684 ACTIVE IMMUNIZATION 



ing the characteristic Negri bodies in the large ganglion-cells, and con- 

 firmed by inoculating emulsions of the brain into guinea-pigs or rabbits. 

 The latter requires from ten to twenty days before the result may be 

 known. A negative animal inoculation test is better evidence than a 

 negative smear or section; obviously, these examinations are to be 

 made only by properly trained persons. 



According to Park, the value of the smear method of diagnosis may 

 be summarized as follows: 



1. Negri bodies demonstrated, diagnosis, rabies. 



2. Negri bodies not demonstrated in fresh brains, very probably 



not rabies. 



3. Negri bodies not demonstrated in decomposing brains, uncer- 



tain. 



4. Suspicious bodies in fresh brains, probably rabies. 



4. If the animal was clinically rabid, the Pasteur treatment should 

 be commenced as soon as possible, without waiting for the laboratory 

 report, if this will be delayed for several days. Wounds about the face 

 and hands, where there is no clothing to retain the infectious saliva, 

 should receive intensive treatment; otherwise the milder course of 

 immunization will suffice. 



5. As a general rule, it is well to send the patient to a regular Pasteur 

 institute, where there are special facilities for the proper treatment of 

 these cases. Otherwise the physician may treat the patient at home. 

 Several large manufacturing firms are prepared to ship by mail the fresh 

 daily treatments properly preserved and ready for administration. 



6. The Pasteur treatment should be given to every patient bitten 

 by a rabid animal or by one suspected of being rabid. Not all persons 

 are necessarily infected, even by bites of rabid animals, but this should 

 not unduly influence the physician, for he will not have fulfilled his duty 

 unless he carefully explains the etiology of the disease and advises im- 

 mediate immunization. Aside from the actual benefits of the treat- 

 ment, the mental effect upon the patient is deserving of consideration. 

 Even slight wounds by rabid animals, wherever their location, should 

 be regarded as dangerous, and the Pasteur treatment advised in addi- 

 tion to routine cauterization. 



7. With severe bites of angry but not necessarily clinically rabid 

 dogs, the treatment depends upon various factors. In any case the 

 wound should be thoroughly cauterized and the animal carefully 

 guarded (not killed) for two or three weeks. If rabid symptoms appear, 

 the animal should be destroyed, the cerebral tissues examined, and the 

 Pasteur treatment of the patient begun. 



