Chapter IV: CYSTOPHORIDA (Cystonectae, Haeckel). With a very large (2)

A table which indicates the weight per gallon of spirituous liquors
for every degree of Sikes's hydrometer is printed in 23 and 24 Vict.
c. 114, schedule B. This table differs slightly from that given above,
which has been abridged from the table given in Keene's _Handbook of
Hydrometry_, apparently on account of the equal divisions on Sikes's
scale having been taken as corresponding to equal increments of
density.

Sikes's hydrometer was established for the purpose of collecting the
revenue of the United Kingdom by Act of Parliament, 56 Geo. III. c.
140, by which it was enacted that "all spirits shall be deemed and
taken to be of the degree of strength which the said hydrometers
called Sikes's hydrometers shall, upon trial by any officer or
officers of the customs or excise, denote such spirits to be." This
act came into force on January 5, 1817, and was to have remained in
force until August 1, 1818, but was repealed by 58 Geo. III. c. 28,
which established Sikes's hydrometer on a permanent footing. By 3 and
4 Will. IV. c. 52, § 123, it was further enacted that the same
instruments and methods should be employed in determining the duty
upon imported spirits as should in virtue of any Act of Parliament be
employed in the determination of the duty upon spirits distilled at
home. It is the practice of the officers of the inland revenue to
adjust Sikes's hydrometer at 62° F., that being the temperature at
which the imperial gallon is defined as containing 10 lb. avoirdupois
of distilled water. The specific gravity of any sample of spirits thus
determined, when multiplied by ten, gives the weight in pounds per
imperial gallon, and the weight of any bulk of spirits divided by this
number gives its volume at once in imperial gallons.

Mr (afterwards Colonel) J. B. Keene, of the Hydrometer Office, London,
has constructed an instrument after the model of Sikes's, but provided
with twelve weights of different masses but equal volumes, and the
instrument is never used without having one of these attached. When
loaded with either of the lightest two weights the instrument is
specifically lighter than Sikes's hydrometer when unloaded, and it may
thus be used for specific gravities as low as that of absolute
alcohol. The volume of each weight being the same, the whole volume
immersed is always the same when it floats at the same mark whatever
weight may be attached.

Besides the above, many hydrometers have been employed for special
purposes. Twaddell's hydrometer is adapted for densities greater than
that of water. The scale is so arranged that the reading multiplied by
5 and added to 1000 gives the specific gravity with reference to water
as 1000. To avoid an inconveniently long stem, different instruments
are employed for different parts of the scale as mentioned above.

The lactometer constructed by Dicas of Liverpool is adapted for the
determination of the quality of milk. It resembles Sikes's hydrometer
in other respects, but is provided with eight weights. It is also
provided with a thermometer and slide rule, to reduce the readings to
the standard temperature of 55° F. Any determination of density can be
taken only as affording prima facie evidence of the quality of milk,
as the removal of cream and the addition of water are operations which
tend to compensate each other in their influence on the density of the
liquid, so that the lactometer cannot be regarded as a reliable
instrument.

The marine hydrometers, as supplied by the British government to the
royal navy and the merchant marine, are glass instruments with slender
stems, and generally serve to indicate specific gravities from 1.000
to 1.040. Before being issued they are compared with a standard
instrument, and their errors determined. They are employed for taking
observations of the density of sea-water.

The salinometer is a hydrometer originally intended to indicate the
strength of the brine in marine boilers in which sea-water is
employed. Saunders's salinometer consists of a hydrometer which floats
in a chamber through which the water from the boiler is allowed to
flow in a gentle stream, at a temperature of 200° F. The peculiarity
of the instrument consists in the stream of water, as it enters the
hydrometer chamber, being made to impinge against a disk of metal, by
which it is broken into drops, thus liberating the steam, which would
otherwise disturb the instrument.

The use of Sikes's hydrometer necessitates the employment of a
considerable quantity of spirit. For the testing of spirits in bulk no
more convenient instrument has been devised, but where very small
quantities are available more suitable laboratory methods must be
adopted.

