Commonplace 70 George & His Devoted, Slightly Not Very Objective Fans (you know who you are!).      

CLICK!! GO ON!!! YOU KNOW YOU WANT TO click

Recent posts have covered George and syphilis and how he passed this on to Edith. Not everyone will appreciate the views expressed therein and will be experiencing some sort of mental meltdown at the effrontery of it all. To compensate the critics for not being able to hunt me down and shoot me like a mad dawg, here is a resource from Arthur Schopenhauer to help ease the effects of cognitive dissonance. Enjoy.

Schopenhauer's The Art of Being Right or 38 Ways To Win An Argument.  

Arthur Schopenhauer (1788-1860) was no stranger to arguing, and so he came up with these 38 Stratagems - excerpts from "The Art of Controversy", first translated into English and published in 1896 - to aid the wannabe controversialista. 

Schopenhauer's 38 ways to win an argument are:

1.     Carry your opponent's proposition beyond its natural limits; exaggerate it. The more general your opponent's statement becomes, the more objections you can find against it. The more restricted and narrow his or her propositions remain, the easier they are to defend by him or her.

2.     Use different meanings of your opponent's words to refute his or her argument.

3.     Ignore your opponent's proposition, which was intended to refer to a particular thing. Rather, understand it in some quite different sense, and then refute it. Attack something different than that which was asserted.

4.     Hide your conclusion from your opponent till the end. Mingle your premises here and there in your talk. Get your opponent to agree to them in no definite order. By this circuitous route you conceal your game until you have obtained all the admissions that are necessary to reach your goal.

5.     Use your opponent's beliefs against him. If the opponent refuses to accept your premises, use his own premises to your advantage.

6.     Another plan is to confuse the issue by changing your opponent's words or what he or she seeks to prove.

7.     State your proposition and show the truth of it by asking the opponent many questions. By asking many wide-reaching questions at once, you may hide what you want to get admitted. Then you quickly propound the argument resulting from the opponent's admissions.

8.     Make your opponent angry. An angry person is less capable of using judgement or perceiving where his or her advantage lies.

9.     Use your opponent's answers to your questions to reach different or even opposite conclusions.

10. If your opponent answers all your questions negatively and refuses to grant any points, ask him or her to concede the opposite of your premises. This may confuse the opponent as to which point you actually seek them to concede.

11. If the opponent grants you the truth of some of your premises, refrain from asking him or her to agree to your conclusion. Later, introduce your conclusion as a settled and admitted fact. Your opponent may come to believe that your conclusion was admitted.

12. If the argument turns upon general ideas with no particular names, you must use language or a metaphor that is favourable in your proposition.

13. To make your opponent accept a proposition, you must give him or her an opposite, counter-proposition as well. If the contrast is glaring, the opponent will accept your proposition to avoid being paradoxical.

14. Try to bluff your opponent. If he or she has answered several of your questions without the answers turning out in favour of your conclusion, advance your conclusion triumphantly, even if it does not follow. If your opponent is shy or stupid, and you yourself possess a great deal of impudence and a good voice, the trick may easily succeed.

15. If you wish to advance a proposition that is difficult to prove, put it aside for the moment. Instead, submit for your opponent's acceptance or rejection some true proposition, as though you wished to draw your proof from it. Should the opponent reject it because he or she suspects a trick, you can obtain your triumph by showing how absurd the opponent is to reject a true proposition. Should the opponent accept it, you now have reason on your own for the moment. You can either try to prove your original proposition or maintain that your original proposition is proved by what the opponent accepted. For this, an extreme degree of impudence is required.

16. When your opponent puts forth a proposition, find it inconsistent with his or her other statements, beliefs, actions, or lack of action.

17. If your opponent presses you with a counter proof, you will often be able to save yourself by advancing some subtle distinction. Try to find a second meaning or an ambiguous sense for your opponent's idea.

18. If your opponent has taken up a line of argument that will end in your defeat, you must not allow him or her to carry it to its conclusion. Interrupt the dispute, break it off altogether, or lead the opponent to a different subject.

19. Should your opponent expressly challenge you to produce any objection to some definite point in his or her argument, and you have nothing much to say, try to make the argument less specific.

20. If your opponent has admitted to all or most of your premises, do not ask him or her directly to accept your conclusion. Rather draw the conclusion yourself as if it too had been admitted.

