About 2 million prescriptions are issued every day in England and over two thirds of these are for repeat medicines but where did it all start?  The oldest known written prescription, etched on a clay tablet, dates from about 2000 BC and was found in what is now Iraq.  The Egyptians used prescriptions written on papyrus but it is not certain when doctors in Britain started writing prescriptions as opposed to just giving verbal instructions.  Although the word ‘prescription’ can be traced back as early as the 1500s, it is rare to find prescriptions which date earlier than the 18^th century

Historically, prescriptions were written in Latin and were shrouded in mystery.  What was written on the prescription was a secret between the prescribing doctor and the pharmacist who dispensed it.  It was not until as late as 972 that it was recommended to label a patient’s medication with its name.  

The symbol, ℞ at the beginning of a prescription is universally accepted as an abbreviation for ‘recipe’, Latin for ‘take thou’.   The medicinal ingredients of the ‘recipe’ would be written showing quantities in weight, volume or proportion for the pharmacist to measure out and mix up. 

Although many computer generated prescriptions these days are written in plain English, it is by no means uncommon for Latin abbreviations still to be used, especially on hand written prescriptions.  For example, many antibiotic dosages would be written as ‘tds’, an abbreviation for ‘ter die sumendus’ – ‘to be taken three times a day’

At the end of the prescription will be written ‘Mitte’ which is Latin for ‘send’ and is the amount to be dispensed expressed as a number, a weight or a volume.

Records were kept of all prescriptions dispensed and these were carefully written up into a bound book with the exact recipe details and prices charged.  Fine examples of these books dating back to 1856 are on display at Gibbs and Gurnell Pharmacy in Ryde, where it is alleged that Queen Victoria’s prescriptions are recorded.

The prescribing of multi-dose mixtures by physicians only became widespread around 1850. Until then most prescriptions were for a single 'draught' (a one-dose medicine) or a selection of herbs from which the patient would prepare a brew. Should the doctor have prescribed a solid medicine form, he might also have prescribed plain or flavoured water or a julep (a flavoured, syrupy drink) to wash this medicine down.  By the end of the 19th century the mixture had become the most popular way of prescribing medicine.

The skill of the pharmacist was to combine the prescribed ingredients to produce a stable and palatable mixture containing an accurate dose within a measurable amount of liquid. An early method of dosage was to incorporate markings on to a bottle. A label would advise the patient to take a designated amount of the medicine every so often. Measures of glass or porcelain were manufactured to enable accurate dosing.  This was later replaced by the more familiar teaspoonful.  It was not until around 1940 that tablets and capsules began to take over as the preferred method of administration making things much more palatable and more stable.