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The Palgrave Handbook of Infertility in History pp 335–358Cite as

Palgrave Macmillan

‘The Great Foe to the Reproduction of the Race’: Diagnosing and Treating Infertility Caused by Venereal Diseases, 1880–1914

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Abstract

Infertility was a source of great anxiety for childless couples and a subject of uncertainty and concern for doctors. Yet the specificities of infertility caused by venereal diseases have been overlooked. Medical authors at the turn of the twentieth century and historians in more recent decades have instead been preoccupied with the congenitally syphilitic child or the infant with gonorrhoeal ophthalmia neonatorum. This chapter remedies these historiographical gaps, addressing some of the more significant problems attendant upon diagnosing and treating infertility among infected men and women. Even with the development of bacteriological and serological testing, the venereal aetiology of a patient’s infertility was difficult to confirm. Venereal diseases did not always result in infertility and doctors found that many infertile patients showed few clear signs of infection. Having established the place of infertility within medical discourse and patient care, this chapter situates it within a wider eugenic framework of perceived degeneration and national efficiency.

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Notes

  1. 1.

    Jonathan Hutchinson, a respected English authority on venereal diseases, had defined the characteristic signs of congenital infection – what would become known as ‘Hutchinson’s triad’. Doctors were instructed to look for notched malformations of the milk and permanent teeth, as well as a saddle nose, sabre shins, a persistent snuffle, severe bone pain, joint inflammation, and visual impairment. See Jonathan Hutchinson, Syphilis (London, 1887).

  2. 2.

    Arabella Kenealy, ‘A Question of Conscience’, British Medical Journal (BMJ), 14 September 1895.

  3. 3.

    Sarah Grand, The Heavenly Twins (London, 1893); Emma Frances Brookes, A Superfluous Woman (London, 1894); Teresa Mangum, Married, Middlebrow, and Militant: Sarah Grand and the New Woman Novel (Ann Arbor, MI, 1998).

  4. 4.

    Michael Worboys, ‘Unsexing Gonorrhoea: Bacteriologists, Gynaecologists, and Suffragists in Britain, 1860–1920’, Social History of Medicine, 17 (2004); George Granville Bantock, ‘On the Importance of Gonorrhoea as a Cause of Inflammation of the Pelvic Organs’, BMJ, 4 April 1891; George Granville Bantock, ‘The Modern Doctrine of Bacteriology, or the Germ Theory of Disease’, BMJ, 8 April 1899.

  5. 5.

    See, for example, Philippa Levine, Prostitution, Race and Politics: Policing Venereal Disease in the British Empire (New York, 2003); Peter Baldwin, Contagion and the State in Europe 1830–1930 (Cambridge, 1999); Lesley Hall, Hidden Anxieties: Male Sexuality, 1900–1950 (Cambridge, 1991); J.E. Ross and S.M. Tomkins, ‘The British Reception of Salvarsan’, Journal of the History of Medicine and Allied Sciences, 52 (1997).

  6. 6.

    Simon Szreter, ‘Fertility Transitions and Venereal Disease’, in Nick Hopwood, Rebecca Flemming and Lauren Kassell (eds), Reproduction: From Antiquity to the Present Day (forthcoming).

  7. 7.

    Simon Szreter, ‘The Prevalence of Syphilis in England and Wales on the Eve of the Great War: Revisiting the Estimates of the Royal Commission on Venereal Diseases 1913–1916’, Social History of Medicine, 27 (2014).

  8. 8.

    Richard A. Soloway, Demography and Degeneration: Eugenics and the Declining Birthrate in Twentieth-Century Britain (London, 1990); Richard A. Soloway, Birth Control and the Population Question in England, 1877–1930 (Chapel Hill, NC, 1982); G.R. Searle, The Quest for National Efficiency: A Study in British Politics and Political Thought, 1899–1914 (Berkeley, CA, 1971).

  9. 9.

    Andrew Smith, Victorian Demons: Medicine, Masculinity and the Gothic in the Fin-de-Siècle (Manchester, 2004); Lucy Bland, ‘“Guardians of the Race”, or “Vampires Upon the Nation’s Health”?: Female Sexuality and its Regulation in Early Twentieth-Century Britain’, in Elizabeth Whitelegg (ed.), The Changing Experience of Women (Oxford, 1982); Mary Spongberg, Feminizing Venereal Disease: The Body of the Prostitute in Nineteenth-Century Medical Discourse (New York, 1997), pp. 143–59.