21. When your opponent uses an argument that is superficial, refute it by setting forth its superficial character. But it is better to meet the opponent with a counter argument that is just as superficial, and so dispose of him or her. For it is with victory that you are concerned, and not with truth.

22. If your opponent asks you to admit something from which the point in dispute will immediately follow, you must refuse to do so, declaring that it begs the question.

23. Contradiction and contention irritate a person into exaggerating his or her statements. By contracting your opponent you may drive him or her into extending the statement beyond its natural limit. When you then contradict the exaggerated form of it, you look as though you had refuted the original statement your opponent tries to extend your own statement further than you intended, redefine your statement's limits.

24. This trick consists in stating a false syllogism. Your opponent makes a proposition and by false inference and distortion of his or her ideas you force from the proposition other propositions that are not intended and that appear absurd. It then appears the opponent's proposition gave rise to these inconsistencies, and so appears to be indirectly refuted.

25. If your opponent is making a generalization, find an instance to the contrary. Only one valid contradiction is needed to overthrow the opponent's proposition.

26. A brilliant move is to turn the tables and use your opponent's arguments against him or herself.

27. Should your opponent surprise you by becoming particularly angry at an argument, you must urge it with all the more zeal. Not only will this make the opponent angry, it may be presumed that you put your finger on the weak side of his or her case, and that the opponent is more open to attack on this point than you expected.

28. This trick is chiefly practicable in a dispute if there is an audience who is not an expert on the subject. You make an invalid objection to your opponent who seems to be defeated in the eyes of the audience. This strategy is particularly effective if your objection makes the opponent look ridiculous or if the audience laughs. If the opponent must make a long, complicated explanation to correct you, the audience will not be disposed to listen.

29. If you find that you are being beaten, you can create a diversion that is, you can suddenly begin to talk of something else, as though it had bearing on the matter in dispose. This may be done without presumption if the diversion has some general bearing on the matter.

30. Make an appeal to authority rather than reason. If your opponent respects an authority or an expert, quote that authority to further your case. If needed, quote what the authority said in some other sense or circumstance. Authorities that your opponent fails to understand are those which he or she generally admires the most. You may also, should it be necessary, not only twist your authorities, but actually falsify them, or quote something that you have invented entirely yourself.

31. If you know that you have no reply to an argument that your opponent advances, you may, by a fine stroke of irony, declare yourself to be an incompetent judge.

32. A quick way of getting rid of an opponent's assertion, or throwing suspicion on it, is by putting it into some odious category.

33. You admit your opponent's premises but deny the conclusion.

34. When you state a question or an argument, and your opponent gives you no direct answer, or evades it with a counter question, or tries to change the subject, it is a sure sign you have touched a weak spot, sometimes without knowing it. You have as it were, reduced the opponent to silence. You must, therefore, urge the point all the more, and not let your opponent evade it, even when you do not know where the weakness that you have hit upon really lies.

35. This trick makes all unnecessary if it works. Instead of working on an opponent's intellect, work on his or her motive. If you succeed in making your opponent's opinion, should it prove true, seem distinctly to his or her own interest, the opponent will drop it like a hot potato.

36. You may also puzzle and bewilder your opponent by mere bombast. If the opponent is weak or does not wish to appear as if he or she has no idea what you are talking about, you can easily impose upon him or her some argument that sounds very deep or learned, or that sounds indisputable.

37. Should your opponent be in the right but, luckily for you, choose a faulty proof, you can easily refute it and then claim that you have refuted the whole position. This is the way which bad advocates lose a good case. If no accurate proof occurs to the opponent or the bystanders, you have won the day.

38. A last trick is to become personal, insulting and rude as soon as you perceive that your opponent has the upper hand. In becoming personal you leave the subject altogether, and turn your attack on the person by remarks of an offensive and spiteful character. This is a very popular trick, because everyone is able to carry it into effect.

How many of the rampant syphilis deniers will be making use of number 38?  

George was a big fan of Schopenhauer and no doubt made use of these tactics when managing his women. Which is probably (one of the reasons) why he didn't have much luck with them haha.

Commonplace 69 George & Syphilis PART EIGHT Edith's Heroic Life part 4 THE END.

           There lies the heat of summer

by Heinrich Heine 

There lies the heat of summer

On your cheek’s lovely art:

There lies the cold of winter

Within your little heart.

That will change, beloved,

The end not as the start!

Winter on your cheek then,

Summer in your heart.

