_Of the Bite of a mad Dog_
There are many surprizing things in nature, in so much, that ocular
demonstration can only convince us of their existence. Amongst those
wonderful phenomenons, the direful effect of the bite of a mad dog is
equally astonishing as it is melancholy.
That dogs and wolves are more liable to madness of this kind, called the
_Rabies_, is because of their deficiency of external perspiration; and
are obliged to supply that defect with their open mouth and their
lolling-out the tongue; whence their blood is subject to become
overheated, and thence generate a malignant inflammation, which infects
the saliva with this direful poison. But the astonishment is, why it
should have so very powerful a contagion as to infect the mass of blood
of every animal that receives the least atom of it? Yet so it is,
confirmed by sad experience.
From frequent observation we are able however to communicate such signs,
which attend the symptoms of madness in a dog, whereby we may the better
avoid the danger of being plunged into the most deplorable misery by
this wretched animal.
_The Signs of a mad Dog._
The dog with symptoms of madness evidently discovers a malignant fever;
he runs confusedly forwards; the tongue hangs out of the mouth with much
slabber; his head hangs downwards; his eyes look dull and heavy; his
tail is drawn up between his legs; and in every respect he has all the
sign of confused wildness and pain; he runs confusedly forward, and
snaps about him without distinction of persons or fear. He is always
restless; will neither eat nor drink; and is terrified at the sight of
water; the tongue hanging out of his mouth, grows black; and at last
expires a spectacle of horror, unless the poor beast is put out of his
misery, and thereby many dreadful consequences prevented.
_The Effect of the Bite of a mad Dog._
So subtile is this fatal poison, that the symptoms do not appear
immediately; but the part bitten will sometimes even heal up, the same
as any other wound; and two, four, or six months after the injury, the
symptoms of the malady will appear and gradually reduce the patient to
the most deplorable state in nature.
The first symptoms of the disease are, a pain in the part where he was
bit, which gradually spreads all around; the whole body in general is
attended with a dull heavy pain, a lassitude and weariness. The mind
grows depressed and anxious, together with a loss of appetite and a
nausea at the stomach; and, in particular, a difficulty of swallowing,
sore throat, and accumulation of spittle.
Soon these symptoms encrease. The peculiar soreness of the throat, which
renders the swallowing liquids very painful, begins to create the utmost
horror and dread of every thing that is liquid; and this first gives
rise to the _Hydrophobia_, or dread of water, which compleats the
patient’s misery in this terrible disorder.
The eyes become full and staring, the face bloated, florid intermixed
with lividness; the mind is impaired; rage, lust and mischief, agitates
the confused will; at length, convulsions, foaming of the mouth,
priapisms, and seminal emissions, barking, howling, and endeavouring to
bite every thing near, ends the wretched life of the most deplorable
object in nature.
_Of the Cure of the Bite of a mad Dog._
With respect to the remedies, we have had many delivered to us; but few
indeed with success. Before I enter on the best method that I know, by
experiment, to recommend, I must beg leave to mention a peculiar
successful instance, in the course of my practice, in this deplorable
case.
A mad dog on shore, in the West-Indies, bit two men, one belonged to my
ship’s crew, the other to a ship in the same harbour; both were bit in
the calf of the leg. It happened that the surgeon of the other ship and
myself were immediately at hand at the time of the accident. I was for
cutting the part bitten fairly out without delay; to which the man of my
ship readily contented; and it was done accordingly upon the spot,
having fortunately my pocket instruments about me. But this operation
was not approved of by Mr. E——; nor suited it the timidity of the man
belonging to his care; it was therefore omitted.
When I had performed the operation, viz. (as near as I can guess) I cut
more than an ounce and a half of flesh out of the gastrocnemius muscle
(every where round the bitten part) I spread a pledget with basilicon,
mixed with precipitate, and laid it on the wound, having first let it
bleed, perhaps six or eight ounces; over the pledget I laid plenty of
dry lint; and when he was carried on board, I fomented it with spirits
of wine and camphor, in which _sublimate mercury_ was dissolved (about
one grain to about four ounces of the spirit). Inwardly I gave him one
grain of calomel every morning and night for at least a fortnight. The
sore I continued to dress with mercurial ointment; which within a month
healed up perfectly sound. From the mercurial treatment, the patient had
a small ptyalism, which I checked by gentle cathartics. My patient, by
this severe, though efficacious method, recovered perfectly well, and
remained so at least three months after the accident, when we parted.
The other unfortunate man, however, had not so good luck; for, as I was
afterwards informed (the ship going soon to sea after the accident) the
unhappy sufferer died a horrible object, raving mad in the
_hydrophobia_.
Mercury is certainly the greatest antacrid we have; and I am firmly of
opinion, that in this case it is the most powerful of any medicine that
is yet known.
The cold bath is strenuously recommended by Dr. Mead; and since his
recommending it, is generally practised on suspicion of this misfortune;
but in real cases, very seldom with the wished-for success. Yet, Reason
says much in its favour, and should by all means be had recourse to.
Others have recommended strong salt brine, which also is not to be
rejected.
Before I lay down the method to be observed, I shall first give Dr.
Mead’s recipe in his own words.
