"The bee helps to heal all thy internal and external maladies, and
is the best little friend whom man possesses in this world."--More
in Cotton's _Book of the Bee_, p. 138.
Since Hahnemann's successful attempt to develop the medicinal nature of
Aconite, no other discovery has been made in the domain of practical
medicine, as comprehensive and universally useful as the discovery of
the medicinal virtues of the poison of the bee. It is of the utmost
importance to the interests of humanity to become as intimately
acquainted with the efficacy of this poison as possible. It is the
object of these papers to contribute my mite to this work.
As soon as Dr. Hering had published the provings of the bee poison, in
his "American Provings," I at once submitted them to the test of
experience in an extensive practice. I prepared the drug which I used
for this purpose, by pouring half an ounce of alcohol on five living
bees, and shaking them during the space of eight days, three times
a-day, with one hundred vigorous strokes of the arm. From this
preparation, which I used as the mother-tincture, I obtained
attenuations up to the thirties centesimal scale. So far, the effects
which I have obtained with this preparation, have been uniformly
satisfactory. It has seemed to me that the lower potencies lose in power
as they are kept for a longer period; hence, I consider it safer to
prepare them fresh every year. As a general rule, I have found either
the third or the thirtieth potency, sufficient.
Day after day I have obtained more satisfactory results, and now I look
upon Apis mellifica as the greatest polychrest, next to Aconite, which
we possess.
The introduction of this poison to the medical profession, will be
looked upon as the most brilliant merit of one of the most deserving
apostles of hom[oe]opathy, and will secure immortality to the honored
name of Constantine Hering. The following statements will show how far
this faith of a grateful heart is founded upon facts:
_Apis mellifica is the most satisfactory remedy for acute hydrocephalus
of children._
The more acute and dangerous the attack, the more readily will it yield
to the action of Apis. Sudden convulsions, followed by general fever,
loss of consciousness, delirium, sopor while the child is lying in bed,
interrupted more or less by sudden cries; boring of the head into the
pillow, with copious sweat about the head, having the odor of musk;
inability to hold the head erect; squinting of one or both eyes;
dilatation of the pupils; gritting of the teeth; protrusion of the
tongue; desire to vomit; nausea, retching and vomiting; collapse of the
abdominal walls; scanty urine, which is sometimes milky; costiveness;
trembling of the limbs; occasional twitching of the limbs on one side of
the body, and apparent paralysis of those of the other side; painful
turning inwards of the big toes, extorting cries from the patient;
accelerated pulse, which soon becomes slower, irregular, intermittent
and rather hard; these symptoms inform us that life is in danger, the
more so the more numerous they are grouped together.
In comparing with these symptoms the following symptoms from Hering's
American Provings, Part I., 3d Num., p. 294: "40, 41, muttering during
sleep; muttering and delirium during sleep; 83, 84, he had lost all
consciousness of the things around him; he sank into a state of
insensibility; 140, 144, sense of weight and fulness in the fore part of
the head; heaviness and fulness in the vertex; dull pain in the occiput,
aggravated by shaking the head; pressure, fulness and heaviness in the
occiput; 170, her whole brain feels tired, as if gone to sleep;
tingling; she experiences the same sensation in both arms, especially in
the left, and from the left knee down to the foot; 175, 176, sensation
as if the head were too large; swelling of the head; 391, when biting
the teeth together, swallowing; after gaping or at other times, a sort
of gritting the teeth; only a single, involuntary jerk frequently
repeated; 501, nausea and vomiting; 506, nausea, as if one would vomit,
with fainting; 512, vomiting of the ingesta; 619, retention of stool;
640, retention of urine; 665, scanty and dark-colored urine; 980, 984,
985, trembling, convulsions, starting during sleep as if in affright;
1020, sudden weakness, compelling him to lie down; he lost all
recollection; 1032, great desire for sleep, he felt extremely drowsy."
If we compare these effects of Apis to the above-mentioned symptoms of
hydrocephalus, we shall find the hom[oe]opathicity of Apis to this
disease more than superficially indicated. If we consider, moreover,
that the known effects of Apis show that it possesses the power of
exciting inflammatory irritation and [oe]dematous swellings, we are
justified, by our law of similarity, in expecting curative results from
the use of Apis in all such diseases.
