TETANUS. 387 



tissues originally injured from the tissues contiguous. Such 

 removal could be readily affected in muscular parts ; but in the 

 region of a joint, or amongst tendinous structures, it would be 

 impracticable. 



Wounds and injuries causing Tetanus should always be 

 examined with care, as foreign bodies may lodge, or purxilent 

 matter may be pent within. Where a sinus exists, its depth 

 and direction should be ascertained, and, if practicable, opened 

 freely to the bottom. A contused wound, when associated with 

 Tetanus, should also be freely opened, and its contents removed ; 

 but where wounds are healthy iu appearance, the skin not 

 stretched, nor the tissues tender, I am of opinion that isolating 

 the wound, or resorting to incisions above and below the injury, 

 will not benefit the patient. The hair should he removed from 

 the back along its entire length, to the depth of three or four 

 inches on each side of the spine ; and by the aid of spongio 

 pUine, the part can be kept constantly wet with the warm 

 belladonna lotion. In three cases of Tetanus, I had the hair 

 shaved from the back to the extent directed, and the exposed 

 skin freely rubbed with the extract of belladonna, aud after- 

 wards the warm lotion regularly applied. Two cases out of the 

 three recovered. 



DiET.-^The diet of the patient should be one easy of 

 digestion. Mashes of boiled rice and bran, boiled barley and 

 bran, bread and milk, boiled turnips, bran, and boiled oats, are 

 all articles of a proper kind. 



For further particulars respecting the diet, see Section VI., 

 pages 108 to 118. 



In conclusion, I may add that Traumatic Tetanus is a dis- 

 ease which, in many instances, the practitioner must expect to 

 fail in his efforts to cure ; and the reason why appears simple. 

 • The direct cause of the tetanic state is evidently of a continuous 



