10. A woman, aet. 45, convalescing from a low fever ( febris nervosa versatilis), took for debility moderate doses of ch., bit “after each dose had a well-marked fit of ague.” (She took, it appears, gr. 1/2 in m., and same twice in e. In about 1 hour there occurred a shivering chill for 1 hour, then a hot fit, and afterwards a sweat of several h.). Medicine was discontinued and attacks ceased, till 10 days later a decoction of bark was prescribed, when a single dose sufficed to produce a fit precisely as before. (OSANN, Ibid., supply. of 1825.)
11.(Haemorrhage.). Baguet observed on three occasions of giving 3 or 4 gr. to prevent relapses of intermittent in same patient, at different times) haemorrhage from mouth, lasting from 4 – 48 hours, and 2nd time accompanied by purpuric spots on arms and legs. (Ann. de la Soc. de Med d’ Anvers, 1844, p. 633.). Cachere reports 2 cases in which Ch. was given to children. In one, a boy of 13, on 5 occasions haematuria followed each attempt at administration; in the other, a girl, haemorrhage from vagina ensued. (Arch. Medorrhinum Belg., 1871, p. 114.) Gauchet has observed one case, and Simon de Ronchard several, of haemoptysis occurring after moderate doses. The affected persons had healthy lungs and hearts. As soon as the drug was discontinued the haemoptysis ceased, but blood once more made its appearance in the sputa when it was again used. (LEWIN, op. cit.) 12. (Eruptions.). GRISSAC classes the eruptions which may appear after the internal use of quinine as purpura, roseola, scarlatinous erythema, and eczema.
11 a. Vepan first observed the petechial form. He reports that in the case of a lady suffering from neuralgia, who took first 0.1, later 0.15 grm., spots of purpura developed all over the body after 2 d. They disappeared 9 days after the suspension of the remedy, but again showed themselves when its use was recommenced. The eruption increased in violence and extent with the increase of the dose, and haemorrhage took place from the gums while it lasted. Gauchet observed a similar pet chill eruption on the person of a lady who had previously suffered from haemoptysis after taking drug. The petechiae were abundantly scattered all over the body and disappeared on the discontinuance of the remedy.
11 b. A simple roseola has been repeatedly observed by Dauboeuf in males and females. It made its appearance attended by intense itching, usually after a number of doses had been taken, in one case even 8 days after last dose was taken. It was sometimes confined to the extremities or trunk, and sometimes spread over the whole body; usually appearing only in the form of disseminated patches.
11 c. The scarlatoid form erythema was first described by English authors. (See ii, 13, 15, 16, 18.)
11 d. The mixed form of quinine eruption, a combination of scarlatiniform erythema and acute in its earliest stage, is illustrated by a case of Kobner’s. an eruption which was mistaken for scarlatina, preceded by chills, precordial anxiety, nausea, vomiting, and burning on skin, appeared in a lady after taking 0.22 grm. When medicine was again administered, face became slightly bloated, and was covered with a uniform dark redness which spread also over scalp, ears, neck and extremities. A few spots of normal skin remained on arms; and flexor aspect of lower third of both thighs was normal, while extensor surfaces were the seat of isolated papules, of size of pea, dark red in colour, becoming pale on pressure. Intervening tissue was healthy, and epidermis showed fine wrinkling. Heisinger has communicated a somewhat similar observation. A nodular eruption appeared in a lady after 0.025 grm. only on eyelids, cheeks, and a portion of forehead, with headache, fever, nausea, sensation of intense burning and marked oedematous swelling. On another occasion in same subject, after 0.01 grm., herpetic vesicles only appeared on cheeks; disappearing with branny desquamation immediately after use of drug was abandoned. Denk reports case of a boy in whom, after use of 0.8 grm. in 4 days, an eruption appeared without itching, which extended over whole body, became pale on pressure, was of a scarlatinal redness, and presented numerous yellow vesicles of pin-head size, most thickly connected on neck, in axilla, and over sternum. the general condition, save for a slight elevation of temperature in m. and evening, was not affected. After drug was discontinued vesicles began to break and dry up. Desquamation occurred in small scales and large lamellae.
According to Grissac, the appearance of an acute eczema may be still more closely stimulated than in the cases just cited, if the numerous vesicles burst and form thick crusts. (LEWIN, op. cit.)
