When our attention has been paid to the wound, we must look to the other excretories for the evacuation of the poison: those most commonly preferred are the skin, the urinary organs, the salivary or intestinal glands. Mercury given in small doses, and long continued so as very slightly, if at all, to affect the mouth, may be considered as a diaphoretic. Sauvages has collected a variety of cases in which those who took mercury in this way escaped, while others bit by the same animal died hydrophobic. Desault, James, and others, have added their testimony to the success of the same measure; but we must add, with regret, that later experience does not support their decision. It is painful to be obliged so often to oppose positive assertions; but it would be injurious to mankind to support a delusive security. We have already observed that a dog, supposed to be mad, seldom is so; and that of ten bitten by an animal really mad, not above one or two are infected with the disease. Of the same kind is the famous Chinese remedy, which consists of ten grains of mosch, with twice the quantity of factitious cinnabar, for the dose is ordered to be repeated, if sleep and sweat do not follow; and Hillary has observed that it is useful in proportion as it proves diaphoretic. The warm bath has been highly commended, particularly by Lieutaud; but later experience has not confirmed its utility.
The principal diuretic is cantharides, but they have been seldom employed. The chief authority we can find for their utility is Baccius de Vencnis and Anti-dotis, and some cases in which they appeared to be useful are recorded in the first volume of the Bologna Transactions. The ashes of the river cray fish, burnt by twigs of bryony; the sponge of the dog rose; the alyssum or mad wort; and the lichen cinercus terres-tris; have been considered as diuretics. They may be such; but they are useless in this disease.
The cathartics employed in hydrophobia have been the rhubarb, the hiera picra, the colocynth, and hellebore; but we have received no positive accounts of their utility, and have reason to think them of little importance.
It has been supposed that the organs may be sheathed with oil, and absorption prevented, or the acrimony of the poison covered. This plan too has flattered and disappointed practitioners; and the Ormskirk medicine, which is principally an antacid, has had no better success.
When the disease has come on, it has been the object of practitioners to sooth the early symptoms of irritation by opium, or to assist the natural discharge by the more active exhibition of mercurials. Dr. Rush, in his reveries respecting inflammation, thought this disease also inflammatory, and proposed active bleeding. We can trace this remedy in the History of the Academy of Sciences at Paris for the year 1699, p. 58, recommended by Poupart; and we find it also mentioned in the Medical Essays of Edinburgh, vol. v. part ii. 51. This also has failed. Later authors have called hydrophobia a putrid fever, and given bark in large quantities, but with the same success.
Opium seems to rest on more rational principles, and two grains, or even a larger dose, given every three hours, seem to have relieved the symptoms, but have done no more. A ptyalism, rapidly excited, and steadily continued, has scarcely succeeded better; and the vinegar, of which four ounces have been directed three times a day, has equally failed. In short,fuil, effectual, and complete excision of the lopundcd part is the only certain means of relief; and this is Certain.
See AEtrus, Coelius Aurelianus, Lommius, Sauvages sur la Rage, Dcsault; James on Canine Madness; Mead on the Bite of a Mad Dog; Seleg, Nugent, and Hamilton on the Hydrophobia; Medical Museum, vol. ii. p. 97, &c; London Medical Transactions, vol. ii. and London Medical Observations and Inquiries, vol. iii.; Edinburgh Medical Commentaries, vol. v. p. 42; Vaughan's Two Cases of the Hydrophobia; Cullen's First Lines, vol. iv.; White's Surgery, p. 102; Memoirs of Medical Society of London, vol. i. p. 243; Memoirs of the Royal Society of Medicine in Paris, Supplement to vol. iv.
The second species arises without any contagion, in some fevers from topical inflammations of the thorax or neighbouring parts; from the accession of an epilepsy; from the bite of an epileptic patient; the bite, it is said, of persons in violent fits of passion: an inferior degree of it will be observable in some hysteric cases, when, from the difficulty of swallowing, patients are fearful of taking liquids, and sometimes cannot be prevailed upon to make the attempt. In all these cases, musk and opium appear to be chiefly efficacious.