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Remington
The Science and Practice of Pharmacy
Remington
The Science and Practice of Pharmacy
23rd Edition
Editor-in-Chief
Adeboye Adejare
Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy,
University of the Sciences, Philadelphia, PA, United States
Department of Chemistry and Biochemistry, Misher College of Arts and Sciences,
University of the Sciences, Philadelphia, PA, United States
Section Editors
Purnima D. Amin
Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai, India
Grace L. Earl
School of Pharmacy and Health Sciences, Fairleigh Dickinson University, Florham Park, NJ, United States
Simon Gaisford
UCL School of Pharmacy, University College London, London, United Kingdom
Islam M. Ghazi
Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA, United States
Zhiyu Li
Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy,
University of the Sciences, Philadelphia, PA, United States
David J. Newman
Newman Consulting LLC, Wayne, PA, United States
Michael S. Saporito
Intervir, LLC, Philadelphia, PA, United States
Jeff Talbert
Department of Pharmacy Practice and Science, University of Kentucky, Lexington, KY, United States
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research
methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, com-
pounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others,
including parties for whom they have a professional responsibility.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to
persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or
ideas contained in the material herein.
ISBN: 978-0-12-820007-0
I would like to dedicate this book to the Philadelphia College of Pharmacy (PCP) family, including, but not limited to
students, faculty, staff, and alumni. As the first school or college of pharmacy in North America, it can be argued that
we are really the home of pharmacy and pharmaceutical sciences in North America! From great educators like Joseph
P. Remington to helping to bring the United States Pharmacopeia to fruition to industrial giants like Eli Lilly, the con-
tributions of PCP to the profession continues to be very significant. The Remington Honor Medal is the highest honor
bestowed by the American Pharmacists Association. I am extremely grateful and proud to be part of this family as a
faculty member. Finally, I would like to dedicate the book to my greatest teacher, I. Abiola Adejare, none other than
my father. Though you have moved on to where the Yorubas say “ibi agba re” (where elders go), the seeds that you
sowed continue to bear great fruits. Your grandson is now a PCP alum!
Adeboye Adejare
Professor, Philadelphia College of Pharmacy
Editor-in-Chief
Contents
Section 1 Section 2
Introduction Natural Products
David John Newman
1. History of pharmacy 3
Gregory J. Higby and Benjamin Y. Urick 3. Botanical dietary products 45
1.1. The drug-taking animal 3 Esperanza J. Carcache de Blanco and
1.2. Prehistoric pharmacy 3 A. Douglas Kinghorn
1.3. Antiquity 4
1.4. The Middle Ages 5 3.1. Botanical dietary supplements 45
1.5. The Renaissance and Early Modern Europe 6 3.2. Botanicals standardization and quality
1.6. American pharmacy 8 evaluation 48
1.7. Antebellum America: Pharmacy finds 3.3. Quality control and quality assurance
its niche 10 of botanicals 50
1.8. The search for professionalism 11 3.4. Potential toxicity of botanical dietary
1.9. Legislation 11 supplements 51
1.10. Transition to a modern profession 12 3.5. Kratom (Mitragyna speciosa), a
1.11. The era of Count and Pour 13 controversial psychoactive plant 52
1.12. The emergence of clinical pharmacy 14 3.6. Concluding remarks 53
1.13. The conflicting paradigms of References 54
pharmaceutical care and managed care 15
4. Natural products and derivatives as
1.14. The promise of a new century 15
1.15. The future 16 human drugs 59
1.16. History as a discipline 16 David J. Newman
1.17. Bibliographic notes 16
1.18. A chronology of pharmacy 20 4.1. Introduction 59
4.2. Agents against pain 59
2. Integrated approach to drug 4.3. Antiinfectives (antibacterial, antiparasitic,
nomenclature 23 and antiviral) 62
4.4. Anticancer agents 70
Amos O. Abioye 4.5. Conclusion 72
2.1. Introduction 23 References 72
2.2. The changing face of drug nomenclature 25
5. Medicinal Cannabis: an overview for
2.3. Principles of drug nomenclature 26
2.4. Types of drug nomenclature 28 health-care providers 75
2.5. Global cooperation on harmonization of Jason Wallach
drug nomenclature 29
2.6. The challenges of selecting INN 5.1. History of Cannabis use 75
for biologics 32 5.2. Clinical indications 77
ix
x Contents
25. Gene and cell therapy 463 28.7. Intravitreal injections/implants 571
28.8. Juxtascleral injections 572
Jieni Xu, Bing Wang and Song Li 28.9. Intracameral injections 572
25.1. Preface 463 28.10. Iontophoresis 572
25.2. Gene therapy 464 28.11. Subconjunctival injections 572
25.3. Cell therapy 478 28.12. Retrobulbar injections 572
25.4. Ethical issues 485 28.13. Ophthalmic preparation characteristics 573
25.5. Marketing and funding 486 28.14. Packaging 573
25.6. Progress and perspective 487 28.15. Antimicrobial preservatives 573
References 487 28.16. Summary 574
References 574
26. Protein drug production and
29. Parenteral preparations 577
formulation 489
Mangal Shailesh Nagarsenkar and
Izabela Gierach, Jackelyn M. Galiardi, Vivek Vijay Dhawan
Brian Marshall and David W. Wood
29.1. Introduction 577
26.1. Biologics versus synthetics—basic 29.2. Advantages of parenteral route and
definitions and history 489 formulations 577
26.2. Complexity and regulatory 29.3. Concerns with parenteral route and
considerations 490 formulations 577
26.3. Biologics manufacturing processes 524 29.4. Considerations for formulation
26.4. Special notes on biosimilars 540 development of parenterals 578
References 545 29.5. Formulation components 578
29.6. Containers and closures 581
Section 7 29.7. Pyrogens (endotoxins) and
depyrogenation 586
Pharmaceutical Materials and 29.8. General considerations—production
Devices/Industrial Pharmacy facilities 587
Purnima Dhanraj Amin 29.9. Personnel 591
29.10. Environmental control evaluation 591
27. Coating of pharmaceutical dosage 29.11. Process simulation testing by media fill 592
forms 551 29.12. Manufacturing of parenteral product 592
29.13. Quality assurance and control 600
Stuart C. Porter References 602
Further reading 603
27.1. Introduction 551
27.2. Evolution of coating processes 551
27.3. Pharmaceutical coating processes 552
30. Pulmonary, Nasal, and Topical Aerosol
27.4. Film coating of oral solid dosage forms 552 Drug Delivery Systems 605
27.5. Coating procedures and equipment 557 Mala Menon, Richard N. Dalby, Isha Naik,
27.6. Coating pans 558 Hemali Savla and Kaveri Kalola
27.7. Fluidized-bed coating equipment 560
27.8. Recent trends in film-coating processes 562 30.1. Introduction 605
References 564 30.2. Modes of drug delivery to the
respiratory tract 606
28. Ophthalmic preparations 565 30.3. Important considerations in the design
of pulmonary aerosol systems 606
Furqan A. Maulvi, Ketan M. Ranch,
Ankita R. Desai, Ditixa T. Desai and 30.4. General aerosol formulation principles 607
Manish R. Shukla 30.5. Aerosol formulation components 614
30.6. Manufacture of pressurized aerosol
28.1. Introduction 565 products 618
28.2. Bioavailability 565 30.7. Product testing 619
28.3. Types of ophthalmic dosage forms 568 30.8. Human factors 620
28.4. Drug administration 570 30.9. Future of aerosols and inhaled
28.5. Irrigating solutions 571 drug therapy 622
28.6. Intraocular injections 571 Further reading 622
xiv Contents
37.4. A brief introduction to OMIC technologies 40.2. Role of the medication safety leader 749
of the central dogma: 40.3. Medication safety analysis 749
DNA-RNA-protein-(metabolite) 703 40.4. Error-reduction strategies 752
37.5. Systems biology: creating context by 40.5. Medication safety practices 753
putting the “OMES” together 715 40.6. Patient Safety and Medication
37.6. A final word—considerations regarding Safety Organizations 756
publicly available OMICS data in silico 716 40.7. Conclusion 757
37.7. Summary 716 References 757
References 717
41. Substance use disorders 759
38. Neurobiologic correlates of depression:
illustration of challenges in bench-to- Daniel J. Ventricelli and Andrew M. Peterson
bedside translation 719 41.1. Introduction 759
41.2. Definitions 760
Bruce Edward Jones
41.3. At-risk populations 761
38.1. Introduction 719 41.4. Addressing the problem 762
38.2. Defining the patient population 720 41.5. Specific substance use 763
38.3. Cultural impact on defining 41.6. Pharmacists role 766
neuropsychiatric disease 720 41.7. Conclusion 767
38.4. Hurdles to basic and translational References 767
research 721
38.5. Models of neuropsychiatric disease 721 42. Global trends in pharmacy practice 769
