Itch, Clap, Pox: Venereal Disease in the 18th-Century Imagination 
by Noelle Gallagher.
Yale, 288 pp., £55, March 2019, 978 0 300 21705 6
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‘When I came​ to Louisa’s, I felt myself stout and well, and most courageously did I plunge into the fount of love, and had vast pleasure,’ James Boswell wrote in his diary on a winter’s night in 1763, after an assignation with a beautiful Covent Garden actress. But the next day ‘came sorrow. Too, too plain was Signor Gonorrhoea.’ The arrival of the Signor was heralded by ‘damned twinges’, ‘scalding heat’ and the excrescence of ‘deep-tinged loathsome matter’. ‘I rose very disconsolate, having rested very ill by the poisonous infection raging in my veins and anxiety and vexation boiling in my breast. What! thought I, can this beautiful, this sensible, and this agreeable woman be so sadly defiled?’ Louisa refused to apologise and even hinted that she might not be the guilty party. ‘Thus ended my intrigue with the fair Louisa,’ Boswell wrote, ‘from which I expected at least a winter’s safe copulation. It is indeed very hard.’ Within a few months he had encountered a ‘fresh, agreeable young girl’, again without the protection of his ‘armour’.

Boswell was plagued by venereal disease and thought his bouts were worse because ‘I am of a warm constitution: a complexion, as physicians say, exceedingly amorous, and therefore suck in the poison more deeply.’ Venereal disease was ubiquitous in London during the 18th century and syphilis in particular reached epidemic levels. Contemporary commentators warned that the ‘clap’ (gonorrhoea) and the ‘pox’ (syphilis) were rife; towards the end of the century almost a third of the patients in St Thomas’s were in its ‘foul wards’, for those suffering from pox symptoms. Doctors prescribed mercury pills; home remedies were equally alarming. At least one vigilant madam took to scrubbing out her prostitutes: ‘She us’d often to say of her Girls, These Chitty-Faces make me undergo more Fatigue than a Vintner’s Boy, for I scower their Insides as clean, every Night, as if I made use of Shot and a Bottle-Brush.’

Gonorrhoea and syphilis were believed to be successive stages of the same infection rather than two separate diseases. The clap could be asymptomatic, but more usually involved a feeling of burning on urination or skin contact (leading to jokes about women having to deal with penises as ‘hot’ as ‘curry’d and spiced’ sausages) and painful swelling in the testicles. The appearance of ‘shankers’ (ulcers) on the body meant the pox, which lived up to its name by producing – sometimes after a delay of a few weeks or months – suppurating, vile-smelling pocks; muscle and bone pain; fatigue and a high fever. All these things went away eventually, and it was easy to assume that the disease had been cured; but for the unlucky ones it came back with a vengeance in a final tertiary phase, eating away at bones and muscles, collapsing the bridge of the nose, and leading to blindness, stroke and dementia. It also stayed in the family. Children ‘born of infected parents’ were believed to be prone to all kinds of illness – rickets, scurvy, spinal deformity – and could pass on their symptoms with interest to their own offspring.

None of this prevented the pox from having a certain glamour. During the Restoration and the early 18th century, the fashionableness of (male) sexual promiscuity made bodily evidence of it fashionable too. Bernard Mandeville, who never avoided controversy, argued in his essay ‘A Modest Defence of Publick Stews’ (1724) that ‘Whoring’ was ‘now-a-days mistaken for Gallantry and Politeness’ and any resulting disease considered a badge of honour. ‘A hale, robust Constitution is esteem’d a Mark of Ungentility; and a healthy young Fellow is look’d upon with the same View, as if he had spent his Life in a Cottage.’ Young men on the Grand Tour contracted the pox in brothels in France and Italy and wrote home as if it were all part of the adventure (‘the whole account of their travels is generally no more than a journal of how many bottles they have drunk, and what loose amours they have had,’ a newspaper commented sourly). France was thought to be ‘the Hotbed to our English Youth, where they are immaturely ripened, and therefore soon become rotten and corrupt at home’. ‘The air of the Southern parts of France is warm, and impregnating,’ a gentlemen tourists’ guide of 1766 warned, ‘consequently the women extremely amorous, and the majority of them have it in their power … to confer upon you a certain favour, which if it does not cost you your life, may stick by you all your days.’

