It is the time of year when we are out and about, children are running around, and injuries, including puncture wounds are more likely.
The biggest concern with a puncture wound, particularly one that does not bleed, is a risk of tetanus.
Tetanus is an infection from an anaerobic bacteria, Clostridium tetanii that releases a tetanus toxin which blocks nerve conduction in the central nervous system.
The bacteria itself is found in the intestines of animals, and the bacterium itself and its spores are excreted with their faeces and then found in the soil.(1) As we no longer have animals on our streets there is fortunately less infected faeces around, but grassy, bush or farm areas could still be risky, and any dirty penetrating wound that does not bleed should be considered a risk for tetanus.
Symptoms usually appear between 3-10 days after exposure, and include weakness, stiffness and cramps. The old nickname for Tetanus was “lock-jaw”, because difficulty swallowing and chewing is a sign, and as it progresses there can be muscle rigidity and painful spasms with a particular facial grimace. Arching of the back and respiratory paralysis causing death are also consequences of the infection if untreated. (1)
There is no conventional medical treatment of tetanus, and untreated it has a mortality rate of up to 1 in 10, so there is a focus on prevention – and vaccination.
In New Zealand the Tetanus vaccination is only available in combination, usually with Diphtheria and Pertussis in the Boostrix vaccine (for adults) or in Infanrix, for children. After vaccination the antibody response begins to rise until around day 5 and peaks around day 14 (2).
Tetanus itself has an incubation period of 3-21 days, but the average is around 8 days (3), so for those who have not had a tetanus vaccine, or the full recommend course of 3 vaccines, and who have a wound particularly high risk for tetanus, it is Tetanus ImmunoGlobulin (TIG) that is recommended by both the CDC (3) and Starship in New Zealand (4). TIG is the antibodies against tetanus toxoid, and is providing them as the vaccination would not have time to work. A form of this – equine antitoxin – was the earliest form of prevention for tetanus and had an 8 fold decrease in the number of tetanus cases in British forces in World War 1 (5).
Let’s talk about the wounds now, what is risky, and what else can we do?
First of all, clean the wound! Tetanus rates declined from around 1900 which corresponds with increased hygiene and wound care (6). Early and thorough cleaning of wounds is the first step for preventing tetanus (and other infections).
Secondly, take Vitamin C. A number of animal studies show that vitamin C is a viable treatment option for tetanus and for strychnine poisoning (that has similar symptoms) (7). As humans do not create our own endogenous vitamin C we are in more need than animals for supplementation when we have an injury or infection. The timing of supplementation is important too – high dose and early prevented symptoms completely in rats, although waiting until symptoms appeared and then using oral or IV Vitamin C did still prevent death (8).
Thirdly, and my go to, is homeopathic treatment.
There are over 200 remedies that may be useful for someone with clinical tetanus, but this post is more about prevention, so will focus on a few of around 15 remedies indicated for prophylaxis (9). For referencing purposes the information about the following remedies comes from two sources – Clarke’s Dictionary of Practical Materia Medica (10), and Boericke’s New Manual of Homeopathic Materia Medica with Repertory (11).
Ledum is a remedy for puncture wounds that do not bleed. The area may be puffy and will be cool to touch. There may also be muscle twitching near the wound.
Arnica is the classic remedy for any wound or injury, the injury is more likely to bleed, and can have aching pains like they have beaten. Arnica is likely to say “I’m fine” in their shock after an injury.
Hypericum is known for injuries to nerve rich areas, and Clarke specifically notes that it “prevents lockjaw from wounds in soles, in fingers and in palms of the hands.” Pains are excruciating, as nerves are involved.
Silica is used in first aid to help expel foreign objects- so if there is a splinter or, after cleaning, the concern there is still something in the wound, Silica may be useful. Small wounds may also take a long time to heal and can be prone to infection.
Other indicated remedies for prophylaxis include Aconite, Angostura Vera, Brlladonna, Cicuta and Strychnine, (9) although the above four remedies are more useful in the stage just after a wound and are also more common ones you are likely to have in your homeopathic first aid kit.
Even with the three measures above, if you have a dirty, penetrating wound, that is at risk for tetanus, seek medical help.
This post is for information and educational purposes only and does not constitute medical advice, diagnosis or treatment. If you are concerned at any stage you should consult a qualified Medical Doctor. In New Zealand you can also ring Healthline at any time on 0800 611 116 to speak to a registered nurse.
(2) B. A. Halperin, A. Morris, D. MacKinnon-Cameron, J. Mutch, J. M. Langley, S. A. McNeil, D. MacDougall, S. A. Halperin, Kinetics of the Antibody Response to Tetanus-Diphtheria-Acellular Pertussis Vaccine in Women of Childbearing Age and Postpartum Women, Clinical Infectious Diseases, Volume 53, Issue 9, 1 November 2011, Pages 885–892, https://doi.org/10.1093/cid/cir538
(5) Manring, M. M., Hawk, A., Calhoun, J. H., & Andersen, R. C. (2009). Treatment of war wounds: a historical review. Clinical orthopaedics and related research, 467(8), 2168–2191. https://doi.org/10.1007/s11999-009-0738-
(7) Hemilä, H (2012). The Effect of Vitamin C on Tetanus Toxin and Strychnine Toxicity: a Systematic Review of Animal Studies
(8) Dey PK. Efficacy of vitamin C in counteracting tetanus toxin toxicity. Naturwissenschaften. 1966 Jun;53(12):310. doi: 10.1007/BF00712228. PMID: 5986216.
(9) Van Grinsven, E. Complete Repertory Practitioner Edition iOS, version 22.7, release date 1 Nov 2022.
(10) Clarke, J. H. A Dictionary of Practical Materia Medica in three volumes (1902). Available online: http://www.homeoint.org/clarke/
(11) Boericke, W. New Manual of Homeopathic Materia Medica with Repertory (1901). Available online: http://www.homeoint.org/books/boericmm/