REPORT ON HYDROPHOBIA. 
BY 
CHARLES W. DULLES, M.D., 
OF PHILADK1.PHTA. 
FROM 
THE MEDICAL NEWS, 
June 16, 1894. [Reprinted from The MEDICAL NEWS, June 16, 1894.] 
REPORT ON HYDROPHOBIA.1 
By CHARLES W. DULLES, M.D., 
OF PHILADELPHlAi"""" 
In June, 1888, I made my last report to this 
Society, in pursuance of the resolution adopted at 
Williamsport, in 1886, asking me to continue my 
studies on hydrophobia and to report to the Society 
from time to time. During the six years which have 
just elapsed I have continued to collate cases of so- 
called hydrophobia and to study them, with a view 
to the report which I now make. 
The period of time covered by my present report 
issix years, from June 1,1888, to nearly June 1,1894. 
I have collated for these six years seventy-eight cases 
which had any claim to be regarded as instances of 
hydrophobia. A considerable number of these are, 
in my opinion, utterly incredible and wholly 
spurious. Admitting them all as true hydrophobia, 
we have for the United States an average of thirteen 
cases per annum, or about one case to four and a 
half million of inhabitants per annum. This is 
1 Read before the Medical Society of the State of Pennsylvania, 
May 16, 1894. 
The table of 78 cases accompanying this report will be pub- 
lished in the Transactions of the Pennsylvania State Medical 
Society and the Transactions of the College of Physicians of 
Philadelphia for 1894. 2 
about the same proportion as I found in my last 
report. 
The geographical distribution of the cases was as 
follows : 62 (about 80 per cent.) in the section of 
country from Maine to Georgia-14 of these being 
in the New England States ; 43 (55 per cent, of the 
whole number) in New York, New Jersey, and Penn- 
sylvania ; and 5 altogether in Maryland, South Caro- 
lina, and Georgia. Only 16 cases (2o>per cent.) 
occurred in the country west of the'Allegheny 
Mountains. 
This distribution I attribute to the inftaence of the 
newspapers published in New York and Philadelphia, 
which have at times, especially those in-New York, 
given too much space td-descriptions of the horrors 
of so-called hydrophobia, and to the exploitation 
of the Pasteur Institute "established in New York. 
Twenty-four cases occurred in New York City and 
places in Long Island and New Jersey which may 
be considered as environs -of New York-like 
Jersey City, Newark, Elizabeth, etc. 
In studying the cases that have come under my 
notice in the last six years I have been impressed 
by their bearing upon the views expressed in some 
books and papers on the subject as to the age at 
which hydrophobia occurs, and the relation of the 
length of the period of incubation to the age of the 
patient and the situation of the bite. 
In regard to age, I find that this varied from what 
was called " a baby " to what was called " old." 
Of the 78 victims, 18 were under ten years old ; 
16 were between ten and sixteen years old ; 8 were 
between seventeen and thirty-one years old; 34 3 
were between thirty five and fifty-seven years old ; 
1 was said to be " old," and the age of one has not 
been ascertained. 
Table of Ages. 
Little 
children. 
From 
io-r6 years. 
From 
17-31 years. 
From 
35-57 years. 
Old. 
Not 
stated. 
Baby, 
I 
ii y'rs, 5 
19 y'rs, 
2 
35 y'rs, 2 
I 
I 
3 years 
2 
12 " 4 
22 " 
3 
Adult, 23 
4 " 
3 
13 " 3 
27 " 
I 
40 y'rs, 1 
5 " 
3 
14 " i 
28 " 
I 
43 " I 
6 " 
4 
15 " 2 
31 " 
I 
45 " 1 
7 
2 
16 " i 
48 " 2 
8 " 
2 
50 " 2 
9 " 
I 
53 " 1 
57 " 1 
Total, 
18 
Total, 16 
Total, 
8 
Total, 34 
I 
I 
Of these victims of so-called hydrophobia, the 
only ones too young to have distinct notions in 
regard to this disease were the "baby" (No. 59), 
about whom I have no evidence that the case was 
one of hydrophobia except a newspaper headline; 
a child of three years (No. 27) that was bitten by a 
dog that was living and well six months later, when 
the child died ; another child of three years (No. 
44), about which I have only a brief newspaper 
item, saying the disease was pronounced hydro- 
phobia; a child four years old (No. 10) that died 
in convulsions six weeks after having been bitten by 
a dog of which nothing was known, and attended 
by a physician whose name I cannot find in any 
medical directory; a child four years old (No. 35) 
that died in Philadelphia after having been bitten 4 
by a pet dog with which he was playing and about 
which there is not a particle of evidence that it was 
rabid (a case that the coroner refused to admit as 
hydrophobia); and another child four years old 
(No. 68), bitten by a dog on whose sore foot he had 
trodden, and the owner of which scouted the idea 
that it was rabid. All the rest were of an age at 
which most persons have very distinct notions about 
and fear of hydrophobia. 
