HYDROPHOBIA IN MAN. 659 



five minutes, or even a quarter of an hour, after a bite has been received, the absorption of the 

 poison, and consequently the occurrence of hydrophobia, are rendered impossible. 



Suction and cauterisation, then, are our sheet-anchors. The mucous membrane of the lips, 

 it must be remembered, is a secreting, and not an absorbing membrane, so the danger of 

 inoculation by the mouth is very small indeed, unless there is some slight abrasion, when 

 poisoning might result, as in the case of the lady whose dress was torn by a rabid lap-dog. She 

 sewed up the rent, and bit off the thread, thus bringing her lips into contact with the little 

 saliva left on the dress ; hydrophobia, and we need hardly add death, was the result. But so slight 

 is the danger of inoculation through the mucous membrane of the mouth, that if the bite is 

 in a position which the individual himself cannot reach, a friend need hardly fear to perform 

 the suction for him. The mouth of the sucker ought to be frequently rinsed with water, and 

 the teeth ought to be used in nibbling the edges of the wound to secure a plentiful flow of blood. 

 The sucking is to be kept up for a quarter of an hour, with short intervals of washing or laving 

 the parts with warm water, or warm water with either a little salt in it, or some spirits, or a few 

 drops of carbolic acid. 



As soon, however, as cauterisation can be resorted to, it must take precedence. What we 

 wish to obtain is the complete destruction of the poisonous matter in the wound, and the 

 sloughing away of the adjacent portions of tissue, that may reasonably be supposed to have be- 

 come imbued with the contagium. 



Probably the best way of fulfilling these indications is either the use of the actual cautery 

 the hot iron or any one of the three powerful caustics, nitrate of silver, potassa caustica, or 

 carbolic acid. 



As to the actual cautery, it has one advantage over the others, it is never far to seek ; a 

 piece of strong wire, a nail, or anything in shape of a probe, can be heated to redness in a 

 few moments in the fire, and its application only requires reasonable courage. 



N.B. It is better to err on the right side, and burn too much than too little, and, 

 remember, the cautery must be of sufficient thickness to retain enough heat to do its work 

 well. The wound had better be kept open for a few weeks by the application of some 

 stimulating ointment. We have seen snake bites cauterised with a burning brand, and by gun- 

 powder ; but this latter plan is not so easily adopted with a wound from a dog's tooth, owing 

 to the greater amount of bleeding. 



There is great difference of opinion among authorities regarding the relative value of the 

 actual cautery as compared to caustics. Probably it is best to apply which ever comes first and 

 readiest. Nitrate of silver, a small pencil of which can easily be carried in the pocket 

 of any one who is constantly among dogs, is greatly extolled by Youatt. We have only 

 to say that the pencils usually sold by chemists are too blunt, and not long enough. They 

 will not go home, as it were, to the bottom of the wound, and it must be patent to everybody 

 that to do any good the cauterisation must be deep and effectual. Potassa fusa is better, we 

 think, than silver, but is deliquescent, and so is not so portable, unless prepared with gutta- 

 percha, as proposed by M. Robiquet. The carbolic acid is diluted with one part of spirits of 

 wine, and a bit of lint or rag, well soaked in this, probed into the wound, and covered 

 over with a pad or bandage, which must be kept on for three or four hours. Afterwards 

 keep the wound open for some time, and frequently wash with a weak solution of carbolic 

 acid. 



The excision of the bitten part is recommended by some. After the part has been well 

 washed and sucked for a short time, a small skewer is thrust into the wound, and you must 



