I ordeied that it the disease might be fairly tested, ^ the patient s be the only medicine prescribed in these cases; milk. Of these ten ca having been confined to bread and these recovered ; two case seven were traumatic, and one of recov ei thus treated, one of these over
idiopathic
HYDRATE OF CHLORAL IN TETANUS. By C. Macnamara. Ox referring to the Returns of the Chandnie Hospital, it appears that, from the commencement of the year 1865 to the close of 1869, no fewer than 83 cases of tetanus have been treated in this institution; of these 50 eases were traumatic, and 33
idiopathic
result of these
tetanus;
llelieved.
Cured.
Traumatic.
Idiopathic.
the
following
table exhibits the
cases:
Traumatic.
Idiopathic.
Absconded. Traumatic.
Idiopathic.
Died.
Traumatic.
Idiopathic.
tetanus 'were
of ia wo> the other died; another case occurred in the instance Eviden y, fifteen days after child birth, she also got well. when & chloral of therefore, the influence of the hydrate C an alone has not yielded so favourable a result in the The c ^ Indian hemp. with Ilospital, as aloes combined few ^ under the chloral treatment have, of course, been too but t in tetanus, this of to drug solutely determine the merits ^ have been sufficiently numerous, I think, to show that althou0 not chloral is invaluable in the treatment of the disease, it is ies be relied upon otherwise than as an adjunct to other reme The hydrate of chloral is invaluable in tetanus simply because, sleep however bad the case may be, it will invariably induce There have been cases in the Chandnie Ilospital of patien ^ were pu suffering the most frightful agony from tetanus, who of grain means sixty into a sound sleep for eight hours by of hydrate of chloral, but on waking, the tetanic spasms returne cour more violently than ever, and destroyed the patient in the of half
21
13
31
Tetanus is
generally supposed to be prevalent at certain of the year; the truth of this idea is hardly confirmed with reference to these 83 cases, as the following table illusseasons
trates
:?
an hour. In fact, I believe that the. hydrate of chloral acts simply at a ^ a hypnotic in cases of tetanus ; it has no specific power a to sleep and for the over the tetanic it but patient puts spasms, keep then not time prevents the spasms. It may be argued, why the patient at rest for three or four days, allowing him, sufficien a
nourishment to support life ? This is precisely, however, we cannot do, for it seems as if the action of the bjdiateo chloral, when prolonged, by keeping back the tetanic energy*
bursting more concentrated subsequently, the spasms forth with renewed violence. "We require a drug or combination of drugs, in addition to chloral, which will, if possible, influence the abnormal nervous action in tetanus, so as to deaden
renders it
a u
power, whatever it may be, which causes tetanic spasms. o shall endeavour on another occasion to illustrate the plan treatment which best accomplishes this end, the drugs employe being calabar bean and Indian hemp, in addition to the hydraof chloral: the first of these undoubtedly seems to control the irregular and abnormal action of the nerves in tetanus, but hardly
.S
H
"With reference to treatment, it will be noticed that ot the 83 two absconded from the hospital, so that, practically, we have to deal with 81 instances of tetanus, and of these 13 are " stated as having been relieved" when discharged from cases,
hospital;
this is doubtless a very unsatisfactory way of accounting for cases of tetanus, but it is unavoidable in this country ; the friends
patient often insisting on his removal from hospital, although there may be a good hope of the sick man's recovery. Supposing we allow that of these 13 cases, said to have been relieved, seven ultimately died, we then have the following
of the
results :?Of 42 cases of traumatic tetanus 16, or 38 per cent., recovered, and of 39 instances of idiopathic tetanus 24, or 60 per cent., recovered. The medical treatment followed in these 81 cases has been uniform, consisting of aloes and Indian hemp, as recommended by Dr. J. Jackson, (formerly in charge of the Chandnie The
patient's
Hospital.) was confined, almost without exception, throughout the whole course of his illness. diet
to
bread and milk "We may now turn to the circumstances of ten consecutive cases of tetanus lately under treatment, in which the hydrate of chloral has been
administered,
and in order that its influence
to cut short the disease ; the chloral gives the patient sound an the refreshing sleep ; and the Indian hemp not only increases it in him patient's appetite, but soothes and keeps good is found from experience that if the hemp is discontinued during
spirits:^
the course of the disease, the anxious, and desponding.
patient frequently
becomes restless,
idiopathic
HYDRATE OF CHLORAL IN TETANUS. By C. Macnamara. Ox referring to the Returns of the Chandnie Hospital, it appears that, from the commencement of the year 1865 to the close of 1869, no fewer than 83 cases of tetanus have been treated in this institution; of these 50 eases were traumatic, and 33
idiopathic
result of these
tetanus;
llelieved.
