80 
A CASE OF IDIOPATHIC HYDROPHOBIA. 
From so many hydrophobic symptoms being present, I was ap- 
prehensive that he might have been bitten by a dog, and there- 
fore questioned him on the subject very closely; but to all my 
interrogations he shook his head negatively. During the inter- 
vals of ease his pulse was full and soft, and averaged eighty 
beats in a minute ; his tongue was clean, the bowels were regular, 
and the skin of the natural temperature. 
Aware that there was a predisposition t(^ spinal disease, I ex- 
amined the back, and found about the lower part of the cervical 
region tenderness on pressure, and I observed that this pressure 
invariably produced an exacerbation of all the symptoms. Of 
this I fully satisfied myself and my patient likewise, by repeat- 
ing the pressure three or four times. 
A blister was applied over this spot. It rose well ; and he soon 
became able to swallow. Doses of opium were given by the 
mouth, and an opiate injection was administered per rectum. I 
should have stated that, from the commencement of the attack 
up to the present period, he had experienced a great difficulty in 
passing his urine, but none in voiding his faeces. 
xyth. — Much improved in every respect, but when his head 
was raised the spasm was speedily reproduced. He had a con- 
stant smacking of his lips, and frequent twitches in his legs and 
feet : the right arjn was partially paralysed ; no headache ; no 
confusion of intellect. 
7th . — Still improving. The spasms had entirely disappeared ; 
he could swallow fluids with the greatest ease. Tongue clean ; 
bowels well opened ; secretions healthy : he can now be raised 
without suffering ; the blister discharges freely. The dorsal re- 
gion was rubbed with an embrocation, containing croton oil, tar- 
tar emetic, 8cc., and quinine w 7 as given during the day, with 
henbane at night. From this period he gradually progressed, 
and at the end of a month was thought sufficiently improved to 
resume his avocation. 
One day, however, previous to his intended departure, he had 
a recurrence of the dyspnoea, but in a much less degree than be- 
fore. This was immediately treated by the application of leeches 
to the cervical region, followed by a blister ; when all the symp- 
toms soon vanished. He has two issues, one on each side of 
the cervical vertebras, which discharge freely ; and he may now 
be considered convalescent. 
Lancet. 
