Perspective — July 31, 2014, 8:00 am

On Joyce and Syphilis

New evidence of the author’s suffering, and reflections on the scholarly debate

James Joyce © Photo Researchers/Getty Images

James Joyce © Photo Researchers/Getty Images

In 1917, while walking down a street in Zurich, James Joyce suffered an “eye attack” and remained frozen in agony for twenty minutes. Lingering pain left him unable to read or write for weeks. Joyce had endured at least two previous attacks, and after the third he allowed a surgeon to cut away a piece of his right iris in order to relieve ocular pressure. Nora Barnacle, Joyce’s partner, wrote to Ezra Pound that following the procedure Joyce’s right eye bled for days.

Joyce was suffering from a case of glaucoma brought on by acute anterior uveitis, an inflammation of his iris. It was, unfortunately, nothing new. Joyce’s first recorded bout of uveitis was in 1907, when he was twenty-five years old, and the attacks recurred for more than twenty years. To save his vision, Joyce had about a dozen eye surgeries (iridectomies, sphincterectomies, capsulectomies) — every one of them performed without general anesthetic. He lay in dark rooms for days or weeks at a time, and his post-surgical eye patches became his trademark. Doctors applied leeches to siphon blood from his eyes. They gave him atropine and scopolamine, which cause hallucinations and anxiety, to dilate his pupils. They administered vapor baths, sweating powders, cold and hot compresses, endocrine treatment and iodine injections. They prescribed special diets (oatmeal and leafy vegetables) and warmer climates. They disinfected his eyes with silver nitrate, salicylic acid, and boric acid; instilled them with dionine to dissipate nebulae; and doused them with cocaine to numb the pain. Nothing really helped.

This essay is an online companion to Kevin Birmingham’s Annotation “A Portrait of the Artist as a Syphilitic,” which ran in the July 2014 issue of Harper’s Magazine.

Uveitis raises intraocular pressure and produces a sticky exudate, which caused Joyce’s irises to attach to the lenses behind them. Sometimes the exudate was so thick that it congealed and blocked his pupil altogether — his future publisher Sylvia Beach remembered seeing his eye “covered by a sort of opaque curtain.” The increased pressure caused glaucoma, which eroded his optic nerve over the years, making his vision spotted, narrow, and dim.

By the age of forty-eight, Joyce’s left eye functioned at only one-eight-hundredth the normal capacity and his “good” eye at one-thirtieth. His eyeglasses prescription was +17 in both eyes — severely farsighted. One of the twentieth century’s great novelists often required a magnifying glass to read anyone’s writing, including his own. Each new attack brought him a step closer to blindness, and the consequent threat to his literary career contributed to a series of nervous breakdowns.

Joyce lived a thoroughly documented life, but the cause of his lifelong battle with uveitis has never been definitively named. Before the introduction of penicillin in the 1940s, the most common cause was syphilis, and because Joyce had begun visiting prostitutes at the age of fourteen, rumors began circulating that his chronic problems had been sexually transmitted. But the image of a syphilitic Joyce is one that few scholars have wanted to conjure in print. Richard Ellmann, Joyce’s preeminent biographer, had access to extensive biographical materials and didn’t even mention the possibility of syphilis — and yet he had no qualms diagnosing Oscar Wilde with syphilis despite questionable evidence. Joyce’s patron Harriet Shaw Weaver, his grandson Stephen, and Nora Barnacle all destroyed letters from Joyce, raising the question of whether allies were protecting Joyce’s reputation from the stigma of a dreadful disease.

Unlike gonorrhea and chlamydia, a case of syphilis was often a prolonged, multi-systemic affliction. It begins when a person comes into contact with a pale, corkscrew-shaped bacterium called Treponema pallidum that gathers in lesions on an infected person’s skin and genitalia. Once the microbe enters the body, it can lurch and coil its way into virtually every type of tissue it encounters: blood vessels, muscles, joints, nerves, cerebrospinal fluid, and vital organs are all potential targets, and any two cases might present substantially different symptoms. Periods of increased spirochete activity alternate with dormant periods, and the advanced stages sometimes led to what in Joyce’s time was called “general paralysis of the insane,” which could cause abrupt psychosis, erratic personality transformation, memory loss, or grandiose delusion. Raising suspicions of syphilis in virtually any public figure (Lenin and Nietzsche are two examples) stirs controversy because a syphilis diagnosis potentially tarnishes a person’s life and accomplishments, be they a political regime, a philosophy, or Finnegans Wake.

Before penicillin, treatment for syphilis amounted to taking tolerable doses of poison, and about a third of patients who were subjected to these remedies never overcame their infections. Mercury pills and ointments were popular for centuries, though mercury was toxic to bacteria and patients alike, and extended treatment weakened syphilitics until their teeth, hair, and fingernails began to fall out. By 1910, doctors had started using a German drug called Salvarsan (arsphenamine), an arsenical compound that reduced arsenic’s toxicity while keeping much of its treponemicidal properties. Salvarsan was the first modern chemotherapy, but it was as flawed as it was revolutionary. In addition to being only partially effective, Salvarsan had harsh side effects and killed hundreds of patients before it was replaced by a less effective, closely related version called Neosalvarsan. These limited medical options meant that a person diagnosed with syphilis before World War II could expect a long, hard battle with the disease if it persisted past the primary stage.

