Pox: Genius, Madness, and the Mysteries of Syphilis

Rating:
Summary: A book on syphillis that reads like a detective story
Review: Early in January, 1889, the German philosopher Friedrich Nietzsche collapsed on the street in Turin (Torino), Italy. He was taken to his mother in Germany and placed in a mental institution. After a few months he was released to the care of his family, where he lived another eleven years as an invalid.   

After Nietzsche's death in 1900, Nietzsche's close friend, Franz Overbeck, divulged that the director of the hospital where Nietzsche had been taken swore him to secrecy and then told him that Nietzsche had syphilis.   

The consensus of contemporary scholars, including Deborah Hayden, in her study Pox: Genius, Madness, and the Mysteries of Syphilis, is that Nietzsche indeed suffered from syphilis, a disease often called the 'French disease" and the 'Great Imitator" because its symptoms mimic those of many other diseases.   

Deborah Hayden, who lives in Mill Valley, Calif., is an independent scholar and marketing executive. She has lectured widely on "Syphilis and Creativity," most recently at UCSF Medical School, San Francisco Conservatory of Music, and the Bay Area History of Medicine Society.

Now, in Pox, Hayden has written a provocative and controversial work that reads much like a detective story.

"Pox began," writes Hayden, "with my curiosity about syphilis ... to learn more about Nietzsche's illness. But the project quickly expanded as I found one reference after another to other cases--all hidden, mostly disputed--in the higher reaches of culture and politics."   

Who, besides Nietzsche, are candidates for the dreaded pox? Hayden devotes chapters to Christopher Columbus, Ludwig van Beethoven, Franz Schubert, Robert Schumann, Charles Baudelaire, Mary Todd and Abraham Lincoln, Gustave Flaubert, Guy de Maupassant, Vincent Van Gogh, Oscar Wilde, Karen Blixen (Isak Dinesen), James Joyce, and Adolf Hitler.   

In a final "Pox Gallery," Hayden writes: "Suspected (or known) syphilitics include Idi Amin, Darwin, Donizette, Dostoevsky, Durer, Lenin, Meriwether Lewis, Mozart, Napoleon, Paginini, Edgar Allan Poe, Rabelais, Stalin, Tolstoi, and Woodrow Wilson."   

In tracking down the mysteries of pox, there often is no "smoking gun" to establish beyond doubt that a particular subject suffered from syphilis. However, in many of these cases Hayden presents enough circumstantial evidence to convince an impartial jury.   

Many readers will bristle to hear that Beethoven's magnificent Ninth Symphony, including the "Ode to Joy," was probably composed during a mystical euphoria brought on by tertiary syphilis.   

In a quantum universe, almost anything is possible. But one should bear in mind that possibilities do not automatically or necessarily translate into probabilities or actualities.   

The bottom line is that many of Hayden's speculations are fascinating, but they are just that: speculations that must be viewed skeptically.

Roy E. Perry of Nolensville is an amateur philosopher, Civil War buff, classical music lover, and chess enthusiast. He is an advertising copywriter at a Nashville Publishing House.

Syphilis.--(from Syphilus, hero of the poem Syphilis sive Morbus Gallicus (Syphilis or the French disease) (1530) by Girolamo Fracastoro (1553), Italian poet, physician, and astronomer: a chronic contagious usually venereal and often congenital disease caused by a spirochete (Treponema pallidum) and if left untreated producing chancres, rashes, and systemic lesions in a clinical course with three stages continued over many years. Compare Primary Syphilis, Secondary Syphilis, and Tertiary Syphilis.--From Merriam Webster's Collegiate Dictionary, Tenth Edition

Rating:
Summary: Best Book on a Hidden Disease
Review: I am a medical doctor and long-term student of VD in American history. Ms. Hayden has succeeded in a difficult task: writing convincingly about a medical subject when she is not a medical person. She enlisted help from the best of the best, such as my old professor Dr. Eugene Farber, and learned well from their teachings.

