Rabid

by Monica Murphy

  Shortly afterward, Pasteur left Paris for a much-needed rest and relied upon frequent updates from the physicians still monitoring Meister to reassure him of his successful treatment. On August 3, Pasteur wrote to his son from Arbois, “Very good news last night of the bitten lad. I am looking forward with great hopes to the time when I can draw a conclusion. It will be thirty-one days tomorrow since he was bitten.”

  As more weeks passed and Meister remained free from rabies symptoms, Pasteur began to share the news of his success with close associates. One of these, Léon Say, leaked the story to the Journal des Débats, and soon the world began tentatively cheering the news. After Pasteur returned to Paris in the early fall of 1885, he made a statement to the Académie des Sciences describing the treatment received by Meister. More than three months had passed since the child suffered his terrifying bite wounds, and still he appeared healthy. The details of the case were outlined for the academy. Dr. Vulpian rose first to respond:

  Hydrophobia, that dread disease against which all therapeutic measures had hitherto failed, has at last found a remedy. M. Pasteur, who has been preceded by no one on this path, has been led by a series of investigations unceasingly carried on for several years, to create a method of treatment by means of which the development of hydrophobia can infallibly be prevented in a patient recently bitten by a rabid dog. I say infallibly, because, after what I have seen at M. Pasteur’s laboratory, I do not doubt the constant success of this treatment when it is put into full practice a few days only after a rabic bite.

  It is now necessary to see about organizing an installation for the treatment of hydrophobia by M. Pasteur’s method. Every person bitten by a rabid dog must be given the opportunity of benefiting from this great discovery, which will seal the fame of our illustrious colleague and bring glory to our whole country.

  Pasteur’s modest laboratory at the École Normale was immediately transformed into a clinic and dispensary. People terrified of rabies arrived in droves to receive inoculations. By December, eighty courses of treatment had been completed or were in progress in Pasteur’s bustling lab on the rue d’Ulm.

  Every morning, Pasteur’s assistant Eugène Viala meticulously prepared inoculations for the day’s vaccinations. From rows of desiccating flasks, Viala selected and sectioned pieces of aged rabbit spinal cord. The pieces then were isolated in sterilized vials according to the number of days since postmortem harvest and suspended in a few drops of veal broth to create an inoculant. Pasteur supervised Viala’s work closely and saw that, for every patient, an appropriately attenuated inoculation was prepared specifically for each given day of treatment.

  At eleven o’clock, Pasteur’s study was opened to patients. For each, the date and circumstances of the bite, along with the veterinarian’s certificate, were entered into the register alongside the name of the victim. Pasteur stood attentively alongside the pediatrician Jacques-Joseph Grancher as he made each injection according to protocol. The patients and their families were free to ask questions of the celebrated scientist responsible for the vaccine, but these were often redirected to Grancher: Pasteur would never hesitate to gently remind his visitors that he was trained as a chemist, not as a physician. Pasteur’s son-in-law recalls that “he had a kind word for every one, often substantial help for the very poor. The children interested him the most; whether severely bitten or frightened at the inoculation, he dried their tears and consoled them.”

  In December 1885, a telegram arrived at the rue d’Ulm announcing that four children from New Jersey, bitten by rabid dogs, were en route to Paris to receive Pasteur’s now internationally famous cure. Money for their passage had been raised through a public subscription organized in the New York Herald. The published appeal, written by the well-known Newark physician Dr. William O’Gorman, read:

  I have such confidence in the preventive forces of inoculation by mitigated virus that were it my misfortune to be bitten by a rabid dog, I would board the first Atlantic steamer, go straight to Paris and, full of hope, place myself immediately in the hands of Pasteur…. If the parents be poor, I appeal to the medical profession and to the humane of all classes to help send these poor children where there is almost a certainty of prevention and cure. Let us prove to the world that we are intelligent enough to appreciate the advance of science and liberal and humane enough to help those who cannot help themselves.

