Cantharis Vesicatoria
Cantharis vesicator, Lytta vesicatory.
Blister-beetle, ‘Spanish fly’. N.O. Insecta, Coleoptera.
Tincture or trituration of live insects.
The essential features
As is well known from our materia medica, remedies generally prefer a specific system, organ or area of the body and express their action there, although their action is by no means restricted to this location. Cantharis’ preference is definitely the urogenital system, and it usually involves in its action both the urinary and the sexual spheres simultaneously. In Cantharis cases, when we have an inflammation of the urinary system, especially of the urethra and bladder, we see, at the same time, an excitation of the sexual drive. The more the inflammation of the urinary tract the more the sexual excitation, which can reach such a degree that it almost assumes the form of sexual frenzy.
The first key-note of this remedy is a sensation of excessive burning, a burning pain which runs through all of the picture. It has been shown by external applications of Cantharis as well as by provings where the remedy was orally taken, that the remedy produces such burning of the mucous membranes and also on the skin. Consequently, it has been of great use in the treatment of burns and scalds, even when they are very severe. We should, therefore, consider this remedy in all cases where excessive burning pain before, during and after micturition is the prominent characteristic and it is more disturbing and agonising to the patient than any other symptom. This is especially the case for inflammations of the urinary tract but also when other pathological conditions are accompanied by this type of painful urination. Moreover, whenever a patient complains of a feeling of excessive burning in whatever part of the body, Cantharis might also be indicated. This is especially true when such burning is coupled with an over-excitement of the sexual sphere.
A second characteristic of the remedy is that it produces very intense and violent inflammations that develop extremely quickly. In urinary conditions the state proceeds with such speed that within minutes the irritation and burning become so intense, that the patient screams from pain when urinating.
In Kent’s words: ‘When taken internally it proceeds almost immediately to attack the urinary tract and establish a uraemic state… The local inflammatory condition comes on with great rapidity, and this brings the patient down violently sick in a great hurry… The parts become gangrenous at an early state.’ And he goes on: ‘The bladder and the genitals are inflamed and the excitement and congestion of the parts often arouse the sexual instinct, so that there ares exual thoughts and sexual frenzy. Violent, amorous frenzy, an excitement such as accompanies inflammation attended with thoughts that correspond. The sexual instinct has gone mad. The erections in the male are painful and violent. The penis is inflamed and sore and it would be painful to have coitus, yet there is this frenzy.’
This description corresponds to a state of violent acute cystitis. In addition to the features mentioned above there may also be a veritably manic delirium of the sexual type, with tremendous restlessness and outbursts of wild rage. You will not always see all of this extreme state that Kent describes, but rather a picture going towards it.
Sexuality
In its chronic state, the Cantharis picture is an individual who is restless in body and mind, irritable to the extreme and with a sexual appetite that seems to be insatiable. In the chronic state, however, we don’t see the delirium and the extreme conditions of sexual frenzy. The patients can be described as lean, wiry, nervous individuals who tend to use obscene and aggressive language at every opportunity. This is an urge that they seem unable to control. Their behaviour to the opposite sex is rude.
Sexual desire is tremendously increased; a restless sexuality drives them on. It seems that the sexual drive takes possession of the whole individual. The patients cannot think about anything but sex. A Cantharis man or woman has no inhibition about suggesting that another person go to bed with them at once, and the desire is not satisfied by only one orgasm; it immediately rises anew. The obscene language is another way to express the sexual urge, and therefore such words are often also used during sexual intercourse.
Cantharis is more demanding for sex than even Platina, though, in cases of women with such an excessive sex drive, it is almost always Plat. that is prescribed, sometimes erroneously. In addition to the constant demand for sexual intercourse with their partner, these people are likely to have extramarital affairs to satisfy their sexual urges. It is interesting that such individuals do not easily resort to masturbation as they need ‘the real thing’ and mainly the contact with the other person. Let us be aware, however, that an increased sexual drive is only a symptom when it is pathological, an urge that makes the patients suffer and restricts their freedom to live out their human potential.
In chronic Cantharis people, and especially in women, there is often a long history of repeated cystitis, which has not been treated correctly, or of gonorrhoea. The recurrent urinary infections may be the same cystitis reappearing again and again or may be new infections which are connected to their numerous affairs; this is difficult to determine. You often find Cantharis states in prostitutes and men who visit them, as the possibility of infection in these people is great. Regardless of what triggered the infection, it is actually the constitution that breeds the infection. This is why a little girl who is exposed to a draught or to sea water can also get a violent cystitis with the excessive burning mentioned above. In cases of constitutional Cantharis adults, the history of repeated infections is usually present.
A key-note in this remedy that sometimes occurs during sexual activity is that pressure on the throat is unbearable. If by chance during sexual intercourse the hand of her husband presses her throat even slightly, a Cantharis woman, will become angry and will immediately push his hand away, as if frightened. There are also other symptoms that seem to be related to hydrophobia, such as a fear of water and of shining surfaces similar to Stramonium, but without the real aggression of Stram. Another differentiation may become important with regard to the obscene language. Here Cantharis resembles Hyoscyamus, but in Hyos. the desire for sex does not occur nearly as frequently as in Cantharis.
