Noma (Cancrum Oris) in an Adult, With Report of a Case

Abstract

Collapse and Treatment.-The operation had just begun, the incision was made, when it was observed that the patient had become intensely cyanosed. In a moment he was pulseless and soon afterward respiration ceased. The head of the table was rapidly lowered and artificial respiration at once resorted to. Realizing the otherwise hopeless situation, the abdomen was rapidly opened and with one hand on the chest wall and the other against the diaphragm I massaged the heart at the rate of from 15 to 20 movements to the minute. The actual time was not recorded in the excitement of the moment, but in approximately 2 minutes feeble but irregular fibrillary contractions were felt. Gradually the impulses became more forcible and more regular, and after an interval of 8 minutes, during which time massage was continued, resuscitation seemed assured. At this time the pulse-rate registered 130.Result.-The abdominal wound was closed, the operation on the liydroeele completed and the patient returned to the ward. The subsequent history was uneventful.