Rabid Read online

  For the Duke of Richmond, though the chronology remains in some dispute, the hydrophobia seems to have struck first on the evening of August 26, 1819. At dinner with his officers, he found that his glass of claret disagreed with him. “I don’t know how it is,” he is said to have remarked to Colonel Francis Cockburn, one of his retinue, “but I cannot relish my wine tonight as usual. I feel that if I were a dog I should be shot for a mad one!”

  The next day, the duke ate and drank almost nothing and remained in bed. By the evening, he found he could not drink at all. The following morning, a doctor prescribed a gargle, but this, too, had a “convulsive” effect on his throat. He could not even accept his customary shave, so repelled was he by the water in the basin. This day he dragged himself from his bed. He was scheduled to tour the swamps around the Ontario town of Richmond, recently renamed as such in his honor. But his body rebelled as he stepped into the boat. In terror he jumped back to the shore. Taken to the closest house, he begged to be moved farther inland: the very sound of running water had become unbearable to him. He was moved to a barn and laid down on a deathbed of straw.

  Fevers spike high during this final phase of the disease. The mouth salivates profusely. Tears stream from the eyes. Goose bumps break out on the skin. Cries of agony, as expressed through a spasming throat, can produce the impression of an almost animal bark. In the throes of their convulsions, patients have even been known to bite. They also hallucinate. The eminent French physician Armand Trousseau, who practiced in the middle part of the nineteenth century, noted that “the patient is seized with sudden terror; he turns abruptly round, fancying that somebody calls to him.” He cited the account of a colleague, one Dr. Bergeron, whose rabies patient “heard the ringing of bells, and saw mice run about on his bed.”

  Not uncommonly, male patients succumb to an even more lurid sort of abandon. The virus’s action on the limbic system of the brain can cause them to exhibit hypersexual behavior: increased desire, involuntary erections, and even orgasms, sometimes occurring at a rate of once per hour. If the Duke of Richmond evidenced this symptom, his companions were too gallant to set it down for posterity. But other case reports from history describe up to thirty ejaculations in a single day. The Roman physician Galen, in his own remarks on rabies, describes the case of an unfortunate porter who suffered such emissions for three full days leading up to his death. Commenting on this grim fate the eighteenth-century Austrian physician Gerard van Swieten soberly noted, “Semen et animam simul efflavit”: “His seed and his life were lost at the same time.”

  And yet, despite all the horrors of hydrophobia, arguably the most tragic aspect is the fact that the attacks will often subside, for a time, allowing sufferers periods of terrible, poignant lucidity: they are given the opportunity to fully contemplate what their condition portends. Before his death, the duke dictated a lengthy letter to his eldest daughter and also gave instructions that his beloved Blucher be handed over to her. “It will make her cry at first,” he said, “but turn him in when she is alone and shut the door.”

  By now it should be apparent that this book is not for the squeamish or weak-kneed. Encounters with rabies have ever been thus. Louis Pasteur and his assistants, in order to develop their vaccine, had to corral dogs at the apex of their madness and extract deadly slaver from their snarling jaws. Axel Munthe, a Swedish physician, once saw Pasteur perform this trick with a glass tube held in his mouth, as two confederates with gloved hands pinned down a rabid bulldog. Some members of his team soon established a ghoulish fail-safe for these procedures. “At the beginning of each session a loaded revolver was placed within their reach,” recalled Mary Cressac, the niece of Pasteur’s collaborator Emile Roux. “If a terrible accident were to happen to one of them, the more courageous of the two others would put a bullet in his head.”

  We cannot claim so much bravado for this volume, on either our account or yours. A better analogy, perhaps, is the difficult process by which veterinarians submit suspect pets for rabies testing—another case study in how this diabolical disease causes nothing but agony for those who behold it. Even today, vets do not use a blood test for rabies in animals; it’s not a pinprick and wait-and-see affair. Only a sampling from the brain will suffice. Therefore the animal must be killed, with its head removed and shipped off to authorities for study.