  10. 10.

    Such concerns spoke directly to the theory of third-generation infection that was itself a subject of much medical discussion towards the end of the nineteenth century. See, for example, Arthur Conan Doyle, Round the Red Lamp: Being Facts and Fancies of Medical Life (London, 1894), pp. 46–64; Jonathan Hutchinson, ‘On a Case of Supposed Syphilis in the Third Generation’, Polyclinic (January 1900), pp. 40–5; Hutchinson, Syphilis, pp. 394–9.

  11. 11.

    See, for example, Elizabeth Lomax, ‘Infantile Syphilis as an Example of Nineteenth Century Belief in the Inheritance of Acquired Characteristics’, Journal of the History of Medicine, 34 (1979); Joan Sherwood, Infection of the Innocents: Wet Nurses, Infants, and Syphilis in France, 1780–1900 (Montreal, 2010); Anne Hanley, ‘“Scientific Truth into Homely Language”: The Training and Practice of Midwives in Ophthalmia Neonatorum, 1895–1914’, Social History of Medicine, 27 (2014).

  12. 12.

    Angus McLaren, Impotence: A Cultural History (Chicago, IL, 2007), pp. 126–7.

  13. 13.

    See, for example, R.A. Gibbons, A Lecture on Sterility: Its Etiology and Treatment. Delivered at the Medical Graduates’ College and Polyclinic on 21 July 1910 (London, 1911).

  14. 14.

    Spongberg, Feminizing Venereal Disease; Judith Walkowitz, City of Dreadful Delight: Narratives of Sexual Danger in Late-Victorian London (Chicago, IL, 1992); Levine, Prostitution, Race and Politics.

  15. 15.

    M.K. Hargreaves, A Practical Manual of Venereal Diseases: Including Disorders of Generation, Spermatorrhœa, Prostatorrhœa, Impotence and Sterility in Both Sexes (London, 1887); R. Ultzmann, On Sterility and Impotence in Man (London, 1887); Samuel W. Gross, A Practical Treatise on Impotence, Sterility, and Allied Disorders of the Male Sexual Organs (Edinburgh, 1887); Gibbons, A Lecture on Sterility.

  16. 16.

    McLaren, Impotence, pp. 126–8; Naomi Pfeffer, ‘The Hidden Pathology of the Male Reproductive System’, in Hilary Homans (ed.), The Sexual Politics of Reproduction (London, 1985).

  17. 17.

    Gibbons, A Lecture on Sterility, pp. 6, 42.

  18. 18.

    Robert Bell, Sterility (London, 1896), p. 9.

  19. 19.

    One notable exception is Arthur Cooper, The Sexual Disabilities of Man and Their Treatment (London, 1908).

  20. 20.

    Cooper, The Sexual Disabilities of Man and Their Treatment, p. 3.

  21. 21.

    Gibbons, A Lecture on Sterility, p. 6.

  22. 22.

    McLaren, Impotence, p. 127; Victor G. Vecki, The Pathology and Treatment of Sexual Impotence (London, 1901), p. 122; James Paget, Clinical Lectures and Essays (London, 1879), pp. 276–98; Elizabeth Stephens, ‘Coining Spermatorrhoea: Medicine and Male Bodily Fluids, 1836–1866’, Sexualities, 12 (2009); Lindsay Watson, ‘Tom Tiddler’s Ground: Irregular Medical Practitioners and Male Sexual Problems in New Zealand, 1858–1908’, Medical History, 57 (2013).

  23. 23.

    See, for example, Bantock, ‘On the Importance of Gonorrhoea as a Cause of Inflammation of the Pelvic Organs’, pp. 749–51; Charles J. Cullingworth, ‘The Aetiological Importance of Gonorrhoea in Relation to Some of the More Common Diseases of Women’, BMJ, 20 July 1889.

  24. 24.

    Vecki, The Pathology and Treatment of Sexual Impotence, p. 124. My emphasis.

  25. 25.

