480 BARON LARREY’S TREATMENT OF TETANUS. 
denly appeared, and in a few hours after their appearance com¬ 
plete opisthotonos was established. Diaphoretic fluids and large 
doses of opiates were administered ; oily, camphorated, and nar¬ 
cotic lotions were applied over the body. The purulent secretion 
being suspended, the cicatrix made rapid progress, and in forty- 
eight hours it covered the half of the wound. At this period 
the patient felt in the cicatrized part a painful sensation, as though 
the edges of the wound had been enclosed between a pair of 
pincers; and the slightest pressure upon the delicate cicatrix, 
more especially of metals, as iron or steel, obliged him to emit 
piercing cries. Every tetanic symptom gradually increased ; the 
superior extremities became rigid and were turned backwards, the 
cervical vertebrae were completely pulled down, and the power of 
deglutition was lost. In vain were two incisive teeth extracted, in 
order that medicines might be introduced into his stomach : not 
a drop got into the oesophagus, and the mere sight of pure water 
induced the most frightful convulsions. He foamed freely at the 
mouth, every symptom heightened, and this wretched man, 
whose bodily agony was tenfold enhanced by a complete conscious¬ 
ness of his situation, had nothing, to all appearance, before him, 
but the prospect of a sad and sudden death. 
When the disease had arrived at this crisis, Larrey resolved on 
trying the actual cautery. 
“ With this view,” says he, u I made red, even to incande¬ 
scence, four large cauterizing irons; and I applied them in succes¬ 
sion over the whole extent of the wound, so as to bear more 
strongly over those points of the cicatrix where I suspected the 
principal branches of the accessary nerve of Willis (spinal nerve) 
to be compressed and swollen. This application was extremely 
painful; nevertheless I had firmness enough to continue the opera¬ 
tion until all the surface of the wound was deeply and completely 
seared. Scarcely was this effected when a general stop was put. 
to the progress of the disease. The patient voluntarily sat up and 
asked for drink, and the jaws separated spontaneously. Sixty 
drops of laudanum, and a few drops of Hoffman’s mineral liquor 
were given him in a glassfull of almond emulsion, in which a little 
nitre had been dissolved ; the narcotic and camphorated liniments 
were repeated, and the body was enveloped in warm flannel. The 
skin perspired profusely, a perfect calm came on, which was suc¬ 
ceeded by a deep sleep; and the next morning I found my patient 
free from every tetanic symptom.” 
The future dressings of the wound were simple ; the eschar sepa¬ 
rated in nine or ten days, cicatrization recommenced speedily and 
without pain, and, beyond a little stiffness in the right arm and 
shoulder, Demore was completely restored to health. 
Med, Chir . Rev, July 1831. 
