Chapter 2

"398: troublesome pains in the gums. 400: the gums bleed readily. 402: bitterish taste in the back part of the tongue and in the throat. 405: tongue as if burnt. 406: tongue and palate feel sore. 411: a number of vesicles and small, sore, somewhat red spots at the tip of the tongue and along the left margin of the tongue. 413: dry tongue, the inner cheeks look red, fiery, are painfully sensitive. 416: burning from the tongue down the [oe]sophagus, as far as the stomach, eructations every four or five minutes, with flow of tasteless water in the mouth; eructations became worse after drinking water, she almost felt as if choked. 420: swelling of the tongue, the tongue is dry, shining, yellowish. 421: tenacious saliva adhering to the tongue. 424: tongue dry and white. 427: feeling of dryness in the mouth and throat. 441: fetid breath, with gastritis. 445: quantity of thick, tenacious mucus deep in the throat, obliging him to hawk. 447: tenacious, frothy saliva. 450: dryness in the throat, without thirst. 452: loathing, as if out of the throat. 459: sense of fulness, constriction and choking in the throat. 474: loss of taste. 475: complete loss of appetite. 488: no thirst, with heat. 492: very thirsty when waking at night, after diarrh[oe]a. 495: eructations tasting of white of eggs. 501: nausea and vomiting. 504: fainting sort of nausea from the short ribs across the whole abdomen. 512: vomiting of the ingesta. 513: vomiting of bile. 516: vomiting and diarrh[oe]a. 517: nausea, vomiting of the ingesta, and diarrh[oe]a; repeated vomiting, first of bile, afterwards a thin, watery fluid, having a very bitter taste, with violent pains across the abdomen. 518 to 525: oppression, pressing, creeping, drawing and gnawing, pricking, soreness, heat and burning in the stomach. 528: painful sensitiveness in the pit of the stomach, with burning, like heartburn, with bilious diarrh[oe]a, rather greenish, and almost painless. 530: violent pain and sensitiveness in the region of the stomach and epigastrium, with vomiting, coated tongue, fetid breath, costiveness, and sleep disturbed by muttering and dreams, with frequent, wiry pulse. 533: sense of numbness under the right ribs. 532: sense of compression, squeezing, bruising, under the ribs, worse on the left side. 535: violent burning pains under the short ribs on both sides, worst and most permanent on the left side, _where the pain is felt for weeks, preventing sleep_. 543: rumbling in the abdomen, with violent urging to stool. 545: nausea in the abdomen, has to lie down. 546: weight in the abdomen. 547: dull pain in the bowels. 552: occasional attacks of colic, with a feverish, tremulous sensation. 553: violent, cutting pains in the abdomen. 555: slowly pulsating, boring pain above the left crest of the ilium, relieved by eructations. 556: pain in the abdomen, from the hips to the umbilical region. 560: soreness and pressure in the lower abdomen. 563: _feeling of soreness, burning and numbness below and on the side of the right hip, deep-seated_. 566: the inner abdomen feels sore and as if excoriated, painful when pressed upon. 567: feeling as if the bowels had been squeezed, with tenesmus during stool. 576: fulness and sense of distension in the abdomen, as if bloated. 589: frequent urging to stool, with pain in the anus on account of the frequent pressing. 590: violent tenesmus. 593: several thin, yellow evacuations, accompanied by excessive prostration; the stools set in at every motion of the body, as if the anus were wide open. 598: copious discharges of dark brown, green and whitish excrements. 599: dysenteric stools. 608: blood and mucus with stool. 611 and 612: painful and also painless diarrh[oe]a, especially in the morning. 617: retention of stool for one week. 646: disagreeable sensation in the bladder, with pressing downwards in the region of the sphincter, and frequent urging, so that he voids urine frequently in the day-time, and ten or twelve times at night; burning and cutting during urination. 668: the urine is dark colored. 730: hoarseness and distress of breathing. 733: roughness and sensitiveness in the larynx. 738: violent cough, especially after lying down and sleeping. 754: hurried and difficult breathing, with heat and headache. 803: sense of soreness, lameness, bruised and contusive feeling in the chest. 812: trembling and pressure in the chest, with embarrassed breathing. 818: pulse scarcely perceptible. 822: pulse accelerated. 833: swelling of the cervical glands on the injured side. 968: extreme sensitiveness of the whole body to contact, every hair is painful when touched. 971: excessive nervousness. 979: general lassitude, with trembling. 994: in the afternoon he becomes extremely restless and exhausted. 1011: paroxysms of great weakness. 1021: sudden weakness, he had to lie down, and lost his senses. 1025: complete loss of recollection, with vomiting, desire for sleep and rest, slow beating of the heart and scarcely perceptible pulse. 1032: excessive drowsiness. 1039: starting during sleep, as if in affright, with some cough. 1046: sleeplessness. 1047: restless sleep, frequent waking and constant _dreaming_. 1064: chattering during sleep (in the case of a child). 1081: chilly every afternoon at three or four o'clock, she feels a shivering, worse during warmth; chilly creepings across the back, the hands feel numb; an hour after, feverish heat, with rough cough, hot cheeks and hands, no thirst; these symptoms pass off gradually, but she feels heavy and prostrated. 1089: chill after a heat of thirty-six hours. 1090: sudden chilliness, afterwards heat and sweat. 1124: alternate sweat and dry skin. 1198: thick urticaria, itching a great deal (very soon). 1224: swelling and erysipelatous redness. 54: unable to concentrate his thoughts. 57: dulness of the head, it feels compressed. 62: vertigo and weakness. 79: dizziness."

