2. _United States._--"Joseph MacFarland and E. M. Ranck, in addition to a synopsis of the method of manufacture of tetanus-antitoxin, give some facts of interest and importance in regard to its use for prophylaxis and treatment. The studies were made upon several hundred horses used for the production of various immunised serums in one of the large laboratories of the United States. The horses, because of the constant manipulations, frequently became infected with tetanus, and in 1897 and 1898, when scrupulous cleanliness and disinfection were the only precautions employed to prevent the disease, the death-rate varied from 8 to 10 per cent. During 1899 nearly two hundred horses were subjected to systematic immunisation with tetanus-antitoxin; and, in spite of otherwise similar conditions, the death-rate descended to 1 per cent." (_Medical Annual_, 1901.) The preventive use of the antitoxin has, of course, a very limited range outside veterinary surgery. Tetanus, thanks to the use of antiseptic or aseptic methods, not only in hospital surgery but also in amateur and domestic surgery, has become a very rare disease, except in tropical countries. It is no longer a "hospital disease"; and, even in war, it no longer has anything like the frequency that it had, for instance, in the War of the Rebellion. A student may now go all his time at a large hospital without seeing more than a very few cases. But, now and again, attention is called to some wholly unsuspected risk of the disease. For example, certain cases of tetanus occurred in Dundee among workers at the jute-mills there:-- "The last victim was a female worker in the jute-mill, who, six days after a crushed and lacerated wound of the foot, developed tetanus and died within twenty-four hours. Some of the dust, taken from under the machine in which the foot was crushed, was found to contain an unusually large number of tetanus-bacilli. The source of the jute used is India." (_Medical News_, August 1900.) Again, at the Gebaer Anstalt at Prague, in 1899, an outbreak of tetanus occurred, with several deaths; but it was stopped when a preventive dose of the antitoxin was given to the new patients on admission.