Get Well Soon

by Jennifer Wright

  Unsurprisingly, many sufferers wore a metal or wooden nosepiece to cover the rot so that people wouldn’t draw back in horror. Those nosepieces were often connected to an early prototype of sunglasses, which were useful, as syphilis also causes its victims to become extremely sensitive to light.

  For those looking for a more permanent solution, a technique called paramedian forehead nasal flap reconstruction was sometimes used. With this surgery, which had been practiced in India from 600 BC but only became popular in England in the early nineteenth century, a flap of skin was cut from the forehead and sutured onto the donor site, in this case, the nose. For syphilitics, the skin of the forehead was used because it matched the skin of the nose. Are you are thinking, Did this look great after completion?! No, of course not. The procedure often resulted in extremely weird eyebrow positioning, though that is better than having no nose. That said, recipients had to be careful afterward. Their new nose could fall off if they had an especially violent sneezing fit.14

  Other surgeons attempted an “Italian” procedure invented by the surgeon Gaspare Tagliacozzi. It involved grafting skin from the arm rather than the forehead. The sixteenth-century doctor Leonardo Fioravanti described the process: “They snipped the skin on the arm at one end and sewed it to the nose. They bound it there so artfully that it could not be moved in any way until the skin had grown onto the nose. When the skin flap was joined to the nose, they cut the other end from the arm. They skinned the lip of the mouth and sewed the flap of skin from the arm onto it … It’s a fine operation and an excellent experience.”15 “An excellent experience”! In The Professor of Secrets: Mystery, Medicine, and Alchemy in Renaissance Italy, the historian William Eamon writes, “one can only imagine what excruciating agony the operation must have caused.”16 The arm was held in a brace to keep it connected to the nose for a process that often took forty days to complete. Yet, in spite of this torturous approach, when Fioravanti visited the surgeon performing the operation, there were five patients waiting in line for the procedure.

  Naturally, sufferers wanted to actually prevent and cure their disease and avoid creating some flimsy Mr. Potato Head–type nose out of skin from somewhere else on their body. Condoms were created in the sixteenth century specifically to fend off syphilis, but they were expensive and often reused several times, making them ineffective.

  There were a few other treatments available before penicillin was officially recognized as an effective cure in 1947. In 1519 the German scholar Ulrich von Hutten wrote in De Morbo Gallico about the frequent use of the guaiacum plant to treat the symptoms of syphilis. He wasn’t entirely wrong—the plant does have medicinal properties. Today it is used to treat sore throats. The expectorant guaifenesin, found in most cough syrups, is derived from it. Doctors from the past weren’t necessarily idiots. Many of them were good at figuring out which plants and potions worked in some capacity; sadly, these findings usually fell short of actually curing people.

  Imagine, today, how you would feel if your doctor could only give you cough syrup for every ailment. And if, when you protested, he said, “No, seriously, this is the best we’ve got. Good luck.” Let’s now take a minute to appreciate what it means to live in the modern era.

  Despite liberal use of the guaiacum plant, and claims that it had cured him painlessly, von Hutten died from complications of tertiary syphilis in 1523.

  His approach, however, did provide an alternative to mercury treatments, used liberally from the sixteenth century into the twentieth century. Mercury therapies were recommended by our old acquaintance/nemesis from the dancing plague chapter, Paracelsus. The treatments were so popular that people joked, “A night with Venus, a lifetime with mercury.” In “Syphilis: The Great Pox,” S. V. Beck describes a version of the treatment: “A patient undergoing the treatment was secluded in a hot, stuffy room, and rubbed vigorously with the mercury ointment several times a day. The massaging was done near a hot fire, which the sufferer was then left next to in order to sweat. This process went on for a week to a month or more, and would later be repeated if the disease persisted.”17

