Hazards of Improper Dispensary: Literature Review and Report of an Accidental Chloroform Injection.

Several clear, transparent solutions are used in endodontics. Inappropriate dispensing methods can lead to accidental injection or accidental irrigation. These accidents can cause permanent tissue damage including damage to the bone, periodontium, nerves, and vasculature. This article reports on the consequences of an accidental chloroform injection. Nonsurgical retreatment of tooth #8 was planned as part of a restorative treatment plan in a 69-year-old woman. The dentist accidentally injected chloroform instead of local anesthesia because chloroform was loaded into the anesthetic syringe. The patient experienced severe pain and swelling and soft tissue necrosis and suffered permanent sensory and motor nerve damage. A review of the literature was performed on accidents caused by improper dispensary, namely accidental injections and accidental irrigations. The data were extracted and summarized. Sodium hypochlorite, chlorhexidine, formalin, formocresol, 1:1000 adrenaline, benzalkonium chloride, and lighter fuel were accidentally injected as an intraoral nerve block or as infiltration injections. Bone and soft tissue necrosis, tooth loss, and sensory nerve damage (anesthesia and paresthesia) were the most common consequences reported. Such disastrous events can be prevented by appropriate labeling and separate dispensing methods for each solution. There is a need for disseminating information on toxicity and biocompatibility of materials/solutions used in endodontics. The authors recommend training dental students and endodontic residents on immediate and long-term therapeutic management of patients when an accidental injection or accidental irrigation occurs.

[French influence in the US Dispensatory of 1843].

The US Dispensatory first published in 1833 will see several editions and some of them are accessible on Internet. We have evaluated more specifically the 1843 edition, at a time where several similar reference books were published in France, and especially l'Officine of Dorvault, published for the first time in 1844. One can observe that the American book refers very often to French works coming from pharmacists, chemists and biologists who are, at the time, key references. They are particularly mentioned when talking about alkaloids, but also concerning herbs characterization and history of their discovery, as well as drugs or new active principles effects and toxicity. As opposed to Dorvault who try to help pharmacists by very practical information, the authors of the Dispensatory are doing a review of available scientific evidences, as an add on of the recently published American pharmacopeia in 1831. Among the main french authors that are mentioned, we can see Henry and Guibourt, Pelletier and Caventou, but also Soubeiran, Vauquelin, Robiquet, Orfila and many others. If the most consistent chapters are related to Quinquina, Opium and morphin, the American book, as l'Officine of Dorvault pay attention to have an almost exhaustive table of weight and measures that are still very different from one country to another. Globally speaking, the French authors are mentioned close to 700 times in the 1843 edition of the Dispensatory.

[The 'Mühldorfer House and Dispensatory' of the 15th century]. / Das 'Mühldorfer Haus-und Arzneibuch' aus dem 15. Jahrhundert.

This paper shows for the first time that two manuscripts in German and Latin language once belonged together: Cod. Donaueschingen 101 and Cod. Donaueschingen 793, now in the possession of the Badische Landesbibliothek in Karlsruh. Palaeographical and codicological studies show clearly that the 'Visio Philiberti' in German translation was formerly part of a handbook. Several booklets of the fifteenth century are bound together to form a medical, practical and religious guide. The collector of these texts was probably an ecclesiastic who lived in Mühldorf on Inn (Bavaria) or its surroundings. At last the paper presents the descriptions of the above mentioned manuscripts following the rules of the Deutsche Forschungsgemeinschaft (DFG).

Some notes on an early nineteenth century manuscript medical receipt book.

There are 97 remedies listed, including 11 veterinary ones. These numbers include several that are duplicates. The commonest types of medicament are salves or ointments, of which there are ten, but these ten do not include ointments for specific complaints such as haemorrhoids or scurvy. The most frequently found cures are for the itch (10), rheumatism (5), gravel (4), pain (4), and piles (3), all the others having only one or two entries. They were intended to treat 39 human complaints and 9 animal ones. In addition there were formulae for killing lice, making rat poison, and preparing damson wine! The number of different medicaments that were used in the recipes was relatively small, but more than were to be found in the smaller sizes of domestic medicine cabinet. In 1820 Reece's Traveller's Dispensary that was flat and would fit in the pocket of a carriage, only contained ten drugs plus court plaster, lint, scales and weights with a book of directions and cost L3.10s.0d. (L3.50). The Lady's Dispensary which contained twenty medicines, including two pills, with some dispensing equipment and a book of directions cost L5.10s.0d. (L5.50). In all, he listed twenty different cabinets and a sea medicine chest ranging in price from L3.10s.0d. to L32.10s.0d. They included ones suitable for the family, country clergymen, and travellers on the continent and in the tropics. In 1862 Savory and Moore stocked a range of sixty-seven different medicine chests and cases in rosewood, mahogany, walnut, boxwood and leather that were fitted with 'modern appliances and conveniences adapted for the requirements of families, clergymen, officers, owners of yachts, and travellers.' Unfortunately no prices are quoted. I think that we can safely assume that the treatment received at the hands of Evan Jones was likely to be rather rough and ready when compared to the ministrations of a physician, surgeon, clergyman or local 'Lady Bountiful', but, nevertheless, must have been of great value to those who could not afford professional treatment.

