In
May, 1820, I attended on a bitch at Pimlico. She had snapped at the owner, bitten the man-servant and several dogs, was eagerly watching imaginary objects, and had the peculiar rabid howl. I offered her water. She started back with a strange expression of horror, and fell into violent convulsions that lasted about a minute. This was repeated a little while afterwards, and with the same result. She was destroyed.
The horrible spasms of the human being at the sight of, or the attempt to swallow, fluids occur sufficiently often to prove the identity of the disease in the biped and the quadruped; but not in one in fifty cases is there, in the dog, the slightest reluctance to liquids, or difficulty in swallowing them.
In
almost every case in which the dog utters any sound during the disease, there is a manifest change of voice. In the dog labouring under ferocious madness, it is perfectly characteristic. There is no other sound that it resembles. The animal is generally standing, or occasionally sitting, when the singular sound is heard. The muzzle is always elevated. The commencement is that of a perfect bark, ending abruptly and very singularly, in a howl, a fifth, sixth, or eighth higher than at the commencement. Dogs are often enough heard howling, but in this case it is the perfect bark, and the perfect howl rapidly succeeding to the bark.
Every sound uttered by the rabid dog is more or less changed. The huntsman, who knows the voice of every dog in his pack, occasionally hears a strange challenge. He immediately finds out that dog, and puts him, as quickly as possible, under confinement. Two or three days may pass over, and there is not another suspicious circumstance about the animal; still he keeps him under quarantine, for long experience has taught him to listen to that warning. At length the disease is manifest in its most fearful form.
There is another partial change of voice, to which the ear of the practitioner will, by degrees, become habituated, and which will indicate a change in the state of the animal quite as dangerous as the dismal howl; I mean when there is a hoarse inward bark, with a slight but characteristic elevation of the tone. In other cases, after two or three distinct barks, will come the peculiar one mingled with the howl. Both of them will terminate fatally, and in both of them the rabid howl cannot possibly be mistaken.
There is a singular brightness in the eye of the rabid dog, but it does not last more than two or three days. It then becomes dull and wasted; a cloudiness steals over the conjunctiva, which changes to a yellow tinge, and then to a dark green, indicative of ulceration deeply seated within the eye. In eight and forty hours from the first clouding of the eye, it becomes one disorganised mass.
There is in the rabid dog a strange embarrassment of general sensibility — a seemingly total loss of feeling.
Absence of pain in the bitten part is an almost invariable accompaniment of rabies. I have known a dog set to work, and gnaw and tear the flesh completely away from his legs and feet. At other times the penis is perfectly demolished from the very base. Ellis in his
Shepherd's Sure Guide
, asserts, that, however severely a mad dog is beaten, a cry is never forced from him. I am certain of the truth of this, for I have again and again failed in extracting that cry. Ellis tells that at the kennel at Goddesden, some of the grooms heated a poker red hot, and holding it near the mad hound's mouth, he most greedily seized it, and kept it until the mouth was most dreadfully burned.
In the great majority of cases of furious madness, and in almost every case of dumb madness, there is evident affection of the lumbar portion of the spinal cord. There is a staggering gait, not indicative of general weakness, but referable to the hind quarters alone, and indicating an affection of the lumbar motor nerve. In a few cases it approaches more to a general paralytic affection.
In the very earliest period of rabies, the person accustomed to dogs will detect the existence of the disease.
The animal follows the flight, as has been already stated, of various imaginary objects. I have often watched the changing countenance of the rabid dog when he has been lost to every surrounding object. I have seen the brightening countenance and the wagging tail as some pleasing vision has passed before him; but, oftener has the countenance indicated the mingled dislike and fear with which the intruder was regarded. As soon as the phantom came within the proper distance he darted on it with true rabid violence.
