Sulphanilamide in a Case of Abdominal Injury

L. D. was gored by a wild boar at night in his field while watching his crops on the 10th March, 1944 After a lapse of twenty-four hours he was carried to the dispensary, a distance of ten miles over and down the ghats. He had irregular contused wounds of the back muscles and several gashes on the right abdominal * wall and thigh. The peritoneum was ripped open about two inches on the outer border of the rectus and a large mass of omentum and one-and-a-half feet of small intestine had prolapsed. He was suffering from shock, and appeared moribund. The whole mass had been covered with ashes, turmeric powder and a paste made of green jungle-leaves, and tied up with dirty rags and old ' pugreeUnder a morphia injection the skin, wounds and bowels were repeatedly cleaned with boiled water and all foreign bodies were wiped out The bowels were not punctured. The raw surfaces including the mesentery folds were covered with boiled towels, cleaned with ether, and dusted with sulphanilamide, two-and-a-half grammes (Evan's streptocide) Under procaine locally, the prolapsed parts were gradually replaced, and the abdominal opening closed in layers with a drainage tube. Anti-tetanic serum was given. Also streptocide solution 2\ per cent 5 c.cm. intramuscularly, saline with adrenalin by rectal drip, and glucose by mouth were given. One gramme of streptocide powder was given at bed time the temperature being 100?F., pulse 160. Next day the temperature was 100?F., and the pulse 140. Enema given, and rectal saline continued. Streptocide 0.5 gm. given every eighth hour; flatus tube passed with some relief. On the third day the temperature was 98.5?F., and the pulse 120; streptocide continued. The patient was very restless with acute distension of abdomen. Pituitary extract 1 c.cm. given by injection, castor oil 1 oz., and turpentine stupes externally relieved the distension. On the fourth day, the temperature and the pulse became normal. Streptocide was continued till the eighth day and then stopped. The main abdominal wound appeared to heal by first intention, but the damaged skin tags and tissues gave way in