More difficult and terrifying are the Symptoms from the Bite of a Mad Dog, whose Venom has this also surprising in it, that the bad Effects do not appear oftentimes till the Cause of ’em is forgot; for the Wound is as easily cured as a common Bite is; but nevertheless a considerable time after, a melancholy Tragedy succeeds, sometimes sooner, sometimes later; for there are Instances of its being deferred to Two, (70) Six Months, nay, a Year, and longer, tho’ the attack is generally within Forty Days after the Wound; about that time, the Patient complains of Running Pains all over his Body, especially near the Part wounded, like unto those in a Rheumatism, grows pensive and sad, prone to Anger upon little or no Occasion, with an intermitting Pulse, Tremblings and Contractions of the Nerves, with a great inward Heat and Thirst; and yet in a few Days (when the Disease is come to its height) a Dread and Fear of Water, and any Liquor whatsoever; so that at the very sight of it he falls into dismal Convulsions and Agonies, and cannot drink the least drop; and this Hydrophobia, or Aquæ Timor, has been always accounted the surest Sign and Mark of this Poison, as distinguishing it from all others.

The Ancients have at large described these Symptoms, as Galen, Dioscorides, Aetius, Ægineta, but most particularly of all, Cælius Aurelianus (71); and later Writers have given us several Instances of the Hydrophobia; Two Histories of it published, the one by Dr. Lister (72), the other by Dr. Howman (73), I shall more especially take Notice of, and refer to, as containing the most exact and large Account of any I have met with; he that desires more, may consult the several Authors cited by that diligent Observer, Stalpart van der Wiel (74).

That this Disease is accompany’d with a Delirium, is almost the common Opinion both of Ancients and Moderns; Damocrates called it the barking Phrensie (75); but Dr. Lister agrees in this Point with Petrus Salius Diversus (76), and will not allow a Delirium to be the necessary consequent of this Venom; and yet at the same time he tells us, that his Patient barked like a Dog, and bit at the By-standers; that he threw into his Mouth what was given him more hastily and suddenly than it is Natural or Customary for Men to do.

From such Actions as these, together with those mentioned before in relating the Symptoms, it is obvious enough to conclude, that Persons thus affected are in a proper Sence Delirous. Tho’ at the same time I do think that the Hydrophobia it self (whatever is commonly believed) does not at all proceed from this Delirium, as will by and by appear.

I know indeed that the main and plausible Objection against a Delirium is this, that the Patient himself does Reason against his Timorousness, tho’ he cannot overcome it, forewarns the Standers-by of his Outrageous Fits, desires them to take care of themselves, and the like. Which from what I have already said concerning a Delirium, appears to be very consistent with it, nay, convinces that there is the greatest Degree of it in this Case; in as much as that it is not a Distemper of the Mind but of the Body. And to this purpose I remember to have seen my self an Instance of one in a Fever, who foretold some time before any signs of a Delirium were discovered, how raving and unruly He should be, and made good his Prognostick to that degree, that it was very hard Work to tame and master him; tho’, as he told me afterwards, he reason’d as much as he could against that groundless Jealousie of his Friends designing to Murder him, which put him upon his Mad Actions, but was not able to Conquer the prevailing Species of Fear and Anger.

This Delirium therefore, as Cælius Aurelianus (77) says, Proceeds intirely from an indisposition of the Body, which is without all doubt owing to the alteration made in the Blood by the Saliva of the Mad Dog, instill’d into the Wound inflicted by the Bite.

That we may rightly understand this, we must take Notice, that the Rabies or Madness in a Dog is the effect of a Violent Fever; and therefore it is most common in excessive Hot Weather, tho’ sometimes intense Cold maybe the Cause of it; That no Dog in this Case ever sweats; from whence it follows, that when his Blood is in a Ferment, it cannot, as in other Creatures, discharge it self upon the surface of the Body, and therefore must of necessity throw out a great many Saline and Active Particles upon those Parts, where there is the most constant and easie Secretion; and such, next to the Miliary in the Skin in Us, are the Salival Glands; for this reason much more Spittle is separated in a Dog when Mad, than at any other time, and that very frothy, or impregnated with Hot, Subtil Parts.

