General Conference Bulletin, vol. 6

Health Topics - THE GREAT AMERICAN FRAUD

W. A. RUBLE

Read May 27, 5:15 P. M.

For many years, physicians and other scientists have been trying to enlighten the people on the real nature and effects of nostrums and patent medicines. This effort, as is the case with any reform, has met with much opposition. Within the past three years, many of the leading magazines, notably Collier’s Weekly and The Ladies’ Home Journal, have taken up the matter, and given it a wide publicity. This agitation has been the means of enlightening many on the injurious ingredients of many nostrums. It has also caused, or helped to cause, the investigation which has brought about our present pure food laws. It has greatly reduced the number of injurious products which have been so widely exploited by advertising and other methods, and has compelled producers to place on the label of their products the ingredients of the same, so that the people may at least be aware of the composition of the medicines they are taking. GCB June 7, 1909, page 363.12

I shall enumerate some of the facts that have been produced by this general investigation. In beginning a series of articles in Collier’s Weekly some two years ago, Mr. Samuel Hopkins Adams used these startling words:— GCB June 7, 1909, page 363.13

“Gullible America will spend this year some seventy-five millions of dollars in the purchase of patent medicines. In consideration of this sum it will swallow huge quantities of alcohol, an appalling amount of opiates and narcotics, a wide assortment of varied drugs ranging from powerful and dangerous heart depressants to insidious liver stimulants. Should the newspapers, the magazines, and the medical journals refuse their pages to this class of advertisements, the nation would be the richer, not only in lives and money, but in drunkards and drug-fiends saved.” GCB June 7, 1909, page 363.14

In response to this agitation of the subject of patent medicines came the warning from all sides, “Don’t make the mistake of lumping all proprietary medicines in one indiscriminate denunciation;” to which Mr. Adams made reply that “the honest attempt to separate the sheep from the goats develops a lamentable lack of qualified candidates for the sheepfold.” GCB June 7, 1909, page 363.15

Let us consider briefly the habit-producing preparations which crowd the shelves of our modern drug-store. The first of these to claim our attention are the many patent medicines containing a large percentage of alcohol. At the head of this class, according to a list published by the American Medical Association, is Hostetter’s Stomach Bitters, with a percentage of alcohol at that time of forty-four and three tenths. Whiskey bottled in bond, as purchased at the corner saloon, has fifty per cent alcohol. Referring to a recently procured bottle of said bitters, the formula seems to have been changed somewhat since this investigation by the American Medical Association; for the label now bears these words, “Revised Formula.” I read, “Averaging thirty-nine per cent of alcohol by volume in finished product, being only sufficient to hold in solution the extracted medicinal properties of barks, roots, herbs, and seeds contained therein.” Under “Directions for Use,” I read, “Two tablespoonfuls taken three times a day, before meals, for dyspepsia, liver complaint, and every species of indigestion; and also for intermittent fever, fever and ague, and all kinds of periodical disorders; a means of immediate relief in flux, colics, and choleric maladies; a cure for costiveness, for delicate females; a good anti-bilious alterative and tonic preparation for ordinary family purposes; a powerful recuperant after the frame has been reduced and attenuated by sickness; an excellent appetizer as well as a strengthener of the digestive forces; a depurative of the blood and other fluids, desirable alike as a corrective and mild cathartic, and an agreeable and wholesome stimulant. Persons in a debilitated state should commence by taking smaller doses and increase with their strength.” What more could be desired than is promised in this shotgun prescription? I would call especial attention to the latter words; namely, that it is “an agreeable and wholesome stimulant,” and to the fact that it is recommended in small doses, but that these shall be increased. As all know, this is the course that any alcoholic drink pursues. The bottle states further that this remedy is “Guaranteed under the Food and Drug Act of June 30, 1906.” At the bottom of the label is the following promissory note:— GCB June 7, 1909, page 363.16

“For value received, we promise to pay to the bearer one cent on demand.” Signed, “Dr. Herbert Hostetter, Prest.” GCB June 7, 1909, page 363.17

This comes nearest to the truth of anything about the claims made. I say nearest, because if there is any possible benefit derived, it can not be over one cent’s worth. And this states that for such value received, the producer will pay one cent. GCB June 7, 1909, page 363.18

As a matter of comparison, I wish to call attention to a little experiment. Take the bottle of whiskey mentioned before, from which place a small amount in a receptacle. In another receptacle place an equal amount from the bottle of bitters. The sample of medicine burns longer and more readily than the sample of whiskey, indicating a larger proportion of alcohol in the medicine. GCB June 7, 1909, page 363.19

