The Bittersweet Pill As Therapeutic Aid

Leon J. Warshaw, MD
JAMA. 1966;196(4):372. doi:10.1001/jama.1966.03100170114045.
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To the Editor:—  Your editorial, "The Bitter Pill" (195:306, 1966) calls attention to the danger that the fluid required for the ingestion of prescribed medication may exceed the restricted fluid intake allowed certain patients.I have found this a useful stratagem for assuring an adequate intake by certain other patients who, despite being urged to take fluids freely, deliberately or unconsciously limit their intake to undesirably low levels. Especially with elderly, debilitated patients in busy, understaffed hospitals, failure to provide a supply of palatably cool water and the assistance needed to drink it may compound this problem.In such instances, I have frequently prescribed a placebo dose of a few drops of a tincture or other liquid preparation to be given in a full glass of water three or four times a day. Not only does this overcome the patient's aversion to drinking plain water, but, since it is


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