40 Dr. Hancock on 
has worn itself out, and the principle of life perhaps along 
with it.* When debility is the chief symptom prevailing, and 
when, in most cases, the danger is actually over, the bark is 
thrown in, and gets the merit of the cure! Under this view, 
therefore, it seems to me that its uses are not so strictly what 
its title of febrifuge imports. Itis not so much to drive away 
the fever as to prevent its recurrence, when nine times in ten 
dangerous remittent fevers will not recur after once coming 
to acrisis. A real and genuine febrifuge, I should conceive, 
is that which not only braces the nerves as a preventive, but 
which is capable of driving away or taking off the febrile pa- 
roxysm. Such is the true meaning I should attach to a fe- 
brifuge or an anti-febrile remedy and as such I conceive the 
remedy here recommended to be. But I shall leave the 
subject to the examination of better qualified judges. 
This is, as before mentioned, but a small tree; there is ano- 
ther which grows very large, often confounded under the 
same name by the Arowaks: it is the Icica Altissima of 
Aublet. The remarkable large stipula, however, distinguishes 
the right kind most readily from every other tree which 
might otherwise resemble it; the scaly cuticle is also a good 
mark of distinction. 
My experience is chiefly confined to its use in fever, but it 
may doubtless be regarded as a general tonic, and applicable, 
perhaps, in most cases as a substitute for the cinchona; ex- 
ternally it is found to be a very useful application to foul and 
ill-conditioned ulcers, either in powder or decoction. 
There is another tree of the inland parts, called Caramata 
and Arumari by the natives, which affords likewise a very 
valuable remedy, a very bitter bark, which, from many trials I 
have made in those cases, appears to be equally safe and effi- 
cacious in those dangerous typhoid and remittent fevers in 
which the cinchona is either useless or pernicious, especially 
when exhibited during the febrile excitement. Being partial 
to the combination of similar remedies, I have in a few in- 
stances, when both happened to be at hand, infused the two 
barks (Juribali and Caramata) together, half an ounce of each, 
grossly powdered, to a quart of boiling water, giving the pa- 
tient a wineglassful of the infusion, kept warm before the 
fire, once in two to four or six hours, according to the urgency 
of the case, and it has appeared to me to operate in this way 
with uncommon efficacy: but no one person singly is fit to 
* Our profession has given too much reason for the satire of Voltaire, when 
he remarks, that “Nature cures diseases, and the physician assumes the 
credit.” 
