Rabid Read online

  It was more than just the power of Cerberus’s many jaws that was to be feared. In the Metamorphoses, a list of poisonous substances includes “slaver from Cerberus,” along with a creation myth whereby that rabid saliva, sprayed from the hellhound’s lips and flecking a field of battle, gave rise to a notoriously poisonous plant called aconite—also known, tellingly, as wolfsbane. As the veterinary historian John Blaisdell has noted, symptoms of aconite poisoning in humans bear some passing similarity to those of rabies: they can include frothy saliva, impaired vision, vertigo, and finally a coma. It is not improbable that some ancient Greeks would have believed that this poison, mythically born of Cerberus’s lips, was literally the same as that to be found inside the mouth of a rabid dog.

  Until just the past century—and even then only in the developed world—rabies has been experienced by humans as a disease of the dog, a peculiarly canine madness that could reproduce a similar, fatal madness in humans. But all the while, the disease also lurked inside another, far more shadowy species: the bat. Indeed, recent research has indicated that bats harbored the disease even earlier than dogs, going back at least seven thousand years and as far as twelve thousand years, far before the first written languages and perhaps even before dogs were domesticated from wolves.

  How was this calculation made? The answer flows from two simple facts about how viruses evolve over time. The first is that most mutations in a virus are neither beneficial nor harmful to its propagation; instead, they’re neutral, trivially altering the genetic sequence without changing the virus’s overall fitness in any way. The second fact is that these mutations tend, over large populations and long periods of time, to happen on a predictable schedule. So given a set of related viral strains, a computer can analyze the patterns of genetic difference and arrange them into a rough phylogenetic tree, showing which strain evolved from which and how long ago the divergences occurred. In 2001, two researchers at France’s Institut Pasteur used this technique to investigate a large set of rabies virus strains—thirty-six from dogs and seventeen from bats—and the results were fairly clear: the enigmatic bat, a distant presence for most of the cultural history of rabies, was probably responsible for infecting the dog, rather than the other way around.

  This so-called molecular clock research has led to many other insights about the origins of disease. In particular, it’s shown us how many of our worst killers, pathogens that have racked humanity since the earliest civilizations, evolved out of animal populations. Measles, we now know, evolved from a disease in cattle; similarly, the various strains of influenza, as we still see today in our annual flu scares, readily pass back and forth between us and our livestock (for more on this, see Chapter 6). Some of these zoonotic leaps from animal to man have been understood fully only during the past decade or so, as genome sequencing has allowed scientists to trace more precisely the genetic lineage of pathogens. For example, a team led by the Stanford epidemiologist Nathan Wolfe announced in 2009 that it had isolated the origins of malaria in a parasite of chimpanzees, which presumably spread to humans through mosquito bites.

  New sleuthing has yielded particularly intriguing details about smallpox, arguably the deadliest disease in history. A 2007 study, headed up by researchers at the U.S. Centers for Disease Control and Prevention, traced the notorious killer back to a virus in rodents, estimating that it made the leap to humans at least sixteen thousand years ago. What is especially satisfying is the team’s identification of two separate human strains, an earlier and milder version that cropped up in west Africa and the Americas, and a more severe version—the progenitor of the strain that slew untold millions over the past millennium before its eradication in the late 1970s—that emerged from Asia a bit later. This helps explain why the literature, medical and otherwise, of the Greeks and Romans provides little evidence that highly fatal smallpox was common, even though archaeological evidence shows the clear presence of a smallpox-like condition in ancient Egypt. The most spectacular example of this is the mummified body of Pharaoh Ramses V, on whose shriveled skin can clearly be seen the pustular pattern typical of the disease. (This possibly answers the vexing Egyptological question of why Ramses V was not buried for almost two years after his death, when other pharaohs were interred just seventy days after mummification; either fear of infection from his corpse or a paucity of healthy embalmers might account for the lag.)

