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PHARMACY AND MEDICAL PRACTITIONERS.
522 I could give you numerous examples of the positive PHARMACY AND MEDICAL PRACTITIONERS. danger attendant upou their treatment of disease, but it To the Editor of THE LANCET. would only take up your time needlessly.
SIR,-Being much interested in the progress of pharmacy and in the right relationship it should bear to the profession of medicine, I shall feel obliged if you will permit me, as a pharmacist, to pass comment upon your leader and the letter of 11 Reformei" which appeared in your issue of the 17th ult. I have been long an attentive reader of your journal, and I have frequently noticed with pleasure that it has advocated, in the interests of both medicine and pharmacy, the necessity of having well-trained and competent pharmacists. Remembering the frequent expressions of your opinions leading to this desirable end, I must say that your remarks in reference to the charges made by pharmacists for dispensing appear somewhat out of place and unfair. I have always understood that the professional code of ethics did rot permit one medical man to call in - question the charges of another; and, although the comparison is not exactly parallel, I think the calling in question of the charges made by pharmacists is just as much - out of place and unnecessary. If the prescribing druggist is to be expunged from the roll of pharmacists, to undervalue and unduly cheapen dispensing is surely the least likely to effect this result. The truth is, that the dispensing of medicines is unfortunately so small and insignificant a portion of an ordinary chemist and druggist’s work, because nine-tenths of medical men dispense their own, that, if it were desirable, there is no conceivable inducement to charge less than the present rates. It is quite possible, and even likely, that if medical men were generally to give up their dispensing to the chemist there would result a more proportionate charge to the medical fees of general practitioners ; but only by such a vast increase of the amount of dispensing can such an end be obtained. One word on 11 Reformer’s"letter. It is certainly to be deplored that druggists should overstep the limits of their calling by prescribing, though I cannot conceive that the practice can proceed as a result from transferring the work of dispensing to the druggist. It is unreasonable to expect a rapid transformation of the typical chemist and druggist of the present to the bona fide pharmacist of the future. This desirable development can only be brought about by mutual confidence springing up between the medical profession and that of pharmacy. I trust that whilst many pharmacists are working zealously to improve the educational status of their profession, and are trying to confine its duties more within their proper limits, they may rely upon a reciprocal endeavour on the part of the medical profession, whose interests ought to be in every way identical. I am, Sir, your obedient servant, ROBT. HAMPSON. Piccadilly, Manchester. Oct. 1870. To the Editor
of THE LANCET.
SIR,-In your issue of the lith September I saw a lettei from Reformer," complaining of the encroachments of druggists upon our profession. I can verify from my own experience all his statements. Indeed, many of their opinions would be amusing if it were not for the positive danger consequent upon their ignorant presumption. A few days ago one of these gentlemen informed me that a female patient suffering from an abscess of the labia had
inflammation of the yrostccte gland. Only to-day I consulted by a lady suffering from erysipelas of the head and face, and who was assured by a druggist that the blisters on her face were the results of dropsy, for which he prescribed gin. He was quite indignant when she said she would call in her own doctor. He was foolish to be indignant, because he got my prescription to dispense, and was relieved of all
responsibility. I need not tell
you that they give a great deal of physic. They attempt tojustify themselves in prescribing by saying that they haveas good a right to prescribe as we have to dispense, forgetting that we are regularly trained both to prescribe and dispense, whilst they are only trained to dispense, and in many instances cannot do even that
properly.
To such an extent has the evil gone that I detest being called in after them almost as much as after a midwife. I am, Sir, your obedient servant, MEDICO-CHIRURGUS. September 28th, 1870.
INSIDE
(FROM
STRASBURG. A
CORRESPONDENT.)
