Evening star. [volume] (Washington, D.C.) 1854-1972, 1905-07-01
AVOIDANCE OF TETANUS
Suggestions Made by District
Health Officer.
PREVENTIVE MEASURE
INJURY SUPPLEMENTED BY
GIVEN DISEASE GERM.
Liability to Accident July 4 Emphasiz-
ed and Methods Recommended in
Cases Of Emergency.
MEASURE


of the District has prepared a number of
suggestions to those who are periodically
inclined so that. in of injury from
powder explosion or other cause Independ-
ence day, steps may be taken immediately
to prevent tetanus. The celebration of the
Fourth of July in 1903, throughout the
United States resulted in not less than 466
deaths. and in non-fatal injuries in at least
1883 cases. The casualty list in 1904 while
not so appalling, was grave enough; 1S3
persons are known to have been killed and
1886 to have been injured. Among the in
juries that occurred in 1904 that did not
prove fatal are included nineteen resulting
in total blindness. sixty-one in the loss of
the sight of one eye, and sixty-one in the
loss of a leg. arm or a hand. With
such injuries as a whole the health de-
partment is concerned only in Il general
way; deaths and injuries due to violence
are regarded as coming primarily under the
police department and only such deaths
and disabilities as result from disease are
directly within the jurisdiction of the
health office. Most of the deaths. however.
which result from the celebration of the
Fourth of July are not the effect OF the
injury alone. but occur only when the in
jury happens to be associated with given
disease germ-that is the germ of tetanus.
Victims of Tetanus.
OF the deaths reported in 1903. Ais were
due to tetanus, and of those that occurred
last year 105 were traceable to the same
cause. But while the seriousness of the
situation is indicated by the figures just
given, yet these very figures serve to show
what a proper appreciation of the dangers
Incident to Fourth of July wounds can ac-
complish; for there is every reason to be-
lieve that the diminution in the number OF
ttr 10, u TO do n c-
semination of knowledge. chiefly through
the newspapers of the country. of the seri
Gus danger incident to the sale and use of
toy pistols and of the necessity for the
prompt and thorough treatment of Fourth
of July wounds with special reference to
the prevention of tetanus. Washington has
been Particularly fortunate with respect to
this disease in years past, but there is new
ertheless always need for caution.
Tetanus is an extremely fatal disease. due
to the growth of tetanus bacilli at some
point within the tissues of the body. and
to the distribution throughout the body or
a most virulent poison resulting from such
growth. OF the acute cases. which may be
said generally to include all cases in which
the first symptoms occur within seven days
after the injury ninety per cent end IN
death, no matter what form of trea tment
may be adopted OF the chronic cases
those in which the first symptoms are slow
er in appearing, about fifty per cent prove
fatal. But while cure Is difficult at best
comparatively easy.
Commonly Found in the Soil.
The bacilli which give rise to tetanus are
commonly found in the soil, particularly in
garden SOIL in the ordinary dirt of streets
and dwellings, In stable manure, and in
other more or less similar substances. They
are harmless until they find their way into
the tissues Of the body Tetanus bacilli.
haIn To hat linr ola nj
bacteria that do not multiply in the pres
ence of a free supply of air. and, therefore,
they dangerous only when they find
their way into wounds from which air is
eXcluded-Such. for instance, as lacerateo
wounds, in which deep pockets and sinuses
are present, and particularly the deep. mar
row wounds commonly known as punctured
wounds. And in the fact that wounds due
to the use of toy pistols commonly
punctured wounds lies the explanation of
the extreme gravity of such injuries. When
the baciIli have once found their way into
an eligible wound 1T makes but little differ
ence whether the wound be large or small.
If the conditions favor the multiplication of
the bacill they are soon present in the
adjacent tissues In sufficient quantity to
poison the entire system, and the poison to
which they give rise is perhaps the most
deadly known to science.
DR.. Woodward says the very moment a
punctured or a lacerated wound has been
received. with the possibility of tetanus in
lection, no matter how apparently inSignifi-
cant the wound may be, an emergency has
arisen of such gravity as to brook delay
and to tolerate no half way measures. The
case is one at once for treatment by a COM
petent surgeon, not one for the use of
home remedies. After the use of home
remedies tetanus may not develop. for after
all the wound may not have been inocula ted
with tetanus bacilli; but after proper
gical treatment tetanus almost certainly
will not develop. even though incubation
may have taken place.
Recognized Method
The. recognized method of preventing the
development of tetanus after the in1iction
of wounds liable to lead to that disease
has been suggested by what has been al
ready said The bacilli which to be
dreaded are those which are buried in the
recesses of the laceration hidden in the
depths of the puncture. They must be got
ten al and be removed il possible, and If re-
moval is not possible they must be destroy
ed. and the wound must be left in such a
condition as to prevent the growth of any
remaining baclll which have escaped de-
Struction.
To accomplish the results just stated 1t
is necessary in the first place that the re-
cesses and the pockets in which germs may
be hidden be laid open that Is, that the
possible Kidding places of the germs be
converted from deep, narrow wounds into
wounds which are wide open. This accom-
piishes two purposes. Firstly. 1t renders
possible the washing away of at least
part of the germs by means of water or
of germicidai solutions and facilitates the
destruction by germicides of such germs
as may repain. A little bleeding does good
rather than harm. 1t tends to carry away
any germs which may have found Judgment
In the deeper portions of the wound And
secondly. the laying open Of the wound ex-
poses the wound surfaces to the air, and
the presence of air, has already been
stated. will prevent the development of such
tetanus bacilli. IL there be any, as have
neither been washed away nor killed No
effort Is made to secure the healing of
such wound without scars. The edges are
not drawn together. but the wound Is de-
nberately kept open by the introduction
of sterile surgical gauze. possibly med:cated,
SO as better to facilitate free access of air.
1t Is better for the patient to recover with
a scar than to die without one.
Value Of Treatment.
There seems to be no question as to the
value of the treatment just mentioned in
preventing tetanus. In order further to
insure the prevention of this disease many
competent observers recommend the injec-
tion Of tetanus antitoxin Immediately after
the receipt of the injury and without
waiting for SYMPTOMS of tefan,1s tn an