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there do not have iodine, and the people who live on the plants and on the meat produced on that terrain have a deficiency of iodine, and the result is a tremendous overgrowth of the glands of the neck.
Now, the common and almost universal practice is to prescribe iodine for such persons. One of the earliest, before we ever knew that there was iodine, was a homeopathic remedy, sponge. Somehow or other, somebody had discovered that the use of a sponge had a marvelous effect in the reduction of goiter.
Senator MURPHY. The use of what?
Dr. BEAL. It was because it contained iodine. We did not know then what it contained, but we do know it had a marvelous effect. The laws of some States require that salt be iodized; that is, that sodium iodide be put into the sale, so as to assure that those who use the salt will get a sufficiency of iodine; but here, the way this was written, it would prohibit the advertising of salt containing iodide.
Senator COPELAND. Hasn't the medical profession found fault with the indiscriminate use of iodine taken that way?
Dr. BEAL. I expect they have. Senator COPELAND. Well, now, this matter with reference to public advertising. You have taken but two or three simple things, but do you think it would be right to advertise that a remedy would cure tuberculosis or cancer?
Dr. BEAL. No, sir.
“ have any effect." Dr. BEAL. "Have any effect” of the treatment?
Senator COPELAND. All right, “Have any effect.” Would you hold out hope to a person who had tuberculosis or cancer? Do you think it would be right to hold out hope to a person who has tuberculosis or cancer that an advertised drug is helpful, and the treatment is continued until the patient has gone past the stage of when, under proper medical or surgical care, the patient could have been cured?
Dr. BEAL. I do not wish to be misunderstood. I do not think that we should permit the advertising of drugs for the treatment of any of these ailments which cannot be cured by the use of drugs alone. As the chairman of the committee of the American Pharmaceutical Association, I was the author of a resolution, the wording of which I can not recall, but which is to this effect: that you do not recognize as legitimate a remedy which is advertised to be sufficient in the treatment of disease for which medicines alone are not sufficient.
My principal attention to this, gentlemen, is the false implication which it presents. Reading this over, you would say, "Why, the state of pharmacy in this country must be in dreadful condition when they permit all of these things."
Why, we don't permit all of these things. Let me suggest to you that the first opportunity you have, you take this list to your drug. gist and tell him that you want a sample of each one of these, and especially from the preparations intended for the teeth and guins. and possibly for goiter--such things.
He will tell you, "Why, we haven't any such things. We do not tolerate them in the drug store."
Now, some of you will say, “Why, it was only a couple of weeks ago when I saw in the newspapers an announcement of two women who were killed within a very short period of time, by the use of a cancer paste. Isn't that an outrage? Should not the sale of such cancer paste be prohibited ?"
Yes, but I investigated that case. There were two women who were killed by the application of a cancer paste, and that cancer paste never was on sale in a drug store. Both deaths occurred in private sanitariums kept by physicians.
The preparation was manufactured and applied in the private sanitariums, and we dislike to have the implication that our trade is saturated with these things. Why, they are very unusual. You have to go into the byways to hunt them up.
Then, another case, I saw an editorial in the Medical Journal. It said, “ Support the Tugwell bill by all means, because of the dangerous narcotics and habit-forming drugs which are being sold in the form of package medicine.”
I sat down immediately and wrote the editor, and sent an enclosed and self-addressed stamped envelop, and requested the names of some of those preparations. I had quite a lot of trouble getting a reply. Finally he sent me the name of one preparation. I investigated that, manufactured in Ohio by a firm of physicians. It is not sold in the drug stores. The druggists cannot buy it. They get your money, and they send you a diagnosis blank, and you fiil out that blank and send it back with $10, and then they send you a medicine that is good for what ails you.
Senator COPELAND. Doctor, you are getting a little bit away from this question.
Senator MURPHY. Yes.
Senator COPELAND. Surely you are not going to represent-you are not going to take the position that the Department should not make an effort to try to get self-medication in certain diseases, where it is well known in the profession that there isn't any drug which is efficacious in the treatment of the diseases, as such?
