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Home arrow Language & Literature arrow Syphilis in Victorian Literature and Culture: Medicine, Knowledge and the Spectacle of Victorian Invisibility

Wages of Ignorance: Domestic Medicine Manuals

Late nineteenth-century domestic medicine manuals dissented from earlier publications and attitudes that saw ignorance as a way of preserving the innocence of the young. Leeds physician, H. Arthur Allbutt, author of the eponymous The Wife's Handbook, bemoans the state of knowledge among young women who “err through their ignorance of Nature and her unchanging laws” and by that endanger not only their lives but also that of their newborn children (1886: i).17 “Knowledge,” for him, “is power” (ii). In the popular What a Young Wife Ought to Know (1908), also published in Britain for the British market, American physician and obstetrics professor Emma F. Angell Drake repeatedly laments the insufficient preparation of women for their married lives (1908: 37-8).18 For her, women’s education is innately fused with the future of the nation:

When our daughters have had it burned in upon their inner consciousness that a knowledge of self, sensible dress and early hours, hygienic food and habitual outdoor exercise, will do for them and the succeeding generations what nothing elso [sic] can do; and when our young men show their appreciation of these things, and commend them in the highest terms possible, while they are not one whit behind them in this knowledge and practice, then will a better day dawn for the race, and a real start be made for the true betterment of mankind. (39-40)

Women’s health is, at least apparently, Drake’s chief concern and main factor behind publishing the book. A similar goal is articulated in Mary Wood Allen’s preface to Lyman B. Sperry’s Confidential Talks with Young Women (1901), in which she promotes knowledge as a principal means of women’s self-realization. Rather than encouraging immodesty, knowledge will buttress all the qualities necessary for women’s future responsibilities: it will equip them with “a permanent grace and dignity and make [them] more worthy of [their] holiest mission” (n. pag.). The same type of rhetoric is used in another context. Sylvanus Stall, a Lutheran pastor and author of What a Young Man Ought to Know (1897) and editor of the “Self and Sex Series,” envisions a number of disasters which could have been prevented had more attention been devoted to the proper education of young men. It would save them “from the blind blunderings which bring ruin, regret and remorse to such untold numbers” (1897: 21).19 Like for Hamilton, ignorance was both the target of and justification for the educational agenda professed by popular medicine manuals in the late nineteenth century.

As in Hutchinson’s case, the educational mission of domestic medicine manuals was regarded as a rehabilitating factor in broaching the subject of venereal disease. For Stall, like any other of God’s ordinances, the laws of human sexuality should be known and adhered to. Ignorance of the subject was not a valid excuse for bad conduct; sins that arise out of ignorance would be punished (Stall 1897: 23). Accordingly, for him, “the blush belongs to those who, in culpable ignorance or mock modesty, are silent, rather than those who speak out upon these important subjects in the fear of God” (23). With this statement, he targets a wrongly understood modesty and an embargo on certain topics that it inspires while protecting himself against possible allegations of obscenity. The divine mandate, evoked by Hutchinson as a justification for his preoccupations, serves here to address the subject of venereal disease and hail the advantages gained from the access to this type of esoteric knowledge.

Indeed, the authors of domestic medicine manuals presented themselves in opposition to their predecessors. Stall paints a bleak picture of the state of knowledge and popular consciousness in the mid-century “when universal prudishness set up scarecrows to safeguard the fields where Satan found in the profound ignorance of his victims a fruitful soil for rich harvests of vice and immorality” (1897: 24). According to him, medical men’s disinterest in the subject led to a serious neglect of many victims of social diseases (24, 102). This juxtaposition of late nineteenth- century progress and mid-century backwardness was as much produced as it was observed. In fact, some of the early nineteenth-century domestic medicine manuals, which continued to be reprinted throughout the century, included information on venereal diseases and offered some information on their symptoms. Although Thomas John Graham’s popular Modern Domestic Medicine (7th edn, 1837) promised to address women’s diseases (v), it had no entry on syphilis. In contrast, in the 1824 edition of the probably most popular domestic medicine manual The New Domestic Medicine, William Buchan and William Nisbet state that they no longer feel inclined to omit the subject from their publication, hoping that the benefits from their teachings outweigh the dangers of an improper use of the information (441).20 They do not flinch from describing the ravages of the disease as they list its possible symptoms (459). This gives them an ethical foothold and establishes moral high ground. In this context, Stall’s lack of differentiation in his assessment of earlier publications has a similar function as it also clearly allocates the blame for the current state of ignorance.

The technologies of scapegoating were valid strategies that facilitated the enterprise of self-justification and authority-building. Late nineteenth-century domestic medicine manuals also laid the blame on generations of parents, especially on their interference in matters of their children’s matrimonial choices. Stall stressed their responsibility for introducing their daughters to immoral suitors whom they knew to be “nothing less than a mass of moral and physical rottenness and contagion” (Stall 1897: 145). Parental neglect of their children’s proper education was considered detrimental to younger generations. The authors of late nineteenth-century manuals positioned themselves on the side of progress as they heralded a more public discussion of these hitherto tabooed issues, a discussion also made possible due to the “awakening of the woman” (Drake 1908: 7) and a bettering of moral standards (Stall 1897: 25).