    Gross, A Practical Treatise on Impotence, p. 97.

  26. 26.

    Cooper, The Sexual Disabilities of Man and Their Treatment, p. 50.

  27. 27.

    See, for example, Charles Robert Drysdale, Syphilis: Its Nature and Treatment with a Chapter on Gonorrhoea (London, 1873); W. Yeo Harvey, Syphilis and Gonorrhoea: Their Symptoms and Cure Including Articles Relative to Their Influence on Marriage and Life Assurance (London, 1898); Charles Leedham-Green, The Treatment of Gonorrhoea in the Male (London, 1906); David Watson, Gonorrhoea and its Complications in the Male and Female (London, 1914).

  28. 28.

    Hargreaves, A Practical Manual of Venereal Diseases, p. 119.

  29. 29.

    Gross, A Practical Treatise on Impotence, p. 87.

  30. 30.

    Cooper, The Sexual Disabilities of Man and Their Treatment, p. 3.

  31. 31.

    Gross, A Practical Treatise on Impotence, p. 83.

  32. 32.

    Arthur W. Edis, Sterility in Women: Including its Causation and Treatment (London, 1890), pp. 2–3.

  33. 33.

    Edis, Sterility in Women, p. 14.

  34. 34.

    J. Matthews Duncan, ‘The Gulstonian Lectures on the Sterility of Women’, BMJ, 24 February 1883. My emphasis.

  35. 35.

    Edis, Sterility in Women, pp. 2–3.

  36. 36.

    Worboys, ‘Unsexing Gonorrhoea’, pp. 41–2, 52–8.

  37. 37.

    Royal Commission on Venereal Diseases, PP 1913–1916 Cd 7475 (Appendix to First Report of the Commissioners, Minutes of Evidence), qq. 2157, 2736–7, 6731, 9406–9 (henceforth Royal Commission on Venereal Diseases, Appendix to First Report, Cd 7475).

  38. 38.

    Thomas More Madden, ‘On the Treatment of Sterility in Women’, BMJ, 21 April 1888.

  39. 39.

    J. Beresford Ryley, Sterility in Women: Its Causes and Cure (London, 1888), pp. 49–64, 69–72

  40. 40.

    Bantock, ‘On the Importance of Gonorrhoea as a Cause of Inflammation of the Pelvic Organs’, p. 751.

  41. 41.

    Ryley, Sterility in Women, p. 69.

  42. 42.

    Watson, Gonorrhoea and its Complications in the Male and Female, p. 282.

  43. 43.

    Hanley, ‘“Scientific Truth into Homely Language”’; Hutchinson, Syphilis, pp. 380–1.

  44. 44.

    Bantock, ‘On the Importance of Gonorrhoea as a Cause of Inflammation of the Pelvic Organs’, p. 751.

  45. 45.

    Hanley, ‘“Scientific Truth into Homely Language”’, pp. 215–16.

  46. 46.

    Lomax, ‘Infantile Syphilis as an Example of Nineteenth Century Belief in the Inheritance of Acquired Characteristics’, p. 31; Spongberg, Feminizing Venereal Disease, p. 153.

  47. 47.

    The CD Acts allowed authorities to arrest, forcibly examine and treat suspected prostitutes who were residing in various port and military towns throughout Britain between 1864 and 1886. See Ornella Moscucci, The Science of Woman: Gynaecology and Gender in England, 1800–1929 (Cambridge, 1990), pp. 114–16; Kathryn Yeniyurt, ‘When it Hurts to Look: Interpreting the Interior of the Victorian Woman’, Social History of Medicine, 27 (2013).

  48. 48.

    See, for example, Peter Horrocks, ‘An Address on the Instruction of Midwives in the Symptoms and Signs of Abnormal Labour’, BMJ, 28 September 1907; Watson, Gonorrhoea and its Complications in the Male and Female; Royal Free Hospital Archives, Casebooks (1890–1913), RFH/4/PN/1.

  49. 49.

    Edis, Sterility in Women, pp. 3–4.

  50. 50.

    James E. Lane, The Prophylaxis of Venereal Diseases: A Paper Read Before the London Medical Graduates College and Polyclinic, 10 December 1906 (London, 1907), pp. 3–15.

