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HYDROPHOBIA (Gr. i&ip, water, and 4b~9o~, 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.
Ia Dogs, &c.
The occurrence of rabies in the fox, wolf, hyaena, jackal, raccoon, badger and skunk has been asserted; hut 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 weaponsdogs and other carnivora attacking with their teeth, herbivora with their hoofs or horns, and birds with their beaks, when excited ever so slightly. In the absence of excitement the malady 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 JVuth).
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, glooms, 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, anti 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 unfreqtiently 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 abotit with its paws, and if in a room it scratches and tumblet the cushions or rugs on which it usually lies. It is incessantly or the move, rambling about, scratching the ground, sniffing in corner, 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 an~ external influence it will remain for a brief period perfectly still ant attentive, as if watching something, or following the movements 0
some creature on the wall; then it will suddenly dart forward ant snap at the vacant air, as if pursuing an annoying object, or en deavouring to seize a fly. At another time it throws itself, yellint and furious, against the wall, as if it heard threatening voices on th other side, or was bent on attacking an enemy. Nevertheless, thu animal is still docile and submissive, for its masters voice will brin~ it out of its frenzy. But the saliva is already virulent, and the cx cessive affect ion which it evinces at intervals, by licking the hands o face of those it loves, renders the danger very great should ther he a wound or abrasion. lJntil a late period in the disease th masters voice has a powerful influence over the animal. Whe~ it has escaped from all control and wanders erratically abroad ferocious and restless, and haunted by horrid phantoms, the familia voice yet exerts its influence, and it is rare indeed that it attack its master.
:rhere is no dread of Water in the rabid dog; the animal is generall thirsty, and if water be offered will lap it with avidity, and swallo it at the commencement of the disease. And when, at a later periot the Constriction about the throat---symptomatic of the diseaserenders swallowing difficult, the dog will none the less endeavour drink, and the lappings are as frcquent and prolongetl when degli Of inn luernmrq ininossihie Sn Iii ri ctrrnd has fh~ ra hid iin~ of wn it 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 symptomeither 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, horsedung, 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 animals 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 dogs physiognomy by its constantly open mouth and the dark color of the interior is rendered still more characteristic by the dull, sad, or dead expression of the animals eyes. In this condition the creature is not very dangerous, because generally it could not bite if it triedindeed 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-colored fluid is witnessed in some cases, and has been supposed to be dtie 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 croupthe voix du coq, as the French hay it. A preliminary bark is made in a somewhat elevated tone and with open mouth; this is immediately sticceeded 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, anti 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 str6ngly attach to a dog which does not manifest a certain susceptibility tc painful impressions and receives punishment without any cry or m complaint. There is also reason for apprehension when a dol bites itself persistently in any part of its body. A rabid dog is usuall~
stirred to fury at the sight of one of its own species: this test hat been resorted to by Henrie Marie Bouley (1814-1885) to dissipatt doubts as to the existence of the disease when the diagnosis is other wise 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 assume:
the aggressive, and, if allowed, will bite furiously. All rabid animal:
indeed become excited, exasperated, and furious at the sight of a dog a and attack it with their natural weapons, even the timid sheet - when rabid butts furiously at the enemy before which in health i r ttniulci havc- fled in terror, this inversion of sentmniemit issnnletime valuable in diagnosing the malady; it is so common that it may be said to be present in every case of rabies. When, therefore, a dog, contrary to its habits and natural inclination, becomes suddenly aggressive to other dogs, it is time to take precautions.
in the large majority of instances the dog is inoffensive in the early period of the disease to those to whom it is familiar. It then flies from its home and either dies, is killed as mad, or returns in a miserable plight, and in an advanced stage of the malady, when the desire to bite is irresistible. It is in the early stage that sequestration and suppressive measures are most valuable. The dogs which propagate the disease are usually those that have escaped from their owners. After two or three days, frequently in about twelve hours, more serious and alarming symptoms appear, ferocious instincts are developed, and the desire to do injury is irrepressible. The animal has an indefinable expression of sombre melancholy and cruelty. The eyes have their pupils dilated, and emit flashes of light when they are not dull and heavy; they always appear so fierce as to produce terror in the beholder; they are red, and their sensibility to light is increased; and wrinkles, which sometimes appear on the forehead, add to the repulsive aspect of the animal. If caged it flies at the spectator, emitting its characteristic howl or hark, and seizing the iron bars with its teeth, and if a stick be thrust before it this is grasped and gnawed. This fury is soon succeeded by lassitude, when the animal remains insensible to every excitement. Then all at once it rouses up again, and another paroxysm of fury commences. The first paroxysm is usually the most intense, and the fits vary in duration from some hours to a day, and even longer; they are ordinarily l)riefer in trained arid pet dogs than in those which are less domesticated, but in all the remission is so complete after the first paroxysm that the animals appear to be almost well, if not in perfect health. During the paroxysms respiration is hurried and labored, but tranquil during the remissior,s. There is an increase of temperature, and the pulse is quick and hard. When the animal is kept in a dark place and not excited, the fits of fury are not observed. Sometimes it is agitated and restless in the manner already described. It never becomes really furious or aggressive unless excited by external objectsthe most potent of these, as has been said, being another clog, which, however, if it be admitted to its cage, it may not at once attack. The attacked animal rarely retaliates, but usually responds to the bites by acute yells, which contrast strangely with the silent anger of the aggressor, and tries to hide its head with its paws or beneath the straw. These repeated paroxysms hurry the course of the disease. The secretion and flowing of a large quantity of saliva from the mouth are usually only witnessed in cases in which swallowing has become impossible, the mouth being generally dry. At times the tongue, nose and whole head appear swollen. Other dogs frequently shun one which is rabid, as if aware of their tianger.
