Negotiating the French Pox in Early Modern Germany (review)

Claudia Stein's excellent study of the "French pox" in early modern Germany brilliantly links the "socio-cultural reactions to the pox" with "the sixteenth-century conceptual understandings of this disease" (p. 3). Her sources include vernacular German pox treatises as well as the records of three pox hospitals in Augsburg. Indeed, Augsburg provides a particularly rich site for Stein's analysis because it had three separate charitable pox hospitals, one set up and controlled by the city council and two established by the wealthy Fugger family. Stein even found a cache of about one hundred petition letters, written to the city council by (or for) men, women, and children seeking admittance to the civic pox hospital. Together with the records of hospital routines and treatment, these petitions provide a rare glimpse into the experiences of poor pox sufferers.

Stein begins, following Ludwig Fleck, with the claim that the early modern concept of "French pox" is incommensurable with the modern concept of "syphilis." French pox was a disease that could be spontaneously generated in a person's body through weakening of the digestive faculties or consumption of unhealthy foods. Either of these might corrupt the blood by bringing about an excess of phlegm or yellow bile. The disease could be spread through contact with a sick person's "[s]weat, saliva, semen or urine" (p. 43). Thus, a person might contract the pox by handling money or eating food that had been touched by an infected individual. By contrast, syphilis is caused by a specific microorganism that is transmitted from one person to another through sexual intercourse. Furthermore, syphilis is diagnosed by an "objective" bacteriological test. The "subjective" symptoms, which can vary from patient to patient, are largely irrelevant to diagnosis. But in the diagnosis of French pox, the symptoms of the disease, which varied quite widely, were essential. Because every person had a unique humoral complexion, each patient had a highly individualized form of the disease. As Stein puts it, "The decipherment of physical signs was a task undertaken by the pox sufferer in conjunction with a medical practitioner of his or her choice" (p. 48). There was no "objective" diagnosis of French pox and no privileged medical view point.

Stein's book convincingly refutes two pervasive myths about the outbreak of syphilis in the late fifteenth century. The first is that this new sexually transmitted disease brought about drastic changes in sexual mores and played a major role in the closing of public baths and brothels in towns across Germany in the sixteenth century. As Stein demonstrates, the French pox, unlike syphilis, was not seen as a sexually transmitted disease. To be sure, the disease could be spread through venereal contact, but this was only one of the myriad ways the disease could be transmitted. The tightening of social and legal strictures against pre- and extramarital sex and the closing of baths and brothels were products of the Protestant Reformation, not the pox.

The second myth is that this new and frightening disease challenged contemporary medical theory and practice and thus led to the demise of Galenic medicine. Paracelsus and Girolamo Fracastoro are the great heroes of this story. Yet, as Stein shows in meticulous detail, the French pox was thoroughly assimilated into traditional humoral medicine. Understanding of its causes, progression, and treatment fit neatly into the standard six non-naturals. Furthermore, the pox was believed to be a curable disease, and early modern practitioners and patients had considerable faith in the efficacy of mercury, guaiacum wood, and other standard treatments of the day.

Because hospital records are some of her main sources, Stein's focus is on poor pox sufferers. She gives relatively little sense of how middling and well-to-do Augsburgers dealt with the pox, although she does mention that there were numerous private hospitals where, for a fee, patients could receive a course of treatment. Such information...