Lindsey Fitzharris (@ChirurgeonsAppr) recently discussed deformities caused by syphilis and the problems of prevention using early condoms (“Syphilis: A Love Story”). She also regularly tweets horrifying pictures of syphilis sufferers in the past, or the raddled syphilitic bones that remain. Evocative stuff.
But the day-to-day life of someone suffering from venereal disease wasn’t always so dramatic. Some Sloane letters hint at the physical and emotional experiences of those suffering from long-term venereal complaints.
In the early eighteenth century, many venereal symptoms were not immediately obvious to people. The skin rashes, pustules and chancres of late stage gonorrhoea might easily be confused with syphilis, which in turn could be mistaken for scurvy. Treatments for syphilis and scurvy might even be the same: the underlying problem seen as being hot and corrosive or a matter of poisoned blood. As William Salmon explained in a popular remedy book (1703), his family pills would cure, along with other diseases, “the Scurvy (the only reigning disease in this Kingdom) when it is grown so bad, as to become scandalous, so as many People think it to be the POX”. To further confuse matters, any whitish discharge from the genitals—known as ‘whites’ in women, ‘gleets’ in men or ‘running of the reins’ in all— was potentially classed as a gonorrhoea. Gonorrhoea, they believed, might be caused by masturbation or accidents to the lower back, not just sexual intercourse.
The problem of diagnosis can be seen in the letters of Thomas Hewitt, Roger Cook and J. Hopson. In 1721, Hewitt treated an unnamed gentleman aged 60, described as being scorbutic (e.g. ulcerated skin, lethargy and pallor). The patient’s main troubles, though, were a continual need to defecate and rectal pain. He had several rectal growths, which were voiding a frothy substance. Hewitt was obviously of two minds about the cause of the ailments. Although he had administered mercurial purges (treatment for syphilis), he also insisted that the patient was “an honest trustworthy gentleman”. Sloane, incidentally, also prescribed a typical syphilis treatment: salivation. Cook, in his undated letter, reported suffering from weakness caused by a constant gleet and nocturnal pollutions. Although he didn’t specify gonorrhoea, this would have been a suspicion. Hopson, for example, immediately suspected gonorrhoea when he had “running of the reins” for a couple days.
The physical experience of venereal problems and their treatments was inevitably painful, though they varied widely. Henry Downing reported that he’d had a three-month salivation to treat venereal disease when he was in his twenties. By 1726, he was ricketty, frail, and sedentary. His physical symptoms included pain throughout his body; heart palpitations; heat and pain in his anus, scrotum and urethra; difficulty urinating; and scaly rough skin. A pretty miserable existence.
Hewitt’s patient took opiates to deal with his pain, or indeed perhaps some of his other treatments. In order to drain the pus, Hewitt had dilated his patient’s anal supporation with a sponge. Mercurial treatments also generally required extensive bed rest, owing the various leakages, skin eruptions, and tooth loosening. Not so different from the symptoms of syphilis it was meant to be treating!
The case of Mr Campbell, aged 63, also suggests the long-term health problems that people thought might occur. Thomas Molyneaux and other medical practitioners wrote to Sloane on Campbell’s behalf in 1724. While not obviously venereal symptoms, Molyneaux saw Campbell’s experience of clap in 1685 as significant. Campbell had trouble urinating afterwards. By 1724, Campbell had a blockage in the bladder, pain while sitting, and a hot and burning sensation in the urethra. He was also voiding slime instead of urine.
Worse yet, failure to disclose one’s venereal condition could be fatal. In August 1725, J. Hetherington wrote to Sloane about the death of a young man after being inoculated for smallpox. The underlying concern was that the inoculation, a novel treatment championed by Sloane, might have caused the death. Hethrington was adamant that the patient, who had not been in the “correct habit”, was the one to blame. The young man had failed to tell the inoculation surgeon about his venereal disease and recent treatment. (A physician applied a plaster to his swollen scrotum.) The treatment had successfully reduced the inflammation, but a fever started the next day. This, Hetherington was certain, caused the complications with the inoculation.
Given that these men were blamed for their poor bodily condition, stemming from lack of self-control, no wonder shame and fear were constant companions for the venereal sufferer. There are relatively few letters to Sloane discussing sexual problems of any kind, and some—such as that by E.W.—were anonymous. Embarrassment might also suggest why Hetherington’s patient did not tell the surgeon. Once his problem was apparently gone, there was no need to tell anyone else, including the surgeon, about it. A sufferers’ physical condition also needs to be considered alongside his emotional one. Patients listed fear (Downing and Hopson), weariness (Downing), and melancholy (Hewitt’s patient) among their symptoms. Pain in early modern England was seen as simultaneously physical and emotional.
As their bodies leaked in unseemly ways and their skin turned ulcerated or rough, the sufferers who wrote to Sloane must have been terrified at what fate might yet await them: the fallen noses, blindness or ulcerated skin of syphilis or the swollen testicles and impotence of gonorrhoea. And above all, they had only themselves to blame.
 William Salmon, Collectanea Medica, the Country Physician (London, 1703), p. 452.
