An Account of Three Cases of the Hydrophobia. By R. Mead, M. D. F. R. S.

VI. An Account of three Cases of the Hydrophobia. By R. Mead, M.D. F.R.S. The Symptoms from the Bite of a mad Dog are so surprizing and terrible, that it is hardly possible to describe the Agony of a Patient in this unhappy Condition. I have lately had the opportunity to see two Instances of this Case. The first was of a Lad of about the Age of Nine Years, a sturdy and bold Boy. A mad Bitch of the Mungrel kind was hunted in the Street, he struck at her with a Stick, and she flying in his Face, bit him in the right Cheek, which was torn with a large Wound to the middle of the Nose. This was on the 20th of April last. A Surgeon cured the Wound in about 14 days time, by applying for the first three Days, Theriac. Andromach. in Sp. Vin. and afterwards dressing it with Liniment. Arcæi and Balsam. Terebinthin. No other Care was taken, only a Bolus of Theriac. Andromach. was given him every Night while under Cure, and quickly after he was bit, he was persuaded to eat the whole Liver of the Bitch fry'd. He continued very brisk and well to the 22d of May; upon that day he seem'd dull and sick, would eat no Dinner, except a little boil'd Spinnage, walk'd out in the Afternoon, and in the Evening complained of his Stomach and Head; his Mother gave him a small Glass of Brandy, for he would drink nothing else. In the Night he was very bad, bad, startled often, and screamed out as in an Agony, especially when desired to drink, and complained miserably whenever he made Urine, saying it hurt him. The next Morning he vomited up the Herbs he had eat the day before, unalter'd. I was sent for that Day in the Afternoon, and found him in a perfect Agony, all in a sweat, trembling, tossing himself up and down, talking continually, looking very wild; his Pulse low, and sometimes quicker, then slower: His Urine made the Night before as well Colour'd as ordinary. I desired him to Drink; he took a little in his Mouth, but as it was going down, he threw it out with Violence, saying it hurt him; and praying that he might take no more. We over persuaded him to hold a little in his Mouth and swallow it by degrees and gently; he did so with a little more ease, but was glad when 'twas over. We bid him suck the Drink thro' a Quill; he try'd, but could not get it down by continual Gulps, but stopt as soon as a very little was pass'd, still crying out that it hurt him to swallow it. I presently declared the Case to be desperate. However for the satisfaction of the Relations, Blistering Plasters were apply'd to the Back and on each side of the Neck; and a Diuretic Bolus of Sal. Succin. Camphor. and Conserv. Lujul. was given every six Hours; for he seemed from the first of his Complaint to have a difficulty of Urine. The next day, the 24th at Noon, I found him much worse, he had raved all Night; could not bear the sight of any thing white, and said, that if all the Women in the Room who had white Aprons would go out, he should be well presently. He said he would drink if we would give him it in a black Cup; but when brought made many Excuses and could not, tho' at the same time complain'd he was dry, and pleased himself with talking of full Pots. He eat some Bread and Butter heartily, but vomited it up quickly together with a frothy Slime. We dipp'd him in a Tub of warm Water; he said he was not afraid of Water, and was quiet in it for a little while, but soon fell into a Convulsion Fit, which obliged us to take him out. I observed his Eyes to grow more staring, and the Pupil to be prodigiously enlarged. He was thrown continually with such Violence from Place to Place, that it was very hard to keep him in Bed; and quite tired and spent, fell into cold Sweats, and dy'd this day at Four in the Afternoon. The next day I obtain'd leave to open the Body. We examin'd the Brain, Throat, Breast and Stomach, but met with no extraordinary appearance anywhere, excepting that there was a great quantity of greenish viscid Bile in the Stomach. The other Patient was a very lusty vigorous Man of 45 Years. He had ten Weeks before been bit in one of the Fore-fingers near the Nail, by a little Naked Dog of the Guinea Breed. On the 8th of November in the Morning he complained of a great Sickness at Stomach, and vomited green and yellow Choler. The next Morning he took a Dose of Rad. Ipecacuanh. Whilst he was vomiting, he complained of a difficulty of swallowing; and when press'd to drink to work off the Medicine, contrived himself a way of