should come under the jurisdiction of the Bureau of Narcotics or the Food and Drug Administration. I believe that it is pretty much the opinion of the committee that some action must be taken at both the Federal and State levels on this problem. Mr. Jenkins, do you have anything to add? Mr. JENKINS. I will say this: As I understand it, your idea is much the same as mine, since we already have had some hearings with reference to the opinions of these different enforcing officers and potential enforcing officers. Now we are giving this opportunity to those who manufacture and sell these commodities to come in and give their side of the story. Mr. BOGGS. Our first witness this morning is Mr. Robert J. Creevy of the Western Medical Corp. Can you summarize your statement, Mr. Creevy? STATEMENT OF ROBERT J. CREEVY, VICE PRESIDENT, WESTERN MEDICAL CORP., CHICAGO, ILL. Mr. CREEVY. I am afraid that would be impossible if we were to tell our story effectively, because it is a complicated operation we are performing. Mr. BOGGS. It must be complicated to take up 25 or 30 pages. Mr. CREEVY. I think as we get into it you will find that is true. Mr. Chairman and members of the committee: My name is Robert J. Creevy. I am the vice president of the Western Medical Corp., of Chicago, Ill. Our company is a 31-year-old business, employing 105 people, and is engaged in providing medicines by mail for the control of epilepsy seizures. At the outset, I believe it is of extreme importance to read to the committee brief autobiographies of the members of our medical staff, licensed by law to practice medicine, who direct, at all times, the operations of the Western Medical Corp. These autobiographies were supplied to the Senate Committee on Labor and Public Welfare when its Subcommittee on Health was holding hearings on the DurhamHumphrey bill. The first is that of Dr. Harry L. James. (The material referred to is as follows:) BIOGRAPHIES OF THE PHYSICIANS OF THE WESTERN MEDICAL CORP. Harry L. James, M. D.: I attended the University of Chicago from 1902 to 1907, where I took undergraduate premedical courses. In 1907 I entered Northwestern University Medical School. I graduated from Northwestern in 1911 and obtained an Illinois medical license January 15, 1912. I practiced in Springfield, Ill., from 1912 to 1917. On June 15, 1917, I was commissioned as first lieutenant in the Medical Corps of the United States Army and later was promoted to captain. I served in the United States, France, and Germany with Field Hospital No. 131, Thirty-third Division, and Field Hospital No. 1, Second Division. I was discharged with honor from the service in November 1919. After my release from the Army, I was with the Intravenous Products Co. of America and the New York Intravenous Co. from 1920 until 1926. In 1926 I learned of the work of the Western Medical Corp. in the field of epilepsy and joined that organization as a staff physician. I have served continuously with this company since that time and have made a never-ending study of the disease of epilepsy and all its ramifications. Through my many years with the Western Medical Corp., thousands of epileptics have come to my office for free consultation. I was a member of the American Medical Association and the Sangamon County Medical Society until I entered the Army. After service I did not again join either of these organizations, although it was my privilege to do so. It should be mentioned that my father, Addison C. James, and my grandfather, Lorenzo James, both were well known and respected physicians in the State of Illinois. My father obtained his medical degree at Rush Medical College in 1880 and practiced medicine in Springfield, Ill., from 1880 until 1924. My grandfather graduated from the Academy of Medicine, Castletonia, in 1835, and his years as a physician were spent in Atlanta, Ill., from 1835 to 1886. J. J. Hennessey, M. D.: I graduated from the University of Chicago Medical School in 1935 and had my internship at the St. Francis Hospital in Blue Island, Ill. In 1936 I moved to Kankakee, Ill., where I had a private practice, and also was a member of the St. Mary's Hospital staff as physician and surgeon. also served in Kankakee County and southern Will County for the Veterans' Administration. I I went to Harvey, Ill., in 1941 and served as a regular staff member of the Ingalls Memorial Hospital in Harvey for several years. I became associated with the Western Medical Corp., in the year 1943 and have devoted myself entirely to this company's cause in the field of epilepsy since that time. In addition to being a physician and surgeon, I also am a registered pharmacist in the State of Illinois, having obtained a degree in pharmacy at the University of Illinois School of Pharmacy. Erwin S. Hottinger, M. D.: I entered the Northwestern University Medical School October 1902, from which I graduated June 21, 1906. Following graduation I won internship appointments at Cook County Hospital and Alexian Bros. Hospital in Chicago. I decided in favor of the latter and served 21 months as an intern at Alexian Bros. In addition, during 1908 and 1909 I did postgraduate work in Europe at the Clinics of Berlin and Vienna. After returning from Europe, I opened an office in Chicago and practiced in that city until 1917. I served in the First World War from April 1917 to June 1919 in the Army. Medical Corps with an artillery regiment in position warefare and all offensives of the American Expeditionary Forces and was awarded two citations as a result of my efforts. I was gassed and received one minor wound. I was a regular member of the Chicago Medical Society and the American Medical Association until about 1923-24 when I resigned, along with