Without retrospective blood tests, it is impossible to PROVE that a person before 1900 had syphilis, but the combined wisdom of generations of doctors can give us reasonable certainty, and this Ms. Hayden has given us.

Some reviewer has asserted that Beethoven could not have had syphilis, because he wrote great music. (Perhaps logic and epistemology are no longer taught in our schools.)

I give thumbs up to this book for breaking new ground in an informative and thoroughly researched way.

Rating:
Summary: Best Book on a Hidden Disease
Review: I am a medical doctor and long-term student of VD in American history. Ms. Hayden has succeeded in a difficult task: writing convincingly about a medical subject when she is not a medical person. She enlisted help from the best of the best, such as my old professor Dr. Eugene Farber, and learned well from their teachings.

Without retrospective blood tests, it is impossible to PROVE that a person before 1900 had syphilis, but the combined wisdom of generations of doctors can give us reasonable certainty, and this Ms. Hayden has given us.

Some reviewer has asserted that Beethoven could not have had syphilis, because he wrote great music. (Perhaps logic and epistemology are no longer taught in our schools.)

I give thumbs up to this book for breaking new ground in an informative and thoroughly researched way.

Rating:
Summary: Relevant for today
Review: In POX, Deborah Hayden presents the most thoroughly researched, best balanced, most lucid and convincing account of luminary syphilitic devastation that I recall reading during a half-century career in epidemiology. Hayden's incisive historical examination of the powerful role of syphilis in shaping the lives and works of fifteen pre-penicillin lminaries, points the need and way for analogous examination of thousands of other historical events and figures actually scourged by syphilis; but which -- without the syphilis key -- have remained largely inexplicable.

To the American syphilis casualty list of historic figures has been added the tragic death of Meriwether Lewis, whose suicide on the Natchez Trace in 1809, because of paresis and looming madness due to syphilis acquired in the line of duty on a dangerous mission for his President and country, was an act of ultimate courage, shielding himself, other Expedition principals and family from syphilitic disgrace (Epidemiology May 1994).

Many analagous historical enigmas await the research of talented researchers like Deborah Hayden, to lift the veil of time and acquaint current generations with the horrific depredations of syphilis before penicillin.

Rating:
Summary: An ok book, but a little dry
Review: In this book, I really enjoyed the history of syphilis and how it was treated back in the day. That is where the two stars come in. However, towards the middle of the book I was getting sick of her trying to twist every little illness into a symptom of syphilis. Oh Shubert had the sniffles....MUST BE SYPHILIS. Lincoln was depressed.... MUST BE SYPHILIS. I am sorry to say but not everything was syphilis back then. Like Mary Lincoln for example, her husband was shot in the back of the head while he was sitting next to her.... I don't blame her for going mad! A lot of her points are overkilled, and don't make sense. These are one of those books that you can pick up in the middle and read a chapter and not miss anything. I think in every chapter she explains the symptoms and every detail of syphilis. I would recomend another book

Rating:
Summary: genuinely interesting and well-researched, if unfocused
Review: PERSPECTIVE: physician with interest in infectious diseases

Ms. Hayden's thesis here is an interesting one - not only did syphilis afflict many well-known historical figures, but its late-stage effects on the mind (as she terms it, "syphilitic euphoria") contributed to the creative zenith of authors and aritists, as well as shaping the lives and deeds of the powerful and influential. The first section of the book deals with the historical origins (and controversies) surrounding the origins of syphilis outbreaks in the late 1400's, as well as a reasonably adequate lay description of the disease. The main section deals with several figures from the 19th and 20th century, including well-known composers, philosophers, authors, artists, and political figures, none of whom have been confirmed to have syphilis, but suspected of such to greater or lesser degrees. In each case, she makes an argument for their infection and its effect on their lives and work, based on available historical documents, medical records, etc... The final sections include brief paragraphs discussing confirmed famous syphilitics, a list of general clues the author used in analyzing each case, and a reproduction of a 1926 case study on a patient.

