A Case of Traumatic Tetanus successfully treated by Anaesthetic
agents. By T. F. Betton, M. D., of the Borough of German-
town, Philadelphia county.
On Thursday, September 22d, 1853, I was called to see a
young man of some nineteen or twenty years of age, boarding at
Rockville Place, (the residence of Capt. J. D. Miles,) in this
borough. He was supposed to be affected with cholera, or yel-
low fever, and the alarm of the inmates of the house was not in-
considerable. I saw him about 6 o’clock, P. M., and found him
laboring under intense pain in the nape of the neck and back of
the head, and also in the right hypochondriac region, extending
towards the epigastrium. The history of the case given to me
was, that he had arrived in the 11 o’clock train from Philadel-
phia, and walked over to Rockville, a distance of one and a half
miles, feeling very well; nothing peculiar was observed about
him. He himself informed me that about 3 o’clock, P. M., feel-
ing a desire to evacuate his bowels, on retiring for that purpose
he was seized with great pain in the bowels, accompanied by
vomiting and purging. These circumstances, with the addition
of a violent convulsion, gave rise to the idea of cholera. When
I saw him he was strongly convulsed and agitated by the spasms
so characteristic of tetanus, (opisthotonos,) 'which I, at once, sup-
posed the disease to be. On questioning him, however, as to
whether he had recently received any sort of wound, he replied
in the negative. I then concluded that I was mistaken, but his
mind, up to that time, not being very clear, I determined to act
on my first impulse, and treat the case as one of tetanus. I
gave him, at once, a large dose of Hoffman’s anodyne, and tr.
valerian with tr. opii, the only remedies at hand. His spine was
also freely rubbed with a liniment composed of aq. ammon. fort.,
ol. succ. rect., spts. terebinth, and tr. opii, in equal parts. A pill
of one grain of calomel, and half a grain of opium, was directed
to be given hourly. I visited him at 10 P. M., and found the
spasms still as strong as ever, but his mind being somewhat im-
proved, he informed me that some three weeks previously, (in
this he was incorrect, it was but one week,) he had been hurt by
a nail in his foot. On examining his foot, no mark of injury
could be discovered, but great tenderness on pressure existed
near the ball of the great toe. I made a deep incision in the
part affected, without any apparent benefit. Continued the re-
medies during the night, with the addition of tr. cantharid., and
tr. capsici to the liniment.
Friday, 8 o’clock, A. M.—Condition worse. Inability to swal-
low, difficulty of speech, and, thinking himself dying, he had
taken leave of his friends. Spasms increasing in frequency and
intensity. Having provided myself with a mixture of three parts
of sulphuric ether to one of chloroform, I instantly caused him
to inhale it. The result was most gratifying. The spasm
ceased as soon as the anaesthetic exerted its influence, and he be-
came calm. In a few moments he was able to swallow some
brandy and water. The original treatment was continued, with
directions to let him inhale the ether whenever a spasm began to
manifest itself. 3 o’clock, P. M.—Progressing favorably,
spasms perfectly controlled by the remedies, which were con-
tinued. 71 o’clock, P. M.—My friend Dr. Ashmead, of this
borough, saw him with me, and approving of the treatment, it
was continued. My friends, Dr. Squire, and Mr. Henry, student
of medicine, having kindly consented to watch him during the
night, he was left to their care, and I have sincere pleasure in
saying that, to their judicious attention, skilful nursing, and
management of the anaesthetic, his life is mainly due. A mix-
ture of chloric ether and chloroform was freely administered
during the night, (about every fifteen minutes for four hours,')
whenever an indication of spasm was present. Beef tea and
brandy and water were also given.
Saturday, 8 o’clock, A. M.—Much improved, free from spasm.
Seven o’clock, P. M.—Doing well, had a slight spasm at eleven
A. M., and one, more slight, at three, P. M., none since.
Sunday.—This day was passed in tranquillity, his appetite is
good, and condition in every way favorable.
Monday, 9 o’clock, A. M.—Improving rapidly, and may be
fairly considered convalescent. He has been entirely free from
spasm for about forty-two hours.
Tuesday.—Has discharged his doctor, and considers himself
well.
I now regret that I did not employ the chloroform on Thurs-
day evening, instead of waiting until Friday morning, as he
would have been saved some spasms. To the anaesthetic alone I
attribute his recovery, and its influence appeared almost miracu-
lous. May it not be equally valuable in hydrophobia ?