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Some Horse-sense about Tetanus
Tetanus bacteria are found naturally, and always, in the bowels and droppings of horses. When deep wounds in humans (or even horses) are infected with tetanus bacteria, a toxin is produced which causes the illness also known as "lockjaw" Tetanus has nothing whatsoever to do with rust, by the way. You could go into a chemistry lab, open a jar of iron oxide (rust), rub it on your arm all day and not get tetanus. You could have pure iron oxide injected into your bloodstream or even eat it, and you would likely get sick. It would not, however, be tetanus.
The only reason an old rusty nail is associated with tetanus is that it might now be where horses had once been. Encased spores of tetanus bacteria can survive in a dormant state, like seeds, for eighty years. Stepping on a nail delivers the tetanus bacteria spores into the body as if from a dirty hypodermic needle. So tetanus shots are given to this day, even though horses are so rarely around us any more.
During the Civil War, horses were like trucks and cars are today, performing the same function of personnel and equipment transport. Wagons, cannons, ambulances and officers were all horse powered. Confederate cavalrymen J.E.B Stuart and Bedford Forest had thousands of horses with them at a time. Union cavalry forces were even larger. At the time of the Battle of Chancellorsville in 1863, Union cavalry general George Stoneman had some 9,000 horses at his command (Furgurson, 1992). Can you imagine what their camps must have been like?
Why are we horsing around with all these numbers? Let me get to my "mane" point: it is remarkable that there were so few cases of tetanus during the Civil War. Battlefield wounds were very numerous, very severe and very dirty. Blood and tissue and horse droppings were everywhere. Lockjaw cases were not. During the 1860's, surgeons did not even wash their hands, let alone their instruments. Tetanus bacteria must have been literally everywhere, with countless infected, ghastly wounds to match. After a typical battle, thousands of men might lay with their innards on the ground. Forget your visions of neat uniforms and waxed mustaches and glory. Pain and disease and mud and filth and horses were this war.
In the course of the Civil War, medical records and statistics were maintained and published. This is how we know that many more soldiers were killed by sickness (fever and diarrhea in particular) than by bullets or cannon. Of the over 600,000 soldiers who died in the four years of conflict, at least two out of three died of disease.
We know the death rates from various types of amputation, which ranged from 20 to nearly 90 percent, depending on location. And, we know that "lockjaw" cases placed far down on the casualty lists, and numbered surprisingly few: 2,050 cases per 100,000 wounds, a rate of just over 2 percent (Miller, 1994). That, with no sterilization of medical instruments, and not a pair of clean hands in sight. And with all those horses around.
There were still one or two Civil War veterans alive when I was a very little boy in Rochester, New York. There also were just a few working horses left. I can remember horse teams drawing the huge rakes that swept the public beaches clean along Lake Ontario. The degree of tetanus exposure on that beach never occurred to most parents. When we cut ourselves, barefoot boys like myself often didn't even tell our parents. Who wanted to be stuck with a hypodermic needle? A lot of the kids on those beaches had not had tetanus shots, and yet (as in the Civil War), the number of tetanus cases was near zero. I never even knew anyone who had had tetanus. It was, I think, more than just a matter of luck.
When it comes to eradicating tetanus, I think you could make as glowing an argument for the internal combustion engine as you can for vaccination. As gasoline powered vehicles totally replaced horses, there must have been drastic reductions in our exposure to tetanus bacteria.
To bend the needle a bit further, let's look at another kind of injection against tetanus. Over forty years ago, Frederick R. Klenner, M.D. cured tetanus with massive doses of vitamin C (Klenner, 1954 a, b). In some treatments, Dr. Klenner used as much as 250,000 milligrams of vitamin C per day, most of it intravenously. Between 350 to 1,000 mg of vitamin C per kilogram body weight per day was his standard therapeutic oral dose. (Klenner, 1979). While he was indeed in favor of vaccination, Dr. Klenner described tetanus fatalities as being due to conventional medical treatments for the disease and not due to tetanus itself (Smith, 1988).
I offer neither an argument against horses nor against those who freely choose vaccination. This chapter is presented, like one side of a good debate, to get you past the sound bytes and to look into the subject yourself. The human body is almost unbelievably resilient. Perhaps a bridle needs to be put on over-praising or over-using the tetanus shot. Today, horses are rare and shots are the rule. Let us take a moment and accurately recall the days when it was the other way around.
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