Rabid (14 page)

Though a colonist, Rush was far from a rube by European medical standards. For his doctoral training he braved the ocean voyage to Edinburgh, whose university housed one of the late eighteenth century’s finest medical schools. There he was steeped in the teachings of the top European minds of the day, in particular Herman Boerhaave, the revered Dutch theorist who had died in 1738 but remained the towering figure in medical instruction throughout Europe. The chair of Edinburgh’s medical school was William Cullen, a world-renowned doctor and thinker in his own right, though his views diverged only slightly from Boerhaave’s. (On those instances when they did diverge, Cullen later recalled, he was immediately decried as “a whimsical innovator” whose apostasy would “hurt myself and the University also.”) Still influenced by Newton and his revolution in physics, these eighteenth-century doctors saw the body mechanistically, as a sort of hydraulic contraption of solids interacting with fluids, or “humors.” In their view, diseases often were corruptions of these humors, which could become overly acidic or alkaline. In assigning causes, the theory looked
disproportionately to diet, reasoning that just as food could undergo insalubrious transformations outside the body, through spoilage and so on, it could also effect corruption on the inside.

From November to May, Rush imbibed these theories six days a week, with almost no leisure time to speak of. The typical day involved studying all morning, then classes and hospital rounds in the afternoon, followed by still more reading until midnight. Edinburgh also schooled Rush in the experimental method. His chemistry teacher, Joseph Black, himself had used the occasion of his doctoral dissertation to prove the existence of carbon dioxide (or “fixed air,” as he called it), a result that opened the door to the discovery of oxygen. By comparison, Rush’s own dissertation, an inquiry into the acidity of the stomach during digestion, was rather less impressive in both methodology and results. “Having dined on beef, peas, and bread,” he wrote, “I puked up, about three hours afterwards, the contents of my stomach, by means of a grain of tartar emetic, and found them not only acid to the taste, but likewise that they afforded a red color, upon being mixed with the syrup of violets—an invariable mark this, of acidity, among chemists!”

Nevertheless, when Rush returned to America, he was appointed professor of chemistry by the College of Philadelphia. This made him, at twenty-three, the first chemistry professor in what was soon to become the United States. A staunch supporter of American nationhood, Rush eventually had the opportunity, as a member of Pennsylvania’s congressional delegation of 1776, to sign the Declaration of Independence, and during that tumultuous era he increasingly wedded his politics to his profession. After the Tea Act, Rush played upon his status as a noted physician to showily condemn tea itself, as having “mischievous effects on the nervous system,” and as the Revolution loomed, he applied his chemistry, too, penning three essays about how to make saltpeter—the crucial ingredient in gunpowder—from dried tobacco stalks; Congress later distributed these essays as a pamphlet, with an introduction by Ben Franklin. During the Second Continental Congress, Rush inoculated Patrick Henry against smallpox, and at
Trenton, after George Washington’s famous crossing of the Delaware, Rush was on hand to perform battlefield medicine.
*

Rush believed that rabies was, in essence, a “malignant state of fever.” In this opinion he was following a tradition, beginning at least with Boerhaave, that fever could be the immediate (though not always the root) cause of hydrophobia. Boerhaave attributed this fever to “inflammation,” a catchall concept in his mechanistic theory. Cullen, following this notion, developed the idea that such fevers were caused by “overstimulation” due to excess blood. The natural prescription, therefore, was bleeding, which is indeed what Rush advocates for the rabies sufferer. Rush’s main evidence for hydrophobia being an “inflammatory fever” is his observations of the blood, which, when drawn, exhibits both “size” (a term then for viscosity) and yellowness in its serum. He recalls that the blood “was uncommonly sizy in a boy of Mr. George Oakley whom I saw, and bled for the first time, on the fourth day of his disease, in the beginning of the year 1797. His pulse imparted to the fingers the same kind of quick and tense stroke which is common in an acute inflammatory fever.”

One of Rush’s medical students, James Mease, held a somewhat more accurate view—that hydrophobia was a disease of the nervous system—and, awkwardly for the two men, this view had seemingly been endorsed by Rush before the teacher later contradicted his pupil. Mease had laid out this theory in his 1792 doctoral thesis on the disease, which he had dedicated to Rush and for which Rush had even supplied a preface.
†
In 1801, chagrined to see that his old professor had now
published a contrary opinion, Mease furiously produced a second pamphlet on rabies, this one explicitly addressed to Rush. Point by strenuous point he set out to rebut his former mentor. The woundedness of Mease’s tone as he did so (beginning with his florid prefatory note to Rush himself, telling the great physician that he has mistakenly returned to principles “previously destroyed by yourself”) was understandable given the personal connection between the two men. A family friend, Rush had known the young Mease since infancy and personally treated him through several serious childhood illnesses. “One of the first things I can remember,” Mease later recalled, was Rush “calling me ‘his boy,’ and he used frequently to say that I should be his apprentice.” This latter prediction, which Mease averred was “probably in jest,” was eventually realized when Mease enrolled for medical training at the College of Philadelphia.

In many respects, Mease’s gloss on rabies is hardly more helpful than Rush’s. He asserts that the illness can sometimes generate spontaneously in dogs, a widespread theory (as we will discuss later in this chapter) that seriously set back attempts to contain and control the disease. And by contemporary standards, his preferred treatment for hydrophobia—powdered jimsonweed—is every bit as daft as bleeding. But Mease does draw one very perceptive comparison that had eluded medical authors until then. Noting the irregularity of the onset of hydrophobia (the fact that the time between bite and symptoms is usually weeks, or as long as months) Mease realized that another illness involving puncture wounds behaves in a similarly odd way: namely, tetanus, or lockjaw. From what we know today, the two are different in many crucial respects: rabies is a virus, which travels up the nerve sheathings, whereas tetanus is a bacterium, with the chemical poison released by that bacterium, rather than the bacterium itself, journeying up the nerves. But rabies and tetanus are cousins, as it were, in that
they are among the few pathogens whose malign effects spread along the nerves instead of the bloodstream, creating the strange phenomenon of a disease whose time of onset depends on the distance of the wound from the head.

Such minor flashes of insight aside, all these millennia of medical theorizing about rabies had yielded little usable knowledge. The reason for this, of course, is that medicine had yet to embrace the most crucial insight of all: the very existence of viruses and bacteria, agents of disease unseeable by the naked eye. At the time of Rush and Mease, science possessed neither the complex optics nor the practical wisdom required to make this leap. Less than a century later, seventeen centuries of stasis in our understanding of rabies would be obliterated—and largely by the dogged efforts and remarkable genius of a single man.

During one particularly bad rabies outbreak in England, the
Liverpool Daily Post
published a comical ditty, called “The Two Dog Shows,” that captured perfectly the stark dichotomy in the canine universe, between the increasingly cherished domestic and the increasingly terrifying feral. The poem began:

The nineteenth century was indeed the best and the worst of times for the Western dog, the most fortunate of which had finally been invited onto the foot of the bed, but the least fortunate of which met brutal ends in large numbers at the hands of exercised humans. In France, whose reputation as a locus of pet pampering was well deserved (one contemporary book on dogs stated, on its first page, “
Le chien est une
machine à aimer,
” that is, “The dog is a love machine”), rabies fears in Paris led to “Great Dog Massacres,” sometimes called “canicides”—the tally in 1879 alone was 9,479 killed. In England, the preferred method of dispatch was beating the dogs to death with truncheons. Neil Pemberton and Michael Worboys, two University of Manchester historians who have studied the history of rabies in Britain, note that from the perspective of dog lovers, terror of the disease had “turned ordinary people into murderers.”

With little surety to be found in medicine, observers were left to formulate their own theories about which dogs should and should not be trusted. To some, domestication itself was seen as the enemy—“Constantinople and Africa are rabies-free,” it was often noted, erroneously—even as reports were coming in from India that the disease ran rampant among wild dogs and jackals. Some people believed that the best-kept dogs were the most dangerous—that too much idleness, combined with overfeeding, predisposed them to the disease; that the inbreeding of purebred dogs “exhausted” their “nervous system” and made them susceptible. (As one correspondent remarked in the pages of what must be the best-titled publication in history, the
Annals of Sporting and Fancy Gazette,
“Hydrophobia makes its appearance…in dogs which exist in a state of confinement which are kept in towns and take little exercise.”) Different theories fingered different breeds as the primary culprits: retrievers, in one view; foxhounds, in another.

Most common of all, of course, was to blame the dogs of the lower classes. This was largely the view of animal-welfare advocates, who naturally believed that mistreated dogs, such as those made to pull carts (still a surprisingly common practice) or fight in rings, were the most susceptible. But in most people’s minds, it seemed clear that the degradation of the dogs was merely analogous to the degradation of their owners. One letter writer to the London
Times
remarked that these curs “infest our streets unmolested, creating noise, filth, and
general annoyance; nor is this all, the peculiar sexual intercourse of the species renders them very dangerous. I have seen a whole gang of curs so strong excited, as to be little short of mad—so furious, indeed, as to change their very natures.” Wrote another correspondent to the
Times,
“If these no-breed curs, which are at least two hundred to one, were destroyed, there would be little fear of hydrophobia.” In the 1850s, France created its dog tax for the stated purpose of discouraging dog ownership among the poor. Britain had a similar tax, though it was levied only on dogs more than six months old, which wound up worsening the problem it aimed to fix: families would often acquire adorable puppies and then dump them on the streets, leaving them to grow up wild.

In the end, no dog could be trusted. Indeed, some experts cautioned that uncommon affection, of all things, could herald the onset of rabies. George Fleming, the British veterinarian whose 1872 treatise on hydrophobia was probably the definitive English-language survey in the pre-Pasteur era, warned against the “Judas’ kiss” of the rabid pet, explaining that

The French physician G. E. Fredet took this admonition further. In his view, this behavior in the early stages of rabies was not occasional and not confined to masters alone. Instead, such dogs “invariably express an exaggerated attachment and devotion to everyone who approaches them.” That is: even the friendliest dog on the street, or in an acquaintance’s home, might suddenly deliver a bite (or lick!) that became a death sentence.

Given this dual nature of the dog, it is perhaps easy to imagine why fiction of the gothic persuasion, when hoping to conjure an atmosphere of gloom, would trot out so many snarling curs. Few gothic novels play this card better, or at least more often, than Emily Brontë’s
Wuthering Heights
. In the very first pages, when the tenant Lockwood walks up to visit his brooding landlord, Heathcliff, the visitor’s unwelcomeness is underscored by the hostility of his host’s dogs—in particular the mother dog, a “liver-coloured bitch pointer” that “broke into a fury, and leapt on my knees” and that (along with half a dozen other “four-footed fiends, of various sizes”) Lockwood is left to fend off with a fireplace poker. During the ensuing snowstorm, when he tries to escape Wuthering Heights by borrowing one of the house’s lanterns, the servant sics the slavering dogs on him to prevent the theft; on order, “two hairy monsters flew at my throat, bearing me down, and extinguishing the light.”