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Homeopathic Materia Medica by Farrington



APIS MELLIFICA

(apis)

For this remedy, we have two names, according to the. manner in which the preparation is made. It is either APIS MELLIFICA, the honey-bearing bee, or APIUM VIRUS, the poison of bees. The original preparations of the remedy were made in this manner: A large white dish was placed under a bell jar, in which there was a perforation through which a stick was inserted. Several hundred bees were then placed beneath the jar. The stick was then moved about, and, irritating the bees, caused them to sting the jar and the dish. After a while, the bees were allowed to escape, and on the bell jar and plate were seen numerous specks. Alcohol was poured over these, and thus we obtained a powerful extract of the poison of the bee. This is Apium virus. Subsequently the whole bee was used. Triturations were made of the entire insect. Thus we obtain APIS MELLIFICA: The symptoms of the two preparations have not been separated. APIS MELLIFICA is a comparatively new remedy, and is an invaluable acquisition to our materia medica. In order to understand its symptomatology, let us look at its toxicology. Take, if you choose, a sting on the hand or finger as an illustration. Just after the sting, which causes a sharp sticking or burning pain, there commences, quite promptly, swelling of the part, which swelling at the start is extremely sore. The part feels as if it had been bruised or pounded. The swelling at first is of a rosy pinkish hue. It spreads very rapidly ; the pains become intense. They are of a burning, stinging, or shooting character, seldom throbbing. Heat of the part increases with the burning and stinging pains. This may end very speedily in resolution or it may go on. If it pursues the latter course, you will notice that this redness, this rosy appearance becomes more intense, in fact assumes an erysipelatous appearance. Still later, it changes its color and takes on a pale but bluish hue, the swelling pits on pressure showing that the parts are cedematous. After a while, if the condition of the system is such as to permit, gangrene of the part takes place. The inflammation produced by Apis is not then of a sthenic type. It is not, for instance, such as would be cured by ACONITE, quick, sudden swelling of the part coming on rapidly and ending in resolution; not such as would be cured by BELLADONNA, bright red swelling with throbbing pains, but ending either in resolution or suppuration; but IT IS such as goes on to destruction of tissue. In one case where the sting was on the hand, the patient suffered also from a carbuncle on the back of the neck.

Apis attacks the vital forces as is shown by the following characteristics of the drug: The patient feels strangely as if about to die and yet there is no fear of death, thus differing from ACONITE and ARSENICUM; the brain is tired as if gone to sleep; prostration even to faintness as after exertion ; the body feels bruised ; nervous trembling; great prostration as in diphtheria, even in the beginning of the disease; delirium Low and muttering; sensorial apathy ; a happy expression; tongue can hardly be protruded ; face expressive of anxiety as from visceral disease ; loss of consciousness especially in eruptive diseases; the mind is weakened; awkwardness, lets fall what she is carrying and laughs in a silly manner at the mishap.

Apis, may be employed in states of mind resembling hysteria. The

fidgetiness, restlessness, excitability, and ill-timed laughing, together with fickleness at work, have led to its successful use for nervous girls. In addition, it has been observed that they are awkward, dropping things, and then laughing in a silly way at their clumsiness. The sexual passion is too active, and they are prone to jealousy.

The confusion of mind and unconsciousness just noted indicate the remedy in severe adynamic forms of disease, such as malignant scarlatina, diphtheria,, typhoid fever, etc. Also a complete stupor after apoplexy is said to have yielded to it when OPIUM failed.

In scarlatina, the fever runs high, and the attending restlessness is one of nervous agitation. Mouth and throat are very red, with blisters on the borders of the tongue; and swollen puffy fauces; burning stinging, and a scalded, raw feeling in mouth and throat. The skin pricks as from needles, the rash being interspersed with a miliary eruption. There is always puffiness of some part of the surface. Prostration is early. Urine scanty or suppressed. High fever and drowsiness.

In typhoid fever the delirium is of the muttering kind. The weakness is so great that the tongue is protruded with difficulty, and the muscles are so relaxed that the patient slides down in bed. The tongue is blistered, dry, cracked, and even ulcerated. Very important is the soreness of the swollen abdomen to touch.

