witnesses confused by the quotation of medical opinion which has been long discarded and recognized as inacceptable at the present time. It is important to use the phrase "contemporary medical opinion", because nowadays medical opinion does not follow by tradition but science.

Senator COPELAND. I want my colleagues on the committee to realize that medicine is a progressive science.

Dr. EMERSON. We physicians are apt to assume that this is understood, and from time to time it needs repeating.

Senator COPELAND. It is well to have it written into the law, however.

Dr. EMERSON. The samne word on page 13, line 6, is called for before the word “medical”, the last word in the line.

Now, beyond that my other suggestion is with reference to section 22 which appears on page 29. This section is of great importance because it proposes a friendly cooperative and helpful relationship between the suggested inspectorial functions of the Government and the necessary self-protection of the producers.

I should like to suggest that there is a further need which can be met by existing Government facilities if it is provided that the testing of new and untried drugs and mixtures bo a responsibility of the Government at the request of the manufacturer. At present a manufacturer has a difficult time with the very best intention to be honest and effective with his expected consumers. He has a diflicult. time in having new substances, new drugs, biological or chemical in inture, tested so that he will know by laboratory observations whether or not they do harm before they have been tried on the human guinea pig. At the present time the consuming public is the testing laboratory, and until some damage has been created to the human there is no criticism. It is important that the Government make available its facilities for testing these new materials before they are marketed, instead of simply using their power of prosecution after the damage has occurred.

Senator CoPELand. Dr. Emerson, you will recall that in the bill providing for the establishment of the institute of Public Health it was provided that there should be such laboratories that would carry out what you have in mind, but you think that there should be some provision made in this bill for that?

Dr. EMERSON. I believe there should be an obligation put upon the Government to provide such a service. Whether that can best be done in the National Institute of Health or whether in the Inboratories of the Bureau of Chemistry of the Department of Agriculture, I will not attempt to suggest: but I believe the Government should be charged with the duty of providing a place in which a manufacturer can obtain the best skill to determine whether what he proposes to sell is likely to do any damage to the people using it.

Senator COPEland. I am in the fullest accord with you in the suggestion, but the iden is contained now in the law establishing the Institute of Public Health, and the difficulty there is the lack of appropriations to do the very wise thing that you suggest.

Dr. Emerson. It was for exactly that reason that I suggested it being mentioned in section 22, which section presents a very interesting innovation of public practice. This section suggests that a manufacturer can request inspection and pay for the cost of it so that



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

Senator COPELAND. Dr. Emerson, did you formulate some language to cover this point?

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

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

Dr. EmERSON. In closing I have merely to say that I believe there is practically unanimous opinion among physicians dealing with clinical medicine in New York that we are unable at the present time to protect our patients and our families against the hazard of poisoning and damage to health by cosmetics and drugs and by the sophistication of foods without the provisions that are made in this proposed law. As a teacher of public health I find provisions written into this law practical and each one of them indispensable to the proper adminis tration of a service necessary in the interest of public health. We could not do the necessary job of health protection without all of the provisions that are made in this bill. I believe they are practical and will be effective if put into force.

Senator COPELAND. Thank you very much, Dr. Emerson.

We will now hear from a representative of the American Federation of Labor, Mr. Roberts.


Mr. ROBERTS. Mr. Chairman, I am here to approve in the name of the American Federation of Labor the legislation which is proposed. In order to show what has been done by the American Federation of Labor, I wish to refer to a report of the executive council at the Atlanta (Ga.) Convention in 1911. The report states:

Due to untold greed, the health and the lives of the people of our country have been placed in jeopardy through the adulterations and substitutes in the foods and the drugs sold to the masses of our people. The Congress of the United States enacted laws for the better protection of the people in regard to this traffic by the passage of what is known as the "pure food law", 5 years ago. Those who have profited, and still profit, by the imposition upon the people of impure foods and drugs, have become more active in the recent past; they have perfected combinations by reason of the great profits resulting from their traffic and have endeavored to circumvent the law, even to the extent of trying to romuove a faithful public officer who has stood between them and the people. When such men in their greed for profit alone endanger the health and the lives of myriads of men, women, and children--the workers--the duty devolves upon our movement to take such action as shall safeguard our own.

With this object in view, taking cognizance of the efforts made by other associations of men to be of service to the people in regard to this movement, the executive council at its recent meeting adopted the following:

Resolved, That the executive council appoint a committee of three to meet with representatives of all bodies and persons having for their object the securing of legislation or aduinistration to secure pure food and pure drugs for the people of this country.

We have selected President Gompers, Vice President O'Connell, and Secretary Morrison as the committee.

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

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



On the executive council at that time were:

Samuel Gompers, president; James Duncan, first vice president; John Mitchell, second vice president; James O'Connell, third vice president; D. A. Hayes, fourth vice president; William D. Huber, fifth vice president; Joseph F. Valentine, sixth vice president; John R. Alpine, seventh vice president; J. B. Perham, eighth vice president; John 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 committee commends the netion of the Executive Council of the American Federation of Labor in connection with the efforts being made to secure the passage of laws and other enactments which would prevent the manufacture or sale of any articles of food or drugs which were adulterated or placed on sale under misleading labels or advertisement.