The mental picture
A tremendous restlessness prevails in the mental sphere of Cantharis, but it is a unproductive restlessness, a hurried feeling that makes the patient run about and constantly attempt to do something, without accomplishing anything. The provings give the symptoms: ‘Does not find rest, always looking for another place, with internal heat of head.’ And: ‘Extreme restlessness when sitting or lying; she has to move constantly, up and down, to and fro; day and night.’ This is both a physical restlessness and a restlessness of the mind. Too many thoughts intrude upon his mind, and the patient cannot get rid of them (this is seen especially in the morning). This mental unrest does not allow for the peace of mind necessary to finish a job. In the midst of it a new thought imposes itself upon him, and he starts another job, without finishing the original or that one either.
Anxiety and apprehension often accompany this restlessness, sometimes along with a feeling of guilt as if one had committed a crime. The anxious feeling is localized mostly in the stomach (Kali carbonicum, Mezereum, Arsenicum) or begins there and extends to other parts of the body. It can be connected to a sensation of fullness in the stomach and sometimes comes on after eating. There is a general disposition to being anxious and easily frightened, with restlessness, but also with depression and despondency. Some symptoms from the provings are: increasing anxiety with trembling over the entire body; the trembling continues while walking in the open air; anxiety in the morning, as if something important is about to happen; inner anxiety with a lack of self-confidence, distrust of himself in the afternoon; extreme despondency and faint-heartedness; says she is going to die. The inner tension that is expressed by restlessness and anxiety finds genuine release only in sexual intercourse, but there are also defensive and aggressive ways to bring it to the surface. The proving symptom ‘Defiant and contradictory mood in the afternoon’ is one manifestation of it, which has been confirmed by clinical evidence. Others are insolent, easily offended and become very irritable from what he considers an insult. Alternately, there is an inclination to be dissatisfied with everything and anything; morose, fretful, angry, boisterous, feels that no one can do anything right. Anger and rage also easily come on, sometimes with really malicious behaviour. The emotional state may undergo changes from a cheerful and talkative mood to discontent, great depression and despondency with incessant moaning, or to an introverted, pensive, sluggish and indifferent state of mind. A tearful mood together with fretfulness and anger has also been observed several times.
The intellectual faculties may become impaired with states of abstraction of mind. The individual has difficulty concentrating, and experiences a weakness and prostration of the intellect. An example from the provings is: ‘As soon as he wants to reflect upon something, his thoughts instantly vanish; his gaze remains fixed in silence on one object (which he hardly seems to notice, however), and he has trouble to collect himself in order to express a few words coherently.’ This may be connected with a heaviness, confusion, or a foggy feeling in the head. ‘Heaviness in occiput, with drowsiness and incapacity to think’ (Hering). At other times, there is a rush of ideas, which crowd upon each other, leaving the person no peace. The patients are literally overwhelmed with strange ideas which ‘run riot’, as Kent says, which seem to have a life of their own and cannot be stopped or controlled. Actually, the feeling of the patients is that an outside force possesses them and drives them to do things. These mental states can amount to total confusion and finally reach the verge of psychosis. Then an acute delirious state may come on.
Delirium, delusions, states of unconsciousness
To get a notion of the Cantharis delirium, let us first follow Kent who often has very graphic descriptions of acute states: ‘Restlessness ending in rage. Restlessness causing him to move constantly, a rage and delirium intermingled with amorous frenzy. … In some instances, he deliriously sings lewd songs and prattles on the subject of human genitals, urine and faeces, a wild raving about subjects not talked about in health except among the depraved. But in disease, chaste and modest persons, virgins, will speak so that it is surprising where they have picked up such language. …I have seen a dear old mother weep and wring her hands and say: Where did my daughter learn such language?’
Besides the erotic quality, the furious character of the delirium is remarkable. The delirium, which may have its cause in mental disease but also in acute states of fever and excessive pain comes on mostly in the evening or at night and is often coupled with or followed by clonic convulsions, ending in sudden unconsciousness. The convulsive attacks often closely resemble hydrophobic attacks, and indeed Cantharis has been prescribed in olden times for hydrophobia, even as a prophylactic. Great excitement and rage, convulsive paroxysms renewed by touching the larynx, by pressure on the abdomen where it is painful, by trying to drink water or even by hearing the sound of falling water, by the sight of water, or bright or dazzling objects. Great fear of water or bright objects is exhibited; also great fear of death.
Frothy saliva may come out of the mouth during the raging attacks, with alternating trismus and opening of the mouth. Here again a differential diagnosis to Stramonium and also Hydrophobinum becomes important. In Cantharis, during the attacks an excessive desire for sexual intercourse may be expressed. The patient howls frightfully, like the barking of a dog, or screams, laments, moans, whines or weeps. Destructive behaviour can come on in acute delirious states, e.g.: strikes the wall and tries to scrape the stucco from it with excessive pain; grasps an iron stick from a curtain and breaks it, screaming fearfully. These attacks may be immediately followed by general convulsions, fainting and profound stupor.
