Of the Mad DOG.
Moredifficult and terrifying are the Symptoms from the Bite of aMad Dog, whose Venom has this also surprising in it, that the bad Effects do not appear oftentimes till the Cause of ’em is forgot; for the Wound is as easily cured as a common Bite is; but nevertheless a considerable time after, a melancholy Tragedy succeeds, sometimes sooner, sometimes later; for there are Instances of its being deferred to Two,(70)Six Months, nay, a Year, and longer, tho’ the attack is generally within Forty Days after the Wound; about that time, the Patient complains of Running Pains all over his Body, especially near the Part wounded, like unto those in a Rheumatism, grows pensive and sad, prone to Anger upon little or no Occasion, with an intermitting Pulse, Tremblings and Contractions of theNerves,with a great inward Heat and Thirst; and yet in a few Days (when the Disease is come to its height) a Dread and Fear of Water, and any Liquor whatsoever; so that at the very sight of it he falls into dismal Convulsions and Agonies, and cannot drink the least drop; and thisHydrophobia, orAquæ Timor, has been always accounted the surest Sign and Mark of this Poison, as distinguishing it from all others.
The Ancients have at large described these Symptoms, asGalen,Dioscorides,Aetius,Ægineta, but most particularly of all,Cælius Aurelianus(71); and later Writers have given us several Instances of theHydrophobia; Two Histories of it published, the one by Dr.Lister(72), the other by Dr.Howman(73), I shall more especially take Notice of, and refer to, as containing the most exact and large Account of any I have met with; he that desires more, may consult the several Authors cited by that diligent Observer,Stalpart van der Wiel(74).
That this Disease is accompany’d with aDelirium, is almost the common Opinion both of Ancients and Moderns;Damocratescalled it the barking Phrensie(75); but Dr.Listeragrees in this Point withPetrus Salius Diversus(76), and will not allow aDeliriumto be the necessary consequent of this Venom; and yet at the same time he tells us, that his Patient barked like a Dog, and bit at the By-standers; that he threw into his Mouth what was given him more hastily and suddenly than it is Natural or Customary for Men to do.
From such Actions as these, together with those mentioned before in relating the Symptoms, it is obvious enough to conclude, that Persons thus affected are in a proper SenceDelirous. Tho’ at the same time I do think that theHydrophobiait self (whatever is commonly believed) does not at all proceed from thisDelirium, as will by and by appear.
I know indeed that the main and plausibleObjectionagainst aDeliriumis this, that the Patient himself does Reason against his Timorousness, tho’ he cannot overcome it, forewarns the Standers-by of his Outrageous Fits, desires them to take care of themselves, and the like. Which from what I have already said concerning aDelirium, appears to be very consistent with it, nay, convinces that there is the greatest Degree of it in this Case; in as much as that it is not a Distemper of the Mind but of the Body. And to this purpose I remember to have seen my self an Instance of one in a Fever, who foretold some time before any signs of aDeliriumwere discovered, how raving and unruly He should be, and made good hisPrognostickto that degree, that it was very hard Work to tame and master him; tho’, as he told me afterwards, he reason’d as much as he could against that groundless Jealousie of his Friends designing to Murder him, which put him upon his Mad Actions, but was not able to Conquer the prevailingSpeciesof Fear and Anger.
ThisDeliriumtherefore, asCælius Aurelianus(77)says,Proceeds intirely from an indisposition of the Body, which is without all doubt owing to the alteration made in the Blood by theSalivaof theMad Dog, instill’d into the Wound inflicted by the Bite.
That we may rightly understand this, we must take Notice, that theRabiesor Madness in a Dog is the effect of a Violent Fever; and therefore it is most common in excessive Hot Weather, tho’ sometimes intense Cold maybe the Cause of it; That no Dog in this Case ever sweats; from whence it follows, that when his Blood is in a Ferment, it cannot, as in other Creatures, discharge it self upon the surface of the Body, and therefore must of necessity throw out a great manySalineand Active Particles upon those Parts, where there is the most constant and easie Secretion; and such, next to theMiliaryin the Skin in Us, are theSalivalGlands; for this reason much more Spittle is separated in a Dog when Mad, than at any other time, and that very frothy, or impregnated with Hot, Subtil Parts.
