NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
88 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ IV, I,
brain vaccines were less potent as antigens than sheep brain antigens. He uses
for complement fixation as antigen, a filtrate of a three months old 5 per cent.
carbolized Paris (virus) sheep (brain) vaccine prepared as follows: The brain
of a sheep is made into an 8 per cent. emulsion with 1 per cent. carbolic acid in
normal saline; this is incubated for 24 hours at 37°C., and then diluted to a
5 per cent. suspension with normal saline. This is kept at room temperature for
about 30 days before use.
A case of transmission of fixed virus infection from mother to young is report-
ed by Schneider and McGroarty. 20 A sheep was inoculated subdurally with 0.2 cc.
fixed virus. Two days later it gave birth to a lamb. The sheep died of rabies
on the sixth day after inoculation having nursed the lamb for four days. Twelve
days after birth the lamb showed definite symptoms of rabies. The brain of the
lamb was injected subdurally into two rabbits; both rabbits died of rabies in
seven days.
v. METHODS OF TREATMENT AND STATISTICS.
The investigation on the relative immunizing potencies of etherized and
carbolized vaccines undertaken by Cunningham and his co-workers in accordance
with the resolution of the International Rabies Conference (Paris 1927) has been
frequently referred to in these reviews. (Vol. 24, p. 229 ; Vol. 25, p. 190 ; Vol. 26,
p. 219 ; Vol. 27, p. 742.) It will be remembered that the results both of treatment
of human beings and of experiments on rabbits and monkeys were best in the
case of those treated by Alivisatos' method, less good when Hempt's vaccine
was used, and poorest with carbolized vaccines. In those experiments, however,
there was great variation in the dosage of nerve substance, the quantities being
(for human beings) 6 to 8, 4, and 0.7 gm. respectively. It was realized that
until the three methods were contrasted in uniform dosage no definite conclusion
as to relative efficiency could be drawn. The present communication 21 by
Cunningham, Malone and Craighead deals with certain aspects of this problem.
Carbolized. vaccines were given to 4,474 persons, and ether carbolized vaccines to
4,513 according to the alternate case system, and as a check 1,598 persons of the
type of Hempt's Class III were treated by Alivisatos' method. In each case the
20 Schneider (J. E.) & McGroarty (B. J.). Transmission of Experimental Rabies from Mother to
Young.—Jl. Amer. Vet. Med. Assoc. 1933. Apr. Vol. 82. N. S. Vol. 35. No. 4. P. 627.
21 Cunningham (J.), Malone (E.H.) & Craighead (A. C). An Investigation into the Value of an
Etherized Vaccine in the Prophylactic Treatment of Babies. Part VIII. The Comparative Immuniz-
ing Value of Carbolized, Etherized Carbolized and Etherized Vaccines Tested under Identical
Conditions of Dosage and Administration.—Indian Med. Res. Memoirs. Supplementory Series to Indian
Jl. Med. Res. 1933. Jan. Memoir No. 26. Pp. VII and 144 with one chart.
RABIES
89
vaccine was a 5 per cent. emulsion of brain substance. The figures are given in
detail, and the results have been examined for significant differences by McKen-
drick (Appendix B). The general conclusion is arrived at that 5 per cent. car-
bolized and 5 per cent. Alivisatos' vaccines are similar and both superior to
5 per cent. etherized-carbolized vaccine. A large experiment was conducted upon
animals. With regard to the method of preparation of the vaccine it appears
that 5 per cent. Alivisatos' vaccine is superior to 5 per cent. etherized-carbolized
vaccine and to no treatment, and that 5 per cent. carbolized vaccine takes a mid-
position between Alivisatos' vaccine and etherized-carbolized vaccine, though
it is not significantly different from either. As regards strain of virus, Paris
fixed virus is superior to Kasauli fixed virus. (These are in brief the general
conclusions of an investigation which is an example of thoroughness and of patient
labour. That the comparison of methods of treatment is a laborious business
will be recognized by all who read this exhaustive memoir of 144 pages. It should
be studied not only by those interested in rabies, but by those who are concerned
with treatment by vaccines of any sort.)
