56 TETANUS — LOCKED JAW. 



pulse becomes accelerated, and at times acquires such extreme 

 irritability that the least disturbance or alarm will hurriedly run it 

 up to double its former quickness. In regard to the pain the poor 

 animal all the while is suffering, some conception may be formed 

 of it, as Mr. Lawrence has happily observed, by the sharp pains 

 felt by a person experiencing cramp in his leg : tetanus is a con- 

 tinued cramp all over the body, and the consequent suffering is 

 in some cases dreadful, judging from the high state of irritation our 

 poor patient is in, his extreme restlessness and anxiousness, his 

 occasional perspirations, shivering fits, &c. And yet there are 

 remissions of the spasms — -times when the patient suffers less — to 

 dread and feel the more on the accession of the next paroxysm. 

 The bowels generally are constipated ; the urine scanty and high- 

 coloured. 



The latter Stages are marked by an extension of the spasm 

 to the limbs, rendering our unfortunate patient all but a fixture to 

 the place where he stands; for should he attempt to move, retaining 

 little or no power over his muscles, there is great risk of his falling 

 down. And now the animal's aspect becomes wan, and his body 

 begins to shew, in falling away, the effects of irritation and pain, 

 and of deprivation of aliment. Towards the close of the sad scene, 

 the respiration becomes more embarrassed ; the pulse accelerated 

 more, and then, irregular, intermittent, imperceptible; cold sweats 

 and rigors seize the body, during the continuance of which the 

 spasm appears to relax. But, alas ! fatal truce ; our poor patient is 

 now on the point of death : either he stands to the last, and drops 

 down dead ; or he falls headlong, and expires in convulsions. 



The Duration of Tetanus is various. Tn general, it may be 

 said to last from one to three or four weeks. Death has ensued 

 so early as the second day : commonly, in rapid cases, it occurs 

 about the fifth or sixth day ; sometimes the twelfth or thirteenth 

 proves fatal. When symptoms of recovery reward our endeavours, 

 the favourable change may often be dated from the tenth day. 

 Should the tenth and following day or two pass without any sign 

 of amendment, we may begin to despair of our patient. 



Our Prognosis from the beginning must be one of hopelessness. 

 With a few remarkable exceptions — most of which will be found 