38.6. Genomics in depression 727
Claire Anderson
38.7. Antidepressant targets beyond serotonin 729
38.8. Summary 731 42.1. Introduction 769
References 731 42.2. Primary care and universal health
coverage 770
Section 9 42.3. Prevention 775
42.4. Pharmacists role in disease management 775
Pharmacy Practice 42.5. Pharmacist prescribing 777
Grace L. Earl
42.6. Collaborating with other health
professionals 777
39. Pharmacy and patient centered 42.7. Public health roles 777
care 737 42.8. Competency and credentialing to
provide services and advance practice 778
Kimberly A. Galt 42.9. Advancing community pharmacy
39.1. What is patient centered care? 737 globally 778
39.2. Why is patient-centered care needed? 737 References 779
39.3. History of patient centered care 738 Further reading 780
39.4. Future trends in the United States 738
39.5. Considerations affecting pharmacists 43. Value-based payment models
provision of patient-centered care 738 involving pharmaceutical services 781
39.6. Barriers and gaps 741
39.7. Patients, pharmacists, and settings Jing Yuan and Laura T. Pizzi
where patient-centered care is practiced 742 43.1. Introduction 781
39.8. Education and training 746 43.2. Approaches toward improving
39.9. Conclusion 747 health-care value 781
References 747 43.3. Approaches toward improving
health-care value 784
40. Medication safety and medication References 787
error prevention 749
44. Role of the pharmacist in research 789
Michael Claro Dejos
Lisa E. Davis and Sandipan Bhattacharjee
40.1. State of medication safety and
recent advances 749 44.1. Introduction 789
xvi Contents
44.2. What constitutes research? 789 48. Specialty pharmacy services 829
44.3. Roles for pharmacists in research 790
44.4. Implementation science 796 Vivianne K. Celario and Pinal Mistry
44.5. Preparing for careers in research 796 48.1. Practice models and services 830
44.6. Tips for success in pursuing research 797 48.2. Trends and impact 832
44.7. Tips for conducting and assessing 48.3. Stakeholders 832
outcomes research 798 48.4. Technology 833
44.8. Conclusion 798 48.5. Barriers and challenges 833
References 799 48.6. Organizational oversight 834
48.7. Education and training 834
45. Trends in nutrition practice 801 48.8. Resources 835
Diana M. Solomon and Angela L. Bingham 48.9. Conclusion 835
References 835
45.1. Introduction 801
45.2. Overview 801
45.3. Nutrition practice models 802 49. Pharmacy involvement in medical
45.4. Evidence-based medicine 803 missions 837
45.5. Factors leading to transformation
and innovation 804 Mary J. Ferrill
45.6. Oversight by relevant organizations 805
45.7. Education and training 805 49.1. Introduction 837
45.8. Barriers and gaps 806 49.2. Planning logistics 837
45.9. Resources 809 49.3. Health-care logistics 839
45.10. Conclusion 809 49.4. Integrating medical missions into
References 809 pharmacy education 844
49.5. Conclusion 847
46. Medication disposal 811 References 847
55.30. Misbranding and adulteration 950 56. Drug distribution system 967
55.31. Misbranded drugs 951
55.32. Poisons 952 Minji Sohn
55.33. The Comprehensive Drug Abuse 56.1. Health-care delivery and third-party
Prevention and Control Act of 1970 954 payers 967
55.34. Prescriptions 960 56.2. Drug distribution and pharmacy
55.35. Miscellaneous controlled substance reimbursement 971
issues 963 References 973
55.36. Liability for negligent acts 963
Further reading 965 Index 975
List of contributors
Kamilia Abdelraouf, Center for Anti-Infective Research Sandipan Bhattacharjee, Health Outcomes Division,
and Development, Hartford Hospital, Hartford, CT, College of Pharmacy, The University of Texas at
United States Austin, Austin, TX, United States
Anush Abelian, Department of Chemistry and Angela L. Bingham, Philadelphia College of Pharmacy,
Biochemistry, Misher College of Arts and Sciences, University of the Sciences, Philadelphia, PA, United
University of the Sciences, Philadelphia, PA, United States States
Amos O. Abioye, Lloyd L. Gregory School of Asma Buanz, School of Pharmacy, University College
Pharmacy, Palm Beach Atlantic University, West Palm London, London, United Kingdom
Beach, FL, United States Michael E. Burczynski, Department of Pharmacology,
Adeboye Adejare, Department of Pharmaceutical University of Pennsylvania, Philadelphia, PA, United
Sciences, Philadelphia College of Pharmacy, University States
of the Sciences, Philadelphia, PA, United States; Esperanza J. Carcache de Blanco, Medicinal Chemistry
Department of Chemistry and Biochemistry, Misher and Pharmacognosy, College of Pharmacy, The Ohio
College of Arts and Sciences, University of the State University, Columbus, OH, United States
Sciences, Philadelphia, PA, United States
Michael J. Cawley, Philadelphia College of Pharmacy/
Nour Allahham, UCL School of Pharmacy, University University of the Sciences, Philadelphia, PA, United States
College London, London, United Kingdom
Vivianne K. Celario, Pharmacy, Walgreens and Rutgers
Purnima D. Amin, Department of Pharmaceutical University, New Brunswick, NJ, United States
Sciences and Technology, Institute of Chemical
Technology, Mumbai, India Lisa M. Cillessen, University of Missouri-Kansas City,
School of Pharmacy at Missouri State University,
Claire Anderson, Division of Pharmacy Practice and Springfield, MO, United States
Policy, School of Pharmacy, University of
Nottingham, Nottingham, United Kingdom Geoff Curran, Center for Mental Healthcare &
Outcomes Research, Central Arkansas Veterans
Tomefa E. Asempa, Center for Anti-Infective Research Healthcare System, Little Rock, AR, United States;
and Development, Hartford Hospital, Hartford, CT, Departments of Pharmacy Practice and Psychiatry,
United States Center for Implementation Research, University of
Zeynep Ates-Alagoz, Department of Pharmaceutical Arkansas for Medical Sciences, Little Rock, AR,
Chemistry, Faculty of Pharmacy, Ankara University, United States
Ankara, Turkey; Department of Pharmaceutical Richard N. Dalby, Department of Pharmaceutical
Sciences, Philadelphia College of Pharmacy, Sciences, School of Pharmacy, University of
University of the Sciences in Philadelphia, Maryland, Baltimore, MD, United States
Philadelphia, PA, United States
Atheer Awad, UCL School of Pharmacy, University Lisa E. Davis, Pharmacy Practice & Science, University
College London, London, United Kingdom of Arizona, Tucson, AZ, United States; Pharmacy,
Jungjun Bae, Institute for Pharmaceutical Outcomes and Banner University Medical Center, Tucson, AZ,
Policy, College of Pharmacy, University of Kentucky, United States
Lexington, KY, United States Michael Claro Dejos, Department of Patient Safety,
Abdul W. Basit, UCL School of Pharmacy, University Methodist Le Bonheur Healthcare, Memphis, TN,
College London, London, United Kingdom United States
xix
xx List of contributors
Chris Delcher, Department of Pharmacy Practice and Eleonora Gianti, Department of Chemistry and
Science, College of Pharmacy, University of Biochemistry, Swarthmore College, Swarthmore, PA,
Kentucky, Lexington, KY, United States United States; College of Science and Technology,
Ankita R. Desai, Maliba Pharmacy College, Uka Temple University, Philadelphia, PA, United States
Tarsadia University, Surat, India Izabela Gierach, Protein Capture Science, LLC, Dublin,
Ditixa T. Desai, Maliba Pharmacy College, Uka Tarsadia OH, United States
University, Surat, India Amie Goodin, Department of Pharmaceutical Outcomes
Vivek Vijay Dhawan, IPA-MSB’s Bombay College of and Policy, University of Florida, Gainesville, FL,
Pharmacy, Mumbai, India United States; Center for Drug Evaluation and Safety
(CoDES), Gainesville, FL, United States
Michael Dybek, Department of Chemistry and
Biochemistry, Misher College of Arts and Sciences, Paul O. Gubbins, University of Missouri-Kansas City,
University of the Sciences, Philadelphia, PA, United States School of Pharmacy at Missouri State University,
Springfield, MO, United States
Grace Earl, Fairleigh Dickinson University, School of
Pharmacy and Health Sciences, Florham Park, NJ, Sharda Gurram, Department of Pharmaceutical
United States Sciences and Technology, Institute of Chemical
Technology, Mumbai, India
Mohamed Elmeliegy, Pfizer, Inc., San Diego, CA,
United States Gregory J. Higby, School of Pharmacy, University of
Wisconsin-Madison, Madison, WI, United States;
Taiwo Olayemi Elufioye, Faculty of Pharmacy, American Institute of the History of Pharmacy,
University of Ibadan, Ibadan, Nigeria; Department of Madison, WI, United States
Pharmaceutical Sciences, Philadelphia College of
Pharmacy, University of the Sciences, Philadelphia, Jaclyn M. Hoover, Biologics Discovery, Janssen
PA, United States Research and Discovery, LLC., Spring House, PA,
United States
Mary J. Ferrill, College of Pharmacy, Taipei Medical
University, Davenport, FL, United States Ankitkumar Jain, Signet Excipients Pvt. Ltd, Mumbai,
India
