Joan Sherwood, Infection of the Innocents: Wet Nurses, Infants, and Syphilis in France, 1780–1900, McGill-Queen's/Associated Medical Services Studies in the History of Medicine, Health and Science, 37 (Montreal: McGill-Queen's University Press, 2010), pp. xiii + 214, $75.00, hardback, ISBN: 978-0-7735-3741-5.

Abstract

Until the advent of safe artificial feeding, a good wet-nurse made all the difference to the survival of an infant whose own mother was unable to breastfeed. However, as detailed historical examination has shown over the past thirty years, the practice of wet-nursing was once widespread and by no means limited to emergencies. George D. Sussman’s ground-breaking work in France brought out both the economic contribution that routine wet-nursing made to both nurses and mothers and its association with different attitudes to infants; interpretations taken up by other authors, particularly by Valerie Fildes in her comprehensive overview of the topic from classical Greece to the present. However, although there is currently increasing interest in medical involvement in wet-nursing, there has been little examination of a small but significant aspect, the transfer of infection between nurse and nursling, the theme of Joan Sherwood’s new book. Infection of the Innocents uses detailed examinations of the records of the Vaugirard Hospital in Paris, and of nineteenth-century legal cases, to focus on a failed experiment to treat congenital syphilis by mercurialising breastmilk and its long-term impact on French medicine. Infection of the Innocents falls into two parts. The first locates the establishment of the Hospital in 1780 within contemporary understanding of venereal disease and its management. Government-sponsored, it was founded specifically to discover whether infants with congenital syphilis could be cured by being fed the milk of syphilitic nurses treated with mercury, then believed to be an effective treatment. As such, it was envisioned primarily as a ‘clinical workshop’, and displayed a stark attitude towards its patients, in contrast to contemporary British voluntary hospitals. Outside, women typically enjoyed an independent role in both healing and childcare, but inside Vaugirard, Sherwood stresses they were seen only as the ‘technology’ of cure, under strict medical control and following an almost military regime. Nonetheless, she argues that some moral rehabilitation was still expected; citing the Hospital’s belief that supervised wet-nursing would encourage maternal feelings and high-quality care. Sadly, the extremely high mortality among foundlings led rather to despair and even suicide among their young nurses, feelings presumably compounded by their own ill health. Detailed analysis of all patients from the first and final years of the Hospital’s life in fact demonstrates wide variation in outcome – there was a contrasting higher-than-average survival rate among children cared for by their own mothers. However, this reader would have appreciated both a firmer guiding hand through the data, and the making of closer connections with events outside the Hospital. By 1790, the revolutionary government considered the experiment a failure, and Vaugirard Hospital was closed. Yet its unsuccessful treatment lived on, and the second part explores the changing attitudes among the medical profession revealed through a number of compensation cases brought against their employers by wet-nurses infected with syphilis by their nurslings, some of whom had also been treated with mercury without their knowledge or consent. Here, Sherwood illustrates developing medical ethics, arguing that, although initially the doctor felt loyalty only to the family that retained him, and thus might not inform the wet-nurse either of the infant’s condition or the nature of any medicines she was asked to take, by 1870, he was considered to have an over-riding duty of care towards public health in general. Such arguments combine with the earlier exploration of the Hospital to suggest that, while on the surface Infection of the Innocents describes a minor aspect of both wet-nursing and venereal disease, it nevertheless makes a much deeper contribution to the history of medicine.