Now as we every Day observe, that what is thrown out from Liquors in a Ferment, is capable of inducing the like Motion in another Liquor of the same kind, when duly mixed with it; so we may very well suppose in the present Case, that the Saliva, which is it self one of the most Fermentative Juices in Nature, being turgid with Fiery, Saline Particles thrown into it out of the boiling Blood, when it comes by means of a Wound to be Incorporated with the Arterial Fluid of any One, does by Degrees raise a preternatural Effervescence in it; the Effects of which will necessarily be most felt in those Parts which being tender, are the least able to refill the distension of the Blood Vessels; such are the Stomach, and especially the Brain; and hereupon Deliria, with Maniacal, and such like Symptoms, will easily insue.

A Person thus affected may be said in a Degree to have put on the Canine Nature, tho’ his Reason be all this time untouch’d and intire, may Bite, Howl, &c. because the like violent Agitation of the Blood in Him as was in the Dog will present like Species, and consequently (so far as their different Natures will allow) produce like Actions; just as it has been observed, that Sheep bitten by a Mad Dog, have run at the Shepherd like so many Dogs to Bite him; so much can an Alteration of the Blood and Spirits do. And as a Timorous Creature may be imboldened, so we oftentimes see Persons Courageous enough by a change made in the Blood by Evacuations, that is, by want of Force and Motion in that Fluid, made sheepish Cowards, in despight of their Reason, so long as that Defect is continued.

But the main difficulties in this matter are, the Mischief discovering it self so long after the Bite, and the Hydrophobia.

As to the former, we are to consider, that Fermentation being a Change made in the Cohæsion of the compounding Parts of a Fluid, it is sometimes a longer, sometimes a shorter time before this Alteration is wrought; which variety may proceed either from the different Nature and Constitution of the Ferment, or of the Liquor Fermented, and a great Number of Circumstances besides. So that this Venom may be all the while doing its Work, tho’ the change made by it may not be so considerable as to be sensibly taken Notice of till a long time after.

Nay, it may so happen, that the Ferment being Weak may not raise in the Blood any remarkable Agitation at all, till some accidental Alteration in the Body unluckily gives it an additional Force. As we before observed, how much external Heat concurrs to heighten the Symptoms from the Bite of the Tarantula. And this probably may be the Case of Those in whom this Malignity has not appear’d till Six, or Twelve Months after the Wound.

That we may understand the Reason of the Hydrophobia, it is to be Remarked, that this dread of Water does not come on till the latter end of the Disease, Three or Four Days before Death; that is, not till this preternatural Fermentation in the Blood is come to its Heigth; and as in the Dog, so in the Patient, a great quantity of Fermentative Particles is thrown off upon the Glands of the Mouth and Stomach, as appears by his Foaming at the Mouth, &c.

As also, that this Fear is not from a sight of, or any imaginary appearance in the Water, for if the Vessel be close shut, and the Patient bid to suck thro’ a Quill, as soon as he has tasted, he falls into Anguish and Convulsions, as Dr. Lister observed. It is therefore highly probable, if not certain, that this surprising Symptom proceeds from the intolerable Pain which any Liquor at this time taken induces, partly by hurting the inflamed Membranes of the Fauces in Deglutition; partly by fermenting with these Active Particles discharged by the Blood upon the Stomachic Glands, and thus twitching and irritating the Nervous Membranes; the very memory of which grievous Sence, after it is once felt, is so terrible, that the affected Person chuses any thing rather than to undergo it a second time.

The Effects of this Irritation are manifest in the Convulsions of the Stomach, and frequent Singultus, with which the Patient is continually oppress’d. And we all know by how necessary a kind of Mechanism we do fly from and abhor those things which have proved disagreeable to the Animal Œconomy, to which nothing is so contrary and repugnant as Pain; at the first Approaches of which, Nature Starts and Recoils, tho’ Reason be arm’d with never so much Courage and Resolution to undergo the Shock.

Nor will any Body wonder how this Ferment should cause such Torment, who considers how often, even in Colical Cases, Persons are downright distracted by excessive Pain, from a Cause not unlike to this we are treating of, that is, from a corrosive Ferment in the Bowels, rarefying the Juices there into Flatus, and by this means irritating and stimulating those tender Membranes into Spasmodic and Convulsive Motions.

