ON IDI0PATx41C TETANUS. 
678 
that have died tetanic, I have invariably discovered the stomach 
and bowels to be diseased, and the sympathetic nerves, through¬ 
out their various ramifications in the abdomen and chest, hig hly 
vascular. The opinions of others prove the correctness of mine*. 
“ Numerous instances could be adduced, in the human subject, 
of indigestible substances, and of tape and round worms, found 
on inspection of the canal in tetanic cases; and a case of tris¬ 
mus, under Mr. Earle, recovered after the expulsion of a tape¬ 
worm from the bowelsindeed, the epithet idiopathic, if 
strictly to mean a spontaneous and exclusive disease, indepen¬ 
dent of the natural sympathy between part and part, is nonsense; 
for the disease in question is evidently symptomatic. Therefore 
in all tetanic cases, whether the morbid contents of the intestinal 
canal, the efifect of a sudden chill of the surface, or the irritation 
of an external injury, prove exciting causes of the tetanic spasm, 
the disease must be equally regarded as symptomatic. In trau¬ 
matic cases, the injury is certainly apparent; but we are not to 
infer from that, according to the axiom, de non apparentibus et 
non existentihus eadem est ratio, that there is no local irritation 
existing in cases apparently idiopathic. My opinion is, that, 
in cases of this description, the disease is first produced in the 
digestive organs; the morbid contents of the intestinal canal, 
acting upon its highly irritable and nervous tissue, produce 
spasm ; the sympathetic system of ganglions and nerves, which, 
more or less directly communicates with all the nerves of the 
body, next becomes disordered ; the cerebo-spinal system sympa¬ 
thizes with them, and participates actively with its distress; 
convulsions are produced, which, once established, soon gain 
ground, and the disease quickly gets beyond the natural sym¬ 
pathies, for w’e cannot easily control it by the removal of the 
exciting cause, and our medicines prove inert. Alcohol,’^ says 
Abernethy, ‘‘ will not fuddle a tetanic patient, opium will not 
make him sleep, and mercury will not salivate him.’' He is un¬ 
susceptible of the excitement of the most powerfi^ medicines ; 
what will produce a considerable effect on others will not in the 
slightest degree affect him. The reason is obvious—the power 
of the secreting surfaces, and those organs by which the supply 
of these fluids is regulated, have become deranged in consequence 
of the loss of nervous energy. 
The secretory organs are supplied principally with branches 
of the great sympathetic, terminating in various ways ; their 
substance gives to each of them a peculiar sensibility, by means 
of which they discover in the blood which the vessels bring to 
* See Veterinarian, 1832, Cases of Tetanus, by Mr. Alex. Henderson. 
