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Choosing and Using A New CAT Getting The Most From Your Schmidt Cassegrain or Any Catadioptric Telescope Rod Mollise
Choosing and Using A New CAT Getting The Most From Your Schmidt Cassegrain or Any Catadioptric Telescope Rod Mollise
Choosing and Using a New CAT Getting the Most from Your
Schmidt Cassegrain or Any Catadioptric Telescope The
Patrick Moore Practical Astronomy Series 2009th
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Choosing
and Using a
New CAT
Second Edition
Series Editor
Gerald R. Hubbell
Mark Slade Remote Observatory, Locust Grove, VA, USA
Rod Mollise
Rod Mollise
Mobile, AL, USA
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Acknowledgments
Forty-five years of using and loving Schmidt Cassegrain and similar tele-
scopes has taught me a few things about these wonderful instruments, but I
hardly know everything. The Second Edition of this book would not have
been possible without the assistance of many kind and generous members
of the amateur astronomy community.
Dorothy Mollise, my wife and always “the brightest star in this astrono-
mer’s sky,” contributed the most of all. Without her love and understanding,
to say nothing of the hours she spent proofreading the manuscript, this book
could not have been written.
v
Contents
vii
viii Contents
Index������������������������������������������������������������������������������������������������������������������ 337
Chapter 1
Why a CAT?
Since you’re reading this, I’m guessing you’ve made an exciting decision:
You want a telescope. Specifically, you want a telescope for looking at the
sky, a telescope that will open the depths of space to your gaze and allow
you to visit the Moon, planets, and the strange and distant wonders of the
universe. And you are not looking for just any telescope; you’re interested
in a Schmidt Cassegrain telescope (SCT), whose full-color advertisements
fill the pages of astronomy magazines.
Most of us have become wary of high-pressure ads from manufacturers
who promise the Moon and deliver little. Luckily, that isn’t the case when
it comes to SCTs. Sometimes, the advertising does contain hyperbole, but
Schmidt Cassegrains really can deliver the Moon—and the stars, too.
SCTs, like anything else, aren’t perfect, but when all is said and done, the
Schmidt Cassegrain is the most versatile, technologically advanced, and
easy-to-use telescope ever sold to amateur astronomers. Since Schmidt
Cassegrains were first offered at prices the average person could afford in
1970, they have dominated the amateur astronomy telescope market. Don’t
believe that? Take a stroll around the observing field of a local astronomy
club during their next star party. Chances are a majority of the telescopes
there will be SCTs. Fancy advertisements alone couldn’t account for the
enduring popularity of Schmidt Cassegrains. Something good must be
going on.
Fig. 1.1 (SCT) An 11-in. Schmidt Cassegrain telescope set up and ready for an evening
of deep space voyaging. Credit: Author
Not that an SCT (Fig. 1.1) looks much like a telescope of any kind to
novice astronomers. Catadioptric telescopes (CATs, for short), which are
telescopes that use both lenses and mirrors to produce images, don’t much
resemble the telescopes most of us are used to seeing in the movies or on
television. The eyepiece is where it ought to be at the end of the tube, and
the tube is perched on a tripod, but that is where the resemblance ends. The
tube is short and fat, looking more like a beer keg than a telescope. It isn’t
just attached to a tripod, either; it is sitting on a complicated-looking mount
festooned with lights and switches.
The SCT looks different enough in beginners’ eyes to be positively
frightening, maybe scary enough to make a new astronomer who just wants
a good look at the craters of the Moon turn tail and run. Appearances can
1 Why a CAT? 3
deceive, however. The SCT is at heart a simple telescope. Despite its looks,
its basic operation is easy to understand, and it is actually one of the most
user-friendly ‘scopes ever made.
It isn’t just user friendly. A beginning amateur astronomer may start out
just wanting a look at the Moon but will soon find the faithful SCT can take
even a novice observer far beyond our cosmic neighborhood—maybe even
as far as the depths of the universe inhabited by the mysterious quasars.
Although nothing in the design of the SCT is astoundingly innovative, its
basic layout is sound and features good optics in sizes sufficient to take even
a tyro a long, long way from home.
