Commonplace 67 George and Syphilis PART SIX Edith's Heroic Life part 2.
Are we to paint what’s on the face, what’s inside the face, or what’s behind it? Picasso
My contention is that George passed on syphilis to Edith. She developed the tertiary stage and was eventually institutionalised because of ongoing paresis.
Syphilis is famously known as the 'great imitator' because its effects are easily mistaken for a range of destructive diseases, from cancer to consumption; the brain form is just as easy to confuse with the major effective disorders of schizophrenia and bipolar affective disorder (endogenous depression and mania/hypomania). Of course, in Edith's day, this sort of terminology wasn't used, but we already have a problem with nomenclature; just what do we call these differentiated disorders when we hark back to the days before they were isolated as discrete ailments? (Are they 'ailments' at all??) Of course, we can't know for sure if George suffered from syphilis - the indicators are that he did, when taken as a whole picture (see previous post).
Physical signs and symptoms are easier to lay at the feet of 'the great imitator' than are those attached to the brain form of the disease. In part, this has to do with the nature of discussing/identifying mental health, itself. Psychiatry is a very weird science, dealing as it does, with mostly invisible manifestations: a broken leg is visual - a broken mind is not. Visible, physical clues can point us in directions, but the real skill in diagnosing mental health conditions is based on almost random factors conjured up from knowledge of anatomy and physiology, psychology, philosophy, cultural identity, heredity, pathology, linguistics, gender studies, epistemology, pharmaceuticals, history (et al!), with the added factors in the diagnostician of compassion, interpersonal people skills and authenticity of communication. All these, of course, help with any form of medicine, but psychiatry is all about them. In Edith's time, it was a brand new science, with few doctors being true experts in 'alienism' - the Victorian term used to describe psychiatry - because there hadn't been the scientific breakthroughs in aetiology or treatment to make a fully-fledged, differentiated branch of medicine. However, syphology, and paresis in particular, was the 'coming man' of alienism thanks to the study of its effects on the nervous system and the mind, in particular. having previously been so closely linked to physical medicine for as long as it was known in Europe.
Biographers portray Edith as some sort of tarmagant but this is unfair; she had few people with whom to interact - mostly servants all of whom seemed even by George's somewhat lax domestic standards (remember he received complaints about the filthy state of his windows when he was at 7K) to fall below acceptable norms of cleanliness, and neighbours who might well have been exactly the sort of horror show George so detested. His preferred method was to simmer resentfully in silence any time something upset him - we can gather that Edith applied a different approach. But that does not make her insane. Perhaps her interpersonal skills were more in your face than George's but that is not a sin or a crime. Or a sign of mental illness.
Syphilis, when it reaches what is termed its 'tertiary' phase can produce General Paralysis of the Insane (GPI) the brain variant of which is paresis. Something to remember is that the tertiary stage can take upwards of thirty years to emerge; however, it can also strike in three or four years after the primary infection, making itself felt with every bit of force as its later manifestation. Thus, someone can contract syphilis, pass through the two infectious stages in a few years, hurtle through or bypass the latent stage, then move straight to the tertiary phase and die soon after of the very worst of its manifestations. Luck, or as George would put it, Fate, can deal us some very shitty cards.
Paresis. Deborah Hayden in her book POX: Genius, Madness and the Mysteries of Syphilis (2004) describes it thus:
Paresis often begins with a dramatic episode characterised by delusions; grandiosity; identification with religious mythic, or royal figures; and sometimes rage and violent acts... In the following months and years, dementia alternates with periods of such clarity that there seems to have been a cure.
Anthony Petyt, Gissing family history expert and esteemed historian of all things Wakefield, did some very interesting research into Edith's last years. Published in the Gissing Journal of July 2010 (Vol XLVI Number3) his piece contains review notes written by some of the medical staff who treated her. They make fascinating reading - and contain some intriguing anomalies. Let's dive in.
The first admission to psychiatric care.
