3 b. On 3rd d., these symptoms lessened in intensity; but without an exception there appeared at end of 2nd or beginning of 3rd d. swelling of eyelids, accompanied with conjunctivitis. In some, whole face was swollen; in some there was an eruption of urticaria; in two women eruption was scarlatiniform in character. One man suffered only from urticaria of scrotum and herpes labialis. Almost all, even those who had no eruption, suffered from irritation of skin, and in some, scratching caused a transient urticarioid rash. In eight who had eaten of bread during 2 d. there were visual troubles. Three had sensation of light in outer angle of eyes, others that of flames darting forwards, these sensations being present only when eyes were shut or in dark. On this 3rd d. there was great thirst; mucous membrane of throat was red; many presented herpetic vesicles on lips, and one man had herpes on prepuce.
3 c. These symptoms continued, lessening, until 7th d. Appetite was then still deficient; patients complained of a metallic taste; and throat was still red. Swelling of face and skin eruptions had disappeared but there was still some muscular weakness and sense of weight and burning at epigastrium. By 10th day all these symptoms had disappeared, with exception of anorexia and heat in throat. A woman who had a scarlatinoid eruption presented now enormous edema of legs, but without albuminuria. Another local practitioner observed jaundice in one case. (Lancet, May 29th, 1880.)
4. a. July 4th, 1860, man came under Prof. Virchow’s care who had taken a tablespoonful of powdered A., dry. He had keen pains in whole abdomen without much tension; violent thirst; constant diarrhea and vomiting; pulse hardly perceptible; sounds of heart very feeble; deep blue complexion [ So also in BERRIDGE, No. 188 (4)] (including lips and conjunctiva), with quiet respiration; skin very cold, especially on extremities; subsultus tendinum; and cramps in calves. In spite of hydrated iron, &c., death ensued in a few h.
4 b. P. M. July 8th. -No marks of erosion in mouth, esophagus, or alimentary canal. Stomach greatly distended, covered externally with dirty red colouring matter; within, veins greatly enlarged, great quantity of thin yellowish-brown fluid in cavity, mucous lining generally swollen, of livid tinge, a large ecchymosis at fundus. Microscopic examination showed on surface of membrane a very thick granular mass, penetrating whole tissue, but deeper in glandular part; glands very distinct, their epithelium enlarged and opaque, and in many places in advanced state of fatty metamorphosis; interstitial tissue full here and there of little globular cells, giving it a granulating appearance. Intestines contracted at places; in duodenum dark green, almost black matter, at upper part, mixed lower down with whitish mucus, which also lined jejunum. There also a gruel-like fluid, grayish or yellowish-white; in ileum and large intestine becoming like rice-water, in latter tinged with red. Under microscope this was found of same composition as in cholera, especially as regards numerous shoals of bacteria and vibriones, which perfectly corresponded with the cholera fungi described by Klob and others. Intestinal mucous membrane was dirty-white throughout; Peyer’s and solitary glands much swollen from ileo- cecal valve upwards. [ So also in BERRIDGE, Nos. 12, 215] Tissue of membrane throughout appeared, under microscope, full of finely granulated fat.
Prof. Virchow, commenting on this case, points out, Ist, how very similar the post-mortem condition of the alimentary canal is to that found in cholera; and 2nd, that the inflammation of the mucous membrane of the stomach is not such as a corrosive would excite, but rather a gastro-adenitis, very similar to that produced by phosphorus, and occurring also in various typhus forms of fever. (VIRCHOW’s Archiv, xlvii, 3 and 4. Hoffmann observed similar phenomena in two cases. See vol. l, p. 456.)
5. A child, et. 20 months, ate some paste consisting of honey, flour, and arsenic. He was caught in the act, and a considerable portion of the paste was forced from his mouth,. Ipecacuanha wine produced vomiting, which was encouraged, and milk freely given. Between vomitings he appeared lively. In 2 h. had two natural motions, and was sleeping calmly as usual; had complained of no pain; respiration a little hurried. In about 6 or 7 h. he became somewhat restless; and soon after surface grew cold, lips livid, eyes sunk, pupils fixed and rather dilated, scarcely perceptible, respiration feeble with sighing. After lying 1/2 h. in this condition, he expired without a struggle, nearly 8 hours after taking poison. On inspection, stomach and intestines presented little deviation from the healthy state. Stomach contained mucus and a portion of the paste, but villous surface presented no sign of inflammation. (TAYLOR, p. 319). CHRISTISON (op. cit.) relates twelve cases of this form of poisoning.)
