Am.  Jour.  Pharm. 
July,  1909. 
Pepsin. 
333 
The  question  of  the  therapeutic  incompatibility  is  one  that  the 
pharmacist  cannot  consider  and,  if  introduced,  would  certainly  queer 
many  prescriptions.  Again  the  views  of  physicians  on  many  of 
these  supposed  therapeutic  incompatibles  are  continually  changing. 
Not  many  years  ago,  we  were  taught  that  opium  and  belladonna 
were  incompatible,  and  pepsin  and  sodium  bicarbonate  should  not 
be  dispensed  together.  To-day,  physicians  know  the  proper  modi- 
fication of  medical  action  and  how  to  combine  remedies  to  secure 
the  potency  or  modified  action  desired,  and  we  consider  this  phase 
of  responsibility  as  belonging  entirely  to  the  physician. 
The  writer  must  not  be  understood  as  in  the  least  defending 
either  the  therapeutic  action  or  the  chemistry  of  these  compound 
preparations  of  the  digestive  ferments.  While  in  no  wise  blamable 
for  their  inception  he  shares  with  his  brother  pharmacists  only  the 
responsibility  of  daily  dispensing  them  and  believes  that  he  voices 
the  demand  of  the  dispensing  apothecaries  for  accepted  standard 
formulas  for  preparations  so  frequently  dispensed  on  prescriptions. 
On  the  contrary,  it  is  admitted  that  my  own  independent  experi- 
ments have  convinced  me  that  pancreatin  in  acid  solution  with 
pepsin  is  in  a  condition  the  least  advantageous  for  the  preservation 
of  its  characteristic  properties  and  actions  or  for  its  subsequent 
isolation  and  proper  testing.  On  the  other  hand,  tests  made  in  a 
sample  of  Compound  Elixir  of  Pepsin  made  by  the  formula  given 
below  and  more  than  a  month  old,  showed  that  the  pepsin  had  not 
suffered  any  marked  diminution  of  its  digestive  value. 
The  compound  powder  of  pepsin  seems  to  be  less  prone  to  change 
and  to  keep  fairly  well  for  some  time.  We  are  not  ready  to  accept 
the  a  priori  conclusion  of  the  chemist  that  pancreatin  administered  by 
mouth  is  destroyed  by  the  acids  of  the  stomach.  Experiments  by 
physiological  chemists  have  demonstrated  that  after  the  extirpation 
of  the  pancreas  in  dogs  absorption  of  fat  is  entirely  abolished, 
although  the  fat  be  split  up  by  bacterial  fermentation.  If,  however, 
some  pancreas  be  given  to  these  dogs  along  with  the  fat,  a  portion 
of  this  fat  is  absorbed. 
Since,  then,  there  is  a  necessity  for  these  formulas  to  meet  the 
legitimate  demands  on  pharmacy,  it  becomes  pertinent  to  inquire  if 
any  improvement  can  be  made  in  them,  and  the  intent  of  this  con- 
tribution is  to  present  several  proposed  improvements  for  consid- 
eration. 
Compound  Powder  of  Pepsin. — It  is  proposed  that  the  present 
