A CASE OF HYDROPHOBIA, 
3;34 
shorter ones ; and, in a case of hydrophobia, the muscles of the 
throat are, at the same time, violently contracted, so that the 
glottis violently closes, and the attempts of the diaphragm to 
descend, and of the muscles of the chest to elevate the ribs, are 
frustrated from moment to moment. The closure of the glottis, 
however, is not continuous, but alternates with relaxations of the 
muscles, so that a succession of sobs takes place. These con¬ 
vulsive actions of the muscles of the glottis, and indeed of the 
throat in general, are dreadfully violent. Thus the patient is not 
merely distressed with the horrid feeling which causes him, first 
suddenly to inspire, and then to sob, and with the agony of the 
successive interruptions to breathing, but with actual violent 
pain in the convulsed muscles. These acted so violently, that 
his head was drawn down towards the chest at the moment of 
sobbing, and the front of the neck became rigid and furrowed by 
the tension of the fibres beneath the skin; and I observed him, 
at these moments, press against the lower jaw with the inside of 
the thumb and fore-finger, for the purpose of preventing its forci¬ 
ble descent. The attempt at swallowing, and the sight of liquids, 
produce only these very same effects ; and since, from mere in¬ 
flammation of the pharynx and surrounding parts, the muscles 
of deglutition are sometimes thrown into violent spasms, and the 
suffering from this source is so great, that even the offer of any 
thing to be swallowed (and, of course, it is fluids only which are 
offered, on account of their being more easy to swallow), they 
produce the same effects even in a mere nervous state of the 
system. From a groundless apprehension of the disease the 
same circumstances may occur. It is certain, indeed, that many 
cases of these two descriptions have been mistaken for hydro¬ 
phobia ; but, in the mere inflammation of the organs of deglu¬ 
tition, the other—the great symptom—the extreme sensibility of 
the surface to the sudden impression of air, etc., is, of course, 
not present. Nor is it present in mere nervous irritability of 
those organs. When the spurious hydrophobia arises from mere 
apprehension of the disease, the fear of swallowing only is com¬ 
plained of, as it is this which is vulgarly known as the chief cha¬ 
racteristic of the disease; and there is no morbid irritability of the 
surface to the impression of air. Indeed, there is a mere in¬ 
ability to swallow, without that sudden catching of the breath 
which I have described. There is also in this disease a general 
morbid irritability, so that the patient is, from time to time, in a 
violent passion, bordering on frenzy; he is, perhaps, abusive, 
and even attempts to injure those about him; but in a moment 
again is calm, and apologises for his conduct, as this boy actually 
