record, which makes it too probable that the disease, though it may not be communicated often, or easily, is yet communicable;" enough to enforce all necessary caution upon those engaged in attending upon a hydrophobic patient.

"Is a man who has been bitten by a mad dog, and in whose case no precautions have been taken, a doomed man? Will he be sure to have the disease, and therefore to die of it. By no means. But few, upon the whole, of those who are so bitten become affected with hydrophobia. This frequent immunity from the disease in persons who have been bitten has tended to confer reputation upon many vaunted methods of prevention. Ignorant persons and knavish persons have not failed to take advantage of this. They announce that they are in possession of some secret remedy which will prevent the virus from operating they persuade the friends of those who die that the remedy was not rightly employed, or not resorted to sufficiently early and they persuade those who escape, that they escape by virtue of the preventive remedy. If the plunder they reap from the foolish and the frightened were all, this would be of less consequence, but unfortunately the hope of security without undergoing a painful operation leads many to neglect the only sure mode of obtaining safety.

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* * A still more anxious enquiry next arises. Whoever has been bitten by a rabid or suspected animal must be considered, and will generally consider himself, as being in more or less danger of hydrophobia. This dread is not entirely removed, even by the adoption of the best means of prevention. Now, how long does this state of hazard continue? When is the peril fairly over? After what period may the person who has received the injury lay aside all apprehension of the disease? To this enquiry, no satisfactory reply can be given. In a vast majority of instances, indeed, the disorder has broken out within two months from the infliction of the bite. But the exceptions to this rule are too numerous to permit us to put firm trust in the unanimity afforded by that interval.

66 ** Mr. Youatt describes cases in which there had been no symptoms of rabies observed in the dog, at the time the injury was inflicted, though soon afterwards the animal became decidedly rabid. It is much to be regretted that the dog is so often destroyed. When a person has been bitten by a dog or cat suspected to be rabid, the beast ought by no means to be killed, but to be secured and kept under surveillance, and suffered, if it should so happen, to die

of the disease. If he do not die, in other words, if he be really not rabid, that will soon appear, and the mind of the patient will then be relieved from a very painful state of suspense and uncertainty, which might otherwise have haunted him for months or years. Should the dog die mad, the injured person will be no worse off than if the animal had been killed in the first instance; nay, in one respect, he will be better off, inasmuch as certainty of evil is preferable to perpetual and uneasy doubt.

"There are gross errors prevalent with regard to the signs of madness in the dog. If a dog be seen in a fit in the street, some person charitably offers a conjecture that perhaps he may be mad; the next person has no doubt of it, and then woe to that dog. But Mr. Youatt assures us that the rabid dog never has fits; that the existence of epilepsy is a clear proof that there is no rabies. Again, it is a very common belief, that a rabid dog, like a hydrophobic man, will shun water, and if he take to a river, that is thought to be conclusive evidence that he is not mad. But the truth is, that the disease in the quadruped cannot be called hydrophobia; there is no dread of water, but an unquenchable thirst; no spasm attending the effort to swallow, but sometimes in dogs an inability to swallow from paralysis of the muscles about the jaws and throat. They will stand lap, lapping without getting any of the liquid down. They fly eagerly to the water; and Mr. Youatt states that all other quadrupeds, with perhaps an occasional exception in the horse, drink with ease, and with increased avidity.

"There is another superstitious opinion not at all uncommon, viz., that healthy dogs recognize one that is mad, and fear him, and run away from his presence, in obedience to some mysterious and wonderful instinct warning them of danger. This is quite unfounded. Equally mistaken are the notions, that the mad dog exhales a peculiar and offensive smell, and that he may be known by his running with his tail between his legs; except when, as Mr. Youatt says, weary and exhausted he seeks his home.'

It will not be out of place to state what are the symptoms of rabies as observed in the dog, and as described by Mr. Youatt.

affected part, the dog is incessantly and | violently scratching it. if it be the foot, he gnaws it till the integuments are destroyed.

