“One of the foremost favorites among antiseptics is iodine, which, moreover, possesses the power of rendering tetanus-toxin nontoxic. It seems, then, that iodine can not be considered as the best possible antiseptic for the purpose of destroying the bacilli of tetanus, but that we must look further for such an agent” – The American Journal of Clinical Medicine, Volume 23
Iodine is a natural treatment for tetanus that was used in the 19th and 20th centuries by doctors.
Tetanus is caused by an infection with the bacterium Clostridium tetani, which is commonly found in soil, dust and manure. The bacteria generally enter through a break in the skin such as a cut or puncture wound by a contaminated object. They produce toxins that interfere with muscle contractions, resulting in the typical symptoms. Diagnosis is based on the presenting signs and symptoms. The disease does not spread between people.(Wkipedia)
This article appeared in the The American Journal of Clinical Medicine, Volume 23. Here is the full text below.
For years I have been fully satisfied as to the efficiency of antitetanic serum in preventing lockjaw and have likewise been convinced that the serum is at least of value after symptoms of tetanus have made their appearance. As a matter of course, the European war offers ample opportunities for the study of a great variety of surgical problems and beliefs, more particularly because it necessitates such a large amount of emergencysurgery.
Moreover, the wounds of soldiers requiring treatment practically never are clean; as a rule, they are contaminated. Thus it was that during the early months of the conflict tetanus was of frequent occurrence, until the administration of antitetanic serum as early as possible after injuries had become a routine procedure as a prophylactic measure.
According to some of the military surgeons, tetanus now is infrequent, and they attribute this to the prompt injections of antitetanic serum. On the other hand, others insist that serotherapy has not given any convincing results in tetanus, even as a prophylactic measure, and that it is ineffective after tetanus has actually made its appearance. On the whole, however, preponderating opinion insists that every wounded person should receive a prophylactic dose of antitetanic serum, no matter how insignificant the lesion, if there is any probability of its being contaminated.
In contradistinction to these opposing opinions expressed by European military surgeons, American authors are practically unanimous in asserting the efficiency of specific preventive serum-therapy of tetanus, and this opinion has received support particularly in the experience with injuries sustained during the annual Fourth of July celebrations.
As to this fact, it must not be forgotten, though, that these explosive celebrations have become much less numerous than formerly, because of the crusade for a sane Independence Day some years ago instituted by The Journal of the American Medical Association; nevertheless, the warning and insistent counsel repeated from year to year in all our medical journals, to have resort, in all cases of flesh-wounds, to preventive doses of antitetanic serum, has been an important factor.
In this connection, the idea suggests itself that the relative frequency of tetanus-infection and also its virulence possibly may differ in the United States and in Europe, because in the old world the war is being waged on, and in, soil that has been infected with the specific bacillus during many centuries of manuring, in that respect greatly differing from conditions obtaining in our own country.
Certain it is that the experiences of American physicians and surgeons are so universally favorable to the virtues of antitetanic serum, when used as a preventive, that no medical man dare risk neglecting this precaution in all cases of wounds contaminated by soil.
It would be a mistake, however, to assume that this procedure fully meets all conditions of prophylaxis in the case of contaminated wounds, and that, with it attended to, they may be permitted to close forthwith. A little consideration will show the truth of this assertion.
The tetanus bacillus is not carried into distant organs, there setting up mechanical injuries, as is the case, for instance, in infections with the pyogenic bacteria, with the tubercle bacilli, and so forth. After having entered the wound with contaminated soil, dust, clothing or other fomites, the bacilli of tetanus remain in or near the wound without contributing directly to its seriousness, so that the wound may heal and close; but, the bacilli of tetanus continue to multiply, doing even better, for the reason that they thrive best in the absence of air.
As long as the tetanus bacilli are alive and multiply, however, they produce their characteristic toxins, and these act more particularly upon the nerve-tissues; which accounts for the fact that convulsions are the most characteristic symptoms of the disease of tetanus.
Once the toxins have reached the central nervous system, the difficulty of influencing them by means of antitoxin is immensely greater, because of the fact that the antitoxin, even if administered intravenously, does not reach the nerve-tissues in sufficient amounts to neutralize the toxins. In that case, direct treatment by injection into the spinal canal or along the nerve-trunks affords greater hope of success.
This being so, the preventive treatment of tetanus manifestly consists, not only in administering prophylactic doses of antitoxin, but, in addition, in destroying all tetanusbacilli present in the wound. It must not be forgotten that a certain amount of antitoxin can neutralize only a corresponding quantity of toxin.
If more toxin is elaborated, it must produce symptoms of intoxication, unless it is neutralized by further doses of antitoxin; and it is for this reason that the further secretion of toxins must be prevented by energetic antiseptic treatment of the wound, with a view to destroying the tetanusbacilli harbored by it.
One of the foremost favorites among antiseptics is iodine, which, moreover, possesses the power of rendering tetanus-toxin nontoxic. It was believed, therefore, that the usual treatment of wounds, swabbing them freely with tincture of iodine, would suffice for preventing tetanus. Unfortunately, experimental investigations and clinical observation have not confirmed this opinion, and it seems that iodine can be of use only when it is applied to the infected focus, so that it can come into direct contact with the toxin before this is absorbed. There is, however, this difficulty, that iodine exercises a coagulating action upon albuminous substances and thus tends to seal up the wound, thereby only creating conditions that are favorable for the growth of the bacilli of tetanus.
It seems, then, that iodine can not be considered as the best possible antiseptic for the purpose of destroying the bacilli of tetanus, but that we must look further for such an agent. It appears to me that we have such an agent in the preparation recently elaborated by Dakin and Carrel. This antiseptic, paratoluenesodiumsulphochloramide, or, for short, chlorazene, is attracting wide attention among surgeons the world over, and it promises to prove of far greater and far more universal value than any antiseptic agent with which we now are familiar. I believe that it will be found of service in destroying the bacilli of tetanus present in any wound, and I feel safe in recommending the free use of chlorazene-solution in the treatment of such wounds.
H. J. A CHARD
SOURCE: The American Journal of Clinical Medicine, Volume 23