2 d. 14th. – 2:30 p. m., pulse 78, began taking 5 dr. of 1st cent. every hours 4 p. m., began to feel the old sick feeling at stomach; general faintness or goneness all over, but especially in epigastric region, which increased steadily; head feels light, as if intoxicated; face feels warm, but is not much flushed; mouth and throat very dry; saliva scanty and very viscid; on walking, some giddiness, it seemed as if he could not control all parts of body at the same time; headache in forehead; pulse 52, seemed to be full, occasionally would start up and beat at rate of 80 for a few beats. 5:30 p. m., tired aching in eye, as if it had been overworked; face flushed. 15th. – 6:30 a. m., first dose since 5:30 last evening; pulse 64; slight dryness of mouth. 9, pupils begin to dilate; accommodation partially paralysed. 1, stupid feeling; general weakness, as if he had no life in him. 6, accommodation paralysed; cannot see to read at any distance; can read with plus 20 glass; pupils only slightly dilated; dryness of mouth and throat less than last evening, but enough to give much discomfort (” the amelioration seems to be caused by the action of lemon juice, of which I have partaken freely in the effort to relieve the dryness, and from this and the fact that other symptoms have been less, I should think that lemon juice acted as an antidote “); head feels light; great difficulty in concentrating mind on anything for any length of time; unsteady gait, occasionally a feeling as if he stepped on empty space, and would catch himself for fear of falling. 8, pulse 54, full, but occasionally intermits; hoarseness, which has increased all day, so that now talking is difficult; nose very dry and stopped up; slight burning in urethra during micturition. 16th. – 11 a. m., old symptoms all remain. Ringing in ears, especially right, comes on suddenly; vertigo on rising up or walking; it seems as if legs were unable to bear up body; staggering from one side to the other when walking, but can go straight by concentrating mind on the action and watching steps; great inclination to fall backward, more especially on going upstairs; almost impossible to stand with eyes shut; constantly swaying forward and backward, and was obliged to be held by another when eyes were closed. 3 p. m., symptoms same; loss of memory; mind running from one thing to another; tried t connect different subjects of thought together and then forgot what he started with; thoughts very disconnected and nonsensical. 7, pupils somewhat dilated; some photophobia all day; now require plus 18 to read; temp. 101 o; pulse 48, full and very intermittent – would sometimes stop long enough for 12 or 15 ordinary beats; gaping and sneezing all day 9, at this time, being all alone, took temperature and found 110 o; was so alarmed that he took coffee to antidote the drug; was very hot; pulse 48, very intermittent, and he felt worse than at any time during proving. (” I do not feel sure that this temperature was accurate, as I had no one to verify it, and hardly like to rely on my own powers of observation at that time.”)
During whole proving had general heat of the body, especially internal. Accommodation was entirely paralysed before pupils were dilated to any extent. Lemon juice seemed to antidote – to retard action; was obliged to stop using it in order to get the full effects of the drug. (Ibid.)
3. I injected into two men 1/2 gr. and 1 gr. of the extract respectively. In both, pupils became widely dilated and mouth dry. In the man who had the larger dose throat was so dry that he could hardly speak. The dryness lasted 5 h. Both became rather sleepy 15 m. after the injection, the drowsiness lasting about 2 h. The man with the larger dose complained of some general weakness, and both suffered from headache, lasting 3 h. After the larger dose pulse rose from 66 to 120 per m. (Ringer, Lancet, 1878, I, 304.)
4. I was led to test (with the assistance of Mr. W. H. Neale) the relative action of sulphate of atropia and sulphate of duboisin. We first administered by the mouth a dose of sulphate of duboisin, and carefully noted the symptoms, and we then, on a subsequent day, gave a corresponding dose of sulphate of atropia. Duboisin, we find, produces identically the same symptoms as atropia, but is far more powerful.
4 a. After duboisin, the symptoms begin in about 1/2 hours, and reach their height in about 2 h. The earliest symptom is dryness of the mouth. After 1/120 gr. there occurred great dryness of the mouth; dilation of the pupils; much giddiness, almost preventing walking, and increased by exercise; slight drowsiness and rambling; great weakness, so that the limbs felt heavy and were raised obviously with considerable difficulty, with so much difficulty, indeed, that the patient (a woman) could scarcely feed herself, and her grasp was very weak. It produced flushing of the face, and on one occasion patchy erythematous redness, the skin at these places being rather swollen and hard. The pulse became much fuller and rather slower. These symptoms lasted about 7 – 8 h. The same dose of sulphate of atropia only produced slight subjective dryness of the mouth.
