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Tetanus in its incipiency should not be confused with laminitis involving all four feet, or with certain forms of pleuritis, when careful examination is made, yet, in a way, to one not trained, the clinical symptoms are similar. Disturbances of nerve function are caused in a variety of ways.
This explanation of germ disease is more than simple theory. It has been in many cases clearly demonstrated. It has been found that the bacteria which cause diphtheria, tetanus, typhoid, tuberculosis, and many other diseases, produce, even when growing in common culture media, poisons which are of a very violent nature.
This false Angostura, or Angostura pseudo-ferruginea, comes, it is said, from the Brucea antidysenterica; it acts powerfully on the nerves, produces violent attacks of tetanus, and contains, according to the experiments of Pelletier and Caventon, a peculiar alkaline substance* analogous to morphine and strychnine.
Typhoid has been conquered, and infant paralysis; gangrene and tetanus, which have taken such toll of the wounded in Flanders and France; yellow fever has been stamped out in the tropics; hideous lesions are now healed by a system of drainage. The very list of these achievements is bewildering, and latterly we are given hope of the prolongation of life itself.
Cephalic Tetanus is another localised variety which follows injury in the distribution of the facial nerve. It is characterised by the occurrence on the same side as the injury, of facial spasm, rapidly followed by more or less complete paralysis of the muscles of expression, with unilateral trismus and difficulty in swallowing.
It is true of tetanus that the later the onset after the wound is sustained the better the chance of recovery. This is brought out by the second sentence. The third and fourth sentences record untoward symptoms following a severe wound, now well recognized and watched for by every surgeon.
Stephen, with an arrow wound in the lungs, and several more of these wounds in the chest, could hardly have lived, even without the terrible tetanus. He had spent his time in reading his Mota Gospel and Prayer-book, praying and speaking earnestly to the other men on board, before the full agony came on.
The similarity in the symptoms of tetanus and poisoning by vegetable substances is so great, that were I obliged to affirm by oath what I have now stated, I should hesitate; I therefore repeat to you, I speak not to a magistrate, but to a friend. And to that friend I say.
It is not easy at the present stage to sift that which is tentative from that which will be permanent; but so great an authority as Behring does not hesitate to affirm that today we possess, in addition to the diphtheria antitoxine, equally specific antitoxines of tetanus, cholera, typhus fever, pneumonia, and tuberculosis a set of diseases which in the aggregate account for a startling proportion of the general death-rate.
The classic rusty nail does not deserve the bad reputation as a wound-maker which it enjoys, its bad odor being chiefly due to the fact already referred to, that injuries inflicted by it are most apt to be in the palm of the hand, or in the sole of the foot, and hence peculiarly liable to contamination by the tetanus and other soil bacilli.
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