Dr. BEAL. No; I do not wish to be understood as taking that attitude.
Senator MURPHY. Well, I think possibly, Senator, I started this trend of discussion, and my purpose was this. I have a lay mind. This language is very sweeping, there shall not be any advertising if it has any effect in the treatment in any of the diseases.
You have an informed mind on this subject, and I do not understand you as deterring the position that there are drugs that have an effect on these ; that there are drugs that have a palliative effect, or that have curative effect. I do not understand you as taking the position, however, from what you have said, that there are some of these diseases that some of these drugs have an effect on.
Dr. BEAL. Yes.
Senator MURPHY. Now, I should like, if you would, for my own benefit, at any rate, to specify, of these 43 diseases enumerated here, those diseases in which some drugs would have an effect-presumably a helpful effect !
Ďr. BEAL. I would prefer to substitute for this entire line the language which is found on page 15 of the McCarran-Jenckes bill; section 10, beginning with lines 6 to 14:
An advertisement of a drug shall be deemed to be false, within the meaning of this act (1) if it is false in any particular; or (2) if, while not false, it is actually and injuriously misleading to the purchasing public in any particular. But no advertisement of a drug shall be deemed to be false under this section because of any representation regarding its value or effect, if such representation is supported by a substantial medical opinion or by demonstrable scientific facts, as the case may be.
Senator MURPHY. That is covered by what lines, please?
Dr. BEAL. I would substitute that for the
Dr. BEAL. Then, I would call your attention to the continuation of this subsection, page 16, lines 11 to 18.
Senator COPELAND. Doctor, before you get away from that, see how you leave the Department. I am not saying that this list is correct. Indeed, I have said the contrary to those today who were formulating the bill, “Be sure that your list is sensible.” But if we were to have the language of your bill, it puts the burden of proof immediately upon the Department, does it not?
Dr. BEAL. Very largely, yes; that is where it should be.
Senator COPELAND. Now, on the other hand, if this list is too big or too little, if there are conditions in here which ought not to be, they should come out; but when you advertise that you have a remedy that will cure albuminuria
Dr. BEAL. Oh, no; that should not be permitted at all.
Senator COPELAND. Or arteriosclerosis or cataract or diphtheria or encephalitis or epilepsy or gallstones or high blood pressure, and so forth, the people are very badly misled and imposed upon by such advertising, because we haven't remedies which will control those diseases. There are eminent members of the medical profession besides yourself here, and I think they will take the same view that I do regarding it, but that is what is being done. There are drugs on the market, there are bottles sold that are said to be curative in these conditions, and everybody who thinks he is scientifically trained knows it is not a fact.
Dr. BEAL. Such statements are false, and they should be eliminated.
Senator MURPHY. I agree with you, Senator Copeland, on that thoroughly, but by your own admission there are diseases enumerated in here where there are drugs that are palliative. There are drugs that will have an effect.
Senator COPELAND. No; I haven't said that.
Senator MURPHY. And I want to eliminate from this enumeration diseases where there are drugs that do have an effect.
Senator COPELAND. You might have someone who would list hiccups as one of the symptoms of typhoid fever, but Dr. Beal and
every other person here who is informed would know about a drug that would control that particular symptom; but when you talk about a bottle of medicine that you could buy at a drug store, that is beneficial in typhoid fever, everybody here who is informed knows it is not a fact.
Senator MURPHY. I agree with you. I would not permit them to say it, either.
Dr. Beal. I want to make myself clear. I absolutely oppose the sale or advertising of these substances for these purposes named here, but what I said was introductory to this. Go on to lines 11 to 17:
Except that no advertisement not in violation of paragraph (a) or (b) of this section shall be deemed to be false under this paragraph if it is disseminated to members of the medical and pharmaceutical professions only or appears in the scientific periodicals of these professions, or if it is disseminated for the purpose of public health educationand so on. In other words, according to this language as it now stands, an advertisement is legally true or false, not according to its content but according to where it appears.
