TETANUS

(Gr. teino, ‘I stretch’), or Lockjaw, a condition of muscular contraction aggravated by the occurrence of convulsive seizures. Tetanus is due to the action of a bacillus which has a terminal spore, hence called the drumstick bacillus. It exists in garden earth and in stables, and finds acce to the body by wounds. The bacillus generates poisons which travel along the nerves to the spinal cord or brain, and give rise to the symptoms by irritating the nerve centers. It may infect the navel of new-born infants, and give rise to Tetanus neon a to rum. It has been introduced by imperfectly sterilized surgical appliances, and occasionally the mode of entrance cannot be traced. The usual seat of inoculation is a wound. There was an enormous incidence of tetanus in the early months of the World War. After sufficient supplies became available, orders were i ued that prophylactic injections of anti tetanic serum were to be given in all cases of wounds, however slight. Thereafter the incidence of tetanus practically disappeared. Symptoms. — Within a few days of the occurrence of infection stiffne of the muscles about the back of the neck and jaws is experienced. This spreads to the trunk, and great rigidity Inay occur. Sometimes the patient may a ume an arched position, with the head and the heels drawn back (opisthotonos); there may be fixation of the jaws (¢rismus) and of the muscles of the face (risus sardonic us). These symptoms are aggravated at intervals, varying from an hour to a few minutes, by painful spasms which may interfere with breathing. Any sudden noise or bright light may induce a convulsive attack. The temp. varies in different cases, but usually rises before the end, and may reach a great height. In the absence of complications death results from exhaustion, and may occur in from one to twelve days, but in milder cases may be deferred for a month. Recovery sometimes occurs, and prognosis is greatly improved by the early use of anti-tetanic serum. In pre-serum days the mortality in cases due to wounds was about 90 per cent.