17. A carpenter, aet. 30, received for right supra – orbital neuralgia pills of sublimate, which he took for 14 days, and then left the hospital. He had trembling of the limbs, especially when they were extended; heaviness of the extremities; trembling of the feet in walking. The trembling was worse on the left side, especially in the m. on rising, at evening with feverishness. Sense of coldness of the left side, worse after midnight, so that he could not get warm; towards evening icy coldness; cold chills in the sacral region, as if there were shot in there; sweat first in left axilla, then general, on waking from sleep in the n. (BUCHNER, A.h. Z., xxviii, 155.)
18. W -., registrar, received for a slight herpetic trouble sublimate pills, and took altogether 24 gr. The herpetic difficulty was cured, but the effects were frightful. He writes: “My teeth, previously sound, became loose, and six came out. A nasal discharge ensued, of the character of isinglass, drying to a strong hard mass, especially in the posterior choanae and frontal sinuses. Of this mucus, hard pieces, the size of a bean, frequently bloody, were discharged from the nose, at the same time there were often the most dreadful pains in the head. Respiration through the nose was maintained by snuffing water and tobacco. The cartilage of the nose was perforated, but the nose did not fall in; the sense of smell was lost entirely. No improvement from the regular use of water. Subsequently the discharge became more consistent and purulent; the teeth became affected again at the roots, manifested by a prickling pressure, and always ending by prominence in the sockets; profuse lachrymation in the open air. In the front of the head, especially on the right side, an unpleasant pressure, changed to a crampy pain by obstruction of the discharge. Sleep frequently only for an h.” Cure after discharge of a great portion of the necrosed upper jaw. (Ibid.)
19. A woman, aet. 29, contracted syphilis, for which she was treated by means of corrosive sublimate. Violent ptyalism took place, 4 lbs. of saliva being excreted in the 24 h. As this secretion diminished, diarrhoea appeared and increased. Soon after, the patient complained of anxiety and heat, with a fixed, obtuse, and deep – seated pain at the epigastrium; loss of appetite, nausea, tension of abdomen; great thirst and dryness of throat, and rapid pulse. These symptoms were aggravated when the stomach was full. During 5 days some amelioration was remarked, bilious vomiting supervened, and the pain and diarrhoea increased. The frequency of the calls to stool became remarkably great; a watery yellowish fluid, resembling saliva, being voided. The deep – seated plain above the umbilicus prevented the patient from lying on her back and left side, and was increased by a full inspiration. Some days of relief followed, after which a violent increase of fever appeared, with a return of the diarrhoea, an acute pain at the epigastrium, and orthopnoea. Blood – letting was prescribed. The following m. the parotids were hot and painful, the mouth was burning, the pulse small, and the stools were suppressed. Towards evening the breathing became stertorous, the anxiety extreme, the pulse thready and intermittent, the extremities cold, and the face hippocratic. She expired in the n. The pancreas was found red, swollen, and somewhat more consistent than natural. It weighted 8 oz., and the blood ran freely from it upon dividing it. The duct was dilated. The parotids also were inflamed. (COPLAND, Dict., sub voce Pancreas.)
20. In a man and woman who had taken sublimate for chancre, but were not salivated, there appeared inflammation of the right eye, which involved not only the posterior surface of the cornea, but also the serous covering of the iris. The pupil was angular; the eye very painful, as if too small; all the sensations aggravated in bed. (v. AMMON, Zeitsch. f. Ophth., i, 121.)
21a. LEWIN treated a large series of cases of syphilis with subcutaneous injection of corrosive sublimate. The smallest dose injected was 1/10 gr., the largest 3/8 gr. For experiment 3/4 gr. and 1 gr. were injected. Injection is followed either immediately or soon afterwards by more or less lively reactive redness diffused round injection point, with swelling coming apparently from the depths of subcutaneous tissue, and a more or less firm infiltration focus which remains as a hard swelling after the inflammation is gone. Very seldom an abscess is formed. Pain sometimes occurs after the injection, of a pretty severe character, or the puncture sometimes remains for a considerable time sensitive to pressure.
