Syphilitic Insanity and Incontinence: The Uncontrolled Bodily Fluids of Degenerative Decline

Abstract

Syphilitic Insanity and Incontinence:The Uncontrolled Bodily Fluids of Degenerative Decline Rebecka Klette (bio) In the late nineteenth century, self-restraint and bodily discipline emerged as the markers of civilization and evolutionary superiority; conversely, the uncontrolled, unrestrained body signified the threat of devolutionary regression to a primitive past (Gilman 99; Nye 143). One example of the many contemporary attempts to establish boundaries between developmental stages—between animal and human, between savagery and civilization—can be found in taboos surrounding bodily fluids. Transgressive forms of fluidity—sexual, pathological, in excess, or in public—threatened those boundaries and served as atavistic vestiges of humanity's primal origins. These anxieties coalesced in contemporary discussions concerning general paralysis of the insane (GPI), a progressive paralytic dementia caused by late-stage neurosyphilis, which became the primary focus of research into syphilitic insanity and mental degeneracy during the latter half of the nineteenth century.1 The progressive decline of physical and mental autonomy, strength, and self-control rendered the afflicted unable to work; given that the majority of patients were middle-class men at the peak of their careers, the disease had dire socio-economic implications, as well as fuelling anxieties concerning national and racial fitness.2 Drawing on contemporary scientific explanatory models of entropy and nervous energy, British psychiatrist Henry Maudsley proposed that GPI was the result of "spent force—something by which somehow the most refined and sublimed vitality of the cerebral centres has been drained away" (458). The prospect that the vitality of civilized men was finite and could be depleted by physical or nervous excesses emphasized the "destructive element of masculine energy—physical incontinence" (Hurn 85). While syphilis was firmly established as the primary cause of GPI by the early twentieth century—following the discovery of the Spirochaeta pallida organism [End Page 14] in 1905 and the Wassermann antibody test in 1906—physicians were reluctant to abandon the multicausal explanatory model. Alcohol abuse, sexual excesses, intellectual overwork, the nervous exhaustion and stresses of the modern urban environment, moral laxness, and hereditary predisposition were continually invoked as indirect, predisposing, or triggering factors in the etiology of GPI.3 In GPI, the French psychiatrist B.A. Morel's delineation of progressive hereditary degeneration over four generations was compressed into a rapid physical and mental decline over merely a few years. Sufferers accelerated through the stages of moral insanity, impulsive criminality, sexual perversion, intellectual enfeeblement, delusions, epileptiform fits, complete paralytic dementia, and, finally, death. In patient case histories, the general paretic's rapidly progressing physical and mental deterioration and loss of control over bodily functions and fluids was mediated through a degenerationist lens; these symptoms were portrayed as markers of physical, mental, moral, and evolutionary degeneration and decline. As Harry Oosterhuis notes, "Degeneration was associated with the lack of inhibitory control of the 'higher' faculties over the more primitive levels of the central nervous system" (54). In the early stages of the disease, the most refined faculties of moral sense, judgment, higher intellect, willpower, and self-control—as the latest evolutionary acquisitions—were the first to be impaired. Describing a GPI patient, Maudsley noted that "in speech, manner, and behaviour he betrays the loss of refined feeling and … self-restraint" (436), more specifically, a "blunted moral and social feeling" (457). The patient would gluttonously binge on copious amounts of food and alcohol; worsening tremors in the tongue and hands led to drooling and spilling, and he was seemingly indifferent to the stains of sweat, saliva, and food on his unchanged clothes. Succumbing to his more indulgent, brutish, and perverted urges and impulses, the patient violated modern civilized society's mores of propriety: exposing himself in public or carelessly urinating "in the middle of a busy street or on the carpet of a room. The present impulse meets with no restraining reflections, because of the utter dissolution of the bonds of his cerebral reflexes" (460). The processes of pathological excess and disinhibition also manifested in the form of megalomaniac and absurdly extravagant delusions of grandeur, often concerning the baser bodily functions; German psychiatrist Emil Kraepelin noted that a GPI patient would often maintain that: "[h]is urine is Rhine wine; his evacuations are gold. … his...