Die Behandlung der Franzosenkrankheit in der Fruhen Neuzeit am Beispiel Augsburgs (review)

This is a very focused study of the treatment of the "French disease" in three hospitals in the imperial city of Augsburg, Germany, between 1495 and 1632. Thus it makes a contribution to hospital history and, because of the nature of hospitals in the period, to the medical treatment of the poor. It is so important that one wishes it were available in English translation. It is based on considerable and meticulous archival work, but its value and importance are in inverse proportion to its narrowness of focus. I am a little less sure about some of the larger issues that Claudia Stein aims at tackling, and I have the suspicion that a seemingly rigorous attention to methodology may foreclose insight.

Stein investigates the operation of the municipal "Blatterhaus" (started in 1495, thus the first hospital in Germany specifically for this disease) and the two hospitals, also specifically for the treatment of sufferers of the French disease but restricted to Catholic patients, created as a charitable foundation by a famous Augsburg merchant family, the Fuggers, in 1524 and 1572. All three hospitals were for the treatment of the poor, and the author meticulously re-creates from the archives the criteria of admission: these included a documented lack of means and a careful examination resulting in the diagnosis that the patient indeed suffered from the French disease but was not past cure.

In this context the author explodes, in a detailed, digressive Exkurs, the notion that the Fuggers had the exclusive importation rights of guaiacum wood from America—that is, a monopoly—as well as the related hypothesis, certainly not far-fetched if the idea of a monopoly were granted as fact, that the Fugger hospitals were created to promote the cure of syphilis by that wood. I admit to having taken for fact certainly the first half of this web of speculation, and I feel a sense of both unease and exhilaration at being shown rather convincingly that these are legends. My unease is only slightly alleviated by seeing some of the most famous names in the history of medicine in Stein's footnotes as propounders of the "myth." The exposition of these widely published notions as "legends" is alone worth the price of the book.

If, with all my admiration, I find some sections of this book a touch off-balance, it is because they seem somewhat ideologically driven. Stein programmatically clings to the term "French disease," because she feels that the word "syphilis" would falsify the medical historian's work, injecting modern and anachronistic notions—never mind that after Fracastoro a whole bunch of Renaissance "syphilographers," usually writing in Latin, used the term. Connected with this "anxiety of anachronism" is a thesis, not always openly argued, that early accounts and treatments of the disease did not recognize sexual transmission, and that discrimination and stigmatization because of syphilis was minimal or rare.