In regard to the relation of the period of incu- 
bation to the age of the patient and the situation of 
the bite, the statistics of the United States for the 
last six years are, I think, very instructive. They 
indicate precisely what is found upon studying the 
thousands of cases reported in books and medical 
journals which I have investigated, namely : That 
the facts do not in the least support the theory that 
bites near the center of the nervous system are more 
dangerous or more likely to be followed by a brief 
period of incubation than those inflicted on more 
remote parts. In our statistics we find a child four 
years old bitten on the face, with an incubation- 
period of nearly five months, and a man thirty-five 
years old bitten on the hand, with an incubation- 
period of only four weeks. We have also a four- 
year old child bitten on the finger, with an incuba- 
tion-period of three weeks, and an adult bitten on 
the leg, with an incubation-period exactly the same. 
Taking all the cases together, we find that after 
bites on the face the incubation-period was less than 
the time-honored quota of six weeks in only a third 
of the cases, while the same is true of a full fourth 
of the cases of bites on the hand and wrist. These 5 
facts correspond to what other statistics show. No- 
body can predict the length of the period of incu- 
bation, even approximately, from a knowledge of the 
seat of the bite or from a knowledge of the age of 
the patient. Assertions to the contrary are either 
pure assumptions or are founded upon averages, 
which are false and misleading. 
Table of Situation of Bite, Age of Patient, 
and Period of Incubation. 
Age. Incubation. Remarks. 
Baby 
3 
weeks. 
4 years 
6 
" Cauterized. 
4 " 
6 
« •< 
4 " 
8 
<< ff 
4 " 
19 
fl 
5 " 
3 
tf 
6 " 
6 
fl 
6 " 
6 
8 " 
9 
9 " 
13 
•• 
n " 
3 
« 
13 " 
6 
•• 
Adult 
3 
ff 
3 
4« 
6 
" Total, 15 
Arm. 
14 y'rs 
13 
weeks. Cauterized. 
Adult 
13 
40 y'rs 
13 
*' Total, 3 
7 y'rs 
18 weeks. 
Adult 
3 
fl 
ft 
13 
" Total, 3 
Face. 
Age. 
Incubation. 
Remarks. 
5 years 4 
weeks. 
Cauterized. 
11 " 
3 
tc 
11 " 
9 
cc 
12 " 
8 
" Dog not rabid 
13 " 
19 
•* 
15 " 
several " 
15 " 
22 
19 " 
10 
< C 
22 " 
9 
28 " 
7 
<• 
Cauterized. 
Adult 
4 
U 
5 
Ct 
8 
'C 
Cauterized. 
• ' 
9 
• • 
13 
cc 
IC 
13 
78 
12 
years. 
35 years 4 
weeks. 
48 " 
6 
48 " 
13 
cc 
50 " 
40 
(C 
Cat-bite. 
53 " 
8 
Ci 
Old 
13 
tc 
Total, 24 
Hand and Wrist. 
The foregoing table gives the details of the cases 
I have collected in the last six years in regard to 
the situation of the bite, age of the patient, and the 
period of incubation. 
* 6 
The number of cases of hydrophobia that occur 
in this country is happily small. It would doubt- 
less be smaller still but for the exploitation of the 
Pasteur Institute, conducted by Gibier, in New 
York, and of its feeble imitator, conducted by 
Lagorio, in Chicago. These institutions, and the 
newspapers that in times past have published sensa- 
tional accounts of cases of-so-called hydrophobia, 
have in a mild way reproduced some of the condi- 
tions which make France the hotbed of hydro- 
phobia, as well as of hystero-epilepsy. But the 
psychological make-up of Americans is less favor- 
able to the development of the germs of hydro- 
phobia or those of hystero-epilepsy than that of the 
French, and consequently there is less of both here 
than there is in France. There the history of the 
last six years differs but little from that which I 
described to you in my last report. As then, so 
now, the number of deaths in France is greater than 
it was before Pasteur, just ten years ago (in May, 
1884), boasted to a newspaper reporter: "Who- 
ever gets bitten by a mad dog has only to submit to 
my three little inoculations, and he need not have 
the slightest fear of hydrophobia." The year before 
he made that boast there were four deaths from 
hydrophobia in Paris (the Department of the Seine) ; 
the year after, when he had practised his preventive 
method for six months, the deaths from hydropho- 
bia leaped at once from four to twenty-two. In 
1886 the number fell to three again in Paris; but I 
have a list of twenty-three persons that died after 
treatment by Pasteur himself in that year. In 1887 
the deaths in Paris rose to nine, in 1888 to nine- 7 
teen. These oscillations indicate that Pasteur's 
method is no more preventive of hydrophobia than 
is the method which he declared in 1884 would 
eradicate rabies in dogs. On the contrary, Pas- 
teur's method has undoubtedly increased the num- 
ber of deaths from hydrophobia. I have indicated 
what has taken place in France, and can assure you 
that there has been no diminution in the number of 
deaths from hydrophobia in any part of the world 
since Pasteur's infallible cures were inaugurated; 
and at the same time there has been added to these 
a large number of deaths due to inoculation of the 
virus of what ought to be called "Pasteur's dis- 
ease." Just how many these have been no man 
can say. The statistics are confusing. Those from 
friendly sources contain remarkable discrepancies. 
