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A Sharp, but Well Intended Criticism Concerning What Should Be Admitted to Our Advertising Pages, Frankly Answered.
DEAR DOCTOR TAYLOR :—Your fearless stand against frauds, medical, political, and commercial, induced me first to subscribe for THE WORLD, and has kept my name on your subscription list. What is true in my case applies to thousands of your subscribers, as you well know. I have not expected you to invert the world in a day, but don't you think, Doctor, the time has come to take another step forward and cut out some of the questionable ads. carried in THE WORLD? What about tongaline; manola; labordine; pneumo-phthysine; tanformal; unguentine; echitone; Micajah's uterin wafers; trophonine; listerine; Gray's tonic; sphenoids; germiletum; Na
iletum; Naphey's wafers; vapo-cresolene; anasarcin ; uric-antagon; and perhaps others I missed ? Honest, Doctor Taylor, isn't it a pretty bum lot to admit into the pages of your beloved WORLD?
You criticise our Missouri brother for using bromo-seltzer with acetanilid (Jan. WORLD, page 9), but what assurance has any physician who uses any of the above with a U. S. P. drug at the same time, that he will not get a fatal synergistic action or an innocuous antagonism?
It occurs to me that in carrying these ads. you are in a degree responsible for degrading the weaker members of your readers into using these nostrums, and your position is analogous to what a prohibition paper would be which carried Old Tom Jones whiskey in its adv. columns, while hurling anathemas at rum editorially.
I have followed your position closely, Doctor, and am aware that you maintain that it is necessary to exclude only those advertised to the laity. It looks like hairsplitting to me, and in view of the recent exposures in the Journal of the A. M. A., demoralizing, degrading and little short of criminal to be a partner in the slightest degree in the perpetuation of the evil. I fervently hope you will see it in the same light, and THE MEDICAL WORLD will continue in the vanguard of this great movement. Success and the best of wishes for the new year to thee and thine. Fraternally yours, Geneva, Pa.
A. W. CLOUSE. [I guess it is pretty well known by this time that the Editor of this magazine never
dodges an issue. If anyone ever doubted this, the frank publication of the above should remove such doubt. Several (about 3 or 4) letters have been received recently on the above subject, and the above is chosen for publication and reply because it is the most complete, the most severe, and the most courteous of the lot. I do not know Dr. Clouse personally, but I wish to say that the spirit of the above does him credit. And also I wish to say here that the reply which follows, while being a reply to the above communication, is not intended as a reply to Dr. Clouse personally, but, rather, a reply to all who have recently become hypercritical of the adv. pages of medical journals. Now, let us be as frank (but not as severe) as Dr. Clouse, and take up, both in general and in detail, the merits of his communication.
It seems a long time ago since manufacturing chemists and pharmacists came to the aid of physicians; beginning, perhaps, with the separation of morphin from opium, and quinin from cinchona bark, and the preparation of salts of these alkaloids. I say it seems a long time ago, but really it isn't many decades ago; but since then, which we will arbitrarily assume as a beginning of the modern movement of chemistry and pharmacy in aid of the medical profession, manufacturing chemists and pharmacists have been very activly at work, and the medical profession cannot now afford to turn its back on the wonderful advances made by these agencies, in the interest of both physician and patient. Let us keep this broad proposition in mind. Also let us keep in mind that these advances in chemistry and pharmacy in aid of the physician have been chronicled chiefly in the advertising pages of medical journals, except the preparations of those firms that have been smart enuf to "work” the reading matter of medical journals for free advertising, the most conspicuous of these preparations being the German patents, as phenacetin, sulfonal, trional, heroin, protargol, etc.
