DISEASES PREVALENT IN THE ARMY 301 



In addition there are a fairly large number of other organ- 

 isms which have been isolated from wounds of human beings 

 showing gas gangrene, but which have not the power of pro- 

 ducing the disease in animals. 



Jablons reports that the following organisms are capable of 

 producing a toxin and of progressive tissue necrosis and irre- 

 parable damage to the central nervous system : B. welchi, 

 Vibrona septique, B. cedematiens, B. fallax, B. histolyticus, and 

 B. sporogenes. Against all but fallax and sporogenes it has 

 been possible to produce anti-toxic sera for the treatment of 

 the disease. 



Most of these organisms have been isolated from the soil, 

 and as the troops in the trenches had their clothing constantly 

 coated with mud or dust, it is easy to see how soil organisms 

 would be carried into the wounds on fragments of clothing. 

 They are commoner in soil which is polluted with excrement 

 or heavily manured. As the soil of Flanders and most of the 

 western front has been under intensive cultivation for centuries, 

 all the conditions favorable for the development of gas gan- 

 grene were present. 



The bacilli exert their damaging action very largely in the 

 muscles ; the fibres swell and quickly undergo necrosis with the 

 development of bubbles of gas between the fibres. The quan- 

 tity of gas is sometimes large enough to be felt as a cracking 

 sensation as the hand is passed over the skin. 



The treatment of gas gangrene is primarily surgical and 

 consists of complete extirpation of the necrotic and infected 

 wound down to healthy tissue. This radical treatment is 

 usually referred to as debridement. In addition anti-gas gan- 

 grene serum is used, both as a prophylactic measure and for 

 treatment of recognized cases. 



Anti-gas gangrene serum. Bull, at the Rockefeller Institute, 

 was successful in preparing an anti-toxin against the B. welchi, 

 one of the most important of the gas gangrene organisms. He 

 made use of an observation of Flexner's, that the bacillus of 

 Welch was capable of producing lesions in pigeons quite com- 



