George Gissing: A Fan's Commonplace Blog

Commonplace 3          George & Tuberculosis.

Medusa as the implacable and
omnipresent monster of TB 

Early years surrounded by the sick and diseased of Wakefield may have started the fear of ‘Demos’ that so warped George Gissing's humane sensibilities, though an abiding lack of empathy of almost autistic proportions did its part to form the misanthropic tendency he so often displayed. However, fear of incapacity and illness itself shaped his attitudes to the world and informed all parts of what he termed his 'mental development’.

His father, Thomas Gissing, being a pharmaceutical chemist, would probably have been expected to examine his customers when they came for medicines 'over the counter'. Many chemists, like physicians, made up their own treatments from recommendations in well-regarded pharmacopeias, or invented cures from their own scientific research with plants and existing herbals. The rise of the chemical industry was giving pharmacists a range of new ingredients to make use of, such as strychnine, iodine, mercury, bromides, and hypophosphates. The rise of vivisection gave them plenty of ways to trial their cures. Physicians often administered treatments both in their consulting rooms and in a patient’s home; the chemist might have a curtained off area of the shop, or a small room where customers could be examined before a cure was recommended. Some of these illnesses must have been the major contagions of the day: diphtheria, cholera, smallpox, polio, syphilis and tuberculosis.

Heroin sold as a cure for TB

The complaint George referred to as phthisis, is also known as consumption or pulmonary TB.

Tuberculosis is still one of the most destructive and feared diseases, and one of the commonest causes of the spread of tuberculosis was the disgusting habit of spitting in the street. One, can assume some of that pavement spittle was red. Infected sputum came into contact with shoes and so the disease could be taken unwittingly into the home. The lowest servant in the house would be responsible for cleaning boots and shoes - or the lowly working class wife would do it; exposure to contamination must have been a risk.

Coughing and sneezing, kissing, sharing drinking vessels, public baths and drinking fountains were also ways to acquire the disease. Whole families could be infected from one exposure at work, from milk, at school, playing in the street, or social mixing. The malnourished poor, who tended to have compromised immune systems, dwell in over-crowded housing with a lack of facilities for hygiene, would have had few natural defences to protect them from the ravages of this wasting disease. 

Thomas Gissing died at age 41 from 'congestion of the lung' contracted after a chill, but he had been concerned about his health for some time. He complained of 'chronic inflammation of the windpipe' and a persistent cough - both indicators of tuberculosis. And, William, George’s brother, suffered what was probably a pulmonary or aortic aneurysm that ruptured, possibly caused by TB weakening the pulmonary vessels - which led to his sad death at age 20.  

Infection with mycobacterium tuberculosis comes in many forms, affects every organ of the body and causes destruction wherever it breaks out. We think of it as chest disease, but it also affects the skin, the throat, kidneys, liver, genitals, the heart and blood vessels, the bones the brain. Even today, about 50% of those with active TB, eventually die of it, and it is still one of the biggest threats to public health in many developing countries.

Weight loss, persistent cough, night sweats, and malaise accompanied by haemoptysis (coughing up blood-stained sputum) are the main symptoms. George mentions a fixation with checking his mouth after coughing in case he found blood in his sputum - William complained of sporadic haemoptysis and chest pain. 

Gissing’s Letters and Diaries frequently mention colds and bronchitis which could be attributable to phthisis but throughout the early 1890s, there were several outbreaks of influenza that laid low many communities. Anyone with a chest weakened by TB was likely to catch the ‘flu. We are used to thinking of this as a mild infection, but Sir Arthur Conan Doyle, free of TB, mentions in his autobiography how he nearly died of the 'flu – and he was a strapping man in the fullest of robust health, a vigorous sportsman (a football goalkeeper!) and used to exposure to various ailments at his Southsea GP practice.   
George mistakenly believed colds are caused by weather - warmth in particular seemed to flummox him. Obsessions with sandy foundations, altitude, damp, light and the lack of it seem to have affected his mood much as did the vile surroundings of the street. Pulmonary TB is known to improve markedly in high altitudes and dry climates - hence the prevalence for treatment centres in the Rocky Mountains and the Alps. Avoiding warm and wet climates was recommended. William also complained of the heat and damp affecting his chest complaint.

