TETANUS. 
385 
velopment of tetanus cannot be prevented. That is to say, tet¬ 
anus can be prevented with great certainty by the use of anti¬ 
toxin ; but when the symptoms of the disease have once 
appeared there is so much toxin in circulation that it cannot be 
neutralized by any amount of antitoxin that it is possible to in¬ 
troduce, so that the treatment of tetanus with antitoxin is not 
yet established on a profitable basis. 
The prevention of the disease, however, by the use of anti¬ 
toxin is in many instances practicable and a valuable resource. 
For example, it is known that tetanus is much more prevalent 
in some districts than in others, and that exposure is frequently 
followed by tetanus. It is also known that on some farms and 
in some stables tetanus is a common disease, and even slight in¬ 
juries result in death from this cause. Under these conditions 
it may be serviceable to administer to the animal an immuniz¬ 
ing dose of antitoxic serum, after which the contemplated opera¬ 
tion may be performed without risk. Or if a valuable animal 
sustains a puncture of the foot or a punctured wound or a calk- 
injury, and particularly if the animal is kept in a stable where 
tetanus has previously appeared, it would be advisable as a 
general precautionary measure to protect it by the use of anti¬ 
toxin serum. 
My attention was recently called by Dr. Walters, of Wilkes- 
barre, to a mine in Dauphin County' wherein there were almost 
one hundred mules, and of these twenty-three died of tetanus 
during a period of about two years. In January five or six died. 
I obtained some tetanus antitoxin, which was administered to 
fifty mules that occupied the stables in which the tetanus had 
previously appeared. Since that time no cases of tetanus have 
been reported. 
Tetanus antitoxin has been used most extensively by Nocard 
in France, and Schutz in Germany, and they report that the 
mortality from tetanus has been considerably reduced by the 
use of this agent in districts where the disease prevails exten¬ 
sively and where antitoxin has been used before operations, and 
after injuries as a precautionary measure. 
