Prof. J. Redding, M. D., says on this point:--

"While it may be true that an adult, of his own free will, and without incentive, or predisposing causes, does occasionally become a drunkard, I am convinced that nine hundred and ninety-nine out of every one thousand individuals who become drunkards are made so in embryo, infancy, or childhood, by the use of alcoholic decoctions, soothing syrups, opiates, calomel, etc. which are given as medicines to allay pain, obtund nerve sensibility, to cure the little sufferer of his _vital manifestations_, of his _mental discomforts_, but leave the actual disease and its, perhaps, putrid causation to time and debilitated vitality to remove."

Of the danger and harmfulness of patent cough mixtures _The American Therapist_ says:--

"Cough mixtures as a rule, do more harm than good. Nine times out of ten the princ.i.p.al ingredient is opium. It is true that opium may lessen the tendency to cough, but it does great damage by arresting the normal secretions, and the system becomes affected by the poisons from the kidneys, skin, stomach, intestines and the mucous membrane lining the upper air pa.s.sages. Not only do these mixtures arrest every secretion in the body, but they also show their deteriorating and degrading effect through the stomach. They contain substances which tend to disorder and derange digestion."

Several years ago the Post-Office Department at Washington was led to take an interest in the question of fraudulent "patent" medicines, and an examination of many of these nostrums was undertaken by government chemists. Fraud orders were issued against some of the most flagrant offenders, forbidding them the use of the mails. This has not done away with the evil, however, for they usually move to another city, and begin business again under another name.

The examinations made for the Post Office Department revealed the fact that a great many of the so-called medicines on the market were intoxicating beverages in disguise. The Internal Revenue Department then took up the matter and a long list of these beverage medicines was sent out to internal revenue agents with instructions that these must not be sold henceforth unless by persons paying a special tax for the sale of alcoholic beverages.

Some of the manufacturers of these nostrums availed themselves of opportunity given to add a recognized medicinal agent to their flavored alcohol and water and such preparations were stricken from the list of those requiring a whisky license for their sale. Peruna and Hostetter's Bitters were the best-known of these. Peruna had been up to this time what government chemists called "a cheap c.o.c.ktail." The report of the pure food commissioner of North Dakota for 1906 gives on page 157 an a.n.a.lysis of it as now upon the market: "Alcohol by volume, 21.25 per cent.; total solids, 3.846 per cent.; ash, .158 per cent." The report says:--

"The only thing of a medicinal nature that we could find in this preparation appeared to be a small amount of senna combined with a bitters of some kind."

Proprietary "Foods" have not escaped attention from chemists. Dr.

Charles Harrington, for several years secretary of Ma.s.sachusetts Board of Health, was the first to publish an a.n.a.lysis of these preparations showing their alcoholic strength and their small nutritive content. He lists "foods" examined by him as follows:--

"Liquid Peptonoids 23.03 alcohol; maximum amount recommended will yield less than one ounce of nutriment per day, and the equivalent of 3.50 oz. of whisky. Hemapeptone 10.60 alcohol; Hemaboloids 15.81 alcohol; the maximum dose recommended yields about 1/4 oz. of nutriment, and the equivalent of about 1-1/2 oz. of whisky daily. Tonic Beef 15.58 alcohol; doses recommended yield about 1/2 oz. nutriment daily, and the equivalent of one ounce of whiskey. Mulford's Predigested Beef 19.72 alcohol; doses recommended yield about 1-1/4 oz. nutriment daily, and the alcoholic equivalent of about 6 oz. of whisky. There were "Foods" for the sick examined which were non-alcoholic, but their nutritive value was about nothing in comparison to their cost."

The Committee on Pharmacy of the American Medical a.s.sociation reports on the following foods thus:--

Carpanutrine 17.3 alcohol; Liquid Peptones (Lilly & Co.) 22.0; Nutrient Wine of Beef Peptone (Armour) 21.5; Nutritive Liquid Peptone 23.0; Panopepton 18.5; Peptonic Elixir 18.8; Tonic Beef 16.1. The report on these says: "There are no fatty substances present in these products; their food value from this point of view is, therefore, _nil_."

