PATHOLOGY. 313 
the face is faid to be moll generally followed by the 
difeafe ; which might leem to imply, that parts much 
fupplied with veins molt rapidly propagated Lyfla. A 
bite on the hands, however, is equally formidable ; fo that 
we naturally conclude, that the expofed parts of the 
body fuffer more readily from the bite than the covered 
parts; becaufe, in the latter, the clothes rub off part of 
the virus from the teeth before they penetrate the lkin. 
Some have fuppofed, that, if a gulh of blood follows im¬ 
mediately on the bite, the chances of exemption are in 
favour of the patient; but, in Brera’s Memoria per la 
Cura dell’ Idrofobia, four cafes are related in which this 
occurrence happened, and neverthelefs the patients 
died. 
It is a fortunate circumftance, that men are lefs dif- 
pofed to lyfla than dogs: and of the latter fcarcely one 
efcaping, while, of the former, it is computed that only 
one in fixteen, who have been bitten, contracts the 
difeafe. 
The wound inflicted by the bite of a rabid animal has 
nothing peculiar in its appearance, and heals as readily 
as the bite of an animal that is not rabid. From the time 
of the bite until the period when the fytnptoms appear, 
there is no derangement of health, nor any perceptible 
change in the conftitution, provided the perl'on bitten be 
not under the influence of fear. The interval between 
the inflexion and the commencement of the difeafe varies 
confiderably in different inftances: the mod common 
period appears to be about forty days or fix weeks. Dr. 
Hamilton draws the following conclufions, as to the in¬ 
terval between the bite and the occurrence of the difeafe, 
from a table of 131 cafes. Only three took the difeafe 
before the 18th day, none before the nth—from the 18th 
to the 30th, feventeen were feized : fixty-three began to 
be ill from 30 to 59 days after the bite; twenty-three 
were attacked from two to three months inclufive ; nine 
from three to four months ; two at five months; one at 
five months and eleven days; one at fix months 5 one at 
feven months; two at eight months; one between eight 
and nine months; two at nine months ; one at eleven 
months; one at fourteen months ; two at eighteen 
months; and one at nineteen months. TheJaft-tnen- 
tioned interval is, he thinks, the longeft to which any 
credit can be given. On the other hand, a cafe is re¬ 
lated by Dr. Bardfley of Manchefter, which proved fatal, 
as is ufual; and every inquiry refpeCting w'hich corrobo¬ 
rated the patient’s repeated affertion, “ that he had never 
fuffered the leaft injury from any animal, except the bite, 
inflicted twelve years Jince, by an apparently-mad dog.” 
(Memoirs of the Lit. and Phil. Soc. of Manchefter, vol. 
iv. p. 431.) In this inftance, the nature of the difeafe was 
perfectly clear, and the evidence as to the bite not lefs 
fatisfaClory. 
At an uncertain time, then, after the infliction of the 
bite, the patient feels a degree of pain, or uneafy fenfa- 
tion, in the bitten part, tohich is fometimes compared to 
a fcorchingbyheat,isfometimesattended with itching,and 
fometimes fuppofed to be rheumatic. This pain, when the 
bite, as is molt frequent, is in the hand, fpreads up the 
outfide of the arm to the fhoulder (not affecting the 
axilla) and the neck. In foine cafes the cicatrix left by 
the bite is faid to become inflamed, and even to difcharge. 
Thefe pains are foon fucceeded by a general depreflion of 
fpirits, and efpecially a fenfe of undefcribable liltleffnefs 
and anxiety. Sometimes a general rigour or chill occurs, 
a$ in the commencement of a fever. The night is palled 
in the fame reftlefs ftate, without lleep. The appetite 
begins to fail, and feme thirft is prefent. And now the 
peculiar fymptom which gives the difeafe its name, the 
dread of liquids, is difeovered, often accidentally, on 
attempting to take drink ; as the liquid approaches the 
lips, a fudden convulfive fob, or catch in the breath, with 
a momentary fenfation of choking, takes place, which is 
renewed at every attempt. As the difeafe advances, this 
attempt is not thought of without horror, and the very 
idea excites thefe fpafmodic fits of choking in the throat, 
and catching of the breath. 
