Cinchona another fever remedy. The bark of cinchona can be harvested in a number of ways. One approach was to cut the tree but this and girdling are equally destructive and unsustainable so small strips were cut and various techniques such as "mossing", the application of moss to the cut areas, were used to allow the tree to heal. Other approaches involved coppicing and chopping of side branches which were then stripped of bark. The bark was dried into what were called quills and then powdered for medicinal uses. The bark contains alkaloids, including quinine and quinidine. Cinchona is the only
Analgesic tolerance, which may be of particular concern regarding patients suffering with chronic pain and requiring an analgesic over long periods. Opioid tolerance is often addressed with opioid rotation therapy in which a patient is routinely switched between two or more non-cross-tolerant opioid medications in order to prevent exceeding safe dosages in the attempt to achieve an adequate analgesic effect. Opioid tolerance should not be confused with opioid-induced hyperalgesia. The symptoms of these two conditions can appear very similar but the mechanism of action is different. Opioid-induced hyperalgesia is when exposure to opioids increases the sensation of pain (hyperalgesia) and can