24. P. C. aet. 30, on evening of Feb. 18th was suddenly seized while passing water with most violent pain in head, followed immediately by vomiting; pain was so violent that he screamed for assistance. He was found pale; skin cool, covered with clammy sweat; pupils contracted, irresponsive to light; pulse 48, small and feeble. He was perfectly conscious; he complained bitterly of pain in head; voice was feeble and low, and he was evidently in a state of great nervous prostration. He admits having been addicted to drinking ardent spirits to excess, and to inordinate use of tobacco; he was at same time exposed for several hours daily to fumes of tobacco while being “stoved.” 19th. – Head easier, pulse 60, skin warm; says that pain is now most intense when he makes water, coming on suddenly worse just as act begins. Urine high coloured, 1018, non-albuminous; pupils still contracted, but little responsive to light. During following days headache remained much the same, always materially increased on micturition, bit also assuming erect posture. He never complained of uneasiness along urinary tract. By 22nd pupils were widely dilated and obedient to light. On 26th he was admitted to hospital, and found with pulse 60, small and weak; countenance anxious and distressed; pupils dilated; little sleep; pain in head in paroxysms, and greatly increased at micturition; tongue moist, covered with white fur. He improved very slightly, if at all, till March 6th, when a strong smell of nicotine was observed all over his skin. He was now ordered a vapour bath every n., and left hospital on 12th much better, but was still suffering occasionally from pain in head up to April 11th. (There was no syphilitic history.). (BABINGTON, Dublin 2. Journ, of Medorrhinum Sc., xlii, 545.)
25. a man, aet. 63, had smoked excessively since he was 14, and had now smoked Hungarian t. in a meerschaum several times daily for 6 mo., besides several cigars each d. At last there came on almost painful restlessness. “I was,” he says, “frequently obliged to change my position, and, when standing, to stand on one foot and frequently change position of body, to lean or support body in some way; while sitting was obliged to stretch out or bend up the feet and move them backwards and forwards; while reading, the arm speedily became fatigued from holding the book, and sometimes there was stitching in the fingers and especially the thumbs; even in bed I was obliged frequently to change the position, and while asleep became very restless, so that my slumbers were frequently interrupted and I was often weary in m. Following this there was complete e loss of co- ordination of antagonistic muscles, so that while standing the knees gave way, or on sitting down I fell with my full weight on the chair. I become unable to draw on my clothes without supporting myself. At times the gait became slow and shuffling, the steps short, scarcely raising the feet from the ground, so that I frequently stumbled and became weary; it was especially difficult to go upstairs, worse still If there were steep; such ascent caused anxiety and dread of falling backwards, so that I went with the body bent forwards. This was associated with transient attacks of vertigo while walking in open air, especially on suddenly looking upward; with great weakness and speedy fatigue, though there was no confusion of head or difficulty in performing mental labour; and with epistaxis at times without cause.” (RITTER, Medorrhinum Corr. – blatt, Wurtemb., xxxviii, 5.)
26. In a vast number of extreme cases of smoking, when those who have indulged in such excess have had what has been called toothache, their sufferings have great, yet in most instances I have observed that the crowns of the teeth seemed perfect, save that the enamel appeared to be altered in structure and colour. I therefore directed special attention to the state of the fangs, and found them in all such cases, denuded of their periosteum, being rough at the extremities, as if rasped; while the fangs were of a darker hue than healthy dentine presents, and of a porous appearance. In consequence of the active absorption thus shown to be going on, the affected teeth act as foreign bodies and produce much local irritation. Hence I am led to the inference that t. affects the teeth themselves; and that the affection must not be confounded with their injury induced by the acidity often caused by stomach derangement resulting from an inveterate habit of smoking. The symptoms of the smoker’s toothache are as follows: More or less uneasy sensations about the crowns of the teeth, which gradually extend to the fangs; at this stage of the disorder, if the teeth are touched tenderness is experienced, and if bitten on while in this condition a sudden and most painful sensation occurs. As the disease proceeds, the patient seems cognizant of its immediate seat, the agonising pain being confined to the bottom of the alveolar process of the affected tooth or teeth, which is attended with palpable throbbing or, as an unscientific patient expressed it, “jumping pain.” the most distressing symptoms are felt under vicissitudes of climate l in great and sudden changes from heat to cold, and vice versa; or after alcoholic stimulants: in fact the teeth, in this affection, suffer from anything that accelerates the circulation. Among many of my most intelligent patients, when there happened to be a space (from previous extraction) between the affected teeth, they have described their sensation as if a series of galvanic or electric shocks continually passed from tooth to tooth. (LEVISON, Medorrhinum Times, xxi, 27.)
