98  Biological  Standardization  of  Drugs.  ^^u^' 
means  delayed  convalescence  or  even  death,  (i)  These  are  state- 
ments which  may  sound  a  trifle  theatrical.  One  can  not  often 
prove  them.  If  a  patient  is  made  more  violently  ill  or  dies  no 
one  suspects  that  the  medicine  was  at  fault.  It  is  a  visitation 
of  providence  or,  as  the  facetious  would  have  it,  a  doctor  was 
called  and  then  the  undertaker. 
My  attention  has  recently  been  called  to  a  case  of  poisoning. 
The  patient,  who  suffered  from  chronic  heart  disease,  had  been 
receiving  tincture  of  strophanthus  in  a  certain  dose.  The  prescrip- 
tion was  refilled  and  the  medication  continued.  After  the  second 
dose  from  the  new  strophanthus  tincture  poisonous  symptoms 
rleveloped  although  fortunately  ultimate  recovery  ensued  after  two 
days  of  serious  illness.  An  assay  made  at  this  laboratory  of  the 
strophanthus  showed  that  it  was  an  exceeding*ly  active  preparation 
and  whereas  the  patient  was  supposed  to  be  receiving  the  same 
dose  as  of  the  old  he  actually  received  an  amount  of  the  active 
principle  in  this  new  preparation  equal  to  about  three  times  that 
of  the  strophanthus  tincture  which  he  had  formerly  been  taking. 
In  the  opposite  direction  I  have  a  report  on  a  digitalis  prepara- 
tion which  upon  examination  proved  to  be  distinctly  depressing  to 
the  heart  and  not  a  tonic.  Who  would  dare  say  that  the  administra- 
tion of  this  drug  to  an  already  overburdened  heart  would  not 
produce  the  most  disastrous  results.  A  physician  in  Baltimore 
made  inquiry  of  the  firm  exploiting  this  preparation.  The  firm 
replied  that  we  had  made  an  effort  to  secure  an  old  and  deteriorated 
sample  for  our  examination.  Like  certain  other  extravagant  claims 
made  by  an  occasional  manufacturer  this  statement  was  a  bald 
untruth  to  save  their  own  reputation  and  was  absolutely  without 
foundation.  The  facts  are  that  the  original  bottle  was  ordered 
by  our  pharmacist  from  a  local  jobber  and  the  jobber  had  no 
information  whatever  that  the  drug  was  to  be  tested.  It  was 
just  such  a  bottle  as  would  have  been  dispensed  on  a  physician's 
prescription. 
Upon  facts  such  as  these,  and  the  number  of  specific  instances 
could  be  multiplied  almost  indefinitely,  the  whole  theory  of  drug 
standardization  rests.  Any  consideration  of  quality  from  a  com- 
mercial standpoint  is  wholly  secondary  and  drugs  should  be  stand- 
ardized or  assayed  that  the  patient  may  receive  of  potent  remedies 
always  and  invariably  the  amount  of  active  substance  prescribed : 
and  when  this  has  been  done  the  pharmacist  has  given  the  best 
