college to the China Medical Board (CMB) of the ARTICLE Rockefeller Foundation for the sum of US$ 200,000 in 1915.4, 5 Th e CMB had budgeted US$ 1 million for Th e 1927 Formulary of Peking’s First land, building and equipment in the construction of a Western Teaching new medical college, to be named the Peking Union Medical College (PUMC), and a 250-bed hospital, to Zhu Zhu and Zhang Bo be named the Peking Union Medical College Hospital (PUMCH) in 1916. Abstract Th e CMB eventually invested a total of US$ 7.6 Th e Peking Union Medical College Hospital (PUMCH) million in the building of the new PUMC and was one of the earliest western medical and teaching PUMCH, with completion after fi ve years in 1921. Th e institutions in China. Th e Hospital Committee was re- overspend of US$ 6.6 million was due to a lack of man- sponsible for compiling the fi ve editions of its Formu- agement control, inadequate construction experience, lary. Physicians, pharmacists and dispensers were re- and high shipping costs during the First World War.6 quired to prescribe, dispense and supply pharmaceutical Since then, the PUMCH has always been at the fore- products and preparations in strict accordance with the front of original research and the development of phar- Formulary. Th e fi rst edition of the Formulary was a 39- macological therapeutics, and the Formulary was one page cloth-bound book published in 1922. Th e edition of several achievements of the time.7 described in this article is the earliest available to the authors – the pocket-sized third edition consisting of Th e PUMCH Formulary 67 pages, published in October 1927. Prior to the release of the Chinese Pharmacopoeia as the offi cial guide to standards set by the Republican gov- ᪈᪈㾱˄ㆰփѝ᮷˅㾱˄ㆰփѝ᮷˅ ernment in 1931, large missionary developed ेӜॿ઼५ᆖ䲒ᱟѝഭᴰᰙⲴ㾯५५⯇оᮉᆖᵪ their own formularies. Th ese included the Peking Hos- ᶴѻаˈަ५䲒ငઈՊ䍏䍓५⯇㇑⨶о㦟һ㇑⨶ˈ५ pital (1910) and the PUMCH in 1922, and the ‘Hand- 䲒lj༴ᯩ䳶NJㅜа⡸Ҿᒤ䶒цˈӵ亥ˈ䲿ਾ㠣 Book of Prescriptions’ published by the Shangtung ᒤ䰤ޡࠪ⡸⡸DŽ५ᐸ൘༴ᯩᰦ৺㦟ᐸ઼ਨ㦟൘ Christian University Hospital in 1930.8, 9 -䝽ࡦо׋ᓄ㦟૱৺㦟⢙ࡦࡲᰦˈ䜭ᓄѕṬ䚥ᆸlj༴ᯩ Of the fi ve editions of the PUMCH formulary pub 䳶NJ޵䇒・Ⲵḷ߶DŽ lished between 1922 and 1942, copies of only the third ेӜॿ઼५䲒㦟ࡲ、䍏䍓㦟૱৺㦟⭘৏ᯉⲴ䍘 (1927), fourth (1932) and fi fth (1942) editions have been 䟿ǃ䲒޵ࡦࡲ⭏ӗо㦟૱׋ᓄǃ༴ᯩᇑṨо㦟૱䈳䝽 found. Th e other two have yet to be discovered. Th e Ѫ⯵Ӫᨀ׋ᴰާ㓿⍾᭸⳺ⲴĀᴹ⭘㦟 third edition published in 1927 is, therefore, the earliestˈޘ৺⭘㦟ᆹ ⢙āDŽ edition known.10 It is a 67-page, hardcover, pocket-sized ᵜ᮷⹄ウⲴᱟᒤࠪ⡸Ⲵㅜй⡸ˈ亥Ⲵਓ㺻 book, bound in a fabric-lined spine with a cloth border, ҖDŽ measuring 14.5cm by 9.0cm. Th e inside front page con- tains the title and usual details (Figure 1). Introduction September 2021 marks the one-hundredth anniversary of the inauguration of the new Peking Union Medical College Hospital (PUMCH) and its pharmacy depart- ment. Th e origins of PUMCH can be traced back to Dr William Lockhart of the London Medical Missionary Society (LMMS) who founded the Peking Hospital (lo- cally known as the ‘Charity Hospital’) in 1861.1 Th e Peking Hospital and a new medical college, under the name of the Union Medical College, were rebuilt in 1906, with a grant equivalent to £1,400 made to the LMMS by the Empress Dowager Cixi.2 In 1910, the Peking Hospital of the Union Medical College published its fi rst pharmacopoeia; this was a 13-page formulary listing 73 preparations, which was to be used as a reference guide by its physicians.3 LMMS Figure 1. Front cover and title page of 1927 PUMCH subsequently sold both the hospital and the medical Formulary