Joyce’s medical history — which I’ve pieced together from decades of published and unpublished letters and documents — appears to be a painful journey through all of syphilis’s stages, beginning with his initial contraction in the red-light district of Dublin or Trieste, where Joyce lived for over a decade. In a diary, Joyce’s brother Stanislaus described him in 1907 as having not only inflamed eyes but also stomach problems and various “rheumatic” pains.  He was bedridden for weeks, and at the end of an illness lasting nearly three months, he walked around at an “invalid’s pace.”

After the first month of illness, Stannie wrote in his diary that his brother’s right arm had become “disabled,” and that it had remained that way for about a month while Joyce received electrotherapy treatment. What exactly Stannie meant by “disabled” has been a vexing question for Joyceans. If the joints in Joyce’s right arm were stiff and inflamed, he may have had a form of rheumatism. But if his arm was paralyzed or “paretic” (partially paralyzed), then it may have been a symptom of neurosyphilis. This would mean that the spirochete had begun to attack Joyce’s nervous system — presumably nerves in his right shoulder or arm.

As it turns out, Joyce’s right shoulder had a curious little medical history all its own.  Years later, Joyce complained of pain in that shoulder and claimed that his right deltoid muscle had atrophied. In the midst of more eye troubles in 1928, his right shoulder had what he called a “large boil.” For anyone hunting for signs of syphilis, the boil sounds like a late-syphilitic lesion: they occur asymmetrically on the body, are typically large, and sometimes merge to form a single wound.

By 1922, Joyce and his friends had begun subscribing to a now-discredited theory of infection postulating that various ailments were caused by infections migrating outward from just a few bodily sources, particularly the oral cavity. So they started blaming Joyce’s uveitis on his bad teeth, and in two harrowing visits in 1923 a dentist extracted seventeen teeth, seven abscesses, and a cyst from Joyce’s mouth. His eye problems nevertheless continued, suggesting that syphilis may also have caused Joyce’s dental calamity. The disease, after all, frequently causes oral ulcers as well as periodontitis (a reason to extract affected teeth). A syphilitic Joyce would presumably have had colonies of Treponema in his weak eyes, his right shoulder, and his wretched mouth.

But maybe not. Sometimes a boil is just a boil. Diagnosing a person seventy years after death can be a dubious enterprise, and identifying syphilitic lesions requires a degree of detail about Joyce’s condition that we simply don’t have. A posthumous diagnosis of syphilis is particularly perilous because the disease’s symptoms are mind-bogglingly numerous. Treponema’s nearly free rein in the human body means that syphilis can cause headaches, sore throats, nausea, impotence, incontinence, dull or stabbing pain, alopecia, arthritis, jaundice, thrombosis, aneurysms, epilepsy, meningitis, inner and outer bone infections, and arteriosclerosis. And this is a partial list — the array of ocular problems is daunting all by itself. Add to all of this the fact that any two cases might affect completely different organs and that an infection might range from negligibly mild to catastrophically serious, and syphilis begins to seem as complicated as any Joycean text.

All were respectfully silent about Joyce’s condition until an Irish doctor named F. R. Walsh wrote an article for the Irish Medical Times in 1975. According to Walsh, Joyce’s father told a group of medical students in 1920 that he’d contracted syphilis while a medical student and cauterized his own lesions with carbolic acid. Inspired by Walsh’s scoop, an Irish journalist named Stan Gebler Davies added a two-page appendix to his Joyce biography, published months after Walsh’s article, claiming that congenital syphilis had caused James Joyce’s chronic uveitis. Davies was wrong — Joyce had no symptoms of congenital syphilis — but the issue was suddenly wide open.

In 1980, also apparently inspired by the Irish Medical Times article, a comparative literature Ph.D. named Vernon Hall and a medical doctor named Burton Waisbren reread Ulysses with a syphilitic author in mind, and they found syphilis everywhere — in Stephen Dedalus’s “somewhat troubled” sight, in Leopold Bloom’s verbal lapses, in the death of Bloom’s infant son. Their journal article for Archives of Internal Medicine includes a two-page table listing apparent references to syphilitic symptoms throughout Ulysses, among them “Stephen grimaces,” “Bloom and bowel problems,” “Bloom blunders stiff-legged,” and “Stephen staggers.”

Hall and Waisbren explained that “the repetitive use of the letter s as a code symbol for the word ‘syphilis’ occurs throughout the book.” They pointed out that a Ulysses word index requires a remarkable eighty-one columns to list all the novel’s s-words. “The letter ‘s’ hisses throughout the book as a reminder of the ‘s’ in syphilis (a word that not only begins but also ends with ‘s,’ as does the novel).” Molly Bloom’s final “Yes” was no longer her languid, rapturous refrain as she drifts off to sleep. It became the ominous whisper of a disease she presumably contracted from the husband lying next to her in bed.

The investigations went deeper. In 1995, Kathleen Ferris, then an assistant professor at Lincoln Memorial University, published James Joyce and the Burden of Disease, the first book laying out a case for a syphilitic Joyce. Ferris swept through Joyce’s biography and works, venturing much further into the issue than anyone before, and her conclusions were ambitious. She argued that Nora Barnacle had serious syphilitic complications, that their daughter Lucia suffered from insanity brought on by neurosyphilis, and that Joyce developed a form of advanced neurosyphilis — tabes dorsalis — which causes a distinctive doddering gait called locomotor ataxia. Hall and Waisbren had tabes in mind when they noted the staggering Stephen and the stiff-legged Bloom, and Ferris used tabes to explain Joyce’s peculiar habit of walking around with an ashplant cane. She went on to suggest that tabes left Joyce impotent and incontinent before giving him the intestinal ulcer that killed him at the age of fifty-eight.