Their goal was altogether different than that of Hutchinson and his colleagues, who wrote chiefly, if not exclusively, for specialized audiences and could therefore be held responsible for setting limits to public knowledge. In many of the domestic medicine manuals, venereal disease was an integral part of an array of cautionary tales: habitually, tales of familial and national degeneration. The dreary images painted by these educators functioned as deterrents, and as correctors of individual morality and the social order. As the evolutionary theory influenced ideas of progeny and as heredity became the major target of many public debates, domestic medicine manuals listed inheritance along with the influence of the environment as seminal factors in child development (for example, Stall 1897: 138). Like Stall, Drake uses biblical, horticultural language to highlight hereditary interdependencies and to outline the influence of parental moral conduct on future generations (1908: 117, 139-40). In this way, purity campaigners integrated evolutionary theories with “older moral concerns” (Mort 2000: 87). In their narratives, the act of showing syphilis gained particular importance as a means of counteracting an uncontrolled spread of degeneration:

To recognize the full character and effects of syphilis, you would have to compel the world to throw open the doors of all its hospitals, and expose to view the moral lepers, whose flesh and bones reek with rottenness and death [... ]; to throw open the doors of the insane asylums, to show you the large number of their unhappy victims who have been thrust in here from among the primary and secondary sufferers of syphilis; to throw open the doors of the sepulchers and show you the slain; to throw open the gates of the lost world and show you the doomed, and let you listen to the wails of the millions who have been slain for eternity by this awful sin of lust and disease. (Stall 1897: 125-6)

Thrusting open the doors of the confined spaces marked by syphilis, bringing light to the unlit sites of degeneration, making visible the ravages of the disease was a way of elucidating the hazards it posed to the sufferers and their offspring as well as to the quality of their earthly and posthumous lives. Such accounts of (moral) degeneration functioned as cautionary tales in the grand narrative of education that these manuals evoked as a way of salvaging the readers from the grips of the “leprosy of lust” (Stall 1897: 102).

Importantly, despite the mandate for sexual purity, domestic medicine manuals remained quizzically gender specific both with regard to the exposition of the disease and the proposed conduct of the sexes. “Keep thyself pure” was a command directed at men and women alike (Stall 1897: 34). Yet, while they strove to promote the sexual and moral purity of their readers irrespective of their gender, they unreservedly embraced the conviction about women’s subordinate status. Drake stresses gender differences in her chapter on women’s role in marriage, insisting that they should be “equal but not counterpart” to their husbands (1908: 66).21 Women should aspire to be good housewives, keep themselves attractive, be willing mothers and seek physical and intellectual development (Drake 1908: 66-71). Activating anti-slavery arguments, Drake insists that they should, however, also be aware of their rights and refuse to succumb to male sexual prowess, lest they want their marriages to resemble “licensed prostitution” (88).22 While not all manuals were as outspoken about the subject, many were founded on the assumption of distinct gender-based sexual and mental predispositions and framed their advice accordingly. At the same time, like in much of the eugenic feminist writing, they ascribed to women the role of guardians of the domestic hearth and teachers of future generations (Drake 1908: 8).23 It is in this essentialized difference, rather than in the proto-modernist incongruity endorsed by New Woman writers, that these domestic medicine manuals found a way of empowerment, however infinitesimal and in keeping with the custom of the day.

Despite the didactic inclination of many domestic medicine manuals, they had their share in perpetuating existing inequalities in knowledge distribution and in the perception of the disease. They precluded from women’s view the more drastic visions of syphilis either by ignoring the subject entirely or by allowing a few glimpses at venereal disease without, however, educating women in the recognition of its symptoms. Showalter’s contention that the disease “had very different significance and imagery for women and men” is true in this context (1990: 196). In his book addressed to young men, Stall devotes three chapters to the consequences of men’s immoral conduct. In these, he outlines the symptoms of the various stages of syphilis and offers a differential description of the chancre and chancroid for a better recognition of the disease (1897: 117-26). While drawing the reader’s attention to the difficulty of their successful identification and prompting him to visit the doctor, Stall at the same time offers a number of guidelines that could be used in self-diagnosis. Colour, texture, form and positioning of various eruptions are described, as are specific mental and motoric dysfunctions (see especially Stall 1897: 115-40). These detailed descriptions trained male audiences in the recognition of syphilis symptoms and facilitated their self-diagnosis. Many publications encouraged readers to consult practitioners in writing by appending forms that could later be sent for professional evaluation and diagnosis.24

Unlike these publications, many of the general domestic medicine manuals and handbooks specifically addressed to women actually counteracted their own mission by, deliberately or not, ignoring or downplaying the pressing dangers of venereal disease. In Domestic Medicine and Hygiene. Being a Short Account of the More Common Diseases, Their Causes and Treatment (1897) for instance, William J. Russell includes locomotor ataxia and general paralysis of the insane - diseases increasingly associated with the third stadium of syphilis - and mentions “sexual excess” as a possible cause of the first one (1897: 145); yet he entirely ignores venereal complaints in general, although he does mention syphilis as the cause of a number of diseases. Lyman B. Sperry does not reference venereal diseases at all although she insists on women’s health as crucial to good womanhood (1901: 106) and underscores the necessity of taking heredity into consideration when choosing a spouse (59). Drake addresses syphilis once only, yet even she emphasizes its hereditary character and its dangers to future generations without in any way hinting at the ways in which it could affect women (1908: 62). Similarly, while Allbutt pronounces the ruinous influence of sexually transmitted diseases on women’s health, he is also rather reticent on the subject. His advice, confined to one single paragraph, is limited to the advocacy of medical tests as ways of safeguarding the sanctity of marriage (1886: 47-8).

