35 a. W. S – -, aet. 32, ship’s steward, 5 feet 10 in. in height, was admitted on June 12th, 1/2 hours after swallowing the greater part of half an ounce of phosphorus paste (Roth and Ringeisen’s). The stomach was at once washed out with five or six basinfuls of warm water; 3 gr. of sulphate of copper were mixed in a pint of warm water, and given to him to drink. It was immediately vomited. The fluid with which the stomach had been washed out had a strong smell of phosphorus, and was luminous in the dark. In the subsequent course of the case the most prominent symptoms were vomiting and depression, with for a short time a very slow pulse, 46. Jaundice was first noticed on 16th, in conjunctiva, and the urine was of a dark red – brown colour, due to bile – pigment. It was acid, of specific gravity 1020, and contained no albumen. On the following day the jaundice was more marked, especially on the face and chest; the tongue was furred; there was some tenderness over the liver, but the area of dulness was not diminished. The vomiting continued; he passed 40 ounces of urine, of a brownish – black hue, in the 24 hours, and the motion passed on June 18th was very foul, and like chalk – and – water. The motions retained this character; the intensity of the jaundice increased, and there was tenderness over the liver. Nocturnal delirium subsequently became marked. On 22nd, the respirations had the so – called Cheyne – Stokes character, and were only 8 per m. The pulse was 50. A round – worm (ascaris lumbricoides), six inches long, was found in the vomited matter. On 24th, the temperature rose to 100.6 o; the pulse was 120, and the respirations had risen to 26. On 25th, temp. was 102.2 o; pulse 124, full, bounding; and resp. 28 per m., stertorous. The stupor in which the patient had previously remained was passing into coma. The motions and urine were passed involuntarily, and the perspiration was profuse. At noon, temp. was 102 o; at 3 p. m., 102.4 o; at 8, 102.6 o; at 11, 103.8 o. Pulse was then 162, and resp. 44, stertorous. He was in a state of profound coma. At 1:30 a. m. on 26th, temp. was 105 o, pulse was 150, and resp. 54. At 2 a. m., temp. was 105.2 o, and pulse could not be counted. The coma continued until death. Temperature at 3 a. m. was 106 o; at 3:30, 106.4 o; at 4, 107 o; at 4:30, 107.4 o; at 5, 107.8 o; at 6:30, 5 m. after death, 108.6 o.
35 b. The necropsy was performed 30 hours after death. The skin, deeply jaundiced, was of a brownish – yellow colour. The lungs on section had a black tarry appearance; and, on pressure, thick dark frothy blood, mixed with minute oil – globules, oozed out. The heart weighed 13 1/2 ounces, and was very soft and flabby; its outer surface had a pale reddish – yellow appearance. The endocardium and the inner coats of the large arteries were of a mahogany colour, deeper staining being noticed here and there. The liver was much diminished in size, weighing only 42 3/4 ounces, of a drab mottled appearance, very soft and flabby, with thin edges, so that it could almost be rolled up; it was greasy – looking. On section it was found to be of a uniform brownish – yellow colour, bloodless, with abundance of free oil – globules. The gall – bladder contained a little thin greenish fluid. The kidneys (weight – r., 8 ounces; left, 7 3/4 ounces) were very soft, and their capsules loosely attached, so that they were easily peeled off. On section the organs had a pale and oily appearance. The spleen weighed 5 3/4 ounces; its substance was soft, and of a tarry and oily appearance as the lung. The stomach contained some fluid nourishment mixed with mucus; its coats had the general yellowish altered appearance, but no erosion or congestion could be observed. The brain was not examined. On microscopical examination, the organs were all found to have undergone fatty degeneration. This was most marked in the liver; its cells had disappeared more or less completely, and in their places separate globules of oil were seen to be studded all over. The muscular fibres of the heart had lost the striated appearance, and were covered with minute molecules of oil. Extensive fatty change was noticed in the granular epithelium of the kidneys. All these sections for the microscope showed the deep brownish – yellow bile staining markedly. (Brit. Medorrhinum Journ., Nov. 20th, 1886.) 36. A married woman, aet. 20, took rat paste on June 19th. Died 11 day later. Had nausea and vomiting for several d. Feeling of depression. Towards end, insensibility, icterus and profuse metrorrhagia. – P. M., skin and conjunctiva bright yellow. Stomach contained 3/4 of a pint of dark claret – coloured fluid, consisting largely of blood from capillary haemorrhage from m. m., which showed signs of irritation. Its whole surface had a yellow icteric tint, except summits of some rugae which were bright pink. Some wrinkling of m. m. Upper part of small intestine affected like stomach. Large intestine contained a quantity of almost colourless faeces. Liver shrunken, weight 26 oz., both its outer and internal surface resembled acute yellow atrophy, except that there were greater congestion and interstitial haemorrhage in patches. Lobules of liver in many places not recognisable, in others stood out in bold relief as brilliant canary – yellow patches, in strong contrast to deep dark red areas of congestion and extravasation. Gall – bladder contained Zij of thin greyish fluid, all but devoid of bile. Urinary bladder empty, kidneys enlarged, cortex pale and bile – stained, of greater depth and softer consistence than normal. Capillary haemorrhage into right lung and pleura, pericardium and stomach. (Lancet, July 14, 1888.)
