26. Catherine J-, et. 20, came into Hotel Dieu more from misery than from any definite ailment, complaining only of weakness of legs. From September 27th she took daily 3 doses of 4th trit. of arseniate of iron. During the first day she had shootings in temples, coryza and obstruction of nose, lachrymation with burning in eyes. Oct. 2nd, itching on left side of neck, with a little redness; next day, same on the face. On the 5th, general pruritus; on limbs patches of diffused redness. On the following days, vertigo, troubled sight, persistent itching. These accidents ceased when medicine was omitted. (IMBERT-GOURBEYRE, op. cit., where 12 other observations of the arsenical erythema are cited.)
27. Dr. KELLIE treated a chronic rheumatism with A. during 3 months, with three intermissions of 10 d. each. Fowler’s solution was employed, 5-10 drs a d. During each course of treatment, on 3 different occasions, there came on swelling of face and eyelids, then erysipelas [ See BERRIDGE, No. 234] invading whole face and ending in desquamation at end of a week. (Edinb. Medorrhinum Journal, 1808. Several similar observations are recorded in Dr. Imbert-Gourbeyre’s treatise.)
28. A man, et. 27, poisoned himself with A., and died in 8 d. On 3rd d. there was an eruption of phlyctenule around mouth. On 4th d. an intense left parotitis. On 6th d., after a very bad n., there appeared an urticarious eruption over whole body, face excepted. Next day this had disappeared. (KERSTEN, Deutsch. Klin., 8 1851, cited by Imbert-Gourbeyre, who adds 5 other instances of arsenical urticaria, in one assuming form of urt. tuberosa.)
29. MARCHAND writes:-“Four times I have been supervene, in persons taking A. for intermittent fevers, a papular eruption of varying seat. The papules were voluminous, caused a little itching, and were unaccompanied by inflammation. They lasted as long as the drug was continued; when it was left off they disappeared, and the epidermis came off in large thick patches.” (Ann. med. de la Flandre occid., 1851 and 1854; cited by Imbert-Gourbeyre, who adds several other observations.)
30. A man, et. 35, much addicted to drinking, swallowed about 3ij of A., but immediately vomited half of it. GUILBERT found pulse quick, irregular, weak, contracted; breathing heavy, and often interrupted by sighing; expression wild; eyes projected far out of head, they were bathed in tears, which excoriated lids and cheeks; facial muscles from time to time convulsive; voice trembling; tongue dry, and lips covered with small black spots; burning pain in bowels; unquenchable thirst; belly very tense and painful; involuntary watery evacuations, with sense as if red-hot iron were in anus; urine suppressed; fetid sweat all over body; reason left him from time to time. Death seemed inevitable; when, after these symptoms had continued 5 d., on 6th a profuse miliary eruption [ Comp. BERRIDGE, No. 219 (2)] came out all over body, with general amelioration; it was renewed several times in course of a fortnight, and terminated at length in brawny scales. Ulcers appeared on both heels, from which an ichorous matter was discharged, and patient recovered, but with some weakness, general trembling, [ See ii, 12, d.] and frequent attacks of ophthalmia (Journ. de Medorrhinum, iv, 353. 1756. Imbert-Gourbeyre adds a number of instances of the arsenical miliaria.)
31. In Nov., 1857, I was called in consultation to a patient in whom a very small quantity of A. taken internally had brought about an irritation of the skin with general eczema. [ See also ii, 15, a; Brit. Medorrhinum Journ., 1858, p. 215; Edinb. Medorrhinum Journ., 1866, (Balfour) ] The dose had been gr. 1/30, repeated twice daily; and not more than 40 drops of Fowler’s solution, left evening gr. 1/3, had been taken. (TAYLOR, Poisons,, 2nd ed., sub voce.)
