456 
Pharmacologic  Superstitions. 
Am.  Jour.  Pharm. 
October,  19 17. 
would  seem  that  it  is  usually  increased;  secondly,  the  hypophos- 
phites  pass  through  the  body  unchanged,  that  is,  they  do  not  attract 
oxygen  in  sufficient  quantity  to  oxidize  themselves. 
Supposing,  however,  that  Churchill's  theory  of  the  cause  of 
tuberculosis  were  true,  it  would  in  no  way  argue  in  favor  of  the  use 
of  the  compound  syrup  of  the  hypophosphites  as  a  practical  remedy. 
An  ordinary  man  burns  up  from  800  to  1,000  gm.  of  oxygen  a  day. 
It  requires  about  3  per  cent,  of  oxygen  to  saturate  the  earthy  hypo- 
phosphites  ;  compound  syrup  of  hypophosphites  contains,  in  all,  ap- 
proximately 7.5  per  cent,  of  hypophosphites ;  therefore  2  teaspoonfuls 
of  the  compound  syrup  of  hypophosphites  has  theoretical  attractions 
for  0.018  gm.  of  oxygen.  To  cause  an  increase  of  10  per  cent,  in 
the  daily  consumption  of  oxygen  would  require  a  dose  of  about  4,000 
Cc,  or  1  quart  four  times  a  day.  While  it  is  possible  that  a  patient 
might  survive  the  hypophosphites  in  this  quantity,  he  would  certainly 
die  of  strychnine  or  quinine  poisoning. 
Dr.  Churchill's  theory  having  been  shown  to  be  erroneous,  it 
would  require,  according  to  the  postulates  given  above,  the  most 
positive  clinical  evidence  to  establish  his  conclusion.  In  the  book  of 
over  250  pages  announcing  his  discovery,5  he  reports  the  results  of 
thirty-five  cases,  of  which  nine  patients  were  classed  as  cured,  eleven 
as  improved,  and  fourteen  died !  Even  allowing  for  the  progress 
which  has  been  made  in  recent  years  in  the  management  of  tubercu- 
losis, this  record  seems  hardly  favorable  enough  to  justify  his  con- 
clusions as  to  the  specificity  of  the  treatment.  As  for  other  clinical 
evidence,  it  is  equally  unconvincing.  There  has  been  a  relatively 
small  number  of  papers  in  medical  literature  on  this  subject,  and 
most  of  those  which  have  appeared  are  made  up  almost  entirely  of 
such  vague  generalities  as  "  the  treatment  has  given  me  good  satis- 
faction." In  a  brochure  published  in  1881  by  McArthur — who, 
being  commercially  interested  in  this  therapeutic  measure,  is  not 
likely  to  have  overlooked  any  reports  favorable  to  it — the  statement 
is  made  that  the  favorable  conclusions  are  based  on  259  cases,  cer- 
tainly not  an  overwhelming  mass  of  evidence  after  twenty-three 
years  of  clinical  trial! 
Churchill  recommended  only  the  hypophosphite  of  lime,  but  Dr. 
McArthur  modified  this  by  adding  also  the  hypophosphites  of  potas- 
sium and  sodium  and  dispensing  in  the  form  of  syrup.  It  is  interest- 
ing to  note  that  the  real  out  and  out  hypophosphitists  maintain  that 
5  Churchill:  Phthisie  Pulmonaire,  1858. 
