2. On Sunday, the last of Oct., I was requested to visit a lady in great haste, as she was supposed to have yellow fever in its most rapid and malignant form, accompanied with black vomit and other symptoms of that disease. The fever was then prevailing in the city, and a death had occurred from black vomit in the house adjoining. As soon as I was ushered into the room, the patient, in great alarm and agitation, requested her friends and the nurse to leave the room, when, pointing to a quantity of dark brown fluid which she had just vomited, she besought me in extreme anguish to have pity on a miserable being who was about to die from the consequences of her own crime. After extracting from me the promise that I would not, under any circumstances, expose her guilt, to the mortification of her friends and the exultation of her enemies after her death, which she deemed inevitable, she informed me that until Tuesday last she had enjoyed excellent health; she was 32 years of age, had borne three children, with no peculiarity worthy of remark, and was now in the 6th mo. of pregnancy. On Tuesday m. last she commenced taking powder of ergot, in doses of 40 gr. every 25 or 30 m., for the purpose of producing abortion. Three or four doses were taken, with no apparent effect on the uterus, and, a chill coming on, followed immediately by nausea, sharp pain in head, with dizziness and partial blindness, it became necessary to discontinue the medicine. Three or four hours after the chill, spontaneous diarrhoea commenced, continuing 5 to 6 hours, with relief to nausea and headache. She passed a restless, feverish, and sleepless n., in a state of great nervous agitation. On Wednesday m. the diarrhoea had ceased, and the pain in head and fever had returned, with thirst and great irritability of stomach, toast water, lemonade, and iced water being ejected almost as soon as swallowed. Supposing it to be a bilious fever, the patient, after applying a mustard cataplasm to the epigastrium, took a dose of calomel and jalap, which acted well p. m. She slept well, and the next m. felt quite well, which confirmed her in the opinion that the sickness had been caused alone by the presence of bile in the stomach, and that the ergot used was entirely inert. Resolved not to abandon her purpose, she then sent to another apothecary, and procured 1 oz. of a parcel of which a portion had been used the day before by a physician of the city with prompt and energetic action. This quantity was divided into four doses, three of which were taken in 6 hours without producing the slightest expulsive uterine effort: in the words of the patient, “no pains or signs of labour.” She became so sick that she could take no more. Then followed excessive nausea and debility, with very little vomiting of a dark brown coffee-ground looking fluid; pain in head and eyes; a burning, torpid, prickly sensation over whole surface, with much difficulty in moving extremities, accompanied by sensation like that produced in a limb by pressure on the trunk of a nerve, when we say that the limb is”asleep.” These symptoms during Friday and Saturday increased in violence, attended by entire absence of sleep; pain in head became intense, with transient delirium; pain in back and limbs; incessant vomiting of a brownish water with occasional streaks of blood; great prostration accompanied with a slow feeble pulse; pupils dilated; vision imperfect, at times almost total blindness; tongue dry, scarlet at edges, crimson and black in middle; intense thirst, with no abatement by iced water or lemonade; burning fauces and along oesophagus to stomach; tenderness of epigastrium; much difficulty in swallowing. The voluntary muscles responded irregularly, with occasional violent spasms of those of extremities and back. The skin was dry and of a muddy yellow hue. On Sunday at 9 a. m., when I first saw the patient, I found the above detailed symptoms, with the addition of the apparently well – marked black vomit. I assured her that although her case might possibly be somewhat influenced by the prevailing epidemic, yet the symptoms could well be produced by the ergot together with her mental excitement; and that I had little doubt but that her illness was mainly attributable to the latter causes. Purgatives, including 10 gr. of calomel, were given, and an effervescing mixture every 15 m.; sponging of whole surface with iced water and vinegar, and iced water to head. 4 p. m., bowels have been freely evacuated; pulse quicker, with more resistance, 82; vomiting continues, but with less violence; pain in abdomen; other symptoms nearly the same as in m. Continued the cold applications and sponging; ordered calomel, gr. x, sulph. quinine, gr. iii; blister to epigastrium; for drink-gum water, arrowroot jelly, and claret. 