M. PASTEUR AND HYDROPHOBIA.*
TIM enthusiasm displayed about M. Pasteur in Paris last year was something quite beyond English experience. It was worse than heretical not to believe in his cure for hydrophobia it was unpatriotic. It cast a slur upon " la France" to doubt anything that was asserted by his wildest partisans. The cold fit set in about October last, when, according to M. Pasteur's enemies, he did not dare to read his own communication to the Academic de Mededne, and when the communication itself was very ill. received. At the present time, the reaction has reached such a • IL Pasteur et la Rage. Par In Dr. Lutand, Ridartanwea-chet da Tosrnal de rideeine de Paris. Paris Isles Levy. 1887. pitch that many competent men of science in France believe that not only has M. Pasteur not succeeded in curing hydro- phobia, but that in some cases he has actually given the disease in a new form to persons previously free from it. About ten days ago, there was published in Paris a book which, from internal evidence, we gather is, at least in a measure, a reprint of articles which have appeared in the Journal de Medecine de Paris. The book is a violent partisan statement, to be discounted at least as much as the statements made on the side of M. Pasteur. It is in parts disfigured by abuse, imputation of motives, and con- temptible jokes ; written, we should fear, with an occasional. eye to the applause of "lee incompetents," while it professes to- appeal only to experts. Still, when every allowance is made, Dr. Lutaud's book contains cases and statistics which, if M. Pasteur has any regard for the opinion of intelligent men, he should at once either disprove or explain. Otherwise he must be willing to bear the terrible accusation of having experimented on human beings without sufficient scientific grounds to go- upon, and that, too, when, unless he had such grounds to go. upon, he was recklessly inoculating human beings with the most terrible, and at the same time one of the rarest diseases to- which mankind is subject.
We must say at once that the controversy that is raging in France has nothing to do with vivisection, and that the lawful- neas or unlawfulness of M. Pasteur's methods are not now in question. Our own views on that point are well known. The charges here brought against M. Pasteur by Dr. Lutaud are that he has either grossly misunderstood or deliberately falsified statistics ; that his supposed method of curing hydrophobia is a complete failure ; that it has not only failed, but that it has killed more people than it has cured. A good many people may be surprised to learn that the average number of deaths per annum from hydrophobia in France since the year 1850, is only 30. These are the official figures. M. Pasteur makes it 76, a higher figure than that given officially for any one year, the highest being 66, in the year 1864. M. Pasteur puts the average thus high, on the ground that a third of the Departments have not answered the official question as to hydrophobia, and that a great number of cases are intentionally or otherwise concealed. In the same way, the partisans of M. Pasteur claim that he has saved 264 lives in the last year, or reduced the disease by 93 per cent. ; and they do this as follows. It has been authoritatively stated that 16 per cent, of those bitten by mad dogs die of hydrophobia. Some authorities put the case lower, but take it at 16 per cent. There have been 1,726 French people inoculated at the laboratory. Of these, only 12 have died, instead of 276 in the ordinary course. But how cornea it, then, that hydrophobia has become so common ? Even according to M. Pasteur's own showing, the number of fatal cases this year, but for his method, would have been 276, when the average is 76 per annum, and the official average is only 30 deaths per annum. This extraordinary increase is not BO hard to explain when we hear from Dr. Lutand that every one who applies is treated at the Rue d'Ulm. Many of these applicants have never seen the dog who bit them again ; in many other cases, no one can say whether the dog was mad or otherwise ; and the cases where the dog was certainly mad are extremely few. The fact is, that M.. Pasteur's experiments have obtained an extraordinary notoriety in France, and have created a perfect panic about dog and cat bites. Every one who is bitten, therefore, rushes post-haste to- the Rue d'Ulm; but there is no reason to think that even a quarter of those who are treated there were ever in the least danger of hydrophobia. The number of cares claimed for Pasteur before the Academic Is Medecine is, however, nothing to that claimed for him in the Press. But in spite of Dr. Lutand's assertiona, we can hardly believe that M. Pasteur himself is responsible for the daily circular (which is nothing but an advertisement) in the Figaro, aml which states "qua lea 3,000 individus qui out passé k l'Ecole normale out ete- arraches k flue mort certaine." Nevertheless, the extraordinary discrepancy between M. Pasteur's figures and Dr. Lutand's figures as to the number of deaths from hydrophobia in the Paris hospitals (p. 165), show either marvellous carelessness or marvellous effrontery on the part of one of them.
