8 d. The functions of the kidneys are generally increased in activity, in a few cases morbidly so, in others they are diminished. In these instance either of increase or decrease of the urinary secretion, the urine is not changed, except that the iodide is present in it.
8 e. The circulation does not seem to be perceptibly affected by the use of this remedy. In some case when fever was present, this was relieved, sometimes even cured. The author does not consider that this was owing to the direct action of the iodide on the febrile symptoms, but that the disease of which the fever was only a symptom being relieved, it consequently ceased. In some cases which may be considered as exceptions the circulation was rendered more active, yet apparently not directly, but in consequence of the increased action in the digestive apparatus. With regard to the blood itself, its plasticity seemed to be diminished, thus predisposing to haemorrhages, which sometimes took place from the nos, lungs, and intestines.
8 f. Its action on the conjunctiva is already universally known. Considerable chemosis and great tumefaction of the eyelids were sometimes observed. The secretion is increased, yet with little or no tendency to suppuration. These effects are more frequently observed at the commencement of the employment of the remedy than when it has bean used for some time, and do not occur twice in the same individual.
8 g. All authors are agreed with regard to the increased secretion from the Schneiderian membrane. The bronchia were sometimes found to be affected. The symptoms were those of simple bronchitis; the expectoration ended, however, as it had begun, without ever becoming purulent.
8 h. The nervous system was affected in some few cases, particularly the brain. The excitement was similar to that produced by spirituous liquors; indeed, some authors have designated it iodic intoxication. In such instances the locomotive organs of many patients were attacked. Some had spasmodic cramps, slight subsultus tendinum. Guillon informed the author that a medical friend of his believed he had observed a double amaurosis in one man, whose wife, while using the drug, had been similarly affected.
8 i. The action of the medicine on the mucous membrane of the urethra appeared to be not less striking. Ill-cured gonorrhoea sometimes returned, others grew worse. The same phenomena were observed in the mucous membrane of the vagina and uterus. (RICORD, Bull. de Therap., xxiii, 161.)
9. a. If K. iod. is continued for a long time, or if the patient manifests great susceptibility to its action, we produce a condition termed “iodism. ” Many persons can take the drug in very large quantities for an almost indefinite time without the induction of iodism, while very small doses, even of a grain or part of a grain, produce it in others. The tissues most frequently and most severely influenced are the mucous covering of the eyes and lining of the nose, frontal sinus, and mouth, with the skin of the face. Some slight running at the nose is first noticed, with occasional sneezing, and a little frontal headache, these symptoms becoming more marked when the conjunctiva is injected, and the tears flow abundantly. The loose tissues about the orbit become swollen, redden, and oedematous; and occasionally peculiar rash appears on the skin of the face, at first noticed around the eyes, after which it attacks the nose and neighbouring parts, and then the chin. The parts in the order here stated are severely affected. The nose is sometimes reddened, especially a the tip, and is rather swollen. The rash does not always present the same appearance. It is often very much like acne, and is always hard, shotty, and indurated, but the papules may be broad and large, and covered with what looks like a half-developed vesicle or pustule. In the mouth there is redness and injection of the lining of the cheeks, of the throat, soft palate, and tongue, an increased growth and separation of the epithelium covering these parts, and an augmented flow of salvia.
9 b. With some persons the stomach is at the same time deranged, although in the author’s own experience this organ often escapes when the face is affected, and vice versa. When the stomach is singled out by the iodide, it induces nausea and a sensation of sinking at the epigastrium, with loss of appetite and sometimes watery diarrhoea. A grain or even less may thus affect the stomach.
9 c. K. iod. sometimes produces distressing depression of mind and body, rendering the patient irritable, listless, dejected, wretched, and unable to take moderate exercise without fatigue, and perhaps with a tendency to fainting. The appetite is generally very bad. These symptoms may arise from a very small dose, and may occur without coryza or irritation of the stomach. (RINGER, op. cit.)
10. Iodides are eliminated very rapidly by the kidneys, salivary glands, probably by all mucous membranes, and by the skin. during the process of elimination iodine is occasionally set free and causes local irritation. This is especially marked in the mucous membrane of the nose and in the skin, but it may occur also in the conjunctivae, bronchi, and stomach. The irritation of the nasal mucous membrane gives rise to the symptoms generally known as iodism. They consist of running at the nose, and frontal headache, which probably depends upon swelling of the mucous membrane lining the frontal sinuses. There is also frequently running of the eyes. Not unfrequently, the bronchial mucous membrane becoming congested, there is cough and pain in the chest. These symptoms are most readily produced by doses of 2-5 gr., and they may usually be arrested either by discontinuing the medicine or increasing the dose. When the dose is raised to 10 gr. the symptoms usually disappear, and I have only seen one case in which they persisted after the dose had been raised to 3 gr. In some persons the congestion is not confined to the nose, but extends to the back of the throat and to the larynx, so that serious symptoms of suffocation may follow. It sometimes gives rise not only to congestion of the bronchial mucous membrane and cough, but to haemoptysis, exudation into the pleural cavity, and even pneumonic consolidation. (BRUNTON, op. cit.)