A prominent physician of Philadelphia said of these "Foods" in the Journal of the A. M. A.:--

"I have long been convinced that many a patient has suffered severely when preparations such as these were being used, and that not a few of them have died, chiefly of starvation. * * * A very important disadvantage of these foods is their alcoholic content. Even in the small doses customarily used, the quant.i.ty of alcohol is often irritating to the stomach, and may be disadvantageous in other ways."

The Committee on Pharmacy also reported on cod-liver oil preparations.

They said: "A preparation claiming to represent cod-liver oil which does not contain oil in some form is fraudulent. Waterbury's Metabolized Cod-Liver Oil and Hagee's Cordial of Cod-Liver Oil are cited as examples. It is claimed by the manufacturers that the latter represents 33 per cent. of pure Norwegian cod-liver oil, but in neither of these preparations did the tests made by the committee show any oil. a.n.a.lysis revealed sugar, alcohol, and glycerine, none of which is contained in cod-liver oil."

Vinol is advertised as Wine of Cod-Liver Oil, but is admittedly without oil, and according to a.n.a.lysis contains 18.8 per cent. alcohol.

Wampole's Tasteless Preparation of Cod-Liver Oil showed 20.05 per cent.

of alcohol.

Cod-Liver Oil is considerably out of date now as a prescribed remedy because physicians have found that it impairs appet.i.te. Cream and fresh b.u.t.ter and olive oil are advised instead.

Australia has been such a harvest field for patent medicine manufacturers that a government commission was appointed to study the subject. This commission presented a voluminous report to the parliament of 1907. This report gives an a.n.a.lysis of most of the extensively advertised medicines. Doan's Backache Kidney Pills are said to be made of oil of juniper 1 drop, hemlock pitch 10 grains, pota.s.sium nitrate 5 grains, powdered fenugreek (Greek hay) 4 grains, wheat flour 4 grains, maize starch 2 grains. The report says: "The stuff is the cheapest kind of skin-plaster made up into pills." The seeds of fenugreek are used mainly for poultices. Doan's Dinner Pills contain two drastic purgatives, podophyllin and aloin. Both of these are dangerous drugs. Aloin frequently produces hemorrhoids (piles). The _British Medical Journal_ says that the material in forty of the Kidney Pills and four Dinner Pills would cost one English halfpenny (one cent).

Vitae-Ore is given as consisting of ordinary sulphate of iron (green vitriol) to which a little Epsom salts has been added. Munyon's Kidney Cure, which claims to cure Bright's disease, gravel, and all urinary diseases, is given as composed entirely of sugar. Dr. Williams' Pink Pills are said to be an iron pill much the same as the ordinary Blaud's Pills which are sold in drug-stores for half, or less than half, the price of the proprietary article. (Iron is said by recent investigators to be very injurious to the stomach.)

The Committee on Pharmacy of the American Medical a.s.sociation has a.n.a.lyzed many proprietary medicines; from their reports the following a.n.a.lyses are taken. "Health Grains," which are claimed to be a remedy for "Dyspepsia, Indigestion, Nervousness, etc.," were found to consist of 87.50 per cent. of coa.r.s.e quartz sand, and 12.50 per cent. of rock candy and syrup.

"Hoff's Consumption Cure consists essentially of sodium cinnamate and extract of opium, a mixture at one time suggested for the treatment of tuberculosis, but which has been discarded by physicians. A medicine which depends on opium for whatever therapeutic effect it may have is, when sold indiscriminately to the laity, inherently vicious."

Sartoin Skin Food for "sunburn, and all skin blemishes" was made of Epsom salts colored with a pink dye. The government prosecuted the company sending out Epsom salts as a "food," and they were fined $20 for thus seeking to dupe silly women.

Malt extracts are very extensively used at the present time, under the popular notion that they are an aid to starch digestion. That they are a product of the brewery has caused them to be looked upon with suspicion by cautious people, but the mult.i.tude has apparently given no thought, or care, as to whether or not they may be alcoholic. Dr. Charles Harrington presented the results of an examination of these preparations at a meeting of the Boston Society of Medical Sciences, held Nov. 17, 1896. The following is quoted from the journal of the society for November, 1896:--

"Twenty-one different brands of liquid malt extract were obtained and a.n.a.lyzed. That they were not true malt extracts is shown by the fact that in no one was there the slightest diastatic power; all were alcoholic, some being stronger than beer, ale, or even porter. In a number of specimens a large amount of salicylic acid was detected."

