In _Tetanus_ the first symptom noticed is that the infant is unable to suck, and on examination it will be found that this is due to cramp of the muscles of the jaw, which become fixed and hard. The face assumes a peculiar aspect which is quite characteristic of this disease, spasms of the limbs and then convulsions of the whole body take place, the joints become stiff and the case is almost invariably fatal. In regard to the infection by the Tubercle Bacillus it may be said that this occurrence is one of the rarest of the rare sequels of circumcision, but it appears that _tubercular ulcers_ have arisen over the area of the wound when the METZIZAH has been performed by mouth suction on the part of a Mohel who was suffering from Tuberculosis. A number of these cases have been reported from time to time, and in some of them it apparently led to general Tuberculosis (_consumption_). The foregoing brief statements exhaust most of the possibilities of wound infection by means of micro-organisms. There is however another source of infection, not yet definitely proved to be of microbic origin, which has important relations to circumcision. This is the poison of _Syphilis_. If the Mohel should be suffering from this disease the secretions of the mouth are infective and the disease may easily be transmitted to the infant by means of Metzizah. On the other hand, should the infant be born with the disease--a circumstance of not infrequent occurrence--it must be remembered that its blood is charged with the poison, and is capable of infecting a healthy individual when it is brought into contact with any wound, abrasion or other breach of surface. [Illustration] CHAPTER III. _Elements of the Antiseptic Method._ _The purpose of Antiseptic Surgery is to avoid the occurrence of the dangers of infection_ referred to in the preceding chapter. There are many methods of carrying out the system, but the present description being limited to the requirements of circumcision does not aim at being exhaustive. The two objects aimed at are: 1) _The prevention of any micro-organisms gaining entrance to the wound._ This end is attained by the disinfection of the hands and especially the thumbnails of the operator, of the instruments and dressings used; and by perfect cleanliness of the genitals of the infant. It may be said that the brief exposure of the parts during the performance of the circumcision carries with it no risk of infection, because the organisms we have been considering are not usually airborne. 2) _The application of such dressings as will keep the wound in an aseptic condition._ Even the small amount of discharge from a circumcision wound forms a splendid soil for the growth of micro-organisms. It is necessary therefore to apply a dressing which has been saturated with such antiseptics as will destroy that constituent of the discharge which makes it a good culture material.