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The Pamphlet Collection of Sir Robert Stout: Volume 33

Additional Cases

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Additional Cases.

16th October 1867.

Since the foregoing Epistle was despatched to the minister, I have been to-day called to a case pretty well fitted to test the soundness of my hopes in reference to diphtheria. I take notes of it as it proceeds, and will honestly tell the result, whether it proves favourable to these hopes or the reverse. For a reason to be stated, I call the case

A Fight with Diphtheria.

Some six years ago, diphtheria prevailed in Elsrickle and neighbourhood with unusual severity. The number of deaths was frightful. Among others died a young lady in a neighbouring mansion-house, daughter of probably the most heroic of our Indian generals, and most useful in quelling the Indian Mutiny. But if there was one house in the whole district where the enemy seemed to concentrate his force, it was the farm-house of H———. Here I had to fight single-handed with all the usual medical appliances for eight or nine weeks; neither friend nor neighbour almost dared to assist. The result was decided victory on the part of diphtheria; the list of casualties being two killed and five seriously wounded, from this family alone. To-day I got a message to visit this family immediately, for the youngest son, James, had been ill with sore throat since yesterday, and 'they were sure it was the bad throat.' Being prevented from going for half-an-hour, I sent with the messenger some chlorate of potash powders, and a gargle containing sulphurous acid, writing on the envelope of the bottle, 'Not to be touched till I come myself.—R. P.' On visiting shortly afterwards, sure enough I found it decided diphtheria, and threatening to be of a bad type too,—a large slough on each tonsil, foetid breath, foul tongue, hacking of phlegm, hot skin, feverish pulse, etc. I immediately told the family, 'Now, this is most assuredly the old enemy that killed two of your number, and made your hearth so desolate six years ago. I tell you this to put you on your guard. But keep up your spirits; for I mean to fight him with a different weapon,—only rest assured that your safety lies in implicitly obeying my injunctions.' All were only too eager to attend to them. In case, however, the poor patient might be discouraged, I added to him, 'As for you, James, you have no cause for alarm at any rate. I expect to relieve you in a very few minutes. The fight chiefly means keeping the rest from catching the infection.' I then injected some spray into his throat; but first caused him to swallow some water, to try the power of the spray in relieving pain. The patient expressed himself as greatly better, and swallowed some page 36 water much more easily. I then told him, as a curious circumstance, that sulphur fumes and steam formed the very same spray as what had relieved him so much at present; and if he wished to be speedily cured, he could scarcely be inhaling it too often. I then showed him how to use the gargle. In opening the cork, one of the sons stood back with suspicion, expecting some fearful explosion or another. On my laughing at his fears, he said, 'Why write on the bottle, "Not to be touched," etc.?' 'Because,' said I, 'I wished to look the foe fairly in the face, and see whether he was likely to be dangerous. The gargle might have altered things entirely, and made me doubtful whether it was the old adversary or no.'

The eldest son is fortunately a very clever, intelligent young gentleman, well educated, and thoroughly up to all modern ideas of fungi, disinfectants, etc., and he undertook to see all my instructions carried into effect; so that if I fail in gaining the victory it cannot be for want of an efficient Lieutenant. The enemy, on his side, has equal advantages, having been twenty-four hours in possession of the field, and that one of his former fields of triumph; the very first shot of his artillery having evidently been meant to be a serious one, if not, indeed, of a deadly nature. Even now while I write, I can scarcely avoid such feelings as a general might experience in commencing battle, when he exults in the hopes of a brilliant triumph, and feels that the issue of the contest is more momentous than either Austerlitz or Waterloo. I jotted down in writing for the guidance of my Lieutenant his 'Fighting Orders,' and should they prove effectual I commend them to the consideration of all medical soldiers.

Fighting Orders.

1.Mild sulphur fumes almost constantly in the sick-room.
2.Occasional inhalation of steam from warm water.
3.Occasional poultices or warm fomentations to throat.
4.Gargle to be used frequently, and then a little swallowed.
5.A calomel pill at once, to be followed by castor-oil if necessary.
6.A chlorate of potash powder to be dissolved in a tumbler of water, and used up in small draughts in twenty-four hours.
7.Finally, and most important, should any one member of the household feel the slightest touch of sore throat, to use at once gargle, fumes, and steam, and send for me.

Note.—I applied no caustic, under the impression that it can scarcely destroy the fungi, but may screen them from what is able to destroy them.

