The Question of Beethoven's Syphilis Reconsidered

The Question of Beethoven's Syphilis Reconsidered PETERJ. DAVlES Deborah Hayden. Pox: Genius, Madness, and the Mysteries of Syphilis. New York: Basic Books, 2003. xx, 379 pp. ISBN 0-465-02881-0 (hardback) $27.50. THE BOOK POX BY THE INDEPENDENT SCHOLAR DEBORAH HAYDEN follows the style of Brunold Springers' volume published seventy-seven years ago in which he discussed famous people who were suspected or known syphilitics.1 Following an introduction and acknowledgements, the seven chapters of Part I are devoted to the alleged spread of syphilis from the New World by Christopher Columbus and his crew (Chapter 1); the outbreaks in Barcelona in 1493 and Naples in 1495 (Chapter 2); a brief history of the spirochete Treponemapallidum that causes syphilis and its treatment (Chapter 3); the Oslo and Tuskegee syphilis studies (Chapters 4-5); a simplified account of the clinical features of syphilis (Chapter 6); and the difficulties of retrospective diagnosis (Chapter 7). Two significant problems with Part 1 warrant mention. One important omission from the "Key Dates in the History of Syphilis" in Table 5.1 is the development of specific serology antibody tests for Treponemapalluium, which are positive in 96-100 per cent of cases in the ktent and tertiary phase. It should be emphasized that the primary chancre may sometimes persist into the secondary phase. In turn the secondary phase may recur or relapse with infectious mucocutaneous lesions during the first few years of infection. Second, Hayden is confused about the nature of the quiescent latent phase, which is not surprising since at times even medical specialists have difficulty in sorting out the complex clinical manifestations of lues. After the early latent phase, which occupies the first year after infection, comes the late latent phase, which is also silent without symptoms. Asymptomatic neurosyphilis is diagnosed by laboratory tests of the blood and cerebrospinal fluid. Symptomatic neurosyphilis includes meningeal, meningovascular, and parenchymatous syphilis such as general paresis, tabes dorsalis, and mixed rabo-paresis. Individuals with paresis develop mental abnormalities and sometimes insanity. Parts II and III, Chapters 8-20, are devoted to a discussion of the cases for syphilitic affliction of Ludwig van Beethoven, Franz Schubert, Robert Schumann, Charles Baudelaire, Mary Todd, Abraham Lincoln, Gustave Flaubert, Guy de Maupassant, Vincent van Gogh, Friedrich Nietzsche, Oscar Wilde, Karen Blixen, James Joyce, and Adolf Hider. In Part IV (Chapter 21, "A Gallery of Pox: The Myth of Syphilis"), short vignettes are given on Ivan the Terrible, Goya, Heinrich Heine, Jules de Concourt, Edouard Manet, Lord Randolph Churchill, Alphonse Daudet, Arthur Rimbaud, Hugo Wolf, and Al Capone. Such discussions highlight die need for scholarly medical biographies of these subjects. There follows an epilogue, two appendices, notes, bibliography, and index. The book is well illustrated with pictures of the main candidates. The remainder of this review will be confined to Hayden's discussion of Beedioven, which unfortunately suffers from a significant number of biographical mistakes, medical errors, and incomplete and/or inaccurate citations and summaries of physicians' reports and studies. Although she does so with some of her other candidates, it is unfortunate that Hayden fails to consult the primary original sources for her information about Beedioven's life and health. Her reliance on unreliable secondary source material results in errors. It is untrue, for example, that "when he [Beethoven] was twenty-two he received a stipend that allowed him to support his mother and two brothers-his father having just died of alcoholism-and to move to Vienna."2 Beedioven moved to Vienna at the age of twenty-one, his mother died five years prior to his departure for Vienna in 1792, and the "stipend" was actually a portion of his father's salary that had been paid to him since November 1789. …