Edith was doomed from the moment she entered into a mental asylum - few people ever found their way out to the other side, especially those with no support systems in place, and no friends. Without an advocate in the free world, who would represent her? And, when everyone wanted her to remain institutionalised and out of the way, what hope was there? In moments of lucidity, this would have been apparent to her. With the likes of Misses Orme and Collet using their contracts and considerable mental gifts to outwit any opposition Edith might have mounted, all she had recourse to was a raft of poignant, pointless letters to Ellen Gissing.

You have to wonder at the brain power of the two Gissing girls - Madge was written off by George when she was a girl, and her health seems to have been dire - which is probably why religion took such a hold on her. And, as with all George's siblings, the example of Number One Brother was in the negative, not the positive, strain - so we mustn't expect too much of her. But, Ellen, the one more corresponding to George's own underachieving female archetype, hardly seems to have raised her head above the parapet of life - though that would not have been unusual of lower middle class women at the time. But, still... you have to ask what would Jesus have done with Edith's cries for help? The power of influence over her that was Miss Collet's role as executrix seems to have (willingly) overruled her assumed Christian charity where her sister-in-law was concerned. When Edith wrote a heartfelt letter asking for help in being considered for discharge from the asylum she was housed in, Ellen passed on the letter - and the moral decision-making - to Miss Collet (like brother like sister it seems), who was only too pleased to act as some sort of necrophiliac minion. Anthony Petyt, in his Gissing Journal account (see previous Commonplace posts), says he doesn't know if Miss Collet bothered to find out if Edith was eligible or sane enough to be rehabilitated, but that Edith spent the rest of her life in the mental hospital mausoleum she was cast in to.
Judge for yourself; this was written by Edith on August 8th 1910.
Dear Miss Gissing,
I am not writing to ask you to come and see me but to come and make it possible for me to pass out at the end of this year. I have been ten years among the Insane.
I hope the Boys are quite well and yourself also. Hoping to see or hear from you soon.
with love,
From
Edith.

At The Races by Edgar Degas 1877-1880

Ellen did not reply - she never replied to any of Edith's letters; she gave that task over to Miss Collet who didn't, as far as we know, bother to put pen to paper directly to her master's widow. You might recall how George tended to give the dirty work over to his minions - seems Ellen was a chip off that block, too. However, given the rational nature of this letter, you would think she might have found it in her heart to write back - knowing what that might mean to Edith's sense of herself.

Let's take up these doctor's notes on Edith, in 1910, about the time this letter was written. One doctor wrote this in May 1910: Is still deluded about her husband being alive but thinks now the "poisoning" was a mistake & that carbolic acid was only used for cleaning purposes & not to poison her. Is quiet & reserved & clean but is occasionally violent. You will recall Edith often thought carbolic was put in her tea - which might have been because of the strong odour of disinfect used (it was a relatively new form of cleaning agent).
In June (has the regime changed from quarterly to monthly reviews?): Excited at times, very reserved.
September: No change in mental condition. Health good.
Now, something must have happened - because the Edith who wrote the letter to Ellen was not the Edith who, in 1909, was routinely reported as excited, deluded, noisy and abusive. This seeming 'cure' and return to a quiet, reasonable state in 1910, is exactly what might be predicted from a diagnosis of paresis, where 'periods of clarity' - as Deborah Hayden calls them in her study of syphilitic paresis: Pox. Genius, Madness and the Mysteries of Syphilis (2004) - are the norm. The letter certainly seems to be a product of this sort of  phase.
In November 1910: She is usually quiet & reserved & keeping much to herself but occasionally she is abusive & restless, her conversation is incoherent & often her conduct is irrational. How 'rational' should you be acting after years of institutionalisation?? And when does being 'irrational' mean one is insane?? It is irrational to decide to get so drunk you fall down and show you pants in the street - but hundreds of young Brits do it every Friday night; in fact, they do it to stop themselves being 'rational'. And, this is not a term with any value as who knows what the doctor thinks 'rational' to be. 

The Bellelli Family by Edgar  Degas 1856-1867

It seems there are some breaks in the recording of medical notes - Edith was discharged from Fisherton House Asylum and transferred to Dorset County Asylum (near Charminster) on March 9th 1912. No reason (Anthony Petyt writes) is known for the discharge. The Dorset County Asylum had a private wing, a villa set in the grounds, referred to as Herrison House, later amalgamated with the main asylum to form the Herrison Hospital click  

Herrison House Private Patients' Wing. 

