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Medicine, Knowledge and Venereal Diseases in England, 1886-1916 PDF

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y r o t s i h n r e d o m n i s e c n e i c s l a c i d e m o i b d n a e n i c i d e m MEDICINE, KNOWLEDGE AND VENEREAL DISEASES IN ENGLAND, 1886–1916 ANNE R. HANLEY Medicine and Biomedical Sciences in Modern History Series Editors Carsten   Timmermann University of Manchester United Kingdom Michael   Worboys University of Manchester United Kingdom Aim of the series The aim of this series is to illuminate the development and impact of medicine and the biomedical sciences in the modern era. The series was founded by the late Professor John Pickstone, and its ambitions refl ect his commitment to the integrated study of medicine, science and t echnology in their contexts. He repeatedly commented that it was a pity that the foundation discipline of the fi eld, for which he popularized the acronym ‘HSTM’ (History of Science, Technology and Medicine) had been the his- tory of science rather than the history of medicine. His point was that historians of science had too often focused just on scientifi c ideas and insti- tutions, while historians of medicine always had to consider the under- standing, management and meanings of diseases in their socio-e conomic, cultural, technological and political contexts. In the event, most of the books in the series dealt with medicine and the biomedical sciences, and the changed series title refl ects this. However, as the new editors we share Professor Pickstone’s enthusiasm for the integrated study of medicine, sci- ence and technology, encouraging studies on biomedical science, transla- tional medicine, clinical practice, disease histories, medical technologies, medical specialisms and health policies. The books in this series will pres- ent medicine and biomedical science as crucial features of modern culture, analysing their economic, social and political aspects, while not neglect- ing their expert content and context. Our authors investigate the uses and consequences of technical knowledge, and how it shaped, and was shaped by, particular economic, social and political structures. In re-l aunching the Series, we hope to build on its strengths but extend its geographical range beyond Western Europe and North America. M edicine and Biomedical Sciences in Modern History is intended to supply analysis and stimulate debate. All books are based on searching historical study of topics which are important, not least because they cut across conventional academic boundaries. They should appeal not just to historians, nor just to medical practitioners, s cientists and engineers, but to all who are interested in the place of m edicine and biomedical sciences in modern history. More information about this series at http://www.springer.com/series/15183 Anne R.   Hanley Medicine, Knowledge and Venereal Diseases in England, 1886–1916 Anne R.   Hanley University of Oxford Oxford , UK Medicine and Biomedical Sciences in Modern History ISBN 978-3-319-32454-8 ISBN 978-3-319-32455-5 (eBook) DOI 10.1007/978-3-319-32455-5 Library of Congress Control Number: 2016948426 © The Editor(s) (if applicable) and The Author(s) 2 017 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Cover illustrations: Coloured Illustration of the profi le of a face diseased with syphilis, 1898, © VintageMedStock / Alamy Stock Photo Printed on acid-free paper This Palgrave Macmillan imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland For my parents A CKNOWLEDGEMENTS When you spend your days researching the history of syphilis and gon- orrhoea, it must come as no surprise that you are asked many curious questions and fi nd yourself having the most extraordinary conversations. Although writing this book has felt at times like a solitary occupation, many people were instrumental in its completion. First and foremost were my doctoral supervisors, Simon Szreter and John Forrester, who provided so much valuable academic support and advice. Thank you to my doctoral examiners, Michael Worboys and Gayle Davis, for their invaluable com- ments and advice on transforming it into a respectable manuscript. Many thanks also to the anonymous reviewer for their feedback and suggestions and to Claire Jones for her comments on C hapter 6. The lively scholarly communities in the Faculty of History and the Department of History and Philosophy of Science at the University of Cambridge provided important opportunities for discussion and feedback on early chapter drafts. The Centre for History and Philosophy of Science at the University of Leeds also offered invaluable academic support dur- ing my time as a Visiting Research Fellow. Special thanks go to Graeme Gooday for his mentoring and advice on the book proposal. I am also very grateful to New College, University of Oxford for providing an academi- cally rigorous space in which to complete this book. Thank you to the Cambridge Commonwealth and International Trust, and the New College Ludwig Humanities Research Fund, without whose fi nancial assistance this book could not have been completed. Material in Chapter 2 is reprinted from ‘Venereology at the Polyclinic: Postgraduate Medical Education among General Practitioners in England, 1899–1914’ vii viii ACKNOWLEDGEMENTS (2015), with permission from M edical History (Cambridge University Press). M aterial in Chapter 6 is reprinted from ‘“Scientifi c Truth into Homely Language”: The Training and Practice of Midwives in Ophthalmia Neonatorum, 1895–1914’ (2014), with permission from S ocial History of Medicine (Oxford University Press). Thank you to both journals. I am also grateful for the permissions granted to reproduce material held by the Journal of Laryngology and Otology ; the Bodleian Library, University of Oxford; Cambridge University Library; the Thackray Medical Museum, Leeds; and the London Metropolitan Archives, City of London. I could not have completed this book without the friendship and encouragement of Laura, Coreen, Clare, Paul, Matthew, Kiara, Konstantin, Becky and Sean. My sincere thanks also to Lloyd, for his love, pedantry and meticulo o s proofreading. Finally, thank you to my parents, Patricia and Alastair, and my cousin Leah for their constant love and support and for always humouring my strange fascination with venereal diseases. C ONTENTS 1 Introduction 1 2 Training Competent Generalists 2 5 3 Postgraduate Specialism 6 3 4 Under the Microscope 1 07 5 Clinical Practice and Patient Care 1 47 6 Nursing Knowledge 1 89 7 Midwifery and Ophthalmia Neonatorum 223 8 Conclusions 265 Select Bibliography 277 Index 301 ix A BBREVIATIONS BJN B ritish Journal of Nursing BMA B ritish Medical Association BMJ B ritish Medical Journal CD Acts Contagious Diseases Acts CMB C entral Midwives Board CPL L ondon County Council’s Pathological Laboratory at Claybury Asylum DCMA Departmental Committee to Consider the Working of the Midwives Act DCSBC D epartmental Committee on Sickness Benefi t Claims Under the National Insurance Act DCSPW D epartmental Committee on Nursing the Sick Poor in Workhouses DPH D iploma in Public Health GMC G eneral Medical Council GPI General Paralysis of the Insane IDNA I nfectious Disease (Notifi cation) Act LCC L ondon County Council LGB L ocal Government Board LPC L ondon Postgraduate Course LSA L ocal Supervising Authority LSTM L ondon School of Tropical Medicine MGC M edical Graduates’ College and Polyclinic MOH M edical Offi cer of Health NCCVD N ational Council for Combatting Venereal Diseases NHI N ational Health Insurance Act PDC I nterdepartmental Committee on Physical Deterioration RAMC Royal Army Medical Corps xi

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This book reveals the ever-present challenges of patient care at the forefront of medical knowledge. Syphilis and gonorrhoea played upon the public imagination in Victorian and Edwardian England, inspiring fascination and fear. Seemingly inextricable from the other great 'social evil', prostitution,
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