13. Dr. H. ‘s daughter, aet. 11. Took 4 drops of the acid. Besides local burning and nausea, it caused severe headache, “as if somebody were jogging a sword in and out all around,” much aggravated by noise and light. It lasted till evening of next d., at noon of which she was flurried and feverish, with pulse at 90, and pain in right hypochondrium. On the day yet following she took a teaspoonful of 3x, when same symptoms recurred, headache being fixed over right eye (as in No. 12); but all passed off after a quiet sleep. (Ibid.)
14. J. N. MITCHELL, M. D. Three days after application of strong acid to cavity of carious tooth became subject of slight but constant giddiness, followed by a similar dull pressure and pain in back of head and neck. After a week application was renewed daily for 10 d. or more, and symptoms then became much worse. There were also added – right supra-orbital neuralgia; constant dark spot before left eye; severe, band-like compression round head (especially felt in temples); sense at vertex as if brain were swashing about; coldness there in spots on stooping, with clammy sweat; cold sweat on head on least exertion; and tinnitus aurium, though hearing was unimpaired. Mind was unusually clear, but intellectual exertion increased pressure and pain in head, even to numbness. Giddiness was better while walking in open air. He was constantly heavy for sleep, but sleep was dreamful and unrefreshing. He frequently got into an absent-minded state, with starting and trembling on being spoken to. Appetite and digestion were good, and bowels regular, though sluggish. Abdomen always seemed distended with wind, but none could be passed; and there was frequent, but ineffectual desire for stool. Sexual organs weakened and relaxed, but nights much haunted with lascivious dreams and emissions. These symptoms (with great weight on seventh cervical vertebra, which was tender) went on increasing during the use of the acid, but on stopping it, and clearing the cavity, began to diminish in a few hour, and in three d. disappeared entirely with some bilious diarrhoea. An incautious renewal of the application some months after caused them to set in again, but they at once disappeared on its removal. (Amer. Journ. of Hom. Mat. Medorrhinum, N. S., i, 354.)
15. N. ROTHE took 1 grm. in 20 grms. of water, and perceived sharp but cooling taste similar to that of peppermint-oil, warmth in stomach, temporary fulness in head, eructations, and slight gastric catarrh lasting several d. (Die Carbolsaure in der Medicine, p. 7.) 16. From dose of 1 grm. diluted with water, DANION experienced eructations, feeling of warmth as epigastrium, and slight stupefaction, which last, after a does of 2 grms., lasted for 1/2 h., with roaring in ears and formication in extremities. Four grms., taken in 3 doses, produced cramp in calves, fall in temperature of several tenths, and alkaline dark-brown urine. (Recherches sur l’ Acide phenique, Strasb., 1869.)
17. C. A. NORTON, M. D., was exposed for 1 h. while writing to vapor of a strong solution. In 1/2 h. began to feel faint, especially at stomach. In 10 m. more head felt “inflated,” the pressure from inside being greatest at temples; shaking head increased feeling. At end of h. faintness was so general that he desisted writing, and on rising found legs almost too weak for standing. The mind teemed with delightful ideas, but on attempting to express them in writing he found his arms too weak to trace a line. On passing to another room lost all consciousness of a body, but head seemed ten times its proper size. On lying down symptoms abated in order of their oncoming. Entering a meal-room shortly after could smell keenly everything there, however distant or stable, and on a subsequent visit to the water-closet was overpowered with the stench, which was nothing uncommon. Lay down and slept 2 1/2 h., tossing about much while unconscious. Head now felt bruised and sore, and there was a deathly faintness at stomach, so that he could hardly get through undressing for bed. Next m. woke with feeling in head as if he had taken a large dose of opium, and with inclination to diarrhoea, which he found had been indulged involuntarily during n. It came to nothing now; but food seemed to cause nausea. Head and face were extremely sensitive to comb and towel in toilet, and jarring of a carriage in the forenoon was very distressing. On returning from drive bruised, sore feeling began in small of back and extended to hips. There was burning in rectum, and bowels felt as if filled with flatulence. No appetite for food. A tape-like and gluey stool was passed. In e. pain had become concentrated in right thigh; it kept him awake in night, in m. went to foot, and then passed away. It was 3 d. before sensations in head and abdomen left him. Dr. N. has twice since experienced similar symptoms from carbolic acid vapour. (Publications of Mass. Hom. Soc., iv, 285.)
18. Smell of acid while preparing solution caused, in Dr. W. M. WILLIAMSON, pain over right eye, going off in open air; on later exposure to odour extending to temple, with sense of soreness in right eyeball. Urine scanty and high-coloured. On another similar occasion same symptoms recurred, with pricking pains through glans penis and in urethra; straining in passing urine, and uncomfortable sensation for 2 h. afterwards. Five drops of solution taken subsequently internally caused supra- orbital pain slightly, but urinary disorder severely. (Trans. of Penns. State Hom. Medorrhinum Soc., 1870-1, 180.)
19. T. C. DUNCAN, M. D. Nervo-bilious. February 27th. Inhalation of vapour caused full feeling in frontal lobes of brain, increasing to severe headache; great acuteness of sense of smell, and sensitiveness of eyes of light; slight nausea, with prostration; anorexia; great languor; numbness of skin of hands; symptoms increased in severity for 3 h., when a cup of tea dispersed them. He has repeatedly had this train of symptoms from simply smelling the acid. (As I.)
