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Frederick Delius: controversies regarding his neurological disorder and its impact on his compositional output Richard J. Lederman1 Department of Neurology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA 1 Corresponding author: Tel.: +1-216-4445545; Fax: +1-216-4451563, e-mail address: [email protected]
Abstract Frederick Delius was born in Yorkshire, England, on June 29, 1862, the son of German immigrants. He showed early musical talent but his father, a wealthy wool merchant, insisted he pursue a business career. After several failures, including an assignment managing an orange grove near Jacksonville, Florida, his father agreed to support his musical studies in Leipzig, assuming he would then become self-sufficient. Delius spent most of his adult life in France, living with and ultimately marrying Jelka Rosen, a painter of independent means, composing prolifically, and being sexually promiscuous both before and after starting life with Jelka. He contracted syphilis in 1895 and manifestations of neurosyphilis appeared in 1910. Despite periods of relative good health over the ensuing 10 years, he became progressively disabled from 1920 on, ultimately quadriparetic and blind but with preserved cognition and musical inspiration. In his final years, he completed several compositions aided by a young British musician, Eric Fenby, who served as his amanuensis and caregiver, along with Jelka, to his death on June 10, 1934.
Keywords Frederick Delius, British composers, neurosyphilis, sexually transmitted disease, neurological disorders, tabes dorsalis
Progress in Brain Research, ISSN 0079-6123, http://dx.doi.org/10.1016/bs.pbr.2014.11.008 © 2015 Elsevier B.V. All rights reserved.
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1 HIS LIFE Frederick Delius was born on June 29, 1862, in Bradford, Yorkshire, England, the fourth of 14 children, including 3 boys and 11 girls, two of whom died in infancy. His parents had emigrated from Bielefeld, Westphalia, Germany to the United Kingdom, where his father, Julius, prospered as a wool merchant. Julius was later described by Sir Thomas Beecham as “proud, unbending, and intolerant” (Beecham, 1959, p. 17). Christened Fritz (he did not officially change his name to Frederick until 1902), he was delicate in health as an infant but became more robust as he grew. Musically talented, he played piano by ear from an early age and it is said that at age 10, after hearing a Chopin waltz twice, he played it through from memory. Many years later, he admitted to Beecham that he had reproduced the piece “not, of course, very correctly” (Beecham, 1959, p. 18). He was given violin lessons starting at age 6 or 7 by Wilhelm Bauerkeller, a member of the Halle´ orchestra, and ultimately became quite accomplished on that instrument. He was also a passable pianist. From age 12 to 16, he was enrolled at Bradford Grammar School and from 1878 to 1879 attended the International College in Spring Grove, Isleworth, a London suburb. At this time, he already expressed a desire for a career in music, an idea opposed by his father, who insisted he enter the family business. This conflict was to last another 10 years. Over the ensuing 3 years, he was sent on various assignments by his father to Stroud, Gloucestershire; Chemnitz, Saxony; and Norrk€oping, Sweden. Each time, he was recalled to Bradford for neglecting the business, generally preferring to travel to nearby cities for concerts or pleasure, including gambling and women. In March 1884, his father arranged for him to travel in the company of Charles Douglas, the son of another wealthy Bradford businessman, to the United States, where he had acquired an orange grove on the St. Johns River, some 40 miles from Jacksonville, Florida. The intention was to have Fritz manage this operation, known now as Solano Grove (actually, at that time called Solana Grove), without the distraction of nearby cultural centers. Not only did he largely ignore this business as well, but also in fact he encountered a well-qualified musician, Thomas J. Ward, a former church organist in Brooklyn, NY, who had come to Florida for health reasons. Delius invited Ward to live in his cottage at Solana Grove and instruct him in composition. Douglas had contracted malaria and temporarily had to be hospitalized, after which he left the area. His studies in music theory and composition with Ward continued for a little over a year. While in Florida, it is alleged that Delius had a love affair with a local woman of mixed race who bore him a son, although neither the woman nor the boy was ever clearly identified (see below). The story appears to have been confirmed in a letter written by Percy Grainger, a young Australian-born pianist and composer (see Carley, 1983, p. 112) who became one of Delius’ closest friends and confidantes. In November 1884, Fritz’ older brother Ernst, who had earlier moved from Bradford to New Zealand, arrived rather unexpectedly at Solana Grove. Fritz later left him in charge of the plantation and in the summer of 1885 moved to Jacksonville, where he taught music and sang at a local synagogue for a few months. Ernst subsequently
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returned to New Zealand, leaving management of the orange grove solely in the hands of the African-American foreman, Albert Anderson, and his crew. In response to an ad for a music teacher, Delius relocated in the fall of 1885 to Danville, Virginia, where he taught music privately and obtained a position at nearby Roanoke Female College, achieving at least partial financial independence. In the spring of 1886, he moved to Manhattan, where he briefly served as a church organist. By this time, even his father had begun to realize that it was hopeless to expect Fritz to become a businessman and reluctantly agreed to support him for 18 months of study at the Leipzig Conservatory, with the understanding that he would subsequently return to the United States and become self-supporting as a music teacher. The experience in Leipzig was mixed. Delius (Fig. 1) took great advantage of the many musical opportunities, including orchestral concerts, chamber music, and opera, featuring the great artists of the time. He developed friendships with several Norwegians also studying in Leipzig, mainly through the violinist and composer, Christian Sinding, who subsequently introduced him to Edvard Grieg, with whom he formed a close relationship. Academic success was less certain. Classes in composition were available with such eminent musicians as Carl Reinecke and Salomon Jadassohn. He also took violin lessons from renowned violinist Hans Sitt, with whom he had briefly studied previously. Accounts vary as to how assiduous he was in attending classes. There is evidence that the Leipzig Conservatory was reluctant to offer him a diploma at the completion of his time there in 1888 (Beecham, 1959) and Delius never truly acknowledged a debt to his teachers in Leipzig. Indeed, he later avowed that Thomas Ward was the only person who had ever provided him with useful instruction in composition. Eric Fenby later quoted him as saying, “Had it not been that there were great opportunities for hearing music and talking music, and that I met Grieg, my studies in Leipzig were a complete waste of time. As far as my composing was concerned, Ward’s counterpoint lessons were the only lessons from which I ever derived any benefit” (Fenby, 1994, p. 168). After briefly returning to Bradford, he moved to Paris and from 1889 to 1896 lived in Croissy, just west of the city, actively composing, including his early attempts at opera, with frequent trips abroad, primarily to his beloved Norway. In 1895, he apparently contracted syphilis and probably received at least one course of treatment with mercury (see below). It was in 1896 that he met Jelka Rosen, a talented painter who had been studying in Paris. A woman of some means, her father was a German orientalist and diplomat; her mother was also a painter and the daughter of Ignaz Moscheles, the famous pianist and composer. Jelka, who was obviously attracted by his handsome and aristocratic appearance and demeanor (see Fig. 2) and by his love of Grieg and Nietzsche, which she shared, soon became his constant companion. Delius would stay with her on his visits to Grez-sur-Loing, a short distance from Paris, where she preferred to paint and rented a home. When she finally was able to purchase the home in 1897, he moved in with her that summer and they lived together, ultimately as husband and wife from September 23, 1903, to his death in 1934. Earlier in 1897, he had returned to the United States for reasons that are unclear. One possibility is that he was concerned about the status of Solana Grove, ownership
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FIGURE 1 Fritz Delius, age 25, in Leipzig toward the end of his studies there in early 1888, Atelier Herrmann. Courtesy of the Delius Trust, London.
FIGURE 2 Fritz Delius, 1899, by Window and Grove, London, probably taken as a publicity photo for a concert of his music performed on May 30. Courtesy of the Delius Trust, London.
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of which his father had, by then, transferred to him. Another suggested reason, which was supported by his friend Percy Grainger in a letter dated October 5, 1941 (Carley, 1983, p. 112), was that he was searching for his one-time mistress and alleged mother of his son. He did not find her or the boy, some evidence suggesting that she feared he would take him from her and had fled. The British violinist, Tasmin Little, having become enamored of Delius’ music and wishing to understand more fully its emotional origins, has pursued this story, as described in the documentary, “Delius: The Lost Child” (www.youtube.com/watch?v¼EzTojb_A7BY), and in a subsequent review (Little, 1997). It remains uncertain whether the long-deceased woman she identified as Chloe Baker was, indeed, Delius’ ex-lover and whether her son, Frederick W. Baker, also then deceased, was actually Delius’ love child. Over the next several years, Delius divided his time between Grez and Paris, composing and promoting his compositions, primarily in Germany and with less success in England. The first decade of the twentieth century saw him composing some of his most important works (see below), and during those years, still physically vigorous and active (see Fig. 3), he traveled widely in France, England, and Germany, with occasional trips to Scandinavia. In 1910, Delius suffered the first major setback in his health, the initial manifestations of what would prove to represent neurosyphilis. His illness would lead him on
FIGURE 3 Frederick Delius, 1907, prior to the onset of symptoms. Photo used by music publisher Breitkopf and Ha¨rtel, London for its series of postcards of celebrated musicians. Courtesy of the Delius Trust, London.
