BEFORE AND AFTER LISTER 187 



Meantime Souttar 24 extols plenty of fresh air or bet- 

 ter still of oxygen (our old supposed enemies in the 6o's) 

 and says : 



Men with wounds so foul that their presence in the 

 wards could not be permitted, were placed, suitably 

 protected, in the open air, the wounds being left ex- 

 posed to the winds of heaven, covered only with a 

 thin piece of gauze. The results were almost magi- 

 cal, for in two or three days the wounds lost their 

 odor and began to look clean, while the patient lost 

 all signs of the poisoning which had been so marked 

 before. 



Of tetanus in our Civil War there were in the Union 

 army in all 505 cases and 451 deaths, 89.3 per cent. In 

 the War of 1870 i in the German army there were 294 

 cases and 268 deaths, or 91.1 per cent. In the present 

 war there have been many cases in the allied armies in 

 the west, but I have seen no numbers or percentages. In 

 the German army, however, Czerny 25 says that 



the greatest danger to the wounded had been tetanus. 

 Of 60,000 wounded Bavarians, 420 developed tetanus, 

 which proved fatal in 240 cases (57.1 per cent.). The 

 prophylactic value of the tetanus serum had been 

 established, but its extensive employment was not 

 always feasible. 



This is a far larger percentage of cases than in our 

 Civil War, or the Franco-Prussian War, but the mortality 

 is far less probably due to the even partial employment 

 of the serum. 



During the Civil War I never saw a case of "gas gan- 

 grene" which has been so prevalent and dangerous in 



24 Brit. Med. Jour., March 20, 1915, p. 504. 



25 Brit. Med. Jour., March 20, 1915, p. 521. 



