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Rabies.
Treatment.

many cases

flammatory

specific influence on this organ, and is capable of aug- Gen. I.

Spec. VIII. menting its secretion to almost any extent, it seems of the

Entasia utmost importance that, while we endeavour to support Lyssa. the system, and to allay the nervous irritation, we should endeavour at the same time to quicken the elimination of the morbid matter, by exciting the salivary emunctories, and thus probably also carrying it off in a diluter and less irritant form. It is difficult to withhold one's assent to Its apparent

advantage in all the numerous instances of cure which are so confi- mari dently asserted to have followed upon the use of mercury resolvable

? into this carried to the point of free salivation. And hence, without principle. allowing this medicine to be a specific more than any other, we may indulge a reasonable hope of its forming a good auxiliary, and should employ it freely, either externally, internally, or in both modes simultaneously; but with as little disturbance to the patient as possible, till a copious ptyalism is the result.

Fever, or inflammatory action, does not necessarily be- Fever, or inlong to lyssa in any stage: and the present mode of treat

- action, has ment is altogether grounded upon this principle. Either, sometimes however, may become incidently connected with it from as the peculiar state of the habit or some other cause. Hence, and hence as a preventive, the bowels should be kept moderately

to be guardopen ; and wherever there is any just apprehension of by gentle

aperients : plethora, or a turgid state of the vessels, and particularly of the brain, blood should be drawn freely from the arm, times by a

free use of and, if necessary, be repeated. We have already seen

the lancet: that such a state of congestion is sometimes produced especially

when the paeven at the onset of the disease, and is so forcibly felt by

tient intreats the patient himself, that he earnestly intreats the medical to be blooded

from a sense attendant to bleed him. Such intreaty should, perhaps, of never be urged in vain : but the bleedings to deliquium, tion. which have of late years been so strongly recommended, are a rash and dangerous practice, unfounded on analogy, and by no means rest on any sufficient assurance. Such, in the doubt and darkness that at present beset Importance

of intermeus, concerning the real physiology of lyssa, seems to be diate process the safest and most promising path we can pursue, when upon the in

Aiction of called upon for aid in so afflictive a malady. Our best the wound.

associated :

t

and some

es

Treatment.

antidote to

Gen. I. time for action, however, and almost the only time we can Spec. VIII. im

1. improve, is immediately on the infliction of the wound : Entasia Lyssa. a tight ligature above which, with the double precaution Rabies.

of excision and cauterization, may in general be regarded

as an effectual preventive. I do not know, indeed, that Poison of the profession is acquainted with any other. It has, howviper proposed as an ever, been proposed in France, to fight off the poison of

lyssa by pre-occupying the ground with the poison of a that of mad- ?" dog.

viper, upon the principle of combating variolous with vaccine matter : and for this purpose it has been suggested that the part bitten by a mad dog should be again bitten a little below the wound, as soon as may be, by a venomous serpent, whose virus, from its greater 'activity, will, in most cases, be certain of taking the lead, and may, it is presumed, guard the constitution against any subsequent effects from the wound of the mad dog. I have not, however, heard that this proposal has ever been carried into effect, and the claim of ingenuity is, most probably,

the whole it will ever have to receive. Contagion I ought not, however, to conclude without noticing of canine catarrh one very extraordinary fact in the economy of morbid said to

poisons, and especially of that before us, which I have emancipate dogs from had confirmed by the testimony of several veterinary a power of practitioners entitled to credit. It is, that no dog who generating

has ever had the distemper, as it is called, which is the but not of canine catarrh or influenza, has been known to become receiving it by contact.

rabid spontaneously, though he is capable of receiving the Use to be disease by the bite of another dog. If this be true, for made of this which however I cannot fully vouch, we have certainly fact if true.

another instance of morbid poisons mortally conflicting with each other; and it might be worth trying how far inoculation with the matter of canine catarrh might succeed in protecting a human subject after the infliction of a

rabid bite ; though in the dog, perhaps from a stronger Collateral predisposition to rabies, it seems to be impotent. In facts in supe

South America, rabies, as already observed, is altogether port of it.

unknown, and I have hence been anxious to learn whether the distemper be unknown there also: and, in answer to this inquiry, it has been told me, by several intelligent resi

rabies :

NERVOUS FUNCTION.

D. III.

CL. IV.

NERVOUS FUNCTION. . [ORD. III. 417 dents in that quarter, that this last disorder is so common , GEN. I.

Spec. VIII. and so fatal, that two-thirds of the dogs littered there Entasia perish of it while pups : a remark which still further con- Lyssa.

Rabies. firms the home-report concerning its influence on rabies, Treatment. and sufficiently explains the non-existence of the latter on the shores of the Plata.

SPECIES IX.

ENTASIA ACROTISMUS.

Pulselessness.

FAILURE, OR CESSATION OF THE PULSE, OFTEN ACCOM

PANIED WITH PAIN IN THE EPIGASTRIUM; THE PER-
CEPTION AND THE VOLUNTARY MUSCLES REMAINING
UNDISTURBED.