sucking the Gruel given him, through a piece of a Tobacco Pipe, but could not get down above one Pint; and tho' he afterwards often try'd this Trick, yet it did not succeed. On the 10th he had eight Ounces of Blood taken away at the Arm, and took a Bolus of Theriac. Andromach. with Lap. Contrayerv. I came to him on the 11th; found him ty'd in his Bed, raving Mad, biting and spitting at the By-standers, crying out Murder, making an odd Noise as if he cough'd up something from the Throat; this motion I had also took notice of in the Boy, and I suppose this is what some Authors have call'd Barking. He say'd he would drink if we would unbind him, and give him Water; but as soon as it came to his Mouth, he threw away the Cup with the greatest Fury imaginable, and grew so unruly, that he was with much ado ty'd down again. I observed that he had a Palsie of his right Arm, for he moved this only by the help of the other; and those who attended him, had taken notice that this Symptome began the Day before, and that at the same time he had endeavour'd to Read, but could not, complaining of a Mist before his Eyes. As he seem'd afraid of every body, so he shewed the greatest Enmity to those, for whom at other times he used to have the most Love and Respect. I ordered a Surgeon to take away 20 Ounces of Blood at his Arm: And observed it to be very thick and black. He was very tame after this for a few Minutes, but fell again into his outrageous Fit, in which he soon laid himself down quite spent, and dy'd. I could not by all possible means get leave to open the Body. Since these Accidents I have had an Account sent me by a Surgeon from Stamford in Lincolnshire, of a young Man of about 18 Years, who dy'd Hydrophobus by the Bite of a Mad Fox, that had been bit by a mad Dog. The Symptoms discovered themselves three Months after the Wound, which was upon the back of the Hand, and being healed by the Application of Theriaca Andromach. had left a small black Scab behind. Three days before his Death he was seized with a Fever, for which he was Blooded, Vomited and Blistered; he bit to pieces the Glass in which Drink was given him. When When Dissected, the Fauces were found very much inflamed; The left Lobe of the Lungs black, with the Vesicles full of black Blood; The surface in some places, which the blackness had not cover'd, appearing Blistered, as if raised by Cantharides. The Liver was hard and of a yellow bilious Colour. During the whole Violence of the Distemper, the Penis was observed to be continually erected, and as hard as a Bone. This Symptom is particularly taken notice of by Celsus Aurelianus. The Surgeon who opened the Body, with his Knife slightly wounded his Fore-finger, and was surpriz'd to find that it festered, and gave him much more Pain than a greater Cut had at other times done. This I take rather notice of, because something of the same nature happen'd to the Surgeon who Dissected my Patient. His Hand the following Night was taken with an Erysipelas, attended with great Tension and Pain. This was owing to a little Wound made in one of his Fingers a Day or two before, from which, in turning over the Parts, he had rubb'd off the Plaister; and it went not off without the continued Application of Cooling and Discutient Medicines. From all these Histories, it may not perhaps be wrong to conclude, that the Hydrophobia, (a Name not very proper for the Distemper) is the Effect of a particular kind of an Inflammation in the Blood, accompany'd with so great a Tension and Dryness of the Nervous Membranes, and such an Elasticity and Force of the Fluid with which they are filled, that the most common Representations are made to the Mind with too great Effect, and the usual Impressions of Objects upon the Organs cannot be suffered: Hence proceed the Timorousness, unaccountable Anxiety and Inquietude, which are always the forerunners of the Dread of Liquids; as also did the Pain Pain in making Water, and the strange Aversion observed in the Boy at the sight of any thing White; the Retina being really hurt and grieved by the striking of the Rays of Light upon it. Nor is it hard to conceive that when the Salivai Liquor is hot, and the Throat inflam'd and dry, the swallowing of Drink should cause such an intolerable Agony; no more than it is that, when things are wrought up to this wretched Condition, the dismal Tragedy should not last above three or four days at most, in which the Patient is perfectly fatigued and torn to Death by the Violence of his Actions and Efforts.