Ardern's description of a case of traumatic tetanus is very interesting,
because it contains so many elements that are familiar in the history of
this affection. The fact that it occurred in a gardener from a hook, so
likely to be infected with tetanus bacilli from hay or grass, and that the
wound was made where the thumb joins the hand and where, as we know now,
the construction of the tissues is so favourable to that burying of the
tetanus bacilli away from the free oxygen of the air, giving it a chance
to grow anaerobically, all show the disease exactly as in our own time.
The other details of the case probably indicate a wound of an important
bloodvessel, secondary hæmorrhage after suppuration had been established,
and then the development of fatal subacute tetanus.
"A gardinere whyle that he wrowghte in the vynes kytte his owne hande
with ane hooke uppone a ffryday after the ffeste of Seynt Thomas of
Caunterbury in somere so that the thoombe was altogydere departyd from
the hande saff only in the juncture that was joyned to the hande, and
he myghte boowe bakward the thoombe to his arme and ther stremyd out
therof moche blood.
"And so touchynge to the cure. The thoombe was furst reduced in to his
furste ordre and sowyd and the blood was restreyned with the reed
pouder of launfrankes [Lanfranc's red powder] and with the heerys
[hairs] of ane hare and it was not remevyd une-to the iiide day when
it was remevyd tther apperyd no blood. Thanne was ther putte therto
tho medicines that engendren blood, every day ones repeyrynge the
wounde, and tho it begane to purge itselffe and to gadere mater. And
in the iiiithe nyght after the blood brak out abowte mydnyght in the
wheyghte of ii poundes. And whane the blod was restreyned the wounde
was repeyred frome day to day as it was furste.
"Also in the xithe nyght abowte the forseyd oure the blood brake owt
ayene [again] in more quantyte thane it dyde afore tyme, nevertheless
the blood was staunched, and by the morne the pacient was so taken
with the crampe in the chekes [cheeks] and in the arme that he myght
resseyve no mete in-to his mowth ne neyther opene the mowyth (lockjaw)
and so vexynge the pacient in the xv day the blood brake out ayene owt
of mesure and alwey the crampe endured forth and in the xx day he
dyde."
Public-domain text, read in full here on John Shaqi.
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