Episode 95: Rabies [1]
Dog bite accidents happened occasionally in Korea too, but I did not think they could be as frequent as they were here. There were so many stray dogs… Especially when I went toward the slums, I saw quite a few dogs that clearly looked like they had gone mad. Hadn’t I said that dogs were one of the reasons I left that house and went to live with Alfred?
“Ugh, ugh!”
As a result, several people came to this hospital every day with dog bites. It was pure coincidence that I had never paid attention to this particular patient before. No, I had simply been too busy to notice. Think about it. If you looked away, that dog would not tolerate it and might do something strange to you. Killing people because they had a headache?
“Stay still!”
“Yes, aren’t we trying to heal you?”
It was sad that I had to use the word “natural” at times like this, but in any case, now was no exception.
“Quaaaah!”
While I was thinking this, they were already using a hot iron to cauterize the wound the patient had suffered from being bitten by a dog. Speaking of an iron used to support people, of course, if such a thing existed, that would be a big problem… But no, it was just an iron our medical staff used to press clothes. In other words, they were burning human flesh with a clothes iron.
“That’s right! The bleeding stopped!”
In an instant, the acrid smell of burning flesh spread in every direction. Strangely, the smell of burning human flesh made me feel sick, unlike the usual smell of grilled meat.
“Eww.”
Anyway, people cheered when they saw what was happening.
“Is that it? Has the bleeding stopped?”
“Uh-oh. You’re alive now.”
“Whew.”
What was amazing was that even the patient breathed a sigh of relief. If rabies could be prevented like that, it might have disappeared from history. But it was not going to be that easy.
Yes, now I remember.
When the desperate screams finally stopped, my head started spinning. I wondered if I could have saved that patient if I had moved faster, but when I looked at what I knew, I realized it was impossible. Treating rabies was not an easy task. First of all, it was not bacteria. It was a virus. Antiviral drugs…
Hey… when did those first come out?
I did not even remember. Maybe much later than antibiotics? In the first place, no antiviral drug was as effective against viruses as antibiotics were against bacteria. However, it was during Pasteur’s time that a treatment for rabies was developed, so that was still in the nineteenth century. Fleming discovered penicillin in 1929, so Pasteur’s achievement came much earlier. Even more remarkably, he accomplished it before the existence of viruses was even discovered.
It was in the form of a vaccine. Anyway, if an attenuated vaccine was given, antibodies formed quickly… If it was given before the disease progressed too far, it could work as treatment. It might not be one hundred percent safe, but…
Thinking about it this way, Louis Pasteur was truly a monstrous genius. No, didn’t that mean he accomplished something that even I, who studied in the twenty-first century, would find difficult, and in this barbaric era? Of course, it was a time of rapid progress, so things would seem easier after a few decades… But that did not diminish his greatness.
“What are you thinking so hard about?”
“Yes? Oh, no. Hmm. That dog… what are you going to do with it?”
“Dog? We have to kill it. It has rabies. How can I save it?”
Yes. It would be killed. In fact, this was a reasonable measure even in the twenty-first century. Wasn’t rabies still basically incurable? Considering the severity of the symptoms… if prevention was possible, even by killing the animal, that was better.
“Can I take a look?”
But I felt like there was something I could try before the patient died. I looked back at the patient, whose bitten forearm had unknowingly been burned. That person would not survive. That method only worked for simple dog bites, not rabies. Actually, not all dogs that bit people had rabies, right?
Grrrrrr.
However, no matter how you looked at it, the dog in front of us appeared rabid. First of all, the amount of saliva flowing from its mouth was unusual. That was one of the symptoms of rabies. I had never seen it in person, but since this was a surgical hospital, I inevitably saw dog bite wounds… At that time, rabies was a topic in home meetings and conferences, mainly for diagnosis. Anyway, I thought I might find a way to save future patients.
“You want to look at this?”
Of course, Dr. Liston had a look on his face that said he did not understand.
Kki-ing.
In some ways, that face was extremely ghastly. Perhaps that was why even the rabid dog, or rather, the mad dog, started whining in fear. It was truly an amazing sight.
“It doesn’t seem that dangerous now, does it?”
“Does that make sense?! If you get bitten, you die!”
“Then why did you say he survived earlier?”
“He came all the way to the hospital, so are you saying they did nothing? Besides, didn’t the bleeding stop for now?”
“Ah.”
Wow, I was really surprised this time. You people know this too, right? This did not mean everything would work out. Nevertheless, they could burn human flesh with a hot iron without hesitation. I guessed I still had a long way to go before becoming a nineteenth-century person.
“But why do you want to look at this? Well, there are several ways…”
Liston asked while stroking the handle of his knife, looking dazed. Now the dog was quiet. It must have realized that if it made one wrong move here, it would be cut in half by Liston’s knife. A person who could control his anger even while going mad from illness. I was truly fortunate that this man called himself my older brother.
“Like you said, it’s rabies… You can’t cure it yet, right?”
