, spell “ opposit,' preterit,'".“hypocrit," " requisit," etc. When the preceding vowel is long, as in “polite," finite,'

“ unite," etc., retain present forms unchanged, We simply wish to do our duty in aiding to simplify and ratios alize our universal instrument-language.

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"THE MEDICAL WORLD" 1520 Chestnut Street

comes

a

“ Buy September Wheat.” Are doctors such inveterate speculators ? If not, why do so many circulars and circular letters continue to come to me, and presumably to all other doctors ? I thought I had the speculation fever about killed out among the doctors. I certainly stopt a great deal of it; but after being whipt out, its policy is to “bob up serenely” after lying quiet for awhile, as tho nothing had happened. Here

communication from a Chicago firm headed “Speculation in Farm Products now Popular." “Buy September Wheat." Do they think that if a Philadelphia doctor wanted to speculate he would send all the way to Chicago to do it? I have received such communications from St. Louis, also, and I suppose the whole list of doctors in Philadelphia got the same. Does this indicate that doctors do such ridiculous things as to send their money half way across the continent for a firm of entire strangers to speculate with? If they do, do they ever expect to see their money again? I was talking the other night with a fire insurance man of large and wide experience, who comes into contact largely with the drug trade and to some extent with doctors. He said that doctors are all right in their own profession, but outside of it, particularly in business, “they don't know a thing." I referred to the ease with which they can be induced to invest in visionary schemes. Yes," he said, “one can sell them a gold brick any time if they happen to have the money."

But going back to wheat: I have a very dear friend (not a doctor) who had saved a pretty snug little sum by some years of industry and thrift. A time came when all his accumulations were in cash; and then the tempter

Philadelphia, Pa.

VOL. XXII.

APRIL, 1904.

No. 4

Language is a growth rather than a creation. The growth of our vocabulary is seen in the vast increase in the size of our diction. aries during the past century. This growth is not only in amount, but among other elements of growth the written forms of words are becoming simpler and more uniform. For example, compare Eng. lish spelling of a centnry or two centuries ago with that of to-day! It is our duty to encourage and advance the movement toward simple, uniform and rational spelling. See the recommendations of the Philological Society of London, and of the American Philo. logical Association, and list of amended spellings, publish in the Century Dictionary (following the letter z) and also in the Standard Dictionary, Webster's Dictionary, and other authoritativ works on language. The tendency is to drop silent letters in some of tbe most flagrant instances, as ugh from though, etc., change ed tot in most places where so pronounced (where it does not affect the preceding sound), etc.

The National Educational Association, consisting of ten thousand teachers, recommends the following:

"At a meeting of the Board of Directors of the National Educa. tional Association held in Washington, D. C., July 7, 1898, the action of the Department of Superintendence was approved, and the list of words with simplified spelling adopted for use in all pube lications of the National Educational Association as follows : tho (though);

program (programme); altho (although);

catalog (catalogue); thoro (thorough):

prolog (prologue); thorofare (thoroughfare); decalog (decalogue); thru (through);

demagog (demagogue); thruout (throughout);

pedagog (pedagogue). “ You are invited to extend notice of this action and to join in

came

gest that

How easy to put a large part of his by the vendors of proprietaries under fanciful money into wheat margins and see it grow names. That sterling firm, Wm. R. Warner from day to day. He did it, and it grew, and & Co., of this city, sent an exceedingly nice he was elated. How easy! How different letter in reply, but markt it strictly not for from hum drum toil from morning till night as publication in this connection, as they have a retail merchant. He continued. His gains

no antagonisms in connection with manufacwere wiped out. Then his principal was en- turers,' and reter us to pages 58, 69, 76, and dangered. It, at least, must be saved. Some of 178 in their catalog. They further explain the reserve must be brought forward for that that the prices there given are not intended purpose.—But why make the story longer ? for publication ordinarily, because they are His snug little fortune was all swallowed up expected to protect the drug trade. They in the whirlpool of the pit. One who had further add, “However, we would be willing always been sensible, conservativ and thrifty to sell to the profession any of the articles was ruined in a few short weeks or months. indicated at the prices shown in the book, but He had to begin again at the bottom of the would rather prefer not to be taken up too ladder, under much more trying conditions prominently in connection with any controthan the first time, and now after a second versy that might arise.” This position is period of years of struggle, he has his head fair, and the spirit admirable. We turned to just above the waves. Think of this when a the pages indicated, and there found a great broker says to you, “ Buy September wheat." variety of acetanilid preparations in tablet

