TIIE USE OF CALCIUM SULPHIDE IN THE TREAT- 
MENT OF INFLAMMATIONS OF TIIE EXTKSNALi 
AUDITORY MEATUS. 
By SAMUEL SEXTON, M.D., 
NEW YOKE. 
The persistency and painfulness of certain well-known inflam- 
matory processes of the external auditory meatus, and the futility 
of the remedies which have hitherto been available in their rou- 
tine medication — surgical means excepted — have spurred the 
writer to numerous experiments with the hope of ascertaining the 
action of any that would relieve the distressing symptoms. None,, 
however, were attended with the success hoped for, and patients 
were left to time-honored measures until an experiment with the 
sulphides was decided upon. This selection was made chiefly be- 
cause they were reputed to control the suppurative processes, under 
certain circumstances, in other parts of the body. The sulphide of 
calcium was selected for trial, and the conditions of the ear in 
which it was used were the following, namely, furuncles and 
diffuse inflammation. Its use was extended to certain cases where 
the inflammatory action tended toward suppuration: in erythema, 
eczema, pemphigus, herpes, erysipelas, etc. 
Furunculous inflammation, which is described by Schwartze as a 
perifollicular inflammation in the skin, is especially liable to affect 
the outer extremity of the external auditory meatus, and frequently, 
owing to the richness of the locality in connective tissue, the in- 
flammation extends deeply and becomes phlegmonous in character. 
Diffuse inflammation in the skin of the meatus, although liable to 
result in abscesses, etc., at the outer third of the canal, is most 
frequently found in the deeper portions, where, owing to the ab- 
sence of connective tissue, its behavior is different, and there is 
likely to be periostitis as well as an extension of the inflammation 2 
to the drum-head. These affections are characterized, as is well 
known, by their tedious nature, their remote causes being usually 
of long continuance. One crop of furuncles after another appears 
indefinitely, unless arrested by treatment; and the diffuse inflam- 
mation, it may be stated, acts in a similar manner. The irregular 
recurrence of these affections, where the causes remain, is to be 
looked for, in some patients, for years, the attacks being mostly in 
warm weather, but not always. 
It is not my purpose here to enter into details as regards the 
etiologjq pathology, and general symptoms of these affections, as it 
would lead me far away from the purpose of the present paper. 
As regards the usual treatment of these affections by incisions, 
together with the application of leeches, it may be said that al- 
though these are frequently indicated, there are a large number of 
cases where the conditions—idiosyncrasy, etc.—seem to contrain- 
dicate their use, the patients being made much worse by the pro- 
cedure. It is in such cases, which every aurist frequently meets 
with, that the remedy here proposed seems to act with especial 
advantage. There are also cases where the suppurative action is 
uncommonly slow, in which the remedy seems to act favorably. 
That sulphur and its compounds have long possessed great 
repute as curative agents, both in the profession and among the 
laity, is a fact well known. Its uses have extended to an impor- 
tant list of affections, and there can be no doubt but that it is justly 
entitled to the high estimate that has so long been placed upon its 
merits. 
The sulphureous waters of the earth, appearing in springs upon 
its surface, have for a long period of time been sought for on 
account of their reputed healing virtues. 
Sidney Ringer1 says of the sulphides : “ The sulphides appear 
to me to possess the property of preventing and arresting suppura- 
tion. Thus, in the inflammation threatening to end in suppuration, 
they reduce the inflammation and avert the formation of pus. 
The influence of this group on the suppurative process is still more 
1 A Hand-book of Therapeutics, Fifth Edition, Wm. Wood & Co., New York, 
1876. 3 
conspicuous after the formation of pus. They then hasten matu- 
ration considerably, whilst at the same time they diminish and cir- 
cumscribe the inflammation, promote the passage of the pus to the 
surface and the evacuation of the abscess.” Ringer, in speaking of 
these remedies as producing different and apparently opposite 
effects, as the dispersion of inflammation in one case and the ex- 
pulsion of pus in another, likens them to poultices and hot fomen- 
tations, which both subdue inflammation and prevent suppuration, 
and in other cases considerably hasten the process. The therapeu- 
tic action of this remedy is not well understood, but a careful read- 
ing of Ringer’s work will throw some light on the subject. My 
own experience in the use of this remedy for aural affections began 
more than two years ago, and it extends over a very considerable 
field of private and dispensary practice. I feel justified from the 
experience thus had, in this special department, in confirming what 
has been here quoted from the writings of Ringer, the results ob- 
tained having been in many instances quite a surprise to me. 
I have been in the habit of administering the calcium sulphide 
in nearly all cases where inflammation of the meatus externus was 
a symptom, in some stage or other of the disease, but especially 
in those where suppuration has occurred or threatens to occur. 
Should there be caries of the bone, periostitis or extensive destruc- 
tion of the tissue in connection with these affections, the remedy may 
also be employed. In scrofulous affections this medicine is much 
praised, and in certain cases it is said to improve the general health. 
Furuncles in the meatus, under the use of this medicine, are fre- 
quently observed to abort and dry up without a discharge of pus. 
In some instances I rely entirely on this medicine in the treatment 
of inflammation in the ear; but free incisions are in some instances, 
of course, not to be omitted, as when the pain is urgent from dis- 
tention, or a collection of pus exists which is too large to be ab- 
sorbed. Leeches should be resorted to when arterial tension is 
great and the parts are highly engorged with blood ; but in cases 
where they seem to provoke irritation, they should be repeated with 
much caution. The prevention of a continuance or a return of 
furuncles, etc., by this remedy, is very clearly possible, provided no 
remote cause be left active. 4 
The preparation of calcium sulphide that I have lately used is 
the first decimal trituration,1 of which I direct about a grain to be 
taken every two or three hours in urgent cases; in subacute cases 
with less frequency. In children the dose should be less, a grain 
of the trituration being diffused in water ; the amount to be given 
can be easily graduated. 
The medicine is usually given dry upon the tongue, and the only 
unpleasant symptoms complained of by the patient are the bad 
taste, and in rare instances slight nausea. 
The decided effect of this medicine may often be observed in 
the drying up of the sores in the meatus in twenty-four hours ; but 
I am in the habit of continuing it for some days, then discontinu- 
ing it unless the symptoms seem to again indicate its use. 
This preparation can be obtained from Caswell, Hazard & Co. 
Hew York, under the name of Hepar Sulph. Calc. lx Trit. 
1 See Piffard, ‘‘On the Use of certain Triturations,” Medical Record, Dec., 1877.