Lillian Rountree //
Finding a modern literary depiction of syphilis is nearly impossible. The disease has been academically and culturally dismissed — from Susan Sontag’s claim in Illness as Metaphor that the disease is “not mysterious” and thus limited in its metaphorical and literary power, to Matthew Macfadyen’s character on HBO’s Succession noting that “You don’t hear much about syphilis these days. Very much the MySpace of STDs” (“Argestes”). But the current relegation of syphilis to dismissal and comedy belies its profound historical impact. In the nineteenth century, without effective treatment or prevention measures, syphilis was rampant (Kojima). The problem was especially prevalent in France, with one “syphilologist” estimating that 15% of the population of Paris was infected at the end of the nineteenth century (Hayden, Introduction). Indeed, syphilis seemed so universal that the protagonist of Joris-Karl Huysmans’ 1884 novel À rebours famously exclaims that “Everything is syphilis” (Koos, 52).
But if syphilis was everywhere, it was also somehow nowhere. Though several of the major authors of the period—Charles Baudelaire, Guy de Maupassant, Gustave Flaubert—were all rather infamously infected with syphilis, literature was largely silent on the topic. When syphilis made it into contemporary literature, for example, in Maupassant’s Le lit 29 or Huysmans’ À rebours, it was described in opaque terms and turned into metaphors that fit the prevailing viewpoint of syphilis as a moral failing. Medical textbooks were ample, but accounts of individual experiences were sparse. Syphilis was everywhere, but it was also a sexually-transmitted disease, and the stigma around that origin was powerful and silencing.
It was in this highly charged cultural atmosphere that the writer and journalist Alphonse Daudet (1840-1897) began to draft what would eventually become La doulou, a compiled series of notes written from 1887 to 1895 detailing the intense chronic pain that he experienced in the last decade of his life. La doulou, with its fragmented narrative and lucid descriptions of pain, stands in marked contrast to the nostalgic and somewhat folksy stories of Provençal life that made Daudet a staple of nineteenth-century French literature. It is a text that explicitly focuses on the terrible and confounding nature of pain, how to define it, how to express it, and how it changes a person’s sense of self. One thing it decidedly does not focus on, however, is the origin of Daudet’s pain: late-stage syphilis, specifically tabes dorsalis.
If one did not know the symptoms of late-stage syphilis, it would be possible to read La doulou without ever understanding what disease is behind Daudet’s suffering. Yet Daudet knew that the origin of his illness was syphilis. The choice to make that reality opaque was deliberate, along with all of the other choices Daudet made in portraying his world of pain. In “re-introducing” syphilis to the text by considering how its status as a stigmatized, silenced, and misunderstood disease altered Daudet’s understanding and presentation of his suffering, we can both come to a fuller understanding of the reality of Daudet’s pain and reach a greater appreciation for how the cultural moment indelibly alters one’s perception of one’s own pain and illness. The moralizing, negative cultural associations of syphilis of the time emerge in the ways Daudet writes about his pain without writing about his syphilis, disconnecting his suffering and its source in a manner perpetuated by the original editors of La doulou as well as subsequent scholars. It is also present in the recurring declarations of guilt, shame, and desire for solitude Daudet links to his pain.
In La doulou, Daudet struggles to decide what, if any, is the best way to translate pain to paper; in many ways, it seems impossible, as he himself notes at one point. Even so, he attempts several different approaches. What is striking is that, in each case, his pain and his syphilis remain disconnected. The notes of La doulou dedicated solely to articulations of pain can be divided into two categories: clinical descriptions of physical suffering and metaphorical descriptions of abstract pain. These more abstract notes are beautiful in their vagueness, skipping between metaphors at will.
