Additional Observations UPON THE Tetanus and Hydrophobia.
SINCE the publication of the foregoing observa|tions, in the second volume of the American Philosophical transactions, I have received letters from several physicians in America, and one from Doctor James Currie of Liverpool, in Great-Britain; in each of which are contained cases that confirm the efficacy of tonic remedies, more especially of wine and the cold bath, in the cure of tetanus. My own experience has furnished two new cases, in addition to those which are published, in favor of the first of those remedies, joined with mercury. I am, notwith|standing, obliged to own, that the method of cure above mentioned has failed, in some instances, in the hands of several respectable practitioners in Philadel|phia; but I have reason to believe it was only where it was not used in the first stage of the disorder, or where every possible advantage has not been taken of the combined powers of all of the tonic remedies that have been mentioned.
THE Rev. Dr. Henry Muhlenberg, principal of the German college in Lancaster, informed me in the month of June 1787, that he had often met with the trismus nascentium among the children of poor peo|ple Page 178 belonging to his congregation. After reading the account of Doctor Evans's successful method of pre|venting that disorder in Jamaica, by means of gentle purges, he recommended that practice to the parents of children where he suspected the disease might take place, and always with success.
THE more I have considered the causes and symp|toms of hydrophobia, the more I am disposed to ascribe it to the same proximate cause as the tetanus. 1. They both affect the muscles of deglutition. I have lately seen a tetanus brought on by a fractured leg, in which an attempt to swallow the smallest quantity of any li|quid, produced the same sudden and general convul|sions which occur in the hydrophobia. 2. They both proceed from causes which appear to be related to each other, viz. from wounds, and from the action of cold after the body has been previously weakened by heat and exercise. Of the last, we have a remarkable proof in an account of a spontaneous hydrophobia, publish|ed by Mr. Arthaud, president of the circle of Phila|delphians at Cape Francois, in the first volume of the transactions* of that new and enterprizing society. 3. They both sometimes appear as symptoms of the same idiopathic disorder, viz. the hysteria. 4. They both yield to the same remedies, viz. to the excite|ment of an inflammation in the wounded part of the body, or to a long continued discharge of matter from it, and to mercury. Of the efficacy of each of these remedies, there are proofs, not only in Mr. Arthaud's observations upon the hydrophobia, before mentioned, but in Vanswieten's commentaries upon Boerhaave's aphorisms.†.
Page 179 TO these facts I shall add one more, which may serve still further to establish the sameness of the indi|cations of cure in the tetanus and hydrophobia. In the London medical journal for the months of April, May, and June, 1784, I find the following account published by Doctor De Mathiis, physician to the king of Naples' army.
IF more facts should occur, which shall shew the relation that the tetanus and hydrophobia have to each other, perhaps we may be led to conclude, that the wound inflicted by the teeth of a dog sometimes acts in the same manner in producing hydrophobia, that wounds made by a nail, or any obtuse lacerating in|strument act, in producing tetanus; and that both dis|eases may be prevented, or cured, with equal certain|ty by the same tonic remedies.