Commonplace 66 George & Syphilis PART FIVE: Edith's Heroic Life part 1.

In order to address what it was that Edith suffered from in her last years, we need to recap what suggests George was syphilitic. Here are the most obvious clues to a diagnosis of syphilis in our man:

1) George was sexually active at Owens College and was alleged to have visited brothels. He was treated for a venereal disease, possibly by Dr Wahltuch, or by self-medicating from knowledge picked up in his father' chemist's shop, or just street wisdom gleaned from his social set.
2) Experienced alternating periods of system-wide health problems, with remissions and exacerbations of fevers, throat infections, headaches, rheumatism, bowel problems, insomnia. Swellings in groin, and behind ear. Facial lesion. All typical of paresis.
3) Mood swings often with no external impetus, short-lived, and recurrent. Typical of paresis. Personality changes from kind-hearted to hard-hearted, from Socialist to Pessimist. Outgoing to reclusive. Broke with the Positivists and reversed his personal philosophy. All typical of paresis.
4) Four year gap between diagnosis and marrying his first wife, then four years gap between the two children he bore with Edith. As per Dr Fournier's recommendation for the married life of syphilitics.
5) Paretic febrile crises in Cotrone and immediately before death. Florid hallucinations and delusions of grandeur. Typical of paresis. Carried quinine in Italy - a known treatment for syphilitic fevers.
6) Differentiated diagnosis of TB discounted by 3 doctors who examined him on more than one occasion: a chest specialist (Pye-Smith), a doctor who had known him his whole life (Henry Hick), and the doctor in charge of a chest clinic/sanitorium for consumptives (Jane Walker) all did not think he was consumptive.
7) Responded well to iodide of potassium therapy, an anti-syphilitic, especially for tertiary cardiac syphilis.
8) Rapid decline in last two years - incapable of usual workload. Weight loss and fatigue throughout this period. All typical of paresis.
9) Death from damaged heart and pneumonia and from exhaustion following paretic crisis.
10) Edith developed paresis (as early as 1897?) and endured many years of GPI in an institution.

On September 7th 1898, Edith arrived unannounced at George's secret hideaway - 7, Clifton Terrace, Dorking. Not exactly Shangri La, or Xanadu, was it? More of a compound in Abbottabad. He had been feeling poorly all day and was enjoying a lay down on the sofa - we can presume he was exhausted from wooing Gabrielle Fleury via the extraordinarily long letter he wrote her that day, full of loved up yearnings and asking for her reassurance she was hot for him - not that he could tolerate hot (haha), because the weather had been scorching that day and he was physically drained by it. Bless.

Edith and George had been separated for some time; George's Italy trip (with the Cotrone episode of paretic fever) was a few months back. Edith had been living in various places with Alfred, under the guidance of Miss Orme, with whom they had both been living until Edith fell out with her, back in the February - maybe she talked too freely about George's secret life for Miss Orme's refined tastes. Maybe the physical attributes of her illness were beginning to become visually apparent.

Alfred, at the time of the meeting, was two and a half years old. This would be the last time George ever saw his second son. From that day's Diary entry: I gave her to understand that our parting was final, but that I should not take Alfred away from her as long as keeps well. 
What did that mean?

That summer, Edith had upset a number of people, been involved in some low key fracas with a landlord or two, and woken up to the fact Eliza Orme was not the guardian angel she claimed to be. George had been doing his best to make her as miserable as possible and even considered at one time making a public declaration he had died, in order to give her the slip. (Which, in itself, is quite a mentally disturbed thing to do, is it not?) Edith was receiving alimony from her scheming, paranoid, errant husband - through an intermediary - but she was alone in the world, with a small child to care for and another child being held captive half a country away. George should have been with her, but he had deserted her - Edith could have gone to court for his forcible return.

She had no-one to turn to. George's spies were running her life and no doubt middle class Miss Orme and Miss Collet were lecturing her on motherhood - as only childless spinsters can - the irony being that, if either had given birth to children they would have got someone else to do the hands on raising of them - a nanny, for example, or a boarding school. On the level of everyday sorrow, frustration and misery, Edith's dial was switched up to eleven. She had every right to be angry with the two women trampling over her still warm body to get to her husband. However, she was not behaving impulsively and emotionally in this meeting with George. She had made the rational demand the month before of agreeing to a legal separation if she got a house of her own and both of her children - perhaps she had legal advice; if not, this is a very reasonable set of demands, which George could have agreed to if he had wanted to treat her decently. As he did not... On 27th August, George comments on the Bad Eliza Orme postcard Edith sent. Quite a mild rebuke, all things considered, and no doubt a title well-earned by the meddling Ms Orme.