Cured.
Traumatic.
Idiopathic.
the
following
table exhibits the
cases:
Traumatic.
Idiopathic.
Absconded. Traumatic.
Idiopathic.
Died.
Traumatic.
Idiopathic.
tetanus 'were
of ia wo> the other died; another case occurred in the instance Eviden y, fifteen days after child birth, she also got well. when & chloral of therefore, the influence of the hydrate C an alone has not yielded so favourable a result in the The c ^ Indian hemp. with Ilospital, as aloes combined few ^ under the chloral treatment have, of course, been too but t in tetanus, this of to drug solutely determine the merits ^ have been sufficiently numerous, I think, to show that althou0 not chloral is invaluable in the treatment of the disease, it is ies be relied upon otherwise than as an adjunct to other reme The hydrate of chloral is invaluable in tetanus simply because, sleep however bad the case may be, it will invariably induce There have been cases in the Chandnie Ilospital of patien ^ were pu suffering the most frightful agony from tetanus, who of grain means sixty into a sound sleep for eight hours by of hydrate of chloral, but on waking, the tetanic spasms returne cour more violently than ever, and destroyed the patient in the of half
21
13
31
Tetanus is
generally supposed to be prevalent at certain of the year; the truth of this idea is hardly confirmed with reference to these 83 cases, as the following table illusseasons
trates
:?
an hour. In fact, I believe that the. hydrate of chloral acts simply at a ^ a hypnotic in cases of tetanus ; it has no specific power a to sleep and for the over the tetanic it but patient puts spasms, keep then not time prevents the spasms. It may be argued, why the patient at rest for three or four days, allowing him, sufficien a
nourishment to support life ? This is precisely, however, we cannot do, for it seems as if the action of the bjdiateo chloral, when prolonged, by keeping back the tetanic energy*
bursting more concentrated subsequently, the spasms forth with renewed violence. "We require a drug or combination of drugs, in addition to chloral, which will, if possible, influence the abnormal nervous action in tetanus, so as to deaden
renders it
a u
power, whatever it may be, which causes tetanic spasms. o shall endeavour on another occasion to illustrate the plan treatment which best accomplishes this end, the drugs employe being calabar bean and Indian hemp, in addition to the hydraof chloral: the first of these undoubtedly seems to control the irregular and abnormal action of the nerves in tetanus, but hardly
.S
H
"With reference to treatment, it will be noticed that ot the 83 two absconded from the hospital, so that, practically, we have to deal with 81 instances of tetanus, and of these 13 are " stated as having been relieved" when discharged from cases,
hospital;
this is doubtless a very unsatisfactory way of accounting for cases of tetanus, but it is unavoidable in this country ; the friends
patient often insisting on his removal from hospital, although there may be a good hope of the sick man's recovery. Supposing we allow that of these 13 cases, said to have been relieved, seven ultimately died, we then have the following
of the
results :?Of 42 cases of traumatic tetanus 16, or 38 per cent., recovered, and of 39 instances of idiopathic tetanus 24, or 60 per cent., recovered. The medical treatment followed in these 81 cases has been uniform, consisting of aloes and Indian hemp, as recommended by Dr. J. Jackson, (formerly in charge of the Chandnie The
patient's
Hospital.) was confined, almost without exception, throughout the whole course of his illness. diet
to
bread and milk "We may now turn to the circumstances of ten consecutive cases of tetanus lately under treatment, in which the hydrate of chloral has been
administered,
and in order that its influence
to cut short the disease ; the chloral gives the patient sound an the refreshing sleep ; and the Indian hemp not only increases it in him patient's appetite, but soothes and keeps good is found from experience that if the hemp is discontinued during
spirits:^
the course of the disease, the anxious, and desponding.
patient frequently
becomes restless,
