RABIES 297 



increased; the temperature also rises, but falls toward the end of the 

 course of the disease. 



The duration of the second stage, which does not always present 

 all of the characteristic symptoms of this condition, may last from 

 three to four days. After the paroxysms have increased in intensity 

 and the intervals between them grow shorter, the paralytic, or last, 

 stage begins. The animals rapidly become emaciated; the eyes are 

 staring, dull, and the eyeball is retracted into the skull. The conjunc- 

 tiva is generally hypersemic, the cheeks are sunken; the hair is erect; 

 and we begin to see symptoms of paralysis. As a rule, the first sign of 

 this is a paralysis of the muscles that close or raise the lower jaw. This 

 allows the saliva to run out of the corners of the mouth and form threads 

 which hang down, and we easily recognize the fact that the tongue and 

 lower jaw have lost their power. The tongue becomes lead-colored and 

 hangs out of the mouth. Soon we see paralysis of the posterior extrem- 

 ities. This begins with a staggering, unsteady gait, and finally total 

 inability to use the posterior half of the body. Then the animals stretch 

 themselves out and become completely paralyzed, or in the last stage 

 we may see convulsions, but that is very rare. Death, as a rule, occurs 

 in the fifth to the seventh day after the onset of the disease. In rare 

 instances it may last ten days. Variations may occasionally occur in 

 the regular course of the disease; for instance, paralysis of the posterior 

 extremities has been the first symptom observed, and in others the 

 paralysis of the jaw has not been observed, and dyspnoea has been 

 observed for hours before death. 



Dumb Rabies. — The mute or dumb form of rabies, according to Bol- 

 linger, comprises about 15 to 20 per cent, of all cases. The average 

 given of this form of rabies is entirely too small, and should be at least 

 50 per cent., the great majority of cases observed being the dumb form. 

 This is distinguished from furious rabies by the fact that the irritating 

 or nervous symptoms are less marked, and in very rare cases entirely 

 absent, also that the paralytic symptoms appear early in the disease. 

 First, we see paralysis of the muscles of the lower jaw. The mucus or 

 saliva runs out of the opened mouth, and an inclination to bite is entirely 

 absent, although under certain conditions when the mouth is forcibly 

 opened the animal will be able to bite. The voice is also changed, but 

 it is very rarely heard. We see a loss of appetite, the animal being 

 unable to seize or swallow foreign bodies. In this quiet form the three 

 stages follow very closely on each other, the course of the disease being 

 very rapid, and death, as a rule, appears in two or three days, never 

 over five. 



These two forms of rabies in rare instances may merge one into 

 the other so that it is intensely difficult at times to separate the different 



