“The relation of the urea to the solid constituents in my case is somewhat less than that of another observer mentioned by Simon in his Handbook. I had an average of 26.3 per cent. of urea, perhaps dependent upon the peculiarity of my diet, which is generally vegetable. Under the effects of the milk diet this percentage rose to 37.6 and the amount of uric acid became quite small, which during my ordinary diet was 0.6 but was now reduced to 0.45. The amount of urea was perceptibly changed, the daily diminution being 1.5 gramme, and the uric acid entirely disappeared from the urine, under the influence of silver. The amount of incinerated salts during the milk diet remained very constant. After several day use of the silver it rose considerably. In the evening of November 6th there was found 0.127 gramme of pure silicic acid; so far as I know no analysis of urine has shown a like amount of silicic acid. No changes were noticed in the circulation or temperature. Silver was not found in the urine.” (KRAHMER, Das Silber als Arzneimittel betrachtet, 1845.)
9a. -The prover was a prescription clerk in an old-school pharmacy, aged 21, intelligent, skeptical as to the action of infinitesimal doses, and quite ignorant of the pathogenetic properties of nitrate of silver. He was in good general health and free from constitutional dyscrasia. He sought Dr. Brewer’s advice for a catarrhal condition of the mucous membranes, for which the silver was recommended. (The malady and its changes are expunged from the proving). In consideration for his vocation and prejudice a low trituration was ordered-1 gr. of the nitrate of silver to be triturated with 4 drachms of sugar of milk; of this trituration 1 gr. to be taken twice daily. Misapprehending the directions, he took 1 gr. of the nitrate twice a day for 3 d. 2nd d., felt tired on waking, and apathetic in mind and body, but believing he might have taken a slight cold he continued the nitrate as before. 3rd day, in m., felt so ill that he again visited his doctor. The whole head was heavy and full, but frontal sinus the focus of greatest intensity. The operation of the mind were sluggish, so that continued thought required special effort; yet when the mind was so exerted the bad feelings in the head were in no respect enhanced. He stated that the compounding of a prescription was peculiarly irksome at the time, as his mind would aimlessly wander from one subject to another unless he exercised constant effort. In the mouth was a disagreeable metallic taste. The tongue was red and clean, the throat congested, especially at the posterior part, and felt hot and burning. Deglutition unaffected. Tonsils of normal size and appearance. The abdomen below umbilicus felt distended, or as if there was a weight on it. This sensation temporarily abated when flatus was passed, the flatus being discharged without pain and without effort. The bowels, which for weeks had been moving regularly once a d., now moved more frequently, there being two stools on the 2nd d. and four on the 3rd. The stools consisted of a greenish semi-solid mass, made up of lumps of undigested food and mucus, passed with some flatus. The prover was quite sure that their odour was very peculiar, but he could not describe it. Defecation was free from tenesmus, or burning, or any other abnormal sensation. On the anterior wall of the rectum, about an inch above the sphincter, was a hot burning spot (prostate gland?), unaffected by stool. Dragging and weight in the hypogastrium, which at times amounted to actual burning pain. Micturition temporarily palliated the distress, hence the prover urinated frequently, yet the urine could be easily retained without appreciably affecting the distress. The urethra from meatus to bladder felt hot and burning, but at the meatus and below the scrotum were foci of greatest intensity. The lower extremities, especially the legs, were fatigued and seemed too weak to support the body. At times they felt as if they would suddenly fail him.
This ended the first proving. The medicine was stopped. Dr. Brewer says he “considered it desirable that the prover should again take silver, but in the dose originally recommended, gr. 1/240, thrice daily.” He does not mention any interval as taking place between the discontinuance of the larger dose and the commencement of this; but there probably was one.
9b. Second proving. -Gr. 1/240th which sugar of milk thrice daily. 5 d. later, on rising in m., weary and oppressed in body and mind. His ambition seemed to have fled. Even trivial duties were burdensome. He only desired to sit and think. About noon small running chills developed along spine, and followed each other in rapid succession; meantime the face and extremities became flushed and hot. Towards 6 the chills ceased and intense sleepiness set in. He felt that he could not keep awake; notwithstanding, on retiring he remained awake thinking, the thinking when yielded to absorbed the desire to sleep. By 10 he had become so engrossed in thought that restlessness and real wakefulness followed. This continued until about midnight, when he went to sleep. The sleep was disturbed by monstrous dreams. The condition of the mind in sleep seemed but an extension of its state in working h., for the patient stated that all through the d. he was disinclined to talk, but took a morbid delight in building air-castles. The head felt dull and full. No visceral tenesmus or burning. The bowels were unaffected, except that they felt oppressed along the lower half of the abdomen; some flatus was passed. The prover, recognizing the effects as similar to those of the previous attack, stopped the silver, and reported the symptoms as recorded. The symptoms at once decreased in intensity, and in 2 d. had disappeared.