Doctors of the long ago who are still alive and who have kept up to the times, know the difference between the nauseous doses of former days and the elegant preparations of the present day. I have always stood for progress in pharmacy, as well as in other things. The manufacturing pharmacist who makes a specialty of one prepara
ASA tion, or a limited line of preparations, has is a recent comer into the advertising pages special facilities, machinery, etc., for his of medical Journals, and I confess that, not particular purposes, and develops superior knowing anything against the preparation or skill in his one line, just like any other the people putting it out, we have followed specialist; he can select the crude materials the example of many other journals in for his preparations better than those in the admitting it to our advertising pages. Howgeneral line, because, as a specialist, he has ever, I have just critically examined their a better opportunity to do so.
adv., and have written the company conThese, and many other facts have been cerning proofs of statements made therein, freely acknowledged, and their advantages and also concerning the composition of the accepted by the profession. But because of preparation. However, many advertisesome abuses (from which the advertising ments are briefly and tersely put, in order pages of THE WORLD have been exception to attract attention and make an impression, ally free), a small, but well intentioned class while testimonials, composition and other of critics have recently arisen in the pro details are given in circulars, pamphlets fession, and in a spirit of prudery are try- and other literature, which are extensivly ing to “kick over the entire bucket of milk.” circulated among the profession, and which The scientific and economic contributions of can be had for the asking. I will await the chemistry and pharmacy to the needs of company's reply to my letter; in the meanthe medical profession are far too great to time, let me ask if the average doctor can be thus sacrificed; and in spite of all that write an equally good prescription for “a these misleading and misled critics can do powerful reconstructiv alterativ tonic,” the practical portion of the medical profes and if the average druggist can fill the presion will continue to welcome the aid of scription, producing an equally good and progressiv pharmacy.
elegant pharmaceutic product at as low a Dr. Clouse has not limited himself to gen- price? That is, can the patient be served eralities, but has (commendably) "spoken as well? If the wrappings and other right out”, giving names. Let us, in order "original package” features be objected to, to be fair and square, take them up in de- the doctor can order accordingly. tail as he has mentioned them:
Labordine: I have seen the formula in Tongaline: One of the best prescriptions a little pamphlet issued by the company. for rheumatism that I know. The adver- On the strength of it, I immediately got a tisements and literature make no secret of package for a member of my family, who the constituent drugs upon which its action frequently suffers from neuralgic pains. No depends. Not one doctor in a hundred heart depression was experienced. I wrote can write as good a general prescription for the company that in my opinion their adv. rheumatism, and being written, not one would be strengthened if they would put druggist in 500, or 1000, could prepare it as their formula in their advertisement. well as the firm which has made a specialty Pneumo-phthysine: Before we would adof its preparation for years, and has spe- vertise it we demanded a sample, which, cial facilities for so doing; and, as this upon examination, appealed to us as doubtfirm prepares it, it is always uniform. It less a good local application in pneumonia ; is advertised to the medical profession the sample was sent to one of our staff only, to help doctors with a very stubborn to try. While the word “specific" is used class of cases. How many doctors say it in different ways by different doctors, we should be driven from the advertising pages have always discouraged any use at all of of medical publications? If so, why? If one the word; and we think any use of the word medical man in a thousand should prefer to in this or any other advertisement is unwise. always write his prescriptions in full for But some latitude and toleration must be rheumatism and trust to the corner druggist allowed, particularly as “specific” is used for its correct and up-to-date compounding, by the eclectics (a large and respectable how does it hurt him if the other 999 pre- body) in a different way from our usual fer to use the advantages which a specialist understanding of the word; and a specific in pharmacy offers? The advertisement will tendency in a method of cure need not not hurt the critic if he will let it alone. He necessarily mean certainty of cure. Howneedn't read it if he doesn't wish to.
ever, I think that use of the word should be Dr. Clouse next mentions manola. This avoided in this and every other advertise
ment. But if a doctor wants that kind of an application in pneumonia, he and his druggist can't get up as good a one as easily, quickly and at so low a price by extemporaneous methods—at as low a price to the patient, I mean.
