Under this heading, besides emendations, we shall give all additional matter which has come to light, or to our knowledge, since the appearance of our previous articles on the various drugs. Reference will be made to these, and the cases related here will be numbered consecutively with them. The same distinctions of type will be observed as in the primary series; but each drug, whether original or derivative, will appear in its own alphabetical place, e.g., Atropinum among the A, s, not under Belladonna among the B’s. -EDS
ACIDUM CARBOLICUM
II. 13. Madame P., aet. 31, suffering from stricture of rectum (probably of syphilitic origin), had linear rectotomy performed by M. Verneuil. To hinder putrid absorption, a catheter was introduced into the rectum and a sol. of carbolic acid injected, of which only a part returned per anum. An hours later, a second injection was practiced. Patient, who had recovered well from the effects of the chloroform given, had now fallen asleep again, and was not roused by the injection, nor subsequently could she be wakened to take food. Seeing that she also grew weaker, the nurse called the house surgeon, who found her pulseless, eyes dull and sunken, and breathing apparently suspended, so that he thought her dying. By artificial respiration and other such means she was brought to herself, and vomited contents of stomach. After 2 hours more, however, she fell again into this syncopal state, and could not be rallied. M. Weiss found her, 2 hours later, in almost complete coma, which was interrupted only by inarticulate cries and some convulsive movements of diaphragm. Face was pale, extremities cold, temp. 35.1, pulse hurried and hardly to be felt; breathing irregular, broken by the diaphragmatic spasms already mentioned. External warmth and subcutaneous ether led to repeated bilious vomitings, and after 2 hours more patient had regained consciousness and began to reply to questions; temp. becoming 36.2, and breathing deeper and more regular. Vomiting nevertheless continued during following n., as well as great debility. Urine next day was found brown. Gradual improvement now took place; n. was good; and on m. of VOL. IV. 3rd day patient complained only of anorexia, a little heaviness of head, and some tinnitus aurium; she had also a few diarrhoeic stools. Urine was chylous (?), but had lost its brown colour. During the following days patient gradually convalesced, but a pemphigoid eruption appeared on hands, face and ears. (WEISS, Prag. med. Wochenschr., 1878. See a similar case in N.Y. Medorrhinum record, x, 378 )
14. When administered to man in doses of 6 – 8 gr. dissolved in a wineglassful of water, the following phenomena present themselves:
a. Loss of sensibility in mouth and throat, or feeling of numbness, as when aconite is applied to the lips; this is followed by a cooling sensation, like that produced by mint.
b. Slight nausea, especially if the stomach is empty; this is succeeded by an uneasy feeling in the abdomen, like that felt before an attack of gravel.
c. Slight vertigo, ringing in ears, and partial deafness, judged by the ticking distance of a watch. This vertigo is so great, if the drug is taken just after rising (and so on an empty stomach), as to compel the resumption of the horizontal position.
d. Loss of heart – beat; the pulse, according to our repeated observations on different individuals, losing from 4 – 8 beats per m., failing also in fulness. Temp. under tongue undergoes no noteworthy alteration.
e. Diarrhoea; this is not invariable, and does not appear till several doses have been taken. If present, it usually disappears on the 3rd or 4th day of the continued administration of the medicine.
f. After long – continued use of drug, feebleness of heart – beat, muscular debility and loss of flesh occur.
g. On omitting medicine after it has been taken for several day flatulence usually occurs, accompanied with a feeling of depression, like that felt after the stimulating effects of morphia have ceased. (BILL, Amer. Journ. of Medorrhinum Sc., N. S., Ixxiv, 45.)
15. I was called about 1 p. m. to attend a farmer. I found him in violent convulsions with trismus, and blood passing from the mouth in consequence of teeth having wounded the tongue. He was quite comatose; face and neck were livid; breathing stertorous; extremities and surface of body cold; pulse scarcely perceptible. I had him put into a warm bath immediately. In 40 m. convulsions ceased, sensibility partly returned, face and neck assumed their natural hue, breathing became quieter, extremities and body were warm, and pulse much stronger. He was then removed to bed, and heat applied to body and cold to head. I saw him again at 7. He was then perfectly conscious; convulsions had not returned; breathing was calm; pulse 88. He had passed about Oss of urine, which was super – acid. He complained of giddiness, but no pain in head; he had pain in face and neck, and much gastric irritation. Next m. he was much better and soon convalesced. He stated that for 3 hours he had been exposed to the fumes of strong carbolic acid, and was then seized with giddiness, which was followed by the stupor and convulsions in which I found him. (UNTHANK, Brit. Medorrhinum Journ., 1872, ii, 579.)