The vaccines of Fermi and Philipps are compared by Palawandow & Serebren-
naja (Odessa). 22 Because of the weak bactericidal power of glycerine and its thick
consistence, the preparation of Philipps' vaccine involves a loss of about 30 per
cent. of material. Fermi's vaccine requires no dilutions once it is prepared, whereas
Philipps' vaccine has to be diluted daily. The vaccine of Fermi is always sterile,
whereas about 10 per cent. of Philipps' vaccine has to be discarded on account of
bacterial contamination. The immunizing power of Fermi's vaccine is the higher,
as also is the rabicidal power produced in the blood. The advantages which, are
possessed by Fermi's vaccine are probably due to the larger quantity of nerve
substance which it contains, and also to the action of the phenol.
A third analytical review by McKendrick 23 of statistics from Pasteur Institutes
on the results of antirabic treatment undertaken by the Health Section of the
League of Nations at the instance of the International Rabies Conference (Paris
1927) has appeared. It deals with the data relating to 69.541 treated persons,
and relates mainly to the year 1930.
The figures under review again emphasize the fact that the non European
is at a much higher degree of risk than the European. The mortalities for the
two race groups are in the ratio of 7.8 to 1.
22 . Palawandow (Haidar) & Serebrennaja (A. I.). Vergleichende experimentelle Untersuchungen
ueber die Methoden von Fermi und Philipps.—Ztschr, f. Immunitatsf. u, Experim. Therap. 1933. Vol.
78. No. 3/4. Pp. 217-230. (13 refs.)
23 . McKendrick (A. G.). A Third Analytical Review of Reports from Pasteur Institutes on the
Results of Anti-Rabies Treatment.—Quart. Bull. Health Organisation, League of Nations. Geneva. 1932.
Dec. Vol. I. No. 4. Pp. 725-755.
90 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ IV, I.
No evidence has been found which suggests the existence of a superiority
of any one method of treatment over any other, or, more generally, there is no
evidence of the existence of a superiority of treatment by live vaccines over
treatment by killed vaccines. With regard to this point the reader is referred to
the following table which comprises such figures as it was possible to extract from
the three reviews relating to persons of a single race type (European) who were
bitten by animals which were certified to be rabid (Categories A and B).
Treatment
Cords .
.
.
.
.
Dilutions
.
.
.
.
Killed phenol . . . .
Live phenol . . . .
Heated
.
.
.
.
Ether killed . . . .
Mixed
.
.
.
.
.
Ether not killed . . .
Number
treated
1,784
4,731
2,920
526
6,685
5,098
5,338
1,978
29,060
Deaths
Observed
5
7
4
2
16
8
10
4
56
Calculated*
3.4
9.1
5.6
1.0
12.9
9.8
10.3
3.8
Mortality
per cent.
0.28
0.15
0.14
0.38
0.24
0.16
0.19
0.20
0.19
. From the average mortality.
The probability that equal or greater differences than those observed would be
likely to occur in a population which was admittedly homogeneous is found to be
0.8 so that there is no evidence of heterogeneity in the statistics gathered over
the whole period. If the mixed group and those
vaccines be combined, as seems reasonable since in both groups the treatment
of severe cases is by the method of Alivisatos, the figures are as follows : number
treated 7,316 : observed deaths 14: calculated deaths 14.1: mortality per cent.
0.19.
From the figures submitted it would appear that liability to accident varies
significantly according to the method of treatment employed. The relative inci-
dence from the figures collected since the inception of these reviews is given in
Section XII. It appears that the liability to accident from live vaccines is greater
than the liability from killed, and that the liability from killed vaccines is greater
than the liability from heated.
RABIES
91
The table referred to deals with the combined statistics covered by the three
reviews and is as follows:—
Treatment.
Cords
.......
Dilution
.......
Killed phenol
Live phenol
Heated
.
.
.
.
Ether killed
......
Mixed
........
Ether not killed
.
.
.
.
Number
treated.
33,751
14,649
59,911
1,117
22,716
22,038
13,088
3,634
170,904
Accidents.
17
4
5
0
0
3
4
0
33
Proportion.
1 in 1,985
1 in 3,662
1 in 11,982
..
..
1 in 7,346
l in 3,272
..
l in 5,179
Percentage.
0.051
0.030
0.0085
<0.09
< 0.004
0.014
0.031
< 0.028
0.019
If the last two groups be combined the figures are serially 16, 722 ; 4; 1 in
4,180 and 0.024 per cent.
