890 



SCIENCE 



[N. S. Vol. XLI. No. 1068 



Meantime Souttar^* extols plenty of fresh 

 air or better still of oxygen (our old sup- 

 posed enemies in the 60 's) and says 



Men with wounds so foul that their presence in 

 the wards eould not be permitted, were placed, 

 suitably protected, in the open air, the wounds 

 being left exposed to the winds of heaven, covered 

 only with a thin piece of gauze. The results were 

 almost magical, 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 1870-1 

 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^^ says that 



the greatest danger to the wounded had been te- 

 tanus. Of 60,000 wounded Bavarians, 420 de- 

 veloped tetanus, which proved fatal in 240 eases 

 (57.1 per cent.). The prophylactic value of the 

 tetanus serum had been established, but its exten- 

 sive employment was not always feasible. 



This is a far larger percentage of cases 

 than in our Civil War, or the Franco-Prus- 

 sian War, but the mortality is far less — 

 probably due to the even partial employ- 

 ment of the serum. 



During the Civil War I never saw a case 

 of "gas gangrene" which has been so prev- 

 alent and dangerous in the present war. 

 The soil of Belgium and France, which has 

 been cultivated and roamed over by animals 

 for more than twenty centuries, is highly 

 infected. Over ten different gas-producing 

 bacteria have been found. 



the same Journal for April 24, 1915, is another 

 very important paper giving full directions for 

 treatment. See also an interesting editorial in the 

 Journal American Medical Association, May 23, 

 1915, p. 1765. 



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



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



Sidney Rowland's experiment^" well shows 

 the virulent infection of the soil. Shaking 

 up some of the soil from the trenches with 

 some water, he injected a few drops into a 

 guinea-pig and it was dead in eighteen 

 hours with widely diffused gas gangrene. 

 Soldiers have died from the disease in 

 thirty-six hours. 



Delorme has advised, as the germ is anae- 

 robic, the injection of peroxide of hydro- 

 gen. Hartmann believes it needful to open 

 the wounds freely and employ thorough 

 irrigation with the peroxide^^ — a most im- 

 portant procedure. Early treatment of in- 

 fected wounds even in cases of gas gangrene 

 resulted favorably in the hands of Cazin. 

 Of 158 cases received even up to forty-eight 

 hours after battle all recovered in spite of 

 their serious nature. Among those received 

 after four or five days' transportation the 

 mortality reached 10 and even 20 per cent.^' 

 I have related the terrible mortality from 

 typhoid in the Boer and the Spanish-Amer- 

 ican wars. The one bright spot in the pres- 

 ent war is the conquest of typhoid. In 

 spite of greatly increased numbers and of 

 most unfavorable sanitary conditions in the 

 trenches as I have shown, conditions which 

 in former wars would have given rise to 

 dreadful epidemics of typhoid, the follow- 

 ing statistics in the British army officially 

 given to Parliament on March 4, 1915,^^ 

 show emphatically how well this scourge of 

 every past campaign has been conquered. 

 There had been only 606 eases in all: 247 

 among the partially (136) and fully (111) 

 inoculated, with two deaths (0.81 per cent.), 

 and 359 among the unprotected, with 48 

 deaths (7.47 per cent.), over nine times as 

 many deaths proportionately! The one 



26 Brit. Med. Jour., November 28, 1914, p. 913. 



27 Jour. Am. Med. Ass., January 16, 1915, p. 

 259. See also Lawson and Whitehouse, Brit. Jour. 

 Surg., January 9, 1915, p. 444. 



28 Jour. Am. Med. Ass., January 16, 1915, p. 259. 



29 Brit. Med. Jour., March 13, 1915, p. 485. 



