different from that in panophthalmitis traumatica. In the latter the inferior part of the bulbar conjunctiva is much more swollen than the superior part, which really has very little swelling at first, being only well and fully injected, while in the cases after the use of cocaine, the superior part of the conjunctiva was as much swollen as the inferior. The whole oedematous condition of the bulbar conjunctiva was especially marked. Dr. K – suggests that this condition may be pathognomonic of the action of the cocaine in the inflammation which may occur in the reaction that takes place from the balanced condition of the vessels and tissues caused by its use. (Therapeutic Gazette, January, 1885).
Experiments on animals
When a frog has been poisoned with cocaine by hypodermic injection (about 1/10th gr. being used) the almost immediate result is to lessen the heat-beats to 10 or 12 per m. its action at the same time becoming irregular nd intermittent. If this dose be not exceeded, the animal may recover in a few hours, but if it be increased to 1/2 gr. the beats are lowered to 6 or 8 per minutes the heart becomes engorged with blood, and its action laboured and irregular; the rhythmical action of the auricle and ventricles is disturbed, and long pauses occur between the contractions of the ventricles. It is curious to observe that the ventricles are earlier and more severely affected than the auricles, and ultimately (if the dose be lethal) cease to pulsate before a similar effect has been produced on the latter. If applied locally to the hart carefully exposed, a drop or two of the 4 per cent. solution rapidly produces a cessation of the heart’s action, a similar application of salt water having no such effect, showing the result to be due to the drug and not to shock. Injected into a ventricle the same result is achieved even more rapidly and certainly. The heart is arrested in systole. Its influence on the respiratory system is rather less marked, but there is a decided stimulus at first with increased rapidity of respiratory movements, followed by slowing and ultimate arrest of function. If large doses be used, the period of increased action may be bent, and immediate slowing take place, resulting in arrest after a full inspiration. With reference to the nervous system, it appears in small doses to act as a stimulant to the spinal cord, increasing its reflex irritability. When larger doses are given this irritation may be absent, or at any rat much shortened, and there is almost immediate lessening of the irritability of the reflexes and finally loss of response to electrical stimulation. Small doses heighten the irritability of the sensory fibres of nerves without having any effect on the motor filaments. Large doses completely paralyse the sensory, and much diminish the sensitiveness of the motor filaments. Tactile reflexes are much diminished. The pneumogastrics are completely paralysed after even moderate doses, but their inhibitory fibres are not perceptibly affected by small doses. Applied locally to the nerve – trunks, after a transient period of increased irritability, the nerve becomes depressed and finally paralysed, and if the solution be strong this effect may be almost instantaneous. If the exposure of the nerve to the solution be not too protracted, its irritability will return after the lapse of a few hours. If a nerve-muscle preparation be made from a frog poisoned by cocaine, the irritability of the nerve is found to be much diminished (this is also rue of the muscle), and a stronger current is required to produce a contraction than in the normal frog. The muscular pulsations are shorter and less powerful, and it is impossible to produce tetanic contractions if the amount of the drug given be at all large. If the interrupted current be passed through the nerve for some time, there are caused several short, feeble, quick contractions and then nothing further. If the nerve from a nerve-muscle preparation be immersed for a few seconds in a solution of cocaine and then be removed is found that the irritability is very much increased. The slightest touch of a steel instrument throws the muscle into violent tetanic contractions. If the nerve be now again immersed, the irritability becomes very much diminished, and is finally lost to all forms of stimulations. The drug has, moreover, a marked action on the power of co-ordination, which is particularly noticeable after moderate doses of cocaine have but little effect when injected into voluntary (striated) muscles, but large dose diminish their excitability very decidedly, and the character of the muscular contraction called forth is greatly altered. The contractions are shorter, slower, and more feeble, and the muscular excitability is soon exhausted. The local action of cocaine on muscular tissue is very similar to that found in general poisoning. The general effect of cocaine would appear from the above observations to be twofold (apart from its local anaesthetic action on the skin, mucous membrane, and eye): in small doses it seems to act as a stimulant, but in larger doses the depressant effect which may follow even small doses is immediate and marked in its outset, and culminating in cessation of functions. This remark applies to its action on most of the organs. It also paralyses the vagi, and applied locally to any of the more highly constituted organs or tissues, causes a temporary cessation of their functional activity. (GUBB, Medical Press and Circular, March 11th, 1885.)
2. Dr. HERMANN M. BIGGE, of New York, has just completed an inquiry into the physiological action of cocaine on the common frog, and has arrived at conclusions which may be summed up as follows:
2 a. It has a powerful local anaesthetic action on the skin, mucus membrane, and the eye. It usually produces mydriasis.
2 b. It has a depressant action on the heart, reduces the force and frequency of its pulsations, and finally paralyses it (first the ventricle and then the auricle) in diastole.
2 c. In small doses it at first slightly increases the number of the respirations, then decreases them, and in large doses diminishes them rapidly from the first, finally causing death from a paralysis of respiration.
2 d. It at first slightly heightens and then greatly depresses the reflex action of the spinal cord in small doses. Large doses depress from the first.
2 e. Both large and small (not very small) doses have a depressant action on the motor nerves.
2 f. It paralyses the pneumogastric nerve.
2 g. Doses of moderate size diminish the excitability of the striated muscles.
2 h. The local application of cocaine to any of the more highly constituted organs or tissues causes a temporary cessation of their functional activity.
2 i. Form the local and constitutional action on the different organs and tissues, it is rendered probable that its general action is wholly a local one, exercised on all parts for which it has a chemical affinity, through its presence in the blood.
3. Dr. BOLDT, before the New York Pathological Society, reported that after the injection of 11 minims of a 33 per cent. solution into a cat weighing 7.1/2 1b., death took place in 12 m. First effect, leaping gait with dragging of extremities, followed by convulsions; between convulsions animal lay with limbs straightened, head turned up and backward. Cheyne – Stokes respiration; temperature in rectum after death 104 o. Autopsy showed vessels of the pia mater of both brain and cord intensely congested extravasation of blood into fourth ventricle and anterior part of medulla, and very minute extravasation all through substance of brain. Lungs collapsed. R. Ventricle of heart overdistended. Grey substance of cord over-filled with blood, resembling a bloody sponge. Death seemed to have taken plane through the respiratory centre. These experiments were made in the presence of Dr. Spitzka, Waldstein, and Brill. (N. Y. Medorrhinum Record, December 24th, 1885.).
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.