others in protest to the ouster of Dr. Louis E. Schmidt, noted urologist, when he gave his time and experience in helping to establish a social hygiene program for the city of Chicago. This was a free service to patients (except cost of drugs) in syphilology and venereal diseases, under the supervision of the Chicago Department of Health. I was also associated with Dr. Schmidt. In addition to my medical practice, I served as an instructor at Northwestern, Rush Medical School, and the Chicago Polyclinic. I had 36 years of active practice. However, because of having two coronary heart episodes and being ill 9 months, I was enjoined from doing general practice any more and entered the Western Medical Corp. employ July 24, 1942, because I believe they were doing a highly specialized and worthy work in the treatment of epileptics. I have daily, since that date, been concerned with the subject of epilepsy. I am a licensed physician in Illinois and Wisconsin. M. V. Kelly, M. D.: I attended West Virginia University Medical School from 1926 to 1928, and then continued my medical education at Rush Medical College in Chicago, Ill. I was graduated from Rush in 1930. Internships 1931-32: Highland Park Hospital, Highland Park, Ill.; Durand Hospital, Chicago, Ill.; Elgin State Hospital, Elgin, Ill. Staff physician: 1933, Elgin State Hospital, Elgin, Ill.; 1934-35, Weston State Hospital, Weston, W. Va.; 1936, Spring Grove State Colony, Spring Grove, Md.; 1937-38, State Colony, Colony, Va. I have had a great deal of experience in the management of all types of epilepsy in institutional work dealing with the more serious types of cases which cannot be treated in the ordinary home. During my years in this type of medical work in institutions, I dealt regularly with serious psychic disturbances, status epilep-, ticus, and other unusual problems associated with the disease of epilepsy. In the year 1938 I became acquainted with H. L. James, M. D., of the Western Medical Corp., and joined that company as a staff physician as I was very much impressed by the work its physicians were performing. I have remained in the employ of the Western Medical Corp. since 1938 and have devoted my full time to the particular field of epilepsy. I have never been a member of the American Medical Association or any of the smaller societies. Mr. CREEVY. I am accompanied by Dr. Kelley, whose medical background sketch I have just read, and who will be glad to answer any questions directed to him concerning the medical phase of our activities. I should also like to state that Western Medical has been investigated by the Federal Trade Commission and no cease and desist order resulted from that investigation, although we did make some changes in our manner of doing business. Your committee will also be interested in knowing that about a year and a half ago the Food and Drug Administration had an intensive, on-the-spot investigation of our company, and we have never been informed by them of any violations. Our company is engaged in providing medicines by mail for the control of epilepsy seizures. My purpose in appearing before this committee today is to present the true picture of our complex operations in the sincere hope that by so doing the Congress will better understand the good work we are doing and as a direct result of that better understanding will see fit not to take any legislative steps which would hinder or actually prevent us from giving continued assistance to thousands of epileptics. We are aware of the seriousness of the problem of increased misuse of barbiturates; however, it is our contention the Western Medical Corp. is not responsible for abuses, but is instead responsible for the production of relief and security in the homes of multitudes of epileptics through the carefully-controlled use of phenobarbital and many other medicines. It may upon initial consideration seem impossible that an epileptic could be helped by mail when local medical efforts had failed to produce satisfactory results; however, it is believed the following detailed explanation of our methods will successfully erase the doubts, if any, which may exist in your minds at present as a result of reports you may have received from other sources. The statement we have prepared is necessarily quite lengthy. It is hoped, for the sake of our epileptic patients, we will be given the opportunity to not only complete the presentation of this statement, but to openly discuss all matters related to the Western Medical Corp. which are of interest to the members of the committee. With your permission I will give you the story of our operations before coming to the discussion of barbiturate legislation, as I consider it necessary to give you a general understanding of our procedures before the subject of new Federal legislation for drugs and our relationship to that problem can be intelligently discussed. It is the sole aim of our organization to provide relief for those unfortunately afflicted with the disease of epilepsy through three distinct steps, supervised at all times by licensed physicians who have devoted many years to this particular field of medicine. First, anticonvulsant therapy is provided in dosages suited to the needs of each individual patient. Second, multivitamin and mineral medication is given on a continuing basis in a direct effort to improve the patient's general physical health. Third, our physicians through carefully prepared individualized letters provide psychological encouragement for each patient. This last portion of our treatment intended for the control of epilepsy seizures is of extreme importance and is generally recognized as an indispensable adjunct to the anticonvulsant medicines in