In this same class of alcoholic products may be mentioned Peruna, with a percentage of twenty-eight of alcohol; Paine’s Celery Compound, with twenty-one per cent. Champagne contains nine per cent; beer, five per cent; whiskey, as stated above, fifty per cent; Lydia Pinkham’s Vegetable Compound, eighteen per cent; Ayer’s Sarsaparilla, twenty-six per cent. It is stated on good authority that more alcohol was consumed in patent medicines last year than was used in all other alcoholic liquors combined, except beer. One patent medicine firm uses each week five hundred barrels of cheap whiskey in the manufacture of its products. GCB June 7, 1909, page 363.20

If they used the best alcohol, such as is purchased at the drug-store, in preparing their remedies, the cost would be as follows: Many of them are put up in pint bottles, therefore in a gallon of alcohol, there would be eight pints. The percentage of alcohol varies from twenty to forty per cent. Taking as an average twenty-five per cent alcohol, would give us thirty-two pint bottles of these products from each gallon of alcohol. We pay something like three dollars a gallon for alcohol. The patent medicine dealers use inferior whiskey, which is much cheaper. But even allowing that they use good alcohol, the difference between the cost of the product, leaving out all the herbs, burnt sugar, and such ingredients, would give a profit of twenty-nine dollars a gallon on their alcohol. This is a very good margin, and enables the producer of these products to advertise very widely. GCB June 7, 1909, page 363.21

One of the most pernicious features of this business is that it is considered, or rather has been considered, respectable to purchase and use these alcoholic drinks,—for such they are in very many cases,—because they come over the drug-store counter instead of the bar. Many a pious wife laments the fact that her husband patronizes the corner saloon for possibly nothing more than a few glasses of beer a day, while she is partaking several times a day quite freely of some patent medicine which contains several times as much alcohol as does the beverage of her husband. Her boozing is considered respectable because it is from a patent medicine. His is deplored, for he procures his drink over the bar. Both must have a drink occasionally to be able to do the work required, he to keep up his strength, she to get rid of that tired feeling,—both because they have the drink habit. GCB June 7, 1909, page 363.22

Many an ardent W. C. T. U. worker and other temperance advocates have been constant patrons of the patent-medicine vender while denouncing by pen and voice, from platform and pulpit, the drink habit. An interesting incident is told in The Journal of the American Medical Association of a respected clergyman in one of our large cities. This honorable gentleman fell ill, and the family physician was called. After examining the patient carefully, the physician asked to see his son. “I am sorry to tell you,” said the physician, “that your father is suffering from chronic alcoholism.” “Chronic alcoholism,” said the son, “Why, it is ridiculous. Father never drank a drop of liquor in his life, and we know all about his habits.” “Well, my boy,” responded the physician, “it is chronic alcoholism, nevertheless, and your father is now drunk. Has he been taking any medicine of late?” To this question, the young man responded that his father had been feeling somewhat weak at times of late, and had been recommended by a friend to try Peruna. Of this his father had been partaking rather freely, with the result mentioned. Time and again we see testimonials from clergymen and temperance workers for some one of these nostrums. We are glad to know that in general people are becoming enlightened on the subject of patent medicines, and that such instances as the above are becoming infrequent. GCB June 7, 1909, page 364.1

The patent-medicine business is becoming quite obnoxious in many prohibition territories. These various preparations are shipped in by the gross in some places to druggists in prohibition territory, and these stores take the place to a large extent of the saloon which has been closed. While in South Dakota a few years ago, I noticed a certain cordial was very popular in the town where I was located. Investigation showed that it was composed largely of alcohol, and was shipped in under the name of a patent medicine. Men became intoxicated with it as with any other liquor, and the saloon was not missed. This experience is repeated over and over again in prohibition States and “no-license” territory. The government has come to such an understanding of the subject of patent medicines that it prohibits the sale of Peruna to Indians. I quote the following from a letter to the superintendent of an Indian agency:— GCB June 7, 1909, page 364.2

