From wolf to virus: The conceptual journey of understanding lupus

“ Wealth never came, but fame in full measure, and the love and gratitude of their fellow-men.
There is a loathsome disease called lupus, of which, happily, in America with our bright skies we know little. Lupus is the Latin word for wolf, and the ravenous ailment is fitly named, for it attacks by preference the face, and gnaws at the features, at nose, chin, or eye, with horrible, torturing persistence, killing slowly, while the patient shuts himself out from the world praying daily for death to end his misery. ”

“ In the north of Europe it is sadly common, and there had never been any cure for it. Ointments, burning, surgery—they were all equally useless. Once the wolf had buried its fangs in its victim, he was doomed to inevitable death. The disease is, in fact, tuberculosis of the skin, and is the most dreadful of all the forms in which the white plague scourges mankind—was, until one day Finsen announced to the world his second discovery, that lupus was cured by the simple application of light. ”

“ Me thou hast cursed, and I commit myself to the gods—I defy and scorn thee! but breathe but one word against yon maiden, and I will convert the oath on thy foul lips to thy dying groan. Beware!'
'I have done,' replied the hag, laughing wildly; 'for in thy doom is she who loves thee accursed. And not the less, that I heard her lips breathe thy name, and know by what word to commend thee to the demons. Glaucus—thou art doomed!' So saying, the witch turned from the Athenian, and kneeling down beside her wounded favorite, which she dragged from the hearth, she turned to them her face no more. ”

“ Then turning round, still propped upon his elbow, he fixed his proud eye upon Aldyth, and said gravely, “Wife, pale is thy face, and gloomy thy brow; mournest thou the throne or the man?”
Aldyth cast on her wild lord a look of more terror than compassion, a look without the grief that is gentle, or the love that reveres; and answered:
“What matter to thee my thoughts or my sufferings? The sword or the famine is the doom thou hast chosen. Listening to vain dreams from thy bard, or thine own pride as idle, thou disdainest life for us both: be it so; let us die!” ”

“ Whether it come from woe or disease, the stroke which mars a single fibre plays strange havoc with the mind. Slaves we are to our muscles, and puppets to the spring of the capricious blood; and the great soul, with all its capacities, its solemn attributes, and sounding claims, is, while on earth, but a jest to this mountebank,—the body,—from the dream which toys with it for an hour, to the lunacy which shivers it into a driveller, laughing as it plays with its own fragments, and reeling benighted and blinded to the grave! ”

“ We look back through countless millions of years and see the will to live struggling out of the intertidal slime, struggling from shape to shape and from power to power, crawling and then walking confidently upon the land, struggling generation after generation to master the air, creeping down into the darkness of the [50] deep; we see it turn upon itself in rage and hunger and reshape itself anew ”

“ So Nature shapes her hyaline vesicles and modifies them to serve the needs of the part where they are found. The artisan whirls his rod, and his glass bubble becomes a flattened disk, with its bull's-eye for a nucleus. These lips of ours are all glazed with microscopic tiles formed of flattened cells, each one of them with its nucleus still as plain and relatively as prominent, to the eye of the microscopist, as the bull's-eye in the old-fashioned windowpane. Everywhere we find cells, modified or unchanged. ”

“ there can surely be no difficulty in understanding how, under appropriate conditions, a cell may, in the course of untold millions of years, give origin to the human race. ”

“ In this fibrous reticulum are many spindle-shaped and a few rounded cells. Its vascularity is easily demonstrated by injection. The centre of each nest is the palest part of the mass, and unless stained by extravasation it contrasts with the reddish areola. These islets of lymphoid cells, at first isolated and each the size of a pin's head, may enlarge and become confluent, forming the larger nodules. With this increase the centre of each becomes turbid, and the cells are found to have become granular and fatty, and to have in part broken up into a granular débris. ”

“ The other organs are less freely invaded. The bacilli excite inflammation, and by a specific action transform the migrating cell into the leprous cell. Leprosy is probably an infectious disease, and its specific products are contagious—viz. the leprous cells of the tubercles, the tissue-fluids, and the pus containing bacilli or viable spores. On the other hand, the pus may not always be infectious, as the fluid contained in the bullæ is not. ”

“ These bodies, however, are extracellular and are more oval and stain more intensely than the typhus bodies. These Rocha-Lima bodies require a Romanowsky stain to bring them out. In man these bodies are found in the endothelial cells of the small blood vessels, occurring singly or in clumps. In the louse the epithelial cells of the intestine may be found distended with masses of these organisms.
It is not certain whether the virus is transmitted by the bite of the louse or by inoculation of faeces. Monkeys and guinea pigs can be infected by injection of emulsions made from infected lice. ”