In meningitis or in meningeal irritation, Apis holds a prominent position as a curative agent. It is often the remedy, no matter what the ailment, when shrill outcries in sleep lead to the suspicion of cerebral irritation. Such cases frequently begin with the nervous fidgetiness so characteristic of the bee-poison, and advance to more serious conditions. In tubercular meningitis, or in acute cerebral effusions, a suppressed or undeveloped eruption is a good guide to the choice of Apis.

We may profitably compare Apis here with: BELLADONNA, HELLEBORUS, ARSENICUM, BRYONIA, ZINC, SULPHUR, CUPRUM, GLONOINE, LACHESIS, RHUS, HYOSCYAMUS, NATRUM MUR., BOVISTA, etc.

BELLADONNA is doubtless frequently employed when Apis would suit better. A little care, however, will enable the practitioner to distinguish the fidgety nervousness of the latter from the more intense cerebral irritation of the former. The congestions of the former are more violent, with throbbing of the carotids, injected red eyes; and a drowsiness, broken by starts and frightened outcries. The adynamia is much less than in the Apis. If the disease is scarlatina, the rash is smooth and bright red, not miliary. The skin is hot and the face red, or in sorhe cases pale; but not pale and ©edematous as in Apis. The cervical glands may be swollen, but there is not the cellular infiltration, with an erysipelatous blush as in the bee-poison.

If there is meningeal irritation, Belladonna is needed when the symptoms are intense; Apis when the nervous agitation predominates, with the shrill cry, which betokens stabbing-piercing pains or excitement. In meningitis, Belladonna is decreasingly indicated as the symptoms of effusion increase; while Apis is increasingly indicated, so long as symptoms of irritation obtain and the cephalic cry is marked.

HELLEBORUS claims precedence when the irritation of Apis gives place to mental torpor, with want of reaction. The forehead is wrinkled, the pupils dilated, and the lower jaw tends to drop; the sopor is complete. Automatic motions of one arm and one leg; forehead is bathed in cold sweat. It may bring about reaction so that another remedy will cure. In typhoid fever, they differ widely. Apis though it has great weakness, apathy, and stupor, has a dry blistered tongue and exquisite soreness of the abdomen. Helleborus has complete sensorial apathy, dark, sooty nostrils, slow pulse, no response to touch or pressure.

BRYONIA bears some slight resemblances, especially as, like Apis, it may be needed for cerebral effusions following suppressed exanthemata. But the sensorium is benumbed, though the senses are not so perverted as in either Apis or Helleborus. There is a constant chewing motion ; face dark red, lips parched; when offered drink, it is taken hastily and impatiently. If the child is moved, it screams with pain. Later, when the sensorial depression amounts to sopor, Helleborus follows well, even if the chewing motion and hasty drinking continue. Apis follows, if sopor ensues with a more shrill cephalic cry than in either of the other remedies.

CUPRUM compares with Apis when meningitis results from a suppressed exanthem; but the symptoms are quite diverse. Copper causes loud screaming, followed by violent convulsions; the thumbs are clenched and the face is pale, with blue lips; eyeballs constantly rotating. If convulsions occur in the Apis case, they are less violent, consisting of restlessness and twitching of one-half of the body; the other, being lame, trembling.

Much more closely related in Suppressed eruptions, is SULPHUR. The two follow each other well.

GLONOINE, like Apis, has the cephalic cry, sensation as if the head was enormously expanded, etc. Spasmodic vomiting of cerebral origin is most prominent in the former, as is also intense congestion and throbbing.

ZINCUM produces cerebral irritation ; child awakes with fear, rolls the head ; cries out and starts in sleep. Constant fidgety motion of the feet. Anaemic children, too enervated to develop an exanthem. In typhoid states, the prostration is very great, with impending cerebral paralysis. Unconsciousness, blue hands and feet, with coldness, weak pulse, lower jaw dropped. Here the Oxide has been successfully employed.

RHUS TOX., though incompatible with Apis, has many similar symptoms. In scarlatina, for instance, both suit in adynamia, swollen throat, erysipelatous inflammation of the skin of the neck, miliary rash, drowsiness, oedema. In Rhus, however, the eruption is darker, the erysipelas ' dusky red, and there is great bodily restlessness—not the fidgetiness of Apis.

ARSENICUM is similar to Apis in many respects. Both have anxious change of place, fear of death, restlessness; great weakness. (See also in several instances anon.) But although irritability of mind is in both, it is more an anxiety and fear in Arsenic: more a nervous restlessness in Apis.

