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Charles Field Mason.

A complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia online

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the basis. Camphor needs a lit'le alcohol to enable it to be pul-
verized. Volatile substances should be added last to allow of as
little evaporation as possible.

Poivders: Substances which are insoluble and too bulky to be pre-
scribed in pills are often ordered in the form of powder. The in-
gredients are to be thoroughly mixed and accurately, divided. The
mixing is usually done in a mortar unless it is explosive, but may be
effected on a pill-tile with the aid of a spatula. Substances such as
alkaloids are very active and when employed in small doses require
some inert substance to give them bulk sufficient for division and
handling; sugar of milk is usually employed for the purpose. The
active ingredient is placed in the mortar first and thoroughly mixed
with a small quantity of the diluent, the addition being gradually
continued.

Powders are dispensed in bulk when the dose is large, or in papers,
chartulas, when the dose is small.

Hygroscopic and effervescent powders should be dispensed in
waxed paper, others in ordinary white paper. The paper should be
cut to fit the powder and folded to fit the box. It should be the rule
to weigh out separately each dose of the active ingredients.

Suppositories: Rectal and vaginal suppositories usually have



PHARMACY 323

cacao butter as a basis, while glycerinated gelatin is commonly em-
ployed for the urethra. Rectal suppositories are cone-shaped and
weigh from one to two grammes. Urethral suppositories are pencil-
shaped, and either seven centimeters in length, weighing two
grammes, or fourteen centimeters in length, weighing four grammes.
Vaginal suppositories should be globular or egg-shaped and weigh
about four grammes.

Cacao butter suppositories are prepared by reducing the medicine
to a powder or softening it, and then rubbing it up in a mortar with
an equal quantity of the finely grated excipient until a smooth paste
is formed, after which the remainder of the excipient is slowly
added. A little castor-oil or glycerin may be added to make the
mass more plastic. Next roll the mass on a graduated tile until a
cylinder of the proper length is formed, divide this into the required
number of equal parts, and with a spatula form them into the
desired shape. Cacao butter suppositories may also be prepared by
melting the ingredients together and molding them.

Gelatin urethral suppositories are prepared by dissolving or thor-
oughly mixing the medicine with a little water and sufficient glycerin
to make the weight of the mixture one-half that of the finished
product. Then carefully incorporate it with an equal weight of
melted glycerinated gelatin, and pour it at once into suitable molds
which have been greased with a small quantity of petrolatum. Cool
the molds before removing the suppositories.

WEIGHTS AND MEASURES

Three different systems of weights and measures are used in this
country, avoirdupois weight, apothecaries' weight, and metric weight.

Avoirdupois .weight is used in the purchase and sale of drugs.
The divisions of avoirdupois weight are the pound, ounce, drachm,
and grain, which are represented by the following characters: lb.,
oz., drm., gr. ; each pound contains 16 ounces and each ounce 16
drachms or 437^ grains. The term drachm is rarely employed,
quantities less than an ounce being usually designated by common
fractions, such as 1/16 oz., J /s oz., % oz., or in grains.

Apothecaries' weight is frequently employed in the writing and
compounding of physicians' prescriptions, and is divided into grains,
scruples, drachms, and ounces, of which 20 grains are equal to I
scruple, 3 scruples are equal to i drachm, and 8 drachms are equal to
i ounce..



324 MATERIA MEDICA, THERAPEUTICS, PHARMACY

TABLE OF APOTHECARIES" WEIGHT

Scruple.

Grain. (Scru'pulus.) Pound.

(Gra'num.) Rarely em- Drachm. Ounce. (Li'bra.)

Symbol: gr. ployed now. (Dra'chma.) (U'ncia.) Ib.

20. i .

60. 3. s.

480. 24. 8. i.

5,760. 288. p6. 12. I.





TABLE OF


APOTHECARIES


MEASURE




Minim.
(Mi'nimum.)
Symbol :


Fluidrachm.
(Fluidra'chma.)


Fluidounce.
(Fluidu'ncia.)


