643 jaHvs were more tightly clenched, and well-marked risus sat4donicus was present. Ohloral and bromide of potassium, 20 grains of each, were now given every four hours and they were continued for 12 days, after which they were reduced in amount and were finally omitted on the twentysecond day. From the third to the sixth days there were frequent slight general spasms in which the limbs remained rigid whilst the back was suddenly arched, the jaws were clenched, and the facial muscles were

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... acted, each spasm lasting but a few seconds and gradually diminishing in severity. After the sixth day there were no actual spasms but rather momentary twitchings. Food was taken by the mouth throughout, though at times with difficulty. There was no retention at any time, but from the seventh to the eighteenth days there was incontinence both of urine and fseoes. The pulse-rate never exceeded 118 and was usually about 90. The temperature ranged from 990 to 101° F. for the first 17 days, on one occasion reaching 103°, but this was fully accounted for by the suppuration of the finger wounds. Profuse sweating occurred during this time. For 26 days the respiration rate varied from 28 to 20 and cough was troublesome, a good deal of viscid material being expectorated, but no physical signs ware found in the lungs. From the sixth to the twelfth days he was noisy and delirious and at times quite unconscious, but after the twelfth day the mental condition gradually improved. Muscular rigidity gradually passed off and when the patient was discharged on the forty-second day there was but slight stiffness in the neck and jaws. Seen three weeks later he was in perfect health and showed no muscular rigidity anywhere. CASE 4.-The patient was a male, aged 42 years. Six days before admission he sustained a contused wound of the foot with the point of a pickaxe. He was treated at once, the wound being washed out with carbolic acid and dressed with cyanide gauze. Two days later the wound was suppurating. On the sixth day after the injury he noticed some stiffness in the neck and jaws and pain in the back. When admitted there were marked trismus and retraction of the head, the muscles of the neck and back being particularly rigid. The limbs were not affected. The temperature and pulse were normal. Chloroform was given, the wound was excised and swabbed out with 10 in 11 carbolic acid, and a dose of 20 cubic centimetres of antitoxin was injected into the spinal theca. The first general convulsive attack occurred at the commencement of the chloroform administration. On the following day the muscular rigidity was more marked; he complained of a good deal of pain and sweated profusely. There were no general spasms but on attempting to swallow the jaws became more tightly clenched and the head was retracted. He was very restless and slept but little. There was no retention of urine and the bowels acted naturally. The temperature did not rise above 99° F. 12 hours after the first injection of serum a second dose of 20 cubic centimetres was given in the same manner. Death occurred about eight hours later. At the necropsy there was no inflammation of the spinal membranes. No visceral disease was found.