Overall, the novel is flows well, and is easy and entertaining to read. Ms. Hayden's research is extensive and well-documented, and while she is not formally medically trained, she has certainly pored over medical texts from previous centuries up to today in order to educate herself and her readers.

Despite this, there are several issues of note. The "syphilitic euphoria" as a genesis for works of genius, medically, seems a bit of a strech in both its existance (as she characterizes it) and influence. It seems as though she loses her focus at some point - while earlier chapters, such as those on Schubert and Nietzsche, seem goal-oriented towards proving the presence of the infection, and its role in their work, other chapters (Lincoln and Hitler, notably) seem more like meandering discussions that, while interesting, ultimately come to no real conclusion as to the role of the disease. Additionally, while she seems convinced herself that each subject indeed had syphilis, and she works to makes a good case for each, some of her leaps of fact and logic seem a bit long. Ms. Hayden does occasionally make factual medical errors when discussing certain symptoms and their associations. Along those lines, she seems much more comfortable discussing such facts in the less precise medical terminology of "days gone by" than in present-day terms - this may be rooted in both her supposition that modern physicians know nothing of true end-stage syphilis (because we've been able to treat the infection early, successfully, with antibiotics for many decades, although how she can read the same old syphilis texts that physicians can, and be better than them at its diagnosis is a bit of a mystery to me) and that less-specific terminology allows her to make her cases better. The last sections also strike me as "fluff," of mild interest only.

FINAL WORD: The above quibbles aside, there is a lot to enjoy here, especially given Ms. Hayden's excellent historical research and entertaining writing style. A worthwhile read, but keep in mind that a lot of the author's conjectures are just that - conjectures. Buy it, check it out from the library, or buy it and donate it to your local library.

Rating:
Summary: genuinely interesting and well-researched, if unfocused
Review: PERSPECTIVE: physician with interest in infectious diseases

Ms. Hayden's thesis here is an interesting one - not only did syphilis afflict many well-known historical figures, but its late-stage effects on the mind (as she terms it, "syphilitic euphoria") contributed to the creative zenith of authors and aritists, as well as shaping the lives and deeds of the powerful and influential. The first section of the book deals with the historical origins (and controversies) surrounding the origins of syphilis outbreaks in the late 1400's, as well as a reasonably adequate lay description of the disease. The main section deals with several figures from the 19th and 20th century, including well-known composers, philosophers, authors, artists, and political figures, none of whom have been confirmed to have syphilis, but suspected of such to greater or lesser degrees. In each case, she makes an argument for their infection and its effect on their lives and work, based on available historical documents, medical records, etc... The final sections include brief paragraphs discussing confirmed famous syphilitics, a list of general clues the author used in analyzing each case, and a reproduction of a 1926 case study on a patient.

Overall, the novel is flows well, and is easy and entertaining to read. Ms. Hayden's research is extensive and well-documented, and while she is not formally medically trained, she has certainly pored over medical texts from previous centuries up to today in order to educate herself and her readers.

Despite this, there are several issues of note. The "syphilitic euphoria" as a genesis for works of genius, medically, seems a bit of a strech in both its existance (as she characterizes it) and influence. It seems as though she loses her focus at some point - while earlier chapters, such as those on Schubert and Nietzsche, seem goal-oriented towards proving the presence of the infection, and its role in their work, other chapters (Lincoln and Hitler, notably) seem more like meandering discussions that, while interesting, ultimately come to no real conclusion as to the role of the disease. Additionally, while she seems convinced herself that each subject indeed had syphilis, and she works to makes a good case for each, some of her leaps of fact and logic seem a bit long. Ms. Hayden does occasionally make factual medical errors when discussing certain symptoms and their associations. Along those lines, she seems much more comfortable discussing such facts in the less precise medical terminology of "days gone by" than in present-day terms - this may be rooted in both her supposition that modern physicians know nothing of true end-stage syphilis (because we've been able to treat the infection early, successfully, with antibiotics for many decades, although how she can read the same old syphilis texts that physicians can, and be better than them at its diagnosis is a bit of a mystery to me) and that less-specific terminology allows her to make her cases better. The last sections also strike me as "fluff," of mild interest only.

