658 THE BOOK OF THE Doc. 



Before leaving this subject, we think it our duty to inform the reader that tingling and 

 slight pain in the cicatrix of an old dog bite is not uncommon, and there is no reason to apprehend 

 danger from this symptom alone. As a rather curious instance of the force of imagination, 

 we may mention that last year, while writing an article on rabies for a London periodical, we 

 felt a curious nervous sensation in some old cat-bites in the forefinger, and we could not help 

 touching it occasionally ; by afternoon this feeling had increased to pricking pains, although 

 they were by no means constant, and only came on when we thought about the matter. Towards 

 night they were worse, and being in rather low health, sleep was impossible. In the morning 

 the upper cicatrix was inflamed and slightly swollen; and so matters continued for nearly a 

 week, when, gradually abating, they finally ceased. 



Diagnosis. There is a species of dysphagia, or difficulty in swallowing, brought on some- 

 times in the nervous and hysterical from seeing a hydrophobic case, or even from hearing or 

 reading of one. This generally comes on rather suddenly, is unaccompanied by difficulty of 

 breathing, and the absence of convulsions of the body. It may be cured by compelling the 

 patient to drink. Tetanus or lock-jaw may be mistaken for hydrophobia ; but in tetanus the 

 jaw is fixed, while it is almost constantly in motion in the more certainly fatal disease. Again, 

 the tetanic spasm is more continuous in its nature, and not induced by sights or sounds, and 

 there is no fear of water, although the suffering is increased by the act of swallowing. Now, 

 tetanus is just the disease that might be mistaken for hydrophobia, especially as a lacerated 

 wound from the fangs of a dog might produce it. 



In some forms of mania there is a dread of water ; but a case of this kind could easily be 

 diagnosed, because the maniac has hallucinations he has lost his reasoning po\ver ; whereas 

 in hydrophobia, although the patient may at times be "a little off his head," still the reason, 

 the mind, and intellect, remain clear until the very last. 



Treatment. We must begin by frankly confessing that every one of the few cases of true 

 hydrophobia which we have had the great pain to witness, have had but one ending death. 

 We are periodically hearing of certain specifics having been discovered, tried, and proved to be 

 perfect remedies. We regret to say that such reports when weighed in the balance have 

 invariably been found wanting. It would take pages of our space to even name the numerous 

 medicinal agents that have been proposed and prescribed in vain. The older plan of treatment 

 by large bleedings could but hasten death; opium, or chloroform, or chloral, even if they succeeded 

 in allaying to a certain extent the irritation and pain of body and mind, could hardly be 

 expected to eliminate or counteract the poison. In all probability, many years may yet elapse 

 before a perfect antidote to the poison of rabies is discovered, and we can only hope for the 

 happy end through earnest study in the combined science of medicine and chemistry, aided 

 by skilful experiment and well-arranged observation. Meanwhile, if we cannot positively cure, 

 we can do very much to prevent hydrophobia, and to keep it in check. 



If an individual, then, is bitten by a dog or other animal which is undoubtedly or even 

 ^presumably rabid, the local or preventive treatment should be gone about as speedily as it 

 vssibly can be. We have not been able to prove how soon the poison of the saliva becomes 

 absorbed, although some writers tell us in less than five minutes, while others mention a very 

 much longer time. We all know, however, the rapidity with which some of the salts of the 

 metallic poisons can find their way from an abraded surface into the circulation and the 

 secretions themselves. 



Now, we have very little doubt, judging from all we have read and heard, and from the 

 little we have seen of accidents from rabid dogs, that if proper measures are adopted within 



