วันอังคารที่ 1 พฤศจิกายน พ.ศ. 2554

Prelude to misery

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Stephen Walker- Shockwave: Countdown to Hiroshima

There are several great and insightful books written about the bomb (with Richard Rhodes's book being the gold standard), and one is always prone to wonder if there could be anything new on the topic. However, no book, for lack of space, can cover all aspects of this momentous and defining time in history. Stephen Walker's Countdown To Hiroshima is the best account I have seen yet of the personal perspectives of some of the men and women who worked on the bomb. Walker sometimes gives an almost minute-by-minute description of events as a chapter. For example, shortly before the bombing, one chapter is titled "One hour to Hiroshima". The next chapter actually is "45 seconds to Hiroshima", with a riveting description of the dropping and explosion of the bomb almost by the second.

Even among the people who Walker portrays, many of whom were ordinary people who became extraordinary, he especially focuses on two sets of pivotal actors; the men who organised the first atomic bomb detonation in the hot desert of New Mexico on an eerie, black morning, and later and most importantly, the remarkable small group of men who flew the planes that dropped the bomb and changed history. But Walker also considerably focuses on the men and women who finally bore the terrifying relentless of this fever pitch- the people of Hiroshima and Nagasaki, and their leaders.

It was through this book that I got to know about the monumental challenges that the bombers and their commanders faced, and the obssessive yet essentially security that enveloped the whole operation. Walker begins with a riveting account of Trinity, the first atomic bomb test. He focuses on Don Hornig, a young physicist whose job was to safeguard the bomb before the test. The test was conducted in the desert haunts of New Mexico during the black haze of dawn. Everybody had nerves of steel in the moments leading to the test. Nobel laureates worked together with technicians and construction workers. Nothing could be left to chance. Robert Oppenheimer flitted in and out of the scenes, his body racked by a cough worked up by years of compulsive chain-smoking. Everybody worried about his health; he had been almost physically present at every step leading to the bomb in the last four years.
Don Hornig's job was to babysit the bomb on top of a tower where it was supposed to be detonated. Walker paints vivid and apocalyptic sounding accounts of the rain that suddenly turned the desert into muck, the thunder that growled as if in retaliation for some sin that the scientists were committing, and the flashes of lightning that actually threatened to detonate the bomb. The bomb was almost a religious experience for some. Walker takes us to the top of the tower with Don Hornig, sitting beside that black nebulous object amid lightning and thunder inside a makeshift tent. It was only a few minutes before the detonation that Hornig was ordered to step down from the tower. The rest is history. A new force was born in the next few minutes, brighter than than the sun, that has nonetheless cast humanity into a suicidal straitjacket ever since.

The people of Hiroshima of course did not know anything about this. They were gearing up to fight to the last man, woman, and child. The depiction of life in the city is stark. Rationing was strictly enforced, and everybody was supposed to do the backbreaking work necessary to defend their homeland, age and physical condition notwithstanding. Walker focuses on a few sets of people whose lives, either shattered or tragically cut short, he traces in the last few days before August 6. There are the two sisters, one of them sick, who have to come down from their home in the hills everyday to pick grass for eating. There is the doctor who has already been sickened by the war and envelops himself into a drunken stupor the night before. There are the lovers who hold hands in the garden of Hiroshima on the night before, confident that the war can end soon and they can get married. The bomb has the capacity to change everything into nothing, all this imagery, all the stuff which is the raw material for stories and civilization.

It is also interesting to read the political deliberations that went on in the Japanese and US governments. Walker has had access to newly declassified documents, and from them, one gets the painful sense of lost opportunity that could have made things so much more different. For one thing, many Japanese ministers and leaders wanted to negotiate with the US through the Soviet Union for surrender, with the singular condition that they could keep their emperor. There were others though who subscribed to the standard Japanese tradition of considering the thought of surrender as the most revolting and cowardly thing they could possibly do. Our brave soldiers have died in the thousands defending Okinawa, Guadalcanal, Iwo Jima. We should not let their sacrifice be for nothing. We will train our teenage girls to fight to their last breath, with bamboo spears in the absence of all other weapons...One can only remotely imagine the nightmare that would have been precipitated if it become necessary for the Allies to storm the beaches of Japan.