23rd January 1902 - Edith was removed to Lambeth Infirmary because her landlady was concerned about her capacity to care for herself and Alfred. Anthony Petyt reports that, because the County of London Asylum was full, Edith was sent from Lambeth Infirmary to Hoxton House, a private mental institution, and detained there, presumably under the 1890 Lunacy Act. However, in 1902, there was still a good trade in private mental asylums, and so Hoxton House would be a reasonable choice for a middle class patient with means - George reports Edith had saved a good portion of her alimony which he subsequently used to pay for her care, and her class would be assessed as being the same as the husband's and so means testing would have applied. Any other option would have been a very bad reflection on George - he could never claim to be a pauper and eligible for paupers' rates, even if he was a 'non dom' click.
Tony reports that Edith was sent from there to Fisherton House Mental Hospital near Salisbury in 1904 click- but he adds that why she was moved is not clear. However, Hoxton House actually closed in 1902 click, and so there must have been some other care provider between HH and Fisherton. Something about this does not add up. Where was Edith for this two years?
She was examined by Dr Marcus Quarry. He reports She is excited and strange in manner. She states that 'they' won't allow her to live long in any place, doing all sorts of things to turn her out, poisoning and assaulting her. In the streets
she states she is insulted and accused of being an immoral woman. by strangers, etc.
The doctor quotes her landlord, who reports:
...she is very strange in manner & accuses his wife of trying to poison her by arsenic & carbolic acid. She says that she is followed in the street by men etc.
Dr Quarry diagnosed her: 'Lunatic and a proper person to be taken charge of and detained under care and treatment.
Let's consider what this is.
This is either the notes written on her first admission (to Hoxton House in 1902) or brand new notes for a referral from the community. If Edith's landlord makes a contribution, it seems Edith was living in the community after Hoxton House closed and was thus admitted from her place of domicile/home to Fisherton House - otherwise there wouldn't be much point in quoting a landlord who hasn't seen her in 2 years. As Alfred had been taken away from her in 1902, she would have lived alone. I would strongly suggest, based on these notes, Edith had been living in the community and not as in inpatient, between her discharge from Hoxton House to her admission to Fisherton House Asylum. Which makes Dr Quarry's notes all the more understandable - it would explain why he doesn't know much about his patient..
So, let's consider the notes in that context (Edith being admitted from a place of domicile and not transferred from Hoxton House). Back to the Fisherton House notes:
Excited and strange in manner are meaningless in real terms - being subjective judgements. They certainly offer no help towards diagnosis in psychodynamic terms. We have to remember the terminology used at that time is not what we are now used to - there were few terms used in common, and so doctors struggled to describe things as best they could. Nowadays, in the world of mental health, we are aware of cultural differences that make all of us seem strange to someone or other! In Edith's case, if she had been frightened by being rounded up and sectioned, is it any wonder she presented as 'excited and strange? It is worth remembering, then as now, admitting doctors were usually juniors with not much experience - doing the dirty work so the expert can swan in and make the killer diagnosis after all the salient facts are presented by the lesser being. And, it must be remembered, some doctors fell into alienism because they couldn't make a living in other branches of medicine - then as now, psychiatry is considered the 'Cinderella service' of medicine - and so were not really experts in their specialism, or wanted to be.
'they' won't allow her to live long in any place. Delusions of persecution are a feature of many of the mental disorders. However, many delusions have some basis in external reality and, in Edith's case, may well have been based on the interference in her life of the likes of Miss Orme, and those who were trying to supervise her life. Delusions of persecution amounting to paranoia - you might recall George was forever sneaking around behind her back and lying to her, and so were the likes of Misses Orme and Collet as they colluded with their hero - would have constantly undermined Edith's sense of reality. Miss Orme had a hand in having Edith committed - and was responsible for sending Alfred to live in Devon; did maintain some sort of surveillance of Edith after George's death?
poisoning and assaulting her - Edith may have been involved in a scuffle with the law when she was reported by her landlord, and so this could be based on that. Nowadays, this level of low key sort of claim to being poisoned, etc, would be treated sceptically, and at admission, would not be particularly significant unless there were more florid delusions of persecution in the picture. Delusions of being poisoned were common in Victorian times - when your wallpaper could kill you (by arsenism), drinking water (via plumbism from lead pipes), or phosphorus could maim you at work (the Bryant and May match workers), sweets kill you stone dead (the Bradford Poisonings) your father/brother/colleague bumping you off (Dr William Palmer) with strychnine... you can see how cultural events spread like memes and inform the thinking of vulnerable people.