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a journey over the ensuing decade to multiple medical clinics and sanatoria seeking a cure. In between these excursions, however, he had periods of relatively stable health, during which he could again travel for pleasure and promote his everincreasing compositional output. He and Jelka were forced to leave Grez-sur-Loing during World War I when their home was requisitioned for the French army, spending most of that time in England. They returned to Grez in August 1918 only to find the house left in shambles by the French soldiers. In fairness, it can be stated that the French government ultimately compensated them adequately for the damage done. Despite the periods of poor health and the disruption of the war, Delius continued to compose his most mature and enduring works. These would include his Requiem, Eventyr, the cello and violin concerti, and the incidental music for Hassan, a play by James Elroy Flecker. Due to his progressing disability, characterized ultimately by blindness and quadriparesis, his compositional output literally ceased from 1924 to 1928 and only resumed with the arrival on October 10, 1928, of Eric Fenby, a young English musician who offered his services to the totally disabled Delius as an amanuensis. Fenby was able to take musical dictation under the most harrowing and difficult circumstances, transferring Delius’ ideas to paper with remarkable success and allowing him to express what had been trapped in his still active mind. Certainly one of the highlights of Delius’ final years was the opportunity to attend a festival in his honor, organized and carried out by Sir Thomas Beecham in London from October 12 to November 1, 1929, as testimony that Delius’ music had finally achieved some success in his native country. The festival ended with a performance of A Mass of Life, which the eminent critic Newman (2008, p. 110) characterized as “magnificent.” Delius continued to work almost to the end, aided by Fenby, who was as much a caregiver as amanuensis, by a succession of private male attendants, and by his incredibly devoted wife, Jelka, despite her own health problems. During these years, a series of visitors came to Grez (not always enthusiastically welcomed), including some of his old friends, as well as music dignitaries such as composers Arnold Bax and Sir Edward Elgar, Professor Edward J. Dent (Cambridge musicologist), and violist Lionel Tertis. Fenby had left Grez for England in the summer of 1933, promising to return immediately if needed. In late May 1934, Jelka herself was hospitalized in nearby Fontainebleau for surgery to remove a malignant colon tumor and she desperately contacted Fenby to come immediately, as Delius seemed to be failing rapidly. Fenby attended him, along with the German male nurse, during his final few weeks. Jelka heroically returned to Grez after just 3 weeks to spend the last 2 days with her husband, who died on the morning of June 10, 1934. A temporary interment took place in a churchyard in Grez, witnessed only by a neighbor couple, a few old friends who had been notified of his death, Jelka, and Eric Fenby. Delius had expressed the wish to be buried in his garden but the French government forbade it. His remains were ultimately reburied on May 26, 1935, at St. Peter’s Church, Limpsfield, Surrey, in the south of England. Jelka actually missed the ceremony because of illness, dying 2 days later, and she was subsequently buried next to her beloved husband.
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2 HIS ILLNESS Relatively little has been written by physicians about Delius’ illness, except for the flurry of attention amid doubts about the correct diagnosis, primarily in the United Kingdom, in the early 1980s, at the time approaching the 50th anniversary of his death. Wainapel (1980) summarized the clinical features and assumed, correctly of course, that he had neurosyphilis. This was obviously before the questions raised in 1983 (see below). O’Shea (1990) also provided a summary of the progression of Delius’ neurosyphilis, including brief mention of the controversy of 1983, and quoted extensively from Fenby’s (1994) account of his final days. Other biographers, e.g., Jefferson (1972) and Carley (1983, 1988), mention but do not dwell upon the diagnosis, perhaps reflecting the stigma still associated with it. After his time in Leipzig, Delius was clearly attracted to Paris as the center of vibrant cultural life in Europe. It was also described as the sex capital of Europe and was reputed to be home to 100,000–120,000 prostitutes (Corbin, 1990). Delius was alleged to have had numerous sexual liaisons before and during his Paris years; mention was made above of the possible love affair in Solana Grove, producing a son. He is reputed to have shared a mistress, Anna la Javanaise, with his friend Paul Gauguin, who had apparently contracted syphilis early in 1895. Sometime later that year, Delius was diagnosed with syphilis, presumed to be secondary at the time (no primary lesion was ever mentioned), and probably treated at least once with iodine saltpeter (this information from a 1910 medical consultation note at a sanatorium near Dresden; see below). Although this knowledge apparently had a profound effect on his relationship with Jelka, it did not appear to inhibit his sexual activity otherwise. Carley (1983, p. 94) stated, “his attitude to sexual matters gradually became more cynical and perhaps exploitative. He was to become no stranger to Parisian houses of ill repute.” It was not, however, until 1910 that the disease, ultimately diagnosed as neurosyphilis, declared itself with a vengeance. There is a notation of a “bilious attack” occurring in London in 1909 and perhaps several gastric crises and occasional limb or trunk pains prior to 1910, but the attack in early 1910 led him first to a sanatorium in Mannern, Switzerland, where he was informed that he had tertiary syphilis. Asymmetrical pupils were noted. His letter to Jelka, dated June 17, 1910, after this visit, stated, “I don’t believe this at all” (Carley, 1988, p. 50). During a further consultation at Weisser Hirsch sanatorium near Dresden, where he spent 7 weeks, a medical report by Dr. W. Bothe states (translated in the publication by Jones and Heron, 1988, p. 5; see below): “Syphilis acquired 15 years ago [1895] no cure, some iodine saltpeter for further appearances of the symptoms, last time 10 years ago [1900]. . . other pains occurred: arms, shoulders and in the area of the thorax, toes, repeated gastric crises; uneven yet reacting pupils, and indeed increased knee reflexes, reduced feeling of pain in the lower extremities. . . on the upper left thigh a tertiary syphilid. Wassermann positive.” By October, he was able to write that he was again in excellent health; although in late December of 1910, he developed shingles, “which pained him dreadfully for a whole week and still pains him” (letter from Jelka to a relative, Carley, 1988, p. 64).
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Over the next 3 years, he remained in relatively good health with only occasional setbacks, including a severe “bilious attack” in April 1915, while still in England. In June 1917, there was a sudden deterioration, with numbness in his feet and hands, leg weakness, and inability to walk. He was treated at a spa in Normandy and by the end of July was able to take a 10-km walk with only occasional pauses. Further relapses occurred in 1918 and particularly in 1920, at which time Jelka had to write his letters for him because of hand weakness and tremors. In 1921, his health fluctuated as he spent time in Germany, London, and Norway, gradually losing function in his hands and having increasing pain and weakness in his legs. By year’s end, he was in a wheelchair and the decline continued in January 1922. After 3 months undergoing a “cure” in Wiesbaden (generally baths and physiotherapy), he was somewhat better and able to walk with canes. Writing, however, was not possible for him. He also began to lose his vision, and by the end of the year, he had light perception only, presumably the result of optic neuropathy. Despite his decline in health, he was able to spend time in Norway during the summer of 1922. In the spring of 1923, he spent 2½ months taking a cure at Bad Oeynhausen near Hanover, mainly baths, under the care of a Professor Dr. Frenkel, described by Jelka as “the great authority in these illnesses” (Carley, 1988, p. 275) and again seemed to improve enough to walk a few minutes at a time, even without a stick. That summer, they were able to spend time at the chalet they had built in the hills of Lesjaskog, Norway. During a visit from Percy Grainger, Delius expressed the desire to see the view from higher on the mountain. They constructed a chair supported by poles and carried Delius up the mountain, with Grainger in front and Jelka and the maid, Senta, in back. The entire journey took them over 7 h, exhausting all of the participants. The last 10 years of Delius’ life were characterized by progressive, if fluctuating, disability and a variety of treatment approaches, often based on misdiagnoses and Delius’ own refusal to accept the diagnosis of neurosyphilis. Both he and Percy Grainger were well known to have favored homeopathy and nonmedical therapy. It is alleged that, in 1910 at the time of the diagnosis of neurosyphilis, he had been offered treatment with arsphenamine (Salvarsan), which had just been released and shown to be extremely effective, but he had declined. In 1924, while in Rapallo, Italy, he was visited by a Dr. Heermann from a medical clinic in Cassel, Germany. He subsequently spent May to July at Dr. Heermann’s sanatorium, being treated mainly with electrical stimulation for Heermann’s suggested diagnosis of multiple sclerosis. Following this, his vision was said to have improved enough to allow him to read with “weaker” glasses than had previously been required. By September 1924, he reported the ability to walk alone for 5 or 10 min but mostly had to hold on to Jelka’s arm. By December of that year, he wrote a letter to his friend Henry Clews, with whom he and Jelka had spent a month at the Clews’ palatial new home on the French Riviera (see Fig. 4). Clews was a sculptor and close friend of many years, a very wealthy American expatriate, and son of a Wall Street banker. This was the last letter written in his hand, and he subsequently worsened again and returned to Cassel for more electrical treatments through the spring of 1925. During that visit, he stayed not at the clinic but at a nearby hotel, mainly because of his dislike of the poor food at the
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FIGURE 4 Frederick and Jelka Delius, spring of 1924, at the Ch^ateau de La Napoule overlooking the Bay of Cannes, newly purchased and being restored by Henry and Marie Clews. Courtesy of the Delius Trust, London.
