LOCK-JAW. 379 



but here, like the state of the muscles, it may be a secondary effect 

 of the long-continued exertions of the latter, which nothing but 

 the absence of all important lesions of the brain and spinal cord 

 would induce the pathologist to pay the slightest attention to. 



Tetanus may be either idiopathic or symptomatic, but the 

 former condition is somewhat rare. It almost always follows some 

 operation, or a severe injury in which a nerve has been implicated, 

 the most frequent causes being the piercing of the sole by a nail, 

 or a prick in shoeing, or the operations of clocking, nicking, castra- 

 tion, &c. 



The symptoms are a permanent rigidity of certain voluntary 

 muscles, and especially of the lower jaw (whence the popular 

 name, lock-jaw). The mouth is kept rigidly shut, the masseter 

 muscles feeling as hard as a deal board. One or both sides of the 

 neck are rigid, in the former case the head being turned to one 

 side, and in the latter stretched 6ut as if carved in marble. The 

 nostrils are dilated ; the eyes retracted, with the haws thrust for- 

 ward over them; the ears erect and stiff, and the countenance as 

 if horror-struck. At first the extremities are seldom involved, 

 but as the disease progresses their control is first lost, and then 

 they become rigid, like the neck and head. The patient is scarcely 

 able to stand, and plants his feet widely apart to prop himself up, 

 while at last the tail also becomes a fixture. The pulse varies a 

 good deal, in some cases being quick, small, and hard, and in 

 others slow and labored. The bowels are generally costive, and 

 the urine scanty; but this last symptom is not so well marked as 

 the state of the bowels alluded to. The treatment should be of a 

 two-fold nature, partly palliative and partly curative. Since the 

 introduction into use of chloroform we have possessed a drug which 

 invariably enables us to remove the spasm for a time, and if it 

 does nothing more, it gives room for other remedies to act and 

 relieve the patient from the horrible tortures which are occasioned 

 by the spasm, while it also allows the muscular and nervous powers 

 to be recruited. When, therefore, a case of tetanus occurs in a 

 horse of any value, an apparatus for applying chloroform (described 

 under the chapter on Operations) should be procured, and the 

 animal at once placed under its influence. This done, the whole 

 length of the spine should be blistered with tincture of cantharides, 

 and an active aperient should be given, consisting, if practicable, 

 of a pint of castor oil, and six or eight drops of croton oil. This 

 may be pumped down the throat by the usual syringe and tube, 

 if the front teeth can be separated; but if this cannot be done, 

 some solid cathartic must be selected, though there is often as 

 much difficulty in forcing a ball down as in passing an elastic tube. 

 Failing in either of these, two drachms of calomel, and the same 

 quantity of tartar emetic should be slightly damped, and placed in 



