Part 3

In such cases, a cure cannot be effected without some suitable anti-psoric. During the prevailing fever, Natrum muriaticum has proved such an anti-psoric, provided it was used as follows: If the signs of psoric complication became visible at the outset, I gave a pellet of Natrum mur. 30, and awaited the result until after the third paroxysm. If symptoms of improvement had become manifest, no other remedy was given, and the improvement was permitted to progress from day to day. If the signs of psoric complication were obscure at the beginning of the attack, Apis was at once given. If no improvement became visible after the third paroxysm, or if other symptoms developed themselves, this was looked upon as a proof of the existence of psora, and Natrum mur. 30 was given, and no other remedy, until after the third paroxysm. Either the disease had ceased, or it required further treatment. In the latter case, Apis 3 was continued in drop-doses, morning and evening, until the patient was decidedly convalescent. No further medicine was given after this, and the Natrum mur. was permitted to act undisturbed, without a single repetition. Every such repetition is hurtful; it disturbs the curative process, excites an excess of reaction in the organism, exhausts it, and develops artificial derangements, which often mislead the judgment, and induce an uncalled-for and improper application of remedial means. Such repetitions are unnecessary; any one who is acquainted with the action of Natrum mur., will at once perceive that the psora-destroying effect of this agent had not been neutralized by Apis. Recovery becomes more and more completely established, and sometimes terminates in the breaking out of a wide-spread, bright-looking eruption, resembling recent dry itch, and attended with the peculiar itching which always exists in this disease. The complete peeling off of the epidermis shows the true cause of the disease. In a few cases, an itch-eruption of this kind proved contagious, and communicated itself to other persons in the family.

A similar course of treatment was pursued, if some other anti-psoric had to be resorted to, according as one or the other of the three miasms seemed to require.

_The thoroughness of this treatment of intermittent fevers is proved by the fact, that no relapses ever took place, or that no secondary diseases were ever developed._

If these sequelæ were the consequences of an abuse of Cinchona, and this China-cachexia was the source of subsequent paroxysms of fever, I have, even in such cases, when nothing else would help, seen Apis cure both the fever and the China-cachexia, in most cases which came under my treatment. In the most inveterate cases, which had perhaps been mismanaged in various ways, and where the reactive power of the organism seemed entirely prostrated, I found it necessary to resort to the employment of a most penetrating agent, more particularly the 5000th potency of Natrum muriaticum, which I have so far found the only sufficiently powerful curative influence under the circumstances. The rules of administering this potency are the same as those for the exhibition of the 30th.

Not only does Apis afford help in the affections which habitually and most generally occur among us; it is likewise in curative rapport with the

TYPHOID-GASTRIC CONDITIONS WHICH DEVELOPE THEMSELVES DURING THE COURSE OF AN ERYSIPELATOUS OR EXANTHEMATOUS CUTANEOUS AFFECTION, MORE PARTICULARLY SCARLATINA, RUBEOLA, MEASLES AND URTICARIA.

