BACILLUS TETANI 519 
monly in the excrement of the herhivora, notably horses and cattle.^ 
Sormani' has claimed that the virnlence of the tetanus bacillus is 
maintained by frequent passages of the organism through the intestines 
of the herbivora. Pizzini^ has found tetanus bacilli in the feces of 
peasants who tended horses. Not all observers, however, subscribe 
to the intestinal theory. Hoflfmann,^ for example, found the organism 
only once out of 22 samples of feces from 22 different horses. 
Tetanus spores are found widely distributed in Nature, particularly 
in the upper layers of the soil; in temperate climates their distribu- 
tion is somewhat irregular, but in the tropics they appear to be very 
widely disseminated. Tetanus spores also occur in gelatin occasionally, 
and they have even been detected in catgut. Levy and Bruns,'^ and 
Anderson*' have found tetanus spores in commercial gelatin. The 
potential dangers attending the use of gelatin as a hemostatic are 
apparent,^ although the injection of tetanus spores without the associa- 
tion of other organisms, as the Welch bacillus, or the staphylococcus, 
is frequently without result. Tetanus spores have also been found in 
vaccine virus in the past,^ and Carini^ has found spores in vaccine virus; 
and at least two outbreaks of tetanus, one in this country and one in 
Europe, have resulted from the infection of diphtheria antitoxin with 
tetanus spores. Rabinovitch'" has also found tetanus spores in wash- 
ings from straw^berries sold in Berlin. The arrow poison of the New 
Hebrides islanders has been found to contain tetanus spores.^^ 
Pathogenesis.— Tetanus occurs spontaneously in man, horses, cattle 
and sheep, rarely in dogs and goats. Birds and reptilia are highly 
refractory to experimental inoculation. The disease tetanus both in 
man and animals is purely toxic in character; notwithstanding the wide 
distribution of tetanus spores, it is relatively uncommon. It may 
follow traumatism, particularly deep, narrow wounds and contused 
wounds to which tetanus spores, together with other organisms gain 
entrance. In the tropics an infection of the umbilicus of the new-born 
(tetanus neonatorum) is quite common. '^ Postpartum infections, par- 
ticularly of the uterus (tetanus puerperalis), were also at one time very 
common. ^^ 
The lesions observed in tetanus are very slight and postmortem there 
may be no marked changes other than a slight congestion of the internal 
organs. Bacilli may occasionally be found at the site of inoculation, 
> Sanchez, Toledo and Baillon La Semaine Med., 1890, 10, No. 45; Centralbl. f. 
Bakteriol., 1890, 9, 18. 
2 Behandl. der Tenth Internat. med. Kong., Berlin, 1890, 5, 152. 
■■' Riv. d'igiene e san. publ., 1898, 10, 170. ' Hyg. Rund.. 1905, 15, 1233. 
i Grenzgeb. der Med. u. Chir., 10, 235; Deutsch. med. Wchnschr., 1902, 28, 130. 
e Marine Hosp. Lab. Bull., 1902, No. 9. 
7 Zibell: Miinchen. med. Wchnschr.,, 1901, 48, 1643. 
8 McFarland: Lancet, 1902. ii, 730. 
9 Centralb. f. Bakteriol., orig., 1904, 37, 48. "' Arch. f. Hyg., 1907, 61, 103. 
11 Le Dantec: Ann. Inst. Pasteur, 1890, 4, 716. 
12 Anders and Morgan: Jour. Am. Med. Assn., 1906, 47, 2083. 
'3 Stern: Deutsch. med. Wchnschr., 1892, 18, 252. Hej'se: Deutsch. med. Wchnschr., 
1893, 19, 318. 
