388 TETANUS 



The theory as to the nature of antitoxic action will be 

 discussed later in the chapter on Immunity. 



Methods of Examination in a case of Tetanus. The 

 routine bacteriological procedure in a case presenting the clinical 

 features of tetanus ought to be as follows : 



(a) Microscopic. Though tetanus is not a disease in which 

 the discovery of the bacilli is easy, still microscopic examination 

 should be undertaken in every case. From every wound or 

 abrasion from which sufficient discharge can .be obtained, film 

 preparations ought to be made and stained with any of the 

 ordinary combinations, e.g. carbol-fuchsin diluted with five parts 

 of water. Drumstick-shaped spore-bearing bacilli are to be- 

 looked for. The presence of such, having characters corre- 

 sponding to those of the tetanus bacilli, though not absolutely 

 conclusive proof of identification, is yet sufficient for all practical 

 purposes. If only bacilli without spores resembling the tetanus 

 bacilli are seen, then the identification can only be provisional. 



The microscopic examination of wounds contaminated by soil, 

 etc., may, as we have said, in some cases lead to the anticipation 

 that tetanus will probably result. 



(b) Cultivation. The methods to be employed in isolating 

 the tetanus bacilli have already been described (p. 373). It 

 may be added, however, that if the characteristic forms are 

 not seen on microscopic examination of the material from the 

 wound, they may often be found by inoculating a deep tube of 

 one of the glucose media with such material, and incubating for 

 forty-eight hours at 37 C. At the end of this period, spore- 

 bearing tetanus bacilli may be detected microscopically, though 

 of course mixed with other organisms. 



(c) Inoculation. Mice and guinea-pigs are the most suitable 

 animals. Inoculation with the material from a wound should 

 be made subcutaneously. A loopful of the discharge introduced 

 at the root of the tail in a mouse will soon give rise to the 

 characteristic symptoms, if tetanus bacilli are present. 



MALIGNANT (EDEMA (Septicemie de Pasteur). 



The organism now usually known as the bacillus of malignant 

 cedema is the same as that first discovered by Pasteur and 

 named vibrion septique. He described its characters, distin- 

 guishing it from the anthrax bacillus which it somewhat 

 resembles morphologically, and also the lesions produced by it. 

 He found that it grew only in anaerobic conditions, but was 

 able to cultivate it merely in an impure state. It was more 



