28. J. Z -, aet. 52, tall, thin, but well made, with broad chest and robust constitution, had been engaged for 9 mo. in a match manufactory. The commencement of his occupation he was affected with dry cough, which however went off when he put on warmer clothing and took some diaphoretic drinks. After 6 mo. he fell ill with the same symptoms, which were this time more severe, and at length compelled him to abandon his occupation. On examination, his face appeared congested; forehead covered with perspiration; tongue furred; taste slimy; frequent excitement to cough, with flying shootings under sternum and towards right side of chest; copious much – purulent expectoration, with constant tickling and scratching sensation at bifurcation of trachea; anxious, short, and hurried breathing, with elevation of whole thorax, and especially of left side. Percussion gave a clear tone in middle of right side; auscultation revealed diffused mucous rales with pectoriloquy. Pulse was rapid, full, and hardish; skin dry and hot; thirst increased. Besides these, great depression and debility. No gastric symptoms. After antiphlogistic treatment and expectorants, he slowly improved, and sputa became mucous only; but great debility and depression, with anorexia, still remained, and required a lengthened course of quinine to remove them. (GEIST, in Ibid.)
29. a. The most notable effect of the action of the Ph. fumes on the workpeople is the development of a peculiar disease of the jaw – bones. The first symptom is toothache. This begins after having been in the factory from 6 mo. to 12 years (one case, however, occurred after only 5 weeks); it attacks one or several teeth, or in some cases spreads over one side of the jaw like rheumatic faceache. Only in the rarest and most severe cases it attacks both sides. It is characterized by gnawing, throbbing pain, alternating with violent shooting, sometimes intermittent and sometimes continued. In some cases it comes on as soon as the occupation is commenced, lasts a few weeks, then leaves the worker for months or years, but afterwards recurs several times, until at length the more deeply – seated affection breaks out. With the exception of but few cases, in which the patients had not directed attention to the subject, or the teeth were extracted before coming under observation (as not infrequently happens), it was ascertained that it is decayed teeth in which the pain commences, and whence it seems to extend. With the toothache, according to Neumann’s observations, in some cases itching of the gums occurs. After this toothache has lasted for weeks or months, it spreads over whole side of jaw in which the carious tooth is situated, and in more severe cases over face and neck of same side. In some cases the cervical glands swell and become painful; the gum surrounding the diseased tooth reddens and swells, as also the cheek, and sometimes the soft palate. In other cases there is formed, amid drawing throbbing pains, a circumscribed phlegmon of the gum beside the diseased tooth; an abscess is produced, which discharges at first laudable but afterwards grey fetid pus, and changes into an ulcer, which grows always larger by gradual recession of its border. In either case the gums recede, and the teeth, whether carious or healthy, become loose and fall out (according to the extent of the diseased bone). The abscesses now multiply, discharging fetid pus; gums are livid, and undermined with fistulous sinuses, through which probe detects carious bone; at last they altogether disappear, and the denuded alveolar processes are seen projecting into the buccal cavity. The cheek, the throat and the parotid may become sympathetically affected.
29b. At the commencement of the disease the patients are affected with slight febrile action, lose their appetite. suffer from increased thirst and irregularity of the bowels, constipation being the most frequent complaint. Gastric symptoms are not infrequently present – furred tongue, slimy bitter taste, pressure in epigastrium with frontal headache. The febrile action may continue throughout the whole course of the disease; or it may go off completely; or, if there are tubercles in the lungs, it may cause them to soften, and turn into hectic.