It is worth pointing out that Miss Orme gets quite a bit of credit for her (paid) supervision of Edith, but you have to wonder at her motives. She made is abundantly clear how much she disliked Edith and mocked her mental health and Edith's justifiable anger at being all but confined by a patronising, moralising, nulliparous female who went bleating to the cruel dictator of a husband at the drop of a hat. In a letter to her minion colleague and clone, Miss Collet, she writes:

She is a disappointed child as none of her relatives have invited her to their Xmas parties and in consequence her temper has been very bad. But her appetite is excellent and as far as I can judge the boy is all right. She has cut him off from all communication with us or the servants but I think she will soon grow tired of this... We have had some good laughs over her extraordinary conduct... Perhaps only another woman can detect the sneers here, the nastiness at the bottom of it. 


George had played a blinder in appointing her as Edith's gaoler - it was calculated to annoy his wife and wear her down; well, to be supervised by a smug, middle class do-gooder would inflame the feelings of any red-blooded woman - or is it just me that thinks that?? Anyhoo, daily reports could be gathered and broadcast back with the added bonus of Miss Orme being seen by all and sundry as an impartial, well-meaning outsider. Of course, she was no such thing. She knew what George wanted and she was happy to give it to him - intelligence on Edith that would give him reasons for labelling his wife as a mentally defective bad mother, not fit to look after her children. And Miss Orme's reward was the title of George's confidante - one in the eye for Miss Collet! Remember what George used to say about how he thought women were all back-stabbing cows to each other? Neither Miss Orme nor Miss Collet would have known that, of course - he wouldn't have passed that snippet on to them haha!

Just as he told lies to Miss Collet about Marianne  aka Nell (claiming she died five years before she did, for an example), was George terraforming Miss Orme's mental landscape into believing Edith was some sort of diseased wretch? His treatment of his wife was cruel and calculated to undermine her sanity - was he preemptively seeking to blame Edith for any sickness she might manifest, because further down the line, he knew she would very probably be fully paretic, and someone, sooner or later, would be asking awkward questions - like, from where had she contracted her disease? If he paved the way for Miss Orme - probably with little or no experience herself of syphilis and its consequences - to assume that, if Edith became syphilitically ill, then she must have caught it after the marital separation? If so, that might explain the extraordinary story he told in 1899, when he claimed to have received an anonymous letter accusing Edith of having an affair. (We might pause here to recall the Mysterious Case of the Policeman in the Nighttime - when a policeman came to tell George Marianne was in trouble. Commonplaces 35-37 deal with this.) Creepily, George advertised for more info (he could be quite the little Mr Grundy at times). By miring Edith's name in a sex scandal, was he really making sure no-one would suspect him of infecting her with syphilis, because this alleged  affair was 'proof' she was sleeping with other men? No smoke without fire, what! Of course, nothing came of it - because it was a ridiculous notion only a chump would believe. But, George had done his usual thing and lied to manage the perceptions of his friends, and involve others who were only too willing to do his dirty work for him or come up with ideas to solve his problems. Frederic Harrison was set up to do the same with Marianne. Henry Hick was used similarly with Edith. Morley Roberts, ditto.

Pause for a moment and consider how vile an act this would be, if true. He has given his wife syphilis, cast her aside with his children, moved on to another female and then, the cherry on the cake: told a pack of lies to frame his wife for her paresis. You couldn't make this wickedness up, could you? Well, perhaps you could, if you were a fading late Victorian writer. Heroic? Non.

That phrase - 'as long as she keeps well' - implies that she has been ill. George tends to think all women are mad, but is he hinting at the paresis that he knows has made Edith unpredictable and, at times, aggressive and irrational, and likely to be progressively worse fairly quickly? He knows about the mental effects of paresis - some of the most famous people of the age were fellow-sufferers, and he read about their sad ends - Jules de Goncourt, Alphonse Daudet, Arthur Schopenhauer, Heinrich Heine (a particular hero of his), Arthur Rimbaud, to name but a few. The man who spent a lot of time in libraries would have had access to all manner of research items to broaden his knowledge. He had visited a mad house himself when in Paris, where syphilitics would have made up a fair proportion of the patients, and paretics would be roaming the streets of all the big cities, rubbing shoulders with the uninfected - so plenty of evidence of mental meltdown for him to see where Edith might be inevitably heading. Marylebone workhouse would have a special wing for them - and adverts for syphilis cures would hound him from their hoardings. This September meeting was the last time George and Edith were together. Was she beginning to look like a woman with paresis?


