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ASPIRIN, ITS CHARACTERISTICS AND ADULTERATION.

JASON L, RUSSELL,
Assistant Chemist, Ohio State Board of Health.

The drug aspirin was prepared as far back as 1853 but it is only in recent years that it has come into prominence. At that time little was understood about it and it was given little consideration.

Chemically, aspirin is the mono-acetic ester of salicylic acid, a definite chemical compound, from which it derives the name by which it is known-acetylsalicylic acid. It is also known by the following names: acetosalin, acetyl-sal, aletodin, salacetin, acetylin, and cetylopirin.

Aspirin may be prepared by heating for two hours at one hundred and fifty degrees Centigrade, acetic anhydrid and salicylic acid in a vessel provided with a reflux condenser. Upon cooling acetylsalicylic acid crystallizes out. Acetic anhydrid is removed by pressing and the product recrystallized from chloroform. It occurs in colorless crystalline needles, which melt at 135° Centigrade. It is colorless, odorless, and has an acidulous taste. It is suitable in one hundred parts of water and freely soluble in alcohol or ether. Aspirin is readily split up on boiling with water or with alkali with the production of acetic acid and salicylic acid or a salicylate. Its qualitative examination depends largely upon this splitting up, hydrolysis, as it is known, into acetic and salicylic acids. If it is allowed to become moist some hydrolysis will take place and free salicylic acid can readily be detected. For this reason the powder should always be dispensed in waxed paper. It is incompatible with heat, moisture, alkalies, and their carbonates and bicarbonates. It should never be dispensed in solution, and it is best dispensed by itself. The dose of aspirin varies from five to fifteen grains and should always be followed by a swallow of water or milk.

It is quite frequently asked if there is any difference between aspirin and acetylsalicylic acid. It must be remembered that aspirin is simply a trade name and that patents which have just expired have covered the name "aspirin.” Chemically, they are identical and the physical properties are the same with one exception; namely, their crystalline form. The crystals of aspirin are rather broad and blunt while those of acetylsalicylic acid are narrow and long. This is due to the method of crystallization and in no way affects them therapeutically.

Aspirin acts as an acid and its quantitative determination depends upon this action. It readily forms salts which are soluble in water Calcium acetylsalicylate is probably the most common. Its salts, however, are of little value in medicine.

Aspirin is said to be better borne by the stomach than the older salicylates and more continuing in its influence. It is employed largely as an anti-rheumatic and analgesic of almost every description. It: use is not accompanied without some danger for it is capable of caus

ing synchonism and the disagreeable symptoms characteristic of the salicylates. It is more prone to cause sweating and also collapse when used freely. In a recent number of “The Druggists' Circular” seventeen cases of aspirin poisoning are cited. Its administration was followed by edema, the lids and face swelling, the skin puffing up sometimes as far down as the chest; in some of the cases the mucosa of the nose and pharynx was involved; in two cases the larynx. The edema rapidly reached its height and subsided as a rule in twentyfour hours. The doses had ranged from five to fifteen grains. A pathologic reaction occurred at the first dose and regardless of the amount taken. A case of acute intoxication in which the effects were similar but more persistent has been reported. The poisoning resulted from the ingestion of two five-grain tablets of aspirin. There was a marked edema of the mucous membranes of the eyes, nose and mouth, to such an extent that the patient could hardly breathe. There was also a swelling of the head and neck, conjunctiva and other impairment of vision. The symptoms disappeared in from ten days to two weeks. There is no doubt but that this drug is sufficiently dangerous to discourage its indiscriminate use.

The derivation of the word "aspirin" is interesting. The flowers of Spiræa Ulmaria of Meadow Sweet or Queen of the Meadow contain methyl salicylate, the active principle being known as acidum spiricum which is still a synonym for it. The prefix "A" stands for acetyl, hence we have "aspirin.

