In this issue of The Journal appears the seventh annual compilation of deaths and injuries resulting from the celebration of the Fourth of July. The fact that the celebration was spread over three days this year, since the Fourth came on Sunday, may be partly responsible for the increased number of tetanus cases, the total being nearly double that of last year. Except in a few progressive cities which passed prohibitory or restrictive ordinances, however, there seems to have been a relaxation of authority regarding the use of fireworks, chiefly in Illinois, Massachusetts, New Jersey, New York and Pennsylvania. More serious has been the absence or non-enforcement of restrictions on the use of blank cartridges, which, of course, accounts for the increase of tetanus cases.
Tetanus antitoxin, although extensively used, was still not employed as much as it should have been, either as a preventive measure or after active symptoms