Neurology
Copyright © 1998 American Academy of Neurology
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Volume 51(3) September 1998 pp 856-859
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Rabies: A possible explanation for the vampire legend
[Historical Neurology]
Gomez-Alonso, Juan MD
From the Servicio de Neurologia, Hospital Xeral, Vigo (Galicia), Spain.
Received January 7, 1998. Accepted in final form April 16, 1998.
Address correspondence and reprint requests to Dr. Juan Gómez-Alonso,
Servicio de Neurología, Hospital Xeral, Pizarro 22, Vigo (Galicia), Spain.
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Outline
Article abstract
Acknowledgments
References
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Article abstract
In the 18th century, belief in vampires-allegedly dead persons who left their
graves and killed people and animals-raised great concern in the Balkans and an
extensive debate in Europe. This historic phenomenon still awaits a comprehensive
explanation. This article proposes that rabies may have played a key role in the
development of the vampire legend, given the coincident time of the phenomena
and the striking similarities between them.
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Nowadays, vampires are generally regarded as fictional characters. However,
almost three centuries ago, when the concept and word "vampire" were created,1
they were seen as a real threat by many people. "Vampires were the sole matter
of conversation between 1730 and 1735," as Voltaire stated.2 The current study
was done to evaluate a previous hypothesis 3 proposing the existence of some
link between rabies and the vampire legend.
Vampires. In 1693, a gazette revealed the existence of strange cadavers that
were full of liquid blood, allegedly taken by the Devil from people and
animals.4 Subsequently, the belief that those corpses left their graves spread
through the Balkan region.
The inhabitants of the village saw a ghost which appeared to some people in the
form of a dog, to others in the shape of a gaunt and hideous man, and who was
seen not only by one individual but by many, and who caused persons the greatest
alarm and torment by assaulting them fiercely, by seizing their throats so that
they were almost suffocated. The ghost even attacked animals, and cows were
found half dead just as if they had been severely beaten.5
The most famous story of vampires occurred in the Serbian village of Medvedja,
in the winter of 1731-1732.6 The death of some peasants was attributed to a
vampire who allegedly had also killed other people and animals. Eventually, 17
cadavers with "all the signs of vampirism" were uncovered and pierced with
stakes, decapitated, and cremated. The repeated violations of graves provoked
the intervention of the Austrian authorities, and the echo of these events
generated one of the most extraordinary debates of the Enlightenment.6-8 In
1746, the French abbot Augustin Calmet summarized the situation 9:
In this century, since around sixty years ago, a new scene is offered to our
eyes. People who have been dead for several years, or at least for several
months, have been seen to return, to talk, to walk, to infest the villages, to
maltreat people and animals, to suck the blood of their close ones, making them
become ill and eventually die. Antiquity has certainly not seen or known
anything of the like.
Rousseau also wrote on the subject:
If there is in the world a well documented story it is that of vampires. Nothing
is lacking: oral trials, certificates of outstanding people, of surgeons, of
priests, of magistrates. After that, who would believe in vampires?10
The protagonist of the legend attained such popularity as to earn a portrayal by
Goya.1 During the second half of the 18th century, vampires progressively
vanished from the Balkans, but they later reappeared in the works of many
European and American writers.1 Dracula, a literary character created in 1897,
has become the paradigm of vampires after being depicted in many films. The name
and some other attributes of Dracula were taken from those of a 15th century
Walachian ruler who had no connection to the vampire legend.
