{"id":459,"date":"2019-05-21T14:22:10","date_gmt":"2019-05-21T18:22:10","guid":{"rendered":"http:\/\/sites.miamioh.edu\/hst-journeys\/?p=459"},"modified":"2024-12-09T13:04:58","modified_gmt":"2024-12-09T18:04:58","slug":"medicine-and-disease-in-history-tetanus","status":"publish","type":"post","link":"https:\/\/sites.miamioh.edu\/hst-journeys\/2019\/05\/medicine-and-disease-in-history-tetanus\/","title":{"rendered":"Medicine and Disease in History: Tetanus"},"content":{"rendered":"\n
\"\"



Wounded Australian soldiers receiving tetanus antitoxin outside a medical dressing station<\/em>. 1918,\u00a0Australian War Memorial E05242, Campbell, Australia.\u00a0 From: Shanks, Dennis. How World War 1 changed global attitudes to war and infectious diseases. <\/em>New York: The Lancet, 2014. \u00a0 <\/figcaption><\/figure>\n\n\n\n

By Karley Carter<\/strong><\/p>\n\n\n\n

Note: Essay 6 in a series, all from Dr. Amanda McVety\u2019s Spring 2019 class on Medicine and Disease in Modern Society <\/p>\n\n\n\n

Tetanus has been a well known disease for thousands of\nyears, with its effects becoming devastating at times when treatment was\nunknown.  Due to developments of the late\nnineteenth and early twentieth centuries, there were revolutionary improvements\nin the way the disease was handled.  While\ntetanus carried with it a lack of social stigma due to its non-communicable\nnature, the fear of tetanus during war time prior to the twentieth century was\nreal.  With the discovery of both the\ntetanus antitoxin and toxoid, tetanus transformed from being a killer in war to\nsomething that was less than an afterthought in the minds of soldiers and the\ngeneral population.   <\/p>\n\n\n\n

            Tetanus has\nbeen regarded in history all through time, with documents noting tetanus\nsymptoms found from 1500 BC in Ancient Egypt, but are thought to have been\ncopied from as early as 3000 BC.[1]<\/sup><\/a>  While there was a general understanding that\nthe disease came from something infecting an open wound, many ideas for\ntreatment were not beneficial, such as early Chinese physicians needling\npatients above the ears around 300 BC, Hippocrates\u2019 ideas in Ancient Greece of\npromoting sweating through drinking strong wines and being wrapped in oil\nsoaked cloths, and ideas in the Renaissance of covering the patient with\nmanure.[2]<\/sup><\/a> The\n19th century was revolutionary for tetanus research, as the disease was first\nreplicated in 1884 through producing tetanus in animals, and pure cultures of\ntetanus bacillus were acquired soon after to study.[3]<\/sup><\/a>  These studies led to Kitasato and Emil von\nBehring among others discovering the tetanus antitoxin in 1891, something that\ngreatly reduced deaths due to tetanus after being administered in World War I.[4]<\/sup><\/a>   In 1924, the first tetanus toxoid was\ndeveloped and was given to all U.S. soldiers prior entering World War II, being\neventually widely administered as the tetanus vaccine in the late 1940\u2019s.[5]<\/sup><\/a>  National report of tetanus cases began in the\n1940\u2019s as well, allowing the decline in tetanus cases over the next half\ncentury to be noted.[6]<\/sup><\/a> <\/p>\n\n\n\n

            Tetanus was\nrelatively well understood in the early twentieth century.  With the new discoveries found between the\n1880\u2019s and 1920\u2019s, tetanus was known to be caused by the bacteria tetanus\nbacillus, which is an anaerobic organism that enters the body through\nsubsurface wounds.[7]<\/sup><\/a>  In addition, there was knowledge of\ncontraction of tetanus being through contamination of the wound with soil, due\nto puncture wounds, wounds entering joints, or through other subsurface wounds,\nsuch as surgical incision sites, that were not properly treated.[8]<\/sup><\/a>  <\/p>\n\n\n\n

While there was ability to destroy the bacteria through\nantiseptics, it was known to be unable to be destroyed in spore form, due to\nits ability to live through a wide range of temperatures.[9]<\/sup><\/a>  This information is relatively true to today,\nwith most discrepancies between the times being small, such as many of the\narticles of the early to mid-twentieth century referring to tetanus as tetanus\nbacillus, with few calling it Clostridium tetani as it is officially referred\nto as today.  There is also a wider\ndescription of causes today as risks and dangers in society have changed, such\nas contraction due to non-sterile needles in drug use, body piercing, and\ntattooing.[10]<\/sup><\/a>  Recent articles also provide more information\non the different kinds of tetanus, being general, local, cephalic, and\nneonatal, describing the specifics of each as well as how common each one is.[11]<\/sup><\/a><\/p>\n\n\n\n

