15 b. P. M. next d. -Slight tubercular infiltration in apex of each lung, and in left a small cavity. Trachea and large bronchial tubes much injected and red. Heart small and pale, otherwise healthy. Liver slightly enlarged, saffron-coloured, friable, fatty. Interior of stomach slightly vascular in its greater curvature; smaller curvature presented groups of small vessels gorged with blood, so numerous and its larger and as to make redness almost universal and like a sheet of blood under mucous coat, which was soft and friable. Duodenum was vascular internally; and full of black matter; jejunum much in same state; ileum redder still, and throughout lower third denuded of its mucous coat in many patches, varying in size from a shilling to a crown, and here and there involving its whole circumference, -at the latter points the peritoneal coat was bare, thin, and very easily torn. Many mesenteric glands were prominent and black. Colon everywhere vascular; numerous small ulcers pierced mucous coat in ascending and transverse portions; and rectum [ “It is a curious fact that the rectum is sometimes much inflamed, though the colon, and more particularly the small intestines, are not” (CHRISTISON, who cites 3 cases in point) ] was similarly but less extensively affected. Pancreas somewhat vascular; kidneys and spleen congested.
Arsenic was found during life in urine, and after death in various viscera. (Ed. Medorrhinum Journ., 1856, i, 625, 707.)
16. W. Grinley, et. 16, took liq. pot. ars. for 7 weeks in doses of miij ter die for a scaly eruption on arms and legs. The eruption had improved when seen (April Ist, 1848), but he at present suffers from the effect of the remedy. He complains of great weakness and partial paralysis of upper and lower extremities, with burning pain in feet; conjunctiva is slightly inflamed; eyes are suffused with tears; slight pain in epigastric region; bowels regular; tongue tolerably clean; urine not very plentiful, and covered with a pellicle. No pain or tenderness in spine. Complains of want of sleep at n. Took sesquiox. of iron and Dover’s powder at n. On 12th, complained of more pain in feet, and there was spasmodic action of muscles of extremities. May 5th. -Less pain, and slight increase of power. 9th. -Both changes more decided. The eruption has appeared in different parts of body. 20th-A vesicular eruption has now appeared on hands and legs, to which sulphur ointment was applied. June Ist. -Vesicular, eruption has now disappeared, but scaly one still remains over considerable extent. He walks better, and has no pain in hands or feet, but hand remain stiff, so that he cannot grasp anything firmly. He is generally much emaciated. He now took iodide of potassium, and slowly gained strength. On July 4th it is noted that numbness of feet (not previously mentioned) “still continues,” but that other symptoms are gradually disappearing. (HASTINGS, Prov. Medorrhinum and Surg. Journ., 1848, p. 459.)
17. A young woman took 3 tablespoonfuls of ars. about 11 p.m. Vomiting was produced by warm water, and the hydrated peroxide of iron given. She afterwards had some fever, but gradually became better. Eight d. after the ars. she had severe pains in upper and lower extremities, which were swollen, but neither red nor hot. Three d. after this she almost entirely lost power over extremities, and has since continued bedridden. She can move her arms freely, and can close and open her hands, but with no force. Feet are still paralyzed, but she can bend knees. (Bost. Medorrhinum and Surg. Journ., xxxviii, 207.)
