Medical Prescription - History

History

The concept of prescriptions dates back to the beginning of history. So long as there were medications and a writing system to capture directions for preparation and usage, there were prescriptions.

Modern prescriptions are actually "extemporaneous prescriptions" from the Latin (ex tempore) for "at/from time". "Extemporaneous" means the prescription is written on the spot for a specific patient with a specific ailment. This is distinguished from a non-extemporaneous prescription which is a generic recipe for a general ailment. Modern prescriptions evolved with the separation of the role of the pharmacists from that of the physician. Today the term "extemporaneous prescriptions" is reserved for "compound prescriptions" which requires the pharmacist to mix or "compound" the medication in the pharmacy for the specific needs of the patient.

Predating modern legal definitions of a prescription, a prescription traditionally is composed of four parts: a "superscription", "inscription", "subscription" and "signature".

The superscription section contains the date of the prescription and patient information (name, address, age, etc.). The symbol "℞" separates the superscription from the inscriptions sections. In this arrangement of the prescription, the "℞" is a symbol for recipe or literally the imperative "take." This is an exhortation to the pharmacist by the medical practitioner, "I want the patient to have the following medication" - in other words, "take the following components and compound this medication for the patient."

The inscription section defines what is the medication. The inscription section is further composed of one or more of:

• a "basis" or chief ingredient indended to cure (curare)
• an "adjuvant" to assist its action and make it cure quickly (cito)
• a "corrective" to prevent or lessen any undesirable effect (tuto)
• a "vehicle" or "excipient" to make it suitable for administration and pleasant to the patient (jucunde)

The "subscription" section contains dispensing directions to the pharmacist. This may be compounding instructions or quantities.

The "signature" section contains directions to the patient and is often abbreviated "Sig." or "Signa." It also obviously contains the signature of the prescribing medical practitioner though the word "signature" has two distinct meanings here and the abbreviations are sometimes used to avoid confusion.

Thus sample prescriptions in modern textbooks are often presented as: