Tetanus; Relapsing Typhoid
[image:13690 align=left hspace=1] Editor Ellingwood's Therapeutist:
In reading the THERAPEUTIST I noticed the article on tetanus and was much interested as that has been a bugbear to me. I have never tried the phenol treatment but once, but as you asked for the experience of any and all cases I will add mine.
This man was injured in a cement mill, having the inside of his hand ground out with a pulley wheel. I tried for several weeks to save it but could not get any result so did an amputation at the wrist. In about ten days, which was over two months from the time of the injury, he showed a rgidity of the muscles of the abdomen, next day the masseter muscles were slightly affected and I at once began the use of the serum. He got along nicely for one week, not having a single convulsion, then died suddenly one night,
Another case, a boy shot in the hand with a twenty-two caliber blank, I cleansed the wound and dressed it every day for a week when he showed signs of tetanus. I had him taken to the hospital and began the injection of phenol at once, giving as high as ten minims every three hours. We could not stop the convulsions and he died in about four days. You see my experience with tetanus has not been a pleasant one. The next case I get I will try the phenol with the gelsemium and will report the result to you. These things are of deep interest to all of us, and if anything can be done to cure the dread disease we are only too glad to know of it.
I have a case now of relapsing typhoid that is of interest. The patient was in the hospital three weeks and his temperature was down to normal for two days when it suddenly went up to 103 and has resisted all efforts to pull it down for one week. Tonight it is 104.4, two-fifths lower than at the same time last night. I have tried everything I know or can read on the subject but I am afraid he will get away from me. It will be my first typhoid to lose and I do not relish it very much. I have had a great many cases of it here, and this is the first one that would not respond promptly to specific medicine.
His tongue is almost clean, pulse strong, full, ranging from 112 to 120, face pallid, no tympany and bowels moving freely, skin dry and rough. Can you suggest anything?
Long live the THERAPEUTIST and its editor. I get many good things from it each month.
RALPH G. CRESSMAN, M. D.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.