Senator MURPHY. Yes.
Senator COPELAND. Well, I don't think that is a fair statement. It is false, for the purposes of the act, but if science has gone to the point of knowing that a certain peroxide is used for the treatment of diphtheria, the local effects of diphtheria, it would be perfectly proper that the profession should be informed of that, but on the other hand, if that were advertised to the public as curative of diphtheria, the man who puts that statement out ought to be put in jail.
Dr. BEAL. The point I have started to make is this: That all advertising should be truthful. You should not make an exception, because the way this bill worded a statement that is 100 percent truthful, published in a daily or weekly paper or a monthly magazine, is criminally false under this bill as now written, and, on the other hand, as the bill is now written, a statement which is absolutely and provably false is noncriminal if disseminated to the medical profession. You have been reading the Journal of the American Medical Association for many years. The American Medical Association has for years been opposed to frauds in medicine. That is one of its principal functions, and one of the things it has continually harped upon, properly, is the false advertising circulated to members of the medical profession. They are among the most gullible creatures on earth. I say that from my own experience. They know that the advertising of patent medicines to the general public is false, but they are not aware of the fact that much of the truck that comes to them by so-called “medicinal ” manufacturers is equally false. Now, † am not a medical man, Doctor. My doctor's degree comes
I from a different source. I am not a doctor of medicine.
Senator COPELAND. I have great respect for your medical knowledge, so far as I am concerned, Dr. Beal. The long experience you have had in your professions has made you competent to speak on this subject.
Dr. BEAL. But I want you to reflect on the amount of fun the writers of the comic columns will get out of this section, if you
permit this to go through. Strike out this exception. Require all of those statements to be truthful, and I withdraw my objection.
Senator COPELAND. Of course, the term "false" used here is used in its legal sense. There could be other language used that would not mean the same thing, but of course the purpose of the original writer of the bill—this was in the original bíll—was to make it possible for the medical profession to receive even those glimmerings of hope that are held out by the scientific research men, and I am inclined to think that it is right that they should have that information. If I were to choose between eliminating the first part of this section and the last, I would not hesitate a moment, because I know from my contact with the world that it is an outrageous thing for men to advertise cures, and to put out the hope of recovery to those poor devils who are afflicted with a disease which is sure to become incurable unless given proper treatment early in the condition.
Dr. BEAL. It is highly reprehensible.
Senator COPELAND. So I am perfectly willing, myself, if I had to make a concession, to strike this out, and say it should not be disseminated to the medical profession also; but at the same time, that is going pretty far, in my judgment.
Dr. BEAL. Let them be sure of the fact that it has a substantial basis of fact before they circulate it to the medical profession. Now, they do not look for any substantial basis of fact.
Senator COPELAND. Well, you take some great research laboratory, that will do a lot of work in connection with one of these diseaseswe will say goiter, or nephritis, or high blood pressure, or something like that-it develops what in the laboratory appears to be something worthwhile. It gives that information to the profession. I would not want to say that the profession experiment with the public, yet the wise physician makes use of it, to see if it does change the issues of the disease. If it does, we are on the way to a cure of a disease which has heretofore been considered incurable, and that is the purpose of the exception.
Dr. BEAL. I don't want to be understood as defending the advertising of these various medicines.
Senator COPELAND. I am sure you would not.
Senator MURPHY. Which of these diseases enumerated here do you think should be eliminated ?
Dr. BEAL. Dental caries or erosion should be eliminated, and beriodental diseases, and I am afraid in making that recommendation, I disappoint some of my dental friends, but I leave that to your own judgment.
Senator COPELAND. Well, there are men here representing the American Medical Association as observers. They are here as observers, and I want to say to them what I said to the Department, when this was under consideration. You would not say, now, this list is correct, and so I think the members of the medical profession who are here ought to help us. If this list is an imperfect one, if there are too many diseases included, or not enough, we should be given the benefit of the knowledge of the medical profession. That is what you have in mind too, isn't it, Dr. Beal? Dr. BEAL. I think so, substantially. I