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JAMA 100 Years Ago
June 24, 1998


Author Affiliations

Edited by Brian P. Pace, MA, Assistant Editor.

JAMA. 1998;279(24):2005. doi:10.1001/jama.279.24.2005

The fact that there is such a disorder as canine rabies has been so long accepted by the medical profession that the other fact, made rather manifest within a year or two past, that there are some respectable physicians who doubt its existence seems at first sight unreasonable, if not absurd. Certainly the burden of proof lies on those who thus contest one of the established beliefs not only of medicine but of the general public from all time past, and it ought to require more than ordinary evidence to overthrow it. It may be admitted that it is a rare disease of the human species, in this country at least, and that its conventional syndrome is often counterfeited by nervous and hysteric subjects, even to the extent of carrying them to a fatal termination, without the actual infection having ever been in play, but these are by no means conclusive that such infection is a myth and that there is really no such disorder. The existence of a pseudo-rabies does not exclude a genuine form any more than does a pseudo-syphilis, and the mere fact of the comparative rarity of an affection is no argument against its occurrence, when that is attested not only by history and experienced observation but also by scientific control inoculations and other tests. There have been too many cases thoroughly observed and reported to make the skepticism that some profess, appear even reasonable, though it may be allowed as evidence of mental idiosyncrasy that when confined to purely professional discussions is harmless if not altogether admirable. The importance of prophylaxis in this disorder, however, is such, that if such views were likely to be generally adopted mischief might result, and this possibility is the more serious when statements are made in the lay journals by popular writers that there is no such disease as hydrophobia and that the reported cases are "in reality nothing more nor less than instances of people who have been bitten by dogs and frightened into hysteric conditions in which they involuntarily reproduce all the supposed symptoms of hydrophobia," that the public, and especially the nervous and impressible portion of it, "should believe that there is no such thing as ‘hydrophobia'" and rid themselves of the "bugaboo of the mad dog." There is perhaps not much probability of the popular faith in the existence of this disorder being destroyed, but it is more than questionable whether, on hygienic grounds, the medical profession ought to let such misleading statements go unheeded. Certainly they should not if they are accepted by any considerable portion of the public and acted upon accordingly. Such a course would very possibly cure itself in time by furnishing some indubitable examples of the disease that would have been avoided under the ordinary conditions and the heretofore accepted popular beliefs, but this is not a desirable outcome, of itself, and would be better avoided. The fact that the disease is rare in man, in this country, is largely due to the popular apprehension, and the precautions thus induced. . . .