56 BACTERIOLOGICAL DIAGNOSIS. 
were not for the discomfort and pain caused by the 
throat lesion of diphtheria the antitoxin treatment of 
the disease would have probably been abandoned as 
useless. 
But tetanus may be diagnosed by means of a. bac- 
teriological examination of the local lesion before toxic 
symptoms have appeared, and in cases where this is 
done we may safely look for results from tetanus anti- 
toxin which are as good as those obtained from the 
early use of diphtheria antitoxin ; for the experimental 
evidence in favour of the one is every whit as great as 
that in favour of the other. 
Considerations of time would prohibit the bacterio- 
logical examination of the multitude of small wounds 
which are seen by the majority of medical men. But 
a wound which clinical experience and bacteriological 
research as to the occurrence of tetanus bacilli outside 
the body, indicates as being one which is likely to 
become infected with the bacillus in question, should be 
submitted to a careful and prolonged search for the 
bacillus, These are deep incised and lacerated wounds, 
especially those of the hand and foot, and especially if 
garden earth or horse-dung has been rubbed into the 
tissues. Wounds made with splinters should be exa- 
mined, especially if there is reason to think that the 
splinters were dirty. The same remiark applies to deep 
stabs with rusty nails, &c. Tetanus may follow a 
wound which heals up by first intention, but this is 
unlikely; suppuration or necrosis of the edges (though 
not due to the tetanus bacillus itself) is present in the 
majority of cases. 
