GEN. I. SPEC. VIII. Lyssa. Rabies. of the chest and throat became more permanent. At spasms three o'clock fourteen ounces more were taken away when deliquium followed, succeeded by a considerable augmentation of the spasms in extent as well as in violence. At Remedial seven in the evening the respiration became frothy as well treatment. as difficult, the difficulty increased, and the patient ex- tention. pired in a few minutes, about twelve hours only after the commencement of the hydrophobia. Second in tion to counteract the poison by general or specific Third inten antidotes. The poison of rabies has, by a numerous body of pathologists, been contemplated as of a nature akin to the poison of other venomous animals, and particularly serpents, and consequently best to be opposed by the usual remedies and specifics to which these are found most effectually to yield. And hence, in the first place, the use of the radix Mungo of Kompfer (ophiorrhiza Mun- Radix Mungo. gos, Linn.) still supposed to be a specific for the bite of the cobra di capello and the rattle-snake. In India and Ceylon it is used to the present day as an antidote against the bite of the mad dog: Kaempfer highly extols it, and Gremmius, who practised with great reputation at Columbo, employed it very largely. Acids and alkalies belong to the same class of antilyssics. Acids. Of the former Agricola, who was hostile to the depleting system, preferred the muriatic acid, and regarded this as a specific even when restrained to a topical application. Poppius preferred the sulphuric; but by far the greater number of practitioners the acetous was held in most esteem. Many combined this last with butter, and used it both internally and externally: Wedel, with other materials; 66 as a cure", says he, "for the bite of a mad dog, let the patient drink vinegar, theriaca, and rue.”† The general suffrage, however, was far more consider- Alkalies. able in favour of the alkalies, and especially of ammonia or volatile alkali. There is some reason for this preference. It is well known that ammonia is a valuable medicine, whether applied externally or internally, in a variety of animal poisons. I have successfully used it more Useful in many animal poisons. GEN. I. SPEC. VIII. Entasia Lyssa. Rabies. Remedial treatment. Third intention. or less diluted in various instances, as a lotion against the sting of gnats, wasps, bees and vipers; and I have seen it of great service in checking the poison of the rattlesnake, and restraining the extent of the inflammation. On the continent, and especially in France, the usual form in which ammonia was formerly employed in cases of Eau de luce. lyssa, was that of the eau de luce, a caustic spirit of ammonia prepared with quick-lime combined with rectified oil of amber, rendered more easily miscible by being rubbed into half its weight of soap. This was in general employed both externally and internally *, though in the Journal de Medicine, we have several reports of a successful use of it when confined to an internal trial alone : especially one related by M. Hervet †, and another by M. Rubiere+. Mercury: first recommended by Desault, afterward freely employed by James, coexternally and internally, and regarded both as a prophylactic and antidote: in quadrupeds as well as in man. Mercury, from its proving a specific in syphilis, and more especially from its specific action on the salivary glands, the immediate outlet of the poison of rabies, has had a strong claim to general attention; and has been very extensively tried in various forms, and acquired a high degree of reputation. It was first recommended by Desault of Bordeaux in 1736, and afterwards very confidently by Dr. James in our own country, as a certain cure for man and other animals. He used it both as a prophylactic at the time of the bite, and an antidote at the commencement of the disease. He employed it as well externally as internally; but his favourite form was that of the turbeth mineral, in the shape of pills. He has published in the Philosophical Transactions, a full account of his success with this medicine on Mr. Floyer's hounds, after they had made a trial of every other favourite and fashionable remedy in vain. These dogs, as we have already observed, were affected with a severe hydrophobia, which has been denied by some writers to Sage, Erfahrungen, &c. p. 49. Guettard, Mémoires sur differentes Parties des Sciences et Arts. Paris. 1768. P. 122. † Journ. de Médicine. Tom. LXII. Id. Tom. LXIV. GEN. I. SPEC. VIII. Entasia Rabies. Remedial Third in be a symptom of the disease as appertaining to quadrupeds. All the hounds, we are told, that were salivated with the mercury, in whatever stage of the malady, re- Lyssa. covered, and the rest died *. His experiments on mankind are less complete: for they amount to not more treatment. than three, and in each of these the medicine was em- tention. ployed as a preventive, shortly after the infliction of the But to be bite; and hence, as the patients never became rabid, useful must we cannot be sure that they had received the contagion, salivation. produce or would have had the disease, had the mercury never His expebeen employed. The muriate of the metal was another riments on favourite form, which by Loisy, was used together with incomplete. inunction. mankind Denied by many to be either a specifio, or The grand object was to excite a speedy salivation, and maintain it so long as there was supposed to be any danger; and especially where the administration had been delayed till the paroxysm had shown itself. Frank, Girtanner, De Moneta, Raymond and a host of writers upon the subject, deny, not only that mercury is a specific, but that it has ever produced a cure, in whatever way it may have been employed. Kaltschmid, on the contrary, with an unjustifiable confidence, calls it remedium indubiumt; and De Choiseul a methode sure et facile ‡. In the fortieth volume of the Journal de Médicine there is a relation in which mercurial inunction seems to have been suc- certain cure. cessful in a genuine case, and I have heard of one or two other instances that have occurred in our own country. of any use; but regardschmid and ed by Kalt De Choionly and seul as an As diuretics were supposed to possess a strong alexia- Diuretics. pharmic power, or that of expurgating the system from animal poisons in general, these have also had their votaries, and been in high reputation, as a remedy for lyssa. Cantharides were at one time the favourite medicine under Cantharides this head, or some other stimulant insect of the coleop- coleoptera. and other Phil. Trans. Vol. xxxix. Year 1735-6. † Dissertatio de Salivatione Mercuriali, ceu indubio præservationis et curationis remedio adversus rabiem caninam. Jan. 1760. Nouvelle Méthode, sure et facile, pour le Traitement des Personnes attaquées de la Rage. Paris, 1756. GEN. I. SPEC. VIII. Lyssa. Remedial treatment. Third intention. terous order, as the meloe, lytta, or one or two species of scarabæus; which, like and ammonia, were somemercury times taken internally alone, and sometimes applied topically also, to keep up a perpetual irritation. Bohadsch tells us gravely that the disease will always yield to ten cantharides powdered and introduced into the stomach *: Monconys, that the powder should be continued from the bite to the time in which we may reasonably expect the symptom of hydrophobia; and adds that this medicine, which was regarded as an arcanum in his day, was a remedy of publicity over all Greece +. He might have extended his theatre; for Egypt was as well acquainted with the general principle of this practice as Greece or Hungary; and it is a positive exhortation of Avicenna, that whatever diuretic may be employed should be carried to its utmost acrimony, even to the discharge of bloody Cantharides urine ‡. M. Axter of Vienna has of late revived the use re-employed of cantharides, and tell us that he has for thirty years by Axter. Ash-colour- employed this medicine with far more success than any other, after having previously made experiments with and been disappointed in the use of all other remedies, as musk, camphor, belladonna, opium, or oil, used internally and externally, and water-bathing. But it does not seem that he can speak further than to its supposed prophylactic powers, as he does not appear to have tried it in the acute stage of the disease §. The ash-coloured liver-wort (lichen terrestris cinereus Raii), was another diuretic of great popularity, and which seems at length to have triumphed over the stimulant insects, and to have superseded their use; on which account Linnéus changed its trivial name from cinereus to caninus. In our own country, this medicine was at one time peculiarly in vogue. It was given in powder, with an equal quantity of black pepper, a drachm and a half of the two forming the dose for an adult, which *Posit. Zoolog. in Klinkosch. Diss. Select. Lib. iv. Fen. vi. Tr. iv. GEN. I. SPEC. VIII. Entasia Rabies. Third in was taken for four mornings fasting, in half a pint of warm cow's milk; the patient, however, was first to lose nine or ten ounces of blood, and afterwards to be dipt in Lyssa. cold water for a month together, early in the morning. Medical And such was the general confidence in this plan, or treatment. rather in the antilyssic power of which the lichen was tention. supposed to be the most active principle, that its virtues formed one of the most common subjects of eulogy in the Philosophical Transactions at the time when Mr. Dampier introduced it to public notice at an early period of the history of the Royal Society*; while, at the earnest solicitation of Dr. Mead, the powder was admitted in the year 1721 into the London Pharmacopoeia, under the title of Pulvis antilyssus; who declares, that, "When Pulvis antilyssus. united with the previous venesection, and subsequent cold-bathing, he had never known it fail of a curet, though he had used it a thousand times in the course of thirty years' practice." cola: more lately by Satterley, How far emetics may be serviceable general trial has Emetics. not, perhaps, been sufficient to determine. They have often been found capable of relieving spasms of the throat, and enabling the patient to swallow liquids when every other plan has failed. They were hence recom- formerly employed mended by Agricola, but only, perhaps on account of by Agritheir violence upon a weakened frame, as a sort of forlorn hope, for he does not advise them till after the third day. Dr. Satterley, however, has given a case in the Medical Transactions, which he regards as rabies, in which vomiting was employed from an early period of the disease, but in a and with very decided advantage. But there seems to be a doubt whether the patient here referred to laboured under genuine lyssa. He had been bitten three months before by a dog, but the fate of the dog was not known: the cicatrix betrayed no uneasiness or irritation precursive to the disease, or during its course: the hydrophobia was remittent, or intermittent, so that the patient drank liquids Mechanical Account of Poisons, Art. 3. + Chirurg. parv. Nurüb. &c. 8vo. 1643. Vol. IV. p. 348. with success, doubtful case. |