TETANUS— LOCKJAW 381 



should be used only when absolutely necessary to keep the 

 animal on its feet and where the temperament of the patient 

 permits of their use. If there is difficulty in defecation the 

 feces may be removed from the rectum. If the bladder is 

 distended it should be emptied best by careful pressure. 

 While theoretically the primary wound should be curetted 

 and disinfected, in the horse this is often a difficult pro- 

 cedure. Furthermore, it is not always possible to find the 

 wound. 



Medical. — Internal medication is of little avail. On ac- 

 count of the danger of drenching, drugs should be given as far 

 as possible with the food and water. To keep the bowels 

 open salts may be administered. Opiates such as morphin, 

 chloral hydrate and the bromids afford only temporary relief. 

 Inhalations of chloroform and ether just before a meal un- 

 doubtedly assist mastication by temporarily relieving the 

 trismus. 



Subcutaneous and intramuscular injections of phenol solu- 

 tions are highly recommended by some authorities. Sub- 

 cutaneously 1 ounce of a 2 per cent, solution or 2 drams of a 

 10 per cent, solution of phenol in glycerin may be admini- 

 stered twice daily. One dram of a 5 per cent, solution may be 

 injected into the muscles of the neck and shoulders. The 

 injection may be repeated once every three hours for the first 

 thirty-six hours. 



Tetanus Antitoxin. — The administration of tetanus anti- 

 toxin, while it confers temporary immunity against the dis- 

 ease, has not proven valuable as a curative agent. It is most 

 affective when used early and in subacute cases. As a cura- 

 tive agent 3000 to 20,000 units should be given. This amount 

 may be split into several doses: For instance, 20 c.c. may be 

 used for the first dose followed by 15 to 20 c.c. in five to ten 

 hours. 



Prevention. — Tetanus may be prevented by thoroughly dis- 

 infecting all fresh wounds and by the use of small doses of 

 antitoxin. In infected districts the use of antitoxin to pro- 

 duce immunity prior to important surgical operations, treat- 

 ment of fresh wounds (especially punctured feet in horses, 

 castrations, etc.) has proved extremely valuable. In coal 



Digitized by Microsoft® 



