10 b. I resumed proving on the 24th with a dose of grm. 0.5 of the crude substance. Almost immediately (10 a. m.) quivering of facial muscles, especially the orbicularis palpebrum. After an hours stretchings, repeated yawnings, nausea as if on the point of vomiting, complete lassitude of muscles, chiefly of inferior extremities, as if from being poisoned by tobacco. In walking vacillation and tottering. Prostration as after an acute and severe illness. Urine watery; pulse 53. Aversion to mental occupation, in spite of lucidity of mind. At midday almost all the symptoms disappeared; and I dined, feeling the need of it, nevertheless with little taste for my food. 25th. – At 3:30 p. m. a fresh dose of 0.05 grm. No important symptom all evening, with exception of a troublesome weariness at right shoulder, as if the humerus would be wrenched out of the glenoid cavity. 27th. – At 11 a. m., 0.05 grm. Instantly, dizziness as if I were struck down, which got worse in looking upwards. Deep pains in the wrist, as if the periosteum were affected. Motion did not make them worse, rather rendered them less sensible. On seating myself, my head appeared as if it were covered with a bar of iron. After 3/4 hours extreme tiredness with desire to lie down. Urine watery. Stiffness of legs as soon as seated. A return of the dislocative pain of the right arm. 29th. – 11 a. m., grm. 0.05. Almost immediately indescribable general feeling of malaise, with increase of flying heat, and relaxation of strength, chiefly in lower limbs. Sense of languor as if I had fasted long. Colic pains about umbilicus. At 7 p. m. (after supper) malaise at epigastrium as if from indigestion, without nausea. The alvine functions tended predominantly to costiveness. The day after stiffness of all the limbs, troublesome and persistent, also during motion. Obtuse memory with deafness on right side. From 30th 31st n. disturbed by pressive gastralgia, which recurred for several mornings, as if stomach were pushed against the spinal column. The food rose again momentarily.
10 c. On 12th April at 3:30 p. m. I took 10 centigr. of the crude substance at one dose. Almost immediately constrictive pains at the cardiac region, and after 1/2 hours copious epistaxis. During whole evening flying burnings here and there over surface of body, as if an electric current had been applied. N. full of visions, heavy somnolence in m. Greater debility of limbs on day following, with profound pains in articulations, which were not modified by movement. 14th. – At 11 a. m. I took a gramme of the 3x at once. Pains at left wrist, with stiffness of arm of same side. Weakness at scrobiculus cordis as if after long fasting. Flexion from nostrils, especially left, with deafness as if from the noise of bells. The flying burnings and itchings of the cutaneous surface were repeated, also the deep pains in the thighs, which were more felt in repose. A tranquil night. In m. copious flatulence, very foetid, without pains in abdomen; general feebleness with immoderate hunger. Inaptitude for study and for walking. 17th. – At 7 and at 10 a. m. repeated dose. Immediately there returned the prostration of the whole muscular system. Pains in abdomen about umbilicus, and in ileum. Tensive gastralgia in correspondence with the desire for eructation. Tasteless eructations which arose only for an instant. Pains in right knee, as if I had hurt it in falling, which lasted all evening, hindering sleep, and continued nearly all the following day; pressure at the tuberosity of the tibia, which was swollen, increased the pain. Pains as of contusion in the deep layers of muscles of thigh and biceps, first to the right and then to the left. The gastralgia was alleviated by food in evening, but the prostration and the feebleness of the limbs continued until the succeeding d. Feeling of sadness and of being cast down. Taste bitter and metallic, without altering the flavour of any food taken. A burning pain as if in periosteum of left elbow. Crampoid drawing in left gemellus muscle. The gastralgia, assuaged in evening, returned with more force in m., as if from indigestion of acid fruits or of brown bread badly baked. At the same time neither nausea, nor bad taste. On 19th the cardialgia continued as if the stomach were contracted over a rough stone. A return of the luxation pain in right wrist. (Bonino, L’Omiopatia in Italia, xi. 1889.)
COCAINUM (see vol.ii, pp. 270, 747; vol.iv, p.556)
9 a. Dr. J. H. Way, at 6 p. m., injected gr. 1/4 under skin of forearm. No result appearing, injection was repeated in 15 m. At 6:30, general symptoms not having appeared, gr. 1/2 was taken. In 10 m. he became restless, resp. 30, shallow and sighing; pulse 120. There was aphasia, and increasing praecordial oppression. ” It was now about 6:50. My pupils were dilating slowly; mental faculties perfectly clear and collected; no pain in head or other part of body; respiration reduced to normal frequency, but very shallow and sighing; pulse 140, and barely perceptible at wrist. I walked the room for 3 – 4 m., when I grew weak and exhausted, and was compelled to lie down on the lounge. At 7:20 my condition was almost that of collapse. Pupils were now widely dilated; mouth dry, and a sensation as of a foreign body in pharynx; resp. same and only 11 per m.; pulse 180, very feeble and fluttering; extremities cold; body was warm to touch, but my sensations were those of intense cold. I was placed in front of a large fire, and my body enveloped in heavy woollen blankets, while my feet and hands were briskly rubbed. A sense of impending dissolution came over me – not a feeling of fear, but a conviction that my condition was such that death was inevitable. My mind was perfectly clear, and I gave my attendants all directions as to my care. I took frequent doses of ammonia and digitalis; the former seemed to be of great advantage. At 7:30 my condition was worse, and myself and attendants were momentarily expecting my death. My extremities seemed to lose all power of either motion or sensation. I struggled against this with all my will – power, and would call for frequent doses of ammonia, which would give me (so it seemed) sufficient strength to move. Painful emesis occurred twice, each time being attended with ejection of about 2 oz. of frothy matter, which soon evaporated, leaving only a small white residuum. Resp. was now only 9 per m., and exceedingly shallow; carotid pulse faintly beating at 200, radial pulse entirely imperceptible, and no cardiac impulse felt on palpation. Mind still clear; suffered no pain.
