This section is from the book "The Home Hand-Book of Domestic Hygiene and Rational Medicine. Volume 2.", by J. H. Kellogg, M.D.. Also available from Amazon: The Home Hand-Book of Domestic Hygiene and Rational Medicine, Volume 2.
Begin suddenly; muscles of the throat and jaw usually affected first: sensation of stiffness and difficulty in swallowing: jaw becomes set. mouth closed, teeth clenched; mouth drawn to one side; in children, mouth partly open and lips puckered; muscles of the back, neck, and abdomen hard and tense: violent spasms every few minutes; sometimes body bent back in the form of an arch, patient resting on head and heels: pulse frequent and feeble: great thirst, but difficulty and great increase of pain on attempting to swallow; frightful suffering.
This disease most frequently occurs in adults, though it is not unknown in children, in whom it generally occurs soon after birth. It is a very fatal disease, death generally occurring within three to fourteen days. When life is prolonged more than two weeks the prospect of recovery is greatly increased.
The most common cause is lacerated or contused wounds, especially wounds in which foreign bodies are left in the tissues, as from splinters, rusty nails, glass, bullets, etc. Wounds of the extremities are much more likely to give rise to tetanus than those of any other part of the body. It is generally believed by physicians that the affection is most often caused by taking cold in a wound, and not by the wound alone. In infants, it always occurs within one to five hours after the fall of the navel string, and probably arises in the same way as from wounds. The disease generally makes its appearance within nine days after the occurrence of the wound; when the interval is longer than this, it is said to be chronic. The disease is most common in tropical countries, and affects negroes more than people of other nationalities.
Nearly all known remedies which affect the nervous system have been tried; the majority, however, without any effect, as the disease still continues to be one of the most fatal maladies which the physician has to encounter. The most effective remedy is the continuous application of the ice pack to the spine. Ice bags or rubber bags filled with ice-cold water, frequently changed, should be employed if possible; care should be taken to keep other portions of the body dry. Prof. Niemeyer recommends the use of warm baths. Either the full bath or the hot-air bath may be employed. Probably the most effective is the Russian bath, in which the patient can lie full length while the bath is being administered. Care should be taken to give the patient an ample supply of fresh air at all times. This is especially necessary on account of diminished ability of respiration. When the patient is not able to swallow without great suffering, as is generally the case, nutritive injections should be employed.