Arch Surg. 1934;29(6):923-928. doi:10.1001/archsurg.1934.01180060030003.
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The ordinary development of tetanus in man comprises tonic spasm of the masseter muscles (trismus) with spreading to other groups of muscles (descending tetanus). Occasionally the spasm is initiated in the wounded limb and extends to the whole body (ascending tetanus) or remains localized in the affected member (local tetanus). Spasm or paralysis limited to one or more muscles of the head may be considered a variety of local tetanus.1

In reviewing reported cases of local tetanus placed on record prior to the World War and occurring in civil practice, I2 encountered only four cases, of which I was doubtful;3 to this number I added a civil case of the monoplegic type developing in a patient who had not received prophylactic antitoxin. During the war the number of cases of local tetanus occurring in inoculated patients rapidly increased, causing an interest among French investigators reflected in the


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