The routine is to inject into a patient bitten upon the limbs or trunk an emulsion of -I c.c. of a cord dried for 14 days and rubbed up with 3o mins. sterilised broth. This is done in the morning, and a similar dose is given the same evening from a cord dried for 13 days. Upon the second day injections of cords dried for 12 and is days are administered, and so on till upon the ninth day a single injection is administered from a cord which has only been dried for 3 days. This is the strongest dose employed during the 15 clays of treatment.
For the treatment of face and head bites and wounds caused by rabid wolves a more vigorous routine known as the intensive method is em ployed, in which t c.c. of a cord dried for 3 days is administered as early as the seventh clay, and the injections are prolonged over a period of 22 clays.
The mortality after rabid wounds has by these means been reduced (froni 15 per cent. in the untreated) to about t in 400. Many modifica tions in the original Pasteur method are carried out, such as (t) dis pensing with the drying process by the use of fresh virus; (2) diminishing the activity of the virus by treating it with antirabic serum as now practised at the Paris Institute; or (3) by Harris's plan of carrying out the desiccation in vacuo till a dry powder is obtained many times more powerful than the cords used by Pasteur; this powder preserves its virulence for a couple of years when kept in a refrigerator. Harris
has reduced the mortality to T in t.000 by the use of this modifica tion.
When symptoms of hydrophobia appear in an individual previously bitten by a rabid animal death may be regarded as certain; the few reported recoveries are believed to have been cases of pseudo-rabies or of a neurosis produced by the dread of the disease. The only thing that can be accomplished by the physician once the symptoms of hydro phobia have appeared is to ameliorate the dreadful sufferings of the patient. He should he placed in bed in a very quiet and darkened room, and as few people as possible should be permitted to congregate about his bedside. Hypodermic injections of Morphia, or Opium and Chloral by the bowel, afford some measure of relief to the suffering when Chloroform or Ether inhalations cannot be tolerated. The difficulty and dread of swallowing may be minimised by painting the pharynx with Cocaine solution. Tracheotomy may ward off death from asphyxia through laryngeal spasm. Of the host of narcotics and antispasmodics, none have been proved of any curative value. By Curare the patient's life may be prolonged; to gr. may be injected every 20 minutes till there are evident signs of general loss of muscular power. Harris reports one case cured by intravenous injections of Hydrochloride of Quinine and Urea, t5 grs. every two hours.