Traumatic Tetanus Research Articles

Etiopathogenic theories of nervous system diseases in Vilnius in the early 19th century: “insanity and epilepsy exacerbate when the moonlight shines”

Neurology as a separate branch of clinical medicine was not yet formed in Europe in the early 19th century. However, in the medical writings of the Vilnius University (VU) authors of that time, the brain was already called the “noblest organ of the human body”, the seat of the soul, the centre of external senses, and the primary beginning of all bodily movements. The aim of the present study is to reveal various etiopathogenic theories of diseases of the nervous system (NS) in Vilnius region, since this knowledge may indicate that there were some beginnings of clinical neurology in the early 19th century in Vilnius. First, we analysed old doctoral dissertations on NS diseases defended at VU in 1803-1832; we then turned to Consessus Caesareae Societatis Medicae Vilnensis (The Protocols of Vilnius Medical Society) and analysed clinical reports recorded in 1806-1842. Our study revealed that although humoralism was the most popular system of medicine, the main causes of NS diseases were believed to be in the solid parts of the human body (influence of solidism theory). It was also assumed that some NS diseases may be inherited or caused by fetal diseases in utero. On the other hand, one of the oldest theories, imaginatio gravidarum, was still prevalent in Vilnius at the time. It was also stated that some NS diseases may be triggered by physical and mechanical causes, concomitant diseases, medications and drinks, strong emotions, or violation of sleep hygiene. “Inflammatory agents” were reported to cause traumatic tetanus as inflammation spread upwards from the nerve endings, tendons, and ligaments to the brain. The authors also described the theory of “poison, specifically acting on the NS” that was transmitted by a rabid animal to a bitten patient. To describe the etiopathogenesis of spinal cord diseases, the concept of “diminishing vital spirits through the loss of bodily matter” was used (it was claimed, e.g., that excessive number of sexual intercourses dried out the spinal cord). In addition, the astrological causes of NS diseases were also believed to be of great importance (“somnambulism, insanity, and epilepsy exacerbate when the moonlight shines”). Finally, cutting off the Polish plait (plica polonica) was considered to be an essential etiological factor of various NS diseases in Vilnius in the early 19th century.

The case of traumatic tetanus

In speaking with this communication, I mean mainly to give a description of the picture, the data, which I received when studying the brain of a man who died of traumatic tetanus. The interest of this study lies, by the way, in the fact that the material for my work was a fresh human brain, and the study could be done using the Nissl method, which of course is not always possible. We usually have the opportunity to study the human brain already at a time when the corpse has undergone significant decomposition, when, consequently, the application of the Nissl method is not entirely reliable, and the results obtained in this case are inconclusive and doubtful. Since I performed the study of the brain mainly according to the Nissl method, I consider it necessary to say a few words beforehand about this method.

Tetanus, in childhood

110 cases of tetanus, excluding neonatal tetanus, were studied with reference to aetiology, clinical manifestations, prognosis and evaluation of an effective combination of drugs. Most of the children belonged to rural (92.8%) areas, with unhygienic environmental conditions and a poor socioeconomic status. Otogenic tetanus was the commonest followed by idiopathic tetanus (22.6%) and traumatic tetanus (14%). Lockjaw, rigidity, spasm and fever were the most common presenting symptoms. Phenobarbitone and diazepam was the best combination of drugs for the treatment of tetanus. The overall mortality rate was 17.1%. This could be due to the drugs used in the present study. The incubation period, period of onset and fever had an inverse relationship with mortality. Tetanus following injury had the highest mortality (18.7%) followed by otogenic tetanus (16.4%) and cases with unknown aetiology (16%).

RECENT TRENDS IN TETANUS.

Introduction Tetanus, although less common today than in former years, remains a challenge to the medical profession. The case fatality rate for tetanus is generally regarded to approximate 50%, and the organismClostridium tetani, an anaerobic, Gram-positive rod which forms spores, is universal in distribution, particularly in soil and feces. The case fatality rates observed in various studies of tetanus conducted at the Charity Hospital of Louisiana at New Orleans have declined since 1906 but still remain alarmingly high (Table 1). The present review of experiences at this same institution from 1957 through 1961 was undertaken to bring attention to continuing problems in diagnosis and treatment of this preventable infection. Of the 80 patients with tetanus seen at Charity Hospital during this five-year period, 65 had traumatic tetanus and 15 had tetanus neonatorum (Table 2). Their ages ranged from the newborn period to 84 years. Prophylaxis. —Tetanus rarely occurs in

