20. a. Dryness of mouth and fauces, huskiness of voice, and diminution in the sense of taste, occur in a short time, after administration of the drug in small medicinal doses, and continue during the whole period of its influence. To the dryness succeeds a viscid secretion, which contains excrementitious matter having a foil odour. When O. does not produce nausea, the appetite may not be impaired, may be even increased; but the rule that the desire for food is lessened. The secretion of mucus, and of the special glandular apparatus of the gastrointestinal mucous membrane, is lessened by O., and hence the digestion and the peristaltic movements are less active. The excretions being thus locked up, dulness and hebetude are experienced, the skin looks muddy, the tongue is coated and the breath offensive. When the influence of the O. ceases, it not infrequently happens that the constipation is succeeded by relaxation of the bowels; and rather profuse and foetid evacuations, and increased urinary discharges, take place. The action of the heart becomes stronger, and the arterial tension rises. The face flushes a little, the pupil contracts slightly, the Conjunctivae may be somewhat injected, and the expression of the eyes more brilliant. At this stage the ideas flow more rapidly, but are less sustained and orderly. The appreciation of time, the sequence of events, and the sense of moral fitness, are diminished. The cerebral excitement is, after a period which varies in different individuals, succeeded by calm and drowsiness; sleep when it occurs is usually disturbed by visions and dreams, often of a frightful character. In most subjects, when the stupor has passed off, headache, vertigo, confusion of mind, nausea, constipation and muscular hebetude are experienced.
b. When full medicinal doses are administrated the symptoms above described occur in a more intense degree. The stage of cardiac stimulation and of cerebral excitement is of much shorter duration, and the stage of intoxication and sopor not only comes on more quickly, but is much more pronounced. At first the pulse is increased in frequency, and the respiratory movements are more rapid, but the cardiac pulsations, soon diminish in number and force, and the respirations become sighing in character and the move shallow. There is also present decided dryness of mouth, fauces, and larynx, and swallowing becomes somewhat more difficult, and the voice grows husky. Nausea and vomiting, or at least weight and oppression of the epigastrium, ensure. Confusion of ideas, vertigo, somnolence, are succeeded by deep sleep, contracted pupils, slow and relaxed pulse, slow and snoring respiration, a perspiring skin, and in many persons a general pruritus, which, however, is more harassing at the nasal orifice. Persons not habituated to the use of O. usually experience, after a full dose has expended its force, very distressing sequelae, referable to the cerebro – spinal system. The most important of these after – effects are headache, confusion of mind, vertigo – which is especially severe on assuming the erect posture, nausea, retching and vomiting, plus complete anorexia, and constipation. A mild but defined hepatogenic jaundice not infrequently occurs, and the urine is tinged with the colouring matter of the bile. plus (BARTHOLOW, op. cit.)
21. a. Where the quantity of O. is large, and the form such as to permit rapid absorption of the whole, the course of symptoms is as follows: – The patient, if an adult, quickly becomes conscious of a sense of fulness in the head, which seems to commence in the nape of the neck, and to spread therefrom; and in the course of a few m. feels great and increasing drowsiness, and a sensation of general heat, which increases to an almost intolerable degree, and is then accompanied by sweating. This sweating, which generally bathes the body in moisture, tends to suspend all its other secretions.
b. If the dose given has been very large, it reduces the surface to a clammy coldness. The drowsiness passes into semi – coma; the patient, unless aroused, lies unconscious, and is heedless of everything around him, but if roughly spoken to and shaken can still be induced – though the speech is thick and hesitating – to answer question, and even to get up and walk about; on leaving him, however, he immediately subsides into his former stupor. The pupils are generally contracted to the size of a pin’s point, and become insensible to light; and there is buzzing in the ears. The pulse, which in the first or hot stage was rapid and somewhat full, becomes feeble or irregular, and falls to the normal rate, or even below it; simultaneously with this alteration the features become pinched and ghastly, and flushing gives place to livid pallor, while the muscles of the limbs are affected with spasmodic jerkings. The mouth and fauces are dry, and there is commonly nausea, and often vomiting. The general depression of the system is marked. The respiration becomes more and more embarrassed; in the later stages the presence of a quantity of mucous secretion in the tubes makes itself known by the rattling sound of the breathing. The respiration comes to standstill usually some m. before the entire cessation of the heart’s action. Death, that is to say, takes place by apnoea.