In England, the Finance Act 1907 (7 Ed. VII. c. 13), section 4,
provides as follows: (1) The Commissioners of Customs and the
Commissioners of Inland Revenue may jointly make regulations
authorizing the use of any means described in the regulations for
ascertaining for any purpose the strength or weight of spirits. (2)
Where under any enactment Sykes's (sic) Hydrometer is directed to be
used or may be used for the purpose of ascertaining the strength or
weight of spirits, any means so authorized by regulations may be used
instead of Sykes's Hydrometer and references to Sykes's Hydrometer in
any enactment shall be construed accordingly. (3) Any regulations made
under this section shall be published in the London, Edinburgh and
Dublin Gazette, and shall take effect from the date of publication, or
such later date as may be mentioned in the regulations for the
purpose. (4) The expression "spirits" in this section has the same
meaning as in the Spirits Act 1880. (W. G.)

FOOTNOTES:

[1] In _Nicholson's Journal_, iii. 89, Citizen Eusebe Salverte calls
attention to the poem "De Ponderibus et Mensuris" generally ascribed
to Rhemnius Fannius Palaemon, and consequently 300 years older than
Hypatia, in which the hydrometer is described and attributed to
Archimedes.

[2] _Nicholson's Journal_, vol. i. p. 111, footnote.

HYDROPATHY, the name given, from the Greek, to the "water-cure," or the treatment of disease by water, used outwardly and inwardly. Like many descriptive names, the word "hydropathy" is defective and even misleading, the active agents in the treatment being heat and cold, of which water is little more than the vehicle, and not the only one. Thermotherapeutics (or thermotherapy) is a term less open to objection.

Hydropathy, as a formal system, dates from about 1829, when Vincenz Priessnitz (1801-1851), a farmer of Gräfenberg in Silesia, Austria, began his public career in the paternal homestead, extended so as to accommodate the increasing numbers attracted by the fame of his cures. Two English works, however, on the medical uses of water had been translated into German in the century preceding the rise of the movement under Priessnitz. One of these was by Sir John Floyer (1649-1734), a physician of Lichfield, who, struck by the remedial use of certain springs by the neighbouring peasantry, investigated the history of cold bathing, and published in 1702 his [Greek: "Psychrolousia], _or the History of Cold Bathing, both Ancient and Modern_." The book ran through six editions within a few years, and the translation was largely drawn upon by Dr J. S. Hahn of Silesia, in a work published in 1738, _On the Healing Virtues of Cold Water, Inwardly and Outwardly applied, as proved by Experience_. The other work was that of Dr James Currie (1756-1805) of Liverpool, entitled _Medical Reports on the Effects of Water, Cold and Warm, as a remedy in Fevers and other Diseases_, published in 1797, and soon after translated into German by Michaelis (1801) and Hegewisch (1807). It was highly popular, and first placed the subject on a scientific basis. Hahn's writings had meanwhile created much enthusiasm among his countrymen, societies having been everywhere formed to promote the medicinal and dietetic use of water; and in 1804 Professor Örtel of Ansbach republished them and quickened the popular movement by unqualified commendation of water drinking as a remedy for all diseases. In him the rising Priessnitz found a zealous advocate, and doubtless an instructor also.

At Gräfenberg, to which the fame of Priessnitz drew people of every rank and many countries, medical men were conspicuous by their numbers, some being attracted by curiosity, others by the desire of knowledge, but the majority by the hope of cure for ailments which had as yet proved incurable. Many records of experiences at Gräfenberg were published, all more or less favourable to the claims of Priessnitz, and some enthusiastic in their estimate of his genius and penetration; Captain Claridge introduced hydropathy into England in 1840, his writings and lectures, and later those of Sir W. Erasmus Wilson (1809-1884), James Manby Gully (1808-1883) and Edward Johnson, making numerous converts, and filling the establishments opened soon after at Malvern and elsewhere. In Germany, France and America hydropathic establishments multiplied with great rapidity. Antagonism ran high between the old practice and the new. Unsparing condemnation was heaped by each on the other; and a legal prosecution, leading to a royal commission of inquiry, served but to make Priessnitz and his system stand higher in public estimation.

Increasing popularity diminished before long that timidity which had in great measure prevented trial of the new method from being made on the weaker and more serious class of cases, and had caused hydropathists to occupy themselves mainly with a sturdy order of chronic invalids well able to bear a rigorous regimen and the severities of unrestricted crisis. The need of a radical adaptation to the former class was first adequately recognized by John Smedley, a manufacturer of Derbyshire, who, impressed in his own person with the severities as well as the benefits of "the cold water cure," practised among his workpeople a milder form of hydropathy, and began about 1852 a new era in its history, founding at Matlock a counterpart of the establishment at Gräfenberg.

