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The Pamphlet Collection of Sir Robert Stout: Volume 33

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

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.