Dermatology practice management enhancement: implications for dermatology in the age of managed care.

Health care delivery in the United States has changed dramatically during the past 10 years. Dermatologists are faced with challenging changes in the way they learn new skills, practice, and provide dermatologic care. Dermatologists can survive and flourish in this environment if they learn proper management and enhancement skills. These skills include proper coding and documentation, regulatory compliance, and new levels of practice effectiveness and efficiency. Dermatologists can offer also the benefit of cosmetic procedures and ethical office-based dispensing to their patients. Greater future unification of this specialty will allow dermatology to flourish and show its need, efficiency, and cost-effectiveness.

Reductions in finger doses for radiopharmaceutical dispensing afforded by a syringe shield and an automatic dose dispenser.

A gamma extremity monitoring system (GEMS) has been used to measure finger doses during radio-nuclide dispensing procedures. GEMS uses a small semi-conductor probe that can be attached to a finger from which a continuous read-out can be obtained that is related to dose rate. The pattern of dose accumulation can be analysed to allow doses received from individual operations within a procedure to be evaluated. GEMS has been used to compare the radiation dose reduction afforded by a syringe shield and an automatic dose dispenser. Dispensing procedures were simulated using 10% of the activity normally administered in order to avoid problems with detector saturation. Results show that the syringe shield and the automatic dose dispenser reduced finger doses by more than a factor of 10 for the procedures tested. The disadvantages of the automatic dispenser tested were a failure to transfer activity in 10% of cases and a longer time taken for the dispensing process. GEMS has the potential to facilitate greater optimization of finger doses through analysis of finger dose patterns.

[Translation of the prologue to the Libro de medicamentos simples by Abû-l-Salt of Denia]. / Traducción del prólogo del Libro de medicamentos simples de Abû-l-Salt de Denia.

This article offers the Spanish translation of the theoretical introduction that Abu-l-Salt of Denia (1068-1134) placed at the beginning of his treatise on simple drugs. In his introduction he explained the reasons for preparing compound drugs, and how to prepare them. Although the rest of the book was translated from Arabic into Latin by Arnau de Vilanova (c. 1283) this introduction is not found in any of the extant Latin manuscripts and therefore does not appear in the critical edition of the works of Arnau.

[Elements of medical scholasticism in The Secrets of Alex of Piemont]. / Elementy medycznej scholastyki w sekretach Aleksego z Piemontu.

In the Secrets of Alex of Piemont, a 16th century prescription book, originally published in Italian and soon after translated into eight European languages (including Polish) one can find curious enumerations of about twenty or even thirty different diseases which can be cured by only one medicine just described. Enumerations of this kind are possible to be find also in some other ancient and Middle Ages works on medicine. The author of the paper makes an attempt to find an explanation of such the curiositiy in Hippocrates' and Galen's humoral theory as well as in scholastic methods of teaching medicine in Middle Ages schools and universities.

Drug information resources in the Veterans Affairs healthcare system.

Results of a survey characterizing drug information services and resources from a defined practice area are presented. At the end of 1992, a questionnaire was mailed to 167 Veterans Affairs Medical Centers and Outpatient Clinics. One hundred fifty-one of the surveys (> 90%) were completed and analyzed. The knowledge obtained from this survey may provide a basis for future development of an essential clinical service within the Veterans Affairs health care system.

[Xin'an Dispensaries and its role in medicine in the Ming-Qing dynasties].

The Xin'an Dispensaries were set up in the Song dynasty, completed in the Ming dynasty and reached its peak of development at the end of the Qing dynasty. The representative ones of the dispensaries include Lu's Baohetang of the Song dynasty, Xu's Baoyuantang, Zhengtian dispensary, and Baoyutang of the Ming dynasty, Hu Xian Chun, Zhongdetang of the Qing dynasty. All these dispensaries were mostly run by the physicians themselves in the Ming dynasty, while they were run by Anhui businessmen in the Qing dynasty. As a union embodying health care, production and trading of traditional handicraft, not a few of them had become famous pharmaceutical factories today, such as Hu Qing Yu Tang, Jianmin Pharmaceutical Factory of Wuhan. Rich experience on production and management were accumulated, alongside achievements on prescription, drug processing, storage, collection and ready-made drug manufacturing.

Early years of the out-patient services, Singapore (1880-1946).

This article traces the history of the Out-patient Services from its humble beginnings in the late 19th Century to just after World War II. The class of patients catered for, the disease pattern, the work done and benefits accrued are recorded.