13. a A small dose of quinia in one of my patients always brings out a uniform red rash over the whole body, most marked on the back of the neck, accompanied by very severe stinging pain, especially on the nape, and in the clefts between the fingers. Desquamation, as free as after an attack of scarlet fever, always follows the rash.
13 b. A patient tells me that even small doses always excite violent urticaria, her face swelling till she can hardly see out of her eyes. She is so intolerant of it that a quinine hair-wash brought out a crop of urticaria on her head, and a tooth-powder containing a small quantity of the drug caused her lips and gums to swell. (RINGER, op. cit.)
14. Gr. 1/2 was given to lady in aperient pill; in 30 m. patient was conscious of irritation over skin of head and face, which ended in erysipelatous redness and oedema of right side of face, eyelid, &c. This lasted 12 h. The patient gave following previous experiences of the drug: She first took a dose when about 16 as a tonic at bedtime. Passed a very restless n., and in m. entire head was much swollen, and opening mouth to take food was difficult. Shortly afterwards took glass of port wine, in which was very small quantity of solution of C., and was attacked by same symptoms, only less severe. On another occasion, when recovering from smallpox, C. was taken, and produced large weals with local redness over neck, chest and arms. All preparations of bark acted in the same way. (NEWMAN, Brit. Medorrhinum Journ., 1871, i, 361.)
15. A lady, aet. 40, took 2 gr., and was shortly attacked with erythematous rash and oedema of face and limbs and precordial uneasiness; arms felt ready to burst. the rash subsided in 3 or 4 days, and was followed by desquamation. (GARRAWAY, Ibid., 18969, ii, 388.)
16. An elderly lady took 2 doses of mixture, containing 1 gr. in each dose. Afterwards she passed sleepless n., and in m. was covered with vivid red rash attended with great itching. Slight puffiness of face, white tongue and praecordial uneasiness were also present. The rash persisted several day, and was followed by desquamation, which lasted more than three weeks. (HEMMING, Ibid., p. 533.)
17. a young woman took C. on several occasions, and each time suffered from rash resembling measles. (THOROGOOD, Ibid
18. A lady was given 1/4 gr. doses three times a day after second pill rigor followed by heat occurred, and a brilliant scarlatinoid eruption appeared all over body, accompanied with pain and intolerable itching. Afterwards the skin exfoliated for nearly three months. Some months afterwards same lady received a mixture containing 1/2 gr. in each dose. After first dose same symptoms followed. (SKINNER, Ibid., 1870, i, 103.)
19. Bark in large doses and in not very soluble form excites dyspepsia. Soluble preparations soon appear in urine. Small doses sometimes irritate kidneys and bladder, especially in old persons. Doses of about 1:00 to 1.5 gram. cause giddiness, ringing in ears, vomiting, sleeplessness, and general prostration, sometimes disturbance of hearing and vision. The frequency of the pulse increases after small doses, the contrary after large doses; by the latter the pressure is lowered. 12 to 15 grm. cause death from paralysis. The spleen of warm-blooded animals contracts under influence of quinia in a few hours. It becomes tougher, and its surface is thrown into folds. In moderate doses it temporarily lowers temp. One dose of 1.5 gram. reduces amount of urea by 24 per cent. and sulph. ac. by 40 per cent., but raises quantity of water. Ch. prevents putrefaction of nitrogenous substances, and simple fermentative processes. In both cases it acts directly on the protoplasm. Diminishes absolute number of white corpuscles. Lymphatic glands become small and dry. It limits the escape of while corpuscles from the vessels, and hence diminishes suppuration. It prevents the protoplasm from absorbing oxygen from the air. (BINZ, Elem. of Therap., sub voce.)
20. MONNERET, from wide experience in treatment of acute rheumatism with large doses of ch. (2-6 grm.), reports following pathogenetic effects.
20 a. One cannot say that the digestive canal receives with impunity the larger doses of c. At first, in most cases, there is nothing but nausea, disgust, and occasional vomiting. But if its use be continued several days vomiting becomes more frequent and obstinate a great quantity of yellow or green bile being brought up, leaving unpleasant taste in mouth. I have observed in ten patients pains in epigastric region, in xiphoid cartilage, or behind sternum. The epigastric pain was increased on pressure or by deep inspiration. It extended through rest of abdomen. Constipation was more frequent than diarrhoea; 3 complained of very painful tenesmus. some had pain or sense of dryness in fauces and pharynx, without visible swelling there.
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.