12. H. E. R- proved same, 1:15 p.m. Soon after gtt. j. peculiar sensation in right chest. 2:30, repeated dose. Tingling sensation in different parts of body; slight dull aching in right chest. 3, same dose. In 10 m. slight frontal headache; chest pain more severe, but not constant. At 4, 2 drops. Pain in back of eyes on looking at near objects. At 4:30 took 3, and at 5 took 4 drops. Slight pain in right temple; general weakness felt about 10, with tendency to perspire easily on slight exertion Next day woke about 5, with extremely dry and parched sensation in mouth and throat; and on rinsing mouth noticed marked stiffness and dryness of lips. (Ibid.) 13. Miss A. W. S- proved same. At 1:30 p.m. took 1 drop. In 5 m. pain in right occiput; sudden sharp pain under left eye; face flushed and hot (last two transitory only). At 3 another drop; at 5 2 drops, and at 9 repeated dose, without new symptoms. Two day later took 5 drops. Great heaviness of head in joint, head would fall from side to side; overpowering drowsiness for more than 1 hours; severe colicky pains in abdomen, increased on lying down. At 7:45 p.m. repeated dose. No marked symptoms at night; in m. severe dull heavy pains across forehead; pain and weakness in loins. On another occasion, after 10 drops, pulse fell, in 25 m., from 83 to 63, after 2 hours rising to 73, and not returning to first its normal rate for 2 day more. (Ibid.) 14. L. A. P- proved same. At 7 p.m. took 3 drops. Dizziness with slight nausea, worse when eyes are closed; dull, heavy pressure over eyes as if heavy weight were within. At 8 repeated dose. Painful pressure outward in temples, especially left, with dull heavy aching in occiput extending to nucha (while walking); burning in stomach and crampy pain; later, throbbing in temples. At 10, same dose. Sleep restless, full of anxious dreams; frequent waking, with severe pain in temples, and in stomach and bowels. Next day vertigo, headache, and nausea, on rising; anorexia. At 9 a.m. 3 drops. Severe pain as before, in temples, occiput, and over eyes, with burning in stomach; everything appears as if trembling and wavering; aching in eyes when in sunlight, with profuse lachrymation, followed by sneezing; drowsiness; crampy pains in umbilical region; sense of oppression in chest, especially in lower sternum; drawing pains in left side between 7th and 9th ribs, shout but frequent; pulse quickened, full and hard; skin moist, and free perspiration during moderate exercise. (Ibid.) 15. L. G. H. R- proved same. At 1:45 p.m. 2 drops; pulse 63. 1:55, pulse 68; slight pain over both eyes. 2.5, dull pain in occiput; pulse 65, not regular; slight heat in face. 2:15, pulse 68; burning in face; boring pain in occiput; uneasy feeling in extremities. 2:25, face flushed and still hotter; occipital pain continues. At 3.17 repeated dose; pulse 63. 3.27, dull feeling in forehead; beating of arteries felt in fingers; occipital pain returned. 3.37, pulse 70, and irregular; burning in face; pain in cardiac region, extending round to back. 3.47, pulse 65; face and head as before. 4.5, pain in occiput, aggravated by heat of room and by writing; when forehead was painful occipital pain was less severe. 4:30, after writing, pulse 63, and quite full; heat of face still sensibly felt. (Ibid.) 16. H. P. C- proved same. This student is described as “sensitive, inclined to neuralgia.” After doses of 1 drop, 3 drops, and 6 drops respectively, a number of slight and transitory pains occurred in various parts of body; but a later dose of 6 drops on same day had no effect. Next day 10 drops produced no decided symptoms, but he was restless after it. Four day later took 15 drops, after which there was slight oppression at front-parietal suture, then proceeding to frontal bone; dimness of sight; pulse accelerated. After 1/2 hours took 20 drops, with no further effect; and in 3/4 hours more 40 drops, which simply made him confused and drowsy. (Ibid.) 17. Miss A. E. S- proved same. After taking, at 1/4 hours intervals, 3 drop doses, in 10 m. face flushed, in 25 m. sharp pain in left calf; slight griping in bowels; feeling as though band were drawn tightly about head; dull pain over eyes. At n. nausea; dizziness; also contraction of muscles in hypogastrium, which felt hard on pressure; rumbling in bowels. (Ibid.) 18. Miss M. M- proved same. After 1 drop had, in succession during 3/4 hours, slight discomfort in right shoulder; decided dizziness and heaviness of head; drowsiness; suggestion of pain in right side of head; burning of right cheek, extending up into eye and round to ear; heat in left ear; lameness of flexors of right arm. After 1 hours all symptoms subsided. (Ibid.) 19a. The subjective colour-sensations which occur under the influence of amyl nitrite are not alike in all cases, as Schroder (Zeitsch f. Psychiatrie, xxxii, 527) found in a number of patients, but are only now and then very distinct, and are not identical at every inhalation. In their typical form they consist, according to Pick (Centralblatt f. d. medic. Wissenschaften, 1873, p. 866), in the appearance of an intensely yellow halo around any fixed point upon a clear background. The yellow circle is surrounded by a bluish-violet border. This phenomenon is probably nothing more than the projection of the macula lutea, and the bluish-violet border its complementary colour. The patients treated with nitrite of amyl by Sander stated, of their own accord, after the inhalation, that for some time everything had seemed yellow to them. It could not be clearly determined whether or not his phenomenon was due to the yellow colour of that portion of the field of vision which corresponds to the macula lutea. The yellow vision disappears only after some minutes, growing gradually paler. 