The Fantastic Laboratory of Dr. Weigl: How Two Brave Scientists Battled Typhus and Sabotaged the Nazis (4 page)

A century ago, typhus’s unique life patterns posed a thorny challenge to researchers. How were they to maintain a steady supply of the organism for study? It was hard to keep typhus bacteria alive in artificial cultures or in the bodies of mice or guinea pigs; there was no way to infect lice with typhus other than to feed them on the bodies of people sick with the disease. But patients were generally available only during typhus epidemics. Even the wobbly medical ethics of those days forbade intentionally infecting people with typhus. After many discussions with Eisenberg about this problem, Weigl hit upon an idea in 1916. Out of concern for his assistant’s future career, Eisenberg had been urging Weigl to drop typhus research and concentrate on cholera, an organism that was easier to culture and grow.

“
Tell me, Sir, where
are you going to get the cultures?” Eisenberg asked. “You won’t have access to the typhus organism until you have patients. And you won’t get patients when there is no disease. So how is this going to work?”

Weigl thought for a moment, then with characteristic earthiness replied, “Well, if we can’t get the louse to eat the germs, we’ll stick them up its ass.”

Eisenberg did not understand and was not amused. Weigl told him, “Have a look.”

Whereupon he strode to his workbench and, using a bunsen burner, drew out a long, thin glass pipette. After pinning a louse down on a piece of blotting paper, he proceeded to stick the pipette into its anus, and injected the louse with a tiny droplet of water. Weigl knew from his anatomical work that the insect’s rectum was made of a stiff, chitinous material that would not be easily damaged, if the tube was carefully inserted and its tip carefully rounded.

Rudolf Weigl, left, Filip Eisenberg, seated, with other lab workers in Przemy
l, around 1916. (Courtesy of National Museum, Przemy
l. Photograph of original by S. Kosiedowski.)

And thus a new experimental animal was born—the louse. Grotesque though it was, this was one of the true eureka moments in typhus research, and an important one for the expansion of research into viruses as well. Never before had an insect been used as an experimental animal; Weigl owed his ability to take advantage of this idea to a marvelous manual dexterity. “
To watch him tenderly
section an insect or create a microscope slide was an intense aesthetic pleasure,” one colleague noted.

For Weigl, as well as Fleck and the scores of other medics in the employ of the Austrian crown, there was considerable urgency in the work. Austria was largely free of typhus before the war, and the troops of the empire, lacking natural immunity, were ripe for contagion. The crown lands whose health they defended soon burned with typhus, which erupted first in the Balkans, then in Ukraine and Russia.

The word “typhus” comes from the Greek
typhos
, which means “smoky” or “hazy,” and refers to the hallucinatory symptoms that arise in the sick mind. The disease is distinct from typhoid fever, whose symptoms can be similar but are caused by an intestinal bacterium present in contaminated food or water. Typhoid fever (in the early days of bacteriology, scientists tended to add the suffix “-oid” or the prefix “para-” to name a “new” organism that they had previously mistaken for another) was distinguished from typhus in the mid-19th century, but the original mistake left a linguistic muddle. In German, for example,
Tyfus
describes the disease that English speakers call typhoid fever, while the German word for typhus is
Fleckfieber
, literally “spotted fever.” In English, “spotted fever” may refer to typhus or to Rocky Mountain spotted fever, caused by similar bacteria spread by the bite of certain ticks.
To add to the confusion
, epidemic louse-borne typhus has less deadly cousins—murine typhus and scrub typhus—spread by fleas and chiggers and ticks in parts of Asia and the Americas, including Texas.

The body louse bites in order to attach itself to the skin, then feeds by poking a tiny tube called a stylet through the outermost layer. It uses a mechanical pump to draw out blood, and as it eats, it excretes. The bite of the typhus-infected louse does not transmit typhus; rather, the bite and the bug’s saliva cause itching, which leads the human to inoculate himself with the typhus-laden feces by scratching where the louse bit. Typhus germs can live in human cells contained in dried louse waste for up to four months, and some unknown but small percentage of infections occur when the excrement infects people through the lungs, eyes, and nose.

Rickettsia
are very tiny, primitive bacteria. Recent genetic analyses have shown that they share a common ancestor with mammalian mitochondria, the energy-producing organelles of the cell.
Typhus bacteria live
in the cells of the host, which they rely upon to metabolize the sugars they need to exist. Typhus germs colonize the cells that line blood vessels in tissues throughout the body, including the brain. The immune system’s attack on the infected cells floods the lungs and other organs with fluid, and like a lighted match in a box of firecrackers, sets off a cascade of immune responses that contribute to the memorable and horrific symptoms of the disease.