Pint.
(Octa'rius.)
O.


Gallon,
(Co'ngius.)

c.


60.
480
7,680.
61,440.


i .
8.
128.
1,024.


. i-
16.
128.


i.
8.


I.



The metric or decimal system is prescribed for use in the medical
department of the army. The name metric is derived from one of
the units of the system, the meter or unit of length, which is the
forty-millionth part of the earth's circumference around the poles.

The unit of capacity is the liter, which is equal to 1,000 cubic centi-
meters. The unit of weight is the gramme, which is the weight of
one cubic centimeter of water at its maximum density. The prefixes
which indicate multiplication are Deka (10), Hecto (ico), and Kilo
(1,000), while division is indicated by Deci (i-io), Centi (i-ioo),
and Milli (i-iooo).

The system resembles the United States money system, which is
also decimal, in the latter the dollar is the unit, and there are mills
(i-iooo), cents (i-ioo), dimes (i-io), and eagles (10) ; like the
money system, too, only a few of the terms are used in pharmacy ;
thus we use cubic centimeters (Cc.), kilogrammes (Kilo), gramme
(Gm.), and milligramme (Mgm.) ; also the term ^2 gramme and ^4
gramme may be employed. Fractional parts of a dollar may be
written in several ways, thus : $0.50, 50 cents, and 500 mills, all
mean the same thing, and so do grammes 0.50, 50 centigrammes, and
500 milligrammes ; but while we use cents as applied to fractional
parts of a dollar, we usually employ mills as applied to fractional
parts of a gramme.

Concerning the relative values of these two systems of weights and
measures, there can be no question of the great advantage of the
Metric over the Apothecaries' system. The former is founded upon
a decimal basis, and thus everything is in tens; thus it is easier to
compute amounts and divide doses ; it is expressed more easily ; then,



PHARMACY 325

again, there is an exact correspondence between the metric system of
weights and the measures one cubic centimeter of water at 4 C.
weighing exactly one gramme. In the Apothecaries' system, such
an exact correlation does not exist, the minim not weighing exactly
one grain, and one fluidounce of water (480 minims) weighing only
455 grains ; the difference is, however, only trifling, and in the case
of liquids having a specific gravity differing but little from that of
water, need not be considered ; and thus we can, as a rule, take one
minim as one grain.

The quantities are expressed much more simply in the Metric
than in the Apothecaries' system ; instead of being required to place
the sign before each figure, we place on the top of the column the
words " grammes,'' or " cubic centimeters " and then below this the
figures, separating the whole numbers from decimals either by a
line or period; or "grammes" or "cubic centimeters" may be
abbreviated to " Gm." or " Cc."

Translation from one system into the other can be done very
easily, as will be seen from the following tables. The approximate
equivalents are the ones ordinarily to be employed, the exact ones
being added for reference only :

TABLE OF EQUIVALENTS

Length
Meters. Inches.

i 39-37

o.i 3-93

o.oi 39

Capacity

Liters Fluidounces Minims

i 33-8i

o.oi (Cc.) 15

Weight

Grammes Grains

i 15-43 ( 1 5i approximately).

o.i i-54 ( ii approximately).

o.oi 15 ( i approximately).

o.ooi . , 015 ( approximately).



326 MATERIA MEDICA, THERAPEUTICS, PHARMACY

TABLE OF EQUIVALENTS Continued.

Domestic Measures

i teaspoonful = approximately 5 Cc.
i dessertspoonful = approximately 10 Cc.
I tablespoonful = approximately 15 Cc.

To convert metric weights and measures into those in ordinary
use, and vice versa, multiply by the corresponding equivalents.

To convert :

Meters into inches, multiply by 39.370.
Example : 39 . 370

5



5 meters 196.850 inches.

Liters into fluidounces, multiply by 33.815.
Example: 33 .815

5



5 liters 169.075 fluidounces.

Grammes into grains, multiply by 15.432.
Example: 15.432

5



5 grammes 77. 160 grains.

Inches into centimeters, multiply by 2.539.
Example: 2 -539

5



5 inches 12.695 centimeters.

