3 f. There is, moreover, pruritus, usually confined to upper extremities, with swelling and redness of hands; also eruptions of red patches on divers parts of the body, or vesicular ones on the whole arms, but chiefly on hands and between fingers; and sometimes an erysipelatous swelling of the face. (Ibid.)
COCA. (see vol, ii, p.261.)
I. 20. A singular statement respecting the effect of C. on the voice has been made by Dr. Sandras before the Societe de Medecine pratique. He says all C. preparations and cocaine, used either through atmosizers or in infusions and inhalations, have a disastrous action on the voice of singers. It is a great mistake, he thinks, to go on repeating that C. sharpens and strengthens the vocal cords, since, on the contrary, it will slacken and deaden them through the paralysis of the extensor muscles, as many singers have found to their cost. To better illustrate the truth of his averment, Dr. S. stopped speaking for a moment, and before the meeting drank a tablespoonful of ” coca wine,” swallowing it slowly and by small portions. Now speaking again, his voice sounded much altered for the worse; the words were husky, low, and scarcely audible. (Me. Counselor, Nov., 1889.)
COCAINUM (see vol. ii, pp.270, 747)
I. 7. Da Costa, in experimenting with C. hypodermically, gives the following results: No effects were produced until at least m viij of a 4 per cent. solution were injected; in some instances gr. 1/3 – 1/2 was used. The general sensibility was only slightly altered. The temp. rose, not abruptly however, from 1 o to 1 1/2 o, and was maintained thus for several h. The effect on the circulation was to render the pulse fuller and stronger, while its rate may be increased or diminished; in a few instances no change in frequency was noticed. In the sphygmographic tracing, the higher vertical line of ascent and the more pointed summit showed increased force of cardiac contraction; while the sudden fall in the line of descent, and a well – marked dicrotic wave, indicated rather a lessened than an increased arterial tension. Pupils were speedily dilated, and uncertainty of vision was complained of. (N. York Medorrhinum Times, June, 1885.)
8. I began with 1 gr. (hypodermically) at n. The result was pleasant; I felt happy – happier than before on that d. But I did not sleep until 4 a. m., and had a severe headache. The exhilaration was about equal to that given by two or three glasses of champagne. Next m. I took a gr. with the same result, and – in addition – an inordinate disposition to write. I wrote 8 – 10 pages of foolscap, and thought it was unusually good – the best I had ever written, in fact; but when I read it over next m., though each sentence was complete, the ideas were incoherent. The 3rd n. I took 3 gr. My energy then turned to talking; I made speeches to myself. Still, I could restrain myself; I had a splitting headache. After 4 – 5 d. I injected 6 gr., 3 into each arm. I was upset; I did not lose my relation to events, but could not sleep. After 3 n. I injected 8 gr. with the same result. The next n. I put in 18 gr. in six injections. I am not sure I was conscious of what I did after that; I was intensely exhilarated. I got to bed somehow. When I rose things were generally mixed; I had not arranged my papers, &c., as usual; I presume, from appearances, I had had a pretty lively time all by myself. I had headache, and my heart beat so that I could feel it and hear it when I raised my arm. But there were none of the horrible effects attributed to cocaine, no disposition towards violence. I acquired no habit, and left off easily. (Hammond, N. Y. Medorrhinum Journ., xliv, 637.)
II. 8. Ten gr. were injected in an inebriate. The action of the C. ensued in 15 – 25 seconds, arriving at its height in less than an hours in 2 hours effects were almost gone, and reaction gradually followed. The drug had a very decided effect upon the heart, pulse gradually rising from its normal standard to 120 – 130. Appetite was destroyed; also obstinate constipation was produced, lasting many day and hard to overcome. The secretion of urine was arrested for the time, and the sexual function suspended. (Bauer, N. Y. Medorrhinum Record, 1885.)
