Disease Detective

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

By Peter Byrne

published: January 15, 2003

Two women drive into a parking lot near the Ferry Building in San Francisco. They show identification to a bald man sitting in a van. "Is this the place for ... the dinner?" asks one of the women. "Shhh," the man cautions, eyes scanning the almost empty lot. He hands them a map. They walk a few blocks to Schroeder's Cafe, a German hofbrau-style restaurant hunkered down amongst Financial District skyscrapers. Treading gingerly inside the dimly lit, cavernous dining hall, past a small herd of glass-eyed deer heads nailed to a wall, syphilis researcher Deborah Hayden and her nervous friend join a small group of white people gathered in a back room. The friend fears she is entering a den of neo-Nazi skinheads, but most of those waiting are middle-aged and have at least a little hair. They are here to eat schnitzel and schmooze with historian David Irving, the controversial Hitler apologist and author of two dozen books about World War II. When Irving brags that he has shaken hands with more people who knew Hitler than anyone else alive, Hayden's friend, wigged out by the scene, buries her face in a plate of veal stroganoff. The historian complains that his house in England was recently seized to pay a bankruptcy court judgment. Irving -- who insists that the Third Reich did not systematically exterminate Jews -- went broke after losing a libel suit in 2000 against an American author who charged that he had falsified Holocaust history. His dinner companions nod their heads in sympathy and open their wallets.

Hayden, however, is not here to support Irving (she has no doubts about what happened in Hitler's ovens). She has a scholarly purpose in mind. She approaches Irving with a question: Did Hitler have syphilis? Irving tells her, as he has written, that Hitler tested negative for the venereal disease, which at the time was usually fatal. Despite Irving's unpopular Holocaust views, his professional opinion still carries weight with some Hitler scholars. Hayden, on the other hand, believes that Hitler was rotting to death from late-stage syphilis and that his condition affected the course of history. It is typical of the intrepid Hayden that she chose to beard Irving in his lair, rather than contact him via a more antiseptic method such as e-mail or telephone.

"I wanted to look him in the eye," she says, smiling.

Hayden, 57, owns and operates a direct-mail consulting firm in Corte Madera. In her spare time, she has become a remarkably persistent medical detective, developing a method for following the trail of syphilis in the lives of the dead and famous. Her first book, Pox -- Genius, Madness, and the Mysteries of Syphilis, arrived in the nation's stores last week. If early reviews -- including a positive one recently in the New York Times -- are any barometer, Hayden's book promises to be both controversial and popular. It is certainly timely, since syphilis is resurgent in urban America. (In San Francisco, the Department of Public Health has mounted a "Healthy Penis" campaign, replete with bus-shelter posters of chuckling syphilis chancres attacking innocent dicks.) Pox breaks ground in the fields of medical history and biography by presenting a template of how syphilis manifests itself in the historical record. As examples of syphilitics, Hayden presents 15 historical celebrities, including Ludwig van Beethoven, Friedrich Nietzsche, Abraham Lincoln, James Joyce, and her pièce de résistance, Hitler.

Hayden is what is known in academic circles as an independent scholar, i.e., she is not associated with an institution, and she has a day job. But her attention to historical and scientific detail and her talent for understatement have earned her the respect of many prominent scholars. And even experts who disagree with Hayden's findings are impressed by her detective zeal.

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Hayden lives with her dog Rugby in a ranch house atop a mountain near San Anselmo. You can see San Francisco from the bay window of her living room. The spacious home is sparsely furnished: bed, a few chairs, treadmill, dining table covered with books, computer niche, and shelves and shelves of volumes about syphilis.

"My garage burned down a few years ago," Hayden says wistfully. "I lost 28 boxes of books."

Her father, an inventor who patented a popular wool-braiding machine, and her mother, who wrote unpublished children's books, ran a flight school in Oakland during Hayden's childhood. To this day, she loves to go up in small planes and gliders. An only child, she liked her parents. "I learned to be creative and independent from them," she says.

"My mother was a smoker. Watching her die of lung cancer [in 1982] was horrendous. I was surprised by the depth of my grief. My father pined away and died a few years later.

