Albuquerque morning journal. [volume] (Albuquerque, N.M.) 1903-1926, 1907-06-26
FIRST AID TO THE
INJURED ON THE
GLORIOUS 4TH
Physician Urges Great Import
ance of Administering Anti
Toxin in Cases of Powder
Burns,

Prepare for the Glorious Fourth.
Get out the arnica and the salve and
the b~andages and the cold cream and
w%hoop'er up for the late George
Washington and Independence. And
above all, don't forget the antitoxin.
The city drug stores are having the fore
sight 10 lay in a supply. A local ply
stefan said yesterday:
although there have never to my
knowledge been any fatalities in this
city as the result of Fourth of July eX-
plosives there have been some serious
accidents and it is always possible h a
there will be more serious ones. The
greatest danger from such accidents
is the possibility of tetanus. In my
opinion the parents of the A%lbuquer-
que small boy should have strongly
impressed upon them the necessity Of
a%nti-tOXin in case of such injuries. 1t
saved thousands of lives in this u
country last summer n its more gem
eral use will have the effect of greatly
reducing the Fourth Of July mortality.
The administration of antitoXin just as
soon after the accident as possible may
mean the saving of a small life
The physician in question, who, ac-
cording TO the ethics of the profession
has a horror of seeing his name in
print. calls attention to the following
extract from the current number of
the journal of the American Medical
association, Chicago:
1t is again time to sound the alarm
and to prepare for the annual tetanus
/ epidemic. We approach the celebra-
ton with somewhat less apprehension
this year than We did a few years ago
for there Is now every reason TO be-
lieVe that a few of the many deaths
that will follow can be ascribed to
anything but municipal and parent
ltal negligence. Physicians will do
their part to keep the mortality figures
at a minimum. For four years the
Journal has compiled statistics and
published comments on the injuries or
the Fourth and their results. and for
immediate valuable results 1t mas
been a most profitable undertaking.
The first year. 1908, yielded 466 deaths
as our tribute to Independence day,
and of these 41A were due to etanus.
on the basis of these figures a Vigor-
GUS campaign was started and taken
up enthusiastically by other medical
journals and the daily papers, which
resulted in a fall of the mortality OF
the following ear to 1873 deaths, l05
being from etanus. This decrease, 1t
was easy to demonstrate, was the re-
suit of two factors, one being a constd-
cradle decrease go per cent? in
the number Of blank cartridge
wounds; the other, and perhaps the
more striking, was the improved pro-
phylactic treatment of blank cartridge
wounds, especially as regards the use
of tetanus anti-tOXin. In 1905 the total
deaths and the number Of tetanus
cases remained about the same; 1872
deaths and 104 cases Of tetanus; while
last year a gratifying decrease In te-
! t1nlIS IN 80 pQCRG was rpPnTnp1. thA IN
tai number of deaths being 1853. These
SO cases of D~reVentable disease We're
shown by the reports we received to
be almost entirely of patients who
We're not seen by physicians until lock-
! jaw had already set in. The old story
of lack of appreciation of the dangers
of Fourth of July injuries by the fam
lily physician was seldom heard, And
so, as we remarked before, we look
with confidence to a continuance of the
record of the past three years. and
feel assured that the profession will
do its part in making the price of our
senseless celebration" as small as
possible.
There is little that we can add to
the advice as to the prophylaXiS of te-
tanus which we have printed in pre-
vious years. Every lacerated wound
received from Fourth of July eXplos-
ives, 10 matter which variety, must be
looked on as a wound that Is very posi-
sibly infected. with tetanus The
character of these wounds is such that
their cleansing can only be properly
accomplished, as a rule, under general
aneSthesia. n to render conditions
~unfavorable for the anaerobic tetanus
bacillus they should be permitted to
heal from the bottom. And especially i
il must be remembered that, in spite
Of even the best surgical cleansing, te-
tanus still may result. and conse-
H. .--- l. 7
injection of from 5 to 10 cubic CEN
timeters of tetanus antitoxin can one
be absolutely certain of preventing the
disease. This Is most particularly
true of wounds which are not seen un-
til one or more days old. As the
usual incubation period of tetanus is
from five to fifteen days, there are few
physicians too far removed from a
supply of antitoXin to secure ii in time
to be of value. The positive sefficacy
of tetanus antitoXin as "A prOphylactiC,
as well as its harmlesSness, have been
repeatedly proved, but never better
than by the results of its use after
the last three celebrations, 1t may be
we'll to emphasize the prophylactiC
treatment Of wounds from cannon
crackers and the various explosives
other than blank cartridges. Our stat
istiCs show that so far the decrease in
deaths from etanus has been accom-
- 49, SO hA1 I@
~Vention Of tetanus i'm blank cartridge
wounds. while the number of cases Of
etanus from the other explosives has
remained almost constant. As a re-
suit, in 1906 the blank cartridge te-
Janus was but little more than te-
tanus from all other eauses combined.
whereas in 1908 il constituted seven
eighths of all the cases. Apparently
this is because the etanus danger of
blank cartridge wounds has been so
wen emphasized that the danger in the
other wounds has been overlooked.
Although it seems that some slight
improvement in the curative treatment
of tetanus is being made from year to
year, yet the percentage Of r%ecOveries
Is still extremely small. and most Of
these are i'm patients whose incubation
period was of considerable length. I'm
der no form OF treatment do patients
with an incubation period of less than
nine days often recover Consequently
there is no disease in which the ounce
Of prevention is worth so many pounds
of cure. Such Improvement in results
as has so far been observed seems To-
be largely due to more vigorous use
Of a%ntitoxin. especially by the intras-
pinal and -intrancural routes. The
French also cover the wound with dec
icated serum. We have also learned
not TO be afraid OF large doses Of anti
toxin. as these seems to he Of advan-
Control of the spasms by in
frasufuaI infpctfous of ~befa-pucain I.