UNITED STATES OF AMERICA
WASHINGTON,  D. C.
SPO  16—67244-1 
 
 
OBSERVATIONS
                ON   THE
   SUPERIOR'  EFFICACY
                OF   THE
 RED  PERUVIAN  BARK,
                IN   THE
  CURE of AGUES and itherFE VER S.
         INTERSPERSED  WITH
Occasional  Remarks  on  the  Treatment   of
      other Diseases by the fame Remedt%
       THIRD   EDITION.
   V
  "WITH  CONSIDERABLE  ADDITIONS.
And an Appendix, containing a more particular Ac-;
          count  of  its  Natural Hiftory.
By  WILLIAM    SAUNDER  S,
                M.  D. F. R. 8.
Member of the Royal College of Phyficians in Lon-^
      don, and Phyfician to Guy's Hofpital.
-JEque pauper ibus pre deft, locupletibus ^$p$£ [\„ Bor,,

          B   O   S   T   O   iV :   ^jf  J/
  Printed  by  ROBERT  PI O D G E5   '
   For   WILLIAM  GREEN. 
0
o
 
INTRODUCTION.
      TH E fuperior efficacy of the Red Peruvian Bark
      has alone eftablilhed its ufe, in preference to the
 common kind, and in oppofition to the moft interefted
 views of dealers in the article of Pale Bark.
   The intelligence I have received from every part of
 England,  and from  many parts, of the Continent of
 Europe, conveying the moft unequivocal  evidence of
 its aftive powers, would exceed many volumes ; I am
 therefore obliged to reft fatisfied with  alluring my rea-
 ders that in no one inftance  where the Red Bark has
 been employed with judgment, has its fuperior effica-
 cy been called in queftion.   Its ufe, on its firft intro-
 dudion, was chiefly direded and confined to the cure
 of Intermittent Fevers, which, from their lingular ob-
 ftinacy,  had refitted  the common Bark j. farther ex-
 perience has. however clearly  afcertained  its great
 efficacy  in  other febrile diforders,   and  in  cafes of
 gangrene and  fcrophula, accompanied with a defedive
 tone in the fyftem.  It may  be  admitted, that as the
 Red  Bark contains more refinous parts, and is more
 adive, that greater caution is neceffary in the ufe of it,
 and that an injudicious application of it may prove ha-
 zardous to the conftitution •,  this  argument will how-
 ever apply to all remedies in their moft $dive and per-
 fed forms.
   I am now employed in colleding fads from the beft
 authorities,  and comparing them  with my own obfer-^
 vations  in  order  to afcertain with precifion the real
 operation of Bark on the habit, and the particular cir-
 cumftances and periods of difeafes which either juftify
 or condemn the ufe of this valuable remedy.
 •> ~,     -                                    Since
5 T ' ""(•'' 
[  iv  ]
  Since the publication of the fecond Edition of this
Treatife, I have  not been disappointed in any one in-
flance of curing Agues, and even  fome of the moft
complicated and  unfavourable nature, by the ufe of a
cold infufion of the Red Bark in Water, a preparation
of it which always fits eafy and light upon the ftomach,
and which is fufficiently impregnated with the powers
of this medicine, to anfwer every purpofe to be obtain-
ed by Peruvian Bark.
  I believe a cold infufion of the Pale Bark has never
been confidered as fufficiem to cure Intermittent  Fe-
vers.
  I have procured, by the favour of my learned friend
Dr. Simmons, fome important information regarding
the natural hiftory of the Red Bark,  which  I have
inf-.-rted in  this Edition of  my Treatife ;  we  are now
fufficiently encouraged to hope for  a liberal and regu-
lar iupply of this kind of Bark  from its growing in the
province of Santa-Fe,  through which  a large river
flows wnicu empties itfelf into the harbour of  Cartha--
gena : for  other particulars I refer you to the Doc-
tor's Letter,  which is replete with  ufeful information.
  My friend, Mr. Aikin, of Warrington, whofe works
in matters  of tafte, as well as fcience,  have been fo
imiverfaily  admired, and who is now preparing for the
prefs a new  edition of that excellent book on the Ma-
teria Medica, by Dr. Lewis, confirms the truth of my
experiments on  the Red Bark.  I have thought pro-
per, in this edition, to give an extrad of  this Letter,
from an  author in whofe accuracy and candour fo
much confidence may be repofed.  1 lately fawa let-
ter from a Phylician  in St. Domingo to his friend in
London,  informing him  that a Peruvian Bark  of a
red colour,  and  in  general  of  a larger fize, was lately
introduced  into  that  ifland,  and  which had proved
more efficacious than the pale Bark; he adviied his
friend to Speculate largely in  the article, and afiured
him that he might bsfupplicd with it next year in any 
[  V  ]
quantity;  he fuppofed it was from  a new foreft of
trees which had been lately difcovered.
  My friend,  Dr. Lifter, now at Paris, has been able
to procure .me from the colledion of M.  Jofeph  de
Juflieu, the different Specimens of Bark mentioned in
Dr. Simmon's Letter, and particularly one Specimen,
which, by the defire of the Spanilh Minifter  for the
American department,  was prefented to  the Royal
Medical  Society  at Paris,  by Don Cafimir Ortoga,
Profeffor of Botany at Madrid.   I was lately requeft-
ed  to  procure a quantity of Red Bark of the beft
quality  for  Le  Compte de Carburi, Phyfician to  the
Count D'Artois, fo that the ufe of it will probably foon
hecome general on the continent.
  There  is  fome danger, from the avarice of dealers,
of its being  adulterated, more efpecially, however, in
the form of powder, a circumftance which may bring
it into difcredit, 1 have therefore taken fome pains in
colleding fpecimens of it, and  arranging them in  the
order of their goodnefs, chiefly  for  the  benefit of the
young Gentlemen  who attend  my  Ledures.  The
many applications to me on this fubjed, rendered this
plan  neceffary,  the Red Bark  being  hitherto little
known by Apothecaries in the country.  The efficacy
of this remedy is fo well eftablifhed, that it is a matter
of very little confequence, if Botanifts fhould (till fup-
pofe  that there  are not Data  fufficienc to determine
whether  it  be from  the fame fpeci'es or not, with the
Cinchona Officinalis  of Linnseus.   My  friend, Dr.
 Hope, Profeffor of Botany, in  the Univerfity of E-
dinburgh, in a Letter to me, fays, " If this Red Bark,
" which  feems  to be more efficacious than the Com-
" mon Bark, can be had ; that is the great point, *and
 u whether it  be, or be not,  the Cinchona Officinalis
Ci of Linnaeus,  is but a fecondary, and much lefs  im-
" portant confideration -, however, I  think your opi-
'* r,;cn ihe moft probable ; your Trea:ife will, I think,
                                            H have 
I
                     [  Ti  ]
 " have the efTed of making the public attend to this
 " matter, and of rendering the ufe of it more general."
   Since the following pages went to the prefs, I have
 feen  fome exceeding good Red Bark, imported by a
 Spanifh Merchant, a confiderable part of which was
 as fmall as the  Quilled  Bark in  common ufe,  but It
 Hill preferved its Rednefs in that form,  approaching,
 feowever, more to  the colour of Cinnamon ; it was
 evidently  more  compact and heavy  than common
 Quill Bark, and appeared extremely  refinous,  its ex-
 terior coat, thin, whitiffi, and rough; it broke  brit-
 tle, and gave evident proofs of its  being the Quin  of
 the larger Red Bark, which was in the fame cheft : this
 conveys the agreeabie information of its being either a
 variety of the Cinchona Officinalis of Linnseus, or per- T
haps a diftind fpecies, fo that the  trees may not be
 confidered as in danger  of being deftroyed by the'in-
 irodudion  of this  Bark.  A difference of colour in
the fame fpec.ies is ofte.ii influenced by  age, foil, or ex-
polure.
i
O F
t 
OF   THE
GENERAL    HISTORY

                 OF   THE,

 RED        BARK*
    1H A D long fufpeded, that the Peruvian Bark in
    common ufe,  was very inferior in power and effi-
cacy to that recommended by the early writers on the
fubjed ;  but more efpecially by  our countrymen,
Morton  and Sydenham, in whofe works the  medi-
cal virtue of this drug,  in Intermittent and other Fe-
vers are  extolled as little fhort of infallibility.  In
their time the Quill Bark, (at leaft fuch as is now in
ufe),  was not  mentioned;  their cotemporary writers
on the Materia Medica, evidently defcribe the Peruvi-
an Bark of that  period,  as of a larger kind, of  more
compad pieces, and of the colour of the ruft of iron,
which marks are  very expreflive of the Red Bark ;
the innermoft coat of which has an  ochrey appearance,
and its refinous or middle layer refembles very much
the Lapis H<ematitis*.  M. La Condamine expreffed
his furprife, when he was  told by Mr. Thomas  Bla-
chynden, Diredor oftheEnglifh  South  Sea  Com-
pany,  at Panama,  that the writers on Pharmacy and
Materia Medica in England  had  preferred the  Small
and Quill Bark,  while the inhabitants-of New Spain,
                                              held

  * Cortex crafiitiemediocri, foras fcaber, paululum canefcens, a!i
quando mufco obduftua, intus laevjs, coloris  ferruginei, faporis acr's
et intenfe amari. Autumno colligitur et cortex circumcirca dehbra-
tur, tam trupci quam ramorum.
                   Datti Pharmacologic!, p. iqi. Anno  1692. 
[    8   ]
 field the larger Bark in higher eftimation. *  I can on-
 ly explain luch a preference from  this circumftance,
 that the  larger  pieces of Bark, which were imported
 into this country along with  the fmaller Bark,  were
 either of  a  fibrous,  fpongy,  or ligneous texture •, or
 probably, damaged  by moillure, and taken from  the
 decayed trees.
   Druggifts have fometimes  fuggefted this as an ar-
 gument  againft  the  ufe of the Red  Bark, and  many
 probably  endeavour to oppofe its introdudtion, until
 the quantity  in the  markets  be  greater, and  more
 equally divided among them, or until they have been
 able to. difpofe of the large quantity of common Bark
 they have in their  ware-houles.
   The tafte and" flavour of the Red Bark  is more dif-
 ficultly evolved, and is therefore at firft not fo obvious
'from the clofenefs of its texture, and from the refinous
 coat being (o well  defended and inclofed between two
 other layers.  It is evidently  heavier than any  other
 kind  of Bark, and feems to have  been prepared and
 dried with  greater attention,  its original  appearance
 and form being better preferved.
    I think it probable from  a  more attentive  view of
 the fubjed, that it may be the Bark of the trunk, or
                                                  larger

   * They commonly reckon three fpecies of the Quinquina,  though
 fome make four ,• the white, the yellow, and the red; I was told at
 Loxa.that thefe three  kinds differ in their vixtue only; the white
 having fcarce any virtue, and the red excelling the yellow.
   The  trees from whence the firfl Bark was taken, which were very
1 large, are all dead, having been  entirely (tripped, which infallibly
  kills them when they come to be old.  Experience has fliewn, tha*
  Gripping kills fome of the young ones alfo, but the greateft part efcape.
  For this operation they ufe a common knife, which they hold »n both
  hands ; the barker flicks it into the bark as high as he can reach, and
  fo draws it downwards  as low ar, he can.  It does not appear that the
  trees which grow where the old ones flood, have lefs virtue than they,
 ■the (ligation and foil being the fame; the difference, if there be any,
  may arife, perhaps, from the different ages of the trees.  Few but-
  young ones are now to be met with : I do not  remember to have
 1 feen any much thicker than my  arm, or above iz or 15 feet high;
  thoi- which are cut voung, (hoot forth new branches from the Rumps.
                                                   I was 
t    9    ]
 larger branches of the tree, and  I am the  more con-
 firmed in this opinion  by the ideas of my friends Dr.
 Withering and Dr. Fothergill, conveyed in their let-
 ters vj me,  in which  they obferve,  that the efiential
 and adive parts of the  Oak Bark are more entire, and
 in larger quantity  in  the trunk  and larger branches,
 than in the twigs  or fmaller branches, which are com-
 paratively of an imperfed growth ; perhaps the Small
 and Quilled  Bark may be procured from younger trees,
 not yet arrived at  their  full  maturity, and  therefore
 yielding a Bark of a weaker quality *.
   I am joftified very much by the analogy  of other
 Barks, and  by the influence of foil  and expofure,  in
 changing the appearances, and even of  affeding the
 virtues of the fame fpecies of  vegetables,  to conclude,
 that  the diverfity  both in fize and colour  of the Red
 Bark from the common Peruvian Bark,  may depend
                           B                       either


  I was informed atLoxa, that heretofore they preferred the coarf-
 eft Bark, and laid it by as a rarity, but now the fineft is moil  efteem-
 ed : The merchants may poflibly find their account in it, as  it takes
 up lefs room in  packing. But a Direftor of the Englifh South Sea
 Company at Panama,  through which all the Quinquina that comes
 to Europe muft  pafs, affured me, that  the preference given at  prefent
 to the fine Bark, is in con/equence of  feveral chymical analyfes and
 experiments which have been made on both forts in England.  It
 feems probable, that the difficulty  of thoroughly drying the large
 coarfe Bark, and the humidity it is naturally apt to contraft  and re-
 tain, has helped  to bring it into difrepute.  Vulgar prejudice will have
 it, that tolofe nothing of its virtue, the tree fhould be barked in the
 moon's decreafe, and on the eaft fide.   Thefecircumfiances, as ajfo its
 bei^g gathered on the mountain of Cajanuma, were certified by a
 Notary in 1735, where the Marquis de Caftlefuerte procured a quan-
 tity of Quinquina from  Loxa, to carry to Spain on his return.
                             Memoir de  I9 Acad. d. S.  1738.

  * Mr. Arrot, a Scotch Surgeon, who had gathered the Bark in the
 place where it grows, fays, that the fmall curled Bark fo much  efleem-
ed in England, is the Bark of younger trees, which frequently reco-
 ver the Barking,  while the older trees never  do.  This affords a
ftrong proof, that the early bark introduced into Europe was of the
larger kind, and from the older trees,  while the difficulty  of procur-
ing it, has been  the means of introducing a fmall and younger Birk.
Mr. Arrot, and every other Traveller agrees in preferring the Red
 Bark to any othej.
                             $ncjchf*4ia. Cortex. Vol, I. 
[  io   ]
either on the lafgenefs of the branche's, or on other
circumftances  not neceiTarily implying  a fpecific dif-
ference  in the tree.—On comparing the larger Bark
of the Oak with its  twig Bark even colleded from the
fame  tree,  I  find  the  former of a reddifh  colour,
while the latter is  much paler, the roughnefs of the
coat of the larger Oak Bark  and its general appearance
may be compared to that of the Quill  Oak Bark, as
the Red Bark  is to  the common Peruvian Bark •, and
I  have  not only learned from confulting Tanners on
this fubjed, that  the larger  Bark is  fuperior in its
powers as an aftringent; but  I have found by com-
paring infufions of both, and fubmitting them to the
moft decifive experiments regarding their aftringcncy,
by adding to them folutions of iron, that the precipi-
tates were pf a blacker colour and in greater quantity,
 from the larger and more compad pieces of Bark,
 than from thetmaller twig Bark.—I have convinced
 many medical  gentlemen,  who have  feen my fpeci-
 mens of the Oak Bark,  that they tend very much to
 illuftrateand confirm the opinion that the Red Bark  is
 the Cinchona Officinalis of Linnaus.
   The following  defcription  of the Peruvian Bark
 taken from Pomet is likewife  a further confirmation
 of this dodrine ;—" The  Kinquina  is the bark of a
 lt  tree that grows in Peru,  in the province of  ^uitto,
 "upon the mountains near the city of Loxa.   This
 *4' tree3is almoft the fize of a Cherry-tree, the leaves
 *c  round and indented •, it bears a long reddifh flow-
 «•'  er, from whence arifes  a kind of pod, in which is
 ^  found a  kernel  like an  almond,  flat and white,
 «*  cloathed with  a flight rind  -,  that Bark  which
 «*  comes from the trees at the  bottom of  the moun-
 u tains is thicker,  becaufe  it receives in more  nourifh-
 ** ment from the earth  ; it is fmooth, of a whitifh yel-
 " low without, and of a pale brown within.   That
 « which comes from trees on the top of the moun-
 « tains  is  abundantly  more  delicate ; it is  uneven,
                                         " browner 
[    »    ]
 " brov/ner without, and of an higher colour within ;
 " but  the trees  which  grow on  the  middle  of the
 ?' mountains, have a Bark yet browner than the other
 " and  more  rugged.   All  thefe Barks are bitter, but
 " that from the trees at the bottom of the mountains,
 €< lefs than the  others.
   *' It follows from hence, that the Bark of the leaft
 " virtue, is that which grows in the loweft places, be-
 *' caufe it abounds more with earthy and watry parts,
 " than  that  which grows high, and  which for the
 ?c contrary reafon is better •,  but the beft of all is that
 " which grows  in the middle of the mountains, be-
 " caufe it has not too much or too little nourtfhment.
 " There is another kind of Bark  which comes from
 " the mountains of PetoJi> and is browner, more aro-
 " matic, and bitterer than the former, but abundant-
 " ly fcarcer than any of the reft.
   " The conditions or qualities we ought to obferve
 <£ in the  Bark, are, that it  be heavy,  of a firm fub-
 " ftance, found and dry.  Beware of  fuch  as is rot-
 " ten,  and will link in water prefently, and that flies
 " into duft in breaking, or  is dirty and unclean, as ic
 " happens to be fometimes •,  but make choice of fuch
 " as is in little thin pieces, dark and blackilh without,
 " with  a little  white mofs, or fome fmall fern-leaves
 " (ticking to it, reddiih within, of a bitter  and difa-
 " greeable  tafte ; and  refufe that which  is full of
 " light chives when broke and of a ruffet colour, and
 " take  care that there be not fevxral pieces  of wood
 " mixed with it, which you have more of fometimes
 " than  the Bark.
   " This was brought firft into France  in the year
 " 1650, by the  Cardinal Lago, a Jefuit, who having
" brought this  from Peru,  it was  had  in fuch  vogue
" in France, as to be fold  weight for  weight  at the
" price of gold."
  I have fince the publication of the firft edition of
this trcatife,  extended my enquiries into other  coun-
                                             tries, 
[   M    1
tries, from which  I  am convinced that there cannot a
doubt be entertained of its being the Cinchona Officinalis*
I have  a fpecimen of the Red Bark which was given
me by  Mr. Babbington,  the Apothecary  of Guy's
Hofpital-^-it contains in it a branch of  Quill Bark,
exadly as it was imported.
  I have  feen fome fpecimens of Red Bark fo ve*ry
large, that, they contained a great proportion  of woody
part, and therefore lefs fit for ufe than thofe of a more
moderate fize ; indeed from  having made  fuch  fre-
quent  experiments  on this fubjed,  I am  able with
great precifion to afcertain the comparative quantity
of refia in any two pieces of Bark from their external
appearance.
   It has been  fuggefted by  fome,  that the Red Bark
refembled much the mahogany Bark  ; but having ex-
amined that Bark, and having converfed with  perfons
to whom it is  extremely  familiar, I am perfuaded that
there is no foundation for the opinion of its being the
fame.   If future naturalifts,  by having better oppor-
tunities of inveftigating this part of our fubjed, fhould
be perluaded  that it is the Bark of  a tree  of a diflfer-
rent genus,  or /pedes, from the  Cinchona  Officinalis,
fuch a difcovcry  cannot  invalidate  the proofs of its
fuperior efficacy ; and I fhould have been  happy Jiad
it been  found to  be the  produdion of anyof our co-
lonies,  inftead of its being as yet known  in  Europe
only as a  native of South America.  Several very in-
telligent men,  who were difpofed to  think  it the Bark
of a different tree, immediately changed  their opinion,
from examining ic in tindure, decodion, or infufion,
 in which  forms it conveys the genuine tafte and fla-
vour of the common Peruvian Bark,  under the ap-
pearance of a  much ftronger impregnation.   I fufped
that we have  been long in error by judging chiefly  of
the goodnefs of Peruvian Bark, from the colour of its
external coat.  I have feen  fome fpecimens of Red
Bark  extremely rich in refinous parts with a very
                                             white 
f.    n   ]
white coat, but whofe inner layers were compact,  and
of a dark  red or ochry colour.   I have examined
twenty  chefts of this Red Bark in the very ftate in
which it was imported, and there is always found a
very  confiderable t proportion of Quill Bark amongft
it.
  If the execution of this work was equal to  its  im-
portance, it would challenge the  attention of the pub-
lic, in a degree far above moft medical fubje&s.  This
will  be unqueftionably  admitted  by thofe who have
been  eye  witnefies to the malignancy and fatality of
intermittent and remittent Fevers, in every part of the
globe,  but more efpecially  in  warm climates ; this
fatality is by  no means  owing to the ignorance or un-
fkilfulnefs  of the praditioners in thole countries, but
to the inefficacy of the common Bark in  general ufe.
   The numbers who  fall a facrifice to the epidemic
and feafoning Fevers of warm climates, are  admitted
infinitely  to  exceed  thofe who  are  deftroyed by the
enemy.  In  almoft  all  the  dangerous  Fevers which
occur in our Eaft  and Weft  India fettlements, the
Bark is a principal remedy.  I think it therefore an
objed  of  the greateft   national importance, that our
 fleets and armies fhould be liberally fupplied with this
 Bark, which willTeldom or ever dffappoint them.
   I have been told by a drliggift, that its great adivity
 rendered it a dangerous remedy ; my anfwer was, that
 wine mixed with water was much fafer in the hands
 of an unfkilful praditioner, than wine alone, but that
 did not prove that wine was not a better cordial than
 water.   The fame reafoning may be applied to prove,
 that weak and  decayed remedies,  by  being  much
 milder in  their operations, are therefore preferable to
 fuch as are more perfed of  their kind.   I believe the
 general,  and  beft founded  complaint  is  againft the
 want of power and efficacy  of Bark, and not  that it is
 too powerful and adive.  In proof of this, I refer my
 readers to the letters annexed, which dernonftrace, that
                                              fuch 
[    14   ]
fuch was the ftubbornefs and obftinacy of the inter-
mittent FeveVs of the prefent year, even in this coun-
try,  that they refilled common Bark, and only  gave
way  to the Red Bark.
  Notwithstanding I formed very early a favourable
opinion of this Bark,  yet it fell far fhort of that
which I am juftified in maintaining, from the colleded
evidence  of fo many  gentlemen in diftant and remote
parts of the country.   Many letters which I have re-
ceived, are written with fuch zeal in favour of its fu-
perior efficacy,  that  they  could only  be didated by
the ftrongeft convidion, arifing from extenfive and
diligent obfervations.
  I  have perfuaded  many of  my medical friends to
ufe the Red  Bark in  our foreign  fettlements,  and   I
fhall take, pleafure in  communicating to  the public
the, refult of  their obfervations as- foon as I  am fa-
voured with  them.   A more powerful Bark is parti-
cularly defirable in thofe countries, where the violence
and  danger  of the paroxyfm is fo great.  In the fol-
lowing  obfervations,  I have confined myfelf very
much to the ufe  of  the Red Bark in febrile difeafes,
but  I am 'in pofTeflion of  many fads in proof of its
fuperior powers in other difeafes, in which the com-
mon Peruvian Bark has been found  ufeful.
   The  introdudion  of the Red Bark into  this coun-
try  was  the effed of  chance.  In the year  1779,   a
Spanim fhip from Lima, bound to Cadiz, was  taken
bv the Huffar  frigate, and carried into  Lifbon ; her
 cargo confifted chiefly of this  Bark,  fome  part  of
which was  immediately imported into this  country,
and  a confiderable quantity was bought at a very low
price at Oftend,  by  fome  of our London Druggifts.
The boxes in which it was brought to Europe were of
the fame kind as thofe in which the common  Peruvian
Bark was contained,   and  all fold by the general title
of Quinquina.  The  Druggifts in  whofe  hands the
Red Bark at firft was, found it difficult to difpofe of
                                               it, 
                   I   V5   3

