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etc. To discriminate between the false and true will require great experience, care, and skill in the diagnosis of disease. While it is of the greatest importance to detect the impostor and hold him to strict accountability, it is not the less important to the public service, and but common justice to the individual, that the genuinely disabled should be exempt. If the latter is pressed into the army, he becomes at once an incumbrance. He may endure the slight fatigue of the camp, and become a well-drilled soldier, but the first exposure or fatiguing march sends him to the hospital, an invalid for the remainder of his term of enlistment. The medical examination of persons claiming exemption from service, and alleging disability, must, therefore, always be a responsible duty. A distinguished medical author has very justly remarked: "It is obvious that the more we know of disease by reading and observation, the more patience and temper we possess, the more successful shall we be in the detection of imposture." Again, the chief of the army medical department of the Prussian army states, "that a knowledge and experience greater than is generally believed, along with an acquaintance with anatomy, physiology, and pathology, is especially required to decide upon the health and general efficiency of recruits, and to distinguish between defects that may be real from those that are only feigned."

XXXIV.

PRESCRIPTION WRITING.

THE

HE recent case of death in consequence of a mistake in compounding a prescription, reveals one of those careless habits of physicians which demand reform. It is probable that the prescription, in this instance, was as legible as the penmanship of physicians ordinarily is, and that the druggist was the censurable party in the main; but the fact that, in the present mode of prescribing, mistakes similar to this not unfrequently occur, sometimes producing the most melancholy consequences, should lead the profession to inquire whether there is not some remedy or some safeguard against this evil. Only a few years ago, at one of the best known and best patronized drug-stores in Broadway, the clerk "put up" antim. tart. in place of antim. pulv., and as a consequence an interesting child with scarlet fever was vomited to death. At another store, powders containing poisonous doses of opium were dispensed, and the druggist, culpably remiss, gave no warning, so that the victim, an infant, was narcotized beyond recovery. Again, a liniment containing the most poisonous ingredients was administered to a child, through the

fault of a physician or druggist, or both, and immediate death was the result. These cases, among others, have been made public, and almost every physician in general practice is aware of instances which have fallen under his own observation, but which few knew beyond the circle of those immediately interested, in which the lives of patients were hazarded, even if they were not lost, by similar mistakes. Aside from the danger which attends the administration of a wrongly prepared medicine, the effect of such mistakes is very bad, particularly as regards public opinion. Probably the proportion of these mistakes to the number of prescriptions dispensed is not greater than one to five hundred, yet in consequence of the publicity given to some of them, a widespread fear, a distrust of the present system of dispensing, pervades all classes of the community. How often does the physician find that the medicine which he ordered the day before has not been given, or has been given in reduced doses and at long intervals, through the fear that it was improperly prepared, and this, too, when it is very important, in order to arrest or control the disease, that the remedy should be given regularly? How often, too, do we hear the wish expressed, through fear of these mistakes, that physicians would carry medicines with them, as is done in the country, or in smaller cities, or as was customary in cities of olden times? No doubt, the dread of being

poisoned or injured by incorrectly prepared medicines operates as an inducement to the employment of irregular practitioners, who provide their own remedies; and yet, with proper care on the part of physician and druggist, and a proper relation between the two, the system of written prescriptions is as safe as any; since although there are two to make mistakes, there are also two to detect them. We purpose to mention some particulars, by attention to which on the part of physicians the number of deplorable cases of fatal errors will be materially diminished. And first, and most importantly, we would call attention to the miserable specimens of medical penmanship which can be seen at any of our retail drug-stores. Druggists are often puzzled with prescriptions coming from men eminent in the profession, in which the writing resembles Egyptian hieroglyphics or the queer marks of a phonographer rather than that of educated men. For such penmanship there can be no excuse. There is a second particular in which physicians are even more reprehensible, for it is the result of gross carelessness. We refer to the careless practice of those who rarely write the directions on prescriptions, or even the doses. The directions are given to the friends at home, who in their grief or excitement frequently forget what is said, and as the druggist can not enlighten them, the medicines are liable to be improperly administered. It is so

easy a matter to write full directions on prescriptions, and thereby prevent much mischief, that any practitioner is censurable who neglects to do So. There is the greatest liability to mistake in the administration of medicines in those cases where several are sick in a family at the same time, as often occurs when contagious diseases are prevalent. The medicine designed for one may be given to another. The German physicians avoid this risk by writing the name of the patient on the prescription, which is transferred to the label on the bottle. It would be well if all practitioners would do the same. The physician can not justify himself by saying, that if such mistakes are made it is not his fault, but the fault of the family. It is his duty to remove, as far as possible, the liability to mistakes, whether on the part of the druggist or the friends of the patient. Let him not only write plainly, but if necessary use the vulgar terms rather than the classic, if thereby he can avoid the danger of error. Finally, prescriptions should be written upon white paper of ample size. Too frequently the practitioner makes no preparation when he begins his daily calls, and seizes upon any scrap of paper to write his prescription. Sometimes he finds a bit of paper partly written over; again, he takes the fly-leaf of a book; or, finally, as a last resort, the margin of a newspaper. No prescription written under such circumstances is positively safe.

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