form, from simple acetanilid in tablets of from Analgesics at a Reasonable Price. I to 5 grains, to many different formulas of Please see the article entitled “How a Vil- compound acetanilid tablets, tablets either lage Doctor Saves $45 Per Year on One Prep- plain or chocolate coated, and the prices are aration," and our comments on same in March exceedingly reasonable. We hesitate to men. WORLD, pages 102 and 103. Continuing the tion the prices here on account of not wishing effort to serve the daily interests of the average

to embarrass the firm in any way, but we sugdoctor, and knowing that many would put off

you

could not do better than to write from time to time the making up of a prepara- for their catalog (Messrs. Wm. R. Warner & tion like this in quantity (many would be too

Co., 639 N. Broad street, Philadelphia), and busy and others would procrastinate), and also after you get it indicate to your druggist what knowing that many like tablets for convenience you wish him to carry in stock for your prein dispensing, and that still others write pre- scriptions, or send an order direct if you are scriptions instead of dispensing, and that they in the habit of supplying medicins directly to would rather prescribe preparations of definitly your patients-country doctors cannot avoid known composition at a moderate price instead doing some of this. of a preparation of secret composition (tho The following excellent reply came from knowing that acetanilid is the chief constitu- Messrs. H. K. Mulford Company, of this city. ent) under a fanciful name at a fancy price,we

Dr. C. F. Taylor, Editor MEDICAL WORLD. sent the following letter to our leading pharma

Dear Doctor :-In reply to your letter of the 3rd ceutical houses :

inst., we have pleasure in forwarding you, under sep. Gentlemen :-We have been publishing the well

arate cover, one of our catalogs. You will note that known fact that for years the physicians of this coun

we list Acetanilid, together with following combinatry and their patients have been paying an extravagant

tions: price for acetanilid mixtures under fanciful names,

Acetanilid Comp. No. 1, the formula usually emantikamnia, for example, and for combinations of such

ployed for relieving migrain, contains : mixtures with quinin, salol, codein, heroin, etc,, chiefly Acetanilid

grs. in tablet form for convenience in dispensing. We wish Camphor monobrom to know, in order to inform the profession, what you, Caffein cotrated as legitimate manufacturing pharmacists, have done and is furnisht to physicians in bottles as follows: to meet the wants of the profession for a safe acetanilid mixture, at a reasonable price. Also, we wish to know

100 . . 200.; 500. .750.; 1,000 . . $1.45. what (if any) combinations of the same with quinin Acetanilid Comp. No. 3 contains : and other drugs in daily use you make in tablet or pill

Acetanilid form for convenience in dispensing. Please give price

3 grs.

Camphor monobrom. of each to physicians, in ounce lots, for comparison

Caffein alk. with the prices of the proprietary mixtures with fanci

I gr. ful names. Physicians should have this information,

400.; 500 . $1.75; 1,000. $3.25. and we propose to give it to them. Please give full Acetanilid Comp. No. 4 contains : information, and prices, for publication. Very truly, Acetanilid

35 grs. THE MEDICAL WORLD, Caffein alk.

gr. We found to our gratification, upon receiv

Sodium bicarb..

gr. ing the price lists from the various firms, that

220.; 500. . 90c.; 1,000 . . $1.60. this want is very well supplied, and that there

Acetanilid and Quinin : is no excuse for physicians paying, or forcing

Acetanilid

.2 grs.

Quinin sulf. their patrons to pay, the fancy prices charged

2

1% gr. 14 gr.

• 2 grs.

100.

100.

500.

90c.; 1,000 $1.60

100. .22C.;

22 grs.
272 grs.

*

*

Acetanilid and Salol:

with it are usually for the purpose of protecting Acetanilid

the heart. In this connection I feel that I am Salol . . 100. . 350.; 500. . $1.50; 1,000.

$2.75.

expected to say something about the class of Acetanilid and Soda Comp. No. 2 contains :

remedies to which acetanilid belongs. I will Acetanilid

3 grs.

only briefly outline, for anything like a thoro Soda bicarb.

i gr.

discussion would lead to great length. Soda bromid.

