Am.  Jour.  Pharm.  ) 
September,  1920.  ) 
The  Ethics  of  Prescribing. 
667 
facts,  which,  if  borne  in  mind,  will  save  endless  trouble  and  render 
the  prescription  a  much  more  valuable  thing  than  it  otherwise 
would  be. 
In  the  first  place,  the  prescription  should  contain  no  ingredient 
or  ingredients  whose  action  is  not  known  to  the  profession.  Many 
American  and  foreign  concoctions  are  largely  advertised,  but  no 
one  can  really  say  why  they  are  beneficial,  if  indeed  they  ever  are. 
Some  medical  men  get  into  the  habit  of  ordering  a  ready-made 
formula,  which  perhaps  consists  of  a  dozen  different  ingredients, 
just  because  it  has  been  brought  to  their  notice  by  the  manufac- 
turers. Such  prescriptions  are  ethically  bad,  and  should  not  be 
encouraged.  One  often  hears  the  remark  that  patients  like  out- 
of-the-way  things,  and  that  ladies  like  to  be  told  to  get  a  bottle  of 
compound  elixir  of  "ovario-thymo-thyroid,"  and  to  take  a  teaspoon- 
ful  after  every  meal.  Probably  if  they  were  given  a  prescription 
for  rhubarb  and  soda  they  would  think  the  physician  a  very  ordinary 
man.  All  this,  however,  savours  of  quackery,  and  ought  not  to 
receive  the  sanction  of  members  of  a  scientific  profession.  We 
once  heard  of  a  very  good  country  doctor  who  gave  a  patient  a  pre- 
scription containing  iron  and  arsenic  in  pill  form.  She  happened 
shortly  afterwards  to  be  on  a  visit  to  some  friends,  and  she  was  ad- 
vised to  consult  a  "famous  specialist."  He  told  the  lady  to  get  a 
box  of  iron  and  arsenic  capsules,  at  a  certain  shop  in  that  particular 
city.  For  this  word-of-mouth  advice  she  paid  three  guineas,  and, 
of  course,  valued  it  accordingly.  She  continued  to  have  these  cap- 
sules sent  to  her  in  the  country,  and  altogether  ignored  the  pills 
containing  exactly  the  same  ingredients.  Certainly  the  public 
are  very  gullible  where  drugs  are  concerned,  but  it  is  our  bounden 
duty  not  to  pander  to  their  gullibility  by  giving  prescriptions  likely 
to  appeal  to  the  imagination  in  this  way. 
The  fact  that  very  few  medical  men  know  how  to  write  prescrip- 
tions is  probably  accountable  for  another  breach  of  ethical  pre- 
scribing. We  refer  to  the  common  custom  of  simply  telling  the 
patient  what  to  get.  This  is  a  most  reprehensible  practice,  and  does 
the  doctor  a  great  deal  of  harm,  besides  giving  the  patient  a  foolish 
sense  of  medical  knowledge.  "Take  a  pinch  of  chlorate  of  potash 
and  dissolve  it  in  a  teacupful  of  water."  "Get  half  a  dozen  15 -grain 
bromide  of  potash  powders,  and  take  one  at  bedtime."  "I'll  repeat 
your  arsenic  mixture."  "I'm  going  to  give  you  a  prescription  for 
strychnine  and  hydrochloric  acid."    "Go  to  the  chemist  and  get 