There seems to be no reason found for why Edith was moved. Usually, patients remained in the asylums in which they were situated, until funds ran out and they were transferred to 'County Asylum' care. However, Edith was a paying, private patient, and so Fisherton House would be happy to keep her, whatever her diagnosis. So, what might be the reason for her to be transferred to another fee-paying situation? The most obvious is that it would place her further out of reach of her sons. Walter was 19 years old in December 1910, and so would have been responsible for his own affairs. He had been taken on as an assistant to Ernest Grimson, an 'architect and furniture designer', according to the Gissing Journal of July 1996 (Volume XXXII; Number 3). This meant he was based in Cirencester, about 55 miles from Salisbury and Fisherton House Asylum. By his mother being transferred south to Charminster, another 40 miles were added to the trip - and even today, that's a 6 hours and 40 minutes train journey, with three line changes and quite a bit of walking. Even accounting for the pre-Doctor Beeching cuts click to the railway system, and factoring in the 1910 time spent at all the stops between, that is a commensurate amount of time in today's terms.

Emma Dobigny by Edgar Degas 1869

We can assume once Walter was old enough to know all the details of his mother's detention, he would be inquisitive. Lordy knows what the minions told him, but he might very well have wanted to find out for himself what was going on - having been fed propaganda for so long, and being a headstrong and resilient sort of fellow, starting out in life, ploughing his own furrow. Letters between them would not have survived - asylums tended to keep patients' correspondence on file, and would have censored and redacted anything untoward. There is the possibility the minions told the hospital not to let letters get through.

All this talk of Edith wanting contact with her 'Boys', even to be remembered to them, is the sort of thing Gissing biographers miss. They prefer to see Edith as a subhuman monster - which she clearly was not. Even without the affliction of paresis to affect her judgement and mood, she was in a terrible situation - in her marriage, totally at the mercy of a heartless and self-centred man who callously exploited her femininity then rejected her when it suited him. Just as he had done with Marianne aka Nell. Just as he was planning to do with Gabrielle - in fact, was doing as he spent so little time with his third life partner, giving her the slip whenever he could, holing up out of her reach - for his health haha. How could Edith have survived George, even if she had been meek and mild and the very epitome of Richard Mutimer or Marian Yule's mother (is there something Freudian/Oedipal in George's depictions of working class mothers and his choice of wife???) - how could that role be attained, except by caving in to his every demand and irrational rule?

Two Ballet Dancers by Edgar Degas 1856

Edith's mental health, as described in the admission report at Herrison House, had deteriorated, but, again, this fits the pattern of paresis. She is described as conscious and aware of her surroundings, answers questions sensibly - but deluded. Asks in a very childish manner to see a solicitor in order to be discharged, but mostly tries to avoid MD. Taciturn and solitary. Health fair.  

Again, she thinks George is alive and nearby; she frets over wanting to be being discharged, but it is all in vain. Anyone who has read Erving Goffman's 'Asylum' click will know it is much easier to get into a mental hospital than it is to get out. And so it goes on, the inevitable slow walk to the exit. Patients similarly incarcerated speak of only being discharged 'in a pine overcoat' - you know well what they mean.

January 1913 - No improvement or change of any kind to report. Well, shame on them for being so useless. What a waste of an interview - if they ever did one.
April 1913 - Edith's physical health begins to decline. There is a bit of pyrexia. Her respiration count is fast at 25 (per minute - resting, it should be 15ish); her pulse is 100 (resting pulse is usually 70ish per minute), but she will be stressed on examination, so nothing untoward. She has pain in her left side. No cough or sputum (so no phthisis, it seems) She reluctantly agrees to being examined by the MD. He reports:
Whole of left side dull to percussion, and he finds bronchophony and pectoriloquy well marked. These are abnormal readings, indicating changes in lung tissue producing hardening and loss of function. Fine crepitations can occasionally be heard - here, meaning abnormal sounds of the lungs as they expand and contract. A little bronchitis and rales (similar to crepitations) and rhonchi (the sound of crackling you can hear in 'wheezy' chests). Diagnosis - probably a dry? fibroid phthisis.

This seems to be a reasonable diagnosis - we know George had TB and could have passed it on to Edith, and fibroid phthisis is a clearly defined disease click. However, there is a possible differentiated diagnosis: pulmonary syphilis - click.