The nature of Ferris’s work made a troubling idea even more difficult to accept. When her argument needed help, she crossed from Joyce’s biography into his fiction, including into the tangled puns of Finnegans Wake. She argued, for example, that Joyce encrypted the word “Salvarsan” in the phrase “the repleted speechsalver’s innkeeping” (her emphasis). Signs that anyone in Ulysses had syphilis counted as evidence that Joyce had syphilis, and this raised perennial questions about how to use literary evidence. When Ferris’s publisher sent an advance copy of her book to the director of the Zurich James Joyce Foundation, Fritz Senn, he responded with a detailed critique. Senn tried to dissuade Ferris from claiming that Joyce invokes gonorrhea and syphilis with the sound of applause in Ulysses (“Clappyclapclap”) and that the “sand in the Red Sea” harming a sailor’s eyes is really code for spirochetes in the blood. “You are throwing sand in your readers’ eyes,” Senn wrote to her. She kept the readings anyway. Cautious or not, Ferris was the first scholar willing to argue that Joyce suffered privately with venereal disease for the majority of his life, and her dedication to this idea required no small amount of bravery.

Senn was one of many skeptical Joyceans in attendance when Ferris presented her research at a 1995 Joyce conference in Miami. Joseph Kelly, a professor at the College of Charleston, remembered that for her everything pointed to syphilis. “If Joyce had written in a letter, ‘I don’t have syphilis,’ she would have seen that as evidence that he did.” Ferris’s conviction, many thought, was unwarranted. I repeatedly contacted Ferris this past winter and spring hoping to hear more about her struggle to revise Joyce’s biography so radically, but she did not respond.

The most vehement reaction to Ferris’s work came from J. B. Lyons, who was an Irish doctor, a Joyce enthusiast, and, apparently, a defender of Irish virtue. One Joycean, Frank Delaney, recalls how irritated Lyons became at the subject of Joyce’s syphilis, which he considered a British smear against an illustrious Irish artist. “If the English can’t get you one way they’ll get you another,” Lyons grumbled. Lyons (who died in 2007) took it upon himself to quash syphilis rumors in a 1973 book called James Joyce and Medicine and a 1982 symposium lecture later published in his essay collection, Thrust Syphilis Down to Hell. When Ferris’s book came out, Lyons wrote a review deriding her argument as “a facile degradation of a great writer.” He followed it up with an article for the Journal of the History of the Neurosciences in which he repeatedly reminded his readers that he was a medical doctor, a credential that apparently doubled as a license to mock a handful of Ferris’s arguments while ignoring the others. His favorite rhetorical weapon was outraged exclamation: “This suggestion is preposterous!” “What a derogation of self-identity!” “What evidence is there that Nora Barnacle contracted syphilis? None!” Ferris was, for Lyons, a dilettante stumbling around outside of her proper professional realm. The debate was simultaneously expansive and minuscule, and it highlighted the way large conclusions can rest on the smallest textual pieces. For example, Lyons and Ferris marshaled the same Joyce letter to support their opposing arguments, which hinged on their differing interpretations of the word “it.”

In lieu of syphilis, Lyons proposed the only other reasonable diagnosis: an autoimmune affliction called Reiter syndrome, which afflicts roughly three in 100,000 men under thirty-five (whereas estimates of syphilis rates in European cities were roughly 10 percent in Joyce’s day). The syndrome is typically triggered by chlamydia or a gastrointestinal infection and lasts from two to six weeks, featuring three telltale symptoms: arthritis, urethritis, and conjunctivitis (an inflammation of the eye’s outer membrane). To fit this diagnosis, Lyons interpreted Joyce’s “disabled” right arm in 1907 as a particularly nasty case of arthritis.

But to claim that Joyce had Reiter syndrome is to claim that he had a particularly rare version of a rare illness. One of the largest studies of the syndrome followed an outbreak among Finnish soldiers at an army hospital on the Russian front in 1943. Among the 344 cases documented, over two-thirds of the patients suffered from conjunctivitis, while only eleven had uveitis. Going deeper into the pathology makes Joyce’s case seem more anomalous. His eye problems were recurrent — they disappeared and reappeared for decades — which is exactly what we would expect from syphilis, but such prolonged recurrence rarely happens in Reiter syndrome. A 1960 study estimated that the annual risk of recurrence is about 15 percent, and the study of Finnish soldiers placed those odds far lower. Moreover, the syndrome rarely causes arthritic arms. The vast majority of cases affect the lower limbs, and when arthritis does occur it is unlikely to “disable” anything. The Finnish study reported that most cases featured “relatively mild” joint tenderness and that patients suffered only partially limited movement.

And so a doctor thinking about diagnosing Joyce with Reiter syndrome would have encountered an assemblage of ill-fitting facts: Joyce had problems with upper-body movement rather than lower-body movement. He had uveitis instead of conjunctivitis. His problem recurred for decades instead of weeks. His episodes were acute rather than mild. We have no indication one way or another if he had urethritis at any point after 1904. Taken together, these inconsistencies make it hard to accept that Joyce had Reiter syndrome — which was the most likely alternative to syphilis.

