Prognosis, Treatment. 457 



is also of importance, as every increase in temperature during 

 the course of the disease is an unfavorable sign. Such an 

 increase indicates in cases without complications that the end 

 is near ; in other cases it is due to some inflammatory process, 

 usually pneumonia. 



The cases of localized tetanus are, as already stated, al- 

 ways more favorable, and the prognosis of tetanus in dogs is 

 usually better. 



Among 247 horses with tetanus observed at the Budapest clinic in 1886-1906, 

 202 died, i. e., 81.8%. — In the stables of the Prussian army tetanus was diagnosed 

 from 1881 to 1908 in 1,139 horses, 848, i. e., 74.4% died, while in the French army 

 from 1904 to 1905 among 172 cases, 115 or 66.8% died. — According to Dieudonne 

 the mortality from tetanus after docking of the tail (58 oases) is 75%. 



Treatment. The first essential part in the treatment of 

 tetanus consists in a thorough disinfection of the seat of in- 

 fection. If it is possible, by removing 

 the pus and necrotic tissue, as well as 

 by a subsequent disinfection of the 

 wound, to render the tetanus bacilli 

 and spores harmless, the source of the 

 poison is thereby eliminated, and if 

 the already absorbed toxin has not yet 

 produced severe changes in the ner- 

 vous system, the recovery of the ani- 

 mal may be hoped for, especially since 

 a portion of the toxin is probably 

 eliminated from the bodv with the se- 

 cretions (perspiration, urine, saliva), ^'s- '^}- _P'f^'^'T'i''f^Xfi°f 



. ,. ^'- . ji . V. ,. ' n ^ wound or ahog afrectediDithtei- 



AGCOTdmg to these indications caretul „.««s. Besides spore-containing 

 search should be made at the sup- tetanus bacilli, streptococci, 



posed place of. infection by means ^'^'^'^'^^l!^^^'''- 

 of an appropriate incision, to de- 

 termine whether it contains any purulent or ichorous secre- 

 tion. If so it should be washed, &,nd if a foreign body is present 

 it should be removed, the suspicious tissue should be cut from 

 the walls of the cavity with the aid of scissors, or curetted with 

 a spoon, and the cavity should be thoroughly washed with a 

 concentrated disinfectant. For this purpose a 1% nitrate of 

 silver, or corrosive sublimate solution, 8% chloride of zinc 

 solution, or 5% iodide of glycerin (Van), are satisfactory; 

 cauterization may also be applied. The disinfection acts also 

 by destroying the less resistant foreign bacteria, and thereby 

 rendering the conditions for the propagation of the tetanus 

 bacilli unfavorable. By the application of a Bier's ligature 

 the absorption of the toxins may also be made more difficult. 

 If the disease appears after docking the tail it is advisable to 

 amputate another portion, and to apply the thermocautery to 

 the surface of the wound. 



In practice the local treatment of horses is sometimes very difficult, as the 

 patients become much excited, and it is hardly possible to lift the leg from the 



