This is a disease of the true spinal system, and is manifested by spasm and rigidity of the voluntary muscles. When the muscles of the neck and face are affected it is termed Trismus, or locked-jaw; when the muscles in front, Emprosthotone, when the muscles of the back, Opisthotonos; and when bending to either side, Pleurosthotonos.

Tetanus may be either acute or chronic; the former is the most frequent and most formidable; the latter, apt to be partial, milder, and more subject to treatment.

It is called traumatic when it follows a wound or injury, and idiopathic when of spontaneous origin.

Acute traumatic tetanus is more common in hot climates, and in military practice, and may follow a slight bruise or puncture, especially if some nerve has been injured. The symptoms may appear in a few hours, or in many days; at first, there is a stiffness and soreness about the neck and face, the contraction of the muscles causing a ghastly smile; chewing and swallowing are difficult, the forehead is wrinkled, eyeballs are distorted, nostrils dilated, and the grinning countenance is expressive of horror. Respiration is rapid, the tongue protrudes, and the saliva dribbles. The mind is clear until just before death, which generally takes place in a few days.

TREATMENT. -- The indications are to remove all sources of irritation and diminish the spasm. The wound is to be cleansed from all foreign bodies, pus to be discharged by a free incision, if necessary, and warm anodyne poultices and fomentations are to be applied. Excision of the wound, or division of the nerve leading to it, may be done by the surgeon. Nutrition and opium are indispensable; the latter may be used either externally or internally. A lobelia emetic, if it can be administered, should be given, and a brisk purgative should be given. Tobacco, either by the mouth, or in enema, is an excellent relaxant. Camphor, assafoetida, etc., may also be used as anti-spasmodics. Cannabis indica internally, and ice to the spine, have been used advantageously in some cases. If, in opinion of the attending physician, it is necessary, chloroform or ether may be used as an anaesthetic.