For some, the uncertainty surrounding Joyce’s condition has turned the issue into his most captivating puzzle. Erik Schneider, an independent scholar, became particularly fascinated. Schneider had dropped out of the University of California, Santa Barbara in 1972 and spent years educating himself at the school’s library. His abiding interest in Joyce eventually drove him to Dublin, and later to Trieste (following a brief period in London inspired by a similar devotion to the Sex Pistols), where he read Ferris’s groundbreaking book in the late 1990s. The emergence of this new dimension in Joyce studies — something glossed over by Ellmann, something that divided Joyceans — inspired Schneider to begin avidly pursuing Joyce’s medical records. “I went over half of northern Italy looking for them,” Schneider told me in February. From memoirs and clinical archives, he gathered impressive pieces of evidence suggesting Joyce had syphilis. An expanded edition of his book, Zois in Nighttown, which is out this week, compiles a vast number of references to syphilis and prostitution in Joyce’s life and works.

About the only things Schneider didn’t find were Joyce’s medical records (though he hasn’t given up), and over the years the syphilis controversy died down. Ferris left the academy, and scholars’ vision of Joyce remained more or less unchanged. Gordon Bowker’s 2012 biography of Joyce is the most serious treatment of Joyce’s life in years, but it notes only in passing that Ferris’s argument for a syphilitic Joyce “is not entirely improbable.” Bowker’s book is the eighth biography of Joyce and the eighth to leave the writer’s body a cipher. That, in any case, is how it appeared to me when I began to examine Joyce’s medical biography for my recently published history of Joyce’s censorship struggle, The Most Dangerous Book: The Battle for James Joyce’s Ulysses. From my perspective, Joyce was going blind, and there was no clear reason why.

The key to unlocking James Joyce’s medical mystery isn’t in his eyes, his teeth, his boils, or any of his nagging symptoms. It’s in his treatment. In 1928, Joyce walked into Dr. Borsch’s eye clinic in Paris after his latest episode of eye problems and with a large boil on his right shoulder. The doctor, following his clinical examination, considered two possible treatments.

 The first was “a cure of I have forgotten what,” as Joyce put it in a letter to Harriet Shaw Weaver, though he left an important clue about the unnamed cure when he added that “the drug in question had had a bad effect on the optic nerve.” Possibly the only drug that could have helped a patient’s uveitis while potentially harming the optic nerve is Salvarsan; while Salvarsan might have killed the spirochete causing Joyce’s uveitis, one of the drug’s side effects was that it caused optic neuritis in about one in forty patients.

Whether or not “the drug in question” was Salvarsan (or Neosalvarsan), Joyce decided to take Dr. Borsch’s more mollifying medication. In October of 1928, Joyce, nearly blind, dictated two letters that explained his condition and Dr. Borsch’s treatment essentially the same way: “They are giving me injections of arsenic and phosphorous but even after three weeks of it I have about as much strength as a kitten and my vision remains stationary.”

What decades of Joyce biographers have overlooked is that the chemical compound of arsenic and phosphorus is a little-known medication called Galyl (phospharsenamine). And doctors administered Galyl only as a treatment for syphilis. Galyl’s properties fit all the descriptions in Joyce’s letters. It was injected intravenously in extended regimens — the researchers who developed it, in fact, suggested a course of precisely three weeks. (At least one doctor, writing for American Medicine, seconded the three-week recommendation.) While other arsenicals often caused nausea and vomiting, Galyl improved a patient’s appetite. Joyce reported having a “ravenous appetite” after the injections, and his physician would have valued this advantage of the medication because Joyce’s weight had become alarmingly low. At five feet ten inches tall he weighed less than 125 pounds.

But the most telling fact is that Galyl was the only injectable compound of “arsenic and phosphorus” around. Various pharmacopoeias, national formularies, and pharmaceutical dispensaries of the 1910s and ’20s all indicate the same thing — no other medication fits Joyce’s description, nor could he have received separate injections of arsenic and phosphorus because both elements are highly toxic — probably lethal — even in relatively small doses. The unavoidable conclusion is that Joyce’s doctors gave their sickly patient Galyl in 1928. James Joyce was treated for syphilis.

Joyce’s “arsenic and phosphorus” injections were an unremarkable detail buried in his overwhelming medical history (Richard Ellmann’s biography mentions them without comment) because Galyl is only a blip in the long history of syphilis treatments. In fact, the treatment enjoyed its brief vogue for purely political reasons: Salvarsan and its variants were German products, and the outbreak of World War I left British doctors rushing to find an alternative after the British government suspended the patents and trademarks of German antisyphilitics. French researchers developed Galyl in 1914, and its national origin made it a patriotic wartime substitute in Allied countries.

Galyl AdvertisementAdvertisements touted the fact that Galyl was “made in France” because its Frenchness was a bigger selling point than its effectiveness. As it turned out, the more-toxic German drugs were simply better, which is why Galyl fell out of favor so quickly after the war. And yet Dr. Borsch apparently prescribed it to Joyce because the terror Joyce harbored about his incipient blindness left him adamantly opposed to any medication that might further damage his eyes — “that ended that for me,” Joyce wrote to Weaver about learning that the unnamed drug affected the optic nerve. And so when Joyce refused the conveniently forgotten “cure,” Dr. Borsch would have administered the only available substitute he knew out of an abundance of caution for the famous writer’s career. Unfortunately, taking the safest option for Joyce’s eyes increased the chances that his syphilis would stick around — which it did.