4 b. After the administration of 1/60 gr. in two doses, with 2 hours interval, we observed the same symptoms for the most part. The man became very drowsy and delirious; his delirium was of the busy kind, he incessantly tried to pick up imaginary things from the floor. He had also decided twitchings of his limbs, and his pulse rose from 84 to 120, and his respirations from 18 to 30 per minute. The symptoms left him in about 10 h. The 1/60 gr. of atropia, on a subsequent day, only caused subjective dryness of his mouth. (Ibid, Pract., 1879.).
Poisonings
1. Dec. 9th, 1884, a lady aet. 40 took by mistake 3 gr. of the 1x trit. of Martindale’s duboisin at 10 p. m. I give her own account, in the words written by herself: “Almost directly I had taken the powder I felt very uncomfortable. There came a sense of oppression about the heart, and a longing to get rid of the medicine. This oppression steadily increased, with a feeling of great agony and fear of impending death. The legs began to feel very heavy, and I found I could only move them with considerable difficulty. Then the tongue appeared to swell. It became too large for my mouth, impeding speech to a marked extent. I now began to grow incoherent, and was quite unable to call things by their right name. The oppressive agony at my heart grew worse, my sight became confused and dim, and I gradually passed into a state of complete unconsciousness.” This lasted 6 h. Between 10 and 11 a doctor was sent for, who administered strong coffee; this caused vomiting, but did not restore consciousness. The left leg was powerless during the unconsciousness, and the right leg quite rigid. The teeth were tightly clenched. The face was congested; eyes occasionally opened, but they were for the most part closed; she could be roused by a shout to temporary semi – consciousness. The respiration was puffy and noisy; occasional drunken muttering. She constantly tried in vain to sit up, more rarely to get out of bed, a sort of ” busy delirium.” She would occasionally pluck at the collar of her nightdress. After opening her eyes she would direct her gaze intently at the foot of the bed, where no one stood, and she would reach out towards an imaginary person or object. No urine passed, and the bowels did not act. Skin was bathed with sweat. Pupils dilated. To resume the patient’s own narrative: ” When I recovered consciousness the next m., I found that I had great difficulty in raising myself in bed. I could not stand because there seemed to be no power in my loins. There was a constant desire to pass water, but great difficulty in doing so. Severe pain in lower back, in the bowels, and in the outer side of the right leg. I could not distinguish objects; I saw faces repeated in all directions; the countenances of bystanders appeared to have deep cavities in their cheeks. The walls seemed to have great hollows excavated in them. At first I found difficulty in expressing myself properly. I could not give proper utterance to my thoughts, for speech was embarrassed and difficult. I was again troubled with nausea, which presently passed into actual vomiting. During the next d. I had a recurrence of the distressing oppression at my heart. There was a return, too, of the agony of breathlessness, and the sense of death being imminent.” All day, indeed, patient was gravelly ill, and there was occasional muttering delirium. The arms were frequently and involuntarily jerked away from the sides, and the dorsal and lumbar muscles were thrown into violent rhythmic contractions. Sharp myalgic pains subsequently testified to the vigour of these movements. (Communicated by Dr. Edward Blake.)2. A patient at the Illinois Charitable Eye and Ear Infirmary, during convalescence after Graefe’s operation for cataract, was provided with a small bottle of sulphate of day, gr. j to Zj, in place of sulphate of atropia, which caused considerable conjunctival inflammation. On the 27th April, about 9 p. m., he took by mistake a ” teaspoonful ” of the solution. It cannot be determined whether the teaspoon was quite full. The patient at once informed other patients near him that he had taken the wrong solution, but concluded to await the result before reporting to the nurse. In about 10 m. there was dryness of the throat, and in 1/2 hours a peculiar sensation in the legs, then in the thighs, arms, and other parts of the body, as if they were asleep. At the end of 3/4 hours or more the patient could scarcely talk or stand. Strange to say, not till this time did it occur to the patient or those around him to call the nurse. An active emetic was at once given, with the apparent effect of entirely relieving the stomach of its contents. Without delirium the patient rapidly passed into a state of unconsciousness, and remained in this condition till about 5 a. m. He complained for 2 day of muscular weakness in legs and arms, and especially noted a peculiar jerking action of the muscles of the arm in extending the hand to grasp a glass or other object. (Dr. Holmes saw the patient at midnight. He was lying quietly, breathing naturally, but in a stupor from which he could not be aroused. The face was not specially flushed, although the mouth and tongue were remarkably dry. The temperature, as determined by the thermometer, had been normal. The pulse varied from 108 to 112. Some time previous to this, before unconsciousness became quite complete, the patient made efforts to sit up in bed. The pulse always fell to 80 when the patient sat up, and increased on lying down. No other symptoms were noticed. An ounce of brandy was given through the n.) (E. L. Holmes, Chicago Medorrhinum Journ., Nov., 1880.)
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.