July 1913 - Still  very foulmouthed. Was she swearing, using profanity, or speaking out loud about sexual topics?? One woman's foul mouth is another's lyric poetry.
Edith's health stabilised and throughout the rest of the year and on into 1914...
April 1914 - General health is much better as she spends almost the whole day out of doors. Mental condition is as bad as ever. There are no summer notes, and then...
October 2nd - Is quite demented, takes no notice of anybody or anything. 
November - She seems quite lost and is unable to realise her present surroundings. In moderate health.

Dancers in Pink by Edgar Degas 1880-85

So, we have a typical slide to dementia - which is an umbrella term in 1914, when ich is not typical or fibroid phthisis or TB or functional psychoses. Organic psychoses - where the brain is changed by damage from any infection, disease, trauma, toxic overload, and many other brain-damaging factors - generally slower and more insidious.

April 1915 - Ideas confused. Perception disordered.
May 1915 - This 'two-word' entry is indecipherable (according to Anthony Petyt reporting in the Gissing Journal). Then, there is a mysterious gap of 16 months in recorded notes. Is this just a Gissing Journal editorial condensing for publication thing? No explanation is forthcoming from the GJ but it is worth noting this period of missed months coincides with Walter's time in the British Army and his sad death at the Somme, estimated to be July 1st 1916.
September 1916 - There is a tumour in one of her breasts... She is sullen and solitary. 
January 1917 - A hopeless case of delusional insanity... 
February 20th 1917 ... She was supposed to be phthisical but no signs of pulmonary tuberculosis can be made out.
February 22nd 1917 - Albumin in urine (indicative of kidney failure)  complains of pains in chest but is probably due to her tumour in her breast. 

Edith grew weaker and more helpless, and required catheterising. She vomited frequently, her pulse was tachycardic, she had a slight fever (temp 99.6). On February 27th, she died at 10.50pm. There is no note of her last moments, who was present, or how she was mourned. Were her Boys at the funeral? I doubt it - the minions would not have allowed that!

Young Spartans Exercising by Edgar Degas 1860-1862

There was a post mortem. This is taken from the Gissing Journal account, so, in the interests of editorship it might not be complete:
Tumour in left breast - no diagnosis for why there is a tumour. As it wasn't tuberculous, it might have been cancerous. However, there is no mention of the cancer spread to other organs, which would have been perfectly likely in a case of mammary cancerous tumour. Edith, George reported in his Diary, had trouble breastfeeding - was this because she was experiencing syphilitic lesions to her breasts, being in the secondary stages of the disease? 
Bowel congested in parts. No sign of enteric fever or dysentery. Important information for the hospital as contagion would have spread quickly, and would have required attention.
Spleen enlarged, weight 8 ounces, surface or organ studded over with white spots (tubercles). Tubercles are not to be taken as TB - a tubercle is a descriptive term for a type of tissue growth click. 
Lungs - normal  - spread of cancer to the lungs might have been expected in a case of breast cancer, but the symptoms and signs of this are not reported - either via post mortem exam or in patient's clinical signs and so were not a factor. In the above mentioned report click we have the case of a patient with Pulmonary syphilis mimicking pulmonary hematogenous metastases on chest. 
Heart - normal. 

Edith's cause of death was given as Organic Brain Disease - and, yet, there is no mention of post mortem exam of her brain! Was this skipped and a general cause of death given to save time and effort? After all, who would care? Or, was it patently obvious Edith had paresis, and so there was no need to bother with a full PM? In a case of insanity and/or dementia, and in the laboratory of a mental asylum, wouldn't it be standard practice to examine patients' brains?? Or, was it that a diagnosis of GPI/paresis was not recorded because the doctors were unfamiliar with it? It was still a mysterious concomitant to tertiary syphilis, and the full extent of its prognosis was unclear, so it may be the doctors were unfamiliar with the appearance of it in brain tissue.

Organic Brain Disease - here is the definition from here click:
Organic brain syndrome (OBS), also known as organic brain disease (OBD) Organic mental disorders organic brain disorder, is an older and nearly obsolete general term from psychiatry, referring to many physical disorders that cause impaired mental function.^[1]It does not include psychiatric disorders. Originally, the term was created to distinguish physical (termed "organic") causes of mental impairment from psychiatric (termed "functional") disorders. Treatment of OBS varies with the causative disorder or disease. It is important to note that it is not a primary diagnosis and a cause needs to be sought out and treated.

