Saved From Hydrophobia

By E. H. Julian

From The Wide World Magazine, April 1899

The Author, Mr. E. H. Julian, who went
through the trying experience related. The author tells how he was bitten by a mad dog, and then describes his hopes and fears, the agonising delays, his first impression of the world-renowned Pasteur Institute, his fellow-patients, the inoculations, etc. With a portrait of himself, the dog, and M. Pasteur, etc. The narrative will be read with interest and ready sympathy, for the accident might happen to anyone.

THE idea of being bitten by a mad dog is generally regarded, even by persons who are not wanting in courage, with fear almost amounting to terror. While this may be, to some extent, accounted for by the incurable nature of hydrophobia, the intense suffering of the victim, the horror and mystery which surround the subject, and the mythical tales of the violent means resorted to to put sufferers out of their misery (a belief which is still very general), I think the chief reason is dread of the long, wearying, anxious suspense which must ensue before the person bitten can feel that all danger is past.

Discussing the Pasteur, treatment with some friends a few days before my accident, I ventured the opinion that, if I were ever bitten by a rabid dog, I should go at once to the Pasteur Institute - little dreaming that my resolution was so soon to be put to the test. The scene of my accident I may say was a house in the south of Ireland, near Cork, and the precise date, September 18th, 1889. Looking back now, with a full knowledge of what undergoing the treatment means to the patient, the risk attending it, the extreme debility, and, in some cases, permanent injury to health which ensues, I have possibly no hesitation in saying I should take precisely the same course if the occasion again arose.

The dog which did all the mischief -
Mr. Julian's fox-terrier 'Blackie' This is the room in which Mr. Julian was bitten One evening, shortly after the conversation above referred to, my groom complained that "Blackie," one of my dogs (a fox-terrier), was badly hurt, and at my request he brought him into the room where I was dining. Seeing the poor brute was badly cut about the head, a large part of the scalp being torn or cut away, and hanging loose from his skull, I pulled out my handkerchief and took him in my arms, with the intention of binding up the wound temporarily. The moment I attempted to do so, however, he turned on me with a savage growl, and seized my thumb in his teeth. Although I drew my hand away, he was too quick, and inflicted a slight wound.

I dropped the dog at once, and he crawled out of the room with a peculiar reptile-like motion. I immediately sucked the wound vigorously, afterwards washing my mouth with whisky. Probably the best thing one can do is to suck a bite, provided the mouth and lips are sound; otherwise it adds to the risk. It was some hours before I could get the wound cauterised, and I have since learned it was then a useless proceeding. I took these steps merely as precautionary measures, as I had no serious reason to think the dog was rabid, though, of course, I noticed his shyness and peculiar slinking gait.

The following morning, on entering the stable-yard with a friend, the dog at once rushed at him. I shouted a warning, and he only saved himself by springing on to a water-barrel standing near. I was now convinced there was something more serious the matter with the animal than his wound (which I afterwards found was given him by the owner of a bitch with a litter of puppies that he had attacked the previous day). I believe it is most unusual for a dog to attack a bitch with pups, and it is considered by experts a very bad sign.

We drove the dog into an outhouse, securing the door; and I then instructed the groom to obtain the assistance of a veterinary surgeon when he had completed his morning duties. Before he could do so, however, the animal escaped. The madness now developed into the "running stage" and, after attacking another dog of mine (his great chum and play-fellow), a strong Irish terrier twice his size, and attempting to tear up several trees and shrubs by their roots, foaming at the mouth all the time, he was at length shot by a policeman, called in by the affrighted cook and groom, the only inmates of my house at the time.

I only learned this quite late in the evening, too late to do anything that night. The following morning I consulted a local doctor (who had recently had experience with a hydrophobia case), and on his advice started for London by the next train, there to await the report of the veterinary surgeons, who, it was arranged, should hold a post-mortem on the mad terrier - one acting on my behalf, the other being a Government official. It was arranged that the report should follow as soon as possible, and in the event of its being unfavourable, I was to see the eminent surgeon, Sir James Paget, and act on his advice.

I reached London early on a Saturday morning, but for some unexplained reason the report was sent by post, instead of being wired. In consequence, I was detained there till Monday evening - of course, in a condition of great anxiety and nervous impatience - thus losing nearly three days.