The experiments which I have instituted for the last four years, have
convinced me of the correctness of this observation. Whenever I had an
opportunity of giving Apis at the commencement of the diseases, it would
produce within twelve to twenty-four hours quiet sleep; general
perspiration, affording relief; the feverish and nervous symptoms,
together with the delirium, would disappear from hour to hour, and on
waking, the little patient's consciousness was lucid, the appetite good
and recovery fully established. This is a triumph of art which inspires
us with admiration for our science. Less surprising, but equally
certain, is the relief, if Apis is given after the disease has lasted
for some time. In such a case, the medicine first excites a combat
between the morbific force and the conservative reaction. The greater
the hostile force, the longer the struggle between momentary improvement
and aggravation of the symptoms; it may sometimes continue for one, two,
or three days. It is not until now, that a progressive and permanent
improvement sets in. The desire to vomit is gone; the twitching,
trembling, and the struggle, generally diminish from hour to hour;
consciousness returns; the squinting and the dilatation of the pupils
abate; gritting of the teeth and protrusion of the tongue cease; the
position and movements of the head and limbs become more natural; the
pulse becomes more regular; its slowness yields to a more normal
frequency; the feverish heat terminates in sweat which affords great
relief, and the retention of stool and urine is succeeded by a more
copious action of both the bowels and bladder. The natural appetite
returns; the reproductive process is restored; sleep is quiet and
refreshing, and recovery is perfectly established in an incredibly short
period. A cure of this kind generally requires five, seven, eleven, and
fourteen days. This result is so favorable, that those who have not
witnessed it, or who are too ignorant and egotistical to investigate the
facts, may reject it as incredible.
Such brilliant results are obtained by means of a single drop of Apis,
third attenuation. I mix a drop with seven tablespoonfuls of water, and
give a dessert-spoonful every hour, or every two or three hours; the
more acute the attack, the more frequently the dose is repeated; this
method generally suffices to effect a cure more or less rapidly. As long
as the improvement progresses satisfactorily, all we have to do is to
let the medicine act without interfering. If the improvement is
arrested, or the patient gets worse, which sometimes happens in the more
intense grades of this malady, the best course is to give a globule of
Apis 30, and to watch the result for some twenty-four hours. After the
lapse of this period the improvement will either have resumed its
course, or else it will continue unsatisfactory. In the latter case we
should give another dose of the above-mentioned solution of Apis 3. Not
unfrequently I have met with patients upon whom Apis acts too
powerfully, causing pains in the bowels, interminable diarrh[oe]a, of a
dysenteric character, extreme prostration and a sense of fainting. In
such cases the tumultuous action of Apis is mitigated, and the continued
use of this drug, rendered possible by giving Apis in alternation with
Aconite in water, every hour or two hours.
Except such cases, I have never been obliged to resort to other
accessory means.
_Apis is no less efficacious against the higher grades of ophthalmia._
It is particularly rheumatic, catarrhal, erysipelatous, and [oe]dematous
ophthalmia, which is most rapidly, easily, and safely cured by Apis, no
matter what part of the eye may be the seat of the disease.
The symptoms 188-307 distinctly point to the curative virtues of Apis in
ophthalmia: "Sensitiveness to light, with headache, redness of the eyes;
he keeps his eyes closed, light is intolerable, the eyes are painful and
feel sore and irritated if he uses them; weakness of sight, with feeling
of fullness in the eyes; twitching of the left eyeball; feeling of
heaviness in the eyelids and eyes; aching, sore-pressing, tensive,
shooting, boring, stinging, burning pains in and around the eyes, and
above the eyes in the forehead; redness of the eyes and lids; secretion
of mucus and agglutination of the lids; the lids are swollen, dark-red,
everted; the conjunctiva is reddened, full of dark blood-vessels which
gradually lose themselves in the cornea; the cornea is obscured, smoky,
showing a few little ulcers here and there; profuse lachrymation;
stinging itching in the left eye, in the lids and around the eye;
sensation of a quantity of mucus in the left eye; sensation of a foreign
little body in the eye; soreness of the canthi; styes; [oe]dema of the
lids; erysipelatous inflammation of the lids."
I have found the correctness of these observations uniformly confirmed
by the most satisfactory cures of such affections. I use the medicine in
the same manner as for acute hydrocephalus. In some cases I found the
eye so sensitive to the action of Apis, that an exceedingly violent
aggravation of the inflammatory symptoms ensued, which might have proved
dangerous to the preservation of such a delicate organ as the eye.
Inasmuch as it is impossible to determine beforehand the degree of
sensitiveness, I obviate all danger by exhibiting Apis in alternation
with Aconite in the manner indicated for hydrocephalus. By means of this
alternate exhibition of two drugs, we not only prevent every aggravating
primary effect, but we at the same time act in accordance with the
important law, that, in order to secure the effective and undisturbed
repetition of a drug, we have first to interrupt its action by some
appropriate intermediate remedy. All repetitions should cease as soon as
a general improvement sets in; if the medicine is continued beyond the
point where the organism is saturated with the drug, it acts as a
hostile agent, not as a curative remedy. This important point is known
by the fact, that the improvement which had already commenced, seems to
remain stationary; the patient experiences a distressing urging to
stool, a burning diarrh[oe]a sets in, and a disproportionate feeling of
malaise develops itself. Under these circumstances, a globule of Apis 30
will quiet the patient, and the action of the drug will achieve the cure
without any further difficulty, and without much loss of time, unless
psora, sycosis, syphilis, or vaccine-virus prevail in the organism, or
sulphur, iodine or mercury had been previously given in large doses. In
the presence of such complications Apis will prove ineffectual until
they have been removed by some specific antidote. After having made a
most careful diagnosis, a single dose of the highest potency of the
specific remedy be given, and be allowed to act as long as a trace of
improvement is still perceptible. As soon as the improvement ceases, or
an aggravation of the symptoms sets in, Apis is in its place and will
act most satisfactorily. We then give Apis 3 in water, as mentioned
above, with the most satisfactory success.
