188 VETERINARY SURGICAL THERAPEUTICS. 
the trunk or the extremities. The nostrils are dilated, lips contracted, 
ears erected and stiff, eyes partly covered by the nictitans, tail more or 
less elevated and stiff. Contraction of the masseters—trismus—is 
more or less marked, prehension of food and mastication are difficult 
or impossible; saliva slobbers from the mouth. In most patients the 
muscles of the tongue, pharynx, and larynx are also contracted. 
Ordinarily the neck is elevated and the dorso-lumbar regions slightly 
curved downwards (opisthotonos); in other cases the vertebral column 
forms a straight horizontal line (orthofonos) ; exceptionally it is curved 
one side or the other (p/eurosthonos). Contractions are continuous, with. 
spasms at certain times. Various causes of excitement produce in- 
creased convulsions. Respiration is difficult, more or less rapid; 
during the access it increases three or four times the normal number. 
At the outset, circulation is not disturbed, nor in the periods of calm, but. 
‘it increases at the time of the access. Temperature remains normal or 
only a few tenths higher in benignant cases; in general serious cases. 
are characterized by a rise of two or three degrees ; however, they may 
also develop without great elevation of temperature. In the few hours. 
preceding death it may rise to 42°C. and above. However, numerous. 
causes exist to produce this hyperthermia. 
In acute tetanus the invasion is rapid, the contractions are severe: 
and generalized, trismus great, prehension of food and deglutition 
impossible, respiration very difficult and accelerated, pulse quick, 
paroxysms frequent, temperature elevated. 
Death occurs generally from the second to the fourth day. 
In chronic tetanus, incubation is generally longer, contractions slight, 
trismus weak, disphagia little marked, respiration and circulation not 
much disturbed, paroxysms rare, temperature normal or raised only a 
few tenths. There are cases where this condition remains stationary 
for two or three weeks ; thus by degrees the contractions subside and. 
disappear ; in others the disease presents alternate conditions of im- 
provement and of relapse until resolution takes place ; finally, sometimes. 
after a variable length of time, most ordinarily towards the end of the- 
first week, the severity of the contraction increases, tetanus becomes. 
acute, and death takes place within a few days. Even when the stiff- 
ness seems mild, the disease may last for weeks, and an increase, a. 
relapse or complications ought to be always looked for. Pneumonia by 
foreign bodies is possible during the entire disease; it may occur during: 
convalescence, the fourth week, or even the second month. 
The principal symptoms of tetanus are the same in all species. In 
cattle the movements are less rapid than in horses and the contractions 
are less severe. On the contrary, in sheep and dogs the evolution of 
the disease is rapid. Death ordinarily takes place from the sixth to- 
the eighth day. 
