Page:Encyclopædia Britannica, Ninth Edition, v. 12.djvu/561

545 H Y D H Y D simply ; and finally, still without change of application, the skin will heal, or, at most, show a little psoriasis, pityriasis, or eczema, or, it may be^ but a faint tinge of red. The bandages are then withdrawn. The original symptoms meanwhile have disappeared with more or less celerity and completeness ; and with the eruption has departed the disease that called for it and made it possible. Strength grows apace, no longer taxed by disease or crisis, until recovery in appropriate cases is absolute and secure. Occasionally the cutaneous inflammation extends in the form of psoriasis, eczema, sudamina, a papular rash, or a succession of boils, invading parts untouched by the wet compress. This is called a general crisis ; it usually occurs in the last stage of the local one, sometimes after it has ceased, and is advantageous and transient. Debility, whether pre-existing or consequent on the crisis, may call for some modification of its severity and duration, whether by instalments at proper intervals, or curtailment in the later stages, the natural emunctories being relied on to complete the work of purification at greater leisure. A residuum of incurable organic degeneration, as of the kidneys or liver, may likewise put limits to recovery, and provide perpetual material for crisis until the patient is worn out in a vain and ignorant attempt at cure. It was the failure of the earlier hydropathists through inexperience, default of medical education, or inordinate enthusiasm to recognize these limitations, that brought crisis into its present discredit and com parative desuetude. Where it is necessary from these or other causes to relieve the patient of the eruption, the substitution of simple ointment, unsalted lard, or other oleaginous or viscid material for the stimulating bandages or poultices, permits the excitement to subside, and, with occasional exceptions, the skin, in a few days, it may be hours, bears little trace of the eruption. In the course of hydropathic treatment there occur, though rarely, attacks of diarrhoea, sickness, diuresis, or diaphoresis, which, having been observed frequently to mark the turning point in the history of the case, are held to be varieties of crisis, disturbances attendant on the expulsion of the materies morbi from the system. The theory of crisis may be stated thus. The digestive and assimilative organs are, as is well known, involved, whether -j - .m.jjuii v_*.j u.vpij. v cu. ui tile ulclilUllUBS LllclL pertains alone to a pure and perfect condition, with what may be termed an inflammatory disposition as the result. The most familiar, because pronounced, forms are the gouty, rheumatic, tubercular, and strumous diatheses. Later the excretory organs, in common with the whole economy, must more or less become deranged, with additions, in consequence, to the sum of morbid elements in the blood, such as uraemia and biliary matters. A vicious circle of action and reaction is established from which escape is difficult, if not im possible, in its more pronounced developments. The digestive dis order begets imperfect and impure blood, and the morbid blood keeps up, and cceteris paribus increases, the initial and originating digestive disorder. In all but its most advanced stages ordinary measures, hydropathic or other, may suffice to break this chain, and, by eliminating one or more of its links, render recovery possible or accomplish it. It is when the complication is beyond their reach that the domain peculiar to crisis begins. The superior vascularity and vitality of the digestive organs the alimentary tract of mucous membrane, the pancreas, and the liver is what makes them (in addition to their susceptibility to injury through errors in diet) so commonly the seat of diseased action. The highly nervous and vascular structure of the skin makes easy its elevation to at least an equality in vital activity with the mucous membrane. Warmth and moisture continuously applied to a given portion will, in time, itlect this, aided doubtless by maceration and denudation of the suticle and exposure of the sensitive cutis vera. It thus becomes the seat of greatest vital activity ; pre-eminence in morbid activity naturally follows, and a genuine metastasis is effected, such as the latural history of disease is rich in examples of. There is a decline, pro tanto of the primary internal disorder