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Occasionally, vomiting and a depraved appetite are very early noticeable. The dog will pick up and swallow bits of thread or silk from the carpet, hair, straw, even dung, and frequently he will lap his own urine, and devour his own excrement. Then the animal becomes irascible, flies fiercely at strangers, is impatient of correction, seizes the whip or stick, quarrels with his own companions, eagerly hunts and worries cats, demolishes his bed, and, if chained up, makes violent efforts to escape, tearing his kennel to pieces with his teeth. If he be at large, he usually attacks only those dogs that come in his way; but if he be naturally ferocious he will diligently and perseveringly seek his enemy.

According to Mr. Youatt, the disease is principally propagated by the fighting dog in towns, and the cur, or lurcher, in the country; by those dogs, therefore, which minister to the vices of the lower classes in towns and country respectively. He maintains that if a well-enforced quarantine could be established, and every dog in the kingdom confined separately for seven months, the disease might be extirpated.

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'Very early in the disease, as it appears in the dog, the expression of countenance is remarkably changed; the eyes glisten, and there is slight squinting. Twitchings of the face come on. About the second day a considerable discharge of saliva commences; but this does not continue more than ten or twelve hours, and is succeeded by insatiable thirst; the dog is incessantly drinking or attempting to drink; he plunges his muzzle into the water. When the flow of saliva has ceased, he appears to be annoyed by some viscid matter in his fauces; and in the most eager and extraordinary manner he works with his paws at the corners of his mouth to get rid of it; and while thus employed, he frequently loses his balance, and rolls over.

"A loss of power over the voluntary muscles is next observed. It begins with the lower jaw, which hangs down, and the mouth is partially open; but by a sudden effort the dog can sometimes close it, though occasionally the paralysis is complete. The tongue is affected in a less degree. The dog is able to use it in the act of lapping; but the mouth is not sufficiently closed to retain the water. Therefore, while he hangs over the fluid, eagerly lapping for several minutes, it is very little or not at all diminished. The paralysis often attacks the

loins and extremities also. The animal staggers about and frequently falls. Previously to this, he is in almost incessant action. Mr. Youatt fancies that the dog is subject to what he calls spectral illusions. He says he starts up, and gazes eagerly at some real or imaginary object. He appears to be tracing the path of something floating around him, or he fixes his eye intently upon some spot in the wall, and suddenly plunges at it; then his eyes close, and his head droops."

"Frequently, with his head erect, the dog utters a short and very peculiar howl; or if he barks, it is in a hoarse inward sound, altogether dissimilar from his usual tone, and generally terminating with this characteristic howl. Respiration is always affected; often the breathing is very laborious; and the inspiration is attended with a very singular grating, choking noise. On the fourth, fifth, or sixth day of the disease he dies, occasionally in slight convulsions, but oftener without a struggle.

"Most people think that the disease is generated, de novo, in the dog at least; and causes have been assigned for it which certainly are not the true or the sole causes. Thus, hydrophobia in the dog has been ascribed to extreme heat in the weather. It is thought by many to be particularly likely to occur in the dog-days; and to be, as Mr. Mayo observes, a sort of doglunacy, having the same relation to Sirius that insanity has to the moon; which, indeed, in another sense is probably true.' Many cautions are annually put forth about that period for muzzling dogs, and so on. Very good and proper advice, but if those who have noticed the statistics of the disease may be depended upon, it would be as appropriate at one period of the year as at another. Rabies occurs nearly as often in the spring, in the autumn, and even in winter as it does in summer. M. Trolliet, who has written an interesting essay on rabies, states that January, which is the coldest, and August, which is the hottest month in the year, are the very months which furnish the fewest examples of the disease. The disorder has often been ascribed to want of water in hot weather, and sometimes to want of food. But M. M. Dupuytren, Breschet, and Magendie have caused both dogs and cats to perish with hunger and thirst without producing the smallest approach to a state of rabies. At the veterinary school at Alfort, three dogs were subjected to some very cruel, but decisive experiments. It was during the heat of summer, and they were all chained in the full blaze of the sun. To one, salted

meat was given, to the second water only, and to the third neither food nor drink. They all died, but none of them became rabid."