Ernst Brand (1826-1897) of Berlin, Räljen and Theodor von Jürgensen of Kiel, and Karl Liebermeister (1833-1901) of Basel, between 1860 and 1870, employed the cooling bath in abdominal typhus with striking results, and led to its introduction to England by Dr Wilson Fox. In the Franco-German war the cooling bath was largely employed, in conjunction frequently with quinine; and it now holds a recognized position in the treatment of hyperpyrexia. The wet sheet pack has become part of medical practice; the Turkish bath, introduced by David Urquhart (1805-1877) into England on his return from the East, and ardently adopted by Dr Richard Barter (1802-1870) of Cork, has become a public institution, and, with the "morning tub" and the general practice of water drinking, is the most noteworthy of the many contributions by hydropathy to public health (see BATHS, ad fin.).

The appliances and arrangements by means of which heat and cold are
brought to bear on the economy are--(a) Packings, hot and cold,
general and local, sweating and cooling; (b) hot air and steam baths;
(c) general baths, of hot water and cold; (d) sitz, spinal, head and
foot baths; (e) bandages (or compresses), wet and dry; also (f)
fomentations and poultices, hot and cold, sinapisms, stupes, rubbings
and water potations, hot and cold.

(a) Packings.--The full pack consists of a wet sheet enveloping the
body, with a number of dry blankets packed tightly over it, including
a macintosh covering or not. In an hour or less these are removed and
a general bath administered. The pack is a derivative, sedative,
sudorific and stimulator of cutaneous excretion. There are numerous
modifications of it, notably the cooling pack, where the wrappings are
loose and scanty, permitting evaporation, and the application of
indefinite duration, the sheet being rewetted as it dries; this is of
great value in protracted febrile conditions. There are also local
packs, to trunk, limbs or head separately, which are derivative,
soothing or stimulating, according to circumstance and detail.

(b) Hot air baths, the chief of which is the Turkish (properly, the
Roman) bath, consisting of two or more chambers ranging in temperature
from 120° to 212° or higher, but mainly used at 150° for curative
purposes. Exposure is from twenty minutes up to two hours according to
the effect sought, and is followed by a general bath, and occasionally
by soaping and shampooing. It is stimulating, derivative, depurative,
sudorific and alterative, powerfully promoting tissue change by
increase of the natural waste and repair. It determines the blood to
the surface, reducing internal congestions, is a potent diaphoretic,
and, through the extremes of heat and cold, is an effective nervous
and vascular stimulant and tonic. Morbid growths and secretions, as
also the uraemic, gouty and rheumatic diathesis, are beneficially
influenced by it. The full pack and Turkish bath have between them
usurped the place and bettered the function of the once familiar hot
bath. The Russian or steam bath and the lamp bath are primitive and
inferior varieties of the modern Turkish bath, the atmosphere of which
cannot be too dry and pure.

(c) General baths comprise the rain (or needle), spray (or rose),
shower, shallow, plunge, douche, wave and common morning sponge baths,
with the dripping sheet, and hot and cold spongings, and are
combinations, as a rule, of hot and cold water. They are stimulating,
tonic, derivative and detergent.

(d) Local baths comprise the sitz (or sitting), douche (or spouting),
spinal, foot and head baths, of hot or cold water, singly or in
combination, successive or alternate. The sitz, head and foot baths
are used "flowing" on occasion. The application of cold by "Leiter's
tubes" is effective for reducing inflammation (e.g. in meningitis and
in sunstroke); in these a network of metal or indiarubber tubing is
fitted to the part affected, and cold water kept continuously flowing
through them. Rapid alternations of hot and cold water have a powerful
effect in vascular stasis and lethargy of the nervous system and
absorbents, yielding valuable results in local congestions and chronic
inflammations.

(e) Bandages (or compresses) are of two kinds,--_cooling_, of wet
material left exposed for evaporation, used in local inflammations and
fevers; and _heating_, of the same, covered with waterproof material,
used in congestion, external or internal, for short or long periods.
Poultices, warm, of bread, linseed, bran, &c., changed but twice in
twenty-four hours, are identical in action with the heating bandage,
and superior only in the greater warmth and consequent vital activity
their closer application to the skin ensures.