Owing to the popularity which this drug has enjoyed in the last few years and the present high market cost, it has been grossly adulterated. Out of twenty-one samples submitted by the inspectors of the Ohio Dairy and Food Bureau, Mr. T. C. Calvert, Chief, for examination in the laboratories of the State Board of Health, nine have shown no aspirin. The chief adulterants are starch, sugar, salicylates, acetanilid, acetphenetidin, lactose, and talc. One of these fraudulent aspirins was found to be composed of starch, salicylic acid, sugar and talc; another of starch, salicylic acid and acetanilidfi two of starch, lactose and acetphenetidin ; one of starch, salicylic acid and talc; one of salicylic acid, acetanilid and lactose; one of salicylic acid, acetanilid, lactose and tale; one of salicylic acid, starch, acetanilid and lactose. It is quite evident from the above that such products are not only fraudulent but are much more dangerous than aspirin. However, it is not within the scope of this article to consider the danger and effects of these adulterants

. The sale of these fraudulent substitutes is being prosecuted and prevented by the federal and state governments.

The continued use of aspirin has frequently been observed. It cannot be denied that it has a tendency to produce a feeling of wellbeing which leads to its repeated use. This together with the fact that it is not used without danger, should be a caution against its indiscriminate use.

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SHALL TERMINAL DISINFECTION BY FUMIGATION BE

DISCONTINUED?* DR. JOHN H. LANDIS, Health Officer, Cincinnati, first speaker. The title to this Round Table Discussion as printed in the program is misleading, and everyone here ould vote "no" to the question.

There is a world of difference between disinfection and fumigation, the one indicating destruction of pathogenic organisms, the other, a method of accomplishing this end, which is very seriously questioned by public health officials of wide experience.

Fumigation is probably the oldest method employed to control the spread of epidemic diseases. It had its origin at a time when comparatively little was known concerning the cause and methods of distribution of the acute communicable diseases. Its efficacy has been under fire for a number of years, Dr. Chapin being the leader and most emphatic of the forces arrayed against fumigation.

Dr. Chapin based his decision against disinfection by fumigation on experience and sound reasoning, refusing to accept anything as true that was simply a matter of belief based on tradition and custom.

From 1902 to 1905, 1,457 families in which diphtheria occurred, and in which fumigation was employed, showed recurrences within sixty days after disinfection, of 25 or 1.71 per cent. From 1905 to 1911, in 3,000 infected families without terminal fumigation, there were 54 recurrences, or 1.80 per cent. Dr. Chapin compared these results with those obtained in Baltimore where fumigation was very carefully done.

"In order to make the Providence figures comparable with those of Baltimore, it was necessary to include recurrences in other families in the house as well as the family first invaded and to calculate the percentage of total cases rather than on invaded households.”

Baltimore shows the following:

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The scarlet fever situation in the matter of recurrences is set forth in the following table:

Scarlet Fever With Fumigation.
Years. Infected Recurrences. Ratio.

Families.
1904-9 2429

37

1.52

* Summary of discussion at conference of municipal health officers and the State Board of Health, Columbus, January 18 and 19, 1917.

Scarlet Fever - No Fumigation.
Years. Infected Recurrences. Ratio.

Families.
1908-11 1240

20

1.61

The Health Commissioner of Buffalo reports, as illustrating the efficacy of disinfection, that after 3029 cases of scarlet fever where terminal fumigation was practiced and tested, there were 117 recurrences or 3.8 percent. This percentage of recurrences is over one hundred per cent higher than in Providence where no terminal disinfection by fumigation is done.

With our present knowledge concerning the methods of distribution of communicable diseases, the employment of fumigation appears to many to be not only a waste of money but an actual aid in their distribution, because it encourages people to neglect the things that are worth while through the creation of a false sense of security.

Measles, whooping cough, diphtheria, scarlet fever, cerebrospinal meningitis, infantile paralysis, influenza and acute colds in the nose and throat are spread chiefly through personal contact with those actually sick or carriers.