it, its abearance was fo very unlike  that, of common
bark •,  at laft they offered it by way  of trial  to fuch
Apothecaries as refide  in  counties  where  aguesare
frequent; the fuccefs attending its  ufe foon  convin-
ced them  of its fuperior efficacy.   It- was early intro-
duced  into the hofpitals, and its  greater powers be-
came  univerfally acknowledged.   It has  continued
ever fince in general ufe in  the Hofpitals of  St. Bar-
tholomew, St. Thomas,  Guy, and the London.  The
reputation,  therefore, of the Red Bark ftands better
eftablifhed, and is  fupported by the concurring teifi-
mony  of more  Phyficians, than that of any  other arti-
cle of the Materia Medica.  I am allured by every
Druggift with whom I have converfed on the  fubjed,
that the demand for it in this country is preffing and
general.   I  am likewjfc informed,  that the  markets
may be wellfupplied with it;  and,  as  it is no longer
in the hands of a  few dealers,  the prejudices of  the
Druggifts have fubfided,  and I have lately heard no-
thing  of its deftrudive qualities, which were faid to
have arifen from its fuperior powers.
   Being highly fenfible of the difficulty of eftablifh-
ing fuch fads, either on the effeds of remedies, or on
any branch  of medicine which regards the  animal  ce-
conomy,  I,have folicited the opinion of many ingeni-
ous and attentive praditioners, who from their fuua-
tion have had frequent opportunities  of  trying  the
 Red Bark.   This caution  appeared  the more necefla-
 ry, becaufe I am well perfuaded that the love of no-
 velty,  and too great a credulity in admitting fads on
 very  doubtful authorities, have corrupted  medicine
 more than any other fcience, and proved  more inju-
 rious  than the moft abfurd and fanciful  theories,  the
 errors of which are eafily deteded.
OF 
[   i«   1
       OF ITS  SENSIBLE QUALITIES.

   THE Red Bark is in much larger -and thicker
 pieces than the common Peruvian Bark.   It evident-
 ly confifts of three diftind layers.   The external, thin,
 rugged,  and  frequently covered with a mofTy fub-
 ftance, and of a reddifh brown  colour *.  The mid-
 dle* thicker,  more compad, ana1 of a darker colour/
 In this appears chiefly to refide its  refinous part, be-
 ing extremely brittle, and evidently containing a larger1
 quantity  of inflammable matter than  any other kind
 of Bark.
   The innermoft  has a more woody  and fibrous ap-
»|iearance, and is of a brighter red than the former.
   The intire piece breaks in  that brittle manner de-
 fcribed by writers on the Materia Medica, as a proof
 of the fuperior excellence of the Bark.
   In  reducing it to powder, the middle layer, which
 feems to  contain the greateft proportion of refin, will
 not give  way to the peftle fo eafily as the other layers;
 this fhould be particularly attended to when it  is ufed
 in fine powder.   Its flavour  is chiefly difcoverable ei-
 ther in powder or folution,  is evidently more aroma-
 fic, and  has a greater degree of bitternefs  than the
 common Bark*      '
OF  ITS  CHYMICAL  AND  PHARMACEU-
              TICAL  HISTORY.

           EXPERIMENT  I.

  TO an ounce of Red Bark, reduced to a fine pow-
der,  were  added fixteen  ounces  of diftilled water;
                                              and

  * I have lately feen fome very good Red Bark whofe external coat
had a white appearance, though its internal furface is  of a deep red
coiour, extremely refmotis, compact, and heavy. 
[  >7  ]
and after  remaining together twenty-four hours in a
Florence flafk, the liquid was carefully filtered.  The
fame experiment  was  made  with  the Peruvian Bark
commonly in ufe.
  The colour of the two infufions  was very different,
that  made with  the Red  Bark being much deeper.
The tafte and flavour of the infufion of the Red Bark
were confiderably more powerful  than of the other.
In the opinion of many gentlemen who tafted the in-
fufions, the cold  infufion of the Red  Bark was more
fenfibly impregnated th^n even the ftrongeft decodion
of the common Bark.

        EXPERIMENT  II.

  TO  two ounces of the cold  infufion of Red Bark,
were added twenty drops of the  Tintlura Florum Mar-
tialium.  It immediately became of a darker  colour,
foon loft its tranfparency,  and after a fhort time pre-
cipitated a black powder.

        EXPERIMENT   III.

  TO two ounces of the cold infufion of the common
Bark were added twenty drops of the Tintlura Florum
Mar tialium in the fame manner as to the other.   It re-
tained its tranfparency fome time,  and afterwards  be-
came of a dark colour, but there was no precipitation
from it as from the laft.

        EXPERIMENT  IV.

  TO  an ounce of  Red Bark, reduced to a eoarfe
powder, were added fixteen ounces of diftilled water,
and after  boiling until one half was  evaporated,  the
liquid while hot was (trained through a piece of linen*
The fame experiment, under  fimilar circumftances,
was made with the common Bark.   The fuperior tafte
                        C                    and 
[   i8    ]
and flavour  of the decodion of the Red Bark was
equally obfervable with that of the infufion.  The de-
codion of the Red Bark, in  cooling,  precipitated a
larger quantity of refinous matter than the decodion
of the common Bark.  The difference of colour was
likewife very diftinguifhable.

         EXPERIMENT   V.

  To  an ounce of Red Bark,  reduced to a coarfe
powder, were added eight ounces of proof fpirit, and,
after landing a week together, the Tindure was fil-
tered.
  The fame experiment, under fimilar circumftances,
was made with the common Bark.   The Tindure of
the Red Bark, both when  tafted by  itfelt  and  under
precipitation j?y water,  had  more  flavour and tafte
than that of the Common Bark.
   The Tindure from the Red Bark  is of a much
deeper colour than the other.

         EXPERIMENT  VI.

   To each reftduum of the above  Tindures were added
 eight ounces of proof fpirit, which were infufed in a
 moderate fand heat for the fpace of twenty-four hours,
 and afterwards allowed  to  remain  together a week,
 occafionally  agitating them.   The Tindures were
 then poured off, that of the Red Bark evidently ap-
 pearing to be the ftrongeft.
   The Tindures both  of Experiments  V. and VI.
 were by a gentle heat evaporated to  the confiftence of
 a refinous extrad.
   The extrad from the  Tindure  of the Red Bark
 was of a fmooth, homogeneous appearance, not un-
 like  the  Balfam  of Peru, when thickened : The fla-
 vour and tafte  of the original  Tindure were imirely , ,
 preferved in it,                                   ♦
                                             The 
[    19    ]
   The extrad  from the Common  Bark  had a very
different appearance.  It feemed coarfe and gritty, and
by ho means fo charaderiftic of its original Tindure.
   The  quantity of extrad  procured from  the Red
Bark  was  confiderably greater than  from  the fame
quantity  of common Bark •, but  as  the rejiduum of
neither was rendered entirely inert, the abfolute quan-
tity could not be afcertained, *


          EXPERIMENT   VII.


    A tea fpoonful of each of the  Tindures, prepared
by Experiment V. was added to two ounces of water;
the refinous precipitation from the Red Bark  was not
only more copious,  but  fell  more quickly to  the bot-
tom of the glafs  than  that from the other,  and  yet
what remained (till diflblved  in the water, was infinite-
ly  more  in the Red  Bark than  in the common Bark,
fo far as we could judge from the tafte  and flavour of
both.

                                EXPERIMENT

  * To 26  lb. of Red Bark were added 26 gallons of proof fpirit,  af-
ter remaining, together for fome time the  Tincture was poured off,
and fubmitted to a diftillation in a water  bath, the quantity of fpiri-
tous extract obtained was 12 lb. and a half  ; a quantity of water be-
ing poured on the re/tduum of the Tincture, the watery extract ob-
tained was 4 lb.
  In another experiment with 30 lb.of Red  Bark, of an inferior qua-
lity, treated in the fame manner as the former, only n lb. and a half
of fpiritous extract was procured, and-4 lb- and a half of watery ex-
traft.
  To the fame quantity of the belt  Peruvian Bark hitherto in ufe
giv^s from 61b. and a half to 71b. and a half of fpiritous extract.
  It may be proper to obferve, that the  facts here mentioned are on
the authority of a very eminent druggifi, who had accurately marked
the quantity of extract obtained by the  ufual procefs from a given
quantity of Red Bark at  two different  trials; the reader will like-.
wife obferve, that although the fpirit employed for miking the Tinc-
tures may have been faturited  with refin,yeta frefh quantity  was
notpouredon  the refiduum, which by  extracting the whole relm
would have yielded  alarger proportion of refinous extract, andcon-
fequently left little or nothing for the watery extract.  Though thefe
experiments were not made  with any view to a philofophical pur-
pore, yet I  am  fufficiently convinced of their accuracy; they are
more conclulive than experiment: conducted on a.much fm.allee
fcale. 
                   [    20   ]

        EXPERIMENT  VIII.

  In  imitation  of the experiments of my ingenious
friend Dr. Percival, I added to two ounces of the wa-
tery infufion of each. Baric  a  few drops of the Sp.
Vitriol, ten.   The acid loft its>tafte more in the iniu-
fion of  the Red, than  in the common Bark, fo that
there  were more obvious  appearances of  its  being
neutralized.

        EXPERIMENT  IX.

  A decodion of both Red  and Common  Peruvian
BaFk  was prepared by taking an ounce  of each and
boiling  them in  a  pint and  a half of water, to one
pint  ♦,  the  former had  greatly the  fuperiority  in
ftrength and power, as mentioned in a preceding Ex-
periment.   A  pintoffrefh water  was added to each
decodion ; the boiling ftill continued till that quanti-
ty was evaporated.  The decodion of the common
Peruvian  Bark feemed gradually  to lofe  its fenfible
qualities, while that of the Red Bark ftill retained its
own.
  The fame quantity  ©f water was added  as before
to eacli, and the decodion repeated until a gallon-of
water was exhaufted ;  at the expiration of which time,
the common Peruvian  Bark was  rendered almofttafte-
Jefs ;  the  Red Bark  ftill retained nearly  its former
fenfible  qualities.   This  experiment proves that the
common pradice of boiling the  Bark is hurtful to its
powers.
  By my defire Mr. Skeete,  a very ingenious and at-
tentive young gentleman  from Barbadoes,  and  a-ftu-
dent of medicine in Guy's Hofpital, made feveral Ex-
periments in order  to afcertain  the comparative an-
tifeptic power of Red Bark, with the common Peruvian
Bark; and he found  that the infufion of  Red Bark
preferved animal matter much better,  and for  a lon-
                                             ger 
t    «   I
ger time, than the infufion,  or  even decodion of the
common Bark,  indeed,  the decodion of- common
Bark,  after its  powdery part  had  fubfided,  was
lefs bitter, and preferved animal mauer for a fliort-
er time than the  infufion of the  fame Bark.  His
experiments were conduded wifh great accuracy, and
the refult  of them were fubmitted to the examination
of many gentlemen at Guy's  Hofpital.
   The conclufions to which the above experiments
evidently lead, are,
   Firft, That the Red Bark  is more foluble than the
Peruvian IJark, both  in water and fpirit.
   Secondly,  That it contains a much  larger propor-
tion of active and refinous parts.
   Thirdly,  Tjiat its adive parts, even when greatly
diluted, retain  their  fenfible  qualities in a  higher de-
gree than  the moft  faturated folutions of common
Bark.
   Fourthly, That it  does not undergo the  fame de-
compofition of its parts by boiling, as the common
Peruvian Bark.
 (  Fifthly,  That  the Red Bark is more aftringent
than the common Peruvian Bark.
   Sixthly, That its antrfeptic powers are greater;  as
an additional proof of this  it may be proper to ob-
ferve  here,  that  both its cold infufion and decodion
preferved  entire their bitter and other medicated  pow-
ers in the month of June, in the Elaboratory of Guy's
^lofpital  for five weeks, and  perhaps for a much
longer time, while* a decodion of common Bark gave
evident marks  of a change in  a  few days.  In the
decodion  of Red Bark, the powder, which is feparat-
ed during the cooling of it, remains intimately diffufed
through the liquor,  which therefore  continues loaded
and turbid when at  reft.  In the decodion of com-
mon Bark,  the  powder quickly  fubfi.des  to the bot-
tom, the Red Bark therefore contains in it a large pro-
portion of mucilaginous parts, fuch as have been pro-
r                     r              '  '    pofed 
[   42    I
pofed by the late Dr. *Fothergrll,  to be  added to the
decodion  of  the common Peruvian Bark,  in  order
that it may remain turbid when at  reft,  and thereby
that its refinous parts be more  perfedly fufpended in
the body of the liquor.  It is  obvious, that this cir-
cumftance will favour exceedingly  the adion of the
ftomach upon it.
   The advantages therefore to  be expeded from the
Red  Bark cannot  be obtained  from any quantity of
common Bark, the beft common Bark, compared with
the Red  Bark appears rnerte and effete.
   All the above evpe hnents were executed in the
prefence of feveral Gentlemen.
   I was led  more particularly  to profecute this fub-
jed, from an opinion that the Red Bark might fo im-
pregnate cold water by  infufion,  as to cure  Intermit-
tent Fevers with more  certainty than  could be done
even  by the  decodion or powder of common Bark:
The fenfible  qualities  which appear from the above
Experiments,  being fo much  greater, in the cold in-
fufion of the one than in the decodion of the other.
   It cannot I think be  denied,   that the Experiments
above related, and which have  been executed and fre-
quently  repeated  with great   accuracy, fufficiently
prove, that the Red Peruvian Bark, exceeds  the other
in its fenfible qualities, and that it contains a much
larger proportion of thofe refinous and adive parts on
which the power and efficacy V>f Bark  have been by
all writers on the practice of medicine and Materia Me*
ilca believed to fj":Kiid.
OF THE  GENERAL OPERATION OF BARK
         ON 'THE  HUMAN BODY.

  T H E following remarks are intended to appiy to
rive Peruvian Bark, generally in ufej  but I am certain
                                             d%t 
C   *i   1
that the effeds enumerated  are found to be produced
[n a much  higher degree by the Red Bark.
  The cold infufion of Bark feems evidently to pro-
mote both appetite and digeftion,  it increafes the tone
and adion of the  ftomach, by which the gaftric li-
quor, the  great  Menfiruum of our folid aliment,  is
more perfedly prepared.
   In  moft cafes,  the  Bark rather promotes coftive-
nefs,  the common effed of ftrong and vigorous inte-
itines.  In very  large dofes, however,  it generally
proves purgative, but  this effed ceafes after  a fnort
time.
   It renders the  pulfe ftronger and  fuller in  health,
and in moft difeafes unaccompanied with Fever.
   In Low and Malignant Fevers,  and more efpecially
under remiflion, it renders the pulfe ftronger and even
flower.
   In  particular circumftances of  Fever marked with
debility and a tendency to remifiion, though of a very
irsegular type, it diminilhes febrile heat.
   It encreafes the animal heat  and aggravates every
fymptom, in Fevers accompanied either with  much
local  inflammation, or  a general inflammatory  diathe-
tic, which is ftrongly indicated by the pulfe, the man-
ner of the original attack, the want of due  freedom in
the fecretions, and the painful and oppreffive exerciie
of every fundion.
   It checks profufe and colliquative difcharges, efpe-
cially thofe by the fkin, while it does not  feem to di-
minifh infenfible perfpiration, or other natural  evacu-
ations.
   It  checks every tendency to putrefadion or gan-
grene, occurring under circumftances of debility, but
it may promote both, if injudicioufly employed, while
the adion of the fyftem is too violent,  or the inflam-
matory diathefis is too prevalent.   It feems more rea-
fonabl; to refer its adion, as an antifeptic,  to its tonic 
                    [   24    3

power on the moving fyftem,  than to any primary
adion on the animal fluids.
  .Perhaps this dodrine  will apply  in explaining the
hjftory of remedies ufed in the  Scurvy, a difeafe invit-
ed and favoured by every means  which can  induce de-
bility, and evidently preceded  by fymptoms of a di-
minifhed vis vit<s which neceftarily lead to others that
in a fecondary manner only take place in the animal
fluids *.
  It promotes under many circumftances a favourable   '
fuppuration, and improves the nattfrc of fanious and
ichorous difcharges.
   Us adion here can only be explained from its gene-
ral  tonic power, for either general or local debility re-
tards  fuppuration,  and favours the obftinacy of ill-
conditioned ulcers.
   Upon tlie fame principle its power of promoting the
generation  of true  pus in the fmall-pbx may be ex-
plained.
   The  period of debility is that only in  which fhe
Bark  fhould be employed.
   I have feen patients under the moft confident Small
Pox require Bark in the progrefs of fuppuration, and
yet, in  the  more advanced ftate Of the difeafe,  the
fame  perfons have been faved  by the feafonable and
repeated ufe of  the Lancet in the fecondary Fever,
which attacked  with  freih rigors and inflammatory
fymptoms of a true Peripneumony.
   In  delicate and irritable  habits,  which feem more
efpecially to favour  fcrophulous affedions,  and which
produce inflammation of a  peculiar nature, that gives
way fooner to tonics than evacuants,  the Bark has
been  found the  beft remedy :  this may  probably ad-
mit of  the explanation already given on the fubjed of
Scurvy.
                                              OF

  * Ah Enquiry into the fource from whence theSymptoms of Scur-
vy and of putrid Difeafes arife, by Dr. Milman. 
X   25   ]
OF ITS USE IN THE CURE OF INTERMIT-
                TENT FEVERS.

