E. W., a man, aged 27, with a negative history, had a root filling put in a tooth, Jan. 3, 1922. January 15, the neck became stiff, and he was unable to open his mouth. On the 16th, he began to have tonic and clonic spasms, involving all the muscles of the body, particularly the extremities and abdomen. Thirst increased, sweating became profuse, and there was great irritability. On the 19th, 11,000 units of tetanus antitoxin was given subcutaneously by a local physician. January 22, he was removed to the Park Avenue Clinical Hospital, Rochester, where a diagnosis of tetanus was made. The spinal canal was tapped, and he was given 4,000 units of tetanus antitoxin intraspinally, 11,000 intravenously and 20,000 subcutaneously. The filling was immediately taken from the dead tooth, which was extracted on the following day. He was given 200 c.c. of a 25 per cent. solution of
Goler GW, Reitz CM. TETANUS WITHOUT EVIDENT PORTAL OF ENTRY. JAMA. 1922;79(27):2229. doi:10.1001/jama.1922.26420270001015
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