This dread of liquids is, as we have before dated, not 
always prefent, nor is its prefence a certain fign of the 
difeafe ; and in dogs and other animals is fo far from be¬ 
ing general, that they often fwim through rivers, and 
drink copioufly. The caufe of this fymptom, in man, 
has engaged the attention of many pathologilts. It can 
only be referred to two caufes : firft, an actual experience 
of difficulty of fwallowing, which renders the patient » 
fearful to attempt an aCtion which gives him lb much 
pain ; or, on the other hand, a dread of the water itfelf 
from fome fearful aftbeiation connected with it, an affo- 
ciation, as it would feem, quite unconnected with the 
will. For our own parts, we cannot conceive the hydro¬ 
phobia to arife from experience of the difficulty of fwal¬ 
lowing, becaufe in the moll violent cafes no difficulty of 
fwallowing food attends ; becaufe alfo the fymptom often 
comes on fuddenly, on the fight of water, before any 
difficulty has been experienced ; confequently before the 
patient can have had any experience on the matter. 
Moreover, a ftream of air, a flafti of light, nay the reflec¬ 
tion of light from a looking-glafs, has fometimes filled 
the patient with an equally fevere emotion of horror as 
water has ; and often again, when the fight of water was 
painful, wine has been freely drank. It is not, Jiowever, 
an eafy talk to explain how the hallucination of mind in 
lyfla fliould be particularly directed to water. It may 
be that the nervous fyftem, excited to the higheft degree, 
acknowledges, with a quicknefs and intenfity amounting 
to pain, tho fe undulating motions which are lo peculiarly 
manifefted in almoft all the natural phenomena which 
imprefs our nerves. Hence the undulating motion of a 
candle excites uneafinefs ; the fight of water excites the 
recollection (unacknowledged by the will) of the roar¬ 
ing of the fea,the dizzy whirl of the current, or perhaps 
of the danger to which we are often expofed on this ele¬ 
ment. That on fome occafions wine has been Iwallovved 
when water could not, may arife from the different recol¬ 
lections to which wine gives rife. That it is the fight 
of water, and not the difficulty of fwallowing it, that 
produces hydrophobia, is corroborated by this; that a 
child requefted his father to put fome tea in a tea-pot, fo 
that he might be able to drink it out of the fpout, with- 
out the pain of looking at it. 
But the dread of lwallowing liquids, although the moll 
Angular fymptom of the difeafe, conftitutes but a fmall 
part of this diftrefling malady. The ftate of diforder 
into which the nervous fyftem is thrown, is evinced by 
the extreme irritability of the whole frame, mind and 
body, and the exceffive fufeeptibility to all impreffions. 
Hence the conftant watching and inquietude; and the 
fudden fits of anger and impatience, arifing from the 
moll trifling caufes, as the patient himfelf readily allows, 
and even wonders at, and apologizes for, in the fucceed- 
ing moments of compofure. Hence alfo the diftrefs,and 
even the recurrence of his fpafms, occafioned often by the 
flighteft motion of the air, as from opening the door, 
from the approach of any perfon, or even of a perfon s 
hand, in front of him ; or even by the buzzing of a fly. 
This morbid excitability of the nervous fyftem is far¬ 
ther manifefted in the extreme timidity and fufpicion of 
the patient, in the imaginary objects of terror and unea¬ 
finefs which the fenfes frequently reprefent to him, and 
in the occafional delirium and incoherence of ideas, from 
which, however, he eafily collects himfelf. 
There are fome other circumftances belonging to the 
difeafe, of lefs note, which remain to be mentioned. One 
of thefe isa conftant collection of a thick ropy tenacious 
faliva in the fauces, which is often productive of extreme 
diftrefs; for, as the miferable fufferer is unable to make 
the fmalleft attempt to fwallow it, without exciting the 
convulfive choking, he fpits it out inceflantly, and with 
great vehemence and difficulty, often cautioning the by- 
ftanders to keep out of the way. The pulle in the be¬ 
ginning 
