The Propaganda for Reform

1918 Journal of the American Medical Association (JAMA)  
The tablet form of administering medicines is popular among many physicians because of its convenient availability and dosage. There is no doubt about the convenience of tablets, but the accuracy of the dosage content is not always to be depended on. One reason for this is that the demand for palatable and convenient "medicaments has led manufac¬ turers to attempt to produce in tablet form mixtures which, from the nature of the case, are not suited to that method of compounding." In a series of
more » ... ng." In a series of painstaking experiments' on Bismuth, Opium and Phenol tablets, conducted a number of years ago in the A. M. A. Chemical Laboratory, it was shown that no tablets on the market then contained the amount of phenol the label indicated, the variation being from 12.3 to 112.5 per cent. Similarly the laboratory found that in the case of several different brands of Aromatic Digestive Tablets,2 the amount of hydrochloric acid present in these absurd com¬ binations was true to label in only one half of the specimens notwithstanding the fact that the amounts claimed to be present were ridiculously small ; in two specimens there was no hydrochloric acid whatever present, while a third con¬ tained only a trace. These examples illustrated clearly the very evident unwisdom of attempting the pharmaceutically impossible merely for the sake of convenience or pharma¬ ceutical "elegance." Another reason for doubting the accuracy of dosage, irre¬ spective of the characteristics of the drugs composing the tablets, has been the manifest lack of care in their manufac¬ ture. In 1914, Kebler3 reported the results of a far-reaching investigation of tablet compounding in which he pointed out that tablets on the market were not as uniform or accurate as was generally believed, the variations being "unexpectedly large in numbers and amount." During the past year, the Connecticut Agricultural Experiment Station" undertook the examination of tablets-proprietary and nonproprietarytaken from the stock of dispensing physicians. The variations found in weights of the tablets were strikingly similar to those reported by Kebler. VARIATION IN WEIGHTS OF TABLETS Kebler Connecticut Variation Per Cent. Per Cent. Less than 10 per cent. 43 44 More than 10 per cent. 57 56 More than 12 per cent.. 44 35 More than 15 per cent. 28 26 More than 20 per cent. 9 10 The determinations of the composition of the tablets when compared with that claimed for them showed wide variation -from 54 per cent, above to 70.5 per cent, below ; in almost two thirds of the tablets examined, the variation amounted to more than 10 per cent.; in three fifths of the tablets, the variation was more than 15 per cent.; in one fourth, more than 20 per cent., and in one twentieth, more than 50 per cent. ; only in one eighth of the tablets was the variation less than 5 per cent. Allowing a tolerance in composition of 10 per cent., one or more products of the following manufac¬ turers were found deficient :
doi:10.1001/jama.1918.02600300064019 fatcat:ynjowokrbrcy7duii56aobhypa