More on vampires. The anthropologic data collected by folklorists from people
who believed in vampires, together with the historic reports, permit a fairly
good reconstruction of the legend. Dogs and wolves were the animals most related
to vampires, and were also reported as being their worst enemies.11,12 A vampire
could allegedly turn into a dog and kill all the dogs of its village.13 Apart
from having a human figure, these creatures could appear in the shape of a wolf,
dog, or cat, or be invisible.12-14 Vampires were usually male,13,14 and used to
be poor people from rural areas.5,15 The vampires' activity was mainly
nocturnal,8,12-14 but could be diurnal.5,9,14 Vampires were thought to suck
blood and attack people, dogs, cattle, and other tame animals.5,8,11,12,16,17
Vampires were thought to leave their graves to have sexual intercourse.17 A
person could become a vampire by being attacked by a vampire,6,8 eating the
flesh of animals killed by vampires,17 having been a great lover,15,16 or having
died of plague, rabies, or other epidemic diseases.9 A cadaver could turn into a
vampire if it saw itself in a mirror, or if a dog, cat, or bat walked over it
before burial.12,14,16 Protective measures used against vampires included
rubbing garlic or burning resin,16 burying suspicious cadavers in islands or
lakes, or pouring water around their coffins.18 The vampires' victims were said
to experience suffocation before death.8 The vampires' life was supposed to last
for 40 days.14 Signs that made a cadaver suspicious included good external
appearance,6,8 a swollen body full of liquid blood that flowed out of the
mouth,4,6 prominent genitalia,18 and the emission of a cry when a stake was
driven into it.6,7
Medical approach to vampires. Many features attributed to vampires have also
been described in disorders of the limbic system. This"brutish part" of the
brain plays a central role in the regulation of emotion and behavior.19 In
patients with diseases such as rabies or epilepsy, a clear link has been found
between aggressiveness and the dysfunction of some limbic system regions, i.e.,
the hypothalamus, the amygdaloid complex, or the hippocampus.19 Likewise, a
relation has been shown in humans between altered sexual behavior and some
limbic system structures, such as the septal area.20 Nocturnal activity may be
present in patients with insomnia or disruption of the sleep-wake cycle; both
have been reported in disorders of the anterior hypothalamus.21
The involvement of people and animals in vampirism could be evocative of a
zoonosis, i.e., a disease transmitted from vertebrates to humans.22 The fact
that the vampire bite transformed its victim into a vampire 18 would evoke a
zoonosis transmitted through a bite. Among the few zoonoses of such type,22 only
rabies resembles vampirism in its fatal prognosis and in the implicated animals.
Certain modificatory factors of the usual postmortem evolution 23 could explain
the preservation of the vampires' cadavers. Their retarded decay could be the
result of coldness. Their good appearance would also suggest the presence of
saponification. This process, characteristic of burials in humid places,
transforms the subcutaneous tissues into a wax-like substance, and permits the
identification of cadavers years after burial. Such phenomena could have taken
place in Medvedja; it is near the Morava river and covered by snow several
months every year. Blood can be fluid postmortem after different types of death,
but it appears to remain liquid longer after sudden deaths due to asphyxia,
shock, or collapse.23 The swelling and foul odor of the vampires' cadavers 4,9
suggest that they were in the second stage of decomposition, when dissolution of
internal tissues with formation of gases occur. This produces a distention of
the body, genitalia, neck, and face, with protrusion of the tongue and
appearance of a bloodstained froth at the mouth.23 Therefore, some features
described in vampires could be explainable by natural processes; others bring to
mind a fatal zoonosis with a tendency to involve the limbic system, as is the
case with rabies.
Similarities between vampirism and rabies. The rabies virus is normally
introduced into the body through a bite and, after a silent interval, reaches
the CNS by following the peripheral nerves.24 In humans, this incubation period
can last from less than 10 days to several years (usually between 2 weeks and 2
months).24 Subsequently, nonspecific prodromal symptoms, such as loss of
appetite, fever, anxiety, disturbed sleep, and fatigue, are present for several
days.24,25 Pain and abnormal sensation in the bite wound are characteristic
symptoms that can appear even when the wound is healed.24 Eventually, the overt
manifestations of the disease become evident.24-27 In fewer than 20% of
patients, symptoms take the form of a flaccid and progressive paralysis(paralytic
rabies). Humans usually develop a form of encephalitis known as furious rabies
due to the predilection of the virus for the limbic system. The untreated
patient with furious rabies frequently manifests a wandering tendency,
restlessness, signs of autonomic dysfunction, hypersensitivity to stimuli, a
feeling of terror, persistent insomnia, and an increasing agitation. In a few
days, the most characteristic features of rabies, hydrophobia and muscular
spasms, usually become apparent. Finally, paralytic symptoms and coma may appear
before death.
