Both sides finished with 10 men, the game's best player sported the deepest shade of black eyes and the roll call of the injured lengthened. Fulham's victory was eked out at a heavy price, once more losing Papa Bouba Diop and Steed Malbranque, although they were also aided by Sunderland's unfailing ability to inflict damage on their own forlorn cause.
Having taken an early lead through a wonderful volley the visitors conceded a poor equaliser, then had Steven Caldwell dismissed - only for the winning goal to be struck almost immediately from the territory the defender would have been expected to have covered. "Groundhog Day," said Mick McCarthy, the Sunderland manager . "I don't think we deserved to be beaten."
Collins John scored twice for Fulham, with opportunistic headers, but it was Brian McBride who provided the determined aggression and guile to haul his team back.
"The lads are knackered," said the Fulham manager, Chris Coleman. "We have won today but I have to look at the damage that has been done to my players. It's nuts." He reeled off a list of eight who had been hurt. "We have not played well," he conceded of a game that had to be won. "But we have shown some balls."
When McCarthy made a triple substitution, after falling behind, it was followed by a chant of "you don't know what you're doing" from the Sunderland fans, which will not have gone unheeded by the club's trigger-happy chairman, Bob Murray. Maybe he will indeed dispose of McCarthy but that would be ridiculously harsh.
"I should not be surprised," McCarthy said of the speculation. "I'm bottom of the league with six points." Indeed Sunderland may well break their own record of the lowest points tally ever in a Premiership season - just 19 - but there was hope when, on seven minutes, Danny Collins's cross was headed on, inadvertently, by Zat Knight. The ball looped to Liam Lawrence just outside the penalty area and he struck the crispest of left-foot volleys that arced beyond Tony Warner and into the net.
Fulham looked stunned and their belief drained further with the departure of Diop after just 40 minutes with a recurrence of his ankle injury. But then, and vitally just before half-time, McBride reached Sylvain Legwinski's cross, helping the ball on. As the defenders failed to react, John headed in with ease.
It switched the course of the match. Doubts seized Sunderland and McBride had a free-kick desperately palmed away before the substitute Heidar Helguson ran through. His heels were clipped by Caldwell just outside the area and the Scot did not even wait for the referee, Dermot Gallagher, to show the red card.
Three minutes later Fulham were ahead. Helguson, on the left-wing, crossed for John to execute an even more routine header. Coleman sent on Malbranque to test his knee. It proved a disaster as the midfielder was caught by Tommy Miller's high boot. Having used all three substitutes, Fulham were forced to play the last 13 minutes depleted. But Sunderland could not find a way through.
Fulham (4-1-4-1): Warner; Leacock, Knight, Pearce, Rosenior (N Jensen, 75); Legwinski; John (Malbranque, 69), Boa Morte, Diop (Helguson, 40), Radzinski; McBride. Substitutes not used: Drobny (gk), Rehman.
Sunderland (4-4-2) Davis; Hoyte (Murphy, 64), Caldwell, Breen, D Collins; Lawrence, Miller, Whitehead, Arca; Le Tallec (Nosworthy, 64), Stead (Gray, 64). Substitutes not used: Alnwick (gk), Woods.
Referee: D Gallagher (Oxfordshire).