21b. It causes several forms of affection of mouth: 1. Slight inflammation (stomatitis), with swelling and tenderness of submaxillary glands. The stomatitis is characterised by hyperaemia of buccal m. m., of gums, and of mucosa of cheeks. Afterwards there is swelling, hyperaesthesia, tenderness of organs of mastication, and increased secretion of parotid and submaxillary glands. 2. Stomatitis ulcerosa diphtherica; ulceration of buccal m. m. with tendency to gangrene, covered with dirty yellow coating resembling the diphtheric membrane. This is particularly at the last tooth and at the fold at junction of the upper and lower jaw, which is liable to be bruised during mastication; on the cheek where it is exposed to pressure of teeth; and on the sides of the tongue. 3. Ptyalism without stomatitis. At beginning of treatment patients sometimes complained of falling out of hair. Perspiration, especially at n., was a frequent phenomenon. Some of the patients got a chlorotic colour of skin and m. m., and complained of debility. In some, 6 to 12 hours after injection, there appeared single spots on various parts of body the size of a pin’s head, and resembling ecchymosis, surrounded by a pale red areola. They appeared suddenly, and went off gradually with desquamation of epidermis. the lymphatic glands of pharynx and of submaxillary region are apt to become affected in cold weather. The patients complain of sore – throat, particularly when swallowing, the tonsils are swollen and red, and there are sometimes swollen and sensitive glands in the region of the angle of the lower jaw. Very seldom is there mercurial tremor or erethism. 21c. If the injection cure is pushed too far it may cause a state resembling malignant gastro – enteritis. This commences with gastric symptoms such as anorexia, loaded tongue, bad taste, which is sometimes described as metallic, rarely nausea or vomiting. After some time in stomach a burning, increasing to pain and most felt on pressure. Later diarrhoea, sometimes the stools tinged with blood. Sleep at n. disturbed by anxious starting. Face pale, conjunctiva especially pale, eyes dull, countenance looks suffering. Great weakness, must sit down after walking a few steps. Urine often increased, and its sp. gr. diminished, pale yellow colour. Pulse contracted, quick, 90 to 100, and on exertion 130. Attacks of sickness and vertigo were common. Vertigo even in bed, faintness and coma. Then the pulse would sink to 68. Skin sometimes covered with sticky sweat. The gastric symptoms sometimes increased, then there came vomiting and dysenteric bloody stools with tenesmus. (G. LEWIN, Die Behandlung der Syphilis mit subcutaner Sublimat Injection, 1869.)
25. Dr. MULLER, of Berne, described a case of hysterectomy for carcinoma uteri, in which a 1 in 1000 solution of the perchloride had been used for disinfection of operator’s hand, a 1 in 2000 solution for the sponges, and a 1 in 4000 solution for washing the wound. Two day after the operation the patient was seized with diarrhoea and albuminuria, the stools were mixed with blood, and the quantity of urine passed was very small. Death ensued on the 3rd day, and the postmortem revealed the existence of ulceration in the colon. There was no nephritis. (Lond. Medorrhinum Record, p. 118,1886.)
26. Dr. BUTTE summarises as follows the effects of corrosive sublimate solution used as antiseptic injections. Some hours after the injection, sometimes only on the following day, diarrhoea supervenes, with tenesmus, the motions soon becoming slimy, stained with blood, and exceedingly offensive. The rectal pain is marked, and severe colicky pains are complained of in the abdomen. Nausea and vomiting are often present. Salivation is generally absent, at any rate for some day, but stomatitis may occur. There is great dryness of mouth and throat, with intolerable thirst. The quantity of urine excreted is most frequently diminished, sometimes to the extent of anuria, and it contains more or less albumen with epithelial cells and casts. The pulse becomes small and rapid; the temperature is probably only affected secondarily to the enteritis. [ Mr. S.Snell relates (Pract., 1882, i.180) the case of woman, aet. 41 in whom a drachm dose of lig. hydrarg. perchlor. immediately caused vomiting and a temperature of 104o. Under 2 grs. of hyd. c cret. the temperature rose to 101.8o, accompanied with vomiting, & c, as before.] The patients generally complain of intense headache, with much prostration, which may amount to collapse. Erythematous eruptions on the skin of vulva, thighs, face, arms, and trunk are often noticed, or the skin may become dry and irritable. Certain patients appear to be abnormally amenable to the toxic influence of the sublimate, especially cachectic and debilitated subjects. The post – mortem appearances comprise injection of the lower part of the small intestines, while in the large intestines the mucous membrane is extremely hyperaemic, and is necrosed in patches and often covered with a diphtheritic exudation. The kidneys are enlarged and pale in colour; examined microscopically the canaliculi are blocked by deposits of oxalate of lime, and there are sign of parenchymatous inflammation. (Ibid., p. 266.)
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.