15b. She now left hospital. Haematuria gradually diminished, and ceased early in September. Haematemesis recurred only on Sept. 28th, after emotional disturbance. Jaundice and hepatic tenderness persisted longer, but at last disappeared. Since her confinement catamenia have occurred regularly, but are very scanty. (TARDIEU, op. cit.)
16. M. J -, sempstress, aet. 29, affected with syphilis, resolved to poison herself on the n. of 27th March. She soaked a number of heads of Ph. matches in water, and drank the mixture. During n. and following m. vomited copiously. Seen 30 hours afterwards. – Temperature and Circulation. The first 5 day her temp. rose slightly in evening and in m. was normal. Pulse ranged from 104 to 120. On 6th day she got remittent febrile symptoms, which reached their acme on the 8th day, e. Then the temp. rose to 40.6 deg. Pulse 136, very small and weak. Thereafter the temp. declined, 9th day, m., 38.6 deg.; evening, 38.7 deg; 12th day, evening, 39.2 deg. Pulse, 9th evening, 96; 12th, evening, 112. With the 12th day the fever became more intermittent, rigor with increased temp., which gradually fell. – 13th day after poisoning. 1st rigor came on 8:15 a. m., lasted 20 m. Max. temp. 41.8 deg., pulse 144. Temp. fell with advent of profuse sweat 5 to 40.1 deg., rose in evening to 41 deg. – 14th day 2nd rigor, m. Max. temp. 40.6 deg., pulse 112; temp. fell in profuse sweat, evening, to 37.9 deg.; pulse 96. – 17th day 3rd rigor came on evening, lasted 25 m.; temp. not observed. – 18th day 4th rigor, m., lasted 30 m.; temp. 41 deg., pulse 140. Temp. fell, evening, to 38.8 deg.; next m. to 38.2 deg., with pulse 84. There was then a cessation of fever till 32nd day 5th rigor, m., slighter, and duration less than formerly. Max. temp. 38.9 deg. With sweat, temp. fell, evening, to 37.8 deg. – 36th day 6th rigor, m.; max. temp. 38.3 deg.; fell, till next m., to 37 deg. After this the temp. was very low for a considerable time, 36.4 deg. to 36.1 deg. m., 36.8 deg to 36.9 deg. e. Then 4 weeks elapsed without any fever. – 63rd day 7th rigor, lasted 20 m. Temp. 37.4 deg. – 65th day 8th rigor. Max. temp. 38.3 deg., fell during sweat to 37.4 deg. – 71st day 9th rigor. Max. temp. 38.4 deg., fell, p. m., during sweat, to 36.4 deg. – 79th day 10th and 12th rigors, 1st, 8 a. m.; 2nd, 10 a. m. Max. temp. 38.1 deg., fell, p. m., to 36.7 deg.; next m. to 36.2 deg. – 89th day 12th rigor. Max. temp. 38.4 deg., fell during sweat to 37.0 deg. Then came 3 paroxysms in which the temp. never exceeded 38 deg. – 129th day 16th rigor. Max. temp. 38.8 deg., fell. p. m. to 36.4 deg. – 130th day 17th rigor. Max. temp. 38 deg., fell to 37 deg. – 143rd day 18th rigor. Max. temp. 37.8 deg. – 144th day 19th rigor. Max. temp. 37.8 deg. – 146th and 149th day 20th and 21st rigors. No particular rise of temp. For the next three weeks during which the patient was in hospital no more paroxysms occurred. – Icteric symptoms. 3 day after poisoning skin quite dry, 4th day it had an icteric tint, the Conjunctivae more yellow. – 10th d. The skin began to perspire. The icterus increased until 17th day, then gradually subsided till it disappeared on the 48th d. The urine on the 4th day was slightly coloured with bile, and showed a little albumen; its quantity decreased and sp. gr. increased. The bilious discoloration continued to increase, but albumen could not always be detected. On 18th day the urine became more copious, was of a brownish – green colour, sp. gr. 1009, albumen present. With the 20th day the urine became clearer, the biliary colouring matter less apparent. After 30th day only some albumen and biliary colouring matter appeared in small quantity. Between 35th and 38th day there was strangury with urgent call to urinate, which the patient could not satisfy. As soon as the urine is passed the urging recommences. The urine is clear and very acid. – Sensorium. On 5th day, when the icteric symptoms were getting worse, there was great delirium, which lasted till the 7th d. Shoe forgets to pass urine, respiration very laboured, very small pulse, dry skin, and brown furred tongue; says she is quite well. The nights were mostly sleepless. From 10th day the sleep improves, and her mental state also. On the 15th day there is still a dazed feeling in head, with great exhaustion, and on 18th a manifest improvement sets in, with the decline of the icteric symptoms and the diuresis. This improvement continues till the 38th, when the patient wishes to get up. – Peculiar symptoms. Copious epistaxis occurred oil the 7th, 11th, 14th, 20th, 22nd, and 33rd day, and latterly was always attended with profuse sweat. A pustular eruption appeared on forehead on 20th day, which on the 22nd extended over face; the pustules were the size of a hemp seed and surrounded by broad red areola; their centre was a hair follicle filled with pus. Ecthymatous pustules appeared on the nates and about anus, and some day later on the left natus a boil the