George Gissing: A Fan's Commonplace Blog

Commonplace 65 George & Syphilis PART FOUR  What Ended His Unheroic Life? And What Was His Legacy to Edith?

Red Disaster by Andy Warhol 1963

In Commonplace 64 we revisited the famous reference to what was clearly a syphilitic lesion on George's forehead - he mentioned to Henry Hick that the two-year old skin lesion was finally cured with iodide of potassium. Henry Hick told him that this made it pretty obviously syphilitic in origin. This was 1902.

Iodide of potassium click was a cure for the disease going back to the early nineteenth century, when newly isolated elements were being explored as universal miracle cures for the most debilitating diseases. As a side note, you might recall that radium, when first identified by Marie Curie, was touted as a wonder drug, and all sorts of claims for its beneficial effects were made. You could buy radium sweets to enjoy at parties, drink radium cocktails and wear it as underwear - that was how keen the capitalists were to exploit it. There was a similar tale with mercury for treatment of syphilis - believe it or not, male sufferers could buy mercury chocolates to give to their untainted spouses to secretly treat them for an infection the poor wee wifey didn't know she'd caught from her husband. However, in the interest of balance, it is successful in treating lesions caused by other diseases such as erythema nodosum click - including those caused by TB. However, a diagnosis of syphilis seems correct in the case of George's forehead lesion - few sores hang around for two years without spreading or resolving. Another indicator is George's amazing response to the drug.

Close Up Red Disaster by Andy Warhol 1963

Iodide of potassium: George loved it and sang its praises. After being prescribed it by Dr Jean Blazy, his doctor in St Jean de Luz, he wrote to Hick: 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. Now, what could account for this extraordinary reaction in him, one of his most unreservedly positive outpourings? We can presume he didn't consult with Dr Blazy on account of his forehead lesion - after all, he had put up with it for 2 years and didn't seem bothered by it. Did the French doctor find evidence for a diagnosis of cardiac syphilis, prescribe the iodide of potassium for this, and abracadabra: lead arose in the old Gissing pencil?

In her book POX, Genius, Madness and the Mysteries of Syphilis, Deborah Hayden writes, apropos the syphilis that afflicted Adolf Hitler: The medication of choice in the 1940s for late cardiovascular syphilis was iodide salt, either potassium or sodium. In 1937 Stokes wrote: 'Of late, a German revival of non-specific therapy for syphilis has brought various iodid(e) derivatives to the front of the literature... Many drugs have been used over the centuries but none except potassium iodide have been able to hold its place as of permanent value in the treatment of the disease'... 'In the treatment of cardiovascular syphilis, the iodides deserve a high though in many respects intangible place. They should be used invariably and from the outset in every case of actual syphilitic vascular disease'. Hayden takes this from: Dermatology and Syphilology for Nurses (Philadelphia: Saunders, 1937). 

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Paul Delany in his biography (2008) mentions the attending physician wanting to terminate George's struggle by administering an overdose of morphia - the standard model still used today in thousands of cases of incurable disease where great suffering and pain are predominant. A 'chill' does not cause this sort of a serious reaction in itself, even when exposure to bad weather (the alleged cause of the chill) leads to suppression of the immune system and allows chest infection to prevail; but it might trigger a response from vulnerable organs such as the heart, already over-stretched by coping with chronic infection and lethally damaged by syphilitic changes.

What did George die of? If we recall the time George was in Cotrone and treated by Dr Sculco (see Commonplace 64) and how that has certain similarities in terms of florid hallucinations and delirium, it is clear there was something more sinister going on - and maybe something always destined to be fatal. In George's book, By The Ionian Sea, the account of this Cotrone episode differs from the one in the Diaries, as possibly befits a work for publication to a wider readership. George says, of his scary sickness: 
The dyspepsia - I clung to this hypothesis - was growing so violent that I had difficulty in breathing; before long, I found it impossible to stand. Dr Riccardo Sculco is summoned. After an examination of which I quite understood the result, he remarked in his airy, amiable manner that I had 'a touch of rheumatism'; as a simple matter of precaution, I had better go to bed for the rest of the day, and just for the form of the thing, he would send some medicine. Having listened to this with as pleasant a smile as I could command, I caught the Doctor's eye and asked quietly, 'Is there much congestion?' His manner at once changed; he became businesslike and confidential. The right lung; yes, the right lung. Mustn't worry; get to bed and take my quinine in dosi forte (strong doses), and he would look in again at night. 
Is this not a doctor desperate not have to state the obvious - that his patient has syphilis? He offers 'rheumatism' as a euphemism (causing dyspepsia, breathing difficulties and trouble standing?? Obviously not) and George grabs at it - then throws back 'lung trouble' and Dr Sculco takes this, and then adds the recommendation that George take his quinine. For rheumatism? For lung congestion? Obviously not. So, the doctor does not think the quinine is for malaria; he knows it is for something else - the syphilis. 

