Page in Book: 477
184. applying paint directly: BVG 441, 12/19/1885: Vincent imagines two ways in which photography could be useful to him as a portrait painter. The first involved finding employment in a photographer's studio: "The photographers seem to have plenty to do here. One also sees painted portraits in their shops, which they apparently work up on a background obtained by photography, which obviously has a weak, feeble effect to anyone who knows what painting is." (JLB 549, 12/19/1885.) Vincent takes this notion of a combination of photography and painting and pushes it even further. The first of these proposals involves using a photograph only as a background. Vincent's elaboration appears to involve using a photograph not just for the background, but for the actual portrait, in the manner of a paint-by-numbers template -- except, of course, Vincent intends to add expressive color to the flat visage in the photograph. This goes far beyond the use Vincent made of photographs early in his career as guides for drawing (JLB 169, 7/15/1881-7/20/1881). Although he apparently did not pursue the idea in Antwerp, he did paint a portrait of his mother based on a black-and-white photograph in Arles in 1888 (Portrait of the Artist's Mother [F 477 JH 1600]), although the method he used was closer to the early one in Etten than to the one proposed here.
Context:
JLB 549, 12/19/1885: "It occurs to me now that one could get very much better colours if one worked with studies painted directly from life from the photographs that people want to see painted"

185. "one could get": BVG 441, 12/19/1885.
Context:
BVG 441, 12/19/1885: "Now it seems to me that one could get a much better colouring if one worked from studies painted directly from life on the photographs which one wants to have painted."
JLB 549, 12/19/1885: "It occurs to me now that one could get very much better colours if one worked with studies painted directly from life from the photographs that people want to see painted."

186. "fantasy heads": BVG 441, 12/19/1885.
Context:
BVG 441, 12/19/1885l: "There seems to be a lot of beautiful women in this city, and I feel sure that money is to be earned by painting women's portraits or fantasy heads and figures of women."
JLB 549, 12/19/1885: "There seem to be a lot of beautiful women in this city, and it has to be the case that there's money to be earned with either women's portraits or imaginary women -- heads and figures."

187. blamed tight-fisted buyers: BVG 441, 12/19/1885.
Context:
JLB 549, 12/19/1885: "The prices -- the public -- everything needs renewing. And the future is working cheaply for the bourgeoisie, perhaps. At any rate -- the ordinary art lovers themselves seem to be getting more and more set, becoming hard."

188. out-of-touch dealers: Vincent has particularly harsh words for the dealers in Antwerp -- a reflection, perhaps, of the mistreatment he suffered at their hands. He says he saw " virtually nothing" at the shops he visited (JLB 544, 11/26/1885; emphasis in original) and disparages their "poor displays" (JLB 549, 12/19/1885). He describes them as whining cowards ("the dealers are complaining -- sheer destitution") and blames their troubles on their own avarice in raising prices too high ("Pushing the prices high is the ruin of the trade and makes it as quiet as the grave") (JLB 547, 12/14/1885). Elsewhere, he blames their old-fashioned ways (citing, in particular, their heavy framing): "Why -- for the trade -- are all paintings always in frames? As a commercial article there's surely sometimes a lot to be said for something's being light and easy to handle and to move. The trade is old-fashioned and ... thrice mouldered." (JLB 549, 12/19/1885.) And, finally, he blames them for being out of touch with the market: "at the moment the dealers are all suffering somewhat from the same ill, that of being more or less a breed withdrawn from the world. They're all too sunk in gloom, and how can one be very inspired to go scratching around in that indifference and that apathy -- particularly since this disease is contagious." (JLB 550, 12/28/1885.)
The last part of this sweeping indictment may betray Vincent's real agenda. He wants to use the dealers' negative attitude about the marketplace (i.e., about the salability of Vincent's art) as an excuse to stop visiting dealers ("scratching about") altogether, thus relieving himself of the duty to sell his own work -- a promise he made repeatedly to Theo before coming to Antwerp -- and the unpleasantness of hearing criticisms of his work.

189. a moribund market: BVG 436, 11/24/1885-11/27/1885. In mid-December, he quotes his conversation with one dealer who "lamented in a dreadful manner that literally no one had set foot in his shop in a fortnight" (JLB 548, 12/17/1885). "The shops look grim" (ibid.). Elsewhere, Vincent calls as witnesses some of the painters he reports meeting: "All these gentlemen, though, are complaining bitterly that nothing's moving. Still, that's not news." (JLB 546, 12/6/1885.) Vincent also cites an article he read in Étoile Belge reporting that "affairs in general are really bad" everywhere (JLB 547, 12/14/1885).
Context:
JLB 544, 11/26/1885: "I'm afraid that the trade is categorically as quiet as the grave."

