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Lock-jaw - (Tetanus).Symptoms.- The earliest symptom is usually a stiffness of the muscles about the neck and at the back of the head, which is commonly noticed first upon awakening in the morning. This stiffness extends or perhaps begins in the muscles of the lower jaw, while the throat becomes dry and somewhat painful. At first the pain and stiffness may not attract attention, since precisely similar symptoms may follow exposure to currents of air. But it soon becomes evident that this is something more than the stiffness following a cold, for the jaws are found to be firmly closed by the spasmodic contraction of the muscles; at first the patient opens his mouth with great difficulty and can swallow but imperfectly. It is from this feature of the affection that the disease derives its name of locked jaw. In some cases these contractions remain limited to the muscles about the neck and face. The mouth in many instances cannot be opened either by the patient himself or by the use of any force which it would be prudent to employ; nourishment can only be given through the spaces which naturally exist between the teeth. Sometimes the muscles of the face also are involved in these contractions, occasioning the most frightful contortions of the countenance. Sometimes the muscles of the throat are so much involved that swallowing becomes quite impossible. If the muscles of the trunk also become involved, the movements of the chest necessary to breathing are embarrassed, so that the patient appears at times in danger of suffocation. The abdomen is drawn inward and becomes very hard and stiff. Sometimes the limbs too are similarly affected, so that they are held as firmly as bars of iron. In such cases the entire body may be raised from a single limb or even by the head, as if it were a statue of marble. In many cases when the limbs and trunk are involved in this rigidity the body rests not flat on the back but in the shape of a bow, the weight being supported by the head and heels. Sometimes the body is bowed in the opposite direction, so that the patient can be placed with his head and toes on the floor while the body is raised some inches. It may also happen that the body is bent toward one side or the other. The sufferer from tetanus is a most pitiable object; the remarkable positions which the body assumes during the spasms, the fantastic and distorted countenance produced by spasm of the muscles of the face, the peculiar sardonic grin caused by the contraction of the muscles about the mouth, and withal the evident pain and distress of the individual, combine to render the sight an extremely painful one. The muscles remain rigid continuously, but there occurs at intervals a spasm, whereby the force of their contraction is increased. It is during these spasms especially that the peculiar postures are assumed by the body. These paroxysms occur at intervals and vary extremely in their duration ; they are attended also with extreme pain. These spasms seem to be excited by movements of the body and by mental emotion, and may even be induced by contact of external objects with the skin. The mind remains unaffected ; there is no delirium nor stupor in uncomplicated cases. The spasms are more apt to occur during the day than by night, presumably because the influences which can excite the patient are more abundant by day. There is, usually, some fever, and the skin is often moist with clammy perspiration. The disease usually terminates fatally in from two days to two weeks. Sometimes death is caused by suffocation, the patient's chest being so convulsed that he is unable to draw his breath. At other times the patient's strength cannot be sustained in consequence of the difficulty of introducing nourishment into his mouth ; and in many cases the fatal termination of the disease seems to be the result of exhaustion consequent upon the extreme muscular exertion performed by the patient. This exhaustion is increased by the fact that the patient is usually unable to sleep, being kept in constant wakefulness day and night by the muscular activity. Tetanus, or locked jaw, occurs also in infants. In these cases there is usually no cause apparent for the difficulty ; though it occurs almost entirely among the poorer classes, who live without any observance of the principles of hygiene. It usually appears within two weeks after birth, and commonly terminates fatally two or three days later. The paroxysms are provoked by the slightest causes, such as a flash of light, a breath of air, or a sudden noise. Treatment*-It seems to be well established that tetanus can often be controlled and cured by the use of calabar bean, given in frequently repeated doses, if treatment be begun sufficiently early. Good results have also been obtained by the use of curare. But these remedies are too powerful and too dangerous to be used by any one except a physician. Other measures to be employed are opium, a grain of which may be given every two hours ; chloral, twenty grains of which have been employed in the same way; bromide of potassium, and stimulants, especially brandy and whisky. If the services of a physican cannot be at once procured, the following mode of treatment should be adopted until a medical man can arrive : Ice should be applied to the spine, wrapped up in soft, thin cloths. A grain of opium may be given in a tablespoonful of brandy or whisky, mixed with the same quantity of milk, every two hours. The violence of the spasms may be controlled by permitting the patient to inhale chloroform. The great difficulty attending success in the treatment of tetanus arises from the fact that the disease is not recognized until some time after its appearance, because the early symptoms of lock-jaw are not distingushed from the stiffness and soreness of the neck, such as occurs after simple exposure to cold. It should be remembered that if the patient has been wounded or injured in any way, if even his skin has been bruised, the possibility of tetanus must not be forgotten ; and the appearance of stiffness in the jaws and of difficulty in swallowing must be regarded as the possible evidences of the onset of this disease. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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