MEDICAL HINTS. 
175 
Treatment by Ipecacuanha .—When the bowels have been opened, give 
twenty drops of chlorodyne, and in half an hour give thirty grains of 
ipecacuanha; the chlorodyne is to quieten the stomach, enabling it to 
retain the ipecacuanha. Give the ipecacuanha either solid or mixed 
with a wineglass of water; arrowroot, starch, or gum-water will help 
to suspend the drug. Of course, ipecacuanha will act more quickly if 
it can be taken suspended in a liquid, instead of in the solid form. To 
prevent vomiting, put a mustard leaf to the pit of the stomach. Absolute 
quiet must now be observed; darken the room, and allow no moving in 
bed or talking. Withhold food and liquid for at least two hours if 
possible, but if there is much thirst, teaspoonful doses of water may be 
given. 
If there is no vomiting for an hour, probably a good part of the 
ipecacuanha has been digested; if it has been vomited, wait for half- 
an-hour, and then give another full dose. If vomited again, wait for 
two hours, and give twenty drops of chlorodyne, followed by fifteen 
grains of ipecacuanha. In about twelve hours from the first dose, repeat 
it in exactly the same way. If thirty grains are too much at a time, 
give twenty, three times a day, for not less than sixty grains should be 
given in twenty-four hours. The drug is not a dangerous one, and, if 
the patient can take it, too much can hardly be given. Between the 
doses feed the patient, giving but little at a time. If the ipecacuanha 
is going to do good, marked improvement should be apparent in four or 
five days; failure of the drug is often due to its not being given or 
retained in sufficiently large quantities. 
If ipecacuanha cannot be retained by the stomach, it must be given by 
the bowel. For the convenience of travellers, I have had tablets—called 
enimols—manufactured by Messrs. Burroughs, Wellcome & Co. Each 
contains one grain of powdered opium (equal to about fifteen drops of 
laudanum), fifteen grains of powdered ipecacuanha, and fourteen grains 
of gum acacia. 
To administer an enimol, fill the ball of an enema syringe with water, 
empty the fluid into a cup, bruise up the tablet with a spoon in another 
cup, gradually add the water, stirring constantly, so that the gum may 
dissolve, and suspend the ipecacuanha and opium, then warm the liquid 
by standing the cup in hot water. Oil the tube, squeeze out the air 
from syringe, draw up the fluid, and inject the solution into the bowel. 