Dr. J. H. Kellogg, in commenting upon this report, said in the Dec., 1896, _Bulletin of the A. M. T. A._:--

"In the light of these facts, it is apparent that ale or lager beer might as well be prescribed for a patient as these so-called malt extracts, which are practically nothing more than concentrated ale or lager."

There are malt extracts, made up like honey, or syrup, in consistency, which are valuable.

The following list of malt extracts, with accompanying letter from Prof.

Sharples, is taken from a paper published by Hon. Henry H. Faxon, of Quincy, Ma.s.s.:--

"Boston, Ma.s.s., March 20, 1897.

"I enclose a list of the malt extracts examined in this office during the past year or two. These samples were all in original packages, obtained by officers in various parts of Eastern Ma.s.sachusetts. They probably very fairly represent the various malt extracts on the market. I have added two samples of Porter and one of Old Brown Stout for purposes of comparison.

"Yours respectfully, "S. P. SHARPLES.

"State a.s.sayer."

Name. Solids. Alcohol.

5193 English Malt Extract 9.70 5.63 5214 Old Grist Mill Malt Extract 10.57 5.54 5418 Old Grist Mill Malt Extract 9.98 5.63 5490 Old Grist Mill Malt Extract 12.28 5.86 5626 Old Grist Mill Malt Extract 9.63 5.00 5207 Liquid Food, a Malt Extract 10.47 4.27 5225 Pure Malt, a Liquid Food, a Tonic 9.71 5.00 5416 Pure Malt, a Liquid Food, a Tonic 10.76 6.32 5619 King's Pure Malt[C] 9.52 6.60 [Footnote C: The label on King's Malt states that for a strong, healthy person, with a good appet.i.te, a pint with each meal and another on retiring at night will not be too much.]

5421 A Nutritious Tonic, Pure Malt Extract 10.88 6.24 5226 Noris' Extract of Malt 11.57 5.94 5258 Noris' Extract of Malt 9.31 6.55 5397 Noris' Extract of Malt 10.63 6.24 5485 Noris' Extract of Malt 10.50 6.63 5620 Noris' Extract of Malt 12.55 5.90 5229 Pabst Malt Extract, The Best Tonic 10.43 5.16 5230 Hoff's Malt Extract (Tarrant's) 11.33 8.88 5489 Hoff's Malt Extract (Tarrant's) 12.25 7.17 5231 Johann Hoff'sches Malz-Extract, Gesundheit's Beir 11.31 4.34 5491 Johann Hoff'sches Malz-Extract, Gesundheit's Beir 11.02 4.85 5621 Johann Hoff'sches Malz-Extract, Gesundheit's Beir 10.49 4.50 5408 Johann Hoff'sches Malz-Extract, Gesundheit's Beir 11.47 4.78 5340 Haffenreffer & Co. Malt Wine 11.02 6.65 5423 Haffenreffer & Co. Malt Wine 11.71 5.63 Liquid Bread, A Pure Extract of Malt 6.78 6.63 5395 Durgin's Malt, Liquid Extract of Malt 7.12 5.94 5433 Durgin's Liquid Extract of Malt 6.49 5.55 5396 Wyeth's Liquid Malt Extract 14.80 3.35 5488 Wyeth's Liquid Malt Extract 15.50 2.86 5622 Wyeth's Liquid Malt Extract 15.73 2.35 5406 Wampole's Concentrated Extract of Malt 9.84 9.86 5407 Anheuser-Busch's Malt Nutrine 15.98 3.00 5600 Anheuser-Busch's Malt Nutrine 15.82 2.25 5417 Malt Extract (Sterilized), John L. Gleeson 7.97 4.71 5422 Malt Extract (Sterilized), Charles C. Hearn 8.58 5.00 5436 Burkhart Brewing Co.'s Malt Extract 10.73 7.01 5486 Menzel's Extract of Malt 5.90 5.24 5625 Menzel's Extract of Malt 6.75 4.35 5623 King of Malt Tonics, Lion Tonic 10.95 7.05 5624 Teutonic, "A concentrated Extract of Malt and Hops" 9.95 7.45 5409 Van Nostrand's Old Stout Porter, "a pure malt extract" 7.97 6.55 5233 Philadelphia Porter 5.34 6.63 5232 Burke's Guiness Stout 6.66 7.17

