TETANUS. 
151 
Now, in this case, leaving the hot-worms and the farmer’s 
theory out of the question, it was very evident that the cause 
existed in the digestive organs. If this disease had not been so 
very acute, I might probably have attempted to produce a fresh 
action in the wound underneath the jaw, by means of caustics, 
&c.; but this the reader will perceive could have been of no ser¬ 
vice, inasmuch as the local irritation had altogether ceased. But, 
though the irritation of the wound had ceased, it had existed suf¬ 
ficiently long to produce the morbid appearances which were ob¬ 
served in the stomach and bowels, and which, re-acting on the ner¬ 
vous system, was the cause of tetanus. Admit this, and we can 
easily explain why, after the amputation of a limb, from the in¬ 
jury of which tetanus has arisen, the symptoms are not mi¬ 
tigated:'because the disordered state of the digestive organs, esta¬ 
blished during the irritative state of the wound, is still present, 
although the original irritation has ceased. This also explains 
why the indication of cure, which is generally applicable in 
other diseases, namely, the removal of the exciting cause, has 
but little effect in a morbid condition which is the consequence 
of causes that have ceased to act. I have heard instances of 
tetanus being produced by docking, when re-docking has re¬ 
moved the disease as by a charm. I have tried this once ; I 
nearly cut off the whole tail of the animal, but did not succeed 
in producing the least mitigation of the symptoms. 
In such cases as these, where we might reasonably suppose 
local irritation to be still operating, the most effectual method of 
counteracting its effects on the system, would obviously be, to 
intercept all communication between the seat of the irritation 
and the sensorium. 
In another case of tetanus, produced by a prick from shoeing, 
and in one proceeding from a wound of the joint capsule of the 
navicular bone, by picking up a nail on the road side, I tried the 
experiment of dividing all the nerves going to the part affected ; 
but in neither of these cases did I perceive the least mitigation 
of the symptoms. I found in all three cases, on dissection, 
some slight inflammatory appearance in the membranes of the 
brain, and spinal envelopes. A more or less inflammatory ap¬ 
pearance in the sensible portions of the stomachs, and likewise in 
the small intestines. The sympathetic nerves were likewise 
observed to be inflamed, as in the former cases that 1 have 
mentioned. 
With regard to idiopathic tetanus, I am of opinion that a 
diseased state of the digestive organs is invariably the primary 
cause, as, on dissection, I have ever discovered it to exist. 
The reader wil recollect the two cases of idio[)athic tetanus 
