Tetanus Discovery

One of the most violent and fatal of infectious diseases is tetanus or lockjaw, caused by the tetanus bacillus which dwells in earth, manure, intestines of many animals, rusty nails and tools. The germs usually enter a dirty wound (sometimes only a pinprick) and incubate for more than a week, producing a poison hundreds of times more virulent than strychnine. A victim of tetanus first complains of stiff neck, then tight jaws, in a mild case muscular spasms in the region of his wound. Sometimes his mouth becomes drawn in a sardonic grin, and finally he writhes in painful, uncontrollable muscular paroxysms, sometimes rocking on his head and heels. Spasms may be so severe that his stout abdominal muscle is ripped in two.

Every year about 1,200 people die from tetanus in the U. S., many of them in the South because of greater exposure to the germs from walking barefoot. Although 70% of tetanus cases are fatal, the disease can usually be prevented by injections of tetanus antitoxin given right after a wound has been dressed. But once the disease gets to the central nervous system, tetanus antitoxin does little good.

Dr. Warfield Monroe Firor of Johns Hopkins has long worried about this paradox. About 18 months ago he got the hunch that the tetanus toxin which causes the first stage of the disease must be different from the poison which causes the second fatal stage. To test his hunch he injected both small and large amounts of tetanus toxin directly into the spinal cords of more than 60 dogs. The injections were always followed by muscular paroxysms and death, even though 100 times the neutralizing dose of antitoxin was in the bloodstream and even though some doses of the poison were not large enough to cause death when injected into the veins.

Last week Dr. Firor told members of the Society of University Surgeons, meeting at Rochester, N. Y., the conclusions of his research. As long as tetanus toxin has not had time to enter the spinal cord, he said, tetanus antitoxin can neutralize the poison and check the disease. But once toxin enters the cord, it somehow becomes transformed into a new poison. "The new substance is not attacked by the present antitoxin," said Dr. Firor. In answer to questions of enthusiastic colleagues, he said that he will shortly try to prepare a second antitoxin which will cure the final stages of tetanus.

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