890 



SCIENCE 



[N. S. Vol. XXXII. No. 834 



ism, and, like all nihilism, was an unjustifi- 

 able extreme. It is, of course, true that a 

 great number of the remedies used by 

 physicians of fifty years ago were either 

 inert or incapable of producing the results 

 claimed for them, but the gradual recogni- 

 tion of this fact should not have occasioned 

 a blindness as to the actual value of others 

 which are still employed, and with demon- 

 strable worth. 



Another fact which contributed not a 

 little to the growing distrust among physi- 

 cians of the efficacy of drugs was the very 

 marked development of the patent medicine 

 business, and its peculiar exploitation 

 through the daily press. Many of the so- 

 called patent medicines were simply pre- 

 scriptions which had enjoyed some local 

 popularity for particular ailments. Turn- 

 ing them into cure-alls, while serving to 

 catch the public, would naturally condemn 

 them among the great body of physicians, 

 and with them many other remedies used 

 for the same purposes. The condemnation 

 of patent or proprietary remedies by 

 physicians was naturally ascribed to jeal- 

 ousy, and the fear of losing business. The 

 doctors' attitude was classed as a trade 

 interest and the newspapers which profited 

 by advertising patronage took care not to 

 dispel this notion, which was often a false 

 one. 



This ugly situation soon became worse 

 by the entrance of another factor. While 

 the greatest triumphs of organic synthetic 

 chemistry were first in the color industries, 

 it was in time shown that many of the coal 

 tar derivatives possessed marked physio- 

 logical properties which might give them 

 value in medicine. The developments in 

 this direction were enormously rapid. Ee- 

 eall what has been done in twenty-five 

 years! In the efforts to produce artificial 

 alkaloids with the properties of quinine a 

 number of aromatic synthetics were de- 



veloped. The first of these was known as 

 kairin, a quinoline derivative, with some 

 good properties, but having certain secon- 

 dary actions rendering it risky in use. A 

 host of others followed, and great factories 

 were soon engaged in the manufacture of 

 artificial products, mostly coal tar deriva- 

 tives, for use in medicine. In the twenty 

 years following the introduction of kairin 

 not far from 2,000 of these had been ad- 

 vertised to the medical profession. Most 

 of them were soon found to have little 

 practical value, but more came on and they 

 are still coming. All classes of important 

 remedial agents have been represented; 

 antipyretics, local and general anesthetics, 

 hypnotics, intestinal and external anti- 

 septics, and a great variety of bodies with 

 special physiological properties. 



It is not hard to imagine the result. The 

 most extravagant claims were made for 

 many of these new compounds, and it was 

 indeed an able and independent physician 

 who could dare to refuse to be imposed 

 upon by their promoters. Unfortunately, 

 the great body of medical practitioners the 

 world over soon fell victims to the craze 

 for "synthetics," either in their original 

 form as they came from Germany, or in 

 the form of imitations or mixtures as put 

 out by other houses. It is not too much to 

 say that the use of many of these newer 

 remedies soon became a veritable scandal. 

 Of rational therapeutics little was left, 

 and, apparently confused by the wealth of 

 things ofi'ered, physicians were often only 

 too willing to follow the advice of the 

 agents of the medicine houses. Aeetani- 

 lide alone has made millions for those who 

 have pressed it in a business way, under, 

 new names. As acetanilide its value and 

 also its dangers soon became known to the 

 body of physicians, as a whole, and in this 

 form it is safe to say that its use has 

 seldom been excessive. But mixed with a 



