AmlilusiFmfm'}        American  Medical  Association.  375 
THE  WORK  OF  THE  AMERICAN  MEDICAL  ASSOCIA- 
TION, WITH  SPECIAL  REFERENCE  TO  THAT  OF  THE 
COUNCIL  ON  PHARMACY  AND  CHEMISTRY  IN  IM- 
PROVING THE  PRACTICE  OF  MEDICINE  AND  PHAR- 
MACY IN  THE  UNITED  STATES.1 
By  C.  S.  N.  Hau/bbrg,  Ph.G.,  M.D.,  Chicago. 
RETROSPECTIVE. 
When  in  the  city  of  Philadelphia  some  forty  years  ago  several 
pharmacists  began  exploiting  the  local  physicians  with  some 
unusually  elegant  preparations,  who  could  have  dreamed  that  from 
this  small  beginning  would  evolve  the  modern  manufactured  phar- 
maceuticals. 
These  preparations  were  at  first  limited  to  a  few  elixirs,  then 
included  syrups  and  wines,  and  rapidly  increased  by  the  addition  of 
dosage-forms  until  they  finally  comprised  the  entire  gamut  of  thera- 
peutic agents  in  every  conceivable  and  inconceivable  form.  Their 
manufacture  was  originally  confined  to  a  few  ambitious  retail  phar- 
macists, but  was  followed  by  some  of  the  more  enterprising  old- 
time  wholesale  drug-houses  and  eventually  by  regularly  established 
manufacturing  chemists  and  even  by  some  herb-collectors,  such  as 
the  Shakers  at  Lebanon,  N.  Y.  While  educated  pharmacists  even 
at  this  early  period  regarded  the  exploitation  of  the  physicians  by 
these  ready-made  preparations  as  an  encroachment  on  their  pre- 
rogative and  sometimes  resented  the  idea  that  there  was  any 
necessity  for  them,  there  was  no  general  opposition  and  they  grew 
and  multiplied. 
THERAPEUTIC  SACRIFICE. 
It  was  often  charged  that  some  of  these  preparations  could  not 
be  duplicated  even  in  skilful  hands  from  the  purported  formula,  and 
that  their  medicinal  strength  was  overstated  so  as  to  give  rise  to  the 
oft  repeated  charge  that  their  therapeutic  value  was  often  sacrificed 
for  palatability  and  elegant  appearance.  The  tendency  toward  these 
preparations  was  also  largely  promoted  by  the  numerous  specialties 
from  France,  where  the  "  pharmacie  elegance  "  had  its  inception  and 
has  always  thrived  and  flourished. 
These  ready-made  preparations  were,  however,  not  so  objection - 
1  Read  at  the  Philadelphia  College  of  Pharmacy,  April  21,  1908. 
