The relation of tetanus to the hypodermic or intramuscular injection of quinine / by Sir D. Semple. --.

  • Semple, David, Sir, 1856-1937.
Date:
1911
Catalogue details

Licence: In copyright

Credit: The relation of tetanus to the hypodermic or intramuscular injection of quinine / by Sir D. Semple. --. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    but as these conditions have no direct connection with quinine as a favouring agent it will be necessary to mention only a few of them. It has long been known that in campaigns where soldiers are subjected to great fatigue coupled with extremes of heat and cold many cases of tetanus occur. Here the depressing influences of fatigue, in conjunction with great heat or great cold, would diminish the resistance in those who harboured infection. Fournier Pescay^ states, '' On several occasions when men had marched all day under a blazing sun in Spain, a number were attacked on the following day with generalised tetanus. Baron Larrey^ states, In the Austrian Campaign in 1809, the wounded who. happened to be most exposed to the cold and damp air of the freezing nights in Spring, after having endured different degrees of very high temperature during the day were almost all attacked with this disease which was prevalent only at this season when the thermometer fell at night to half its daily maximum. The day on which the battle of Bautzen was fought was very hot, and the following night very cold; next day there were 110 cases of tetanus. After Austerlitz, and Eylau and during the retreat from Eussia, there was scarcely a case of tetanus, the temperature was very low but uniform. Seidillots states, Our wounded at Constantine in 1836, who were placed in narrow corridors, and who had to endure hot days and frosty nights, were attacked by tetanus in very large numbers. It will be seen from the few quotations given that extremes of heat, cold, and fatigue, were clearly recognised as factors conducive to tetanus, and at a time when nothing whatever was known about the causal micro-organism. Possibly some of the wounded mentioned by the observers here quoted may have con- tracted tetanus from the ground on which they lay, but the fact of such an acute observer as Baron Larrey associating the disease with extremes of heat and cold is significant, and in the example given by Fournier Pescay the men were not wounded at all. Quinine, when given hypodermically to a spore-infected person would produce favouring conditions for the production of tetanus in two ways— (1) By a paralysing effect on the phagocytes when given in large doses and for some time. (2) By destroying tissues at the seat of injection, and by this means pro- ducing a suitable local anaerobic focus where a stray phagocyte carry- ing tetanus spores might get stranded. It will be seen from the experiments in this paper, that a hypodermic injection of quinine in animals invariably destroys tissue at the site of injection, and dead subcutaneous tissue would act in every way as a suitable medium for the germina- tion of tetanus spores irrespective of how they found their way there.