A
spaniel
, seemingly at play, snapped, in the morning, at the feet of several persons. In the evening he bit his master, his master's friend, and another dog. The old habits of obedience and affection then returned. His master, most strangely, did not suspect the truth, and brought the animal to me to be examined. The animal was, as I had often seen him, perfectly docile and eager to be caressed. At my suggestion, or rather entreaty, he was left with me. On the following morning the disease was plain enough, and on the following day he died. A
post-mortem
examination took place, and proved that he was unequivocally rabid.
A
lady
would nurse her dog, after I had declared it to be rabid, and when he was dangerous to every one but herself, and even to her from the saliva which he plentifully scattered about. At length he darted at every one that entered the room, until a footman keeping the animal at bay with the poker, the husband of the lady dragged her from the room. The noise that the dog made was then terrific, and he almost gnawed his way through the door. At midnight his violence nearly ceased, and the door was partially opened. He was staggering and falling about, with every limb violently agitated. At the entreaty of the lady, a servant ventured in to make a kind of bed for him. The dog suddenly darted at him, and dropped and died.
A
terrier
, ten years old, had been ill, and refused all food for three days. On the fourth day he bit a cat of which he had been unusually fond, and he likewise bit three dogs. I was requested to see him. I found him loose in the kitchen, and at first refused to go in, but, after observing him for a minute or two, I thought that I might venture. He had a peculiarly wild and eager look, and turned sharply round at the least noise. He often watched the flight of some imaginary object, and pursued with the utmost fury every fly that he saw. He searchingly sniffed about the room, and examined my legs with an eagerness that made me absolutely tremble. His quarrel with the cat had been made up, and when he was not otherwise employed he was eagerly licking her and her kittens. In the excess or derangement of his fondness, he fairly rolled them from one end of the kitchen to another. With difficulty I induced his master to permit me to destroy him.
It
is not every dog, that in the most aggravated state of the disease shows a disposition to bite. The finest Newfoundland dog that I ever saw became rabid. He had been bitten by a cur, and was supposed to have been thoroughly examined in the country. No wound, however, was found: the circumstance was almost forgotten, and he came up to the metropolis with his master. He became dull, disinclined to play, and refused all food. He was continually watching imaginary objects, but he did not snap at them. There was no howl, nor any disposition to bite. He offered himself to be caressed, and he was not satisfied except he was shaken by the paw. On the second day I saw him. He watched every passing object with peculiar anxiety, and followed with deep attention the motions of a horse, his old acquaintance; but he made no effort to escape, nor evinced any disposition to do mischief. I went to him, and patted and coaxed him, and he told me as plainly as looks and actions, and a somewhat deepened whine could express it, how much he was gratified. I saw him on the third day. He was evidently dying. He could not crawl even to the door of his temporary kennel; but he pushed forward his paw a little way, and, as I shook it, I felt the tetanic muscular action which accompanies the departure of life.
On the other hand there are rabid dogs whose ferocity knows no bounds. If they are threatened with a stick, they fly at, and seize it, and furiously shake it. They are incessantly employed in darting to the end of their chain, and attempting to crush it with their teeth, and tearing to pieces their kennel, or the wood work that is within their reach. They are regardless of pain. The canine teeth, the incisor teeth are torn away; yet, unwearied and insensible to suffering, they continue their efforts to escape. A dog was chained near a kitchen fire. He was incessant in his endeavours to escape, and, when he found that he could not effect it, he seized, in his impotent rage, the burning coals as they fell, and crushed them with his teeth.
If by chance a dog in this state effects his escape, he wanders over the country bent on destruction. He attacks both the quadruped and the biped. He seeks the village street, or the more crowded one of the town, and he suffers no dog to escape him. The horse is his frequent prey, and the human being is not always safe from his attack. A
rabid
dog running down Park-lane, in 1825, bit no fewer than five horses, and fully as many dogs. He was seen to steal treacherously upon some of his victims, and inflict the fatal wound. Sometimes he seeks the more distant pasturage. He gets among the sheep, and more than forty have been fatally inoculated in one night. A rabid dog attacked a herd of cows, and five-and-twenty of them fell victims. In July, 1813, a mad dog broke into the menagerie of the Duchess of York, at Oatlands, and although the palisades that divided the different compartments of the menagerie were full six feet in height, and difficult, or apparently almost impossible to climb, he was found asleep in one of them, and it was clearly ascertained that he had bitten at least ten of the dogs.