“Yes. There is no way. Avoiding bites is the best policy. There’s also a medicine called Ashrion, but if it were effective, rabies would have disappeared by now.”
“There is a record like this in Joseon.”
Anyway, I started yelling again. At first, I really could not stop myself, but now there was no need to complain. As soon as I opened my mouth, nonsense just poured out.
“A drooling dog bit a person and was slaughtered. Originally, the dog should have been burned, but the person who slaughtered it kept the meat to eat.”
“Huh, gangsters really are something else. How can anyone eat that?”
“It was so bad that he simply did not eat it…”
What did Pasteur do? To be precise, how did they make the attenuated vaccine? It would not have been a particularly complicated process. No, I could not have done it. What dramatic changes could have happened in the 1890s?
Oh, right.
I remembered. I had been very embarrassed when I heard this.
“They say it was dried in the sun.”
“Um… That helps… Does it work?”
No. Do not get sick. If it were pickled in salt, the sterilizing effect would be stronger, but the rabies virus would die completely, making attenuation impossible. Drying it in the sun was enough. Because of the temperature, it would become unpleasant… but it had some sterilizing effect. Above all, since the dog was dead, the environment was naturally unfavorable for the virus to survive. I did not know the exact principle, but since it had been done that way, the person who did it must have been right.
“Listen.”
“Oh, sure.”
Now the dog was very scared when it saw me. It must have been because Dr. Liston and I seemed equal while talking. It did not make sense, but when you were mad, how could you see clearly?
“It is said that when the person who was bitten started to feel sick, the person who slaughtered the dog had this thought: wouldn’t that pain get better if he ate the meat? Something like that.”
“Uh-huh, so?”
Not only Liston, but everyone around me listened intently. Joseph, Alfred, Colin, and the others. What kind of faces would they make if they realized everything I was saying was nonsense? I was curious, but I did not want to get stabbed just to find out, so I kept going.
“It seems the person who was bitten also wanted to eat some meat. Since the record did not say otherwise, it must have been so.”
“Huh. What kind of person…?”
“It is too early to be surprised. It is said that the man gave him the dog’s head. It would have been a waste to give away the other delicious parts.”
“Is he a bastard?”
Liston was fair in many ways, especially about food. I thought it was because he ate a lot, but he said that without hesitation.
“The surprising thing is… this is what happened next. Before medical school, I wondered why that was. I thought it was a coincidence.”
“What? What makes you talk like that?”
“That person lived. That meat… To be precise, he lived after eating the head of the dog that bit him.”
“Hmm…? How? Like you said, isn’t that a coincidence? Not all rabies cases are fatal one hundred percent of the time.”
As he said, the fatality rate was not one hundred percent. There had been truly strong people since ancient times. Even when someone caught Ebola, some people survived. Rabies was no exception. I did not say this just to comfort myself.
“I thought so too, but after I came here… I learned there was an experiment done in the seventeenth century.”
“What experiment?”
“Someone took blood from a rabid dog and injected it into another dog’s veins, and that dog developed rabies. An experiment like that.”
“Hmm… Ah, I vaguely remember that. But what does that mean?”
“That means the rabies is caused by… No, I’m saying there is something in the blood or bodily fluids, right?”
“I suppose so. Maybe saliva too?”
Liston was not interested in my rambling. He was simply staring at the drooling dog. Yes, that was correct. Saliva contained a lot too. But eventually, it invaded the head. That was the key. And when saliva was dried, it really dried out and became unusable.
“I think it’s probably in the dog’s head… Something in the brain and medulla dries out in the sun and becomes weakened, and the patient who ate the weakened tissue survived… That is what I think.”
“What are you talking about?”
I explained it in detail. What did he mean? I was not hurt by saying it. I forgot to mention antigens and antibodies, but I thought that was what I meant.
“I’m not completely sure either, but the important thing is…”
“You want to kill that dog, dry its brain and medulla, and feed it to the patient?”
“Uh… yes. That’s what it boils down to.”
“Then let’s do it.”
Nevertheless, Dr. Liston, who called himself my older brother, raised his knife high.
Translator’s Notes
Rabies — A viral disease usually transmitted through the bite or saliva of an infected animal. Once symptoms appear, it is almost always fatal without modern preventive treatment.
Virus — A microscopic infectious agent smaller than bacteria. Rabies is caused by a virus, not bacteria.
Antiviral drug — A medicine used to treat viral infections. These generally do not work in the same broad, powerful way antibiotics work against many bacterial infections.
Louis Pasteur — French scientist who developed the first successful rabies vaccine in the nineteenth century.
Attenuated vaccine — A vaccine made from a weakened form of a pathogen, meant to stimulate immunity without causing full disease.
Antibody — A protein produced by the immune system that helps recognize and neutralize pathogens.
Cauterization — Burning tissue with heat or chemicals to stop bleeding or destroy infected tissue.
Medulla — Part of the brainstem involved in vital functions such as breathing and heart regulation. In this passage, it is referenced as part of the infected nervous tissue.
Antigen — A substance recognized by the immune system, often from a pathogen, that can trigger an immune response.