Posted by ed_uk on July 22, 2005, at 17:47:15
An English pharmacist talks about the past.....
It used to be that NHS prescriptions had a tick-box inscribed with the letters NP. These letters, standing for nomen proprium, the Latin for “proper name”, allowed doctors to keep aspects of their prescribing practices shrouded in mystery. If GPs did not wish their patients to know the name of their medicine, the box could be left without a tick.
Older pharmacists will remember when all dispensed medicines were issued with no identifying names. Their labels read “The mixture”, “The tablets” and so forth. Before 1980 most medical practitioners considered it inappropriate to give their patients such privileged information as the generic or proprietary name of their medicine. Many pharmacists held similar views, myself included. We thought that lay people should be kept in the dark. A popular saying of the time was: “A little knowledge is a dangerous thing.” As a supporter, I lamely argued that knowing the correct name of what your doctor had prescribed would lead to sharing of the medicine with others. This attitude derived largely from the notion that most people would never understand the science behind their drug treatments. The credo was that professional activities were best kept private.
We pharmacists preferred working in dispensaries hidden behind an ornately carved screen using Latin terms to give added aura to our calling. Doctors, in their turn, would write sick notes to say their patient was suffering from coryza, this sounding more impressive than revealing here was a case of the common cold. Critics of the system said such practices stemmed from a need to justify physicians’ fees. It may have been true.
I took pleasure in dispensing prescriptions that read “Adeps lanae hydras, more dicto utendus, mitte ounces iv”, and then presenting an anonymous jar impeccably wrapped in white demy. Clinging to my apothecary image, I could well have audibly muttered “fiat secundum artem”.
Ironically, defenders of Latin cited that, by learning its exact rules of grammar, words acquired a clearer meaning and this would benefit the way English was used. So why did we take such pains to cloud our public pronouncements?
Such ideas had persisted for generations. Consider the opposition to adopting metric measurements. The resistance prevailed throughout pharmacy (indeed the entire medical profession) until the latter part of the 1960s. Not until the end of that decade did those curious squiggles denoting drachms and scruples and the use of Roman numerals disappear from doctors’ prescriptions. The bilateral use of the avoirdupois and the apothecary systems was an absurd anachronism. How can I begin to explain to present-day pharmacists the logic of a 1 per cent aqueous solution consisting of one grain of solute dissolved in 110 minims of water?
There followed another period of inertia. The implementation of typed labels took a further 10 years. Have we forgotten the handwritten (often indecipherable) prescriptions that prevailed into the 1980s? Many doctors seemed to take a pride in their bad handwriting. Was this another device to give the aloof medical fraternity the appearance of being learned beyond the understanding of the masses? A scribbled prescription for “Tab acid acetylsal” might serve to disguise that only a commonplace aspirin tablet had been ordered.
But mysticism was under threat and eventually I became a convert to more transparent communications. There was no room in medicine for old-fashioned mumbo jumbo, I now declared. We must be scrupulously honest with patients. After all we were belatedly being encouraged to offer clear advice to the public on medical problems. How could I ever have simultaneously embraced science and superstition? I had my pompous excuse ready. Had not Isaac Newton and Robert Boyle, back in the 18th century, both supported alchemy while making their singularly important contributions to mathematics and physics? My hypocrisy was still intact.
~Ed
poster:ed_uk
thread:531776
URL: http://www.dr-bob.org/babble/20050718/msgs/531776.html