A treatise on tetanus : being the essay for which the Jacksonian Prize for the year 1834 was awarded by the Royal College of Surgeons in London / by Thomas Blizard Curling.

  • Curling, Thomas Blizard, 1811-1888.
Date:
1837
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on tetanus : being the essay for which the Jacksonian Prize for the year 1834 was awarded by the Royal College of Surgeons in London / by Thomas Blizard Curling. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    27/132
    Mr. Dickinson mentions an instance of a negro, twelve years of age, in which the disease ended fatally in twenty-two hours.* In the following case, for the particulars of which I am indented to my friend and colleague Mr. Adams, who was called to the patient on the fifth day after the injury, the disease proved fatal in sixteen hours. Case I. October 23, 1S35.—A little boy, ten years of age, and of spare habit, accidentally received the contents of one barrel of a double- barrelled gun loaded with small shot in the lower'part of the calf of the right leg, which carried away a large portion of skin, and ex- posed and lacerated the tendo Achillis. The wound was dressed by a surgeon at Old Ford, where the accident occurred, and during the first few days the patient appeared to be going on well, when on the evening of the fifth day after the injury (Oct. 2Sth) he complained of difficulty in swallowing, the pulse was accelerated, he had passed less urine than usual, and the bowels had not been relieved for two days—there was no rigidity about the muscles of the neck, and the wound was in a favourable condition. Decided symptoms of Teta- nus appeared about three o'clock the following morning, and when seen at 11 a.m., he was labouring under rigid opisthotonos—the body representing a complete arch and immoveably fixed, except during occasional paroxysms, when the curvature was still further increased. The muscles of the abdomen and neck were extremely rigid, and the sterno-cleido imstoidei being thrown considerably behind the axis of motion, had become complete extensors of the head. The jaws were firmly clenched, and the peculiar expression of the eyes consequent upon a partially closed state of the lids, the angles being widely separated, was very striking. He was incapa- ble of swallowing, the attempt inducing a sense of suffocation, and he experienced so much pain during the paroxysms as to cry aloud with agony. The bowels were relieved three times.in the course of the day by means of castor oil, and an enema of the infusion of senna. 13eing placed in a warm bath medicated with a decoction of hops and a drachm of tartar emetic, he was seized with a paroxysm that nearly proved fatal ; but being removed he rallied, and after an enema of 3ss of Tinct. Opii, which had been ordered every hour, was able to open his mouth and to swallow. He was attacked with another paroxysm about 7 *. M., in which he died suffocated, sixteen hours after the first appearance of decided tetanic symptoms, and the sixth day after the injury. In the table, fifty-three cases were fatal within eight days after the appearance of symptoms ; eleven by the following day ; fifteen on the second day after, eight on the third, seven on the fourth, three on the fifth, four on the sixth, three on the seventh, and two on the * Lib. cit.