3. Whenever the action of the atmosphere occasions change.
In apportioning the dose of mixtures, the following proportions are admissible, although not perfectly accurate. A Table Spoon full (Cochleare Amplum) f℥ss. Dessert Spoon (Cochleare Mediocre) more than fʒij. Tea Spoon (Cochleare Minimum) fʒj. A Wine Glass (Cyathus) although very variable, may be estimated as containing f℥iss. The custom of measuring the dose of a liquid by dropping it from the mouth of a phial is very erroneous;[[303]] it will therefore be proper to dilute an active medicine that is to be so apportioned, with at least a triple quantity of water, that its real dose may not be essentially altered by any slight variation in the quantity.
The temperature at which a liquid medicine should be given may perhaps merit a few observations. In general, the ordinary degree of heat is that which will best answer the intention, but in cases of dyspepsia, the sense of weight and uneasiness, which often follows a dose of medicine, will be prevented by giving it in a tepid state. This remark will apply to the administration of the Decoction of Sarsaparilla; Refrigerants should of course be given as cool as possible; Camomile Infusion, and other vegetable Ptisans, which are designed to promote the operation of an emetic, will be more efficient when warm. In delicate chlorotic females I have sometimes found chalybeate draughts not only more efficacious, but less distressing to the stomach, when exhibited in a tepid state.
ENEMATA. Clysters.[[304]]
“Lavamenta.”
This form of applying a medicine furnishes the practitioner with many valuable resources, although the remedy has not escaped its due share of persecution. Paracelsus bestowed upon it the epithet “turpissimum medicamentum,” and Van Helmont that of “pudendum medicorum subsidium.”
It is calculated to fulfil the following indications, viz.
1. To promote the tardy operation of a Cathartic, or to evacuate the bowels, where, from delicacy of stomach, medicines cannot be retained, or from debility of body they cannot be safely administered.
In the administration of a remedy of this kind, there are two essential circumstances, independent of the strength of its ingredients, which will modify its activity, viz. Impulse and Quantity, by which we obtain the stimulus of distention; warm water without any adjunct may thus be made the means of overcoming those unrelenting obstructions, which had refused obedience to more common measures: Clysters, however, when most forcibly urged, rarely reach beyond the sigmoid flexure of the colon, and yet when the largest quantity of fluid which the bowels will admit is introduced with considerable impulse, the local impression is so powerful that it is at once extended by the medium of sympathy, through the whole of the alimentary canal, and very thorough and copious discharges result.
2. To induce extreme relaxation: