The Pamphlet Collection of Sir Robert Stout: Volume 33
Case I.—Gastric Fever
Case I.—Gastric Fever.
On the 8th September 1867, I was called to see Miss——, residing at——Cottage, Biggar. I at once pronounced the case gastric fever; page 15 and in two days it was very decidedly so. No delirium; but severe headache, requiring leeches, cold applications, and shaving the head. The most prominent symptom was distressing cough. But what gave me chief concern was the state of the tongue; very clean, very dry, and very red, indicating (as I thought) a tender state of mucous membrane, and the probability that obstinate diarrhœa would accompany the case, one of the most usual as well as alarming symptoms of gastric fever. As gastric fever of a bad type (as I was informed, and where it was supposed she must have caught the infection) was prevailing at the time in the two adjoining houses, and had already prostrated several of their inmates, on the second day of my attendance I ordered some chloride of lime as a disinfectant. 'Please, Sir,' was the reply, 'we do not know how to use it. Will you bring it yourself the next time you come down?' On my next visit the question was put, 'Have you brought the lime?' 'Dear me!' said I, 'I have quite forgot. Never mind : have you any sulphur in the house?' 'No; but it could easily be got.' I then took a kitchen-shovel, put on it some live coals, and laying the shovel in the middle of the floor of the sick-room, sprinkled over it half a tea-spoonful of sulphur.1 This producing no irritation to the patient's lungs, I added a little more sulphur, when she began to cough a little. The inmates being surprised, asked if these fumes would not increase the cough. I answered, that to relieve the cough was one reason of my doing it, as well as to keep the air of the sick-room sweet and pure, whereby I hoped both that the fever would be mitigated, and they themselves escape the infection; but at the same time honestly confessed that I had never tried the experiment before; I was only acting to the best of my judgment; if they had the slightest objection I would not persist with it. The answer was, 'What-ever you prescribe shall be implicitly obeyed.' The same fumigation was adopted twice a day during the whole of the fever; and the following was the result (but whether owing to the fumigation or not it would be rash to say) :—1. The case turned out extremely mild, though expected to be severe, the patient getting the turn about the tenth or eleventh day, and the subsequent recovery remarkably rapid. 2. No bad symptom ever supervened, not even diarrhœa, except a very sharp purge from less than half an ordinary dose of castor-oil, showing the tender state of the mucous membrane. 3. In the course of three days or so the patient's cough left her entirely, except when the fumes filled her bedroom, and no cough mixtures or mustard blisters were given to relieve it. 4. None of the inmates (consisting however of only two other individuals) took the fever. The household are under the impression that the fumigation did good both in quieting the patient and relieving the cough, and would certainly call for fumigation again, were any of their number prostrated with fever. Practical Remarks.—Contrary to my expectation this fever might have proved of a mild type (independently of the fumigation), though I scarcely think the cough could have been relieved in such a rapid page 16 manner. I only draw from it this conclusion, that fumigation is safe, even in a sick-room, if cautiously applied.
1 Experience soon taught me a slower and better mode of burning the sulphur, without live coals (see in Appendix, 'How to Fumigate.')