Wages of Sin: Sex and Disease, Past and Present

\ The Wages of Sin\ \ \ \ Sex and Disease, Past and Present\ \ \ \ By Peter Lewis Allen\ \ \ University of Chicago Press\ \ \ Copyright © 2003\ \ \ University of Chicago\ All right reserved.\ \ ISBN: 0-226-01460-6\ \ \ \ \ \ Chapter One\ \ \ The Just Rewards of Unbridled\ Lust:\ Syphilis in Early Modern Europe\ Shortly after Christopher Columbus and his sailors returned from their\ voyage to the New World, a horrifying new disease began to make its way\ around the Old. The "pox," as it was often called, erupted with dramatic\ severity. According to Ulrich von Hutten (1488-1523), a German knight,\ revolutionary, and author who wrote a popular book about his own trials\ with syphilis and the treatments he underwent, the first European\ sufferers were covered with acorn-sized boils that emitted a foul, dark\ green pus. This secretion was so vile, von Hutten affirmed, that even the\ burning pains of the boils troubled the sick less than their horror at the\ sight of their own bodies. Yet this was only the beginning. People's flesh\ and skin filled with water; their bladders developed sores; their stomachs\ were eaten away. Girolamo Fracastoro, a professor at the University of\ Padua, described the onward march of symptoms: syphilis pustules developed\ into ulcersthat dissolved skin, muscle, bone, palate, and tonsils-even\ lips, noses, eyes, and genital organs. Rubbery tumors, filled with a\ white, sticky mucus, grew to the size of rolls of bread. Violent pains\ tormented the afflicted, who were exhausted but could not sleep, and\ suffered starvation without feeling hunger. Many of them died.\ The public was appalled by this scourge. Physicians too, von Hutten\ reported, were so revolted that they would not even touch their patients.\ As in the earlier Middle Ages, divines quickly announced that the\ extraordinary sins of the age were responsible for the new plague; others\ blamed the stars, miasmas, and various other causes. Barrels of medical\ ink were spilled on the question of where the disease had come from.\ Treatments, preventions, and cures were sought. The idea of infection\ began to be taken far more seriously than it ever had before. Hospitals\ transformed themselves in response to the new plague-sometimes for the\ better, but often for the worse, as when, in fear, they cast their\ ulcerated patients out into the streets. Most of all, people continued to\ follow their old ways: in the face of this new threat, they castigated and\ persecuted the sick. As infection spread, so did fear; and where fear\ went, blame followed close behind.\ Perhaps more than any other disease before or since, syphilis in early\ modern Europe provoked the kind of widespread moral panic that AIDS\ revived when it struck America in the 1980s. Syphilitics were condemned\ from pulpits and from chairs in university medical schools. John Calvin\ (1509-1564) announced that "God has raised up new diseases against\ debauchery"; medical authorities willingly agreed. The greatest English\ surgeon of the sixteenth century, William Clowes (1540-1604), who counted\ Queen Elizabeth among his patients, announced to his colleagues and\ patients that syphilis was "loathsome and odious, yea troublesome and\ dangerous, a notable testimony of the just wrath of God." A century later,\ a French physician, M. Flamand, summed up this point of view concisely by\ announcing that venereal diseases were "the just rewards of unbridled\ lust." Disease commonly invited theological speculation, but in the case\ of syphilis people felt that little speculation was necessary. Just as\ fornication opened the door to the pox, so the pox opened the door to\ chastisement and blame.\ Motivated by these fears, panicky towns and hospitals barred their gates\ against syphilitics. Within two years of the first reported cases, cities\ from Geneva to Aberdeen evicted the pox-ridden. Often, city fathers blamed\ prostitutes for the disease, and some threatened to brand their cheeks\ with hot iron if they did not desist from their vices. Sexual morality was\ becoming stricter, and prostitutes were usually condemned far more\ savagely than the men who used their services.