The Natural History of Rabies

George M. Baer

• Publisher: Routledge
• Year: 2017
• eBook ISBN: 9781351409780
• Topic: Medicine
• Subtopic: Veterinary Medicine

This book provides essential worldwide reference information regarding rabies for public health officials, veterinarians, physicians, virologists, epidemiologists, infectious disease specialists, laboratory diagnosticians, and wildlife biologists. The book is divided into six main sections, covering topics such as the rabies virus, including antigenic and biochemical characteristics; pathogenesis, including the immune response to the infection, pathology, and latency; diagnostic techniques; rabies epidemiology in a variety of wild and domestic animals; rabies control, including vaccination of wild and domestic animals, as well as control on the international level; and finally a discussion of rabies in humans, local wound and serum treatment, and human post-exposure vaccination. Natural History of Rabies, First Edition has been the principal worldwide reference since 1975. The new Second Edition has been completely updated, providing current information on this historically deadly disease.

Chapter 1

HISTORY OF RABIES AND GLOBAL ASPECTS

James H. Steele and Peter J. Fernandez

Rabies has a long and interesting history that is lost in antiquity. Plutarch asserts that, according to Athenodorus, it was first observed in mankind in the days of the Asclepiadae, the descendants of the god of medicine, Asculapius. Acteon, the famous hunter of myth who was torn to pieces by his hounds when he surprised Diana and her attendants at the bath, was thought to have been destroyed by rabid dogs. In the Iliad, Homer is thought to refer to rabies when he mentions that Sirius, the dog star of the Orion, exerts a malignant influence upon the health of mankind. The dog, Sirius, was associated with mad dogs all through the eastern Mediterranean and Egypt, and later Rome. Homer further uses the term “raging dog” in the epithets that are thrown at Hector by Teucer. The Greeks had a special god in their mythology to counteract the effect of rabies, Arisaeus, son of Apollo. Artemis is represented as the healer of rabies.¹

The Greeks called rabies Lyssa or Lytta, which meant madness. The disease in man was described as hydrophobia in which the sick person is tormented at the same time with thirst and the fear of water. The Latin word “rabies” comes from an old Sanskrit word “rabhas” which translated means “to do violence.” The German word “tollwut” originates with the Indogermanic “Dhvar”, to damage, and “wut” from middle German “wuot” which is rage. The French word “rage” is derived from the noun “robere”, to be mad.

Democritus is thought to have made the first recorded description of canine rabies some 500 years B.C. Aristotle, in the 4th century B.C., wrote in the Natural History of Animals, Book 8, Chapter 22, “that dogs suffer from the madness. This causes them to become very irritable and all animals they bite become diseased.” Fleming¹ states that Aristotle believed that mankind was exempt from its attacks. This is strange indeed, when hydrophobia was already known as a disease of men. Hippocrates is supposed to refer to rabies when he says that persons in a frenzy drink very little, are disturbed and frightened, tremble at the least noise, or are seized with convulsions. He is said to have recommended boxwood (Buxus) as a preventive. Plutarch also writes about the dangers of rabid dog bites, and that the illness can be spread by the bite of a rabid dog. Others who mention rabies in ancient times include Xenophon, in the Anabasis, Epimarcus, Virgil, Horace, and Ovid. Lukian, a Roman writer, was of the belief that not only was the disease spread by biting dogs but that persons who became rabid could spread the disease by biting other persons, and could affect a whole group of people.²*

The infectivity of the saliva of rabid dogs is described by Cardanus, a Roman writer. The Roman writers described the infectious material as a poison for which the Latin was “virus”. Another cause of rabies which is first mentioned by Pliny and Ovid is the so called dog tongue worm. To prevent rabies, in ancient medical times, the attachment of the tongue (the frenum linguae, a mucous membrane) was cut and a fold removed in which the worm was thought to be. This idea was to persist until the 19th century, when Pasteur demonstrated the cause of rabies.

