THE BACILLUS OF TETANUS. 391 
with garden earth have shown, and are fairly common 
in New York City. 
Man and almost all domestic animals are subject to 
tetanus. On examination of an infected individual 
very little local evidence of the disease can be discov- 
ered. Generally at the point of infection, if there is 
an external wound, some pus is to be seen, in which, 
along with numerous other bacteria, tetanus bacilli or 
their spores may be found. By successive inoculation 
of this pus in susceptible animals the disease can often be 
reproduced for from four to five generations; but some- 
times there is a break in the chain, which proves that 
in such cases the infection has been brought about less 
by the bacilli than by the toxin which was transmitted 
with them. 
Not only traumatic tetanus, but also all the various 
forms of tetanus, are now conceded to be produced by 
the tetanus bacillus—puerperal tetanus, tetanus neona- 
torum, and idiopathic and rheumatic tetanus. In 
tetanus neonatorum and puerperal tetanus the infection 
is introduced through the navel and the inner surface 
of the uterus. It should be borne in mind, however, 
that when there is no external and visible wound there 
may be an internal one. Carbone and Perrero report 
a case of so-called rheumatic tetanus in which attenu- 
ated forms of tetanus bacilli were found in the bronchial 
secretions. These bacilli possessed the morphological 
and cultural peculiarities of the tetanus bacilli, but 
they did not produce toxin. Similar anaérobes have 
been found in meat-juices and in the soil. The bacilli 
found in the bronchial secretions, therefore, may have 
been tetanus bacilli which, owing to certain conditions, 
had lost their virulence, just as we know it to happen 