As to M. Pasteur's method, Dr. Lutand asks several questions which will have to be answered before it can be recognised by the scientific world. For instance, why does not the inoculation with virus display itself by some local or general symptom, like inoculation in small-pox or other diseases ? What quantity of spinal cord does IL Pasteur put into the sterilised broth for the purpose of injection ; or does he really think, as his language implies, that "dear ou trois veils morceaux de melte" more or leas will not make any appreciable difference F' On what prin- ciple, again, has he selected the degrees of the virus to be used in the mithode intensive ? The first day come three inoculations with numbers 12, 11, 10; the second, the next three numbers ; the third, the next three. On the fourth day, there is only one inoculation with No. 3, and so on (see p. 324) ; but no sort of reason is given for this or any other division of the number or strength of the injections. Again, Dr. Lutand, we think, sue- cessfally shows that by the test of actual experiments (many of them tried on human beings) Pasteur has failed to cure subjects who have been bitten or purposely inoculated with virus, even when preventive measures were applied within one, two, or three days. The first series of experiments to throw real doubt on M. Pasteur's success were those of Professor von Friech, of Vienna, who had studied under Pasteur. These experi- ments were reported in September, 1886. (p. 131). First, of sixteen rabbits inoculated by way of trepanning with a piece of spinal cord taken from a rabid dog, dissolved in sterilised broth, fifteen were treated in Pasteur's method, by inoculating them under the skin with virus of a constantly increasing strength. The preventive measures began with the first rabbit in twenty- four hours, with the others a day later. The sixteenth rabbit was not treated preventively, and was taken ill on the eighteenth day, and died on the twenty-first day of hydrophobia. Of the others, thirteen died from the fourteenth to the twenty-first day after trepanning, three presenting symptoms of rabies before the treatment had been applied. The other two died twenty-five days and thirty-three days after the trepanning. As a second experiment, five dogs were inoculated the same day with rabid virus. With three of them, preventive measures were begun within twenty-four hours. The other two were let alone, and were seized with rabies on the twelfth and thirteenth day respectively. Of the three dogs treated preventively, two had died, and the third was alive twenty-three days after the trepanning. Again, six rabbits were inoculated by injection under the skin (and not by trepanning) with the spinal cord of a dog suffering from rage de rus. Three of them were treated on Pasteur's method, and three not. All were alive four weeks after the first injection. Professor von Frisch's conclusion, therefore, is that "it is not possible, either with rabbits or dogs, to prevent the appearance of rabies by the preventive inoculations of M. Pasteur when the vim (of a period of incubation of fourteen days at the least) is transmitted to the animals by the certain means of trepanning." The answer of M. Pasteur, given before the :Academie des Sciences (p. 140 of Dr. Lutaud's book), is very remarkable. He says the vaccination ought to commence "tin pest temps apres rinoculation, des le lendemain, et ron doit y presider rapiclement donner la aerie des moelles preservatrices en vingt-quatre heures, et meme dace eon (Mai moindre puis repeter, de deux en deux henres, Is traitement une on deux fois." We think Dr. Lutaud is not too severe in his criticisms of the extraordinary looseness of the expressions we have italicised, which as a scientific statement of the method to be pursued must surely be absolutely useless. It would appear also that M. Pasteur, though he acknowledges in the same state- ment that up to August, 1885, the success of his experiments on animals "had been partial," had begun to practise them on man—namely, on little Meister—on July 6th of the same year. This case shows M. Pasteur's recklessness, and other cases given by Dr. Lutaud, unless they can be disproved, show the conse- quences. We are content to leave out of the question cases such as those of the Roumanian Gaga, and that of Bouvier of Grenoble, in which M. Pasteur contends that the victim contri- buted to his own destruction, though this seems by no means certain. But without counting these, Dr. Lutand produces twenty-two well-authenticated cases in France, all of which were treated in 1886, in which the patients died, some of rage con- vulsive, or ordinary hydrophobia, and some of rage para- lytique, which, as Dr. Lutand contends, is a disease of the laboratory, communicated by M. Pasteur, and not by any rabid animal. One thing is exceedingly remarkable, that owing to the belief in M. Pasteur's method, in only two of these twenty-two cases were the wounds cauterised, a treatment which may be old-fashioned, bat which has certainly saved life in many cases. In five of these cases, M. Pasteur was applied to within three days of the bite, in one of them, within twenty-four hours. In seven, he was applied to in some time between four days and a week ; and in two, between a week and a fortnight.