PHARMACEUTICAL HISTORIAN · 2021 · Volume 51/2 33 In 1927 John Cameron, the pharmacy supervisor at Th ere are eight sections in the 1927 Formulary, as PUMCH, shared his views on the Formulary with read- follows: A) Foreword; B) Treatment of Poisoning; C) ers in an article published in the National Medical Jour- Antidotes of Acute Poisoning; D) Narcotics; E) Abbre- nal: viations; F) Formulary; G) Th erapeutic Index; and H) General Index. Th e ‘Committee on the Hospital’ (the In the Peking Union Medical College for many Hospital Committee) expected that the Formulary years, we have had a Formulary of all the drugs and would be used in conjunction with the current edition pharmaceutical chemicals used in the hospital. We of the list of ‘Useful Drugs’ published by the Council have recently published our third edition (October of Pharmacy and Chemistry of the American Medical 1927), and it occurred to the writer that it might Association.15 We now describe each of the eight sec- serve a very useful purpose in China if this publica- tions. tion were printed in Chinese. We have suggested to the Committee on the Hospital (PUMCH) that Th e Foreword such a publication would be great in many of the Th e Formulary was published by the Hospital Commit- smaller hospitals in China. Th eir decision in the tee, and the four executives in the 1927 Hospital Com- matter will be awaited with interest.11, 12 mittee were:16 • J. Heng Liu, MD., medical superintendent, (Chair- Th e fi rst edition of the Formulary was published man); one year after the opening of the new PUMCH phar- • F.R. Dieuaide, MD., professor of medicine and act- macy in 1921, and from that date until the implemen- ing head of the department; tation of the offi cial Chinese Pharmacopoeia in 1931, the • J. Preston Maxwell, MD., BS., LRCP., FRCS., pro- Formulary – along with western pharmacopoeias – fessor of obstetrics and gynaecology and head of the were relied upon as the offi cial standard for materia department; and medica and imported drugs used at the hospital. Th e • Adrian S. Taylor, MD., FACS., professor of surgery Formulary was developed in response to a number of and head of that department. needs, as articulated by John Cameron: Although John Cameron, the su- pervisor, was not part of the Hospital Committee, he For the most part, the Formulary consisted of drugs and Moody Meng, assistant pharmacist, were involved and preparations which were offi cial in the British in the consolidation of drug monographs and formula- Pharmacopoeia or United States Pharmacopoeia or tions, and in the dispensing of prescriptions according were included in ‘New and Non-offi cial Remedies’. to the dosages laid out in the British Pharmacopoeia. Prescriptions of preparations peculiar to PUMCH Th e objectives of the Formulary, since the publication were given in detail in the text.13 of the fi rst edition, were stated in the Foreword:

