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Homeopathic Materia Medica by Farrington



CANTHARIS

(canth)

The remedy which I propose to bring before you for study today is CANTHARIS, the so-called Spanish fly. It is my purpose to speak of the more important symptoms produced by the drug, comparing it superficially with quite a number of others having effects similar to it. First of all, for sake of completeness, let me give you notes on two other drugs, the LYTTA VITTATA and the CANTHARIS STRYGOSA. The first of these is the potato-fly, not the potato-bug, the pharmacopoeial name of which is DORYPHORA. The potato-fly acts much like Cantharis when applied to the skin. It produces first a dermatitis, which is sopn followed by the formation of vesicles. The affected parts become red, almost erysipelatous in appearance. The vesicles finally rupture, leaving an ulcerated surface. Finally, death of the part may ensue.

The CANTHARIS STRYGOSA is a species of Cantharis, which infests the cotton plant. This, too, has vesication for its characteristic.

There are other varieties of this Cantharis, among which are the C. CINEREA, C. MARGINATA, C. ATRATA, C. NUTTATTI and MYLABIS EICHORII ET PHALATERIA ; these last two being imported from China.

Cantharis or Spanish fly has long been used by allopaths as a counter-irritant ; when applied to any part of the surface of the body, it excites a violent inflammation. This inflammation begins, of course, with erythema, rapidly advancing to vesication. The blisters thus formed are filled with a yellowish-white serum. As the inflammation progresses, they enlarge, and their contents' assume a purulent character. Finally, death of the part ensues, presuming, of course, that the application is continued long enough. At other times, large blisters termed bullae may form. These are sometimes as large as a silver half-dollar. They are raised above the surface, and are filled with a fluid which is excoriating. THIS IRRITATING PROPERTY OF CANTHARIS IS THE FOUNDATION STONE OF THE WHOLE PROVING. The pains incident to this kind of inflammation are, of course, very severe. They are of a burning character. At times when the nerves seem to be implicated in the inflammatory process, there will be sharp lancinating pains along the course of the nerve.

 

Still Cantharis is not the only drug that has these highly irritating effects when applied to the skin or taken internally.

Thus from external use the following will, sooner or later, cause vesicles to develop on the skin : Varieties of CANTHARIS, FORMICA ; varieties of RHUS, ANACARDIURN ORIENTALE ET OCCIDENTALE ; Ranunculous plants, as CLEMATIS, RANUNCULUS BULB., RANUNCULUS SCELERATUS, PULSATILLA, ACONITE, CALTHA, HELLEBORUS, ACTEA SPIC, Aracese, especially ARUM MAC, ARUM TRI., CALADIUM; FIX, TEREBINTHINA, THUJA, NUXJUGLANS, CHININUM SULPH.; several species of plumbago; ALLIUM SAT.; Euphorbious plants, particularly CROTON TIG., HURA, EUPHORBIA COROL., EUPHORBIUM OFFIC, MANCINELLA, SINAPIS, PIPER NIGRUM, CAPSICUM, MEZEREUM, THAPSIA GARGANICA, CHLORAL, COTULA MARUTA, DROSERA, PODOPHYLLUM, CHIMAPHILA, OLEANDER, CHELIDONIUM, COCHLEARIA ARM., VERATRUM ALBUM, CAMPHOR, PICRIC ACID, AMMONIUM CAUSTICUM, CALCAREA CAUSTICA, SULPHUR, SULPHURIC ACID, KALI SULPHIDE, NITRIC ACID, Arsenic preparations, CARBOLIC ACID, MERCURY, CUPRUM ARSENICOSUM, ANTIMONIUM TART., etc.

RHUS TOX. and ANACARDIUM cause vesication, with much redness of the skin and infiltration. The latter adds loss of appetite and other gastric symptoms as essential concomitants. The former causes red skin and numerous vesicles surrounded with a red rim from infiltration. A well-defined advance-line of inflammation marks the progress of the disease. The predominant sensations are itching or tingling; while in Cantharis burning and smarting as from salt are leading sensations. The latter, in some cases, when topically employed, induces an eczematous eruption around the plaster, and in others the vesicated surface assumes a soft, pultaceous, almost gangrenous appearance; but the skin is not the reddish-brown of Rhus.

CROTON TIGLIUM gives rise to myriads of small, terribly itching vesicles on a red base. When the genitals are attacked, there is pain on urinating, and some of the blisters become large, others break, leaving a red, moist surface. The vesicles may develop into pustules, which finally break and form grayish crusts.

