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How could this be possible for rabies to lie dormant for 5 years?
This makes me thankful for modern medicine
H. L., aged 17, was admitted to the Huddersfield Infirmary with symptoms of hydrophobia about midday on September 5th, 1892. He had been bitten near Shepley, a country district, by a mad dog (fox terrier) on August lst, 1887. Abrother and neighbour were bitten at the same time. The bite was on his left hand, his brother being bitten on the wrist and arm more severely. All three went to Paris on August 5th, and stayed there until August 19th, being treated by Pasteur. On October 4th his brother was admitted into theinfirmary suffering from hydrophobia, and died on October 5th. His age was 26.
Since the bite H. L. had been perfectly well with the exception of lymphangitis of his left arm two years ago, for which he was treated by Dr. Alister Macgregor, who traced the mischief on that occasion to a deep scratch from a rusty nail; the inflammation soon subsided, although at the time the lad's mother was deeply concerned, thinking it was the result of the dog bite three years previously. His parents stated that he first complained on August 31st of pain about the neck and the back of the head; he thought it was a cold, but as Dr. A. Macgregor, the family medical attendant, has kindly supplied me with an account of the illness previous to his admission to the infirmary, I give it in his own words.
He writes:-
I was called to see H. L. on September 4th. On arriving at his house
I met his father outside the door, and he said to me that his son was
sleeping on the hearthrug, and that I should not waken him, as he had
been very violent. He went on to explain that on September 1st H.
had complained of a pain in his left shoulder and in his back, which pain
steadily grew worse, much to his father's alarm, as his other son F. (who
died of hydrophobia five years ago) had been taken the same way. They
bathed the shoulder, and the pain in it disappeared on the morningof
September 4th, although the pain in the back (where M. Pasteur had inoculated)
still remained, though not so severe. During this time the lad
seemed out of sorts, but took his food fairly well, and showed no aversion
to fluids. On September 4th, at dinner time, he had taken some
food, when, on beginning to drink some beer, he was seized with a spasm,
and said the beer stuck in his throat, and he could not swallow it. Immediately
afterwards he began to look very wild, as the father expressed
it. The poor parents were very alarmed, and sent for me. After hearing
this history, I entered the house and found the patient lying on the
hearthrug, apparently sleeping. I had hardly sat down when he wakened
and spoke quite sensibly to me-so sensibly, in fact, that I formed
the impression that the parents (who had never really got over the death
of the other son) had got needlessly alarmed about him. H.toldmethat the
ain in hisshoulder and back had kept him from sleeping for three nights,
fut that hethought he could sleep a bit now that the pain was rather better.
He said he " didn't ail so much now." On questioning him about his
a-petite, he said that some beer he had had at dinner had upset him, so
that he could eat no more, but on my asking him if he could drink some
milk he said " Oh, yes, I think I can." He had by this time got up and
sat in a chair, and when the milk was handed to him he took the mug
quite calmly and proceeded to drink it. Hardly, however, had It touched
his lips when a violent convulsion seized him in his arms, and with a
groan he flung the mug away. I said to him.: "Come, now, H., try.
again and see if you can't drink some." He said "I'll try." Then he
braced his shoulders back and made a convulsive grasp at the mug
handed to him, but directly he tried to swaUow it his eyes gleamed fire
(exactly like a cat's in the dark); his features worked convulsively; he
tried to gulp the milk down, but it all came back; he let the mug drop
and, with a peculiar weird cry, sank back in the chair. He immedilately
afterwards showed signs of becoming very violent, so 1 injected half
a grain of morphine subcutaneously, and got him put to bed. At midnight
(that Is, about 8k hours afterwards) he was sleeping calmly, but
about 6 A.M. on September 5th he was seized with convulsions. On my
visit at 8 A.M. I again injected half a grain of morphine, which quieted
him until he reached the Huddersfield Infirmary. On the journey he
seemed quite easy; in fact, on arriving at Huddersfield he said he had
had a very pleasant ride. While waiting in the cab at the infirmary gates
he said he felt very hungry; but when some beef-tea was offered to him
he became violently convulsed. I shall never forget the scene when the
poor lad was saying "Goodbye" to his parents brothers and sisters;
it was really mos heartrending. He realised fully on Monday morning
(September 5th) what was to be his fate; but always previously, his father
told me,'he had made very light of his dog bite, and said it did not
bother him much, so that, in his case at least, morbid glooming was not
the exciting cause of the hydrophobia symptoms. The other la who was
bitten by tie same mad dog is up to now, I believe, quite well, but, as
yrou may Imagine, in a fearful state of mind.
