86 a. A lady, aet. 56, married, and with a large family, had enjoyed excellent health till 18 mo. ago. Since then she had suffered a good deal from pain, and had been treated for gout and rheumatism. When first seen, Sept. 22nd, 1888, she had an appearance of suffering and an unhealthy, muddy – looking complexion; tongue was thickly coated posteriorly, appetite very bad, there was obstinate constipation, pulse was 110, and temp. normal. For the past few months she had, as she described, lightning – like pains down the legs, and suffered at intervals of 3 or 4 weeks from what seemed an almost typical “gastric crisis.” The pain now seemed more fixed in soles of feet, which were found to be completely anaesthetic to pricking and pinching. Sensibility was very much blunted on the dorsum of the foot, and less so up the front of the leg; in latter region muscles were notably atrophied. There was great unsteadiness of gait; she could only maintain the upright position with some difficulty, and swayed sensibly when eyes were closed. In attempting to walk she swayed from side to side, knees were bent very much, and toes turned outward and dropped. On being placed against the wall with heels fixed, toes could not be raised from floor. Skin of legs had a glossy appearance, and there was some mottling. Complicated movements could be performed with both hands, and the grasp was fairly strong. Some of the finger – joints were swollen and painful to pressure; extreme coldness alternating with heat was complained of in both feet, and these symptoms were also objective. Plantar reflex was abolished; the knee – jerks were exaggerated in both legs, and there was no ankle – clonus. The muscles supplied by the anterior tibial nerve gave no reaction to faradism, and only feebly to the galvanic current; but there was no qualitative change. The eyes reacted to light, but did not accommodate for distance; pupils were equal and moderately contracted. and the discs seemed normal.
86 b. Relief to pain was obtained from static electricity and general electrisation by friction. During this treatment one of the gastric attacks occurred. She had severe pain in region of stomach, nausea and extreme faintness, accompanied by a feeling of unsteadiness even when in bed, objects in room seeming to rise and fall before her eyes. These symptoms had quite passed off in 2 d. About this time patient developed a well – marked “writer’s cramp” in right hand, with total anaesthesia of tips of thumb and first two fingers. All symptoms improved under static electricity; pain went and sensation was almost completely restored. She now complained mostly of a feeling of heaviness and stiffness in the legs, especially at n., and as if a board were hung to her feet. By Nov. she had improved so much that she could walk without help, and could raise both feet with heels fixed. There was no pain, and the atrophied muscles had notably grown. The power in the hand had equally increased. All went well till Dec. 15th, when there was a complete breakdown, ushered in by extreme pain and tenderness of right foot, with a distinct blush on its outer aspect. There was paresis of both feet, with almost total anaesthesia of tips of fingers, and inability to close hand. Extensor muscles of foot were very tender, and sensation of pricking and deep pressure was markedly retarded on sole of foot and front of leg; above knee sensation was normal. Muscles supplied by anterior tibial nerves of both legs gave no response to faradism, and slightly exaggerated reactions to galvanism; there were no qualitative changes. The knee jerks were diminished. There was also gastric pain and nausea.
On investigation, it was found that patient had been working for nearly two years with some suspicious Indian muslin, which were found to contain A. Dr. Gowers, on being consulted, unhesitatingly considered the symptoms due to an arsenical neuritis. (Ibid., 1889, left 1237.)
87 a. I prescribed A., in very full doses, for Mrs. -, in order to cure psoriasis of the nails. It was effectual, and she took it regularly for several months. In March, 1888, she reported to me that about the previous Christmas she had suffered a most severe attack of shingles on the right side of her chest. Her local attendant told her he had never seen a case with so much inflammation. Fortunately for me he had not suggested to her any suspicion as to its having been caused by the medicine. The latter was, however, discontinued, as Mrs. – was suffering from a cold.
87 b. In this case my patient was strongly of opinion that the A. did not improve her personal appearance. She was greatly distressed by the state of her nails. and willing to do anything for their cure; but she thought that the A. made the whites of her eyes look thick and a little yellow. The blue of the sclerotic, which in her showed through, did not do so as much as usual. A friend who lived with her had assured her that the medicine made her eyes look dull, and that the blue iris became more grey. I could myself somewhat confirm this impression, for Mrs. – certainly looked older, and had a less brilliant complexion than formerly. She was naturally fair and florid. The nails, which had got well when the drug was pushed, had somewhat relapsed during the two months it had been left off. The A. had not disagreed in any other way.
