CHAPTER XVI. 



TETANUS. 1 



SYNONYMS. LOCKJAW. GERMAN, WUNDSTARRKRAMPF. 



FRENCH, TETANOS. 



Introductory. Tetanus is a disease which in natural con- 

 ditions affects chiefly man and the horse. Clinically it is 

 characterised by the gradual onset of general spasms of the 

 voluntary muscles, commencing 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 de- 

 nied by earth or dung. Such a wound may be very small. 

 The disease is, in the majority of cases, fatal. Post mortem 

 there is little to be observed on naked eye examination. 

 The most marked feature is the occurrence of patches of 

 congestion in the spinal cord, and especially the medulla. 



Historical. To the pathologist the disease was, till recently, a 

 complete mystery ; for, while certain lesions were often met with, they 



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

 in its essential pathology probably differs from tetanus. This remark of 

 course does not exclude the possibility of the occurrence of true tetanus in 

 very young subjects. 



