290 
CINCHONA. 
nued fevers, or typhus of the nervous or putrid kind, the bark is very 
generally used, as well suited to counteract the debility or putres- 
cency which marks the progress of the disorder." There is however, 
he adds, " one state not unfrequently present in these epidemic 
fevers, in which the bark is found to be hurtful ; i. e. symptoms of 
conjestion, or topical inflammation of the head, manifested by head- 
ache, redness of the eyes, and phrenitic delirium." From our own 
experience, we would say that bark should never be resorted to in 
any case of fever, until the primie vire had been well cleared, and 
the stomach in a proper state to receive it ; neither should it be given 
when the head is engaged, or during the dry hot state of the skin, 
accompanied, as it usually is, with a hard pulse. Dr. Haygarth, 
and some practitioners of his day, recommended the use of bark in 
acute rheumatism ; we however agree with Dr. Ciillen, who savs, 
" As I consider this disease as essentially consisting in a phlogistic 
diathesis, I hold the bark to be absolutely improper, and have found 
it manifestly hurtful, especially in its beginning, and in its truly 
inflammatory state." In confluent small pox, we have given the 
decoction of bark, conjoined with a few drops of nitrous or sul- 
phuric acid, with the greatest success after the inflammatory symp- 
toms had subsided ; not, as some former writers have said, to promote 
a languid eruption, and suppuration of the pustules, but to prevent 
putrescence and gangrene. In gangrenous sore throat, the decoction 
of bark, with sulphuric acid, is most advantageously used as a gar- 
gle; and indeed in every species of gangrene, its use, both internally 
and externally seems to be indicated. In diff^erent forms of the vene- 
real disease, bark has been recommended by Mr. Pearson of the Lock 
Hospital, to reduce incipient bubo, to heal ulcers of the tonsils, 
and to cure gangrenous ulcers arising from the venereal. In pas- 
sive haemorrhagies, and other increased discharges, it has been much 
used, as well as for obviating the disposition to nervous and convul- 
sive diseases;* and joined with sulphuric acid, it has been resorted 
to in cases of phthisis, scrofula, ill conditioned ulcers, rickets, and 
scurvy. In contagious dysentery, after due evacuation, it has been 
used, taken internally, and by injection, with and without opium. 
In dropsy arising from debility, it is often alternated or conjoinied 
with diuretics, and frequently prevents a fresh accumulation of 
water: we have generally found however the different preparations 
of iron more eff'ectual for this purpose. 
* Its success, we think, here depends upon its action as a tonic. 
