Page images

available until after the registration is and liniments, ointments and other prepaccomplisht, as the name and number of arations for external use that is, applied the registered person or firm must be to the skin. Liniments, ointments, etc., printed on them before they can be issued. containing cocain or coca preparations,

The order blanks for drugs will be sold however, are not excepted. in lots of 10 or its multiple. The price for The use or having possession of opium, these will be 10 cents for each 10 blanks. morphin, codein, heroin or other opium When making out orders on the official preparation or cocain or coca preparations blanks for the narcotic drugs specified in for hypodermic use, comes within the scope the law, duplicates of the orders must be of this act and the physician possessing such made and kept on file for two years. drugs must register and pay the tax.

Every person, firm or company dispensing directly to consumers any of the

Remarks on the Federal Narcotic Law. narcotic drugs must, on the first day of March, prepare and keep on file an inventory

All purchases or securing, in any manner, of all such drugs on hand at that date.

of the narcotic drugs, subject to this law, No special form of inventory is required by the physician, dentist or veterinary sur

, but the inventory made must fully and

geon must be made on official order forms

obtained from the local internal revenue clearly set forth the quantity of each kind of such drugs, preparations or remedies so

collector, and official duplicate copies of held, and must be verified by oath not

such order forms must be made out and later than the 5th day of March, 1915.

preserved for two years. To sum up, the physician receives an

Prescriptions issued by the physician, application blank for registering under the

dentist or veterinary surgeon authorizing act. He fills it in properly, makes affidavit

the sale or disposition of the narcotic drugs to its truthfulness before a notary public or

subject to this law by the druggist or deputy collector and then takes or mails it apothecary must be in writing and indicate with 34 cents (check or money order) to the

certain definit information. collector of internal revenue of the district

Dispensing: When the physician, dentist from whom he received it. This must be

or veterinary surgeon does not personally done on or before the 1st of March.

attend-i. e., personally see—the patient he After receiving his “stamp" and appli- information, to be preserved for two years.

must keep a record, showing certain definit cation form for order blanks he fills in this application blank and sends in the amount

The physician, dentist or veterinary surof money necessary for the number of geon, upon the request of the local collector,

must render to such collector a true and blanks he requires. We believe that ten or twenty such blanks would be plenty for

correct statement or return verified by any physician to start with.

affidavit showing the quantity, etc., of On the 1st of March he must make an

narcotic drugs received by him within a inventory of all narcotic drugs, preparations,

certain stated period. etc., on hand, which must be sworn to on

Narcotic Drugs Affected by This Law: or before the 5th of March, to be kept for

The narcotic drugs affected by this law, official inspection upon demand.

except as expressly exempted in the following, are: opium or any compound, manufacture,

salt, derivativ or preparation of opium, and We have already received an inquiry coca leaves or any compound, manufacture, from a subscriber, who evidently does not salt, derivativ or preparation of coca leaves. wish to register under this law, asking for Narcotic Drugs Entirely Exempted From a list of the drugs which a doctor may This Law: The following three classes of lawfully carry and use in making calls and narcotic drugs are entirely exempted from in office practise in case he does not register all the requirements and obligations imand pay this tax. They can be briefly posed by this law, provided, always, that stated to be: (1) All drugs not mentioned such drugs are sold, distributed, given in the bill; (2) certain exceptions, given in away, dispenst or possest as medicins and the copy of the bill sent you by the collector not for the purpose of evading the intentions of internal revenue and also given in our and provisions of this law, viz., following editorial, where they are fully I. Preparations and remedies (for either enumerated.

internal or external use) which do not conThe exceptions are compounds containing tain more than-only slight amounts of the narcotic drugs (a) 2 grains of opium, or


(6) 4 grain of morphin, or

factorily account for the original order (c) 18 grain of heroin, or

form. (d) 1 grain of codein, or

Great care should be exercised to safely any salt or derivativ of any of them in one preserve for the required two years the fluidounce, or if a solid or semisolid prepara- duplicate copies of the official order forms.

a tion, in one avoirdupois ounce.