Adulterated and counterfeit medicines were fre- First, to promote the teaching of rational drug ther- quently supplied by unscrupulous pharmaceutical apy within the institution; and Second, to secure the wholesalers, and routine quality checks were required greatest degree of economy compatible with the wel- to ensure that the quality of the chemicals and drugs fare of of the hospital. Th e Hospital Com- delivered were up to the standards specifi ed. mittee also agreed to a special list of drugs in the ex- From our own experience, we have found that it is perimental stage which might at some future date be sometimes necessary to submit drugs to careful analysis included in the Formulary. Additions and deletions before issuing them to the wards of our hospital or as from this list were to be made from time to time by prescriptions to our outpatient department. We have the Hospital Committee, on the recommendation published elsewhere some of the results of our analyses, of the head of a clinical department.17 and these prove that it would be a mistake to accept chemical and drug stocks without verifying the con- In this edition of the Formulary, minimum and tents of the bottles. Unless some pharmacopoeia stand- maximum dosages are given, which as a rule comply ard is referred to in the order, wholesale dealers in Chi- with those of the British Pharmacopoeia. In cases na are able to supply chemicals and drugs of any grade. where the maximum dosage is exceeded, the pre- If no standard of purity or strength per cent is men- scriber is required to initial the amount; otherwise, tioned in the order, there is little point in analysing the the pharmacist was not authorised to dispense the item concerned and complaining that it diff ers from prescription without verifi cation by telephone or in- what was required.14 person. Th e hospital pharmacy could only dispense

34 PHARMACEUTICAL HISTORIAN · 2021 · Volume 51/2 Table 1. Poisoning cases at PUMCH, 1926 Type of poisoning Poison Inpatient cases Outpatient cases Deaths Animal poisons: Miscellaneous 1 1 Drugs, habit: Alcohol 0 3 Morphine 18 3 Opium 7 23 Drugs, acute poisoning by: Arsphenamine 7 0 2 Mercury 3 0 Opium531 Drugs, miscellaneous: 15 6 2 Poisoning by gases and vapours: Carbon monoxide 5 0 2 Coal gas201 Miscellaneous121 Total: 64 41 9

drugs which were included either in the Formulary B) Treatment of poisoning or in the special list. Requests for the purchase by Th e treatment of poisoning guidelines contained in the the pharmacy of drugs not included in the Formu- 1927 Formulary addressed three basic principles: lary were to be referred to the Chairman of the Hos- prompt relief, the maintenance of normal body tem- pital Committee.18 perature, and the removal or dilution of the ingested poison using emetics or lavage. Patients underwent Cost was a signifi cant consideration in the selection of treatment for poisoning as a result of drug overdose, drugs and dressings for the 1927 Formulary. To improve drug abuse or accident (Table 1). the cash fl ow of PUMCH, better control of inventory Th e only formula listed contained one central levels was the top priority. From the standpoint of the emetic, apomorphine, and four other components – economy, it was considered that the minimum number copper sulphate, zinc sulphate, sodium chloride (salt) of drugs and special preparations should be carried in and warm water. Th is was a potent emetic and lavage stock. Every eff ort was also made to eliminate needless- formulation, which emptied the stomach by induc- ly expensive drugs, especially proprietary preparations, ing vomiting without excessive loss of sodium chlo- particularly in cases where other cheaper drugs were ride.23, 24 known to possess the same therapeutic value.19 Irvine McQuarrie, who was head of paediatrics at Since the opening of the new hospital building in the University of Minnesota School of Medicine, and September 1921, free treatments and the prescriptions a visiting professor of paediatrics at PUMCH in 1939- of outpatients constituted a signifi cant proportion of 40, presented his observations on some of the medical the total dispensed. Th ese numbers were refl ected in the and social problems in China. In a note on drug addic- fi scal year ending 30 June 1922, in which 12 percent of tion, in one of his Porter lectures at the University of prescriptions (3,355 of 27,976) were free, equivalent to Kansas in 1944, he reported that: ‘At least two patients 18 percent of outpatient treatments (13,615 of 74,763).20 who had taken opium with suicidal intent were treated Th e revised 1927 Formulary helped to improve the in the emergency clinic of PUMCH each week; two- cost-eff ectiveness of the pharmacy department, by vast- thirds of those in a coma died, despite lavage, paren- ly reducing the number of patented medicines available teral fl uids, and the use of a Drinker respirator’.25 and replacing them almost entirely with generics. Al- though the number of prescriptions increased to 36,250 C) Antidotes for acute poisoning for outpatients, the total number of dispensed items Although PUMCH did not have an Accident and dropped to 70,000, or 94 percent of the 1922 level.21 open to the public in 1927, Th e Formulary also contributed to administrative im- emergency patients suff ering from injuries or poisoning provements in connection with the admission and rout- were treated as and when required. A total of twenty- ing of patients in medical outpatient clinics. Staff were four antidotes were listed in the 1927 Formulary, which furnished with a simplifi ed Formulary, and – with the covered almost the entirety of possible poisoning situ- co-operation of pharmacy staff – there was a great re- ations (Figure 2). duction in the time taken in fi lling prescriptions.22

