Venereal Disease, Hospitals and the Urban Poor

Venereal Disease, Hospitals and the Urban Poor: London's "Foul Wards," 1600-1800

Kevin P. Siena
Copyright Date: 2004
Edition: NED - New edition
Published by: Boydell and Brewer,
Pages: 375
https://www.jstor.org/stable/10.7722/j.ctt14brsss
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  • Book Info
    Venereal Disease, Hospitals and the Urban Poor
    Book Description:

    This book explores how London society responded to the dilemma of the rampant spread of the pox among the poor. Some have asserted that public authorities turned their backs on the "foul" and only began to offer care for venereal patients in the Enlightenment. An exploration of hospitals and workhouses shows a much more impressive public health response. London hospitals established "foul wards" at least as early as the mid-sixteenth century. Reconstruction of these wards shows that, far from banning paupers with the pox, hospitals made treating them one of their primary services. Not merely present in hospitals, venereal patients were omnipresent. Yet the "foul" comprised a unique category of patient. The sexual nature of their ailment guaranteed that they would be treated quite differently than all other patients. Class and gender informed patients' experiences in crucial ways. The shameful nature of the disease, and the gendered notion of shame itself, meant that men and women faced quite different circumstances. There emerged a gendered geography of London hospitals as men predominated in fee-charging hospitals, while sick women crowded into workhouses. Patients frequently desired to conceal their infection. This generated innovative services for elite patients who could buy medical privacy by hiring their own doctor. However, the public scrutiny that hospitalization demanded forced poor patients to be creative as they sought access to medical care that they could not afford. Thus, Venereal Disease, Hospitals and the Urban Poor offers new insights on patients' experiences of illness and on London's health care system itself. Kevin Siena is Assistant Professor of History at Trent University.

    eISBN: 978-1-58046-626-4
    Subjects: History of Science & Technology, Health Sciences, History

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-v)
  3. LIST OF FIGURES
    (pp. vi-vi)
  4. ACKNOWLEDGMENTS
    (pp. vii-viii)
  5. INTRODUCTION: INSTITUTIONS AND EXPERIENCES
    (pp. 1-29)

    So wrote one of the governors of the Westminster Infirmary in 1738. It is clearly a strong invective against allowing so-called “foul” patients into hospitals. Many have presumed that this policy was pervasive in early modern London. It was not.

    Considerably more scholarship has explored venereal disease² in the modern period. However, there is a growing body of literature on the early modern period that has explored medical treatises, graphic art, and literature, analyzing the various meanings that early modern doctors, artists, and playwrights attached to sexual infection.³ Yet early modern institutional care has received rather less attention. Robert Jütte...

  6. 1 THE FOUL DISEASE, PRIVACY, AND THE MEDICAL MARKETPLACE
    (pp. 30-61)

    People of means did not lack for medical options when they contracted the “foul disease” in early modern London. This book is not about people of means. However, an understanding of the experience of poverty and the pox demands a point of comparison. For that reason we should first consider the place of the foul disease within the oft-described medical marketplace of Stuart and Georgian London. If one had money to spend, what were their options? There is no doubt that there were plenty of customers for anyone who could relieve the suffering just described. There was a rich living...

  7. 2 THE FOUL DISEASE IN THE ROYAL HOSPITALS: THE SEVENTEENTH CENTURY
    (pp. 62-95)

    Many Londoners could not avail themselves of the services that the market provided. This posed a problem. What can be done, lamented surgeon Charles Peter in 1693, for “those poor unhappy wretches where the Pox and Poverty are complicated”?¹ In a sense, that is the central question of the remainder of this book. Such folk were not entirely without options in the seventeenth century, as scholars have sometimes presumed. One of their main options lay in one of the two royal hospitals that offered venereal care, St. Bartholomew’s and St. Thomas’s.² However, contemporaries did not always see these as a...

  8. 3 THE FOUL DISEASE IN THE ROYAL HOSPITALS: THE EIGHTEENTH CENTURY
    (pp. 96-134)

    As the eighteenth century dawned, beds in royal hospital foul wards were becoming harder to get. The financial effects of fire and war in the 1690s severely depleted the coffers as the seventeenth century drew to a close. This fiscal pressure forced St. Bartholomew’s to stop paying to support foul patients in the outhouses after 1696. So as the new century began, venereal patients now had to come up with the four pence per day in order to stay in the outhouses, even though the hospital continued to pay to support the hundreds of patients treated each month in the...

  9. 4 THE FOUL DISEASE AND THE POOR LAW: WORKHOUSE MEDICINE IN THE EIGHTEENTH CENTURY
    (pp. 135-180)

    On August 22, 1728, Flora Price applied to her churchwardens in the parish of St. Margaret’s Westminster. When questioned by the overseer’s of the poor she admitted that she was poxed and sought their help. The clerk recorded that she “be admitted into ye House till such time she can be got into ye Hospital for cure of the foul distemper.” However, she never entered a hospital. Instead, it seems she entered the workhouse and underwent mercury treatment there. Following her salivation she was discharged on October 21. The workhouse committee ordered “That Flora Price be discharged ye house &...

  10. 5 THE FOUL DISEASE AND MORAL REFORM? THE LOCK HOSPITAL
    (pp. 181-218)

    In the summer of 1746 London hospital provision for the poor with venereal disease entered a new phase. Surgeon William Bromfeild placed advertisements in theLondon Evening Postand theDaily Advertiserinviting donations for a new charitable hospital for impoverished patients suffering under the disease. Within six months his new charity had solicited enough support to launch the venture officially. The new London Lock Hospital opened its doors in January 1747. Unlike the royal hospitals supported by rents, or the workhouses supported by the public poor rates, the Lock was a private endeavor. That hospital would stand at the...

  11. 6 RETHINKING THE LOCK HOSPITAL
    (pp. 219-250)

    Extremely high incidence of the pox in the mid eighteenth century necessitated more ward space for London’s venereal poor. This may seem strange since the royal hospitals had large operations, and parishes treated an increasing number of patients within workhouses. By the 1740s there were more hospital beds for the city’s poxed poor than ever before, and thus the Lock’s emergence in that decade still confuses. Understanding the Lock’s original purpose ultimately rests on understanding how it related to the pre-existing network of medical institutions. When we consider the Lock within the wider context of the city’s medical welfare system,...

  12. CONCLUSION: POVERTY AND THE POX IN EARLY MODERN LONDON
    (pp. 251-266)

    On the night of February 7, 1734, Elizabeth and John Byon lay in a rented room that they could barely afford. John was a fan painter and he paid two pence to Magdalen Jones for one night’s lodging so that he and Elizabeth could get off the street. Elizabeth was extremely sick. John tried to explain away his wife’s weakness by telling Magdalen that she was drunk. But when what a servant would later describe as “dismal groans” emanated from Elizabeth’s bed, Magdalen came upstairs to check what was wrong. John was afraid that Magdalen would turn them out if...

  13. NOTES
    (pp. 267-328)
  14. BIBLIOGRAPHY
    (pp. 329-360)
  15. INDEX
    (pp. 361-367)