Felix W. Frueh, Opus Three, Del Mar, CA, United
States Bruce Edward Jones, Research and Development, CSO
Score Pharma Inc., Exton, PA, United States
Simon Gaisford, UCL School of Pharmacy, University
College London, London, United Kingdom Kaveri Kalola, Department of Phamaceutics, Bombay
College of Pharmacy, Mumbai, India
Jackelyn M. Galiardi, Department of Chemical and
Biomolecular Engineering, The Ohio State University, James M. Kidd, Center for Anti-Infective Research and
Columbus, OH, United States Development, Hartford Hospital, Hartford, CT, United
States
Kimberly A. Galt, School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, United A. Douglas Kinghorn, Medicinal Chemistry and
States Pharmacognosy, College of Pharmacy, The Ohio State
University, Columbus, OH, United States
Francesca K.H. Gavins, UCL School of Pharmacy,
University College London, London, United Geetanjali Laghate, Signet Excipients Pvt. Ltd,
Kingdom Mumbai, India
Boyenoh Gaye, Department of Pharmaceutical Sciences, Sherry L. La Porte, Biologics Discovery, Janssen
Philadelphia College of Pharmacy, University of the Research and Discovery, LLC., Spring House, PA,
Sciences, Philadelphia, PA, United States United States
Richard Thomas Layer, Research & Development,
Brian Geist, Biologics Development Sciences, Janssen
Ganglion Therapeutics, New York, NY, United States
Research and Development, LLC., Spring House, PA,
United States Maria Leibfried, Fairleigh Dickinson University, School
of Pharmacy and Health Sciences, Florham Park, NJ,
Islam M. Ghazi, Philadelphia College of Pharmacy/ United States
University of the Sciences, Philadelphia, PA, United States
Song Li, Center for Pharmacogenetics, Department of
Oliver Ghobrial, Teva Branded Pharmaceuticals R&D, Pharmaceutical Sciences, School of Pharmacy,
West Chester, PA, United States University of Pittsburgh, Pittsburgh, PA, United States
List of contributors xxi
Yan Li, Department of Pharmaceutical Outcomes and David J. Newman, Newman Consulting LLC, Wayne,
Policy, College of Pharmacy, University of Florida, PA, United States
Gainesville, FL, United States; Division of Jeffrey P. Norenberg, Chemistry, Invicro—A Konica
Pharmacovigilance I, Office of Surveillance and Minolta Company, Boston, MA, United States; Pharmacy
Epidemiology, Center for Drug Evaluation and and Anesthesiology, University of New Mexico Health
Research, U.S. Food and Drug Administration, Silver Sciences Center, Albuquerque, MA, United States
Spring, MD, United States
Brian R. Overholser, Department of Pharmacy Practice,
Zhiyu Li, Department of Pharmaceutical Sciences, College of Pharmacy, Purdue University, West
Philadelphia College of Pharmacy, University of the Lafayette and Indianapolis, IN, United States; Division
Sciences, Philadelphia, PA, United States of Clinical Pharmacology, Department of Medicine,
Heather Lyons-Burney, University of Missouri-Kansas School of Medicine, Indiana University, Indianapolis,
City, School of Pharmacy at Missouri State University, IN, United States
Springfield, MO, United States Jacob T. Painter, Division of Pharmaceutical Evaluation
Christine M. Madla, UCL School of Pharmacy, & Policy, Department of Pharmacy Practice,
University College London, London, United Kingdom University of Arkansas for Medical Sciences, Little
Mohammed Maniruzzaman, Pharmaceutical Engineering Rock, AR, United States; Center for Mental Healthcare
and 3D Printing (PharmE3D) Labs, Division of & Outcomes Research, Central Arkansas Veterans
Molecular Pharmaceutics and Drug Delivery, College Healthcare System, Little Rock, AR, United States
of Pharmacy, University of Texas at Austin, Austin, Michelle Parker, Thermo Fisher Scientific, Waltham,
TX, United States MA, United States
Brian Marshall, Department of Chemical and Nathan Pauly, Office of Health Affairs, West Virginia
Biomolecular Engineering, The Ohio State University, University, Morgantown, WV, United States
Columbus, OH, United States Jaywant Pawar, Department of Pharmaceutical Sciences
T. Joseph Mattingly II, University of Maryland School and Technology, Institute of Chemical Technology
of Pharmacy, Baltimore, MD, United States Mumbai, Mumbai, India
Furqan A. Maulvi, Maliba Pharmacy College, Uka Amy Sutton Peak, College of Pharmacy and Health
Tarsadia University, Surat, India Sciences, Butler University, Indianapolis, IN, United States
Annette McFarland, College of Pharmacy and Health Andrew M. Peterson, Philadelphia College of
Sciences, Butler University, Indianapolis, IN, United States Pharmacy, University of the Sciences in Philadelphia,
Mala Menon, Department of Phamaceutics, Bombay Philadelphia, PA, United States
College of Pharmacy, Mumbai, India Laura T. Pizzi, Center for Health Outcomes, Policy, and
Andrew W. Mina, St. Michael’s Medical Center, Staten Economics (HOPE), Ernest Mario School of Pharmacy,
Island, NY, United States Rutgers University, Piscataway, NJ, United States
Pinal Mistry, Pharmacy Revenue Integrity, Corporate Varsha Pokharkar, Department of Pharmaceutics,
Pharmacy Services, OhioHealth, Columbus, OH, Poona College of Pharmacy, Bharati Vidyapeeth
United States (Deemed University), Pune, India
Daniela Moga, Department of Pharmacy Practice and Stuart C. Porter, Pharmaceutical R&D, PPT Pharma
Science, College of Pharmacy, University of Technologies, Hatfield, PA, United States
Kentucky, Lexington, KY, United States;
Divya Prabhudesai, Signet Excipients Pvt. Ltd,
Epidemiology, College of Public Health, University of
Mumbai, India
Kentucky, Lexington, KY, United States
Elisabeth G. Prinslow, Biologics Discovery, Janssen
Monica Muñoz, Division of Pharmacovigilance I, Office Research and Discovery, LLC., Spring House, PA,
of Surveillance and Epidemiology, Center for Drug United States
Evaluation and Research, U.S. Food and Drug
Administration, Silver Spring, MD, United States Bahijja Tolulope Raimi-Abraham, Institute of
Mangal Shailesh Nagarsenkar, IPA-MSB’s Bombay Pharmaceutical Science, School of Cancer and
College of Pharmacy, Mumbai, India; VES College of Pharmaceutical Sciences, King’s College London,
Pharmacy, Mumbai, India London, United Kingdom
Isha Naik, Department of Phamaceutics, Bombay Ketan M. Ranch, Maliba Pharmacy College, Uka
College of Pharmacy, Mumbai, India Tarsadia University, Surat, India
xxii List of contributors
Michael S. Saporito, Intervir, LLC, Philadelphia, PA, Benjamin Y. Urick, Practice Advancement and Clinical
United States Education (PACE), University of North Carolina
Hemali Savla, Department of Phamaceutics, Bombay Eshelman School of Pharmacy (UNC ESOP), Chapel
College of Pharmacy, Mumbai, India Hill, USA
Krutika Khanderao Sawant, Department of Pharmacy, Daniel J. Ventricelli, Philadelphia College of Pharmacy,
Faculty of Pharmacy, The Maharaja Sayajirao University of the Sciences in Philadelphia,
University of Baroda, Vadodara, India Philadelphia, PA, United States
There is arguably no textbook that has been more influen- introduced preparations of the age.” Even more so than
tial on the profession of pharmacy than Remington: The the late 19th century, the profession continues to rapidly
Science and Practice of Pharmacy. First Authored by evolve and Remington continues to serve us as both a
Joseph Remington in 1885, an eminent pharmacist and valuable reference text and a record of pharmacy’s prog-
long-serving faculty member and the second dean of ress over the last 135 years. Our profession is unique
Philadelphia College of Pharmacy (PCP), the textbook among the sciences and health-care arenas in that it is
has been published continuously since then and as such, I truly a science and practice profession. The original sec-
am proud to introduce the 23rd edition of Remington. As tions of Remington detailing the pharmaceutical apparatus
an alumnus of PCP (now part of University of the and the listings of inorganic and organic chemical sub-
Sciences) and it’s 16th dean, I am particularly delighted stances of the day, which may seem irrelevant and foreign
that the newest edition of Remington is being edited once to the contemporary pharmacist, have been replaced with
again by a PCP faculty member, Dr. Adeboye Adejare chapters such as therapeutic antibodies and molecular pro-
who “moved mountains” to bring Remington to fruition. filing. In Remington’s time (and for many years thereaf-
Remington: The Science and Practice of Pharmacy ter) the practice of pharmacy was much closer aligned to
will be forever tied to the legacy of PCP and the profes- a shopkeeper than a health-care provider. The ever-
sion of pharmacy. Joseph Remington was profoundly changing role of pharmacists in the direct care of patients
influenced by William Proctor Jr—another PCP faculty is elucidated in chapters such as point-of-care testing and
member—and considered by many to be the father of the role of the pharmacist in the COVID-19 pandemic.
