292 while confusion with rickets 439 continued to be a problem in the nineteenth century (Holmes et al. 1178). Given the complete ignorance of the causes of these distinct conditions, several of which might often appear in the same individual, recourse to the unifying nosological metanarrative of degeneration, with its great explanatory power, must have been very attractive.
With the almost excessive number of Galdós‘s pointers to the nature of Maxi‘s underlying condition, some of which would have been understood by contemporary readers, there has been a remarkable reticence among Galdós scholars to identify it.440 Congenital syphilis has been recognized since 1529 (Crissey & Parish, 92) and can vary in manifestations from stillbirth to childhood lesions such as skin rashes, jaundice and bone disease, though many other features were described (Caldwell 1768). Of particular relevance to Galdós‘s portrayal of Maximiliano Rubìn, however, was the announcement by Jonathan Hutchinson 441 in 1858 of his recognition of congenital syphilis presenting in adult life rather than childhood, with characteristically irregular permanent teeth indicating that exposure to the disease dated from or before early infancy. Irregularities in position of the teeth are ―very common‖ (Hutchinson 264-65). Features that Hutchinson described included: a bad, pale, earthy complexion, though the skin my be thin and stretched, a sunken and
confusion with rickets [with syphilis]: a notable example of this confusion was expressed by the pioneer Paris pediatrician, Joseph Marie Jules Parrot (1829-1883), who claimed at an international conference in London in 1881 that inherited syphilis was the only cause of rickets and that it represented the transformation of one disease into the other. (Parrot 35-40, 57) 440 Scholarly reticence: Howard Mancing tells me that there is a comparable reluctance among literary scholars to recognize obviously sexual references in Cervantes‘ works. (personal communication 25th June 2010) 441 Jonathan Hutchinson (1828-1913): English surgeon and pathologist, and leading authority in the field of venereal disease. His discovery and description of, ―On the Means of Recognizing the Subjects of Inherited Syphilis in Adult Life‖ (1858) is regarded as one of the classic texts of nineteenth century venereology. 439