I then left, and promised to call to-morrow.

Oct. 17.—When Cæsar described some of his immortal victories, it was in three graphic and most telling words, 'Veni, vidi, vici;' a specimen of thrilling historical eloquence only equalled in the first chapter of Genesis. Fain to save time would I adopt such a pæan of triumph as my own. But it won't do. The battle still rages fiercely on both sides; victory doubtful, but I think slightly inclining to the page 37 side of right. The enemy in no respect dislodged from his strongholds. Both tonsils much swollen, and still covered with sloughs, held out by the adversary as flags of triumph. It strikes me that the right side flag is not quite so audaciously displayed to-day. A shot of spray from Dewar's tremendous cannon having again given great relief, I left the piece of ordnance in the hands of my Lieutenant, with orders to be used very frequently till my visit to-morrow. I ordered also the whole house to be fumigated once a day, lest the insidious foe might be lurking in ambuscade in some hole little thought of.

Oct. 18.—Visited to-day the Crimean field. Signs of victory in Sebastopol at any rate! which means, of course, the patient's throat. The shots of spray have been frequent and effective, dislodging the enemy from one Malakoff Tower or tonsil, while his force is decidedly weakened in the other. A medico-clerical friend accompanied me today, who was highly satisfied both with the relief afforded by the spray, the energy displayed in the 'fighting orders,' and manner in which Lieutenant T. was carrying them into effect. Ordered wine and beef-tea, and a continuation of all the former tactics. Pulse still very quick; face flushed, and skin hot.

Oct. 19.—Progress still satisfactory. The fever of war quite abated; its pulse of excitement quiet and steady; the citadel of health out of danger from the enemy's brisk but futile onset, though he still shows a feeble flag on the left Malakoff. My Lieutenant thinks he can deal with the foe now without my help. 'Well,' said I, 'see and watch him well; and for the sake of the other citadels not yet threatened, don't neglect to give the whole "Castra Quadrata" a smell of gun-powder once or twice a day at any rate.' This he promised faithfully to do; and this indefatigable officer, though strong in mind, having been rather weakly in body for several years, my final advice was—'In covering yourself with fumes, you may not only cover yourself with glory, but perhaps with a bloom of health besides, that your cheeks have not seen for many years.' A. 'Indeed, Doctor, it strikes me I am a little the better of them already.'

Oct. 20.—Latest despatch from the seat of war. Lieutenant T. writes:—'J. keeps on improving.' 'Getting rather a better appetite.' 'Still two small spots in the throat.' 'Getting out of bed.' Answer. Told him to keep brushing the spots with sulphurous acid, and for the safety of the rest, not to neglect fumigating the whole house for a time. Lesson.—Fumes are harmless, and don't increase fever at any rate. For it was while the sick-room was almost constantly filled with them, that the fever abated in a marked degree.

Nov. 4.—The patient's recovery satisfactory, and up to this date no threatening of attack on any other inmate. The enemy apparently slain.

Practical Conclusion.—People of Elsrickle, and of every hamlet in the land! attend to this case. Clean your houses; see to your ditches; dry up your dubs; look to your drains; and if diphtheria again invade your village, why not scare him from your hearths by lurid burnings systematically adopted, and choke him to death by sulphur fumes?

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Case X.—Cancer of the Lip.

16th Oct. 1867.—Strictly speaking, this should have been noticed under the head of 'Trifles.' What! call cancer of the lip a trifle? Certainly. Because such sores are not generally real cancers at all, but mere local incurable sores, with hard cartilaginous edges, that won't heal by any applications; and though they will certainly kill the patient if neglected, they may take twelve or fifteen years to do so, which allows ample time to excise them with a bistoury, a slight operation almost invariably successful. Be this as it may, I happened to have such a case in hand before hearing of the sulphur cure. I told the patient at the first that it must come to the knife; but as it had only existed some six weeks, or thereby, beginning with a small blister that never healed, he might try a little salve in the first place. Some three weeks of the salve doing no good, it was agreed to cut it out any day he chose to come to me. But people have a natural affection for their lips. It was always to be done 'some day;' but before that day came, I came into possession of the sulphurous acid. So, on the 5th October, I gave him a small phial of the acid mixed with glycerine, and told him to keep a piece of lint constantly wet with it on the sore. Having more important cases to attend to, this case was neglected till two days ago. On calling to ask for him, the patient being out, his wife told me it was no better. 'But the truth is,' says she, 'it has never had a chance. He won't be seen with white lint on his lip, and is scarcely ever at home.' 'Indeed!' exclaimed I, 'and your husband in such imminent danger of his life!' which being interpreted, means, 'Please, ma'am, advise him to give the lotion a trial.' Strangely enough, even this device was not sufficient, for, on calling to-day, I found that the lotion was still neglected, or imperfectly used. Not to be done with such an unruly patient, I changed my tactics. 'Here have I now been your family doctor for many years, and during that time have done you all the good I can. You cannot refuse such a small favour as allow the lotion fair play for two days' time. This lotion is a new thing, and I am exceedingly anxious to test its powers. Your lip is but a trifling sore, but most unhealing; if it can cure it, what a lesson it will teach me how to cure other things of more importance!' This appeal had the desired effect. I applied the lint myself to-night (16th October), and he promised to keep within doors for two whole days, and keep the lint always wet with the lotion. The result shall be stated on the 18th.

