Two cases of Trismus Nascentium, ivltich recovered under the use of
Cannabis Indica. Reported to the Medical Society of S. Carolina,
Oct. 1st., 1853, by P. C. Gaillard, M. D., Charleston, S. C.
I am induced to report the following case, with some details, in con-
sequence of its unusual termination in recovery. 11 Trismus of new born
infants,” says Romberg, 11 is the most absolutely fatal of all children’s
diseases. Cases in which a cure has been effected, must be received
with great suspicion, unless the diagnosis be verified by very accurate
details.” With us, the disease is, unfortunately, too common to allow
us to be ignorant of its characteristic features ; and our experience teaches
us that the German professor has not exaggerated its fearful mortality.
But I am happy to be able to report another case of recovery, under the
same treatment, which occurred in the practice of my friend, Dr. De
Saussure, during the month of March, 1853. The details of this case,
furnished by Dr. DeS., will be found below, (case 2.) Time and fur-
ther experience must determine whether we possess in cannabis an agent
capable of controlling the disease ; or whether the cases which follow
must be reckoned amongst those fortunate accidents, or coincidences,
which too often mislead us in estimating the value of therapeutic agents.
Case 1.—Rachael, a negress, aet. 38, of good constitution, was deliver-
ed of her eleventh child on Saturday, 23d July, 1853. The cord fell
on the sixth day, and the child, a fine robust boy, did well until Tues-
day, August 2d, when, towards evening, it was observed to be fretful
and to nurse with difficulty. During the night it lost the power of
taking the breast, and paroxysms of spasm became evident. I saw it
the next day, August 3d. The child was lying on the mother’s lap.—
Paroxysms of spasm could be readily brought on by blowing into the
face, or by attempting to introduce the finger or a spoon into the mouth.
During the paroxysms, the muscles of the face were contracted so as to
produce the characteristic expression ; the lips prominent; the jaws
fixed and slightly separated ; the tongue pressed against and filling the
narrow space between them ; the nose compressed ; the forehead wrin-
kled longitudinally; and the child uttered the grunting, whining cry so
peculiar in this disease. The muscles of the back and arms were rigid
and the fingers were forcibly shut upon the palms of the hands.
The navel had healed ; there were no signs of irritation about it. The
examination of the head showed that the occipital bone was in its nor-
mal position ; the parietals did not override, or in the slightest degree
overlap its anterior border. The child was still able to swallow a little ;
for, although whenever the milk with which the mother fed it was pour-
ed into the mouth, the greater part was forced out by the spasmodic ac-
tion induced by its introduction, yet after a time a little was swallowed.
The following directions were given : the child to be constantly fed,
while awake, with milk drawn from the mother’s breast and poured into
the mouth ; large warm poultices to be kept constantly to the abdomen;
a warm bath to be given twice a day, and a teaspoonful of the following
mixture to be administered every two hours : Tinct. Cannabis Indica
3ii, Camphor Water §ii.
On the 4th no change. On the 5th the spasms were reported as hav-
ing increased in frequency and severity ; the medicine was directed to
be given every hour and a half. On the 6th and 7th no appreciable
change ; the treatment was assiduously prosecuted. On the 8th the
dose of the medicine was increased : jii. of the tincture of cannabis
to §ii. of camphor water, a teaspoonful every hour. On the 9th the
mother said that the child had nursed a little twice when she forced the
nipple into its mouth. The spasms of some of the muscles were, how-
ever, still very violent, as I could with difficulty, and only by using
considerable force, extend the fingers, which were forcibly contracted on
the palm. On the 10th the child took nourishment more freely by the
spoon. On the 11th the spasms were rather less frequent, and not so
severe ; the rigidity was less, and the child nursed twice. The improve-
ment continued progressively. On the 21st the spasms were very short,
and the child took the breast readily when placed to its lips. On the
24th the mother reported that there had been no paroxysm of spasm
for 24 hours, and that the child nursed freely. From the IS th, the in-
tervals between the doses of medicine were gradually increased, and it
was continued, three doses a day, for some days after the disease had
disappeared. The child has continued well up to this time, October 1st.
Case 2.—Reported by IT. W. DeSaussure, M. B. Priscilla, a
stout, healthy negress, mt. 26, was delivered of her third child on the
13th March, 1853. The infant was a large healthy looking male. The
cord was detached on the fifth day ; on the seventh day the child was
noticed as unusually fretful, and passed several greenish, watery stools ;
on the night of the eighth day, it was fretful, restless, scarcely slept at
all, and was unable to move, although apparently anxious to do so, I
saw it on the morning of the 9th day, the 22nd of March. It was lying
in the nurse’s arms, with the features contracted, the brows corrugated,
the muscles of the neck and back rigid and hard, the arms and legs
flexed, so as to be extended with difficulty; the hands contracted, with the
thumbs drawn tightly upon the palms; the jaws not very tightly closed—•
the little finger could be introduced into the mouth by a little effort ;
deglutition was possible, but the child could not nurse. The navel was
not entirely healed, but the ulceration left by the dropping of the cord
lpoked healthy. The child was ordered to be placed in a warm bath, a
large poultice applied to the abdomen, and a teaspoonful of the following
mixture given every two hours, viz : R Tinct, §ss. ; Syr. wild cherry,
giss. ; and the mother’s milk to be given by teaspoonfuls frequently.
On the 23d there was aggravation of all the symptoms ; the jaws were
so firmly closed that a teaspoon was with difficulty introduced into the
mouth ; deglutition was extremely difficult ; the arms, hands and legs
were more firmly flexed ; opisthotonos was present to a great degree ;
the slightest motion, a breath of air upon the face, even touching the
lips with the finger, was sufficient to bring on general spasms, accom-
panied by the peculiar whimpering cry so characteristic of this disease.
The head was carefully examined ; no depression of the occipital bone
could be detected. The same treatment was continued, and a teaspoon-
ful of the mixture was given every hour. From the 24th to the 28th,
the intensity of the disease gradually increased, until it seemed im-
possible that the child could survive each spasmodic paroxyism. It was
with great difficulty, and only by patient perseverance, that either milk
or medicine could be swallowed. All general treatment was now aban-
doned. A dose of the cannabis mixture was ordered to be given every
half hour, and as much milk given as the infant could be made to swal-
low. On the 28th, 29th, 30th, and 31st March, half an ounce of tinct.
cannabis was administered every twenty-four hours. On the 1st of
April symptoms of amendment began to be visible ; the spasms were
less frequent, and less easily excited ; the rigidity of the arms, hands
and legs, was less ; and deglutition was effected with less difficulty.
This improvement gradually but steadily progressed ; the quantity of
cannabis was proportionately decreased, and by the 10th of April, the
child was entirely convalescent. It is now a fine, healthy infant.—.
Charleston Med. and Sure/. Journal.