776 PASSIVE IMMUNIZATION SERUM THERAPY 



ally, however, it is far inferior to the latter, for the reason that part of 

 the toxin produced by the tetanus bacilli soon unites with the nerve- 

 cells of the spinal cord. 



One of the greatest dangers from this terrible infection lies in the 

 fact that while the local lesion may show no signs of disturbance, the 

 central nervous system may suddenly manifest symptoms of poisoning. 

 The wounds that are likely to contain the tetanus bacillus are the following: 

 All wounds that may contain dirt contaminated by manure, such as 

 that from the streets, stables, barns, and even fields; wounds made by 

 firecrackers or toy pistols; gunshot wounds, especially those made by 

 blank cartridges; crushing injuries, made by machinery or in other ways. 

 The feet and hands are especially prone to be infected with tetanus germs. 

 Street injuries that are not deep or perforating, but grinding and lacerat- 

 ing, are very likely to develop tetanus infection. It has also been stated 

 that tetanus bacilli may be harbored in an old injury, and yet cause no 

 symptoms until some additional injury or general disturbance of the 

 body causes the normal protection against infection to be broken down, 

 when toxins from the bacilli may be absorbed and tetanic symptoms 

 develop. This theory would seem to be responsible for an otherwise 

 apparently unaccountable development of tetanus. 



From what has been said it will be seen that any injuries received on 

 the street, or those inflicted on workers about horses or cattle and in 

 stables, are more likely to develop tetanus than are injuries received 

 in other ways. New-born babies may be infected through the stump of 

 the umbilical cord. Likewise a suppurating wound, or even a fresh 

 wound, which may be innocent at first, may become infected with the 

 tetanus bacillus if the wound or suppurating focus is improperly cared 

 for. Many cases of vaccinal tetanus can thus be accounted for, i. e., 

 due to negligence in the care and treatment of the wound. It is now 

 generally agreed that proper treatment of the original wound, combined with 

 the administration of tetanus antitoxin, will surely prevent the development 

 of lockjaw, 



In former years Fourth of July wounds claimed a heavy toll of fatal- 

 ities due to tetanus. Owing to the efforts of the American Medical 

 Association municipalities have been urged to adopt legislative measures 

 for enforcing a saner form of celebration, and efforts have been made to 

 educate physicians in the proper care of these wounds and to impress 

 upon them the great prophylactic value of tetanus antitoxin. These 

 efforts have been crowned with success, as statistics collected from all 

 parts of the country will show. In 1903 there were in the United States 

 406 deaths from tetanus; in 1904, 91; in 1905, 87; in 1906, 75; in 1907, 



