7. ELISE STARK, millioner, aet. 23, took June 15th, m., the scraped off heads of 1000 phosphorus matches [= 10 gr. Ph.]. She felt nothing till the n. of the 16th, when she had frequent vomiting, continuing on 17th and 18th, after which the pains in stomach which had been severe, became less. On 18th pains in sacrum. She was brought to the hospital on the 19th. Her skin and conjunctiva were strongly icteric. Mucous membranes and cheeks very red. Countenance and demeanour indicated the greatest exhaustion. Pulse 92, hard and bounding. Tongue dry in the centre, and with a grey coating. Disgusting taste, anorexia. Abdomen distended, especially about epigastrium. Pain in splenic and iliac regions, and liver, which projects 1 to 1 1/2 inches in left lobe. Spleen enlarged. Stool retarded for some d. Urine brown, containing bile – colouring matter and some albumen. Six leeches were applied to epigastrium and she got a mixture of decoct. althaeae with aq. amygd. amar. Some vomiting, p. m. Temp. 38.1 deg. C., pulse 108. Next m. pulse still 108, temp. 37.7 deg. Pains in stomach less; yellow firm stool. Though so weak, the pulse was full and strong. P. m., collapse, soon followed by death. – P. M., 30 hours after death. The icteric colour of skin and conjunctiva well marked. In all the serous cavities small quantities of bloody fluid. Mesentery, especially the appendices epiploicae of sigmoid flexure, much congested, and the surrounding parts red. The endocardium, especially on the valves, shows bloody imbibition. Muscular substance of heart on both sides pale grey, on the left side of a greenish hue. The blood in heart fluid. M. m. of pharynx, larynx, and trachea partly dirty red, partly greenish. Dark red suffusion on both sides of entrance to larynx. Both lungs in posterior parts airless and very hyperaemic. The greyish – yellow m. m. of stomach, when its blackish – brown contents were removed, showed shallow depression the size of peas oil fundus and both curvatures. Similar matter appeared in duodenum, and a thick pappy matter in jejunum. In the ileum the contents were of a pale yellow colour, further down the yellow colour was deeper. The faeces in rectum were dirty green. Some patches of red in intestines. Small prominent pimples on jejunum, which when scraped off left small Pits. Gall – bladder empty. Thin dark brown bile in ductus choledochus, its m. m. at its entrance through the intestinal parietes corrugated and red. Liver large and heavy, under its peritoneal covering large emphysematous bullae. Surface and interior of liver greyish green, the central part of the large acini green. Spleen enlarged, firm and chocolate coloured. Follicles hardly visible, trabeculas numerous. The bladder, relaxed and empty, has ecchymosed spots in its fundus. Kidneys large, their glomeruli very red and the canaliculi very opaque. A red secretion can be pressed out of the papillae. The cellular substance of the pelvis of the kidneys is deeply imbibed with blood. The liver cells under the microscope were partly filled with fat molecules, partly destroyed and changed into drops of fat. Uterus enlarged; the blackish m. m. of the cervical canal shows a blackish slimy secretion. M. m., of uterus is blackish red with shreds of membrane attached to it. (Dr. E. MANNKOPF, Spital’s Zeitung, 1863, 26, in A.h. Z. Mnt. Blatt, viii, 16.)
8. SCHLAWIG, a servant – girl, aet. 27, scraped off the heads of 3000 lucifer matches (= 30 gr. Ph.) into a pint of water and drank the whole, April 2nd, 10 p. m. Next m. no symptoms. In forenoon fainted twice, felt sick, and after noon vomited continually blackish – green matter, at first slimy, and afterwards watery. Entered the hospital e. She got milk, magnesia usta, and mucilage, and on account of violent pains in head cold compresses to it. After cutting pains in abdomen vomited thrice. No sleep. – 4th M., skin slightly yellow and covered with profuse sweat. Conjunctivae of a deeper yellow than skin. Cheeks very red, expression dull and aching. Heart’s action and respiration accelerated. Tongue red, clean. Arch of palate and posterior pharyngeal wall slightly reddened. Abdomen distended. Burning pain in pit of stomach, increased by deep pressure; right hypochondrium very tender. The vomited matter contains only bile, no blood. Liver enlarged, its lower border on the median line lies 4 inches below base of ensiform cartilage. Urine scanty, clear. Yesterday there were pains in renal region, today pain is only felt there on pressure. Cataplasm to stomach and decoct. althaeae and aq. amyd. amar. The patient after this vomited thin bilious fluid. On the 3rd and 4th day there were several thin liquid stools, and no more till 7th day, when an enema brought away a pappy, bright brown stool. Temp. rose gradually to 39.6 deg. C., and the pulse became quick in proportion. Perspiration ensued, and the skin became more active. At the same time the liver increased in size. The spleen, too, increased in size. Pressure on the liver caused great pain. The urine during the last 2 day became more copious, sp. gr. 1020 – 26, acid, at first copious triple phosphates, latterly much uric acid. The colour was dark, and contained a quantity of colouring matter of bile. From the 4th day it contained albumen and hyaline casts and some fat corpuscles. The headache increased, and there were often attacks of faintness. The limbs were at first as heavy as lead, feeling as if paralysed, with pains in the muscles. The countenance expressed great exhaustion; consciousness was