The pox was also considered a badge of honour because it was associated with soldiers and sailors (men who were away from their wives for long periods and thought more likely to visit whorehouses and risk the consequences). Symptoms of venereal disease figured as ‘battle scars’ or ‘war wounds’; suffering in war was connected with suffering in love. Even doctors played up the metaphors. The physician John Sintelaer wrote a long treatise on venereal disease called The Scourge of Venus and Mercury (1709), in which he discussed the case of a ‘certain great Officer in the Army’ who ‘had receiv’d a very deep Wound in the Wars of Venus’, and counselled ‘young, raw, unexperienc’d Soldiers’ in those wars not to panic if ‘after an illegal Coition with a suspicious Woman’ they noticed a ‘small Scratch’ or ‘insignificant Pimple’. Condoms – thought of as keeping men safe and ensuring the viability of the prostitution trade – also had military associations because they were said to have been invented by Colonel Condom, doctor to Charles II. Those who wanted to stop the spread of venereal infection used the connection to present protected sex as more heroic than unarmoured. An anonymous mock-epic of 1744, The Machine, or Love’s Preservative (‘In Imitation of Homer and Virgil, and Dryden and Pope’), took the colonel as its hero: ‘In cundum’s Praise/I sing.’ The poem attacks those stupid enough to venture ‘all unarm’d to th’ hostile Field’:

Happy the Man, in whose close Pocket’s found,
Whether with Green or Scarlet Ribbon bound,
A well made cundum; he nor dreads the Ills
Of Cordees, Shanker, Boluses, or Pills;
But arm’d thus boldly wages am’rous Fight
With Transport-feigning Whore, in Danger’s Spight.

Mock-epics aren’t written about real wars, so the treatment here is intended to stick a pin in its subject as it inflates it. Like John Durant Breval’s The Progress of a Rake (1732), another poem in ten cantos which compares the grisly suicide of a young syphilitic to the noble death of Cato, it exposes the absurdity of the comparison and the forms of masculinity it props up.

Women had their own heroic disease narratives. Memoirs of well-known prostitutes and bawds celebrated their protagonists’ survival skills as their feeble clients fell down dead around them. In a Life of the Covent Garden brothel-keeper Jane ‘Mother’ Douglas, Genuine Memoirs of the Late Celebrated Jane D****s (1761), the narrator describes with glee the sufferings of a gentleman foolish enough to pick out ‘one of her French girls’ and trust her with the condom:

He soon afterwards found himself p––––d in the most shocking manner imaginable; and having unfortunately fallen into the hands of an unskilful surgeon, he lost the part which he thought so well secured by the instrument above-mention’d. It was cut off inch by inch, and his groin being covered with buboes, he one day, in the height of misery, took a knife and cut and gash’d himself in a most terrible manner.

In Charles Walker’s Authentick Memoirs of the Life, Intrigues and Adventures of the Celebrated Sally Salisbury (1723), one of Sally’s ‘gallants’ encounters an even worse fate: marriage. A French baron newly arrived in London and eager to ‘Engage in the Field of Love with an English Woman’ has the ‘Damn’d ill Luck to be introduc’d to the Heroine of the History’ and suffers the usual consequences. After he’s cured, he returns to her in a rage, bringing an interpreter to help with the English: ‘You Damn’d Confounded Pocky Whore, I am glad we are met, for now will I give you as many Stripes as I’ve taken Pills, Bolus’s, and other Hellish Slip-slops on your account.’ Sally escapes his uplifted cane by shedding ‘sham Tears’ and claiming she was infected without her knowledge by a previous gentleman who also took her virginity. In an ingeniously stage-managed series of events, the credulous baron is tricked into marrying a local gardener’s daughter in the belief that she is a young lady of quality with jewels and a great fortune; the debts the girl incurs to Sally in getting herself ‘Rigg’d handsomely’ for the role are passed on to her new husband; and he ends up ‘in a Starving Condition’ in the Fleet Prison.

