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Emil Amberg, M.D.; Robert S. Hewitt, M.D.
JAMA. 1935;105(8):585. doi:10.1001/jama.1935.92760340001009.
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C. S., a youth, aged 17 years, a patient of Dr. Glenn Stockwell, entered Harper Hospital Oct. 29, 1934. The patient had run a thorn in his right heel October 21, while hunting. For several days there had been a small localized inflammatory area at the site of the wound. About thirty-six hours before admission there was noticed some difficulty in opening the jaws. Physical examination revealed that the neck was somewhat rigid. The lower jaw was drawn back slightly and the patient was unable to open it. The abdominal muscles were very rigid, and all reflexes were extremely hyperactive. There was a definite ankle and patellar clonus. Until November 3, heavy doses of tetanus antitoxin were given. November 3 at 3 a. m. the patient became very cyanotic. Respirations were of Cheyne-Stokes type. The temperature was 103 F. November 5 there was severe urticaria over the entire


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