If they meet in cerebral affections, as possibly they may, especially in hydrocephaloid, Arsenic is to be selected by hot skin, pale and hot face. Child lies in a stupor, suddenly it twists its mouth and a jerk goes through the body; or the child lies as if dead, with half-open eyes, gum on the conjunctivae, and no response to touch of the eyelids.

HYOSCYAMUS and LACHESIS are similar in jealousy.

NATRUM MUR., BOVISTA, LACHES., AETHUSA, IGNATIA, NUX VOM., have awkwardness; the first is most similar.

I have already hinted that Apis might be of use in dropsies. The symptoms calling for it are briefly these. In general dropsies, we find it indicated by the peculiar appearances of the surface of the body. There is a sort of waxen hue to the skin ; the skin has a transparent look, with a whitish or perhaps a slightly yellowish tinge. The urine is scanty, and there is almost always absence of thirst. The characteristic symptoms are the transparency of the skin and the thirstlessress. Now as to cause. Apis is especially useful in dropsies of renal origin, whether the result of scarlatina or not. The urine is scanty and highly albuminous, and contains casts of the uriniferous tubules. There is a swelling about the eye-lids. The surface of the body feels sore and bruised ; in some cases, the pain is of a burning character. If the dropsy is of cardiac origin, the feet are oedematous, especially after walking. This is attended with almost intolerable soreness and burning.

Even when the dropsy has invaded the chest and we have hydrothorax, Apis may be the remedy, especially when the trouble is of cardiac origin. The patient is unable to lie down. He has the same constrictive feeling about the chest that we find under LACHESIS. He has a dry cough which seems to start from some place in the trachea or larynx, usually the trachea, the cough not ceasing until a small quantity of phlegm is loosened. Thus far the remedy is exactly like Lachesis. But Apis has in addition to these symptoms a mental symptom which comes from the chest, and that is a constant feeling as though he could not live. It is not that feeling of dyspnoea, but it seems to be a sort of anguish of mind that the patient cannot understand how it would be possible for him to get another breath, so great is this suffocative feeling. Often associated with these chest symptoms, the patient has a strange feeling as though he was going to die, but to distinguish it from ACONITE in febrile states and ARSENIC in hydrothorax, there is no fear of death.

In pleuritis with exudation, Apis is one of the best remedies we have to bring about absorption of this fluid. Apis and SULPHUR will cure the majority of these cases.

Apis also acts on the synovial membranes, giving you a perfect picture of synovitis, particularly when it affects the knee. It is indicated when there are sharp, lancinating, stinging pains shooting through the joint, with aggravation from the slightest motion.

BRYONIA affects the joints and their synovial membranes: but the pains are more stitching, with tension; better from warmth of bed, Apis being better from cold applications.

IODINE is useful in dropsy of the knee, and has followed Apis well, especially in scrofulous children (Compare also KALI IOD.).

WE have still another form of dropsy in which Apis is a remedy, that is, dropsy of the brain, what used to be called hydrocephalus. It is not so often indicated in the true hydrocephalus, that is when from some mechanical cause there is inflammation set up in the membranes of the brain, followed by accumulation of serum in the brain; but it is in tubercular meningitis in which this remedy is useful. Apis is here indicated in the first stage. The symptoms which call for it, are these: The child bores its head backwards into the pillow, and rolls it from side to side; every little while the child arouses from sleep, with a shrill, piercing cry. This peculiar shriek is due to pain. In addition to this cry, the child is usually convulsed ; one side of the body is convulsed, and the other lies as if paralyzed. Strabismus shows itself. The pulse is rapid and weak, and the urine is scanty. Now there is no remedy which can do any good in this stage if Apis does not. In some cases, there is a peculiarity of Apis which I should mention, and that is slowness of action. Sometimes you will have to wait three or four days before you notice any effects from its administration. The favorable action of the remedy is first shown by increased flow of urine.

In dropsies, Apis may be compared first of all with ARSENICUM ALBUM, which has the same transparency of the skin, and is also of use in dropsies of renal, cardiac, or hepatic origin. The differences between the two remedies are these: First, Arsenicum has intolerable thirst, usually drinking but small quantities at a time, because water annoys the stomach. Eating and drinking cause vomiting. I have seen cases in which even a single teaspoonful of medicine provoked vomiting. The patient exhibits marked restlessness.