In the annual report of the Pasteur Institute at Kasauli (India) Shortt 24
reports that as a result of the series of experiments carried out by Cunningham and
his co-workers, the vaccine now employed is, as before that of Semple, but that the
dosage has been largely increased in the case of the severely bitten. The dosage for
the slightly bitten is 1,400 mgm. during 7 days, whilst for the severely bitten it has
been increased to a maximum of 8,500 mgm. in 15 days. The figures are still
experimental in the sense that Paris and Kasauli strains of fixed virus are com-
pared, as are also vaccine from the sheep and from the rabbit. The combined
results are as follows:—
Europeans treated at Institute
......
Non-Europeans treated at Institute
Europeans treated outside......
Non-Europeans treated outside
.
.
.
.
Cases.
314
7,389
801
2,634
Deaths.
0
95
0
8
Mortality
per cent.
0
1.29
0
0.30
One rather doubtful case of post-vaccinial paralysis is reported. The percent-
age of health returns received after six months from the termination of treatment
for those treated at the institute is above 72 per cent., and for those treated at out-
centres it is above 63 per cent.
24 Kasauli, Pasteur Institute of India. The Thirty-First Annual Report of the Director of the
Institute for 1931. Part II. (Scientific). Shortt (H. E.), Director. 46 pages. Delhi Government
Printers.
92 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ IV, I.
At Coonoor 25 the dosage of carbolized vaccine has also been increased; in this
case the variation is between 700 and 3,500 mgm. administered during 14 days.
The results published by Iyengar, are as follows :—
Europeans at Institute
........
Non-Europeans at Institute
Europeans outside .......
Non-Europeans outside
.......
Cases.
40
462
236
7,790
Deaths.
0
7
2
58
Mortality
per cent.
0
1.51
0.75
0.74
No cases of post-vaccinial paralysis have occurred. The percentage of health
returns received six months after the expiration of treatment is above 94 per cent.
The method of Semple is employed at the ' Instituto Vital Brasil '. The num-
ber treated is 544, and no deaths from rabies nor cases of post-vaccinial paralysis
have been observed. Brasil and Leal 26 discuss the treatment of rabies generally.
Viala 27 reports that during the year 1932, 561 persons were treated at the
Pasteur Institute, Paris, and that none of these developed rabies. No post-vacci-
nial paralysis were observed.
VI. RABIES IN ANIMALS.
From experiments on 45 frogs (Rana temporaria) Battaglino 28 confirms the
observation of Remlinger and Bailly that the frog is refractory to rabic infection.
The frogs were killed at intervals and their brains tested for virulence. In frogs
which were in a state of lethargy, virulence was retained for a period of about 32
days, whereas when the frogs were active virulence was lost after about 3 days.
The tests for virulence were carried out on guineapigs, which were more suscepti-
ble than rabbits. The virus recovered from the frog's brain had not become atte-
nuated.
Five more cases of rabies in the mongoose are reported by Greval 29 from India.
25 Coonoor, Pasteur Institute of Southern India : Twenty-Fifth Report of the Director of the
Institute for 1931. Iyengar (K. R. K.), Director. 69 pages. Madras : Madras Publishing House.
26 Brasil (Vital), Jr. and Leal (A- Estillac). Vaccinacao anti-rabica pelo methodo de Semple.
Brasil.Medico, 1932, November 5, Vol. 46. No. 45, pages 931-933.
27 Viala (Jules). Les Vaccinations antirabiques a I' Institute Pasteur en 1932. Ann Inst.
Pasteur, 1933, May, Vol. 50, No. 5, pages 745-748.
28 Battaglino (Giuseppe). Contributo allo studio Del virus rabido nella rana. Giorn di
Batteriol. e Immunol. 1932, December, Vol. 9, No. 6, pages 961-971. English summary (5 lines).
29 Greval (S. D. S.). Rabies in the Mongoose. Further Observations. Indian Medical Gazette.
1933, Jan., Vol. 68, No. 1, pp. 20-23.
RABIES
93
The statistics of post-infectional antirabic treatment of domestic animals in
Hungary during the last thirty years are analysed by Aujeszky 30 . In all 19,979
domestics animals have received treatment. The method employed is a modifica-
tion of the dilution method of Hogyes (eight inoculations during 6 to 9 days). In-
formation regarding the fate of the animal was available in 19,583 cases. Of these
34.7 died during the course of treatment or during the succeeding 14 days; of the
remaining 19,236, 130 developed rabies (0.67 per cent.). Three cases of paralytic
accident, none of which were fatal, were observed. Data are also given of the
incubation periods observed in the different animals.
