Deoembeb 23, 1910] 



SCIENCE 



891 



little caffeine and soda as antikamnia, and 

 praised as an original and newly discov- 

 ered synthetic, it soon found a market 

 where it was sold in enormous quantities. 

 Chemists pointed out the facts, but physi- 

 cians were easily duped, and some depart- 

 ments of the United States government 

 even bought antikamnia for their hospital 

 stores. The fortunes made in this product 

 stimulated a dozen or more imitations, and 

 ammonol, orangeine, phenalgin, salacetin 

 and other mixtures containing aeetanilide 

 as the chief active constituent were soon on 

 the market, advertised as new and valuable 

 remedies. Most of them, like the anti- 

 kamnia, contained caffeine. 



That a new remedy hailed from Ger- 

 many, and that its use was backed up by 

 the favorable opinion of almost any doctor 

 of that country was considered sufficient to 

 justify its use here, where therapeutic ex- 

 perimentation had sunk to the level of try- 

 ing almost everj'thing which came along. 



The business of manufacturing proprie- 

 tary remedies ready for use grew to enor- 

 mous proportions, and unfortunately the 

 main element in selling many of them was 

 the air of mystery with which they were 

 surrounded. In the old materia medica, 

 while the situation was bad, it was not so 

 entirely hopeless. The average physician 

 had always seen and certainly knew some- 

 thing about calomel, cinchona and opium, 

 but the things with the long high-souuding 

 names, made in German J^ were clearly be- 

 yond him. He naturally and easily 

 dropped into the position where the 

 pseudo-scientific jargon of the glib-tongued 

 detail man of the medicine factory over- 

 powered him. 



I am talking of the position of physi- 

 cians, as a class, but fortunately there was 

 a saving remnant. Not all of our iVmeri- 

 can practitioners were fooled by the cam- 

 paign of advertising madness. Not all of 



them were swamped by the flood of pro- 

 prietary remedies which flowed from the 

 medicine factories in an ever-increasing 

 stream. A remnant remained to attempt 

 the saving of therapeutics and the wiping 

 out of the disgrace of proprietary enslave- 

 ment. In this remnant were a number of 

 men active in the councils of the American 

 Medical Association and they were sufS- 

 ciently alive to the seriousness of the situa- 

 tion to undertake a reform. The Journal 

 of the association was the medium through 

 which the reform was begun and primarily, 

 perhaps, because here the need became the 

 most apparent. The Journal has had a 

 wonderful growth in the last two decades 

 and much of our best medical research is 

 published in it or reviewed by it. At the 

 same time in its advertising columns the 

 praises of some of the worst products of 

 the medicine factories were sounded. The 

 incongruity of the situation was apparent. 

 Where is the sense, it was asked, in advo- 

 cating modern and scientific therapeutic 

 measures, supported by pharmacological 

 evidence, if but a few pages away a dozen 

 ols and ins and phens are advertised in 

 exaggerated terms, and about which no 

 man knows anything. This irrational re- 

 lation should be reformed, but how? 



The way in which the reform was ef- 

 fected and the far-reaching consequences 

 of the same developed somewhat slowly. 

 The editor began by consulting a small 

 group of chemists and pharmacists re- 

 garding the possible or probable merits of 

 a number of substances offered for adver- 

 tisement, with the hope of developing 

 some scheme by which objectionable matter 

 might be easily weeded out. Naturallj^ the 

 editor and the advertising manager of a 

 journal could not be expected to pass on 

 the reasonableness of the claims for a com- 

 plex new synthetic. This is the province 

 of men trained in chemistry and pharma- 