  Smallpox was far from the only ancient epidemic with its origins in the rodent. Both plague and typhus ravaged by way of the rat, whose fleas would transmit the deadly bugs to unsuspecting humans. For all the emphasis placed on livestock in the development of civilization, the case can be made—and indeed has been made, most elegantly by the biologist Hans Zinsser in his 1935 book Rats, Lice, and History—that human affairs have been stirred far more vigorously by the rat, whose companionship with people has tended to be involuntary on our part but whose omnipresence among us, like that of the stray dog, became more or less inevitable with the emergence of the city. With most zoonotic leaps in disease, animal contact is the spark, but urbanization is the bone-dry tinder; a newly evolved pathogen can’t spread from person to person, after all, unless people run across one another in the first place.

  How to treat the rabies patient or the dog-bite victim? Consider the predicament of an ancient physician on this terrible question. The cause of hydrophobia (the bite of a rabid animal) was often separated by many weeks from its effect (the onset of neurological symptoms), and only a fraction of bites—even assuming an animal that is actually rabid and not merely vicious—progressed to the fatal infection. Meanwhile, it was hard to distinguish real cases of hydrophobia from hysterical ones, which were common right up to the twentieth century. Worse, because of the relative paucity of cases, ancient medical scholars often compiled alleged cures from second- and thirdhand reports.

  For all of these reasons we should forgive, at least to a point, the extraordinary nonsense that passed for rabies treatment in the ancient world. Let’s begin with bite treatment. Here again the Sus´ruta samhita deserves the most respect. Not only does it acknowledge, without wavering, the fatality of hydrophobia, but it prescribes a treatment for rabid bites—bleeding and cauterization of the wound—that is as sensible as any. (Also as delicious as any: the Samhita recommends cauterizing with clarified butter, which the patient is then invited to drink. It also prescribes a sesame paste for the wound and advises that the patient be fed a special fire-baked cake made of rice, roots, and leaves. The Varanasian patient did not face death on an empty stomach.)

  In ancient China, where mentions of rabies in extant texts are relatively spare, the disease does appear in Ge Hong’s “Handy Therapies for Emergencies,” from the third century A.D. Ge prescribes “moxibustion” for the wound, a process that involved burning mugwort, a species of wormwood, and applying it to the bitten region. This was likely to have been more effective, or at least to do less harm, than another of his recommendations: to kill the offending dog, remove its brain, and rub that on the wound.

  Among the Greco-Romans, perhaps we should not be surprised that Celsus, the encyclopedist, drawing as he did on many different sources, some of uncertain provenance, should supply us with a far more varied list of dog-bite treatments. These include bleeding and cauterization, but also the application of salt, or even a brine pickle, to the wound. Some physicians, he says, send their patients to a steam bath, “there to sweat as much as their bodily strength allows, the wound being kept open in order that the poison may drop out freely from it.” After that, the doctors pour wine into the bite. “When this has been carried out for three days,” Celsus says, “the patient is deemed to be out of danger.”

  Things totter off the rails with Pliny the Elder. As with Ge Hong, Pliny’s thoughts tend to involve using the animal to treat the man. His best-known cure—to “insert in the wound ashes of hairs from the tail of the dog that inflicted the bite”—lives on today in our expression “hair of the dog,” referring to a not-quite-
so-dubious hangover remedy. But Pliny thought that a maggot from any dead dog’s carcass would do the trick, as would a linen cloth soaked with the menstrual blood of a female dog. Or the rabid dog’s head could be burned to ashes, and the ashes applied to the wound; or the head could just be eaten outright.

  Still not see a treatment that works for you? Let Dr. Pliny lay out some more options:

  There is a small worm in a dog’s tongue…: if this is removed from the animal while a pup, it will never become mad or lose its appetite. This worm, after being carried thrice round a fire, is given to persons who have been bitten by a mad dog, to prevent them from becoming mad. This madness, too, is prevented by eating a cock’s brains; but the virtue of these brains lasts for one year only, and no more. They say, too, that a cock’s comb, pounded, is highly efficacious as an application to the wound; as also, goose-grease, mixed with honey. The flesh also of a mad dog is sometimes salted, and taken with the food, as a remedy for this disease. In addition to this, young puppies of the same sex as the dog that has inflicted the injury, are drowned in water, and the person who has been bitten eats their liver raw. The dung of poultry, provided it is of a red colour, is very useful, applied with vinegar; the ashes, too, of the tail of a shrew-mouse, if the animal has survived and been set at liberty; a clod from a swallow’s nest, applied with vinegar; the young of a swallow, reduced to ashes; or the skin or old slough of a serpent that has been cast in spring, beaten up with a male crab in wine.

