Sal Hepatica, marketed by the Bristol-Myers Co. of New York, has been refused recognition by the Council, because its composition is secret; because it is advertised indirectly to the public for the treatment of diseases; because exaggerated and unwarranted claims are made for its therapeutic qualities; and because the name fails to indicate its chief constituents but does suggest its use in liver disorders. The Council has authorized the publication of the report of its referee, because it is an important illustration of the ways in which physicians are being made parties to the introduction to the public of a patent medicine, whose indiscriminate use must often have resulted in harm, direct or indirect. W. A. Puckner, Secretary. The report of the referee follows: Sal Hepatica is a saline laxative sold by the Bristol-Myers Company of New York. No information seems to be given regarding its composition except such as is contained in the following vague and uninforming phrases: “Effervescent saline combination, hepatic stimulant, laxative and an eliminant of irritating toxins.” “Sal Hepatica is a saline combination containing the alterative and laxative properties similar to the natural ‘Bitter Waters’ of Europe with the addition of sodium phosphate.” “... more palatable and efficient than sodium phosphate alone or other salines.” A circular around the bottle contains the following: “We invite the physicians’ careful consideration of the merits of Sal Hepatica in the treatment of Rheumatism and Gout, in Constipation and Auto-intoxication, and to its highly important property of cleansing the entire alimentary tract, thereby eliminating and preventing the absorption of irritating toxins and relieving the conditions arising from indiscretion in eating and drinking.” In the same circular, its promiscuous use is invited in these terms: “Owing to its palatability, Sal Hepatica is particularly well adapted to the requirements of childhood or the feeble and delicate.” Further suggesting its use in the treatment of that popular, if somewhat vague ailment, “biliousness,” we read: “It is especially valuable where there is intestinal sluggishness arising from functional derangements of the liver or portal circulation....” As further suggestive of its all-around “goodness,” are the claims: “It increases the appetite and promotes digestion by stimulating the flow of gastric juice.” “In rheumatism and gout Sal Hepatica furnishes the physician with an ideal eliminant, usually affording prompt relief.” The label on the Sal Hepatica bottle suggests--both to physicians and to the public--its use in the following diseases and conditions: