11 b. The only treatment adopted was rubbing, and the internal administration of quinine. Improvement set in almost immediately. On the 23rd anaesthesia had almost entirely disappeared on left side. On 29th he could walk unsupported; knee – jerks were active on both sides, but right foot and leg were still slightly anaesthetic. He was discharged April 18th, walking well; and on June 18th presented himself with both legs quite strong, and no anaesthesia to be detected anywhere. There was, however, no return of cremasteric or plantar reflex. He returned to the factory, but obtained employment in a room where he was not exposed to the bisulphide vapour. He felt quite well when showing himself Sept. 21st, but a considerable amount of anaesthesia was found involving right foot and lower third of leg; and cremasteric reflexes were still absent. He acknowledged that when the wind was in a certain direction the fumes generated in the ” curing room ” were blown into the room in which he worked. (Edge, Lancet, April 7th, 1890.)
12. Changarnier describes the following cases:
12 a. A man presented himself with all the symptoms of alcoholic amblyopia. He was, however, a temperate man, and not a smoker. He had worked for 8 mo. where sulphide of carbon was employed. He had noticed a cloud before his eyes for about 6 weeks. His vision deteriorated daily and, after 12 – 15 day, he could not read. All objects appeared yellow. Ophthalmoscope revealed nothing abnormal. Visual field showed a centre scotoma for red and green. He was treated with eserine locally and potass. iod. internally, and recovered.
12 b. A man of 42 had worked in sulphide of carbon 11 mo. Vision had commenced to fail 1 mo. before he was seen. Symptoms, treatment, and result were as in former case. (Lond. Medorrhinum Record, 1886, 310.)
CHELIDONIUM (see vol. ii, p.61.)
II. 24. The symptoms I experienced from frequent – about hourly – 1 dr. doses of the 3x dil. continued during 3 day were: On whole surface of face an agreeable visible glow of heat; a transient cardiac pain; sharp pain under sternum; great anal flatulence every n. on lying down; on getting into bed sharp spasm in chest, together with oppression of breathing and much cardiac anxiety (have no organic disease); awful dreams; thighs itched; neuralgic pain in neck and left ear; back, in renal region, felt weak and painful; sacrum painful when in bed; cold feeling in stomach after food. On 4th day felt very queer; pharyngeal angina; pustule like an incipient boil on hip. 5th day, much pain during previous n. in sacrum and rectum; blood passed at stool (never occurred before); spasm under sternum at n. again. (” Agricola,” in M. H. Rev., xxxiii, 763.)
CHINA. (see vol. ii, 118)
I. 17. C. F. S., in full health, pulse 60 and regular. Took 10 dr. of tinct. in water at 8 a. m. Soon distension of stomach and repeated watery regurgitations. 8:10, warm perspiration on face and hands, without cause. 8:25, fulness and rumbling in abdomen with griping; passed much flatus; perspiration continues. 8:45, copious urine. 9:30, stool urgent and loose; increased saliva; tongue whitish; skin moist all over. 10:30, pulse 80, thin and irregular; feels restless and uneasy; occasional twitching of limbs. 11, head and face hot and congested, veins full and swollen. 11:15, fluent coryza, with sneezing and lachrymation; slight photophobia. 12, pulsating headache with heat; cold hands and feet; repugnance to food. 2, pulse 84, full and hard; headache continues; palpitation of heart after slight exercise, with oppressed breathing; slight chilliness, increased by drinking. 5, aching in sacral region, extending down thighs, with languor; abdomen distended; ineffectual desire for stool. Sleep dreamful at night; awoke with languor, coated tongue, and anorexia; urgent call to stool soon after rising. (Woodward, Trans. of Int. Hom. Convention, 1881, p. 32.)