  WHAT  1 have to offer on this fubjed is the re-'
fult of  careful, and  diligent obfervation, totally un-
connede<i with  prejudice of any kind, in favour of
any particular theory, or a blind attachment to fyftem^
  Notwithftanding the cautious and timid praditioner
has very generally forbid the  ufe of Bark until eva-
cuations fhould have  been made -, I am very well.per-
fuaded from  obfervation, that in Intermittent Fevers,
fuch as rage and  are endemic, particularly in low and
marftiy fituations, and fuch as frequently occur on  the
banks of the Thames, and the lower parts of this me-
tropolis, the Bark cannot be given too early •, the  ufe
of emetics or purgatives, as preparatory, is not only
unnecefTary, but in fome cafes produdive of greater
debility, and therefore to be avoided.
  The dodrine of concodion, however juft it; may be
in continued  Fevers, and in fome cafes of inflammati-
on, does not apply iii Intermittents produced  by  the
Miafmata of low and fwampy grounds, and which  af-
ford the principal fource of  agues in the environs of
this city.
  In this opinion I am confirmed by the  teftimony of
Dr. Cleghorn and  others; who  frequently  found ic
neceffary to give it on the firft acceflion of the difeafe,
in order effedually to obviate, or weaken the return
of a fecond paroxyfm, which in many cafes would  in-
evitably have proved fatal ;  and Dr. Lind  has very
properly obferved that  fuch fymptoms which have
been  attributed  to Bark, are rather the effeds of  the
paroxyfm being allowed to return, from the negled of
that medicine.
  There are many fymptoms  which would forbid  the
ufe of Bark, did they occur diftind and  independent
of Intermittent Fever,  fuch  as  Cough, difficulty of
                    D                   breathing 
[   **    1
breathing and pain in  the  fide : they  are frequently
brought on by the paroxyfm of Intermittent, and only
give way to the ufe of the Bark by which that pa-
roxyfm may be prevented.  Such fymptoms do not
admit of a diftind and feparate treatment, but arc al-
ways aggravated by the ufe of evacuants, more efpe-
cially bleeding, the moft probable means of relief in
common Depuratory Fevers.
   I have  fometimes found a complication  of Inter-
mittent and Hedic Fever in the fame perfon and could
diftinguifh between the paroxyfms  of each ;  the Bark,
while it cured the Intermittent, has  even moderated
the Hedic ; though Hedic  Fever of itfelf,  efpecially
as a fymptom of Phthifis  Pulmonalis does not appear
to give way at any  time under the ufe of the Bark ; I
think  it probable,  therefore, that although in the
treatment  of  intermittents, complicated with other
difeafes, our chief attention mould be firft direded to
the cure of the intermittent, yet it may be neceffary to
purfue an indication that may have in view  the  other
disorders, not incompatible with the treatment of the
Intermittent.  In Dropfies, which accompany Inter-
mittents, I have found more  benefit  from the ufe of
Bark, joined to the neutral  falts,   and  other  mild diu-
retics, than from adive purgatives, which always tend
to protrad the Intermittent.  Every returning parox-
yfm of an ague confirms more and more the caufe of
that difeafe which it has produced.
   It is not intended to infinuate,   that no cafes do oc-
cur, in which  it may not be prudent to adminifter a
vomit, efpecially to perfons fubjed to bilious accu-
mulations in the ftomach;  but this  is  more with a
view of removing an obftacle to the operation of Bark,
than as neceffary to render it fafe ;  and I  have fre-
quently feen naufea and vomiting  fo much a fymptom
of the paroxyfm, that they gave  way only to the free
wfe of Bark itfelf.
                                        A pradice 
[   *7    ]
   A pradice  more abfurd than that  of preceding e-
vacuations has been adopted and recommended, viz.
That of evacuating by purgatives  after the cure had
been  compleated  by the  Bark,  this feldom fails of
bringing back the Intermittent, as one caufe of indu-
cing debility,  the "moft favourable ftate of the body
for the attack of Intermittent Fevers..
   In perfons who are rendered coftive by the ufe of
the Bark, I  would recommend the common pradice
of giving a few grains of Rhubarb, or Pilul Rufi.   If
On the other hand  it fhould prove purgative,  a few
drops  of the Thebaic Tintlure is  the ufual, and beft
means of checking that operation.
   Intermittent Fevers are frequently fo very anomal-
ous in their appearances, and afiume fo much  the
charader of other difeafes, that an unfkilful, or inat-
tentive praditioner may be deceived ;  they, however,
under  any  form  or  any type,  generally give way to
the Bark ;  fometimes  aided  and aflifted  by  other
means.
   Much experience is required todeted the paroxyfm
difguifed under different forms, and although the Bark
is  our  beft remedy, yet the violence of fome  fymp*
toms which  accompany the difeafe, and interrupt its
natural and ufual form, render it neceffary that other
remedies be occafionally employed,  as adapted to the
particular  circumftances of. the cafe; not always fo
much  with a view of rendering the Bark a fafe reme-
dy, as  of rendering it an effedual one.
   Such anomalous appearances are greatly influenced
by the  nature of the prevailing epidemic  of the fea-
fon, they more particularly interrupt  the  progrefs of
the cold fit, and  are generally much aggravated dur-
ing the paroxyfm of the Intermittent.
  The diforders which  I have feen complicated with
Intermittent Fevers have been chiefly thofe of a bili-
ous kind,  occuring in the autumnal feafon, fuch as
violent and excefiive vomiting, Diarrhasa, with pain in
                                              the 
[   **    1
the bowels, Cholera Morbus,  periodical Head-Aehs,
Pain in the  Side, and  frequent inflammatory difor-
ders, fuch as Pleurify, Peripneurnony, and the acute
Rheumatifm, and even fometimes fpafmodic difeafes,
terminating in apoplexy and death.
  Such difeafes have been fuppofed to be only varie*
ties of the Intermittent Paroxyfm, and have been be-
lieved to give way to the fame remedy which cures an
ague.
  I think, however, we have no analogy in nature  to
fupport this dodrine, and it feems  highly unreafona^
ble to fuppofe, that the fame caufe can produce fuch a
diverfity of appearances.  Indeed the  influence of the
prevailing epidemic difeafes  on  fporadic complaints
evidently fhew,  that the human body is fubjed to be
aded upon by more than one caufe  at a time,  and
that the remedies te be  employed fhould have a view
to fuch a diverfity of circumftances.   It therefore be-
comes  the objed of the phyfician to know which,of
two or more  difeafes are moft deferving of his early
attention,  Which the human body may labour under
ac the fame time.  He will generally  find, that as the
paroxyfm of  an Intermittent  Fever excites fuch vio-
lent  adion in the fyftem, and generally aggravates the
fymptoms of other difeafes,  it ought to be early re-
moved.
   In fome cafes however I, have feen fuch adive ap-
pearances of inflammation prevailing  in a perfon la-
bouring under an Intermittent Fever,  and fo much
encreafed in the hot fit, that unlefs a quantity of blood
had been  taken, which was always iizy, the patient
moft probably would have died.  Such^ fymptoms of
inflammation retard the cure of the Intermittent,  and
therefore are in the  firft inftance to  be removed.
   This may probably explain the reafon why inflam-
matory Fevers in their decline often afiume the appear-
ance of Intermittent difeafes.
                                               In 
[   *5>    ]
   In the fame manner it may be neceffary to remove
 Symptomatic  Vomiting,  Cholera  Morbus,  and the
 like, by remedies peculiarly adapted to thefe difeafes,
 before the ftomach will fo far  favour the  adion of
 Bark as to enable it to cure the Intermittent Fever.
   Peruvian Bark is chiefly adapted to the cure of ge-
 nuine and  idiopathic  Intermittent  Fevefs,  and not
 thofe of a fymptomatic  nature,  which frequently re-
 quire remedies of a different kind.
   It is impoffible in a treatife of this nature to point
 out more minutely the  circumftances which ought to
 regulate and dired the condud of praditioners in the
 treatment of complicated intermittents, and the con-
 dition of the  habit, which may render neceffary the
 previous life of other remedies, or the combination of
• them with Bark, in order to render its operation either
 fafe or effedual.
   It appears to  me, that the advantages at any time
 derived from the ufe of other remedies, depend upon
 their having removed fome other difeafe,  which may
 have protraded  the ague, or interrupted  the adion of
 JBark in the cure of the Intermittent, and not on their
 obviating future effeds which have  been falfely attri-
 buted to Bark, while they are chiefly produced by the
 obftinacy and imperfed treatment of the  Intermittent
 Fever.
   Both the Vernal and Autumnal Intermittents of Dr.
 Sydenham yield to it,  the  latter however fometimes
 with more obftinacy than the former.
   Jn feveral cafes I have experienced  the efficacy of
 the Red  Bark in  removing  Tertians and Quartans
 which had refifted the common Bark, this however  is
 not to be wondered at, when  we confider the diverfity
 in the power even  of different kinds of  the, common
 Bark in general  ufe.
   I hope I fhall be  excufed in digreffing  fb far, as to
 mention the ufeful effeds I have frequently experien-
 ce^ rr-?rr» the exhibition of Opium in Intermittent Fe-
                                             vers. 
                   [    3°   1
vers.   We are chiefly indebted for this pradtice to Dr.'
Lind.   It moderates fo effedually the force of the pa-
roxyfm, by fhortening the duration of the cold fit,  as
well as by diminifhing the violence of the hot fit,  that
I had often flattered myfelf,  it was capable of curing
Intermittents.   In this however I  was difappointed.
   From the experience of it in many hundred cafes, I
conclude  with  Dr. Lind,  4C That  an Opiate given
"  foon after the commencement  of the hot fit, by  a-
'4  bating the violence  and leffening the duration of the
"  Fever, preferves the conftitution fo  entirely  unin-
"  jured, that fince I ufed Opium in Agues neither a
"  Dropfy nor Jaundice  has attacked any  of my pa-
"  tients in thefe difeafes."  The  mam*^-;  in which I
employ it, is either by giving a grain of the Thebaic
extrad upon the acceffion of the cold  fit,  or twenty
drops of the Thebaic Tindure upon  the  acceffion  of
the hot fit,  the adion of the former being later from
its flower folubility.
   The Red Bark is fo much warmer than the other,
that it would feem to anfwer all the purpofes derived
from  the union of Cordials,  Aromatics, Serpentaria,
and the like, fo much recommended  in the obftinate
Quartan Intermittents of elderly people.
   Some difference  in  opinion has prevailed regarding
the manner of giving the Bark.   Moft praditioners
concur in thinking,  that it cures intermittents more
readily when taken in fubftance than in any  other form.
In this^ate, it  is both a bulky and .-.aufeous dofe in
the quantity neceffary to  cure an Initrar ttent; at any
rate, it ought rather to be diffufed \n fome liquid, than
given in the form of an elednary c; pals,  which are -
fometimes difficultly foluble.
   I have  found milk cover  the  tafte  of Bark, and
make it more acceptable to children than any  other
vehicle.  The extrad of Liquorice diffolved in wa-
ter, may be likewife  employed to cover  the tafte of
                                            Bark. 
I   31    ]
Bark.   Its tafte is alfo corrected by  wine,  efpecially
by Old Hock.
   It would appear from the general preference given:
to Bark in fubftance,  that its decodion, infufion, or
tindure>  are found too weak in any quantity for the
purpofe of curing Intermittents, otherwife as they are
much lighter to the  ftomach and  ad  more quickly,
they fhould be preferred.
   I hope to make it  appear, that in this refped the
Red Bark has the advantage of any other kind now in
ufe, fince  either its infufion or decodion will cure In-
termittents, and  its  powder in a much fmaller  dofe
than that  of common Bark will produce fimilar effeds.,
   The  beft time  for giving  the Bark  is in the inter-
miffion  between the paroxyfms and when the ftomach
is empty.   In Quartan Fevers, where there are  two
days of Apyrexia, we fhould be particularly defirous
of  getting down  a larger quantity on the day imme-
diately preceding the approaching paroxyfm, and in
other Intermittents as near the period of the returning
paroxyfm as the ftomach will bear it.
   A very prevailing  argument  in favour of the  Red
Bark has  been fuggefted to me  both  by apothecaries
and their  patients, viz.  that it  will cure  when taken
in half the quantity which has been found neceffary of
other Bark. I  am likewife perfuaded from a great va-
riety of trials,  that while other Bark only  gradually
weakens the force of the Intermittent Fever, the  Red
Peruvian  Bark will frequently obviate the return of  a
fecond paroxyfm. It is feldom I  have found  it ne-
ceffary to  give more than half a dram every  two hours
in the interval of the fit, and  in no one Intermittent,
even of a  Quartan type, have I found it neceffary to
give more than fix drams between the paroxyfms.  I
have frequently known double that quantity of com-
mon Bark"fail to produce the defired effed.
  It is however unneceffary to limit  the  dofe.   One
dram may be given every hour, if the ftomach will re-
                                              tain 
f.   3*   ]
tain it, and wiH perhaps in fome cafes remove the dif-
eafe more quickly  than a fmaller quantity given at
longer periods *.


The following f&Bs will beft determine how far Iamjuf-
  tified in favouring the opinion of the fuperior excellence
  of the Red Bark.

  Edward  Vircob,  aged 21, had laboured under an
Intermittent Fever five months.   It was firft a Terti-
an  and  afterwards  became a  regular Quotidian, ac-
companied with Cough, Dyfpncea, and Hoarfenefs,
particularly  in the paroxyfm.   The common Peruvi-
an Bark,  given  in  the dofe of one dram every hour,
prevented the return of the paroxyfm for a few days ;
the patient however relapfed nocwithftanding the  Bark
was continued,  he  was  at laft cured by taking one
dram of the Red Bark every fecond hour for thetpace
often days.
  It appears from the above cafe of Edward Virgoe,
and feveral others which have occurred to me,  that
Intermittent Fevers, which had refifted common  Bark
and other remedies,  have yielded to the  Red Bark,
even under very complicated  and  unfavourable ap-
pearances.
  In this opinion I am likewife juftified by the expe-
rience and teftimony of  many eminent praditioners,
and fo decided are they in its  favour, that the demaneV
for it every day increafes, efpecially in  fome  of the
neighbouring counties where Intermittents are  not on-
ly more frequent, but more obftinate.

                                          I began

  • I have likewife frequently  adopted the praaice recommended
by Dr. Home, of giving the Bark as foon as the fweating fit  of the
Fever has fufficiently Carried off the hot fit; this is particularly pro*
per  when the interval is  fhon between the parofcyfirt*. 
[   33    )
   I  began now to fufped that its powers were  even
fufficient in cold infufion  in moft cafes to cure Inter-
mittent Fevers, and in all  other cafes to anfwer every
purpofe which might be expeded from common Pe-
ruvian Bark, in any form in which it had hitherto been
employed.
 The following falls are fufficient to authorife this opinion]

   James Youngman, aged fixteen, had laboured un-
 der a Tertian  Intermittent many months; it was ac-
 companied with a fevere cough,  and his ftrength was
 confiderably impaired.   He was ordered co  take four
 ounces  of the cold infufion of the  Red  Bark every
 third hour ; after taking it for two days,  the parox-
 yfm did not return.  Its ufe was perfevered  in  four-
 teen days, and he continued perfedly well.

   Thomas  Pugh, aged twenty-two, from Woolwich
 in  Kent,  had  an  Intermittent  Fever of five weeks
 ftanding of the Tertian type, accompanied with a con-
 fiderable degree of cough,  occurring efpecially in the
 cold fit; he took the cold  infufion,  as  recommended.
 in the former cafe, after which time  he had only one
 flight return of the paroxyfm,  his cough is likewife
 totally removed.

   John  Welding, aged  twenty-five,  had an Inter-
 mittent Fever  at Sheernefs, for near  a year,  he  took
 large quantities of  common  Peruvian Bark,  without
 effed.   It was of  the Quotidian type.  After taking '
 a cold infufion of the Red  Bark in the quantity of a
 quart in twenty-four hours for three  days, the parox-
 yfm difappeared and  has  never fince  returned.  It
 proved at firft  purgative, but foon loft that effed. His
itrength and appetite were greatly improved under the
 ufe of the infufion.
                   E                       Since 
C   34    3
   Since the firft edition of this work,  I have had fre:
quent experience of the efficacy  of the cold infufion
in the cure of Intermittent Fevers,  but it requires to
be continued.for a greater length of  time than is ne-
ceffary, when  the Bark  is taken in  fubftance with
wine.  I have  however {een cafes  where the ftomach
had  rejeded the Bark in fubftance, which yielded rea-
dily  to the cold infufion when taken  in  the dofe of
four ounces, every two hours in the interval of the pa-
roxyfm.   I have likewife met with cafes  of  Intermit-
tent  Fevers fo  complicated with other diforders, as to
make it neceffary to ad  more gradually and cautiouf-
ly on the conftitution, by  the ufe of the cold infufion,
than by giving the Bark in fubftance  in the dofes ne-
cefTary for inftantly removing the  Intermittent Fever.
   As I. confider a perleverance in the  ufe  of the Bark
proper for fome time after the paroxyfm has been re-
moved, I think that it is  only neceffary  to  have re-
courfe to the  cold infufion for that purpofe, and it will
be found a much more agreeable  preparation than any
other.   I have found great benefit from continuing its
ufe in the convalefcent ftate of perfons after Intermit-
tent  and other Fevers.
   I  could here enumerate a  great  variety of cafes
which have occurred to me,  both in  public and pri-
vate pradice, in confirmation of the general dodrines
I have now laid down,  but I think it better to men-
tion  the general refult of a fuccefsful pradice.
   The cold infufion employed in the  above cafes was
prepared by pouring  a  quart of cold water on two
ounces  of the Red Bark in fine powder, frequently
agitating them for the fpace of twenty.four hours *.

                                               OF


  Tj .*k°ugh :he cafe;, ibove n.-stioned, evidently prove that the
cold infufion will curs Agues, yet they are not intended  to divert the
attention from other more effectual means of giving^his medicine. 
r   35    i
 OF  ITS  USE  IN  THE  CURE OF OTHER
                    FEVERS.

