Mother's Remedies, Thomas Jefferson Ritter [reading well .TXT] 📗

virulent, till no increase in activity of the poison was shown after the fiftieth successive inoculation. "Rabbits inoculated with a brain suspension of rabbit number fifty all died in seven days." This caused Pasteur to name the virus of number fifty "virus fixe," a virus of definite length. He now had obtained a virus of definite strength and the next question was, how could the virulence be gradually and definitely reduced. [246 MOTHERS' REMEDIES]

This he accomplished after many experiments. He proved that pieces of the "medulla oblongata" suspended in sterile tubes which contained fragments of caustic potash, steadily and gradually reduced their virulence as they dried, till the fourteenth day, when they were practically inert. New specimens were prepared each day and cords which had dried in one day Pasteur called "one-day virus;" cords which had dried in two days, "two day's virus," and so on up to the fourteenth day. With this graduated virus he now experimented on dogs, and the injection he used on the first day consisted of an emulsion of fourteen-day virus; for the second day, the thirteen-day virus, thus using a stronger virus each day, until on the fourteenth day he used the full strength virus. This treatment produced what is called immunity in the dog, and even the direct inoculation into the brain of the strong virus would not produce death.

After Pasteur had thoroughly satisfied himself by repeated trials, he announced his wonderful discovery, and it was in 1886 that Pasteur considered the preventive inoculation in human beings as resting upon a satisfactory experimental basis. During these five years this eminent man proved that it was possible to protect or immunize the lower animals, rabbits and dogs, against inoculation with the virulent virus.

The efficiency of this immunity was given trials by different methods of inoculation. It was found that sixty per cent of dogs inoculated under the "dura" (a membrane of the brain) were saved if treatment was given the second day. This test is more severe than is required to meet the ordinary infection of rabies. Pasteur, after a series of these final tests were so convincing, prescribed the preventive inoculations in human beings and on July 6th, 1886, the first human patient received the first treatment of his series of inoculations.

The method of obtaining the attenuated virus used in the treatment is as follows: A rabbit is inoculated by the brain method before described, each day, with suspension of the fresh, fixed virus. These rabbits die in six days after the inoculation. In this way a rabbit dies each day; the spinal cord is removed, divided into sections, and suspended in a flask containing potassium hydrate. The action of potassium hydrate is drying (desiccating). A series of these cords, which have been hung on fourteen successive days, are always kept in stock for the treatment of patients. The virus becomes less active with each successive day of exposure to drying (desiccation) and finally the virulence is altogether lost.

When the patient comes for treatment the fourteenth and thirteenth-day cords are used for the first inoculation, and on each successive day the patient receives inoculation, the strength of which has been regulated by the number of days the cord has been hanging. During the first four days patients receive injections of six cubic centimeters of emulsions made from cords aging from fourteen to seven days, and from the fifth day until the completion of the course of treatment patients receive emulsions from cords of higher immunizing properties, but no cords desiccated for less than four days are used.

[INFECTIOUS DISEASES 247]

Death rate from 1878-1883 before Pasteur treatment was instituted taken from documents in the department of the Seine:

1878 143 bitten. 24 deaths. 1879 76 " 12 " 1880 68 " 5 " 1881 156 " 22 " 1882 67 " 11 " 1883 45 " 6 "

Average of one death to every six bitten, or seventeen per cent mortality.

Incubation period from eleven days to thirteen months, average one hundred and twenty days, depending upon location of bite. Pasteur Institute records during the years 1886-1887 and first half of 1888, show that Pasteur had under his supervision 5,374 persons bitten by animals either proven or thought to have been mad. Mortality for 1886 was 1-34 per cent, during 1887 it was 1-12 per cent, during 1888 it was 77/100 per cent. With the later treatment the mortality has decreased to 3-10 per cent in 1908. The Pasteur method of treatment is a process of immunization which must be completed before the development of the disease. It is of no value after the symptoms have appeared.

Those who have not been affected can be immunized the same as those who have been bitten. The individual who has been bitten by a mad dog realizes when and how severely he has been bitten, and were it not for the so-called period of latent development of the virus, it would not be possible to carry out the Pasteur treatment. The patient may, if he will, take advantage of this fact and be immunized by treatment before the disease has developed. Deep and severe bites are most dangerous, but the disease may develop simply from a rabid dog licking a scratch of the skin. As before stated bites on exposed or uncovered surfaces, are more dangerous than those through clothing. There is a very easy access of the saliva to the wound in the unprotected part, while in the protected parts the teeth in passing through the protection, clothing, are freed of their saliva at least partially. The virus is conveyed from the bitten part or inoculation to the central nervous system through the nerve trunk, and the rapidity of extension depends upon the resistant powers of the patient, the virulence and the amount of virus deposited in the bitten part at the time the person was bitten. This disease develops only in nerve tissues. Virus can be found in the nerves of the side bitten, while the corresponding nerves on the opposite side are free from it. It can be ascertained that the virus is present in the medulla oblongata before the lower portion of the cord.

