2  8o  Minutes  of  the  Pharmaceutical  Meeting,  {^"^^^^Zl^^""^- 
"  Whereas,  the  practice  of  medicine  and  pharmacy  are  so  dependent  on  one  another,  that  it  behooves 
the  physician  and  pharmacist  to  be  in  entire  accord,  and  to  endeavor  by  conference  and  mutual  enlighten- 
ment to  ensure  a  more  strict  conformity  to  the  standards  of  their  calling:  In  this  spirit  the  Richmond 
Pharmaceutical  Association  would  urgently  invite  the  attention  of  the  Richmond  Academy  of  Medicine, 
and,  through  it,  the  practitioners  of  the  city  generally,  to  the  following  suggestions  in  regard  to  writing 
prescriptions,  for  it  is  within  the  knowledge  of  members  of  both  Societies,  that  each  are  liable  to  errors  in 
writing  and  dispensing  prescriptions,  and  to  guard  against  these  is  the  object  of  this  communication. 
''First.  We  would  urge  the  great  importance  of  writing  in  a  legible  hand,  and  never  to  erase  a  word  or 
quantity  and  re-write  over  it ;  always  to  use  the  technical  language  and  abbreviations  of  the  "  Pharmaco- 
poeia "  and  "  United  States  Dispensatory,"  and  to  write  directions  for  use  and  dose  on  every  prescription, 
and  state  whether  for  adult  or  infant,  as  a  guide  to  the  dispenser  in  case  of  error  in  quantity  of  any  active 
ingredient. 
"Secondly.  We  suggest  that  when  an  unusual  dose  or  quantity  of  an  active  and  potent  medicine  is  pre- 
scribed— such  as  strychnia,  opium,  morphia,  belladonna,  digitalis,  &c. — that  the  prescriber  shall  affix  oppo- 
site a  caution  mark  or  sign,  to  inform  the  dispenser  that  he  is  aware  that  the  dose  is  unusual,  but  required 
in  the  case.  In  some  portions  of  Europe,  such  a  regulation  is  a  law  of  the  State.  In  Germany  the  cau- 
tion mark  is  an  exclamation  point  in  brackets  :  (I),  and  is  placed  on  the  right  hand  side  of  the  prescrip- 
tion, in  a  line  immediately  opposite  the  ingredient  in  question.  We  propose  that  the  mark  shall  be  placed 
on  the  left  hand  side,  and  that  it  shall  be  the  letters  "Q.  R. —  "  {quantum  rectum)  with  a  dash  or  line 
connecting  it  with,  or  nearly  so,  the  ingredient  to  which  attention  is  called,  for  example  : 
P?. — q.  r. — Tinct.  digitalis. 
Tinct.  valer.  am.,  aa  iji. 
— SiG.    Dose,  teaspoonful  every  3  hours. 
"  We  further  suggest,  that  the  physician  should  never  write  any  of  the  following  or  similar  prescriptions 
■without  accompanying  them  with  some  written  direction  or  explanatory  note,  as  to  the  use  intended  to  be 
made  of  them,  so  that  the  dispenser  may  not  be  left  in  doubt : 
It. — Plumbi  acetat,  5i.  ^i- — Chloral  hydrat.,  .jii. 
]^. — Morphise  sulph  gr.  v.  Y^. — Opii  pulvis,  .ai. 
— Hydrarg.  chlor.  corros.,  gr.  v.  1^. — Tinct.  digitalis,  31. 
"All  of  these,  and  many  others  of  like  import,  we  could  refer  to,  on  the  files  of  apothecaries,  are  dan- 
gerous in  the  hands  of  the  inexperienced  and  ignorant,  and  it  would  take  but  little  time  or  trouble  to  de- 
signate in  some  way  the  use  intended.  It  requires  discretion,  judgment  and  prudence  in  manner  and  ac- 
tion on  the  part  of  the  apothecary,  to  so  demean  himself,  as  to  avert  buspicion  from  himself,  and  to  avoid 
casting  injurious  reflections  on  the  physician,  when  he  sees  or  thinks  he  sees  an  error  in  a  prescription,  or 
is  doubtful  about  the  propriety  of  dispensing  "five  grains  of  morphia"  in  a  single  package,  upon  a  pre- 
scription handed  in  by  a  little  child  or  ignorant  servant,  perhaps,  and  we  respectfully  urge  that  the  practi- 
tioners of  medicine  should  give  serious  attention*to  these  important  suggestions. 
"The  joint  committee  of  the  Association  and  the  Academy  unanimously  approve  the  suggestions,  and 
recommend  their  observance  by  the  medical  profession  as  one  sure  means  of  preventing  errors  in  com- 
pounding and  dispening  prescriptions. 
"  The  caution  mark  proposed  by  the  Richmond  Pharmaceutical  Association,  "Q.  R. — "  {quanttan  rec- 
they  discarded,  and  recommended  "  P.  C,"  {prceter  consuettidinem)  as  less  liable  to  objection. 
This  mark,  like  the  former,  it  is  proposed,  shall  be  placed  on  the  left  side  of  the  prescription,  and  immedi- 
ately in  line  with  the  ingredient  prescribed  in  ejrcess  of  the  usual  dose,  when  it  is  a  potent  one,  such  as 
strychnia,  prussic  acid,  morphia,  digitalis,  aconite,  &c. 
"  The  committee  also  discussed  the  evil  consequent  upon  the  frequent  unauthorized  renewing-  of  pre- 
scriptions composed  in  whole  or  in  part  of  opium,  chloral  and  other  powerful  remedies,  liable  to  be  abused; 
and,  therefore  recommend  that  physicians  be  requested  to  write  " Not  Renewable"  on  any  prescription 
which  they  do  not  desire  to  be  renewed,  and  the  apothecaries  are  requested  not  to  renew  prescriptions  so 
designated,  except  upon  the  written  or  verbal  authority  of  the  physician  in  attendance. 
"  It  was  also  resolved,  that  the  Richmond  Academy  of  Medicine  and  the  Richmond  Pharmaceutical 
Association  request  the  national  Associations  of  their  respective  professions  to  take  action,  in  view  of  the 
fact  that  the  symbols  representing  the  drachm  and  the  ounce  are  frequently,  and  sometimes  fatally  con- 
founded, because  there  is  so  slight  a  difference  in  their  appearance  ;  that  we  recommend  the  Richmond 
Academy  of  Medicine  and  the  Richmond  Pharmaceutical  Association,  and  propose  that  they  shall  do  the 
same  to  the  National  Associations  of  Medicine  and  Pharmacy  to  lay  aside  the  use  of  the  5  mark,  and  to 
substitute  the  Greek  Delta  A,  the  first  letter  in  A/Js^^^^JJ,  which  is  easily  made  and  cannot  be  mistaken. 
"  We  also  hold  that  the  apothecary  is  not  authorized  to  reveal  to  the  patient  the  components  of  a  phy- 
sician's prescription,  when  such  prescription  is  written  in  technical  language. 
A.  P.  Browa  said,  the  Camden  Association  had  adopted  the  mark,  Q^R. 
