TETANUS FOLLOWING SURGICAL 

 WOUNDS 



By HENRY SMITH, V.H.S. 



Up to the present time tetanus following operation 

 has been put to the charge of the surgeon. The impli- 

 cation has been that he introduced the tetanus through 

 suture, lotions, dressings, instruments, sponges, or from 

 his own hands or those of his assistants — not a very 

 comforting reflection for the surgeon. Why should this 

 tetanus occur in spite of the utmost care on the part 

 of the surgeon? I believe that the reason is explained 

 by Sir David Semple's paper. An anaerobic area has 

 been left — the sine qua non for the development of 

 tetanus from tetanus spores. Sir David Semple has 

 shown that the spores of tetanus are frequently present 

 in the human intestine. He has shown that when tetanus 

 spores are injected into a given area of a guinea pig, and 

 quinin injected into a different area of the same guinea 

 pig, tetanus bacilli are to be found in the anaerobic 

 slough produced by the quinin and nowhere else, and 

 that a control guinea pig which has similarly received 

 an equal number of spores, but has not received any 

 quinin, is not affected by tetanus. How do the spores 

 reach the anaerobic area in this case? I can explain it 

 only on the supposition of some of them traveling 

 through the blood circuit and eventually becoming 

 stranded in the area of dead anaerobic tissue, where 

 they develop into toxin-producing tetanus bacilli. 



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