Ill PASTEUP. AND HYDROPHOBIA 131 



experienced in various parts of the l^ocly ; and signs of digestive 

 disorder are not unfrequent. After the continuance of one 

 or more of these preliminary, or rather premonitory, symptoms 

 for a period varying from a few hours to five or six days, and, 

 though very rarely, without all or even many of them being 

 observed, the patient becomes sensible of a stiffness or tightness 

 about the throat, rigours supervene, and in attempting to swallow 

 he experiences some difficult}^, especially with liquids. This may 

 be considered as really the commencement of the attack in man. 



The difficulty in swallowing rapidly increases, and it is 

 not long before the act becomes impossible, unless it is attempted 

 with determination ; though even then it excites the most painful 

 spasms in the back of the throat, with other indescribable 

 sensations, all of which appeal to the patient, and cause him 

 to dread the very thought of liquids. Singular nervous par- 

 oxysms or tremblings become manifest, and sensations of stricture 

 or oppression are felt about the throat and chest. The breathing 

 is painful and embarrassed, and interrupted with frequent sighs 

 or a peculiar kind of sobbing movement ; and there is a sense of 

 impending suffocation and of necessity for fresh air. Indeed, the 

 most marked symptoms consist in a horribly violent convulsion 

 or spasm of the muscles of the larynx and gullet, by which 

 swallowing is prevented, and at the same time the entrance 

 of air to the windpipe is greatly retarded. Shuddering tremors, 

 sometimes almost amounting to general convulsions, run through 

 the whole frame; and a fearful expression of anxiety, terror, 

 or despair is depicted on the countenance. 



The paroxysms are brought on by the slightest causes, and 

 are frequently associated with an attempt to swallow liquids, 

 or with the recollection of the sufferings experienced in former 

 attempts. Hence anything which suggests the idea of drinking 

 to the patient will throw him into the most painful agitation and 

 convulsive spasms. . . . This is particularly observed when the 

 patient carries water to his lips ; then he is seized with the 

 terrors characteristic of the disease, and with those convulsions 

 of the face and the whole of the body which make so deep 

 an impression on the bystanders. He is perfectly rational, feels 

 thirsty, tries to drink, but the liquid has no sooner touched 

 his lips than he draws back in terror, and sometimes exclaims 



