Tetanus. 293 



Wurtenburg (Hering). It is so prevalent in San Domingo that 

 a gelding costs twice as much as a stallion (Wagenfeld). Heat 

 and filth favor its preservation. 



In man tetanus is most frequent as the result of wounds (in 

 feet and hands) which are most likely to come in contact with the 

 soil, and it has visibly decreased in connection with the general 

 adoption of antiseptic surgery. 



Pathology and Etiology. Sir James Simpson suggested in 1854 

 that puerperal and surgical tetanus was due to the absorption of a 

 poison produced in the wound (Woodhead). Spinola charged it 

 on infection in wounds in horses. Carle and Rattone in 1884 

 successfully inoculated 11 out of 12 rabbits with the products 

 from the wound of a man suffering from tetanus. A year later 

 Nicolaier produced tetanus in animals by inoculating them sub- 

 cutem with garden mould or street dust, and found in the suppur- 

 ating wounds in connection with various other microbes a minute 

 bacillus longer but thinner than that of mouse septicaemia to 

 which he attributed the tetanizing action. In 1886 Rosenbach 

 inoculated two Guinea-pigs with the pus of a tetanic man, and 

 found in the sores of the tetanic pigs the bacillus of Nicolaier in 

 company with another larger spore-forming bacillus. In 1889 

 Kitasato succeeded in making pure cultures of the bacillus tetani, 

 and successfully inoculated the disease on mice, rabbits, and 

 Guinea-pigs producing typical tetanic symptoms and death. This 

 was promptly corroborated by Tizzoni and Cattani and later by a 

 great variety of observers. 



Bacillus Tetani. This organism is a minute rod 4 to 5 /x in 

 length by 0.2 to 0.3/x.in thickness, with slightly rounded ends. 

 In many mature forms the one end is enlarged by the formation 

 of a spherical, refrangent spore which gives the bacillus the 

 appearance of a pin or a " drum-stick." 



The bacillus is anaerobic, liquefying, tardily motile, and sporo- 

 genous. When spores form the bacillus loses its motility. It 

 grows at room temperatures, in ordinary culture media which 

 have a feebly alkaline reaction, and in an atmosphere of hydrogen, 

 but more actively at a temperature of 36 to 38 C. Below 14 C. 

 growth ceases and the bacillus is killed at 6o° to 65 C. The 

 spores, however, can resist a temperature of 8o° C, in water for 

 an hour, and ioo° C. for four minutes. It was this unusual 