At length the rabid dog becomes completely exhausted, and slowly reels along the road with his tail depressed, seemingly half unconscious of surrounding objects. His open mouth, and protruding and blackened tongue, and rolling gait sufficiently characterise him. He creeps into some sheltered place and then he sleeps twelve hours or more. It is dangerous to disturb his slumbers, for his desire to do mischief immediately returns, and the slightest touch, or attempt to caress him, is repaid by a fatal wound. This should be a caution never to meddle with a sleeping dog in a way-side house, and, indeed, never to disturb him anywhere.
In an early period of the disease in some dogs, and in others when the strength of the animal is nearly worn away, a peculiar paralysis of the muscles of the tongue and jaws is seen. The mouth is partially open, and the tongue protruding. In some cases the dog is able to close his mouth by a sudden and violent effort, and is as ferocious and as dangerous as one the muscles of whose face are unaffected. At other times the palsy is complete, and the animal is unable to close his mouth or retract his tongue. These latter cases, however, are rare.
A dog must not be immediately condemned because he has this open mouth and fixed jaw. Bones constitute a frequent and a considerable portion of the food of dogs. In the eagerness with which these bones are crushed, spicula or large pieces of them become wedged between the molar teeth, and form an inseparable obstacle to the closing of the teeth. The tongue partially protrudes. There is a constant discharge of saliva from the mouth, far greater than when the true paralysis exists. The dog is continually fighting at the corners of his mouth, and the countenance is expressive of intense anxiety, although not of the same irritable character as in rabies.
I was once requested to meet a medical gentleman in consultation respecting a supposed case of rabies. There was protrusion and discoloration of the tongue, and fighting at the corners of the mouth, and intense anxiety of countenance. He had been in this state for four-and-twenty hours. This was a case in which I should possibly have been deceived had it been the first dog that I had seen with dumb madness. After having tested a little the ferocity or manageableness of the animal, I passed my hand along the outside of the jaws, and felt a bone wedged between two of the grinders. The forceps soon set all right with him.
It is
time
to inquire more strictly into the
post-mortem
appearances of rabies in the dog.
In dumb madness the unfailing accompaniment is, to a greater or less degree, paralysis of the muscles of the lower jaw, and the tongue is discoloured and swollen, and hanging from the mouth; more blood than usual also is deposited in the anterior and inferior portion of it. Its colour varies from a dark red to a dingy purple, or almost black. In ferocious madness it is usually torn and bruised, or it is discoloured by the dirt and filth with which it has been brought into contact, and, not unfrequently, its anterior portion is coated with some disgusting matter. The papillæ, or small projections on the back of the tongue, are elongated and widened, and their mucous covering evidently reddened. The orifices of the glands of the tongue are frequently enlarged, particularly as they run their course along the frœnum of the tongue.
The fauces, situated at the posterior part of the mouth, generally exhibit traces of inflammation. They appear in the majority of cases of ferocious madness, and they are never deficient after dumb madness. They are usually most intense either towards the palatine arch or the larynx. Sometimes an inflammatory character is diffused through its whole extent, but occasionally it is more or less intense towards one or both of the terminations of the fauces, while the intermediate portion retains nearly its healthy hue.
There is one circumstance of not unfrequent occurrence, which will at once decide the case — the presence of indigestible matter, probably small in quantity, in the back part of the mouth. This speaks volumes as to the depraved appetite of the patient, and the loss of power in the muscles of the pharynx.
