488 RESULTS OF WOUNDS. 



affected, the chin drawn towards the breast, the spine curved 

 backwards, the disease is named emprosthotonos. In the lower 

 animals, trismus, with opisthotonos, is generally met with. I 

 have seen a modified form of tetanus lateralis, but the other 

 form — namely, emprosthotonos — is, I think, unknown in either 

 horse or ox. 



Tetanus, whatever be the variety, may be acute, subacute, or 

 even chronic. The acute is that which is most common, and 

 most fatal ; it has a tendency to involve the whole frame, and 

 to destroy life by arresting the respiratory movements. Amongst 

 the variety of causes which may produce tetanus, in addition to 

 the irritation of wounds, I have observed worms in the stomach 

 and intestinal canal, collections of sand in the large intestines, 

 and uterine irritation after abortion. 



Traumatic tetanus follows injuries, whether inflicted surgically 

 or otherwise, in an indefinite but limited period of time, — in 

 some instances within an hour after the infliction of the injury, 

 but usually the occurrence of the spasm is not observed until 

 the wound is nearly or quite healed. Neglect in the treatment 

 of, the presence of a foreign body in, or the application of 

 iiTitating medicaments to, a wound, is apt to cause tetanus. 



The Syinpto7iis of Tetanus. — In the earliest stage there will be 

 a stiffness of the muscles near the seat of the injury ; if a limb is 

 wounded, the animal will move it with difficulty ; the stiffness 

 spreads over the whole body ; the animal wiU begin to champ 

 his jaws, and grind his teeth. There is often a flow of saliva 

 from the mouth, and a collection of froth upon the lips. The 

 breathing now becomes accelerated, the nostrils dilated, the nose 

 protruded, the membrana nicti^ans pushed more or less over the 

 eyes, which are withdrawn within their sockets. If the animal 

 be suddenly disturbed, the superficial muscles will be seen to 

 twitch or tremble ; the eyeballs convulsively withdrawn within 

 the orbits, causing the patient to show the white of the eye 

 at every convulsive retraction ; the tail is suddenly elevated, 

 and is maintained in that position by an irregular clonic spas- 

 modic action of the levator muscles so long as the excitement 

 continues. 



At first the pulse is not much affected, and in aU but the 

 most severe attacks it continues undisturbed for two or three 

 days ; it has a hard, incompressible character, however, and as 



