130 TETANUS. 



appearance around the openings. Most commonly 

 the wounds have nearly healed ; or are at the moment 

 of closing, without any seeming unhealthy change of 

 appearance, when this strange affection bursts forth. 



It is a nervous affection. A fibre of some nerve 

 has been injured, — irritation ensues, — it rapidly 

 spreads along the various branches of that nerve, and, 

 through the spinal marrow, affects the entire body. 



For the relief of tetanus there are some persons who 

 adopt very decisive and severe measures. They bleed 

 largely in order that they may gain the full advantage 

 of its sedative influence. When this plan is pursued 

 the blood should flow in a free full stream ; it should 

 flow on until the circulation is evidently affected. 

 That will not soon happen, for the irritation is too 

 great, and too general, readily to yield to any seda- 

 tive ; and more than ten or twelve quarts of blood will 

 sometimes be lost before the pulse indicates that any 

 effect has been produced on the circulation. 



The consequence of this copious depletion will 

 generally be a temporary remission of the symptoms; 

 and, advantage being taken of the relaxation of the 

 muscles, a strong purgative ball or drink is given. 



Having proceeded thus far, the next aim is to at- 

 tack the disease as much as possible locally. It is 

 evidently a nervous affection. The practitioner, 

 therefore, who admires the severer plan of treatment, 

 endeavours to bring the principle of counter- irritation 

 to bear as far as may be practicable. A blister is 

 applied from the poll to the rump. The common 

 liquid blister (Recipe 24, p. 78) will be as effec- 

 tual as any. Some practitioners have carried the 