18th October 1867.—Unsuccessful. For a short period (for the healing powers of sulphurous acid seem a question of hours rather than of days) it promised well. But my opinion is, it must come to the knife. I will try for a few days longer.

22d October 1867.—'Delenda est Carthago.' I excised the sore to-day with the aid of my professional brother, Dr. A. Kello. It is almost gratifying to find one case of failure. Amid all my eager searching for flaws, positively I was beginning to fear that the most serious flaw of all was hurting the material, by improving the therapeutical resources of the profession!

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Case XI.—Hœmorrhoids or Piles of several years' duration (Nov. 3).

A lady patient of mine, of sedentary habits, has been afflicted with piles for three or four years, not at all times alike, but often bleeding, festering, and extremely painful during that period. Concealing her complaint long, the disease went to such a height, that two months ago she consulted me and submitted to an examination. I found them swollen, inflamed, and painful to the touch; told her that an operation was her only chance; and intending to send her to Professor Syme if necessary, I offered in the meantime to apply a ligature to the more prominent as a means of affording temporary relief. She agreed to this; but first I put her on some sulphur and cream of tartar internally, and advised the frequent application of either warm or cold water cloths, as she found most suitable. This treatment doing some good, the ligature was never yet applied. Three weeks ago she took a dish containing burning sulphur, and contrived by some convenient apparatus to have the fumes applied directly to the parts every night before going to bed. After the third or fourth application all bleeding and festering ceased, and the pain became greatly relieved. To-day (3d November) she is all but perfectly cured. There are still some remains of the piles, but nothing to give her any inconvenience. Probably a little spray would have been equally effectual. On asking her what superior skill had put her up to such a plan, she said, 'No doctor's skill at any rate, but that of Mr. J——N——,' mentioning the name of a shrewd old Biggar mason. In less than three minutes I was in the mason's house, and found to my surprise that he had never heard the name of Dr. Dewar. An old 'pensioner body' on the bounty of the Castle-Craig family had told him of this in the year 1803! Since then he had recommended it in 'scores' of cases, and never once knew it fail either in making a cure, or at least 'durring,' i. e., soothing the pain very quickly. I told the gentleman that his name might yet live, long after he was dead, as the 'Biggar Mason.' 'But, you old rascal!' I continued, 'why did you not tell me this thirty years ago, and save the world from many a groan, long before "Dewar" or "chloroform" was heard of?'—A. 'You laugh so much at "old wives' cures," I never thought it worth my while.' He then repeated the names of many parties who had used it.

Note.—When the first edition came out, some true friends of mine, of taste and refinement, seriously objected to this case being introduced into a popular pamphlet. 'What!' said I, 'must etiquette then be the grave of usefulness? and must secretly suffering multitudes not be relieved lest a false delicacy be offended?' The following letter, I think, from a most respectable lady, and published by permission, is a sufficient answer:—

'——18th Nov. 1867.

'Sir,—It may gratify you to learn that the reading of your pamphlet has enabled me to cure myself of bleeding piles by two applications of a sulphur lotion, furnished by you for a neighbour's sore hand. The first application caused great smarting for about fifteen minutes; then all pain left, and perhaps the second dose was needless, but I put it on.—Yours most gratefully,

'To Dr. Pairman, Biggar.' '————.'

Note.—This lotion consisted of—Sulphurous Acid 2 oz., Glycerine ½ oz., Water 2 oz. Mix.