On admission he looked fairly well but rather flushed, and
his lips were very dry. He talked rationally, and said that
two minutes before the severe attack, on attempting to drink
at dinner on the previous day, he had been able to drink quite
easily. He was offered some beef-tea, but was seized with
convulsions, complained of some oppression in his respiration,
and a feeling as if there were a lump in his throat.
About half an hour after admission he managed to drink a
little milk without much trouble, and to eat a slice of bread
and butter, but about four hours afterwards he became restless
and nervous, and sat up on the side of his bed. He was
still quite rational, but seemed afraid of the spasm coming
on. His tongue was dry in the middle, with a little frothy
deposit at the edges. Pulse 120, respirations 36. After a
hypodermic injection of half a grain of morphine he became
quite calm. There was, however, an occasional sudden respiratory
spasm, apparently caused by attempting to swallow
some saliva. He was ordered to have chloral by the bowel
alternately with the hypodermic injections of morphine, and
to be fed by enemata of peptonised milk and beef-tea. These
were given every four hours. Up till midnight he was fairly
quiet but with slight respiratory spasm. At 2 A.M. he became
restless, and started up in bed several times, and the spasms
became more severe. At 4 A.M. he grew worse, and was shouting,
foaming at the mouth, and jumping out of bed. He remained
pretty much-in this condition until 6 A.M., when he
quieted down a little, and an hour and a half later took about
a teaspoonful of tea, and liked it, although he drank it with
great difficulty. A few minutes later he again became much
worse, and shouted, and threw himself about in bed. Spasm
became more severe; there was much foaming at the mouth;
he was quite unable to drink, and had a severe attack of
spasm when the nurse wanted to wash his face. By 9 A.M.
the nurse and his two brothers, who were with him during
the night, could not control him. He had to be held down
in bed, and struggled very violently, at the same time spitfing
out large quantities of saliva, and rambling and
shouting. He was put under the influence of chloroform,
and half a grain of morphine was injected, and his hands,
shoulders, and feet were secured to the bedstead.
He was kept more or less under the influence of chloroform,
and whenever he commenced to come out of it he began
struggling and shouting. There were frothing at the mouth,
spitting all over the bed and floor, widely dilated pupils, great
restlessness, profuse perspiration, violent efforts to get out of
bed, vomiting of greenish watery fluid, and some priapism.
The saliva was very abundant, and was every now and then
sucked into the windpipe, and then violently ejected. At
times he would suddenly stiffen the whole body, throw his
head backwards and to one side, put his features into a half
grin, and scream loudly. His pulse was 136, very feeble, and
there were abundant coarse rdle8 in the chest. Shortly after
11 A.M., on coming round from the chloroform, he was fairly
quiet, but was foaming at the mouth, and vomiting mouthfuls
of saliva and mucus continuously, which he spat all round
his bed. The respiratory spasm became worse, and caused
more sucking in of the saliva into his trachea, and somewhat
cyanosed him. The pulse rose to 180. An hour and a-half
later he was still very restless. He had intervals of apnoea
lasting sometimes about half a minute, when he became
rather cyanosed, and then the respiratory spasm came on. He
was still vomiting and spitting out large quantities of saliva.
He continued to ramble, and threw himself about as much as the
straps would allow him, and became gradually weaker.
The respiratory spasm also became worse, and the cyanosis
also increased, whilst the vomiting b'ecame more frequent.
Shortly after 2 P.M. the cyanosis' was more or less continuous.
The pulse was only just perceptible at the wrist. He was still
bringing up mouthfuls of saliva, but did not spit it out, but
allowed it to run out of his mouth. He still rambled a little,
and moved his head about. At 2.30 he died, little more than
forty-eight hours after the commencement of the serious
symptoms.