Little will depend on the tonsils of the throat. They occasionally enlarge to more than double their usual size; but this is more in quiet than in ferocious madness. The insatiable thirst of the rabid dog is perhaps connected with this condition of them.
The epiglottis should be very carefully observed. It is more or less injected in every case of rabies. Numerous vessels increase in size and multiply round its edge, and there is considerable injection and thickening.
Inflammation of the edges of the glottis, and particularly of the membrane which covers its margin, is often seen, and accounts for the harsh guttural breathing which frequently accompanies dumb madness. The inflammatory blush of the larynx, though often existing in a very slight degree, deserves considerable attention.
The appearances in the trachea are very uncertain. There is occasionally the greatest intensity of inflammation through the whole of it; at other times there is not the slightest appearance of it. There is the same uncertainty with regard to the bronchial tubes and the lungs; but there is no characteristic symptom or lesion in the lungs.
Great stress has been laid on the appearance of the heart; but, generally speaking, in nine cases out of ten, the heart of the rabid dog will exhibit no other symptoms of disease than an increased yet variable deepness of colour in the lining membrane of the ventricles. No dependence can be placed on any of the appearances of the œsophagus; and, when they are at the worst, the inflammation occupies only a portion of that tube.
With regard to the interior of the stomach, if the dog has been dead only a few hours the true inflammatory blush will remain. If four-and-twenty hours have elapsed, the bright red colour will have changed to a darker red, or a violet or a brownish hue. In a few hours after this, a process of corrosion will generally commence, and the mucous membrane will be softened and rendered thinner, and, to a certain extent, eaten through. The examiner, however, must not attribute that to disease which is the natural process of the cession of life.
Much attention should be paid to the appearance of the stomach and its contents. If it contains a strange mingled mass of hair, and hay, and straw, and horse-dung, and earth, or portions of the bed on which the dog had lain, we should seldom err if we affirmed that he died rabid; for it is only under the influence of the depraved appetite of rabies that such substances are devoured. It is not the presence of every kind of extraneous substance that will be satisfactory: pieces of coal, or wood, or even the filthiest matter, will not justify us in pronouncing the animal to be rabid; it is that peculiarly mingled mass of straw, and hair, and filth of various kinds, that must indicate the existence of rabies.
When there are no solid indigesta, but a fluid composed principally of vitiated bile or extravasated blood, there will be a strong indication of the presence of rabies. When, also, there are in the duodenum and jejunum small portions of indigesta, the detection of the least quantity will be decisive. The remainder has been ejected by vomit; and inquiry should be made of the nature of the matter that has been discharged.
The
inflammation of rabies is of a peculiar character in the stomach. It is generally confined to the summits of the folds of the stomach, or it is most intense there. On the summits of the rugæ there are effusions of bloody matter, or spots of ecchymosis, presenting an appearance almost like crushed black currants. There may be only a few of them; but they are indications of the evil that has been effected.
From appearances that present themselves in the intestines, the bladder, the blood-vessels, or the brain, no conclusion can be drawn; they are simply indications of inflammation.
We
now rapidly, and for a little while, retrace our steps. What is the cause of this fatal disease, that has so long occupied our attention? It is the saliva of a rabid animal received into a wound, or on an abraded surface. In horses, cattle, sheep, swine, and the human being, it is caused by inoculation alone; but, according to some persons, it is produced spontaneously in other animals.
I will suppose that a wound by a rabid dog is inflicted. The virus is deposited on or near its surface, and there it remains for a certain indefinite period of time. The wound generally heals up kindly; in fact, it differs in no respect from a similar wound inflicted by the teeth of an animal in perfect health. Weeks and months, in some cases, pass on, and there is nothing to indicate danger, until a degree of itching in the cicatrix of the wound is felt. From its long-continued presence as a foreign body, it may have rendered the tissue, or nervous fibre connected with it, irritable and susceptible of impression, or it may have attracted and assimilated to itself certain elements, and rabies is produced.