Sickness typically begins
around a week after the louse bite, with fatigue and a bad headache or backache. Soon the patient begins to appear pale and absent, and his or her reflexes fail. Around the fifth day, red circles pop out on the shoulders, torso, and arms resembling tiny jewels embedded in the skin. This is called petechial rash. Long before doctors knew what caused typhus, they diagnosed it on the basis of the spots and the delirium that typically emerges soon after their appearance. For a week or more, a severely ill patient will lie muttering and inert, with sporadic flashes of anger or frustration accompanied by spastic movements, incontinence, and loss of bowel control. Temperature can rise to 108 degrees Fahrenheit; the heart beats at 120 beats per minute. Complications include bronchitis, deafness, numb extremities, swollen testicles, or gangrene of the toes, penis, labia, or fingers. Deafness and memory loss occur and can be permanent.

At the peak of illness
, many patients become profoundly distressed. “A ward full of typhus patients in the second week of the disease bears more resemblance to an acute mental ward in an asylum than to a hospital ward,” one doctor wrote. “Some patients lie in a drowsy, comatose condition, others shout incoherently at the top of their voices, while still others, nearing the critical period, lie with very shaky hands outside the bedclothes and exhibit marked carphology and
subsultus tendinum
[twitching, plucking, and grasping].” The better typhus hospitals had table straps to keep patients from attacking the staff, throwing themselves out windows, or fleeing down flights of stairs to plunge into traffic or bodies of water. Suicide, if it can be called that, was a common sequela of typhus, because the patients were driven mad by pain and terrible visions that sent them hurtling through windows.

Typhus ward of Grace Hospital in Warsaw, 1921. (Library of Congress.)

An entire literature could be created from the visions of typhus sufferers. An American volunteer who had been put in charge of 6,000 sick Austrian, Turkish, and Russian prisoners of war on a six-week train meander through Siberia in 1920 fell ill himself and lay down on a patch of straw. He was engulfed by an unforgettable vision. “It seemed there were two couches next to me and upon them reposed dark bodies, monsters of indefinite form and at the same time parts of my own body,” he said later. “At other times, I was able to see myself from outside in a relatively logical way.”
Another American, a volunteer
serving in the Italian army during World War I, suddenly was struck by the not-so-crazy inspiration that war was wrong, and thereafter refused to return to the front and preached pacifism among his fellow patients. Doctors responded to this feverish inspiration by placing him in a mental asylum for the remainder of the war.

Some patients temporarily gained marvelous mental powers, or lost the most basic skills. “
Although my memory
is not the sort that can normally capture verse, I recited three poems that I had read shortly before my illness,” a Russian patient recalled. “Two days after this exaltation, my mind was a complete blank.”

Some hallucinatory motifs
were characteristic of different cultures: during World War II, German soldiers at the eastern front often imagined that the Führer had personally pinned medals on them and promoted them for brave deeds in battle.
American famine relief
workers, delirious in their camp hospital in Ufa in 1922, entertained fantastic escape dreams in which they boarded comfortable, pillow-cushioned airplanes and flew around the world.
The journalist John Reed
, who spent his last days in the Moscow typhus hospital after watching his beloved revolution fall to tatters, retreated into an idyll of beautiful visions and dreams of his long-lost boyhood in Portland, Oregon. “He would tell me that the water he drank was full of little songs,” wrote Reed’s widow, Louise Bryant, who sat with him in his dying days. “He told me, ‘You know how it is when you go to Venice. You ask people—Is this Venice?—just for the pleasure of hearing the reply.’”

Those who recovered
described a ravenous convalescent hunger and a vivid sense of rebirth. In Chekhov’s 1887 short story “Typhus,” the character Klimov awakens in a stream of light: “His whole body from head to foot was overcome by a sensation of infinite happiness and joy in life, such as the first man must have felt when he was created and first saw the world. Klimov felt a passionate desire for movement, people, talk. . . . He rejoiced in his breathing, in his laughter, rejoiced in the existence of the water-bottle, the ceiling, the sunshine, the tape on the curtains.” When his aunt tells Klimov that his sister, Katya, has died of typhus and that he had infected her, “this terrible, unexpected news . . . startling as it was, could not overcome the animal joy that filled the convalescent. He cried and laughed, and soon began scolding because they would not let him eat.”

Lice-borne typhus has been known under many names: jail fever, malignant fever, spotted fever, but surely the most apt name, at least for latter centuries, is “war fever.” Typhus followed soldiers and refugees into bombed-out houses and mud hovels, burrowed into their trenches and encampments, shrouded their train yards and horse-drawn wagons. The disease played a decisive role in many military campaigns, among them Napoleon’s catastrophic invasion of Russia.
The Grand Army marched
to Moscow with 500,000 men and returned with 3,000. It is likely that 20 percent of the casualties were typhus deaths.