18. H. P. Perkins, M. D., et. 35, never before had a day’s sickness to his knowledge, had even been free from all ordinary diseases of children, as was the case with all his relatives on male side. He was, however, at the time treating himself for a dyspepsia, with biliousness and some hepatic tenderness-produced, as he thought, by suddenly leaving off smoking (which habit he had indulged in to excess for fifteen or sixteen years, average about thirty cigars a day) some three weeks previously. On Saturday, July 24th, 1852, at 4:45 p.m., he sent for a small quantity of potass-bitart., and took the powder brought him in ice-water with sugar and a little tr. gent. co. on an empty stomach. In 25 m. he was seized with giddiness and slight loss of vision, burning sensation in stomach, great coldness of surface of body and profuse cold perspiration, inclination; to vomit and purge, without ability to do either, and very severe cramp in stomach and abdomen. Imagining he had an attack of cholera, he took a large dose of calomel (40 gr.) and an aromatic mixture without relief. In about 1 1/2 h. he began to vomit, with great difficulty, and some 10 m. after to purge, and, when this had continued 15 or 20 m., to vomit and purge bloody matter. Latter did not cease till 3 a.m. (on 25th) when he became quiet. At 3:30 thirst commenced, for first time. He drank up all water, tea, &c., he had by him, but thirst increased and became distressing. This led him to suspect he was poisoned. From this time till a little after 5, being unable to walk or arouse anyone, he lay in great agony from thirst, praying for death-at length he was able to make himself heard by a servant, who brought him a pint of water, which he drank at once and immediately threw it up. He then sent for hydrated peroxide of iron and a physician, who ascertained, about 8 o’clock, that instead of potass. bitart. he had taken 127 gr. of pure arsenic. At 12, he fell asleep, and slept 15 m., but seemed in great distress. His physician had no hope of recovery, but he himself thought that he should eventually get perfectly well. On m. of 26th, 43 h. after taking the ars., he was weighed, and was found to have lost in that time 43 lb. From this time he suffered severely from cramps, constipation, and gastritis until May, 1854, when he began to be relieved of cramps, and constipation and gastritis were much improved. He now (in course of about a fortnight) lost entire use of feet, legs, arms and hands; and severe neuralgic pains set in and continued for 2 1/2 years. These were so violent that he could obtain relief only by very large doses of morphine-he averaged daily, for 18 months or more, 36 or 38 gr. Also, on one occasion, he swallowed at once 3viij of laudanum, without producing slightest narcotism.
He is now (April 1857) entirely free from gastritis, cramps and constipation. (His breath has a peculiar, very offensive pungent odour. Feet are still partly paralyzed, so that it is difficult for him to walk any distance, and there is but little sensation as yet below the instep. There is some soreness on motion and pressure in arch of right foot. Neuralgia nearly gone; he hopes in a few months to be entirely well.
18 b. Amongst first symptoms he noticed, after he suspected he was poisoned, were crimson line on gums (which he had remarked in other cases of arsenical poisoning), and injection of conjunctiva, with symptoms of iritis. His mind was all the time perfectly clear, and all his senses rather morbidly acute. For a long time he was troubled with bad dreams and nightmare, which would dwell on his mind and annoy him during d. Appetite usually inclined to be ravenous. Cramps appeared to affect all muscles of inferior extremities at once, and especially (he thought) plantaris of right leg. Neuralgic pains were confined to arms below elbows, and to legs below hips; they did not seem to follow course of main nervous trunks. They were never darting, but always steadily increasing to climax, and then gradually decreasing. Cold air or water would always bring them on-they were worst between 9:30 p.m. and 8 a.m. Paralysis was of both motion and sensation; but he remained acutely sensitive in paralyzed parts to cold. (JOHN MCE. WETMORE, M. D., North Amer. Journ. of Hom., vi, 369.)
19. C. Wilson, et. 41, was admitted December Ist, 1849. About 5 months ago he took some A.; the primary effects were counteracted by prompt treatment. He felt perfectly well for 7 d. afterwards; was then attacked at n. with violent cramp in right index, successively invading other fingers, and lastly thumb, then attacking other hand in same manner, and finally feet, pains in hands subsiding as feet became affected; whole duration of cramp was about 30 m., after which he fell into sound sleep, which lasted till m. When he awoke, he felt free from pain, but on trying to rise found that he had lost use of affected parts, and was perfectly helpless. This paralysis has continued unchanged to present time, accompanied by a feeling of heat and numbness which invaded upper extremities from tips of finger to a point about 3 inches below elbow, and legs from toes to a point a little below knee. He has also had lancinating pains in these parts, regularly commencing about 5 p.m., and continuing until midnight. He can neither feed himself, nor stand alone when placed upon his feet. He has dryness of throat and great thirst. Under quinine, strychnine, and electricity, he slowly but pretty steadily improved and on Jan. 7th first began to walk, with shuffling, unsteady gait; soon afterwards could use his hands in feeling himself. Urine still retained traces of A. In July he was discharged. He could then walk quite well, grasp the hand with some firmness, but could not yet button his own clothing. He had no pain for some time, save on approach of stormy weather, when peculiar painful sensations are felt in fingers. (N. Y. Journ. of Medorrhinum, N. S., v, 62, 177. Two similar cases are mentioned here. See also “Etudes des paralysis arsenicales,” by Dr. IMBERT- GOURBEYRE, Gaz. Medorrhinum de Paris, 1858.)
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.