332 
Pepsin. 
Am.  Jour,  Pharm. 
July,  1909. 
bromides,  etc.,  is  really  increasing.  Very  recently,  he  has  heard 
reputable  physicians  commend  such  elixirs  of  pepsin  and  pancreatin 
and  knows  that  the  pharmaceutical  manufacturers  are  supplying 
these  to  the  dispensing  physicians  in  five-  and  ten-gallon  containers. 
In  a  recent  communication,  Prof.  C.  Lewis  Diehl,  the  Chairman 
of  the  N'.F.  Committee,  says :  "  Nevertheless,  we  are  confronted 
with  the  fact  that  Compound  Digestive  Elixir  is  the  most  frequently 
prescribed  preparation  of  the  National  Formulary,  and  that  this 
demand  comes,  not  from  that  class  of  physicians  which  some  one 
has  facetiously  designated  as  c  physicians  who  append  M.D.  to  their 
names,'  but  largely  from  physicians  who  stand  high  in  their  pro- 
fession and  who  enjoy  the  confidence  and  respect  of  the  community 
in  which  they  practice.  In  short,  even  though  the  three  component 
enzymes  reciprocally  nullify  their  individual  functions ;  even  though, 
from  the  theoretical,  chemical,  and  biochemical  standpoint  this  prep- 
aration is  a  '  monstrosity  ' ;  it  is  a  pertinent  question  whether  we 
are  justified  in  eliminating  Compound  Digestive  Elixir  from  the 
Formulary,  if  it  can  be  shown  that  reputable  physicians  insist  on 
prescribing  it,  convinced  that  it  is  a  desirable  and  efficient  adjunct 
to  other  and  more  potent  medicaments.  For,  to  use  a  commonplace, 
'  we  can  lead  a  horse  to  water,  but  we  cannot  make  it  drink ' ;  and 
so,  if  we  expunge  Compound  Digestive  Elixir  from  the  Formulary, 
we  can  rest  assured  that  those  who  wish  to  prescribe  it  will  have 
no  difficulty  to  have  their  prescription  filled — if  not  with  a  prepara- 
tion made  by  an  authoritative  formula,  most  likely  with  one  or  the 
other  of  the  many  proprietary  preparations  of  the  market." 
It  is  established  beyond  any  controversy  that  these  compound 
elixirs  of  the  digestive  ferments  have  an  extensive  use  in  medical 
practice.  It  is  not  within  the  province  of  the  National  Formulary 
to  recommend,  nor  to  advise,  nor  to  question,  the  therapeutic  action 
of  remedies  dispensed  on  physicians'  prescriptions,  and  as  long  as  it 
makes  no  claim  for  the  product  it  is  only  filling  its  mission  and 
keeping  well  within  its  intended  scope  of  simply  supplying  approved 
formulas. 
It  was  a  condition  and  not  a  theory  that  confronted  the  com- 
mittee who  introduced  the  formulas  in  the  National  Formulary  and 
it  remains  a  condition  that  confronts  the  committee  that  are  now- 
laboring  on  its  revision.  If  the  physicians  consider  these  undesirable, 
they  should  cease  prescribing  them  and  the  disuse  would  eliminate 
them  from  future  revisions. 
