CHAPTER XVII. 



TETANUS i : CONDITIONS CAUSED BY OTHER 

 ANAEROBIC BACILLI. 



Introductory. Tetanus (German, Wundstarrkrampf) is a 

 disease which in natural conditions affects chiefly man and the 

 horse. Clinically it is characterised by the gradual onset of 

 general stiffness and spasms of the voluntary muscles, com- 

 mencing in those of the jaw and the back of the neck, and 

 extending to all the muscles of the body. These spasms are 

 of a tonic nature, and, as the disease advances, succeed each 

 other with only a slight intermission of time. There are often, 

 towards the end of a case, fever and rise of respiration 

 and pulse-rate. The disease is usually associated with a wound 

 received from four to fourteen days previously, and which has 

 been defiled by earth or dung. The disease is, in the majority 

 of cases, fatal. 



Historical. The general association of the development of tetanus with 

 the presence of wounds, though these might be very small, suggested that 

 some infection took place through the latter, but for long nothing was 

 known as to the nature of this infection. Carle and Kattone in 1884 

 announced that they had produced the disease in a number of animals by 

 inoculation with material from a wound in tetanus. They thus demon- 

 strated the transmissibility of the disease. Nicolaier (1885) infected mice 

 and rabbits with garden earth, and found that many of them developed 

 tetanus. Suppuration occurred in the neighbourhood of the point of 

 inoculation, and in this pus, besides other organisms, there was always 

 present, when tetanus had occurred, a bacillus having certain constant 

 microscopic characters. Inoculation of fresh animals with such pus 

 reproduced the disease. Nicolaier's attempts at its isolation by the 

 ordinary gelatin plate-culture method were, however, unsuccessful. He 

 succeeded in getting it to grow in liquid blood serum, but always in 



1 This disease is not to be confused with the "tetany " of infants, which in 

 its essential pathology probably differs from tetanus (vide Frankl-Hochwart, 

 " Die Tetanie der Erwachseneu," Vienna, 1907). This remark, of course, does 

 not exclude the occurrence of true tetanus in very young subjects, in whom, 

 in fact, infection frequently takes place. 



