The principles and practice of modern surgery / by Roswell Park ... with 722 engravings and 60 full-page plates in colors and monochrome.
- Roswell Park
- Date:
- 1907
Licence: Public Domain Mark
Credit: The principles and practice of modern surgery / by Roswell Park ... with 722 engravings and 60 full-page plates in colors and monochrome. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![CHAPTER VIII. SURGICAL DISE^VSES COMMON TO MAX AM) 1)( )MESTIC ANIMALS. TETANUS. SjTioiiynis: Trismus, Lockjaw. Tetanus is an acute infccfious disease, of ri-lativcly infrequent oecurrenco, invarinhly of tuicrohic origin, characterized hij more or Ics.s tonic musclr spasm with chniic r.racer- batioiis, whieh, for the most ])art, oeeurs first in tiie nuiscles of tiie jaw and neek, involving progressively, in fatal cases, nearly the entire musculature of the body. Certain races of peoj^le seem predisposed, and in certain climates and geograj)hical areas the disease is exceedingly prevalent. Negroes, Hindoos, and many of the South Sea Islanders show a |x^culiar racial predisposition, and, in a general way, inhabitants of warm countries are less resistant. This is shown partly by the fact that in various European wars the Italians and French have suffered more than the soldiers of more northern climes. Tetanus is by no means confined to adult life, since infants are far from exempt, and in the tropics the trismus of tJie newborn is the cause of a high mortality rate. In Jamaica one-fourth of the newborn negroes succumb within eight days after birth, and in various other hot countries the proportion is at times equally great. One plantation owner states that fully three-fourths of the colored children born upon his plantation succum})cd to the disease. The peculiar reason for this infection will aj>pear later when speaking of tetanus nconatoruvi. ISIen seem more commonly affecteil than women, probal)ly because of their occupations, by which they are more exj)osed. ^Military surgeons have had to contend with the disease in its most virulent form, and it has been noted that soldiers when worn out by fatigue or suffering from the disaster of defeat seemed more liable to the disease. Li LSI3 the English soldiers in Spain suffered from tetanus in the proportion of 1 case to SO wounded men. In the East Indies, in 1782, this proportion was doubled. Quick variations of heat and cold, such as warm days and cold nights, coupled with the other exposures incidental to military life, seem to exert a great effect. Curiously enough, the wounded in many campaigns who have been cared for in churches have suffered more from the disease than those cared for in any other way. Tetanus, however, is by no means necessarily confinetl to any one clime or race, but may be met with anywhere, at any time, providing only that infection has occurred. A celebrated Belgian surgeon lost by tetanus ten cases of major opera- tions before he discovered that the source of the infection was his hemostatic forceps. As soon as these were thoroughly sterilized by heat he had no further undesirable complications. If the disease can be conveyed by the instruments of a careful surgeon, how much more so by the dirty scissors of a careless midwife, etc. It is true, also, that the popular notions of the laity concerning the liability to tetanus after certain forms of injury are not ill-founded. Small, ragged wounds of the hands and feet are those which ordinarily receive little or no attention, and are among those most likely to be followed by this disease. The toy pistol, which, a few years ago, was such a prevalent and widely sold children's toy, was the cause of many a small laceration of the hand, due to careless handling and the peculiar injury produced by the explosion of a small charge of fulminating powder in a paper or other cap. It was not the character of the laceration or injury thereby produced, but the fact that such injuries occurred in the dirty hands of dirty children, which were most likely to become infected, that has caused the so-called toy-pistol tetanus to be raised almost to the dignity of a special form of this disea.se. During the month of July, 18S1, in Chicago alone, there were over 60 deaths from tetanus among children who had been injured in this way by these little toys. This led to their sale being suppressed by law^ Etiology.—Two theories have had strong advocates, one being that which would account for the disease by irritation of nerves; while the second, the humoral, would](https://iiif.wellcomecollection.org/image/b21211176_0105.jp2/full/800%2C/0/default.jpg)