Treatment of traumatic tetanus with report of five cases

Treatment of traumatic tetanus with report of five cases

POSTVACCINATION TETANUS AND ITS PREVENTION

Tetanus as a complication of vaccination against smallpox, while rare, has occasionally developed in the United States. During the past fourteen years cases have occurred in thirty-two states and in the District of Columbia. The complication, however, is almost unknown in Europe and the same condition appears to be true for other portions of the world, although so far as our information goes traumatic tetanus occurs everywhere. CHARACTER OF THE ATTACK The symptoms of postvaccination tetanus do not differ from those of severe traumatic tetanus. The onset is usually from eighteen to twenty-four days subsequent to the vaccination. The first symptoms noted may be difficulty in swallowing or in opening the jaws, or stiffness of the muscles of the back or limbs. Trismus, general spasticity, opisthotonos and generalized convulsions usually develop rapidly. From 75 to 80 per cent of the cases prove fatal, many of them within twenty-four hours from

CALCIFICATION OF THE VAS DEFERENS AND THE SEMINAL VESICLES.

During my stay in the Pathologic Institute of the German University in Prague, I had the opportunity of examining some cases of pathologic changes in the ampulla of the vas deferens and the seminal vesicles. Two of these seemed to be more than ordinarily interesting and, as little is to be found in the literature concerning calcification, particularly in this region, they appear to justify publication. Case 1. —From Professor Pribram's clinic. Patient. —Man, aged 63, died at 5 a. m., Feb. 4, 1906. The body was brought to the pathologic institute with the clinical diagnosis of endarteritis obliterans, gangraena digiti I. et II. pedis sin, tetanus traumaticus . AUTOPSY. Anatomic Diagnosis. —This was briefly as follows: Traumatic tetanus. Old endocarditis involving the bicuspid valve, with stenosis of the opening of the left vein and thrombosis of the valves. Embolism of left popliteal artery, with consequent necrosis obliteration of first and

KENSINGTON INFIRMARY.: A CASE OF TRAUMATIC TETANUS WITH RECOVERY

KENSINGTON INFIRMARY.: A CASE OF TRAUMATIC TETANUS WITH RECOVERY

The Treatment of Traumatic Tetanus with Antitoxins

The Treatment of Traumatic Tetanus with Antitoxins

A Case of Traumatic Tetanus Treated with Antitoxin

A Case of Traumatic Tetanus Treated with Antitoxin

A Case of Traumatic Tetanus Treated by Antitoxin and Morphine: Recovery

A Case of Traumatic Tetanus Treated by Antitoxin and Morphine: Recovery

STAMFORD, RUTLAND, AND GENERAL INFIRMARY.: CASE OF TRAUMATIC TETANUS TREATED BY ANTITOXIN ; RECOVERY IN THREE WEEKS

STAMFORD, RUTLAND, AND GENERAL INFIRMARY.: CASE OF TRAUMATIC TETANUS TREATED BY ANTITOXIN ; RECOVERY IN THREE WEEKS

A Case of Traumatic Tetanus which Recovered Under Antitoxin Injections

A Case of Traumatic Tetanus which Recovered Under Antitoxin Injections

A Case of Traumatic Tetanus which Recovered under Antitoxin Injections

A Case of Traumatic Tetanus which Recovered under Antitoxin Injections

BRECKNOCK INFIRMARY.: A CASE OF TRAUMATIC TETANUS; RECOVERY; REMARKS

BRECKNOCK INFIRMARY.: A CASE OF TRAUMATIC TETANUS; RECOVERY; REMARKS

A Preliminary Report of Experimental Researches concerning the Infectious Nature of Traumatic Tetanus

A Preliminary Report of Experimental Researches concerning the Infectious Nature of Traumatic Tetanus

Abstract of a Preliminary Report of Experimental Researches Concerning the Infectious Nature of Traumatic Tetanus

Abstract of a Preliminary Report of Experimental Researches Concerning the Infectious Nature of Traumatic Tetanus

The treatment of acute traumatic tetanus by curare

The treatment of acute traumatic tetanus by curare

Spontaneous Recovery from Traumatic Tetanus

Spontaneous Recovery from Traumatic Tetanus

Traumatic Tetanus Cured by Nitrite of Amyl

Traumatic Tetanus Cured by Nitrite of Amyl