Pox: Genius, Madness and the Mysteries of Syphilis

  • Deborah Hayden
Basic Books, 2003 352 pp. hardcover, $27.50 ISBN 0465028810 | ISBN: 0-465-02881-0

The funny thing about syphilis is that it was historically more a middle-class disease than one that affected the working class. University students would contract it from prostitutes, experience the chancre and swollen lymph nodes characteristic of the primary infection, then forget about it. They would later marry, infect their wives and, at age 43—big surprise!—the syphilitic infiltration of the central nervous system would start to become evident. Therein lies the drama of this book.

Years after the primary infection had been forgotten, these men—now prosperous lawyers, judges, writers and musicians—would one day come home with a wagon of wine, or a costly painting, or nine wristwatches—evidence of the compulsive shopping that often accompanies mania, an early symptom of neurosyphilis.

Men whose syphilitic career proceeded to the symptomatic stages of neurosyphilis—at the time called 'paresis', 'general paralysis of the insane' or 'tabes dorsalis'—were inexorably doomed to a particularly horrible end stage in which they would die demented, paralyzed and beset by bedsores and convulsions. For unknown reasons, neurosyphilis affected far more men than women.

Hayden's book is not about syphilis, however, but about the celebrated, talented and powerful who developed these late-stage complications. The magnetic appeal of the book lies in poring over the medical histories of cultural and political heavy hitters of the past and determining that their talent was goosed by early mania, or their judgment dragged down by paresis. Like Oscar Wilde, they perhaps came to generally bad ends because of heedless dalliances many years earlier.

To us, it seems like the most colossal act of historic unfairness that a single encounter with a prostitute could reach out and ensnare a man's life decades later. Today, for the most part, we don't give syphilis much thought because of its eminent treatability. But there is no doubt that syphilis and its late-stage sequelae had major consequences in Western society of the early nineteenth century, when the spread of the primary infection to the central nervous system started to become common. It did not subside until 1917, when Viennese professor Julius Wagner-Jauregg devised the malarial-fever treatment, for which he received a Nobel Prize in 1927.

There were problems with the fever cure, too, however. The critical date in syphilis treatment is really 1943, when a staff physician at the US Public Health Service determined that all stages of the disease respond exquisitely to penicillin.

Hayden, a freelance scholar with no medical background, has done a creditable job of working up syphilology, a medical specialty that today has virtually ceased to exist. She sets out to retrospectively diagnose the famous, armed with a good understanding of the characteristic signs. Her list includes some candidates whose syphilitic infections have long been known: Franz Schubert, Charles Baudelaire and French novelist Guy de Maupassant. But there are some surprises on the list for whom she makes a plucky case: Abraham Lincoln and his wife, Oscar Wilde and James Joyce.

The biggest fish in Hayden's net is Hitler, although she fails to conclusively demonstrate that neurosyphilis was the basis of his aberrant behavior and bizarre medical ailments. She takes on literally hundreds of monographs and mounts a brave case, concluding that there is “enough evidence to warrant reopening the file.” At least Hayden rescues Hitler from the hands of the psychoanalysts who had held him in durance with speculative diagnoses related to his toilet training.

The book is a good read that readers with an interest in history might think of dragging along to the beach. But it is not really a contribution to scholarship because it is based almost entirely on secondary sources—primarily biographies of the protagonists and collections of their letters translated into English—rather than on archival research or letters and diaries in their original languages. Hayden strays occasionally from this schoolchild reliance upon the work of others—a foray into the archives at the University of California in Los Angeles for information on Wilde, for example. The great majority of her material comes, however, from the vast body of previous scholarship on such icons as Robert Schumann, Vincent van Gogh and James Joyce. Unfortunately, too many US-based journalists, though they aspire to big projects, are comfortable only in English.

The idea that the canon of creativity in Western society is modeled by pathology tugs at our curiosity. Hayden's book is reminiscent of Kay Redfield Jamison's Touched with Fire: Manic-Depressive Illness and the Artistic Temperament, which suggested that much of English literature was dictated by the vagaries of manic-depressive illness. Living up to that promise, this fluently written book makes for an engaging read.