620 HYDEOPHOBIA 



The 4 details of the prophylactic treatment with regard to 

 dosage and virulence of material used vary in different Pasteur 

 institutes. The most important modification which has within 

 recent times taken place is the substitution by Hb'gyes of 

 increasing concentrations of a fairly fresh virulent rabbit's 

 cord for emulsions of cords subjected to decreasing periods of 

 drying. Equally good results apparently are obtained by this 

 method, and it is stated -that in cases so treated certain 

 symptoms sometimes following the ordinary treatment, the 

 gravest of which may be the occurrence of temporary paralyses, 

 are not so frequently observed. This, according to Harvey and 

 M'Kendrick, who have studied the subject very fully, may be 

 due to the fact that a smaller amount of nerve tissue is injected 

 under the Hbgyes system. 



The success of the treatment has been very marked. The statistics of 

 the cases treated in Paris are published annually in the Annates de 

 VInstitut Pasteur. The ordinary mortality is probably 16 per cent, 

 of all persons bitten. During the ten years 1886-95, 17,337 cases 

 were treated, with a mortality of - 48 per cent., and recent statistics 

 show oven more favourable results. It has been alleged that many 

 people are treated who have been bitten by dogs that were not mad. 

 This, however, is Dot more true of the cases treated by Pasteur's 

 method than it was of those on which the ordinary mortality of 16 

 per cent, was based, and care is taken in making up the statistics to 

 distinguish the cases into three classes. Class A includes only persons 

 bitten by dogs proved to have had rabies, by inoculation in healthy 

 animals of parts of the central nervous system of the diseased animal. 

 Class B includes those bitten by dogs that a competent veterinary surgeon 

 has pronounced to be mad. Class C includes all other cases. During 

 1895, 122 cases belonging to Class A were treated, with no deaths ; 940 

 belonging to Class B, with two deaths ; and 449 belonging to Class C, 

 with no deaths. Besides the Institute in Paris, similar institutions exist 

 in other parts of France, in Italy, and especially in Russia, as well as 

 in other parts of the world ; and in these similar success has been 

 experienced. It may be now taken as established, that a very grave 

 responsibility rests on those concerned, if a person bitten by a mad 

 animal is not subjected to the Pasteur treatment. Sometimes during or 

 after treatment there appear slight paralytic symptoms with obstinate 

 constipation and it may be retention of urine, but these usually pass off 

 within a few weeks and leave behind no ill-effects. 



The principles underlying the prophylactic treatment of 

 rabies raise questions of the highest interest from the standpoint 

 of immunity. The prime fact is, as has been stated, the taking 

 advantage of the long period of incubation of the disease in man 

 to neutralise an infection which may be supposed to be gradually 

 gathering force. We have here again to deal with an example 

 of the reinforcement of the natural powers of resistance of the 

 body in order to enable it to cope with a local pathological 



