Disease Detective

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."

In December, the first capsule appraisals of Pox appeared. Kirkus Reviews complimented Hayden's scholarly understatement. The Publisher's Weekly reviewer complained that she had romanticized the final stages of the disease as mystically creative and that the chapter on Hitler was poorly organized. Nonetheless, the reviewer predicted that her arguments "are sure to provoke debate."

Hayden, who describes herself as a private person, has no desire to become the center of an intellectual storm. She has, in fact, gone to tremendous lengths to minimize the possibility of scholarly attack on her case studies. Pacing her austere living room a week before Christmas, she says with uncharacteristic forcefulness: "I did not make a blanket statement where the opposite can be argued. Do you know how hard I worked to not make wild statements that can be argued against? Not to go to the dreaded 'therefore'?" Clearly, though, Hayden believes that all of her subjects were syphilitic; she just refuses to curse them with a final pronouncement.

Nevertheless, the case histories of Hayden's "patients" can be teased toward summary, although it is necessary to read each chapter in order to fairly weigh the circumstantial evidence she piles up.

- Beethoven, who frequented houses of ill repute, very likely went deaf, then insane from syphilis -- but not before he had created great, swelling, euphoric symphonies, possibly as a result of late-stage syphilitic elation.

- Schubert's disease was "common knowledge among his friends, shared in their letters, although, of course, it was never named." The composer died at age 31, singing maniacally on his deathbed.

- Schumann's autopsy revealed the presence of what were probably syphilitic tumors at the base of his brain. As madness and paralysis set in, he felt that he was being serenaded by heavenly angels.

- Poet Charles Baudelaire, who soothed his chronic ailments with opium, laudanum, valerian, and brandy, told his mother in a letter that he had a recurrent venereal disease.

- Long before he became president of the United States, Abraham Lincoln told his biographer, friend, and law partner, William Herndon, that he had caught the disease "during a devilish passion with a girl." His wife, Mary Todd Lincoln, died suffering from a wasting disease of the spine that is often caused by the pox.

- Flaubert, author of the first "realistic" novel, Madame Bovary, was a bisexual swinger who seems to have picked up the disease during his travels. His regular mercury rubs caused him to drool profusely, often three pints of saliva a day.

- French writer Guy de Maupassant bragged about having caught syphilis. "Allelujah, I've got the pox," he wrote to a friend. "So I don't have to worry about catching it anymore, and I screw the street whores and trollops, and afterwards I say to them 'I've got the pox.' They are afraid and I just laugh."