But even more than the Japanese, the Allies lost a chance not only to avoid getting a blot on the escutcheon of their history, but also to preserve their hard won nuclear knowledge and preserve the lead for a little while more in the arms race. It is now clear that Truman and others consistently ignored entertaining the thought of letting the Japanese surrender by keeping their emperor. They did not do this with the wilful intention of killing innocent Japanese, but as I have written before, they were too preoccupied with possible Allied casualties, and more tellingly with the diplomatic potential of the bomb, to contemplate conditional Japanese surrender. Truman's secretary of state Henry Stimson had visited and studied Japan and knew of the strong commitment to culture, emperor, and traditions that the Japanese exemplified. Truman chose instead to focus on the looming Soviet threat. The atomic bomb would be the perfect preemptive weapon.
History would indeed have been very different if Truman had considered letting the Japanese keep their emperor and surrender without the bomb, something to which they would likely have agreed sooner of later. That he did not in some ways paved the way for the next fifty years of nuclear enslavement, a trend that continues to the present day.

But the main part of the book really concerns men about whom relatively less has been written. These were the men who commandeered the planes that dropped the bombs. Walker's book will put to rest any illusions that dropping the bomb was as easy as uploading it onto a standard bomber and then simply releasing it at the opportune moment. Dropping the bomb involved choosing the best bomber pilots in the air-force, training them for almost a year at a top-secret base in Utah, acclimatizing them to the rigors of living and traning in the South Pacific, and finally making sure that they preserve the nerves to carry out their mission. To lead such a band of handpicked and hardened pilots, technicians, bombers, and crew would need a remarkable air-force commander. Fortunately, Colonel Paul Tibbets was just the man for the mission.

Probably the most amusing anecdote in the book concerns the grilling that Tibbets received before they could make sure he was the perfect man for the mission. Experience and skill was not an issue; Tibbets had been one of the best bomber pilots in Europe. But to lead and organise such a secret mission, it would take much more than just skill. They wanted to look for rock solid resolve, courage, and also honesty, so that the man would never compromise the utmost secrecy of the project. To gauge these qualities, they asked Tibbets if he had ever been arrested. There was one occasion when Tibbets had been arrested for being in intimate association with a women in the back of a car on a Florida beach. The officials waited for his answer. If Tibbets lied, he would have been out of the show right away. Tibbets spoke the truth, and changed his life for all of of history to read about.

In Wendover, Utah, Tibbets assembled a crew of handpicked men who would accompany him on the flight. They trained for a year in specially modified B-29 bombers, day after day, making pass after pass in the air, till they would get it perfect and drop with fatigue. Life in Wendover did not come without perks. To make sure they stayed happy and honest, Tibbets's men were given carte blanche to behave almost any way they wanted. Alcohol was generously supplied in infinite quantities. Living quarters were such that generals would not get them. Affairs with local girls were hushed up with bribery and cajoling. The men could not be distracted from their goal, which in large part involved a single manuever, to learn to bank at an angle of 60 degrees and fly away as fast as they could. This was for an important reason on which their lives depended; the bomb's shockwave would rapidly reach them, and this impossible pass in the air was about the only way they could get away from it safely without having their plane flattened like a tin can. But they did learn how to do the pass, after practising it literally thousands of times, until they could do it blindfolded.

From Wendover, the team flew to Tinian Island, one of the hard won, sun baked South Pacific islands that the Allies had captured the previous year. In the sweltering year-round heat, the island had been turned into an engineering marvel, the largest airforce base in the world until then, with the largest possible runways one could imagine. The few Japanese who had escaped into the overlooking hills watched with frightened faces and wide eyes. The giant B-29s that bombed Japan day and night lined up like hundred of mosquitoes or pirhanas, and like zombies, got off the runway, dropped their cartload of bombs on Japan relentlessly, and came back for more before taking off again. The operation was harsh and obssesive, because it was commandeered by the harshest and most obssesive man in the armed forces- Curtis LeMay. LeMay had only one mission, to bomb Japan back to the stone age until it surrendered. There was absolutely no concern in his mind about civilian deaths or their numbers. Indeed, LeMay probably annihilated more cities and people than either "Butcher" Harris (commander of the RAF who ordered the Hamburg and Dresden bombing raids) or Hermann Goering (commander of the Luftwaffe). It is one of the ironies of history that by the time the bomb crew was ready to drop their payload, Japan was a smouldering heap in which many times more people had been killed than would die in the atomic bombings.