Capability is just the beginning of the SCT story, though. What also sets
these CATs apart is their versatility. Other telescope types—Dobsonian
reflectors and apochromatic refractors, for example—may do some things
better than the SCT, but no telescope is as capable of doing so many things
as well as the Schmidt Cassegrain. One of the reasons is that, like the per-
sonal computer, the SCT is a system. Much as the computer industry has
done, the world’s two SCT makers, Meade and Celestron, have standardized
their products. For example, a camera adapter sold by Meade will work on
a Celestron telescope. Also, as in the computer industry, there are numerous
third-party manufacturers making accessories for the telescopes. Actually,
some of the best accessories for Meade and Celestron SCTs don’t come
from either company but from hordes of aftermarket vendors large and
small. SCTs have been in production and mostly unchanged for nearly
50 years, and that means almost any accessory—focus motors, digital set-
ting circle computers, electronic cameras, spectrographs, and much more—
will likely work on any Schmidt Cassegrain, old or new.
Does the SCT’s ability to do so many things in astronomy have a down-
side? An old aphorism that is often all too true is “jack of all trades, master
of none.” In some ways, that is the case when it comes to these CATs. As
good as an 8-in. SCT is for planetary observing, for example, it will never
be able to do quite as well as a high-priced refracting (lens-type) telescope.
As far as it may be able to voyage out into deep space, it will never show as
many objects to the eye as a Dobsonian reflecting telescope with a 20-in.
diameter mirror.
The SCT really doesn’t fall far behind other telescopes, however. The
differences in the planetary images of an SCT and a refractor are small and
subtle. New observers may not be able to detect this difference for years.
When observing deep space objects, the SCT has some features that help it
keep up with the largest Dobsonians. Following is a discussion of a few of
the many things a Schmidt Cassegrain can do well.
4 1 Why a CAT?
There are plenty of cool things out there in deep space for you and your
friendly CAT to admire: star clusters, nebulae, galaxies, and more. The SCT
is not only capable of showing these deep sky objects (DSOs), it is able to
deliver remarkably detailed visual images of them under good sky condi-
tions. It can do that because of its generous aperture (the diameter of its
main mirror). To see an inherently faint object like a galaxy well, what is
needed is plenty of light. Not all telescope designs are created equal in this
regard. A large refracting telescope, for example, will have an objective lens
6 in. in diameter. An average SCT has a main mirror 8 in. in diameter, which
will collect nearly twice as much light as the 6-in. lens. (Objective area, not
diameter, is what counts.) Also, a fine 6-in. refractor is a heavy and expen-
sive instrument. An 8-in. SCT, in contrast, is light, easily transported, and
inexpensive enough to be within the financial reach of just about anybody.
It is not just optics that has allowed the SCT to pull ahead in the contest
for the hearts and minds of amateur astronomers interested in deep sky
observing. Almost all SCTs currently available have easy-to-use GOTO
computers. What’s “GOTO”? Select the object of interest on a little TV
remote control-like “hand controller,” push a button, and a pair of motors
automatically points the ‘scope at the target and tracks it as it moves across
the sky. This is a boon for people more interested in looking at objects
rather than looking for objects. Big Dobsonian telescopes, which are often
recommended for deep sky observing, usually don’t have GOTO, and find-
ing objects to observe often involves squinting at star charts and peering
through dim finder ‘scopes. Some Dobsonians can be adapted for goto and
can use other computerized pointing aids, but in general they are still not as
accurate or easy to use as a GOTO SCT.
Another Schmidt Cassegrain advantage for visual observers is the com-
fort inherent in CATs. An SCT allows its user to observe anything in the sky
while comfortably seated. A big Dobsonian telescope can deliver a lot of that
prized light, sure, but to see anything, the observer will often be swaying at
the top of the tall ladder required to reach the eyepiece observing position of
a large ‘scope. A DSO may be brighter in the Dobsonian, but if it can be
viewed in comfort while seated, almost as much—or sometimes more—may
be seen in an SCT with a considerably smaller aperture. Most Dobsonians
lack the SCT’s motor drives and can’t track stars and other objects automati-
cally. Dobsonian users must continually nudge the ‘scope along to follow
objects, which can be distracting. Push a button to find an object. Sit com-
fortably to view. Stare at an object for as long as desired as it sits centered
in the eyepiece. What could be better for visual deep sky observing?