This threat to remove her child - she knows he means it - he has form on the child abduction front. No concern for the children, of course; even as he and his wife sit talking over their marriage, he is planning his rout of Gabrielle and her total capitulation to the old Gissing charm offensive (or, is that offensive charm??) because the clock is ticking and he needs a nurse for his last years. How far he has come from that dopey dingbat who trolled along the Oxford Road in Manchester looking for girl action. From those idealistic days when he had goodwill in his heart to the creature engineering Edith's downfall whilst manipulating his way round Gabrielle is a mighty fall. As Alphonse Daudet put it: Men grow old, but they do not ripen.

So, George off in France with Gabrielle, and Edith, in England with Alfred, overwhelmed by her situation, becoming increasingly isolated and unable to cope, is invisible. She is the block to George's marriage to Gabrielle, but she does not exist to him and neither do his sons. Money and the odd letter to Walter, are all they get from him. George's health declines rapidly from the day he sailed for France. Edith, her dreadful plight undocumented, is finally too ill to carry on looking after Alfred. 

There are psychiatric medical records that give tantalising clues to Edith's mental state during the last years of her life, and point us in a certain direction. These notes were presented in the Gissing Journal of July 2010 Vol XLVI Number 3 (sadly, not yet available online) by long-time Gissing family researcher and all-round esteemed Wakefield historian, Anthony Petyt.
JOIN ME IN COMMONPLACE 67 FOR PART TWO OF EDITH'S HEROIC LIFE AND THE DECODING OF THOSE MEDICAL RECORDS.

All the illuminated illustrations are by an unknown artist, taken from an edition of Giovanni Boccaccio's, “De Mulieribus Claris,” c1440 British Library click for more.

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. 

Untitled Andy Warhol 1971

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. 

Untitled Andy Warhol 1971

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!!

Untitled by Andy Warhol 1971

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.

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

The Borghese Gladiator by Agasias of Ephesus c 100 BCE

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

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

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.

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.

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...

Relief of Emperor Lucius Verus c  166-70 CE

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 the gummata 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

Commonplace 63 George & Syphilis PART TWO How it Blighted Him

Self Portrait with Carnation
by Otto Dix 1912

In Commonplace 62 we looked at the John George Black letter sent to George that addressed his own venereal infection, and the one George had contracted earlier. I suggested the JGB description of his own ailment plus the evidence available in the first of the set of letters presents a picture of a secondary syphilitic infection. This indicates JGB did not catch it when he visited the girl in the boarding house (the girl that George had his eye on), because he would have already had it for some weeks, based on his symptoms. However, there is no way of knowing what George's infection was, based on JGB's infection (unless they slept with each other haha.) However, it doesn't discount that possibility. Of them having the same sort of infection - not of them sleeping together!

My own contention is that George caught an infection of some sorts probably in about November 1875. Two reasons suggest this: 1) by the time of the JGB second letter George was already familiar with the treatment, and so probably caught his infection (if it was syphilis) about 3-4 months earlier than the letter was written (March 26th). And JGB is asking if theirs are the same - if they had both caught it from the same person, he would not need to ask that question. 2) November 22nd 1875 was George's 18th birthday, that time when childhood has officially, legally ended. He was not old enough to vote, but he was old enough to assume some of the responsibilities of adulthood. It was also the age at which he moved out of Alderley Edge school, where he had boarded and worked part-time as a teacher, and into digs in Manchester. What better way to celebrate your 18th, than by casting your fate to the wind? Like most of us do when we are desperate to prove to the world (and ourselves) that we are all grown up. For the purposes of this section, let's assume it was syphilis - based on the reasons given in the previous post.