So, the final cause of death was equivocal, little more than a bog-standard entry, and very probably derived without an examination of brain tissue. However, there is a very strong case to suggest this was paresis.
1) George was known to have contracted some form of venereal infection, very likely to have been syphilis.
2) Physical symptoms such as breast problems, post-natal infections in her teeth, in the secondary stage of the illness.
3) 4 year gap between children being conceived. Standard time recommended by Ricord.
4) Behavioural changes began as early as 2-3 years after infection. George records this as problems with the servants and not doing the right 'middle class' thing becoming of a lady of the house, and arguing.
5) Bursts of violent behaviour and aggression which certainly were not a feature of early married life - typical of paresis.
6) Monomaniacal ideas about pursuing George when he deserted her.
7) Rapid onset of mental impairment.
8) Delusions of persecution which may have been over-reactions to real experiences (carbolic acid, men staring at her in public etc)
9) Hallucinations of touch - felt 'electricity' in her feet, as did Daudet; Van Gogh and Nietzsche (known syphilitics) also described experiences of being afflicted with sensations of being lit up by electricity, or pained by it.
10) Described as 'excitable' - and this was how Van Gogh was described, and Flaubert, Nietzsche, and de Maupassant. Remember George reported he felt anxious/hyper alert when the door knocker sounded, back in the living with Marianne days - was this at the start of his paresis?
11) Paresis attacks women more often than men - who suffer more from tabes dorsalis than do women.
12)Periods of remission, depression - and protean nature of this mental illness.
13) Possible pulmonary syphilis misdiagnosed as breast tumour. All those lung sounds previously listed should have been seen in exam at PM of the lung tissue - their absence indicates pulmonary syphilis.
14) Cause of death OBD - consistent with brain syphilis diagnosis as cause of dementia. Perhaps this is why no findings for PM exam of the brain was listed - it was dissected and syphilis was found, but for whatever reason, it was decided not to record it.
15) Edith was only 50 when she died - very young for OBD, and approx 30 years after contracting the disease - the typical span for syphilis.

Edith was buried at St Mary's Churchyard in Charminster, on March 6th 1917. The location of the grave is unknown as renovations and changes to the landscape have meant graves were lifted and bodies removed elsewhere or paved over. She is mentioned in the burial register 1916-17, page 23, entry 180. I doubt if Miss Collet or Bad Eliza Orme attended the funeral.

Commonplace 68 George & Syphilis PART SEVEN Edith's Heroic Life part 3

'Nothing but terror and despair at first; then, gradually, the mind, like the body, adjusts to this appalling condition.' Alphonse Daudet.

The Bride, Bridegroom and Sad Love
by Simeon Solomon 1865

We are looking at the probability that Edith, George's second wife, suffered from paresis, one of the neurological forms of syphilis - contracted from George. There is a very strong case (presented in Commonplace 66) for the assertion George was syphilitic when he married both Edith and Marianne aka Nell.

We take up the story using the article from the Gissing Journal of July 2010 (Volume XLVI Number 3) written by Anthony Petyt.

The Fisherton House Asylum records (AP discovered) show clinical reviews every three months - these would have been the doctor's notes. Nursing notes on patients' care and treatment would have been made weekly, at least, usually on a Sunday, but all kinds of basic things would be recorded by nurses, including weight measurement, bowel movements (vitally important when nursing epileptic patients!), baths taken, treatments administered (such as wound care and dressings); injuries, doctors' deliberations and examinations, medication given, monthly menses; food and drink taken/refused, visitors received, and pocket money expenditure - all standard depending on hospital policy and the thoroughness of staff to record such happenings. 'Incidents' would be recorded - these would include entries for how compliant vs troublesome the patient was with regard to staff and other patients. Woe betide any patient who pissed off a nurse with too much backchat - it would all be recorded; if a patient attacked a fellow patient, that would be described and logged. If a patient attacked a nurse...that would be dealt with summarily and harshly. It should be remembered, psychiatric nursing was not the noble profession it is today - staff working in institutions then were little more than gaolers and had no real sense of vocation. In Edith's time, of course, some nursing staff were compassionate and caring, but the system was not set up for too much identification with the patient - the bedrock of today's more empathic and Humanistic service - but as a form of containment and supervision. For a good understanding of asylums in Edith's time, read Sarah Wise's book: click. Another thing to dwell on - even today, in psychiatry, once a patient is given a diagnosis it is very hard for anyone to change it - or challenge it.