"Somewhere around 1990, I made an appointment to talk to a therapist because I was working absurdly long hours on the [direct-mail] business and I was feeling burned out -- there was something missing. In the first session, he asked what I would most like to do and, without thinking, I said I'd like to read everything I could find about Lou Andreas Salomé." Salomé, an early 20th-century female psychologist, was close to both Sigmund Freud, an originator of modern psychology, and nihilist philosopher Friedrich Nietzsche.

Hayden had become intrigued by Salomé in the mid-'60s as a student at Bucknell University in Pennsylvania. She had taken a class about Salomé's tempestuous friendship with Nietzsche before the influential philosopher slipped into madness. After college, Hayden moved to Paris, studying at the Sorbonne and working part time at the famed Shakespeare & Co. bookstore, a mecca for English-speaking literati. Returning to San Francisco, she managed a bookstore for the Esalen Institute, a New Age outfit that mixed spiritual self-discovery with pop psychology, futurism, and deep body massage. After working on direct mail for Esalen, Hayden started Pacific Lists, which matches nonprofit groups like Doctors Without Borders, the San Francisco Food Bank, and Harvard Medical School with potential donors.

In 1992, after two decades of immersion in direct mail, Hayden cut back on her office hours to renew her study of Lou Salomé. Over the next year, as she amassed 1,000 pages of research notes, she wondered why Nietzsche broke off his relationship with Salomé. The question took on significance as it became increasingly clear to Hayden that the author of Ecce Homo and Beyond Good and Evil, who suffered from horrible headaches, chronic nausea, failing eyesight, muscle cramps, and, in the end, hallucinations, paralysis, and a fatal stroke, was, in all likelihood, afflicted with syphilis. The disease is often called "The Great Imitator" because its symptoms closely resemble many other maladies.

Hayden's success in finding diagnostic evidence of syphilis in Nietzsche put the Salomé project on indefinite hold. One discovery led to another as she followed the syphilis trail from Nietzsche to famous writers such as Charles Baudelaire, Oscar Wilde, and Karen Blixen (Isak Dinesen), and music composers including Franz Schubert and Robert Schumann. Although historians had speculated that many of Hayden's subjects had suffered from the ravages of syphilis, Hayden began uncovering new evidence in each case, and assembling a pattern of how the disease manifested in all of them. When she discovered important new evidence that pointed to Hitler as a syphilis carrier, she became so consumed by her intellectual investigation that she organized her entire life around it.

"There are escapes from the body," says Hayden, "but we always return to the body, and that's probably why I am so interested in syphilis. There are hundreds of biographies written about people who are sick as if their illness does not matter. I say that syphilis is more relevant than any other disease because it profoundly affected all aspects of a life -- social, marriage, job, mental change, philosophy."

Paraphrasing Nietzsche, she says, "A man's work is an unconscious memoir of his life." It is of obvious historical import when leading cultural and political figures are found to have been afflicted by a terrible, debilitating, socially unacceptable disease.

Hayden set herself two tasks. The first was to marshal and present evidence that selected historical characters suffered from syphilis. The second was to correlate the behaviors of each doomed individual into an overall pattern indicating the presence of syphilis. Along the way, Hayden tried to get inside the heads -- and aches, pains, and ecstasies -- of her subjects. She wrote a stream-of-consciousness introduction to Pox, which reads in part:

"no one must know i'm rotting inside. rotting in the bones, melting like an old camembert. oozing sores now on my shins, i bandage them, hide them. when will i find an end?

"today i felt a breeze from the wing of madness.

"is that how it will end? but, oh, such visions. i fall to the earth and weep for such ecstasies. a mystical light. could there be a god? electricity lights my brain ... someday, the world will explode, because of me ... i chase thoughts like colored butterflies, my urine is full of jewels. i scream, i rage. then i play the piano, gently, and all is well. i remember everything ... and then, one day, i ask: who is that face in the mirror?"

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What started out as a diversion turned into an obsession. By 1999, Hayden was known as an expert syphilologist from the Bay Area to South Africa.

William Schaberg, author of The Nietzsche Canon: A Publication History and Bibliography (University of Chicago Press, 1995), reviewed the Nietzsche sections of Hayden's book prior to publication. "It's a testimony to [Hayden's] intellectual curiosity," he says, "that she traveled so far down the syphilis road. It is still an indelicate subject; she looked at it square in the face."

