The national Food and Drugs Act raised the National Formulary to the position of an official standard and gave it a significance and an importance which previously it could not claim. In order to meet the requirements of the new function of this book, the American Pharmaceutical Association, at its last meeting, invited the Section on Pharmacology and Therapeutics of the American Medical Association to cooperate in the revision and a committee of five members was appointed.
This idea of having the cooperation of physicians is a good one, for the National Formulary is a book in which physicians are becoming more and more interested since the propaganda against nostrums was initiated. A thorough study of the book is now necessary in order to adapt it more closely to our present knowledge and to eliminate certain features that are not a credit to it. When some of the formulas were selected there was not sufficient investigation made to show whether or not they were of therapeutic value; and in others there was evident disregard of chemical and other incompatibility. Thus, in liquor antisepticus alkalinus, small amounts of reputed antiseptic drugs satisfied the implied demand for an antiseptic solution, and no investigation was made to determine whether or not the strength was sufficient for antiseptic or germicidal results. In a similar manner, because acids were found to be necessary to the digestive action of pepsin, a little acid (not sufficient for any therapeutic purpose) was added to a popular digestive powder. The same thing was done with the compound elixirs; and thus was perpetrated the absurdity of combining pepsin and pancreatin in an acid solution, an incompatibility that we fully demonstrated three years ago.1 But it is asserted that the use of elixir digestivum compositum (N. F.) and proprietary elixirs of similar composition as a vehicle in the administration of salicylates, bismuth salts, bromids, etc., is actually on the increase. It hardly seems possible that this can be true, that a physician should continue to use something supposed to be a digestive when all he needs is a suitable elixir. But there is no doubt that the demand for these elixirs and for the proprietaries of which the elixir digestivum compositum is an imitation is to a great extent a demand for a vehicle. The Pharmacopeia already contains two highly alcoholic elixirs which serve as vehicles, elixir adjuvans and elixir aromaticum, so that it would seem unnecessary to add still another more or less similar preparation. If, however, it is deemed desirable to have a colored vehicle, one could be made by omitting the digestives from the elixir digestivum compositum and giving it a name to signify its use as a vehicle.
THE REVISION OF THE NATIONAL FORMULARY. JAMA. 2010;303(14):1432. doi:10.1001/jama.2010.268
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