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Case XII.—Erysipelas or Rose of Face.

Late on the evening of Monday 11th Nov., Mrs. H—, aged sixty-seven, residing at a farm-house near Broughton, bad with erysipelas in face, sent an urgent message to me to see her immediately, the erysipelas having extended across the nose to both cheeks, a large blister on one cheek from the severity of the inflammation, the pain of a burning character, and both eyes shut up from swelling. Unable to attend at the time, I ordered a dose of castor-oil, gave a lotion consisting of equal parts of glycerine and sulphurous acid, to be applied frequently with a brush, and promised to visit by first train in morning.

12th.—This morning she expressed herself as free of pain; and instead of the eyes being shut up, there is scarcely swelling about them at all; though the patient is very feverish, tongue very dry, and she appears to me to be in a serious state. 'When did the pain leave you?' asked I. Ans. 'On the instant after the lotion was applied.' Q. 'Was your sight restored as rapidly as that?' A. 'Not quite; it took several minutes before the swelling about the eyes subsided.'

13th.—Visited to-day. Still very feverish; inflammation extending down the neck and across one ear. No pain. When pain threatens the lotion checks it.

14th.—Scarcely a trace of inflammation except on left ear, and on scalp amongst the hair. But constitutional symptoms very bad, the most alarming of which are weakness and restlessness; the patient having scarcely tasted food since 11th. Prescribed wine, beef-tea, and tincture of steel every two hours.

16th.—The severity of the local symptoms decidedly subdued, apparently checked; but constitutional symptoms no better. Pulse quick and intermitting, restlessness, thirst, great debility, etc. But being no worse since last report, and there being no delirium, the case is hopeful.

18th, 8 A.M.—To save me the trouble of visiting to-day, the husband has just called, reporting his wife as greatly better. Yesterday the inflammation spread on brow and down one cheek a little, but to-day appears completely killed. Curiously enough, however, she had considerable local pain and smarting which the lotion did not control until the afternoon. How to account for this I know not. But the disease has lasted exactly one week, and except in its origin and death she never complained of pain at all.

Remarks on this Case.—Some medical men, thinking erysipelas a kind of fever, and its specific inflammation virtually a rash analogous to the rash of scarlatina, may doubt the propriety of controlling the inflammation so much as sulphurous acid seems to give us the power of doing. For my part I think the treatment was good; that had the patient died, she would have died in spite of sulphur, and that since she lives, she lives partly in consequence of it; because if to the serious constitutional symptoms had been added very severe local pain and inflammation, she might probably have succumbed. The family had no idea that the clear watery-looking lotion, when first applied, had page 41 any sulphur in it. But so astonished was the husband at the rapidity of its effects that he said, 'This must be some other new thing of the Doctor's, very different from the brownish stuff (iodine) that he used to give my daughter.' Does this case not explain, almost with the force of ocular demonstration, how spray acts so quickly on the inflamed and swollen mucous membrane in stuffed nostrils, sore throat, laryngitis, etc.? Dr. Joseph Bell writes me that some of his cures in these affections have bordered on the 'miraculous.' If this case is not a key to the 'miracle' performed in such hidden cavities, it seems at least its counterpart visible to the eye.

Note.—While this case was being treated at Broughton, another case, almost precisely similar, was being treated in Cowgate, Edinburgh, by an intelligent trustworthy student in connexion with the Thistle Street Dispensary. The two cases were so nearly identical (the one in an adult, and the other in a child), the lotion and its results being so much alike, that we may consider it as a truth now established by the mouth of two witnesses, that sulphurous acid is the best application yet discovered for erysipelas.—(Certified to me by one of the Physicians of the Dispensary.)

Case XIII.—A Story important to Public Speakers.—(18th Nov.)