\ What was more extraordinary, however, was that hospitals refused to admit\ syphilis patients. Hospitals in early modern Europe were charitable\ institutions, designed to provide care and shelter to the sick poor. The\ most famous of them, the Paris Hotel-Dieu prided itself, with one single\ exception, on the breadth of its generosity. This hospital boasted that it\ "receives, feeds, and tends all poor sufferers, wherever they come from\ and whatever ailment they may have, even plague victims-though not if they\ have the pox." The Hotel-Dieu expelled its syphilitic patients in 1496,\ and, after relenting briefly, expelled them again in 1508. Two years after\ that, another Parisian hospital shunted its pox victims off to the\ stables, to sleep with the animals. Many cities threw the poxy poor into\ the leper houses that for years and years had housed only ghostly\ memories; Toulouse kept its infected prostitutes in a ward that was little\ more than a high-security prison. Two infamous hospitals in Paris, Bicetre\ and the Salpetriere, had patients "piled upon one another," in the words\ of historian Michel Mollat, "like a cargo of Negroes in an African slave\ ship." And another, the Petites Maisons, which warehoused syphilitics and\ the mentally ill from the 1550s until the 1800s, became known as the\ "pox-victims' Bastille."\ Fear of contact was one reason for this behavior. Even more than this,\ however, the sick-like lepers-were often reviled because people believed\ that they had brought their torments upon themselves. Some pundits, early\ on, announced that blasphemy was the vice that had called down this new\ torment from heaven, but most often syphilis was attributed to the sin of\ lust. This was certainly a logical assumption: soldiers and prostitutes,\ traditionally associated with sexual license and moral disorder, were\ among the first victims, and the connection became even closer when people\ noticed that the disease's first sores often turned up on the genital\ organs. The loathsome symptoms were taken as signs that the sick housed\ debauched and sinful souls. This reasoning stood behind many of the\ cruelties that individuals, doctors, hospitals, priests, ministers, and\ even entire towns and cities inflicted on people with the pox, as the\ stories in this chapter will show.\ The Source of This Distemper\ Horror was the first emotion the pox provoked among the general public,\ but what the medical community first felt was confusion. Was this an old\ disease, and, if so, which one? If it was new, what did that say about the\ state of medical knowledge? And in any case, how could physicians make\ sense of it?\ Medical research in the twentieth century mostly takes place in the lab;\ in the Renaissance, though, researchers went first and foremost to the\ library to see what the ancients had said. The problem, however, was that\ it was not clear that in this case the ancients had anything useful to\ offer. Nothing the Greek and Arabic authorities had described seemed very\ similar to the cases turning up in increasing numbers on the physicians'\ rounds and in the streets, and so it was hard to affirm that the old\ remedies would do any good.\ If the pox was a new disease, how had it arisen? Some cast the blame on\ supernatural powers-the planets, the stars, God, or even witches.\ Galenists claimed that the pox came from corrupted air, or even, like\ lovesickness, from an excess of black bile. Some said the disease was\ God's punishment for sin; others attributed it to the recent and risky\ voyages to the New World.\ The theories that tied the disease to the Americas were the most\ innovative, since they focused on the new idea that diseases could travel\ from one person to another. (They may also have been the most accurate:\ many scientists today believe that the New World was the source of the\ syphilis bacterium, or of a new strain or cofactor that triggered the\ epidemic of the 1490s.) In a quirky 1672 screed entitled Great Venus\ Unmasked, the English writer Gideon Harvey looked backward to argue that\ it was Columbus's Neapolitan sailors who had acquired this "new pretty\ toy." With it, he reasoned, they had infected the prostitutes of their\ native city, which was under siege by the French in 1494-1495: when\ provisions in Naples ran out, wrote Harvey, the whores crept over to the\ besiegers' camp, and offered their services to the French soldiers. If the\ Neapolitan prostitutes were hungry for food, Harvey explained, the French\ soldiers were "almost starved for want of women's flesh, which they found\ so well seasoned, and daubed with mustard, that in a few weeks it took 'em\ all by the nose."\ Other exotic theories abounded. One Leonardo Fioravanti (1518-1588)\ claimed that the French soldiers became sick because they had devoured the\ rotten carcasses of their dead enemies. Some said the malady had been bred\ when a French leper had sex with a Neapolitan whore. Others said soldiers\ became sick from drinking Greek wine adulterated with lepers' blood; still\ others blamed the "entailed manginess" of the French, who-as Harvey\ reminded his English readers-"are slovens in their linen." One anonymous\ author even suggested that syphilis was spontaneously generated by\ promiscuous sex.