THE BACILLUS OF TETANUS. 391 



with garden earth have shown, and are fairly common 

 in New York City. 



Man and almost all domestic animals are subject to 

 tetanus. On examination of an infected individual 

 very little local evidence of the disease can be discov- 

 ered. Generally at the point of infection, if there is 

 an external wound, some pus is to be seen, in which, 

 along with numerous other bacteria, tetanus bacilli or 

 their spores may be found. By successive inoculation 

 of this pus in susceptible animals the disease can often be 

 reproduced for from four to five generations; but some- 

 times there is a break in the chain, which proves that 

 in such cases the infection has been brought about less 

 by the bacilli than by the toxin which was transmitted 

 with them. 



Not only traumatic tetanus, but also all the various 

 forms of tetanus, are now conceded to be produced by 

 the tetanus bacillus puerperal tetanus, tetanus neona- 

 torum, and idiopathic and rheumatic tetanus. In 

 tetanus neonatorum and puerperal tetanus the infection 

 is introduced through the navel and the inner surface 

 of the uterus. It should be borne in mind, however, 

 that when there is no external and visible wound there 

 may be an internal one. Carbone and Perrero report 

 a case of so-called rheumatic tetanus in which attenu- 

 ated forms of tetanus bacilli were found in the bronchial 

 secretions. These bacilli possessed the morphological 

 and cultural peculiarities of the tetanus bacilli, but 

 they did not produce toxin. Similar anaerobes have 

 been found in meat-juices and in the soil. The bacilli 

 found in the bronchial secretions, therefore, may have 

 been tetanus bacilli which, owing to certain conditions, 

 had lost their virulence, just as we know it to happen 



