witnesses confused by the quotation of medical opinion which has. been long discarded and recognized os inncceptable at the prosent tiine. It is important to use the phrase "contemporary modical opinion", bernuse nowadays medical opinion does not follow by tradition but science.

Senator COPELAND. I want my collengros on the committeo to realize that modicino is a progressivo scienco.

Dr. Emerson. We physicians are npt to nssume that this is understood, and from tiine to time it needs repenting.

Senntor COPELAND. It is well to havo it written into the law, however.

Dr. EMERSON. 'Tic snine word on page 13, line 6, is called for before the word "medical", tho Inst word in the line.

Now, beyond that iny other suggestion is with reference to section 22 which appears on pngo 29. This section is of great iniportnnce because it proposes a friendly cooperative and helpful relationship betwoon the suggested inspectorial functions of the Government and tho necessary self-protortion of the producers.

I should like to suggest that there is a further need which can be met loy existing liovernment incilities if it is provided that the testing of new ind intriod drugs and mixtures bon responsibility of the (overurnent at the request of the minnufacturer. At present a inanufacturer hins a dillicult time with the very best intention to be honest and effective wille liis expected consumers. llc lines in villirult. time in having now substancos, now rucs, biological or chemical in 111re, frosted so that doe will know by lodogntory observations wluether or 110t. Joey do burmi besoro Ilory have been criod o wae human kuinen pig. At the present time the consuming public is the testing laboratory, and until some damago lias been created to live human tlıero is no criticism. It is important that the Government muko nvnilable ils facilities for testing theso now materials ivefore they aro marketol, instend or simply using their powor of prosecution after tho damage has occurred.

Sonntor COPELAND. Dr. Emer011, you will recall that in the bill providing for the criablishment of the Instituto of Public Health it was provided that there should be auch Inboratories that would carry out what you have in mind, but you think thint there shouid bo some provision juade in this bill for that?

Dr. Emerson. I believe there should be an obligation put upon tho Government to provide such a service. Whether that aren best bo done in the National Institute of liculth or whether in the Inborntories of the Burrogate of Chemistry of the Department of Agriculture, | will not attempt to sucerat: bit. I believe the coverminent should be charged will the duty of providing place in which a manufactutop rooli oblain the best skill to determine wlinilor what loc proponog to soll is likely to do any comment to the people using it.

Senntor ('ÜNELAND. I am in the fullest ircord with you in the suge gestion, but thin julen is contained now in the law establisining the Instituto of Public Health, and the villiculty there is the lack of approprintions to do the very wise thing that you suggest.

Dr. BALRsoN. 11. was for exnctly thinetronson thai longosteel it being nuentioned in section 22, which section presents a very intor. osting inmovillions of public practice. This section Surgests that a inanufacturer can request inspection and pay for the cost of it so that



he will know that the products he issues aro valid and properly manufactured.

Sonntor COPELAND. Dr. Emerson, did you formulate some langunge to covor this point?

Dr. EMERNON. No, Mr. Chairinan; this is a suggestion of a principle. I have no skill in legal phrascology, but I believe that this is an appropriate place to improve the text of the bill.

Senator COPELAND. A note will bo made of your suggestion and consideration given to it.

Dr. Emerson. In closing I havo merely to say that I believe there is practically unanimous opinion among physicians dealing with clinical medicine in Now York that we aro unable at tho present time to protect our patients and our families against the hazard of poisoning and damage whealth by cosmetics and drugs and by the sophistication of foods without the provisions that are niade in this proposed law. As a toncher of public honlth I lind provisions written into this law praction and each one of them indispensable to the proper administration of a service nocessary in the intorest of public health. We could not do the necessary jobs of hoalth protection without all of the provisions thnt are made in this bill. I believe they are practical and will be elloctive is put into force.

Senator C'OPELANI). Thank you very much, Dr. Emerson.

We will now hear from a representativo of the American Foderation of Labor, Mr. Roberts.



Mr. ROBERTH. Mr. (hairman, I am here to approve in the name of the American Moderation of labor the legislation which is proposed. In order to show wlint has been dono by the Ainorican Foderation of Labor, I wish to refer to a report of the executive council at the Alluita (Gu.) Convention in 1911. The report states:

Due to intoll greed, the hicalth and the lives of the people of our country have been plucuc in jeopardy through the adulterations and substitutes in thic foods and the origs sold to the mousses of our people. The Congress of the United States enucled laws for the better protection of the people in regard to this truflic by the passage of what is known is the "pure fuori luw”, yours ugo), Those who have prolited, and still prulit, by the inpositioe upon the people of impure foods and drugs, have become more active in the recent pust; they have perfected combinations by reason of the great protits resulting from their truflic and have endeavored to circumvent the law, even to the extent of trying to roluove a faithful puilic ullicer who has stooil between them and the people. When sucht man in their greed for profit uline endanger the health and thic lives of myrinca vf men, women, and childrun---the workers--the duty devolves upon our movement to take much action un shall safeguard our own.

