TETANUS. 55 



TETANUS. 



The pathology of tetanus is very much like that of 

 diphtheria. In each disease the specific bacilli are 

 localised at or near the region at which they enter the 

 body, and form a toxin which is absorbed into the 

 blood and affects distant organs. In each case research 

 has shown that an antitoxin is formed which neutralizes 

 this toxin and prevents it from uniting with the cells of 

 the body, but which has not the power of turning it out 

 from such a combination. In other words tetanus 

 antitoxin, like that of diphtheria, is preventive but not 

 curative. But here, unfortunately, the resemblance 

 between the two diseases ceases. The local lesion in 

 diphtheria is obvious and its presence causes a good 

 deal of inconvenience to the patient ; he sees a medical 

 man early, and the diagnosis of diphtheria is made 

 before much of the toxin has entered the blood. It 

 is different with tetanus. In this the local symptoms 

 are practically nil ; there may be suppuration at the 

 region of inoculation but this is so common as not to 

 excite suspicions. The result is that the diagnosis is 

 not made until the appearance of the symptoms refer- 

 able to the nervous system indicates that the period at 

 which antitoxin might have been used with success has 

 gone by. 



To illustrate this we will imagine that the local lesion 

 of diphtheria to be so slight as to be unnoticed by 

 doctor and patient. The result would be that the 

 disease would only be diagnosed when the severe 

 toxsemic symptoms had manifested themselves, and 

 antitoxin would then be almost or quite useless. If it 