Otherwise, the full penalty of this law will II. Liniments, ointments, or other prepa- apply. These duplicate copies must be so rations which are prepared for external use preserved, also, as to be readily accessible, only except liniments, ointments or other at all times, to official inspection, upon preparations which contain cocain or any demand. No particular place for preserof its salts or alpha or beta eucain or any of

vation is provided. their salts or any synthetic substitute for No restriction is placed upon the source them. The following ruling has been made from which the physician, dentist or veterby the Internal Revenue Department con- inary surgeon may obtain the specified struing this exemption: Any liniment, oint- narcotic drugs-from either the manufacment, or other preparation containing drugs turer, importer, or wholesale or retail not specifically exempt by the law (see si dealer, provided, always, such obtaining is above) used for oral, nasal, aural, ocular, for lawful purposes. The giving of an rectal, urethral, or vaginal administration is official order may not be avoided by the not an external use of such liniment, oint- writing of a prescription (hereafter described) ment or other preparation, and is, therefore, to be filled by the retail druggist, when such not exempt from the provisions of this a prescription is used by the physician, law.

dentist or veterinary surgeon as a subterfuge III. Decocainized coca leaves or prepara

to obtain the specified narcotic drugs for tions made therefrom or other preparations professional use without giving an official of coca leaves which do not contain cocain.

order. The retail druggist may only sell (No preparation or remedy containing

remedy containing or distribute the specified narcotic drugs cocain or any of its salts or alpha or beta upon a duly issued prescription to a coneucain or any of their salts or any synthetic substitute for them is exempted from

No restriction is placed upon the quantity the requirements and obligations of this of the specified narcotic drugs which may law.)

be duly obtained by a physician, dentist or Lawful Purchase, Prescribing and Use veterinary surgeon for medicinal use in his Only Permitted: A physician, dentist or professional practise. veterinary surgeon, under this law, may Attention is again directed to the fact obtain, prescribe, use or dispose of the that no official order form or duplicate copy narcotic drugs subject to this law, only for is required in the purchase of any of the medicinal purposes in the course of the narcotic drugs expressly exempted from legitimate practise of his profession. Any this law. procedure to the contrary constitutes a Druggists and apothecaries must refuse to violation of this law.

fill any such original written prescription The penalty for a violation of or a failure unless signed and filled out as required, to comply with any of the requirements of and if they have reason to suspect that it this law, on conviction, is very severe_a was fraudulently issued or obtained. fine of not more than $2,000 or imprison- The druggist or apothecary filling such ment for not more than five years, or both, original written prescriptions may only in the discretion of the court.

sell, dispense or distribute the narcotic If a physician, dentist or veterinary drugs subject to this law, so prescribed, to surgeon, in addition to the professional a consumer. The physician, dentist or prescribing of the narcotic drugs subject to veterinary surgeon may not use an original this law, conducts a distinct retail drug written prescription to obtain the specified store for the sale or dispensing of such narcotic drugs for his own dispensing. In drugs, he must make a separate application the latter case, the official order forms, prefor registry and pay a special tax, in each viously described, must be used. Such such case.

original written prescriptions may not be If for any reason an original official order refilled. form is cancelled, destroyed, or not used, The druggist or apothecary filling such the duplicate thereof should recite the original written prescriptions must eitherexact facts. Each duplicate must satis- 1. Keep a separate file of all such original

written prescriptions, which may be num- record, so long as the record is duly made bered consecutively with other prescriptions out and preserved. It is not required that received, or

the physician, dentist or veterinary surgeon 2. Keep a record showing

shall sign any entry so recorded. Great (a) The file number given to each such

care should be exercised to safely preserve original written prescription filled.

these records for the required two years: (6) The name of the physician, dentist or otherwise, the full penalty of the law will veterinary surgeon signing the same and apply.

(c) The name of the person for whom Note: Attention is again directed to the such prescription is filled.

fact that no record is required in the disDruggists must furnish their own record pensing of the narcotic drugs expressly books for this purpose.

exempted from this law. The druggist or apothecary filling such Sworn Statements: Every physician, denoriginal written prescriptions must preserve tist or veterinary surgeon, registered under them for the period of two years from the this law, must, at any time, upon the request

, day on which said prescriptions were filled of the collector of his revenue district, in such a way as to be at all times readily

render to said collector a true and correct accessible to the authorized inspection statement or return, verified by affidavit, officials.

setting forthDispensing: A physician, dentist or 1. The quantity of the specified narcotic veterinary surgeon, registered under this drugs, received by such physician, dentist or law, may dispense or distribute any of the veterinary surgeon within his revenue district narcotic drugs, subject to this law, to a during such period immediately preceding patient, without limitation, provided, always. the demand of the collector, not exceeding that such dispensing or distributing is made three months, as the said collector may fix for medicinal purposes and in the course of

and determin. his professional practise only.

