In the furious type the animal first appears to be restless and somewhat excited. He seeks dark places and apparently prefers to be by himself. In this stage of the disease the dog's appetite is good and may be excessive; he responds to orders although his attention can be attracted only for a moment at a time. As the malady progresses the animal becomes more and more restless, and develops a desire to tear those things about him into pieces. There is described a peculiar bark at this stage of the disease; instead of ending as it ordinarily does, it is prolonged and terminates in a higher pitched note simulating a cry. This is supposed to be very characteristic at this stage of the affection. The appetite gradually diminishes, food is refused, and swallowing becomes difficult. As the symptoms gradually progress the dog shows signs of delirium and begins to wander. As a rule, he goes about with his tail hung, mouth wide open, and with a wild look in his eyes, biting as he goes, anything that happens to be directly in his path; seldom does he turn aside to disturb anything or anybody. In the later stages of the disease paralysis generally develops, beginning in the hind legs and soon involving the body. If the animal be now carefully observed it will be seen that he cannot swallow. There is no dread of water, as the name “hydrophobia” implies, and as is commonly thought, the animal often attempting to drink, but owing to the paralysis of the muscles of the throat this is impossible. Inability then to swallow either water or solid food is one of the surest and most reliable signs of rabies. Weakness becomes very marked, and the animal finally lies down in a stupor and dies. The entire course of this type may last from six to ten days; generally it is four or five.
The paralytic type of the disease occurs in fifteen or twenty per cent. of the cases. The onset is, as a rule, the same as that observed in the furious type. Instead, however, of the dog beginning to wander, as previously mentioned, the animal becomes paralyzed, the paralysis first affecting the muscles of the jaw, later of the tongue. As is the case in the furious type of the disease, the animal loses the power to swallow both solids and liquids, but has no fear of water. The mouth remains wide open, the tongue protruding, and an abundant amount of thick saliva exudes. The animal remains quiet, does not attempt to bite any animal or individual. Death occurs on the second or third day of the disease.
Precautions.—When an individual is bitten by an animal either supposed or known to be rabid, the wound should be immediately cauterized with some caustic, preferably concentrated nitric acid. This should be applied without fear because it is safer to use too much than too little. In case this is not available any strong caustic may be used. Punctured wounds should be laid open with a knife and the surfaces freely cauterized. It should not be forgotten that the slightest scratch from the tooth of a rabid animal may lead to the development of hydrophobia in man, and it therefore behooves all persons bitten by dogs to take every precaution possible. Even though the animal at the time may appear to be healthy, some strong antiseptic should be applied to the wound, and the animal carefully watched until all possibility of his having the disease has passed. Many persons have died from slight wounds inflicted by animals appearing at the time to be perfectly well.
Attention should also be directed to the fact that wounds where the teeth of the animal pass through the clothing are not so dangerous as those where no such protection intervenes. Bites about the face and head are much more frequently followed by rabies than those inflicted on the extremities, and, of course, where wounds are deep the chances of infection are much greater; where injuries of the latter kind are inflicted it is practically out of the question to thoroughly cauterize them, and the patient should immediately receive the Pasteur treatment. It is probable that if thorough cauterization be not done within five minutes that it cannot be relied on to prevent the development of the disease; where there is any doubt the only safety lies in the Pasteur treatment. Where a person is bitten by a dog supposed to be rabid the animal should be caught, if possible, and kept carefully isolated for at least ten days; should it appear well after the expiration of this period no fear need be felt as to the results of its bite, but if it should die the head should be cut off, packed in ice, and sent to some laboratory for examination.
Under no condition should the animal be killed, as the best possible proof of the harmlessness of its bite would lie in its continuing to live.
Treatment.—Since the epoch-making researches of Pasteur, laboratories have been installed in various parts of the world for the purpose of making a vaccine by means of which it is possible, by gradual immunization, to prevent the development of hydrophobia in persons bitten by rabid dogs. This is done by a series of injections of a weak virus prepared according to the directions of Pasteur. It should always be remembered that no harm can come from the treatment whether the patient was bitten by a rabid dog or not, and that in all cases of doubt no hesitation should be felt in resorting to it.