HYDROPHOBIA.

Previous

This term has been erroneously applied to the disease arising from the bite of a rabid animal, since many instances are recorded of mad dogs not only drinking freely of water and other fluids, but actually swimming across rivers; while, on the other hand, the horror of water has attended maladies totally unconnected with rabid injuries: Sauvages plainly expresses himself on this subject. “Apud Gallo-provincales, experientiÂ, canes lubosque rabidos bibisse, munducasse, flumen transnasse, ut olim Maralogis et bis Forolivii observatum, adeoque nec potum aversari.” Dr. James relates the case of a mad dog that drank both milk and water, and swam through a pond. Similar cases are recorded of mankind.

This disease was known to the ancients, and the Greek term for rabies was lyssa, referred to several times by Homer, when Hector is compared to a mad dog by Teucer and Ulysses. It was also known by the name of cynolisson, phobodipson, and hygrophobia. According to Plutarch, the disease was first observed in the time of Asclepiades. Coelius Aurelianus is the most correct of the ancient writers on the subject. This disease, although it may appear in every climate, is far less common in hot regions than in those of a moderate temperature. In the West Indies it is unknown; nor has it been observed in South America. In Egypt and Syria it has never been seen. Mr. Barrow informs us that at the Cape of Good Hope, and amongst the Caffres, their dogs are exempt from the malady, although constantly fed upon putrid meat.

Water-dread has been observed in various rheumatic and inflammatory affections, and frequently arises in a spontaneous manner; while many cases are recorded of the alarming symptoms being witnessed when no rabid bite has been inflicted. Violent passions, both in men and animals, seem to impart a peculiar acrimony to the saliva. Meekren, Wolff, Zacutus Lusitanus, mention fatal cases after the bite of a man in a passionate fit. Le Cat gives a case of death produced by the bite of an enraged duck. Thiermayer gives us two fatal cases of the bite of a hen and a goose, and Camararius has an instance of epilepsy produced by the bite of a horse.

Of the cause of this disease we are utterly ignorant: thirst, without the means of quenching it,—the use of putrid food,—sultry weather, have been considered as producing the fearful disorder; but no one instance is recorded that can justify the opinion. The streets of Lisbon are crowded with dogs, feeding upon disgusting offal, under a burning sky, yet rabies is scarcely ever observed among them. It is more probable that certain mental emotions, such as anger and fear, have a peculiar influence on the animal. All the aggregate symptoms of the disease show that the nervous system is disturbed; and the singular effect of confidence in the treatment of persons bitten by a rabid animal, confirms the fact. This is further proved by many cases of hydrophobia unconnected with rabid bites. Marcel Donat relates the case of a woman who complained of pains in the neck and right arm, with constant trembling. In three days the pain ceased, but the tremor continued; a sense of suffocation followed, which was attended with a horror of water and every liquid, although the throat was burning. In five days she died in excruciating agonies, but preserving her senses until the last. Koehler saw a young soldier, who, having fallen asleep against a stove, was suddenly awakened with a sensation of intense thirst, which he quenched with a draught of cold water. Hydrophobia immediately ensued, and the next day terminated his existence. Selig relates the case of a man at Neukirchen, who was attacked with all the alarming symptoms of this malady after having laboured in the fields on a very hot day, and bathed in the river. The following day he was affected with violent rheumatic pains, which shortly ushered in an intolerance of fluids, and inability of swallowing. In the course of twenty-four hours he expired. It appeared upon inquiry that a year before he had purchased from the hangman of the town some dog’s grease, to rub himself to relieve some troublesome affection; and it was stated that the dog had been killed by a gamekeeper, who suspected him of being mad.

Cases of plague have been attended with water-dread. Lalius Diversus saw a woman labouring under the epidemic, who was thrown into agonies when she even saw other persons drinking. Sarcotius, in his history of the epidemic diseases of Naples, informs us that the fever was invariably attended with hydrophobic symptoms. The fever that prevailed at Breslau in 1719, presented the same peculiarity.

Various venene substances have also been known to give rise to this disease. Professor Brera, of Pavia, witnessed it after the use of stramonium. Rancid oils have caused similar accidents. In regard to the causes that produced madness in dogs, numerous experiments have been made, particularly in the Veterinary School of Alfort: one dog was fed with salted meat, and totally restrained from drinking; another was allowed nothing but water; and the third was not allowed food or drink of any kind. The first died on the forty-first day; the second on the thirty-third; and the third on the twenty-fifth; not one of them evincing any symptoms of rabies.

