Venereal Disease, Hospitals and the Urban Poor: London's 'Foul Wards', 1600-1800 (Rochester Studies in Medical History)

377 Pages·2004·1.15 MB·English

by  Kevin P. Siena

VENEREAL DISEASE, HOSPITALS
AND THE URBAN POOR
London's 'Foul Wards', 1600-1800

Kevin P. Siena

Rochester Studies in Medical History
VENEREAL DISEASE, HOSPITALS AND
THE URBAN POOR
Rochester Studies in Medical History
Senior Editor: Theodore M. Brown
Professor of History and Preventive Medicine
University of Rochester
ISSN 1526–2715
Mechanization of the Heart:
Harvey and Descartes
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The Workers’Health Fund in Eretz Israel
Kupat Holim, 1911–1937
Shifra Shvarts
Public Health and the Risk Factor:
A History of an Uneven Medical Revolution
William G. Rothstein
Venereal Disease, Hospitals and the Urban Poor
Kevin P. Siena
VENEREAL DISEASE,
HOSPITALS
AND THE URBAN POOR
London’s “Foul Wards,” 1600–1800
Kevin P. Siena
Copyright © 2004 Kevin P. Siena
All Rights Reserved. Except as permitted under current legislation, no part of this work may be
photocopied, stored in a retrieval system, published, performed in public, adapted, broadcast,
transmitted, recorded or reproduced in any form or by any means, without the prior permission
of the copyright owner.
First published 2004
by the University of Rochester Press
The University of Rochester Press
668 Mount Hope Avenue, Rochester, NY 14620, USA
and at Boydell & Brewer, Ltd.
P.O. Box 9, Woodbridge, Suffolk 1P12 3DF, UK
www.urpress.com
ISBN 1–58046–148–4
Library of Congress Cataloging-in-Publication Data
Siena, Kevin Patrick.
Venereal disease, hospitals, and the urban poor ; London’s foul wards,
1600–1800 / by Kevin P. Siena.
p. ; cm. — (Rochester studies in medical history, ISSN 1526–2715 ; 4)
Includes bibliographical references and index.
ISBN 1–58046–148–4 (hardcover : alk. paper)
1. Sexually transmitted diseases—England—London—History—17th century.
2. Sexually transmitted diseases—England—London—History—18th century.
3. Urban poor—Health and hygiene—England—London—History—17th century.
4. Urban poor—Health and hygiene—England—London—History—18th century.
[DNLM: 1. Sexually Transmitted Diseases—history—London. 2. History
of Medicine, 17th Cent.—London. 3. History of Medicine, 18th Cent.—London.
4. Urban Health Services—history—London. WC 11 FE5
S572v 2004] I. Title. II. Series.
RA644.V4S495 2004
362.196’951’00942109032–dc22
2003025102
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Designed and typeset by Mizpah Publishing Services Pvt. Ltd.
Printed in the United States of America
This publication is printed on acid-free paper
CONTENTS
List of Figures vi
Acknowledgments vii
Introduction: Institutions and Experiences 1
Chapter 1: The Foul Disease, Privacy, and the
Medical Marketplace 30
Chapter 2: The Foul Disease in the Royal Hospitals:
The Seventeenth Century 62
Chapter 3: The Foul Disease in the Royal Hospitals:
The Eighteenth Century 96
Chapter 4: The Foul Disease and the Poor Law:
Workhouse Medicine in the Eighteenth Century 135
Chapter 5: The Foul Disease and Moral Reform?
The Lock Hospital 181
Chapter 6: Rethinking the Lock Hospital 219
Conclusion: Poverty and the Pox in Early Modern London 251
Notes 267
Bibliography 329
Index 361
v
LIST OF FIGURES
1: Watercolor Drawing of a Lock Hospital Patient, 1849 20
2: Watercolor Drawing of a Lock Hospital Patient, 1849 21
3: Watercolor Drawing of a Lock Hospital Patient, 1850 22
4: Outhouse Patients as a Percentage of All Patients in
St. Bartholomew’s Hospital, 1622–1696 71
5: Annual Average Capacity of the Lock and Kingsland
Outhouses (combined), 1622–1696 72
6: Annual Average Number of Venereal Patients Supported by
St. Bartholomew’s Hospital, 1622–1760 98
7: Annual Average Number of “Clean”Patients Supported by
St. Bartholomew’s Hospital, 1622–1760 99
8: Annual Average Number of “Clean”Patients and
Venereal Patients Supported by St. Bartholomew’s
Hospital, 1622–1760 100
9: Admissions Fees at St.Thomas’s Hospital, 1715–1800 104
10: Gender Breakdown of Venereal Patients in Four
London Parishes 162
11: Ages of Venereal Patients in the Workhouse of St. Luke’s
Chelsea, 1742–1769 and 1782–1799 163
12: Ages of Female Venereal Patients in the Shoe Lane
Workhouse, St. Andrew’s Holborn, 1776–1781 165
vi
ACKNOWLEDGMENTS
