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March 14, 1908


JAMA. 1908;L(11):844-846. doi:10.1001/jama.1908.25310370010002b

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Serious mental symptoms of any kind rarely occur during or after an attack of tetanus. In the great majority of cases consciousness remains unclouded, judgment fairly clear, memory good and the moral sense normal, until the end or very near the end. Emotional control, when we consider that almost always the patient, if an adult, knows he is suffering from a very serious disease, is usually better than would be expected. When, then, mental symptoms do occur, three questions arise: (1) Is the abnormal mental state a mere accidental complication, merely happening at the time of the tetanus and in no way caused by it? (2) Is it due to the medication employed? (3) Is it the direct result of the exhaustion produced by the disease or a result of a secondary intoxication set up by the primary intoxication of the tetanus bacillus?

In certain of the acute infectious fevers,

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