The treatment of clinical tetanus is in an uncertain and unsatisfactory state. The mortality is high; there is no agreement as to the form of treatment that gives the best results, and the therapeutic use of antitoxin has not brought about an appreciable decrease in the death rate. The explanation commonly given for this therapeutic failure is that tetanus antitoxin cannot neutralize toxin which has become fixed by the tissues. It is impossible to verify this statement in human beings, but with dogs Abel and his associates have thrown some light on the fate of tetanus toxin in the body.1 They have shown that up to a certain time one or more lethal doses of toxin which are apparently fixed can still be neutralized if considerable excess of antitoxin is given, but if administration of antitoxin is delayed for too long a time the fixed toxin is not susceptible
FIROR WM. INTRATHECAL ADMINISTRATION OF TETANUS ANTITOXIN. Arch Surg. 1940;41(2):299–307. doi:10.1001/archsurg.1940.01210020095011
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