SOURCE: “Renaissance Moralizing about Syphilis and Prevention,” in Medical Ethics in the Renaissance, Washington, D.C.: Georgetown University Press, 1995, pp. 162-202.

[In the following excerpt, Schleiner considers the moral connotations that physicians of the Renaissance associated with veneral disease.]

While the problems of removing male and female seed have received little attention by modern historians of medicine or of anthropology, the history of venereal disease—more specifically, the morbus Gallicus or syphilis—has been the focus of considerable interest. Modern discussions include the following questions: Was the morbus Gallicus a new disease or not? Why did it spread so quickly at the end of the fifteenth century? How and why did cures shift during the Renaissance (for instance, from mercury to guaiacum or lignum Indicum)? To what extent did the difficulty or even impossibility of integrating the disease into humoral medicine contribute to that system's demise? All these questions are of only peripheral interest in my context, for my focus is the moral interpretation of the disease (most notably as flagellum Dei or punishment of God), and moral issues relating to its prevention. On the one hand, my topic is an aspect of the larger nexus between sin and pathology as discussed by Paul Diepgen for the Middle Ages; on the other hand, through its multinational scope, it complements other actual or possible approaches to the moral interpretation of syphilis, for example: Owsei Temkin's emphasis on the difference between the three virulent decades immediately after the disease first appeared, when (as he claims) it was not generally recognized as a venereal disease, and the period after 1520 or 1530, when the connection was generally made; Temkin's claim that the gentler guaiacum therapy was reserved for the nobility, while the common people were subjected to the torture of mercury “for the atonement of their sins”; and, finally, the distinction between accounts of syphilis by writers who revealed themselves as sufferers from the disease (the German nobleman von Hutten, the Spanish priest Francisco Delgardo, the German secretary to Maximilian I, Joseph Grünpeck, perhaps even the artist Benvenuto Cellini) and accounts by writers not suffering from it, since one may assume that having or not having syphilis would color a person's moral interpretations of the disease. Undoubtedly Anthony Grafton is correct when he says in a recent review of Renaissance writings on syphilis that “the most striking feature of this literature is, indeed, the power of existing explanations, beliefs, and social attitudes, many of them traditional, to incorporate the experience.”¹ My interest is both more general and more precise. Except for occasional references to von Hutten or an interpretation by a moral theologian, I deal with works by surgeons or physicians. Restricting my focus to the Renaissance allows me to cross national and geographic borders with the hope of arriving at some tentative comparisons. To what extent, in different parts of Europe, was this particular disease not considered accidental but a deserved punishment for individuals or groups (or nations)? How did moral tenets about syphilis influence medical teaching about prevention? Who were the intended readers of these books, most of which were written in Latin? How did women figure in the early construction of this disease, both as infectors and as healers?

If some English writers are discussed here first, this is not to suggest that theirs were in any way central and innovative minds in diagnosing and curing the disease—in fact, of the roughly one hundred works that Lipenius lists on the subject a few decades after the end of the period of my interest,² none appears to have been by an English author. I am dealing with only one facet of a complex of problems relating to the disease, however—moral interpretation; and there can be no question that in the field of medical ethics, what was printed in English soon came to be important.

SOME ENGLISH SYPHILOGRAPHERS

As is well known, most Renaissance writers considered syphilis a new disease, although they did not necessarily believe that it had been imported from America by Christopher Columbus's sailors. In his famous treatise celebrating what he thought was an effective remedy, Ulrich von Hutten found that its recent (though not explicitly American) origin was the only matter relating to it that the physicians of his time could agree upon, and this statement appears generally true although not disinterested, since Hutten had set out to praise the effectiveness of the “Indian wood.” (Before and after von Hutten, however, there were some dissenters from this view, of whom Nicolò Leoniceno [1428-1524] was one of the best known.)³ In any case, in his Methode of Phisicke, the Englishman Philip Barrough (fl. 1590) assumes the American origin as a standard element of medical history in his account, to which he gives an anti-Catholic moral-political slant:

First, the Spaniardes borrowed it of the Indians, and brought it home in stead of their gold, and afterward Charles the fift Emperour of Rome, who was a man of great power, and delighted much in shedding of bloud, spared neither man, woman, nor child; insomuch that he spoiled a great part of Italy, and subdued the dukedom of Millan, with great hurt, ruine and spoile, to all the commonwealth of Florence: and at the last he came to Rome and Naples, with his whole hoast, spoyling all as he went with great cruelty: and for his hire, this disease began first to show it selfe plentifully among his people, and specially because his soldiers were much given to venery.⁴

Barrough's account is clearly spiked: there is the ironic switching of disease for expected gold; and rather than heading the Holy Roman Empire, Charles is the Emperor of Rome, a city that to Elizabethans connotes the home of the Antichrist. (In later editions, as for instance, the sixth edition [1624], the same passage reads “Charles the eight, King of France.”) Of course such anti-Roman sentiment (and the link with syphilis) was not limited to England but expressed in other Protestant countries as well. Toward the end of the seventeenth century, the Dutch physician Stephen Blankaart (1650-1702) records a malicious anagram using the first letters of “Spanische Pocken Quälen Rom” (Spanish pocks torture Rome): S P Q R, conventionally standing for Senatus Populusque Romanus.⁵ Barrough makes Charles V a sadist enjoying destruction. The outbreak of the disease in his army at Naples is ironically presented as the reward or pay (“hire”) specifically for him, for his cruelty, and generally, for his soldiers for being “much given to venery.” Providential history thus has been using the disease for a purpose, as he makes even clearer when he continues: “The frenchmen at that siege got the buttons of Naples (as we terme them) which does much annoy them at this day. But the first finding of this grievous sicknesse, was brought into Spaine, by Columbus at his coming home, so that all Christendome may curse the Emperour and Columbus.” Thus, at the time when a major encounter with Spain was already looming (the first edition of the book is of 1583), Barrough sees the disease as a deserved curse on everything the Elizabethans hate: the Emperor, Rome, and the Spanish. According to Barrough:

Then Columbus travelled again, and brought with him little gold, but all his men were, well infected with this griefe: insomuch that the Physitions in those daies did not knowe what to make of the griefe, nor how to helpe the people. So for want of knowledge many were spoiled. After (as I told you before of the Siege of Naples) the Spaniards for friendship they bare to the Frenchmen, sent to them of their curtizans infected with this griefe, minding to let them have some of their iewels, which they brought out of the Indian countrey. The Frenchmen (not knowing their kind hearts) fell in love with them, and (being ravished with their beauty) dealt with them, to their great cost and trouble to this day. Now to the variety of names: First, the Italians call it Morbus Gallicus, and some call it Variolam Gallicam, because it first appeared among the Frenchmen at the siege before named. The French call it Scabiem Hispanicam, because the Spaniards first brought it out of the Indies. The Germans call it Menium, why they should term it so, I know not well, unless Menium doe signifie the privy parts infected with this disease. Some of them call it also Scabiem Hispanicam. In Spaine they name it Morbum Neapolitanum, the cause I told you before … and we in our countrey call it the French disease. But however it bee called it skilleth not, so that we knowe how to helpe it, which I minde to declare hereafter by Gods grace. (p. 362)

Although this account seems to contain straightforward and even commonplace information, it is not as innocent as it may first appear: there is the ironic exchange or commercium of Columbus bringing infection instead of the expected gold; the ironic “friendship” of the Spaniards (really their malice of sending infected women to the French); the wordplay in “jewels” (those about which they are misers versus those metaphorical jewels with which they are generous, i.e their genitals or even their sores or “buttons”) and in the Frenchmen's “knowing” the Spaniards kind hearts (which is both knowing and not knowing and leads to another kind of knowing, their “dealing” with the women). I cannot tell whether Barrough entirely invented these malicious interpretations. Curiously, the more topically reported acts of harming the opponent during these campaigns are more specific than the ones narrated by the English physician (and are usually adduced as an alternative to the “American hypothesis” to explain the sudden emergence of the disease, thus serving a specific medical rather than a moral-political purpose): they include the report that the Spanish poisoned the water for the French troops (Gabriele Falloppio) or that they added the blood of lepers to the wine of the French (David Planis Campi).⁶

The philological material then added by Barrough is also standard in most Renaissance works on syphilis. Some of the comments are appropriately tentative, as on the Germans' reported name for the illness, information that may derive from Ulrich von Hutten's well-known work on syphilis and its cure.⁷ Displaying the name of something is of course a traditional rhetorical strategy dating from the time when the etymology of a word (as even the etymology of etymology indicates) was thought to reveal some part of the “truth” of what it named. Even with Barrough's final disclaimer that “however it bee called it skilleth not,” the survey of names (except for some debatable item like menium or, in a sentence I omitted, pendendagra [for pudendagra?]) has the cumulative effect of validating the previously given moralized history of the disease.

At least Barrough is straightforward and quite specific on cures for the disease, unlike William Bullein (d. 1576) a couple of decades before him, who prefaced his list of somewhat more cursory prescriptions with a harsh invective against what would have been a considerable segment of his most interested readership of this section: Bullein said that his therapy was not intended for those who had contracted the disease by their own fault—which amounts to an at least rhetorical refusal to treat them:

Yet would I not, that any should fyshe for thys disease, or be bolde when he is bitten, to thynke hereby to be helped: but rather eschue the cause of thys infirmity and filthy, rotton, burning of Harlots etc. As to fly from the Pestylence, or from a wylde fyre, for what is more to be abhorred, than a pocky, fylthy, stynking Carcasse? But if through blynde Ignorance, sodayne chaunce etc. any gotten it: then do thus to be delivered from it.⁸

Like Bullein, who would not encourage anyone “to fyshe for thys disease,” Barrough has little to say about prevention. When he touches on the topic, he addresses also those recovering from it, trying to prevent a relapse.

Typical of most writers on the subject, including the continental ones (some of whom he cites), Barrough's perspective is entirely male; he sees the infection as coming from women (usually prostitutes, but also infected nurses):

Chiefly Venus must be shut out of the dore quite, especially while this decoction [guaiacum] is in giving. Some by committing this act but once in this cure have failed of remedy through the same. There be develish women desirous to be handled and dealt withall, who will beautifie themselves, to inflame mens hearts to lust towards them; abandon these your company, and thrust them out of the dores and house. (p. 373-74)

The male perspective is just as apparent in the work on syphilis by William Clowes the Elder (1540-1604), a surgeon who many times refers to his practical experience in dealing with the disease. Clowes's statement about transmission takes into account the fact that babies can receive the disease from a nurse or parent who is infected, but he makes no attempt to explain how women might contract it: “The sickness is sayed first to be engendred by the accompaning [sic] with unclene women, which although it be most commonly true, yet it is not alwayes so, not in all persons.”⁹

Clowes's moralizing of the disease, although not any less pronounced than Barrough's, has different characteristics. In contrast to Barrough's manner of turning the history of the disease to nationalistic propaganda, Clowes's nationalism is turned inward, to stirring the English to recognizing their sins. At the same time the disease remains God's just punishment (as he says in the prefatory epistle): “Lues Venerea, the pestilent infection of filthie lust: a sickness verie loathsome, odious, troublesome, and dangerous. A notable testimonie of the iust wrath of God against that filthie sinne, which at this daie not onely infecteth Naples, Spaine, and France, but increaseth yet daily, spreading it self through Englande …” (sig. Aiii). He reports that, together with three other surgeons or physicians, he has in five years cured “one thousand and more” at the Hospital of St. Bartholomew (fol. 1^v), where in nine or ten years, on the average, every other patient asking for treatment “had the pockes” (fol. 2). Thus he speaks with authority when he claims that the medical problem of the disease (which to him is at least as much a moral problem) has become eminently and perhaps even primarily English: “The disease was never in mine opinion more rife among the Indians, Neapolitans, yea in Italie, France, or Spaine, then it is at this daye in the Realme in England, I praye God quickly deliver us from it, and remove from us that filthy sinne that breedeth, nurseth, and disperseth it” (fol. 1-1^v).

