felt pains in lier jaw^in masticating food, in deglutition, and also in the abdomen; the lochial discharge had ceased since On the 12th, I found the patient in a 3rd or 4th April. most pitiable state : body b>jnt like a bow (opisthotonos) and getting spasms every now and then. On enquiry I learned that the patient had been much exposed to a cold wind on the night preceding the attack. Abdomen was painful to the touch ; 110 trace of discharge from the vagina : bowels costive ; for the last 3 days has felt pain all over the body. Muscles of the neck in a state of spasm; is very thirsty; pupils contracted; look anxious ; pulse full and quick ; temperature 103'4?F. I gave her the following :?
Jk
Syrupi Simplicis
...
Pot. Bromide Chloral Hydrate Aqute destil
...
...
5iv.
...
gr. gr.
...
...
...
xx xx
ji.
To be given every 3 hours. Castor oil enemata with turpentine : Anodyne liniment to be rubbed over the spine and jaw, and warm linseed meal poultice to the abdomen. Diet milk and sago. In the evening I found her lying on her back, asleep ; I was told that the fits had declined in number and severity, and that she had four stools after the enema While examining her she had a fit: the whole of the muscles were affected with spasms and there was a good deal of difficulty of breathing. The fit lasted 3 to 5 minutes. The discharge from the womb re-appeared, and the pain in the abdomen was much better. The urine was free; temperature 104"4?F.; pulse full and regular. Took milk and sago regularly. I continued the mixture, liniment and poultice to the abdomen as before. 13th April, morning.?Had 3 paroxysms during the night; one good stool; discharge from the womb copious, with clots of blood; feels much better; slept pretty well; stiffness of the muscles of the neck and jaw has subsided : can swallow her food better than yesterday ; temperature 101'2?F.; pulse full and regular. Medicine continued, also liniment to the back and jaw, poultice to the abdomen as before Diet milk and sago. 7 p.m.?Had two paroxysms during the day; stiffness of the neck and jaw much less ; had one stool; urine free ; temperature 101 "4? ; pulse good and full ; took about a seer and a half of milk ; discharge from the womb free ; pain in the abdomen much less. Medicine, liniment and poultice continued. 14th April.?Had a pretty good night and only one morning fit. Discharge from womb moderate; no pain in the abdomen ; temperature 98'4?F. Medicine continued evi ry 4 hours, instead of every 3 hours as before. Liniment continued, poultice omitted. Diet milk and sago, and broth ?viii. made of Liebig's extract of meat. 14th April, 9 p.m.?~No fit during day; had one motion ; temperature 98'5? ; discharge from womb diminishing ; no pain ; took milk and sago cheerfully ; had a short sleep during day. 15th April, morning.?Had one fit in the night; temperature normal; good in all respects.
p,
Chloral Hydrate Pot. Bromide
Syrupi Simplicis Aqua) Destil
A CASE OP PUEEPEEAL TETANUS TEEATED
WITH CHLOEAL HYDE ATE AND BEOMIDE OF POTASSIUM : EECOYEEY. By Shamloll Mullick, L.M.S., Calcutta. A TEMALE Hindoo, aged 30 years, mother of three children, came \mder my treatment on 12th April 1876 for trismus.
1 was told that she gave birth to a male child on the 26th March 1876 : delivery was natural. The child, after a week, died, and the mother abandoned the lying-in-room, after the usual washing and bathing ceremonies, as is the custom among native females. On the 16th day after delivery (i.e. on the 11th April) she
...
...
...
...
...
...
...
...
...
...
...
...
gr. gr.
x x
jii gi
To be given every 3 hours (4 doses during 24 hours) ; liniment to be continued if patient required it. From 15th to 25tli April she had no fits ; temperature all the time was normal ; discharge (lochial) gradually ceased, and she made no complaint of pain. 2Gth April.?Found her well and cheerful; no pain, but feels very weak ; was ordered to take a tonic mixture Remarks.?Bromide of potassium in combination with chloral hydrate produced a marked effect on the system. The temperature of the body never rose above 101'4?, and did not interfere with the administration of chloral. It is generally observed that puerperal tetanus is very frequently fatal, but the later the attack the more hopeful is the prognosis. An attack within a week after delivery is nearly always fatal, but when it comes on 15 days after delivery there is great hope of recovery if early and prompt measures are adopted. This case was attacked on the 16tli day after delivery, and the cause was ascribed to irritation in the womb, from the retention of clots of blood, &c. in that organ after the sudden cessation of She took about one the lochial discharge, consequent on cold ounce five drachms and one scruple of chloral, and about the same quantity of bromide. Calcutta, 9th January 1877.
