5. LUSSANA, giving the subnitrate in large doses, chiefly in tuberculous diarrhoea, witnessed no irritation, nor any arrest of the disease, but the supervention of a colliquative and scorbutic state. “The patient acquires a leaden aspect; the eyes become sunken, and present a livid sub-palpebral circle; the breath is rendered offensive; the gums swell, grow livid, and discharge a sanious blood; hemorrhage is readily excited, and sometimes profuse passive hemorrhages arise.” (Gaz. med. It. Fed. Tose., 1852, pp. 44.)
6. M. Z -, a girl on March 21st was operated on for fungous inflammation of knee joint by excision of joint. The wound, which was large, was washed out with sol. of zinc. chloride., and subnitr. bism. well rubbed into it. On 28th, March the urine showed a black discoloration as in carbolic acid poisoning, which was not attended to as there was a compress of carbolic acid over the bismuth compress. The carbolic was left off on 11th April, but the urine continued brown and left a back sediment on utensil. On 19th April it was ascertained that the sediment was at first white but became black on standing. On April 22nd the urine was examined and found to contain a considerable quantity of albumen; under microscope many epithelial casts were found. The black deposit was found to contain bismuth,. On the 1st April a small black border was observed in gums of upper jaw. After leaving off the bismuth the desquamative nephritis and the black border of the gums rapidly disappeared. (KOCHER, Volkmann’s Samml;. Klin, Vortr., No. 224,1882.)
7. A girl was operated on for hip joint disease and bismuth in powder introduced into the wound. In a few days there occurred a slight turbidity and blackish discoloration of urine. The urine when heated with acid showed a considerable cloudiness, and some casts and cylinder epithelium were seen under microscope. – Several other cases of wounds dressed with bismuth powder showed albumen and casts in urine. (Ibid.)
8. A man aet. 32, had his enlarged servile glands excised on 25th March. The large wound was dressed with bismuth powder. He had first a chloroform icterus. On 28th March complained of toothache and bad taste in mouth; there was considerable swelling of gums, with a bluish border. Chlorate of potash relieved the mouth, but the symptoms returned again more severely. After being dressed with bismuth on 4th April he complained of severe burning in mouth, the gums were swollen and the teeth loosened. The wound being healed the mouth affection improved rapidly, but there occurred blackening of teeth and of the edge of gums. These symptoms went off during a mineral water treatment. (Ibid.)
9. A woman, aet. 46, who had been operated on for cancer of mamma, had the wound dressed with bismuth. She had black discoloration of gums, nothing more. (Ibid.)
10 A single woman, aet. 29, had large keloids removed from both sides of the neck on 25th March. the wounds were dressed with powdered bismuth. She was dismissed cured on 4th April. She afterwards was affected with heat of mouth, some of her teeth fell out, and she had diarrhoea of greenish black colour with pains in abdomen of 14 d. (Ibid.)
11 A man, aet. 56, had on 14th March his arm cut off at shoulder-joint of osteosarcoma of humerus. Bismuth powder was rubbed into wound. On 17th March he had colicky pains in abdomen and diarrhoea. The urine was found to contain some albumen. On 23rd he had vomiting and the diarrhoea continued. On 28th, dyspnoea, signs of collapse. He died on 29th. Extensive disease of kidneys and liver was found. The intestinal tract, especially colon, showed great black pigmentation (Ibid).
12 A girl, aet 14, on 14th July had her right knee resected. The wound was dressed with bism. subnit. About 14 d. after operation she got stomatitis with salivation bluish discoloration of the inflamed parts and great tenderness. A black sediment was deposited from the urine. – 30th July. Patient complains of want of appetite. There is a blackish blue seam on the gums of upper and lower jaw. Great tenderness of gums especially when eating. – 4th Aug. Black discoloration increased. Under surface of tongue tip and both borders much discolored. – 9th Aug. Uvula, hard palate, soft palate, arch of fauces, and m. m. of cheeks discolored. On leaving off bismuth dressing these symptoms of bismuth poisoning gradually went off. (PETERSEN, Deutsch. med. Wochenschr., No, 25, 1883.).
