Because previous studies assumed that tetanus is an acetylcholine intoxication, atropine as a potent anticholinergic agent has been employed as a continuous infusion in the treatment of 4 severe tetanus cases as a supplement to routine therapy. With this treatment all patients maintained complete cardiovascular stability; clinical symptoms like bronchospasm, bronchial hypersecretion, hypersalivation, hyperperspiration were not encountered at any period of the treatment. All patients were markedly sedated and despite the use of mechanical ventilation, curarisation was not necessary at all. These results suggest that the multiple effects (CNS, cardiovascular respiratory and muscular tone) of atropine might be very useful in the management of severe tetanus.