154 TETANUS. 



ease was necessarily the seat of intense congestion, I resorted to 

 chloroform as an anaesthetic instead of ether. The usual operation 

 for necrosis of the lower end of the femur was performed, and a 

 large triangular sequestrum removed from the lower and posterior 

 aspect of the bone. The involucrum was imperfect and its inner 

 side lined with a thick layer of flabby granulations. Gelatin tubes 

 were inoculated with blood, pus, and granulation tissue. The blood 

 cultivations remained sterile, while the two remaining tubes showed 

 a copious growth of staphylococcus pyogenes albus which rapidly 

 liquefied the gelatin. A portion of the granulation tissue was dis- 

 infected with a weak solution of carbolic acid, dried between layers 

 of antiseptic gauze, and inserted under the skin of a rabbit. No 

 suppuration followed, and the animal remained perfectly well for 

 six weeks, when both posterior extremities became rigid so that it 

 could only move from place to place by dragging the hind legs. 

 The next day tetanic convulsions affecting the muscles of the back 

 and all the limbs appeared, and on the fourth day death supervened. 

 The interesting features in this case are that the patient recovered 

 from the tetanus after a long illness, extending over three months ; 

 that marked improvement followed the operation, which had for its 

 object thorough disinfection of the infection-atrium ; and that the 

 inoculation with granulation tissue in the rabbit was followed by 

 an acute attack of tetanus six weeks after infection. In the experi- 

 ments related above the animals were inoculated with cultivations, 

 or with wound secretions from tetanic patients ; the stage of incu- 

 bation rarely extended over two to three days, and often only 

 eighteen to twenty-four hours, aud the disease produced death in 

 from twelve hours to three days. 



Prophylactic and Curative Treatment of Tetanus by Antiseptic 



Agents. 



More than a year ago Sormani (La Riforma Medica di Napoli, 

 January 11-13, 1890), of Naples, found that iodofortn was one ol 

 the most energetic disinfectants of the virus of tetanus, and that 

 iodol and an acid (2 per cent.) solution of corrosive sublimate were 

 similar in their action. A second series of experiments has shown 

 that also chloral and chloroform had a similar power. Since then 

 Mazzuschelli has used iodoform (locally) in two cases, which in and 

 toward the end of May, 1889, came under treatment. In one case 

 a girl while working in a garden with a spade, inflicted upon her- 

 self a large, torn wound in the calf of the right leg. Eight days 

 after tetanus set in and she was taken into the hospital at Pa via. 

 After removal of the dead tissue the wound was cleansed with a 2 

 per cent, solution of sublimate, dusted over with iodoform, and 



