- Jeffrey K Aronson
Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
Follow Jeffrey on X (formerly Twitter): @JKAronson
Vocabularies, lexicons, and glossaries
All languages have vocabularies. The definition of a vocabulary in the Oxford English Dictionary (OED)1 is “The body or range of words used in a particular language.” “Vocabulary” is synonymous with “lexicon,” defined as “The complete set of meaningful units in a language; the words, etc., as in a dictionary, but without the definitions.”2
These two words are both connected to speaking. “Vocabulary” comes from the Latin word vocabulum, a term or a name, or more specifically a noun, from the verb vocare, to call out or address by name, which in turn derives from vox, the voice. “Lexicon” is Greek, from the adjective λεξικός, of or for words, which is from the noun λέξις, speech or diction, a word or phrase, and that comes from the verb λέγειν- to speak; λεξικόν βιβλίον is a book of words, in other words a glossary. “Glossary” is also Greek in origin, from γλῶσσα, a tongue and also an obsolete or foreign word that needs explaining. A glossary is “a list with explanations of abstruse, antiquated, dialectal, or technical terms; a partial dictionary.”3
Approved names
The set of approved names of medicines constitutes a specialised vocabulary, a subset of words in the language to which it belongs.
The General Medical Council (GMC) was established under the Medical Act of 1858, “An Act to regulate the Qualifications of Practitioners in Medicine and Surgery.”4 One of the council’s responsibilities, enunciated in Section LIV of the act, was the production of “a Book containing a List of Medicines and Compounds, and the Manner of preparing them, together with the true Weights and Measures by which they are to be prepared and mixed, and containing such other Matter and Things relating thereto as the General Council shall think fit, to be called ‘British Pharmacopoeia’.” The BP, as it came to be known, replaced three existing pharmacopoeias, the London, Edinburgh, and Dublin Pharmacopoeias.
It seems that the task was not an easy one. The preface to the 1864 edition of the British Pharmacopoeia begins thus5:
“Of the several functions conferred on the General Medical Council of the United Kingdom by the Medical Act of 1858, not one has caused the Council more anxiety than the preparation of the British Pharmacopoeia. To supersede three Pharmacopoeias, each of them long held in great repute, — to reconcile the varying usages, in pharmacy and prescriptions, of the people of three countries hitherto in these respects separate and independent, — to consult the prepossessions of three important public professional bodies, which have ruled long and ably over this branch of Medicine,— to represent accurately, yet with caution, the advancement made in chemistry and pharmacy during the thirteen years which have elapsed since the last edition of any of the Pharmacopoeias of the Colleges of Physicians was published,— has been no light task.”
Accordingly, the GMC established a British Pharmacopoeia Commission to help it in the task, and the commission reported to a Pharmacopoeia Committee, which met twice a year.6
The idea of giving approved names to medicines in the UK arose during the second world war, when efforts were being made to ensure the continued supply of medicines such as antimalarials in the face of shortages. As was reported in The BMJ,7 “it is much to be desired that a [medicine should have a] name which is free from trade-mark rights and which can be used by any manufacturers … There is a regrettable tendency for manufacturers of British equivalents or alternatives for drugs previously manufactured abroad to introduce their own proprietary names for them. This diversity of nomenclature can only mystify and confuse the practitioner who uses the drugs.”
Thus, for example, “Atebrin” was given the name mepacrine hydrochloride, “Fouadin” became stibophen, and “Plasmoquin” became pamaquin. The desirability of coining new names for these particular products was enhanced by the fact that they were all originally manufactured in Germany. Nor did the fiscal advantages of the introduction of such names go unnoticed.8 The approved names in these cases were largely derived from aspects of the structures of the compounds, and the -pa- in “mepacrine” was an infix derived from the Latin word palus, a swamp, swamp fever or marsh fever being synonyms for malaria. Proguanil hydrochloride was later given the brand name Paludrine.