With his aim of a moral reformation in England, Clowes reveals his Puritan leanings, which are also evident both in his analysis of the social origin of the disease and his proposal of a remedy: “The causes whereof, I see none so great as the licencious and beastly disorder of a great number of rogues, and vagabonds, the filthy lyfe of many leude and idle persons, both men and women, about the Citie of London” (fol. 1^v). Social and moral disorder go together and, in this case, breed disease. That Clowes needs to add the admission that in these alehouses among the “dis-ordered persons, some other of better disposition, are many times infected,” is reverse proof that for him the lower class and moral depravity go essentially together.

It is consistent with Clowes's generally moralized view of syphilis that in his advice about prevention of the disease a moral sense (loathing of sin) is invoked in the interest of avoidance of infection.

And foreasmuch as the best avoiding and curing of everie disease, consisteth in shunning and removing the cause thereof, I wish all men generally, especially those which be infected, to loathe, detest, hate, and abhorre that striking sinne that is the original cause of this infection, and to praie earnestly to God the heavenlie Physition and Chirurgeon, for his gratious assistance to the perfect amendment of life, the most safest and surest waie to remove it. (Aiii-Aiii^v)

While the opening clause of this sentence draws on a medical commonplace, the passage actually argues that there is a link between this sin and sickness or, more specifically, that disease is but a manifestation of sin, and that hence avoidance of sin, a moral sense, is the most powerful motivation in taking care of one's health. By pointing to sin as “the original cause of this infection,” he may also be invoking associations with original sin.

Of course, in that period a preacher's striking that note would hardly be noteworthy.¹⁰ Similar uses of disease, particularly the French disease, but also of the plague, could be demonstrated in dozens of writings belonging to various religious genres written by persons belonging to groups we now call “Puritans.” Thus George Wither (1588-1667) devotes the entire second canto of his long poem Britain's Remembrancer to demonstrating that the reason for the plague is God's “fury.” (Perhaps significantly, the pestilence was “discover'd at / A Frenchmans house without the Bishopgate.”¹¹) But Wither is not a physician and therefore is beyond the scope of my topic, which is to surmise that the surgeon Clowes's sympathy with the Puritan cause led him to blend medical cure with moral regeneration. Clowes encourages the magistrate to assume a task both moral-religious and civic, namely to seek “correction and punishment of this filthie vice, as also the reformation of those places above mentioned” (fol. 1^v). Indeed, the idea of prevention by moral reform is at the core of Clowes's publication.

He seems to be trying to discourage any prospective readers who might pick up his book in order to cure themselves or to reduce the chance of infection without changing their sexual habits: “And here I protest that the very cause that moved me to set forth this booke, is not to encourage those wretches that wallow in this sinne, to continue in their beastlie lyfe, hoping by this booke, or any other whatsoever, to be able to deliver themselves from this sicknesse” (fol. 2). Therefore it is understandable that one does not find in Clowes's book even the minimal advice on hygiene that by then had become standard in continental works on syphilis, namely that the male should wash his member carefully immediately after intercourse.

Of course Clowes was familiar with this and other recommended preventive measures through Almenar, Falloppio (whom he cites), and others. Clowes published a translation of Almenar's Treatise on the French Pocks, with a chapter (5) on prevention entitled, “What cautions must be observed to escape the French Pockes,” in which the Spanish author recommends such cleansing as well as application of a certain powder to the penis after intercourse. Almenar (fl. 1500) also says that absolute prevention means abstention and avoidance of sin, but restrains his moral-theological zeal. Clowes translates: “They which are careful to escape the French Pockes, let them first escheve sinne. But because these things perteine to another Phisition, this shall be sufficient.”¹² As we have seen in Clowes's own treatise, to call himself back from moral reform and leave that topic to the theologian would be inconsistent with the Puritan temperament of this Elizabethan physician.

Like Bullein and Barrough, Clowes is tight-lipped on prevention. In a general sense Theodor Rosebury is no doubt correct when he says that in the centuries after Shakespeare's death the subject of syphilis became shameful. He adds: “And English influence, beneficial, baneful, or whatever it may have been, ranged over the world.”¹³ But if we are willing to accept a writer's forthrightness about prevention as a litmus test, we will have to acknowledge that the English moral or moralizing tradition (which we may loosely call “puritan”) goes much further back: to medical works decades before Shakespeare's death.

WRITING ON PREVENTION SOUTH OF THE ALPS

Without retracing early continental writings about syphilis in detail, I can say confidently that the moral vision in them is not so pronounced and general as in England. In his treatise, written with the encouragement of Paul Ricius (or Paolo Ricci), professor of medicine at Padua, Ulrich von Hutten (not a physician and not a disinterested observer, since he had the disease) had already ridiculed priests for espousing moral views of syphilis as if they were revealed fact.¹⁴ Particularly medical works in Italy (very numerous on this topic and diligently read in northern Europe) do not seem to be informed by the degree of moral conviction that gives some logical consistency to the English treatises but is also their limitation,¹⁵ although even here an occasional moralizing strain attaches itself to the writing about this disease. After all, the fictional shepherd Syphilus of Fracastoro's famous epic, after whom the disease is named, receives the disease as punishment for having overturned the sun god's altars.

I begin with Gaspar Torrella of Valencia (1452-1520), who as the personal physician of Pope Alexander VI (and also of his notorious son Cesare Borgia) came to live at Rome, where he published his Tractatus cum consiliis contra pudendagram seu morbum Gallicum (1497). Sudhoff and Singer report that “[at] the beginning of his exposition Torrella speaks of the disease as due to the divine wrath and to the influence of the stars, the familiar flagellum Dei and the constellatio corporum superiorum of the Middle Ages.”¹⁶ Since this makes Torrella sound like a spiritual ancestor of Barrough and Clowes, we should examine the passage in question:

The astrologers say that this disease comes from the constellation of the higher bodies. For they say that the universal effect must be traced back to universal causes. Others say that it is God's punishment (flagitium Dei).¹⁷

Torrella here uses dicunt (“they say”) three times, which has the effect of distancing him from the views reported—Sudhoff and Singer are imprecise if not misleading in this regard. Indeed, that this physician of the Borgias is quite secular in his sensibility (although he was rewarded with a bishopric) also speaks through his advice about prevention: primarily directing his advice at (supposedly celibate) clerics, he recommends that if one cannot entirely abstain from women, one ought at least to find those who are not infected.¹⁸

Like the Spaniard Almenar, Nicolò Massa (d. 1569), cited much more often in the Renaissance than Torrella, advises the male to wash his groin immediately after intercourse, and then supplies hints about how to recognize whether his female partner is infected.¹⁹ Massa begins his book by pointing out that with many people the disease does not immediately affect the genital area and by giving some memorable examples of how the disease was transmitted without sexual intercourse (from nurse to infant and from infant to nurse). The effect of this account in which he speaks of infected patients aged three, six, and eleven, can only be to remove from the disease some of the moral opprobrium of promiscuity (Massa, pp. 14-15). At the same time there is still in Massa's work a general sense of religious boundedness within which cure is attempted, as he puts it, “with divine guidance (from which all good things derive.)”²⁰

From the second half of the sixteenth century, we have the account of Henri Estienne (1531-1598) about what struck him as he attended a medical lecture at the famous University of Padua. In the book into which Estienne incorporated his impressions, the outstanding philologist and committed Protestant argues in great detail that the modern world, notably the “popish” culture controlled by Rome, surpasses the ancient world in decadence. La vérole (syphilis) is grist for his mill, for he too interprets it as God's punishment for promiscuity, notably in Rome. In the absence of accounts by Protestant Englishmen about attending medical lectures on our subject in Italy, we may let Estienne's reaction stand for what some radical English Protestants might have experienced in Padua: “In fact, I remember well finding myself in Padua in a lecture by Falloppio, in which he promised his students that the following day he would teach them the means of womanizing to their heart's content without any fear of Mme. Vérole or any of her accoutrements.”²¹ After “finding himself” in the lecture of the famous professor—at least rhetorically a way of minimizing his responsibility for being there—and finding his moral sensibility offended, Estienne apparently did not return to hear the sequel of the lecture, and in any case that same moral sensibility would have forbidden him to communicate Falloppio's preventive means.

But fortunately we have Falloppio's De morbo Gallico, apparently a transcript made by a student of his lectures, which seems to bear out Estienne's recollection. In chapter 89, entitled, “About Preservation from the French Disease,” Falloppio (1523-1562) says: “I would seem to have achieved nothing unless I taught you how someone who sees a most beautiful ‘siren’ and sleeps with her although she is infected can avoid the French disease. I have always thought that there should be a method of prevention so that ulcerations would not come about through transmission of this kind. But what is that method?”²² Falloppio then expounds upon the careful cleaning of the male organ after intercourse, by the middle of the sixteenth century a standard recommendation for prevention (if concern with prevention can be considered “standard”). Realizing that cleansing may not always be successful in removing the infection from the susceptible glands, Faloppio is searching for some topical agent to apply to the penis strong enough to penetrate it and then extract and “vanquish” the infectious matter. “Thus I have looked for such a medication. But since we also have to think of the frame of mind of the prostitutes, we cannot bring with us ointments from home: therefore I have invented a small cloth, soaked in medication, that can easily be brought along if you have pants (femoralia) wide enough to carry your entire pharmacy with you.”²³ Falloppio explains that after intercourse he expects his students to clean themselves and cover the penis with a cloth bag prepared to size and soaked several times in particular ointments. He says that he made the “experiment” on eleven hundred men and calls on God as witness that none of them became infected. Claude Quétel is factually correct but somewhat judgmental when he says: “In a sense, then, Fallopio's protective is a precursor of the ‘French letter,’ although it is not impossible that the Romans, a highly depraved people, had already adopted methods of this sort.”²⁴

The quoted sentences highlight Falloppio's secular and possibly amoral stance with respect to disease prevention. The encounter with the good-looking sirena that the physician wants to make “safe” is clearly imagined to be casual. His word for the woman invokes Homer's nefarious females whose attraction Ulysses was able to resist only by having himself tied to a mast, i.e. by total and enforced abstinence. The later reference to meretrices (prostitutes) disambiguates the matter further. What is extraordinary, however, is that such a secular stance coexists in this work with a moralized view of the origin of disease in general and of this disease in particular: “This is permanent and eternal dogma: that because of sin came death and because of failing, punishment. Thus it came about that God has punished our sins by diseases.”²⁵ Falloppio reports in this context that the victorious Pompey in his triumph brought leprosy from Egypt to Rome. In turn, the Hebrews and Egyptians knew the morbus elephanticus, while it was unknown among the Italians, Gauls, and the Germanic tribes: that disease spread first to Rome and from there to other areas. The point of his historical digression is to show that graver sins (maiora peccata) called for new diseases in the past and continue to do so in the present. He fails to name these new diseases and by some form of praeteritio claims he is abstaining from a theological interpretation: “The cause of this I leave for the theologians to explain.”²⁶ Nevertheless, as to “the most recent” disease, he himself gives a moral-theological reasoning and theodicy: “The newest disease is the one we are talking about and call the French disease, sent from God so that, made more cautious, we stop indulging in promiscuity and devote ourselves to the study of letters and all the other useful arts.”²⁷ Although the perception of specific illnesses as God's punishment is not unusual in sixteenth-century writings, it would seem that Falloppio's ideas go a little beyond the commonplace in that he sees syphilis not merely as punishment for some “other” (of another nationality [England's foe, as in Barrough], or the incorrigibly promiscuous), but as a corrective to the sexual habits of all of “us,” including himself.

