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February 1964

Horse Serum and Horse Sense

Arch Ophthalmol. 1964;71(2):155. doi:10.1001/archopht.1964.00970010171001

An article appearing in one of our sister journals points up the promiscuous use of tetanus antitoxin.* A survey showed that approximately 50% of ophthalmologists would give antitoxin to patients who had perforating wounds of the cornea and who were not known to have had toxoid. The motivation for this liberal use of antitoxin was, according to the author, as much to cover the doctor from medicolegal liability as to cover the patient from tetanus.

Yet antitoxin and other components of the serum are not without their own hazards. They may give rise to an acute anaphylactic reaction (rarely) or some form of serum sickness (commonly). Nor is the usual dose of 1,500 units a certain preventive of tetanus, possibly less effective than a few days of treatment with penicillin or tetracycline.

A study some years ago showed that tetanus resulting from eye injuries was a great rarity even before