- Infection of the Innocents: Wet Nurses, Infants, and Syphilis in France, 1780-1900
Sherwood's intriguing monograph relates two stories from eighteenth-and nineteenth-century France concerning the intersection of the widespread practice of wet nursing and congenital syphilis in newborns. The first story tells of the Vaugirard hospital in Paris, an institution founded in 1780 to test the practice of treating syphilitic newborns through mercurial solutions administered to their mothers or wet nurses, who were also syphilitic. What was being tested was not mercury treatment for syphilis—which was a universally accepted medical practice almost until the advent of penicillin in the 1940s—but the mode of administration via the nurse's milk. Vaugirard was closed down in 1790 because the cost [End Page 291] of the institution was not judged to be justified by the limited success that it claimed. The practice of treating syphilitic newborns via breast milk, however, persisted in private arrangements. Families, often advised by their physicians, deliberately selected uninfected wet nurses who were not advised of the risks that they faced from both exposure to syphilis and the mercury treatments that they were induced to take. Sherwood's second story concerns those nineteenth-century arrangements and the lawsuits brought against the families and their physicians by wet nurses infected with syphilis by their nurslings.
Sherwood's sources for the first story are the records of Vaugirard hospital preserved in the Archives de l'Assistance publique in Paris, along with published writings by the physicians involved. For the second story, she relies primarily on the medical press, which published extensive debates about such issues as the transmissibility of congenital syphilis from infant to nurse and the conflict between a doctor's obligations to maintain the confidentiality of the families that engaged him and to protect the health of the wet nurses hired by those families. The major compilations of French legal proceedings, out of deference to the medical profession, rarely included these cases.
Sherwood mines the approaches and knowledge of several historical sub-disciplines. Wherever feasible, she has quantified the information that she collected. This is an easier task with the hospital records of Vaugirard than with the spotty nineteenth-century trial reports in the medical press. She deals sensitively with the slowly developing scientific knowledge of syphilis, always attentive to the contemporary understanding of the disease, its mode of transmission, and its treatment. A key development was the consensus formed in the 1850s that, contrary to then-prevailing theory, congenital syphilis could be transmitted from secondary symptoms (such as the sores on a baby's mouth) as well as from the primary genital chancre. Sherwood also skillfully expounds upon a range of French legal doctrines and practices and their interaction with medical ethics. Finally, she argues that the infected wet nurses, in their legal struggle for damages, belonged to a French tradition of feminist activism dating back to the Revolution. Readers, however, may be less likely to view the infected nurses—poor, uneducated, rural women—as agents of change than as exploited victims, like the African-American subjects of the notorious Tuskegee Experiment.
Putting aside two minor factual errors (the armies of Charles VIII of France, not of Charles V, were infected with syphilis in Italy in 1494 , and Middlesex Hospital in London was founded in 1745 to provide smallpox inoculations, not vaccinations, which Edward Jenner did not introduce until fifty years later [181, n.19]), Sherwood has woven together two stories and several social and professional perspectives into a fascinating tapestry of scientific, professional, and social change in revolutionary France. [End Page 292]