1.3 Imaging 5
There is a lot to view in the great “out there” of deep space, but there are
also myriad wonders closer to home in the Solar System: comets, asteroids,
and, most of all, the planets. When it comes to visual observing of the plan-
ets, as mentioned, the SCT cannot claim to be “the best.” The SCT can
deliver excellent planetary images, though. When the atmosphere is steady,
an 8-in. SCT can deliver magnifications of 400× and higher, allowing the
observer to not just view the rings of Saturn but to detect subtle detail in the
rings—detail that may escape a smaller-aperture refractor. Light is impor-
tant in planetary observation. Sharp is good, but if the image is so dim the
eye has difficulty picking out details, a refractor’s sharpness doesn’t do
much good.
The other plusses the SCT brings to the deep sky help it master the Solar
System as well. These telescopes’ excellent, accurate drive systems are even
more of an advantage in the kingdom of the Sun than they are in deep space.
Imagine trying to nudge a telescope along to keep Jupiter in view at a mag-
nification of 500×. Sitting relaxed on an observing chair while looking
through the eyepiece helps even more when viewing the planets than it does
viewing deep space objects. The planets—especially Jupiter and Mars—
offer a wealth of detail, but it is subtle. When trying to see these details,
being comfortable and relaxed helps a lot.
1.3 Imaging
In the first edition of this book this section was titled “Photography” and
concerned film cameras. Things have changed tremendously over the years.
These days it is hard to find good film to use to photograph terrestrial
objects, much less celestial ones. CATs are still taking pictures of the uni-
verse, but they are now doing it with sophisticated electronic cameras. The
digital picture-taking revolution has hit amateur astronomy with a ven-
geance, and SCTs are at the forefront.
There is no doubt digital astrophotography techniques have made the
difficult art of astrophotography a little easier; at least you don’t have to
wait until film is developed to find out whether any of the shots turned out.
Taking long-exposure pictures of the deep sky is still a difficult and some-
times maddening pursuit, however. Is an SCT a good telescope to use for
digital astrophotography? Of course.
6 1 Why a CAT?
Fig. 1.2 (The Silver Dollar Galaxy) NGC 253, a beautiful near-edge-on spiral galaxy,
is a prime target for CAT users. Credit: Author
Although almost any telescope can be adapted for imaging, the SCT is
one of the few instruments that won’t require extensive modifications
before picture taking can begin. Newtonian reflecting telescopes, for exam-
ple, may require their primary mirrors be moved up the tube before a cam-
era can even be focused. The SCT may need the addition of a few accessories
before it is ready to take pictures of the sky, but it does not require any major
alterations. Tom Johnson, Celestron’s founder, designed his Schmidt
Cassegrains for astrophotography from the beginning, and Meade and
Celestron have continued to pay due attention to astronomical picture tak-
ing. Attach a modern digital single lens reflex to an SCT and even a novice
can start capturing pleasing shots of the universe’s distant wonders almost
immediately (Fig. 1.2).
The capabilities of the SCT don’t stop with visual observing or astro-
imaging. The Schmidt Cassegrain’s versatility allows it to conduct advanced
pursuits as well as basic ones. There is nothing wrong with just having fun
looking at the Moon or showing off the wonders of the deep sky to friends
and family. The new SCT owner does not have to take even one picture to
be a real amateur astronomer, and nothing says any amateur has to contrib-
ute to science. One of the great things about amateur astronomy is that there
are no rules to dictate how someone should enjoy the night sky. Some ama-
teur astronomers do eventually find they are interested in contributing to
our store of astronomical knowledge, however, and undertake some pretty
1.5 SCT Liabilities 7
By the middle of the twentieth century, the two pieces of the Schmidt
Cassegrain puzzle, the classical Cassegrain telescope and the Schmidt cam-
era, were lying around waiting for someone to assemble. It was also at about
this time that amateur astronomers began to be in need of a telescope of a
new type.
Two things were changing the amateur’s world as the 1960s arrived: light
pollution and an interest in picture taking. The unchecked growth of the
suburbs and the brightening of most astronomers’ home skies meant more
and more observers had to travel to get good views of the night sky. Also,
quite a few of the more serious amateurs were trying to take pictures of
what they saw. The average amateur’s traditional instrument, the long-tubed
Newtonian reflector, did not fit in well with either of these new realities.
Long Newtonians weren’t easy to haul to dark sites and often had to be
rebuilt if not redesigned before they could be used for astrophotography.
