12a. March 14th, 1848, at 6 p. m., I was called to a young man aet. 21, who had taken poison at 10 a. m. When I saw him he was in a condition of extreme exhaustion, and confessed having taken over a drachm of sublimate, which he had obtained ostensibly for use in his business as a jeweller. He had eaten nothing since 6 p. m. the day before. He looked pale and anxious; surface, especially of the extremities, cold; pulse almost imperceptible; tongue very dry. No injury to the buccal mucous membrane could be discovered. The vomiting began a few m. after the poison was taken and continued almost incessantly. The vomit was a white froth with considerable blood, covering the floor for some distance about his bed. He had also had a profuse, firm, natural – looking stool. He complained greatly of pain in the gastric region, not aggravated by pressure however. On account of the incessant vomiting, as well as from fear of greater injury, the stomach – pump was not used. He was immediately given the whites of four eggs in water, and ordered the same very hours 15th, 8 a. m. – N. sleepless. He complained much of abdominal pain, especially in the gastric region, increased by pressure. He had had three stools, which, contrary to strict orders, the servant had thrown out. She said they were dark fluid. He had vomited three or four times the same bloody froth as before. The pulse had risen to 80, but was still very small and weak, with frequent intermissions. Tongue red and dry, papillae elevated, like a ripe strawberry. (Laudanum with syr. aurant.) About 10 p. m. pulse 100 and stronger, with fewer intermissions; the skin warmer; the pain less; neither vomiting nor stool the whole day 16th, 8 a. m. – No sleep. He complained of considerable pain and tension; neither vomiting nor stool in the n,; pulse 100, strong, regular; tongue still unnaturally red, with elevated papillae. (Castor oil.) About 9 p. m. I learned that he had slept 3 h. After the oil he vomited about a quart of very acrid stuff, looking like port wine dregs, with great relief. Pulse 100, regular, strong; skin generally warm; he had scarcely any pain; no vomiting since m. Tongue less red and somewhat moist on the edges. The young man and his friends were very sanguine in their hopes, and in fact all the symptoms were improved. 17th. – N. sleepless again with very little pain. Two fluid stools with considerable blood; no vomiting; pulse quite regular, moderately strong. Tongue had become pale and moist; scarcely any pain in abdomen even to hard pressure. His countenance, however,, did not correspond with these apparently favorable symptoms. It had an anxious expression and was extraordinarily pale, with blue about the lips and alae nasi. I now observed for the first time that the breathing was pretty difficult, and immediate auscultation showed the smaller bronchi filled with mucus. No pain in deep breathing. He had complained of dyspnoea 2 hours before my visit. He said he felt a constriction and pressure on the chest. (Blister to the chest.) At my next visit, about 1 o’clock, I found the breathing loud and rattling. He had no pain, but was evidently in extremis; as during the whole illness the intelligence was undisturbed. Within 24 hours he had passed no urine. For food during his illness he had received white of egg, oatmeal gruel, arrowroot with broiled meat and water. Death about 2:30 p. m. 12b. Autopsy, same evening about 8. – Mucous membrane of mouth and oesophagus entirely normal, the chief action being visible in the stomach, whose mucous and muscular coats from the cardia out for a distance of 3 1/2 in. were changed to a gangrenous mass, having a corroded torn aspect and a dark brown, almost black colour. The mucous membrane for a considerable distance about this gangrenous portion was brown red, but the pyloric half of the stomach, with the exception of some little red spots, was quite normal. In the duodenum and the rest of the intestinal canal nothing abnormal was perceived, except a slight congestion of some of the valvulae conniventes in the jejunum and ileum. The bladder contained about half an ounce of urine. Cavities of heart empty. Blood did not seem to be coagulated. Lungs crepitant throughout. The entire respiratory mucous membrane in larynx, trachea and bronchi as far as could be seen in a condition of intense congestion and varied from dark red to purple. The smaller bronchiae were filled with a frothy, bloody fluid. As no disturbance of the cerebral functions had occurred the brain was not examined. (WADE, London Medorrhinum Gazette, 1848.)