In the parts of the text that are intentionally conceptual, it is easy to understand how descriptions of pain are detached from syphilis, or indeed any specific illness. Not directly referencing any specific symptoms, these notes instead approach a greater universality of pain. More intriguing is the way that the more “factual” and straightforward articulations of his physical pain still manage to skirt around directly discussing syphilis. Daudet’s descriptions align, of course, with the “checklist” of symptoms for late-stage syphilis; a passage discussing bouts of intense pain in his legs and increased difficulty in taking stairs and walking on waxed floors, for example, fits quite neatly with the checklist of “unsteady gait, progressive degeneration of the joints, loss of coordination, episodes of intense pain and disturbed sensation” from the NINDS page on symptoms of tabes dorsalis. However, even in passages like this, Daudet still manages to avoid using the definitively incriminating word “syphilis,” or even the “higher-medical” term, as translator Julian Barnes describes it, “tabétique.” “Tabétique” refers to the disease tabes dorsalis itself and its relation to the nervous system; Daudet instead opts for the more ambiguous term “ataxique,” which merely describes the outward symptoms of tabes dorsalis (Barnes, 32). In this way, Daudet’s experience of pain is kept at a remove from the disease itself; by erasing its biological origin, his suffering seems more abstract and inexplicable.
In a somewhat ironic twist, Daudet at one point bemoans this societal taboo whereby even medical professionals would avoid directly mentioning syphilis. Some of La doulou’s pointed silence on syphilis may reflect the choices of his editors rather than his own; after all, the text was only published after his death, and an unknown number of other writings were cut from the edition that was eventually published in 1930—an edition which manages, even in its contextualizing introduction and afterword, to refer to Daudet’s syphilis only as his “illness.” Perhaps those deleted notes dared to speak the true name of Daudet’s illness; perhaps not. Regardless, the surviving notes remain silent on the topic. In offering an explicit description of pain but never blatantly calling the illness by its name, La doulou ends up perfectly mimicking the opaque, there-but-not-there strategies of predominant nineteenth-century literary depictions of the disease. Indeed, La doulou actively upholds the prevailing cultural understanding of syphilis by passively agreeing to uphold silence.
Such avoidance goes hand-in-hand with the mix of guilt, shame, and desire for solitude that Daudet expresses throughout the text. Daudet repeatedly brings up his frustration and guilt at being unable to withstand his pain, underscoring his own expectation that he should be able to bear what is happening to him. When he inevitably fails to sufficiently tolerate his suffering, Daudet writes of the degrading shame this supposed failure brings. Daudet frames himself as the exception, the only one, out of all his family and friends, who is incapable of handling his pain. He longs for solitude and isolation, for separation from everyone, even his wife and children. He expresses the desire to live “alone, alone” like a mole in the earth (26). In a fictional dialogue at the end of La doulou, two “ataxiques” discuss the nature of pain and decide that true suffering is only done in solitude—the presence of family alleviates pain. Taken with this, Daudet’s repeated requests for solitude and isolation from his family take on an additional dimension of self-hatred and shame. Striking an unusually religious tone for the text, one particularly damning note literally crucifies Daudet in his pain (19-20).
On several occasions, Daudet privately expressed to his confidant, Edmond de Goncourt, the feeling that his illness was “some sort of just punishment for past sins,” as the scholar Michael Worton puts it, or was payment for his “crime of sensuality,” as Goncourt himself wrote (Worton, 41; Wilson, 183). While Daudet refrains from any open, moralistic lamenting of a divine punishment, choosing instead the bleak recognition of the reality of his illness, the lingering effects of shame from Daudet’s private feeling of a “just punishment” can still be found in La doulou. The disappointment that he has failed to withstand his pain becomes guilt if Daudet believes he brought it on himself. His desire to suffer alone becomes a desire to maintain secrecy in light of the fact that Daudet kept his consultation with noted “syphilologist” Fournier a secret from his wife (Hayden, 312). The image of Daudet’s “crucifixion” becomes particularly pointed and grounded in guilt, playing into a Christian tradition of correlating venereal disease as retribution for sexual promiscuity (Wilson, 183). Although neither Daudet nor the editors of La doulou dare to name the disease in the text, the impact of syphilis on Daudet still managed to make its way into the work, staining his understanding of his pain with a strong sense of guilt and shame about the origin of his suffering.
