European syphilis first began to appear among the strumpets and scamps of Barcelona's waterfront shanties before migrating through Spain to Italy, France, Germany, India, China, Japan, and Russia. It typically flourished during times of war, aided in its proliferation by the travels of transnational mercenaries and the imbedded battalions of prostitutes who serviced them. A particularly virulent strain visited misery on Napoleon's army during its occupation of Rome in the early nineteenth century; French poet Theophile Gautier witnessed its horrors and, perhaps after consulting a pocket medical dictionary, produced this piece of vividly overwrought prose:

"boils are exploding in groins like shells, and purulent jets of clap vie with the fountains in the Piazza Navona . . . tibias are exfoliating in extoses like ancient columns of greenery in a Roman ruin. . . ."

While Napoleon plotted the movements of soldiers and munitions, syphilis developed a new tactic of its own-a mutation that enabled it to enter the central nervous system and wreak havoc on the brain. The grab-bag of ailments that syphilis produced-chancres, rashes, joint pain, headaches, fever, eye inflammation, and gastrointestinal agony-swelled to include paresis (gradual paralysis and periods of dementia) and tabes dorsalis (a progressive wasting of the spinal column). The most significant result of this, at least for the purposes of Hayden's book, is that the long-suffering syphilitic "was often rewarded, in a kind of Faustian bargain for enduring the pain and despair, by episodes of creative euphoria, electrified, joyous energy . . . and almost mystical knowledge."
In the nineteenth century, the artistic and medical communities were convinced that syphilis could produce genius.
In a few cases, it's hard to dispute this apparent connection: Van Gogh became "a human charged with electricity," painting for long hours in an ecstatic, dreamlike state, abandoning his coal sketches to instead produce the brightly hued oil paintings for which he is now famous. Nietzsche was fed the inspiration for Thus Spake Zarathustra in a (religious) flash; Freud marvelled at the unprecedented introspection the philosopher commanded and attributed it to paresis. Guy de Maupassant went from being an idle mediocrity to a master of the short story and "the most talked about writer in Paris," capable of composing a 14,000-word piece in his head and putting it to paper without a single correction. In a career that lasted only a decade, "he turned out more than twenty-seven volumes-three hundred stories, six novels, three plays, travel books, and poetry."
It's difficult sometimes to tease apart the mind-altering effects of syphilis from those of certain medicines-laudanum, absinthe, mercury-ingested by the subject to ease their suffering. Moreover, isn't it conceivable that the drama of living with any serious disease-the fear, the sudden liberation from more banal concerns, the realization that time is short-lead some to create works they might otherwise never have gotten around to?
There are no easy answers where the syphilis-genius connection is concerned. Maybe it was Leon Daudet, writing about his famous syphilitic father, who best described the enigmatic relation:

"Nervous illness raises to the power of two . . . both the qualities and the faults of those it touches. It sharpens them like pencils . . . The miser becomes a hyper-miser . . . the jealous man surpasses Othello, the lover turns frenetic . . . On the other hand, noble, generous, disinterested souls acquire, in the face of incessant pain . . . an almost saintly goodness . . ."

Alphonse Daudet's life might not seem either "noble" or "saintly" upon initial inspection. One of the leading French novelists and playwrights of his age, he was also an incorrigible philanderer-a diminutive satyr who lost his virginity at 12, contracted syphilis from an imperial courtier at 17, and, even after marrying and fathering three children, maintained an "active, carefree, careless sex life" with not just his own mistresses but his friends' as well. We learn from his writings, however, that the many betrayals he perpetrated upon his family through physical means were almost absolved by the deep emotional fidelity he held for them. Throughout his decades-long battle with his illness, his paramount concern was to avoid burdening them. As Julian Barnes recounts in his introduction to In the Land of Pain-a collection of wrenchingly eloquent notes towards a literary confession Daudet never lived to write-the author was

"sitting with a friend one morning, eyes closed, barely able to speak, martyred by pain. The door-knob gently turned, but before Mme Daudet could enter, her husband was on his feet, the colour back in his cheeks, laughter in his eye, his voice filled with reassurance about his condition. When the door closed again, Daudet collapsed back into his chair. Suffering is nothing,' he murmured. It's all a matter of preventing those you love from suffering.'"

The notes introduce us to Daudet at the age of 45, just as the symptoms of his tabes dorsalis are ramping up to intolerable levels. He writes about "the first moves of an illness that's sounding me out, choosing its ground." Some of its effects are merely annoying, like his "heightened awareness of sound . . . the screech of doorbells . . .. the ticking watch . . . a spider's web on which work begins at four in the morning." Others, like his eroding sense of balance and the involuntary jerking of his limbs, are both dangerous and humiliating:

"shooting pains . . . either nail me to the spot, or twist me around so that my foot pumps up and down like a knife grinder's . . . On the Boulevard Saint-Germain a carriage nearly runs me down, and I react like a berserk marionette."

Pain stalks him at all times, harassing him in a myriad different ways: "in my back and the nape of the neck, as if all the marrow was melting .. . . a burning feeling in the eyes . . . a penknife stabbing away beneath the big toenail." Sometimes only a ceaseless supply of morphine can keep him from screaming.
As the years drag on, Daudet seeks treatment for his maladies in the springs and mud baths of various French spas. He submits to a torturous treatment known as the Seyre suspension, hanging from a chamber ceiling by his jaw to stretch out the atrophying muscles of his back. He goes on "esoteric diets." He's injected with elixirs made from guinea pig extract. None of it helps.
Daudet never found true relief. He did, however, win adulation quite apart from his literary acclaim for transforming, as much as possible, his life into a work of art. Said Marcel Proust: "I saw this handsome invalid beautified by suffering . . . whose approach turned pain into poetry." When Leon accompanied his father on an annual trip to the spa in Lamalou, its motley assortment of patients-dwindled, haunted, haggard- put aside their own private agonies to greet their favourite fellow-sufferer:

"From the first evening, we would be surrounded by about sixty people, familiar faces smiling at us through their torments. It was the most extraordinary display of moral attraction I have ever been permitted to witness."
Daudet died suddenly at his dinner table on December 16, 1897, while chatting with his family about, of all things, the upcoming theatre production of Cyrano de Bergerac. The longed-for cure, penicillin, would not be used for another 46 years.
And what of our fell disease today, the insidious killer that terrorized the world for nearly five centuries? "Syphilis," say doctors, "has become boring."