A physician once told an apothecary that he prescribed fluid extracts because he found them more reliable than the tinctures. This was not true, and could not be proven. Upon investigation it was found that his prescribed dose of fluid extract of digitalis was equivalent to fifty-five drops of the tincture, a dose larger than he intended to prescribe. With such science the witch-hazel doctor will ride a high horse, and come in on the home stretch with flying colors. No singer can sing well who sings too many songs, and no beginner will prescribe well who prescribes too many medicines. This song has been sung much but not half enough, for it is not borne in mind. Many fail with a remedy simply because they have failed to master it.
Mastering the few is said to be the key to success, and the writer believes it, for he has seen it proven. An eminent physician from New York was once called in consultation to a western city. His prescription was mercury iodide, potassium iodide, and infus. gentian. He stated (and the other physician said, “I see”) that the only object of the potassium was to dissolve the mercury iodide. But potassium's great affinity for iodide accepted it, at once dropped the free mercury to the bottom, likely to be taken all at the last dose, equal to fifteen or twenty grains of blue pill. He had failed to master this remedy.
The witch-hazel doctor could not declare this time that the untaken medicine saved the patient's life, for he died before taking it. But he could smile at the prescription appropriately, were none of his own to be found on file.
Another phase of fashion reminds one of the old saying “distance lends enchantment;” for there is just as good sense in going to New Brunswick to have a boil lanced as there is in bringing syrup hypophosphates from that place.
The present pharmacopœia contains a splendid formula for this syrup—one, too, with which phosphoric acid, quinine and strychnine are perfectly compatible. A pharmacist that will not exert himself to furnish the very best article for a physician's prescription is not entitled to the physician's respect. But for a physician to expect a pharmacist to send all over town for some foreign preparation that might, in almost all cases, be better made at home, affords a weapon to retard medical science and advance the nostrum manufacturer. The more scientific physicians well know and admit that a good pharmacist can better judge of a compound than a physician, who seldom stops to test it, but prescribes it a few times and, in many cases, never thinks of it again, or, perhaps, not until he presents his bill and finds the patient's money all gone for semi-proprietary medicines that cost from fifty to one hundred per cent. more than would have paid for better compounds. Physicians will only have to examine these medicines after they have stood a year or two, and in many cases a much less time, to see the force of this argument.
Among these nostrums are found numerous preparations we could mention, including many emulsions, elixirs, etc. It is comforting to see the better class of physicians giving these nostrums a “wide berth.” Others will follow their example if they investigate and master their remedies.
Having no time to continue this rehearsal, I close with a plea for more science, more investigation, that we may not have to send to Buffalo for syrups of Dover powder or farther east, west or south for nostrums, but master the remedies we have, saving to the physician and patient from fifty to one hundred per cent., thus mitigating the popular cry of the high price of medicine. There should be a table of incompatibles in every medical college as prominent as the multiplication table in the schools, or pharmacists should be allowed more freedom to prepare medicines properly, instead of being held to the letter.
The writer should not complain, for he has been liberally treated by the profession in this respect; but he does not feel at liberty to add magnesia to a mixture unless so ordered. A pharmacist did this at one time in a tar-and-water mixture, gaining great praise from the physician. (Making the tar quite thin with a little alcohol, then absorbing the whole with magnesia, and emulsifying by adding the water gradually.)
BREUS' OBSTETRIC FORCEPS.
BY C. B. PARKER, M. D.,