2. The names of the persons from whom When a physician, dentist or veterinary such narcotic drugs were received. surgeon, registered under this law, does not 3. The quantity in each instance received personally attend, i. e., does not personally from each of such persons. see his patient, but dispenses or distributes 4. The date when received. any of the specified narcotic drugs (other Collectors will require such sworn statethan the narcotic drugs expressly exempted ments in all cases where, from the number from this law) to such patient, in some

of order blanks obtained by any physician, other manner, e. 8., by messenger, then

dentist or veterinary surgeon, or from the such physician, dentist or veterinary surgeon

character of the practise of any such medmust keep the following record of all such ical practician, the collectors have reason to narcotic drugs so dispenst or distributed suspect that such drugs are being used for showing: (1) The date when any such illegal purposes, or may be required in such narcotic drug is dispenst or distributed; other cases as the collectors may think it (2) the kind and quantity dispenst or dis- advisable. tributed in each case, and (3) the name and Possession by the Physician, Dentist or residence of the patient to whom such nar- Veterinary Surgeon: There is no restriction cotic drug was dispenst or distributed. or regulation placed upon the possession of

No particular form or record book is pro- the specified narcotic drugs by a physician, vided for. Each physician, dentist and dentist, or veterinary surgeon, registered veterinary surgeon must supply himself under this law, as to the quantity which with a suitable blank book for such record. may be possest, etc.- provided, always, This record must be made out on the day of that such possession was lawfully obtained such dispensing or distributing, as it must and had for medicinal use in the course of be preserved by the physician, dentist or legitimate professional practise. veterinary surgeon making it for a period of There is no restriction or regulation placed two years from the date of such dispensing upon the possession of the narcotic drugs or distributing, always readily accessible subject to this law by a patient, provided, for inspection by the duly authorized always, that such possession was lawfully officials. No particular place for preserva- obtained from a physician, dentist or vetertion is provided for. It is not required inary surgeon registered under this law or that the physician, dentist or veterinary from a nurse acting under his direction, or surgeon shall personally make out this through the medium of a prescription duly

issued, providing always such narcotic drugs Here is a notable example: A journal were prescribed in good faith for medicinal declares that the hypophosfites and the glycpurposes and in the course of legitimate erophosfates should be dropt because the professional practise.

hypotheses on which they were originally There is no restriction or regulation placed introduced are not now believed by the proupon the possession of the narcotic drugs fession in general. Note the glaring error subject to this law by a nurse, acting under in logic: Reduce to a syllogism and we the supervision of a physician, dentist or have: A remedy whose original introducveterinary surgeon, registered under this tion was based on a hypothesis not now genlaw, provided, always, that such possessionerally accepted should be dropt. The hypowas lawfully obtained and had by virtue of phosfites were introduced on a hypothesis his employment or occupation and not on not now generally accepted. Therefore the his own account.

hypophosfites should be dropt. The falThere is no restriction or regulation placed lacy, of course, lies in the improved major upon the possession by an employee of a premise. It does not follow that a remedy physician, dentist or veterinary surgeon, is useless because the original idea back of registered under this law, provided such it is not now accepted. employee is acting within the scope of his The place of this particular remedy is employment, and not in violation of this due to the results noted by the profession law.

Such employee does not have to as following its administration in cases register or pay the special tax under this where it appeared to be indicated. These law.

results have been so decided that there are Hospitals and Other Institutions: All the very few practicians who do not rely upon requirements hereinbefore described im- this combination as one of their most powposed upon the physician, dentist or veter- erful general tonics. Comparativly few of inary surgeon by this law relate, in like us know, and fewer care, that the hypomanner, to hospitals and other institutions: phosfites were originally introduced to supProvided, however, That officers of the ply an assumed lack of oxygen to the lung United States Government or of any state,

tissues. For that matter, has anybody as territorial, district, county or municipal or yet proved that these salts do not supply insular government, lawfully engaged in oxygen? making purchases of the specified drugs for It has also been said that petroleum is the various departments of the army and not absorbed by the human body. We know the navy, the public health service and for of one instance where petrolatum rubbed government, state, territorial, district, upon the abdomen by a pregnant woman recounty, or municipal or insular hospitals sulted in her having a thick layer of fat in or prisons are not required to register or the area so treated. In a subsequent pregpay the special tax under this law or to use nancy she did not rub in the petrolatum and official order forms in purchasing or securing did not have the fat abdomen afterward. in any manner the specified narcotic drugs This proves that it is absorbable by the skin. and may lawfully send, ship, carry, deliver It may not be absorbed from the alimentary or possess such drugs, when duly acting canal, however. in their official capacity.

