PREVENTION I93 



§ 149. Prevention. Owing to the wide distribution of 

 tetanus bacilli, precautions can consist only of the careful and 

 thorough disinfection of all wounds. With animals at pas- 

 ture, it is impossible often to know of the wounds until it is 

 too late to apply this measure. In stables where the disease 

 becomes prevalent, the floors and siding should be thoroughly 

 disinfected and special watchfulness exercised to find at the 

 earliest moment any injury by which infection could occur. 

 The practitioner should learn as soon as possible the tetanus 

 infected lands and stables in his commnity and, knowing 

 these, give wise instruction to his clients to take such precau- 

 tions as are possible. If the present knowledge of this disease 

 is properly availed of, there should be only occasional cases 

 which as yet there seems to be no way to avoid. 



§ 150, Tetanus antitoxin. It was first pointed out by 

 Behring and Kitasato that animals could be made immune to 

 tetanus by using cultivations of the tetanus bacilli which had 

 been attenuated with iodine trichloride. The blood serum of 

 such immunized animals has the power to immunize healthy 

 animals against the disease and to render the toxin in animals 

 affected with tetanus inert. The antitoxin is prepared now, 

 however, by injecting horses with the filtrate of bouillon 

 cultures, either alone or with a quantity of antitoxin. After 

 the first dose the animal becomes tolerant to a certain degree 

 so that by repeated and constantly increasing doses complete 

 resistance to the toxin is acquired. When this point is reached 

 the serum usually possesses a strong antitoxin power. As a 

 practical remedy for the disease in animals the recorded results 

 from the use of this antitoxin are somewhat contradictory. In 

 human practice the results are similar. Moschcowitz has col- 

 lected 290 cases in man, where it has been used subcutaneously 

 with 173 recoveries and 117 deaths or amortality of 40.33 per 

 cent. In a total of 48 cases where the antitoxin has been injected 

 intracerebrally 23 recovered and 25 died, a mortality of 52.08 

 percent. 



Some interesting experiments suggested by Krokiewitz 

 directed toward the finding of a specific treatment consist in 

 the injection of an emulsion of brain substance. Primarily 



