8 c. Body of boy examined 24 hours after death. Lungs were full of bloody serum; bronchi injected and covered with red mucus; [ So also in BERRIDGE, Nos. 84, 87, 103, 219 (4,8,9)] trachea and epiglottis presented marks of inflammation. Blood dark and fluid in body generally, but there were coagula in heart. Liver slightly enlarged, exteriorly showed many yellowish- green patches, internally of uniform slate or ash colour. Some redness in patches of mucous membrane of stomach, duodenum, jejunum, colon, and rectum; that of ileum and cecum discoloured throughout, and solitary glands of former unusually large and numerous. Veins and sinuses of brain congested, and a little serous effusion at base and in ventricles. (Edlin. Medorrhinum and Surg. Journ., lxvi, 43.)
9 a. Man, et. 28, after partaking of a dish in which A. had been mixed instead of flour, was seized with vomiting, which lasted 3 d. There was little else on Ist day, Jan. 28th, but on 29th head felt heavy; skin was hot, but not dry; pulse quicker; tongue dry, without redness; slight sensibility of epigastric and left iliac regions; no stool. After a remission on 30th symptoms returned, and expression was dull. On 2nd Feb. eyes fixed; stupor, slight delirium; he tries to remove cold cloths applied to head; eyes injected; pulse 88; tumultuous beating of heart. 3rd. -Restless night; slight delirium; dull look confused, but able to answer questions; no headache; heart and pulse as yesterday, latter jerky, full, and strong; skin hot and dry; tongue dry. A pustular eruption (in its appearance and course analogous to smallpox has appeared on face, upper arms, and chest; some isolated, most confluent; they formed thick scabs, and left very evident cicatrices. Almost complete loss of motion of limbs, especially of left side; sensibility a little dull. Being bled, blood showed buffy coat.
9 b. From 4th to 6th more restless nights; delirium, with great agitation, especially during night; pupils dilated, though room was dark; action of heart more tumultuous, strong pulsations, with distinct bellows-murmur; pulse 110, full and jerking; copious sweats, which continued till end of month. On 7th, delirium was replaced by stupor; other symptoms same; murmur did not disappear till 12th-15th, during which time stupor diminished, but great prostration set in.
9 c. From 15th-20th, stupor became greater again; his appearance resembles that of a typhus patient; [ Compare BERRIDGE, No. 219 (8,9).] dull look; noise in ears; no headache; flushing of cheeks; slight ophthalmia; decubitus dorsal; relaxation of limbs; clammy skin; great emaciation; pulsations of heart readily felt over cardiac region, but not beyond; dullness here slightly increased; sounds normal, but loud and sharp; pulse 100; no tenderness of abdomen, which is much retracted; no diarrhea; incontinence of urine, which continued till March 10th.
9 d. From this point gradual improvement, but he was unable to use fingers and toes, and hand was always flexed. Motion in hands and feel continued for a long time imperfect, and he experienced acute lancinating pains like needle-stitches in the. A year later he was still unable to flex or extend the toes. (ORFILA, op. cit., i, 329.)
10. Intermittence is a very important point in the history of the morbid phenomena of arsenical poisoning; there are cases in which we observe, in the course of the disease, periods of aggravation more or less marked. Thus, for instance, after a dose of poison, there will occur nausea, vomiting, colic, &c.; then for 2, 3, 4, or 5 d. the patient will seem to get better; he can take a little food; in a word, he seems to be getting convalescent, when the same symptoms recur with the same intensity, and often a second time with more intensity, and again a third time. (DEVERGIE, Medorrhinum legale, sub voce. Similar testimony to the remittent and even intermittent character of arsenical symptoms is given by A. T. Thomson, Christison, Taylor, Maclagan, and others. See IMBERT-GOURBEYRE, Brit. Journ of Hom., xxiv, 77.)
11. I have noticed the occurrence of quotidian ague, which I was obliged to treat with quinine, in one of my patients who had taken gr. 24/100ths of arsenious acid in 12 day for ichthyosis. Was this a simple coincidence? I know not; all I know is that with the exception of the cutaneous affection the patient enjoyed the best of health, and that his intermittent fever showed itself at a time when there was no much malady present in the city. (BOUDIN, Fevers Intermittent, 1842. Similar occurrences are reported by DELAHARPE, Schmidt’s Jahrb., lxxiv, 303, and IMBERT-GOURBEYRE, loc cit., p. 81. See also ii, 80.)
