8 b. Soon after the above named symptoms, there was manifested a more or less considerable enlargement of the pupil, with tendency to immobility of the iris, even when only two milligrammes (gr. 1/32) had been given. This mydriasis was accompanied by no very remarkable injury to the sight, as the patients were not prevented from reading very small print.
8 c. As I gradually raised the dose to 4 to 5 mill., 23 of the subjects of experiment complained of difficulty in swallowing either liquid or solid substances, but especially of the small quantity of saliva which they had in their mouth; frequently they could only effect deglutition after making several stains with the muscles of the neck and throat. Yet the dysphagia did not proceed from a spasmodic contraction of these muscles, as in hysterical or epileptical attacks. They seemed rather to be the consequence of a partially paralysed condition, for none of these patients experienced the constrictive sensation in the gullet which hysterical and many epileptical persons complain of at the beginning of their attack; and, on passing the hand over the throat, one did not perceive the swelling and drawing together which is observed when the muscle of this region are spasmodically contracted.
8 d. After the dose of 6 mill., I found in 19 cases a failure of voice, which in one individual, amounted to complete aphonia. At the same time there appeared in 13 a slowness and hesitation in the articulation of certain words. The hindrance to utterance seemed to lie not merely in the muscle of the lips – as is the case, for instance, in paralysis of the facial nerves, where the pronunciation of vowels demanding the cooperation of the lips, such as o and of the labial consonants, such as b and p, impeded. In our case the impedient seemed to lie quite as much in the muscles of the tongue, as I often observed a slight quivering of this organ. This impediment utterance has moreover, seemed to me to present a great resemblance to the difficulty of pronouncing certain words which characterizes the so called progressive paralysis of the insane.
8 e. After the dose of 7 mill., all the subjects of experiment complained of dimness of sight, and I found the pupils then regularly in a state of great dilation. They saw all objects as if involved in a mist, and could no longer distinguish their contour properly; could barely read very large print, could not thread a needle, &c. Twelve persons presented diplopia or sight strabismus, and 6 complained of difficulty of moving the eyeballs.
8 f. After a dose of 8 mill., 9 out of 16 of the subjects complained that they could no longer so well command their organs of locomotion. They felt at intervals, in spite of strong efforts of the will, a staggering in walking, like that of drunken man, though not so marked a degree. They could no longer keep themselves so steady on their legs, nor make use so rapidly and easily of their hands to button their clothes. In a word, they exhibited, in the movement of the upper and lower extremities, a certain heaviness and helplessness, which was very like that which one observes in the first stages of progressive paralysis of the insane. The resemblance between the symptoms which characterizes this disorder and the hindrance to movement produced by A is often so great that, in the commencement, it is difficult to draw the line.
8 g. Eight out of 12 subjects of experiment, with whom I proceeded to a dose of 9 mill., complained of a difficulty of passing urine. Besides, the sensibility of the skin was remarkably diminished; when they were tickled with feathers on the alae nasi and in the nostril, or on the commissure of the lips, they hardly seemed to feel it. If they were pricked suddenly, and without being made aware of it, on the skin of the neck, trunk, or extremities with needles, the pain which they felt was much slighter than in the normal condition.
8 h. Lastly, in six cases of individuals who had been epileptic for a long time, with whom the dose of A. amounted to a centigramme, ther appeared, besides the above-mentioned symptoms, a moral and physical apathy; the intellect was beclouded in a way which had resemblance to the stupor in typhus. These persons seemed to understand with great difficulty the questions put to them; they answered very indifferently and slowly. Not withstanding, their ideas were still connected and not very obscure; only in a single case three was exhibited a noisy delirium, accompanied with hallucination.
It is important to add this remark, that all these physiological effects, though some of them were of a somewhat alarming nature, never had dangerous results; and that; moreover soon after the administration of the A. had ceased, they disappeared, excepting the dilation of the pupils and the dryness of the throat, which often continued still from 6 to 10 d. after the discontinuance of the medicine.
From these observations the following general conclusions present themselves: –
(1) A. and its salts act especially on the cerebro-spinal nervous system.
