Ashley Robins Con Statement "Did Wilde Have Syphilis?" Published in THE WILDEAN, Jan-Feb 2004

A more neatly spaced version of Ashley's article will be posted soon. This is for a few people who asked to read it right away. Subscription info to THE WILDEAN will be posted soon as well. Next, I'll post my response.

DID WILDE HAVE SYPHILIS?

Deborah Hayden may not be medically trained but her knowledge and
understanding of syphilis, especially in the nineteenth and early
twentieth century context, are remarkable. She is to be congratulated on
her recently published and acclaimed book, Pox: Genius, Madness, and the
Mysteries of Syphilis, in which she gives an overview of
syphilis and then develops case studies on about a dozen historical
figures (Beethoven, Nietzsche, van Gogh and Joyce to mention a
few)suspected of having been infected. In these individuals she
describes the impact of the disease on their lives, careers and
personalities.

One of her more controversial subjects is Oscar Wilde and, although
she avoids any dogmatic pronouncement, her discussion
and arguments all lead to the conclusion that he probably suffered from syphilis during his lifetime. On the other hand, I went public in an article I wrote for The
Lancet (25th November 2000, page 1841), together with Professor
Sean Sellars, with the following statement: "There is no evidence that Wilde
ever harboured the infection[syphilis]". After the appearance of this
paper, Deborah wrote to me for further clarification and this was the
start of a spirited but amicable e-mail dialogue in which, notwithstanding some common ground between us, she defended and I opposed the hypothesis that Wilde suffered from syphilis. Once her book was published I thought it would be a fruitful exercise to open up the debate to the readership of The Wildean. The editor agreed and this is my contribution.

Deborah sets a great deal of store on what I shall term the "anecdotal
evidence". This consists of statements made at varying times by Wilde's
inner circle of friends to the effect that he not only suffered from
syphilis but that syphilis was a major factor in his death. Ross, Turner
and Harris are cited but the principal witness is undoubtedly Robert
Sherard who, nearly 35 years after Oscar's demise, unleashed a series of
allegations: that the undergraduate Wilde had acquired syphilis at Oxford
from a prostitute; that he had undergone mercurial treatment which had
"cleared" him for marriage; that he subsequently had a relapse which terminated
conjugal relations with his wife and supposedly triggered his switch to
homosexuality. The astounding aspect of these revelations
is that Sherard had exhaustively trawled Wilde's life in his
biographical trilogy which, beginning in 1902, spanned over a decade; yet
in all those pages the sole reference to the disease is a single
paragraph which in fact denies that Wilde showed signs of syphilis (The
Real Oscar Wilde, page 385)! This syphilitic saga, instead of being scotched 70 years ago, was perpetuated by a succession of biographers from Boris Brasol to Hesketh
Pearson to Montgomery Hyde and (distressingly) to the master, Ellmann
himself, in his magnum opus. Indeed, for any serious scholar
trying to unravel this web of anecdotal evidence there is but one
conclusion- myth, plausibility and reality are so intertwined that it is
just not possible to make any meaningful or objective assessment. The
task is compounded by the interpersonal bitterness and ulterior motives
of the protagonists coupled with their questionable reliability and
distorted memories after exceedingly long intervals of time. Moreover, even if Wilde's coterie had genuinely believed that he had syphilis, such a belief is hardly proof of the diagnosis.

A clinical diagnosis is not based on hearsay or rumour but on a rational
interpretation of signs and symptoms. This is the only basis on which a
biographer can hope to achieve any semblance of the truth.
In the case of Oscar Wilde there are substantial problems and
pitfalls. The medical records of his illnesses are sparse and he lived at
a time when clinical medicine had little or no recourse to even
rudimentary laboratory or radiological investigations. The spirochete, the
causative organism of syphilis, was only identified five years after
Wilde's death, followed two years later by a blood test.

However, a crucial document came to light in 1982.This was the original
medical certificate issued on the 27th November 1900 (a few days before
Wilde's death) by Dr Paul Claisse, a renowned Parisian physician, and Dr
Maurice a'Court Tucker, who had been Oscar's general practitioner. This
certificate established beyond doubt that Wilde had developed acute
meningoencephalitis as a complication of longstanding
suppurative (pus-producing) middle ear disease. As a result of this
diagnosis by two reputable practitioners, Professor Sellars (an
otologist at the University of Cape Town) and I were able to make what we
considered to be a reasonable retrospective formulation of Wilde's terminal
illness. In our Lancet article we commented that the history of
ear disease had predated his imprisonment but there had been a
prolonged relapse during his sojourn in Reading Prison. This had
eventually abated and Oscar then appeared to be symptom-free (other than
deafness in the right ear) for about four years. In September 1900 he
succumbed to an even more serious episode which by then had involved
the mastoid. The failure of conservative treatment necessitated urgent
surgery (a radical mastoidectomy) which was performed in October 1900 to
arrest the spread of the disease to the brain, a common sequel to this
type of chronic ear condition. Unfortunately the operation proved
unsuccessful and, as feared, the middle ear and mastoid infection
penetrated to the brain to cause the fatal meningoencephalitis.
We made the diagnosis that Wilde suffered from chronic suppurative
otitis media (middle ear disease).The chronic relapsing and remitting
course of the illness over a number of years, the deafness, perforation of
the right eardrum with a foul discharge, ear pain, and the
terminal extension to the brain suggested to us that he had the
destructive form known as cholesteatoma.

