THE NATIONAL FORMULARY—A REVIEW OF THE FOURTH EDITION

The fourth edition of the National Formulary appears simultaneously with the U. S. Pharmacopeia IX, and is to become official at the same time (September 1). The principles which determine its scope, as frankly set forth in the preface, are apparently the same as those applied, though more faint-heartedly, in the compilation of the Pharmacopeia. A statement in the preface of the new National Formulary runs:

“The scope of the present National Formulary is the same as in previous issues, and is based on medical usage rather than on therapeutic ideals. The committee consists entirely of pharmacists, or of men with a pharmaceutical training, and it cannot presume either to judge therapeutic practice or to follow any particular school of therapeutic practice. The question of the addition or deletion of any formula was judged on the basis of its use by physicians and its pharmaceutical soundness. The considerable use by physicians of any preparation was considered sufficient warrant for the inclusion of its formula in the book, and a negligible or diminishing use as justifying its exclusion.”

Part I of the volume contains formulas, good, bad and indifferent, including the equivalents of a large number of shotgun proprietaries. Part II contains descriptions of drugs. This is a new feature. The purpose is to provide standards for those drugs not described in the Pharmacopeia but used in N. F. preparations. Many of these drugs were described in the U. S. Pharmacopeia VIII, but have not been included in the ninth revision. Practically all are either worthless or superfluous. Part III contains descriptions of special tests and reagents.

Among the thera­peutically useful formulas are those for aromatic castor oil, emulsion of castor oil, sprays or nebulae, solution of aluminum acetate, solution of aluminum subacetate and wine of antimony. The two last named are also included in “Useful Drugs.” Several formulas for new classes of preparations which may or may not be found superior to old forms are paste pencils for the application of medicaments to limited areas of the skin, mulls, which are ointments spread like plasters, and fluidglycerates, which are fluidextracts in which glycerin takes the place of alcohol. It should be noted also that, as a result of criticism, the alcohol content of some preparations has been reduced.

As a whole, the present edition of the National Formulary, like its predecessors, is “pharmaceutically useful but not a therapeutic necessity.” To say that it is not a therapeutic necessity is to state the matter mildly, since most of the formulas and almost all of the drugs described have been discarded long since by rational therapeutists. So long as there are physicians who prescribe therapeutic monstrosities, however, the druggist should have the aid that is furnished by this book in compounding them. From the pharmacist’s point of view, therefore, the book is a valuable one. Physicians who have a scientific training in the pharmacology of drugs will not want it; others will be better off without the temptations offered by its many irrational formulas.—(Book Review in The Journal A. M. A., Sept. 2, 1916.)