But lots of people are starting to find literary value hidden among the porn, penis patches, generic Viagra deals and mortgage offers.

Some have composed poems using the subject lines of the spam they receive; others are creating verse using the strings of strange words that are often found inside spam messages.

A lucky few have even found excerpts of novels buried in spam.

Text message

Blogger and journalist Clive Thompson found an excerpt from Chapter 20 of The Master Key by Wizard of Oz author L Frank Baum in a message that had as its subject line “the big unit” (no prizes for guessing what the rest of it was hawking).

This is happening because of the success of spam filters, the best of which can catch 99% of junk mail.

NUMBER 1, BY KRISTIN THOMAS Quality ink up to 80% off. Answers Now on the Distortion of Evidence; Clean your colon. Improve sense of well being. Uncover what other’s don’t want you to know - Check it out, man - Success, ! What is an MBA really worth? Ask yourself - could your penis be bigger? For Target guests, Its safe, now.

These filters work by scanning the words in e-mail messages to identify which ones spammers prefer and which ones are favoured by your friends and colleagues.

For a while now spammers have tried to defeat these filters by breaking up offending words with full stops to produce subject lines like e.hance your attra.ctiveness.

for the spammer, this just makes spam even easier to spot.

Some spammers have taken to inserting decidedly non-spammy words in e-mail to try to convince the filters they are not junk mail.

As a result spam is starting to appear with phrases such as “bernadine rustle lappet” and “arboretum severe acerbity henri” inside them.

A few words are unlikely to make a lot of difference to the filters so some spammers load their junk mail with huge amounts of random words. One recent message had 780 words of nonsense in it.

By including random text the spammers hope to fool the filters into thinking that a human, not a spammer, wrote the message.

Cut-up class

But as Clive Thompson points out, automatically generating text that reads like it was written by a human hand is difficult. This is perhaps why some spammers are turning to out-of-copyright novels for their text. It is an ideal source of real writing.

It remains to be seen whether the filters are fooled by classic .

The inclusion of rare words and literary works has spurred some people to create poetry from the spam that lands in their inbox.

Blogger Kristin Thomas has composed a series of poems using only subject lines from spam.

Bowie used random compositions to write songs

Grant specialises in three-line subject line spam poems but others, such as Paulette Adell who contributes to the Nonfamous blog, are happy to use words from inside the message too.

Of course finding art in random collisions of words is a craft with a long history.

Beat poets such as Bryon Gysin and William Burroughs were pioneers of the cut-up method in which they chopped up other texts and then arranged the words randomly to try and unleash its hidden , says a spokesman for the Poetry Society.

Gysin used the cut-up method on Rimbaud’s poems to create new works in his own words and many parts of Burroughs’ novels were created using the cut-up method.

The method has reportedly also served pop maestro David Bowie well - the song Moonage Daydream was apparently created using this cut-up method.

“There is a certain amount of composition that goes into this method,” said the spokesman, “it is not completely random.”

Perhaps this will be one of the redeeming virtues of spam, that buried in the filth and lucre are some gems of ingenuity and creativity. But don’t count on it.

Aug. 20, 2003 — Levitra has just won FDA approval — a move toward challenging the groundbreaking erectile dysfunction drug Viagra. But what does Levitra have to offer that the little blue pill doesn’t?

The news will hopefully bring more men to their doctors, opening up more about this still-secret subject, says Natan Bar-Chama, MD, urologist and director of male reproductive surgery at Mt. Sinai Medical Center in New York City.

“We’ll hopefully encourage more patients, and also physicians, to be more proactive in addressing this problem,” he tells WebMD. Bar-Chama, who was not associated with the studies, agreed to comment on the announcement.

The Drugs

Viagra, the first pill for erectile dysfunction, was developed by Pfizer, Inc. and put on the market in 1998.

Levitra, co-developed by Bayer and GlaxoSmithKline, takes effect a bit quicker than Viagra — in less than 20 minutes for some men. Also, it keeps acting for about five hours, compared with Viagra’s four hours, the company says. GlaxoSmithKline is a WebMD sponsor. Bayer and Glaxo say Levitra will be available in September.

Cialis, another erectile dysfunction drug in the pipeline, is expected to get FDA approval later this year. Cialis takes effect quickly (in 30 minutes or less), and its effects last about 36 hours. Also, its effectiveness is not affected by food, which has been a problem with Viagra, says Cialis maker Eli Lilly and Company, a WebMD sponsor.

The Mechanics

Levitra has been studied in more than 50 clinical trials involving 5,700 men. In Europe, it has been available since March 2003, and has shown to be effective and safe in treating erectile dysfunction.

Like Viagra, Levitra acts by relaxing muscles and blood vessels in the penis, allowing increased blood flow into the penis, which produces an erection.

