It would save the pharmacist a great deal of anxiety if prescribers would take the trouble to initial unusual doses, for many instances occur where it is impossible for the dispenser to know whether the dose is safe or not; for example, the official dose of potassium iodide is 5 to 20 grains, yet 30 grains is a frequent dose, and even 1 or 2 drachms twice or three times a day, but some patients experience very unpleasant effects from a single dose of 2 grains. Again, the official dose of ext. ergotae liq. is 10 to 30 minims, although 1 drachm is a very common dose, and in some cases 4 drachms or 1 ounce may be given with impunity. Another example:

Pil. coloc. co. ....................................................................

gr. ij.

Pil. cambogiæ co. . ......................................................

gr.j.

Strychninæ ................................................................

gr. 1/24

Ext. bellad. ........................................................................................

gr. ij.

Ft. pil. in arg. Mitte xxiv. Sig. : One at bedtime.

Two grains of ext. bellad. (green extract, B.P. 1898, was intended) for a dose is unusual, but as the pill was for an adult, and was given only once a day, it might have been dispensed. But the dispenser happened to know that the prescriber gave only small doses of belladonna; the prescriber was therefore consulted, and the dose altered to 1/4 grain.

Where unusual doses are prescribed, the quantity should be indicated in words as well as figures. Thus:

Tr. opii . . . . mL (50 minims) h.s.s. would save the dispenser from any hesitation as to whether the quantity was l. or 4. A case was reported early in 1904 in which 'mvi.' was so written that the dispenser read it for 'm 61,' and, not knowing that the medicine was for a baby, dispensed the larger quantity of morphine solution, and the child died.

Cipher Prescriptions are, happily, not common, and are usually a convenience to the prescriber rather than an attempted concealment of his intentions in favour of a particular pharmacist. They are annoying, nevertheless, to those who have to tell customers that they cannot dispense the prescriptions without consulting the prescriber or the pharmacist who first dispensed the prescription. The best course to adopt with customers when such prescriptions are received is to say that this is a special preparation of Dr. So-and-so's, about which you will need to write to him. Then write to the prescriber, enclosing a stamped and addressed envelope for a reply.