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LOCKJAW. (Tetanus)





Category: Infectious Diseases

Tetanus or lockjaw, as it is commonly called, is an
infectious disease and is characterized by painful and violent
contractions of the voluntary muscles; it may be of the jaw alone or of a
considerable part of the body.

Causes. The intelligence and mental faculties are not impaired. In most
cases it follows a wound or injury, although in others there seems to be
no exciting causes. Fourth of July celebrations furnish a great many of
our lockjaw cases. Ten to fifteen days usually elapse after the wound
before lockjaw really sets in.



Symptoms. It comes on occasionally with a chill or chilly feelings;
usually by rigidity (stiffness) of the neck, jaw and face. On arising in
the morning there is sometimes a stiffness of the muscles at the back of
the head. It is not unusual on taking a slight cold to have a stiff neck
and often the patient's attention is not attracted by this symptom.
Sometimes this stiffness begins or soon extends to the muscles of the
lower jaw; the throat becomes dry and is painful and gradually the
stiffness increases to a continuous contraction, spasm, and extends to the
muscles of the trunk and extremities. The body becomes rigid in a straight
line or bent backward, forward or sidewise. This spasm occurs after any
slight irritation and is extremely painful. Temperature is usually low.
During the first spasms the patient may attempt to open his mouth as he
may naturally be suspicious of the trouble that is coming; he succeeds
with difficulty and even finds it hard to swallow; soon the jaws may be
firmly closed, and it is from this feature of the disease that it gained
the name of lockjaw. The contractions in some cases do not extend beyond
the neck and face muscles. During the contractions the face may be drawn
into frightful contortions. Food can be given only through such spaces as
may exist between the teeth, as often the patient cannot open his mouth
himself, nor can it be pried open by any force that would be allowable.
When the muscles of the trunk are affected the abdomen may be drawn
inward, become very hard and stiff, chest movements are affected, making
it difficult to breathe, sometimes almost to suffocation. Sometimes the
body becomes bent like a bow, as in some cases of spinal meningitis, so
that only the head and heels support the weight of the body. The body may
become so rigid that it can be lifted by a single limb as you would a
statue. It is fortunate that there are few cases, comparatively, of
lockjaw as the distorted face and general contractions of the body are
painful to witness.

Recovery. The mortality in lockjaw cases runs about eight per cent.
Sometimes death is caused by exhaustion from the muscular exertions; the
patient is seldom able to sleep and sometimes wears out in a few days.
Sometimes suffocation brings a sudden end to his sufferings and usually
one or two days to ten or twelve days is the limit. Among the lower
classes where sanitary science is seldom observed, and even among the
better classes, lockjaw has been known to occur in infants. It usually
comes on, in ten to fifteen days after birth, and the child seldom lives
more than a few days, It is hard to account for such cases which may come
on suddenly from the slightest excitement such as sudden noises, etc.

MOTHERS' REMEDIES. l. Lockjaw, Successful Remedy for. "A very good and
successful remedy for this disease, is to apply a warm poultice of
flaxseed meal, saturated with laudanum and sugar of lead water, to the
jaws and neck."

2. Lockjaw, Smoke as a Cure for. "Smoke the wound for twenty minutes in
the smoke of burnt woolen cloths. This is considered a never failing
remedy."



PHYSICIANS' TREATMENT. If from a wound cut open and use antiseptics.
Isolate the patient and have absolute quiet. Antitoxin is used with
success in some cases of lockjaw, but this and other remedies or measures
must be handled by a physician, Opium is sometimes given and stimulants
such as brandy, whisky, etc. As it is a case of life or death in a very
short time, we cannot advise depending upon home treatment. A preventive
caution that must always be observed is the use of antiseptics and the
strictest care of all injuries and wounds that might result in lockjaw.
This is a disease where an ounce of prevention is worth a thousand pounds
of cure, because by the time the disease is recognized as lockjaw and has
really made an appearance, it may be too late for medical skill. While you
are waiting for the doctor you may apply cold cloths or even an ice bag to
the spine. If the spasms are severe let the patient inhale chloroform to
kill the pain and quiet him. In the meantime secure the best physician
within your reach, and follow his directions carefully, be calm and self-
possessed when in the presence of the patient, for you must remember that
he has full possession of his mental faculties and will notice every
evidence of fear or worry in the faces of those who are nursing him. This
will only add to his sufferings, affect his nervous system and undermine
his general vitality. Read carefully the nursing department in this book
and you will gain some valuable hints and knowledge regarding the sick
room.





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Previous: MALIGNANT ANTHRAX (swelling)



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