TETANUS, 189. 
Some authors believe that the mortality is not as high in our day as. 
in the past, that acute cases are less common, which would be due to an 
attenuation of the pathogenous agent, or a more rational therapeuty. 
But in horses it seems to have preserved all its severity; only that 
which is observed is the predominance of acute or chronic cases, accord- 
ing to years or periods of times. 
The diagnosis of tetanus offers no difficulties. In some light cases, 
one might, at first sight, mistake it for laminitis ; but the generalized 
stiffness, the tension of the muscles, the attitude of the conical rod and 
of the head, the protruding of the membrana nictitans upon the eye, 
and the tail stiff and extended, are signs permitting the differentiation. 
In all species of animals, the prognosis is most serious. In horses, 
the average mortality is 75%. Out of 30 horses affected with tetanus in 
our wards, from 1888 to 1894, 21 died—a mortality of 70%. Seventeen 
of those affected with acute tetanus died: 1 the day of its admission, 
4 the second, 4 the third, 3 the fourth, 2 the fifth, 1 the sixth, 2 the 
eighth. Four others, in which‘the symptoms were less marked, died: 
1 the tenth day, 1 the thirteenth, 1 the twentieth, 1 the twenty-sixth. 
Sudden attack, rapid extension of the contractions to all the muscular 
groups, complete trismus, sweating, great acceleration of respiration 
and circulation, and hyperthermia, are manifestations to be dreaded. 
The greater the dyspncea, the more death is to be feared. A recumbent 
position is a bad sign. Almost all creatures affected with tetanus that 
drop down in a fit or through exhaustion, die quickly. At all periods of 
the disease, but especially in the first, death may be the consequence of 
pneumonia by foreign bodies. After the second septenary, the chances 
for recovery are great. 
The prophylaxy of tetanus includes: rst, the means belonging to. 
surgery and hygiene; 2d, the injection of antitoxic serum. With the 
first, a treble indication is fulfilled: prevent the infection of the wounds 
of operations, disinfect accidental traumas, protect the operated and 
lhe wounded from the effect of cold. 
Animals operated upon should be protected from tetanus by observ- 
ing the rules of asepsis and antisepsis. The lips of aseptic wounds 
should be held together by sutures, covered with a dressing, or occluded 
with an impermeable substance (collodion); the latter dressing should 
be made at long intervals, as this renewal exposes the wounds to in- 
fection. Wounds of operation soiled during the interference should be 
minutely disinfected ; if they are left open and exposed, they should be 
frequently dressed with antiseptic solutions. All suspected wounds, 
accidental or of operation, soiled by matter ordinarily tetaniferous. 
(manure, ground), should be cleansed with a warm antiseptic liquid 
(a strong solution of carbolic acid), carefully washing every part 
and corner of them); all foreign bodies that they may contain should. 
