CAUSES OF TETANUS. 1023 



further learn from the British and French army 

 surgeons, that, among wounded soldiers, tetanus 

 is rarely brought on without exposure to cold, 

 fatigue, or the depressing passions. On the 9th 

 of January, 1839, Dr. Bird related before the 

 Westminster Medical Society, the case of a man 

 who had chopped the nail of his thumb on one 

 hand, and injured the adjoining finger, but re- 

 mained well for three days, when he was exposed 

 to cold and wet, which produced a chill, followed 

 by fever, and decided symptoms of tetanus. On 

 the same occasion, Mr. Streeter related another 

 case that was produced by cold alone ; and which, 

 like that of Dr. Bird, was cured by the ordinary 

 treatment employed in fever. (Lancet, 1839.) 



But whether the disease be idiopathic or trau- 

 matic, and whatever the remote or exciting cause 

 may be, the prominent symptoms are essentially 

 the same ; viz. difficult and hurried respiration, 

 cold extremities, a pale or livid hue of the sur- 

 face, small and irregular pulse, loss of appetite, 

 nausea, and sometimes vomiting, constipation of 

 the bowels, with such a derangement of all the 

 secretions, that the formation of pus is arrested 

 in ulcerating wounds. Dr. Elliottson regards the 

 disease as analogous to chorea, hysteria, and the 

 shaking palsy. He also observes, that in ninety- 

 nine cases out of a hundred, tetanus in females is 

 attended with flatulency, globus hystericus, and 

 other like symptoms. 



