BARON LARREY’s TREATMENT OF TETANUS. 479 
relaxed, and sleep returned towards night. Next morning the 
patient felt much better; suppuration of the wound was re-esta¬ 
blished : the remainder of his medicine was taken as a second 
dose, all went on favourably, and he proceeded along his journey 
in return to his prince. Friction with oil, which some have so 
liberally extolled, he has not found to do any good; cataplasms 
made with the leaves of tobacco have been fruitless, and mercu¬ 
rial unguents produced only evident evil. “ The employment of 
this last remedy,” he observes, “ even against syphilis, requires, 
in Egypt, the greatest care ; for this mineral, administered in that 
climate as it is in Europe, has occasioned the worst consequences, 
among which we may enumerate madness and diseases of the 
liver.” When tetanus appears after the wound has healed, 
cutting freely dow 7 n upon the cicatrix is strongly recommended ; 
but if after a ligature has been applied, it is probable that some 
nerve is included, and the ligature should be removed. In all 
compound fractures and dangerous wounds of the extremities, 
complicated with tetanic symptoms, the baron’s only sheet-an¬ 
chor is the amputation knife. From the success which he has 
experienced in removing tetanus by amputating the wounded 
part, he has been encouraged to make the following proposal:— 
“ If in tetanus, induced by such a wound of the extremities as 
would not on its own account demand amputation, it be not better 
to remove the limb immediately tetanic symptoms appear, than to 
expect from the resources of nature and most uncertain remedies 
a very doubtful cure ?” We cannot enter into his defence of this 
proposal, which merits serious consideration; but he concludes 
it by saying that, “ although I regret not having a greater num¬ 
ber of recoveries to attest the value of this plan, I yet have suffi¬ 
cient to conclude that amputation, faite a propos, appears to me 
the most certain means of arresting and removing the effects of 
tetanus which depends on a wound situated upon the extre¬ 
mities.” * 
The baron’s favourite caustic is no mean remedy in tetanus, as 
well as gangrene ; and the recovery of the patient with whose 
case we shall conclude these observations upon this disease, 
which the author considers one of the most remarkable in military 
surgery , cannot certainly be ascribed to any inferior agent. A 
soldier was struck by a ball, which carried away a part of the 
spine belonging to the right scapulum, a portion of the trapezium, 
the sub and supra-spinati muscles. The shattered tendons were 
cut away, the lacerated pieces of muscles were removed, some 
splinters of bone were extracted, and the wound was carefully 
dressed. All went on well for some time, and the circumference 
of the wound began to cicatrize, when symptoms of tetanus sud- 