clinic. By the end of 1925, he was virtually blind and had no use of his limbs, but remained unimpaired mentally. Dr. Heermann attributed his illness to a problem with the pituitary and apparently stated, “His optic nerve is not dead and, could Fred be really strengthened it could possible [sic] improve again. It is very shrunken and impoverished” (Jelka letter, August 31, 1925; Carley 1988, p. 306). In March 1927, Sir Thomas Beecham brought an eminent British physician, Sir John Conybeare, to Grez for a consultation. Conybeare was the editor of an authoritative and widely used textbook of medicine. In his examination, Conybeare found no evidence of involvement of the posterior columns of the spinal cord and no intellectual impairment. Furthermore, the Wassermann reaction was apparently negative at that time and he thought Delius might have a spinocerebellar degeneration, either sporadic or possibly hereditary (a cousin of Delius may have had a somewhat similar ailment), but not syphilis. Conybeare suggested a prolonged treatment at a sanatorium and recommended seeing a doctor in Paris regarding this possibility. The Paris physician thought it would be a mistake to carry out such a radical treatment, which could make him much worse, and recommended against it. Interest in the consultation by Sir John Conybeare, who had died in 1967, was revived early in 1983, as the
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50th anniversary of Delius’ death was approaching. Professor J. F. Soothill had written to The London Times regarding an evening spent with Sir John in 1948 at his home, at which recordings were played, including music by Delius ( Jones and Heron, 1988). Discussion then ensued about Delius’ illness and Conybeare produced his notes from the consultation in Grez and repeated that he was sure that Delius did not have neurosyphilis. Dr. Thomas Stuttaford (1983) referred to this communication in the medical briefing section of The Times, dated March 18, 1983, again questioning the diagnosis of neurosyphilis. This ultimately led to a thorough review of the evidence, using additional sources then available, by Dr. Philip Jones, a prominent British musicologist and author of a book on Delius’ style of composition, and by Dr. J. R. Heron, a consultant neurologist at the North Staffordshire Royal Infirmary and senior lecturer in postgraduate medicine at Keele University. They published a definitive summary of Delius’ case titled, “A Fever Diluted by Time: Notes on Frederick Delius” in The Delius Society Journal in 1988, indicating with confidence that the diagnosis of neurosyphilis was, in fact, correct ( Jones and Heron, 1988). In the spring of 1928, Dr. Heermann came to Grez from Cassel and spent a week trying further treatment for his vision, convinced that his “eyes are not blind but the optic nerve is not nourished with blood, as it should be” (letter from Jelka to Grainger, May 11, 1928; Carley, 1988, p. 355). In June 1930, a Scotsman named Erskine came to Grez for 2 weeks to treat Delius with hypnotism. His goal was to restore Delius’ ability to see. This was not accomplished, but during that summer, he was able to adjust his hat himself and flick away a mosquito, tasks which had been impossible previously. On one occasion, he had Delius sit at the piano and attempt to play while in a hypnotic trance. All that came out was a series of meaningless sounds. The last 4 years were spent in Grez, confined to a wheelchair, but remaining alert and cognitively unimpaired to the end. Bilateral ptosis and facial muscle atrophy were increasingly obvious (see Fig. 5). Shooting limb and trunk pains were frequent and severe, at times causing him to cry out. Morphine would provide some needed relief, administered by a local physician. Toward the end, it would be given every 4 h and his final hours were described by Eric Fenby “as if in a sound and noisy sleep” (Fenby, 1994, p. 225). He died early Sunday morning, June 10, 1934, without awakening.
3 BRIEF REVIEW OF NEUROSYPHILIS Although there remains controversy, it appears likely that syphilis was introduced to Europe by Christopher Columbus and his crew in 1493. Indeed, it may well be that Columbus himself suffered from the disease (Hayden, 2003). The first major European epidemic occurred among the soldiers in the army of Charles VIII of France during his invasion of Naples in 1495. The disease subsequently and rapidly spread throughout the civilized world and remained prevalent over the next four centuries (Frith, 2012). It can be stated that it was particularly prominent in Paris in the late 1800s. Jean Alfred Fournier, an eminent Parisian dermatologist/syphilologist,
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FIGURE 5 Frederick Delius in the late stages of his illness, 1932. Photograph taken in Grez by Esparcieux, Fontainebleau. Note particularly the ptosis and facial muscle atrophy. Kindly supplied by Lionel Carley and courtesy of the Delius Trust, London.
estimated that at that time, “13 to 15 percent of the male population of Paris (about 125,000 individuals) were infected” (Corbin, 1990, p. 264). Science, however, would soon begin to influence that. In 1905, Fritz Schaudinn and Erich Hoffmann in Berlin identified the causative organism, Treponema pallidum. The following year, August von Wassermann developed the complement-fixation test named after him that allowed identification of the infection from a sample of serum. In 1909, Paul Ehrlich (with his colleague Sahachiro Hata), also in Berlin, found that arsphenamine effectively killed T. pallidum and Salvarsan (brand name) was released for treatment of syphilis in 1910. This remained in common use until the 1940s when Alexander Fleming discovered penicillin and, in 1943, four patients with syphilis were successfully cured by Mahoney, Arnold, and Harris. Except for situations in which a penicillin allergy precludes its use, nothing more has proved necessary to the present time. Although of great historical importance, the Wassermann test has now been replaced (perhaps modified would be more accurate) by other nontreponemal serological reactions, the RPR (rapid plasma reagin) and the VDRL (venereal disease research
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laboratory). These are now supplemented by newer and more specific assays, which detect the presence of the organism itself (fluorescent treponemal antibody absorption, FTA-ABS; T. pallidum particle agglutination assay, TPPA; and syphilis enzyme immunoassay, EIA). It should be noted at this point that the nontreponemal tests can revert to nonreactive later in the disease, as apparently occurred in Delius’ case. The disease is typically divided into early and late phases. Early syphilis includes primary, secondary, and early latent forms; late (tertiary) syphilis may have cardiovascular or gummatous manifestations and, most relevant in this context, neurosyphilis. The primary lesion is a painless chancre at the site of inoculation. This is highly contagious and about 1/3 of patients exposed to an active lesion contract the disease after an incubation period of a few to 90 days, about 3 weeks on average. The chancre may, depending on its location, go unnoticed and heals spontaneously in 3–6 weeks, treated or not. T. pallidum can be identified in the chancre by examining material under dark field microscopy but, unfortunately, the organism cannot be cultivated in vitro. The secondary phase follows a few weeks to a few months later and may include rash, fever, headache, malaise, anorexia, and lymphadenopathy. It can be shown, incidentally, that dissemination of the organism, including entrance into the cerebrospinal fluid (CSF), occurs during the initial phase of infection and, as is clearly demonstrated in Delius’ case, may remain asymptomatic (i.e., latent) for many years. Positive serology may be the only detectable abnormality at this time. Neurosyphilis can take many forms and can occur at any time after the initial infection. It is estimated from studies in the preantibiotic era that 25–35% of patients with syphilis will develop nervous system involvement. About 30% will be asymptomatic, 30% will ultimately develop tabes dorsalis (see below), 10% will have general paresis, another 10% will have meningovascular forms, and the rest will have a variety of less common subtypes. Early forms of neurosyphilis include an asymptomatic pleocytosis or outpouring of inflammatory cells in the CSF, usually less than 100 per mm3, elevated protein up to 100 mg/dl, and a positive serological test, generally the VDRL. Symptomatic meningitis at this stage usually occurs within the first year after infection and includes typical features such as headache, stiff neck, fever, and a vigorous meningeal reaction, including 200–400 cells/mm3, protein of 100–200 mg/dl, and a positive VDRL. Hearing loss may accompany this phase as well as ocular involvement, usually a posterior uveitis. MRI may show meningeal enhancement. Spontaneous resolution may occur after either symptomatic or asymptomatic meningeal forms. Meningovascular neurosyphilis may occur as early as a few months up to a few years after initial infection, with involvement of meningeal vessels producing stroke and focal neurological findings. The CSF may show 10–100 cells/mm3 and protein in the range of 100–200 mg/dl. The VDRL is usually but not always reactive. Late neurosyphilis usually means either general paresis or, more commonly, tabes dorsalis, the form Delius presumably had. General paresis, sometimes in the past called GPI (general paresis of the insane), is a progressive dementing illness, usually beginning 10–25 years after initial infection, but it can occur as early as 2 years after
ARTICLE IN PRESS 4 His music
inoculation. In its early stages, forgetfulness and personality changes are noted, with increasing memory loss, poor judgment, and psychotic symptoms. In its fully developed form, almost any neurological sign can develop, including the pupillary abnormality typically seen in the tabetic form. The spinal fluid is almost always abnormal; the VDRL in the CSF is reactive in virtually all cases. Tabes dorsalis (locomotor ataxia) has the longest latent period, averaging 20 years, and is characterized by involvement of the spinal cord posterior columns and dorsal roots. Clinically, it presents with a sensory ataxia and lancinating pains, paresthesias, and gastric crises, comprising severe epigastric pain with nausea and vomiting (what Jelka described as “bilious attacks”). The characteristic pupillary abnormality, a small pupil unresponsive to light but constricting with accommodation and convergence, known as the Argyll Robertson pupil after the man who first described it, is seen in about 1/2 of patients with tabes dorsalis and in a smaller percentage of those with general paresis. It is generally considered pathognomonic for neurosyphilis. Other common abnormalities include absent muscle stretch reflexes in the legs; impaired vibratory and joint position sense; marked incoordination of the lower, and often upper, limbs; and optic atrophy, with largely preserved cognitive function. CSF may be normal, including a nonreactive VDRL. The specific treponemal serum tests are virtually always reactive. The spinal fluid FTA-ABS is highly sensitive but not very specific. Thus, a nonreactive study excludes the diagnosis of neurosyphilis in almost all cases, but a reactive test does not necessarily confirm the diagnosis. It might be mentioned at this point that Percy Grainger, who played such a large part in Delius’ later life, was actually well acquainted with syphilis, although not himself afflicted. His father had contracted the disease in an alcohol-related series of extramarital affairs shortly after Percy’s birth and had transmitted the disease to his wife. Both parents eventually developed neurosyphilis; his father died of tabes dorsalis and his mother, who appeared to be developing general paresis, committed suicide (O’Shea, 1987).
