TETANUS. 185 
membranes. And when tetanus appears, the trauma, which has permitted 
the passage of the pathogenous agents, can be entirely cicatrized. For 
these reasons, the numerous observations of ‘‘ spontaneous tetanus” col- 
lected in the past and those that are reported in our own day cannot be 
seriously opposed to the “results of experimental researches, which have 
shown, as irrefutable, the demonstration that tetanus is always traumatic, 
always inoculated and always microbian. Without a wound and without 
the Nicolaier bacillus there is no tetanus. ‘here is no occasion to make 
exceptions for the cases of ‘‘ tetanus consequent upon a contusion ;” in 
these, either there has been, on the surface of the injured part, destruction 
of the epidermis and introduction in that place of the specific elements 
through a lesion to all appearance closed, but in reality open, or the 
disease has had for its starting-point another solution of continuity, 
cutaneous or mucous, which remained unseen, and the incriminated 
contusion is only an incidental accident, having no relation to the 
tetanic complication except that resulting from their coexistence. 
Enzootics of tetanus have no other cause than the microbe, the trauma, 
and the co/d, which promotes its infection. If the Nicolaier bacillus 
is the efficient cause of tetanus, some etiological factors noted by old 
observers remain as adjuvant causes of infection. Powerless to pro- 
duce the disease, they diminish the resistance of the organism, and 
although their mode of action may be obscure they do not the less 
render the soil favorable to the development of specific germs. The 
most efficacious of these occasional causes is damp cold. Numerous 
are the facts collected in veterinary medicine, which show the disastrous 
influence of a damp and cold atmosphere. Those related by military 
surgeons are still more convincing than ours ; sometimes, there have 
been counted by hundreds cases of tetanus in wounded animals exposed 
to the cold of night. In the polyclinic at Vienna, Roll has seldom 
observed isolated cases of traumatic tetanus; he has seen it almost 
always in several animals at atime. We have made the same observation 
at the clinic of Alfort. Months may elapse without a single case being 
brought to the consultation, then a time arrives—almost always after 
a lowering of the temperature—when several are seen in a week, even 
a day, upon animals coming from different localities. One must 
acknowledge, however, that the pathogeny of the disease is not entirely 
elucidated, and that certain conditions of its etiology remain yet unknown. 
The microbe of tetanus has been found in various media. It is 
especially é//uric: has for principal abode the superficial layers of the 
ground, where it is found more or less abundant according to countries 
and localities of the same region. It is very common in the northwest 
part of the Paris suburbs ; more than three-quarters of the animals which 
we have treated came from there. It is found in dust, hay, water, 
dung, contents of the intestines, and on the surface of animals’ bodies. 
