CHAPTER XVI. 

 TETANUS. 1 



SYNONYMS. LOCKJAW. GERMAN, WUNDSTARRKRAMPF. 



FRENCH, TETANOS. 



Introductory. Tetanus is a disease which in natural con- 

 ditions affects chiefly man and the horse. Clinically it is 

 characterised by the gradual onset of general spasms of the 

 voluntary muscles, commencing in those of the jaw and the 

 back of the neck, and extending to all the muscles of the 

 body. These spasms are of a tonic nature, and, as the 

 disease advances, succeed each other with only a slight 

 intermission of time. There are often, towards the end of 

 a case, fever and rise of respiration and pulse-rate. The 

 disease is usually associated with a wound received four to 

 fourteen days previously, and which has been denied by 

 earth or dung. Such a wound may be very small. The 

 disease is, in the majority of cases, fatal. Post mortem there 

 is little to be observed. The most marked feature is the 

 occurrence of patches of congestion in the spinal cord, and 

 especially the medulla. 



Historical. To the pathologist the disease was, till re- 



1 This disease is not to be confused with the ' ' tetany " of infants, which 

 in its essential pathology probably differs from tetanus. This remark of 

 course does not exclude the possibility of the occurrence of true tetanus in 

 very young subjects. 