4 HIS MUSIC It is not the author’s intent to offer a critical analysis of the music of Frederick Delius. There are clearly many commentators far better qualified to provide that kind of information. It can be stated that Delius ranks among the greatest of British composers (he would not have wished to be considered as such), and yet it must be admitted that, even within the country of his birth, and certainly in the United States, his name is not nearly as well known as his contemporaries such as Sir Edward Elgar and perhaps even Ralph Vaughan Williams. Many reasons have been suggested for this lack of recognition. Although he attempted to have his music played in England, he was much more successful in Germany, at least early on, having found a champion in the conductor Hans Haym. While British by birth, of course, he can truly be considered international, having spent a relatively brief but formative 2 years in the United
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States, having lived most of his adult life in France, where his music was hardly ever played, having traveled and vacationed by preference in Scandinavia, and having studied in Leipzig and obtaining most of his medical care in Germany. It was primarily through Sir Thomas Beecham that he developed an audience in England and most successfully at the time of the festival in his honor in October 1929 at the very end of his career. Beecham (1959) offered a number of reasons why his music was not played more frequently. He recognized that Delius did not often provide a bravura ending for an orchestral piece or a “resounding top note at the conclusion of a soprano or tenor aria” (Beecham, 1959, p. 216). Rather, he typically ended a piece with what Beecham and others characterized as “a dying fall” (Beecham, 1959, p. 216), making soloists and conductors less likely to program his music. With respect to his larger works, including his operas, he pointed out that Delius demanded a larger number of instruments than are required by such composers as Wagner, in Tristan and Isolde and Die Meistersinger; Verdi, in Otello; and Puccini, in any of his operas (Beecham, 1959, p. 142), thus straining the resources of all but the largest and wealthiest companies. The celebrated British cellist, Julian Lloyd Webber (Webber and Guinery, 2008), further commented on the sheer technical difficulty in performing the music of Delius as yet another reason for its infrequent programming. He also noted the tendency of his music to fade away quietly rather than end with a flourish. The eminent English musicologist and critic, Ernest Newman (2008), also a devoted admirer of Delius’s music, again pointed to the technical difficulty and added the fact that the music was often published with a minimum of notation as to how it should be performed, lacking details such as phrasing, accents, slurs, and other indications of the composer’s wishes. Contrary to a common perception that the music of Delius tends to be bland and “all the same,” Newman, in a glowing testimonial after the Delius Festival of 1929 wrote in the New York Times Magazine, his “harmonic language that on the surface of it seems inclined to softness can on occasion say so much that is big and strong” (reprinted in Newman, 2008, p. 110). Delius himself emphasized, in offering advice to his young devoted admirer and aspiring composer, Philip Heseltine (aka Peter Warlock), that there “is really only one quality for great music and that is ‘emotion’. . ..” (Carley, 1988, p. 179). It is often pointed out that, despite the instruction in composition provided by Thomas Ward, during the relatively short time he spent with Delius in Florida, and the 18 months Delius spent at the Leipzig Conservatory (probably with little actual time in the classroom), Delius was largely self-taught (Webber and Guinery, 2008). The opinion has often been expressed that this lack of formal training showed itself in a deficiency of structure in his compositions. In this regard, Webber went on to say, “if you actually study the music there’s an awful lot of structure to it” (Webber and Guinery, 2008, p. 116). Jefferson (1972, p. 95) added, “most of his scores are models of good organization, so that the finished material appears utterly spontaneous.” If melody and harmony are the main elements on which musical composition depends, Delius emphasized harmony and few melodies in his works are readily
ARTICLE IN PRESS 5 Conclusions
reproduced after a hearing ( Jefferson, 1972). The harmonic language which he developed was his alone, and he neither built upon the foundation provided by his predecessors nor did he join the radical path being embarked upon by some of his contemporaries, such as those in the second Viennese school (e.g., Schoenberg, Berg, and Webern). Certainly, however, one can identify early influences of “Negro” music, Chopin, Grieg, and Wagner ( Jefferson, 1972). His compositional output is often divided into periods. An early phase (sometimes referred to as the “apprentice period”) includes the Florida Suite of 1887 and his three initial operas, Irmelin, The Magic Fountain, and Koanga, none of which has found a place in the repertoire. His “middle” period (1900–1906) includes his most well-known opera, A Village Romeo and Juliet, which many consider his first true masterpiece, as well as Appalachia (utilizing his impressions of Negro music from his time in Florida), Sea Drift (based on a Walt Whitman poem), A Mass of Life (reflecting his reverence for the philosophy of Friedrich Nietzsche), and Songs of Sunset, on poems by Ernest Dowson (suggested by Jelka). The so-called mature period, from 1907 to 1924, produced a wide variety of compositions, including his popular On Hearing the First Cuckoo in Spring, Brigg Fair, North Country Sketches, and A Song Before Sunrise, along with a number of instrumental sonatas and concerti. Also produced in this time was his Requiem, described by Heseltine as “the first atheistical requiem in musical literature” (Carley, 1988, p. 110). His late period, which began only after a nearly 6 year hiatus of no output for health reasons, was enabled by Eric Fenby, who was able to take musical dictation, producing among other pieces A Song of Summer, Songs of Farewell (again utilizing poems of Walt Whitman), and his 3rd sonata for violin and piano. That he could compose at all as his illness progressed is remarkable enough. Jelka, while hardly an objective observer, commented on the clarity of his mind as he became increasingly disabled physically. It is undeniable that musical ideas continued to flow, and on reading Fenby’s account of the method of dictation and Delius’ attention to details of harmony and orchestration, one can only marvel at the preserved richness of his musical imagination. Nonetheless, an observer as astute and devoted as Beecham would later comment that, despite the “heroic” effort required in the collaboration with Fenby, the late works give us “little of Delius that we did not know before; and even that little does not ring with the sound of unadulterated inspiration” (Beecham, 1959, p. 218). For Beecham (1959), even the later works of the mature period, from 1915 to 1923, show signs of decline. “The ancient fire burns brightly for a few rare moments. . . but by slow degrees sinks to eventual extinction” (Beecham, 1959, p. 221).
5 CONCLUSIONS Is it possible, or even productive, to try to relate the quality of Delius’ creative output to his health? Certainly, in terms of the number of compositions, the years of his maturity from 1911 (after largely recovering from the initial “attack” of 1910) to his
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subsequent major relapse in 1917 were prolific and obviously the years from 1924 until the arrival of Eric Fenby toward the end of 1928 were barren. With respect to the quality of the compositions, that is clearly more hazardous to judge and, as stated above, something I am not qualified to do. Large-scale works, such as the operas, A Village Romeo and Juliet and A Mass of Life, are generally regarded as among his greatest compositions. Smaller orchestral pieces, including Brigg Fair and On Hearing the First Cuckoo in Spring, appear with sufficient frequency on concert programs and recordings to indicate popularity with conductors and audiences alike. Sir Thomas Beecham’s comments regarding his later works notwithstanding (quoted above), there is considerable beauty to be found in the compositions produced (often from fragments of earlier efforts) by the collaboration of Delius and Eric Fenby. Taken as a whole, the musical legacy of Frederick Delius would seem to merit a broader exposure than has been accorded it to date.
REFERENCES Beecham, T., 1959. Frederick Delius. Alfred A Knopf, New York, NY. Carley, L., 1983. Delius: A Life in Letters I: 1862–1908. Harvard University Press, Cambridge, MA. Carley, L., 1988. Delius: A Life in Letters II: 1909–1934. Gower Publishing Company Ltd, Aldershot. Corbin, A., 1990. Women for Hire: Prostitution and Sexuality in France after 1850 (translated by Alan Sheridan). Harvard University Press, Cambridge, MA (originally published in French, 1978). Fenby, E., 1994. Delius as I Knew Him. Dover, New York, NY. Frith, J., 2012. Syphilis—its early history and treatment until penicillin, and the debate on its origins. J. Mil. Veterans Health 20, 49–58. Hayden, D., 2003. Pox: Genius, Madness, and the Mysteries of Syphilis. Basic Books, New York, NY, p. xv. Jefferson, A., 1972. Delius. J.M. Dent, London. Jones, P., Heron, J.R., 1988. A fever diluted by time: notes on Frederick Delius. Delius Soc. J. 98, 3–8. Little, T., 1997. The loss at the heart of his music. Delius Soc. J. 122, 20–22. Newman, E., 2008. His country at last claims Delius. Delius Soc. J. 143, 105–111. O’Shea, J.G., 1987. Medicine and musicians: Percy Grainger. Med. J. Aust. 147, 578–581. O’Shea, J., 1990. Was Mozart Poisoned? Medical Investigations into the Lives of the Great Composers: Frederick Delius and Scott Joplin. St. Martin’s Press, New York, NY, pp. 187–200. Stuttaford, T., 1983. Medical Briefing: Unsullied Delius. London Times (March 18). Wainapel, S.F., 1980. Frederick Delius: medical assessment. N. Y. State J. Med. 80, 1886–1887. Webber, J.L., Guinery, P., 2008. The real Delius. Delius Soc. J. 143, 112–120.
