BACTERIOLOGY IN A NUTSHELL. 
Arching of 
the Back. 
Effect of 
Medicines. 
Management 
of Tetanus. 
Preventive 
Measures. 
they are kept up almost continuously. (The 
spasms seen in tetanus are somewhat similar to 
the spasms from strychnia poisoning.) Eventual¬ 
ly the jaws become tightly clenched, the back is 
bowed and the patient is frequently found to rest 
only on the back of his head and his heels, the 
rest of the body arching upward from the bed. 
Death commonly occurs from exhaustion. The 
majority of cases prove fatal. 
Medicines seem to have no effect in arresting 
the progress of tetanus. Chloroform and opiates 
are used by many physicians for the temporary 
relief they give from the violence of the spasms. 
In recent years the antitoxin treatment has saved 
some lives. In order to be of any marked value 
it must be administered early in the case. 
The nurse is instructed to keep the patient’s 
room darkened and to guard him from all dis¬ 
turbances. Noises are said to aggravate the 
spasms, and she is cautioned to keep him quiet. 
He should be watched very closely and must not 
be left alone a minute. Strenuous efforts to give 
him nourishment must be made. As the jaws 
are tightly clenched, recourse is had to nutrient 
enemata. “Nose feeding” is not recommended 
by the best authorities, as it is believed to aggra¬ 
vate the spasms. Opiates are sometimes given 
by rectal injection also. 
Some physicians now recommend opening up 
accidental wounds as quickly as possible after 
they occur. A thorough irrigation of the wound 
with an antiseptic solution then follows, such 
irrigation to be kept up at frequent intervals un¬ 
til all danger of the invasion of the bacillus te- 
tani is over. Between the irrigations, the 
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