‘Direful Attendants’: The Great Pox and Shame

‘The pestilent infection of filthy lust’  – William Clowes, A … treatise touching the cure of the disease called (morbus gallicus(London, 1579).

‘[the great pox] has the direful Attendants of Shame, Reproach and Ridicule.’  – John Profily, An easy and exact method of curing the venereal disease (London, 1748).

L0070284 A woman representing syphilis

A woman representing syphilis; advertising Dr Abreu’s sanatorium for syphilitics in Barcelona. Colour lithograph by R. Casas (1900). Source: Wellcome Library, London.

From the sixteenth century until today there have been those who have strongly associated the pox, syphilis, and other sexually transmitted diseases with shame and who have stigmatised those who contract these infections.

During the eighteenth century some people argued that medical practitioners ought not to cure those who contracted the pox. It was, they contended, a disease spread through sinfulness, and therefore a just punishment for any who contracted it. They argued that the potential to readily obtain a cure encouraged those who contracted the disease to persist in their debauched lives, thus infecting British society with an epidemic of immorality.

However, not everyone agreed with this line of thinking. The London-based John Marten wrote:

But I must declare, I cannot be of their Opinion, because it seems to shut out Charity, which at least however ought to be afforded to our Fellow-Creatures in Misery; And besides we are all frail, the same Flesh and Blood as others all subject to the same Venereal Pleasures. (From: John Marten, Treatise of all degrees and symptoms of the venereal disease.)

Indeed Marten’s treatise is one which treats some pox victims in a very sympathetic manner, showing us that the reaction to the pox was not uniformly negative. He emphasises that there were numerous victims of the disease who contracted it through no fault of their own – citing many cases wherein an adulterous husband (and occasionally wife) gave the disease to their faithful and unsuspecting spouse. In these cases he is always very much at pains to emphasise the innocence of the faithful party.

Nevertheless, single women who contracted the disease were in particular danger of stigmatisation. Eighteenth-century ideals of femininity idolised faithful wives and pure virgins. Some writers warned that women were especially deceitful and would use makeup and cosmetic strategies to trick men for financial gain, infecting them with the pox in the process.

Whilst Marten believed that a few innocent female virgins were infected through violence or seduction, he strongly condemned the many women whom he perceived as lacking sexual morals (i.e. those who had sex outside of marriage). In his Treatise he included some advice for his male readers. He urged them to find a pocket-sized portrait of a beautiful woman, and then to diligently deface it, erasing the nose, giving it rotten teeth, etc. They were to carry this image about with them and to look upon it when they had ‘a fancy for a woman’ to remind themselves of the sin and disease that apparent beauty could conceal.

Syphilis remains very present in global society. In England the diagnosis of syphilis has increased by 76% since 2012 (rising from 3,001 diagnoses in 2012 to 5,228 in 2015) and in the US rates have also been increasing. When reading about the stigmatisation of pox victims in the eighteenth-century, it is very easy for us to shake our heads, to say ‘wasn’t that awful, well things are better now’. But are they? Whilst more effective care is more readily available in some areas of the world, have societies’ attitudes progressed toward STDs, women’s and non-hetrosexual sexualities?

Interviewer: And what comes into your head when I say sexually transmitted infection, or STI to you?

Participant: You shouldn’t really say it ‘cos anyone can get them but kind of, more it’s perceived as slightly, not dirty people but kind of more promiscuous, stuff like that…(i24, man, aged 16–19)’

An unexpectedly fashionable career

If asked today to list fashionable careers, it is highly unlikely that any of us would include ‘syphilis specialist’ in our list. During the eighteenth and nineteenth centuries the prevalence of the disease in British society and the ongoing debates surrounding its nature and cure provided many medical men with the opportunity to carve out very fashionable, and indeed lucrative, careers.

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Medical instruments in A complete treatise on the virulent gonorrhoea, by Jacques Daran (London, 1766), University of Glasgow Library, Sp Coll NH.6.24; with permission of University of Glasgow Special Collections.

Among those who became famous for their work on the disease were two Scottish surgeons – John Hunter and Benjamin Bell. Hunter and Bell were particularly important and noted because they debated whether gonorrhea and syphilis were caused by the same pathogen.  Hunter argued for the same pathogen, whilst Bell took the position that they were separate diseases. Their work on the diseases was widely read and debated in the medical community, for instance Solomon Sawrey, a surgeon, published a book on An inquiry into some of the effects of the venereal poison on the human body; with… observations on some of the opinions of Mr. John Hunger and Mr. Benjamin Bell (1802).

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John Hunter (portrait on left-hand page),  A Treatise on the Venereal Disease (London, 1810), University of Glasgow Library, Sp Coll 84.b.12; with permission of University of Glasgow Special Collections.

The London-based surgeon John Marten also appears to have carved out a successful career as a pox practitioner (despite some accusations of quackery from contemporaries!). Marten published a very popular Treatise on all degrees and symptoms of the venereal disease. The book was clearly successful, running to seven editions. However, Marten did not just seek fame and fortune through his published endeavors. He also sought these through treating the upper circles of London society for the disease. The service that he offered was clearly tailored to meet the desires of an elite clientele; he offered to meet patients in clandestine locations away from their homes and his surgery and would send letters and remedies anonymously and to alternative collection addresses rather than directly to people’s homes. This was all to help fashionable Londoners maintain a respectable facade, free from association with a disease considered immoral and associated with horrific physical suffering and disfigurement. Moreover, all of these services were mentioned in Marten’s book, thus making it a sort of extended advertisement; a way to win him more wealthy patients!

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John Marten (portrait on the left-hand page), A Treatise of all the Degrees and Symptoms of the Venereal Disease (London, 1708), University of Glasgow Library, Sp Coll Hunterian Ab.6.11; with permission of University of Glasgow Special Collections.

Today we sometimes say that something is ‘to die for’, well during the eighteenth century, a successful career as a practitioner treating the pox was just that. Self-experimentation was common among medical men during this period, and some injected themselves with material extracted from the sores of venereal patients. This was undoubtedly risky, it could result in the need for months of mercury treatment, and had the potential to prove fatal. There is at least one known case of a student, who was preparing a thesis on venereal disease, dying from injecting himself with material from a pox sore.

Thus, whilst the great pox was not a fashionable disease to suffer from during the eighteenth and nineteenth centuries, it provided many medical men with the opportunity to obtain fame and fortune. To be a pox practitioner, surgeon or doctor, was so desirable that it was literally seen as a career worth dying for.