GEN. I. SPEC. VIII. Rabies. animals. "Constat repetitâ," says Sauvages," apud Gallo-provinciales experientiâ, canes luposque rabidos Entasia bibisse, manducasse, flumen transasse, ut olim Marologii, Lyssa. et bis Forolivii observatum, adeoque nec cibum nec potum aversari." The same fact is affirmed of rabid wolves in a case given by Trecourt in his Chirurgical Memoirs and Observations. Dr. James in like manner relates the case of a mad-dog that both drank milk and swam through a piece of water*; and one or two similar cases are said to and said to have occurred among mankindt; though even here a spasmodic constriction of the muscles of the chest, and in mankind. sometimes of the throat, seems to have been present. Dr. Vaughan, indeed, gives the case of a patient who called for drink through the whole course of the disease, and only ceased to ask for it a short time before his death. be some times absent bia sometimes found rabies. I have occasionally met, on the contrary, with a few Hydrophoobstinate cases of hydrophobia, or water-dread, without any connexion with rabies: one especially in a young without lady of nineteen years of age, of a highly nervous tem- Exemplified. perament, which was preceded by a very severe toothache and catarrh. The muscles of the throat had no constriction, except on the approach of liquids, and the patient through the whole of the disease, which lasted a week, was able to swallow solids without difficulty; but the moment any kind of liquid was brought to her a strong spastic action took place, and all the muscles about the throat were violently convulsed if she attempted to swallow. Similar examples are to be found in Battini, Dumas, Alibert, and several of the medical records, and particularly one of great obstinacy in the Edinburgh Medical Essays, which was chiefly relieved by repeated venesections, as the preceding case was by large doses of opium. On Canine Madness, p. 10. + Fehr. Nachricht von einer tödslichen Krankheit nach dem tollen Hundsbisse. Gött. 1790, 8vo. Inflammation of the Stomach with Hydrophobia, &c. by Dr. J. Innes. Ed. Med. Ess. 1. p. 227. GEN. I. SPEC. VIII. Pathology difficult and evaded by most writers, and especially Cullen. An outline attempted by the present author. Close ana with tris mus and tetanus in Hydrophobia is therefore too general and indefinite a term to characterize the genus before us, unless we mean to include under it diseases to which it is by no means commonly applied, and which, in truth, have little connexion with rabies. Hunauld has, indeed, employed it in this extensive signification, and has hence made it embrace no less than seven distinct species, of which two only are irremediable*; and Swediaur has followed his example+. There is, even in the present day, so little satisfactorily. known, and so few opportunities of acquiring any practical knowledge concerning the general nature and pathology of rabies, that it might, perhaps, be most prudent to imitate the modesty which Dr. Cullen has set us upon this subject, and to let it pass without a single remark. Yet the following hints, derived from the only three cases in which the author has ever been consulted, compared with the larger range of observation and practice of a few other physicians, and especially the valuable work of professor Trolliet of Lyons, together with the reflexions to which they have given rise in his own mind, may afford a little glimmering light into the principle of the disease, and give an opportunity to succeeding pathologists of describing it more perspicuously. The symptoms enumerated in the definition, and eslogy of lyssa pecially the constrictive spasm that oppresses the muscles of deglutition and of the chest generally, sufficiently its mischief, show that the present species of disease bears a very close analogy to the two preceding, in the mischief which it excites; and, as by far the most frequent cause of the two preceding species is the irritation of a wound or puncture on the surface of the body, it bears quite as close an analogy to them in the nature of its cause as in that of its effects. and in the nature of its cause. Law by which the extremities of a continuous chain of functions We have seen it to be a law operating throughout the animal system, that if a morbid action commence in any * Discours sur la Rage, et ses Remedes. Chateaus Gontier, 1714, 12mo. † Nov. Nosol. Meth. Syst, vol. 1. p. 511. GEN. I. SPEC. VIII. Lyssa. Rabies. or fibres equally tremities, often laid down, and here again appealed to. This law appealed to in illustration at their ex part whatever of a continuous chain of functions, or of fibres, it often produces a peculiar impression upon its Entasia extremities; so that the extremities themselves form in many instances, the chief seat of distress and even of danger: and this more especially where the one extre- suffer mity of the chain becomes affected in consequence of the primary affection of the other. And we have also endeavoured to show, from the general course and intermediate connexions of the nerves which supply the surface of the body, and particularly the extremities, that they constitute a direct fibrous chain, of which those that are, in all common cases, primarily irritated by wounds or punctures in the spastic diseases before us, form the one extremity, and those which enter into the muscles of the upper regions of the chest and the cheeks the other*. It is not necessary, therefore, to travel over the same ground again; the reader may turn to it at his leisure: and he will find that we have hence endeavoured to trace out something of the means by which trismus and tetanus are produced by simple wounds or punctures in the limbs, and especially in an irritable habit. of trismus and tetanus, to lyssa, which, for applicable various reasons, capable of a more fatal Now if the reasoning be sound, as applied to trismus and equally and tetanus, it must be equally good as applied