5 d. The eczematous form. – This is very rare, and appears especially on the hairy scalp, and in the neighborhood of the scrotum.
5 e. The petechial form. – Fournier describes this eruption, which he calls idiosme petechiae, as very rare. He saw the eruption, which has also been mentioned by Ricord (see II, 8, a), in the majority of cases during the first 3 days after the use of K. iod., more rarely from the 3rd to the 6th day. In some individuals it always appeared as soon as the drug was administrated, and in one case a new eruption occurred every time the dose was increased. It appeared exclusively on the legs (save once only on the trunk), more profusely on the extensor than on the flexor surfaces. It never attacked the knees or the feet. There are usually as many as 100 discrete patches on each leg. They are miliary, usually of pin-head size, rarely as large as a bean, and cause no general disturbances of any kind. The eruption usually reaches its height in 2-3 days, and lasts at most 2-3 weeks. (LEWIN, Opium cit.)
[ Fournier adds that all the subjects -15 in number – in whom he had observed the affection enjoyed either a flourishing or a medium condition of general health; and while all were syphilitic, two thirds of them were exempt from any specific manifestations of the disease at the time when the iodide, which was only administered as a preventive, produced the purpuric eruption. ” Iodic purpura” has also been observed in subjects of chronic rheumatism and of cancer-see Medorrhinum Times and Gaz., 1879, i, 280, 502, also following case. -EDS.]
6. a. It is well known that iod. of pot. occasionally produces a petechial rash, limited generally, as in the following case, to the legs. A case of this kind occurring in University College Hospital, it was considered a good opportunity to learn whether other iodides act in a similar manner and equal degree. The subject was a lad of 17, convalescent from acute rheumatism, and free from fever, to whom, from December 4th, K. i. was given for a few lingering pains in 10 gr. doses thrice daily. On 9th a petechial rash broke out on front and sides of legs and ankles. The spots were numerous, and varied in size from a pin’s head to a split pea. Neither on this nor on any subsequent occasion did any spots appear on any part of the body above the knees. Rather sharp blows over the shins did not bruise. The shins were a little tender. Slight coryza preceded the spots by a few day. The medicine was discontinued on morning of 10th, and by 15th spots disappeared. On 18th he began medicine again, and on morning of 20th rash reappeared more abundantly than at first, and coryza set in same evening. Similar results followed a third course, after temporary discontinuance of the drug.
6 b. On January 4th, 4 days after last disappearance of rash, iod. of ammonium was given in same doses. After 2 doses in 6.1/2 hours. petechial spots broke out on both legs. He took a 3rd dose, and then the medicine was discontinued and the spots disappeared on the 9th. He took later iod. of sodium in 10 gr. dose thrice daily for 4 days. without appearance of any petechiae or coryza. He then began iod. of ammonium. In 2 hours after 1st dose a few spots were visible on both legs, and next day they were more numerous and well marked. No other effects weave the petechiae and the coryza were produced by either iodide. (RINGER, Pract., viii, 129.)
7. Dr. WALLACE treated many syphilitics with K. i,., using (to adults) a mixture of 3ij to 3viij of water, a tablespoonful 4 times a day As incidental effects he noted the following.
7 a. “Its most common effect, by far, is an increase of appetite, combined with an increase of strength and of spirits.
7 b. “I have sometimes noticed this medicine to cause an increased secretion of saliva, sometimes an increased action of the bowels, and in some cases a remarkable increase of perspiration. I have also known the bowels to be constipated by its use. The most remarkable instance of salivation occurred in a child of 4.
7 c. ” An effect of this medicine which is not very uncommon, and is sometimes troublesome, is a state of throat which the patient calls sore-throat, saying he feels as if he had caught cold; or else a state of stomach described by the patient as like heartburn, along with which there exist sometimes other symptoms of indigestion, such as flatulency. In some cases there was great ingestion caused. I have also not unfrequently observed a state of irritation of the Schneiderian membrane, testified by a considerable discharge from one or both nares, and uneasiness extending along the nose to the forehead.