Tanformal: "Samples and literature on request." Send for samples and literature and see if you and your druggist can do as much for a patient needing this kind of a preparation. To disregard the long and honorable career of the firm of Wm. R. Warner & Co. in service to the medical profession, and to set aside the superior skill and facilities of such a firm as this, seeins to me like leaving a well equipped, modern steamboat and going back to an Indian "dug-out” canoe; and I believe that is the deliberate sentiment of the profession in general. A spasm of imaginary virtue that would lead us to throw aside the advances of civilization, we should regard in our sane moments as a nightmare, or hysterics, and not ethics.
Unguentine: The best healing salve in my knowledge. The composition used to be given in the advertisement, and is still
nent, and is still given in the literature that the firm is glad to send to physicians. The corner druggist couldn't make up, extemporaneously, upon your prescription, anything like as good a preparation, and he would charge your patient more than the selling price of this article. It is put up in tubes, as well as jars, by the manufacturers, and in tubes it is very convenient; and your corner druggist couldn't put an ointment up this way at all. Unguentine is not advertised to the laity; but, being for external use only, it would not be dangerous in the hands of the laity; nevertheless, it is advertised only to the medical profession. What earthly objection can there be to it? Are some of our doctors losing their senses?
Echitone: We are bothered more for prescriptions for eczema than for any other one trouble; there is scarcely a month that we are not called upon to discuss this subject and give a formula. With this in mind, turn to the adv. of echitone and read it, and see if it offends in any way.
Micajah's Uterin Wafers: We have frequently publisht formulas ior uterin wafers, and expect to do so in future. Isn't that "playing fair” with our readers ?
Trophonine: A liquid food, formula given. If the critics object to foods being
advertised to doctors, particularly specially prepared foods for invalids, by an old and honored firm, what do they think should be advertised to doctors?
Listerine: Our business is to give information to the profession. See directions for making “liquor antisepticus, U. S. P.," on page 507 of December WORLD. Turn to it and try making it, and see if you wouldn't rather buy listerine, made on a large scale by specialists with special facilities for that purpose, always producing a uniform article. Why should we turn our backs on the advantages offered by trained specialists with superior facilities?
Gray's Tonic: What's the objection? Isn't it an excellent tonic? Send for samples and be convinced; and examin their literature and see if the information isn't satisfactory. Can your druggist, upon your prescription, make as elegant a tonic as this, and sell it to your patient at the price of this?
Sphenoids: Read the adv. and see if you can find any fault. Can you or your druggist do as well in preparing a similar preparation?
Germiletum : Can you or your druggist make as good and as elegant a germicide and deodorant? If not, why not use this one? If you, for any reason, don't want to use this one, what objection can you have to others using it?
Naphey's Wafers: Can you or your druggist equal them at the price? If not, what's the use to try? And what's the use to complain of wafers that are made specially for you?
Vapo-cresoline: I don't find it in January World; but did you ever use it for the purpose recommended ? Did it disappoint? We have never heard of a complaint. Do you know anything better for its purpose? Yes; it is in January, on page 28, bottom of second col., which please see.
Anasarcin: I am inclined to think that some of the claims formerly made for this preparation in advertisements were unjustifiably extravagant. But turn to the adv. of it in January WORLD (page 30) and read it. I don't see anything wrong with it; do you? The style is very much like that in many works on therapeutics. Send for their literature and see if it is satisfactory.
Uric-antagon: Many uric acid antagonists have been offered to the profession; this is comparativly a new one. I don't know anything for or against it; do you? Turn to the adv. and see how it strikes you. We didn't see anything wrong about it when we accepted it. Do you think you, your interests or your ethical principles are endangered by this advertisement ? If so, please explain.
The fact is, our advertising pages are guarded with unusual care. We always in sist that advertisements shall be clean and above suspicion ; that they shall be honest; that they shall not conflict with the interests of the profession. THE MEDICAL WORLD was the first and only medical magazine to refuse all advertisements of a speculativ nature, and to expose in its reading columns the many rascally schemers who prey on the medical profession. No other journal has done what it has in the way of showing up the practices of antikamnia, the Medical Brief, and other concerns that are using, rather than serving, the medical profession. Our record is well known to the rank and file of the profession, but, unfortunately, many loud and assuming “leaders” remain egotistically ignorant of our work, and think they are doing it all, while, as a matter of fact, they are doing more harm by indiscriminate onslaught on the good as well as the bad, than they are doing good by attacking the real evils. I do not mean Dr. Clouse, but he has, unfortunately, been influenced by that class of men.