“Department of the Interior, GCB June 7, 1909, page 364.3

“Office of Indian Affairs, GCB June 7, 1909, page 364.4

“Washington, D. C., GCB June 7, 1909, page 364.5

“Aug. 10, 1905. GCB June 7, 1909, page 364.6

“In connection with this investigation, please give particular attention to the proprietary medicines and other compounds which the traders keep in stock, with special reference to the liability of their misuse by Indians on account of the alcohol which they contain. The sale of Peruna, which is on the lists of several traders, is hereby absolutely prohibited. As a medicine, something else can be substituted; as an intoxicant, it has been found too tempting and effective. Anything of this sort under another name which is found to lead to intoxication you will please report to this office. When a compound of that sort gets a bad name, it is liable to be put on the market with some slight change of form and a new name. Jamaica ginger and flavoring extracts of vanilla, lemon, and so forth, should be kept in only small quantities and in small bottles, and should not be sold to Indians, or at least only sparingly to those who it is known will use them only for legitimate purposes.” GCB June 7, 1909, page 364.7

If the government can take such care of the Indians under its supervision, why should not something be done for our own race? GCB June 7, 1909, page 364.8

It is said that about two thirds of the business of most small drug-stores is in patent medicines. One drug-store in Chicago placed in its window this placard: “Please do not ask us, what is any old patent medicine worth, for you embarrass us, as our honest answer must be that it is worthless. If you mean to ask what price we sell it, that is an entirely different proposition. When sick, consult a good physician. It is the only proper course. And you will find it cheaper in the end than self-medication with worthless ‘patent’ nostrums.” This was followed up by a salesman informing all applicants for nostrums of their nature, and explaining that the purchaser was wasting money in buying them; but still the store was unable to get rid of its patent medicine business, and now nostrums comprise one third of its sales. GCB June 7, 1909, page 364.9

Headache Powders GCB June 7, 1909, page 364.10

An interesting article appeared in the Literary Digest of Feb. 20, 1909, entitled, “Is Sudden Death Hereditary?” This intimates to us the importance of this subject. In New York in 1902, the death-rate from this cause was one and one third per thousand, or six times as great as the typhoid death-rate. This rate is increasing year by year. It has been noted that this death-rate varies very closely as the consumption of headache powders varies. Headache-powders depend almost entirely for their effect upon acetanilid, a powerful coal-tar product. Doctor Hare, of Philadelphia, a leading therapeutist in this country, says of this drug: “On the nervous system acetanilid has been found to act as a sedative, the sensory portion of the nerves and spinal cord particularly being quieted.... The action of this drug upon the blood is more pronounced than its influence upon any other part of the body, causing this tissue to become brownish-red, decreasing its oxygen-carrying power, and, finally, reducing the hemoglobin to methemoglobin to a very considerable extent.” GCB June 7, 1909, page 364.11

White and Wilcox in their book, “Materia Medica,” which describes the different drugs, say:— GCB June 7, 1909, page 364.12

“In the blood it causes the red corpuscles to break up, and arrests the movements of the white. Upon the heart, this substance depresses the heart. It has a directly paralyzing action on the cardiac muscle. It is a powerful analgesic. Dose, two to five grains.” GCB June 7, 1909, page 364.13

A Chicago physician gives the following experience with Orangine, a noted headache remedy, the active principle of which is acetanilid:— GCB June 7, 1909, page 364.14

“I was first called to see the patient, a young lady, physically sound, who had been taking Orangine powders for a number of weeks for insomnia. The rest of the family noticed that she was very blue, and for this reason I was called. When I saw the patient, she complained of a sense of faintness and inability to keep warm. At this time she had taken a box of six Orangine powders within about eight hours. She was warned of the danger of continuing the indiscriminate use of the remedy, but insisted that many of her friends has used it, and claimed that it was harmless. The family promised to see that she did not obtain any more of this remedy. Three days later, however, I was called to the house and found the patient dead. The family said that she had gone to her room the evening before in her usual health. The next morning, the patient not appearing, they investigated and found her dead. The case was reported to the coroner, and the coroner’s verdict was: ‘Death was from the effect of an overdose of Orangeine powders, administered by her own hand, whether accidental or otherwise, unknown to the jury.’” GCB June 7, 1909, page 364.15

Bromo-Seltzer is another of this class. The full dose is a heaping teaspoonful. This amount contains ten grains of acetanilid. The maximum dose, as given by the Materia Medica, is five grains. The prescribed dose of Bromo-Seltzer is dangerous, and has been known to produce sudden collapse. GCB June 7, 1909, page 364.16

The Headache Habit GCB June 7, 1909, page 364.17

Such drugs as acetanilid, when taken for headache, simply benumb the nerves, so that the pain is not felt. It does not cure the condition, but simply deadens the feeling. When the effect of the drug has passed off, the headache very often remains, with additional and uncomfortable feelings superadded. This calls for another dose of the acetanilid-bearing prescription. This time it must be increased somewhat, in order to produce the same effect. The physical condition which has caused the headache still remains, and is not only not relieved or benefited by the drug, but is even aggravated, so that a person habitually has headache unless he is under the influence of the drug. The acetanilid habit is contracted, and a person must go on taking the drug in increasing doses. GCB June 7, 1909, page 364.18

