[Prescription of medicines by two medical officers in Jutland in 1797. An analysis of the prescription practice of C.D. Hahn, Physicus of Aarhus Diocese, and K.N. Carstensen, Physicus of Aalborg Diocese].
The concept of authorized medicines was introduced and defined by the Danish Government during the first half of the 17th century, thus establishing the basis for the sale of such medicines by pharmacists and their prescription by medical practitioners. The concept of authorized medicines was linked to the drug tariff in force until 1772 when the Pharmacopoea Danica was first published. The pharmacopoeia fixed the assortment of substances to be stocked by all pharmacies, including about 580 medicamenta simplicia, i.e. substances to be used as medicines or for the preparation of medicines, as well as 640 medicamenta composita, i.e. composite medicines already prepared. The pharmacopoeia helps us to understand the basis of medical therapy at that time, but it does not tell us which medicines were favoured in practice. However, two other sources prove valuable for that purpose. One of these is a large collection of patient records found in the archives of the Medical Museion of Copenhagen. These records were written by Christopher Detlev Hahn, medical officer in Aarhus from 1777 to 1817, and they include all his prescriptions to his patients. The other source is the prescription record from Aalborg Swan Pharmacy, kept in Jens Bang's House in Aalborg. It contains copies of prescriptions by Knud Nicolai Carstensen who was the medical officer in Aalborg from 1783 to 1802. We compared the prescription practice of these two doctors in the year 1797, studying 280 prescriptions by Hahn to 59 patients and 267 prescriptions by Carstensen to 137 patients. Both doctors used a large selection of the substances and preparations described in the pharmacopoeia, showing that they were familiar with that book, but usually they did not prescribe these substances and preparations as such. They individualized their treatment to suit each patient, composing medicines, whose ingredients, however, were mostly found in the pharmacopoeia. Medicines for internal use included drops, mixtures, electuaries, powders, teas and other herbs. Medicines for external use were usually ointments. In a number of cases Hahn prescribed pills, whereas Carstensen did not do so, although the production of pills at that time was common practice. Carstensen paid greater attention to the durability of the prescribed medicines than Hahn, probably because Carstensen's patients came from all of Northern Jutland. Therefore, it was important in his case that the keeping quality of the medicines permitted a time-consuming transport from pharmacy to patient and storage by the patient during the whole course of treatment. In contrast, most of Hahn's patients lived in Aarhus and surroundings. We compared the 22 substances used most frequently by Hahn and the 22 used most frequently by Carstensen. In both cases these included (in alphabetical order): bitter orange peel, camphor, cinchona, ether, peppermint, potassium carbonate, potassium tartrate and rhubarb roots. 60% of the substances in the preparations by either doctor were herbal drugs and 40% mineral or other chemical substances. Both Hahn and Carstensen favoured "evacuative" treatment, according to the theory of humoral pathology, using laxatives, diuretics and sudorifics. However, their choice of medicines differed, and, in contrast to Carstensen, Hahn also frequently prescribed emetics. The two doctors rarely prescribed the chemical substances recommended by the iatrochemists.
Dansk Farmacihistorisk Samling, Pharmakon a/s, Milnersvej 42, DK-3400 Hillerød.
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D003718:Denmark; D011307:Drug Prescriptions / Q000266:history*; D049670:History, 17th Century; D049671:History, 18th Century; D010602:Pharmacopoeias as Topic / Q000266:history*; D010818:Practice Patterns, Physicians' / Q000266:history*