   Remittent  Fevers  are  frequently equally fteady in
 their periods of remiffion and  acceffion with thofe of
 the intermittent kind, but the Apyrexia being lefs per-.
 fed and complete, has given rife to many doubts  re-
 garding the fafety of giving Bark.  As remittent Fe-
 vers are more particularly marked by appearances  in-
 dicating the prevalence of bile in the ftomach ;  the
 propriety of giving an emetic, prior to the ufe of the
 Bark, feems  well founded,  and the remiffion is fre-.
 quently rendered more complete by fuch a pradice.
   In the remitting fevers, however, of warm climates,
 the acceffion of the paroxyfm is fo extremely violent*
 and the ftrength of the patient fo  quickly exhaufted,
 that ic becomes abfolutely neceffary to catch the firft
 opportunity of the moft trifling remiffion, and to give
 the Bark with the fame freedom that you  would do in
 common Intermittents.
   In Remitting Fevers,  the concomitant fymptoms
 are more to be regarded than in Intermittents, becaufe
 they more efpecially difturb, interrupt and fhorten  the
 periods of remiffion ;  even in  the warmeft climates,
 and under the fevereft  prejudices,  it has been found
 neceffary to take away a few ounces of  blood to re-
 lieve pain in the head, oppreflion in breathing,  an  in-
 tenfe dry heat on the fkin,  and  other fymptoms pro-
 trading the paroxyfm -, by fuch means the remiffion
 has been brought on, and the Bark given  with greater
-effed.
   The Fevers of this country feldom have regular re-
 miflions, until they have been .properly treated by e-
 vacuations j  the inflammatory by bleeding,  and  the
 bilious by vomiting and purging.
   When Fevers are brought into  a  ftate of obvious
 i-emiffion j that is, when the pulfe becomes from ten
                                               to 
[   3«   1
to twenty flower at fome particular time in the twen-
ty-four  hours; when the reftlefsnefs,  anxiety, and
tendency  to  delirium  abate;  when  the  mouth and
fauces are moift ; when the organs of fecretion, and
efpecially the fkin are more open and pervious,  fuch
fymptoms of remiffion admit the ufe of Bark with the
fame freedom as in Intermitting Fevers.
   The Acute  Rheumatifm,  notwithstanding  its in-
flammatory attack, and the appearance of the blood,
and though the joints often continue  inflamed feveral
weeks, very early affumes the  form  of a Remitting
Fever.
   Under fuch circumftances,  a perfeverance  in the
Antiphlogifiic plan is generally found to be ineffedual.
I have in feveral cafes of this kind, employed a cold
infufion of the Red  Bark, and the difeafe feemed to;
give way only \6 this treatment.
   The Acute Rheumatifm in  its  remiflions affumes
the form of a double  Tertian,  and the patient is fre-
quently-greatly exhaufted by  the profufe  fweatings
which terminate the paroxyfm.
   It is in fuch cafes that I would particularly  recom-
mend  the ufe  of Bark.   I  have found  this pradice
more fuccefsful,  and it muft  be allowed  to  be more
rational, than the ufe of Volatiles and Guaiac.
   The tedioufhefs, as well as the inefficacy of the an-
tiphlogiftic pradice  in  the cure of the Acute Rheu-
matifm, has frequently direded my  attention to that
difeafe in a particular manner,  and after being repeat-
edly  difappointed  and diffatisfied  by  purfuing the
ufual mode of  treatment  recommended  by the beft
writers,  either antient or  modern, on the  fubjed, I
was  determined to adopt other means, which I think
have proved more fuccefsful.   The Rheumatic Fever
appears to me, notwithftanding the violence of its in-
flammatory fymptoms,  to be an Intermittent Fever in
a ftate of difguife, and  its periods are evidently,  as  I
have already  mentioned,  thofe of a  double Tertian.
                                              Its 
[   37    1
Its inflammatory fymptoms, however, ought in a cer-
tain degree to be  reduced by modarate  bleeding, oc-
cafional purging, and great  dilution, before it can be
treated as an Intermittent Fever •, it does not however
appear to me incompatible  with the ideas of its being
inflammatory, to have recourfe to the moderate ufe of
the Bark, to obviate the weaknefs which may be  in-
duced by the  neceffary ufe of the lancet, nor does it ap-
pear repugnant to the idea of its  being  intermittent,
that the  inflammatory fymptoms which render the in-
termittent anomolous  and  irregular,  fhould be mo-
derated  and  checked by an  antiphlogiftic treatment
accompanying the ufe of Bark.   I have found in many
cafes  by this pradice,  the Rheumatic  Fever greatly
fhortened, arid  the debility and torpor  in the joints,
which is frequently the  effed of that difeafe, together
with the difpofition  to  the Chronic Rheumatifm, ge-
nerally prevented.   The Acute Rheumatifm appears
from the ftate  of the pulfe,  the tendency to profufe
fweating, the depofition in  the  urine, the frequent ac-
ceffion of chilly paroxyfm to be an Intermittent Fever,
which is probably prevented  from affuming the more
ufual and natural form  of that difeafe by the inflam-
matory adion on the joints, which I have fometimes
feen merely local, (i. e.) unaccompanied with any gene-
ral Inflammatory  Fever in  the habit :  in fuch cafes,
while leeches have befn applied to the joints,  and  the
hemorrhage  from them encouraged by fomentations,
I  have given Bark freely,  which I have never known
to increafe the inflammatory fymptoms while the ufual
means  of promoting   inflammation  were  guarded
againft.  General and vague maxims, appfifed  in rea-
foning on the adion of Bark, and its tendency in all
cafes to  promote inflammation are therefore ill found-
ed,  and had they not been correded  by experience
and obfervation,  would have  deprived us the advan-
tages we have  derived  from the ufe of this  medicine
in  the  cure  of  Rheumatic Fevers, Scarophulous In-
                                       flammation, 
[   3«    i
 flammation, and  perhaps  a great variety of other d if- '
 eafes,   I  have feen  in delicate and  irritable habits
 Rheumatic Inflammation on the joints, accompanied
 with a low Nervous Fever, which gave  way only to
 Bark and  Sedatives.
   In the  Rheumatic Fever I  generally begin about
 the  feventh day from the attack with the  cold  infu-
 fion of the Red Bark, in the dofe of three ounces every
 two or three hours, until the evening paroxyfm comes
 on ; nor am I,  by this pradice, in any degree, divert-
 ed  either  from, general or local bleeding, or evacua-
 tions  by (tool, when  the circumftances occur  which
 may render them neceffary.
  In  that  low Fever,  which Huxham has fo well de-
 fcribed  under the title of nervous,  I  have prefcribed
 the cold infufion of the Red  Bark with  advantage,
 where the  fkin hath been fofr, and the pulfe under one
 hundred and ten.
  In fuch  Fevers, it chiefly ads as a Cordial in  fup-
 porting the Vis Vit<£, and for which reafon I think ic
 may be given with advantage in the decline of all Fe-
vers,  even where the fymptoms on the attack of the
difeafe were evidently  inflammatory.
  Almoft every Fever remits in its decline.
  Fevers originally  putrid  and malignant, as arifing.
 from Miafmata and putrid vapour, very fiidom occur
in this C:ty, they  are  moft  generally to be found  in
Fleets and in  Camps,  and in fituations where air  (tag-
nates  or where  animal bodies are confined  in a  dole
place.
  In fu .h  Fevers, the  cure is effeded by vomiting and
warm Cordials  ; of the  laft is the Red  Bark in an
eminent degree.
  Ic may   be infufed  in  wine,  which will render its'
operation more analeptic.
  It intimately  unites with the feveral  aciris, from
which a very favourable operation in fuch cafes  may
bcexptded.    _ .-$«.    ,   .
                                                In 
t   39   ]
  In the Putrid Fever, attended with  a gangrenous
Sore Throat, I have in many inftances experienced the
efficacy of Bark, but care fhould be taken not to con-
found this difeafe with the Angina Mucofa of Dr. Hux-
ham, or the Angina Eryftpelatofa of Dr. Grant, dif-
eafes, though contagious, and accompanied with erup-
tions on the fkin, evidently of the moft inflammatory
nature, and requiring  the ufe of evacuations.
   In  Petechial fevers,  with fymptoms of. great pro-
ftration of ftrength, I  have  frequently feen the pulfe
not much quickened, and the animal heat very little
encreafed.  In fuch cafes  I would recommend the ufe
of the Red  Bark infufed in Old Hock.
   I have feen a Jail Fever with no other diftinguifh-
ing fymptoms than Petechiae and Debility •, the tongue
ciean,  the pulfe moderate though fmall, and the fe-
cretions apparently not difturbed.   In that cafe, blis-
ters  on the  extremities, Bark and Wine, are the beft
remedies.
   In general, we find  that Fevers marked with fyra-
toms of debility are chiefly found to remit, and there-
fore they admic of the ufe  of Bark ;  by iricreafing the
tone and  vigor of the fyftem, it oppofes a  returning
paroxyfm.
   Fevers of more violent adion, fuch as we denomi-
nate inflammatory, do  not remit at leaft fo obvioufly,
until that adion is moderated by Evacuations, fo that
they chiefly remit only in their decline.
   The primary attack of moft Fevers in  this country,
is attended with violent adion, which is beft moderat-
ed fometimes  by  |he prudent ufe of the lancet, but
moft frequently, by the Tart. Emetic,  with  the infu-
fion of Sena and fome  of  the  neutral falts.  All Fe-
vers beginning with a violent Rigor,  and followed with  .
great heat, require  early evacuations,  while fuch  as
creep on flowly and imperceptibly  in the beginning,
with giddinefs in the  head, rather  than acute pain;
much  anxiety and watchfulnefs, tremor  and debility,
                                              give 
C   40    ]
give way to Opiates,  Bark, Serpentaria  and Wine;
Blifters applied to  the  arms are extremely ufeful in
keeping up the pulfe, efpecially if the fkin be fofr, the
tongue and fauces fufficiently moift ; much more may
be learned by attending to this  laft appearance than is
generally known.
  It is necefiary, however, to diftinguifh between the
drynefs of the tongue and mouth,as a fymptom of the
Fever, and as arifing from the  circumitance of  a pa-
tient fleeping with his mouth open.
  I hope  tne obfervations here offered to the public,
on the fubjed of this invaluable remedy, will remove
all prejudices again it a Peruvian Bark of a large and
coarfer appearance, than is generally employed.
  It is at prefent in very  great demand,  the difficulty
of procuring it  will not, I hope, inftigate Druggifts
and Dealers in the article, to fubftitute  at any time a
fpurious kind in its room.


ExtraR of a Letter from Mr. Edward Jacob, fun. an
       eminent Surgeon, at Fever/ham, in Kent.

  I  H A V E  had fuch repeated opportunities of try-
ing the Red Bark, that I hope to be able to give you
every fatisfadion you can wifh, of its fuperior efficacy
over the Bark in common ufe.
  Our fituation being in a country not far diftant from
the marfhes, renders the inhabitants more expofed to
intermittent complaints than thofe of cities and more
inland counties; and I  affure  you, before the ufe of
the Red Bark was known, the Ague, from its particu-
lar ftubbornnefs fas we thought, or what we have fince
obferved from the want  of efficacy in the other Bark)
might be  truly called  the opprobrium Medicorum -, but
now I think that ftain is  entirely  removed,  for I havft
not met with one finglecafe, where (when I could per-
                                             fuade 
                    [    41    ]

fuade the patient to adhere fteadily to my advice) I
have ever found the Red Bark to fail.
  The  Peruvian  Bark, with which  I  was formerly
provided, was of the beft kind, and always had in the
quill; yet,  it was even much inferior in its effeds to
what ought reafonably to be expeded from it.
  The  firft knowledge that ever  we had of the Red
Bark was in March,  1781, when a few  pounds were
fent us to try its effeds ; our Druggift informed us,
that ic  was then in ufe  at St. Bartholomew's Hofpital,
and was there found effedual.  Ic  remained in our
houfe till May following, when  I  was attacked  with
an  Ague ; I did not at firft think of trying  the new
Bark, for I gueffed,  by taking  of the  old in  great
quantity, which would  not be difagreeable to me, that
my Ague would foon  leave me;  but,  to my  great
disappointment, fit fucceeded fit,  without fhewing the
leaft good effed of  the remedy applied.  I was then
determined to try  the new Bark; but finding my A-
gue ftubborn, I emptied the Prima Via  by an emetic
and carthatic,  and immediately, on the fever going
off, I took  one dram of the Red Bark in fine powder,
mixed with three ounces of the decodion, and a fmall
quantity of the tindure, which being a draught well
loaded with Bark, at firft feemed to fie uneafy on the
ftomach (which I have feveral  times on being firft
taken, found the cafe with fome of my  patients, but
which never took from its effed) but, after refting for
fome time I found myfelf  in  a  ftate to continue its
nfe.  My  Ague from that time kept off; till, from
omitting the Bark too foon, and finding myfelf quite
well, in  a few weeks  after,  flight fymptoms appeared
again;  but which never formed a dired  fit; the Bark
being again repeated, eradicated  the diforder.
  My father,  now in the 70th year  of his age, has
fince that time been  attacked  with an  Ague;  but,
from his having been  before feized with a  chillinefs
                       F                  without 
[   42    ]
without fubfequent fever, fuffered himfelf to have
three fits without trying any remedy ; being then con-
vinced of the reality of the Ague, applied to this Bark
in decodion,  with  fome tindure made of the fame j
he found it fo effedual, that after taking it,  the fit did
not once return ; he omitted the Bark too foon,  and
had one flight fit;  but,  after repeating the fame re-
medy a few days, it has not fince returned> and he is
now perfedly well.
   The patients who have  received immediate relief
from  the new Bark, are fo numerous, that I cannot,
with any degree of certainty,  guefs the number.
   The  quantity that we have ufed from July 1781,
to the prefent time, is upwards of fixty pounds.   The
manner in which we have ufed it, with a view to pre^
vent the return of an approaching paroxyfm, is by giv-
ing half a dram or one  dram of the  powder,  mixed
with two ounces of the decodion, and a fmall quantity
of the tindure. The decodion we have ufed, has been
prepared by boiling three ounces of the grofs powder
boiled in two quarts of water to one quart.
   When the patient has been of a more delicate frame,
or when it has been ufed as  a  corroborant,  we have
civen the decodion and tindure without the powder.
When the Ague has been but recently contradcd, we
have feldom  trufted to any  thing  but  the Bark,
 but when ftubborn, evacuants  have  been firft given ;
 half an ounce of the powder  has very frequently cured
 an Ague without evacuants,  or more Bark, when the
 fit was a recent one ; we have now  entirely  left off
 giving the old Bark in  any form fince we have found
 fo good effeds from the Red Bark,   and we ufed the
 refin of Red Bark with  good fuccefs  in many cafes,
 where the patient  could cake it only in the form of
 pills.  I  heartily hope  the above account  will prove
 fatisfadory  to you, if  not I fhall think myfelf very
                                            happy 
[   43    ]
 happy in anfwering at any  time any future enqui-
 ries.
                I am, Sir,
                   with great refped,
                     your moft obedient
                       and humble fervant,
                     EDWARD JACOB, Jun.
 Fever/ham, June 23, 1782.


 A Letter from Mr. Bovs,  an eminent Surgeon aud Apo-
            thecary at Sandwich, in Kent.

     S I R,

   I  AM forry it is not in my power to fend you par-
 ticular cafes of the effeds of  the Red Bark : having
 made no memorandums,  I can  only fay,  in general,
 that it is a much better kind of Bark, than any I have
 been able to procure hitherto.  Whether the  Inter-
 mittents have been worfe than common, or  the Grey
 Bark has been  of inferior quality,  I will not take up-
 on me to determine ; but we were unufually foiled in
 our attempts to cure  that complaint, till we were fur-
 nifhed with  the new Bark.
   I can have no inducement to give a higher charac-
 ter of this drug, than it deferves: but I do affure you,
 that  fince I began to ufe it, it has not once failed me,
 when the  patient has  taken  it in a proper manner.
 Hence, I have a firm perfuafion of its fuperior effica-
 cy, and I am the more  confirmed in my opinion, by
knowing that  my fentiments correfpond with  yours,
and with thofe of all my medical acquaintance, in this
neighbourhood, who have made trial of it.  My beft
wifhes attend  your publication;  not only becaufe  I
am perfuaded it will operate to the advantage of man-
kind, by extending the knowledge and ufe of this va-
luable medicine, but likewife,  becaufe I am in hopes
                                               it 
[   44    3
it will  haften a frefh importation  of the article,  of
which I have very little left,  and I know not  where
to go for a fupply.
            I have the honour to be,
                  Sir,
              Your  moft obedient fervant,
                                W.  B O Y S.
Sandwich, June 19, 1782.


In.addiiion to the char abler'given of the Red Bark, by fe-
  veral Practitioners  in the country,  is a  Letter I re>
  ceivedafew days ago from Sir William Bishop, an
  eminent Surgeon, at Maidjlone,  in Kent, dated June
  16th.

  IN which he fhews, by a variety of cafes, that in
the cure of Intermittents,  in that part of the  world,
the Red Bark, had not only been infinitely more effed-
ual than the common Peruvian Bark or any other re-
medy ufually employed, but that it had radically cur-
ed where Cold Bathing, Emetics, Opiates, Bitters, and
Fridion failed, and where the beft Pale Bark, both  by
itfelf, and with a variety of other medicines,  was ex-
hibited without effed, even to the quaptity of fixteen
ounces.   The form he gives  ic in,  is that of an elec-
tuary, with the addition of a fmall quantity of the  ef-
fential Oil of Pepper-mint and Carraway-feed ;  and
he feldom has occafion, he fays, to ufe more than from
four to fix ounces.   One cafe he mentions, where a
Sphacelus had taken place  in a Malignant Fever, ac-
companied with delirium and every other bad  fymp-
tom, the patient was recovered by the ufe of the Red
Bark,  Anodynes,  and Wine ; the Sphacelus feparat-
ing kindly, the Fever and  every  bad fymptom fpeedi-
ly gave way.
lam 
t   45    ]
/ am liketvife favsured with another  Letter from Sir
  William Bishop,  dated June 23, which contains
  many fenfible and judicious hints upon thisfubjeel.

