518 



HYDROPHOBIA 



skin by means of a hypodermic syringe. The first injection was 

 made with a very attenuated virus, i.e. a cord fourteen days old. 

 In subsequent injections the strength of the virus was gradually 

 increased, as shown in the table : 



July 7, 1885, 9 A.M., cord of June 23, i.e. 14 days old. 



old. 



The patient never manifested the slightest symptom of hydro- 

 phobia. Other similarly favourable results followed ; and this 

 prophylactic treatment of the disease quickly gained the con- 

 fidence of the scientific world, which it still maintains. (The 

 principal is, of course, the same as in artificially developing a 

 high degree of active immunity against a bacterial infection.) 



The only modification which the method has undergone lias been in 

 the treatment of serious cases, such as multiple bites from wolves, 

 extensive bites about the head, especially in children, cases which come 

 under treatment at a late period of the incubation stage, and cases where 

 the wounds have not cicatrised. In such cases the stages of the treat- 

 ment are condensed. Thus on the first day, say at 11 A.M. and 4 P.M. 

 and 9 P.M., cords of 12, 10, and 8 days respectively are used ; on the 

 second day, cords of 6, 4, and 2 days ; on the third day, cords of 1 day ; 

 on the fourth day, cords of 8, 6, and 4 days ; on the fifth, cords of 3 and 

 2 days ; on the sixth, cords of 1 day ; and so on for ten days. In each 

 case the average dose is about 2 c.c. of the emulsion. 



The success of the treatment has been very marked. The statistics 

 of the cases treated in Paris are published quarterly in the Annales de 

 I'Institut Pasteur, and general summaries of the results of each year 

 are also prepared. As we have said, the ordinary mortality formerly 

 was 16 per cent of all persons bitten. During the ten years 1886-95, 

 17,337 cases were treated, with' a mortality of '48 per cent. It has been 

 alleged that many people are treated who have been bitten by dogs that 

 were not mad. This, however, is not more true of the cases treated by 

 Pasteur's method than it was of those on which the ordinary mortality 

 of 16 per cent was based, and care is taken in making up the statistics 

 to distinguish the cases into three classes. Class A includes only persons 

 bitten by dogs proved to have had rabies, by inoculation in healthy 

 animals of parts of the central nervous system of the diseased animal. 

 Class B includes those bitten by dogs that a competent veterinary surgeon 

 has pronounced to be mad. Class C includes all other cases. During 

 1895, 122 cases belonging to Class A were treated, with no deaths ; 940 

 belonging to class B, with two deaths ; and 449 belonging to Class C, 



