15. a. E. M -, aet. 35, was admitted May 26th, 1835. About 17 years before she began to suffer from a pain in the right iliac region, for which a medical man ordered her to take 10 dr. of laudanum n. and m. This was gradually increased, the pain continuing, until at last she took 3 teaspoonfuls every 4 hours n. and d. At first the 10 dr. relieved the pain, but it was found necessary to increase the dose to produce the same effect, so that the 3 teaspoonfuls at last did not produce so much relief as did the 10 dr. at first. As the dose was increased, she found it produce a very comfortable condition of the mind. She felt likely and cheerful, and capable of doing any amount of work; it also produced a sense of warmth over the whole body. She had severe family afflictions, but was not at all distressed by them while under the influence of O., though she felt them severely at other times. If she passed over the usual time for taking a dose, she felt the most distressing sensations about the joints, not of pain, but such as she was unable to describe. She suffered from involuntary motions of the arms, fingers, and toes; numbness in the limbs and body generally; profuse perspiration; nausea, vomiting, and loss of appetite; saline taste of the saliva and bad taste in mouth; tremor in limbs; great sense of debility and lassitude. Memory and mental powers generally became greatly impaired, attended by a miserable depression of spirits. These symptoms were all relieved by a repetition of the dose. The O. also produced constipation, – not more than one motion occurring in a week, and she does not recollect whether even this was produced by medicine or not. If the dose was deferred, she always suffered from severe headache; her sense of smell was so much impaired that she could perceive no pungency in snuff; her taste was so much lost that she could not distinguish pepper or mustard; and her hearing had become so defective that she could hardly detect the voice of anyone who spoke, yet her own voice sounded most disagreeably loud to her; her touch was so much affected that she could not execute any needlework. The acuteness of all her senses were restored by the usual dose, the want of which was attended by flushing and heat of the face. During the period of taking the O. she had very little sleep, and in the intervals she could not attempt to sleep for want of the desire, so that she generally worked all n. What sleep she had was generally in the daytime, and that little was much confused, and easily ended.
b. About 5 or 6 years ago, her resources being exhausted, she obtained admission into the hospital. Her laudanum was here left off for the first 3 day, and all the above symptoms continued; she now, for the first time, began to see frightful animals and other objects in the ward. The symptoms were again relieved by her usual doses. The laudanum was decreased during the whole time, and when she left the hospital she took only a teaspoonful in the course of the d. On returning home, and being dependent on her friends, he was obliged to discontinue the laudanum and wine, and was even unable to get beer. She was now more miserable than before, all the symptoms returning with increased severity, and for the first 6 mos. she was almost entirely helpless. She was then first affected with pain in her chest and a cough, which has continued ever since. She was 12 mos. at home before the above distressing symptoms disappeared. The only consequences of her opium eating at present are a much impaired taste, numbness of the limbs, coldness of the feet, inability to walk far without aching pains in the limbs, and a general sense of lassitude. (TAYLOR, op. cit., p. 589.)
16. The habitual opium eater (in Turkey) is readily recognised by his appearance. A total attenuation of body, a withered yellow countenance, a lame gait, a bending of the spine, frequently to such a degree as to cause the body to assume a circular form, and glassy deep – sunken eyes, betray him at the first glance. The digestive organs are in the highest degree disturbed; the sufferer eats scarcely anything, and has hardly one evacuation in a week; his mental and bodily powers are destroyed. As the habit becomes more confirmed, his strength continues decreasing; the craving for the stimulus becomes greater, and, in order to produce the desired effect, the dose must be constantly augmented. After long indulgence, the opium – eater becomes subject to neuralgic pains, to which O. itself brings no relief. These persons seldom attain the age of 40 if they have begun to use O. early. (OPPENHEIM, quoted in Ibid.)
17. A gentleman of a very haggard, sallow, gloomy appearance, and trembling all over, entered a druggist’s shop and asked for an ounce of laudanum, which was properly refused without medical sanction. He then asked to be shown how much an ounce was; and when it stood before him, measured in a graduated glass, he seized it from the counter, and eagerly swallowed it. The druggist was struck powerless. The gentleman, seeing his great alarm, assured him it was needless, as he had been a long time an opium – eater, and took twice daily as much as he had now drunk. He remained for 1/2 hours in conversation with the druggist, who was surprised to observe the wonderful change which so short a period had made in his visitor, whose manner became animated, at the same time that his face became plump and suffused with a pleasing blush. (KIBBY, quoted in Ibid.)
