11 b. Man, aet. 44. Many years ago, when first employed in chrome works, about 3 days after being exposed to solution, small pustules made their appearance at roots of nails on both hands, but chiefly on left, extending soon over whole back of hand to wrist, and also, though to less extent, on palm; back of hand, he said, was one mass of suppuration. Arms at same time swelled, became painful, red and inflamed as far as shoulder; and glands of axilla suppurated, but did not break. Uvula and tonsils became red, swollen, and painful, and finally ulcerated. In all other respects he was quite well. He consulted a medical man, who accused him of having contracted a venereal affection. After recovery he returned to works, and was affected again in a similar way, but not to such an extent. Since then he has been careful to avoid touching anything impregnated with the chrome; but more than once, after accidentally being in contract with it, he has had breaking out of pustules the following days.
11 c. The general impression from an examination of men engaged in the manufacture of K. bich. is that they suffer from dyspepsia; and though appetite is generally good, yet many become anaemic, skin acquiring yellowish hue which affects also conjunctivae. In three fourths of them fauces and soft palate were red and injected, although without pain or soreness; in two cases deep ulcers on palate, but painless. Pain mostly complained of was across loins. Chronic catarrh existed in about 25 per cent. of the cases, attended with expectoration of tough viscid tenacious mucus, generally white, but sometimes dark grey approaching to black. (Brit. Journ of Hom., ii, App.)
12. Individual symptoms occurring in workmen.
Head and sensorium. Giddiness, increased on stooping, with stabbing pains in left hypochondrium. Giddiness in morning, also frontal headache as after a debauch; musty taste in morning; bad appetite and foul tongue; some vomiting, excited by stooping or moving, with pain at epigastrium. Vertigo on rising from seat, everything seemed turning round, with pain in epigastrium, also across loins so that he cannot straighten himself after stooping.
Eyes Redness of conjunctiva with lachrymation; heaviness and soreness of eyes; pain in eyes first fortnight; eyelids inflamed and much swollen; eyes; pain in eyes first fortnight; eyelids inflamed and much swollen; eyes tender; conjunctiva ocular injected, lids slightly granular; pustule on left cornea, with surrounding indolent inflammation, attended with pricking pain; leucoma on left cornea; heat in eyes, lachrymation in morning at home, appearance of small white pustules on conjunctiva of left eye towards inner canthus, with red areolae; in second week itching and pain in eyes as from sand in them worse in evening and at night; conjunctiva both of bulb and lids injected; ophthalmia, commencing with itching for several days, followed by pain and heat in eyes and agglutination of lids, conjunctiva red; tarsal edges rounded, irregular, and destitute of eyelashes.
Nose (see 10 b). First week frequent epistaxis, which returned at intervals for a year, and since then (19 years) has been detinue of smell.
Mouth Heaviness across forehead, and in evening dimness of vision in walking; ulcerations with indurated edges, and smarting pain on mucous surface of both lips; dryness in mouth and throat; great thirst; bad appetite; coppery taste; disposition to constipation and then symptoms aggravated. Painful ulcer on tongue, lasting for weeks. Excavated cicatrix on roof of mouth, from which a slough separated 7 mo. ago; no pain till separation of slough; sore took 6 mo. to heal; velum presents a rough, papular, elevated appearance.
Stomach Occasional dyspeptic attacks, loss of appetite, food lies like a load, with low spirits and much flatulence, laziness
of head in morning, and nausea, with sometimes vomiting of clear fluid. Habitual attacks of sour vomiting, excited by stooping or moving, with pain at epigastrium; pressure in stomach after eating.
Abdomen Periodic attacks of constipation, with red urine (about every 3 mo.). Habitual constipation is common among the chrome workers. Dysenteric attacks, with pain at navel and bloody evacuation.
Kidneys At times, for about a week or fortnight, pain across loins and scanty high – coloured urine. Same, – pain extending to groins, with nausea and impaired appetite. Same, – pain running down on left side into hip, with dryness in mouth and throat, sight confused and dim, singing in ears.
