Abstract

Although tetanus is rarely encountered in temperate zones, it remains quite common in tropical areas. In India, where patients may not report for treatment until late in the course of the disease, the mortality is high, varying between 46 and 56% 1 Since the discovery of immunoprophylaxis and immunotherapy about 50 years ago there has been little further advance in the treatment of clinical tetanus save perhaps for the introduction of penicillin and tracheotomy 2 as prophylactic measures against complications of the disease. It is well known that the severity of tetanus can be estimated from the period of incubation, time between injury and first symptom, and from the period of onset, time between the first symptom and the development of convulsions. When the incubation period is less than seven days or when the period of onset is less than 48 hours, there is little chance of recovery. In a

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