RABIES. 147 



If the incision is made freely and properly round the wound, and does 

 not penetrate into it, yet the blood will follow the knife, and a portion of 

 it will enter into the wound caused by the dog, and will come in contact 

 with the virus, and will probably be contaminated, and will then overflow 

 the original wound, and will be received into the new incision, and will 

 carry with it the seeds of disease and death : therefore it is, that scarcely 

 a year passes without some lamentable instances of the failure of incisions. 

 It has occurred in the practice of the most eminent surgeons, and seems 

 scarcely or not at all to impeach the skill of the operator. 



Aware of this, there are very few human practitioners who do not use 

 the caustic after the knife. Every portion of the new wound is submitted 

 to its influence. They do not consider the patient to be safe without this 

 second operation. But has the question never occurred to them, that if 

 the caustic is necessary to give security to the operation by incision, the 

 knife might have been spared, and the caustic alone used ? 



The veterinary surgeon, when operating on the horse, or cattle, or the 

 dog, frequently has recourse to the actual cautery. I could, perhaps, ex- 

 cuse this practice, although I would not adopt it, in superficial wounds ; 

 but I do not know the instrument that could be safely used in deeper ones. 

 If it were sufficiently small to adapt itself to the tortuous course of little 

 wounds, it would be cooled and inert before it could have destroyed the 

 lower portions of them. If it were of sufficient substance long to retain 

 the heat, it would make a large and fearful chasm, and probably interfere 

 with the future usefulness of the animal. The result of the cases in which 

 the cautery has been used proves that in too many instances it is an ineffi- 

 cient protection. The rabid dog in Park Lane has already been men- 

 tioned. He bit several horses before he could be destroyed. Caustic was 

 applied to one of them, and the hot iron to the others. The first was saved, 

 almost all the others were lost. A similar case occurred last spring ; the 

 caustic was an efficacious preventive ; the cautery was perfectly useless. 

 What caustic then should be applied ? Certainly not that to which the 

 surgeon usually has recourse a liquid one. Certainly not one that 

 speedily deliquesces ; for they are both unmanageable, and, what is a more 

 important consideration, they may hold in solution, and not decompose the 

 poison, and thus inoculate the whole of the wound. The application 

 which promises to be successful, is that of the lunar caustic. It is per- 

 fectly manageable, and, being sharpened to a point, may be applied with 

 certainty to every recess and sinuosity of the wound. 



Potash and nitric acid form a caustic which will destroy the substances 

 with which they come in contact, but the combination of this caustic and 

 the animal fibre will be a soft or semi-fluid mass. In this the virus is sus- 

 pended, and with this it lies or may be precipitated upon the living fibre 

 beneath. Then there is danger of re-inoculation ; and it would seem that 

 this fatal process is often accomplished. The eschar formed by the lunar 

 caustic is dry, hard, and insoluble. If the whole of the wound has been 

 fairly exposed to its action, an insoluble compound of animal fibre and the 

 metallic salt is produced, in which the virus is wrapped up, and from 

 which it cannot be separated. In a short time the dead matter sloughs 

 away, and the virus is thrown off with it. 



Previous to applying the caustic it will sometimes be necessary to enlarge 

 the wound, in order that every part may be fairly got at ; and the eschar 

 having sloughed off, it will always be prudent to apply the caustic a second 



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