746 fact in the history of hydrophobia which makes it probabl that the poison may remain for a long time imbedded in th bitten part. This probability is enhanced when we compar the long and uncertain period of latency with the remarkabl; sharp and sudden outbreak of the symptoms which usher i and constitute the hydrophobic attack. We have not in th whole range of disease anything so strangely contrasted as ar these two portions of the history of hydrophobia-the Ion interval and the sudden

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... ak. Though not in a position to explain the steps of the process, I would urge whether the, do not suggest that the wound may long be the matrix of th fatal venom, and whether from this point of view the preven tion of the disease may not be in our hands. In that excellent article on Hydrophobia (" Cyclopzedia o Medicine," t833), by Dr. Bardsley, he writes as follows :-" I seems to be an established fact, that the virus of a rabi( animal does not, like other morbid poisons-such as small-pox cow-pox, syphilis, and plague-always produce its effect within a limited time. Dr. Todd Thomson has expressed his opinion that the hydrophobic virus is not regulated by the usual law of morbid poisons; and on that account he is inclined to believe that it remains in the bitten part, and the individual is saf, till the habit becomes predisposed to the action of the poison so that the part may be advantageously excised in the inter vening time. A case is related by Professor Rust, where th wound was excised thirty-one days after the bite, and after th hydrophobic symptoms had appeared, and still the patient'; life was saved." All writers, from Celsus to the present time have, with different degrees of conviction, insisted upon the importance of removing the bitten part, or destroying thl poison in the wound. Although obviously nothing can bl more fallacious than limited statistics on such a matter as the 'effects of the bites of rabid animals-since there may be a mis take as to the animals being rabid or not, or the wound ma3 be inflicted in various ways, as through the dress or on a naked part-still there remains fair evidence, from collectec cases, that prompt and sufficient treatment of the wounc markedly lessens the liability to the disease. Bollinger ("Cyclopædia of Medicine," edited by Ziemssen, 1875), one of the most modern writers on hydrophobia, gives statistic; which go to prove that, where cauterisation of the wound is resorted to, seven out of ten persons escape ; whilst if no suet means are used, eight out of ten die. These conclusions, thu: rigidly stated, may be well open to question ; but it will stil be admitted that there remains evidence of lessened liabilit3 to the disease from local treatment. If this be admitted, i1 may be fairly inferred that, could the local treatment be mad( more perfect, the preventive effects would be greater ; and, indeed, it would be a fair inference that if it were quite perfect; prevention would be absolute. The late Mr. Youatt, who wal in his day considered the first living authority on canine mad ness, was four times bitten by dogs decidedly rabid. Each time he freely applied caustic to the wound, and remained free from the complaint. He operated on more than four hundred persons, who were unquestionably infected, and without losing a patient. Against a disease so dreadful as hydrophobia, where treat, ment has always failed, and where the conditions of the disease are such as to lead to the reasonable conviction that failure will still attend our efforts to cure, it must certainly behove us to lose no chance of prevention. The question may even arise whether the prevalence of hydrophobia at the present time may not be due to defective local treatment of these hydrophobic wounds. If the hydrophobic poison remains for a time inoperative in the bitten part, though there might be good reason for destroying it as quickly as possible, there would be none for attempting to do this hastily, and with the attendant risk of doing it imperfectly. Sucking the part in the meanwhile, if practicable, is desirable, and is unattended with risk, provided there are no abrasions on the lips. What means should in any given case be employed against the infection of the bite-whether removal of the part or destruction of the whole track of the tooth by mineral acids, nitrate of silver, or the like—1 will not venture to say, lest my surgical friends should exclaim, " Ne sutor ultra crepidam !" But if I had to choose for myself, I would inhale ether, and have the whole track of the wound destroyed by strong nitric acid or nitrate of silver. I shall hope that we may have an expression of opinion from those who are better able than I am to give advice on this strictly surgical part of the question. I am, Sir, your obedient servant, Brook-street, November 13th, 1S77.