2b. 21st. -Awoke 5 a. m., light dreamy sleep after. On waking, sense of constriction at lower half of thorax, impending respiration, with subacute pain, increased by lying on r. side; continuous aching in l. lower molars. 10 a. m., took 3ss. Within 1 h. dull frontal headache; vital depression; heavy aching in cervical region; acute pain at apex of heart, not relieved by pressure, but driven by friction to l. subscapular region, then passing to mid-dorsal region, severe; continuous aching in left lower molars; return of acute pain at apex, with distress. Pulse regular, feeble, not altered as to rate; later, parched feeling in upper lip; severe aching in occiput, with cessation of cardiac pain; general oppression of brain; acute pain over l. temple; giddiness, with tendency to stagger to the r. 12, noon, persistent lumbar aching; dull oppressive headache. Pulse scarcely perceptible, 76 sitting, regular; 84 standing, irregular. 1 p. m., acute pain down right inguinal canal, partially relieved by upward pressure on external ring; occipital aching. Later, prickings, as if bitten by insects, in l. forearm, hypogastrium, r. leg, right forearm, back, and again in l. forearm; slight achings in r. leg, lumbar region, nape of neck and r. inguinal canal. Examiner’s report. -“Pulse extremely varying both as to time and volume, at first almost imperceptible, 76 to 86, sitting, not intermittent; cardiac pulsation much stronger than pulse indication would lead one to expect; no special murmurs.” N., slight achings; pulse 72, lying and sitting, regular; 84 to 88 standing, varying in volume. Urine shows but little trace of mucus, acid, sp. gr. 1010 fresh, 1014 on cooling. For several m. excessive flatulent rumblings on awaking. 22nd. – Awoke during n. with pressive aching down left inguinal canal, relieved by upward pressure on external ring, lasting several m. Before rising, intercostal pains, worse when lying on r. side, extending to apex of heart. During the day a double set of pains, from cold, and from the drug. The former chiefly affected upper teeth on l. side, decayed lower teeth, and head; the latter l. lower molars, sound teeth, and lower limbs. The pains from cold were relieved by aconite, port wine, and warmth, increased by cold air. The dental drug pains were not relieved by aconite, mercurius, or direct warmth. evening, feverish feeling (from cold), pain went from lower molars to lumbar region, then went rolling up spine like a ball, and settled in mid-dorsal region, chiefly to l. of spine; afterwards returned to l. lower molars; severe general headache, with giddiness. Pulse 72, lying and sitting, regular; 84 standing, regular; feeble; temp. 36:70 degree C. Urine scarcely clouded, acid, sp. gr. fresh 1015, on cooling 1019. Bowels acted twice, second motion half solid, with straining, half-slimy, gushing out. 23rd. -On awaking severe intercostal pains, both right and 1., with repeated acute darting pains at apex of heart, increased by lying on right side; severe aching down spine, somewhat relieved by friction, passing off after rising; exercise flatulence. During day, severe and continuous aching in left lower molars, sound teeth; frontal headache. During day severe irritation, like urticaria, on various parts. Before retiring, troublesome urticaria, especially affecting left forearm and right leg. 24th. -On waking, subacute pain in lower dorsal region to l. of spine. 2 p. m., acute darting from anterior superior angle of left parietal to malar bone, succeeded by sensation if brain were compressed, followed by long-continued irritation of scalp over line of pain. During day troublesome irritation (urticaria) especially of left forearm and right leg. (“I cannot say this irritation is a drug effect, as I have had slight urticaria on previous occasions, but its development follows the rule of preceding symptoms.”) First examiner’s report, 5 p. m.-“Impulse feeble, heart-sounds very weak, action irregular in force and rhythm, not intermittent, no murmurs. Pulse feeble, very compressible; 76 sitting, 80 standing.” evening, urticaria more troublesome, has extended to right forearm. Before retiring, frontal headache; slight aching to l. of lower dorsal region; irritation persists. Pulse feeble, compressible, 68 lying, 72 sitting, 76 to 82 standing, irregular in force and rhythm, not intermittent. Urine slightly clouded, acid, sp. gr. fresh 1004, on cooling 1006, free from albumen, phosphates, lithates, and sugar; microscope shows scattered mucus and epithelia cells, abundance of spermatozoa, and oxalate of lime crystals. Motion to-d. slimy of the peculiar shining dark brown, offensive, gushing out. 25th. -On waking, subacute pain in intercostal muscles, below 5th rib on each side, increased by lying on r. side. After rising, severe aching in l. lower molars, sound teeth, spreading to l. upper bicuspids, sound teeth, lasting several hours; succeeded by frontal headache, on the passing off of which increased mental and physical activity. evening, irritation has returned in l. forearm, r. leg, to l. of lower dorsal vertebrae, r. forearm, and l. leg. Pulse 68 sitting. Motion slimy, of a shining yellow colour, offensive. 26th. -Sleep has been dreamy. On waking, laboured cardiac action, excessive flatulence. Pulse 62 lying, feeble, less compressible. During day, urticaria. evening, marked cardiac depression, causing slight faintness on quickly ascending a few stairs, lasting 1/2 hours; returning later, on quietly ascending, with substance cardiac pain; cardiac action barely perceptible, pulse stronger than heart’s action would indicate, less compressible, not intermittent, 72 lying, sitting, and standing. Urine slightly turbid, free from deposit, acid, sp. gr., fresh and on cooling, 1010. Motion partly solid, natural, partly slimy, dark brown, offensive. 