482 ANAEROBIC BACTERIA 



Pathogenesis. Tetanus occurs spontaneously in man, horses, cattle 

 and sheep, rarely in dogs and goats. Birds and reptilia are highly 

 refractory to experimental inoculation. The disease tetanus both in 

 man and animals is purely toxic in character; notwithstanding 

 the wide distribution of tetanus spores, it is relatively uncommon. 

 It may follow traumatism, particularly deep, narrow wounds and con- 

 tused wounds to which tetanus spores, together with other organisms 

 gain entrance. In the tropics an infection of the umbilicus of the 

 newborn (tetanus neonatorum) is very common. 1 Postpartum infec- 

 tions, particularly of the uterus (tetanus puerperalis), were also at 

 one time very common. 2 



The lesions observed in tetanus are very slight and postmortem 

 there may be no marked changes other than a slight congestion of 

 the internal organs. Bacilli may occasionally be found at the site of 

 inoculation, but they do not as a rule penetrate deeply into the body, 

 although Hochsinger 3 and Creite 4 have found the organisms at autopsy 

 in a very few instances in the spleen and heart blood. 



Tarozzi 5 and Canfora 6 have studied the fate of tetanus spores after 

 subcutaneous inoculation into guinea-pigs and rabbits very carefully. 

 They find the spores may be transmitted rather rapidly to the paren- 

 chymatous organs, liver, spleen, and kidneys principally, where they 

 may remain alive but latent for seven to eight weeks. If trauma 

 or injury resulting in inflammation occurs during this time, acute 

 or chronic tetanus may result. These observations suggest a possible 

 explanation for the so-called cryptogenetic, ideopathic, or rheumatic 

 tetanus; the intestinal tract is supposed to be an occasional portal 

 of entry, thus explaining another source of cryptogenetic tetanus. 



Experimental Pathogenesis in Animals. The disease tetanus may 

 be produced in susceptible animals by injecting soil or active cultures 

 of tetanus bacilli, spores mixed with tetanus toxin, or tetanus toxin 

 alone. If, however, tetanus spores carefully freed from toxin are 

 injected alone, tetanus frequently fails to develop. Vaillard and 

 Vincent 7 and Vaillard and Rouget 8 have furnished an interesting 



1 Anders and Morgan, Jour. Am. Med. Assn., 1906, xlvii, 2083. 



2 Stern, Deutsch. med. Wchnschr., 1892, No. 12. Heyse, Berl. klin. Wchnschr., 1893, 

 No. 24. 



3 Centralbl. f. Bakt., 1887, ii, 145. Hohlbeck, Deutsch. med. Wchnschr., 1903, 172. 



4 Centralbl. f. Bakt., Orig., 1904, xxxvii, 312. 

 6 Ibid., 1905, xxxviii, 619. 



6 Ibid., 1908, xlv, 495. 



7 Ann. Inst. Past., 1891, 24. 



8 Ann. Inst. Past., 1892, 428; Centralbl. f. Bakt., xvi, 208. 