Schaberg says that Nietzsche believed a writer's personality imbues his work -- that systems of philosophy do not exist independently of the philosopher's emotional life. Schaberg has not thought about how his own work reflects his personality, but, he says, people often end up where they are in life by "following threads." Hayden, he says, is a dedicated thread follower.

One thread led her to the late Dr. Eugene Farber, former chairman of the dermatology department at Stanford University School of Medicine.

"When I called him and told him what I was working on, he said he would be glad to meet with me if I could answer a test question: Who first viewed the syphilis spirochete [the bacterium that causes the disease]? My mind went blank. Just as I sensed that he was about to hang up, I blurted out: 'Fritz Schaudinn, parasitologist of ducks and owls.'"

Farber was impressed. He later spent many hours guiding Hayden through the symptomatology of syphilis, which largely disappeared after the invention of penicillin, leaving most modern doctors unknowledgeable about its chronic effects. Farber told Hayden to read 19th-century medical texts to find out more about the disease's dreadful consequences. He even lent her, she says, "his treasure: a beautiful art book of colored pictures of syphilitic lesions."

Using her favorite research tool -- Google -- Hayden located several dozen old textbooks, including the 1,400-page Modern Clinical Syphilology, the last edition of which was published in 1945. The classic text's author, John H. Stokes, M.D., called upon syphilologists to cultivate "suspiciousness of mind."

"This does not mean a vague awareness of [syphilis'] existence," wrote Stokes. "It means ... an alert sense of nearness such as experienced by the hunter stalking big and dangerous game. A zest in the ferreting out of the obscure, a positively detective zeal in the running to earth of this most subtle master of the dissembling art .... [T]hink of syphilis as a disease of signs rather than symptoms."

As she searched for signs of syphilis in biographies, personal correspondence, and medical records of her famous subjects, Hayden kept in mind that their doctors may have been unaware of the real reasons why their patients were chronically ill. Conversely, a prescription of mercury was a good sign that a doctor had diagnosed syphilis, since ingestion of the toxic metal in the form of salves, fumes, and pills was thought to be curative.

By correlating medical and biographical histories, Hayden makes strong evidential cases that her characters had the disease. She is extremely careful, however, to assert only that her evidence amounts to a high probability of infection, since no one has performed definitive clinical tests on her dead. She knows, too, that "people will come out of the woodwork" to dispute that their particular heroes, such as Lincoln, were infected.

"We do not have tissue diagnosis [for Hayden's subjects], so we will never have absolute proof," says Dr. Norbert Hirschhorn, a medical historian who lectures at Yale Medical School. "She is careful not to be sensational, but she pulled together many different strains of biography. It's quite a tour de force."

Brandeis University history professor Rudolph Binion, who has written biographies of both Salomé and Hitler, says he didn't believe Hayden's thesis that Nietzsche's sexual inhibitions with Salomé were attributable to his syphilis. Now, says Binion, he does.

"I did not believe her about Hitler, either," he says. "I gave her his medical records. Her case for Hitler [as a syphilitic] is extremely strong and cast light on his conduct at the end."

Even some who disagree with Hayden's conclusions admire her. One such person is Lise Deschamps Ostwald, a UCSF psychiatry professor's widow who annually sponsors a lecture-recital at UCSF, followed by a complementary musical recital at the San Francisco Conservatory of Music. In 1999, she invited Hayden to lecture to 400 psychiatrists about her theory that Schumann had syphilis. After the talk, Ostwald, a concert pianist, performed a Schumann composition.

"Deborah is very flexible," says Ostwald, who disagrees with her that Schumann was syphilitic. "She is not dogmatic. It is hard to prove who had syphilis 100 years later."

Ostwald also helped kick-start Hayden's new career, referring her to literary agent Rosalie Siegel in Pennington, N.J. Siegel was intrigued enough to read an article that Hayden wrote about Nietzsche's syphilis that appeared in a 1999 publication, Nietzsche and Depth Psychology. She was impressed. She helped Hayden develop a book proposal and then sold it to Basic Books. The print run is moderate for a first effort -- 10,000 copies -- but Siegel hopes Pox will "outrage" enough people to warrant additional printings. She's excited about the New York Times review, which, she says, positions Pox "as a serious book, a must-read."