  But mercury is poisonous. Excessive exposure to mercury causes skin to peel; hair, teeth, and nails to fall out; and insanity. The term mad hatters comes from the fact that nineteenth-century hat makers were often exposed to and indeed went mad from mercury fumes. Mercury—whether rubbed on, ingested through a pill, or injected as became popular in the eighteenth and nineteenth centuries—cannot make you “healthy.” In 1812 a “clinical test” was carried out, where British soldiers with syphilis were given mercury treatments, and Portuguese soldiers with syphilis were given none. The Portuguese soldiers had fewer health problems. Admittedly, that could be attributable to other factors. Maybe those Portuguese soldiers were just very hardy! However, an Oslo study conducted on two thousand syphilitics from 1891 to 1910 had similar results, finding that 60 percent of patients in the study who were not treated with mercury experienced fewer negative complications than those who had been.18

  The reason von Hutten preferred guaiacum was that complications from mercury treatments could be so severe. As the medical historian Lawrence I. Conrad explains, “Von Hutten describes the distress and pain of the mercury treatment with its effusions of sweat and saliva, and the heat of the sweat-room in which patients suffocated, their throats so constricted that they could not vomit their own mucus.”19 So mercury treatments were painful, time-consuming, and ultimately detrimental to the sufferer’s health.

  One primitive method of treating syphilis that did technically work was raising a person’s body temperature to an extreme degree. However, for the syphilis bacteria to die, the patient’s temperature has to be raised to 107 degrees, which can result in major organ failure and seizures. If body temperature rises to 108 degrees, the person will die, along with the syphilis bacteria. So there’s not a lot of room for error, and that “exactly 107 degrees” temperature is hard to hit without the aid of modern technology. Another approach was considered in 1917, when Julius Wagner-Jauregg attempted to inject syphilitics with malaria to cause a high fever and then cure them with quinine. He won the Nobel Prize for his work, but he also killed around 15 percent of his patients. And then there were arsenic-based treatments—such as the “magic bullet,” Salvarsan. Arsenic treatments could work but often produced toxic side effects. Because arsenic is a poison.

  Reading about all of these well-meaning but certainly dangerous attempts at a cure, I sometimes think the treatment for syphilis consisted of “trying things so terrifying that the disease is literally scared out of your body.”

  Perhaps the most terrible aspect of syphilis—even worse than chopping off part of your arm to give yourself a fake nose—was the fact that no one who had syphilis was ever able to talk about it. To call a respectable person syphilitic was unthinkable. To share that you were someone with syphilis with anyone but your closest intimates was similarly unthinkable. Perhaps you wouldn’t even wish to share the diagnosis even with your closest intimates.

  The same Upton Sinclair novel in which the doctor describes the woman whose lips have rotted away revolves around a young man named George who, after cheating on his fiancée, discovers he has syphilis. Unable to break off the engagement without ruining their reputation, he marries her, never tells her he has syphilis, and infects her. She in turn infects their newborn child. The newborn then infects the family’s wet nurse. The compounding repercussions of George’s secret seem incredibly realistic.

  When George first sees the red sore that he, correctly, identifies as a sign that he is a syphilitic, he confides in a friend. This exchange follows:

  The friend was willing to talk. It was a vile disease, he said; but one was foolish to bother about it, because it was so rare. There were other diseases which fellows got, which nearly every fellow had, and to which none of them paid any attention. But one seldom met anyone who had the red plague that George dreaded.

  “And yet,” he added, “according to the
books, it isn’t so uncommon. I suppose the truth is that people hide it. A chap naturally wouldn’t tell, when he knew it would damn him for life.”

  George had a sick sensation inside of him. “Is it as bad as that?” he asked.

  “Of course,” said the other. “Should you want to have anything to do with a person who had it? Should you be willing to room with him or travel with him? You wouldn’t even want to shake hands with him!”

