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HYDROPHOBIA

HYDROPHOBIA (Gr. ὕδωρ, water, and φόβος, fear; so called from the symptom of dread of water), or Rabies (Lat. for “ madness ”), an acute disease, occurring chiefly in certain of the lower animals, particularly the canine species, and liable to be communicated by them to other animals and to man.

In Dogs, &c.-The occurrence of rabies in the fox, wolf, hyaena, jackal, raccoon, badger and skunk has been asserted; but there is every probability that it is originally a disease of the dog. It is communicated by inoculation to nearly all, if not all, warmblooded creatures. The transmission from one animal to another only certainly takes place through inoculation with viruliferous matters. The malady is generally characterized at a certain stage by an irrepressible desire in the animal to act offensively with its natural weapons-dogs and other carnivore attacking with their teeth, herbivore with their hoofs or horns, and birds with their beaks, when excited ever so slightly. In the absence of excitement the rnalady may run its course without any fit of fury or madness.

Symptoms.—The disease has been divided into three stages or periods, and has also been described as appearing in at least two forms, according to the peculiarities of the symptoms. But, as a rule, one period of the disease does not pass suddenly into another, the transition being almost imperceptible; and the forms do not differ essentially from each other, but appear merely to constitute varieties of the same disease, due to the natural disposition of the animal, or other modifying circumstances. These forms have been designated true or furious rabies (Fr. rage vrai; Ger. rasende Wuth) and dumb rabies (Fr. rage mue; Ger. stille Wuth).

The malady does not commence with fury and madness, but in a strange and anomalous change in the habits of the dog: it becomes dull, gloomy, and taciturn, and seeks to isolate itself in out-of-the-way places, retiring beneath chairs and to odd corners. But in its retirement it cannot rest: it is uneasy and fidgety, and no sooner has it lain down than suddenly it jumps up in an agitated manner, walks backwards and forwards several times, again lies down and assumes a sleeping attitude, but has only maintained it for a few minutes when it is once more moving about. Again it retires to its corner. to the farthest recess it can find, and huddles itself up into a heap, with its head concealed beneath its chest and fore-paws. This state of continual agitation and inquietude is in striking contrast with its ordinary habits, and should therefore receive attention. Not infrequently there are a few moments when the creature appears more lively than usual, and displays an extraordinary amount of affection. Sometimes there is a disposition to gather up straw, thread, bits of wood, &c., which are industriously carried away; a tendency to lick anything cold, as iron, stones, &c., is also observed in many instances; and there is also a desire evinced to lick other animals. Sexual excitement is also frequently an early symptom. At this period no disposition to bite is observed; the animal is docile with its master and obeys his voice, though not so readily as before, nor with the same pleased countenance. There is something strange in the expression of its face, and the voice of its owner is scarcely able to make it change from a sudden gloominess to its usual animated aspect. These symptoms gradually become more marked; the restlessness and agitation increase. If on straw the dog scatters and pulls it about with its paws, and if in a room it scratches and tumbles the cushions or rugs on which it usually lies. It is incessantly on the move, rambling about, scratching the ground, sniffing in corners and at the doors, as if on the scent or seeking for something. It indulges in strange movements, as if affected by some mental influences or a prey to hallucinations. When not excited by any external influence it will remain for a brief period perfectly still and attentive, as if watching something, or following the movements of some creature on the wall; then it will suddenly dart forward and snap at the vacant air, as if pursuing an annoying object, or endeavouring to seize a fly. At another time it throws itself, yelling and furious, against the wall, as if it heard threatening voices on the other side, or was bent on attacking an enemy. Nevertheless, the animal is still docile and submissive, for its master's voice will bring it out of its frenzy. But the saliva is already virulent, and the excessive affection which it evinces at intervals, by licking the hands or face of those it loves, renders the danger very great should there be a wound or abrasion. Until a late period in the disease the master's voice has a powerful influence over the animal. When it has escaped from all control and wanders erratically abroad, ferocious and restless, and haunted by horrid phantoms, the familiar voice yet exerts its influence, and it is rare indeed that it attacks its master.

There is no dread of water in the rabid dog; the animal is generally thirsty, and if water be offered will lap it with avidity, and swallow it at the commencement of the disease. And when, at a later period, the constriction about the throat—symptomatic of the disease—renders swallowing difficult, the dog will none the less endeavour to drink, and the lappings are as frequent and prolonged when deglutition becomes impossible. So little dread has the rabid dog of water that it will ford streams and swim rivers; and when in the ferocious stage it will even do this in order to attack other creatures on the opposite side.

