DOCUMENTS 345 



face of the thorax, nearly as far as the inner margin of the false 

 ribs. This oedema was not very painful, though fairly tense, 

 yielding but slightly to pressure. In the affected region the skin 

 was cold, of a dull livid colour, with a few ecchymosed patches. 

 In the bitten finger, a small wound with no special characteristics. 



" General condition bad ; the child was unable to stand. He 

 was indifferent to what was passing around him, merely groaning 

 a little when examined. The pulse was feeble, thin, and easily 

 compressible ; it was also very irregular. The extremities were 

 cold. Lungs : nothing abnormal on auscultation, rapidly performed, 

 it is true. Kespiration, however, was distinctly accelerated, 80 

 per minute. Temperature not taken on admission. No urine 

 passed since the accident. 



" The patient's condition being so alarmmg, not to say desperate, 

 we thought it almost useless to have recourse to Calmette's method, 

 more especially since at least seven hours had already elapsed since 

 the child was bitten. Nevertheless we gave a hypodermic injection 

 of 20 c.c. of Calmette's serum. At the same time the wound was 

 crucially incised, and bathed with a 1 in 1,000 solution of perman- 

 ganate of potash, after which a damp dressing was applied to the 

 whole of the swollen Hmb. The patient was put to bed, and kept 

 warm. He was given an injection of 50 centigrammes of caffeine, 

 and 800 grammes of artificial serum. In the evening the tempera- 

 ture was 36 '8° C. 



" May 27. — General condition more satisfactory ; pulse still weak, 

 but less irregular. Persistence of dyspnoea, explained by a series 

 of small rales at the bases of both lungs. This morning the Httle 

 patient passed his urine, about 200 grammes. He is more lively, 

 and rephes better to any questions addressed to him. 



" May 28. — The improvement continues ; the dyspnoea has almost 

 entirely disappeared ; only a few rales are still heard at the extreme 

 base. The pulse is stronger and remains regular. The secretion 

 of urine gradually reappears. The temperature of the extremities 

 has become normal. 



