This section is from the book "Smith's Family Physician", by William Henry Smith. See also: Natural Physician's Healing Therapies: Proven Remedies that Medical Doctors Don't Know.
"Some of the most modern French writers on Tetanus hold that it is always an inflammatory complaint; and that it consists essentially in inflammation of the spinal marrow; and some of them have sought to remedy it by enormous bloodlettings, from fourteen to fifteen pounds of blood being taken in the course of a few days by one practitioner, and another bleeding his patient eight times, and applying 792 leeches along the course of the spine, and to the stomach. But this doctrine of inflammation being at the bottom of every case of Tetanus is contradicted by the plainest facts; and the practice founded upon it has been pushed to an extravagant and absurd extent." "Some writers, especially MM. Laurent and Lombard, nave maintained that Tetanus is almost always, even when it supervenes after wounds, the result of the presence of worms in the digestive organs." Almost all the acute and severe traumatic cases are fatal. Hennen declares that he never saw a case of "acute symptomatic Tetanus" recover. Dr. Dickson found all curative measures followed by "unqualified disappointment." Mr. Morgan, of Guy's Hospital, uses these words: "I have never yet seen or heard of an instance of recovery from acute Tetanus."
On the other hand Dr. E. Watson, of Glasgow, has collected the history of eighteen cases treated with Calabar Bean, of which ten resulted in recovery. Dr. W. W. Keen obtained recovery in one case under the use of one or two hundred minim doses of the Tincture. Dr. E. Watson, and Dr. Eraser, of Edinburgh, have used much smaller doses; Jive drops of the Tincture, or one grain in substance. Chloral Hydrate has been given, with success in some cases, by Verneuil, Dufour, Denton and others.
The American physician, Dr. Rush, regarding the disease as essentially a disease of debility, wrote a paper to recommend the employment of bark, and wine, and spirits in full doses. It is curious enough, that no matter how much wine may be swallowed by the patient, nothing like intoxication is produced by it. The system resists the ordinary influence of the alcohol. In one instance related by Dr. Curric, the disease lasted six weeks, and in that space of time the patient drank 110 bottles of Port wine. The same author mentions a remarkable case, in which a horse, which was attacked by Tetanus, and happened to be a great favourite with its master, was treated with wine,and got well, after swallowing more Port wine than he was worth. Whenever this plan has appeared to do good it has been in the more chronic variety of the complaint.
The warm bath has been tried, and in some cases has been found useful. The cold has also been tried. In one case, at St. Thomas's Hospital, a tetanic patient, at his own request, was plunged into a cold bath. "All the symptoms disappeared, says Mr. Morgan, in a moment; and he was almost immediately taken out of the bath, but he was taken out lifeless." Sir James McGregor says that, during the campaign in Spain, "the warm bath gave only momentary relief; the cold bath was worse than useless."
Opium is a medicine which has been much used in Tetanus, and from which much has been expected. Very large doses of it have been given and borne in Tetanus; and some have recovered under its use, and more have died. Sir Thomas Watson says: "I was assured by a physician, with whom I formed an acquaintance in Edinburgh, some years ago, that his own wife, while labouring under a tetanic affection, swallowed, in twenty successive days, upwards of 40,000 drops of laudanum, which is at the rate of more than four ounces a day; in all, more than two imperial quarts. The lady recovered."
Purgatives have been much used, and much recommended in Tetanus, and in some cases considerable benefit has been derived from their use; but it is hard in this disease to get them to act. An extraordinary case is detailed by Dr. Briggs, in the fifth volume of the "Edinburgh Medical and Surgical Journal." In little more than 48 hours, the patient in that case took 210 grains of Scammony, 89 of Gamboge, 80 of Calomel, an ounce and four scruples of Jalap, and 2 1/3 pints of Black Dose: and all this without either sickness or griping; but on the contrary, with the most decided benefit. In the first week of his disease, the patient swallowed of Calomel 280 grains, Scammony 260, Gamboge 110, Jalap 3 ounces and 10 grains, Infusion of Senna 5 5/6 pints. And altogether, in the first 25 days-of Calomel 320 grains, Scammony 340, Gamboge 126, Jalap 5 ounces and 7 1/2 drams, Infusion of Senna l0 2/3 pints; besides an ounce and a half of the Colocynth Pill.
