Rabies in Dogs and Other Animals Part 3

A tax should be laid on every useless dog, and doubly or trebly heavier than on the sporting-dog. No dog except the shepherd's should be exempt from this tax, unless, perhaps, it is the truck-dog, and his owner should be compelled to take out a license; to have his name in large letters on his cart; and he should be heavily fined if the animal is found loose in the streets, or if he is used for fighting.

The disease is rarely propagated by petted and house-dogs They are little exposed to the danger of inoculation; yet, we pity, or almost detest, the folly of those by whom their favourites are indulged, and spoiled even more than their children.

We will now suppose that a person has had the misfortune to be bitten by a rabid dog: what course is he to pursue? What preventive means are to be adopted? Some persons, and of no mean standing in the medical world, have recommended a ligature. The reply would be, that this ligature must be worn during a very inconvenient and dangerous period of time. The virus lies in the wound inert during many successive weeks and months.

Dr. Haygarth first suggested that a long-continued stream of warm water should be poured upon the wound from the mouth of a kettle. He says that the poison exists in a fluid form, and therefore we should suppose that water would be its natural solvent. Dr. Massey adds to this, that if the wound is small, it should be dilated, in order that the stream may descend on the part on which the poison is deposited. We are far, however, from being certain that this falling of water on the part, may not by possibility force a portion of the virus farther into the texture, or cause it to be entangled with other parts of the wound2.

There is a similar or stronger objection to the cupping-glass of Dr. Barry. The virus, forced from the texture with which it lies in contact by the rush of blood from the substance beneath, is too likely to inoculate, or become entangled with, other parts of the wound.

There is great objection to suction of the wound; for, in addition to this possible entanglement, the lips, or the mouth, may have been abraded, and thus the danger considerably aggravated. There also remains the undecided question as to the absorption of the virus through the medium of a mucous surface.

Excision of the part is the mode of prevention usually adopted by the human surgeon, and to a certain extent it is a judicious practice. If the virus is not received into the circulation, but lies dormant in the wound for a considerable time, the disease cannot supervene if the inoculated part is destroyed.

This operation, however, demands greater skill and tact than is generally supposed. It requires a determination fully to accomplish the desired object; for every portion of the wound with which the tooth could possibly have come into contact, must be removed. This is often exceedingly difficult to accomplish, on account of the situation and direction of the wound. The knife must not enter the wound, or it will be likely to be itself empoisoned, and then the mischief and the danger will be increased instead of removed. Dr. Massey was convinced of the impropriety of this when he advised that,

"should the knife by chance enter the wound that had been made by the dog's tooth, the operation should be recommenced with a clean knife, otherwise the sound parts will become inoculated."

If the incision is made freely and properly round the wound, and does not penetrate into it, yet the blood will follow the knife, and a portion of it will enter into the wound caused by the dog, and will come in contact with the virus, and will probably be contaminated, and will then overflow the original wound, and will be received into the new incision, and will carry with it the seeds of disease and death: therefore it is, that scarcely a year passes without some lamentable instances of the failure of incisions. It has occurred in the practice of the most eminent surgeons, and seems scarcely or not all to impeach the skill of the operator.

Aware of this, there are very few human practitioners who do not use the caustic after the knife. Every portion of the new wound is submitted to its influence. They do not consider the patient to be safe without this second operation. But has the question never occurred to them, that if the caustic is necessary to give security to the operation by incision, the knife might have been spared, and the caustic alone used?

The veterinary surgeon, when operating on the horse, or cattle, or the dog, frequently has recourse to the actual cautery. I could, perhaps, excuse this practice, although I would not adopt it, in superficial wounds; but I do not know the instrument that could be safely used in deeper ones. If it were sufficiently small to adapt itself to the tortuous course of little wounds, it would be cooled and inert before it could have destroyed the lower portions of them. If it were of sufficient substance long to retain the heat, it would make a large and fearful chasm, and probably interfere with the future usefulness of the animal. The result of the cases in which the cautery has been used proves that in too many instances it is an inefficient protection. The rabid dog in Park Lane has already been mentioned. He bit several horses before he could be destroyed. Caustic was applied to one of them, and the hot iron to the others. The first was saved, almost all the others were lost. A similar case occurred last spring; the caustic was an efficacious preventive; the cautery was perfectly useless. What caustic then should be applied? Certainly not that to which the surgeon usually has recourse — a liquid one. Certainly not one that speedily deliquesces; for they are both unmanageable, and, what is a more important consideration, they may hold in solution, and not decompose the poison, and thus inoculate the whole of the wound. The application which promises to be successful, is that of the lunar caustic. It is perfectly manageable, and, being sharpened to a point, may be applied with certainty to every recess and sinuosity of the wound.

Potash and nitric acid form a caustic which will destroy the substances with which they come in contact, but the combination of this caustic and the animal fibre will be a soft or semi-fluid mass. In this the virus is suspended, and with this it lies or may be precipitated upon the living fibre beneath. Then there is danger of re-inoculation; and it would seem that this fatal process is often accomplished. The eschar formed by the lunar caustic is dry, hard, and insoluble. If the whole of the wound has been fairly exposed to its action, an insoluble compound of animal fibre and the metallic salt is produced, in which the virus is wrapped up, and from which it cannot be separated. In a short time the dead matter sloughs away, and the virus is thrown off with it.

Previous to applying the caustic it will sometimes be necessary to enlarge the wound, in order that every part may be fairly got at; and the eschar having sloughed off, it will always be prudent to apply the caustic a second time, but more slightly, in order to destroy any part that may not have received the full influence of the first operation, or that, by possibility, might have been inoculated during the operation.

Mr. Smerdon, in the Medical and Physical Journal, March 1820, thus reasons:

"All the morbid poisons that require to lie dormant a certain time before their effects are manifested, pass into the system through the medium of the absorbents," (we somewhat differ from Mr. Smerdon here, but his reasoning is equally applicable to the nervous system,) "and if the absorbents are excited, their action is increased. I am satisfied that even in a venereal sore the application of a caustic, instead of destroying the disease, causes its rapid extension. Then," asks he, "if the virus on a small venereal sore is rendered more active by the caustic, is it not highly probable that the same law holds good with respect to the poison of rabies?"

The sooner the caustic is applied the better; but I should not hesitate to have recourse to it even after the constitution has become affected. It is related in the Medico-Chirurgical Annals of Altenburg (Sept. 1821), that two men were bitten by a rabid dog. One became hydrophobous and died; the other had evident symptoms of hydrophobia a few days afterwards. A surgeon excised the bitten part, and the disease disappeared. After a period of six days the symptoms returned. The wound was examined; considerable fungus was found sprouting from its bottom. This was extirpated. The hydrophobia symptoms were again removed, and the man did well. This is a most instructive case.

Also read: Dog Health Info.