11. Of the much-dreaded atrophic influence upon the generative organs a single example presents itself, in a case of cancer recorded by Mr. Nesse Hill (Ed. Medorrhinum and Surg. Journ., 1826, p. 282). In the space of 4 mo. a large carcinomatous ulcer of the breast had almost completely cicatrised under the use of K. iod. in the form of ointment, and taken in small quantities internally. By this time both mammae are stated to have completely disappeared. (COGSWELL, op. cit.)
12. About the year 1840 I treated a young woman with K. iod. for chronic rheumatism; but, the glands in the neck, enlarging, the medicine was omitted. Again in 1854 I gave th iodide to a young lady affected with amenorrhoea; after continuing the medicine for 3 weeks the glands in the neck suddenly enlarged, and that to a degree highly disfiguring. At least 2 mo. elapsed before the swelling showed the slightest symptoms of subsidence. (CARTWRIGHT, M. H.R., xii, 411.)
13. A man, aet. 62, vary bilious and from his youth affects with gout, got for sciatica 3ij of K. iod. in 3iv of water with directions to take, morning, and night, a tablespoonful. After about 8 dr. their came on an extremely rapidly growing swelling of the thyroid gland with some sensitiveness to the touch and feeling of oppression. He was, however, ordered to continue the medicine, and in the second week he got all the signs of endocarditis, oppression, weakness, almost amounting to fainting, tumultuous throbbing, intermitting and unequal beats of heart and pulse, tensive pain across chest. Anorexia and vomiting also set in. On omitting the medicine and taking merc., ars., and sepia, all these symptoms subsided. (GOULLON, A.h. Z., xlv, 63)
14. I took K iod. some time back for a rheumatic affection of the acromio-clavicular joint. I began with 3 gr. ter die. After 3 days 1 gr. per dose was added, and then another. On morning after the 5 gr. doses had been taken I awoke with uneasy feeling of left eye. I found edge of orbit at external part tender on pressure, and on inspection eyelids were found swollen and infiltrated on that side. The following morning the right side was similarly affected; the tenderness was evidently seated in the periosteum of the orbit and exclusively at the outer part. On 3rd day a strange sensation was felt, as of a pain extending from outer edge of one orbit to that of the other; and on this I discontinued medicine. (ROODS, Lancet, 1860, i, 479.) 15. A man, aet. 40, affected with contraction and callosity of bowels, took K. i by spoonfuls of a mixture of K. i. 3ssq. dist. 3vj, mucilag. 3j After each dose he felt in a few minutes a peculiar change in his system; congestion of head, vertigo, contraction of throat dryness of mouth, anxiety, constant oppression of chest, cough trembling of limbs and staggering as if drunk, so that he had to go to bed. After 1 hour all these symptoms went off. The pulse was tense, hard not quick. (HORST, Hufeland’s Journ., xcvi, pt. 4, 97; in Frank’s Mag., ii, 763.) 16. A lady, between 25 and 30, who in her childhood and first youth had taken with advantage iodic preparations- especially the Wildegg springs-for anorexia and a disposition to somnolence, being unable to procure this mineral water, replaced it by pilules each of which contained about 28 centigrammes of K. iod. On these she took 6 daily. The only iodic symptoms were, from time to time, salivation and nocturnal agitation. After taking the pilules for several weeks, s Madlle. X- was seized with violent gastralgia, which came on suddenly, and lasted several months, accompanied by palpitation and costiveness. The patient left Geneva for the south, and at first her health improved; but little by little the change of air lost its good effect; the anorexia and gastralgia reappeared; and the menses, which had previously been copious, were suppressed Madlle. X-, remembering that Iodium always revived her appetite, had brought with her the prescription for her pilules; but the druggist, being unable to decipher it, gave her tinct. of Iodium instead. The lady writes: -“I began to feel some effect on the brain; I was as if I had caught cold, had to use my handkerchief frequently, the saliva flowed freely, and there was a sort of contraction in the jaw, which made me clinch my teeth; the gums swelled and in the jaw, which made me clinch my teeth; the gums swallowed and inflamed, with a general sensation of toothache. There was great excitement of circulation, with violent determination to head and heart, and general trembling. The night was sleepless, but I craved food and digested it well, which I had not done for some time. Next day I wished to continue my medicine, diminishing somewhat the dose, but the same baleful effects flowed in the circulation and nervous system, the stomach only continuing better. I ate a little, and drank some lemonade to refresh my mouth, when I immediately felt a very sharp, though only transient, pain at the pit of the stomach. I wished to persevere with the treatment; but after 4 days I had to interrupt it, the blood being always in commotion, especially towards head and heart, gums always inflamed, face swollen, nervous tremor, sleeplessness. (RILLIET, op. cit.)
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.