Another remedy for comparison is APOCYNUM CANNABINUM. This is much used in the West for general-dropsies, for swelling of any part of the body, ascites, hydrothorax, etc., usually without any organic disease as a cause. The patient cannot tolerate any food. Food or water is immediately ejected. There is a sunken, gone, exhausted feeling at the pit of the stomach.

The next remedy similar to Apis is ACETIC ACID. This is useful in dropsies when the face and the limbs too have this waxen or alabaster appearance. It is especially indicated when the lower parts of the body, the abdomen and limbs, are swollen; hence it is useful in ascites. Thus far, it is similar to Apis. But it has thirst, which Apis has not and there is almost always gastric disturbance present, sour belching, water-brash and diarrhoea. Acetic acid is an undeservedly neglected remedy in dropsy. You see how it stands between Apis and Arsenicum. It differs from both of these remedies in the preponderance of gastric symptoms.

Now, in hydrocephalus, the most similar remedy to Apis in the stage of exudation is Sulphur. SULPHUR is indicated more on general principles than for its particular affinity for the meninges. Tubercular meningitis cannot occur in an otherwise healthy child. There must be a diathesis at the bottom of the trouble. Sulphur helps in the same stage as Apis when Apis fails to bring about a reaction, particularly when the child is scrofulous and has other Sulphur symptoms. The child lies in a stupor, with cold sweat on the forehead, with jerking of the limbs, particularly of the legs, with spasms of the big toes and sometimes of the thumbs also. The urine is suppressed. Sulphur is all the more indicated if there had been a retrocession of some eruption before the disease had displayed itself.

HELLEBORUS is also similar to Apis in hydrocephalus. Apis is useful while there is still some irritation of the brain as indicated by the cephalic cry. Hellebore is indicated when torpor predominates, when the child lies wholly unconscious. The eyes do not react to light. Th.e urine is suppressed. . There is automatic motion of one side of the body. You will notice, too, a peculiar corrugation of the muscles of the forehead, particularly the occipito-frontalis. In milder cases before the stupor is profound, you will find Helleborus indicated by these symptoms; This corrugation of the muscles of the forehead is present, together with a constant chewing motion of the mouth. The child seems to have no wants. It asks for nothing; yet, when given water, it drinks with avidity.

Now, a word respecting the differences between BELLADONNA and Apis. BELLADONNA is not usually indicated in tubercular meningitis. It is the remedy above all others for the simple meningitis but not for the tubercular form of the disease. Belladonna is the very essence of acuteness in its symptomatology. Every symptom appears suddenly and with great intensity. Tubercular meningitis is a slowly developed disease. However, if the premonitory symptoms are violent, you may use Belladonna in tubercular meningitis in the stage of hyperaemia with acute pains, restless, tossing about, crying out in sleep, and boring the head into the pillow, but it ceases to be the remedy when the exudation is established. The range of Belladonna is at an end when that of Apis begins.

There is another remedy which sometimes comes in between Belladonna and Apis, and that is BRYONIA, which acts on serous membranes, causing copious exudation. It is indicated after Belladonna. The child becomes more stupid from increased pressure on the brain. The face suddenly flushes up and then pales off, usually a bad symptom. The child cries out, particularly when moved in the least; this is a characteristic symptom. The child is stupid, the abdomen distended, and the tongue is usually coated white down the middle. So much for Apis and its concordant remedies in dropsies.

The next use we may make of Apis is in erysipelas. It is useful in erysipelas, particularly of the face when it commences under the right eye or about the eye and spreads thence across the face to the left side, the parts quickly becoming oedematous and at first assuming a pinkish rosy hue. The soreness becomes more severe, and burning stinging pains follow. There is high fever with dry skin, and usually thirst. Now, if the disease is not checked, and the face assumes a purplish livid hue, Apis may be indicated in phlegmonous erysipelas, which dips deeply in the connective tissue and ends in the destruction of the part. The concordant remedies of Apis in erysipelas are several.

First of all, BELLADONNA. The difference lies in this: BELLADONNA is indicated in bright red swelling of the face (the smooth form of erysipelas). There is not much tendency to oedema or to the formation of vesicles. The pains are almost always acute with throbbing in the affected parts. The brain almost always sympathizes markedly, giving you throbbing in the head, visions as soon as the patient closes his eyes. The patient jerks in his sleep. The pulse is full and hard.