FINAL WORD: The above quibbles aside, there is a lot to enjoy here, especially given Ms. Hayden's excellent historical research and entertaining writing style. A worthwhile read, but keep in mind that a lot of the author's conjectures are just that - conjectures. Buy it, check it out from the library, or buy it and donate it to your local library.

Rating:
Summary: Syphilis and creativity
Review: This is a profoundly interesting book. Well written and well researched, Pox: Genius, Madness, and the Mysteries of Syphilis is a great study in how disease can alter one's perspective about the environment and how one interacts with those around them. Deborah Hayden spares no one from her magnifying glass. Abraham and Mary Lincoln, Adolf Hitler, James Joyce, Karen Blixen (Of Out of Africa fame), Beethoven are just a few of those investigated. Hayden also does a good job in looking at the connection between creativity, madness and the disease. I found myself skipping a head in places because the topic dragged but then an hour later flying along from page to page because the story grew intense.
This is a good read. The scholarship certainly speaks well of the author.

Rating:
Summary: Best on causes of death
Review: This is a very medical, military, and philosophical book about the pox. Much of the text is concerned with what doctors knew at certain points between 1492, when a large number of men who traveled with Christopher Columbus (who died in 1506) started raging epidemics of various diseases on both sides of the Atlantic Ocean, and 1948, when Adolf Hitler's doctors died. The cause of death of everyone mentioned in the book is not included, but one of the doctors responsible for the information in the Military Intelligence Service Center Report, "Hitler as Seen by His Doctors," "Brandt was executed on 2 June 1948 at Landsberg prison for his role in Hitler's euthanasia program." (p. 290). The form of poetic justice involved in any consideration of the pox is similar to a poem of the early Greek general Archilochus, selection 184 in 7 GREEKS/ TRANSLATIONS BY GUY DAVENPORT, p. 55:

In the hospitality of war
We left them their dead
As a gift to remember us by.

In 1495, the French army of 18,000 horsemen and 20,000 foot soldiers for Charles VIII, king of France, took Naples, defended by Spanish troops and some women who came with them from Spain, but the people "expelled Charles within a week. . . . Poor Charles was the first of many monarchs to fall prey to the disease. Charles died of apoplexy three years later, at age twenty-eight, after hitting his head against the frame of a low door." (p. 13). Spanish "soldiers expelled the women, who were cheerfully accepted by the French soldiers--an early example of germ warfare." (p. 14).

Hitler's heartbeat, heard through a stethoscope, had an extra musical note due to aortic weakness. In 1875, a British army surgeon "found that about two-thirds of the records of fifty-three cases of rupturing aortic aneurysm had a previous history of syphilis." (p. 34). Beethoven, (pp. 71-88), Schubert (pp. 89-96), and Schumann (pp. 97-111), then Hugo Wolf (1860-1903) whose "agonized tone" could be traced "to his infection," (p. 314) get credit for setting the vibrations of their nerves to music.

Nietzsche, with a case that is well documented on pages 172-199 of this book, is the key philosopher for understanding the psychic link which bind the subjects of this book. Jaspers and Jung are mentioned a few times, but Hayden can look directly at his work for evidence that "He thought of a future time when his work would be understood and appreciated. In all these things we see a parallel with van Gogh during that same year. Pure creative inspiration, mental illness, or paretic disinhibition: whatever the combination, the result in each case was astonishing." (p. 199).

