Circulation.-The heart’s beats are quickened and may be forcible, and the pulse increased by several beats a minute, except in cases of collapse, when no pulse may be felt at the wrist. Sudden, sharp, stitching pains occur over the cardiac region and may disturb respiration.
Back.-Apis causes stiffness in the back of the neck and painful stitches in the right side of the nape, which are worse from bending the head to the right side. Pains extend from the nape to the left side of the head. Pressive pains are felt under the shoulder blades, especially the left. The back feels tired and bruised, as from over-exertion, burning, stinging pains occur here and there along the spine, There is stiffness in the small of the back and the sacrum, in the latter are felt burning stitches. Sudden flushes of heat occur over the back with a sensation as if sweat is about to break out.
Extremities.-In the extremities there are rheumatic pains about the shoulders, dull pains in the bones of the legs, arms and fingers, pricking and burning in the palms, backs of hands and tips of the fingers, or a feeling of numbness in the finger tips, especially round the roots of the nails, violent pains about the knees, a sensation of weight in the feet and of swelling and numbness in them, the soles and balls of the toes feel cushioned, and there are shooting. burning and redness in the toes, while the feet are cold. the hands and feet tremble. There is great restlessness and a desire to change the position frequently.
Sleep is restless and dreams many and various, but most commonly of business, journeyings and flying; the patient may scream out in sleep, the brain seems too active and to have no rest day or night. On the other hand there may be extreme sleepiness and continuous deep sleep, sometimes followed by aggravation (arg. met., lach.).
The kind of fever that apis produces is one characterized by thirst during the cold stage but absence of it during the hot stage. There is but little sweat. The chill commences about 3 p.m.; during its continuance the hands feel dead. The hot stage is the predominating one and is accompanied with a racking headache, which merges into a continuous deep sleep.
In the skin apis causes burning, itching and pricking; the skin is excessively sensitive to contact; red and white blotches or wheals, like urticaria, which itch, sting and burn, occur all over the body. The rash may be rough, or smooth like erysipelas. A hot, dry skin alternates with moisture; it may appear pale, waxy, almost transparent, from oedema or blue-black or livid.
Some general effects of the drug may be noted that have not been considered under the special localities; they are the great prostration, weakness and lassitude that it causes, and the tired, bruised feeling in the back and limbs, as after great exertion the day before; awkwardness; the tendency to fainting fits; the swollen sensation as if the whole body is too large, as well as the feeling of swelling in particular parts; the actual oedema which is partial or general; internal trembling sensations, with shuddering over the back, especially the upper part; the twitching of muscles and loss of muscular power and the convulsions that sometimes occur. It has occasionally been observed that while one side is convulsed the other side is paralysed.
THERAPEUTICS.
Acute inflammations with oedema are the complaints for which apis is especially suitable. These comprise a large number of disorders. Thus it is a remedy for glossitis when the tongue, especially the right half, is much swollen and has a raw surface covered with little burning, stinging vesicles; for tonsillitis when the tonsils are swollen and bright red and there is stinging pain on swallowing, and also for deep ulcers on the tonsils and palate with an oedematous appearance round them and an oedematous uvula. When oedema is extreme there is no pain. The scarlatina sore throat is often of this description and then apis is the indicated remedy; similarly it may be the suitable medicine in diphtheria.
Apis is of great value in oedema of the glottis, such as may occur from extension of the inflammation in tonsillitis or from a scald caused by inhaling steam from the spout of a kettle. The inflammatory swelling of the larynx and tracheal mucous membrane is the cause of the cough for which this drug is useful it is excited by a tickling low down and in the suprasternal fossa, is short and dry and constantly repeated, it causes, from concussion, pain in the head and soreness in the upper chest, is worse in a lying position and in warm air. If the swelling is great, breathing becomes asthmatic, there is violent dyspnoea and a sensation of suffocation as if every breath will be the last.