 ^ HE recommends the grinding Red Bark  into the
fineft  powder  by a  mill,  and  afterwards lifting  it
through  the fineft cyprefs fieve, in order that it may
fit lightly on the ftomach,  and  that its parts may be
uniformly blended together : heobferves,  that if,  af-
ter  breaking the Bark, you examine the broken pieces,
by  means of aglafs in the fun-fhine, you will fee the
refin like fpangles of gold  between the internal woody
fibres and the outward  grey coat; by comparing this
appearance with the beft Pale Bark, you will difcover
the Red  Bark contains a much larger quantity of refi-
nous parts.
  Two fcruples of Bark,  as  coarfely powdered as is
commonly fold by the apothecaries,  will be as difa-
greeable to take,  as  a dram or  four  fcruples  finely
ground.   One dram is the dofe  he generally gave to
an adult, although  he fometimes met with patients,
who would choofe to take two or three drams at a dofe,
and thofe dofes, at longer  intervals ; and from  expe-
rience  he found that,  when this laft pradice agreed
with the ftomach,  it  was the moft effedual way  of
curing the  Intermittent.    One patient  took  three
ounces in  twelve hours,   and had no  return  of  an
obftinate Quartan.
   Many Intermittents, which could not be  cured by
fmall  dofes, were removed by larger dofes, more fre-
quently employed.
   He mentions that a period of five or fix hours, be-
fore the expeded return of a Quotidian or  Tertian \n-
termittent,.is all that is neceffary for the taking  a fuf-
ficient quantity of the Red Bark, in order to obviate
the approaching paroxyfm. Some have been  cured
 by taking two ounces, as  quick as poffible after the
                                               fit, 
[   46    ]
fit, but fuch  as perfevered  in the ufe of it, until four
or fix ounces  were taken,  aded moft prudently, their
health was fooneft and moft perfedly reftored.   He
likewife obferves, that fuch perfons ought to take  the
greateft quantity  of  Bark,  whofe blood is in the moft
diffolved ftate, and where the fibres have been relaxed
by the moft profufe  fweating, which frequently takes
place in obftinate Quartans.
  Quotidians-require  but a fmall quantity, Tertians will
yield to fewer dofes than our Kentijh Quartans.
   He found  it better to get down five or fix ounces
of Bark, in eight or  ten days, than to allow a larger
time for  the  fame quantity.  Labouring people, who
work out of doors in cold  foggy  mornings,  either in
marfhy grounds or wet lands,  from  fun-rife till the
dew of the evening, and who fweat profufely, and  fuf-
fer their  wet  linen to dry on their backs, will  not be
fafe from a  return of the Quartan  Fever,  with lefs
than  five ounces  taken after the laft fit, as the good
effeds of all they had taken before, are very probably
carried off and diffipated in the enfuing paroxyfm.
   He likewife obferves, that the Bark in large dofes
will not  cure the  irregular fits of an ague and  fever,
which fo often afflid perfons, when matter is forming
in the lungs, in the Phthifis Pulmonalis.
   The letters from Sir William Bifhop, which convey
thefe obfervations, likewife  contain much  valuable in-
formation on other medical fubjeds,  and  I  hope the
ingenious author  will, on fome future occafion, favour
the public with them.
A Letter 
[   47   3
A Letter from  Dr. Withering, an  eminent Phyfician, at
            Birmingham, June  29, 1782,

     Dear  Sir,

  I AM much pleafed that you have undertaken to
give  us an account of  the Red Peruvian Bark.   A
publication upon that  fubjed, cannot fail to produce
good effeds, by removing  the prejudices of fome, the
ignorance of  others,  and ultimately  by exciting our
merchants to  obtain liberal fupplies of a medicine fo
truly valuable.  The univerfal prevalence of Intermit-
tent Fevers this fpring gave us a large experience of
its  effeds.  We  have not many Intermittents in the
town of Birmingham ; but in other parts of the coun-
ty of Warwick, in  Staffordfhire, Shropfhire, Worcek
terfhire, and  Oxfordfhire, fo far as my rides  extend,
they have been more general than ever known before
in the memory of  the oldeft praditioners I have con-
verted with.
   After taking pains to recommend the Red Bark to
all the Apothecaries I met with, and confequently not
lefs anxious to learn their obfervations  relative to its
effeds, I can fay, that they unanimoufly concur in af-
ferting, " that they have never been  difappointed  in
 " their expedations, when they exhibited it to patients
" labouring under Intermittents."
   Now the  Intermittents which I  have  feen,  have
 pretty  generally  affumed the Tertian Type  in  light
 foils, and the  Quartan Type in  clayey countries.   Of
the latter,  I have the  care of fome  which were  from
fix to eighteen months  duration, originating  in  Kent
and Effex.   I have known  two  inftances  only  of
Quartans in which  the Red Bark did not  prevent a
recurrence of the Fits;  I faw one of thefe patients af-
terwards ; he  laboured under hepatic and anafarcous:
fymptoms,  thefe  were  removed  in a  fortnight by the
                                             ufual 
I   48   ]
ufual methods, and then the Bark affeded a cure. The
other cafe was at a confiderable  diftartce from this
place, and I have not yet learnt its termination.
  It will require fome farther experience to afcertain
the neceffary dofes.   I know fome praditioners who
have given  one or  two drams every four hours be-
twixt the fits, but I have never had  occafion to give
more than thirty or forty grains at fimilar intervals of
time.
  As to its preparations I can fay but little, preferring
always in my own pradice the fimple powder; but,  I
am told, that it makes a very rich tindure, and I have
feen  decodions of it very high coloured and turbid.
  But it  may he afked—-Would not the common or
Quill Bark, have produced  fimilar good effeds in the
Intermittents of the prefent year ?  From the reports
of other praditioners, I believe it would not. From my
own experience, I can  gfve no other anfwer to  fuch  a
queilion,  than, by faying, that after  frequent and al-
moft continual difappointments, from the life of com-
mon Quill Bark, I  have not tried to cure a fingle In-
termittent with it for more  than feven years palt; re-
lying entirely upon the ufe of evacuants, opium, and
metallic falts.  To  render  this laft affertion reconcil-
able to the daily experience  of others, it  may  be necef-
ceffary to obferve, that with us, a Phyfician is feldotfl
eonfulted  in  Fevers of the  intermittent kind,  unlefs
fome unufual appearance,  or fome uncommon obfti-
nacy in the  recurrence of the attack, alarms the pati-
ent or his friends.
   Whether the medicine inqueftion be  the produd of
the  fame tree from*r which the Quill Bark is derived,
may be difficulty  determine, but I  am perfuaded  it
is the" medicine that was ufed by Morton and  Syden-
ham, or its efficacy could never have been fo prover-
bial.  I know ndt  what could firft induce the writers
upon the Materia  Medica, to prefer the'Quill Bark,
but  1 know if you were  to  afk  an Englifh Tanner,
                                          whether 
t   19    3
 whether the Bark  from the trunk* or that from the
 twigs  of the Oak is the ftrongeft, he would laugh at
 your ignorance.
   I communicated the contents of your letter to my
 worthy friend and colleague Dr.  Afh, together with
 my opinion Upon the fubjed •,  he authorifesme to fay,
 that  the refult of his  experience perfedly coincides
 with mine.
               I  remain,
                  with the trueft efteem,
                    Yours',
                              W. WITHERING:

   P. S. Thus, my good friend,  have I  freely  com-
 municated my fentiments  and obfervations upon the
 fubjecl: you have in band.
   i ou are at liberty to make what ufe you pleafe of
 them,  and I fhall think myfelf happy in having con*
 tributed a little towards the extenfive ufefulnefs of your
 defign.  I have  feen no bad effeds from it, notwith-
 standing the reports of fome of the London Druggifts,
 but  their motives were too evident to need a  com-
 ment.
   I feel, with you, that diftance alone has interrupted
 our  communications ; but I feel too, that diftance
 can never abate the regard with which I once more fub-
 fcribe  myfelf,
              Affectionately,
                   Your*s,
                                         W. W.
 5T<? Dr. Saunders, Jeffieries Square, .

 A Letter from  Mr. Sherwin, an ingenious Surgeon at
                      Enfield.
     Sir,                            /
   S TN C E we have ufed the Red Peruvian Bark,1
we have had great fuccefs in curing Agues and Inter-
mittent Fevers.   Thefe diforders returned fo frequent- 
C   50    ]
ly after the ufe of the beft Peruvian Bark, which wc
could  formerly procure, that our credit, as  well as
that of the medicine, began to fail very much, and
numbers of our patients got into the hands of perfons
unacquainted with  phyfic.  They  feemed willing to
truft rather to noftrums and charms,  than to a medi-
cine which they have feen fo repeatedly fail, and to
the effeds of which they very ingenioufly afcribe every
ache and pain  which continue  after Agues, or which
are the confequences  of Agues  when  imperfedly
cured.
 • I  could give- a very ample detail of the inefficacy
of the common Bark ;  but as the complaint is gene-
ral, it, would  be unneceffary.   I fhall, therefore, only
take the liberty to prefent you  with  the more agree-
able  hiftory  of a  few cafes that have  immediately
yielded to the Red Peruvian Bark, and that even when
given in very  moderate dofes, after having obftinately
refifted large quantities of the other.

   Richard Parsley,  a hard working  young man,
about twenty-eight  years of age,  was feized with an
Ague laft autumn, which  continued either as a Quoti-
 dian,  Tertian  or Quartan*, with  very little intermiffion,
till the 20th of April laft, when I faw him accidental-
ly.  He gave me the following account:
   That he had taken every thing that had been re-
commended  to him ;  and that his mafter,  a worthy
and refpedable gentleman in this neighbourhood, had
procured  him the  advice of different praditioners of
phyfic, who   had  prefcribed Bark for him  in large
quantities, but without benefit, as the diforder always
returned with greater violence after it had been check-
ed a few days.  He added, that the  laft  medicine
 which he  had been advifed to take, was half an ounce
of Allum boiled in a pint of Ale,  to half a  pint,  .
which he was  ordered to repeat three different times,
as foon as he  felt  the Ague  approach.  He had in
                                              this 
[   5t    ]
 this way, he faid, taken feven half ounces upon the
 approach of as many different fits of the Ague.
   I fufpeded, that fo large a quantity of Allum, taken
 at  one dofe, muft have produced fome dangerous ef-
 feds, and doubted  whether  he had  fwallowed the
 whole of it; but I  founcj, upon more particular en-
 quiry, that he really  fwallowed half an ounce each time,
 as he fays > that he  ftirred it up from  the bottom and
 felt it gritty in his  teeth.  It gave  him great pain in
 his ftomach.  So large a quantity of Allum being
 taken at one dofe?  without  materially injuring the
 fyftem, is a fad which I am perfuaded  you will think
 worthy of notice.
   I took companion upon thisN poor fellow, and fent
 him eight papers  of the Red  Peruvian Bark, contain-
 ing a dram in each,  which he finifhed in two interme-
 diate days,  the diforder being then a Quartan.   It is
 now  feven weeks fince  he took this medicine,  and he
 has had no return  of the complaint, but, to ufe an
 expreflion  of his own,  " hath felt  ever fince as if he
 had a new in fide."                        ,

   Anne Pigot, a  poor girl, fourteen years old, has
 been afflided with an Ague fince Autumn laft in the
 fame family with Parfley, and has  alfo tried various
 methods without effed.  I prefcribed fmall dofes of
 the Vitriolum Carul. fourteen days without gaining any
 advantage.  I gave her alfo three or four dofes  of a
 hot aromatic powder,  confiitiag of Bay Berries and
 Caian Pepper, which I have  frequently feen to cure,
 but fhe  found no benefic from it.   I cannot fay whe-
 ther this  girl had given the common Bark a fair trial.
 She begged to have fome of  the  fame  medicine  that
 cured her relation, and about a month fince  had three
 papers, containing only one fcruple  in each, and I af-
fure you,  fhe has been  perfedly free from  the com-
plaint ever fince.
                                              Mr.; 
t   52    ]
   Mr. Barn is, a very ftrong, hard working man, was
 feized laft Autumn with a very violent Intermittent
 Fever, attended with delirium,  and apparently much
 danger.   After  three or four  paroxyfms,  I removed
 the diforder by giving him one dram of the common
 Peruvian Bark every  hour, and continuing the fame
 quantity twice  a day afterwards ;  but at the end of
 fourteen days, the Feyer returned with the fame vio-
 lence as before, and was again ftopped  by the fame'
 quantity of Bark.   From Autumn, till the beginning
 of laft April,  it returned in this  manner (at the end
 of about fourteen days  from the time it was ftopped)
 five or fix times, and always with uncommon violence.
 The common  Feruvian Bark, newly  powdered, was
 repeatedly given.
  In the beginning of April,' I prefcribed fix  dofes
 of the Red Peruvian Bark, oi one dram each, which he/
 took upon the going off of the paroxyfm,  and I have
 the pleafure to inform you,, that he has had no return
 fince that  time;  though I no longer ufed the precau,-
 tion of continuing the daily ufe of the fame medicine.
  It is not worth while to mention common cafes, where
 the Red Bark hath cured without the other having had
 the trial.  A few  have occurred, and I have not yet
 had any inftance of a relapfe.
  I was lately called to a very feverc cafe, like that of
 Mr.  Barnes, where the intermiffion  was  not longer
 than fix or eight hours.  I prefcribed, and the patient
 took fix drams of the Red Bark, without interrupting
 the paroxyfm, which came at the expeded hour •, and
 during, the  ficknefs and horripilatio the Bark feemed
 to be entirely rejeded  by vomiting -, however, the fuc-
 ceeding paroxyfcrv abated fomething of its fury.   My
 patient was extremely  averfe to Bark in every fhape ;
 but my deceiving him, during the following intermif-
 fion, I got  him to fwallaw near the quantity  of two
drams at once, which rendered  him fo  entirely averfe
 to the medicine, that he would take no more after-
                                           wards. 
    -  a

                    [    53   1
wards.  However, to his great joy and my furpfize,'
the Fever left him.   He afcribes his cure to three  or
four draughts of Camphorated Julep, which were pre-
fcribed as a placebo upon bis refufing to  perfevere in
the ufe of the  Bark.  But it  may  with more juftice
be afcribed to the two drams of Red Bark, taken at
one dofe •,  as I think  the firft fix were in a great mea-
fu re loft.
   I confider the Red Peruvian Bark as a valuable ac-
quifnion to the  Materia Medica: or, perhaps,  it may
be only a  reftoration  of what was  ufed in the days of
Sydenham, and fome time after, when it was common
for medical writers to fay,  that this, or that medicine
would cure, with as much certainty as Bark would an
Ague.  An Eulogium  to which  the Bark in  this
country has not been of late years entitled.
   Before I became acquainted with the fuperior  effica-
cy of the Red Peruvian  Bark,  I had tried a variety'of
Tonics, with  very indifferent fucccfs  in  general,  but
now  and   then  with very happy effeds, fuch  as the
Cuprum  Ammoniacum,  Vitriolum  Cceruleum,  Sal
Vitrioli, Sal Martis,  &c.

   William  King,  an athletic young man, applied to
me laft Autumn, on account of a tedious irregular In-
termittent, complicated  with acute fixed  pain in the
fide, and  a full fbrong pulfe, much cough and hoarfe-
nefs.   Under thefe  circumftances, I  thought  it  im-
prudent to adminifter the Bark in any form, and had
recourfe to a  plentiful  bleeding,  applying'blifters to
the part affeded, and  giving the Decod. Taraxac,
with  Tart. Solubile, and honey in large quantities.
The diforder was clearly an Ague ;  but attended with
fymptoms that  threatened a pulmonary confumption.
His blood was  remarkably fizy, which induced  me to
make ufe  of venefeftion, four times, which, with the a-
bove medicines,  and a very ftrid  antipbfagifiic regi-
men, removed the  cough and the pain in the fide,
                                          though 
[   54    ]
 though the Ague ftill  continued.  I ventured at laft
to give him eight dofes of common Bark, one dram in
each, which removed the Ague  feveral weeks,  and
mended his habit much.  A continuance of the Bark,
twice a day, for fome  time after the Ague ftopped,
brought on a frequent bleeding at the nofe.
  The Ague returned  twice during the winter,  and
gave way foon to the fame Bark,  and he kept  tolera-
bly well till the fecting-in of cold  north-eaft winds in
fpring, when his Ague again returned, and  brought
with it the pain in the fide,   a  bloated ideric counte-
nance,  much hoarfenefs and cough.   After one more
bleeding, and the ufe of the Apozem for a month,  I
gave him fix drams of the Red Peruvian Bark in April
laft, and  have  had the pleafure  to  fee him continue
free from  the Ague fince that time, though he never
repeated the dofe after it ftopped.
  I was unwilling to perfift in the  ufe of the Bark af-
ter the  Ague ftopped, left ic fhould increafe the circu-
lation too much,  and  again excite  a bleeding at the
nofe.
  I have now indeed almoft entirely laid afide the cuf-
tom of perfevering in the ufe of  the  Bark,  after the
Intermittent is ftopped.  I  have  for fome time  fuf-
peded  that it anfwers no good purpofe,  and  that it
may poflibly now and then  be  the reafon why large
quantities of good Bark  have been given in vain.
  It is a well known  fad,  that every fpecies  of inter-
mittent complaint frequently-returns  in fourteen days
after being interrupted by means  of  Bark,  notwith-
standing that medicine is continued every day.  May
not the daily ufe of Bark fo habituate the constitution
to its effed, as to render ic ufelefs when the Intermit-
tent returns P
  I am now fatisfied when I have put a ftop to the ex-
peded  paroxyfm, n:id  prefcribe  an anodyne to be in
readinefs if ever :n.\cold fit  returns,  advifing my pa-
tient to have r-coiiMc :o the fame quantity of Bark
                                            which 
:   55    ]
which he found neceffary at firft, and to take it as foon
as the Succeeding Fever abates.  I adopted this  prac-
tice a little time before I became acquainted  with the
fuperior efficacy of the Red Bark,  and thought  it an
improvement, but  fince that time I have fucceeded fo
well by giving fix or eight drams between the parox-
yfms, that I have feldom had occafion to repeat a Sn-
gle dofe.  -
              I am,
                     Sir,
                with great refped,
                   your obliged and
                     moft obedient Servant,
                          JOHN SHERWIN.
Enfield, June 23, 1782.


A Letter from Dr. Fothirgill, an eminent Phyfician,
                 in Harpur-ftreet.

     Dear  Sir,

   I N  anfwer to your obliging requeft, I fhall now
proceed to lay before you the beft information I can
concerning the New Bark, lately introduced into prac-
tice, under the name of Cortex Ruber,' or Red  Bark.
As it was found on board a Spanifh prize,  intermixed
with a fmall quantity of common  Peruvian Bark, it
would  feem to  be  no other than  the  produce  of the
trunk or large branches of the fame tree.  It feems to
be poffeffed of the fame fenfible qualities, only in a
much  higher degree, hence  it yields a much  larger
proportion of refinous extrad, and gives a more fatu-
rated tindure and decodion than  the common  Bark.
Hence too J have found (according to what you late-
ly obferved; that the decodion may be expofed a long
time to the open air,  without contrading the degree 
f   56   ]
«f acidity which manifeftly takes place in that of the
common Bark in a few days.
 . Ic has been remarked for many years paft,  that the
Peruvian Bark has often difappointed the expedation
<*f the public ; having fallen greatly fhofc of that tran-
fcendent degree of efficacy, for which writers of the
h& century have  fo highly extolled it.   Few Phyfici-
ans of extenfive  pradice, but  muft fometimes have
had the mortification to obferve their  favourite fpe-
cific entirely baffled  by a regular Intermittent with-
out  being  able to affign  any probable caufe for the
defeat,  except  the  ungetiuinefs  of  the medicine;
whence ic would feem to follow, either that the Inter-
mittents of late years have been more obit in ate in their
nature, or that the Bark has been of an inferior quali-
ty to that which was ufed by Dr. Sydenham, and ma-
ny of his refpedable cotemporaries, of whofe veracity
we can entertain no reafonable doubt.   The latter ap-
pears to me to be the more probable, efpecially when
ic is confidered that of late years, it has been' cuftoma-
ry (for what reafon  I cannot imagine) to feled the
Bark of the fmall  branches,  under the denomination
of Quill Bark, in preference to  that  of the trunks.
Should this preference hereafter be difcovered to have
been groundlefs (agreeable to what I have long  fuf-
peded) it may perhaps contribute to explain the prin-
cipal caufe of our difappointments.
  In the art of tanning, experience has long determjp-
ed in favour of large Oak Bark, as being greatly pre-
ferable to that of the fmatter twigs.   Why the reverfe
«jf this fhould take place in a  medicinal view, is by no
means evident, efpecially if the virtue of the Peruvian
Bark keeps pace in any degree with its aftfingency.
  Spanifh practitioners, as I have been lately inform-
ed,  are fo well convinced of this, that they always pre-
fer the  large Peruvian  Bark ;  feparating it from the?
frnaUer fort, for aii important purposes,- vrhieh the late
                                            capture 
t  57     1
 capture indeed  feems to render probable *.  Future
 obfervations may probably  difcover that this was the
 real genuine Bark, with  which our anceftors cured all
 the various kinds of Intermittents, with a degree of
 certainty,  which now aftonifhes their fuccefforsr
   If Bark  taken from the  large  branches  fhould be
 found to be more efficacious than that of the fmall, is
 it not reafonable to believe, that, that of the trunk or
 rather  of  the  root, might furpafs both in virtue ? Po«
 litical reafons, however,  refpeding the prefervation of
 the trees, which produce fo  important an article of
 commerce, will,  it is to be apprehended, effedually
 deter the inhabitants from every experiment  of this
 nature.
   A  very  eminent  Druggift,  who purchafed a large
 fhare  of the above cargo, affures me,  that many of
 the Apothecaries whom  he has fupplied  with the  Red
 Bark, and  who  have carefully compared  its  effeds
 with thofe of the common cortex, make no fcruple of
 deciding in its favour.  He further adds, that the de-
 mand for it  has  increafed fo rapidly of late, that the
 ftock in hand is already nearly exhaufted.
   Ic is  to be regretted, that the paflion for  interlard-
 ing this  fimple febrifuge  with other bitters and  aftrin-
gents (after the  ufual complex mode) fhould ftill too
 much prevail  in pradice.   Under this  falfe idea of
 adding  to  its efficacy, its virtue may often be greatly
 diminifhed, and  at all events,  the refult of the trial
 rhuft  be rendered extremely  equivocal.   In  juftice to
the remedy, and  to obviate  this uncertainty concern-
 ing its  effeds,  I  have  embraced every opportunity
(which  fo fhort a fpace would admit)  of adminiitring
it in its fimple  ftate, without intermixing  it with other
                       H                medicines.

