Stuff You Missed in History Class: "SYMHC Classics: Rabies"

Hosts: Holly Frey & Tracy V. Wilson
Release Date: August 30, 2025

Overview

In this classic episode, Holly and Tracy revisit the fascinating and harrowing history of rabies. They explore humanity's long struggle with this notorious disease—from ancient references in Babylonian law to the development of life-saving vaccines, global eradication efforts, and the challenges that persist today. The conversation blends historical anecdotes, scientific breakthroughs, ethical debates, and memorable pop culture references. With a focus on the almost invariably fatal nature of rabies post-symptom onset and the crucial role of prevention, the episode offers a thorough, thoughtful narrative about one of the world’s most dreaded zoonotic diseases.

Key Discussion Points & Insights

Introduction and Relevance (02:10–03:01)

• Rabies in the News & Listener Mail
  Tracy explains their recent obsession with rabies, triggered by:
  • A fox biting several people near the US Capitol.
  • Concern over whether all bite victims got proper rabies shots.
  • Email from a listener about a mass rabies exposure in Morocco, which Holly and Tracy are planning to visit (a high-risk rabies area).
  • “Rabies is virtually always fatal once people develop symptoms… today’s rabies prophylaxis is almost 100% effective at preventing that from happening.” – Tracy (03:01)

Rabies: Origins and Ancient References (05:15–10:12)

• Virology & Etymology
  • Rabies is caused by rabies lyssavirus, likely originating in old world bats.
  • The term “rabies” stems from Latin (“to rage”); “lyssavirus” from Greek (“frenzy”/”madness”).
  • Main human connection has always been through dogs.
• Ancient Laws and Texts
  • First written record: The Ashnunna code (ca. 2000 BCE, present-day Iraq) outlined fines for owners of mad dogs causing deaths.
    • “If a dog is mad… if it bites a man and causes his death, then the owner shall pay 2/3 of a mina of silver.” – Tracy reading (05:43)
  • In 4th century BCE, Aristotle wrote:
    “Rabies drives the animal mad… the disease is fatal to the dog itself and to any animal it may bite, man excepted.” – Tracy (06:57)
    • Holly clarifies this mistranslation; people have long known rabies is virtually always fatal to humans. (07:25–07:56)

The Disease & Its Cultural Image (07:56–12:05)

• Symptoms and Cultural Fear
  • Rabies takes two forms: paralytic (lethargy, paralysis) and furious (agitation, aggression).
  • Hydrophobia (fear/inability to swallow water) was recognized as a hallmark; referenced as early as Celsus (2nd cent. CE).
• Rabies in Literature & Metaphor
  • Homer refers to Hector in The Iliad as a “rabid dog”.
  • Roman philosopher Celsus described the connection between rabies and saliva, and ancient treatments like wound washing and cauterization.

Rabies Spreads Worldwide (10:12–13:38)

• Geographic Spread
  • By 1500 years ago, rabies had reached much of Europe, Asia, and the Middle East.
  • Medieval and early modern Europe saw periodic outbreaks in wolves, foxes, and dogs.
  • In the Americas, pre-Columbian rabies mainly infected bats and skunks. Europeans brought dog rabies to the continent—first major outbreak: Mexico City, 1709.
  • “Rabid dogs rarely existed in the Americas prior to colonization…” – Tracy (11:13)

Early Prevention and Cure Attempts (17:55–21:44)

• Preventative Measures
  • People used folk remedies, St. Hubert’s key (heated iron for cauterization), and washing wounds—not always effective but sometimes helped reduce infection.
  • Early laws (like the UK’s Metropolitan Streets Act, 1867) allowed muzzling of stray/dangerous dogs, which reduced rabies cases.
  • Thorough wound washing is still the first step today.
  • “Thoroughly washing the wound is still step one in rabies prevention today. But none of this was enough…” – Holly (20:11)

Scientific Understanding & the Search for a Vaccine (21:44–29:41)

• Scientific Milestones
  • 1769: Giovanni Morgagni observed rabies traveled via nerves, not blood.
  • 1804: Georg Zinke proved rabies transmission through saliva.
  • 1879–1881: Victor Gaultier and others experiment on animals; discover attenuation (drying weakens the virus).
• Louis Pasteur’s Breakthrough
  • Pasteur and his team developed an attenuated rabies vaccine by air-drying infected rabbit spinal cords.
  • July 1885: First widely publicized successful human treatment—9-year-old Joseph Meister, who survived after a series of inoculations.
    • “Pasteur didn’t publish his first two human attempts.” – Tracy (27:45)

[Memorable Segment]

“Joseph Meister was given a series of inoculations… starting with a very weak preparation and working up… Three months later he had no sign of rabies.”
– Tracy (28:53)

• Ethical Debates and Public Reaction
  • As word spread, rabies vaccine treatment became sensational news—especially after American children were sent to Paris for it.
  • Some criticized the experiments for animal use (anti-vivisectionists) or for treating patients who may not have needed it.
  • By 1898, over 20,000 people had been treated at the Institut Pasteur, with a fatality rate of less than 0.5%.
    • “This was still a dramatic improvement over an untreatable fatal disease.” – Tracy (37:39)

Advances in Testing and Vaccine Safety (37:24–39:32)

• Negri Bodies and Improved Vaccines
  • 1903: Aldecchi Negri identifies “Negri bodies” in the brain, aiding diagnosis (38:09).
  • Vaccine improved to use tissue cultures instead of infected brain matter for safety.