(f) Fomentations and poultices, hot or cold, sinapisms, stupes,
rubefacients, irritants, frictions, kneadings, calisthenics,
gymnastics, electricity, &c., are adjuncts largely employed.

BIBLIOGRAPHY.--Among the numerous earlier works on hydropathy, the
following are worth mention: Balbirnie, _Water Cure in Consumption_
(1847), _Hydropathic Aphorisms_ (1856) and _A Plea for the Turkish
Bath_ (1862); Beni-Barde, _Traité d'hydrothérapie_ (1874); Claridge,
_Cold Water Cure, or Hydropathy_ (1841), _Facts and Evidence in
Support of Hydropathy_ (1843) and _Cold Water, Tepid Water and
Friction Cure_ (1849); Dunlop, _Philosophy of the Bath_ (1873);
Floyer, _Psychrolousia, or the History of Cold-Bathing_, &c. (1702);
J. S. Hahn (Schweidnitz), _Observations on the Healing Virtues of Cold
Water_ (1738); Hunter, _Hydropathy for Home Use_ (1879); E. W. Lane,
_Hydropathy, or the Natural System of Medical Treatment_ (1857); R. J.
Lane, _Life at the Water Cure_ (1851); Shew, _Hydropathic Family
Physician_ (1857); Smedley, _Practical Hydropathy_ (1879); Smethurst,
_Hydrotherapia, or the Water Cure_ (1843); Wainwright, _Inquiry into
the Nature and Use of Baths_ (1737); Weiss, _Handbook of Hydropathy_
(1844); Wilson _Principles and Practice of the Cold Water Cure_ (1854)
and _The Water Cure_ (1859). A useful recent work dealing
comprehensively with the subject is Richard Metcalfe's _Rise and
Progress of Hydropathy_ (1906).

HYDROPHOBIA (Gr. [Greek: Hydor], water, and [Greek: phobos], 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.

_In Dogs, &c._--The occurrence of rabies in the fox, wolf, hyaena, jackal, raccoon, badger and skunk has been asserted; but there is every probability that it is originally a disease of the dog. It is communicated by inoculation to nearly all, if not all, warm-blooded 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 weapons--dogs 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 Wuth_).

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,
gloomy, 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, and 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
unfrequently 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 about
with its paws, and if in a room it scratches and tumbles the cushions
or rugs on which it usually lies. It is incessantly on the move,
rambling about, scratching the ground, sniffing in corners 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 any external influence it will
remain for a brief period perfectly still and attentive, as if
watching something, or following the movements of some creature on the
wall; then it will suddenly dart forward and snap at the vacant air,
as if pursuing an annoying object, or endeavouring to seize a fly. At
another time it throws itself, yelling and furious, against the wall,
as if it heard threatening voices on the other side, or was bent on
attacking an enemy. Nevertheless, the animal is still docile and
submissive, for its master's voice will bring it out of its frenzy.
But the saliva is already virulent, and the excessive affection which
it evinces at intervals, by licking the hands or face of those it
loves, renders the danger very great should there be a wound or
abrasion. Until a late period in the disease the master's voice has a
powerful influence over the animal. When it has escaped from all
control and wanders erratically abroad, ferocious and restless, and
haunted by horrid phantoms, the familiar voice yet exerts its
influence, and it is rare indeed that it attacks its master.

There is no dread of water in the rabid dog; the animal is generally
thirsty, and if water be offered will lap it with avidity, and swallow
it at the commencement of the disease. And when, at a later period,
the constriction about the throat--symptomatic of the disease--renders
swallowing difficult, the dog will none the less endeavour to drink,
and the lappings are as frequent and prolonged when deglutition
becomes impossible. So little dread has the rabid dog of water 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 symptom--either 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, horse-dung,
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 animal's 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 dog's physiognomy by
its constantly open mouth and the dark colour of the interior is
rendered still more characteristic by the dull, sad, or dead
expression of the animal's eyes. In this condition the creature is not
very dangerous, because generally it could not bite if it
tried--indeed 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-coloured fluid is witnessed in some cases, and has been
supposed to be due 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 croup--the "voix du coq," as the French have it.
A preliminary bark is made in a somewhat elevated tone and with open
mouth; this is immediately succeeded 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,
and 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 strongly attach to a dog
which does not manifest a certain susceptibility to painful
impressions and receives punishment without any cry or complaint.
There is also reason for apprehension when a dog bites itself
persistently in any part of its body. A rabid dog is usually stirred
to fury at the sight of one of its own species; this test has been
resorted to by Henrie Marie Bouley (1814-1885) to dissipate doubts as
to the existence of the disease when the diagnosis is otherwise
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
assumes the aggressive, and, if allowed, will bite furiously. All
rabid animals indeed become excited, exasperated, and furious at the
sight of a dog, and attack it with their natural weapons, even the
timid sheep when rabid butts furiously at the enemy before which in
health it would have fled in terror. This inversion of sentiment is
sometimes 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 bark, 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 briefer in trained and 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
laboured, but tranquil during the remissions. 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 objects--the most potent of these, as has been said, being
another dog, 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 danger.

