Sunday 30 November 2014

Commonplace 25   George & His Health. So Much More Than Man Flu.
Aesculapius - Greek God of Healing
George suffered from a range of ailments over his relatively short life, cataloguing them in the Diaries, along with any treatment or intervention used. This might seem like a morbid way of carrying on - guaranteed to depress anyone. Before the time of antibiotics, x-rays and all manner of medicines we now take so for granted, most diseases were not fully understood or diagnosed. Syphilis, the 'great imitator' was often mistaken for cancer or any form of TB. I recently totted up the number of skin lesions syphilis is still routinely mistaken for - and stopped at 28. click and follow link for complete article

In a time of poor standards of health amongst the vast majority of the population, it is easy to see why everyone must have monitored the state of their own health - and that of their associates - obsessively, especially within the middle class who had the education to research their ills and the money to pay for cures. Indeed, over the course of his recorded life-story, so often is George ill, that it is a remarkable thing when he records he feels well.

Over the counter American cure
circa 1878.
One of the first bits of intelligence on record about George's state of health is that infamous letter from John George Black back in the Owens days. John writes not exactly in great distress, to consult George about the state of his penis. It appears George is a penis health expert, having been afflicted with some sort of malady in that direction, himself. Odd that George, ever the prude should discuss his private parts with another fellow (a very modern notion, I always presumed), but there is 'nowt as queer as folk' - as they say in Yorkshire. As George had a background of sorts in medicine by being the son of a dispensing chemist, presumably he was in a good position to feel such matters as sexual health advice were very much his sphere of expertise. We are talking of spring 1876 when George was 18. John is a little older, but a whole lot less knowledgeable because it is the older chap who needs guidance about the blebs on his penis, and some sort of supplementary advice about what George had to do about his own infection - assumed to have been treated by Dr Wahltuch. Was John George what might be termed a bad influence, or was it the other way round?
George had gastric problems which might have been a bit of wheat intolerance.

We know George had phthisis, the pulmonary form of TB, because he tells us he has it. Worries about his chest in the form of bronchitis, catarrh, coughs, sore throats, endless colds - does George hold the record for the number of sore throats suffered by any writer in the English language? A sore throat and a cold seemed to break out at every change in circumstance or fleeting weather condition, change of location, sea voyage, train ride, long walk, lack of long walk.... Wind, sun, rain, snow - all brought George out in some sort of ailment. And then there were the mystery complaints with no real specific features - generalised anxieties, feelings of doom and unwellness, emotional crises, suicidal thoughts, various skin rashes, lumps... All these seemingly trivial ailments could have been systemic TB - but could just as easily have been the signs and symptoms of syphilis. Generalised feelings of unwellness, vague sensations in bodily systems...  mighty suspicious.


George also complained of trouble with 'rheumatism' in his shoulders. Apart from the cold and damp living conditions he sometimes endured, and the wet weather of wherever he walked, the endless weight of wet clothes, also the posture sat at the writing desk, or in an armchair could produce trouble with the joints and muscles. However, in George's day, the term 'rheumatism' meant aches and pains generally and did not refer to a specific condition. Nowadays, there is no such thing as 'rheumatism' as a diagnosis - it is referred to as 'rheumatoid disease'. It is not a result of living on wet foundations or wearing wet clothes or feeling the cold - it is an auto-immune condition with no known aetiology, presenting as swollen and painful joints. Did George have this? Auto-immune disease is not a twenty-first century condition so it is possible he had a form of it, contracted from any one of the predisposing factors of stress, immune reaction to viruses and diseases, even environmental pollutants. click for more

What about his tendency to solitude and solitary fretting?

We know George physically isolated himself from company refusing most of the social invites he received. More pernicious was the removing himself emotionally and sympathetically from his fellow human beings - his loneliness was deep-seated anomie. Such a dislocation of social interactions and the self-imposed solitude must have affected his wellbeing. This is a characteristic of the tertiary stage of syphilis - but there is no hard evidence this was the actual cause of his antisocial tendencies. However, he began this attitude early in his adult life, about the time that syphilis might begin to impact on personality, and so these changes might have alerted him to the possibility he was approaching the latter stages of the disease. He often spoke of dying young - was this because William, his brother, had died very young, and his father, too? Was George afraid the signs of syphilis might prove shameful if his friends discovered them. Whenever there were eruptions or manifestations of systemic disease, it would be embarrassing to turn up for a social event, and have the women scared off by his disease. Men of the world like Frederic Harrison would not have over- reacted, but Mrs Harrison might have had friends she was wanting to shield. Having said that, Harrison probably knew about it and told his wife - they were both intelligent and worldly.