PHARMACEUTICAL HISTORIAN · 2021 · Volume 51/2 35 Figure 2. Antidotes to poisoning in 1927 PUMCH Formulary

D) Narcotics ber, date, name of narcotic and the amount dis- Th e control of import of narcotic drugs for clinical use pensed. In this way we are able to check up on our was regulated in China by the 1915 Law on Pharma- stock of narcotics at any time.27 ceutical Traders, promulgated by the First Republican Government (1912-1928) in Beijing.26Since John Cam- In the 1927 Formulary, seven narcotic drugs were al- eron became the pharmacy supervisor at PUMCH in lowed to be prescribed, with opium being an ingredient 1921, he had introduced best practice management in of four preparations, including a mixture, powder and the dispensing, supply and storage of poisons by follow- tincture (Figure 3). ing the principles laid down in the British Pharmacy Act of 1868. Cameron reported on his experience of E) Abbreviations narcotics management at PUMCH in 1922: As with other formularies, the 1927 Formulary gave ab- breviations for frequency and times in the administra- From 1 July 1921 till 30 June 1922, we dispensed tion of medications, which refl ected subtle changes over 35,000 prescriptions in this pharmacy, and in no the course of a century. Note that private patients had case was there any accident due to the dispensing of meals served later than patients in the public ward a poisonous preparation wrongly. We have found by (Table 2). experience that what might have been a fatal mistake in the dispensing of a prescription has been noticed F) Contents of the Formulary by the checker before the medicine has been issued A total of 44 of the 67 pages in the 1927 Formulary from the pharmacy. In dealing with narcotics in this were dedicated to the Formulary drugs, pharmacopeia pharmacy we adopt the same system as with poisons, or own formulations, including 230 generic fi nished with this addition – that we enter in a special ‘Nar- products and materia medica meeting USP standards. cotic Book’, all issues giving the prescription num- Fifty-four of the Formulary preparations were

36 PHARMACEUTICAL HISTORIAN · 2021 · Volume 51/2 Table 2. Abbreviations for frequency and times of admin- istration Abbreviation In- When given location a.c. (ante cibum, Public Ward 6am,11am, 4pm before meals) Private Patients’ 8am, 12pm, Pavilion 5pm p.c. (post cibum, Public Ward 7am, 12pm, after meals) 5pm Private Patients’ 9am, 1pm, 6pm Pavilion B.I.D. (bis in 8am and 4pm die, twice daily) T.I.D. 8am, 12pm, (ter in die, three 4pm times daily) Q.I.D. (quater 8am, 12pm, in die, four 4pm, 8pm times daily)

Four antisera that met Non-offi cial Remedies standards Figure 3. Rules for narcotic drugs and preparations (1927 NNR Standards) were included, consisting of anti-anthrax serum, anti-dysentery serum, anti-menin- PUMCH’s own formulations, of which diff erent con- gococcal serum, and anti-pneumococcal serum. centrations, dosage forms and specifi cations were avail- Th ere were four antitoxins (antitoxinum) of which able. Th ese included liquids, mixtures, lotions, creams two met USP specifi cations (diphtheria antitoxin and and ointments, syrups, spirits and tablets (Figure 4). tetanus antitoxin), and two met NNR standards (strep-