HURA BRASILIENSIS, a near relative of the former, also produces red vesicles. Both of these remedies cause a tension of the skin, a hidebound feeling, which is best confirmed in Croton ; but Hura carries this feature into its vesication, for the blisters become so tense that, on opening, their serous contents fairly burst forth. A characteristic of this remedy is a sensation as of a splinter under the thumbnails. The eruption prefers projecting portions of bone, as the skin over the malar bones.

 

FORMICA locally applied sets up inflammatory redness, with itching and burning, slight exudation and desquamation. The urine is albuminous and bloody, and there is much urging to urinate.

CLEMATIS CRISPA is food for the Spanish fly. The CLEMATIS ERECTA we know irritates the skin to the production of burning vesicles, which pustulate and discharge a yellowish corrosive ichor. Urine is discharged in drops, or intermittingly, from a narrowed urethra.

RANUNCULUS BULBOSUS and RANUNCULUS SCELERATUS act similarly. In the former, the vesicles may become blue-black, or they may discharge a secretion, which becomes horny. The latter raises blisters, which leave a raw surface with acrid discharge, and resembles Cantharis in pemphigus. In blueness, Ranunculus bulbosus rather resembles LACHESIS; the latter causes deep-seated bluish blisters (which appear after scratching). In horny crusts, it resembles ANTIMONIUM CRUDUM.

The several species of Spurge have caused vesication. And the variety called EUPHORBIUM OFFICINARUM has been employed in vesicular erysipelas; red cheeks, covered with yellow vesieles as large as peas (from an application of the juice); violent fever. Like the Hura, this plant and the EUPHORBIUM CYPARISSIAS have an affinity for the malar region. Cantharis attacks the surface of the nose (like Graph.) EUPHORBIA PEPLUS also attacks the nose, as well as cheeks.

MANCINELLA is so irritating, that even the water dropping on the skin from the leaves may raise blisters; but the accompanying erythema far exceeds that of Cantharis. It resembles the blush of scarlatina, and has been used in that disease.

THAPSIA GARGANICA, an umbelliferous plant, closely resembles Croton. It, however, causes more pustules, and these fill rapidly with pus.

MEZEREUM develops numerous small vesicles, with intolerable itching; but the secretion quickly forms into thick, high scabs, from beneath which, an acrid pus oozes.

CAPSICUM, CAMPHOR, TEREBINTHINA, PIX and PIPER NIGRUM vesicate very slowly. Several of them are used rather as rubefacients. The first may be distinguished by the fact that the blisters appear on surfaces which have been wet with sweat, and the sensation is a pungent burning, while in the flY it is a smarting burning as from salt.

CAMPHOR, topically, causes an erysipelatous dermatitis with bright redness, and, eventually, blisters (from concentrated solution). We generally think of it when there has been a retrocession of skin disease, with its well-known symptoms of collapse and convulsions.

PIX and TEREBINTHINA cause violent itching, especially the former.

 

The skin becomes cracked under Pix, with sleeplessness, and bleeding when scratched.

Potash preparations favor more a papular than a vesicular eruption, the latter form being mediate between the papule and the pustule. KALI SULPHIDE and KALI NITRICUM develop papular vesicles when locally applied. KALI BROMATUM causes vesicles about the hair follicles (from internal use). KALI BICHROMICUM induces an eruption, which presents a vesicle with depressed centre; it suppurates, and on healing leaves a cicatrix. KALI HYDRIODICUM causes papular vesicles (from internal use); the resulting vesico-postules contain minute quantities of iodine. None of these, therefore, resembles the superficial blister of the fly.

CHLORAL is capable of producing several forms of eruption. Its vesicles are surrounded with a marked capillary hyperaemia.

CHININUM SULPHURICUM has caused an erythematous appearance strongly resembling scarlet fever; but it also forms confluent vesicles, which ulcerate or dry into crusts. Pemphigus, also, may appear.

In pemphigus, Cantharis compares with CAUSTICUM, RHUS, RANUNCULUS SCELERATUS, etc. The following have induced this form of eruption, and deserve a trial: CALTHA, NITRIC ACID, COPAIVA, SULPHURIC ACID, CHININUM SULPHURICUM, CARBONEUM OXYGEN.

In CALTHA, the bullae are surrounded by a ring, and itch a great deal. On the third day they are transformed into crusts.

