As regards the stomach, we will simply note that vomiting of food the frequent efforts to vomit, must be associated with the Apis symptoms in meningitis, the early stage of scarlet fever, etc.
In dropsies of the abdomen (11) or in general anasarca (63) especially when resulting from peritonitis or dependent upon inflammation of the kidneys, Apis is of great value.
One symptom must be borne in mind in reference to all abdominal affections, or in remote conditions that give rise to troubles in the abdomen, and that is a sore bruised feeling in the abdominal walls, with excessive tenderness to touch (12); sometimes when the abdomen is not swollen, a in hydrocephalus and a hydrocephaloid condition due to infantile diarrhoea and cholera infantum (31), this bruised soreness of the abdominal walls would be very characteristic of the remedy.
It is of value in cholera infantum, with constant relapses, threatening brain troubles (31) characterized by stupor which is interrupted by occasional short cries, sunken abdomen, vomiting, involuntary stools with every motion, or constant oozing from the anus of which the patient is unconscious, and no thirst. If in addition here should be oedema of the feet and genitals, the case would present still further indications calling for Apis.
It is a remedy to be thought of in chronic diarrhoea (58), stools that are dark and worse after eating (57), or where the stools is so loose that they cannot urinate without being prepared for, or having a movement of the bowels (62).
It is useful in haemorrhoids (86), and in haemorrhoids after confinement (153), with sharp stinging pains, “better form cold and cold water” (Lilienthal).
In acute inflammation of the kidneys, croupous nephritis (124), it is very frequently called for perhaps associated with aching and soreness in the back or in the region of the kidneys, and a bruised sensation in the abdominal walls.
This croupous nephritis is found especially as the result of cold, or during or subsequent to the eruptive disease and diphtheria. The urine, in these cases, is apt to be scanty or almost suppressed (200), with the usual accompaniments of albumin, casts, etc., but it is rarely bloody.
The dropsy (63) is very great, comes on rapidly and is especially marked on the face and upper part of the body; along with this we have stupor, dryness of the skin and absence of thirst.
In chronic interstitial as well as in chronic croupous nephritis, it is useful in temporary exacerbations, with an increase of the dropsy, sometimes about the head, when there would be an increase in the stupor, and sometimes in the chest, when there would be great difficulty in breathing and suffocation on lying down.
While the urine is usually more or less suppressed in nephritis due to erysipelas, scarlet fever and diphtheria, still, when there is no inflammation of the kidneys, the urine in Apis is quite free and pale, although the patients drink but little.
It is useful in incontinence of urine in old men (199) as well as in cystitis, with frequent or involuntary micturition, often passed with a stinging pain (194). At times in cystitis there may be strangury or the urine may be retained in the bladder.
It is to be thought of in hydrocele (119) and in inflammation and in inflammation and swelling, especially of the right testicle (188).
Apis affects, particularly, the right ovary (147) and it is of value in various forms of inflammation (148) and neuralgia of the right ovary, with sharp stinging pains and sensitiveness to touch (148); it is also of value in pelvic cellulitis, with the pains and the extreme soreness over the lower abdominal region. Remember it also in cystic tumor of the ovary (147).
Apis would be indicated in dysmenorrhoea, when there was soreness in the ovarian region and a puffed, waxy appearance of the face, and in threatened abortion (13) with soreness of the ovaries.
In hydrothorax, either as the result of pleurisy or dependent upon disease of the kidneys, Apis has as a prominent symptom a feeling of suffocation on lying down (24); along with this there is dyspnoea, with the sensation as if he could not draw another breath.
The power of Apis to remove or absorb serous exudation is undoubted and we want to keep the remedy in mind in whatever part of the body we find the fluid.
The cough of Apis is usually suffocative and spasmodic, as from irritation in the upper part of the chest or suprasternal fossa (44), and it is short and dry. We also have a fit of coughing brought on by pressure on the larynx (44).
In pericarditis, requiring this remedy, we would find great soreness over the region of the heart, dropsy (109) and scanty urine.
It is of value in synovitis, especially of the knee (125), with swelling and rosy redness, stinging pains and extreme sensitiveness to touch.
It is frequently called for in an inflammation around the nail, run-round (163), with burning, stinging and great soreness.
The intermittent fever for which we prescribe Apis has, with one exception, just the characteristics that the study of the remedy would lead us to expect.
The chill comes on from 4-5 P.M. and is worse in a warm room and from external heat; they do not want to be wrapped up warmly in bed. The chill is accompanied by oppression of the breath and a sensation as if they would smother.
There is more or less apathy and drowsiness throughout the chill and as it passes off the patient falls into a deep sleep which lasts until the end of the paroxysm.
The sweating stage is slight or wanting. There is thirst during the chill (121), which is to be noted as the exception spoken of, but no thirst during the fever or sweat.
Many authors state that Apis and Rhus tox. are incompatible and that neither should precede not directly follow the other, Hering says: Apis “often disagrees after Rhus tox. in eruptive diseases; and Rhus tox. given after Apis has often disagreed.”
Farrington says: “Remember also its (Apis) inimical relation to Rhus tox.”
H.N. Guernsey says the same thing.
I have questioned as to whether our remedies when used in the potencies acted in an incompatible or inimical relation one towards the other.
On making inquiry amongst those for whose knowledge on the subject I have the greatest respect, no satisfactory answer has ever been given me, the substance of the replies, in this instance, being that as Hering has said so, the rest of us had better accept it.
It is a question on which there is, perhaps, no positive answer to be given at present, but I wish to quote from a recent lecture by Dr. William Boericke, who says: “It is said that Apis is inimical to Rhus. Such statements must not be made dogmatically, they are at best suggestive, only needing further clinical observation. I have seen strikingly prompt curative action from Apis in cases of Rhus poisoning so common in California, when the swelling around eyes and face generally was the chief objective symptom.”
I use Apis 30th.