Jk
Syrupi Simplicis
...
Pot. Bromide Chloral Hydrate Aqute destil
...
...
5iv.
...
gr. gr.
...
...
...
xx xx
ji.
To be given every 3 hours. Castor oil enemata with turpentine : Anodyne liniment to be rubbed over the spine and jaw, and warm linseed meal poultice to the abdomen. Diet milk and sago. In the evening I found her lying on her back, asleep ; I was told that the fits had declined in number and severity, and that she had four stools after the enema While examining her she had a fit: the whole of the muscles were affected with spasms and there was a good deal of difficulty of breathing. The fit lasted 3 to 5 minutes. The discharge from the womb re-appeared, and the pain in the abdomen was much better. The urine was free; temperature 104"4?F.; pulse full and regular. Took milk and sago regularly. I continued the mixture, liniment and poultice to the abdomen as before. 13th April, morning.?Had 3 paroxysms during the night; one good stool; discharge from the womb copious, with clots of blood; feels much better; slept pretty well; stiffness of the muscles of the neck and jaw has subsided : can swallow her food better than yesterday ; temperature 101'2?F.; pulse full and regular. Medicine continued, also liniment to the back and jaw, poultice to the abdomen as before Diet milk and sago. 7 p.m.?Had two paroxysms during the day; stiffness of the neck and jaw much less ; had one stool; urine free ; temperature 101 "4? ; pulse good and full ; took about a seer and a half of milk ; discharge from the womb free ; pain in the abdomen much less. Medicine, liniment and poultice continued. 14th April.?Had a pretty good night and only one morning fit. Discharge from womb moderate; no pain in the abdomen ; temperature 98'4?F. Medicine continued evi ry 4 hours, instead of every 3 hours as before. Liniment continued, poultice omitted. Diet milk and sago, and broth ?viii. made of Liebig's extract of meat. 14th April, 9 p.m.?~No fit during day; had one motion ; temperature 98'5? ; discharge from womb diminishing ; no pain ; took milk and sago cheerfully ; had a short sleep during day. 15th April, morning.?Had one fit in the night; temperature normal; good in all respects.
p,
Chloral Hydrate Pot. Bromide
Syrupi Simplicis Aqua) Destil
A CASE OP PUEEPEEAL TETANUS TEEATED
WITH CHLOEAL HYDE ATE AND BEOMIDE OF POTASSIUM : EECOYEEY. By Shamloll Mullick, L.M.S., Calcutta. A TEMALE Hindoo, aged 30 years, mother of three children, came \mder my treatment on 12th April 1876 for trismus.
1 was told that she gave birth to a male child on the 26th March 1876 : delivery was natural. The child, after a week, died, and the mother abandoned the lying-in-room, after the usual washing and bathing ceremonies, as is the custom among native females. On the 16th day after delivery (i.e. on the 11th April) she
...
...
...
...
...
...
...
...
...
...
...
...
gr. gr.
x x
jii gi
To be given every 3 hours (4 doses during 24 hours) ; liniment to be continued if patient required it. From 15th to 25tli April she had no fits ; temperature all the time was normal ; discharge (lochial) gradually ceased, and she made no complaint of pain. 2Gth April.?Found her well and cheerful; no pain, but feels very weak ; was ordered to take a tonic mixture Remarks.?Bromide of potassium in combination with chloral hydrate produced a marked effect on the system. The temperature of the body never rose above 101'4?, and did not interfere with the administration of chloral. It is generally observed that puerperal tetanus is very frequently fatal, but the later the attack the more hopeful is the prognosis. An attack within a week after delivery is nearly always fatal, but when it comes on 15 days after delivery there is great hope of recovery if early and prompt measures are adopted. This case was attacked on the 16tli day after delivery, and the cause was ascribed to irritation in the womb, from the retention of clots of blood, &c. in that organ after the sudden cessation of She took about one the lochial discharge, consequent on cold ounce five drachms and one scruple of chloral, and about the same quantity of bromide. Calcutta, 9th January 1877.