190. "If they showed more": JLB 548, 12/17/1885. Not surprisingly, Vincent lodges this complaint on behalf of the kind of work he wants to make but is unable to sell: "although one has far more difficulties with figures because of the models -- all the same, it may be a better chance. What the dealers say is that they still think women's heads or figures of women are most likely to sell." (ibid.) Given how neatly it fits into Vincent's current obsession, one is entitled to ask how much of this report of what the Antwerp dealers "say" is Vincent's partisanship and how much is true.
Context:
BVG 440, 12/15/1885: "If there were more better things on view, more business would be done."

191. "The prices, the public": BVG 441, 12/19/1885.
Context:
JLB 549, 12/19/1885: "The prices -- the public -- everything needs renewing."

192. "overstrained": BVG 441, 12/19/1885.
Context:
BVG 441, 12/19/1885: "Goodbye, but try to write me by return mail, for I am feeling rather faint, as I have somewhat overstrained myself with one thing and another, and I need my strength."
JLB 549, 12/19/1885: "Regards -- but see that you write to me by return, for I have a faint sensation in my body because I've exerted myself rather a lot on this and that, and I need my strength."

193. "far from well": BVG 445, 1/17/1886-1/20/1886.
Context:
BVG 445, 1/17/1886-1/20/1886: "It is very cold here, and most of the time I feel far from well, but as long as the painting flourishes, it doesn't matter so much."
JLB 553, 1/19/1886-1/20/1886: "It's dreadfully cold here, and I often feel far from well, but anyway, as long as the painting's going, that doesn't really matter."

194. Antwerp's bitter, wet winter: BVG 445, 1/17/1886-1/20/1886.
Context:
JLB 553, 1/19/1886-1/20/1886: "It's dreadfully cold here, and I often feel far from well."

195. his stomach rebelled: BVG 442, 12/28/1885.
Context:
JLB 550, 12/28/1885: "I notice that my appetite has been kept in check for rather too long and that when I received the money from you I couldn't stomach any food."

196. his gums grew sore: BVG 449, 2/3/1886.
Context:
JLB 558, 2/4/1886: "I think that getting the teeth attended to will help in itself because, as my mouth was usually painful, I just swallowed my food as quickly as possible."

197. developed a hacking cough: BVG 448, 2/1/1886-2/15/1886.
Context:
JLB 557, 2/2/1886: "It was the last month that I've had a lot of trouble with it -- I also started to cough all the time, bring up phlegm &c., so that I became worried."

198. losing weight: BVG 444, 1/12/1886-1/16/1886.
Context:
JLB 552, 1/12/1886-1/16/1886: "At the moment I'm losing weight, and moreover my clothes are getting too bad &c. You know very well yourself that this won't do. All the same, I have a degree of confidence that we can pull through."