The use of Apis in erysipelas is indicated by: "Nos. 168, 169: great anxiety in the head, with swelling of the face; inflammatory swelling and twitching so violent, that an apoplectic attack is dreaded. 175 to 178: sensation as if the head were too large; swelling of the head; sensitiveness to contact on the vertex, forehead; burning, stinging about the head. 292: erysipelatous inflammation of the eyelids. 295: after the most violent pains of the right eye, a bluish, red, whitish swelling of both eyes, which were closed in consequence. 297: swelling under the eyes during erysipelas, as when stung by a bee. 316: red swelling of both ears, with a stinging and burning pain in the swelling, with redness of the face every evening. 356: erysipelas spreading across the face, and proceeding from the eyes. 359: tension in the face, awakening her about one o'clock, the nose was swollen, so were the right eye and cheek, stinging pain when touching the part; under the right eye, and proceeding from the nose, red streaks spread across the cheek, until four o'clock; next day, after midnight, sudden swelling of the upper lip, with heat and burning redness, continuing until morning; on the third night, sudden crawling over the right cheek, with stinging near the nose, after which the cheek and upper lip swelled. 363: face red and hot, with burning and stinging pain, it swells so that he is no longer recognized. 388: pimple in the vermilion border of the lower lip, which he scratches, after which an erysipelatous swelling arises, spreading rapidly over the chin and the lower jaw, and invading the anterior neck and the glands, so that he is unable to move the jaws, as during trismus, or as if the ligaments of the jaws were inflamed; with constant disposition to sleep, the sleep being interrupted by frightful dreams. 706 to 707: swelling of the right half of the labia, with inflammation and violent pain, rapid, hard pulse, diarrh[oe]a consisting of yellow, greenish mucus, in the case of a girl of three years old; deeply-penetrating distress, commencing in the clitoris and spreading to the vagina; the labia minora are swollen, they feel dry and hard, they are covered with a crust; at the commencement urination is painful. 948: burning of the toes, and erysipelatous redness with heat at a circumscribed spot on the foot, the remainder of the foot being cold. 1167, 1168: acute pain and erysipelatous swelling, hard and white in the centre; bright red, elevated, hard swelling of the place where he was stung, and round about a chilly feeling. 1170-1173: red place where he was stung, with swelling and red streaks along the fingers and arm; red streaks along the lymphatic vessels, proceeding from the sting along the middle finger and arm; inflammatory swelling, spreading all around. 1181: throbbing in the swelling. 1182: wide-spread cellular inflammation, terminating in resolution. 1224, 1225: swelling and erysipelatous redness; erysipelatous redness of the toes and feet."

If we add to these remarks, that Apis corresponds to gastric and typhoid conditions, as was shown before, with remarkable similarity of symptoms, we find, without doubt, that all known erysipelatous forms of inflammation are covered by the pathogenetic effects of Apis. Hence we may with propriety give Apis in these affections. Practical experience has abundantly confirmed these conclusions. For the last four years, I have cured readily, safely and easily all forms of erysipelas which have come under my notice--[oe]dematous, smooth, vesicular, light or dark colored, seated or wandering, phlegmonous, recent or habitually recurring, of a light or inveterate character, repelled, among individuals of every disposition and age. I have never seen all kinds of pain yield more readily; I have never seen the accompanying fever abate more speedily; I have never arrested the further spread of erysipelas, nor effected a resolution of the inflammation of the cellular tissue, more certainly; nor, if the termination in suppuration was no longer avoidable, have I ever succeeded in effecting the formation of laudable pus, the spontaneous discharge of the pus, the radical healing of the sore without any scar--_how important is all this in erysipelatous inflammation of the mammæ_--with more certainty and thoroughness, than by means of Apis! No remedy possesses equal powers in protecting internal organs from the dangerous inroad of this disease.

I effected all this without any other medicinal aid, or without resorting to an operation. Keeping quiet and dry, and in a uniform temperature, is all that is required, in order to secure the full curative action of Apis. In this disease it is used in the same manner as we have indicated before. If the liver should be very much involved in this disease, we effect a cure still more rapidly, by alternating Aconite with Apis, in case inflammation is present; Carduus mariæ, in case of simple inflammatory irritation, and Hepatin, if disorganizations have already set in. In phlegmonous and suppurative habitual erysipelas, a cure is generally facilitated, if a dose of Sulphur 30 is interpolated, in the manner which we have explained before, in order to neutralize the psoric taint which is here generally present.

According to this experience, in conjunction with the symptoms 706, 707, I believe that Apis will prove a successful prophylactic and curative agent in a disease of children, which terminates fatally in almost every case. I mean erysipelas of new-born infants, which commences at the genital organs, thence spreads over the skin, and terminates in the induration and destruction of this organ. Until now, I have not had an opportunity of verifying the truth of this theoretical conclusion by actual experiments. Hence I content myself with offering this suggestion for further practical trials.