  Terror of and reluctance to associate with known syphilitics, especially if you were unsure of exactly how the disease spread, is an understandable response. And it was difficult to educate people on something they did not want to hear about. People barely even referred to syphilis by name; they often called it a “rare blood disease.” As late as 1906, when Ladies’ Home Journal published a series of articles about STDs including a discussion of syphilis, it lost seventy-five thousand subscribers.20

  You might marvel that anyone could hide a disease that resulted in their nose rotting off their face. It’s possible, though. My wonderful agent tells a story of how her great-grandfather had a wooden nosepiece that he wore when he had to go into town. His family claimed his nose had rotted away because it was always being flicked by cows’ tails. My agent now realizes that a cover-up might have been in play.

  Hiding the disease led to disastrous outcomes. That began to become clear to people during the divorce case between Lord Colin Campbell and his wife in 1886. Lady Campbell, née Gertrude Blood, agreed to marry Lord Colin after a three-day romance in Scotland when she was age twenty-two. It seemed great! Campbell was rich, Lady Gertrude was poor, and they … liked each other as much as you can after three days. The only problem was that Lord Colin Campbell had syphilis. They didn’t consummate their marriage right away (Lord Campbell was operating on the assumption that the symptoms would go away, and they’d be able to consummate their union more safely), but according to the Times: “In October of 1881, after remaining in London, the parties went to Bournemouth and there, the marriage not having been then consummated, Lord Colin passed a slip of paper to his wife, purporting to contain an extract from a doctor’s letter, which said that if they now occupied the same room it would be beneficial to Lord Colin. They went to Inverary later in October, and there, for the first time, intercourse took place.”21

  It may well have been beneficial to Lord Campbell, but not Lady Campbell. She was infected with syphilis within months. By 1883 she obtained a degree of separation, claiming “cruelty”—the cruelty being that he gave her syphilis. You cannot imagine how genuinely shocked people were by this news at the trial. According to the biography Love Well the Hour: The Life of Lady Colin Campbell (1857–1911) by Anne Jordan, Gertrude’s lawyer, Sir Charles Russell, “exposed what he attested was the true nature of Colin’s illness—syphilis. Most of the newspapers ignored it, skirted the issue, or like The Times indicated that the coverage would be ‘utterly unfit for the columns of a newspaper.’”22 The press struggled to report accurately on the trial. The Evening News was charged with “obscene libel” by the National Vigilance Association for putting the word syphilis in print. The public, despite gobbling up the details about the trial—the Evening News’s circulation had doubled—were furious that anyone had written about the disease at all.

  Look. If you have ever read Harry Potter, you know that being so afraid of something that you cannot speak its name only makes that thing more terrifying.

  The judge didn’t grant Lord and Lady Campbell a divorce, but he did seem to favor Lady Campbell, asking, “Do you think Lord Colin Campbell’s attempt to treat his wife as a common prostitute was anything short of an outrage?”23

  Yes, it was outrageous! Lord Colin Campbell should have been more candid about the nature of his disease, especially since Lady Campbell couldn’t read or learn about it anywhere. However, continually reinforcing the concept that only monsters or common prostitutes contracted the disease did not make people more likely to talk about having syphilis. It would be great even today if people could talk about STDs without hissing “sinner” at the people who have the mere misfortune of contracting them.

  The silence around the nature of syphilis continued for many years. It laid the groundwork that made the horrific Tuskegee Syphilis Study possible. During that shameful experiment the effects of untreated syphilis on six hundred rural African American men were studied. They were never told they had the disease. The experiment would last for forty years from 1932 to 1972. Participants were never told that as of 1947 it was known that pencillan would cure their disease. (Studies of this sort now, fortunately, require informed consent by participants.) The Tuskegee Study was utterly diabolical, but it was made possible because a culture of ignorance surrounding syphilis was embraced. This is the kind of thing that happens when you have a disease that most of the population is kept entirely in the dark about or views with only vague, abstract terror. This is what happens when silence and shaming campaigns are considered acceptable responses to diseases.