During my enforced detention in London I was buoyed up by the hope that Sir James Paget would not consider it necessary for me to go to Paris even if the dog had been rabid, as the wound was very slight. However, on consulting him, he advised me to start at once, and appeared very much annoyed and surprised at the long and unnecessary time which had been allowed to lapse, giving it as his opinion that after a week from the time of being bitten it would be quite useless to go. Therefore, in company with a friend, who kindly volunteered to accompany me, I started for Paris by the next boat-train.

Of course, everyone said the dog was not mad. I believe they always do on such occasions, and some kind friends suggested that I was teasing the poor brute - a most ingenious plan for diverting any sympathy which might otherwise have been felt for me.

But even the elements seemed to have conspired to delay me, for, owing to a very stormy passage, we arrived some hours after the usual time. Thus, as it afterwards turned out, another day's delay was caused.

On arriving in Paris there was the usual tedious examination of luggage, amidst a Babel of shrill tongues, in various languages. At last, however, we escaped from the Customs officers and drove to our hotel, and, after a hasty toilet, we hailed a fiacre in the Rue de Rivoli and drove to the Institut Pasteur. It is situated in that quarter lying away beyond the Invalides, in the Rue Dutot. Our first view of it was anything but reassuring.

A long, two-story building standing back from the street, surrounded by a grass lawn, the jalousies, which were to every window, closely shut, the gravel walk leading from the entrance gates moss-grown. The whole place was absolutely devoid of either sign or sound of life, and had a melancholy and deserted appearance, in ill-keeping with a building evidently quite recently erected. Nor was our surprise lessened when we found that the entrance gates were securely locked, and that no means existed for making our presence known to anyone who might be within.

We were on the point of turning away in blank confusion and growing astonishment, when a passer-by, evidently guessing our dilemma, directed us to a small lodge at the farther end of the grounds, which till then had escaped our notice. After repeatedly ringing the bell, a young girl opened the door, and looked quite startled at seeing us. She appeared utterly to fail to grasp the situation, and we thought her very dense; I have no doubt she thought us equally stupid.

My friend, who acted as interpreter, asked for M. Rome. She said he was not there.

"Where could we see him?"
"He is away ; somewhere in Russia, sir."
"M. Pasteur, then?"
"He is not here."
"Where is he?"
"No one knows."
"Is no one here?"
"No one, sir."
"But the gentleman wishes to be inoculated."
"It is impossible."

As my friend translated each reply I had ample opportunity as the conversation proceeded for increasing mystification and surprise. M. Rome -- somewhere in Russia! M. Pasteur -- no one knew where! It was impossible to inoculate me!

By the time the interview had arrived at this point we were both reduced to a condition of utter bewilderment and dismay. All sorts of wild half-formed ideas passed through my mind. I think the one that most nearly assumed a definite shape was, that the whole thing was an exploded sham, and that MM. Pasteur and Rome had "bolted" to escape the consequences of having foisted a fraud on the public.

However, after some further questioning, we elicited the information that inoculations only took place in the morning, about eleven o'clock (it was then nearly two), and that if we came the following day, at that hour, one of the surgeons in charge would be in attendance. They both lived several miles from Paris, and it was quite out of the question to obtain the attendance of either that day. So one more day was lost, and with it went almost all hope of any benefit from the treatment.

So it was with no pleasant feelings that I turned away to face another day of suspense, feeling that every hour lessened my chance. I thought of Sir James Paget's impatience and astonishment at the loss of time, and his frank and emphatic opinion that after a week the inoculations would be useless. Yet, through no fault of mine - in fact, in spite of every exertion on my part - seven days would now have elapsed, from the time of being bitten, before I could be operated on.

During the afternoon we called on a lady, to execute a trifling commission for a friend. On hearing I had come to Paris to undergo the Pasteur treatment, she uttered a pious exclamation of horror. She said, "M. Pasteur kills all his patients," and shouted for her daughter to come and see the silly Englishman who had come to Paris to be murdered - evidently regarding me as a curiosity!

Under ordinary circumstances, her thoughtless words might have made me uncomfortable, but at that time I had arrived at a state of desperation almost amounting to reckless indifference. I knew that if the virus had actually entered my system (of which there appeared to be little doubt), there was only a remote chance of the inoculations doing any good. Still, I had made up my mind to go through with the treatment, and, so far from shrinking from any risk, I think at the time the thought of ending the suspense was more a relief than otherwise.