But the charge against M. Pasteur is not of failure only. It is a charge of actually communicating a variety of the disease which he professes to cure. The human patients, it will be remembered, are inoculated, by way of prevention, with the virus produced or cultivated in the inoculated rabbit. In eleven cams of which the names, dates, and other particulars are given, Dr. Lutand shows that the disease of which the patient died after leaving M. Pasteur's laboratory was not the ordinary hydrophobia, but a disease exactly resembling the rabies pro- (laced in rabbits by inoculating them with virus taken from rabid dogs. We will content ourselves with the following com- pressed account of two of these cases, given and commented on by Professor Peter in his communication to the Academy :—
The first case is that of Reveille(' (p. 372), who lived at La Villette. He was bitten by a dog in the finger, and went to the laboratory forty hours after he had been bitten. He was treated by the new methode intensive. He remained healthy for five weeks. He then began to feel pain, not at the place where he was bitten, but at the places where he was inoculated. Malaise genital et sentiment &extreme faiblesse ensued, and the day was passed in immobility and in distress. The faintness increased on the next day, Monday. On Thursday the patient took to his bed, and died on Friday, six weeks after the bite. From subsequent informa- tion, it appears that he had spasms of the throat on the third and fourth days of the illness, and found it impossible to swallow liquids. At other moments he was able to take small quantities of drink. He never suffered from convulsions, bat from weakness (faiblesse) fol- lowed by paralysis. "It seems impossible," says Dr. Lulea, "not to be struck with at least two fasts. The first, that the premonitory pains were experienced only at the point of the punctures made by the preventive inoculations. The second, that the symptoms were not those of ordinary rabies, since, apart from the spasms of the cesophagns, the leading characteristics, instead of being convulsive, were paralytic." The second case is that of Leopold Nee, of Arras (p. 34(5), a hawker, who was accnatomed to tie his dog under his cart. He was bitten in trying to let him loose on November 12th, 1886. He killed the dog at once ; but up to that time the dog had con- tinued to eat. A veterinary made an autopsy of the dog, and certified that he had no reason to think the dog was mad. The body of the dog was sent to M. Pasteur, but up to January 6th, 1887, no answer had been received from him as to whether or not the dog was mad. Née himself arrived at the Institute of M. Pasteur on November 17th. He remained there eleven days, and underwent twenty-two inoculations, from three to one a day. He complained of smarting pains at the point where he was inoculated, and in going out of the establishment he complained of dazzling sensations, faintness, and often vomiting. He returned to Arras on November 29th, and the case presented nothing in particular till December 10th, except an exaggerated appc. the, which had already manifested itself during his stay at Paris. On the night between December 10th and 11th he experienced abundant vomitings of sticky matter, which continued in a less degree on the following days. He felt, besides, severe pains at the point where the punctures had been made for inoculation. He never complained of any pain at the place where the dog bit Mm (the right leg), nor the corresponding limb. The doctor who was called in attributed the pains to lumbago, and some days afterwards to myelitis. The above phenomena were accompanied and followed by great inconvenience in respiration, by a pricking sensation at the level of the anterior part of the breast, and by expectoration. The speech became short, jerky, and interrupted by involuntary and broken respiratory move- ments; convalsions manifested themselves in the muscles of the face, which was very much altered, in those of the thorax, and in the upper extremities. His sleep was restless and troubled by nightmares, the skin, which was sensitive to cold, was hot and always covered by excessively abundant perspiration. He had not any general convul- sions or hydrophobia. Deglutition was easy, except in the last two days. After this, paralysis set in, and the patient died on December 17th.
Professor Peter examined the above case of Beveillac himself, and declared before the Academy (p. 330) that " Reveillac n'est pas mort de In rage du chien, main d'une affection qui rapelle Ia rage experimentale." Of the second ease, communicated to him by Dr. L. Germe, he says :—" Jo n'insisterai pas longtemps our rimportance de cette observation. ljn veterinaire the l'existence de la rage chez le chien, neanmois le mordn se fait inoculer par la method° intensive, et il menrt 25 jours apres d'une rage :Strange, d'une rage exceptionelle chez l'homme, de la rage paralytique, frequents an contraire chez la lapin."
For other cases we must refer the reader to Dr. Lutand's book, where among others he will find the two English cases, as to which a letter from Dr. Clarke appeared in the Daily Telegraph on December 6th, 1886. It seems to us that these and the other cases cast the greatest doubt on M. Pasteur's method, and seem to show that be has not succeeded in finding any cure for hydrophobia after the patient has been bitten, whatever may be the case beforehand. On the other hand, if it be net true that in some cases M. Pasteur has given rabies to his patients in its paralytic form, the only other alternative is that, by submitting to his mgthode intensive, the patient can, if he prefers it, die of the paralytic form of hydrophobia instead of the convulsive or raging form. Whether, as Sam Weller's friend said of the alphabet, it is worth while going through so much to gain so little, must, we suppose, be left to the judgment of the individual patient. In any case, after Dr. Lutand's book, not only does the burden of proof as to the success of the new method still lie on M. Pasteur and his friends, but they now have very grave charges to meet, both as scientific investigators and as men.
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