Dose

“ The Doses of Medicinal Substances are specific with respect to each, and can therefore be only learnt from experience; the young and eager practitioner, however, is too often betrayed into the error of supposing that the powers of a remedy always increase in an equal ratio with its dose, whereas The dose alone very often determines its specific action. ”

“ Few persons who have not been specially educated in science have ever learned this great lesson of Materia Medica, "that everything depends on the size of the dose." It is not merely that a small dose will often produce effects differing in degree from those produced by a large dose ”

“ The ordinary dose when used as medicine is from 1⁄4 to 1⁄2 grain, and is very unstable and treacherous in its effects. Some patients will tolerate large doses while in others small doses produce unpleasant effects. Deaths are recorded from the use of 1-7 to 1 grain. ”

“ Then the dose of the medicine is to be lessened. It is administered with most advantage in the form of a pill. A quarter of a grain is the least dose which need be used in the beginning for an adult; and it may be given twice or thrice in the day. The dose is to be increased according to its effects: and it is stated by M. Magendie, that some persons have borne the augmented quantity of thirty grains in the day: but from four to six grains per diem, is the maximum amount usually required. ”

“ It defendeth every body from all hurtfull Causes and Diseases, and admits not the least venomous Air, but if the Dose be augmented, it doth also display its vertues, by a visible operation, and drives out by Sweat and Urine, or Spittle, sometimes upwards and downwards, every noxious thing, and operateth even as you will have it, according as your dose is either more or less, and as your Disease needeth. A dose that is very small and void of any visible operation, is wont to heal many Diseases, yea and the greatest part of them. ”

“ Q.—If homœopathists give, as they profess to do, the decillionth of a grain of medicine, for a dose, and which decillionth can only be obtained by dissolving the grain of medicine in a decillion drops of some liquid—say alcohol—how long would the grain of medicine last, if the population of the world were a thousand millions, and if there were a thousand millions of such worlds, and if each inhabitant lived for a thousand years, and if they each took a dose per second during their whole existence? ”

“ Modifying Circumstances.—The ordinary action of a poison may be greatly modified by the largeness of the dose, by the state of aggregation, admixture, or of chemical combination of the poison, by the part or membrane to which it is applied, and by the condition of the patient. Thus, for example, opium may be a medicine or a poison, according to the dose in which it is given; and a dose of the drug which may be beneficial to an adult in certain states of the system may be fatal to a child, or to an adult when suffering from some forms of disease. ”

“ In fact the Unguentum Armarium and Sympathetic Powder resemble some more recent prescriptions; the latter consisting in an infinite dilution of the common dose in which remedies are given, and the two former in an infinite dilution of the common distance at which they are applied.
Whether philosophers, and more especially metaphysicians, have any peculiar tendency to dabble in drugs and dose themselves with physic, is a question which might suggest itself to the reader of their biographies. ”

“ An American physician, who was conversant with their practice, assured me that in one of their prescriptions they had one hundred and seventy-five ingredients, to be taken in three doses, and they are sure enough doses, as the common way of paying a doctor is by the potful thirty to sixty cents per pot, each holding from two quarts to one gallon, and a dose is as much as a man can swallow at one time, frequently a quart. ”

“ A small dose of a drug may serve as a stimulant for the lagging forces, while a larger dose would directly repress them or produce injurious secondary effects. As soon as we recognise that the aim of medicine is not to destroy the disease but rather to stimulate the resisting forces of the body, the whole logic of therapeutics assumes a new aspect. ”

“ The degree of solubility possessed by a medicinal substance may perhaps be regarded by some practitioners as a circumstance of but little or no importance; it will however appear in many cases that it not only influences the activity of a remedy, but, like its dose, goes far to determine its specific operation; indeed, where a medicine is not, in itself, very soluble, the increase of its solubility by any chemical expedient, is tantamount to an increase of its dose. ”

“ Very few persons have recovered where the quantity was considerable.
In every instance in which the dose was considerable, and the solution concentrated, the first symptoms have been immediate burning pain in the stomach, and generally also in the throat. But when the dose was small, more particularly if the solution was also rather diluted, the pain has sometimes been slight, or slow in commencing. Mr. Hebb’s patient, who took only half an ounce dissolved in ten parts of water, and diluted it immediately after with copious draughts of water, had not any pain in the belly for six hours. ”

“ The choice of the aperient, or the dose, or the exact condition of the health of the infant, or whether it is an aperient at all that is required, are points entirely overlooked: a little medicine is thought necessary, because the child appears unwell, and a purgative, or a little white powder, is forthwith given. The great art of medicine is the proper application of the proper medicine, in the proper dose, at the proper time ”

“ We ought to have noticed that each medicinal dose contains a great number of atoms which are perfectly inactive, in consequence of their being shut up in the interior of the molecules, and not brought into contact with our organs; it therefore follows that every time we by any means whatever, come to divide these molecules into smaller corpuscles, and thus augment their whole surface, the energy of the dose will so increase that the smallest part will become capable of exercising an influence, if not superior, at any rate equal to that of the entire dose in its primitive condition. ”

“ Maton has found that the value of this extract is greatly increased by including the seeds in its preparation. Dose, grs. v to ℈j; or more, twice or thrice a day; in a full dose it produces giddiness, a slight nausea, and a tremor of the body; a peculiar heavy sensation is also experienced about the eyes; and the bowels become gently relaxed: unless some of these sensations are produced, we are never sure that the remedy has had a fair trial of its effects. Patients will generally bear a larger dose at night than at noon, and at noon than in the morning. ”