II. 3. On 3rd July, 1878, Dr. L. M. Yale asked me to see a case of loss of sight, of which the following history was obtained: – Mr. B., aet. 50, a man of very intemperate habits as regards the use of alcohol, had been accustomed for years to drink enormously of brandy and whiskey at intervals; but there were periods of varying length, from one to three or four months, of total abstinence from intoxicating drinks. Mr. B. was told that the use of the tincture of cinchona would relieve him from his periodic craving for alcohol. On June 24th of this year he began its use, with a view of correcting his intemperate habits. On that day, as well as on the 25th, 26th, 27th, and 28th he continued to take the compound tincture in ounce and two ounce doses, at short intervals, literally drinking it as a beverage from a quart bottle, in which he had caused an apothecary to place as strong a preparation as possible. On the 28th, although he had taken none of his ordinary alcoholic stimulants, his clerk thought from his conduct that Mr. B. had been drinking heavily. Dr. Yale estimates that in these days the patient took an amount of the tincture which would be equivalent to 125 gr. of an alkaloid of cinchona. Mr. B. has no recollection of any occurrence after the 27th. He is confident that he took no alcohol, except that contained in the preparation of cinchona, during these days. This, however, may be doubtful, for the clerk of the hotel to which he went, when in what proved to be a semi – conscious state, on the 28th, states that while he lay in bed he was constantly ringing the bell for liquor. It is possible that during this time some doses of alcohol were added to those of cinchona, although Mr. B. does not believe this to be the case. On the m. of July 1st he was seen by Dr. Hills in the absence of Dr. Yale. He found the patient stupid or half conscious, with flushed face and conjunctivae, and apparently unable to see or hear. Mr. B. remembers Dr. Hills’ visit on Sunday, m and knows that he was then blind and deaf. Dr. Yale saw the patient on Monday and Tuesday, July 2nd and 3rd. His hearing power improved so much in that time as to become apparently normal, but his vision remained very much impaired. On the day I saw Mr. B., the 3rd, he was groping about his room, apparently in excellent general health. V. R. E. – quantitative perception of light. L. E. counts fingers at one foot. The Ophthalmoscope showed lessened size of the arterial vessels; no abnormity in the veins; lessened number of vessels on the papillae, but no marked paleness. No changes observed in the membrana tympani. The patient was advised to take strychnia in increasing doses and nutritious diet. On July 6th he was able to walk about. V. = 20/30 each eye, but the visual fields were very much contracted, so that vision was telescopic. On 16th both visual fields were found concentrically limited. The measurements, drawn on a blackboard 14″ distant, were as follows: – R. field, vertical, 9 in.; horizontal, 7 1/2 in.; limitation most marked on temporal side. L. field, vertical, 7 in.; horizontal, 8 in.; limitation more regular. B – found this symptom rather novel than troublesome. The optic papillae looked very pale, and the arteries were narrow. 23rd. – V. = 20/20 each eye. Patient states that he can see perfectly well in a straight line, but that when walking about room he has some difficulty in seeing small articles of furniture. Sept. 10th. – The same condition is maintained. The strychnia was taken until 1/10 grain had been reached at a dose, and was continued for two months. The visual field remains as on July 16th. April 23rd, 1879. – Mr. B – ‘s condition remains substantially the same. He continues to abstain entirely from the use of alcohol, and carries on a large business successfully. His vision is still 20/20 each eye. The visual field has increased somewhat in the left eye. It now measures 9 in. vertically and 16 in. horizontally. F. of R. E. 6″ vertically, 9″ horizontally. Limitation most marked at upper inner quadrant. The optic disks are pale, and the arteries small. There are no other ophthalmoscopic appearances.
Remarks. – Mr. B. – had taken no alcohol for some months prior to his beginning the use of the cinchona, and he took none until he became unconscious on the fourth or fifth day. Although he went about and transacted business on the fourth day, he has no recollection of what he did. When found, he had an empty bottle (holding a quart) in his room, labelled and giving positive evidence of having contained cinchona. He certainly did not take many drinks, if any, after he reached the hotel, for the clerk, knowing his former habits and supposing him to be suffering from an ordinary debauch, refused to answer his demands. It is not known that he took anything but the cinchona at any time after he began the treatment of the alcohol habit. We have here, then, a case of hyperaemia of the vessels of the ear from the use of cinchona and alcohol – a hyperaemia which passed away without going on to an exudative process; but the same condition in the vessels supplying the retina continued until a true vasculitis, with its consequences, resulted. The future condition of this patient, even if he never resumes the alcohol habit, cannot be regarded without anxiety. It is to be feared that in time the macula may be insufficiently nourished from further contraction of the vessels. The peripheric parts of the retina have now very little, if any, perceptive power; the nerve is perhaps undergoing atrophy. It is, I think, undoubted from many experiments, among which are my own, that cinchona causes at least temporary hyperaemia of the vessels of the base of the brain. I am fully aware, however, that, although certainly there was absolutely no loss of sight until the poisoning by cinchona occurred, there may have been changes in his circulation induced by alcohol prior to this attack, and I also do not forget that there was enough alcohol in the preparation which he took to prevent the case from being a typical one of cinchona poisoning, yet the quantity must have been too small to have added much to the effect of the other drug. He may, however, have drunk considerable brandy on the day of which he has no recollection, and some also after reaching the hotel. Certain it is, however, that he reached the unconscious state upon doses of the tincture of cinchona alone. Imperfect as is the case in some respects, if may, I think, be regarded as a contribution to our knowledge of the effects of cinchona upon the nutrition of the eye. (St. John Roosa, Arch. of Ophthalm., viii, 392.)
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.