  51. 51.

    Worboys, ‘Unsexing Gonorrhoea’, p. 52.

  52. 52.

    Frances Ivens, ‘On the Incidence of Gonorrhoea in Gynaecological Hospital Practice’, BMJ, 19 June 1909.

  53. 53.

    Leedham-Green, The Treatment of Gonorrhoea in the Male, p. 142.

  54. 54.

    Watson, Gonorrhoea and its Complications in the Male and Female, p. 245.

  55. 55.

    Cooper, The Sexual Disabilities of Man and Their Treatment, p. 50; Watson, Gonorrhoea and its Complications in the Male and Female, p. 280; Gibbons, A Lecture on Sterility, p. 23; Edis, Sterility in Women, pp. 14–15.

  56. 56.

    J.A. Coutts, ‘The Hunterian Lectures on Infantile Syphilis’, Lancet, 11 April 1896; J.A. Coutts, ‘The Hunterian Lectures on Infantile Syphilis’, Lancet, 25 April 1896; A.W. Gilchrist, ‘Medical Doctrines of Heredity’, Lancet, 15 August 1903.

  57. 57.

    Hutchinson, Syphilis, p. 427.

  58. 58.

    Royal Commission on Venereal Diseases, Appendix to First Report, Cd 7475, p. 11767.

  59. 59.

    Royal Commission on Venereal Diseases, PP 1913–1916 Cd 8190 (Appendix to Final Report of the Commissioners, Minutes of Evidence), qq. 14631–33 (henceforth Royal Commission on Venereal Diseases, Appendix to Final Report, Cd 8190).

  60. 60.

    Royal Commission on Venereal Diseases, Appendix to First Report, Cd 7475, pp. 6388–89.

  61. 61.

    Ivens, ‘On the Incidence of Gonorrhoea in Gynaecological Hospital Practice’, p. 1476.

  62. 62.

    Szreter, ‘The Prevalence of Syphilis in England and Wales on the Eve of the Great War’, pp. 518, 529.

  63. 63.

    Bantock, ‘On the Importance of Gonorrhoea as a Cause of Inflammation of the Pelvic Organs’, pp. 749–50.

  64. 64.

    Worboys, ‘Unsexing Gonorrhoea’, p. 51; Ross and Tomkins, ‘The British Reception of Salvarsan’, p. 403.

  65. 65.

    Medical Research Committee, Reports of the Special Committee upon the Standardization of Pathological Methods: The Laboratory Diagnosis of Gonococcal Infections (London, 1918), p. 3.

  66. 66.

    Hargreaves, A Practical Manual of Venereal Diseases, p. 166.

  67. 67.

    Gibbons, A Lecture on Sterility, p. 48.

  68. 68.

    Leedham-Green, The Treatment of Gonorrhoea in the Male, p. 141.

  69. 69.

    Roger Davidson, Dangerous Liaisons: A Social History of Venereal Disease in Twentieth-Century Scotland (Amsterdam, 2000), pp. 18–23.

  70. 70.

    Royal Commission on Venereal Diseases, Appendix to First Report, Cd 7475, p. 9593–97; Hutchinson, Syphilis, pp. 495–6.

  71. 71.

    Worboys, ‘Unsexing Gonorrhoea’, p. 52.

  72. 72.

    Cooper, The Sexual Disabilities of Man and Their Treatment, pp. 66–7.

  73. 73.

    Hargreaves, A Practical Manual of Venereal Diseases, p. 120.

  74. 74.

    Hargreaves, A Practical Manual of Venereal Diseases, p. 121.

  75. 75.

    T.C.A., ‘A Question of Conscience’, BMJ, 21 September 1895; J. Braxton Hicks, John Ormsby, M.G. Biggs, and A.G. Welsford, ‘A Question of Conscience’, BMJ, 28 September 1895; J. Foster Palmer, ‘Correspondence’, BMJ, 5 October 1895; Arabella Kenealy, ‘A Question of Conscience’, BMJ, 12 October 1895.

  76. 76.

    Alfred Cooper, Syphilis and Pseudo-Syphilis (London, 1884), pp. 440–70; Michael Worboys, ‘Was There a Bacteriological Revolution in Late Nineteenth-Century Medicine?’, Studies in History and Philosophy of Biological and Biomedical Sciences, 38 (2007), p. 28.