The trouble with clinical evidence is that it is uncertain, is with difficulty transmitted

from doctor to doctor, and that the obThe Value of Evidence.

servations of any one practician in themFor thousands of years doctors have de- selves relate only to personal experiences voted themselves to the study of the ail- and environment, and are so deeply modified ments of humanity and their treatment. All by the doctor's personality that they may the plants that grow, all the minerals, not apply to the general requirements of his metals, earths, gases, salts, and innumerable colleagues. other agencies, have been tried out as reme- All these and many other objections are dies. Many of these have been establisht obviated when the testimony of one is reinand the consensus of opinion assigns them forced by that of hundreds and thousands definit places in the armory of our weapons of others. Any one of us may be fooled ; for staying the assaults of disease. But as but the many thousands of readers of THE concerning farr too many, there is yet the MEDICAL World cannot all be fooled by the widest variance of opinion as to their true same thing. In this we fulfil a function place.

that only a practician's journal, a periodical

[ocr errors]

They milk.

for actual interchange of views and experi- many years various emulsions of fats, ences, can supply.

chiefly of cod liver oil, have been tried by If you have a good idea in medical prac- the profession. They are rendered palatable tise, write and tell us about it. If you see a by sweetening. The usual quantity taken good suggestion in our pages, try it out is one tablespoonful at a dose, and, while and tell us the result. If you see one of some benefit results, the effort to build up our writers publishing what you know to a patient would require his ingesting as be an error, write and tell us, and how you much fat as he could assimilate. know it.

Pure cod liver and oliy oils have often Don't be stingy. Recollect that every been ordered by physicians to supply fat time you give us one of your good things, in readily available forms, with success. you incite many others to give you theirs, Various devices have been resorted to in and you are all-fired smart chaps if you the effort to smother the taste of these can't learn anything from the rest of the substances, with more or less success. One great World family.

of these ways is to take them with milk.

Another is to take them in some kind of
Fat as a Food.

wine or grape juice. Not every physician recognizes the im

Milk itself has been recommended for the portance of fat to the human body. Nor cream it contains. For a long time overdoes the laity. The tendency for many

The tendency for many feeding with great quantities of milk was years with great numbers of people has attempted. This, too, was partially successbeen to carefully avoid eating the fat

ful. However, the small percentage of attacht to meat served at the table, only virtually impossible to secure enuf fat for

cream present in the average milk makes it the lean being consumed, and the fat thus discarded is usually wasted unless a house

a wasted, wan patient by drinking whole hold pet is at hand to be fed on it.

Whole milk is very often constisay that a Chinese can live on what a

pating. The idea of using the cream alone Caucasian wastes. We have developt a as a means of supplying a readily available very dainty appetite as a consequence and quantity of fat occurred to a number of many now look with repugnance on fat as

physicians, who have been acting on it. a food. We can tolerate it in cooking, such Its superiority to whole milk as a fatty as pastry, fried meats, oysters, eggs, and

food is apparent at a glance. vegetables; even salted, as in ham and Dr. W. E. Robertson, of Philadelphia, bacon; and oliv oil in salads. But most some years ago called a patient's attention people very carefully avoid eating the fat to the fact that she would have to drink with the meat.

eight quarts of milk a day if she were to We remember one tubercular patient who get from that source the amount of fat she went home from the office and told his needed. He suggested that she drink cream sister, “The doctor told me to eat fat,” instead. We have ourselves recommended showing extreme disgust in his tone and the drinking of cream to a number of manner and his emphasis on "fat."

patients to build up their physiques, and Fat is a splendid food. The pity of it is with success where it has been persisted that we eat so little of it and waste so with. We have usually recommended the much. Fat is the one food that we may drinking of a half-pint of cream daily, to lay in a store in the tissues for a future be increast to one pint, if possible. This time when food may be scarce, a la the is to be continued for a long period of hibernating bear. By eating it regularly time, several years, preferably. We have and constantly we can build up a layer of

a number of patients improve very fat around the body that may not only greatly after this cream feeding for a year serve to sustain it later on, but also act as or more. Where the cream is too rich for a protectiv layer for the internal organs toleration by the stomach it can be mixt and tissues against injuries and cold and with an equal quantity of milk. This has the effects of cold. The layer of fat also been found to bridge the difficulty for some serves to fill out external hollows and adds patients. a rounded contour to an otherwise gaunt Dr. B. J. Kendall, of Geneva, Ill., for a and bony form.

number of years has advocated the drinking The great desideratum is to find a palatable of cream as a cure for tuberculosis. He fat, since humanity's taste has been turned believes it will cure all early cases.

He against the most available sources. For recommends that the patient get a speciaj


« PreviousContinue »