American Pharmacy. Further, Remington is being pub- This truly is a marvelous and comprehensive textbook!
lished to coincide with the 2021 bicentennial of the For many seasoned pharmacists, Remington was the
founding of PCP, the first college of pharmacy in the pharmacy textbook. We no longer carry this massive
nation and often considered the birthplace of American tome under our arms, but the book (in particular the elec-
Pharmacy. There can be no better tribute to our tronic version!) will continue to inspire generations of stu-
profession. dents, pharmacists, and pharmaceutical scientists for years
I found it profound that Professor Remington, in the to come.
Preface to the first edition (a reproduction which is
Edward F. Foote
included in this edition!), wrote, “The rapid and substan-
Dean, Philadelphia College of Pharmacy,
tial progress made in Pharmacy within the last decade has
University of the Sciences,
created a necessity for a work treating of the improved
Philadelphia, PA, United States
apparatus, the revised processes, and the recently
xxiii
Preface to the first edition
The rapid and substantial progress made in pharmacy Pharmacopoeia, the National authority, which is now so
within the last decade has created a necessity for a work thoroughly recognized.
treating of the improved apparatus, the revised processes, In order to suit the convenience of pharmacists who
and the recently introduced preparations of the age. prefer to weigh solids and measure liquids, the official
The vast advances made in theoretical and applied formulas are expressed, in addition to parts by weight, in
chemistry and physics have much to do with the develop- avoirdupois weight and apothecaries’ measure. These
ment of pharmaceutical science, and these have been equivalents are printed in bold type near the margin, and
reflected in all the revised editions of the pharmacopoeias arranged so as to fit them for quick and accurate
which have been recently published. When the author was reference.
elected in 1874 to the chair of Theory and Practice of Part III treats inorganic chemical substances.
Pharmacy in the Philadelphia College of Pharmacy, the Precedence is of course given to official preparation in
outlines of study which had been so carefully prepared for these. The descriptions, solubilities, and tests for identity
the classes by his eminent predecessors, Prof. William and impurities of each substance are systematically tabu-
Proctor, Jr. and Prof. Edward Parrish, were found to be lated under its proper title. It is confidently believed that
not strictly in accord, either in their arrangement of the by this method of arranging the valuable descriptive fea-
subjects or in their method of treatment. Desiring to pre- tures of the Pharmacopoeia will be more prominently
serve the distinctive characteristics of each, an effort was developed, read reference facilitated, and close study of
at once made to frame a system that should embody their the details rendered easy. Each chemical operation is
valuable features, embrace new subjects, and still retain accompanied by equations, while the reaction is, in addi-
that harmony of plan and proper sequence which are tion, explained in words.
absolutely essential to the success of any system. The carbon compounds, or organic chemical sub-
The strictly alphabetical classification of subjects stances, are considered in Part IV. These are naturally
which is now universally adopted by pharmacopoeias and grouped according to the physical and medical properties
dispensatories, although admirable in works of reference, of their principal constituents, beginning with simple bod-
presents an effectual stumbling block to the acquisition of ies such as cellulin and gum and progressing to the most
pharmaceutical knowledge through systematic study; the highly organized alkaloids, etc.
vast accumulation of facts collected under each head Part V is devoted to extemporaneous pharmacy. Care
arranged lexically, they necessarily have no connection has been taken to treat the practice that would be best
with one another, and thus the saving of labor effected by adapted for the needs of the many pharmacists who con-
considering similar groups together, and the value of the duct operations upon a moderate scale, rather than for
association of kindred subjects, are lost to the student. In those of the few who manage very large establishments.
the method of grouping the subjects which is herein In this, as well as in other parts of the work, operations
adopted, the constant aim has been to arrange the latter in are illustrated, which are conducted by manufacturing
such a manner that the reader shall be gradually led from pharmacists.
the consideration of elementary subjects to those which Part VI contains a formulary of pharmaceutical pre-
involve more advanced knowledge, while the groups parations which have not been recognized by the pharma-
themselves are so placed as to follow one another in a copoeia. The recipes selected are chiefly those which
natural sequence. have been heretofore rather difficult of access to most
The work is divided into six parts. Part I is devoted to pharmacists, yet such as are likely to be in request. Many
detailed descriptions of apparatus and definitions and private formulas are embraced in the collection, and such
comments on general pharmaceutical processes. preparations of the old pharmacopoeias, that have not
The Official Preparations alone are considered in Part been included in the new edition, but are still in use, have
II. Due weight and prominence are thus given to the been inserted.
xxv
xxvi Preface to the first edition
In conclusion the author ventures to express the hope Mr. George M Smith for their valuable assistance in revis-
that the work will prove an efficient help to the pharma- ing the proof sheets and to the latter especially for his
ceutical student as well as to the pharmacist and the phy- work on the index. The outline illustrations, by Mr. John
sician. Although the labor has been mainly performed Collins, were drawn either from the actual objects or from
amidst the harassing cares of active professional duties, photographs taken by the author.
and perfection is known to be unattainable, no pains have
been spared to discover and correct errors and omissions
in the text. The author’s warmest acknowledgments are JPR
tendered to Mr. A B Taylor, Mr. Joseph McCreery, and Philadelphia, October, 1885
Preface to the 23rd edition
The 200th year anniversary of the founding of the
Philadelphia College of Pharmacy edition
It is indeed an honor and a career high to be able to lead fundamentals remain same. To quote the first paragraph
the development of the 200th year anniversary of the of the 1885 Preface, “The rapid and substantial progress
founding of the Philadelphia College of Pharmacy (PCP) made in Pharmacy within the last decade has created a
edition of Remington: The Science and Practice of necessity for a work treating of the improved apparatus,
Pharmacy. It is also the 23rd edition of Remington. This the revised processes, and the recently introduced pre-
fruition did not come without significant challenges and parations of the age.” That statement is true of the new
obstacles. The first challenge was to truly examine Remington and topics of this “age” are “treated.” There
whether or not there is need for a compilation of this are indeed chapters dealing with new formulation and
nature and what such might look like, especially given the manufacturing techniques, translational research, and nat-
easy access to information for free on the internet. ural products including medicinal cannabis. There are
Another task was to carefully examine reasons why the also chapters dealing with modern issues including phar-
22nd edition was not well received. After consulting with maceutical chemistry, prodrugs, biotechnology, protein
appropriate stakeholders, the findings were clear and formulation, therapeutic antibody, specialty pharmacy,
pointed to marching forward with this edition and we substance use disorders, and health policy. As the work
decided to do so. A major development along the way was rounding up, the pandemic of 2020 [Coronavirus
was ability to recruit one of the largest publishers, SARS-CoV-2, Coronavirus Disease 2019 (COVID-19)]
Elsevier, Inc. to partner with us on the new Remington. became a reality and is thus addressed.