Chest Chronic loud cough from stuffing at epigastrium, chiefly on waking in morning; he then has fit of coughing and expectoration of tough mucus, with tightness in head; dyspnoea; capricious appetite; in morning gnawing pain at epigastrium, with sensation it of emptiness and faintness. Dyspnoea, especially in morning, with cough and expectoration of tough mucus, with tightness in head; dyspnoea; capricious appetite; in morning gnawing pain at epigastrium, with sensation of emptiness and faintness. Dyspnoea, especially in morning, with cough and expectoration of white mucus “as tough as pitch” which could be drawn out into strings. Same, with yellowish green, yellowish or reddish mucus, with pain, or weight and soreness in chest. In 5 or 6 days after beginning work with the neutral chromate, epistaxis, coryza with violent headache, then suffocative attacks, with orthopnoea at night, which continued till he gave up the work. Intense dyspnoea and abundant sonorous rales in chest. Respiration impeded, with oppression and pain in sides, followed by cough and expectoration of indurated mucosities in large masses size of finger; in night frequent attacks of suffocative dyspnoea with no relief till these masses are expectorated.
Back and Limbs.
Bitter taste in morning, with aching at lower angle of scapula. Stabbing pain from 3rd cervical to 5th dorsal vertebra, striking forward through chest to sternum, increased on motion with inability to straighten spine after stooping, – previsioning him from working for six weeks; also constipation, with pains across loins, and heartburn in evening after tea. Violent tearing aching pains in one or both shoulders, worse at night. Rheumatic pains in hip, coming on at night. Same in right thigh. Same, with stiffness but no swelling, in knees, felt only in waling and not at night. Aching and jerking pains in, felt only in day in morning shooting and pricking pains in all limbs, he is stiff all over and can hardly move.
Eruptions papular, like measles, vesicular, but chiefly pustular. (Mat. Medorrhinum, Phys. and Applied, loc. cit.)
13. In March, 1857, I admitted into the Manchester Infirmary a man greatly emaciated, with hectic symptoms. Urine contained large quantity of pus; re – action was acid; contained no tube – casts or more albumen than pus accounted for. Patient stated that his water had been milky for more than a year, and that his health had been failing for same time; he attributed his complaint to the nature of his occupation, which was to manufacture bichromate of potash. He died 11 days after admission. P. M. – Thoracic and digestive organs were found perfectly healthy. When bladder was opened some injection of mucous membrane was found, but it was not thickened and viscus was not contracted. both ureters were dilated to about double their usual size and filled with pus. The renal pelvis and infundibula were enlarged and their lining membrane opaque and bathed in pus. Kidneys themselves presented very slight signs of disease; papillae were flattened and yellowish as if containing pus in their ducts, but rest of renal tissue appeared healthy. No foreign body was detected in either pelvis and path of urine was free throughout. (ROBERTS, Urinary Diseases, 2nd, ed., p. 452.)
14. M. M. Delpech and Hillariet report that the perforation of septum narium was found to be general among the workmen in France, though the men themselves were mostly unaware of it. The ulceration and loss of substance was preceded by headache, swelling of nose, sneezing, sharp pricking pains, copious discharge with frequent desire to blow the nose, expulsion of bloody membranous shreds, at times repeated epistaxis, at others thick grayish or black (the “clinkers”) With all this there was often no sore – throat or cough or affection of the general health; with the loss of substance there was little pain, the external form of the nose was unaltered and the voice was not nasal. The perforating ulcer is always almost exactly at the same point, viz 1.1/2 to 2 centimeters, above inferior border of sub – septum. It destroys upper septum as far as its articulation with vomer and ethmoid, while antero-inferior part is left quite intact. They think the action topical and caustic. (Ann. d’ Hygiene publique, 1829.)
15. Round ulcers with raised borders form on fingers and elsewhere. They begin with a sharp persistent pain, increasing rapidly, worse in cold of winter, when it even extorts cries; a slight excoriation first appears at painful spot, and in next and following day environment becomes red, thick, and swollen; then a central eschar forms which spreads in depth rather than circumference, and thus may penetrate to bone. Fully formed, they show at bottom and in middle a reddish, fleshy body, soft and spongy, isolated all round and attacked to bottom by narrow base. They discharge a sero – purulent fluid like that of fistulous openings. The borders become fallen in and smooth and partially cicatrized. Finally, the ulcers cicatrize from circumference to centre, leaving a depressed, dead – white scar. (Ibid.).
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.