It could be that by calling the link between disease and sin “dogma,” Falloppio is not only removing it from the purview of the physician to that of the theologian, but that he is also taking it to some axiomatic realm within which for him argumentation does not have the same cogency as within the field of medicine. But I admit that this hypothesis may be circular, since I am brought to this explanation by the seeming contradiction between his theology and his medical advice, which I am trying to explain. The notion of syphilis as a means (even if divine) of correcting or controlling human sexual habits is at the borderline of entirely secular notions of health care: by all moral or theological accounts, it is a higher form of virtue to resist sin for the love of the good (or of God) than merely for the avoidance of infection. And in any case, like other medical writers on syphilis before and after him, Falloppio knows that even the innocent (for instance infants) get infected and, therefore, that the link between this illness and sin is inconsistent. To point up such difficulties is not to blame this distinguished physician for failing to express a believable theodicy in the face of disease (for one may doubt, with Albert Camus's characters in The Plague, whether such can be had), but to notice that Falloppio does not carry his analysis very far. And surely, if Falloppio's notion of correcting sexual habits by the threat of infection is almost secular, his medical advice to his students for prevention is entirely so. Thus his nexus between the new disease and sin on the one hand, and his notions of prevention on the other are not quite as contradictory as they may at first appear.

In Italy, Falloppio's method of safeguarding against syphilis entered the mainstream of writing about the disease. Thus, in his Luis venereae perfectissimus tractatus (Patavii, 1597), Ercole Sassonia (1551-1607) reports Falloppio's ideas at length and develops them even further (chap. 16: De praeservatione), although he shows a measure of skepticism in his warning that anyone living promiscuously may not escape the disease for long (fol. 10). Also, in Sassonia, there is no question that the elaborate passage instructing the reader about what lotions to use for cleansing and how to prepare the cloth that will enclose the male member after intercourse is intended for frequenters of prostitutes. Indeed the index rerum et verborum summarizes the subject as, “Remedies for those who use a prostitute, so that they may not be so easily infected by the disease.”²⁸ Sassonia's skepticism may be fueled also by his recognition that lues venerea, which as infectious disease he considers to be of a “cause” or origin (causa) “dark, malicious, and hot” (fol. 1), can be transmitted by sharing cups and meals. As always in this context, causa occulta points to a cause that is dark in the sense of unknown (or inexplicable in the traditional Galenic system); particularly with this physician of a predominantly secular temperament, the word does not have the meaning of our occult. Any attempt on Sassonia's part at an inclusive moral interpretation of the disease is checked by his knowledge that innocent people (he specifically mentions midwives [fol. 2]) can be infected.

For Eustachio Rudio (1551-1611), a professor at Padua, the French disease has a similarly problematic position within Galenic medicine and is therefore included in his work Dark and Poisonous Diseases. In his chapter on prevention,²⁹ he also refers to Falloppio and elaborates on the prescriptions of the latter: the compress is to be worn on the penis even before intercourse to fortify it against infection (p. 191). Falloppio's recommendation for cleansing after the act, his piece of cloth carefully prepared to enclose the penis, as well as his bragging account of successes, are all reported in detail, although Rudio recommends avoidance of prostitutes “and similar women” as the safest prevention (p. 192; also p. 168).

Rudio's discussion of the disease and his recommendations for prevention are possibly even more secularly motivated than those of Falloppio. One seeming exception is a passage in which Rudio tells of a recent case in his experience: an infected mother, after a stillbirth, nursed two orphaned infants; they were almost immediately infected and died a painful death. Rudio concludes: “But she will find that God avenges such a disgraceful action and crime.”³⁰ But perhaps rather than a deep religious conviction this sentence shows an understandable human or even humanist outrage, fed also by a sense of the physician's utter helplessness.

Rudio presents one of the few suggestions about how women can avoid becoming infected (a pessary steeped in a concoction of “Indian wood” [guaiac] is to be worn a whole day after intercourse), but even so, his perspective is so secular-humanistic-male as to strike us as inhumane: Rudio speaks of “paid women, who are worth preserving not for their own health, but primarily for the sake of their male customers.”³¹ Just as Falloppio's words were directed to his students less as future diagnosticians, counselors, and healers than as users of that medical knowledge in their personal lives, so Rudio's are addressed to single men (among whom he seems to include himself [p. 168]), whom he admonishes to exercise caution should a woman offer herself to them. This caution, however, is not equivalent to absolute abstinence. Rudio tells the case of a young man who inserted his member only, as he swore by oath, “for a single moment” (soli quasi momento temporis, p. 169), until he felt some hardness in the woman's pudenda that made him suspect that she had the French disease. Nevertheless this man caught the infection and soon was ravaged by the disease. Rudio wants to have this matter (so graphically) expressed “for the common good” or “common health” (pro communi saluti, [p. 169]), and recommends that his students retract immediately and interrupt the act when noticing suspicious symptoms in the woman's genital area.

If “common health” (salus communis) appears to be focused on the health of men, there are passages—and they are among Rudio's most forceful ones—where he has in mind even more narrowly the health of physicians. Since he considers a doctor's infection with the virus Gallicum a public shame, these passages relate to the topic of medical ethics as a more limited topic of physicians' professional ethics as perceived by the public. Thus his concern is not, as one might expect from the modern perspective, to warn physicians of the danger of contracting the disease while treating a diseased patient, but to impress on them the need to be cautious in their sexual habits. In his estimation, a good thousand men in medicine have been infected by women whom they thought true and faithful Penelopes (p. 168). And he adds: “This warning here I have meant to issue for the physicians' health. For if it is shameful that others are deceived, it will be most shameful if those who profess the art of medicine are made to shipwreck.”³² He describes the dilemma of two doctors known to him years before who were graced by the most beautiful beards. After losing those beards through the effects of syphilis, both had to leave Venice to avoid public ridicule and shame (pp. 168-69).

In his extraordinarily graphic and concrete passages about prevention, whether talking about loss of hair, coitus interruptus, or forms of lascivious kisses that transmit the virus (p. 169), Rudio indicates awareness of stretching accepted bounds of decorum. His justification is the appeal to a salus communis and salus medicorum, concepts which, although not strictly defined and somewhat overlapping, are with him essentially secular.

DANIEL SENNERT'S RESPONSE TO FALLOPPIO

The reaction of Falloppio's contemporary, Protestant Henri Estienne (see the previous section), prepares us for the response of the widely acclaimed Daniel Sennert (1572-1637), Professor at Wittenberg in the early seventeenth century. What could be discussed at Padua in the middle of the sixteenth century apparently was not sayable in Protestant Wittenberg several decades later.

In the chapter, “On Prevention,” of his treatise on venereal disease, Daniel Sennert sharply criticizes Falloppio and the tradition of writing on prevention deriving from him, although, as we shall see, Sennert's view is somewhat contradictory. According to the English translation of 1660, he says:

Wheneas ‘tis safer to prevent a Disease than to cure it, some Physitians endeavor to teach, by what means one may keep himself clear, though he have had to do with an infected Woman. Of which business Falloppio treats in the whol Chapter, 89 De Morb. Galli, and he writes that he should seem to have done nothing unless he teach, how one seeing a handsome Woman, and lying with her though infected, may be preserved from the French Disease: and he calls the immortal God to witness, that he hath made tryal of it in ten thousand (sic) men, and none of them was infected: and he propounds there two medicaments, by which the Contagion received may presently be drawn forth, dissipated, or dryed up.”³³

By calling attention to the appeal to “the immortal God to witness,” Sennert teases out the contradiction between Falloppio's seeming encouragement to sin even more boldly (fortified by the preventive measures) and the Italian's somewhat conventional or even routine religiosity that allows Falloppio to call upon God to guarantee the veracity of his discourse. He charges that syphilographers in the tradition of Falloppio (including Ercole Sassonia and Eustachio Rudio) give people a sense of security so that, guarded with these medicines “as with a buckler” (tamquam clypeo), they “enter the most infected Whores, and freely ramble all the world over” (p. 27). Sennert thus seems to disagree with the principle of such prevention: “But indeed I do not believe, that those things can be taught with a good conscience, by which so many men are encouraged to lust, whom perhaps the fear of this disease might have frightened from it; and therefore we will say nothing of these medicines.”³⁴ Sennert indeed does not report Falloppio's preventive stratagems, most notably the linteolum (small linen cloth) cut and shaped to the size of the penis and steeped in certain lotions, and if he had ended his chapter on prevention with this morally charged figure of omission (praeteritio), one would have to grant his stance a logical and moral consistency. But Sennert does not stop here.

Drawing on Aurelio Minadoi (fl. 1596),³⁵ Sennert now wonders whether Falloppio and the others following him are not deceived about the nature of the infection: perhaps the disease is not communicated only “by very small purulent corpuscles” (per minima corpuscula saniosa) which can be wiped away. “He [Minadoi] teacheth that the Contagion does not only enter by the external parts of the Privities, but also chiefly by the internal, and runs through the Body, and that the infected Vapors, and spirits do pass through the internal porosities, and are admitted by the Veins” (p. 27). With hardly a touch of the moral indignation that informs Sennert's reaction to Falloppio, Minadoi had argued that the “shield” was only imaginary, and in addition to the internal porosities of the genitals, there was also oral infection.³⁶ For Sennert, the consequence of this doubt about the kind of prevention advocated by Falloppio is clear: “Therefore no man can promise himself health and safetie from washing, which only reaches to the external parts, nor from other Medicaments outwardly applied, neither can such external Medicaments take away the Pollution conceived within. The safest way therefore to avoid this disease is to abstain from whores, and to remember that Whoremongers and Adulterers the Lord will judge, who is wont also to punish them in this Life, with the most filthy Disease” (pp. 27-28). Even this view has some limited consistency: one should not teach prevention that induces people to sin more boldly. The moral-theological view is supplemented (if not supported) by the medical consideration that the sense of safety from the disease may be false. This means of prevention may not be effective—two good reasons, then, why Sennert does not mention Falloppio's linteolum.

But Sennert does not leave matters at that, going on to report that the physician Palmarius (Julien Le Paulmier de Grentemesnil [1520-1588], disciple of the celebrated Jean Fernel) has another means of preventing this disease, namely an internal medication. This antidote or “mullet” is claimed to make the body impervious to the infection:

Yet he [Palmarius] entreats and conjures al Physitians and Chyrurgeons, that they do not communicate and make known that Medicine in obedience to lustful people, and that they make not themselves fosterers of lusts, but to them only who must necessarily converse with those that are suspected or defiled. But he describes that Antidote, Lib. 1 cap. 8. and this is it. (p. 28)

Then follows the recipe and dosage, printed for everyone to see.

