This drug has very irritating properties, is very poisonous, and exerts its action chiefly upon the mucous membranes of the genito-urinary tract and the skin. It contains cantharidin. The mucous surfaces become congested, and inflamed.

The kidney is very sensitive to the action of cantharides, which produces a parenchymatous nephritis, the glomerular portion being the first involved. "The protoplasm of the epithelial cells of the tubules is in an extreme state of degeneration; cloudy swelling, fatty degeneration and necrosis are all present. Casts, composed largely of disintegrated epithelium, can be seen where the lumen of the tubule is not obliterated by the epithelium." These kidney changes are not apt to result if the urine is alkaline in reaction and "consequently with threatened cantharidin poisoning in man the administration of alkalies would appear to be indicated.."

The bladder becomes irritated and inflamed; a constant desire to urinate is present, which is painful. Priapism may ensue and cystitis results from sufficiently large doses. Inflammatory irritation of the genito-urinary tract, with an attendant vasodilatation may produce sexual excitement.

The skin is readily affected by can-tharides and following either its local application, or internal administration, there results an inflammation readily passing into vesication; 0.1 milligram is sufficient quantity to produce this effect.

Other tissues acted upon by Cantharides are the pleura, mucous membranes of the stomach and lower bowel. The changes herein produced are those characteristic of acute violent inflammation, resulting in exudation.

Cantharidin acts more vigorously on persons with tubercular lesions than in normal individuals.

Summing up the general physiological action of this drug, it is seen that it produces symptoms very similar to the following diseases: erysipelas, pleurisy, nephritis, cystitis, acute gastritis, gonorrhea, and dysentery.

Therapeutics

Cantharis: This remedy is indicated when there is irritation of the mucous membrane, skin, and meninges, which may reach the stage of severe inflammation. This is noted on the mucous membranes of the genito-urinary, the gastro-intestinal and respiratory tract when there are burning, stinging pains.

The great use for this remedy is found in the genito-urinary tract, when there is a constant desire to urinate, which is attended with strangury and tenesmus. It thus becomes a most important remedy in urocystitis when there is a constant desire to urinate, with complete strangury. There is a burning distress in the urethra, and pains in the loins and kidneys, and superficial tenderness over the hypogas-trium, when the bladder is full. The passing of a single drop of urine causes moaning, on account of severe and agonizing pain.

Much the same group of symptoms indicates its use in cases of cystospasm, in hysterical, neurasthenic persons who masturbate; as well as in cystoplegia, in much the same type of patients. It has been found of service in postoperative dysuria when there is a frequent and continual urging to urinate, with violent cutting and burning pains in the bladder and urethra, accompanied by severe tenesmus.

It should be remembered during the acute stage of a specific, posterior urethritis, when there is urgent desire to urinate, and at night there is severe chordee.

It should be studied in acute parenchymatous nephritis, especially that attending scarlet fever and diphtheria, following the stage in which aconite, Belladonna, or

Veratrum viride is indicated. The urine is scanty, highly colored, contains blood, albumin, an abundance of casts and epithelial cells, and there is severe strangury present. In a more chronic type of nephritis with much the same group of symptoms and the addition of a general dropsy, it is of service. It is also of service in this class of cases when there is anuria or hematuria.

It has been found of service in pyelitis when, with the symptoms common to this disease, there is pronounced tenderness over the region of the kidney and blood in the urine; also in cases of uremia due to inflammation of the kidney.

It should be remembered in cases of insanity. In females who suffer from intense nymphomania, and males who suffer from satyriasis. An examination usually reveals an inflammatory condition of a portion of the genito-urinary tract which so excites the sexual desire that the patient loses self-control and resorts to debasing practices. There may be present a furious delirium during which the patient cries or barks like a dog and may manifest great excitement, at the sight of water.

It is also of service when sexual excesses have produced exhaustion and a condition of prostration is present. Melancholia may be present, with indifference, lack of will power and utter despair. There is frequently a sensation of burning along the spine, with weakness of the back and legs, severe pain in back and occiput. The least exertion causes prostration.

It has a place in the management of cases of dysentery when the stools consist of a bloody, watery material that resembles scrapings from the intestines. The stools may consist of blood. There is great tympanitis of the abdomen, which is excessively tender after stool. There is also a sensation of burning in the abdomen and anus, after stool. The colic ceases following the stool; but the tenesmus and dysuria are associated with the tenderness.

It is an important remedy in cases of pleurisy when the stage of effusion is reached. There is a sensation of heat and burning referred to the diseased parts, with dyspnea, palpitation of the heart, attacks of syncope, and a sense of great exhaustion when attempting to speak. There is apt to be urinary irritation. The temperature is not high. Much the same group of symptoms forms its indication in pericarditis.

It is indicated in the cystic hemorrhages, and suppression of urine, present in yellow fever; also in the acute stage of pemphigus; and during the vesicular stage of herpes zoster when there is burning and smarting referred to the affected parts. This is worse at night and is relieved by cold applications. It should be studied in cases of erysipelas, when there are large vesicles, which contain a fluid that is excoriating.

Characteristic Symptoms Of Cantharis

1. Scales on scalp, copious dandruff.

2. Intense burning pains in the mouth, throat, stomach and intestinal tract.

3. Dysentery of blood and mucus, or like scrapings from the intestines, accompanied by burning in anus and by dysuria.

4. Violent pains in bladder, with frequent urging to urinate, and intolerable tenesmus and burning; urine passed drop by drop.

5. Violent, burning cutting pains in the urethra, before, during and after urination.

6. Urine bloody, or dark colored as if mixed with blood.

7. Strong, persistent, and painful erections; or painless and without voluptuous sensations, with sore pain along urethra.

8. Pruritus in women, with strong sexual desire.

9. Pain in the loins, kidneys and abdomen, with such pain on urinating that he can not pass a single drop without moaning or screaming. 10. Erysipelatous inflammation forming blisters; or burns before blisters have formed.