Though Arthur never acknowledged it, Louise may have been consumptive even when they married. Consider the wording in his autobiography, Memories and Adventures, concerning when he allegedly first learned of Louise’s condition.
I had no suspicion of anything serious, but sent for the nearest good physician. To my surprise and alarm he told me when he descended from the bedroom that the lungs were very gravely affected, that there was every sign of rapid consumption and that he thought the case a most serious one with little hope, considering her record and family history, of a permanent cure. With two children, aged four and one, and a wife who was in such deadly danger, the situation was a difficult one.
Arthur doesn’t clarify what he meant by “her record” or “family history.” We do know that her younger brother, John, died of cerebral meningitis, that that affliction is frequently caused by TB turned active, and that TB runs in families due to close contact.
Other bits and pieces of evidence suggest that Arthur knew of Louise’s affliction much earlier than he let on. Arthur kept from his mother the fact that Louise had become pregnant. He didn’t mention it until after Louise had given birth. In a sure-to-surprise letter, Arthur assured his mother that Louise and the previously unannounced baby were doing nicely. He wrote his mother again on 14 February, seventeen days after the birth, informing her that Louise was not yet sitting up, but might soon try. On 26 February, four full weeks after the birth, Arthur offered an encouraging announcement:
Touie & baby came down yesterday.
In Victorian times, it was consider unsafe for a consumptive woman to even engage in sex, much less give birth. Apparently, that is why Arthur chose to keep Louise’s pregnancy from his mother. Had the baby not made it, he presumably would have never told his mother. As it was, Louise’s recovery from giving birth seemed particularly challenging.
Suspicious episodes appear yearly after Louise’s hushed up pregnancy. In 1890, according to Memories and Adventures, Arthur claimed he became suddenly interested in Koch’s proposed cure for tuberculosis.
I could give no clear reason for this, but it was an irresistible impulse and I at once determined to go.
Since there is good reason to believe that Arthur did not actually travel to Berlin, we should be skeptical of his claim that he had only recently become interested in cures for tuberculosis.
In 1891, after having settled in the London suburb of South Norwood, Arthur informed his mother that he had purchased a tandem tricycle. The cycle had two large side-by-side wheels and a small trailing wheel. Arthur sat between the large wheels, above and behind the axle. Louise sat somewhat lower, in front of the axle. Arthur was proud of how fast and far he could propel them both. In the image below, Louise is hardly looking hale and hearty.
Arthur described to his mother one particular challenging outing: a trip through Woking, Reading, and Chertsey before returning home. He did not mention that the distance would have been seventy-five miles. “We both find it very healthy exercise,” he wrote. “I don’t know when we have been in such good condition.”
On one instance at least, Louise became too tired to continue. Arthur sent her home on a train and continued without her.
The cycling may have been an effort to force fresh air deep into Louise’s tubercular lungs. Climbing, horseback riding, sailing, and cycling were all considered preventative and curative exercises, since each allegedly forced air into the lungs. Hobart Amory Hare discussed the benefits of such exercises to consumptives in his A System of Practical Therapeutics (1891).
[W]here the character of the country permits it, ascents proportionate to the age and strength of the individual should be prescribed. These ascents should be made with slow and measured steps, in order to avoid fatigue to the respiratory organs; and there should be occasional rests by the way. To expand the lungs as much as possible, especially while climbing, the elbows should be made to approach each other behind the back, and a walking-stick be supported between them; or the arms may be folded behind the back, with or without a stick being thrust through. Even without this the head and trunk should be kept erect and the shoulders well thrown back. Whether walking on a level or climbing the patient must be instructed to breathe deeply and slowly. He must take a long breath, hold it as long as possible without causing distress, and let it out slowly. […]
Walking or other exercise—let it be repeated—whether for prophylaxis or for cure, should never be permitted to pass the point of gentle and pleasant fatigue. A wealthy patient in the city or country may have his carriage follow him while he walks. Riding on pony-, donkey-, or horse-back, on tricycle or bicycle, is also a good form of exercise. “One brisk ride is (sometimes) worth a dozen lazy walks;” and Sydenham, echoed by Rush, declares a journey on horseback to be a sure cure for consumption.
Early in 1892, Arthur wrote to his mother that he intended to have his small family spend the next winter on the Riviera. That region had long been believed to be an ideal wintering ground for consumptives. The tubercular Dr. James Henry Bennet described, in Winter and Spring on the Shores of the Mediterranean (1875), how he went there “to die in a quiet corner […] like a wounded denizen of the forest.” Dr. Bennet survived and spread the word.