Pasteur's own statistics, published in the Annales 
de I'Institut Pasteur for March of this year, admit 
seventy-two deaths in seven and one-half years after 
treatment in Paris. My own show a much larger 
number, while I find that Dujardin-Beaumetz, a most 
enthusiastic supporter of Pasteur, reported to the 
Academic de M.edecine on June 21, 1892, ninety- 
eight cases in only six years, which is just twenty- 
six cases more than Pasteur himself reported for 
eight years. One way in which such curious figures 
appear may be seen when we examine Pasteur's 
detailed report for 1893, in which we find that ten 
actual deaths are set down as four, because two of 
the ten unfortunates succumbed in less than fifteen 
days, three developed their fatal disease while 
receiving the inoculations, and one did not stay to 
have the treatment completed. The same manipu- 8 
lation may be found in the reports for other 
years. 
In view of these facts, and of others which I can- 
not detain you with, it is astonishing to see how 
medical writers quote approvingly the claim that 
the Pasteur method has reduced the mortality from 
hydrophobia from 15 or 16 per cent, of those 
bitten by rabid animals to a fraction of 1 per 
cent., especially as this claim of Pasteur and his 
disciples, besides being in the face of the fact that 
more people die now from this disease and Pasteur's 
disease than used to die from hydrophobia, rests 
upon the stupendous fallacy that Pasteur has saved 
from death by hydrophobia during the last eight 
years nearly 15,000 persons, who are in the report 
spoken of as "cured," of whom about nine-tenths 
were Frenchmen, say about 1500 a year. Of this 
number he is supposed to have "cured" about 1400 
Frenchmen in the year 1893-more persons than 
have died from hydrophobia in the United States 
in a century. 
But for the frequent use of the word "cure" by 
Pasteur and his disciples, it would be better to 
assume that his claim to have saved life covers only 
15 or 16 per cent, of the figures given here. 
One of the perils of the science of medicine at 
the present time is the credulity which some writers 
show for statements published from experimental 
laboratories and the contempt which they manifest 
for sources of knowledge that conflict with labora- 
tory-theories. One might suppose that prolonged 
study of what has been written in regard to a sub- 
ject from a clinical, an experimental, and a philo- 9 
sophical standpoint would warrant a conscientious 
and fairly intelligent investigator in believing that 
he knew something about it; but my experience 
shows that this will not protect one against the scorn 
of some who spend more time in producing artifi- 
cial diseases in test-tubes and guinea-pigs than they 
do in curing natural diseases in human beings. 
On this occasion you may be spared the labor of 
trying to follow figures to establish what I say. 
You know that I have said such things as this often 
before, and that they have been published and 
spread abroad where their credibility might be 
impeached if they were incorrect, and their fallacy 
exposed if they were fallacious.1 But nothing of 
this kind has happened. Thus far no man has 
cared to proceed to a deliberate and detailed review 
of the arguments by which I have at various times 
endeavored to present to others the views in regard 
to hydrophobia which I hold, and which are held 
by a large number of intelligent men. 
With this I conclude what I have to say on this 
occasion. I speak e arnestly, because I feel deeply, 
and I believe what I have said to be of great im- 
portance to humanity. With less earnestness I 
should long ago have given up a course which has 
had abundant pains and few rewards. 
1 Disorders Mistaken for Hydrophobia, Trans. Med. Soc. of 
State of Pennsylvania, 1884. Treatment of Hydrophobia, His- 
torically and Practically Considered, Journ. of the Amer. Med. 
Assoc., Aug. 6, 1884. Comments on Pasteur's Method of Treat- 
ing Hy drophobia, Medical Record, New York, Feb. 13, 1886 
Case of So-called Hydrophobia, with Remarks, etc., Lancet, Lon- 
don, May 1, 1886. The Medical News. 
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