To gr. Caffein cotrated

gr. 100. . 200.; 500. 75C.; 1,000. $1.40. These preparations are offered by us not as substi- About twenty years ago a wonderful coal tar tutes for any preparations that are offered to physi. synthetic chemical was announced that would cians under proprietary names, but as strict pharma

reduce temperature like magic. On account of ceutical preparations, the full quantities of ingredients being as specified on label." One hundred tablets this quality it was called antipyrin, and it was practically represent an ounce. Very truly yours, patented under that name. We thought that

H. K. MULFORD.

we had found the thing with which we could The Upjohn Company, of Kalamazoo, control fever with definit certainty, which Mich., answer as follows:

would give us an undreamed-of power over C. F. Taylor, M.D., Philadelphia, Pa.

disease. The medical press was filled with Dear Doctor :-Replying to your favor of the 3rd inst., will say that we do not manufacture any com

praises of this wonderful drug. But while it binations which we put out as substitutes for the

cooled the fever patient, many of them got proprietary preparations, altho we fully realize that coldand are cold yet-in their graves. The many of them are sold at an extravagant price. We do, however, manufacture several combinations in pill

alarm was sounded, and a rapid retreat was and tablet form which contain the ingredients you made. It would not do to subject the fever mention.

patient to such a risk. The heart depression We are inclosing you one of our price lists in which we list several different acetanilid combinations, some

was too great. in the form of pills, some in uncoated tablets, and Antipyrin was soon followed by other coal some in chocolate coated tablets. Our list prices are subject to a discount of 25 percent, and we make

tar derivativs, but now their power to relieve special net prices on bulk quantities of 5,000 or more. pain was brought into prominence, and they You will note that we have checkt the list and would became known as analgesics rather than antirefer you to the following pages : 7, 26, 55, 56, 59, 84, 96, 103, 105, 117. Very truly yours,

pyretics, tho they are both. Their use in THE UPJOHN COMPANY. fevers were so condemned on account of the We note that the tablets are cheaper than danger of heart depression in connection with the pills of similar composition. There is a

the non-resistance occasioned by prolonged or wide selection of acetanilid tablets, both

severe illness, that their use as antipyretics was simple and compound, the latter embracing lost sight of; but they could be given with apmany useful combinations at reasonable prices. parent impunity for headache, neuralgia, painMessrs. Parke, Davis & Co., of Detroit,

ful menstruation, etc.,-conditions of a temHenry K. Wampole & Co., and John

Wyeth porary nature and in which the heart resistance & Bro., of Philadelphia, reply by referring had not been reduced. So you see the changed us to their catalogs, which they send, and in

application, and the reasons therefor. So all of which we find an ample variety of acet

now drugs of this class are known as analgesics. anilid tablets both simple in 1 to 5 grains, and compound tablets showing many excellent Acetanilid and phenacetin became, and still combinations, at reasonable prices.

are, the most popular of this class. By some *

good fortune, acetanilid did not become Do you here find food for thought? The patented, and so we have always had it at a MEDICAL WORLD is publisht in the interest of very low price. For a while it had no special the medical profession. The medical pro- friends, because it was to nobody's special fession is learning the value of THE WORLD, financial advantage to push it; while phenacetin for subscriptions have been pouring in dur- was vigorously pusht for the great profit in it, ing the last two years as

never before. and for awhile - antifebrine,” which was only And we are learning better and better how a copyrighted name for acetanilid, was pusht at to serve the interests of the profession, and about the same price as phenacetin, until the the increast patronage by the profession gives fact just stated was found out. Then arose us more courage than ever before. Let The "antikamnia-opposed to pain." By dint of MEDICAL WORLD and the medical profession very skilful advertising and liberal samples, join hands closer than ever before to help each this mixture of acetanilid with some bicarboother, and to find evils and crush them.

nate of soda to increase its solubility, and perSo much for acetanilid (and combinations of haps some caffein to counteract the depressing acetanilid with other drugs) as an analgesic, or tendency of the acetanilid, got a start. Knowpain reliever. As is well known, acetanilid is ing ones were surprised at this, for it was supa heart depressant, and the drugs combined posed that every one knew that it was a mere