  * This nmli not however be confounded with thofe coarfe woody
 flakes, which conftiture a large proportion of the worft kind of Bark,
 now in ufe. For thefe, having been already ftripped of the outer rind,
 together with the refinous cells confift of a mere  ligneous fubftance,
 divefted of medica! virtue. 
                   C   58    J
medicines.  The cafes in which I have chiefly tried it,'
have  been low putrid Fevers, attended with extreme
proftration of ftrength,  delirium during the evening
exacerbations, with fhort and obfcure remiffions in the
day time.
   For the fake of brevity I will but mention one in-
ftance.   William Henton, a  Silk Weaver, laboured
under a Fever of this kind,  accompanied with  Pete-
chiae,  and a  profufe nafal  Hemorrhage, which laft
fymptom generally returned with the exacerbations. To
thefe  were added cold fweats, muttering delirium, in-
voluntary twitchings, &c.  Before I faw him, common
Peruvian Bark had been prefcribed, and his cafe pro-
nounced defperate.   In  this  very critical fituation,
however, I was not  deterred from recommending the
Red Bark, in proper diluents, acidulated with Spiritus
Vitrioli.   Accordingly  he took from two fcruples to a
dram  every  two hours, except  during  the midnight
exacerbation,  when  it was ordered to be cautioufly
avoided ; becaufe I  have  long been convinced by ex-
perience, and attentive obfervation,  that  the febrile
fymptoms are generally exafperated when a Bark re-
medy is given at  that period.   The medicine agreed,
the Hemorrhage abated,  and Fever foon fubfided.
Some weeks  have now elapfed, and I have the fatis-
fadion to add that lately, on entering his room,  he af-
fured me with a joyful countenance, that fince he had
taken the Red Bark (or as might now, perhaps, with
more propriety be faid, the Real Bark J he had fuffered
no fymptoms of relapfe,  and  that he remained free
from  all complaints, except a little weaknefs of fight,
to which he had been formerly liable.   Should this
medicine be  hereafter found to anfwer as compleatly
in the other various types of Fevers, and that in fmaller
dofes than the common Bark,  it will become  highly
interefting to the patients, and no lefs pleafing to the
Phyfician, efpecially when he fhall be enabled before-
                                             hand, 
                    ~[    59   ]
hand, thus to pronounce with real confidence concern'
ing the event*

     " Hi motus, atque hac urtamina tanta,
     " Pulveris exignijaSlu compreffa quiefcent."

                                        Virgil,^

  From its fifccefs in this and feveral other inftances,'
which have fallen under my own obfervation, 1  am
ftrongly inclined to believe, that it will foon become
an objed  worthy of attention, but muft decline giving
a  decifive opinion  concerning its  fuperiority,  till I
know the refult of a variety of cafes, in which it is now
under trial,  and  alfo  receive addicional confirmation
from fuch  correfpondents, as are lefs prepoffeffed in
its favour than myfelf, becaufe they may  be fuppoled
to prove in reality more impartial judges.  Therefore
in the interim, I fhall wait with patience for your in-
tended publication, hoping, that by thus collecting the
fentiments and obfervations of feveral praditioners in
different parts of  the kingdom, we may at length be
enabled to afcertain the true comparative merit of the
Red Bark, which  cannot  but afford great fatisfadion
to the public at large, as well as to.

                          Sir,

                    Your moft obedient fervant.

                             a.  fothergill;

Harpur Street, July 6, 1782.
'A Letter 
r   fo    ]
A Letter from Mr. Edward Rigby, an eminent Sur-
                geon, at Norwich.

     Dear Sir,

  I  AM very much obliged  to you for  the honour
you have done me, in fending me your Treatife on the
Red Peruvian Bark, and I feel myfelf particularly flat-
tered by the manner in which you have  folicited an
anfwer to your letter.
  I am happy that ic is in my power to bear the moft
ample  teftimony to the great and certain efficacy of
this Bark ;  I have had the fulleft opportunity of try-
ing ic in every fpecies of the  Intermittent,  and have
given it to patients under the greateft variety of cir-
cumftances refpeding age, conftitution, date of the
difeafe, &c. and out of more than a hundred and fifty
perfons, who have taken it under my diredion, it has
not failed in a fingle cafe, flopping   the return of the
paroxyfm in the very firft inftance of its application.
  I was fortunate enough to receive a fmall parcel of
this Bark  fo  early as Odober 1781,  owing to the
friendly communication of Mr. Talbot,  Surgeon,  at
Wymondham, in this county,  to whom Mr; Hopkins
had lent a few ounces as a fpecimen for  trial, half of
which  he  immediately fent to me ;  Intermittents  be-
ing at  that time very frequent in  Norwich, and its
neighbourhood, I had an opportunity of trying ic the
day after I received it, and I chofe the two  worft cafes,
which  then occurred to me, the one was a  Quartan, of
many months ftanding, the patient,  a boy about  ele-
ven year.sof age, very much  worn down  by a Quotidi-
an, of nearly as long a date ; the other patient, a young
woman of about eighteen years of age,  whofe confti-
tution  was alio much fhattered by the  long continu-
ance of the complaint:—to both of them I  gave half a
grain of Tarur Emetic," at the approach of the next
                                              fit, 
[   6-1    ]
fit, which brought off a good deal of Bile from the fto-
mach, and when the Fever terminated, they began to
take the Bark, an ounce of which was divided into
twelve dofes, all  which were taken by each of them
before the times of the expeded returns  of the com-
plaint ;  they both loft the fits, and though they took
no more of  it,  for they had taken all which was lent
me, they had no return of them  until many weeks af-
ter, when the weather  proved very wet, and then they
went away without taking any more  of this,  or the
common Bark, for they were both  at this time remov-
ed to fuch a diftance in the country as not to be able
to fend to-me.
  My fuccefs in thefe cafes, induced me to procure a
confiderable quantity of  it, and as foon as I received
it, I made ufe of  it in  feveral Tertians then under my
care, in all which it immediately  anfwered the intended
purpofe.  About this time I had a patient,  a gentle-
man about fifty years of age, who had had a Quartan
more than three months, he  had been endeavouring
to cure himfelf by a variety of popular  receipts, a-
mongft which was one which contained a confiderable
quantity of the common  Bark ; when I firft faw him
it was the day after  he had had a fit;  but he was then
much indifpofed,  his pulfe  was  too quick, he had no
appetite, and was much reduced,  he  took a faline Fe-
ver medicine, and an opening draught before the next
fit, at the approach  of which,  I gave him a grain of
Emetic  Tartar, which vomited  him confiderably, and
he  repeated half a grain of  it every three hours, until
the Fever terminated, which, though it lafted a long
while, went off with a greater  and more general per-
fpiration than was ufual with him.
   I now  thought it  right  to  begin  giving him" the
Bark, but his intermiffion not  being  quite fo perfed
as I wifhcd it, and moreover, my not having yet had
a fufficient number of cafes, in  which I had given the
Red Bar!*, fully to  eftablifh its reputation with  me, I
                                          though: 
[   6z    ]
thought it moft prudent tp give the common Bark, of
which he took two fcruples at  fuch intervals  during
the intermiffion, that he got down more than an ounce
and a half of ic before the time when the fit was etf-
peded, but it did not fucceed,  and  he  had another fit
fully as fevere as his former one ; I then refolved to
make the next trial with the Red Bark,  an ounce of
which was taken in the  courfe of the fucceeding inter-
miffion, and in dofes of two fcruples, and this ftopped
the fit; I prevailed upon  him to  continue its ufe in
the fame dofe three times a day for a little time,  which
he did till he had taken two ounces more,  but he has
taken none fince;  and though his employment expofes
him very much to the weather,  and he was foon after
frequently wet, yet he had not the flighteft return.
  From this time I confidently gave it in every cafe
which came under my care, and its  ufe was invariably
attended  with the fame  immediate fuccefs.   In the
number of thofe which were cured, were feveral  whofe
legs were much fwelled,  and their  bodies  hard,  and
who appeared to be very rapidly haftening into a Drop-
fy ; more than twenty of  them  were  children,  two
were infants, not a year old ; and one,  whofe cafe I
fhall relate, was a ftriking  inftance of the  truth of
your remark in the Treatife, that the  Bark given in
confiderable quantity as near as may be to the time of
the approach of the fit, is particularly efficacious.
  My patient was a gentleman about twenty-five years
of age, robuft, and of a full habit;  he  had had an ir-
regular Intermittent about a fortnight, it began as a
Quartan, of which he had three fits, it  then became a
Quotidian, and he had three or four more fits ;  I faw
him about the time when it began to come every day,
and I found the Fever was very confiderable ;  the u-
fual treatment,  which  I need  not  particularize,  was
made ufe of, until  he appeared to be in a ftate to take
Bark;  the fit after which  he was to begin  to  take it,
terminated about ten£'clock at night,  and its return
                                              was 
t   63    ]
was expeded the next day between twelve  and one at
noon.  The time of the intermiffion  being fhort,  he
began to take it in dofes of a  dram :  I had a meffage
from him in the night, that it difagreed with him, and
that he could not keep it down ; I defired him to per-
fevere, but to confider what came up as if he had not
taken ic, and co fupply  its place with another dofe :
between five and fix o'clock in the morning he fent to
me again, and defired me to go and fee him.   I found
him much fatigued for  want of fleep, which he had
been  entirely hindered  from getting, by his repeated
endeavours to take the  Bark,  every dofe of which, ex*-
cept the firft, had been rejeded, and he feemed con-
vinced that his ftomach would not retain it. I pre-
vailed upon him, however to take half a dofe, and this
kept down ;  I ftaid with him fome time, and half  an
hour after taking the  firft half dram, I repeated the
fame  quantity, which likewife kept down ; I then left
him, defiring him to continue it every half hour in the
half  dofes.  Between  eight  and  nine  o'clock I was
fent for again,  and he gave me the fame  account of
its coming up again as before; notwithstanding this,
I ventured to give  him another dofe, which he im-
mediately  threw out   of  his mouth, before he had
fwallowed any of it; obferving this, I was  more par-
ticular  in enquiring in  what  manner he had vomited
up, as it was called, the former dofes ; and from the
attendant's account I was convinced, that what he ima-
gined to have been  vomited up, had never been fwal-
lowed ; by this unlucky mifmanagement of himfelf,
he had taken but two  drams and a half inftead of five
drams,  and  there remained five drams  ana* a half to
complete the ounce, which was to  be  taken in little
more than three hours;  however,  I was determined
he fhould perfevere, and I  immediately gave him a
dram, as I was  no longer under any apprehenfion of
its coming up,  being  fully fatisfied that all had been
retained  which  had been adualfy  taken   into  the
                                         ftomach; 
[   64    ]
ftomach ; this  kept down, and by ftridly attending
him with a dofe every half hour, or at longeft every
three quarters of an hour, the whole was gotten down
before the time of the expeded return of the fit, which
happily  prevented  its corning, and he  has continued
well ever fince.  The night having been entirely with-
out fleep,  and the  patient having  been  exceffively
fatigued and fretted by his many  fruitlcfs endeavours
to take his medicine, were very unfavourable circum-
ftances in his fituation, and prevented his Fever from
going off fo  perfedly as it did in the former intermif-
fion, for he was much  hotter, and his pulfe quicker
than was to be wifhed, when  taking Bark; however,
the event fully juftified my  perfeverance, and ftrongly
proved the efficacy of the  medicine.
   Many of my patients having been poor and igno-
rant people, and fome of them living at fome diftance
from Norwich, to whom I could only give general di-
redions,  as ic was impoflible for  me to attend them,
you may eafily imagine that moft of that clafs of them
took it carelefsly ;  fome of them I know did  not take
the quantity prefcribed ; and  I recolleded one perfon,
a ftrong country girl, about feventeen  years of age,
who took an ounce of it at two dofes;  yet all of them
were immediately  cured.  One patient of this clafs
was a child about eight years old, who had  a Quotidi-
an more than two  months,  and was  direded  to take
half an ounce of the Cortex between  the fit, which was
to terminate on a Monday noon, and was expeded to
return on the Tuefday,  about the fame time ;  on the
following Saturday the child's father called to inform
me that he was cured.   Upon enquiry how the child
had taken ir, I  was furprized  to  find  that he had not
then finiihed the half ounce, for when I told him that
 I meant the child fhould have gotten the whole quan-
tity down in one day,  he faid he had underftood be-
fore, that I direded it to be taken between the Mon-
day and the Saturday night, fo that  it was evident the
                                             child 
t    65 •]
child could not, the firft day,  have taken more than
one  dram of the medicine, which it4s clear, proved fuf-
ficient to ftop the fit.
   From the foregoing, and  frbm fome other cafes
which I have had, as alfo from thofe communicated to
you  by my friend Mr. Sherwin of Enfield,  one may
certainly  very ftrongly prefume, that a  much  lefs
quantity of this Bark  than what I have ufually given
would anfwer  the  purpofe ; it would be a  very eafy
matter to afcertain this by more trials, but at prefent
I am not willing to give it in-  a fmaller quantity, nor
would I recommend it to other praditioners to do Co9
until the reputation of  the Bark has been  fully and
univerfally  eitablifhed, for  whilft  the  prejudices of
fome praditioners,  who are averfe to new medicines,
and  the intereft of  fome Druggifts, who  will be pro-
bably fuffcrers, by having large flocks of the common
Bark by them, may in the leaft degree tend to oppofe
its general ufe, it is to  be wifhed that the teftimonies
in its favour fhould not only be ftrong and clear, but
that  its fuccefs fhould be as uniform and  invariable as
the  nature of the medicine admits of,  and therefore I
would not yet venture to prefcribe a quantity fo fmalJt
as to run a poffible rifque of  its  failure, when the
quantity I have hitherto ufed, which is an ounce to an
adult, and a proportionable lefs quantity  to 'children,
has not, with me, in a fingle inftance been  fallible.
  In relating  the few cafes above, I did not think it
neceffary to mention the names of the patients, but as
the  circumftances  which tend to recommend a new
medicine  cannot have  too great notqriety, I will,  as
they   occur to my memory, give you a lift of fome  of
the perfons  who have been cured of Intermittents by
this  Bark, and whofe fituations in this neighbourhood
render them well known.
  Mr. Thomas Smith—Mr.  Garland—Mr. Carter,
Jun.  twice—Mr. Money—-Mafter Money,  and Mifs
Money, of Trowfe—two children of  Mr. Barham of
      J                  I                 Kirby-- 
                  t   66   ]

Kirby—Mr.  Oliver—Mr.  Taylor—Mr.  KiddclPs
daughter,'of Qolney—Mr. Howlett, of Earlham—Ser-
vant of John*Gay, Efq;—Servant of Mr. Bloom, of
Trowfe—Mr.  and  Mrs.  Clift—Mifs Clift—Son of
Rev> Mr. Anfdell—Mr. Dixon,—Matter Webb-Mifs
Kett-Mafter Bu-nn-Mrs. Denny of Shottifltam--Mr.
Wright of Brecondale-Mrs. Glover of Kirby-Mr.
Smith of Burlingham-Servant of Sir Lambert Black-
well, Bart.
  With  regard to the common  Peruvian  Bark, not-
withstanding the complaints of its inefficacy have been
great and general, my experience  for a few years paft
has given me no reafon to be fo much diffatisfied with
it as I find many others are.  I will acknowledge, in-
deed, that for fome time  paft, I have found  it necef-
fary to give a much larger  quantity of it  than ufual,
and that even when I have given from an  ounce and
a half  to  two  ounces of it in fubftance, it has not  al-
ways fucceeded in ftopping the fit in the firft inftance of
its  application, but when  I have been  able to prevail
upon my patients to perfevere  in its ufe,  in  the fame
quantity, I have never known it  fail  to  ftop the fit
after  the fecond intermiffion,  in  wfcjich  it  has been
taken.   I fhould imagine  there is no reafon to believe
that the common Bark, which has been ufed for fome
years paft, is not the fame with what was formerly in
ufe, or which was perhaps, originally introduced \ as
far as can be judged by its  tafte, and its  appearance,
either in the lump, in powder, in  decodion,  or in any
of the  other preparations of it,  it feems to me, at leaft,
to be precifely  the fame  as I have always feen it;  I
have, therefore, never once  fufpeded that, as a natu-
ral produdion,  it  has degenerated, much lefs have  I
 apprehended that any artful  means have been ufed by
Druggifts,  to  render it  more faleable, or to increafc
their profit  upon it, by which its medical  quality has
 been diminifhed : Intermittents having been  more  ge-
 neral in  this country for two years paft,  than, perhaps,
                                             wa3 
I    67   ]
 was ever remembered by any Praditioners now living,"
 probably the fame caufe which has made them fo fre-
 quent, has made them of  a worfe  kind,  arid confe-
 quently  more difficult to remove ;  and to this  caufe,
 rather than  to any change in the quality of the Bark,
 is, in  my opinion,  to  be attributed the late general
 want of fuccefs in the treatment Of this difeafe.   Upon
 the whole then, Sir, from the experience  I have had
 in ufing the two kinds of  Bark, which has not been
 jnconfiderable,  it is evident to me, that they poffefs
 the fame medicinal quality, but  that the Red Bark
 has it in  a degree greatly fuperior to  the pale, which
 flrongly  favours your fuppofition, that they are both
 the produce of the  fame tree, the Pale or Quill being
 the Bark of the fmaller branches, and the Red, that
 of the larger branches, or the trunk of the tree.   Hav-
 ing myfelf found fuch finguiar fatisfadion in the ufe
 of this Bark, I  fincerely wifh it may be univerfally in-
 troduced, and I  am perfuaded that every Praditioner,
 who will give it a fair trial, will immediately prefer it
 to the Pale.  Nothing can  be more agreeable in  the
 administration of a medicine, than to be  abletofpeak
 of, and foretel its effeds with confidence, as it mutt be
 very  encouraging to the patient; this circumftance,
 and its anfwering the purpofe in a  much fmaller quan-
 tity than  the Pale, are very peculiar advantages which
 the Red Bark  poffeffes; for in the ufe of the  Pale,
 though, as  I before obferved, I make no doubt, but
 by perfeverance, and taking it. in large dofes,  ic will
 for the moft part fuccecd, yet I have  more than once
 been awkardly fituated with patients, who have taken
 a large quantity of ic withouc its having anfwered the
 intention  in  the firft inftance, I mean in  ftopping the
 (ic, after  the firft intermiffion, in  which it has  been
given,  it  not being always an eafy matter to perfuade
perfons, under fuch  a difappoincment,  to perfevere
taking down a large  quantity of a naufeous medicine,
                                             more 
[   62    ]
  more, efpecially, when there ftill  remain popular pre*
  judices againft the Bark ; and it is a notion received
  by fome, that when it does not immediately fuccced it
  muft be hurtful.
    I havejuft received a letter from Mr. Talbot,  the
  gentleman whom 1 mentioned before, as having  firft
  fan me a fpecimen of the Red Bark,  with  an extrad
  from which, relative to the  fubjed, I  fhall conclude
  this already too long letter; he informs me, that from
v  the time he firft made trial of it,   he has ufed  no Ci-
  ther in Intermittents, that he has  given it to more
  than fifty perfons, and he has not failed removing the
  difeafe in a fingle inftance,  though  before  that time
  he had been very unfuccefsful in the ufe of the Pale
  Bark.   He mentions a cafe,  in which  four ounces of
  the common Bark had been  given without effed,  and
  that an ounce and a  half of the-Red immediately put
  a flop to the fit:—And  he further fays, that he lately
  made enquiries about it amongft fome Praditioners  in
  his-neighbourhood, to whom he recommended it,  and
  that Mr. Swallow of Watton, Mr. Bringloe, of Hing-
  ham,  Mr. Gibbs, of Buckenham,  and one or two
  more, have been equally fuccefsful in its ufe as him-
  felf.
               I am, Sir,
                 With the utmoft relped:,
                    Your obliged and humble fervant,
                            EDWARD RIGBY.
  Norwich, Sept. 8, 1782.
A Letter 
t   69   3
A Letter from Dr. James Maddochls, Phyfician to the
                 London Hofpital.

