the proportion of people bitten and escaping without
infection is overwhelmingly greater than those who acquire the disease.
The mortality of genuine hydrophobia is from 30 to 80 per cent,
influenced by efficient and early cauterization and scientific
treatment. There is little doubt that many of the cases reported as
hydrophobia are merely examples of general systemic infection from a
local focus of sepsis, made possible by some primitive and uncleanly
treatment of the original wound. There is much superstition relative to
hydrophobia; the majority of wounds seen are filled with the hair of
the dog, soot, ham-fat, and also with particles of decayed food and
saliva from the mouth of some person who has practiced sucking the
wound.

Ordinarily, the period of incubation of hydrophobia in man is before
the end of the second month, although rarely cases are seen as many as
six months from the reception of the bite. The first symptoms of the
disease are melancholia, insomnia, loss of appetite, and occasionally
shooting pains, radiating from the wound. There may be severe pain at
the back of the head and in the neck. Difficulty in swallowing soon
becomes a marked symptom. The speech assumes a sobbing tone, and
occasionally the expression of the face is wild and haggard. As regards
the crucial diagnostic test of a glass of water, the following account
of a patient's attempt to drink is given by Curtis and quoted by
Warren: "A glass of water was offered the patient, which he refused to
take, saying that he could not stand so much as that, but would take it
from a teaspoon. On taking the water from the spoon he evinced some
discomfort and agitation, but continued to raise the spoon. As it came
within a foot of his lips, he gagged and began to gasp violently, his
features worked, and his head shook. He finally almost tossed the water
into his mouth, losing the greater part of it, and staggered about the
room gasping and groaning. At this moment the respirations seemed
wholly costal, and were performed with great effort, the elbows being
jerked upward with every inspiration. The paroxysm lasted about half a
minute. The act of swallowing did not appear to cause distress, for he
could go through the motions of deglutition without any trouble. The
approach of liquid toward the mouth would, however, cause distress." It
is to be remarked that the spasm affects the mechanism of the
respiratory apparatus, the muscles of mastication and