In battles during the age of steel, were tetanus infection cases documented and was such an infection a significant risk to wounded soldiers?

by TomTheNurse

I work in an ER. Anyone who gets so much as a paper cut pretty much automatically gets a tetanus shot unless they are a child with up to date immunizations. I was wondering if there were cases documented of tetanus infections after battles prior to the germ theory era and if so did that present a significant risk to the mortality rate among wounded participants.

(I was debating between asking this in /r/askscience and here. I chose /r/AskHistorians because this addresses an issue well over 60 years old. If the AWESOME moderators here feel this would be better answered in /r/askscience, please say the word!)

Aurevir

I've yet to come across a good breakdown of infection types, probably due to both lack of records and insufficient knowledge, but I can provide an illuminating example. At the Battle of Shrewsbury in 1403, England's Prince Henry (the future Henry V) was shot in the face by an arrow which penetrated deeply. He was treated by the surgeon John Bradmore, receiving medical care that was cutting-edge for the time, including the use of honey as an antiseptic, and survived the ordeal without suffering infection.

In Bradmore's account of the post-op treatment he administered, he mentions using "ointment to soothe the muscles" in order to reduce the risk of "spasm, which was [his] greatest fear." It is generally agreed that he was referring to tetanus, and as he had significant experience in dealing with battle wounds, we can extrapolate from there that he had seen tetanus infections before and that they presented a major threat above and beyond that of sepsis or other potential complications.

For further reading on the young prince's injury, including the surgeon's description of his procedure, here's a publicly available source I found: http://historyofdentistry.co.uk/index_htm_files/2006Nov3.pdf

If you expand your purview outside the medieval period, a good era to look for more information on would be the U.S. Civil War, for which I'm sure there's quite a bit of available documentation on medical treatment. If your hospital is associated with an academic institution, or if there's a medical school nearby whose library you could access, that'd be a great place to investigate further.