Another remedy, and one, too, more similar to Apis than the Belladonna, is RHUS TOX. You should be particular in differentiating these remedies, because they are inimical, and one cannot be given after the other. Under Rhus tox. the color of the face is dark red, and not the bright red of Belladonna nor the rosy or purplish livid hue of Apis. There is almost always a formation of blisters, which burn and sting, and which are distinguished from those of Apis by the preponderance of itching. Under Rhus tox. the disease usually travels from left to right when attacking the face.

LACHESIS may be similar to Apis in some cases when the face is bluish. But the other symptoms will enable you to decide.

Apis may be of use in urticaria, when there suddenly appear on the surface of the body long pinkish white blotches raised above the skin. The itching, burning, and stinging are almost intolerable. They may come as a result of cold or during the course of intermittent fever.

Here Apis is similar to ARSENICUM, which also produces hives, and to URTICA URENS. This last remedy is indicated in hives when they are in not so large welts as in Apis. The itching and burning are intolerable. It is especially indicated when the disease has been produced by eating shellfish.

TEREBINTHINA is also useful in urticaria after eating shellfish.

KALI BROMATUM is indicated when the hives occur with nervous diseases.

RHUS TOX. when they are an accompaniment of ague or rheumatism.

BOVISTA when they are attended with diarrhoea, the stools being followed by tenesmus and burning.

PULSATILLA comes in when the hiv«s are of gastric or uterine origin.

CALCAREA OSTREARUM is especially suited to chronic cases; and SEPIA is indicated when the trouble is worse in the open air. (Also RUMEX CRISPUS.)

 

Apis may also be used in variola when there are intense itching and swelling.

Apis may be used in rheumatism, whether it is of articular or muscular origin. It is more frequently indicated in articular or what is commonly called acute inflammatory rheumatism. You will find the affected parts feeling very stiff and exceedingly sore to any pressure, and often with a sensation of numbness. The joint or joints affected are swollen and give the patient a kind of "stretched-tight feeling." The swelling is rather pale red in color, and there is often some fluctuation about the joint. There are burning, stinging pains, worse on any motion.

The paralytic weakness of Apis is that form which is so common a result of animal poisons, and compares with the sudden and violent effects of certain vegetables and minerals. It has often been successfully employed in paralysis following devitalizing affections, such as diphtheria, typhoid fever, and also when meningeal effusions remain after inflammations. In all such cases, suppressed or preexisting exanthemata constitute a leading indication for the bee-poison, and the reappearance of skin symptoms calls for its discontinuance, so long as the improvement thus instituted lasts. Sulphur is a great aid here.

In these cases of prostration the patient is either nervous, restless, and oversensitive, or hot and drowsy, whether thirsty or not.

Apis is useful in febrile conditions. It produces an intermitting type of fever, and it may, therefore, be used in intermittent fever. It is particularly useful when the chill comes at three o'clock in the afternoon. There may be thirst or there may not. But there is oppression about the chest, with a feeling as if it was too full, which it really is, there being congestion of the thoracic viscera. This chill is followed by burning heat of the whole body, with increase of this oppressive feeling of the chest. The heat is followed by sweat which may, however, be imperfect. There is never any thirst during the sweat. That is characteristic. During the apyrexia many characteristic symptoms are present. The patient often complains of pains under the ribs on either side. The feet are swollen and oedematous, the skin is sallow or waxen, the urine is scanty and urticaria is present. So you see that it is indicated in rather severe forms of the affection, when excessive use of quinine has spoiled the case, and in chronic forms which have undermined the general health and produced disease of the liver, spleen, etc.

The most similar concordant to Apis here is NATRUM MUR. This is indicated in exactly the same type of intermittent fever as Apis, the difference between the two remedies lies in the time of appearance of the chill, at ten o'clock in the morning in the case of Natrum mur., and at three o'clock in the afternoon in the case of Apis.

