Part 10

10. All waters (aquæ) may be given in doses up to 1 ounce (30 c.c.), except aqua ammoniæ, aqua chlori, and aqua laurocerasi (cherry-laurel), the dose of which is about ½ dram (2 c.c.).

11. Volatile or essential oils may be given in doses up to 5 minims (0.3 c.c.) or more, except the oil of bitter almond, the dose of which is from ¼ to ½ minim (0.015-0.03 c.c.).

TO ASCERTAIN DOSES OF MEDICINE FOR CHILDREN.

The following rule of Young is sufficiently accurate for most drugs: Add 12 to the age and divide by the age to get the denominator of the fraction, the numerator of which is 1. Thus, for a child of two years,

2 + 12 ——— = 7, and the dose is ⅐ of that for an adult. 2

For children up to twelve months of age, Young’s rule may be worked out as follows: Add 144 to the age in months, which sum becomes the denominator of the fraction, the numerator of which is the child’s age. Thus, for a baby of eight months,

8 8 ——— = ——, or ¹/₁₉ of an adult’s dose; 8 + 144 152

for a baby of six months,

6 6 ——— = ——, or ¹/₂₅ of an adult’s dose. 6 + 144 150

The following table, based on Young’s rule, is sufficiently accurate in ordinary cases, and its use will avoid the necessity of mathematic calculations on the part of the physician:

Child aged one month ¹/₁₄₅ of an adult’s dose. “ “ two months ¹/₇₃ “ “ “ “ “ three months ¹/₄₉ “ “ “ “ “ four months ¹/₃₇ “ “ “ “ “ five months ¹/₃₀ “ “ “ “ “ six months ¹/₂₅ “ “ “ “ “ seven months ¹/₂₂ “ “ “ “ “ eight months ¹/₁₉ “ “ “ “ “ nine months ¹/₁₇ “ “ “ “ “ ten months ¹/₁₅ “ “ “ “ “ eleven months ¹/₁₄ “ “ “ “ “ twelve months ¹/₁₃ “ “ “ “ “ two years ¹/₇ “ “ “ “ “ three years ¹/₅ “ “ “ “ “ four years ¹/₄ “ “ “ “ “ five years ⁵/₁₇ “ “ “ “ “ six years ¹/₃ “ “ “ “ “ seven years ⁷/₁₉ “ “ “ “ “ eight years ²/₃ “ “ “ “ “ nine years ³/₇ “ “ “ “ “ ten years ⁵/₁₁ “ “ “ “ “ eleven years ¹/₂ “ “ “ “ “ twelve years ¹/₂ “ “ “

Of powerful narcotics, such as opium, scarcely more than one-half of this proportion should be used. In the case of mild cathartics, however, two or even three times this proportion may be given.

THE DOSE OF DRUGS ADMINISTERED SUBCUTANEOUSLY AND BY THE RECTUM.

The dose of a drug given hypodermically is usually about one-half the quantity given by the mouth, while twice as large a dose is generally given by the rectum as would be given by the mouth.

PROPER TIME TO TAKE MEDICINES.

Alkalis should be given before food. Iodin and iodids should be given on an empty stomach, when they rapidly diffuse into the blood. If given during digestion the acids and starch alter and weaken the digestion. Acids, as a rule, should be given between the digestive acts, because the mucous membrane of the stomach is in a favorable condition for the diffusion of the acids into the blood. Acids may be given before food when prescribed to check the excessive formation of the acids of the gastric juice. By giving it before meals you check the osmosis stomachward of the acid-forming materials. Irritating and dangerous drugs should be given directly after food, such as the salts of arsenic, copper, zinc, and iron, except where local conditions require their administration in small doses before food. Oxid and nitrate of silver should be given after process of digestion is ended; if given during food, chemic reactions destroy or impair their special attributes and defeat the object for which they were prescribed. Metallic salts, especially corrosive sublimate, also tannin and pure alcohol, impair the digestive power of the active principle of the gastric juice, so should appear in the stomach during its period of inactivity. Malt extracts, cod-liver oil, phosphates, etc., should be given with or directly after food, so that they may enter the blood with the products of digestion.

POISONS AND ANTIDOTES.

=General Treatment.=—Eliminate if possible by emetics, as zinc sulphate, 10 to 20 grains; copper sulphate, 5 grains; or hypodermic injection of apomorphin, ⅒ grain. Use stomach-pump or -tube where vomiting cannot be produced, observing great care if irritant poison has caused injury to tissues. In cardiac failure give stimulants. In narcosis keep patient awake. In threatened paralysis of respiratory movements use alternate hot and cold spray to chest, slapping, and artificial respiration. Ammonia, atropin, caffein, and strychnin are useful respiratory stimulants.

=Acetanilid.=—Emetic; rest in recumbent position; stimulants—ammonia and strychnin; artificial respiration; oxygen inhalations; external heat.

=Acid, Carbolic.=—Alcohol or Epsom salt as an antidote. Three or four ounces of diluted alcohol, followed by lavage with a solution of Epsom salt; external heat; demulcents; stimulants hypodermically.

=Acid, Hydrocyanic.=—Fresh air; artificial respiration; oxygen inhalations; ammonia by inhalation and by intravenous injection.

=Acid, Oxalic.=—Chalk or lime as an antidote; demulcents, like oil or egg-albumin.

=Acids, Mineral.=—Chalk, magnesia, soap, or white-wash from wall to neutralize poison; demulcent drinks—bland oils or egg-white; stimulants hypodermically.

=Aconite.=—Recumbent position; empty stomach with pump with patient flat on back; external heat; stimulants—alcohol, ammonia, strychnin—hypodermically.

=Ammonia.=—Vinegar with lemon-juice to neutralize the poison; white of egg or oil to allay irritation.

=Anilin Dyes.=—Give plenty of warm water to induce emesis; place patient in recumbent position; loosen clothing and permit free circulation of fresh air.

=Antimony (Tartar Emetic).=—Tannic acid as an antidote; use stomach-pump; external heat; stimulants.

=Antipyrin.=—Same as Acetanilid.