public initerest to criticize the miiatter wllicll appeared in

Document Sample
public initerest to criticize the miiatter wllicll appeared in Powered By Docstoc
					                                                        CCORRESPONDENCE.                                         1
   APRIL 17, 1 91I5]                                                                                             SNE BrmTIg
ideals; in a determination to face the problemis of social            of the knowledge gained fromn animial experiments, bu t
ameliorationi; anid to fiind anid root out tlle fulndamiiental        because of the toxic effects tlle earlier ones lhad upon man,
causes of all the foul sores that at pr-eselnt disfigure tlle         anid because a more satisfactory metlhod was fotund of
body politic. Among tlhese sores the effects of miiedical             gettiing a bigger yield of tlle druL. I amii firmly of the
quackery are niot those least conispiceuous. The report of            opinionl, fromi the several very toxic effects I have seen
the Select Conmmittee lhas demeioinstrated for the first              followv tlle use of the new produicts, that the successful
time aitholritatively the overwvleliniig strength of the              maniufacture lhas not been solved, and tllat the medical
case, and the uirgent nieed for drastic reforimi. It will rest        profession would be well advised to await the reports of
mainily with the Association wlhetlher at the proper tiimie           clinicians before using tlle products, even if they have
the case is brouglht to the froiit witlhouit delay, and, if           beeni passed by scientific workers, andl submitLed to tlle
possible, carried to a satisfactory conclusion.-I am, etc.,           strictest laboratory controls. Tlle products are not, as
  Earlswood Commiion, April 10th.           HENRY SEWILL.             stated, fully up to tlle standard of tlle best German samples
                                                                      previously sold.
                                                                         Whiile on the subject of cllemiiiotlherapy I slhould like to
THE MIANUFACTURE OF SALVARSAN PRODUCTS                                say a few words on another aspect of it. The German
                                                                      patents are so drawn up that they woould be infringed by
               IN ENGLAND AND FRANCE.                                 any one mianufacturing an arseinic compound at all re-
    SiR,-Sinice the war broke out, and it at once became              scinlbling salvarsan. This practically excluLdes any observer
obvious that tlho Germiian stock of salvarsan anid nieo-              in the Britislh EImipire and in tihe Uniited States of Amiierica
salvarsan in this couutry would soon run out, I lhave been            fromii attempting to improve upon salvarsan. Frenclh law
experiinientinig witlh the clheniotlherapy of syplhilis, and          forbids the patenting of a drug; therefore in France not
lhavc been tlhroualg the literature, including all the patents,       only may salvarsan be made, provided the name is
 vwhich lhad up to July of last year been publislhed. Witl            changed, but any product manufactured, differing only a
the knowvledge gaiined tlherefroiii I feel I ouglht in the            little from it, becomes a French invention; lhelnce the
public initerest to criticize the miiatter wllicll appeared in        reasoni whly ludyl and galyl lhave seen daylihlit. It is
 your last.issue under the above hieading.                            lhardly likely that tlle war will last lona enough to allow of
    The secretary of thle National Medical Research Comi-             tlle making of salvarsan anid neo-salvarsan up to the
 mittee states that the products now obtainable in tllis              standard of tlle German articles, or of a produiet superior
country are clhemiically identical witlh salvarsan and neo-           to tlhem. Unless this is tlle case, it is highlly probable
salvarsan, anld thlat they differ in no respect from- Elhrliclh's     that following the cessation of lhostilities, slhould a superior
original products, eitlher in their final constitution or in tlle     product be manufactured, it will mean infringement of
details of their preparation. Because tlhe druigs are cllemi-         the Germanl patents. Could not therefore the National
cally idelntical it does not follow tllat they are similar in         Medical Researchl Committee bring pressure upon the
otlher respects. The chienmical formitula of natural salicylic        Governmiienit to institute in the Britishl Empire suclh a
acid is tlle same as that of the syntiletic produict; tlley are       state of affairs as exists in France ?-I amii. etc.,
not only different to look at, but the tlherapeutic action             London, W., April 10th.              J. E. R. McDoNAGH.
