PART THE THIRD in the lecture series is about syphilis. The 17th century was full of disease, and this was one of the big ones. And so, with no further ado:
Syphilis:
Galenic Theory
* Pox, like all disease, resulted from humoral imbalances.
* Phlegm was generally held as most important in pox. Therefore, although some advocated bleeding, the promotion of spitting and sweating were the most accepted therapies.
* Guaiacum was one therapy.
Guaiacum:
* Hard wood from the Americas
* Popularized by Ulrich von Hatten in 1519.
* Augsberg banking house of Fugger controlled the marketing of guaiacum and heavily promoted von Hatten and his therapy increased the price of guaiacum.
* Guaiacum was hung in churches, homes, etc., as objects of veneration.
to use guaiacum as treatment for syphilis:
* Grind the wood.
* Boil in water.
* Drink.
* Lock yourself in a heated, sealed room or chamber, and sweat out the ill-humours (phlegm).
However, the most common treatment for syphilis was mercury:
* Earliest therapy against syphilis.
* Long tradition in Arab medicine as therapy for a wide range of skin afflictions.
* Popularity waxed/waned, but remained the most generally widespread therapy through the 19th century.
* Appealed to Galenists, since it produced copious saliva, thereby expelling phlegm.
* This is a classic sign of mercury poisoning.
Syphilis in the 16-18th century:
*Syphilis was accepted as disobedience to the laws of religion and morality, and those who suffered received their just deserts.
*From the onset of the epidemic, arrest and quarantine of infected persons, prostitutes, foreigners and other high-risk persons was practiced.
*Prostitution was variably outlawed and subjected to regulation.
*Whereas the upper strata could call upon specialized care givers and/or discreet therapy (such as Van Swieten's liquor--mercury and brandy), the poor were treated in public facilities designed for those of "moral and physical decrepitude."
*Punishment was both explicit and implicit in therapy
*Prior to 1701, it was a matter of public policy to have women whipped unless she could prove infection from her husband or a soldier.
Louis Mercier:
*Tours of public treatment facilities were encouraged for children to show what happens to those unable to control lacivious passions.
Quetel:
*"From at least the 16th century, the tendency was to avoid giving advice regarding individual prophylaxis on the grounds that it was not wise to encourage sexual excesses by guaranteeing those who performed them impunity sic from venereal disease."
To thinkers of the Enlightenment, syphilis threatened to undermine the view of a new world based on science and reason.
Congenital syphilis was the leading killer of infants at most Parisian hospitals.
Diderot and other political theorists recognized the importance of healthy children to a strong and progressive state.
1780: Vaugirard Hospital
*Dedicated to the therapy of congenital syphilis.
*Designed to safely and efficiently deliver state of the art care (i.e., mercury) to infants.
*Pregnant syphilitic women were brought from other public institutions, treated with mercury, and then served as wet-nurses to newborns.
*Marked the first attempt by a government to deal with syphilis as a demographic and medical problem, rather than moral or religious.
*Closed in 1790
Conclusions of a review committee:
*371 lives saved at a cost of 500,000 livres
*"Of those, one-half to two-thirds would not reach an age to be of service to society".
*"Judging from the immoral and debased output from our hospices today, the type of life saved was not worth the expense."
