A Study of Tetanus and Its Treatment with Magnesium Sulphate

. Tetanus is a fairly common disease in India ln hospital practice, but a rarity in general practice. Numerous papers have been published lrorri time to time in which the relative merits of the different methods of treatment have been discussed. The treatment with large doses of antitetanus serum, as advocated by Cole and others, has been very favourably reported upon, ^nd is, consequently, the treatment of choice these days. The cost of this treatment however is so high that in India it is quite impossible for most people to bear it. The hospitals too cannot afford to provide such large quantities of this expensive serum for the use of their patients. During a period of four years (1934^1938) Jhave had the opportunity of treating a large number of tetanus cases in the tetanus ward ?f the Patna Medical College Hospital. My experience in the ward soon led me to the conclusion that the search for, and adoption of, a pheaper method of treatment was a matter of Operative necessity, particularly in view of the extreme poverty of the average patient and the Paucity of funds available for treatment in ttiost Indian hospitals. Though the prophylactic treatment has been a great success, the treatment of tetanus, once established, is beset with many difficulties. With the appearance of the earliest signs of tetanus, the tetano-toxin becomes fixed to the nerve cells. J; he neutralization of this toxin, or its' dissociation from the nerve cells and neurones to which it is attached, is generally considered to oe practically impossible. But certain French authors claim that the administration of chloroform may cause the nerve cells to release the ?^n bound to the lipoids of the nerve cells (phylactic theory of Billard) and may thus make possible the maximum antitoxic effect from each injection of antitetanus serum. Yodh's experience with chloroform was, however, by no means encouraging, as in many cases it caused pulmonary oedema and proved fatal.