Am.  Jour  Pharm.) 
March.  1920.) 
Teaching  of  Therapeutics. 
cal  school  has  no  training  in  pharmacy,  Httle  or  no  training  in  the 
use  of  the  official  names  of  drugs  or  of  their  doses,  and  no  training 
whatever  in  the  fact  that  doses  of  different  sizes,  although  they  be  of 
one  drug,  may  be  useless,  useful  or  harmful,  or  become  so  after  some 
days.  He,  therefore  enters  practice  utterly  at  sea  when  he  is  called 
on  to  write  a  prescription. 
I  have  known  of  eye  drops  to  be  ordered  by  the  quart,  oleoresins 
mixed  with  aqueous  solutions,  powerful  alkaloids,  such  as  strychnine, 
put  in  a  mixture  with  potassium  iodide,  whereby  nearly  all  the 
strychnine  went  into  the  last  dose,  and  a  host  of  other  errors  too 
numerous  to  mention.  I  have  seen  a  thousandth  of  a  grain  of  ar- 
senous  oxide  given  three  times  a  day  to  an  adult,  and  a  grain  of 
atropine  put  in  each  pill;  and  no  druggist  exists  who,  if  diplomacy 
did  not  restrain  him,  could  not  humiliate  almost  every  physician 
whose  recipes  come  to  his  shop.  Because  the  medical  man  knows 
nothing  of  the  bulk  of  drugs  or  the  most  efficient  vehicles,  or  ex- 
cipients,  he  takes  the  easiest  way  out  of  his  dilemma  and  orders 
products  already  prepared,  which  products  are  often  the  result  of 
much  experience  and  scientific  pharmacy. 
The  remedy  for  all  this  is  to  have  every  student  make  in  a  phar- 
macy laboratory  at  least  one  representative  of  each  class  of  prep- 
arations official  in  the  Pharmacopoeia  and  the  National  Formulary. 
I  believe  that  this  is  done  in  only  one  school  of  medicine  in  the 
United  States. 
The  young  graduate,  having  had  no  experience  or  teaching  as  to 
doses,  naturally  used  doses  that  some  commercial  laboratory  names. 
He  may  have  been  taught  "doses,"  but  he  has  no  idea  that  small 
doses  of  digitalis  may  be  useful  in  one  case,  whereas  almost  toxic 
doses  may  be  absolutely  essential  in  another,  and  so  loses  the  pa- 
tient that  needed  the  large  dose.  He  uses  the  compound  mixture  of 
licorice  as  a  vehicle  in  a  case  of  profuse  bronchorrhea  or  threatened 
pulmonary  edema,  not  knowing,  or  forgetting,  that  its  most  active 
ingredient  is  antimony,  which  is  absolutely  contraindicated. 
When  he  becomes  an  intern  in  a  hospital,  he  learns  one  thing  of 
great  importance,  namely,  that  the  chiefs  who  prescribe  little  and 
"let  the  patient  get  well"  often  obtain  the  best  results;  or  if  he  is  on  a 
surgical  service,  the  entire  drug  therapy  may  be  in  his  hands,  and  the 
chief  often  boasts  that  he  "knows  nothing  about  drugs  and  don't 
want  to."  On  the  medical  side  in  large  hospitals  he  will  find  a 
hospital  formulary  from  which  mixtures  are  made  up  by  the  gallon 