To some extent Sennert is here reproducing the inconsistencies of the French physician's moral stance in his chapter, “Precaution Against Lues Venerea.” Palmarius had said that “if someone intends to avoid lues venerea, he will either have to abstain entirely from illicit coition (impurus concubitus) and other veneral contact, which Christians ought to do anyway, or else so prepare and arm his body that it will admit least of it.”³⁷ After referring to the proverbial King Mithridates as his model (who by frequently imbibing an alexipharmacum is supposed to have made his body eventually resistant to poison), Palmarius had indeed claimed to have “found” or “invented” (invenimus) such an antidote against venereal disease. Since he did not want base whoremongers go free of the dire punishment for their shameful acts (gravissimae flagitiorum suorum poena) but rather have them rein in their lusts by considering God's wrath and vengeance (numinis ira et ultio), Palmarius had indeed, as Sennert reports, implored physicians and surgeons to keep his “amulet” from the wrong people. But finally Sennert's account takes another turn: after printing the recipe for the French physician's amulet or antidote, Sennert adds the skeptical note: “But whenas all those simple Medicaments, which are in the Antidote, are not proper to this Venereal Disease, we must consult with experience, whether their virtue be so great, as Palmarius cries it up for.”

Sennert's chapter on the prevention of venereal disease is unusually challenging. I consulted the Latin text hoping to find that some of the difficulties were the result of a moralizing English translator. But the translation is quite accurate: the bobbing and weaving is all Sennert's. At least three explanations of this tortuous movement of the text can be offered. It might be said that some of the contradictions are the result of the principle of inclusiveness or completeness, so powerful in the prescientific era, a principle that impelled a Robert Burton to collect everything available on the subject of melancholy, even if he was unable (in spite of repeated attempts to divide and order) to shape the contradictory elements into an entirely coherent new whole. Second, Sennert's moral sense, which dictated both his attack on Falloppio and his withholding of the Italian's preventive measures, may have been a little shallow, since after the broadside on Falloppio Sennert did not hesitate to give the details of Palmarius's internal “antidote,” in possible violation of the Frenchman's insistent request not to divulge it to potential abusers. Finally, Sennert's way of revealing some measures of prevention and concealing others might still have been controlled by the same moral sensibility: in spite of Minadoi's reported skepticism, Sennert might have feared that readers could be seduced by the authority of Falloppio to rely on his preventive prescriptions and engage in sex acts both illicit and injurious to their health. Minadoi, on the other hand, was pretty much a medical unknown, the tractatus being his only publication.³⁸ There is even the possibility that Sennert, although registering Minadoi's skepticism, might himself have been attracted to the view that the prevention advocated by Falloppio would work. As to Palmarius, who, as Jean Fernel's student, was better known than Minadoi but certainly not of the eminence of Falloppio, Sennert might have considered his own reservations about the Frenchman's antidote, the simples of which were not specifically indicated for the new disease, persuasive enough to discourage reliance upon it; but since commission on Sennert's part is at least as bothersome as omission, this latter point must remain hypothetical.

Sennert's ideas on venereal disease are important partly because, translated into English, they had considerable impact on an English public familiar only with the vernacular. At the end of the century, the anonymous author of “Some Curious Problems,” in A Method of Curing the French-Pox (London, 1690), allegedly a Frenchman, follows the tortuous movement of Sennert's argument surprisingly closely when writing his Problem VII, entitled, “If there be any infallible Preservative against the Venereal Distemper.” These are the opening sentences of a detailed answer:

Libertines have been, for a long time, searching for some preventing Medicine to Arm them against the Venereal Distemper, that they might continue their dissolute Life, and yet be without the reach of that Disease. We also see, that some Authors do give Prescriptions for this purpose; from which some promise themselves marvellous Success, and are very confident, that by that means, Men may take their swing, keep as much company as they do please with Persons infected with the Venereal Distemper. By this, all Men of Sence may easily judge, that such Authors are Cheats, which to purchase Credit at the cost of others, do venture all at one, and so prostitute their Conscience, which must needs be struck with horror, for teaching a Remedy in favour of a debauched Conversation. … (p. 117)

With such a “remedy,” the anonymous author argues, males would flock to the “stews,” just as young women (according to the anonymous author) would not value virginity if they had a contraceptive. Then he takes the same turn as Sennert, “All such Preservatives, to speak properly, are nothing else but Impostures” (p. 118), possibly achieving a little more precision by adding: “the most conclusive is such, as at most, does only prove the possibility of such a Remedy.” Like Sennert, the anonymous author then launches into a discussion of “talismans” as he remembers “men who being fortified with good Antidotes did so vigorously defend themselves against Poyson that they suffered no alteration from them”—a version of Palmarius's reference to Mithridates. He gives credence to such talismans for preventing the plague, but apparently not venereal disease; the reason is that God sees no need for it:

But, as to the Venereal Distemper, seeing that it is commonly the reward of the Sin of Fornication, which God has always had in Abomination, and that that Distemper may be avoided by Continence, which is the true Preservative, it seems that it was no ways necessary that God should create a specific Preservative against that. (p. 120)

Although largely paralleling Sennert's argument, the anonymous author goes beyond him in one respect, namely in raising the question of the plight of those guiltlessly infected by the disease:

And for those, being innocent, have contracted the Venereal Distemper, as Infants in the Mother's Womb, or on the Breasts, Virtuous Women who have got it from their dissolute Husbands, and those good Husbands that are trespass'd by their extravagant Wives; It is sufficient, that there are assured Medicines in Nature, and in the hands of skilful Artists for the Cure of that Distemper. (p. 120)

Here ethical curiosity is apparently quickly stinted by moral-religious justification, a seemingly easy theodicy that minimizes human suffering. The author does not go far beyond Sennert.

Sennert fits into the intellectual landscape of Europe somewhere between, on the one hand, the Italian syphilographers willing to furnish their students with the prophylaxis that would allow them to enjoy compliant women safely and yet capable of invoking God for a witness in the same context and, on the other, the English surgeons and physicians writing on the subject, imbued with values that make them view almost every aspect of the disease through a moral lens. (That the English works are in the vernacular and might have been considered more easily misused by their authors may skew the comparison slightly, but not significantly. Clearly Falloppio's lectures, although in Latin, attracted a varied, though of course entirely male, audience.) Between the physicians in Italy, whose interest in preventing disease is so immediate and seemingly without reflection that they feel no need to justify it, and the Englishmen, whose moral stance is consistent with their silence on prevention (but whose medical stance may have its contradictions), the Wittenberg professor articulates his moral opposition to a prevention that he believes will make men morally irresponsible. But at the same time genuine doubts were being raised about the effectiveness of Falloppio's ideas or about any kind of prevention, doubts Sennert thought it his duty to communicate. If these doubts were justified, the entire matter seemed to shift back from being a moral problem to a primarily medical one. Perhaps because the unsettled question of medical effectiveness then could be seen as superseding the moral question of prevention or as taking priority over it, Sennert was unable to address with greater clarity the possible conflicts between a physician's medical and moral duties. Obviously such Renaissance discussions relate to pressing issues of our day, for instance to what has been called “the clash of pragmatism and morality.”³⁹

Ultimately, Sennert may also have lacked the tools that had been sharpened by the canonistae and summistae in a long tradition of moral casuistry, terms like “commission” and “omission,” as well as various categories of conditional speech and indirect enticement. Another limitation, which he shared with most physicians of his time, was that he perceived the dangers of venereal disease primarily in terms of dangers to men. Tapping into the large reservoir of Roman Catholic casuist thinking and using the important ethicist and physician Paolo Zacchia (1584-1659) as an intermediary, Giovanni Battista Sitoni, an Italian physician of a curiously “feminist” temper, was soon to challenge the Italian secular teaching about syphilis (for which he chose Sassonia as his prime and negative example) as misguided in order to advocate a medical ethics guided by higher norms.

WOMEN AND THE ORIGIN OF SYPHILIS

In the previous section we traced Renaissance ideas according to which particular groups of people or individual nations are punished with syphilis, as well as the ways such moralized views of pathology inform Renaissance ideas about prevention. For us these ideas adumbrate the modern dilemma of ethicists whether to recommend abstinence or use of condoms.⁴⁰ Anna Foa has shown how, during the first few decades after the appearance of syphilis in central Europe, the tendency was to make an “other” responsible for it: it was the disease of the French, Italian, American Indian, or the Jew.⁴¹ However, beyond incidental comments (for instance, by Foa and Anthony Grafton), no one has yet studied in detail how women figure in these early speculations about the origin and transmission of a deadly disease. This is surprising since early ideas about syphilis offer a more powerful argument for the social construction of disease and its nexus with gender than complex recent examples like chlorosis and AIDS, through which that argument has been proposed. Further, as we will see, one rather special (and admittedly rare) application of the gendered form of these ideas in the Renaissance was to elicit in the mid-seventeenth century a wide-ranging attack on a secular medical ethics.⁴² In fact, one cannot read far into the works of Renaissance syphilographers without being struck by the gendered perceptions of syphilis in the period.

Pervasive in so many contexts of Renaissance physicians' writing about this disease is the assumption that women are the agents, the active infectors. Philip Barrough's comment on the dangers of the French disease may stand for the most general form of this assumption: “There be develish women desirous to be handled and dealt withall, who will beautifie themselves, to inflame mens hearts to lust towards them.”⁴³ Ercole Sassonia (1551-1607), in the period celebrated as a distinguished medical practitioner and author, believed that at least sometimes the disease is caused by excessive heat of the vulva.⁴⁴ Occasionally the view was held that syphilis arose from sexual intercourse during menstruation. The modern reader may immediately recognize this hypothesis as another way to hold women responsible. However, an anonymous (allegedly French) medical author (whom I quote in a translation of the seventeenth century) interprets this as a fabrication to excuse women:

There is frequently a specious Pretext used to palliate the the Crimes of such Women as have given the Venereal Distemper to their Husbands, by telling them, that the mischief has therefore befallen them, because they would needs embrace them whilst they had their Courses. There are some who tell some Old Women's Stories, or some Passages taken out of Cardan, John Baptista Porta, or the Book of Albertus Magnus, de secretis mulierum. They alledge that the Vapour of the Menstrua does stain Looking-glasses, so as no man can remove the Infection, that Women kill the Plants that are near them. …⁴⁵

This explanation of the origin of syphilis, here effectively ridiculed, obviously makes use of the view of the menses as poisonous, a view strongly opposed by the well-known physician Mercuriale (1530-1606, who was held in high esteem by Pope Pius IV and Emperor Maximilian II). But Mercuriale's view gained acceptance only gradually over what is here, in a gendered polemic, called “Old Women's Stories.” (If, as late as the eighteenth century, the notoriously commercial publisher Curll could market an English translation of the de secretis enticingly as on the secrets of women, it may not be surprising to find the notion of the poisonous menstrual discharge very much alive in the seventeenth.)⁴⁶

Pietro Rostino (sixteenth century), who wrote a popular tract on syphilis (in Italian), thought that all infectious diseases were caused by some form of humidity (that swamps are unhealthy is a medical commonplace, reappearing in different guise also in Fracastoro's notion of infectious seminaria arising from humid places). In the case of syphilis, the “humidity” (according to Rostino) was supplied by the ulcerated pudenda of a woman during intercourse. According to another hypothesis about the origin of the French disease, neither the menses nor ulcers in the woman's organs but leprous infections were the catalyst. According to Gaspar Torrella (1452-1520), the disease erupted after a leprous knight on the way to the Italian campaign had intercourse with a woman at Valencia, who then infected many other men.⁴⁷ A little later, Thierry de Héry (ca. 1500-1560), who accompanied Francis I in 1539 on his ill-fated Italian campaign (during which Héry learned to treat the disease that, as he boasted, was to make his fortune), has a more precise version of what seems to be the same encounter: “The authors say, and it is the most common opinion, that when King Charles VIII went to Italy in 1493 to put down Naples, a leprous knight at Valencia in Spain bought a night with a woman for 50 ecus, who afterward infected several young men sleeping with her, several of whom followed the king's train.”⁴⁸

I am reporting this hypothesis in detail because it is close to the theory of origin that Paracelsus (1493-1541) is alleged to have had. In his Chirurgia magna (1536), he said that syphilis came from the intercourse of a leprous Frenchman and a prostitute with uterine sores,⁴⁹ and it seems to be this passage that, in the seventeenth century, Stephen Blankaart has in mind when he reports without giving his source that Paracelsus attributed the outbreak of the French disease to a leprous prostitute in 1478.⁵⁰ However, either Paracelsus was vacillating between different explanatory attempts or he arrived at the one just named only gradually; for the Latin and German versions of Paracelsus's Vom Ursprung und Herkommen der Franzosen (1529) are slightly different. Here, at the beginning of bk. 1, chap. 1, Paracelsus indeed gives a pre-Columbian date for the outbreak of the disease (1480) and (without reference to a prostitute) attributes it to luxuria (voluptuousness) at the moment of conception. In the following chapters, particularly chapter 5, he stresses the proximity of the disease to leprosy.⁵¹ For a compiler like Blankaart, Paracelsus's view was important, although Paracelsus seems to have borrowed the attribution of the origin of the disease to leprous women from other physicians. Indeed, in the first half of the sixteenth century, Pietro Andrea Mattioli, personal physician to two emperors, says he has this version from “several” informants or authors (nonnulli).⁵²

Finally, and perhaps most interestingly in my context, there is a theory which, for convenience, I will quote from A New Method of Curing the French-Pox, since it is in English. The already adduced anonymous (and allegedly French) author of that book subscribes to it. (An earlier version can be found in Giovanni Tommaso Minadoi, another highly reputed physician and professor at Padua, who died in 1615.)