On the following morning we attended at the Institute some time before the hour mentioned. But what a contrast was now presented to its appearance the previous day! All was now bustle and life. Surgeons, dressers, clerks, and assistants hurried backwards and forwards preparing for the daily work, while groups of patients and visitors stood about, conversing in that animated manner peculiar to French people.

Passing through the crowd, we entered the glass porch leading to the waiting-room. It is a large, oblong room, plainly furnished with oak forms and tables, the walls being hung with maps of various countries; suggesting, but for the strong smell of carbolic, a classroom in a college. Opposite the entrance-door is a wide passage, leading to the surgeons' "dressing" rooms (where bad wounds are dressed every morning), the laboratories, operating-room exit, and ladies' dressing-room.

The men are not provided with the latter luxury, and are expected to arrange their clothes as best they can, in full view of the other patients and visitors. On the left hand of the passage above referred to is the office, where all records of past and present cases are kept, and all particulars are entered on admission. The patients enter the operating-room through the office, and leave by a door leading into the passage above mentioned.

The hall-porter came forward on seeing us, and on giving him Sir James Paget's card, he appeared to understand. Of course, we concluded that the promised letter of introduction had been received, and that they were expecting me. We afterwards found that, owing to the absence of the head surgeon, the letter had been forwarded to St. Petersburg unopened. I mention these details, because the mistake led to a very unpleasant experience. The porter invited us to follow, and conducted us to the operating-room, where having indicated seats immediately behind the surgeon's chair, he left us to contemplate our surroundings.

Mr. Julian's turn at last! He is innoculated
in the presence of M. Pasteur This room is furnished with a partition about 4ft. or 5ft. high, running round three sides, behind which the visitors sit, the upper part being lattice-work; so that, while a good view is obtained, the spectators don't objectionably obtrude themselves on the attention of the patient. The presence of various surgical appliances on the operator's table suggested anything but pleasant thoughts, and added to the nervousness I naturally felt on being placed in such close proximity to the surgeon.

While I was considering the advisability of removing to a seat farther off, and wondering if it was part of the prescribed system that new comers should sit by while the inoculations were taking place, a number of visitors entered the room and, crowding in on either side, effectually prevented my moving till the whole of the operations were completed. I was surprised to notice that a large proportion of these were young ladies, who appeared to visit the Institute as they would a theatre or other place of amusement, and certainly displayed very bad taste and a want of modesty in doing so.

After what seemed to me a very tedious delay (though probably it was not many minutes), the surgeon for the day entered the room, followed by an assistant carrying several wineglasses containing the virus, (a milky-looking liquid in which a white stringy substance floated), and a small brass vessel with a lamp beneath. This latter I afterwards found contained boiling oil, in which the point of the syringe is heated before using. Two other assistants quickly followed, and when all was ready the clerk took up his position, book in hand, at the door communicating with the office, and commenced calling the roll beginning with the last arrival of the previous day. The object of this is that the recent patients, who are naturally more nervous than those who have been through the treatment several times, shall have the shortest time to wait. Thus, in proportion as one becomes more hardened and indifferent, they also get lower and lower on the list. So that, while a recent arrival may be attended to and dismissed in ten minutes, a patient of ten days' or a fortnight's standing may be detained an hour or more. The patient stands in front of the surgeon, with his left side towards the latter, for the first inoculation, two assistants holding him firmly during the operation, to prevent any movement.

The exterior of the Pasteur Institute The first two or three patients were Frenchmen, evidently of the working class, and not troubled with over-sensitive nerves. They stood the double inoculations without flinching, and walked away, buttoning up their clothes as they left the room, with an air of nonchalance. The inoculations are not hypodermic, or merely skin-deep injections, such as I have seen performed, the intensely poisonous nature of the virus making it imperative that it should be deposited at a considerable depth (nearly an inch) beneath the surface, to prevent any possible contact with the air, otherwise mortification would ensue.

