Wounds of Men ivho received Prophylactic Inoculation. 533 



(B) On making a similar inquiry into the prevalence of different serological 

 types of B. tetani in wounds of men showing no evidence of tetanvjs, a number 

 of important points were brought out. 



(i) In a series of 100 wounds, B. tetani was recovered and typed in 19 

 instances. The distribution of the Types was as follows : 



Fifteen contained Tjrpe I bacilli; two contained Type II bacilli ; one 

 contained Type III bacilli ; one contained Type IV bacilli. 



The method adopted was, if possible, to obtain five swabs from each 

 wound at intervals of approximately one week. In the 19 cases in which 

 B. tetani was found, the organism was not invariably present in all five swabs. 

 This can be readily understood when it is borne in mind that the infection 

 may be localised to a particular area in the granulating surface. This is, 

 in fact, the same problem as that which is met with in making statistics of 

 diphtheria carriers ; but in the case under consideration, the error is magnified 

 owing to the technical difficulties of the investigation. 



(ii) The "persistence or recrudescence of tetanus infection of wounds is 

 remarkable. This is well exemplified in the present series by one case 

 especially, in which the bacillus was recovered 882 days after injury. 



(iii) In those cases of the series in which B. tetani was demonstrated in 

 more than one swab, the organism recovered on each occasion remained true 

 to type. 



(iv) In all, 25 strains of B. tetani have been obtained from non-tetanus 

 cases. This includes the 19 instances above mentioned, together with six 

 specimens sent for investigation from various sources. 



The results are given in the following Table : — 



Table II. — Distribution of the Different Types of B. tetani, obtained from 

 wounds of men showing no evidence of Tetanus. 



Nvimber. 



Type. 



Percentage. 



19 



1 



76 



3 



11 



12 



2 



III 



8 



1 



IV 



4 



It', now. Tables I and II be compared it will be seen that : 



(i) If the total number of cases in Tables I and II be taken together, the 

 number of infections with Type I is large, but the percentages of declared 

 tetanus and of the death rate, on the other hand, are low. 



(ii) In the case of infections from Types II and III respectively, the total 

 numbers of infections is not so large as in the case of Type I, but the 