The virus does not appear to have the same effect on every animal. Of four dogs bitten by, or inoculated from, one that is rabid, three, perhaps, would display every symptom of the disease. Of four human beings, not more than one would become rabid. John Hunter used to say not more than one in twenty; but that is probably erroneous. Cattle appear to have a greater chance of escape, and sheep a still greater chance.
The
time
of incubation is different in different animals. With regard to the human being, there are various strange and contradictory stories. Some have asserted that it has appeared on the very day on which the bite was inflicted, or within two or three days of that time. Dr. Bardsley, on the other hand, relates a case in which twelve years elapsed between the bite and the disease. If the virus may lurk so long as this in the constitution, it is a most lamentable affair. According to one account, more than thirty years intervened. The usual time extends from three weeks to six or seven months.
In the dog I have never seen a case in which plain and palpable rabies occurred in less than fourteen days after the bite. The average time I should calculate at five or six weeks. In three months I should consider the animal as tolerably safe. I am, however, relating my own experience, and have known but two instances in which the period much exceeded three months. In one of these five months elapsed, and the other did not become affected until after the expiration of the seventh month.
The quality and the quantity of the virus may have something to do with this, and so may the predisposition in the bitten animal to be affected by the poison. If it is connected with œstrum, the bitch will probably become a disgusting, as well as dangerous animal; if with parturition, there is a strange perversion of maternal affection — she is incessantly and violently licking her young, continually shifting them from place to place; and, in less than four-and-twenty hours, they will be destroyed by the reckless manner in which they are treated. In both cases the development of the disease seems to wait on the completion of her time of pregnancy. It appears in the space of two months after the bite, if her parturition is near at hand, or it is delayed for double that time, if the period of labour is so far distant.
The duration of the disease is different in different animals. In man it has run its course in twenty-four hours, and rarely exceeds seventy-two. In the horse from three to four days; in the sheep and ox from five to seven; and in the dog from four to six.
Of
the
real nature of the rabid virus, we know but little. It has never been analysed, and it would be a difficult process to analyse it. It is not diffused by the air, nor communicated by the breath, nor even by actual contact, if the skin is sound. It must be received into a wound. It must come in contact with some tissue or nervous fibre, and lie dormant there for a considerable, but uncertain period. The absorbents remove everything around; whatever else is useless, or would he injurious, is taken away, but this strange substance is unchanged. It does not enter into the circulation, for there it would undergo some modification and change, or would be rejected. It lies for a time absolutely dormant, and far longer than any other known poison; but, at length, the tissue on which it has lain begins to render it somewhat sensible, and assimilates to itself certain elements. The cicatrix begins to be painful, and inflammation spreads around. The absorbents are called into more powerful action; they begin to attack the virus itself, and a portion of it is taken up, and carried into the circulation, and acquires the property of assimilating other secretions to its own nature, or it is determined to one of the secretions only; it alters the character of that secretion, envenoms it, and gives it the power of propagating the disease.
Something like this is the history of many animal poisons. In variola and the vaccine disease the poison is determined to the skin, in glanders to the Schneiderian membrane, and in farcy to the superficial absorbents. Each in its turn becomes the depôt of the poison. So it is with the salivary glands of the rabid animal; in them it is formed, or to them it is determined, and from them, and them alone, it is communicated to other animals.
Professor
Dick, in his valuable
Manual of Veterinary Science
, states some peculiar views, and those highly interesting, respecting the disease of rabies. He holds it to be essentially an inflammatory affection, attacking peculiarly the mucous membrane of the nose, and extending thence through the cribriform plate of the ethmoid bones to the interior part of the brain, and so giving rise to a derangement of the nervous system as a necessary consequence. This train of symptoms constitutes mainly, if not wholly, the essence of an occasional epidemic not unlike some forms of influenza or epizootic disease, and the bite of a rabid animal is not always, to an animal so bitten, the exciting cause of the disease, but merely an accidental concomitant in the prevailing disorder. Also the disease hydrophobia, produced in man, is not always the result of any poison introduced into his system, but merely the melancholy, and often fatal result of panic fear, and of the disordered slate of the imagination. Those who are acquainted with the effects of sympathy, and imitation, and panic, in the production of nervous disorders, will readily apprehend the meaning of the Professor.