After the first few men-patients had been disposed of, some women were called in. They usually groaned during the inoculation; some even screamed, and most of them staggered away holding their sides, and uttering expressions of agony. The inoculation in the case of adults is made just in front of the "false" ribs, or rather below, on each side of the stomach. The surgeon grasps the flesh in his left hand, and rapidly sponges the surface with carbolic, the assistant meanwhile filling a syringe with virus, and afterwards warming the point in boiling oil and handing it to him when ready. He then performs the operation, and, in the case of recent patients, repeats the inoculation in the right side.

After a few women had been disposed of, some children were brought in. Those under seven or eight years of age are inoculated rather differently from adults, as in children of that age there is not sufficient depth of tissue in the region generally selected, so that part which in children does not usually present this defect is chosen. Most of the children shrieked for mercy, and pleaded most piteously to be spared, while being held down across the doctor's knee, and they continued their cries until they left the building, the chorus being taken up by those whose turn was yet to come.

After this, things began to get decidedly lively - men, women, and children indiscriminately followed each other in quick succession. One or two of the men fainted and were carried out, and this, together with the groans of the women and the cries and pleadings of the children, made me feel anything but happy, and seemed a very bad preparation for my ordeal. On mentioning my thoughts to a doctor sitting by me, he was surprised to hear I had come as a patient, and said I ought not to have seen any of it, and that the porter evidently misunderstood our object in visiting the Institute. However, as I was closely penned in, I was obliged to put up with it for over an hour, and do my best to shut out surrounding sights and sounds. I afterwards found that no patient is allowed to enter the operating-room until the preceding one has been dismissed.

The patients were, of course, principally French people, and of the working class; but most countries were represented, and the English cases averaged about three or four during my stay. One of the latter, a young lad, had one day picked up a stray dog, and, boy-like, persuaded his mother to allow him to keep it. The dog was tied up in a stable, and on his going there the following morning the brute, which had broken loose during the night, sprang upon him, biting him severely. He managed to escape and rushed to the gardener for protection, pursued by the dog, which would probably have killed him but for the timely assistance of the latter, who, however, was also bitten before he succeeded in killing the animal. The lad's case was considered a bad one, and as for some reason the virus did not "take," he had been detained there some weeks.

As soon as the last case had been dismissed, the assistants packed up the apparatus and, accompanied by the surgeon, left the room. Up to that moment I was under the impression they knew of my attendance, and that I would be invited to step forward when the prior cases had been attended to. It now dawned upon me that some mistake had been made, and that unless I acted promptly the surgeon would have left, and I would not be inoculated that day, in which case over a week would have elapsed since I had been bitten, when (according to the best authorities) I might just as well return home as I came, for any good it was likely to do.

I was still hemmed in on both sides by the visitors, who displayed a provoking reluctance to leave until it was clear no further entertainment would be provided. But I saw the doctor's departure must be arrested at all costs, leaving explanations to follow; so with a reckless disregard for politeness and my neighbours' toes, I scrambled out and just overtook him as he was leaving the building.

My friend, coming up immediately after, explained matters, and after a hasty consultation and scrutinising the veterinary's report (I may here mention that unless there is reasonable evidence of rabies they won't inoculate; One case was refused while I was there), they decided my dog was rabid, and we returned to the operating-room. The assistants were recalled, and in almost less time than it takes to tell I was operated on. There is a curious stunned sensation and a good deal of nerve pain, chiefly caused by the virus forcing a way for itself between the tissues. I, however, was lucky in my operator on the first occasion. Another surgeon, who afterwards operated on me, caused much more pain, and earned anything but blessings.

One gentleman whenever this doctor attended always left the operating-room using language more forcible than polite; but, as he spoke in English, probably few noticed his remarks, and no doubt the French thought he was referring to some lady, as he used the French equivalent for that word very freely. Soon after leaving the Institute my sides began to ache, and this and stiffness increased from day to day, so that I could only lie flat on my back at night.

The following morning I found, contrary to my expectation, that I was first on the list. The patients congregate in the waiting-room, which has also to answer for a dressing-room for the men. The preparations, however, are not elaborate: the waistcoat and suspenders are unbuttoned, and the underclothing is turned up out of the way so that all may be ready on entering the operating-room. It is after the operation that the want of a private dressing room is felt, as it is extremely awkward to be obliged to arrange one's clothing in the presence of ladies.

