Question.—“Is it one of the characteristic features of tetanus that the consciousness is not affected?”
Answer.—“It is.”
Dr. Todd, for twenty-one years physician to King’s College Hospital, well known for his lectures on Tetanus and the diseases of the Nervous System, and who had seen only two cases of what appeared to him to be idiopathic tetanus, so rare are they in this country, gave the following evidence:[39]—
“In my opinion the term tetanus ought not to be applied to disease produced by poisons, but I should call the symptoms tetanic in order to distinguish the character of the convulsions. I have observed cases of traumatic tetanus. Except that in all such cases there is some lesion the symptoms are precisely the same as those of idiopathic tetanus. The disease begins with stiffness about the jaw. The symptoms gradually develope themselves and extend to the muscles of the trunk.”
Question.—“When the disease has begun is there any intermission?”
Answer.—“There are remissions, but they are not complete; only diminutions of the severity of the symptoms, not a total subsidence. The patient does not express himself as completely well, quite comfortable. I speak from my own experience.”
Question.—“What is the usual period that elapses between the commencement and the termination of the disease?”
Answer.—“The cases may be divided into two classes. Acute cases will terminate in three or four days, chronic cases will go on as long as from nineteen to twenty-two or twenty-three days, and perhaps longer. I do not think that I have known a case in which death occurred within four days. Cases are reported in which it occurred in a shorter period. In tetanus the extremities are affected, but not so much as the trunk. Their affection is a late symptom. The locking of the jaw is an early one. Sometimes the convulsions of epilepsy assume somewhat of a tetanic character, but they are essentially distinct from tetanus. In epilepsy the patient always loses consciousness. Apoplexy never produces tetanic convulsions. Perhaps I may be allowed to say that when there is an effusion of blood upon the brain, and a particular portion of the brain is involved, the muscles may be thrown into short tetanic convulsions. In such a case the consciousness would be destroyed. Having heard described the symptoms attending the death of the deceased, and the post-mortem examination, I am of opinion that in this case there was neither apoplexy nor epilepsy.”
The deposition of Dr. Bamford, before reported, was here read, his inability to attend from illness having been proved.