But 'tis known, that if a Virgin, that is perfectly sound (if the Matter be so ordered as to free her from all suspicion of the Venereal Distemper) shall keep Company with half a dozen young Fellows, as sound as herself, and be debauched with them severally, time after time, some one or other of them shall quickly have the Pox, and all of them, by a repetition of Venereal Acts, shall at last be infected. (p. 3)

The French disease is thus imagined to arise without extraneous infection, a scenario that would most commonly hold in the case of prostitutes. Our author restates the matter, perhaps slightly more ambiguously, but adding what to him is the crucial element of the theory:

I suppose that a common Woman has the Pox, and though she were not infected, if she has a particular Conversation [intercourse] with many Men, the mixture of so many Seeds does occasion such a Corruption in the Passage of the Matrix, that it degenerates into a proper virulent Ferment. … (p. 20)

The author explains at length and by various analogies how he imagines the “venereal ferment” to develop into the “venereal distemper”: still holding, according to the Galenic tradition, that women also have seeds, he thinks that “the Seeds of one Man and of one Woman only can never degenerate into contagion and Venereal Ferment …” (p. 29). This leads him to the conclusion that “it shall therefore happen when a Common Woman has kept company with many Men, that the Seeds (which are of different, and often times of opposite qualities) being mixed into that womans Womb (which is naturally fitted to preserve the Seeds and all their Spirits) do forcibly justle against one another” (pp. 29-30), and the resulting agitation leads to the ferment, which turns into the venereal distemper.

In this scenario (clearly shown also in the hypothetical case of the virgin turning promiscuous), the woman's body becomes the locus of corruption (for which she would also be primarily responsible) and the vehicle of the infection of others. At the risk of overinterpretation, I venture to add that the notion of spirits of male seed in conflict (unnaturally locked in as it were) leading to the corruption of syphilis also has a homophobic element, a version possibly of the homophobic shudder that can be observed elsewhere in the period.⁵³

SYPHILIS AND THE POWER OF VIRGINS

In his well-known Instruction of a Christian Woman, which was translated into many vernacular languages, the famous humanist Juan Luis Vives (1492-1540) reports the following case of a married couple at Bruges. I am quoting the most important parts (of what Vives presents as an eyewitness account) from a Renaissance translation, but supplying some words from the Latin original:

Clare the wyfe of Barnarde Valdaure, a fayre and goodly mayde (virgo tenerrima et formosissima), whan she was fyrste maryed at Bruges, and brought to bedde unto her husband, whiche was 46 yere of age (iam plus quadraginta annos natum), the fyrste nyghte saw his legges rolled and wrapped with cloutes (crura eius fasciis involuta vidit), and founde that she had chaunced on a sore and sickely husband: yet for all that, she lothed hym never the more, nor beganne nat to hate hym: whom yet she had no space to love (quum praesertim nondum posset videri amare). Not long after that, the forsayde Valdaure fell into a great syckeness, in so moche that all the phisitions dispayred his lyfe: than she and her mother gave such dilygence unto the sicke man, that for syx wekes continually together, neyther of them ones put of their clothes, excepte it were to chaunge the smockes: nor rested in the nyghte paste one houre, or iii at the most, and that but in their clothes. The roote of the disease was, that we call the french pockes, (erat radix morbi Indici, quem Gallicum hic vocant), a wonderous sore and contagious sickness, phisitions counsayled her, nat to touche him so, nor come so nere hym: and the same, her friendes counsayled her. And her companions and gossyppes said: it was synfully done, to vexe the man in the worlde, or kepe him longer on live with his sickenes, and bad her provide some good thynge for the soule, as for the bodye care no more, but howe it myght be buryed. … Soo at the laste by the goode meanes of his wyfe, Valdaure escaped the great ieoperdye, that both the phisitions, and all other men swered, his wyfe had plucked hym from deth by stronge hande. And some iested more merily than becommeth christen folkes, and sayd, that god had purposed to have slaine Valdaure, but his wyfe wolde not let him go out of her handes. … Streight after he fell in to an other longe disease, which lasted vii yere. … Moreover whan the ayre of hym and breth was such, that no man myght abyde nere by ten passes, she wolde swere, that she thought it marveylous swe[e]te: And once she was very angrye with me, bycause I sayd it stanke, for she sayd, it semed unto here lyke the savour of rype and swete frute. … So he by the meanes of his wyfe with that dolefull body, more lyke unto a grave than a body (cadaveroso corpore, seu sepulchro verius), continued ten yere from the begynning of his sycknes, in the whiche space she had two chyldren by hym, and six before. For she was married xx yere in the holle: and yet was never infected, nor ones touched with the contagious scabbe, neither she nor yet none of her chyldren, but had all their bodyes both holle and clene. Wherby a man may clerely perceyve, how moch theyr holynes and virtue is worthe (ex quo liquidum sit quanta sit virtus), that love their housbandes with all theyr hartes as dutie is, whiche doubtless god wyll never leave unrewarded.⁵⁴

While the passages attributing agency in the genesis of the disease to women (discussed in the previous section) are perhaps revealing to modern intellectual historians, there is one topic centrally located in the field of medical ethics that called for conscious reflection on gender roles as early as the seventeenth century: the notion that sexual intercourse with a virgin could cure an infected male of syphilis. To counter the objection that fortunately even then the idea may have belonged more to the area of folklore and superstition than to medicine, I have quoted Vives's case of Clara Cerventa and Bernard Valdaura, who were in fact Vives's parents-in-law. Obviously the case fits my context only imperfectly: Vives tells it in his chapter entitled, “Quomodo se erga maritum habebit” (how she will conduct herself toward her husband), and there is no suggestion that the virgo tenerrima cured her husband instantly by sleeping with him—after all, he had what we would call “relapses,” and died (twenty years later) apparently of the same disease. But “she plucked hym from deth” to the astonishment of the community, and in the largest Renaissance compendium of received knowledge, the Theatrum vitae humanae, by the Swiss physician Theodor Zwinger (1533-1588), the story is summarized as a cure from syphilis by a virgin.⁵⁵ Although Vives's modern biographer finds its realism “revolting,”⁵⁶ the case is so redolent of sixteenth-century life that one may be allowed to ask a question that Vives most pointedly does not ask, namely what Bernard Valdaura's motives for marriage were: did he merely want a nurse or did he hope to be healed from his disease by the virtus of the virgo tenerrima? As in the previous chapter on the treatment of hysteria, we are dealing with a subject that is of course highly tabooed, although the proof texts demonstrating the special sensitivity that the topic elicited are in this case even later. But since in the seventeenth century earlier authors are castigated for ever mentioning the belief that virgins might heal syphilitics, it is possible that the outrage Erasmus articulated against pairing diseased men with healthy young women in his colloquy Coniugium impar (Unequal Marriage), and even Alciati's emblem “Nupta contagiosa” (comparing such a marriage to being chained to a corpse), may have this belief as an unmentionable background.⁵⁷

The notion that virgins have the power to heal syphilis has left some interesting echoes in the works of at least two physicians. In his Luis venereae perfectissimus tractatus (1597), Hercole Sassonia raises the following problem in a chapter entitled “De gonorrhaea antiqua”:

But one needs to inquire into what I have heard was experienced by some people in Venice: they claim [dicunt] to have been cured instantly of gonorrhea by having intercourse with a Black woman [mulier Aethiopis]. The experimentum [experience; experiment; demonstration or proof] is true and it seems can be confirmed by [Julius Caesar] Scaliger's exercitatio 180, c. 18, according to whom Africans are cured from lues venerea by sleeping with a Numidian or Ethiopian woman. That I know, too, even though I would consider as invented the reports that indeed more men were freed from gonorrhaea antiqua by sleeping with a virgin spouse; but then the woman gets infected.⁵⁸

In his Exoticarum exercitationum liber, Julius Caesar Scaliger (1484-1553) indeed reports that in Africa (where, according to him, the disease was first imported by Jewish refugees expelled from Spain), “those suffering from it recover, by a gift merely of the Heavens, by sleeping with a Numidian or Black Ethiopian woman, without any other medications.”⁵⁹ Perhaps Sassonia felt some uneasiness about the moral interpretation of this remedy as a “gift of the Heavens,” or else his secular temperament makes him drop or reduce such interpretation generally. But he did not express his uneasiness clearly. His inaccuracy about section and chapter numbers in Scaliger is minor. But there are more serious problems with Sassonia's passage.

First, an ambiguity about what Sassonia reports to be “true” (verum) is somewhat troubling: “they say” (dicunt) they have been cured in this special way—is it true that they say so (i.e. is it true that people making such claims exist?), or is the content of their claim true? Most troubling is the form consignam: is it a printer's misreading of consignari? (As we shall see, a seventeenth-century reader and fluent Latinist did not think so.) Then there is the possibility that consignare literis should not be translated idiomatically as “record,” but as “to assign to letters,” i.e. a realm differing somehow in status from reality. Finally, a punctuation mark may be missing after consignam, resulting in ambiguity as to what Sassonia wants to “note,” “record,” or “assign to letters”: what precedes the verb (the Numidian and Ethiopian story) or what follows (namely the general cure by virgins). By choosing the latter reading, my translation may be said to give Sassonia the benefit of the doubt and avoid the more obnoxious reading. If however, a syntactic break after consignam was intended (which could have been, but need not have been, indicated by a mark of punctuation), Sassonia is saying that several or “more” (plures) have been cured in this way. If we accept the Latin as it is, nothing is ambiguous about the final sentence: Sassonia knows for certain, as the verb in the indicative indicates, that the woman gets infected in this process. As we shall see, not everyone gave Sassonia the benefit of the doubt.

Sassonia was taken to task in the seventeenth century by the physician Giovanni Battista Sitoni (1605-1681), who discussed the matter under the chapter heading: “Whether a man suffering from the French disease will be cured of the disease by intercourse with a virgin?”⁶⁰ To my knowledge, Sitoni is the first physician to emphasize that man and woman both labor under the scourge of venereal disease. In fact, the discussion of this farsighted Milanese physician (on whom the standard biographical dictionary by August Hirsch is disappointingly brief) has a preface that we may call (admittedly anachronistically) “feminist” on the relative value of man and woman. It concludes that both are “correlative” (correlativa, p. 288). Far from being a commonplace at that time, the idea of their correlative nature becomes a focal point of Sitoni's argument.

