20. On Sept. 3rd, 1861, three well-marked cases of poisoning by stramonium seeds were admitted to the Pennsylvania Hospital. One was a man, aet. 31, the other two were women, aet. respectively 34 and 58 years. They partook of some whiskey which contained some stramonium seeds. The man drank a cupful, the elder woman about a gill, the younger only one or two mouthfuls. A child of the latter was also given a little of the mixture, and it was in this case that the effects of the poison were first noticed. Within 4 or 5 m. after taking the drought the child became violently flushed in the face, the eyes glittered and rolled about, and it tottered so as almost to fall from its chair. This alarmed the mother, who, although already giddy and half blind, managed to run with the bottle to a neighbouring druggist. With much difficulty she again reached her house, where she found the other woman and the man lying speechless on the floor. They were at once taken to the hospital. The man and elder woman were nearly comatose, their faces flushed to an almost violet hue, the conjunctivae injected, and the pupils were insensible to light and so strongly dilated as to leave visible merely a rim of iris; the skin of the face and upper extremities was burning hot; the tongue and throat parched and dry; respiration slow and laboured; pulse 100, and very tense and dull. The younger woman had taken a smaller dose of the poison, and had reached only the maniacal stage of its influence; the skin was scarlet and burning hot, and the mydriasis as marked as in the other cases; the tongue parched; intense thirst, but no constriction of the fauces on swallowing; the respiration was hurried; the pulse fluttering, and beating 140 to the minute. The patient was violently delirious, resembling in a marked degree the most excited stage of delirium tremens, struggling to get out of bed, and continually rolling from side to side; she was unable to stand by herself, and, unless supported, feel forwards to the ground. When her hands were not restrained it was observed that she pursued imaginary objects in the air, or picked at the bedclothes, as in the delirium of typhoid fever. The man exhibited much the same symptoms as the woman, catching and striking at imaginary objects around him; but the retina was insensible to light, for a hand passed close in front of the eye failed to make him wink unless the cornea was touched; he was also more comatose at first, and with a more feeble and rapid pulse – 150 per minute. Another alarming symptom was an apparent somnolency, which, according to some authors, marks only the worst cases. Next m. he was able to walk and to read large type. Some abnormal dilatation of the pupil and vertigo remained during the day; by evening he was quite well. Opium and morphia constituted the principal portion of the treatment. (LEE, Ibid., N. S., xliii, 54.)
21. C. McK -, aet. 10, and his brother, aet. 8, left their home at 10:30 a. m. upon an excursion to some vacant lots at a distance of over a mile from their residence, whence they returned about 3 p. m., and asked for their dinner as if nothing unusual had occurred. While eating, the mother observed a peculiar uneasiness and a tendency to wander from the subject on which they were being questioned, and she asked their comrades if they had not been using intoxicating drinks, but was assured that such was not the case. The two children were then unable to walk. In 1/2 hours the symptoms became more alarming, and I was sent for, and reached the house at 4:30 p. m. I found the children lying on their backs; their eyelids slightly dropping; cornea very bright; pupils widely dilated and insensible to light; conjunctive injected; face deeply suffused, and of a dark crimson colour; an apparent difficulty in breathing; inability to articulate, and a state of complete insensibility, broken occasionally by a paroxysm, during which they would utter some indistinct sounds and throw the hands about the head as if attempting to ward off some threatening evil; this would soon subside into a semi – comatose state, not the stupidity, however, which results from opium, but rather a state of intense apathy which persisted for a few seconds, when the delirium would again recur, unless sooner produced by the efforts of those about to render assistance, when the state of excitement assumed such a form and violence as to render necessary a certain amount of restraint to prevent escape from the imaginary object which engaged the attention; occasionally they would grasp at something in the space in front, appear as if they possessed or rejected it, then turn the head as if called by a voice beside them, and attempt to speak to it, the sound resembling a squeak more than the natural tone of voice. Neither of them was able to support himself alone upon his feet, but would take a step or two with a staggering gait, falling to the floor as if intoxicated or in a state of complete exhaustion. During the period of excitement the extremities were in constant motion, co – ordinate only so far as they related to the corresponding limb, yet wanting in that harmony of action which is found in those movements of a higher order, as standing in an erect posture, walking, &c.; there was constant action of the fingers, as if attempting to pick something from the person or bedclothes; at times they would burst into a paroxysm of excessive laughter, which would persist for some seconds, then suddenly cease; at times they would have a smile so quiet and pleasant that we could not but contrast it with the highly excited state previously witnessed. To each was given an emetic of sulphate of zinc, gr. v, and pulv. ipecac., gr. x; their jaws being closed, and as they could not be made to comprehend our object, there was no little difficulty in causing them to swallow. Emesis followed, consisting of food and about half a drachm of the seeds. Cold water effusions were employed and seven drops of tinct. opii. At 5:15 p. m. the sulphate of zinc was repeated without immediate result, and also the opium. Twenty m. later, no marked effect having been produced, 10 dr. of laudanum were given; they are now lying more quiet; dilatation and immobility of the pupils; general appearance unchanged; still insensible, and even when loudly spoken to the eyes would scarcely be turned towards the speaker; till continue to pick at the bedclothes and grasp at the imaginary objects about them; suddenly move as if spoken to, and apparently attempt to articulate some reply, the limbs being at the same time actively moved, not spasmodically, however, but as if attempting to perform some action which failed for want of a proper guiding influence. 6 p. m. – They appear to lie more quiet, now, and the iris still remains dilated and uninfluenced when exposed to the action of the light; are not so frequently excited, though at times they laugh immoderately; surface of the body continues very red, though less so than a short time previously. 5 dr. of laudanum to each. 9 p. m. – Both children are held sitting upon the knees of an attendant, whose attention is fully directed towards preventing them from falling during the periods of excitement, which are less violent and appear to be more in the direction of intelligence. The skin remains as from the beginning, somewhat relaxed, though not moist, and very slightly elevated in temperature; pulse 95, compressible, and full in volume, and has varied but little from this since the commencement of the symptoms, even during the paroxysmal state, and this is to be attributed perhaps to the muscular movements after rather than to direct action on the heart. Pupils now are less dilated, though very slightly influenced by light; children are able to articulate, but cannot be made to comprehend question put to them, and occasionally laugh or attempt to sing. 5 dr. more of laudanum are given now, and repeated in 30 m. 9 a. m. – The youngest child was now quietly sleeping, but could be awaked without difficulty. During the n. 10 dr. more of the laudanum had been given to each. The eldest was quietly lying on the bed; pupils more contracted than when last seen, and became more so when exposed to strong light; skin moist and cool, has lost that efflorescent appearance which was before so strongly apparent; pulse 86; respiration normal; responds yes and no to necessary inquiries, but does not complain or attempt to converse; is wholly uninterested in all that passes about him, and as he lies on side smiles as if amused at some ludicrous idea passing in his mind; at intervals has slept during the n., though frequently disturbed by illusions. 6 p. m. – Much better; pupils nearly normal in diameter, but not quite so susceptible to light as desired; complain of slight dryness of the fauces; some vertigo, with occasional delirium through the day; and the eldest, when asked in reference to his thoughts, replied that he felt as if dreaming, though not asleep. Next day all were well.
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.