[pg 90]

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CHAPTER XX

PATENT MEDICINES

"Men who prescribe purifications and spells and other illiberal practices of like kind."—Hippocrates.

"...Corrupted

By spell and medicines bought of mountebanks."

"Othello." Act I.

[Thomas] Carlyle said the world consisted of "so many million people, mostly fools"; and he was right, for to public credulity alone is due the immense growth of the patent-medicine trade.

It was formerly thought that for each disease, a specific drug could be found, but this idea is exploded. The doctor determines the exact condition of his patient, considers how he best may assist nature or prevent death, and selects suitable drugs. He carefully notes their action and modifies his treatment as required. The use of set prescriptions for set diseases is obsolete; the doctor of to-day treats the patient, not the disease.

A few patent medicines are of limited value; many are made up from prescriptions culled from medical works, and the rest are frauds, like potato starch. The evil lies in charging from three to four hundred times a just price, in ascribing to a medicine which may be good for a certain disorder, a "cure-all" virtue it does not possess, and in inducing [pg 91] ignorant people to take powerful drugs, reckless of results.

Ephemeral patent-medicine businesses, run by charlatans, whose aim is frankly to make money before they are exposed, spring up like mushrooms; and their cunningly worded advertisements meet the eye in the columns of every paper one opens for a few months; then they drop out, to reappear under another name, at another address. These rogues buy a few gross pills from a wholesale druggist, insert a small advertisement, and so lay the foundations of a profitable business.

The lure of the unknown is turned to account. "The discoverer went back to the Heart of Nature—and found many rare herbs used by Native Tribes." "The "Heart of Nature" was probably a single-room office tucked away down a Fleet Street alley, and analysis proves these medicines contain only common drugs, one "Herbal Remedy" being metallic phosphates.

A common procedure is to send a question form, and, after answering the query, "What are you suffering from?" with "Neurasthenia", the company "carefully study" this, and then inform you with a gravity that would grace the pages of "Punch", "You are the victim of a very intractable type of Neurasthenia", so intractable in fact that it will need "additional treatment"—at an "additional" fee.

The quack's advertisements are models of the skillful use of suggestion, and turn to rare account the half-knowledge of physiology most men pick up from periodicals. He frightens you with alarming and untrue statements, gains your confidence by a display of semi-true facts reinforced where weak by false assertions, and, having benefited himself far more than you, leaves you to do what you should have done at first, go to a doctor or a hospital.

[pg 92]

Were it made compulsory for the recipe to be printed on all patent medicines, people would lose their childlike faith in colored water and purges, and cease the foolish and dangerous practice of treating diseases of which they know little with drugs of which they know less.

The British Medical Association of 429, Strand, London, W.C., issue two 1s. books—"Secret Remedies: What they cost and what they contain", "More Secret Remedies"—giving the ingredients and cost price of most patent medicines. You are strongly urged to send for these books, which should be in every home.

The basis of every cure for epilepsy (not obviously fraudulent) is bromides. The usual method is to condemn vigorously the use of potassium bromide, and substitute ammonium or sodium bromide for it. Some advertisers condemn all the bromides, and prescribe a mixture of them; others condemn potassium bromide, and shamelessly forward a pure solution of this same salt in water as a "positive cure!"

In all cases the sale price is out of reasonable proportion to the cost, victims paying outrageous sums for very cheap drugs.

Most epileptics are poor, because their infirmity debars them from continuous or well-paid work, leaving them dependent on relatives, often in poor circumstances also. The picture of patients, already lacking many real necessities, still further denying themselves for weeks or months to purchase a worthless powder, is truly a pitiful one.

Bromides are unsatisfactory drugs in the treatment of epilepsy, but they are the best we have at present. Get them made up to the prescription of a doctor, and see him every month to report progress and be examined. In the end, this plan will be very much [pg 93] cheaper, and incomparably better, than buying crude bromides from quacks.

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There is no drug treatment for either hysteria or neurasthenia, and when the doctor gives medicines for these complaints, it is to remedy organic troubles, or, more often because necessity forces him to pander to the irrational and pernicious habit into which the public have fallen of expecting a bottle of medicine whenever they visit a doctor. Osier, the famous Professor of Medicine at Oxford, truly observed that he was the best doctor who knew the uselessness of medicines. But when public opinion demands a bottle, and is unwilling either to accept or pay for advice alone, the doctor may be forced to give medicines which he feels are of little value, hoping that their suggestive power will be greater than is their therapeutic value.

Neuropaths invariably contract the habit of physicking themselves, and taking patent foods and drugs which are valueless.

So universal is this pernicious habit that we deem it desirable to criticize it here at some length.

One highly popular type consists of port wine, reinforced (?) by malt and meat extracts, and sold under a fanciful name. It has about the same value as a bottle of port, which costs considerably less. It is well to remember that many a confirmed drunkard has commenced with these "restoratives".

