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Osis, Francis (2021) the Venereal Poison: a Historic and Genetic Analysis of Categories of Sexually Transmitted Diseases, 1718-1850

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Osis, Francis (2021) the Venereal Poison: a Historic and Genetic Analysis of Categories of Sexually Transmitted Diseases, 1718-1850 Osis, Francis (2021) The venereal poison: a historic and genetic analysis of categories of sexually transmitted diseases, 1718-1850. PhD thesis. http://theses.gla.ac.uk/82215/ Copyright and moral rights for this work are retained by the author A copy can be downloaded for personal non-commercial research or study, without prior permission or charge This work cannot be reproduced or quoted extensively from without first obtaining permission in writing from the author The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the author When referring to this work, full bibliographic details including the author, title, awarding institution and date of the thesis must be given Enlighten: Theses https://theses.gla.ac.uk/ [email protected] The Venereal Poison: A Historic and Genetic Analysis of Categories of Sexually Transmitted Diseases, 1718- 1850 Francis Osis (B.Sc.) Submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy School of Humanities College of Arts University of Glasgow Abstract 1 Abstract During the first half of the eighteenth century, the monolithic term ‘venereal disease’ or lues venerea covered all signs and symptoms of diseases transmitted through sex. In 1766, Francis Balfour – a medical student at the University of Edinburgh – suggested that lues venerea could actually be divided into two separate diseases, each caused by a unique contagion: syphilis and gonorrhoea. This opened a debate that continued for decades, between the monists, who believed that syphilis and gonorrhoea were merely symptoms of the same disease, and the dualists, who believed that the two should be separated. In this thesis, I investigate how the dualist theory was introduced, debated and finally accepted in Britain, particularly London and Edinburgh. Thomas Kuhn’s paradigm shift framework is loosely used as a lens to investigate this process. In the decades prior to 1766, changes in how doctors approached venereal disease lay the necessary foundation for the dualist doctrine. This period also saw a set of crises, both scientific and social; the persistent inability to successfully treat venereal disease, the increase in demand for treatment as patient numbers rose, and an increased perception as syphilis of a moral issue via the Reformation Societies. Immediately after the introduction of the dualist doctrine, those who accepted the new doctrine were all found within the social circle of Balfour. Doctors outside this network did not begin to accept the new theory until the dualists began to produce experimental evidence in their favour, showing the shift in priorities between early and late adopters of a theory from a matter of faith and social trust, to one of hard evidence. The ability to separate gonorrhoea and syphilis, however, was confounded by the inability to define venereal disease. This difficulty is reflected in how lues venerea was represented with anatomical specimens. A comparison of six medical museums in London and Edinburgh shows that specimens emphasised the lesions of disease. This encouraged a flexible approach which prioritised signs and symptoms, rather than through disease categorisation. The difficulty in diagnosing venereal disease is further highlighted by genetic analysis of one of these anatomical specimens, which finds a possible underlying case of nasal infection and food poisoning rather than syphilis. This work demonstrates the importance of shared language and agreed definitions when introducing new scientific theories. 3 ABSTRACT ......................................................................................................................... 1 LIST OF TABLES .............................................................................................................. 8 LIST OF FIGURES .......................................................................................................... 10 ACKNOWLEDGEMENTS .............................................................................................. 12 AUTHOR’S DECLARATION ......................................................................................... 14 CHAPTER 1 - INTRODUCTION ................................................................................... 15 Terminology ..................................................................................................................................................... 16 Syphilis and Gonorrhoea ................................................................................................................................ 17 Pathology and clinical presentation of syphilis. ........................................................................................... 17 Other diseases in the Treponema family. ..................................................................................................... 19 Pathology and clinical presentation of gonorrhoea. ..................................................................................... 19 Origins of syphilis and gonorrhoea in Europe. ............................................................................................. 20 Historiography ................................................................................................................................................. 21 Methodology .................................................................................................................................................... 24 Theory. ......................................................................................................................................................... 24 Curation of printed sources. ......................................................................................................................... 27 Thesis Outline .................................................................................................................................................. 28 CHAPTER 2 - THE PROTEAN DISEASE: DEFINING LUES VENEREA 1718-1767 ............................................................................................................................................. 31 Introduction ..................................................................................................................................................... 31 Crisis ................................................................................................................................................................. 32 Moral Pressures and the Societies for the Reformation of Manners ............................................................ 33 Syphilis as a Market Force ........................................................................................................................... 36 Drift .................................................................................................................................................................. 39 Defining Venereal Disease ........................................................................................................................... 39 A Purulent Catarrh ........................................................................................................................................ 43 Dissection and the Pathology of Gonorrhoea ............................................................................................... 46 4 Conclusion ........................................................................................................................................................ 51 CHAPTER 3 – THE VENEREAL POISON: SEPARATING GONORRHOEA AND SYPHILIS, 1767-1792 ....................................................................................................... 53 Introduction ..................................................................................................................................................... 53 1766-1778: Balfour, Duncan, and the Edinburgh School ............................................................................ 54 The University of Edinburgh and the Edinburgh Medical Society .............................................................. 54 Francis Balfour and William Ellis ................................................................................................................ 56 Andrew Duncan ............................................................................................................................................ 61 1778-1792: Hunter, the Monist Wave, and Alternative Theories ............................................................... 69 Pushback in the Edinburgh Medical Society ................................................................................................ 80 Conclusion ........................................................................................................................................................ 83 CHAPTER 4 – PLURALITIES, INOCULATIONS AND VENEREAL DISEASE(S), 1793-1850 ........................................................................................................................... 86 Introduction ..................................................................................................................................................... 86 Benjamin Bell: Paradigm Change ................................................................................................................. 87 In rurally isolated areas, cases of sibbens are not accompanied
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