 Women in particular are absent. This may partly be because of the many ways in which the ‘whites’ might be interepreted medically, if symptoms were present at all. Hopson had asked “the woman”, but she claimed to have no symptoms. As we know today, many women never have any symptoms. Women and their physicians might, deliberately or not, be able to avoid a more shameful venereal diagnosis that called the woman’s behaviour, or that of their husbands, into question.
On shame, see for example K. Siena, Venereal Disease, Hospitals and the Urban Poor: London’s Foul Wards, 1600-1800 (Rochester: University of Rochester Press, 2004).
On the moral implications of leaky bodies, see L.W. Smith, “The Body Embarrassed? Rethinking the Leaky Male Body in Eighteenth-Century England and France“, Gender and History 23, 1 (2011): 26-46.
This past week has been an exciting time for portents! What with a meteor blasting into Russia, an asteriod passing close to earth, St. Peter’s Basilica being struck by lightning, and the Pope resigning, early modern people would have been getting a bit nervous… As it is, some people believe that the lightning strike was a sign that God approves the Pope’s decision. Perhaps we live in a more optimistic era.
There are several letters in the Sloane Correspondence database about early modern astronomy, although only two that mention comets. By the eighteenth century, there was a growing shift away from seeing dramatic astronomical events as portents. Clergyman William Derham (1657-1735), for example, wrote to Sloane regularly about natural philosophy and his letters (dated 28 March 1706) reveal a careful attention to matters of fact rather than a concern with religious signs.
In one of Derham’s letters, which also appeared in the Philosophical Transactions (vol. 25, 1706), he described his star-gazing just before Easter. While observing the satellites of Saturn, he spotted a “glade of light” in the constellation of Taurus. The light had a tail like a comet, but a pointy upper end instead of a rounded one. This, Derham was certain, was similar to what Joshua Childrey and Giovanni Domenico Cassini had observed. When the following nights were cloudy, Derham was unable to spot the glade again–and, although Easter Day was fair, he “forgot it unluckily then”. By the time he was next able to look at the skies, the glade of light was gone.
This was the only bit of Derham’s rather long letter that was published in the Phil. Trans. this time. In the letter, Derham also dicussed sunspots and requested advice about his wife’s eye problems. This was typical of many of Sloane’s correspondents, whose letters blurred the boundaries between scholarly, social and medical matters.
Anna Derham, aged about 31, was suffering from eye problems. Sloane had recommended that she take a variety of medicines, including a purge (and rather revoltingly, woodlice), in addition to eye drops. The eye drops, Derham reported, did not agree with his wife and had caused an inflammation. The purge, moreover, had left Mrs. Derham with violent pains spreading from above her eye to throughout her head and face. Derham believed that the eye medicine had resulted in his wife’s cornea wasting away. The outcome of the eye problem was not noted, but a letter from later that year (30 August 1706) mentioned Mrs. Derham’s increasingly severe headaches, which worried both her and her husband. Whether her health improved (or Derham simply distrusted Sloane’s advice in this case) is unclear, but Derham did not mention his wife’s health again until November 1710 when he feared that she might die from peripneumonia. (Mrs. Derham didn’t, managing to outlive her husband.)
What strikes me as particularly interesting in Derham’s account is the small detail that he forgot to look at the skies on Easter Sunday. As a clergyman, he was no doubt very busy in the week leading up to and including Easter. It would be entirely understandable that he might forget… but he did manage to look out his telescope in the nights prior to Easter.
The rather pressing matter of his wife’s health, on the other hand, is the most likely reason. It’s clear that her symptoms were alarming and disabling (as would have been the treatments, as purges kept one very close to the chamberpot). To compound the domestic disruption, the couple had four children between the ages of two and six in 1706. At the very least, Derham was monitoring his wife’s health and overseeing her medical care. Even with domestic help, Mrs. Derham’s poor health would have posed a challenge for the household at the best of times, but even more so at the busiest time of year for a clergyman’s family.
Early modern scientific endeavours often took place within the early modern household, meaning that these activities were inevitably subject to the rhythms and disruptions of daily life. With his ill wife, several young children, and Easter duties, Derham simply did not have time to remember.
 For other recent blogging on historical comets, see Darin Hayton on “Meteorites and Comets in Pre-Modern Europe” and Rupert Baker on the comets in the Philosophical Transactions (“Watch the Skies“).
 The other letter was from Leibniz (5 May 1702), which was an account in Latin of a newly discovered comet.
 On Derham and his family, see Marja Smolenaars, “Derham, William (1657-1735)”, Oxford Dictionary of National Biography. Oxford University Press, 2004. [http://www.oxforddnb.com/view/article/7528, accessed 7 June 2011.]
 For more on men’s medical caregiving roles within the family, see my article “The Relative Duties of a Man: Domestic Medicine in England and France, ca. 1685-1740”, Journal of Family History 31, 3 (2006): 237-256.
I apologise for my unexpectedly long absence from the blog, occasioned by a nasty cold followed by an even worse chest infection. But now that I’m on the mend thanks to a course of antibiotics, I have the luxury of sufficient oxygen in my blood stream to reflect on colds in days of yore.