  Contributors to the subscription included Andrew Carnegie and the former secretary of state Frederick Frelinghuysen, along with neighbors and friends from the children’s Newark neighborhood, whose nickels, dimes, and dollars within twenty-four hours had amassed to a thousand dollars. The four boys quickly embarked for Paris, accompanied by a doctor and by the mother of the youngest among them. That boy, only five years old, reportedly exclaimed upon experiencing the trifling sting of his first injection, “Is this all we have come such a long journey for?” As their treatment proceeded, the story was raptly followed by the New York press—whose articles were subsequently reprinted in newspapers across the nation. As much as 10 percent of the Herald was devoted to rabies while the children were under Pasteur’s care. All of America waited breathlessly for news of the boys’ cure.

  When the healthy, vaccinated boys stepped off the boat from Paris several weeks later, they were celebrities in New York and across the nation. For months afterward, the four of them were trotted out in theaters and dime museums, from the Bowery in Manhattan to the heartland of America. For ten cents, the curious could witness with his or her own eyes the ongoing health and vigor of the treated boys, and even question them about their experience in Pasteur’s laboratory. Around the United States and around the world, the media of the day continued to dwell on the particulars of Pasteur’s rabies treatment as experienced by the four young Americans. Many newspapers also went out of their way to explain Pasteur’s laboratory-based scientific research that gave rise to the vaccine.

  According to the historian Bert Hansen, the popular sensation caused by the Newark boys receiving Pasteur’s cure led to a profound change in the way Americans thought about science and medicine. “It reversed the assumption that older doctors and older medicines were better than new ones,” explains Hansen. “It created a new expectation that medicine can and should change, that progress is to be expected, that the new advances would come from laboratory experiments on animals, and that specific injections would be a major tool of the new medicine.” The public, led by journalists and public officials, now waited breathlessly for the arrival of new medical breakthroughs and greeted these with ready fanaticism. Some, in the decade or so following Pasteur’s rabies vaccine, would prove to be worthy—like diphtheria antitoxin and diagnostic X-rays—while others would fall flat, such as Koch’s tuberculin treatment for consumption. Meanwhile, the global medical establishment was forced to adapt to the popular view. In the French journal Concours Médical, one Dr. Jeanne editorialized in 1895:

  From the heights of our settled situations, we should no longer laugh at bacilli and culture media. Those who cultivate them already deserve our respect for the services that they have given mankind; for us, the old guard of the medical profession, they must also inspire salutary fear and a determination to be useful. We must march with the times. The coming century will see the blossoming of a new medicine: let us devote what is left of this century to studying it.

  Let us go back to school and prepare the ground for an evolution, if we are to avoid a revolution.

  Before the four children had even begun the return voyage from Paris, enthusiastic groups of physicians in New York, Newark, and St. Louis had initiated steps to bring Pasteur’s cure to the United States. Pasteur made it known that he would welcome American scientists, along with those from all corners of the globe, to study his methods in his laboratory. By the year 1900, there would be at least six clinics devoted to administering rabies vaccines in the United States.

  Back in Paris, having assembled enough cases to demonstrate a statistical differ
ence in survival between those vaccinated and those not, Pasteur set his sights on creating an institution that could meet the growing demand for his rabies treatment, as well as provide a home for the ongoing scientific research that might lead to even more cures. Although fervently proud of his contribution to the glory of France, he wanted this establishment to remain independent of the government. On announcing a fund-raising campaign in 1887, Pasteur immediately began to receive donations from all around the world. From the editor of the Herald, to the tsar of Russia, to little Joseph Meister in Alsace, donors gave generously to the cause. But much was needed in order to endow Pasteur’s grand vision. Around Paris, Pasteur became a philanthropic fixture, regularly appearing at charity balls, bazaars, and banquets—and in the drawing rooms of wealthy Parisians, discreetly soliciting financial contributions. His personal contribution of 100,000 francs made Pasteur himself one of the largest single donors to his own cause. On November 14, 1888, the Institut Pasteur was formally inaugurated.