Fluidounces into cubic centimeters, multiply by 29.572.
Example: 29.572

5



5 fluidounces 147.860 cubic centimeters.



PHARMACY 327



TABLE OF EQUIVALENTS Continued.
Grains into grammes, multiply by 0.064.
Example: 0.064

5



5 grams o. 320 gramme.

Pharmacists can not be too careful in the use of metric weights
and measures in the writing and reading of prescriptions. In
Europe, where the metric system has been in use for many years,
no signs are used in prescriptions, because all ingredients, whether
solid or liquid, are weighed, and it is understood that weight is
always intended; whenever, for any reason, measures are wanted,
the signs " L." (liter) and " Ccm." (Cubic centimeter) are em-
ployed. But in this country, where it is still customary to weigh
solids and to measure fluids in the dispensing of medicines, the
official abbreviations given in the U. S. Pharmacopeia should be
used invariably, so as to avoid all possible confusion. With water,
and the average diluted alcohol tinctures, it would probably not
make much difference whether grammes or cubic centimeters were
dispensed, but in the case of all liquids having a higher or lower
specific gravity than water a marked variation will be observed;
thus 20 Gm. of glycerin measure 16 Cc., and 20 Cc. of glycerin
weigh 25 Gm. ; 60 Gm. of simple syrup measure 45.5 Cc., and 60 Cc.
of syrup weigh 79.02 Gm. ; 30 Gm. of chloroform measure 20.13 +
Cc., and 30 Cc. of chloroform weigh 44.7 Gm. ; 4 Gm. of bromoform
measure only 1.4 Cc., and 4 Cc. of bromoform weigh 11.32 Gm. ;
10 Gm. of ether measure 13.77 + Cc., and 10 Cc. of ether weigh
only 7.26 Gm. ; 50 Gm. of alcohol measure 60.97 + Cc., and 50 Cc.
of alcohol weigh 41 Gm.

SCALES AND WEIGHTS

The most useful instrument in pharmacy is the balance or scales.
The form usually employed is a single beam with equal arms. The
beam or lever is divided at the center into two equal arms by a knife
edge upon which it rests. There are also, at each end of the beam,
knife edges upon which the scale pans are suspended, these knife
edges being hard and indestructible, and usually of agate.



328 MATERIA MEDICA, THERAPEUTICS, PHARMACY

The scale pans are generally of nickel or silver, but for weighing
corrosive substances glass scale pans are employed.

The balance should be enclosed in a glass case and carefully pro-
tected from moisture, corrosive vapors, dust, and from jarring and
shaking. They should be kept very clean by polishing with leather
and dusting with a camel's hair brush.

Weights are usually of brass or aluminum, and platinum is also
used for small weights, on account of its hardness and resistance to
corrosion.

The term tare denotes the weight of the empty vessel or container
in which the substance is to be weighed ; gross weight includes both
the substance and the container, while net weight is the weight of
the substance alone.

Measures in pharmacy are used for liquids only; they are ordi-
narily glass, and are known as graduates.

Approximate measurements. The number of drops contained in
a certain volume of liquids varies according to its density and the
size and shape of the vessel from which it is dropped ; they are not
identical with the minim.

The following table gives certain domestic measures and their
equivalents :

One teaspoonful = i fluidrachm
One dessertspoonful = 2 fluidrachms
One tablespoonful = fluidounce
One wineglassful = 2 fluidounces
One teacupful = 4 fluidounces

One tumblerful = 6 to 8 fluidounces

According to the U. S. Pharmacopoeia, the following are the
metric equivalents :

One teaspoonful = 4 Cc.
One dessertspoonful = 8 Cc.
One tablespoonful = 16 Cc.

FILLING PRESCRIPTIONS

(Extemporaneous Pharmacy)

This includes a variety of operations, and requires a knowledge
of the meaning of the Latin words and abbreviations ordinarily



PHARMACY 329

used in prescription writing, as well as great care and accuracy in
the various steps required.

