3. Mr. B – has been affected, for a considerable period, with its douloureux, occurring at regular intervals and in paroxysms of excessive violence. For the relief of the pain of these attacks he has been in the habit of making use of the muriate of morphia, at first in small quantities, and afterwards in gradually increased doses, until 3 1/2 gr. were necessary to produce its effect. At this time he went into the shop of a druggist in the town in which he reside, for the purpose of obtaining some muriate of morphia, and received a quantity of a powder, slightly yellowish in colour, which was stated to be that substance. On the same day, having occasion to go a short distance into the country on business, he took, previous to going out, his usual 3 1/2 gr. of the powder, which was simply placed on the tongue and swallowed, and he remarked at the time that it was extremely bitter, and that the taste was more than usually persistent; but it did not occur to him that anything was wrong. Shortly after, however, while walking along the street, he felt slightly indisposed, the most prominent symptom being a sense of numbness in the back and legs, which he attributed to the effects of cold, to which he had been exposed in the early part of the m. As these symptoms did not appear of any importance, he proceeded by a public conveyance to the village where his business lay, and returned by the next opportunity. During the whole of this time the symptoms remained precisely as they were the moment he first observed them; but as he was walking along, on his return, they suddenly increased, the numbness being accompanied by a sense of want of power, and a sort of dragging of the muscles of the legs, which soon became so great that, as he described it, he had to put his hands at the back of his thighs in order to push his legs along. This occurred nearly 2 1/2 hours after he had taken the dose of the supposed muriate of morphia, and at this time there could have been nothing remarkable or unusual in his appearance, for on his way home he met a friend to whom he communicated his sensations, and who laughed at his evident apprehensions and assured him that it was all imagination. As he was in the midst of describing the effect upon his muscles, and bending himself so as to show how it occurred, he suddenly overbalanced and fell heavily backwards. He was immediately raised, and on attaining the upright position he felt himself much in the same state as before, except that he was excessively nervous and alarmed. The want of power in the legs did not at all increase in intensity, and no spasmodic affection was observed, although the patient was himself under the impression that his fall, was somewhat connected with the previous symptoms. The patient’s fall and the nervous state into which he had got now fairly alarmed his friend, who begged him to get home as fast as he could, and accompanied him on his way, as he experienced considerable difficulty in walking, and could not get on without support. On reaching home he felt somewhat better, and remained sitting for some time, and at length retired to bed about 5 hours after the first appearance of the symptoms. Just previous to stepping into bed, in order to ensure a good night’s rest, of which the recent symptoms rendered him some – what doubtful, he took a second dose of the powder equal in amount to the first. In less than 10 m. after he was seized with a violent tetanic spasm, affecting the legs and muscles of respiration, and had only time to call for assistance before the sensation amounted to absolute suffocation. Fortunately assistance was close at hand, and he was immediately raised up in bed, with the effect of entirely relieving the sense of suffocation, and a medical man was sent for. Spasms now followed each other in rapid succession, the intervals being about 1/4 hours or 20 m., and the affection was confined principally to the legs, back, and respiratory muscles, the arms being comparatively unaffected. The numbness and dragging of the muscles, which had been continuous during the first 5 hours, disappeared entirely during the intervals of the spasms, and the patient was left without any uneasy sensation, excepting the exhaustion of the previous fit and the apprehension of its successor. During the whole of this time he was not only perfectly conscious, but his senses were preternaturally exalted, and he distinctly heard a variety of whispered observations of the physician and his friends, which from their tenor were obviously not intended to reach the ears of the patient. The paroxysms, after continuing for some time, began gradually to diminish, the intervals becoming longer and duration of each spasm shorter, and it was hoped that they were about to pass off, when all at once they returned to all their original violence. This proved, however, to be the last expiring effort of the poison, for the symptoms now entirely ceased, about 13 hours after the first dose was taken. At the conclusion of the spasms the patient was left in an excessively exhausted state, and was unable to turn himself in bed. From this, however, he recruited with great rapidity, as he was able to get up on the evening of the next day, and on the second he walked out and went about his usual business. The most remarkable face connected with the case is, that from that time the attacks of tic douloureux entirely ceased, and he has not since had any return of it. The medical treatment employed in this case was unimportant and had not any effect on the progress of the symptoms. Chemical analysis proved the drug to be S., and not morphia. (ANDERSON, Monthly Journ. of Medorrhinum Sc., 1848.)
