TETANUS — LOCKED JAW. 57 



recorded — tetanus and death have proved but cause and effect. In 

 man, traumatic cases are accounted a great deal more dangerous 

 than others ; and the same observation holds good in respect to 

 horses : most of the instances of recovery turning out to be cases 

 of central tetanus, and remedies which appeared to have proved 

 curative in this, manifesting no such efficacy in the centripetal form 

 of the disease. When the case, therefore, is not of traumatic 

 origin — the spasm neither severe nor universal, not such as to lock 

 the jaws to that degree that neither food nor medicine can be taken — 

 and so long as the voluntary muscles exclusively be affected, the 

 breathing and pulse remaining little or nothing disturbed, hope 

 may reasonably be entertained of our patient. 



Treatment. — This, I fear, will turn out the least satisfactory 

 part of our account. Tetanus is one of those diseases with whose 

 nature we are but imperfectly acquainted, and over which in its 

 worst forms medicine exerts its power in vain : in the emphatic 

 language of our excellent and elegant writer, Mr. Karkeek, "there 

 are few things that shew so substantially the mighty and awful 

 power of disease, and of our incapability of arresting its progress, 

 as to see a fine noble horse die tetanic." Nevertheless^ it is our 

 duty to set about our task energetically, and in accordance with the 

 best rules of our art. Our treatment, in whatever it may consist, 

 must have regard to the origin, the kind, the stage, the intensity 

 of the disease, and the age, constitution, and condition of our pa- 

 tient. The traumatic we have ascertained to be the kind of tetanus 

 whereto horses are especially obnoxious; and this is one reason 

 why the disease so frequently ends in death. The wound, there- 

 fore, whatever it may be — slight or severe, recent or of some dura- 

 tion — apparently or by possibility giving rise to the tetanic disorder, 

 of course becomes an object of peculiar interest in the treatment. 



Traumatic Treatment. — The removal or destruction of that 

 from which the disease is supposed to have taken its origin, and 

 which possibly may still prove a source of irritation, has always 

 been considered a primary object in the treatment: accordingly, 

 surgeons have amputated wounded limbs to cure tetanus ; have 

 excised or destroyed by caustic wounded or abraded surfaces, and 

 so forth; and the same has been practised to the extent it was 



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