Some of these diseases speedily run their course and exhaust themselves. Cowpox and farcy, in many instances, have this character. Perhaps, to a certain degree, this may be affirmed of all of them. I have seen cases, which I could not mistake, in which the symptoms of rabies were one after another developed. The dog was plainly and undeniably rabid, and I had given him up as lost; but, after a certain period, the symptoms began to be less distinct; they gradually disappeared, and the animal returned to perfect health. This may have formed one ground of belief in the power of certain medicines, and most assuredly it gives encouragement to perseverance in the use of remedial measures.
It has then been proved, and I hope demonstratively, that rabies is propagated by inoculation. It has also been established that although every animal labouring under this disease is capable of communicating it, yet, with very few exceptions, it can be traced to the bite of the dog.
It
has still further been shown that the malady, generally appears at some period between the third and seventh month from the time of inoculation. At the expiration of the eighth month, the animal may be considered to be safe; for there is only one acknowledged case on record, in which the disease appeared in the dog after the seventh month from the bite had passed.
Then
it would appear that if a species of quarantine could be established, and every dog confined separately for eight months, the disease would be annihilated in our country, or could only reappear in consequence of the importation of some infected animal. Such a course of proceeding, however, could never be enforced either in the sporting world or among the peasantry. Other measures, however, might be resorted to in order to lessen the devastations of this malady; and that which first presents itself to the mind as a powerful cause of rabies is the number of useless and dangerous dogs that are kept in the country for the most nefarious and, in the neighbourhood of considerable towns, the most brutal purposes; without the slightest hesitation, I will affirm that rabies is propagated, nineteen times out of twenty, by the cur and the lurcher in the country, and the fighting-dog in towns.
A tax should be laid on every useless dog, and doubly or trebly heavier than on the sporting-dog. No dog except the shepherd's should be exempt from this tax, unless, perhaps, it is the truck-dog, and his owner should be compelled to take out a license; to have his name in large letters on his cart; and he should be heavily fined if the animal is found loose in the streets, or if he is used for fighting.
The disease is rarely propagated by petted and house-dogs They are little exposed to the danger of inoculation; yet, we pity, or almost detest, the folly of those by whom their favourites are indulged, and spoiled even more than their children.
We
will now suppose that a person has had the misfortune to be bitten by a rabid dog: what course is he to pursue? What preventive means are to be adopted? Some persons, and of no mean standing in the medical world, have recommended a ligature. The reply would be, that this ligature must be worn during a very inconvenient and dangerous period of time. The virus lies in the wound inert during many successive weeks and months.
Dr
. Haygarth first suggested that a long-continued stream of warm water should be poured upon the wound from the mouth of a kettle. He says that the poison exists in a fluid form, and therefore we should suppose that water would be its natural solvent. Dr. Massey adds to this, that if the wound is small, it should be dilated, in order that the stream may descend on the part on which the poison is deposited. We are far, however, from being certain that this falling of water on the part, may not by possibility force a portion of the virus farther into the texture, or cause it to be entangled with other parts of the wound
2
.
There is a similar or stronger objection to the cupping-glass of Dr. Barry. The virus, forced from the texture with which it lies in contact by the rush of blood from the substance beneath, is too likely to inoculate, or become entangled with, other parts of the wound.
There is great objection to suction of the wound; for, in addition to this possible entanglement, the lips, or the mouth, may have been abraded, and thus the danger considerably aggravated. There also remains the undecided question as to the absorption of the virus through the medium of a mucous surface.