37. Dr. Nathanson, in a Berlin graduation thesis, discusses the effect of phosphorus poisoning on the liver. He follows Virchow in drawing a sharp distinction between the infiltration of the liver – cells by fat – globules and their metamorphosis into fat. He treated hardened sections with ether, and found that when these were from a healthy subject no change was produced thereby. When they were from a liver affected with fatty infiltration, the fat – globules were dissolved, the remaining cell – structure continuing pretty much as it had been before. When, however, the sections were taken from bodies which had died of phosphorus poisoning, the structure was entirely obliterated by the ether, and the same occurred in the case of sections of the kidneys from the same subjects. The inference is that poisoning by phosphorus produces a true fatty metamorphosis of the tissues of the liver and kidney. (Lancet, June 28, 1890.)
38. An aged woman, after an attack of asthma, was much weakened, and had a dry spasmodic cough, which brought back the dyspnoea. I gave her Phosph. 3 every 2 hours ” Immediately, ” she said, ” on taking the first spoonful, there came on, between the nose and eye, on the left side, a peculiar sensation, like a strong pressure, or a pain proceeding from a nerve. At the same time it seemed as if the globe of the eye was swollen and pushed out of the orbit. The eye is painful during the cough, but especially the middle and side of the nose. On the forehead there was a drawing headache, describing as it were a semicircle.” These symptoms troubled the patient so much that she determined not to repeat the medicine. She attempted this next day, however, but with recurrence of precisely the same results. (Revue Hom. Belge, Avril, 1875.)
PHOSPHORUS HYDROGENATUS. (see vol.iii, p.605)
III. 1. Hugo Schulz, after 13 experiments on animals, arrives at the following conclusions:
1 a. Ph. hydr. has a narcotic cerebral action, like that of Ph. itself.
1 b. Its action on the spinal cord is also that of Ph. The author has observed motor paralysis, arising from the spinal motor centres; hyperaesthesia, depending on the spinal centres of sensibility; excitation of sexual and vesical irritability; shivering; tremor.
1 c. He has not noticed any marked alteration in the blood, or in the abdominal organs. The fulness of the abdominal vessels was very variable.
1 d. The lungs nearly always showed lesions of inflammatory nature. (Rev. Hom. Belge, Fever., 1891.)
PHYTOLACCA. (see vol.iii, p 625)
II. 10. On Dec. 10th, 1889, I was engaged in cleaning, scraping, and slicing some fresh roots of Ph., preparatory to making a tinct. with them. While doing so I happened to touch – – about 2 p. m. – my lower right eyelid with a finger damp from the moistened root. About 4 my eye began to feel ” sandy ” when I winked; then tears began to flow; and on looking into a glass I found that the eye was quite rid. About 5 I had to go out, but the cold air did not increase the lachrymation, and sight was not affected. All evening was unable to read for the flow of tears; there was no pain, but sense as of sticks or sand – paper in eye. Slept well, but on awaking next m. could not open eye on account of agglutination of lids Conjunctivitis was greater than the previous evening; sight was good, but on looking at electric lamps in evening saw on their upper right – hand quadrant a brilliant carmine spot, or ball, = about 1/15 of the whole circle.
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.