;qo 



NA TURE 



[April 19, 1 b94 



belong to chemical groups, and are as well defined ns the alka- 

 loids derived from pyridine or chinoline. Every day the number 

 of contumelious substances — substances which do not wish to 

 reveal to us their secrets — grows less. Chemistry has revealed 

 to I'.s the presence of more than twenty alkaloids in opium, and 

 of more than six in quinine ; and it will soon be extremely 

 difficult to name the drug, of animal or vegetable origin, in 

 which there have not been found one or several active prin- 

 ciples. And, going from victory to victory, chemistry has also 

 succeeded in producing a great number of alkaloids by the 

 synthetic manner. These have not been the exceptional lucky 

 strokes {coups de maitre exceptioneh). No constitution and 

 composition of other bodies that chemistry has not yet repro- 

 duced for us is already familiar to the chemist who can trans- 

 form morphia into codeia ■s^-^A vice versa, and worthless cupreine 

 into effective quinine. We may predict with every confidence 

 that the manufacture by synthesis of all the known alkaloids 

 is only a question of time for chemistry. But the triumphal 

 march of chemistry does not stop here ; it has constructed for 

 us new alkaloids endowed with therapeutic effects of great 

 value. It has furnished us, inter alia, with apomorphine and 

 apocolaine. 



It would be unequalled ingratitude to fail to recognise the 

 imperishable services that chemistry has rendered to materia 

 medica in endowing it with the alkaloids and the pure active 

 principles because there are a few blark clouds on the horizon. 

 That there are such I do not deny, but they are not wholly 

 the fault of chemistry. Is the gunsmith responsible for the acci- 

 dents that a new firearm may cause in the hands of a client who 

 does not know how to use the weapon properly? Surely not. 

 Why did not the purchaser take the trouble to understand the 

 structure of the gun ? Why was he not more careful ? Why 

 did he pay no attention to warnings ? Why did he behave like 

 a happy child, with nothing more important to do than to 

 display his new acquisition to all the world and to put it to the 

 test with the innocence of youth ? On the other hand, should 

 not the gunsmith help to avoid such disasters by explaining 

 matters to the purchaser? And if he i^ not hiinself sufficiently 

 informed and does not thoroughly understand the mechanism of 

 the weapon, should he have offered it for sale? Either 

 party may be to blame. What I want to convey by my 

 parable is this : by a very pardonable illusion, to which the 

 many physicians and some chemists have given way, it has 

 become generally believed that the active principles of drugs, 

 when chemistry can furnish them for us in a crystallised 

 state, are purely chemical bodies, and that identity of name 

 guarantees identity of chemical composition. This illusion 

 is rapidly being dispelled, but, alas ! not without having done 

 harm to physicians and their patients. As far as the chemical 

 purity of crystalline products is concerned, it is to-day a 

 secret of Polichinello that crystallised quinine contains cin- 

 chonidine, that atropine contains hyoscyanine, and atropa- 

 mine, and that pilocarpine contains jaborandi. As much in 

 organic as in inorganic chemistry we come across this 

 phenomenon of mixed crystallisation. The crystallisation of 

 substances is no guarantee of their chemical purity. These 

 facts are sufficient to condemn entirely the new therapeutic 

 system that M. Burggraeve has wished to inaugurate under 

 the name of "dosimetric medicine." Dosimetric medicine is 

 doubly on the wrong track — first, in assuming the chemical 

 purity of active crystallised principle of which it exclusively 

 makes use, and secondly, in enunciating the therapeutic heresy 

 that the administration of a single active principle is worth 

 much more than the administration of the drug from which 

 the active principle has been derived. I do not hesitate 

 to describe this dosimetric profession of faith as a heresy. 

 The drugs that are most used are admirably made com- 

 positions in which different principles, working for or against 

 each other, are found together. Their therapeutic effect 

 on the system is altogether difterent from the effect that 

 would be obtained by adding and substracting the thera- 

 peutic effects of each ingredient. Recent pharmaceutic re- 

 searches have conclusively demonstrated this fact. I do 

 not wish to say too much against domestic medicine. I 

 think it has been, on the whole, inoffensive. Alas ! I cannot 

 say as much of the unreasonable faith which leads persons to 

 believe that similarity of name and of active principle in crystal- 

 line form will produce chemical and pharmaceutical identity. 

