COLUMBIA LIBRARIES OFFSITE 
 
 HEALTH SCIENCES STANpARD 
 
 HX641 26498 
 RC1 48 .M85 Rabies and how to pr 
 
 RECAP 
 
 IIOTT 
 
 m 
 
 P.ABIES MD HO' TO PREVEIMT IT 
 
 i 
 
^C\.4& 
 
 V\&S 
 
Rabies and How to Prevent It. 
 
 J^ F^PER 
 
 READ BEFORE THE 
 
 American Social Science Association, 
 
 S-A.PI.A.TOG-A., SEI'TEIwfrBEK. 8, 1886 
 
 VALENTINE MOTT, M. D., 
 New York. 
 
 BOSTON : 
 
 PRESS OF GEO. E. CROSBY & CO., 383 WASHINGTON STREET. 
 
 1887. 
 
• M ^ ^^ 
 
 Digitized by the Internet Archive 
 
 in 2010 with funding from 
 
 Open Knowledge Commons 
 
 http://www.archive.org/details/rabieshowtopreveOOmott 
 
RABIES AND HOW TO PREVENT IT. 
 
 BY VALENTINE MOTT, M. D., OF NEW YOBK. 
 
 Essentially an old disease, despite of what many say, since we 
 find mention of it in old Latin and Greek authors, — it is proba- 
 ble that the name of none of the ills inflicted on suffering human- 
 ity strikes with such dire effect upon the ordinary mind as does 
 this one word, — rabies or hj^drophobia. For many j-ears this last 
 term has been applied more especially to the disease as it mani- 
 fests itself in the human being, but even in this case it is a misno- 
 mer, and the sooner it is done away with and banished from both 
 scientific and ordinary dictionaries the better. Derived from the 
 two Greek words hudor, water, phobos, fear, it indicates a symptom 
 found in certain cases in man, but by no means invariably, and 
 only rarely met with in dogs and other animals. The apparent 
 dread of all liquids in man is more especially intensified by the 
 fact that all attempts to swallow are extremely painful, even in the 
 case of solid food, and spasm of the larynx, pharynx and (Esopha- 
 gus being brought about by the attempted ingestion of liquids. 
 There is no fear of the liquid itself ; it is the paroxysm that is 
 almost certain to follow its being swallowed or even an attempt at 
 swallowing it, that is much feared and dreaded by the human 
 being. Because a dog drinks water let not the mistake be made 
 of saying that he is not sufl^ering from rabies. During the first 
 stages of the disease, the dog drinks water ravenously, and even 
 after the constriction has taken place in the throat, which renders 
 its deglutition difficult, the mad dog will push his head deep into 
 the water and try to force it down. Dogs have been known to 
 swim rivers during the ferocious stage, and in many cases described 
 by the most competent authorities water has not only been drank, 
 but taken in such exceptionally large quantities as to cause re- 
 mark. Let not, then, the fact that the suspected dog drinks water 
 lead any one to pronounce the bitten person free from danger, and 
 not in need of precautionary and preventive treatment, as has 
 been done before this and serious results followed. 
 
 To this end let us do away with the word hydrophobia, and sub- 
 stitute the more generic term rabies. Let this term be used by all 
 
to denote the disease caused by the specific poison generated in 
 tiie dog, cat, fox, jackal, hyena and wolf, manifested b}' certain 
 symptoms referable to the nervous and secretory systems, and ca- 
 pable of being transmitted by inoculation (more especially by the 
 bites of these animals) to man and almost all warm-blooded ani- 
 mals. This disease, when once manifested, is almost invariably 
 fatal ; in fact, those cases reported as cured are to a great measure 
 doubtful, being probably what is known as pseudo-hydrophobia — 
 the result of an over-wrought imagination. This state undoubt- 
 edly exists, and in certain cases death results from it, so great is 
 the power of the mind over the body. Nor is the state always 
 recognized, and it is only by Gubsequent experiment, namely', the 
 inoculation of dogs and rabbits from the brain and cord of the 
 subject, and their becoming or not becoming affected with rabies, 
 that a correct diagnosis of what the disease was can be arrived 
 at. 
 