Contrary to their alleged educational mission, domestic medicine manuals for women, only sparingly, if at all, broached the subject of venereal disease and, as they did so, they failed to prepare the readers for an apt recognition of its symptoms. Venereal disease was used rhetorically to spread fears of the mental and physical degeneration of future generations. In this way, these textbooks paradoxically sustained, and participated in, the conspiracy of silence around venereal disease despite heralding and advocating women’s education. Since they abstained from illuminating the subject, domestic medicine manuals for women also tended to produce its invisibility.

In contrast, literature directed at a male readership was full of dreary visions of rotten bodies. Stall seems to find particular pleasure in morbid, Bible-inspired descriptions of putrefaction. In his manual, morose examples of men breaking their bones as they attempt to undress are followed by accounts of women with broken constitutions. He almost exults in grisly depictions of corporeal decay - “The nose is liable to be eaten away, and, piece by piece, through great sores in the flesh, the bones slough and pass out, or they may weaken and break by sudden strain” (1897: 119) - and in listing all the diseases brought on children by their syphilitic parents. These bleak but poignantly visual accounts become a warning to those who tread “the paths of vice” and endanger the lives of the innocent (149). Stall’s narrative functions as an imaginary opening of the spaces of syphilis intensification.

Wesley Manning Carpenter and Frederick Albert Castle’s Wood's Household Practice of Medicine, Hygiene and Surgery: a Practical Treatise for General Use (1886) singlehandedly unifies the divergent tendencies in syphilis depiction. Chapter IX: “Diseases peculiar to women” (1886: 287-308), written by Mary Putnam Jacobi, New York professor of materia medica, entirely excludes any debate about venereal diseases. Chapter XVIII, “Male genito-urinary organs. Chancroid and syphilis” (1886: 632-58), on the other hand, devotes five pages to the topic. In it, Edward L. Keyes, visiting surgeon to Bellevue Hospital and Professor of Dermatology in Bellevue Hospital Medical College, has no reservations to discuss the subject. Signalling the incidence of the disease among the innocent, Keyes laments the lightness with which many treat the subject. “It becomes the duty of the syphilitic,” he insists, “to use every means to prevent others from innocently acquiring the disease from him” (657). Like Stall, he recognizes the inappropriateness of “delicate phraseology” to account for this grave matter and promises to address the subject plainly and clearly (657). Although he favours the rule of two years without symptoms as a sufficient period to allow marriage, he also insists that any intercourse should cease under the slightest threat that the disease is active (658). His vehemence about the matter is articulated in his belief that “[t]he State prison is the proper place for a man who would thus knowingly and wilfully expose so many of his kind to the risk of infection. Every proper-minded man, therefore, will abstain absolutely from sexual intercourse as long as there is any danger of conveying the disease” (657). Keyes’s continuous insistence on men’s primary role in the transmission of the disease to women indicates that the popular opinion of female innocence, characteristic of the late nineteenth century, was also expressed here. While compliant with the tradition of equating women’s sexuality with their reproductive function, and concentrating on gender-specific ailments, the manual nonetheless does not even hint at the danger of infection with venereal diseases through reproductive practices. That the bringing of these two chapters together in one publication could be a source of knowledge for women, who would not be prevented from reading the chapter on male disorders, while viable, can only be a matter of contention. It is unsettling that one single publication so drastically conveys the politics of (in)visibility characteristic of the genre.

Domestic medicine manuals addressed to women did offer, if to varying degrees, veiled warnings against the disease. While they devoted more space to explaining the reproductive functions, childbearing and childrearing along with highlighting a number of domestic, health and beauty issues, however, they allocated an inconsiderable amount of space to the dangers of venereal disease. This tendency meant that in spite of their didactic mission, they often only signalled but seldom explained the dangers that women should be wary of. Nor did they use illustrative examples to illuminate these hazards or to disseminate among women the knowledge of the disease symptoms. In this way, the striking imbalance of knowledge continued to be produced, albeit in complex and erratic ways. When highlighting gender differences in sexual education, Showalter echoes Hamilton’s assertion and perpetuates her hyperbolical rhetoric: “While boys and men were lectured, warned, or even terrorized about venereal disease, well-brought-up girls were not supposed to know that such dangers existed. Girls found out about syphilis accidentally in reading forbidden medical books” (1990: 196). Showalter’s argumentation maps out general tendencies in the gender-specific distribution of knowledge. Because of that, however, it disguises the more nuanced and complex realities exemplified by Carpenter and Castle’s publication.

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