I was once requested to meet a medical gentleman in consultation
respecting a supposed case of rabies. There was protrusion and
discoloration of the tongue, and fighting at the corners of the mouth,
and intense anxiety of countenance. He had been in this state for
four-and-twenty hours. This was a case in which I should possibly have
been deceived had it been the first dog that I had seen with dumb
madness. After having tested a little the ferocity or manageableness of
the animal, I passed my hand along the outside of the jaws, and felt a
bone wedged between two of the grinders. The forceps soon set all right
with him.
It is time to inquire more strictly into the post-mortem appearances of
rabies in the dog.
In dumb madness the unfailing accompaniment is, to a greater or less
degree, paralysis of the muscles of the lower jaw, and the tongue is
discoloured and swollen, and hanging from the mouth; more blood than
usual also is deposited in the anterior and inferior portion of it. Its
colour varies from a dark red to a dingy purple, or almost black. In
ferocious madness it is usually torn and bruised, or it is discoloured
by the dirt and filth with which it has been brought into contact, and,
not unfrequently, its anterior portion is coated with some disgusting
matter. The papillae, or small projections on the back of the tongue,
are elongated and widened, and their mucous covering evidently reddened.
The orifices of the glands of the tongue are frequently enlarged,
particularly as they run their course along the froenum of the tongue.
The fauces, situated at the posterior part of the mouth, generally
exhibit traces of inflammation. They appear in the majority of cases of
ferocious madness, and they are never deficient after dumb madness. They
are usually most intense either towards the palatine arch or the larynx.
Sometimes an inflammatory character is diffused through its whole
extent, but occasionally it is more or less intense towards one or both
of the terminations of the fauces, while the intermediate portion
retains nearly its healthy hue.
There is one circumstance of not unfrequent occurrence, which will at
once decide the case--the presence of indigestible matter, probably
small in quantity, in the back part of the mouth. This speaks volumes as
to the depraved appetite of the patient, and the loss of power in the
muscles of the pharynx.
Little will depend on the tonsils of the throat. They occasionally
enlarge to more than double their usual size; but this is more in quiet
than in ferocious madness. The insatiable thirst of the rabid dog is
perhaps connected with this condition of them.
The epiglottis should be very carefully observed. It is more or less
injected in every case of rabies. Numerous vessels increase in size and
multiply round its edge, and there is considerable injection and
thickening.
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