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In the Land of Pain

Ed Julian Barnes
Jonathan Cape, £10, pp 102
ISBN 0 224 06267 0
Rating: **

Alphonse Daudet was a novelist who lived in France in the second half of the 19th century. At the age of 17 he contracted syphilis, which lay dormant for some 20 years. He eventually developed locomotor ataxia as a result of tabes dorsalis, when the disease moved to his neurological system. He died in 1897 at the age of 57.

For the last decade of his life, Daudet kept a notebook. Some might call it a diary, but it was more a record of Daudets thoughts about the terrifying effects of syphilis. In the Land of Pain is the first English version of this notebook, which was originally published by Daudets widow in 1930 and has now been translated by the British novelist Julian Barnes.

Syphilis may not be the great problem today that it was before antibiotics, but nevertheless it is not confined to history. Daudets book is fascinating as it puts syphilis into context, and offers an insight not only into the disease and the almost incomprehensible pain that accompanies it, but also into 19th century attitudes about sexually transmitted infections. You would expect some shame, or caution, but Barnes tells us that one man felt triumphant to have caught syphilis: “Ive got the pox! The great pox the majestic pox.” The man went on to express his relief that he would not have to worry about catching it anymore.

Daudet describes the various treatments that he received. One of these, mercury, gave rise to the saying “One night with Venus, a lifetime with mercury.” Some of the treatments now seem absolutely ludicrous. When Daudet died, doctors worked for an hour trying to revive him by “rhythmical and forceful contractions of the tongue” before pronouncing him dead.

Barness introduction and endnotes are valuable and interesting, but although this book is short, it is not an easy read. Daudets writing is poetic and occasionally hard to understand. It is constantly interrupted by long footnotes, which, while explanatory, become irritating after a while. However, if you like history and have the patience to read a collection of musings with no beginning and no real end, then you many find In the Land of Pain fascinating.


Anna Ellis fourth year medical student
University of Sheffield
aellis@bmj.com

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