\ This wild proliferation of theories showed that nobody really knew where\ the pox had come from; it also showed that people were deeply troubled by\ it, and thought that something had gone gravely amiss in the world to\ provoke such a strange and awful evil. Their confusion and anxiety were\ also revealed by the names that people gave the new arrival. The name most\ commonly used today, syphilis, came from an Italian poem, written in 1530,\ which traced the disease to a punishment inflicted by Jupiter on a\ fictional character named Syphilus, an impious shepherd. More commonly,\ however, the pox was called after whichever country people wanted to blame\ for the disease. To the French, it was the mal de Naples, the sickness\ from Naples; to many others, it was the morbus gallicus, the French\ disease. But also accused were the Americans, the Mexicans, the Spanish,\ the Germans, the Poles, and the Portuguese. Everyone, observed the astute\ author of A New Method of Curing the French-Pox (1690), "to excuse\ himself, is forward to ascribe to his neighbors the source and original of\ this distemper."\ Regardless of its geographic origin, people quickly began to notice that\ the pox traveled from one person to another. They sometimes blamed\ transmission on common and morally innocuous practices-drinking from a\ common cup, kissing friends in church, following a syphilitic comrade on\ the latrine. But from 1495 on, the route of transmission people talked\ about most was sex. Von Hutten noticed that men in their sexually active\ years were much more susceptible to the French disease than boys or the\ elderly; soldiers and prostitutes remained highly suspect. As early as\ 1504, infection became grounds for breaking off engagements, and even\ saying that someone was infected was enough to provoke a lawsuit. Syphilis\ was well on its way to becoming a "venereal" disease, and a public mark of\ shame.\ * * *\ \ Worse than the Disease\ Treatments for the pox were often more excruciating than the disease's\ symptoms. According to their place in society, early modern Europeans\ received varying types of medical care, but all were problematic. The rich\ were seen by physicians, whose treatments ranged from the useless to the\ deadly; the middle classes could consult self-help books, or hire\ barber-surgeons to torture them with knives, drills, and white-hot cautery\ irons. The poor had to deal with charity hospitals. If admitted to these\ institutions, they were housed and fed, but they also shared beds and\ germs with all the other diseased patients in their wards, and often\ received little medical help; if they were refused admission, they\ suffered and died in the streets. It was hard to say which was worse-to\ languish untreated, as syphilis ate its way through one's organs, or to be\ tortured by poisonous and savage remedies administered by physicians and\ surgeons who often believed that their job was to punish their patients\ for their sins. To have syphilis in early modern Europe was a torment and\ a tragedy for rich and poor alike.\ Doctors did not use harsh remedies at first, perhaps because the disease\ had not yet earned real opprobrium, or perhaps because these early cures\ derived from the Galenic model, which, whatever its limitations, at least\ employed fairly gentle methods. Physicians who viewed the disease as a\ humoral imbalance recommended baths, chicken broth, bloodletting, syrups,\ the milk of a woman who had given birth to a daughter, and even that old\ standby used for curing lovesickness, sexual intercourse. (This last piece\ of medical foolishness, fortunately, did not garner many endorsements.)\ Others warned of the dangers of promiscuous sex, particularly with\ prostitutes; some even proposed safer sex techniques for preventing the\ pox, such as washing the genitals, before or after intercourse, in hot\ vinegar or white wine. It probably took physicians a while to realize that\ these mild remedies, while doing no harm, did little good, either.\ Syphilis was new, after all, and nobody knew at first that the disease\ passed through primary, secondary, and tertiary stages, each with distinct\ symptoms and with quiescent periods in between. Eventually, though,\ physicians did realize that they were doing their patients no particular\ service with remedies of this sort.\ Gradually doctors came to understand that, once acquired, syphilis tended\ to persist, and gradually its severe symptoms and venereal taint attracted\ much more aggressive medical treatment. Some doctors, for example,\ injected drugs directly into male patients' infected urethras. A character\ in the writings of the Dutch humanist scholar Desiderius Erasmus\ (1469-1536) spoke in favor of binding female syphilitics in chastity\ belts, and of deporting, castrating, and even burning pox-ridden men\ alive. Surgeons treated racking syphilis headaches by trepanation, the\ ancient practice of boring holes into the skull. Oozing ulcers in skin and\ bone were cauterized with fearsome, white-hot irons. Mild remedies quickly\ gave way to these treatments, which at least showed that doctors were\ doing something their patients could feel.