In certain cases, rabies appears similar to vampirism. The characteristic spasms
regularly involve the facial, laryngeal, and pharyngeal muscles, and may cause
emission of hoarse sounds and an appearance with "the teeth clinched and the
lips retracted as those of an animal."26 Meanwhile, "the saliva cannot be
swallowed, so frothing at the mouth and vomiting of bloody fluid occurs."27 The
spasms are generally triggered by some stimuli, such as air draughts (aerophobia),
water(hydrophobia), light (photophobia), noises, odor, a minimal excitement, or
the sight of mirrors.24,25,27 A man was not considered rabid if he was able to
stand the sight of his own image in a mirror. Intermittent furious accesses may
be impressive in some instances."The rabid patient rushes at those who approach
him, biting and tearing them as if he was a wild beast."28 During these
episodes, the patient's appearance is frightening, and has been compared to that
of a furious wolf.26 Nowadays, this dramatic picture is seen rarely, partly due
to early medical intervention and partly because the aggressiveness caused by
rabies is inversely related to the cultural level of the sufferer.25,26 During
quiet intervals, the patient "lies in bed mentally alert but terrified, with
bloody saliva drooling from the mouth."27 Nightmares, illusions, and hallucinations
may be present at this stage.25,26 Difficulty in breathing and a sensation of
tightness in the throat are also frequent symptoms.25,26 Hypersexuality may be a
striking manifestation of furious rabies. Some men can stay "several days with
permanent penile erection and even with ejaculations associated with voluptuous
sensations."25 The literature reports cases of rabid patients who practiced
intercourse up to 30 times in a day,25 or who made violent rape attempts.24,26
Vampirism and rabies share many zoonotic features, for instance, in the animals
involved in both conditions. Dogs have been the most frequent transmitters of
rabies to man. However, the stories of rabid wolves biting scores of people in a
single day made them the most feared animals in Europe some centuries ago.29
Vampire bats in America and nonhematophagous bats in America and in Europe have
also transmitted rabies to humans.27,30 The puzzling metamorphosis of vampires
from human to animal shape might have some form of explanation. Rabies is
considered an isosymptomatic zoonosis because it can produce a similar furious
picture in humans and in animals such as dogs, wolves, cats, and bats.
Consequently, it would be imaginable that men and beasts with identical
ferocious and bizarre behavior might have been seen, by a primitive witness, as
similar malign beings. Farm animals were said to be frequent victims of vampires
but they were usually not regarded as vampires. Likewise, farm animals usually
contract paralytic rabies and become victims but not aggressive transmitters of
the disease.
Rabies is usually communicated through a bite. However, humans have also
acquired the infection through intact bucal or genital mucosae, or by inhalation
of the virus in caves densely populated by bats.24 Transmission of rabies from
human to human has occasionally been reported, and attributed to sexual
practices, bites, or nursing of patients.24 Man has a tendency to bite, both in
fighting and in sexual activities.31 The intensification of such tendency by
rabies increases the risk of transmission, as the virus is in the saliva and
other body secretions.24 Consequently, prophylactic treatment is recommended for
those in close contact with a person with rabies.32 Although difficult to
imagine in countries with sophisticated medical care, in the past, interhuman
transmission of rabies may have occurred, especially in remote regions.
Similar to the case in vampirism, rabies is seven times more frequent in males
than in females, both in humans and in animals,24 and prevails in rural areas.28
In addition, a major epidemic of rabies in dogs, wolves, and other wild animals
was recorded in Hungary around 1721-1728.29
Patients with rabies usually live less than 2 weeks and die by asphyxia or
cardiorespiratory arrest.24,25 These types of death would account for some
postmortem features documented in rabies, such as persistence of liquid blood,
turgescence of the genitalia, and emission of sperm.25,28 People with this
disease, however, sometimes faced a more dramatic end: "The fear of rabies was
such that often persons even suspected of hydrophobia were killed like wild
animals . . . (by being) shot, poisoned, strangled or suffocated."33 The social
alarm prompted by rabies moved some medical academies, religious institutions,
and kings to propose remedies.29 Rabies inspired the work of many writers,1 and
possibly gave rise to some classic Greek myths.29 Furthermore, a connection
between rabies and the development of the werewolf legend could be hypothesized.1
Theories about the vampire legend. In the 18th century, some enlightened
thinkers attributed the vampire legend to ignorance and superstition.2,7,9,10 In
modern times, other interpretations have been made. Some psychoanalysts,
following their particular approaches, have concluded that vampires represented
different symbolisms.34,35 In 1985, Dolphin suggested that porphyria might have
been the basis for the vampire legend 36; his unpublished theory has been
criticized elsewhere.37 Kayton supported a connection with schizophrenia,
arguing that "many behaviors and inner experiences of schizophrenics are similar
to aspects of the vampire legend."38 Barber 18 attributed the belief to the fact
that laymen are prone to misinterpret the observations made on cadavers. Thus,
the idea that vampires sucked blood would be based on the presence of liquid
blood inside bloated corpses and at the corners of corpses' mouths. Barber
hypothesized that dead bodies might have been disinterred by dogs, wolves, or
spontaneously due to superficial burials in times of epidemics. This would
explain, in his view, both the idea that vampires left their graves and the
implication of animals in the legend. Although the aforementioned theories may
contain some reasonable points, they do not provide a comprehensive explanation
for the legend.1,37 In recent years, some similarities between rabies and
vampirism have been noted.3,39,40 This resemblance was advocated as early as
1733, when an anonymous physician argued that vampirism "is a contagious illness
more or less of the same nature as that which comes from the bite of a rabid
dog."7
Origin of the legend. According to Calmet's description,9 the vampire concept
included two components, i.e., the dead body, which could be termed the "lying
vampire"; and the allegedly reanimated body, which could be called the"wandering
vampire."