Walker also gives a good sense of the immense secrecy surrounding the project. None of the bomber crew except Tibbets actually knew what kind of bomb they were going to drop. Nobody else on the whole of Tinian Island except the general commander knew what the crew was there for. The assembly of the bombs took place in remote buildings on the island. The buildings were guarded around the clock with dozens of military police (who also did not know what was going on inside). The secrecy was enforced without exception; there were shoot-on-sight orders for anyone who ventured close to the bulidings, generals included. The uranium and plutonium bombs promptly made their way after the test to Tinian, one on a ship guarded by men willing to pay with their lives, and the other one by plane. With the bomb sat specialists recruited by Oppenheimer for their realiability and nerves, specially inducted into the army for the mission. One of them was Deke Parsons, whose job was to "arm" the bomb in flight. Walker conveys the immense difficulty of this seemingly simple task. The bombs could not be armed before they were loaded on because there was actually a danger that they could detonate prematurely by electrical discharges or impact. Once on board, they had to be armed quickly, in an extremely cramped space amid turbulence and constant movement. The arming was complex, with many pins to be inserted, removed, and turned. The casing was rough. Parson, like a man possessed, practised arming the bomb in the 100 degree heat for hours when the plane was on the ground, until his hand was bleeding from the effort. Once up in the sky, failure could not possibly be contemplated.

On Tinian as in Wendover, the quirky crew, men of all shapes, sizes, and inclinations and personalities, were treated like kings. The treatment oddly resembled that given to condemned men before they are executed. They were treated to fine gourmet food specially made by the chef, gallons of booze, air-conditioned quarters, movies in their own theater. Jealous and curious inquirers were quickly shooed away at gunpoint. Even if the men did not know their exact mission till the last moment, they knew that it carried the risk of capture or easy destruction. To make sure the weather was right for bombing and to serve as a cover against anti-aircraft fire, two other planes would lead the plane with the bomb. Taking off itself was no simple operation. With the increased load, the plans could easy tumble down and crash on the runway, ending the mission, the lives of the crew, and possibly detonating the bomb and the entire island before it all even began. It was hard to imagine anyone in the world except Tibbets and his crew pulling it off at that point.

On the day of reckoning, Deke Parson finally told them the nature of the "gadget" that armed guards had been safeguarding with their life for so long, and which they were supposed to deliver that day. He still did not tell them the mechanism by which the gadget operated. Before the crew took off, they posed for historic photographs. Just before take off and after coming back, they would become some of the most unlikely rock stars of the century. Tibbets's mother went down in history. Her proud son named his plane after her- Enola Gay.

After take off, things went smoothly. But a measure of how much attention to detail had to be still paid is illustrated by a fascinating fact recounted by Walker. The bomb was exquisitely designed to be detonated at a particular height above the ground, where it would cause the most destruction. To achieve this, it had built inside, a precise set of radar antennas that were activated sequentially. Each radar antenna would send signals vertically to the ground as the bomb was falling, and judge the height from the reflected signal. The timing circuitry was programmed to detonate the bomb at the precise height as indicated by the antenna. But there was a problem. If Japanese radio transmitters broadcast anything at the particular radar frequency, the bomb could be activated and possibly detonate in flight. To circumvent this deadly and bizarre possibility, one man was recruited for the express purpose of scanning radar frequencies emitted by Japanese transmitters. Space on the Enola Gay was exclusive to say the least. The radar scanner was finally installed in the only remaining space- beside the toilet.
As the bomb falls, Walker's riveting, almost second-by-second account of what was happening inside it and inside the plane creates a bizarre contrast; a clinical and sanitized description of bomb and flight physics, as if almost divorced from the very much human impact that was going to be created in ten seconds.

If one can call anything associated with the conception of such a terrible weapon as perfect, then everything in the mission went perfectly. The weather cleared up soon, but not before Hiroshima was consigned to fate at the last moment; the initial intended target was Kokura. It was the bad weather over Kokura that sealed Hiroshima's fate. Apart from this, the mission went smoothly, with no Japanese antiaircraft fire, and perfect detonation and destruction of a beautiful city. As they watched the burgeoning mushroom cloud with astonishment, the crew of the Enola Gay exemplified the ambivalence about the bomb that everyone has felt since then. For some, it was simply a job to be done. For others, it was a vision that would rob them of sleep throughout their lives. After coming back, the men were in a surreal mood, not having slept in days. They were hounded by the media and declared heroes. Everyone was satisfied and happy, including General Leslie Groves, head of the Manhattan Project in Washington, but admittedly excluding Robert Oppenheimer.

