Tetanus Treated as a Respiratory Problem

Pathologic physiology, pharmacology, and therapeutics of tetanus

“…Agents without continuous artificial respiration. It is certainly possible to control convulsions without depressing respiration sufficiently to require artificial respiration, 51, 82,94,170,195,265,271,272,296,298,310,332,343,381 but it is difficult, 15,154,198,238,268,319,360,364,378,399 and patients cannot generally be safely left alone, for artificial respiration is liable to be needed from time to time. Because of the relative ease of reversing the effect of drugs acting by competition, they would seem to be preferable to depolariZing neuromuscular blocking agents.…”

Tetanus in African Children

“…The most important complications were respiratory obstruction and bronchopneumonia which might have been avoided in many cases had tracheotomy been carried out as recommended by recent authors (Turner and Galloway, 1949;Godman and Adriani, 1949;Creech, Woodhall and Ochsner, 1950;Biehl and Helm, 1951;Herzon, Killian and Pearlman, 1951;Segar et al, 1952;Diaz-Rivera, Trilla and Pons, 1954;Forbes and Auld, 1955).…”

“…According to Herzon et al (1951) this operation was first advocated for the treatment of tetanus by Thomas Curling in 1837 and first performed by G. M. Humphry in 1856, but it did not take its place in routine treatment until recently. Most authors who have written about tetanus during the past few years stress the importance of tracheo-tomy as a means of maintaining a good airway in patients with respiratory difficulty (Harris, McDermott and Montreuil, 1948;Turner and Galloway, 1949;Creech et al, 1950;Herzon et al, 1951;Segar et al, 1952;Diaz Rivera et al, 1954;Forbes and Auld, 1955).…”

Tracheostomy: Its Management and Alternatives

“…From his suggestion two potential benefits of the operation were realized: namely, protection against inhalation of foreign matter into the trachea, and removal by suction of retained secretions in the lower respiratory tract. As a result tracheostomy was reported in the management of other patients with poliomyelitis (Galloway 1943(Galloway , 1946(Galloway , 1947, tetanus (Turner & Galloway 1949), head injuries (Bryce-Smith 1950), chest injuries (Carter & Giuseffi 1951), barbiturate intoxication (Lewy & Sibbitt 1951), after neurological operations (Taylor & Austin 1951), and following other types of major surgery (Atkins 1952). The period of 'enthusiasm' had begun and it became fashionable to say: 'if you think of tracheostomy do it' or 'you should have done it'.…”