The Eye. - Here lotions (collyria) of boric acid or hot water are applied. Ointments and caustics are applied directly. Calomel may be dusted into the eye for sluggish chronic inflammatory conditions.

The Ear. - This is reached by direct application, or by means of syringe. Alcoholic solutions of mild antiseptic drugs, such as boric acid, may be employed, the evaporation of the menstruum depositing the antiseptic in place. The ear is also reached by the Eustachian catheter from the inside.

The Nose. - Direct application of caustics or astringents can be made to the nose. Sprays and insufflations of antiseptic solutions or powders are useful. For children one of the most efficient methods of cleansing the posterior pharyngeal vault, which often is necessary in scarlet fever, measles, influenza, etc., in order to avoid middle-ear infection, is to let the little patient lie on his back, and, by means of a tablespoon, the antiseptic solution can be placed directly in the nose. Children will permit, even enjoy, this, when no amount of coaxing will persuade them to submit to the use of a spray. Moreover, a spray rarely cleanses the entire nasal cavity.

The Pharynx is reached best by direct application of absorbent cotton on an applicator. The applicator is made capable of being bent so as to reach the posterior pharynx. Solutions of cocaine, 4 per cent., and freshly prepared solutions of suprarenal gland, 10 to 50 per cent. are widely employed as local applications for anesthetic and astringent purposes in these localities. Gargles are now largely superseded by direct applications, sprays, or by syrupy or mucilaginous solutions containing astringent drugs.

Respiratory Tract. - As a means of producing anesthesia the respiratory tract has been utilized for some time. Opium is also taken in this manner by the opium-smoker. The confirmed cigarette inhaler also utilizes the respiratory tract. In young children breathing of steam, medicated or not, is an efficient means for treating spasmodic laryngitis, bronchitis, and bronchopneumonia. It is probable that the breathing of medicated vapors, as advocated by the disciples of the pneumatic cabinet, as a means of treating tuberculosis of the respiratory passages is largely illusory.

Rectum. - Medication as well as feeding by means of the rectum is indicated in conditions of great irritability of the stomach or under special circumstances, such as stenosis of the esophagus, gastric cancer with stenosis of the cardiac entrance, hysterical dysphagia, or in certain insane states, notably melancholia. Local disease may require local application of cautery, astringents, etc. By means of the proctoscope, enteroscope, or rectal specula, such topical applications may be made with ease and precision. Before making use of the rectal mucous membrane as a means for absorption it should be cleaned thoroughly. The alkaline reaction of the mucus should be remembered in prescribing, else incompatibility may easily arise. Most drugs are absorbed much less rapidly through the rectal wall than through the stomach; there are, however, a few exceptions. These are notably strychnine, morphine, and iodine. Such is the teaching of many modern text-books. Personally, I have not been able to verify this.

Enteroclysis, or intestinal hydrotherapy, as one author puts it, is a method of intestinal irrigation, including the use of enemata, used for the relief of a variety of conditions. It is a highly valuable procedure. Any syringe will suffice, but for large quantities of water, the fountain or bag syringe is perhaps best adapted.

Large quantities of fluid may be thrown into the bowel - as much as 9 pints may be used. If the temperature of the fluid is high, - 115-118F., - there is less tendency to the development of intestinal cramps. When a large quantity of water is used to irrigate the bowel, its course may be followed by percussion, and its descent into the ascending colon noted. In this manner the cecum can be reached and thoroughly cleansed, a procedure of much value in the medical treatment of appendicular disorders. Normal salt solution may be used to subserve the same purposes as by hypodermoclysis.

Urethra. - Here direct application, irrigation, and suppositories afford the best means of medication. The cystoscope may be used here or for direct applications to the walls of the bladder.

Stomach. - Medication by means of the stomach is the most convenient and practical method. The passage through the mouth and esophagus does not alter, to any great extent, the principles of drugs. Some drugs, such as strong acids, must be well diluted in order to protect the mucous membrane of the mouth and the enamel of the teeth. The administration of certain of the metals requires caution. Thus, some of the soluble iron preparations alter the color of the teeth somewhat; lead acts injuriously if the teeth are carious; and when mercury is being administered, the hygiene of the mouth must be carefully watched. In the stomach many drugs that are insoluble or slightly soluble in water are rendered more soluble by the weak acids; many chemical reactions take place, which are further complicated as the drugs pass into the intestines and meet the alkaline fluids, the bile salts, and the products of intestinal digestion.

Intravenous Injection may be resorted to in desperate cases: its dangers are obvious, however, and, save for the purpose of transfusion after severe hemorrhage, it can seldom be attempted with impunity.

Internal Administration. - The most obvious, and by far the most useful, method of internal administration is by the mouth; yet care and discretion are to be used even in so ordinary a process, and the physician should consider thoughtfully the time, consequent effects, and chemical changes, that the drug may produce the most beneficial results.

Inhalation is in many respects of the first importance as a method of internal administration. Its great facility in practice and its unquestionable efficiency - as in the case of anesthetics -render it readily available and highly beneficial, although the method has attained as yet only a limited use in therapeutics beyond a resort to it in pulmonary diseases.