9. A young woman snuffed up about 3 gr. of the muriate. In 15 – 20 m. she became dizzy, vision grew dark, and a sinking sensation occurred, with great weakness. The doctor found her in a semi – comatose condition, from which, however, she was easily roused to a clear mind. Temp. was above normal, skin hot and dry; pulse very rapid and so weak as to be scarcely discernible. Pupils were widely dilated. Deglutition and articulation were difficult. There was some dyspnoea. She complained of dryness of fauces and bitter taste in mouth; also of cold shivers, her teeth chattering. Later she became drowsy; eyes were closed and muscles of face affected. There was great weakness, she could not support her head; also some nausea, but she did not vomit. She recovered in about 3 hours under stimulants and digitalis. (Kennicott, Ibid.)
10. Preparatory to an intranasal operation, pledgets of C. were introduced into the nostrils on several occasions. On each application the patient, a man of 35, mentioned a cold, ” gone,” relaxed feeling about the external genitals, and a sensation as if the penis were absent. Towards end of treatment he noticed a permanent weakness of the sexual organs, and finally seminal losses and impotence set in, and continued until the C. was entirely withheld. (Schadle, Medical Register, Aug. 11th, 1888.)
11. A man suffering from chronic tubercular disease of kidneys and urinary passages took by mistake 20 gr. of C. in Zj of water. What the initial effects were is not known, for it was not till nearly an hours had elapsed that the nurse, hearing patient make some unusual noise, had her attention drawn to him. It is said that there was some arching of the back resembling opisthotonos, and a convulsive movement of the limbs. Consciousness was to some extent retained almost up to the fatal issue, which occurred in about an hours after swallowing the solution. The P. M. appearances were mainly those of the patient’s disease; but it may be mentioned that lungs and brain were congested, with some serous effusion beneath arachnoid, and that cavities of heart were neither contracted nor dilated, and all contained blood – clot. (Lancet, Feb. 9th, 1889.)
12. M. Magnan, at the Societe de Biologie, lately described 3 cases of chronic poisoning by C. characterised by marked mental and sensory disturbance. The first was one where C. had been substituted for morphia for relief of renal colic. After 2 mo. use of the drug patient began to suffer from illusions of sight and hearing and neuro – muscular irritability. He discontinued the C. for 6 mo., reverting to morphia; but on resuming it the illusions recurred, patient feeling imaginary blows on body, or something under skin, with a certain degree of analgesia. At end of a short time he had an epileptic seizure. In the second case, one of hepatic colic, the same substitution of C. for morphia had been effected, and produced very similar effects, also terminating in an attack of epilepsy. The third case also presented hallucinations of sight and hearing, sensation of foreign bodies beneath the skin, and slight analgesia. M. Magnan pointed out that in its action on sensation and the sensory organs C. seemed to resemble the alcohols and absinthe rather than morphia, with this difference, that whereas the influence of C. poisoning seemed to operate on the cerebral cortex from the occipital lobes forwards, alcohol and absinthe appeared to affect the cortex in the reverse order. (Ibid.)
13. A retired druggist had for many years been a hopeless victim to the morphia habit. This drug was suddenly withdrawn, and hypodermic injections of 1 – 1 1/2 gr. of C., twice daily, were substituted. The result was brilliant and marvellously rapid. The craving for morphia immediately ceased, and the distressing phenomena usually following the sudden cessation of the use of the drug failed to manifest themselves. But I was somewhat alarmed at ascertaining that a corresponding demand for C. was rapidly developing itself. I sought to diminish the quantity, and finally to disallow the use, of the new poison, but in vain. He daily became more and more enthralled, often taking 20 – 30 gr. daily. About this time he sustained a severe concussion of the spine, and came under my daily observation. I found the teeth implicated in the ravages wrought by the drug, decay and absorption of the roots occurring. The appetite was completely abolished; there was sense of dryness of mouth and fauces, but they were moist on inspection. Although very little nourishment was taken, the body did not emaciate in any corresponding degree. Insomnia was the rule, and one not followed by the exhaustion ordinarily thus produced. Nausea, and excitation of the sexual functions, added to the patient’s distress; and visual and auditory hallucinations, and illusions of a painful character, made him fear that at every pass he would encounter some dread object. (Banding, N. Y. Medorrhinum Journ., 1885.)
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.