With the assistance of sunshine, a dry, bracing atmosphere, a mild temperature […] I have found pulmonary consumption in this favoured region, especially in its earlier stages, by no means the intractable disease that I formerly found it in London and Paris. After fifteen winters passed at Mentone, I am surrounded by a phalanx of cured or arrested consumption cases.
When arguing for the Riviera, Arthur explained, “We shall work better & be better in the Riviera than here.” The use of the plural we, as in “we shall work better”, is particularly tantalizing. Certainly Arthur was referring to his writing; was he referring also to Louise’s?
Later that year, in an interview for The Strand, Arthur pontificated about climatological health benefits, but not of the temperate Riviera. He spoke instead of the freezing Arctic.
What a climate it is in those regions! We don’t understand it here. I don’t mean its coldness—I refer to its sanitary properties. I believe, in years to come, it will be the world’s sanatorium. Here, thousands of miles from the smoke, where the air is the finest in the world, the invalid and weakly ones will go when all other places have failed to give them the air they want, and revive and live again under the marvellous invigorating properties of the Arctic atmosphere.
Still later that year, Arthur did explore for therapeutic air, but in neither in the Riviera nor the Arctic. Instead he traveled to Norway in the company of family and friends, and apparently in the absence of Louise. She is never mentioned among the travelers, perhaps understandably so, since she was at that time pregnant with Kingsley. Arthur learned to ski while in Norway, and he boasted later that he introduced the sport to Switzerland.
While in Norway, Arthur visited St. George's Leprosy Hospital in Bergen, on the southwest coast of the country. Leprosy and tuberculosis are similar diseases in several respects. Leprosy is a chronic infection caused by Mycobacterium leprae. Tuberculosis is a chronic infection caused by Mycobacterium tuberculosis. The bacteria are quite similar in appearance, in their ability to hide inside their host for decades, and in the nature of their symptoms when they burst forth. Classic symptoms of leprosy include granulomas (nodules) of the skin, eyes, nerves, and respiratory tract. Tuberculosis is most commonly associated with masses (tubercles) formed within the lung, but the scrofulous form exhibits itself as grotesque masses on the neck.
Bergen is of interest also because it was renowned for the quality of its cod liver oil, which is known also (not surprisingly) as Bergen oil. In 1848, physicians at the Hospital for Consumption and Diseases of the Chest in Chelsea tested cod liver oil as a treatment for tuberculosis. The study, untrustworthy by today’s standards, suggested that cod-liver oil increased the chances of improvement by a factor of three and cut the chance of further deterioration by nearly half.
Beyond its leprosy hospital and its high-grade cod liver oil, Bergen might have been of interest because the city was the disembarkation point for anyone traveling between London and the Tonsaassen Sanatorium. The hospital for consumptives was located 2000 feet above sea level in the mountains of Norway. Richard Douglas Powell, the person who would later tell Louise of her terrible prognosis, described the sanatorium in his 1899 Sanatoria for Consumptives.
There are verandahs or balconies on every floor. The furniture is simple. The lighting is by electricity. Ventilation by open windows, day and night, summer and winter. There are said to be good water-closets and baths. The waste water is carried into a brook. In winter the sewage is covered with earth.
The establishment is open throughout the year. It was built in 1881, and has been a winter station since 1885. No advanced cases are admitted. Treatment is by open air, in the verandahs or balconies, or in the pavilions in the woods. Patients who are fit for it take plenty of exercise. There is a very complete apparatus for hydrotherapy, with vapour baths, needle baths, ferruginous, hot and cold baths, etc. Patients in summer have friction with water at 15° to 20° C, or douches [showers]. In winter, dry friction and partial ablutions are substituted. Five or six meals are provided daily, with alcohol in great moderation. Cod-liver oil and specifics are little used. The sputa are put into a cask with [a solution] of ferrous sulphate, and after a month are burnt. Patients bring their own bedcovers and pillows. Mattresses are disinfected by brushing with [a corrosive sublimate] followed by solution of washing soda. Rooms are rubbed with bread and then washed with soap and water. There is one nurse.
In 1893, Louise and Arthur considered visiting, perhaps moving to, the South Pacific. Robert Louis Stevenson had moved there already after finding that the cold, clean air of Switzerland’s Davos Platz did not cure his tuberculosis. Stevenson mentioned the impending visit in a letter to Arthur.
