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To the Editor:—
These are some personal observations on the treatment of active tetanus. After the fall of Okinawa and the surrender of many Japanese there were many wounded with active tetanus. They all had complete trismus, many with opistotonos, a few in coma.Our treatment at first consisted in giving tetanus antitoxin intraspinally, intravenously and intramuscularly. The routine consisted of once daily intraspinal and intravenous administrations and a four hour intramuscular sequence. There occurred no change in the clinical state, and after ten days of this treatment without progress we tried the effect of penicillin.The penicillin was given by once daily intraspinal and intravenous injection of 40,000 units and a four hourly intramuscular injection of 20,000 units. The improvement and eventual recovery following the institution of penicillin therapy was very impressive and warrants further investigation.
Margulies HL. TREATMENT OF TETANUS. JAMA. 1946;130(5):305. doi:10.1001/jama.1946.02870050057023