With Levitra, onset of action occurs within 16 minutes for some men, between 30 to 60 minutes for others. Viagra starts acting 45 to 90 minutes after taking the pill. “On a practical level, it doesn’t make a big difference. Both time-frames are adequate to engage in relations,” says Bar-Chama.

Also, Levitra works well when taken either before or after a low-fat meal, Bar-Chama tells WebMD, but a high-fat meal will decrease its aborption, making it less effective. High-fat meals also hinder Viagra.

For difficult-to-treat men who have diabetes and or have had prostate surgery, both Levitra and Viagra work equally well in solving erectile dysfunction, he adds. However, like Viagra, Levitra is not advised for men taking nitrate drugs (such as tablets or patches) or alpha-blockers (drugs used to treat benign prostate hyperplasia and/or high blood pressure).

Cialis takes effect in 16 to 30 minutes, and stays active in the body for about 36 hours. Also, absorption of Cialis is not affected by either high-fat or low-fat meals, according to Carole Copeland, a Lilly .

Wide-Scale Problem

More than 50% of men over age 40 will experience erectile dysfunction at some time,” says Bar-Chama.

“And yet, nine out of 10 are currently not being treated. This is a medical problem that significantly affects quality of life, and yet, for the vast majority, there is still a barrier to discussing and getting effective medical therapy. Hopefully, this news will awaken more men, get them to talk to their doctors.”

SOURCE: FDA Talk Paper. Natan Bar-Chama, MD, urologist; director of male reproductive surgery, Mt. Sinai Medical Center, New York City. Bayer Pharmaceuticals Corp. GlaxoSmithKline. Carole Copeland, spokeswoman, Eli Lilly and Company.

Sept. 29, 1999 (Washington) — Filling prescriptions through the Internet might seem like a convenient way to keep the family medicine cabinet stocked, but there are a number of dangers associated with buying medications through Web sites, say researchers at the University of Pennsylvania in Philadelphia.

A study of 46 Web sites that sell prescription medications found that some would not reveal where they are based or where their medications are manufactured. Internet pharmacies may use physicians from outside the U.S. to provide online to people without prescriptions. And despite the common belief that the Internet can provide bargains, the researchers found the medications and physician services cost more when they are purchased online than they would if obtained the way.

The study, which was released early due to its public health implications, is scheduled to be published in the December issue of the Annals of Internal Medicine and was conducted by Bernard S. Bloom, PhD, and Ronald C. Iannacone, BS. Their search of Internet pharmacies, conducted in February and March, yielded 37 sites that required a prescription or an online physician consultation to dispense and nine — all based outside the U.S. — that did not.

For consumers, the greatest risks come from sites that don’t require a prescription or physician consultation, or that market medications that are not approved by the FDA. But even with an online consultation, there is potential for harm because the quality of the physician is generally not known, Bloom and Iannacone write.

“Let’s hope to God it is a physician. It could be your Aunt Mildred. You just don’t know,” Bloom tells WebMD. And as for those “sites that offered physician consultants, there was a disclaimer that said the physician may not be in your country.” Bloom is a research professor in the department of medicine at the University of Pennsylvania.

Bloom says it’s not practical to suggest that consumers stay away from ordering all prescription medications without a physician visit. “It’s remarkable how accurate people are in doctoring themselves,” he says, adding that there should be some physician involvement. “It seems to me, certainly for most prescription medications, you want to have a physician have some input, to know the patient, know something about other medications they might be taking.”

The list of the commonly sold medications reads like a “who’s who” of the most popular and heavily advertised medications today: Viagra (sildenafil) and Propecia (finasteride), Claritin (loratadine), Celebrex (celecoxib), Valtrex (valacyclovir), and Zyban (bupropion). Many of the medications are not covered by insurance plans because they are so-called “lifestyle” drugs. Some sites existed only to sell specific medications, and little information was available about them, according to the authors.

The authors also reviewed the costs of medications and consults. “Among the 37 sites selling Viagra, the median per pill price was $4.50 (range, $4.30 to $4.65). Among the 16 Internet sites offering Propecia, the median per pill price was $1.94 (range, $1.55 to $1.95). On average the two medications were about 10% more expensive when they were obtained from a web site than from a local pharmacy,” the authors write.

Internet physician consultations ranged in price from $20.00 to $90.00, while a primary care visit reimbursed by managed care plans or Medicare in Philadelphia averages about $60.00, according to the study.

In an accompanying editorial, FDA Commissioner Jane E. Henney, MD, and three other FDA officials counsel physicians and patients to report potentially illegal sites to the agency or the National Association of Boards of Pharmacy.

They also suggest a number of steps consumers can take to reduce the risk of buying medications through the Internet. These include not buying from sites that offer to sell the drug without a physician’s examination or a valid prescription, offering to sell medications not approved by the FDA, or sites that do not include a U.S. location and address. They also recommend consumers verify that a site is duly licensed by going to the Boards of Pharmacy site at www.nabp.net.

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