  The first part of that process—capturing and humanely dispatching a deranged animal—is fairly standard stuff for your local vet. But carrying out a decapitation, even of a smallish creature, is much harder than they make it look in slasher pics. This is true not just for the obvious emotional reason: that in many cases the vet had been trying to save the life of this beloved pet just hours beforehand. It is also an ordeal in the purely practical sense. The cadaver is laid out on its back, contorted face canted skyward. With a scalpel the vet slices readily through the soft tissue around the animal’s neck: fur and skin, muscles and vessels, esophagus and trachea.

  Now the vet is stuck with the problem of the spine, the very conduit through which the rabies virus may—or may not—have passed; like Schrödinger’s cat, the animal must be dead for this question to unravel. If the vet is lucky, her hospital has seen enough suspected rabies cases that it has thought to keep a hacksaw handy. In that case, she can take a brute-force path through bone, sawing straight through the tightly interlocked top vertebrae, the axis and the atlas. If she is not so lucky, she will have only her scalpel to work with. A five-minute job can thereby stretch out to twenty, as she is forced to disarticulate those two top backbones, severing the tendons that bind them and separating one from the other: a decidedly grisly brainteaser.

  To be honest, our tour through the four-thousand-year history of rabies has felt a little like that. Sometimes whole weeks got lost in a blur of blood and fur. Our exploration into the cultural meaning of rabies took us deep into the gruesome medical case reports, from ancient and modern times. Then it flung us out again, into the murky realm of myth, to dog-headed men and zombie mobs and the mass butchering of Cairo’s pigs. We’ve made pilgrimages to the Ardennes, to see the site of the holy rabies cure; to the rue d’Ulm in Paris, to behold the humble building where Pasteur performed his heroics; and to the island of Bali, where we finally came to stare the devil in the face ourselves.

  Now, after two years of sawing, we feel we have finally finished the job, and we are pleased to ship it off to you, the reader. Come to think of it: in the case of a fox, or a cat, or even a toy-breed dog, the severed head might weigh just about the same as the book in your hands right now. Hold it in your outstretched palms, why don’t you, and close your eyes. Not so very heavy, is it? And yet from packages this small—as suburban home owners sometimes learn, and as the Duke of Richmond discovered far too late—considerable mayhem can be unleashed.

  Roman-era mosaic from England, depicting a wolf with Romulus and Remus.

  1

  IN THE BEGINNING

  For more than a week, Achilles sulks while the Trojan War carries on without him. By just the third day of his absence, momentum has shifted decisively toward the Trojans, whose onslaught has repelled the invading Greeks back to their ships. As night falls, a Greek delegation, led by Odysseus, rushes to Achilles’ encampment in hopes of luring him back into the scrum. The emissaries arrive to find the great hero listlessly strumming a lyre, warbling to no one in particular about the great deeds of warriors past. He is excited to have visitors. “Mix us stronger drink,” he tells his henchman.

  Libations poured, Odysseus lays out the Greeks’ predicament. Their drubbing that day was accomplished almost entirely by one man, the Trojan hero Hector. Unlike Achilles, whose reputation in battle preceded him to the plain of Scamander, Hector has discovered his talent for killing more recently—“I have learned to be valiant,” he remarks to his terrified wife. In this day’s fighting he was particularly brilliant. When a Greek archer, aiming for Hector, killed instead his chariot driver, he leaped from the chariot, picked up a rock, and
smashed the archer’s collarbone, even as another arrow lay poised in his bow. Then Hector roused his army to drive the invaders back, his wild yet determined aspect in the chase resembling, in the words of the poet, “a hunting hound in the speed of his feet pursuing a wild boar or a lion.”

  In his pitch to Achilles, Odysseus describes Hector’s battlefield ragings as “irresistible.” And he attributes them, somewhat mysteriously, to a sort of possession, to a “strong fury” that has entered the Trojan hero. Hector has threatened to descend upon the Greek camp at dawn, to dismantle and burn their ships, and then, his quarry blinded by smoke, to dismantle the Greeks as well. Without Achilles, Odysseus warns, the Trojan might very well make good on the promise. If, however, Achilles returns, he will almost certainly slay Hector himself—for the very same “fury” has blinded Hector into believing that no man, not even Achilles, is his equal on the battlefield.

