RUPTURE OF THE STOMACH. 
217 
a pure culture of the tetanus bacillus on the 2nd of January ; 
on the 7th the first symptoms appeared, and on the same 
day the patient was given over to the clinic. Pulse 60, respi¬ 
ration 32-36, temperature ioo.o° F. (37.8° C). The morpha- 
logical picture of tetanus was cofnplete: position character¬ 
istic— ears, neck and limbs stiff and hard, tail raised and 
carried out of the median line. At 2 o’clock P.M., the incisors 
could be separated only sufficiently wide to pass two fingers 
into the mouth. Patient removed to the slings, and at 2.40 P.M. 
took a subcutaneous injection of 0.4 g pilocarpine; the 
working, which appeared in five minutes, continued three 
hours, and was very severe. Defecation occurred eighteen 
times, and the salivation lasted two hours; pulse 80, respira¬ 
tion 52. A spasmodic intermission was not observed, but on 
the contrary, the contractions were more intense, and so pro¬ 
gressive, that in three hours one finger could with difficulty 
be introduced between the teeth. 
Toward morning of the same night, the case had to be re¬ 
moved from the slings, in order to prevent suffocation, and 
remained apathetic upon the floor until 1 P.M., on the eighth 
of January, when the animal died under symptoms of intense 
opisthotonos. 
As is known, congestion and oedema of the lungs, together 
with dissolution of the blood, and fatty degeneration of the 
heart muscle, are the most prominent and constant patho- 
logico-anatomical alterations found in tetanoid cases. 
Since the changes just mentioned,—especially the lung 
oedema—occurs in the tetanoid process, whether it be of long 
or short duration, and compromise the life of the patient, it 
would seem, reasoning a priori , that death is induced earlier 
through the hypersecretions ot the bronchial glands, which 
is ascribable to the physiological action of pilocarpinum hy- 
drochloricum. In the foregoing cases the fact that death 
rapidly followed the injections, confirms this view. 
RUPTURE OF THE STOMACH. 
By Claude D. Morris, Y.S., Bath, N. Y. 
Having read the interesting communication in the Re¬ 
view for April, by Dr. Johnson, on the rupture of the 