Table 3. Th erapeutic group and selected sub-groups and drugs Section Group Sub-group Drug example 1 Skin, wounds, or visible Antiseptic Mercurochrome mucous membranes Local anaesthetics Aethylis chloridum Menthol 2 Alimentary canal Antacid Magnesii carbonas Anthelminthic Santoninum 3 Circulatory system Strengthen contractions Digitalis Anti-hypertensive and vasodilation agent Trinitrini tabellae 4 Genito-urinary system Uterine contraction Ergotae fl uidextractum 5 Respiratory system Cough suppression Codeinae phosphas General anaesthesia Nitrogenii monoxidum 6 Central nervous system Analgesia Acetphenetidinum, acidium acetylsalicylicum 7 Blood Increase haemoglobin Ferri carbonatis pilulae Increase coagulation Sodium chloridum 8 Eye Pupil constriction Physostigminae sulphas Pupil dilation Atropinae sulphat 9Specifi c diseases Cholera Vaccine cholera Diabetes Insulin

PHARMACEUTICAL HISTORIAN · 2021 · Volume 51/2 37 Figure 4. List of soaps and toothpastes made by PUMCH Pharmacy tococcus erysipelas antitoxin and streptococcal scarlet ly replaced materia medica containing minerals and antitoxin). Th ere were also four vaccines, of which three whole or parts of plants from a traditional pharmacy. met NNR standards (antirabies, cholera and typhoid- For syphilis, there were nine drugs including two arse- paratyphoid vaccines), and a smallpox vaccine that met nic compounds, one of which was an intravenous dos- USP specifi cations. age form of Neo-Arsphenamine, listed in the 1927 For- PUMCH also produced toiletries for use by in-pa- mulary. Th e list refl ected a wide selection of chemical tients, such as toothpaste and tooth powder, 10 percent drugs available to treat syphilis, which represented one- and 50 percent soap, talcum powder and skin whiten- fi fth of outpatient visits in the year (Figure 5). ing emulsions (Figure 4). According to the 1926/1927 PUMCH Annual Report, In the interests of error-free dispensing and patient the composition of outpatient visits in the year was one- safety, prescriptions were to be written by physicians in third general medicine, one-third dermatology and an format. Drug names were to be written in syphilis, and one third others (Table 4). the shortened Latin version, Morphin. Hydrochlor. (for Morphinae Hydrochloridum), which was also to be Conclusion written and labelled on the dispensed medicine. In the Th e PUMCH attracted many British and US clinical case of Potassium Chlorate, the BP and USP titles of and professional staff in the 1920s. Of the 112 hospital Potassii Chloras (shortened to Pot. Chloras) was to be staff , 42 were expatriates serving in clinical and man- used rather than the German Pharmacopoeia’s Kalium agement positions.30 Th e hospital also had a large num- Chloricum.28 ber of visiting professors and medical scientists from other parts of Asia and Europe. An active research pro- G) Th erapeutic Index gramme in pharmacognosy was conducted by the in- Th e classifi cation of drugs in the 1927 Formulary fol- ternational faculty at the PUMC, beginning in the ear- lowed that of Arthur Robertson Cushny’s A Textbook ly 1920s. Th is had resulted in over 20 plant-based drugs of Pharmacology and Th erapeutics (also known as Th e being listed in the 1927 Formulary. Th ese drugs all con- Action of Drugs in Health and Disease with nine thera- formed with the 1926 USP standards. Examples in- peutic groups,29 (Table 3). In the Th erapeutic Index, cluded aloe vera, orange peel wine, belladonna, euca- alkaloids from plant extracts and chemical drugs large- lyptus, wintergreen, camphor and charcoal powder.