This fact is significant not just in the global availability of With PCP as anchor, we have been able to recruit edi-
the book but also in ability to utilize modern publishing tors and authors from all over the world consistent with
technologies, giving access to the whole book or just a the mission of Remington. I indeed hope that you find the
chapter, electronic or hard copy. The resulting book is compilation useful.
indeed true to Remington!
Adeboye Adejare
The Preface to the first edition in 1885 is reproduced
Philadelphia College of Pharmacy,
above for historical and relevance purposes. It is impor-
University of the Sciences, Philadelphia,
tant to note that while there have been many develop-
Pennsylvania, United States
ments in the profession of pharmacy and the underlying
sciences in over a century between then and now, the October 2020
xxvii
Acknowledgments
I would like to gratefully acknowledge all those who have played roles in making this edition possible. I thank the edi-
tors and authors for a phenomenal job in spite of dealing with the current pandemic (COVID-19) and many other duties.
I thank the Dean of PCP, who also happens to be an alum of PCP, Dr. Edward Foote who has been very encouraging
on this journey; as well as my colleagues. I would also like to thank Kristine Jones for bringing me to the Elsevier fam-
ily as an author. With the success of the book “Drug Discovery Approaches for the Treatment of Neurodegenerative
Disorders: Alzheimer’s Disease,” there was no doubt in my mind as to where to go once deliberations about the new
edition of Remington began. I would like to thank the many colleagues at Elsevier, especially Barbara Makinster, Erin
Hill-Parks, and Sreejith Viswanathan. It has been great working with you and I hope that we get to do it again!
I would like to acknowledge the support for my career in academia and for this book granted by my family, starting
from my lovely wife, Adekemi, to our children Adeboye Jr. (AJ), Adekunle (PCP alum), Aderonke, and Adeola. I
would also like to thank many people who have been helpful in one way or another, with special thanks going to my
mother, Ayoola Adejare.
Adeboye Adejare
Professor, Philadelphia College of Pharmacy
Editor-in-Chief
xxix
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which he noisily refused to be ejected in the morning to permit of other
guests turning the room to its proper uses—raise their prices to absurd
heights, and when the season suddenly collapses, the managers still
endeavour to screw from their lingering guests as near an approach as
possible to the season’s prices. Montevideo hotels that three or four years ago
were charging from $3.50 to $4.00 per day (the Uruguayan dollar is worth
two cents more than the American) now demand in the season from seven to
nine dollars for accommodation which consists of one small room, with full
board, half a dollar extra having to be paid for each bath taken on the
premises! When I protested against this extra charge for baths, the hotel-
keeper said that under no circumstances was he prepared to deduct it, as
water in Montevideo was “dearer than wine,” because a maldita English
company owned the waterworks, and made the poor townspeople pay dearly
for the privilege of keeping themselves clean. Under the circumstances, my
wife and I were quite willing to substitute the cheaper wine for the water, but
even this condescension on our part did not meet with his approval.
Certain it is that, although Buenos Ayres cannot really maintain the proud
claim to be the most expensive city in the world—for I defy you to beat the
record of four dollars paid by an acquaintance of mine in Rio de Janeiro for
one cake of Pears’ soap, a small packet of tooth-powder, and four ounces of
tobacco, all bought in the same shop!—it is in all conscience one of the most
remarkably easy places in the world for getting rid of money quickly. Mr.
Punch’s immortal Scotsman who wasn’t in London half an hour before “bang
went saxpence” would assuredly have had an apoplectic fit within a quarter of
an hour of arriving in Buenos Ayres. Fortunately, the preliminary shocks,
which ought to be the severest, are the least felt, for one takes some little
time to become familiarised with the relative values of the money, and not
until one can instantly figure the American or English values of the Argentine
notes he is paying away does he quite realise how rapidly his hard-earned
cash is slipping from him.
The real unit of value in most transactions is the paper peso,—these notes
are usually so dirty that they are in very truth “filthy lucre”—and as the
exchange stands about 11.4 to the English sovereign (the standard
throughout South America), it will be seen that a peso is value for about 42
cents. Many English residents, in endeavouring to regulate their expenditure,
follow the somewhat simple plan of reckoning a peso as a shilling. This
method certainly saves worry, though it is extremely bad finance, and worse,
when it is known that, even reckoned as a shilling, the peso can purchase
nothing that is the equivalent of a shilling’s worth in England. Thus bad
begins, but worse remains behind, for,—as we shall all too surely find,—not
only have we often to spend three times, and sometimes four times the value
of English money to secure what the English unit would have obtained at
home, but the article so bought will often prove to be falsificado,—a shoddy
imitation!
But what most strikes the observer at first is the seeming negligence with
which the Buenos Ayrian throws his money about, and the brazen audacity of
the shopkeeper, as illustrated by the price he places upon his wares. The one
is, of course, a resultant of the other, though, obviously, there must be other
forces at work to inflate prices. Mainly, we have to bear in mind that in this
great city, perhaps the most cosmopolitan in the world, with a population of
nearly a million and a half gathered from the ends of Earth, a motley
multitude of money grubbers, money is the only standard of value. Thus, an
art dealer who placed a statue in his window and ticketed it at a reasonable
figure, leaving to himself a fair profit after importing it at a fair price, would
not long continue to thrive in Buenos Ayres. A very large percentage of the
spending class are people who have come by their money easily, and, lacking
all knowledge alike of commercial values and intrinsic worth, can judge only
that a thing is good or bad according as the seller prices it. It is a happy state
of affairs this, which cannot last forever, and already there are signs that the
Golden Age is passing. In October of 1912, for instance, I witnessed a
portentous demonstration, in which a hundred thousand citizens took part, to
petition the Government and Municipality for some immediate legislative
action to lessen the cruel burden of the common people, to whom high wages
and brisk trade mean absolutely nothing, in view of the excessive prices for
the merest necessaries of life. To this I shall make further reference in the
present chapter.
I remember how impressed I was in one of my earliest walks, window
gazing in Calle Florida, by the curious care certain shopkeepers had taken to
display articles which in New York would have been heaped in tray-loads and
ticketed, “Anything in this basket 20 cts.” In fancy goods dealers’, for example,
insignificant little purses and common pencil-holders, cheap fountain pens and
little desk calendars, paper knives, and all the familiar odds and ends which
are classed under the generic head of “fancy goods,” were not crowded into
the window, as with us, suggesting overflowing richness of stock, but were
each disposed in solitary state at respectful distance from one another, much
as though they were valuable jewels, and indeed when one noted the prices,
they might have been precious stones, for a leather purse which would sell in
New York for a dollar would there be ticketed relatively at $3. I paid exactly
$3.15 for a small loose-leaf pocket book, an exact copy of which I had
previously bought in London for $1.30.
The chief disparity between English and South American prices is found in
articles of clothing, which, fortunately for most temporary residents, is a
matter that does not greatly trouble them, as it is always possible to take
sufficient clothing to last one for a considerable period. But certainly when
you see an ordinary straw hat, that would sell in the Strand, London, for
$1.25 ticketed somewhere around $4 you are inclined to catch your breath.
The common “bowler,” that sells in London at $1.50 will cost you anything
from four to five dollars; while the average price for a suit of clothes made to
measure in Buenos Ayres, equivalent in all respects to a suit costing twenty
dollars in London, is fifty dollars. Consequently, many Argentines have their
measure taken by a London tailor, who, charging them thirty dollars for a suit
(thus leaving an unusual margin of profit to himself) enables the purchaser,
after paying $10 import duty, to wear an actual London made suit for 20 per
cent. less than he can get one of inferior quality made in Buenos Ayres.
To give anything like an exhaustive list of the excessive prices charged for
the simplest necessities in the way of personal clothing might be to lay
oneself open to the charge of exaggeration, except that, fortunately, I have
preserved several newspaper advertisements as evidence of the bona fides of
any statements I have made, should these ever be called in question. So far
as clothing is concerned, I shall limit myself to the further statement that on
the day of my leaving Buenos Ayres for travel further afield, I bought one
dozen pairs of common socks, which in London sell for 40 cts. a pair, and paid
for these exactly forty pesos, or $1.40 per pair. This was one of the few
occasions, during my stay in South America, when I found it necessary to
purchase any articles of personal wear, and afterwards on looking at the
prices in New York and London stores, I congratulated myself very heartily
that I went forth to my adventures in South America well stocked. I
remember an English traveller, whose business takes him to Buenos Ayres for
three months of every year, stating in the most emphatic manner that he
would rather walk down Florida in his shirt tail than commit the economic
crime of purchasing a stitch of clothing in the town,—and he was not a
Scotsman!