  The Institut Pasteur would serve as the flagship for the growing syndicate of Pasteur Institutes worldwide. According to its official statute, registered in 1887, the institute’s purposes were “(1) the treatment of rabies according to the method developed by M. Pasteur; (2) the study of virulent and contagious diseases.” Unofficially, the Institut Pasteur was intended to foster science that would not only protect human lives and livelihoods but also engender profitable applications to support the institute’s self-perpetuation and growth. The modern buildings, erected according to Pasteur’s specifications on an expansive property in the then-suburban Parisian plain of Grenelle, would house laboratories, kennels, libraries, and Pasteur’s own comfortably appointed residence. Its opening ceremony was attended by the president of the French Republic; ambassadors from Turkey, Italy, and Brazil; the most esteemed French scientists of the day; and a robust international press corps, who would ensure that the triumphant opening remained prominent in newspapers worldwide for several days.

  Even as Pasteur was seeing his doctrines grandly institutionalized, in Paris and around the globe, he was constantly under attack from scientific detractors. Foreign microbiologists, especially those in Germany and Italy, claimed that they could not reproduce his rabies vaccine results. Physicians at home and abroad insisted that the improvements in survival from rabies due to being vaccinated were insignificant. Scientific journalists, who had risen to prominence in Europe during the latter half of the nineteenth century because of the popularization of intellectual issues, for the most part supported Pasteur, but those who chose to make their careers questioning the contemporary scientific orthodoxy missed no opportunity to chip away at Pasteurian principles. Each time the vaccine failed to save a life, even if it was simply because the treatment was delivered too late in the course of disease, the case would occasion a whole new trial of Pasteur’s methods in the dock of a skeptical press. Numerous publications gave column space to Pasteur’s scientific rivals, further fanning controversy. Some writers emphasized alternatives to Pasteurian treatment. Others expressed a nostalgic view that traditional methods were better or even argued that Pasteur’s vaccine was somehow derivative of historical therapies.

  If Pasteur’s contemporary popularity and eventual historical legacy did not suffer, it is because he never gave anyone else the last word about his research and its fruits. Each and every hostile article, whether published in an academic journal or in a popular magazine, would receive an aggressively didactic response from the man himself. To a Naples newspaper, Pasteur wrote about one of his rivals, “Dr. von Frisch…has not succeeded, I am sorry to say. But I can counter his trials with positive results that will overthrow any negative facts he claims to have obtained.” To his family, Pasteur remarked in frustration, “How difficult it is to obtain the triumph of truth! Opposition is a useful stimulant, but bad faith is such a pitiable thing. How is it that they are not struck with the results shown by statistics?”

  Pasteur would die at home on September 28, 1895. His health, during the years leading up to his demise, had been undermined by a series of strokes, as well as by the confining fatigue of congestive heart failure. His last years were spent in somewhat diminished productivity at the institute, as described by Mme Pasteur in 1893: “Pasteur continues to be fairly well, but he must resign himself to put aside all work that is in any way strenuous. He takes much interest in the work of others. He still enjoys going to the Academies.”

  The “work of others” was Pasteur’s principal source of pride in those final years, especially as those other scientists were frequently men he had trained himself at the École Normale Supérieure or who had learned their discipline at the Institut Pasteur. “Our only consolation, as we feel our own strength failing us, is to feel that we may help those who come after us to do more and to do better than ourselves, fixing their eyes as they can on the great horizons of which we only had a glimpse,” pronounced Pasteur, with characteristic gallantry. Many of the Pasteurians would eventually be remembered for their own contributions to science and medicine—though acknowledgment of their individual achievements would not generally be realized until after Pasteur’s day-to-day involvement in laboratory activities had decreased.