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In the little book 'Henry Hick's Recollections of George Gissing', edited by Pierre Coustillas, the editor (a man strangely opposed to the notion George had syphilis) writes:
Lest it should entail any misconception, it should be said that the doctors whom Gissing consulted in the last years of his life differed widely in their diagnoses. Pye-Smith, Henry Hick and Jane Walker tended to minimize his ailments and repudiated the view that he was consumptive (my emphasis).The others, whether English or French, regarded his condition as a very serious one, thinking he was in some degree phthisical. That he eventually died of myocarditis consequent on a pneumonia does not remove the contradictions of the practitioners with whom he had to do.

What about this diagnosis of myocarditis caused by pneumonia? First, definitions:

1) Myocarditis is an inflammation of the myocardium, the middle layer of the heart wall click. 
Myocarditis can be caused by bacteria click including treponema pallidum, the bacterium of syphilis. 

2) Pneumonia is lung inflammation caused by bacterial or viral infection, in which the air sacs fill with pus and may become solid. Inflammation may affect both lungs (double pneumonia ) or only one (single pneumonia). click  It can be caused by treponema pallidum.

What does this mean? That the doctors who knew him best thought he did not have TB. Others who might have been included in this rosta of medicos: Dr Sculco recognized the syphilis treatment (quinine) George carried with him to Italy; he examined George and suggested the euphemism of 'rheumatism' to cover embarrassment. In France, Dr Jean Blazy prescribed George a medicine (iodide of potassium) that produced remarkable results in syphilitic patients (particularly those with syphilitically diseased hearts); Henry Hick used the term syphilis as a cause of the skin lesion on George's forehead. If George died of myocarditis caused by pneumonia there is a correlation between both and syphilitic infection. And then there are the hallucinations and delirium, which speak - scream! - of paresis. As Shakespeare forgot to say, if it looks like a bear and smells like a bear and shits like a bear... it's a usually a bear. 

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Syphilis can, of course, produce a discreet negative effect on the heart. Take this entry from this site click: Syphilitic aortitis (SA) is a disease of the aorta associated with the tertiary stage of syphilis infection. Syphilitic aortitis begins as inflammation of the adventitia, including the vessels that supply the aorta itself with blood, the vasa vasorum. As it worsens, the vasa vasorum show hyperplastic thickening of their walls that restricts blood flow and causes ischemia of the outer two-thirds of the aortic wall. Starved for oxygen and nutrients, elastic fibres become patchy and smooth muscle cells necrose. The wall weakens and scars. If the disease progresses, syphilitic aortitis leads to an aortic aneurysm. Unlike atherosclerosis, which clinically manifests in older people, syphilitic aortitis typically affects those under the age of 50. 

George was 46 when he died. His end was marked by delirious, hallucinatory febrile outpourings typical of syphilitic paresis - and similar to the florid attack he had experienced when in Cotrone. His heart may well have given out under the strain, but, as suggested by Paul Delany, he might have been compassionately euthanased with morphia - aortitis is notoriously painful and distressing for the sufferer. What a sad end for our man, whom we all love dearly.

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Which brings us to Edith.

Of the many terrible injustices meted out by Gissingites and critics, biographers and fans, it is the first two wives who seem to come in for the worst of the insults - as if they somehow made George the selfish, secretive, reactionary, heartless and emotionally stunted, sexually screwed up, blighted character he so often was. Is it a class thing - because Marianne aka Nell and Edith were working class - or a class and misogyny combo? Women have been equally hard on Marianne and Edith... you only have to think back to the loathsome Miss Orme to see where it all began. Touted as a 'feminist' (whatever that means!), she was clearly as self serving as Clara Collet in her dealings with Edith in order to gain access to George. Maybe both 'feminists' had their caps set for him when he was free of his wifely burden. Imagine a wrestling match on the croquet lawn between these two 'emancipated femmes', with George as the prize haha!! How he would have loved to see that - women fighting over him... hell, that's what he encouraged them for! Leave the filthy business of disposing of wife number 2 to two gals with love on their minds, so he could sod off to Italy and indulge his onanistic love of all things Rome. Still, I'm sure all serious Gissing scholars have already come to that conclusion!!

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Edith was a terribly unlucky young woman to be wooed by George. On paper, he must have seemed like a good bet - a widower while still sprightly with a bit of go in him, posh, clean, a bit staid. Reliable, misguidedly might be the word to sum him up; a cut above Edith's usual social set.

She would not have been at all worldly, having lived and worked in the family home all her life, and probably with few friends to mix with. Like all young, single girls, she would have had her heart set on a family and a home of her own, and a husband who would love and cherish her, keep her safe, nurture her dreams and keep her company; who would whisper sweet nothings and softly seduce and charm, whilst sharing all life's little trials together. She had no idea what a price she would pay for these normal female aspirations, and how far she would fail in obtaining them.

