The New Dominion

GENUINE HYDROPHOBIA.

An Article Which Should Find a Place in Every Family Scrap-Book.

Did you see what that patient did when I offered him a glass of water? He turned from it with fear and distress. The offer was not so cruel as it seemed, as he had been able to swallow a little water in the house. That has given the name to the disease, hydrophobia. He wants water, he craves water, yet he fears it. When he was coming down here, in his suffering, he grasped a handful of snow, which was to him, doubtless, one of the rarest treats which he has enjoyed for some time. This is undoubtedly hydrophobia. A strong, substantial farmer, fifty-two years old, who never knew what hysteria was, nor nervous disease, is rather too old to pick it up now. His pet spaniel, of which he was very fond, had strayed from home—an unusual thing for it to do. Then, in a season of sanity, which these dogs sometimes have, returned to his master, who rejoiced at the finding of his pet, was fondling him; and the dog, with those tokens of affection common to them, struck his teeth against the lips of his master, and inflicted the wound which will soon cause his death. The injury was not on the part of the body covered with clothes, where the poison might have been wiped away, but on the bare lip. Sixty per cent. of bites on the face prove fatal; forty per cent. of those on the hand, and only from twenty to thirty per cent. of those occurring on parts covered by the clothing. The exciting cause of this attack may be a sudden noise, a slam of the door or any sudden impression. In this case it was an appeal to the senses, and that of smell was the one selected. He was butchering hogs forty-five days after the reception of the injury and inhaled some irritating vapor. He was attacked with dyspnoea. An officious neighbor told him that hydrophobia commenced so. This was a most unfortunate occurrence. Fear has much to do with the aggravation of the disease. Men have had what appeared to be a sure case, and were relieved after seeing the dog in health, and thus being made to know that he was not mad, as they had feared. You can not deceive this man. All our efforts in this line have been fruitless. He knows that he has hydrophobia, and knows he will die.

The chain of evidence in this case is very complete. The dog lived a few days afterwards, and died with hydrophobic symptoms. It is of great importance, in all suspected cases, to keep the dog and watch it closely. It was not known where this dog got hydrophobia. It was not known that there were mad dogs about. Rabies is not confined to dogs, but is also found among cats, foxes and other animals. The history is quite enough in this case to support the diagnosis. The history of the bite was obtained here; but this is apt to be forgotten, especially in this country. Some sudden impression may start it up.

It is very essential to follow up the history of the animal. Hammond reports a case in which a man died and the dog did not bite him at all. The period of incubation is not so long in any disease as in hydrophobia. It varies between eighteen and sixty-four days. This case is about an average. Cases do occur in three, six, twelve and twenty-four months. In the older literature, we have statements of its happening after five to ten years, but we look on these statements with incredulity. We know how a man can inhale the micro-organisms of tuberculosis, which will lie latent for a long time, then assert itself. The fact that the period of incubation is so long gives great encouragement in preventive treatment. We can cut out the wound, suck out the poison, or apply the ligature if properly located. There is nothing better than fire. Heat an iron white hot and apply it to the surface of the wound. Thorough destruction of the wound is the only hope. We must at all events cauterize the wound; lunar caustic is poor, chloride of zinc is better, fire is the best. Destroy the wound at once; but do not fail to do so if as much as two weeks have elapsed. Pasteur thought he could make the victim used to an attenuated form of virus, and thus keep the disease in check. Pasteur's treatment may prove useful. It is too early as yet to tell what will become of it. Patients attacked with this disease die in from two to eight days. This man looks as if he would die in twenty-four hours. We can only prove beyond a possible doubt that a case is hydrophobia by inoculation. It is doubtful if a true case of hydrophobia ever recovered.

We can relieve symptoms. This man has received forty grains of chloral by the rectum, then one-half grain of morphia hypodermically; one-half hour later, one-third grain of morphia hypodermically, then five grains of chloral hypodermically, all of which was followed by no effect worth speaking of. This morning one grain of cocaine was put in the oesophagus and throat, then one-third grain of curare. Moerck's preparation was given subcutaneously, which should be repeated every half hour till the dyspnoea is relieved. All the tact of the physician is needed to take the fear from the patient. He should be kept quiet; only those necessarily engaged in attending him should be left about him. Put him in a bed, hung around with curtains, so as to exclude the sound and light. This, it is said, will retard the convulsions, but does not stop the advance of death. Euthanasia, happy death, is all that we can hope to secure in this case.—Report of a Lecture by Dr. J. T. Whittaker, in Medical and Surgical Reporter.