A Modern Slave Trade is a title that might be appropriately applied to the use of the various soothing syrups which flood the market. Almost without exception these preparations depend for their “soothing” properties upon opium or morphine. Innocent children are thus given the habit by unsuspecting mothers, and thus become slaves to the opium or morphine habit. This may not manifest itself until later in life, when some accident or severe pain caused by disease calls for the use of morphine to deaden the pain. The old habit is thus set into a flame. The person recognizes that for which he has felt a longing throughout his life, but has never before found. The habit is immediately taken up, and the person finds himself a slave. The advertising sheet flaunts the significant words in our faces, “Baby cries for Mother Somebody’s Soothing Syrup.” Of course it does. It has the habit. It has been repeatedly noticed by druggists that mothers will purchase possibly a small bottle a week of soothing syrup for a time; then later possibly two small ones; then a large one, gradually increasing the amount given to the child. The baby demands it and cries for it. The mother, not knowing the reason (which is simply that the child has contracted the morphine habit), yields, and furnishes that which is demanded by the craving appetite of the child. GCB June 7, 1909, page 365.1

Catarrh GCB June 7, 1909, page 365.2

Other habit-forming preparations are those advertised as catarrh cures. These depend almost exclusively for their action upon cocaine. I can take any severe case of hypertrophic catarrh into my office where the nasal passages through congestion of the mucus membrane are almost entirely closed, and the patient experiences great discomfort and can hardly breathe, and in fifteen minutes send him away breathing perfectly free, and feeling as if he were entirely cured. How can this be accomplished?—Simply by taking the solution of cocaine, with possibly a little adrenaline to contract the blood-vessels, and spraying the nasal passages with it. Cocaine is a local anesthetic. These catarrh preparations, many of them, contain as high as four per cent of cocaine. If I should take this strength of cocaine, and place it in your mouth, and have you hold it there for five minutes, I could burn your mouth or cut it or pinch it or injure it in any way without your feeling the least sense of pain. The same thing takes place in the mucus membrane of the nose when cocaine is used. Those who purchase the catarrhal remedy very often do so for the purpose of getting the cocaine. As with other similar drugs, a habit is formed which demands more and more of the drug. The experience of the head of a department in one of the large Chicago stores is interesting. Every day at noon when the girls of the department were excused, he noted that many of them went directly to a drug-store near at hand. Investigation showed that it was for the purpose of securing a special catarrh remedy. Speaking of the matter, he said, “This is why so many of our girls have gone wrong of late.” The druggist, upon being informed of this, immediately put in a substitute for the catarrh remedy which had no cocaine in it. The girls immediately demanded the old remedy, and when they could not get it, they went elsewhere. It was noticed, too, that these same girls would compare the labels on the catarrh remedies, and invariably choose the one which had the highest percentage of cocaine. So conspicuous did this become, that the city passed an ordinance that catarrh remedies containing cocaine should not be offered for sale. GCB June 7, 1909, page 365.3

The most inhumane class of medicines is the one intended to catch the large class of incurables, such as consumptives, people affected with cancer, and the like. The number of worthless, yea, worse than worthless, remedies exploited for these diseases is legion. I say worthless, because they have been proved such by use and by analysis. I say worse than worthless, because they not only do no good, but lead those who are really in a critical condition to believe that they are receiving help from the medicine, and thus to neglect to take the precautions and secure the help that will restore them to health. The following interesting conversation occurred between an investigator of patent medicines and the manufacturers, including the medical man employed by the company and the learned (?) president of the company:— GCB June 7, 1909, page 365.4

Q. Dr. Smith, will Ozomulsion cure consumption? GCB June 7, 1909, page 365.5

A. Ozomulsion builds up the tissues, imparts vigor, aids the natural resistance of the body, etc. (Goes into a long exploitation in the manner and style made familiar by patent-medicine pamphlets.) GCB June 7, 1909, page 365.6

Q. But will it cure consumption? GCB June 7, 1909, page 365.7

A. Well, without saying that, it is a specific, etc. (Passes to an instructive, entertaining, and valuable disquisition on the symptoms and nature of tuberculosis.) GCB June 7, 1909, page 365.8

