HYDROPHOBIA FROM SKUNK-BITE. 235 



are exceptional, and when reported to extend beyond the fourth month it 

 may be questioned whether the patient has not been unconsciously inocu- 

 lated by the caresses of a pet dopj, suffering from the disease unsuspecterj, 

 from tetanus, or, as Baron Larrey* remarked, when coramentatinor upon Dr. 

 FereoFs case of hydrophobia with two years and a half incubation : ' For 

 my part I should be disposed to regard his case not as an example of rabies, 

 with an incubation of two years and a half, but as one of cerebral hydro- 

 phobia or symptomatic of acute delirium, provoked or aggravated by the 

 coincidence of the bite of a dog presumed to be mad/ In all the cases from 

 the bite of a skunk the prodromic jtage of the disease was more or less 

 mark'eTl, though n?5T3e'oFthem amounting to acute melancholy. An indefinite 

 feeling of dread and a general malaise — the most prominent symptoms, 

 together, in most cases, with pain or numbness at the seat of the wound, 

 were present from one to three days. To most of these unfortunates the 

 fearful result of the trivial wound they had received was unknown, and 

 unaware of their perilous condition were not incessantly tormented with 

 sad forebodings or dread of the onset of the malady. 



"2. The characteristic pustules which the writer of Rabies Mephitica lays 

 stress npon were not found in any of the cases of hydrophobia produced 

 either by the bite of the skunk, wolf, or dog. Niemeyert states that 'the 

 assertions of Marochetti, who claims that during the incubation stage vesi- 

 cles form beneath the tongue, and that by destroying these vesicles the out- 

 break of the disease can be averted, have not been substantiated.^ 



" 3. That the invariable accompaniments of Rabies Canina were not want- 

 ing in the cases of R. Mephitica. The specific action of the poison was made 

 manifest first by the oesophageal branch of the eighth pair, giving rise to 

 the characteristic symptom of the disease, or to the extreme difficulty of 

 swallowing, especially of fluids ; then the frequent catching of breath no- 

 ticed in all cases, showing that the recurrent nerve was also affected ; later 

 brilliant eye, and the sense of touch becomes painfully excited, hyperfesthe- 

 sia existing in a marked degree, with the exception of the case reported of 

 R. Canina, all of which point to some lesion of the central and spinal nerves. 

 That the brain itself, and especially the region of th© medulla oblongata 

 becomes affected by the terrible convulsions and delirium in the more ad- 

 vanced stage of the malady. The spasms in all the eases were unlike those 

 of tetanus, less continuous, remittent, and often intermittent. In none of 

 the cases produced by the skunk bite was there any loss of perception. In 

 no case that I saw did morphia have any effect in abridging the fearful 

 struggles; death either ended with convulsions, or exhausted by the terrible 

 exertions a sudden calm took place, and, as if nature gave up the conflict, 

 di ed wi thout a groan." 



* " London Medical Times atid Gazette, Aug. 8, 1874, p. 159." 

 t •' Nieuiever, Pract. of Med.'^ 