 Rabies was feared b}' the ancient Greeks and we find it men- 
 tioned b}" Aristotle and undoubtedly referred to in Homer, Euripi- 
 des and Hippocrates. Celsus, the celebrated physician, who lived 
 during the century before the Christian era, described it well in 
 his " De Medicina," and recommends those measures which have 
 been deemed so efficacious in modern times, — namely, caustics, 
 burning, cupping, and the sucking of the wounds of those bitten 
 by rabid dogs. Paulus ^gineta, in his work entitled " De Re 
 Medicina," gives a good account of rabies in the human being, 
 enumerating the symptoms as described by previous authors, of 
 which there were man}', and dividing it into two essential varieties, 
 namely : That produced from the specific poison of the bite of a 
 rabid animal and always fatal, and the purel}' nervous or pseudo- 
 hydrophobia produced by other causes. Authors in various lan- 
 guages have followed the lead of these forefathers of medicine, 
 and in every tongue we find descriptions of rabies, together with 
 infallible nostrums for its cure. Not only were external remedies 
 recommended, but also internal treatment of the most nauseous 
 kind, and even religion itself was called to the aid of those af- 
 flicted or likel}' to be afflicted after bites, and the good St. Hubert 
 was invoked, and certain ceremonies performed at his shrine in 
 order to obtain immunity therefrom. 
 
 Many epizootics of rabies have occurred, and it ma}' almost be 
 said that no place is absolutely free from its ravages, though it 
 
seems to be most frequently found in France, Germany, upper 
 Italy and Holland. Great Britain is by no means free from it, and 
 in Russia it is frequent, especially among the wolves that infest 
 that country. In this country, to my mind, it undoubtedly exists 
 at times — during the last year to a greater extent than for some 
 time before, far more cases having been brought to the attention 
 of the public at large through the press. 
 
 As regards the question of the spontaneous origin of rabies in 
 the dog, no point in connection with this disease has been more 
 thoroughly discussed, and in no case have the authorities come to 
 so little conclusion. To me it seems still a doubtful point, with 
 the weight of the evidence in favor of spontaneity. Undoubtedly 
 the great majority of cases are of a traumatic origin, but the dis- 
 ease must at one time or another have had an origin, and we hear 
 of a number of cases in which it is utterly impossible to trace any 
 bite from a dog alreadj' mad. For a long time it was supposed 
 that the season of the year had an influence in determining the 
 existence of madness, and the term " dog-days" has become uni- 
 versally used in the English language to designate that hot 
 weather during which the dog was most likely to be taken. Sta- 
 tistics, however, seem to point out that April and May are the 
 months during which, perhaps, the outbreak of the disease is the 
 most prevalent ; though there is only a slight difference, and it 
 would seem as though it were as prevalent in the winter months 
 as in the summer, a fact startling though true. It does not seem 
 as though warm climates tended to increase the disease ; in fact, 
 the contrary may almost be said to be true, as we find it more fre- 
 quently in the temperate zone. Many have maintained that the 
 disease only existed in the male, or, at all events, that the female 
 was comparatively free from it. The first statement is absolutely 
 false, in one case a whole pack of female hounds being attacked 
 by it ; and the second being well accounted for by the fact that 
 the dogs outnumber the bitches to a great excess, there being, I 
 believe, in the state of New York alone, seven dogs to every 
 bitch. 
 
 We will now take up some of the more characteristic symptoms 
 of rabies as manifested by the dog, — symptoms it would be well 
 for every one to know and guard against, by having the suspected 
 animal confined and carefully watched, so that any outbreak might 
 be warded off. In case any one has been bitten it is far better 
 
6 
 
 that the dog should be allowed to live, so that it might be watched 
 and the people put out of their suspense, should the dog not be 
 mad. Death will ceitainl}' follow inside of ten days, should the 
 dog be suffering from rabies ; in the majority of cases on the 
 fourth, fifth or sixth daj- after the appearance of the first symp- 
 toms of the disease. 
 
