GENERAL PAPERS 79 
A third and potent reason for the limited scope of the Phar- 
macopoeia is found in the fact that no article of proprietary 
origin, that is, no article of secret composition, or one the man- 
ufacture of which is controlled by virtue of a patent or trade- 
mark, is given recognition. That is to say, no article can be 
admitted into the Pharmacopoeia unless the right to manu- 
facture it is open to all, and this regardless of its remedial 
value. If an infallible remedy for tuberculosis were to be dis- 
covered tomorrow it could not be admitted to the official list as 
long as its composition were kept secret, or as long as free com- 
petition in its manufacture was prevented by virtue of a patent 
or by other means. 
LACK OF CONFORMITY OF MEDICAL PRACTICE TO THE U. S. P. 
At the time of the publication of the first United States 
Pharmacopoeia, in 1820, that volume probably contained the 
titles of a majority of the substances then used by the medical 
profession. The revision in force today probably does not 
recognize more than 10 per cent of the substances in common 
medical use. Thus we have the strange situation that the vol- 
ume popularly supposed to be the standard of medical practice 
is, as a matter of fact, practically unrecognized by the medical 
profession. A majority of physicians in practice today prob- 
ably do not own a copy of the Pharmacopoeia, and probably 
never saw one. 
Much of the responsibility for the failure of the medical 
profession to recognize and use the pharmacopoeial prepara- 
tions rests upon the manufacturers of patented or otherwise 
protected proprietary remedies. Hosts of these proprietaries 
have been introduced, and as their popularity has increased 
with physicians, the popularity of U. S. P. remedies has de- 
clined. 
The extent to which proprietary and semi-proprietary medi- 
cines are used by the medical profession cannot, of course, be 
determined with any degree of exactness, but it is certain that 
the quantity is very much greater than of the remedies recog- 
nized by the Pharmacopoeia and National Formulary. It is 
perhaps not strange that this should be so. 
Physicians are like other people in that they are most likely 
to concern themselves with the things most frequently brought 