And indeed Dr. Lister’s Patient told him, that the very swallowing of his own Spittle put him to such Torture in his Stomach, that Death it self was not so Terrible as the Inexpressible Agony.

It may serve both to Illustrate and Confirm this Theory, to take Notice, that not only may (according to these Principles) other Bites besides that of a Dog happen to induce the like Symptoms; thus Malpighi (78) relates a Story of a Mother made Hydrophoba by the Bite of her Epileptic Daughter; but that there are other Cases, without any Bite at all, which are attended with an Hydrophobia.

Thus Schenkius (79), Salmuth (80) and others have observ’d a Dread of Water, without any Suspicion of a Bite, from Malignant Fevers. Now in These there is doubtless a Hot, Putrid Ferment in the Blood; and it is no wonder if Part of it be discharged upon the Throat and Stomach, which we do evidently find in these Distempers to be more particularly affected by It, especially towards the latter End, from the Aphthæ, Singultus, and the like usual Symptoms of a fatal Malignity.

Nay, Hippocrates (81) himself seems more than once to have remarked something like this Symptom in Fevers, and to call those who were thus affected Βραχυπόται, or little Drinkers; for I cannot assent to Dr. Lister, (tho’ Cælius Aurelianus be on his side) who thinks that the Βραχυπόται are ὑδροφόβοι, from the Bite of a Mad Dog; as well for other Reasons, as because Plutarch (82) assures Us, that the Hydrophobia and Elephantiasis were both first taken Notice of in the time of Asclepiades the Physician; who liv’d in the Days of Pompey the Great, many Years later than either Hippocrates or Aristotle.

Neither is it amiss to add, that Ioannes Faber (83) in the Dissection of one who dy’d at Rome of the Bite of a Mad Dog, and a Hydrophobia succeeding it, found the Blood Coagulated in the right Ventricle of the Heart, the Lungs wonderfully Red and Tumefied; but especially the Throat, Stomach, and Bowels, bearing the Marks of the Inflammatory Venom.

The same Observation has been made by others in Bodies Dead of this Disease. Thus the Acta Medica Hafniensia (84) relate one Case, in which, part of the Liver was Inflamed, the Lungs Parched and Dry, and the inner Coat of the Stomach so Mortified, that it might be abraded with one’s Fingers.

Bonetus (85) tells another, where all the Viscera were found quite arid, without any Juice at all.

And in a very particular History of an Hydrophobia, lately published at Ulm, (86) We are informed, that the Stomach, when opened, discover’d the Marks of an Erosion or Excoriation, with something like a Gangrene, and Suffusion of Blood here and there. Which does very well agree with the Observations in the German Ephemerides (87), where we find several Footsteps of a Sphacelus or Mortification in the Bodies of Those who died Hydrophobi.

The Cure of this Poison is either immediately upon the Wound made, or some Days after, before the Fear of Water is discover’d; for at that time all Authors do agree the Malady to be Incurable; and the Reason is plain from what has been already deliver’d.

As in other Venomous Bites, so in this, Galen (88) very wisely advises to inlarge the Wound, by making a round Incision about it, to Cauterise it with a hot Iron, and apply drawing Medicines, so as to keep it a running Ulcer at least Forty Days. (89) Scarifying and Cupping may answer where this Severity is not allow’d: And however, the Dressing it with Unguentum Ægyptiacum (or the like) Scalding Hot, must not be omitted; by which alone, timely applied, I am assured that one Bitten was happily preserved.

But where these Means of destroying the Ferment in the beginning are omitted, the dangerous Consequences of its being mixed with the Blood is by all possible Care to be prevented.

To this purpose, to say nothing of the many Inconsiderate Jumbles of Antidotes, Theriacas, &c. nor of such vulgar Trifles as the Liver of the Mad Dog, of which Galen (90) observed, that tho’ some who made use of it, together with other good Medicines, recover’d, yet that they who trusted to it alone died; one of the greatest Remedies commended to us by Antiquity, is the Cineres Cancrorum Fluviatilium; which Galen (91) says, no Body ever made use of, and miscarried; and before Him Dioscorides (92) assured, that ’tis a Medicine may be rely’d on. These were given in large Quantities, viz. a good Spoonful or Two every Day for Forty Days together, either alone, or rather mix’d with the Powder of Gentian Root and Frankincense. The Vehicle was either Water or Wine. In like manner at this Day the Remedy in the greatest Repute of any against most Poisons in the West-Indies, is a kind of a River-Craw-Fish, call’d Aratu (93).

