The London Lock Hospital in the Nineteenth Century: Gender, Sexuality and Social Reform by Maria Isabel Romero Ruiz (review)

Established in 1747, the London Lock Hospital was the first voluntary hospital in London to specialize in the treatment of venereal disease. At its nineteenth-century peak, the Lock Hospital was a substantial institution capable of accommodating hundreds of both female and male patients in its primary location, as well as maintaining an important outpatient clinic and an asylum for the rehabilitation of “fallen” women.

There already exists a fine traditional medical history of the London Lock by David Innes Williams.¹ Maria Ruiz’s contribution is to examine the history of the London Lock from the perspective of the “cultural history of sexuality and its social policing” (p. 24). Her central argument is that the London Lock’s operations not only reflected the “hegemonic ideology of the middle class” (p. 114) but represented an attempt to impose those values on a working-class population that was perceived as a threat to society. The aim of the institution, therefore, was never just the medical treatment of persons suffering from venereal disease but their confinement and, hopefully, the “reform of the morally deviant” (p. 75).

Ruiz’s account makes clear the importance of the London Lock’s moral mission and the connection its donors made between the physical confinement and cure of the hospital’s patients and their moral reform, as well as the wider purpose of protecting society from the propagation of vice. For most of the century, the London Lock was dependent on charitable donations for its financial survival, and Ruiz makes a case that much of the attraction of the Lock for its donors lay in its moral mission. The women’s asylum was the most visible aspect of this mission, but Ruiz also documents a surprisingly wide range of hospital-sponsored activities aimed at the moral uplift of working-class men and women, including a Friendly Visiting Society, the Westbourne Penny Provident Bank, a Soup Kitchen, a clothing exchange, Bible and singing classes, and Sunday and Night Schools for young men and women. The hospital’s participation in the Contagious Diseases Acts of 1864–87 proved more problematic, both because of its increasing dependence on government funding for the duration of the acts and because of the controversy surrounding the acts and the claims of their opponents that the acts amounted to an official acceptance of prostitution. The repeal of the acts provoked a financial crisis from which the hospital never fully recovered, in part, Ruiz suggests, because of the changing landscape of charitable support for medical institutions in the last decades of the nineteenth century.

The extent to which the rhetoric of the institution shaped its day-to-day operations, let alone led to the control and containment of the “behavior of working class patients” and the “subjugat[ion of] their identities,” is more difficult to ascertain (p. 80). Part of the problem is the nature of Ruiz’s source material, the London Lock’s surviving archives: these materials are long on purposive intent and general administration, but they would not appear to lend themselves to a detailed account of the actual operations of the hospital. Ruiz thus enumerates the many rules and regulations that the administration issued, but one wonders to what extent they were actually respected. The evidence suggests that they were in fact often violated. The evidentiary problems are also reflected in Ruiz’s extensive use of context to elucidate the activities of the Lock Hospital. Especially in the later chapters, the London Lock literally disappears for pages at a time (see, e.g., pp. 171–86), while her emphasis on the moral mission of the hospital so overshadows its medical activities that the reader might well be forgiven for forgetting that the London Lock Hospital was a major medical establishment. This is a matter of interpretative balance, and historians will disagree on...