486 PRINCIPLES OF VETERINARY SURGERY" 



is easy when the wound is conveniently located, for exam- 

 ple, the end of the tail. If from a seton the entire tract is 

 laid bare by incision. Such operations must be performed 

 early to be of service. They must be performed on the very 

 first appearance of the symptoms in order to remove the 

 micro-organisms before they have injected a fatal dose of 

 the toxin into the organism. Ansesthesia is essential to pre- 

 vent excessive excitement. Such operations are only advis- 

 able when the wound is located in structures of secondary 

 importance (skin, muscles, etc.). Simple disinfection alone 

 is possible when important org-ans are involved, or where 

 the operation would necessitate extensive mutilation. Be- 

 sides, the effects are very uncertain. Vaillard had shown 

 experimentally that the extirpation of the muscle into which 

 a few drops of toxin have been injected does not prevent 

 the development of tetanus. 



ANNOTATION. 



The results obtained in practice from extirpation, ablation, re-amputation, 

 disinfection, etc., of the tetanigenic wound is never followed by any imme- 

 diate change in the progress of the disease. Alone it will accomplish nothing, 

 but when applied as one of the various efforts, there is but little doubt that 

 some benefit is actually derived. In the very early stage, while poison is still 

 being elaborated in the wound, and in view of what is now known of the 

 pathogenesis of tetanic intoxications, the treatment of the wound, by either 

 mechanical or medicinal disinfection, is a palpable duty of the surgeon. — 

 I,. A. M. 



General treatment aims at the toxin already in the or- 

 ganism and the arrest or diminution of its effects on the 

 nervous system. The first recommendation is the injection 

 of antitetanic serum. Contrary to the opinion once held 'by 

 Behring and Kitasato, antitoxic serum is not curative. Its 

 employment is, however, useful in neutralizing the poisons 

 not yet fixed in the nerve cells and which continue to be 

 formed in the wound. The antitetanic serum will give var- 

 iable results. If the animal has absorbed a fatal dose of 

 the toxin, no benefit will be derived, while in the opposite 

 case its action is effectual. It prevents further intoxication 