This is manifestly an Absorbent, and very Diuretic Medicine, especially when prepared after the right manner, which was by Burning the Craw-Fish alive upon a Copper-Plate, with a Fire made of the Cuttings or Twigs of White Briony: For whether the latter part of the Management signifies much or no, the former most certainly does; and the Salt of the Copper, which powerfully provokes Urine, being mix’d with that of the Ashes, may very much exalt their Virtue.

And it is upon this same Score, that the Spongia of the Cynnorrhodos or Rosa Sylvestris is so Celebrated an Antidote, not only for this Poison, but also for that of the Viper, Tarantula, and others too, that ’tis call’d in Sicily Sanatodos, or All-heal; this being not a Vegetable, as P. Boccone (94) who has wrote a whole Letter of its wondrous Virtues, terms it, but an Animal Alkali, as well as the former; for as Mr. Ray (95) has observed, this Spongy Excrescence, if it be cut, is found full of White Worms; Being the Nest of these Insects, which lodging here all the Winter, do in the beginning of the Spring turn to Flies, and quit their Quarters. Indeed this Remedy was antiently too of so great Esteem, that Pliny recommends it as the only Cure of an Hydrophobia, divinely discovered by an Oracle (96).

As all Insects abound with a Diuretick Salt, so Cantharides more than any others; therefore the Learned Bacchius (97) goes farther, and from the Authority of Rhazes and Joannes Damascenus, advises to give these in Substance for many Days together. The Preparation of this Antidote, (so he calls it) is by infusing the Cantharides in Soure Butter-milk Twenty Four Hours, then drying them, and with the Flower of Lentils and Wine making them up into Troches of a Scruple Weight, of which one is to be taken every Day, By which means he assures us, that tho’ the Patient make bloody Urine, yet that Milk largely drank will abate that Symptom, and that an Hydrophobia will be happily prevented. Boccone (98) tells Us, That in Upper Hungary They give Cantharides to Men bitten by a Mad Dog, Five to a Dose; and to Beasts in greater Quantity. But of the inward Use of these Flies more in its proper Place.

In short, all the Specifics in this Case are such as do either absorb a peccant Acidity in the Stomach, or carry it off by Urine; as Terra Lemnia, highly commended by Galen (99), Garlick, Agrimony, Oxylapathum, and many others, of which a Catalogue may be seen in S. Ardoynus. So the Alyssum or Madwort, celebrated for this use by the Ancient Physicians, as well that described by Diascorides, which is a Species of Leucoium, as the other of Galen, which is a Marrubium, is very manifestly a Bitter, Stomachic, and Diuretic Plant (100). The Lichen cinereus terrestris, recommended in the Philosophical Transactions (101), Operates the same way.

But the greatest and surest Cure of all, is frequent Submerging or Ducking the Patient in Water. The first mention I find of this is in Cornelius Celsus (102); whether he had it from the Ancient Grecian Physicians, or it was the Discovery of his own Age, matters but little to our Purpose; certain it is, that he collected his Principal Rules of Bathing from Cleophantus, who, as Pliny says (103), did, besides many other delightful things, first introduce the Use of Baths; As appears by comparing the Writings of the One with the Fragments of the Other, preserv’d in the Works of Galen. And that from Asclepiades, who afterwards so far improved this Part of Physick, that he discarded almost all inward Medicines, he might learn this Management, is not improbable; for the Hydrophobia (as we before took Notice) having been first regarded in the time of this great Physician, ’tis very likely that among other Advantages of his new Method, he might commend it for the Cure of so deplorable a Malady.

However it be, This Practice was in this last Age with great Authority revived by the Ingenious Baron Van Helmont (104), who having in his own Country seen how great Service it did, has at large set down both the manner of the Operation; and, Consonant to the Principles of his own Philosophy, shewn the Reason of its good Effects. Since him Tulpius (105), an Observer of very good Credit, takes notice, that tho’ he saw many, yet that never one miscarry’d, where it was in time made use of.

