Tetanus. 309 



in this way too, it tends to relaxation of the bowels, instead of 

 constipation. Carbolic acid which can be conveniently given by 

 enemata has an anaesthetic action. 



Antiseptic and Antidotal or Antitoxin treatment is more prom- 

 ising, yet it has failed to come up to the full measure of expec- 

 tation, mainly because the nervous changes have already 

 reached a stage which cannot be undone speedily or at all. 

 Under this heading would come phenic acid (^ oz.) and probably 

 chloral hydrate (i oz.), already referred to, and the various 

 compounds of iodine which may be here noted. 



Iodine Terchloride. Iodine. Behring and Kitasato secured im- 

 munity of two months duration, by injecting the animal with 

 a filtrate of a culture of tetanus bacillus, and then injecting at 

 the same point 3CC. daily, for five days, of a i per cent solution of 

 iodine terchloride. Roux and Chamberland had similar results by 

 using iodine instead of the iodine terchloride, and maintained the 

 full measure of immunity by repeating the inoculation every 

 fortnight. Here it is evident that the action of the iodine is di- 

 rectly antitoxic or antidotal, when introduced along with the 

 toxins and before they can reach the nerve centres. 



Iodide of Potassium. In an experimental case of general tetanus 

 in the dog. Babes had a recovery in ten days, by injecting sub- 

 cutem 5CC. of Lugol's solution and thereafter for eight days 10 

 to 30CC. daily. This suggests the use of this agent along with 

 phenic acid, or as an alternate, in any case in which phenol ap- 

 pears to be losing its effect by use. It may be used hypodermi- 

 cally,or in the drinking water or by rectal injection. It has an 

 advantage over phenic acid in being actively diuretic and eliminat- 

 ing, while phenic acid has the recommendation that it tends to 

 lower nervous excitability and moderate the reflex spasm. 

 Theoretically the combination of the two agents, which do not 

 mutually decompose each other, should give the best results. 



These experiments have been often repeated showing clearly 

 the antidotal action of the iodine compounds when mixed with 

 the virus before inoculation, or injected with the virus into the 

 seat of the wound. When employed later when the symptoms 

 have developed, everything depends on the changes already ac- 

 complished in the nerve centres, and the severity and generahza- 

 tion of the spasms. 



