Disease Detective

Deborah Hayden's new book, Pox, pulls the covers off famous people with syphilis. That's right: syphilis.

Little is known about the evolution of the syphilis spirochete. Researchers speculate that 100 million years ago, the whiplike, double corkscrew-shaped organism symbiotically colonized the guts of cockroaches. A few thousand years ago, it started to attach itself to human beings, slipping into the bloodstream through cuts in the skin. When our species began bathing, the spirochete found it expedient to move into our moist sexual orifices, following warm pathways of saliva and ejaculate into the mucus membranes of new hosts. The little viral beastie reproduces by repeatedly splitting in two, massively infecting the penis, vagina, or anus with hideous but painless lesions that soon vanish, in an apparent cure, as the bacterium wiggles its way deeper into the lymphatic system. Syphilis is only transmittable during the first few years of infection through open sores in the mouth and on the genitalia; nonsexual infection is rare, although the disease can be transferred by a wet towel.

As the pus-filled abscesses of primary-stage syphilis dry up, the spirochetes chew away at the heart, liver, brain, bones, muscles, and eyeballs. During its second and third stages, the disease evades diagnosis by mimicking the symptoms of rheumatism, arthritis, gout, eczema, epilepsy, headache, stomachache, jaundice, mania, depression, dementia, paralysis, schizophrenia, deafness, and "nerves." The tertiary and final stage gradually brings about the disintegration of mind and body; the longer the unfortunate sod hangs onto life, the worse his end is likely to be.

With spirochetes lodged permanently in his brain, a carrier may experience moments of preternatural clarity, emotional ecstasy, and even creative genius. "I do not want to romanticize syphilis, but there is a Faustian bargain to the experience," says Hayden. "The sufferers are often rewarded with a creative, disinhibiting burst. Euphoria and exhilaration are not so horrible -- that's all I can say." In the end, though, a stroke, an aneurysm, a heart attack, or systemic organ failure sends the syphilitic to his grave.

Hayden points out that shortly after Columbus returned from raping and pillaging Hispaniola, a nasty strain of syphilis invaded the bodies of millions of Europeans, vectored thither by the vaginas of prostitutes. Five hundred years of raging debate has yet to solve the question of geographic origin. New World or Old World, the cold fact remains that the fearful syphilis pandemic (rivaled only by AIDS for insidiousness) ravaged Europe and the Americas at the dawn of the 16th century, killing millions.

The tempo of mass infection slowed in the intervening years; by the 19th century, syphilis was considerably less virulent, although it was thought to infect as much as 15 percent of the population of the industrialized nations. It was known to be an unpleasant consequence of promiscuity and considered by many doctors to be hereditary. It was treated with mercury, arsenic, spider webs, and burnt deer horn. (One company manufactured mercury-laced chocolates for husbands to give to unsuspecting wives.) And since the visible signs of the disease — the chancres, pustules, and skin lesions — faded away after these treatments, it was often presumed cured. When the paralyzed syphilitic expired in coronary agony decades later, blame was often laid to other causes. The only sure way not to catch it in those pre-penicillin days was virginity (no kissing either!).

Hayden's work is significant because, as she points out, biographers have treated the pox "parenthetically, or in a footnote ... as if instead of being a life-changing and defining event, infection with syphilis was not more important than a passing head cold." Biographers tend to ignore or minimize its presence for an obvious reason: It was usually contracted as the result of extramarital fucking, a sensitive subject, especially for the hagiographer. In the present era, both biographers and medical professionals harbor mistaken ideas about the disease, since they usually have not seen it in its chronic, untreated form. For many reasons -- its symptomatic invisibility, the social stigma attached to it -- syphilis was usually a well-kept secret. But Hayden noticed that medical biographies written by physicians often record symptoms that can be seen as syphilis -- if you know what to look for.

In making her cases for retrospective diagnosis, Hayden examines the person's whole life; "a single clue," she says, "is never enough." She strives to put together a "preponderance of the evidence," noting that "absence of evidence is not evidence of absence." She looks at the experience of having syphilis. To assemble the puzzle's pieces she must act as scholar, detective, and psychologist. For the final diagnosis is often greater than the sum of its parts.

She is fastidiously careful not to conclude that even the most obvious syphilitics in her canon -- Schubert, Schumann, Baudelaire, Blixen, Gustave Flaubert -- had the pox, although "few if any who review the literature today would disagree." While most students of the matter would agree that Nietzsche had it, there is hot debate over Beethoven and Wilde. The question has been "discreetly avoided for the most part in respect to Mary and Abraham Lincoln," Hayden says, "and it has not been considered seriously at all in the van Gogh scholarship." As for Hitler, his life needs to be examined "through the selective filter of a diagnosis of syphilis."

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