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 meets--preferring 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
in 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 cases 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
tall, head inclined towards the ground, open mouth, and protruded
tongue (of a leaden colour 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 of exhaustion as great as the fits have been
violent and oft repeated. This compels the animal to stop; then it
shelters itself in obscure places--frequently in ditches by the
roadside--and 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 are speedily followed by death. During the
remission in the paroxysms these paralytic symptoms are more
particularly manifested in the hind limbs, which appear as if unable
to support the animal's weight, and cause it to stagger about; or the
lower jaw becomes more or less 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 semi-opaque; 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 animal's back were
broken, until at length it becomes general; it is then the prelude 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 consequently
wide open, showing the flaccid or swollen tongue covered with brownish
matter, and a stringy gelatinous-looking 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 be poured 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 unfrequently 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 symptoms--such
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 course--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. Dumb madness differs, then, from
the furious 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.

_In Human Beings._--The disease of hydrophobia has been known from early times, and is alluded to in the works of Aristotle, Xenophon, Plutarch, Virgil, Horace, Ovid and many others, as well as in those of the early writers on medicine. Celsus gives detailed instructions respecting the treatment of men who have been bitten by rabid dogs, and dwells on the dangers attending such wounds. After recommending suction of the bitten part by means of a dry cupping glass, and thereafter the application of the actual cautery or of strong caustics, and the employment of baths and various internal remedies, he says: "Idque cum ita per triduum factum est, tutus esse homo a periculo videtur. Solet autem ex eo vulnere, ubi parum occursum est, aquae timor nasci, [Greek: hydrophobian] Graeci appellant. Miserrimum genus morbi; in quo simul aeger et siti et aquae metu cruciatur; quo oppressis in angusto spes est." Subsequently Galen described minutely the phenomena of hydrophobia, and recommended the excision of the wounded part as a protection against the disease. Throughout many succeeding centuries little or nothing was added to the facts which the early physicians had made known upon the subject. The malady was regarded with universal horror and dread, and the unfortunate sufferers were generally abandoned by all around them and left to their terrible fate. In later times the investigations of Boerhaave, Gerard van Swieten (1700-1772), John Hunter, François Magendie (1783-1855), Gilbert Breschet (1784-1845), Virchow, Albert Reder, as also of William Youatt (1776-1847), George Fleming, Meynell, Karl Hertwig (1798-1881), and others, have furnished important information; but all these were put into the shade by the researches of Pasteur.

The disease is communicated by the secretions of the mouth of the affected animal entering a wound or abrasion of the human skin or mucous membrane. In the great majority of cases (90%) this is due to the bite of a rabid dog, but bites of rabid cats, wolves, foxes, jackals, &c. are occasionally the means of conveying the disease. Numerous popular fallacies still prevail on the subject of hydrophobia. Thus it is supposed that the bite of an angry dog may produce the disease, and all the more if the animal should subsequently develop symptoms of rabies. The ground for this erroneous notion is the fact, which is unquestionable, that animals in whom rabies is in the stage of incubation, during which there are few if any symptoms, may by their bites convey the disease, though fortunately during this early stage they are little disposed to bite. The bite of a non-rabid animal, however enraged, cannot give rise to hydrophobia.

The period of incubation of the disease, or that time which elapses between the introduction of the virus and the development of the symptoms, appears to vary in a remarkable degree, being in some cases as short as a fortnight, and in others as long as several months or even years. On an average it seems to be from about six weeks to three months, but it mainly depends on the part bitten; bites on the head are the most dangerous. The incubation period is also said to be shorter in children. The rare instances of the appearance of hydrophobia many years after the introduction of the poison are always more or less open to question as to subsequent inoculation.

