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ccjually in the two forms of rabies : dumb and furi- ous. They arc more readily found in the (hunh form, because in the latter the animals are not killed until they exhibit symptoms of paralysis. In the furious form of rabies, when dogs are sometimes killed very early in the 50 Mg Viagra disease, .the Xegri bodies may be absent or very small. But the\' are found without trouble when the animals have died of the disease or when they have been killed in the ]Kir- alytic state following the furious stage. Lastly, the number of Negri Ijodies found in the slides under the microscope does not indicate anything. Whether they are numerous or scarce, they prove that rabies is present; it may have been the furious form or the dumb variety. Dr. 50 Mg Viagra McLaughlin's second assertion is : "as far as my personal experience goes, the bite of a rabid dog is absolutely harmless to man." It seems triv- ial to refute such a statement, and yet it must be done, wTien, within the last three days we have had occasion to see two cases of rabies, one in a man bitten on February 7th and who died of it on .\pril 17th, the other 50 Mg Viagra a little girl bitten about three months ago and who died yesterday (April i8th). 50 Mg Viagra In lioth cases life would have been saved if those concerned had not shared Dr. McLaughlin's views. In the article on rabies which I contributed to the recent American Practice of Sur^^ery I mentioned that .some years ago Tardicu and Bouley, in France (the one a world known surgeon, the other a famous veterinarian, dean of the Alfort School, and at one time president of the .icademie des sciences), had collected 855 cases of persons bitten by 50 Mg Viagra rabid dogs ; of these, 399, or 46.6 per cent., died of rabies. More recently, in igo8. in India, the Kasauli Institute re- ported that among 108 persons bitten by supposedly rabid dogs and not treated, 44 died ; of 154 pcrsf)ns bitten by sujiposcdly rabid jackals and not treated, 48 died — so that out of 262 persons bitten, <)2, or 826 KIXC: TKEATMEST OF HICCOUGH. over 35 per cent., died of rabies ! Will Dr. Mc- Laughlin continue to base his conclusions on the three cases which came within his personal experi- ence ? As to the person whom he mentions as hav- ing died after receiving the Pasteur treatment, what does it prove? If the patient died of rabies, it sim- ply proves that the Pasteur treatment is not infal- lible, and we all know that. I just mentioned the Kasauli Institute of India : In 1908, when they collected the ninety-two fatal cases referred to. 1 .398 cases were treated at the institute, with a mor- tality of 3.6 per mille. It oddly compares with the mortality of almost thirty-six per cent, among the nontreated persons. Here, at the New York Pasteur Institute, 2,032 persons received the Pasteur treatment from 1900 to 1910. Rabies was proved in the animals inflicting the bites, either by the presence of Negri bodies or by experimental in- oculation, in 1,110 cases, and in 253 cases rabies had been pronounced by veterinarians. In the re- maining 669 cases the 50 Mg Viagra disease was suspected but no examination had been possible. Among these 2,032, four 50 Mg Viagra died of rabies in spite of the treatment — a faiUire of 1.9 per mille. It not infallible, the Pasteur t-'eatment may be alleged to be quite effi- 50 Mg Viagra cient, may it 50 Mg Viagra not? In taking up the third assertion of Dr. McLaugh- lin : that "the diagnosis of rabies is purely guess- work," that "if it is impossible for an experienced veterinarian to diagnosticate rabies in the dog. it is just as impossible (I came near saying presump- tuous) for the physician to attempt its diagnosis in man," I shall not raise any 50 Mg Viagra question of propriety, for "silence is golden." Let me say, however, that the diagnosis of rabies in man is one of the easiest to be made in the field of medicine. Anyone who has ever seen one case can diagnosticate the second one almost at a glance without being presumptuous. .As to the diagnosis of rabies in dogs by veterin.- rians, I would refer Dr. ^McLaughlin to one of his 50 Mg Viagra confreres, Dr. J. F. De \'ine, who read a paper on the subject before the First District Branch of the Medical Society of the State of New York, at New- burgh, on October 27. 1910. Dr. De Vine 50 Mg Viagra gave an 50 Mg Viagra excellent and very full description of the symptoms of rabies in dogs in both its furious and dumb forms. They 50 Mg Viagra can be, as he showed 50 Mg Viagra it, very clearly defined, instead of being "a pneumonia, in^amnia- tion of the bowels, distemper, a cold, any old thing!" We quite agree with Dr. McLaughlin that "in our present state of knowledge it is impos.sible to say a 50 Mg Viagra dog has or has not Negri bodies while he is alive," and I don't see that we should care as long as the dog does not bite anyone and is appar- ently well. But when Dr. McLaughlin says "the laboratory has not made good" we must differ. Ever since Pasteur's discovery, the laboratory ,/!(/,'.■ "made good." At first, we had as the only resort to clear up the mystery experimental inoculation. When a dog had been killed, after 50 Mg Viagra having shown no symptoms of rabies, or only suspicious .symptoms. we had to take a piece of its brain to inoculate guineapigs 50 Mg Viagra and rabbits. The process was slow, for the inoculated animals could show no symptoms for from ten to fifteen days or more. This test, how- ever, has always been absolutely positive and trust- ■vvorthv ; it is now the only infallible one. In 1900. \'an (iehuchten and Nelis found in rabies micro- scopical lesions which are quite specific, if not in nature, at least in their location. The characteris- tic changes in the pyramidal cells of the cerebro- spinal ganglia enabled us to make a correct diag- nosis in at least eighty-five per cent, of the cases. In 1903 Negri helped to make the diagnosis of rabies still easier for laboratory workers ; the bodies described by him, and which now bear his name, are present in ninety per cent, of the cases of rabies 50 Mg Viagra in dogs and other animals. In the remaining ten per cent, negative cases we still have to resort to experimental inoculation. Therefore, if the labora- tory can "make good" in clearing up the diagnosis of rabies within a few hours in ninety per cent, of all cases, and in several days in the remaining ten per cent., what more can Dr. McLaughlin want? I might dissect more elaborately Dr. McLaugh- lin's paper, but it would serve no useful purpose.