19b. H. now proved the first six decimal trits. Aug. 4th, about 6 a. m., took 25 gr. of 6th. 11 a. m., frequent attacks of dull headache, deep in left forehead, at rest and when moving, sometimes increasing to drawing throbbing. 2 p. m., dizzy confusion of head, heat and redness of face, and sensible throbbing of arteries of head and neck (lasting over 1/4 h.). From 4 p. m. constant pain in corns as if boot pressed upon them, and frequent drawing penetrative pain, with stiffness, now in left great toe – joints, now in and about right ankle (in rest and motion). N. in bed rush of blood to head, with heat and confusion in it; noise of water boiling out at both ears, and frequent painful drawing in right ear. N. very restless. After midnight, cramp – like, penetrative pain spreading from metatarsal bones to sole and instep of left foot, which, after lasting a short time, was succeeded by precisely similar pain in right foot. In m. he felt tired and unrefreshed. 5th – At 7 a. m., 25 gr. A.m., some violent shoots, now in left, now in right great toe. P. m., drawing pains (at rest), now over left inner ankle, now in shoulder – joints, now in right or left wrist, often alternating with sharp shoots in rectum. In evening sudden shooting itching in fossa navicularis. 6th. – About 8 a. m. took 5 gr. of 5th. In an hours painful drawing in proximate joint of great toe, at rest; afterwards, when moving, cramp – like penetrating pain, at one time in inner ankle, then in lower calf, in knee, and in groin. P. m., a precisely similar pain, first in right metatarsus, then in elbow, wrist, and metacarpus of same side, always lasting a few m. whether at rest or in motion. 7th. – At 7 a. m., 10 gr. In an hours cramp – like drawing pain (in rest or motion) in right inner ankle, alternating with dull drawing pain in right forehead. Thereafter burning in skin of whole extensor side of right upper arm, which lasted above 1/4 hours, and after scratching left raw pain. P. m., burning shooting beneath left lids, as if sand had got into eye. On moving, cramp – like tensive pain, now in posterior muscles of left thigh, now in left calf, now in other muscles of extremities. 10 – 11 p. m., in bed, cramp – like drawing pain, penetrating right knee outwards, and sometimes alternating with precisely similar but slighter pain in left knees, – therewith much offensive flatus repeatedly forming and being discharged. About 3 a. m. very severe cutting pain darting like lightning from right deltoid to middle of upper arm. 8th. – M., took 5 gr. of 4th. After rising from bed, itching on several parts of skin of left hand; after scratching red spot arise, on which several closely packed papules appear, lasting several day, and itching periodically. Three hours after dose, wrenching pain in left hip (walking and standing) and shooting here and there in skin. P. m., frequently the above – described pains in joints of extremities (like those experienced by arthritic patients on a change of weather – weather now very fine), alternating with cramp – pains in their muscles, former most at rest, latter when moving. At n. anxious dreams of danger from fire and water. 9th. – In m. on awaking feeling of sand in eyes, with raw pain on rubbing them. 10 gr. were taken. During day frequent cramp – like tensive pains in muscles of both mastoid processes. At n. restless sleep and frequent waking. 10th. – In m. 5 gr. of 3rd. A.m., loss of appetite, vertigo, confusion of head, dimness of vision, constant sweating, and frequent itching in left auditory meatus. 11th. – E., 10 gr. In 1/2 hours (at rest) dull drawing headache in left forehead with similar pain, now in left knee, now in left outer ankle, now in left wrist. 12th. – M., 15 gr. in 1/2 hours (in bed) aching tension in left sacrum and hip, then sudden sharp cutting pain through right knee forwards, alternating after a few m. with similar pain in left elbow. After getting up pain in back went off, but there occurred feeling of roughness within throat, hoarse deep voice, and constant irritation to dry cough. Usual m. stool was scanty; first part hard, causing sore shooting pain in passing, second part soft like birdlime. All a. m. weakness and dimness of eyes, and frequent dry tussiculation. About noon some sharp shoots in urethra. P. m., while driving, aching in whole left head; afterwards, while at rest, brief shooting cutting pain above ant. sup. spinous process of right ilium, followed by cramp – like pains in flexor muscles of right upper arm. At n. in bed drawing in right upper row of teeth, and, somewhat later, distention of abdomen, griping, and frequent emissions of offensive flatus. 13th. – Wrenching pain (while walking) in left sacral region and hip, and some shoots in left sole and left testicle. 14th. – M., in bed, sudden, sharp, cutting pain from behind forwards in left great toe. P. m., some shoots in left tendo Achillis. At n., in bed, for some seconds, penetrating cramp – like pain in left metacarpus. 15th. – In m. 5 gr. of 2nd. In 1/2 aching in pit of stomach, and sensation like scratching in stomach; after a time aching tension in left sacral region and hip, and in whole extent of pelvis, sometimes so violent that pelvic bones seemed to be separating; this lasted 1/2 hours (in bed). After getting up, urging to make water, with cutting pain (as in strangury) over symphysis pubis. The whole forenoon sprained pain in left hip – joint (on walking), and very often gouty pains in joints of the extremities, alternating with cramp – like pains in their muscles (at rest and in motion). About 2 p. m. (at rest) several violent shoots in tendo Achillis near os calcis. In 2 hours dull aching in whole of right half of brain; dimness of vision and weakness of both eyes, with innumerable confused dark spots floating before the eyes; after this, long – continued giddy confusion of whole. At n., in bed, a semilunar painful drawing in root of nail of the right little fingers. 