The indefatigable Mr. George Easton, Agent of the Scottish Temperance League, is subject to bad colds, which generally last several weeks; and as he has to address meetings almost every night, they are apt to go on from bad to worse. Such a cold shut his mouth (not easily done), and debarred him from all meetings during July and August of this year. On Wednesday last he caught such a cold. It was growing worse daily, though he was still performing duty, till he reached Biggar on Friday forenoon, for the purpose of advancing the cause of temperance. Having addressed a meeting at Skirling on Friday evening, on Saturday his cold was making progress; some huskiness or hoarseness was beginning to set in, which made him very concerned about the work before him next evening, to end probably in other two months' vacation. On Saturday night he happened to get hold, in the Biggar Temperance Hotel, where he was residing, of the First Edition of my pamphlet. He began to read; before being half-finished with it sent for me in haste; told me his predicament and fears, and asked if a little spray would not help him. 'Help you?' said I, 'only promise to keep silent till Monday morning, and I 'll have you cured.' For two nights past, he had coughed incessantly for upwards of an hour on going to bed before falling asleep. And the cough was none of your gentle things, but hard and pithy, stout and earnest, that reminded one of his own stentorian oratory! He would not promise to give up the meeting, but requested a few whiffs at once. After fifteen whiffs or thereby, I told him to have an hour of the fumes in addition before going to bed. That night he never gave a cough, but 'slept like a top' till morning. Coughed slightly during Sunday, page 42 but quite loose; addressed his crowded meeting on Sunday evening; felt nothing the worse of it, though the night was frosty; repeated both fumes and spray before going to bed; and after another night's repose, rose on Monday morning in great glee and spirits, found his gloomy fears of being torn from his work at once dispelled, and himself a great enthusiast in another cause besides that of temperance. With apostolic zeal this gentleman has long advocated what he considers a righteous cause; but let the League beware : even temperance now shares not his undivided affection. Note.—I insert Mr. Easton's name at his own request, because, being well known in almost every quarter of Scotland, he invites all who may doubt this case to ask particulars of himself.

'Edinburgh, 22d November 1867.—The foregoing particulars are correctly stated; and as the lady who showed me the pamphlet was Miss——, who sung two lines to the tune of Old Hundred (Case III.) I certify that her case also (by her own account) is strictly true.

'George Easton.'

Case XIV.—Case of Tic, worth the attention of Sufferers in general, and Homœopaths in particular.—(24th November.)

Mr. L. P., shoemaker, Biggar, has been subject to severe attacks of tic for the last twenty years, during which period I have treated him myself some eight or ten times, with quinine, etc., and various external applications; the attacks generally lasting a fortnight or thereby. On Thursday, the 21st, he consulted me for an attack of his old enemy. This was the fifth day of the disease. The pain was most acute in left eyeball, and above the eyebrow across to the temple. It always came on about nine A.M., and lasted till early in the afternoon. I gave as usual a dozen of quinine powders, one to be taken three times daily; and as the patient was suffering much during the consultation, I applied on the instant a pledget of lint, soaked with strong sulphurous acid, and covered over this pledget with oiled silk. I gave him also a phial of the acid, to repeat the application for a few times. In half an hour the pain was gone, before he had time to take one dose of quinine!

What makes me think that the sulphurous acid was the cause of relief is, that the pain left on that occasion two hours before its usual time; and, especially, that it has never since returned, except to a trifling extent next day. When he felt it threaten, he fain would have applied the acid and lint to the eyebrow again; but the part being all blistered from three applications of the previous day, he very sagaciously adopted milder measures. Uncorking his bottle he took a few sniffs up his nostrils, and the potent imponderable homoeopathic dose, thus imbibed, checked it in a moment.

Note.—It would be rash to draw conclusions from a single case. But if this be a fair sample of how we are to deal with tic in future, what a curative weapon have we not discovered for fighting not only page 43 tic, but toothache, rheumatism, neuralgia, sciatica, and a host of other most intractable diseases?

Note.—Since writing the foregoing, I can report as follows:—Slight case of Earache.—One day's duration; slight pain; disagreeable ringing in car : considerable deafness. Treatment.—A few whiffs of spray. Immediate Result.—No pain; no ringing; hearing perfect. Result next day.—Hearing keeps perfect; ringing scarcely perceptible; kept free of pain till midnight, remained sharp for several hours, towards morning some blood escaped from ear, giving great relief. Now (twenty-four hours after spray) so nearly well, that she won't have another whiff.

Toothache.—My experience in toothache is, that spray generally gives relief, but not invariably. To-day I tried first soaking the cavity with strong acid, then applying a pledget of lint, wet with acid, between the gum and cheek. Result.—Immediate relief, which continued during the fifteen minutes of the patient's stay in my house. Query.— How will this acid, frequently applied, affect the teeth? Do harm, like other acids? or good, by preventing decomposition and decay? Beyond all dispute it does good, by preventing decomposition and decay. Indeed, mixed with glycerine, and rubbed on with a sponge, it forms an admirable tooth-wash.

