Edgefield advertiser. [volume] (Edgefield, S.C.) 1836-current, 1899-10-04

He got q purgative and forty grains
of bromide OF potassium in two doses:
The next dny he slopt well, but the
rigidity of the muscles was more
marked mud the muscles OF the abdo-
minal wall were rigid.
A diagnosis of tetanus was made
and ten grains of chloral hydrate and
fifteen minims of tincture Of hyosey:
anus were added to the twenty grains
of bromide of potassium, and were
given every three hours. On tile
second day the symptoms became
more marked. Tho mouth could be
opened only three-quarters of an
inch. Saliva collected and could not
be expectcrated. Spasms came on
which gave rise to much pain and dis
tress. There wns inability to swallow
solids. but milk was taken easily: A
consultation OH the case was held; and
it was considered that it was q suita.
BILE one for treatment by intercranial
injection ofserum, after the method
of NJ. Roux and NJ. Bcrrol of Paris,
first performed in England by Major
D. Semple, R. A. NJ. c., of Netley.
The operation was performed with
the strictest nsceptic precautions, the
sterilization of the, needle with Which
the injection was made being carried
out carefully md the patients head
being shaved and scrubbed. An imag!
mary line from the root OF the nose to
the occipital protuberance was taken,
another from one external auditory
opening to the other, and third from
the point in intersection of these to
the outer angle of the left orbit: At
the centre of this third line On in.
cision half m inch long was male
down to the bone. The skull was
then drilled with a specially construct
ed drill, which, being provided with
stop, could penetrate bone and dura
mater only. Through the hole thus
made serum injection needle three
inches long, having the point rounded
so as to avoid injury to the cerebral
vessels, was introduced into the brain
substance; being directed toward the
spinal column. The injection syringe
was so constructed that 2.5 cubic CEN
timetres of concentrated serum could
be injected and no more. The "con-
| centrated" serum was made by dry
| ing ten cubic centime etres of ordinary
anti-tetanic serum; the dry serum was
kept asceptically until required and
then dissolved before use in five cubic
centimetres of sterile saline solution.
The injection was made slowly in ten
mir tes, and while the injection was
be4ug made the needle was held per
fectly steady by an assistant to pre-
vent any laceration Of brain tissue.
After its completion the needle was
withdrawn and the small wound closed
by one horsehair sature and sealed
with collodion. The operation was
repeated in a precisely similar man
ner on the right side, five cubic CEN
timetres of the concentrated serum,
corresponding to ten cubic cent?
metres of ordinary anti-tetanic serum,
being thus given intracerebrally. A
subcutaneous injection of ten cubic
centimetres of ordinary auti-tetanic
,um was given under the skin OF
the abdomen in the right flank. The
original wound was thoroughly scraped
by Volkmann's spoon, the scrapings
being received in sterile tube for
cultivation of the bacteria.
The third day the patient passed a
fairly good night. There was no
vomiting and no spasms; he was tax
ing milk and beef ten well. The tenn
perature was 100 degrees T. and the
pulse was 104, hard and bounding.
The mouth could be opened only half
an inch. The leastnoise caused spasms
and light also being displeasing, the
patient was moved to darkened
room aud a special nurse was pro,
vided for him. He had n quiet day
up to & p. m. but then began to suffer
from severe spasms, frequently recur-
ring, lasting about half minute,
the muscles affected being those
OF the lower jaw and abdomen.
The teeth were fixed tightly during
the attacks and the pulse became
rapid Q2O), full and hard. The
heart sounds were easily audible
two feet from the patient without
steihoscope. At $50 p. m. the
patient being in much distress
and pain, subcutaneous iniec-
tion of five minims OF solution OF
hydrochlorate of morphia was given,
after which he slept for an hour and
a half, but was awakened by marked
and violent attacks. He received
simultaneously ten centimetres OF
anti-tetapic serum and a draft of 25
gains of chloral bydlate. He slept
fairly for the remaindev OF the night.
The next day twenty cubic cent?
metres of serum were given under the
skin of the abdomen. This treatment
was continued eight days, 200 cubic
centimetres being given subcutane-
ously in all, rs we'll as the five cubic
centimetres of concentrated serum in
tercranially During the whole of the
fourth day he had attacks OF spasms
OF varying degrees OF intensity. A
slight noise while the patient was
asleep would cause spasms without
awakening him.
Towards evening the patient seemed
to become worse; he was in great dis
tress and said he thought he was 60
ing. to die. A bromide and chloral
draught was given at 8 p. H., and at
IL p. m., as he had not slept and was
in great pain, n subcutaneous iniec-
ton of three minims of liquor NOR
phin;e hydrochloride was given, after
which he had fairly quiet night.
The patient took fluid food well. The
following day at noon he had had
three attacks OF spasms, more in the
shoulders and neck than in the trunk
muscles. He said that he felt better
but for the pain in the back of the
neck. The spasm caused by the serum
,Dl4 oil