Remarks on hydrophobia : read before the Philadelphia County Medical Society, May 23, 1883 / by Charles W. Dulles.

  • Dulles, Charles W. (Charles Winslow), 1850-1921
Date:
1883
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Licence: Public Domain Mark

Credit: Remarks on hydrophobia : read before the Philadelphia County Medical Society, May 23, 1883 / by Charles W. Dulles. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    IO able. Dr. Agnew and I saw a case which pre- sented the typical symptoms of hydrophobia: Dr. Agnew considered it a brain-tumor, but the autopsy did not reveal any gross lesion. Many physicians would have put it down as hydrophobia, unacquainted with the previous history. The clinical symptoms of hydropho- bia were very marked at one time, but the case closed with the symptoms of acute para- lytic dementia. Hydrophobic symptoms are not very uncommon in many brain-diseases. Dr. Bartholow : The disease hydrophobia admits of a large latitude of opinion, as has been well shown by Dr. Dulles’s paper. Two groups of cases are presented. In one group imagination or morbid fear is the causative influence. All the objective symptoms of hydrophobia may be produced in this way. Persons who have been bitten by dogs brood and worry over the matter, closely study every symptom as seen in cases, until they develop a condition of the most serious character. The influence of the mind over the body un- der such circumstances is well illustrated by a case recorded in Tuke’s work on the Influ- ence of the Mind over the Body. Two brothers were bitten by the same dog, and shortly after this event they separated, one going to Bel- gium, the other remaining in France. The one in France was a few days after seized with hydrophobia, and died. The other, after a long absence, returned to France, learned for the first time of the manner of his brother’s death, was shortly seized with hydrophobia, and died. Numerous cases have been re- corded, in both sexes, having all the objective phenomena of hydrophobia, produced merely by mental causes, by fear, and by mimicry or morbid irritation. These constitute a dis- tinct group. We have thus a neurosis hav- ing all the ordinary characteristics of hydro- phobia. I am a firm believer, also, in the existence of a morbid entity, to which we ap- ply the term hydrophobia, which is propagated by a distinct virus that is inoculable. We have knowledge of the fact that the saliva and other secretions may become toxic. Montgomery records a case in which an in- fant was poisoned by nursing at the breast of the mother while she was in a very high pas- sion. Sternberg has shown that human saliva may become poisonous; and authentic in- stances are known of the communication of hydrophobia from man to man by bites given in states of tremendous passion. The. recent discoveries in regard to the ptomaines, alka- loidal poisons produced during the decay of animal tissue, will throw some light on this subject. In the case referred to by Dr. Blackwood we have evidence of how close confinement and deprivation of customary indulgences can unfavorably affect an animal; and in the same manner a dog chased or an- noyed in the street may be so affected that its saliva will become dangerous. As regards the length of the period of incubation, we must remember that this period varies in all diseases. If the period of in- cubation is two weeks,—which is not unusual, —why not two months, or two years? Dr. Hamilton : I recall the following case, which may be interesting in this connection. A man had fallen against a rail and hurt his shin severely, but continued at work for two or three days. The wound inflamed and sup- purated, and then tetanoid symptoms set in. To these hydrophobic symptoms supervened, shuddering, and going into spasms whenever an effort was made to drink water. This condition continued about thirty hours, when death ensued. The patient had never been bitten by a dog. Dr. Wittig: About forty years ago I saw a case in which a young man who had been sleeping with a dog found his mouth covered with foam, and foam on the mouth of the dog also. The young man was very much alarmed when I saw him, but he recovered under the use of calomel and diaphoretics associated with a remedy that is used in Russian practice, —the genista. I was told that vesicles had appeared under the tongue and had been cauterized. In another case, a young man was bitten in the finger, caustic was applied, but the patient got very much frightened and sent for me. I used remedies similar to those in the case just mentioned, and the patient got well. Dr. Heger, of Vienna, has said that in his opinion the saliva is not the cause of the disease, but it is a lesion of a nerve causing peripheral irritation. I incline, how- ever, to the opinion that it is a virus, and that it mav become latent and lie dormant for J some time in the system. Dr. W. S. Stewart: In Westmoreland County, in this State, lives a family of phy- sicians who claim to have a remedy for hydro- phobia, and people come to them from all points for treatment. In one case, a patient of my preceptor’s, feeling symptoms of an alarming kind, went to one of these doctors, and received from him one pill, to be taken on arriving home. This pill on being opened was found to be made of bread-crumbs and to contain a piece of paper bearing the word abracadabra. This pill, taken with restric- tion as to stimulants and excitement of all kinds, constituted the treatment, whether the cases were real or imaginary. Dr. Dulles, in closing the discussion, said: I will endeavor to reply to some of the points raised, in the order in which they came up; for time will not permit a systematic reply. In the first place, I must call attention to the vagueness of some of the statements of Dr. Wood. Flis figures in regard to success- ful artificial inoculations are not to be accepted without question. If his statement that sixty- six per cent, of experimental inoculations of rabies are successful is true of the Labo- ratory of the University of Pennsylvania, then
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