These inversions – high brought low; low elevated (temporarily) high; the triumph of the lesser over the greater – are characteristic of the unsettling social narratives the pox or the clap could be used to tell. As Noelle Gallagher shows in her elegant book, venereal disease was intellectually and imaginatively useful in this period: the obscurity, changeability and shiftiness people saw in its symptoms could be turned outwards. As a metaphor the pox had a rare cultural penetration. Its signs and symbols – the marked cheek; the collapsed nose; the quack doctor with his pills and tonics; the badly patched prostitute – were the lexicon of political cartoons and cheap jestbooks, and could be used to indicate pressure points and signs of weakness in social and economic systems.

Sex could be likened to the economy by way of prostitution, which connoted any undertaking that required dishonouring or corrupting oneself for financial gain. Sex, prostitution and the economy were all connected by venereal disease, which was spread by cash but also spread like cash – circulating, multiplying, creating debtors, being entailed and passed on to heirs. The poet Richard Ames (about whom little is recorded save that ‘wine and women were the great bane of his life and happiness’) put it baldly: ‘For while he nibbles at her Am’rous Trap,/She gets the Mony, but he gets the Clap.’

The structural resemblances between economies and diseases allowed writers to present commercial exchange as rotten and the new monied classes as pox carriers. In ‘The Play-House: A Satyr’ (1689), Robert Gould attacks not only actors and prostitutes but also the surgeons who ‘heap up an Estate by our Debauches’, participating in the pox economy by charging ruinous amounts for ‘cures’: ‘Expensive Malady! where people give/More to be kill’d than many wou’d to live!’ (The bills advertising the wares of venereal disease ‘specialists’ in satirical prints – an advert for Dr Richard Rock’s pills on a billboard in Hogarth’s Four Times of Day: Morning (1736), for instance – suggest a similar view.) In the ‘moral drama’ Bickerstaff’s Unburied Dead (1743), the greed of the undertakers who deal with poxed corpses points to a connection between rotten money and rotten morals. ‘This fashionable Distemper is a great Loss to us,’ Mr Quicandead observes to Mr Seizecorpse. ‘We can seldom get a Body sound enough for the Surgeons; they object, Rotten Bones will never make good Skeletons.’ Undertakers weren’t the only targets. The spendthrift Prince Regent, notorious for his hedonism, was a living incarnation of the intersection of sex, money, prostitution and disease. In Isaac Cruikshank’s cartoon A Meeting of Creditors (1795) he looks bloated and unhappy, hands shielding his crotch, in the middle of an angry crowd of pock-marked madams waving bills.

Power, access and votes could be paid for, and so prostitution and pox became part of political discourse too. The prince’s Catholic mistress Maria Fitzherbert was depicted in several prints connecting royal access with profligacy and infection. In The King’s Evil (1786), she is opening a package of pox medicine while the prince stands sullenly next to her with a long but drooping sword sticking out from beneath his folded arms. Disease had been used to smear those who got close to monarchs or ministers for at least a hundred years. The most brutal late-17th-century attacks were poetic libels, circulated in manuscript to generate gossip and controversy and in some cases printed in the notorious miscellany Poems on Affairs of State. ‘Portsmouth, that pocky bitch,’ began one piece of 1680 on Louise de Kéroualle, the Catholic duchess of Portsmouth and Charles II’s mistress,

   A damn’d Papistical drab,
An ugly deform’d witch,
   Eaten up with mange and scab.


This French hag’s pocky bum
   So powerful is of late,
Although it’s both blind and dumb,
   It rules both Church and State.

