Commonplace 64 George & Syphilis PART THREE From Paresis To The Ionian Sea and Beyond.
There is no escape for you. From poor you shall become poorer; the older you grow, the lower you shall sink in want and misery; at the end there is waiting for you, one and all, a death in abandonment and despair. This is Hell! - Hell!- Hell! - Mad Jack in The Nether World
Syphilis, of course, brings on madness and suffering and eventual death, but between the beginning and the end, something terrific happens to you. You kind of explode in your head and are capable of genius - Susan Sontag.
Here, Sontag is describing PARESIS the aspect of syphilis known by its mnemonic:
Personality disturbance Affect disturbance Reflex hyperactivity Eye abnormality Sensorium changes
Intellectual impairment Slurred speech
Of all the insults to the body and mind that syphilis brings, it is the tertiary stage, with its tabes dorsalis and paresis that finally destroys the human in human beings. It can transform a personality beyond all recognition. remove all dignity and purpose, reduce intellect and inculcate madness with terrifying delusions and hallucinations. Friedrich Nietzsche was a suffer and lived locked in an attic for the last several years of his life, blighted by syphilitic disease, avoiding all company, being cared for by his sister, Elizabeth. For a basic exploration of paresis (also known as General Paresis of the Insane) click. In her fascinating book 'POX, Genius, Madness and the Mysteries of Syphilis', Deborah Hayden click (an education in itself, this link) describes the many signs and symptoms of paresis and how it affected the likes of Flaubert, Van Gogh, and Abraham Lincoln.
To briefly recap: Nature has imposed no set rules for syphilis. Not everyone exposed to the bacterium will contract the disease; not everyone who has it will rot away. Some sufferers can go a whole lifetime and not suffer its worst consequences - some work through the disease to its final triumph in a few years. There is no knowing where it will set up home, but untreated, it will gradually take over its host and produce decay. You can almost admire it for its infinite flexibility, its perseverance and the stealth with which it operates. In a time of Darwinian notions of 'survival of the fittest', the Victorians came to realise syphilis was fitter than most for survival in their world.
By The Ionian Sea contains some of George's most personal writing. For those who find the novels not to their taste (idiots! These are the ones who have to be reminded The Private Papers of Henry Ryecroft is fiction) can find much to admire in his criticism and non-fiction. Apart from the book covering what was, for its author, the realisation of a life's ambition, it is also George wide open to 'being in the moment', to feeling without self-censorship or self-consciousness. He is vulnerable, acutely in tune with his world, and at times, joyful; there are moments when it feels intense and mystical, and you sense he will never be the same again for taking this journey to the place he has spent so much time thinking and dreaming of. There is a moment where he moans that he should have had someone to accompany him (so he could have an audience for all his gushings?) but he never would have written such a good book if he had discharged all that energy in conversation; it needed to be pent up and then allowed to flow when he was back home in his writing chair. Morley Roberts said this trip is what changed George from seeing only in monochrome, to suddenly waking up to a world of colour - and how transformative that was for our man. (It's well worth rereading The Private Life of Henry Maitland again for all the good bits Roberts gives us, in between the toss.) This is a crucial piece of evidence - if George underwent some sort of crisis brought on by tertiary syphilis, in the form of paresis, then a diagnosis becomes clear. Possible signs of paresis are in blue.
It was a trip George made his mind up to take back in August of 1897 when he was enjoying a holiday with Edith and the children in Castle Bolton (I say 'enjoy', but that's not how George saw it, and no-one else was enjoying it, either). It was at this time George reported Walter (who was bused in from Wakefield for the hols) had a fine feeling for Greece - when the little boy mentioned some clouds looking like Greek mountains. The infamous shaving brush argument made its deep impression on George - and Edith had accused him of being in a foul temper for ages, and he resented this feedback. This was August. Let's go back to the beginning of 1897, and take a look at George's health and general wellbeing for signs something syphilitic was brewing in his economy.