The patients stood about on the lawn, awaiting the arrival of the surgeon, unless they were very badly injured, in which case they were attended to by the dressers before being inoculated.

Being more composed than on the previous day I was able to study my fellow-unfortunates. They represented almost every country and quite as many different states of mind. There were evidently some Mark Tapleys among them, cracking jokes and telling funny stories to admiring groups, whose loud laughter showed their appreciation. It was not difficult, however, to see that their mirth was somewhat forced, and the majority appeared to be labouring under intense nervous excitement. The wounds were principally on the hand, but a good many had also been bitten in other parts. One poor fellow (whom I did not see) had an eye torn out; he died a few hours afterwards.

As I stood first on the list I was soon disposed of, when, of course, we left our painful surroundings at once, amusing ourselves for the rest of the day by "doing" some of the milder sights of Paris. Each day's experience at the Institute was much the same, but from time to time I missed persons whose faces had grown familiar. No one cared to enquire the cause of their absence - whether their treatment was complete, or if hydrophobia had supervened and they had been sent to an hospital.

I recall two or three who attended only a few times. Possibly they had "funked" the inoculations, but one could not help speculating as to the cause of their absence.

Naturally, during my course of treatment (I was inoculated twenty times in the fifteen days I attended) I gleaned many particulars as to the preparation of the virus, etc. It is first obtained from the brain of a rabid dog or other animal; then a guinea-pig or rabbit is inoculated with this pure hydrophobia virus. After about three days the animal becomes rabid, though, to an ordinary observer, it looks simply stupid or sleepy in its cage. It is then killed, and the virus obtained is used for inoculating a second animal - and so the virus is gradually attenuated by passing it through thirteen guinea-pigs or rabbits, as the case may be. And the virus from the last is used for the human subject.

The Late M. Pasteur, who was present
when the author was innoculated. One day, shortly after my arrival, I noticed a most unassuming old gentleman entering the grounds. His face was very striking, and though deeply lined with thought, and indicating great firmness and resolution, it wore an exceedingly kind and gentle expression. I had seen him before, I thought, and while trying to recall where, someone shouted that M. Pasteur was coming! Immediately every window was crowded by visitors and patients anxious to see the great scientist. When he entered the waiting-hall everyone stood up, all the men raising their hats; and the officials seemed to regard him with sincere affection. I saw M. Pasteur on several occasions afterwards, when he stood close in front of me while I was being treated, watching my face with his keen, observant eyes.

After a few days I began to develop very unusual and alarming symptoms. My eyes and nose were constantly running; I had a heavy, dull pain over the eyes; my sight was confused, and the least excitement caused my temperature to rise to an alarmingly high point; while my appetite quite failed.

On the fifth day the surgeon looked at me very closely and questioned me in French. Not being conversant with that language, I answered in English. Evidently, however, it made no difference, for he immediately asked, "How are you now? How do you feel?" I described my symptoms, and he nodded to the clerk. Afterwards the injections were reduced to one a day. From this I concluded that the symptoms present in my case indicated when the virus had "taken," and possibly they, to some extent, corresponded with the reaction produced by the anti-toxine test for disease.

Shortly before I left, a young English doctor arrived for treatment. He was badly wounded, three of his fingers being bitten to the bone by a lad suffering from hydrophobia, who was brought to the hospital by friends, quite in ignorance of the boy having been bitten. Shortly after his admission, a paroxysm coming on, the doctor and nurse ran to his bedside and both were bitten. I saw an account of the death of this lad in the morning papers a few days after my return home.

On the fifteenth day, on entering the operating hall, I thought the clerk shouted something like "final!" It seemed too good to be true; but on enquiring of the surgeon he confirmed my supposition and said they now considered my course of treatment complete, and that I was hydrophobia-proof.

I left for England by the first train out of Paris, as I was anxious, in case of accident, to be at home. A fortnight's stay with kind friends at Clifton, and the unremitting care and attention of a skilful doctor, removed some of the more alarming symptoms; but it was a long time before I fully recovered my usual health.

I cannot conclude this article without paying tribute to the kindness and attention which I, in common with patients of all nationalities, received from the officials at the Pasteur Institute. One and all, from the head surgeon to the most subordinate assistant, showed the utmost consideration. They knew no distinction, and extended their assistance, skill, and sympathy equally to everyone without expectation of reward.