This chapter considers the constructions of Teleny and Des Grieux through the filter of late nineteenth-century medical writing. It suggests that it is the medical content of the novel which inhibits and shapes its depiction of homosexual acts and relationships. The Gothic aspects of Teleny are considered with reference to Eric, Count Stenbock's short story 'The True Story of a Vampire' and George Du Maurier's Trilby, both published the year after Teleny in 1894. The fact that, in Teleny, Des Grieux gains access to Ambroise Tardieu's clinical work raises interesting questions about the availability and dissemination of medical discourse on sexual inversion beyond the limits of specialist practitioners. It suggests, perhaps, that such literature might have had a rather wider distribution. If one accepts that Teleny is a book ostensibly about same-sex desire but channelled through and informed by medicine, the calamitous ending hardly constitutes a big surprise.