3B0 THE DANGER OF PRESCRIBING CONCENTRATED MEDICINES. 
from experiments made by Dr. Kemmerich, he does not attempt to disguise the 
fact that even beef-tea, when highly concentrated in the form of extract of 
meat, may be easily administered to an injurious extent. But how much more 
is this the case with medicines ! Substances which are comparatively harmless 
when diluted may be capable of readily destroying life when highly concen¬ 
trated. The numerous additions which, of late years, have been made to our 
Materia Medica by the introduction of powerful chemical agents have tended 
greatly to increase the danger attending the use of concentrated medicines. 
The Legislature has recognized the necessity for requiring a greater amount of 
knowledge and experience in those who are engaged in dispensing medicines 
than was formerly considered to be sufficient, and new regulations are about to be 
imposed upon all those who deal in dangerous drugs, with the view of protect¬ 
ing the public from the injurious effects which might result from their careless 
or improper employment. It becomes, therefore, more than ever incumbent on 
all those who have the means of doing so to assist in furthering the object thus 
contemplated. 
What is desired is, without diminishing the efficacy of medicines, to render 
their administration as free from danger to life or injury to health, arising from 
any accidental misuse, as possible. 
it is very rarely that the efficacy of a medicine depends upon the state of 
concentration in which it exists when administered. Even in the form in which 
liquid medicines are prescribed they are often directed to be mixed with water 
when taken, and this method of prescribing has greatly increased of late years. 
This subject demands the very serious attention of medical men, for it is obvious 
that to the extent to which medicines are prescribed in a more concentrated form 
than is necessary the danger attending their use is increased. If it were pos¬ 
sible to establish a fixed and uniform quantity as the dose by volume of all 
liquid medicines, leaving the strength to be adjusted according to the required 
effects, the greatest security would be provided against fatal accidents, for the 
quantity constituting a dose would never contain enough to produce poisonous 
effects. 
We are far from thinking it would be possible completely to establish such a 
system, especially in the existing state of society and with the increasing ten¬ 
dency there is to diminish all unnecessary encumbrance to the means of moving 
easily and rapidly from place to place ; but much, we are convinced, may be 
done in this direction, and it ought to be done as far as it is practicable. The ap¬ 
portioning out of doses of poisonous substances, such as strychnia, by drops, is 
an operation that ought never to be entrusted to unskilled hands ; and it would 
surely be a wise regulation to make, that such medicines should never be sup¬ 
plied to patients in a concentrated state, or in any state in which dilution was 
required in taking them. Then, if the volume of a dose were fixed at half an 
ounce or an ounce, there would be no great probability of fatal accidents occur¬ 
ring in the use of such medicines. 
But it is not only with a view to the prevention of accidental poisoning that 
it is important, as far as possible, to avoid supplying unduly concentrated me¬ 
dicines to the public; there is another ground upon which the prevailing prac¬ 
tice may be equally deprecated, and that is, that the doses are thus very imper¬ 
fectly adjusted. If the intended dose of strychnia is contained in two drops 
of a prescribed solution, a slight tremor of the hand or a failure of distinct 
vision might cause the dose to be doubled or trebled ; besides which, the size of 
a drop varies with the kind of surface from which it falls. If medicines are 
thus administered haphazard, what becomes of therapeutics, for the physician 
hardly knows what his patient is taking ? 
The case we have referred to is certainly an extreme and unusual one, but 
the objection urged in that case applies in degree to others of more frequent 
