ACTIVE IMMUNIZATION 



In severe injuries the entire treatment is repeated after one month's interval. 



There is at present no doubt whatsoever as to the value of these antirabic vaccina- 

 tions. Compiled from a great number of statistics, the mortality of those infected or 

 exposed to infection but untreated is 15 to 16 per cent., while the death rate of those 

 treated at the Berlin Institute during 1898 to 1901 was 0.55 per cent. Similar figures 

 are given by the other institutions. 



The serum of individuals who have taken the Pasteur treatment con- 

 tains antibodies that can neutralize the toxic effects of the rabies virus. 

 If a virulent strain of the latter is mixed with the serum and injected into 

 an animal, no symptoms will develop. A similar serum is manufactured 

 at the Pasteur Institute by the intravenous injection of sheep with emul- 

 sions of the street virus or virus fixe. It is used mainly for immunization 

 of animals by the so-called " simultaneous method/' whereby mixtures of a 

 virulent virus and the serum are employed. In this way an immunity is 

 attained much more rapidly than by the classical method. A. Marie and 

 Remlinger have made use of this simultaneous method also in man, with 

 good results. It is of value especially when a rapid immunity is essential 

 as in severe infections (bite of wolf, injuries of the face) or neglected cases. 

 The time elapsed between the injury and the onset of treatment is an im- 

 portant deciding factor as to the final result. The following table of 

 Diatroptoff demonstrates this: 



The immunity attained by vaccination is of comparatively short duration; 



probably only several years. It is advisable therefore in case of reinfection 



not to depend upon the previous immunity but go through another 



treatment. 



Attempts have been made to employ this principle of virus attenuation 

 for other infections. Behring and Koch tried immunization 

 a S amst bovine tuberculosis by inoculation with living human 



Tuberculosis tubercle bacilli. These can be bought under the name of 

 Bcvovaccine (v. Behring) and Tauruman (Koch). 



L 



Tauruman is prepared by the Hochst Farbwerke and is put up in sealed glass tubes 

 which contain 0.02 to 0.04 gm. of living tubercle bacilli suspended in 10 c.cm. of 

 normal saline solution. This Tauruman is previously examined in Ehrlich's Institute 

 and note is taken of its purity, quantity of bacteria, virulence against guinea-pigs and 

 avirulence against rabbits (characteristics of the human type of tubercle bacilli). 



