Tetanus. 303 



with the length of the incubation, and severity of the attack. 

 Cases that set in with great violence after an incubation of two 

 or three days or less are likely to advance to an early death. An 

 early generalization of the spasms, with high temperature 

 (104 F), hurried breathing, congestion of the mucosae, and ex- 

 treme excitability may end fatally in twenty-four hours or within 

 a week. 



If on the other hand the incubation appears to have extended 

 over one, two or three weeks ; if the disease is at first equivocal, 

 with some stiffness and firmness of the muscles, but with little or 

 no trismus ; if the patient can open the jaws an inch or more and 

 masticate even slowly for a number of days after the onset of the 

 first symptoms ; if the haw projects only slightly over the eye- 

 ball and the excitability is not extreme the prospect for recovery 

 is much better. Such tardy cases may seem to staixl still for a 

 week and then have a slight aggravation and this may be re- 

 peated, or a slow improvement may set in and go on gradually to 

 complete convalescence. Improvement may be manifested by a 

 softer or more relaxed condition of the muscles, by a slightly 

 freer movement of the limbs and jaws, by a greater ease in 

 swallowing, by encreasing movements of the ears and eyes, by 

 the lessened projection of the haw, by the freer breathing and 

 circulation and by the permanent lowering of temperature to the 

 normal standard. Convalescence is always slow, but especially 

 slow in severe cases in which time must be allowed for repair not 

 only of the central nervous lesions but also of the ruptures and 

 trophic changes in the muscles. 



In cattle the disease is usually slow in its progress and im- 

 provement may not set in till the close of the third week. In 

 sheep, goats and dogs on the other hand it is habitually acute, 

 and death may supervene from the third to the eighth day In 

 the horse all forms are met with and the result will vary ac- 

 cording to the severity of the attack. 



Mortality. Friedberger and Frohner sets the mortality in 

 sheep and pigs at nearly 100 per cent. : in horses at 75 to 85 per 

 cent. : and in cows at 70 to 80 per cent. In tetanus neonatorum 

 in lambs, the deaths reach about 100 per cent. In this case the 

 disease usually sets in within forty-eight hours after birth, and 

 with a very high temperature difficult deglutition becomes a 