The disputes surrounding Joyce’s condition underscore the fact that reading is a biased enterprise. Readers are not neutral observers. We read with the qualms, motives, and filters that help us find order in complicated texts, and the more elaborate a text is, the more likely a motivated reading will find whatever it’s looking for. Motivations can exaggerate the significance of s-words and obscure other details that don’t quite fit. When we aren’t reading too much into a text, we read too little of it.

Like all scholarship, the research surrounding Joyce’s biography has made a practice out of this selective blindness. Lyons and Ferris had opposite motives, but they both read Joyce’s injections of arsenic and phosphorus as nothing more than injections of arsenic. Ferris’s book misdescribes Joyce’s treatment as “injections of arsenic for three weeks,” omitting the key component entirely. Ignoring phosphorus altogether was convenient for both writers, as it allowed Ferris to argue that doctors treated Joyce for syphilis while permitting Lyons to insist that they were giving him arsenic for its “tonic” effects.  Ferris read “arsenic” and thought, “Aha! Arsphenamine!” Lyons read “arsenic” and thought, “Aha! Fowler’s Solution!” — an over-the-counter tonic containing small amounts of arsenic (without phosphorus) that had been available from pharmacists and snake-oil salesmen since the eighteenth century.

Lyons disregarded the fact that Fowler’s Solution was never injected. Ferris focused on arsenic, apparently believed it was Salvarsan, and disregarded the likelihood that three weeks of the standard arsenical injections might very well have killed Joyce. Both readings treated “phosphorus” as irrelevant textual noise. Armed with interpretations that suited their purposes, Ferris and Lyons did not have a compelling reason to dig any further into pharmaceutical history, and so they didn’t. No one found the antisyphilitic medication written in Joyce’s letters because no one needed it.

To this day, Joyceans are not always perceptive about the issue. Luca Crispi, a well-known lecturer at University College Dublin, fumed in an interview in the Irish edition of the Sunday Times that my own research resembles “historical fiction.” The historical truth, according to Crispi, lies in the cast-off theory that oral-cavity infections cause uveitis — never mind that Joyce’s eye problems preceded his oral infections by more than a decade. It takes a special blindness to overlook basic chronology and a century of medical research: Crispi’s reaction is a form of kneejerk defensiveness about the extensive work of his academic field. The most unsettling prospect to certain Joyceans is not that Joyce’s life was ravaged by a sexually transmitted disease but that amid the mountains of scholarly research into Joyce’s acquaintances and influences, his primary-school education, his eating habits, his love letters, the songs he sang, and the marginalia he scrawled in his books, the most talked-about writer of the twentieth century has never really been seen.

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More from Kevin Birmingham:

From the July 2014 issue

A Portrait of the Artist as a Syphilitic

Revisiting James Joyce’s medical record

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  • LidaLWyrick

    Lingering pain left him unable to read or write for weeks. Joyce had endured at least two previous attacks, and after the third he allowed a surgeon to cut away a piece of his right iris in order to relieve ocular pressure. Nora Barnacle, Joyce’s partner, wrote to Ezra Pound that following the procedure Joyce’s right eye bled for days. http://alturl.com/brjkr

  • Michael Nolan

    Jimmy would love this!

  • Laurens M. Dorsey

    The Irish knifefight will have its saints. All Joyce’s vacuous bullshit hipped no one to nothing.

  • Anita Feldman

    I marvel continually at the impossible things Kevin Birmingham asks me to believe: I’d no sooner got used to the idea that Sean O’Casey was a wealthy Protestant writer mining Irish peasant themes than I was told, in Birmingham’s online Harper’s article, that all scholarship is selectively blind. Maybe so, but, as his publications show, some scholars are more blind than others.

    Birmingham’s blindness must have lifted temporarily (or maybe selectively) when he read page 75 of James Joyce and the Burden of Disease (1995), by Kathleen Ferris. He must have realized that, in recognizing arsenic as a substance “not commonly used for any malady other than syphilis,” Ferris had also recognized that James Joyce’s treatment with injections containing arsenic, in October 1928, “constitutes virtual proof of his doctors’ diagnosis of the disease”.—that is, of syphilis.

    His vision, though, had obviously darkened again after he’d claimed that he too, had found evidence that Joyce had been diagnosed with syphilis— and, moreover, that he had supplanted Ferris’ achievement by identifying a substance she had not mentioned. Like arsenic, he explained, this substance—galyl— was used to treat only syphilis, but it contained a second ingredient, phosphorus, which, according to its maker, could mitigate the harsh effects—the blindness and even death—resulting from treatment with arsenic alone.

