One hobby of mine is trying to imagine what it would be like if elephants developed human-level communication and thus civilization. They are close enough that it seems like a coincidence of evolution that apes got there and elephants didn't: maybe ape brains were selected somewhat differently, or maybe we went through moments of high evolutionary pressure (and survived), where elephants didn't (or like the woolly mammoths, didn't survive).

Imagining how a civilization might develop with musth is interesting: it seems biologically antisocial, like periodic insanity. Would there be pressure to self-regulate? Ostracism during that time? Evolutionary selection against musth?

It feels like there's an analogous suspicion and fear of human men as well, similarly peaking for adolescent humans, like adolescent elephants, who are least able to self-regulate. But the fears would be much stronger in elephants, and so acute since musth is temporary and outwardly visible.

If not ostracism, what social pressure could be applied via punishment? Elephants' scale would require different approaches: for instance, I don't believe any number of elephants could work together to lift another elephant. Elephants would have a degree of physical autonomy that, while not unbounded, would be greater than humans: they can hurt each other, but not subdue except through threat. And if you are crazy on hormones a threat might not be enough!