Now as we every Day observe, that what is thrown out from Liquors in a Ferment, is capable of inducing the like Motion in another Liquor of the same kind, when duly mixed with it; so we may very well suppose in the present Case, that theSaliva, which is it self one of the most Fermentative Juices in Nature, being turgid with Fiery, Saline Particles thrown into it out of the boiling Blood, when it comes by means of a Wound to be Incorporated with the Arterial Fluid of any One, does by Degrees raise a preternatural Effervescence in it; the Effects of which will necessarily be most felt in those Parts which being tender, are the least able to refill the distension of the Blood Vessels; such are the Stomach, and especially the Brain; and hereuponDeliria, withManiacal, and such like Symptoms, will easily insue.
A Person thus affected may be said in a Degree to have put on theCanineNature, tho’ his Reason be all this time untouch’d and intire, may Bite, Howl,&c.because thelikeviolent Agitation of the Blood in Him as was in the Dog will present likeSpecies, and consequently (so far as their different Natures will allow) produce like Actions; just as it has been observed, thatSheepbitten by a Mad Dog, have run at the Shepherd like so many Dogs to Bite him; so much can an Alteration of the Blood and Spirits do. And as a Timorous Creature may be imboldened, so we oftentimes see Persons Courageous enough by a change made in the Blood by Evacuations, that is, by want of Force and Motion in that Fluid, made sheepish Cowards, in despight of their Reason, so long as that Defect is continued.
But the main difficulties in this matter are, the Mischief discovering it self so long after the Bite, and theHydrophobia.
As to the former, we are to consider, that Fermentation being a Change made in the Cohæsion of the compounding Parts of a Fluid, it is sometimes a longer, sometimes a shorter time before this Alteration is wrought; which variety may proceed either from the different Nature and Constitution of the Ferment, or of the Liquor Fermented, and a great Number of Circumstances besides. So that this Venom may be all the while doing its Work, tho’ the change made by it may not be so considerable as to be sensibly taken Notice of till a long time after.
Nay, it may so happen, that theFermentbeing Weak may not raise in the Blood any remarkable Agitation at all, till some accidental Alteration in the Body unluckily gives it an additional Force. As we before observed, how much external Heat concurrs to heighten the Symptoms from the Bite of theTarantula. And this probably may be the Case of Those in whom this Malignity has not appear’d till Six, or Twelve Months after the Wound.
That we may understand the Reason of theHydrophobia, it is to be Remarked, that this dread of Water does not come on till the latter end of the Disease, Three or Four Days before Death; that is, not till this preternaturalFermentationin the Blood is come to its Heigth; and as in the Dog, so in the Patient, a great quantity of Fermentative Particles is thrown off upon the Glands of the Mouth and Stomach, as appears by his Foaming at the Mouth,&c.
As also, that thisFearis not from a sightof, or any imaginary appearanceinthe Water, for if the Vessel be close shut, and the Patient bid to suck thro’ a Quill, as soon as he has tasted, he falls into Anguish and Convulsions, as Dr.Listerobserved. It is therefore highly probable, if not certain, that this surprising Symptom proceeds from the intolerablePainwhich any Liquor at this time taken induces, partly by hurting the inflamed Membranes of theFaucesin Deglutition; partly by fermenting with these Active Particles discharged by the Blood upon theStomachicGlands, and thus twitching and irritating the Nervous Membranes; the very memory of whichgrievous Sence, after it is once felt, is so terrible, that the affected Person chuses any thing rather than to undergo it a second time.
The Effects of thisIrritationare manifest in the Convulsions of the Stomach, and frequentSingultus, with which the Patient is continually oppress’d. And we all know by how necessary a kind ofMechanismwe do fly from and abhor those things which have proved disagreeable to theAnimal Œconomy, to which nothing is so contrary and repugnant asPain; at the first Approaches of which, Nature Starts and Recoils, tho’ Reason be arm’d with never so much Courage and Resolution to undergo the Shock.
Nor will any Body wonder how thisFermentshould cause suchTorment, who considers how often, even inColicalCases, Persons are downright distracted by excessive Pain, from a Cause not unlike to this we are treating of, that is, from a corrosive Ferment in the Bowels, rarefying the Juices there intoFlatus, and by this means irritating and stimulating those tender Membranes into Spasmodic and Convulsive Motions.
