ARTICLE III.

Hydrophobia. By S. P. HEDGES, M. D., of Chicago, Ill.

The word hydrophobia is from two Greek words, and signifies a "dread of water." Notwithstanding the objections to this word as generally employed, it is perhaps better adapted than any other to the disease as manifest in man.

It would be straining a point, I think, to call a disease hydrophobia, when there was dread of liquids. Yet we are aware, at the same time, that this is only one symptom. A mere dread of water, with difficulty or inability to swallow it, does not constitute hydrophobia or rabies proper. There are other grave and fatal symptoms. But this dread of water is the characteristic symptom of this disease; is always present in man, and very properly gives name to the affection.

But the term rabies is more applicable when dogs and other of the lower animals are affected with the disease. Dogs, when rabid, are never afraid of water, but eagerly lap it up to quench their thirst. They have even been known to swim rivers when rabid.

This disease is not of recent origin. Aristotle mentions it about 400 years B. C. To avoid confusion in writing of hydrophobic affections, authors have made something like the following distinctions: (1) Cases which are not the result of the bite of a mad dog, or of the application of any of its secretions to an abraded surface. (2) All cases which are the result of such inoculation.

The first are called symptomatic and spontaneous. Symptomatic hydrophobia, or simple dread of liquids, undoubtedly occurs in various diseases, as hysteria, tetanus, epilepsy, and angina pectoris. But it differs from real hydrophobia, in that, the dread of liquids come on the same day as the cause which gives rise to it, and is generally cured at the same time with the disease with which it occurs. Real hydrophobia, however, has a longer or shorter period of incubation, as it may be, like other zymotic poisons. Symptomatic and real hydrophobia, differ, also, in their etiology, progress, curability, and method of treatment.

That there is a possibility of real hydrophobia or rabies arising spontaneously among men, separate from every other disease, and [Senate, No. 77.] 4

without inoculation is not proven by reliable cases. The instances reported by Raymond, Roupa and Pouteau, leave doubts as to whether there may have been some inoculation, though unknown to the patient. This is quite probable since we know that the handling of dogs, which were not suspected of being rabid at the time, has resulted in death from hydrophobia. There are very many cases of this kind on record; and it is the fact that the virus may gain entrance in some insidious manner, through some slight abrasion, or crack, or pimple which is not noticed.

The case of a hostler who died from hydrophobia, in England, having, as it was said, never been bitten by any dog, is not of weight as disproving the point. He was an intemperate man, and often laid in a drunken sleep for hours, where the dogs could lick his hands and face. He undoubtedly became inoculated with the poison, and did not have spontaneous hydrophobia.

The case of the man Haly, in New York city, who was taken with hydrophobia while drinking a glass of water, and died in four days, with all the symptoms so characteristic of the disease, has been published. He could not remember of ever having been bitten by a dog. But he took care of horses, and slept in the stable, and was probably inoculated in some manner unknown to himself.

Another case is reported where fatal hydrophobia resulted from untying with the teeth a knot in a rope with which a rabid dog had been tied. Hence it is generally conceded that hydrophobia occurs among men only as the result of inoculation of the specific virus from some rabid animal, and never spontaneously.

And it is generally admitted, on the other hand, that rabies arises spontaneously among the animals of the canine and feline race; as the dog, wolf, fox, jackal and cat. Opposed to this, however, stands Mr. Youatt, the great English veterinary surgeon, who denies that it is ever propagated, except by inoculation, even among dogs. He believes that if you could "perform a quarantine" with each individual, dog and cat, and their species, you might rid the world of the dread disease, hydrophobia.

According to the best authorities, this disease originates among dogs and their species. It is, perhaps, always endemic among them, and perhaps sometimes epidemic. It is a specific, inoculable disease. The pecular poison is contained in the saliva. It has not been demonstrated as to whether the virus comes from the salivary glands or not. As these glands are rarely swollen or

sore during the progress of the disease, and never reveal any morbid signs on sectio-cadaveris, it seems probable that their secretion may not be perverted at all. But, on the other hand, it is quite as evident that the rough, ropy, viscid secretion found so generally in the air-passages of both man and animals, when laboring under this fearful malady, does contain, or is, in fact, itself the peculiar poison. Moreover, post-mortem examinations often reveal a state of congestion and inflammation of the larynx, bronchi and trachia, with a copious secretion of this peculiar ropy, viscid sputa, which collects and forms the foam at the corners of the mouth. But this point is not demonstrated as yet. No experiments have revealed the poison as contained in any other fluid or solid in the body. It is not in the blood, as transfusion from rabid to healthy dogs does not cause the disease. Neither is it contained in the mother's milk. The poison is not absorbed through the unbroken integument. But the sputa of a rabid animal must be applied to an abraded or wounded surface somewhere in order to produce inoculation.

As it is important that the practitioner should be able to judge as far as possible respecting the real condition of a dog supposed to be mad, in the event of his having bitten a human being, I quote from the graphic description of Mr. Youatt, the early symptoms of rabies in the dog. "In the greater number of cases," he remarks, "there are sullenness, fidgetiness, and continual shifting of position. When I have had opportunity, I have generally found these circumstances in succession. For several successive hours, perhaps, he retreats to his basket or bed. He shows no disposition to bite, and he answers the call upon him laggardly. He is curled up, and his face is buried between his paws and his breast. At length he begins to be fidgety. He searches out new restingplaces; but he very soon changes these for others. He takes again to his own bed, but is continually shifting his posture. He begins to gaze strangely about him as he lies on his bed. His countenance is clouded and suspicious. He comes to one and another of the family, and fixes on them a steadfast gaze, as if he would read their very thoughts. 'I feel strangely ill,' he seems to say; 'have you anything to do with it? or you? or you?' Has not a dog mind enough for this? If we have observed a rabid dog at the commencement of the disease, we have seen this to the very life."

We see also, that the dog early becomes delirious. He sees