Ghosts

Ghosts Syphilis

One of the things that made Ibsen’s Ghosts so controversial when it was written and first staged was its relatively frank treatment of syphilis, a sexually transmitted disease. We will take a deeper look at the history of this disease, some of the early ideas on how to treat it, and where it came from. Historian John Frith says succinctly, “From its beginning, syphilis was greatly feared by society—because of the repulsiveness of its symptoms, the pain and disfigurement that was endured, the severe after effects of the mercury treatment, but most of all, because it was transmitted and spread by an inescapable facet of human behaviour, sexual intercourse.”

In 1495, Niccolo Squillaci wrote a letter concerning a disease sweeping Europe, now known to be one of the first records of a syphilis epidemic: “There are itching sensations, and an unpleasant pain in the joints; there is a rapidly increasing fever. The skin is inflamed with revolting scabs and is completely covered with swellings and tubercules, which are initially of a livid red color, and then become blacker. It most often begins with the private parts.” Erasmus opined, “If I were asked which is the most destructive of all diseases I should unhesitatingly reply, it is that which for some years has been raging with impunity … What contagion does thus invade the whole body, so much resist medical art, becomes inoculated so readily, and so cruelly tortures the patient?”

Some historians believe that the disease was carried over to Europe by Christopher Columbus and his New World travels. This seems to be backed up by the fact that there were no records of it before, but other historians suggest that blaming other nationalities for diseases was common among Europeans (it was called “the Neapolitan disease,” "the Gallic disease,” “the Turkish disease,” "the Christian disease,” and many more), and syphilis could have existed earlier but not have been known for what it was. A study from Emory University reported in 2008, “It is not clear whether venereal syphilis existed in the New World prior to Columbus’s arrival. While it is possible that Columbus and his crew imported venereal syphilis from the New World to Europe, it is also possible that the explorers imported a non-venereal progenitor that rapidly evolved into the pathogen we know today only after it was introduced into the Old World.” Overall, both theories have a modicum of evidence but nothing truly conclusive.

In the Victorian era, the time in which the play debuted in the major theaters in the Western world, public censure was shifting from prostitutes as the primary carriers to debauched, affluent men who brought back the disease to their own families. Historian of medicine Anne Hanley offers insights into the patriarchal component of the disease among respectable Victorian couples: “If a husband infected his wife with syphilis or gonorrhea, a doctor went to great lengths, usually at the behest of the husband, to conceal the cause of her illness. She would know that she was ill, but she wouldn’t necessarily know that she had VD. Doctors who withheld information from women claimed that they were bound by patient confidentiality—a doctor couldn’t tell a wife that she was suffering from syphilis because doing so would reveal that her husband also had syphilis. A degree of pragmatic paternalism informed these decisions: doctors believed that they knew best and prioritized expediency. After all, a woman who discovered that she was infected with VD might cause a fuss and make her husband’s life difficult. And since the husband was usually the one paying the doctor’s fee, his interests took priority.”

The first symptom of syphilis for most people would be a painless ulcer usually on the genitals, but it would clear up quickly. Oftentimes during this latent stage, people assumed the infection had passed or considered it to be something else. Secondary-stage symptoms could include rashes, ulcers, pustules, and swollen glands. In some cases without treatment, syphilis became tertiary, meaning that patients could have developed acute cardiovascular disease and have an aneurysm, develop necrotic facial gummas, or have neurosyphilis (Osvald Alving), in which case they might have experienced paralysis, locomotor ataxia, aphasia, and imbecility. Many people ended up in asylums or otherwise exiled from society. Also, syphilis could cause infertility, induce miscarriages and stillbirths, cause babies to die in infancy, or, amazingly, never produce any signs of infection at all.

There were innumerable treatments and supposed palliatives and cures, many of which were rather dubious. Some people took morphine injections, other elixirs, drugs, or even mercury pills. One Hungarian doctor suggested a soup of vegetables and grains that wreaked havoc on the digestive system. Julian Barnes described some of the 19th-century French writer Alphonse Daudet’s experiences: “He saw a range of specialists and visited a range of thermal establishments, taking the waters and mud-baths. He tried all the latest treatments, no matter how violent and outlandish. Charcot recommended the Seyre suspension, in which the patient was hung up, some of the time by the jaw alone, for several minutes. This was intended to stretch the patient's spine, loosen his joints, and thus combat the effects of ataxia. Daudet was suspended 13 times, in excruciating pain, until he began coughing blood. He noted of the treatment: ‘No observable benefit.’” Daudet wrote volubly of his experience. He wrote, “Every evening, a hideously painful spasm in the ribs. I read, for a long time, sitting up in bed—the only position I can endure. I'm a poor old wounded Don Quixote, sitting on his arse in his armour at the foot of a tree. Armour is exactly what it feels like, a hoop of steel cruelly crushing my lower back. Hot coals, stabs of pain as sharp as needles. Then chloral, the tin-tin of my spoon in the glass, and peace at last. This breastplate has had me in its grip for months. I can't undo the straps; I can't breathe.“

The cure for syphilis did not come about until 1943 with the invention of penicillin.