Experiments on animals
1 a. About 30 centigr, of the nitrate (liquid were injected, at midday, in jugular vein of small dog. At 4, nothing noteworthy; next day, 10 a.m., after great efforts, vomited a little liquid matter four or five times in succession (had had no food for forty-eight h.); plaintive cries, hind legs agitated with convulsive trembling; heart beats strong, noticeable at a distance, very frequent; breathing slightly hurried and impeded; took deep inspirations; downcast, hardly sensitive to external impressions remained lying on side. At 1.30 was dying; convulsive movements stronger, especially in muscles of posterior extremities; respiration rather more impeded general tumbling. Died at 3. Lungs of dark colour, crepitating in nearly all portions; lung tissue held much air; in one of right lobes there were some small dense portions, similar in structure to spleen and not crepitating. Stomach and intestines showed nothing noteworthy. 2 b. Injection of 4 centigr. of nitrate into jugular of small dog; no effects after 2 d. Further injection of 75 centigr., but into jugular of opposite side; dog had vertigo instantly; could not make a step without stumbling; fell, and when helped up again, widened his legs and dropped again; state was of drunken man. After 3 a.m., breathing difficult, deep inspirations; tongue and mouth very livid. Died 8 m. after injection. Autopsy immediate. Heart no longer contracted; 1. ventricle empty, or rather only held a little black blood; arteries the same. Lungs furrowed and shrunk, fairly crepitating, colour slightly red. 2 c. At 11, small dog swallowed 3 grammes of subnitrate: directly after his oesophagus was detached and ligatured. After 6 m. had nausea with efforts to vomit; mouth full of white and fluent mucus; plaintive cries. At l, seemed to suffer much; renewed attempts to vomit; face downcast, hind legs trembling. Next day, at 12 walked easily and only had prostration. Died in following n. mucous membrane of stomach was of bright red; that of duodenum had some very red small spots. Back part of lungs was of livid aspect.
2 d. At 11, small dog swallowed 5 grammes of nitrate; after 2 m. vomited white, stringy matter which it was easy to detect part of poison. After 3/4 h. more vomiting. At 1, breathing impeded noisy and very deep; not faster than usual. At 7 p.m., greater difficulty in breathing, seemed to suffer in abdomen. Died during n. Great portion of mucous membrane of stomach was almost destroyed by suppuration; least rubbing was enough to get it away in strips; it was ulcerated near pylorus; muscular tunic of this part was bright red, and could easily be separated from serous membrane; many spots in lungs of a livid red dense tissue like that of liver, not crepitating, containing much reddish serum and black blood, not floating on water.
2 e. Spaniel took 10 grammes of subnitrate at 4; did not vomit; suffered much at n., died next d. at 12. Mucous membrane of stomach was very red and ulcerated for 5 centimeters, easily peeled off; that of duodenum and jejunum also very red. Lungs filled with dark red blood, and very slightly crepitating.
2 f. At 11 a.m. 6 grammes and 5 decigr. of nitrate in powder were applied to cellular tissue of inner part of thigh of small dog. Died next m. in collapse. Autopsy: seat of operation had ulcer size of palm of hand, surface covered with pale yellow powder; was neither red or infiltrated. Muscles under powder looked dried up, hardened, and as if bruised. Digestive canal seemed in natural condition. Lungs were red and injected. Heart and liver seemed normal. Same experiment on a rather stronger dog than preceding, only with 3 grammes and decigr. Died after forty h. with signs only of prostration. Digestive canal, liver, spleen, kidneys. lungs, all in natural state. Seat of operation similar in appearance to preceding case. Heart full of black coagulated blood. In left ventricle several spots of a cherry red, rather Tensive, but not deep; especially on carneae columnae. (ORFILA, op, cit., sub voce.)
2. The soluble salts of B., such as the citrate of B. and ammonia, when given in large doses have an action like that of antimony and arsenic, and cause gastro- enteritis with fatty degeneration of the liver. (BRUNTON, op. cit., p. 657.)
3 a. According to Lebedoff, glycogen disappears from the liver of animals after long-continued feeding with B.
3 b. The ammonio-citrate of B. is said by Stephanowitsch to be a very powerful poison, and to act in a similar manner to phosphorus. (NAUNYM, LKZiemssen’s Cyclamen, xvii, 682.).
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.