9 b. ” After about 1/2 hours of this condition, I inhaled 3 dr. of nitrite of amyl. A marked improvement in the cardiac action was now noted. Resp. increased to 14; pupils contracted to normal; and skin became moist and warm. At 10 radial pulse returned, and, though 140, was full. Resp. was of normal frequency and almost vigour. At 11 pulse was 120. Suffered at this time from dull aching in lumbar region, and sense of great weakness and prostration. Half an hours later very copious diuresis took place. At 1 a. m., save for exhaustion, I was quite well. I was now put to bed, where I slept soundly till 8. Next d. I suffered much annoyance from dryness pharynx, and also from muscular weakness. ” (Therap. Gazette, 1888, p. 16.)
II. 14. Dr. W., aet. about 30, of excellent physique, began use of muriate upon nasal and pharyngeal mucous membrane for hay – fever, gradually increasing dose to 5 gr., which he had in evening, when the hay – fever was usually most distressing. This dose gave almost immediate relief from it, and produced sense of mental stimulation as from champagne. He was almost at once seized with desire for brain – work, and would pass greater part of n. reading and writing on professional topics, experiencing a keenness of perception and a mental vigour greater than normal. Towards m. he would fall asleep, and next day would have no appetite and but little desire for work. He soon had a very irregular and rapid action of the heart, and passed by rapid stages to a condition of deplorable neurasthenia. He had little desire for food, thickly – coated tongue, feeble digestion, considerable emaciation, scanty urine – much of the time loaded with uric acid and urates. There was also dyspnoea. The stools for some time were chalky; skin was dry and pallid; pupils dilated; reflexes, especially the patellar, much increased; muscular powers greatly diminished. He continued the use of the drug 10 day, and then left it off. The profound depression of the nervous system followed upon its stoppage. The depression gradually passed away; but it was four months before he could resume the practice of his profession. (Brower, Medical Age, 1886, p. 27.)
15. Dr. B., aet. 35, of neuropathic temperament, at one time in the habit of using opium largely, began the use of C. in 1/8 gr. doses, being at the time much run down by professional work. It gave him such a sense of well – being as he had never experienced from any agent before, the sense of complete repose and self – satisfaction being much more marked and agreeable than that derived from opium. He gradually increased the dose till he consumed (by hypodermic injection) about 15 gr. a d. These doses soon began to produce mental disturbance; he became irritable, quarrelsome, impetuous, and considered himself possessed of a mission to revolutionise medical practice, claiming to be able to cure all diseases by C. He gave it indiscriminately to all his patients, and to the members of his family. He was formerly a modest man of science; but now became bold and unscientific in his methods, engaged in law – suits, went about carrying a pistol and frequently displaying it in public places, threatening vengeance on all who dared doubt the correctness of his various extravagant statements, and becoming a perfect terror in his neighbourhood. The same general deterioration as before noticed was manifest in his case – extreme pallor and dryness of skin, great emaciation, loss of appetite, and no desire for sleep, so that for at least one week he did not assume the recumbent posture. My repeated efforts to persuade him to stop the use of the drug were unsuccessful; he went from bad to worse, until his friends thought it best to restrain him. In the asylum the C. was gradually withdrawn, but his mental extravagance continued unabated. (Ibid.) III. 4. While the physiological and clinical literature of cocaine has attained already truly enormous dimensions, the chapter on morbid lesions arising under the influence of the alkaloid remains yet almost untouched. Hence the practitioner cannot help feeling very grateful to Dr. Vasily M. Zantchevsky, of St. Petersburg, who has just published an ably written experimental work (St. Petersburg Inaugural Dissertation, 1888, p. 39; analysed by Dr. V. Idelson, London Medorrhinum Record, Dec. 20th, 1888), aiming to fill up an important gap in our knowledge of a drug which undoubtedly represents the most brilliant acquisition of modern therapeutics. Dr. Zantchevsky’s experiments, conducted under the guidance of Professor N. P. Ivanovsky, were made on healthy adult dogs (animals which are fairly sensitive in regard to cocaine, as Professor Anrep has first pointed out) into which (usually Merck’s, sometimes Boehringer’s) hydrochlorate of cocaine was injected hypodermically. In one group the effects of lethal doses, and in another chronic poisoning, were studied.
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.