42O RABIES 



powerful immunizing properties. In the preventive treatment of 

 rabies on Marie's system the fresh fixed virus, made into a fine 

 emulsion with normal saline solution, is partially neutralized with 

 immune serum, and a dose of 6 c.c. (2 c.c. of i : 10 emulsion of 

 virus and 4 c.c of serum) is given in two places under the skin of 

 the abdomen. This is done for four days, and then injections of 

 dried cord, beginning at that of the sixth day, are commenced. 



Other methods involve the use of heat, of chemical methods 

 (e.g., partial digestion with gastric juice, as practised by Centanni), 

 in order to bring about attenuation or partial destruction of the 

 virus. 



Whatever the method, it appears necessary that the patient 

 should undergo a course of active immunization, various causes 

 (e.g., the long incubation period and the localization of the virus 

 in the nerves) rendering passive immunity an unsafe method of 

 protection. 



Of the value of the process there cannot be the slightest doubt. 



The incidence of hydrophobia after the bite of a rabid animal 

 is variously estimated, the figures usually given being about 

 15 per cent, in the case of dog-bites, and 40 to 80 per cent, 

 in bites from wolves. The probability of the patient's developing 

 the disease depends on the severity of the bite, its position 

 (i.e., whether in regions rich in nerves or the reverse), and 

 on whether the bite is through the clothing, so that some of 

 the virus is wiped from the teeth. In the twenty-two years (down to 

 1907 inclusive, the last year of which the figures are available), 

 ^0,359 patients have been treated at the Pasteur Institute in 

 Paris, with 126 deaths a death-rate of 0-31 per cent. (The 

 patients dying within fifteen days of the commencement of the 

 treatment a small number are excluded from the figures, since 

 in them the disease was too far advanced for a preventive treat- 

 ment to be of value.) 