  Which is why I think the hero of this story is not only the inventor of penicillin. (The inventor of penicillin, which cures syphilis, is Alexander Fleming. He is great. So is the lesser-known Howard Florey. Alexander Fleming: The Man and the Myth by Gwyn Macfarlane is a very good biography in which you can read and learn more about both of them.) My favorite hero can be found in a reference in an 1818 edition of Blackwood’s Edinburgh Magazine, which described a unique London club called the “No Nose’d Club.” The author writes: “A certain whimsical gentleman having taken a fancy to see a large party of noseless persons invited every one he met to dine on a certain day at a tavern, where he formed them all into a brotherhood bearing the above name.” The man, who is referred to as Mr. Crumpton, apparently gathered a large group of noseless, syphilitic people. Surely, most of them were unused to seeing others suffering from the some disease they were. “As the number increased the surprise grew the greater among all that were present who stared at one another with such unaccustomed bashfulness and confused oddness as if every sinner beheld their own iniquities in the faces of their companions.”24

  Let’s skim over the fact that they’re called sinners and marvel instead at what it must have been like to finally connect with other people who shared their affliction. To be able to talk to others about a disease that most people were afraid to name. If they were shocked, that reaction seems understandable; most of them would have spent much of their time covering up their noselessness as best they could. According to the article, the men got along and began making jokes almost immediately: “‘If we should fall together by the ears how long might we all fight before we should have bloody noses?’ ‘Ads flesh,’ says another, ‘now you talk of noses I have been looking this half hour to find one in the company.’ ‘God be praised,’ says a third, ‘though we have no noses we have every one a mouth and that by spreading of the table seems at present to be the most useful member.’”25

  They sound like a fun bunch. They have no noses, but they still have their senses of humor! My favorite people are those who can make jokes when most of us would despair. And look, this may be the first record of people with syphilis being portrayed in a way that doesn’t make them seem like they are somehow inhuman—either as genius creative monsters or as just plain ogres. The fact that the sufferers are depicted as real people was a big step, even if the disease’s actual name is never referenced in the article.

  Shaming people for contracting a disease that we don’t have a cure for is still common today. In part we want to believe that those people are not like us. We like to believe that people somehow brought diseases on themselves, but diseases are mindless and do not judiciously pick the worst people in the world to murder. The more we distance ourselves from diseases and their victims, the harder it becomes to educate people about prevention or raise the funds for a cure (because why would you want to cure something only monstrous people get?). Portraying the afflicted in a way that acknowledges their suffering but also shows t
hem to be brave and humorous and able to joke makes them seem like any one of us.

  Sadly, according to the article, the founder of the No Nose’d Club died after a year—likely of syphilis—and the “flat faced community were unhappily dissolved.” In the final meeting, the following poem was recited in honor of the founder:

  Mourn for the loss of such a friend

  Whose lofty Nose

  no humble snout disdained

  But tho of Roman height could stoop so low

  As to sooth those who ne’er a Nose shew

  Ah sure no noseless club could ever find

  One single Nose so bountiful and kind

  But now alas! He’s sunk into the deep

  Where neither kings nor slaves a Nose shall keep

  But where proud Beauties strutting Beaux and all

  Must soon into the noseless fashion fall

  Thither your friend in complaisance is gone

  To have his Nose, like yours, reduced to none.26

  That’s a much more enjoyable poem than the one praising syphilis we read earlier.

  Diseases don’t ruin lives just because they rot off noses. They destroy people if the rest of society isolates them and treats them as undeserving of help and respect. In the best cases, like Strasbourg during the dancing plague, communities come together to care for their weakest members. In other cases, outside supporters might take up the cause of these people as their own. But more often, the ill are forced to look to others like themselves to find strength. Those describing the No Nose’d Club regarded it as a humorous—and maybe even bizarre—novelty, but the formation of this group helped lay the groundwork for associations for those suffering from diseases ranging from alcoholism to AIDS.