Reprinted from the Chicago Medical Journal and Examiner for June, 1887. 
Hydrophobia Vera, 
WITH REPORT OF A CASE. 
By JAMES I. TUCKER, M. D. 
Chicago, III.: 
Press of the Clark & Longley Co. 
1887. HYDROPHOBIA VERA, WITH A REPORT OF 
A CASE. 
[Read before the Chicago Medical Society, May 16th,] 
By James I. Tucker, A.M., M.D. 
During my student years, from 1863 to 1867, the 
prevailing doctrine in this country seemed to be that 
there was no such disease as hydrophobia vera-i. e.: 
a disease due to the inoculation and subsequent prolif- 
ication of germs of a specific animal poison which re- 
sides in the altered saliva of rabid animals, or, to omit 
the pathological clause and adopt the definition of Rey- 
nolds,* a disease due to a specific animal poison which 
resides in the saliva of animals affected with it. This 
doctrine, I believe, is at the present day very generally 
held in medical circles. Just now, when the experiments 
of Pasteur are attracting world-wide attention, and giv- 
ing rise to heated controversy, every ray of light that 
can be thrown upon this interesting subject is timely and 
appropriate. That there is a specific disease caused by 
the saliva of a rabid animal I have no longer a particle 
of doubt, or the case which I am about to report has 
not the importance which I attach to it. 
A few years ago I was frequently called to attend 
a Swedish family residing on Waupanseh avenue, 
now Thirty-seventh street, in this city. I never en- 
tered the house without being greeted with brutal 
courtesy by a snarling cur. The assurance from his 
* System of Medicine, vol. i, p. 711. 2 
Tucker--Hydrophobia Vera. 
master: " The dog is harmless; he barks but never 
bites. Down, Tiger! " was an incentive to duty, but 
hardly sufficient to allay my apprehensions. I did not 
feel so sure that the dog would not bite, and I was glad 
enough to get out of the house. Finally the family 
moved away and I heard no more of them for some 
time afterward. 
One morning about 5 o'clock, Dr. Flavius M. Wilder* 
called at my office and asked me to go and see a 
patient with him. I got into his buggy and we drove 
to Langley avenue. On the way the doctor asked me 
this question: "Is there, in your opinion, such a disease 
as hydrophobia? " I replied that the question was 
still unsettled in my mind; that I had never seen a case 
and had been taught that the disease commonly called 
hydrophobia, notwithstanding its classical history and 
high modern authority, was a form of acute mania with 
the characteristic delusions and hallucinations. 
We entered a cottage and saw lying on a bed the 
Swede whose family I had attended on Thirty-seventh 
street a year or two before. 
He was rational, but his physiognomy denoted ex- 
treme anxiety. His eyes were more brilliant than 
usual; his pulse rapid and jerky; his tongue coated 
and dry; he expectorated forcibly from time to time a 
viscid phlegm, and I observed that his neck was badly 
scratched, and on uncovering his chest that the skin 
was lacerated in a horrible manner. Dr. Wilder in- 
formed me that the patient had done this with his finger- 
nails during the paroxysms. I was curious to know 
* Whose permission was obtained before I wrote this paper. Tucker-Hydrophobia Vera. 
3 
what these paroxysms might-be. Accordingly I went 
to a cupboard, took therefrom a glass and drew some 
water into it. Into the water I put a few drops of a 
tincture. We raised our patient up and requested him 
to take a couple of teaspoonfuls of this medicine. As 
soon as he attempted to swallow the first teaspoonful, 
there followed a paroxysm of dysphagia which it would 
be* difficult to describe. It consisted, in brief, of a 
dysphagic constriction of the pharynx, and ccsophagus, 
in the hope of relieving the agony of which he had torn 
the flesh from his throat and chest. This paroxysm 
was only one of a series which the attending physician 
had been observing, and which had led him to diagnos- 
ticate the case as one of rabies canina. Shortly after 
the patient had another paroxysm, which caused him 
such extreme suffering that he sprang from his bed, 
leaped from the window into the garden, and, clad 
only in his night-shirt, rolled in the dust. Upon being 
calmed down he exclaimed: " I have dog disease! It 
can be none other! It is incurable! It means death. 
