Probably the paper by Dr. Lambert of New York, in the _Medical News_,
July 1900, gives fairly the general opinion of the treatment, so far
as the subcutaneous administration of antitoxin is concerned:--
"The following cases of tetanus, treated with antitoxin,
comprise published and unpublished cases. We have a total of 279
cases, with a mortality of 44.08 per cent.: but of these we must
rule out 17 cases--4 deaths from intercurrent diseases, 8 deaths
in cases in which the antitoxin was given but a few hours before
death, and 5 recoveries in which antitoxin was not given until
after the twelfth day (as they probably would have recovered
without it). We have left 262 cases, with 151 recoveries, and
111 deaths, a mortality of 42.36 per cent. Dividing the cases
into acute and chronic, we have 124 acute cases, with 35
recoveries and 89 deaths, a mortality of 71.77 per cent., and
138 chronic cases, with 116 recoveries and 22 deaths, a
mortality of 15.94 per cent. In interpreting critically these
statistics, we see that in acute cases the mortality is but
slightly reduced, being but 72 per cent. instead of 88 per cent.
But, in the less acute cases, there is a decided improvement,
from 40 per cent. to 16 per cent. Taking the statistics as a
whole, there is a distinct improvement in the mortality of
tetanus since the introduction of antitoxin."
It would be foreign to the present purpose to pursue this matter
further: for the other treatments, used by Baccelli and by Krokiewicz,
and the sub-dural use of antitoxin, are also founded on experiments on
animals; and the same will be true of any better method that shall be
developed out of them.
The _preventive_ use of the tetanus-antitoxin, for the immunisation of
human beings or of animals, has given excellent results. Horses are
very apt to be infected by tetanus; and the antitoxin has been used in
veterinary practice, both for prevention and for cure. The curative
results are not, at present, very good. But, as regards protection
against the disease, there is evidence that horses can be immunised
against tetanus by the antitoxin with almost mechanical accuracy. In
some parts of the world, the loss of horses by tetanus is so common
that their immunity is a very important matter; and that the antitoxin
does confer immunity on them is shown by statistics from France and
from the United States:--
1. _France._--"The results of Nocard's method of preventive
inoculations in veterinary practice are most striking. Among 63
veterinarians, there have been inoculated 2737 animals with
preventive doses of antitoxin, and not a single case of tetanus
developed; while during the same period, in the same
neighbourhoods, 259 cases of tetanus developed in non-inoculated
animals." (_Med. News_, 7th July 1900.)
Public-domain text, read in full here on John Shaqi.
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