JESUITS-BARK PERUVIAN-BAlJK, 155 



but to give them every hour for some hours near to the times of 

 accession." Some again order it in the quantity of an ounce 

 between the fits ; the dose beiug more frequent and larger accord- 

 ing to the frequency of the fits ; and this mode of procedure, al- 

 though it may perhaps lead to the employment of more bark than 

 is necessary, is considered by Dr. Duncan as upon the whole pre- 

 ferable, from being best suited to most stomachs. When the bark 

 pukes, or purges, or oppresses the stomach, it is to be counteract, 

 ed by remedies particularly appropriated to them. Thus, vomit- 

 ing is often restrained by exhibiting it in wine ; looseness, by com. 

 bining it with opium ; and oppression at the stomach, by the addition 

 of an aromatic. But unless tor obviating particular occurrences, it 

 is more. successful when exhibited in its simple state than with any 

 addition. 



It may Be given from the very commencement of the disease 

 without any previous evacuations, though "it commonly answers 

 better after emptying the alimentary canal, particularly the sto- 

 mach; and it is to be continued not only till the paroxysms cease, 

 but till the natural appetite, strength, and complexion return. 



In remittent fevers, especially during the times of remission, the 

 bark may also be employed with great success ; for as both these 

 and intermittents arise from the same cause, prevail at the same 

 seasons, and assume mutually the form of each other, they show a 

 strict affinity, and found a presumption which is confirmed by ex- 

 perience, that they may be cured by the same remedy. In conti- 

 nued fevers, or typhus of the nervous and putrid kind, the bark is 

 very generally used, as well suited to counteract the debility or 

 putrescency which marks the progress of the disorder. There is, 

 however, one state not unfrequently present in these epidemic 

 fevers, in which the bark is found to be hurtful; i. e. symptoms of 

 congestion, or topical inflammation of the head, manifested by 

 headach, redness of the eyes, and phrenitic delirium. And when- 

 ever delirium is accompanied with much subsultus tendinum, or 

 frequent convulsive twitchings of the limbs, Dr. Cullen thinks opium 

 iti large doses is the only remedy to which we can trust. 



Of late the bark has been much employed in acute rheumatism, 

 particularly after the violence of the disease has been in some mea- 

 sure moderated by the antiphlogistic treatment, or when evident 

 remissions take place. Many, however, have recourse to this medi- 



