Madness, of all diseases the germs of which may be introduced into the bodies of all warm-blooded animals, including man, is perhaps the most distressing; not only because of its almost universal fatality, others are that, but because of the horrible suffering, both of mind and body, that it gives rise to. Some persons affect to believe that no such disorder exists; this opinion is against the truth and not intelligent. Others have thought that it is not a purely germ disease, but can arise, without the seed having been planted, in dogs wolves, foxes, cats, and skunks. This is as bad a misbelieve as the first, but far less dangerous. It is absolutely certain that rabies cannot be set up in the body of any animal, under any possible combination of circumstances, unless its germ or seed has first been implanted by inoculation into the body of that animal. It is also true that au bites from animals that are undoubtedly mad do not set up rabies in the bitten animal. There is, or appears to be, a certain percentage of natural exemption in this as in other similar disorders, in which the systems of various bitten persons and animals do not seem to be good soil for the propagation of the seed, at the time when the inoculation occurs and the germ does not sprout. Then again it makes considerable difference what kind of animal has been bitten; if he is covered with long, close hair or, in the case of man, the bite is through the clothing, there is much less danger, because the teeth of the attacking animal are wiped and so made more or less free from the saliva, which contains the germ, just before the wound is made; then animals having blunt teeth, as horses, are far less liable to break the skin in biting than are those with sharp ones, and the longer and heavier the teeth of the biting animal, the greater danger there is that the germ will be conveyed.
Rabies is commonly thought of as belonging to and arising in dogs; this is not true; the fact being that dogs running about as they do, meeting others and having a little fight with them, as is their nature, live under circumstances which are ideal for its maintenance and spread. As a matter of fact a mad cat is by far the more dangerous animal of the two, because, at the time she attacks, she does so with both teeth and claws, filling the air at the same time with the poisonous saliva by "spitting" with greatly increased fury and with a considerable increase in the quantity of saliva at her disposal.
Causes. These have been sufficiently described in a general way. It may be said in addition that nothing more is known as to where the first germ came from than as to where the first seed of corn came from. The dog days have nothing to do with its spread or existence; in fact carefully kept records, in various countries, show that it as often appears in cold as in warm weather; the disease is not known in many tropical countries, whereas we know that it is most prevalent in the temperate zones. It was formerly thought that the malady arose spontaneously through restraint put upon the sexual desires of the animal. This cause was carefully and systematically investigated and found to be without any foundation in fact. Other theories of less importance have from time to time been advanced and exploded. That extension by inoculation is the only cause is well shown by action undertaken by the government of the city of Berlin,, in Germany, a number of years since, when it was ordered that all dogs going at large should be muzzled. For the nine years preceding the execution of this order, two hundred and seventy-eight cases of rabies were verified there; while for the eight years immediately after its enforcement only nine such cases were found, and all of these within the first three years after the institution of the muzzling order. The germ of rabies is a fixed one and is discharged from the sick body in the saliva; it is most certainly introduced into the bodies of animals by the bite of a rabid creature; and if the wound thus inflicted be upon an exposed part, as the face or hands, in man, or conditions approaching that in animals, it is much more commonly followed by the development of the malady.
As to this, good reliable statistics, in human cases, show that of face bites 90 per cent resulted in death, in the hand 73 per cent, on the arm 28 per cent, on the legs 29 per cent. In body bites, which are usually delivered by large animals, wherein the clothing gets much torn and the bites are several in number, the death rate is 63 per cent. No authentic cases have been reported in which rabies has followed the eating of meat or the drinking of milk from a rabid animal, although many cases are reported wherein both animals and men have partaken of such viands. Notwithstanding this the practice had much better be avoided.
Symptoms. Rabies has been described as divided into three stages and as appearing in two forms, the furious and the dumb. The change from one stage to another is not by any means sudden. The malady never commences with fury or with a sudden fit.
In the Horse, rabies is usually first indicated by restlessness, biting at the seat of the injury, if within reach of the teeth, as if it itched, changing position frequently, starting suddenly as if frightened. The ears are moved as if the animal heard strange sounds, and it appears as if it saw objects in the air, when there are none. Sexual desire is generally heightened in mares and stallions; urination is frequently attempted, in many cases. As the malady progresses there are quivering of the skin followed by more or less decided convulsions; there is loss of appetite and difficulty in swallowing appears. During the convulsions or paroxysms, in proportion to their severity, the animal kicks violently, and bites so furiously at any object within reach that sometimes its teeth or even jaw!,)ones are broken. It will at times also bite its own body. Breathing becomes hurried; the voice, when heard at all, is hoarse and unnatural in sound. Salivation is very slightly increased. The duration of the paroxysms is variable, and during the intervals between them the animal regains his faculties more or less. Each succeeding attack of fury is more intense, and the period of quiet between them becomes shorter and shorter; the general strength declines rapidly until toward the end all power of movement of the hind extremities is lost and the horse remains lying down. Death usually takes place in the midst of a paroxysm from the second to the sixth day.