20. Mrs. E. J.D. About 1/2 h. after smelling acid (5 p.m.) complained of severe headache with nausea; sense of smell exceedingly acute; no appetite for next meal. A cup of green tea somewhat relieved headache, but did not reduce the olfactory sensibility. The catamenia, which were present, became more copious, and next m. were still further increased and darker than usual, with headache and great nervous irritability; sense of smell continuing acute. By e. the symptoms had vanished. (Ibid.)
21. DECLAT (Traite de l’ Acide phenique, Paris, 1854) observed slight headache after its use, lasting from 5 to 15 m., spreading over whole head, and returning every time drug was taken; in some persons most intense in frontal region, in others in occiput. After administration of acid in form of pills, NEUMANN observed heaviness and fulness of head, weakness of legs, dizziness, appearance of circles before eyes, horripilation, and profuse sweating. (LEWIN, Incidental Effects of Drugs, New York, 1882.).
Poisonings
1. When a thin layer of the pure acid is painted on the skin, a pretty severe smarting is felt for about an hour. The epidermis wrinkles, and a white coating spreads over the part touched, and gradually disappears, being succeeded by a congestion which lasts 20 d. This presents all the characters of inflammation, but on tearing the raised epidermis no serosity flows out. The epidermis gradually exfoliates, leaving a brown stain for a long time. The whole exactly resembles a burn in the second degree, which does not go on to suppuration. (LEMAIRE, de P Acide phenique, Paris, 1863.)
2. A curious local action of carbolic acid, to which attention was drawn almost simultaneously by Mr. Erasmus Wilson and by Dr. J. H. Bill, U. S.A., is the property it has when applied in concentrated form of causing very great local anaesthesia. The loss of feeling is not confined to the tissue killed by the drug, but extends some little distance inwards. (H.C. WOOD, Therap., sub voce.)
3. Where poison comes in contact with mucous membrane, a white scab forms, thickness of which depends on concentration of acid. (BOEHM, Ziemssen’s Cyclopaedia, xvii, 525.)
4. The dark-green, and often almost black, colour of the urine after standing for some time, which often occurs when this poison is absorbed from the surface of a wound, is strikingly characteristic. It is seldom, yet sufficiently often, seem when the poison is taken internally. This symptom clearly depends on the presence in the urine of some product of the decomposition of carbolic acid, the chemical nature of which has not been discovered. E. Salkowsky, in commenting on this striking fact, inclines to the opinion that the decomposition occurs before the absorption of the carbolic acid, as it so rarely occurs from the internal use of this substance. (Ibid.)
5. Miss J., aet 51, had elbow-joint excised December 2nd, 1868, on account of disease of cartilages. Wound was dressed with weak carbolic acid and water lotion (1 to 50), applied on a lint bandage covered with oiled silk, limb being supported by a leather splint. She rallied well after operation, and progressed favorably for first 72 h., when a shivering fit occurred; the tongue rapidly fouled, the pulse rising from 100 to 120, with a weak and fluttering beat, the skin becoming very cold and clammy; at the same time vomiting of a very uncontrollable nature began. Bowels had not acted since the operation. Her face became much pinched and anxious, her spirits being greatly depressed. Nothing came from the wound save a drop or two of sanious non-purulent discharge, its edges being very dry and glassy. So suspicious were the local and general symptoms that we were led to suspect pyaemia. Still there was no tendency to wandering, jaundice, or sweet breath, either now or at any other time. Poultices were now substituted for the lotion, and in the course of 40 hours actual pus was present in them, and the constitutional irritation was entirely removed, the sickness being the last to leave. Our patient continued to do well for a week, gradually improving up to December 15th, when the carbolic lotion, same strength, was re-employed. Within 36 hours vomiting began again, accompanied by the same train of symptoms as on the previous occasion. The discharge, which was abundant and purulent on e. of 15th, became scanty and rusty by m. of 17th; the urging, if possible, was worse than before. Now on the 5th d. after the operation Miss J. seemed to be rapidly sinking from the exhaustion caused by the violent and ceaseless urging. Her pulse that day was 130 to 140 per m. and very thready; the tongue was covered with a thick brown coat; the mental faculties perfectly clear. The bowels acted after an enema; urine scanty, loaded with lithiates, but not dark or carbonaceous looking. That same day (December 7th) the carbolic dressings were changed for linseed-meal poultices, and this had not been done many hours before a change for the better showed itself. Poultices were again substituted on the 18th, when we almost had given up hoping to save the patient’s life. She was entirely supported at this time by enemata, her stomach not being able to retain even a little beef tea or brandy-and-soda. Two or three d. after the change in the application healthy pus in fair quantity was coming from the elbow; and with the exception of great prostration the evil symptoms had all abated. Our suspicions were now awakened as to the existence of some undoubted relation between the above symptoms and the nature of the dressing; yet our faith in carbolic acid was so strong that we hardly dared suspect it as the cause. The patient went on very well with the use of poultices up to December 27th, when, for the last time and with a similar result, the carbolic lotion was resumed. The wound was now nearly healed; two sinuses which had formed we thought to benefit by a bi-daily injection of the foregoing lotion. Fortunately the first appearance of suspicious signs (i.e. slight sickness after food) found us on the alert, and the injections were at once discontinued, the mischief being thereby nipped in the bud. For the next 3 week warm-water dressing constituted the sole treatment, and the patient left for her home on January 22nd, 1869, quite cured, with an arm which has since become fairly useful. (LIGHTFOOT, Brit. Medorrhinum Journ., 1870, i, 333.)
Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.