  Emile Roux, Pasteur’s closest collaborator during the creation of vaccines against fowl cholera and anthrax, and who had been so instrumental in devising an attenuation method for the rabies virus, would go on to develop serum therapy against diphtheria toxin. Élie Metchnikoff, a Russian biologist who had trained in Germany with Koch, would help, during his time at the Institut Pasteur, to lay the scientific foundations of immunology by describing the mechanisms of cellular immunity. Albert Calmette, after establishing a Pasteur Institute in Saigon, would build on the antitoxin research of Roux and develop antivenom serum therapy for snakebites. Later, at a Pasteur Institute he had founded in Lille, Calmette would join Jules Guérin, another Pasteur disciple, in his work on tuberculosis; together they would identify the famous BCG (Bacillus Calmette-Guérin), a strain of bovine TB that functioned as a human vaccine. Alexandre Yersin, a Swiss physician who was working under Roux when the Institut Pasteur was inaugurated, went on to spend his most productive years in Indochina. When a plague outbreak threatened Hong Kong in 1894, Yersin quickly established a field laboratory in the afflicted city and within days had discovered the plague bacillus. He furthermore determined that the dead rats littering Hong Kong were the origin of the deadly epidemic and quickly developed and began production of a lifesaving serum therapy against plague. Charles Nicolle, who met Pasteur only once, worked under Roux and Metchnikoff, then later at the Pasteur Institute in Tunis. He determined that typhus was spread by the human louse and that leishmaniasis was transmitted from dogs to humans by the bite of the sand fly. Jules Bordet, who worked in Metchnikoff’s laboratory from 1894 to 1901, made great progress in the field of immunology, particularly concerning humoral immunity, and he discovered the bacillus responsible for whooping cough after creating a Pasteur Institute in Belgium. Together, these early Pasteurians would further the laboratory-based approach to medical problems favored by their master and would carry his doctrines linking science, medicine, and public health to all the corners of the earth.

  Pasteur’s remains were interred not in the Panthéon but instead, according to his family’s wishes, in a specially appointed crypt beneath the Institut Pasteur. There, fifteen years later, his wife, Marie, would be laid to rest also. Mosaics depicting Pasteur’s research triumphs watched over the tombs—and so did Joseph Meister, who, years after being the first to be vaccinated successfully against the horror of rabies, became the concierge of the institute. When the Nazis, on occupying Paris, attempted to visit the Pasteur crypt in 1940, Meister bravely refused to unlock the gate for them. Soon after this discouraging event, he took his own life.

  Then, as now, Pasteurian science remained very much alive. Soldiers at the front in that war, on both sides of the battle, were protected from disease with Pasteurian vaccines,
treated for illness with Pasteurian sero-therapies, and benefited from hygienic first aid and surgical techniques based on Pasteurian asepsis. As remains the case today, there were then still scientists ready to argue against Pasteurian principles—but history would take little note. Indeed, though many miraculous cures lay in the future, no figure in medicine since has ever enjoyed the heroic status conferred upon Louis Pasteur, conqueror of rabies.

  * * *

  * Duclaux’s account was supported by the biography written by Pasteur’s son-in-law, René Vallery-Radot, but some modern scholars dispute it. In 1985, based on a thorough study of Pasteur’s notebooks, the French historian Antonio Cadeddu asserted an alternate history: Pasteur’s collaborator Roux determined the method for attenuation of chicken cholera through prolonged, deliberate laboratory experiment—without the knowledge of Pasteur.

  * The superior technique of carbolic acid attenuation was devised by the veterinary researcher Henri Toussaint and perfected by Pasteur’s assistants, Roux and Charles Chamberland, after Pasteur had already announced the creation of attenuated anthrax using temperature manipulation.

  † The Koch group, which relied on different culture methods than did the Pasteur laboratory, doubted the particulars of Pasteur’s thermal method of attenuation.

  Cover of a pulp horror novel, 1977.

  6

  THE ZOONOTIC CENTURY

  It is impossible to overstate how utterly Louis Pasteur, during just two decades of work in the late nineteenth century, remade mankind’s understanding of rabies. His great discovery did not just radically reduce the number of humans dying from hydrophobia in the West each year. Through his invention of a preventative rabies vaccine for dogs, he also significantly reduced the incidence of the disease in the animal most responsible for spreading it. Moreover, during the course of the twentieth century, Pasteur’s treatment for humans was improved and refined. Growing the vaccine in duck embryos (and later in cell cultures), rather than in rabbits, simplified the process and standardized the product. Researchers eventually discovered that supplementing the postexposure vaccine with rabies immunoglobulin, derived from the blood plasma of already-vaccinated humans, would markedly improve the success rate. As death from rabies declined in the West, the disease came to exist in the public consciousness largely as an archaic holdover from an earlier age: seldom seen, nearly mythical. Not only did rabies cease to be a meaningful cause of death in industrialized countries; it became largely absent from the streets and lanes. No longer did rabies threaten to invade the home, to colonize the trusted creature sleeping at the hearth.