Waterbury evening Democrat., 1904-06-30
FOURTH OF JULY TETANUs.

sown in necrotic tissue or burned areas which may depend on the fact that such areas are bloodless. and therefore poor in oxygen. These facts alone are sufficient to explain why certain wounds are more favorable than others for the onset of tetanus.
 Another important characteristic of the organism Is its habitat. Tn a city the size of Washington there will occur an average of about five cases q year 1t is, therefore, evident that the germ cannot pass directly from case to case, but must spend the greater part of it's career either as harmless saprophyte or else In some other host, only living ron human tissues as a rare incident in it's career. As tetanus is not frequent enough in any other animal to explain it's continuance of existence as a para site. we are compelled to fall back to the belief that 1t lives the greater part of its existence as q saprophyte The organism can be found anyhere that contamination with ordinary dirt or soil is possible, particularly i'll sub- stances contaminated with horse ma nure. From this fact it has been thought by some that it may multiply in the alimentary tract of the horse without causing harm and be spread about in this way. However that is, 1t is certain that such material is it's most usual location. and therefore street dirt is an especially dangerous substance, as well as barnyard and sta ble soil or earth fertilized by manure.
 From these facts we see that in the case of tetanus we have to do with an organism that is almost universally present. especially in ordinary street dirt, and that possesses great resistance to injurious agencies, and long life under favorable conditions. These properties would make 1t common ir- fecting agent were it not for its strict ly anaerobic nature. which limits the favorable opportunities for it's growth, these favorable opportunities consist ing in the introduction of the bacillus or spore into the depth of wound so constructed as to shut out the air, and especially favorable if there is much in- jury to the tissues and simultaneous infection with other bacteria It thus becomes evident why there is no class of wounds so frequently followed by tetanus as those produced by blank cartridges Tn them we usually find that one or two pasteboard wads have been driven deep into hand or finger, [ often carrying with them disc of the tough palmar skin. and this accident usually occurs in person whose hands have been most thoroughly covered with street dirt in the process of vigor- 0us celebration. At the same time the explosive force and the heat of the cartridge have led to much destruction of the tissues and hemorrhage, which l furnish the remaining desiderata. Of course, mixed infection under these circumstances is certain to be added to assure anaerobic conditions. There has been some discussion as to whether te- tanus bacilli are present in the blank cartridge wads or not; it really matters l little for without so direct an origin fo1 the bacteria there remains the street dirt, which we know contains them l Wounds made by giant crackers and cannons are also more or less favora ble sites for tetanus infection accord l ing as they produce the conditions de scribed above or not. When they cause much laceration and burning oi flesh they are not fnfrequently fol lowed by lockjaw.
 l After the infection has occurred the