Celsus, a physician and naturalist, made rabies his particular study in the 1st century. He was emphatic that the bites of all animals that contained virus were dangerous to man and beast. Indeed, Celsus and his contemporaries recognized that the saliva alone contained the poisonous agent. In his description of wounds he says, “I have spoken concerning those wounds which are mostly inflicted by weapons, so it follows that I may speak concerning those which are made by the bite, sometimes of a man, sometimes of an ape, often of a dog, and sometimes of wild animals or of serpents. But every bite has mostly some venom” (autem omnis morsus habet fere quoddam virus). Of the malady itself he writes “The Greeks call it hydrophia, a most wretched disease, in which the sick person is tormented at the same time with thirst and the fear of water, and in which there is but little hope”.²

He recommends the practice of resorting to caustics, burning, cupping, and also sucking the wounds of those bitten by rabid dogs. He points out that there is no danger in sucking wounds except if there should be an abrasion or sore on the lip or in the mouth. If the wound is serious the cupping instrument is to be applied; if slight, a plaster can be used. Afterward, if the wound does not involve a nerve or muscle, the wound is to be cauterized. If it cannot be burnt, bloodletting should be attempted. The wound should then be treated as a bum. But if it cannot be burnt then use those medicines which violently corrode, after which the ulcer will be healed in the usual way.

These sagacious precautions not only show the disease was well understood but that it was more or less prevalent and taxed the medical skills of the times. Hot and cold baths were other measures recommended by Celsus. He states that when the disease appears, “The only remedy is to throw the patient unexpectedly into a pond, and if he has not a knowledge of swimming to allow him to sink, in order that he may drink, and to raise and again depress him, so that though unwillingly, he may be satisfied with water; for thus at the same time both the thirst and dread of water is removed.”* Celsus also mentions the danger of cold water, lest it destroy the enfeebled body. In those cases, the patient should be put into hot oil. In some cases, he says hot baths should be given immediately after the bite of a rabid dog, allowing the patient to sweat while he still has the strength. In doing this the wound is also opened and the virus distills out. Then, large quantities of pure wine should be taken which is antagonistic to all poisons. When this has been done for 3 days the person should be free from danger. Celsus also recommends salt as an application to wounds caused by the bites of dogs.

Virgil, in his Georgies, classes rabies among the diseases caused by a pestilential state of the air. Pliny, in his hearsay story of the dog tongue worm, states further, if the worm is removed and carried three times around a fire and is given to an exposed person, this will prevent him or her from becoming mad. Many other tales of the prevention and treatment of disease are found in Fleming.¹ These include eating a cock’s brain or a cock’s comb pounded and applied to the wound, and using goose grease and honey as a poultice. The flesh of a mad dog is sometimes salted and taken with food as a remedy. In addition, young puppies of the same sex as the dog that inflicted the wound are drowned, and the person bitten eats their liver raw. The urine of mad dogs was also considered poisonous by the ancients. If trod upon it was considered injurious, more so if a person had an ulcerous sore. In these cases, horse dung sprinkled with vinegar and warmed should be applied. Other treatments stretch the imagination. They include applying the ashes of a dog’s head to the wound, or ashes used in a potion; some even recommended eating the dog’s head. Others were the placing of a maggot, taken from the carcass of a dead dog, on the wound. The hair or ashes of the hair of the tail of the dog that inflicted the wound were also inserted into the wound.*

Another story of antiquity — which has lived down to this day in some parts of the world — is related by Columella; shepherds believed that if, on the 40th day after the birth of a pup, the last bone of the tail is bitten off, the sinew will follow with it. After this the tail will not grow, which will prevent the dog from getting rabies.

Writers of the early Christian era had much to say about rabies, describing it both in dogs and man. This is true of all of the Roman empire but especially Greece and Crete, where the disease was widespread. Sicily must have had much disease, as noted by the frequent references. The administration of fluids is discussed by many writers. Some recommend snow, others the use of a straw in a dark room and, if no oral methods succeed, the use of enemas. Treatment of lower animals is described in the 3rd century by Vegetius Renatus, one of the early writers on veterinary medicine. He recommended as an antidote for cattle that have been bitten by a mad dog, to feed the boiled liver of the dog to the cattle to eat, or to make it into balls and force it down as medicine. In the 6th century there are further accounts of the disease. Aetious, a physician of Mesopotamia, has left an accurate description of the dog disease. The symptoms were manifested by the dogs becoming mute, then delirious and incapable of recognizing their masters and surroundings; they refuse food, are thirsty but do not drink, and usually pant; they breathe with difficulty, keep the mouth open with the tongue hangi...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• Chapter 1 History of Rabies and Global Aspects
• PART I: THE VIRUS
• PART II: PATHOGENESIS AND PATHOLOGY
• PART III: DIAGNOSIS
• PART IV: EPIDEMIOLOGY
• PART V: RABIES CONTROL
• PART VI: RABIES AND ITS PREVENTION IN MAN
• Appendix: World Health Organization Guide for Postexposure Treatment
• INDEX