The next remedy mentioned was opium. It is a medicine more admissible and useful in this than any other kind of fever. The same cautions nearly apply in the administration of it as have been given with regard to the Peruvian bark. The caution with regard to foul bowels is particularly necessary in a hot climate, where an over secretion of bile is so apt to take place. When, the Boreas frigate arrived from England in March, 1783, there was a very bad fever of the infectious kind on board, some cases of which being sent to the hospital at St. Lucia, were treated unsuccessfully with bark and opium, which I had been induced to try upon the authority of the authors above alluded to. I attributed this want of success to the neglect of previous evacuation; for, upon inspecting the bodies, the intestines were found full of bilious _feces_. I profited from this, and was more successful in the other cases. It were to be wished that physicians could oftener bring themselves to confess their errors in practice, and their writings would be more instructive; for it is of consequence to know what we are to avoid as well as what we are to follow. It has been mentioned that the best effects arise from the conjunction of an antimonial with an opiate; but, in this sort of fever, antimonials, and even most of the neutral salts, are hurtful after the first stage, and opiates may after this be given alone or combined with camphor. With regard to the precise period of leaving off antimonials, it must be left to discretion, and the constitution of the patient is the best guide. There is so great a difference in patients in this respect, that all practical precepts should be qualified by a due discrimination of constitutions. Absolute and dogmatical rules are so far from applying in the practice of physic, that there are some cases of the same disease that require a treatment even opposite to what is in general most adviseable. This may be very aptly illustrated by the small pox, of which there are cases that ought to be treated very differently from the general method laid down by Sydenham, and in which cordial medicines are highly proper and necessary. This difference in diseases themselves seems to be one great cause of the difference of opinion among physicians on practical points, each party finding some countenance in experience for their general doctrine, do not make allowance for the varieties that exist in nature; so that, in one sense, both may be said to be in the right. If the patient is not very much sunk, and if there are bilious symptoms, or an obstinate dryness in the skin, a few grains of James’s powder may be given with advantage even in an advanced period of the disease. If a hot and dry skin should at this period be the only troublesome symptom, it will be more safely and effectually removed by camphor combined with something opiate and the _Spiritus Mindereri_, which is the only neutral now admissible,