[248 MOTHERS' REMEDIES]

Comparative danger.—A wound of the hand after a delay of three weeks is as dangerous as a bite on the head exposed only a few days. There is always a possibility of an accumulative action and extension of the virus along the nerve trunk to the central nervous system during the interval of exposure, and this should be always borne in mind. It is stated by authority that the virus is not transmitted by the bite of a rabid animal until two days previous to the appearance of the first symptoms. It is with some difficulty that a decision is reached in advising patients who are bitten to take treatment early in the course of the disease. The symptoms are often so very obscure and slight that they are not recognized. If a dog which is not naturally vicious suddenly bites without any cause it should be tied securely and watched for seven days; and should it develop symptoms of the disease during this period the bite should be considered dangerous.

Immediate treatment of the wound.—A temporary measure is the cauterization of the wound; do not neglect this because a few hours have passed since the person was bitten, for wounds may be cauterized with advantage even after two or three days have elapsed. Of course the earlier it is done the better. If they are thoroughly laid open and scrubbed it is more effective. Nitric acid used freely is the best method to use. Wash the wound freely with boiled water after the acid has been applied; ninety-five per cent carbolic acid may be used if nitric acid cannot be obtained.

If carbolic acid is used it is necessary that it be washed from the wound by the free use of absolute alcohol, followed by boiled water and a dressing of bichloride of 1-7000. This prevents the ulceration of the wound by the carbolic acid. Cauterization thoroughly done destroys a part of the inoculated virus. Thorough cauterization is especially necessary with large wounds in which large quantities of the virus is inoculated.

When to send patients to an Institute.—Send them immediately, if there is good reason to believe the animal had rabies. It is not wise to wait until the animal dies; it is very important that treatment is begun as soon as possible, especially in severe bites.

What to send for examination.—The entire head may be sent by express, or better, the health officer should bring it in person. This saves time and relieves anxiety; or a portion of the brain may be removed under thoroughly clean conditions and placed in a sterilized twenty per cent solution of glycerin and water. In this way the virus retains its virulence and putrefaction is diminished. The first method is the best, taking the head directly. The head after it reaches the laboratory is examined microscopically for "negri bodies," and if there is no contamination the microscopic findings are verified by animal inoculations. The presence of negri bodies in a specimen is of great value owing to the rapidity with which a diagnosis can be made. In one case a positive diagnosis was reported within twenty minutes after the specimen entered the laboratory and within the next hour and a half the patient bitten by the dog the same day had begun her course of protective injections and was saved.

[BLOOD AND DUCTLESS GLANDS 249]

Protection.—To stamp out this disease city authorities, etc., can enact laws. All ownerless dogs should be killed, and the keeping of useless dogs should be discouraged by taxation. All dogs should be thoroughly muzzled where the disease prevails. This article is made up from an article written by an acknowledged authority on this disease, a man in charge of a Pasteur Institute.

Cities where Pasteur Institutes are located:
    Ann Arbor, Michigan. Baltimore, Maryland.
    Chicago, Illinois. Austin, Texas.
    Minnesota. Toronto, Ont.
    New York City.

DISEASES OF THE BLOOD AND DUCTLESS GLANDS.

Anaemia, or Anemia.—This may be defined as a reduction of the amount of blood as a whole or of its corpuscles, or of certain of its more important constituents, such as albumin and haemoglobin. Primary or essential anemia includes chlorosis and pernicious anemia; secondary anemia results from hemorrhages, poor nourishment or intoxications, poisons. Chlorosis, a primary anemia chiefly of young girls, characterized by marked relative decrease of haemoglobin.

Causes.—It usually occurs in blondes of from twelve to twenty years of age and most often from fourteen to seventeen years of age, when the menstrual function is being established and during which time they are rushed with their school work. There may be a family history of chlorosis or tuberculosis. Poor food, hard, unhealthy work, confinement in close unventilated rooms are other causes.

Symptoms.—Rounded fleshy appearance may continue. There is some difficulty of breathing, palpitation of the heart on slight exertion, from a fright or from excitement, tendency to faint feeling or even fainting, headache, a tired feeling, hard to stir or do anything, irritable temper, poor or changeable appetite, the digestion is disturbed, there is constipation, coldness of the hands and feet, difficult menstruation, irregular menstruation, leucorrhea, amenorrhea, and sometimes there is a slight fever. The color is often of a yellowish-green tinge, and this is more noticeable in the brunette type, though the cheeks may be flushed; the whites of the eyes bluish white in color. The heart sounds are not right. The blood is pale in color. The red cells are diminished, but usually are not below eighty per cent of the normal; the haemoglobin is greatly reduced, sometimes to thirty-five or forty per cent. The age, greenish tint of pallor, bluish whites of the eyes, poor nutrition, etc., aid in making the diagnosis.

[250 MOTHERS' REMEDIES]

Treatment.—Fresh air,