In many ways, Rabid feels like an alternative riff on the same sexualized body horror and plague paranoia of Shivers, this time working its way from the countryside to urban centers instead of vice versa. Because of the fundamentals of its plot and chills, the film often gets dismissed as one of David Cronenberg’s more derivative efforts, particularly in light of the rapid evolution he would show over the next half-decade. Nonetheless, it demonstrates clear growth in the director’s aesthetic talents, marking the first shifts away from the more antic exploitation style of his earlier efforts toward the carefully composed, starkly modulated tone that would define his mature work.

The opening of the film certainly maintains the brisker tempo of its predecessor, cutting quickly between a couple on a motorcycle joyride through the Quebec backwoods and doctors at a rural plastic surgery clinic discussing the medical (and monetary) potential of new techniques and bioengineered technology. When the former is involved in a terrible accident, the surgeons get the inadvertent chance to test their new methods on the woman, Rose (Marilyn Chambers), who has been badly burned and requires skin grafts. Using genetically modified skin, the doctors cover her wounds, but as the new skin adjusts to her body, it mutates and grows an appendage under her arm that stabs and feeds on others, in turn transforming them.

This subtle modification of the conceit of Shivers, replacing an external parasite with a completely internal mutation of one’s own flesh, hints at Cronenberg’s later explorations of the grotesquerie of the human body. In addition, the arduous process by which Rose starts an infection chain that can lead from the sticks all the way to the city necessitates patience from the director. Where the previous film swiftly escalated as an apartment complex became a petri dish, Rabid works slower, adopting the more clinical tone that would become Cronenberg’s calling card. The first act is as much a serious inquiry into the technological possibilities and existential questions that arise from experiments with new flesh as it is a slow-burn horror.

Shivers centered its action on a new apartment complex that promised all the comforts of modern living and state-of-the-art amenities, but architecture and interior design play a far more significant role here. Nestled among a forest stripped bare by winter chill, the plastic surgery clinic’s imposing modernist design—an unadorned block of brick housing with an interior of lacquered wood and glass—is all the more alienating for its shocking contrast with the natural environment. The clinic is then juxtaposed further with Montreal General Hospital, a building so massive that the entrance alone is several stories tall and Cronenberg’s camera must slowly tilt further and further upwards to capture the full height of the facility. When the disease finally reaches the city, it spreads like wildfire through Montreal’s metro system.

Yet even as the action escalates, society crumbles and martial law is enacted, the film maintains its atmosphere of curiosity. As gory as the appendage under Rose’s arm and the chaos that ensues from it is, Cronenberg remains resolutely fascinated by the concept of the human body’s malleability, rejecting the notion of our selves as fixed states in a world of accelerating medical understanding and technology. He’s also interested in how people might react to their changing nature: Chambers plays Rose not unlike Frankenstein’s monster, both beast and victim. Much of the film’s horror comes from her sorrowful inability to stop herself as she claims more victims, though both the actress and director play up the sexual undercurrents of Rose’s attacks. In the film’s most memorable scene, Rose, played by a pornographic actress, heads to an adult movie theater where a male patron attempts to hit on her. In a flash, Rose turns the tables on him, seducing him closer to feed on him in an unexpected but jolting change in personality.

Rabid was not Cronenberg’s first success as a director; indeed, Shivers was both a greater commercial and critical hit. Nonetheless, its use of both body horror and production design to manifest modern uncertainty in the self, mixed with its strong undercurrents of local political history (the October Crisis of Québec and the military crackdown that suppressed it are heavily referenced throughout), reveal immense depths beneath a surface of exploitation. The film feels like the director’s first work that is fully and unmistakably his, containing all the stylistic and tonal tics that he would rapidly develop over his next few features.

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