(From water, and to fear). A dread of water; aquae pavor, is a symptom of the disease caused by the bite of a mad animal; but not peculiar to this disease, nor always attendanton it. (See Dyscapatotia.) The disorder has usually-had the same appellation, and is called also canina rabies, cynanthropia, cynolesia. Dr. James observes, that this kind of madness properly belongs to the canine genus, viz. dogs, foxes, and wolves, to whom only it seems innate and natural; scarcely ever appearing in other animals, except communicated from these. Dr. Heysham defines it to be an aversion and horror at liquids, as exciting a painful convulsion of the phar; occurring at an indetermined period, after the canine virus has been received into the system.
The hydrophobia is a nervous disorder, though attended with some appearances of inflammation. Dr. Cullen places it in the class neuroses, and order spasmi. defines it a loathing and great dread of drinking any liquids, from their creating a painful convulsion of the pharynx, occasioned most commonly by the bite of a mad animal. This definition, however, scarcely includes the full idea of the disease; and we would suggest the following as more complete: melancholy, a dread of
1. Hydrophobia rabiosa, when there is a desire of biting, from being bitten by a mad animal.
2. Hydrophobia simplex, without rabies, or a desire of biting.
The principal and original seat seems to be about the stomach, and parts contiguous to it. Dr. Seleg thinks that it is seated in the par vagum and intercostal nerves; for most of the symptoms happen where these nerves are interspersed.
The smallest quantity of the saliva of a mad dog produces the disease. The infection may lie dormant for a period, differing according to the habit of the patient, the time of the year, the degree of the disease in the animal, or the place in which the wound is made. If the patient is not of a strong inflammatory habit, and no circumstances intervene, which otherwise affect his health, it seldom takes effect till after about forty days: if in six weeks, or two months, no sign of disorder appears, the patient is usually concluded to be safe. It has been observed, that the nearer the place bitten is to the head, the sooner the symptoms appear. If the part bitten is covered with woollen or leather, the bite is harmless. The dread of water is a symptom in some fevers, and in some particular inflammations (Edinburgh Medical Commentaries, vol. xi. p. 331); and it is highly probable, that in those cases where the poison is said to lie dormant for six or nine months, or even a year, the disease was connected with fever rather than the rabid poison.
When a dog is affected with madness, he becomes dull, solitary, and endeavours to hide himself, seldom barking, but making a murmuring noise, and refusing all kinds of meat and drink. He flies at strangers; but, in this stage, he remembers and respects his master: his cars and head hang down; he walks as if overpowered with sleep; and a bite at this period, though dangerous, seldom conveys the disease. After these symptoms, the dog begins to pant; he breathes quick and heavy; hangs out his tongue to discharge a great quantity of froth from his mouth, which he keeps perpetually open; sometimes he walks slowly, as if half asleep, and then suddenly runs, but not always directly forward: at length he forgets his master; his eyes look dispirited, dull, full of tears, and red; his bark is hollow and hoarse; his tongue of a lead colour; he grows faint, thin, and weak, often falls down, again rises, attempts to fly at every thing, and soon grows furious: this second stage seldom continues thirty hours, death by that time putting an end to the disease, and a bite received at this time is the most dangerous.
When the human species are the subjects of this disorder, a slight pain in the wound is first felt, sometimes attended with itching, but usually resembling a rheumatic pain: it extends into the neighbouring parts, and the cicatrix begins to swell, inflames, and at length discharges an ichor; this pain is considered as the primary invariable mark of a beginning hydrophobia. There are more general pains, of a flying, convulsive kind, which are said to affect the patient in the neck, joints, and other parts; often a dull pain seizes the head, neck, breast, belly, and along the back bone: towards the conclusion of the disorder the patient complains of this pain shooting from the arm towards the breast and region of the heart. A lassitude, a dull pain in the head, and a vertigo, soon come on: the patient is melancholy, mutters, is forgetful, and drowsy; his mind seems disordered; his temper irritable and irregular; his slumbers disturbed, and convulsive agitations immediately follow his waking; a deafness is sometimes complained of; the eyes are watery; the aspect sorrowful; the face pale and contracted; sweat breaks out upon the temples; an unusual discharge of saliva flows from the mouth, though the fauces are dry; the tongue becomes foul, and the breath occasionally fetid. The fetor is often only perceived by the patient; and sometimes it attends the discharge from the wound, the dressings of which are said to be frequently black. Besides these, from the beginning, there are a peculiar stricture and heaviness on the breast, a struggling as it were for breath, a sighing, a nausea, and often a bilious vomiting. This oppression of the precordia is one of the constant symptoms of this disorder; it begins, increases, and ends with it. As the above symptoms increase, the second stage advances; a fever comes on, which at first is mild, and attended with momentary horrors, though there is sometimes no fever; sleep is lost, the mind is more and more disturbed, a delirium approaches, and an aversion at first to polished bodies, then to light, afterwards to fluids, is perceived. The air offends if it touches the skin, and the slightest sound is very painful. A constriction of the gullet, with difficulty of swallowing, first occurs; but as yet liquids are freely taken; afterwards, however, they are refused. This symptom augments so visibly, that on the sight of any liquid a horror seizes the patient; and if he strives to drink, spasms, anxiety, and loss of sense, follow. As soon as the surface of the liquid is touched, a strangulation in the throat is felt; the stomach is inflated; the larynx is suddenly swelled externally, though the swelling quickly disappears. While liquids are thus rejected, solids are swallowed with tolerable ease; yet this symptom may become so violent as totally to prevent solids also from being swallowed. The patient now mourns bitterly; at times loses all knowledge of his intimate acquaintance; but reason returns at intervals, and he laments his own calamity: the thirst excites a desire of.drink, but he strives in vain to swallow, and soon sinks into the most affecting despondency; he advises his friends to keep at a distance, and it is supposed that he feels an inclination to bite; but this is suspicion only, and it is highly improbable that, with the disease of a dog, he should adopt his manners: biting is the common method by which that animal shows his resentment. The barking like a dog is equally imaginary. A priapism and involuntary emissions of semen and" urine sometimes attend this stage; and as the conclusion approaches, the fever and thirst increase; the eyes are bright and furious; the urine is high coloured, acrid, and in small quantities; the tongue hangs out; the mouth foams; the pulse throbs, strength fails, cold sweats come on, the tightness of the breath increases, and the patient soon expires in spasms, often losing the difficulty of swallowing liquids, for many hours; so that the dread of water is by no means a pathognomonic symptom.