This method of using antitoxin is not, however, available in the new born. The injection may be repeated, and possibly several times, if no beneficial effects are shown after twenty-four hours. The serum has no deleterious effects; its curative powers, according to what has been said, are uncertain. The injection of brain emulsion, which, according to fixes the tetanus toxin, has given no beneficial results; therefore we must avail ourselves of those drugs which are capable of lessening the irritability of the central nervous system. Of these the choice is chloral. It is given in solution, by mouth as long as the child can swallow and then by rectum, 0.5-2.0 Gm. (S-30 gr.) per clay. The bromides and chloroform anesthesia have as a rule little effect. The use of morphine in effective doses is made difficult by reason of the age. Monti recommends the subcutaneous injection of the fluid extract of physostigma in the close of 0.006 Gm. (A gr.). Others recommend hypo dermics of atropine, 0.00001-0.00002 Gin. ( TM gr.) per day. Espe cial care must be taken to protect the child from being disturbed and from cold, inasmuch as all stimuli further the occurrence of the tetanic spasms.
Rest and quiet, enveloping the child in wraps and the use of ther mophores are worthy of recommendation. The nourishment requires especial attention. As long as the child can suck it is put to the breast. At the very beginning of the disease, however, the child sucks unsatis factorily, or else not at all. Then it becomes necessary to pump the breast-milk and to feed the infant by using a spoon. With artificially fed children the same procedure is carried out using modified cow's milk. Very soon, however, difficulty arises in feeding the child even by the spoon, since the trismus interferes. The child must then be fed through a catheter passed through the nose into the stomach. For this purpose one employs a thin, soft catheter, about No. 6 English, equipped with a glass tube and with a glass funnel attached to the latter by means of a soft rubber tube. This apparatus must be boiled immediately before each feeding.