516 Howrah Hospital Report for 1846. 



whether appertaining to the blood vessels only, or to them 

 and the nervous tissue conjointly. 



Tetanus. — The case of a man, age 29, admitted into the 

 hospital in the middle of May, of a very severe description, 

 followed by death on the third day after admission. The 

 only assignable cause seems to be sleeping on deck at night. 



The principal symptoms in the case were locked-jaw ; great pain 

 and sense of constriction of the throat, and difficulty of swallowing 

 the smallest quantity of liquid, and difficulty of speaking ; severe pain 

 is felt at the hypogastrium, as of compressing the bowels, obstructing 

 breathing, and, simultaneously with it, the head and back are curved 

 backwards, attended with frightful spasms, recurring in quick suc- 

 cession ; rapid, soft, pulse ; perspiring skin ; the attempt to swallow 

 calling into play the whole associated morbid train of spasmodic 

 action. 



Post mortem examination 12 hours after death. Externally, lividi- 

 ty of the surface of the back and other parts of the body. Head, 

 very great cerebral congestion of the sinuses and blood vessels of the 

 brain, neither effusion of serum, nor softening of the cerebral sub- 

 stance observed. Medulla spinalis, a pulpy softening of the lumbar 

 portion for the extent of an inch, a few blood vessels distinctly 

 injected ramifying over the medulla at the part posteriorly j general 

 vascular fulness of the other organs of the body observed ; nothing 

 remarkable observed in the lining membrane of the wind-pipe. The 

 treatment consisted of large doses of tartar emetic at first, of calomel 

 jalap and croton oil, venae sectio, leeches to the back, of blisters, 

 turpentine enemata, extract belladon, gr. ss. every hour for 8 doses, 

 extract hemp, gr. ij. for several repeated doses, administered per 

 os et anum. 



In another case, in a lad of 1 9 years, in which decided relief was 

 obtained on the evening of the 4th day, the attack commenced with 

 gastro-enteritic derangement, vomiting and watery purging, burning 

 pain in the epigastrium extending along the chest up to the throat, 

 with a sense of dryness of the throat and globus hystericus obstruct- 

 ing breathing, and great pain and difficulty of swallowing liquids, 

 difficulty also of speaking, respiration hurried at times and attended 