Image: Wikipedia

Of course, George was a heavy smoker. He experimented with giving it up, but could never quite break the habit. Later, he claimed his doctor advised against giving it up as it did him good to smoke. This echoes the (nowadays) outrageous claims made by the tobacco industry back in the twentieth century. I can remember in the 1950s smokers with 'smoker's cough' first thing in the morning saying they were convinced this cough was a healthful result of smoking because they believed without this hacking cough all manner of filth accumulated in the lungs. And this, despite the dangers of lung disease being caused by smoking made in 1912 and 1929.

Apart from cancer, smoking causes coronary heart disease and chronic obstructive pulmonary disease (COPD), a lung disease that often includes chronic bronchitis and emphysema in its wake. We know George thought he had emphysema because he mentions it several times. However, it would not be implausible to think this was George’s wishful thinking, even denial, about his consumption. A good deal of the letters to Gabrielle contain reassurances to her that he doesn't have serious lung disease - ie consumption - whilst clearly demonstrating that he does have some very serious defects. Sensing that he had almost left it too late to find a soul mate and nurse, he goes to great lengths to blame his condition on Edith and the hard life he'd had - a condition which could only be ameliorated by the love of a good woman. He later reiterates the popularly-held belief that good food and a robust body weight are signs he has no consumption - called 'consumption' because of its tendency to cachexia or drastic all-over weight loss. His subsequent obsession with food in his French household may have its roots in a fear of weight loss, but he may also have needed extra food to offset the actual wasting of TB. Mrs Wells knew how to fatten him up when he stayed with the Wellses and Nayland Clinic (a specialist sanatorium for consumptives) offered a food-centric cure that must have been quite mind-boggling. Of course, to have an adequate body weight was still a sign the ravages of consumption had not yet struck. 

Sleep and his Half Brother Death 1874
by John William Waterhouse is a tribute to the artist's brothers who died of TB 

Back in his days with Edith, George’s friend from the Wakefield days and sometime surrogate parent for young Walter, took George to see a lung specialist, Dr Philip Pye-Smith, who told his patient he did not yet have the active form of TB but if his living conditions did not improve, he soon would have. Perhaps the strain of his unhappy second marriage brought the physical defences so low that the TB broke out and developed into the pulmonary version. He wrote to Gabrielle that he was glad she realised emphysema could be caused by mental suffering. Of course, we now know what he was referring to is the psychosomatic response to stress, or even a veiled reference to something worse than TB.

Earlier, George’s physician, Dr Beaumont had diagnosed a ‘patch’ on his lung, after George went to see him about chronic coughing, bronchitis and shortness of breath, When he told Edith, she berated him for bringing TB into the house. However, as far back as 1890 when 

Nymphs and Satyr by William-Adolphe Bouguereau 1973

George was on his Ionian journey in the town of Cotrone, when he developed 'malaria', the attending physician, Dr Sculco, discussed with him 'congestion' and a patch on his right lung. Was it really malaria? Or something more insidious, shameful and incurable? Something like syphilis?

In the love letters, George sent to Gabrielle in the early days of his romantic suit, he claimed to have had 'weakness in the chest' for only two years, when in fact it was for a lot more. George was capable of  'economies of truth' and confabulation and downright lying, at times - though this tended to be from a position of weakness, not strength, As manipulative as he was, he was not aware of how much he deceived himself as much as he did so many others.  That he only suffered from the pulmonary form in his thirties is in keeping with a disease that could have been dormant for many years before overwhelming his immune system. As Marianne, his first wife, also known as Nell,  had been diagnosed with scrofula, a form on TB, it might seem entirely fitting that Gissing could have contracted it from her, but this is also equally unlikely – the streets of Wakefield, Manchester, London, Boston, Chicago would have been awash with infected spittle and thronged with infected people. Accepting fully that consumption carried a social stigma of dirt, was there anything else about this disease that made George ashamed of having it? Again, we must consider something just as sinister; maybe even more shameful - syphilis.

