Tetanus. 349 



Treatment. For fully developed tetanus no known resort of 

 theraputrics can be relied on. In slight cases that have shown a 

 long incubation and a slow increase and extension of spasm and in 

 those having trismus only, a recovery may be expected. Treatment 

 has been conducted largely on theoretic lines and may be divided 

 into antispasmodic, eliminating and antidotal or antiseptic. 



E.est, darkness and absolute quiet are the first and main con- 

 siderations. A dark stall, with no straw litter, the rustling of 

 which often excites the patient, but rather a little chaff, saw dust 

 or even earth to prevent noise from the feet, and the exclusion of 

 all visitors are essential. As a rule slings should be put under 

 the patient so that he cannot lie, nor drop down, and this becomes 

 more imperative as the disease advances. The aggravation of the 

 spasms when down, and the danger of their extension to the res- 

 piratory muscles are far more to be dreaded than the temporary 

 excitement caused by the application of slings. Food should be 

 sloppy mashes, of bran, middlings, oat meal, linseed meal, gruels 

 or milk, or green food may be allowed in moderate amount if the 

 jaws are still movable. It must not be forgotten that digestion is 

 impaired and food that is indigestible, especially fermentescible, 

 or in excess, jnay arouse fatal colics and bloating, yet in a pro- 

 tracted exhausting disease like tetanus, the strength must be sus- 

 tained by all means in our power. Pure water should always be 

 accessible. Food and water should be furnished in buckets at a 

 level which will not necessitate either raising or dropping the head 

 to get to them (about 4 feet). The food must be given often, 

 in small quantity to avoid fermentation and spoiling. If noise 

 . cannot be wholly excluded it may be an advantage to put cotton 

 wool in the ears. I have seen a mare recover when completely 

 covered with cotton wool under blanket and hoods. 



Local antiseptic treatment. Theoretically this is of great value 

 since the microbe is confined to the inoculation wound and by the 

 time the first symptoms appear, the spores have developed into 

 bacilli and are in a condition to be easily destroyed by disinfect- 

 ants. We can, therefore, by caustics or active disinfectants de- 

 stroy the infecting microbian colony, and prevent the further 

 entrance of any toxins into the circulation and nerve centres. 

 The principal has been shown experimentally successful in cases 

 of inoculation in the tails of cats and Guinea-pigs, and the ampu- 



