CEREBRAL TETANUS 121 



very mild nature. During the same period these veterinary surgeons 

 saw 259 cases in animals that were not so inoculated. 



M'Watt records a case in the Brit. Med. Journal of a boy affected 

 with tetanus, whose recovery he attributed to the use of Tizzoni's 

 antitetanic serum. 



CEREBRAL TETANUS. 



At the Ninth International Congress of Hygiene, held at Madrid, 

 the result of the experiments of Dr Borrel and Dr Roux regarding the 

 tetanic disease produced by the direct inoculation of tetanic toxin in the 

 brain substance of susceptible animals, was communicated by Dr Borrel. 

 The special malady cerebral tetanus produced is defined by a set of 

 symptoms, including excitement, epileptiform convulsions, strange or 

 manifold desires, and other symptoms, varying according to the portion 

 of the brain in which the antitoxin is introduced. This tetanic malady 

 is absolutely different from the ordinary tetanus, but is none the less 

 specific. Dr Borrel and Dr Roux also discovered that an animal 

 rendered immune against injections under the skin was not immune 

 against injections into the substance of the brain, and from this they 

 conclude that subcutaneous injections of antitoxin do not affect the nerve 

 cells and do not protect them. The same occurs when for therapeutic 

 purposes serum is injected into an animal which has commenced to 

 manifest the symptoms of tetanus, the nerve substance being already 

 attacked by the toxin. The serum does not reach the nerve cells, 

 and therefore the toxin can continue its deadly effects undisturbed. 

 This explains the many failures to treat tetanus by antitoxin. The same 

 authorities then tried to treat the disease by conveying the antitoxin 

 direct to the brain substance, and were thus able to cure rabbits, guinea- 

 pigs, etc., even when the disease had prevailed for some hours, and this 

 at a time when very large subcutaneous injections had proved of no use 

 whatever. On the other hand, when injected into the brain matter 

 very small quantities of serum were sufficient. These researches on 

 cerebral tetanus demonstrated that with animals immunized passively or 

 actively the nerve cells are not immunized. An immunized animal 

 which resists a subcutaneous inoculation of the toxin will die if the 

 smallest quantity of this toxin is introduced into the brain matter. 

 Immunity is not therefore due to some new property acquired by the 

 nerve cells, as they remain unaffected unless directly attacked. 



DIFFERENTIAL DIAGNOSIS TABLE 



