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Home arrow Language & Literature arrow Syphilis in Victorian Literature and Culture: Medicine, Knowledge and the Spectacle of Victorian Invisibility
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Self-fashioning

The Polyclinic and the adjacent museum became instrumental in training the medical gaze while their spatial orientation supported a civic and professional narratives of progress, in turn ascribing to medical men a more prominent and respectful place in society. Likewise, Hutchinson’s use of the trope of syphilis recognition also helped him justify his choice of profession and became an important part in his practice of respect- garnering self-fashioning. Most prominently, these tendencies are visible in the preface to the second edition of Syphilis:

I have [... ] during a long series of years been a diligent observer of all that concerns syphilis in the living subject, and my opportunities in this department have been extensive. [... ] having become Surgeon to the Metropolitan Free Hospital, I obtained a wide range of observation amongst the poorest classes and in all races. Not long after this date I became attached to the staff of the Royal London Ophthalmic Hospital, and also to that of the Blackfriars Hospital for Diseases of the Skin, with both of which I maintained official connection for a long series of years. It was at the former that the observations were made which resulted in my papers on the teeth and physiognomy of congenital syphilis, and the nature of interstitial keratitis and other affections of the eye not previously suspected to be syphilitic in causation. In 1859 I became surgeon to the London Hospital, without resigning my appointments at the special institutions just mentioned, and thus secured what was the object of my desire - a very wide range of both general and special study of disease. I had not at that time, nor, indeed, subsequently, any desire to cultivate practice in venereal diseases - rather, indeed, to avoid it - but my papers having attracted attention, [... ], private patients were sent to me, and I soon had plentiful opportunities for observing syphilis among those whose education and intelligence enabled them to afford information far more trustworthy than that obtainable in hospital practice. [... ] Year by year my records accumulated [ ...]. My own years having been unusually prolonged, in association with fair powers of memory and mental vigour, I have been able to secure a kind of experience which falls to the lot of but few. I have seen many of those whom in their early adult vigour I had treated for syphilis, now in honoured grey hairs and apt to boast of their grandchildren. (1909: x-xii; my emphasis)

This narrative emphasizes Hutchinson’s magisterial recognition skills as the source of his authority. Not any unwholesome curiosity but his clinical skills, unique contribution to the medical study and public interest are presented as the major stimuli in his professional pursuits. This narrative positions Hutchinson as uniquely qualified to pronounce judgement on the prospects of curing the disease. Not only has he had more opportunities than many others to observe its symptoms, he also has the advantage of seeing both hospital and private cases. Finally, his old years, “fair powers of memory and mental vigour” and his ceaseless note-taking allow him to accomplish what “falls to the lot of but few,” namely to offer to his colleagues and to posterity complete histories of chronically ill patients. Indirectly, this insistence on his experience and authoritative judgement concerning the therapeutic regimen also links him to the ethos of civic virtues, as he establishes a strong correlation between his work and the health of his patients. His idyllic image of a healthy patrilineage - grandfathers who in their seniority enjoy the company of healthy grandchildren - turns him into a benefactor of the generations of patients, and by extension, of the whole nation.

And yet his personal narrative also betrays anxieties generated by a growing pathologization of middle-class masculinities. In Victorian Demons, Andrew Smith argues that the late Victorian era saw a particularly strong association of dominant masculinities with “disease, degeneration and perversity” (2004: 1). While many Victorian scientists had to grapple with this problem, the situation was particularly precarious for medical men, whose ‘unseemly’ preoccupations and interests made them especially vulnerable to the accusations of degeneration (see Walkowitz 1992: 20910, Harris 1992, Gilman 1989: 250-1). In view of this, Smith sees the tendency of medical men to conceal the role of the middle-class client in the transmission of the disease as a political attempt to preserve traditional notions of male identity, which, rather than severing the link between masculinity and degeneration, paradoxically highlighted it (2004: 94). Although Smith rightly recognizes the dialectics ofvisibility and invisibility that Hutchinson’s text is beset with, the effects of this intertwining are much more complex and surpass the issues of gender performance that he addresses.

Cognizant of the public image of the profession and aware of the potentially unsavoury character of knowledge he transmitted, Hutchinson had to walk a tightrope between asserting his own position as syphilis expert, counteracting any suspicions of unhealthy interests, keeping the identity of his clients concealed, their trust unbent and money flowing, along with presenting his views on the disease. The trope of syphilis recognition helped him in this task. Before the discovery of the causative organism, recognition was the only way of asserting the type of ailment and was central to the diagnostic enterprise of clinical medicine. Hutchinson’s insistence on the insidious character of the disease highlighted the importance of differential diagnosis and, with it, clinical studies to the practice of medicine, thereby participating in the current discussion concerning the future of the discipline. Syphilis recognition also helped signal Hutchinson’s experience and expertise. Most prominently, however, the uncertainties due to the protean nature of syphilis were a motivation for further comparative and multimedia study and a means of communicating the necessity to expand the work on syphilis. Expertise in syphilis recognition rehabilitated practitioners who chose to pursue such unbecoming subjects: it helped them bolster the authority that their profession could not yet guarantee at the time.

Despite the recurrence of the trope of syphilis recognition and Hutchinson’s continuous work on syphilis, the seemingly unobstructed view of the disease he offered was in fact only a narrow vista flanked by a number of personal, didactic and moralist narratives, which warranted the salubriousness of the subject and transformed its pursuit into a philanthropic exercise. Such cocooning hints at a number of anxieties that the subject was surrounded by, even as an apt recognition of the disease was associated with professional insight and authority. Invariably, syphilis was integrated into innumerable tales of progress and narratives of development. Interestingly, the same type of alliance - between the horrors of seeing and the power of education - was characteristic of public discourses around the disease.

 
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