Cantharis may quickly reach a state of loss of consciousness (with or without delirium), with a red face, and often with the body having a cold surface, the patient looking like Opium. The idea is that he goes suddenly into a stupor. ‘Lies in a stupor, with cold surface and occasional jerks’ (Hering). The patients may lie down unconscious with arms stretched along the body, but from time to time start and strike out with shrieking, tossing about and even falling into clonic convulsions. These states can come from a suppuration of an internal organ, as for instance the intestinal canal, or from an inflammatory irritation of the meninges.
Some other delirious symptoms are: fancies she hears something walk quietly about the room, then it knocks under the bed and seems to elevate it; something seems to grasp her hand and bend it several times up and down, then her throat is grasped by two icy-cold hands; talks much and incoherently about business and about people long dead.
Cantharis may be indicated in manic depressive states where the raging attacks alternate with conditions of great depression, dejection, and despondency, with incessant moaning or with weeping without apparent cause.
Generalities
Cantharis should be considered in: rapidly destructive inflammation in the serous and mucous membranes which moves quickly towards gangrene; suppuration of internal organs or meningitis, causing unconscious states and convulsive attacks; inflammations of the urinary and genital organs.
Cantharis should be considered in any condition where the urine is scanty, cutting and burning, with intolerable, constant urging to urinate. Pain is generally burning in any part of the body. All body cavities burn as if raw and sore. The body feels raw and sore pain all over, both internally and externally. There is a crushed feeling all over the body, with sensitivity of every part, both internally and externally, and great weakness, such that he has to lie down. The pain is generally accompanied by great excitement and irritability. Cantharis is also a valuable remedy for burns and scalds.
There are convulsions from dysuria and bladder or kidney calculi, with the above-named hydrophobic symptoms; very marked is the aversion to being touched on the throat. The convulsions may be very violent, with alternating emprosthotonus and opisthotonus; with convulsive tremors of all the limbs, with cold sweat on the forehead and chest. The patient cannot get a moment’s rest on account of immediate recurrences.
The patient has great thirst, but often aversion to drink and a horror of liquids. This may be due to his mental state, but also to the throat feeling as if it were strangulated or to a burning pain in the throat upon swallowing, which is most marked on swallowing liquids.
There are sudden attacks of unconsciousness, loss of strength, extreme weakness, prostration, great emaciation, fainting and collapse and general coldness. An interesting modality that has been observed in a proving is that a progressive languor was relieved by drinking freely of alcoholic liquors, which produced no symptoms of intoxication.
Cantharis cured a hemiplegia of the right side, apparently without sensation in the affected side, where the speech was affected and very indistinct, hardly understandable.
The individual has an aggravation from drinking, especially cold drinks and from water, even if only seen or heard, from coffee (gastric, abdominal and hepatic complaints) and from urinating. Some mental symptoms are worse in the morning or afternoon; delirium mostly in the evening and at night.
Amelioration comes from lying down and rest (but some symptoms are better from physical exertion) and warmth.
Vertigo
On walking in the open air, vertigo with quickly subsiding attacks of unconsciousness, with foggy vision, returning several times within half an hour. Vertigo and fainting.
Giddiness and weak feeling in the head.
Head
Congestion in the head with feelings of heaviness and burning heat of the head and especially burning in the brain is frequent. Boericke describes a characteristic sensation as if boiling water were in the brain. Burning in the sides of the head, ascending from the neck, with soreness and giddiness; worse in the morning and afternoon; when standing or sitting; better while walking or lying down.
Aching deep in the brain, of a dull, sore, or stitching quality. Violent lancinating pain deep in the brain, especially in the occiput. Violent sore pain inside the head. Heaviness and a stupid feeling in the forehead, deep in the brain, with the sensation as if someone pressed her head forward. This latter sensation is characteristic and may be coupled with an outward pressure in the forehead. For instance: Tearing and dragging pain, only on motion; when stooping and turning the head, it is as if something came up from nape of neck and pressed the head forwards, and as if everything would come out of the forehead. Or: pressing outward from within the forehead, waking him at night; ceases when sitting up in bed.
Headache that interrupts sleep at night, may also have a stitching quality: Cutting stitches in the head, waking her from sleep.
Generally, stitching headaches are frequent, especially in the sides of the head; stitching in the left os parietale while speaking. Painful tearing on the vertex with the sensation as if a lock of hair were being pulled upwards.
Twitching and jerking is felt in the muscles and bones. A strange symptom is: ‘Intermittent painful twitching, now at the right os occipitale, now at the outer side of the left knee.‘ Headache from washing or bathing.
Cantharis has been successfully prescribed in neuralgia of the head and face from exposure to the cold, with loud screams and jerking of the muscles; also in cases of meningitis or irritation of the meninges with lancinating pain or with unconsciousness and convulsions.