The report of the committee was unanimously adopted.

In 1912 the executive council's report to the American Federation of Labor stated:

The American Federation of Labor has continued its efforts along the lines of having enacted better pure food and pure drugs laws, and in this work has cooperated with the American Society of Equity, the National Consumers' League, and other reform associations interested in and working along similar lines.

In 1915 the American Federation of Labor adopted a resolution urging legislation requiring the transportation of all foodstuffs in cloan receptacles to better safeguard public health.

If this bill carries out what the American Federation of Labor has determined could be done, we approve it gladly; but if it means any changes for the better we hope certain changes may be made. Senator COPELAND. Now, Mr. Campbell, you may proceed.


Mr. CAMPBELL. At the time of adjournment for lunch, Mr. Chairman, I think we had concluded those paragraphs in section 8 down to paragraph (e) which is to be found on page 11.

This paragraph requires a declaration of the important ingredients of drug products. It states that a drug product would be held to be misbranded if not subject to the provisions of paragraph (b) of section 4, relating to official United States Pharmacopoeia and National Formulary products if it fails to bear first the common name of the drug, if any there be; and, second, the name and quantity or proportion of each medicinal or physiologically active ingredient thereof. The paragraph 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 his ills. I know of nothing in the entire scope of this bill which will operate more effectively to dispel the mystery now so extensively capitalized in the sale of nostrums for every imaginary disease than a declaration on the labels of the ingredients of which a particular nostrum is composed.

That mystery developed adreitly and effectively, through the medium of advertisements which appear in the columns of the press, and


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

There is no issue, as I have told you previously, from the standpoint of the enforcement of the Food and Drugs Act about self-medication.

This bill does not contemplate its prevention at all. If it did a single short section in the measure could have been drawn up to that effect. But what is desired by this particular paragraph and by others which impose restrictions on statements made about the remedial properties of drugs is to make self-medication safe.

There always will be self-medication to some extent. As I have said, from our law enforcement standpoint we do not object to it, but it should be intelligent; it should not be based on a faith croated by a supposition, usually an erroneous supposition. I have alrondy exhibited to you some of the products which are now sold for the treatment of serious diseases and which have no remedial power for the treatment of those diseased.


It is alleged in connection with this particular section that it is extreme; that it calls upon a manufacturer to make a surrender of property rights in which he has a definitely vested interest; that it requires disclosure of trade secrets. To a large extent that is sheer nonsense. Competitors through observations, expert analysis and other investigations that may be carried out can easily ascertain tho essential 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 manufacturing technique which may be of value to manufacturing firms. I have had manufacturers of drug products tell me repeatedly that there was no objection to this requirement; that it was not the ingredients or the composition of the article which constitute the secret, but rather the method 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 forego ills and distress which they would otherwise experience. There are a large number of drug products for which many people have idiosyncracies which prevent them from using such drugs effectively or comfortably. It has been alleged that the psychological benefits to be derived from lack of knowledge of the medicines which one takes, plays an im portant part in the improvement of people who are sick. Again, to my mind, that is sheer nonsense. There may be some value in refusing to disclose to the patient the medicine that may be prescribed to him by a physician: but bear in mind that when the patient himself purchases a prorietary product, or a drug that is designed for self-medication, he stands in respect to himself as self-diagnosing and self-prescribing. He is entitled in such circumstances to the same sort of information that the physician has when the physician administers to him.

This requirement is not new; it is not an innovation. There are a great many countries in the world at the present time that impose requirements of this sort. Among those nations that require a quantitative declaration-and that is essentially what is being proposed hero--at the present time as revealed by a very brief and cursory review of the laws of the foreign countries are Chile, Denmark, Fin



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

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

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

All manufacturers exporting medicinal products to the countries to which I have referred declare the formulas quantitatively or quali tatively.

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

Senator CoPELAND. That package 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. CAMPBELL. The formula is printed on the label and in that particular instance in a very inconspicuous place. The typewriting to which you refer is a translation into English of that formula in order to bring out more definitely the composition of it. The same is true of these others. I have had that typewritten statement placed on there, Mr. Chairman, so that the cominittee could without any delay appreciate the difference between the labeling of the product for homo consumption and that intended for exportation.

It seems 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 have. There is no justifiable 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 take down their gullet, whether in the form of food or medicino, should be made known to them, if they have any curiosity about it. Ali that is being asked is that those who are curious, those who want to buy discriminatingly and intelligently, be given some means by the pro visions of this bill whereby they can inform themselves.

Senator COPELAND. How far do you go at present in the demand for labeling and inclusion of the names of the active ingredients?

Mr. CAMPBELL. There are very few ingredients that are required to be stated under the terms of the present law. Those we discussed in connection with the previous section. They are largely the opiates. They are 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 a provision in the bill that requires the declaration of these habit-forming narcotics, with a statement to the effect that they are habit forming. That is to be found in this same section, section 8, in a previous paragraph, paragraph (b), page 10.

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