Whosoever compares the totality of these effects of Apis to the symptoms of the prevailing abdominal typhus, will admit that Apis is hom[oe]opathic to this disease. He will even admit that this hom[oe]opathicity of Apis to abdominal typhus extends to the minute particulars of the disease _in their totality_. Even the course which Apis pursues, in developing its effects in the organism, is similar to the progressive development of typhus. Any one who has witnessed, as I have, the course which this disease pursues, will admit that mucous membrane of the alimentary canal is first affected by the disease, in the same manner as Apis affects it; that this irritation of the mucous membrane is followed by gastric catarrhal symptoms, which are speedily succeeded by symptoms of disintegration of the animal fluids and typhoid phenomena; that the gastric irritation is generally characterized by boils, urticaria, erysipelas of the skin, and the nervous irritation by symptoms of abdominal typhus; that the internal and external development of the disease is determined by a striking sympathetic derangement of the organic functions of the liver, and still more of the spleen, and likewise by a more striking prominence of the intermittent type of the fever; and that all these varied disturbances finally culminate in abdominal typhus.

Owing to this remarkable similarity, Apis will effect striking cures of all these different derangements.

If, after more or less distinctly felt premonitory symptoms--after a sudden cold, excessive exertions, prostrating emotions or enjoyments--a more or less violent fever is developed, accompanied by dulness and painfulness of the head, retching and vomiting, distention and sensitiveness of the pit of the stomach, and soon after of the whole abdomen, with urging diarrh[oe]a, pappy and foul taste in the mouth, loss of appetite and thirst, feeling of dryness in the mouth and throat, tongue sore, as if burnt and swollen, with antagonistic change of symptoms, suspicious and extraordinary prostration, and feeling of fainting; a few spoonfuls of the above-mentioned solution of Apis 3, will afford such speedy relief, that it may seem incredible to those who have not witnessed it. The nausea, the vomiting, the diarrh[oe]a, and the painfulness of the abdomen, disappear; quiet sleep sets in, with general perspiration, which terminates the fever, and affords great relief; after waking, the patient is comforted by the internal sensation of returning health; a natural appetite is again felt, the strength returns, and in a few days the healthy look of the tongue and buccal cavity shows that the mucous membrane of the stomach and bowels has recovered its normal quality. The longer help is deferred, the longer time the morbid process has had in making its inroads upon the system, the more frequently will it be necessary to repeat the medicine, until a cure is achieved.

