After the use of this mixture there was no relapse of tristhe rigid state of the limbs gradually disappeared, .and with occasional doses of brandy the patient steadily improved, and left the hospital quite well on the 4th November after a stay of 32 days. I am convinced that Bromide of Potass, and Hydrate of chloral are very .useful drugs in the treatment of tetanus, when administered in time in its early stages, accompanied with proper treatment for keeping up the powers of the doses of stimulants and nourishsystem, by carefully repeated ing diet, for preventing the fatigue and exhaustion induced I also believe that the above drugs have been much used in cases of hydrophobia, with advantage. mus,
by?convulsions.
T. Jesuda Sen, Native
Tinnevelly,
Surgeon,
1 bth February 1SS1.
/ TRAUMATIC TETANUS. To the Editor
of
the
"
Indian Medical Gazette."
reference to the very full and interesting paper on the " Statistics of Tetanus" published in page 2G of your valuable journal'for last month, permit me to make brief mention of a case of traumatic tetanus which occurred recently in the Municipal Dispensarj' of this town. Dandameah, a strong, muscular, athletic Maliomedan, 37 years of age, was brought, on the evening of 2nd October last, in a state of collapse, having been severely beaten in a riot that took place between him and his antagonists. On admission he was speechless, with considerable difficulty of breathing, and vomiting bright frothy blood ; much pain and oppression in his chest; emphysema on the upper part of the right side, with fracture of the 3rd, 4th and 5th ribs. He had contused wounds over his body : not able to sit up : much pain and tenderness over the spleen and in the scrotum ; pain in .his left hip, which was much contused and swollen, greatly increased in attempting to move the limb, with eversion, and quite powerless to move it. On recovering his senses, lie showed by signs that he was severely kicked and beaten, and dragged about the ground. Stimulants and anodynes were administered ; warm fomentations to painful parts, and cold lotions to the bruises. Bowels, which were costive, were kept open by aperients and injections whenever required; adhesive plaster was applied on the chest, over the broken ribs to restrain their movements, and a broad flannel roller put over it, which gave him much relief. Inflammatory action was prevented by the use of salines, spare diet, and complete rest. The spitting of blood, which continued more or less for about 25 days, gradually ceased, giving way to sputa of a rusty character, and at times with dark coagulated viscid blood. Astringents, such as Gallic acid, Turpentine, and Perchloride of Iron, were also used according to circumstances for stopping the hemorrhage. On the morning of the 7th day after the infliction of the injury, symptoms of tetanus set in ; he was giddy with pain and oppression in chest, abdomen rigid, eyes closed, pain in the neck, with trismus, and quivering of the lips. In the afternoon of that day he became speechless, with cold extremities bathed in perspiration ; teeth and hands strongly clenched, so that he could not swallow anything, with convulsions of the upper extremities ; pulse small, quick, and easily compressible. Turpentine frictions and mustard poultices were largely used ; stimulants as ammonia and
Sie,?With
brandy
were
freely given
;
stimulating antispasmodic
enemas
administered ; carbolic oil and poultices were applied to the superficial wounds on his body to remove all sources of irritation. During that night he rallied and slept little after 12. On the 8th day he was better : no convulsions ; teeth not clenched, bowels moved; took some milk and brandy. Speech low, abdomen not so rigid as before, pulse 104, full and quick, limbs rigid. The following prescription was ordered :? E.
Ammon. Carbon.
...
Potassii Bromid
... '
Hydrate
of Chloral
Aq. Cam ph. Misce
...
gss. 3 i. 3 ss.
...
^i
every 2nd hour.
^vi,
by?convulsions.
T. Jesuda Sen, Native
Tinnevelly,
Surgeon,
1 bth February 1SS1.
/ TRAUMATIC TETANUS. To the Editor
of
the
"
Indian Medical Gazette."
reference to the very full and interesting paper on the " Statistics of Tetanus" published in page 2G of your valuable journal'for last month, permit me to make brief mention of a case of traumatic tetanus which occurred recently in the Municipal Dispensarj' of this town. Dandameah, a strong, muscular, athletic Maliomedan, 37 years of age, was brought, on the evening of 2nd October last, in a state of collapse, having been severely beaten in a riot that took place between him and his antagonists. On admission he was speechless, with considerable difficulty of breathing, and vomiting bright frothy blood ; much pain and oppression in his chest; emphysema on the upper part of the right side, with fracture of the 3rd, 4th and 5th ribs. He had contused wounds over his body : not able to sit up : much pain and tenderness over the spleen and in the scrotum ; pain in .his left hip, which was much contused and swollen, greatly increased in attempting to move the limb, with eversion, and quite powerless to move it. On recovering his senses, lie showed by signs that he was severely kicked and beaten, and dragged about the ground. Stimulants and anodynes were administered ; warm fomentations to painful parts, and cold lotions to the bruises. Bowels, which were costive, were kept open by aperients and injections whenever required; adhesive plaster was applied on the chest, over the broken ribs to restrain their movements, and a broad flannel roller put over it, which gave him much relief. Inflammatory action was prevented by the use of salines, spare diet, and complete rest. The spitting of blood, which continued more or less for about 25 days, gradually ceased, giving way to sputa of a rusty character, and at times with dark coagulated viscid blood. Astringents, such as Gallic acid, Turpentine, and Perchloride of Iron, were also used according to circumstances for stopping the hemorrhage. On the morning of the 7th day after the infliction of the injury, symptoms of tetanus set in ; he was giddy with pain and oppression in chest, abdomen rigid, eyes closed, pain in the neck, with trismus, and quivering of the lips. In the afternoon of that day he became speechless, with cold extremities bathed in perspiration ; teeth and hands strongly clenched, so that he could not swallow anything, with convulsions of the upper extremities ; pulse small, quick, and easily compressible. Turpentine frictions and mustard poultices were largely used ; stimulants as ammonia and
Sie,?With
brandy
were
freely given
;
stimulating antispasmodic
enemas
administered ; carbolic oil and poultices were applied to the superficial wounds on his body to remove all sources of irritation. During that night he rallied and slept little after 12. On the 8th day he was better : no convulsions ; teeth not clenched, bowels moved; took some milk and brandy. Speech low, abdomen not so rigid as before, pulse 104, full and quick, limbs rigid. The following prescription was ordered :? E.
Ammon. Carbon.
...
Potassii Bromid
... '
Hydrate
of Chloral
Aq. Cam ph. Misce
...
gss. 3 i. 3 ss.
...
^i
every 2nd hour.
^vi,