32. A robust man, et. 67, took 5 min. doses of liquor arsenicalis for sciatica. He is now the subject of the herpes zoster, which began a few d. ago. He says he had very trifling pain before rash began to come out. It first appeared behind right ear; it now covers right side of neck, right shoulder as low down as spine of scapula, and right side of front of chest as low as upper border of third rib. On front of right arm it extends as low as about 2 inches below axilla. The vesicles are quite characteristically those of herpes zoster, with some tendency to ulcerate at parts. Looking at front of chest inflammation of skin stops abruptly at middle line, but at a distance from this, on left side there are a few isolated small patches of vesicles over precisely the same area is as affected on other side. There are a few isolated vesicles on left side of neck, but they are only to be seen when looked for frequently. The amount of irritation has been much less than usual. ( Medorrhinum Times and Gaz.,, 1868, ii, 722. In this article, and in another at p. 407 of vol. i for 1869, Mr. HUTCHINSON calls attention to the frequency with which shingles occur in patients taking ars., and cites 12 more cases in which the disease appeared in its typical form, with unsymmetrical herpes. In vol. iii of Practitioner, p. 70, Dr. SISSON states and illustrates the same fact. Other references for it are Lanchet., 1869, ii, 508; 1867, i, 455; Pract., July 1878; HUNT on Dis. of Skin, 5th ed., 44; St. Bart. Hosp. Rep., 1873; L’Art Medorrhinum, lviii, 432; Brit Medorrhinum Journ., 1882; PIFFARD, Mat. Medorrhinum and Theridion of Skin, p. 316. [ For simple herpes see BERRIDGE, NOs. 110, 239, and IMBERT-GOURBEYRE, p. 42] )
33. An English nobleman, et. 60, of good health, took-while wintering on the Nile-for a local irritation of the skin 2 1/2 gr. of Ist trit. of ars. alb. m. and e. After 3 weeks of this medication he complained of his tongue being so dry and thirst so great that it made him quite ill. This increased; tongue became hot also, and “as dry as a parrot’s;” he had chilly fits, got very pale, his face white and pinched, his pulse weak and quick, and at times very irregular, with extreme prostration. Eyelids were swelled and puffy, especially r. Medicine was now stopped, and he got rapidly better, perspiring profusely. Five weeks later he took up his residence in a villa at Florence, where the rooms which he occupied were subsequently found to have their walls coloured with an arsenical pigment. Here the cutaneous irritation, which had been better, returned more distressingly and over a larger surface. He took the medicine again; but in about a week dry mouth, chilliness, and swelled eyelids returned, and it was stopped. A fortnight later, general pemphigus set in, first attacking feet and arms, then back, and then suddenly developing at once into a general red and shiny condition of skin, as in erysipelas, covered with a multitude of small blisters. The whole body swelled to nearly twice the natural size, and there was extreme irritation of the surface. General health, nevertheless, was unaffected; though pulse was weak and quick, temp. was normal, appetite and sleep good, bowels regular, urine normal. Little change till he removed to a place among the hills, when swelling began to diminish, and diarrhea set in, lasting about two months-stools at times perfectly liquid, and as many as fifteen or sixteen a d. General state remained good, though tongue was rather red at tip; and swelling rapidly subsided. When this had ceased, the only trouble was the state of the skin, which remained red and tender (though with much less heat and irritation), and blisters, fewer but larger, formed here and there continually. Similar blisters formed in mouth, having a blackish fringe around them, and sometimes leaving blackish depressions. Under ant. tart. internally and anointing the body with oil, great improvement ensued; but all the nails came off, he was inclined to sleep a great deal during the day, and when he woke he was rather confused, and took a few m. to gather himself up. His sleep also was disturbed with dreams which were half- visions, and awoke him; while the pulse had become extremely intermittent. A little Lord-returned to his former residence, occupying the same rooms; and after sleeping three four n. experienced a decided return of the eruption, and was not nearly so well in himself. At this point the presence of the arsenic was discovered, and he was at once removed. He continued to feel weak and shaky, and complained much of his mouth. The blackness noticed there had disappeared while he was away, but now the inside of mouth looked as if he had been eating charcoal, and the saliva, which was abundant and clear, seemed to have little black grains in it. Tongue looked sodden; many papilla were hard and blackish; tip and edges red and very sore. The mucous membrane of mouth and tongue was cold to the touch. Lord-now took a slight cold, which, however, did not extend below throat. Some difficulty of swallowing and of expiration supervened. As he was taking some soup, suddenly his eyes closed and his head dropped forward, a dark flush passed for one instant over the face, and without a gasp he was dead. [ Aetius (5th cent.), cited by Imbert-Gourbeyre, speaks of “eruptio bullarum” as a symptom of (probably) arsenical poisoning.] (HUGHES, Annals of Brit. Hom. Soc., ix, 486.)
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.