I HAVE just spent a day in Strasburg. The health of the citizens appears to have suffered little from the extraordinary privations and fearful mental excitement to which they have been exposed. The chief mortality has been amongst the infants, no doubt due to the absence of milk, and to the imperfect nourishment of the parents. Some of the poorer people bore traces of great suffering ; but on the whole it cannot be said that there was any considerable alteration in their looks. The number of persons killed has been enormous. The shells appear to have been particularly fatal. In one bedroom seven persons were killed in their beds, and it was quite impossible to go many yards in the streets without being compelled to lie down to escape a bursting shell. The main hospitals, which are on the south-eastern side of the city, and near the citadel, were not injured by the fire; but the Seminary, which is close to the Cathedral, and contained about 160 wounded, was seriously exposed. The sick were removed from the upper floors, but even then they were not entirely free from danger. Two sisters of charity and one attendant have been killed. The chapel diningroom and school-rooms are all occupied by men, chiefly those who were wounded at Fieschweiler on the 6th of August, and many of whom have suffered amputation. The wards are simply unexceptionable; spacious, lofty, with windows open on both sides; no unnecessary furniture, and every essential comfort. A poor fellow was dying from amputation at the thigh. He was screened off, and a sister was beside him, giving him grapes, &o. There has been no lack of any necessary whatever. The School of Medicine has furnished students, the religious houses sisters, and the public generally, particularly the clergy, attendants. In these wards there has been no gangrene, and wounds have on the whole done well. But at one time, when the severity of the bombardment made it necessary to place some of the wounded in the cellars, and when the nourishment fell of in quality, there were a few cases. The cellars were, of course, damp and ill ventilated. Some of the wounded were at first placed in the crypt of the cathedral; but when bomb-shells began to burst every few minutes close by, it became necessary to remove them. Nevertheless, the exertions of the medical men must have been excessively heavy and exhausting. The civilians have rendered great assistance, and have acted in perfect concert with the military. They have worked incessantly. The hospitals were specially provided with 200 cows, but when meat became scarce, these were of course gradually sacrificed. After that the best portion of the horses and sheep were reserved for the sick. One of the greatest wants was that of salt, but from this the sick suffered less than the inhabitants generally. There were several wounded Turcos in the wards, and to judge from their appearance they are not the savages they have been described to be. The universal testimony is, that the French soldiers are excessively devoted to each other; and, if a casual observer may offer a remark, they certainly contrasted favourably with the Germans. On the Rhine men were seen with a cigar in their lips, and half a dozen in their coat, whilst their neighbours were without any; but a French soldier was seen to distribute the half-dozen which a gentleman gave to him amongst his comrades before he lighted the last for himself. In all the hospitals smoking is allowed whilst the windows are open, but not after nightfall. Few will perhaps doubt the soothing, or rather sedative, influence of tobacco ; but the great craving which has been described as characteristic of the present war is probably more due to the inveterate habit of the
SIR,-Being much interested in the progress of pharmacy and in the right relationship it should bear to the profession of medicine, I shall feel obliged if you will permit me, as a pharmacist, to pass comment upon your leader and the letter of 11 Reformei" which appeared in your issue of the 17th ult. I have been long an attentive reader of your journal, and I have frequently noticed with pleasure that it has advocated, in the interests of both medicine and pharmacy, the necessity of having well-trained and competent pharmacists. Remembering the frequent expressions of your opinions leading to this desirable end, I must say that your remarks in reference to the charges made by pharmacists for dispensing appear somewhat out of place and unfair. I have always understood that the professional code of ethics did rot permit one medical man to call in - question the charges of another; and, although the comparison is not exactly parallel, I think the calling in question of the charges made by pharmacists is just as much - out of place and unnecessary. If the prescribing druggist is to be expunged from the roll of pharmacists, to undervalue and unduly cheapen dispensing is surely the least likely to effect this result. The truth is, that the dispensing of medicines is unfortunately so small and insignificant a portion of an ordinary chemist and druggist’s work, because nine-tenths of medical men dispense their own, that, if it were desirable, there is no conceivable inducement to charge less than the present rates. It is quite possible, and even likely, that if medical men were generally to give up their dispensing to the chemist there would result a more proportionate charge to the medical fees of general practitioners ; but only by such a vast increase of the amount of dispensing can such an end be obtained. One word on 11 Reformer’s"letter. It is certainly to be deplored that druggists should overstep the limits of their calling by prescribing, though I cannot conceive that the practice can proceed as a result from transferring the work of dispensing to the druggist. It is unreasonable to expect a rapid transformation of the typical chemist and druggist of the present to the bona fide pharmacist of the future. This desirable development can only be brought about by mutual confidence springing up between the medical profession and that of pharmacy. I trust that whilst many pharmacists are working zealously to improve the educational status of their profession, and are trying to confine its duties more within their proper limits, they may rely upon a reciprocal endeavour on the part of the medical profession, whose interests ought to be in every way identical. I am, Sir, your obedient servant, ROBT. HAMPSON. Piccadilly, Manchester. Oct. 1870. To the Editor
of THE LANCET.
