THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.

OKAY BACK FROM THE INTENSIVE CARE UNIT 🛏️

A Medical Journal Describes Two Patients With Rabies

Both Had Laboratory Confirmed Rabies

The First Was A 48 Year Old Construction Worker

He Was Admitted To The Intensive Care Unit Of A Hospital In Hanoi

The Second Was A 37 Year Old Farmer

He Presented Himself To A Hanoi Outpatient Clinic

Two Months Before Admission The Worker Had Butchered A Dog

The Dog Had Been Killed In A Traffic Accident

He Opened The Skull To Remove The Brain

The Brain Was Then Steamed In Leaves And Eaten

Three Weeks Before Admission The Farmer Had Killed A Cat

The Cat Had Been Sick For Three Days

He Pulped Its Brain With His Bare Hands

Rua Man Is The Vietnamese Dish He Made With It

Others Who Ate Parts Of The Same Dog Remained Well

None Of The Others Who Ate The Cat Dish Fell Ill

The Farmer Said A Pet Dog Bit His Heel A Month Before His Visit

That Dog Had Stayed Healthy Since The Bite

The Authors Had No Specimens From The Butchered Animals

They Were Unable To Test Those Animals For Rabies

Their Paper Says The Exact Source Remains Uncertain

It Adds That Another Unnoticed Animal Contact Cannot Be Excluded

The Two Patients Arrived Unable To Drink Normally

Involuntary Inspiratory Muscle Spasms Were The Cause

The Worker Could Not Swallow When Offered A Glass Of Water

He Had The Same Spasms When He Felt A Breeze

The Paper Calls The Reaction To Water Hydrophobia

It Calls The Reaction To A Draft Of Air Aerophobia

The Authors Say Hydrophobia Is Specific For Encephalitic Rabies

Destruction Of Brain Stem Neurons Causes These Spasms

Those Neurons Inhibit The Inspiratory Motor Neurons

Patients Can Have An Inexplicable Terror Of Water

The Worker Was Treated With Diazepam And Intravenous Fluids

Several Hours After Admission He Developed A Fever

Coma Was Induced With Thiopental And Ventilation Was Started

His Fever Persisted And He Developed Acute Renal Failure

Six Days After Admission His Family Took Him Home To Die

The Farmer Was Taken Home On The Day Of Admission

Poor Prognosis Was The Reason Given

He Died One Day After Discharge

The Authors Note That Relatives Often Take Patients Home To Die

They Attribute That To Perceived Unnecessary Costs

N Senn Described A Similar Reaction To Water In 1879

He Read His Report To A Medical Society

Its Title Was A Case Of Hydrophobia With A Brief General Review

His Patient Was A 30 Year Old Norwegian Sailor

He Had Felt Well Until The Evening Before Senn Was Called

Then He Felt A Vague Pain Through His Left Ear

He Began To Have Difficulty Swallowing Fluids

Senn Offered Him A Glass Of Water

Its Sight Appeared To Excite Severe Laryngeal Muscle Spasms

Senn Also Saw Tremors Of The Extremities

An Attempt To Drink Increased The Spasms

Senn Wrote That The Attempt Was Abandoned After Fruitless Efforts

A Family Dog Had Sickened And Died Seven Weeks Earlier

On A Later Visit Senn Learned What That Dog Had Done

While Sick It Had Licked A Small Abrasion On His Left Ear

Almost Uninterrupted Spasms Continued Until Midnight

Senn Wrote That Death Seemingly From Exhaustion Came To His Relief

Six Hours After His Death Senn Examined The Body

The Abrasion Had Healed Without A Scar

Senn Judged Infection To Have Undoubtedly Taken Place There

The Report's Review Names It Hydrophobia Or Rabies Canina Or Lyssa

Senn Reports That Galen Declared It The Worst Of All Diseases