Apis is useful for hydrothorax coming on after pleurisy and associated with the same sense of oppression and impending suffocation. Similarly it is of service in another serous effusion, viz., in ascites from peritonitis. An inflammatory oedema of synovial membranes for which it is useful is that of the joints in acute rheumatism.
Apis is indicated in acute nephritis not only by the scanty urine, albumin and casts caused by the drug, but also by the general or partial oedema which is present, especially in the lower extremities, the labia pudendi, and the loose tissue under the eyelids. It is often employed in nephritis occurring in scarlet fever or the exanthemata, when the patient is drowsy; or in stupor, with puffed face and absence of thirst.
Brain.-Apis has gained a great reputation in meningitis and congestion of the brain, when probably there is effusion into the arachnoid. Tuberculous and cerebro-spinal meningitis, and the cerebral affections of children, associated with dentition and worms, all come under its influence,. In these cases there is sopor interrupted buy sudden piercing cries, the cri cerebral the head is retracted, rolls from side to side boring into the pillow, and there is strabismus. The little patient frequently carries its hand to its head. Convulsions may occur and are made worse by putting the patient into a hot bath; they are usually accompanied with opisthotonos.
The nervous and mental symptoms of the provings suggest that apis might be useful for oedema of the brain in general paralysis of the insane, tumours and encephalitis, also in the following conditions-Melancholia; anxiety neurosis; suspicion in (a) confusional cases; (b) paranoia; (c) alcoholic toxaemia; also loquaciousness in confusional cases stupor. The modality worse from heat should be present if apis is the correct drug.
Fear and premonition of death may be present.
Many eye complaints are influenced by apis, notably conjunctivitis when there is chemosis and the lids are so swollen that the eyes can hardly be opened; hot tears gush out from between the lids and there is photophobia. In keratitis and ulceration of the cornea the drug is useful and also in rheumatic ophthalmia. a characteristic indication for the use of apis in eye diseases is that they are aggravated from exposure of the eyes to radiant heat; the patient cannot bear to look into the fire.
All the above complaints are distinguished by the presence of oedema, and the same holds true for the affections of the skin for which apis is indicated, viz., urticarias, where the skin is covered with large white or pink wheals which itch burn and sting. Erythema nodosum also presents the conjunction of inflammation and oedema and is beneficially treated with apis. Some cases of lichen are suitable for it. The erysipelas cases that require it are those where there is much oedema, perhaps vesication, with red shiny skin and which progress rapidly. They commonly commence in the neighbourhood of the right ear, spread to the eyes and nose and across to the other side of the face. Erysipelas starting in the umbilical wound in newly-born children is frequently of the kind indicating apis. It has been used for panaritium and felons about the nails, as it seems to have a special affinity for that region. Its characteristic stinging burning pains render it suitable for the allayment of similar pains when occurring in cancers and carbuncles.
Apis is one of the remedies for morning diarrhoea and is indicated in that affection when the stools are thin, yellow watery with some mucus, and passed without pain but with some tenesmus; flatus is often passed before the stool.
Sexual.- Apis is useful in disorders of the female sexual organs; it both causes and prevents abortion, most commonly at the second or third month. It is a remedy for metritis and cellulitis after delivery, for menorrhagia and dysmenorrhoea. It has been used for pains occurring in the right ovarian region and thought to be due to disease of the ovary. Its value in ovarian cysts, for which it has been recommended, is more than doubtful.
Beside its value in nephritis, it is a remedy frequently required for inflammation of the neck of the bladder with strangury, there is frequent desire with passage of only a very few drops of urine associated with burning pain along the urethra. Apis antidotes a similar condition caused by the abuse of cantharides.
Edwin Awdas Neatby founded the Missionary School of Homeopathy and the London Homeopathic Hospital in 1903, and run by the British Homeopathic Association. He died in East Grinstead, Sussex, on the 1st December 1933. Edwin Awdas Neatby wrote The place of operation in the treatment of uterine fibroids, Modern developments in medicine, Pleural effusions in children, Manual of Homoeo Therapeutics,