 The dog attacked with rabies in the beginning does not show 
 any violent symptoms of madness or fury, he does not bite, but 
 rather becomes more affectionate, licking the hands and face of 
 those whom he has been attached to. Even at this period the sa- 
 liva is poisonous, and inoculation ma}'^ take place. It soon after 
 begins to be more morose and sullen, tries to hide itself away, but 
 not content with any one place or position, is restless and change- 
 able, and wears a far-off look in the eyes, snaps and barks at 
 imaginary objects. It still, however, continues obedient to its 
 master, (and this continues to a great extent through the whole 
 disease,) acknowledging his power and seeking to compl}' with his 
 commands. The desire to bite is soon developed and manifests 
 itself in the first place against iuanimate bodies — pieces of wood, 
 stones, matting, rugs, in fact, anything that may be near it, all of 
 which goes to form a mass in the stomach, which is regarded as 
 one of the post-mortem characteristics of rabies. It now, if pos- 
 sible, escapes from home and rushes around the country, its anger 
 being more especiall}^ developed by the sight of other dogs, whom 
 as a rule it immediately attacks and bites. In fact, though a rabid 
 dog ma}^ be in the quiescent state, upon the approach of another 
 dog access of fury will be developed and a violent onslaught will 
 be made. The well dog, recognizing by some unknown process 
 the presence of danger, will slink awaj', even though more power- 
 ful, and try to escape. Early in the disease a peculiar bark is 
 developed, which is known as the cock-crow, resembling this in a j 
 certain way ; the first note of each three successive howls remain- 
 ing constant, the second notes being in an ascending scale one 
 tone apart, the last being the octave of the first note. There is 
 no fear of water, and although there ma}- be foaming at the mouth 
 it is b}' no means a constant symptom. A peculiar characteristic ' 
 in the mad dog is the absence of the sense of pain ; a red-hot 
 poker will be grasped and held on to. Dogs will bite themselves j 
 and still utter no cr}'. Periods of calm succeed these accesses, j 
 the danger from inoculation still existing. Exhausted b}' the par- 
 
oxysms and the fighting it has done, the dog will still continue on, 
 in its unsteady gait, with the tail between its legs, eyes wander- 
 ing, and head rolling from side to side, and the mouth open and 
 tongue protruding, until at last^ entirely gone, it will lie down to 
 die of asphyxia and paralysis. What is known as dumb madness 
 rarely affects dogs, though when rabies is communicated to rab- 
 bits by inoculation and introduction of rabid material under the 
 dura mater, tliis variety obtains in 99 cases out of 100. Its dis- 
 tinctive characteristic is paralysis. In it the lower jaw hangs 
 down, the saliva pours from the mouth, motion becomes less and 
 less, and the animal dies a comparatively painless death, the func- 
 tions of the various organs of the body gradually being suspended. 
 
 In the human being, the first symptoms of the fatal attack seem 
 to be a peculiar itching of the old wound and the spread of neu- 
 ralgic pains from it toward the nerve centres ; a general feeling of 
 malaise and an impending dread of something frightful about to 
 happen ; there is a tightness about the throat and difficulty in 
 swallowing ; breathing becomes affected and there is oppression 
 over tlie whole chest. Violent paroxysms follow, showing evidently 
 that the whole nervous system is in a most frightfully excited 
 state — a ray of light, a breath of wind on an exposed part of the 
 body, the sight of water sometimes, the constriction following an 
 attempt to swallow it, greatl}' craved though it may be, are sufficient 
 to determine a spasm. Ropy, viscid mucus is secreted by the salivary 
 glands and vehemently expelled from the mouth. Violent convul- 
 sions of the larynx and pharynx take place, in many cases closing 
 the windpipe and preventing the access of air. Hallucinations 
 come on and sometimes wild delirium. During the interval of the 
 attacks, the sufferer is often calm and rational, and in many cases, 
 feeling the approaching access, begs to be restrained so that he 
 may do no harm. Paralj'sis finally supervenes, and, totally ex- 
 hausted, death mercifully relieves the sufferer. True rabies is 
 necessarily fatal in the present state of our scientific knowledge. 
 Drugs and treatment of every kind, sort and description have been 
 tried without avail ; all that can be done is to attempt to relieve 
 the frightful symptoms as best we can ; and it is certain^ justifi- 
 able to try any remedy that holds out the slightest chance of af- 
 fording even a minimum of relief, to say nothing of anything that 
 might effect a cure. 
 