Falling of hair on combing, during confinement or lactation. Scalp very scaly; a lot of dandruff.
Eyes
Eyes protruding, very bright, even looking fiery or sparkling, with a fixed, staring gaze; pupils widely dilated. Or they are restlessly in motion, frightfully rolling, alternating with fixed staring; pupils contracted. These features are found especially in acute delirious or manic states. In other conditions they may look sunken and bleary, surrounded by blue rings.
Burning in the eyes, glowing heat as if from coals; biting sensations as from having salt in them. Biting in the eyes after closing them.
Aching in the eyes from exerting them, especially from writing, which makes them water and causes cutting pain.
In the open air the eyes water; he has to close them; when he opens them again the margins of the lids ache as if sore, like raw flesh. Acute or chronic inflammation of the eyes, with biting and smarting; particularly when caused by a burn.
Retinal haemorrhages; watery discharge mixed with blood.
Everything appears yellow; letters on a page look green and yellow.
Ears
Burning, glowing heat of the ears; otitis.
Sensation of hot vapour coming out of the ears in intervals.
Stitching and tearing pain in the region of the ears, especially in the right mastoid process, where it may be so severe that it feels as if the bone would will be torn out, making the prover scream.
Pimples at on the mastoid process, burning on touch.
Ringing, humming, buzzing ear noises buzzing noises in the ear; buzzing in the ears after supper.
Nose
Secretion of much tenacious mucus from the nose, without sneezing; the tough discharge is drawn from the posterior nares into the mouth.
Red, swollen nose, with a feeling as if it were going to suppurate, mostly felt mostly internally; pain worse on touch and talking.
Inflammation at the margin of the right wing of the nose, red and shiny. Red, hot nose, with suppurating pimples.
Erysipelatous inflammation of the nose, preceded by a pain on the dorsum of the nose as if pressed or pinched. Strong disagreeable odour, foetid and sickly, is smelled in the nostrils; with strangury.
Face
The expression is extremely sickly and miserable, showing fear, terror, despair.
Congestion in the face with sudden glowing heat and redness. On stooping, the face instantly becomes very red, with a violent rush of blood to the head, and even while sitting the face becomes hot (but not while walking). Red face during sudden fits of unconsciousness. The face is often very swollen and puffy but a sunken, pale, sallow, even death-like look has also frequently been observed, especially during and after severe pain; it may also be discoloured yellow, with yellow-looking eyes. Or the right side of the face glows, while the left side is waxy yellow.
Right side of the face is swollen, with tension but without redness and heat.
Burning in the face, even if it is no warmer than usual on to the touch.
Erysipelas, beginning on the dorsum of the nose, spreading to both cheeks, but more to the right; with burning, biting heat; with urinary symptoms. Vesicular erysipelas in the face with burning pain and great restlessness. Pimples appear on various parts of the face and burn when touched.
Mouth
Painful burning of the whole buccal cavity and oesophagus, extending down to the stomach. Burning on the tongue and palate; hot feeling at on the palate as if something spicy had been eaten.
All mucous membranes of the mouth are inflamed, excoriated, red and covered with small blisters. White vesicles, up to the size of a pea, in all parts of the buccal cavity, at on the palate, gums, and tongue.
Mouth dry; tongue dry in the morning, covered with mucus.
Tongue swollen; thickly coated, white or yellow, and red at the edges, or bleached at the tip and sides, with a blackish-brown centre.
Trembling of the tongue.
Taste is bitter, accompanied by disgust for everything; offensive. The sense of taste may be totally lost for a time, or food tastes as though it were unsalted.
Copious and frequent salivation; accumulation of tasteless saliva in the mouth, or it is disgustingly sweet, forcing him to spit. During manic or convulsive fits, grinding of teeth, frothy salivation, lockjaw.
Sublingual glands swollen and red.
Gums spongy and swollen; inflamed spots, with swelling. Dental fistula, with suppuration.
Throat
Burning sensation and soreness in the throat, literally feels on fire. The burning is worse on swallowing anything The burning is made worse by swallowing any substance, but even more so on drinking water, which makes the pain intolerable.
Inflamed throat, sore, burning, feeling as if scraped; covered with plastic lymph; swollen internally. Inflammation and suppuration of the tonsils.
Throat blistered and ulcerated. Aphthous ulcers, covered with a whitish adherent crust, at the back part of the fauces and on the tonsils. A spasmodic contraction of the throat, or a feeling of constriction amounting almost to strangulation; to swallow a single drop of fluid is an agonising experience.
Swallowing is very difficult, sometimes impossible, especially of fluids; on account of the pain, a feeling of strangulation or a dread and horror of liquids.
Water drunk regurgitates through the nose.
All the throat symptoms are worse from drinking and are ameliorated while lying down.
Voice, respiration, chest and heart
Speech is very feeble and timorous, because of a sensation of weakness of the respiratory organs. Hoarseness, with painful rattling of viscid mucus coming from the chest, and with incisive shootings in the trachea. Voice almost or totally lost during attacks of weakness; or in laryngeal diphtheria.
