TREATMENT WITH ANTITETANIN 59 



and should be made of some tough, unbreakable 

 material. The animal should be placed in such a 

 position that the fore and hind legs approximate, so 

 that the back is arched ; the needle is then pushed 

 perpendicularly into the spinal canal at the site 

 indicated. "When the canal is reached, which is 

 indicated by absence of resistance to the needle, 

 there is an escape of intraspinal fluid. If this does 

 not come of its own accord, as often it does not, a 

 quantity up to 10 to 20 c.c. should be withdrawn ; 

 at the same time the animal's pulse should be care- 

 fully observed for any sudden alteration. On this 

 appearing withdrawal of spinal fluid should be stopped. 

 Having withdrawn the spinal fluid, the antitoxic 

 serum is injected very slowly into the spinal canal. 

 The intraspinal injection should be made once daily. 



A method of treatment from which I have had good 

 results is a combination of antitoxin, given by the 

 different methods mentioned, and large doses of 

 chloral hydrate. My procedure was to give f to 1 

 ounce of chloral intravenously half an hour before ad- 

 ministering the serum, or the chloral may be given 

 intracsecally through a cannula, to which is attached a 

 rubber tube and a funnel ; in either method care 

 must be taken that all the chloral solution is removed 

 from needle or cannula by the use of normal saline, 

 before either is withdrawn. If the chloral should gain 

 access to intercellular tissue severe inflammation will 

 follow. 



I adopted this treatment as the result of a theory I 