  What is this peculiar fury that, in Odysseus’s view, has possessed Hector, spurring him to unstoppable acts of martial courage but also to a mortal vulnerability? It is no ordinary anger. Homer’s epics are awash in anger, with no fewer than nine terms employed to describe all the subtle flavors of fury. In The Iliad, this litany begins with the poem’s very first word, menin, which so famously frames the entire epic around the “rage” of Achilles. But here in Odysseus’s presentation to Achilles, the term for what has provoked Hector to such frenzy—lyssa—is something rather more primal. It has not been invoked anywhere in the poem before this scene, and with one notable exception the term will not appear again during the tale. It is a term closely linked to the word lykos, or “wolf,” and is used to connote an animal state beyond anger: an insensate madness, a wolfish rage. Later, in tragedies, Lyssa is sometimes personified, goading Heracles to slay his family and Pentheus’s own mother and aunt to dismember him. Vase paintings occasionally depict her as a feminine form wearing a dog’s head as a cap.

  In the realm of epic and myth, lyssa is impossible to properly define. In the factual prose of Attic Greece, however, the word had a quite literal meaning: rabies. As much as we hesitate (obeying the injunction of Susan Sontag) to deploy illnesses as metaphors, such links can hardly be resisted even in the present day, when the emergence of new diseases—usually originating in animal populations—threatens us with unforeseen manners of death. Consider how inconceivable it would have been to disentangle such links at a time before men knew of viruses, a time when diseases spread by means the keenest eye could not discern nor the keenest mind divine. With this particular convergence, the twinning of rabies with notions of savage possession, it is hard even to say which member of the pair took precedence, chronologically or otherwise. Both were there from the beginning. To link the two states, medical and metaphorical, was natural in both senses of that word. Lyssa was rare, terrifying; violent, and animalistically destructive of others; ultimately (and pathetically) destructive of self. It made creatures maim and kill those closest to them. It hollowed out reason and left nothing but frenzy.

  After Odysseus’s speech to Achilles, lyssa makes one last, dramatic entrance in The Iliad. Though he resists the entreaty at first, Achilles does eventually return to the fight. He leads the Greeks to the gates of Troy, which open to shelter the Trojan warriors in their desperate retreat. Odysseus’s prediction is destined to come true: Hector, unmoved by the pleas of his parents, will wait outside the city gates the next day—“as a snake waits for a man by his hole, in the mountains, glutted with evil poisons”—intent on doing combat against the Greek hero alone. On the eve of this fateful encounter, as the king of Troy opens the gates of his doomed city, Achilles pursues the fleeing Trojans with spear aloft, and the “powerful lyssa unrelentingly possesses his heart.”

  Rabies has always been with us. For as long as there has been writing, we have written about it. For as long, even, as we have kept company with dogs, this menace inside them has sometimes emerged to show its face to us. But perhaps the most impressive sign of its longevity is this: rabies serves as the setup for one of humanity’s first recorded jokes. (Stop us if you’ve heard it before.)

  A Babylonian fellow gets bitten by a dog. He travels to Isin, renowned city of the goddess of health. There, a high priest recites an incantation upon him, and the patient is very pleased with the quality of care.

  “May you be blessed for the healing you have done!” the visitor cries. “You must come to Nippur, where I live. I’ll bring you a coat, carve off the choicest cuts for you, and give you barley beer to drink—two jugfuls!”

  Perhaps to his surprise, the priest takes him up on the offer. “Where in Nippur shall I come?” he asks.

  “Well,” the patient continues, his voice betraying some hesitation, “enter by Grand Gate…keep Broad Avenue, the boulevard, and Right Street on your left. A woman named Beltiya-sharrat-Apsî, who tends a garden there, will be sitting at a plot selling vegetables. Ask her and she will show you.”

  Despite these suspiciously difficult directions (keep Right Street on the left!), the old doctor somehow arrives at the garden in question. But it turns out that Beltiya-sharrat-Apsî is the most unhelpful woman alive. And because she speaks such a thick Nippurian dialect, she and the holy man from Isin can hardly communicate. After a tortured exchange, the old woman gives up on the priest in exasperation, and the patient (we are left to presume) is never forced to make good on his promised co-pay.

