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THE POPULAR SCIENCE MONTHLY.— SUPPLEMENT. 



lambs, and could not find a single wound on any 

 of the latter. In about a month both sheep and 

 lambs began to die at the rate of two or three a 

 day. The sheep ran wildly about, sometimes 

 carrying stones in then - mouths, and the lambs ran 

 away. Of the eighteen sheep that had been bitten 

 sixteen died ; and of the thirty lambs, not one of 

 of which was believed to have been bitten, four- 

 teen died. On the next farm the same thing hap- 

 pened to a smaller extent." 



What can be said of the treatment of hydro- 

 phobia or of rabies ? There is no authentic case 

 on record that I am aware of in which an hydro- 

 phobic person has recovered. As it has been so 

 it is still. 'Iarpta larai davaros — the Physician 

 that cures is Death. It would be idle to discuss 

 any curative measures after the peculiar symp- 

 toms of the disease have once set in. 



Not so, however, with respect to prevention ; 

 that is the most important object of our practice 

 — that and the euthanasia. 



The early and complete excision of the bitten 

 part is the only means of prevention in which 

 much confidence can be placed ; and even that is 

 open to a source of fallacy. In the majority of 

 cases no hydrophobia would ensue, though noth- 

 ing at all were done to the wound. No doubt 

 many persons undergo the operation needlessly. 

 But in no given case can we be sure of this. If 

 excision should for any reason be impossible, the 

 wound should be cauterized. Of the efficacy of 

 the latter plan we have this evidence : Mr. You- 

 att, who trusted to it, and who had himself been 

 bitten seven times, tells us that he had operated 

 with the lunar caustic — nitrate of silver — on 

 more than four hundred persons, all bitten by 

 dogs unquestionably rabid, and that he had not 

 lost a case. One man died of fright, but not 

 one of hydrophobia. Moreover, a surgeon of St. 

 George's Hospital told him that ten times that 

 number had undergone the operation of excision 

 there after being bitten by dogs (all of which 

 might not, however, have been rabid), and it was 

 not known that there had been a single fatal is- 

 sue. Excision, in my judgment, must, when prac- 

 ticable, be the most trustworthy and eligible pro- 

 cedure. Trousseau recommends, as a ready and 

 quick preventive, the actual cautery — that is, the 

 destruction of the poison and the tissues of the 

 bitten part by searing them with a red-hot iron. 

 They might be as readily and thoroughly de- 

 stroyed by brushing the interior of the wound, 

 by means of a glass brush, with nitric acid. 



But if the wound be of such a size and in 

 such a place that it can be excised, what is the 



best method for its excision ? This is the advice 

 of my old master, Abernethy : 



" The cell " (he says) " into which a penetrat- 

 ing tooth has gone must be cut out. Let a wooden 

 skewer be shaped as nearly as may be into the 

 form of the tooth, and then be placed into the 

 cavity made by the tooth, and next let the skewer 

 and the whole cell containing it be removed to- 

 gether by an elliptical incision. "We may examine 

 the removed cell to see if every portion with which 

 the tooth might have had contact has been taken 

 away : the cell may even be filled with quicksil- 

 ver to see if a globule will escape. The efficient 

 performance of the excision does not depend upon 

 the extent, but upon the accuracy, of the opera- 

 tion." 



Early ezcinon, then, is almost a sure preven- 

 tive ; but in all suspicious cases, if the operation 

 have been omitted in the first instance, it will be 

 advisable to cut out the wound or its scar within 

 the first two months, or at any time before pre- 

 liminary feelings in the spot foreshow the coming 

 outbreak. Later would be too late. Dr. Rich- 

 ard Bright has recorded a case in which the arm 

 was amputated upon the supervention of tingling 

 and other symptoms in the hand on which the 

 patient had been bitten some time before ; but 

 the amputation did not save him. 



The new power which we have happily ob- 

 tained of suspending sensation generally by the 

 inspiration of certain vopors, or locally by the 

 ether-spray, will contribute at least to the pre- 

 vention of hydrophobia by divesting the process 

 of excision or cauterization of its pain, and there- 

 fore of its terrors. « 



For my own part, if I had received a bite 

 from a decidedly rabid animal upon my arm or 

 leg, and the bite was such that the whole wound 

 could not be cut out or thoroughly cauterized, 

 my reason would teach me to desire, and I hope 

 I should have fortitude enough to endure, ampu- 

 tation of the limb above the place of the injury. 



As to the euthanasia, it may best be promoted 

 by some narcotic drug; and I know of none more 

 eligible than the chloral hydrate, administered in 

 such doses and at such intervals as may suffice, 

 without shortening life, to quiet the restless agi- 

 tation, and to mitigate the sufferings, of its in- 

 evitable close. Should the patient be unable to 

 swallow that remedy, recourse may be had, under 

 similar limitation, to its subcutaneous injection, 

 or to some anaesthetic vapor. 



What, it may be asked, should be done by or 

 for a man who has been bitten by a rabid animal, 



