A case of Rabies from the BMJ archives

Geoffrey Russell Steele Grogono.

Weymouth

Basil John Steele Grogono.

Halifax, Nova Scotia

The casebook of our grandfather, Dr Russell Steele of Reigate, has a graphic account of rabies in a young boy.

"On July 4th 1876, shortly after 7 o'clock in the morning, the patient, a little boy called Alfred Cox (aged 91/2 years), the son of the stationmaster at Bletchworth, was playing with a strange dog which had bites about its muzzle, and was bitten several times by it on the right hand and leg. He was brought to me soon afterwards, when I cauterised the wounds freely with linear caustic. He came to see me twice afterwards to have the wounds dressed with water dressing, after which they healed up. Six weeks and three days from the date of the bite, on August 18th, it was said that he seemed to be tired.

"On August 21st he went with a number of children on an excursion to Dover. After eating a good breakfast and a good night's rest he was very anxious to go, but feared he would be too tired to do so. When on the pier at Dover about 11 o'clock, he complained that the sight of water made him feel unwell and of his feet `feeling so light.' He drank a little tea and ate some bread and butter, directly afterwards asking for some water, but unable to drink it. He `snapped at it' as his mother expressed it, but could not swallow a drop."

On 22 August Dr Steele was sent for by the boy's mother.

"On my arrival at half past 10 I found him lying in bed, face flushed, pulse irregular, complaining of pain in the epigastrium. He said he could not swallow. After a few attempts, swallowed a mouthful, immediately afterwards throwing back his head into the pillow exhausted. 10.30pm much the same. Unfolding a towel (for auscultation) the boy inspired deeply and spasmodically and gave a loud shriek with expiration."

Dr Steele visited the boy frequently both by day and night; he died at 6pm on 26 August.

An inquest was held at which Dr Steele said that the boy died from exhaustion caused by hydrophobia arising from the bite of a dog. Inspector Gray said that no one knew where the dog had come from. The coroner did not think it necessary to take further evidence, adding that no one could tell the cause of madness in dogs but the old idea about hot weather causing it was known to be false.

Exactly 10 years later a boy of 9 presented himself to the laboratories of Louis Pasteur in Paris. Pasteur had perfected a vaccine by inoculating rabbits with virus from the spinal cord of an infected dog. The boy was certain to die, but Pasteur inoculated him with a series of injections and he lived.

Hydrophobia is one of the most terrible diseases known to man. We must make sure that it cannot return to Britain ever again.

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