“ The female alone bites, blood apparently being necessary for ovulation. It feeds especially during the morning and afternoon hours,—much less commonly at night unless there is a light. The life history of Stegomyia is discussed more fully under yellow fever.
As regards the transmission of the disease by blood filtered through a diatomaceous filter it will be remembered that Ashburn and Craig, by proving this fact, placed the dengue virus in the same category with the filterable viruses of the two diseases just considered. Cleveland found the virus in the washed cells as well as in the serum. ”

“ The death close before me was terrible, but far more terrible than death was the dread of being misremembered after death. And so quick were my thoughts, that I saw myself despised by unborn generations—Estella's children, and their children—while the wretch's words were yet on his lips.
"Now, wolf," said he, "afore I kill you like any other beast—which is wot I mean to do and wot I have tied you up for—I'll have a good look at you and a good goad at you. Oh, you enemy!" ”

“ My curse upon thy venom’d stang,
That shoots my tortur’d gums alang;
[156] And thro’ my lugs gies mony a twang,
Wi’ gnawing vengeance;
Tearing my nerves wi’ bitter pang,
Like racking engines! ”

“ Thus the will to live everywhere preys upon itself, and in different forms is its own nourishment, till finally the human race, because it subdues all the others, regards nature as a manufactory for its use. Yet even the human race, as we shall see in the Fourth Book, reveals in itself with most terrible distinctness this conflict, this variance with itself of the will, and we find homo homini lupus. ”

“ There are beaten tracks here and there. Here and there a fool has been known to leave them. It may be days or weeks before I happen across his body—the eyes slipping forward of their lids, his mouth puckered out of shape from sucking and gnawing at the knuckles of his hands.”
“It is terrible! And none comes hither but thou?”
“I, and the beasts of blood that must not be denied. When they hunt, I lead; therefore it is well to win my favour.”
Carinne hurriedly raised herself. ”

“ It is not a mere paleness-a skin-deep loss of colour: it is as if the whole bloom of youth had rushed away; hollows never discernible before appear in the cheek that was so round and smooth; the muscles fall as in mortal illness; a havoc, as of years, seems to have been wrought in a moment; flame itself does not so suddenly ravage—so suddenly alter— leave behind it so ineffable an air of desolation and ruin. Waife sprang forward and clasped her to his breast.
"You will bear it, Sophy! ”

“ We look about us with dimmed eyes, and our breath grows short and thick, and pains and coughs, and shooting aches come upon us at night; it is a bitter life—a bitter life—a joyless life. I would I had never commenced it. And yet the harsh world scowls upon us: our nerves are broken, and they wonder we are querulous; our blood curdles, and they ask why we are not gay; our brain grows dizzy and indistinct, (as with me just now,) and, shrugging their shoulders, they whisper their neighbours that we are mad. ”

“ Following entry into the epithelium via an abrasion, the virus multiplies in the stratum germinativum of the epidermis. Hydropic degeneration occurs, followed by necrosis of infected cells. Intracellular edema (hydropic degeneration) and intercellular edema account for vesicle formation (Madin and Traum 1955) . Virus spreads from cell to cell as the infection progresses. Local lymph nodes may become involved, with extensive lymphocyte destruction and congestion; a low-level viremia occurs and may account for some secondary lesions. ”

“ The type of cell in syphilitic diseases is preponderantly the small lymphocyte. A low percentage, that is, very rarely over 20%, of large lymphocytes, endothelial phagocytic cells, polymorphonuclear leucocytes and plasma cells may also be found. The finding of plasma cells in any number in the spinal fluid is suggestive although not conclusive evidence for the diagnosis of paretic neurosyphilis. ”

“ In tropical work we combine the large mononuclears and transitionals in a differential count. They are the phagocytes of animal cells or parasites. The disease in which their increase is best recognized is malaria and an increase to 15% where the blood shows moderate leucopenia is very significant. The melaniferous leucocytes of malaria are cells of this type.
Other protozoal infections, as kala-azar, trypanosomiasis and amoebiasis cause it. Filterable-virus diseases may show a mononuclear increase, thus yellow fever and dengue both give an increase about the fifth or sixth day. ”

“ Viral nucleic acid, as detected by in situ hybridization, was widespread in epithelial tissues of cattle only 6 hours after aerosol exposures (Brown et al. 1992) . In swine following intradermal inoculation in the snout, widespread FMDV nucleic acid was detected by in situ hybridization on the first sampling 24 hours after infection (Brown et al. 1995) . Langerhans cells may be the primary means of this rapid distribution of virus. ”