20. On Feb. 26th, 1875, Pauline Philipoff took by mistake, instead of chalk, some white arsenic. An h. after, vomiting came on which lasted 48 h. 4 or 5 d. later, she had feeling of cold and numbness in extremities. Cold then reached fore-arm and legs; at same time, great weakness in hands and feet came on, so much so that on 10th d. after ingestion of poison she could not walk without help, and towards March 13th she had to remain in bed. From that date up to mid-April (when I first visited her) she was unable to stand on her legs. On April 19th, I made following notes: Extensor and flexor muscles of extremities are highly atrophied, atrophy being greatest where muscles are nearest to periphery; so that bones, epiphyses, and tendons of legs, feet, arms, and hands are very apparent. However, muscles most affected are those of calves and forearms, also interosseous, thenar, and hypothenar eminences. Atrophy is also manifest, though to a less degree, in muscles of thighs and arms, especially extensors. What strikes one at first is contrast between look of health and vigour of face and trunk and that of muscles of extremities, which are wasted and atrophied. When in bed, patient can do nearly all movements, though she cannot seize small objects; movements, however, are only slowly and awkwardly done. Each movement is followed by pain in muscles employed. Muscular power is notably weaker. Patient can shake hands, but feebly; she can only hold objects of small size. Sensitiveness of skin is much lessened, especially in those portions of extremities nearest periphery; thus, tactile sensitiveness of palms of hands, of soles of feet, and of fingers, has entirely disappeared; it has considerably diminished on extensor sides of feet and hands, legs and fore-arms; the same is true of lower half of thighs, superior half of fore-arms and lower third of arms, though in a less degree. Appreciation of weight is much diminished in legs and fore-arms, in hands and feet: a weight of 150 grammes placed on calves, then on fore-arm, was not felt. She cannot sew, feel any small object, or pick it up with fingers, even when she sees-say a match; to put a spoon to her mouth, she holds it in hollow of closed hand. She does not feel object of same temperature as her own body; hot water seems boiling to her, lukewarm water seems freezing cold (hyperesthesia as to temperature). Sensitiveness to pain is increased in the parts where there is less tactile sensitiveness, left evening on skin of feet, hands, and fingers; slight prick on finger draws loud cries from her, and produces severe reflex movements. Skin of extremities is normal to look at; to touch it is very cold. Even when in a state of complete rest, she feels in legs pains which increase on motion; at n., besides these pains, she has sensation of cold which makes her constantly cover up her legs with fur, though room is well warmed. Organs of respiration, circulation, and those of abdomen, as also intellect, are normal. During illness, there was noticed no attention of urine or constipation, and no incoordination of movements. If she cannot stand on her legs or make normal movements, this certainly is owing to great weakness of atrophied muscles, to muscular pains, to hyperalgesia, and lastly to diminished sensation as to weight. (SCOLOUSUBOFF, Ann. d’Hygiene, 1876.)
21. A woman took ars. twice a d., for 3 months, to cause abortion, altogether about 2 tablespoonfuls. When seen at end of this time she was in bed, looking pale and haggard, with prickling pains in both legs, from soles to about 2 inches above knees. Sensation was completely lost in left leg, and considerably in right; in both there was total loss of motion. She said she had been unable to get about for the last fortnight, and that for some weeks previously she had considerable difficulty in doing so. She had no appetite; bowels irritable; urine high coloured and scanty. She had lost flesh considerably, and seemed scarcely able to collect her thoughts. Labour was not hastened; and no effect seemed to have been produced on the child. (Brit. Medorrhinum Journ., 1859, p. 725.)
22. A young man came to Dr. Morell Mackenzie, labouring under almost complete aphonia. At first this was attributed to commencing laryngeal phthisis; but examination with laryngoscope showed right vocal cord performing its movement, while left was pale, shrunken, and immobile. Later, the paralytic condition became more general, and was discovered to be dependent on chronic arsenical poisoning. (Medorrhinum Times and Gaz., Jan. 11th, 1862. [ For other cases of arsenical paralysis see BERRIDGE, Nos. 125, 236, 337, 378, 529; and IMBERT-GOURBEYRE, L’Art Medical, I, 88.])
