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43
[1932

TETANUS.
On the 2nd January a sewerman in the employ of the Islington Borough
Council died from Tetanus infection of a wound of the right hand sustained on the
25th December, 1931 at home. There was a Coroner's Inquest, and a verdict of
accidental death was returned. The cause of this man's death was specially noted,
and the details here given with the results of the special investigation made by the
Public Health Department are put forward, because the risk of contracting this
disease is not generally appreciated by the public. The history was as follows:—
On the 24th December, 1931, he bought a toy pistol, and when firing it at home
injured the right hand at the base of his first finger. He was treated in the outpatient
department of the local hospital until the 31st December, when he was
admitted with lockjaw. Large doses of anti-tetanus serum were given, but he
died on the day stated about 48 hours after admission. An endeavour was made
by the Medical Officer of Health to purchase a similar toy pistol, and some blank
cartridges as used, immediately afterwards, but without success. Owing to the
publicity of the Coroner's Inquest the pistols and blank cartridges had been withdrawn
from sale and could not be purchased at any of the usual shops which had
been in the habit of selling them.
Tetanus resulting from toy pistol and blank cartridge wounds has not received
a great deal of attention in this country, although the cause has received consideration
in the United States of America, where it is known as "Fourth of July
Tetanus," because a large number of cases occur during the Independence Day
celebrations. It is recorded that in 1903 in spite of official warnings of this danger
of Tetanus, over 400 deaths were reported. The infection is extremely virulent,
the incubation period being only 4 to 5 days, and death occurring within 72 hours.
The vast majority of cases of wounds were in the hands. Owing to the recognition
of this danger in America, special instructions had been issued in regard to dealing
with such wounds, and the necessity of giving prophylactic doses of anti-tetanus
serum. These measures appear to have been fairly successful, as in 1914 only