The American Provings likewise show that Apis may be of great use in scarlatina.

"No. 349: redness of the face, as in scarlatina. 408 to 413: tongue very painful, the burning and raw feeling increases; vesicles spring up along the margin of the tongue, the pains are accompanied by stitches; at the tip of the tongue, toward the left side, a row of small vesicles spring up, some six or eight, which are very painful and sore; dryness of the tongue, red and fiery appearance of the inside of the cheeks, with painful sensitiveness. 311: pains in the interior of the right ear. 413 to 417: burning at the upper portion of the left ear; stitches under the left ear, tension under and behind the ears; red swelling of both ears, with a stinging and burning pain in the swelling. 462 to 463: difficulty of swallowing, staging pains when swallowing. 466: burning in the fauces down to the stomach. 470: difficulty of swallowing in consequence of redness and swelling of the tonsils. 473: ulcers in the throat during scarlet fever. 1236: scarlatina does not come out, in the place of which the throat becomes ulcerated. 1237: retrocession of scarlatina, violent fever, excessive heat, congestion of the head, reddened eyes, violent delirium. 832: redness and swelling in front of the neck, swelling of the glands. 833: swelling of the cervical glands on the injured side. 836: tension on the right side of the nape of the neck, below and back of the ear. 897, 898: itching and burning of the dorsum of the hand and of the knuckles and first phalanges; cracking of the skin here and there; itching and chapping of the hand and lower lip."

If we add to these symptoms the above enumerated cerebral symptoms, the typhoid alteration of the internal mucous membrane of the whole alimentary canal and of the respiratory organs, the disorganizing and paralyzing action upon the blood and nerves, the inclination to dropsical effusion, the affection of the cervical glands with tendency to suppuration, the appearance of otorrh[oe]a,--we have a group of symptoms which resemble very accurately the prevailing type of epidemic scarlatina. I know, from abundant experience, that the hom[oe]opathic law has been brilliantly confirmed in this disease. Thanks to the curative powers of Apis, scarlatina has ceased to be a scourge to childhood. The dangers to which children were usually exposed in scarlatina, have dwindled down to one, which fortunately is a comparatively rare phenomenon. It is only where the scarlet-fever poison acts at the outset with so much intensity, that the brain becomes paralyzed at once, and the disease must necessarily terminate fatally, that no remedy has as yet been discovered. In all other cases, unless some strange mishap should interfere, the physician, who is familiar with Apis, need not fear any untoward results in his treatment of scarlatina.

In all lighter cases, where the disease sets in less tumultuously, and runs a mild course, it is proper, as soon as the disease has fairly broken out, to give a globule of Apis 30, and to watch the effects of this dose without interference. The immediate consequence of this proceeding, is to bring the eruption out in a few hours, all over the skin, with abatement of the fever and general perspiration, after which the eruption runs its course in a few days, with a progressive feeling of convalescence, the epidermis peels off from the third to the fifth day, and, at the latest, to the seventh day, with cessation of the fever, so that the process of desquamation is generally terminated within the next seven days, after _which the patient may be fairly said to be convalescent, and the patient may be said to be absolutely freed from all danger of consecutive diseases_.

The same result is obtained by nature in cases of mild scarlatina, without the interference of art. But the experience which I have had an opportunity of making during my long official employment as district-physician, has convinced me that Nature accomplishes her end far more easily, more speedily and satisfactorily, if assisted by art in accordance with the law of hom[oe]opathy. The sequelæ especially are rendered less dangerous by this means.

But if the disease sets in with a considerable degree of intensity at the very outset, and the fever continues without abatement, it is advisable to keep up a medicinal impression by repeating the dose. To this end we dissolve a globule of Apis 30, in seven dessert-spoonfuls of water, by shaking the solution vigorously in a corked vial, and giving a dessert-spoonful every three, six, or twelve hours as the case may require. In all ordinary cases a single solution of this kind sufficed to subdue the fever and to secure a favorable termination of the disease.