     Dear  Sir,

  AGREEABLY to  your requeft, I here fend
you  an anfwer to the questions you propofed to me,
relating to the large and Red Peruvian Bark, lately
introduced into ufe in England.
  Your firft queftion related to my opinion'of the me-
dicinal efficacy of this Bark,  with thac  of  the paler,
fmaller, and quilled Bark,  which for a long fcries of
years has been considered in this country as fuperior to
every other  fpecies.
  In anfwering this queftion, the  fhort notice  you'-
have given me, and the little time I have at  prefent to
fpare,  will not admit either  of my taking notice of
many different kinds of difeafes, in which I have had
opportunities of obferving its  fuperior efficacy, or of'
defcribing particular cafes of the few diforders I am to
mention ; on which I fhall content myfelf with giving
you  the general refult of my obfervations.
  The cafes which have afforded  me  the  moft  fre-
quent opportunities of obferving, and of drawing the
moft fatisfadory conclufions relative to the fuperior
efficacy of the Red Bark, are thofe of the Intermittent
Fever.
  To the beft of my  recolledion, it was about the
month  of Odober,  1781,  when  we firft began to
make ufe of the Red Bark,  at the London Hofpital.
Immediately after its introdudion,  the difference, in
point of efficacy,  between this and the common Bark
became very remarkable; infomuch,  that my learned
Colleague, Dr. Dickibn, and myfelf, recommended to
the Committee of the Hofpital,  at one of their week-
ly meetings, to purchafe of the Druggist,  who  had
furnifhcd the firfv fpecimen, the whole of his ftocjc of
                                              the 
                    I    ?°   ]
the medicine,  however great  its  quantity might be :
upon which meafure the Committee, without any he- ,
fkatjon, immediately, refolved.
   The London Hofpicaiis, perhaps, never without a
very confiderable number of patients under Intermit-
tent Fevers; to which its comparative  vicinity  to the
county of Effcx not a little contributes.—When, be-
fore the introdudion of the Red Bark, we were  in the
ufe of employing the common Bark upon all occafi-
ons, we had found it, in Intermittents,  to fall exceed-
ingly fhort of that high charader for efficacy, which
is affigned to it  by Dr. Sydenham,  and his cotempo-
raries.              ,
   As to myfelf, I can truly affert,  that  in the cafes of
patients under Intermittent Fevers in the Hofpital, ve-
ry feldom indeed was the return of  the fit prevented,
or-even the violence of it much diminifhed at the firft
attempt  to flop it,  by any quantity of the medicine
given in the interval.  On the contrary, portions of
the Bark for a confiderable length of time, and in very
large quantities,  were generally neceffary to  (top the
progrefs of the diforder, or even to abate its violence ;
and on many occafions, from a total want of  fuccefs,
I have judged it proper to defift from its farther ule,
and to have recourfe to. other means of cure.
   On the other  hand, by the ufe of  the Red Bark, I
have frequently feen the return of the fit entirely  pre-
vented upon the firft trial  of the medicine  given in
the interval; where this is  not the  cafe,  the fubfequent
fit is generally lefs  violent,  and in almoft every cafe
the diforder generally difappears in a fhort time.
   Several of the cafes  in  which I have obferved the
abovementioned  good effeds of the  Red Bark, were
cafes in which the common Bark had previoufly been
employed, and continued for a longer or fhorter time,
without fuccefs.
   With refped to the out-patients, or fuch as do not
refide in,  bin occafionally come  to the Hofpital  for
                                            advice 
advice and medicines, thefe are much more numerous*
than the in patients; among which theFe occur a great
variety of Intermittents, in all its different types.  The
fuperior efficacy of the Red, compared with the com-
mon Bark, I have found to be  as  remarkable in thefe
cafes as in thofe of the inpatients.
   Whilft I was.in the pradice of employing the com-
mon Bark, very large dofes of  it were generally necef-
fary to the cure, and the patients ufed to return to the
Hofpital again and again,  for repetitions of their me-
dicine; but fince I have ufed the Red Bark,  many of
thefe  patients have not returned a fecond time.   Of
fuch as have returned, fome have informed  me  that
the dofe prefcribed to be  taken during the firft inter-
val had entirely prevented the return of the fit; others,
that the fubfequent fits had been very moderate. And
where the cafes have been otherwife, and I have been
informed of the event, the diforder has given way  in a
fhort time.
   I fhall  trouble you with only one other tribe of dif-
eafes, in  which I have had occafion  to obferve the fu-'
perior efficacy of the Red Bark.   Thefe are periodic
pains, of which difeafes, the periodic Head Ach is the
moft common, and moft generally known.
   But I  meet  pretty frequently with cafes of a fimilar
diforder affeding various other parts of the body than
the head.  In fome of thefe, the feat of the pain feems,
to the feelings of the patient, to be  fome part of  the
parietes of chc abdominal, or.thoracic cavity, but more
frequently of  the former;  in  others,  it feems to be
fome  or other  of the contents of one of thefe cavities,
but more frequently of the abdominal.
   With refped ro the cafes in Which the diforder feems
to be feated in fome of the contents  of the abdominal
cavity, I have met with many of them, and with fome
chat, during the  paroxyfm, have been  accompanied
with a fharp pyrexia, a moft acute pain,  and moft, or
all of the effential, or charaderiftic fymptoms of an in-
                                       flammation 
   »                      - .   ..

                     t  fi     I
 flamtfiatton of the vifcus ; which, from the place of
 the pain, feemed to be the feat of the diforder.
    Thefe cafes, however, differ from inflammation^ in
 this, that their paroxyfms are fucceeded by  intermit
 fions, and return at intervals, generally of the Quoti-
 dian, fometimes of the Tertian,  at  other times of  left  -
 types ; and blood taken  from the patient during  the
 utmoft: violence of the fit, is without the Imalleft apt
 pearance of the  fize.
   In^many cafes of thefe diforders,  where our view is
 to prevent the return of the fits, by remedies employ--
 ed in their intervals, tonics, undoubtedly,  are not al-
 ways proper remedies ; fome of them, as, in particular
 the periodic Head Ach, when  it  occurs in young and
 plethoric fubjed-s,  may  fometimes require the ufe of
 evacuants ;  but in thofe cafes in which I have judged
 tonic remedies to  be  indicated,  and  have employed
 the Red Bark, I have found its effeds, compared with
 thofe of the common Bark,  to be  fimilar  to thofe I
 have above defcribed, refpeding Intermittent Fevers.
   In fupport of my opinion of the fuperior efficacy of
 the Red  Bark in the difeafes  I have above fpecified, I
 have been led from the nature of the fubjed, to draw
 my arguments' principally from  cafes of hofpital  pa-
 tients, as  thefe, on account of their fuperior number,
 afford the better  opportunities of  comparifon  ; but
 the obfervations I have made in private  pradice upon
 thefe, not to mention other difeafe^, correfpond with
 and tend to fupport the conclufion.
   You  defire to have my opinion relating to the na-
 ture of the Red Bark, from what tree it is taken, whe-
 ther from that which affords the fmall Quilled Bark
 commonly in ufe,  or  from a different  one.   In  my
 opinion there can be very little doubt,  but that both
 are taken' from the fame tree, and that their difference
 in  appearance depends on  this circumstance only, that
the fmall- or Quilled Bark,, is taken either from very
young-trees, of  which all the  parts are yet fmall, or if 
                     r    73   i
 ever taken  from large, is the produce of their twigs
 or very fmall branches ; and that on the other hand
 the Red  Bark  is taken  from well-grown  trees, and
 from their trunks or larger branches-
   Certain arguments which I find in your publication
 on the  Red Bark, fome  of which are fuggefted by
 yourfelf, and others, by fome of your correfpondents,
 are, I think, fufficient to  warranc our resting in this
 conclufion.   The principal reafons from which I have
 been led to adopt ic  are the following :--
   Firft, Becaufe the Red  Bark agrees in its fenfible
 and other qualities,  with the fmall Quilled Bark, pof-
 feffing however thefe qualities in  a much higher de-
 gree.
   Second, Becaufe it is very well known, that the pe- '
 culiar fenfible qualities and powers of moft vegetables,
 are comparatively little obfervable in the young plants,
 or tender fhoocs.
   Third,  Becaufe the Tanners  know very well from
 experience,  that  the Oak  Bark which is taken from
 the  trunk or  larger  branches  of the tree,  poffeffes
 much ftronger powers than that taken from the fmall-
 er branches ;  and therefore  always prefer this in the
 bufinefs of tanning.
   Lastly, What appeared to me upon examining the
 fpecimens, you lately ffiewed me,  of Oak Bark, which
 afforded me an opportunity of comparing the Bark of
 the  trunk,  or larger branches of the Oak,  with that
 taken from the fmaller branches, where the Bark of the
 larger kind appeared of a red hue, and expanded, that
 of che fmaller, pale and quilled ;  a difference exadly
 fimilar to that  we obferve between the two  different
 fpecies of Peruvian  Bark.
   The only other obfervation I fhall make relating to
 the Red Bark, is, that when we refled on the very ex-
traordinary virtues afcribed to the Peruvian Bark, by
Dr.  Sydenham and Dr. Morton,  and particularly On
the degree of certainty with which ic is  by  them af-
                        K                 firmed 
[   74    ]
 firmed  to  have cured Intermittent Fevers •, of which
 virtues, the fmall and quilled Bark  is allowed by all
 Praditioners, to fall fo very far lhort •, and confider
 further,  that the  defcriptions given by the Materia
 Medica writers, cotemporary with the eminent perfons
 now mentioned, of the  Peruvian Bark then  in ufe,
 does not apply to  the fmall and  Quilled  Bark, but
 does exadly fo to  the Red Bark ; and laftly, that the
 inhabitants of New Spain, and, if I am rightly inform-
 ed by a gentleman lately arrived  from that country,
 of Old Spain alfo, adually hold the Red Bark in high-
 er eftimation, it muft appear highly reafonable  to con-
 clude, that the Red Peruvian Bark is  truly the fpecies
 of this medicine, the  virtues of which arefo much ex-
 tolled by Dr. Sydenham and Dr. Morton,  and which
 was  in  common  ufe with  them  and  their cotempo-
 raries.
  To conclude, Sir, I confider the work in  which you-
 are engaged as highly  commendable.   I confider it as
 one not only of great public utility,  inafmuch as  it
 tends to fix  the reputation,  and extend the ufe of a
 moft efficacious and important medicine; but alfo as a
 neceffary one co counterad the endeavours of prejudi-
 ced or interested perfons'to oppofe its  deferved repu-
 tation, and difcourage its general ufe.

              I am,  Dear Sir,

                Your fincere friend,

                  And humble Servant,

                       JAMES MADDOCKS^

London, Capel Court, Sept. 20, 173a,
Dtt 
[   75   ]
  Dr. Keir, Phyfician to St. Thomas's Hofpital, in-
forms me,  that in that Hofpital about 150 lb. of the
Red Bark  have been ufed,  and he thinks with more
fuccefs than is ufually experienced from the common
Peruvian Bark.
  The employment of it  in his pradice has not been
confined to Intermittents ; he has alfo ufed it in Mor-
tifications,  in Phagedaenick Ulcers,  in the Convale-
fcence of Fevers, and in every other complaint that oc-
curred, where the common  Bark would have been
deemed a proper remedy.
  In oppofition to the objedion ftated, and refuted by
me, Dr. Keir obferves, that during the whole of this
extent!ve and mifcellaneous ufe of the Red Bark,  no
cafe occurred in which there was reafon to believe any
bad effeds to have been produced by it.


Extra& of a Letter from Mr. Shireff, an eminent Sur-
      geon and Apothecary at Deptford,  in Kent.

  After obferving that the fituation of Deptford, and
its environs, renders the inhabitants of that village ex-
tremely fubjed to Intermittent Fevers of a very obfti-
nate nature,  fome of which he found more difficult to
cure, than  even fuch as he had feen on the weft coaft
of Sumatra, where they put on a more formidable ap-
pearance than in Europe.   He proceeds as follows :
  " From the feveral patients  whom I attended, I fe-
leded  the three following cafes to try the effeds of the
Red Bark ; not to enumerate every particular, I fhall
only obferve,  that in all of them the common  Bark
had failed in  a Angular manner.   Each  of  them had
fuffered frequent relapfes, the firft cafe efpecially; fhe
had fcarce any refpite for  nine months in Lincolnfhire ;
fhe  had removed to this place  to try the effeds of a
different air ;  before I faw her fhe had  been here for
three months, without finding any benefit. 
             C   A    S   E    L

   A gentlewoman of a weak constitution,  and natu-
rally of a nervous habit of body, had been feized laft
autumn with a  fimple Tertian in Lincolnfhire 5 upon
her removing to this  place it  had affumed the Quar-
tan type, and was of three months ftanding;  having
found very little relief from Bark and other remedies,
fhe had declined calling in any affiftance ; but her hof-
band, alarmed  at her extreme weaknefs during a pa-
roxyfm, fent for me:  I  was informed of the above
particulars, and found her with an ideric countenance,
fwelled ancles, and other marks of great debility : af-
ter fome difficulty, I prevailed upon  her to take me-
dicines ; I fent her immediately feveral dofes  of Red
Bark, each containing only one fcruple, on account of
her naufeating every thing that was prefented her,  de-
fying her to begin after a  general moifture had come
on, with an abatement of thirft  and head ach, and  to
be  repeated  every four or fix hours;  fhe continued
the medicine in  this manner, for four or five days, and
as the fubfequenc paroxyfm had  been more mild than
the one preceding  it;  I  could not prevail upon her to
take the Bark fo frequently;  fhe however  continued
its ufe for fourteen days longer, each day taking four
fcruples, which  entirely removed her complaints—fhe
is now in perfed health.

             CASE     II.

   A young gentleman, naturally of a robuft and heal-
thy habit of body, had  fuffered feveral paroxyfms of a
double Tertian  to attack him, without ufing any me-
thod to prevent them ; it was  his determination  to
truft to nature for a cure, rather than take fuch large,
and  frequent dofes  of the  Bark,  as he had  fome
oioaths before  donex  without any permanent effeds*
                                             Hue 
I  77     I
But  a delirium feizing him  in one of the paroxyfms,1
his relations fent for me  at  midnight: I found hin»
fenfible, his body covered with a moft profufe  fweat,
and loaded with bed-cloaths,  the curtains drawn clofe,
and the external air carefully excluded from the room ;
having removed every obftacle to die  free admiflion
of air, and his body wiped wich a dry  cloth, and in
place of hot drinks, made ftill hotter with fpice,  I or-
dered toaft and water, acidulated with lemon, and o-
ther  diluting liquors, to be given him almost:  cold ;  I
procured his confentto make one more  trial of  medi-
cine -, accordingly, half a dram of Red Bark was giv-
en him immediately, and repeated every four hours ;
he miffed the  next period,  and after continuing his
medicine  three days longer,  only  three times in the
day; he left it entirely off;—he has fuf&rcd no re-
lapfe, and is now in health.

             CASE    III.

   A gentleman, after expofing himfelf  to a damp e-
vening, was feized with the common fymptoms of Fe-
ver ; an  emetic was given immediately,  and  followed
by a laxative,  not apprehending that he was attacked
again with an  Intermittent, he continued to go to Lon-
don  ; at the expeded period, however,  he was again
taken ill, and  the paroxyfm ,was rendered  very fevere,
by his imprudently walking  home after it had com-
menced.  When the febrile fymptoms abated, and the
fkin became moift, I gave him half a dram of the Red
Bark, with orders to repeat it every three  hours ;  he
fuffered no return, and now remains well -, being much
expofed to the weather,  I have advifed him  to conti-
nue fmall dofes of ic twice in the day.
       I  am,  Dear Sir,
             Your obliged  and humble Servant,
                            J. L. SHIRREFF.
Deptford, Sep. 14, 178a,
                                         A  Second 
[   7*   I
A Second Letter from Dr.  Fothergill to Dr. Saun-
                      ders.

