Dhanusthamba/Dhanurvata/Tetanus

Dr. Mahesh C Kundagol

अन्तरयाम/मन्यास्तम्भ
• मन्ये संश्रित्य वातोअन्तर्यदा नाडीः प्रपध्यते
मन्यास्तम्भं तदा कु र्यादन्तरायामसंग्नितम्
अन्तरायम्यते ग्रीवा मन्या च स्तभ्यते भ्रुशाम्
दन्तानां दशनं लाला प्रुष्टाक्षेपः शिरोग्रहः
ज्रुम्भा वदनसंघ्श्चाप्यन्तरायामलक्षणं ( च.चि. २८/४३,४४)
बहिरायाम
• प्रुष्ट्मन्याश्रिता बाह्याः शोषयित्वा सिरा बली
वायुः कु र्याद्दनुस्तम्भं बहिरायामसंग्नयकं
चापवन्नाम्यमानस्य प्रुष्ट्तो नीयते शिरः
उर उत्क्षिप्यते मन्या स्तब्धा ग्रीवव्यम्रूध्यते
दन्तानां दंशनं ज्रुम्बा लालाश्रावश्च वाग्रहः
जातवेगो निहन्तन्ये वैकल्यं वा प्रयच्छति ( च. चि. २८/४५-४८)
Modern Description
• When the tetanic spasm affects the muscles of the head and
neck the condition is described as trismus. When the spasm
affects the muscles of the back, and pulls the head backwards,
the term opisthotonos is applied; in the opposite condition the
word emprosthotonos was used to indicate the bending of the
body forward, and in cases where the spasm affected one side
of the body, causing it to curve to that side, the condition was
defined as pleurosthotonos. All these states are recognized in
different phases of the disease in the human subject, but they
are rarely met with in the horse, with the single exception of
the first, described as trismus, which is the most common form.
Emprosthotonos
• Etymology: Gk, emprosthen, forward, tenein, to cut
• A position of the body characterized by forward, rigid flexure
at the waist. The position is the result of a prolonged
involuntary muscle spasm that is most commonly associated
with tetanus infection or strychnine poisoning.
Opisthotonus
Opisthotonus or opisthotonos, from Greek roots, opistho
meaning "behind" and tonos meaning "tension", is a state of a
severe hyperextension and spasticity in which an individual's
head, neck and spinal column enter into a complete "bridging"
or "arching" position.[1] This abnormal posturing is an
extrapyramidal effect and is caused by spasm of the axial
muscles along the spinal column.
Pleurothotonus
• Pleurothotonus, also known as Pisa syndrome, refers to an
involuntary state of lateral flexion of the thoracic and lumbar
spine (hence the reference to leaning tower). It is an
extrapyramidal neurological syndrome.
• It may occur secondary to chronic administration or overdose
of antipsychotic medications, as well as antiemetics
चिकित्सा
• वायुना वेष्ट्य्माने तु गात्रे स्यादुपनाहनम् (च.चि.२८/९७)

• तैलं सड् .कु चिते अभ्यंगो माषसैन्ध्वसाधितम् (च.चि.२८/९८)

Vaccination
• Tetanus can be prevented through the use of an
effective vaccine, simple or adsorbed Tetanus
vaccine, combined Tetanus and Killed Polio
vaccine, or the older DTP (diphtheria, tetanus,
pertussis) vaccine. Side effects are rare, but if
they do occur, include:
• Fever
• Pain at the injection site
• Unexplained crying in infants, irritability in older children or adults.
• Severe reactions are extremely rare and include anaphylaxis,
seizures and encephalopathy. These events are thought to occur less
if only the tetanus-diphtheria component of the vaccine is given [
citation needed]
. It is recommended that all infants receive the vaccine at 2,
4, 6, and 15 months of age. A fifth booster dose should be given at
4-6 years of age. After that, it should be given every 10 years.
However, if a bite, scratch, or puncture occurs more than five years
after the last dose of vaccine, the patients should receive another
dose of vaccine.
Treatment
• When a tetanus infection becomes established, treatment usually
focuses on controlling muscle spasms, stopping toxin production,
and neutralizing the effects of the toxin. Treatment includes
administration of tetanus immune globulin (TIG), which comprises
antibodies that inhibit tetanus toxin (also known as tetanus
antitoxins), by binding to and removing unbound tetanus toxin
from the body. Binding of the toxin to the nerve endings appears to
be an irreversible event, and TIG is ineffective at removing bound
toxin. Recovery of affected nerves requires the sprouting of a new
axon terminal.[4] Large doses of antibiotics (such as metronidazole
or intramuscular doxycycline) are also given once tetanus infection
is suspected in order to halt toxin production.
Contd…
• Prevention of tetanus includes vaccination and cleaning the
primary wound. Prophylaxis is effective in the form of a
tetanus toxoid vaccine, which is given with or without
passive immunization with tetanus immune globulin. Very few
cases of tetanus have occurred in individuals with up-to-date
tetanus vaccinations. DPT vaccine (diphtheria-pertussis-
tetanus) is administered in most of the world. It is given at 2, 4,
6, and 15–18 months of age, followed by a booster before entry
to school (4-6 years). This regimen provides protection from
tetanus for about 10 years, and every 10 years thereafter, a
booster shot of tetanus vaccine is recommended.[2]
Attention
• Tetanus is not contagious from person to person, and is the
only vaccine-preventable disease that is infectious but not
contagious. A C. tetani infection does not result in tetanus
immunity, and tetanus vaccination should be given as soon as
the patient has stabilized