Arizona republican., 1911-06-29
ANNUAL FOURTH OF
 JULY TETANUS

We have every reason to hope that
 the annual crop of tetanus cases will
 not be so large after this Fourth of
 July celebration as in previous years.
 for the sane Fourth" movener5
 seems to show a healthy growth. and
 tetanus occurs only in those places
 that still tolerate an insane Fourth.
 In 1909 there were reported 1923
 blank cartridge wounds with l50
 cases of tetanus, while in 1910, largely
 as a result of improved control of
 celebration by municipalities, only 450
 blank cartridge wounds were in
 flicted-a mere trifle-causing Sut =
 cases of tetanus. of which abuu- C.
 were fatal. says the Journal ot Am
 crican Medical Association. Even
 though this great improvement has
 taken place. We are still of the ppIn
 ion that such comfort, Joy and pa
 triOtic fervor as may be yielded by
 the primitive custom of celebrating
 Independence day by explosives, is not worth the 131 lives and 2792 in
 juries of greater or less severity which it cost last year. Enough others seem to be of the same opinion tn assure a decreased expenditure of life. blood and cuticle for the 1911 Cele- bration, but not enough to reduce this to zero.
 IL is still necessary tO impress on practicing physicians the fact that, however many accidents may c,ur, the loss of life from tetanus is al- most entirely preventable. Sixty seven deaths from totanus last year means that at least 65 lives might have been saved by prompt injection of antitoXin immediately after tEe wound was received. Undoubtediv in many cases this failure was caused by the neglect of the patien- 1r his parents; but not a few failures. we regret to say, rest on the shoulders of the attending physician. Surely. after all the years in which the dan ger of tetanus from blank cartridge wounds and the efficiency of tetanus antitoXin as prophlactic have been heralded in the medical press, there is no reasonable excuse for such neg Iect II should be remembered that the percentage of deaths from blank cartridge wounds received in last years celebration was greater than from bullet wounds. only 10.2 per cent of the latter causing death. while 12 : per cent of the blank cartridge wounds were fatal. The experience of each year. as to both Fourth of July injuries and ordinary traumas. strengthens the standing of tetanus as a prophylactic agent, es- pecially when given immediately after the wound k received. We would emphasize. however. that antitoxin is not a substitute, but an accessory to thorough surgical cleans ing, and also that the most thorough | surgical care without antitOXin is not proof against tctanus when blank | cartridge wounds are under consider ! ation It must be realized that the cleansing of these wounds is a major i operation. which can be performed 1 only under complete anesthesia. The 1 few recorded cases in which antitoXin has failed to prevent tetanuS after ! suspicious injuries have usually oc 1 cured when a local infection has per i mitted the tetanus bacilli to live in | the tissues until such time as the 1 antitoxin has been eliminated or de l stroyed: hence in cases in which sup | puration takes place in the wound. re- | petition of the prOphylactic injection | should follow at intervals of from | eight to twelve days until complete ! healing has taken place. Neither | should antitoxin be omitted when pa tieEts are not seen until the wound ! is several days old. but rather it | should then be given in large doses. ! for although not certain to prevent | tetanus when given this late. vet if 1 tetanus does arise the prognosis is ] decidedly better if antitoXin has been | used
 As to the curative treatment of te- -anus. there still fails to be any de- rided step in advance. The magne-