panied in parentheses by some such phrase as "preparation of opium" or "opium preparation," followed by the number of minims or grains, as specified in the regulations; for instance, "laudanum (preparation of opium), 40 minims per ounce."
James Wilson,
Secretary of Agriculture.
Washington, D. C., March 13, 1907.
(F. I. D. 57.)
PHYSICIANS' PRESCRIPTIONS.
The Status of Packages Compounded According to Physicians' Prescriptions and Entering into Interstate Commerce.
Packages resulting from the compounding of physicians' prescriptions under the food and drugs act are the subject of many queries, of which the following are representative:
If a druggist compounds a physician's prescription and sends it into an adjoining
State, will it be necessary to state upon the label the amount of alcohol, morphin, etc.,
that may be present?
Supposing a regularly licensed practicing physician has patients located in various States of the Union and supplies medicines to them through the mails, by express, and otherwise, do such packages come under the provisions of the law, and, if so, can the required information be given in pen and ink on the label?
We treat drug addictions on a very gradual tonic treatment reduction plan. For instance, if John Doe writes for information as to the home treatment for his addiction, I send him a symptom blank which contains, among other questions, an inquiry as to the kind of drug he uses, how he uses it, the length of time he has used it, etc. In addition to giving me a complete history of his case, he states he is using 10 grains of sulf. of morphin (each twenty-four hours), hypodermically or internally, as the case may be. In prescribing in his case I immediately put him on just one-half of the amount he reports as his daily allowance, combining same with a bitter tonic.
It is necessary for the reduction in drug cases to be made without the patient's knowledge. It is, of course, understood by all physicians that you can not trust a drug habitué to properly make his own reductions, for, as a matter of fact, if he knew to what extent I was reducing his daily allowance of opiates, he would imagine the reduction too rapid, he would get frightened, and would take to his former drug for relief. Treatment prepared in this way I do not think would come under the head of a proprietary preparation or a patent medicine, as I prescribe the contents of each bottle to meet the requirements of each individual patient. All instructions as to the conduct of treatment and the use of auxiliary remedies are given by letter; consequently there are no printed labels or cartons containing any claims concerning the efficacy of this treatment.
I would be pleased to have you inform me whether in your opinion I would be violating the pure-food law in any manner, shape, or form should I continue to label my preparations as I am now doing, and in having them prepared in and forwarded direct to my patients in this and other States.
If a package compounded according to a physician's prescription be shipped, sent, or
transported from any State or Territory or the District of Columbia to another State or
Territory or the District of Columbia by a compounder, druggist, physician, or their
agents, by mail, express, freight, or otherwise, the label upon such package is required
to bear the information called for by Congress. If, however, the patient himself, or a
member of his household, or the physician himself carries such package across a State
line, and such package is not subject to sale, it is held that such package need not be
marked so as to conform with the law, because such a transaction is not considered one
of interstate commerce.
The package may be marked so as to comply with the act by either stamp, pen and
