PRINCIPLES OF VETERINARY SURGERY 487 



£.nd enables the animal to eliminate and destroy the 

 poison already combined. In cases of chronic tetanus, pro- 

 gressing slowly, the serum has produced good results in the 

 hands of Dieudonne, Chennot, Rohr and Lang. In acute 

 cases it was always a failure. 



The investigations of Nocard show that injections of the 

 serum are the best treatment for confirmed tetanus. The 

 crises are less intense, less numerous, and when recovery 

 begins the period of convalescence is shortened. 



Statistics support this opinion. In 28 observations by 

 Dieckerhoff the mortality fell from 80 and 90 per cent to 50 

 per cent. The injections should be given in the jugular in 

 doses of 20CC every two or three days. According to No- 

 card the results should be better among cattle and sheep. 



Treatment by Intracerebral Injections of Antitetanic 

 Serum. — Roux and Barrel have shown that in animals in- 

 jected for preventive purposes the antitoxin remains in the 

 blood and does not come into contact with the nerve cen- 

 ters. If tetanic toxin is injected into the brain of the sub- 

 jects thus immunized they will exhibit tetanic manifesta- 

 tions (cerebral tetanus). It is therefore clear that the serum 

 treatment is ineffectual after the disease has once developed, 

 because at that time a part of the toxin is already adhering 

 to the nerve cells. The antitoxin neutralizes the toxin that 

 still circulates, but it does not attack that part already set- 

 tled in the nerve centers. These authenticated facts have 

 suggested the idea of directly introducing the antitoxin into 

 the nerve centers. The antitoxin introduced into the brain 

 protects it, if the medulla is not already affected. This 

 method has giyen good results against experimental tetanus 

 of rabbits and cavies, and it has been applied to man, but the 

 results up to the present time are not conclusive. Out of 24 

 cases in the human being treated in this manner 6 recovered 

 and 18 died, a mortality of 75 per cent, which is higher than 