In typhoid types of fever, Apis is sometimes indicated. We select it first of all by the mental state. The delirium is not of an active type; the patient lies in a stupor, with muttering; the face is either flushed red, or, more frequently, pale and waxen—at other times there is a happy expression to the face. The skin in this, type of fever we will find to be burning hot 'in some places while in others it is unnaturally cool; the cutaneous surface is almost always dry; should there be any sweat it is almost always of a transient character; the prostration is so great that the patient slides down in bed, he cannot exercise sufficient muscular force to retain his position on the pillow. The tongue is dry and red, and like that of LACHESIS, it catches on the teeth when the attempt is made to protrude it, and trembles; you often find, too, that there may be a whitish or darker coating on the dorsum of the tongue, while the edges, especially about the tip, will be red and covered with little blisters and vesicles.

In these cases Apis resembles MURIATIC ACID, which has this prostration, but it has the characteristic acid diathesis.

In scarlatina, Apis, as you may have already anticipated from what I have said of the remedy, may be indicated. It is not often the remedy in the Sydenham variety of the disease, in which BELLADONNA is so frequently indicated. But it is of use where the eruption is interspersed with a miliary rash. Here, too, we find the same defective effort on the part of nature to get up a fever. The body is very hot in some places and cool in others. The rash is deep-red in color, very much like that of Belladonna, but differing from that remedy, you remember, in the presence of this miliary eruption which Belladonna does not produce. The child is drowsy, sleeping most of the time, or he is drowsy, but cannot sleep. This symptom you must remember, because it is identical thus far with one of Belladonna. Associated with this sleepy or wakeful state the patient is fidgety and restless. You notice, too, that he is peevish, and manifests every symptom of being very irritable.

This restless state of Apis must be distinguished from those of RHUS TOX. and Belladonna. In Rhus tox. it is a general restless state of the whole body, and mind too. The patient lies first on one side of the body and then moves to the other. This is not associated with the Arsenic anxiety. The general feeling is a desire to move about. In Apis it comes from a general nervous feeling.

The inability to go to sleep in Belladonna comes from inflammation or congestion of the brain. The hyperaemia gives you this drowsy state, and the brain is so exhausted that the patient cannot go to sleep.

In addition to the symptoms already mentioned for scarlatina, we have Apis further indicated when the condition advances to effusion of serum about the brain. The throat symptoms are unimportant. You often find diphtheritic patches on the tonsils. The throat inside is swollen and rosy-red, while externally it is engorged, with erysipelatous blush to it. Apis may also be used late in the disease for the sequelae, that is, when the kidneys become affected and dropsy appears with albuminuria.

Again, we find Apis indicated in diphtheria, and I think that the remedy is indicated in the genuine disease. From the very beginning the child is thoroughly prostrated. There is not much fever; in fact there is a suspicious absence of heat. The pulse is rapid but not strong. At first you find the throat having a varnished appearance, as though the tonsils and fauces particularly were coated with a glossy red varnish. The membrane forms on either tonsil, oftener on the right than on the left, and it is thick, looking like wash-leather. The tongue is often swollen so that the child can scarcely swallow. If the child is old enough, he will complain of a feeling of fulness in the throat which necessitates swallowing, but makes it very difficult. The explanation of this is found in the next symptom, that is the uvula is swollen and cedematous, consequently there is a feeling of fulness. If you examine the throat thoroughly you will find the rim of the glottis swollen, red and oedematous, making the breathing very difficult. Breathing is labored owipg to the narrowing of the entrance of the larynx. In some of these cases the breath is very foetid, while in others there is little or no foetor. In still other cases you will find as characteristic of Apis a red rash over the surface of the body and this rash at first makes you think you have a case of scarlatina. We find the external throat swollen and erysipelatous. Now, there are several remedies similar to Apis in diphtheria. One of them is Arsenic.

ARSENICUM is indicated in rather severe cases of diphtheria, as you might expect, when the throat is very much swollen, inside and outside, when the membrane has a dark hue, and there is great foetor. There is thin excoriating discharge from the nose. The throat is osdematous, just as it is in Apis; the patient is restless, especially after midnight; the urine is scanty, and the bowels are either constipated or else there is offensive watery diarrhoea.

In still other cases, when, despite the dark purplish hue of the throat, and the great swelling and great prostration, there is not much pain, NATRUM ARSENICOSUM is the remedy. Here, the uvula hangs down like a sac of water.

Still another remedy is KALI PERMANGAN.. This remedy, which is seldom used in the high potencies, is indicated when the throat inside and outside is swollen, the membrane in the throat is horribly offensive, the throat oedematous, and thin discharge from the nose. The great characteristic is the extreme foetor.