La doulou was an idea that Daudet had toyed with for years, its form shrinking from a full-length novel on pain down to the series of notes he ended up writing. Daudet was determined to tell the story of his suffering; equally formidable a force, however, was the prevailing standard of silence and stigma surrounding this determination to speak the unspeakable. The clash of these two forces is fundamental for understanding La doulou. In an important departure from the treatment of syphilis in literature at the time, Daudet strives to capture the individual experience of his suffering, but to do so, he separates his suffering from his syphilis. While Daudet rises above the moralizing so prevalent in the understanding of syphilis at the time, that lingering, internalized guilt makes its way into the text all the same.
Syphilis is nowhere in La doulou, yet it is on every page. Daudet’s presentation of pain can be largely understood without the context of the disease—indeed, it was designed to be read that way. But such a reading belies the full truth of Daudet’s pain and his perception of it. That disease-less, disconnected pain is as much a product of the cultural stigma of syphilis as it was an intentional choice, and to ignore these aspects of La doulou’s meditation on pain is to keep our understanding of it incomplete. With our historical distance we can, and should, “reintroduce” syphilis into the lens with which we read La doulou as both a universal exploration of chronic pain and an unparalleled and insightful representation of the experience of syphilis at a time when the very word was barely uttered.
Author: Lillian Rountree is a third-year undergraduate at Columbia University, studying statistics and French language and literature. Her research interests include the cultural place of disease in 19th-century French society and contemporary public health knowledge on menstrual health.
Image: Rodolphe Bresdin, “The Convalescent.” The J.B. Neumann Collection, Gift of Dr. Franz H. Hirschland, 1951. The Metropolitan Museum of Art.
Daudet, Alphonse. In the Land of Pain. Edited & translated by Julian Barnes, Jonathan Cape, 2002.
—. La Doulou (La Douleur): 1887-1895. Né varietur, Librarie de France, 1930, https://gallica.bnf.fr/ark:/12148/bpt6k3413411x.
Hayden, Deborah. Pox: Genius, Madness, And The Mysteries Of Syphilis. Kindle Edition, Basic Books, 2003.
Kojima, Noah, and Jeffrey D. Klausner. “An Update on the Global Epidemiology of Syphilis.” Current Epidemiology Reports, 2018/02/19 ed., vol. 5, no. 1, Mar. 2018, pp. 24–38, doi:10.1007/s40471-018-0138-z. PubMed, 30116697.
Koos, Leonard R. “Damaged Literary Goods: Telling the Tale of Syphilis in Nineteenth-Century France.” Dalhousie French Studies, vol. 80, Dalhousie University, 2007, pp. 45–58. JSTOR.
NINDS. “Tabes Dorsalis Information Page.” National Institute of Neurological Disorders and Stroke, 27 Mar. 2019, https://www.ninds.nih.gov/Disorders/All-Disorders/Tabes-Dorsalis-Information-Page.
Shakman, Matt. “Argestes.” Succession, Season 2, Episode 6, HBO, 15 Sept. 2019.
Sontag, Susan. Illness As Metaphor. Farrar, Straus, and Giroux, 1978.
Wilson, Steven. “‘Dictante Dolore’: Writing Pain in Alphonse Daudet’s La Doulou.” Medicine and Maladies: Representing Affliction in Nineteenth-Century France, edited by Sophie Leroy, vol. 422, Brill | Rodopi, 2018, pp. 171–189. Brill.
Worton, Michael. “Of ‘Sapho’ and ‘Syphilis’: Alphonse Daudet on and in Illness.” L’Esprit Créateur, vol. 37, no. 3, The Johns Hopkins University Press, 1997, pp. 38–49. JSTOR.
Editor’s Note: This essay is part of a collection that grew out of a course on illness and francophone literature and culture at Columbia University. Each essay speaks to the range of epidemics and medical encounters in France and the French empire that the course covered — from the plague outbreak in Marseille in 1720, to recent outbreaks of Ebola in West Africa, to the class’s own context of COVID-19. Offering new perspectives on these topics, the essays demonstrate how a pedagogical focus on illness can engage students in thinking about how literature might spark ethical and political reflection, and about how colonialism and race function as driving forces of history.