Q. Yes, but will Ozomulsion cure consumption? GCB June 7, 1909, page 365.9

A. We don’t claim that it will cure consumption. GCB June 7, 1909, page 365.10

Q. Does not this advertisement state that Ozomulsion will cure consumption? (Showing advertisement.) GCB June 7, 1909, page 365.11

A. It seems so. GCB June 7, 1909, page 365.12

Q. Will Ozomulsion cure consumption? GCB June 7, 1909, page 365.13

A. In the early stages of the disease— GCB June 7, 1909, page 365.14

Q. (Interrupting) Does the advertisement make any qualifications as to the stage of the disease? GCB June 7, 1909, page 365.15

A. Not that I find. GCB June 7, 1909, page 365.16

Q. Have you ever seen that advertisement before? GCB June 7, 1909, page 365.17

A. Not to my knowledge. GCB June 7, 1909, page 365.18

Q. Who wrote it? GCB June 7, 1909, page 365.19

A. (By President Richardson) I done that ad. myself. GCB June 7, 1909, page 365.20

Q. Mr. Richardson, will Ozomulsion cure consumption? GCB June 7, 1909, page 365.21

A. Sure, we got testimonials to prove it. GCB June 7, 1909, page 365.22

Q. Have you ever investigated any of these testimonials? GCB June 7, 1909, page 365.23

Q. (To Dr. Smith) Dr. Smith, in view of the direct statement of your advertising, do you believe that Ozomulsion will cure consumption? GCB June 7, 1909, page 365.24

A. Well, I believe in a great many cases it will. GCB June 7, 1909, page 365.25

The discussion of the use of patent medicines in consumption will serve to illustrate the objections to these remedies in any serious chronic condition. It is true that some of these remedies give temporary relief of consumption; for instance, the chloroform taken will relieve the cough; but this is anything but beneficial. Cough is the effort of nature to throw off the germs and the other products through the expectoration. When chloroform relieves the cough, these injurious products remain in the lungs and aggravate the condition. Morphine will, of course, relieve any pain or discomfort, and make the person feel much better. For a while he can increase the dose, so that the improvement seems quite marked for a time. All this while, the disease is progressing even more rapidly than without the medicine. The alcohol contained in the medicine is recognized by all practitioners as being injurious in tuberculosis. The person who has contracted this disease, and recognizes it, will fasten his hope upon a patent medicine which will relieve his symptoms for a time, but the disease progresses, and he finally reaches the point where there is no hope. If during this time he had been giving proper attention to his living, had had the advice from a physician that he should have had, he might have recovered. As it is, he is beyond hope, and must succumb to the disease. GCB June 7, 1909, page 365.26

We might go on indefinitely with these medicines, exposing the claims which are made for them. Locomotor ataxia, epilepsy, insomnia, diabetes, Bright’s disease, and scores of other maladies offer fields for the patent-medicine producers, which prove very remunerative to them. GCB June 7, 1909, page 365.27

We will content ourselves by calling attention to one more line of medicines. Those who prepare them and urge them upon the public might be called the scavengers and vultures of the patent medicine business. They devour the stranded men and women who have contracted some drug habit. They offer to them some substitute which in itself is as bad as the one to which the person is addicted, or worse, so that even if he should overcome one habit, he only finds himself in the clutches of another. But usually the cure consists of a preparation of the same drug that he is already taking. Alcoholics, morphine, cocaine, and cigarette fiends, and tobacco habitues, grasp at a straw in the form of the many exploited habit cures. The plan is one of tapering off; but the tapering goes the wrong way. A person is led to believe that he is getting a little less each day of the drug for which he has a habit, by taking the substitute; but strange to say, there are very few if any cures from this practice. It is, however, a very profitable business; for the cure sells for several times as much as an equal amount of the drug would cost for which the cure is taken. GCB June 7, 1909, page 365.28

The question is often asked why physicians interest themselves in trying to stem this tide which is carrying thousands into a hopeless physical and moral condition. The patent-medicine vender say, “You attack us because we cure your patients.” If that be true, why are physicians so active in securing the very best conditions for water supply, for fresh’air in the rooms, for pure food laws, and all such actions directed toward the bettering of the public health? If we could see that these patent medicines were beneficial, we certainly should be glad to adopt them. Is it that the physician wants a monopoly of the practice of medicine?—Surely not. He knows all the while that the person who for a time may take patent medicines, will later come back to him, needing more than ever his attention. He deplores, however, the loss of time and opportunity for getting well that such patients are sustaining. GCB June 7, 1909, page 366.1