Acute inflammation of the larynx, with extreme heat and burning.
Burning and stinging in the larynx, especially when attempting to hawk up a tough to hawk up tough, tenacious mucus from the chest. Dry, cutting stitches along the trachea at night.
An important indication of Cantharis is bronchitis where the mucus is profuse, tenacious, and ropy (compare Kali-bichromium) and burning up on urination is present at the same time. Mezger found the remedy useful in influenza-related bronchitis with cystitic irritation, albuminous urine, and spurting of urine during coughing. Hering mentions: ‘Catarrh in larger bronchia, with profuse, yellow expectoration.’ Frequent dry hacking cough. Bloody expectoration.
Difficult respiration, sometimes with oppression, on account of a spasmodic contraction of the throat or chest.
Stitching and shooting pain in the chest, worse on inspiration, or impeding or arresting respiration. The stitches may go from one side to the other, from the front right through to the back, or they extend to the axillae. ‘A pain in chest like a shot, from the front towards the back, with arrest of breathing.’
Cannot lie on the left side because of stitching on inspiration, at midnight.
Extreme heat and burning in the chest, as if from fire.
Pleuritis exsudativa. Pericarditis, with effusion.
Violent palpitation. Drawing pain in the region of the heart. Stitch in the heart, followed by a crawling sensation.
Praecordial anxiety; sensation of anxiety in the heart, in the afternoon.
The pulse is very variable: mostly hard, full and frequent, at times intermittent; frequent and weak or slow, feeble, and scarcely perceptible; more full and rapid in the morning.
Stomach
The person’s appetite is usually diminished and often he is easily disgusted by food, drink and tobacco. If his appetite begins to return, coffee will make him lose it.. He gets nausea, as if from a weakness in the stomach, after coffee.
Constant great thirst, often excessive, with burning pain in the throat and stomach; but at the same time we often see an intense aversion to all fluids; if someone hands him a glass of water, he pushes it away. Or: water cannot be swallowed in spite of the thirst on account of the burning pain, or because of a spasmodic contraction of the throat. Or: dry lips without thirst.
Heartburn and heat rising, without thirst; drinking water increases the burning pain.
Nightly regurgitation of food.
Eructation of sour frothy mucus, tinged bright-red; sour belching after drinking.
Nausea and frequent vomiting, first of food, then of bilious mucus. Vomiting of tenacious mucus in lumps. Vomiting with violent retching and severe colic; in pregnancy.
Haemorrhages from the stomach, with the vomiting of blood.
Violent burning pain in the stomach; also stitching and griping pain. Extremely violent gastritis.
Tremendous sensation of fullness in the region of the stomach, accompanied by anxiety and restlessness.
Abdomen
Cantharis produces extremely violent inflammation of the gastro-intestinal canal, especially in the lower intestines. Peritonitis, with burning, cutting pain, urinary tenesmus, and spasms of the bladder. Cantharis may be indicated in different gastric, hepatic, and abdominal complaints that are aggravated by coffee. The provings report a feeling of fullness in the chest, stomach and abdomen after coffee.
The whole intestinal tract feels very hot and burns.
Great distension and tenderness of the belly; tympanitic. The whole abdomen is excessively tender to touch and pressure. Incarceration of flatus under the short ribs (flatus is very offensive). Audible rumbling while sitting. Colic-like pain, causing the patient to double over.
The abdominal pain is very violent and mostly cutting, burning, and lancinating. Frightful cutting pain from 5 p.m. until the next morning, compelling the patient to ‘roll around.’ Tremendous cutting pain in the hypogastrium, constantly moving to and fro, stopping only for a short time. Cutting pain during stool toward evening; or after each evacuation of stool.
Burning pain around the umbilicus and in the hypogastrium. Burning pain above the navel on coughing, sneezing, and blowing the nose, with a rather hot feeling in the hypogastrium; around the area of pain some yellow spots on skin, which ache on touch (more stitching than burning).
Acute pain in the region of the stomach and bladder, with such extreme sensitivity that the slightest pressure produces convulsions. The pain is ameliorated on lying down and from warmth.
Hepatitis. Right side of the abdomen and liver painful and sensitive, with urinary symptoms. Cutting, stitching, and burning in the groin, with violent cutting on urination.
Rectum
Constant, violent urging for both stool and urine, with extreme tenesmus. Constant ineffectual urging; returns soon after stool; when urinating, an ineffectual urging for stool comes on. Retention of stool and urine. Kent says: ‘The patient will sit on the commode with violent tenesmus to pass
urine and stool, feels that if he could only pass a few more drops of urine or a little more bloody stool he would get relief, but no relief comes.’ Violent diarrhoea with unbearable burning in the anus, which continues for a long time; watery stool excoriates the anus.
Diarrhoea consisting of blood and mucus; or pure blood is discharged after violent straining. Dysentery. Evacuation of white, solid mucus, as if from scrapings of intestines, with streaks of blood.
