TYPICAL figures from the recent literature show that the mortality in tetanus varies from 35%1 to 63%.2 Experimental physiological3 and histopathological4 studies reveal the primary factor to be respiratory failure. In addition, the use of central-nervous-system depressants may contribute to respiratory decompensation.
These facts on mortality, pathogenesis, and causation of death3 prompted the present inquiry into the rationale of the current treatment of tetanus. In this review six cases of tetanus are presented in which, during the clinical course, tracheotomy was required for the patients' survival.
REPORT OF THE CASES
Case 1.—F. C., a Negro woman aged 57, entered the hospital on Feb. 7, 1950, at 12:45 a. m., with generalized spasms and trismus of two days' duration. Four days previously she had accidentally spilled boiling water on her left thigh. She applied sodium bicarbonate and soap to the burn. Two days later she was
EMANUEL HERZON, EDGAR KILLIAN, SAMUEL J. PEARLMAN. TRACHEOTOMY IN TETANUS. AMA Arch Otolaryngol. 1951;54(2):143–156. doi:10.1001/archotol.1951.03750080031003