When the disease is about to declare itself it not unfrequently happens that the wound, which had quickly and entirely healed after the bite, begins to exhibit evidence of irritation or inflammatory action, or at least to be the seat of morbid sensations such as numbness, tingling or itching. The symptoms characterizing the premonitory stage are great mental depression and disquietude, together with restlessness and a kind of indefinite fear. There is an unusual tendency to talk, and the articulation is abrupt and rapid. Although in some instances the patients will not acknowledge that they have been previously bitten, and deny it with great obstinacy, yet generally they are well aware of the nature of their malady, and speak despairingly of its consequences. There is in this early stage a certain amount of constitutional disturbance showing itself by feverishness, loss of appetite, sleeplessness, headache, great nervous excitability, respiration of a peculiar sighing or sobbing character, and even occasionally a noticeable aversion to liquids. These symptoms--constituting what is termed the melancholic stage--continue in general for one or two days, when they are succeeded by the stage of excitement in which all the characteristic phenomena of the malady are fully developed. Sometimes the disease first shows itself in this stage, without antecedent symptoms.

The agitation of the sufferer now becomes greatly increased, and the countenance exhibits anxiety and terror. There is noticed a marked embarrassment of the breathing, but the most striking and terrible features of this stage are the effects produced by attempts to swallow fluids. The patient suffers from thirst and desires eagerly to drink, but on making the effort is seized with a most violent suffocative paroxysm produced by spasm of the muscles of swallowing and breathing, which continues for several seconds, and is succeeded by a feeling of intense alarm and distress. With great caution and determination the attempt is renewed, but only to be followed with a repetition of the seizure, until the unhappy sufferer ceases from sheer dread to try to quench the thirst which torments him. Indeed the very thought of doing so suffices to bring on a choking paroxysm, as does also the sound of the running of water. The patient is extremely sensitive to any kind of external impression; a bright light, a loud noise, a breath of cool air, contact with any one, are all apt to bring on one of these seizures. But besides these suffocative attacks there also occur general convulsions affecting the whole muscular system of the body, and occasionally a condition of tetanic spasm. These various paroxysms increase in frequency and severity with the advance of the disease, but alternate with intervals of comparative quiet, in which, however, there is intense anxiety and more or less constant difficulty of breathing, accompanied with a peculiar sonorous expiration, which has suggested the notion that the patient barks like a dog. In many instances there is great mental disturbance, with fits of maniacal excitement, in which he strikes at every one about him, and accuses them of being the cause of his sufferings--these attacks being succeeded by calm intervals in which he expresses great regret for his violent behaviour. During all this stage of the disease the patient is tormented with a viscid secretion accumulating in his mouth, which from dread of swallowing he is constantly spitting about him. There may also be noticed snapping movements of the jaws as if he were attempting to bite, but these are in reality a manifestation of the spasmodic action which affects the muscles generally. There is no great amount of fever, but there is constipation, diminished flow of urine, and often sexual excitement.

After two or three days of suffering of the most terrible description the patient succumbs, death taking place either in a paroxysm of choking, or on the other hand in a tranquil manner from exhaustion, all the symptoms having abated, and the power of swallowing returned before the end. The duration of the disease from the first declaration of the symptoms is generally from three to five days.

Apart from the inoculation method (see below), the treatment of most avail is that which is directed towards preventing the absorption of the poison into the system. This may be accomplished by excision of the part involved in the bite of the rabid animal, or, where this from its locality is impracticable, in the application to the wound of some chemical agent which will destroy the activity of the virus, such as potassa fusa, lunar caustic (nitrate of silver), or the actual cautery in the form of a red-hot wire. The part should be thoroughly acted on by these agents, no matter what amount of temporary suffering this may occasion. Such applications should be resorted to immediately after the bite has been inflicted, or as soon thereafter as possible. Further, even though many hours or days should elapse, these local remedies should still be applied; for if, as appears probable, some at least of the virus remains for long at the injured part, the removal or effectual destruction of this may prevent the dread consequences of its absorption. Every effort should be made to tranquillize and reassure the patient.