“Let the patient be blooded at the arm nine or ten ounces. Take of the
herb called in Latin, _lichen cinereus terrestris_; in English
_ash-coloured ground liverwort_, cleaned, dried, and powdered half an
ounce. Of _black pepper powdered, two drachmes_, mix these well
together, and divide the powder into four doses, one of which must be
taken every morning fasting, for four mornings successively in half a
pint of cow’s milk warm. After these four doses are taken, the patient
must go into the cold bath, or a cold spring, or river, every morning
fasting for a month: he must be dipt all over, but not stay in (with his
head above water) longer than half a minute, if the water be very cold.
After this he must go in three times a week a fortnight longer.”
But to speak my real sentiments, I have no great opinion of this recipe;
yet as other methods may be pursued along with it, I thought proper to
insert it, as in a malady of this consequence, nothing should be left
undone that is practicable with propriety.
Celsus I think was the first who recommended cold bathing[14]; but
indeed to a degree of drowning and reviving the patient again
alternately. In the mania itself, it carries much reason with it in this
miserable extremity, for the poor wretch at the eve of expiring, a
spectacle of horror, may as well run the risque of drowning; and
besides, the shock that plunging gives to the whole system, may probably
work an alteration in the malignant habit.—But alas! when the
hydrophobia has actually commenced; Death, and death only—can give
relief! Yet let it ever be a maxim, (and especially with a seaman)
_never_ to forsake _hope_; for _despair_ is only a punishment reserved
for the damned. I repeat it; no means should be left untried, that has
the least prospect of recovery.
Footnote 14:
_Unicum remedium est, nec opinantem in piscinam non ante ei provisam
projicere, et, si natandi scientiam non habet, modo mersum bibere
pati, modo attollere; si habet, interdum deprimere, ut invitus quoque
aqua satietur: sic enim simul et sitis, et aquæ metus tollitur. Lib.
v. cap. 27._
But to avoid being tedious, I will proceed to the method I would have
pursued in an accident of that terrible kind.
If you by the before description find that the dog who gave the wound is
actually mad, then without a moment’s delay let the piece bit, be cut
fairly out; if that is not practicable, apply immediately the ointment
made of _mercurial ointment_ and _precipitate_, No. XXI. Over which
apply _mercurial plaister_. Give one of the pills No. X. every morning
and night, and continue this course for a whole month. Let the plaister
remain on the place a good while after the sore is healed up.
This method I pursued with a gentleman, and a little boy in New-York,
who both were bit by the same dog, without provocation, the dog having
never attempted the like before; upon which he was immediately shot, and
was found to have all the signs of madness.——The accident happened at
noon, and I was immediately sent for; but not being in the way, my
assistant dressed it with basilicon, and laid over it a compress with
_spirit of wine and Camphor_, supposing it of no consequence, as the
wound was but very small. But on my hearing of it in the evening, I went
that moment to their assistance, removed the dressing and applied what I
have before mentioned.
I was not mistaken, for the sore and all around, after some time grew
angry, and had an unfavourable appearance; but with diligent attendance
gradually became better.—— The little boy was bit deeper than the
gentleman; His wounds were on both sides of the _tendo achillis_: But
the gentleman’s wound was a little above the _maleolus externus_ on the
right leg, inclining to the _tendo achillis_.
It was in the month of July—I ordered bathing every morning and night,
which suited the season. In the mean time, during three months, I gave
one grain of calomel every morning and night; and every thing succeeded
to our wishes.
But to return; should the mercurial medicines go to the mouth, a gentle
cathartic will divert this, for I am an utter enemy to salivation. If
however these remedies are administered too late, so that,
notwithstanding all those applications, the patient should grow
melancholy, have a difficulty in breathing, and a sore throat; but
especially a pain in the sore, or bitten part, recourse should be had to
frequent cold bathing, or rather plunging; mercurials should be
continued, and every method pursued as will be advised in the putrid
malignant fevers.
Should the patient however be seized with madness, care should be taken
that those about him have no wounds where the least of his spittle may
be introduced; and that the deplorable patient is rendered incapable to
make any wounds or mischief on himself, or those who attend him; as he
will be apt to snap and bite about him like a dog. He should be sewed up
in a hammock, to which his arms should also be confined: in this method
he may, by help of a tackle, be plunged up and down in the sea, but not
his head under water. This is far superior to the unnatural and cruel
way of smothering with beds, where the patient has no chance at all
left.
The subject is melancholy; but, willing to contribute all the relief in
my power to the distressed, I have been insensibly led on; and summed up
all that might promise success. Innumerable are the remedies delivered
to us, but few prove successful if the case be real.
Of all, I never knew any meet with better success than where mercury was
concerned; and as I have been so fortunate as to have experienced the
exalted virtue of that great medicine, in this and other deplorable
cases, I stand so much upon the firmer grounds, to recommend it beyond
any other medicine that I am acquainted with at present.
To conclude, I think it requisite to observe, that, dreadful as the bite
of a mad dog is, when the poison has infected the unfortunate patient,
yet this unlucky accident happens much seldomer, than mankind from the
dread of the misfortune, are apt to apprehend it does. Many nostrums are
published as specifics, and their virtue artfully confirmed, with cases
of being bit by dogs, that had however not the least symptom of madness;
and thence cures enumerated, that could have no foundation on reality;
by which artifices much mischief has been done in real cases. Due
observance should therefore be had to the state of the dog that has
given the wound, and the circumstances attending; that either the
patient may not be brought into unnecessary pain, or that proper and
substantial remedies may not be neglected.
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