You can take a lot from this – that the long 18th century wasn’t always (or even mostly) polite and sentimental; that its poetry certainly wasn’t – but it’s essentially making a simple connection between political influence and disease. Another libel on ‘the damn’d dirty Dutchess’ calls her a ‘Pickled Pocky Whore’, claims that she smells worse than ‘the thing that beshit us having got the wild squirt’ and likens her to Edward IV’s mistress Jane Shore, who according to a 17th-century ballad died naked by the side of a road: ‘Jane Shore was more wholesome when dead in a Ditch.’ Some refinement is attempted in a poem by the Earl of Dorset on the Countess of Dorchester, James II’s mistress, which gives its target a delicate pseudonym, but the emphasis is still on her ‘Pox’ and ravaged looks. ‘Can any Dresses find a way/To stop the Approaches of Decay,/And mend a ruin’d Face?’

Male​ court favourites were attacked too, particularly if they weren’t English. Syphilis was colloquially referred to as the ‘French disease’, which made it available to xenophobic commentary. Genital scabies, a condition often identified as venereal, was the ‘Scotch itch’, on the basis that the supposed poverty and squalor north of the border created the right conditions for its spread. No one was easier to smear with both the French pox and the Scotch itch than the 3rd Earl of Bute, George III’s childhood tutor who became his prime minister, and was popularly supposed to have ruined the Seven Years’ War for Britain by negotiating an overly generous peace settlement with the French. His ‘doctoring’ of government and the peace translated into opposition prints of a tartan-clad quack prescribing bad medicine, as in The Evacuations: or an Emetic for Old Englands Glorys (1762), which has him gleefully forcing Britannia to spew up her territorial gains into a bucket. His quackery is connected with itchiness and the pox in The Mountebank (1762), in which he’s shown addressing a crowd of eager Scotsmen afflicted with the ‘Gowden Itch’ (greed, or a hunger for gold); the remedy, he tells them, lies in England, from where he’s gathered (or stolen) the ‘Gowden Lozenges’ that ‘cured’ his own itching avarice. The pox comes in here through the glimpse we get of George III’s mother, Augusta, Bute’s alleged mistress and the reason for his privileged access, stage-managing the spectacle from behind the curtains of what looks like a four-poster bed.

A meeting of creditors

The lozenges in this caricature are two things – pills and ingots – but given their elongated shape and the proximity of Augusta’s bed they’re also potentially a third thing. Puns, verbal and visual, are everywhere in representations of venereal disease once you start to see them; they are carriers, circulated and recirculated, bits of language or symbols that have become infected, besmirched. Innuendos start life as a way of avoiding saying something (‘muff’, for instance, which emerged in cant dictionaries at the end of the 17th century), but over time became a way of saying it directly: by the end of the 18th century no one could be in doubt what the presence of a fur muff on a lady in a satirical print signified.

To contemporaries, writing about curried sausages or misfiring pistols was funny in two ways: in the ‘straight’ sense in which a decoded innuendo is funny, and in a secondary sense that came with repeated, playful usage (and had an additional importance in the case of words like ‘sausage’, where the suggestion required no decoding). The phrase ‘Pandora’s box’, for example, used popularly to mean infected vagina – as in Ames’s couplet ‘Aches, Buboes, Shankers, Nodes and Poxes,/Are hid in Females Dam’d Pandora’s Boxes’ – had sufficient amusement value and imaginative appeal that it wasn’t merely a placeholder for the thing it suggested. This is Breval’s description of his young protagonist’s diseased testicles in The Progress of a Rake:

            such Bags of Sorrow,
Pandora might a Box full borrow,
They’d overrun Pandora’s Box
With Plagues, and fill her with a Pox.

‘Bags of Sorrow’ as a metaphor is manifestly absurd, but the reason for picking it becomes clear when we get to her. Since her mythical box contained troubles and sorrows, mentioning ‘Sorrow’ allows Breval to mention Pandora, and then to swivel from this ‘straight’ reference to the suggestive one (‘Pandora’s Box’), which in turn sets up a satisfying rhyme with ‘Pox’. Innuendo here is what the verse has been leading up to, not a means of getting at something else.

