6. Dissections of bodies which have died of the hydrophobia, exhibit the same appearances which are observed in the bodies of persons who have perished of malignant fevers. These appearances, according to Morgagni and Tauvry[79], are marks of inflammation in the throat, œsophagus, trachea, brain, stomach, liver, and bowels. Effusions of water, and congestions of blood in the brain, large quantities of dark-coloured or black bile in the gall-bladder and stomach, mortifications in the bowels and bladder, livid spots on the surface of the body, and, above all, the arteries filled with fluid blood, and the veins nearly empty. I am aware, that two cases of death from hydrophobia are related by Dr. Vaughan, in which no appearance of disease was discovered by dissection in any part of the body. Similar appearances have occasionally been met with in persons who have died of malignant fevers. In another place I hope to prove, that we err in placing disease in inflammation, for it is one of its primary effects only, and hence, as was before remarked, it does not take place in many instances in malignant fevers, until the arteries are so far relaxed by two or three bleedings, as to be able to relieve themselves by effusing red blood into serous vessels, and thus to produce that error loci which I shall say hereafter is essential to inflammation[80]. The existence of this grade of action in the arteries may always be known by the presence of sizy blood, and by the more obvious and common symptoms of fever.
The remedies for hydrophobia, according to the principles I have endeavoured to establish, divide themselves naturally into two kinds.
I. Such as are proper to prevent the disease, after the infection of the rabid animal is received into the body.
II. Such as are proper to cure it when formed.
The first remedy under the first general head is, abstracting or destroying the virus, by cutting or burning out the wounded part, or by long and frequent effusions of water upon it, agreeably to the advice of Dr. Haygarth, in order to wash the saliva from it. The small-pox has been prevented, by cutting out the part in which the puncture was made in the arm with variolous matter. There is no reason why the same practice should not succeed, if used in time, in the hydrophobia. Where it has failed of success, it has probably been used after the poison has contaminated the blood. The wound should be kept open and running for several months. In this way a servant girl, who was bitten by the same cat that bit Mr. Bellamy, is supposed by Dr. Fothergill to have escaped the disease. Dr. Weston of Jamaica believes that he prevented the disease by the same means, in two instances. Perhaps an advantage would arise from exciting a good deal of inflammation in the wound. We observe after inoculation, that the more inflamed the puncture becomes, and the greater the discharge from it, the less fever and eruption follow in the small-pox.
A second preventive is a low diet, such as has been often used with success to mitigate the plague and yellow fever. The system, in this case, bends beneath the stimulus of the morbid saliva, and thus obviates or lessens its effects at a future day.
During the use of these means to prevent the disease, the utmost care should be taken to keep up our patient's spirits, by inspiring confidence in the remedies prescribed for him.
Mercury has been used in order to prevent the disease. There are many well-attested cases upon record, of persons who have been salivated after being bitten by mad animals, in whom the disease did not show itself, but there are an equal number of cases to be met with, in which a salivation did not prevent it. From this it would seem probable, that the saliva did not infect in the cases in which the disease was supposed to have been prevented by the mercury. At the time calomel was used to prepare the body for the small-pox, a salivation was often induced by it. The affection of the salivary glands in many instances lessened the number of pock, but I believe in no instance prevented the eruptive fever.
I shall say nothing here of the many other medicines which have been used to prevent the disease. No one of them has, I believe, done any more good, than the boasted specifics which have been used to eradicate the gout, or to procure old age. They appear to have derived their credit from some of the following circumstances accompanying the bite of the animal.
1. The animal may have been angry, but not diseased with a malignant fever such as I have described.