27. Dr. G. DECAISNE has submitted to the society of Public Medicine the results of some interesting observations on the effects due to the use of t. among boys. there were placed in his charge 38 youths, aet. 9 – 15, who were in the habit of smoking to a greater or less degree. The effects of course varied. In 22 there was distinct disturbance of circulation, bruit in carotids, palpitation, deficient digestive power, sluggish intellect, and craving, more or less pronounced, for alcoholic stimulants IN 3 there was intermittent pulse. Analysis of blood showed in 8 cases a notable falling – off in the number of red corpuscles. 12 had frequent epistaxis, 10 complained of agitated sleep; 4 had ulcerated mouths, and 1 became the subject of pulmonary phthisis. the younger the body the more marked were the symptoms, and the better fed suffered least.
Out of 11 who were induced to cease smoking, 6 were completely restored to health in less than 6mos., while 3 others continued to suffer slightly; the other 2 were lost sight of. Treatment with iron and quinine gave no satisfactory results. ( Gaz. d. Hip., June 30th, 1868.)
28. Dr. CORSON had been in the habit of chewing T. and swallowing the juice. After 7 years of this he was suddenly seized with intense pain in chest, gasping for breath, with sensation as if a crowbar were pressed tightly from right breast to left, till it came and twisted in a knot round heart, which now stopped deathly still for a. m., and then leaped like a dozen frogs. After 2 hours of death – like suffering, the attack ceased; but ever after the heart missed every fourth beat. For the next 27 years he continued to suffer milder attacks like the above, lasting from one to several m., as often as 2 or 3 times in day or n. After discontinuance of T. attacks ceased. (Bost. Medorrhinum and Surg. Journ., xlix, 518.)
29. D. W -, a student of law, of nervo-sanguine temperament, had been a martyr to dyspepsia two or three years; applied for treatment of eyes, which were highly injected, cornea vascular and semi-opaque, and lids granular. He had low spirits wants of resolution, and general hypochondriasis. Had good relish for food, but a train of nervous symptoms came on directly after meals and lasted until stomach was empty. Acidity, cardialgia, gastrodynia, palpitation of heart, vertigo, and fulness of head; profound gloom, while keenly alive to every feeling; in constant fear of death, yet tempted to commit suicide. Had suffered thus for months, when a new symptoms arose. Had frightful dreams for more than a year; now, in first hour of sleep, was suddenly awoke by shock in epigastrium, causing great alarm. This recurred several times in n., as often as he fell asleep. the shocks were first confined to epigastrium, but a after a few weeks they were transmitted to head, and were even more unendurable. They were followed in head by sensation of rush of blood, and a firm conviction he should die of apoplexy. Symptoms were palliated by morphine hand carbonate of ammonia, but only temporary benefit was obtained. He used tobacco freely, by smoking, chewing, and snuffing. Abandoned the two later, and his health improved, particularly the shocks and epigastric sinking. He then renounced smoking entirely, and the whole train of nervous symptoms vanished as if magic. The gloom and despondency cleared away, and the inflammation of the eyes yielded readily to treatment. (SHIPMAN, Bost. Medorrhinum and Surg. Journ., xxxi, 354.)
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.