This makes me thankful for modern medicine
H. L., aged 17, was admitted to the Huddersfield Infirmary with symptoms of hydrophobia about midday on September 5th, 1892. He had been bitten near Shepley, a country district, by a mad dog (fox terrier) on August lst, 1887. Abrother and neighbour were bitten at the same time. The bite was on his left hand, his brother being bitten on the wrist and arm more severely. All three went to Paris on August 5th, and stayed there until August 19th, being treated by Pasteur. On October 4th his brother was admitted into theinfirmary suffering from hydrophobia, and died on October 5th. His age was 26.
Since the bite H. L. had been perfectly well with the exception of lymphangitis of his left arm two years ago, for which he was treated by Dr. Alister Macgregor, who traced the mischief on that occasion to a deep scratch from a rusty nail; the inflammation soon subsided, although at the time the lad's mother was deeply concerned, thinking it was the result of the dog bite three years previously. His parents stated that he first complained on August 31st of pain about the neck and the back of the head; he thought it was a cold, but as Dr. A. Macgregor, the family medical attendant, has kindly supplied me with an account of the illness previous to his admission to the infirmary, I give it in his own words.
He writes:-
I was called to see H. L. on September 4th. On arriving at his house
I met his father outside the door, and he said to me that his son was
sleeping on the hearthrug, and that I should not waken him, as he had
been very violent. He went on to explain that on September 1st H.
had complained of a pain in his left shoulder and in his back, which pain
steadily grew worse, much to his father's alarm, as his other son F. (who
died of hydrophobia five years ago) had been taken the same way. They
bathed the shoulder, and the pain in it disappeared on the morningof
September 4th, although the pain in the back (where M. Pasteur had inoculated)
still remained, though not so severe. During this time the lad
seemed out of sorts, but took his food fairly well, and showed no aversion
to fluids. On September 4th, at dinner time, he had taken some
food, when, on beginning to drink some beer, he was seized with a spasm,
and said the beer stuck in his throat, and he could not swallow it. Immediately
afterwards he began to look very wild, as the father expressed
it. The poor parents were very alarmed, and sent for me. After hearing
this history, I entered the house and found the patient lying on the
hearthrug, apparently sleeping. I had hardly sat down when he wakened
and spoke quite sensibly to me-so sensibly, in fact, that I formed
the impression that the parents (who had never really got over the death
of the other son) had got needlessly alarmed about him. H.toldmethat the
ain in hisshoulder and back had kept him from sleeping for three nights,
fut that hethought he could sleep a bit now that the pain was rather better.
He said he " didn't ail so much now." On questioning him about his
a-petite, he said that some beer he had had at dinner had upset him, so
that he could eat no more, but on my asking him if he could drink some
milk he said " Oh, yes, I think I can." He had by this time got up and
sat in a chair, and when the milk was handed to him he took the mug
quite calmly and proceeded to drink it. Hardly, however, had It touched
his lips when a violent convulsion seized him in his arms, and with a
groan he flung the mug away. I said to him.: "Come, now, H., try.
again and see if you can't drink some." He said "I'll try." Then he
braced his shoulders back and made a convulsive grasp at the mug
handed to him, but directly he tried to swaUow it his eyes gleamed fire
(exactly like a cat's in the dark); his features worked convulsively; he
tried to gulp the milk down, but it all came back; he let the mug drop
and, with a peculiar weird cry, sank back in the chair. He immedilately
afterwards showed signs of becoming very violent, so 1 injected half
a grain of morphine subcutaneously, and got him put to bed. At midnight
(that Is, about 8k hours afterwards) he was sleeping calmly, but
about 6 A.M. on September 5th he was seized with convulsions. On my
visit at 8 A.M. I again injected half a grain of morphine, which quieted
him until he reached the Huddersfield Infirmary. On the journey he
seemed quite easy; in fact, on arriving at Huddersfield he said he had
had a very pleasant ride. While waiting in the cab at the infirmary gates
he said he felt very hungry; but when some beef-tea was offered to him
he became violently convulsed. I shall never forget the scene when the
poor lad was saying "Goodbye" to his parents brothers and sisters;
it was really mos heartrending. He realised fully on Monday morning
(September 5th) what was to be his fate; but always previously, his father
told me,'he had made very light of his dog bite, and said it did not
bother him much, so that, in his case at least, morbid glooming was not
the exciting cause of the hydrophobia symptoms. The other la who was
bitten by tie same mad dog is up to now, I believe, quite well, but, as
yrou may Imagine, in a fearful state of mind.
