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Show ee ee n aR. aoe,* gates :Vib ee Aeome 192 COMMON PERUVIAN BARK TREE. cinchona: andits use in gangrene is said to have originated from its curing one in anagueish patient. It has had various appellations. About the year 1640, from curing the lady of the Spanish viceroy, the Comitissa del Cinchon, it was called Cortex or Pulvis Comitisse, Cinchona, &c.; fromthe interest which cardinal de Lugo and the Jesuit fathers took in its distribution, Cortex or Pulvis Cardinalis de Lugo, Jesuiticus, Patrum, &c. ; from the place where it was originally found, Peruvian bark, or simply, from its preeminence, Bark. On its first introduction into Europe it was reprobated by many eminent physicians, and at different periods, long after, it was considered as a dangerous remedy ; but its character, in process of time, became universally established. It was first introduced for the cure of intermittent fevers ; and these, when it is properly exhibited, it rarely fails to cure. But there have been considerable differences of opinion with regard to the best mode of exhibition ; some prefer giving it just before the fit, some during the fit, others immediately after it. Some, again, order repeated doses between the fits; and this modeof exhibition, although it may perhaps sometimes lead to the employment of more bark than is necessary, upon the whole appears preferable, from being best suited to most stomachs. The requisite quantity is very different in different cases ; and in many vernal intermittents cinchona seems even hardly necessary. It is now given from the very commencement of the disease, vithout previous evacuations, which are thought to retard the cure, aud to induce, they say, abdominal inflammations, scirrhus, jaundice, hectic, dropsy, &c.; symptoms formerly attributed to the premature or immoderate use ofthe bark, but which are best obviated by its early and liberal use. It is to be continue d not only till the paroxysms cease, but till the natural appetite, strength, and complexion return. It is then to be gradually left off, and repeated at proper intervals to secure against a relapse, to which there often seems to be a peculiar disposition, especially when the wind blows from theeast. Although, however, evacuation rather counteracts the effects of cinchona in the cure of intermittents, yet, previous to its use, it is often adviseable to empty the alimentary canal, particularly the stomach; and onthis account good effects are obtained from premising an emetic. It is a medicine which seems not only suite d to both formed and latent intermittents, but to that state of fibre on which all COMMON PERUVIAN BARK TREE. 123 periodical diseases seem to depend; as periodical pain, inflammation, hemorrhagy, spasm, cough, loss of external sense, &c. Cinchona is now used by some in all continued fevers ; at the same time attention is paid to keep the bowels clear, and to promote, when necessary, the evacuation of redundant bile, always, however, so as to weaken the patient as little as possible. In confluent small-pox it promotes languid eruption and suppuration, diminishes the fever, and prevents or corrects putrescence and gangrene. Dr. Haygarth has lately extolled its use in acute rheumatism, from the very commencement, even without premising venesection. In gangrenous sore throats, and indeed in every species of gangrene, it is much used, both externally and internally. In contagious dysentery, after due evacuation, it has been used, taken internally and by injection, with and without opium. Inall those hamorrhagiescalled passive, and likewise in other increased discharges, it is much used; and in certain undefined cases of hemoptysis, some allege that it is remarkably effectual when joined with an absorbent. It is used for obviating the disposition to nervous and convulsive diseases; and some have great confidence in it, joined with sulphuric acid, in cases of phthisis, scrofula, ill-conditioned ulcers, rickets, scurvy, and in states of convalescence. In these cases it is proper to conjoin it with a milk diet. In dropsy, not depending on anyparticular local affection, it is often alternated or conjoinedwith diuretics or other evacuants, andby its early exhibition after the wateris once drawn off, or even begins to be freely discharged, a fresh accumulationis prevented, and a radical cure obtained. Peruvian bark may be exhibited, 1. In substance. The best formof exhibiting this valuable remedy is in the state of avery fine powder,in doses of from ten grains to two drachms and upwards. Mutis and Zea say that two drachms of true genuine bark, in powder, are sufficient to prevent the excess of an intermittent, while, to produce the sameeffect, it requires the decoction of two ounces. Nay, even the residuumof an infu- sion is capable of curing agues, provided it be given in a larger dose than the entire powder. As it cannot be swallowed in the |