The late 15th century introduced a period of momentous transition to European history. A stream of intellectual, religious, economic, and political developments set Europe on a course of turbulent change that left little time for social adjustment. It was into this climate of tension and social unease that syphilis spread across the continent as a new, devastating, and rapidly spreading plague. Syphilis, or the pox, shocked all who encountered it; sufferers were afflicted with nasty sores and pains, often resulting in a particularly gruesome death.[1] No record of a similar ailment could be found in any of the ancient philosophical texts, from which, in addition to medieval Christian theology, Renaissance scholars derived all their knowledge of ethics, medicine, and science.[2] Unequipped with the knowledge to understand, combat, or control the pox, early modern Europeans contended with their fear by projecting blame onto the marginalized groups of society over whom they could assert control and by utilizing a providential worldview to justify the ensuing devastation.[3]
Though the exact origins of European syphilis are unclear to this day, the start of its spread through Europe is believed to have coincided with Columbus’ return from America in 1493.[4] The timing gave rise to a popular theory that Neapolitan men in Columbus’ crew contracted the strange disease from Native Americans and infected the prostitutes in their home city. French soldiers invading Italy, so the story goes, contracted the disease from Naples’ prostitutes. In this way, the early modern phenomena of international and trade and warfare facilitated the illness’ progress of infection across the continent.
The religious and philosophical European worldview included a providential and moralistic understanding of causation. In a society that placed God at the head of every action, it was natural to assume that God meted out rewards to His people in the form of favourable circumstances and punishments as misfortunes, such as poverty and disease. Symbolic, metaphorical reasoning turned a person’s exterior into a representation of their interior qualities; imperfections, such as the debilitation and blemishes that came with syphilis, were then interpreted as signs of immorality on the part of the sufferers.[5] Syphilitics must then, logically, have sinned a great deal to bring such a horribly gruesome affliction upon themselves, and fear of the disease caused a significant degree of social tension. A mere accusation of infection could provoke lawsuits or terminate marriage engagements; contraction was synonymous with public shame.[6]
With the concept of health linked to personal integrity, groups began to associate syphilis with those whom they disliked. Increasingly powerful nation-states found the popular abhorrence of syphilis to be an effective propaganda tool, naming rival nations as the origins of the disease. This gave political leaders grounds to criticize the habits and practices of their neighbours and maintain a popular nationalistic sentiment among their own people with regards to their nation’s purity. For example, a widely-used term for syphilis was the French Disease; this had the effect of not only blaming the French for causing the illness, but also of pathologizing Frenchness itself, attributing negativity to everything from the speech patterns, dress and customs of France among a nation’s own citizens. [7]
While uneasiness over what was foreign was now inextricably linked with anxiety over the pox, the appearance of syphilitic sores on the genitals allowed Europeans to additionally link its spread to sexuality, though the mechanics of transmission remained unclear. Jacques de Béthencourt, a French physician practicing in 1527, believed that the illness was generated by the passions aroused during immoral sexual behaviour. [8] Though sexuality applies to both men and women, it was women who received the majority of the blame, both for the pox’s origin and for its spread. Europe’s steadfastly patriarchal structure made it easy for women, with their “natural” inferiority, to be incriminated for society’s social ills.
Greek medical philosophy had established femininity in the European mindset as abnormal and somehow inherently diseased. The Galenic humoural model of male and female anatomy exacerbated the sexual double standard. It was believed that qualities of the uterus, coupled with the dark, “cavernous” nature of the female interior, encouraged the corruption of vapours generating syphilitic infection.[9] Additionally, men’s hot complexion caused them to suffer from the disease more than women. Women, however, were cold, dry and dense, making them less susceptible to damage. In other words, a defenseless man could fall ill by a single sexual encounter with an infected woman, but a woman could only catch syphilis through repeated intercourse with an infected man, automatically branding female syphilitics with promiscuity.[10] An Italian theory claimed that the pox could lie dormant in women without displaying symptoms, and the disease would only become “activated” when exposed to heat during sex; thus no woman, chaste or otherwise, was exempt from suspicion.[11]
The view of promiscuous women as the primary source of the disease brought tremendous persecution onto Europe’s prostitutes. Prostitution, by no means a respectable profession, was not particularly shameful for women during the 15th century. The occupation served as a profitable refuge for women with little other means of subsistence, such as orphans, the homeless, and victims of rape and domestic abuse. The era held a relatively free attitude toward male sexuality, and prostitution was actively endorsed by many Church and town authorities. St. Augustine declared prostitution a necessary evil and compared it to a sewer system; prostitutes, he said, were “full of shame and disgrace,” but by providing men’s vulnerable sexual impulses with a controlled outlet, the industry saved society from being “overturn[ed] with lust.”[12]
This attitude changed with the shifting moral climate of the 1500’s. Stricter familial and personal values being enforced by the Protestant and Counter-Reformations as well as the providential fear of sexual disease provoked a renewed aversion to sexual immorality. Prostitutes were punished harshly for spreading the pox, while the men who bought their services were pitied as victims. “L.S.,” the 17th century author of the Prophylaktikon, advised Europeans to be patient with men, for it was the strength of passion that drove them to foolishness; on the other hand, prostitutes, he wrote, could provide a more productive service to society by hanging themselves.[13] Authorities in Scotland declared that all “loose women” would have their cheeks branded with hot irons. Many brothels were shut down with the prostitutes banished from the town.[14] The Counter-Reformation used the image of the repentant Mary Magdalene to urge “fallen women” away from prostitution and the uninfected public.[15] The Convertite in Venice was a convent specifically established for reformed syphilitic prostitutes who were cloistered after having been treated in the hospital for Incurables.
