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March 9, 1918


Author Affiliations

(ST. PAUL) Director, Robert Walton Goelet Research Fund, the American Red Cross Hospital of Paris PARIS, FRANCE

JAMA. 1918;70(10):681-682. doi:10.1001/jama.1918.26010100005010

Among the anaerobic infections, the two that deserve special consideration are tetanus and gas gangrene. Fortunately, modern prophylaxis with antitoxic serum has controlled the former to a very large extent; the latter still continues to be the scourge of the armies.

Most shell and shrapnel wounds are probably infected by both the tetanus and the gas bacillus. The same type of wound is favorable to the development of the two—a deep wound of the muscles showing considerable trauma,1 the presence of débris, foreign bodies and clothing, and especially comminuted fractures. Tetanus infection is not, however, limited to wounds of this type. Instances of acute tetanus have been reported following frostbite, and these cases should receive the same prophylactic treatment as wounds.

ACUTE TETANUS  At present this is a comparatively rare disease in the base hospital. Its incidence averages, perhaps, two or three cases in a thousand. This is due