It appears that a peculiar predisposition renders some individuals more subject to the accidents that follow the bite of rabid animals than others. Mr. Hunter gives an instance in which, out of twenty persons who were bitten by the same dog, only one received the disease. It appears, however, that this virus is less volatile than most others, and is capable of remaining in a dormant state for a very long period; and if we are to give credence to many reports on the subject, it may linger in the system for several years. At other times, its destructive nature has proved immediately injurious. Heisler has given a case where a man was affected by merely putting into his mouth the cord by which the mad dog had been confined. Palmarius relates the case of a peasant, who, in the last stage of the disease, communicated it to his children by kissing them. It has, however, been clearly demonstrated, that inoculation of rabid saliva does not propagate the distemper. Experiments were made both by Magendie and Breschet in 1813. In 1800, when a dresser in the HÔtel Dieu of Paris, I witnessed several experiments of the kind, and with similar results. At the same period, I had occasion to observe the effect of imagination in many cases. Several persons had been bitten by a rabid dog in the Faubourg St. Antoine, and three of them had died in our wards; a report, however, was prevalent that we kept a mixture that would effectually prevent these accidents; no less than six applicants were served with a draught of coloured water, and in no one instance did any accident ensue.

The period of the development of the accidents after the bite in animals is various. According to Meynall, the disease appears amongst dogs from ten days to eight months after the injury. In the hounds of Earl Fitzwilliam, who were bitten in June 1791, the intervals varied from six weeks to six months. Dr. James made a similar observation in Mr. Floyer’s pack.

No malady has been submitted to more curious and fearful modes of treatment than hydrophobia; and in many cases such has been the dread of the disease, that patients have been smothered or drowned. Dioscorides seared the wound with irons heated to whiteness; other practitioners first excised the wounded part, and then applied fire or caustic. While fire was resorted to by some practitioners, water was recommended by others, and submersion in a river or a pond has frequently been urged as an effectual remedy. In the time of Celsus, the miserable sufferer was thrown without any warning into a fishpond, alternately plunging his head under water and raising it: when the poor wretch could swim, he was forcibly kept immersed until filled with water. After this experiment, which Celsus terms the unicum remedium, for fear that the patient might be attacked with convulsions, he was taken out of the pond, and soused in warm oil. Van Helmont recommended that the poor devil should be kept under water while the psalm Miserere was sung, and most probably the terrified choristers were not expeditious in their performance. Morin relates the case of a young woman, twenty years old, who was plunged in a tub of water, with a bushel of salt dissolved in it, and dipped repeatedly, until she became insensible; however, much to the surprise of the bystanders, who thought her dead, she recovered, and could not only look upon water, but was able to drink it. Bleeding nearly to death, mercury, cantharides, and various medicines, have been also called into aid; but none have appeared to prove effectual in curing this dreadful disorder. One of the most singular modes of treatment was the introduction of rabid blood into the system of the patient,—in fact, a homoeopathic plan of Dr. Rithmeister of Powlowsk, in Finland, who has recorded several cases to prove that the blood of a rabid animal, when drunk, is a specific against canine hydrophobia. The doctor communicates a letter from Dr. Stockmann, a Russian physician, stating this practice to be both common and effectual in White Russia.

With a view of producing a fresh poisonous action that might neutralize the former one, it has also been proposed that a venomous serpent should be made to inflict a wound under the bite of the mad dog. I do not believe that this experiment has ever been tried; and, as Good observes, the claim of ingenuity is, most probably, the only one it will ever have to receive. This fatal disease is enveloped in so much darkness, both as regards its causes and its treatment, that it may well be considered one of the opprobriums of the profession. The experiments of my late friend Sir David Barry are, however, of great importance; and in many cases of poisonous wounds, the application of cupping-glasses has been followed by evident favourable results.