COPAIVA affects mucous membranes, then the stomach and bowels, and later, the skin. A red, miliary rash forms on a red base; urticaria ; pemphigus, with excessive offensive discharge.

CARBONEUM OXYGEN is prone to excite vesication along the course of nerves (sciatic, trigeminus, etc.), and hence resembles herpes zoster—a disease which Cantharis has occasionally cured. It also causes "large and small vesicles of pemphigus."

Cantharis has a most remarkable affinity for the urinary organs. Marked symptoms of the kidneys and bladder may even result from the use of the drug externally. The same is true when the drug is taken internally. Let us now look at some of its symptoms. We find dull aching pains in the region of the kidneys. At other times violent cutting, burning pains extend from the kidneys down either ureter to the bladder. The parts externally over the region of the kidneys are very sensitive to touch. There is persistent and violent urging to urinate. Often, too, these cutting pains extend along the spermatic cords to the testicles and down the penis; attended by drawing up of the testicles. At other times, there is irritation in the glans penis, exhibited in children by frequent pulling at that organ. This pain in the glans penis may not be of an acute nature, but may be simply an uneasy, uncomfortable sensation. When in children, you notice this symptom, Cantharis is generally indicated; at other times, you may think also of MEROURIUS SOLUBILIS; of course, the symptom may be a habit which the child has been allowed to practice. That, of course, does not call for these remedies.

Coming to the bladder itself, we find here, too, extreme superficial sensitiveness over the hypogastrium (especially when the bladder is distended with urine), and almost unbearable tenesmus vesicae. Sometimes the patient will have the desire to urinate every two or three minutes. The urine does not pass freely or copiously, but dribbles away in drops, with burning, cutting pains, almost setting the teeth on edge. The urine could not be worse if the urine were molten lead. This burning and urging continue after urination, so that the poor sufferer is really in constant torture. Exacerbations come on every few minutes as endeavors to urinate become too urgent to resist. The urine itself shows changes in its composition. Blood is more or less thoroughly mixed with it, according to the part of the urinary tract from which the haemorrhage proceeds. The urine, however, is of a deep red color, independently of its containing blood, and deposits a sediment of mucus. Fibrinous casts of the lining membranes of the parts through which it passes, the tubules of the kidney, the ureters and the bladder, are observed under the microscope.

This is the picture of the effects of Cantharis as they attain their maximum. From these extreme symptoms, you have all grades of severity down to the slightest irritation at the neck of the bladder, with aggravation after micturition.

Sometimes we find an urethritis with the urinary symptoms I have already mentioned, and a gonorrhosal discharge of mucus or of purulent matter.

Now these symptoms characterize Cantharis, and indicate it in quite a variety of affections. You would expect it to be of use in inflammation of the kidneys; particularly in acute inflammation of one or the other of these organs rather than in chronic Bright's disease.

We find, too, that Cantharis is a valuable remedy in the passage of renal calculi, especially when the pains are very violent. It has been stated in controversy that it was nonsense to talk about relieving the pains from the passage of renal calculi by homeopathic medication. The ureter is a narrow tube and the stone is frequently large, and it is said that this cannot be passed without pain. This is a mistake. The indicated remedy may so lessen local irritability, that the pain attendant on the passage of renal calculi may be greatly modified.

Often, you find Cantharis indicated in gravel in children, when they have this irritation extending down the penis, with almost constant pulling at that organ.

Cantharis you will find indicated in acute cystitis more frequently than all other remedies put together.

It is also indicated in haematuria of inflammatory origin.

It also has a secondary action producing retention of urine, an effect due to the severity of the preexisting symptoms.

In gonorrhoea, Cantharis is indicated WHEN THERE IS MOST INTENSE IRRITATION, not a simple discharge with the necessary burning smarting and tingling, etc. Chordee is present. There is marked sexual erethism. It is also indicated in cases in which the disorder has been suppressed by the use of injections, and the disease involves the neck of the bladder.

Now, a word in relation to the remedies acting on the urinary organs in a manner similar to Cantharis.

CANNABIS SATIVA is very similar to Cantharis in its urethral phenomena. It has the same yellow purulent discharge from the urethra. There seems to be more burning and smarting under Cannabis, while there is more tenesmus under Cantharis. The glans penis is dark red and swollen. Chordee may be present. CANNABIS SATIVA may be indicated in simple acute nephritis, but it is not likely to be of much use in Bright's disease of the kidneys. It has, however, drawing pain in the region of the kidneys, extending into the inguinal glands, with anxious nauseous sensation in the epigastrium.