199. syphilis: Nowhere in the surviving correspondence does Vincent admit to contracting or seeking treatment for syphilis. The text allows for the possibility that he was misdiagnosed. (As Lubin points out, misdiagnoses were common prior to the introduction of a reliable test in 1906 [Lubin, p. 116].) The evidence that he was treated for syphilis in Antwerp breaks down into four types: direct, circumstantial, inferential, and actuarial.
The single most persuasive piece of evidence is direct. It was developed by Tralbaut and subsequently verified by Wilkie. In a small sketchbook from Antwerp, Tralbaut recognized a notation Vincent had made ("A Cavenaile, Rue de Hollande, 2 consultations: 8 à 9, 11½ à 3") as a reference to a doctor named Hubertus Amadeus Cavenaille, who established himself in Antwerp in 1883 and was 44 years old in 1885 (Tralbaut, p. 177). Tralbaut interviewed Cavenaille's grandson, also a doctor, who remembered that his grandfather had claimed to have treated the painter and "sometimes discussed [Vincent] in the family" (ibid., p. 178). According to Tralbaut, "Dr. Cavenaille [the grandfather] clearly remembered the 'queer dauber' in disreputable clothes who told him straight off that he had no money" (ibid.). According to the grandson, Dr. Cavenaille also "made no secret of the fact that he had treated Vincent for syphilis, and this explains the nature of the prescriptions" (ibid.). Wilkie followed up with the same witness and secured confirmation of Tralbaut's account: "Did your grandfather tell you what he treated Van Gogh for?" Wilkie asked the grandson, Dr. Amadeus Cavenaille. "Yes," Cavenaille replied. "He said he treated Van Gogh for syphilis. He prescribed a treatment with mercury and sent him to the Stuyvenberg hospital for hip-baths" (Wilkie, pp. 143-144).
If the subject of this reputable and unbroken chain of hearsay had been less inflammatory, it surely would have been accepted into the biographical canon long ago. Resistance from the Van Gogh family, especially Vincent Willem van Gogh, Vincent's nephew and Theo's son, may have been responsible for the quarantining of this and other unflattering aspects of Vincent's biography for so long. Although Vincent Willem did contribute a laudatory preface to the 1969 work by Tralbaut that first broached the subject of Vincent's syphilis, Wilkie reports that, behind the scenes, he was infuriated by the breach (ibid., p. 146). Wilkie himself, by his account, encountered bitter hostility when he attempted to interview Vincent Willem on the subject of Vincent's and Theo's syphilis (ibid., pp. 150-151). This probably had more to do with the implications of the finding for Vincent Willem's father, Theo; the nature of Theo's death (it was later confirmed that he died from the effects of tertiary syphilis); and the unflattering light both threw on the relationship between Vincent Willem's parents. This long and hidden controversy over the revelation of Vincent's (and Theo's) diagnoses of syphilis is relevant to the current discussion in that it illustrates the shame associated with the disease among "decent" people in Vincent's and Theo's class, even a hundred years later; and helps explain the lengths Vincent went to at this time (in Antwerp) to conceal his condition even from his brother.
For that reason, much of the evidence for the diagnosis is circumstantial: (1) While Vincent never explicitly reported syphilis's signature affliction, cankers, he did report the major consequences of oral cankers: mouth pain and difficulty chewing and swallowing. (2) Although he never admitted to mercury treatments, he complained repeatedly about the primary side-effects of mercury treatments administered orally (i.e., salivation and gastrointestinal problems), and later suffered gruesomely from another known side-effect of mercury treatment: tooth loss. (3) The "bain de siège" that he noted in his sketchbook next to Cavenaille's name (see Ch. 26, n. 266) could have referred to the "fumigations" that were commonly used at the time to treat syphilis (see Ch. 26, n. 268). These were conducted while the patient sat covered in blankets. (4) Another of Vincent's jotted notes "alum 20c pinte ou ½ temps à autre" (alum 20c pint or ½ from time to time) could refer to the use of alum as an astringent or styptic -- a (painful) treatment for open sores. (Given Vincent's stomach troubles, it is unlikely that it was prescribed as an emetic, its other common use in medicine at the time.) (5) The "castor oil" Vincent noted could have been prescribed as an ameliorative for his chronic stomach upset -- another side-effect of mercury treatment. (6) According to Wilkie, Dr. Cavenaille's grandson specifically recalled that his grandfather prescribed mercury for Vincent's affliction (ibid., pp. 146-147). (7) After he moved to Arles in 1888, Vincent revealed that he (along with Theo) had received treatments of "iodide of potassium" while living in Paris after leaving Antwerp (JLB 611, 5/20/1888). As discussed in Ch. 26, n. 264, iodide of potassium was commonly used to treat syphilis in its later stages, when mercury was considered less effective. (According to Wilkie's research, it was not used to treat gonorrhea [Wilkie, p. 153].) Setting aside the implications for Theo's health (see Chapter 26), the fact that Vincent received iodide of potassium treatments in Paris strongly suggests that he had been diagnosed and treated for "primary" syphilis by the time he arrived there. (The classic three-stage progression of the disease had not yet been articulated.) (8) The fact that Vincent did not mention the sitz-baths, the castor oil, the alum, the Stuyvenberg hospital, or Dr. Cavenaille in his letters to Theo suggests that the condition for which he was being treated carried a significant burden of shame.
Theo was well aware of his brother's bout of gonorrhea in The Hague so there would have been no reason to hide a recurrence from him. Which is not to say that Vincent was able to completely conceal his afflictions from Theo. The letters from Antwerp are, in our opinion, fraught with hints or "slips" that reveal Vincent's private torment. (1) He complained about the "indifference" and "apathy" of Antwerp dealers, "particularly since this disease is contagious" (JLB 550, 12/28/1885). (2) Speaking unsympathetically of Rubens's "weeping Magdalen or Mater Dolorosas," he wrote that they "remind me of the tears of a pretty tart who's caught the clap" (JLB 552, 1/12/1886-1/16/1886). (3) In discussing the effects of his stomach problems on his teeth, he wrote, "I thought that my teeth were bad for another reason," but he never says what that reason was (JLB 557, 2/2/1886). (4) In "explaining" his sickness, he reminded Theo, "You understand that I'm no better than the next man," and warned that if he neglects himself "just like so many other painters (SO MANY if one looks into it) -- I would drop dead or, worse still, become mad or slow-witted" (ibid.; emphasis in original). This dire prognosis (insanity or death) bears no relationship at all to the symptoms or treatments Vincent has admitted to. It is, however, where syphilis was thought to lead (and, in Theo's case at least, did lead). (5) Similarly, Vincent later described his condition as "a ruin" and reported that his unnamed doctor prescribed a "better way of life" (JLB 562, 2/14/1886). At the time, these terms, especially "hygienic," almost invariably signaled sexual afflictions.
Finally, it is almost statistically certain that Vincent was exposed to syphilis either during his time in Nuenen or in Antwerp. Not only did he see prostitutes regularly in Eindhoven, but he almost certainly visited them on his rare visits to Utrecht, Amsterdam, and Antwerp before he moved to the latter city in late 1885. This was an era in which syphilis was rampant within the prostitute population -- so much so that prostitution and syphilis were widely seen as inseparable problems. (See Corbin; and Harsin, pp. 250-260.) Rates of infection were especially high in port cities like Antwerp and they spiked when major events brought foreigners and provincials (both clients and prostitutes) to town (Corbin, p. 248). Antwerp had hosted a World Exhibition in 1885, just months before Vincent's arrival. For cosmopolitan cities like Paris, the rate of syphilis infection among all adult males was estimated at fifteen percent or more (Micale, p. 202). Given Vincent's obsessive emersion in Antwerp's prostitute population, it is virtually inconceivable that he did not contract the disease there, assuming that he had not already contracted it by the time he arrived.