38 PHARMACEUTICAL HISTORIAN · 2021 · Volume 51/2 Table 4. Out-Patient attendances during 1926/1927 fi s- in adopting best-practice hospital management. Break- cal year through drugs such as insulin – fi rst used at PUMCH in 1923 – were included in the 1927 Formulary.32 Th is Medical New Returning Total early culture of the pursuit of excellence in academic department research, and best pharmacy practice, has remained un- General 4,105 6,660 10,765 altered, despite the many changes that occurred during Dermatology 2,029 3,705 5,734 the fi rst one hundred years of the PUMCH. Syphilis 157 5,063 5,220 Bernard Read, John Cameron, Moody Meng, Ar- Tuberculosis - 2,148 2,148 thur Tye and other British pharmacists who served at Heart - 266 266 the PUMCH pharmacy department from 1910 to 1941 Paediatrics 1,126 1,919 2,045 have all left a lasting legacy as pioneers in the develop- Total 7,417 19,761 27,178 ment of hospital formularies in modern China.33

Acknowledgements: We thank the China Medical Board Beijing Offi ce, Rockefeller Archive Center; the Medical Literature Center of Peking Union Medical College of the Chi- nese Academy of Medical Sciences; for enabling the au- thors to review their collection of PUMCH’s historical documents. Gratitude is also owed to Mr Patrick Chiu in sharing his research work on British pharmacists who served at the PUMC Hospital during the period 1910 to 1942.

Authors’ addresses: Zhu Zhu, Research Fellow, and Zhang Bo, Executive Deputy Director, both at Phar- macy Department, Peking Union Medical College Hospital, 1 Shuifuyuan, Dong Cheng District, Beijing 100730, China. E-mail: [email protected].

Notes and References 1. Patrick Chiu, British Pharmacists and the Peking Union Figure 5. Syphilis drugs in 1927 PUMCH Formulary Medical College Hospital, 1910-1941. Pharmaceutical Historian. 2017: 37(3); 57. 2. Bowers, John Z., Western Medicine in a Chinese Palace, Adulterated or sub-standard drugs of dubious ori- Peking Union Medical College, 1917-1951, Th e Josiah Macy Jr Foundation, William F. Fell, Philadelphia, 1972: 9. gin supplied by pharmaceutical traders were tested re- 3. Pharmacopeia 1910. Th e Peking Hospital of the Union peatedly by the PUMCH. Hence the 1927 edition of Medical College. (Publisher Unknown). the PUMCH Formulary – with substantial revisions 4. Bowers, John Z. (Note 2) 1972: 43. – served two essential functions: it was a teaching tool 5. Th e China Medical Board was set up as a medical foun- about rational drug use for interns, medical students dation by the Rockefeller Foundation in 1914 to build a model medical school and in China. and nurses; and it ensured that the supply of standard- 6. Bowers, John Z. (Note 2) 1972: 59. ised generic drugs was in conformity with pharmaco- 7. Original research work included chaulmoogra oil for poeia specifi cations. the treatment of leprosy conducted by Dr Bernard Read, and the In 1927, Cameron had the foresight to suggest a na- rediscovery of ephedrine from Mahuang (ephedra) by Drs K.K. tional pharmacopoeia, which could provide the legal Chen and Carl F. Schmidt in 1924. 8. Formulary. A List of Drugs and Preparations Selected basis for hospital and retail pharmacies in the purchase as Offi cial for Use in Peking Union Medical College Hospital. of pharmaceutical raw materials and products from Journal of American Medical Association. 1923: 81(13); 1137. wholesalers in China. His advocacy – along with that 9. Th e Th ird Edition of the Hand-book of Prescriptions of of others – for the safe and cost-eff ective supply of drugs the Shantung Christian University Hospital was compiled by to the public, led to the eventual publication of the Chi- members of the Faculty of the School of Medicine in 1930. 31 10. Th e earliest editions of the Hospital Formulary available nese Pharmacopeia in 1930. for study by the authors were the third and fourth editions, Th e 1927 PUMCH Formulary was an example of which were published in 1927 and 1942.Th e third edition is now a holistic approach by clinical and pharmaceutical staff in the possession of Th e Medical Literature Museum, a private

