The Propaganda for Reform in Proprietary Medicines, Vol. 2 of 2Council on Pharmacy and Chemistry (American Medical Association)
Science
The Propaganda for Reform in Proprietary Medicines, Vol. 2 of 2
Council on Pharmacy and Chemistry (American Medical Association)
Patent medicines
The Council, appreciating that long established customs cannot be
changed at once, has applied Rule 10 concerning the recognition of
mixtures with the greatest leniency compatible with consistency. When
there has been a reasonable doubt concerning the value of a mixture
it has frequently directed that Rule 10 should not apply pending
further clinical trial of such mixture. In no instance has subsequent
experience shown that a strict interpretation of the rule would have
worked hardship or injustice. The Council feels that there is no longer
warrant for the admission of complex mixtures to New and Nonofficial
Remedies or for the retention of any that have been admitted unless
definite evidence of the therapeutic value of such combinations is
available. In accordance with this decision several mixtures now
described in New and Nonofficial Remedies will be omitted at the
expiration of the three year period for which articles are accepted.
Reverting to the Carminzym tablet: When it is desired to obtain the
effects of pancreatic extract by oral administration it must be
administered with a view of preventing its destruction by the gastric
fluid. With this end in view an antacid should be administered to
decrease the acidity of the gastric juice. The amount of alkali may
be supplied in the form of any of the official preparations, but the
amount must be adjusted to the individual patient for the reason that
no two successive patients are likely to have the same degree of
gastric acidity.
Ipecac has a well defined though limited field of usefulness. When it
is used, it should be given with a due regard to the amount needed by
the patient and the frequency of the repetition of the dose. There is
no reason to suppose that any two successive patients will require
ipecac and extract of pancreas in a fixed proportion and with equal
frequency. As a matter of fact, the amount of ipecac in Carminzym is so
small that no definite therapeutic action can be assigned to it and its
use in this combination is purely empirical.
In a word, the employment of mixtures of pancreatic extract, alkalis,
ipecac and carminatives in fixed proportion leads to slipshod treatment
and irrational therapeutics. Carminzym is an irrational mixture the use
of which is detrimental to therapy.
The preceding report was sent to Fairchild Bros. and Foster for comment
in accordance with the Council’s usual procedure. The following reply
was received:
The long established custom of the use of mixtures of remedial
agents rests upon considerations well known and generally accepted.
This is equally true of combinations of drugs of similar and
dissimilar properties. The drugs of these combinations, especially
those of marked therapeutic action, are well known and used by
themselves when indicated.
In fact, dissimilarity of action is a cause of combination, an
essential of synergism.
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