the cutaneous exhalation.

If the liver is organically diseased, Apis is no longer sufficient. In
such a case, the action of the liver has first to be restored to its
normal standard. In dropsical diseases, I have effected this result most
frequently, for years past, by means of Carduus mariae, less frequently
by Quassia, still less frequently by Nux vomica, and only in a few cases
by Chelidonium: according as one or the other of these agents seemed
indicated by the epidemic character of the disease. In all non-malignant
cases, if the medicine was permitted to act in time, the whole disease
was often cut short by the use of these drugs, and the development of
typhoid symptoms prevented. Not, however, in all more inveterate cases,
where the prevailing character of the disease, by its more penetrating
action upon the tissues, induced a slower and more threatening course of
development. As soon as the pains in the right hypochondrium had
disappeared, the bilious quality of the faeces had been restored, and the
urine had become lighter colored, but the fever still continued, tongue,
throat, pit of the stomach and abdomen had become more sensitive; the
head duller and tighter, and the prostration more overpowering. In such
a case, Apis, prepared as above, became indispensable, in order to
remove all danger to life. Its curative action soon became manifest in
two different ways.

If the reactive force of the organism was still sufficient, the medicine
succeeded very speedily in preventing the supervention of the typhoid
stage, in changing the fever-type from a remittent or even continuous to
an intermittent type, during which the convalescence of the patient,
aided by a suitable diet, was more and more firmly established and
generally completely secured after the lapse of a week.

If the typhoid stage could not be prevented and set in with the
following symptoms: the patient lies on his bed in a state of apathy,
with loss of recollection, sopor, muttering delirium, hardness of
hearing, inability to protrude the tongue or to articulate; dry,
cracked, sore, blistered, ulcerated tongue; difficult deglutition;
painful distention of the abdomen, which is sensitive to contact or
pressure; retention of stool, or else frequent, painful, foul, bloody,
involuntary diarrh[oe]a; fermentous urine, which is sometimes discharged
involuntarily; the skin is at times and partially dry, burning, at times
and partially clammy, cool; trembling