Contract in hand, Hayden focused on writing for two years. She read and reread her medical texts plus hundreds of biographies and other secondary sources. She put in 18 hours a day organizing her material, corresponding with experts, writing hundreds of thousands of words, and getting friends to help edit the ever-growing draft.

"I am a literary gumshoe," Hayden says. "I did not do primary research. If it was a biography about one person's infection, it would have to be primary sources. But this is a book about a pattern; the pattern of the experience of having syphilis. It gives biographers leads to work with.

"I often asked myself how my delightful little investigation of Lou [Salomé] got so far afield. Finding so much on syphilis that no one had written about kept me following details farther and farther afield. I had to stop digressing if I was ever to finish the book!

"Working on 15 characters at once, focusing on their horrible deaths, it was very depressing, like living in a hospice. There were high moments, the spy-thriller aspect of the story; beneath that lay the horror of working on Hitler so intensely."

But there was exhilaration in working so intensely. Over her computer she hung a sign, "Art is a vampire." She is intrigued by vampire symbolism -- "the poisoned blood passed from person to person, sexualized," she says. In a very real way, her immersion in the tainted blood of the dead was giving her creative life.

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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."

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."

- Painter Vincent van Gogh wrote 874 letters to his syphilitic brother, Theo. "A careful reading reveals numerous references that suggest that Vincent and his brother were well aware of each other's disease and wrote of it in safe, veiled language," writes Hayden. Her book sympathetically examines the life of van Gogh's common-law wife, Clasina Hoornik, who also was infected and whom the painter cast off to fend for herself as their mutual doom approached. Hoornik is the only "common" person treated by Hayden and is, without a doubt, the least despicable syphilitic of the lot.

- Whether or not Oscar Wilde died from syphilis has been the subject of learned articles in prestigious medical journals. Hayden summarizes this literature, noting that Wilde probably caught the disease from the "one and only campus prostitute" at Oxford University, and possibly passed it on to his wife, Constance, who died of spinal paralysis. Wilde's chances at syphilitic euphoria were canceled by his consumption of a liter of brandy every day.

- Karen Blixen, who wrote Out of Africa under the pen name Isak Dinesen, caught the pox from her husband, Baron Bror von Blixen-Finecke. In 1926, Blixen wrote to her brother, "If it didn't sound so beastly I might say that, the world being as it is, it was worthwhile having syphilis in order to become a Baroness."

Hayden treats each of her subjects in a detached fashion, methodically marshaling the evidence for syphilis while acknowledging the arguments of naysayers. But it is for Nietzsche and Hitler -- who among all her characters arguably had the greatest impact on history -- that she reserves her most thorough treatment.

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"Nietzsche is a personal philosopher," Hayden says. "His aphorisms may be read in many different ways. His influence on religion, politics, art, music, and psychology is remarkable." When she goes to scholarly conferences on Nietzsche, she says, she knows more about his life than do many of the academics, who are focused on his philosophy.

Nietzsche's works were known only to the few during his lifetime, but in death he influenced many Western intellectuals with his nihilistic (the desire for nothingness) approach to all systems of thought. His writings shaped the thinking of many early psychologists, including Freud, Carl Jung, and Salomé. He also influenced political reactionaries, including Hitler and his followers, with his notion of the "superman" whose duty is to exploit inferior human beings.

In 1889, shortly after experiencing a burst of creative activity, Nietzsche was admitted to the psychiatric clinic of Dr. Ludwig Wille of Basel, Switzerland, an expert on how general paralysis manifests itself in the insane. Wille recorded his new patient as "Syphilit Infect," noting that he had acquired the disease in 1866 at the age of 23. Finally diagnosed in middle age, Nietzsche took 11 long years to die, during which he had moments of lucidity even though he was as likely on any given day to be smearing his feces on the wall.

