2. A lady had struck the left leg against a door, some ten years before, so that she could not lie upon it. Subsequently a hardness appeared on the place, which a quack treated with two caustic plasters. On the evening of May 7th he sprinkled upon the place 3ss of sublimate, with the direction not to remove the plaster before 4 a. m. Meanwhile the lady was attacked with such an intolerable pain that she walked the room as if crazy, and uttering loud screams. Up to the next evening there were added general cramps and convulsions of the hands and feet. 9th. – Retching and actual vomiting. 10 and 11th. – Swelling of the throat, m which increased in the n., so as to threaten suffocation. On the 12th Degner was called, and found her head and neck very much swollen; the tongue rigid and swollen; the throat so inflamed that it was only with difficulty she could speak or swallow; the teeth loose; the breath mercurial; on the leg a crust a hand’s breadth wide and twice as long; below the scab an open sore the same size; and about the affected locality a great inflammatory swelling. 13th. – With the rest, the throat continued so swollen that she could not swallow any fluid; besides heat in mouth and throat as from red – hot coals. 14th. – Having expectorated clots of blood, the patient pulled the membranes from the roof of the mouth with her fingers, causing so great a haemorrhage that Degner feared she might die, in consequence, that very d. The apothecary, on calling that evening, found roof of mouth, throat, and tongue so swollen that she could scarcely speak; in the fauces an ulcer the size of a pea, and on left side of soft palate a fissure; loose teeth and profuse salivation. 15th. – Condition the same; salivation profuse; diarrhoea, the excrement having the same odour as the mouth. Next day throat seemed less swollen externally, but face and cheeks were swollen as much, and hard. 17th and 18th. – the same pitiable condition. Pain in stomach; inclination to vomit; sleeplessness; bloody salivation; headache, especially about temples. The next day the patient complained greatly of slight delirium; she did not know what she was about. 20th. – Increased delirium; she could scarcely be moved any longer, and refused both medicine and nourishment on account of the pain in swallowing. The next day worse. Beside the daily expectoration of clotted blood and membranes from the mouth, weakness, which would not permit her to get up; constant salivation. 23rd. – No improvement. The next day swelling in right cheek was less, but not the hardness. In the n. of 24th to 25th a tooth fell out of itself. 25th. – Salivation less. Weakness and delirium increased. In m. pulse imperceptible; salivation less; she seemed to sleep a little, which had not been the case previously, wakening in a fright, and no longer complaining of pain. 27th. – No pulse. Great anxiety. At n. she wept bitterly, and her cries filled the house. 28th. – She died at 7 a. m., unconscious, with distortion of limbs. During the whole time there was no fever, and the urine was natural, with a white sediment. The surgeon who attended to the dressing of the limb said that not only were the cheeks, gums, palate, and throat ulcerated, but the maxillary bones were exposed also. Autopsy not permitted. (App. ad. vol. vi. Actea Nat. Curios., Norimb. 1742; p. 22.)
3. Two servant girls, who had had an inunction over the whole body of sublimate ointment for itch, got a vesicular erysipelatous inflammation of the skin, with vomiting, diarrhoea, and tenesmus; also ulceration of the buccal mucous membrane, without salivation. Both died in spite of medical treatment; the one after 4 1/2, the other after 6 days, having had formication of the extremities, but no convulsions or sensorial disturbance. In both corpses, the epidermis was found loosened in various places, the corium highly inflamed. Serous and mucous membranes of stomach and small intestine as well as the omentum were inflamed; the mucous membrane of larynx and trachea cinnabar – red and covered with reddish mucus. In the one who died first was found redness of the mucous coat of the bladder and ureter; intense hyperaemia of the kidneys; two purulent deposits in the region of the pelvis of the left kidney; congestion of the uterus and tubes, and in the vascular territory of the venae cavae, of the coronary veins and cerebral sinuses. In the other an inflamed place on the serous covering of the liver; bloody serous exudation in the pericardium and mediastinum; inflammation of endocardium and of endothelium of large arteries. Only in the kidneys of the first was M. chemically detected. (Canstatt’s Jahresb., 1864, B. 5, p. 106.)
