The surgeon, the X-ray, radium, etc., all play their individual part in the decline of prescriptions. These are a few of the reasons for a more or less elimination of prescription writing, for which we may say that science is either directly or indirectly the contributing cause.
THE COMMERCIAL SIDE.
Several times agents for tablet houses have called on me and said: “Dr. So and So has just given me a little order, or intends to increase his line of our goods; of course, we don’t sell doctors direct, so if you will let me send these goods through you I will bill them straight, subject to a 10 per cent. discount to you; this means business for me and 10 per cent. on the doctor’s purchase for you. In other words, I was to guarantee their bill, wait for my money until the doctor was ready to pay, and act as their collecting agent, for all of which the above traveling man most magnanimously offered the above highly remunerative 10 per cent. and this for the worst enemy the druggist has—the dispensing doctor. That gentleman who pays no taxes on his stock and fixtures, needs no traders’ license, is subject to no drug inspection, who is insincere with his patients, and needs but the occasion to discredit druggists, as a whole, in furthering his schemes of diverting from the proper channels that which rightfully does not belong to him.”
Another reason is the mistake made at times by the druggists, as a body, of often plunging headlong, and with the purest motives possible, into any vortex created by a few overzealous men, both physicians and pharmacists, who are more often theorists than practical druggists, and to illustrate my point I recall an incident of more or less recent occurrence that tended to inspire little confidence of thoughtful physicians in them as a whole.
Various medical associations, pharmaceutical associations, and nearly every journal allied to medicine and the drug trade decried the use of hand-me-downs. The committee on revision of the N. F. immediately offered us a number of preparations of varying merit, that were not even good substitutes for the above, and these I have understood at the suggestion of some physicians.
Glycerinated Elix. Gentian, if made according to formula, with its excessive amount of solution of saccharine and its repulsively excessive amount of acetic ether, would never supplant the preparation it was intended to take the place of.
Pulv. Acetanilid Comp. is as dangerous a heart depressent as the nostrum it was supposed to displace.
We were told that Lactopeptine was too expensive to use as a vehicle, and was worth not a continental medicinally; that Pancreatin and diastase were destroyed by Pepsin in the presence of an acid; besides, after the chemists of the A. M. A. were through their analysis, they found there was so little Pepsin that it was scarcely worth mentioning, but if the doctor wanted a good pharmaceutical we could supply Pulv. Pepsin Comp. or Elix. Digestive Comp., either just as good, not quite so expensive, and certainly would do no more harm. Associations printed proprietaries and substitutes side by side and launched this matter as a propaganda of education for the physicians; material that filled no void, supplied no deficiency and appealed to many only as a means to increased profit.
That some physicians did prescribe was only because they had more confidence in the druggists as compounders of the above preparations than they had in the manufacturers of the nostrum; because they were friendly enough with the individual druggist to open an opportunity for a little better profit; because they thought their patients would be more economically handled; but had the revisionists advanced a few scientific combinations, elegant pharmaceuticals or easily prepared chemicals, they would have given the druggist better material for propaganda work and appealing agents to most physicians. It was, however, to a certain extent a wasted effort, lacking in conception, devoid of originality and decidedly wanting in producing lasting results. So much for some of the contributing causes.