Apis causes an irritation of the mucous lining of the larynx and trachea, and also soreness in the chest-walls.

It has been found most useful when laryngeal symptoms accompany erysipelas, oedema of the throat, glottis, or larynx, or suppresion of eruptions ; less often in simple laryngitis or laryngeal catarrh.

Difficult breathing, and especially the unique symptom, "he does not see how he can get another breath," has led to the successful employment of the drug in hydrothorax, hydropericardium, oedema pulmonum and asthma.

The lancinating, darting pains, palpitation, orthopnoea, etc., have rendered Apis valuable in cardiac inflammations and dropsy. Essential symptoms seem to be, oedema or sudden mucous swelling, dyspnoea, and sudden, lancinating, or stinging pains; restlessness and anxiety. Compare: LACHESIS, ARSENIC, SULPHUR, BELLADONNA, KALI CARB., SPIGELIA, DIGITALIS, ASPARAGUS, APOCYNUM CANNABIN.

ARSENIC has many resemblances. So apparently alike are the restlessness, changing of place, and dyspnoea, that the two are often misapplied, the one for the other. The best distinction lies in the fidgety restlessness peculiar to Apis. If dropsy obtains, both may be needed in pale, tensely swollen limbs, but Apis often has a redness, itching or erysipelatous condition present, as well as thirstlessness.

BELLADONNA is too often mistaken for Apis in laryngeal affections. The latter has the most cedematous swelling, with consequent dyspnoea; the former most spasmodic constriction.

In cardiac affections ARSENIC, APOCYNUM CANNABINUM, DIGITALIS, and ASPARAGUS, bear some similarities with Apis, especially with great debility and dropsy. APOCYNUM CANNABINUM is needed when the pulse is small and weak, heart-beat irregular, now weak, now stronger ; sinking at the epigastrium. ASPARAGUS suits in the aged, with weak pulse and pain about the left acromion. DIGITALIS causes a doughy appearance of the skin ; pulse slow or weak, quickening with every bodily movement; gone, deathly sick feeling at the epigastrium, soon after eating.

 

The cough of Apis is a not uncommon symptom, when this remedy is needed. It resembles more or less, LACHESIS, CARBO VEG., RUMEX, BELLADONNA, CHAMOMILLA, CROTALUS HORRIDUS, NUX VOMICA, BRYONIA, IGNATIA, ARSENIC,. HYOSCYAMUS.

LACHESIS, NUX, BRYONIA, and HYOSCYAMUS agree in adherent mucus.

But LACHESIS has intolerance of touch, even of clothing, about neck, a symptom not marked in Apis, except with the sense of suffocation.

RUMEX has a teasing, persistent cough, aggravated by cool air, or by anything which increases the volume or rapidity of the inspired air.

CHAMOMILLA differs mentally.

NUX VOMICA cures cough from adherent mucus high up in the trachea; but there is a rough, scraped feeling in the throat.

BRYONIA adds epigastric irritation to the suprasternal, and the pains in the trachea and chest-walls are sharp, stitching, as well as bruised, aching.

IGNATIA induces a nervous cough, and the more the patient coughs, the more annoying is the irritation.

ARSENIC causes more a burning tickling in the fossa; but since it so often concurs with Apis, it should be compared with the latter, especially when cough accompanies dropsy, heart disease, etc. Arsenic, then, is really a concomitant.

BELLADONNA may be misapplied for Apis, but we ought to be able to distinguish the former by its greater constriction of the throat, and deeper inflammatory redness.

CARBO VEG. agrees in hoarseness, rawness, and tickling cough, but the irritation is as from vapor of sulphur.

Now, the action of Apis on the genital organs. Apis is often indicated in diseases of the female organs. Nearly all the provers experienced symptoms referable to the uterus and ovaries. It must be given cautiously during pregnancy, because if given in low potency and frequent doses it may bring about a miscarriage especially before or at the third month, because Apis produces bearing down in the uterus. We may use it in amenorrhoaa when we have congestion to the head as a result, with bearing down in the uterine region without the appearance of the menses. Particularly is it indicated in girls at the age of puberty, when they are somewhat hysterical with this amenorrhoea; they are nervous and awkward, it is not a natural awkwardness but one that comes from inco5rdination of the muscles. With these symptoms there is flushing of the face.