“ The majority omit chemical formulae. An alphabetical arrangement is followed in all. The maximum doses of preparations are given in several pharmacopoeias and the physician must indicate on his prescription, if he exceeds this limit, by using a note of exclamation after each article, that he purposely intends such a dose to be employed. ”

“ The quantity or dose is the most important of these; many substances which are deadly in large doses being exceedingly useful as remedies in small quantities; such are prussic acid, opium, digitalis, arsenic, &c. Then again, the mechanical and chemical state of aggregation are all-important; a solid being usually much less active than a fluid or a gas, and a pure substance much more active than one mixed with insoluble materials. ”

“ The usual method pursued by medical men in calculating the doses of medicine for children is to average the dose in proportion to their approximate weight or to figure out a dose upon the assumption that at 12 years of age half of an adult dose will be about right. ”

“ The Discussion on Poisons. would have taken a centigramme; at the end of twenty days, increasing another milligramme, you would have taken three hundred centigram-t mes; that is to say, a dose which you would support without inconvenience, and which would be very dangerous for any other person who had not taken the same precautions as yourself. ”

“ Treatment.—In most cases if there is heat and feverish excitement of the system, give fifteen drops of A.A., and B.B., alternately, five times per day, that is, a dose of B.B. morning, noon and night, and a dose of A.A., at say ten o’clock in the forenoon and at three in the afternoon, until the heat and lameness are partially subdued, and then give B.B., morning and night, until the lameness and irritation have entirely subsided. Old cases may only require a dose every day. ”

“ It must be observed, that a frequent repetition of the use of this class of medicines so habituates the body to their stimulus, that their dose may gradually be increased to an astonishing quantity, such as otherwise would instantly destroy life; as is frequently seen in those, who accustom themselves to the daily use of alcohol and opium ”

“ Infusion, two ounces of root to the pint of water.
Diseases, Dose, etc.—Dose of infusion one to two ounces. Juice, ten drops to one-half teaspoonful. Extract, ten grains. Fluid extract, one to two teaspoonfuls. It should be taken often enough, when the liver is torpid, to move the bowels once or twice a day. If the infusion is used, begin with a half ounce and take every three hours; increase or decrease as necessary. The extract is pleasanter and less bulky and best to use in winter. Take two or three grains every three hours more or less. ”

“ Prescribers ought not to forget that the action of medicines is not simply proportioned to the amount, but that each remedy has a dose below which it either produces no effect or one contrary to that which we desire it to produce. ”

“ 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:
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. ”

“ But of money as of morphine it is true that a single dose soon makes the patient call for another, and often a larger dose; that it soon makes the patient dependent on this sort of relief, and so forms a dangerous habit. ”

“ The ordinary mode of preparing a decoction is to use one ounce of the plant, root, bark, flower, or substance to a pint of water. The dose internally varies from a tablespoonful to one ounce.
ALTERATIVES.
Alteratives are a class of medicines which in some inexplicable manner, gradually change certain morbid actions of the system, and establish a healthy condition instead. They stimulate the vital processes to renewed activity, and arouse the excretory organs to remove matter which ought to be eliminated. ”

“ I mix a drop with seven tablespoonfuls of water, and give a dessert-spoonful every hour, or every two or three hours; the more acute the attack, the more frequently the dose is repeated; this method generally suffices to effect a cure more or less rapidly. ”

“ For children medicine is mixed at the same strength, but a less quantity is given. The proper quantity for a dose is always given in books and manuals for the homœopathic treatment of disease. Small cases of the principal medicines used in homœopathy can be procured from most chemists, and with each case a little book showing the symptoms and treatment of all ordinary complaints is usually given. ”

“ If the patient be stronger than usual, or the symptoms very urgent, this dose may be given once in eight hours; and on the contrary in many instances half an ounce at a time will be quite sufficient. About thirty grains of the powder or eight ounces of the infusion, may generally be taken before the nausea commences.
The ingenuity of man has ever been fond of exerting itself to vary the forms and combinations of medicines. ”

“ The dose, as a general rule, at the commencement is a teaspoonful three times daily, gradually increased as the stomach is able to bear it. It is rarely requisite to exceed a table-spoonful twice or thrice daily; large quantities either derange the stomach and liver, or pass off unabsorbed by the bowels. ”

“ When the process of reducing the dose is too greatly prolonged, the sufferings of the patient are unnecessarily aggravated. As the diminution progresses the relief produced by each dose is followed by distressing reaction. The anticipation of smaller doses from time to time or from day to day is a matter of great distress to patients. ”

“ Drugs classed as similar are by no means alike in action; laxatives, tonics, carminatives, diuretics are combined with distinct advantage, economy of dose, enhanced effect, potency not obtainable with the single drug. ”

“ Oxygen, which gives us life, slays also, when administered in too strong a dose. I have had to study thoroughly this paradoxal poison to determine the different effects of varying doses, and its action upon our tissues. ”

“ His view is that the pharmacopaeal doses are in nearly every instance much too low. Excessive timidity has cut down the dose until it has ceased to produce a real effect upon the disease.
Medical men, according to his view, have been afraid of producing a poisonous effect with their drugs. ”

“ A little experience will enable one to take up five, ten or more drops as may be required. The Medicator thus charged with the dose, can, at the convenient moment, be inserted just within the lips of the animal’s mouth, the farther back upon the tongue the better, when a slight pressure upon the top of tube injects contents, and medicine is given. ”