FOR ANALGESIC ACTIVITY 0292* Tablets 0222*Tablets INDICATIONS: For relief of mild to moderate pain, fever and inflammation as in influenza, common cold, low back and neck pain, headache, trauma, following dental and surgical procedures. DOSAGE: 222*.Adults.1 or 2 tablets one to three times daily; Children's dosage, when recommended bya physician: 10 to 14 years, one tablet, one to three times daily; 5 to 10 years, one-half tablet, one to three times daily; 292*. Aduits-1 tablet two to three times daily. CONTRAINDICATIONS: Gastrointestinal ulceration and sensitivity to any of the components. WARNINGS: Salicylates increase the effects of anticoagulants. Caution is necessary when salicylates and anticoagulants are prescribed concurrently. Also, salicylates may depress the concentration of prothrombln in the plasma. Large doses of salicylates may affect insulin requirements of diabetics. Salicylates may potentiate sulfonylurea hypoglycemic agents. Analgesic abuse (excessive and prolonged therapy) has been associated with nephropathy. TO AVOID ACCIDENTAL POISONING ACETYLSALICYLIC ACID PREPARATIONS MUST BE KEPT WELL OUT OF REACH OF CHILDREN. PRECAUTIONS: Give with caution to patients with asthma, other allergic conditions, bleeding tendencies, or hypoprothrombinemia. Saucylates can produce changes in thyroid function tests. Observe care in use of codeine, aithough tolerance and addiction are rare. Give codeine with caution to patients with severe respiratory depression. Its depressant effect may be enhanced by concurrent administration of sedatives and tranquilizers. ADVERSE REACTIONS: Acetylaailcyilc acid: Gastrointestinal: dyspepsia, heartburn, nausea, vomiting, diarrhea, gastrointestinal ulceration and bleeding. Ear reactions: tinnitus, hearing loss. Hematologic: anemia, leukopenia, thrombocytopenia, purpura. Dermatologic and Hypersensitivity: urticaria, angioedema, pruritus, various skin eruptions, asthma and anaphylaxis. Misceiianeous: mental confusion, drowsiness, sweating and thirst. Codeine: Average or large doses may cause various gastrointestinal symptoms such as nausea, vomiting and constipation. Caffeine: May cause nausea, nervousness, insomnia, headache, vomiting, palpitation, vertigo, muscle tremor, sensory disturbances, excessive diuresis in sensitive patients. Large doses may cause gastric ulceration. FULL INFORMATION AVAILABLE ON REQUEST HOW SUPPLIED 0292* Tablets - Peach, 0 marked, scored, engraved 292 on one side. Each tablet contains: acetylsalicylic acid 375 mg, caffeine citrate 30 mg, codeine phosphate 30 mg. Available in bottles of 50 and 500. 0222* Tablets - White, scored, engraved 222 on one side. Each tablet contains: acetylsalicylic acid 375 mg, caffeine citrate 30 mg, codeine phosphate 8 mg. Available in tubes of 12; botties of 40 and 100; also bottles of 60 with safety cap.
FOUNDED IN CANADA IN 1899 CHARlES E. FROSST & CO. KIRKLAND (MONTREAL) CANADA
ly understood. If the pressure within the container is increased, the diameter of the balloon is symmetrically decreased; the force acting on the wall of the balloon would tend, if anything, to prevent the formation of diverticula. CHARLES J. WRIGHT, MB, CH B, M Sc, FRCS[C], FRCS (ENG & EDIN) Department of surgery University Hospital Saskatoon, Sask.
achieve and why. Hepburn would agree with Dr. Wade Hampton Frost, who was supported by another of the greatest in the history of medicine, Dr. Charles V. Chapin,1 that such rendering account is not only the scientific way and the way to progress but also the only honest way. NEll. E. MCKINNON, MD 16 Eastbourne Ave. Toronto, Ont.
Evaluation in medicine
1. CHAPIN CV: In Discussion, FROST wH: Am J Public Health 15: 194, 1925
To the editor: The following comment came, unsolicited, from a recent graduate of one of the outstanding medical Recombinant DNA experiments schools in London, England. and universal guidelines In our whole medical course, we got nothing on evaluation. We were drilled, To the editor: Last February the Medand I think very effectively, in diagnosis; ical Research Council (MRC) officially then the instructor, the authority whose words were sacrosanct, told us what to adopted the report from its ad hoc comdo and how to do it. But not one word of mittee on guidelines for handling recomevaluation! Not a word even about the binant DNA molecules and animal use of simple arithmetic, for example, for viruses and cells. This committee was comparison of attack-rates, case-fatality made up of some of the most eminent rates, survival rates, etc.! It was not until members of the Canadian scientific I came to this country I found out, not community, all experts in the field of only the absolute necessity for constant viruses or DNA recombination or both. evaluation, but also the fascination and The committee was chaired by Dr. Louis satisfaction of it. Siminovitch, one of the world's leadThis is traditional medicine, in ac- ing geneticists. The MRC and its comcord with the Hippocratic oath. mittee must be complimented on a In this connection the preterminal magnificent report that has no equal for judgement of Dr. John Hepburn is lucid and clear presentation. Such a rehighly relevant and significant. Dr. port should be in the hands of all bioHepburn was a company sergeant-ma- medical research workers in Canada jor in the infantry in World War I, and be given as wide dissemination as carried shrapnel in his back to the end possible. of his days and graduated in medicine It is sad that every country has to in 1921. He was an outstanding car- evaluate a problem, its risks and its diologist, widely and favourably known advantages when it would be to greater throughout Canada and beyond, and advantage, for a lesser expenditure of was a past president of the Royal Col- energy, time and monies, to have the lege of Physicians and Surgeons of World Health Organization or the Canada. He was referred to by Dr. United Nations make such guidelines John Qille, of revered memory, as the and apply the strongest possible moral most honest man Oille had every pressure on all countries for their uniknown - surely a worthy representa- versal adoption. It would defeat the tive of his time. A short time before purpose if Canada, the United States his untimely and lamented death Hep- and Great Britain were the only counburn said, "Here I am at the end of the tries to stick by these guidelines while road and I don't know whether any- competent scientists in other countries thing I ever did was worth a damn without such guidelines could perform the types of experiments that are danIt isn't right." His meaning is clear enough. He gerous, involving grave risks for manmeant that anyone graduating in medi- kind. The dissemination of the knowlcine - or even having spent a lifetime edge is so wide and our world so small in medical practice - should carry that it is crucial that such regulations constantly an acute sense of the im- be devised and adopted by a world perative necessity for evaluating and body and applied universally. These re-evaluating all pertinent evidence, three countries, led by leading and socrucially discounting or rejecting the cially conscious scientists, have shown hazards of bias and opinions that lack the way and it is to be hoped that huan adequate basis. He meant that we man wisdom will prevail for the worldowe it to ourselves as well as to our wide application of these guidelines. patients to know as precisely as posJACQUES GENEST, CC, MD, LL D, sible what we expect or hope to achieve 11 SC, FACP, FRCP[C], FRC5 Scientific director with any patient, what we actually Clinical Research institute of Montreal achieve, and how and what we fail to Montreal, PQ 116 981 7, 1977/VOL. CMA JOURNAL/MAY