In Cattle the symptoms are similar to those in the horse, excepting that sometimes their beginning is much less well marked. Depraved or lost appetite, great restlessness, increased excitability, muscular trembling, saliva flowing constantly from the mouth in considerable quantities, sexual excitement, especially in bulls, difficulty in swallowing, evident uneasiness at the bitten part, and seeing imaginary objects, complete the first stage. Next the periods of fury begin: the eyes are staring, bloodshot, and the pupils are dilated; the mouth is hot and foamy, the voice dull and hoarse, the animal bellows frequently, champs its jaws, paws the ground with its front feet, falls down and rolls about, or tries to break away from its fastening. Rabid cattle strike with their horns at any object within reach, with such force as often to break them off and cover the forehead with masses of blood. They will bite, but do not commonly attack with the teeth. The manure, at first expelled at long intervals and in small quantity, later on becomes liquid and passes involuntarily; there may even be extrusion of the rectum. As the third stage begins the animal shows considerable emaciation, weakness is extreme, the hind legs will not sustain, and the animal goes down, to remain so. Death follows a state of profound insensibility (coma) in from two to six days
In Sheep there is at first diminution of appetite and chewing of the cud stops, the skin begins to itch, there is increase of sexual desire, the voice is changed, the eyes stare, and the nasal secretion increases in quantity. This is closely followed by the second stage in which the paroxysms begin and continue at intervals; the animals make unusual jumps, paw with their front feet, grind the teeth, and butt at any animal or object within reach. It is not unusual for them to show a disposition to bite people and animals; and the disease has been transmuted by them, in this way. The third stage is reached; there is considerable emaciation, debility, with following paralysis. The animal lies or falls down, there is a profuse discharge from the mouth and nose. Death takes place during a paroxysm in from the fifth to eighth day.
In the Dog. It will be noticed, at first, that the animal becomes dull, gloomy, and quiet, he tries to hide in some out of the way place, as in a dark corner or under some piece of furniture, but even so he is restless, uneasy, and fidgety; no sooner does he lie down than he suddenly jumps up again, walks about, again lies down and perhaps assumes a sleeping attitude; after a few minutes he is up and walking about again, and so on until he finally goes to the most obscure place that he can find, and huddles himself into a heap with the head beneath the chest and front paws. Any such uneasiness as this in a dog should lead to his being carefully secured, by a good chain or otherwise, in some safe place, and watched carefully. Not infrequently there are short intervals in which he appears more lively than usual, and displays an unusual amount of affection, during which an animal under suspicion should on no account be allowed to lap the hands or face with his tongue. If at liberty he shows a disposition to pick up all sorts of foreign bodies, as straw, bits of wood or coal, stones, etc., and to swallow such of them as he can. At this early stage sexual excitement may be increased. As yet there is no disposition to bite, he will obey the master's voice, but not so quickly or cheerfully as usual, and he still has a gloomy expression of face.
Second Stage. These symptoms gradually become intensified and the animal goes about sniffling in the corners and at the doors, as if seeking for something; he moves strangely as if haunted by fancies. When not excited by any external occurrence, he will remain still as if watching something, or following with his eye some moving object on the wall or in the air; then he will suddenly j ump up and snap at vacancy as if endeavoring to catch a fly. At other times he throws himself furiously against the wall as if he heard strangers on the other side. Up to this time he eats voraciously. Soon, however, the uncontrollable desire to bite begins to show itself, and at this time, if he can possibly get away, he will travel long distances from home, biting any man or animal that he goes near so long as his strength lasts. From the commencement of this evidence of a desire to bite, whether he has been secured, or is at large, the more highly nervous symptoms begin to appear; the animal will not eat or drink; this is not that he dreads either water or food, but rather that a feeling of constriction in the throat, which prevents attempt; indeed it is not at all infrequent to see them make an effort, with their paws, as if to remove some object that had fastened itself in the back teeth or the throat. The voice becomes peculiarly changed in sound. The sight of another dog or a sudden loud noise will often induce the first real paroxysm of fury, which is to be followed by others, at intervals, until by their repetition, and perhaps the labor of traveling and the approach of the paralysis of the third stage, he will he down entirely worn out.