to lyssa; and will induce us to expect a more complicated disease and a still more severe and desperate result; as we have, in the present instance, not merely an ordinary and may be mechanical, but a specific and chemical source of irrita- supposed tion to encounter, and so indecomposible in its nature producing that it is capable of lurking in the system, and apparently disease. in the part where it may chance to be deposited, for weeks or even months without losing its activity of continuing dormant, if there be no sufficient irritability of constitution or nervous fibre for it to operate upon, and of operating as soon as such a condition may arrive: for that some exciting cause is usually necessary to rouse it into action, will sufficiently appear in the sequel of this inquiry. Sir Lucas Pepys, however, Dr. Bardsley, and * See the preceding Species ad init. GEN. I. SPEC. VIII. Entasia Lyssa. Whether the disease be ever sponta neous. Denied by Proofs of a spontaneous origin. This princiciple limited by Trolliet. Yet in most animals a wound in various other writers have made it a question whether the virus of rabies is ever originated, or produced spontaneously, or in any other way maintained than by a direct communication from one animal to another; while M. Girard, of Lyons, has denied that there is any such thing at all, and contended that rabies consists in nothing more than an acute degree of local irritation, and its effects on a highly mobile and excitable constitution. We have long, however, had various examples on record, and have recently been furnished with another by Mr. Gillman, in which a dog chained up in a yard, and cut off from all medium of contamination by other animals, has occasionally been attacked with genuine lyssa, and exhibited its most decisive characters. Professor Trolliet, whose extensive experience I shall soon have occasion to advert to more minutely, while he has no doubt of its occasional spontaneous origin, limits its appearance in this form to the dog, the wolf, the fox, and the cat, believing that all other animals only receive it from the one or the other of these by inoculation*. Nevertheless, whilst we are thus establishing that the symptoms of rabies are dependent upon a specific virus, it may not be foreign to remark that most animals, when ing rage, roused to a high degree of rage, inflict a wound of a much more irritable much more irritable kind than when in a state of tran flicted dur tranquillity: liar acrimo ny were se creted. than during quillity: and we have numerous examples in which such as though wound has been very difficult of cure, and not a few in some pecu- which it has proved fatal; as though at all times, under such a state of excitement, some peculiar acrimony was secreted with the saliva. In the Ephemera of Natural Exemplified Curiosities, is an example of symptoms of hydrophobia or water-dread, produced by the bite of a man worked up into fury+; and in the Leipsic Acta Eruditorum is another instance of the same kind‡, though neither of them seem to have been fatal. Meekren§, however, Wolff, in other animals. * Noveau Traité de la Rage, Observations Cliniques, Recherches d'Anatomie Pathologique, et Doctrine de cette Maladie. 8vo. Lyon. 1820. Ann. Ix. x. App. p. 249. Ann. 1702. p. 147. § Observ. Cap. LXVII. Observ. Med. Chir. Lib. II. N. 5. Rabies. and Zacutus Lusitanus* have each an instance of such a GEN. I. bite terminating in death, yet without hydrophobia. Le Entasia Cat gives a case of death produced by the bite of an en- Lyssa. raged duck+; and in a German miscellany of deserved repute we have another of the same kind‡. The in- In which it stances, indeed, are innumerable; but it may be sufficient proved fatal to observe further that Thiermayer gives us two cases, hydrophoone in which the bite of a hen, and another in which that of a goose proved fatal on or about the third day§, without hydrophobia: and that Camerarius has an instance of These stateepilepsy produced by the bite of a horse||. And whose Marvellous as these facts may appear, it is more consistent with reason to accredit them than to impugn the host of authorities to whose testimony they appeal. it hence seems to follow that the passion of rage, influence is always considerable on the trachea and salivary glands, has often a power of stimulating the one or other of them, among most animals, to the secretion of an acrimonious and malignant virus with which the saliva becomes tainted. but without bia. ments to be accredited rather than impugned. Hence rage has a peculiar influ ence on the salivary glands, and secretion of an acrimo excites the nious virus. But the virus of rabies is pe itself. The only known to originate it animals are of the canine and Rabies, however, has sufficiently shown itself to be dependent upon a peculiar virus, and capable of producing specific effects; to be sometimes originated, and sometimes received by communication. Now the only animals which have hitherto been ascertained to have a power of originating it are, as just observed, several species of the genus canis, as the dog, fox, and wolf, and one species of the genus felis, which is the domestic cat; it is probable, however, there are others belonging to different classes endowed with a like power; and some writers have attempted to bring instances from the horse, mule, ass, Ox, others. and hog, yet they are not instances to be depended upon. Man assertIn like manner, Plater, Doppert, and even Sauvages him- ed to have self, have asserted the same of mankind, and have brought forward a few casual cases in support of such assertion. Prax. Admir. Lib. 1. Obs. 84. 88. Samml. Med. Wahrnehm. B. 1. p. 98. In Goekelü Consil. et Obs. N. 19. VOL. IV. B B + Recueil Periodique, 11. p. 90. Diss. de Epileps. freq. p. 15. feline kinds, though probably the power be longs to a like power: but the cases alluded to are those of strongly excited passions in an irritable habit. |