  “This slough,” Pliny adds, “put away by itself in chests and drawers, destroys moths.”

  To the credit of Pliny, and of Celsus (with one exception, below), all these proffered treatments address the rabid dog or its bite, not hydrophobia itself. But even the fatal manifestation of the disease occasioned some elaborate and entirely chimerical cures. Oddly, the methodists, whose observations about hydrophobic symptoms became increasingly admirable over the centuries, seem to get more addled when the subject is treatment. Both the anonymous Greek text and, later, Soranus himself wrote of treatment as if recovery were more likely than not. They recommended creating a spa-like atmosphere. “Have patients suffering from hydrophobia lie in rooms with good air well tempered,” remarked the anonymous author. “Massage his limbs,” added Soranus, and “cover with warm, clean wool or cloths those parts that are affected by spasm.” Both authors presented hydrophobia as an acute attack that would often recede in time—a bewildering judgment that flies in the face of observable facts. They prescribed various poultices made from dates crushed with quinces, or olive oil, or ripe melon, or vine tendrils, or coriander. Some unnamed physicians, cited by Soranus, recommend that a plaster be made from hellebores—the flowering perennials—and applied to the anus.

  The most remarkable, and perhaps fitting, prescription for hydrophobia is the one offered by Celsus, who, as noted previously, had the good sense to admit that there was “little help” for the hydrophobic patient at all. Yet he apparently could not refrain from offering just one little cure: that is, “to throw the patient unawares into a water tank which he has not seen beforehand.” He explains this method to be, as we might say today, win-win:

  If he cannot swim, let him sink under and drink, then lift him out; if he can swim, push him under at intervals so that he drinks his fill of water even against his will; for so his thirst and dread of water are removed at the same time.

  If this proto-waterboarding happens to spur muscle spasms in the subject, Celsus recommends he be “taken straight from the tank and plunged into a bath of hot oil.” A patient could be forgiven for preferring hydrophobia to that particular fate.

  * * *

  * In the philosopher’s defense, R. H. A. Merlen, author of a fine volume entitled De Canibus: Dog and Hound in Antiquity, surmises that cynanche was actually itself a form of rabies—so-called dumb rabies, in which the afflicted dog, rather than raging, stands mute with its mouth agape. Merlen points out that Aristotle characterizes cynanche as fatal in dogs, unlike any commonly presenting throat malady.

  * Xenophon even enumerates, at humorous length, a list of ideal names for hounds: Psyche, Pluck, Buckler, Spigot, Lance, Lurcher, Watch, Keeper, Brigade, Fencer, Butcher, Blazer, Prowess, Craftsman, Forester, Counsellor, Spoiler, Hurry, Fury, Growler, Riot, Bloomer, Rome, Blossom, Hebe, Hilary, Jolity, Gazer, Eyebright, Much, Force, Trooper, Bustle, Bubbler, Rockdove, Stubborn, Yelp, Killer, Pêle-mêle, Strongboy, Sky, Sunbeam, Bodkin, Wistful, Gnome, Tracks, Dash—“short names,” he reasons, “which will be easy to call out.”

  The basilica at Saint-Hubert, 2010.

  2

  THE MIDDLE RAGES

  On the subject of Saint Hubert, protector of hunters, healer of rabies sufferers, we might as well begin with the myth; for while the truth about his life remains stubbornly opaque, it was the myth, and not the truth, that brought generations of fearful dog-bitten pilgrims from across Europe, by foot and horse and eventually even train, to be cured at the site where his holy relics resided.

  The myth begins when Hubert is a young seventh-century nobleman in the Frankish kingdom, son of the Duke of Aquitaine. Hubert decides to spurn courtly life. He retreats to the deep forests of the Ardennes, the range of noble hills that roll through what is now Belgium and into the east of France, and devotes himself to the hunt. One Good Friday, so the legend goes, the young man is giving chase to a stag when the beast rears around, a crucifix hovering between its antlers. “Unless thou turnest to the Lord,” a heavenly voice intones, to the bewilderment of the stag’s pursuer, “and leadest an holy life, thou shalt quickly go down into Hell.”