9c. Third proving. -4 or 5 d. later the dose was renewed. 3rd d., on waking in m., head felt full and confused; it ached all over, but with increased force at l. frontal eminence, temple, and occiput. He described the pain as heavy aching. At indefinite periods the occipital pain would cease, and the pain in the temples increase. The pain in the l. frontal eminence remained constant and unvarying. The head felt enlarged and weighty; occasionally slight vertigo suddenly appeared and ceased. Some relief was afforded to the pain by tightly binding or pressing the head; cold air also palliated. The eyes were sensitive to light, and smarted and burned after long use. The lachrymal secretion was somewhat increased. Face pale. Peculiar, fetid, metallic taste in the mouth. Tongue coated at base with yellow fur, and felt dry to the prover, though to touch and sight it was moist; drooling during sleep. Slight thirst. Congestion of the throat, with a slight burning soreness on the r. side. Dysphagia. Slight flatulent distension of the lower half of the abdomen: it felt greatly distended and oppressed. Emissions of flatus temporarily relieved the heaviness. Stool normal. The urinary organs were markedly affected. In the urethra, during and after micturition, there was an intense burning, at times amounting to a stabbing pain; there was also a sore and swollen feeling. At irregular intervals the cremaster muscle would contract spasmodically and draw the testicle high up into the scrotum. With this spasm a drawing pain extended into the testes. Independent of the cremasteric spasm, although sometimes associated with it, was a pain in the testes and scrotum, as from pins and needles, worse in the r. side. The lower extremities, and especially the legs, were weak and tired as after prolonged exercise, yet the amount of exercise taken had not been unusual. A short walk exhausted. He said he felt as though he had experienced a long illness. In the afternoon and e. the feet were cold. In the lower lumbar and sacral regions the same lassitude was felt as in the gastrocnemii. About noon small chills developed along the spine, and with them a sensation of heat and increased lethargy. The hands and feet were not cold but rather hot, as also was the head. The chills appeared in the upper part of the spine, close to the occiput, and extended downward to the extreme end of the coccyx, but did not radiate from the spine. Warmth dissipated them for a time. Neither motion nor open air affected them. About 5 o’clock the chills subsided; no sweats followed, but profound sleepiness set in, a sleepiness so intense that the prover retired 3 h. earlier than was his custom. He did not fall asleep, however, but only lay enchanted by a vivid imagination. This elysian state lasted till nearly 10 o’clock, and then slowly faded away. Then the prover became restless-the bed felt burning hot, the legs and back ached, and the brain seemed too large for the skull. With these feelings he tossed about till near midnight before sleep came. Before falling asleep he noticed that the palms of the hands, the lower part of the abdomen, and the inner sides of the thighs were bathed with perspiration. 4th d., med. discontinued. All symptoms as yesterday. Sleep disturbed by bad dreams. 5th d., a burning spot is noticed in fore part of rectum, about an inch above the sphincter, and is aggravated by urinating. Micturition is more frequent, and the hypogastric tenderness is increased. The headache has become intolerable. Administered 1 drop of the tincture of actea r., and repeated it in 2 h. This removed the headache. Has lascivious dreams during sleep. 6th d., the headache is gone; the legs are less weary, but the lumbo-sacral lassitude persists. The chill appears regularly at 12 m., and ends about 5 p.m., without sweating. Dreamed of snakes last n. The rectal burning is very annoying. 7th d., no change from yesterday’s condition; stool normal. Abdomen still distended and oppressed. 8th day, same as yesterday. Chill as usual. 9th d.., the rectal burning became so distressing that I prescribed ac. nitric, 1x, gtt. v every 4 h. 10th d., abdomen still oppressed. Chill as yesterday. 11th d., weakness in sacrum and legs much less; the chill did not appear. 14th day, ac. n. discontinued. Rectal burning nearly gone. 22nd day, burning spot in rectum occasionally felt, especially at n., but is not distressing. 25th d., the prover is well again. (Dr. E. P. BREWER, in Hahn. Monthly, July, 1833.)
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.