It is strange that a book on such a grim topic could be such a pleasure to
write. This was certainly the case thanks to the help and encouragement
of friends and colleagues, only a few of whom can be thanked here.
Pauline Mazumdar and Barbara Todd assisted me enormously while
researching and writing the dissertation out of which this book grew.
Donna Andrew shared her great knowledge of eighteenth-century char-
ity with me, read several versions of the manuscript in its entirety, and
proposed key revisions. I am just as indebted to Tim Hitchcock. He also
read the manuscript, suggested revisions, and shared with me many
nuggets he’d unearthed in the archives related to the pox. My friend Ted
Brown has had a unique perspective on this project, watching it develop
from a seedling of an essay more than a decade ago, and now helping to
shepherd it through the process of becoming a book. His careful reading
at various stages improved the quality of the manuscript significantly.
I am also thankful for the suggestions made by Vivian Nutton, Lesley
Hall, the external manuscript reviewers, and the readers who adjudicated
the dissertation for the 2001 Hannah-Millennium Dissertation award.
That award was the generosity of Associated Medical Services,
Inc., a foundation to which I owe a tremendous debt. AMS supported
theproject at both the doctoral and postdoctoral levels. This book would
not have been written without this support. AMS also enabled me to
return to London to conduct further archival research as the 2002
Hannah-Wellcome Traveling Fellow. I wish to thank the Wellcome Trust
at UCL for being such gracious hosts. I also received funding from the
University ofToronto and its Department of History. I benefited greatly
from the support and stimulating seminars of the Lupina Foundation’s
vii
viii Acknowledgements
Comparative Program on Health and Society. Archival and Library staffs
at the Royal College of Surgeons, Royal College of Physicians, London
Metropolitan Archives, Guildhall Library, British Library, Corporation of
London Records Office, Wellcome Library, Westminster City Archive
Centre, Westminster Abbey Library and Muniments Room, Public
Records Office, Royal London Hospital, and St.Bartholomew’s Hospital
all deserve my sincere thanks and admiration.
A few people warrant special mention: Marion Rea, Sally Gilbert,
Claire Jackson, Richard Mortimer, Jonathan Evans, Geoff Hudson, Kim
Kippen, Nicole Schulman, Keith Walden, Peter Warrian, Margaret
Hovanec, Tim Madigan, and John Blanpied. I want also to thank sincerely
my colleagues in the History Department at Trent University who sup-
ported a teaching release to allow me to finish writing. Finally, I would be
remiss if I did not thank Adrianna Bakos who eleven years ago first
suggested that I take a look at early modern VD. Sage advice. Despite my
good fortune to have received the help of so many, all responsibility for
errors or oversights rests with me.
My wife Kate endured the trials of completing this book with
immeasurable grace. Her smile makes it all worthwhile. I pledge the same
support to her work.
I owe the greatest debt to my parents, Louis and Patricia Siena, whose
support means more to me than they will ever know. I can only guess how
many times they have had to report to perplexed family and friends that
“Kevin is still studying syphilis.”They gave me the drive to aim high and the
humor to keep things in perspective. I dedicate this book to them, with love.
INTRODUCTION
INSTITUTIONS AND EXPERIENCES
The Admission of Venereal Patients . . .[is] a Subversion of the
Charity, or a Misapplication of the Money given in trust for the
Poor. . . the Society [has]constantly rejected Venereal Patients for
the very reason of Being Venereal.1
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 mod-
ern 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 litera-
ture, analyzing the various meanings that early modern doctors, artists, and
playwrights attached to sexual infection.3Yet early modern institutional
care has received rather less attention. Robert Jütte has identified the area
as a notable gap in the literature and called for further research. This study
hopes to add to Jütte’s work on Germany and that of Jon Arrizabalga,
John Henderson, and Roger French on Italy.4
1