90 MAJOR W. McADAM ECCLb:S, M.S., M.B., F.R.C.rf., E.^.M.C, OJf 



lodge in tlie muscles of the thigh, and the pathogenic organisms' 

 introduced induce septicaemia — blood-poisoning — and death re- 

 sults. This is the death by the action of micro-organisms^ 

 or perhaps, strictly speaking, it is a death by both accident and 

 the action of micro-organisms. 



An attempt is made by the man immediately after he is hit to 

 prevent infection by applying a spirit solution of iodine to the 

 area of the wound, and covering the aperture with an antiseptic 

 dressing. Every soldier carries this antiseptic and this field, 

 dressing. Unfortunately only a comparatively small proportion 

 of cases are either sterile from the first, or are rendered so by the 

 first-aid application. At the casualty clearing station, behind the 

 regimental aid post, many wounds are excised, and in this way 

 the actual infected tissue is removed. 



There are three chief types of organisms which infect wounds 

 and lead to fatal issues. They are : streptococci, the bacillus 

 producing gas gangrene," and the bacillus of tetanus. 



(a) Streptococcus, or the coccus which forms chains when it 

 multiplies, is very virulent. Introduced into the tissues, these 

 cocci multiply very rapidly, and pass into the circulation. They 

 are capable of producing very potent toxins, so that the delicate 

 muscular tissue of the heart, and the sensitive nervous tissue of 

 the nerve centres, are quickly poisoned ; and ceasing to work, 

 death ensues. 



There is always a high temperature, and a quick pulse, with 

 increasing exhaustion. Once these minute vegetable parasites 

 get a hold it is very difficult indeed to cope with them. 



(6) Bacillus aerogenes mpsulatus, or the bacillus which is the 

 chief agent in the production of ''gas gangrene," is also very 

 virulent. Unlike the streptococcus, this bacillus grows and mul- 

 tiplies best in the absence of oxygen, and therefore of air. 

 Hence its rapid and fatal activity when pent up in the tissues. 

 Within a few hours gangrene has occurred and the patient is so 

 poisoned as to become moribund. Fortunately easier and more 

 thorough treatment in the way of wound-cleansing has led to a 

 great diminution of gas gangrene. 



(c) Bacillus tetani, often called the '' drum stick " bacillus, is 

 the cause of tetanus, or lock-jaw. It is an interesting point 

 that it is found chiefly in garden mould, especially when this has 

 been richly manured, and in road sweepings. Hence the great 

 liability for wounds received by men in trenches to become 

 infected. The clothing of the soldier very commonly holds these 