c. The course of events differs considerably in young children, especially in infants. Here there is a more rapid passage into profound stupor, but what is specially characteristic, is the much greater frequency with which convulsions occur. The convulsion movements vary from more twitchings of the facial muscles to rhythmical startings of the limbs; to severe clonic convulsions, which may be hemiplegic, or may affect both sides of the body alike; and even to tetanic spasms. I have seen there adults thrown into a state of apparently complete tetanic rigidity of the whole body, the mouth open and squared, all the facial muscles highly tetanised, the spine strongly curved, resembling the shape of a well – drawn bow; and this state of opisthotonos continue in each case without abatement 12 – 48 hours, and then only become relaxed to grow again for a longer or shorter time, according as the effect of the O. was kept up. One of the patients remained more or less in this state for 4 or 5 weeks, O. having been given in the first instance to relieve toothache, and continued for the convulsive spasms which followed. As soon as the O. was discontinued the patient recovered, but some months afterwards, having accidentally taken it again, the same results quickly reappeared. (PHILLIPS, op. cit.).
Experiments on animals
1. a. O. acts on all invertebrate animals by diminishing the contractility in the tissues which have this property, and consequently weakening all their movements. These animals always die in a completely powerless state, in a viable time, and without having shown any signs of excitement.
b. In vertebrate animals, O. exerts the same action on contractility; it also depresses the nerves, further weakening movements, and blunting the impressibility of the surface. It causes at the same time convulsive movements, tetanic contractions recurring paroxysmally, and the other signs of a violent over – excitement of the cerebro – spinal axis.
c. In fishes, amphibia, and reptiles the convulsions are not strong enough to cause death, and they die powerless like the invertebrata. Mammalia and birds often perish during the tetanic paroxysms.
d. The highest mammalia, besides the two previous classes of effects, may present the phenomena of cerebral congestion, as in man; but this is not strong enough to cause death.
These propositions are the result of numerous experiments. (CHARVET, L’Action de l’ Opium, Paris, 1826.)
2. SCHROFF, who performed numerous experiments with O. and its constituents, remarks that although 2 and even 3 gr. certainly contain less than a gr. of morphia, yet their action is strikingly more intense, occasioning rapidly a degree of narcotism bordering in coma, but soon subsiding without leaving decided secondary effects behind; while morphia does not readily produce narcotism, but its after – effects are of longer duration. O., he further remarks, increases the temperature of the body and also the sense of heat, but morphia lowers the temperature even when the sense of warmth is increased. O. primarily augments the frequency of the pupils, and afterwards diminishes it as narcotism comes on; but morphia renders the pulse less frequent. O. is less than morphia to disturb the stomach and excite vomiting, or it dose so, if at all, for a shorter time; and it is also much less apt to produce vesical irritation and retention of urine. (STILLE, op. cit.)
3. a. I injected mxx of tinct. beneath skin of a bitch, pulse being 120, pupils contracting to 1/2 in. in the light and dilating to 1/3. Between 5th and 15th m. she was very qualmish, and at last vomited a heap of food. The diaphragm acted spasmodically for 3 m. more. She then lay down with head on the ground. After 7 m., bowels acted, clear mucus ran from mouth, and pulse was 112. In 3/4 hours after injecting, pulse was 78 and irregular; respiration irregular and sighing; glairy alkaline mucus continued to drop from mouth; pupils were broadly dilated in moderate light. Slight somnolency was now manifested for the first time, with a little twitching of the kind legs. As the somnolency did not increase, I injected at the end of the hour mxx more. In 1/4 hours, pulse was 72, and very regular in relation to the breathing-i. evening the expiratory rate was 40, and the inspiratory about 120. Resp. 16, and regular. She continued in the same position, and there was no further contraction of the pupils. Every now and then she raised her head and looked about her, and then slowly laid it down again upon the carpet and closed the eyes. In 15 m. more she became decidedly drowsy, and the pupils, from being broadly dilated, contracted to 1/4. The drowsiness continued for an hours, but did not amount to sound and continuous sleep at any time; and at the end of this period, upon, being a little disturbed, she got up and walked away, and began to retch. From this time the drowsiness began to pass off, and she continued to walk about, listen to footsteps on the other side of the door, and pry about. Pulse was now 78, and less irregular; resp. 18.
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.