ANALYSIS OF CONTINENTAL JOURNALS. 
855 
the temperature be examined before and after the spasm, 
there is frequently no difference observed, or the column of 
mercury ascends but one fifth of a degree. The elevation of 
temperature, when it exists, should not be ascribed to the 
muscular contractions. The real cause is to be sought else- 
where, and we shall not he far wrong in attributing it to a 
lesion of the nervous centres. Indeed, high temperatures are 
met with in the most serious cases, when there are few, if any, 
extensive contractions ; and if in the acute form elevated tem- 
peratures are the rule, it is precisely because these cases are 
nearly always fatal. 
With regard to the lesion itself, we can only say that 
many times we have remarked that the spinal cord was con- 
gested, and that nuclear proliferation was evident. M. 
Bouchard has particularly verified these results in two cases 
of subacute tetanus, and he is of opinion — contrary to the 
principle established by Bokitanski — that this only occurs 
when the disease has lasted for a certain time. Moreover, if 
we do not always find alterations appreciable to our means of 
investigation, we have no right to conclude that there are no 
lesions. In our opinion, the disease commences by irritation 
of the peripheral nerves, and this irritation may remain there, 
or, on the contrary, be propagated to the nervous centres. If 
not very intense, the nervous centres are merely excited, 
there is but little elevation of temperature, and the patient 
may recover ; but if the irritation be strong, then to this ex- 
citation is added a veritable alteration, the temperature 
rapidly rises, and there is a great chance of a fatal termina- 
tion. 
In a therapeutical point of view, we believe that neuro- 
tomy is still the most rational means that can be employed, 
but it must always be resorted to as soon as possible. 
Besides, the section should not be confined to one nerve, as 
has been recommended for a long time, but all the nerves of 
the limb should be divided. Our experimental researches 
on the section of peripheral nerves have peremptorily esta- 
blished the fact, that so long as a nerve remains intact in the 
limb the transmission continues to be made. In one of the 
notes presented to the Institute last year, we cited the case of 
a patient who, in consequence of a gunshot wound at the 
root of the thumb, gradually felt cramps increasing in the 
limb, accompanied by inordinate flexion of the hand on the 
forearm, and then on the arm ; in a few days there was tris- 
mus. Section of the median nerve was practised at the 
middle part of the arm, but, so far from amending, the affec- 
tion continued; the muscles of the trunk, until now un- 