Frederick Delius: controversies regarding his neurological disorder and its impact on his compositional output Richard J. Lederman1 Department of Neurology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA 1 Corresponding author: Tel.: +1-216-4445545; Fax: +1-216-4451563, e-mail address: [email protected]
Abstract Frederick Delius was born in Yorkshire, England, on June 29, 1862, the son of German immigrants. He showed early musical talent but his father, a wealthy wool merchant, insisted he pursue a business career. After several failures, including an assignment managing an orange grove near Jacksonville, Florida, his father agreed to support his musical studies in Leipzig, assuming he would then become self-sufficient. Delius spent most of his adult life in France, living with and ultimately marrying Jelka Rosen, a painter of independent means, composing prolifically, and being sexually promiscuous both before and after starting life with Jelka. He contracted syphilis in 1895 and manifestations of neurosyphilis appeared in 1910. Despite periods of relative good health over the ensuing 10 years, he became progressively disabled from 1920 on, ultimately quadriparetic and blind but with preserved cognition and musical inspiration. In his final years, he completed several compositions aided by a young British musician, Eric Fenby, who served as his amanuensis and caregiver, along with Jelka, to his death on June 10, 1934.
Keywords Frederick Delius, British composers, neurosyphilis, sexually transmitted disease, neurological disorders, tabes dorsalis
Progress in Brain Research, ISSN 0079-6123, http://dx.doi.org/10.1016/bs.pbr.2014.11.008 © 2015 Elsevier B.V. All rights reserved.
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1 HIS LIFE Frederick Delius was born on June 29, 1862, in Bradford, Yorkshire, England, the fourth of 14 children, including 3 boys and 11 girls, two of whom died in infancy. His parents had emigrated from Bielefeld, Westphalia, Germany to the United Kingdom, where his father, Julius, prospered as a wool merchant. Julius was later described by Sir Thomas Beecham as “proud, unbending, and intolerant” (Beecham, 1959, p. 17). Christened Fritz (he did not officially change his name to Frederick until 1902), he was delicate in health as an infant but became more robust as he grew. Musically talented, he played piano by ear from an early age and it is said that at age 10, after hearing a Chopin waltz twice, he played it through from memory. Many years later, he admitted to Beecham that he had reproduced the piece “not, of course, very correctly” (Beecham, 1959, p. 18). He was given violin lessons starting at age 6 or 7 by Wilhelm Bauerkeller, a member of the Halle´ orchestra, and ultimately became quite accomplished on that instrument. He was also a passable pianist. From age 12 to 16, he was enrolled at Bradford Grammar School and from 1878 to 1879 attended the International College in Spring Grove, Isleworth, a London suburb. At this time, he already expressed a desire for a career in music, an idea opposed by his father, who insisted he enter the family business. This conflict was to last another 10 years. Over the ensuing 3 years, he was sent on various assignments by his father to Stroud, Gloucestershire; Chemnitz, Saxony; and Norrk€oping, Sweden. Each time, he was recalled to Bradford for neglecting the business, generally preferring to travel to nearby cities for concerts or pleasure, including gambling and women. In March 1884, his father arranged for him to travel in the company of Charles Douglas, the son of another wealthy Bradford businessman, to the United States, where he had acquired an orange grove on the St. Johns River, some 40 miles from Jacksonville, Florida. The intention was to have Fritz manage this operation, known now as Solano Grove (actually, at that time called Solana Grove), without the distraction of nearby cultural centers. Not only did he largely ignore this business as well, but also in fact he encountered a well-qualified musician, Thomas J. Ward, a former church organist in Brooklyn, NY, who had come to Florida for health reasons. Delius invited Ward to live in his cottage at Solana Grove and instruct him in composition. Douglas had contracted malaria and temporarily had to be hospitalized, after which he left the area. His studies in music theory and composition with Ward continued for a little over a year. While in Florida, it is alleged that Delius had a love affair with a local woman of mixed race who bore him a son, although neither the woman nor the boy was ever clearly identified (see below). The story appears to have been confirmed in a letter written by Percy Grainger, a young Australian-born pianist and composer (see Carley, 1983, p. 112) who became one of Delius’ closest friends and confidantes. In November 1884, Fritz’ older brother Ernst, who had earlier moved from Bradford to New Zealand, arrived rather unexpectedly at Solana Grove. Fritz later left him in charge of the plantation and in the summer of 1885 moved to Jacksonville, where he taught music and sang at a local synagogue for a few months. Ernst subsequently
ARTICLE IN PRESS 1 His life
returned to New Zealand, leaving management of the orange grove solely in the hands of the African-American foreman, Albert Anderson, and his crew. In response to an ad for a music teacher, Delius relocated in the fall of 1885 to Danville, Virginia, where he taught music privately and obtained a position at nearby Roanoke Female College, achieving at least partial financial independence. In the spring of 1886, he moved to Manhattan, where he briefly served as a church organist. By this time, even his father had begun to realize that it was hopeless to expect Fritz to become a businessman and reluctantly agreed to support him for 18 months of study at the Leipzig Conservatory, with the understanding that he would subsequently return to the United States and become self-supporting as a music teacher. The experience in Leipzig was mixed. Delius (Fig. 1) took great advantage of the many musical opportunities, including orchestral concerts, chamber music, and opera, featuring the great artists of the time. He developed friendships with several Norwegians also studying in Leipzig, mainly through the violinist and composer, Christian Sinding, who subsequently introduced him to Edvard Grieg, with whom he formed a close relationship. Academic success was less certain. Classes in composition were available with such eminent musicians as Carl Reinecke and Salomon Jadassohn. He also took violin lessons from renowned violinist Hans Sitt, with whom he had briefly studied previously. Accounts vary as to how assiduous he was in attending classes. There is evidence that the Leipzig Conservatory was reluctant to offer him a diploma at the completion of his time there in 1888 (Beecham, 1959) and Delius never truly acknowledged a debt to his teachers in Leipzig. Indeed, he later avowed that Thomas Ward was the only person who had ever provided him with useful instruction in composition. Eric Fenby later quoted him as saying, “Had it not been that there were great opportunities for hearing music and talking music, and that I met Grieg, my studies in Leipzig were a complete waste of time. As far as my composing was concerned, Ward’s counterpoint lessons were the only lessons from which I ever derived any benefit” (Fenby, 1994, p. 168). After briefly returning to Bradford, he moved to Paris and from 1889 to 1896 lived in Croissy, just west of the city, actively composing, including his early attempts at opera, with frequent trips abroad, primarily to his beloved Norway. In 1895, he apparently contracted syphilis and probably received at least one course of treatment with mercury (see below). It was in 1896 that he met Jelka Rosen, a talented painter who had been studying in Paris. A woman of some means, her father was a German orientalist and diplomat; her mother was also a painter and the daughter of Ignaz Moscheles, the famous pianist and composer. Jelka, who was obviously attracted by his handsome and aristocratic appearance and demeanor (see Fig. 2) and by his love of Grieg and Nietzsche, which she shared, soon became his constant companion. Delius would stay with her on his visits to Grez-sur-Loing, a short distance from Paris, where she preferred to paint and rented a home. When she finally was able to purchase the home in 1897, he moved in with her that summer and they lived together, ultimately as husband and wife from September 23, 1903, to his death in 1934. Earlier in 1897, he had returned to the United States for reasons that are unclear. One possibility is that he was concerned about the status of Solana Grove, ownership
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FIGURE 1 Fritz Delius, age 25, in Leipzig toward the end of his studies there in early 1888, Atelier Herrmann. Courtesy of the Delius Trust, London.
FIGURE 2 Fritz Delius, 1899, by Window and Grove, London, probably taken as a publicity photo for a concert of his music performed on May 30. Courtesy of the Delius Trust, London.
ARTICLE IN PRESS 1 His life
of which his father had, by then, transferred to him. Another suggested reason, which was supported by his friend Percy Grainger in a letter dated October 5, 1941 (Carley, 1983, p. 112), was that he was searching for his one-time mistress and alleged mother of his son. He did not find her or the boy, some evidence suggesting that she feared he would take him from her and had fled. The British violinist, Tasmin Little, having become enamored of Delius’ music and wishing to understand more fully its emotional origins, has pursued this story, as described in the documentary, “Delius: The Lost Child” (www.youtube.com/watch?v¼EzTojb_A7BY), and in a subsequent review (Little, 1997). It remains uncertain whether the long-deceased woman she identified as Chloe Baker was, indeed, Delius’ ex-lover and whether her son, Frederick W. Baker, also then deceased, was actually Delius’ love child. Over the next several years, Delius divided his time between Grez and Paris, composing and promoting his compositions, primarily in Germany and with less success in England. The first decade of the twentieth century saw him composing some of his most important works (see below), and during those years, still physically vigorous and active (see Fig. 3), he traveled widely in France, England, and Germany, with occasional trips to Scandinavia. In 1910, Delius suffered the first major setback in his health, the initial manifestations of what would prove to represent neurosyphilis. His illness would lead him on
FIGURE 3 Frederick Delius, 1907, prior to the onset of symptoms. Photo used by music publisher Breitkopf and Ha¨rtel, London for its series of postcards of celebrated musicians. Courtesy of the Delius Trust, London.
