A look at traditional Pharmacy Compounding Practices and Thoughts on What we Have Forgotten
Remembering the Past
Someone once asked me why I go by "The Digital Apothecary" and not "The Digital Pharmacist," and my response came down to that I loved the mashup of old and new. Personally, I enjoy and love reading history, and feel that pharmacy has a long rich history in itself that is not worth forgetting as we strive to move into the future. Take for instance our movement from traditional drug dispensing roles into providers.
For centuries, the forebears of modern pharmacists manually collected and prepared medications for patients. Whereas today we can simply order medications and keep a relatively straightforward inventory, it sure beats traveling in the countryside finding herbs and whatnot ingredients.
That being the case, I recently came across a series of videos demonstrating old pharmacy compounding techniques, and wanted to share those here for those interested (along with some personal comments, I did watch them all after all). It's a documentary from the early 90s, and while the video quality is alright, the content still seems spot on to me.
Drug Extraction Techniques
I like this video, as it makes me wonder how patients would respond if we told them it would take several days just to make a drug. We take for granted the bottles we can just pull off the shelf and measure out to be dispensed these days. A recurring theme that runs through this is the time and sweat that goes into preparing each medication, and why pharmacists were happy for industrialization of medication manufacture in the mid 1900's, just due to the fact that it got them away from the legwork.
Pills and Powders
This is just amazing to me, and probably my most favorite video. For years, I wondered how those pill rollers worked. I would see them in pharmacy and medical museums, but never came across any books, guides, or videos that demonstrated their actual use. Watching him make these pills is quite interesting, and I feel really gives a great example of what pharmacists/apothecaries/chemists/druggists used to have to do in drug preparation.
Tablets
Now this is really an eye-opener on how hard it was to prepare tablets when they just started coming out. In an age when scientists are trying to 3D print drugs (Take a Look), its really intriguing to see the work that went into making a tablet (alot of force!). Now what I really like is the tablet making machine, I am just trying to imagine cranking that thing all day to roll out tablets to keep up with demand today. Think about it, how long would it take to prepare all the tablets a pharmacist prepares in one day by hand versus industrial machines?
Suppositories
This process surprisingly doesn't seem vastly changed over the past few decades, and probably because the process is straightforward in preparation. The tools he is using are rather interesting though I thought.
Medicinal Platers (aka Medicated Bandages)
Ok, it actually took me a bit to figure this one out in the beginning. I had never seen it, read about it, or heard about these. However, it makes sense that we have been making some form of medicated patches for centuries, and that our modern day nitro and fentanyl patches didn't spring out of anywhere.
Where do we go from here?
I think current pharmacists and students would benefit from watching a few of these videos. My reasoning is that it really demonstrates the significant change in roles the profession is undergoing. Imagine, decades ago this was the face of pharmacy. We didn't vaccinate, we weren't engaged in MTM or any form of medication management, and we sure as hell were not going for provider status.
Things change, sometimes it takes alot of time, sometimes in the grand scheme it takes a bit of work and effort. I think pharmacy will change it's identity beyond medication dispensing in the near future, but we should never forget our roots and what we were and still are.