16. The acid was applied in too strong solution (15 per cent.) to a phlegmon on the arm. Almost immediately afterwards patient felt violent pains in arm and lost consciousness. She was found throwing herself about in bed, face flushed, pupils contracted, pulse slow; she breathed with much difficulty. Dressing was immediately removed, and in course of an hours patient recovered consciousness, complaining only of fatigue and frontal headache. (Ibid., 1879, ii, 629.)
17. I have lately used carbolic acid injections for ascarides, using Zij of a 1/40th or 1/60th solution. Unpleasant symptoms sometimes follow, lasting perhaps an hours; within 2 m. patient complains of giddiness, singing in ears, clammy skin, and taste of acid in mouth, pupils are unaffected. There has occasionally been abdominal pain, and in one or two instances confusion of ideas for the next 24 h. Temp. is unchanged; pulse, if anything, quickened. (PEARSE, in Ibid., 1879, i, 852.)
18. A woman, aet. 30, swallowed 4 c. c. of carbolised alcohol (=13 grm. of pure carbolic acid). Immediately vertigo, followed 10 m. later by absolute loss of consciousness with cyanosis of face. 1.1/2 hours after ingestion there was still coma with relaxed limbs, no convulsions; pupils extremely contracted and immovably; cold sweat; respirations slow, irregular, with tracheal rale; countenance pale and cyanosed; vomiting; pulse very quick, regular, sometimes extinct during inspiration. Stomach was washed out, but she seemed rather worse afterwards. Urine passed an hours after poisoning was normal, but that passed 15 m. later was of colour of blood; microscope showed no red corpuscles, but spectroscope revealed bands of oxyhaemoglobin. Temp. in vagina was as low as 24.4 C. The tracheal rale increased; mucus was continually ejected from mouth and nose; tongue was retracted. She gradually recovered; but 8 hours after the poisoning temp. was above normal, there were pains in throat and stomach, extreme hoarseness, and bilious vomiting; urine had to be drawn off, no more haemoglobin, but some albumen and granular casts, some red globules and renal epithelium. The day after she had circumscribed pneumonia at right base. She left hospital on 8th day, when vocal cords were still red and swollen and m. m. of larynx injected; and urine was still albuminous, containing granules and hyaline casts. (Reuve des Sc. Medorrhinum, Oct. 15, 1883.)
19. A man, aet. 37, had daily injections of a 2 per cent. solution for a fistulous empyema. Though the injections immediately returned, he always complained of sweetish taste on tongue, slight giddiness, and sometimes headache that lasted several h. Hoping to produce a quicker cure, his wife injected a double quantity of a 3 per cent. sol. Before the operation was at an end the man uttered a cry and fell off his chair unconscious. There was stertor, agitation, groaning, violent nausea, flaccidity of limbs save for some transient convulsions in left arm, pupils dilated and insensible; respiration irregular, laboured, noisy during inspiration; pulse not quick, very compressible, and occasionally intermitting; sensibility almost entirely lost. After 2 hours he recovered consciousness, but remembered nothing of what had passed. He complained of horrible headache, and of nausea, soon followed by vomiting. Vision of both eyes was entirely lost; ophthalmoscope shows very indistinct outline of papillae, especially r. Next m. nausea was gone, and patient perceived dawn of day. Some hours later he was able to see outline of objects in room. The 4th day there was no longer any affection of sight. R. eye recovered itself more slowly than 1. He still had heaviness of head, and vomited when he got up. (Ibid.)
20. a. A man, aet. 30, given to drink, drank off a glassful of C. acid in mistake for whiskey. As his mouth and throat burned, he gargled with water, and went to a public – house. There he felt ill, and did not know what happened. Half an hours after he was found stretched unconscious, insensible to all excitations, skin cyanosed, limbs cold and relaxed, pupils contracted and immovable; resp. was laboured and jerky, mouth exuding bloody slime, pulse small and scarcely perceptible, chest full of large mucous rales. He was bled, sinapisms employed and friction to limbs, cold compresses to chest; benzoic acid internally. After 12 hours consciousness returned; cyanosis diminished; resp. easy, no rales; burning pain in mouth, throat, and pit of stomach; copious vomiting; urine black as ink. The 3rd day he still vomits; skin and m. m. of throat and mouth still livid. On 4th day vomiting ceased; tissues less deeply coloured, now of a dull brown; pain in chest, especially right side; rusty expectoration. On 5th day urine clear; fever, bloody expectoration, violent delirium; dulness and bronchial breathing at right base posteriorly. Died 6th d.
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.