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a journey over the ensuing decade to multiple medical clinics and sanatoria seeking a cure. In between these excursions, however, he had periods of relatively stable health, during which he could again travel for pleasure and promote his everincreasing compositional output. He and Jelka were forced to leave Grez-sur-Loing during World War I when their home was requisitioned for the French army, spending most of that time in England. They returned to Grez in August 1918 only to find the house left in shambles by the French soldiers. In fairness, it can be stated that the French government ultimately compensated them adequately for the damage done. Despite the periods of poor health and the disruption of the war, Delius continued to compose his most mature and enduring works. These would include his Requiem, Eventyr, the cello and violin concerti, and the incidental music for Hassan, a play by James Elroy Flecker. Due to his progressing disability, characterized ultimately by blindness and quadriparesis, his compositional output literally ceased from 1924 to 1928 and only resumed with the arrival on October 10, 1928, of Eric Fenby, a young English musician who offered his services to the totally disabled Delius as an amanuensis. Fenby was able to take musical dictation under the most harrowing and difficult circumstances, transferring Delius’ ideas to paper with remarkable success and allowing him to express what had been trapped in his still active mind. Certainly one of the highlights of Delius’ final years was the opportunity to attend a festival in his honor, organized and carried out by Sir Thomas Beecham in London from October 12 to November 1, 1929, as testimony that Delius’ music had finally achieved some success in his native country. The festival ended with a performance of A Mass of Life, which the eminent critic Newman (2008, p. 110) characterized as “magnificent.” Delius continued to work almost to the end, aided by Fenby, who was as much a caregiver as amanuensis, by a succession of private male attendants, and by his incredibly devoted wife, Jelka, despite her own health problems. During these years, a series of visitors came to Grez (not always enthusiastically welcomed), including some of his old friends, as well as music dignitaries such as composers Arnold Bax and Sir Edward Elgar, Professor Edward J. Dent (Cambridge musicologist), and violist Lionel Tertis. Fenby had left Grez for England in the summer of 1933, promising to return immediately if needed. In late May 1934, Jelka herself was hospitalized in nearby Fontainebleau for surgery to remove a malignant colon tumor and she desperately contacted Fenby to come immediately, as Delius seemed to be failing rapidly. Fenby attended him, along with the German male nurse, during his final few weeks. Jelka heroically returned to Grez after just 3 weeks to spend the last 2 days with her husband, who died on the morning of June 10, 1934. A temporary interment took place in a churchyard in Grez, witnessed only by a neighbor couple, a few old friends who had been notified of his death, Jelka, and Eric Fenby. Delius had expressed the wish to be buried in his garden but the French government forbade it. His remains were ultimately reburied on May 26, 1935, at St. Peter’s Church, Limpsfield, Surrey, in the south of England. Jelka actually missed the ceremony because of illness, dying 2 days later, and she was subsequently buried next to her beloved husband.
ARTICLE IN PRESS 2 His illness
2 HIS ILLNESS Relatively little has been written by physicians about Delius’ illness, except for the flurry of attention amid doubts about the correct diagnosis, primarily in the United Kingdom, in the early 1980s, at the time approaching the 50th anniversary of his death. Wainapel (1980) summarized the clinical features and assumed, correctly of course, that he had neurosyphilis. This was obviously before the questions raised in 1983 (see below). O’Shea (1990) also provided a summary of the progression of Delius’ neurosyphilis, including brief mention of the controversy of 1983, and quoted extensively from Fenby’s (1994) account of his final days. Other biographers, e.g., Jefferson (1972) and Carley (1983, 1988), mention but do not dwell upon the diagnosis, perhaps reflecting the stigma still associated with it. After his time in Leipzig, Delius was clearly attracted to Paris as the center of vibrant cultural life in Europe. It was also described as the sex capital of Europe and was reputed to be home to 100,000–120,000 prostitutes (Corbin, 1990). Delius was alleged to have had numerous sexual liaisons before and during his Paris years; mention was made above of the possible love affair in Solana Grove, producing a son. He is reputed to have shared a mistress, Anna la Javanaise, with his friend Paul Gauguin, who had apparently contracted syphilis early in 1895. Sometime later that year, Delius was diagnosed with syphilis, presumed to be secondary at the time (no primary lesion was ever mentioned), and probably treated at least once with iodine saltpeter (this information from a 1910 medical consultation note at a sanatorium near Dresden; see below). Although this knowledge apparently had a profound effect on his relationship with Jelka, it did not appear to inhibit his sexual activity otherwise. Carley (1983, p. 94) stated, “his attitude to sexual matters gradually became more cynical and perhaps exploitative. He was to become no stranger to Parisian houses of ill repute.” It was not, however, until 1910 that the disease, ultimately diagnosed as neurosyphilis, declared itself with a vengeance. There is a notation of a “bilious attack” occurring in London in 1909 and perhaps several gastric crises and occasional limb or trunk pains prior to 1910, but the attack in early 1910 led him first to a sanatorium in Mannern, Switzerland, where he was informed that he had tertiary syphilis. Asymmetrical pupils were noted. His letter to Jelka, dated June 17, 1910, after this visit, stated, “I don’t believe this at all” (Carley, 1988, p. 50). During a further consultation at Weisser Hirsch sanatorium near Dresden, where he spent 7 weeks, a medical report by Dr. W. Bothe states (translated in the publication by Jones and Heron, 1988, p. 5; see below): “Syphilis acquired 15 years ago [1895] no cure, some iodine saltpeter for further appearances of the symptoms, last time 10 years ago [1900]. . . other pains occurred: arms, shoulders and in the area of the thorax, toes, repeated gastric crises; uneven yet reacting pupils, and indeed increased knee reflexes, reduced feeling of pain in the lower extremities. . . on the upper left thigh a tertiary syphilid. Wassermann positive.” By October, he was able to write that he was again in excellent health; although in late December of 1910, he developed shingles, “which pained him dreadfully for a whole week and still pains him” (letter from Jelka to a relative, Carley, 1988, p. 64).
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Over the next 3 years, he remained in relatively good health with only occasional setbacks, including a severe “bilious attack” in April 1915, while still in England. In June 1917, there was a sudden deterioration, with numbness in his feet and hands, leg weakness, and inability to walk. He was treated at a spa in Normandy and by the end of July was able to take a 10-km walk with only occasional pauses. Further relapses occurred in 1918 and particularly in 1920, at which time Jelka had to write his letters for him because of hand weakness and tremors. In 1921, his health fluctuated as he spent time in Germany, London, and Norway, gradually losing function in his hands and having increasing pain and weakness in his legs. By year’s end, he was in a wheelchair and the decline continued in January 1922. After 3 months undergoing a “cure” in Wiesbaden (generally baths and physiotherapy), he was somewhat better and able to walk with canes. Writing, however, was not possible for him. He also began to lose his vision, and by the end of the year, he had light perception only, presumably the result of optic neuropathy. Despite his decline in health, he was able to spend time in Norway during the summer of 1922. In the spring of 1923, he spent 2½ months taking a cure at Bad Oeynhausen near Hanover, mainly baths, under the care of a Professor Dr. Frenkel, described by Jelka as “the great authority in these illnesses” (Carley, 1988, p. 275) and again seemed to improve enough to walk a few minutes at a time, even without a stick. That summer, they were able to spend time at the chalet they had built in the hills of Lesjaskog, Norway. During a visit from Percy Grainger, Delius expressed the desire to see the view from higher on the mountain. They constructed a chair supported by poles and carried Delius up the mountain, with Grainger in front and Jelka and the maid, Senta, in back. The entire journey took them over 7 h, exhausting all of the participants. The last 10 years of Delius’ life were characterized by progressive, if fluctuating, disability and a variety of treatment approaches, often based on misdiagnoses and Delius’ own refusal to accept the diagnosis of neurosyphilis. Both he and Percy Grainger were well known to have favored homeopathy and nonmedical therapy. It is alleged that, in 1910 at the time of the diagnosis of neurosyphilis, he had been offered treatment with arsphenamine (Salvarsan), which had just been released and shown to be extremely effective, but he had declined. In 1924, while in Rapallo, Italy, he was visited by a Dr. Heermann from a medical clinic in Cassel, Germany. He subsequently spent May to July at Dr. Heermann’s sanatorium, being treated mainly with electrical stimulation for Heermann’s suggested diagnosis of multiple sclerosis. Following this, his vision was said to have improved enough to allow him to read with “weaker” glasses than had previously been required. By September 1924, he reported the ability to walk alone for 5 or 10 min but mostly had to hold on to Jelka’s arm. By December of that year, he wrote a letter to his friend Henry Clews, with whom he and Jelka had spent a month at the Clews’ palatial new home on the French Riviera (see Fig. 4). Clews was a sculptor and close friend of many years, a very wealthy American expatriate, and son of a Wall Street banker. This was the last letter written in his hand, and he subsequently worsened again and returned to Cassel for more electrical treatments through the spring of 1925. During that visit, he stayed not at the clinic but at a nearby hotel, mainly because of his dislike of the poor food at the
ARTICLE IN PRESS 2 His illness
FIGURE 4 Frederick and Jelka Delius, spring of 1924, at the Ch^ateau de La Napoule overlooking the Bay of Cannes, newly purchased and being restored by Henry and Marie Clews. Courtesy of the Delius Trust, London.
