CORD LESIONS AFTER THE PASTEUR TREATMENT 615 



1000 c.c. One gram of cord is rubbed up with 5 c.c. of fluid. Of 

 this emulsion 1 to 3 c.c. are used on persons which receive the pre- 

 ventive Pasteur treatment, the dose varying as to the severity of 

 the case and as to the age of the patient. Pasteur devised three 

 methods which are still practised: one for cases of light wounds 

 which came to treatment immediately, the two others for more severe 

 cases and for later treatments. In all cases treatment is begun with 

 an emulsion from a cord which has been subjected to the drying-out 

 process for fourteen days, next a cord is used which has been dried 

 out for thirteen days, and so on, until finally a cord is used which 

 has been kept in a bottle over caustic soda for three days. The 

 whole course of treatment lasts from eighteen to twenty-one days, 

 because the same type of emulsion is used on two consecutive days at 

 times. Wounds of the face are always treated by the most energetic 

 method, which is carried out for twenty-one days. 



The original method of Pasteur has been modified by a number 

 of authors. Hoegys uses fresh virus obtained from the medulla of 

 the rabbit. The fully virulent tissue is first emulsified with sterile 

 physiologic salt solution in the proportion of 1 to 100. Then the 

 following dilutions are prepared: 1 to 200, 1 to 500, 1 to 1000, 1 to 

 2000, 1 to 5000, 1 to 10,000. Three c.c. of the last-named dilution 

 forms the first injection, and finally 1 c.c. of the strongest vaccine; 

 i. e., 1 to 100 is given on the twentieth day of the treatment. Babes 

 uses a fixed virus which has been attenuated by being heated to 80 C. 

 Tizzoni and Catanni use a virus attenuated by artificial gastric juice. 



There have now been treated by Pasteur's original method or one 

 of its modifications many thousand persons bitten by rabid animals, 

 and the mortality among those treated is less than 1 per cent. This 

 result shows clearly the great efficiency of the method. It is believed 

 that the results will still be improved by using for the vaccination less 

 attenuated and more virulent fixed virus, because it appears from the 

 work of Marx, Babes, and Nitch that the fixed virus of the rabbit 

 for man in subcutaneous injection represents already an attenuated 

 virus. Kraus believes that the best method of inoculation after bites 

 of rabid animals, particularly after extensive lacerations, will be the 

 subcutaneous injection of comparatively large doses of the virulent 

 fixed virus. 



Cord Lesions after the Pasteur Treatment. The Pasteur treatment 

 for rabies does not, in the vast majority of cases, lead to any disturb- 

 ances due to the injections themselves. However, there have been 

 reported a number of cases less than 1 for each 1000 cases treated 

 in which the injections appear to have led to some transitory lesions 

 in the cords of the persons treated. These lesions manifest themselves 

 by disturbances of sensation, disturbance of the reflexes, slight paresis 

 or paralysis and the symptoms developed sometimes resemble some- 

 what the very serious disease known as Landry's paralysis. That 

 these symptoms are not an abortive form of rabies, but due in some 



