TETANUS — LOCKED JAW. 51 



•' doubts that the horse has ever the disease except from sympathy;" 

 and in confirmation of this opinion states, that, although during life 

 the symptoms have proved insufficient to direct his attention to the 

 seat of the source of irritation, examination after death has mani- 

 fested appearances which left no doubt on the mind of Mr. H. 

 about the nature of a case which he had at first considered to be 

 idiopathic i. e., central. And in the position which Mr. H. has 

 taken up, I am very much disposed to think, that (although I do not 

 believe his theory complete) he stands very strong. I feel no doubt, 

 myself, that a very large proportion of our cases of tetanus originate 

 either from wound, discovered or not discovered, or from some 

 other cause of local irritation ; and that cause Mr. H. has found 

 frequently to be, " an unusually vascular appearance of the large 

 sympathetic nerves throughout their various ramifications in the 

 chest and abdomen." In one case, in combination with this appear- 

 ance, he found distention and redness of the stomach, with crimson 

 spots upon its pyloric portion ; in a second case, with the same, an 

 enormous quantity of bots, several of which had eaten through the 

 coats of the stomach ; in a third, with the same, an immense 

 number of the worms called terites, in the stomach and small in- 

 testines, and in some parts of the duodenum and jejunum, sufficient 

 to block up the passages. The vessels of the pia mater were also 

 unusually distended, the brain in this case being examined ; and 

 there was more water than usual in the ventricles. To this it may 

 be right to add, that Mr. H. found the sympathetic nerves similarly 

 affected in a case of tetanus apparently caused by broken knees. 

 Mj". Karkeek, V.S., Truro, has made the same observation since, 

 in idiopathic tetanus ; and in regard to it, coupled with the consi- 

 deration of other facts, sagaciously remarks, that " tetanus depends, 

 if any disease does, upon sympathy." And in another place, " I 

 am of opinion that a diseased state of the digestive organs is 

 invariably the primary cause, as on dissection I have ever discovered 

 it to exist:" thus confirming Mr. Abernethy's opinion. 



Climate. — Mr. Karkeek believes the climate of West Cornwall 

 to be favourable to the production of tetanus, on account of the land 

 being almost surrounded b}' sea and bordering so closely upon it. 



