CHAPTER XVII.. 



TETANUS 1 : CONDITIONS CAUSED BY OTHER 

 ANAEROBIC BACILLI. 



Introductory. — Tetanus is a disease which in natural conditions 

 affects chiefly man and the horse. Clinically it is characterised 

 by the gradual onset of general stiffness and spasms of the 

 voluntary muscles, commencing in those of the jaw and the 

 back of the neck, and extending to all the muscles of the body. 

 These spasms are of a tonic nature, and, as the disease advances, 

 succeed each other with only a slight intermission of time. 

 There are often, towards the end of a case, fever and rise of 

 respiration and pulse-rate. The disease is usually associated 

 with a wound received ordinarily from four to fourteen days 

 previously, and which has been defiled by earth or dung. The 

 disease is, in the majority of cases, fatal. 



Historical. — The general association of the development of tetanus with 

 the presence of wounds, though these might be very small, suggested that 

 some infection took place through the latter, but for long nothing was 

 known as to the nature of this infection. Carle and Rattone in 1884 

 announced that they had produced the disease in a number of animals by 

 inoculation with material from a wound in tetanus. They thus demon- 

 strated the transmissibility of the disease. Nicolaier (1885) infected mice 

 and rabbits with garden earth, and found that many of them developed 

 tetanus. Suppuration occurred in the neighbourhood of the point of 

 inoculation, and in this pus, besides other organisms, there was always 

 present, when tetanus had occurred, a bacillus having certain constant 

 microscopic characters. Inoculation of fresh animals with such pus 

 reproduced the disease. Nicolaier's attempts at its isolation by the 

 ordinary gelatin plate-culture method were, however, unsuccessful. He 

 succeeded in getting it to grow in liquid blood serum, but always in 

 mixture with other organisms. Infection of animals with such a culture 



1 This disease is not to be confused with the "tetany" of infants, which in 

 its essential pathology differs from tetanus (vide Frankl-Hochwart, "Die 

 Tetanie der Erwachsenen," Vienna, 1907). This remark, of course, does 

 not exclude the occurrence of true tetanus in very young subjects, in whom, 

 in fact, infection frequently takes place, often at the umbilicus. 



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