18. In the larger medicinal doses the effects of Nux v. manifest themselves by a disordered state of the muscular system. A feeling of weight and weakness in the limbs, and increased sensibility to external impressions (of light, sound, touch, and variations of temperature), with depression of spirits and anxiety, are usually the precursory symptoms. The limbs tremble, and a slight rigidity or stiffness is experienced when an attempt is made to put the muscles into action. the patient experiences a difficulty in keeping the erect posture, and in walking, frequently staggers. If, when this effect is beginning to be observed, he be tapped suddenly on the ham while standing, a slight convulsive paroxysm is frequently brought on, so that he will have some difficulty to prevent himself from falling. I have often in this way been able to recognise the effects of Nux v. upon the muscular system, before the patient had experienced nay particular symptoms. if the use of the medicine be still persevered in, these effects increase in intensity, and the voluntary muscles are thrown into a convulsed state by very slight causes. Thus, when the patient inspired more deeply than usual, or attempts to walk, or even to turn in bed, a convulsive paroxysm is brought on. the sudden contact of external bodies also acts like an electric shock on the patient. The further employment of the drug increases the severity of the symptoms; the paroxysms now occur without the agency of any evident exciting cause, and affect him even while lying perfectly quiet and still in bed. the muscular fibres of the pharynx quiet and still in bed. The muscular fibres of the pharynx, larynx, oesophagus, and bladder also become affected; I am acquainted with two cases of paralysis, in which the use of Nux v. caused almost constant nocturnal erection. the pulse does not appear to be uniformly affected. Previous to the production of th affection of the muscles, various painful sensations are oftentimes experienced in the skin, which patients have compared to the creeping of insects (formication) or the passage of an electric shock; an occasionally an eruption makes its appearance. (PEREIRA, op. cit.)
19. The first effects of the drug are a drawing in the temples and nape, which patients call headache, but which they know to be quite different from any trouble of this kind they have hitherto experienced. The jaws are a little drawn, or after they become stiff, as if the play of the articulations were a little less free. It is not long before the stiffness invites all the muscles of the trunk and limbs. the patients cannot completely dilate the chest, and their great efforts at inspiration are cut short by a sort general muscular spasm. This stiffness, however, is not constant, or after it becomes aggravated at intervals. The spasms are often preceded by horripilation, accompanied by marked shivering; tingling then comes on along the course of the peripheral nerves, sometimes with painful sensations described as like the passage of electric sparks. The more marked these precursory phenomena the more severe the subsequent spasms. Other muscles, which are usually less under the control of the will, become affected; such are those of the pharynx and oesophagus, and the erectors of the penis, so that swallowing becomes difficult and nocturnal and diurnal erections trouble persons who have long lost their virile power. Women even experience increased sexual desire. The tinglings which have been mentioned are at first deep, but afterwards become superficial, and when all the spasmodic phenomena have passed off there sometimes remains an almost intolerable itching. The itching is of ten the first effect noticed; it occurs chiefly on the parts covered with hair. It is only later that the rest of the skin becomes involved. When the dose of Nux v. is a little larger, the electric shocks resemble a veritable tetanic convulsion, which though not dangerous is decidedly painful, and may be followed by such stiffness of the limbs that walking is impossible. When the shocks surprise the patient standing, he has difficulty in maintaining his equilibrium, and sometimes he falls; in some cases he is thrown as if from a spring and falls. the intellect is in no way affected; some swimming and ringing in the head and flashes before the eyes, and a certain nervous excitement like hysteria may appear, but they pass off as soon as the drug is discontinued. the symptoms do not all come on at once, nor do they all last equally long. rigidity is the first symptom, then the “electric sparks” then the shivering and the spasms. the tingling and itching only supervene after the drug has been given several days. When examined by means of the galvano – forceps it is found that the excitability of the muscles, motor nerves, and spinal cord is preserved, while that of the sensory nerves is abolished. In animals it has been found by experiment that strychnine has an elective action on the extensor muscles, the flexors remaining at rest, except a few fibrillary contractions. In healthy eyes strychnine does not increase the perception of colours in general, but augments the sensibility of the periphery of the retina for blue rays. The field of vision is temporarily enlarged and acuteness of vision increased, so that objects situated at the periphery of the visual field can be distinguished at a greater distance than usual. (TROUSSEAU et PIDOUX, op. cit., sub voce.).
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.