Tetanus is a disease caused by an anaerobic bacillus, Clostridium tetani, and characterized by stiffness of the jaw and tetanic spasms of the neck and back. The agent causing tetanus is found in soil and in the gastrointestinal tract of man and many animals. It has been isolated occasionally in man from the body surface and oral cavity. Essential to the development of tetanus is the preexistence or fresh deposit of spores in tissues favoring their growth, i. e., traumatized, inflamed, or necrotic tissue. On occasion such conditions prevail without trauma, and in these tetanus may develop without any apparent wound. The case to be presented is in this category.
The tetanus bacillus elaborates a toxin affecting the anterior horn cells of the brain stem and cord and the myoneural end-plates. Thus, the chief clinical manifestation is tonic spasticity of various voluntary muscle groups, and the symptoms vary with the