Hydrophobia (Dog-Madneas—Rabies).—The word hydrophobia is derived from two Greek words, huddr, water, and phoboa, fear, the dread of swallowing and the spasms produced by the attempt being emarked feature of the disease. It is a disease to which dogs, cats, wolves, and foxes are liable. It is due to a particular poison, which seems specially to exist in the saliva or spit of animal by the disease. It can only be produced in human beings by the direct introduction of this material into the body by a bite or other wound. A person may be bitten by a dog and may in consequence be seized with the disease, although the dog did not at the time show signs of the disease. Cases have been due to a dog, not known to be suffering from the disease, licking the hand of its master on which some slight wound was present. The bite of a cat may produce it. Probably, however, not more than a third of the persons bitten by mad dogs take hydro phobia, even when no attempt has been made to destroy any poison that may have been im parted from the dog's mouth. When the bite has been through clothes the risk is less than if the part of the body had been uncovered. More men suffer from the disease than women. There seems no doubt that a bite from a healthy dog cannot produce the disease. A dog must be suffering from the poison, whether it is evi dent or not, before it can impart the disease to another.
Symptoms.--It is very doubtful how long the poison requires to reside in the body before the disease appears. The shortest interval be tween the bite and symptoms has been about twelve days. The interval is seldom less than a month, and is on an average six or seven weeks. In some cases many months have passed before the disease appeared, and some have been recorded in which the interval extended to years. The appearance of the disease after four months is, however, seldom. The wound by which the poison gained admission to the body usually heals as easily as an ordinary wound. It is said that among the first symp toms in many cases is return of pain to the place of bite, hot tingling pain, shooting from the part. Such is often not present. Other
symptoms are restlessness, shivering, uneasi ness, a feeling of illness, disturbed sleep, low ness of spirits, and discomfort about the throat with some difficulty in swallowing liquids in particular, while at the same time there is thirst. As the disease advances the patient becomes excited, the eyes look wild, and he wears an expression of terror, and is liable to outbreaks of delirious excitement in which he may strive to injure himself or others. The chief symptom is the spasm that occurs on attempt ing to drink. At first it is mere difficulty of swallowing, but soon the attempt causes a spasm, a "catch in the breath," which, in the course of a few hours, becomes marked as a strong contraction of the muscles of breathing, there being a strong effort as in taking in a deep breath, so that the shoulders are raised and the corners of the mouth drawn outwards. The spit cannot be swallowed. It collects in considerable amount, and hangs thickly from the mouth, a source of great annoyance to the patient. Even when the patient is quite con scious, the impossibility of swallowing is marked. The person may take a glass of water, and, making up his mind with great effort, may carry it quickly to his mouth with agitation, but the spasm conies on and the glass is vio lently thrown away, and any water that may have got into the mouth is violently thrown out, while the patient shudders, and marked spasms of the muscles for breathing occur. The very thought of drinking is terrifying. The mere sound of running water produces spasm, and the state of terror and agitation is extreme. In advanced cases any sudden noise, or a rush of cold air, will bring on a convulsive attack. As the disease advances the patient becomes feeble, the voice hoarse, and the convulsions more frequent and severe. Death occurs from exhaustion or from suffocation in convulsion. The disease is without exception fatal, death occurring in from two to six days.