Sexually-transmitted diseases were rife: the principal ones were syphilis – the pox – the longer-term effects of which were still not fully appreciated, and gonorrhoea – the clap – which was somewhat less pernicious, but could have deleterious later effects, and could cause sterility in women, who might not even know they were infected.
There were a number of other genital afflictions around but in the absence of reliable diagnostic methods, even syphilis and gonorrhoea might be mistaken for one another and the local sore of soft chancre believed to be syphilitic.
Men might endeavour to protect themselves from infection by employing a baudruche, or condom, made of animal gut. These were individually handmade, and consequently expensive, but were reusable.
The main treatment employed for syphilis (and anything that looked as if it might be syphilis) was mercury, applied until it produced copious salivation. While this did do something to ameliorate the symptoms of the secondary stage of syphilis, and possibly retard the progress of the disease, it did so at the cost of metallic poisoning and very obvious signs of having undergone the treatment such as hair loss and discolouration of the gums. The treatment was also prolonged. This opened up the opportunity for quacks to offer rapid and discreet treatment without mercury.
The baudruche could also, of course, be used for contraception. There was subcultural knowledge in the sexual underworld of various forms of contraception, including the spunge as employed and advocated by Clorinda, but by the early decades of the nineteenth century there were increasing arguments in radical circles for the use of prudential checks on conception within marriage. The youthful John Stuart Mill was arrested for distributing pamphlets on the subject.
Abortion, though only after quickening, had been criminalised by Lord Ellenborough’s Act, 1803. There were numerous traditional preparations to ‘bring on the courses’ of greater and lesser efficacy and greater and lesser dangerousness. It was the purlieu of traditional female knowledge rather than elite medical practice.
Childbirth was risky and maternal mortality was high, but the rate had declined significantly since the seventeenth century. Irvine Loudon, in his classic work Death in childbirth: an international study of maternal care and maternal mortality,1800-1950 (Oxford University Press, 1992), indicates that it was by no means the leading cause of death even among the most at-risk age group of women. There were many women who survived bearing large numbers of children, including Queen Charlotte, wife of George III, who bore him 15 children, 13 of whom survived. However, a particularly grim instance of a fatal accouchement was that of Princess Charlotte, the daughter of the Prince Regent, who died aged 21 after giving birth to a stillborn son.
While the vast majority of women would have been attended in childbirth by midwives, there were increasing numbers of ‘man-midwives’ with pre-existing training as surgeons, in elite practice. Birth normally took place at home, but there were already a few lying-in (maternity) hospitals in London.
L.A. Hall, FRHistS