clinic. By the end of 1925, he was virtually blind and had no use of his limbs, but remained unimpaired mentally. Dr. Heermann attributed his illness to a problem with the pituitary and apparently stated, “His optic nerve is not dead and, could Fred be really strengthened it could possible [sic] improve again. It is very shrunken and impoverished” (Jelka letter, August 31, 1925; Carley 1988, p. 306). In March 1927, Sir Thomas Beecham brought an eminent British physician, Sir John Conybeare, to Grez for a consultation. Conybeare was the editor of an authoritative and widely used textbook of medicine. In his examination, Conybeare found no evidence of involvement of the posterior columns of the spinal cord and no intellectual impairment. Furthermore, the Wassermann reaction was apparently negative at that time and he thought Delius might have a spinocerebellar degeneration, either sporadic or possibly hereditary (a cousin of Delius may have had a somewhat similar ailment), but not syphilis. Conybeare suggested a prolonged treatment at a sanatorium and recommended seeing a doctor in Paris regarding this possibility. The Paris physician thought it would be a mistake to carry out such a radical treatment, which could make him much worse, and recommended against it. Interest in the consultation by Sir John Conybeare, who had died in 1967, was revived early in 1983, as the
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50th anniversary of Delius’ death was approaching. Professor J. F. Soothill had written to The London Times regarding an evening spent with Sir John in 1948 at his home, at which recordings were played, including music by Delius ( Jones and Heron, 1988). Discussion then ensued about Delius’ illness and Conybeare produced his notes from the consultation in Grez and repeated that he was sure that Delius did not have neurosyphilis. Dr. Thomas Stuttaford (1983) referred to this communication in the medical briefing section of The Times, dated March 18, 1983, again questioning the diagnosis of neurosyphilis. This ultimately led to a thorough review of the evidence, using additional sources then available, by Dr. Philip Jones, a prominent British musicologist and author of a book on Delius’ style of composition, and by Dr. J. R. Heron, a consultant neurologist at the North Staffordshire Royal Infirmary and senior lecturer in postgraduate medicine at Keele University. They published a definitive summary of Delius’ case titled, “A Fever Diluted by Time: Notes on Frederick Delius” in The Delius Society Journal in 1988, indicating with confidence that the diagnosis of neurosyphilis was, in fact, correct ( Jones and Heron, 1988). In the spring of 1928, Dr. Heermann came to Grez from Cassel and spent a week trying further treatment for his vision, convinced that his “eyes are not blind but the optic nerve is not nourished with blood, as it should be” (letter from Jelka to Grainger, May 11, 1928; Carley, 1988, p. 355). In June 1930, a Scotsman named Erskine came to Grez for 2 weeks to treat Delius with hypnotism. His goal was to restore Delius’ ability to see. This was not accomplished, but during that summer, he was able to adjust his hat himself and flick away a mosquito, tasks which had been impossible previously. On one occasion, he had Delius sit at the piano and attempt to play while in a hypnotic trance. All that came out was a series of meaningless sounds. The last 4 years were spent in Grez, confined to a wheelchair, but remaining alert and cognitively unimpaired to the end. Bilateral ptosis and facial muscle atrophy were increasingly obvious (see Fig. 5). Shooting limb and trunk pains were frequent and severe, at times causing him to cry out. Morphine would provide some needed relief, administered by a local physician. Toward the end, it would be given every 4 h and his final hours were described by Eric Fenby “as if in a sound and noisy sleep” (Fenby, 1994, p. 225). He died early Sunday morning, June 10, 1934, without awakening.
3 BRIEF REVIEW OF NEUROSYPHILIS Although there remains controversy, it appears likely that syphilis was introduced to Europe by Christopher Columbus and his crew in 1493. Indeed, it may well be that Columbus himself suffered from the disease (Hayden, 2003). The first major European epidemic occurred among the soldiers in the army of Charles VIII of France during his invasion of Naples in 1495. The disease subsequently and rapidly spread throughout the civilized world and remained prevalent over the next four centuries (Frith, 2012). It can be stated that it was particularly prominent in Paris in the late 1800s. Jean Alfred Fournier, an eminent Parisian dermatologist/syphilologist,
ARTICLE IN PRESS 3 Brief review of neurosyphilis
FIGURE 5 Frederick Delius in the late stages of his illness, 1932. Photograph taken in Grez by Esparcieux, Fontainebleau. Note particularly the ptosis and facial muscle atrophy. Kindly supplied by Lionel Carley and courtesy of the Delius Trust, London.
estimated that at that time, “13 to 15 percent of the male population of Paris (about 125,000 individuals) were infected” (Corbin, 1990, p. 264). Science, however, would soon begin to influence that. In 1905, Fritz Schaudinn and Erich Hoffmann in Berlin identified the causative organism, Treponema pallidum. The following year, August von Wassermann developed the complement-fixation test named after him that allowed identification of the infection from a sample of serum. In 1909, Paul Ehrlich (with his colleague Sahachiro Hata), also in Berlin, found that arsphenamine effectively killed T. pallidum and Salvarsan (brand name) was released for treatment of syphilis in 1910. This remained in common use until the 1940s when Alexander Fleming discovered penicillin and, in 1943, four patients with syphilis were successfully cured by Mahoney, Arnold, and Harris. Except for situations in which a penicillin allergy precludes its use, nothing more has proved necessary to the present time. Although of great historical importance, the Wassermann test has now been replaced (perhaps modified would be more accurate) by other nontreponemal serological reactions, the RPR (rapid plasma reagin) and the VDRL (venereal disease research
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laboratory). These are now supplemented by newer and more specific assays, which detect the presence of the organism itself (fluorescent treponemal antibody absorption, FTA-ABS; T. pallidum particle agglutination assay, TPPA; and syphilis enzyme immunoassay, EIA). It should be noted at this point that the nontreponemal tests can revert to nonreactive later in the disease, as apparently occurred in Delius’ case. The disease is typically divided into early and late phases. Early syphilis includes primary, secondary, and early latent forms; late (tertiary) syphilis may have cardiovascular or gummatous manifestations and, most relevant in this context, neurosyphilis. The primary lesion is a painless chancre at the site of inoculation. This is highly contagious and about 1/3 of patients exposed to an active lesion contract the disease after an incubation period of a few to 90 days, about 3 weeks on average. The chancre may, depending on its location, go unnoticed and heals spontaneously in 3–6 weeks, treated or not. T. pallidum can be identified in the chancre by examining material under dark field microscopy but, unfortunately, the organism cannot be cultivated in vitro. The secondary phase follows a few weeks to a few months later and may include rash, fever, headache, malaise, anorexia, and lymphadenopathy. It can be shown, incidentally, that dissemination of the organism, including entrance into the cerebrospinal fluid (CSF), occurs during the initial phase of infection and, as is clearly demonstrated in Delius’ case, may remain asymptomatic (i.e., latent) for many years. Positive serology may be the only detectable abnormality at this time. Neurosyphilis can take many forms and can occur at any time after the initial infection. It is estimated from studies in the preantibiotic era that 25–35% of patients with syphilis will develop nervous system involvement. About 30% will be asymptomatic, 30% will ultimately develop tabes dorsalis (see below), 10% will have general paresis, another 10% will have meningovascular forms, and the rest will have a variety of less common subtypes. Early forms of neurosyphilis include an asymptomatic pleocytosis or outpouring of inflammatory cells in the CSF, usually less than 100 per mm3, elevated protein up to 100 mg/dl, and a positive serological test, generally the VDRL. Symptomatic meningitis at this stage usually occurs within the first year after infection and includes typical features such as headache, stiff neck, fever, and a vigorous meningeal reaction, including 200–400 cells/mm3, protein of 100–200 mg/dl, and a positive VDRL. Hearing loss may accompany this phase as well as ocular involvement, usually a posterior uveitis. MRI may show meningeal enhancement. Spontaneous resolution may occur after either symptomatic or asymptomatic meningeal forms. Meningovascular neurosyphilis may occur as early as a few months up to a few years after initial infection, with involvement of meningeal vessels producing stroke and focal neurological findings. The CSF may show 10–100 cells/mm3 and protein in the range of 100–200 mg/dl. The VDRL is usually but not always reactive. Late neurosyphilis usually means either general paresis or, more commonly, tabes dorsalis, the form Delius presumably had. General paresis, sometimes in the past called GPI (general paresis of the insane), is a progressive dementing illness, usually beginning 10–25 years after initial infection, but it can occur as early as 2 years after
ARTICLE IN PRESS 4 His music
inoculation. In its early stages, forgetfulness and personality changes are noted, with increasing memory loss, poor judgment, and psychotic symptoms. In its fully developed form, almost any neurological sign can develop, including the pupillary abnormality typically seen in the tabetic form. The spinal fluid is almost always abnormal; the VDRL in the CSF is reactive in virtually all cases. Tabes dorsalis (locomotor ataxia) has the longest latent period, averaging 20 years, and is characterized by involvement of the spinal cord posterior columns and dorsal roots. Clinically, it presents with a sensory ataxia and lancinating pains, paresthesias, and gastric crises, comprising severe epigastric pain with nausea and vomiting (what Jelka described as “bilious attacks”). The characteristic pupillary abnormality, a small pupil unresponsive to light but constricting with accommodation and convergence, known as the Argyll Robertson pupil after the man who first described it, is seen in about 1/2 of patients with tabes dorsalis and in a smaller percentage of those with general paresis. It is generally considered pathognomonic for neurosyphilis. Other common abnormalities include absent muscle stretch reflexes in the legs; impaired vibratory and joint position sense; marked incoordination of the lower, and often upper, limbs; and optic atrophy, with largely preserved cognitive function. CSF may be normal, including a nonreactive VDRL. The specific treponemal serum tests are virtually always reactive. The spinal fluid FTA-ABS is highly sensitive but not very specific. Thus, a nonreactive study excludes the diagnosis of neurosyphilis in almost all cases, but a reactive test does not necessarily confirm the diagnosis. It might be mentioned at this point that Percy Grainger, who played such a large part in Delius’ later life, was actually well acquainted with syphilis, although not himself afflicted. His father had contracted the disease in an alcohol-related series of extramarital affairs shortly after Percy’s birth and had transmitted the disease to his wife. Both parents eventually developed neurosyphilis; his father died of tabes dorsalis and his mother, who appeared to be developing general paresis, committed suicide (O’Shea, 1987).