It was becoming more and more obvious something like a Cassegrain
with its short tube and convenient eyepiece (or camera) position would be
an ideal telescope for amateur astronomers. Many amateurs did build or buy
classical Cassegrains at this time. Unfortunately, home-built Cassegrains
were often a bust. The convex secondary mirror was considerably harder to
make than it seemed. Store-bought Cassegrains? Even if made perfectly, the
optical problems inherent in the design discouraged even the most forgiving
amateurs.
A few brilliant amateur telescope makers thought they had a better idea.
They had been experimenting with a design that combined the Schmidt
camera and the classical Cassegrain. This “Schmidt Cassegrain” took the
Schmidt camera’s spherical primary mirror and corrector plate and added
the Cassegrain’s convex secondary and behind-the-primary eyepiece
arrangement (Fig. 2.1). In most designs, the secondary, like the primary,
20 2 What’s a CAT?
was spherical in shape. These mirrors’ curves were figured so the secondary
could be placed in a holder suspended near the corrector end of the tube or
even attached to the corrector itself. This SCT design would be easy enough
to make—two spherical mirrors are relatively simple for even a novice
“glass pusher” to produce—if only a way could be found to produce that
difficult corrector easily.
Some advanced and enterprising amateurs tried their hand at SCTs nev-
ertheless. A few of the most talented workers were able to grind and polish
correctors by hand. Most, however, tried Schmidt’s vacuum trick. Some
were successful, but most found the Schmidt procedure hard to execute
without a well-equipped optical shop at their disposal. There things
remained for a while. An SCT would occasionally show up at Stellafane, the
big U. S. amateur telescope-making yearly convention, but these CATs were
curiosities. The SCT’s impact on the average amateur was nil. Correctors
would never be practical for most people to produce at home, and commer-
cially made telescopes that required these labor-intensive lenses would, it
seemed, be far too expensive for the average amateur to afford.
That’s what everybody thought.
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6 Of one of Hennen's cases it is reported that “the life of the patient and the perfect
healing of the wound were terminated on the same day.”
7 Morrison seventy years ago wrote: “Wounds from which there is a copious
discharge of bland pus are seldom or never followed by this disease;” and as a rule
this is true.
The nerves in and about the injured area have often been found
reddened and swollen, their neuroglia thickened and indurated, and
blood extravasated at various points. At times, even when to the
naked eye healthy, microscopic examination has shown one or a few
of the constituent bundles inflamed. But repeatedly the most
thorough search has failed to find any departure from the normal
state, and the same appearances of congestion and inflammation
are not seldom observed when there has been no tetanic
complication. In an interesting case reported by Michaud the sciatic
in the uninjured limb presented the same neuritic lesions as that of
the wounded side.
In the cord and the medulla vascular congestion has been the
condition most generally seen, associated not infrequently with
hemorrhages and serous effusions—a condition occasionally absent,
and when present due, it is probable, in great measure, perhaps
wholly, to the muscular spasms, or consequent in part upon post-
mortem gravitation of the fluids. Increase in the amount of the
connective tissue of the white columns of the cord (thought by
Rokitansky to be the essential lesion of the disease); disseminated
patches of granular and fluid disintegration (to which Lockhart Clarke
called attention in 1864); atrophy of the cells, especially those of the
posterior gray commissure; nuclear proliferation; changes in the
color, form, and chemical reaction of the ganglion-cells; dilatation
and aneurismal swellings of the vessels, with development of
granulation-masses in their walls; and changes in the sympathetic
ganglia,—such have been the reported lesions. But each and every
one has at times been absent—at times been discovered in the
bodies of those dead of other diseases. Some of the changes have
without doubt been produced after death; some perhaps have been
but errors of observation.
Not infrequently for a day or two before any distinct evidences of the
disease are manifested there is prodromal malaise, associated at
times, but by no means constantly, with unusual sensitiveness, or
even positive pain, in the wound and slight muscular twitching in its
vicinity. In the larger number of cases the first symptoms noticed are
stiffness about the jaw, more or less difficulty in opening the mouth,
and perhaps slight interference with deglutition, the patient feeling as
if he had taken cold; such symptoms often appearing early in the
morning after waking from the night's sleep. With more or less
rapidity well-marked trismus comes on, the jaws being locked, the
corners of the mouth retracted, and the lips either firmly closed or
separated so as to uncover the teeth, producing the peculiar grin
long known as the risus sardonicus.