    This claim, however, rests on two unexamined assumptions. The first is that the contents and properties of galyl had been accurately labeled and described by its maker. If Birmingham had thought about this assumption, he might have found the 1922 report of the American Medical Association cited by the Irish poet and novelist Brian Lynch in his review of Birmingham’s book (The Irish Independent, 21 June 2014). And he might have reconsidered his claims for galyl if he had known that , according to the A.M.A.’s laboratory tests, gally’s original contents had been changed, by 1922, to make it easier to administer; that its makers had stopped selling the original compound; that , according to the A.M.A. report, the new galyl was a “useless duplication of the well established arsphenamin” (arsenic) and that this supposedly new and improved product was not even consistent in its composition: ”Galyl,” according to the report, “is not a definite chemical entity and . . . each lot manufactured should be assayed for arsenic at the factory and the true percentage stated on the label.” He might also have found an online source that casts doubt on galyl as a treatment for syphilis alone; it reproduces a letter dated 1923 from a Dr. Oliver Ashe in which he reported that he had used galyl to treat a patient for Maltese Fever. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2316387/pdf/brmedj06247-0092b.pdf).

    BIrmingham’s second unexamined assumption was that, in saying Joyce had been treated with arsenic, Ferris meant that he’d been treated with arsenic alone. Any student of basic logic could recognize that this assumption is invalid. Birmingham, however, continued to insist that the phrase “with arsenic,” as Ferris used it, meant “with arsenic alone”: in his online article, he wrote that “Ferris . . . read Joyce’s injections of arsenic and phosphorus as nothing more than injections of arsenic.” This was despite Ferris’ citation, as her source, a letter in which Joyce stated he’d been treated with arsenic and phosphorus (75). He also convinced himself that Ferris’ Chronology of Joyce’s Medical History (155-59), in which, on page 157, she had identified both phosphorus and arsenic as the ingredients in Joyce’s treatment, was an irrelevant “appendix” that he could (and did) overlook until her criticisms of his book forced him to read it (The Guardian, 1 and 8 July 2014). Then, forgetting his complaint, in his letter to the Guardian, that Ferris had mentioned phosphorus only once in her book, he resorted, in his online article, to the patently false statement that , “ignoring phosphorus altogether,” she had omitted the key component in galyl. He has never recognized that, although phosphorus may be the key component identifying galyl (Birmingham’s discovery, in 2014), arsenic is the key to Joyce’s treatment for syphilis (Ferris’ discovery, in 1995).

    Instead, Birmingham has continued to blind himself to any evidence that contradicts or weakens his claims. And so I can only wonder whether, if Dr. Borsch injected Joyce with a compound of arsenic and phosphorus, that compound was something other than galyl; or whether Dr. Borsch, unaware of the A.M.A. report, told Joyce that galyl contained what its advertisers claimed it did; or whether its makers had, by 1928, reverted to their earlier formula. But Birmingham, it seems, has not considered or researched these possibilities. Nor has he opened his eyes to the distortions in his account of Ferris’ work. His “discovery” of new evidence that Joyce had syphilis, therefore, seems as flimsy as the claims the manufacturers of Galyl made for it in 1922. Birmingham’s claims, like theirs, belong to the history of advertising and marketing, not the history of Joyce and Ulysses.

  • Richard Gerber

    It is Mr. Birmingham who indulges in reading “as a biased enterprise,” his “research surrounding Joyce’s biography [that] has made a practice of selective blindness,” he who “comes armed with [preconceived] interpretations that [suit his biased] purposes.”

    For instance, NONE of Birmingham’s writings on the subject of Joyce and syphilis make any reference to the postmortem performed on Joyce’s body which showed NO evidence of syphilis
    (see Lyons, Thrust…, p. 79). Additionally, Birmingham’s repeated attacks on Ferris for using the
    word “arsenic” alone for the arsenic and phosphorus compound she CLEARLY first identified
    is disingenuous; Joyce himself used the “arsenic” alone to describe his treatment
    later in the same letter Birmingham cites as his source, but apparently did not read in full.

    Dr. Crispi is not far off in characterizing Birmingham’s book as “historical fiction.” With its
    surfeit of purple prose, it approaches being a romance novel. The Most Dangerous Book is itself dangerous for what it leaves out, and the distorted portrait it paints of Joyce’s medical
    issues.

  • Kathleen Ferris

    Apparently Mr. Birmingham feels a need to diminish previous Joycean scholarship in order to elevate his own accomplishment. In doing so, he has distorted my work by repeatedly claiming that I use literary evidence as if it were biographical. Actually my
    method was the reverse: to comb the biographical and medical evidence and then
    to show that some of Joyce’s characters exhibit the same symptoms. Yes, literary
    evidence can support biographical, but only after the establishment of
    the latter. I challenge Mr. Birmingham to provide specific examples, with page
    numbers please, of where I have done what he claims.

    Likewise, in regard to Joyce’s ashplant, with which Mr. B. enjoys beating me over the head. In this case, he uses my statement about Stephen Dedalus’s ashplant, “Perhaps he [Stephen] carries his ashplant out of physical necessity, not merely as an affectation” (p. 84) as if it were a reference to Joyce himself. It is Mr. B.
    who is confused, not I. When discussing Joyce’s strange walk, I provided a page
    and a half of descriptions of Joyce’s unusual gait given by his friends, but
    Birmingham prefers to ignore my biographical evidence.

    About my omission of the word “phosphorus” from my analysis of Joyce’s treatment for syphilis: if my words are read within the context of my discussion of poisons
    being administered in an attempt to cure the disease, it is apparent that I
    omitted phosphorus because, contrary to Mr. B’s assertion, it is not poison
    except in its pure form or in an overdose. Phosphorus, in the form of phosphates,
    is an essential element for the functioning of the cells of the human body. Actually
    it is administered to athletes to improve their use of oxygen, and also for
    balancing out the system of anyone who suffers from an excess of calcium.