The struggle between disease and medicine assumes a far different form, if the morbific poison has penetrated the organism more deeply; if a process of disorganization has already developed itself in the intestinal mucous membrane, and if the alteration of the sanguineous fluid, which is an inherent accompaniment of such a disorganizing process, has depressed the nervous activity to such a degree that typhus, or paralysis of the brain or lungs seems unavoidable, as may be inferred from the bright-red tongue, which is thickly studded with eruptive vesicles, and speedily becomes excoriated, fissured and covered with aphthæ; by a copious discharge of thick, white, bloody and fetid mucus from the nose; by the swelling and induration of the parotid glands, increasing difficulty of deglutition; sensitiveness of the abdomen to pressure; badly-colored, slimy, bloody diarrh[oe]a; scanty emissions of turbid, red, painful urine; accelerated and labored breathing; loss of consciousness; delirium; sopor; convulsions; trembling of the limbs; appearance as if the patient were lying in his bed in a state of fainting; the skin is at times burning, hot and dry; at others it feels like parchment, cooler; at others again, hot and cool together in spots; the fever increases with changing pulse, and is more constant; in short, all the symptoms, although developing themselves less rapidly, show that a fatal termination becomes more and more probable. In such a case it is above all things necessary to saturate the organism with Apis. If there is much fever, this result is best accomplished by means of alternate doses of Aconite and Apis, a few drops of the third potency, shaken together with twelve tablespoonfuls of water, each drug by itself, the dose to be repeated every hour; and if the temperature is rather depressed, by giving Apis without the Aconite, a tablespoonful every hour or two hours. In favorable cases the fever becomes more remittent within one to three days; a moderate and pleasant perspiration breaks out all over the skin; the sleep becomes calm and natural, and the typhoid symptoms abate. If this change takes place, it is proper to exhibit Apis in a more dynamic form, in order to assimilate it more harmoniously to the newly awakened reactive power of the organism. To this end we dissolve a few globules of Apis 30 in seven dessert-spoonfuls of water, giving a dessert-spoonful morning and evening, and we continue this treatment, until the symptoms of typhoid angina have gradually abated, the tongue has been healed, the normal desire for food has returned, and the digestive functions go on regularly; after which the natural reaction of the organism, assisted by careful diet, will be found sufficient to complete the cure. If no improvement sets in after Apis has been used for three days, we may rest assured that a psoric miasm is in the way of a cure, which requires to be combated with some anti-psoric remedy. I have generally found Kali carbonicum efficient, of which I gave one globule thirty on the fourth day of the treatment, permitting it to act uninterruptedly from one to three days, according as the disease was more or less acute, after which I again exhibited Apis in the manner previously indicated. In this way I succeeded in developing the curative powers of Apis, so that in a few days a gradual improvement, however slight, became perceptible to the careful observer. As soon as the improvement is well marked, all repetition of the medicine should cease, and the natural reaction of the organism should be permitted to complete the cure. Any one who is acquainted with the action of the Kali, must know that it continues without being interrupted by Apis. An invaluable blessing of Nature!

This proceeding is crowned with the desired results; the convalescence is shorter and easier, and there is less danger of serious sequelæ, which, according to all experience, are so common in complicated cases of scarlatina, otorrh[oe]a and suppuration of the parotid glands are generally avoided under this treatment without any other aid, or, if it is impossible to avert such changes, they generally come to a speedy and safe end. This treatment likewise keeps off dropsy and its dangers.