At the commencement of the disease the dog does not usually refuse to eat, and some animals are voracious to an unusual degree. But in a short time it becomes fastidious, only eating what it usually has a special predilection for. Soon, however, this gives place to a most characteristic symptom—either the taste becomes extremely depraved or the dog has a fatal and imperious desire to bite and ingest everything. The litter of its kennel, wool from cushions, carpets, stockings, slippers, wood, grass, earth, stones, glass, horse dung, even its own faeces and urine, or whatever else may come in its way, are devoured. On examination of the body of a dog which has died of rabies it is so common to find in the stomach a quantity of dissimilar and strange matters on which the teeth have been exercised that, if there was nothing known of the animal's history, there would be strong evidence of its having been affected with the disease. When a dog, then, is observed to gnaw and eat suchlike matters, though it exhibits no tendency to bite, it should be suspected. The mad dog does not usually foam at the mouth to any great extent at first. The mucus of the mouth is not much increased in quantity, but it soon becomes thicker, viscid, and glutinous, and adheres to the angles of the mouth, fauces and teeth. It is at this period that the thirst is most ardent, and the dog sometimes furiously attempts to detach the saliva with its paws; and if after a while it loses its balance in these attempts and tumbles over, there can no longer be any doubt as to the nature of the malady. There is another symptom connected with the mouth in that form of the disease named “ dumb madness ” which has frequently proved deceptive. The lower jaw drops in consequence of paralysis of its muscles, and the mouth remains open. The interior is dry from the air passing continually over it, and assumes a deep red tint, somewhat masked by patches of dust or earth, which more especially adhere to the upper surface of the tongue and to the lips. The strange alteration produced in the dog's physiognomy by its constantly open mouth and the dark colour of the interior is rendered still more characteristic by the dull, sad, or dead expression of the animal's eyes. In this condition the creature is not very dangerous, because generally it could not bite if it tried—indeed there does not appear to be much desire to bite in dumb madness; but the saliva is none the less virulent, and accidental inoculations with it, through imprudent handling, will prove as fatal as in the furious form. The mouth should not be touched, —numerous deaths having occurred through people thinking the dog had some foreign substance lodged in its throat, and thrusting their fingers down to remove it. The sensation of tightness which seems to exist at the throat causes the dog to act as if a bone were fixed between its teeth or towards the back of its mouth, and to employ its fore-paws as if to dislodge it. This is a very deceptive symptom, and may prove equally dangerous if caution be not observed. Vomiting of blood or a chocolate-coloured fluid is witnessed in some cases, and has been supposed to be due to the foreign substances in the stomach, which abrade the lining membrane; this, however, is not correct, as it has been observed in man.

The voice of the rabid dog is very peculiar, and so characteristic that to those acquainted with it nothing more is needed to prove the presence of the disease. Those who have heard it once or twice never forget its signification. Owing to the alterations taking place in the larynx the voice becomes hoarse, cracked and stridulous, like that of a child affected with croup—the “ voixdu coq,” as the French have it. A preliminary bark is made in a somewhat elevated tone and with open mouth; this is immediately succeeded by five, six or eight decreasing howls, emitted when the animal is sitting or standing, and always with the nose elevated, which seem to come from the depths of the throat, the jaws not coming together and closing the mouth during such emission, as in the healthy bark. This alteration in the voice is frequently the first observable indication of the malady, and should at once attract attention. In dumb madness the voice is frequently lost from the very commencement—hence the designation.

The sensibility of the mad dog appears to be considerably diminished, and the animal appears to have lost the faculty of expressing the sensations it experiences: it is mute under the infliction of pain, though there can be no doubt that it still has peripheral sensation to some extent. Burning, beating and wounding produce much less effect than in health, and the animal will even mutilate itself with its teeth. Suspicion, therefore, should always strongly attach to a dog which does not manifest a certain susceptibility to painful impressions and receives punishment without any cry or complaint. There is also reason for apprehension when a dog bites itself persistently in any part of its body. A rabid dog is usually stirred to fury at the sight of one of its own species: this test has been resorted to by Henrie Marie Bouley (1814–1885) to dissipate doubts as to the existence of the disease when the diagnosis is otherwise uncertain. As soon as the suspected animal, if it is really rabid, finds itself in the presence of another of its species it at once assumes the aggressive, and, if allowed, will bite furiously. All rabid animals indeed become excited, exasperated, and furious at the sight of a dog, and attack it with their natural weapons, even the timid sheep when rabid butts furiously at the enemy before which in health it would have fled in terror. This inversion of sentimentis sometimes