87 c. By several observers cases have been published in proof that in some obscure manner the skin may be made muddy and dull by the medicinal use of A. I have myself given an extreme illustration of the in the Pathological Transactions for 1888. In this instance the skin became earthy and brown, and in some places took on the condition of psoriasis. Pricking of the eyes and redness of the conjunctiva are also well – known results of A. The patient whose case I have given above, however, is the first who has complained of objective dulness of the eyes. She was an acute observer, and so was her companion, and I have no doubt they were right. It is certain that A. does affect the nutrition of all the tissues, and produces changes – it may be very minute at first – concerning the precise nature of which it is difficult to give any explanation. In arsenical herpes zoster we have a definite peripheral neuritis; but it is far from being the only disturbance of nutrition which we witness in connection with the use of this powerful drug. (HUTCHINSON, Archives of surgery, July, 1889.)
88. F. K. H -, aet. 42, suffering from an acute attack of eczema, took full doses of Fowler’s solution for 2 weeks, followed by treble the quantity, until violence of symptoms compelled him to desist. The first symptoms were those of acute gastritis, violent and distressing nausea and vomiting, with burning from mouth to stomach; insatiable thirst for cold water in large quantities, which would be ejected immediately; frequent watery diarrhoea with urging. 10 day later there was oedema of eyelids and ankles; ruddy bloated look; tongue dry and dirty white, with red, raw – looking edges. Shooting burning pains in lower extremities, especially through calves to bones of tarsus and through each toe. In addition, formication and soreness of calves when other pain ceased. Well marked numbness of palms and soles; feeling as though he walked on velvet. Could not stand alone, but could walk with assistance. Gait was peculiar, legs being thrown sideways and forwards, coming down heel first. Paresis of flexors and extensors of fingers, especially marked in former; complete flexion of fingers could not be performed. There was no history of tabes, and patient, mason by trade, was well before the attack. During convalescence urine was acid and loaded with amorphous urates, no albumen or casts. (HONAN, North Amer. Journ. of Hom., April, 1890, p. 215.)
89. DR. CLAUDE proved the mineral waters of La Bourboule These waters, though containing carbonate and chloride of sodium, owe their activity mainly to the appreciable quantities of arsenic they contain EDS. on 8 persons, 3 men and 5 women, during the last fortnight of July, 1878, an exceptionally dry and hot month. Nos. 1, 2, 6 and 7 consumed between them a full bottle at both luncheon and dinner. Nos. 3, 4 and 5 took only half a bottle each per diem.
89 a. No. 1 (A.) was a healthy man of 36, of nervous temp., subject to migraines or neuralgia, and to looseness of bowels; also to sudden and involuntary emission of urine if exposed to damp cold, from certain odours (as of turpentine), or to mental excitement. Damp will even cause cystitis with him. In the summer this disappears; appetite is good and regular, and the nervous pains are rare. His eyes are oversensitive to certain shades of red and violet. He first remarked that the beverage seemed warmer than was natural, requiring the addition of ice. Thirst then came on, and increased day by day, This symptom showed itself in all the provers, to a greater or less degree. His appetite, which was a moderate one, suddenly increased, and by end of 4 day had become voracious; but his sense of taste was blunted. Digestion seemed to go on very rapidly, and from 2nd day stools became softer and more frequent, at length – towards end of proving – being quite liquid, and passed 8 – 10 times by day, and 3 – 4 times by n. Urination also became more frequent and more copious, especially at n. He felt no fatigue, and was more lively and inclined to action than usual; he seemed to himself lighter, and breathed more freely. Sight was keener, and there was slight photophobia. All this was up to 5th day; but now his disposition grew peculiar, and he had causeless fits of anger. Brain was active, but he could not fix mind long. Taste was now extinct, and he could hardly distinguish salt from sugar. Light distressed him, and his eyes shone as in fever. Breathing was free and deep, but pulse became rapid, especially at n., reaching 110 – 120, with occasional lively palpitation of heart. Appetite was yet more canine, and diuresis augmented. Micturition now became frequent during day, also about 3 p. m., occurring nearly every 10 m., and preceded by pressing and almost painful desire, with no subjective symptom indicating the cessation of the passage of urine. No albumen or sugar appeared in his urine, or in that of any of the patients which was examined. On the 9th day the amount of urine passed at n. was nearly 4 litres. On 10th day prover became more uneasy, but vesical tenesmus was less intense, and micturition less frequent and copious; the stools still very watery, but less frequent. At 8 p. m., at the dinner table, he complained of great photophobia, followed by severe lancinating pain in both eyes; on raising the hands to press upon the lids was seized with sudden pain at the heart and violent palpitation., He could not speak, and seemed suffocating; he ran to the window, raised it, and drew in great breaths of fresh air. This lasted 5 m., when he was found by friends pale, trembling, and with dark circles round the eyes. After a few m. of repose, he quite recovered, and returned to table. 11th day – The polyuria nearly ceased, and diarrhoea less. At dinner – time he again suffered from an attack similar to the one of the preceding evening, m and as brief, but more severe. The water was not tested again, and the urinary symptoms gradually disappeared.
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.