            The\nexperience of having tetanus, if acquired, is very painful and incessant.  After contraction of the disease, the\nincubation period is around 2-21 days, with symptoms tending to start around\nthe seventh or eighth day.[12]<\/sup><\/a>  The first symptoms would be spasms in the\nmuscles near the location of the wound, or tightness in the jaw,  in which the spasms would spread throughout\nthe body as the bacteria travel through the bloodstream.[13]<\/sup><\/a>  Swallowing can become difficult and stiffness\nand pain may occur in the muscles of the shoulders, neck, and back, with\nadditional spasms possibly spreading to the muscles of the arms, legs, and\nabdomen.[14]<\/sup><\/a>  There can be other symptoms too,\nincluding fever, sweating, high blood pressure, and rapid heart rate.[15]<\/sup><\/a>  In some cases, the spasms can be so strong\nthat they causes fractures and muscle tears, as well as ones in the throat that\ncause difficulty breathing and can sometimes lead to brain damage.[16]<\/sup><\/a>\nThese symptoms tend to lessen after around 17 days, but spasms can continue for\nthree to four weeks, and in some cases a recovery can take months.[17]<\/sup><\/a>  The prognosis for the disease can be dire,\nwith twenty-five percent of people with the disease dying if not properly\ntreated, and around ten percent of people with the disease dying when properly\ntreated, even into modern day.[18]<\/sup><\/a><\/p>\n\n\n\n

            The\ntreatments for tetanus created in the early twentieth century completely\naltered the prevalence of the disease. \nThe discovery of the tetanus antitoxin completely changed its effects in\nwar, with soldiers in battle being the primary victims to the disease\nprior.  In the Civil War, one of every\n500 men died of tetanus by sustaining wounds during battle and then becoming\ninfected with tetanus.[19]<\/sup><\/a>  In World War I, there was less than one case\nthat occured for every 5000 wounded, due to the fact that every wounded soldier\nin the U.S. troops received a prophylactic injection of the tetanus antitoxin.[20]<\/sup><\/a>  To create the antitoxin that was distributed,\na tetanus toxin was injected into horses who form antitoxins to protect\nthemselves from the poison.[21]<\/sup><\/a>  The resulting antitoxins created a serum that\ncould be obtained from the horse containing the antitoxin and be used for\ntreatment in humans.[22]<\/sup><\/a>  This was the primary way to treat tetanus\nuntil the development of the tetanus toxoid in 1924.[23]<\/sup><\/a>  While it was not commonly used in the\nthirties,  the toxoid was administered to\nall U.S. soldiers in World War II to protect them from contracting the disease.[24]<\/sup><\/a>  It was then used for the vaccine that was\nadministered to the public, most commonly together with the Diphtheria and\nPertussis vaccine, which created the DTP vaccine.[25]<\/sup><\/a>  <\/p>\n\n\n\n

Unlike many communicable diseases,\ntetanus did not have a strong social stigma, as it was not contagious from\nperson to person.  Although there was no\nstigma, there was still a fear of tetanus in people up until the antitoxin and\ntoxoid became widely available, for soldiers in battle, in cases of surgical\nprocedures gone wrong, and even on the Fourth of July.[26]<\/sup><\/a>  Tetanus cases on the Fourth of July were\nextremely prevalent due to injuries by blank cartridges, firecrackers, and\nother Fourth of July festivities.[27]<\/sup><\/a>  This caused the Fourth to become nicknamed\nthe Bloody Fourth, due to the amount of deaths it caused due to tetanus.[28]<\/sup><\/a>  While this was devastating in the 1800\u2019s due\nto lack of treatment, articles of the 1900\u2019s urged those injured on the Fourth\nto seek treatment to prevent the onset of tetanus, eventually reducing the\nnumber of deaths.[29]<\/sup><\/a>  In addition, there was little regulation by\npublic health officials of tetanus due to it not being contagious.  When looking at the sanitary code from New\nYork City in 1940, tetanus was mentioned as a communicable disease, but there\nwere no specific regulations for it, unlike the majority of other communicable\ndiseases.[30]<\/sup><\/a>   <\/p>\n\n\n\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The discovery of the tetanus antitoxin and toxoid transformed tetanus from being devastating in war to becoming one less trepidation in the minds of soldiers and the general population.\u00a0 This was tremendously helpful during both World Wars, as it greatly reduced deaths which created a better morale for both soldiers and their families.\u00a0 The advancements in science during the late nineteenth and early twentieth centuries caused this disease to become something extremely uncommon in places where vaccines are easily accessible, which helped to manifest the current health system that we know today.\u00a0 <\/p>\n\n\n\n

