TETANUS.
Though no case of this disease occurred to us while in Egypt, I met with a severe one on the voyage thither. As I was successful in this case, and by a mode of treatment which, with the theory which gave rise to it, is, I believe, now considered as obsolete, it may not be uninteresting to mention what led me to give it a trial.
In the year 1794, the first tetanic case I met with, occurred at Bergen-op-Zoom. A sergeant of the 88th regiment, after remaining drunk out all night, was in the morning found lying in a ditch. This was in August, and the weather was unusually warm. When brought to the hospital, his jaws were so firmly locked, that the blade of a pen-knife could not be introduced between the teeth. Mercury was had recourse to, but in a few hours the muscles of the neck became convulsed. By the advice of a Dutch physician, a man of great eminence, I immersed my patient four times, in the course of the day, into a bath of broth. He continued in it half an hour each time, and, after he came out, his whole body was rubbed with mercurial ointment. I do not recollect that any thing else was given to him, unless a stimulant enema. Next morning the good effects of the Dutch practice were evident: a violent salivation came on, and, in about three weeks, the man was doing his duty.
In the next case which occurred, though a cure was not completely effected, the same treatment was, for some days, attended with good effects. In the island of Grenada, a negro, attached to our pioneers, received a contusion and a slight wound of the head, which was soon followed by locked jaw. The warm bath, and the liberal use of mercury, were ordered. He, for some time, appeared to be better, and I flattered myself with the hopes of another cure; but the disease gaining ground, the cold bath and the tonic treatment were had recourse to. The patient died.
The next was a sailor, who, a few days before our embarkation, in the Minerva, at Bombay, had been slightly wounded in the foot by a copper nail. On my first seeing him, his symptoms were slight, but were gaining ground fast. On the 10th of December, the day after our embarkation, he had the most violent symptoms of the disease: the jaws were firmly locked; the muscles of the neck, before and behind, were strongly convulsed; and he had twitchings of the muscles of his face. He pointed to the region of the stomach, where, he afterwards told me, that he had intolerable pain and sickness. This man was immediately put under the same treatment as was employed in the case of Sergeant Kirkland, with this difference, that, instead of broth, a bath was made from fat, or what is, on ship-board, called the slush. The same success attended; but the symptoms yielded more slowly, and it was several months before the sailor recovered.
From hearing me relate these successful cases, by the warm bath and mercury, some cases in the Bombay general hospital were treated in the same manner. My friend, Dr Keir, informed me that he tried it in three cases of tetanus, in the garrison hospital. It succeeded in one, but failed in the other two.