|THE ART AND MODE OF PRESCRIBING|
Homeopathic Materia Medica by Dunham
THE ART AND MODE OF PRESCRIBING
( )The spirit of homeopathic practice requiring the administration of a single remedy at a time, there is no room for the compounding of drugs in prescriptions. When it is required to order a dose of any quantity of a remedy from a pharmaceutist, it suffices to inscribe the name of the drug and to add in plain English the form in which it is desired, with the potency and the quantity.
Nevertheless, the venerable antiquity of the art of rightly marshaling drugs in the serried ranks of a complex prescription, demands a passing notice at our hands.
The writing of a prescription involves two things:
1. That we know what drugs we desire to associate together, and in what relative quantities.
2. That we know how to express our desires in the terms of the art.
The first demands scientific knowledge of a high order, embracing a full acquaintance with the chemical and physiological actions and reactions of drugs.
The second requires an acquaintance with the language in which prescriptions are written (generally, but not necessarily, the Latin), and with the symbols of the apothecary.
It is not a matter of indifference what drugs are mixed in a prescription.
Drugs of which the united or joint action might seem desirable, may yet be chemically incompatible in such way that through their mutual action a third and altogether different substance may be formed. This third substance may be simply inelegant and inert, or it may be noxious and poisonous. Of the former we have an example in the following prescription :
R. Tinct. Ferri chloridi f|ss. Quiniae sulphatis gr. xx. Syrupi rosae Gallicae f§ijss. Misce. Signa. Sumat seger cochleae magnum quaque hora in apyrexiam.
By the action of the iron upon the tannic acid of the roses ink is formed and a precipitate occurs. The object of adding the syrup of roses, viz., to give a fine color, is completely frustrated by the addition of the iron. But this is not noxious, though inelegant.
Again, the incompatibility may spring from the tendency of the ingredients to form a noxious product, as in the following effervescent draught, which has twice, in New York, caused instant death :
R Sodae Bicarbonatis gr. xx. Potassii Cyanidi gr. iv. Aquae destillatae f 3 ijss. Solve. Deinde adde— Succi limonis recentis f3j. Misce. et bibat aeger, mistura effervescente.
In this case the citric acid decomposes the cyanide of potassium, and hydrocyanic acid is formed as the draught is taken. It proves fatal.
Again, the incompatibility may come from the ingredients being physiological antidotes, E. G., morphine and strychnine.
R Morphiae acetatis gr. viij. Strychniae sulphatis, gr. ij. Panis q. s. Fiant pillulae minimae quadriginta.
It is probable that these pills might be taken freely without the physiological effect of either of these powerful alkaloids being experienced, because they antidote each other.
It is requisite, therefore, for success, in writing prescriptions, that one know the chemical and physiological properties and relations of drugs.
Again, it has been found by experience that certain combinations of drugs possess properties not known to be possessed by any of the ingredients. The Dover's powder, or pulvis ipecacuanhas composita, is an example of this. Such knowledge is hit upon by chance, and is a matter of memory.
Presupposing the possession of knowledge to select the drugs suitable to be associated in a prescription, the form of composition of the prescription is merely technical. It may be done as well in English as in Latin. The following is an instance of a correct and quite harmless prescription:
Carminative for an infant.
R Cretae praeparatae. Sacchari albi aa3j. Acacias pulveris "% ij. Aquae cinnamoni f§iv. Misce. Signa. Sumat cochlear parvum bis vel ter die, pro re nata.
As an example, at one and the same time, of the mode of writing prescriptions, and of the pedantic and nonsensically stilted language and manner in which simple and familiar beverages are sometimes ordered, let the following serve:
Agreeable refrigerant. R Succi limonis recentis - Corticis limonis recentis magnopera tenuis 3ss. Sacchari albi %'W. Aquae Crotonis glacialis Oiij. Misce. Cola. Divide in amicis. Sumat quisque quantum ilibet.
Or the following:
Haustus stimulans calorifaciens et roborifaciens.
R Spiritus frumenti Borbonica f^iv. Aquae bullientis Oij. Succi limonis recentis ffiss. Corticis limonis recentis magnopera tenuis 3ss. Sacchari albi fiv. Infusi these sinensis 3 ij. Misce. Teneatur mistura calleda. Divide in poculis octo. Suraat quisque amicus unum in animum oblectandum.
The whole art of prescribing consists first in knowing exactly what you want to give the patient, and in what doses; and then in writing your directions so clearly and intelligibly that the apothecary may fully understand you.
Homeopathic Pharmacy and Posology
The preparation of drugs in the homeopathic pharmacy is simple. We have: 1. Triturations. 2. Tinctures. From each of these forms preparations are made, called, indifferently, DIHDIONS, ATTENUATIONS or POTENCIES.
Metals, chemical salts and some dry vegetable substances are prepared by trituration with an inert substance, such as milk sugar, which is especially suitable from the hardness and sharpness of its crystals, and from its non-hygrometric properties.
Vegetable substances that are prepared in the form of TINCTURES may be divided, according to their mode of preparation, into three classes.
1. Roots, barks and leaves that are dry. These are coarsely powdered, and a tincture is prepared by the process of percolation.
2. Plants which contain a large quantity of juice. These are bruised, mixed with an equal weight of alcohol, the mixture kept in a cool, dark place for a day or two, and then subjected to pressure and filtered.
3. Plants which contain but a small quantity of juice are bruised, mixed with double their weight of alcohol, and then treated as class No. 1.
The alcohol and milk sugar used must be carefully purified.
The attenuations, dilutions or potencies (as they are variously called) are prepared by triturating the preparation obtained as above with milk sugar, or by mixing them with alcohol, according to one of two different scales, known as the decimal and centesimal, respectively. Thus, if one grain of metallic gold be triturated with one hundred grains of milk sugar, this forms the first centesimal trituration. A grain of this first trituration, triturated again with one hundred grains of milk sugar, forms the second centesimal trituration; and so on. If with ten grains instead of one hundred, they are the first and second decimal triturations. With alcohol instead of milk sugar they are dilutions or attenuations ; all are called potencies.
These attenuations or potencies have been carried to very high numbers. In the way I have described, I know them to have been carried to the two hundredth ; of higher, prepared positively in this way, I have no personal knowledge.