27th. -On waking intercostal pain; urticaria persists. 5 p. m., subacute pain over cardiac region with cardiac distress; slight aching in lower dorsal and lumbar region. Pulse compressible, irritable, varying greatly in force and rhythm, 74 to 76 sitting, 85 to 92 standing, with frequent intermissions. 7 p. m., acute pain in l. axilla, extending down edges of pectoral muscles to thorax, then passing to base of heart, then to apex; faintness with slight nausea when walking in open air; persistent giddiness, commencing when walking in open air, continuing after entering the house, while sitting; subacute pain down muscles of l. calf; sighing respiration; return of acute pain at apex of heart; trembling of hands; return of giddiness while sitting, with constriction; shooting pain through l. frontal eminence; constriction to l. of larynx; cardiac depression; continuous constriction of larynx; aching at superior curved line of occiput, an inch to l. of occipital protuberance, passing to corresponding spot on r. side; pulse less compressible, irregular, and intermittent. Symptoms lasted over 3 h. Pulse, on retiring, 72 sitting, 80 standing, regular, not intermittent. 28th. -Afternoon, severe general headache, lasting several hours; slight pains. 29th. -Severe fronto-occipital headache, from 3 to 7 p. m., succeeded by laboured cardiac action, then by cardiac depression, with faintness, lasting 2 hours; pulse at same time about 76, stronger than cardiac impulse indicates. 10 p. m., sharp darting pains through epididymis of l. testicle, several times repeated, passing to r. testicle, leaving dull achings, recurring till midnight; aching in l. inguinal canal. Bowels acted twice, motion more natural. 30th. -Before rising, spasms in right intercostals while lying on r. side. After rising, acute aching in l. testicle with occasional darting pains, changing to r., then again to 1. 11:30 a. m., acute extensive pain from l. kidney to l. inguinal canal, lasting several m. 12 noons, pains in l. testicle cause aching in l. inguinal canal, and extend to r. testicle, at times very severe; aching across lower dorsal region. 1:45 p. m., acute pain in intercostal muscles over base of heart, lasting several m. 3 p. m., slight return of headache. 5 p. m., acute pain down anterior muscles of right thigh, causing lameness, afterwards in both. evening, acute pains in testicles, first l., then r., then both, recurring and lasting whole evening, with aching in inguinal canals; cardiac depression, causing faintness; increased mental and physical activity. Oct. Ist. -Slight aching in various parts; general depression. Examiner’s report. – “Cardiac impulse very feeble, haemic murmur again distinct, no other murmur; pulse feeble, extremely compressible, irregular in force and rhythm, not intermittent, 72 to 80 sitting and standing, quickened by movement.” Urine clear acid sp. gr. 1018, free from albumen. Motions of past day have been of peculiar shining brown, offensive. 3rd. -1 p. m., aching in l. testicle, 1. hand, and right knee, while sitting; region, l. knee, and right forearm. Pulse 72 sitting, 78 standing, feeble, compressible; temp. 36:95 degree C.; resp. 30. During past 3 d., frontal headache, extending afterwards through to occiput, commencing about 3 p. m., and continuing 2 or 3 h., similar to that of 29th ult., but much less severe. Before retiring, severe pain in r. side thorax at insertion of pectoral muscles, becoming acute on inspiring deeply. 4th. -On awaking in m., return of pain right side thorax. evening, slight cardiac depression; headache recurred 3 p. m., and continued till 6 p. m. 5th. -Symptoms very slight; bowels acted twice, first part of each motion solid and natural, last part slimy, of the peculiar shining brown, but much less offensive. 6th. -4:30 p. m., recurrence of frontal headache, lasting till 6 p. m.; succeeded by cardiac depression, followed by cardiac oppression, with quickened pulse; giddiness, with strong tendency to stagger to r.; then neuralgic pain in r. supra-orbital region, and in l. testicle, with return of cardiac depression, depression, causing faintness and nausea, with subacute pains at apex and base of heart, passing off before 10 p. m. with eructations and yawnings (while out walking). Pulse 78 sitting, 88 standing, irregular in rhythm extremely compressible; resp. 23. Urine clear, acid, sp. gr. 1010. 10. -7:30 p. m., marked cardiac depression; pulse stronger than indicated by cardiac impulse, 66 lying, sitting, and standing, extremely irregular in force and rhythm; resp. oppressed, lasting till 9 p. m. During the past 5 d. faeces have been partly solid and natural, partly soft and of the peculiar shining brown, first part being passed with much straining, last part quite freely. 15th. -No special symptoms since last report. The faces are gradually assuming their natural since last report. The faces are gradually assuming their natural character. Cardiac action still rather depressed. First examiner’s report. – “Cardiac impulse feeble haemic murmur distinct on strong pressure, systolic sound not quite natural at apex, not amounting to a murmur, probably due to feeble action; pulse regular, very compressible, 76 sitting.” 10:30 p. m., pulse 68 sitting, 72 standing regular, compressible; temp. 36:40; resp. 20. Urine clear, acid, sp. gr. 1014. (Monthly Hom. Review, xvi, 737.).
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.