When an individual has been bitten by an animal, respecting which the slightest suspicion of hydrophobia exists, the one remedy cannot be too quickly resorted to, complete excision of the bitten part. Some persons have possessed sufficient nerve to do this for themselves, few perhaps could, but it has often been effected by unprofessional persons for others; indeed, there might be more danger in waiting many hours for a surgeon, than in submitting to unprofessional operation. The method of excision most to be trusted, is the insertion of a skewer of wood, made to fit into the wound caused by the tooth, and carrying the incision so far round, that the entire hollow or cone of flesh is cut out along with the piece of wood. This might be done with safety in the thick part of the calves of the legs, or on the back parts of the thighs or buttocks. Where excision is not resorted to, the free application of lunar caustic or of aqua-fortis, whichever may be most readily procured, would be advisable; or in lieu of these, a piece of iron, heated to whiteness, may be inserted into the wound, so as thoroughly to destroy the surface which may have been poisoned. These may seem severe measures, but they are light compared to the unceasing anxiety of mind which must haunt a person who, after having been bitten, feels that due precaution has not been taken; and light indeed compared with liability to the disease itself. In the event of none of the above measures being submitted to, or available, the wound may be thoroughly washed for hours, by means of a stream of warm water poured upon it from a height; a cupping-glass being applied at intervals. These measures are of course only provisional, until the attendance of a surgeon can be procured.

As might be imagined, the preventive medicines for hydrophobia are very numerous; some have been thought highly of by medical men, but for the most part they are secret quack remedies, and perfectly worthless. It is absolute folly to trust to them, to the exclusion of the only certain preventive-excision or destruction of the wounded tissues.

When, from the peculiar symptoms, and taken in connection with the circumstances altogether they can scarcely be overlooked, an individual is thought to be attacked with hydrophobia, if the hope of saving life is small, much may be done to alleviate so terrible an affliction by proper medical care,

which must be sought for at once; in the meantime, whilst all those sights and sounds alluded to in the first part of this article, are carefully avoided as fearful aggravation to the necessary suffering, laudanum may be given in thirty-drop doses, and repeated as circumstances seem to dictate. If ice can be taken, it is said to afford relief, put into the mouth in small morsels; it has also been found of service applied to the back of the neck. If, on the arrival of a medical man, he likes to try any of the various remedies which have been proposed in this disease, he of course can do so, but the above-mentioned will be sufficient for lay interference.

The general interest and anxiety, and the very erroneous ideas on the subject of hydrophobia which are entertained by people generally, have rendered the length of this article necessary, and in taking it almost entirely from the valuable writings of Dr. Watson, the author has endeavoured to draw, from the best possible source, information which, fortunately, few medical men have an opportunity of acquiring personally.

HYDROTHORAX.-Water in the chest.

HYPOGASTRIUM.-See Abdomen. HYSTERIA-is a disease more particularly manifested through the nervous system, and is, almost without exception, peculiar to females between the age of puberty and the fiftieth year of life. The affection is, but very rarely so, developed in the male sex.

Hysteria in the female, is unquestionably closely connected in sympathy with the womb and its functions, and few cases, perhaps, occur, in which there cannot be traced some disorder of this important organ as the exciting cause.

Hysteria may manifest itself particularly in three different modes. First, either as a pure nervous and spasmodic affection; second, as a simulator of other and more directly definable disease; and third, as a modifier of other diseases really existing. The varied forms of hysteria, and the way in which it modifies and masks, or closely simulates other more important affections,

is apt to render it at times one of the most puzzling disorders with which the physician has to deal; it is one, moreover, especially liable to mislead the young or inexperienced practitioner.