    I am impressed by Mr. B’s omniscience in reading the minds of other people. He does a lot of that in his book. But in my case, I’m afraid he got it wrong. I saw arsenic and I thought, “Syphilis!” And that is what I said,almost twenty years before he did.

    Finally, I would like to comment on Mr. Birmingham’s attempts to contact me before he published his articles in Harper’s. The reason that I didn’t respond to him is that his emails were lost in the hundred or more I receive each day. I had to do a search to find the following email, dated Feb. 3, 2014, and a later one in the same vein dated May 28:

    Dear Professor Ferris,
    My name is Kevin Birmingham, and this June Penguin Press will be publishing
    a book I wrote about the censorship history of Ulysses. In the course of
    my research, I stumbled across what I think is further (and possibly
    conclusive) evidence that James Joyce suffered from syphilis. I have,
    obviously, read your book avidly and believe it deserves much more
    attention.

    Harper’s is interested in publishing an article that chronicles both Joyce’s history and your academic dispute surrounding it — including your exchange with Dr. Lyons (you can imagine which side I take). However, the magazine would like to know more about your story and the pushback you have gotten from Joyceans (inside the academy or out) before we move forward. Would you be willing to speak with me about this? On the phone or over email?

    Forgive me for intruding upon your private email account, but I have been
    working on this project for quite some time and your perspective and experience
    is indispensable. As you can imagine, this is somewhat time-sensitive, but I
    promise not to take too much of your time! Please feel free to contact me at
    this address or by my cell phone: xxx-xxx-xxxx. If I cannot answer, please
    don’t hesitate to leave a message.

    Thanks for all of your help — I’m truly grateful for anything you can do,

    Kevin Birmingham

    I find the obsequious tone of this email to be in stark contrast to the tone
    of Mr. B’s public criticisms of my work. I wonder, would his derogatory
    attitude toward my book have been different if I had checked my email more
    frequently? Would he have given proper attribution to me for all his borrowings
    from my work? Would he have included my book in his “Selected Bibliography”?

  • Kathleen Ferris

    Apparently
    Mr. Birmingham feels a need to diminish previous Joycean scholarship in order
    to elevate his own accomplishment. In doing so, he has distorted my work by repeatedly
    claiming that I use literary evidence as if it were biographical. Actually my
    method was the reverse, to comb the biographical and medical evidence and then
    to show that some of Joyce’s characters exhibit the same symptoms. Yes, literary
    evidence can support biographical, but only after the establishment of
    the latter. I challenge Mr. Birmingham to provide specific examples, with page
    numbers please, of where I have done what he claims.

    Likewise, in
    regard to Joyce’s ashplant, with which Mr. B. enjoys beating me over the head.
    In this case, he uses my statement about Stephen Dedalus’s ashplant, “Perhaps
    he [Stephen] carries his ashplant out of physical necessity, not merely as an
    affectation” (p. 84) as if it were a reference to Joyce himself. It is Mr. B.
    who is confused, not I. When discussing Joyce’s strange walk, I provided a page
    and a half of descriptions of Joyce’s unusual gait given by his friends, but
    Birmingham prefers to ignore my biographical evidence.

    About my
    omission of the word “phosphorus” from my analysis of Joyce’s treatment for syphilis:
    if my words are read within the context of my discussion of poisons being
    administered in an attempt to cure the disease, it is apparent that I omitted
    phosphorus because, contrary to Mr. B’s assertion, it is not poison except in
    its pure form or in an overdose. Phosphorus, in the form of phosphates, is an
    essential element for the functioning of the cells of the human body. Actually
    it is administered to athletes to improve their use of oxygen, and also for
    balancing out the system of anyone who suffers from an excess of calcium.

    I am impressed by Mr. B’s omniscience in reading the minds of
    other people. He does a lot of that in his book. But in my case, I’m afraid he
    got it wrong. I saw arsenic and I thought, “Syphilis!” And that is what I said,
    almost twenty years before he did.

    Finally, I
    would like to comment on Mr. Birmingham’s attempts to contact me before he
    published his articles in Harper’s.
    The reason that I didn’t respond to him is that his emails were lost in the hundred
    or more I receive each day. I had to do a search to find the following email,
    dated Feb. 3, 2014, and a later one in the same vein dated May 28:

    Dear Professor Ferris,

    My name is Kevin Birmingham, and this June Penguin Press will be publishing
    a book I wrote about the censorship history of Ulysses. In the course of
    my research, I stumbled across what I think is further (and possibly
    conclusive) evidence that James Joyce suffered from syphilis. I have,
    obviously, read your book avidly and believe it deserves much more attention.

    Harper’s is interested
    in publishing an article that chronicles both Joyce’s history and your academic
    dispute surrounding it — including your exchange with Dr. Lyons (you can
    imagine which side I take). However, the magazine would like to know more about
    your story and the pushback you have gotten from Joyceans (inside the academy
    or out) before we move forward. Would you be willing to speak with me about
    this? On the phone or over email?

