The play reintroduced the subject of syphilis to a startled world which for many years had done its best to sweep the whole disagreeable subject under the rug. Through the syphilis theme Ibsen attacked the prudishness and hypocrisy of his time, as he had done in A Doll’s House by other means. It is hardly surprising that Scandinavian theaters would not touch Ghosts even though Ibsen's reputation was already established. His publisher issued 10,000 copies of the text, but most of them remained unsold. The play was published in 1881 but was not translated into German until 1884. The first performance was in May, 1882, by a Danish touring company, at the Aurora Turner Hall in Chicago!

When Ghosts was staged in London later, it was condemned by the critics with such labels as "putrid" and "an open sewer." What must have shocked its early audiences as much as the syphilis theme was the portrayal of disease and death not clearly as the wages of sin doing so might have softened the blow to Victorian morals but rather as a punishment for virtue, at least of virtue as it was then understood. The sinful father does not appear on stage. The mother, Mrs. Alving, conforms to all the dictates of the good Victorian woman. By more modem standards she is, of course, a prude, with more than a suggestion of frigidity. Pastor Manders is a credulous fool whose unrelieved puritanism heightens a sense of morbidity that beclouds the whole play. Engstrand is close to being a burlesque villain. Regina, the only healthy character in the play, still lacks a chance for humor in her lines; and Osvald, the play's thematic center, is no more than barely believable. But Ibsen obviously intended the mood of portending sickness and death, emphasizing it with his insistence on Norwegian sunlessness. The people of the time probably needed a powerful cathartic. For today, as part of the treatment we need for VD as a disease of society, this seems to me to be the wrong medicine.

It may be incidental, even unimportant, that the medical verisimilitude of Ghosts is pretty thin. Alving, the father who does not appear, is presumed to have had syphilis without outward sign, and to have infected his son without the wife and mother even knowing about it. He has also sired the healthy child, Regina, by another mother. Osvald himself is a congenital syphilitic whose symptoms appear only in maturity and only in the central nervous system. All this is perhaps possible; but even in 1880 it ought not to have been hard to come a little closer to probability. (see VENEREAL DISEASES AS A SUBJECT FOR LITERATURE PART III)