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| Image credit: Liszt Collection/Heritage Images/Getty Images |
The Clef de Saint-Hubert (referred to in Dutch was the Hubertussleutel) may sound like a medieval practice at first, but it origins are in fact not entirely certain. References appear in the twelfth and thirteenth century, but the exact nature of the object and practice isn't completely clear. It is well attested to have been in use until the 1800s and even later. The 'key' takes the form of a metal nail, cone, or cross, dedicated to St Hubert as patron saint of hunters, and is used as a preventative against rabies. Rather than being used solely as an amulet the key, carried by priests at churches dedicated to St Hubert, was used to treat bites from rabid dogs - being heated and pressed against the wound - in effect cauterizing the wound and potentially eliminating the viral load. It was also used to treat animals suspected of having been bitten by infected animals. This practice does however take its name from a different Clef de Saint-Hubert - referring to a single reliquary said to be associated with St Hubert, and it is here that the lines between the associated medical practice, hagiography, and legal history begin to blur together. The reliquary is said to contain filings from the chains which held St Peter, and was said to have been given to Hubert while in he was in Rome either in a vision by St Peter himself, or by Pope Gregory II. The current reliquary is, however, not medieval, having been noted in several sources as having been a reproduction of a lost or destroyed original, and it is now believed that this version dates from the seventeenth-century. To complicate matters further, it is possible that this reliquary was part of a number of artifacts and documents created to support the legitimacy of the diocese of Liege during the Investiture Controversy in the Twelfth century - since prior to this date there is no reference to the object, it's association with St Hubert, or its ties to Saint Peter (which were necessary to prove the legitimacy of the church of Liege's claim). It is clear that the metal nails and related objects dedicated to St Hubert developed later by association with this specific relic, but that the relationship between the saint and the specify prevention of rabies is a tenuous one.
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| La clef de Saint-Hubert on display at Trésor de la cathédrale de Liège - in Belgium |
Rabies itself was and is a disease greatly feared - and even today it is, in effect, the most deadly virus known to man. The modern treatment - the administration of rabies vaccines over a set period - is only effective if carried out immediately after the patient has been bitten. Once symptoms present themselves the treatment is ineffective and death is almost completely certain. Rabies has been known since around 2000 BCE being mentioned in the Mesopotamian Codex of Eshnunna - an early law code which ordered owners of dogs suspected of rabies to take measures to prevent bites and fined them if an individual bitten died of the disease. The fear of rabies remains prevalent in the modern era - making a frequent appearance in popular culture where 'mutated rabies', 'weaponised rabies', or 'rabies-like viruses' often appears in horror movies as the aetiology of zombie outbreaks or similar including 28 Days Later.
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| Colorized transmission electron micrograph of the rabies virus (red) infecting cultured cells |
Rabies is caused by the virus Rabies lyssavirus - a neurotropic virus that causes rabies in animals, including humans.
The name has Latin and Greek roots - rabies derived from the Latin for madness - with lyssavirus coming from the Greek lyssa meaning 'violent' - lyssaviruses literally translates as 'violent viruses' or 'violence viruses'. The time between infection and the onset of symptoms can vary from a few days to more than a year - however in most cases the onset of symptoms begins one to three months after contracting the disease. This is one reason why seeking treatment after a possible exposure (such as a bite from a wild animal in an area where rabies is known to be present) is essential regardless of initial symptoms. In 2016 the total number of individuals documented as having survived rabies was 14. Per the USA's Centre for Disease Control approximately 59000 people die of rabies worldwide every year with more than 95% of human deaths occurring in Asia and Africa.
Recent public health research has classified rabies as a Neglected Tropical Disease - one of a diverse group of diseases which, though common in Asia, Africa and the Americas, especially amongst low income populations, have attracted little medical treatment or research funding. There are numerous causes of this, and the exact definition of a Neglected Tropical Disease varies between organisations. The WHO has moved to prioritise a number of NTDs for further research and funding, but the organisation itself is hugely underfunded compared to the importance of the work which it carries out. Rabies vaccines are both safe and effective in humans and other animals. Vaccinating dogs is very effective in preventing the spread of rabies. After a full course of treatment a long-lasting immunity to the virus develops. The WHO recommends that those who are at high risk of exposure be vaccinated before any potential exposure.
In terms of medical folklore St Hubert's Key also bears some similarity to the 'madstone' - a folkloric cure of rabies from the early history of the United States of America (primarily from the colonial population, rather than the native population). The madstone was believed to draw out the poison. The Key highlights the longevity of such items and associated beliefs - in effect being a form of traditional folk medicine within the European tradition. It also underlines the fact that during the Middle Ages the lines between what would be seen as science in modern terms, religion, magic, and folklore were not clearly delineated in the way they are today. This should not be used as the basis for the assumption that medieval medicine was 'primitive' per se - medieval physicians were operating within the limitations of what was known and believed at the time - in some cases as the cutting edge of contemporary medical knowledge, just as modern medics are today. It is easy to conceived of the Middle Ages as being backward - the very term 'medieval' has come to denote something uncontrolled, brutal, anti-intellectual, etc but this is at best as vast oversimplification, and at worst a completely false construct of later thinking. In a work of public history Ian Mortimer argued that referring to a medieval house as dirty because it had not be cleaned using modern products to modern standard was no different to someone from the twenty-seventh century considering modern homes to be dirty because they had not been treated using some super-detergent developed in the twenty-second century. By the standards and understanding of the time those who treated the sick in the Middle Ages were working at the very edge of contemporary understanding.
The legend of St Hubert, the origin of the key, and the associated ecclesiastical politics which may underlie its origin, are not widely known in the current era. Perhaps ironically given St Hubert's original association with curing mental and physical ill health, the symbol of St Hubert - a cross between dear's antlers, is now most familiar in Europe as forming the logo of German alcoholic digestif Jägermeister - which became heavily associated with binge-drinking during the 2010s, having been marketed to students in the 1990s and early 2000s. One may wonder what the monk physicians who treated individuals with variations of St Hubert's Key, would make of such developments.