size of a hazel nut, which discharged brownish bloody pus. This was all perfectly healed by the 32nd day – On the 58th day the menses, which had been absent 9 weeks, came on, the next time 27 day afterwards, and the third time 21 day after that. On the 105th day after the poisoning there came on a gumboil in the 3rd right carious upper molar, which caused the cheek to swell. – Stomach and bowels. Immediately after the poisoning there was copious vomiting, afterwards nausea, great tenderness of epigastrium, dry tongue with brownish – yellow coat, distension of abdomen, firm and lumpy stools of a clay colour. Purgatives caused copious stools of the same colour. On the 3rd day there were 3 stools, 4th day 8, 5th day 6, 6th day 3, 7th day 3, some liquid but most firm. After leaving off the purgatives the bowels became very sluggish, and could only be moved by enemata, which brought away copious evacuations, very loose, consisting partly of white, partly of yellow faeces. About the 10th day the tenderness of epigastrium ceased, the tongue became clear and moist. During the 1st and 2nd ague fits the epigastric tenderness increased, and there was on both occasions great vomiting of grayish – yellow half – digested food, and this was generally observed during subsequent rigors. From the 16th day the stools became coloured with bile, and occurred without enemata about once a d. On the 23rd day the tenderness of epigastrium gone; on the 25th day the appetite returned. A few day later there was constipation, which was overcome by castor oil and enemata. There were symptoms of accumulation of faeces in colon descends, tenderness to pressure above left leg. Poupartii, and abnormal resistance in left iliac region. The oil brought away hard balls of faeces well coloured with bile. On the 40th day there occurred quite watery stools mixed with purulent and cheesy masses, occasional vomiting, tenesmus; the stools are always more or less coloured with bile. These symptoms lasted till the 60th day, and then constipation again set in, which was removed by purgatives. The bowels only became regular after the 112th day – Liver. Within the first 4 day there was painfulness oil pressure in the hepatic region. On the 5th day the dull percussion sound became more extensive. On the 6th day, evening, the lower border of liver can be felt just above the navel. On the 7th day the extreme boundary of the left lobe in 3″ from the median line, the dull hepatic percussion sound is heard behind 5th rib, in mammillary line. The liver after this never grew larger, the painfulness on pressure declined, it only increased during the rigor. On the 17th day the percussion sound of liver became less intense, its upper boundary is still at the upper border of the 6th rib. A marked decrease in the size of the liver was observable from the 23rd day; the lower border is perceptibly higher up, and cannot be felt so easily. On the 36th day the size of the liver is nearly normal, the upper boundary is at the lower border of the 5th rib, its lower border reaches 2 inches below the ribs on the right sternal line, 1 1/2 in. in parasternal, 1 inch in mammillary line. On the 79th day percussion showed the liver to be abnormally small. The lower border does not project below ribs. On the 98th day the spleen shows an increase in size. – Respiratory apparatus. In the early days very decided increased of frequency of respiration, apparently owing to the tenderness in the abdomen; auscultation showed only rare catarrhal rales posteriorly and in right side anteriorly. Soon a frequent dry cough came on, with scanty expectoration branched like the bronchial tubes. (nach den Bronchien verzweigten Auswurf), and the catarrhal sounds in posterior lungs, especially the right, increased. On 13th day (1st rigor) percussion shows slight dulness posteriorly in lower part of right lung, with masked respiratory murmur and fine rales. Change of posture alters the line of the dulness; diminished fremitus under line of dulness on right side. posteriorly, from 9th dorsal vertebrae downwards. 14th day (2nd rigor), the dulness 1 1/2 inch higher, bronchial respiration in the dull part. 17th day, the height of dulness somewhat lower, and the expansion of the lower border of the right lung posteriorly is obvious on deep breathing. The rales diminished, but the cough continues unabated; it comes on in paroxysms, brings up a viscid muco – purulent expectoration, branched like the bronchial tubes; after every rigor the paroxysms of cough increase. 50th d. Nothing abnormal in physical sounds of respiration, but there is still great irritation to cough, which only goes off at a later date. Heart showed no important physical abnormality. The second (arterial) sounds were at first very weak; in the first weeks a very rough first sound was heard over the pulmonary artery. (KNOEVENAGEL, Berl. klin. Wochensch., April 19, 1869.)
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.