The Evil of Prescribing a Larger Quantity of Medicine Than Is Necessary

Clarence D. Selby
1909 Journal of the American Medical Association  
another method, by which the ligatures, instead of encircling the jaws of the clamp, were put through notches and each tied as an interrupted suture before the clamp was removed. This is nearly the same as the second operation described by Dr. Hawkins. This continuous-suture method was not entirely original with me, as Dr. Earle of Baltimore described nearly the same operation in Matthews' Medical Quarterly, in 1896. Dr. Robert Jones of Liverpool used nearly the same method long before Dr.
more » ... ong before Dr. Earle's paper was written, the only difference being that Jones left, above the clamp, an eighth of an inch of the hemorrhoid, through which he placed the continuous suture, instead of putting it around the jaws of the clamp. Many others had done somewhat similar operations, some simply excising the tumor, sewing the parts together, and including the bleeding vessels in the grasp of the ligature; others ligated the stump and sewed the mucous membrane over it. All these procedures led along the same line, and therefore it did not seem best to me to credit any one of them to one person. \p=m-\E. M., a woman aged 26, was seized with an a tack of diarrhea, for the alleviation of which she took medicine that had been prescribed for a similar contingency two years previously. The diarrhea continuing, she took on December 26 two teaspoonfuls of the medicine, of which there was a small quantity remaining, and two more teaspoonfuls December 27. During the afternoon of December 27 her vision began to be blurred, she grew nervous, her mouth became dry and her heart action rapid. Soon after, her hands and feet grew chilly and numb. By this time she was alarmed and summoned medical aid. I found her pacing the floor and nervously loquacious. The dryness of her mouth and the history, together with the dilated pupils and the uncontrolled heart action, confirmed the diagnosis of atropin poisoning. Treatment along accepted lines was satisfactory in its result. Often we prescribe medicine in quantities that far exceed the duration of the illness, and, consequently, the pa¬ tient, loth to throw away good medicine, places that which remains aside for future use. A similar occasion for the use of this medicine arising in the family, the old bottle is uncorked and its contents administered. To all purposes this medicine then becomes a self-prescribed proprietary mix¬ ture, purchased, however, with the sanction of the doctor, rather than on the recommendation of the druggist. The harm that might result from such self-drugging with these leíú-over drugs is worthy of our attention.
doi:10.1001/jama.1909.02540310059015 fatcat:d44wrxtlfbhdfe7i6kkzmwb3ie