PROXIMATE CAUSE OF TETANUS. 1025 



For it has been observed, that during the advanced 

 stages of tetanus, the most active purgatives rarely 

 move the bowels ; and that from thirty to sixty 

 grains of opium have been given every six hours, 

 without producing any visible effect. Mr. Aber- 

 nethy relates the case of a man who died of the 

 disease, in whose stomach were found thirty 

 drachms of opium, which had not undergone any 

 material change. 



From all the foregoing facts and observations 

 it is evident, that the proximate cause of tetanus, 

 as in spasmodic cholera, is a torpid condition of the 

 circulation, a dissolved state of the blood, and a 

 great loss of vitality. Nor is it less certain, that 

 if all the most powerful remedies in the Materia 

 Medica were given in succession, they would be 

 wholly unavailing, without restoring the vital 

 properties of the blood, which can be done only 

 by augmenting its circulation through the lungs, 

 where it is formed and endowed with the power 

 of carrying on all the functions. If the case be 

 not too far advanced, this object can be attained 

 by a judicious employment of the warm bath, the 

 application of dry heat to the surface, inflation of 

 the lungs with pure oxygen gas, or with the 

 nitrous oxide, and the use of internal stimulants. 

 In short, we must employ that agent by which 

 the blood is perpetually formed in a state of 

 health, enabled to excite the heart, and maintain 

 all the functions in their natural state. But the 