Turpentine has been recommended in Tetanus. It should be given in ounce doses, combined with Castor Oil.
Tobacco is said to have proved more efficacious in this disease than most other remedies. It is usually given in the form of injection after the bowels are cleared, or without waiting for that, if the symptoms are urgent. It soon induces deadly sickness, cold perspiration, fainting, and relaxation of the muscles, followed perhaps by sleep. But it is a dangerous remedy, and care must be taken to keep up the strength, and to administer hot brandy and water, or other stimulants, if the heart's action appears enfeebled.
Dr. E. M. Wuth, surgeon to the Springsure Hospital, Queensland, last year published a case of a young man who got Tetanus from a fall from his horse. After giving a statement of the case and the symptoms, he says: "From all the remedies tried I thought Chloroform deserved here the first rank, and it was administered therefore by me for three consecutive days, and with temporary benefit. However, on the fourth day of my treatment, terrible opisthotonos recurred, and the patient was so weakened, and the tetanic symptoms had so gained command over him, that it led me to inject half-a-dram of a solution of one drop of pure Nicotine in an ounce of pure water, into the cellular tissue of the thigh. Though immediately the pulse sank to 60, the temperature showed little deviation. All the muscles, except those of the neck, suddenly relaxed, and presently the patient began to perspire. He fell into a sound sleep for four hours, after which he had fully recovered the use of the organs of speech. His first question was: ' What has the doctor done with my thigh? I feel all benumbed.' He then partook of some wine and water, and an egg beaten up in milk. The injection was used at twelve o'clock at night. The patient awoke about four o'clock next morning." One hour later a pill of one grain of Extract of Tobacco was given; he again awoke drowsy at nine o'clock a. m. Although his body felt very sore, the tetanic symptoms had ceased, and from this time his bowels and bladder acted regularly. A pill of the same extract was given for three nights following, after which the patient felt, and has been since, as well as ever.
Dr. A. Or. Lawrence of Chepstow, last year published a case of Tetanus, successfully treated with Hydrate of Chloral; and Dr. Widerhofer also last year published a case of Tetanus in a child at the end of the first week after birth. It was then a fine, healthy-looking child of three months old. This is the sixth case (out of ten or twelve) that Dr. Widerhofer has had of recovery under Chloral. Dr. Widerhofer gives from two to four grain doses of Chloral, by injection, if the infant cannot take it by the mouth.
A most extraordinary case of cure of Tetanus is recorded in Tonka (Op. Cit., p. 444.) "A ship was trading on the coast of Angola in 1763, and a native boy, who was ill with Tetanus, had been treated for some days without benefit by the ship's doctor. His case was considered hopeless, when one of the savages cured him in the following extraordinary manner. He made a small wound in the thigh, into which he inserted a pipe, and then blew with all his might, till the whole body was inflated with emphysema. Strange to say, the boy recovered from that moment."
It is in all cases necessary to keep up the strength by beef tea, wine, arrow root, etc., especially towards the close of the malady. Mr. Travers believes that more patients have •been lost from want of nutriment than from want of medicine. Where there is a difficulty in swallowing, beef tea may be given as an injection. The following plan, according to Sir Thomas Watson, has been in use for some time in lunatic asylums. It is strongly recommended, after much experience of its value, by Dr. Moxey. The patient is supposed to be lying on his back, and restrained, should restraint be necessary. A small wedge-wood funnel is then held in one of his nostrils, through which food, or drugs, in a liquid form, or of such consistence as to allow of its being poured, may be passed to the throat, where the muscles of deglutition will catch and carry it onward to the gullet, in spite of any effort made by the patient to prevent it. Whatever is so administered should first be warmed.