During the paroxysms the respirations are hurried, the pulse is quick and hard, the temperature is increased, and the animal seizes with the teeth whatever is within reach and bites and pulls at it in a most violent manner, so much so as oftentimes to wound the mouth or break out the front teeth. These attacks of fury are increased by sudden noises or excitement of any kind, while, ff the animal be kept in a dark, quiet place, the paroxysms may be very slight. If large quantities of saliva flow from the mouth it is because he cannot swallow the amount of that fluid that naturally flows into the mouth. Mad dogs but rarely show the frothy foaming mouth so commonly supposed to be a constant symptom. The paroxysms continue until finally his strength is gone, paralysis begins, and he lies down to enter upon the
Third or Last Stage. The hind legs lose the power to support the weight, the lower jaw becomes more or less drooping, emaciation is great, the paroxysms diminish in intensity, the coat is dull, the eyes lose their luster, become clouded and are sunken in their sockets. The breathing becomes labored and the paralysis general, the dog lies in a state of stupor, full insensibility follows, with or without convulsions, and the animal dies within two to four days of the beginning of the second stage.
Dumb Madness. In this, which is almost a purely paralytic form of the disorder, after having a few of the first symptoms of the first stage, the voice is lost, the lower jaw drops, paralyzed; the animal can neither eat nor drink, although if given the opportunity he will try to do both. The desire to drink is so great that the whole head up to the ears will be thrust into a pail of water in a vain endeavor to relieve the intense pain due to the always open mouth and inability to swallow. The tongue may be fairly natural in substance, or swollen; it is covered by a brownish material, and a stringy, gelatinous looking saliva is present in a moderate quantity in the mouth and throat. Anything like the tendency to follow imaginary objects, run away, desire to bite, and the frenzied paroxysm does not appear and the dog is generally quite passive; there may be some swelling about the throat and the tongue is pushed out of the mouth. The other symptoms, as rapid exhaustion, loss of flesh, paralysis of the hind limbs and finally of the whole body, as well as the progress of the whole course of the disorder, is as rapid in this as in the furious form. While it is true that in dumb rabies the animal evidences very little if any desire to bite, and that he cannot do so if he would, because of his inability to use the lower jaw, it is well worth while to remember that the saliva is just as dangerous in the one case as the other. Death occurs generally about the fourth day from the visible commencement of the attack.
Treatment. After a dog has clearly shown that he is undoubtedly rabid he should at once be killed, unless he has just previously bitten some person or other animal; in which case he must be securely kept alive until it is found whether or not there has been any mistake about it; for among people a nervous disorder (false hydrophobia), which is purely imaginary but nevertheless sometimes fatal, follows the bite of a dog which was not only well at the time of the biting, but which lived in health for a long time afterward. If a dog is really mad he will die from the disorder in a few days, and the fact, if the dog is allowed to live to the end, will be known and measures can be taken to prevent its development in the bitten person or animal. If, on the other hand, the dog lives for more than four or five days it is certain that the bitten person is in no danger of having contracted the disease from his bite. The nervous dread will thus be allayed and the person's fife saved.
If an outbreak of rabies happens in a neighborhood all dogs there, that are allowed to go at large, should be muzzled, and the muzzling should be continued at least thirty days after the last known case has been taken care of, for the period of incubation is not always a short one. This, however, is a matter which can be taken care of by the proper State or town officers only.
If a dog or other animal, which is known or thought to be rabid, has bitten other animals or men, the bitten one should at once be subjected to measures which will lessen the likelihood of inoculation. These measures are sucking the wound, squeezing out the blood and perhaps the virus from the wound while it is covered with water or held under a "tap"; twisting a piece of rope or other strong, suitable material around a part between the wound and the heart, as closely to the wound as possible; cutting out the bitten parts with a sharp, clean knife, or, best of all, burning out the wound thoroughly, with a red-hot iron or a stick of lunar caustic. If the burning or cutting out the part is done before any of the virus gets into the circulation there will be no further danger; but it must follow within a few minutes of the infliction of the bite, or it will be too late.
No Curative Medicines, to be used after the disease has shown
itself, are known, nor should any attempt be made to administer anything of the kind to sick animals; the risk is entirely too great.
Between the time of the bite and the development of the disease there is always a period of incubation of longer or shorter duration. If, during this period, before any of the symptoms are shown, a bitten person can be put into the hands of a good Pasteur institute and there subjected to a series of proper protective inoculations, it is almost certain that no hydrophobia will result from the bite. The lives of valuable dogs may be saved in the same way. There are such institutes in New York City and in Chicago.
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