Evening star. [volume] (Washington, D.C.) 1854-1972, 1907-07-02
Thorough Cleansing Needed.

The recognized method of preventing the
development of tetanus after the inf1iction
of wounds liable to-lead to that disease has
been suggested by what has already been
said The bacilli which are to be dreaded
those which are buried in the recesses
of the liberation or hidden in the depths of
the puncture. They must be gotten at and be
removed if possible and If removal is not
possible they must be destroyed, and the
wound must be left in such a condition as
to prevent the growth of any remaining
bacilli which have escaped destruction
ITO accomplish the results just stated, it
Is necessary in the first place that the re-
cesses and the pockets in which germs NAV
be hidden be laid open; that is that the
possible hiding places of the germs be con-
Verted from deep narrow wounds into
wounds which are wide open. This accom-
plishes two purposes. Firstly, It renders
possible the washing away of at least a
part of the germs by means of water or of
germicldal solutions and facilitates the de-
struction by germicides of such germs as
may remain. A little bleeding does good
rather than harm, 1t tends to carry
away any germs which may have found
lodgment in the deeper portions of the
wound, and. secondly. the laying open OF
the wound exposes the wound surfaces to
the air. and the presence of air as has al
ready been stated. will prevent the deyel-
opment Of such tetanuS bacilli. II there be
any. as have neither been washed away
nor killed.
No effort is made to secure the healing
of such wounds without scars. The edges
are not drawn together. but the wound is
deliberately kept open by the introduction
of sterile surgical gauge possibly medi-
ca ted. SO as better to facilitate the access
of air. 1t is better for the patient to re-
cover with a scar than to die without one.
The Use of Anti-Toxin.
There seems to be nc 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 iniec-
ton of tetanus antitoxln Immediately after
the receipt of the injury and without wait
ing for symptoms of tetanus to anpear
Certainly the injection of this substance
does no harm, and much that has been pub
llshed seems to bear out the claims Of
those who contend for its usefulness as a
preventive of this disease.
Gases in which patients with blank
cartridge wounds who received prophylactic
injections of tetanus antitoxin and later de-
Veloped tetanuS are almost unknown al
though there are instances enough in which
patients not SO treated subsequently deveI-
oped the disease. 1t seems, the refore only
fair to the victim of Fourth of July in
jury such as ordinarily gives rise to tetanus
that he should have the benefit of the pro-
tective influence, whatever it may be. that
lies in tetanus 9nttoxin. So well is this
established that in some instances hospitals
and dispensaries. which have anticipated
demand for the immediate treatment of such
injuries. have provided themselves before
hand with this remedy in order to be able
to administer it at the earliest possible
moment.
"a certain number of wounds and GER
tain number of deaths are the almost I'M
avoidable result of celebrating the Fourth
of July in the manner that now prevails.
The ignorance of children and the indis-
cretion of adults will result in injuries more
or less serious and more less numerous
just so long as infants and mentally imma-
ture adults are allowed in large numbers to
amuse themselves with explosives. but for
tunately the adoption of measures for the
prevention of deaths from Fourth of July
tetanus need not wait for the prevention of
the injuries that give rise to this disease.
THE prevention of the original wound is
undoubtedly the best way of preventing
tetanus infection. but the avoidance of
death in one of its most dreadful forms Is
scarcely less certain If the wound that has
been received Is promptly and properly
treated. and it is for such treatment that
plea Is now made