 The period of incubation of rabies is very variable, different 
 
8 
 
 authorities giving the shortest period in the clog at from 5 to 10 
 days (Renault), and the longest 14 months (Haubner), the major 
 ity of cases occurring in from three to seven v^eeks after the bite. 
 In the human being the ordinary period of incubation is six weeks, 
 though cases have been noted in which the period was only two 
 days, and others which extended over four and five years (Tham- 
 haym). As regards the likelihood of having rabies after having 
 been bitten by a rabid dog, the authorities are also at variance, 
 though at the present time it is about fair to say that about 16 per 
 cent, of those bitten are affected. (Holmes and Leblanc, a veteri- 
 nary of Paris.) Others make the percentage of escape 60. Again, 
 out of 320 cases 12S perished, making 40.31 per cent. (Bouley) ; 
 in another lot 33 per cent, died (Renault) ; and again, in 24 cases 
 only one died (John Hunter) . Van Buren says that two out of 
 three bitten have rabies. i 
 
 As regards prevention — undoubtedly in the first place the 
 wound should be cauterized, no matter what subsequent course is 
 to be pursued. Let water be dashed over the wound so as to 
 cleanse it, and apply immediately nitric acid. This, to my mind, 
 is infinitely better than nitrate of silver, carbolic acid, or the ac- 
 tual cautery, any of which may be used in the absence of the first- 
 named. To make assurance doubly sure, the part bitten may then 
 be excised, and the wound again cauterized. I am opposed to 
 the method of sucking the wound, as it exposes another person to 
 danger. 
 
 For over five years experiments have been going on in the 
 laboratory of the Ecole Normale in the Rue d'Ulm, Paris, seek- 
 ing to attain this great end — the prevention of rabies — and this 
 end has been attained. The master mind in prophylactic treat- 
 ment and destruction of disease was at work, and he who dis- 
 covered the principles of acetic fermentation, the cause and means 
 of prevention of the silk-worm sickness, inoculation as a preven- 
 tion of anthrax, etc., has given the world one more great gift, and 
 put all nations in his debt. This method is no child of the mo- 
 ment. Pasteur has given it years of thought and rigid research, 
 and now shines forth triumphant in its success, a blessing to hu- 
 manity. 
 
 On the 30th of May, 1881, Pasteur, in conjunction with his as- 
 sistants, Chaniberland, Roux and Thuillier, made a report to the 
 Academ}' of Sciences, that, despite of previous experiments to the 
 
contrary, the spinal chord, and more especially the medulla oblon- 
 gata, contained the specific rabic poison, and that in order to ren- 
 der the inoculation more certain, the poison should be injected un- 
 der the dura mater, by means of trepanation and not subcutane- 
 ously. At the same time, by this method the period of incubation 
 became more fixed, not exceeding three weeks. More than a year 
 afterward, December 11, 1882, Pasteur and his collaborateurs 
 made a further announcement, in which they promulgated the fol- 
 lowing facts : — 
 
 I. Dumb madness and furious rabies, in fact all kinds of 
 rabies, proceed from the same virus. 
 
 II. The symptoms of rabies are infinite in variety. Each case 
 has its own, and their character depends on the nature of the 
 points of the nervous system, — brain, spinal cord — at which the 
 virus localizes itself and is cultivated. 
 