From the Diaries, he reports that on January 25th he has a bad headache. As the year progresses he can't settle to a new writing project - the unknown to us, disappeared, 'Polly Brill' - a state of affairs that endured throughout late January; from February 10th there is a break in entries of almost four months. On June 2nd, he recounts what has happened: arguments with Edith 'drove him from home' to Romney and his old friend Henry Hick - George was so worried about his health he sought refuge in a place of sympathy. As ever with big decisions - in this case, to abandon Edith forever - he needed someone else to make the decision for him. See Commonplace 57 for what HG Wells said Henry Hick had to say about this. (Was this a paretic crisis where his physical and mental health were reaching some sort of a crescendo?) He stayed there a week, and Hick examined his chest, found it required an expert opinion, and went with George to London to consult Dr Pye-Smith, who told George to go to Devon to recuperate. Off he went to Budleigh Salterton.
He stayed there until May 31st, 'solely attending to my health'. The Whirlpool was published - all 2000 copies sold by the end of May.
Over this period in Devon George was reading about the Ostrogoths and formulating his great opus about Veranilda. (Was this project an example of delusional grandiosity? A preoccupation with gods, royalty, myths and legends, marching triumphal armies all point that way. And, did he pursue his subject to the point of obsession?)
He returned home to Edith and Alfred on May 31st.
June 1st went to Pye-Smith again - who said he was better but must look to live on high, dry soil (not Budleigh, then haha).
June 7th - the Rothenstein drawings are completed (see above). George liked the standing one best.
June 8th thinking up The Town Traveller. Between June 9th and July 14th he averages just under 3 pages of the manuscript a working day - 102 pages in all. Which is a lot of words in George's minute script. Is this a sign of the paresis clearing his mind and providing impetus to complete projects?
On July7th, he reports he is suffering badly with rheumatism. July 10th, he has been awake all night, but says he doesn't feel any adverse effects. On July 14th, the book is finished and posted off.
August 28th, he has a bad headache.
September 6th he told Edith he was going to Italy (he had been secretly planning it for weeks). This would mean the lease on their house was ended and Edith and Alfred were, effectively, homeless. George notes how distressed she was at this shock news, but he doesn't care. Miss Orme, one of his adoring female easily manipulated minions, is looking for a place for them to live, but then the decision is taken: Edith and Alfred have to go and live with Miss Orme. Evidence of lack of affect and empathy? No, that was always a feature...
Here is the diary of his ailments during the first part of his Italy trip, leading up to the famous febrile crisis:
September
25th sore throat - 'Throat causing much suffering'. Arrived in Siena (where he was to write his Dickens pieces). Suppressed immune response?
26th throat better, cold gone to head.
30th My cold practically gone, but as usual, it has left a bad cough
October
2nd My cough very troublesome
7th Dare not go out in the evening. Yesterday, and in the night, my cough was very bad. I noticed an unmistakable stain of blood on my handkerchief once. (Hemoptysis can be caused by coughing too hard - and isn't always sign of something sinister, However, given the medical history...)
8th Going to take some olive oil every morning; see if it will help me. Bad fit of coughing last night.
10th. Had a bath... and got weighed...77 and 1/2 kilos (12 stone 2 pounds). Still losing from my Budleigh Salterton weight. I have begun to take olive oil, and I think it does me good. Cough very slight now.
On 29th October, George writes this, after a short period of a few hours of not being able to write: Then, to my surprise, I felt able to write again, and by 5.30 had done my second page. How impossible, this, a few years ago! It is strange how much more control I am getting over myself... An example of the effects of paresis removing blocks to creative flow?
30th Suffering much from diarrhoea. Digestive disorders.
31st Diarrhoea still troublesome.
November
2nd Suffering much from the cold in this sunless room.
3rd Aching fingers. Formication?
7th Suffering much from liver. Unable to walk. This is a profound indicator something is seriously wrong - not with the digestion. Pain over the site of the liver (in the lower back) can be a sign of tabes dorsalis in its early stages. To be rendered immobile could be a sign the spinal cord was involved. All that lumbago he suffered was another sign of this.
