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The Pamphlet Collection of Sir Robert Stout: Volume 33

Case XII.—Erysipelas or Rose of Face

page 40

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.)