TETANUS. 501 



markedly extended on the neck ; the ears were directed forwards, and 

 could not be moved ; the membrana nictitans covered part of the globe 

 of the eye. Trismus was very marked. The animal made unsuccessful 

 attempts to swallow its saliva, which dribbled from the mouth in long 

 filaments. Any excitement caused paroxysms. Temperature 39'3° C. ; 

 respirations 78 ; pulse 85. A wound about two inches in length, with 

 contused margins, was found in the left hind pastern. 



Treatment. — Disinfection of the wcmnds with dilute tincture of 

 iodine, immersion of the foot in a 'i per cent, sublimate solution, fol- 

 lowed by iodoform dressing of the pastern. The patient was afterwards 

 placed in a dark box and fed with nourishing enemata. At g p.m. 75 

 grains of Behring's dry antitoxin, dissolved in iij fluid drachms of luke- 

 warm sterilised water, were injected into the jugular. The animal was 

 found dead next morning. 



Autopsy. — Lesions of asphyxia; suppurating scirrhous cord; the 

 base of the left spermatic cord was swollen, as large as a hen's egg, and 

 contained numerous suppurating centres. 



194. A four-year-old gelding, castrated on the 27th November, 

 1896, in the northern suburbs of Paris. The operation was performed 

 by the covered method with clams, and partial antiseptic precautions 

 were taken, During the days following operation the wounds were 

 washed with *i per cent, sublimate solution three times daily. 



On the 4th December the clams were removed. Next morning 

 considerable swelling of the genital region appeared, but in a few days 

 again diminished. The wounds suppurated slightly. 



Until the 20th December nothing unusual was seen. Next morning, 

 however, symptoms of tetanus appeared, and the horse was sent to 

 Alfort. 



State on Examination. — Generalised tonic contractions ; tail elevated ; 

 head extended and held stiffly ; ears directed forwards ; membrana 

 nictitans covering part of the globe of the eye ; trismus ; respiration 

 rapid, varying between 32 and 36 per minute ; temperature 38° C. 



Treatment. — The horse was placed in a box. Every care was taken 

 to guard it against the action of light, cold, and noise. The wounds 

 were disinfected. Morphine and chloral were given. During the day 

 and ensuing night the symptoms became aggravated. 



On the morning of the 21st the skin was covered with sweat. 

 Hypersesthesia was very marked ; opening the door, touching the 

 animal, or making the smallest noise produced paroxysms. Respira- 

 tions 36 ; pulse 46 ; temperature 38*2° C. 



Seventy-five grains of Behring's dry antitoxin, dissolved in iij 

 drachms of lukewarm sterilised water, were injected into the jugular. 

 During the day the patient took milk, and in the evening gruel. Res- 

 pirations 36 ; pulse 48 ; temperature 38*5° C. 



On the 22nd the condition was more severe. The respirations were 

 70 to 80 per minute during the attacks. Seventy-five grains of aqueous 

 extract of belladonna and 5 ounces of sodium sulphate of soda were given 

 in the drinking-water. Morphine was subcutaneously injected, and 

 chloral given in enemata. 



