28. On March 31st a man aet. 40, his son, aet. 12, and a girl aet. 2 1/2 were brought under Dr. UNGEFUG’s care suffering from ergotism (Kriebelkrankheit). They had been eating for a week rye meal, which, it is known, contains a quantity of ergot. The previous day they were all seized with extremely violent pain in arms and legs, accompanied by electric shocks as in tetanus. Face pale and thin, tongue furred white. The father’s appetite was normal, one of the children had ravenous hunger. Throat dry; arms and legs in a semiflexed prone position, very stiff and painful if attempted to be extended; pulse and temperature of skin normal; pains in sacrum. The elder child died with incessant pains and twitchings, he remained conscious to the last; the man and the other child recovered. – P. M., 29 hours after death. Cadaveric stiffness and decomposition moderate; brain, cerebral membranes, and transverse sinus full of blood; lungs congested, filled with frothy fluid dark blood; bladder full of urine; spinal cord and its membranes very congested, its substance softened. (Viertelj. f. gericht. Medorrhinum, ix, i, 1856.)
29. In 1831 ergot appeared in unusual quantity in the rye- corn and constituted often one fifth of the whole meal. WAGNER attributes the morbid affections he observed in a number of cases to the action of the ergot.
29 a. August L -, aet. 16, and Rosalind L -, aet. 12, to whom he was called in the n. of the 30th July, had for 8 day complained of periodical attacks of transient weariness, which continued till the 29th, when there came on in addition painful drawing in hands and feet, which occurred quickly and frequently, allowing of little rest. On the 30th the state was as follows; Complete stiffness of arms and legs. The thighs were drawn forwards and the legs backwards, forming with the thighs an acute angle; the feet were drawn forwards and the toes backwards. The upper and forearms formed a similar angle directed upwards, the hands drawn towards the chest, and all the fingers bent inwards as though they would tear the flesh from the chest, and this position they maintained persistently. About every 1/4 hours three occurred a very painful formication, alternating with burning, from the tips of the toes up to the tips of the fingers, sometimes with a sensation as if ants were running beneath the skin. The tips of fingers and toes were numb. Immediately after the formication the chest was spasmodically contracted, so that the air was rapidly expelled from the lungs, causing the patient to emit a loud cry, and for a short time inspiration was stopped, the patient started up involuntarily from the recumbent position and supported himself on knees, elbows, and head in order to be able to take an inspiration. The skin of the extremities and body became hot, and only moist on the head. Pulse slow and irregular. Face bloated, red. The patient retained full consciousness. No sleep either by n. or d.
29 b. Six other cases were observed with similar symptoms, with this difference that the lower extremities were stretched out straight and the toes bent backwards; one of the patients vomited frequently.
29 c. Many other cases were observed, in which the following symptoms occurred: Several complained of heaviness in the legs, vertigo, violent cramps in the calves, and occasionally such violent contraction of the abdominal muscles that the whole abdomen was compressed towards the spine and the patients rolled on the ground uttering shrieks. In one case the contraction assumed the form of several hard balls in the abdomen; in this case the attack commenced with maniacal and cerebral inflammatory symptoms, for which bloodletting was employed; then there came on frequent formication, burning, and running under the skin of hands and feet as if worms were wriggling under the skin, cramps of calves, the above – mentioned abdominal spasm followed by numbness of skin and then symptoms of inflammation of the bowels, for which bloodletting was again employed. The patients after these attacks seemed quite well, and several day would pass without a recurrence of the spasms. But the formication and burning in skin with the numbness persisted. Sometimes one or the other arm went to sleep. There were sometimes sensations which the patients could not describe. In this form the affection assumed a chronic character. (WAGNER, Hufeland’s Journ., lxviii, Pt. 4, p. 5. 1831.)
30. A peasant woman, aet. 48, said that 10 weeks previously she was suddenly seized at n. with violent vomiting, which lasted 2 days with violent headache and pain all over her body; after this she had burning headache and feeling of pain and bruised sensation in all the limbs, which persisted and made her keep her bed for 9 d. These symptoms then ceased, and though weak she got about for 8 d. Then there came on in her extremities crawling betwixt skin and flesh, and attacks of shooting tearing from one point to another, sometimes with, sometimes without cramps; trembling of arms and legs, especially when she attempted to use them, with such weakness in them that she staggered and could not grasp anything securely, with numbness of fingers and toes. These symptoms increased every day, so that when seen on Nov. 14th she could not raise her arms or legs, but must maintain a recumbent position. She had formication in extremities, with shooting, tearing pains; the pain in feet and calves was particularly severe, of a gnawing, boring character, worse at n., hindering her from sleeping; she is so paralysed that she cannot raise arms or legs, though she can move them about in bed; the tips of her fingers and toes are quite insensible; normal sensibility begins only above elbows and knees. (HUSS, Chronic Alcoholism, &c., 224; in Frank’s Mag., iv, 687.)