the successful management of this dread disease. Every effort is made to aid all of our patients to realize that there is no disgrace in being epileptic and that there is a place for them in our society alongside those not afflicted. Mr. Chairman, I think it is extremely important to advise the committee that our patients do not come to us through newspaper, magazine, television, or radio advertising. When a direct inquiry from the prospective patient is received by the Western Medical Corp., a letter explaining our method of treatment for epilepsy is immediately mailed to the person making the inquiry. In addition to the reply letter, a considerable amount of descriptive literature is sent to the inquiring person. If, upon receipt of our reply and additional literature, a prospective patient wishes to take advantage of our method of treatment, he then, in accordance with our instructions, completes a lengthy case history form which is concerned only with the individual patient. On this form the questions presented, if answered properly, give our physician a thorough knowledge of the type and severity of the prospective patient's attacks. Two additional questions of extreme importance which appear on this form are: A. Has your case been diagnosed as epilepsy by a physician? If the answer to the diagnosis question is "No," we do not accept the case for treatment under any circumstances, even though the prospective patient may give a vivid description of seizures which are most likely epileptic. Mr. BOGGS. Suppose they use a fictitious name? Mr. CREEVY. I am coming to that. We realize that is a problem and I explain that in detail. We do not attempt at any time to diagnose by mail, nor have we at any time ever claimed to cure anyone of epilepsy. Prospective patients sending case histories are now required to give us samples of the anticonvulsants they are taking from their personal physician, at the time of expressing their wish to come under Western Medical's care, insofar as treatment of their seizures is concerned. Mr. BOGGS. You never claim to cure epilepsy? Mr. CREEVY. That is right. We never do. There may have been reports that we have, but I think it can be established we have never claimed to cure anyone of that. Mr. BOGGS. You never have had any difficulty with the Food and Drug Administration? Mr. CREEVY. No, but with the Federal Trade Commission which implied we were stating a cure was possible. However, even at the time that was suggested we had in our literature definite information stating we did not cure epilepsy. Mr. BOGGS. Did you change your literature after that? Mr. CREEVY. That was years ago, and our literature has been changed completely since that time. We have definitely never claimed to cure anyone of epilepsy. These sample medicines are mostly prescription drugs and in almost every case are medicines which are prescribed only for the control of epilepsy seizures. To properly obtain drugs used only for epileptics and for no other purpose a patient would necessarily have obtained a diagnosis of epilepsy from a local physician or else his physician definitely would not have prescribed such medicines for him. Under our present procedure if a prospective patient sends us samples of phenobarbital only (or any other barbiturate) which may be used for the control of epilepsy seizures and many other purposes as well, we then require that individual to send us a statement signed by a licensed physician certifying the prospective patient to be an epileptic. We have taken this precautionary step for the protection of the public as well as ourselves. This system is considered more than adequate in preventing nonepileptics from obtaining Western Medical's medicine through fraud. The initial treatment may consist of anticonvulsant medication, principally phenobarbital, multivitamins or multivitamin mineral combinations and laxative tablets. Phenobarbital is used primarily for three reasons: First, because Western Medical physicians (with convincing medical support) believe it to be the most effective anticonvulsant agent known today. Second, because experience has shown phenobarbital to be by far the least toxic of effective anticonvulsant agents. Third, because the patient is spared the heartbreak of having the attacks controlled only to find suddenly that it is necessary to discontinue treatment due to severe side reactions, possibly seriously toxic in nature, which frequently occur when some other drugs are used. It is most important to note that in addition to the combination of medicines mentioned in the foregoing paragraph the Western Medical physicians may employ other very effective preparations. Tribromotertiary butyl alcohol is used in combination with phenobarbital and the other portions of the treatment is particularly resistant cases. This preparation is made only for the Western Medical Corp. and cannot be purchased from any other source at this time. Also, caffeine, alkaloid and ammonium chloride are employed with excellent results in difficult cases. Dilantin also is used as an adjunct to the other medicines. However, this drug, because of its toxic potential, is never prescribed unless regular protective laboratory precautions are taken. The necessary laboratory work is always performed by local physicians or technicians. It is significant to note that even though plain phenobarbital can certainly be purchased on prescription at any drugstore, it is not possible to obtain the formula containing phenobarbital used by the Western Medical Corp. from any source other than the company itself. Returning to our procedure, if all of our protective requirements are met and the questions on the case history are properly answered, |