The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
Animals thought to have hydrophobia should be kept by themselves in a
secure enclosure and carefully watched, especially those known to have
bitten men or other animals. If a suspected dog have been killed before
the suspicion has been confirmed, the head and upper part of the neck
should be removed for examination. Veterinarians claim that what they
call the plexiform ganglion permits an almost certain diagnosis to be
made. The presence of foreign bodies in the stomach of the animal is a
corroborative feature. Diagnosis by subdural inoculation requires two
or three weeks, and in at least one case a human patient died while
waiting for diagnosis to be thus established.
_Hydrophobia in man_ is rare in this country, yet is occasionally
observed. Its etiology is as yet obscure. That a _contagion vivum_ is
present is positive, but its nature is uncertain. Negri, of Pavia, has
recently described certain bodies observed in the nervous system of
animals dead of hydrophobia which may offer the solution of the problem
that has so long been sought. They are found in the protoplasm of nerve
cells, but not in their nuclei. They are round or oval in shape, vary
in size from 25 microns down to those which can be barely seen with the
highest powers. They take ordinary stains.
Negri maintains that these bodies are parasites and he has invariably
failed to find them in animals which did not have rabies. His work has
been confirmed by a number of his colleagues, and bids fair to furnish
a reliable and rapid means of diagnosis. The fact that the virus of
hydrophobia will pass through a porcelain filter nowise contradicts the
view that these bodies may be parasitic, for it is quite possible that
they undergo different stages of development, in some of which they are
small enough to pass even barriers of porcelain.
In fact it seems to have been positively demonstrated that these bodies
described by Negri, in 1903, are diagnostic for rabies. They are most
likely to be found in the horns of Ammon or the cerebellum. When found
here, careful examination must be made of the Gasserian ganglion, where
may be found the lesions first described by Van Gehuchten and Nelis,
which consist of a proliferation of the endothelial cells to such an
extent that the ganglion cells are first invaded and then destroyed,
their places being taken by the new cells.
The Negri bodies have been generally regarded as protozoa and the
specific cause of the disease. At all events, it seems possible always
to successfully reproduce the disease in rabbits or guinea-pigs by
inoculation with these bodies.
If examination shows neither the Negri bodies nor the lesions in the
ganglion the presence of the disease can scarcely be suspected, and
could only be proved by animal inoculations, which, however, would be
advisable in doubtful cases where human beings have been bitten.
Public-domain text, read in full here on John Shaqi.
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