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September 1948


Author Affiliations

Dr. Smathers is from the Department of Surgery, Wayne University College of Medicine and the Detroit Receiving Hospital, and Dr. Weed is from the Department of Medicine, Wayne University College of Medicine.

Arch Surg. 1948;57(3):291-300. doi:10.1001/archsurg.1948.01240020297001

THE CONTROL of tetanic muscle spasms and neutralization of the toxin constitute the aims in treatment of tetanus. Firor and his associates1 have contributed much to knowledge of the use of antitoxin, but treatment of tetanus is still unsatisfactory and there is a wide disparity in therapeutic regimens employed. It is the purpose of this paper to formulate a plan of treatment based on a review of 82 cases from three Detroit hospitals, including 6 cases in which "intocostrin" (contains raw crude curare), and d-tubocurarine in wax and oil were used in treatment.

Analysis of the entire series is given in table 1. The mortality rate, somewhat higher than reported in other series, is partially explained in table 2, which reveals 36 deaths occurring within forty-eight hours of the time of admission. Nine of the patients died within ten hours, and 1 died in the admitting room.

Table 3