4 HIS MUSIC It is not the author’s intent to offer a critical analysis of the music of Frederick Delius. There are clearly many commentators far better qualified to provide that kind of information. It can be stated that Delius ranks among the greatest of British composers (he would not have wished to be considered as such), and yet it must be admitted that, even within the country of his birth, and certainly in the United States, his name is not nearly as well known as his contemporaries such as Sir Edward Elgar and perhaps even Ralph Vaughan Williams. Many reasons have been suggested for this lack of recognition. Although he attempted to have his music played in England, he was much more successful in Germany, at least early on, having found a champion in the conductor Hans Haym. While British by birth, of course, he can truly be considered international, having spent a relatively brief but formative 2 years in the United
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States, having lived most of his adult life in France, where his music was hardly ever played, having traveled and vacationed by preference in Scandinavia, and having studied in Leipzig and obtaining most of his medical care in Germany. It was primarily through Sir Thomas Beecham that he developed an audience in England and most successfully at the time of the festival in his honor in October 1929 at the very end of his career. Beecham (1959) offered a number of reasons why his music was not played more frequently. He recognized that Delius did not often provide a bravura ending for an orchestral piece or a “resounding top note at the conclusion of a soprano or tenor aria” (Beecham, 1959, p. 216). Rather, he typically ended a piece with what Beecham and others characterized as “a dying fall” (Beecham, 1959, p. 216), making soloists and conductors less likely to program his music. With respect to his larger works, including his operas, he pointed out that Delius demanded a larger number of instruments than are required by such composers as Wagner, in Tristan and Isolde and Die Meistersinger; Verdi, in Otello; and Puccini, in any of his operas (Beecham, 1959, p. 142), thus straining the resources of all but the largest and wealthiest companies. The celebrated British cellist, Julian Lloyd Webber (Webber and Guinery, 2008), further commented on the sheer technical difficulty in performing the music of Delius as yet another reason for its infrequent programming. He also noted the tendency of his music to fade away quietly rather than end with a flourish. The eminent English musicologist and critic, Ernest Newman (2008), also a devoted admirer of Delius’s music, again pointed to the technical difficulty and added the fact that the music was often published with a minimum of notation as to how it should be performed, lacking details such as phrasing, accents, slurs, and other indications of the composer’s wishes. Contrary to a common perception that the music of Delius tends to be bland and “all the same,” Newman, in a glowing testimonial after the Delius Festival of 1929 wrote in the New York Times Magazine, his “harmonic language that on the surface of it seems inclined to softness can on occasion say so much that is big and strong” (reprinted in Newman, 2008, p. 110). Delius himself emphasized, in offering advice to his young devoted admirer and aspiring composer, Philip Heseltine (aka Peter Warlock), that there “is really only one quality for great music and that is ‘emotion’. . ..” (Carley, 1988, p. 179). It is often pointed out that, despite the instruction in composition provided by Thomas Ward, during the relatively short time he spent with Delius in Florida, and the 18 months Delius spent at the Leipzig Conservatory (probably with little actual time in the classroom), Delius was largely self-taught (Webber and Guinery, 2008). The opinion has often been expressed that this lack of formal training showed itself in a deficiency of structure in his compositions. In this regard, Webber went on to say, “if you actually study the music there’s an awful lot of structure to it” (Webber and Guinery, 2008, p. 116). Jefferson (1972, p. 95) added, “most of his scores are models of good organization, so that the finished material appears utterly spontaneous.” If melody and harmony are the main elements on which musical composition depends, Delius emphasized harmony and few melodies in his works are readily
ARTICLE IN PRESS 5 Conclusions
reproduced after a hearing ( Jefferson, 1972). The harmonic language which he developed was his alone, and he neither built upon the foundation provided by his predecessors nor did he join the radical path being embarked upon by some of his contemporaries, such as those in the second Viennese school (e.g., Schoenberg, Berg, and Webern). Certainly, however, one can identify early influences of “Negro” music, Chopin, Grieg, and Wagner ( Jefferson, 1972). His compositional output is often divided into periods. An early phase (sometimes referred to as the “apprentice period”) includes the Florida Suite of 1887 and his three initial operas, Irmelin, The Magic Fountain, and Koanga, none of which has found a place in the repertoire. His “middle” period (1900–1906) includes his most well-known opera, A Village Romeo and Juliet, which many consider his first true masterpiece, as well as Appalachia (utilizing his impressions of Negro music from his time in Florida), Sea Drift (based on a Walt Whitman poem), A Mass of Life (reflecting his reverence for the philosophy of Friedrich Nietzsche), and Songs of Sunset, on poems by Ernest Dowson (suggested by Jelka). The so-called mature period, from 1907 to 1924, produced a wide variety of compositions, including his popular On Hearing the First Cuckoo in Spring, Brigg Fair, North Country Sketches, and A Song Before Sunrise, along with a number of instrumental sonatas and concerti. Also produced in this time was his Requiem, described by Heseltine as “the first atheistical requiem in musical literature” (Carley, 1988, p. 110). His late period, which began only after a nearly 6 year hiatus of no output for health reasons, was enabled by Eric Fenby, who was able to take musical dictation, producing among other pieces A Song of Summer, Songs of Farewell (again utilizing poems of Walt Whitman), and his 3rd sonata for violin and piano. That he could compose at all as his illness progressed is remarkable enough. Jelka, while hardly an objective observer, commented on the clarity of his mind as he became increasingly disabled physically. It is undeniable that musical ideas continued to flow, and on reading Fenby’s account of the method of dictation and Delius’ attention to details of harmony and orchestration, one can only marvel at the preserved richness of his musical imagination. Nonetheless, an observer as astute and devoted as Beecham would later comment that, despite the “heroic” effort required in the collaboration with Fenby, the late works give us “little of Delius that we did not know before; and even that little does not ring with the sound of unadulterated inspiration” (Beecham, 1959, p. 218). For Beecham (1959), even the later works of the mature period, from 1915 to 1923, show signs of decline. “The ancient fire burns brightly for a few rare moments. . . but by slow degrees sinks to eventual extinction” (Beecham, 1959, p. 221).
5 CONCLUSIONS Is it possible, or even productive, to try to relate the quality of Delius’ creative output to his health? Certainly, in terms of the number of compositions, the years of his maturity from 1911 (after largely recovering from the initial “attack” of 1910) to his
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subsequent major relapse in 1917 were prolific and obviously the years from 1924 until the arrival of Eric Fenby toward the end of 1928 were barren. With respect to the quality of the compositions, that is clearly more hazardous to judge and, as stated above, something I am not qualified to do. Large-scale works, such as the operas, A Village Romeo and Juliet and A Mass of Life, are generally regarded as among his greatest compositions. Smaller orchestral pieces, including Brigg Fair and On Hearing the First Cuckoo in Spring, appear with sufficient frequency on concert programs and recordings to indicate popularity with conductors and audiences alike. Sir Thomas Beecham’s comments regarding his later works notwithstanding (quoted above), there is considerable beauty to be found in the compositions produced (often from fragments of earlier efforts) by the collaboration of Delius and Eric Fenby. Taken as a whole, the musical legacy of Frederick Delius would seem to merit a broader exposure than has been accorded it to date.
REFERENCES Beecham, T., 1959. Frederick Delius. Alfred A Knopf, New York, NY. Carley, L., 1983. Delius: A Life in Letters I: 1862–1908. Harvard University Press, Cambridge, MA. Carley, L., 1988. Delius: A Life in Letters II: 1909–1934. Gower Publishing Company Ltd, Aldershot. Corbin, A., 1990. Women for Hire: Prostitution and Sexuality in France after 1850 (translated by Alan Sheridan). Harvard University Press, Cambridge, MA (originally published in French, 1978). Fenby, E., 1994. Delius as I Knew Him. Dover, New York, NY. Frith, J., 2012. Syphilis—its early history and treatment until penicillin, and the debate on its origins. J. Mil. Veterans Health 20, 49–58. Hayden, D., 2003. Pox: Genius, Madness, and the Mysteries of Syphilis. Basic Books, New York, NY, p. xv. Jefferson, A., 1972. Delius. J.M. Dent, London. Jones, P., Heron, J.R., 1988. A fever diluted by time: notes on Frederick Delius. Delius Soc. J. 98, 3–8. Little, T., 1997. The loss at the heart of his music. Delius Soc. J. 122, 20–22. Newman, E., 2008. His country at last claims Delius. Delius Soc. J. 143, 105–111. O’Shea, J.G., 1987. Medicine and musicians: Percy Grainger. Med. J. Aust. 147, 578–581. O’Shea, J., 1990. Was Mozart Poisoned? Medical Investigations into the Lives of the Great Composers: Frederick Delius and Scott Joplin. St. Martin’s Press, New York, NY, pp. 187–200. Stuttaford, T., 1983. Medical Briefing: Unsullied Delius. London Times (March 18). Wainapel, S.F., 1980. Frederick Delius: medical assessment. N. Y. State J. Med. 80, 1886–1887. Webber, J.L., Guinery, P., 2008. The real Delius. Delius Soc. J. 143, 112–120.