Balkan villagers considered the lying vampire to be undead and harmful; the
enlightened people of the time had a rational explanation for such atypical
cadavers.7,9 Therefore, ignorance and the tendency to attribute obscure
phenomena to metaphysical forces (i.e., animism) could have been responsible for
the generation of the vampire legend. On the other hand, priests were involved
in exhumation of cadavers, and the Greek Orthodox Church considered incorruptibility
of a corpse as an evil sign.9 This supports some role of religion in the
development of the legend.
Rabies may have had an important role in the generation of the legend. The
wandering vampire was said to attack people and animals, sometimes invisibly and
sometimes in human or animal shape. These wandering vampires might have been
people or animals with unrecognized furious rabies. At that time and in some
circumstances, the diagnosis of rabies could have been easily missed. This could
be the case if the bite was old or due to an animal other than a dog, if the
infection was acquired by inhalation or sexual contact, or if the patient
developed a bizarre behavior. Certain symptoms of rabies, such as aggressiveness
and hypersexuality, may be overlooked as manifestations of disease. A recently
published case is illustrative:
An unknown, middle-aged man . . . was seen as a "wandering lunatic" on the road,
wearing dirty clothes, talking in excess, dancing, singing and occasionally
weeping. He made sexual advances and remarks to the ladies passing by. When he
tried to assault a lady on the road, he was severely beaten up.41
In this instance, the unsuspected diagnosis of rabies was made after a
postmortem study. Given the predominance of violent behavior among rabid
patients with a low educational level, such "wandering lunatics" could be
expected to have been more common at the beginning of the 18th century.
Balkan peasants believed that the lying and the wandering vampire were the same
being. An explanation for this mystery could be that they had discovered some
analogies between them. One may imagine how this could have happened, especially
if rabid patients were taken for wandering vampires. A rabid patient, buried in
a cold and humid place, would have had the capacity to develop, during his
illness and after death, all the features attributed to a wandering and a lying
vampire. If this occurred in a rural society, it could have caused a tremendous
impact and an erroneous interpretation.
Much evidence supports that rabies could have played a key role in the
generation of the vampire legend. This would be in accordance with the
anthropologic theory that assumes that many popular legends have been prompted
by facts.42 Under this approach, saying that the vampire is "mere fiction"37 may
be somewhat inappropriate. The past occurrence of epidemics of men and animals
that bit others and transmitted the same disease to them can now be scientifically
understood. It can also be accepted that those men showed hypersexuality,
intolerance to mirrors and smelling substances, and liquid blood after death.
Finally, it can be scientifically stated that this unique picture may be seen,
even nowadays, in some unfortunate cases of furious rabies.
Acknowledgments
The author thanks David Troncoso and J.C.P. Davila for their help in the
preparation of the English text and Beatriz Armada for her secretarial support.
References
1. Gomez-Alonso J. Los vampiros a la luz de la Medicina. Vigo, Spain: Neuropress,
1995:38, 186, 149-159, 53-61.
2. Voltaire. Oeuvres complétes, vol. 43. Dictionnaire philosophique/Questions
sur l'encyclopedie. Edition de Kehl, 1784. Vampires.
3. Gómez-Alonso J. Rabia y vampirismo: hipótesis sobre una interpretación
médica del vampirismo. Jano (Barcelona) 1982;514:30-33.
4. Mercure Galant. Paris. May 1693:62-69.
5. Summers M. The vampire in Europe. Wellingborough, UK: Aquarian Press,
1980:143-159.
6. Question physique: sur une espéce de prodige dûement attesté.
Le Glaneur Historique. The Hague: March 3, 1732.
7. Courtes reflexions physiques sur le vampirisme. Le Glaneur Historique. The
Hague: April 23, 1733.
8. The travels of three Englishmen. Harlein Miscellany, vol. IV. London, UK:
1745:348-359.
9. Calmet A. Dissertations sur les apparitions des anges, des demons et des
esprits et sur les revenants et vampires de Hongrie, de Boheme, de Moravie.
