The Rusty Nail (Tetanus Scare)

The Rusty Nail (Tetanus Scare)

I recalled the well-known Telugu (Vemana’s) poem with extreme excruciating pain in the left foot:

చెప్పులోని రాయి చెవిలోని జోరీగ/కంటిలోని నలుసు కాలిముల్లు/ఇంటిలోని పోరు నింతింత కాదయా/విశ్వదాభిరామ వినర వేమ!

Even when the roads and neighborhood are meticulously clean we still see an occasional nail, a broken twig, a discarded soda can, or a car wiper steel blade. In modern towns most things on the road or wayside are harmless except for a sharp nail or screw. On the highways too we come across sharp objects – but it is quite rare here in the northeast US; probably I experienced a few tire blowouts once or twice on expressways moving at seventy miles (mph).

Perhaps some unknowable power is instructing me to write these infrequent articles on personal health and bodily maintenance. They may help other sadhakas (spiritual aspirants) - they may instill some courage in bearing the troubles of a fragile human body. Even with utmost care we can run into unexpected health problems, get a cut here or there, or stumble into thorny bushes or fall into rocky valleys. Or get suspended upside down in a rollover auto accident. Such is life. In most of the developed world tetanus related illnesses (గుఱ్ఱపు వాతము, ధనుర్వాతము) have come down drastically due to the arrival of modern vaccine shots, footwear, and hygiene. The vaccine shots must be administered (and regularly updated) with booster shots every ten years.

Recently I got into this terrible situation (rather, pickle) suddenly out of the blue in one morning. Some weeks ago we went through house repairs (roofing, gutters) work; the contractors did all the cleaning and clearing of debris, they did with utmost meticulous care. We thought all the discarded loose nails were gathered (through a magnetic broom) and thrown into the trash. Then suddenly one day a lone rusty nail was on the garden floor sitting (rather lying horizontally) prettily on the slate tiled floor next to the porch. Unaware of the rusty troublemaker I put my sprightly foot on it while descending on the porch steps. Then everything happened within the blink of an eye: The rusty nail flipped into semi-vertical (450) position, went through the Hawaii slipper (flip-flops), and pierced my sole brutally. At the moment I felt as though I got pierced through the heart. It appears there are very sensitive nerves in our feet, particularly in the underneath cushiony areas.  To help us with our erect walking strides we have soft (rubber like patches) of muscular bumps in our soles, i.e., the underneath of feet. That evolutionary gift helps us walk smoothly without any jerks, with minimum friction on our skeletal frames.

There was nothing I could do immediately after the terrible accident; I was in total shock with the shooting pain, barely able to recover. As I looked at the blood-dripping slipper I realized the enormity of the dangerous situation. Quickly I pulled the nail and limped back into the house. After pressing the wound with a soft white tissue I sealed the spot with a bandage (Band-Aid). My immediate concern was to stop the bleeding quickly, as I am prone to excessive bleeding. Luckily the bleeding stopped fully within ten or fifteen minutes. I kept the wound totally dry for a whole day; later I applied a dab of antibiotic topical cream (Bacitracin), just to be on the safe side.

There was no remnant of the rusty nail (piercing tool) in the foot but I could not trust my own care and instincts. So, I followed it with a visit to our family doctor (GP, Internist). There, in the physician’s office they checked my records for the tetanus vaccine and did a thorough exam of the wound. I was discharged with a course of antibiotics (Cipro) prescription; it was to ward off any spread of infection to the heart, etc.. 

Recuperation 

It took more than three weeks for the wound to heal completely – both externally and internally. Still the wounded region (spot) feels a bit sore to the touch sometimes. A long walk or extended hours of standing vertically does make it slightly painful. At the moment I am using only lukewarm sudsy (soapy) water with Epsom salt. It appears such immersion in warm salty water relaxes the muscles – it offers relief for tired feet. 

How do the elderly adults cope with such wound (puncture, pierced) complications? I am particularly concerned about folks in developing countries without easy access to doctors or modern hospitals. But all is not lost due to lack of money or modern medicines. Many societies have sound cultural roots to overcome minor (or even major) medical emergencies. Usually an herbal doctor is at hand to attend to such wounds. Immediate bleeding arrest followed by proper wound dressing should take care of the problem. However in the case of some adults (elders, seniors) we must also take into account these factors: blood thinner medications, diabetes (type II) complications, and tetanus shots.

Both in the immediate (first aid) wound dressing and follow up care I mostly followed my own instincts and intuition gained through experience. In the early days I used to limp and put greater burden on the other healthy foot.

