DOCUMENTS 345 
face of the thorax, nearly as far as the inner margin of the false 
ribs. This œdema 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. Respiration, however, was distinctly accelerated, 30 
per minute. Temperature not taken on admission. No urine 
passed since the accident. 
“The patient’s condition being so alarming, 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 limb. The patient was put to bed, and kept 
warm. He was given an injection of 50 centigrammes of caffeine, 
and 300 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 little 
patient passed his urine, about 200 grammes. He is more lively, 
and replies 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. 