Sunrise by Otto Dix 1913

A few months after the first John George Black letter, George was arrested and sent to prison. As a brand-new prisoner, he would have been processed and documented. The prison admission record is where a prisoner's physical condition is noted - all identifying scars, signs of illness and disabilities or deformities would be logged. This was not just to make sure any ailments are treated, but to stop the spread of infection and disease, and to prevent any attempt at blaming the institution for any disease or injury that might emerge whilst in custody. There is, on record, mention of George's physical condition in terms of a general description of him (height, distinguishing features - moles, etc) when he was processed at Belle Vue, but no mention of disease or incapacity. If George had been treated with mercury within the past several months before admission to prison, there would probably be physical signs apparent of both the mercury and the disease itself still apparent - we would expect to find that in the prison record. If it is not there, then the disease (if present) had progressed beyond the secondary, very visible, stage, and gone underground to do its tertiary worst. If he has signs of syphilis, these would have been logged. Chancre leaves a scar on the affected site of infection - if George had been thoroughly examined, this should have been logged. Is absence of this evidence also evidence for absence of syphilis?

The Match Seller by Otto Dix 1920

It is interesting to consider that George's decision to settle down and to find himself a girlfriend and so give up his philandering ways might have been a reaction to the fact he had contracted a venereal disease - and not because he fell madly in love, as some biographers and romantics suggest. It would seem to be a pragmatic, cool-headed decision; if he looked for a girlfriend it was to keep him on the straight and narrow and out of harm's way, and not because he was a hopeless doofus who fell in with a scheming female, a poor wee sap who gave it all up for love. As Anthony West says, Marianne aka Nell came a cropper when she met George - she was singled out for disaster.

We know (if Anthony West's account of what HG Wells told him about it is correct) John George Black recommended a place where George could find a girl with little or no sexual experience. Would this mean, to George, she might fit the bill as wife? He certainly always spoke of the girl he was interested in as 'wife material', but was it - as it was with Edith - the fact that any girl would do, and it didn't really matter who she was as a person? Did he think: 'Any girl who is not too picky, is what's required - a middle class one would find syphilis a bit too much of a challenge to accept - but a working class girl won't be so choosy - she'll thank her lucky stars to be picked by one who is her social better. And the working classes are enured to venereal disease - at least, the ones who came into father's shop were'. If this was George's rationale, it might throw some light on why he considered middle class women out of his range as potential mates - the shame of an incurable venereal disease would put them off. (His notion no decent woman would marry a man who earned less than £400 pa is a crock as women are very sympathetic to the pathetic in a man... look to yourselves, boys!!)

Portrait of Max John
by Otto Dix 1920

In George's time, attitudes to the sexes commingling (that's the google approved spelling of co-mingling, apparently) amongst the working class were not as driven by fears of the stigma of promiscuity, when compared to the strict segregation practiced by the middle classes. Indeed, part of George's attraction for mixing with the working classes could have been to have informal and free and easy access to girls. But that does not mean women who socialised freely worked as prostitutes. In fact, you only have to read George's Workers In The Dawn, Thyrza, The Nether World, etc, to appreciate how the sexes met and mingled and socialised - and very few of the women were ever paid, or charged a fee for it. Maybe the fixation amongst Gissingites that George married a prostitute is a male myth (or fantasy! You know what Freud would say about it haha) made flesh? As Jerry Hall notoriously said: My mother said it was simple to keep a man; you must be a maid in the living room, a cook in the kitchen and a whore in the bedroom. Is this how George saw it? It seems to sum up all he expected from Edith!

So, we have young George, a veteran of venereal disease and fresh from prison. There is one strong piece of evidence that might indicate George did suffer from syphilis at that time. According to Anthony West, George willingly went to America and even thought up the idea. A question always worth asking is, why didn't Marianne go with him? The answer generally given is that George's sponsors would not have been too keen on paying for her one-way ticket. This is rubbish. If he was going to America forever, what did they care if he took her with him? The few extra pounds her fare would cost would be a bargain if it got him off on the right footing in his new homeland - after all, they wouldn't want him getting lonely and getting himself in trouble. And, he had promised to marry Marianne - and that was seen as a completely binding contract at the time - you will recall when he had promised to marry Edith and Morley Roberts' rescue plan for George marrying one of Roberts' sisters was scuppered because George took his promise - morally binding - seriously. George and Marianne were seen as a partnership, even if his mother disapproved of his choice, and it makes no sense to keep Marianne in England. Was it to break them up? He was already damaged goods - Mrs Gissing would accept he couldn't marry anyone from his own class; in America, the young couple could start together with a clean slate and build some social credibility in a more democratic society. Did his mother know about his infection? Was that second letter from JGB made known to her?

