muscles are sometimes ruptured by the violence of their own action. The circulating system and sensorial functions are often not much disturbed; but during the whole course of the disease, the bowels are much constipated. In most cases of traumatic tetanus, after four or five days, all the symptoms become aggravated; the countenance is horribly distorted, the spasms of the diaphragm are more frequent and violent, and the patient dies convulsed. Sometimes, though rarely, the fatal termination does not take place till the eighteenth or twentieth day. On dissection, the pharynx is found contracted, and bearing marks of acute inflammation. In one case, which fell under my observation, there was ultimately great difficulty in breathing and expectorating; and on examination, the trachea, as well as the pharynx, bore evident marks of inflammation, and were filled with a viscid mucus. In some instances, there are evident marks of inflammation of the spinal chord; the vessels, more especially at the lower part, are found enlarged, tortuous, and engorged with blood; portions of lymph are seen deposited on the arachnoid covering, and a serous fluid is effused, not unfrequently mixed with blood. Such appearances, however, are not observed in every case of fatal tetanus, and therefore it cannot be asserted as a fact, that the disease is dependent on a morbid condition of the spinal chord, though in certain cases the two affections coexist. By some it has been supposed, that in consequence of the distended and engorged state of the spinal arteries, the origins of the nerves are stimulated, and that a morbid affection of them ensues, giving rise to the tetanic symptoms; but want of uniformity in the morbid appearances prevents such a cause from being generally set down as the origin of tetanus.