Ignorance and credulous hope make the market for most proprietary remedies. Intelligent people are not given largely to the use of the glaringly advertised cure-alls, such as Liquozone or Peruna. Nostrums there are, however, which reach the thinking classes as well as the readily gulled. Depending, as they do, for their success on the lure of some subtle drug concealed under a trademark name, or some opiate not readily obtainable under its own label, these are the most dangerous of all quack medicines, not only in their immediate effect, but because they create enslaving appetites, sometimes obscure and difficult of treatment, most often tragically obvious. Of these concealed drugs the headache powders are the most widely used, and of the headache powders Orangeine is the most conspicuous.

Orangeine prints its formula. It is, therefore, its proprietors claim, not a secret remedy. But to all intents and purposes it is secret, because to the uninformed public the vitally important word "acetanilid" in the formula means little or nothing. Worse than its secrecy is its policy of careful and dangerous deception. Orangeine, like practically all the headache powders, is simply a mixture of acetanilid with less potent drugs. Of course, there is no orange in it, except the orange hue of the boxes and wrappers which is its advertising symbol. But this is an unimportant deception. The wickedness of the fraud lies in this: that whereas the nostrum, by virtue of its acetanilid content, thins the blood, depresses the heart and finally undermines the whole system, it claims to strengthen the heart and to produce better blood. Thus far in the patent medicine field I have not encountered so direct and specific an inversion of the true facts.

Recent years have added to the mortality records of our cities a surprising and alarming number of sudden deaths from heart failure. In the year 1902 New York City alone reported a death rate from this cause of 1.34 per thousand of population; that is about six times as great as the typhoid fever death record. It was about that time that the headache powders were being widely advertised, and there is every reason to believe that the increased mortality, which is still in evidence, is due largely to the secret weakening of the heart by acetanilid. Occasionally a death occurs so definitely traceable to this poison that there is no room for doubt, as in the following report by Dr. J. L. Miller, of Chicago, in the Journal of the American Medical Association, on the death of Mrs. Frances Robson:

"I was first called to see the patient, a young lady, physically sound, who had been taking Orangeine powders for a number of weeks for insomnia. The rest of the family noticed that she was very blue, and for this reason I was called. When I saw the patient she complained of a sense of faintness and inability to keep warm. At this time she had taken a box of six Orangeine powders within about eight hours. She was warned of the danger of continuing the indiscriminate use of the remedy, but insisted that many of her friends had used it and claimed that it was harmless. The family promised to see that she did not obtain any more of the remedy. Three days later, however, I was called to the house and found the patient dead. The family said that she had gone to her room the evening before in her usual health. The next morning, the patient not appearing, they investigated and found her dead. The case was reported to the coroner, and the coroner's verdict was: 'Death was from the effect of an overdose of Orangeine powders administered by her own hand, whether accidentally or otherwise, unknown to the jury.'"

Last July an 18-year-old Philadelphia girl got a box of Orangeine powders at a drug store, having been told that they would cure headache. There was nothing on the label or in the printed matter inclosed with the preparation warning her of the dangerous character of the nostrum. Following the printed advice, she took two powders. In three hours she was dead. Coroner Dugan's verdict follows:

"Mary A. Bispels came to her death from kidney and heart disease, aggravated by poisoning by acetanilid taken in Orangeine headache powders."