dog-poison w man. 



343 



is carried across Europe to the plains of India ! 

 We must apply to death brought about by rabies 

 the same general principles as to death from 

 snake-bite ; but in the one case the poison works 

 its fatal end at once, in the other it may lie dor- 

 mant for years. It lies dormant probably by 

 being entangled at the head of the wound, and 

 there held in its place till some new action liber- 

 ates it, and lets it loose into the circulation: the 

 view advanced by Sir Thomas Watson some years 

 since, and now also held by others. 



We have briefly considered the effect of the 

 poison of rabies inflicted by one dog upon an- 

 other, as well as the effect of virulent snake- 

 poison inflicted on a man. It remains to com- 

 pare the effects of the dog-poison on a man with 

 that of the cobra upon him. 



There arc points of similarity and points of 

 divergence. 



The points of similarity are — first, that the 

 poison, if allowed to enter the circulation in suffi- 

 cient quantity, is uniformly fatal ; and, secondly, 

 that the fatal termination seems certainly to be 

 by way of the nervous system. 



We are not yet in a condition to say with ab- 

 solute precision what are the anatomical changes 

 in the nervous system either in man, or in ani- 

 mals not man. But observations are rapidly ac- 

 cumulating. 1 It is certain that in each case the 

 injury arises from the introduction of the animal 

 poison into the blood. In each case, therefore, 

 the end can be averted only by keeping the 

 poison out of the circulation ; or, if in it (in a 

 moderate quantity), by maintaining life till it com 

 be eliminated: the way by which alone the wou- 

 rali can effect a cure ; and this only if the poison 

 has not wrought or set up changes destructive to 

 the vitality or regenerative power of the nerve- 

 elements. 



The nervous symptoms in man, when once the 

 poison has fairly entered the system, gradually 



1 Many persons are engaged in prosecuting re- 

 searches into the actual alteration of structure which 

 can be detected after death from hydrophobia, among 

 whom may be named Dr. Gowers, of University Col- 

 lege Hospital, Dr. Greenfield, of St. Thomas's, and Dr. 

 Savage, to whom I am indebted for valuable micro- 

 scopic preparations. All available knowledge will 

 shortly be collected, under the best auspices, by a 

 committee of the British Medical Association, includ- 

 ing Dr. Burdon-Sanderson, Dr. Lauder Brunton, Dr. 

 Gowers, Mr. Ernest Hart, and Mr. Callender. Whether 

 the knowledge they will certainly gain as to the modus 

 operandi of the poison, and the changes it effects in 

 vessels and nerves, will help the cure when the 

 changes have been set up, is in the womb of the 

 future. 



increase until thirst and inability to drink remove 

 all doubt as to the only result. The inability to 

 drink is only a sign of deep-seated changes in the 

 nerve-structure. 



Prof. Rolleston has pointed out to me that 

 these changes, though hardly discernible, may be 

 so great (having regard to the actual character 

 of the force-producing nerve-cell) as to explain 

 entirely, first, the excitement, and, second, the 

 destruction of the ordinary functions of the 

 nerve-centres, which regulate life. In a paper 

 to which the professor has referred me, by Dr. 

 Mayor, I find it noticed that " there may be dif- 

 ferences between these delicate structures in man 

 and other animals so slight as to be nearly in- 

 appreciable," but still differences of the widest 

 significance and importance ; and so it may quite 

 be that fundamental changes shall take place by 

 sudden shock or otherwise in the fine structures 

 by which the nerve-force is developed in man, 

 and yet the physical changes may be wholly out- 

 side the reach of our observation. It is right to 

 add that already these changes have been ob- 

 served by Dr. Gowers, though their exact import 

 cannot yet be declared. 



Hydrophobia occurring in man, after com- 

 munication of the poison of rabies, is thus shown 

 to be a " toxoneurosis." It would not be desir- 

 able, nor would it be of any use in a paper of 

 this kind, to enter into a detailed description of 

 the symptoms of this mode of death. 1 I have 

 thought it best rather to illustrate the character 

 of the malady in other ways. We must admit 

 that there is, as yet, no cure known for the dis- 

 ease when once established in man. The most ex- 

 travagant remedies have been suggested. Every 

 form of pharmacy and charlatanism has expend- 

 ed itself throughout all generations — advocated 

 sometimes by otherwise great names. The pages 

 of Ccelius Aurelianus, Morgagni, and a host of 

 others, would create considerable interest, and 

 one may say even amazement, on this subject. 

 The danger is generally preventable by prompt 

 measures taken at the time when the injury is 

 inflicted. The weight of evidence seems to show 

 that the actual cautery is the most efficacious 

 means, excision the next, and caustics, though 

 sometimes sufficient, are the least to be relied 

 upon. This much said, I must advert to state- 

 ments in various journals to the effect that a case 

 had been cured by means of wourali-poison by 



1 Those who desire a graphic account of a case of 

 hydrophobia, should consult Sir Thomas Watson's 

 "Lectures on the Practice of Medicine," vol. i., p. 590, 

 sixth edition, 1871. 



