By Lord Campbell: I believe this is not peculiar to traumatic tetanus, but my observation is taken from such cases.
Examination resumed: There is a contraction of the eyelids, a raising of the angles of the mouth, and contraction of the brow. In traumatic tetanus the lower extremities are sometimes affected, and sometimes, but somewhat rarely, the upper ones. When the muscles of the extremities are affected, the time at which that occurs varies. If there is no wounds in the arms or legs, the extremities are generally not affected until late in the progress of the disease. I never knew or read of traumatic tetanus being produced by a sore throat or by a chancre. In my opinion, a syphilitic sore would not produce tetanus. I know of no instance in which a syphilitic sore has led to tetanus. I think it a very unlikely cause. The time in which traumatic tetanus causes death varies from twenty-four hours to three or four days, or longer. The shortest period that ever came to my knowledge was eight to ten hours. The disease, when once commenced, is continuous.
Did you ever know a case in which, a man was attacked one day, had twenty-four hours’ respite, and was then attacked the next day?—Never. I should say that such a case could not occur.
You have heard the account given by Mr. Jones of the death of the deceased,—were the symptoms there consistent with any forms of traumatic tetanus that has ever come under your observation?—No.
What distinguishes it from such cases?—The sudden onset of the disease. In all cases which have come under my notice, the disease was preceded by the milder symptoms of tetanus, gradually proceeding to the complete development.
Were the symptoms described by the woman Mills as being presented on the Monday night those of tetanus?—No; not of the tetanus of disease.
Assuming tetanus to be synonymous with convulsive or spasmodic action of the muscles, was there in that sense tetanus on the Monday night?—No doubt there was spasmodic action of the muscles.
There was not, in your opinion, either idiopathic or traumatic tetanus?—No.
Why are you of that opinion? The sudden onset of the spasms and their rapid subsidence are consistent with neither of the two forms of tetanus.
Is there not what is called hysteric tetanus?—Yes. It is rather hysteria combined with spasms, but it is sometimes called hysteric tetanus. I have known no instance of its proving fatal, or of it occurring to a man. Some poisons will produce tetanus. Nux vomica, acting through its poisons strychnia and bruchsia, poisons of a cognate character, produces that effect. I never saw a case of human life destroyed by strychnine.