With this ooject in view, taking cognizance of the efforts mulle by other Associations of men to be of service to the people in regard to this movement, the oxecutive council ut its recent meeting adopted the following:

Resolvell, Thut the executive council appoiut a committee of three to ineet will representatives of all bodies and persoun baving for their object the securing of legislution or rulluinistration to secure pure fooil and puru oroigs for the people of this country.

We have selecteil President Compers, Vice President O'Connell, and Secretary Morrison as the committee.

Sonutor COPELAND. Was that report made, Mr. Roberts?

Mr. Rolety. In 1911, at the Atlanta (Ga.) convention, 5 years after the original law was enncteil.



On the overitivo council at that time were:

Sninuel Gompers, president; James Duncan, first vice president; John Mitchell, second vice president; James O'Connell, Third vice president; D. 1. nyes, fourth vice president; William D. Hubor, fifth vice president; Joseph F. Valentiac, sixth vice president; John R. Alpine, seventh vice president; .). B. Perham, cighth vice president; Jolin B. Lenon, treasurer; and Frank Morrison, secretary.

This report of the executive council was referred to the committee on resolutions, which made the following report to the convention:

Your cornwiltre comincnols Ilir nchi0n1 of the Kircrutive Council of the American Federation of labor in commection with the efforts being made to secure the passage of laws and other enactments which would prevent the man lacturo or sale of any articles of food or drugs whici were adulterated or placed on salu under misleading labels or advertisement.

Tbo report of the committee was imanimously adopted. In 1912 the executivo council's report to the American Federation of Labor slated:

The American Pietrosiation of Laluar his rollimined its effortx 110ng the lines of linving ouncted better pure food and pure drugs laws, and in this work has cooperated with the incrican Society of buity, the National Consumers' League, and other reform associations interested in and working along similar lives.

In 1915 the American Federation of Labor wlopted a resolution urging legislation requiring the transportation of all loodstuffs in clonn receptacles to better safeguard public health.

ir thuis bill carries out what the Armerican Foderation of Labor las determined could be done, we approve il rally; but if it means any changes for the better we hope certain changes inay be made.

Senator COPELAND). Now, Mr. Campbell, you nay proceed.



Mr. CAMPBELL.. At the time of ardjournment for lunch, lir. (hairman, I think we had concluded those purngraphs in section 8 down to parngruph (e) which is to be found on page 11.

This paragraph requires a declaration of the important ingredients of drug products. Il states that a drug product would lie held to be misbranded is not subject to the provisions of purngrupis (b) of seco tion 4, relating to official United States Pharmacopain and Nntional Formulary products if it foils to bear first the common name of the rug, if any there be; and, second, the mend quantity or proportion of ench moclicinal or plıysiologically active ingredient thereof. Tho porngraph explains itself

Its purpose is to give to the consumer knowledge of the composition of the product that he is going to take for the treatment of bis ills. I know of nothing in the entire scope of this bill which will operate more ofl'ectively to dispel the mystery now so extensively capitalized in the sale of nostrunus for every imaginary discuss than a declaration on the Inbels of the ingredients of which a particular nostrum is composcul

That mystery developed dreilly and effectively, through the maili um of advertisements which appear in due columns of the press, and



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are heard over the radio, constitutes the principal urge for the purchase of drugs for self-medication.

There is no issue, as I buvo told you previously, from the standpoint of the enforcomont of the food and Drugs Act about soll-modlication,

This bill does not contemplato its provention at all. If it did a single short section in the monsure could have been drawn up to that effect. But what is dosired by this particulur paragraph and by others which impose restrictions on stnteinents made about the remedini properties of drugs is to make solf-medication safo.

There always will bo solf-inedication to somo oxtont. As I havo suici, from our Inw onsorcomont standpoint wo do not object to it, but it should be intelligent; it should not be based on a faith crontod by a supposition, suully in orroneous supposition. I uvelroudly oxlubitod to you some of tho products which are now sold for the trentment of serious disonses and which liavo no romediul power for the trontment of thoso disenyod.