PHARMACEUTICAL HISTORIAN · 2021 · Volume 51/2 39 museum in Shanghai. Th e fi fth edition is kept by the Peking 24. Nineteenth Annual Report of the Medical Superinten- Union Medical College Hospital Museum in Beijing. dent (Note 16): 131. 11. Cameron, John, A Chinese Pharmacopoeia – When? 25. Bowers, John Z. (Note 2) 1972: 185-186. Th e National Medical Journal, Shanghai, China, 1927: 13(6); 26. Zhao Min, Zhang Jianxue. Th e History Change and 449-453. Enlightenment of Traditional Chinese Medicine Legislation 12. Both John Cameron and Moody Meng were registered Since Modern Times. Practitioners, Medicine and Law. 2016:8(4): as pharmaceutical chemists with the Pharmaceutical Society of 12-19. Accessed 17 April, 2020.https://www.doc88. Great Britain, in 1920 and 1924 respectively. com/p-3807667294264.html. 13. Foreword, Formulary, Th ird Edition. Peking, China: 27. Cameron, John. Note on Th e Storing, Checking and Peking Union Medical College Press, 1927: II-III. Dispensing of Poisons and all Poisonous Preparations. Th e Na- 14. Cameron, John, (Note 11) 1927: 13(6); 449-453. tional Medical Journal, Shanghai, China, 1923: 3; 54-58. 15. Foreword, Formulary, Th ird Edition (Note 13) 1927: II. 28. Standardization of drug names such as Potassium Chlo- 16. Nineteenth Annual Report of the Medical Superintendent, rate by choosing the B.P., and U.S.P. version of Potasssii chloras Peking Union Medical College Hospital. Year, 1927: 13. (shortened name as Pot. chloras) in the 1927 Formulary instead 17. Foreword, Formulary, Th ird Edition (Note 13) 1927: of Kalium chloricum (or shortened name as Kali chloricum) used II-III. in the German or Russian Pharmacopoeias. 18. Foreword, Formulary, Th ird Edition (Note 13) 1927: 29. Formulary, Th erapeutic Index, Th ird Edition (Note 13) III. 1927: 54-62. 19. Foreword, Formulary, Th ird Edition (Note 13) 1927: II. 30. Nineteenth Annual Report of the Medical Superinten- 20. Report of the Out-Patient Department, Fourteenth An- dent (Note 16) 1927: 4-8. nual Report of the Medical Superintendent, Peking Union Medi- 31. Th e fi rst edition of the Chinese Pharmacopoeia was cal College Hospital. Peking, China. Year Ending 20 June 1922: published in 1930 and distributed in 1931 by the Ministry of 21. Accessed 12 April, 2020. https://www.pdffiller.com/ Health of the Republican government. Th e Editor-in-Chief was 227741120-Xie-he-yi-yuan-Beijing-China-1922-v14pdf-peking- Dr J. Heng Liu, Minister of Health, who was a former medical union-medical-college-hospital-Yale-University-. superintendent of the PUMCH. Moody Meng, one of the fi ve 21. During the 1926/27 fi scal year, the number of out-pa- editors, was a former assistant pharmacist at the PUMC, and one tient items dispensed jumped from 36,250 to 70,000, or an av- of the nine reviewers, Dr Bernard Read was the professor of erage of 200 prescriptions a day. Prescriptions fi lled for inpatients pharmacology, at PUMC. and staff members, including repeats, amounted to 21,300. Th e 32. Li, Naishi. Th e First Case of Using Insulin in the Treat- total number of prescriptions fi lled by the pharmacy during the ment of Diabetes Mellitus at the Peking Union Medical College year was 91,300, an average of over 300 per working day. Hospital, Chinese Journal of Diabetes Mellitus. 2012: 4(1); 56-57. 22. Nineteenth Annual Report of the Medical Superinten- 33. Patrick Chiu. (Note 1) 2017: 57. dent (Note 16) 1927: 39. 23. Formulary, Treatment of Poisoning, Th ird Edition (Note 13) 1927: IV.

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