In Hiroshima of course, the story was different. Walker gives a sobering narration of the destruction of the city. These stories have been recounted in detail in dozens of books, including John Hersey's famous Hiroshima and Rhodes's book. There was the drunken and disturbed doctor, who was saved from the brink of death because he had to attend an early morning house call on a house on a nearby hill. When he started walking back to the city, dazed, the sky a fantastic hue of colours in the background, he saw people looking like zombies ascending the hill towards him. Many of them uttered animal-like screams and fell down motionless. They were human beings, charred black by the heat, bones sticking out, desperately looking for water, and a way to survive. The man who had spent the earlier night with his lover in the garden never saw her again. The sister whose twin was sick did not see her either. The soldier who was on duty a short distance away saw two huddled figures, his wife and child, blackened and fused together on the road near his house. All he did was pick the bones up, to bury the later. Many of these survivors must have died of radiation poisoning later. The few surviving photographs of the time depict a snapshot of misery and things that the human mind can do, tales for generations to come.

Paul Tibbets is still alive. To this day, he has never regretted dropping the bomb.

วันเสาร์ที่ 29 ตุลาคม พ.ศ. 2554

Medical Quackery Meets Legal Quackery

If there's one thing I can't stand, it's lawsuits that are only filed to intimidate people into silence. Well, there are lots of things that I can't stand, actually, but this one sucks because, not only does it inconvenience the people who run web sites and news businesses, but it often deprives us, the readers, of useful information. Hiring lawyers is expensive, even when all you have to do is show up and ask the legal equivalent of "why are they wasting our time by filing this suit?"

A case in point is a suit recently filed by a medical laboratory that was accused of fulfilling requests for tests of dubious medical value. The lab, Doctor's Data, Inc. (DDI), was identified as having performed such a test by Steven Barrett, a retired psychiatrist according to his web bio, who runs a website named Quackwatch. The article begins:


Many patients are falsely told that their body has dangerously high levels of lead, mercury, or other heavy metals and should be "detoxified" to reduce these levels. This article explains how a urine test is used to defraud patients.

The report pictured to the right is a "urine toxic metals" test from Doctor's Data, a Chicago-based laboratory that caters to chelation therapists and other offbeat practitioners. The patient who gave it to me was told that his mercury and lead levels were high and should be reduced with EDTA chelation therapy.

How the "Urine Toxic Metals" Test Is Used to Defraud Patients

Chelation, incidentally, is a treatment where chemicals are introduced into a patient for the purpose of removing metals from his body. What that does is raise the level of mercury detected in the subject's urine:

In contrast, Doctor's Data uses reference values of less than 3 ug/g for mercury and 5 ug/g for lead. Standard laboratories that process non-provoked samples use much higher reference ranges [4,5], which means that if all other things were equal, Doctor's Data is far more likely than standard labs to report "elevated" levels. But that's not all. A disclaimer at the bottom of the above lab report states—in boldfaced type!—that "reference ranges are representative of a healthy population under non-challenge or nonprovoked conditions." In other words, they should not be applied to specimens that were obtained after provocation. Also note that the specimen was obtained over a 6-hour period, not the standard 24-hour period, which raised the reported level even higher.


How the "Urine Toxic Metals" Test Is Used to Defraud Patients

As befits a medical site, it goes on for some length about why this isn't a valid test. The upshot is that a patient who was given this test would assume he had unhealthy levels of mercury or other heavy metals in his body, when that was not really the case. Several states, according to Dr. Barrett, have found that using this form of test was worthy of censure or suspension of a doctor's license.

To make matters worse, one of the cures for excess heavy metal toxicity is chelation, which has some dangerous potential side effects:

Absolutely! All chelating agents have both minor and potentially life threatening side effects. They must be used under the supervision of a physician in a hospital setting.

Side effects of CaNa2-EDTA include: [kidney damage, loss of nutrient metals like iron and zinc, skin peeling]

Your online pharmacy: Chelation Therapy

It's not something you want to go through if you don't have to.