Prage Strasse by Otto Dix 1920

Some suggest Marianne stayed behind in England to get 'finished' in the middle class sense of being made socially acceptable. Remember, at this time, she already was socially acceptable - to George - and would have been acceptable to the more democratic Americans. My theory is that the decision George (though probably not in consultation with Marianne) took to separate and spend time apart was based on him having a syphilitic infection that he did not want to pass on to Marianne - or any children they might have. For some time before the 1870s, many (predominantly male) sufferers, following infection with the disease, made the decision to abstain from sex and deny themselves marriage, for the whole of their lives, a decision taken on the recommendation of medical experts. As more came to be known about the highly contagious primary and secondary stages of syphilis, and the relatively benign later stages, it was determined that, after a reasonable period free from overt signs of disease, a person might be able to marry - when the dreaded secondary stage was completed and the sufferer was no longer able to pass on the disease. This appropriate length of this period was debated, but four years was considered a reasonable benchmark - two years for the disease to fully pass both its two worst stages and two years to prove the disease was definitely absent in its contagious form. In 1880, Alfred Fournier, the renowned French syphilologist, delivered his ground-breaking Paris lecture on 'Syphilis and Marriage', advocating the length of abstinence from marriage for syphilitics as four years - which became the standard advice given by physicians from then on. So, if George contracted his syphilis in November 1875, then he would be eligible to marry four years later in around November 1879. And, when did George and Marianne get married? 27th October 1879.

Working Class Boy by Otto Dix 1920

We know George and Marianne split up and eventually, she died of acute laryngitis in 1888. In Commonplaces 31-34 I state as firmly as I can that I do not think Marianne ever contracted syphilis, because of what George describes at her death scene and the diagnosis she had of scrofula, a form of TB that attacks the glands. Syphilis and TB are so similar, it is possible to confuse them in terms of how they present (see previous post) - differentiation is always tricky, even today, if you factor out modern blood testing as a diagnostic tool. However, there isn't any hard evidence Marianne ever contracted the disease, but we do have George's letter to Algernon mentioning she has TB in the form of scrofula. Of course, she might have had both diseases, but there is no evidence for this. At her death, she was cachexic but her teeth were perfect - according to George. Treatment for syphilis was very hard on teeth and tended to rot the gums - the correct dose of mercury was assessed by its effect on the gums - teeth became loose and often wobbled and then fell out when too much mercury was administered, or the correct dose was used, but treatment given for too long. The physician attending Marianne's death did not attribute her death to syphilis, which he would have done if that had been the cause of death, or a significant contributory cause. In 1888, causes of deaths were required to be reported for statistical purposes to the parish health board (and contagious diseases in particular), so if the disease contributed to her death, it would have been described as such on the death certificate. Both Morley Roberts and Pierre Coustillas suggest 'acute laryngitis' is a euphemism for syphilis - which is a leap of imagination from two non-medical minds who bat for George with good, if misguided, intentions.

Skat Players by Otto Dix 1920

After Marianne's death. George began to pine for female company. When she was alive, this loneliness wasn't mentioned. Was this because he still had a sexual relationship with her almost up until the end of her life, because he was legally entitled? (That would explain why news of her death was such a shock). It is unlikely he was entirely celibate during all this time - he was young, and vigorous in the days before the decline set in. In The Odd Women (1893), George put these words in Rhoda Nunn's mouth: 'What man lives in celibacy? Consider that unmentionable fact.'

If he contracted syphilis in 1875, then by 1888 he had gone 13 years with the threat of it emerging in its tertiary stage. When he went to Paris with Plitt... did he take in all the sights and experience all the sensual pleasures of this zestful city? Plitt liked Italy (but not Rome - the philistine! haha) possibly because it afforded unlimited sex - did he show George the places he knew of in Paris and did George imbibe? (Was this why George disliked Paris with Gabrielle? Everything so near, yet so far...) Because, it is possible to contract a second dose of syphilis - you are not immune just because you already have it in its third stage. It seems quite likely that he was, for some time throughout the 1890s, suffering from the exacerbations and remissions typically associated with the disease. Take his trip to Italy and the time he wrote about being treated with quinine - for malaria?

JOIN ME IN PART THREE FOR MORE ABOUT THIS ITALIAN BUSINESS AND HOW IT POINTS TO A DIAGNOSIS OF SYPHILIS.