940 TETANUS 
Prevention. Owing to the wide distribution of B. tetant or their 
spores precautions consist in the thorough disinfection of all wounds 
and in localities where tetanus is prevalent the injection of tetanus 
antitoxin. With animals at pasture, it is impossible often to know 
of the wounds until it is too late. In stables where the disease 
becomes prevalent, the floors and siding should be thoroughly disin- 
fected 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 
community and, knowing these, give instruction to his clients to take 
such precautions as are possible. In case operations are to be per- 
formed on animals in such localities an immunizing dose of tetanus 
antitoxin should be administered. This practice is followed in many 
places in Europe. 
Tetanus antitoxin. The antitoxin is prepared 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 cer- 
tain degree so that by repeated and constantly increasing doses com- 
plete resistance to the toxin is acquired. When this point is reached 
the serum usually possesses a strong antitoxic 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 collected 290 cases in man 
where it has been used subcutaneously, with 173 recoveries and 177 
deaths or a mortality of 40.33 per cent. In a total of 48 cases where 
the antitoxin was injected intracerebrally 23 recovered and 25 died, a 
mortality of 52.08 per cent. 
Specific biologic treatment. The tetanus antitoxin has been 
recommended but its value as a prophylactic seems to be greater than 
as a remedy after symptoms have appeared. 
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 this method of treatment 
is based upon the hypothesis, set up by Goldscheider and Flatau, who, 
as a result of their research came to the conclusion that “the morpho- 
logical changes in the nerve cells are the expression of a chemical pro- 
cess, i. e., of the chemical combination of the toxins with the nerve 
cells. Every nerve cell possesses atom groups which have a certain 
affinity for the atom groups of the tetanus toxin and are able to com- 
