Course, Diagnosis. 455 



The disease occurs very rarely in fowls. Dre>^nann observed 

 it in a turkey gobbler four days after a dog bite. The symptoms 

 Avere spasm of the entire musculature, stiffness of the head 

 and neck, trismus, close approximation of the wings to the 

 body, ruffled feathers and cyanosis of the comb and wattles. 



Course. The most varied transitional stages may be ob- 

 served in the course of tetanus in the rapidly progressing cases 

 which terminate fatally in 2 or 3 days as well as in those that 

 progress slowly and attain only a limited degree of intensity. 

 Death usually follows in 3 to 10 days after the appearance 

 of the first symptoms, very rarely earlier and even more rarely 

 later. The symptoms in the fatal cases, aside from slight re- 

 missions, are progressive in intensity until death supervenes. 

 There are cases in which the patient's condition may become 

 improved for a time to such an extent that recovery is hoped 

 "for; suddenly a remission occurs, followed in a few days by 

 death, while no cause for the change is discernible. In favorable 

 cases the symptoms, especially the spasmodic contraction of 

 the musculature, abate towards the end of the second week, 

 and finally cease altogether. Convalescence will be long, how- 

 ever, a certain stiffness of movement being noticeable in the 

 animals even 4 to 6 weeks later, but this also gradually dis- 

 appears. 



The course of the disease is influenced by nutrition in that 

 those cases where ingestion of food and water is difficult or 

 impossible on account of the trismus, exhaustion occurs earlier, 

 and this is accelerated by the exertion occasioned by the con- 

 stant muscular tension. Further, the superficial respiration 

 occasions danger of suffocation, which is enhanced by the easily 

 induced hypostatic hyperemia of the lungs. Mild cases may 

 be shaped unfavorably by occasional complications, and in this 

 respect pneumonia is especially dangerous. It is produced almost 

 exclusively by aspiration of fluid or particles of food and usually 

 runs an unfavorable course. ' (Schindelka has observed a 

 marked decrease in the tetanic symptoms after an intercurrent 

 influenza in four horses.) 



Diagnosis. A characteristic picture of the disease is pre- 

 sented by the continuous tonic muscle spasms with retained 

 consciousness and normal temperature. Strychnine poisoning 

 simulates it very closely; here, however, the spasms develop 

 much more rapidly and death results much more quickly. 



Tetanus may be mistaken for other diseases only in the 

 initial stages of the disease, as long as the muscle contractions 

 are confined to one part of' the body and while they are not 

 very pronounced. Cerebrospinal meningitis comes into con- 

 sideration on account of the rigidity of the neck, but here symp- 

 toms are also present pointing to an inflammation of the brain 

 (dullness, paralysis in the area of certain cerebral nerves), 

 trismus is usually absent, reflex irritability is increased, but 