SIR,-In your issue of the lith September I saw a lettei from Reformer," complaining of the encroachments of druggists upon our profession. I can verify from my own experience all his statements. Indeed, many of their opinions would be amusing if it were not for the positive danger consequent upon their ignorant presumption. A few days ago one of these gentlemen informed me that a female patient suffering from an abscess of the labia had
inflammation of the yrostccte gland. Only to-day I consulted by a lady suffering from erysipelas of the head and face, and who was assured by a druggist that the blisters on her face were the results of dropsy, for which he prescribed gin. He was quite indignant when she said she would call in her own doctor. He was foolish to be indignant, because he got my prescription to dispense, and was relieved of all
responsibility. I need not tell
you that they give a great deal of physic. They attempt tojustify themselves in prescribing by saying that they haveas good a right to prescribe as we have to dispense, forgetting that we are regularly trained both to prescribe and dispense, whilst they are only trained to dispense, and in many instances cannot do even that
properly.
To such an extent has the evil gone that I detest being called in after them almost as much as after a midwife. I am, Sir, your obedient servant, MEDICO-CHIRURGUS. September 28th, 1870.
INSIDE
(FROM
STRASBURG. A
CORRESPONDENT.)
I HAVE just spent a day in Strasburg. The health of the citizens appears to have suffered little from the extraordinary privations and fearful mental excitement to which they have been exposed. The chief mortality has been amongst the infants, no doubt due to the absence of milk, and to the imperfect nourishment of the parents. Some of the poorer people bore traces of great suffering ; but on the whole it cannot be said that there was any considerable alteration in their looks. The number of persons killed has been enormous. The shells appear to have been particularly fatal. In one bedroom seven persons were killed in their beds, and it was quite impossible to go many yards in the streets without being compelled to lie down to escape a bursting shell. The main hospitals, which are on the south-eastern side of the city, and near the citadel, were not injured by the fire; but the Seminary, which is close to the Cathedral, and contained about 160 wounded, was seriously exposed. The sick were removed from the upper floors, but even then they were not entirely free from danger. Two sisters of charity and one attendant have been killed. The chapel diningroom and school-rooms are all occupied by men, chiefly those who were wounded at Fieschweiler on the 6th of August, and many of whom have suffered amputation. The wards are simply unexceptionable; spacious, lofty, with windows open on both sides; no unnecessary furniture, and every essential comfort. A poor fellow was dying from amputation at the thigh. He was screened off, and a sister was beside him, giving him grapes, &o. There has been no lack of any necessary whatever. The School of Medicine has furnished students, the religious houses sisters, and the public generally, particularly the clergy, attendants. In these wards there has been no gangrene, and wounds have on the whole done well. But at one time, when the severity of the bombardment made it necessary to place some of the wounded in the cellars, and when the nourishment fell of in quality, there were a few cases. The cellars were, of course, damp and ill ventilated. Some of the wounded were at first placed in the crypt of the cathedral; but when bomb-shells began to burst every few minutes close by, it became necessary to remove them. Nevertheless, the exertions of the medical men must have been excessively heavy and exhausting. The civilians have rendered great assistance, and have acted in perfect concert with the military. They have worked incessantly. The hospitals were specially provided with 200 cows, but when meat became scarce, these were of course gradually sacrificed. After that the best portion of the horses and sheep were reserved for the sick. One of the greatest wants was that of salt, but from this the sick suffered less than the inhabitants generally. There were several wounded Turcos in the wards, and to judge from their appearance they are not the savages they have been described to be. The universal testimony is, that the French soldiers are excessively devoted to each other; and, if a casual observer may offer a remark, they certainly contrasted favourably with the Germans. On the Rhine men were seen with a cigar in their lips, and half a dozen in their coat, whilst their neighbours were without any; but a French soldier was seen to distribute the half-dozen which a gentleman gave to him amongst his comrades before he lighted the last for himself. In all the hospitals smoking is allowed whilst the windows are open, but not after nightfall. Few will perhaps doubt the soothing, or rather sedative, influence of tobacco ; but the great craving which has been described as characteristic of the present war is probably more due to the inveterate habit of the