15a. J. W -, a strong man, aet. 38, took, Feb. 10th, 1843, at 10 a. m., 2 dr. of sublimate in coarse pieces which he chewed and swallowed, and afterward drank about a pint of water. Soon after that a doctor gave him 4 eggs. He vomited, and a piece of sublimate half as large as a nut was found in the chamber, which, it was supposed, had not been swallowed. Brought into the hospital soon after, he exhibited great prostration, cold extremities, natural respiration, pulse almost imperceptible, tongue and lips swollen. He was sensible, and complained of constriction in oesophagus. He got the whites of 4 eggs. 2 p. m., increased swelling of lips and gums. Beginning salivation; pain along oesophagus to stomach, causing intense dysphagia. Yellow masses with blood had been expelled by several paroxysms of vomiting. Some pain in abdomen; cramp in lower extremities; pulse small and weak; tongue white and almost filling cavity of mouth; skin somewhat warmer. (About 2 pints of milk and the whites of 24 eggs.) 11th. – Violent hiccough during night; great pints in stomach on pressure; swallowing more difficult; headache; several evacuations up and down, the latter of a green colour. Feet very cold; the entire skin yellow. 12. – Skin still very yellow; pulse much contracted; swelling of lips diminished. Evacuation, upward greenish, downward dark coloured, mixed with blood. Stomach region very painful; swallowing still difficult, extremities warm. 13th. – Swallowing goes better, but there is still a burning in the oesophagus. Pulse like yesterday. Has passed no urine since his admission. Very little sleep last n. Hiccough continues. Pupils contracted. Extremities cold. Several stools, streaked with blood, one or two consisting entirely of blood and mucus. Tongue cannot be protruded for swelling. 4 p. m., some delirium, increasing up to evening 14th. – 6 a. m., breathing stertorous; facial muscles paralysed; toward noon he seemed to have a great constriction of oesophagus. The ability to speak was lost, and gradually consciousness also. Since last evening no stool, and no urine till death at 3 p. m.
15b. Autopsy, 22 hours after death. – Body rigid throughout. No signs of decomposition (atmosphere cold and dry). Peritoneum healthy, containing about an ounce of bright yellow fluid. Inside the stomach, about 4 inches from the pylorus on the greater curvature, an inflamed place the size of the palm of the hand. The mucous membrane was very injected with red blood, and showed throughout signs of inflammation. Of the slate – grey colour sometimes seen after sublimate poisoning, there was nothing, nor any appearance of erosion or ulceration. Duodenum and jejunum healthy. In the lower two thirds of the ileum there was slight inflammation of the mucous membrane, which from the caecum on was more considerable, with at last many small ulcers. Liver large and full of blood; gall – bladder contracted, almost entirely empty. Spleen normal as to size, full of blood, its peritoneal covering thin and adherent healthy. Kidneys of normal consistence, the cortex showing many little red points, especially between the infundibula, apparently from incipient inflammation. On the back of the right kidney was a cyst the size of a marble, filled with clear fluid. Bladder very much contracted, containing about 1/2 oz. of turbid urine. Mucous membrane of oesophagus showed in inflammatory redness, but was otherwise normal. Old pleuritic adhesions in chest; lung – substance oedematous, rather firm and doughy; at base of right lung inflammatory oedema. Bronchial mucous membrane universally inflamed, and tubes full of frothy mucus. l Bronchial glands slightly enlarged. Pericardium contained 3vj of clear yellow fluid. Heart seemed healthy, only somewhat smaller than natural. Cranium not opened. (TAYLOR, Poisons, 1st ed.)