Karley Carter is a freshman majoring in Architecture with a minor in History. <\/p>\n\n\n\n

Bibliography<\/strong><\/p>\n\n\n\n

Chalian,\nWilliam. \u201cAn Essay on the History of Lockjaw.\u201d \nBulletin of the History of\nMedicine<\/em>.<\/p>\n\n\n\n

           Vol. 8, No.2. Baltimore: The Johns\nHopkins University Press, 1940. JSTOR. <\/p>\n\n\n\n

City\nof New York\u2019s Department of Health, Provisions of the Sanitary Code of the City of New                                                                                                                                      \n                                                                                                  York and Regulations Relative to\nReportable Diseases and Conditions and Control of                  Communicable Diseases.  <\/em>Washington DC, 1940.<\/p>\n\n\n\n

Coleman,\nGeorge E.  \u201cInvestigating Tetanus.\n(Lockjaw).\u201d  The Scientific Monthly.  Vol 31,                   No.\n6.  Washington DC: American Association\nfor the Advancement of Science<\/a>,\n1930.<\/p>\n\n\n\n

Faulkner,\nAmanda E. and Tejpratap S. P. Tiwar. \u201cManual for the Surveillance of                                                                                                   \n            Vaccine-Preventable\nDiseases.\u201d Centers for Disease Control\nand Prevention.  <\/em>November                       17, 2017. \nhttps:\/\/www.cdc.gov\/vaccines\/pubs\/surv-manual\/chpt16-tetanus.html<\/p>\n\n\n\n

Huber,\nJohn B. \u201cTetanus and the Glorious Fourth.\u201d Scientific\nAmerican, <\/em>Vol. 101, No. 1. <\/p>\n\n\n\n

New\nYork: Scientific American, a division of Nature America, Inc., 1909.  JSTOR. <\/p>\n\n\n\n

Krantz,\nC. John. Fighting Disease with Drugs<\/em>.  Baltimore: Williams & Wilkins Co., 1931.           \n<\/p>\n\n\n\n

Lerner, Brenda Wilmoth and K. Lee Lerner,\nInfectious Diseases: In Context.  <\/em>Detroit: Gale,                       2008. \nGale Virtual Reference Library. <\/p>\n\n\n\n

 Spaeth, Ralph. \n\u201cTetanus.<\/em>\u201d  <\/em>The American Journal of\nNursing, Vol. 42, No. 7.  New York:<\/p>\n\n\n\n

Lippincott\nWilliams & Wilkins, 1942.  JSTOR. <\/p>\n\n\n\n

United\nStates Surgeon General\u2019s Office.  FM 21-10 Military Sanitation and First Aid.<\/em><\/p>\n\n\n\n

Washington,1940.\nhttps:\/\/archive.org\/details\/FM2110\/page\/n121<\/p>\n\n\n\n

Vyas,\nM. Jatin et al. \u201cHealth Information from the National Library of Medicine.\u201d MedlinePlus<\/em>,                    Accessed March 1, 2019. medlineplus.gov\/. <\/p>\n\n\n\n

Image:\n<\/p>\n\n\n\n

\nhttps:\/\/marlin-prod.literatumonline.com\/cms\/attachment\/56d4e890-8a72-4555-af18-b889930ad088\/gr2_lrg.jpg\n<\/div><\/figure>\n\n\n\n

Wounded\nAustralian soldiers receiving tetanus antitoxin outside a medical dressing\nstation<\/em>. 1918, Australian War Memorial E05242, Campbell,\nAustralia.  From: Shanks, Dennis. How World War 1 changed global\nattitudes to war and infectious diseases. <\/em>New York: The Lancet, 2014.\n <\/p>\n\n\n\n


<\/p>\n\n\n\n

\n\n\n\n

[1]<\/sup><\/a> William Chalian, \u201cAn Essay on the History\nof Lockjaw,\u201d Bulletin of the History of\nMedicine.<\/em> Vol. 8, No.2 (1940): 173. JSTOR.<\/p>\n\n\n\n

[2]<\/sup><\/a> Ibid.,\n175, 179, 193-194.<\/p>\n\n\n\n

[3]<\/sup><\/a> Ralph Spaeth, \u201cTetanus.<\/em>\u201d\nThe American Journal of Nursing<\/em>, Vol. 42, No. 7, (1942), 733. JSTOR.<\/p>\n\n\n\n

[4]<\/sup><\/a> Ibid.,\n733. <\/p>\n\n\n\n

[5]<\/sup><\/a> Amanda E. Faulkner and Tejpratap S. P.\nTiwar, \u201cManual for the Surveillance of Vaccine-Preventable Diseases,\u201d Centers for Disease Control and Prevention.<\/em><\/p>\n\n\n\n