The same good result is perceived, if the morbid process is accompanied by furuncles, urticaria, erysipelas--the latter principally on the head and in the face, less frequently upon the extremities, and inclining to shift from one place to another. Such a combination of symptoms not only shows a higher degree of intensity of the disease, but also shows that the organism is still capable of battling against the internal disease, by compelling it to leave the interior tissue, and to develop itself externally. It is the first business of the physician to support the organism in this tendency, and to guard the brain and bowels from every destructive relapse. Apis, employed as above, accomplishes this result more speedily than any other drug. Of course, a few days are required for this purpose, although the rules of using the drug and the course of treatment are the same.

The same observation applies to the not unfrequent complication with organic disease of the spleen and consequent dropsy. Apis, used in the same manner, effects, in as short a period as the intensity of the symptoms will permit, a mitigation and gradual disappearance of the painfulness of the spleen, restores the normal action of the spleen more and more, and neutralises the tendency to dropsical effusion at the same time as it expels the accumulated fluid by increasing the secretions from the bladder and bowels, and the cutaneous exhalation.

If the liver is organically diseased, Apis is no longer sufficient. In such a case, the action of the liver has first to be restored to its normal standard. In dropsical diseases, I have effected this result most frequently, for years past, by means of Carduus mariæ, less frequently by Quassia, still less frequently by Nux vomica, and only in a few cases by Chelidonium: according as one or the other of these agents seemed indicated by the epidemic character of the disease. In all non-malignant cases, if the medicine was permitted to act in time, the whole disease was often cut short by the use of these drugs, and the development of typhoid symptoms prevented. Not, however, in all more inveterate cases, where the prevailing character of the disease, by its more penetrating action upon the tissues, induced a slower and more threatening course of development. As soon as the pains in the right hypochondrium had disappeared, the bilious quality of the fæces had been restored, and the urine had become lighter colored, but the fever still continued, tongue, throat, pit of the stomach and abdomen had become more sensitive; the head duller and tighter, and the prostration more overpowering. In such a case, Apis, prepared as above, became indispensable, in order to remove all danger to life. Its curative action soon became manifest in two different ways.

If the reactive force of the organism was still sufficient, the medicine succeeded very speedily in preventing the supervention of the typhoid stage, in changing the fever-type from a remittent or even continuous to an intermittent type, during which the convalescence of the patient, aided by a suitable diet, was more and more firmly established and generally completely secured after the lapse of a week.

If the typhoid stage could not be prevented and set in with the following symptoms: the patient lies on his bed in a state of apathy, with loss of recollection, sopor, muttering delirium, hardness of hearing, inability to protrude the tongue or to articulate; dry, cracked, sore, blistered, ulcerated tongue; difficult deglutition; painful distention of the abdomen, which is sensitive to contact or pressure; retention of stool, or else frequent, painful, foul, bloody, involuntary diarrh[oe]a; fermentous urine, which is sometimes discharged involuntarily; the skin is at times and partially dry, burning, at times and partially clammy, cool; trembling and twitching of the limbs; white miliaria on the chest and abdomen; extreme debility, with settling towards the foot-end of the bed; changing pulse, which is at times slow, at others accelerated, feeble, intermittent: in such a case Apis requires more time to heal the mucous membrane of the alimentary canal; to restore the normal action of the bowels; to regulate the digestive functions; to procure quiet and refreshing sleep, and to gradually effect a complete restoration of health. If the mucous membrane of the respiratory organs was invaded by the morbid process, the cure was nevertheless completed as soon as the mucous lining of the intestinal canal was restored to its natural condition.