It might be thought that the Gringo was a legitimate object of prey for the
harpy shopkeepers of Buenos Ayres, but it is not so. The present writer, being
not only competent to ask for anything in the native language, but, when
occasion serves, to engage in heated and lengthy discussion in that delightful
tongue, never found it possible to secure better terms than were granted to
any Gringo who could not utter a sentence of Spanish. It is not a case of one
tariff for the native and, another for the foreigner, as we find in Paris and
other European resorts. The native pays as highly—and, from long practice,
much more cheerfully—for all that he buys, as the stranger.
In proof of this, I cannot quote a better example than that afforded by an
incident in which the silk hat of my native secretary figured somewhat
eminently. He had been wearing it one Sunday at some special function—for
the “stove pipe” is throughout Latin America the symbol of importance and of
special occasions, as it used to be in England—and, happening to be caught in
a heavy shower, he required to send it round to the hatter’s for ironing next
morning. His wife, also a native, speaking only Spanish, called in and took the
hat back home (errand boys are at a premium). The charge made for merely
ironing the hat was 4 pesos ($1.68). The good lady had no idea whether this
was much or little, but her husband considered it a trifle excessive, as he,
having lived some little time in New York, and having found it possible to have
a hat ironed there for 10 cents went round to the Buenos Ayres hatter, and
after much argument succeeded in recovering two pesos, or 50 per cent. of
the charge from that gentleman, who was quite indifferent to the business,
and told him to keep his old hat at home, as he had no wish to iron anybody’s
hats!
That is the spirit in which all repairing business is done. If you want
anything repaired, you have got to pay so much that it is about as cheap to
buy a new article. One day my watch stopped: the spring was not broken, and
evidently it was only some slight fault, requiring, probably, a speck of oil. I left
it with the watchmaker and asked him to regulate it. Calling next day, the
watch was ready and going perfectly well, but to my surprise I was asked to
pay eight pesos ($3.35) for the craftsman’s skill and labour in putting it right.
The Luxurious Domestic Architecture of Buenos Ayres.
“Oh, evidently the mainspring was broken when you charge so much,” I
remarked.
“No, sir, the mainspring was not broken,” he replied.
“Then surely one of the jewels must have fallen out, or there was
something to replace, to justify so heavy a charge.”
“No, none of the jewels was missing, but it was quite a difficult little job,
and, besides, we do not like to repair watches,”—which was all the satisfaction
I was able to secure for parting with eight pesos!
On mentioning my experience that afternoon to an Englishman of longer
residence in the city, he remarked that these were the sort of things that
never could happen to one after two or three years, because one soon
discovered it was cheaper to buy, as you can, a good useful 5 peso American
watch, and whenever it goes out of order, throw it away and buy another.
There is a perfectly reasonable explanation of this. Workmanship, artisan
skill, labour of all sorts, are the commodities at highest premiums in Buenos
Ayres. People are making their money, reaping fortunes, not from honest,
productive workmanship and exercise of creative skill, as in North American
and in other settled industrial countries, but merely from sale and exchange.
The men who grow rich are the agents, the middle-men, and it is the middle-
men who are taking back as quickly as they can from the wage-earners the
high salaries which the latter can easily obtain but not so easily retain. The
stationer, for instance, who sold me for ten pesos a mechanical pencil
sharpener, which my office boy immediately broke by carelessly inserting the
point of the pencil, charged five pesos to repair the little machine. His
business was to sell at a profit what he had imported from Europe, but not to
supply skill and labour to put anything right.
As rather an inveterate smoker, and one with a preference for cigars, I
recall how disappointed I was to be told by the captain of the ship on which I
sailed to the River Plate, that there was probably no place in the world where
cigars were so bad or so expensive as in Buenos Ayres. I cherished for a time
some faint hope that this was perhaps a sweeping generalisation founded on
unfortunate experience, but I must bear witness to its general accuracy. The
cigar shops are many of them most beautifully appointed, fitted up with a
luxury rare even in London or New York. In not one of them is there a
smokable cigar to be had at less than 60 centavos (roughly 25 cts.) and in
order to enjoy something approximating to the pleasure of a fine Cuban cigar,
which would sell in New York for 40 cts., you will have to disburse at least 3
pesos, or $1.25. It is a custom among the Argentines, who are notably
abstemious, to invite a friend to smoke a cigar, under circumstances where an
American or Englishman would ask him to “have a drink.” Often I have noticed
at the tobacconist’s a gentleman taking in a friend to “stand” him a cigar, and
seldom, if he is a gentleman who values his self-respect and reputation in the
community, will he offer a friend anything less than a cigar that cost three
pesos. It is naturally a biggish cigar, and it will certainly have a very wide
band, with a good splash of gilt on it, and it will probably smoke not quite so
well as a 25-ct. cigar sold in Broadway. So far as I could discover, the moist
atmosphere deteriorates the imported Havannas. Locally made imitations are
concocted from Brazilian tobacco, packed up in disused Havanna boxes and
hawked among the offices by men who pretend to have smuggled them into
the country without paying duty. Admirably “faked” as to outward appearance
—for the art of falsification is one of the few local industries that flourish in
Buenos Ayres—these cigars can deceive no one after the first puff, but
thousands of boxes are annually sold to ready buyers, who, unable to afford
the shop prices, at least make a pretence of smoking Havannas, though they
know quite well they are being fobbed off with cheap Brazilian tobacco. Cigars
are sold at all sorts of prices, from 20 centavos upwards, and occasionally it is
possible to smoke one sold at 50 centavos, as I had frequently to do at my
hotel, where I was charged one peso for a cigar, on the band of which 50
centavos was printed. Representing to the manager that 42 cents seemed a
good deal to pay for a 21-cent cigar, the value of which in New York would not
have exceeded ten cents, he blandly assured me that they always charged a
peso for a 50 centavo cigar in the hotel!
Hotel prices are naturally in excess of all shop prices in Buenos Ayres, as
elsewhere, and of course there are degrees even among the hotels. At one
hotel where some of the modern comforts common to the better class of
hotels in London or New York may be obtained, the tariff is so formidable that
even an Argentine millionaire whose acquaintance I made, and who had been
making the hotel his headquarters for a year or two instead of living in a town
house, told me that he would have to quit, as he felt it was little short of
sinful to pay the weekly bill with which he was presented. Another gentleman,
the manager of a very large industrial concern in England, whose market is
mainly in the Argentine, was spending several months in Buenos Ayres during
my stay, and left the palatial hotel in question to come to the more modest
establishment where we two Gringos put up. In talking over the relative
charges with me, he said that while we had to pay enough in all conscience
for what we received (and for which no praying could have made us “truly
thankful”!), there was at least the difference between paying excessively for
very common fare and having your money literally “taken away from you.” Yet
the hotel in question, thanks to the extraordinary difficulty of obtaining
competent assistants at reasonable wages, and to the famine prices which
must be paid for every domestic commodity, as well as the immense capital
that has to be invested in steel frames, reinforced concrete, and furnishings, is
no very profitable business for those who conduct it. I doubt if they could
charge less than they do! This was often my experience when I came to
inquire into what seemed altogether unreasonable prices: to find that those
who seemed to be imposing on one were really asking no more than the
circumstances warranted.
All the same, a knowledge of the economic conditions does not greatly help
you to look with approval upon a charge of $2.35 for placing a bunch of about
six roses and half-a-dozen other flowers in a bowl on your table at dinner
when you are entertaining a couple of guests, especially if, as you happen to
know for certain, the said flowers have been left over from a wedding
celebration in the hotel the evening before. On several occasions this was the
charge which appeared on our weekly bill for decorating our little table in the
gorgeous manner described. Myself, having scant use for alcoholic beverages,
my main expenses on liquids touched “soft drinks.” Certainly the prices were
hard enough. I have retained some of our hotel bills as reminders. From these
I extract the following interesting items: One bottle of San Pellegrino Water,
55 cts.; Salus Water, 70 cts.; Small Apollinaris, 35 cts.; Schweppe’s Soda, 58
cts.; Vichy, 55 cts.; Small Perrier, 35 cts. As most visitors make it a point never
to drink the water of the town, and can easily dispose of several bottles of
Perrier or Schweppe’s Soda per day during the hot weather, the reader can
figure what proportions the weekly bill for mineral waters will reach, and it
must be borne in mind that the figures given are those charged at a hotel of
an extremely modest character. Nor would these prices appear so excessive if
each bottle contained what was indicated on the label. There is no security
that such is the case, and I know that many a time have I had to accept some
local concoction put forth in the guise of an imported European mineral water.