Excision of the part is the mode of prevention usually adopted by the human surgeon, and to a certain extent it is a judicious practice. If the virus is not received into the circulation, but lies dormant in the wound for a considerable time, the disease cannot supervene if the inoculated part is destroyed.
This operation, however, demands greater skill and tact than is generally supposed. It requires a determination fully to accomplish the desired object; for every portion of the wound with which the tooth could possibly have come into contact, must be removed. This is often exceedingly difficult to accomplish, on account of the situation and direction of the wound. The knife must not enter the wound, or it will be likely to be itself empoisoned, and then the mischief and the danger will be increased instead of removed. Dr. Massey was convinced of the impropriety of this when he advised that,
"should the knife by chance enter the wound that had been made by the dog's tooth, the operation should be recommenced with a clean knife, otherwise the sound parts will become inoculated."
If the incision is made freely and properly round the wound, and does not penetrate into it, yet the blood will follow the knife, and a portion of it will enter into the wound caused by the dog, and will come in contact with the virus, and will probably be contaminated, and will then overflow the original wound, and will be received into the new incision, and will carry with it the seeds of disease and death: therefore it is, that scarcely a year passes without some lamentable instances of the failure of incisions. It has occurred in the practice of the most eminent surgeons, and seems scarcely or not all to impeach the skill of the operator.
Aware of this, there are very few human practitioners who do not use the caustic after the knife. Every portion of the new wound is submitted to its influence. They do not consider the patient to be safe without this second operation. But has the question never occurred to them, that if the caustic is necessary to give security to the operation by incision, the knife might have been spared, and the caustic alone used?
The veterinary surgeon, when operating on the horse, or cattle, or the dog, frequently has recourse to the actual cautery. I could, perhaps, excuse this practice, although I would not adopt it, in superficial wounds; but I do not know the instrument that could be safely used in deeper ones. If it were sufficiently small to adapt itself to the tortuous course of little wounds, it would be cooled and inert before it could have destroyed the lower portions of them. If it were of sufficient substance long to retain the heat, it would make a large and fearful chasm, and probably interfere with the future usefulness of the animal. The result of the cases in which the cautery has been used proves that in too many instances it is an inefficient protection. The rabid dog in Park Lane has already been mentioned. He bit several horses before he could be destroyed. Caustic was applied to one of them, and the hot iron to the others. The first was saved, almost all the others were lost. A similar case occurred last spring; the caustic was an efficacious preventive; the cautery was perfectly useless. What caustic then should be applied? Certainly not that to which the surgeon usually has recourse — a liquid one. Certainly not one that speedily deliquesces; for they are both unmanageable, and, what is a more important consideration, they may hold in solution, and not decompose the poison, and thus inoculate the whole of the wound.
The
application which promises to be successful, is that of the
lunar caustic
. It is perfectly manageable, and, being sharpened to a point, may be applied with certainty to every recess and sinuosity of the wound.
Potash and nitric acid form a caustic which will destroy the substances with which they come in contact, but the combination of this caustic and the animal fibre will be a soft or semi-fluid mass. In this the virus is suspended, and with this it lies or may be precipitated upon the living fibre beneath. Then there is danger of re-inoculation; and it would seem that this fatal process is often accomplished. The eschar formed by the lunar caustic is dry, hard, and insoluble. If the whole of the wound has been fairly exposed to its action, an insoluble compound of animal fibre and the metallic salt is produced, in which the virus is wrapped up, and from which it cannot be separated. In a short time the dead matter sloughs away, and the virus is thrown off with it.
Previous to applying the caustic it will sometimes be necessary to enlarge the wound, in order that every part may be fairly got at; and the eschar having sloughed off, it will always be prudent to apply the caustic a second time, but more slightly, in order to destroy any part that may not have received the full influence of the first operation, or that, by possibility, might have been inoculated during the operation.