Stools slimy and red or green.
Copious stools.
Shivering after stool, with the feeling as if icy-cold water were poured over her.
Urinary organs
This region is, as said before, Cantharis’s main area of action, and the remedy should always be taken into consideration when any condition is accompanied by its characteristic symptoms in the urinary region. Cystitis and urethritis are the pathological states where Cantharis is most often prescribed, especially when they are accompanied by increased sexual desire, but it will only act successfully where the symptoms agree. Mercurius corrosivus, Nux vomica, Sarsaparilla and Apis are remedies that have to be differentiated in cystitis cases. The main symptoms are constant urging to urinate with violent tenesmus and strangury and burning and cutting pain before, during and after urination. The pains usually extend downwards, from the bladder through the urethra (compare Cannabis, where the pains often extend backwards to the bladder). Scanty micturition and painful retention of urine are often present, and the urine is frequently bloody. Due to the rapid development of the inflammatory states of the bladder, urethra and kidneys, blood will appear appears quite early in the course of the inflammation.
A selection of symptoms from the provings and from clinical experience:
Pain in the loins, kidneys and entire abdomen, with such pain on urinating that he cannot pass a single drop without crying and screaming.
Pain in the loins with the incessant desire to urinate, however, only a small quantity is passed.
Violent paroxysmal cutting and burning pain in both kidneys; the region is very sensitive to touch; alternating with equally severe pain and burning in the tip of the penis, urging to urinate, and extremely painful evacuation, by drops, of bloody urine; at times pure blood is passed, with some clots. Constant dull aching in the region of the kidneys, late in the evening.
The kidney pain spreads downwards along the whole course of the ureters to the bladder.
Cutting and constricting pain from the ureters to the penis; pressure upon the glans penis brings slight relief.
Heaviness in the region of the bladder, on the slightest motion is transformed into a sore pain.
Pressive stitching pain in the neck of the bladder before urination, and constant urging, but only a few drops pass.
Violent burning-cutting pain in the neck of the bladder, extending to the fors navicularis, mostly occurring before and after urination. Intense vesicular spasms.
Violent pains in the bladder that are increased by drinking even minute quantities.
Retention of urine from too full a bladder. Ischuria. But a more copious and frequent urination than usual has also been observed in the provings. A kind of paralysis of the neck of the bladder; urine is passed without any urging and can hardly be retained. Ischuria paradoxa; constant involuntary dribbling of urine.
Peculiar pain on urinating as if the urine cannot get out, with disagreeable pressure in the region of the bladder; along with this sensation, a pressive pain in the meatus has also been observed.
Painful discharge of a few drops of bloody urine, causing very severe sharp pain, as if a red-hot iron were passed along the urethra; most acutely felt at the membranous portion of the canal, and in the meatus urinarius.
Constant burning sensation in the urethra, even when not urinating.
Frightful pain in the urethra before, during, and after urination; the prover (female) had to bend over double and screamed with pain.
Very frequent urging, intolerable tenesmus. The urinary organs are so highly irritated that he can hardly bear more than a spoonful of urine in the bladder without having the urge to urinate.
Sudden urge to urinate on seeing or hearing running water. Urging which awakes him from sleep, with very scanty micturition, leaving intolerable burning.
There is much more urging while standing, and still more during walking, than while sitting.
Violent urging to urinate every few minutes, but no more than a spoonful is passed, and at the end of this scanty urination the unbearable burning cutting pains in the urethra arise.
Violent urging without any evacuation.
Frequent painful urination, constantly preceded by violent pain in the glans penis.
Urine is only discharged drop by drop; it scalds and burns. Constant painful urging with dribbling discharge of scanty reddish urine, sometimes intermingled with blood.
Urine is passed in a thin and parted stream, which is difficult to discharge.
Blood is passed with agonising burning cutting pain through the urethra and with violent tenesmus; bright red blood or clots of coagulated blood appear.
Urine albuminous; cloudy immediately on passing; containing mucus, pus, blood and casts.
Discharges from the urethra such as non-specific urethritis, white and watery, accompanied by a constant desire to urinate. Some more pathological states of the urinary tract where Cantharis might be indicated:
Acute parenchymatous inflammation of the kidneys.
Cystitis after scarlatina; post-scarlatinal nephritis.
Ulceration of the bladder and urinary passages.
Painful retention of urine from suppressed gonorrhoea.
Spasmodic stricture of the urethra.
Inflammation of the orifice of the urethra.
Genitalia
Cantharis has been prescribed in acute gonorrhoea with the most intense suffering, with constant distress in the bladder, bloody discharge, and sexual arousal; in men with chordee (painful erection with downward curvature of the penis).
The most characteristic feature of Cantharis in the sexual area is an intensely increased sex drive of both sexes which cannot be satisfied by coitus; satyriasis or nymphomania.
