458 Tetanus. 



ground. If however the place of infection is known with sufficient certainty, it 

 appears justified to anesthetize the animals for the purpose of local treatment. 



Suitable quarters and proper food are of great importance. 

 The patients should be put in a quiet place, if possible, with 

 soft ground, and on account of the increased reflex irritability, 

 they should be protected from loud noises and from direct 

 sunlight (complete darkness- is not necessary), and also from 

 unnecessary handling and examinations. It is only in severe 

 cases advisable to place the horses in slings, usually when the 

 animals are exhausted to such an extent that they can stand 

 up only with difficulty, for once the animals have fallen to the 

 ground the condition becomes very rapidly aggravated. If 

 the animal is found lying on the ground it is advisable to allow 

 it to lie for awhile on soft bedding; then it should be raised 

 carefully, and placed in slings if this is possible without unduly 

 exciting the patient. 



As long as the patients are not unable to eat they should 

 be given soft, easily digestible food; later, when mastication 

 becomes difficult on account of approaching trismus, flour and 

 bran- gruels, to which eggs or red wine have been added, may 

 be given, while if trismus is fully developed nutritive enemas 

 (milk and eggs) may be employed. At the same time the ani- 

 mals should have fresh water within reach, so that they may, 

 at their desire, rinse their mouth and quench their thirst. In 

 order to prevent the decomposition of the saliva and of the 

 remnants of food it is advisable to rinse the mouth from time , 

 to time with pure water or water containing a little vinegar. 

 The retained feces should be removed by manual emptying of 

 the rectum, or by enemas of soap water ; the retention of urine 

 is relieved by pressure on the bladder, or if necessary by the 

 introduction of the catheter. 



The internal treatment proper is of minor importance. 

 The administration of drugs per os is dangerous even if trismus 

 is only slightly developed, and for this reason usually only 

 such remedies are given as the patients can take with their 

 drinking water (salines for the prevention of constipation);, 

 in cases where the infection appears to have occurred through 

 the intestines oil of turpentine (01. thereb., 01. oliv. ai lOO.O g. 

 per diem:) is now administered per os or per rectum, as advo- 

 cated by Hart'enstein and Nocard. Inhalations of chlorofom, 

 or chloroform and ether appear to act beneficially, by diminish- 

 iiig the trismus somewhat, so that the animals can more easily 

 partake of food. Such inhalations should be ^ven immediately 

 before feeding, but only up to the commencement of anesthesia. 

 Matozzi recommends for reducing the trismus an ointment of 

 cyanide of potassium (2:8), Schleg a mixture of gray mercury 

 ointment and camphor liniment, to be rubbed into the cheeks. 

 Chloral hydrate or ether (3-50 g. daily per rectum), morphine 

 (0.2-0.5^. subcutaneously ) , cyanogen (0.3-0.5 g. subcutaneously 

 or injected into the trachea), extract of belladonna (2-4 g. I'll 



