PROPHYLACTIC VACCINATION 285 



a few moments at the site of inoculation. The treatment, although 

 practically safe, is not entirely free from danger. Remlinger in a 

 study of 107,712 cases that had received treatment found forty cases 

 which developed paralysis of the extremities and two of these ter- 

 minated in death. The cause of this paralysis is not clear. Certain 

 authorities maintain that the virus contains a toxin and that this may 

 lead to lesions of the nerves. The mass of evidence, however, is 

 against rather than in favor of the conception that toxin plays any 

 important part in the virus of rabies. It is also possible that the 

 repeated injections of foreign protein may have some influence. Such 

 accidents are extremely rare and should not interfere with a decision 

 concerning administration of the treatment. 



SCHEME OF TREATMENTS. 

 Day Mild treatment Intensive treatment 



ist 14 and 13 day cord 12 and n day cord, repeat 



in afternoon 



2nd 12 and u day cord 10 and 9 day cord; 8 and 7 



day cord in afternoon 



3rd 10 and 9 day cord 6 day cord 



4th 8 and 7 day cord 5 day cord 



5th 6 day cord 4 day cord 



6th 5 day cord 3 day cord 



7th 4 day cord 2 day cord 



8th 3 day cord 4 day cord 



9th 2 day cord 4 day cord 



loth 4 day cord i day cord 



nth 3 day cord 4 day cord 



I2th 2 day cord 3 day cord 



I3th 4 day cord 2 day cord 



I4th 5 day cord 4 day cord 



I5th 2 day cord I day cord 



i6th 4 day cord 4 day cord 



I7th 3 day cord 3 day cord 



i8th 2 day cord 2 day cord 



I9th 4 day cord 4 day cord 



2oth 3 day cord 3 day cord 



2ist 2 day cord 2 day cord 



Results of Treatment. The benefits of this form of treatment 

 depend to a certain extent upon the time when the injections are begun 

 and also to a certain extent upon the situation of the bite. Granting 

 that fatalities occur in from 6 to 16 per cent, of untreated bitten indi- 

 viduals, the reports of fatalities in from .46 per cent, to 1.25 per cent, 

 of treated cases show markedly beneficial effects. More recent statistics 

 are highly encouraging. During the year 1916 Viala reported that 654 

 persons were treated at the Pasteur Institute with but one death. 



VACCINATION WITH KILLED ORGANISMS 



Vaccination Against Typhoid and Paratyphoid Fevers. Al- 

 though various investigators had appreciated the possibility of active 

 immunization against typhoid fever, this subject was first placed on a 

 practical basis by Wright in 1896. In the subsequent year Wright 

 and Semple described in detail a satisfactory method for vaccination. 