On admission he looked fairly well but rather flushed, and
his lips were very dry. He talked rationally, and said that
two minutes before the severe attack, on attempting to drink
at dinner on the previous day, he had been able to drink quite
easily. He was offered some beef-tea, but was seized with
convulsions, complained of some oppression in his respiration,
and a feeling as if there were a lump in his throat.
About half an hour after admission he managed to drink a
little milk without much trouble, and to eat a slice of bread
and butter, but about four hours afterwards he became restless
and nervous, and sat up on the side of his bed. He was
still quite rational, but seemed afraid of the spasm coming
on. His tongue was dry in the middle, with a little frothy
deposit at the edges. Pulse 120, respirations 36. After a
hypodermic injection of half a grain of morphine he became
quite calm. There was, however, an occasional sudden respiratory
spasm, apparently caused by attempting to swallow
some saliva. He was ordered to have chloral by the bowel
alternately with the hypodermic injections of morphine, and
to be fed by enemata of peptonised milk and beef-tea. These
were given every four hours. Up till midnight he was fairly
quiet but with slight respiratory spasm. At 2 A.M. he became
restless, and started up in bed several times, and the spasms
became more severe. At 4 A.M. he grew worse, and was shouting,
foaming at the mouth, and jumping out of bed. He remained
pretty much-in this condition until 6 A.M., when he
quieted down a little, and an hour and a half later took about
a teaspoonful of tea, and liked it, although he drank it with
great difficulty. A few minutes later he again became much
worse, and shouted, and threw himself about in bed. Spasm
became more severe; there was much foaming at the mouth;
he was quite unable to drink, and had a severe attack of
spasm when the nurse wanted to wash his face. By 9 A.M.
the nurse and his two brothers, who were with him during
the night, could not control him. He had to be held down
in bed, and struggled very violently, at the same time spitfing
out large quantities of saliva, and rambling and
shouting. He was put under the influence of chloroform,
and half a grain of morphine was injected, and his hands,
shoulders, and feet were secured to the bedstead.
He was kept more or less under the influence of chloroform,
and whenever he commenced to come out of it he began
struggling and shouting. There were frothing at the mouth,
spitting all over the bed and floor, widely dilated pupils, great
restlessness, profuse perspiration, violent efforts to get out of
bed, vomiting of greenish watery fluid, and some priapism.
The saliva was very abundant, and was every now and then
sucked into the windpipe, and then violently ejected. At
times he would suddenly stiffen the whole body, throw his
head backwards and to one side, put his features into a half
grin, and scream loudly. His pulse was 136, very feeble, and
there were abundant coarse rdle8 in the chest. Shortly after
11 A.M., on coming round from the chloroform, he was fairly
quiet, but was foaming at the mouth, and vomiting mouthfuls
of saliva and mucus continuously, which he spat all round
his bed. The respiratory spasm became worse, and caused
more sucking in of the saliva into his trachea, and somewhat
cyanosed him. The pulse rose to 180. An hour and a-half
later he was still very restless. He had intervals of apnoea
lasting sometimes about half a minute, when he became
rather cyanosed, and then the respiratory spasm came on. He
was still vomiting and spitting out large quantities of saliva.
He continued to ramble, and threw himself about as much as the
straps would allow him, and became gradually weaker.
The respiratory spasm also became worse, and the cyanosis
also increased, whilst the vomiting b'ecame more frequent.
Shortly after 2 P.M. the cyanosis' was more or less continuous.
The pulse was only just perceptible at the wrist. He was still
bringing up mouthfuls of saliva, but did not spit it out, but
allowed it to run out of his mouth. He still rambled a little,
and moved his head about. At 2.30 he died, little more than
forty-eight hours after the commencement of the serious
symptoms.