Anxiety over the destructive nature of the female body increased to a point at which girls were being confined even before they became infected. Renaissance Italian culture valued beauty, but beauty was defined in terms of harmony and balance, with ideal beauty existing only in nature. Excessive feminine beauty upset this balance, and beautiful women were regarded as prone to infidelity and vice.[16] Following the example of the Convertite, Venice founded the Zitrelle, an institution with the mandate of cloistering the young girls with the highest risk of succumbing to prostitution; those admitted were required to be young (between the ages of 12-18), healthy, poor, and beautiful. While the Zitrelle’s aim was supposedly to protect these girls from sin and infection, they were equally intended to protect outsiders from them. Society equated attractive women with wicked temptresses and maintained that feminine beauty was powerful enough to rob men of their ability to control their actions.[17] The community responded to this agitation in conventional early modern fashion; the girls and their feared feminine sexuality was confined, with the intention that they would remain so until marriage.
In this age of religious warfare, popular attitudes were growing increasingly puritanical. The first victims of the illness having been soldiers and prostitutes, both infamous for immoral lifestyles, confirmed the association held by many between pox and the sin of lust.[18] The interpretation of the pox as divine displeasure with human sexuality combined morality with medicine to an unprecedented degree.[19] Law enforcement authorities used the disease as a tool to police sodomy, that is, criminal sexual behaviour. A diagnosis of syphilis was used as legal grounds for criminal investigation; agents searched for sodomites by interrogating patients in pox hospitals.[20]
Medical responses to the pox threw scholars into what Kevin Siena has called “an intellectual scramble.”[21] Early modern conceptions of medicine proved problematic with regards to venereal disease. Latin Galenism described sexual intercourse as a primary method of maintaining good health; one of the earliest reactions to syphilis was to encourage the infected to continue copulating – a counter-productive measure, to say the least. It was not long before Europeans made the connection between sexual activity and transmission, while also recognizing non-sexual means of contracting the disease, such as from a mother to baby in childbirth.
When early treatments, such as prescribed sex and washing of the genitals, proved ineffectual against the pox, more extreme procedures rose in popularity. The first of two principle treatments was the use of mercury, which ancient Arabic writers recorded as a remedy for skin disorders. European physicians tested mercury’s effects on syphilitic sores and combined it with the Galenic concept of humoural balance. The patient was confined to a hot room for periods between five and thirty days so they might sweat out the corrupt matter in their bodies, while mercury was rubbed onto the patient’s body in the form of ointments. Instead of curing the patient of syphilis, this procedure had seriously damaging side effects.[22] While mercury possesses certain anti-bacterial qualities that may have helped the Arab’s immune systems fight off their ailments, it is also a deadly poison that would have been especially dangerous when entering the person’s respiratory tract during the sweating procedure. One physician went so far as to suggest that his patients ingest the liquid mercury mixed with hot chocolate, but he warned them that this treatment was risky – he worried that the chocolate might be too dangerous for his patients’ consumption.[23] Not only did mercury fail to cure patients of the pox, but mercurial overdose commonly resulted in the loosening and loss of teeth, uncontrollable shaking, paralysis, and sometimes death.[24]
An alternative treatment gained popularity among those who rejected or feared mercury. Many Europeans supported a theory that the most effective remedies for an ailment would be found in the region of the ailment’s origin. Thus, physicians who believed the pox hailed from the New World turned to guaiac wood, a plant native to the Indies, for the cure. The guaiac treatment involved grinding the wood into a powder and boiling it in water. The syphilitic patient was then confined to a warm room, as in the mercury treatment, and was restricted to a diet consisting of the guaiac decoction, little other food, and laxatives.[25] While guaiac wood was not poisonous, it had no other effect on the patient other than to induce sweating. This procedure, which lasted roughly one month, took a debilitating toll on those who tried it.
Despite the ineffectiveness of these processes at curing syphilis, physicians’ patients continued to repeat them; many of them believed that the greater their suffering, the more likely they were to be healed. Their attitude is more understandable when one considers that in the early modern period, it was not expected that an ordinary life would be free of pain.[26] The painful and detrimental effects of prescribed medical treatments were not even necessarily perceived as negative. If the illness was a punishment for bad behaviour, then it made sense that redemption would come at a price, and Christian doctrine dictated that suffering in the present allotted for future rewards.