200. big Stuyvenberg hospital: Tralbaut, pp. 177-180: This is another of the "clues" provided by Vincent's jottings in his sketchbook. Photographs of the sketchbook pages are reproduced in ibid., p. 180.

201. "monstrosities": Corbin, p. 230.

202. the treatment certain:
Quétel, pp. 83-84: In the eighteenth century, "there was virtual unanimity in favour of mercury, which was considered to be the only specific remedy for the pox." The nineteenth century added iodides to the armamentarium, but "the star of the pharmacopeia," according to Crissey and Parish, continued to be mercury (Crissey and Parish, p. 360). The only disagreements among experts related to the dosage: "The question of optimum dose and timing led to an incredible amount of bickering in print. Short and intensive courses of treatment, moderate doses intermittently given, protracted courses with smaller amounts -- each permutation had its stable of champions, and the matter had not been settled to the satisfaction of anyone when the discoveries of [the scientist Paul] Ehrlich finally rendered the whole business irrelevant." (ibid.) In general, mercury was recognized as most effective in the early stages of the disease, while iodides were more effective in the later stages (Crissey and Parish, pp. 363-365). (The three-stage symptomatology -- "primary," "secondary," and "tertiary" -- was not codified until the publication of The Parasyphilitic Diseases by the dermatologist Alfred Fournier in 1894.) Both Vincent and Theo were treated with iodides in Paris between 1886 and 1888 (JLB 611, 5/20/1888), suggesting that both were suffering symptoms of late-stage syphilis at that time (see Chapter 28), and further supporting the conclusion that Vincent was being treated for an earlier stage of the disease in Antwerp (see Ch. 26, n. 199). Theo died of tertiary syphilis in 1890, only six months after Vincent's death. Wilkie offers direct evidence, albeit hearsay, that Vincent's doctor in Antwerp prescribed mercury treatments (Wilkie, pp. 146-147). (See Ch. 26, n. 199.)

203. the famous blue pills: Crissey and Parish, p. 360: Other ways of administering mercury orally were in gum form; in a tasteless, salt-like additive called calomel (mercurous chloride); or in a granular form that could be mixed with liquids (Quétel, p. 85). The latter led to one of the most famous forms of mercury treatment, Dr. Gerard van Swieten's liquor, which mixed mercury sublimate with alcohol in a potent and popular elixir (ibid.). The advantage of such treatments, of course, was that they could be self-administered. The disadvantage was that they opened the door to a parade of charlatans.

204. a foul-smelling ointment: Crissey and Parish, pp. 361-362: Crissey and Parish write amusingly about this unamusing subject: "The preparation most widely used was that old blue ointment, sometimes called gray, celebrated in ribald verse and song, which in one of its commonest forms was a mixture of 50% mercury in suet and lard. Avoiding the hairy areas the patient rubbed the ointment in daily from neck to toes, smoothing out the lumps until the skin took on the requisite blue-gray sheen ... For the traveling man whose adventures in pursuit of the supposedly innocent maidens of the rural scene kept him constantly in need of attention, the ointment was marketed in soft gelatin 'ovules' to be packed along with his samples. Proper application consumed 20 to 30 minutes ... It was dirty and disagreeable, destructive to clothing and bed linen, and difficult to hide from nosy neighbors, much less family and friends. What mother could fail to notice when one of her offspring appeared with a neck stained blue and smelled like a french-fried potato?"