And indeed Dr.Lister’s Patient told him, that the very swallowing of his own Spittle put him to such Torture in his Stomach, that Death it self was not so Terrible as the Inexpressible Agony.
It may serve both to Illustrate and Confirm this Theory, to take Notice, that not only may (according to these Principles) other Bites besides that of aDoghappen to induce the like Symptoms; thusMalpighi(78)relates a Story of a Mother madeHydrophobaby the Bite of herEpilepticDaughter; but that there are other Cases, without any Bite at all, which are attended with anHydrophobia.
ThusSchenkius(79),Salmuth(80)and others have observ’d aDread of Water, without any Suspicion of a Bite, fromMalignant Fevers. Now inThesethere is doubtless a Hot, PutridFermentin the Blood; and it is no wonder if Part of it be discharged upon the Throat and Stomach, which we do evidently find in these Distempers to be more particularly affected by It, especially towards the latter End, from theAphthæ,Singultus, and the like usual Symptoms of a fatal Malignity.
Nay,Hippocrates(81)himself seems more than once to have remarked something like this Symptom in Fevers, and to call those who were thus affected Βραχυπόται, or little Drinkers; for I cannot assent to Dr.Lister, (tho’Cælius Aurelianusbe on his side) who thinks that the Βραχυπόται are ὑδροφόβοι, from the Bite of a Mad Dog; as well for other Reasons, as becausePlutarch(82)assures Us, that theHydrophobiaandElephantiasiswere both first taken Notice of in the time ofAsclepiadesthe Physician; who liv’d in the Days ofPompeythe Great, many Years later than eitherHippocratesorAristotle.
Neither is it amiss to add, thatIoannes Faber(83)in the Dissection of one who dy’d atRomeof the Bite of a Mad Dog, and aHydrophobiasucceeding it, found the BloodCoagulatedin the right Ventricle of the Heart, the Lungs wonderfullyRedandTumefied; but especially theThroat,Stomach, andBowels, bearing the Marks of the Inflammatory Venom.
The same Observation has been made by others in Bodies Dead of this Disease. Thus theActa Medica Hafniensia(84)relate one Case, in which, part of the Liver wasInflamed, the Lungs Parched and Dry, and the inner Coat of theStomachsoMortified, that it might be abraded with one’s Fingers.
Bonetus(85)tellsanother, where all theViscerawere found quitearid, without any Juice at all.
And in a very particular History of anHydrophobia, lately published atUlm,(86)We are informed, that theStomach, when opened, discover’d the Marks of anErosionor Excoriation, with somethinglikea Gangrene, and Suffusion of Blood here and there. Which does very well agree with the Observations in theGerman Ephemerides(87), where we find severalFootstepsof aSphacelusor Mortification in the Bodies of Those who diedHydrophobi.
The Cure of this Poison is either immediately upon the Wound made, or some Days after, before the Fear of Water is discover’d; for at that time all Authors do agree the Malady to be Incurable; and the Reason is plain from what has been already deliver’d.
As in other Venomous Bites, so in this,Galen(88)very wisely advises to inlarge the Wound, by making a round Incision about it, to Cauterise it with a hot Iron, and apply drawing Medicines, so as to keep it a running Ulcer at least Forty Days.(89)ScarifyingandCuppingmay answer where this Severity is not allow’d: And however, the Dressing it withUnguentum Ægyptiacum(or the like) Scalding Hot, must not be omitted; by which alone, timely applied, I am assured that one Bitten was happily preserved.
But where these Means of destroying the Ferment in the beginning are omitted, the dangerous Consequences of its being mixed with the Blood is by all possible Care to be prevented.
To this purpose, to say nothing of the many Inconsiderate Jumbles ofAntidotes,Theriacas, &c. nor of such vulgar Trifles as theLiverof the Mad Dog, of whichGalen(90)observed, that tho’ some who made use of it, together with other good Medicines, recover’d, yet that they who trusted to it alone died; one of the greatest Remedies commended to us by Antiquity, is theCineres Cancrorum Fluviatilium; whichGalen(91)says, no Body ever made use of, and miscarried; and before HimDioscorides(92)assured, that ’tis a Medicine may be rely’d on. These were given in large Quantities,viz.a good Spoonful or Two every Day for Forty Days together, either alone, or rather mix’d with the Powder ofGentian RootandFrankincense. TheVehiclewas either Water or Wine. In like manner at this Day the Remedy in the greatest Repute of any against most Poisons in theWest-Indies, is a kind of aRiver-Craw-Fish, call’dAratu(93).
