404 PRACTICE OF PHYSIC. 



in any way ; and it is to this state the term of Tetanus has been 

 strictly applied. At the same time, the arms, little affected be- 

 fore, are now rigidly extended ; the whole of the muscles be- 

 longing to them being affected with spasms, except those that 

 move the fingers, which often to the last retain some mobility. 

 The tongue also long retains its mobility ; but at length it also 

 becomes affected with spasms, which, attacking certain of its 

 muscles only, often thrust it violently out between the teeth. 



At the height of the disease, every organ of voluntary motion 

 seems to be affected ; and among the rest the muscles of the 

 face. The forehead is drawn up into furrows ; the eyes, some- 

 times distorted, are commonly rigid, and immoveable in their 

 sockets ; the nose is drawn up, and the cheeks are drawn back- 

 wards towards the ears, so that the whole countenance expresses 

 the most violent grinning. Under these universal spasms, a 

 violent convulsion commonly comes on, and puts an end to 

 life. 



MCCLXI. These spasms are every where attended with 

 most violent pains. The utmost violence of spasm is, however, 

 not constant ; but, after subsisting for a minute or two, the 

 muscles admit of some remission of their contraction, although 

 of no such relaxation as can allow the action of their antagonists. 

 This remission of contraction gives also some remission of pain ; 

 but neither is of long duration. From time to time, the violent 

 contractions and pains are renewed, sometimes every ten or 

 fifteen minutes, and that often without any evident exciting 

 cause. But such exciting causes frequently occur ; for almost 

 every attempt to motion, as attempting a change of posture, 

 endeavouring to swallow, and even to speak, sometimes gives 

 occasion to a renewal of the spasms over the whole body. 



MCCLXII. The attacks of this disease are seldom attended 

 with any fever. When the spasms are general and violent, 

 the pulse is contracted, hurried, and irregular ; and the respira- 

 tion is affected in like manner : but, during the remission, both 

 the pulse and respiration usually return to their natural state. 

 The heat of the body is commonly not increased ; frequently 

 the face is pale, with a cold sweat upon it ; and very often the 

 extremities are cold, with a cold sweat over the whole body. 

 When, however, the spasms are frequent and violent, the pulse 