Malt extracts are also popular. They contain diastase, and therefore aid the digestion of starch, but the diastatic power of most commercial extracts is negligible.

Meat extracts of various makes contain no nourishment, but are valuable appetisers. Meat gravy is as effective and far cheaper.

[pg 94]

Foods containing digestive ferments, which are widely advertised under various proprietary names are practically valueless, as are the ferments themselves sold commercially. Digestive disorders are very rarely due to deficiency of ferments, while pepsin is the only one among all the ferments that could act (and that only for a little while) in the digestive system.

Some of the disadvantages of predigested foods have been noted, and their prices are usually so exorbitant that eggs at 2s. 6d. each would be cheaper. The remarks of Sollmann the great pharmacologist are pertinent:

Limitations. The administration of food in the guise of medicine is sometimes advantageous; but medicinal foods are subject to the ordinary law of dietetics, and therefore cannot accomplish the wonders which are often claimed for them. The proprietary foods have been enormously overestimated, and have probably done more harm than good. The ultimate value of any food depends mainly on the amount of calories which it can yield, and on its supplying at least a minimum of proteins. In these respects, the medical foods are all inferior, for they cannot be administered practically in sufficient quantity to supply the needs of the body. They have a place as adjuvants to other foods, permitting the introduction of more food than the patient could otherwise be induced to take. Aside from the special diabetes foods and cod-liver oil, their value is largely psychic.

Predigested Foods. The value of these is doubtful, for digestive disturbances involve the motor functions and absorption more commonly than the chemical functions. Their continued use often produces irritation.

Liquid Predigested Foods. As sold, these are [pg 95] flavoured solutions containing small amounts (½-6 per cent) of predigested proteins, ½-15 per cent of sugars and other carbohydrates, with 12-19 per cent of alcohol, and often with large quantities (up to 30 per cent) of glycerin. Their protein content averages less than that of milk, and in energy value they are vastly inferior. Their daily dose yields but 55-300 calories including their alcohol; this is only one-thirtieth to one-fifth the minimum requirements of resting patients. To increase their dose to that required to maintain nutrition would mean the ingestion of an amount of alcohol equivalent to a pint of whisky per day.

Of recent years very expensive preparations of real or alleged organic iron compounds have had a large sale. Iron is a component of hæmoglobin, a solid constituent (13 per cent by weight) of the blood, which combines with the oxygen in the lungs, and is carried (as oxyhæmoglobin) all over the body, giving the oxygen up to the tissues. Hæmoglobin is an exceedingly complex substance, but it contains only one-third per cent by weight of iron in organic form.

The liver is the storehouse of iron, its reserve being depleted when there is an extraordinary demand for iron. The minute amounts of iron in ordinary food are amply sufficient for all our needs; any excess is simply stored, and, later excreted, and has no effect whatever on the circulating hæmoglobin.

Iron is only of value in certain forms of anæmia, and the many patent medicines purporting to contain hæmoglobin or organic iron are therefore useless to neuropaths. The Roman plan of drinking water in which swords had been rusted, is quite as valuable as drinking expensive proprietary compounds. When iron is indicated Blaud's Pills are perhaps the best preparation.

[pg 96]

Huge quantities of patent medicines containing phosphates in the form of hypo-or glycerophosphates, and (or) lecithin are sold annually.

All phosphorus compounds are reduced to inorganic phosphates in the digestive tract, absorbed and eliminated, so that, as with iron, if phosphates are needed, the form in which they are taken is of no moment. Why, then, pay huge sums for organic-phosphorus compounds (synthesized from inorganic phosphates) when they are immediately reduced to the same constituents from which they were constructed, the only value in the reduction process being seen in the immense fortunes which patent-medicine proprietors accumulate?

Lecithin is isolated from animal brain, or egg-yolk, and commercial lecithin is impure. Not only does the ordinary daily diet contain ample lecithin (5 grammes), but two eggs will double this, while liver or sweetbread, both rich in phosphorous, may be eaten.

The much-vaunted glycerophosphates are decomposed to and excreted as phosphates. Sollmann's remarks apply to all similar proprietary articles:

"A proprietary compound of glycerophosphates and casein has been widely and extravagantly advertised as 'Sanatogen'. It is a very costly food, and in no sense superior to ordinary casein, such as cottage cheese."

Hypophosphites have been boomed by various people, chiefly for financial reasons. Five or six of them are usually prescribed, with the addition of cod liver oil, and perhaps quinine, and (or) iron and strychnine, the complexity of the prescription being expected, apparently, to compensate for the uselessness of its various ingredients.

To deduce rational remedies, it is first necessary to [pg 97] elucidate the causes of inefficiency; and to expect a brain which is out of order to function in an orderly manner simply because it is supplied with one of the substances necessary to its normal functioning (regardless of whether a deficiency of that substance is the cause of the disorder), is as rational as it would be to expect to restart an automobile engine, the magneto of which was broken, by filling up the half-empty petrol tank.