The rabid dog, if lodged in a room or kept in a house, is continually endeavouring to escape; and when it makes its escape it goes freely forward, as if impelled by some irresistible force. It travels considerable distances in a short time, perhaps attacking every living creature it meetspreferring dogs, however, to other animals, and these to mankind; cats, sheep, cattle and horses are particularly liable to be injured. It attacks in silence, and never utters a snarl or a cry of anger; should it chance to be hurt in return it emits no cry or howl of pain. The degree of ferocity appears to be related to natural disposition and training. Some dogs, for instance, will only snap or give a slight bite in passing, while others will bite furiously, tearing the objects presented to them, or which they meet iii their way, and sometimes with such violence as to injure their mouth and break their teeth, or even their jaws. If chained, they will in some eases gnaw the chain until their teeth are worn away and the bones laid bare. The rabid dog does not continue its progress very long. Exhausted by fatigue and the paroxysms of madness excited in it by the objects it meets, as well as by hunger, thirst, and also, no doubt, by the malady, its limbs soon become feeble; the rate of travelling is lessened and the walk is unsteady, while its drooping tail, head inclined towards the ground, open mouth, and protruded tongue (of a.leaden color or covered with dust) give the distressed creature a very striking and characteristic physiognomy. In this condition, however, it is much less to be dreaded than in its early fits of fury, since it is no longer capable or desirous of altering its course or going out of its way to attack an animal or a man not immediately in the path. It is very probable that its fast-failing vision, deadened scent, ,and generally diminished perception prevent its being so readily impressed or excited by surrounding objects as it previously was. To each paroxysm, which is always of short duration, there succeeds a degree pf exhaustion as great as the fits have been violent and oft repeated. This compels the animal to stop; then it shelters itself in obscure placesfrequently in ditches by the roadsideand lies there in a somnolescent state for perhaps hours. There is great danger, nevertheless, in disturbing the dog at this period; for when roused from its torpor it has sometimes sufficient strength to inflict a bite. This period, which may be termed the second stage, is as variable in its duration as the first, but it rarely exceeds three or four days. The above-described phenomena gradually merge into those of the third or last period, when symptoms of paralysis appear, which arc speedily followed by death. During the remission in the paroxysnis these paralytic symptoms are more particularly manifested in the hind limbs, which appear as if unable to support the animals weight, and cause it to stagger about; or the lower jaw becomes more omless drooping, leaving the parched mouth partially open. Emaciation rapidly sets in, and the paroxysms diminish in intensity, while the remissions become less marked. The physiognomy assumes a still more sinister and repulsive aspect; the hair is dull and erect; the flanks are retracted; the eyes lose their lustre and are buried in the orbits, the pupil being dilated, and the cornea dull and semiopaque; very often, even at an early period, the eyes squint, and this adds still more to the terrifying appearance of the poor dog. The voice, if at all heard, is husky, the breathing laborious, and the pulse hurried and irregular. Gradually the paralysis increases, and the posterior extremities are dragged as if the animals back were broken, until at length it becomes general; it is then the preltide to death. Or the dog remains lying in a state of stupor, and can only raise itself with difficulty on the fore-limbs when greatly excited. In this condition it may yet endeavour to bite at objects within its reach. At times convulsions of a tetanic character appear in certain muscles; at other times these are general. A comatose condition ensues, and the rabid dog, if permitted to die naturally, perishes, in the great majority of cases, from paralysis and asphyxia.
In dumb madness there is paralysis of the lower jaw, which imparts a curious and very characteristic physiognomy to the dog; the voice is also lost, and the animal can neither eat nor drink. In this condition the creature remains with its jaw pendent and the mouth conseqtiently wide open, showing the flaccid or swollen tongue covered with brownish matter, and a stringy gelatinouslooking saliva lying between it and the lower lip and coating the fauces, which sometimes appear to be inflamed. Though the animal is unable to swallow fluids, the desire to drink is nevertheless intense; for the creature will thrust its face into the vessel of water in futile attempts to obtain relief, even until the approach of death. Water may bepourecl down its throat without inducing a paroxysm. The general physiognomy and demeanour of the poor creature inspire the beholder with pity rather than fear. The symptoms due to cerebral excitement are less marked than in the furious form of the disease; the agitation is not so considerable, and the restlessness, tendency to run away, and desire to bite are nearly absent; generally the animal is quite passive. Not iinfrequently one or both eyes squint, and it is only when very much excited that the dog may contrive to close its mouth. Sometimes there is swelling about the pharynx and the neck; when the tongue shares in this complication it hangs out of the mouth. In certain cases there is a catarrhal condition of the membrane lining the nasal cavities, larynx, and bronchi; sometimes the animal testifies to the existence of abdominal pain, and the faeces are then soft or fluid. The other symptomssuch as the rapid exhaustion and emaciation, paralysis of the posterior limbs towards the termination of the disease, as well as the rapidity with which it runs its cGurse are the same as in the furious form.
The simultaneous occurrence of furious and dumb madness has frequently been observed in packs of fox-hounds. Dumbmadness differs, then, from the ftmrious type in the paralysis of the lower jaw, which hinders the dog from biting, save in very exceptional circumstances; the ferocious instincts are also in abeyance; and there is no tendency to aggression. It has been calculated that from 15 to 20% of rabid dogs have this particular form of the disease. Puppies and young dogs chiefly have furious rabies.
These are the symptoms of rabies in the dog; but it is not likely, nor is it necessary, that they will all be present in every case. In other species the symptoms differ more or less from those manifested by the dog, but they are generally marked by a change in the manner and habits of the creatures affected, with strong indications of nervous disturbance, in the majority of species amounting to ferociousness and a desire to injure, timid creatures becoming bold and aggressive.