The Lefèvre Findings

Toulouse, August 15, 1798 My dear colleague, I know that I am still yet to reply to your earlier enquiries. For that I must seek forgiveness. I have spoken with M. Feraud and shall pass his sentiments on to you post-haste. Instead, I am writing to you today with concerned countenance, to recount a series of observations that, I fear, may herald the birth of a new malady, the nature and effects of which still elude our full understanding. In recent months, I have treated several cases of what can only be described as a partial madness or hysteria. Pain seemed to have deserted the patient's body. These subjects, incapable of feeling pain even under the cruelest stimulus, then begin to lead fragile lives, often marked by unnoticed injuries, until illness or accident carried them away. But what struck me even more is that these poor souls seemed to manifest, as they approached their end, symptoms that cannot help but recall that terrible hydrophobia we know as rabies. Though they do not display the characteristic fear of water, they are nevertheless seized by violent spasms, and their minds, previously lucid despite their insensitivity, become clouded until they descend into a fury that suggests rabies has taken possession of their souls. Critically, their lack of pain does not seem to abate, and the marriage of the two conditions leads to a patient who is both enraged and unencumbered by sensations of pain that would otherwise temper a rage-full fit. In those moments, it is as if a disease, hitherto dormant and hidden in the depths of their being, awakens and reveals itself in all its virulence, manifesting only at the threshold of death.This leads me to contemplate a frightening hypothesis: could it be that we are in the presence of a new malady, born from the strange confluence of these symptoms and rabies, a sort of hybrid virus whose malignancy expresses itself only as life draws to a close? I hesitate to draw hasty conclusions. It seems essential to bring this to your attention that you may pay attention to those who visit your Infirmary, and to that of our Parisian colleagues. Perhaps through a doubled effort, we can shed light on the exact nature of this phenomenon and the means to combat it before there are further eventuation. There is something here, I am sure of it, and I cannot imagine the consequences if this new bacterium were to change in character or form any further. M. Henri and several students are now observing the malady as it presents itself in a young woman. I shall write soon to impart my findings. Please accept, my dear colleague, the expression of my highest esteem and consideration. Dr. Jean-Baptiste Lefèvre Toulouse