At 10 A.M. (October 19th) the limbs were quite relaxed, and the child's face was somewhat dusky. Very little air seemed to be entering the lungs. On passing the catheter into the stomach very little spasm was excited.
At 2 P.M. Mr. Battams was sent for, as the infant was thought to be dead.. On making artificial respiratory movements the child gave a gasp. From this time until 5 P.M. he continued to breathe eight times per minute. The conjunctivae were insensible, the surface was cold, but there was less cyanosis. Some brandy was administered. At 10 P.M. his condition remained unaltered, except that the respirations were now reduced to four per min ute. No more spasms had occurred.
On October 20th, at 2.30 the child was again thought to be dead, but artificial respiration revived him for a time ; he, however, finally sank about 3 A.M.
The _temperature was on admission (October 18th), 99° at 9 p.m. On the 19th it was 100.6° at midnight, 99.8° at 2.15 P.M., at 5.30, P.M., 95.8° at 7.30 P.M., and 96° at 10.30 P.M. No post-mortem examination was allowed.
In this case the remedy was, no doubt, administered too energetically. It would have been better, after the first dose or two of the chloral, to have given the drug in smaller quantities, even if it had to be repeated more frequently. Had this been done, the result might have been differ
ent. I have been unable to find any rule by which the administration of the remedy may be regulated. Whether it be advisable to proceed to actual narcotism, or whether it is preferable to stop short of that point, must be a matter for individual experience to acquire, and in this country such experience is difficult or impossible to obtain. Widerhofen directs gr. j.-ij. by the mouth, or gr. ij.-iv. by the rectum, to be given " at the time of each onset of convulsion." This direction is too vague to be useful as a guide in practice, and can scarcely be intended to apply to a ease such as the present, where the intervals of remission were so brief.
Tobacco and woorara have also been recommended, but must be very dangerous drugs to use at so early an age, even when, as in this disease, there is such a remarkable tolerance of sedatives. External applications are sometimes employed. Warm baths and cold packing have both their advocates. In Mr. Parker's case the warm bath seemed to have a decidedly unfavourable effect upon the infant.