So far as can be learned from the incomplete statistics available, tetanus following Fourth of July injuries is particularly virulent. The period of incubation is usually short, the attack violent, and the rate of mortality seems to be not far from 95 per cent., while the usual rate for traumatic tetanus is probably about 80 per cent. This great virulence is due apparently to the unusually favorable conditions furnished in the lacerated, necrotic, air-tight wound produced by blank cartridges, which give the bacilli the best possible opportunity for rapid and unrestricted growth, with the production of corresponding amounts of toxin. In each of the last two epidemics, the percentage of mortality has been about the same and far too high to indicate any substantial results from the treatment used. Unfortunately the more modern methods of treatment seem to have been seldom tried, the usual routine of sedatives and the subcutaneous
THE TREATMENT OF TETANUS.. JAMA. 1905;XLIV(23):1858–1859. doi:10.1001/jama.1905.02500500038007
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