 III. As in the rabic saliva the virus is found associated with 
 different microbes, its inoculation may give rise to death in three 
 ways : — 
 
 1. Death by rabies. 
 
 2. Death by (pyaemia) excessive development of pus. 
 
 3. Death by reason of the microbes which he had made known 
 as the saliva microbes. In December, 1880, he had inoculated 
 two rabbits from the saliva of a child who had died mad in the 
 hospital Saint Eugenie. These rabbits died in 36 hours ; others 
 inoculated from these died, and so on through several series. A 
 microbe was discovered in the blood. Subcutaneous injections of 
 this blood failed to produce madness in dogs. He first supposed 
 this to be the microbe of rabies, but soon determined that this was 
 not the case, as it was found in the saliva of a healthy man, and 
 rabbits inoculated by M. Vulpian with it died. 
 
 IV. The medulla oblongata of people and animals who have 
 died of rabies is always virulent. 
 
 V. Rabic virus is found not only in the medulla, but also in the 
 whole or part of the encephalon. It is found localized in the cord 
 and often in all parts of the cord. The virulence in the cord 
 equals that of the medulla or portion of the encephalon. Viru- 
 lence remains as long as putrefaction does not set in. The viru- 
 lence of a rabic brain was kept for three weeks at a temperature 
 of 12 degrees c. 
 
 VI. To develop rabies certainly and rapidly, inoculation must 
 
10 < 
 
 be made on the surface of the brain under the dura mater by 
 means of trepanation. These results are also obtained by in. 
 travenous injection. Madness often declared in six or seven days. 
 
 VII. Eabies brought on by intravenous injection differs from 
 that produced by bites or trepanning. It is possible that many 
 cases of this silent madness have been passed over. In these 
 cases [of medullary rabies, prompt paralysis is frequent, fury of- 
 ten absent, rabic howling rare, while on the other hand, frightful 
 itching and tearing take place. Our experiments have led us to 
 the conclusion that in intravenous inoculation, as far as we can de- 
 termine, the spinal marrow is first attacked ; that is to say, the 
 rabic virus first fixes itself there and is propagated. 
 
 VIII. Inoculation of rabic saliva or blood not followed by death, 
 in intravenous injection in the dog, does not protect against sub- 
 sequent madness and death, upon a fresh inoculation of pure rabic 
 material introduced by trepanation or intravenous inoculation. 
 
 IX. Cases of spontaneous cure are met with after the appear- 
 ance of the first symptoms, never after the severe symptoms have 
 appeared. In certain cases the severe symptoms appeared much 
 later and were followed by death. 
 
 X. In one case, out of three dogs inoculated in 1881, two died 
 shortly of rabies, and the third, after having shown the first sj^mp- 
 toms, got well. This dog, although reinoculated hy trepanation 
 twice in 1882, did not become mad. 
 
 XI. Three other dogs could not be made rabid even with the 
 strongest virus. Did these become refractor^' by reason of a mild 
 rabies cured? or is it that some are naturally so? 
 
 These propositions are the result of over 200 experiments on 
 dogs, rabbits and sheep. In this report Pasteur first propounds 
 the idea : It is possible to render man refractory to rabies. 
 
 In his communication to the Academy of Sciences, dated Febru- 
 ary 25, 1884, Pasteur reaffirms his statements made December 11, 
 1882, and amplifies them, giving the results of various experi- 
 ments verifying them. He announced that he had succeeded in 
 rendering dogs refractory to rabies. The virus was found located 
 also in the nerves of the peripher}-, as well as in the central ner- 
 vous system and salivary glands. He said tliat different quanti- 
 ties of virus inoculated gave rise to different sj'mptoms ; a small 
 quantity to furious rabies, a larger quantity to dumb rabies. At- 
 tention is then called to the fact that the discovery of the attenua- 
 
11 
 
 tion of a virus and the application made of this fact to prophy- 
 laxis in certain diseases, had brought to light this fact of the pos- 
 sible experimental production of the different grades of virulence 
 of a virus. Rabies is essentially a disease produced b}' a virus. 
 Can different degrees of a rabic virus be obtained? The 
 answer is yes. In different animals the virulence varies, and 
 passing it from one animal to another of the same species it 
 finally becomes of fixed strength. 
 
