In this paper it will be taken for granted that the physician is well educated and experienced in his profession, that the apothecary knows his business thoroughly, and that both are actuated by high moral purposes. The grievance of neither, therefore, will result from the intentional wrong-doing of the other, but from his thoughtlessness or conservative adherence to long-established custom. The honesty of each being presupposed, such a charge as the substitution of an inferior article for some ingredient in a prescription, or the false insinuation that a mistake in the medicine is due to the compounder’s carelessness need not be raised. Let us consider the grievances of each against the other.
The physician complains that the apothecary exceeds his function by prescribing for the sick. A person applies to the pharmacist for a remedy for a specified disease. The latter consults the dispensatory, finds a number of medicines mentioned in the therapeutical index under the name of that malady, selects one, and sells the article to the patient. He regards the protest of the doctor merely as the wail of one who is disappointed at not getting a fee for prescribing. The physician has a right to complain of those who prescribe for any but the indigent without a professional fee, for this makes it vastly harder for him to collect the charges to which he is entitled; but he has higher ground than this. With him the first step in every case of disease is diagnosis, without which prescribing is simply drawing a bow at a venture, with small probability of penetrating a joint of the harness; and he insists that neither the apothecary nor the patient is qualified to make a diagnosis. The determination of the character of a disease is not a simple matter, often baffling the profoundest learning and the broadest experience, and, in most cases, requiring special knowledge and discriminating judgment. The most obtrusive symptoms are by no means necessarily the most characteristic; a given symptom may be the accompaniment of different diseases, and sometimes attends pathological changes of diametrically opposite nature. But one who is uninstructed in this branch has nothing but symptoms to guide him, and therefore frequently, if not commonly, is led into error, which may produce the gravest results. The educated physician is the only person who is equipped to solve the problems of disease; and it is, in the long run, cheapest, even from the financial point of view, for one who is ill to obtain competent medical advice. Therefore, considering merely the welfare of the patient, the physician deplores the custom of counter-prescribing.