Many doctors knew what Nietzsche was suffering from, even if his mother and sister didn't know (p. 181) what he admitted when he was taken to "the nerve clinic of Dr. Wille, an expert on general paralysis of the insane," (p. 174) in Basel in January, 1889. Guy de Maupassant (1850-1893) was the rare author who told people, "I've got the Pox!" (pp. 142, 144). His story, "Bed Number 29" is summarized on page 145 of this book. The victim in the story "was infected by the invading Prussians, but she got her revenge by passing her disease on to as many soldiers as possible. . . . she boasts that her score of deaths is greater than his." Deborah Hayden has done a tremendous amount of correlation of the information relating to the years from 1492 to 1948, but the psychic roots of much that she found is all too common, even though spirochetes did not provide a basis for the modern understanding of syphilis until they were discovered in 1905.

Recently in Science magazine (17 July 1998) the complete genome sequence of Treponema pallidum, the syphilis spirochete, was revealed to have 1,138,006 coding pairs containing 1,041 predicted coding sequences (Hayden, p. 26) but we still don't know everything. "Existing diagnostic tests are less than optimal. Even after treatment with penicillin some patients harbor spirochetes in `treponemal sanctuaries' such as the eye and the lymph glands. Many of the details of its life cycle remain unanswered." (p. 27).

My favorite page 252, shows a young Hitler staring out of a picture in the top half of the page, then has, "In 1936 Hitler hired a syphilologist, Theo Morell, to be his private physician." By 1941, there is "a pattern of syphilis beginning with one of the most terrifying manifestations of late syphilis, disease of the heart." The main comedy of the book is the urban legend aspect, how many people relied on beliefs which had no scientific basis, which is not funny as it applies to modern HIV infections on page 45. In Hitler's case, I think the funniest anecdote is related by Putzi Hanfstaengl, "who became Hitler's foreign press secretary" (p. 254) though "He ended up in Washington writing psychological profiles of Hitler and the Nazi inner circle for his old friend from the Harvard Club, Franklin D. Roosevelt." (p. 255). The funny story was related by Putzi to Rudolph Binion "in the early 1970s" (p. 255) and elaborated in this book through page 256, when this book turns to "In Landsberg prison after the Beer Hall Putsch, Hitler wrote thirteen pages in MEIN KAMPF about syphilis being the direst threat to the future of the race," based on the belief "that syphilis could be inherited for many generations." (p. 264). In the syphilis epidemic after World War I, even Hitler had to wonder, "Finally, however: who can know whether he is sick or healthy? Are there not numerous cases in which a patient apparently cured relapses and causes frightful mischief without himself expecting it at first?" (p. 264). Please remember, "a glassblower with an infectious mucous patch in his mouth who infected a coworker when he passed a glassblowing pipe." (pp. 182-183). This book is not entirely about sex.

Rating:
Summary: Best on causes of death
Review: This is a very medical, military, and philosophical book about the pox. Much of the text is concerned with what doctors knew at certain points between 1492, when a large number of men who traveled with Christopher Columbus (who died in 1506) started raging epidemics of various diseases on both sides of the Atlantic Ocean, and 1948, when Adolf Hitler's doctors died. The cause of death of everyone mentioned in the book is not included, but one of the doctors responsible for the information in the Military Intelligence Service Center Report, "Hitler as Seen by His Doctors," "Brandt was executed on 2 June 1948 at Landsberg prison for his role in Hitler's euthanasia program." (p. 290). The form of poetic justice involved in any consideration of the pox is similar to a poem of the early Greek general Archilochus, selection 184 in 7 GREEKS/ TRANSLATIONS BY GUY DAVENPORT, p. 55:

In the hospitality of war
We left them their dead
As a gift to remember us by.

In 1495, the French army of 18,000 horsemen and 20,000 foot soldiers for Charles VIII, king of France, took Naples, defended by Spanish troops and some women who came with them from Spain, but the people "expelled Charles within a week. . . . Poor Charles was the first of many monarchs to fall prey to the disease. Charles died of apoplexy three years later, at age twenty-eight, after hitting his head against the frame of a low door." (p. 13). Spanish "soldiers expelled the women, who were cheerfully accepted by the French soldiers--an early example of germ warfare." (p. 14).