Of course I learned my lesson through this accidental injury. A thick-soled sneaker would have prevented or at least reduced the severity of the wound. That is why in most factory floors workers are advised to wear strong boots. Also it wouldn’t hurt to keep the premises clean without loose debris, particularly after major repairs. I want to conclude with several herbal remedies for skin lesions: turmeric (పసుపు), marigold (బంతి), vinca (బిళ్ళ గన్నేరు), Aloe vera (కలబంద) and gum Arabic (తుమ్మ). These have been well researched (see Materia Medica India)  and there is substantial literature on the Internet (ex:Traditional therapies for Skin Wound Healing). Ideally keeping the wound dry should make it heal faster; ultimately the physical body heals itself aided by our Guru. Our only concern should be this: not to let the patient slip into a grave tetanus infection or other complicated prolonged wound enlargement, etc. Timely medical intervention is a must for such traumatic situations. While writing this article I often think of individuals in the remote corners of Indian villages or some hilly terrain in the Himalayas. As a kid I used to accidentally step on thorny bushes (Acacia) or on the sharp Date Palm leaves. Then mother or sister would gently apply first aid and ease my pain. And we had many (probably more than a dozen) well-trained doctors of various systems (Ayurveda, herbal, Homeopathy, allopathy) in the village. Often they would attend such emergency injuries without charging upfront fees. The tetanus bacterium is mostly found in agricultural environments. It is also found in animal manure (horse dung) and droppings. People with bare feet are especially vulnerable to wounds on the lower limbs. The bacteria can find its path into the body through any accidental cut. The mortality and morbidity from tetanus complications in India is quite high (>40%), hence beware! Copyright 2025 by the author

 

Boils, Carbuncles, and Furuncles - II

Boils, Carbuncles, and Furuncles (Contd.)

In the early stage, that is when the boil is small and slightly red we can try putting hot pack on the site. Some times the boil will become soft and slowly it will disappear within a day or two. Normally it is not advisable to do pin pricking at home because it can lead to serious infection. It may unnecessarily lead to complications. A number of home remedies can be applied with good results; they avoid direct puncturing of the boil. Here are several inexpensive tricks: 1. Mix freshly cooked white rice with a bit of castor oil and apply to the boil. Cover the paste (poultice) with a plant leaf and apply a tight (but not too tight) bandage to the site. Leave the bandage intact for ten or twelve hours. Hibiscus, castor tree, banana, Four O’clock, gongura – these leaves will work wonders. 2. Instead of rice one can also use a wheat flour paste. 3. Sandalwood paste, particularly freshly ground wet paste also is very effective for boils. It cools the skin (boil) locally and helps in healing fast. 

Traditional (herbal or Ayurvedic) healers use castor, mustard, or neem oil for topical applications. Such oils make the skin soft and prevent additional infections.I should mention here a few (celebrity) cases to highlight the severity of skin diseases. Many people particularly those with brown or dark skin develop pigment (dark) patches due to excessive exposure to sun. One should be careful with sun’s radiation. It can lead to skin cancer – it happened to Sri Ramana, President Jimmy Carter, and senator John McCain. Carl Marx suffered life long with skin problems, particularly boils. 

If a boil, blister, or skin wound happens on outer accessible regions of body, then it is easy to apply bandage or antibiotic ointment (Bacitracin, Boroline, Soframycin). However, some times boils can pop up at very inconvenient places (under arm, inner thighs, etc.) and they can create unbearable pain leading to severe impairment or restricted body movement. If they show up on face – they create embarrassing situations. Often this often happens with facial acne during adolescent growth stage with active hormones. 

Now, internally what to drink or eat? We should try to keep the body in a cool state, in its own natural equilibrium. That means taking good (freshly prepared) food, fresh fruits, juice, yogurt, and buttermilk. Periodically it is advisable to give the skin an oil massage. Often boils happen near the roots of hair; oily skin massage keeps the skin clean, soft, and it helps to retain natural moisture. Avoid as much as possible dry itchy skin situations – this happens in extreme dry hot climate or in cold indoors during winter. 

So, basically we have two or three methods of handling stubborn boils: 1. Take immediate action as soon as it appears. Apply hot pack and massage gently with one of the oils mentioned above. Usually the boil should start improving in appearance. That is, it becomes less red in color and feels a bit soft to the touch. Normally within a few days the skin should return to its normal feel and color. 2. In acute cases we have to resort to minor but very careful local surgery. At this stage one can consult a physician if one can avail easily (within the bounds of cost, accessibility, etc.). Thoroughly clean tools must be used to pin prick the boil. After gentle draining of blood and pus, we have to cover the wound with gauge and keep it dry. In the last stage one can use antibiotic ointment to help in the process of healing. Even a small drop of turmeric mixed mustard oil can seal and heal the broken boil. 3. Applying a poultice is an alternative method to deliberate surgical puncturing. Here we take a warm paste (freshly cooked white rice, wheat flour mixed with castor seed oil) and apply directly to the boil. The poultice is securely fastened to the site with clean leaf (betel leaf, hibiscus, castor seed, banana, etc.) and clean cloth. Usually just one application is enough. Or, one can remove the old bandage and apply a fresh paste after ten or twenty hours.    

According to the Indian Materia Medica  the following help in the management of boils (healing, pressing down, or cracking open): Fig fruit, (country) kanda (Elephant’s Foot Yam, Zamin Kanda/Suran), boiled rice, castor seed, moon plant, fenugreek, thorny amaranthus, onion, tamarind, cilantro (coriander), cumin, clay, gongura, dhaniya, tobacco, sour poyi (Basella alba), drumstick leaves, neem oil, garlic, custard apple, lime, alum, and turmeric. “A stitch in time saves nine” – that proverb holds lot of truth in skin care. Proper nutrition (fruits, buttermilk, vitamin supplements) and a little hygiene do wonders for the skin. Otherwise even a tiny boil can make life unbearable and miserable. This article is no substitute for a doctor’s visit. No AI (Artificial Intelligence) tools were used in writing this article. Copyright 2025 by the author