I also find some notes as to alcoholic drinks in our hotel bills, which will
give some notion of the casual expenses of entertaining friends. For a bottle
of Guinness’ Stout, 45 cts.; for a glass of Tonic Water and Gin, 50 cts.; for a
bottle of Chandon, $5.30; the same for a bottle of Veuve Clicquot; Chateau
Lafitte, $3; and so on. It will be noticed that the disparity between American
and Argentine prices in the matter of alcoholic drinks is less glaring than in
the case of mineral waters. But I find an occasional item in these weekly bills
which probably touches the high water mark of imposition. Under the heading
of “Alcohol,” we were charged from time to time 75 cts. for a pint bottle of
methylated spirits for use in a small spirit lamp!
Apart altogether from the normal excessive charges in the ordinary hotels,
which one comes to accept without demur simply because they are universal,
a further stage of imposition is to be noted in the swindling propensities of
restaurant employees. Thus, I have a note that I was once made to pay $1.05
for one glass of tonic water and gin which I “stood” a friend, and on various
occasions I was charged 63 cts. for a glass of whisky and soda, while I had
myself consumed frequent glasses of hot water with half-a-lemon squeezed
therein and a spoonful of sugar added, at a charge of 27 cts., before I realised
that a portion of these casual expenses was finding its way into the pocket of
the gentleman with the shifty eyes who presided over a certain “bar” where
the drinks were obtained. But the hotel charge of 62 cts. for half an hour’s
game of billiards, which conformed in every particular to that imagined by W.
S. Gilbert as the punishment of the billiard sharper,—
For some years past the Press has been urging upon the
National and Municipal authorities the necessity of adopting
measures for improving the condition of the working-classes
by reducing the cost of the necessaries of life and by providing
convenient and hygienic dwellings for workmen and their
families, but hitherto, the people having remained patiently
submissive to the economic state of things which counteracts
the higher remuneration obtainable for labour, the authorities
have failed in their duties to promote, to the utmost of their
power, the well-being of the mass of the population of this
great city. Congress has voted lavishly the resources for the
embellishment of the city, for the construction of monumental
buildings and monuments, for the acquisition of useless
warships, for the granting of hundreds of pensions to persons
who have no claim to public charity, for the sending of
representatives to congresses held in foreign countries upon
subjects in which this Republic is not interested, and special
embassies and commissions under different excuses, to enable
favoured individuals to make the tour of Europe with their
families at the expense of the public, but there is never any
surplus revenue to permit the diminution of the duties and
taxes which weigh most heavily upon the shoulders least able
to bear the burden....
The place of meeting was in the Congress plaza, to which,
in spite of the threatening state of the weather, the people
flowed from all parts of the city and suburbs, and at the
appointed time marched in orderly procession to the Plaza
Mayo. A deputation, headed by Mr. Adrian Patroni, a member
of the staff of La Argentina, was received in the Government
House by the Minister of Finance, Dr. Perez, who was
accompanied by his private secretary and by the Administrator
of the Custom House. Mr. Patroni presented to the Minister a
petition, together with numerous lists of thousands of
signatures in support of the petition, which asks, among other
things, for the reduction of the import duties on the
necessaries of life; for a diminution of the cost of transport of
articles of general consumption; for the erection of 10,000
houses for workmen and their families; for the grant of
sufficient funds for paving all the streets of the suburbs in
order to give work to the unemployed as well as to improve
the hygiene of the city; for the prohibition of races on working
days, and for the closing of the hippodromes (race-courses)
within five years....
Numbers of people in the procession carried placards upon
which were inscribed the requirements of the proletariat,
including, besides those mentioned in the petition, demands
for the concession of the public land, with facilities for the
payment of the same, to those who are willing to cultivate it;
for personal security for all the inhabitants of the provinces
and territories; for the improvement of the roads; for the
suppression of trusts and monopolies; for severe legislation
against usury; for regulations of the auctioneers’ profession;
for issuing bonds for 100,000,000 pesos for pavement in the
suburbs; for the reduction of license taxes on the vendors of
articles of consumption; for establishing free fairs in all
sections of the municipality; for permission to introduce the
carcasses of animals slaughtered outside the boundaries of
the Municipality.
Now what is the reason for this extraordinary expense of living? It is not a
matter that can be explained in a few sentences, so many factors are at work
to make the conditions what they are. I can at most throw a beam of light on
several of these factors. Visitors are astonished, for instance, to be told that in
a country popularly supposed to be one of the most naturally fruitful in the
world (though there is no greater illusion), that the commonest fruits which in
North America and Europe are within the reach of the very poorest, are only
to be enjoyed in Buenos Ayres by the rich. The country is almost destitute of
native fruit-bearing trees; it is naturally a treeless, bushless, wilderness of
rich, loamy soil, capable of producing enormous crops of grain if properly
cultivated, or of maintaining almost fabulous herds of cattle. The contents of
the orchards and vineyards that do exist must be reckoned as exotics. Few
people, indeed, seem to trouble about the cultivation of fruit or vegetables,
though the vineyards round about Mendoza on the Andine frontier, and Bahía
Blanca in the south of the Province of Buenos Ayres, show what unlimited
possibilities the soil possesses for the vine. Cattle and grain have occupied
(and not unnaturally) the energies of the agriculturists, but fruit-growing has
been comparatively neglected. Even so, it has fallen into the hands of a
vicious “ring,” who, adopting the worst of North American methods, have set
themselves to exploit the public. In the islands of the Tigre, at carting
distance from Buenos Ayres, where fruit and to spare could be grown to
supply the needs of the capital; and across the river, in Uruguay, where there
are ideal conditions for fruit culture, and where peaches, pears, apples, and
other fruits are almost as plentiful as blackberries; this ring has seized control,
and I have been told that thousands of tons of peaches and other fruit have
been thrown into the river in a single season rather than that the harvest, by
its natural abundance, should have been permitted to lower the market prices.
A successful English fruit-grower, attracted by the possibilities of Buenos
Ayres and the crying need for supplies, came out to study the situation, and
found that although he could easily have secured ideal orchard land, and
could have raised enormous crops of apples, pears, peaches, and all sorts of
table fruits, he would have been powerless to have brought his products to
the market in face of this sinister ring. He, therefore, abandoned the project
and returned to England. Thus, within walking distance of orchards laden with
peaches, it would cost you 6 cts. for one, and in Montevideo the conditions
are more outrageous still, as during our summer there we bought hundreds of
Californian apples at a cost of from 16 cts. to 25 cts. each, the local product,
at best inferior to the imported, and nearly as expensive, being then
inaccessible.
One effect of this scarcity of fruit—and the vegetables are only a little less
scarce, the country people seldom tasting them!—is the vogue of English
preserves, which are served as table delicacies. Jams, which the London
workman buys at 12 cts. a pot, are dealt out in the restaurants in spoonfuls at
more than 12 cts. a helping! Dulce inglésa is the line on the menu and when
you ask for it (which you do but once) you find it means a tablespoonful of
common strawberry jam, and you could have had a peche melba for the
money at home! Common 12 ct. pots of marmalade are sold in Buenos Ayres
at 43 cts. In Montevideo we two Gringos were responsible for the
consumption of many a tin of American fruit, such as sells in London at 20
cts. or 25 cts., the uniform price of which in Montevideo was 80 cts.
In the matter of manufactured articles, one naturally expects to pay extra,
since everything has to be imported from Europe or the United States. From
the latter country comes most of the polished oak office furniture, on which
there is an infamous import duty, on top of which again the selling agents
exact large profits. In this way the price swells to four or five times the home
selling cost. Import duties on ready-made clothes and every variety of
household wares are so excessive that the original cost is augmented by 25
per cent. to 50 per cent. before the seller secures possession of the goods.
The seller in turn has such enormous expenses in the shape of high wages to
assistants and iniquitous rentals, that he must clap on another 25 per cent. or
so for handling expenses, and finally, as he himself has heavy outgoings for
his own living and will naturally endeavour to secure some little luxuries from
the limited possibilities open to him, on must go another 25 per cent. or more
for profit.