When distributed through an infected food supply, fumigation of the rooms occupied by the patient could do no possible good, and fumigation of patients is out of the range of possibilities.

The logical method of disinfection is a continuous process during the period that a patient is capable of transmitting the discase, either by direct or indirect contact. It includes sterilization of discharges containing the infectious element and the sterilization of all articles coming in contact with the patient.

Last week a health officer in a neighboring state informed me that two cats left in a room by mistake during the time the fumigation was being done, went through the ordeal safely.

The facts developed by Dr. Chapin have been verified by Dr. Goler of Rochester and Drs. Goldwater and Emerson of New York City

With these facts as a basis for action, it is recommended that the health officers of Ohio go on record as favoring changes in the laws governing disinfection in this state, which will place this important branch of preventive medicine on a plane harmonizing with our knowledge of the methods of distribution of communicable diseases.

Discussion. DR. FRANK G. BOUDREAU, State Board of Health. Terminal disinfection by fumigation might be an effective measure if carried out in the manner prescribed by the State Board of Health, but as usually performed in Ohio it is absolutely useless. Some health officers are attempting to fumigate whole houses with one candle. Others do not properly seal the room or fail to provide for enough moisture to make the fumigation effective. I am in favor of doing away with terminal fumigation as we have it in Ohio, but would substitute some other method of disinfection. I would recommend

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Other horses cannot be stimulated to antitoxin production. As far as the efficiency of the immune serum is concerned, it is entirely dependent on the animal. Horses vary greatly in their individual predisposition toward the production of an effective serum; some animals even completely fail to do so, not that the latter are not actively 1:"";dinized, for they are, but because they contain very little antitoxin within their serum. The difference among horses is well known to manufacturers, who have no means of knowing beforehand which horses will be profitable. There is absolutely no way of judging which horses will poduce the highest grades of antitoxin. The only practical method at present known is to discard those animals which refuse to respond to the stimulation of toxin injection. Roughly estimated, those horses that are extremely sensitive and those that react icebly are the poorest, but there are exceptions even in these cases. The "Romer Test” has been suggested by some laboratory workers, as a means by which one might determine whether an animal be lisable for the production of antitoxin. The only reliable method, therefore, is to make "test bleedings" of the horses at the end of ten weeks or three months and test their serum. If only high grade serum is wanted, all horses that give less than 200 units per c. c. should be discarded.

The present adopted method of producing toxin for injection purposes is as folows: A virulent culture of diphtheria bacilli--that known as Park and Williams' No. 8is grown in specially prepared toxin bouillon under conditions best suited to the greatest production of toxin. The culture after six to ten days' growth at incubator temperature is removed, and rendered sterile by the addition of a 5% solution of carbolic acid. The toxin is stored for several days in a refrigerator and the sterile culture is filtered through asbestos wool or paper pulp and finally through a Berkefeld filter. If the preliminary tests show that the toxin has the required toxicity, it is allowed to "age” or “season” for several weeks at a low temperature protected from light before being used for injection purposes.

Before injecting the horse with diphtheria toxin, its minimal lethal (fatal) dose is established by inoculating a series of guinea pigs of known body weight (250 grams or about 8 ozs.) with graduated doses of toxin. The toxin is so potent that about (1/2000) 0.002 c. c. is generally sufficient to kill a 250 gram guinea pig within four days after inoculation.

Having determined the relative strength of the toxin it is now ready for use. The object primarily is to establish in the animal a "basic or partial” immunity and then to increase the immunization until the antitoxin is present in the blood in high concentration. As the injection consists of toxin from which the killed bacilli have been removed the horse does not contract diphtheria, for the disease can only be conveyed by the living bacteria. Injections are made subcutaneously and with all possible precaution to preclude bacterial infection. The first dose is a fraction of a c. c. and is injected under the skin of the horse in the region of the shoulders, of the thorax or side of the neck.

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