A fit of hysteria may assume different forms, but, generally, the female becomes, apparently of a sudden, partially insensible, it may be, falls down, but more generally has sufficient warning to seat herself on a chair; the eyes are closed, the lids tremulous, the limbs are stretched out, and spasmodically and suddenly contracted at intervals, or there is violent struggling, the chest heaves, the heart, and vessels of the neck beat violently, the face is more or less flushed; frequently, the patient puts the hand to the throat and neck, as if to dispel some uneasiness, and not uncommonly gives utterance to incoherent or disconnected sentences, generally in a peevish or distressed tone of voice. In most cases the power of supporting the body when seated, remains, unless it is worked off the chair in the struggles. At length, the attack, having lasted for a longer or shorter period, from a few minutes to some hours, terminates, probably with a fit of sobbing and crying; the patient recovers consciousness, but is left exhausted and fatigued with the efforts and struggles, and, perhaps, falls into disturbed or heavy snoring sleep. When a fit has terminated, or even during its progress if continued, the kidneys act very freely, and large quantities of urine, almost resembling pure water, are voided.

Such are the leading features of a "fit" of hysteria, but they may be greatly varied; the struggles, especially, being so violent as to require the assistance of two or three strong men to restrain a comparatively feeble female, and to prevent her injuring herself, and sometimes, though not commonly, those around her.

Such are the outward manifestations of a fit of hysteria; but before it comes on, many patients complain of a sense of general oppression or uneasiness, with coldness or numbness of the limbs. Just previous to the accession, the characteristic hysteric globus,' or ball in the throat, is, probably felt; it seems as if a ball commenced rolling upwards in the bowels, generally from the lower left side, and as if it kept gradually ascending towards the throat, which it seems entirely to fill up, causing those sensations which induce hysteric patients so often to carry the hand to, and pull at the fore-part of the neck or throat.

It would serve no good purpose here, to follow the history of hysteria, into the

minutiæ of its various phases. It might be said, that there is scarcely a disease to which the human body is liable which it may not simulate so closely as to call for all the tact and discrimination of the physician to detect the difference between the two. Continued, incessant, hard cough, loss of voice, delirium of various kinds, paralysis, contractions of the limbs, obstinate vomiting or constipation, nay, even pregnancy, may be enumerated amid the various simulated conditions. Neither would it be profitable, in the present work, to enter into an investigation of the way in which the hysteric tendency will modify the various diseases to which the body is liable; this can only be conducted by the medical practitioner, but it is a matter of importance, that not only parents, but that the individuals themselves should be aware of those habits, &c., which tend to develop the hysteric tendency, and, further, that the best mode of managing a hysterical individual during the fit, and, in the absence of a medical man, should be understood.

During the continuance of a fit of hysteria, little either need or should be done, beyond preventing the patient hurting herself during the struggling. Cold water dashed upon the face may be useful, or it may be poured in a stream upon the head for a few minutes at a time; a mustard-plaster on the lower part of the back may be applied. If there is much flatulence, a teaspoonful or two of sal-volatile in water will give it relief. It must be remembered, that in most cases of hysteria, the patient is sensible of what is going on around, and may, in the excited state of the nervous system, be painfully alive to any unguarded or unfavourable opinions uttered by those in attendance; for this reason, it is not to be recommended that, as sometimes is done, severe and violent remedies should be proposed within hearing of the patient with the view of frightening her out of the fit; such a course has had the opposite effect, causing an aggravation of the symptoms. This is a different thing from threatening severe remedies whilst the patients are comparatively well; such a plan of treatment, it is well known, has often succeeded in putting a stop to the spread of hysteria by imitation-through schools, or such like collections of young females.

The exciting causes of hysteria are, remotely, whatever tends to exalt the influence of the nervous system. Among the moderately-fed and hard-working population in the country, hysteria is comparatively rare, but it is not unfrequent in servants who remove from the poor living of their