It is not necessary, however, especially in the advanced stages of the disease in this climate, to wait for an absolute remission, in order to administer the bark. In a cold or temperate climate it will seldom be found advisable to give it in any period of this fever; but in a hot climate it is sometimes admissible where there are symptoms of general debility, such as a small pulse and muscular weakness, even though the frequency of the pulse, delirium, and a dry skin and tongue, should indicate some degree of fever. It may be remarked, by the bye, that a dry tongue is a fallacious symptom, for it may happen in consequence of the patient’s breathing through the mouth instead of the nose, without any fault in the secretions of the _fauces_. The symptom which forbids the use of the bark more absolutely than any other is an inflammatory or dysenteric state of the bowels, in which cases it seems to be invariably pernicious. Where it happens that we are extremely anxious to throw in the bark, as we usually are in the West Indies, where fevers are very rapid and dangerous, and yet the symptoms seem hardly to admit its use, it was very commonly tried either in conjunction with some antimonial medicine or neutral salt, or these were given alternately with it, in order to soften and qualify its effects by preventing it from heating or otherwise aggravating the symptoms. Antimonial wine or _Spiritus Mindereri_ were conveniently employed with this intention. With regard to the quantity of bark to be given, it may be proper in doubtful cases of this kind to begin with small doses, in order to feel how far it agrees or not; but in general it may be laid down as a rule with regard to this medicine, that, where it is really proper, and the medicine to be depended on, it is to be given in as large doses and as frequently as the stomach will easily bear it.