In rare cases it is the depressors, and not the elevators, of the lower
jaw that are in a state of contraction, the mouth consequently being
kept wide open. The forehead is wrinkled, the eyes staring, the nose
pinched, and not seldom there is the facial expression of old age.
The voice is altered and swallowing is difficult. Occasionally the
spasms of the muscles of deglutition are so intense as to be the
principal tetanic symptom, such dysphagic or hydrophobic (Rose)
tetanus very generally proving fatal. In a few cases, after wounds of
the face and head, these violent spasms have been found
associated with facial paralysis, almost always, if not always, on the
injured side; such paralysis having been present in at least one case
(Bond's) in which throat-spasm was wanting, the wound being in the
temporo-parietal region. Often there is early felt in greater or less
intensity pain, as from pressure, in the epigastrium, piercing through
to the back—a symptom by some regarded as pathognomonic, and
due without doubt to contraction of the diaphragm.
From the region of the jaw the disease passes on to successively
attack the muscles of the neck, the back, the abdomen, the chest,
the lower, and, last of all, the upper, extremities, those of the forearm
long after those of the arms. The muscles of the fingers, of the
tongue, and those of the eyeball are very late if at all affected, the
tongue probably never being tonically contracted. The anterior
abdominal wall is broadened, depressed, and hard. In the fully-
developed acute cases the whole body is rigid, remaining perfectly
straight (orthotonos), arched backward (opisthotonos), forward
(emprosthotonos), or laterally (pleurosthotonos), according as the
muscular tension is balanced or greater on one side than another.
The action of the extensors being usually the more powerful,
backward bending (opisthotonos) to a greater or less extent is the
ordinary condition; but only in rare and extreme cases is the
contraction such as to curve the body like a bow and keep it
supported upon the occiput and heels. Frequently the bending is not
specially noticeable except in the neck. Emprosthotonos is rare, and
pleurosthotonos has been so seldom observed that its very
existence has been denied. Occasionally, in well-marked cases of
opisthotonos, there is some associated lateral arching, due rather to
voluntary efforts on the part of the patient (for the purpose of
obtaining relief) than to tetanic contraction. Larrey's opinion that the
location of the wound (behind, in front, or on the side) determined
the direction of the curving has been proved to be incorrect. Except
in a small proportion of cases to the persistent tonic spasm8 there is
added convulsive seizures of the affected muscles, developed upon
any, even the slightest, peripheral excitation of the reflex irritability,
as by a movement, a touch, a draft of air, a bright light, a sudden
noise, an attempt at swallowing, etc. The frequency of these clonic
exacerbations and their intensity vary much, being severer and
coming on closer together in the grave acute cases and in the later
stages of those terminating fatally. They may occur only once in
several hours or four, five, or more times in a single hour, each
spasm lasting from but a few seconds to a minute or two. During its
continuance the suffering is intense, both from the pain of the
contraction and the experienced sense of suffocation. Between the
paroxysms there is usually but little pain, the sensation being rather
one of tension or pressure. Occasionally cessation of spasms and
complete relaxation of all muscular contraction suddenly take place
six, eight, or twelve hours before death, the patient quickly passing
into a state of collapse.
8 This is not, in reality, a state of uninterrupted spasm, but one of very numerous,
quickly-repeated muscular contractions, as many even as six hundred and sixty per
minute (Richelot).
Throughout the whole course of the disease the mind remains clear,9
except in the later stages of a few cases; and then the existing
delirium or coma is often, it is probable, an effect of the treatment
that has been employed. Except in the more chronic cases the
patient is generally unable to sleep, and even when fortunate
enough to do so the tonic spasm may not relax. In other than the
mildest attacks there is usually noticed a marked increase, local or
general, of the perspiration; such sweating being a much more
prominent symptom of the disease as met with in tropical than in
temperate regions.
9 “The brain alone in this general invasion has appeared to us to constantly preserve
the integrity of its functions down to the very last moment of existence, so that the
unfortunate subject of this disease is, as it were, an eye-witness of his own death”
(Larrey).