 On May 19, 1884, the following fact was announced: In passing 
 the rabic virus from monkey to monkey it gradually becomes les- 
 sened in strength, so that finally it is incapable of giving rabies to 
 a dog by hypodermic injection. With rabbits, on the contrary, 
 the virus increases in strength in passing from one to another, and 
 finally it reaches a fixed period of incubation of seven days. 
 Pasteur now declared that he had arrived at a principle of render- 
 ing dogs refractory to madness, and asked the minister of public 
 instruction to appoint a commission to examine and report. The 
 commission was appointed as follows : Messrs. Beclard, P. Bert, 
 Bouley, Tissorand, Villemin, Vulpian. They reported, August 6, 
 as follows : Of the 19 dogs experimented on, three out of six bitten 
 by rabic dogs died ; six out of eight subjected to intravenous inocu- 
 lation of rabic material died ; five out of five inoculated by trepan- 
 ation died. Of the 25 vaccinated dogs (rendered refractory by 
 Pasteur) none were attacked by rabies. One died of diarrhoea on 
 the seventh day ; however, to be certain that it had not died of 
 rabies, three rabbits and a guinea-pig were inoculated from its 
 cord and did not become mad. 
 
 On the 25th of October, 1885, Pasteur made the report to the 
 Academy in which he announced his treatment as applied to human 
 beings and its application to the case of Joseph Meister some time 
 previous. In addition to the principles mentioned above the fol- 
 lowing are intimately connected with this process : — 
 
 The inoculation under the dura mater of a rabbit by means of 
 trepanation of the rabic cord of a dog dead of ordinary rabies, 
 produced rabies in about 15 days. If the virus of this rabbit is 
 passed to a second and from this to a third and so on, there soon 
 is a decided tendency for the period of incubation to shorten. 
 After 25 passages the period of incubation becomes eight days, 
 and finally, after 25 more passages seven days ; here it remains 
 fixed. (After 110 passage^ some showed signs in six da^-s.) 
 These cords are virulent in their whole extent. 
 
12 
 
 If short pieces of cord are taken and suspended in sterilized jars 
 n which the air has been rendered dr}' b}* means of small pieces 
 )f caustic potash placed in the bottom, the virulence will disappear 
 ittle by little until it is entireh* extinct, depending upon the length 
 >f time kept, the temperature and the thickness of the cord, 
 rhese results constitute the scientific point of of the method. The 
 :ord is dissected each day from a rabbit dead that day and care- 
 uU}^ put awa}^ in jars. Each day fresh rabbits are inoculated 
 vith the virus taken from rabbits dead that day so as to keep up 
 he series. In order to induce the refractory state in man or 
 inimals, successive inoculations are made, beginning with a virus 
 ;ufl3ciently old to have lost all its strength, and day by day in- 
 ;reased till that which is finally given if it had been first given 
 vould have produced rabies. In order to introduce the poison 
 nto the system a very small piece is rubbed up with sterilized broth 
 md introduced under the skin by means of a hypodermic s^'ringe 
 n the hypochondriac region. 
 
 Originally Pasteur began with virus 15 daj's old, — that is hav- 
 ng been kept in the desiccating jar that length of time, — and 
 iuished with virus one day old, given 13 inoculations in 10 days ; 
 low he begins with 14-da3'-old virus and ends with five-day-old, 
 >ne inoculation being given each day. 
 
 The claim on which the treatment of those bitten is maintained 
 s as follows : The ordinary period of incubation after the bite of 
 I rabid dog being about six weeks, if we can before that time in- 
 ;titute a refractory state in man the poison will not act. Inocnla 
 ions with the strong virus taken from the rabbit do this in a 
 horter time, so the rabies produced by the dog-bite is warded off. 
 rhe system has become accustomed to the poison b}' the gradually 
 ncreasing strength of the dose thereof. This foundation principle 
 3 sound, and the application is possible so long as we are able to 
 ;et a diminulation in the strength of the virus. These problems 
 lave been worked out by Pasteur and practically applied with 
 uccess. 
 
