Page 119 - My FlipBook

about ; wasn't suffering any considerable pain : said his foot
felt a little sore and stiff", and that was all. I proposed to
amputate the leg up the middle of the thigh as a possible
means of saving that boy's life. But with the comparative
absence of symptoms of danger I couldn't induce the parents
to submit to such a procedure. A course of treatment was
determined upon and followed out vigorously, but was of no
avail. In twenty-four hours other muscles were stiff and
rigid, and in forty-eight hours the whole muscular system
was in a state of rigidity, and in the course of ten or twelve
days the boy's life was squeezed out by his own muscles,
that instillation of poison into the system affecting nervous
function and causing a chronic contraction of all of the mus-
cles of the body which was continuous, more or less paroxys-
mal, but never letting up. Now, in this case you will find no
micro-organisms in the blood. These micro-organisms will
not be found circulating through the blood to any consider-
able extent. They will be found in the neighborhood of the
wound, but there is no inflammatory process particularly.
They will be found spreading more or less from that local-
ity, and yet no inflammatory process of any consequence.
It is not the mere presence of the micro-organisms, but the
formation of a poison by them. Another case was described
to me by a physician. There had been some injury to the
foot—and that is a very common point of infection, because
we do not have this micro-organism entering the system ex-
cept through w^ounds, and it may be a mere scratch, and as
they are found growing in the earth we find the infection
often comes from wounds about the feet. He described the
case as "the leg drawing up." Nothing particularly wrong
except that the leg was stiff. The wound amounted to noth-
ing, practically, but in ten days that patient w-as dead of
tetanus.
Now, there are some cases that give a very great differ-
ence in appearance. During our civil war I became pretty
well acquainted with hospital gang^rene. Fortunately, I have
seen but few cases since, but I have seen a few cases that
have occurred indigenously, i. e., without the association of
other cases. I remember one case that occurred in Dr.
Prince's infirmary at a time when he was himself away in
Europe. A case of injury to the ankle had come in. It had

107