18. MADDEN, having witnessed O. eating in Turkey (which he described as do others), tried it himself, taking 4 gr. in divided doses, and thus relates his sensations: – “My faculties appeared enlarged; everything I looked at seemed increased in volume. I had no longer the same pleasure when I closed my eyes which I had when they were open; it appeared to me as if it was only external objects which were acted only the imagination, and magnified into images of pleasures; in short, it was ‘the faint exquisite mucus of a dream’ in a waking moment. I made my way home as fast as possible, dreading at every step lest I should commit some extravagance. In walking, I was hardly sensible of my feet touching the ground; it seemed as if I slid along the street, impelled by some invisible agent, and that my blood was composed of some ethereal fluid, which rendered my body lighter than air. I got to bed the moment I reached home. The most extraordinary visions of delight filled my brain all n. In the m. I rose, pale and dispirited; my head ached; my body was so debilitated that I was obliged to remain on the sofa all day, dearly paying for my first essay at O. eating.” (Travels in Turkey, &c., Lond., 1829.)
19. a. There not infrequently occurs in some persons, even after doses of gr. 1/4 to 3/4, a feeling of excessive fulness of head, dizziness, and headache lasting several hours, or even a number of day, seated sometimes in frontal, sometimes in occipital region. After larger doses, but still less than the maximum, there have been noticed buzzing and ringing in ears, confusion of ideas, dimness of vision, disturbances of hearing, and partial or complete unconsciousness. The motor sphere may also be affected, there occurring in some cases, as Albers stated, spasm of tendon, s particularly of extensor muscles; tremor of the hands; jerking, weakness, and even temporary paralysis of legs.
b. The changes which sometimes occur in the skin after the use of O. are especially worthy of study. Aside from the sometimes very profuse sweating which takes place, there face is congested and intensely reddened, and the rest of the skin feels hot to the touch. Annoying itching, without eruption, may also be present. This “pruritus opii” was mentioned by Dioscordes and Paulus Aegineta, and also by authors of the last century, and described as a tormenting and intolerable affection. In rare cases an eruption, with or without pruritus, is noticed after the use of O. The first recorded observation on this subject emanated from Tralles, who believed that the eruption bore a certain relation to the sweating which appeared simultaneously with it. The presence of the latter symptom is, however, not essential to the production of the exanthema. Duclos lays special stress on the fact that this may occur without augmentation of the secretion of the skin. It consists usually of small red isolated spots, resembling in form those of measles. According to an observation of Rieken, these spots may spread diffusely over the whole body, and thus present the appearance of scarlatina. Even the mucous membrane of the mouth the throat, this writer states, may be attacked by this “erythematous inflammation.” He witnessed the occurrence of such an eruption on a man every time he took O. internally, and even after the employment of ointments and collyria containing it. According to Berenguier, the erythematous spots show themselves shortly after taking the drug, on face, neck, arms, and breast, and disappear without leaving traces of their presence behind. Behrend has also recently studied an O. eruption. It appeared after taking a few 1/4 gr. doses, accompanied with violent itching on the chest from clavicles to lower end of sternum, on inner surfaces of both upper arms, flexor surfaces of forearms, and over wrist joints, spreading down legs and terminating at ankles in a stripe of livid colour about three fingers in width. It appeared as a pale scarlatina like redness, which, on closer examination, was seen to be composed of papules of pin – head size lying close together. Several day after the eruption had passed away there occurred a fine branny desquamation of the epidermis. Brand also observed an eruption which spread over the trunk and flexor surfaces of the body, was attended with intense itching and high fever, and presented the appearance of a diffuse redness made up of innumerable small points. In this and a similar case there appeared after 8 day a desquamation in the form of flakes of various sizes, which lasted nearly 10 day (LEWIN, op. cit.)
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.