This disease is one of the most intractable with which the surgeon has to contend. In the acute form, time is scarcely allowed for remedies; and in the advanced stage, it is with much difficulty that medicine can be received internally. Of course all irritations must be removed, both local and general, as far as that can be accomplished. If the patient be robust, and if the tetanic symptoms be ushered in with arterial incitement, general depletion ought certainly to be practised; and if the symptoms be such as to render the propriety of general bleeding dubious, blood may be abstracted locally, from the back of the head, or along the spine; and this may be followed by such counter-irritants as act rapidly. At the same time, powerful purgatives must be given, so as to bring the bowels into a better state; for, as already observed, obstinate constipation is a constant attendant on this disease. But the most important indication is to alleviate and prevent, if possible, the spasms; and for this purpose, opium is to be administered in large doses, either by itself, or combined with camphor or other antispasmodics. By such means, the disease has in some cases been arrested, but in the majority it has proceeded unabated. Some practitioners recommend and employ cold affusion and immersion, whilst others prefer the warm bath; and the latter appears to be the safer application, though neither can be considered as efficacious. Great relief and benefit seem to have accrued from the frequently repeated use of a warm bath, with some drachms of the tart. antimonii dissolved in it. I have had only two opportunities of trying this practice; one a chronic ease, where, after the division of the nerves proceeding from the wound, this remedy, with others, seemed to allay the spasms in a very remarkable manner: the patient recovered. In the other, a very acute case, after the extraction of a splinter from betwixt the thumb and forefinger, the bath was tried; the patient felt much comforted by it; but suddenly expired in a violent convulsion, whilst being replaced in bed. Great relaxation follows this remedy, profuse perspiration, and subsidence of the rigidity and convulsive action of the muscles. The practice was recommended to my notice by my excellent friend Dr. Stevens, Professor of Surgery at New York. In some cases, it would be worth trial to produce instant vesication by the acetic solution of cantharides or ammonia, and then try the effect of the application to the blistered surface of some of the alkaloids, such as morphia, aconitine, &c., or belladonna might be applied.