Am6rt°oUt£rP?9™"  ^       Pharmacologic  Superstitions.  455 
ures,  we  persuade  ourselves  that  we  see  beneficial  effects  from  the 
treatment. 
It  seems  to  me  fair  to  conclude  that  we  are  justified  in  giving 
credence  to  claims  of  therapeutic  usefulness  when  the  known  action 
of  the  drug  permits  of  a  plausible  explanation  of  its  asserted  benefits, 
not  inharmonious  with  the  accepted  theories  of  the  disease  and  sup- 
ported by  a  fair  amount  of  bedside  corroboration. 
In  the  absence  of  a  reasonable  hypothesis  as  to  the  mode  of 
action,  a  gigantic  accumulation  of  clinical  evidence  may  establish  the 
utility  of  any  therapeutic  measure ;  but  when  a  candidate  for  thera- 
peutic recognition  can  present  no  scientific  logic,  or  only  one  which 
is  demonstrably  erroneous,  and  its  clinical  credentials  are  both  vague 
and  scanty,  we  are  certainly  justified  in  regarding  its  claims  with 
suspicion. 
It  is  my  purpose  to  judge  some  traditional  remedies  by  the 
standard  set  forth;  if  there  is  neither  reason  nor  result  to  appear 
in  defense  of  a  drug,  no  matter  how  ancient  its  lineage  may  be,  I 
opine  it  should  be  relegated  to  the  limbo  of  all  forgotten  supersti- 
tions. 
Compound  Syrup  of  Hypophosphites. 
This  preparation,  Avhich  is  so  widely  employed  as  a  tonic,  espe- 
cially in  tuberculous  conditions,  contains,  beside  the  hypophosphites 
of  calcium,  magnesium,  potassium  and  sodium,  small  quantities  of 
iron,  of  quinin  and  of  strychnin.  The  amount  of  iron  in  2  fluidrams 
of  the  syrup,  which  is  the  pharmacopeial  dose,  is  equivalent  to  ap- 
proximately }<20  grain,  of  quinin  %  grain,  and  of  strychnin  1-- 
grain.  It  is  manifest  that  neither  the  iron  nor  the  quinin  can  have 
any  effect  on  the  body,  and  that  the  strychnin  can  have  onlv  an  in- 
finitesimal hypothetic  action.  As  for  the  hypophosphites  them- 
selves, they  owe  their  introduction  into  medicine  to  a  Dr.  Churchill.4 
His  theory  Avas  that  phthisis  was  due  to  diminished  oxidation  in  the 
tissues;  phosphorus  has  a  strong  affinity  for  oxygen  and  therefore 
would  attract  oxygen  into  the  body,  but  it  is  too  highly  poisonous 
for  remedial  use ;  the  hypophosphites,  being  incompletely  oxidized 
derivatives  of  phosphorus,  would  have  the  same  affinity  for  oxygen, 
and  being  only  slightly  poisonous,  could  be  given  in  larger  dose.  As 
regards  this  theory  it  may  first  be  pointed  out  that  there  is  no  reason 
to  believe  that  there  is  diminished  oxidation  in  phthisis ;  in  fact  it 
4  For  the  history  of  the  hypophosphite  fallacy  see  The  Journal  A.  M.  A.,, 
April  25,  1914,  p.  1346. 