We may also use Apis in affections of the ovaries, especially of the right. It holds the same relation to the right ovary as LACHESIS does to the left. It is indicated in ovaritis with extreme soreness in the right inguinal region, together with burning or stinging sensations, and some tumefaction directed either over the pelvis or more characteristically through the rectum or vagina.

In ovarian cysts, Apis is an excellent remedy to control the trouble, especially in the incipient stages. We have here, in addition to the burning and stinging pains, numbness down the thigh and over the right side of the body, feeling of tightness across the chest, with cough. This is not a symptom of lung disease, but is reflex from the uterus.

Now there is a combination of honey with salt, known as MEL CUM SALE. This was for years a popular remedy in Germany for bladder troubles and for diseases peculiar to women. I have used this remedy in prolapsus uteri and even in chronic metritis, especially when associated with sub-involution and inflammation of the cervix. The special symptom which leads you to the remedy is a feeling of soreness across the hypogastrium from ilium to ilium.

Apis may be of use in diseases of the eyes. I have had several cases of asthenopia cured by this remedy when reading causes smarting in the eyes, with lachrymation and itching of the eye-lids and some burning and stinging. Apis is also a remedy for staphyloma, whether of the cornea or sclerotic. In external diseases of the eye, Apis is not without value. The eyes are over sensitive to light. The conjunctiva is reddened or puffy and chemosed. Still this swelling of the palpebral conjunctiva under Apis is more from congestion than from a true chemosis as under RHUS TOX., which is very similar, especially in oedematous swelling of lids ; chemosis ; hot, gushing lachrymation ; erysipelas. But Apis has less tendency to the formation of pus—a symptom highly characteristic of Rhus. In the former the pains are stinging, the time of exacerbation is evening, and cold water relieves the inflamed lids. If erysipelatous, the lids are a blue-red, looking watery as if semi-transparent. In the latter, the pains are worse at night, particularly after midnight, warmth relieves; the erysipelatous lids are of a dusky red, and together with the cheeks are studded with small watery vesicles. The pains are usually drawing, tearing ; though in erysipelas they may be burning, stinging, but with more itching than the bee-poison. The eyelids often feel heavy and stiff.

ARSENIC compares with Apis in hot tears, violent pains, oedematous lids. But the lachrymation is more acrid. The oedematous lids are pale, not blue-red. The palpebral conjunctiva and edges of lids are very red. The restlessness is more pronounced. Relief is usually obtained from warm applications, though the scrofulous patient can open his eyes in the open cool air, but not in the room, even if dark. Worse at and after 12 P.M.

To return to the eye symptoms of Apis, the lids are swollen, red and (edematous. There is burning of the tarsi, with agglutination of the lids. Sudden and very severe pains shoot through the eyes, and these are relieved by the application of cold water. The eyes are generally worse in the first part of the night. Apis is often indicated in scrofulous ophthalmia, in which affection it is often followed by KALI BICHROMICUM.

It now only remains for me to speak of the intestinal symptoms of Apis. It may be of value in diarrhoea, such, for instance, as comes on during the course of typhoid fever or scarlatina, or as the result of the debilitating influence of continued heat.

You will find it useful in the diarrhoea of children who are very much debilitated. There is generally present irritability of the brain, with the condition known as hydrocephaloid. The symptoms are much like those indicating Apis in hydrocephalus. The child wakens up with a scream. The stools are thin, watery, yellow in color and usually worse in the morning. At every motion of the body the bowels move as though the anus had no power. The stools may or may not be offensive.

It differs from BRYONIA, which has morning diarrhoea worse from motion ; in that under Apis, the motion aggravates, not because of its general effects, but because the anus is so uncertain.

In bad cases you will find the urine scanty.

Apis may also be thought of in panaritium. The finger swells rapidly with tense glossy-red surface and violent burning, stinging pains.

In this respect, Apis is very similar to SULPHUR, and may be followed by Sulphur when its action is imperfect.

Apis is antidoted by PLANTAIN and LACHESIS and is complementary to NATRUM MUR.

LEDUM was proposed by Teste as an antidote for stings of insects. Dr. Drysdale has cured nightly itching of the feet with it.

In closing let me ask you to remember the relation of Apis to ARSENIC, ACETIC ACID, BELLADONNA, RHUS and SULPHUR. Remember also its inimical relation to RHUS TOX.