98 MODERN BIOLOGIC THERAPEUSIS 



in New York City and elsewhere to immunize all 

 Fourth-of-Jnly wounds by injecting Tetanus 

 Antitoxin and, according to Park, none of these 

 cases has ever developed tetanus. 



Dose The immunizing dose agreed upon by 

 a committee of American bacteriologists as suf- 

 ficient to protect against the development of 

 tetanus within the incubation period, is 1500 

 units of American standard. The antitoxin 

 should be administered subcutaneously, prefer- 

 ably in the interscapular region, so that it will 

 be absorbed slowly and the immunity persist for 

 a maximum period. It is important to remem- 

 ber that a large percentage of the antitoxin is 

 eliminated from the system in the course of 

 about ten days. Hence, in cases where the 

 wounds are extensive, and where it is impossi- 

 ble to thoroughly cleanse the wounds, it is ad- 

 visable to give a second prophylactic injection 

 at the end of ten days. 



Surgical Care The immediate radical cleans- 

 ing of wounds in which there is ground for sus- 

 pecting that tetanus may develop is of the high- 

 est importance. The surrounding parts should 

 be thoroughly cleaned with soap and water and 

 the wounded tissues cleansed with sterile salt 



