, 1907-08-22
ARE PHYSICIANS PRESCRIPTIONS
NOSTRUMS?

To one not qualified, and few lay
men are, to discriminate intelligently
between physicians prescriptions, pro-
prietary medicines and nostrums, 1t
may seem little short of a crime to
hint even that physicians prescrip-
ions are in any manner related to
nostrums; nevertheless. an impartial
examination of all the facts in the
case leads irresistibly to the conclu-
sion hat every medicinal preparation
compounded and dispensed by a physi-
clan is, in the strict sense of the word,
a nostrum, Inc that the average,
ready-nrepared proprietary remedy is
superior to the average specially-pre-
pared physicians prescription.
What is a nostrum? According to
the Standard Dictionary a nostrum is
"a medicine the composition of which
is KEEP a secret" Now, when a physi-
clan compounds and ~dispenses with
his hands a remedy for the treat
ment of a disease-and it is authorita-
lively stated hat probably 60 per
cent. of all physicians prescriptions
in this country are so dispensed-the
names and quantities of the ingre-
dents which constitute the remedy
are not made known to the patient.
Hence, since its composition is kept a
secret by the physician, the remedy or
prescription is unquestionably, in the
true meaning of the word, u Simon
pure nostrum. Furthermore, the pre-
scription compounded by the average
physician is more than likely to be a
perfect jumble-replete with thera-
peutic, physiologic and chemical in
compatibilities and bearing all the ear
marks of pharmaceutical incompe-
tency; for it is o generally admitted
that unless a physician has made a
special study of pharmacy and passed
some time in a drug store for the pur-
pose of gaining a practical knowledge
of modern pharmaceutical methods.
he is not fitted to compound remedies
for his patients. Moreover, a physi-
clan who compounds his W prescrip-
tons not only deprives the pharmacist
of his just emoluments, but he endan-
gers the lives of patients; for it is
only by the detection and elimination
of errors in prescriptions by clever,
competent prescriptionists that the
safety of the public can be effectually
shielded from the criminal under
of ignorant physicians.
Nor can it be said hat the average
physician is any more competent to
formulate a prescription than he Is to
compound it. When memorized or di-
rectly copied from a book of ''favorite
prescriptions by famous physicians"
or from some textbook or medical
journal. the prescription nay be all
that it should be. 1t is only when the
physician is required to originate n
formula on the spur of the moment
hat his i~ncompetency is distinctly evil
dent. Seemingly, however, the physi-
clans of the United States are little
worse than the average British physi-
clan: for we find DR.. James Burnett,
lecturer on Practical Materia Medica
and Pharmacy. Edinburgh, lamenting
in the Medical Magazine the passing
of the prescription and bemoaning the
fact that seldom does he find n final
man" able to devise a prescription
even in good contracted Latin"
And what. it may be asked, is the
status Of the written prescription-the
prescription that is compounded and
dispensed by the Pharmacists it,
DO, a nostrum? 1t ma be commended
that the patient, with the written
formula in his possession, may learn
the character of the remedy pre-
scribed. So, possibly. he might If lie
understood Latin and were a physician
or a pharmacist, but as he usually pos
sesses no professional training and
cannot rea Latin, the prescription is
practically a dead secret to him.
Furthermore, the average prescription
is so badly written and so greatly
abbreviated that even the pharmacist,
skilled as he usually is in "deciphering
medical hieroglyphs, is constantly
obliged to interview prescribers to
find out what actually has been pre-
scribed. 1t may also be contended,
that inasmuch as the formula is known
to both physician and pharmacist the
prescription cannot therefore be a Sc
cret. But with equal truth it might be
contended hat the formula of any So
called nostrum is not a secret since 1t
is known to both proprietor and manu-
facturer: for it must not be forgotten
that, according to reliable authority,
So per cent. of the proprietors of So
called patent medicines prepared in
this country have their remedies made
for them by large, reputable manufac-
turing pharmacists. But even should
a patient be able to recognize the
names of the Ingredients mentioned in
a formula he would only know half
the story. 1t is seldom, for instance.
that alcohol is specifically mentioned
in a prescription, for it is usually
masked in the form of tinctures and
0mid extracts. as are q great many