CANNABIS INDICA is much used in Asiatic countries. It produces the most wonderful mental phenomena, far exceeding Opium in its effects. The two central points of the mental phenomena of this Cannabis indica are delusions as to distance, and as to time. Time and space seem to be greatly extended. For example, the patient tells you that he is hungry, that he has eaten nothing for six months, when the dishes from which he has just partaken are yet by his bedside; or, on looking out the window he tells you that objects, but a few feet off, are many yards distant. But it is the urinary symptoms of Cannabis indica that concerns us more particularly just now. It is very similar to Cantharis, and is said to be even superior to that drug for gonorrhoea when the chordee is well marked. In renal disease, Cannabis is indicated when uraemia sets in, attended by severe headache, with a sensation as if the vertex was opening and shutting. If delirium appears, it is associated with the delusions respecting time and space just referred to.

EQUISETUM HYEMALE is a plant growing in water. It contains a large quantity of silicic acid. It acts very similarly to Cantharis on the kidneys and bladder. There are, however, less escape of blood and less tenesmus vesicae than may be found under Cantharis. The urine is less scalding and does not contain so many fibrinous flakes. Cantharis is not called for as often as Equisetum, when there is an excess of mucus in the urine. The bladder is tender and sore, with severe dull pain, which does not lessen after urination. There is constant desire, to urinate, sometimes with a feeling of distension in the bladder and with profuse urination. During urination, a burning pain is felt in the urethra. Equisetum has won most favor in enuresis. It has proved curative in these cases even when vesical irritation is marked, especially in women, and the urine contains blood and albumen.

LINARIA is another drug which has produced and cured enuresis with frequent painful urging to urinate, causing the patient to rise at night.

EUPATORIUM PURPUREUM is similar to the EQUISETUM in vesical irritability of women, for which condition it is used by Dr. Richard Hughes, of England. It causes frequent and painful urging with either excessive or scanty flow of high-colored urine containing mucus.

PETROSELINUM, one variety of the parsley, is a very handy remedy when indicated. It is indicated by the sudden urging to urinate. In the case of a child, it will be suddenly seized with the desire to urinate. If he cannot be gratified immediately, he will jump up and down with pain. You will find Petroselinum useful in gonorrhoea with this sudden urging and strangury. CANNABIS, CANTHARIS and MERCURIUS, have all that sudden urging to urinate, but it is strongest under Petroselinum.

CLEMATIS ERECTA is to be selected when there is mucus in the urine, but not pus; when the urine flows by fits and starts, or the patient has to wait a long time before his efforts to urinate are successful, with intense pains along the urethra at the glans penis. Clematis is to be thought of in the beginning of inflammatory stricture. It will cure the trouble then, but not when it has become fully developed.

CONIUM is useful in urethral and bladder diseases, when there is pus in the urine. Otherwise it is like Clematis. It has "passage of the urine by fits and starts."

DORYPHORA is indicated in urethritis in children under ten years of age, when the trouble has been provoked by local irritation. In these cases, think also of HYOSCYAMUS.

CAPSICUM is sometimes useful in gonorrhoea, especially in fat persons of lax fibre and of rather indolent disposition. The discharge is of a thick yellow character. The patient complains of fine stinging pains in the meatus urinarins, and stitches in the urethra between the acts of micturition.

COPAIVA and CUBEBA have been so abused by allopaths that I think we are too apt to neglect them. COPAIVA causes a urethritis with burning at the neck of the bladder and in the urethra. The discharge is of a milky color and 'of corrosive character. The meatus urinarius is tumid and inflamed.

CUBEBA causes cutting and constriction after micturition. The discharge is of a mucous nature. Both COPAIVA and CUBEBA, are useful in the irritation attending thickening of the lining membrane of the bladder. Neither remedy has as violent an action as has Cantharis.

THUJA gives us symptoms of continued or oft-repeated gonorrhoea. The patient has continued desire to urinate. The urging is violent, yet he passes only a few drops of bloody urine at a time; or, if these do not pass, there is intense itching. The urethral discharge is thin and green. Warty excrescences appear on the genitals and about' the anus. At night there are painful erections which drive away sleep. In Cantharis the erections prevent urination; this is not the case in Thuja.

