406 PRACTICE OF PHYSIC. 



fore concluded, that the fatal tendency of it is not so unavoida- 

 ble as has been imagined. 



In judging of the tendency of this disease, in particular cases, 

 we may remark, that, when arising from lesions of the nerves, 

 it is commonly more violent, and of more difficult cure than 

 when proceeding from cold ; that the disease which comes on 

 suddenly, and advances quickly to a violent degree, is always 

 more dangerous than that which is slower in its progress. Ac- 

 cordingly, the disease often proves fatal before the fourth day ; 

 and when a patient has passed this period, he may be suppos- 

 ed to be in greater safety, and in general the disease is the safer 

 the longer it has continued. It is, however, to be particularly 

 observed, that, even for many days after the fourth, the disease 

 continues to be dangerous ; and, even after some considerable 

 abatement of its force, it is ready to recur again with its former 

 violence and danger. It never admits of any sudden, or what 

 may be called a critical solution ; but always recedes by degrees 

 only, and it is often very long before the whole of the symptoms 

 disappear. 



MCCLXVII. From the history of the disease now described, 

 it will be evident that there is no room for distinguishing the teta- 

 nus, opisthotonos, and trismus or locked jaw, as different species 

 of this disease, since they all arise from the same causes, and are 

 almost constantly conjoined in the same person. I have no 

 doubt that the emprosthotonos belongs also to the same genus ; 

 and as the ancients have frequently mentioned it, we can have 

 no doubt of its having occurred : but, at the same time, it is cer- 

 tainly in these days a rare occurrence ; and, as I have never 

 seen it, nor find any histories in which this particular state of the 

 spasm is said to have prevailed, I cannot mention the other cir- 

 cumstances which particularly attend it, and may distinguish it 

 from other varieties of tetanic complaints. 



MCCLXVIII. This disease has put on still a different form 

 from any of those above mentioned. The spasms have been 

 sometimes confined to one side of the body only, bending it 

 strongly to that side. This is what has been named by Sau- 

 vages the Tetanus lateralis, and by some late writers the 

 Pleurosthotonos. This form of the disease has certainly appear- 