This is manifestly anAbsorbent, and veryDiureticMedicine, especially when prepared after the right manner, which was by Burning the Craw-Fish alive upon aCopper-Plate, with a Fire made of the Cuttings or Twigs ofWhite Briony: For whether the latter part of the Management signifies much or no, the former most certainly does; and theSaltof theCopper, which powerfully provokes Urine, being mix’d with that of theAshes, may very much exalt their Virtue.
And it is upon this same Score, that theSpongiaof theCynnorrhodosorRosa Sylvestrisis so Celebrated an Antidote, not only for this Poison, but also for that of the Viper,Tarantula, and others too, that ’tis call’d inSicily Sanatodos, or All-heal; this being not aVegetable, asP. Boccone(94)who has wrote a whole Letter of its wondrous Virtues, terms it, but anAnimal Alkali, as well as the former; for as Mr.Ray(95)has observed,thisSpongy Excrescence, if it be cut, is found full of White Worms; Being the Nest of these Insects, which lodging here all the Winter, do in the beginning of the Spring turn to Flies, and quit their Quarters. Indeed this Remedy was antiently too of so great Esteem, thatPlinyrecommends it as the only Cure of anHydrophobia, divinely discovered by an Oracle(96).
As all Insects abound with a Diuretick Salt, soCantharidesmore than any others; therefore the LearnedBacchius(97)goes farther, and from the Authority ofRhazesandJoannes Damascenus, advises to give these in Substance for many Days together. The Preparation of this Antidote, (so he calls it) is by infusing theCantharidesin Soure Butter-milk Twenty Four Hours, then drying them, and with the Flower of Lentils and Wine making them up intoTrochesof a Scruple Weight, of which one is to be taken every Day, By which means he assures us, that tho’ the Patient make bloody Urine, yet that Milk largely drank will abate that Symptom, and that anHydrophobiawill be happily prevented.Boccone(98)tells Us, That inUpper HungaryThey giveCantharidesto Men bitten by a Mad Dog,Fiveto a Dose; and toBeastsin greater Quantity. But of the inward Use of these Flies more in its proper Place.
In short, all theSpecificsin this Case are such as do either absorb a peccantAcidityin the Stomach, or carry it off by Urine; asTerra Lemnia, highly commended byGalen(99),Garlick,Agrimony,Oxylapathum, and many others, of which a Catalogue may be seen inS. Ardoynus. So theAlyssumor Madwort, celebrated for this use by the Ancient Physicians, as wellthatdescribed byDiascorides, which is a Species ofLeucoium, as the other ofGalen, which is aMarrubium, is very manifestly a Bitter, Stomachic, and Diuretic Plant(100). TheLichen cinereus terrestris, recommended in the Philosophical Transactions(101), Operates the same way.
But the greatest and surest Cure of all, is frequentSubmergingor Ducking the Patient in Water. The first mention I find of this is inCornelius Celsus(102); whether he had it from the AncientGrecianPhysicians, or it was the Discovery of his own Age, matters but little to our Purpose; certain it is, that he collected his Principal Rules of Bathing fromCleophantus, who, asPlinysays(103), did, besides many other delightful things, first introduce the Use of Baths; As appears by comparing the Writings of theOnewith the Fragments of theOther, preserv’d in the Works ofGalen. And that fromAsclepiades, who afterwards so far improved this Part of Physick, that he discarded almost all inward Medicines, he might learn this Management, is not improbable; for theHydrophobia(as we before took Notice) having been first regarded in the time of this great Physician, ’tis very likely that among other Advantages of his new Method, he might commend it for the Cure of so deplorable a Malady.