Delighted to hear I have a chance of seeing you and Mrs. Doyle; Mrs. Stevenson bids me say (what is too true) that our rations are often spare. Are you Great Eaters? Please reply.
As to ways and means, here is what you will have to do. Leave San Francisco by the down mail, get off at Samoa […] We are in the midst of war here; rather a nasty business, with the head-taking; and there seem signs of other trouble. But I believe you need make no change in your design to visit us. All should be well over; and if it were not, why! you need not leave the steamer.
Louise did not follow Stevenson to Samoa, but she did follow him to Davos Platz. By September of that year, 1893, her tuberculosis became too obvious to ignore. In his autobiography, Arthur claimed the turning point came after they had returned from an earlier trip to Switzerland.
I now come to the great misfortune which darkened and deflected our lives. I have said that my wife and I had taken a tour in Switzerland. I do not know whether she had overtaxed herself in this excursion, or whether we encountered microbes in some inn bedroom, but the fact remains that within a few weeks of our return she complained of pain in her side and cough. I had no suspicion of anything serious, but sent for the nearest good physician. To my surprise and alarm he told me when he descended from the bedroom that the lungs were very gravely affected, that there was every sign of rapid consumption and that he thought the case a most serious one with little hope, considering her record and family history, of a permanent cure. With two children, aged four and one, and a wife who was in such deadly danger, the situation was a difficult one. I confirmed the diagnosis by having Sir Douglas Powell down to see her, and I then set all my energy to work to save the situation. The home was abandoned, the newly bought furniture was sold, and we made for Davos in the High Alps where there seemed the best chance of killing this accursed microbe which was rapidly eating out her vitals.
Almost nothing here withstands scrutiny. One deception is his claim that he “set all his energy” to save her. They had returned from Switzerland near the beginning of September, meaning that her terminal diagnosis must have been in that month. Yet, instead of making for Davos, Arthur set off on a lecture tour throughout England and Scotland. Through October, November, and early December, he gave somewhere between eighteen and twenty-one lectures. Also during that period he attended several meetings of the Upper Norwood Literary and Scientific Society, joined the British Society for Psychical Research, and hung out at the all-male Reform Club in London.
Arthur’s most poignant lie, however, is the plural pronoun in his claim “we made for Davos in the High Alps.” According to a residence list provided in the Davoser Blätter, Louise and her sister Emily were residents of the Curhaus Davos as of 2 November. Arthur was not with them. He was still in England, only then beginning his lecture tour, and having no intention of cutting it short, as we learn from a letter to his lecture agent, Gerald Christy.
My wife has fallen ill and has had to go to Davos. Of course, I shall let no private matter—however urgent—interfere with my engagements.
He signed his unfaithful letter “Yours faithfully, A Conan Doyle.”
Arthur joined Louise in Davos just barely by Christmas. During her remaining thirteen years, however, Arthur managed to frequently remove himself from her, both physically and emotionally. In 1894, he absented himself from Switzerland and Louise for nine months. In 1895, he indulged Louise with his company somewhat more, returning to England for extended stays perhaps only twice that year.
Arthur longed for England. After two years in the Alps, the disintegrating couple wintered in Egypt. There, Arthur left her twice to sail up the Nile, hoping to join Kitchener’s army as it prepared to invade Sudan. Thereafter the two returned to England. Within a year, they settled into an expensive, expansive, custom-designed mansion called Undershaw, located in the village of Hindhead, forty miles southwest of London. Arthur rationalized the move by declaring that the slightly elevated English air would be better for Louise than the high-altitude cold air of Switzerland, or the balmy, sea-level hot air of Cairo. He wrote his mother -
If we could have ordered Nature to construct a spot for us we could not have hit upon anything more perfect.
The 10,000 square-foot, fourteen-bedroom house included a generator for electric lighting, a dining room large enough to seat thirty, a billiards room, a grand staircase with shallow steps to ease Louie's ascent, and doors that swung in both directions to ease her coming and going. Arthur's wood-paneled drawing room featured weapons, stuffed birds, walrus tusks, and trophies. No room in the house, however, was large enough for a grand piano. Louise settled for an upright.
Arthur and Louise moved into Undershaw in October of 1897. The very next month, Arthur had the temerity to allow Jean, his second wife in waiting, to dine there with his family.
For at least ten years, as Louise was slowly being consumed from the inside, Arthur would frequently abandon Louise to spend hide-away vacations with the Jean. Arthur justified his behavior by claiming that the relationship was platonic, by claiming that Louise never knew, and by proclaiming that his relationship with Jean was among the the grandest in history.