Nietzsche's writings at once enlighten and infuriate liberal scholars, such as Schaberg, the Nietzsche expert who consulted on Pox for Hayden. Schaberg complains that the philosopher was "a radical aristocrat, very anti-democratic." Hayden acknowledges that Nietzsche was an elitist, but argues that he nonetheless has broad appeal. She likes Nietzsche's letters the best of all his work. If his problems were indeed caused by syphilis, she says, "then his archive is the most profound and eloquent record of a syphilitic that exists."

She is drawn to Nietzsche's notion that truth is perceived differently by different people, that a person's reality is relative to his personal story. To Hayden, the "superman" is not about genetic superiority. Rather, she says, "it is about self overcoming adversity, such as illness."

Hayden's book spends little time analyzing the creativity of her syphilitics in the light of their disease. But she agrees with Nietzsche's observation that "every great philosophy so far has been: namely, a personal confession of its author and a kind of involuntary and unconscious memoir." In Nietzsche's case, it is easy to place his misanthropic, messianic, nihilistic exaltations in the context of his miserable life, which was marked by social isolation, sexual confusion, and horrible physical pains attributable to syphilis.

In the 1930s, Nietzsche's name and philosophy were publicly associated with Hitler by Nietzsche's racist sister, Elizabeth. Although the two men certainly shared a hatred of democracy, Nietzsche was neither an anti-Semite nor a nationalist and would have viewed Hitler as a filthy upstart.

Hayden's main achievement as a scholarly sleuth is her chapter on Hitler. She relied heavily on two secondary sources, The Medical Casebook of Adolf Hitler, by Leonard and Renate Heston, and The Secret Diaries of Hitler's Doctors, by David Irving. She also worked with a primary source: a postwar debriefing of Hitler's doctors by U.S. military intelligence agents. Irving transcribed and published records of Hitler's primary physician, Dr. Theo Morell, a renowned syphilologist. These documents do not directly record syphilis as one of Hitler's afflictions, even though by 1944 the farting, eczematous, jaundiced, jerking, inattentive, drooling Führer was exhibiting signs of tertiary syphilis.

One of Hayden's discoveries is the significance of Morell's notation that Hitler's second heartbeat had a telltale tonal quality that often goes undetected unless the doctor is listening for it. The Stokes textbook Modern Clinical Syphilology had called attention to this aortic afterbeat as an almost sure sign of syphilis. Another Hayden discovery is that Morell aggressively treated his patient with potassium iodide, the medication of choice in 1940 for late-stage cardiovascular syphilis.

Adding to Hayden's pile of circumstantial evidence is a published remark by Hitler pal Putzi Hanfstaengl that the German leader had caught the pox in Vienna about 1908, presumably from a prostitute (according to some rumors, she was Jewish). His experience with syphilis might explain, Hayden says, why Hitler included sections in his memoir, Mein Kampf, devoted to "Syphilis, Blood Sin and Desecration of the Race"; "The Task of Combating Syphilis"; "Sound Mind-Sound Body"; "Sterilization of the Incurables"; and "Prostitution of the People's Soul."

Hayden believes that Hitler may have hastened the German war effort in a race against his impending death from heart failure or syphilitic paralysis. She takes pains, however, to point out that his well-known grandiosity and paranoia may not have been signs of syphilitic dementia (although they could have been), since he was, after all, Hitler, and even his own generals were trying to blow him up. In the end, though, Hayden concludes with characteristic detachment, "There is no definitive proof that Adolf Hitler had syphilis, any more than there is undeniable evidence that he did not."

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As Pox's publication date approached, the trove of books, Xeroxed documents, rough drafts, and photographs of horrible sores, lesions, and syphilitically deformed babies that decorated Hayden's digs for so many years was neatly cataloged and filed away. Pox is being uncrated in bookstores across the land, graced with a cover featuring lightning flashes and images of the (probably) afflicted. There is nothing left for Deborah Hayden to do except some yoga, maybe have friends in for a gourmet meal.

Well, there is something. A Google search just turned up the death certificate of Bram Stoker, author of Dracula. It seems that he, too, had syphilis -- and the disease may have influenced his creation of that genteel man of the night whose befanged visage still haunts our culture. Hayden is off and running -- so little time, so many syphilitics to discover.