205. "fumigations": Crissey and Parish, pp. 361-362: Like many anti-syphilitic treatments, fumigations fell in and out of favor over the roughly four hundred years between the debut of the disease in Europe and the introduction of a truly effective remedy, penicillin. Early fumigations were elaborate rituals, as described by Quétel: "First the patient is subjected to a preparatory treatment consisting of alterants (thirst-producers) and purges to 'temper the humours'. He is then placed, either naked or in a shirt, under a tent erected in a draught-free and overheated room. At his feet is a portable stove full of embers on which pinches of cinnabar (mercuric sulphide) are thrown from time to time. The patient's body is exposed to fumigation for a long spell. If he begins to faint he is made to breathe fresh air brought in from outside through a pipe. No sooner has the patient left the tent (or 'archet') than he is put in a very warm bed, where he is buried under blankets and made to sweat for an hour. After five or six sessions he may produce a profuse mercurial salivation, which is the desired effect." (Quétel, p. 60.)
According to Crissey and Parish, the method was revived in the 1850s and became "widely used in the last three decades of the century, although it never achieved the popularity of the oral [pill] and inunction [ointment rub] methods" (Crissey and Parish, p. 362). Crissey and Parish quote the instructions from one fumigation manual in 1866, showing that the basic procedure had hardly changed over the centuries: "The best time for taking the bath is just before going to bed. The circular groove, B, is to be filled one third full of boiling water, the alcohol lamp beneath lighted, and at the last moment about a scruple of calomel [mercurous chloride] to be deposited on the plate, A. The patient, stripped of his clothing and enveloped in one or more blankets drawn closely round the neck, sits upon a cane-bottomed chair with the lamp between his legs. In the course of five to ten minutes, profuse perspiration is induced; the calomel is wholly evaporated within fifteen minutes, when the lamp may be blown out, and the patient, after waiting five to ten minutes longer exposed to the moist vapor may retire to bed. I commonly advise, as recommended by Mr. Lee, that the use of a towel after the bath should be avoided, so that the thin layer of mercury deposited upon the surface of the body may remain and be farther absorbed." (ibid.) The special equipment and supplies required by this procedure would have been too expensive for Vincent to purchase, whereas they would have been available at a hospital like Stuyvenberg (see Ch. 26, n. 200).

206. " bain de siège": Tralbaut, pp. 177-180: This phrase, which Vincent jotted on the back cover of a sketchbook, is usually translated "sitz-bath," following Tralbaut. The nature of this procedure, or whether Vincent actually received it, is not known. He may have been referring to a common method for administering mercury, or he may have been referring to an antiquated method for treating syphilis that had been designed early in the nineteenth century specifically to avoid mercury and its adverse side-effects. According to Quétel, advocates of an "inflammatory theory" of the disease opposed the use of mercury and substituted "an antiphlogistic treatment consisting of baths, enemas, laxatives and lenitives, the intention being to counteract the irritation of the tissues" (Quétel, p. 116). While this countermovement permanently moderated the claims of mercury's enthusiasts, it did not dislodge mercury from its position as the preeminent treatment for the disease. "In the 1860s mercury enjoyed a revival when injections were added to the classic treatments of frictions, pills and Van Swieten's liquor" (ibid.). It is possible that Vincent's doctor, Cavenaille, still adhered to these older forms of ameliorative treatments, especially for less severe cases.

207. "liquefied wastes": Quétel, p. 60.

208. one huge, fetid ulcer: Quétel, pp. 62-63: Quétel quotes from a very graphic early description of the effects of mercury treatment, written by a critic of such treatments and therefore particularly (and probably exaggeratedly) grim: "The throat becomes ulcerated; the tongue, palate and gums swell; the teeth become loose; salivaruns constantly from the mouth, unimaginably fetid, and so contagious that the lips and the interior of the mouth become ulcerated on contact with it. Because this stench chills and upsets the stomach, the patients lose their appetites and are tormented by an unquenchable thirst; they can scarcely drink, however, because each one's mouth has been transformed into one huge ulcer. Even their speech is unintelligible, and they become deaf, sometimes incurably so. A foul smell pervades the place they inhabit."

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