Reports of Societies

1883 BMJ (Clinical Research Edition)  
inferior external part of the left cornea, occupying about one-tenth of its whole area. The conjunctivae were much congested, and there was some extravasation of blood at the upper part of the globe, together with ciliary congestion. Both pupils were fully dilated. Solution of atropine was directed to be applied to the eye, and a mixture containing one grain of iodide, and three of bromide, of potassium, was ordered three times a day. May 22nd.-The ulcer of the cornea was no better. The
more » ... better. The temperature was 100.80 Fahr. May 23rd.-At 4 P.M., the child was sick after a dose of oil; he appeared to gasp for breath, and was noticed to be drowsy. The conjunctival reflex was deficient. The temperature was 103°Fahr. At 9 P.M., the temperature was 105°Fahr. Therewas no pneumonia; he was dull and heavy. At midnight, the temperature was 106.60 Fahr. in the axilla, and 1070 Fahr. in the rectum. The child was insensible; and there was no conjunctival reflex. The right eye was bright, while the left was dull; the eyelid was widely open; conjunctiva dry, and the eyeball sunken and shrivelled; the pupil was dilated from the previous use of atropine. The right pupil was moderately dilated, but did not respond to light. The right leg was extended, anid quite stifl, and the right arm and fingers were also stiff and extended, and could not be bent. There was no apparent sensibility on this side. In the left leg, power appeared normal; but at intervals there were partial tonic spasms. There was no clonus at the ankle, and no patella-reflex. Sensibility was diminished. If touched or covered with clothes, the thigh was at once flexed, and the leg again extended. The left arm lay passive, but flaccid. If the child were placed on his back, he sluggishly turned over on to the left side, with a marked tendency to arching of the back. He had not passed urine; the mouth was open, and there was some difficulty in swallowing, fluid remaining in the mouth for a short interval. The lips did not close on the spoon. The left arm was used to remove the spoon. The tongue was slightly protruded, and both it and the mouth markedly drawn to the left side. Respiration was sighing, but not at all abdominal; the chest expanded moderately, and equally on both sides. The pulse was very quick, but good. Cold sponging reduced the temperature to 1060 Fahr. May 24th.-The right arm and leg were slightly rigid, but were moved voluntarily. Tile child lay on his back in a semicomatose condition. He had passed urine freely, during the night, but the bowels were confined. One grain of calomel was given. The temperature had fallen to 103.80 Fahr. No fresh symptom had arisen. Ice-bags were ordered to the head, and cold sponging every two hours. 4 P.M. The temperature was 1080; the skin was dry, and burnincg hot. The urine could not be saved. May 25th-At midnight marked twitching of the mouth was noticed, and the fingers of the right hand were firmly clenched; the left fingers also were flexed; respiration was laboured. At 2 A.M., the face was blanched; respiration was calm; the child could not swallow, and died at 8.30 A.M. Temperature.
doi:10.1136/bmj.2.1191.822 fatcat:id6f7pwcvzbztekl6cnv42jvni