the programmes of church, festival, and glee-club concert to charity, not to business. Warning people once does no more lasting good than sending a child to school once a month. The exposure of patent-medicine evils must be as constant as efforts to sell the medicines.

Overexposure is ineffective. It is the evils of patent medicines that do harm, not their name and not their patents. The medical profession has in vain protested against proprietary medicines. Ethical barriers cannot be erected by resolution. Calling things unethical does not make them unethical. The mere patenting of medicines for profit does not make the medicine injurious any more than the mere mixing of unpatented drugs makes a physician safe. Physicians who would not themselves patent a drug will use certain patented drugs whose ingredients are known to be safe and uniform. True exposure of patentmedicine evils will enable the average physician and the average layman to distinguish the dangerous from the safe, the fraud from the genuine, lies from truths.

Legislation is needed to crystallize modern knowledge and to establish in courts the right to protection against the evils of patent medicines. The national Pure Food Law, passed January 1, 1907, and now in force throughout the country, requires on the "labels of all proprietary medicines entering into interstate commerce, a statement of the quantity or proportion of any alcohol, morphine, opium, heroin, chloroform, cannabis indica, chloral hydrate, or acetanilid, or any derivative or preparation of any such substance contained therein; this information must be in type not smaller than eight-point capital letters; also the label shall embody no statement which shall be false or misleading in any particular." This law does not forbid patent medicines nor the use of alcohol and narcotics in patent medicines; it merely says, "Let the label tell, that all who buy may read." It does not require that all

who run may read, for it does not say that advertisements of a patent medicine shall tell the truth about its ingredients or its action on the human body; only that the label on the bottle shall tell. The object of this law is to explain to the consumer the exact nature of the medicine. But to the majority of people the word "acetphenitidin " on the label of a headache medicine does not explain. The new order that requires manufacturers to substitute acetanilid for acetphenitidin does no more than replace fog with mist. Protection requires legislation that cannot be evaded by technical terms. The present law requires that packages must be properly labeled on entering the state. To carry out the national law, state laws should make it an offense for dealers to have in their possession proprietary medicines without explanatory labels that explain. Where state laws to this effect do not exist, the packages once in the state may be deprived of their labels and sold as secret remedies, thus nullifying the whole effect of the national law.

Enforcement must be insured. Impure drugs may do as much harm as patent medicines containing harmful drugs. In New York a vigorous campaign was recently inaugurated by the department of health to drive out impure drugs. Drugs are dangerous enough at their best. When they are not what they pretend to be, whether patented or not, they may take life. One extreme case where a patient's heart was weakened when it ought to have been strengthened, led to the discovery that practically all of one particular drug offered for sale in New York City was unfit to use and calculated to kill in the emergency where alone it would be used. Yesterday four lives and several million dollars were lost in a New York fire because the hose was rotten or weak. As inspection and testing were needed to insure hose equal to emergency pressure, so inspection and testing of patent medicines and drugs are needed to make legislation effectual.

Legislation and enforcement should reach the newspaper, magazine, billboard, street car, that advertises a falsehood or less than the essential truth regarding drugs, foods, and patent medicines. Public sentiment condemns the advertising of many opportunities to commit crime or to be disorderly or indecent or to injure one's neighbor. The facts about hundreds of nostrums can be absolutely determined. The advertising agency, whether secular or religious, that carries misrepresentation of drugs and foods should be forbidden circulation through the mails. The existence of such advertisements should be made evidence of complicity in a public offense and punished accordingly. Treat them as we treated the Louisiana lottery. Boards of health, instead of furnishing names to druggists and manufacturers who want to sell patent foods and medicines, should print circulars exposing frauds, and punish so far as the law permits.

While trying to secure adequate legislation and efficient administration of the above-mentioned standards, there is much that can be done by individuals and clubs. We can give preference to those journals that refuse drug and food advertisements unless evidence is produced that the truth is told and that the goods are not harmful. We can refuse to have in the house a paper or journal which prints notices that lie or that conceal the truth. If this drastic measure would cut us off entirely from daily papers, we could choose the least offensive and petition it to exclude specific lying methods. When it preaches health, honesty, and philanthropy, we can cut out of one issue the noble editorial and the exploiting advertisements and send them to the editor with our protest. Knowledge of the ingredients and dangers of patent medicines should be a prerequisite for the practice of medicine or pharmacy. We can help bring about such conditions, and we can patronize physicians who send patients to drug stores that cater to intelligence rather than to ignorance.

Fighting patent-medicine evils is a civic duty to be accomplished by civic coöperation, not private effort. It is impossible to organize unofficial educational agencies that can offset the cumulative, lying advertisement. Personal opposition is but the beginning. Official machinery must be set running and kept running so as to protect the public health against the commercial motive that preys upon ignorance and easily inspired faith.

CHAPTER XXXVIII

HEALTH ADVERTISEMENTS THAT PROMOTE

HEALTH

It is usually considered futile to attempt to defeat the devil with his own methods, because he knows so much better how to use them. But abuse does not do away with use, and the success of quacks in reaching the people demands our respect. There is no reason why their methods, based on a knowledge of human nature and human psychology, should not be employed to appeal to needs rather than to weaknesses. A good thing may lie unused because of lack of advertisement. Vitality is coming to be the passion of the American people. It is on this sincere passion that fakirs have so long traded.

There can be no doubt that advertisements of healthpromoting goods are quite as profitable as health advertisements that injure health, when equally effective methods are used to make them reach the public. The tradition has been repeatedly mentioned in this book that the better the doctor, the less he advertises himself, except in medical and scientific journals that notoriously fail to reach the people. The same is too often true of reputable remedies and goods. The theory that these things stand or fall on their merits is not borne out by practical experience, conspicuously in the case of "fake" remedies. Purely philanthropic undertakings for the advancement of health fail, if not placed before the people whom they aim to help in an attractive, convincing form. Failure to advertise a worthy cause limits. its usefulness, and is therefore unjustifiable, whether we speak of medicine, legal aid, or dental clinics.