The pulse, which is normal in the earlier stages, may later be but
little increased in frequency (except during the exacerbations, when,
small and compressible, its beats may run up to 140, 160, or even
180 per minute), or it may become progressively feebler and more
rapid as the case advances toward the fatal termination. The
irregularity often noticed during the convulsive seizures is doubtless
owing to the muscular contractions so compressing the vessels as to
hinder the passage of the blood through them. That the heart itself is
not tetanically contracted would seem to be proved by its regular
quiet action during anæsthesia.
The bowels are usually constipated, because of the little food taken,
the profuse sweating, the tonic spasms of the abdominal muscles,
and the contraction of the external sphincter and the levator ani, the
muscular coat of the bowel, like all the other involuntary muscles,
remaining unaffected.
How far the age of the patient affects the prognosis cannot be very
definitely stated. The prevalent opinion (entertained as long ago as
the time of Aretæus), that the disease is less dangerous in the
middle part of life than as either extreme is approached, is probably
an erroneous one. Yandell, from the analysis of the cases he had
collected, found that the mortality was greatest in children under ten,
and least in individuals between ten and twenty years old. Kane's
statistics would place the time of greatest danger in the early adult
period, from the age of twenty to that of thirty-five or forty.
Conium, the action of which is much akin to that of curare, and which
primarily is upon the terminal portions of the motor nerves, has been
occasionally employed—successfully in two cases by Christopher
Johnson of Baltimore, who gave it hypodermically in doses of from 1/6
to 2 minims every one, two, or three hours. In two other cases under
the care of the same surgeon death took place, but the remedy
seemed to have acted beneficially in relieving the spasms and
relaxing the tonic rigidity.
Of all the sedatives and narcotics, opium has been longest and most
often used, and in so far as it relieves pain and causes sleep it is of
service. Like the other agents, it must be administered in large
doses, reference being had to the effect produced and not to the
number of grains given. The difficulty of swallowing even the liquid
preparations has of late years made the hypodermic injections of
morphia the favorite mode of administering the drug. Demarquay has
advised that the solution (1 part to 50 of water) should be thrown
deeply into the substance of the affected muscles, as near as
possible to the place of entrance of their supplying nerves; the result
being to especially relieve the trismus and allow of the taking of food.
Fayrer in India found opium-smoking of advantage. The mortality-
rate of the 185 cases tabulated by Yandell treated with opium was 43
per cent., but, as is true of the other drugs that have been referred
to, it is chiefly if not wholly in the mild and chronic cases that the
beneficial effects have been observed.
So far as has yet been determined, chloral is our most valuable drug
in the treatment of tetanus, as it is in that of the allied condition of
strychnia-poisoning—not because of any direct antidotal action, but
by reason of its producing sleep, lessening the reflex irritability of the
spinal cord, and diminishing the violence and frequency of the
muscular spasms, thus enabling the patient to keep alive until the
morbid state can spontaneously disappear. Given usually by the
mouth or the rectum, it has been administered hypodermically (as
much as 5 grs. at a time by Salter) or, as proposed by Oré, thrown
directly into a vein. If it is true, as has been claimed, that its
beneficial effect is due entirely to the sleep secured (not infrequently
after waking up the spasms return with increased violence), the drug
should be administered in doses sufficiently large and repeated to
maintain a continuous slumber. Verneuil (whose therapeutic formula
has three terms, rest, warmth, sleep) has found that while with
certain patients a drachm a day is enough, to others four times as
much must be given, and directs that the chloralic coma be
continued for about twenty days. Further experience may show that
small doses may suffice to secure the needed quiet—as, e.g., the 40
grs. at bedtime, with, if necessary, 30 grs. more at midday,
recommended by Macnamara. Such small doses are far safer than
the enormous ones that have at times been employed,17 since
chloral can exert a powerful toxic influence upon the circulatory and
respiratory centres, death being almost always due to arrest of
respiration, though in tetanic cases it may be the effect of slight
spasm upon a heart the enfeebled state of which is indicated by a
very rapid and thready pulse. The intravenous injections expose the
patient further to the risk of the formation of clots and plugging of the
pulmonary artery, several instances of which accident have already
been reported, though this method of treatment has but seldom been
employed. The death-rate of those treated by chloral alone was 41
per cent. in the 134 cases analyzed by Knecht, and 41.3 per cent. of
the 228 tabulated by Kane.