* * * * * * This matter has been brought into prominence during the last few years, thru the agency of the Journal A. M. A., by men who are few in number, but whose inAuence is great; their intentions are good, but their judgment is—well, to say the least, is inaccurate and indefinit, and their knowledge of most that they criticise is limited, for they have, as a rule, never used the things they criticise, and their knowledge of the needs of the rank and file of the profession and the economic phases of the case as affecting the patient, is deficient. I have talkt this matter over many times, thoroly and deliberately, with many who are most interested, including some of the highest and most influential officials of the A. M. A., and with all there has been a woeful lack of any definable ideal, and no agreement between any two as to what standard shall be maintained. I have
maintained. I have been driven to the belief that, upon this
question (as to what shall appear in the advertising pages of medical journals), every doctor and everyone else interested is a law unto himself. Hence, without wishing to appear egotistic, I am brought to the conclusion that my own judgment is about as good as that of anybody else, particularly so far as THE MEDICAL WORLD is concerned. I have had plenty of experience, and I have turned down a "mighty lot” of advertisements, and I expect to do so in the future. However, I will here ask my subscribers to help me in this matter. If you know any reason why any advertisement that you see in our pages should not appear, please be free and frank to say so. If any advertisement shall be shown to be dishonest, it will be immediately dropt (but I think we catch all these before they get in); if any advertisement shall be shown to be opposed to the interests of the medical profession, it should not find a place in these pages. As to ethical ideals concerning this matter, there is much latitude for disagreement—so much that I have not yet found two who agree; particularly as there has been so much "straining at a gnat and swallowing a camel" of late. I try to entertain a high ethical ideal (and live up to it), and yet one which will not interfere with the practical needs of a profession large in numbers, variously composed, scattered over a vast territory, and the members of which are variously circumstanced.
To illustrate the extreme position which a few men take, I present the following:
THE MEDICAL WORLD:-I am in receipt of your special offer designed to induce one to subscribe for THE MEDICAL WORLD. It is scarcely worth while to take up the subject of former correspondence with you on the subject of my reasons for not accepting your very generous proposition. It will save you time and some expense, however, if I again mention the fact that I take no journals that advertise proprietary medicins, without giving the formula. The last number I saw of THE MEDICAL WORLD, it would fairly rival The Journal of the American Medical Association in this line. I am not a member of The American Medical Association, because of what I deem the unethical advertising of its official journal.
I know of but one medical journal that can find a place on my table. That is Thr Pennsylvania Medical Journal. I would not take any other journal that I know of out of the post office, were it sent me gratis. I know of many
physicians that take the same stand. In the comtimūtiņ2\2 timòū2ņēmēģēņģ2 ūtiņ2§2\/22?Â2âÒti2/22/2/2/2ÒâẦ ??
There is much more that could be said along these lines, but this is sufficient, and I would
men who are of the Journ fews
State Ment containishto monthly Denver,
advise you to save your advertising materialalism, the primary end is the rendering the servand postage, rather than to squander it on me. ice of a vocation; the reward is secondary, and Very truly yours,
is based on the theory that “the laborer is worthy
W. W. LITTLE. of his hire." It is not accumulation of gain, Mosiertown, Pa., Jan. 8, 1906.
but livelihood, that is looked for. (4) The phyI can tell the doctor of another journal sician 'must either prepare his remedies for himthat will please his heart. It is Colorado
self or engage commercial men to prepare them
for him. (5) Pharmacy is a commercial purMedicin, the official organ of the Colorado
suit. (6) It must therefore be judged on comState Medical Society, and constituent so mercial principles and its reward must be calcieties. It contains no advertising of any culated in terms of gain, not of mere livelihood. kind. It is publisht monthly by the so
(7) This implies the equity of acquiring prop
erty right in the results of labor, knowledge, exciety (address, Steele Block, Denver, Col
ploitation, convection, and all the various factors orado), at $2 per year. Perhaps Dr. Lit that enter into a successful commercial undertle is acquainted with the journal (state or taking; and so long as the methods are honest ganization journal) which has been the
there is no sound reason why physicians should most severe in its criticism of the Jour. A.