In the streets she states she is insulted and accused of being an immoral woman. by strangers, etc
This may be a direct link to the syphilis - if she felt unclean, she might be so bothered by the implications of having a sexually transmitted disease that she feared anyone finding out about it. To get some sense of how the Victorian public responded to syphilis, think of the AIDs reactions in the 1980/90s. At some stage of the disease, there would have been physical signs - gummas, rashes, sores, all manner of horrible things any woman would fear and dread - especially as, being visible, these might be difficult to hide from others' eyes. If it looked like she had a syphilitic infection, she might well have been shunned in public (or feared it happening), so the burden of being diseased might well have produced delusions around health and hygiene... and, if neighbours saw evidence of syphilis they might have assumed she was an 'immoral woman'. (Did George's minions assume Edith gave George his infection rather than it being the other way round?) This could have been why Alfred was considered at risk - living with a syphilitic mother they assumed was leading an immoral life. If she had found it hard to find lodgings or to settle after Hoxton House, and was suffering an increasingly debilitating mental illness - which paresis is - it would be inevitable that she fall foul of unscrupulous landlords (is there any other kind, where poor people are concerned?).
In fact, most of these delusions are about her body - its state of health or lack of it. Carbolic acid in the form of carbolic soap, in the late nineteenth century, was a newish product in terms of being touted as an antiseptic click; it had a characteristic strong smell, which might draw attention as a treatment, and so be a cause of embarrassment to the user. Arsenic, as we know, was a common cure for syphilis thanks to Salvarsan, but that was not invented till 1910. In 1904, everyone knew it as a rat poison and a useful tool in the uxoricide arsenal, an ingredient in cosmetics, and a basic of Fowler's Solution, often prescribed for eczema and psoriasis.
She says that she is followed in the street by men etc - this ties in with the 'immorality' thoughts. How much did Edith ever know about George's early years? Presumably, when he had to confess to giving her syphilis, he would have to offer some sort of explanation. And, when they lived together, he must have made sure she was medically treated for whatever associated ailments presented. Did George live in fear of her telling their sons about this disease - was this the real reason he took Walter away and would have taken Alfred, and why he made his move to France?
Not known whether present is first attack. Again, odd - if she was transferred from another asylum - her previous hospital's referral letter and/or medical notes would have shown she had been admitted previously and a reason given for her forcible detention. Again, this suggests she was admitted from home. And, as she was being detained against her will she would have been examined by a JP and there would be 2 independent doctors' certificates - one of whom had to be the patient's physician - stating she was of unsound mind - the requirements of the 1890 Lunacy Act. If these were not in the file - then why not? Could it be that the legal paperwork was ongoing - these admission notes are part of the assessment required by law in order to detain her against her will?
More anomalies in these Fisherton records: her social class is 'unknown'; family history is 'unknown'. Not even her landlord comes forward to fill in these blanks. If there were Hoxton transfer records, they would have given this information.
Tony Petyt also records that this admission sheet indicated Edith was not epileptic, syphilitic or demented. As we are looking into the possibility of paresis, it may seem conclusive that, if the admitting physician said she was syphilis-free, that the argument cannot still be made for a diagnosis of paresis. As there were no blood tests for syphilis, physical signs of the disease (such as scars from chancres, eczema-like rashes etc, evidence of tabes dorsalis, etc) were all the doctor had to go on. Remember how difficult syphilis is/was to identify? Women presented a particular challenge to correct syphilis diagnosis because the seat of the primary infection was often deep inside the female sex organs and out of sight at examination. No doctor would routinely examine a female patient vaginally on admission.
One diagnostic test for positive syphilis infection available to the doctors was the absence/presence of Argyll-Robertson pupils click. These pupils are generally small in size, and react poorly to low light sources - as in, they do not enlarge to bring in more light to the retina.
Dr Quarry says this of Edith's physical condition:
Patient is a tall, fairly well-built woman with black hair, dark brown eyes, small equal pupils, straight nose, tongue clean, teeth good. First sound of heart somewhat accentuated, lungs & abdom(inal) organs normal. 'Small and equal' pupils - this does not exclude a paresis diagnosis, because frequently, there is no difference between them - but we don't know how proficient the doctor was in recognising this, or if he checked for other signs - for example, patients would be asked to walk a straight line - such as along a carpet edge - to test for tabes dorsalis.
