Pharmaceutical practices have changed considerably over the past fifty years. My first few years consisted of mixing, grinding with mortar and pestle, weighing, measuring, dissolving, heating, cooling, colouring, flavouring and depositing finished products into suitable bottles with appropriate, laboriously – typed directions. This was called extemporaneous dispensing and accounted for about 90 per cent of all prescriptions. The only ready-prepared items were a few antibiotics (penicillin and sulphonamides), barbiturates, thyroid extracts and a few others.
We made up an enormous range of mixtures, creams, ointments, lotions, liniments, eye, ear and nasal drops, suppositories, pills, pessaries, soaps, tinctures, spirits, emulsions, dusting powders, powders for internal use, elixirs, gels, inhalations, linctuses (lincti?) pastes and even injections. These were mostly based on Formularies – the British Pharmacopeia (and Codex), and the APF (Australian Pharmaceutical Formulary),with some American and European formulae thrown in.
These preparations had been passed down through the ages, based on herbal, animal and mineral sources. I believe some of them were just as effective or even more so, than current modern drug treatment. They were also less expensive and had few side-effects. There was little treatment for cardiovascular ailments, and none at all for cancer except morphine.
This extemporaneous system worked well, with doctors and pharmacists having knowledge and being trained, to prescribe and dispense respectively (and respectfully). It obviously took more time to dispense these compounds, and was probably the origin of – “that will be about 20 minutes”, said to each patient. We shortened much of the dispensing time by making up pre-prepared stock solutions and concentrates.
I enjoyed the extemporaneous system, getting great satisfaction and knowledge from pharmacology, botany, material medica, pharmacognosy (drugs extracted from plant sources), drugs from mineral and animal sources, organic chemistry, physics and forensics. We were educated on incompatibilities (no- not Tom Cruise and Katie), especially when making up emulsions and creams—with the wrong combinations, these would “crack”, separating into gooey oily and watery messes – hastily dumped into the nearest bin.
The dispensing techniques used the apothecary system of weights and measures when I started, so we measured in grains, drachms, ounces, minims, fluid drachms and ounces, and occasionally pints, pounds, quarts and gallons (for bulk dispensing and hypochondriacs). Doses of liquids were given as teaspoons or tablespoons, and prescriptions were scrawled out by doctors in a mixture of old Latin, arcane abbreviations and symbols, and occasionally, even modern English.
Some of the writing was truly terrible but we managed to decipher most of it. One memorable scrawl from my early days was a script for “Pulv. ABT”. I knew “pulv” was Latin for “powder” but the “ABT” had me tossed – no such thing in any formulary I knew. I rang the doctor who just said, “Give him Any Bloody Thing- he’s a hypochondriac”.
This apothecary system changed later into the metric system which is probably more logical and consistent, but didn’t have the same charm. All our dispensing was based on centuries – old methods of combining, blending and compounding various naturally occurring substances which were standardised and purified.
These formulae and techniques were based on old, sometimes pre-historic, hunter-gatherer societies who had learnt – by bitter experience – which plants were safe and useful. Shamans, medicine men (and women) and community leaders passed this knowledge on to succeeding generations, eventually forming the basis of European medical practice right up to recent times. It is only in the last 50 years or so that this system has been almost totally replaced by modern potent drugs, big Government and giant multi-national drug cartels.