15th No appetite and a little feverish.
17th Went to bed with my headache.
22nd George's 40th birthday
27th Towards night felt feverish, and had a very bad night, sleepless.
28th feeling so ill this morning, that, after a short walk, I decided to send for a doctor. He came at 4 o'clock, said I had caught cold, and must go to bed...
29th fever going on... (The doctor) made me take two of my quinine powders...two hours later I had to take another dose. The result of all this quinine was an extraordinary night - reminding me of De Quincey's opium visions. 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 and tombs and vases. Landscape flooded with sunshine. There is a condition caused by quinine overdose - cinchonism - but what George describes does not fit that picture click. Neither does it fit malaria click You could not have a clearer description of a paretic crisis; grandiosity, hallucinations, sensory overload... as experienced by Van Gogh, Nietzsche, Flaubert et al.
30th ...Told him (Dr Sculco) of my strange night, and he was much impressed, - looked at me oddly.
Was this because Dr Sculco assumed George knew he was having a syphilitic paretic crisis which is why he had travelled with a supply of quinine powders of his own with him? Because in quinine was prescribed for syphilitic patients who could not tolerate mercury, and was, by the 1920s, one of the main treatments for the disease click. If Dr Sculco had examined George he would have been able to see signs of the venereal disease, but delicacy might have prevented him from mentioning it to a tourist, passing through. (Or, George could be editing his Diaries to exclude the real problem.)
Let's pause here to reflect. In the twentieth century, a clear link was established between high fevers and remission from the worst of the symptoms of GPI - General Paresis/Paralysis of the Insane. The only Nobel Prize for Medicine ever awarded to a psychiatrist was given to Austrian physician Julius Wagner-Jauregg who won the Nobel Prize for his invention of malaria therapy (that is, inoculating a GPI sufferer with malaria protozoans) as a treatment for the relief of GPI.
December
1st Beginning to feel better, There has been a good deal of congestion of the that old enemy, the right lung...
2nd Much better...Doctor often refers to my 'visions' as he calls them. Is the doctor suspicious? Perhaps he wasn't sure George knew his diagnosis.
3rd All fever gone. Able to get up.
4th Able to get up... Doctor called for the last time and gave me a prescription for a 'cure' of the right lung. If Dr Sculco realised George was suffering from latent syphilis, this prescription might have been something to deal with this. George's lung problems are always assumed to by phthisis but might very well have been syphilitic in origin. George does not say what Dr Sculco had diagnosed as the problem in the lung or the nature of the 'cure'.
5th I myself feel inwardly better but a little shaky.
6th Have a slight cold in the head,
7th Cricelli took me lastly to a chemist's shop.
No entries regarding health until...
26th Cold very severe. No doubt as a result of it, I have a swollen gland behind the right ear - very painful. Gummas are painful swellings associated with all stages of secondary and beyond syphilis: The course of thegummata is very chronic. This syphilide may occur on the scalp, the face or the neck; its favorite sites are on the extremities, near the joints, the back more frequently than the chest, very often upon the gluteal regions, rarely upon the lower part of the abdomen, never on the palms or soles. click
In October 1902, George wrote to Henry Hick: By the bye, you remember that patch of skin-disease on my forehead? Nothing would touch it; it has lasted for more than 2 years, and was steadily extending itself, when at last, a fortnight ago, I was advised to try Iodide Potassium. Result - perfect cure after one week's treatment! I had resigned myself to being disfigured for the rest of my life; the rapidity of the cure is extraordinary. I am thinking of substituting Iodide of Potassium for coffee at breakfast and wine at the other meals. I am meditating a poem in its praise.
Henry Hick replied that a 'half educated' person would know this to be a treatment for syphilis. Now, biographers of a certain persuasion might reject this remark as Hick being facetious... For example, one biographer states emphatically that George had a patch of psoriasis - not syphilitic lesion - on his forehead, and that iodide of potassium would remove this. Well, the fact is, iodide of potassium is more likely to cause psoriasis than cure it click. This abstract outlines research suggesting psoriasis is actually aggravated by the drug. So it seems Dr Hick's was the more accurate diagnosis.
