The Medical Tribune.

VOL. VI.

ROBERT A. GUNN, M.D., EDITOR.

AUGUST 15, 1890.

No. 6.

HYDROPHOBIA AND THE PASTEUR HUMBUG.

RABIES has come to be considered a malady peculiar to the summer season. Of late years the scare concerning it has commenced with the balmy days of spring, and has continued to increase till the height of the excitement is reached in the sultry days of midsummer.

This year has been no exception to the rule. A great many persons have been bitten by dogs, and patients from all parts of the Union have flocked to the recently established Pasteur Institute in this city to receive the Pasteur inoculations at the hands of Dr. Gibier, who came here from Paris to foist the Pasteur humbug upon us.

The sensational reports of the daily press concerning the ferocious attacks of rabid dogs upon men, woman and children, and the false or ignorant statements of Dr. Gibier and others regarding the great prevalence of rabies during the hot weather, have been instrumental in causing a panic of fear, regarding hydrophobia, which is as senseless as the Pasteur theory of preventing the disease is unscientific.

As hydrophobia in man, when met with, can generally be traced to inoculation from a rabid dog, it becomes necessary in our examination of this subject, to carefully study the symptoms and progress of rabies in the dog, that we may be better prepared to deal with the disease in the human race.

Among the ancient Egyptians, Greeks and Romans, and down through the centuries almost to the present day, the "dog days" were supposed to have a mysterious influence upon the canine race. During the reign of Sirius, the dog-star, dogs were supposed to be affected with madness, the same as persons were supposed to be

come insane during certain phases of the moon; but within the present century, careful inquiry has established the fact that no season of the year has any special influence in the production of rabies. Of 2520 authentic cases observed in France, Italy, Austria, England and the United States, there occurred, in the spring, 704; in summer, 621; in autumn, 608; and in winter, 587.

Of this number, only 101 were observed in this country, and these were collected by Dr. Blatchford and reported to the American Medical Association in 1856. Since that time the number of authentic cases is much smaller than is generally supposed, and the great hue and cry made about mad dogs, every summer, is more the result of ignorance and fright than reality.

From all the experiments that have been attempted to ascertain the origin of the disease, no case of its spontaneous development has yet been observed, and the theory of its reproduction solely by inoculation, from animal to animal, is now generally accepted. Such, certainly, is the way it appears to be transmitted in a vast majority of instances at the present day, no matter what may be the source from which it originally sprung. This being true, it is reasonable to suppose that a knowledge of the disease in the dog would soon enable us to make hydrophobia in man impossible.

RABIES IN THE DOG.

People do not, as a rule, know a mad dog when they see one, and often mistake other diseases in the dog for rabies, and thus they expose themselves to be bitten by a rabid dog, while they avoid and kill a perfectly harmless one. Some writers divide rabies in the dog into two varieties, dumb and furious, while others describe a third variety under the name of tranquil rabies. Virchow denies the existence of these varieties, and considers the different forms as merely prolonged conditions or stages, which he divides as follows: First, the stage of melancholy; second the irritable and furious, and third, the paralytic stage.

The early symptoms of rabies are somewhat obscure, but in the greater number of cases sullenness, fidgetiness and continued shifting of posture are the most prominent. For several consecutive hours the dog may be seen to retreat to his basket, bed or some dark corner. He shows no disposition to bite; he is curled up and his face is buried between his paws and his breast, and he answers the call upon him laggardly. At length he becomes very

fidgety, he is constantly searching out new resting places and changing his posture, he begins to look strangely about him, and goes from one to another of the family, fixing on them a steadfast gaze, as if he would read their very thoughts. He shows an increased attachment for his master, and will almost unceasingly lick the hands, face or any part he can get at. Costiveness is often present, and some dogs vomit once or twice in the early period of the disease. The natural appetite generally fails and becomes strangely depraved, and he usually occupies himself in gathering and swallowing bits of thread, hair, wood, straw, glass and dung.

Delirium soon shows itself. After a momentary quiet a rabid dog will start up, and with ferocity on its countenance, plunge with a savage howl to the end of his chain, in pursuit of some imaginary object. Then comes a moment's pause-a moment of actual vacuity-the eye slowly closes, the head droops, and he seems as if his fore feet were giving away, but he springs up again, every object of terror once more surrounds him; he gazes wildly around, he snaps, he barks, and again rushes to the extent of his chain, prepared to meet his imaginary foe.