19b. SCHRODER also observed a diminution of the clearness of sight. Patient who had inhaled nitrite of amyl for a considerable time were unable e.g., to see clearly the figures on a large clock, which seemed blurred to them. Normal vision returned immediately after they stopped using the drug. 19c. After inhalation of drug, and to certain extent as an after-effect, Sander observed profound collapse, which appeared suddenly and was characterized by fainting, falling to the floor, pallor of face, smallness of pulse, and cold clammy perspiration. Samuelsohn describes a similar case, in which a patient, while fully under its influence, made a few deep spasmodic inspirations, and presented coldness of skin, which was bathed in sweat, and a small, thready, and extremely slow pulse while consciousness, though weakened, was not entirely lost. Urbantschitsch has drawn attention to similar occurrences (Wiener Medorrhinum Presse, 1877.) [ “In one or two instances I have known alarming prostration to supervene” (H.C. WOOD, op. cit).] 19d. BOURNEVILLE states that tremor of lips and difficult mastication often follow inhalation (Gaz. Medorrhinum de Paris, 1876, No. 13). Urbantschitsch noticed dryness of mouth lasting from 12 to 24 hours after its use. Lalendorf (Berl. klin. Wochenschrift, 1874, p. 539) noticed occurrence of a violent dry spasmodic cough in a patient, on two occasions, during a four weeks’ course of nitrite of amyl. A number of authors have reported distressing nausea and vomiting as following repeated inhalations. (LEWIN, op. cit.) 20. The paralyzing effect on the arterial system is well shown by the sphygmographic tracings, the flushing of the face, and the increase in the size of visible arteries like the temporal, which often becomes notably large-sometimes, indeed, doubled in size, and branches previously invisible become plainly apparent; also by the interesting fact observed by Talfourd Jones, who, while cupping a patient over the loins, and finding that blood would not flow, administered nitrite of amyl by inhalation, when the cuts immediately to bleed freely. (RINGER, op cit.) 21. Administering drug by inhalation to a patient in status epilepticus, DR. CHRICHTON BROWNE found it excite profound and repeated yawning, and this effect was confirmed by observations on other subjects in a similar state of coma. Given to a dog in this condition (from convulsions), animal beat ground with fore- paws and opened and closed mouth with rhythmic regularity. “In all the observations there were movements of the mouth. These were exceedingly various, the most common being a short munching movement of the lower jaw, which was depressed and elevated as in the act of chewing. The next most common movement was a smacking of the lips, as if in the act of tasting.” (Practitioner, 1883.).
Experiments on animals
1 a. In the lower animals the first stage of the action is like that described in man. After this the breathing becomes violently hurried and panting, progressive muscular weakness and diminution of reflex activity ensue, and finally death from failure of respiration, sensation and consciousness being preserved almost to the last. Convulsions are sometimes present, but in my experience more often the animal is exceedingly quiet throughout the poisoning. 1b. Elaborate experimental studies of the action of the nitrite of amyl upon the circulation in animals have been made by Dr. Lauder Brunton (Journ. of Anat. and Phys., v), by myself (Amer. Journ. of Medorrhinum Sciences, July 1871), and by Dr. Amez- Droz (Arch. de. Phys., Sept., 1873). The results are so uniform and in such accord that they must be accepted as proven facts. Although the pulse is very much increased in frequency sometimes from the very beginning, the arterial pressure is diminished, and finally reduced almost to zero; and the fall of pressure occurs equally after section of vagi as at other times. As the number of heart-beats in the uninjured animal is increased rather than diminished, whilst the strength of the individual beat is not perceptibly lessened, it is evident that, at least in the early stages of the poisoning, the diminution of tension is not cardiac in origin, but must be due to dilatation of the arterioles. This conclusion is confirmed by an experiment of Brunton’s who found that if the descending aorta was tied high up no perceptible fall of pressure was produced by inhalation until very late in the poisoning, when the heart itself was acted upon the drug…. Is the dilatation centric, due to an action on the vaso-motor nerve- centres, or peripheric, due to a direct action on the muscular coat of the arterioles? It must be peripheric, it cannot be centric, since, according to the experiments of Brunton and myself, it occurs when, by division of the cord, the arterioles are separated from the vaso-motor centres. [ “Recent experiments of Nussbaum, if correct, show that in the frog, and therefore probably in other animals, the vaso-motor centre is not situated solely in the medulla, but extends the whole length of the spinal cord; for after its section below the medulla, time being allowed for the animal to recover from the shock of the operation, irritation of a sensory nerve will cause contraction of the arteries. If Nussbaum’s observations are confirmed they would seem to show that nitrite of amyl may act through an influence on the vasomotor centre” (RINGER, Therap., sub voce).] It must be due to a direct paralyzing action of the drug upon the coats of the arterioles, a conclusion confirmed by our knowledge of the local action of the nitrite upon muscular tissue. In the latter stages of the poisoning another factor enters into the causes of lessened blood-pressure, the heart’s force itself becoming largely extinguished by a direct action of the poison on the muscle.
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.