JOIN ME IN PART FOUR FOR THE SAD STORY OF EDITH GISSING AND HER FATE AT THE HANDS OF SYPHILIS
There is no escape for you. From poor you shall become poorer; the older you grow, the lower you shall sink in want and misery; at the end there is waiting for you, one and all, a death in abandonment and despair. This is Hell! - Hell!- Hell! - Mad Jack in The Nether World
 |
| The Borghese Gladiator by Agasias of Ephesus c 100 BCE |
Here, Sontag is describing PARESIS the aspect of syphilis known by its mnemonic:
Personality disturbance Affect disturbance Reflex hyperactivity Eye abnormality Sensorium changes
Intellectual impairment Slurred speech
 |
| The Dying Gaul Roman copy of lost Hellenic statue from 300 BCE |
Of all the insults to the body and mind that syphilis brings, it is the tertiary stage, with its tabes dorsalis and paresis that finally destroys the human in human beings. It can transform a personality beyond all recognition. remove all dignity and purpose, reduce intellect and inculcate madness with terrifying delusions and hallucinations. Friedrich Nietzsche was a suffer and lived locked in an attic for the last several years of his life, blighted by syphilitic disease, avoiding all company, being cared for by his sister, Elizabeth. For a basic exploration of paresis (also known as General Paresis of the Insane) click. In her fascinating book 'POX, Genius, Madness and the Mysteries of Syphilis', Deborah Hayden click (an education in itself, this link) describes the many signs and symptoms of paresis and how it affected the likes of Flaubert, Van Gogh, and Abraham Lincoln.
To briefly recap: Nature has imposed no set rules for syphilis. Not everyone exposed to the bacterium will contract the disease; not everyone who has it will rot away. Some sufferers can go a whole lifetime and not suffer its worst consequences - some work through the disease to its final triumph in a few years. There is no knowing where it will set up home, but untreated, it will gradually take over its host and produce decay. You can almost admire it for its infinite flexibility, its perseverance and the stealth with which it operates. In a time of Darwinian notions of 'survival of the fittest', the Victorians came to realise syphilis was fitter than most for survival in their world.
On
the down side of syphilis - apart from being disfigured, contagious and likely to beget children with teratologic deformities - there is a plethora of unwanted, debilitating signs and symptoms:
pain, paralysis, headaches, insomnia, fevers, rashes, visual difficulties,
gastric upset, cachexia (characterised by weight loss and loss of energy)
suppressed immune response, palpitations, indigestion, fits, depression and
hypermanic mood swings, aggression, grandiose or paranoid delusions, megalomania
, paraesthesia and formication click,
nightmares, sensory hallucinations and delusions, poor concentration, sensory
overload, obsessional thinking and behaviour, monomania, loss of empathy and
affect - or an over-abundance of empathy and affect. Just for starters. And
then there is tabes dorsalis and paresis.
 |
| Bacchus. Roman copy of Greek statue of Dionysus 200 CE |
Paresis is characterised by the way it dominates and destroys the nervous system and brain, affecting the intellect, imagination, personality, memory - all the functions that make up the person. As Susan Sontag suggests (and Deborah Hayden describes), on the way to extinction, a person can rise like a phoenix and exhibit wondrous facility with creative projects, have new ideas, or experience immense transcendent moments of clarity, fuelled by raging, manic highs of gargantuan proportion. Creative blocks fall away - the wildly manic muse moves in and sets up home in the imagination. For some, the mind totally clears, and all plans, fixations, theories, and projects become completable. Nietzsche produced some of his most ground-breaking writings when he was exploding with ideas under the influence of paresis. As for George, was his late flowering brilliance a sign he, too was afflicted with it? As this process seems to have begun in the early 1890s, could paresis be responsible for the excellent work that came after The Nether World - and not to be laid at the door of the sexual release he had with his second wife, Edith (as many claim - they would rather George be taken for a sex god than a sick man)? His Dickens criticism, The Private Papers of Henry Ryecroft, and By The Ionian Sea, short-stories and short and lighter in theme pieces - its the variety of genres and themes, moods and settings, the quantity of excellent work that suggests some sort of radical change has come over him for the last five years of his life.