Note for Thirteenth Edition.—As the result of further experience I find that strong sulphurous acid, locally applied, generally gives relief in tic, neuralgia, toothache, sciatica, lumbago, and rheumatic joints. It seems to act both as a counter-irritant and anæsthetic, or like mustard-poultices and chloroform combined; though in some instances it certainly fails. A slight headache, in or near the frontal sinuses, is often relieved by simply smelling the acid from a bottle.

Case XV.—Croup in a Child—(9th December.)

Since beginning the system of sulphurous acid medication, I have been on the look-out for a case of croup, feeling quite assured, from its influence over larynx diseases generally, that its controlling power over croup would be something marvellous. Having no case of my own to record, it affords me great pleasure to make the following extract from a private letter just received from my friend Dr. Crawford of Peebles. I insert this the more readily (with Dr. Crawford's permission of course) because the writer happens to be my first professional convert; and especially because he did me the honour to become converted on my own ipse dixit, from his personal knowledge of me, before he had an opportunity of testing the system for himself:—

'The other day I was called to a case of croup in its second stage, the breathing being stridulous and the cough dry and characteristic. After half-an-hour's use of the spray, the cough got loose, the breathing moist, and the patient soon got well. In other circumstances this little patient would have been frightened to death with leeches, page 44 sickened nigh death with emetics and antimonials, and perhaps have died after all its torture. Although you could point to no other result than this one case, you could controvert all the doctors opposed to you. . . I cured myself of a nasty hoarseness in a few minutes, which might have bothered me for days. My friend Dr. Balfour, Edinburgh, after much experience, has unbounded faith in the treatment, has never less than six "machines" constantly out, and would not want them for anything.'

(Note.—This testimony is all the more valuable, as having been written in the confidence of private friendship, without any expectation of publication.)

Case XVI.—Asthma.—Detail of Treatment as a Guide to others. (2d December.)

W. M., aged twenty, residing in Biggar, came to my house after dark, on the evening of Monday, 2d December, to be cured, by a few whiffs of spray, of an attack of asthma of several days' duration. He was breathing with the greatest difficulty, very feverish, cough of a stridulous character, stomach out of order, and could get up little or no expectoration. The night being frosty, and the roads all covered with snow, the treatment began by ordering him home at once, and off to bed, where he would scarcely go, his breathing was so bad. He had experienced similar attacks during the last two years, during the last year especially. Indeed, for twelve months he had rarely wanted a cough, some wheezing in chest, with the addition besides of such asthmatic attacks for a fortnight or more every now and again. He was looked on by his neighbours as a poor, wheezing, weak-chested lad, on the borders of decline; but always contrived to recruit sometimes, gain better breathing, and pick up a little strength. On visiting him I first administered a few very cautious and gentle whiffs, which excited coughing and increased the breathlessness considerably. At intervals of one minute, and sometimes two, I continued injecting a dose of spray. In fifteen minutes or thereby the breathlessness was at its height, and cough of a 'squealing' character. Soon afterwards the cough changed a little, brought up some expectoration freely, for the first time, and by continuing the spray (now more continuously) the cough became decidedly looser; he expectorated well; so that in half-an-hour the victory was virtually gained. To keep up the good effects thus induced, I forthwith set agoing sulphur fumigation, ordered it to be kept up for two hours, until the family retired to bed, with inhaling of steam occasionally, and then left.

Tuesday Morning, 3d December.—Greatly better. Less feverish. Cough much looser. Says he passed a good night and slept well,—though his parents declare that he moaned considerably, and seemed uneasy during sleep. Tongue being very foul, ordered him laxative medicine, a restricted diet, and an hour's mild fumes three times daily, especially before bedtime.

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Wednesday, 4th December.—Comparatively well. Never saw more of him until the 9th.

Monday, 9th December.—Says he felt as well as ever he did in his life; but this is an exaggeration,—for a slight cough still remains, though very loose and not troublesome. He means (on cross-questioning him) that he is better than he has been for the last year. Put him on gentle laxatives and a restricted diet, to see if treatment directed especially to the stomach will ward off any future attacks, and eradicate asthma out of his system.

Case XVII.—Sulphur Fumes in Pneumonia, or Inflammation of the Lungs.—(5th January 1868.)

