A few rules to be remembered in giving medicines are:

1. Always give exactly what the doctor orders, neither more nor less.

2. Always give medicine on time-if a dose is due at twelve, give it at twelve and not at half past.

3. Medicines intended to be taken before meals should be given twenty minutes before meal-time, those to be taken after eating, twenty minutes after the meal is finished.

4. Never give medicine without reading the label on the bottle twice; before and again after pouring it out.

5. When pouring medicine always hold the label on the upper side, to avoid defacing it.

6. Do not use spoons for measuring for they are never accurate; small graduated glasses, which are infinitely better, can be bought at any drug store for about ten cents.

7. When pouring hold the mark of the quantity you require on a level with your eye.

8. Always shake the bottle before pouring out the medicine.

9. The bottle should always be recorked immediately after use, for many medicines contain volatile substances and are apt to become either stronger or weaker than intended, if left uncorked.

10. Medicines containing iron should be taken through a glass tube or straw, as they discolor the teeth.

11. Some medicines, notably several that are given for coughs, should be given undiluted, while others on account of their irritating properties should be very well diluted. Never dilute more than necessary, for the addition of a large quantity of water often renders a disagreeable dose still more unpleasant to take.

12. Holding a piece of ice in the mouth for a short time before taking medicine will often render a disagreeable flavor less noticeable; a drink of seltzer afterward will help to "take away the taste." Castor oil given with lemon juice, a piece of ice small enough to swallow, seltzer added just before taking, and a drink of seltzer after, is not at all unpalatable. Holding the nose while taking medicine will also diminish the taste.

13. Insoluble powders such as calomel, bismuth and acetanilid should be placed far back on the tongue and washed down with a swallow of water. Those with a disagreeable taste can be given in jam or bread or encased in wafers or capsules which can be bought for the purpose.

14. Pills also can be made easier to swallow by giving in bread or jelly. Unless pills are freshly made, they should be pulverized, as they soon become so dry and hard that they will not readily dissolve in the stomach.

15. Never buy a large quantity of medicine at a time, there are very few kinds that will not deteriorate by keeping; and because a medicine is beneficial in one case, do not imagine that you can give it to everyone whom you may think has the same ailment.

16. Medicines should be kept in a cool, dry place and properly labeled. All poisons should be marked as such and kept under lock and key.

Medicine is occasionally given by rectum, either when a local effect is desired or when the stomach is unable to retain it.

When medicine is given by rectum it is generally ordered well diluted. The water, added for this purpose, should be warm enough to make the injection about

100° F. A rubber rectal tube, or a large size rubber catheter, connected by a glass connecting tube with a piece of rubber tubing about eighteen inches long, into the further end of which has been fitted a small glass funnel, are the best in giving medicinal enemata.

Let warm water run through the tube to be sure that it is in working order; this will also heat it and thus avoid cooling the medication. Grease the tube well, with oil or vaseline, and before inserting it fill the funnel with the solution, allow half of it to run

Porcelain Feeding Cup

through, back into the pitcher, pinch the rubber to prevent the rest running through. This is done to avoid getting air into the intestine.

For sedative enemata (these generally consist of bromide or chloral) the tube is only inserted about six inches, but for stimulating enemata (brandy or whisky and salt solution) and nutritive enemata, the tube is inserted about fourteen inches, and a small pillow placed beneath the hips to help the upward flow. When giving these enemas have the patient lie on her back. Holding a folded towel to the anus, after the removal of the tube, will help the patient to retain the injection.

Nutritive enemata generally consist of peptonized milk, white of egg, salt and one of the beef preparations made especially for that purpose; but every doctor has his own formula and will specify how he wishes it prepared. When patients are having nutritive enemata constantly they must have a cleansing enema daily, and this must be given at least an hour before the next nutritive one is due, and not till two or three hours after the last one has been given.

Starch and other emollient enemata are sometimes given in diarrhoeas and dysentery. To prepare the starch mix a teaspoonful of laundry starch in cold water, add a teacupful of hot water, let it come to the boil. A few drops of laudanum are sometimes added to this; when it is ordered, be very accurate in counting the drops.

The suppository is another method of giving rectal medication. This is a conical shaped preparation of cocoa butter in which the required drug is incorporated. It is oiled and gently inserted, pointed end foremost, the patient lying on the left side.

Nutritive Enemata

Suppositories

Medication for the throat is often given by means of the atomizer. When using this see that the patient's tongue is held down sufficiently to allow the spray to reach the affected parts, and be careful not to let the end of the atomizer touch the back of the patient's throat, as this tends to induce vomiting.

The -inhalation of vapor is another method of conveying medication to the throat and also to the bronchial tubes and lungs. Mix the medicine with boiling water and put in a small kettle over an alcohol lamp. With stiff brown paper, make a cone, one end to fit over the mouth and nose, the other over the spout of the kettle.

Glass Drinking Cup

Hypodermic Injections

When rapid absorption is necessary medicine is sometimes given hypodermically. The hypodermic is a graduated syringe to which a hollow needle is attached. As hypodermic injections are attended with great danger unless properly given, no one should attempt to administer medicine this way without being personally instructed by a physician or nurse. In giving medication hypodermically, the greatest cleanliness should be observed; the flesh, where the injection is to be made, must be well washed with alcohol, the needles should be attached to the syringe and alcohol drawn into the syringe and expelled several times before the medicine is drawn in. When the syringe is filled with the required amount, expel the air by pointing the needle upward and gently pressing the piston till a drop appears at the point of the needle. Be careful not to let the needle touch anything after it has been cleaned-if it should, hold it in the alcohol again for a minute before inserting. The injection may be given in the outer side of the arms, thighs or abdomen. Hold the flesh between the thumb and first finger of the left hand, plunge the needle in with one quick downward movement, inject the fluid slowly by gently pressing the piston. Draw the needle out quickly. Rub the spot where the injection was made for a few seconds to hasten absorption.

Clean the instrument with alcohol before putting it away.

Hypodermic Syringe