 |
| Augustus of Prima Porta 100 CE |
 |
| Young Roman slave bronze c 300 CE |
It was a trip George made his mind up to take back in August of 1897 when he was enjoying a holiday with Edith and the children in Castle Bolton (I say 'enjoy', but that's not how George saw it, and no-one else was enjoying it, either). It was at this time George reported Walter (who was bused in from Wakefield for the hols) had a fine feeling for Greece - when the little boy mentioned some clouds looking like Greek mountains. The infamous shaving brush argument made its deep impression on George - and Edith had accused him of being in a foul temper for ages, and he resented this feedback. This was August. Let's go back to the beginning of 1897, and take a look at George's health and general wellbeing for signs something syphilitic was brewing in his economy.
 |
| The Rothenstein drawing that George liked. |
He stayed there until May 31st, 'solely attending to my health'. The Whirlpool was published - all 2000 copies sold by the end of May.
Over this period in Devon George was reading about the Ostrogoths and formulating his great opus about Veranilda. (Was this project an example of delusional grandiosity? A preoccupation with gods, royalty, myths and legends, marching triumphal armies all point that way. And, did he pursue his subject to the point of obsession?)
He returned home to Edith and Alfred on May 31st.
June 1st went to Pye-Smith again - who said he was better but must look to live on high, dry soil (not Budleigh, then haha).
June 7th - the Rothenstein drawings are completed (see above). George liked the standing one best.
June 8th thinking up The Town Traveller. Between June 9th and July 14th he averages just under 3 pages of the manuscript a working day - 102 pages in all. Which is a lot of words in George's minute script. Is this a sign of the paresis clearing his mind and providing impetus to complete projects?
On July7th, he reports he is suffering badly with rheumatism. July 10th, he has been awake all night, but says he doesn't feel any adverse effects. On July 14th, the book is finished and posted off.
August 28th, he has a bad headache.
September 6th he told Edith he was going to Italy (he had been secretly planning it for weeks). This would mean the lease on their house was ended and Edith and Alfred were, effectively, homeless. George notes how distressed she was at this shock news, but he doesn't care. Miss Orme, one of his adoring female easily manipulated minions, is looking for a place for them to live, but then the decision is taken: Edith and Alfred have to go and live with Miss Orme. Evidence of lack of affect and empathy? No, that was always a feature...
 |
| Relief of Emperor Lucius Verus c 166-70 CE |
September
25th sore throat - 'Throat causing much suffering'. Arrived in Siena (where he was to write his Dickens pieces). Suppressed immune response?
26th throat better, cold gone to head.
30th My cold practically gone, but as usual, it has left a bad cough
October
2nd My cough very troublesome
7th Dare not go out in the evening. Yesterday, and in the night, my cough was very bad. I noticed an unmistakable stain of blood on my handkerchief once. (Hemoptysis can be caused by coughing too hard - and isn't always sign of something sinister, However, given the medical history...)
8th Going to take some olive oil every morning; see if it will help me. Bad fit of coughing last night.
10th. Had a bath... and got weighed...77 and 1/2 kilos (12 stone 2 pounds). Still losing from my Budleigh Salterton weight. I have begun to take olive oil, and I think it does me good. Cough very slight now.
On 29th October, George writes this, after a short period of a few hours of not being able to write: Then, to my surprise, I felt able to write again, and by 5.30 had done my second page. How impossible, this, a few years ago! It is strange how much more control I am getting over myself... An example of the effects of paresis removing blocks to creative flow?
30th Suffering much from diarrhoea. Digestive disorders.
31st Diarrhoea still troublesome.