Paris: 1746:249-250, 273, 402-403, 451-457.
10. Rousseau JJ. Lettre à Christophe de Beaumont. Amsterdam: M.M. Rey,
1763:97-102.
11. Vukanovic TP. The vampire. J Gypsy Lore Soc 1959;38:44-55.
12. Cremene A. La mythologie du vampire en Roumanie. Monaco: Editions du Rocher,
1981:39-106.
13. Kulisic S, Petrovic PZ, Pantelic N. Srpski mitoloski recnik. Beograd,
Yugoslavia: Nolit, 1970:50-51.
14. Vukanovic TP. The vampire. J Gypsy Lore Soc 1958;37:21-31.
15. Perkowski JL. Vampires of the Slavs. Cambridge, MA: Slavica Publishers,
1976:3-17.
16. Perkowski JL. The Romanian folkloric vampire. East Eur Quart 1982;16:311-322.
17. Vukanovic TP. The vampire. J Gypsy Lore Soc 1958;37:111-118.
18. Barber P. Vampires, burial, and death. New Haven, CT: Yale University Press,
1988:58, 9, 32, 195-196.
19. Goldstein M. Brain research and violent behavior. Arch Neurol 1974;30:1-35.
20. Heath RG. Pleasure and brain activity in man. J Nerv Ment Dis 1972;154:3-18.
[Medline Link]
21. Jones B. Basic mechanisms of sleep-wake states. In: Kryger MH, Roth T,
Dement WC, eds. Principles and practice of sleep medicine, 2nd ed. Philadelphia:
W.B. Saunders, 1994:145-162.
22. Toma B, Fabiani G. Les zoonoses. Paris: Presses Universitaires de France,
1983:30, 126.
23. Gordon I, Shapiro HA. Forensic medicine, 2nd ed. Edinburgh, UK: Churchill
Livingstone, 1982:37-53.
24. Warrell DA. Rabies in man. In: Kaplan C. Rabies: the facts. Oxford, UK:
Oxford University Press, 1977:32-52.
25. Babes V. Traité de la rage. Paris: Baillière, 1912:98-103,
439-440.
26. Gastaut H, Miletto G. Interprétation physiopathogénique des
symptomes de la rage furieuse. Rev Neurol(Paris) 1955;92:5-25.
27. Baker AB, Baker LH. Clinical neurology, vol. 2. New York: Harper and Row,
1978:28-31.
28. Andry M. Recherches sur la rage. Societé Royale de Médecine.
Paris: 1780:2-4, 33-34.
29. Théodoridès J. Histoire de la rage. Paris: Masson, 1986:100-108,
22-23.
30. Lumio J, Hillbom M, Roine R, et al. Human rabies of bat origin in Europe.
Lancet 1986;327:378. Letter.
31. Paljarvi L, Partanen J. Biting palsy of the accessory nerve. J Neurol
Neurosurg Psychiatry 1980;43:744-746. [Medline Link]
32. Anderson LJ, Winkler WG, Vernon AA, Helmick CG, Roberts MR. Prophylaxis for
persons in contact with patients who have rabies. N Engl J Med 1980;302:967-968.
Letter.
33. Viktor TJ. Historical aspects of rabies treatment. In: Koprowski H, Plotkin
SA. World's debt to Pasteur. New York: Alan R. Liss, 1985:141-152.
34. McCully RS. Vampirism. J Nerv Ment Dis 1964;139:440-452.
35. Du Bulay J. The Greek vampire. Man 1982;17:219-238.
36. Dolphin D. Werewolves and vampires [dissertation]. Los Angeles, CA: American
Academy for the Advancement of Sciences (AAAS); 1985.
37. Cox AM. Porphyria and vampirism: another myth in the making. Postgrad Med J
1995;71:643-644. Editorial.
38. Kayton L. The relationship of the vampire legend to schizophrenia. J Youth
Adolesc 1972;1:303-314.
39. Hurwood BJ. Vampires. New York: Omnibus Press, 1981:5-6.
40. Heick A. Prince Dracula, rabies and the vampire legend. Ann Intern Med
1992;117:172-173. Letter.
41. Goswami U, Shankar SK, Channabasavanna SM, Chattopadhyay A. Psychiatric
presentations of rabies. Trop Geogr Med 1984;36:77-81. [Medline Link]
42. Van Gennep A. La formación de las leyendas. Barcelona: Alta Fulla,
1982:146-148.
Accession Number: 00006114-199809000-00044
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