CHAPTER V.

THE ART OF PRESCRIBING.

The nurse will not often prescribe medicine, but it may be of use to know how to read the prescriptions of others, and to know a few of the general rules or principles upon which physicians act in trying to produce the greatest curative effect with least possible inconvenience.

THE DOSES OF MEDICINE.

Generally in the following prescriptions the ordinary dose for an adult is stated. The young require a smaller dose than older persons, or those at maturity; and the very aged cannot bear as large doses as the middle aged. The following is designed to exhibit the dose proportioned to the age; the dose for a person of middle age being one drachm:

That for a person from 14 to 21 will be 2 scruples. That for a person from 7 to 14 will be ½ a drachm. That for a person from 4 to 7 will be 1 scruple. That for a person of 4 years will be 15 grains. That for a person of 3 years will be 10 grains. That for a person of 2 years will be 8 grains. That for a person of 1 years will be 5 grains.

There are some medicines however which require to be given to children in much larger proportioned doses than those stated above. For example, a child of three years might require half as much castor oil for a dose as an adult. Females usually require smaller doses than males, and those of sanguine temperament than the lymphatic and phlegmatic. Idiosyncracies sometimes exist in individuals rendering them peculiarly susceptible to the action of certain remedies, or causing a medicine to act on an individual in a manner wholly different from the ordinary mode.

In general the susceptibility to the action of a medicine is diminished by its frequent use; some medicines are of variable strength, and all these considerations should lead to great care in prescribing; some medicines require more care than others, however, and such formula will be selected for insertion here as may be pretty generally used with safety. I believe they do not require more effort to adapt them to particular cases than ordinary patent medicines.

MODE OF ADMINISTERING MEDICINE.

Medicines given together should be combined with a definite purpose in regard to each article in the formula. Remedies of the same general character may be given together in order to increase their efficacy. In F. 74 there are several aromatics because a small amount of each when combined, will be more certain in their action than a large amount of one kind, and at the same time they will be less irritating.

The effects of one medicine are in many cases increased by the influence of another in augmenting the natural susceptibility of the system to its action.

One medicine is given with another to counteract the more disagreeable effects of the more active one.

One medicine is sometimes given as a vehicle for another; perhaps to cover the disagreeable taste or odor and to render the medicine acceptable to the stomach. For example, the aromatics and ammonia in F. 74 are much more agreeable to the stomach than either of them would be separately.

In the mixing of medicines care should be taken that they are neither chemically nor physiologically incompatible. When the action of an acid is desired, an alkali should not be given at the same time, as they unite to form a compound different from either. A soluble salt should not be given with another, or with an acid that would decompose it, and produce an inert compound. If medicines are given that have an apparent physiological incompatibility, it should be with a full understanding of their effects, and with reference to them. The FORM in which medicine is given must vary according to the nature of the medicine, the taste of the patient, or the condition of his stomach, as it is always desirable to have it so that it can be swallowed without difficulty.

The physician should always write his prescription with neatness, order and precision, but it will be found an advantage to the nurse to have a ready comprehension of the symbols and abbreviations used in writing prescriptions. Hence I have appended a table designed to explain the signs and abbreviations habitually used. Ordinarily the Roman numerals are employed, and follow always the symbols to which they relate. A glossary which will include some latin terms will hereafter be added.

