408 PRACTICE OF PHYSIC. 



therefore very properly observed, that, in tetanic affections, as 

 the opium shows none of those effects by which it may endan- 

 ger life, there is little or no reason for being sparing in the exhi- 

 bition of it ; and it may be given, probably should be given, as 

 largely and as fast as the symptoms of the disease may seem to 

 demand. 



It is particularly to be observed, that, though the first ex- 

 hibitions of the opium may have produced some remission of 

 the symptoms, yet the effects of opium do not long continue in 

 the system ; and this disease being for some time ready to re- 

 cur, it is commonly very necessary, by the time that the ef- 

 fects of the opium given may be supposed to be wearing off, 

 and especially upon the least appearance of a return of the 

 spasms, to repeat the exhibition of the opium in the same quan- 

 tities as before. This practice is to be continued while the 

 disease continues to show any disposition to return ; and it is 

 only after the disease has already subsisted for some time, and 

 when considerable and 'long-continued remissions have taken 

 place, that the doses of the opium may be diminished, and the 

 intervals of exhibiting them be more considerable. 



" As spasmodic affections are so often begun by an increased 

 excitement of the energy of the brain, so opium being the 

 most powerful means of diminishing its excitement, it must 

 very often be the most certain and ready means of both obviat- 

 ing and curing spasmodic affections ; but, at the same time, we 

 must remark, that it often fails to answer either purpose. If 

 the increased excitement arises from an irritation applied to a 

 particular part of the body, to the removal of which opium can- 

 not contribute, the disease may continue to recur, although the 

 largest doses of opium have been employed. Thus it hap- 

 pens in tetanus, from wounds whose communications with the 

 brain cannot be intercepted, that opium often fails to prove a 

 cure. M. M. 



MCCLXXII. The administering of opium in this man- 

 ner has, in many cases, been successful ; and probably would 

 have been equally so in many others, if the opium had not been 

 too sparingly employed, either from the timidity of practitioners, 

 or from its exhibition being prevented by that interruption of 

 deglutition which so often attends this disease. This latter cir- 