10 p. m., skin hot and dry; pulse 110; thirst abated; vomiting at longer intervals, and the matters ejected changed to the appearance of those taken; has had two full black watery evacuations from the bowels; vision improved; pain in head, back, and limbs abated in some measure. Ordered effervescing draught with sulph. morphia, flax-seed poultices to abdomen and to blistered surface of epigastrium; cold to head continued; gum mucilage and claret for drink during n. Monday, 8 a. m., the patient took 1/2 gr. of sulph. morphia before 1, when she slept 4 hours, then had a copious; dark gummy evacuation from bowels. Violence of all symptoms was much abated; pulse 100; vomiting ceased; tongue red and dry; thirst, pain in head and dizziness yet troublesome, but much alleviated. Continued flax – seed poultices to abdomen, and drink of gum water, claret, and arrowroot jelly, 4 p. m., patient much more tranquil; two or three thin watery stools almost without colour, attended with griping and nausea. Continued prescriptions of m., with addition of calomel, gr. xv; opium, gr. j. Tuesday, 9 a. m., patient much improved; head, limbs, and bowels almost free from pain; pulse 80; has slept well during night; no evacuation from bowels. Ordered ol. ricini every 2 hours until it operates, and, with the exception of the calomel and opium, the prescriptions of the last n. continued. 4 p. m., patient quite relieved; oil has acted well; pulse 80. This afternoon she perceived the motions of the foetus for the first time since Thursday last. After this she continued to improve without any occurrence worth notice, and after a few days resumed her accustomed occupations. (Three months later patient was naturally delivered of a healthy child.) (FEARN, New Orleans Medorrhinum Journ., 1844 – 5, i, I.)
3. About 2 years ago there was brought to our hospital a young woman, pale, feeble, and evidently labouring under the effects of haemorrhage; and upon examination the fact was brought out that she had been suffering from uterine haemorrhage for weeks. The history of the case, as near as could be obtained, was this: She had for some time been indulging in illicit intercourse, and her menses having ceased, she feared that she was pregnant, and had taken large and repeated doses of ergot; haemorrhage had at last been produced; the blood at first was slight but was constantly increasing, till she was sent to the hospital, where she died on the next d. What treatment she received I cannot tell, as she was not in my department, and the hospital records barely mention the case, and that she died from uterine haemorrhage. I was requested to assist at a post-mortem examination, conducted by the county corner. The examination revealed the fact that she had not been pregnant at all; and also that there were no lesions of structure in either the vagina or uterus (as we expected to find) from the use of instruments used to procure abortion; but the ovary of the right side was completely disorganized. (Dr. J. T. BOYD, St. Louis Clinical Review, 1879, p. 253.)
4. Some years ago I was consulted by a woman of about 35, bilious temperament, sallow complexion. She without hesitation declared that she was pregnant. A man who had boarded with her had had frequent intercourse with her, and her menses were not regular, &c. The woman appeared in great distress of mind, from the fact that her husband, who had been absent for some time, was expected home in 2 mo., and exposure was inevitable, as she was certain she was 3 mos. gone in pregnancy. She had taken large doses of ergot in her endeavour to cause a miscarriage, but it had only produced a slight haemorrhage. She was sensible of an enlargement of the uterus; had a constant feeling as if insects were crawling over her; dull pain in region of ovaries; tenderness on pressure over the uterus, &c. I was satisfied that she was labouring under the effect of ergot, and told her so; requesting her to abandon all medicine, and all efforts at abortion, for in my opinion she was not pregnant, but was keeping up the disagreeable symptoms by the use of medicine. It required a great deal of argument to convince her, but she finally agreed to do nothing more for one month, and then she was to call again. I did not see her till 6 weeks afterward, when she came looking quite happy, saying that she had taken my advice, that all the hemorrhage and the disagreeable symptoms had subsided, and that her menses had appeared and passed off naturally. (Ibid.)
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.