Orac, who writes the medical blog Respectful Insolence, takes up the tale from there:

[P]rovoked urine testing is a bogus test. According to Dr. Barrett, only does DDI use reference ranges for unprovoked urine tests, values that are utterly meaningless for provoked urine testing, but it uses reference ranges that are lower than what is commonly accepted by reputable laboratories and academic medical centers. This combination of factors virtually guarantees that it will produce many "positive" results for "elevated" mercury and other heavy metals in the urine, which practitioners can then apply dubious therapies, such as chelation therapy, to treat. Obviously DDI disputes this, but it doesn't provide any quality scientific data to do so, in my opinion. Consequently, in my view, what DDI does in essence is to do a technically sound measurement of mercury and heavy metals in the urine but on urine specimens collected using a completely inappropriate methodology that is not scientifically or medically valid.

More Legal Thuggery

As you might expect, DDI took action, which was to sue Dr. Barrett. They sent a cease and desist letter to Dr. Barrett which did not identify the specific things they found wrong with his article. The letter is reprinted in that link, by the way. Barrett requested that they identify the portions of the article that they found objectionable, and he would try to correct it if possible. They did not. As Orac explains:

This is typical. Note that [DDI lawyer Algis] Augustine doesn't actually list which specific parts of Dr. Barrett's article are incorrect, false, fraudulent or otherwise not truthful in the view of his client. Doctor's Data doesn't appear to be interested in accuracy, at least not if the letter from its lawyer is any indication. It appears far more interested in shutting up the opposition, of purging the Internet of material that can be used against it in the lawsuit it is facing in Texas. The rest of the text of the letter comes close to actually admitting this.

More Legal Thuggery

Which is what honks me off. As I said, lawyers are expensive. This kind of lawsuit, commonly referred to as strategic lawsuits against public participation or SLAPP suits, are discouraged in some states by making the losing party in such suits pay all court costs. But that's not true everywhere. According to John Pieret, an attorney who runs the site Thoughts In A Haystack, DDI's case has little merit. In his first reaction, he wrote:

As I explained in my post about the the suit by the doyen of the anti-vaccination movement, Barbara Loe Fisher, against Dr. Paul Offit, under US libel law, specific words must be alleged that make a factual claim about a person. Complaining that you are described as part of a class of people who are irrational, uneducated, unscientific, controlled by fear and/or a danger to public health is not enough to allege defamation under US law.

So, saying that someone is "catering" to loonies "nonstandard practitioners" is not good enough. Not only is that not a factual claim, but no reasonable person could interpret that as anything other than a statement of opinion, which is fully protected speech under the First Amendment. As I pointed out before, even calling someone a "pathological liar" is protected speech, so it is hard to see how calling someone a 'caterer' could rise to the level of defamation.

This Could Take Awhile

In a later article, he added:

The Doctor's Data, Inc. (DDI) suit against Dr. Stephen J. Barrett and his excellent resources Quackwatch and The National Council Against Health Fraud is a piece of work. It's not loony-tunes, like the Institute for Creation Research's lawsuit against the Texas Higher Education Coordinating Board. In some ways, it is much worse. It is a professionally drafted complaint that throws plenty of s**t against the wall in hopes that something might stick. It is nothing but (a lot of) smoke and mirrors in furtherance of an obvious SLAPP suit.

The DDI DDIdn't

It appears that John hasn't quite gotten all the way through the complaint yet, so he may have additional thoughts. I doubt, though, that this basic opinion will change.

Which means that there's a website that needs help. Quackwatch provides a valuable service, which is to warn us against the sort of quackery that this lab seems to be enabling. Letting miscreants intimidate expert bloggers into silence will only make it that much harder to get honest information.

So, if you can, please drop a bit of change at Quackwatch's contributions page.

UPDATE: John Pieret was kind enough to add this in a comment:

Just so you know, I've been through all the allegations of fact and I don't see any viable actions for libel. But the plaintiff has included claims for "restraint of trade" under Federal law, "trademark dilution," "consumer fraud" and "deceptive trade practices" under Illinois law, "tortious interference with contracts," "fraud" and "civil conspiracy." None of those should survive a determination that Barrett was exercising his freedom of speech but they introduce nuances that I'm not yet willing to pontificate on.