To ascertain the existence of rabies in animals, more especially in dogs, is a matter of great importance, as being frequently the source of moral depression or of sanguine hope, that may tend to increase or diminish the severity of the accidents. One may apprehend madness in a dog when we see the animal dull, and seeking solitude and darkness, his sleep disturbed, and when awakened refusing food or drink. Its head droops, the tail hangs between the legs. The animal soon quits the abode of his master, the mouth secreting a viscid foam, the tongue pendulous and dry, the eyes bright and sparkling. His gait soon becomes uncertain; now precipitate, then slow and undecided. Impatient, and parched with a burning thirst, he cannot rest; and the sight of any fluid occasions an instinctive shudder. The rabid symptoms now become more violent; the animal will attack and bite other dogs, although much superior in strength. It is asserted that dogs avoid him with terror. On these occasions the fury of the animal is not to be controlled; all ties of attachment are dissolved; and his master is but too frequently the first victim of his indiscriminate rage. Hence the absurd popular notion that mad dogs inflict their first bite on those to whom they are attached,—a circumstance that simply can be attributed to the natural endeavours of a master to check the violence of a domestic creature whom he generally can control. Mad dogs seldom bark, but express their angry uneasiness with a growl, which gradually becomes weaker, until the animal staggers, droops, and dies. Yet as there may exist many maladies amongst animals in which these symptoms are observed, to destroy them, as is usually the case, is a most absurd practice, since the individuals whom they may have bitten will sink into a fatal despondency; whereas, by allowing them to live, if they recover, it is evident that the patient will be easily persuaded that the dog was not in a rabid state.

The following cases, recorded by Dr. Perceval, are curious instances of the dormant state of this fearful virus, the effects of which are accidentally developed.

A wine-porter was labouring under a low fever; after a time appeared some symptoms of hydrophobia, and much inquiry elicited the recollection of his having been slightly bitten by a dog six weeks before. In the interval he was convicted of some fraudulent practice in the cellar of his master, to whom he owed great obligation, and was dismissed with disgrace. Anxiety on this event seemed to produce the fever, which terminated in rabies.

Lately an officer was bitten by a dog, whose madness being recognised, the bitten part was excised immediately: after an undisturbed interval of two months, he was advised to go to England to dissipate the recollection of the accident. There he exercised himself violently in hewing wood, felt pain in the hand which had been bitten, embarked for Ireland, had symptoms of hydrophobia on board the packet, and died soon after his arrival. From the varying period of attack, we might infer that the influence of occasional causes is very considerable. In the last patient, hydrophobia supervened exactly five weeks from the time of the bite: he lost one hundred and twenty ounces of blood in twelve hours, which sunk him much; violent perspiration, and at length delirium, attended the water-dread; during the last twenty-four hours he swallowed, and recovered his senses; and died slightly convulsed, whilst cutting an egg. These cases seem to point out agitation of mind and feverish excitation as powerful occasional causes.

Herman Strahl has recently related the following case of rabies in which the dog that had bitten the patient was not mad. In the month of January, 1833, an innkeeper was taken ill. The doctor found him dressed, and stretched upon his bed. He did not complain of any particular ailment, but loathed all food. He at last admitted that he experienced some difficulty in swallowing; and his mother having offered him a cup of tea, he refused it with a sense of horror, and his countenance immediately assumed a character of ferocity that terrified the bystanders. An apple having been given to him, he ate it without repugnance. It was now discovered that, five weeks before, he had been bitten by a dog he was training; and the wound was slow in healing. The dog was sought, and did not show the slightest sign of disease,—barking, playing, and drinking freely. In the evening the patient’s case was aggravated; and it was with the utmost difficulty that he was made to swallow a spoonful of ptisan. The next day he was seized with a violent attack of rabies: seeing one of his sisters drinking, he fell into a furious rage, dashed a looking-glass to pieces, and entreated his relatives to withdraw, as he otherwise would inevitably bite them. This outrageous paroxysm lasted half an hour; at its expiration he fell into a tranquil sleep. But at night he was seized with another attack; and he began to howl and imitate the barking of a dog, and commenced breaking every thing in the room of a shining appearance. His sisters fled in dismay; but he seized his mother, a woman of sixty-five years of age, cast her on the ground, and bit her in the cheek. After this desperate act, he seemed to be struck with a conviction of what he had done, and became more tranquil; but, half an hour after, on entering his chamber, he was found dead, his head under the bedclothes. His mother did not experience any accidents from the injury.

It is singular that, in this miserable condition, the patients will frequently show singular partialities; and, although repulsing any fluid offered to them by some individuals, will take it from others, and attempt, however vainly, to drink. In the HÔtel Dieu of Paris, a young girl, affected with hydrophobia, would only take a cup of ptisan from me; but with looks of inexpressible anxiety returned it to me, after having struggled to moisten her burning lips. At Boulogne, a postilion, bitten by a mad dog, was violent with every one but one of my nephews: from him he also accepted drink, although unable to swallow it; before dying in excruciating agonies, he repeatedly asked for him, and begged that he might be sent for. He would not allow, even in his last moments, any other person to come near him;—another striking instance of that unknown power of sympathy to which I have frequently alluded in the preceding pages.


                                                                                                                                                                                                                                                                                                           

Clyx.com


Top of Page
Top of Page