This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol2", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
Sulphur has been used as a medicine both internally and outwardly from ancient times. it was formerly supposed to act favourably in phthisis; but the notion of its usefulness in that affection probably originated in the imperfect means of diagnosis possessed by our predecessors, and has been generally abandoned. At present it is employed as an alterative, and gentle stimulant of the secretions, in chronic rheumatism, chronic and irregular gout, various cutaneous diseases, old paralytic cases, and different forms of neuralgia. it is particularly adapted to these affections when attended with constipation; as, in connection with its alterative effects, it can be so administered as to maintain the bowels in a wholesome laxative state. A full purgative effect should be avoided, when the sulphur is given to influence the system.
Of the above-mentioned affections, chronic rheumatism is probably that in which it displays its best powers as an internal remedy. it is wholly unsuited to cases having any activity of inflammation, and should nut be administered during the existence of febrile heat, or circulatory excitement. in chronic gout it is of much more uncertain efficacy, though probably not without occasional good effect, especially in its nervous forms.
In chronic catarrh, particularly when attended with excessive and exhausting expectoration, it acts beneficially probably by a direct stimulant and alterative influence on the diseased membrane. it has, from the earliest times of its employment, had some reputation in bronchial diseases. Asthma ranks among those supposed to be benefited by it; but that it is capable of exercising any decided influence over the paroxysms of spasmodic asthma, whether in preventing or arresting them, would scarcely be maintained at present. Different affections were formerly often confounded under this name; and it was sometimes applied to simple chronic bronchitis, attended with dyspnoea. it was probably in cases of this kind that sulphur proved useful.
Much of the reputation of sulphur, as an internal remedy in skin affections, is owing to its extraordinary influence over a special eruption when locally applied. Now that it is believed to operate, in scabies, by a direct poisonous action on the parasitic animalcule on which that disease depends, and not by an alterative influence on the skin, which might readily be supposed to extend to other cutaneous affections, it is less relied on than formerly, as an internal remedy in those diseases generally. Nevertheless, the fact seems to be, that it has a real influence over the functions of the skin, as over those of the bronchial mucous membrane, and operates on cutaneous eruptions as it does on chronic catarrh, with a certain degree of efficiency. Even in scabies, it is supposed to have some effect when taken internally; the sulphuretted hydrogen developed upon the surface of the body being perhaps poisonous to the insects. The cutaneous affections in which, after scabies, it is thought to be most effective, are porrigo, chronic eczema, and chronic impetigo; but it may be used in any one of them, in which general excitement is wanting, and the local affection has subsided into the obstinacy of habitual wrong action, with little or no tendency to acute inflammation.
Besides the complaints mentioned, sulphur has been used as a supposed antiperiodic, with considerable asserted success, in intermittent fever, the hectic paroxysm, and periodical neuralgia; as an alterative in scrofula and secondary syphilis; as an emmenagogue in amenorrhoea, and as an anthelmintic against worms in the bowels.
It is used in substance both internally and externally, and in the latter mode also in the form of vapour.. There are, moreover, various chemical preparations of it, which exercise an alterative influence identical with that of sulphur, and the consideration of which, therefore, belongs to this place. I shall treat first of the forms in which sulphur is used with little or no change, and afterwards of its chemical preparations.
Sulphur is usually given in powder, the dose of which, for the alterative effects of the medicine, is from one to two scruples three or four times a day. it may be administered mixed with syrup, or molasses, or stirred up with milk.
A Confection of Sulphur (Confectio Sulphuris, Br.) is made, according to the British Pharmacopoeia, by rubbing well together four avoirdupois ounces of sublimed sulphur, an avoirdupois ounce of bitartrate of potassa, and four fluidounces of syrup of orange peel. The dose is from two to four drachms as a laxative.
Sulphur Ointment (Unguentum Sulphuris, U. S., Br.) is made, according to the U. S. Pharmacopoeia, by simply rubbing together one part of sulphur and two parts of lard, until thoroughly mixed. The British ointment is prepared with one ounce of ointment to four of lard. For this purpose the unwashed sulphur is considered preferable; as the small portion of acid contained in it may add to its efficiency. This ointment is an almost certain remedy for scabies. it should be thoroughly applied to every part of the body affected; and, when the disease is diffused, the application should extend to the whole surface. it may be used daily, at bedtime; the patient being anointed in a warm room, allowed to sleep in his unctuous coating, and in the morning washed clean in a bath, or with soap and water. I have usually found four such applications, if thoroughly made, sufficient; but sometimes the affection is not completely eradicated; requiring renewed applications, or the use of some other preparation to effect a permanent cure. A little oil of lemons or of bergamot may be added to the ointment, to conceal in some measure its disagreeable odour.
Various compound ointments have been recommended, containing, in addition to the sulphur, other substances poisonous to the insect, and some odorous substance to cover the smell. Our late officinal Compound Sulphur Ointment (Unguentum Sulphuris Compositum, U. S. 1850), besides sulphur, contained ammoniated mercury, sulphuric and benzoic acids, nitre, and oil of bergamot. it has been omitted in the existing edition of our Pharmacopoeia. The London College formerly directed a compound ointment containing sulphur, white hellebore, nitre, and soft soap, with lard; but it is not recognized in the British Pharmacopoeia. These may possibly have been somewhat more efficacious than the simple ointment; but they were much more irritant to the skin.
In the Paris hospitals, they make much use of sulphur ointment containing an alkaline ingredient. A preparation famous by the name of "Pommade d'Helmerich," contains two parts of sulphur, one of carbonate of potassa, and eight of lard. Another formula directs fifteen parts of sulphur, five of common salt, and one hundred and twenty-five of lard. This is used at the Hospital Saint Louis, where the patient is put into an alkaline bath in the evening, next day is rubbed over the whole body, every six hours, with the ointment, on the third day takes another bath, and is not allowed to put on his clothes until they have been well baked, so as to destroy the insect and its eggs. Two days of treatment are said to be sufficient to effect a cure. A sulphurous bath is sometimes substituted for the alkaline bath.
Instead of employing the ointment, some practitioners content themselves with directing their patients to sleep between sheets, which have been well strewed over with the flowers of sulphur.
Some combine the internal with the external use of the sulphur; but it is very doubtful whether the cure is in any degree hastened; or rather it is pretty certain that it is not.
These sulphur ointments are also frequently used in the treatment of other eruptions, especially the eczematous and impetiginous, in their most chronic forms. in porrigo or tinea capitis, a mixture of equal parts of sulphur and tar ointment has been employed with advantage.
The following are the chemical preparations of sulphur in more or less general use.