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dissolves and removes mucus from the gastro-in- testinal walls, thus promoting healthy action, and, being sedative, prevents the griping that occasion- dosage for ibuprofen ally follows calomel when given alone. This grip- ing is really due to acridity of the bile poured out, not to the calomel. Follozv with a Saline. — Salivation may occur whenever mercury is given. Even small doses may cause it if there is an idiosyncrasy. Therefore, unless given with more powerful cathartics, calomel should generally be followed six hours later by a saline aperient. In this way its specific action is not interfered with and the unabsorbed drug is swept out of the system. If purgation does not occur within twenty-four hours after dose ibuprofen the adminis- tration of a large dose, a saline motrin is ibuprofen must certainly be given. Calomel may be given in a single dose of from three to ten grains or in small doses of from a ibuprofen motrin tenth to a sixth of a grain every fifteen minutes until from one to three grains have been taken. Where the system responds readily to drugs, ibuprofen and acetaminophen as in delicate women and children, or where there is intestinal irritation, as in diarrhoea, and we advil and ibuprofen further desire to secure its prolonged antiseptic action, the small, fre- quently repeated dose is to be preferred. Thus, in cholera infantum from one fortieth to one thirtieth of a grain every fifteen minutes until two or three grains have been administered gives as good results as any other method of treatment. Where prompt action is necessary, as in severe malarial fevers (quinine often failing to act beneficially until the system has been purged by a mercurial), and in strong adults where simple catharsis is the main ob- ject, the large dose should be given, followed by a saline. The advantage of the large dose is the greater certainty and promptness of specific action ; the dis- advantage is the risk of excessive action or saliva- use of ibuprofen tion. The advantages of divided doses are gentle- ness of action and ibuprofen mg no danger of ptyalism ; the disad- vantages are the tediousness of the administration, occasional nausea, and the uncertainty, when an evacuation does occur, whether it is due to the calo- mel or dosage of ibuprofen to the saline that followed it. Time of Administration. — This will depend upon the condition to be relieved. In urgent cases it should be advil ibuprofen given at once, regardless of the time when catharsis will occur. Otherwise give it at bedtime nnd let a saline be taken the acetaminophen with ibuprofen following morning be- July 27, 1901.] OUR SUBSCRIBERS' DISCUSSIONS. 163 fore breakfast. In the conditions for which calomel is usually prescribed, the patient will be all the bet- ter, and the drug more effective, if it is taken fasting or near the end of digestion, and if only light food is taken while it is in ibuprofen use the system. Large Doses for Biliousness, Small Ones for DiARRHCEA. Dr. B. Ray Brozmiing, of Littleton, N. C, writes: dose for ibuprofen The answer to the query would, it appears to me, depend upon just what conditions are being treated and what is desired to be brought about. The spe- cial merit of mercurial purgatives is their chola- gogue properties — i. e., to increase the discharge of bile. Calomel possesses this property to a marked degree. This, and its being free from taste and easily retained when other purgatives are rejected by the stomach, make it a purgative of exceptional 600 ibuprofen value. Calomel acts upon the upper part of dose of ibuprofen the ali- mentary canal, hence it is my custom to follow it with some other general purgative, such as Epsom salts, to hurry forward from the upper canal that which the calomel has carried down from the upper bowel. Now, as to the best way of prescribing it as a purgative, that is determined in my practice by the existing conditions. In that condition generally called biliousness, where we recognize the clinical, though not the pathological, condition, calomel ex- erts its peculiar beneficial influence at once, curing the condition. I give ten grains, sometimes twelve or fifteen, at ibuprofen acetaminophen night, followed by a tablespoonful of Epsom salts early the next morning. In this con- dition experience has demonstrated that the single large dose is indicated, whereas in ibuprofen and motrin that condition of diarrhoea with acrid, burning stools and some tenes- mus, it is better to give one grain as a purgative and corrective at night for several nights. In the diar- rhoeas of infancy (not cholera infantum) we get the best purgative action acetaminophen or ibuprofen of calomel by the administra- tion of very small doses, while in older children the dose is correspondingly increased. In typhoid fever dosage ibuprofen

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