Rabies Eradication Efforts & Modern Status (38:50–44:17)

• Mass Vaccination and Global Discrepancies
  • Discussion of modern campaigns to vaccinate dogs and wild animals—some countries/regions now rabies-free (e.g., UK, Iceland, Japan, New Zealand).
  • Even in “rabies-free” zones, bat lyssaviruses remain—so bat bites always warrant medical attention.
    • “Just don’t touch bats with your bare hands… but they’re so cute!” – Tracy (39:32)

Contemporary Pop Culture and Misconceptions (44:17–46:01)

• Treatment Myths & Current Protocols
  • Addressing myth of rabies shots as “horrifyingly painful stomach injections”—no longer accurate.
  • Now: one dose of immune globulin + 4 vaccine shots in the arm, much safer and easier.
• Non-Bite Transmission
  • Rare cases occur via organ transplant or mucous membranes.

Rare Survival & The Milwaukee Protocol (46:01–47:35)

• A Near Miracle – and Its Limits
  • 2004: Gina Giese survives rabies with “Milwaukee Protocol” (induced coma + antivirals)—first ever documented.
  • Protocol has a very low success rate (11 survivors out of 38 tries); requires extensive, expensive hospital care, not realistic for most regions affected by rabies.

Final Thoughts and Global Rabies Context (47:35–50:58)

• Global Cost and Prevention
  • Rabies costs ~$8.6 billion/year globally, and over 15 million receive post-exposure prophylaxis annually (PEP); U.S. cost per PEP: $1,200–6,500.
• World Rabies Day & The Importance of Dog Vaccination
  • September 28: World Rabies Day (and Pasteur’s death anniversary).
  • Hope for the future: more widespread vaccination of dogs, the main reservoir for human cases worldwide.
  • “A lot of people who die of rabies are just a kid who wanted to pet a dog.” – Tracy (50:58)

Notable Quotes & Memorable Moments

• “Rabies is virtually always fatal once people develop symptoms… but today’s rabies prophylaxis is almost 100% effective.” – Tracy (03:01)

• “If a dog is mad… if it bites a man and causes his death, then the owner shall pay 2/3 of a mina of silver.” – Tracy reading Ashnunna code (05:43)

• “Thoroughly washing the wound is still step one in rabies prevention today. But none of this was enough…”
  – Holly (20:11)

• “This was still a dramatic improvement over an untreatable fatal disease.”
  – Tracy, on the Pasteur vaccine (37:39)

• “Just in general, don’t touch bats with your bare hands… but they’re so cute!”
  – Tracy & Holly (39:32)

• “A lot of the people who die of rabies are like just a kid who wanted to pet a dog.”
  – Tracy (50:58)

Timestamps for Important Segments

• Story setup / Modern relevance: 02:10–03:01
• Ancient historical references: 05:15–10:12
• Disease symptoms, hydrophobia, and literature: 07:56–10:12
• Arrival and spread in the Americas: 11:13–12:51
• Middle Ages to 19th C.: 17:55–21:44
• Scientific discoveries – nerves and saliva: 21:44–24:12
• Pasteur’s vaccine development: 24:38–29:41
• American children sent to Paris – media sensation: 33:57–35:01
• Ethical debates / Institut Pasteur founded: 35:42–37:24
• Negri bodies; vaccine safety advances: 37:24–39:32
• Mass vaccination & eradication campaigns: 38:50–41:02
• Modern PEP (post-exposure prophylaxis): 43:09–44:17
• Survivor Gina Giese & Milwaukee Protocol: 46:01–47:35
• Economic cost & closing thoughts on vaccination: 49:10–50:58

Tone Notes

• Conversational and accessible, balancing scientific accuracy with storytelling.
• Moments of humor: “Don’t touch bats with your bare hands… but they’re so cute!” (39:32)
• Empathetic emphasis on the tragedies rabies still causes—especially among children.
• Occasional off-the-cuff admissions (“I would not want to get 14 to 21 shots…” – Tracy, 43:09) and personal experiences with veterinary care reinforce the human side of the history.

Conclusion

This episode provides a comprehensive, engaging, and sometimes sobering look at the persistent menace of rabies. From ancient laws to scientific advances, and from local outbreaks to present-day global campaigns, Holly and Tracy demonstrate that rabies has shaped—and continues to challenge—public health in profound ways. Their exploration makes clear that while rabies deaths are far less common in many countries today, the fight for universal prevention and access to vaccines is far from over.