     Dear Sir,

  A S medical attention has of late been defervedly
engaged  on the fubjed of the  Red Peruvian  Bark,
and as the public,are not a little interested in the re-
fult, I take  liberty to fubmit to your confideration, a
few more curfory ebfervations, which have occured
fince my laft.
  The teftimony  which you have already produced
from fo many refpedable Praditioners,  who could be
under no temptation, either  to conceal its failures, or
to exaggerate its virtues, renders it unneceffary to add
any frefh evidence of its fuperiority ; other wife I might
mention  fome  late  inftances of its fuccefs, in certain
inveterate Agues, which had entirely  baffled the ordi-
nary Bark.  Therefore, whatever doubts or difficul-
ties may be now raifed concerning its  identity with the
Bark formerly ufed by Morton and Sydenham, can by
no means invalidate the fads which have been advanc-
ed in fupport of its real efficacy.  That it was, how-
ever, in a&ual ufe about  the beginning of the prefent
century feems demonstrable.
  In the year 1702, the cargo of Bark which was cap-
tured on board a Spanifh galleon, a  parcel of which
fell into the poffeffion of Mr.  Pearfon,  an  eminent
apothecary  in  the  city only four years ago, appears,
from every circumftance, to have been no other than
the drug now  under confideration.  But  what feems
ftill more worthy our attention, is, that after the fpace
of about 78 years, it fhould ftill afford a much ftrong-
er decodion than that of the common Bark, and alfo
furpafs it in the cure of fevers, and other difeafes : an
evident proof that this Bark retains it medicinal pow-
ers much longer than could have been imagined.  In
                                           further 
C   79   1
further confirmation of this fingular property, and al-
fo of  its early ufe in this country, allow me to tran-
scribe  a remarkable  paffage from  Dr. Lifter, who
mentions fome of its moft charaderiftic marks : " Pro-
" pria  experientia  teftor,  me  ante  20 annos cortice
" trunci faepe ufum effe  ad craffitiem,  & latitudinem
" volas manus,  magnis & profundis fulcis, & fiffuris
" confpicuo, velut  in vetufto arbore, imo eundem ali-
" quando  cariofum ; & olim,  & nunc, vix unquam
" fruftravit  eventu  Optimo, & defiderato, maxime fi
" ejus  modus, ec tempus exhibitions  rite  obfervan-
" tur *."  Add to this, a ftill further proof with
which  I have been lately favoured by  Dr. Smith, a
very ancient phyfician near Andover, who affures me,
that having obtained a fample of the Red Bark, he im-
mediately recognized it, " both by the fmell, tafte and
" colour, to  be the  fame that was commonly ufed
" fifty  years  ago."   To which he fubjoins fome re-
cent inftances  of its fuccefs in Intermittents, which
had refifted the ordinary  Bark.
  From the year 1640,  that  the Peruvian  Bark was
firft imported into Spain, its reputation increafcd till
the old unpeelcd trees becoming fcarce, the inhabi-
tants of Loxa,  mixed other Barks with it, which be-
ing deteded, it fell  into fuch  difcrcdit, that,  in the
year 1690, feveral chefts of it lay in the warehoufes at
Piura, and nobody to purchafe it.  From this circum-
ftance,  and from the infignificant dofes  in which it was
administered, it difappointed the public expedation fo
much, as to be generally difcarded, till Tabor, an ad-
venturous  Englifh  praditioner, by giving more ade-
quate dofes of  the genuine drug,  revived its reputa-
tion ;  when its fame fpread fo rapidly, that the Spanifh
merchants, at length, found it  difficult to fupply the
demand of their cuftomers  for full grown Bark, and
therefore partly through necefiity, and partly through
                                          political
• De Hydr. p. «5, 
[    Jo   ]
political  ceconomy, fubftituted the fmall Bark with
which they hav? long furnifhed the European markets.
Hence may be explained, why they now affed to extol
the Quill Bark,which is more eafily prepared,and more
readily  obtained, in  almoft  any  quantity,  and that,
without deftroying  the trees.  M. Condamine, who
vifited Loxa, about  fifty years ago, affures us, that the
Red Bark was allowed to furpafs  the other forts,  but
was grown, even then,  extremely fcarce, on account
of the reafon already affigned  *.
 Of late years Peruvian Bark has become fuch an impor-
tant article  of commerce, that  our  merchants are glad'
to procure  fuch as is offered ; but no candid Spanifh
Praditioner, who has tried the different forts, will, it is
prefumed,be at a lofs in  determining to which the real
preference ought to be given.
  As the prefent ftock of  genuine Red Bark cannot
but be extremely difproportionate to  the demand, it
only remains,  that  we  earneftly  admonifh  younger
praditioners hoc to be too  precipitate  in  drawing un-
favourable  conclufions from the refult of their prefent
trials, but to fufpend their  judgment, till a frefh fup-.
ply fhall enable  them to  pronounce with more cer-
tainty, concerning its comparative powers.
  As it hitherto promifes to  be much fuperior to the
common Bark, in the  fpeedy  cure of Intermittents, ic
will alfo behove them to ufe the greater circumfpedion
in afcertaining the true  nature,  and tendency of the
difeafe, viz. whether it is a primary, or only a fecon-
dary affcdion,  whether  certain obstacles  are not pre-
vioufly  to be  removed ; whether the cortex  is not
contraindicated;  and  laftly, yhether the fudden fup-
preflion of  periodical  motions may not prove produc-
tive of fome more dangerous derangement in the fyf-
tem.
                                             From
• Mem. de l'Acad. de* Sc. 1738. 
[   «I    }
   From the prefent indifcriminate ufe of the Peruvian
Bark, in difeafes  fo diametrically oppofite in their na-
ture, I cannot help  thinking, that the inadivity of this
univerfal  Catholicon,  fo generally lamented of late,
has been rather a fortunate circumstance, and that the
inertnefs of the remedy has often prevented a feries of
evils-, which muft have  enfued from fuch a preposter-
ous abufe of the genuine drug.
   In Intermittents which  are purely idiopathic, and
proceed  from an epidemic  conftitution of the atmof-
pherc, without any concomitant difeafe, or internal in-
flammation,  the  Bark may  generally, without hefita-
tion,  be  freely exhibited $  and in  highly urgent cafes
of this  kind, which prevail in rnarfhy countries, and
fultry climates, wherein the remiffions are very fhort,
this medicine can  fcarcely be  administered too foon,
or too liberally.  Under fuch hazardous circumftances
time is too precious to admit of preparatory evacuati-
ons, and  I  moreover  concur with you in confidering
them as frequently unneceffary, if not injurious.
   On the contrary, it muft be allowed, that  Agues are,
fometimes merely  fymptomatic  of fome  other more
dangerous affedion, and ought to be confidered by the
attentive Praditioner, as remedies, rather than difeafes.
Thus in the  gout, the pain,  in flammation,  and tume-
fadion of the toe,  is not the principal  difeafe,  but  a
critical metafiafis, in order to its  cure; fo febrile pa-
roxyfms are,  in  certain cafes, to  be confidered as the
falutary  efforts  of nature,  to  fubdue  fome morbific
caufe, or to  remove fome confirmed difeafe, of a more
fatal tendency.   In fuch cafes, nature is to be affiftcd,
not  difarmed of  thefe  ffeful weapons,  by  which fhe
fometimes combats Palfies, Epilepfies, and other Her-
culean  maladies, which all the  artillery  of medicine
could otherwife never have  fubdued.
   This being accomplifhed, the febrile paroxyfms ei-
ther fubfide  fpontaneoufly,  or may be now fafely re:
moved by this powerful febrifuge.
                        L                      On 
I   .**  .;•!
,  On the other hand, there are not wanting  inftances^
where the fupervening Ague  is fo  far from removing
the former difeafe, that it ferves but to, exafperate its
fymptoms, and if fuffered  to continue, to produce ftill
other dangerous affedions.   To determine with accu-
racy and precifion in  thefe-different fituations, demands
a degree of. medical difcernment and  deliberation,
which  but too feldom occur  in the hurry of modern
pradice.
  With  refped to the general operation of the Peru-
vian Bark, I entirely coincide with what you have fo
fatisfadorily advanced, and fhall only prefume to fub-
join che following refledions.
  Phyficians,   in attacking  Putrid Fevers  and other
obftinate difeafes with the Bark, feem extremely foli-
citous co impregnate the whole mafs of fluids with its
fpecific virtue, yet excellent as ic is, when applied to the
nervous  furface of the alimentary canal, nature feems to
me, never to have intended  that  it fhould  enter the
blood, and has therefore wifely placed firm barriers to
. prevent  its admiffion into the interior parts of the ma-
chine.    A fubftance which  js capable of undergoing
 repeated macerations, and, decodions in  water  for
 many  months, without  being wholly divefted of its
 bitternefs and aftringency, could not eafily be fubdu-
 ed  in  the  blood-veffels;  but would  probably  prove
 (at leaft in its native ftate)   utterly incompatible with
 the laws of the fyftem.   Dr. Friend accordingly in-
 forms us, that no fooner had he injeded two. ounces of
.a decodion of this medicine into the  jugular, vein of a
 dog, than it produced fevere palpitations, convulfions,
 and death *.  The  Provident Guardian of the human
 frame, thus kindly  checks the wild career of afpiring
,morcals,  when,  through the mifts of boafted  fcience,
 they blindly purfue  devious paths that  often  lead to
                                          dangerous
* Emnjealag. c. xiv. 
                     t   83   ]

 dangerous  errors.   Not  that our refearches into the
 laws of the ceconomy, and the Operation of medicines1
 can be too deep, or profecuted with too much ardour,
 fo  long as we follow the clue of accurate obfervation,
 and draw no  conclusions but what are fairly, deduci-
 ble from the phenomena; but unforcunately, from the
 little we know  of thefe  matters,  we often prefume a
 great deal  concerning the major part which remains
 unknown,  and  the mifconceptions which thence enfue
 in theory, are transferred  into pradice.
   In the late German war, the French army on their
 return from Bohemia,  were feized  with Tertian Agues
 of the putrid kind, which at  length terminated  in cri-
 tical  abceffes, which formed  behind the ears, and in
 the arm-pits.  When  thefe  abceffes were fully  ma-
 tured, they were opened  according to the ufual mode
 of pradice  in fimilar  cafes.   But no fooner was  this
 unfortunate operation  performed,  than the fymptoms
 recurred,  accompanied  with extreme prostration of
 ftrength, under  which the patients generally funk  in a
 few days.  But  when  the fick were left to  Nature's
 own  management,  without  ariy attempt to promote,
 or retard fuppuration,  or to open the abcefles, the pu-
 rulent matter was fpontaneoufly difcharged by the in-
 teftinal canal, or fome of the  other emundories.   The
 praditioners were now  led to acquiefce in the mode of
 cure pointed out by Nature,  and from this time, al-
 most: all  who were afftfded with the difeafe recovered. *
   Thus Art often boldly ufurps the province of Na-
 ture, and undertakes to  regulate the inordinate mo-
tions of  a complicated machine,  and not unfrequently
by very  improper, or very inadequate means.   From
 this  fource  proceed innumerable  errors in the treat-
ment of difeafes, and endlefs mistakes concerning the
effeds of  medicines.  Intermittent  Fevers, and  the
Bark, the fubjeds  now under difcufiion,  afford preg-
nant examples of both.  Nor can any reformation be


   • Mem. de I'Acad, des Scien. de Stockholm, 
                  C   «4    I

expend  till more attention« paid to that excellent
maxim of the illuftrious Verujam :

    " N^nfingendumt fflt Mcogitandtm, fed inveniendum
        auid Natu&a faciat, aulferjtt."

           I remain, Dear Sir,

                Your moft obedient  Servant,

                            A.  FOTHERGILL.

'London, Siept,, to, 1783.
              1
APPENDIX 
   APPENDIX



                 TO   T H  B



    THIRD    EDITION.



ALetter from Dr. Samuel Foart Simmons, F. ft. S.
                to  Dr. Saunders,


     Dear Sir,

      THE fuperior  efficacy of the Red  Bark k now
      fo clearly eftablifhed,  that it would be fuperflu-
pus to trouble you with a detail of the numerous cafes
in which I have tried it.  In the cure of Intermittents,
fome of them very obftinate ones, and that had refifted
the Common Bark,  it has not once failed  me;  and J
have lately feen an infufion of it remove a double Ter-
tian of three months Handing, in a young woman, who
had taken a large quantity of Oak Bark,  and of  the
pale Peruvian Bark, both in decodion and in fubftance,
without experiencing  any relief  from either.  A lady
upwards of fixty years old,  who refides in  a pare  of
Kent where Agues are very frequent, and who for more
than a twelvemonth  had laboured under a Quartan,
which had brought on fymptoms of Jaundice,  and re-
fitted  the Common Bark,  change of fituation,  and a
variety of other remedies,  likewife owes her recovery
to the Red Bark. My learned and worthy friend,  the
                                        celebrate4 
                      [    86   ]

  celebrated Profeffor Camper, informs me,  that he has
  experienced the fame good  effeds  from this Bark in
  Friefland, a country where agues are endemial.  From
  repeated experiments, he is convinced that fix grains of
  ic  are equal in efficacy to  a fcruple of the pale Peruvi-
  an Bark.  Now that the virtues of this excellent reme.
 dy are fo fully afcertained, you will naturally be defi-
 rous of enquiring more  particularly  into its hiftory.
 From the largenefs of this Bark, you were at  firft  in-
 clined to confider it as the Bark of the trunk, or larger
 branches of the Cinchona Officinalis, Lin. and the Quill-
 ed  Bark as a  production of the twigs,  or fmaller
 branches of the fame tree  ; but having lately met with
 fome very good Red Bark, as  fmall as the Quilled Bark
 in common ufe, you are now, it feems, difpofed to think,
 that  the tree which produces  it may be a variety,  or
 perhaps a diftind fpecies of the Cinchona Officinalis___
 On this head I have fome intelligence to communicate,
 which I am perfuaded will be acceptable to you.
   Amongft the papers of the late M. Jofeph de Juffieu,
 (brother of the famous Bernard de Juffieu) one of the
 French Academicians, who went to Quito in  Spanifh
 America, in order to afcertain  the figure of the earth, ■
 and who died lately at Paris,  feyerarinterefting obfer-
 vations have been found relative to the Peruvian Bark..
 Thefe have  been  communicated to the Royal Medical
 Society  at Paris,  by his nephew Dr.  Anthony de Juf-
 fieu.  In his defcription of the genus, M. de  Juffieu :
 agrees with his fellow traveller, M. la Condamine, but
 he admits a greater number of fpecies.  Thefe,  how-
 ever, may perhaps be very properly  reduced  to two,
 as the reft feem to be only  varieties.
  The firft fpecies includes the  red,  the  yellow, and
the knotty (Je noueux) Barks,  all of  which have very
fmooth leaves, flowers of a  purplifh colour, and inodo-
rous, with a  Bark that is bitter to the tafte,  and more
or lefs coloured.   Of thefe three the Red is held in the
Irghed eftimarion, and it is this fore of. Bark, accord-,
        •■>                                     ing 
C   »7    ]
ing to M. de Juffieu,  which was employed in the early
days of this remedy in Europe,  and which acquired it
fo much, and fuch deferved celebrity.   The tree that
produces it is become fo  exceeding fcarce, that in the
-year 1739,  M. de Juffieu found it growing only in a
few places  in the neighbourhood of Loxa, fp that the
inhabitants of Peru had been obliged to fubftitute the
yellow  and knotty Barks  in its, ftead,  both of which
they are faid to prefer for  their  own ufe, becaufe they
fuppofe them to be  lefs adive  and heating.  But M.
de Juffieu,  who  had experienced the good effeds of
the Red Bark, both  in his own perfon, and in others,
confidered it as  infinitely fuperior to the reft.  Even
the trees that produce the yellow and knotty Barks are
faid to be diminifhing in number fo  faft,  that it is to
be feared they will in time become extind, unlefs a re-
gular mode of cultivating them  is adopted,  or they
are difcovered elfewhere.
   The  fecond fpecies includes  the White Barks, of
which there are four varieties.   They have all of them
broad roundifh harry  leaves; the flowers are red, very
.odoriferous,  and fumifhed with hairs on their infide
furface.  The fruit is longer than that of the former
'fpecies, and the outer Bark is of a whitifh colour.  In
two of thefe varieties, the  inner  layers of the Bark are
of a reddifh hue;  they have a flightly bitter tafte,  and
when frefh,  are faid  to poffefs a flight febrifuge quali-
ty, but which they foon lofe.   The Bark of the other
two is entirely white,  infipid, and  of no efficacy.
   M. Ant. de Juffieu  has still in his poffeffion fome
extrad  prepared by his uncle upwards  of  forty years
ago at Loxa,  from the Red Bark. . Some trials lately
made with it, prove it to be infinitely fuperior in effica-
cy to the extrad of Bark in common ufe, fo that its
virtues do not feem to have been diminifhed by keep-
ing.
   M. de Juffieu, in his travels,  found a few of the trees
that produce the yellow and knotty Barks, growing in
                                           different 
I    *   ]
different parts of the valley  that extends along the
Cham of the Andes, and in the diftrid of Yungas, which
is near it •, but it was only  about Loxa, in the 4th deg.
Of S. Lat. that he faw forefts of thofe trees.  It would
feem therefore, that the heat peculiar to fuch a latitude
is more genial to  the  Cinchona than that of any other
climate, and of courfe we can hope to meet with it on-
ly in fuch a temperature.  Upon this principle we
tnight be tempted to  look for  ic at  a fimilar diftance
from the equator in a  northern  latitude.   This has ac-
tually been done : Don Cafimir Ortoga,  Profeffor of
Botany  at Madrid, has lately  by order of the Spanifh
Minister for  the American  department,  fent to the
Royal Medical Society at Paris, fpecimens of two fpe-
cies of Cinchona recently difcovered in America, in the
province of Santa-Fe,  which is  fituated 4 deg.  and half
of Jiorth latitude.
  Thefe fpecimens are well preferved, but not quite per-
fed, as the flowers are wanting.  The leaves and fruit
of one  of thefe fpecies exadly refemblc  thofe of the
Red Bark, fent by M. la Condamine, from Peru, and
which are ftill preferved in M.  de Jufneu's Hortus Sir
evs.   The other fpecimen proves to be a White Bark,
and of courfe  a bad  fpecies.  The Spanifh  Minifter
accompanies  thefe fpecimens with a  request,  that the
Society  would inform  him what  degree   of attention
they merited.   The  Society have of  courfe given-his
Excellency every neceffary  information on this fubjed,
and as he is now aware of the  great importance of the
Red Bark, there can be no doubt but proper diredi-
ons will be given for its  cultivation  in Santa-Fe, not
only  on account of its fcarcity at Loxa,  but becaufe
it will be much more eafily conveyed to Europe, as a
river that runs through the province of Santa-Fe emp-
ties itfelf into the harbour of  Carthagena, fo  that we
may  hope foon to fee a new fource  opened  for this
admirable remedy.
                                           I cannot 
t   *9    ]
   I cannot conclude this long letter, without thank-
ing you  for  the  pleafure and information  I  have re-
ceived from the perufal of your ingenious publication,
which forms fo  valuable  an addition to the Materia
Medica.   Believe me, with great truth,
                   Dear Sir,
           Your faithful and obliged  Friend
                   and  humble Servant,
                       SAM. FOART SIMMONS.1
Air-Street, Piccadilly, Feb. 17, 1783.
 Extraif of a Letter from Mr. Aikin,  Surgeon, at War-
                       rington.

   THE fpecimen  of Red  Bark that I examined,'
 agreed perfedly with  your defcription.  I  tried its
 ftrength  by the tests  of the adion of water and fpirit,
 and was immediately  convinced of its poffeffing a much
 larger fhare of adive matter than the beft Pale Bark ;
 the moft  decifive experiment was the quantity ofrcfin
 obtained  by  evaporating a fpirituous tindure drawn
 from  equal  quantities of both forts ; that yielded by
 the Red  Bark, was in  proportion of three  to two of
 that extraded from the Pale Bark, and yet on infufing
 the woody refidua  of  each in boiling water, that of the
 Red gave a  bitter liquor,  which ftruck a   manifeft
 black  with martial vitriol,  whereas, that of the Pale,
 gave out  neither fapid  nor  colouring particles.  My
 friend, Dr. Haygarth,  informs me,  that on a fimilar
 experiment made  at  Chester  Infirmary,  the refin ex-
 traded from Red Bark was, to that from Pale, as 229
 to 130.
  'With refped to the medical efficacy of this Bark, I
am notable to relate any fair companion of it, with the
common forty as Agues, in which the beft  opportunity
is afforded for fuch a comparifon, have been uncommon
                         M                  here 
                   C   90   ]
here fince I attended to this fubjed ; I have prefcri
ed it in  moft'of  the cafes  in which Peruvian Bark \.
ufually given, and  from the general refult, I have no
doubt of its virtues being fimilar,  but probably fupe-
rior, to thofe of the kind commonly preferred.
           I am, Dear Sir,
              With fincere Regard,
               Your obedient Friend and Servant,
                                    J.,A I KI N.
Warrington, Feb. 10, 1783.
  I H O P E I fhall noc be confidered as prefumptu-
ous, in concluding, that the foregoing obfervations are
fufficient for determining the  fuperior efficacy of the  '
Jled Peruvian Bark.  And it feems reafonable to hope,
that the introdudion of this kind of Bark may be at-
tended with the happieft effeds, and enable  us to op-
pofe more fuccefsfully thofe malignant and  remittent
fevers of warm  climates, and  unfavourable fituations
fo deftrudive to our fleets and  armies.
  1 cannot, however, finifh, without returning my beft
thanks to the gentlemen  who have favoured me with
their correfpondence; and I .think it neceffary  to exprefs
my obligations  to  many gentlemen whofe letters  were
too late for publication.
  They all concur in recommending  the Red Peruvi-
an Bark, as more efficacious and  powerful  than any
other kind.
   From the numerous trials  I have  made with it, in
Intermittent  Fevers, and other difeafes, I am difpofed
to conclude, that it need be employed only in half the
quantity we generally recommend of other Bark.
   I have likewife the fatisfadion  of  alluring my rea*
ders,  that it is now in general ufe in all the large Hof-
pitals in London  ;  and fuch is the preference given to
it, that the demand is difficultly fupplied.
                                                 Be 
t   9»    ]
   Be careful in the choice of it, by attending to the
charaders which diftinguifh ic from the large Bark,
hitherto rejeded by our Druggifts.
   I fhall continue to be diligent in my enquiries on
the  fubjed,  and I moft earneftly  requeft the favour of
my friends,  that they will perfevere in fupplying me
with  accurate obfervations, fo  as to determine, with
precifion, in what other difeafes this valuable  remedy
may be ufed with fafety and advantage.
   The operations and effeds of remedies can only be
afcertained  by the  united  industry and experience of
intelligent men ;  who, by being aware of the difficulty
of making obfervations, are fufficiently guarded againft
the fallacy to which they are unavoidably expofcd.
The     EN   D. 
        THE  GENUINE





RED      BARK,





  EXAMINED AND  APPROVID  «Y





DOCTOR  SAUNDERS,






  May be had (neat as  imported) of





 Mr.  OLIVER  SMITH,





                A  K D





Mr.  WILLIAM  SCOLLAY,





 Druggists, in  Cornhill,  Boston;





tWhere alfo may be had, the beft  Assortment of




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