It is allogod in connection with this particular soction that it is extreme; thut it calls upon a manufacturer to make a surrender of property rights in which he has a definitely vosted intorest; that it roquiros disclosure of trudo secrets. To a large extent that is shoor nonsense. Competitors through observations, expert analysis and othor investigations that may be courried out can onsily ascertain tho esson tinl composition of various drug products to be found on the market.

The ingredients are not secrets, but there is, I will grant, in the preparation of such products munulucturing technique which may be of value to manufncturing firms. I have lind manufneturers of drug products toll me repeatedly that there was no objection to this requirement; that it was not the ingredients or the composition of the article which constituile the secrot, but rather the mnothod of combining the various ingredients.

It is important from the standpoint of those who seek to protect themselves by intelligent purchasing that they have information of the ingredients in drug products in order to forogo ills and distress which they would otherwise oxperience. Thero aro n large number of drug products for which many people have idiosyncracies which prevent them from using such drugs cffectively or comfortably. It hins boen alleged that the psychological benefits to be dorived from lack of knowlodge of the medicines which one tukos, pluys an important part in ile improvement of people who are sick. Agnin, to my mind, that is sheer nonsense. There muy be some valuo in refusing to disclose to the patient the medicine that may be prescribed to him by u physician: but bear in mind that when the pationt himsell purchusos a prorietary, product, or a drug that is designed for self-inedication, le stands in respect to Junself as self-diagnosing and self-prescribing. lle is entitled in such circumstances to the same sort of information that the physician hus when the playsician udministery to him.

Thus requiroment is not new; it is not an innovation. There are a great inuny countries in the world at the present time that imposo requirements of this sort. Among those nutions that require u quuntitative declaration-ind thut is essentially what is being proposed hero-at the present tine as revealed by a very briol und cursory roview of the laws of the foreign countries are ('inile, Denmark, Fin



land, Guatemala, Italy, Mexico, Nicaragua, Sweden, Uruguay, Yugoslavin, and the Philippine Islands.

Those that require a qualitative declaration and enumeration of tho ingredients without an indication of the quantity in which they aro present, include Argentina, Belgium. Costa Rica, El Salvador, France, Panama, Peru, Portugal, and Spain.

That is not all, Mr. Chairman. There are some manufacturors in this country who voluntarily have met in principle is not in letter the requirements of this section. Dr. Kilmer's "Swamp Root” is nn illustration. You will find on the carton here the ingredients of which that product is composed.

All manufacturers cxporting inedicinal products to the countries to which I have referred declare the formulas quantitatively or qualitatively.

Let me present to you an identical product in two different packages. One is to be ninrketed in the United States for the consumption of the people of this country. The other is for export. You will note thnt on one of these there is no disclosure of the ingredients. That is the one intended for honic consumption. On the other there is a statement of tie fcrinula, in such terms as the country to which it is to be exported may require.

Senator COPELAND. Thnt packnge is identical, but there is attached to it a typewritten formula to meet the requirements of the country to which it is to be sent.

Mr. CampheLL. The forinula is printed on the Inhrl and in that particular instance in a very inconspicuous place. The typewriting to which you refer is a translation into English of what forinula in order to bring out more definitely the composition of it. The same is true of these others. I have had that typewritten stateinent placed on there, Mr. Chairman, so that the cominitter: could without any elny approcinte tho difference between the labeling of the product for homo consumption nnd that intended for exportation.

It seerns to me that information of this kind which is also provided in the companion section on food products is nothing more than what the consumer is entitled to linve. There is no justifinble pretext that can be advanced by the manufacturer, to my mind, that disclosure of this sort should not be made, because it is his own private right.

I think that the commodities individuals of this country are going to trke down their gullot, whether in the forin of food or modlicino, snould be madlo known to them, if they have any curiosity nbout it. All thint is being askoal is that those who are curious, those who want to buy discriminatingly and intelligently, be given somo mrons by tho provisions of this bill whereby they can inform themselves.

Sonntor COPELAND. Jlow far do you go nt present in the demand for Inbeling nud inclusion of the names of the nctive ingredients?

Mr. CAMPBELL. There are very few ingredients innt are required to be stated under tho torms of the present inw. Those we discussed in connection with the previous sectiou. They are inrgely the opintes. They aro to be found in section $ under "drugs”, paragraph (2); in such cases as the content of alcohol, morphine, opium, cocaine, heroin, and others.

There is n provision in the hill that requires the declurntion of those habit-forming narcotics, with a statement to the ofect that they are habit forming. Thnt is to be found in this some section, section 8, in a previous parngraph, parngraph (b), page 10.

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