CHAPTER X.
SOME SERVICES FREQUENTLY DEMANDED OF ATTENDANTS, AND HOW TO DO THEM.
The Administration and Effect of Medicine.—The only proper way of giving medicine is by using standard weights and measures. Dropping medicine, or using spoons or cups, is not sufficiently accurate. A drop may be half a minim, or as large as two or even three. The modern teaspoon holds ninety or more minims, and a tablespoon more than half an ounce.
Medicines are introduced into the system through the stomach, the lungs, the rectum, the skin, or by being injected into the tissues, under the skin. They are either local or general in their effects. A blister or a poultice is a local remedy, so is an emetic, that acts by irritating the walls of the stomach. General medicines are absorbed into the blood, and carried to different parts of the body.
The following are a few of the reasons for which medicine is given: to relieve pain, to give sleep, to produce vomiting, to check vomiting, to move the bowels, to check diarrhœa, to assist digestion, to produce a greater or diminished flow of urine, to increase the perspiration, to increase the red blood corpuscles, to check hemorrhage, to regulate the action of the heart, to overcome the effects of poison, to increase or diminish the amount of blood in the brain, to control spasm, to diminish the temperature in fever.
In some cases the effect desired and expected from a medicine given to a patient is told to the attendant, who should closely observe and be able to report the result. Sometimes medicines are left in the hand of the attendant, to give in repeated doses, at stated intervals, till a desired effect is produced. The attendant is also instructed to watch for certain symptoms which show that the medicine is doing harm, when it is to be discontinued. An attendant, who has studied and learned, “how and what to observe” in his patient, will be able to give intelligently any medicine ordered by a physician.
Sometimes medicines, given in large or long-continued doses, cause symptoms that an attendant should notice and report to the physician; some of these are, eruptions on the face and body, puffiness about the eyes, irritation and running of the eyes, a metallic taste in the mouth, bleeding of the gums or soreness of the teeth and profuse flow of saliva, nausea, vomiting, diarrhœa, constipation, indigestion, ringing of the ears, feeling of fulness in the head, headache, dizziness, drowsiness, coma, convulsions, or convulsive movements of muscles.
In asylums, medicines are mostly sent to the wards in single doses, each cup or bottle being marked with the name of the patient for whom it is intended. The tray in which they are carried should never be set down and left, for a mischievous or suicidal patient may poison himself by taking every thing he can get hold of.
No patient, unless ordered by the physician, should be allowed to keep his cup and take his medicine at his leisure. Suicidal patients often ask to do this, and then save the medicine, until they have enough to poison themselves. Others will throw the medicine away. The way to administer medicine to the insane is to give it personally to the patient, and also see that it is swallowed. It is a frequent custom of many patients to retain the medicine in the mouth, and, when the attendant has left, to spit it out.
It is often very important that patients should take the medicine ordered, and every effort should be made to induce them to take it. Such patients should be designated by the physician. Night medicines, or those given about bedtime, are usually of great importance. All patients who refuse to take their medicine should be reported to the physician.