The genuine Peruvian bark is one of the most effective tonics ever employed for the cure of intermitting fever or ague. It may be used as a general tonic in all cases where the use of this class of medicine is indicated. As a general rule powerful tonics should not be employed in the first stage of disease attended with fever and a dry coated tongue. Under these circumstances bitters, unless combined with a large portion of Capsicum, would repress rather than promote the secretions, and aggravate the disease. When by the free use of Capsicum and other appropriate remedies the secretions are restored, the tongue cleaning and the skin warm and disposed to perspiration, then Peruvian bark or other tonics may be employed with advantage.

Peruvian bark is rendered more efficient as a tonic by combining it with Virginia snake root, cloves and Capsicum. I frequently mix equal parts of Peruvian bark and spice bitters, and have always found it a good preparation.

A tea made of equal parts of Peruvian bark and liquorice root is a good remedy for colic in infants, more especially where the spells of colic are observed to come on periodically.

The title Jesuit's Bark has been applied to the Peruvian bark, from the circumstance of the Jesuits having had the chief control of the sale of the article during its first introduction into use in Europe about the year 1640. It is not known whether they really introduced it into Europe, but if they did, it was about the only good thing they ever did.

There are three species of Peruvian bark imported to this country, the pale, yellow and red. These are now officially known as Cinchona Officinalis (pale), Cinchona Calisaya (yellow), Cinchona Succurubra (red). At one time the red bark was esteemed the most valuable. This induced druggists to convert other species into red bark by adulterations which so materially lessened the efficacy of the bark that at one period the red bark was little used. Each species of bark above mentioned is efficient as a tonic, provided it be free from adulterations.

Peruvian bark is most active when taken in substance, mixed with some liquid, as a tea of spice bitters, Virginia snake root, a solution of licquorice, or simply with water. The unpleasant taste of the bark will scarcely be perceived when it is taken in a solution of liquorice.

When the bark cannot be taken in substance its virtues may be extracted by boiling water, and taken in decoction. A small portion of orange peel, liquorice root, or spice, added, will improve the flavor of the tea; and where there is acidity of the stomach a portion of the sup. carbonate of soda should be added.

Peruvian bark is often taken in wine, and with the most happy effects in many instances, as in recovery from disease where the strength of the patient has been much exhausted.

Dose: The quantity of bark taken at a time varies from that of a teaspoonful to an ounce. Whilst some recommend it in small doses, repeated every hour or two, others direct an ounce to be taken at once. More especially is it recommended to be taken in large doses, in cases of intermitting fever where by a proper course of treatment the system is placed in a condition that warrants the free use of tonics.

When Peruvian bark or quinine is used, all astringents medicine, viz: bayberry, sumac, No. 3, pills, etc., must be laid aside at the time, as the tannin and gallic acid in the astringents form an insoluble compound with the active principles of the bark, rendering it inert. Astringents may be used in the forenoon and barks in the afternoon, or vice versa.

Three important indications in the treatment of disease are: 1st. To restore the natural warmth of the system. 2nd. To cleanse the stomach and bowels of "canker," or morbid secretions; and 3rd. To restore digestion. The first requires the use of pure stimulants, and sometimes the application of the vapor bath; the second, the use of astringents and detergents; and the third, tonics. Hence the general indications for the use of tonics is when the secretions are restored and the stomach and bowels cleansed of "canker."

The majority of the Herbalists and Physio-Medical physicians condemn Quinia or Peruvian bark as bad results follow the use of it in so many cases, and I have yet to learn of a single case in which it was given by the "regulars" where it did not cause a fearful headache and ruin the liver. The reason for this is not in the remedy, but in the way that it was made use of. By following the foregoing very plain instructions for its use, the physician can make no mistake and he will be sure to get the good results from its use that he is looking for. The dose of Quinine is from one to ten grains.

Quinine is the active principle of Peruvian bark, and may be used as a substitute for the bark. Quinine has sometimes been discovered to be adulterated with starch, stearin, sulphate of lime and sugar. There are means, however, of detecting adulterations of quinine, for a knowledge of which the reader is referred to the U. S. Dispensatory.

Quinine is usually taken in the form of pills. Eight quinine pills of the usual size are supposed to be equivalent to an ounce of Peruvian bark. A pill to contain a grain of quinine (equal to a drachm of bark) must be considered larger than pills are generally made.

Quinine is rendered more active by the addition of Capsicum, and in using quinine all the rules should be followed that are laid down in the use of Peruvian bark.

As a cure for intermittent fever, when the condition of the system is favorable for the exhibition of tonics, there is probably no remedy of equal value with quinine. This medicine, however, is so easily taken that it may be used too indiscriminately. It may be continued until large quantities have been taken, the system at the same time not being in a condition to be benefited by its use. It is for this very reason that so many bad results follow its use. Almost daily patients come to me and warn me not to give them quinine as they could not stand it. They tell me it ruins their liver, gives them headache, etc., and this shows the improper use that is made of this remedy.