*

*

*

*

*

*

mechanical mixture and not a definit, distincttions of antikamnia under some fanciful name and individual chemical, and if doctors wanted -an acetanilid mixture. So you see I cannot an acetanilid mixture, why not make it, at one- speak from experience, nor do I desire to. tenth the cost ? But antikamnia was persist. However, we cannot deny that drugs of this ently and very skilfully advertised, and to the class have been and still are very popular, fillgreat surprise of many, it continued to prosper. ing a large and perhaps growing place (I rePerhaps one reason was its preparation in tab- gret to say) in the practise of today. lets convenient for dispensing. So in spite of

* the vast difference in price of about 30 cents a pound for acetanilid and $1.00 per ounce for

As those who remember my editorials in the antikamnia, the latter still prospered, mainly last several years know, I have been opposed to thru the medical profession-and perhaps there phenacetin because of the following: It is made are some doctors still so in the dark as to pay,

in Germany and imported from there into this or have their patients pay, the extravagant

and other countries, and the price charged to price for antikamnia, when acetanilid is so

consumers in this country is about three times cheap, and when it is now put up in tablets of that charged to consumers in other countries. various sizes, and numerous combinations of it

For example, it is $i per ounce here, while with other drugs are put up into tablets, by our just over the line into Canada it can be bought leading pharmaceutical manufacturing houses, for about 35 cents an ounce. And the differat right prices.

ence is not in the tariff; our tariff would make a little difference, but very little. Our patent

laws permit them to thus impose on us, and But we are wandering from our subject. they do it. It is to this injustice that I have We started to consider phenacetin and acetan- vigorously objected. The patent will run out ilid, the two drugs that have been the leaders in a few years, and then the price will take a of the antipyretic-analgesic group. Antikam- delightful tumble. nia, and the numerous imitations of antikamnia, caused to come into existence doubtless by the surprising commercial success of antikam- In this connection I have been interested in nia, are only acetanilid mixtures.) I intended the appearance of an American chemical of to try to present the rather complex chemistry of this class, an improvement upon all its forethese chemicals so simply that any reader could runners in that it is claimed that it is positivly easily understand; but it is a difficult task, and not depressing to the heart. It is called perhaps many readers will thank me for quot thermol, because of its effect on the tempera. ing from Bartley's Medical Chemistry, page ture, and it is boldly recommended as an anti460, simply this statement; speaking of phen- pyretic in such serious diseases as pneumonia, acetin it says: “ This compound is closely typhoid fever, etc., as well as an analgesic in related to acetanilid.” We know that they are headaches, neuralgias, menstrual pains, etc. closely related therapeutically. Phenacetin Today I called on the inventor, Dr. S. Lewis has been very popular. At $i an ounce its Summers, to get some final points before manufacturers could afford to make it so, and writing this, particularly as to its chemistry, foster the claim that it is less depressing than and I finally got him to state the chemistry of acetanilid. Many doctors believe this to be the group so simply that I will present it here: true ; many don't. I cannot say. My obser

Acetanilid = acetic acid plus aniline. vation has been limited, as I am not in practise Phenacetin phenetidin (a chemically com(tho the rest of the staff is--and our numerous

plex substance in the form of a brownish, contributors), my specialty being medical

oily liquid, the chemistry of which I will

not attempt here) plus acetic acid. journalism. No one man can be a successful Thermol phenetidin plus acetic acid plus editor and publisher and at the same time con

salicylic acid. duct a practise as it should be conducted. My These are not mechanical mixtures, as antiobservation is that these two drugs are about kamnia is a simple mechanical mixture of its equally depressing. I have always counseled constituents in a mortar, but the constituents against the use of these depressing and blood de- are put into special apparatus in definit quantistroying drugs; but there are painful conditions ties, and subjected to great heat and pressure which with most people require a pain reliever, for a long time. The result is a chemical and these drugs are usually not as objection- union—the creation of a new and distinct able as opiates. I usually prefer pain to drugs chemical product, which is then washt of any when I must choose between the two evils; hence accidental uncombined excess, and then tested I have never taken but a single dose—a small and prepared for the market. one at that—of any of this class of drugs, and I I askt Dr. Summers why the addition of the have forgotten what one it was, but I think it was salicylic element should prevent depression. a sample tablet of one of the numerous imita- He referred to clinical experience, with the

