TETANUS. 381 



until there is sufficient toxemia to produce spasms, and 

 that therefore it is impossible to attack the disease in its 

 inception ; we are obliged to meet it upon the same 

 grounds as diphtheria in the later days of the disease — 

 a time when it is well known that the chances of im- 

 provement are greatly lessened. 



Of course, as there is no other remedy that combats 

 the disease at all, the antitoxin is one which, when ob- 

 tainable, should always be employed. 



While tetanus antitoxin is extremely disappointing in 

 practice for the cure of the disease, even when it is admin- 

 istered, as Roux has suggested, by injection beneath the 

 dura mater, it is most satisfactory for its prevention. In 

 the biological laboratory of the H. K. Mulford Co., where a 

 large number of horses are constantly being injected with 

 toxins of various kinds, and having antitoxic blood with- 

 drawn day after day, the number of horses that died of 

 tetanus was alarming, on several occasions reaching as 

 high as 10 per cent. It occurred to me that these horses 

 should be kept immunized to tetanus by periodical injec- 

 tions of tetanus antitoxin — say every three months. This 

 was tried with the greatest success, and the results given 

 in a paper by Mc£arland and Ranck 1 show that teta- 

 nus immediately disappeared from these stables, the 

 deaths falling to less than 1 per cent. The inference that 

 is to be drawn is that " an ounce of prevention is better 

 than a pound of cure, " and if the surgeon would admin- 

 ister a prophylactic injection of the antitoxin in every 

 case in which the occurrence of tetanus was at all likely, 

 the disease would rarely develop. 



An interesting observation has been recently made by 

 Wasserman, 2 who, assuming that the destruction of 

 nerve-cells in the cerebrum and cord during tetanus tox- 

 emia might have something to do with immunity, be- 

 lieved it possible to obtain from these cells an immuniz- 

 ing substance. Investigating the subject, he found that 



1 Proceedings of the American Veterinary Medical Association , 1 899, p. 258. 



2 Berlin, klin. Wochenschrift, 1898, No. I. 