Dr Quarry noted a heart murmur on the first beat. First sound of heart somewhat accentuated. Was this the beginning of syphilitic aortitis? click Edith subsequently developed a mass in her left breast - syphilis destruction of heart tissue might spread to breast tissue over time, and so gradually destroy it.
From September 24th (11 days after the 1904 admission to Fisherton House) until the end of that year, Edith was reported as deluded, solitary, uncommunicative, at times violent - throwing dishes at other patients and striking them - and then, on December 13th we have this:
Are we to paint what’s on the face, what’s inside the face, or what’s behind it? Picasso
 |
| Girl With A Pearl Earring by Johannes Vermeer 1665 |
My contention is that George passed on syphilis to Edith. She developed the tertiary stage and was eventually institutionalised because of ongoing paresis.
Syphilis is famously known as the 'great imitator' because its effects are easily mistaken for a range of destructive diseases, from cancer to consumption; the brain form is just as easy to confuse with the major effective disorders of schizophrenia and bipolar affective disorder (endogenous depression and mania/hypomania). Of course, in Edith's day, this sort of terminology wasn't used, but we already have a problem with nomenclature; just what do we call these differentiated disorders when we hark back to the days before they were isolated as discrete ailments? (Are they 'ailments' at all??) Of course, we can't know for sure if George suffered from syphilis - the indicators are that he did, when taken as a whole picture (see previous post).
Physical signs and symptoms are easier to lay at the feet of 'the great imitator' than are those attached to the brain form of the disease. In part, this has to do with the nature of discussing/identifying mental health, itself. Psychiatry is a very weird science, dealing as it does, with mostly invisible manifestations: a broken leg is visual - a broken mind is not. Visible, physical clues can point us in directions, but the real skill in diagnosing mental health conditions is based on almost random factors conjured up from knowledge of anatomy and physiology, psychology, philosophy, cultural identity, heredity, pathology, linguistics, gender studies, epistemology, pharmaceuticals, history (et al!), with the added factors in the diagnostician of compassion, interpersonal people skills and authenticity of communication. All these, of course, help with any form of medicine, but psychiatry is all about them. In Edith's time, it was a brand new science, with few doctors being true experts in 'alienism' - the Victorian term used to describe psychiatry - because there hadn't been the scientific breakthroughs in aetiology or treatment to make a fully-fledged, differentiated branch of medicine. However, syphology, and paresis in particular, was the 'coming man' of alienism thanks to the study of its effects on the nervous system and the mind, in particular. having previously been so closely linked to physical medicine for as long as it was known in Europe.
 |
| The Girl With The Wine Glass by Johannes Vermeer c 1659 |
Syphilis, when it reaches what is termed its 'tertiary' phase can produce General Paralysis of the Insane (GPI) the brain variant of which is paresis. Something to remember is that the tertiary stage can take upwards of thirty years to emerge; however, it can also strike in three or four years after the primary infection, making itself felt with every bit of force as its later manifestation. Thus, someone can contract syphilis, pass through the two infectious stages in a few years, hurtle through or bypass the latent stage, then move straight to the tertiary phase and die soon after of the very worst of its manifestations. Luck, or as George would put it, Fate, can deal us some very shitty cards.
It seems logical to assume
Edith did not have a functional mental health difficulty (such as schizophrenia
- a condition not identified by that term until long after Edith's time - or
endogenous depression - an old-fashioned term, but useful for us here) before
she met George - she would have exhibited tell-tale signs in her behaviour,
thinking and cognitive function and so George would have rejected her - or
moaned about it in his Diaries and Letters. She was about twenty-four when she
married George; by this time, early onset functional mental illness has usually
arrived. She might have had post-natal depression after Walter, but George does
not report any depression - though he is an unreliable witness to his own
feelings, let alone someone else's. However, she seems to have functioned well
enough to run the house and accompany him on family outings and holidays, and
to hold the fort while he was gallivanting off here and there, so I think it is
safe to assume she was not displaying real signs of mental health problems
until after Alfred was born - 1895; about the same time
George decided he wanted to be rid of her. As he often questioned the sanity of
women based on their capacity to annoy him, it might be reasonable to expect
that if he saw it, he would tell the world about it.
 |
| Allegory of The Faith by Johannes Vermeer 1670-73 |
Paresis often begins with a dramatic episode characterised by delusions; grandiosity; identification with religious mythic, or royal figures; and sometimes rage and violent acts... In the following months and years, dementia alternates with periods of such clarity that there seems to have been a cure.
