Rabid cattle lose appetite, become very restless and excitable, grind the teeth, lick the cicatrix, evert the upper lip, and otherwise show sexual excitement, bellow often in a loud, terrified manner, as if still apprehensive of the attack of the dog, paw and scrape the ground with the fore feet, butt and kick viciously, have twitching of the muscles, and finally paralysis and death in from four to seven days. When paralysis is coming on the hind feet are often drawn forward as in inflammation of the feet. The pulse and breathing are accelerated during the paroxysms, but I have not found the temperature raised.
Rabid sheep and goats present the same general symptoms, bleat hoarsely, but viciously, have sexual excitement, nibble the cicatrix, have muscular weakness, emaciation, and paralysis, and die in from five to eight days.
Rabid swine show much fear, restlessness, and excitability, hide under the litter, start violently at noises, grunt hoarsely, champ the jaws, show a great disposition to bite and to gnaw and tear objects to pieces, have dark red, glaring eyes, gape and yawn, and become weak and paralytic. Breathing is often labored, and the mucosæ and white skin assume a dull red or leaden hue. Death ensues as early as the fourth or fifth day.
In Herbivora and Omnivora a paroxysm is usually induced by the sight of a dog—a fact of importance in diagnosis.
Rabid skunks have naturally received but little study. They tend, however, to steal up to men and animals and bite some exposed part of the body, like the finger, ear, or nose, and as stealthily retire. It is claimed that their odorous secretion is suppressed.
Symptoms of Hydrophobia in Man.
In some cases the prodromata are altogether omitted, the disease setting in suddenly with spasms of the pharynx and inability to swallow. More commonly, the premonitory symptoms last from one to three days. The first symptom is often an itching, prickling, or more or less violent aching in the seat of the bite, and even of an aura, a numbness, or shooting pain extending from that point toward the heart. In such cases the wound is red or bluish, and even swollen. In other cases there is chilliness, a general feeling of headache, malaise, and prostration, with lack of appetite or nausea, gloomy forebodings, taciturnity, nervous excitability, and restlessness. That restlessness which in patients cognizant of the consequence of the bite often induces insomnia during incubation, now often shows itself in an inability to keep quiet or to remain in one position or place—the exact counterpart of the initial restless stage shown in the canine patient. The sleep is now even more broken and unrefreshing and disturbed by fearful dreams. The restlessness soon merges into intense nervous irritability. Though devoured by thirst, the patient is afraid of water, and the attempt to drink will cause slight spasms with a sensation of filling of the throat and difficulty of deglutition. Even the air blowing upon his surface produces nervous irritation and apprehension, and a sudden glare of sunshine or other strong light is still more injurious. The pulse is increased in frequency, hard, and small; the breathing accelerated, oppressed, with at times yawning, sighing, or sobbing; there is some redness of the fauces, vascular injection of face and eyes, with, in some cases, dilated pupils; nausea or oppression at the epigastrium, sometimes vomiting; and usually constipation, which cannot, as in dogs, be referred to the earth, sand, and unsuitable materials swallowed. Intelligence is unimpaired.
With or without some or all of the premonitory symptoms above described the patient is sooner or later seized with constrictive spasms of the pharynx and respiratory muscles, the immediate occasion being an attempt to swallow liquid or some sudden fright or excitement. So great is the agony produced by this attack that, though consumed by thirst, the patient will rarely afterward attempt to drink, and the mere sight or offer of water, the noise of liquid flowing from one vessel to another, or even the sight of the vessel in which liquid was contained, suffices to bring on a violent paroxysm. This hydrophobia is peculiar to the human being suffering from this disease, being rarely seen in rabid animals; and it serves to enormously enhance the agony and horror of the affection. During a paroxysm the dyspnoea is usually extreme; there is a gasping or sighing respiration, and shrill, inarticulate sounds or screams are emitted which have been likened to the bark of a dog. These are manifestly due to the threatened suffocation rather than to an attempt to bark. The sensations have been described as a rising of the stomach into the throat, while others felt as if the throat had turned into bone and could not admit nor pass on the liquid. The abdominal contractions are often well marked, and retching and vomiting ensue. This reflex irritability of the nerves of deglutition and respiration is followed or attended by a condition of the most intense hyperæsthesia and a great exaltation of the special senses. A deaf and dumb child is said to have heard distinctly at this stage. There are, besides, during a paroxysm, general muscular trembling and clonic spasms of the muscles of the trunk and extremities. The facial muscles are contracted, the nostrils dilated, the face and eyes red and injected, and the pupils dilated, producing a spectacle of the most intense agony. Even in the intervals the hyperæsthesia is so extreme that the slightest touch of an attendant, a current of air, the approach of a candle, or even the ordinary tones of conversation, produce extreme agitation and may precipitate a violent convulsive paroxysm. The duration of the paroxysms and of the intervals varies much, but in general terms the former increase rapidly in number and severity, while the latter are correspondingly shortened. Restraint serves to aggravate the paroxysm, while, according to Hunter, the earlier and lighter ones may be relieved by running. The intense excitement sometimes becomes manifest in the persistent talking, and it is noticeable that the patient is free from mental delusions. As it is impossible to swallow, the patient spits out the now viscid saliva on all sides—a feature, like the fear of water, peculiar to man. As the disease advances the paroxysms are marked by the most perfect hallucinations and delirium, which impel the victim to acts of insane violence toward every one and every thing about him. In these fits he will use every available means of offence, even to the snapping of the jaws, though on the subsidence of the fit he will often express the greatest regret and warn his victims to be on their guard when he finds another paroxysm coming on. In some few instances the delusions continue even during the remissions, and the patient remains possessed of a sense of suspicion and horror of all about him, and yet the fear of being left alone is usually greater still. The convulsions may become tetanic (as opisthotonos). They are habitually more severe in men than in women and children. During a convulsion the victim will at times become black in the face, and may die from suffocation, apoplexy, or nervous exhaustion.
Should he survive this danger the final paralytic stage sets in. The spasms gradually become weaker, reflex irritability is lessened, and a period of quiet, and even comparative composure, may ensue, during which the former sights and sounds fail to produce a paroxysm, and some patients even recover the power of deglutition; but muscular weakness and prostration become more extreme, the lower jaw may even drop, and the viscid saliva drivel from the lips; finally, stupor supervenes, and the patient dies in a state of profound coma or complete exhaustion. This last stage lasts from one to eighteen hours.
Cases are met with in the human subject, as in the dog, in which the paroxysmal stage is omitted in greater part or entirely. The patient complains only of oppressed breathing, and sighs deeply when he attempts to swallow, and paroxysms, if they occur at all, are very mild. Decroix indeed claims that if a person suffering from hydrophobia is kept in a dark room and perfectly quiet, no paroxysms appear. The malady is, however, none the less fatal.