Statistics of preventive inoculation of animals furnished by Balozet 31 from Tunis,
show that of 482 dogs vaccinated prophylactically during the period 1st October
1931 to 31st December 1932, three developed rabies. These three had been bitten
by a rabid dog a month or two before vaccination, and so cannot be considered
as failures or prophylactic inoculation. The effect of the prophylactic measures
is demonstrated by the following figures from the town of Bizerta. In 1931, 22
cases of rabies occurred. In the first quarter of 1932, 20 cases were reported. In
the 2nd quarter, that is 9 to 15 months after the administration of the vaccine,
only one case of rabies was observed.
An '.antirabic week' has been instituted in Japan 32 for the control of rabies in
districts where the disease is present. During this period all dogs are registered,
Year.
1921
1022......
1923 ......
1924 ......
1925 ......
1926 ......
1927 ......
1928 ......
1929 ......
1930 .....
1931
......
1932 ......
No. of rabid
dogs.
..
..
2,644
3.205
3,036
1,799
986
434
172
65
44
63
No. of dogs
inoculated.
..
..
116,050
194,177
255,097
234,680
200,032
225,636
145,653
128,753
..
..
No. of persons
bitten.
..
..
..
..
..
..
1,446
1,122
5*6
267
65
..
No. of deaths
from rabies.
54
79
174
235
143
80
30
22
12
4
..
..
* The figure between the 5 and 6 is illegible.
30 Aujeszky (A.). Dreissig Jahre der Postinfektionellen Wutschutzimpfung der Haustiere in
Ungarn. Deut. Tierarzt. Woch, 1933, Apr. 8, Vol. 41, No. 14, pp. 209-210.
31 Balozet (L.) La vaccination antirabique des animaux en Tunisie du ler octobre 1931 au 31
decembre 1932. Arch. Inst. Pasteur de Tunis. 1933, Apr., Vol. 21, No. 3, pp. 538—543.
32 Journal of the Public Health Association of Japan, 1933, Apr. Vol. 9, No. 4, pp. 2-3. Measures
taken in Japan for the Prevention of Rabies.
94 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ IV, I.
unclaimed dogs are destroyed, preventive inoculation is given, etc. The results
appear in the table (p. 93).
VII. POST-VACCINIAL PARALYSES.
Three cases of post-vaccinial paralysis amongst persons treated by Semple's
carbolized vaccine are described by Stuart and Krikorian 33. They occurred within
the period April 28th to July 29th 1932, and two had a fatal termination. The
occurrence of such accidents at Jerusalem has been as follows :—The first occurred
after 4,580 bitten persons had been treated, the second after 5,409, and the fifth
after 9,950. Again, ' while the period 1923-27 was entirely free from accident, the
period 1928-32 showed 5 cases of post-treatment paralyses '. Of the five, three
showed Landry's syndrome and ended fatally ; the other two were cases of dorso¬
myelitis and have recovered. " A parallel is found in the statistics of the Vienna
Institute: whereas between 1894 and 1914, 7,632 bitten persons were treated with-
out accident, between 1915 and 1923, 6,764 treatments yielded 39 cases (5.7 per
thousand)." These periodic increases cannot be ascribed to intensification of treat-
ment or be explained by the numbers of passages to which the fixed virus used has
been submitted (Bujwid's theory). They lend support to the view that the inci-
dence shows periodic increases. The histopathological appearances were those of
varying degrees of degenerative change in the nerve cells, with considerable perivas-
cular congestion. Perivascular demyelination and " cuffing" were absent. No
Negri bodies were found. " A cytotoxin, rather than a virus theory of origin, is
again advanced. Thus in the basic nerve substance of all anti-rabic vaccines there
seems to exist some deleterious component which, though adversely affected by
various physical and chemical agencies, is still capable, in peculiarly susceptible
individuals, of producing neuroparalytic disorders."
