In 1903, the Fourth of July tribute was 466 dead and 3,983 injured; in 1904, it was 183 dead and 3,986 injured. The first year the reported cases of tetanus numbered 415, while last year there were but 105. Within one year the deaths from tetanus were reduced by 75 per cent., although the deaths from other causes were increased by over 50 per cent., and the total number of recorded injuries was practically unchanged. Our analysis of the epidemics of previous years made it evident that the chief reason for the great tetanus mortality lay in a lack of appreciation of the danger that lies in every blank cartridge wound and the need for vigorous and skilled treatment immediately after its reception. Just before the last Fourth of July a vigorous "campaign of education" on this point was carried on throughout the country, by both the medical and the
PREPARE FOR THE FOURTH OF JULY. JAMA. 1905;XLIV(22):1781–1782. doi:10.1001/jama.1905.02500490057007
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