 Ingentem, regina, juhes renovare dolor em! We all know the 

 grievous results that may be caused by giving aconitine or 



NO. 1 277, VOL, 49] 



digitalin derived from different sources. Here again the pro- 

 gress of chemistry promises improvement. The animal organism 

 is most sensitive to stimulus, and modern chemistry has so many 

 methods of stimulus at its disposal that the task will not be too 

 arduous. It is a question which interests all civilised countries, 

 which is brought forward at all medical and pharmaceutical 

 international congresses, and which is in most urgent need of a 

 satisfactory solution. 



The Vagaries of Modern Pharmacy. 

 The services rendered by chemistry to therapeutics is not 

 an exhausted subject. Certainly our predecessors already 

 possessed a goodly medicinal treasury, but it seems very 

 insignificant when compared with what we now utilise. Che- 

 mistry has loaded Materia Medica and Pharmacology with 

 wealth ; it is the mother of new remedies, and we are proud of 

 its aid ; it has given us our anaesthetics, antiseptics, hypnotics, 

 and antipyretics. These groups of remedies enable us to give 

 relief in many cases where our forefathers were quite help- 

 less. To them chloroform, ether, carbolic acid, iodoform, 

 creosote, chloral, the salicylates, antipyrin, were all alike 

 unknown. But here, again, and more so than with respect to 

 the alkaloids, there are shades in the picture. Chemists and 

 chemical manufacturers add more and more to our store of 

 remedies day by day without stint or truce, without heeding 

 the great despairing physician already overstocked with drugs. 

 We are tempted to cry out for mercy. This is no exaggera- 

 tion, for these new chemical products are all forced upon the 

 same therapeutic market under the most attractive names, 

 and all proclaimed aloud with the noise of the most perfect 

 advertising machinery. This is now done to an extent that, 

 in my opinion, is detrimental to the interests of therapeutics. 

 I am not speaking of quack remedies, the ovietara of our 

 day, of these secret specifics which the medical man views 

 with wholesome horror, to which, and to whose use, the old 

 adage, Tronipeiirs, ttomfes, tromfettes can be so well applied. 

 I am speaking of genuine well-known products ; for, unfortu- 

 nately, modern and industrial chemistry, in manufacturing 

 and in placing at the disposal of doctors these drugs, does 

 not at all object to their being purchased by the general 

 public. If this is not so, why do their proprietors select for 

 their names the fascinating names that act as veritable 

 flags to attract the public — for instance, anti-nervine, anti- 

 phthisine, anti-rheumatic, anti dysenterine, and, most ex- 

 pressive of all, migrainine. I fully appreciate the difSculty of 

 finding new names for these new products, and can under- 

 stand that the manufacturer should shrink from giving them 

 the names derived from their chemical composition, for 

 these, generally speaking, could only be pronounced with 

 linguistic gymnastics and intolerable strain upon our memory. 

 I must, with great regret, note that we have departed from 

 the ancient method, which taught us to denominate new 

 products according to their origin, and we have followed 

 freely a course that I cannot blame too severely — that of 

 seeking for euphonious, sonorous names, pompously proclaim- 

 ing the therapeutic use and effect of the drugs designated by 

 them. It is not sufficient nowadays to have a good remedy — 

 say agathine ; — we must be assured of its superlative excel- 

 lence, hence aristol. Do you want to prescribe for a patient 

 who is " out of sorts," you have euphorine ; for a lack of 

 appetite, you have orexine. You desire to procure sleep for 

 him : you have hypnal, hypnon, somnal, or somniferine. 

 You wish to lower a febrile temperature : do not let the 

 emergency trouble you, for you have antipyrine, antifebrine, 

 antithermine, thermomine, thermofugine, pyrodine, and 

 thermodine. You want to assuage pain? Eh bien, you have 

 awaiting your orders analgesine, analgeine, exalgine, exo- 

 dyne, and' neurodyne. Or you desire to stimulate urinary 

 secretions, you have diuretine, pheduretine, and uropheime. 

 To check the formation of pus there is a remedy 

 termed pyoktonine ; and to combat spasms antispasmine. 

 I do not wish to exhaust your patience, and I will spare you 

 the enumeration of the antiseptics, the disinfectants, the 

 microbidines e iiitti qtiaiito. Ten years exactly have elapsed 

 since my honoured colleague, Prof. Rossbach of Jena, 

 published an article full of wit and sound sense in ridicule 

 and blame of these tendencies of modern therapeutics, and m 

 those days we had not the long lists of antiseptic and anti- 

 pyretic remedies. Nor was it then imagined that the essential 

 extracts of the organs of animals, of which the late Prof. 