4. A merchant from Liege, aet. 30, of strong constitution, who had never been sick, went to Paris on business. Aug. 6th, 1813, he got a slight diarrhoea, without known cause, which lasted 3 day and was cured with ipec. On the 13th, seeming to be fully recovered, he drank, about 3 p. m., from a glass without any mark upon it, containing a solution of sublimate in alcohol. The horrid taste disgusted him so that he broke the glass. An astringent feeling in the throat and frightful pains in the epigastric region were the first symptoms. The physician came at 3.50 p. m., and was told that the man had vomited much green, bitter, not bloody matter, and had had 3 stools. His conditions was as follows: – Dorsal decubitus; red, swollen face; very restless; sparkling eyes; contracted pupils; reddened conjunctiva; dry, cracked lips; rather moist, yellow – coated tongue; frightful pains in the entire alimentary canal, especially in the pharynx; abdomen distended, especially painful to pressure. The vomiting had ceased, but the diarrhoea continued. Pulse 112, regular, small, contracted; burning hot skin, especially on the forehead; respiration obstructed; infrequent and difficult micturition, urine red; perfect consciousness; inclination to sleep; occasional spasmodic movements in muscles of face, arms and legs; persistent cramps in all extremities. (White of egg water; 20 leeches to epigastrium; two cold, laxative clysters). About 5, decided improvement; he had taken all the drink (6 lbs.), vomiting profusely, and had had four stools. He got 4 lbs. of a decoction of linseed to drink. About 6, vomiting, cessation of cramps, pulse 100. About 9, very imperfect sleep. About midnight, in anus, bloody stools, severe pains in sigmoid flexure, pulse 115, small, contracted. (Ten leeches along descending colon; two clysters with laudanum.) Vomiting; 4 much less bloody stools; almost sudden cessation of pain; inclination to sleep. On 14th, about 8 a. m., less distension and less painfulness of abdomen; tongue moist; no inclination to vomiting or diarrhoea; pulse 96; skin less hot; cessation of cramps; consciousness perfect. Evening, pulse 106; extreme heat of skin without increased pains (narcotic clyster). On 15th, he felt much better; had slept part of the n. and wanted to eat. Tongue moist; pulse almost normal; great weakness; at evening the same condition. On m. of 16th, having slept well, he complained only of trifling, not persistent, pains in epigastrium; appetite good. On 17th and 18th, condition the same. On 21st, convalescence set in, and on 31st, he returned home quite cured. (ORFILA, Tox., sub voce.)
5. a. May 6th, 1825, about 11 p. m., a woman was found by the physician in the following condition: – She lay in bed with the limbs relaxed; skin cold and covered with sweat; face pale; eyes dull and heavy, with dark rings surrounding them; an expression of pain and horror, as one might feel who lives but to die. Whitish, contracted lips and tongue; great thirst; swallowing so difficult and painful that the least liquid caused contractions of oesophagus and stomach followed by vomiting of whitish, slimy, stringy, and subsequently green bilious matter. Pressure on the throat was painful; burning along whole oesophagus. Skin of abdomen cold; pain in epigastrium on slightest pressure. Diarrhoea, with intense urging and smarting. She complained of great burning and intolerable pains in stomach. Pulse slow, weak, thready, almost imperceptible. Respiration very slow. On the floor, in various places, lay patches of white slimy matter, seemingly vomit. Under a table in a corner there was a wet place strewn with a white powder, having the taste and look of sublimate. (White of egg water, 30 leeches to epigastrium, 20 to neck, and a large poultice to abdomen.) At 8 a. m. she could speak more easily; pulse fuller and skin warmer. Noon. – Depression greater; sensibility gone in lower half of body. She had had a cold sweat. About 5 p. m. she died, retaining her consciousness to the last. There was no trace of delirium observed at any time.
5b. Autopsy, 17 hours after death. – A very fat, large corpse. Rigor mortis very great; body cold; upper extremities semi – flexed, lower ones extended. No trace of ecchymosis in skin, connective tissue or muscles. Vessels of dura mater slightly injected. Arachnoid injected, especially on left side; some bloody serum in cerebral ventricles; brain substance slightly injected and firmer than natural. Tongue thick, with large papillae and glandulae mucosae, the latter almost as large as a small pea; inside of larynx violet – coloured and injected; on lower surface of epiglottis a gangrenous – looking spot. Trachea rose – red; bronchi and their ramifications still more manifestly inflamed; lungs crepitant and their substance reddish; 4 oz. of reddish serum in pleurae. Heart larger than normal; both sides enlarged; the walls thickened; the endocardium not reddened. Pharynx red; velum strongly injected; an ecchymosis on back of uvula; oesophagus almost normal, except in its lower third, where congestion begins, increasing toward stomach, which was small and thickened; its external surface brick – red; under the serous membrane a number of little ecchymoses, giving it a marbled appearance; its veins distended with air; its internal surface throughout blackish – red, especially on the folds formed by its contraction; its mucous membrane easily torn; contents greenish; between the folds a considerable number of whitish granules resembling sublimate or calomel in appearance. In the duodenum very much fainter traces of inflammation; it was filled with green bile. In the omentum many ecchymoses along both curvatures of stomach. In the other intestines nothing noteworthy, and only in the rectum some traces of congestion. In the pelvic cavity about 8 oz. of sanguinolent fluid. Liver spleen and kidneys normal. In the right ovary an ecchymosis an inch in size. Chemical examination of the powder found in the room discovered sublimate. Neither in the vomit nor in the contents of the stomach was there a trace of sublimate; but metallic mercury was demonstrated by various methods, a proof that the sublimate had combined with the albumen, milk, & c. (DEVERGIE, Arch. Gen. de Medorrhinum, ix, 463, 1825.)
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.