TETANUS. 489 



the disease advances it becomes accelerated, harder, and more 

 incompressible. When the spasm becomes general, the position 

 of the various parts of the body is regulated by the action of 

 the more powerful muscles. The limbs are extended, flexion of 

 them is performed with difficulty, and the patient stands with 

 outstretched limbs. The course of the levator humeri can be 

 easily traced, and the contraction of this, and other muscles 

 which act upon the superior part of the cervical region, 

 cause the neck to assume the appearance of what is termed 

 *' ewe neck." The peristaltic motion of the bowels is stopped ; 

 the urinary bladder firmly contracted ; a dry, husky cough 

 comes on when the animal attempts to swallow, and the act of 

 deglutition is performed with a difficulty which increases from 

 day to day. The muscles of the abdomen are rigid ; the belly 

 looks small and hard ; the intercostals act imperfectly ; and 

 when the diaphragm becomes involved, the breathing is per- 

 formed with very great difficulty. 



Although the spasm of tetanus is of the tonic or persistent 

 kind, there are exacerbations of a clonic intermittent character ; 

 and the whole course of the disease is marked by paroxysms of 

 great severity if the animal be subjected to meddling attendance, 

 strong light, or rustling noises. In a modified light, and when 

 the animal is kept quiet, the spasms are usually diminished, and 

 the exacerbations much milder. 



But little is known about the general pathology of tetanus. 

 Some writers are of opinion that it is due to an exalted polarity 

 of the nervous centres, excited by the injury in the traumatic 

 form, or resulting from a mal-condition of the blood, or the 

 effects of cold acting upon the nerves of sensibility in the idio- 

 pathic form of the disease. 



In post-mortem examinations of traumatic tetanus I have in- 

 variably found the nerves leading from the injured parts to 

 present some signs of inflammation ; the neurilemma more 

 vascular than natural, the vessels of the spinal cord engorged, 

 and the sub-arachnoid space to contain some effusion. 



Treatment of Tetanus. — Suppose the disease to be caused by 

 docking or neurotomy, the first question to be considered is 

 whether a portion of the stump of the tail or the end of the 

 nerve should be removed or not. Some are of opinion that the 

 nervous irritation is due to the nervous fibrilloe of the part being 



