Venereal Disease, Hospitals and the Urban Poor

Kevin P. Siena, Rochester: University of Rochester Press, 2004. Pp. 280. £55 (hbk). ISBN I-58046–148–4. This book may deal with an unsavoury subject but it treats it with sensitivity, both to the reality of disease and to the way it played into wider debates on gender, poverty, shame, secrecy, and social structure. Kevin Siena uses a range of institutional sources to investigate his subject and also marshals coroners' reports, advertisements for practitioners and cures, and examinations made by poor law officials to fully colour his discussion. This combination of sources and the insight it gives into what it meant to be poxed (and often poor and poxed) are among the strengths of the book. The careful contextualization exists on several levels. In his introductory chapter, Siena makes a rare connection between early modern provision for ‘pox’ and the more well-known nineteenth- and early twentieth-century developments. Early modern private practitioners are shown to be as alive to the need to provide out-of-the-way premises and discreet visiting times as those running VD clinics early in the twentieth century. Doctors dealing with the pox are portrayed as being among the first to appreciate the importance of medical confidentiality. This long-range view is very valuable in providing context for often-rehearsed assumptions on gender and policing. Indeed, these topics are also considered in detail with a definite gender divide being identified in attitudes to male and female patients. The implications of social standing are also shown to have been crucial, however, with patients of means accessing a much more vibrant medical marketplace than those without. Money bought secrecy, while the poor might have to undergo public examinations of both their bodies and their stories. Rich women could also access female healers, while the poor had no such choice (although they do seem to have used female support networks in posting bonds to the hospitals they entered). The disease itself is also firmly rooted in contemporary medical beliefs. Siena avoids the term ‘syphilis’ because of its modern specificity and notes that we are frequently unsure as to exactly what was meant by ‘the pox’ and ‘the foul disease’

Confidentiality · Context (archaeology · Contextualization · Interpretation (philosophy · Library science · Political science · Poverty · Secrecy · Shame · Sociology · Subject (documents · Historical Economic and Social Studies · Historical Studies on Reproduction, Gender, Health, and Societal Changes · Medicine · History · Law

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