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War Surgery and Medicine



THE distribution of tetanus spores in the soil varies to a marked degree over the world. In the First World War most cases were infected in France and Belgium. Few cases were reported in British armies in other areas—seven in Mesopotamia, six from Gallipoli (all in cases of trench foot), four in Salonika, and three in Italy. Lack of recorded cases suggested there were few cases in Egypt. In 1 NZEF the number of cases is not known, but there were three deaths. Among the British troops in France the rate of infection at the beginning of the war was over eight per 1000 wounded, but this was reduced by the giving of injections of anti-tetanic serum after wounding from the end of 1914, so that the over-all rate for the period of the war was 1·47 per 1000 wounded. The total number of British cases was 2529. Mortality was 50 per cent in these cases, but death was not necessarily due to tetanus alone.