    Forgive me for intruding upon your private email account, but I have been
    working on this project for quite some time and your perspective and experience
    is indispensable. As you can imagine, this is somewhat time-sensitive, but I
    promise not to take too much of your time! Please feel free to contact me at this
    address or by my cell phone: xxx-xxx-xxxx. If I cannot answer, please don’t
    hesitate to leave a message.

    Thanks for all of your help — I’m truly grateful for anything you can do,

    Kevin Birmingham

    I find the obsequious tone of this email to be in stark contrast to the tone
    of Mr. B’s public criticisms of my work. I wonder, would his derogatory
    attitude toward my book have been different if I had checked my email more
    frequently? Would he have given proper attribution to me for all his borrowings
    from my work? Would he have included my book in his “Selected Bibliography”?

  • Margaret Ordoubadian

    Kevin Birmingham’s failure to acknowledge in full the contributions of Kathleen Ferris to his work, as well as his continuing to demean and dismiss her work here and in England, could suggest that the gender, the institution, and the age of the parties are the basis for his obvious self confidence. He casually drops the bit of information that Ferris left the academy. It is disheartening that a young male Harvard academic finds it easy to dismiss the research of an older female scholar from another institution (in this case Emory University). Since the Harvard scholar decided to “turn over every stone” (his words quoted by Alison Flood in The Guardian 3 June 2014), one of those stones must surely have been James Joyce & the Burden of Disease by Kathleen Ferris.

  • Kathleen Ferris

    Apparently
    Mr. Birmingham feels a need to diminish previous Joycean scholarship in order
    to elevate his own accomplishment. In doing so, he has distorted my work by repeatedly
    claiming that I use literary evidence as if it were biographical. Actually my
    method was the reverse, to comb the biographical and medical evidence and then
    to show that some of Joyce’s characters exhibit the same symptoms. Yes, literary
    evidence can support biographical, but only after the establishment of
    the latter. I challenge Mr. Birmingham to provide specific examples, with page
    numbers please, of where I have done what he claims.

    Likewise, in
    regard to Joyce’s ashplant, with which Mr. B. enjoys beating me over the head.
    In this case, he uses my statement about Stephen Dedalus’s ashplant, “Perhaps
    he [Stephen] carries his ashplant out of physical necessity, not merely as an
    affectation” (p. 84) as if it were a reference to Joyce himself. It is Mr. B.
    who is confused, not I. When discussing Joyce’s strange walk, I provided a page
    and a half of descriptions of Joyce’s unusual gait given by his friends, but
    Birmingham prefers to ignore my biographical evidence.

    About my
    omission of the word “phosphorus” from my analysis of Joyce’s treatment for syphilis:
    if my words are read within the context of my discussion of poisons being
    administered in an attempt to cure the disease, it is apparent that I omitted
    phosphorus because, contrary to Mr. B’s assertion, it is not poison except in
    its pure form or in an overdose. Phosphorus, in the form of phosphates, is an
    essential element for the functioning of the cells of the human body. Actually
    it is administered to athletes to improve their use of oxygen, and also for
    balancing out the system of anyone who suffers from an excess of calcium.

    I am impressed by Mr. B’s omniscience in reading the minds of
    other people. He does a lot of that in his book. But in my case, I’m afraid he
    got it wrong. I saw arsenic and I thought, “Syphilis!” And that is what I said,
    almost twenty years before he did.

    Finally, I
    would like to comment on Mr. Birmingham’s attempts to contact me before he
    published his articles in Harper’s.
    The reason that I didn’t respond to him is that his emails were lost in the hundred
    or more I receive each day. I had to do a search to find the following email,
    dated Feb. 3, 2014, and a later one in the same vein dated May 28:

    Dear Professor Ferris,

    My name is Kevin Birmingham, and this June Penguin Press will be publishing
    a book I wrote about the censorship history of Ulysses. In the course of
    my research, I stumbled across what I think is further (and possibly
    conclusive) evidence that James Joyce suffered from syphilis. I have,
    obviously, read your book avidly and believe it deserves much more attention.

    Harper’s is interested
    in publishing an article that chronicles both Joyce’s history and your academic
    dispute surrounding it — including your exchange with Dr. Lyons (you can
    imagine which side I take). However, the magazine would like to know more about
    your story and the pushback you have gotten from Joyceans (inside the academy
    or out) before we move forward. Would you be willing to speak with me about
    this? On the phone or over email?

    Forgive me for intruding upon your private email account, but I have been
    working on this project for quite some time and your perspective and experience
    is indispensable. As you can imagine, this is somewhat time-sensitive, but I
    promise not to take too much of your time! Please feel free to contact me at this
    address or by my cell phone: xxx-xxx-xxxx. If I cannot answer, please don’t
    hesitate to leave a message.

    Thanks for all of your help — I’m truly grateful for anything you can do,

    Kevin Birmingham

    I find the obsequious tone of this email to be in stark contrast to the tone
    of Mr. B’s public criticisms of my work. I wonder, would his derogatory
    attitude toward my book have been different if I had checked my email more
    frequently? Would he have given proper attribution to me for all his borrowings
    from my work? Would he have included my book in his “Selected Bibliography”?

  • Guest

    Looks like the sand-throwing continues in the comments section. Arsenic isn’t arsphenamine. Phosphorus isn’t phosphate. Galyl–with phosphorus–was used in France well into the 1930s. And Lyons’ analysis of Joyce’s postmortem was debunked years ago by a medical doctor. Read more about all of this here.

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