JAMA. 1911;LVI(24):1820. doi:10.1001/jama.1911.02560240050026.
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We have every reason to hope that the annual crop of tetanus cases will not be so large after this Fourth-of-July celebration as in previous years, for the "sane Fourth" movement seems to show a healthy growth, and tetanus occurs only in those places that still tolerate an insane Fourth. In 1909 there were reported 1,225 blank-cartridge wounds with 150 cases of tetanus, while in 1910, largely as a result of improved control of celebration by municipalities, only 450 blank-cartridge wounds were inflicted—a mere trifle—causing but seventy-two cases of tetanus, of which about sixty-seven were fatal. Even though this great improvement has taken place, we are still of the opinion that such comfort, joy and patriotic fervor as may be yielded by the primitive custom of celebrating Independence Day by explosives, is not worth the 131 lives and 2,792 injuries of greater or less severity which it cost last year.


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