TONICS _with_ PURGATIVES. In the exhibition of tonic medicines it is frequently essential to accompany their operation with purgation; in intermittent fevers, for instance, when attended with a redundant secretion of bile, or any obstruction of the viscera, the _bark_ must be given in combination with some laxative, for which purpose Boerhaave has recommended _Muriate of Ammonia_; _Mead_, _Rhubarb_; whilst in many cases, experience suggests the propriety of selecting some of the warmer cathartics, especially the Alöetic: and I shall take this opportunity to observe, that notwithstanding the opinion so strongly expressed by Sydenham, that “_to add any thing to the bark argues either ignorance or craft_,” the most respectable testimony may be adduced to demonstrate the great advantages which have arisen from the various combinations of this heroic remedy. Sir George Baker has said that “_there is less of reason than of severity_,” in the above remark of Sydenham; for that it was found in the cure of the intermittent fever, which he describes, that, according to circumstances, sometimes the _Virginian snake root_, and in other cases _Myrrh_, were added with propriety and advantage; and, according to the experience of several practitioners, a drachm of the _rust of iron_, and the same quantity of the powder of _black pepper_, added to each ounce of _bark_, were the means of subduing the most inveterate agues. _Formula 44_ presents a combination, which we learn from Dr. Petrie’s letter to Sir George Baker, constitutes a celebrated Dutch remedy for an ague, and which was tried with success in the hospital at Lincoln, in those obstinate intermittents which prevailed in the year 1781. Hillary speaks of an epidemic intermittent at Barbadoes, in which the bark was of no avail, unless combined with saline remedies, or some of the tonic bitters. Dr. Barton has stated that Bark combined with Mercury in a small proportion, is one of the best remedies for removing the swelling of the spleen after an intermittent. EXPECTORANTS _with_ DIFFUSIBLE STIMULANTS. We have seen that expectorants may be usefully associated with tonics; it sometimes occurs that these remedies require the addition of some diffusible stimulant. In certain states of _Peripneumonia notha_, where the powers of life are ebbing, and the lungs become inundated with viscid mucus, I have experienced the value of a combination of some stimulating expectorant and _ammonia_. ANTACIDS _with_ TONICS. In the cure of cardialgia we have obviously two indications; to neutralize the offending acid by some chemical agent, and to correct the morbid state of the digestive functions by some appropriate remedy. _See Form. 152_. The same observation will apply in the treatment of certain cases of chlorosis, where cardialgia is not unfrequently a very vexatious attendant, and solicits the union of emmenagogues with antacids, or absorbents, as in _Form. 99_.