ACROTISMUS is literally “ defect of pulse", from apótos, Gen. I.

Spec. IX. “pulsus", with a privitive a prefixed : whence the technichal term crotophus or crotophium, importing “painful the specific pulsation or throbbing in the temple”. Asphyxia is the term. term employed for this disease by Ploucquet, and would

sometimes have been used in the present arrangement but that it used syhas been long appropriated to import suspended animation or apparent death; a total cessation, not of the pulse only, but of sense and voluntary motion.

This failure or cessation of pulsation sometimes ex- Failure of tends over the whole system, and is sometimes confined PR to particular parts. In every case it imports an irregu- general,

sometimes larity in the action of the heart, or of the vessels that issue from it, and in most cases, an irregularity proceed- Importing ing from local or general weakness, and dependent upon debility of

the heart and a spasmodic disposition hereby produced in the muscular arteries ; tunic of the vessels. Of this last cause we have a clear VOL. IV.

E E

sation

sometimes

limited.

Entasia

Pulselessness.

Gen. I. proof in the universal chill and paleness that spread over Spec. IX.

4. the entire surface in the act of fainting or of death, to Acrotismus. which fainting bears so striking a resemblance. Except,

however, in the agony of dying, the spasmodic constricand mostly tion for the most part soon subsides, and the arteries reconnected cover their proper freedom and diameter. Yet this is with a spasmodic dis by no means the case always, for in violent hemorrhages, position.

and especially hemorrhages of the womb, the rigidity has sometimes continued for several days, during the whole of

which time the heart has seemed merely to palpitate, and Exemplified. there has been no pulse whatever. Morgagni relates,

from Ramazini, a case of this kind which extended to four days. The patient was a young man of great strength and activity even during this suppression. The arteries were as pulseless as the heart : and, through the whole period he was quite cold to the touch, and without micturition. On the fourth day he died suddenly *. Examples indeed are by no means uncommon in which the spasm has existed for three t, four, or even five

days I before death. Other irri- Other irritations, besides that of weakness, have occa

sionally led to a like spastic state of the arteries. The ness are stimulus of an aneurism of the aorta has produced it in

the brachial arteries, so that there has been no pulse in the wrists: and gout or some acrimony in the stomach has operated in like manner on the arterial system to a much greater extent: as has likewise general pressure on the larger thoracic or abdominal organs, from water in the chest or cavity of the peritoneum. The cause, how

ever, is not always to be traced, and hence Marcellus Sometimes Donatus has given an instance which he tells us was unhabitual after the

accompanied with any disease whatever $; the irritation irritation probably having subsided. Berryatt, in the History of has subsided.

the Academy of Sciences, has furnished us with a very singular example of this disease which was general as well as chronic, and continued through the whole term of life.

tations than that of weak.

sometimes causes.

• De Sedibus et Causis Morb. Ep. xlvii. Lugd. Bat. 4to. 1767.
+ Pathology, p. 25. Pelargus, Med. Jahngange. Band. v. p. 23.
$ Lib. vi. cap. II. p. 620.

ness.

mon, some

In all which cases, however, though the heart itself should Gex. I.

Spec. IX. seem to participate in the pulselessness, we are not to Entasia suppose that it is entirely without any alternation of sys- Acrotismus.

Pulselesstole and diastole, but only that its action is indistinct from weakness or irregularity. In treating of the nature Hence has of the pulse in the Physiological Proem to the third class, attended

through the we observed that it is in some persons unusually slow, whole of a and has been found, as measured by the finger, not more long life

In all which than ten strokes in a minute * : and that in many of these

na mwamy on these cases the cases the cause of retardation seems to be a spasticity or heart prowant of pliancy in the muscular fibres of the heart or

bably beats, arteries, or both, rather than an actual torpor which is distinctly. also an occasional cause. I have never met with any case Great re

tardation of in which the ordinary standard of the pulse was not more the pulse than ten strokes in a minute ; but I have at this time a not uncompatient of about thirty-six years of age, whose pulse has times not exceeded twenty-four or twenty-six strokes, and has amounting

to only ten often been below these numbers. He is a captain in the strokes in a Royal Navy, of a sallow complexion and bilious temper- minute. ament; till of late he enjoyed good health, but about Exemplifieds three years since was attacked with a fit of atonic apoplexy from which he recovered with difficulty. At an interval of a few weeks from each other, he had several other fits ; on recovering from the last of which he instantly married a young lady to whom he had for some time been engaged. He has now been married about fifteen months, has a healthy infant just born, and has had no fit whatever. His spirits are good, and he is residing by the sea-side, which situation he finds agree with him best.

Dr. Latham gives a similar example in a merchant whose pulse, though never intermissive, seldom, for ten or twelve years that he had known him, exceeded thirty-two beats in a minute ; occasionally was as slow as twenty-two, and at one time only seventeen. “I once”, says Dr. Latham, “ attended him through a regular fever, when his Further

illustration. pulse was not more than sixty, notwithstanding the disease ran on for at least a fortnight with a hot and dry

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