Amyloid bodies constantly found in the central nervous system, disposed in an irregular manner. They are composed of homogeneous substances in which a large number of granulations, character ized by their intense color, may be seen. They consist partly of distinct bacilli that frequently show at one extremity a longitudinal club-shaped swelling resem bling the erosure of actinomyces. The constant presence of these parasitic bodies suggests that they may represent the pathogenic agent of rabies. Puseariu (Sem. Mcd., Mar. 22, '99).
The microscopical examination of a fatal case of rabies led to the following conclusions: In the dorsal and lumbar regions of the spinal cord there was in tense hyperaemia of the vessels in the white substance, and especially in the gray matter, with an infiltration of the perivascular spaces by lymphoid ele ments. In sections prepared after the method of Bousch there were several small black agglomerations at the pe riphery of the white substance, as well as a pigmentary degeneration of the cells of the anterior cornua and of Clarke's columns. In preparations stained with basic aniline dyes numer ous cells of the anterior cornua and of Clarke's columns seemed deformed and altered. presenting a ehromatolysis dif fuse or in spots, and marginal or per- nuclear. The nucleus was displaced toward the periphery, deprived of its membrane, and it sometimes stained more intensely than the cell-body itself. In certain cells the processes were broken. All these changes were more marked in the cervical enlargement and in the bulb. In the depths of the floor of the fourth ventricle there were small haemorrhages. S. Tchernischeff (Ar chives de Neurol., Apr., '99).
The pathologico-anatomical changes of asphyxia are often present, predomi nating in some eases or even being the only lesions found. The mucous mem brane of fences, pharynx, and larynx is often congested. The salivary glands have been found to show the changes of a mild inflammation, and a mild paren chymatous nephritis is often present. In dogs the stomach may contain straws, sticks, and other foreign matter eaten by the animal.
Prognosis. — The hope of recovery from true well-marked rabies is very slight, death ensuing after a few days in almost every instance. During the past ten years excellent results in pre venting the development of rabies in persons bitten by rabid animals have been obtained by the use of the pre ventive inoculations spoken of below.
Treatment.—Immediately upon being bitten by a supposedly rabid animal a ligature should be placed upon the limb above the wound, the wound should be disinfected or, better still, thoroughly cauterized by heat or by nitrate of silver, or carbolic acid, or in some cases may preferably be excised. The wound should not be closed, but kept freely open and allowed to bleed as much as it will.
In dog-bites immediate treatment with strong fuming nitric or hydrochloric acid is recommended. One or 2 drops will suffice, and the slough soon separates, leaving a clean wound, which heals readily. J. C. Vaughan (Indian Med. Gaz., No. 8, p. 273, '96).
In treating a patient bitten by an ani mal, the history of the animal should be obtained as far as possible. If the lo cality where the patient was bitten has been the seat of other eases recently, and the wound was in an exposed part of the body, hand or head, it should be cauterized thoroughly within twenty four hours, an anmsthetic and nitric acid being used. Fuming nitric acid is more efficient than the actual cautery or pure nitrate of silver. If the wounds were severe, Pasteur preventive treat ment should be given. If the bite was superficial or through the clothes, and the cauterization was made thoroughly within the twenty-four hours no more need be done, certainly not if there had been no cases of rabies in the neighbor hood. The Pasteur preventive treatment can never do harm and, if the patient desires it, should be advised.
The disposition of animals which have bitten people should be as follows: Never killed, but captured, and placed in a kennel under lock and key for a week. If at the end of that time they are well, there is naturally no danger for the per son bitten. If the animal dies, an au topsy should be made, all the organs ex amined, and a portion of the brain and spinal cord emulsified and inoculated in guinea-pigs and rabbits. If a disease which could cause death should be found in other organs, it is of impor tance; the inoculation tests should be made to demonstrate beyond a doubt that rabies was not also present in the same case. Follen Cabot (Med. News, Mar. 18, '99).