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On the Consequences of Deviations from the PharmacopœiaAuthor(s): Jacob BellSource: Provincial Medical and Surgical Journal (1840-1842), Vol. 3, No. 25 (Mar. 19, 1842), p.490Published by: BMJStable URL: http://www.jstor.org/stable/25491027 .

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490 DEVIATIONS FROM THE PHARMACOPCQIA.

ON THE CONSEQUENCES OF DEV IATIONS

FROM THE PHARMACOPCEIA.

By JACOB BELL.

The ambiguities which arise in che'mical nomencla hire from the progress of discoveries, and the changes which, from the same cause, are introduced into phar maceutical processes, must inavoidably occasion some temporary inconvenience wihen a new edition of the Pharmacop(eia is published. The invention of a few iew terms is attended with no disadvantage, if they involve no ambiguity in reference to the terms for

merly in use; and the introduction or alteration of formulr is unimportant, provided the name assigned to each be distinctive. But this rule not being in variably observed, it is of the highest importance that a proper understanding should exist between pre scribers and dispensers, as to the precise period at

which the alteratioiis sholuld be universally adopted. The dispensing chemist is bound by law to obey

the instlruetions contained in prescriptions, and to fiulfil to the letter the intentions of the writer; but the medical practitioner is at liberty to use his owni discretioni, and to prescribe from any Pharmacopaia w%vhich lie may thinik proper to adopt. We, therefore, find that the practice of medical men in this respect varies very much. There are some who take an in-/ terest in the introduction of new remedies, and are generally rather in advance of the times in regard to pharmaceutical improvements; while others, consider ing that our list of materia medica is already sutfi ciently extensive, and devoting their attention more to researclhes strictly pathological than to chemical science, continue to prescribe from the Pliarmacopwaia to which they are accustomed, and with which they are satisfied, for maniy years after a new edition has been in use. We not unfrequently see prescriptionis containing terms which have been discarded nearly half a century, and others the valuie and meaning of which have been changed, and which latter are evi dently used with reference to their former signiifica tion. Hence the chemist frequiently meets with cases in which, if lie act according to law, he must violate the intentions of the prescriber. For instailce, iii the following prescription;

Liq. Plumbi Acetatis, draclhmam i. Acidi Acetici, iincias v. Aq. flor. Sambuci, uncias iij. M.

Fiat lotio.

It is evident that acidum aceticum is intenided to imply distilled vinegar, or diluted acetic acid; amid it had this signification in the Pharmacopaia of 1815. But, according to our present Pharmacopmia, it de notes the strong acetic acid which was formerly called acidum aceticuim fortiums. The liquor ammnonim and liquor ammonite for tiiis are a parallel instanice of ambiguity. When carbonate of potash and carbonate of soda are ordered in effervescing drauiglhts, it is sometimes evident that the bi-carbonate and sesqiii carbonate were intended, and the clhemist is in doubt

whether he ought to attend to the letter or the spirit of his instructionis.

It has already been pointed out to time society that, in many instances, chemists have incurred the repii tation of using worthless hiydrocyanic acid, because they had employed that of the Pharmacopoeia, wlheii prescriptions had been writteii with reference to Scheele's standard.

In some instances changes in formuke have been accoompanied w%ith alterations in the names by iehirkh all ambiguity is removed, as in the case of aiitiniioniial vine.

Vinum antimoniale (1753) is prepared by digestin(Z an ounce of crocus of antimnony in a pint and a halt ot

mountain wiiie.

Liquor anitimoniii tartarizati (1815) is a solultioni of a scruiple of tartarised antimony in ten ounces of wine and water.

Viniiim antimoniii tartarizati (1824) is a sinmilar pre

parationi; but an equivalent of rectified spirit is sub stituted for the vine.

Vinum antimonii potassio tartratis (1836) is a solii tion of two scrnples of the potassio-tartrate of antimony in a pint of sherry.

Althouglh these formulre are intended to represent the samne preparation, the dispenser shouild be ac quainted witlh the distinction in this and other similar cases.

In the Pharmacopria of 1815, the oil of aniseed was omitted in the tinctura opii camphorata, and the name of the preparationi was changed to tinctura cam phoram composita; by which means those wlho pre ferred the old formula had only to order it under its former name. Buit in the Pharmacoptia of 1836, thte oil of aniseed is added, and the name remains unal tered. Another ambiguity is now observed, when the

word compound is omitted in a prescription, wlhich is sometimes the case, as it was until lately unimportanit. Tinctura camphorae now means camphorated spirit, and accordingly the omission of the word composita perplexes the dispenser.

When tinctura rhei is ordered, the simple tincture of rhubarb of 1824 should be used, as the present Pharmacopeia contains no preparation iunder that

name; tinctura rhei composita of course denotes thte preparation of 1836, which is different from the tinc tura rhei composita of 1824.

It is needless to miultiply examples; but it slhould be undeistood as a general rule, that when an ambi guouis term ocecurs in a prescription, it shouild be in

terpreted accordinr to the meaning assigned to it in the last Pharinacop:ria, unless the old nomiienclatuire is adopted in other parts of the prescription, or the question involves any risk to the patient.*

In cases where doubt exists, and the result is evi denitly importanit, application should be made to the writer of the prescriptioni. If this nile su vere invariably observed, nmedical men would sooni become? faniliar with all the alterations and inlm)rovelments in phauniiacy wlhich are taking place, and to wi-hichl their other duties preclude the possibility of their devotinig so muelh attention as the chemist, fromn the nature ot his occupation, habitually does.

'rhere is another questioni whiclh refers to this sub ject, and on wlhich some difference of opinion exists.

When it is discovered, as in the case of acetiin can tharidis, that the preparation ordered in the Plharma copceia is less potent than thlie urgency of a majority of cases wouild seem to demand, is .a chemist juistitied in deviating from the formula of tlhe college, in order to prodiuce a more effective remedy ?

If the principle of this deviation be allowed, the person who substitnites preparations of his oWII for formulh ordered by the college, may, it is truie, obtain t.he credit of suiperior skill, while those wlho are isiore scrupulous, anid conisider it their duity to obey the Pharmacopceia, are discarded on this account.

Uniformity in the preparation of medicinies beimig the great desideratumii, it is obviouis that if any im

provement in a recognised formula be found desirable, the fact should be muade know%vn, and uintil the altera tion is made by authority, it should not be adopted by dispensers, unless express orders to that eflect be given by the prescriber.t-Pharnacentical Journal, No. 9.

T hne alteration in the pint measure is not disciussed, but it is of couirse understood that the terins oetassmt tt ill a pre scriptioin always denotes twenty ounces.

This rule, inust ntot be understood to apply to those cases in whicib the result is idenitical in strength and composition

with the Pliaismacopoeia preparation, latitude to) a certain extent being allowed by the college in the details alnd mani pulationis of processes.

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