These new names were originally known as “official names” or “pharmacopoeial names,” but before long the term “approved names” was introduced. For example, in May 1941 The Lancet reported9 that “The General Medical Council has now approved names for further substances which are produced, or are likely shortly to be produced by British manufacturers, in some instances under licences granted by the Comptroller-General of Patents, Designs and Trade Marks. These substances have hitherto been known under other names. The question of including these substances in the British Pharmacopoeia is under consideration, and if any of them is included the intention is that the approved name given below will be its official title.” There followed a list of six “Approved Names,” each with its corresponding “Proprietary Name.” For example, what had previously been known as “Cignolin” now became “dithranol,” a derivative of dihydroanthracenone.
In 1944 The BMJ also reported that the Pharmacopoeia Commission “has continued its active interest in the provision of approved names for drugs, which, it hopes, will be generally used in prescribing. If any of the names is used in association with a proprietary name, the label should bear the approved name in letters no less conspicuous than those in which the proprietary one is printed.”10
From the early 1940s the British Pharmacopoeia Commission issued lists of new Approved Names and included lists of them in leaflets enclosed with copies of the Addenda to the British Pharmacopoeia. And by the late 1950s approved names had become known as British Approved Names (BANs).11
The legal position
The Pharmacy and Medicines Act of 1941 prohibited retail sale of all substances that were recommended for use as medicines, unless the ingredients of the product being sold were listed on the product. If the substance was named in the official poisons list, according to the Poisons Act of 1933, the name would be that on the list; otherwise it would be the name, typically the approved name, given in the BP or the British Pharmaceutical Codex (BPC), which had been a parallel publication of the Pharmaceutical Society of Great Britain since 1907.
Subsequently, the Therapeutic Substances Regulations of 1952 required that the “proper name” of a substance (i.e. usually the approved name) must be included on the label of any product that contained it.
However, there was no statutory requirement that the proper name should be the officially approved name. In 1962 therefore, the GMC proposed that, although manufacturers should be allowed to continue using their brand names on their labels, the proper names that they were also required to use should be required to be the British Approved Names. The same applied to advertising material. This would be facilitated by the assignment of an approved name before the medicine was allowed to be marketed.
The Committee on Safety of Drugs
In the early 1960s, in the wake of the problems caused by the use of thalidomide, the UK government established a working party to consider legislation relating to control of medicines. The working party’s report led to the establishment of the Committee on Safety of Drugs in 1963, and its report resulted in a government white paper, which became the 1968 Medicines Act. There is no mention of approved names in the act, but section 100 refers to “suitable names to be used as the names of any substances and articles to which subsection (1) or subsection (3)(b) of section 99 of this Act applies and to be placed at the head of monographs relating to those substances or articles in any edition of the British Pharmacopoeia, or in any compendium or edition of a compendium, prepared under that section.”
The BAN Book
The first compilation of all the British Approved Names (“the BAN Book”) was published in 1970. It included all of the approved names that had been issued since 1948, as well as those that had been issued earlier for substances that had not been described in monographs.12 Updates have appeared regularly since then. Today, almost all British Approved Names are the same as the WHO’s International Nonproprietary Names (INNs).
Footnotes
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Competing interests: JKA chairs The British Pharmacopoeia Commission’s Expert Advisory Group on Pharmacy and Nomenclature and is a member of the WHO’s Expert Advisory Panel on International Pharmacopoeia and Pharmaceutical Preparations.
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Provenance and peer review: Not commissioned; not peer reviewed.
References
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“vocabulary, n.” Oxford English Dictionary. Oxford University Press, July 2023, doi:10.1093/OED/7683214052.
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“lexicon, n.” Oxford English Dictionary. Oxford University Press, September 2023, doi:10.1093/OED/7713886356.
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“glossary, n. (1).” Oxford English Dictionary. Oxford University Press, September 2023, doi:10.1093/OED/6627915500.
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Anonymous. British Pharmacopoeia. Spottiswoode & Co, 1864: ix-xx.
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