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It could be argued that George picked a working class girl to marry because she would be less likely to complain when she found out she had caught his syphilis. Think about the urgency of his suit - was this because he was recovering from a bout of tertiary symptoms and needed her to commit before it returned? Was this why he decamped to Exeter - far from anyone he knew and their awkward questions, and out of the way of Edith's family, especially her brothers who might have a thing or two to say to the man who infected their sister?

Edith is always portrayed as a battleaxe with no redeeming features, and she is not well-served by the one photo (below) we have of her - looking glum and 'staring at vacancy' - as George would describe it. When was this taken - before or after she was ground down by the old Gissing charm? She was acceptable enough for him to impregnate with Walter... was his birth the first sign she had that she was diseased? We know she had difficulty breastfeeding, but what was the nature of this problem? In George's father's day of running the Wakefield chemist's shop, it was believed by some that the infection could be passed on in breast milk. However, in 1891, when Walter was born, it was widely accepted that only contact with a chancre sore on the breast could pass on the disease. If a diseased breast was supporating, then the child would be farmed out to a clean wet nurse. Edith had sore breasts... were they supporating? She would have been prevented from feeding Walter herself, but George, recording this in his Diaries and Letters was not likely to reveal why she had this problem - especially if he had infected her. The physician attending her accouchement would have noticed sores around her private parts. Was this breast problem another way for Edith to discover George was diseased and had gifted it to her?

Edith

Fear of passing on the contagion through generations was not a novel idea in the late nineteenth century. In fact, well into the twentieth century, it was believed that once the 'taint' had established itself in the blood, nothing could be done to eradicate it - with the possible exception of deflowering a virgin for its therapeutic effects - because that is still considered the treatment of choice in some parts of Africa for syphilis and HIV infections. The idea that a whole bloodline was written off is ridiculous now, but in a time when the disease was little understood and incurable, and diseases such as cholera killed thousands in London click, it must have seemed logical to think this silent and invisible monster was omnipotent. Congenital syphilis can be passed on through the placenta or in the birth canal. However, there is a 1:4 chance the infant will be disease free click.

George's relationship with Walter was always fraught and ambivalent. Biographers tend to blame Edith for this - George marrying a commoner and not an aristocrat like himself haha - but, with the lesion on Walter's right eyebrow, foreshadowing the syphilitic lesion George later developed, and with his difficulty feeding, his tetchiness and failure to thrive, this might point some in the direction of an acquired syphilitic infection. George noted that, when he was out in his pram, the neighbours were scared of Walter's appearance. Were the neighbours reacting to something conspicuously sick in the child? Not being the dream baby she was hoping for, Edith might very well have failed to bond with the wee man - but the thought of giving him an infection might have upset her capacity to demonstrate maternal feelings more than any other factor.

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In the Diaries, George reports how fractious Edith is just after Walter's birth. Of course, what this might mean is that George, having to do more and get more hands-on involved, is bemoaning his own fate - fatherhood has seriously eaten into his solitary reading time - but something seems to have unsettled Edith and made her angry and the knock-on effect of this could have added to Walter's distress and made him fretful. Edith's breasts were giving her trouble. Fast-forward to her post mortem in 1917, and Edith is reported to have had a tumour in her breast - was this syphilitic in origin? Cancer and TB and syphilitic tumours all looked similar in the days before the electron microscope. Chancres were often located on the female nipples because of the place of breasts as erogenous zones - kissing the breasts can spread the infection. If this manifested itself during parturition then this might be what is making her so upset. Walter was farmed out fairly swiftly - when he was four weeks old. He could have been fed at home on formula - wet-nursing was going out of vogue in 1891, with very few exceptions - often based on social class and maternal illness.
In April 1892, George took Edith to London 'to see her relatives and to consult a doctor'. This is a very long way to go for a doctor's appointment, so was this because he didn't want local doctors in Exeter knowing what was wrong with her/them? Certainly, you wouldn't want a doctor in a small community like Exeter gossipping about your wife's venereal disease, would you? Much better to get that sort of thing sorted in the Big City.

You may recall the recommendation of Dr Alfred Fournier, in his Syphilis and Marriage Lecture (see previous Commonplace) that sufferers of syphilis should abstain from sexual relations and only resume intimacy four years after a bout of the infectious stage of the disease. Walter was conceived around February/March 1891 (when George and Edith were first married); four years later, Alfred was conceived around April/May 1895 - when George got back from visiting, alone, his old haunts of Cheshire and Manchester. A question that might be asked: did George visit Dr Wahltuch (his former doctor from the Owens days) for the syphilis all-clear when he was in Manchester?

JOIN ME IN PART FIVE FOR THE END OF THE AFFAIR WITH EDITH.