It should ever be the object of the practitioner to accommodate, as far
as he is able, the form and flavour of his medicines to the taste and
caprice of his patient, provided always that he does not compromise
their efficacy, and which often appears to be nearly connected with
those sensible qualities which render them disgusting and objectionable.
Some medicines are more grateful to the stomach, as well as more
efficacious in their operation, when exhibited in the state of
effervescence. To effect this we have only to introduce an alkaline
carbonate into the formula, and to direct a portion of some vegetable
acid to be added just before it is swallowed. We must, however, take
care that the ingredients are of a nature not likely to be decomposed by
the alkali, in the first instance, or by the neutral salt, which is
formed, in the second. See _Form. 27, 82, 86_.
C. _By which it is_ PRESERVED _from the spontaneous decomposition to
which it is liable._
It is sometimes adviseable to add an ingredient for the purpose of
preventing the sudden decomposition of a medicine; thus is the _Compound
Tincture of Cardamoms_ added to the _Compound Decoction of Aloes_, in
order that the latter may be preserved a longer period without change.
The addition of sugar will prevent ointments from becoming rancid.
Vegetable infusions, that are susceptible of mouldiness, are best
preserved from such deterioration by some aromatic addition. For the
knowledge of this fact we are indebted to Dr. Mac Culloch, who in a very
interesting paper, lately published in the Edinburgh Philosophical
Journal[273] has observed, that perfumes, such as _Essential Oils_, &c.
will prevent the production and growth of those minute cryptogamous
vegetables, upon which the phenomenon of mouldiness depends.[274]
Such are the objects which are to be attained by combining several
substances in one _Formula_, and such the laws by which these
compositions are to be regulated; but unless a physician can
satisfactorily trace the operation of each element in his prescription
to the accomplishment of one or more of the objects which I have
enumerated, SIMPLICITY should be regarded by him as the greatest
desideratum. I was once told by a practitioner in the country that the
quantity, or rather complexity of the medicines which he gave his
patients, for there never was any deficiency in the former, was always
increased in a ratio with the obscurity of their cases; “if,” said he,
“I fire a great profusion of shot, it is very extraordinary if some do
not hit the mark.” Sir Gilbert Blane[275] has given us a similar
anecdote; “a practitioner being asked by his patient why he put so many
ingredients into his prescription, is said to have answered more
facetiously than philosophically, _in order that the disease may take
which it likes best_.” A patient in the hands of such a practitioner has
not a much better chance than the Chinese Mandarin who, upon being
attacked with any disorder, calls in twelve or more physicians, and
swallows in one mixture all the potions which each separately
prescribes!
Let not the young practitioner however be so deceived; he should
remember that unless he be well acquainted with the mutual actions which
bodies exert upon each other, and upon the living system, it may be laid
down as an axiom, that _in proportion as he complicates a medicine, he
does but multiply the chances of its failure_. SUPERFLUA NUNQUAM NON
NOCENT: let him cherish this maxim in his remembrance, and in forming
compounds, always discard from them every element which has not its mode
of action clearly defined, and as thoroughly understood.
The perfection of a Medicinal Prescription may be defined by three
words; it should be PRECISE (in its _directions_,) CONCISE (in its
_construction_,) DECISIVE (in its _operation_.) It should carry upon its
very face an air of energy and decision, and speak intelligibly the
indications which it is to fulfil. It may be laid down as a position
which is not in much danger of being controverted, that _where the
intention of a medicinal compound is obscure, its operation will be
imbecile_.
A Medicinal Formula has been divided into four constituent parts, a
division which will be found to admit of useful application to practice,
in as much as it was evidently suggested with a view of accomplishing
the more prominent objects which have been related in the preceding
pages; or, in the language of Asclepiades, of enabling the BASIS to
operate “CITO,” “TUTO,” et “JUCUNDE.” Quickly, Safely, and
Pleasantly—thus