Study of A Girl by Simeon Solomon 1873

What we have to go on, from the Fisherton House notes on Edith, needs looking at in terms of definitions and frequency of occurrence of observable signs of illness. However (and this is the voice of experience speaking!), what we have has been recorded by different doctors with differing levels of knowledge and skill in their specialism, some of whom possibly never sat and spoke to Edith but used nursing notes, and a chat with the ward superintendent over a cup of tea, as references. Or, read the previous doctor's entry, and thought, 'Well, this patient has an intractable condition; she won't have changed much since last quarter, will she?' and just cut and paste what was previously in the file.

Superficially, it looks impossible to pick apart the Fisherton notes and make any sort of a diagnosis - so we just assume Edith was 'mad' - that dreadful, powerfully negative term now rightly out of use. But, we can find clues here, even in these brief entries - some of them amount, in the Gissing Journal's rendering - to five words (for three months' reflections on observations!).

Untitled Simeon Solomon 1905

From her admission (to Fisherton House) September 1904, and through to June 1905, Edith was described as excited, deluded, threatening and dangerous and violent.  We might take 'excited' in this as meaning hypermanic or over-active, or even anxious. But, some people are highly strung by nature and 'live on their nerves', as they say in common parlance. However, this can also be a symptom of paresis (see below). Delusions are false beliefs - or, erroneous translations of internal thoughts or memories which become confused in the mind. They are not lies - the patient believes them to be true. In Edith's case, she thought George Gissing was her husband - which he had been. She also thought he was still alive - as covered in the previous post, she may not have known he was dead. So, her delusions are not entirely false beliefs, are they? 'Threatening and dangerous' sound much worse than they probably were - based on the fact Edith did not do much damage to anyone - or it would have been recorded in the notes. I seriously doubt if she was 'dangerous and violent' to any degree (any more than any of us might be when detained against our wishes and surrounded by demented people) - again, there would have been serious repercussions to this sort of behaviour and she would have been medicated or 'dealt with' to suppress them, on orders of the medical staff. If it is not recorded, it was trivial. 'Dangerous', used here, is meaningless - unless we are told in which way she is dangerous, it could mean anything and nothing. Generally, any threats to staff are treated with a zero tolerance approach - and patients tend to be penalised either legitimately, or in underhand ways. If Edith was free to move around the ward, and if she wasn't restrained by any manual restraint (straitjacket, etc) she can't have been that much of a handful. As Edith tended to be a bit verbal, she probably specialised in spoken threats and abuse. Before the days of the 'liquid cosh' click, physical punishment was meted out in psychiatric care, and solitary confinement and restrictions were used to penalise troublesome people. Unless Edith was punished - which would have been recorded - the chances are she was never much of a challenge.

The Angel Of Death by Simeon Solomon 1896

Something happens in or about June 1905. Edith is described as quieter and better behaved since the last note but continues full of delusions, will not believe her husband is dead, says she got carbolic acid in her tea previous to coming here, etc. In the September, she is described as obstinate and troublesome at times... in the December: Has quite a depressed air, states that she tasted carbolic acid in her tea, that her husband is in this asylum & that he writes on the ward door. As the tea claims involve the sense of taste - which is an external-stimulus response - the chances are this might have been an hallucination, not a delusion. Hallucinations are based on sensory input being wrongly processed either physically (by an altered or abnormal brain) or cognitively - depending on your school of psychology beliefs. However, carbolic acid as a disinfectant was becoming standard in the early 1900s and was of particular interest to psychiatric settings as it masked the smell of urine. Patients who were 'difficult', in terms of behaviour, were often housed with others who were difficult - and many of these would have been incontinent of urine and faeces. Carbolic acid 'gets in the mouth', as we call it, and produces an aftertaste - as strong odours tend to do. Maybe that smell is what tainted the tea - to Edith's taste buds? Smell is the last sense to die - and it is, therefore, the strongest to persist in memory.

Dawn by Simeon Solomon 1871

The important feature from this time is that Edith has changed - we see 'depression' entering the story. Depression is a feature of all mental health difficulties - mania, a feature of manic-depression (an outmoded term but easy for the lay person to understand) is a form of depression, not bliss. Paresis brings its own form of depression - partly the effects of the spirochete eating away at brain tissue, partly because of the disease affecting all other bodily systems, and, in Edith's case, as she was incarcerated in an asylum, the comprehension that the situation is hopeless. Bluntly, Edith had a lot to be depressed about. 
In June and September 1906: Patient has been exceedingly noisy & troublesome on account of her delusions of persecution & visual & auditory hallucinations and her hallucinations cause her to be troublesome. No explanation or description is given of these hallucinations, and so it is difficult to try and fathom what they meant to Edith. But, she is back to responding to them - they are interfering in her life. That really is the definition of mental illness - when your ideas and actions begin to negatively affect your life, it becomes an illness - until then, it is just you being eccentric, my friend! 

