TETANUS BACILLUS IQI 



face or hand, tetanus symptoms more quickly supervene, while if 

 the wound is on the foot, these are apt to be delayed. The sooner 

 the symptoms appear after the reception of the injury, the more 

 likely will the disease be virulent and fatal. If spores are washed 

 free from toxin, according to Viallard and Rouget, and then injected 

 into a susceptible animal, they do not cause tetanus, but are taken 

 up by the phagocytes. In other words, the rods not the spores 

 produce toxin. Necrotic tissue in wounds favors infection with 

 tetanus, since it helps to fulfil anaerobic conditions, and in some 

 way hinders phagocytosis. Aerobic bacteria favor tetanus infec- 

 tion by absorbing the free oxygen which prevents the growth of 

 tetanus organisms. Free oxygen never kills the organism or its 

 spores, but merely prevents their development. Wounds that 

 have, apparently, healed, may be the origin of tetanus. The toxin 

 is produced rapidly in wounds, or what is more likely, some is 

 introduced with the bacilli and other dirt. Kitasato found, in the 

 case of mice, that if bacilli were introduced in the skin, near the 

 tail, and in an hour the whole area was excised, and the wound 

 cauterized, fatal tetanus nevertheless supervened. Rheumatic 

 tetanus follows pulmonary infection. 



As related in the chapter on toxins, the mode of disease produc- 

 tion is as follows : The toxin is conveyed from the wound by 

 means of the motor nerves to the central nervous system affect- 

 ing the motor elements. It causes microscopic degeneration of 

 the fibers and cells of the motor apparatus. Death is caused 

 either by a spasm of the glottis or diaphragm, or by cardiac 

 failure and exhaustion. A local manifestation merely affecting 

 certain groups of muscles may occur. Laking of the blood by 

 tetanolysin found in the bodies dead from tetanus is a well- 

 known phenomenon. In fatal cases, toxin may be demonstrated 

 in the bladder by injecting the urine into mice, causing in them 

 tetanic symptoms. Various groups of muscles are affected in 

 tetanic seizures. The muscles of the jaw, if affected, cause 

 trismus; if those of the back are involved the individual suffers 