29c. The form of the disease differs according to whether the upper or lower jaw is attacked. In the former it pursues generally a chronic and mild course, ending in exfoliation, cicatrisation, and cure. In the latter the necrosis may be either acute or chronic, but is always severe, and the patients usually die of “consumptive fever.” Of 30 cases, the termination of which was known to the authors, 15 died. (Ibid.) 30. A country woman, who had always enjoyed good health, came to work in a lucifer – match manufactory. After 14 day, during which she had been employed in dipping the wood spills in the Ph., she became affected with intolerable dry cough and later with violent bronchial catarrh. She now spent her time between the works and the hospital. On the 5th occasion of her coming into the hospital she suffered from frequent tiresome cough with muco – purulent expectoration, quick respiration, great oppression so that she had to sit up to cough, at same time severe pain under sternum and feeling of constriction; remarkable resonance in upper third of right side of chest, with moist sibilant rales; ribs almost immovable, thorax distinctly arched. Besides, – complete anorexia, furred tongue, several loose stools per diem; earthy complexion, emaciation, fever. In others the same work caused cough, difficulty of breathing gradually amounting to violent bronchitis, at first without fever, very weak pulse, great ability, emaciation. (Ann. de. Therap., Fever., 1846, from A.h. Z., xxxiii, 58.)
31. J. D -, aet. 21, had been engaged 4 years in preparation of lucifer matches. For 2 1/2 years, further than the laryngeal irritation produced by the acrid fumes he suffered but little. At end of this time, however, he began to cough very much, and to expectorate a thick white mucus. He then suffered much from toothache, which he describes as having become violent, and which was accompanied with considerable swelling on right side of face. A double tooth was extracted, but without relief; one tooth after another dropped out; he became so weak that he was unable to walk; a swelling the size of an egg formed below right orbit, and in a fortnight burst, discharging a large quantity of white pus. He continued to get worse; all teeth fell out, and gums of lower jaw were retracted. On admission to dispensary, May 4th, 1846, right cheek was considerably swollen. At right angle of lower jaw is an opening discharging laudable pus, and through which probe can be passed 2 in. along bare bone; and 2 in. anterior to this another aperture leads to same. On opening mouth whole lower jaw, as far as ascending rami and down to reflection of mucous membrane on cheeks, is denuded and of leaden grayish colour. On upper jaw, right side, probe can be passed over a portion of bare bone. (WALKER, Brit. Journ. of Hom. iv, 287.)
32. LORINSER thinks that in Ph. workers the poison acts oil the jaws through the blood, and states that individuals under its influence have a peculiar sallow bloated complexion, combined with dull expression of eye and gastric derangement. I have myself observed this remarkable appearance of the countenance in the dipper of a congreve match manufactory, whose jaws, however, were quite sound. (PEREIRA, op. cit.)
33. ANSTIE prescribed for a neuralgic patient gr. 1/30 in pill 3 times a d. He took pills regularly for a week, but during last 2 day suffered from constant and increasing burning sensation at epigastrium; urine was dark coloured, and on examination proved to be albuminous and bloody, but without casts. After omitting drug for 2 day renal symptoms had almost disappeared, and stomach was much easier, though patient still felt a rather burning pain between scapula. (Practitioner, xi, 105.).
Experiments on animals
1. BIBRA experimented on rabbits in three ways, – 1st by Ph. introduced into the stomach; 2nd, by exposure to its fumes so as to induce either rapid or slow poisoning (according to concentration of vapour). The first series merely show the violent irritant action of the poison on the parts with which it came into immediate contact. Of the second the following are specimens: 1a. Rapid poisoning – On October 10th an old rabbit was put into the box employed for the purpose. It seemed to be pretty well, ate its food, and showed no signs of uneasiness. On the 20th, however, it was found dead. Dissection showed venous system enormously distended with blood; right auricle and ventricle quite filled with a black coagulum, left ventricle empty; lungs much reddened, in some places bluish; liver congested, but blood very fluid (under microscope normal); gall – bladder contained a little cloudy bright green fluid; intestines strongly injected. Other organs normal. A young rabbit was put into box Oct. 27th; it died Nov. 4th. Dissection showed circulatory system as before, but lungs almost completely hepatized, very little of their normal parenchyma to be seen, and on cutting into them some portions were found beset with tubercles; muscular parts much injected; stomach and intestines congested only; liver exhibited some pale spots on surface and throughout substance; gall – bladder very full, as also urinary bladder. Some of the rabbits that resisted the poisonous effects of the fumes longer exhibited an eruption, chiefly on abdomen, axillae and genitals, hair fell off, and skin became covered with a scabby humid exanthem. In these rabbits the lungs were always healthy, whereas in the others there was often hepatization and tuberculous formation, and always congestion.
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.