Two special points of interest have arisen in recent years in connexion with this disease. One is the Pasteur treatment by inoculation with rabic virus (see also PARASITIC DISEASES), and the other was the attempt of the government to exterminate rabies in the British Isles by muzzling dogs.

Pasteur treatment.

The Pasteur treatment was first applied to human beings in 1885 after prolonged investigation and experimental trial on animals. It is based on the fact that a virus, capable of giving rabies by inoculation, can be extracted from the tissues of a rabid animal and then intensified or attenuated at pleasure. It appears that the strength of the rabic virus, as determined by inoculation, is constant in the same species of animal, but is modified by passing through another species. For instance, the natural virus of dogs is always of the same strength, but when inoculated into monkeys it becomes weakened, and the process of attenuation can be carried on by passing the virus through a succession of monkeys, until it loses the power of causing death. If this weakened virus is then passed back through guinea-pigs, dogs or rabbits, it regains its former strength. Again, if it be passed through a succession of dogs it becomes intensified up to a maximum of strength which is called the _virus fixe_. Pasteur further discovered that the strength can be modified by temperature and by keeping the dried tissues of a rabid animal containing the virus. Thus, if the spinal cord of a rabid dog be preserved in a dry state, the virus loses strength day by day. The system of treatment consists in making an emulsion of the cord and graduating the strength of the dose by using a succession of cords, which have been kept for a progressively diminishing length of time. Those which have been kept for fourteen days are used as a starting-point, yielding virus of a minimum strength. They are followed by preparations of diminishing age and increasing strength, day by day, up to the maximum, which is three days old. These are successively injected into the circulatory system. The principle is the artificial acquisition by the patient of resistance to the rabic virus, which is presumed to be already in the system but has not yet become active, by accustoming him gradually to its toxic effect, beginning with a weak form and progressively increasing the dose. It is not exactly treatment of the disease, because it is useless or nearly so when the disease has commenced, nor is it exactly preventive, for the patient has already been bitten. It must be regarded as a kind of anticipatory cure. The cords are cut into sections and preserved dry in sterilized flasks plugged with cotton-wool. Another method of preparing the inoculatory virus, which has been devised by Guido Tizzoni and Eugenio Centanni, consists in subjecting the _virus fixe_ to peptic digestion by diluted gastric juice for varying periods of time.

The first patient was treated by Pasteur's system in July 1885. He was successively inoculated with emulsions made from cords that had been kept fourteen and ten days, then eleven and eight days, then eight, seven, six days, and so on. Two forms of treatment are now used--(1) the "simple," in which the course from weak to strong virus is extended over nine days; (2) the "intensive," in which the maximum is reached in seven days. The latter is used in cases of very bad bites and those of some standing, in which it is desirable to lose no time. Two days are compressed into one at the commencement by making injections morning and evening instead of once a day, so that the fifth-day cord is reached in four days instead of six, as in the "simple" treatment. When the maximum--the third-day cord--is reached the injections are continued with fifth-, fourth-, and third-day cords. The whole course is fifteen days in the simple treatment and twenty-one in the intensive. The doses injected range from 1 to 3 cubic centimetres. Injections are made alternately into the right and left flanks. The following table shows the number treated from 1886 to 1905, with the mortality.

+------+--------+-------+---------+
| Year.|Patients|Deaths.|Mortality|
| |Treated.| |per cent.|
+------+--------+-------+---------+
| 1886 | 2671 | 25 | .94 |
| 1887 | 1770 | 14 | .79 |
| 1888 | 1622 | 9 | .55 |
| 1889 | 1830 | 7 | .38 |
| 1890 | 1540 | 5 | .32 |
| 1891 | 1559 | 4 | .25 |
| 1892 | 1790 | 4 | .22 |
| 1893 | 1648 | 6 | .36 |
| 1894 | 1387 | 7 | .50 |
| 1895 | 1520 | 5 | .33 |
| 1896 | 1308 | 4 | .30 |
| 1897 | 1521 | 6 | .39 |
| 1898 | 1465 | 3 | .20 |
| 1899 | 1614 | 4 | .25 |
| 1900 | 1419 | 10 | .70 |
| 1901 | 1318 | 5 | .37 |
| 1902 | 1105 | 2 | .18 |
| 1903 | 630 | 4 | .65 |
| 1904 | 757 | 5 | .66 |
| 1905 | 727 | 4 | .54 |
+------+--------+-------+---------+