As all Baths do chiefly act by the sensible Qualities of Heat and Cold, and the Gravity of their Fluid; so we need go no farther to fetch the Reason of the great Advantage of this Method in the present Case, than to the Pressure of the Water upon the Body of the Patient.

Every one knows how plentifully plunging into cold Water provokes Urine, which proceeds no doubt from the constriction hereby made of the Fibres of the Skin and Vessels. Thus this outward Cure differs not much in effect from the inward Medicines beforementioned, but must necessarily have the better of them in this Respect, that when the Fermenting Blood stretches its Vessels, the exceeding weight of the ambient Fluid resists and represses this Distension, and so prevents the Effects of It. For this Reason the Salt Water of the Sea is especially chosen for this Business, because its greater Gravity than that of Fresh does more powerfully do all this, and break the beginning Cohæsion of the Parts of the Blood.

Thus we may, without having recourse to the Fright and Terror, with which this Method, when rightly practis’d, (by keeping the Party under Water for a considerable time, till he is almost quite drowned) is usually accompanied, probably enough account for the Advantages of this Immersion. Tho’ it is not unlikely that this new Fear may have some good Effect in the Case too, for not only Convulsions, but Agues, and other Diseases, have oftentimes been happily Cured, merely by terrifying and surprising the Patient.

The Reason of this will easily be understood by him who knows what Alterations the Passions of the Mind do make in the Fluid of the Nerves and Arteries; of which in another Place.

It may for our present purpose suffice to take Notice, That as in Consideration of the last mentioned Effect upon the Mind, Van Helmont commends this same Practice in all Sorts of Madness, and Chronical Deliria; so upon the account of the before hinted Alterations on the Body, Bathing was, among the Ancients, the common Cure of Melancholy, and such like Distempers (106). And as the younger Van Helmont (107) to confirm his Father’s Notions, tells Us, that one Dr. Richardson did with wonderful Success make use of this Management in these Cases, so in like manner Prosper Alpinus (108) takes Notice, that the Egyptians do at this Day perfectly recover Melancholy Persons by the same Method, only with this Difference, that they make their Baths warm.

He that compares what has been already advanc’d concerning Deliria, with the Bellinian Theory of Melancholy and Maniacal Distempers, and reflects upon the Nature of Baths, and their manner of Acting, will see so much Reason in this Practice, as to be sorry that ’tis now-a-days almost quite laid aside and neglected. For we must observe, that altho’ there be some Difference in the Treatment and Cure of Deliria, whether Maniacal or Melancholy, when they are Originally from the Mind, as the Effects of Care, Trouble, or the like, and when from an Indisposition of the Body; yet that both do agree in this, that they require an Alteration to be made in the Blood and Spirits; inasmuch as the Mind, by often, nay, almost continually, renewing to it self any one Idea, of Love, Sorrow, &c. does so constantly determine the Spirits and Blood, one and the same way, that the Body does at last as much share in the Alteration, as if it had been primarily affected, and consequently must have, in some manner, the same Amendment. Upon this Score Baccius (109) asserts the admirable Use of Temperate Baths, in all kind of Distractions; and assures us, that not only common Deliria, but even the Dæmoniaci, Phanatici, Lycanthropi themselves, &c. are cured by frequent Washings in fresh Water, and a moist and Nourishing Diet.

But to insist upon this Subject is foreign to our purpose; only in regard that the most usual Methods of Cure in these Cases are so very tedious, and oftentimes unsuccessful at the last, I thought it not amiss to hint thus much, in order to the advancing something more Certain and Effectual towards the Removal of the greatest Unhappiness to which Mankind is liable.

To conclude with the Hydrophobia; where these Remedies fail, or are Administred too late, the Patient, from the prevailing inflammatory Disposition of the Blood, grows more and more Delirous, and by Degrees downright raving Mad, at last (as it most commonly happens in Maniacal People) suffers a total Resolution of Strength, and Dies. Thus Dr. Howna’s Case ended in a perfect universal Paralysis.