Poisonings
1. “On August 4th, 1860, I was called to visit two children who, the messenger said, were vomiting themselves to death. In 1/2 h. I reached the house, and found two girls of 6 and 8 respectively stretched upon their beds bathed in cold perspiration; faces pale as a corpse’s, eyes sunken in orbits, noses pinched; pulse very weak, and scarcely perceptible at wrist; great thirst; and stomach contracting so hard and rapidly, in efforts to vomit, that the wrenching pain would cause them to utter hard screams, one after another, for 5 m. at a time. I was told that the vomiting had been going on for the last 4 hours almost without intermission: it was now noon. On examining the matters ejected, I found them to consist for the most part, of the seeds, pulp, and membranous covering of the ripe May apple, having the peculiar odour of the fruit.” They were treated with morphia, blister or sinapism to abdomen – which was tympanitic and very tender, hot flannels with mustard to extremities, carbonic acid water to sip, and, as bowels had not been moved, enemata of castor oil and molasses in warm water. “In 1/2 hours the younger child had fallen asleep, but the elder vomited bilious matter mixed with blood – the bile dark green and very thick, the blood dark and coagulated. She complained frequently of burning in throat. Injections having failed to move the bowels, I have her 12 gr. of calomel and 1 gr. of sulphate of morphia. In both extremities were now becoming warm. I left powders of morphine and camphor, l one to be given after each vomiting; and enjoined that the heart was to be kept up in the extremities. I was called next day at 7 a. m., and found elder child past all hope, – eyes glazed and motionless, the death – rattle in her throat, abdomen swelled almost to bursting, and under jaw fallen. She had continued to vomit thick bile, with more or less blood mixed with it, about every hours during n. At 2:30 p. m. she expired. The younger was much better, save that there was considerable tenderness over stomach. To remove this I applied a blister; gave Dover’s powder to keep her quiet, and slippery elm water for drink; kept the bowels solvent with sulphate of magnesia; and by m. of the 8th she was convalescent.” (D. C. OWEN, from Hale’s New Remedies, 2nd ed.)
2. Not a week since the writer was called up at n. to visit a lady apparently seized with a severe attack of cholera, – watery purging every 2 or 3 m., vomiting, coldness of surface, and great prostration. On inquiry he found that alarming symptoms were due to pill containing Podophyllin. (Brit. Journ. of Hom., xxi, 454.)
3. Mrs. hours, aet. 45, strong healthy, had been constipated for a week, and was feeling badly in consequence. A bottle of Podophyllin was in the house, and from it she took as much as could be held on the handle of a teaspoon, mixed it with a little water, and swallowed it, 5 p. m., April 9th. At 7 she had cutting pains on both sides of abdomen, with desire for stool. At 8, feeling very badly, went to bed. Pain had ceased; there was great exhaustion, with relaxed muscles and feeling as though body was bathed in sweat (which it was not); then came a fearful pain in occiput, “as though the head was being split open,” lasting about 2 m., and followed by dull throbbing ache and feeling of heaviness so that head could not be raised from pillow. At 8:30 vomiting began, first contents of stomach, then thin, bitter dark green fluid, from each time. There were 6 or 7 such- attacks between this and 4 a. m.; with each bowels moved, first constipated, then thin water stools, but no blood and no pain. Frequent sensation of heat passing over face and head were noticed. With each vomiting exhaustion was so great that patient felt as though drying. She could not raise her head to assist in the act of emesis. Dr. Prentiss was called to the cast at 1 a. m. He found patient in a state bordering on collapse, features pinched, extremities cold, pulse very feeble, disposition to drowsiness. The greatest distress was from the exhaustion and the pains in the head; the intellect was unaffected. eyesight and pupils normal; no involuntary discharges. Mrs. hours kept her bed on the 10th, but got up on the 11th, feeling well, but with tingling in extremities and weak as from a long illness. (Philad. Medorrhinum Times, 1883.)