6. A young woman accidentally took a quantity of A. When visited by Dr. Maclagan she was lying in a drowsy torpid condition, eyes sunk, face blue, and, like extremities, cold and clammy. She presented the most perfect resemblance to a case of Asiatic cholera in the stage of collapse. No urine passed, bowels not moved. Next d. reaction; small quantity of urine passed, sp. gr. 1015, strongly acid, showing large amount of albumen when heated, and copious deposit of purpurine on addition of hydrochloric acid; by Marsh’s test yielded abundant arsenical crust. On 4th d. passed 36 oz. of urine, less albuminous. On 8th day, extensive bronchitis; pulse 120; urine copious, but not kept for examination. 9th d., bronchitis less; urine abundant, sp. gr. 1019, much blood, [ Dr. Imbert-Gourbeyre states that in all the literature of arsenical poisoning he can only find three cases (not including the above) where haematuria was observed. In poisoning by arseniuretted hydrogen it is almost constant.-EDS] coagulating copiously by heat. 12th d., sp. gr. 1020; hematuria seems to have ceased, no blood-corpuscles visible under microscope, but there is still full coagulation by heat; pain in loins increased by pressure. 13th d., incontinence of urine; severe pain in thighs and legs, numbness of both feet, inability to use them; bowels constipated. 3 d. later incontinence had ceased, but she complained of strangury; no urine was passed for 2 day and on 20th day from taking poison she died comatose. Kidneys were found healthy. (Edin. Monthly Journ. of Sc., xiv, 124.)
7. Woman, et. 23, took part of tablespoonful of A. on m. of Feb. 11th. In 2 hours became sick, and continued to be so at intervals for some hours. At 3 p.m. was found lying almost lifeless; extremities cold; pulse scarcely perceptible at wrist; eyes bright and glistening; cornea much injected. Intense headache, increased by light and noise; quite unable to raise herself without assistance; tongue dry and morbidly red, papilla at tip considerably raised; lips dry and covered with herpes; mucous membrane of mouth slightly abraded; face pallid and anxious; great pain in epigastric region in paroxysms, accompanied by general tremor. A zinc emetic produced vomiting of blood. 8 p.m., frequent severe rigors, pain in epigastrium on pressure; annoying sense of contraction in esophagus. 12th, 8 a.m., intense pain about scrobiculus cordis, extending up esophagus; great dysphagia even of fluids; breathing hurried; face flushed and anxious; constantly asking for cold water; tongue dry and parched, with papilla much raised; pulse 110, very small; skin dry and harsh, emitting pungent odour; violent throbbing headache. [ Comp. BERRIDGE, Nos. 29, 48 (sister); in both with hyperaemia and fever as here] Abundant dark feces had passed during n., after castor-oil. Leeches were applied to epigastrium, and pain subsided; returning next day very severely, and in paroxysms. Urine, which had been absent at first, then scanty and high coloured, was on 15th highly charged with lithic acid. By 18th convalescent. (Lancet, 1851, i, 552.)
8 a. A whole family was poisoned by drinking water from a well, into which had percolated a solution of A. thrown down a drain from a neighbouring colour factory. Mr. Bickersteth found mother in a dying state, unconscious, surface cold, arms in continued motion about her head; she died in a few h. Youngest son had died a week before, from “hydrocephalus,” but this preceded-as also with mother-by bilious vomiting and great thirst. Latter symptoms appeared 2 d. later in eldest son and daughter; pulse very quick in both. Drinking from well was now stopped, and eldest son, who was little at home, soon recovered.
8 b. On 19th, both daughters and another son were suffering. Girl previously ill had no more vomiting, but was very restless, with numbness of lower extremities, indisposition to answer questions, arms in continual motion above head, as if grasping at something; skin hot but not dry; tongue dry and brown; great thirst; throat seemed dry; breathing quick and audible; pulse 125-130, not hard; heart acted forcibly. Others had similar symptoms. On 20th, all were much worse; breathing and pulse very rapid; tongue and lips dry, cracked, and covered with blood and sordes. Eldest girl unconscious, throwing limbs and body about; in other two consciousness fast departing. On 21st boy died at 4 p.m., peculiar movement of arms continuing till death. During next 24 h. girls died.
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.