Book Review: The Fever of 1721

BookReviewLogoReview by Kasandra Lambert

In his debut book, The Fever of 1721: The Epidemic that Revolutionized Medicine and American Politics (Simon & Shuster, 2016), writer Stephen Coss highlights and emphasizes the interconnectedness between the smallpox outbreak of 1721 and the first independent newspaper in the colonies that would become the United States. To change the course of medicine and potentially lay groundwork for the later American Revolution, In this work of narrative non-fiction, Coss demonstrates how an entire cast of characters, ranging from a minister, to an outcast doctor, to newspaper publishers, to a young Benjamin Franklin were involved in the crisis and controversy of smallpox.

25814342The book describes how minister Cotton Mather, a man with a negative reputation after the Salem Witch Trials, was determined to clear his name by preventing the spread of smallpox using inoculation. Inoculation requires an individual without smallpox to purposely be exposed, hopefully resulting in a milder form of disease. Mather finds an ally in Zabdiel Boylston, a physician who lacked formal education. Coss describes how Bolyston collected the smallpox sample writing, “At first light he had gone to the sickroom, of a smallpox patient approximately twelve days into a regular or ‘distinct’ outbreak of disease — one whose vesicles were fully formed and ripe but still white and fluid, not yellow and malodorous — and using a ‘fine cut sharp toothpick’ instead of a lancet…he sliced open several fully emerged blisters at the side and pressed them so as to express their matter into the end of a quill” (91). Bolyston and Mather have a successful trial, with Bolyston’s son being the first patient, but it is met by mixed reviews from the Boston public. Continue reading “Book Review: The Fever of 1721”

Book Review: The Germ of an Idea

BookReviewLogoReview by Sandra G. Weems

A remarkable feat of textual synthesis, The Germ of an Idea: Contagionism, Religion, and Society in Britain, 1660-1730 (Palgrave Macmillan, 2016) traces the complex narrative of emerging medical theories of disease and their relationship to physicians’ fractured, fractious religious and social alliances in this period. Margaret DeLacy, a Harvard- and Princeton-trained independent scholar who has written extensively about medical history and contagionism, acknowledges drawing on “a reference base of thousands of books and articles” (xix) over decades of research to answer a single question: Why were medical thinkers “diverted” from pursuing “the germ-theory of disease” in the early-eighteenth century, when clearly several had earlier amassed evidence that “should have made possible the formulation” (iv) of germ-theory developed only much later, in the nineteenth century? The answer is neither simple nor straightforward, but DeLacy tells the story in nine meticulously annotated chapters, each helpfully structured with clearly-marked introductions and conclusions.

25993547Grounding the reader, as well as showing what may have precipitated this perceived lull in scientific progress, Chapter 1 features a historical survey of contagionism prior to 1660. The belief that disease spreads through some contagion reaches back to classical times, although the notion that these contagions might be living agents remained uncommon in the mid-seventeenth century. In England during the mid-seventeenth century (Chapter 2) major religious and social changes during the Restoration caused abruptions in medical education and professions. As part of the Clarendon Code (1661), religious Nonconformists were denied degrees from Cambridge and Oxford. Only MDs from these universities were permitted to become Fellows of the London College of Physicians—the Galenic institution that held the legal authority to regulate physicians in and around London. Thus, Dissenters were forced to seek medical degrees abroad and were prevented (in theory) from reaching the top of their profession in Britain. Continue reading “Book Review: The Germ of an Idea”

MedHum Monday Presents: 19th c. Contagious Disease Acts

DailyDose_darkstrokeWelcome back to the Daily Dose!

A few years ago, I wrote a book chapter on the Contagious Disease Acts, a chapter which spoke about prostitution, unfair treatment of women, syphilis… and vampires. (I promise, it makes sense). But I left that work with a renewed interest in these problematic acts and their ethics (or not). Today, I’m very happy t0 present the work of Jennifer Brosnan, PhD student at University of Leicester. She has been studying 19th century sex education, and today she gives us a brief account of the CDA’s beginnings and their champion William Acton. Welcome, Jennifer!


The Contagious Disease Acts  caused serious contention in Britain during the 1860s and 70s, encouraging intense debate both in the public sphere and on the floor of the House of Parliament.Why? The Acts proposed a “solution” to stem the (literally) virulent rise of venereal disease in Britain, particularly in areas of the country where armed forces were based and prostitution rife. William Acton, an eminent surgeon during the mid-nineteenth century, expressed his views concerning prostitution in his book, lengthily titled Prostitution considered in its moral, social and sanitary aspects in London and other large cities, with proposals for the mitigation and prevention of its attendant evils, published in 1857. It outlined recommendations to the government on how to implement searches on “suspected prostitutes” and medically treat them. While his book generally focused on the cold hard facts of prostitution, it did give an indication of its impact on every echelon of society.

London, 1851
London, 1851

William Acton saw himself as “one of those who look upon prostitution as an inevitable attendant upon civilised, and especially closely-packed, population”.[1] He saw it as a necessary evil within Victorian society and an unavoidable occupation in a city such as London where there was a high concentration of people. Acton argued that there were four main causes for prostitution, particularly amongst the lower classes. First, Acton talks of “the extreme youth of the junior portion of the “street-walkers” as a remarkable feature of London prostitutes”.[2] He suggests that prostitution was often a family business with the children and siblings of older or former prostitutes engaging in similar activities to bring in income. Child prostitution was so common during the nineteenth century that it was “the subject of much comment by foreign travellers who have published their impression of social London”.[3] The next two causes of prostitution Acton recognises feed into one another with lack of valid employment along with low wages and the threat of starvation – or “sad hard times”.[4] Often prostitution was the only way for women to bring money to the family especially if their husband had left or died. Finally, the fourth cause was ‘the loss of virtue’. This generally applied to the upper classes and in particular mistresses, but they were less likely to be infected with venereal disease and not explored further by Acton.