12 a. The wife of Dr. BUCHMANN, et. 28, of nervous constitution, and experienced by several provings in observation of medicinal symptoms, on 14th Aug., 1858, at 6:30 p.m., drank by mistake a glass of fly-poison, which contained about gr. 1/2 of A. dissolved in water. In 10 m., anxiety and perspiration; oppression, as if chest were bound with hoop; burning glow over whole body; shortness of breath, especially on walking, even to sense of suffocation; strong palpitation; trembling of legs; great weakness; stupefaction and vertigo. At 7, cannot walk for weakness; nausea, and vomiting of water; cramp in jaws, can scarcely separate teeth; face distorted by spasms, features twisted, sunken, expression of anguish; burning in chest, especially at pit of stomach; sense of faintness, with ringing in cars; sensation of dryness, soreness, scraping, and burning in throat; circumscribed burning of scalp on vertex; contractive pain over eyes and in temples; distension of temporal veins. Total prostration, so that she can only speak with great effort. 7:15, desires to go to bed, but sinks down with deadly anguish on attempting to assume erect posture; skin of face icy cold, hands and feet of burning glow internally. Forcible vomiting, as if all inside were torn loose; thereafter complete prostration, pulse weak, small, frequent, strong twitchings of whole body, she can only take breath with difficulty. After each attack of vomiting she sleeps till next; sleeps with half-closed eyes, short breathing with effort, incomprehensible murmuring and loud speaking, tossing from side to side, and endeavouring to throw off bedclothes. On awaking springs out of bed, with staring eyes, tears clothes off her, declares she is on fire internally, and forebodes imminent death. After some 10 m. of this terrible mortal anxiety, severe vomiting of bitter-tasting matter, previous to which she complains of being icy cold all over, succeeded by glowing burning of whole surface (which always feels cold to touch), and feeling as if blood ran boiling-hot through veins; has frequent shuddering and shaking of head. Can only open her mouth a little to drink, and bites rim of glass. 9, symptoms still unchanged; also burning in eyes; eyelids frequently drawn together spasmodically; so that she can only open them with difficulty; bruised pain and creeping in all limbs, worst from knees downwards; and cramps in calves, with sense of constriction in bowels. 11.0, vomiting every 20 m.; anguish still more intense; recurring severe pain over loins, with stiffness of nape; tonic cramps in fingers; a fit of dyspnoea every 1/2 hours, lasting 5-10 m., occurs also during sleep. If not awakened by pain, lies insensible, replies not to questions, and is hardly roused even by shaking. 12.0, as yet no relaxation of symptoms. Feels as if she lies under burden of a heavy body. 1 a.m., urgent desire to urinate, with burning in urethra and desire for stool; pappy-like evacuations (3 in h.) with much urine; burning in rectum. She cannot plainly perceive anything.
12 b. 15th. -Symptoms gradually became slighter during night; vomiting every 1/2 h. till 5; in intervals slept with frequent startings; easy sleep from 5 to 6. This m. great debility; sensation of burning and constriction in abdomen, especially on stretching out legs; attacks of nausea; tingling in legs; on walking knees give way; pain in legs to touch; voice rough and hoarse; soreness in throat and at pit of stomach in speaking, breathing, and motion; continual desire for stool; heat and redness in face; pain of face and of scalp to touch; conjunctive much injected, with burning in eyes, which are without lustre; photophobia; eyes pain on movement or steadfast gazing; whites tingled yellowish; occasional humming in ears; constant thirst, as from heat ascending from stomach; heaviness in head, with stupefaction and pains in temples; taste sourish; frequent shuddering; pain in teeth of upper jaw on mastication; she could eat something, but feared she could not swallow. 9.0, feels again more unwell than on awaking, and more pain and burning in stomach and whole abdomen, which is painful on pressure. 12.0, periodically great anguish, pain in bowels and tearing in limbs; after a spoonful of beef tea, great aching at stomach. Has been up 1/2 h., but cannot walk without assistance. 7 p.m. Towards 1 p.m. great desire for stool, which drove her out of bed; was faint, and had to be lifted back; thereupon severe pain in abdomen; burning in stomach and frightful anguish; oppression at chest; throat felt constricted, as if she would suffocate; cannot open her mouth; nausea and sour vomiting, with shuddering. She thinks she must die; her face is swollen, dark- red, and hot; pulse full, hard, quickened; heat felt all over body; burning in eyes and soles of feet; throbbing in head and face, as from maturing abscesses; inclination to eat, but everything is disgusting. Finally, vertigo, twitchings in extremities, stupefaction, fainting, loss of consciousness, from which she is roused by the pains and mortal anguish. This condition has lasted from 1 p.m. till now, when the symptoms are gradually declining; and she complains only of stupefied feeling, and a slight burning at stomach; feels very weak, but in better spirits.
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.