Abstract
AbstractThis article provides for the first time a robust quantitative estimate of the amount of syphilis infection in the population of London in the later eighteenth century. A measure of the cumulative incidence of having ever been treated for the pox by the age of 35 is constructed, providing an indicator of over 20 per cent syphilitic infection. The principal primary sources are hospital admissions registers, augmented with an analysis of London's workhouse infirmaries. A range of potentially confounding factors are taken into account, including the contemporary conflation between syphilis and other sexually transmitted infections, patients who shunned hospitals in favour of private treatment, possible double‐counting of patients, institutional patients who may have hailed from outside London, and the complexity of establishing what should constitute the ‘at‐risk’ population of London for this period. Cultural and medical historians have demonstrated considerable pre‐occupation with venereal disease in the texts of the eighteenth century, while demographic and epidemiological historians, lacking any quantitative evidence, have tended to ignore the disease. This article can now demonstrate for the first time just how extensive syphilis was likely to have been and, by doing so, offer an original contribution to major debates in the history of sexuality and the demography of early modern London.
Highlights
This article provides for the first time a robust quantitative estimate of the amount of syphilis infection in the population of London in the later eighteenth century
His diary, which records up to 19 episodes of venereal disease, most contracted through commercial sex transactions, rather than from adulterous or extra-marital liaisons, suggests there was a considerable amount of venereal disease (VD) circulating in the late Georgian metropolis.[1]
Our results must necessarily be treated as only estimates, their implications are potentially significant and diverse
Summary
Sources: LMA, H1/ST/B3/1–8, St Thomas’s Hospital Admissions Registers, 1773–89 (surviving registers cover 207 weeks of data spread across these 17 years); LMA, Guy’s Hospital Admission and Discharge Registers, H9/GY/B4/4 and H9/GY/B4/6, 1770, 1780 (two complete years). 42 At St Marylebone, London’s largest parish with a massive 600-bed workhouse by 1777, there is direct evidence that about 30% was devoted to infirmary patients and that there were multiple venereal wards extant, but there is no precise information on the latter’s size; Bye Laws, Rules, Orders and Constitutions, p. Given that patients were treated in the foul wards for an average of 42 days, Howard’s testimony would imply that St Thomas’s was treating 695 patients per year in September 1788 if there had been 100 per cent bed occupancy.[46] we have the admissions registers for St Thomas’s during the period 1788–9 These indicate that during an eight-month period at that time, immediately following Howard’s visit, 491 patients were admitted, which indicates an actual, achieved annual occupancy rate of 90.4 per cent.[47] It would seem to be a safe, conservative procedure to assume an occupancy rate for these 185 beds in the workhouse infirmaries of no lower than 80 per cent.
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