NERVOUS AFFECTION RESEMBLING RABIES. 477 
heat, were compelled to drink in his presence. lie drank bitter 
ptisans, and other coloured liquids, with more or less avidity. 
These were his principal symptoms when he came under the ma¬ 
nagement of Larrey ; not on their account, but for a sprain of the 
right foot, which he had received during violent exertion. To this 
affection were soon superadded symptoms of nostalgia, and Cour- 
montague expressed a strong desire to be dismissed the service. 
Obstinately bent upon this purpose, far from allowing his cure to 
proceed, he secretly employed means to swell the leg, and to ag¬ 
gravate the disease; so that in a short time gangrene appeared in 
the inside of the foot, and spread so hastily that the whole limb 
became sphacelated, and was amputated. After some attacks of 
traumatic irritation, caused by deviations from the prescribed re¬ 
gimen, two-thirds of the wound had cicatrized, when, on the thir¬ 
tieth day after the operation, the patient suddenly refused all kinds 
of transparent liquids, and became attacked with signs of cerebral 
inflammation. He was convulsed, he locked his jaws, he ground 
his teeth, and fell into a complete state of tetanic contraction. 
All the excretions were suppressed, the spasm and rigidity in¬ 
creased, and during the night of the thirty-third he expired. On 
inspection, were found hypertrophy of the cranium, principally in 
the occipital region; considerable engorgement of the vessels, 
both of the membranes and brain, of the superior longitudinal 
sinus and plexus choroides ; slight granulations on the surface of 
the hemisphere ; about an ounce of yellow serum in the lateral 
ventricles; firmness and density of the whole brain, of the spinal 
cord, and especially of the tuber annulare, in the substance of 
which a red tinge was evidently manifest, and the neurilema of 
the spinal nerves were stained of the same colour. The mucous 
membranes were all healthy; except a few old adhesions, nothing 
morbid could be detected in the lungs; and all the viscera of the 
abdomen presented a natural appearance. The pericardium was 
firmly attached to the heart in its whole extent, but evidently by 
adhesions of a former date; its cavities were very contracted, and 
the great vessels which issued from it were not more than two- 
thirds of their ordinary size. 
It is tolerably evident, from the history of this case, both be¬ 
fore and after death, that the first and last symptoms by which it 
was distinguished were referrible to the wound occasioned by the 
bite of the mad dog ; and that the poison which had been thus 
inserted in the system remained comparatively latent for the pe¬ 
riod of six years, giving rise to some anomalous nervous symp¬ 
toms only, which scarcely if ever amounted to disease, until, meet¬ 
ing with an exciting cause, which awoke this dormant principle 
ipto full activity, the patient was no longer respited from its fatal 
VOL. IV. 3 T 