Sitoni is possibly also the first to say with similar emphasis that the disease “is not only transmitted from women to men but (since it is reciprocal) also from men to women.”⁶¹ In this context Sitoni reports that “nevertheless a certain remedy of this scourge is pranked up as if it could serve as the safest cure of infected men,” namely coition with a virgin.⁶² Sitoni objects that there is no truth to the claim, nor can there be, for it would be just as absurd to claim that an infected woman could be cured of the disease by sleeping with an inexperienced male. He is so fond of this argument, derived from his axiom of the correlative nature of man and woman, that he will repeat it later in even greater detail (p. 292). He assigns the presumed powers of virginity to mere popular belief (credit vulgus, p. 291) and, drawing on humoral physiology, reasons that coition does not change the balance of the patient's humors, which (according to Galen) would be necessary for a cure. In any case, he reports, experience tells us only that when syphilitic men marry virgins, they infect them without in the least being cured of the disease: he has not seen a single case where such a man was healed.

All this is preparation for taking on the famous physician and syphilographer Ercole Sassonia. “In this respect we say that the presentation of the most learned Sassonia … is insufficient when he writes the following.” As he then quotes, Sitoni does not give Sassonia the benefit of the doubt. In fact, he inserts a colon in the critical space after the verb consignam (which he amends to consignem), making sure that Sassonia is not read as assigning to letters (fiction?) the cure of plures by their virgin spouses, but that his skepticism refers to what precedes the verb. (He also changes licet to scilicet.) Thus he has Sassonia say: “That [i.e. the habits of Africans] I know, too, even though I would consider it letters [fiction?]; more men were evidently freed from gonorrhaea antiqua by sleeping with a virgin spouse, but then the woman is being infected.”⁶³ Possibly because he reads the sentence as casting some doubt on the African practices, Sitoni does not separately raise the issue whether Sassonia's passage might induce someone to look for a Black woman. Sitoni charges that the counsel he interprets Sassonia to be proffering is governed by the subtlety of lust rather than the desire for health; it behooves no decent man to deceive some poor young virgin and, by the ruse of seeking health, expose her to such a scourge, putting her life at the highest risk. He adds that “a believing physician” (pius medicus) should not offer such advice to anyone, since he would be advocating something “novel and voluptuous,” i.e. would be going beyond accepted modes of cure.

He reasons in even more detail that such medical advice would either lead to “illicit” intercourse (with just any virgin) or to a “licit” act (with a virgin married just for that purpose). Advice to do the former is improper, since it is an accepted principle of ethics that one should neither commit, nor advise anyone to commit, any act in the interest of health that leads to sin. Here he refers among others to Zacchia (1584-1659), protomedicus of the Vatican and personal physician of Innocent X and Alexander VII, and to the physician Codronchi (sixteenth century), author of the often quoted book on Christian (and decidedly Catholic) medical ethics that I have adduced several times (particularly in chapter 4). Advice to do the latter, i.e. to marry a virgin for the sake of health, is improper for the same reason, and Sitoni lists a number of legal and medical authorities (among the latter Rodrigo a Castro) for the traditional principle to stick with “safe and certain” (tuta et certa) remedies. He points out that it is an equally accepted principle not to ruin the welfare of one for the sake of that of another and makes explicit what was perhaps not always implied, namely that the life of a woman is to be valued as much as that of a man (p. 294). Since offspring are traditionally the major purpose of licit intercourse (while with the wife's infection no healthy offspring, if any at all, can be expected), medical counsel to enter matrimony for such an extraneous reason would endanger the patient's spiritual health in this respect also. That such action is neither to be comitted nor to be counseled “not only all Canonists conclude, but also all physicians thinking as Catholics.”⁶⁴

The phrase medici catholice sentientes is typical of Zacchia's grouping of medical authorities and is indeed used by the canonist/physician Zacchia in a very similar context (without, however, referring to this presumed remedy for syphilis).⁶⁵ Since all Sitoni's references on this problem of extraneous reasons for marriage are also in Zacchia and precisely so (except that Sitoni erroneously drops a digit in a reference to a chapter by Codronchi—it should be 20, as Zacchia has it), Sitoni was undoubtedly following Zacchia, perhaps exclusively.

Given the scarcity of my information about Sitoni, I can only offer surmises as to why he so deftly took to task the earlier physician, who enjoyed a high reputation and is almost universally referred to with utmost respect. Particularly his strong feeling about gender equity, which I loosely called “feminist,” must unfortunately remain inexplicable. But beyond that, it is clear that his sensibility is formed by writers like Zacchia and the canonistae behind him. On the very page of Zacchia that Sitoni must have consulted on the subject of the inadmissibility of medical counsel endangering the patient's soul (and from which he took the phrase medici catholice sentientes), Sitoni would have found Zacchia adducing the canonists for their opposition also to indirect, conditional, or ambiguous counsel that could induce the patient to sin. Specifically Zacchia quoted the Roman Catholic moral casuist Navarra's example: “I do not advise you to do so, but if you do this or this, you will recover,” and agreed with the Spaniard that such conditional speech was inadmissable. Sitoni would have found Zacchia deliberately going even one step further in also ruling out speech “by exception,” of which he gave this example: “If its sinfullness did not argue against it, intercourse would restore your health.”⁶⁶Unquestionably Sitoni's suspicion that Sassonia was engaging in such forms of indirect counsel triggered his outrage. However dubious his way of repunctuating the earlier physician's sentence may be by modern standards of scholarship, his “revision,” or editing, was only explicating one particular way in which Sassonia's ambiguous sentence could in fact be read; and ambiguity, like indirectness, could lead to results that were obnoxious.

But was Sitoni not using the very mode Zacchia chastised in his example, namely saying that such intercourse for the purpose of recovery from disease was sinful yet thereby indirectly encouraging or at least tempting some desperate males to consider this action? Of course not. He unambiguously said that the cure from syphilis could not be gained by intercourse—while Sassonia had been ambiguous, an ambiguity that could lead to irreparable harm.

I am less certain about a related matter, the occasion of the essay. This particular piece (tractatus 45) of his Miscellanea medico-curiosa is dedicated to Count (comes) Iacobo Francisco Attendolo, who is addressed personally at the end. The author expresses his hope that the addressee, convalescing from a sudden fever, will not loathe perusing the essay, for “so the opportunity of the hour urges, which provides festivities (bacchanalia) to those whom the calamity of the present war does not cause to mourn.”⁶⁷ Most likely these are polite sentences of “paratextual” wrapping, quite conventional in this genre, referring to a contemporary occasion unimportant for the subject of the piece. But there is at least the possibility that the somewhat elliptic language is coded, namely that the “fever” from which the comes illustrissimus is suffering is a euphemism, and that he personally could profit from the argument.

Ercole Sassonia (whose moral sense is critiqued by Sitoni) is one of the most secular-minded writers on syphilis we have reviewed, and it may not be surprising that he struck a seventeenth-century reader as objectionable. Thus, on the subject of lues venerea in conjunction with fever, Sassonia reports two successful cures from that fever: one was Petrus Basalù, “still living and healthy”; the other was Nicoletta, “a most well-known prostitute in Venice, who after suffering for four continuous years from Hectica Venerea and through that period always being confined to her bed, was restored to health through a concoction of Indian wood, so that she can at this time again practice the meretricious art.”⁶⁸Unlike Rudio, whose revealing comment we noted earlier, Sassonia does not feel impelled to explain or excuse his treating prostitutes. That Nicoleta returned to practicing the “art” is part of his story of her successful cure, a matter of professional pride, and not cause for moral reflection.

Thus this vignette of the cure of a prostitute can serve as an example of medical praxis illustrating the more secular frame of mind one finds in some Italian writers on syphilis but also, more generally, in such an articulate writer on both medical ethics and women's diseases as Rodrigo a Castro. In his work on medical ethics, Castro had criticized physicians who, out of excessive zeal (ex nimio zelo), chide or castigate their patients for their vices rather than putting them at ease.⁶⁹ We saw earlier (in chapter 3) that when Castro, an expatriate from Portugal, was attacked for being Jewish by malevolent and self-serving detractors, his apologists defended him, saying, “Physicians do not concern themselves with conscience, with the health of the soul, but with the health of the body and the remedy and cure of diseases.”⁷⁰ This view, a polemical sharpening of secular trends in Galenic medicine, was precisely the position in medical ethics that Sitoni resented and which he wanted to challenge by writing his piece. Unfortunately Sitoni does not identify the quisquam (someone) whose view he cites and ridicules by applying it to the case in point (the “cure” of sleeping with a virgin):

The physician who is a sensitive [sensitivus = “feeling”? “attending to the sensus”?] master of his art, someone says, must apply himself to the body alone and heal pleasantly [jucunde]. What can be thought up more pleasant for the cure of the French disease than embracing and enjoying a virgin? But the physician is also, one will have to object, a sensitive master of his art; however, “sensitive” does not mean that he should take into account the body alone and not worry about the soul.⁷¹

There is no evidence that Sitoni was pointing to Rodrigo a Castro behind his elusive and possibly merely rhetorical quisquam, although it is true that in one of his most emphatic definitions of his model physician, Castro had pointed out that the ideal cure should also be pleasant, using the word Sitoni highlights (jucundus): “But a prudent, learned, and serious physician always strives for this: that with greatest modesty he cure quickly and pleasantly, and above all safely.”⁷² It would be absurd to argue that Sitoni is charging Rodrigo a Castro with advocating the presumed remedy for syphilis. In this passage Sitoni is interested in a larger and more theoretical point, so theoretical in fact that he has to assume for a moment even the hypothetical curing powers of a virgin, an assumption he knows to be false. “Theoretical,” of course, does not mean ethereal, nebulous, or removed from praxis. It means that the argument has moved beyond the issue at hand (for the “somebody” certainly is not Sassonia) to an evaluation of important opposing positions that inform a physician's action. With his cas limite that balances the worth of man and of woman and taken into consideration both their physical and spiritual health, Sitoni shows convincingly the limitations of such an ethical position as Castro's when it is pushed to its extreme. Against that position, which as he charges takes into account “the body alone,” Sitoni holds up a medical practice that is bounded by Roman Catholic ethics as demonstrated by the physician and canonist Zacchia. It would seem that what I provisionally called Sitoni's “feminist” sensibility is a vehicle for this larger argument, although we may have reached the margin of what is provable. With his argument, opposing the secular medicine that seemed dominant at least for some time at Padua and at Hamburg (where Castro wrote all his books), Sitoni fits perfectly into the emerging line of Catholic medical ethicists (close to the Counter-Reformation) from Codronchi through Zacchia to the physician-priest Girolamo Bardi (1600-1667), who had wanted to be a Jesuit.⁷³ In any case, the opposition between a “secular” medical ethics and a medical practice bounded by traditional religious ethics adumbrates the ideological fault lines that have appeared again in modern discussions of syphilis and AIDS.⁷⁴ In the first sections of this chapter we saw that, despite the demise of the particular prescriptions for the care and prevention of syphilis (such as mercury, guaiacum wood, Falloppio's linteolum), Renaissance discussions of the prevention of this disease relate to pressing issues of our day. However, the material adduced in the final section may put us on guard against facile homologies, for it now appears that the “secular” and “progressive” medical ethics of Sassonia and Castro could more readily accommodate sexist views of disease and therapy than could the religiously defined ethics (of physicians like Sitoni and Bardi), while today the opposite may be true.