Medical Quackery Meets Legal Quackery: Comment #1

Thanks for that update, John. As a non-lawyer, it's hard for me to believe they'd have much of a case with any of that, but the courts seem to make a habit of surprising me.


วันจันทร์ที่ 23 พฤษภาคม พ.ศ. 2554

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    5. Suwe-Xi kapsul produksi PJ Kaki Langit Jawa Tengah (mengandung sildenafil sitrat, nomor izin edar fiktif).
    6. Tang Pe Fu Serbuk produksi PJ Alami Makassar (mengandung sildenafil sitrat, nomor izin edar fiktif).
    7. Purwoceng Serbuk produksi PJ Sidowaras (mengandung fenilbutason, tidak terdaftar).
    8. Tangkur Buaya Super Kapsul produksi PD. Meringis Sehat Jawa Tengah (mengandung parasetamol, tidak terdaftar).
    9. World Quick Strong Kapsul produksi World (Tianjin) Nutrition & Health Food Co.Ltd/PT Woo Tekh Indonesia (mengandung Tadalafil, tidak terdaftar).

    C. Obat Tradisional Lain
    1. Yin Chiao Tablet produksi Cengde Trad. Chinese Medicine Factory/PT Tjahaja Baru Surabaya (mengandung parasetamol, izin edar dibatalkan).
    2. Zhongganling Pian Tablet produksi Guangdong Jiaying Pharm Co.Ltd/PT Intra Aries Jakarta (mengandunng metampiron, izin edar dibatalkan).
    3. Zhong Gan Ling Pian Tablet produksi Heping Pharmaceutical Factory Guangdong Cina/PT Sinar Herba Radix Jakarta (mengandung metampiron, ijin edar dibatalkan).
    4. Wan Tong Pegal Linu Kapsul produksi PJ Herbalindo SM (mengandung parasetamol, izin edar dibatalkan).
    5. Wan Tong Pegal Linu Rheumatik produksi PJ Herbalindo SM (mengandung parasetamol, izin edar dibatalkan).
    6. Pegal Linu Cap Putri Sakti Cairan Obat Dalam produksi H. Moh. Khusni Banyuwangi (mengandung fenilbutason, izin edar dibatalkan).
    7. Salurat Putri Sakti Cairan Obat Dalam produksi H. Moh. Khusni Banyuwangi (mengandung fenilbutason, izin edar dibatalkan).
    8. Jaya Asli Anrat Serbuk produksi PJ Jaya Asli Cilacap (mengandung fenilbutason, izin edar dibatalkan).
    9. Akar Dewi Putri Multi Khasiat Serbuk produksi CV Laser Group (mengandung parasetamol, izin edar dibatalkan).
    10. Pamong Raga Pegel Linu Serbuk produksi IKOT Kopja Aneka Sari Unit I Cilacap (mengandung fenilbutason, izin edar dibatalkan).
    11. Pegal Linu Kalimajaya Serbuk produksi Drs. H. Moh. Nur Hidayat, Kopja Aneka Sari Unit IX Sifaul Mustajab Cilacap (mengandung fenilbutason, izin edar dibatalkan).
    12. Pegalinu No.2 Serbuk produksi PJ Cipta Rasa (mengandung fenilbutason, izin edar dibatalkan).
    13. Randa Linu (Asam Urat) Serbuk produksi Kopja Aneka Sari Unit III/PJ. Gunung Sugih Cilacap (mengandung parasetamol, izin edar dibatalkan).
    14. Sari Buana Serbuk produksi Kopja Aneka Sari Unit VII (mengandung parasetamol, izin edar dibatalkan).
    15. Turrat Serbuk produksi Serbuk produksi IJ Sinar Mujarab Mojokerto (mengandung, parasetamol, izin edar dibatalkan).
    16. Darah Tinggi Serbuk produksi CV Sinar Mujarab Jawa Tengah (mengandung parasetamol, tidak terdaftar).
    17. Gatal Eksim Serbuk produksi PJ Sinar Mujarab Jawa Tengah (mengandung parasetamol, tidak terdaftar).
    18. Sehat Boyok Sakit Pinggang Serbuk produksi CV Sinar Mujarab Nojokerto (mengandung parasetamol, tidak terdaftar).
