602 RABIES AND THE NEGRI BODIES 



the term 'black tongue/ which is used in some localities, especially 

 in the South, and a bad synonym for this form of the disease. The 

 use of the term should be discouraged, as it tends to confound the 

 disease with dog distemper. The hind legs, trunk, and forelegs 

 become paralyzed, and death usually ensues in about three days 

 while the furious type lasts from six to eight days. 



"Recovery from rabies in the dog after well-marked symptoms have 

 developed is possible, and authentic cases have been reported by 

 Pasteur, Roux, Babes, Courmont, Ligniere, and Remlinger. This is 

 so rare, however, that it is of little importance except in cases where 

 a person has been bitten by a dog showing all the symptoms of rabies 

 and the animal afterward recovered. The saliva in such cases 

 remains virulent for several days or a week after the subsidence 

 of symptoms, and a diagnosis can be made by inoculating rabbits 

 with some of the salivary secretion." 



The consumptive form of the disease mentioned above develops 

 sometimes after the inoculation, natural or artificial, of a virus of a 

 low degree of virulency. This form, perhaps, is a more or less pure 

 toxemia, characterized by slowly progressing emaciation, marasmus, 

 and finally death after complete exhaustion. 



Symptoms in Man. When persons are bitten by rabid dogs, if the 

 wounds are not too lacerated, and if they are cleansed and treated 

 in the proper antiseptic manner and burnt out with the actual cautery, 

 they generally heal rapidly and do not give rise to any special local 

 manifestations, except that there is occasionally a good deal of itching. 

 There are no special symptoms during the period of incubation 

 except that there may be more or less depression on account of 

 apprehension. When the first symptoms of the stage of excitement 

 are about to become manifest there may be a good deal of irritation 

 at the site of the already healed wound, with lancinating pains shooting 

 out from it; a slight tremor may be present in an extremity if it has 

 been the seat of the bite. The voice becomes changed, it is not clear 

 but slightly hoarse. The patient becomes decidedly depressed and 

 irritable. Fever then generally occurs, and the disease progresses 

 rapidly to its typical picture. The laryngeal symptoms become more 

 severe, there is difficulty in respiration, the face becomes drawn, and 

 shows an expression of great anxiety. Intense thirst compels the 

 patient to make strong efforts at drinking, and these bring about 

 contraction of the muscles of the larynx, so-called spasm of the 

 glottis, with great air hunger or dyspnea. Salivation becomes 

 marked and all reflexes are accentuated, so that a slight irritation 

 may bring about attacks of muscular contractions. The patient, 

 while very thirsty, is afraid to take water, and the mere thought of 

 it may bring about spasm of the muscles of deglutition and of the 

 larynx. As the disease progresses farther the convulsions affect more 

 and more muscles, including the respiratory muscles of the thorax. 

 Patients now often suffer from hallucinations and delirium, and 