I have to leave to the student of mythology the exploration of how to derive the notion that intercourse with a virgin should have a curative effect. Perhaps in this notion her role is analogous to what in early Greek literature is called the therápon, some alter ego onto whom one's impurities may be transferred. (Thus, as Gregory Nagy and others have pointed out, Patroklos functions as therápon of Achilles.)⁷⁵ More specifically, other ideas about the powers of virginity and even about the powers of the Virgin might be relevant, for at work might be a form of thinking theologians call recirculatio, quite common in medieval theology (as, to give one instance, “lost by the tree—saved by the tree,” i.e. the tree of paradise versus the tree of the Cross): lost by a woman—saved by a woman.

It may be objected that the two kinds of gender imbalance in relation to syphilis pointed up in this essay, i.e. imputation of blame for venereal infection to women and the notion of male cleansing through intercourse with a virgin, are arcane and recondite. However, the former kind of imbalance seems to cut across a good number of both rational (i.e. Galenic) academic physicians and those willing to draw on Paracelsus; such references could easily be multiplied. As to the antithetical notion that the virgin is capable of healing the syphilitic, I may have exhausted learned documentation or elite discourse on that point with the passages quoted from Scaliger, Sassonia, and Zwinger. But paucity of passages in this field of sexuality, for obvious and demonstrated reasons highly tabooed, does not mean lack of importance. For, to use George Boas's words, it characterizes the proper detachment of the historian of ideas “to treat ideas that seem silly or superstitious and are perhaps obsolete with the same care as [one] would give to established truths. For the history of ideas tells us among other things how we got to think the way we do—and if that is not of importance, one wonders what is.”⁷⁶

Notes

1. Paul Diepgen, Über den Einfluss der autoritativen Theologie auf die Medizin des Mittelalters (Wiesbaden: Steiner, 1958 (Akademie der Wissenschaften und der Literatur: Abhandlungen der geistes- und sozialwissenschaftlichen Klasse, 1958; No. 1), p. 8 and passim; Owsei Temkin, The Double Face of Janus and Other Essays in the History of Medicine (Baltimore and London: Johns Hopkins University Press, 1977), particularly the essays, “Medicine and the Problem of Moral Responsibility,” and, “On the History of ‘Morality and Syphilis.’” On Francisco Delgardo, see Richmond Cranston Holcomb, Who Gave the World Syphilis? The Haitian Myth (New York: Froben, 1937), p. 146. Anthony Grafton with April Shelford and Nancy Siraisi, New Worlds, Ancient Texts: The Power of Tradition and the Shock of Discovery (Cambridge, Mass.: Harvard University Press, 1992), p. 193.

2. In his indispensable Bibliotheca realis medica (Frankfurt, 1679), pp. 189-93.

3. Ulrich von Hutten, De guaici medicina et morbo gallico (Mainz, 1524), c. 2 (sig. b2). For an early trans. see De morbo Gallico, trans. Thomas Paynel (London, 1533; STC 14024), fol. 1. For a scholarly translation with valuable footnotes, see Ulrich von Hutten, Le livre de la maladie française, ed. F. F. A. Potton (Lyon: Perrin, 1865), p. 17. A facsimile reprint of Leoniceno, Libellus de epedemia, quam vulgo morbum Gallicum vocant (Venice, 1497), is included in The Earliest Printed Literature on Syphilis, ed. Karl Sudhoff and Charles Singer (Florence: Lier, 1925). The best recent general study addressing the problem of the origin of syphilis and many other matters relating to the disease, which would serve as an ideal background reading for my more narrow study, is Claude Quétel, History of Syphilis, trans. Judith Braddock and Brian Pike (London: Polity Press, 1990).

4. Barrough, “The Sixth Booke Containing the Cure of the Disease Called Morbus Gallicus,” in The Methode of Phisicke (3d. ed., London, 1596), p. 361.

5. Blankaart, Abhandlung der sogenannten Frantzoss oder Spanischen Pocken-Krankheit, in his Die belägert- und entsetzte Venus (Leipzig, 1689), p. 2.

6. Ibid, pp. 4 and 487, respectively.

7. De guaiaci medicina, c.1 (1524 ed., fol. a4^v). De morbo Gallico, trans. Paynel fol. 1^v, and Hutten, livre de la maladie française, ed. Potton, p. 4. Hutten says that the word derives from a saint whose name he does not know. According to the editor (Potton), this would be Mevius or Menius, invoked against skin diseases. Potton also notes that the physician Laurent Joubert (1529-1583) derives mevium from minnen, an “obscene word” for the genitals. Minne of course means “love.” I suggest that there may be a confusion with L. menium, usually glossed by L. vestibulum, “front room” or “gallery,” possibly used for genitals by euphemistic transference.

8. Bullein, “The Booke of Compoundes,” fols. 42^v-43, in his Bulwarke of Defence Against All Sicknesse (London, 1579); first ed., 1562.

9. Clowes, A Briefe and Necessarie Treatise Touching the Cure of the Disease Called Morbus Gallicus (London, 1585), c. 2, fol. 2^v. Johannes Fabricius calls Clowes “the first English venereologist.” See Fabricius, Syphilis in Shakespeare's England (London and Bristol, Pennsylvania: Jessica Kingsley, 1994), p. 106.

10. See the section “Sin as Sickness” in chap. 3 of my Imagery of John Donne's Sermons (Providence, R. I.: Brown University Press, 1970), pp. 68-85.

11. Wither, Britain's Remembrancer (London, 1628), fol. 45v.

12. Clowes, A Prooved Practice, for All Young Chirurgians, Concerning Burnings with Gunpowder. Hereto is adjoyned a Treatise of the French and Spanish Pockes … by J. Almenar (n.p., 1588), p. 111. Almenar's work is of 1502.

13. Rosebury, Microbes and Morals: The Strange Story of Venereal Disease (New York: Viking, 1971), p. 122.

14. Von Hutten, (1524 ed.), c.1 fol. a4^v: “Ibi tum Dei iram interpretati sunt Theologi, quem hanc malorum a nobis morum poenam exigere, hoc supplicium sumere, ac si in supernum illud consilium admissi aliquando didicissent, publice docuerunt, quasi nunquam peius vixerint homines. …” Ed. Potton, p. 6. In his English translation of 1533 [fol. 1^v-fol. 2], Paynel tones down the ridicule.

15. For a broader treatment of the subject, see Claude Quétel, History of Syphilis, particularly the section, “Remedies,” pp. 58-63.

16. The Earliest Printed Literature on Syphilis, ed. Sudhoff and Singer, Introduction, p. xxxii.

17. Tractatus, cum consiliis contra pudendagram sive morbum Gallicum, in Earliest Printed Literature on Syphilis, p. 190: “Dicunt Astrologi hunc morbum evenire a constellatione corporum superiorum. Nam dicunt quod effectus universalis in causas universales resolvi debet. Alii dicunt quod est flagellum dei.”

18. Ibid., p. 113.

19. Massa, Il libro del mal francese (Venice, 1566), p. 279; cf. Quétel, History of Syphilis, p. 58.

20. Massa, Il libro del mal francese, p. 282: “… con il presidio divino (donde derivano tutti i beni).”

21. Estienne, L'introduction au traitté de la conformité des merveilles anciennes avec les modernes (Lyon, 1592), bk. 1, chap. 13, p. 86.

22. Gabriele Falloppio, De morbo Gallico, in Opera omnia (Frankfurt, 1600), vol. 1, 737: “Ego nihil fecisse videor, nisi doceam vos, quomodo quis videns pulcherrimam sirenam, et coiens cum ea, etiam infecta, a carie et lue Gallica praeservetur. Ego semper fui huius sententiae, quod adsitratio praecavendi, ne per contagium huiusmodi ulcera oriantur. Sed quae est ista ratio?” In the Paduan edition of 1564, the passages to which I am referring are pp. 52-53^v.

23. Ibid., vol. 1, p. 737: “Ideo investigavi hoc medicamentum. Sed quia oportet etiam meretricum animos disponere, non licet nobiscum unguenta domo afferrre. Propterea ego inveni linteolum imbutum medicamento, quod potest commode asportari, cum femoralia iam vasta feratis, ut totam apothecam vobiscum habere possitis.”

24. Quétel, History of Syphilis, p. 59.

25. Falloppio, De morbo Gallico, in Opera omnia, vol. 1, p. 682: “Hoc est perpetuum et aeternum dogma: quod propter peccatum advenit mors, et propter errorem poena. Hinc factum est, quod Deus saepe morbis castigavit peccata nostra.”

26. Ibid., 683: “Causam huius explicandam relinquo Theologis.” On the use of the rhetorical figure praeteritio in sensitive contexts, see my essay, “Burton's Use of praeteritio in Discussing Same-Sex Relationships,” in Renaissance Discourses of Desire, ed. Claude J. Summers and Ted-Larry Pepworth (Columbia, Mo., and London: University of Missouri Press, 1993), pp. 159-78.

27. Falloppio, Opera omnia, vol. 1, 683: “Novissimum est, quod prae manibus habemus, et morbum Gallicum seu Gallicam scabiem appellamus, missum a Deo, ut timidiores facti Veneris luxuriam relinquamus, et studiis non solum literarum, sed etiam bonarum omnium artium incubamus.”

28. Ercole Sassonia, Luis venereae perfectissimus tractatus (Patavii, 1597): “Remedia iis, qui scortantur ne tam facile lue corripiantur.”

29. Rudio, De morbis occultis et venenatis (Venice 1610; first ed., 1604), lib. 5, c. 13: “Remedia valida pro praeservatione a Gallica lue.”

30. Ibid., p. 168: “Sed tanti sceleris, atque flagitii Deum ultorem habebit.”

31. Ibid., p. 192: “In mulieribus vero meritoriis, quas non propter ipsarum sanitatem, sed propter mares operaepretium est praeservare. …”

32. Ibid., p. 168: “Hoc pro salute Medicorum praesertim monuisse volui. Nam si turpe est alios decipi, turpissimum erit, si artem Medicam profitentes in salebras inciderint.”

33. Daniel Sennert, “Of the French Pox,” in Daniel Sennert, Nicholas Culpeper, Abdiah Cole, Two Treatises. The First of the Venereal Pocks, The Second Treatise of the Gout (London 1660), p. 27. The Latin version is in De lue venerea, c. 1, in Sennert, Opera omnia (Lyon, 1666), vol. 4-5, p. 1014.

34. Sennert, “Of the French Pox,” in Two Treatises, p. 27.

35. Aurelio Minadoi, Tractatus de virulentia venerea (Venice, 1596).

36. Ibid., chap. 31, pp. 164-65.

37. Julien Le Paumier, De morbis contagiosis (Paris, 1578), lib. 1, c. 9, p. 37: “Quae cum ita se habeant, si cui luem veneream declinare est animus, eum vel in totum ab impuro concubitu, alioque venereo attactu abstinere, quod Christianos omno decet, vel ita corpus praeparare ac praemunire opportet ut eam minime admittat.”

38. August Hirsch's standard biographical dictionary of important physicians in history has no vital dates for Minadoi. (Biographisches Lexikon der hervorragenden Ärzte aller Zeiten, 2d ed. [Berlin: Urban und Schwarzenberg, 1929-34]).