16th. – In m. 10 gr. In 1/2 hours (in bed) aching tension in left sacral region and hip, lasting several m., and soon recurring. After this, very violent piercing, cramp – like pain deep in right orbit (probably in the muscles), which, as far as he could judge, seemed to extend through bony wall of orbit into the frontal sinus; it lasted a few m., and then alternated with a similar pain in left orbit. After rising from bed a hard motion, causing pain in its passage through rectum. About 10 a. m. a pretty violent drawing in left temple, which only lasted a short time. Before dinner he observed, on inside of lower lip, a vesicle size of a hemp – seed, filled with dark blood, but it did not annoy him much, and after dinner was found to have disappeared without leaving a trace behind. P. m., in addition to a frequent alteration of the already described pains in head and joints, there occurred a violent, cramp – like, tensive pain close to right mastoid process (at rest), which seemed to pierce into deepest parts of bone; it lasted a few seconds, and then made way for a shooting pain in right temple. E. (when at rest) a sharp cutting, from behind forwards, along inner border of left great toe. 17th. – In m. 20 gr. On mucous membrane of right under lip, two aphthae, which went off in 2 d. Two hours after taking medicine, sudden drawing above right eyebrow, and afterwards (at every step) dislocation pain in left knee and ankle. At n., in bed, a pain piercing through knee – joint, which lasted 25 – 30 seconds, and was followed by a sharp cutting pain under nail of. r. great toe. 18th. – In m., after awaking, painful rubbing dry feeling in borders of right eyelids, with cramp – like penetrating pain in right mastoid process; after this, dryness of tongue, which after 1/4 hours, gave place to slimy taste in mouth. A.m., painful cramp – like tension, now in muscles of anterior internal aspect of left thigh, now in left calf. On inner surface of left lower lip he observed a group of greyish – white aphthae, which were rather painful; after a time several aphthae appeared on right upper lip (they lasted a week). About 4 p. m. griping in bowels from umbilical region to the symphysis pubis, coming in fits, and followed by a diarrhoeic evacuation of a yellowish – green, pappy, slimy mass. 19th. – Feeling of tiredness in left leg; cramp – like penetrating pain in left metatarsal bones, and pain in left sole as if it were ulcerated. 20th. – In m. 5 gr. of Ist. In 1/2 hours, in bed, violent pain in left sacro – lumbar region, worse on turning in bed. After getting up, a hard motion, which causes cutting in its passage through rectum; afterwards (on taking a step) shooting dislocation pain in left hip, which extended from sacro – lumbar region across pelvis to trochanter, lasted above 1/4 hours, and caused him to limp. About 11 a. m. giddy confusion in head with dimness of vision; dull pressive headache, at one time deep in forehead, then in occiput, but always alternating with gouty pains piercing through joints of extremities. About 7 p. m., when at rest, first a painful drawing along left tibia (feeling as if in periosteum), followed by very violent stitches in back, near left scapula. At n., in bed, there occurred, deep in right side of forehead, in a circumscribed spot size of a crown – piece, a slight digging, shooting pain which lasted a few m. The night’s rest was disturbed by anxious, half – remembered dreams. 21st. – In m. 10 gr. In 1/4 hours, in left sacro – lumbar region, an excessively violent, aching, tensive pain, as if muscles were too short; it spread over left side of pelvis to trochanter, and even involved sympathetically the abdominal muscles above crest of left ilium. This pain lasted as long as he lay on left side; on turning it went off instantaneously, but then attacked same parts on right side. On getting up, no trace of backache, but, instead, dryness of tongue and palate. P. m. (at rest), frequent painful drawing, now in head of fibula, now in left side of forehead, now in left elbow – joint, and now in right great toe. About 7 p. m., in open air, very troublesome confusion of head; and in back, close to right scapula, an aching, tensive pains, as if muscles were too short. 22nd. – In m. 30 gr. In 1/2 hours dryness of tongue, and burning feeling in skin which spread from axilla over right upper arm and right chest. Afterwards acrid water ran out of eyes. The whole forenoon, frequent dislocation pain in joints, even on a slight movement; and profuse perspiration when walking. About noon, burning pain in a spot of skin size of a crown – piece over right inner ankle. In evening fine burning, like sparks, on some parts of right upper lid. About 2 a. m. he awoke with aching pain in occiput, violent throbbing of all arteries of head; painful dry sensation in both eyes; aching tensive pain in sacro – lumbar region; prickling warm feeling all over skin, with disposition to perspire; and troublesome burning feeling which extended from shoulder over left upper arm and between scapula. 23rd. – A.m., at every step, sore feeling in abdominal parietes, as if muscles of abdomen and peritoneum has been bruised. About noon (at rest and in motion), in muscles of left upper arm, close to bend of elbow, a cramp – like pain, which, in course of 2 hours, gave place to an exactly similar pain in sinews of left popliteal space. About 4 p. m., at first some griping in bowels, then call to stool, followed by pappy motion of yellowish – green colour, in moderate quantity. 24th. – A.m.., frequent alternation of headache (at one time in forehead, at another in occiput) and the previous (gouty) pains in joints, but only when at rest; when walking dislocation pains in left hip, and at head of left fibula, causing him to limp. About noon, burning hot feeling in skin of whole back, especially annoying between scapula lasting more than 1/2 hours, and after scratching turning into sore pain. In evening, for a few seconds, shootings pains in right side of chest (judging by the feeling, in the pleura), and several shoots through arms, like lightning; followed by burning pain in skin of whole extensor surface of left elbow – joint. 25. – In m. burning and redness of skin of whole of dorsum of right hand, as if an eruption were about to appear. P. m. violent burning in skin of whole back, with perceptible throbbing in arteries beneath skin at affected part. In evening several jerking, lightning – like shoots in rectum. The night’s rest was often disturbed owing to burning pains in parts of skin lain on.
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.