Which Mental Illness Encompasses This Problem?

In an analysis almost 147 years after his death, doctors at the University of Maryland Medical Center believe that writer Edgar Allan Poe may have died as a result of rabies, not from complications of alcoholism. Poe's medical case was reviewed by R. Michael Benitez, M.D., a cardiologist at the University of Maryland Medical Center. His review is published in the September 1996 issue of Maryland Medical Journal.

"No one can say conclusively that Poe died of rabies, since there was no autopsy after his death," says Dr. Benitez, who is also an assistant professor of medicine at the University of Maryland School of Medicine. "But the historical accounts of Poe's condition in the hospital a few days before his death point to a strong possibility that he had rabies."

Poe was 40 years old when he died on October 7, 1849. He had traveled by train from Richmond, Virginia to Baltimore a few days earlier, on September 28. While in Richmond, he had proposed marriage to a woman who would have become his second wife. (His first wife had died). Poe intended to continue on to Philadelphia to finalize some business when he became ill.

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In his analysis, Dr. Benitez examined all of the possible causes for delirium, which include trauma, vascular disorders in the brain, neurological problems such as epilepsy, and infections. Alcohol withdrawal is also a potential cause of tremors and delirium, and Poe was known to have abused alcohol and opiate drugs. However, the medical records indicate that Poe had abstained from alcohol for six months before his death, and there was no evidence of alcohol use when he was admitted.

"In addition, it is unusual for patients suffering from alcohol withdrawal to become acutely ill, recover for a brief time, and then worsen and die," says Dr. Benitez, who adds that withdrawal from opiates does not produce the same scenario of symptoms as Poe's illness.

Dr. Benitez says in the final stages of rabies, it is common for people to have periods of confusion that come and go, along with wide swings in pulse rate and other body functions, such as respiration and temperature. All of that occurred for Poe, according to medical records kept by Dr. John J. Moran who cared for Poe in his final days. In addition, the median length of survival after the onset of serious symptoms is four days, which is exactly the number of days Poe was hospitalized before his death.

Poe's doctor also wrote that in the hospital, Poe refused alcohol he was offered and drank water only with great difficulty. Dr. Benitez says that seems to be a symptom of hydrophobia, a fear of water, which is a classic sign of rabies.

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"Poe's death is one of the most mysterious deaths in literary history, and it provided us with an interesting case in which to discuss many principles of medicine," says Dr. Mackowiak, who runs the weekly Clinical Pathologic Conference at the medical center.

Dr. Mackowiak agrees with Dr. Benitez that rabies was the most likely cause of Poe's death, based on the available evidence.

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http://www.umm.edu/news/releases/news-releases-17.htm