A Remarkable Account of an Hydrophobia, in a Letter from Dr Roger Howman, Physician in Norwich, to William Briggs M. D. Fellow of the Coll. of Phys. Lond. and Physician of St. Tho. Hospitall

A remarkable account of an Hydrophobia, in a Letter from Dr Roger Howman, Physician in Norwich, to William Briggs M.D. Fellow of the Coll. of Phys. Lond. and Physician of St. Tho. Hospitall. Sir. I had long since (if business had not prevented me,) returned you thanks for the Philosophicall Collections you sent me; and therein, particularly, for your new Theory of Vision, to highly rational & satisfactory. Among your many other exact and curious observations, I can't pass by that remarkable relation of the Hydrophobia (given by the learned and ingenious Dr Lister,) without applauding the curiosity of the observer, in his most exact historie of that disease; and having lately had an opportunity of making some remarks upon a case not much differing (tho' the occasion is more rare,) the biting of a mad Fox; I thought myself obliged to satisfy your curiosity therewith (if worth reading,) as followeth. On Wednesday at evening the 1. of Octob. last past I was called to a patient in this City, who about 6 weeks before had been bitten with a mad Fox on the right hand; he began to be indisposed the Saturday before with running pains, yet so well as to be abroad next day at Church: on Monday his pains grew more troublesome, and the day following, much worse, especially, on his right hand, arm, shoulder and back, but not to confinement: on Wednesday (I know not by whose advice,) he took a dose of the common purging spirit of Scurvy-grass, which gave him 7 or 8 stools, and made him very faint, and weak; so I found him; and complaining that he he could not use his right hand (it beginning to be paralytical,) tho' his pains were much abated there, and where else they had been most troublesome; only on the lower parts, or small of his back, which soon after vanished also. He told me he bled freely at the wounds the Fox had made, and that they healed without any farther trouble, than now and then a little girding pain on that hand & arm; and further said, (to please his friends,) he had taken a white Powder of an Apothecarie, and believed himself in no danger of what was feared (for I had discovered the danger I apprehended in his condition:) tho' the Aquæ Pavor did not yet appear, his heat was much encreased and his Pulse intermitted every 5th or 6th stroak, but on the right side only; which I again and again examind, finding no variation: he also looked gantly & thin, but his Eyes sparkling and fiery. I prescrib'd the best temperate Antispasmodic and Antiparalytic Remedies I knew, to be mixt with the specifics of common use in a Hydrophobia; thus much on Wednesday at Night. Next morning he complained his Night had been restless, that then he had wholly lost the use of his right hand, and tho' the pains were more abated, yet he was very hot, and uneasy: his Pulse then was much stronger, then over Night, but intermitted on the right side only as before, his countenance was somewhat more gantly, yet his Veins very full as in initio & augmento febris, and no Hydrophobia appearing; I advised him to bleed 6 or 7 ounces at the left arm, (the right being paralytical,) and the continuance of what I had prescribed before; he bled 8 ounces very freely, the blood well coloured but very thick. This on Thursday morning: in the afternoon going into the Country to visit some patients, to whom I was preingaged there, I could make no further observations till my return on Friday 6 at Night; not many hours before he died. On Thursday after I left him, the great Symptome appeared, and in my absence, another was consulted who who gave him many remedies. At my return his heat was very great, and his Pulse very high, and intermitted then on both wrest's, and if any thing were offered him to drink standing or sitting, he started as if his head would have fallen backwards off his shoulders, but when lay'd upon his pillow, could (tho' with great difficultie & uneasines,) now and then get down a spoonfull: he looked then very thin and gasty, and seemed shy or afraid of every body that came fuddainly near him, telling them they Stifled him, or stopt or hindred his breath in coming so hastily to him. His reason was all along very good, and (as some observed,) better than in his health: his voice was broken and imperfect, as theirs whose tongue and other organs of speech are growing paralytical, thus at 6 a clock Fryday at Night. I saw him again at 10 that Night when all Symptom's were growing worse; yet he could then walk out of one Chamber into another, with very little help, but between 12 and 1 next morning he died, without any convulsive motions, sighs or groans; as if in a moment, there had been a total paralysis. Thus as briefly and as plainly as I could, you have the relation; from whence it's most observable, that as the pains, (which were like those in a Rheumatism,) abated, the paralysis and feaver increased. As the feaver increased, the intermission of the Pulse grew more frequent, tho' the Pulse were much stronger; but why it intermitted first on but one side, is not easily accounted for. 3. That the imperfection of Voice, as well as the difficultie of swallowing were the effects of the paralysis, may probably be allowed, & be a satisfactory reason why the Person Dr. Lister mention's, could not use the Quill which was given him to suck with. 4. That his thin gasty aspect, the defect of spirits and tonic vigour (if I may so call it, was from a paralytical Original, is not unreasonable to conjecture. 5. That the paralysis chiefly affected the muscles of the head and upper parts, may be partly collected from from his inability to hold his head steady at the approach of any liquor; the fear thence rising, causing him to start, and his head so to fall backwards, as if it would fall off his shoulders. 6. And that his lower parts were lesse affected, is probable; because, 2 or 3 hours before he died, he could walk out of one Chamber into another, even when his voice was hardly intelligible. Some Queries offer themselves from what's written, it being a subject never yet well considered of: but I have not time now to name them, nor to be longer troublesome then to tell you I am. Norwich Jan. 27. 1684. Sir Your humble Servant Roger Howman.