23 a. A man, et. 42, had been affected with general psoriasis since he was 15. When 27 he began to use arsenical preparations, which he took every year for 2 or 3 months consecutively, and in increasing doses; sometimes he repeated the course 2 or 3 times a year. After each his disease was ameliorated; the patches disappeared, but they recurred just as certainly after a few weeks or months. The patient thereupon was compelled to have always recourse to ars., and was so insensible to its action that he could take 5 centigrammes daily for several weeks at a time without experiencing any particularly disagreeable effects. The only symptoms felt were a little ptyalism and some slight gastro-intestinal derangement. In 1857 skin became of a permanent dirty-brown colour, especially in those parts usually exposed to light. In 1862 this man came to Dr. Charcot complaining of a symptom he had for three months that plunged him into the deepest melancholy. His sexual functions, which had formerly been very vigorous, were seriously threatened; erections had become rare and incomplete; coitus was almost impossible. He was advised to leave off A. completely for a long time; and after he had done so for 4 or 5 months the former sexual vigour returned.
23 b. In a second instance a man, et. 35, who, on account of psoriasis, took for many years pills made of A. and afterwards Fowler’s solution, was thereby rendered impotent. On leaving off the A. the anaphrodisia left him, but the skin disease returned with increased virulence. A fresh employment of the drug was again followed by impotence. (Gaz. des Hopitaux, July 23rd, 1864. Rayer is quoted here, and Biett in Brit. Journ. of Hom., xxiii, 81, as having observed the same thing. Dr. Imbert-Goubeyre also states that Brockman treated a workman in arsenical mines who complained of diminution of sexual power since he had followed his occupation. L’Art Medorrhinum, 11, 176.)
24. J. G. -, et. 33, took ars. in tea. In about 5 m. a peculiar tingling sensation in left arm, lasting about 45 m.; this was followed by nausea, vomiting, and headache, which continued till next day, when much thirst was added, with hoarseness, lachrymation, and swelling of eyelids. On 4th d., having almost completely recovered, he took 2 teaspoonfuls in coffee and milk. In about 30 m. he had headache and nausea, followed by vomiting of green matter and ropy mucus, continuing for 30 h. There were also cramps, some collapse, constriction of throat, hoarseness, and burning along esophagus, which last symptom continued until 6th day 2nd d., line of excoriation on integument at external angle of each eye, and desquamation of cuticle-with redness-of lids; eruption of pustules about angles of mouth; redness of fauces with aphthous ulceration. 3rd d., cough with yellowish-white expectoration, and bronchitic rales in chest; difficult micturition, but without pain; tingling sensation in the axilla (for 8 d.); heat of skin; quick pulse. 5th day, numbness of thighs and calves. 11th day, anaesthesia of fingers, and partial paralysis of flexor of forearms. A similar condition shortly afterwards attended the lower extremities, and was accompanied in both by pain persisting for a few d. In 5 weeks from commencement of illness, skin of entire body had desquamated, most remarkably so on hands. [ Comp. BERRIDGE, Nos. 93 (P.M.), 219 (18). In 6 weeks paralysis of flexors of both extremities was unabated, and accompanied with soreness on pressure. In 2 1/2 months he was still unable to stand without support. During interval between 8th and 24th months he gradually improved, and finally quite recovered. (Dublin Zuart. Journ. of Medorrhinum Sc., xi 68.)
25. A man, et. 21, took 3ss of A. on evening of April 26th. Emesis and catharsis continued during n., and gastro-enteric inflammation set in next d. On e of 28th complained of “much pain throughout system, great and incessant itching of skin, some tenesmus and strangury.” Improvement set in one the 30th, and the pruritus is not again noticed. (Amer. Journ. of Medorrhinum Sciences, 1836, xviii, 531. To these Dr. IMBERT-GOURBEYRE, in his L’Action de l’Arsenic sur la peau, Paris, 1871, adds 4 more cases. See also another in Brit. Medorrhinum Journ., 1873, i, 88; and others here, ii, 26, 34, 39.)
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.