VIII. MISCELLANEOUS.
From an experiment carried out on 12 guineapigs, three treated with fixed
virus brain, three with normal brain, and three controls, Dolfini 34 comes to the
conclusion that anti-rabic treatment (method of Puntoni) has no influence on the
occurrence of characteristics of anaphylactic shock induced by horse serum. As
anti-rabic vaccine is rich in lipoids, this result is considered to be of importance in
relation to the view held by many that anaphylactic shock is inhibited by the
parenteral injection of lipoids.
33 Stuart (G) & Krikorian (K. S.). Neuroparalytic Accident's Complicating Antirabic Treatment.
Brit. Med. Jl. 1933. Mar. 25, pp. 501-504. [ 21 refs.]
34 Dolfini (G.). Puo la vaccinazione antirabica modificare uno stato di sensibilizzazione aller¬
gica ?—Policlinico. Sez. Prat. 1933. Feb. 20. Vol.40. No. 8. Pp. 285-287. (20 refs.)
RABIES
95
In the second part of a memoir entitled " Studies in Rabies", Remlinger and
Bailly 25 have collected a number of recent papers. In the first and second sections
they describe the treatment of dogs and other animals by etherized virus, and give
the results of their experience in Morocco. (This Bulletin, Vol. 30. p. 137, and
earlier papers). In the second they describe their experiments with the Trinidad
virus (Vol. 29, p. 596). The third section deals with the effects of alcoholism during
immunization (Vol. 30, p. 143). The fourth on phylazis deals with the action of
sparteine (Vol. 30, p. 140). The fifth on the persistence of rabies virus in the brain
of the tortoise has already been reviewed (Vol. 29, p. 605, and Vol. 30, p. 141). The
sixth is on the influence of cachexia on the pathogenesis of rabies (Vol. 29, p. 607).
The seventh discusses the influence of anaesthesia on the incubation period or rabies
(Vol. 29, p. 607). The eighth and last is on the passage of rabies virus through the
milk (Vol. 30, p. 137). The results of these researches are thus already in the hands
of the reader.
35 Remlinger(P.) & Bailly (J.). Etudes sur la rage (deuxeme memoire).—Ann. Inst. Pasteur.
1932. Dec. Vol. 49. No. 6. Pp. 665-735. (Refs. in footnotes.)
H
FURTHER NOTE ON FOOT-AND-MOUTH DISEASE IN
SOUTHERN RHODESIA AND AN EMERGENCY METHOD OF
INOCULATION
BY
LL. E. W. BEVAN, M.R.C.V.S.,
Director of Veterinary Research, Southern Rhodesia.
[ Reprinted from Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol. XXVII, No. 1.]
In December, 1931, an article was sent to this Society for publication describing
certain unusual features presented by foot-and-mouth disease in Southern Rhodesia.
A method of emergency inoculation based upon these peculiarities was suggested,
with a view to setting up a mild form of the disease and establishing herd immunity.
This article being too long, an epitome only appeared in these Transactions (1932),
Vol. XXVI, No. 1 (June), p. 89. It stated that at the time the report was compiled
some 20,000 to 30,000 cattle had been inoculated by the method described, and a
further and fuller report, embodying the observations of field officers in charge of
the work and giving details of practical and scientific interest, was promised.
The special features of the disease as it occurred in Southern Rhodesia, in the
laboratory and in the field, were briefly as follows :—In the majority of cattle the
infection was extremely mild, " occult " cases characterised by thermal reaction only
without " open " lesions, predominating. The blood of cattle suffering from such an
" occult " reaction was found to be virulent even from the first rise of temperature.
Under Rhodesian conditions, also, infection was only transmitted with difficulty,
close head-to-head contact being necessary. In the laboratory, attempts to infect
by intra-oral and subcutaneous inoculation failed, but intra-nasal injections were
almost invariably successful. It was also found that when virus of low virulence
was passed from animal to animal in low condition the mildness of reaction persisted,
but that a single passage through a fat animal would result in an exaltation of virulen-
ce and the appearance of typical lesions. The viability of the virus outside the animal
body was extremely brief even under laboratory conditions, and at first it was
believed that it was equally vulnerable in vitro. This, however, was found to be
incorrect and, when a preservative of appropriate composition and pH had been
found, blood-virus and infected epithelium were sent to England where they arrived
virulent and maintained their infectivity for several months.
The slow spread of infection under natural conditions, the indefinite nature of
the symptoms, the vast and inaccessible areas in which the disease occurred, and
( 96 )