478 Rabies. 



mentioned also affect the other nerves, there develops besides 

 total aphony and inability to swallow, a partial and shortly 

 a total paralysis of the muscles of the lower jaw, tongue, and 

 eyes. The mouth is kept open most, if. not all the time, the 

 dry and livid tongue hangs out of the mouth paralyzed, and 

 the saliva flows in long threads from the lips. Owing to the 

 irregular position of the eyes the animals squint, the cornea 

 is dull and Itisterless and the pupils are dilated. These symp- 

 toms give the face a peculiar cunning and troubled expression 

 (Fig. 75 and 76). 



Owing to the process of degeneration in the spinal cord, 

 paralysis of the muscles of the tail and the extremities appears. 

 The hind limbs are generally first attacked, which causes the 

 animal to stagger and tumble, at first when running and later 

 when walking, and to drag the hind legs along the ground. The 

 paralysis then progresses to the tail, which hangs down between 

 the legs. The paralysis of the hind limbs finally reaches a 

 stage which makes it impossible for the animals to move and 

 they remain recumbent on the ground; if urged to rise they 

 will make only a few fruitless attempts with the fore legs. 



Before the disease has reached this stage, the animals 

 are already quite emaciated; the exhaustion now increases 

 rapidly, and the patients succumb within a brief time, usually 

 in convulsions. 



Owing to the danger connected with intimate association 

 with the animals little is known of those symptoms which can 

 only be determined by a close examination. As to the tem- 

 perature, Hertwig and Monin have found that it rises 1 to 3 

 degrees during the maniacal stage, but that during the paralytic 

 stage it falls down to several degrees below normal. The pulse 

 is rapid and tense from the beginning (Blaine). In the blood 

 *the polynuclear leucocytes are multiplied, and the hyperleuco- 

 cytosis increases toward the end of the disease (Oourmont and 

 Lesieur). The urine usually contains sugar (Nocard; Rabieaux 

 & Nicolas found sugar in the urine in 33 out of 44 examined 

 cases). 



In artificially infected dogs the temperature is increased during the initial 

 stage for % to 3 days, but afterwards it is low; in rabbits infected with street 

 rabies on the contrary the temperature commences to fall at the onset of the disease 

 and continues thus until the death of the animal (Lote). In human beings, the 

 symptoms of the stage of irritation are accompanied by a moderate rise in tem- 

 perature, with morning and evening remissions, but before death the temperatwe 

 becomes very high and may continue to be high for some time after death 

 Moravcsik, Schaffer). 



The described clinical picture of rabies in dogs is in some 

 cases subject to considerable modification. Above all, varia- 

 tions occur in the duration of the various stages and in their 

 mutual relations, the several stages being briefer than here 

 stated, or longer at the expense of the others. This is especially 

 true of the second stage, that of irritation, which is often vety 



