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RABIES AND ANTI-RABIC TREATMENT.
Since the Pasteur Institute, Kasauli, was first opened in 1900 research
on rabies and prophylactic inoculation has been continuously carried out
there. Other centres opened at a later period have also carried out investi-
gations on varying scales. Semple, the first Director of the Institute in
Kasauli, was responsible for the introduction in 1911 of a vaccine of different
type from the Pasteur dried cord method which had been used up to that
time. His experimental studies on anti-rabic inoculation led to the intro-
duction of a dead carbolized vaccine the use of which reduced to a very
large extent the risk of accidents which had occurred when the vaccine
containing live virus was employed. After an extended period of study
of the results of the use of the carbolized vaccine and on the basis of
extensive experimental observations Harvey and Acton were able to show
that the new vaccine gave at least as good or even better protection than
the original Pasteur type under Indian conditions. The introduction of
carbolized vaccine made possible the preparation of anti-rabic vaccine in
plains stations and also the decentralization of treatment to out-centres
where patients could receive treatment with the vaccine sent out from
the Institute where it was manufactured.
2. At the International Conference on Rabies held at Paris in 1927 a
general acceptance of the value of treatment with vaccines in which
the virus was killed with carbolic acid was obtained, and the carbolized
vaccine which had, on a large scale, been first employed in India, had
already been adopted in certain other countries. There has since been a
further extension of the use of Semple's method or modification of it
and carbolized vaccines are now used to a greater extent than other
types.
3. When the Pasteur Institute was first established at Kasauli about
400 cases were treated in a year in India. The number, from different
centres now reaches about 40,000 and treatment on this scale is only
possible by the use of methods based on researches at Kasauli and other
centres.
4. Research on the pathology of rabies, accidents of treatment and other
points have been carried out extensively in the Institutes in India, pro-
minent workers on the subject besides those already mentioned being
McKendrick and Cornwall.
5. A recent phase of work was that initiated by Cunningham in 1927
and carried on by his successors at Kasauli on the relative value of different
methods of treatment. High value had been claimed for the other methods
of Alivisatos and Hempt, but it was found that when an equivalent total
of fixed virus brain substance was used carbolized vaccine was equally
efficacious. It was also ascertained that the Paris strain of fixed virus
was of higher value than others. On the basis of these observations
anti-rabic inoculation is now carried out by means of courses of a dosage
and duration fixed in relation to the risks which are assessed for each
case.
Contributed by Colonel J. Taylor, C.I.E., D.S.O., V.H.S., I.M.S.
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