Anthony Petyt, Gissing family history expert and esteemed historian of all things Wakefield, did some very interesting research into Edith's last years. Published in the Gissing Journal of July 2010 (Vol XLVI Number3) his piece contains review notes written by some of the medical staff who treated her. They make fascinating reading - and contain some intriguing anomalies. Let's dive in.
The first admission to psychiatric care.
23rd January 1902 - Edith was removed to Lambeth Infirmary because her landlady was concerned about her capacity to care for herself and Alfred. Anthony Petyt reports that, because the County of London Asylum was full, Edith was sent from Lambeth Infirmary to Hoxton House, a private mental institution, and detained there, presumably under the 1890 Lunacy Act. However, in 1902, there was still a good trade in private mental asylums, and so Hoxton House would be a reasonable choice for a middle class patient with means - George reports Edith had saved a good portion of her alimony which he subsequently used to pay for her care, and her class would be assessed as being the same as the husband's and so means testing would have applied. Any other option would have been a very bad reflection on George - he could never claim to be a pauper and eligible for paupers' rates, even if he was a 'non dom' click.
Tony reports that Edith was sent from there to Fisherton House Mental Hospital near Salisbury in 1904 click- but he adds that why she was moved is not clear. However, Hoxton House actually closed in 1902 click, and so there must have been some other care provider between HH and Fisherton. Something about this does not add up. Where was Edith for this two years?
 |
| What remains of Hoxton House |
There are no Hoxton House notes but the admission examination notes by Fisherton House's Dr Quarry are included in the Gissing Journal piece. We learn from the Journal that on 13th September 1904, Edith's Fisherton House doctor's notes commence with a résumé of the reasons of her admission: she is aged 30 years, married, no occupation; Ch of E. This is odd, as Edith was born in 1867 - so she was 37 in September, 1904.
she states she is insulted and accused of being an immoral woman. by strangers, etc.
The doctor quotes her landlord, who reports:
...she is very strange in manner & accuses his wife of trying to poison her by arsenic & carbolic acid. She says that she is followed in the street by men etc.
Dr Quarry diagnosed her: 'Lunatic and a proper person to be taken charge of and detained under care and treatment.
 |
| Girl With Milk Jug (aka The Milkmaid) by Johannes Vermeer 1658 |
This is either the notes written on her first admission (to Hoxton House in 1902) or brand new notes for a referral from the community. If Edith's landlord makes a contribution, it seems Edith was living in the community after Hoxton House closed and was thus admitted from her place of domicile/home to Fisherton House - otherwise there wouldn't be much point in quoting a landlord who hasn't seen her in 2 years. As Alfred had been taken away from her in 1902, she would have lived alone. I would strongly suggest, based on these notes, Edith had been living in the community and not as in inpatient, between her discharge from Hoxton House to her admission to Fisherton House Asylum. Which makes Dr Quarry's notes all the more understandable - it would explain why he doesn't know much about his patient..
So, let's consider the notes in that context (Edith being admitted from a place of domicile and not transferred from Hoxton House). Back to the Fisherton House notes:
Excited and strange in manner are meaningless in real terms - being subjective judgements. They certainly offer no help towards diagnosis in psychodynamic terms. We have to remember the terminology used at that time is not what we are now used to - there were few terms used in common, and so doctors struggled to describe things as best they could. Nowadays, in the world of mental health, we are aware of cultural differences that make all of us seem strange to someone or other! In Edith's case, if she had been frightened by being rounded up and sectioned, is it any wonder she presented as 'excited and strange? It is worth remembering, then as now, admitting doctors were usually juniors with not much experience - doing the dirty work so the expert can swan in and make the killer diagnosis after all the salient facts are presented by the lesser being. And, it must be remembered, some doctors fell into alienism because they couldn't make a living in other branches of medicine - then as now, psychiatry is considered the 'Cinderella service' of medicine - and so were not really experts in their specialism, or wanted to be.