I want you, doctors, to give me something to terminate 
my life speedily, that I may not suffer unnecessarily! " 
Thereafter, I am told he made attempts to destroy his 
life by opening the radial arteries with a needle. 
Paroxysm after paroxysm, increasing in frequency and 
intensity, marked the further progress of the disease, 
and on the following morning after I saw him he died, 
either from exhaustion or asphyxia-which I cannot 
say, for he was then unattended except by his family. 
The intervals between the paroxysms were lucid and 
rational. He told his wife what to do after his death. 
He told me that he had been bitten six months before 4 
Tucker-Hydrophobia Vera. 
by the same "innocent " cur which he had assured me 
" barked only, but did not bite." That the cur had 
been immediately thereafter killed. He attached no 
importance to the bite till two weeks before we saw 
him, when, upon going to the lake to bathe, he ex- 
perienced a peculiar constriction about the throat and 
returned. On the following evening he tried the experi- 
ment a second time, and again felt the sensation of 
constriction. Upon returning he became feverish, the 
constrictions became more and more frequent and 
severe, and he directed his wife to send for a physician 
If we had not been pre-occupied at the time, we would 
doubtless have paid closer attention to the more remote 
phenomena of the disease. We would have looked 
for the peculiar swellings of the tongue known as lyssi, 
for general hypersesthesia, exaltation of special senses, 
priapism, etc.; but, as it was, our attention was 
absorbed by the observation of the gross appearances. 
Treatment was ineffectual except as a palliative. 
To recapitulate: i. The man was bitten by a 
dog, which was immediately thereafter killed; not be- 
cause he was supposed to be mad, but because his 
master was angry with him. There was, therefore, no 
suspicion or dread of hydrophobia. 
2. The dog was a sullen, snarling cur, which so 
many foreigners keep about them as a body-guard. It 
was unwise to kill him, for it was sacrificing the prin- 
cipal witness. 
3. The idea of the biting, and the thought of hydro- 
phobia, did not occur to our patient until the symptoms 
unmistakably manifested themselves. Tucker-Hydrophobia Vera. 
5 
4. The difficulty of deglutition was caused, first, by 
the sight of water; second; by the attempt to drink 
water; third, the disease fully developed, the spasms 
occurred independent of either provocation. There 
was extreme thirst. 
5. The paroxysms, consisting principally of con- 
striction of the pharynx and oesophagus and unex- 
plainable from any other stand point, psychical or neuro- 
logical, were almost pathognomonic. 
6. Between the paroxysms, there' were distinct in- 
termissions, during which the mind was lucid and 
rational. 
7. Rabies confirmed, the phenomena were unmis- 
takable to the physicians and justified the grave sus- 
picions of the patient. 
8. No treatment mitigated the symptoms or fore- 
fended the result. 
9. He died on the morning of the fourth day. 
So far as we know at present the prognosis is of the 
worst description. Death is inevitable. I have not 
received evidence to convince me of the efficacy of 
Pasteurization. 
It is somewhat remarkable that, if the disease is as 
common as is popularly supposed-a supposition which 
the Pasteur inoculations would seem to countenance- 
how few physicians seem to have seen a single case! 
In an uninterrupted practice of nearly a quarter of a 
century I have seen only one case. I have witnessed 
lyssaform mania and tetaniform dysphagia and a num- 
ber of cases of pseudo-hydrophobia, to which the 
secular press is so fond of giving a sensational coloring, 6 
Tucker-Hydrophobia Vera. 
but never before have I seen hydrophobia vera; the 
symptoms of which are, nevertheless, so unique that 
no one in the daily habit of practical differential diag- 
nostication can possibly mistake them. 
52 Douglas avenue. ©HE 
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