31. A peasant lad, aet. 22, of strong vigorous frame, was received into hospital March 22nd, 1880. He was affected by ergotism in beginning of December. One day he stood stock – still in the stable and then fell down in convulsions. These were repeated frequently by day and by night. When the attack came on he felt tired and lay down in bed, then he uttered a cry and had twitching in arms, the eyes rolled upwards, there was rattling in chest and he foamed at the mouth, the hands were doubled into fists, he frequently bit his tongue, consciousness was temporarily lost. Latterly the appetite was remarkably increased; he slept much, since Christmas he could not follow conversation, was very confused, and often sighed. Pulse full. Knee -jerk absent. He hardly understands what is said to him, his speech is slow, often stammering and incomprehensible. He sometimes laughs suddenly. The epileptic fits occur almost daily. They began usually by heaving a sigh and bowing his head, the eyeballs rolled upwards, the fingers were flexed, the thumbs turned in, then there were convulsive movements in the forearms, face, and masticatory muscles, during which the tongue was generally bitten; there were shuddering movements of the trunk. Face at first pale. Pupils seemed contracted at beginning of attack, later dilated. These symptoms only lasted about 1/2 a minute, then the convulsions ceased and the patient lay in deep coma, his respiration was rattling and laboured, foam gathered upon his lips. Muscular convulsions occurred occasionally, especially of the chewing muscles. The face became red, sometimes cyanotic, the pupils greatly dilated, not very sensitive to light. Several attacks of epilepsy often occurred during the coma. Ophthalmological inspection showed redness of the papilla optica. In course of time there occurred catarrh of trachea and bronchial tubes, with copious expectoration. From April 20th the fits became very severe, the tongue was bitten to pieces, and its wounds became covered with a greenish fetid layer. He died suddenly on April 26th. Tuczek made a microscopic examination of the spinal cord. He says: A section of the fresh cord shows nothing peculiar. After the cord had been hardened for several weeks in a solution of bichrom. of pot., parts of posterior columns of the cord were seen by naked eye to be altered and of a much brighter colour. These extend the whole length of the cord from the crossing of the pyramidal bodies to the conus medullaris, as shown by sections in different parts. In the lower part of the lumbar portion the bright part includes the posterior external angle to the posterior border of one side, and the posterior root on the other side. In the upper part the figure gradually grows forward till towards the anterior angle, sends a prong into the upper part of the dorsal portion of the cord, which grows out to a stripe bounding the column of Goll, whilst the outer bright part gradually retreats to the posterior angle. (SIEMENS, Arch. f. Psychiatr., xi, 377.)
32. A girl, aet. 9, received Jan 19th, 1881. Had suffered more than a year from symptoms of ergotism, which were aggravated by again partaking of ergot bread. For a fortnight has had psychical disturbances, great restlessness, loud screaming. She is well developed for her age. Pupils dilated, but react to light. No knee – jerk. She wags head to and fro and calls, “Mother! mother!” She snaps greedily at everything, is very thirsty, is dirty, stools diarrheic, temperature normal, tongue moist -.21st. Had an epileptic attack lasting 10 m., followed by shorter coma. After 3 respirations there always occurred a pause. Her fits increased in number, and on the 19th Feb. she died in the coma. The cord having been hardened in pot. bichrom. sol., a considerable degeneration of its posterior columns was visible to naked eye. The microscope showed these degenerated parts to be very advanced atrophy of the nerve – fibres. the degeneration is symmetrical in both posterior columns, and extends through the whole length of the cord up to the med. oblongata. (Tuczek relates a long series of cases in which ergotism was attended by various symptoms pointing to affections of the nervous centres, such as epileptic fits, mania, ataxia, stupor, dementia, extreme anxieties, vertigo, religious despair, great lethargy, impossibility to remain standing with eyes shut, loss of power of coherent speech, feeling of being surrounded by a tight girdle, occipital headache, analgesia, Romberg’s symptoms, and in every case loss of knee – jerk. Four of the cases, including that given above, died, and P. M. examination showed more or less degeneration of the posterior columns of the spinal cord.).
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.