4. A man, aet. 34, paralysed on right side, had 1 1/2 gr. sprinkled on raw surface of powerless leg. In less than an hours he had twitchings in it, which increased in intensity every m., boring pain in occiput, slight vertigo, and noise in ears. The twitchings spread to right arm, and then over whole left side, with increase of headache, and at last unconsciousness, with rattling difficult breathing. Pulse was very full, hard, slow and intermitting; face bluish red, puffed; eyes projecting, pupils very much dilated, mouth open. He tossed about in bed for the violent convulsions and difficult breathing. Skin of right leg had a blue marbled appearance. This patient recovered under the morphia endermically administered. (RICHTER, Frank’s Mag. i, 104.)
5. A man, aet. 60, took about 75 dr. of a solution of 3 gr. of the acetate in 3j of water. In 1/2 hours he had vertigo, and in drinking a cup of coffee his hands trembled and he was forced to rise from his chair, when he led to bed. He then had general trembling and dyspnoea. His look was wild; pupils dilated; face red; tongue dry in middle, red at edges; very rapid breathing; full, hard, quick pulse. The least noise, the slightest touch produced tetanic convulsions accompanied by frightful cries. Patient continued to get worse, preserving, however, perfect consciousness. The cry was forced from him involuntarily, and was not occasioned pain. The most disagreeable symptom he experienced was the oppression of the chest. The symptoms lasted altogether 2 1/2 hours, and then went off, leaving only thirst and exhaustion. (FOHR, Ibid., iii, 899.)
6. In May, 1850, Dr. BARTLETT was called to see a young man, aet. 22, suffering from “spasms.” He had red hair, blue eyes, fair skin, and had red hair, blue eyes, fair skin, and had previously suffered from dyspepsia. He complained of a singular indescribable sensation all over, quickly followed by general tonic spasm. The extremities were held in a convulsive movement (both flexors and extensors being rigidly contracted), and he looked like one in an ague fit. His continuance was extremely sad and despondent; he was morose and indisposed to answer questions. 8 p. m., patient on back breathing heavily, dysphagia, eyes closed, pulse 120 and full, continued tetanic spasms of all the muscles, spasm lasted 4 m., attacking chiefly back an throat. As he lies, legs are wide apart, toes strongly flexed; wide awake, mind active and anxious, intense thirst, dry mouth and tongue, burning heat and great fulness and throbbing in head (a little pain in forehead). Starts every 15 or 20 seconds; least noise or slightest touch starts spasms, which are all alike, differing only in severity and duration, lasting from 10 seconds to 5 m. One description will suffice: He starts very suddenly, his legs are immediately drawn as under as far as possible, his body curved so that head and heels only touched floor, muscles of arms and legs rigid, respiratory muscles frightfully affected, so that it is with great difficulty he breathes at all; his face becomes blue and then black; jaws tightly closed; vomiting occurs. During this spasm he has not breathed at all for 3 m. and has lost consciousness, looking like a suffocated man. Tongue protrudes, eyes stand out from sockets, and no action of pulse or heart, yet the paroxysm holds on. Mind harassed with dread, and he weeps, but cannot tell why. After a spasm, sighing, aching of insteps, and a dead numbness all through body. At midnight, nausea, burning heat all over; hot sweat, followed by a dried – up feeling all over surface of body; feels warmth in bowels; eructations of bitter and tasteless wind before vomiting; bitter taste in mouth. By 5 a. m. he was much better; only slight twitchings; other symptoms present, but slight. This patient had taken 3 gr. of S. in ignorance of the proper dose. (N. Amer, Journ. of Hom., i, 469.)
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.