7 d. ” Sometimes patients, particularly delicate females, under the influence of the drug, lose the power of sleeping as much as is natural to them. A state of watchfulness, in fact, comes on, often accompanied by feelings in the head which are variously described by different persons. They are, however, seldom so severe as to deserve the name of headache.
7 e. ” On one occasion two females took, by mistake, double doses. There resulted in both sickness, soreness of throat, colicky pains, vomiting and purging to a slight degree, frequent pulse and exhaustion. In both these symptoms disappeared on the following day.
7 f. “Several patients, while under th full action of the drug, were attacked with an acute pain in the anterior and lower part of their left side, precisely in the centre of the supervises formed by the false ribs, accompanied by some cough and difficulty of breathing. All these patients were bled, and in all the blood was buffed and cupped. There was considerable pain, in one case with dry and brown tongue. In all cases this affection went off without much trouble.
7 g. ” In a patient, where the drug had already used indigestion, with remarkable acidity of stomach, soreness and constriction of pharynx, and emaciation, on resuming the remedy there gradually came on severe headache, rapid and quivering pulse, and a recurrence of the indigestion; also a peculiar state of the eyes, the pupils being dilated, and both globes in. state of incessant motion, as in a child with congenital cataract. He was quite unable to fix them on any object, and kept his hands constantly over them as if to shade them from he light, yet he said the light did not hurt them. He was very soon seized with symptoms of hemiplegia, this being preceded by muscular tremblings. He continued 2 or 3 weeks in an apparently hopeless state; the paralytic symptoms, however, then went off; he gained strength, his eyes lost their restless character, pulse became slower and stronger, and headache ceased. I think these symptoms were due to the drug, for they have some resemblance to those which occurred in certain cases where Lugol had given baths of l. dissolved in alcohol. Dr. Jahn, of Meiningen, has also related a case analogous in many respects, particularly in the quivering of the eyes. ” (Lancet, 1835-6, ii, 7.)
8. a The skin is unquestionably the tissue most readily impressed by K. iod. Nothing is more common than to see patients under its influence affected with divers eruptions, and more particularly with those of a psydracious character, resembling the pustules of acne, but more widely spread. There are, however, hardly any acute eruptions which may not be simulated by K. iod. One man may have an eczema, another a herpes, others simply an erythema, which in two recent cases has taken the form of e. Populosum in some parts of evening nodosum in others. In a case of cancer of the face, where the drug has been given in strong doses, we have seen it on several occasions develop an impetigo on the hairy scalp and a rupia like right cachectic on the legs and forearms, these symptoms subsiding as soon as the drug was discontinued but reappearing on its resumption. I have several times seen K. iod. give rise to a veritable purpura haemorrhagica. Several patient only experienced heat, pricking, and sometime a certain amount of itching.
8 b. The activity of the digestive functions is generally increased, as is also the appetite, hence embonpoint is frequently the result. In certain circumstances injurious effects are produced one of the most constant of which is pain in the greater curvature of the stomach. This is sometime very severe, without, however increasing the thirst, impairing the appetite, coating the tongue, or producing the least reaction of the circulation. The pain is not increased on pressure; it seems indeed, to be owing entirely to gastralgia. The appetite is sometime so enormously increased that it must be regarded as morbid. In some cases actual phlegmasia occurs, either of the stomach or of the alimentary canal; hence vomiting, diarrhoea, and all the symptoms of poisoning. It must be observed, however, that the most frequent action on the mucous membrane of the intestinal canal is a seromucous secretion. There is an analogous effect on the other mucous membranes.
8 c. The author has frequently observed ptyalism occur, which may even become as great as the most severe mercurial salvation; it generally, however, resembles that which occurs in pregnant women. The saliva is not very viscid. The mucous membrane of the mouth may be a little irritated, but inflammation and ulceration are never produced. The salivary gland are not swollen; the patient only complain that the saliva has a saltish taste, reassembling that of the drug. The breath has never a peculiar odour.
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.