[6]<\/sup><\/a> Ibid.\n<\/p>\n\n\n\n

[7]<\/sup><\/a> United States Surgeon General\u2019s Office, FM 21-10 Military Sanitation and First Aid <\/em>(Washington, <\/em>1940), 115.  https:\/\/archive.org\/details\/FM2110\/page\/n119<\/p>\n\n\n\n

[8]<\/sup><\/a> Ibid.,\n115.<\/p>\n\n\n\n

[9]<\/sup><\/a> Ibid.,\n115.<\/p>\n\n\n\n

[10]<\/sup><\/a> Ed.\nBrenda Wilmoth Lerner and K. Lee Lerner, Infectious Diseases: In Context (<\/em>Detroit: Gale, 2008), 816, Gale Virtual\nReference Library. <\/p>\n\n\n\n

[11]<\/sup><\/a> Ibid., 817. <\/p>\n\n\n\n

[12]<\/sup><\/a> Ibid., 816. <\/p>\n\n\n\n

[13]<\/sup><\/a> Ibid.,\n816. <\/p>\n\n\n\n

[14]<\/sup><\/a> Ibid.,\n816. <\/p>\n\n\n\n

[15]<\/sup><\/a> Ibid.,\n816. <\/p>\n\n\n\n

[16]<\/sup><\/a> Jatin M Vyas, et al. \u201cHealth Information\nfrom the National Library of Medicine.\u201d MedlinePlus<\/em>,\naccessed March 1, 2019, medlineplus.gov\/.<\/p>\n\n\n\n

[17]<\/sup><\/a> Lerner,\nInfectious Diseases: In Context, <\/em>816.\n<\/p>\n\n\n\n

[18]<\/sup><\/a> Vyas,\n\u201cHealth Information from the National Library of Medicine.\u201d<\/p>\n\n\n\n

[19]<\/sup><\/a> Krantz, C. John. Fighting Disease with Drugs<\/em>. (Baltimore: Williams & Wilkins\nCo., 1931), 107. <\/p>\n\n\n\n

[20]<\/sup><\/a> Ibid.,\n107. <\/p>\n\n\n\n

[21]<\/sup><\/a> Ibid.,\n103. <\/p>\n\n\n\n

[22]<\/sup><\/a> Ibid.,\n103-104. <\/p>\n\n\n\n

[23]<\/sup><\/a> Faulkner and Tiwar, \u201cManual for the\nSurveillance of Vaccine-Preventable Diseases.\u201d<\/p>\n\n\n\n

[24]<\/sup><\/a> Ibid.<\/p>\n\n\n\n

[25]<\/sup><\/a> Ralph Spaeth, Tetanus, <\/em>738-739. <\/p>\n\n\n\n

[26]<\/sup><\/a>  United States Surgeon\nGeneral\u2019s Office, FM 21-10 Military\nSanitation and First Aid,<\/em> 115.  <\/p>\n\n\n\n

[27]<\/sup><\/a> John B. Huber, \u201cTetanus and the Glorious\nFourth,\u201d Scientific American<\/em>, Vol.\n101, No. 1 (1909), 8, JSTOR.<\/p>\n\n\n\n

[28]<\/sup><\/a> Ibid.\n<\/p>\n\n\n\n

[29]<\/sup><\/a> Ibid.<\/p>\n\n\n\n

[30]<\/sup><\/a> City of New York\u2019s Department of\nHealth.  Provisions of the Sanitary Code of the City of New York and Regulations\nRelative to Reportable Diseases and Conditions and Control of Communicable\nDiseases. <\/em>(Washington D.C., 1940).<\/p>\n","protected":false},"excerpt":{"rendered":"

By Karley Carter Note: Essay 6 in a series, all from Dr. Amanda McVety\u2019s Spring 2019 class on Medicine and Disease in Modern Society Tetanus […]<\/p>\n","protected":false},"author":781,"featured_media":460,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"gallery","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[8,26,23],"tags":[],"class_list":["post-459","post","type-post","status-publish","format-gallery","has-post-thumbnail","hentry","category-essays","category-issue-3-volume-iii","category-volume-iii","post_format-post-format-gallery"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/posts\/459","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/users\/781"}],"replies":[{"embeddable":true,"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/comments?post=459"}],"version-history":[{"count":0,"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/posts\/459\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/media\/460"}],"wp:attachment":[{"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/media?parent=459"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/categories?post=459"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sites.miamioh.edu\/hst-journeys\/wp-json\/wp\/v2\/tags?post=459"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}