DISEASES OF THE NERVOUS SYSTEM. 52 I 



pharynx ; and we are justified in giving the! name of retching-fits 

 to these spasms, which form the pathognomonic — characteristic— r 

 symptom of lyssa, and are given in every well-recorded case. 



" The dread of water is entirely due to the dreadful experience 

 of the patient on trying to drink. Reports of cases where hydro- 

 phobia is given as a primary symptom are worthy of no credence. 

 It is a curious fact that, at first, the act of swallowing solid food is 

 not attended by spasms. Even a draught of air on the skin, or 

 touching anything cold, sudden irritation of the eye by dazzling, 

 even sudden mental excitement or surprises, may induce attacks. 

 According to my observation, the pharyngeal muscles do not par- 

 ticipate in the reflex spasms induced by irritating other parts, as 

 the mouth or palate. At the height of the disease, it appears as 

 if attacks occurred from time to time without cause ; but I think 

 that these apparently spontaneous attacks must be regarded as 

 reflex spasms, and be referred to the collections of tough mucus 

 in the pharynx, or to the trickling into it of saliva. This supposi- 

 tion is based on the haste, and abandon with which the patient 

 ejects saliva and mucus, and the attempts to introduce the 

 finger far into the throat, for the purpose of removing mucus and 

 sputa. 



" Various authors name tetanic or epileptiform spasms among 

 the symptoms of lyssa ; but on careful examination, I have not 

 been able to discover a case where the detailed description of the 

 spasms fully convinced me that they were tetanic or eclamptic. 

 It is nowhere stated that the muscles of the back were tense, ex- 

 cept during the attacks, or that consciousness was lost during the 

 general convulsions. In one of my patients there was opisthot- 

 onos * — he threw his hands and feet about, and pitched around, 

 so that he frequently fell on the floor. But these symptoms re- 

 minded one far more of hysterical spasms, or of the actions of a 

 tortured, despairing man. 



" The above symptoms are soon accompanied by attacks of 

 boundless rage, in which the patients are hard to manage, destroy 

 all that comes in their way, strike, kick, scratch, and bite, if held 

 fast, and not unfrequently kill themselves, if they are carelessly 

 watched. 



* Opisthotonos ; bending of tlie body backwards. 