4. A girl, aet. 20, took 2 gr. of Podophyllin. After 5 hours severe pain in bowels; after 9 hours vomited contents of stomach, and then much bile; felt better, but after 12 hours vomited again, and bowels were moved twice, not copiously, but with very much pain and deadly nausea. In n. pain in stomach, which continued to increase in severity, and was attended with much thirst and sense of burning, and great feeling of prostration. On 2nd day took a number of drugs to antidote effects. On 3rd day, p. m., had a chill, followed by some fever and headache. The two latter continued on 4th day, pulse being 100; great tenderness over stomach and bowels, could scarcely bear pressure of bedclothes; pain in bowels occasionally, but not severe; no stool since 2nd day., but feeling every now and then as if it would come; urine very red; tongue white; great thirst. On 5th day, white fur on tongue, except on centre; everything tasted sweet; still great thirst, also tenderness over stomach and bowels, increased by last motion, could not bear to be touched; pulse 100. Soon after eating some toast pain commenced in stomach, extending into bowels, increasing to such severity that she could not resist screaming at every breath; by afternoon it had extended into lower bowels and right ovary, pulse being now 116. Spasmodic sensation in right thigh and leg in morning; p. m., more pain and cramp in right leg. On 6th day still very tender over lower bowels; micturition painful; pain in right ovary and uterus. On 7th day two green watery stools. On 8th day five thin watery green discharges, with considerably pain and griping; intolerable itching of skin on body and arms, scratching produces blotches, as in urticaria. (KNAPP, Trans. of Pacific Hom. Medorrhinum Soc., i, 55, from Allen.)
5. T. C., aet. 17, while powdering the resin got some in his face and eyes. Next m. he noticed that his face and eyes were red, and the skin about the latter discoloured. This discoloration extended during day over whole face, forehead, and front of neck, and at n. eyes were so painful as to prevent sleep. On following day all parts which had been in contact with powder were of yellowish – red colour, but not appreciably swollen. The ocular conjunctivae were much injected, the palpebral only slightly; pupils small; eyes painful, and sensitive to light. (WEBSTER, Lond. Medorrhinum Record, 1877, p. 357.)
6. It appears from the statement of a patient now under Mr. Hutchinson’s care at Moorfields that P. dust is well known in the trade to produce “inflamed eyes” and an eruption of “scabs” on the arms and legs of the men who attend the mill in which the root is ground. This man came with extensive superficial ulceration of each cornea, attended by intense general conjunctival congestion. The ulceration of cornea was central and large in extent. He had had several other attacks of the same sort, but not nearly so bad as this one. He showed also one or two dusky spots on the arms where there had been scabby places a few day before. The day’s work which gave rise to the present attack occurred about 10 day before he came under care at the hospital. No symptoms of irritation appeared while he was at work or during that evening, but on walking next m. his eyes were inflamed. He was not purged by the dust. [Other observations of this kind will be found in Amer. Mag., 1851, i 63; Pharm. fourn., 1862, p. 462 ] (Medorrhinum Times and Gaz., 1872.).
Experiments on animals
1. HUGHES BENNETT experimented on dogs. His conclusions are –
1a. Doses of Podophyllin, varying from 2 to 8 gr., diminish the solid constituents of the bile, whether they produce purging or not. 1b. Doses which purge lessen both fluid and solid constituents of bile. (Brit. Medorrhinum Journ., 1869, i, 418.) 2. ANSTIE made 10 experiments on dogs, cats, and rats, injecting the drug (Podophyllin) in sol. into peritoneal cavity. His conclusions are as follows:
2a. P., when so injected, has no irritant action on the serous membrane unless it remain unabsorbed, lying for some time in contact with it.
2b. P., when so injected, passes into the blood and exerts a special influence of an irritant kind upon the mucous membrane of the intestine (usually of the small intestine only). 2c. As a secondary result of this irritation, or perhaps as a mere consequence of the squeezing of the gall – bladder by the abdominal muscles, in repeated efforts at defecation, bile is occasionally poured out in large quantities, but this is by no means necessary.
2d. Neither poisonous doses, nor those which produce what may be called a medicinal effect, appear capable of exciting any inflammatory process in the liver.
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.