Zois in Nighttown: Prostitution and Syphilis in the Trieste of James Joyce and Italo Svevo: 1880–1920 by Erik Holmes Schneider (review)

Any scholar investigating the possibility that James Joyce had syphilis will encounter a medico-historical minefield. Joyce’s medical records do not survive, which leaves us with imprecise descriptions of symptoms in letters. Even if his symptoms were clear, comparing them to current manifestations of syphilis falsely assumes that diseases are not historically determined, and ignoring pathoplasticity is especially problematic for a protean disease like syphilis, known as “the great imitator.”¹ Joyce’s treatments provide potential answers. His letters reveal that doctors injected him with an arsenical compound. Yet if we cannot specify which compound it was, we leave open the possibility that Joyce was treated with, to pick one possibility, Tryparsamide (an injectable arsenical administered primarily for African Sleeping Sickness) or perhaps a restorative tonic called Fowler’s solution, which is what Dr. J. B. Lyons asserts—never mind that it wasn’t injected. Lyons initially raised the possibility that Joyce had syphilis, only to dismiss it vehemently in his 1973 James Joyce & Medicine.² Joyce’s iritis was not syphilitic, he argues, because syphilitic iritis lasts only a few weeks—never mind the countless pre-penicillin cases of syphilitic iritis recurring for years. The redoubtable doctor defends Joyce from syphilis as if defending him from shame. The debate did not end there, of course,³ but Lyons’s statements remind us—if we needed reminding—that having a medical degree does not make one a good medical historian. It also reminds us that diagnosing Joyce with syphilis remains a sensitive subject. Perhaps Gordon Bowker was wise to leave the issue virtually untouched in his recent Joyce biography.⁴

Erik Holmes Schneider’s Zois in Nighttown: Prostitution and Syphilis in the Trieste of James Joyce and Italo Svevo: 1880–1920 is a first-rate medical history that treads carefully and capably through this minefield. Schneider scours medical and state archives for syphilitic cases and treatments in early-twentieth-century Trieste—eliminating historical variables—and he illuminates two spaces that syphilis helped shape: the brothel and the clinic. Zois in Nighttown examines aspects of Joyce biography that deserve more attention, for the brothel influenced his writing from his 1904 lyric essay “Portrait of the Artist” to Finnegans Wake, and the clinic loomed over Joyce’s entire adult life. In one important section, “A Grievous Distemper,”⁵ Schneider explores Joyce’s months-long illness in 1907 and recreates the scene of his clinical treatment under Dr. Alessandro Marina. According to Stanislaus Joyce’s “Trieste Diary,” Joyce had inflamed eyes, stomach and back pains, and a “disabled” right arm, which Marina treated at the Poliambulanza’s electrotherapy unit.⁶ Marina bequeathed his 650 medical texts—many published before 1907, with some regarding syphilis—to the Biblioteca Civica di Trieste, and Schneider’s examination of this collection enables him to adopt Marina’s perspective, viewing Joyce’s case not just through modern nosology but through the doctor’s own professional guides. For added perspective, Schneider compares Joyce’s treatment with similar cases recorded “in the one surviving register (1912–1915) of the electrotherapy outpatient clinic at Ospedale Maggiore” (130).

Did Joyce have syphilis? While Marina’s treatment is not definitive, Schneider’s painstaking methodology leads him to claim that Joyce’s illness was “most probably syphilis” (121), and his evaluation is based on Joyce’s treatments, his symptoms, and the exclusion of Lyons’s alternative diagnosis. Lyons argues that Joyce’s iritis stemmed from Reiter’s syndrome, which Schneider aptly calls “a case of pulling clinical rabbits out of one’s hat” (141–42). Reiter’s typically involves lower joints, not arms, and the symptoms are very rarely prolonged.⁷ Schneider adds another prong to his argument when he reveals a highly suggestive (if anecdotal) piece of evidence from Santiago Grimani’s memoir, Los Pasillos de la Memoria.⁸ Grimani is a pseudonym for...