The signatura consists of the directions that are to be copied on the label by the compounder for the instruction of the patient or nurse. They should, therefore, always be written so that when copied verbatim et literatim they will constitute the desired label. The prescriber substantially tells the compounder to"write on the label the following,"and while the druggist usually is competent and willing to take upon himself the responsibility of writing what he understands the doctor wishes, it still does not make the position of the careless prescriber correct. The point is well illustrated by an incident occurring in a Southern city, where the railway warehouse keeper was in the habit of directing a porter:"Go tell Mr. Blank that if he does not take out his freight I will come up and beat the face off him."The porter would modestly say to Mr. Blank:"The boss say wont you please git out your freight."A new porter finally terminated the custom by delivering the message literally, with disastrous results. This understanding of the instruction to the dispenser bars all Latin abbreviations and, in fact, all but complete plain, every-day English.

Dismissing as even not meriting discussion such as Teaspoonful t. i. d. or 3j q. 3 v. 4 h., we will take up the simple English directions.

The directions As directed are justifiable only under rare conditions, if ever, and then only when the remedy would hardly admit of injurious use; for example, in the use of mercurial ointment by inunction; and then it would be better to indicate something more, as Apply as directed or Apply with massage as directed. In the case of a remedy as a concentrated solution of potassium permanganate to be used in making a vaginal douche, in composing the label the patient's feelings must be considered. Many merely order As directed. There are few objections to and many reasons for a label as Use tablespoonful to gallon of hot water, or Dilute with hot water and use as directed.

In directing the use of urethral injections it is permissible to put Use as directed; this contraindicates Take as directed, as would also be the case in the douche just mentioned. In fact, always where a liquid is not to be administered by mouth, it is wise to so indicate on the label. Some use instructions as Not to be taken, and, in case of a poison, Poison-not to be taken. Separate labels bearing these and other legends are frequently employed, but it is much more desirable to have pharmacists use a prescription label carrying the printing desired on its face, as a separate label might become detached. It is understood in many places that the part of the signa that the preserver puts in quotation marks may be supplied by dispenser with printed label. For example:

Sig

"Poison."

Use to moisten dressing. Sig.-"Not to be taken."

Apply to back with massage. Sig.-"For external use."

Apply to swelling twice daily.

Or, if there is any doubt about the particular druggist understanding:

Sig

(Poison-label.)

Use to moisten dressing.

In this connection attention should be called to the many objections to the unfortunate practice of using certain classes of special labels or label information, as "For Cough" or "Teaspoonful every 2 hours for Cough;" "For Fever" or Teaspoonful every 2 hours for fever. For example: In a certain city one"For Diarrhea"prescription was used hundreds of times and for scores of patients suffering with almost every variety of intestinal disturbance. For the original patient and condition it probably was excellent, from all reports; but when used without the necessary intelligent discrimination, it becomes an injustice not only to the patient but to the original prescriber, who is to some extent held responsible for his remedies, even under these conditions, and he and his confreres sustain a loss of legitimate practice represented by the cases that are cured. This example is merely an illustration of a state of affairs that in some communities, particularly, is unfortunately only too prevalent. The prescriber should always remember that in the greater part of the country the custom of the dispensers giving copies of prescriptions on request of patient is so well established that"business judgment"prevents a refusal to conformity.

Unnecessary words should be avoided, especially in the case of prescribing pills, capsules, tablets, etc., as these are dispensed in containers that have very limited label space. To illustrate: The label One pill three times a day before meals could be written One before meals or One before each meal, for the reason that where one is to be taken, and there is nothing but pills in the container, the patient hardly needs specific instructions to take a pill. The three times a day may under most circumstances be omitted, as the patient is probably definitely understood to be taking three meals a day. Only in the case of infants or special feeding, where more than three regular meals are being taken, would a question be raised.

Directions are frequently put up to a dispenser to be put on a label an inch in diameter, such as Take the capsules an hour apart and three hours after last capsule take a bottle of Citrate of Magnesia. Better would be a label Take an hour apart and the instructions as to the saline given to the patient on a special sheet of instructions, as will be discussed later.

Care should be used in the arrangement of words. One before each meal in water would be better One in water before each meal. Or, for example, Teaspoonful on retiring in water might appear better as Teaspoonful in water before retiring.

Where the common quantities as teaspoonful, tablespoonful, and drops are used and the remedy is not for internal use, the first word of the label should so indicate, as Apply teaspoonful to swelling. Pour tablespoonful on bandage, Put one drop in eyes three times daily.

In prescribing powders more label room is available, as they are usually dispensed in envelopes or comparatively large boxes. In the case of liquids the label space available will depend to some extent on the size of the bottle ordered. The label that will fit a half-ounce bottle is so small that only a very few words can be written on it, while a comparatively large label may be used on bottles holding twelve or sixteen ounces, or even on those holding four ounces. It must be remembered that, whatever else may or may not be written on the label, the druggist must have his business card and also put the number and date of the prescription and the name of the doctor and patient, and many also put the name of the clerk compounding the formula.

The following represent labels that may be used on the various-size containers, and show the other information that must be written in addition to the prescriber's instructions.

Of course, these are only rough averages, as there is no uniformity in these matters:

For 1/2, 1, and 2 fluidounce bottles.

For 2, 3, and 4 fluidounce bottles.

For 4, 6, and 8 fluidounce bottles.

For 6 or more fluidounce bottles.

For boxes holding from 1 to 4 capsules or 1/2-ounce ointment jars.

For boxes holding from 4 to 12 capsules or for 1-ounce ointment jars.

For boxes holding from 12 to 24 capsules or for larger ointment jars.

Suppository boxes have very little label space. Larger quantities of capsules are put into square boxes, which give more label space.

If a "shake" label or other special label is used, less space will be available, as a smaller label will have to be employed.