A prescription is an order to the druggist to deliver to the patient
certain medicines. Such orders are written in Latin, this language
presenting decided advantages. It is customary to have so-called
" prescription blanks " on hand, and a convenient size for these is
three and one-half inches by five inches.

Each prescription may be considered to be composed of five
parts :

(1) The preliminaries.

(2) The name of the drug or preparation ordered, or two or

more of such names.

(3) The quantity of such ingredients.

(4) Directions to the druggist as to what he is to do with these

ingredients.

(5) Directions to the patient as to how the medicine is to be

taken.

(l) THE PRELIMINARIES

Besides the portion relating to the compounding and dispensing
of the medicine ordered, each prescription should have added the
name and address of the prescriber, the name of the patient and
the date.

The address may be written or printed at the top of the paper,
and is to be followed by the date, just as in writing a letter. The
name of the patient is also to be placed above, and is preceded by
" For." The prescriber's name is signed below. Should any special
directions to the druggist, not intended to be put upon the label
attached to the medicine, be added, such as " Not to be repeated,"
" To be repeated once only," etc., they are to be written either above
or below the main subject matter of the prescription.

(2) THE NAME OF THE DRUG OR PREPARATION, OR TWO OR MORE
OF SUCH NAMES

Regarding pharmacopoeial nomenclature, the following may be
noted :

(a) The title of a vegetable drug is, with few exceptions, its
botanical genus-name; it is represented by a single term, unless more
than one part of the plant is official, in which case the part of the
plant desired is specified in addition. Thus we say: "Aconitum"



330 MATERIA MEDICA, THERAPEUTICS, PHARMACY

because only the root is official; but " Colchici Radix" and " Colchici
Semen," because both parts are official.

(b) Pharmacopocial salts are usually designated by the Latin of
their chemical names, with the basic name first in the genitive, fol-
lowed by the acid name in the nominative. Thus : " Magnetic
Sulphate" is " Magnesii Sulphas," i. e., "of Magnesium, the
Sulphate." In a few instances, the common names are employed
instead of the chemical ones, as "Alumen " for " Potassio-aluminum
sulphate." When two classes of the same salt are employed, one is
distinguished from the other by a difference in nomenclature (i)
chemically, such as " Sodii Carbonas " and " Sodii Btcarbonas,"
" Liquor Ferri ^w&sulphatis " and " Liquor Ferri TVrsulphatis " ; or
(2) by some reference to their physical or physiological qualities,
such as " Hydrargyri Chloridum Corrosivum " and " Hydrargyri
Chloridum Mite," Hydrargyri Oxidum Flavum and Hydrargyri
Oxidum Rubrum.

(c) Adjectives follow the nouns which they qualify; thus:
" Cinchona Flava," " Yellow Cinchona." When two nouns occur
together in drugs and chemicals (not in preparations), the genitive
following "of" is placed first; thus: " Belladonnas Radix," "Of

belladonna, the root.

*********

Each ingredient of a prescription is to be in the genitive case,
since it follows " Recipe." We say : " Take of so and so certain
quantity." The only exceptions to this rule are the following:

(a) When we order a definite number or size of any pharma-
copoeial preparation, the latter is to be in the accusative case, since
it is now the direct object of "Recipe." Thus we say: "Take
twelve Compound Cathartic Pills," " Recipe Pilulas Cartharticas
Compositas, numero xij." Again : " Take a Belladonna Plaster
six inches by four inches " is " Recipe Emplastrum Belladonnae
six inches by four inches." But if we directed the druggist to
" take a certain quantity of Belladonna Plaster, and then to spread
this upon adhesive plaster," we would write : " Recipe Emplastri
Belladonnae, 3 ij.; extende supra emplastrum resinae, six inches by
four inches."

(&) When we have ordered one or more ingredients, and wish to
add enough water or other liquid, so as to give a desired bulk, with-
out stopping to compute the exact amount necessary, we may order



PHARMACY 331

the final ingredient in the following manner : " Take Water up to
a cretain quantity." Here "water" would be the direct object of
" Recipe," and thus be in the accusative case, thus : " Recipe, Aquaw,
ad fl. g iv." The latter phrase can also be rendered : " Take of
Water a sufficient quantity up to four fluidounces." " Recipe,
Aqucp, quantum sufficiat ad fl. iv."