It is thus one vicious circle, which results in everybody earning far more
money than he can earn anywhere else, and spending four or five times more
to secure about one-half of the comfort or luxury he would expect to enjoy in
any part of Europe or North America. Net result: he is, perhaps, “ahead of the
game,” but I am far from being convinced that the European or the North
American could not equally keep “ahead of the game” in his own country,
earning less, spending less, enjoying more, and saving equally. There is,
however, to some temperaments a certain delight in having money pass freely
through one’s hands, and assuredly that is what happens in the Argentine. If
the money comes easily, it goes with equal ease, and in the getting and the
going there is a certain zest which brings with it a feeling of unusual
prosperity.
CHAPTER XI
SOME PHASES OF SOCIAL LIFE
Indeed, this Argentine informed the French writer that in such a case he
preferred not to notice the lady at all, but to look away from her! Here, surely,
is a suggestive fact. The statement seemed to me so remarkable that I raised
the point with various Argentines, and always had it confirmed, one
gentleman assuring me that he would not even go so far as to pause for a
moment to speak in the street with his sister-in-law if she were
unaccompanied. He thought it was an extremely foolish social custom but
considered it was one to which every gentleman was bound to conform.
So much for the “gaiety” of Buenos Ayres! The reader will probably now
begin to realise what an attractive place it is for the young American or
Britisher. Poor young man, there is no one for whom I feel more pity. He is at
his wits’ end for wholesome amusement after business hours, and his case is
even worse than that of the young Frenchman or the Spaniard, who can
occasionally, at least, enjoy some reasonably good performance in his native
tongue, for English dramatic companies cannot possibly find sufficient support
to warrant the expense of the long voyage out and back. When I come to deal
with the life of the British community, I shall describe the straits they are put
to for social amusement and distraction, and the ingenuity with which they
contrive to render their lives a little less unpleasant than circumstances
conspire to make them. But in the general social life of the town, the English
take little or no part, keeping to themselves with their usual exclusiveness,
rendered the greater here by the almost impenetrable barrier which the
criollos, or older native families present to all advances from without.
In this regard, the British are not singular, as the French, German, Spanish,
Italian, and other nationalities all maintain in a very marked degree their racial
sympathies, although assimilating more quickly with the native element in the
matter of language, which remains the great stumbling block of the Anglo-
Saxons. Each community maintains its own clubs, with many sub-divisions
among Italians and Spaniards, the Neapolitans, for instance, having their
meeting-places apart from other Italians—indeed most decent Italians refuse
to recognise the Neapolitans as fellow-countrymen—and, among Spaniards,
the Asturians especially maintaining their local patriotism and racial interests
in this way. These clubs, almost innumerable, afford the men a common
meeting place to discuss their fortunes in the new land of promise and to
recall their old days at home, and as the social side of them includes frequent
concerts, banquets, and balls, the women of the company have also
opportunities for appearing in their best clothes and seeing photographs of
themselves in groups published in Caras y Caretas, the principal illustrated
weekly, whose every issue contains a large number of such items.
The social side of journalism is even more highly developed in Buenos Ayres
and in South America generally than in North America, so that one judging
only by the newspapers and the illustrated periodicals might suppose there
was nowhere in the world such sociability as in these Latin Republics. In
Buenos Ayres and in Montevideo elaborate guías sociales are published
annually, containing lists of “At-home Days” and other information of a
personal character, while La Prensa, La Nacion, El Diario, and all the other
newspapers devote whole columns daily to the movements of the local
nobodies. No possible occasion for a banquete is allowed to pass, and to the
English reader Caras y Caretas is a weekly joy, with its dozens of photographs
of these quaint little functions.
Señor Don Alonso Moreno Martínez (let us say) is going to Rio de Janeiro
on business for two or three weeks. The friends of Don Alonso thereupon ask
him to dine with them at the Sportsman Restaurant, where, in two hours’
time, they will demolish a quite eatable dinner of five or six courses.
Meanwhile, one of the ten or fifteen hosts of Don Alonso has taken care to
warn the photographer of Caras y Caretas, of Fray Mocho, and perhaps of P.
B. T., and these three photographers turn up in the course of the two hours,
make flashlight photographs of the little handful of diners, none of whom will
be in evening dress, the group presenting the oddest assortment of clothes,
and, behold, in the next issues of these widely circulated periodicals, excellent
reproductions of the said photographs, inscribed: “Banquet offered by his
friends to Señor Don Alonso Moreno Martínez, in view of his departure for Rio
de Janeiro, where he will absent himself for a few weeks on affairs of
importance.” It is no exaggeration to say that thousands of these photographs
are published yearly in the pictorial press, and when the honoured guest is a
little more important than my imaginary Don Alonso, then the big daily
newspapers are pleased to publish the photograph, while the provinces send
up to Buenos Ayres scores of them every week. It is all very pathetic, but very
eloquent of the low level of social interest.
Even the Races, so important an institution in Buenos Ayres, are conducted
in a way that almost entirely eliminates the social element. Among the vast
crowd that frequent the splendid course at Palermo on Thursday and Sunday
afternoons, except in the enclosure belonging to the Jockey Club, very few
women are to be seen. The men are there in mobs, not to enjoy the races, in
which they take no genuine sportive interest, but in the hope of making a bit
of money. An American lady said to me she had never been at so quiet a
demonstration before; she considered King Edward’s funeral was altogether a
livelier ceremony! The undemonstrative character of the people is, to us
supposedly phlegmatic Anglo-Saxons, really extraordinary. I have an
impression that it arises from an inborn laziness of character which is not
altogether foreign to their nature. They are chary of giving applause in the
theatre, and they sit dull and motionless before the most exciting films in the
picture palaces. At the Races there is a feeling of sullen determination to get
back twenty pesos or more for the two they have speculated.
With all this lack of wholesome interest in life, outside the brute struggle for
the dollar, it is not surprising that there should be a widespread devotion to
gambling and the card table, most of the social centres already mentioned
being also resorts of gamblers. And with all its veneer of socialness, there is
no genuine public spirit throughout the heterogeneous community. In a minor
way this was illustrated in February of 1913, when, owing to certain
regulations which the Chancellor of the Exchequer imposed upon the shops
selling drugs and perfumes, some 1,340 hairdressers and about 400
drugshops declared themselves “on strike” by temporarily closing their
premises, to the serious inconvenience of the invalids and the dandies. The
action drew forth the strongest denunciation of the Press for its anti-
humanitarian character, but I noticed that quite as much sympathy was
expressed with the male population who would thus be placed under the
painful necessity of shaving themselves for a day or two, as with the suffering
humanity whose need for medicine makes the druggist’s one of the most
successful businesses in the city.
There is truly little humanitarian feeling evident in the social life of Buenos
Ayres, although the organisation of the Asistencia pública is in every respect
admirable and its first aid to the injured and the sick leaves nothing to be
desired. The Hospital organisation into whose care the patient passes after
leaving the hands of the Asistencia is by no means so well conducted, so that
while you may rely on being taken to a hospital in the best possible way,
Heaven help you after you have been left there! While it is true that the
Argentine is far in advance of most of the other republics in its provisions for
public vaccination, and also in its sane policy of making vaccination
compulsory, the official treatment of disease always seemed to me to suggest
a nervous dread of the possibilities, a feverish readiness to test all the latest
European innovations for its suppression. The memory of past plagues is a
potent factor in this; recollections and traditions of the devastations wrought
in Buenos Ayres by Yellow Jack a generation ago do much to spread the
nervousness when there is any whisper of epidemics in other South American
ports.
January 29, 1913, was the second anniversary of the first great epidemic of
yellow fever that decimated the population of Buenos Ayres, and the
anniversary coincided with an outbreak of bubonic plague in the northern city
of Tucumán. The occasion was seized by the very competent and vigorous
writer of “Topics of the Day” in the Buenos Ayres Standard to deliver an
excellent homily on “Disease as a Hygienist.” From this I quote a few
passages which I think worthy of attention, coming as they do from the pen
of an outspoken local critic:
Clearly social hygiene is not yet a strong point in the Argentine, where 62
per cent. of deaths among children born in the country are due to
malnutrition and errors of diet. Think of the folly of it! A land clamouring for
population, inviting immigrants of all races, yet allowing a high percentage of
its new-born citizens to perish owing to the lack of humanitarianism in its
social system. The life of the individual is valued lightly in the Argentine and in
any sort of society where the welfare of the component atoms is deemed of
no importance, the basis upon which to rear the fabric of social well-being is
insecure.