13. A man, aet. 27, took with suicidal intent, 60 to 70 gr. of sublimate dissolved in water, and came into hospital May 24 th. Soon after taking the poison he observed a strong metallic taste in the mouth, with a peculiar smell, then desire to vomit and soon afterwards vomiting, with a sense of constriction in the throat and trembling of the feet. In stomach and oesophagus he had no severe pains whatever. The vomiting brought up first food, then serum, and ceased some hours later after a physician who was called in had given an emetic. Soon after that he was brought to the hospital, where milk and white of egg in water was prescribed. The next day the feeling of constriction in the throat changed to a severe pain, with an unpleasant tickling, coming paroxysmally and lasting only a few seconds, during which a convulsive cough with great anxiety appeared. The cough was a throat cough, i.e like the cough occasioned by putting the finger in the throat. During these paroxysms of coughing, repeated at short intervals, expectoration of a bloody mucus and feeling of suffocating with extreme anxiety. Evidences of enteritis, severe colic, tenesmus and frequent loose stools (at least twenty in 24 hours) of a slimy liquid, with considerable blood. Stool very painful, so that he had to cry out. 26th. – Gums swollen, and all the signs of a severe mercurial stomatitis, of which, for the sake of brevity, we mention here only a considerable swelling of tongue, cheeks, velum, uvula and pharynx; upon the latter, grey soft pseudo – membranous masses are formed. Some stupor and disturbed intellect. Pulse 86. 30th. – Pulse 72. He suffers less, but there is still blood in all the stools, which, however, are not so frequent. June 2nd. – The inflammation of mouth diminished and circumscribed; the grey membranes begin to come off. Swallowing still painful; face pale; only slight traces of blood in stools. 4th. – No more bloody stools. Pulse 84. He is better generally, getting up and walking in the garden. For some day he had been taking a solution of chlorate of potash. 5th and 6th. – Condition the same, except increasing weakness. 7th. – Pulse 88. Extreme weakness and very pale colour. Stools, coming after eating, of yellowish fluid, without blood. P. m., numerous, reddish – grey, round, ecchymotic spots, not disappearing on pressure, made their appearance over body and limbs, especially on the lumbar region. Urine dark brown, albuminous. Surface very pale. Blowing with first sound of heart, heard at base. Hiccough with every movement of the body. 9th. – Death, without convulsions or agony. (Monit, des sciences med., 1859.) 14. A gentleman, aet. 50, took over a drachm of sublimate in a quantity of water Feb. 27th at 8 a. m., and immediately began to hawk and complain of constriction with burning in the throat and dysphagia. (Oil, and zinci sulph. 3ss.) After 2 h. Blacklock found him hawking, discharging always a mouthful of mucus and blood, and having just passed a bloody stool, preceded by two natural ones ascribed to aloes taken the previous e. Pulse 120. Tongue white and moist; very disquieting hiccough. Thus the whole d. Toward evening hawking and dysphagia less frequent and severe. Face a little puffed. 28th. – Frequent and copious bilious vomiting and purging; a regular cholera. Pulse over 100 and weak. Face puffed and fuller than usual. Thirst so intense that every 2 or 3 m., in spite of the pain in swallowing, he called for milk. Very disquieting hiccough. Ischuria, even with the stools, since the poisoning, and no desire to urinate. Neither fulness nor pain the abdomen except in the scrobiculus, where slight pressure causes pain. March 1st. – Continued vomiting of bile and occasionally curdled milk. Diarrhoea stopped. Complains of burning in oesophagus and return; numbness and loss of feeling in extremities. Pharynx dark red, painful to external pressure. Pulse 100, soft and weak. Inclination to sleep, which is disturbed by the hiccough; continued ischuria. Abdomen soft and compressible, and not painful to pressure except in the scrobiculus. 2nd. – As yesterday; a natural, though scanty stool. 3rd. – Burning in oesophagus and rectum, thirst, dysphagia, and continued suppression of urine. Less frequent hawking. Bilious discharges up and down. Occasional sleep in spite of the hiccough recurring regularly 26 times a m. Face puffed. Pulse 100, soft and weak. Tongue white and moist. 4th. – Breath offensive, but the mouth not at all painful, and no salivation. Stiffness of the arms added to that of the legs, in lesser degree however. Urine still suppressed. 5th. – Pulse almost imperceptible at wrist. Complains of dyspnoea, and desires to be raised up in the bed; continued hiccough. Vomits now and then a little bile, cannot swallow. Death about noon. Autopsy not permitted. (Edinb. Medorrhinum Journ., vol. xxxvi, 1831.)
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.