THE QUANTITY OF THE INGREDIENTS

These are placed in the accusative case, being the direct object
of " Recipe ; " but it is not only customary, but is advisable to
express quantities in symbols and not to write them out.

The cardinal numerals are usually represented by the Roman
symbols : i., ii., iii., iv., etc. It is customary to draw a line over the
symbol and to dot the I. This is an additional safeguard against
mistakes, since the number of dots should correspond to the number
of I's; when the symbol I is final, it is usually modified, and the
fact of its being the final number indicated by changing it into a
"j" thus "j."

DIRECTIONS TO THE DRUGGIST

as to what he is to do with the ingredients which have been
ordered :

These begin with the 1$, the abbreviation of "recipe," at the
commencement of every prescription. The ingredients and quanti-
ties also apply to him, for he is directed to take those different
substances in specified quantities.

Where a certain number or certain quantity of an official prepara-
tion is ordered, there may be no further directions for the druggist
except " Signa," " Label," and then the directions to the patient.

But where two or more ingredients are combined, after enumerat-
ing these, we direct the druggist to mix " Misce." In the case
of all preparations excepting pills, powders, suppositories, and
troches, this would be all that would be necessary. But it is a little
more elegant to add " Fiat ," mentioning the form of medi-
cine which we have prescribed, the name of the medicine being in
the nominative singular, after the passive imperative " Fiat;" thus:
" Fiat mistura," " Fiat linimentum," " Fiat unguentum," " Fiat
collyrium," etc.

In the case of pills, suppositories, and troches, we direct the



332 MATERIA MEDICA, THERAPEUTICS, PHARMACY

druggist to " make a mass and to divide it into a certain number of
pills, suppositories, or troches. This we may express in either of
the following ways:

(1) Fiat massa, et divide in pilulas (suppositoria, trochiscos)
numero

(2) Fiat massa, in pilulas (suppositoria, trochiscos), numero

dividenda.

" Pilulas," " suppositoria," and " trochiscos " being in each case
in the accusative plural after the preposition "in." "Dividenda"
always agrees with " massa"

In the case of a powder which is to be divided into a certain
number of papers, we direct the druggist to " make a powder and to
divide this into a certain number of papers," and again we have two
methods of expressing this:

1 i ) Fiat pulvis, et divide in chartulas numero .

(2) Fiat pulvis, in chartulas numero dividendus.

Here we say " dividends," to agree with " pulvis."

It is quite common in Europe to order a single dose of a powder,
pill, troche, or suppository, and then to direct the druggist to " make
of such doses a certain number." This method is occasionally em-
ployed in this country, and, then, supposing we wished twenty papers
of Dover's powder each weighing five grains, we would write for :
Recipe :

Pulveris Ipecacuanhas et Opii gr. v.

Fiat chartulas tales doses numero xx., or we may also say: Fac
chartulas tales doses numero xx. ; in this case, " chartulas " is in the
accusative plural after " fac."

In ordering pills, it is not necessary for us to specify the sub-
stances which are to be used in making a pilular mass ; this belongs
to the pharmacist. Very often, however, the substances ordered in
pills, such as extracts, are themselves all that are necessary for
making a suitable pill mass.

Next, we direct the druggist to "label" " Signa."
Other Latin words and phrases used in prescriptions are the
following :

A'dde, add.

Ad li'bitum, at pleasure.

Ad satura'ndum, to saturation.

Be'ne, well.



PHARMACY 333

Ana, aa, of each.

Bis; twice.

Bis in di'es, twice daily.

Bu'lliat, let (it) boil.

Ci'bus, food.

Cochlea're ma'gnum, a tablespoon.

Cochlea're parvum, a teaspoon.

Co'la, strain.

Colluto'rium, a mouth-wash.