 Let us look for a moment at some statistics given by Dr. 
 Jrancher, who has performed Pasteur's inoculations on human 
 )eings for him. The report was made in June, but the period of 
 ncubation in rabies derived from the dog-bite being long, only the 
 !ases up to April 22 were taken. The cases were divided into 
 ,hree classes. First-class — Those bitten by dogs proved to be mad 
 
13 
 
 by inoculation of rabbits or subsequent development of rabies in 
 animals bitten by them — 96 cases, one death. 
 
 Second-class — Patients bitten by dogs certified to be rabid by 
 the veterinary practioners of the locality, — 644 cases, three deaths. 
 
 Third-class — Those bitten by dogs who had run off and not 
 been seen again — 232 cases, no deaths. 
 
 In the first two classes 740 cases with three deaths, not quite 
 one-half per cent, of those bitten ; while the ordinary' statistics of 
 like cases given by M. Leblanc, veterinary surgeon of the city of 
 Paris, give 16 per cent, as the number of deaths. Dr. Brouardel 
 has calculated that no less than 80 per cent, of those bitten by 
 rabid dogs on exposed parts of the body die. Of the 84 cases of 
 wolf-bite, not included in the above, seven died. Ordinarily, 66 
 per cent of those bitten by rabid wolves died, and here the per- 
 centage is 6. Looking at these, shall we not say the principles 
 and methods are a success? During the month of April last I vis- 
 ited Pasteur's laboratory, as the representative of the American 
 Pasteur Institute. I was kindly received by him and his assist- 
 ants, and everything in the process of his method of inoculation 
 shown me, from the primary trepanation and introduction of the 
 virus under the dura mater of a well rabbit, to the inoculation of 
 a human being with the spinal cord of a rabbit which had died 
 with rabies. All the steps were shown me ; nothing was con- 
 cealed. Upon leaving Paris, a rabbit inoculated that day was 
 given me. This rabbit was my constant care for the next nine 
 days, when it died, having developed signs of paralysis two days 
 before. I immediatelj' placed the body on ice, and on the next 
 da}', having arrived here, the spinal cord was dissected out, and 
 the work of propagating the virus begun. Rabbits were inocu- 
 lated every day for several days, the cord being kept in carbonic 
 acid gas at a low temperature. Those rabbits developed rabies in 
 due course, and after a time a series was established and the work 
 was begun on the human being. In the first case, unfortunately', 
 the patient's health was such that his parents discontinued the in- 
 oculations, after the fourth. The trouble did not arise from the 
 inoculations, but from a series of accidents which happened to the 
 lad (who was only seven years old) immediately before the begin- 
 ning or during the time of the inoculations — he having been hit 
 with a stone and badlj' cut ; having fallen down the Elevated rail- 
 road stairs, which was followed by severe epistaxis ; having cut his 
 
14 
 
 wrist, and a good-sized branch of the ulnar artery, so that there 
 was a great deal of hemorrhage ; as well as having suffered severely 
 from the bite. In the second case, the inoculations were taken 
 through the whole series, the patient is doing well, not having suf- 
 fered any inconvenience from the treatment. The same may be 
 said concerning the third and fourth cases. In two out of the 
 last three cases the dogs were undoubtedly mad, all the symptoms 
 pointing that way. In the other case there were sufficient indica- 
 tions to warrant the treatment, especially as the parents were 
 anxious to have it done. 
 
 I have also inoculated myself as a means of prevention. A 
 number of people have come to me at various times, having been 
 bitten, wishing to know if inoculation was necessary — in many 
 cases much frightened and in an excessively nervous state. I 
 have been able to allay their fears, assuring them from the detailed 
 circumstances of the absolute absence of danger, and after some 
 slight treatment for their nerves and dressing of the wounds, they 
 have gone home happy and contented. Many more points in the 
 study of rabies might be brought forward, for it is a subject re- 
 plete with interest and worthy of research. If, however, I have 
 succeeded in implanting in your minds a few of the points con- 
 cerning it, and a belief in the efficacy of the method of inocula- 
 tion as a means of prevention, I shall be satisfied with my success. 
 

 Date Due 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 ^ 
 
 
 
 
RC148 
 Mott 
 
 WAR 2 Z id 38 
 
 M85 
 
 C U. Bi7>JDEpy 
 
1^