Here is the response to Ashley's statement about Wilde's hypothesized syphilis, publshed in THE WILDEAN, January/February 2004. See below for Ashley's initial statement.
A RESPONSE TO ASHLEY ROBINS
The email correspondence with Ashley Robins that began with a simple question about Oscar Wilde’s ear infection quickly burgeoned into a stimulating exchange about retrospective diagnosis. Our dialogue focused on the differences of method and philosophy between medicine today and nineteenth century syphilology. His thoughtful, medical-fact-filled emails from South Africa sent me poring over my extensive collection of pre-penicillin syphilis texts as I scrambled to recreate the mindset of a nineteenth century syphilologist.
At the end of our exchange, Ashley and I agreed on the four key points that he has summarized here: 1) syphilis was not the direct cause of Wilde’s death, 2) there is no proof that syphilis was implicated in his ear infection, 3) there was no indication of tertiary neurosyphilis, and 4) Wilde’s itchy rash could have been caused by many different conditions. Statements about Wilde’s syphilis by his coterie require careful scrutiny. And as for Ashley’s summary statement: true—there is no one piece of evidence that leads to a diagnosis of syphilis.
Why, then, am I so convinced that Wilde suffered from syphilis? And why were his close friends, several of his doctors, and the majority of his biographers equally convinced?
In the nineteenth century, medical textbooks described syphilis as the Great Imitator of other diseases. So protean was its manifestation that the eminent Sir William Osler proposed that to know syphilis was to know medicine. At a time when there was no laboratory test to confirm a diagnosis, syphilologists had to have detective zeal in ferreting out clues in a patient’s history and in the clinical presentation. They relished diagnosing a syphilis that had eluded dozens of their colleagues. Since there was no one sign or symptom of syphilis that could not as well indicate another disease, they had to base their diagnoses on the pattern of illness over a lifetime and reach a conclusion based on a preponderance of circumstantial evidence. In Wilde’s time, a diagnosis of syphilis was a dark and shameful secret, shared in carefully veiled euphemistic language (the word itself was taboo in both in polite society and in print) with at most a few intimate friends bound to silence.
In this context, consider how a syphilologist might have looked at the blotchy, recurrent, itchy skin rash on the arms, chest and back that bothered Wilde in the last year of his life. (Frank Harris reported that Wilde said: “I’m all right Frank, but the rash continually comes back, a ghostly visitant.”) Skin lesions often heralded the progression of syphilis to its tertiary stage. So important were they to diagnosis and treatment that Dermatology and Syphilology became sister disciplines. Richard Ellmann dismissed Oscar’s rash because he assumed that syphilitic rashes are not itchy; subsequent medical writers followed his lead. But Ellmann was wrong. The early rash of secondary syphilis that covered the whole body from the scalp to the soles of the feet was not itchy. But there is a group of blotchy, recurrent tertiary syphilitic rashes that do not cover the whole body. They are appropriately named “itching syphilids.”
Paul Claisse, the doctor called in to consult during Oscar’s final days at the Hôtel d’Alsace, a Gold Medalist at the Paris Faculty of Medicine, was well qualified to diagnose the cause of the mysterious rash: he had written papers on both tertiary syphilis and skin disorders. And, apparently, he found syphilis to blame. With colorful euphemism, Frank Harris reports on the medical conclusion:
“The local malady [the ear infection] was inflamed, as I have already said, by a more general and more terrible disease. The doctors attributed the red flush Oscar complained of on his chest and back, which he declared was due to eating mussels, to another and graver cause. . . . They recognized in him the tertiary symptoms of that dreadful disease which the brainless prudery allows to decimate the flower of English manhood unchecked.”
Consider how this passage would read if Harris had used the word syphilis:
The local malady was inflamed, as I have already said, by syphilis. The doctors attributed the red flush Oscar complained of on his chest and back to syphilis. They recognized in him the tertiary symptoms of syphilis.
Reggie Turner also revealed that the attending doctors not only agreed that Wilde had syphilis but also linked the ear infection to the original misadventure: “The ear trouble, which I believe began in prison, was only shortly before his death diagnosed as a tertiary symptom of an infection that he contracted when he was twenty.” Although Ashley Robins and Sean Sellars have made a strong argument that the ear trouble may have been caused by another condition (cholesteatoma), the reports of those present indicate that the doctors believed that the ear infection and the rash were both manifestations of late stage syphilis.
*
Doctors routinely neglected to mention syphilis on death certificates. Sir William Osler reviewed the British actuarial tables to reflect how under-reported syphilis was. That the medical statement that came to light in 1982 did not mention syphilis is in keeping with the conventions of the time. And it is not at all surprising that Robert Sherard failed to mention it in his first three biographical studies of Wilde; no biographer at that time dared to speak it. Even as late as 1937 (three years after he published his outspoken revelation of Wilde’s syphilis in Oscar Wilde Twice Defended from André Gide’s Wicked Lies and Frank Harris’s Vicious Libels), Sherard avoided saying the word: “It must be remembered that during all this period Wilde was fighting a terrible disease, which after wrecking his athletic physique and paralysing his magnificent brain, was then torturing him with unbearable pain.” In his private correspondence, Sherard was not as careful; in 1933, he wrote to a friend that Oscar “knew himself to be syphilitic” and was therefore guilty of being “the potential conveyer of this loathsome contagion.”
Sherard wrote that an eminent critic told him that no proper biography of Wilde could be written without the collaboration of an “expert syphilogue”. Such a specialist reviewing Oscar Wilde’s biography would have found more than enough clues to place syphilis high on an Index of Suspicion and his many ailments, especially in his last years, to be consistent with the progression of the disease to its late stage. Wilde did not end his life institutionalized with the high profile madness of neurosyphilis (paresis, or General Paralysis of the Insane), as did Robert Schumann, Charles Baudelaire, Guy de Maupassant, Hugo Wolf, Friedrich Nietzsche, and so many others. Many writers have wasted their time showing that Wilde was not demented from neurosyphilis. His illness, more like that of Gustave Flaubert, took a different course. But the biographical pattern is the same in each case: youthful infection, veiled references to it in letters, secrecy in the lifetime, posthumous revelation, subsequent debate.
In his biography of Wilde, Richard Ellmann made one of the more sensible statements about syphilis:
[Wilde] never admitted to having it, and many authorities deny it. Admittedly the evidence is not decisive—it could scarcely be so, given the aura of disgrace, shame and secrecy surrounding the disease in Wilde’s time and after—and might not stand up in a court of law. Nevertheless, I am convinced that Wilde had syphilis, and that conviction is central to my conception of Wilde’s character and my interpretation of many things in his life.
Central to his conception—and yet Ellmann consigned this biographical bombshell to an inconspicuous footnote. Ellmann suspected that Wilde’s parable of Dorian Gray’s secret decay, written while he was grievously ill with a nervous fever, expressed fear of the internal damage being done by his own syphilitic poison.
Did Oscar Wilde have syphilis? A nineteenth century syphilologist reviewing “The Case of Oscar Wilde” would find more than enough circumstantial evidence to be convinced that he had suffered from a progressive syphilis of long duration when he died. We will probably never know for sure. But we may surmise with some assurance that Oscar Wilde thought of himself as a syphilitic with all the guilt and shame that implied—and that concept is the beginning of another discussion.
Deborah Hayden
POX: Genius, Madness, and the Mysteries of Syphilis (Basic Books, 2003)
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