Using figures provided by the Metropolitan Police and the 1851 Census, Acton stated that there were 8,600 prostitutes working in London in 1851, with 632,545 men over the age of twenty in London. With these figures he argued that there was one prostitute for every 71 men.[5] If one of these women contracted a venereal disease there was a high likelihood of approximately 70 men also catching such diseases and bringing them home to their wives, often leading to children born with congenital syphilis. In many cases these children were unable to survive and died. In 1855, 318 children under the age of 5 died from syphilis; 59 of these were in London. There were a significant amount of children dying from venereal disease as there was no effective treatment available.

Wellcome Images, congenital syphilis
Wellcome Images, congenital syphilis

In a further bid to highlight the issue of prostitution, Acton analysed the surgical out-patients of Messrs. Lloyd and Wormald during the year 1849. These amounted to 5327 during the year; of whom 2513, or nearly half, suffered from venereal diseases. Within this data the women and children are counted together because if the mother were infected, the child generally would have been infected too, due to transmission in the womb. In any case, it would have been unusual that a woman was willing to see a doctor about a gynaecological-related issue. Many, particularly in the upper classes, would have suffered in silence due to the embarrassment of having contracted these diseases from their husbands.[6]

Why would so seemingly altruistic measures to protect the population come under fire? The Contagious Disease Acts were eventually repealed in 1886 after mounting public pressure, notably by Josephine Butler, feminist and social reformer. While the acts were designed to protect the public from prostitutes spreading disease, the focus was often on demonising prostitutes rather than considering the causes and effects of prostitution. Provision was not made for rehabilitating these women but instead they were locked away for treatment and quarantine. As quoted in Dr. Schillace’s work, Butler made a case for the prostitutes as people and their male visitors–and even the doctors and Acton himself–as the perpetrators:

To please a man I did wrong first, then I was flung about from man to man. Men police lay hands on us. But men we are examined, handled, doctored. In the hospital it is a man again who makes prayer and reads the Bible for us. We are had up before magistrates who are men, and we never get out of the hands of men till we die” (Butler, “The Garrison of Kent, Sheild. 9 May 1870. Qtd. in Smith, 97. [7]

Thank you, Jennifer!

Whatever Acton’s original intent, the Acts punished women–even those who were only “suspected” of prostitution and subjected them to forced medical examinations. Considering that many poor or working women had to walk after dark from factories, the Acts had an economic and social bias as well. Even the best of intentions, blind to the human at the center, can end miserably, and the repeal of the Acts was considered a victory by many. And, in the decades to follow, perspective begins to shift, putting more focus on male customers (rather than “monstrous” prostitutes) as the locus of blame.


Jennifer Brosnan, University of Leicester. Email: Twitter: @Jencasbros

Contributor Bio:

Jennie is PhD Student at the University of Leicester’s Centre for Medical Humanities and Department of Sociology. She also has a BA in History and Religion from University College Cork, an MSc in Gender History from the University of Edinburgh and an MSc in Information Management from the University of Glasgow.

Her thesis focuses on the contribution of Elizabeth Blackwell to the sex education movement during the nineteenth century which is co-supervised by Professor Steve King and Dr Jane Pilcher. The thesis focuses on the notion of sex and the various experiences of sex through the notions of masculinity and femininity as well as class during the nineteenth century. She is also the current chair for New History Lab; an Institute of Historical Research affiliated society within the University of Leicester that acts as a hub for the midlands.


Acton, William. Prostitution considered in its moral, social and sanitary aspects in London and other large cities, with proposals for the mitigation and prevention of its attendant evils (London, 1857)

Blackwell, Elizabeth. Wrong and Right Methods of Dealing with Social Evil, as Shown by Parliamentary Evidence (London, 1883)

Carter, Julian. “Birds, Bees, and Venereal Disease: Towards an Intellectual History of Sex Education”, Journal of the History of Sexuality, Vol. 10, No. 2 (April 2001), pp. 213-249

Frost, Ginger. Living in Sin: Cohabiting as husband and wife in nineteenth-century England (Oxford, 2008)

Moore, Wendy. The Knife Man: Blood, Body-Snatching and the Birth of Modern Surgery (London, 2005)

Vicinus, Martha (ed). Suffer and Be Still: Women in the Victorian Age (Indiana, 1972)

Walkowitz, Judith. Prostitution and Victorian Society: Women, Class and the State (Cambridge, 1982)

Wood, Andrea and Brandy Schillace. Unnatural Reproductions and Monstrosity: The Birth of the Monster in Literature, Film, and Media. Edited collection. (July 2014, Cambria Press)


[1] William Acton, Prostitution considered in its moral, social and sanitary aspects in London and other large cities, with proposals for the mitigation and prevention of its attendant evils (London, 1857), p. 15.

[2] Acton, p. 18.

[3] Ibid.

[4] Acton, p. 21.

[5] Acton, p. 19.

[6] See Martha Vicinus (ed.) Suffer and Be Still: Women in the Victorian Age (Indiana, 1972).

[7] Schillace, Brandy. “Children of the Night: Dracula, Degeneration, and Syphilitic Births at the fin de siecle.” Unnatural Reproductions and Monstrosity: The Birth of the Monster in Literature, Film, and Media. Edited collection, co-editor Andrea Wood. July 2014, Cambria Press