ON THE ACTION OF THE METHYL AND ALLIED SERIES. 157 



this extreme maladj, following upon the infliction of a wound. The spasms 

 were so severe that the man is described as having " been rolled up hke a 

 rigid ball." Five drops of the nitrite were put on a pocket handkerchief 

 and inhaled, with the immediate effect of lessening the spasms. On each 

 return of the spasms the agent was assiduously administered, and by this 

 means the spasms were held in check until the ninth day, when the patient 

 had inhaled an ounce of the fluid. In this example there was complete 

 recovery ; and Mr. Foster reports that of seven similar cases of tetanus which 

 he had previously treated in thirty-four years' practice all had died. Ho 

 had met with no success until he had recourse to the nitrite of amyl. 



You will excuse me of any charge of pride when I express the gratification 

 I feel at these singular results, and you will allow me, 1 hope, to explain 

 how obliged I am to this Association for the sup])ort it afibrded me when I 

 was first engaged on this subject of research. The satisfaction rests, first, 

 on the practical facts I have named ; but a second satisfaction is that the facts 

 have shown the worth of scientific experimental inquii'y, as preliminary to 

 practical application, for the certain and systematic relief and cure of human 

 sufi^eiing. 



Nitrite of amyl was not introduced into use as a remedy against spasmodic 

 diseases, including tetanus, by any mere accident. It was introduced on 

 method of pure scientific investigation ; its properties as a remedy were 

 discerned and estimated, stated before it was applied for the cure of disease, 

 and the results obtained were the simple expositions of the predictions made 

 concerning its value. 



In the course of the year I have studied the best means of keeping and 

 administering this active nitrite. At the Meeting at Norwich I proposed 

 that it should be kept in absolute alcohol, but I find that when it is exposed 

 long in this way it undergoes change, by which its efiiciency is to some 

 extent impaired. I find also that diluted with alcohol the vapour of the 

 nitrite does not pass off with sufficient rapidity to secure good action. At 

 the same it is not well to use it undiluted, as that implies the measurement 

 of it by drops or minims, a plan which is neither safe nor convenient. 

 To meet these difficulties I have made for inhalation an etherial solution, or 

 tincture, in which five grains of the nitrite of amyl are contained in one 

 drachm of absolute ether. 



I have seen no occasion to modify the view expressed at the Meeting at 

 Bath, and again at the Meeting at Exeter last year, that the nitrite of amyl 

 produces its effect by its paralyzing-action upon the nerves which govern 

 the contraction of the blood-vessels ; and I take it that this explanation of 

 its action explains, by the reverse, the mode of action of those agents which 

 it neutralizes, such as strychnia, and of the influence which excites the disease 

 known as tetanus. It seems to me that these agencies either excite extreme 

 action of the nerves which keep up the contraction, or paralyze the counter 

 nervous supply which causes dilatation of vessels, and that the conviiLsive 

 movements induced by siich agents as strychnine are due to removal of 

 blood by contraction of vessels in a manner analogous to that convulsion 

 which follows free abstraction of blood. 



Bichloride of Methylene. — Bichloride of methylene during the past year 

 has grown much in favour, and in some of our large medical institutions has 

 replaced chloroform altogether. I regret, nevertheless, to have to report 

 that two deaths have been recorded as following upon its use. Both cases 

 wei-e pecidiar. In one the subject was, in truth, so near to death at the 

 time of administration that he was apprised by the surgeons and the able 