The progress towards formulating a person-to-person theory of disease transmission in early modern medicine created problems for those who continued to view the pox in providential terms, and treatment of syphilis was dramatically affected as a result.[27] Few denied that the disease was, as William Clowes called it, “the just wrath of God,” but it was also clear that not all sufferers could be morally condemned, as babies and faithful wives also fell victim to it.[28] Christian charities—the primary, if not the only, source of medical treatment for the poor—faced the dilemma of distinguishing between “the deserving and the undeserving poor,” the undeserving being those who brought the pox on themselves through licentious living, and the deserving being those who contracted it through “innocent” means, such as a wife infected by an unfaithful husband or a baby by its nurse’s milk.[29] Clowes’ book, De Morbo Gallico, illustrates the contradictory attitudes toward medicine and syphilis. The book expresses the importance of healing those who suffer, but also that certain people are “unfit to be cured.”[30]
The moral implications of the disease’s sexual nature split physicians on how best to approach it. Was it more important for the physician to save his patient’s body or his soul?[31] Some applied a providential perspective to their treatments, believing that any remedies were gifts directly given from God and required penance and God’s grace to be effective. Others avoided treating syphilitics out of fear for their own souls; if the pox was a punishment issued from God, then it would be a sin for them to interfere with God’s will. [32] Syphilis became “a social disease,” as sufferers were shunned, both for their supposed depravity as well as for the contagion they carried.[33]
Commonly adopted by early modern physicians was the notion that they had a duty to personally punish those who had brought this illness on themselves for their sins.[34] Marie de Maupeou Fouquet, a 16th-century author of a book of medical remedies, stressed that syphilitics were not to be comforted “with mild remedies,” but that caregivers should “increase their torments by meting out the rigorous penances they deserved.”[35] Many charitable hospitals refused to treat syphilitics within their walls, transferring their pox patients to confinement in other locations or barring their doors to them completely. Paris’ Hôtel-Dieu, already full to bursting without the influx of pox-patients, called itself a hospital that “receives, feeds, and tends all poor sufferers, wherever they come from, and whatever ailment they have, even plague victims – though not if they have the pox.”[36] Others mercifully distributed their charity to pox victims, but returning patients would not be allowed treatment a second time; if they insisted on reverting to their licentious habits, then they deserved to suffer the consequences.[37]
Out of this attitude developed the practice of publicly whipping syphilitics. Not only did this function as “necessary” penance on the part of the recipient, but in this way, authorities were able to use the “lewd and incontinent” lives of the sufferers as moral examples for others to follow. The flogging of victims already suffering intense physical torment illustrates the early modern centrality of public shaming rituals to the enforcement of social conformity.[38]
[1] Irwin W. Sherman, Twelve Diseases That Changed Our World, (Washington: American Society for Microbiology Press, 2007), 84.
[2] Peter Lewis Allen, The Wages of Sin: Sex and Disease, Past and Present, (Chicago: The University of Chicago Press, 2000), 42.
[3] Ibid.
[4] Sherman, 84.
[5] Kevin Siena, “Introduction,” Sins of the Flesh: Responding to Sexual Disease in Early Modern Europe, ed. Kevin Siena, (Toronto: Centre for Reformation and Renaissance Studies, 2005), 7.
[6] Allen, 45.
[7] Siena, 16.
[8] John Parascandola, Sex, Sin, and Science: A History of Syphilis in America, (Westport: Praeger Publishers, 2008), 7.
[9] Laura J. McGough,“Quarantining Beauty: The French Disease in Early Modern Venice,” Sins of the Flesh: Responding to Sexual Disease in Early Modern Europe, ed. Kevin Siena, (Toronto: Centre for Reformation and Renaissance Studies, 2005), 219.
[10] Parascandola, 8.
[11] McGough, 219.
[12] Allen, 46.
[13] Ibid, 50.
[14] Ibid, 42.
[15] McGough, 225.
[16] Ibid, 222.
[17] Parascandola, 11.
[18] Allen, 42.
[19] Claude Quétel, History of Syphilis, trans. Judith Braddock and Brian Pike, (Baltimore: The John Hopkins University Press, 1992), 73.
[20] Siena, 19.
[21] Ibid, 20.
[22] John Arrizabalaga, et. al, The Great Pox: The French Disease in Renaissance Europe, (New Haven: Yale University Press, 1997), 139-140.
[23] Allen, 54.
[24] Parascandola, 16.
[25] Ibid, 18.
[26] Allen, 59.
[27] Siena, 20.
[28] Allen, 42.
[29] Quétel, 65.
[30] Bruce Thomas Boehrer, “Early Modern Syphilis,” Journal of the History of Sexuality, Vol. 1, No. 2, (Oct., 1990), 198.
[31] Allen, 48.
[32] Boehrer, 202.
[33] Ibid, 201.
[34] Allen, 51.
[35] Ibid, 50.
[36] Quétel, 69.
[37] Siena, 280.
[38] Ibid, 277.
[39] Siena, 8.
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