CHAPTER XIX 



TETANUS 



History. A disease with such striking, distressing and fatal symp- 

 toms, as those characteristic of lockjaw, could scarcely escape observa- 

 tion and comment whenever seen. It is not, therefore, surprising that 

 the medical records of Greece and Rome supply details of the symptoms 

 and notes of the great fatality of this disease. However, in all ages 

 it has been relatively rare except in certain restricted localities. It was 

 a matter of early record that tetanus was in some way connected 

 with wounds. It was seen to be more common in military than in 

 civil life and in the latter it most frequently follows injury. Before 

 the development of experimental medicine, theories concerning the 

 causation of this disease were many and diversified. It was soon 

 seen that while it generally followed injuries, it did not follow all, and 

 that there was no relation between the severity and extent of the injury 

 and the development of tetanus. The infectious nature of the disease 

 was first emphasized by French physicians, especially Verneuil. How- 

 ever, the first positive demonstration of its infective character was 

 made in 1884 by two Italian physicians, Carle and Rattone, who inocu- 

 lated twelve rabbits with matter taken from an acne pustule on a man 

 with tetanus. Within two or three days, eleven of the animals thus 

 treated developed the disease. Furthermore, they succeeded in trans- 

 ferring the infection to other animals. Soon thereafter, Nicolaier 

 induced tetanus in rabbits, guinea-pigs and mice by inserting bits of 

 earth under the skin. He also found the specific bacillus and grew it 

 in mixed cultures, but failed to separate it from associated bacteria. 

 This was done by Kitasato. 



The Bacillus. Kitasato found that the tetanus bacillus grows only 

 when the air is excluded and that it forms spores which are markedly 

 resistant to high temperature. He smeared the infected material on 

 agar, kept the tubes at incubator temperature for two days, the time 

 required for the bacilli to develop spores abundantly, and then heated 



