Medicine, Disease and Society in Britain, 1750 - 1950
Lecture 16
Vice, VD and prostitution
Lecture themes

Links with previous lectures:
◦ Treatment approaches of regulars and ‘quacks’
(sexual quackery). The development of a modern
‘cure’ and how this was implemented
◦ Issues of morality and blame – innocent and not
so innocent victims. Working classes related to the
degeneration of the nation, etc
◦ Ideas about sexuality and gender roles

Example of how disease relates to socio-cultural
values and responses
Part of fears of national degeneration and related
to war, military service

The opening-up of the
Americas (1492) and the
fusing of Old and New
Worlds gave rise to an
explosion in the rate and
scale of disease exchange.
Europeans introduced
many diseases to America
with severe consequences
for native populations, e.g.
smallpox.
It is thought that Syphilis
travelled to Europe
A medical illustration attributed to Albrecht Dürer (1496)
depicting a person with syphilis. Here, the disease is believed to
have astrological causes.
Portrait of Gerard de Lairesse by Rembrandt van Rijn, ca. 1665–
67, oil on canvas. De Lairesse, himself a painter and art theorist,
suffered from congenital syphilis that severely deformed his face
and eventually blinded him.
Syphilis raged from
the late fifteenth
century.
Known as
‘le mal de Naples’
‘French pox’
morbus gallicus
James Boswell - diary records episodes
‘I rose very disconsolate, having rested very ill by the poisonous
infection raging in my veins and anxiety and vexation boiling in
my breast... I have just got a gleet (discharge) by irritating the
parts too much with excessive venery. And yet these dammed
twinges, that scalding heat, and that deep-tinged loathsome
matter are the strongest proofs of an infection... I thought of
applying to a quack who would cure me quickly and cheaply.
But then the horror of being imperfectly cured and having the
distemper thrown in my blood terrified me exceedingly. I
therefore pursued my resolution of last night to go to my friend
Douglas, whom I knew to be skilful and careful; although I knew
it should cost me more, yet to get sound health was a matter of
great importance, and I might save on other articles’.
January 1763
William Hickey - memoirs (1810)
‘During the last 2 years, I had never been entirely free from
venereal taints, sometimes extremely ill and constantly
using that powerful medicine mercury; not did I ever give
myself fair play - in the worst of the disorder, if I could move
at all, frequenting my nocturnal haunts, sitting up whole
nights committing every degree of folly and excess. Mr
Hayes, the surgeon who attended me, frequently
remonstrated, observing that death and destruction must
inevitably be the consequence of the life I led, and never
shall I forget a speech he once made me. I had, as was
often the case, by inattention, late hour and intoxication,
whilst using mercury, thrown myself into a salivation; my
head suddenly swelled to an enormous size; my tongue and
mouth became so inflamed I could take no other
nourishment than liquids; in which forlorn state he found me;
when, instead of the pity and condolence I expected, he, in
a great rage, swore he had a strong inclination to leave me
to die as I richly deserved’.
Lock Hospital, Hyde Park Corner, London,
mid-nineteenth century
Contagious Diseases Act 1864

Required prostitutes to be medically examined

Forcible treatment in a Lock Hospital for 3-6
months if found to be infected.

1864 - applied to garrison towns. In 1866 and
1869 the Acts were extended to include other
districts.

New departure - compulsory treatment, state
intervention.
‘Syphilis’, by Richard Cooper, 1910
Opposition to Act

Ladies’ National Association, Civil liberties,
medical men
◦ Blamed prostitutes not men
◦ Double standards for men and women
◦ Implied different biology-men ‘biological necessity’;
women were either ‘pure’ or ‘depraved’
◦ Officially condoned ‘vice’

Royal Commission 1873

1886 – Repealed Contagious Disease Acts
Effective treatment-salvarsan

1905 - disease causing bacteria identified treponmema pallidum.

1906 – Wasserman developed a blood test to use
for screening.

Paul Erlich tested effectiveness of arsenical
compounds against the bacteria. Salvarsan was
Number 606.

Within three years claimed to have effectively
treated 10,000 syphilitics.
Salvarsan : ‘the magic bullet’



Ehrlich's best known magic bullet was
arsphenamine (Salvarsan, or compound 606),
the first effective treatment for syphilis. At a
meeting in 1910, Ehrlich and his colleagues
announced the remarkable effects of their
treatment of syphilis with this magic bullet.
A magic bullet is a perfect drug to cure a
disease. The term magic bullet was first used in
this sense by the German physician and
scientist Paul Ehrlich who received the Nobel
Prize in Physiology or Medicine in 1908.
Initially, Ehrlich invoked the notion of a magic
bullet in characterizing antibodies. He then
reused the concept of a magic bullet to apply
to a chemical that binds to and specifically kills
microbes or tumor cells.
Royal Commission 1913 & Venereal
Diseases Act 1916

Free, optional diagnosis and treatment in Local
Authority run clinics & salvarsan supplied free to GPs.

Protected patient’s anonymity

Health education - based on moral behaviour

Recommended be added to the medical curriculum

Banned advertising of quack remedies.
First World War and VD
Defence of the Realm Act 1914 –
powers to stop soliciting soldiers,
clamp down on prostitution
 Venereal Disease Act 1916 – free
clinics
 National Council for Combatting
Venereal Disease
 Further Act of 1918, targeted those
with venereal disease, allowing for
compulsory treatment if caught
suffering from disease

Treatment centres - A successful
experiment?

1917 - 113 centres treating 29,000 patients

1920 - 190 centres treating 105,185 patients

Treated more men than women

Some patients did not complete treatment (1920- c.
40%)

Supported by GPs as ‘national emergency’
Anti-venereal disease campaingn amongst
allied troops in Italy, 1943-44
Conclusion
•
The effective treatment of disease depends not
only on the development of effective treatments
but also on how they are made available.
Education, counselling and clinical services, as well
as cultural attitudes all play an important part
•
Gender roles in sexuality – ‘fallen’ women
(prostitutes) to blame

•
Links with public health movement – Contagious
Diseases Acts 1860s, Royal Commission 1913, VD
Act 1916
•
Concerns over national efficiency – heightened
by WW1