17 Beck is reported to have given 420 grs. in three and a half hours, and Carruthers
1140 grs. in six days; both patients recovered—Beck's after a continuous sleep of
thirty hours. In one case the chloral sleep was maintained without interruption for
eight days, from 250 to 300 grains a day being given; and in another, which also
recovered, over 3000 grs. were taken in the course of thirty-eight days.
Of late years use has been made, either alone or in combination with
opium or chloral, of the bromides, especially that of potassium, which
in full dose unquestionably diminishes reflex irritability, lessens the
sensibility of the peripheral nerves, and moderates excessive body-
heat. Under its influence mild cases of tetanus have recovered and
more severe ones been somewhat relieved, and it has the decided
advantage over the other drugs that have been noticed of not being
a direct cause of death even when given in large dose—as much in
some instances as six, seven, or nearly eight drachms a day. Knecht
found that of 10 cases treated with chloral and the bromide, 9 got
well; and Kane, of 21 to whom such a combination was given, only 5
died (23.8 per cent.); but the number of cases is too small to make
conclusions deduced therefrom of any special value. Voisin reports a
case (in which it should be noted the spasms began in parts near the
wound, and that on the fourteenth day after the receipt of the
gunshot injury of the right thigh) that had for eleven days been
treated without effect with chloral in large quantity, which at the end
of that time was put upon drachm ij doses of the bromide, with three
hypodermics a day of about ½ gr. of morphia each: in three days
decided improvement had taken place, and in four days more the
patient was well.
The sedative and sustaining action of alcohol has many times been
taken advantage of in the treatment of this affection. The
administration of wines or spirits in large amounts has certainly been
found of much service, though it will seldom or never be necessary
to give wine, as Rush advised, “in quarts, and even gallons, daily.”
80 per cent. of recoveries appear to have taken place in the 33
cases that Yandell found to have been treated with stimulants; but,
on the other hand, of Poland's 15 cases treated with wine, 75 per
cent. died: here, again, the numbers are too few to make any
deduced conclusions of much value.
As there is here, apparently, recovery in 34.5 per cent. of the gunshot cases treated
by amputation (nearly one-fifth of all the non-fatal cases reported)—a very gratifying
degree of success, and one that might properly encourage the resorting to this
method of treatment—somewhat careful analysis may well be made of the 7 cases
the histories of which are given. In 2, shell wounds of the foot, operated upon by the
same surgeon, the disease appeared while the men were still upon the field. Of one
of them it is stated that “there was but little hemorrhage, but the shock was excessive
and tetanic symptoms were present;” and of the other, that “the peculiarities in the
case were that symptoms of tetanus were quite marked, with great exhaustion.” There
are certainly good reasons for believing that these two cases were not of tetanus, but
of simple convulsive movements from shock and anæmia. Of the remaining 5 cases,
the symptoms manifested themselves on the fourteenth, nineteenth, twenty-first,
thirty-fifth, and fifty-fourth day after the receipt of the wound. One of the patients (in
whom the disease was longest delayed), having a much inflamed and suppurating
compound fracture of the bones of the forearm, “was suddenly seized with a chill
followed by threatening tetanus,” and amputation was made the following day. In
another (thirty-fifth day case) the “arm became much swollen and symptoms of
tetanus ensued, including stiffening of the jaws, great pain and restlessness, and
irritable pulse;” two days later the limb was removed, and “all symptoms of tetanus
disappeared after the operation.” In another (twenty-first day) the man when admitted
into hospital, one month after the date of the injury, stated that “he was first taken with
trismus about a week before.” “As he was certainly getting worse every day,” the
forearm was removed forty days after the receipt of the wound and nearly three
weeks after the commencement of the tetanic symptoms. Other remedies employed
after the operation (brandy, chloroform, and blisters to the spine) doing no good,
drachm ss doses of the tr. cannabis indica were given every two hours, “under which
the patient slowly improved.” In another case (nineteen days) the symptoms were
those of tetanus; the amputation was made on the following day; twenty-four hours
later “rigidity of the muscles had partly disappeared, and improvement continued until
the patient was entirely relieved.” In the remaining case (fourteen days) the first
symptoms of tetanus “were relieved by active purgatives, calomel, etc. Three days
later the symptoms returned,” and on the next day “tetanus supervened in its usual
form.” Five days afterward “the leg was amputated at the middle third, after which the
tetanus subsided and the patient made a rapid and good recovery.”