Part 3

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 Bnninghausen'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 homopathic law generally, but we fulfil all the requirements of the individualizing method. Apis is the universal remedy in intermittent fevers, for which every homopathic physician has been longing, and which pure experiments, conducted according to the rules of homopathy, 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.

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 sequelae 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, diarrha 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--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 mammae--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 mariae, 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 otorrha,--we have a group of symptoms which resemble very accurately the prevailing type of epidemic scarlatina. I know, from abundant experience, that the homopathic 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 homopathy. The sequelae 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 aphthae; 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 diarrha; 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 sequelae, which, according to all experience, are so common in complicated cases of scarlatina, otorrha 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.