In man when the disease is manifested, palliation has been obtained and very exceptionally recovery, under darkness, quiet, nutritious enemata and antispasmodics or soporifics. Among such antispasmodics and nerve sedatives may be named chloroform, chloral, curare (3 alleged recoveries), eserine (1 recovery), pilocarpin (1 recovery), morphia, datura, atropia, and bromide of potassium. Others have recovered without any medicinal treatment, so that the mildness of the attack must be duly considered in every case.

Prophylaxis. The most effective way of preventing rabies is to eradicate the virus from the country. All immunizing measures resorted to after the infecting bite has been sustained, are of little value as compared with this, they may save the bitten individual, but they do nothing to prevent others from being bitten in the future, and indirectly they contribute to the maintenance of the disease by drawing attention from such radical measures as would rid the country forever of the scourge. In his great work on Diseases of the Nervous System, Gowers puts this not a whit too strongly when he says: “The enforced muzzling of dogs for a period of one year would almost certainly stamp out the disease. That such a measure is not adopted is a national disgrace, which is accentuated by the fact that the Government derives part of its revenue from a tax upon dogs. The opposition to the use of the muzzle is one of the strangest developments of morbid sentiment. There are apparently thousands of well-meaning people who would prefer that hundreds of dogs should perish every year of a painful disease, that many human lives should be annually lost, and scores of persons should be subjected for months to acute mental agony—rather than that dogs should be made to wear an apparatus which causes them a trifling annoyance. This perverted sentiment ought to be met with universal abhorrence as a disgrace to humanity.” Such a statute, backed by a penalty in some degree commensurate to the homicidal criminality of the person who would leave his dog free to inflict this horrible disease on humanity would doubtless be effectual, but some nations have such laws on their statute books, and yet allow them to become dead letters. Others have enforced them to good purpose. Berlin in 1853 had many cases of rabies and muzzling was enforced. In three years the disease was completely eradicated and the city enjoyed nine years of immunity or so long as the law was enforced. Similar successes were met with in Holland, new cases occurring only on the borders or in imported dogs. London in 1889 had 123 cases and muzzling was enjoined. In 1892 the cases were reduced to 3, and the muzzling law was suspended, and a steady yearly encrease resulted, until the 1st three months of 1896 furnished as many as 72 cases.

In the absence of this radical measure muzzling should be enforced for a year in any locality where a case of rabies has occurred, and every dog should wear a collar with the name and residence of his owner inscribed on it. All stray dogs and all unmuzzled ones should be summarily shot. Dogs and cats that have been bitten by rabid animals should be destroyed or shut up in cages for six months under veterinary supervision. Imported dogs should be similarly secluded. Dogs that have bitten animals or men should be shut up for ten days under supervision, when, if rabid, the animal will develop unequivocal symptoms.

Treatment of bites. Absorption from a wound in a limb may be prevented by applying a tourniquet. Wounds on the body may be cupped, or sucked through a tube. Or the wound may be wrung to encrease the flow of blood. As soon as possible it should be thoroughly cauterized. A hot skewer, a Paquelin cautery, a stick of silver nitrate or zinc chloride or caustic potash or a crystal of cupric sulphate will meet this end. If liquid caustics are to be employed they can be applied to all parts of the wound by means of a pipette, a glass tube, or swab.

With thorough cauterization shortly after the bite there is practically nothing to fear, and even if it has not been applied for hours after, it is still valuable in destroying the poison left in the wound from which a continuous infection of the brain, by the transmission of the unknown germ and its toxins, would otherwise take place. It has besides in the human being a good moral effect against lyssophobia by giving the bitten person a certain sense of protection.

The Pasteur Method. This is based on the fact that the spinal cord of the tetanic rabbit when removed aseptically, and kept in vitro in a dry atmosphere, loses in virulence day by day, until on the fourteenth day it is harmless. To render the air more drying, caustic potash is introduced into the flask. The culture of the poison in rabbits intensifies its virulence, until the virus becomes the strongest known and when inoculated subdurally, reduces the incubation to six or seven days.

In Pasteur’s early experiments he began injecting the emulsion of the cord desiccated for 14 days, following with that of the 13th day, and so on to that of the 5th. It was soon found that this was comparatively ineffective when inoculation had been made with a strong virus or in a large dose, and the treatment for such cases was modified to what is now known as the intensive method. The weaker forms of the virus are given at shorter intervals on the first days of treatment, and the stronger forms repeated again and again, and, in place of a 15 days, course of treatment, this is extended to 21 days. The following table illustrates the course:

Day of Treatment. Number of Days that cord had been desiccated. Dose Injected.
1st day morning. 14 days. 3cc.
13 days.
evening. 12 „
11 „
2d „ morning. 10 „ 3cc.
9 „
evening. 8 „
7 „
3d „ morning. 6 „ 2cc.
evening. 6 „
4th „ 5 „ 2cc.
5th „ 5 „ 2cc.
6th „ 4 „ 2cc.
7th „ 3 „ 1cc.
8th „ 4 „ 2cc.
9th „ 3 „ 1½cc.
10th „ 5 „ 2cc.
11th „ 5 „ 2cc.
12th „ 4 „ 2cc.
13th „ 4 „ 2cc.
14th „ 3 „ 2cc.
15th „ 3 „ 2cc.
16th „ 5 „ 2cc.
17th „ 4 „ 2cc.
18th „ 3 „ 2cc.
19th „ 5 „ 2cc.
20th „ 4 „ 2cc.
21st „ 3 „ 2cc.

Under this treatment the system becomes educated in the production of antitoxins, and perhaps also in phagocytosis so that when subjected to the lethal doses of three, four, five and six days preservation, it successfully resists them. The most conclusive argument in favor of its efficacy is this undeniable fact that the individual escapes death under injected doses which in any unprotected system would prove fatal.

The results as given by the report of the Pasteur Institute are furnished in the following table, from which are excluded such cases only as developed the disease during the course of treatment, which therefore remained incomplete.