In cases where the secretion of _black urine_ shows that the liver is deeply involved in the disease, Apis is powerless. These are the only exceptions to the curative power of this drug. Here we are told by our law of cure, that the sphere of Lachesis commences. We give one or two globules of Lachesis 30 in seven dessert-spoonfuls of water, a dessert-spoonful every twelve hours, and in acute cases every three hours; and the good effects of the medicine must seem miraculous to one who is not accustomed to this mode of treating diseases. Already in a few hours the patient becomes tranquil, showing that the process of disorganization has been arrested; the improvement continues from hour to hour; the sleep becomes more tranquil; the cutaneous secretions, and those of the bowels and kidneys, become more active; after the lapse of one, or at most two days, the urine begins to look clearer and lighter-colored, and in about three days a return of the natural color of the urine shows that the functions of the liver are restored to their normal standard; the patient is able to do without any further medical treatment, and the natural reaction of the vital forces will be found sufficient to effect a cure.

If I have not mentioned the affections of the kidneys, which may be present in this disease, it is because I have become satisfied by years of experience, that they constitute secondary affections in scarlatina, and that we should commit a great error if we would draw conclusions regarding this point from post-mortem phenomena.

Nobody who has observed the resemblance, at any rate, during the present epidemic, between

RUBEOLA

and scarlet-fever, will deny that the remarks which we have offered concerning this latter disease, likewise apply to rubeola. In

MEASLES,

likewise, Apis will prove a curative agent.

In the American Provings, Apis is indicated in this disease by the following symptoms: "No. 1103, heat all over; the face is red as in scarlatina; eruption like measles; cough and difficult respiration as in croup; muttering delirium; 1211, superficial eruptions over the whole body, resembling measles, with great heat and a reddish-blue circumscribed flush on the cheeks; 1218, measle-shaped eruption."

If we add to these symptoms the peculiarity inherent in Apis, to cause catarrhal irritations of the eyes, such as occur during measles, we have a right to infer that Apis will prove a valuable remedial agent in measles.

Although common mild measles do not require any medicinal treatment, and generally get well without any prejudice to the general health; nevertheless, cases occur where intense ophthalmia, a violent and racking cough, and the phenomena which appertain to it; an intense irritation of the internal mucous membrane; diarrh[oe]a; dangerous prostration of strength; marked stupefaction and various nervous phenomena render the interference of art desirable. In all such cases, I have seen good effects from the use of Apis, which differed not only from the regular course of the disease, but likewise from the effects which have been witnessed under the operation of other medicines. In ordinary cases, and without treatment, it takes three, five, seven and eleven days, before the eyes get well again; but under the use of Apis, the eyes improve so decidedly in from one to three days, that the eyes do not require any further treatment; and that even troublesome sequelæ, such as photophobia; styes which come and go; troublesome lachrymation; continual redness; swelling and blennorrh[oe]a of the lids; fistulæ lachrymalis, etc., need not be apprehended.

If Apis has had a chance to exercise its curative action in a case of measles, we hear nothing of the troublesome, and often so wearing and racking cough, which so often prevails in measles, and the continuance of which is accompanied by an increased irritation and swelling of the respiratory mucous membrane and an increasing alteration of its secretion, which recurs in paroxysms, assumes a suspicious sound, shows a tendency to croup and to the development of tuberculosis, and finally degenerates in whooping-cough, so that epidemic measles and whooping-cough often go hand in hand. After Apis, the cough speedily begins to become looser and milder, to loose its dubious character, and to gradually disappear without leaving a trace behind. If these results should be confirmed by further experience, we would have attained additional means of preventing the supervention of whooping-cough in measles; a triumph of art and science which should elicit our warmest gratitude.

Any one who knows, how malignant measles, unassisted by art, are accompanied by deep-seated irritation of the mucous membrane of the stomach and bowels; how they lead to diarrh[oe]a; to sopor; how they threaten life by long-lasting and troublesome putrid and typhoid fevers; and how, if they do not terminate fatally, they result in slow convalescence, and sometimes in chronic maladies for life, will admit, on seeing the diarrh[oe]a cease; on beholding the quiet sleep which patients enjoy; the pleasant and general perspiration; the return of appetite; the increase of strength, and the complete disappearance of all putrid and typhoid symptoms, that Apis has indeed triumphed over the disease.