\ These Bitter Pains and Evils\ Bleeding, bathing, cautery, and herbs were used now and then, but, most\ often, physicians fought syphilis with two important drugs: mercury, and\ the wood of the Central American guaiac, or lignum vitae, tree. Ulrich von\ Hutten was well acquainted with these, having suffered through the\ appalling mercury vapor treatment eleven times in nine years. As he\ explained the process in his book, patients were shut in a "stew," a small\ steam room, for twenty or thirty days at a time.\ \ Continues...\ \ \ \ \ \ \ Excerpted from The Wages of Sin\ by Peter Lewis Allen\ Copyright © 2003\ by University of Chicago.\ Excerpted by permission.\ All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.\ Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.\ \

Illustrations Acknowledgments Introduction1. Sex by Prescription: Lovesickness in the Middle Ages2. To Live outside the Camp: Medieval Leprosy3. The Just Rewards of Unbridled Lust: Syphilis in Early Modern Europe4. A Broom in the Hands of the Almighty: Bubonic Plague5. The Heinous Sin of Self-Pollution: Medicine, Morals, and Masturbation6. AIDS in the U.S.A.Conclusion: The Week Nobody Died Notes Bibliography Index

\ Margaret WertheimThe catalyst for Allen’s book was a personal one—the death of a gay lover from AIDS. Attempting to make sense of his beloved’s untimely passing and the tidal wave of AIDS deaths sweeping through the gay community, Allen set out on a historical quest. Seven years later, the result is a beautifully wrought...volume.\ — Los Angeles Weekly\ \ \ \ \ Publishers Weekly - Publisher's Weekly\ A gay man who spent the early years of the AIDS epidemic pursuing a graduate degree in comparative literature--and watching his ex-lover die--Allen has written an engaging contribution to the field of AIDS scholarship. The author (who, after teaching literature at Princeton and USC, is now getting an MBA in health care management at Wharton) traces the history of Western ideas concerning the links between what they saw as sin, sickness and death from the medieval era onward. In the Middle Ages, he observes, diseases such as leprosy, syphilis and bubonic plague--each of which gets a chapter--were seen as God's punishment for sinners; physicians were torn between their duties as healers and their duties as Christians not to obstruct divine justice by aiding the sufferers. This conflict persisted but, according to Allen, took a strange turn after about 1700, when doctors began to believe that one particular sexual practice--masturbation--brought down a righteous medical vengeance upon those who practiced it. Allen looks at how the remnants of these ideas about sex, disease, sin and death have shaped the more recent debates about illness--especially AIDS. He details the public health conflict between those who want to halt the spread of the disease and those who want to see divine justice visited on homosexuals and drug users, praising folks such as the former Surgeon-General C. Everett Koop Alternately thoughtful, passionate and political, Allen has produced a stimulating work on a sensitive topic. (June) Copyright 2000 Cahners Business Information.\|\ \ \ Library JournalEver since Adam and Eve were cast out of the Garden of Eden, Western religious traditions have linked sex to suffering. Allen (The Art of Love: Amatory Fiction from Ovid to the "Romance of the Rose"), uses techniques of literary criticism to trace this relationship from the medieval diagnoses of "lovesickness" (a type of depression) to the AIDS crisis of our own time. Allen also examines the cultural context of leprosy, syphilis, bubonic plague, and the 19th-century fixation on the evils of masturbation, exhaustively searching through medical and theological texts and illustrations to build a fascinating and sometimes shocking case. Allen's narrative, however, could have been greatly strengthened by attention to women's particular experiences of sexuality, pregnancy, childbirth, and sexual assault. For example, bitter disputes surrounded the Victorian use of chloroform during labor, since many theologians viewed pain in childbirth as Eve's daughters' punishment for her original sin. In spite of Allen's omissions, his book provides an important perspective for academic and medical libraries.--Kathy Arsenault, Univ. of South Florida at St. Petersburg Lib. Copyright 2000 Cahners Business Information.\\\ \ \ \ \ BooknewsAn independent scholar details how the religious attitude that "God has raised up new diseases against debauchery" has been reinforced by Western society and medicine, from medieval "lovesickness" and plagues to AIDS. Illustrations include anti-masturbation devices. Annotation c. Book News, Inc., Portland, OR (booknews.com)\ \