From Body to Community: Venereal Disease and Society in Baroque Spain by Cristian Berco (review)

The French disease, also known as the Great Pox and later as syphilis, was one of the great scourges faced by Europeans from the end of the fifteenth century onward. In this study, Cristian Berco leaves aside the still hotly contested question of the disease’s origins and the medical issues of diagnosis and treatment in favour of an analysis of patients themselves: who they were, the communities they were a part of, and some of the social and economic challenges they faced. The study is primarily based on information from an extant patient record book covering the years 1654 to 1665 for Toledo’s Hospital de Santiago, one of Spain’s largest hospitals dedicated specifically to the treatment of the French disease. The intake process for patients included detailed listings of not only their names, but also their place of origin, their spouse’s name if married or parent’s names if unmarried, and a carefully itemized list of all clothing articles they wore upon entry. As the title aptly reflects, Berco has successfully used notarial records to trace a large number of the individual bodies listed in this patient record out into the families and the larger communities in which they lived and worked.

Berco traces the patient experience over eight chapters. The first two chapters examine the social and medical contexts of the disease itself. The first chapter draws on a variety of literary texts to explore early modern understandings of the poxed body and the tropes associated with it. The second uses Spanish medical texts to explore the theory of disease in general and of the pox in particular, showing some of the multiple ways this disease was understood within the medical community. Important here is the belief, not shared by all physicians across Europe, that the French disease was ultimately curable. The following three chapters turn to the patient experience at the Hospital de Santiago itself. Chapter three offers an in-depth analysis of who these patients were by gender, marital status, place of origin and socio-economic status. Chapter four analyzes the use of clothing (particularly by women) as a means of defending reputation as they publically sought treatment at this hospital located prominently in the city centre. Chapter five turns to the hospital itself and the routines of both spiritual and physical treatment. The final three chapters move with patients back out into the community after their treatment regimens, examining first the individual relationships of marriage and sexuality, then the broader relationships of work and family, and finally the larger communities in which pox patients were enmeshed.

Using a variety of notarial documents, such as wills, rental agreements, dowries, and work contracts, Berco is able to bring many of these individual patients to life, situating them within larger networks of kin, work, and community. He shows us the socio-economic diversity of those who sought treatment at the Hospital, whose free treatment regimens were offered to sufferers not only within the city and its immediate hinterland, but also drew people from more distant regions. Given Toledo’s proximity to the court in Madrid, it is perhaps not too surprising to even find a handful of foreigners (specifically Irishmen, Frenchmen, and Italians) in the patient records. One of the more intriguing aspects of this work is the interesting use Berco makes of the carefully recorded descriptions of all clothing items (including fabric, decorations, and amount of wear) provided by the hospital. As all patients had to change into hospital-issued gowns for the duration of their treatment, such an inventory was presumably considered necessary to ensure all proper items were returned for the patient’s departure. Berco analyzes these clothing lists for the nuanced information they reveal about who patients were, how they presented themselves, and in some cases to trace the perceived economic shifts (both for better and for worse) of patients who returned in...