De'in, thereupon.

Dimi'dius, half.

Di'vide, divide.

Do'sis, a dose.

Et, and.

Exte'nde, spread.

Exte'nde su'pra, spread upon.

Fac, make.

Fi'at (sing.), Fi'ant (plur.), let (it, them) be made (into).

Fi'ltra, filter.

Grada'tim, gradually.

Gu'tta, a drop.

Gutta'tim, drop by drop.

Ho'ra, an hour.

In di'es, daily.

Lage'na, a bottle.

Li'bra, a pound.

Li'nteum, lint.

Ma'cera, macerate.

Ma'ne, in the morning.

Ma'ne pri'mo, early in the morning.

Mica pa'nis, a crumb of bread.

Mi'sce, mix.

Non, not.

No'cte, at night.

No'cte mane'qne, at night and in the morning.

Nu'merus, a number.

Nu'mero, in number.

Octa'rius, a pint.

Pa'rtes aqua'les, equal parts.



334 MATERIA MEDICA, THERAPEUTICS, PHARMACY

Pro re na'ta, as required.

Qua'ntum sufficiat, as much as is necessary.

Qua'qua ho'ra, every hour.

Re'cipe, take.

Satura'tus, saturated.

Sea' tula, a box.

Se'mel, once.

Semissis, a half.

Semidra'chma, a half drachm.

Si'gna, mark.

Si'mul, together.

Sine, without.

So'lve, dissolve.

Sta'tim, immediately.

Suffi'ciat, may suffice.

Ta'les, such.

Ta'les do'ses, such doses.

Te're, rub.

Te're si'mul, rub together.

Ter in di'e, three times a day.

Tri'tura, triturate.

5. DIRECTIONS TO THE PATIENT

These are to be written in English, and are to be definite. The
words " as directed," having absolutely no value, are never to be
employed. No greater proof of the uselessness of these words can
be given than to state that when a prescription is sent out without
directions, druggists are in the habit of labelling: " Use as directed."

Compounding means the preparation of the various drugs ordered,
while dispensing includes putting them up and issuing them.

To fill a prescription, first read it over carefully until it is thor-
oughly understood, then number it, and write the label ; next meas-
ure out the ingredients, checking each one off to prevent duplication,
compound them as directed, and dispense. Poisonous prescriptions
should be plainly labeled Poison. The prescription should then be
filed in the prescription book.

Prescriptions should not be refilled without an order from a med-
ical officer in each case; the date refilled should be noted on the
prescription and on the label.



PHARMACY 335

INCOMPATIBILITY

Incompatibility of drugs means unfitness for combination in the
same prescription. Incompatibility may be chemical, pharmaceuti-
cal, or therapeutical.

In chemical incompatibility a chemical reaction takes place result-
ing in the formation of precipitates, explosives, or poisonous com-
pounds. Combination of cinchona preparations with salts of iron
forms an inky mixture; of nitric acid with glycerin an explosive
substance; of dilute hydrocyanic acid with calomel a virulent
poison.

In pharmaceutical incompatibility no chemical action takes place,
but precipitation and an unsightly mixture often results ; the addition
of aqueous solutions to resinous tinctures illustrates this principle.

Therapeutical incompatibility arises when two agents which oppose
each other in their action on the system are prescribed together,
such, for example, as morphine and atropine. It is always to be
borne in mind, however, that chemically or therapeutically incom-
patible drugs are often prescribed together intentionally to serve a
definite purpose.

It will be well to mention certain underlying principles which
should be considered when we order mixtures of two or more
remedial agents.

1. Water is the solvent usually employed for soluble salts, for
acids, sugars, gums, vegetable extractive matters, and for albuminous
and gelatinous compounds.

2. Alcohol is usually employed for dissolving volatile oils, oleo-
resins, resins, gum-resins, camphor, balsams, and vegetable sub-
stances containing oily and resinous principles.

3. When more than a small amount of such aqueous solutions are



Online LibraryCharles Field MasonA complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia → online text (page 24 of 38)