So far, the only obstacle to a cure which I have witnessed, has been tuberculosis of the chest or abdominal viscera, or of both at the same time, and still more the vaccine-virus; likewise a tendency to paralysis in persons who were otherwise morbidly affected. Tuberculosis has often been combated by a single dose of a high potence of Sulphur between the doses of Apis, no Apis being given after the Sulphur, as long as the course of the typhoid symptoms would render it safe to postpone this medicine. I have found it much more difficult to conquer the vaccine-poison, _which I have become satisfied by years of observation, constitutes the most universal and most powerful generator of the typhus which is prevailing in our age and which seems unwilling to leave us_. Tartar emetic proves in this, as in other cases, its antidotal power against the vaccine-virus; but under no circumstances is more caution required in the use of tartar emetic than in typhus, where the vaccine-virus seeks to develop its characteristic pustules with a tendency inherent in each pustule to terminate in the destruction of the mucous membrane. It may seem hazardous to add to this combination of destructive forces another similarly-acting element; but a careful consideration of the circumstances of the case will justify such a proceeding, although death may be the inevitable result of the morbid process. Experience has satisfied me that the alternate use of tartar emetic and Apis, a drop of the third potency of each, every three, six or twelve hours, according as the symptoms are more or less violent, or, in very sensitive organisms, in tablespoonful doses of a watery solution of a drop, will accomplish all that can be expected; for these two drugs, thus administered, seem to compensate or complete each other. I am unable to say how far this proceeding requires to be modified in particular cases; all I desire to do, is to submit this important subject to my colleagues for further inquiry and trial.

If a tendency to paralysis prevails, the danger is less threatening, although equally momentous. In such cases I use Apis and Moschus in alternation, although I am unable to assert, on account of deficient experience, that this treatment will always prove satisfactory. Such cases hardly ever arise under hom[oe]opathic treatment; and if they come to us out of the hands of all[oe]opathic practitioners, they generally prove incurable.

If these three obstacles to a cure appear combined, I have never found it possible to effect any thing. All that I have found it possible to do, has been to prevent such a dreadful combination by carefully attending to my patients in previous diseases.

Sometimes in typhus, the affection of the spleen shows itself again, even after recovery has fairly set in; the intermittent type again breaks forth, and recovery finally takes place, as the intermissions become more and more distinct and lengthened. As long as the intermittent type continues, Apis has to be given; the action of the spleen becomes more and more normal, the fever paroxysms become shorter and less marked, and the restoration of health is effected without any more treatment than a single dose of Apis 30, one globule, which is permitted to act until the patient is well.

Observations of this kind, which I have made under the most diversified circumstances, have taught me that Apis is _the most sovereign remedy for all those morbid processes which we designate as_ INTERMITTENT FEVER.

The following symptoms indicate the hom[oe]opathicity of Apis to intermittent fever:

"1081: every afternoon about three or four o'clock she feels chilly, shivering, worse in warmth; a chilly creeping along the back, the hands seem dead; in about an hour she feels feverish and hot, with rough cough, hot hands and cheeks, without thirst; these symptoms pass off gradually, after which she feels heavy and prostrate. 1088: chilliness all over, recurring periodically, with an undulating sensation. 1089: chill after a heat of thirty-six hours. 1090: sudden chilliness, followed by heat and sweat. 499: loathing, with chilliness and coldness of the limbs. 534: pains on the left side, below the last ribs. 535: violent burning pain below the short ribs, on both sides, worst and most permanent on the left side, where it continues for weeks, preventing sleep. 577: enlargement of the abdomen, with swelling of the feet, scanty urine."

The provings of Apis show that this drug affects every portion of the nervous system--the cerebral, spinal and ganglionic nerves--and the process of sanguification, in the same general and characteristic manner as is the case in fever and ague.

In comparing the symptoms of Apis with those of any other known drug, there is no medicine that bears as close an affinity to fever and ague as Apis. Howsoever useful other remedies may have proved, in the treatment of fever and ague, they are only hom[oe]opathic to isolated conditions, in comparison with Apis. In practice, it was often found very difficult, even for the most experienced physician, to decide in which of these exceptional cases the specifically hom[oe]opathic agent should have been employed. Sometimes no properly hom[oe]opathic remedy could be found, in which case the treatment had to be conducted in a round-about way.