  77. 77.

    James Oliver, ‘The Determinants of Abortion and How to Combat Them’, BMJ, 30 November 1907.

  78. 78.

    Watson, Gonorrhoea and its Complications in the Male and Female, p. 261.

  79. 79.

    Edis, Sterility in Women, pp. 14–15.

  80. 80.

    Watson, Gonorrhoea and its Complications in the Male and Female, p. 282.

  81. 81.

    Watson, Gonorrhoea and its Complications in the Male and Female, p. 278.

  82. 82.

    Watson, Gonorrhoea and its Complications in the Male and Female, p. 281.

  83. 83.

    Hargreaves, A Practical Manual of Venereal Diseases, p. 166.

  84. 84.

    Watson, Gonorrhoea and its Complications in the Male and Female, p. 282.

  85. 85.

    Madden, ‘On the Treatment of Sterility in Women’, p. 846.

  86. 86.

    Gibbons, A Lecture on Sterility, pp. 48–9.

  87. 87.

    Watson, Gonorrhoea and its Complications in the Male and Female, p. 281.

  88. 88.

    Soloway, Demography and Degeneration, p. 18.

  89. 89.

    Interdepartmental Committee on Physical Deterioration, PP 1904 XXXII, Cd 2175 (Report), p. 77.

  90. 90.

    Christabel Pankhurst, The Great Scourge and How to End It (London, 1913), p. 72. Original emphasis.

  91. 91.

    W.R. Inge, ‘Some Moral Aspects of Eugenics’, Eugenics Review (April 1909–January 1910), p. 29.

  92. 92.

    Stephen Arata, Fictions of Loss in the Victorian Fin de Siècle (Cambridge, 1996), pp. 14–15.

  93. 93.

    Pankhurst, The Great Scourge and How to End It, pp. 100–1. Original emphasis.

  94. 94.

    Lucy Bland, ‘The Married Woman, The New Woman, and the Feminist: Sexual Politics in the 1890s’, in J. Rendall (ed.), Equal or Different: Women’s Politics, 1800–1914 (Oxford, 1987); Angelique Richardson, Love and Eugenics in the Late Nineteenth Century: Rational Reproduction and the New Woman (Oxford, 2003); George Robb, ‘Race Motherhood: Moral Eugenics vs. Progressive Eugenics, 1880–1920’, in Claudia Nelson and Ann Summer Holmes (eds), Maternal Instincts: Visions of Motherhood and Sexuality in Britain, 1875–1925 (London, 1997); Worboys, ‘Unsexing Gonorrhoea’, p. 42.

  95. 95.

    Worboys, ‘Unsexing Gonorrhoea’, p. 56.

  96. 96.

    Worboys, ‘Unsexing Gonorrhoea’, p. 54.

  97. 97.

    A.F. Tredgold, ‘The Feeble Minded – A Social Danger’, Eugenics Review (April 1909–January 1910), p. 102.

  98. 98.

    Frances Swiney, The Awakening of Women or Women’s Part in Evolution (London, n.d.), p. 141. Swiney’s eugenic beliefs compelled her to write a number of pamphlets entitled ‘Racial Poisons’ that warned women of the dangers of syphilis.

  99. 99.

    For specific discussion of the economic burden of blindness caused by ophthalmia neonatorum, see James W. Ballantyne, Manual of Antenatal Pathology and Hygiene: The Foetus (Edinburgh, 1902), p. 52; George Reid, ‘Prevention of Blindness from Ophthalmia Neonatorum’, Nursing Notes (September 1911).

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  1. University of Oxford, Oxford, UK

    Anne Hanley

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  1. School of History, Classics and Archaeology, University of Edinburgh, Edinburgh, UK

    Gayle Davis

  2. Department of History, University of Essex, Colchester, Essex, UK

    Tracey Loughran

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Hanley, A. (2017). ‘The Great Foe to the Reproduction of the Race’: Diagnosing and Treating Infertility Caused by Venereal Diseases, 1880–1914. In: Davis, G., Loughran, T. (eds) The Palgrave Handbook of Infertility in History. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-52080-7_18

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