VIII. The sight of food, after long fasting.
IX. Drunkenness.
X. Certain emotions and passions of the mind. Terror brought it on a brewer in this city. He had been previously debilitated by great labour, in warm weather. I have heard of its having been induced in a man by agitation of mind, occasioned by seeing a girl tread upon a nail. Fear excited it in a soldier who kneeled down to be shot. Upon being pardoned he was unable to rise, from a sudden attack of tetanus. Grief produced it in a case mentioned by Dr. Willan.
XI. Parturition.
All these remote and exciting causes act with more or less certainty and force, in proportion to the greater or less degrees of fatigue which have preceded them.
It has been customary with authors to call all those cases of tetanus, which are not brought on by wounds, symptomatic. They are no more so than those which are said to be idiopathic. They all depend alike upon irritating impressions, made upon one part of the body, producing morbid excitement, or disease in another. It is immaterial, whether the impression be made upon the intestines by a worm, upon the ear by an ungrateful noise, upon the mind by a strong emotion, or upon the sole of the foot by a nail; it is alike communicated to the muscles, which, from their previous debility and irritability, are thrown into commotions by it. In yielding to the impression of irritants, they follow in their contractions the order of their predisposing debility. The muscles which move the lower jaw are affected more early, and more obstinately than any of the other external muscles of the body, only because they are more constantly in a relaxed, or idle state.
The negroes in the West-Indies are more subject to this disease than white people. This has been ascribed to the greater irritability of their muscular systems, which constitutes a part of its predisposing cause. It is remarkable that their sensibility lessens with the increase of their irritability; and hence, Dr. Moseley says, they bear surgical operations much better than white people.
New-born infants are often affected by this disease in the West-Indies. I have seen a few cases of it in Philadelphia. It is known by the name of the jaw-fall. Its causes are:
1. The cutting of the navel string. This is often done with a pair of dull scissors, by which means the cord is bruised.