_Apis is the most appropriate remedy for inflammation of the tongue,
mouth, and throat._
The following symptoms may be looked upon as striking curative
indications: 378-380, 383, 384, 399, 400, 405, 406, 409, 410, 413, 419,
436, 437, 439, 443, 444, 449, 455, 458, 459, 463, 470, 471: "Burning of
the lips; the upper lip is swollen to such a degree that the inside
seems turned outside; swelling of the lips and tongue; swelling of the
upper lip, it becomes hot and red, almost brown; dark streaks along the
vermilion border, particularly on the upper lip, rough, cracked, peeling
off; violent pains spreading through the gums, the gums bleed readily;
the tongue feels as if burnt; tongue and palate are sore; raw feeling,
burning, blisters along the margin of the tongue, very painful,
stinging; at the tip of the tongue a row of small vesicles which cause a
pain as if sore and raw; dry tongue; the inner cheeks look red and
fiery, with painful sensitiveness; inflammation of the tongue;
inflammation and swelling of the palate; burning, stinging sensation in
the mouth and throat; pressure in the fauces as of a foreign body;
ptyalism; copious accumulation of a soapy mucus in the mouth and throat;
dryness and heat in the throat; inability to swallow a drop, with
swelling of the tongue; sensation of gnawing and contraction in the
throat, increasing after four hours so as to render deglutition
difficult; sensation of fulness, constriction and suffocation in the
throat; deglutition painful and impeded, stinging pains during
deglutition; swelling and redness of the tonsils, impeding deglutition;
angina faucium; chilliness followed by heat; violent pain in the
temples; redness and swelling of the tonsils; uvula and fauces, painful
and impeded deglutition, and stinging pains when attempting to
swallow."
The more frequently we make use of Apis in the treatment of these very
common forms of angina, and of the inflammation of the salivary glands,
which are so closely connected with the other parts of the throat, the
more we become convinced by the most striking success, that this drug is
by far the speediest, safest and easiest remedy which we possess for the
treatment of these exceedingly common and yet so very distressing
affections. Not only in common affections of this sort, but also in the
most acute and dangerous forms of angina faucium, will Apis be found
efficient; even where these affections are hereditary, or have become
habitual, and generally terminate in suppuration, Apis will still afford
help. In these affections likewise Apis acts most promptly and
efficiently, if given in alternation with Aconite, both remedies in the
third dilution, a few drops dissolved in twelve tablespoonfuls of water,
in alternate hourly doses. After taking a few doses, the patient begins
to feel relieved, enjoys a quiet sleep, and the resolution of the
inflammation takes place, accompanied by the breaking out of a general
perspiration. If there should be a natural tendency to suppuration, this
treatment will hasten it from hour to hour, and after the pus is
discharged, a cure will soon be accomplished. In the most inveterate
cases, which had been previously treated in a different manner, the same
curative process takes place gradually; first one outbreak of the
disease is hushed; next, if another portion of the throat becomes
inflamed, this inflammation is controlled, and this proceeding is
continued with an increasingly rapid success and a continued abatement
of all sufferings, until, finally, a perfect recovery is obtained, even
under these disadvantageous circumstances.
Apis is not sufficient to prevent the recurrence of such inflammatory
attacks; this object has to be accomplished by means of the appropriate
antidotal specific.
_Apis becomes an exceedingly useful remedy in consequence of the
specific power which it possesses over the whole internal mucous
membrane and its appendages._
It is particularly the mucous membrane of the alimentary canal upon
which Apis has a striking influence. It excites an inflammatory
irritation, which not only disturbs the secretion of mucus, but also
disintegrates the intestinal juices so essential to the process of
sanguification, thus disqualifying the blood from properly contributing
to the reproduction of the nervous tissue. By thus altering the blood
and nerves, these two principal vehicles of vitality, it develops a
group of symptoms which is exceedingly similar to our abdominal typhus
that seems to have become stationary among us for the last twenty years.
This similarity, in its totality, results from the following symptoms
contained in the "American Provings."
"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.
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