ARGENTUM NITRICUM follows Cannabis in gonorrhoea when the discharge becomes purulent and the urethra feels sore and swollen.

MERCURIUS SOLUBILIS and CORROSIVUS follow when the discharge becomes worse at night and is green and purulent. The corrosive mercury causes the more violent tenesmus, burning and swelling, hence it is very similar to Cantharis. The meatus urinarius is very red. MERCURIUS SOLUBILIS has more burning between micturition than has Cantharis.

CHIMAPHILA, too, has been found useful in such cases. It produces frequent urination at night with increasing debility.

In irritation of the neck of the bladder, you may use quite a number of remedies, some of which I shall mention:

ERIGERON, with or without bloody urine.

PULSATILLA is indicated when micturition is followed by cutting pains and there are pressure and soreness over the pubes.

Under FERRUM PHOS. the symptoms are worse the longer the patient stands, and better after urination.

 

The DIGITALIS patient finds relief on lying down, as that position relieves much of the pressure from the neck of the bladder.

This brings to my mind BERBERIS VULGARIS. This suits when there is kidney affection, with sharp stitching pains radiating from the renal region in all directions, particularly downward and forward, filling the whole pelvis with pain. There are pains in the loins and in the hips. The urine when passed is more slimy than is the PAREIRA BRAVA urine, and deposits copiously a loamy sediment having a yellowish turbid appearance. Berberis is an excellent remedy in case of stone in the pelvis of the kidney or in the ureter. Now, you see the difference between the two remedies. Pareira has pain going down the thighs, Berberis only in the hips and loins.

You may expect to be called upon to use CAMPHOR when strangury, retention of urine, etc., have resulted from the abuse of'Cantharis.

In some cases Kali nitricum may be substituted for Camphor when renal symptoms have been produced by Cantharis.

APIS, too, is stated to have relieved the cystitis caused by the Spanish fly.

ACONITE frequently suits the incipiency of renal and cystic affections, which, unmodified, progress into a Cantharis condition. The urging to urinate, the dysuria and haematuria are accompanied by an anxious restlessness and high fever altogether different from the expression of Cantharis.

Just as Cantharis acts on the tissues, producing inflammation, so does it excite the brain. Thus we find the patient violent at times, with paroxysms of rage, tearing clothing and biting at any one who approaches him. He barks like a dog. The slightest touch aggravates the symptoms, as does also any dazzling object as a looking-glass or glass of water. These symptoms greatly resemble those of hydrophobia.

They also point to Cantharis as a remedy useful in puerperal convulsions and inflammation of the brain. The eyes are bright, the pupils widely dilated, and the face is pale or yellowish, and bears an expression of deep-seated suffering.

These symptoms indicative of inflammatory action in and about the brain, find their nearest concordant in BELLADONNA, which has the majority if not all the symptoms above mentioned. The intolerance of water even is present under Belladonna. The difference between the two remedies is found in the expression of the face, Belladonna having a bright red face with throbbing carotids; Cantharis usually exhibiting a face that is pale, yellow, and wrinkled, with a constant frown and expression of extreme suffering. Almost always when Cantharis is the remedy you find dysuria present.

CAMPHOR and ARSENICUM are also nearly related to Cantharis. In all three of the drugs the anxiety, restlessness, and the suffering face indicate the severity of the disease or sinking of the vital forces.

ARSENICUM closely resembles Cantharis in violent inflammations, with intense burning, agony, thirst, and subsequent collapse. The two drugs may also meet in ursemia. Arsenicum, however, lacks the sexual erythism, and its delirium is associated with a tendency to self-mutilation or to suicide. The patient exhibits fear of death, restlessness often alternates with the stupor.

CAMPHOR, like Cantharis, causes delirium, convulsions, sexual mania, priapism, strangury, internal burning with external coldness, hyperaemia or inflammation of internal parts, as brain, stomach, bladder, etc. The coldness, and sinking of vital forces in Camphor, are usually regarded as its most characteristic effect, the symptoms of excitement being reactionary. In Cantharis, on the contrary, the principal effects are those of excitement, coldness expressing the result of its prolonged or continued action. Practically, you may decide for Camphor when delirium, mania, or convulsions exist with coldness and extreme prostration, especially if caused by a suppressed eruption.