───────────────────────┬───────────────────────┬─────────────────────── Sign or Abbreviation. │ LATIN WORD. │ ENGLISH WORD. ───────────────────────┼───────────────────────┼─────────────────────── ℔ │Libra or libræ. │A pound or pounds. ℥ │Uncia or unciæ. │An ounce or ounces. ʒ │Drachma or drachmæ. │A drachm or drachms ℈ │Scrupulus or scrupuli. │A scruple or scruples aa. │Ana. │Of each. Add. │Adda. │Add to it. Ad. saturand │Ad saturandum. │Until saturated. Ad. lib. │Ad libitum. │At pleasure. Alt. hor. │Alternis horis. │Alternate hours. Ante Cib. │Ante cibum. │Before food. Aq. ferv. │Aqua fervens. │Hot water. Aq. pluv. │Aqua pluvialis. │Rain water. Aq. pur. │Aqu pura. │Pure water. Aq. tepida. │Aqua tepida. │Tepid water. Bis die. │Bis die. │Twice a day. Bull. │Bulliat. │Let it boil. Cap. │Copiat. │Let him take. Coch. mag. │Cochlear magraum. │A large spoonful. Coch. parv. │Cochlear parvum. │A tea spoonful. Colent. │Colentur. │Let them be strained Collyr. │Collyrium. │An eye water. Comp. or Co. │Compositus. │Compound. Contus. │Contusus. │Bruised or crushed. Cong. │Congius or Congii. │A gallon or gallons. Decoct. │Decoctum. │A decoction. Det. │Detur. │Let it be given Dil. │Dilutus. │Dilute. Div. in p. æq. │Divitur in partes │Divide in equal parts │ æqualis. │ Duo. │Duo. │Two. Ft. │Fiat. │Let them be made. Garg. │Gargarisma. │A gargle Gr. │Granum or granæ. │A grain or grains. Gtt. or gut. │Gutta or guttæ. │A drop or drops. Haust. │Haustus. │A draught. Ind. │Indico. │Daily. Infus. │Infusum. │An infusion. Inject. │Injectio. │An injection. Min. or M. │Minim. │1–60 of a fluid drachm M. │Misce. │Mix Mass. │Massa. │A mass Mist. │Mistura. │A mixture. Pil. │Pilula or pilulæ │A pill or pills. ppt. │Preparata. │Prepared. Pulv. │Pulvis. │A powder. P.R.N. │Pro re nata. │As occasion requires. q. s. │Quantum sufficit. │A sufficient quantity. ℞ │Recipe. │Take. Rad. │Radix. │A root. S. or Sig. │Signatur. │Write. ss. │Semisis. │A half. Tinct. │Tinctura. │A tincture. 2 dis. │Duo dis. │Every two hours. f. ℥ or fl. │Fluid uncia or unciæ. │Fluid oz. or ounces. ───────────────────────┴───────────────────────┴───────────────────────

The succeeding chapter is composed of formulæ giving numerous examples of the different forms in which prescriptions are written. Good taste requires that all directions should be in the English language, and that hieroglyphics and absurd abbreviations should be discarded as much as possible. Very many physicians write the directions in latin, and the druggist is expected to write the same in English and attach a label thus written to the bottle containing the medicine. I have given some examples of the old-form prescriptions written entirely in latin, and also some where the new notation (figures, &c.) is used. Whoever reads them over will learn how to read prescriptions; but I have given none but such as I value highly, and I have used almost every one in my practice, and tested its excellence. I advise people to obtain these rather than those patent medicines whose composition is secret. The person who desires one of these prescribed medicines can obtain it by copying the formula _accurately_ and taking it to a druggist. I adopt the usual

CLASSIFICATION OF REMEDIES.

ANTACIDS neutralize acids existing in the alimentary canal, or circulating with the blood; ANTISEPTICS counteract putrefaction; ANTISPASMODICS relax spasm and calm nervous irritation; ASTRINGENTS cause vital contraction of the organic textures; ANTHELMINTICS destroy worms, or expel them from the bowels; CATHARTICS act on the bowels, producing a purgative effect; CAUSTICS destroy the life of the part upon which they act; DIAPHORETICS increase the cutaneous discharge; DIURETICS produce an increased flow of urine; EMETICS produce vomiting; EXPECTORANTS augment the secretion from the pulmonary mucous membrane; ENEMATA cause evacuations from the rectum, &c.; EMMENAGOGUES excite the menstrual secretion; NARCOTICS affect the cerebral functions; TONICS exalt the energies of the whole system. I shall give examples of remedies which are designed to produce these several effects, besides some belonging to other classes.

Where the word teaspoon is used it signifies one holding about 55 drops of water = ʒ j. (one drachm); 1 table spoon about half an ounce, and this is written ℥ ss; one wineglass equals two ounces, written ℥ ij; one teacup equals four ounces, written ℥ jv.; one coffee cup equals eight ounces, and is written ℥ viij.

The gramme of the FRENCH METRIC SYSTEM equals about 15 grains, and this is the unit of weights. The system is of the decimal character and the latin prefixes deci, centi, milli, &c., are used to indicate its subdivisions, and the Greek deca, hecto, kilo, myria, &c., are its multiples, always on the scale of ten.

.001 gramme = 1 milligramme. .01 gramme = 1 centigramme. .1 gramme = 1 decigramme. 1 gramme 10 gramme = 1 decagramme. 100 gramme = 1 hectogramme. 1000 gramme = 1 kilogramme.

Physicians, many of them, prefer to employ latin names to designate the ingredients of their prescriptions, and to write the directions to the druggist in latin. I will first give a few latin prescriptions with the translation.