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