    19. Sekalor Serbuk produksi CV Sinar Mujarab Jawa Timur (mengandung parasetamol, tidak terdaftar).
    20. Untabat (Batuk Pilek) Serbuk produksi CV Sinar Mujarab Mojokerto (mengandung parasetamol, tidak terdaftar).
    21. Arum Jaya Gemuk Sehat Serbuk produksi PJ Arum Jaya Cilacap (mengandung deksametason, tidak terdaftar)
    22. Asam Urat Akar Dewi Putri Serbuk produksi UD. Lazer Group, Lamongan (mengandung parasetamol, tidak terdaftar).
    23. Asam Urat cap Unta Kapsul produksi PJ Unta Mas Indonesia (mengandung fenilbutason, tidak terdaftar).
    24. Asam Urat, Flu Tulang & Pengapuran Buah Merah Serbuk produksi PJ Buah Alam Papua, Purwokerto, (mengandung parasetamol, tidak terdaftar).
    25. Asam Urat Nyeri Tulang Tjap Dua Daun Serbuk produksi PJ Brotowali, Solo, (mengandung parasetamol, tidak terdaftar).
    26. Asam Urat Rheumatik Akar Sirih Serbuk produksi PJ Inti Sehat Jawa Tengah (mengandung parasetamol, tidak terdaftar).
    27. Brantas, Obat Asam Urat Rheumatik, Nyeri Tulang Kapsul produksi PJ Ampuh Jaya, Cilacap, (mengandung parasetamol dan fenilbutason, tidak terdaftar).
    28. Buah Naga, Asam Urat dan Nyeri Tulang Kapsul produksi PJ Dua Walet, Kopja Aneka Sari, Cilacap (mengandung parasetamol dan fenilbutason, tidak terdaftar).
    29. Daun Dewa Kapsul produksi PJ Daun Dewa Makassar (mengandung fenilbutason, tidak terdaftar).
    30. Dewi Bulan Capsul Sakit Gigi & Sakit Kepala Cekot-cekot Kapsul produksi PJ Songgo Geni, Tangerang (mengandung parasetamol dan asam mefenamat, tidak terdaftar).
    31. Dua Walet Amrat Serbuk produksi PJ Dua Walet, Cilacap (mengandung parasetamol, tidak terdaftar).
    32. Gemuk Sehat/Ideal Tirta Sehat Serbuk produksi PJ Tetap Sehat, Cilacap (mengandung parasetamol, tidak terdaftar).
    33. Gemuk Sehat PJS Serbuk produksi PJ Pusaka Jaya Sakti, Cilacap (mengandung parasetamol, tidak terdaftar).
    34. Gemuk Sehat SP Serbuk produksi Sehat Perkasa, CIlacap (mengandung parasetamol, tidak terdaftar).
    35. Kembang Wijaya Serbuk produksi PJ Fisabillah, Cilacap (mengandung metampiron, tidak terdaftar).
    36. Kencing Manis Serbuk produksi PK Tetap Sehat, Cilacap (mengandung parasetamol, tidak terdaftar).
    37. Kuat Sehat Cap Kuda Liar Serbuk produksi RCK Jabar (mengandung parasetamol, tidak terdaftar).
    38. New Singa Majapahit Serbuk produksi PD Lestari Wiji Dadi (mengandung parasetamol, tidak terdaftar).
    39. Pasti Joss Tablet produksi PJ Mega Raya, Jawa Tengah (mengandung parasetamol, tidak terdaftar).
    40. Ramuan Tradisional Remagel Serbuk produksi PJ Kasturi Dewi, Jawa Tengah (mengandung deksametason dan parasetamol, tidak terdaftar).
    41. Ramuan Tradisional Sarang Semut plus Sirih Merah Tablet produksi PJ Cespleng Jaya, Jawa Tengah (mengandung parasetamol, tidak terdaftar).
    42. Samurat Extra Serbuk produksi PJ Serbat Mustajab, Jawa Tengah (mengandung parasetamol, tidak terdaftar).
    43. Simakit Serbuk produksi PJ Candi Wulan, Banyumas (mengandung fenilbutason, tidak terdaftar).
    44. Temu Ginseng Plus Buah Merah Kapsul produksi PJ Sumber Utama Ginseng Indonesia (mengandung parasetamol, tidak terdaftar).
    45. Walet Kembar Asam Urat Serbuk produksi PJ Kunci Sehat, Cilacap (mengandung fenilbutason, tidak terdaftar).