under this combined pressure, first by the diversion of morbific elements, and then by 3 diversion of an appreciable quantity of the blood itself and by counter-irritation, when the site of the vicarious inflammation has been selected with that in view. The aid of a sustained derivation to the entire cutaneous surface and the extremities is at the same time secured by means of the Turkish bath, full packs, and other initiating agents, while, at the same time, clue care is taken to limmate and negative the original causes of disease. The sum of id activity is for the timeteing increased and intensified ; but, in the new location, no longer self-supporting and self-perpetuating a sooner or later exhausted. The change in the relation of the materies morbi to the digestive system puts an end at one and the same tune to the originating and sustaining conditions. The failure imple counter-irritation (where, as by sinapisms, vosicatories. C., u i irritant is derived from without) to effect the same result in many o the cases afterwards cured by crisis negatives of itself ie view that the results of the latter are to be attributed to the element in it of counter-irritation alone 545 Lytton, Confessions of a Water Patient, 1851 ; Macleod, Theory of the Treatment of Disease, 1868; Mayo, Cold Water Cure, its Use and Misuse Examined, 1845 - Kichardson, Fourteen Years Experience of Cold Water, 1857 ; Rumford, Salubrity of Warm Bathing, 1802; Shew, Hydropathic Family Physician. 1857; Short, On the Inward Use of Cold Water; Schwertner, Medicina Vera Universality Simpson, Trail, Hydropathic Encyclopedia ; Van der Heyden, Arthritifugum Magnum, Ghent, 1649 ; Wainwright, Inquiry into the Nature and Use of Baths, 1737 ; AVeiss, Handbook of Hydropathy, 1844 ; Wilmot, Tribute to the Cold Water Cure, 1843; Wilson, Principles and Practice of the Cold Water Cure, 1854, and The Water Cure, 1859 ; Wright, Memoir on Cold Affusion in Fevers, 1786. (W. B. H.) HYDROPHOBIA, from vSwp, water, and &amp;lt;o/3eo&amp;gt;, to fear (Syn. Babies, Lyssa), an acute infectious disease, occurring chiefly in certain of the lower animals, particularly the can ine species, and liable to be communicated by them to other animals, and to man. The main features of the disease are similar alike in the lower animals and men, but that peculiar symptom from which the malady derives its name, viz., the dread of water, appears only to affect the latter. Rabies as it manifests itself in animals belongs to the subject of veterinary medicine; the present notice refers only to hydro phobia occurring in man. The disease has been known from early times, and is alluded to in the works of Aristotle, Xeno- phon, Plutarch, Virgil, Horace, Ovid, and many others, as well as in those of the early writers on medicine. Celsus gives detailed instructions respecting the treatment of men who have been bitten by rabid dogs, and dwells on thedangers attending such wounds. After recommending suction of the bitten part by means of a dry cupping glass, and thereafter the application of the actual cautery or of strong caustics, and the employment of baths and various internal remedies, he says: &quot;Idque cum itaper triduum factumest^ tutus esse homo a periculo videtur. Solet autem ex e9 vulnere, ubi parum occursum est, aquae timor nasci, opo&amp;lt;o- ftiav Grseci appellant. Miserrimum genus morbi ; in quo simul aager et siti et aquae inetu cruciatur ; quo oppressis in angusto spes est.&quot; Subsequently Galen described minutely the phenomena of hydrophobia, and recommended the ex cision of the wounded part as a protection against the disease. Throughout many succeeding centuries little or nothing was added to the facts which the early physicians had made known upon the subject. The malady was regarded with universal horror and dread, and the unfortu nate sufferers were generally abandoned by all around them and left to their terrible fate. In later times the investiga tions of Boerhaave, Van Swieten, John Hunter, Magendie, Breschet, Virchow, Reder, as also of Youatt, Fleming, Meynell, Hertwig, and others, have furnished important information ; nevertheless much remains obscure as to the nature and pathology of this formidable disease. Whatever may be said as to the spontaneous development of rabies in animals a view which is now generally dis credited there can be no doubt that in man the disease is in every instance the result of the inoculation of the viru* YTT - fin