Book 1
6
In all these varieties, then, to speak generally, there is a pain and tension of the tendons and spine, and of the muscles connected with the jaws and cheek; for they fasten the lower jaw to the upper, so that it could not easily be separated even with levers or a wedge. But if one, by forcibly separating the teeth, pour in some liquid, the patients do not drink it but squirt it out, or retain it in the mouth, or it regurgitates by the nostrils; for the isthmus faucium is strongly compressed, and the tonsils being hard and tense, do not coalesce so as to propel that which is swallowed. The face is ruddy, and of mixed colours, the eyes almost immoveable, or are rolled about with difficulty; strong feeling of suffocation; respiration bad, distension of the arms and legs; subsultus of the muscles; the countenance variously distorted; the cheeks and lips tremulous; the jaw quivering, and the teeth rattling, and in certain rare cases even the ears are thus affected. I myself have beheld this and wondered! The urine is retained, so as to induce strong dysuria, or passes spontaneously from contraction of the bladder. These symptoms occur in each variety of the spasms.
6
But there are peculiarities in each; in Tetanus there is tension in a straight line of the whole body, which is unbent and inflexible; the legs and arms are straight.
6
Opisthotonos bends the patient backward, like a bow, so that the reflected head is lodged between the shoulder-blades; the throat protrudes; the jaw sometimes gapes, but in some rare cases it is fixed in the upper one; respiration stertorous; the belly and chest prominent, and in these there is usually incontinence of urine; the abdomen stretched, and resonant if tapped; the arms strongly bent back in a state of extension; the legs and thighs are bent together, for the legs are bent in the opposite direction to the hams.
