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Looking back at medical history, the fact that humans have survived this long almost seems like a miracle. This is especially so when you see how often things like mercury and bloodletting were prescribed as common cures for any ailment. Medical technology has changed considerably, thanks in part to science and technological advancements, but the 18th century played an important role in developing some of the very cures we still use today: primarily through the creation of vaccines.

Besides some of the more common diseases during that time — such as smallpox, scurvy, and others — one of the biggest health issues of the century were sexually transmitted infections or diseases (STIs or STDs). Since the church still played an important role in determining medical practice, how did people of the 18th-century approach STIs?

 

Medical Knowledge About STIs in the 1700s

Many of the most common sexually transmitted diseases or infections of today were also around during the 18th century, except for HIV/AIDS. Some of the most common STIs during this time included:

 

  • Chancroid: Also known as a soft chancre, this condition occurs due to a bacterial infection that creates a painful ulcer (known as a chancre) near the site of the infection. It was commonly confused with syphilis due to the similar appearance of chancres but was found to be different in the 1850s.

  • Chlamydia: One of the most common STDs today, a bacterial infection causes this condition to occur. Many people that are infected with chlamydia won’t show symptoms, and when they do occur they can be mild. However, women with the condition can spread it to newborn children, and this puzzled doctors for many years. During the 1700s, doctors believed chlamydia was related to (or the same as) syphilis and gonorrhea. It wasn’t until the early 1900s that doctors discovered the true origin, and the condition grew in prevalence in the general population, becoming the most common STI (according to the CDC) in 1994.

  • Genital Herpes: A virus causes this condition to occur (specifically: herpes simplex virus, HSV). In most cases, the condition will lie dormant and will not show any symptoms at all, but when symptoms do occur, they can be painful. The most common symptom is red sores near the infected area. Medical professionals have known about herpes for at least 2,000 years.

  • Gonorrhea (aka “the Clap” or “the Drip”): Bacteria causes this condition to occur. Symptoms do not have to be apparent for an infected person to be contagious, which befuddled doctors for many years. This condition was extremely common between the 1600s and well into the 1900s.

  • Hepatitis B: This condition is caused by a virus and can be transmitted sexually or through blood or saliva. Left untreated, this virus attacks the liver, damaging it and eventually causing liver cancer. This condition has been around since the Bronze Age but wasn’t identified as a virus until 1966.

  • Scabies: Scabies is a skin condition that occurs due to a miniscule parasite. It has been around since ancient times and may have been referenced in the Bible as “leprosy” due to the similarity in symptoms in some cases. The cause was first discovered in the late 1600s and became one of the first human diseases in medicine with a well-understood cause.

  • Syphilis: Bacteria is the root of this condition, and can have up to four stages of symptoms if left untreated. From the 1600s until the 1900s, medical professionals considered syphilis to be one of the largest public health issues in the western world. For some patients infected with syphilis, symptoms were mild or dormant, and the patient wouldn’t develop issues until decades later when the bacterium was well within its fourth stage. The final stage often caused brain, nerve, and spinal injury (neurosyphilis and tabes dorsalis).

 

In general, doctors during the 1700s had difficulty discerning the difference between various forms of STIs. Little was known about how STIs are caused, how they transferred from person to person, and how they should be treated. As was fairly common during this time, not all medical advancements were good in the 18th century, and some medical beliefs caused strife and set back medical practice for quite some time. This is especially evident in the history of one specific STI: the clap, or gonorrhea.

 

This STI has been around since ancient Greece, but for the majority of the 1700s it was considered to be a condition that only affected men (as penises were more likely to show symptoms), and it wasn’t until the 1850s that physicians found it affected women as well but with more hidden symptoms (such as infertility in long-term cases). Gonorrhea was so prevalent in highly-populated areas that attempt to control it actually helped develop some of the earliest stages of disease-mapping as doctors tried to understand its source. Modern-day disease-mapping is similarly focused on trying to find the source of global outbreaks by utilizing big data to monitor and track the growth and spread of diseases.

 

As knowledge grew around STIs in the 1700s, one Scottish physician who specializes in STIs (or venereal diseases), John Hunter, believed that syphilis and gonorrhea were caused by the same pathogen but were different stages of the same disease (he believed syphilis was the more advanced symptoms of the disease). One popular legend is that Hunter experimented on himself — a common thing to do at this time in medical history, as it was the only way to guarantee that the subject hadn’t been exposed to the disease previously (which Hunter knew he hadn’t up until that time) — by attempting to contract gonorrhea with a needle that was (unbeknownst to him) also contaminated with syphilis. Believing his theory was thus proven by his experiment, he reported the results in his 1786 book A Treatise on the Venereal Diseases (volume 6), and the condition was renamed for a short time as the Hunterian chancre. He recommended that treatment consists of mercury and cauterization.

 

Unfortunately, Hunter’s experiment accidentally set back the knowledge of the two conditions for some time, and it took another 51 years for his theory to be proven wrong by a French physician, Philippe Ricord.

 

Safe Sex in the 1700s

Compared to modern efforts to practice safe sex — such as using various forms of protection, cleaning genitalia, practicing abstinence, and getting regular doctor visits or STI checks — many people in the 1700s were not aware of how to avoid contracting STIs. However, there were safe sex options during that time, but whether or not people used them is a different matter altogether.

 

As wild as it may seem, condoms have been around since the 15th century — possibly even long before then in Asia. Primarily made out of lamb intestines (often called simply “lambskin”), they are actually still used in remote areas of the world today. The use of lambskin condoms was mostly to prevent pregnancy, and there is debate if they were effective for preventing the spread of STIs as well.

 

Although condoms were around in the 1500s, it wasn’t until the 1700s that condoms became more popular. Many notable politicians and physicians condemned the use of condoms for various reasons. Daniel Turner, a well-known English physician at the time, stated in 1717 that condoms should not be used because they were ineffective at preventing the spread of syphilis.

 

However, other physicians throughout the century spoke against the practice of condoms for one simple reason: attempts at contraception were immoral and against God’s design. Although their reasons were not medically sound, the church still played a heavy role in how physicians were trained and how the culture at this time viewed medical practice. Yet, the Enlightenment was also happening during the 18th century, and the culture was slowly shifting to become more accepting of discussing “immoral acts” — especially sex.

 

Condoms managed to become extremely popular throughout Europe and into Russia, but only for the middle to upper class who could afford them. They were often referred to as “machines” and sold at bars, pubs, theaters, and open-air markets. They were also intended to be reusable. Besides the lambskin variety, chemically-treated linen options were also created, but lost popularity at the turn of the century. As for the colonies in America, the first recorded use of condoms wasn’t mentioned until about 1800.

 

Yet, despite the Enlightenment, the church still attempted to control how STIs (and sex) were viewed during this time. In England, the Hardwicke Marriage Act of 1753 was enacted by Parliament to prevent premarital sex for Anglican church followers. Across the pond, Colonial American culture frowned upon premarital sex due to Biblical teachings. However, despite these cultural beliefs, many people (especially those that were lower income and less educated) still regularly had sex out of wedlock or visited brothels, which helped spread STIs throughout the region.

 

All in all, the 18th century was rampant with STIs, and many doctors tried (and failed) to find proper treatment options for these pesky diseases. Despite setbacks in medical knowledge and the Church’s attempt to prevent the use of contraceptives, luckily some cultural phenomenon survived the 18th century — primarily the use of condoms in practicing safe sex.

About Author:

Avery T. Phillips is a freelance human being with too much to say. She loves nature and examining human interactions with the world. Comment or tweet her @a_taylorian with any questions or suggestions.