'they' won't allow her to live long in any place. Delusions of persecution are a feature of many of the mental disorders. However, many delusions have some basis in external reality and, in Edith's case, may well have been based on the interference in her life of the likes of Miss Orme, and those who were trying to supervise her life. Delusions of persecution amounting to paranoia - you might recall George was forever sneaking around behind her back and lying to her, and so were the likes of Misses Orme and Collet as they colluded with their hero - would have constantly undermined Edith's sense of reality. Miss Orme had a hand in having Edith committed - and was responsible for sending Alfred to live in Devon; did maintain some sort of surveillance of Edith after George's death?
poisoning and assaulting her - Edith may have been involved in a scuffle with the law when she was reported by her landlord, and so this could be based on that. Nowadays, this level of low key sort of claim to being poisoned, etc, would be treated sceptically, and at admission, would not be particularly significant unless there were more florid delusions of persecution in the picture. Delusions of being poisoned were common in Victorian times - when your wallpaper could kill you (by arsenism), drinking water (via plumbism from lead pipes), or phosphorus could maim you at work (the Bryant and May match workers), sweets kill you stone dead (the Bradford Poisonings) your father/brother/colleague bumping you off (Dr William Palmer) with strychnine... you can see how cultural events spread like memes and inform the thinking of vulnerable people.
 |
| Lady Seated At A Virginal by Johannes Vermeer 1672 |
This may be a direct link to the syphilis - if she felt unclean, she might be so bothered by the implications of having a sexually transmitted disease that she feared anyone finding out about it. To get some sense of how the Victorian public responded to syphilis, think of the AIDs reactions in the 1980/90s. At some stage of the disease, there would have been physical signs - gummas, rashes, sores, all manner of horrible things any woman would fear and dread - especially as, being visible, these might be difficult to hide from others' eyes. If it looked like she had a syphilitic infection, she might well have been shunned in public (or feared it happening), so the burden of being diseased might well have produced delusions around health and hygiene... and, if neighbours saw evidence of syphilis they might have assumed she was an 'immoral woman'. (Did George's minions assume Edith gave George his infection rather than it being the other way round?) This could have been why Alfred was considered at risk - living with a syphilitic mother they assumed was leading an immoral life. If she had found it hard to find lodgings or to settle after Hoxton House, and was suffering an increasingly debilitating mental illness - which paresis is - it would be inevitable that she fall foul of unscrupulous landlords (is there any other kind, where poor people are concerned?).
In fact, most of these delusions are about her body - its state of health or lack of it. Carbolic acid in the form of carbolic soap, in the late nineteenth century, was a newish product in terms of being touted as an antiseptic click; it had a characteristic strong smell, which might draw attention as a treatment, and so be a cause of embarrassment to the user. Arsenic, as we know, was a common cure for syphilis thanks to Salvarsan, but that was not invented till 1910. In 1904, everyone knew it as a rat poison and a useful tool in the uxoricide arsenal, an ingredient in cosmetics, and a basic of Fowler's Solution, often prescribed for eczema and psoriasis.
 |
| Edith |
She says that she is followed in the street by men etc - this ties in with the 'immorality' thoughts. How much did Edith ever know about George's early years? Presumably, when he had to confess to giving her syphilis, he would have to offer some sort of explanation. And, when they lived together, he must have made sure she was medically treated for whatever associated ailments presented. Did George live in fear of her telling their sons about this disease - was this the real reason he took Walter away and would have taken Alfred, and why he made his move to France?
Not known whether present is first attack. Again, odd - if she was transferred from another asylum - her previous hospital's referral letter and/or medical notes would have shown she had been admitted previously and a reason given for her forcible detention. Again, this suggests she was admitted from home. And, as she was being detained against her will she would have been examined by a JP and there would be 2 independent doctors' certificates - one of whom had to be the patient's physician - stating she was of unsound mind - the requirements of the 1890 Lunacy Act. If these were not in the file - then why not? Could it be that the legal paperwork was ongoing - these admission notes are part of the assessment required by law in order to detain her against her will?
More anomalies in these Fisherton records: her social class is 'unknown'; family history is 'unknown'. Not even her landlord comes forward to fill in these blanks. If there were Hoxton transfer records, they would have given this information.