November
2nd Suffering much from the cold in this sunless room.
3rd Aching fingers. Formication?
7th Suffering much from liver. Unable to walk. This is a profound indicator something is seriously wrong - not with the digestion. Pain over the site of the liver (in the lower back) can be a sign of tabes dorsalis in its early stages. To be rendered immobile could be a sign the spinal cord was involved. All that lumbago he suffered was another sign of this.
15th No appetite and a little feverish.
17th Went to bed with my headache.
22nd George's 40th birthday
27th Towards night felt feverish, and had a very bad night, sleepless.
28th feeling so ill this morning, that, after a short walk, I decided to send for a doctor. He came at 4 o'clock, said I had caught cold, and must go to bed...
29th fever going on... (The doctor) made me take two of my quinine powders...two hours later I had to take another dose. The result of all this quinine was an extraordinary night - reminding me of De Quincey's opium visions. 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 and tombs and vases. Landscape flooded with sunshine. There is a condition caused by quinine overdose - cinchonism - but what George describes does not fit that picture click. Neither does it fit malaria click You could not have a clearer description of a paretic crisis; grandiosity, hallucinations, sensory overload... as experienced by Van Gogh, Nietzsche, Flaubert et al.
30th ...Told him (Dr Sculco) of my strange night, and he was much impressed, - looked at me oddly.
Was this because Dr Sculco assumed George knew he was having a syphilitic paretic crisis which is why he had travelled with a supply of quinine powders of his own with him? Because in quinine was prescribed for syphilitic patients who could not tolerate mercury, and was, by the 1920s, one of the main treatments for the disease click. If Dr Sculco had examined George he would have been able to see signs of the venereal disease, but delicacy might have prevented him from mentioning it to a tourist, passing through. (Or, George could be editing his Diaries to exclude the real problem.)
December
1st Beginning to feel better, There has been a good deal of congestion of the that old enemy, the right lung...
2nd Much better...Doctor often refers to my 'visions' as he calls them. Is the doctor suspicious? Perhaps he wasn't sure George knew his diagnosis.
3rd All fever gone. Able to get up.
4th Able to get up... Doctor called for the last time and gave me a prescription for a 'cure' of the right lung. If Dr Sculco realised George was suffering from latent syphilis, this prescription might have been something to deal with this. George's lung problems are always assumed to by phthisis but might very well have been syphilitic in origin. George does not say what Dr Sculco had diagnosed as the problem in the lung or the nature of the 'cure'.
5th I myself feel inwardly better but a little shaky.
6th Have a slight cold in the head,
7th Cricelli took me lastly to a chemist's shop.
No entries regarding health until...
26th Cold very severe. No doubt as a result of it, I have a swollen gland behind the right ear - very painful. Gummas are painful swellings associated with all stages of secondary and beyond syphilis: The course of the
In October 1902, George wrote to Henry Hick: By the bye, you remember that patch of skin-disease on my forehead? Nothing would touch it; it has lasted for more than 2 years, and was steadily extending itself, when at last, a fortnight ago, I was advised to try Iodide Potassium. Result - perfect cure after one week's treatment! I had resigned myself to being disfigured for the rest of my life; the rapidity of the cure is extraordinary. I am thinking of substituting Iodide of Potassium for coffee at breakfast and wine at the other meals. I am meditating a poem in its praise.
Henry Hick replied that a 'half educated' person would know this to be a treatment for syphilis. Now, biographers of a certain persuasion might reject this remark as Hick being facetious... For example, one biographer states emphatically that George had a patch of psoriasis - not syphilitic lesion - on his forehead, and that iodide of potassium would remove this. Well, the fact is, iodide of potassium is more likely to cause psoriasis than cure it click. This abstract outlines research suggesting psoriasis is actually aggravated by the drug. So it seems Dr Hick's was the more accurate diagnosis.
JOIN ME IN PART FOUR FOR THE SAD STORY OF EDITH GISSING AND HER FATE AT THE HANDS OF SYPHILIS
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