Evening star. [volume] (Washington, D.C.) 1854-1972, 1913-07-03
.L0CKJAW IS EVER
MENACE OF FOURTH
Health Officer Woodward Is
sues instructions as to Pre-
ventive Measures.

Methods for prevention of tetanus, or
Fourth OF July lockjaw," as this disease
is known to physicians and municipal
health officials. are suggested in a spe-
cial bulletin issued today by DR.. William
c. Woodward. health officer Of the Dis
tIict of Columbia.
While the sale or use of fireworks in
the District is prohibited by police regula-
tons. many youths as well as grown-ups
of the capital annually avoid this restric-
ton by celebrating Independence day in
Maryland and Virginia. Wounds caused
by explosives. and especially. the toy cap
pistol, constitute the favorite bre eding
places for the tetanus germ
DIR. Woodward in the bulletin, pointing
out methods of treatment that should be
followed to prevent development Of lock-
jaw, says:
Prompt Action Urged.
Preventive measures consist OF two
things-avoiding Fourth OF July wounds
and seeing that any wound that may be
received is properly treated by a thor
oughly competent surgeon.
mo mere examination of a wound will
enable any one to say whether tetanus
will or will not result from II. A Sigh,
and apparently Insignificant wound. par
ticularly IL 1t be small but deep, and with
but little bleeding, affords an ample lodg-
spores A larger wound, with much de-
struction of tissue and with hooks and
crevices for the lodgment of particles of
dirt and other foreign matter. forms an
ideal place for infection. The only safe
rule is to treat all Fourth of July wounds
on the presumption that they are infected.
First, administer tetanus antitoxtn; Sec
ond thoroughly cleanse and disinfect the
wound. The more promptly both measures
be adopted the greater are the chances OF
success.
The almost universal practice Of the
present day is to administer tetanus
antitoxin at once in all cases OF Fourth
Of July wounds. No amount OF cleans
sion Of this precautfon, for the anti
toxin is harmless, and if the wound
be not infected no injury is done the
patient by its administration. Nor can
any delay be tolerated. for while the
sntitoxin is able to prevent the de-
SeIopment of the disease. it is not
able to cure case, once the disease
has developed. Five hundred units
tered may mark the difference between
the life and the death Of the patient,
and as much larger doses can be given
as the physician thinks proper.
Thoroughly Cleanse Wound.
Even however. though tetanus anti
toxin administered at once in proper doses
may be a certain preventive OF tetanus. 1t
would hardly be the part of wisdom to
leave in the wound any foreign matter or
injured tissues containing the spores OF
this disease, or to leave the wound in a
condition favorable to their growth, If
present. The wound must be thoroughly
cleansed and disinfected. 1t must be even
opensd wide by means Of incisions il nee
essary to accomplish those ends. using an
ana sthetic If thorough cleansing and dis
injecting cannot be accomplished with
out it, Wounds OF this kind are not
closed. But in order to allow free access
of air to the wound and to provide for
the easy escape of secretions from the
wound and particles of dead tissue. sur
ricaI gauze is packed into the wound. and
the wound is usually dressed with an
antiseptic dressing. The particular meth
cd of surgical treatment of such injuries
lies in the judgment OF the particular
surgeon in attendance.