Genitalia – male
Strong sexual desire which disturbs sleep at night; sometimes with an annoying tingling and voluptuous heat in the urethra and constant erection. Violent, painful priapism; prolonged erections with excessive pain along the urethra.
Strong erections at night, with pain in the entire urethra as if contracting and sore. But we also see strong and persistent erections without pain and without any voluptuous sensation.
Burning at excretory ducts of the seminal vesicles in the urethra, during and after coitus.
Spermatorrhoea. Sperm is discharged in the morning in bed with a relaxed penis and almost without erotic sensation. Emission of blood instead of sperm, or emission mixed with blood.
Cutting pain from the kidneys along the spermatic cords to the penis, with retraction of the testes.
Drawing pain in the spermatic cord during urination. Violent pain in the glans constantly precedes micturition.
Swelling of the glans penis which is very painful to external pressure which is very painful if external pressure is applied. Dropsical swelling of the penis and scrotum.
Heat and sweat at the genitalia.
If little boys frequently pull at their penis, this is a key-note of Cantharis.
Genitalia – female
Extreme pruritus vaginae, often with greatly increased and constant sexual desire. Unbearable pruritus during menopause, sometimes continuing for years. Swelling and irritation of the vulva. Sexual arousal may be increased during menses, and is often attended by burning and scalding during urination, with the urine being discharged by drops.
Sensation in the hypogastrium as if menses would appear, after midnight.
Menses: too early; too profuse or too scanty; often black blood; attended by great soreness of the breasts.
Uterine haemorrhages with great irritation in the neck of the bladder.
Cantharis has been used successfully in cases of abortion where a constant desire to urinate was present.
The remedy is said to promote fecundity, and it helps to expel moles, dead foetuses and the afterbirth. Retained placenta or membranes, usually with painful urination, is a well-confirmed indication for the remedy.
Puerperal metritis, especially with mania of a sexual character; convulsions, renewed by sight, sound or drinking of water and by touching the larynx.
Bearing-down pain from the abdomen to the genitalia.
Inflammation of the ovaries, with burning pain, especially worse during menstruation, ovaries extremely sensitive. Stitches in the ovarian region, so bad that are so painful/intense as to arrest breathing. Cysts at ovaries; hydatides.
Back
Swollen cervical lymph nodes, sore to the touch.
Nape of the neck stiff, painful tension when bending forward.
Tearing in the cervical muscles; on walking.
Tearing pain in the back, especially in the morning.
Chills and shivering that move up or down the back. A strange symptom from a proving is a repeated feeling of coldness in a region, the size of a hand, at the left side of the lumbar vertebrae; it is a sensation of goose-flesh with violent and annoying formication, restricted to that area. This sensation was most felt when sitting down in the evening.
Pain in the region of the loins and kidneys, stitching, cutting, or tearing, with urinary symptoms.
Dull heavy pain in the lumbar region, increased by pressure; sometimes extending to the perineum.
Cutting pain in both loins, extending up to the axillae, where it transforms into stitching.
Stitching in the small of the back after rising from a seat, when walking.
Stitching and gnawing pain at the sacrum, especially in the evening.
Lancination and tearing sensations in the coccyx, causing him to start.
Extremities
Great lassitude, especially of the lower limbs, can hardly ascend stairs; trembling of the limbs with restlessness; trembling of the lower limbs during motion.
Dryness in the joints.
Dropsical swelling of the hands and feet.
Cold extremities; cold hands and feet, or burning soles with icy-cold hands. But also: palms burn like fire. Cold sweat on the hands and feet.
Tearing and stitching pain in the arms.
Tearing in the right humerus, ceasing on pressure. Gnawing pain in the middle of the right upper arm. Tearing in the bend of the right elbow. Stitches from the right wrist up towards the elbow, each stitch is accompanied by a shock. Pain and tension in the little finger.
Eczematous eruption on the dorsum of the hand and between the fingers; burning, pricking, shallow vesicles, filling with fluid and soon drying into thin crusts, which peel off, leaving denuded spots; worse from cool water, better by warmth. Fearfully itching and burning vesicles between the fingers. The vesicles burn on touch.
Coxalgia with spasmodic pain in the bladder and strangury.
Tearing from the right, and later, the left hip bone, down to the knees.
Violent, sometimes boring pain in the knees, causing the patient to scream; warm, dry applications relieve the pain somewhat. The knees must not touch each other because of the great pain and sensitivity.
Painful feeling of extreme fatigue in the knees and legs; tottering of the knees when descending stairs.
Painful intermittent twitching in the outer side of the left knee, alternating with the same twitching at the right side of the occiput.
Violent tearing in the calves, as if the flesh was torn away.
Tearing and stitching from the right instep up towards the middle of the thigh, alternating with a tearing in the left side of the head. Darting pain from the right foot to the right side of the head in paroxysms.
Fearful pain in the soles, as if ulcerated, cannot step for several days.
Sleep
Sleepy during the day, especially after the evening meal.
Restless nights with agitated feelings and frequent waking; often only light sleep before midnight, resembling a state of ‘half-sleep’.
