greater in the non-registration area, which includes the Southern States-viz., 234.5 per 100,000 infants in cities. The death-rate among coloured infants was far in excess of that among whites-in the registration area: 77.6 whites, 1233.4 coloured, per 100,000 children under one year of age. The facts stated indicate the proper preventive measures in this infectious disease: the thorough cleansing of all wounds and especially of penetrating and lacerated wounds and the use of antiseptic dressings by which the multiplication of the tetanus bacillus will be prevented, if by chance it has been introduced; the banishment of the deadly toy pistol; cleanliness and antiseptic dressings of the navels of new-born children; and last, but not least, the education of the public generally as to the manner in which wounds become infected with the tetanus bacillus and the great danger attending such infection. CHAPTER XX HYDROPHOBIA ANOTHER fatal form of wound infection may result from the bite of a rabid animal — “ hydrophobia." The germ of this infectious malady has not been discovered, but it has been demonstrated by experiment that it is present in the saliva of rabid animals and in the nervous tissues - brain and spinal cord of men and animals who succumb to the disease. A considerable interval elapses after inoculation before the first symptoms of the disease are manifested. This period of incubation varies greatly in its duration, but is rarely less than two weeks or more than six months. By far the largest majority of the cases are developed within three months from the time the bite is inflicted. In the dog the period of incubation usually does not exceed two months. When numerous and severe lacerations have been inflicted, especially if these are upon the face, the disease is apt to develop at a comparatively early date. Bites upon the extremities, especially when the teeth of the rabid animal have passed through the clothing, by which the virus is to some extent removed, are less likely to be followed by an attack of hydrophobia. Among the lower animals the following have been demonstrated to be susceptible to rabies: dogs, cats, cattle, sheep, horses, goats, swine, mice, rabbits, guinea-pigs, skunks. Man usually contracts the disease through the bites of dogs, cats, or wolves, and occasionally of skunks. A considerable proportion of those who are bitten by rabid animals may escape the disease, especially when the bites are upon the extremities and are not severe. Prompt cauterisation of the wound also has the effect of reducing the proportion of these attacks. The popular idea that dogs are especially liable to go mad in summer, during "the dog days," appears not to be well founded, as it may prevail at any season, and dogs do not go mad any more than men, unless they have been bitten by a rabid animal and the virus of the disease has been introduced into the wound; or, as has occasionally happened, the infectious material has been introduced into an accidental wound inflicted in some other way. It has been claimed that certain parts of the world are free from rabies and that it does not prevail in Egypt or in the city of Constantinople, which is noted for the number of its homeless dogs. But this is denied by other authorities and it is said to have been very prevalent in the city of Constantinople in 1839. Like other infectious diseases its prevalence varies greatly at different times and depends to a considerable extent upon the measures taken to prevent its extension - such as the muzzling of dogs and the destruction of those without owners. In northern Europe rabies from the bite of a mad wolf is of not infrequent occurrence and the disease is also occasionally contracted as a result of bites inflicted by foxes, jackals, and ferrets. Wild animals during the excited stage of the disease lose their fear of man and are liable to run through frontier settlements and military posts, and to bite men and animals encountered on their way. A most effectual way of resisting the spread of rabies is by the general muzzling of dogs allowed to run at large. The results of this preventive measure as applied in Great Britain are given below. According to official reports the number of fatal cases of rabies in 1887 was 217; in 1888, 160; in 1889, 312. This increase in the number of deaths from hydrophobia caused much alarm and led to the enforcement of regulations for the muzzling of dogs. As a result of this the number of cases fell to 129 in 1890; 79 in 1891, and 38 in 1892. There was at this time much opposition to the muzzling ordinance and it was not enforced. As a result of this the number of cases again increased until in the year 1895 it reached highwater mark, 672 cases. Again the muzzling ordinance was enforced, with the result that the number of cases fell to 17 in 1898; 9 in 1899, and zero in 1900. The number of deaths from rabies in the United States is not shown in the census reports, the cases being no doubt included under the heading, "Other Causes." In the census of 1900, 33,776 deaths are included under this heading. It is unfortunate that we have no exact statistics with reference to this disease, inasmuch as its existence has been denied by certain members of the medical profession. But It is difficult to understand the mental operations of those who deny the existence of hydrophobia, the value of vaccination, and other well-established facts, except in the case of those who are ignorant. for certain minds the logic of facts appears to have no weight as opposed to prejudice and preconceived theories. That there is an infectious disease, known to us as rabies, which is communicated from one animal to others and from rabid animals to man, by the introduction of infectious material contained in the salivary secretions into a wound-usually inflicted by |