oppose it. (8) Proprietary medicins are, in many
instances, only vastly more elegant, palatable, and M. A. on account of the advertisements con in every way superior forms of the various stock tained in the latter; I refer to the Califor mixtures kept at hand by every dispensing phynia State Journal of Medicin ($3 per
sician, and to be found in every hospital formuyear), edited by Dr. Philip Mills Jones,
lary and even in the various national pharma
copeias, for use either alone or as a base, as ocwho devotes more of his space to what he
casion may require. Therefore (9) a propricalls the "nostrum evil” than any other etary is not objectionable simply because it is a medical editor, with criticism directed par proprietary. (10) Nor because it consists of a ticularly at the Jour. A. M. A. Yet Dr.
mixture of substances in place of being a definit
chemical compound (1) It is objectionable if, Jones welcomes Vin Mariani to his col
being a definit chemical compound, its chemical umns, with editorial endorsement, in spite constitution, or being a mere mechanical mixture, of the fact that this preparation is per its essential component ingredients are kept sehaps the most prolific source of drug ad
cret. (12) It is objectionable if, while containdiction in this country, and that a few years
ing any potent drugs, of markt physiological ac
tion or toxic character, it is exploited to the ago it was openly and enterprisingly ad laity. (13) This objection, however, cannot reavertised to the laity, and is now in Eng sonably be made to apply to remedies of known land, I understand. I well remember see
composition, therapeutically classifiable as laxa
tivs, tonics, and the like, which contain no potent ing their pamphlets a few years ago, con
or toxic drugs, but may be regarded as legititaining page after page of portraits of act
mate domestic medicins; to mineral waters and ors, opera singers, etc., with a testimonial beverages as such, to external applications, disfrom each beneath each picture. These infectants, nutrients, and the like. pamphlets were distributed to the laity. Dr. Yet, that very issue contains the antikamJones is an illustration of the fact that the nia adv., which I thought might be disconmost extreme among the critics are incon- tinued at the end of the year, in harmony sistent, and that none of them can offer a with (12) above; but as the antikamnia adv. standard that will appeal to any consider has been continued ever since (up to Jan. able number of the profession. So the best 16), we must infer that it is not considered we can do is for all to do the best they can, by the editor as containing any "potent seeking the highest, best and most practical drug of toxic character,” or that he is not good of the profession, and be mutually acquainted with the methods and practises tolerant.
of the Antikamnia Chemical Co., so often The best analytic summary of this subject exposed in our pages. It is well known that has appeared, is the following, from that antikamnia is an acetanilid mixture, the Dec. 30th issue of the St. Louis Medical dangerous in the hands of the public, and Review, page 549:
that it is exploited directly to the laity, as Our preceding articles have led us to the we have so often shown, and therefore it following propositions: (1) The spirit of "com should be excluded from the advertising mercialism" lies in the fact that the primary pages of medical journals, under rule (12) object sought is the material benefit of the in
above given.-C. F. T.] dividual; public benefit is, when present, a secondary and incidental motiv. (2) When these
The newest game in mining promotions, which has made its ends are sought honestly, not pretending the appearance in New York, is this heart-to-heart sympathetic talk thing that is not, or denying the thing that is, from miners direct to investors upon the assumption that confi
dence, which has been lost in promoters, can be revived in this and when they are sought in a legitimate sphere,
way. These smooth talks show the master hand of clever that is honest commercialism. (3) In profession schemers.-Financial World.