I recently read an interesting article on the Guardian's webpage. It was an edited version of a preface to a new edition of Lady Chatterley's Lover by DH Lawrence, and written by Doris Lessing. It has been well-established that there are many similarities between Gissing and DH Lawrence, not least in that they both suffered from the disease that determined so much of their lives. Ms Lessing, writing about Lawrence, gives this rationale:

'First, he was dying of tuberculosis, but he was, as we put it, in denial, though it had been properly diagnosed, and with part of his mind he knew the truth. He had always had "a weak chest": in those days this was often a euphemism for tuberculosis. Even as a young man he had suffered all kinds of pneumonia, bronchitis, colds, coughs. It looks as if he succumbed to the great flu epidemic of 1918-19. Yet he refused to admit to tuberculosis, talked of his bronchials, his colds, his coughs, he had caught a chill - anything but TB. And this was strange in a man who valued the truth, and clear thinking and speaking, particularly on physical matters.

He had the temperament that goes with tuberculosis: hypersensitive, excitable. Very irritable, are these sufferers, given to explosions of temper. They know their time is short. They are reminded of their deaths with every rattling breath, every cough. The incessant coughing of Lawrence's later years got him thrown out of hotels, meant he had to choose his lodgings with care. As a young man Lawrence had been proud of his body, his "weak chest" notwithstanding. What comes out of the earlier novels, particularly The White Peacock, is the picture of a youth at home in the countryside, with friends, alert to every bird, animal, insect, plant. He could have said with John Clare, "I love wild things almost to foolishness."…  This body-proud countryman with "a weak chest" became the man whose rotting body filled him with miserable self-loathing. So many weltering aggravating emotions were at work in this very ill man as he wrote and rewrote Lady Chatterley's Lover

His wife Frieda was having an affair with a lusty Italian, and Lawrence knew it. Never the most tactful of women, she did not go out of her way to conceal her assignations. She did not spare his feelings in anything. She is supposed to have told friends that Lawrence had been impotent since 1926 .... Tuberculosis does two unkind contradictory things: it heightens sexuality and its feverish imaginings, and it causes impotence.'


From the Wellcome archive

What was the impact tuberculosis had on George? Ms Lessing's take on Lawrence in some ways fits our man, George spoke of his own debilitating, unfulfilled longings which are generally regarded as sexual frustration. He wrote of the tyranny of expecting young men to have to marry to be sexually active. He longed for love until the keening drove him neurotic with desire - for any sort of intimate connection, I think he saw this need for sex as a sign of personal weakness as much as it was a Darwinian imperative. Either way, it contained very little joy.

He seems to be both attracted and repelled by the sex he makes his characters sign up for - do any of them ever spontaneously break out and ravish each other? 

So, intensified sexual longings coupled with the inability to perform sexual intercourse could have haunted George, and might have been the reason he did not appear to have a sexual relationship with Gabrielle. Lack of fully-potent sex experience - what Maud Lebowski refers to as a 'zestful' activity - dominates the relationships he draws as if he fails to feel real feelings for the topic of sexual love himself and so cannot accurately describe the process. George's men are always driven to sex like it is an inevitable doom - the price men pay for their innate dominance over women, and a hollow, soulless chore. Was it his own lack of knowledge of the simple joys involved in erotic sensual intimacy that makes George's fictional accounts of lovemaking so loaded with anomie, and unerotic? His characters over-think everything at the expense of action, not because they are not animal sexual but because they are superficially 'civilized' or live on the ethereal film above reality, not down in the depths - which is what George hated most about Demos, in his misreading of the working classes. Demos with its lascivious lust for life would be a harsh reminder of his own lack of robust manliness. He certainly did not experience erotic love with his second and third life partners - only with his first, back in the days before tuberculosis claimed them both. However, giving oneself up to the sex urge is to lose control and George was nothing if not a control freak. Maybe the panic this loss of control invoked in him when he had unfettered access to the erotic pleasures of his love with Marianne unsettled him so much he ran from it and never went back - which is why tuberculosis might have been a positive force, on an unconscious level: an acceptable reason for emotional impotence as much as sexual.