  No doubt this gag, found inscribed on a clay tablet, was funnier in the original Akkadian. But baked into its premise is an obvious question: Why, over an injury as straightforward as a dog bite, would a patient venture all the way from Nippur to Isin, a distance of nearly twenty miles, in order to see a healer? And not just any healer: the cuneiform text indicates the high priest to be none other than the main administrator (šangû) of the foremost temple of Isin—which, again, was the city of the goddess of medicine. Having been bitten by a dog, this Babylonian has rushed off to the equivalent of the Mayo Clinic.

  This could very well be part of the joke. Yet ample evidence exists in the records of early Mesopotamia that dog bites were feared for a very rational and very terrifying reason. Nearly two thousand years before Christ, the Laws of Eshnunna—a precursor to the Code of Hammurabi—stipulate punishment for the owner of a kalbum šegûm, or “rabid dog”: “If a dog becomes rabid and the ward authority makes that known to its owner, but he does not watch over his dog so that it bites a man and causes his death, the owner of the dog shall pay forty shekels of silver; if it bites a slave and causes his death, he shall pay fifteen shekels of silver.”

  Contemporary Assyriologists have found references to rabies in private letters (“Like a rabid dog, he does not know where he will bite next”); in the omens of entrails readers (a hole in a particular section of the animal’s liver indicated that a man would contract rabies); in astrology (lunar eclipses in particular months were said to portend outbreaks among dogs); and in the Marduk Prophecy, an apocalyptic text from the first millennium B.C. in which Marduk, then the preeminent deity, threatens to abandon Babylon and thereby unleash a series of plagues, the last of these being rabies:

  I will send the gods of cattle and grain off to the heavens. The god of beer will make ill the heart of the land. The corpses of people will clog the gates. Brother will eat brother. Friend will kill friend with a weapon…. Lions will cut off the roads. Dogs will become rabid and bite people. All the persons whom they bite will not survive but will die.

  Rabies also figures in some of the incantations that were used, as by the high priest of Isin, in attempts to cure disease. One Babylonian list of maladies, in grouping the dog bite together with the scorpion sting and the snakebite, describes the canine affliction as “the bite that grows up.” The surviving incantations against this bite use a curious metaphor to describe what the dog’s jaws have left in the wound: the dog’s “semen is carried in his mouth,” and “where it has bitten, it has left its child.” (Another incantation expresses this with great pith: “May
the bite of the dog not produce puppies!”) Given how many contingencies exist in the transmission of the rabies virus—whether the animal is actually rabid and not merely vicious, whether its bite has actually punctured the skin, whether the virus takes root in the nervous system and begins its climb to the brain—Mesopotamian doctors would often have had reason to believe their spells had cured the patient. “Remove the madness from his face and fear from his lips!” one spell exhorted. “Let the dog die and the man survive!” cried another.

  One Sumerian incantation against rabies tells the priest to work magic on purified water, which the patient is then compelled to drink: “Cast the spell into the water! Feed the water to the patient, so that the venom itself can go out!” Given that hydrophobia has presented throughout history as the defining symptom of the disease, this prescribed treatment is a bit ironic.

  Western histories of medicine tend to favor the Greeks—and understandably so, given the legacy of Hippocrates (ca. 400 B.C.) and the generations of medical authors who expanded on his wisdom in the centuries that followed. But arguably the most impressive description of rabies from the ancient world appears in the Sus´ruta samhita, a classic text of Ayurveda, the Indian system of traditional medicine. By and large, authorship of this tome is attributed to its namesake, Sus´ruta, who practiced medicine in the city of Varanasi, on the banks of the Ganges. Most contemporary historians place Sus´ruta in the first or second century A.D., though some put him far earlier, and that is merely the beginning of our complications in affixing a date to the work. On the one hand, the text was edited, apparently heavily, by a later disciple named Nāgārjuna, who lived sometime between the fifth and the tenth centuries A.D. On the other hand, the Samhita is said to collect wisdom from Sus´ruta’s hallowed ancestor, Divodāsa Dhanvantari, who by all accounts lived in 1000 B.C. or earlier.