All these difficulties have been effectually removed by Apis, and the treatment of intermittent fever may henceforth be said to constitute one of the most certain and positive achievements of the hom[oe]opathic domain. For the last three years, during which period I have experimented with Apis, I have not come across a single case of intermittent fever that did not yield satisfactorily to Apis. I have treated a pretty fair share of obstinate and complicated cases of this disease, and have, therefore, had an opportunity of testing the curative virtues of Apis in a satisfactory manner. Here are the results of my observations:

Apis is the natural remedy for the pathological process which is characterized by periodical paroxysms of chill, heat and sweat; the other morbid symptoms being common to this process, as they are to all other diseases.

All the symptoms which have hitherto been observed in intermittent fever, will be found, with striking similarity, among the provings of Apis. For a confirmation of this statement, we refer to Hering's American Provings, and to B[oe]nninghausen's Essay on Intermittent Fevers.

In making use of Apis in every form of intermittent fever, we not only act in strict accordance with the hom[oe]opathic law generally, but we fulfil all the requirements of the individualizing method. Apis is the universal remedy in intermittent fevers, for which every hom[oe]opathic physician has been longing, and which pure experiments, conducted according to the rules of hom[oe]opathy, have revealed to us;--another shining light on the sublime path of the healing artist!

The beneficent action of Apis, in intermittent fever, is still increased by the fact that it prevents the supervention of typhus, disorganizations of the spleen, dropsy, china-cachexia. In using Apis from the commencement, all such consequences are avoided, and if they should have been induced by different treatment, Apis removes them as speedily as possible.

In all lighter cases, it is sufficient to give a drop of Apis 3, morning and evening, during the apyrexia, and to continue this treatment until the attacks cease; very often no other paroxysm sets in after the first dose; there are scarcely ever more than two or three paroxysms. In a few days the cure is accomplished, provided the action of the medicine is not disturbed.

In more obstinate cases, which had been coming on for a longer period, or had been caused by more noxious influences, had lasted longer, had invaded the organism with more intensity, or where the paroxysms last longer and the intermissions are shorter, or where two paroxysms occur in succession, or the life of the organism is endangered by some cause or other,--the organism has to be saturated with the medicine in the shortest possible period, in order to ensure victory to the curative agent. Under these circumstances, we prepare a solution of from two to four drops of the third potency in twelve tablespoonfuls of water, shake it well in a closed bottle, and give a tablespoonful of this solution every hour. If the case should be urgent, we may give a drop of Apis 3, on sugar, every three or six hours. This treatment is to be continued until the patient is decidedly better; after which the medicine should be discontinued. If the improvement is not quite satisfactory, the last dose is continued several times every twelve or twenty-four hours, after which the proper effect will have been obtained. If the progressive improvement of the patient should be attended with distinct morbid symptoms, it would be injurious to continue the repetition of the drug. Nevertheless, a globule of Apis 30 may sometimes hasten the convalescence of the patient, and otherwise afford relief. Signs of reaction, even if more or less violent, should not deceive one. If left to themselves, they are often and speedily followed by a refreshing calm, and cannot be interfered with, as an aggravation of the symptoms, without damaging the case.

These are all the rules which I have so far been able to infer from my use of Apis. Further experience will have to decide whether they apply to all periods, or only to the prevailing type of fever.

I am unable to say whether Apis will prove effectual against epidemic marsh-intermittents, and if so, how the use of it will have to be modified. May it please those, who can shed light on this subject, to communicate their experience!

Two other exceptions to Apis, as a universal febrifuge, have occurred to me in my practice: _The development of fever and ague in poisoned soil, and fever and ague complicated with China-cachexia._

It is peculiar to intermittent fever to excite the morbid germs which are slumbering in the organism. This is more particularly true in reference to psora. In proportion to universality of the psoric miasm, fever and ague will develop and complicate itself with psoric affections; and it is such complications that give rise to the inveterate character of intermittents and their disorganizing tendency.