Originally Released: September 24, 1996
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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.
Poe was discovered lying unconscious on September 28 on a wooden plank outside Ryan's saloon on Lombard St. in Baltimore. He was taken to Washington College Hospital (now Church Hospital).
Historical accounts of his hospitalization indicate that at first he was delirious with tremors and hallucinations, then he slipped into a coma. He emerged from the coma, was calm and lucid, but then lapsed again into a delirious state, became combative, and required restraint. He died on his fourth day in the hospital. According to an account published in the Maryland Historical Magazine in December 1978, the Baltimore Commissioner of Health, Dr. J.F.C. Handel certified that the cause of Poe's death was "congestion of the brain."
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.
Dr. Benitez theorizes that Poe may have gotten rabies from being bitten by one of his pets. He was known to have cats and other pets. Although there is no account that Poe had been bitten by an animal, it is interesting that in all the cases of human rabies in the United States from 1977 to 1994, people remembered being bitten in only 27 percent of those cases. In addition, people can have the infection for up to a year without major symptoms.
The Poe case was presented originally to Dr. Benitez as part of a weekly meeting of medical center physicians, called the Clinical Pathologic Conference. It is an exercise in which a complex case is presented without a diagnosis, and physicians discuss how they would determine a patient's condition and course of treatment. Dr. Benitez did not know that the patient in question at this particular conference was Edgar Allan Poe.
The idea to analyze Poe's death came from Philip A. Mackowiak, M.D., professor of medicine and vice-chairman of the Department of Medicine at the University of Maryland Medical Center.
"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. He adds, though, that after Poe's death, his doctor went on the lecture circuit and gave varying accounts of the writer's final days. "The account on which Dr. Benitez based his findings was more consistent with rabies than with anything else, but the definitive cause of Poe's death will likely remain a mystery," says Dr. Mackowiak.
Edgar Allan Poe is buried in a cemetery next to Westminister Hall at Fayette and Greene Streets, just one block from the University of Maryland Medical Center.
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