While nobody ever dies from the common cold, complications from colds can be debilitating or even fatal: chest infections, pneumonia, pleurisy… And these sorts of problems regularly developed in eighteenth-century patients. For fun, I trawled through the database for symptoms nearest my own to see how patients would have treated their colds. It’s not a pretty picture: lengthy and dangerous illnesses and ineffective and uncomfortable treatments.
Patients rarely consulted Sloane for recent or urgent problems, but colds often slipped into the chronic category. Elizabeth Southwell, in an undated letter,* noted that her cold had already lasted two weeks. In 1708, Elizabeth Howland referred to hers lasting three weeks. Lord Lempster, who had a chronic lung condition, had already been suffering from a cold for two weeks when his doctor James Keill wrote to Sloane on June 22, 1710. As if that wasn’t long enough, the winner of these misery sweepstakes was the Earl of Thanet who reported on July 31, 1712 that he had been taking remedies for is cold since June 12.
These weren’t just gracefully fading colds, moreover, but ones that worried sufferers. Keill had anticipated Lord Lempsters’s death, given his laboured breathing; the patient remained seriously ill when Keill wrote again on July 9. Lord Lempster, Southwell and Howland had all started to spit occasional blood in their phlegm. Southwell’s cough was so violent she had given up on taking most remedies, except diacodium (a painkiller made of poppies). The Earl of Thanet and Howland both suffered from chest pains, which can indicate the onset of a serious chest ailment, while the Earl and Southwell had sore throats. Howland was also constantly hot, which she attributed to a sharpness and heat in her blood. Colds that wouldn’t clear up might have different–and apparently hot–effects, as Dr. Keill suggested when diagnosing Lord Lempster’s problems as a stoppage of blood rather than the more serious inflammation of the lungs. Either way, these were serious complications from what started as a cold.
Although there were other remedies used, the treatments focused primarily on diet, bleeding, blistering and purging. The Earl and Howland both drank milk, then known for its healthful benefits in lung ailments. The Earl and Southwell ate fruit–possibly to keep their bowels regular. Southwell had eaten figs, while the Earl had tried and rejected oranges (proposing instead pears). All four patients were bled. Southwell, for example, had been bled twice and Lord Lempster at least three times (10 ounces, 8 ounces, and 8 ounces). Keill also suggested that Lord Lempster try blisters and purging; the Earl initially used blisters, but thought a bit of purging could also be useful. Other remedies described included powder of pearl (the Earl), chalybeates to cause vomiting (Lempster), barley water, linseed oil, sarsaparilla and China tea (Howland). The main goal of the remedies was to reduce inflammation of the lungs, break up the stoppages of the blood, or to cool the blood.
The fates of these eighteenth-century patients? Elizabeth Howland (c. 1658- 1719) and the Earl of Thanet (1644-1729) lasted many years after. Elizabeth Southwell (1674-1709) was the youngest sufferer and she died within a few years of her illness (though not necessarily related). Lord Lempster (1648-1711) was already chronically ill before he contracted his cold, and continued poorly for another year and a half before he died.
Whatever the rationale behind eighteenth-century explanations of and treatments for colds, I’m just glad that I didn’t have to suffer bleeding, purging, and blisters in addition to the misery of a chest infection!
*After 1705 when she had a son. The letter refers to visiting her young ill son.
A diverting weekend on Twitter, at least if you’re a medical historian. It all started when John Gallagher (@earlymodernjohn) wondered:
A fine question, which several Twitterstorians pondered. Elaine Chalus (@EHChalus) suggested that this was a gendered concern, since:
Bowels have never featured much in the women’s letters/corresp I’ve read over the years. ‘Face ache’ though does.
I had never paid much attention to the bowel movements of the patients I study, but had a memory that women discussed bowels frequently in a medical context. But what might my Sir Hans Sloane’s Correspondence Online have to offer by way of insight?
First, that I do not have a category for tracing patients’ discussions about their excretion. That said, “bowels”, “stomach”, “diarrhoea”, “constipation”, “stool”, “urination” and “urine” all appear as key terms.
Second, after a quick search for “bowels”, “stool” and “diarrhoea” (sixty-eight out of 713 medical letters), I found that men were indeed much more interested in bowel movements overall. Twenty-six of these letters involved women: most were written by medical practitioners (15) or by male relatives (6). The remainder involved women writing on behalf of other females (2) or male relatives (3). No women wrote about their own bowel movements. In contrast, sixteen men wrote about their own and eighteen wrote about other sufferers’ (eleven males and six females). Medical practitioners wrote for an equal number of male and female patients.
What surprised me most is how few letters discuss this issue. Perhaps there might be more references in the 164 letters mentioning “stomach”. However, it could also reflect the categories chosen for the database and a further choice on the part of individual researchers not to input this data because it is so common. As with any database, decisions must always be made.
Only, I’m left with a lingering question… Would it be meaningful to be able to trace the number of references to bowel movements in the eighteenth century?