The alcohol in the above table represents the cubic centimeters of alcohol in a 100 cubic centimeters of the liquid. The solids are the number of grams of solid extract in each 100 centimeters of the liquid.

S. P. SHARPLES.

The _British Medical Journal_, and the _British Medical Temperance Review_ have been calling attention to the danger in coca wines.

Intemperance among invalids is said to be greatly on the increase from the use of these wines. In every case the basis of these preparations is strongly alcoholic wine, ranging from 18 to 20 per cent. The coca added is either the leaves, or liquid extract of coca, or hydrochlorate of cocaine.

Dr. Frederic Coley says in the _British Medical Journal_:--

"Coca, and its chief alkaloid, cocaine, are drugs which possess some power of removing the sense of fatigue, just as a.n.a.lgesics remove the consciousness of pain. But they no more remove the physical condition of muscles, and nerve centres, of which the sense of pain gives us warning, than a dose of morphine, which removes the pain of toothache, removes the offending tooth, or even arrests the caries in it. The truth of this will be obvious to any one who remembers enough of physiology to know what fatigue really means. A muscle which is tired out is different chemically from the same muscle in its more normal condition, when it is ready to respond vigorously to ordinary stimuli. It has lost something, and is, besides, overcharged (poisoned, in fact) with the products of its own activity, and it can only be restored by a fresh supply of the material which it requires, and the carrying away of the poisonous waste products. Fatigue of nerve centres is no doubt strictly a.n.a.logous to fatigue of muscles.

"It is practically impossible for us, by voluntary exertion, to reach the degree of absolute fatigue, which the physiologist produces by electric stimulation of a nerve-muscle preparation.

The sense of fatigue becomes so intense that voluntary effort cannot overcome it. So no man can produce asphyxia by simply holding his breath, because the _besoin de respirer_ becomes irresistible; but it is quite possible for a narcotic to so dull the sensory part of the respiratory reflex mechanism as to permit asphyxia to take place.

"The sense of fatigue, and the _besoin de respirer_ are both Nature's danger signals. Drugs which hide such signals from us are a more than doubtful benefit. If it were possible for us to suppose that a fraction of a grain of cocaine could afford to exhausted nerve centres, and muscles, the nutriment which they require for their restoration, and at the same time eliminate the poisonous waste products, then it would be reasonable to prescribe the drug for use by all who are overworked, and perhaps suffering from the malnutrition consequent upon, 'nervous dyspepsia,' as well as mere want of rest.

"In this go-ahead century it is no wonder that many are but too ready to experiment with a drug which professes to be able to remove fatigue, and to enable a man to go on working when, without its aid, weariness had become unendurable. Cocaine claims all this; and it is most dangerous just because, for a time, it seems able to keep its promise. That is how victims to cocainism are made. Let us be honest with our overworked patients, who want us to help them with drugs; let us tell them that rest is the only safe remedy for weariness.

"To combine such a drug as coca, or cocaine, with an alcoholic stimulant, is to multiply the dangers of cocainism by those of alcoholism. It would be impossible to find terms sufficiently severe in which to condemn the recklessness of those who promiscuously recommend such a compound for all who are overworked or debilitated. One firm actually has the a.s.surance to advertise a preparation of this kind as a remedy for dipsomania. Truly this is casting out devils by Beelzebub, with a vengeance. Invoking Beelzebub for such a purpose has never been a success. And I suspect that any form of coca wine will make a great many more dipsomaniacs than it will cure."

Dr. Walter N. Edwards, F. C. S., says of coca wines:--

"These wines are sold as being useful in an immense variety of ailments. The following are a few of the many that are named upon the bottles or in the circulars accompanying them:--