Mrs. B., aged 67, has for the last week been under treatment by me for pneumonia in left lung. Pain in side, fever, crepitous râle, cough, sanguineous expectoration, etc. Up to this date (5th Jan.) she has been progressing favourably on the whole, under the ordinary treatment of perfect rest, diaphoretics, mustard and fly blisters, etc.; but on visiting her to-day (the eighth day of the disease) I found her not quite so well. Pulse 80; tongue foul and very dry; pain not worse, but little abated, and much aggravated by coughing or a deep inspiration; face flushed; cough almost incessant; no sanguineous expectoration for several days, and to-day no expectoration of any kind, the cough being dry, and by its continuance threatening to increase the inflammation.

Thinking over these symptoms, I concluded that sulphur fumes would more safely arrest the threatened relapse, than the reapplication of a blister to a surface already raw, or the prescription of antimonials to a system aged and already weak. At half-past 2 P.M., therefore, I lighted up a little sulphur, making the fumes very weak at first to watch the effect. The cough being not made worse, I burned a little more in fifteen minutes or so, and then left, with instructions to continue the same at similar intervals, during the whole afternoon and evening, till I should call and see the result.

Visit at half-past 7.—Has had five hours of mild fumigation. Pulse the same; flush in face the same, and aggravated by the heat of the room from too large a fire. But pain greatly diminished, and cough loose: a deep inspiration causes a catch and induces a cough, but excites much less pain. Gives a pretty free cough, instead of the dry, hampered, and lung-irritating cough of the forenoon. Altogether the change resembles that which often passes over the cough of : child from the operation of an emetic. Even the tongue is a little better, being not so dry.

Ordered the fumes to be discontinued for one hour, and then resumed for two hours before the period of sleep.

Next morning, January 6.—Found the patient under the idea that she was greatly worse and rapidly sinking, and the family giving sulphur all the blame. Seeing on the contrary, that both in respect page 46 of pulse, pain, cough, tongue, etc., she was vastly better, and that her restlessness, uneasiness, and sinking feeling arose from nervousness and want of food, I only ordered a little light nourishment frequently repeated, and a continuance of the fumes during most of the day.

Evening Visit, 8 P.M.—Decidedly improved; cough loose, and not nearly so frequent; pulse 66; tongue soft; appetite improving; pain trifling; patient herself in good spirits, and now convinced (as are all the family) of the great benefit the fumes have bestowed.

3d day, Jan. 7th.—Pulse 62; and the patient begun to recover well. No further report is thought necessary; but so long as there is any cough, I mean to continue the fumigation mildly.

Remarks.—Not to found more on this case than seems its due, I beg to state that in all probability a continuation of ordinary treatment by antimonials and blisters would have carried the patient safely through the disease, which, on the whole, was mild throughout. But it appears evident that the fumes, while apparently acting as a substitute for antimonials, were much more mild, and equally safe.

Lest any one may think that fumigation in pneumonia is carrying the 'Sulphur Cure' to an extreme, I beg to remind him that liquid sulphurous acid, either as lotion or spray, seems to destroy inflammation wherever it meets it, as in the inflamed membrane of throat, nostrils, larynx, and ear-passage; on the inflammation of rose it acts as a charm; even for the inflamed skin around a wound or ulcer, leeches and warm poultices combined can scarcely compete with it. Ergo, Why should the vapour be prohibited from touching an inflamed lung? If mucous or purulent infiltration be not excessive, it may be brought to bear on the very part affected, or, for anything we know, by absorption into the blood, it may so rectify that fluid as to act on the local lesion more indirectly.

Note for Thirteenth Edition.—26th February 1868.—Other two cases of pneumonia, similarly treated, have convinced me of the safety and value of mild fumigation, long kept up, in this disease—though not to the neglect of other treatment.

Case XVIII.—Sulphur Fumes as a Tonic and Cosmetic.—(Jan. 12.)