39. Allan M. Brandt has described in detail the similarity between attitudes toward syphilis and toward AIDS, and an editorial in the same issue of Science speaks of conflicts arising from “the clash of pragmatism and morality.” Brandt, “The Syphilis Epidemic and Its Relationship to AIDS,” Science 239 (1988): 375-80; for the editorial, p. 539. As to attitudes toward AIDS, Harvey V. Fineberg calls the opposing sides somewhat debatably “moralist” and “rationalist”: “There is a fundamental disagreement about the propriety of educational messages to prevent AIDS. … For some the only socially acceptable change is to have people altogether abandon certain behaviors. In this moralist view, it is wrong to have sexual relations outside marriage and it is wrong to use drugs, hence it is wrong to advocate or even discuss anything (such as the use of condoms or sterile needles) that would appear to condone these activities. Others take what might be called a rationalist view: behaviors that will occur and are dangerous should be modified so as to make them safer. Such philosophical differences underlie the reticence of many national leaders about AIDS education, controversies about the propriety of specific educational materials. …” Fineberg, “Education to Prevent AIDS: Prospects and Obstacles,” Science 239 (1988): 592-96, particularly p. 593.

40. See my essay, “Renaissance Moralizing of Syphilis and Moral Issues about Prevention,” Bulletin of the History of Medicine 68 (1994): 389-410.

41. Anna Foa, “The New and the Old: The Spread of Syphilis (1494-1530),” in Sex and Gender in Historical Perspective: Selections from Quaderni Storici, ed. Edward Muir and Guido Ruggiero (Baltimore and London: Johns Hopkins University Press, 1990), pp. 26-45.

42. See Karl Figlio, “Chlorosis and Chronic Disease in 19th-Century Britain: The Social Construction of Somatic Illness in a Capitalist Society,” in Women and Health: The Politics of Sex in Medicine, ed. Elizabeth Fee (Farmingdale, N.Y.: Baywood, 1983), pp. 231-41; and Gerald M. Oppenheimer, “In the Eye of the Storm: The Epidemiological Construction of AIDS,” in AIDS: The Burdens of History, ed. Elizabeth Fee and Daniel M. Fox (Berkeley: University of California Press, 1988), pp. 267-300. On the construction of human sexology through the ages, see Thomas W. Laqueur, Making Sex: Body and Gender from the Greeks to Freud (Cambridge, Mass.: Harvard University Press, 1990). Anthony Grafton and others, New Worlds, Ancient Texts, p. 188. My discussion follows closely my essay, “Infection and Cure through Women: Renaissance Constructions of Syphilis,” Journal of Medieval and Renaissance Studies, 24 (1994): 501-17.

43. Method of Physicke, 3d ed., p. 373.

44. Luis venereae perfectissimus tractatus, fol. 5v: “… ex nimia vulvae caliditate.”

45. “Some Curious Problems … Concerning the Venereal Distemper,” in A New Method of Curing the French-Pox (London, 1690), p. 121 (Wing N672).

46. On the history of female sexuality, see Danielle Jacquart and Claude Thomasset, Sexuality and Medicine in the Middle Ages, trans. M. Adamson (Princeton, N.J.: Princeton University Press, 1985); Ian Maclean, The Renaissance Notion of Woman: A Study in the Fortunes of Scholasticism and Medieval Science in European Intellectual Life (Cambridge: Cambridge University Press, 1985). Specifically, on England, see Audrey Eccles, Obstetrics and Gynaecology in Tudor and Stuart England (Kent, Ohio: Kent State University Press, 1982); and Patricia Crawford, “Attitudes to Menstruation in Seventeenth-Century England,” Past and Present 91 (1981): 47-73. On a related subject, Ottavia Niccoli, “‘Mentruum Quasi Monstrum’: Monstrous Births and Menstrual Taboo in the Sixteenth Century,” in Sex and Gender in Historical Perspective, pp. 1-25.

47. Rostino, Trattato di mal francese (Venice, 1556), pp. 28-36; Torrella, Tractatus cum consiliis contra pudendagram seu morbum Gallicum (1497), in The Earliest Printed Literature on Syphilis.

48. Héry, La méthode curatoire de la maladie vénérienne (Paris, 1660), p. 2. On Héry, see Quétel, History of Syphilis, p. 62.

49. Parcelsus, Chirurgia magna (Strasbourg, 1573; first ed., 1536), p. 97, reported by Anna Foa, “The New and the Old,” in Sex and Gender in Historical Perspective, p. 39.

50. Blankaart (1650-1702), Abhandlung der sogenannten Franzoss oder Spanischen Pocken-Krankheit, in his Die belägert und entsetzte Venus, p. 4.

51. Paracelsus, Sämtliche Werke, ed. Karl Sudhoff, vol. 7 (München: Barth, 1923), p. 189, and Opera omnia (Geneva, 1658), vol. 2, p. 174.

52. Mattioli, in Morbi Gallici curandi ratio equisitissima a variis … medicis conscripta, ed. Joseph Tectander (Basel, 1536), p. 8: “Nonnulli morbum Gallos, cum per montem Salvium iter facerent, a foeminis leprosis per coitum primitus contraxisse, eorum postea intemperantia atram bilem pituitamque procurante, memoriae prodiderunt.”

53. See my essay, “Le feu caché: Homosocial Bonds Between Women in a Renaissance Romance,” Renaissance Quarterly 45 (1992): 293-311.

54. Vives, The Instruction of a Christian Woman (n.p., 1541), fol. 74-77 (STC 24858), and “De institutione foeminae christianae,” lib. 2, c. 4, in Vives, Opera (Basel, 1555), vol. 2, pp. 707-08.

55. Theodor Zwinger, Theatrum vitae humanae (Basel [1604]), 374a. As to the stage of Bernard's syphilis when he married, he was most likely not infectious. Therefore it is consistent with the usual course of the disease that Clara remained uninfected for twenty years and had nonluetic children.

56. Carlos G. Noreña, Juan Luis Vives (The Hague: Nijhoff, 1970; International Archives of the History of Ideas, no. 34), p. 51.

57. In the context of writing on women as innocent victims, Anthony Grafton mentions Erasmus and Alciati: See Grafton and others, New Worlds, Ancient Texts, p. 188. Geoffrey Whitney, A Choice of Emblemes (Leiden, 1586), p. 99, takes over the emblem with the Erasmian lemma: Impar coniugium.

58. Sassonia, Luis venereae tractatus, c. 37, fol. 40: “Sciendum autem est, quod habui a quibusdam expertis Venetis; Dicunt se a Gonorrhaea statim curatos usu Veneris cum mulier Aethiope. Experimentum est verum, et videtur posse confirmari ex Scaligero exercitatione 180. cap. 18. qui scribit Affros a Lue Venerea curari, dum in Numidam, et Aethiopam sucedunt. Haec quoque scio, si tamen literis consignam licet antiqua gonorrhaea plures fuisse liberatos, qui cum uxore Virgine rem habuerunt, sed tunc mulier inficitur.”

59. Scaliger, Exotericarum Exercitationum liber XV de subtilitate, exercitatio 181, c. 19 (Hannover, 1620), p. 563: “Qui eo laborant, si in Numidiam aut in Nigricam sese conferant Aethiopiam, solius Caeli beneficio, sine ullis medicamentis convalescere.” On attributing syphilis to the Jew as the “other,” see Anna Foa, “The New and The Old,” in Sex and Gender in Historical Perspective.

60. Sitoni, Miscellanea medico-curiosa (2d ed., Cologne, 1677), tractatus 45.

61. Ibid., p. 288: “Sed non a foeminis solum in masculos pertransit, cum reciprocus sit et a masculis in foeminas etiam transferatur.”

62. Ibid.: “Nihilominus remedium quoddam huius labis celebratur ab aliquibus tanquam ad infectorum virorum curationem certissimum.”

63. Ibid., p. 293: “Haec quoque scio, si tamen litteris consignem: scilicet ab antiqua gonorrhaea plures fuisse liberatos, qui cum uxore virgine rem habuerunt, sed tunc mulier inficitur.”

64. Ibid., p. 294: “… concludunt non solum Canonistae omnes, sed et Medici catholice sentientes.”

65. Zacchia, Questiones medico-legales (3d ed., Amsterdam, 1651), lib. 6, tit. 1, q. 5, p. 380.

66. Ibid.: “Ego quidem non modo existemaverim peccare Medicum conditionaliter loquentem, ut Navarra dicit, Ego tibi non consulo, sed si tale quid faceres, sanareris, sed etiamsi cum haec exceptione loqueretur, Nisi pecatum obstaret, coitus usus tibi sanitatem restitueret.”

67. Sitoni, Miscellanea, p. 296: “Suadet temporis opportunitas, quae bacchanalia concedit iis, quos praesentis belli calamitas lugere non facit.”

68. Sassonia, Luis venerae tractatus fol. 4: “Altera vero fuit Nicoleta meretrix Venetiis notissima, quae cum iam annos quatuor continuos Hectica Venerea laborasset, ac per id tempus semper decubuisset, ligni Indici decocto sanitati est restituta, ita ut hoc etiam tempore iterum artem mereticam profiteatur.”

69. Castro, Medicus-Politicus (Hamburg, 1614), p. 138. The chapter (lib. 3, c. 8) is entitled, “How far should the patient's wishes be gratified?”

70. “Philaletes Lusitanus,” otherwise unknown, in a prefatory letter to Benedict a Castro, Flagellum calumniantium (Amsterdam, 1631). Benedict (or Baruch) is Rodrigo a Castro's son, also a successful physician. On Rodrigo a Castro, see Harry Friedenwald, Jews in Medicine: Essays, 2 vols. (Baltimore: Johns Hopkins University Press, 1944), vol. 2, pp. 448-49: “The Doctors de Castro.” On the embattled status of expatriate Portuguese Jews in Renaissance Central Europe, see R. Bandeira, “La Renaissance et l'Ecole Iatroéthique Portugaise du XVI^e siècle,” in Atti, XXI Congresso internationale di Storia della Medicina (1988), ed. Raffaele A. Bernabeo (Bologna: Monduzzi, 1988), pp. 675-81, and my essay, “Renaissance Medical Ethics: The Contribution of Exiled Portuguese Jews,” in Expulsion of the Jews: (1492), ed. R. B. Waddington and A. H. Williamson (New York and London: Garland, 1994), pp. 147-59.

71. Sitoni, Miscellanea, p. 294: “Oportet, quod Medicus, qui est artifex sensitivus (dicit quisquam) soli corpori incumbat, et iucunde medeatur. Ad quid jucundus ad morbi Gallici curationem excogitari potest, quam virginis amplexus, concubitus. Est equidem (respondebitur) Medicus artifex sensitivus; sed non ita sensitivus, ut solius corporis rationem habere debeat, ac de anima solicitus non sit.”

72. Castro, Medicus-Politicus, lib. 3, c. 24 (p. 205): “Cordatus vero, eruditus, et gravis medicus id semper ante oculos habet, ut summa modestia cito et iucunde, presertim vero tuto, curet.”

73. Battista Codronchi, De Christiana et tuta medendi ratione (Ferrara 1591) and Bardi, Medicus politico Catholicus (Genua, 1644). Bardi left the Society for health reasons.

74. See n. 39. See also Elizabeth Fee, “Sin versus Science: Venereal Disease in 20th-Century Baltimore,” in AIDS: The Burden of History, ed. Elizabeth Fee and Daniel M. Fox (Berkeley: University of California Press, 1988), pp. 121-46.

75. Nagy, The Best of the Achaeans: Concepts of the Hero in Archaic Greek Poetry (Baltimore and London: Johns Hopkins University Press, 1979), p. 292.

76. Boas, The History of Ideas (New York: Scribner's, 1969), p. viii.