16. A fifteen – year old student, on May 15th, 1874, took and swallowed a portion of a powder containing 2 scruples of sublimate, which had been prescribed for his father for external use. As he at once felt a severe burning, he threw away the remainder. After 5 m. repeated vomiting set in. he drank much milk afterwards, and again vomited, throwing up food which he had eaten for dinner. The violent pains in throat and stomach and constant retching drove him from the garden, where all this happened, to his room, saying that he was unwell, presumably from his dinner. After 2 hours diarrhoea every hour, lasting entire n. and next forenoon. The pains and weakness increased continually, and at non he confessed to his mother that he had taken some of the powder. Condition after 20 h.: Powerful muscular body. Temp. 100.4 degree; resp. 22. Thoracic – diaphragmatic breathing; pulse 108, Skin dry; face red; pupils alike, reacting well. The inner surface of the lower lip, the region of the frenum, base of the tongue, and velum, especially on right side, covered with a grey – white, firmly adherent crust; mortified mucous membrane. Organs of respiration and circulation normal, as also liver and spleen. Abdomen not enlarged, but very resistant. He complains of pains in the mouth, throat, and stomach; the latter sensitive to pressure, as also the region of the sigmoid flexure. The evacuations are painless, consisting of a soft but formed, pulpy mass, light grey, with red streaks in it in considerable quantity, with much liquid. He said he had passed no urine since yesterday evening, that the fluid came exclusively from the rectum. He was perfectly quiet. No appetite; no thirst. (Magn. hyd. in water. Milk, white of 2 eggs.) 16th. – Till midnight he was very uneasy and had frequent stools, afterwards slept well. About 5 a. m., stool of a granular, sulphur – coloured mass. No urine in spite of much straining, the bladder being actually empty. 5 p. m., no evacuation since m.; urged to attempt to urinate, he passed, after much straining, some thick milky drops. Temp. 99.68 degree; resp. 20 pulse 76. Pains in stomach have ceased, but it is still sensitive to pressure. Kidney region not sensitive to deepest, hardest pressure. Since m. he has taken emuls. ol. c. tinct. opii. 17th. – He says he feels very well; has appetite, but swallows with difficulty. Temp. 98.32 degree; resp. 16; pulse 76. No pain at all. For more than 30 hours no evacuation, no vomiting. Not a drop of urine. At n. he had formication all over body. About 4 p. m., copious, normal – looking, pappy evacuation, containing two living lumbrici. Feels well, appetite good, no thirst, no urine. 18th. – Frequent, black, loose stools after midnight. Urinary secretion has begun. Feeling of pressure in gastric region. Temp. 98.24 degree; resp. 18; pulse 76. Abdomen flat. Crusts begin to come off in pieces from mouth and throat. At noon he ate some milk – food with relish. At 5 p. m. a spinach – green evacuation, followed by severe pains in stomach. Cold fomentations to stomach. 19th. – Slept well. In m. two spinach – green evacuations and each time urinated. Itching in whole skin, which is quite dry, Severe pains in stomach region, which is somewhat full; the percussion tone being very muffled. – tympanitic. Apparently there was a haemorrhage into the stomach. Swallowing very difficult. Extreme weakness. Temp. 96.44 degree; resp. 18; pulse 76. 20th. – During n. several dark green, very tenacious stools. Urine steadily increasing in quantity, containing some albumen. Skin dry. Restless. Hiccough now and then. Pains in stomach less. 21st. – N. very restless, no sleep. Hiccough is much more frequent. Burning in chest and abdomen. Crusts have mostly come off from mouth; places thus denuded of epithelium appear as extensive, rather depressed spots sprinkled with coarse red grains. No stool. Urine normal is quantity, containing some albumen. Pains in mouth, and in swallowing; some pains in stomach. (Morphine.) 22nd. – Very little sleep. Much plagued by the very frequent hiccough, so that he cannot eat and can hardly speak. Temp. 93.92 degree; resp. 18 pulse 76. Pure blood flows from anus. Very troublesome itching in skin. Burning in intestines; great depression. Evening, the great increase of heart’s action since m. is very remarkable; there is no enlargement demonstrable. The heart’s impulse is very extended, visible at a distance, and so strong that the whole thorax and both hypochondria, especially left, from stomach to navel are vehemently jarred by it. Beats 76; tone metallic – sounding, but clear. Singultus ceased at e. Very considerable difficulty in swallowing. Temp. 92.12 degree; resp. 18. 23rd. – Considerable sleep during n. Early in m. an evacuation consisting of hard feculent masses in bloody fluid. Urine normal in quantity, containing but a trace of albumen. Hiccough entirely stopped; restless. Temp. 98.24 degree; l resp. 20; pulse 108, small. Heart’s action strong as yesterday. evening, has taken no food today. Face pale, collapsed. Consciousness no longer quite clear. Abdomen flat. Two coffee – ground evacuations. Cold fomentations to abdomen. 24th. – He has groaned whole n. through. Before midnight a black – green, very copious evacuation, followed by involuntary urination and passage of blood peranum. Below navel to the right a hard swelling, the size of a lemon, very painful (extravasated blood); percussion tone over it dull. Restless. (Morphine.) Soon afterward he slept. Temp. 100.04 degree; resp. 14, very deep with long – drawn inspiration; pulse 112, small. Toward evening dullness to right of navel very much increased in extent, apparently also flattened out. Unconscious, very restless, frequent groaning. Skin dry. Thermometer could not be applied, but temperature was seemingly higher than normal. The expired air smells very plainly like spoiled meat. Heart’s impulse still very strong and extended, but no more on the whole than yesterday or this m. At same time pulse became steadily more rapid and smaller, and later was imperceptible in the radial, while heart’s impulse was still vigorous. Blood flows from rectum. Jactitations became less frequent and weaker. Death before midnight. Autopsy neither desired nor permitted. (LOWY, Wiener med. Presse, 1874, NO. 34.)
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.