Among my many striking cases, showing the power of fumes as a tonic, the following, I think, is the most remarkable. Mr. W. T. has been a delicate lad for several years, having been under the necessity of giving up his situation in a lawyer's office in Edinburgh, and coming to the country on account of his health. During most of that period he has been treated by me with steel, cod-liver oil, quinine, citrate of iron, and other tonics, besides nutritious diet; all with a view of keeping up his strength, and warding off that consumption which arises from thin and impoverished blood, on the borders of which he ever seemed to hover. Two and a half months ago, while acting as nurse to a brother prostrated with diphtheria, his assiduous attention page 47 caused him to be almost constantly inhaling, for several days, the fumes prescribed for his brother's disease. The immediate effect was such an increase of appetite and comfort, that after his brother's recovery he continued stated fumigations on his own account. Forthwith his delicacy of years rapidly took wing, and by persistence in the same plan for several weeks, without any aid from tonics, he has now acquired a degree of vigour, power of enduring fatigue in walking, and youthful bloom of health, such as he has not experienced for many years. Chemists may account for this by the ozone given off during the oxidation of sulphurous acid, whereby the air to be respired is made sweet and wholesome by all organic impurities being destroyed. But perhaps still more may be due to that very oxidation itself, whereby what goes up to the atmosphere as sulphurous acid comes in to the patient's mouth as sulphuric acid, or elixir of vitriol in a state of vapour, a tonic and stomachic justly famed for sharpening the appetite all the world over. Be this as it may, it is gratifying to learn that sulphur fumes possessed the same tonic and stomachic properties about sixty years ago. In 1810, Sir Arthur Clarke, M.D., London, erected baths for treating skin diseases, by steam and fumes instead of sulphur and lard, under the idea that unctuous applications to the skin were most unwholesome, by clogging up the pores. He thus succeeded in curing common itch and more inveterate things, in from one week up to three or four; and in his 'Essay on Diseases of the Skin,' Sir Arthur says (page 38), 'The sulphureous fumigation invigorates the system, and fortifies it against the influence of cold; it supples the joints, gives strength to the muscles, and consequently agility to the limbs. It increases the appetite, promotes digestion, and clears the complexion; it gives smoothness and whiteness to the skin," etc. etc.; in short, expatiates on sulphur fumes in such a style as neither Dr. Dewar nor myself dare imitate, for fear of being charged with attempting to enlist ladies instead of physicians in the cause of sulphur, by sounding its praises as the best cosmetic.

Cases XIX. and XX.—Coughs of several years' standing, attended with Lung Disease.—(February 1, 1868.)

The gentleman of wealth and position in London, to whom the following letter is addressed, happens at the same time to be owner of an estate in the parish of Biggar; on which account probably he took an interest in my pamphlet from the first, and sent a copy to Mr. Gilbert, an invalid acquaintance. Mr. Gilbert's reply he has kindly sent to me, with permission to do with it what I please. It is gratifying to learn that the last accounts from Mr. G. are (31st January) that he continues well.

'Grote's Buildings, Blackhealth,

'Dear Sir,—You will perhaps be pleased to hear the result of my trial of the sulphur, as set forth in Dr. Pairman's pamphlet, "The page 48 Great Sulphur Cure," and which you were so kind as to give me about two months since. I should state that about two years ago (November 1865) I consulted an eminent physician for a troublesome cough of long standing, and was told by him that one of my lungs was affected, and recommended change to a milder climate. Being unable to follow that advice, I have since been extremely careful to avoid exposure to inclement weather, and particularly to night air, and have been compelled to take to a respirator; but notwithstanding have had frequent returns of very distressing cough, and great difficulty in breathing; in fact I had almost given up the idea of ever becoming restored to my former state of health; but as a drowning man will catch at straws, I determined to give the sulphur a trial, but I confess with the very slightest expectation of deriving any benefit from it. The first trial gave me relief. I continued it once daily for a week. This was two months since; and since then I have been perfectly free from the old cough, and indeed am altogether in better health than for some years past.

'Had it depended on my own experience only, I might have been doubtful of all this being the result simply of sulphur; but I had a gardener in my employ who was formerly in the army, and was discharged as incurable, suffering from a complaint of the lungs. Last winter I obtained him an outdoor patient's ticket for the Victoria Park Hospital; and he attended there some half-dozen times with some relief, but only slight. This winter his cough returned in a most distressing manner, accompanied with considerable spitting of blood. I advised him to try the sulphur; and he has done so with the same happy result as myself. In fact, he says he is perfectly cured! And from his altered appearance I have great hopes that he is so.

'Judging from these two cases, and particularly from my own feelings, I firmly believe that Dr. Pairman has given to the world a most important and valuable discovery, which is a panacea for all the numerous forms of perhaps the most distressing and fatal complaints of this variable climate .—

I am, my dear sir, yours very truly,

'Alfred Gilbert.

'To J————Esq., London.'