Hitler's heartbeat, heard through a stethoscope, had an extra musical note due to aortic weakness. In 1875, a British army surgeon "found that about two-thirds of the records of fifty-three cases of rupturing aortic aneurysm had a previous history of syphilis." (p. 34). Beethoven, (pp. 71-88), Schubert (pp. 89-96), and Schumann (pp. 97-111), then Hugo Wolf (1860-1903) whose "agonized tone" could be traced "to his infection," (p. 314) get credit for setting the vibrations of their nerves to music.

Nietzsche, with a case that is well documented on pages 172-199 of this book, is the key philosopher for understanding the psychic link which bind the subjects of this book. Jaspers and Jung are mentioned a few times, but Hayden can look directly at his work for evidence that "He thought of a future time when his work would be understood and appreciated. In all these things we see a parallel with van Gogh during that same year. Pure creative inspiration, mental illness, or paretic disinhibition: whatever the combination, the result in each case was astonishing." (p. 199).

Many doctors knew what Nietzsche was suffering from, even if his mother and sister didn't know (p. 181) what he admitted when he was taken to "the nerve clinic of Dr. Wille, an expert on general paralysis of the insane," (p. 174) in Basel in January, 1889. Guy de Maupassant (1850-1893) was the rare author who told people, "I've got the Pox!" (pp. 142, 144). His story, "Bed Number 29" is summarized on page 145 of this book. The victim in the story "was infected by the invading Prussians, but she got her revenge by passing her disease on to as many soldiers as possible. . . . she boasts that her score of deaths is greater than his." Deborah Hayden has done a tremendous amount of correlation of the information relating to the years from 1492 to 1948, but the psychic roots of much that she found is all too common, even though spirochetes did not provide a basis for the modern understanding of syphilis until they were discovered in 1905.

Recently in Science magazine (17 July 1998) the complete genome sequence of Treponema pallidum, the syphilis spirochete, was revealed to have 1,138,006 coding pairs containing 1,041 predicted coding sequences (Hayden, p. 26) but we still don't know everything. "Existing diagnostic tests are less than optimal. Even after treatment with penicillin some patients harbor spirochetes in `treponemal sanctuaries' such as the eye and the lymph glands. Many of the details of its life cycle remain unanswered." (p. 27).

My favorite page 252, shows a young Hitler staring out of a picture in the top half of the page, then has, "In 1936 Hitler hired a syphilologist, Theo Morell, to be his private physician." By 1941, there is "a pattern of syphilis beginning with one of the most terrifying manifestations of late syphilis, disease of the heart." The main comedy of the book is the urban legend aspect, how many people relied on beliefs which had no scientific basis, which is not funny as it applies to modern HIV infections on page 45. In Hitler's case, I think the funniest anecdote is related by Putzi Hanfstaengl, "who became Hitler's foreign press secretary" (p. 254) though "He ended up in Washington writing psychological profiles of Hitler and the Nazi inner circle for his old friend from the Harvard Club, Franklin D. Roosevelt." (p. 255). The funny story was related by Putzi to Rudolph Binion "in the early 1970s" (p. 255) and elaborated in this book through page 256, when this book turns to "In Landsberg prison after the Beer Hall Putsch, Hitler wrote thirteen pages in MEIN KAMPF about syphilis being the direst threat to the future of the race," based on the belief "that syphilis could be inherited for many generations." (p. 264). In the syphilis epidemic after World War I, even Hitler had to wonder, "Finally, however: who can know whether he is sick or healthy? Are there not numerous cases in which a patient apparently cured relapses and causes frightful mischief without himself expecting it at first?" (p. 264). Please remember, "a glassblower with an infectious mucous patch in his mouth who infected a coworker when he passed a glassblowing pipe." (pp. 182-183). This book is not entirely about sex.