Sleeplessness from sexual causes or from anxious thoughts, or from no apparent cause.
Very anxious dreams, all night, especially before the menses; dreams of falling make the patient start in a fright. Voluptuous dreams. Other dream themes from the provings: of stags and walking in the wood; of parties and cooking.
Fever
As most complaints in this remedy, fever heat or chill have a sudden and violent onset and develop rapidly.
External or internal burning heat is frequent, especially of the suffering parts. Burning heat of the skin, which the patient himself does not feel; at night. Nocturnal heat all over, especially in the anus and genitalia. Heat and redness all over, with furious or loquacious delirium.
Long-lasting shaking chills, from 3 p.m. to 3 a.m. Chill at night which returns instantly when rising from bed, even when putting a limb out from the covers. Violent evening chill that is not relieved by the heat of the stove or covers.
Sweat that smells of urine. Profuse perspiration on waking at night or in the morning; also from every movement. Sweat especially on the genitals; also cold sweat on the hands and feet or on the chest.
Skin
Cantharis has a strong action on the skin. If applied locally (undiluted), it produces inflammation leading rapidly to painful blisters. Blisters may turn into large bullae, filled with fluid, causing the parts to look burnt or scalded. This has led to its use in burns and scalds, before blisters form but also when they have already formed. It has been given internally and also has been applied externally. Dorothy Shepherd (‘Magic of the Minimum Dose’) has treated the most severe burns during World War II in London. She says that especially in those cases where an infection of the kidneys is present, with dysuria, pain on passing water and passage of blood from the bladder, Cantharis dealt with the condition effectively. ‘Cantharis will heal up the local burn in a much shorter time than orthodox treatment can accomplish, and the renal and bladder infection will be cured in a short time.’
Another condition where Cantharis will be useful is erysipelas of a vesicular type, especially with great restlessness and burning pain. Nash gives an interesting differentiation between Cantharis and Apis: ‘In erysipelas it is sometimes the best remedy, and choice has to be made between it and Apis, which also sometimes has great urinary irritation in such cases. In the Apis cases there is apt to be more oedema, in Cantharis more blistering. In Cantharis the burning is more intense than under the Apis, while in the latter there is more stinging. The urinary symptoms, if present, are very much more intense under Cantharis. Again, the mind symptoms of the two remedies are quite different. In the Apis cases, aside from the stinging pains which make the patient cry out sharply at times, especially if the eruption is likely to ‘go in’ and attack the membranes of the brain, the patient may not be so very restless and complaining; but in the Cantharis case the patient is uneasy, restless, dissatisfied, distressed, sometimes moaning or violently crying; wants to be moved about constantly.’
Margaret Tyler recommends the remedy in gnat bites. Cantharis C 30, taken internally, stopped the intolerable itching with unbelievable rapidity. Some other skin conditions:
Pustular or vesicular eruptions that itch terribly and burn on touch.
Eczematous vesicular eruptions on the back of the hand and between the fingers (see ‘Extremities’ section); vesicles all over the body, worse between the toes, which are all sore and suppurating.
Dermatitis venenata with bleb formation.
Secondary eczema about scrotum and genitals, following excessive perspiration. Erythema from exposure to the rays of the sun.
Acute drawing pain in the ulcers, with increased suppuration.
There is a gangrenous tendency to this remedy, and Cantharis may help in burns developing quickly and going towards gangrene. A characteristic sensation is: ulcerative pain of the skin when touched.
Clinical
Bladder affections. Burns. Chordee. Diphtheria. Dysentery. Eczema. Emissions. Erotomania. Erysipelas. Eyes, inflammation of. Gastritis. Gonorrhoea.
Herpes Zoster. Hydrophobia. Kidney affections. Mania. Neuralgia. Nymphomania. Ovaries, affections of. Peritonitis. Pleurisy. Pregnancy, disorders of. Retained placenta. Satyriasis. Scarlatina. Spermatorrhoea. Strangury. Thirst. Throat, sore. Tongue, inflammation of. Urine, abnormal. Vesication of skin.
Relations
Antidotes: Camph. antidotes the strangury and retention of urine of Canth., Apis the cystitis, Kali-n. the renal symptoms. For its throat symptom it is nearest to Caps.
Other antidotes: Acon., Laur., Puls. Canth. is antidote to: Camph., Alco.
Compatible: Bell., Merc., Phos., Puls., Sep., Sulph. Incompatible: Coffea.
Compare: Dory., Coc-c., Cocc-s, Apis, Bell., Bry., Cann-s. (More burning and smarting; Canth. more tenesmus); Petros. (Sudden urging); Caps; Puls. (Retained placenta); Ars. (Delayed urination after parturition); Thuj. (Erections; those of Canth. prevent urination; those of Thuj. do not); Merc. (Semen mixed with blood); Sars. (Urine burns like fire, shred-like particles and blood in it);
Arum, Arn., Rhus-t., Ran-s. (Teste classes Canth. with Seneg. and Ph-ac. in his Conium group).
