Foul Georgians of London

Back to a matter of long standing intrigue - how people before the 20th century put up with the risk of extremely serious venereal disease (most notably, syphilis) and just went about having risky sex anyway.     

I think I had missed this study from 2020:

250 years ago, over one-fifth of Londoners had contracted syphilis by their 35th birthday, historians have calculated.

The same study shows that Georgian Londoners were over twice as likely to be treated for the disease as people living in the much smaller city of Chester at the same time (c.1775), and about 25 times more likely than those living in parts of rural Cheshire and north-east Wales....

The researchers are confident that one-fifth represents a reliable minimum estimate, consistent with the rigorously conservative methodological assumptions they made at every stage. They also point out that a far greater number of Londoners would have contracted gonorrhea (or, indeed, chlamydia) than contracted syphilis in this period.

"Our findings suggest that Boswell's London fully deserves its historical reputation," Szreter said. "The city had an astonishingly high incidence of STIs at that time. It no longer seems unreasonable to suggest that a majority of those living in London while young adults in this period contracted an STI at some point in their lives."

"In an age before prophylaxis or effective treatments, here was a fast-growing city with a continuous influx of young adults, many struggling financially. Georgian London was extremely vulnerable to epidemic STI infection rates on this scale."

Although I knew about the mercury treatment for syphilis, I didn't know this level of detail:

Mercury salivation treatment was considered a reliable and permanent cure for syphilis but it was debilitating and required at least five weeks of residential care. This was provided, for free, by London's largest hospitals, at least two specialist hospitals, and many poor law infirmaries, as well as privately for those who could afford it.

To maximise the accuracy of their estimates, Szreter and Siena drew on large quantities of data from hospital admission registers and inspection reports, and other sources to make numerous conservative estimates including for bed occupancy rates and duration of hospital stays. Along the way, they excluded many patients to avoid counting the false positives that arise from syphilis's notoriously tricky diagnosis.

Of particular value to the researchers were surviving admissions registers from the late 1760s through to the 1780s for St Thomas's and Guy's Hospitals which consistently housed 20-30 per cent of their patients in 'foul' wards reserved for residential treatment for the pox. But the researchers also drew on evidence for St Bartholomew's hospital; workhouse infirmaries; and two subscription hospitals, the Lock and the Misericordia, which also cared for 'Foul' men and women.

Patients in London's foul wards often battled their diseases for six months or more before seeking hospitalization.

Here's a link to the full article, which towards the end, makes some other remarkable comments about sex in the period:

Historians of eighteenth-century sexuality have long relied on birth rates, especially those out of wedlock, as an empirical foundation block on which assertions about sexuality can rest. As is well known, rates of illegitimate births and prenuptial pregnancy rose substantially during the long eighteenth century, such that by the early nineteenth century a quarter of all first births were delivered by unmarried women and almost 40 per cent of brides had conceived before their wedding day.83 Demographic historians view this as mainly a predictable corollary of earlier and more frequent marriage in a more dynamic labour market.84 Others have argued this must signal a changing sexual culture, one that historians like Porter or Dabhoiwalla present as sexual liberation, but which scholars like Trumbach and Hitchcock cast in the darker shades of male predation and assault.85 If there was such a new sexual regime manifest during the second half of the eighteenth century, it is typically presented as developing in London first. Wilson argued that this new sexual culture is borne out by London's illegitimacy ratio, which was considerably higher than the national average. However, Levene has revised Wilson's figures downward from 12 per cent to 7 per cent of London baptisms, from three times to slightly less than twice the national average of 4 per cent, noting that while London's rate was higher, the capital was not a ‘sink of illegitimacy’.8

The article goes on to consider what their STI rate findings might mean in relation to this, but it's too much to post here.  All pretty interesting, though.