perfect. On April 9th the symptoms suddenly increased in intensity, the pupils dilated and scarcely reacted, the extremities became cold, pulse intermittent and scarcely perceptible. At 8 o’clock she died. P. M., 3 day after death. – Skin very yellow, with numerous suggillations. The fat brownish. Some reddish fluid in pleurae. Bronchial tubes contain dark red mucus, and the m. m. red. Heart very lax, contains little blood. Endocardium, especially about valves, very red. Muscular substance of heart reddish grey, opaque, shows signs of fatty degeneration. Blood dark red, loosely coagulated. Peritoneal sac contained 1 pint of dark red bloody liquid, m. m. of pharynx and larynx of dirty grey colour. The distended stomach contained 1 1/2 pints of greyish – red thin liquid. The m. m. on fundus red, at pylorus and large curvature grey. Near an old cicatrix are two spots the size of peas, black in their periphery, not discoloured i n the centres, lying under the m. m. In duodenum and throughout intestines grey masses, fluid in small intestine, of more consistence in colon. Gall – bladder relaxed and empty. The m. m. of small intestine is only red on the top of its folds, the rest of it is grey. The follicles are enlarged. The m. m. of uterus much swollen and reddened, covered with reddish secretion. The glomeruli of kidney much injected, the tubuli contorti filled with a granular mass consisting of fat. Spleen enlarged, firm, and full of blood; reaches to left lobe of liver. The liver on the right side extends 3 fingers’ breadth below border of ribs. Its surface is smooth, some large red parts are sunken in; the remainder of it, especially the anterior border, is of an intense yellow colour. On cutting into it the yellow and red parts were abruptly delimited. The hepatic cells in the yellow part were larger and more rounded than normal, they seemed to be filled with firm fat corpuscles. In the red part there was free fat, chiefly in large drops. The yellow parts seemed saturated with yellow bile – pigment, but contained very little brown granular pigment. The red part was quite devoid of these pigments, but its acini were very large. (Ibid.)
9. A workwomen, aet. 26, Nov. 23rd, 4 p. m., swallowed the heads of 1000 phosphorus matches in a cup of coffee. After 8 hours anorexia, increased thirst, vomiting of phosphorescent masses, pains in epigastrium, which increased and extended to both hypochondria, and on the 24th evening, involved the lumbar region; urine scanty. The vomiting was promoted by an emetic, and magnesia usta caused profuse diarrhoea. – 25th evening, patient brought to the hospital. Her expression and posture in bed show great exhaustion; skin dry; frequent dry cough; pulse quick, small, and soft; tongue thickly furred, no appetite, thirst great; pain in pharynx on drinking anything warm; abdomen much distended but soft, persistent pains, especially in epigastrium, both hypochondria and lumbar region, aggravated by pressure; spleen enlarged; liver shows as a firm tumour 2 inches below the ribs. It extends 5 1/2 inches below the base of the ensiform cartilage. The urine drawn off by catheter contains bile – pigment and a little albumen. Cataplasm to abdomen and a mixture of decoction of bark, red wine, aromatic tincture, and syrup. Next m. she had an icteric colour of skin and conjunctiva, which increased next d. The frequent consistent stools were tinged with bile. Urine scanty, contained a little albumen and some bladder epithelium; its sp. gr. had sunk from 1024 to 1012. The liver 1/2 inch lower. Respiration 76, pulse 136. Temperature in axilla rose from 38.2 deg. C. to 39.8 deg. C. She complained of chilliness. Abdominal pains less. Vertigo and exhaustion increased. Headache, anxiety, and restlessness, no sleep for the last nights. The last day her intellect was clouded. – 29th, p. m. After extreme anxiety she suddenly became quiet, and after 3/4 hour she died, 6 day after the poisoning. – P. M., 4 hours after death. Brain and its membrane normal. Both pleurae and pericardium studded with ecchymoses. In cellular tissue of mediastinum considerable suffusion, which extended along the greatly injected bronchial tubes into lungs, which showed some hypostasis but no filtrations. Nothing abnormal in stomach except an old cicatrix, nor in intestines. The contents of the bowels had a slight yellow tinge. Spleen 4 1/4 inches long, 2 5/8 inches broad, 1 inch thick. Liver 9 1/2 inches broad, the right lobe 8 1/4 inches high, left 5 1/2 inches, right 3 1/2 inches thick, left 1- 3/4 inches, of doughy consistence; there were some reddish places on its lower border. Acini ill defined. Gall – bladder contained a little brown bile. Kidneys soft, when cut into they showed congestion of the vessels; the red glomeruli contracted with the icteric coloured, very opaque urinary canals. M. m. of uterus, after the bloody mucus was washed off, appeared bright red. Blood very dark. Cardia muscles doughy, of yellowish – red colour. The epithelia of kidneys were changed into firmly granulated detritus, no epithelial nuclei to be seen. The interstitial tissue appeared loose, and contained some drops of fat. The liver lobules large, no cells could be seen when cut into thin layers; they were all, from vena portae to liver – vein zone, fatty – degenerate. Betwixt the acini were broad bands of cellular tissue, and betwixt its fibres a great number of star – shaped structures, where lay a large number of fat – drops. (Ibid., 28.)
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.