Oscar Wilde was one of the UK’s most popular playwrights in the late 1800s, and his work lives on. One of the best-known novels by the Irish writer and poet is The Picture of Dorian Gray, on which the 2009 movie Dorian Gray was based. In 2000, a report published in The Lancet claimed that Wilde’s death in 1900 was caused by a severe ear infection. Now, a new report published in the journal claims to have identified the cause of death of his wife, Constance.

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Constance Wilde (pictured) is likely to have had multiple sclerosis, but misdiagnosis of the disease led to a mishandled operation that may have caused her death.
Image credit: Merlin Holland

The report reveals that she is likely to have had multiple sclerosis (MS) and have died at the hands of an irresponsible surgeon after a botched operation.

The findings come from medical evidence found in a series of 130 private family letters written by Constance and her brother – Otho Holland – unearthed by Wilde’s grandson, Merlin Holland.

Oscar Wilde met a 32-year-old Constance Lloyd in 1881, also a writer. They married 3 years later and went on to have two sons together, Cyril and Vyvyan.

After Oscar’s imprisonment in 1895 for committing homosexual acts, Constance and the children fled to Europe and changed their surname to “Holland.”

Constance and her two boys settled in Genoa, Italy, where she spent the rest of her days as a single parent. She died suddenly on April 7th, 1898, at the age of 39.

But what was her cause of death? Over the past century, researchers have cited an array of explanations, including syphilis – thought to have been caught from Oscar – and injuries as a result of a fall down the stairs.

This latest report, however, provides solid evidence of the real reason’s behind Mrs. Wilde’s death.

From the newly discovered letters, it is believed that Constance began to experience ill health from around 1889; the letters detail her inability to walk and the use of a stick for support. Two years later, she speaks of periods of severe pain, which she described as “rheumatism” in her arms.

In February 1893, Constance wrote about experiencing debilitating “neuralgia” in her head and back, and in the winter of 1894-95, she detailed her problems with mobility. “I am alright when I don’t walk,” she wrote, “but then I can’t go thro’ life sitting on a chair, especially with two boys to amuse.”

Constance made no further reference to her health until the end of 1895, when she wrote of her meetings with a gynecologist in Genoa – called Luigi Maria Bossi – to discuss her impaired mobility. Her letters reveal that she spent a month in Bossi’s private clinic undergoing major surgery to help her walk.

It seems that the surgery failed to improve her mobility, however; in April 1896, Constance wrote: “I am lamer than ever and have almost given up hope of ever getting well again.”

In October that year, Constance described experiencing debilitation in her right leg and a tremor in her right arm, which impaired her ability to write by hand and caused her to use a typewriter. In addition, she spoke of experiencing severe headache and extreme fatigue; in July 1897, Otho described how Constance collapsed after only a short walk to the station.

As the end of her life approached, the letters reveal Constance suffered paralysis in the left side of her face.

From the symptoms described in the letters – including widespread pain, fatigue, tremors and facial paralysis – report authors Dr. Ashley Robins, of the University of Cape Town Medical School in South Africa, and Merlin Holland believe Constance was suffering from MS.

“A likely diagnosis is multiple sclerosis of the relapsing-remitting type that subsequently developed into secondary progressive multiple sclerosis,” they explain.

MS is a disabling neurological condition that affects more than 2.5 million people worldwide. In the US, it is estimated that around 200 new cases of the disease are diagnosed each week.

Although the exact causes of MS are unclear, it is thought to be triggered by degeneration of myelin – a substance that protects nerve fibers from damage.

MS had been described as a condition around the time of Constance’s illness, according to Dr. Robins and Holland; Jean-Martin Charcot was one of the first physicians to describe the disease in 1868.

However, they note that because the description of MS was recent relative to Constance’s condition, doctors in the 1890s may not have associated her symptoms with it.

This is evident in the incorrect diagnosis that Bossi gave Constance the year she died.

By early 1898, Constance was also complaining of dysfunction of the reproductive organs and the urinary system. From the letters, it is revealed that Bossi claimed this was down to a “uterine fibroid,” and that this was compressing nerves in her thigh and causing the weakness in her leg.

To address this issue, Bossi subjected Constance to a vaginal pessary – a removable device that is placed into the vagina to reduce prolapse – and an antiseptic ointment. But these treatments failed, causing Constance to agree to what, at the time, was life-threatening surgery.

On April 2nd, 1898, Bossi performed a myomectomy on Constance, which involved the surgical removal of fibroids from the uterus. Dr. Robins and Holland believe this procedure is likely to have caused her death:

On the third or fourth postoperative day, Constance developed intractable vomiting. Profoundly dehydrated and in the absence of intravenous fluids, she grew progressively weaker, lapsed into unconsciousness and died on April 7th, 1898.

This sequence of events suggests that she could have developed severe paralytic ileus, either as a direct result of the surgery or secondary to intra-abdominal sepsis.”

According to the letters, Otho considered filing a lawsuit against Bossi after her death, but Bossi managed to dissuade him from taking such action, pointing out that Constance had agreed to undergo the procedure.

Bossi did not live happily ever after, however. On February 1st, 1919, he was shot by the jealous husband of a patient in his consulting room in Milan, Italy.

“Ultimately,” Holland and Dr. Robins write, “both Bossi and the hapless Constance met their ends tragically: he by the bullet of an assassin and she by the knife of an irresponsible surgeon.”