RABIES 157 



In this Stage is noticed slight difficulty in swallow- 

 ing, inclination to vomit, dyspnea, and symptoms of 

 choking. Constipation is usually present. 



The maniacal stage lasts three or four days and 

 is characterized by attacks of mania and convul- 

 sions, with remissions. The patient evinces an over- 

 whelming desire to run away from home, tearing 

 down doors and kennels or breaking his chain in 

 order to effect his escape. 



At first the animal shows only a slight tendency 

 to bite, running along aimlessly, sometimes for 

 long distances, but later on it begins snapping at 

 imaginary objects, or at other animals or people 

 that are directly in its way, until finally, losing 

 all control and impelled by some uncontrollable 

 impulse, it savagely and aggressively attacks every- 

 thing in sight. In some cases the patient may bite 

 and tear its own body, being apparently insensible 

 to pain. A- prominent symptom in this stage is 

 the alteration in the voice, which manifests itself 

 as a peculiarly hoarse, howling bark, the first notes 

 of which are prolonged into a high-pitched, long- 

 drawn-out howl. 



In the paralytic stage the patient is' much emaci- 

 ated. The eyes are deeply sunken, staring, and 

 glassy, and there is usually external strabismus of 

 one eye. The patient now becomes gradually para- 

 lyzed, swallowing becomes impossible, and the 

 saliva runs out of the mouth in ropy masses. In 

 , time comes paralysis of the lower jaw, which hangs 

 down, allowing the tongue to protrude. This con- 

 dition is followed by paralysis of the hind quarters 

 which manifests itself in staggering, stumbling, and 

 by increased bodily weakness. The muscles of the 

 tail, rectum, and bladder become paralyzed, and 

 symptoms of great depression are alternated with 

 paroxysms of excitement that gradually become 