possible explanation that, the phenetidin being

H. John Stewart and Finsen Rays. the real source of danger, its neutralization by The distinguisht Editor of the Journal of two acid radicals may be more complete, thus the American Medical Association writes us as removing the danger and at the same time follows: adding a valuable antiseptic property--the Dr. C. F. Taylor, Editor of THE MEDICAL salicylic element. My experience is confined WORLD, Philadelphia, Pa. to a single case, a member of my family who Dear Doctor Taylor :- I read your apology must have drugs of this kind occasionally for on page 96 under the title of “Beg Your Parpain, and she says that while phenacetin don.' We did not bite, but you have not (which she long ago gave up, but I got her publisht half the journals that contained this some a few days ago to see if it would not now article. act better than formerly) is fully as depressing Besides those you mention, the following were as the various acetanilid mixtures, or more so ; caught : Boston Medical and Surgical Journal, thermol is not; but thermol will not take the Memphis Medical Journal, Cincinnati Lancetpain away quite as promptly, but “is more Clinic, Western Medical Review, Modern soothing I was told of a number of cases of Medical Science, Canadian Journal of Medtyphoid fever, etc. in which thermol was suc- icin and Surgery, St. Louis Medical Review, cessfully used, but I haven't access to the rec- Denver Medical Times, Texas Medical Jourords. I was also told of a case of whooping cough nal, and Western Druggist. Very truly yours, in which the child watcht the clock for the Chicago.

GEORGE H. SIMMONS. time to take its 272-grain tablet of thermol, in [Thanks, Dr. Simmons. As my time perorder to continue to avoid the distressing mitted the examination of my exchanges, I paroxysms of another child near by, not taking found the article in some of the above, but I the thermol. But this evidence—all I know did not reach all. I would not have been at the present time (others may know more)- caught if H. John Stewart had not lied. The is too meager and indefinit upon which to base

profession should know how to size up the an opinion. Besides, an inventor is naturally institution which he sought to advertise in this sanguin concerning his own preparation, and dishonest way.-ED.] his claims perhaps would better be discounted somewhat. Hence the importance of impartial

Thank you, Sincerely. testimony. It is "up to" the profession to determin the value of thermol and act according

As a rule, I don't like the sometimes too to its findings. I am glad that it is the product prevalent habit of giving presents--particularly of an American laboratory, for we Americans wedding presents, which latter custom has have depended far too long on foreign labora- grown into a monstrous abuse. Articles given tories for these synthetic chemicals. As to as presents are frequently not needed, usually price, it is 75 cents per ounce much

not what would have been chosen by the recipmore expensiv than acetanilid, you see,

ient, and they always place the (unfortunate) but worth the difference if the inventor's recipient under obligations, and sometimes in claims are borne out by ample clinical tests.*

an awkward position.

I am very sensitiv in It seems that such new things cannot and

this matter, and have often felt, if either giving would not be conceived and achieved if it or receiving must be done, that it is “more were not for some prospect of profit. The

blessed to give than to receive." But there time, work, risk, initial expense for machinery,

are exceptions to all rules. My old friend etc., are very great, and the result not always

Dr. W. F. Waugh has evidently finisht his certain. But patents on processes run out in

season of travels, for the following note comes time, and then we have the really good things

to me from him at Chicago : at a narrow margin of profit, as on sugar or

Dear Doctor TAYLOR :-I send you herewith a pen salt. But copyrights on such proprietaries as

made from a feather from the wing of an American

eagle, with which to indite your editorials. May you antikamnia, neurilla, etc., never run out; no never write anything unworthy that free and fearless manufacturer except the owner of the copyright

bird, bold and dauntless with lofty flight and keenest

of vision. can ever make and sell a preparation under

This I accept with great appreciation. one of those names; but fortunately nothing of special scientific value is thus perpetually monopolized. They are simple mechanical

Is it a Diploma Mill? mixtures, and their formulas, tho secret, are What seems to be a diploma mill has its approximately known.

Correspondence Department,” to which all

letters must be sent, in a town in Michigan. * Since the above was written, numerous clinical reports on the

Answers to inquiries sent to this Michigan town use of thermol in typhoid fever and pneumonia have been submitted to me. However, I have said enuf above for purposes of are mailed from a town in Pennsylvania. But comparison of the different members of this group, and no more would be appropriate here.

the “ Main Office,'' and the “ College” itself

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