314 
shews itself by an apparent constriction of 
the rima glottidis, and in the corresponding 
gestures of the patient. In these attacks, 
it appears that’ that’ important part of the 
system of respiration, the diaphragm, 1s 
pretérnaturally affected. 10 
2, Another circumstance, characteristic 
of this disease, is an inordinate action of the 
voluntary muscles, The muscles seem 
always: to,oyeract, the intention of the 
mind. f 
3. A third characteristic circumstance 1s 
the peculiar nature of the delirium. The 
patient shall go on talking with vehemence, 
and for many successive hours, of past 
events, as if they were actually present ; 
shall fancy objects to be different from what 
they really are, and shall even act on those 
delusions ; and yet no sooner is his atten- 
tion exerted by questions put to him by his 
friends, than he shall answer them, and 
continue for a considerable time to converse 
with a calmness of manner, and coherency 
of ideas, precisely similar to those of a per- 
son in perfect health. 
4. In the rabies canina the convulsions 
do not take place till long after the dread of 
liquids has been distinctly marked, and till 
the disease is nearly terminated. 
5. Of persons bitten by dogs really mad, 
it is probable that only a small proportion 
become hydrophobous. Bites on the face 
are most certain of infecting: bites through 
clothes generally fail to injure. 
6. The duration of the disease is dif- 
ferent in different patients. In a great ma- 
jority of cases, the disease terminates in 
death within four days from the first affec- 
tion of the organs of respiration. 
7. Some pain, if not in the part itself, at 
least in the course of the nerves supplying 
it, has usually attended the commence- 
ment, and a considerable part of the course 
of the constitutional malady. 
8: There cannot be a greater mistake 
than to suppose, either that the fever of 
hydrophobia is of the inflammatory kind, or 
that its peculiar symptom arises from 
local inflammation of the fauces, or any 
other part. Dissection has shewed no 
disease of an inflammatory kind, ‘either in 
the organs of respiration, or the alimentary 
canal ; appearances about the bilious coat 
of the cesophagus, trachea, &c., are merely 
coincidences or effects; for it is evident 
that they are not essential to canine hydro- 
phobia, either as causes or adjuncts, since 
in many cases in dissection no such appear- 
ances haye existed. The symptoms of in- 
flammation in these parts bear no real re- 
semblance to the phenomena of canine 
hydrophobia. 
9. The dread of drinking in canine hydro- 
whobia is far from arising from an aversion 
to liquids, as such. There is in reality a 
strong desire to drink, and the dread appears 
to originate solely from the recollection of the 
great sufferings produced by the attempt.— 
It cannot be denied, that dogs will often 
Observations on Hydrophobia. 
[ Nov. 1, 
lap while under this disease ; besides which, 
it should continually be borne in mind, /hat 
what is called hydrophobia, or the dread of 
water, is not the disease itself, ‘but only one 
symptomof the disease; which differs in degree 
in different, patients, and without the evist- 
ence of which the patient would as certainly, 
and probably as. soon; die, as when it ewists in 
the greatest degree. A patient has swallowed 
liquids in guantities fully sufficient to preserve 
life, were that conaition alone adequate to the 
purpose. 
10. In order to ascertain the existence 
of the disease in question, the distinguish- 
ing effect of the attempt to swallow liquids, 
or their contact with the mouth, must be 
not mere dread, or resistance, or agitation, 
or even general spasms or conyulsions, the 
last of which. never occur in, the rabies eanina 
till a very short time before death,—but that 
peculiar strangulation, or affection of the 
respiratory organs, which has been before 
fully described. Unless this occurs, the 
characteristic symptom of hydrophobia ca- 
nina is absolutely wanting. 
1l. First, Patients do not rave at the be- 
ginning of injury from animals,—and never, 
at any period, either in connexion with the 
sight of water or without it, except from 
recollection of a bite, and apprehension of 
its consequences. — Secondly, The disease 
for the most part, if not always, begins with 
a hot skin, and certain other symptoms of 
fever, which are anterior by several hours 
to the dread of liquids. —Thirdly, Patients 
sometimes sleep after the commencement 
of hydrophobia. — Fourthly, ‘There are 
rarely in that disease any savage contortions 
of countenance, except temporarily, during 
the local spasms of respiration, or till the 
last general convulsions, take. place. — 
Fourthly, Sometimes the general ,conyul- 
sions do not occur at all; but when they do 
exist, they have usually perfect intermissions 
of Jonger or shorter duration.—Lustly,, The 
characteristic of canine hydrophobia, oy man is 
a local spasm of the respiratory organs _ alone, 
very short as to duration, and having long 
and perfect intervals, but, while it lasts, 
threatening suffocation, — occuring ,.some- 
times spontaneously, whether during sleep 
or watching, and always from the contact 
of liquids with the inside of the fauces. 
Among the equivocal symptoms, that 
are not characteristic of hydrophobia, 
are, difficulty of swallowing, with a 
rising up of the whole larynx and pha- 
rynx, as in hysteria; loss of voice ; 
horror of liquids remaining after the 
difficulty of swallowing has ceased ; 
the production of convulsions from the 
horror of liquids and noises ; difficulty 
of swallowing, and convulsions about 
the throat without disordered respira- 
tion; general agitation and horror from 
the attempt to swallow liquids or solids 
without convulsions, local or general, or 
delirium. 
_ As 
