RABIES 537 



Other methods of immunization against rabies have been proposed 

 by different investigators. But all of these methods have proved on 

 trial to be unsatisfactory and unreliable, beside being not devoid of 

 danger. As early as 1889, Babes and Lepp conceived the idea that it 

 might be possible by means of the blood to transmit conferred immunity 

 against rabies from one animal to another; but although the success 

 of these investigators was not great, Tizzoni and Schwartz, and later 

 Tizzoni and Centanni, worked out a method of serum inoculation and 

 protection in rabies which is worthy of attention. In this method not 

 the rabic poison itself but the protective material formed is injected 

 into the tissues. These observers showed that the serum of inoculated 

 animals is capable of destroying the pathogenic power of the rabic 

 virus not only when mixed with it before injection, but when injected 

 simultaneously or within twenty-four hours after the introduction of 

 the virus into the body. This serum treatment of rabies is still in the 

 experimental stage. We ourselves have had no experience with it, 

 nor has it been adopted in Paris, or, so far as we know, in other places. 

 It is quite possible that others will not obtain such good results as the 

 authors of the treatment, or that it may not prove so efficacious in 

 the treatment of man as it has been found to be in experimental 

 work. 



The Cauterization of Infected Wounds. It is commonly believed that 

 unless a cautery is used within an hour after infection by a suspected 

 animal it is useless to apply it. This belief is held by physicians in 

 general, and also, apparently, so far as the literature seen by me indi- 

 cates, by those familiar with rabies. For this reason physicians when 

 applying a cautery later than an hour after infection do so largely as 

 a matter of form, for its moral effect on the patient, and so the appli- 

 cation is not thorough, and in consequence not effectual. There is no 

 evidence to show that the cautery is useless after an hour; no systematic 

 investigations have been published, so far as we know, to prove the 

 point one way or the other. 



We know that the virus of rabies is not carried into the system by 

 the blood, but through the nervous system. Dr. Follen Cabot carried 

 out an extensive series of experiments in our laboratory upon guinea- 

 pigs which showed : (1) That 91 per cent, of guinea-pigs can be prevented 

 from developing rabies if the wounds be cauterized with chemically 

 pure nitric acid at the end of twenty-four hours from the time of infec- 

 tion, probably a larger percentage if the cautery be used earlier. (2) 

 That fuming nitric acid is more effectual than the actual cautery of 

 pure nitrate of silver. (3) That some degree of benefit is derived from 

 thoroughly opening and swabbing out an infected wound within twenty- 

 four hours from the time of infection when no cautery is used. I believe 

 that he demonstrated that in cases in which the Pasteur treatment 

 cannot be applied great benefit may be derived from the correct use 

 of cauterization, even twenty-four hours after infection, and that even 

 in cases in which the Pasteur treatment can be given, an early cauteriza- 

 tion will be of great assistance as a routine practice, and should be 



