– It is well to remember that of dogs that bite not one in a thousand is rabid, and of persons bitten by actually rabid animals not more than one in twenty become affected by hydrophobia. It is also well to remember that most animals that are “supposed” to be mad are not mad at all. These considerations should be sufficient to do away with the panic many timid persons suffer from to such a degree that the very fear of hydrophobia becomes itself a disease a might be called a hydrophobia-phobia. But there is one more comforting reflection, and that is, that hydrophobia is not incurable, as it is generally stated to be.
Cases have been cured, and there is no reason why they should not be cured again. The disease consists of an irritation of the central nervous system, manifesting itself in convulsions, which gradually wear the patient out. These convulsions are excited by very slight causes, such as a noise, or movement, or blowing on the patient, but especially by any attempt on his part to swallow liquids. This is so marked that the sight or sound of water is enough to set up convulsions. But there are cases in which this does not occur.
The onset of the disease occurs at a variable time after the bite. The symptoms have been known to develop as soon as eight day after, and cases are recorded in which the incubation period (as it is called) has lasted for years. The general run of cases occur in from one to two months after the bite.
Diagnosis.- Some cases the hysteria closely simulate an attack of hydrophobia. There are the choking sensations, inability to swallow, and general convulsions; but the patient is generally known to be hysterical, and the attack does not last long. There is not the profound prostration or the heavy sweat that accompany the real disease.
General Treatment.- This divides itself into two heads: (1) the treatment after the bite, and (2) the treatment of the disease.
(1) Treatment after the bite.
The first thing to be done is to apply cupping glasses to the wound, or, if these are not handy, to suck it. The person sucking runs no risk if he has no sore about his mouth at the time. Whilst sucking pressure should be made with the thumb towards the wound over the adjoining part. If the wound is deep and the orifice small it should be made larger by an incision. When nothing more can be made to exude from it the wound should be washed with a 20 per cent. solution of carbolic acid, or of Sir W. Burnett’s disinfectant fluid, and afterwards, allowed to heal, with nothing but water dressing applied.
The patient should be put on a course of Turkish baths, taking one daily for three weeks.
Medicines.-A course of Belladonna 3, one drop three times a day should be persisted in for three months.
(2) Treatment of the Disease.
When the first signs of the disease show themselves-inflammation showing itself about the wound, irritability of temper, restlessness, soreness or stiffness about the throat-the patient should at once be removed to a Turkish bath.
The Medicines which have proved most useful are Belladonna. Stramonium, Lachesis, Hydrophobinum, and Cantharis. But the treatment must always be directed by a medical man, who will decide what should be given.
