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Indian Journal of Dermatology, Venereology and Leprology, Vol. 77, No.6, November-December 2011, pp.716-717 Letters to the Editor Social implications of the mass hysteria about syphilis in late 19th century Antonis A. Kousoulis1,2, Ilianna Galli-Vareia1, Foteini Kousathana1,2, Ioanna-Maria Athanasopoulou1 History of Medicine Department, 1Medical School, University of
Athens, Athens, 2Society of Junior Doctors, Athens, Greece Code Number: dv11216 Sir, The late nineteenth century was marked by an unprecedented mass social hysteria about syphilis. After Ricord’s doctrine of venereal disease, Bassereau’s work on clinical diagnosis and the founding of the Société Française de dermatologie et de syphiligraphie, syphilis was a widely known disease which almost rightfully took a central position in the century’s social unrest.[1] Many of the era’s major reformations were attempted disguised under the face of a hostile disease. Possible social phenomena which complicated the medical confrontation with syphilis were prostitution’s role in society, church’s perceptions on contraception and sexual relationships, and the epoch’s other major clashes and epidemics. Prostitution was a quite common profession, particularly in Paris of the 19th century. The majority of women who walked the streets were impoverished and abandoned, in constant danger of assault or murder, with syphilis common among them.[2] Prostitutes were thought to incite the husband to commit adultery, thus attacking the integrity of social order and transmitting the allegedly hereditary syphilis to honest families, leading to the degeneration of the race and symbolizing the demoralization of the society by sex.[3] During that time, almost 125,000 filles insumises lived in Paris, of the 1.7 million population. In order to calm the opposing voices to this regime of “pornocracy,” the government saw syphilis, regarded as an unavoidable stage in prostitutes’ life, as the only reliable intermediate to control prostitution. The new regulation included mandatory registration and random, questionable, medical tests, going beyond public health objectives and allowing arrest for any simple reason, regardless of health state. That way, between 1871 and 1903, 725,000 women were arrested, with prison considered the only way to restrain prostitution. The false concept of syphilis control aided decisively these measures.[2,3] On the contemporaneous religious front, the Holy Office deflected the blame for syphilis from witchcraft to the patient’s attitude, reinforcing the stigma attached to the disease, as it was associated with immoral behavior.[1,4] Meanwhile, the Catholic Church insisted on rejecting the major role of contraception in all sexually transmitted diseases, condemning condoms as evil and unethical. The final years of the 19th century was a period of instability and great changes for the power of the Catholic Church which, in the middle of the political-doctrine turbulence, had to remain stable on its principles in order to preserve its unity.[4,5] Medical knowledge and influence could not resist against the imposing authority of a powerful Catholicism, which, in its attempt to further promote the condemnation of condom use, found an unexpected ally in the face of the ominous danger of syphilis’ expansion. Moreover, with Alfred Fournier, the foremost syphilologist of that time, on the forefront, virtuous marriage of a virgin man and woman was proposed as the only method for syphilis’ prevention, as, during the century’s final 30 years, physicians were prohibited by law and male convention from informing the future brides of the risk they ran in marrying.[5] Applying the incitement of prophylaxis to marriage appeared to be the essential motivation of the antisyphilitic crusade; the control of sexuality. Focusing on France, the most characteristic example on the issue, social unrest, and previous epidemics also played an important part. During the century’s final decades, the political France of the Third Republic and the Commune was sharply polarized, also facing a rise in collective violence.[4] Moreover, most of the country’s population was familiar with the major cholera outbreaks of the first half of the century, which overwhelmed people with thousands of casualties in a few days. With the political state resembling a ticking social bomb and the regional devastating outbreaks still seem menacing, syphilis, an infectious social and racial danger, came to become the ultimate strike that citizens, mostly living in indecent conditions, couldn’t understand how to handle.[3,4] The last third of the 19th century was clearly the period when the moral and social implications of syphilis produced a strong breaking. Complicated with the governments and church desire to apply difficult measures, syphilis became the protagonist of the era’s social clashes, serving as an ideal pretense in the attempt to restrain prostitution, repel the use of condoms and control premarriage sexuality. The social unrest and the terrifying eventuality of a new lethal epidemic aided the formulation of such measures. Syphilis in 19th century presents the perfect example of how the mass hysteria on a disease is usually complicated by complex social issues. More than a century later, the intersection between society and epidemics remains an intricate matter. REFERENCES
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