The ultimate visual pun was the syphilitic collapsed nose, both because it was real evidence of venereal disease – as plain as the nose on your face – and because it signified and hinted at something else (other parts of the body obtruded perpendicularly; other parts of the body could collapse). Since a flattened or ‘saddle’ nose was a deformity exhibited by those born with hereditary venereal infection, ‘adventitious’ syphilitics weren’t the only targets of humour. The irresistibility of the connection entailed what Gallagher describes as an ‘extraordinary proliferation of “no-nose” jokes’, as well as jokes about broken noses, fine noses, warty noses, long noses:

The buxom young widow will make smutty speeches,
About your long nose and point to your breeches,
But mercy defend us how loud she will brawl,
Shou’d you come to attack and have no nose at all.

A comic pamphlet of 1736 tells the story of a syphilitic who ‘discharges his Naseal Member’ – that is, sneezes – while walking beside the Thames, but accidentally drops the diseased remains of his nose into the river as he shakes out his handkerchief: ‘He immediately jumped in and drowned himself, uttering these Words before he took his Leap, I always lov’d to follow my Nose.’ In his Secret History of Clubs (1709), the satirist Ned Ward includes a similarly nasty tale about an imaginary ‘No-Nose Club’, established by a ‘Merry Gentleman’ to wine and dine the various ‘stigmatis’d Strumpets and Fornicators’ (‘maim’d Leachers; snuffling old Stallions; young unfortunate Whoremasters; poor scarify’d Bawds’) wandering the streets of London. This noseless company, fearing they have been brought together for a joke ‘by some whimsical Gentleman, that loves to make a Jest of other Peoples Misfortunes’, accost their benefactor:

We must flatly tell you, That we expect to be Respected … Therefore, if you any way Affront us, we shall toss up our Snouts, and, perhaps, bring yours upon a level with the rest of the Company’s; or if you have any design to draw us into Expence, you will find your self deceiv’d, for we are not Persons to be led by the Nose into such an Inconveniency.

The string of puns here – some helpfully indicated by italics – draws the reader’s attention away from the dignity of the argument. The club’s members are right to be suspicious: like the poxed man brought to the edge of the Thames and then into it for a joke, Ward has assembled them for a punchline – and then made them come up with it themselves.

This is the comic landscape of Tristram Shandy, in which the hero is convinced that the crushing of his nose ‘as flat as a pancake to his face’ by a pair of forceps during his birth has determined the disappointing course of his life (his father, an expert in obscure early modern theories of rhino-physiognomy, agrees), and in which noses call to mind other protruding body parts, despite or more likely because of the number of times Sterne insists that they shouldn’t. (‘Now don’t let Satan, my dear girl, in this chapter, take advantage of any one spot of rising ground to get astride of your imagination,’ Tristram warns us during a discussion of ‘the various uses and seasonable applications of long noses’.) The novel goes one step further than Ward’s Secret History of Clubs because it picks up on the oddness of the social assumptions behind nose jokes at the same time as it tells and enjoys them. Sterne’s obsessive circling back to the possible non-noseness of noses admits to something pathological in the humour culture he participates in, some fear or fascination out of proportion to the facts here, or at least a curious unreadiness to accept what he has been telling us all along, ‘as plain as my nose’: that not everything is poxed, and some noses might just be noses after all.

The great appeal of Gallagher’s approach is that she recognises this weirdness. ‘I am deviating from the current trend of relating the 18th century to the present day by identifying it as the beginning of, or precursor to, “modernity”,’ she writes. ‘Implicit in this book’s analysis is a reminder that there is much about 18th-century culture that still seems idiosyncratic or bizarre to 21st-century eyes.’ Nothing brings out its sheer unrelatability more than representations of the pox or responses to it: a suggestion made in 1780 to bring back biblical polygamous marriage laws (‘every man who has seduced a woman, whether with or without promise of marriage, should be obliged to wed her publicly’); or a less serious suggestion of 1750 that if a royal edict were introduced to ‘forbid all Copulation throughout the Kingdom for the Space of one whole Year’ and thus enable women to ‘breed without the Help of Man’, Britain’s poxed race would die out and be replaced by a healthy one (‘British Valour will then recover its ancient Glory; new Cressys, new Agincourts, new Blenheims succeed to grace our Annals’). The pox and the clap altered bodies but they also altered minds, infiltrating language and image: like conspiracies, they made everything seem connected.

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