(2) They depress successively, not synchronously, the functions of the different parts of the system.
(3) They affect the motor nervous system before the sensitive, and the organs which minister to the intellectual and moral faculties are those which are last attacked.
(4) The organs on which fall the first convulsive excitations of epilepsy are the same as those which experience the primary effects, in an opposite direction, of atropine. (Gaz. des. Hopitaux, 1861.)
9. A. is, in the truest sense of the word, a diuretic, and more powerful perhaps than any other we possess. After excessive doses in both man and the lower animals, frequent emission of urine is a marked symptom. In medicinal doses the diuretic effect is often masked by retention of the urine; but is that which is excreted during its operation and a few h. afterwards be examined, an increase either in the specific gravity or of the quantity will be observed. In the latter case the specific gravity will, of course, be proportionately diminished. Analysis will show an increased elimination of all the solid constituents, excepting generally the chlorine, which, on account of the increase of the other constituents, appears to be diminished. The urea is always increased and often to a considerable extent; but the effects of the drug are most manifest in the increase of the phosphates and sulphates, which are sometimes doubled. If the action of the medicine take place during a period of fasting, and maximum acceleration of the pulse be great, and sustained for an h., urine will resemble that voided after the digestion of a hearty meal in the richness of its solid constituents. (HARLEY, op. cit.)
10. After repeated experiments, I find that in profuse sweating produced by the hot chamber of the Turkish bath 1/100th to 1/200th of a grain of A. will, in a few seconds, completely dry the skin, and maintain it dry, notwithstanding the continuance of the bath.[ Experiments indicate the existence of sweat centres in the cord and medulla; and it has been demonstrated that the sweat-fibres run with the vaso-motor fibres. Pilocarpine and muscarine excite sweating by action on the periphery of the sweat apparatus; and atropia checks it, as it does the salivary secretion, by an influence exerted on the same parts. ] (RINGER, op. cit.)
11. In the Pennsylvania Hospital I not long since saw a man who had been wounded by a railroad accident in such a way that the whole of the temporal bone anterior to the petrous portion was thrust into the side of the head; there was complete paralysis of the facial, of the trigeminus, and of the oculo- motor, as could be readily demonstrated on the man, who lived some months, finally dying from abscess of the brain. The carotid canal was so pressed upon that the sympathetic, which passed upwards through it to the eye, must also have been paralysed. The eye was found by the autopsy, separated from all connection with the nerve-centres, and yet when A. was given hypodermically the pupils dilated. The proof seemed complete that the mydriasis was due to a peripheral action. [ Our knowledge of the action of A. on the pupil may be summed up as follows: A. applied locally causes mydriasis by paralysing the peripheral ends of oculo-motor nerve, and probably by stimulating the peripheral ends of the sympathetic. A. given internally almost certainly caused mydriasis, not by influencing the nerve-centres, but by being carried in the blood to the eye itself, and there acting precisely as when applied locally. ] (H. C.WOOD, op. cit.).
Experiments on animals
1 a. A grey horse received gr. 1/2 by hypodermic injection. Pulse was 30. In 12 m. pupils suddenly and completely dilated as they were being examined; pulse at same time obtained its maximum acceleration 72; mouth was drying. In 20 m. pulse 68, soft and full; mouth only dryish. In 1 h. pulse of same rate, but of diminished volume and very soft; lips, mouth, and tongue quite dry; remained very quiet and dull. After 3 h. considerable nervousness. After 6 h. pulse so weak and compressible that it was counted with difficulty; pupils fully dilated, and a bright red glare was reflected from the fundus of the eye, conjunctiva of bright crimson colour; mouth moistened with creamy secretion; tongue white. For an h. previously the horse had been restless, and now there was a moderate amount of delirium; a touch made the muscles quiver, and he was startled by the least noise, and jerked the head backwards on moving, as if he misjudged distances. During the next 4h. the effect gradually wore off. At 18th h. pulse was 36 (6 more than before injection), very soft and weak; mouth and pupils normal; had passed a softer and more copious stool than usual, strongly acid; was tired. Urine frequently voided during action of dose
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.