George certainly lived in challenging environments both inside and out of, the home. One thinks of the filth clogging the streets of any large conurbation, the smoke, the cancerous fumes of industry, the filth of the waterways, the dirt of Demos (I am thinking as he would have). Stress will have paid its part in undermining his immune system - something we understand a little of now, but an unknown concept in George's day. Endless worry over real life and making money, fear of his past being exposed, fretting over marital discord, the dreadfulness of servants, the lack of zestful sex, the nationwide lack of interest in Greek poetry, the dread of taint from mixing with inferiors, and the ever-present threat of rain, could have triggered and auto-immune response that brought about the condition, but, what else might it be?


Extra-pulmonary (ie, not situated in the lungs) TB of the bones: Pott's Disease. What George describes as being located in his shoulders, was probably a problem in his spinal column -  Pott's affects the major bones but the thoracic vertebrae are a common seat of degeneration. Towards the end of his life, George was plagued with what he termed 'sciatica' - again, this could be Pott's Disease of the lower back, long leg bones, and the hip girdle. Added to the phthisis symptoms of bronchitis and colds, the bouts of diarrhoea and pains in the groin (inflammation of the testicles 05/10/95!!) - a diagnosis of TB in many of its forms is probable - the skin lesion on his forehead, the problems with his heart - almost every ailment he suffered from can be laid at the feet of TB. And syphilis.
Cures Consumption???
When he was on his 1897 tour of Italy, George contracted what he initially reported as a severe cold but which was, in fact, an exacerbation of his phthisis in the right lung - 'that old enemy' is how he describes it. His physician, Dr Sculco, recommended a double dose of quinine powders, which George took - and then tripped out on the side effects. he suffered fever and
delirium:
I saw wonderful pictures, beginning with pictured vases, and sepulchral tablets, and passing on to scenes of ancient City life, crowded streets, processions, armies etc. The remarkable feature was the bright and exquisite colouring of everything. Marvellous detail, such as I could not possibly imagine of myself. Scenes succeeded each other without my ever knowing what would come next. A delight - in spite of my feverish suffering. Lovely faces, on friezes, tombs, and vases. Landscape flooded with sunshine.

Perhaps quinine working on the brain - or was it perhaps the beginnings of the brain variant of TB that pre-empted his first wife's heroic struggle or the neurosyphilis/paresis I suspect caused Edith's mental collapse? Quinine was routinely prescribed for syphilis in its tertiary stage; symptoms of tertiary syphilis, with a slow onset, might explain George's frequent severe headaches, the insomnia that left him exhausted, the lack of application to his work, the obsession with Veranilda and its research, the lack of feeling for his fellow beings (but not animals) the depression of affect that dogged him and made life so difficult - even his deteriorating eyesight. it would explain why he tried so many cures - all the latest fads he followed - from creosote to cod liver oil, from vegetarianism to cold baths - and all the stuff Gabrielle recommended in her letters. Who knows how he contracted TB - probably way back in his childhood, in those Wakefield chemist shop days, perhaps, or walking the spit-streaked streets of Manchester, London, Boston, Chicago. He contracted syphilis at Owens College - when he was not much more than a boy. No wonder he was messed up in his mind about so many things - Fate had dealt him a severe blow.

Say 'Ah'.
Like many men, George was not mentally equipped to handle ill-health, despite his close association with it, and his home circumstances did not support adequate nursing care. This is what did for Marianne, of course: chronic illness played out in an environment of great adversity. I wonder if he ever gave her a second thought after her death? When he was laid up in agony and lonely fear of death, did he ever wish he had been more supportive - more sympathetic - to her? Did he come to understand her more deeply? Towards the end of his life, those last few years with Gabrielle, when he had ensured he had a helpmate to care for him, did he ever wish he had been more... kind-hearted... to his first wife? Marianne was denied nursing care at the end: 15/- a week does not stretch to paid staff. As he revised and cut and paste his diaries, did he consciously expunge the entries that demonstrated his lack of feeling towards her? Did shame for how he treated her bring him to decide to destroy all reference to Marianne - not because of her past but because of his heartlessness? Of course, that self-serving stage-managed description of the pathos of her Dickensian death scene and burial arrangements was kept in (probably reworked for maximum effect) so that posterity might be led to believe he did all he could for her. Frankly, Mr Gissing: No, you didn't. At your end you had friends and loved ones around you. Heroic Marianne had no-one.



World TB Day is always March 24th - to commemorate the discovery of the TB bacillus by Robert Koch (1882).
For fascinating info on TB:
http://tbsymptoms.net/
AND
http://www.slideshare.net/ashrafeladawy/history-of-tb

All medicine ads come from the Wellcome Institute website http://www.wellcomecollection.org/tonics-and-curatives/?image=25

George's Diary is the usual one with the very long title ed. Pierre Coustillas, bless him.

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