Much has been said of the profuse discharge of saliva from the mouth of the rabid dog. It is an undoubted fact that in this disease, all the glands connected with the secretion of saliva, become increased in bulk and vascularity. The sublingual glands wear an evident character of inflammation; but it never equals the increased discharge that accompanies epilepsy or nausea. It is a symptom of short duration, seldom lasting longer than 12 hours. The stories that are told of the mad dog covered with froth are altogether fabulous. The dog recovering from, or attacked by, a fit may be seen in this state; but not the rabid dog. Fits are often mistaken for rabies, and hence the delusion. The increased secretion of saliva soon passes away. It lessens in quantity and becomes thick, viscid, adhesive and glutinous.

To this naturally and rapidly succeeds an insatiable thirst; and so long as the animal has power over the muscles of the jaw, he continues to lap. When the jaw and tongue are paralyzed he plunges his head and even his body into the water and makes constant efforts to lap it. Hence, instead of the disease in the dog being always characterized by the dread of water, it is marked by an unquenchable thirst and an inclination to be in or near the water.

When the dog utters any sound during the disease, there is a manifest change of voice. The muzzle is elevated, and the commencement of the noise is a perfect bark, ending abruptly and singularly in a howl of a higher key than at the commencement. Every sound uttered is more or less changed and these should be carefully observed.

About the third day the delirium increases and he bites at all real or imaginary objects within reach. He manifests a desire to leave home, and will only return after many hours. If confined he gives vent to a peculiar bark and howl, but if at large, he makes no noise. He trots on in a straightforward course, turning to avoid obstacles. If struck or interfered with he will attack his adversary savagely, but will seldom go out of his way to attack any object, and will even endeavor to escape if pursued.

This course cannot be long pursued. He soon becomes exhausted, moves with an unsteady, trotting gait. His head is bent to the ground, his mouth is open, his tongue protruded and of a lead-blue color, and his tail drawn between his legs. Finally paralysis ensues, first of the hind quarter, and finally of the whole body, which is soon followed by death.

The ordinary duration of the disease is from four to six days, but it may sometimes extend to ten days.

Nothing is definitely determined in regard to the length of time that elapses between the receipt of the injury and the appearance of rabies in the dog and other animals. It, however, rarely exceeds three months.

What is the cause of this disease in the dogs? So far as investigation has been able to reach, it is conceded that the saliva of a rabid animal must be received into a wound, or on an abraded surface. The virus is deposited on or near the surface, and there it remains for a certain indefinite period of time. The wound heals kindly, as a rule, and weeks, and sometimes months pass by, without any indication of danger. Then it breaks forth when least expected.

Mr. Youatt says he has never seen a case of rabies in the dog, which occurred in less than fourteen days after the bite, and the average time he calculates at five or six weeks, while after the third month he considers the animal tolerably safe.

All animals bitten by a rabid dog do not take the disease, as has been proven by some animals becoming affected with it and others escaping, after having been bitten by the same rabid dog. Dr. John

Hunter mentions an instance in which twenty persons were bitten by a rabid dog, and only one suffered from the disease.

Dogs are liable to many of the diseases common to man, and many times, when sick from various causes, they are believed to be mad, and at once destroyed. Of the so-called mad dogs killed every year, probably not more than one in a thousand had genuine rabies.

HYDROPHOBIA IN MAN.

Little attention would have been given to rabies in the dog, but for the fact that man often fell a victim to the inoculation. Since the existence of the disease in man has been recognized and traced to the bite of a dog, the higher animal has been the greater sufferer from it; for, with all our boasted superiority over the brute creation, in this disease the mind places us at greater disadvantage than simple instinct leaves the dog. Many dogs may be bitten by a rabid one and few take the disease; while many persons who are bitten by non-rabid dogs, sicken and die from the fear of becoming hydrophobic.

Of all the diseases to which the human race is subject, none is associated with so much dread as hydrophobia, none is so little understood by the profession? none has had so many different theories invented concerning it, and none has been treated by so many different and entirely opposite methods. Why is this? Because the superstitions of the past concerning the evil influence of the dog star upon the canine race, and upon those who were bitten during its reign, has come down to us with a strong hold on the popular mind, and the element of fear with which those superstitions are blended, produced such powerful and different impressions upon the imagination, that it has been impossible to separate the real from the imaginary symptoms of the disease.

This fact has been so manifest to all observers that many have denied the existence of any disease resulting from the bite of an animal, but attributed all the symptoms to the influence of fear on the imagination.

Whatever theory of hydrophobia may be correct, whatever subtile influence may have worked to develop the symptoms of the disease, certain it is that persons who have been bitten by dogs sicken and die; and, therefore, it becomes our duty to do all in our power to understand the disease and to arrive at more rational