POX: Genius, Madness, and the Mysteries of Syphilis

Excerpt from Wilde chapter:

Was the red flush that first bothered Wilde in the summer of 1899, the one that Frank Harris “attributed . . . to another grave cause,” a manifestation of tertiary syphilis? A key letter about this condition and about his general ill health at that time, originally thought to be his last correspondence before his death, has been re-dated to be several months earlier, 28 February 1900. “My dear Robbie,” he wrote:
. . . I am very ill and the doctor is making all kinds of experiments. My throat is a lime kiln, my brain a furnace and my nerves a coil of angry adders . . . I see that you, like myself, have become a neurasthenic. I have been so for four months, quite unable to get out of bed till the afternoon, quite unable to write letters of any kind. My doctor has been trying to cure me with arsenic and strychnine, but without much success as I became poisoned through eating mussels, so you see what an exacting and tragic life I have been leading. Poisoning by mussels is very painful and when one has one’s bath, one looks like a leopard. Pray never eat mussels.

At Easter Wilde seemed to get better during a trip to the Vatican. He credited the Pope with the cure: “When I saw the old white Pontiff, successor of the Apostles and Father of Christendom pass, carried high above the throng, and in passing turn and bless me where I knelt, I felt my sickness of body and soul fall from me like a worn garment, and I was made whole.”

Although Wilde attributed the leopard spots to mussel poisoning, the skin condition did not clear up quickly as a rash from mussel poisoning would have done. Macdonald Critchley analyzed the varieties of mussel poisoning and concluded that none of them pointed to chronic dermatitis. And the rash was recurrent, which it would not have been with mussel poisoning. Wilde wrote to Harris: “I’m all right, Frank, but the rash continually comes back, a ghostly visitant.”

Late syphilitic rashes took so many forms and were so difficult to distinguish from other rashes that even syphilologists recommended calling in a dermatologist for a consultation. So important was the proper identification and treatment of skin lesions in late syphilis that Dermatology and Syphilology became sister disciplines, often practiced by the same doctor. John Stokes wrote that cutaneous lesions were of great value to the diagnostician both to arouse suspicion in cases not otherwise indicating syphilis, and to clinch a diagnosis in a dubious case. Although they were not as serious as the deep ulcerative lesions that sometimes occurred in tertiary disease, skin rashes were among the most terrifying harbingers of late syphilis because they were visible to the world. When Wilde showed signs of meningitis at the end, Paul Claisse was called in to consult, presumably because he had published on that topic. But Claisse had also published papers on dermatology and tertiary syphilis, so an expert in late syphilis was on board who could have rendered the opinion on all aspects of Wilde’s disease, including the red flush being due, not to eating mussels, but to the other “graver cause” mentioned by Harris.

Because Wilde complained of the skin rash being itchy, Richard Ellmann eliminated it from consideration as a clue to syphilis, and subsequent writers have cited Ellmann and moved on to look for other possible causes, including allergy to hair dye and vitamin deficiency dermatitis from overuse of alcohol. Wilde was drinking excessively; Dupoirier, proprietor of the Alsace, reported more than a liter of brandy a day, and substantial amounts of absinthe as well.

But Ellmann was wrong about the itchiness ruling out syphilis. While the general constitutional rash of early syphilis is not itchy, the localized rashes of tertiary syphilis are often very itchy and even painful. In Wilde’s case, the itchiness, rather than eliminating syphilis, tended to reduce the numerous possible lesions to a few. Under “itching syphilids” John Stokes lists two forms of late benign lesions—the follicular and the psoriasiform. There is not enough information to know which syphilitic rash Wilde might have had, but because there are several itchy, blotchy, recurrent, localized late rashes in the textbooks, and because of Harris’s note that the doctors suspected the rash was caused by syphilis, we must consider Wilde’s leopard spots after his bath as a strong suspicion arouser. Of artistic note though not diagnostic value: several illustrations of the specifically itchy late rashes in the syphilis texts look remarkably like the spots of a leopard.

If Wilde did have a syphilitic rash, it might have been rather good news. According to Jacobi’s Atlas of Dermochromes, late cutaneous eruptions rarely lead to general paralysis or tabes, which seems consistent with the progression of syphilis in Wilde’s case, and a key point to consider in asking why so many scholars have been reluctant to consider that Wilde might have had syphilis. Nineteenth-century neurosyphilis was so dramatic that other, less ostentatious manifestations of the disease have been forgotten. Wilde never showed any of the warning signs of paresis—grandiosity, euphoria, or bizarre, uncharacteristic behavior. The only sign that was at all suspicious was the degeneration of his handwriting, one of the earliest signs of approaching paresis. He noted that his previously beautiful Greek script had become a scrawl. Certainly Wilde was witty and sharp at the end, although this does not rule out paresis since mental acuity right before onset of paresis was common. A case can be made that his mental state was not what it had been, or that his judgment was at times faulty, perhaps as early as when he took Queensberry to court, which has seemed to many to be reckless and self-destructive. But other circumstances might have had a deleterious effect on his later mental state—in particular, the horror of his incarceration, and his excessive drinking. If there had been any possibility for late syphilitic euphoria, it would probably have been effectively doused by a liter of brandy a day. Around the time of his imprisonment, Constance said that he had been mad for three years. But she may have been equating homosexuality with madness, as others did at the time.