On the mucous surfaces, we find Cantharis causes just as violent an inflammation as it does on the skin. We find it indicated in inflammation of the throat of a diphtheritic character, accompanied by severe burning and raw feeling in the throat, great constriction of the throat and larynx, this constriction amounting almost to suffocation on any attempt to swallow water. By the way, even the bladder-symptoms are aggravated by water. It seems as if the sight of water brings about a constriction of the sphincter muscles. Cantharis has been used very successfully in diphtheria with these throat symptoms and the dysuria present, and when the debility is very marked.

While BELLADONNA has constriction of the throat, worse from swallowing liquids and intense inflammation of the throat, it lacks the burning, vesication, etc., so characteristic of the Spanish fly.

Much more nearly related to Cantharis in its throat symptoms are MERCURIUS CORROSIVUS, ARSENIC, ARUM TRIPHYLLUM, DIFFENBACHIA, and CAPSICUM.

On the alimentary tract, we find Cantharis producing inflammation of the stomach with the same character to the symptoms already mentioned, rawness, great thirst with aversion to drinks and vomiting.

 

It is of use in dysentery. The discharges are bloody and slimy, and are mixed with flakes that look like scrapings of the intestines. These, I believe, are not really portions of the bowel or pieces of the mucous lining, but are fibrinous formations, resulting from the inflammation. Tenesmus is marked and is almost always associated with dysuria. The pains in the abdomen are colic-like, doubling the patient up. They are of a cutting, burning or lancinating character.

In dysentery, Cantharis has several concordant remedies. One of these is COLOCYNTH, which has colicky pains, doubling the patient up. The stools are bloody and slimy, and are made worse by any attempt to eat or drink. They also contain the so-called scrapings of the intestines. COLOCYNTH differs from Cantharis in this; these colicky pains under Colocynth cease after stool, and the patient is relieved by bending double and by pressing firmly against the abdomen. Looking at the two remedies from a pathological stand-point, Cantharis has more inflammation and Colocynth more nervous symptoms.

Another remedy very similar to Cantharis is COLCHICUM. This remedy has tympanitic distension of the abdomen. The discharges from the bowels are composed of white jelly-like lumps, and are followed by violent tenesmus and constriction of the anus, tormenting the patient more than the urging during stool.

Another concordant remedy is CAPSICUM, which is good for dysentery occurring in moist weather. It is best indicated in stout flabby persons. The pains and other symptoms are increased by the slightest draft of either warm or cold air. The drinking of water causes shuddering and increases the pains.

SULPHUR you will find best adapted to chronic or persistent cases; especially when the tenesmus continues from one evacuation to another, (here it is like NUX), or when the blood and tenesmus have abated, but the stools are still slimy, with frequent sudden urging.

ZINCUM SULPHURICUM has several times cured subacute cases of dysentery. The pains are referred to the sides of the abdomen, probably in the colon.

KALI BICHROMICUM follows Cantharis when, though the "scrapings" continue, the discharges become more jelly-like.

We have yet to speak of Cantharis in its action on the sexual organs. Cantharis inflames the sexual appetite, producing a violent almost insatiable desire for coitus, with erection so violent and so persistent as to amount to priapism. Even sexual intercourse does not always reduce the erections. These symptoms indicate the drug in chordee during the course of gonorrhosa. They also point to its use for uncontrollable passion, whether the result of mental disease or not.

This priapism of Cantharis should not be confounded with that of a new drug, PICRIC ACID. Under this remedy the priapism is associated with spinal disease, as myelitis, meningitis or locomotor ataxia. Erections are violent, the penis is distended almost to bursting.

Cantharis also acts on the female genital organs, producing nymphomania, for which condition it may be one of the remedies.

We may also make use of Cantharis in labor. The drug has the property of expelling moles and other foreign materials from the uterus. We may make use of this effect in cases of retained placenta, either after labor at full term or after a miscarriage.

Cantharis is a useful remedy in erysipelas, especially when of the vesicular form. The erysipelatous inflammation begins on the nose, either with or without vesicles. It then spreads to one or the other cheek, with formation of vesicles which break and discharge an excoriating fluid.

GRAPHITES also has erysipelas, commencing on the nose. It is better adapted to the chronic disease.

Cantharis should be remembered as of use in burns about the face when blisters form, and cosmoline is offensive to the patient.

In burns you may compare Cantharis lotion with SAPO SODA, SODA BICARB., ARSENIC, and CARBOLIC ACID,—the last named when the affected parts ulcerate.