 is lnot the samiie. rT'Ile clhemlical formuula of adrenalin
is the samiie as that of the synitlhetic suprarenin, but                     We publish Mr.      McDolnagh's   letter,   because   it is
the plhysical properties of botlh are diamuetricallv opposite.        well that the grounds for the doubts lhe expresses slhould
 It is quite imiipossible to say that the filal constitution          be considered; lhe does not, lhowever, convince us that tlley
and tllo details of preparation are tlle same, because                are well founded. We do Inot know wlhat lie intends to
hlow salvarsan is prepared is unknown outside Hoeclhst,               convey by the statement tllat "whlien the linkage is in-
and tlle patenlts are so drawn uip as to intentionally                complete the arsenic is Inot so colloidal." The memorandum
deceive, as I lhave already fotund to miiy cost. Furtlher-            of tle Researchl Committee miientioned tllat the arsenic in
 more, I believe that the Germ-ian products are not pre-              salvarsan slhould be in a hliglhly reduced state, and that
paredl in the same way as tlley were wvlhen tlle patents              if it becomes oxidized the oxidizatioin product is toxic.-
were talken ou-t. The twvo firms milentioned caninot supply           But this danger has, we understand, been obviated. Nor
the demand, whlichl probably means tllat the yield of                 do we tllink that Mr. McDonaglh's observations as to tlle
tle finislhed article fromii the nmaterial used is infinitesim-nal.   therapeutic actions of natural and artificial salicylic acids
This was a difficulty tlhat was experienced whlen salvarsan           apply hllen a perfectly pure artificial product is used. As
was first made. Tlhe snmaller the yield the less complete             to adrenalin and syntlhetic suprareniin, wlhen tile latter
is the linkage of tlhe arsenic. As tlle arsenic in salvarsani         is first miiade it consists of optically opposite isomers, but
is non-myetallic in its properties and is in a perfect colloidal      if these are separated and the laevo-rotatory cornpound
state, it mieans tllat whleln the linkage is incomiiplete the         only used we believe that its action hlas been found to be
arsenic is lnot so colloidal, and therefore partly muetallic          identical witlh the nattural prodtuct. Withl regard to the
in its properties, with the resuilt that tlle preparation is          patent specifications, it would only be in accordance with
toxic. Dioxydiamiinoarsenobeiizol, whlen first made, wvas             a general clharacteristic of Germiian patent specifications
hiiglily toxic; th6e "ideal" anid "hlyperideal" that super-           foi: inakinog clhemnical products if those for salvarsan did
seded it lhad also to be slhelved; then came salvarsan, whiclh        not disclose tlhe whole process. This, however, does not
was to all initenits aned pturposes innocuous. Those who              necessarily preclude otlher worklers from ascertaining by
lhave tised "606" OIe a large scale must lhave noticed                experiimient all tlhat is necessary to produce a perfectly
that tlle drug hlas becomi-e less potent (a ratio, -within limits,    satisfactory article.
exists betweeu toxicity and potency); thle clhlange appears to
me to have taken place about tlhe beginniing of 1912. The
clhemyiical formntulae of all the products just nmentioned are        TREATMENT OF DRY PLEURISY BY TEMIPORARY
identical, but their miiode of preparation is different, and                 PARTIAL ARTIFICIAL PNEUMOTHORAX.
 as these differenices lhavle niever beeln publislhed, but kept          SIR,-I a11a glad to see that Dr. Claude Lillingstoln has
an absolute secret, it is imipossible to say that the products        noticed miiy short contribution to the JOURNAL of April 3rd.
now obtainable are priepared in the same        iway as the           His letter gives me tlle opportuniity of expressinig to him
 Germuan prodtucts. From the experience I lhave had of tlme           my gratitude for lhaving initiated miie into tlle technlique of
drugs referred to in tllc National MIedical Rtesearelh Coin-          tlle operation and lhaving tlhereby opencd uip for me a new
  nittee's comlmunicationi, I would say that tlley are even           and extremelv interesting field of tlherapeutics.
more toxic tlhanl the (lioxydiamiinoarseniobeiizol (ideal).              Oni general principles I enitirely concur witll tlle opinion
    Unfortulnately, the biolocical controls are valueless,            lhe expresses as to thle desirability of maintaining an arti-
because animilals ale not so susceptible to cllemiiical poisolns      ficial pucumtiotlorax for a coinsidterable period. I slhould
as miian. Even amnong animnals thle grcatest variation                lhave almiost beell iniclined to prolong the period he meln-
exists in their individual idiosyncr asies. All arsenical             tions, lnamely, one to two years. Witli regard to tlle par-
com1pounds exert a muinclh greater texic effect on cats tllau         ticuilar case I reported in the JOURNAL, if Dr. Lillingston
on dogos. If the differelnce is so great between two                  will refer to imy article lie will see that the pulmonary
animllals not far remiioved froml one another, hlow muclh             disease was on the left side, anid that the temporary arti-
greater mnust it be whlen imian is compared witlh rabbits             ficial pneuml-othlorax was indduced on the riqhAt sidle, solely
and mice. Time "dlosis tolerata" of the various German                withi the object of relieving the pain of thle pleurisy ont
preparations to wlhiclh I lhave alluded differed extremely            that side. When relief lhad been given, I concluded the
little, anid one product did not supersede tlle other because         treatment, as in my opinion, to have maintained tlhe

Shared By: