prepara GEN. I. SPEC. VIII. Entasia Rabies. treatment. lished in Mr. Brande's Journal*, we are told that it still retains its popular sway and reputation over a great part of the Russian empire: and that in the government of Isola it has never failed of effecting a cure in a single instance for the last five and twenty years. The tion is simple: the root is reduced to a powder, and the Anomalous powder is to be eaten by being spread over bread and butter. Two or three doses are said to be sufficient in the worst cases and will be found to cure mad dogs themselves. remedies. The butcher's broom (genista tinctoria), and side-leaved Other scull-cap (scutellaria laterifolia), have however rivalled plants. the reputation of the plantago; and in our own day the first is powerfully recommended by M. Marochetti of Moscow, in the St. Petersburg Miscellanies of Medical Science, as employed with great success in the Ukraine; and the second by Dr. S. Spalding of New York, who tells us that it has been successful in America in upwards of a thousand cases, not only in men, but in dogs, swine, and oxen. The next remedy I have to notice is also of extensive use in the present day, and comes before us with no mean authority. Whilst the medical practitioners of the East are pursuing their plan of abstracting rabid blood Rabid blood. from the system, as the surest means of curing canine madness, the physicians of Finland have undertaken to accomplish the same effect by introducing rabid blood into the morbid frame. In the second number of the Hamburgh Medical Repository, Dr. W. Rithmeister of Powlowsk in Finland, has given an article in which he has collected a multiplicity of striking cases and various authorities in proof that the blood of a rabid animal, when drunk, is a specific against the canine hydrophobia, even where the symptoms are most strongly marked. The rabid wolf-dog, or other quadruped, is, for this purpose, killed, and its blood drawn off and collected as an antilyssic ptisan. Dr. Rithmeister's communication contains a • Journal of Sciences and the Arts, No. 1. p. 142. GEN. I. SPEC. VIII. Entasia Lyssa. Rabies. Medical treatment. Anomalous remedies. Chlorine. Conciliation of clashing opinions and practice. Remedies serviceable in some letter to himself from Dr. Stockmann of White Russia, confirming this account, and stating the practice to be equally common and successful in his own country. I will only add, that a discussion has lately taken place between two Italian physicians of distinguished reputation, Professor Brugnatelli of Pavia, and Professor Valetta of Milan, upon the virtues of chlorine as an antidote for the disease in question. The former has strongly recommended it*; and the latter has denied that it is of any uset in answer, however, to which denial, Professor Brugnatelli has adduced various authenticated facts, by which what he calls the specific powers of the chlorine have been established and verified. : I have thus endeavoured, upon a subject of so much interest and importance, to put the reader into possession of the general history of the practice that has hitherto prevailed; and he will at least allow that if the result be highly unsatisfactory-as most unsatisfactory it is-such conclusion does not result from idleness on the part of the medical profession. But how are we to reconcile the clashing and contradictory statements which the present analysis unfolds to us? This is a question of no easy solution. Yet there are many circumstances which ought to be borne in memory, and that will, in a certain degree, account for such opposite views and decisions, without rudely impeaching the veracity of any of the experimenters. In the first place, it is possible that the morbid poison itself, like that of plague or intermitting fever, may vary in its degree of virulence, in certain idiosyncrasies, certain countries, or certain seasons of the year: and hence that a medicine which has proved useless in general practice, though not may succeed in particular persons, particular places, or at particular periods: or, if inactive in itself, may be employed in so much milder a degree of the disease that the cases, in others. • Giornale di Fisica, &c. Pavia, Dec. 1816. + Biblioteca Italiana. Gennaj. 1817. Giornale di Fisica, &c. Pavia, Febbraj. 1817. constitution may be able, in most or many instances, to triumph over it by its own powers alone. may GEN. I. SPEC. VIII. Rabies. posed to be genuine lyssa not always so: hence some medicines celebrated for cures they never performed. Variable nature of the symptoms in lyssa has often led to deception. It is a just remark of Celsus that omnis ferè morsus Lyssa. habet quoddam virus*; and we have already given proof Medical that this is particularly the case when the animal that treatment. Cases supbites is labouring under the influence of violent rage or other sensorial excitement: the symptoms incident upon which produce a severe effect upon the nervous system, and often simulate those of genuine lyssa. And hence, there can be little doubt that these symptoms have often been mistaken for lyssa, and have given a celebrity to the medicines employed for their cure to which they were never entitled. In various cases, as we have already seen, the disease commences almost coetaneously with the external injury, or inoculation: in others, not till months or even years afterwards. In some instances the first symptoms of the disease show themselves in the bitten part, and even this in a very different manner, for there be a troublesome sense of numbness, or of irritation; and this irritation may be confined to the cicatrix, or travel up the limb, and produce acute pain or spastic action: while in other instances there is no local affection whatever through the entire progress of the malady. Ordinarily speaking, hydrophobia, or water-dread, is one of the most common, as well as one of the severest symptoms of the disease; yet there are instances, even where the rabies has terminated fatally, in which water-dread has not been once complained of. Most commonly again, on an early examination after death, the fauces and parts adjoining are found red and inflamed: but we have already observed that Morgagni dissected patients in which there whatever. And in two bodies was no such appearance examined after death by Dr. Vaughan, the fauces, esophagus, stomach, diaphragm, and intestines, were all in a natural state. There can be little or no doubt, morever, where many Where * De Medicina, Lib. v. x. many persons bitten at the same time, the GEN. I. SPEC. VIII. Entasia Lyssa. Rabies. Medical treatment. poison not equally applied to all: persons are bitten in quick succession by the same rabid animal, that the poison is not equally introduced into all of them. In some cases it may be expended entirely upon the earlier victims, and hence the rest, though bitten, may be free from the virus; while in others where the teeth have to pass through various foldings of clothes, it is possible that the virus which still remains may be wiped of in its passage, and the laceration be nothing been supmore than a clean wound from the first. And in all such posed to cases a sanguine experimenter, without allowing for these derive a prophylactic circumstances, will be apt to persuade himself, whatever power from medicine he makes use of, that the absence of the disease is owing to the efficacy of the plan or the medicine he has prescribed, and which he is hence tempted to hold up to the world as an antidote or specific. whence some have medicines which they do not pos sess. Illustration of several of the above remarks. Some of these remarks will best explain the very different results of the same mode of treatment, in the eleven patients entrusted in 1775 to the care of M. Blaise of Cluny, after having been dreadfully bitten and torn by a mad wolf. The principal remedy was mercurial inunction, though combined with antispasmodics. The mercury was carried on in all of them to salivation, and the treatment continued for above a month, in those that lived long enough for this purpose. One died with great horror and water-dread about the twelfth day from the injury, and after the mercury had begun to act. A second perished under hydrophobia, furious, and at length comatose, just at the close of a month, his mouth and gums being slightly affected by the mercury. A third died nearly six weeks after the commencement of the mercurial plan, having been taken away by his friends on the eighteenth day apparently in a state of doing well. The remaining eight, after having exhibited greater or less symptoms of spasmodic affection, but never amounting to hydrophobia, are said to have recovered, and were discharged accordingly*: but in a subsequent work M. Blaise informs us, that even one of these died in a paroxysm of • Methode éprouvée pour la Traitement de la Rage. hydrophobia six weeks after his discharge and supposed restoration to health*. GEN. I. SPEC. VIII. Entasia Different cases capa accounted In all these cases the success is ascribed to the action Lyssa. Rabies. of the mercury, and the want of success to some irre- Medical gularity or other committed by the patient while under treatment. medical care. The enormities, however, are in general results of rather far fetched, and not very convincing. Thus, in the above the last of the above cases, it is ingeniously observed ble of being that the man who had been so long discharged as well, differently four days only before the symptoms of hydrophobia ap- for. peared on him, had thrust his arm down the throat of an ox which was said to be mad; though no proof is offered that the ox was really mad, nor is it pretended that even this reputed mad ox inflicted any bite upon the arm whatever. Who does not see, that in all these cases the mercury may have been guiltless of exercising any controul? that those who died may have died in consequence of an effective lodgement of the virus in the wound inflicted, and that those who survived, may have survived because it obtained no admission to the bitten. part? sometimes, taneously. It is, moreover, highly probable that a spontaneous Rabies cure is occasionally effected by the strength of the con- perhaps, stitution, or the remedial power of nature alone. The cured sponfact appears to be, that the disease requires about six or seven days to run through its course, at the expiration of which period the system seems to be exonerated by the outlet of the salivary glands, of the poison with which it is infested. And hence, if by any means it be able to sustain and carry itself through this period, without being totally exhausted of nervous power in the course of so protracted and prostrating a conflict, it will obtain a triumph over the disease: and any prescribed medicine made use of on the occasion will seem to have effected the cure, and will run away with the credit of having done so, till subsequent instances dissolve the charm, and prove beyond contradiction the utter futility of its pretensions. • Hist. de la Societé de Medicine, Tom. 11. |