There is no remedy so sovereign here as the bark; but it must be given in very different times and manners from those pursued in Europe. Were a physician to take time to prepare his patient for the bark, by first giving him purgatives, he would be dead of the fever before his preparation was completed. Immediately when a nausea or aversion to eat, frequent fits of yawning, straitness about the eyes, and an unusual, but not painful sensation along the spine, comes on, no time is then to be lost; small doses of the bark must be frequently repeated, and perfect abstinence observed, unless from copious draughts of cold water. I never dared to venture, or seldom, upon the deluge of water, but am convinced it is frequently of great use. The second or third dose of the bark, if any quantity is swallowed, never fails to purge; and, if this evacuation is copious, the patient rarely dies, but, on the contrary, his recovery is generally rapid. Moderate purging, then, is for the most part to be adopted; and rice is a much better food than fruit. I know that all this is heterodox in Europe, and contrary to the practice, because it is contrary to system. For my own part, I am content to write faithfully what I carefully observed, leaving every body afterwards to follow their own way at their peril. Bark, I have been told by Spaniards who have been in South America, purges always when taken in their fevers. A different climate, different regimen, and different habit of body or exercise, may surely so far alter the operation of a drug as to make it have a different effect in Africa from what it has in Europe. Be that as it may, still I say bark is a purgative when it is successful in this fever; but bleeding, at no stage of this distemper, is of any service; and, indeed, if attempted the second day, the lancet is seldom followed by blood. Ipecacuanha both fatigues the patient and heightens the fever, and so conducts the patient more speedily to his end. Black spots are frequently found on the breast and belly of the dead person. The belly swells, and the stench becomes insufferable in three hours after death, if the person dies in the day, or if the weather is warm.