THE NATURE OF THE DISEASE 461 



The nature of the disease. The effects of the disease are due 

 to the action of toxins produced by the bacilli upon the central 

 nervous system. The bacilli themselves apparently do not move 

 from the deep seated area of entrance. The symptoms of tet- 

 anus are usually noticeable any time from two to nine days 

 after a wound has been received. The bacillus which entered the 

 wound as a spore may require some time to become active again. 



Treatment. When the organisms have once started to produce 

 their toxins, hope of controlling the disease is only slight. The 

 toxins, even though present in the minutest amount, are so very 

 poisonous to certain parts of the brain and spinal cord that all efforts 

 to neutralize or counteract the activity are usually of no avail. 



Whatever treatment is given must be early. Wounds likely 

 to be contaminated with tetanus, as those into which soil 

 may have entered, or gunshot wounds, should be opened and 

 washed with a strong antiseptic. If the danger of infection is 

 considerable, the wound should be cauterized. In addition to 

 this, a dose of tetanus antitoxin (antitetanic serum) ought to be 

 administered. When precautions have not been taken and " lock- 

 jaw " sets in, the serum injected into the spinal canal sometimes 

 brings about the desired result. 



Tetanus antitoxin. Certain State Departments of Health pre- 

 pare antitoxin to be used both in the prevention and in the treat- 

 ment of the disease. Tetanus bacilli are grown in broth, away 

 from the air. The resulting liquid, loaded with tetanus toxin, is 

 filtered gradually and injected at intervals, in increasing amounts, 

 into the veins of a horse. Later, a large amount of blood is drawn 

 from the animal and the serum is separated. This serum con- 

 tains antitoxin which has been produced in the horse to neu- 

 tralize the introduced toxin. The serum is known as the anti- 

 tetanic serum. The antitoxin has a high preventative but a low 

 curative value. Its production is in many ways similar to that 

 of diphtheria antitoxin. 



