430 Colonel George Adami [Feb. 7, 



the germs of this disease existed in field and garden soil. It was left 

 to Nicolaier, in Germany, to recognise the presence of the charac- 

 teristic drum-stick bacilli — bacilli with a spherical spore at one end— 

 and to the great Japanese bacteriologist Kitasato, to obtain these 

 bacilli in pure culture, and with the pure cultures to reproduce the 

 disease in the lower animals. 



They are remarkable bacilli. Pasteur was the first to show that 

 there exist microbes which can live and multiply in the absence of 

 air and free oxygen, a state of affairs which was thought unbelievable, 

 oxygen being regarded as necessary for life. So it is, but not 

 necessarily free oxygen as it is in the air. These " anaerobes " prefer 

 to obtain what oxygen they want by taking it up in a combined form 

 from their foodstuffs — ^f rom sugars, for example, and proteins — and the 

 tetanus bacilli are anaerobes. As a consequence they will not grow 

 in surface wounds. They need deep wounds such as those made by 

 projectiles, or wounds with pockets. As to these pockets, and how 

 they help the bacillus to grow, Sir Almroth Wright, working for the 

 Medical Research Committee, has made some exquisite observations 

 during the war. It was the leading American bacteriologist. Dr. 

 Theobald Smith, of Boston, who first observed that anaerobes could 

 be made to grow under not strictly airless conditions. He showed 

 that if a small piece of fresh meat, or liver, or kidney be dropped 

 into a tube of broth exposed to the air, and this was then inoculated 

 with the bacilli, they grow in and upon the meat. Wright showed 

 that the same growth occurred if one took a fine capillary tube, filled 

 this with broth containing the bacilli, and dropped it into an ordinary 

 large tube of air-containing broth. Confined in the capillary tube 

 to which the oxygen from the surrounding broth could not gain free 

 access, the bacilli multiplied freely. Evidently the dead tissue of 

 wounds fixes the oxygen in its immediate neighbourhood, and pro- 

 tected thus the bacilli can grow. 



In the States, until quite recently, the crop of cases of lockjaw 

 following 4th of July celebrations was simply appalling. There 

 were more lives lost each year from this cause than in the Spanish- 

 American War. Countless " kiddies " stayed up at night to set off 

 fireworks and crackers in the gardens and streets ; let them explode in 

 their hands begrimed with street or garden earth, and sure enough 

 in a week or two lockjaw set in. Since 1910 or so, " Fourth of July 

 tetanus " has been largely eradicated, and that because everywhere 

 throughout the States tetanus anti-serum or anti-toxin is kept in 

 stock, and the surgeons have been directed in every case of 4th of 

 July wounds to inject immediately an adequate dose, in this copying 

 a procedure originated, if my memory serves me aright, in France in 

 regions where tetanus is common. 



AVhat is this anti-serum ? Well, it is of the same nature as 

 diphtheria anti-toxin. It has been shown that if we take a horse 

 and, beginning with non-fatal, give it progressively larger and larger 



