Armstrong – Table of Contents

and state boards of health developed methods for the commercial production of vaccine
virus by harvesting cowpox lesions from the bare abdomens of young calves. The
regulatory functions of the Hygienic Laboratory and its successor organizations (Division
of Biologics of LID, FDA) oversaw the standardization for potency and sterility of
smallpox vaccine.
Charles Armstrong first announced his interest in the problem of tetanus as a
complication of vaccination in a manuscript in 1925 describing tetanus in the United
States following the use of bunion pads as a vaccination dressing (1). Tetanus (12),
colloquially termed “lockjaw”, is a disease manifested by generalized, uncontrolled
involuntary tonic muscle spasms caused by the action of a potent central nervous system
toxin produced by the bacillus Clostridium tetani. This organism is a motile, gram
positive, anaerobic, non-encapsulated rod; it forms spores located at one end of the rod
under adverse conditions. Heat, disinfectants and various antibiotics inactivate the
vegetative forms of tetanus. The spores are highly resistant to heat, disinfectants and
desiccation. The spores are widely distributed in nature; they can be found in human and
animal feces and can survive in dry soil for several years. Tetanus occurs when spores
gain access into damaged or devitalized tissue where, along with foreign objects,
conditions develop to provide favorable anaerobic environments for germination of the
vegetative forms of the bacteria from the spores. The vegetative forms produce the
central nervous system toxin responsible for clinical tetanus. The toxin enters through the
terminal peripheral nerve endings close to the wound and travels along the peripheral
nerves to the central nervous system, primarily spinal cord and brainstem, at the rate of
approximately 250 millimeters per day (about 10 inches). Once it reaches the cell body of