However it be, This Practice was in this last Age with great Authority revived by the IngeniousBaron Van Helmont(104), who having in his own Country seen how great Service it did, has at large set down both the manner of the Operation; and, Consonant to the Principles of his own Philosophy, shewn the Reason of its good Effects. Since himTulpius(105), an Observer of very good Credit, takes notice, that tho’ he saw many, yet that never one miscarry’d, where it was in time made use of.
As all Baths do chiefly act by the sensible Qualities of Heat and Cold, and the Gravity of their Fluid; so we need go no farther to fetch the Reason of the great Advantage of this Method in the present Case, than to the Pressure of the Water upon the Body of the Patient.
Every one knows how plentifully plunging into cold Water provokes Urine, which proceeds no doubt from the constriction hereby made of the Fibres of the Skin and Vessels. Thus this outward Cure differs not much in effect from the inward Medicines beforementioned, but must necessarily have the better of them in this Respect, that when the Fermenting Blood stretches its Vessels, the exceeding weight of the ambient Fluid resists and represses this Distension, and so prevents the Effects of It. For this Reason the Salt Water of the Sea is especially chosen for this Business, because its greater Gravity than that of Fresh does more powerfully do all this, and break the beginning Cohæsion of the Parts of the Blood.
Thus we may, without having recourse to theFrightandTerror, with which this Method, when rightly practis’d, (by keeping the Party under Water for a considerable time, till he is almost quite drowned) is usually accompanied, probably enough account for the Advantages of this Immersion. Tho’ it is not unlikely that this new Fear may have some good Effect in the Case too, for not only Convulsions, but Agues, and other Diseases, have oftentimes been happily Cured, merely by terrifying and surprising the Patient.
The Reason of this will easily be understood by him who knows what Alterations the Passions of the Mind do make in the Fluid of the Nerves and Arteries; of which in another Place.
It may for our present purpose suffice to take Notice, That as in Consideration of the last mentioned Effect upon the Mind,Van Helmontcommends this same Practice in all Sorts of Madness, and ChronicalDeliria; so upon the account of the before hinted Alterations on the Body, Bathing was, among the Ancients, the common Cure of Melancholy, and such like Distempers(106). And as the youngerVan Helmont(107)to confirm his Father’s Notions, tells Us, that one Dr.Richardsondid with wonderful Success make use of this Management in these Cases, so in like mannerProsper Alpinus(108)takes Notice, that theEgyptiansdo at this Day perfectly recover Melancholy Persons by the same Method, only with this Difference, that they make their Baths warm.
He that compares what has been already advanc’d concerningDeliria, with theBellinianTheory of Melancholy and Maniacal Distempers, and reflects upon the Nature of Baths, and their manner of Acting, will see so much Reason in this Practice, as to be sorry that ’tis now-a-days almost quite laid aside and neglected. For we must observe, that altho’ there be some Difference in the Treatment and Cure ofDeliria, whether Maniacal or Melancholy, when they are Originally from the Mind, as the Effects of Care, Trouble, or the like, and when from an Indisposition of the Body; yet that both do agree in this, that they require an Alteration to be made in the Blood and Spirits; inasmuch as the Mind, by often, nay, almost continually, renewing to it self any oneIdea, of Love, Sorrow,&c.does so constantly determine the Spirits and Blood, one and the same way, that the Body does at last as much share in the Alteration, as if it had been primarily affected, and consequently must have, in some manner, the same Amendment. Upon this ScoreBaccius(109)asserts the admirable Use of Temperate Baths, in all kind of Distractions; and assures us, that not only commonDeliria, but even theDæmoniaci,Phanatici,Lycanthropithemselves,&c.are cured by frequent Washings in fresh Water, and a moist and Nourishing Diet.
But to insist upon this Subject is foreign to our purpose; only in regard that the most usual Methods of Cure in these Cases are so very tedious, and oftentimes unsuccessful at the last, I thought it not amiss to hint thus much, in order to the advancing something more Certain and Effectual towards the Removal of the greatest Unhappiness to which Mankind is liable.
To conclude with theHydrophobia; where these Remedies fail, or are Administred too late, the Patient, from the prevailing inflammatory Disposition of the Blood, grows more and moreDelirous, and by Degrees downright raving Mad, at last (as it most commonly happens in Maniacal People) suffers a total Resolution of Strength, and Dies. Thus Dr.Howna’s Case ended in a perfect universalParalysis.