Cupid by Simeon Solomon 1886 (looking very much like a young Oscar Wilde?)

We discover on March 15th 1907 the 'her tactile hallucinations seem to have disappeared... In June, 1907, she apparently conceals her hallucinations of touch. Then, in September of that year: complains of electricity in her feet. 

This is one of the most compelling bits of evidence for a diagnosis of paresis. Why did Edith feel compelled to cover up her hallucinations? Was it a feature of her persecution delusion - she had insight into how the staff would judge them as being more evidence for madness (which is what happened)? Was it because she knew these sensations were real and were associated with the shameful syphilis; that they were never 'hallucinations' at all? Some of the more prominent syphilitics of George's age were afflicted with this sort of pain, but let's consider Alphonse Daudet, one of George's heroes (though I suspect Daudet's disease was one of the things that put George off reading him, and Edmond and Jules de Goncourt!), who endured agonies in his legs and feet. This was, in Daudet's case, tabes dorsalis click (much more likely to be the syphilis variant in males than females) but the pain he describes is the same. In La Doulou (the basis for Julian Barnes' In the Land of Pain click), an account of his experience of tabes, not published in France until the1930s, there is a description of the pain and sensations it caused. Daudet writes: 
Warning signs going back a long way. Strange aches; great flames of pain furrowing my body, cutting it to pieces, lighting it up... Also, from that time onwards, pins and needles in the feet, burning feelings, hyper-sensitivity. Lighting up? 
In March 1908, Edith is prescribed potassium bromide. This was a treatment for a variety of ailments, and was known for its sedative effects. However, it was also used in cases of insomnia, headaches, epilepsy. And syphilitic pain. Daudet: Haven't had recourse to morphine for a long time, not since I've been taking bromide... How much I suffered last night in my heel... Varieties of pain. Sometimes, on the sole of the foot, an incision, a thin one, hair-thin...Intolerable pain in the heel...I spend half the night with my heel clasped in my hand...Flashes of pain in the foot...Then,  Bad night, woken with a jolt at three; no actual pain, but highly strung and in fear of pain. Might 'highly strung' be taken as 'excited'?

Study of A Woman With Red Hair
by Simeon Solomon 1873

We know paresis has spontaneous remissions and exacerbations - in a way that, for example, untreated schizophrenia, generally does not. In her book on syphilis click, Deborah Hayden highlights the tendency for paresis to appear to spontaneously improve without treatment. Was Edith's more 'settled' (as nurses might record in their notes) behaviour a sign of such a quiescent phase? When the worst of the 'psychotic' symptoms eased, insight would return - Edith would begin to realise what was happening, and have a clearer idea of her situation. Hallucinations can be caused by transient trauma to the brain, such as inflammation caused by infection. Inflammation is the process of tissue swelling, and in such a delicate area as the brain, any form of swelling puts pressure on vital functions. Anyone doubting how this could cause all of Edith's symptoms - have a look here click  

We also have changes in behaviour. When George first met Edith he described her as biddable - he claimed she was just in need of guidance and she would pass muster - as long as her London accent took a hike. She behaved in a ladylike manner and she and George spent a good deal of time together alone - innocently, of course. Their companionship grew, though George (and Edith!) had reservations. However, Edith was not a coarse and brutal woman, judging by the early Diary entries, so something happened to her to make her aggressive and violent. Was it her reaction to his illness - to phthisis and syphilis? - or was it the beginning of her paresis? There are changes, too at Fisherton House from noisy to quiet, scary to calm - typical of paresis. 

Edith died of what was described as 'organic brain disease' in 1917. 

JOIN ME IN THE FINAL PART OF OUR INVESTIGATION INTO THIS FASCINATING SUBJECT TO EXPLORE EDITH'S FINAL YEARS AND SAD END.

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 

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

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.

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. 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?

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 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.

Girl With Milk Jug (aka The Milkmaid)
by Johannes Vermeer 1658 

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. 

Lady Seated At A Virginal by Johannes Vermeer 1672

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.

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.

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.