Tony Petyt also records that this admission sheet indicated Edith was not epileptic, syphilitic or demented. As we are looking into the possibility of paresis, it may seem conclusive that, if the admitting physician said she was syphilis-free, that the argument cannot still be made for a diagnosis of paresis. As there were no blood tests for syphilis, physical signs of the disease (such as scars from chancres, eczema-like rashes etc, evidence of tabes dorsalis, etc) were all the doctor had to go on. Remember how difficult syphilis is/was to identify? Women presented a particular challenge to correct syphilis diagnosis because the seat of the primary infection was often deep inside the female sex organs and out of sight at examination. No doctor would routinely examine a female patient vaginally on admission.
One diagnostic test for positive syphilis infection available to the doctors was the absence/presence of Argyll-Robertson pupils click. These pupils are generally small in size, and react poorly to low light sources - as in, they do not enlarge to bring in more light to the retina.
Dr Quarry says this of Edith's physical condition:
Patient is a tall, fairly well-built woman with black hair, dark brown eyes, small equal pupils, straight nose, tongue clean, teeth good. First sound of heart somewhat accentuated, lungs & abdom(inal) organs normal. 'Small and equal' pupils - this does not exclude a paresis diagnosis, because frequently, there is no difference between them - but we don't know how proficient the doctor was in recognising this, or if he checked for other signs - for example, patients would be asked to walk a straight line - such as along a carpet edge - to test for tabes dorsalis.
Dr Quarry noted a heart murmur on the first beat. First sound of heart somewhat accentuated. Was this the beginning of syphilitic aortitis? click Edith subsequently developed a mass in her left breast - syphilis destruction of heart tissue might spread to breast tissue over time, and so gradually destroy it.
From September 24th (11 days after the 1904 admission to Fisherton House) until the end of that year, Edith was reported as deluded, solitary, uncommunicative, at times violent - throwing dishes at other patients and striking them - and then, on December 13th we have this:
Full of delusions of persecution; also fancies she is the wife of the late George Gissing the novelist who she says is not dead etc.
Now, is it possible that Edith genuinely believed - as in, not as a product of any delusional ideation - that George was still alive? If she had been living in her own home - and not in an asylum - from 1902 to 1904, she might well have never been told George had died. Why wouldn't she be informed that her husband had died? Well, because she would become the legal guardian of Walter and Alfred - and she might rise up and reclaim her boys. Was there a conspiracy between the Wakefield Gissings, and the Misses Orme and Collet to make sure the world saw Edith as an unfit mother/mad woman? If so, that might suggest machiavellian work behind why Edith was forcibly detained in 1904, and suggests a campaign to undermine her mental health - with the help of her landlord - being played out. As George had no contact with her, as Gabrielle didn't know where she was or would not have contacted her if she did know; as Edith was not present at a funeral, and as money was still being paid, and because she did not materially benefit from his will in terms of cash or property, Edith had no reason to suspect George was dead.
JOIN ME IN THE NEXT PART OF THIS OVERVIEW OF GEORGE AND SYPHILIS TO COVER THE LAST ENTRIES IN EDITH'S PSYCHIATRIC MEDICAL RECORDS.
Now, is it possible that Edith genuinely believed - as in, not as a product of any delusional ideation - that George was still alive? If she had been living in her own home - and not in an asylum - from 1902 to 1904, she might well have never been told George had died. Why wouldn't she be informed that her husband had died? Well, because she would become the legal guardian of Walter and Alfred - and she might rise up and reclaim her boys. Was there a conspiracy between the Wakefield Gissings, and the Misses Orme and Collet to make sure the world saw Edith as an unfit mother/mad woman? If so, that might suggest machiavellian work behind why Edith was forcibly detained in 1904, and suggests a campaign to undermine her mental health - with the help of her landlord - being played out. As George had no contact with her, as Gabrielle didn't know where she was or would not have contacted her if she did know; as Edith was not present at a funeral, and as money was still being paid, and because she did not materially benefit from his will in terms of cash or property, Edith had no reason to suspect George was dead.
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| Fisherton House Asylum in the 1970s it is now no longer there. |
JOIN ME IN THE NEXT PART OF THIS OVERVIEW OF GEORGE AND SYPHILIS TO COVER THE LAST ENTRIES IN EDITH'S PSYCHIATRIC MEDICAL RECORDS.
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