The questions that arise in relation to syphilis are severalfold:

1. Did Wilde die from syphilis? No. As explained above, his death was due
to an acute brain infection which was not due to syphilis but to a
complication of chronic ear disease

2. Was the chronic ear disease itself, which ultimately led to the fatal
brain infection, due to syphilis? No. The clinical features and course of
Wilde's ear disease over a period of years are clearly compatible
with chronic suppurative otitis media and probably cholesteatoma, as
outlined above. It is true that syphilis is the 'great imitator' but,
ironically, chronic ear disease, as exemplified in Wilde's case, was not
part of its repertoire. Although there are occasional references to an
association between syphilis and chronic ear disease, these are more
likely to reflect a coincidental occurrence rather than a true causal
connection. Syphilitic tumours (gummas) of the middle ear and mastoid have
been reported but these were very rare whereas chronic suppurative
otitis media was common in Wilde's day. It must be added here that syphilis did
sometimes cause damage to the inner ear [inner ear in italics] with
resultant nerve deafness. This, however, was not applicable to Wilde who
showed the conductive type of deafness.

3. Was there any evidence of tertiary neurosyphilis? No. Tertiary
neurosyphilis would have presented with progressive intellectual
deterioration, personality changes, behavioural abnormalities, psychotic
features, and neurological impairment. Oscar showed none of these and in
fact his cognitive and neurological functions were unimpaired up until
the last week of his life.

4. What about the skin rash which plagued Wilde during the last year of
his life? There is so little clinical information available on the
appearance and characteristics of the rash that it would be reckless to
attempt any sort of diagnosis. According to Oscar's very brief
description and Frank Harris's remarks, it was an irritating and itchy
rash with red blotches ("like a leopard" in Oscar's words). It covered
most of the body and disappeared after some months, only to recur later. There
are many different conditions that might have caused such a rash and, while
syphilis cannot be dismissed, it would not be seriously considered.

In conclusion, Deborah Hayden has put forward a challenging view that
Oscar Wilde, on a balance of probabilities, might have had syphilis. Her
analysis of the situation is accomplished with skill and moderation and
against her impressive insights into the disease. Hers is certainly the best
account that I have yet read of the pro-syphilis position. But,
ultimately, the diagnosis of syphilis is a clinical one and there is no
piece of evidence in Wilde's entire medical history that can reliably
tempt one into making that diagnosis.

Comments

[Walter]

Ashley,

Forgive me, for I have none of the expertise that you and Deborah possess, still my instincts tell me that 104 year-old medical records or forensic reports are only modestly more reliable than the innuendo and allusion found in authentic correspondence. That the cause of death was meningoencephalitis, I can accept. I'm not sure that that, in and of itself, rules out the possibility that Oscar was sphylitic. I go back to an earlier query: there seems to be ample evidence that Wilde took mercury. Do we have any idea what ailment, other than syphilis, he might have been treating? Is it possibly that the symptoms of tertiary neurosyphilis had yet to materialize in Wilde --at age 46?

I have found this debate to be intriguing and expertly argued by both sides. Thank you both for sharing your knowledge and wisdom. I, for one, feel that Ms. Hayden anecdotal evidence is no less compelling than medical records written at a time when the disease was a.) seen as hideous social disgrace and b.) still a mystery to medical practitioners. You say,yourself, that medical records of Wilde's health are sparse. Even if the man's complete history could be unearthed, I, like Ms. Hayden, doubt we'd find a written report of his suffering with syphilis. thank you, both.

W.

[Deb Hayden]

Dear W:

Only a small percentage of syphilitics advanced to teriary NEUROsyphilis--maybe 5%. Most of them had other manifestations. As I pointed out in my chapter, Wilde showed none of the prodrome of neurosyphilis--but he did have ailments that indicated the disease was progressing. Today many think that syphilis was "latent" after the first infection and the infected person healthy until, out of the blue, tertiary syphilis appeared. Nonething could be farther from the truth. Most syphilitics, as you can see from my case studies, were very, very, very sick for years. John Stokes suggests that there were not three but nine stages of disease. Was Wilde's terminal brain disease related to syphilis? It appears that his doctors at the end thought so.

Mercury was used to treat many ailments. Richard Ellmann, for one, had reason to believe that Wilde's use of mercury was for syphilis.

Deb

[Tim Kelly]

Was it true that Wilde did not like having sex in the last years of his life and would rather watch it? This may illustrate signs of illness and did anybody ever hear of an old WashingtonPost story that his body exploded during the autopsy?
Is that just a fantastical story?
Stephen Fry played the best Oscar Wilde ever.