  Hubert bows before the creature that a moment ago was his prey. “Lord,” he asks, “what wouldst Thou have me do?”

  It is a startling cross-cultural transformation: this is the myth of Actaeon, overhauled to serve a distinctly different cosmology. Again we have a hunter, surprised to find himself in the company of a deity. Again a stag is imbued supernaturally with consciousness. But the resolutions of these two brushes with divinity, Actaeon’s and Hubert’s, could not be more divergent. Vengeful Diana chooses to make Actaeon the stag, thereby condemning him to a senseless, though symbolically appropriate, death in his own hounds’ jaws. But the monotheistic deity, resonant with the divine sacrifice of the Christ story, makes Himself into the hunted form. To the early Christian mind, the Hubert tale also resounded because it played on both sides of a sometimes contradictory medieval fascination with the hunt. When hunting appears in medieval narratives, as the historian John Cummins notes, it generally “detaches a man…from his normal environment and, frequently, his companions, and takes him into unfamiliar territory”—territory that “is not merely topographical, but emotional and sometimes moral.” In popular romance, it was in pursuit of the stag that heroes proved themselves above all.

  Yet the finest stag was as revered as (or perhaps more revered than) the finest hunter was. The most exalted prey in the medieval hunt, the hart was believed to be uniquely holy. A stag pursued by hounds would sometimes figure as a marginal illustration in Bibles to symbolize good encroached by evil; one Christian allegorist likened the ten points of its antlers to the Ten Commandments. Bestiaries, in their treatment of the stag, would sometimes invoke Psalm 42: “As the hart panteth after the water brooks, so panteth my soul after you, O God.” The devil, meanwhile, was portrayed as a hunter, setting traps for his human prey. One fourteenth-century German work goes so far as to say that Christ himself was hunted down and killed by “the hounds of hell and the infernal huntsman, the devil.”

  As that last example suggests, the dog was not seen in nearly so rosy a light. Though bestiaries often did remark on the helpful characteristics of dogs, they also lingered on not especially flattering examples: for instance, comparing the recalcitrant sinner to the dog that returns to its own vomit. In general, the spread of Christianity from the fourth to the eighth century had brought along with it a more uniformly dark vision of the dog, a view that is literally inscribed in scripture:
of the forty-odd times that “dog” or “dogs” appears in the Bible, both Old and New Testaments, depictions of the creature range from revolting to merely distasteful. The best that the Bible can deign to say of a dog is this characteristically sardonic aphorism from the narrator of Ecclesiastes: “Anyone who is among the living has hope—even a live dog is better off than a dead lion!”

  From there, though, it just gets nastier. As a holy people, the Israelites are ordered not to eat the flesh of wild beasts; instead, “throw it to the dogs.” Dogs appear often as eaters of human flesh and drinkers of human blood. In 1 Kings alone, they are not just devouring corpses in the towns of Jeroboam and Baasha but also licking up the blood of Naboth; eating the flesh of his infamous murderess, Jezebel; and drinking the blood of her husband, Ahab, king of Israel. Five of the Psalms mention dogs, all painting the creatures as malign forces encroaching: for example, “Dogs have surrounded me; a band of evil men has encircled me, they have pierced my hands and my feet,” or “They return at evening, snarling like dogs, and prowl about the city.” The New Testament is hardly better. Our famous expression “pearls before swine” could just as easily have referred to man’s best friend, given the original verse from Matthew: “Do not give dogs what is sacred; do not throw your pearls to pigs. If you do, they may trample them under their feet, and then turn and tear you to pieces.” (It wasn’t the pigs that would tear you to pieces.) In Luke, the ultimate insult to the beggar Lazarus is the dogs that come to lick his sores. In Philippians, Paul enjoins his audience to watch out for “those dogs, those men who do evil, those mutilators of the flesh.” Even trippy Revelation gets in a parting shot, as the angel uses “the dogs” to lump together all those who will be left out come Judgment Day: “Outside are the dogs, those who practice magic arts, the sexually immoral, the murderers, the idolaters and everyone who loves and practices falsehood.”