The “Great Pox”: A History of Prostitution and Venereal Disease

The “Great Pox”: A History of Prostitution and Venereal Disease

For much of recorded history, the trade of sex and the spread of venereal disease (VD) were viewed as an inseparable, tragic pair. From the high-traffic ports of the ancient world to the military camps of the Napoleonic Wars, the “social evil” of prostitution was often the primary vector for what we now call STIs. Because medical science remained primitive for millennia, these diseases—primarily syphilis and gonorrhea—were not just health crises; they were moral and social scourges that reshaped laws, art, and even the maps of empires.

I. The Dark Symbiosis: Centuries of Spread

Historically, the prostitute was often seen as the “source” of contagion, a viewpoint that fueled centuries of persecution while ignoring the role of the male clients—primarily soldiers and sailors—who carried the bacteria across oceans and borders.¹

Antiquity: In Ancient Greece and Rome, “the clap” (gonorrhea) was recognized, but often confused with other urinary ailments. Prostitution was legal and taxed, but as disease spread, it led to the first public health regulations, such as the Roman Emperor Tiberius’s temporary ban on kissing to stop a herpes-like outbreak.²
The 1495 Explosion: The most pivotal moment in this history was the 1495 outbreak of syphilis in Naples during a French invasion.³ Soldiers returning from the campaign spread a virulent, “mutilating” form of the disease across Europe. This led to the closure of many public bathhouses, which had previously served as centers for both hygiene and sex work.
The Victorian Era (The Age of Regulation): In the 1860s, Britain passed the Contagious Diseases Acts.⁴ These laws allowed police to arrest any woman “suspected” of being a prostitute and subject her to a forced internal medical examination. If she was infected, she was locked in a “Lock Hospital” for months. This era highlighted the double standard: women were imprisoned and poked with metal speculums, while the men who visited them were rarely examined.

II. The “Cures”: From Poison to Penicillin

For nearly 400 years, the treatments for VD were often as lethal as the disease itself.⁵ Doctors operated on the theory of “humors,” believing the body needed to be purged of “corrupt” fluids.⁶+1

Era	Primary Treatment	Method & Effectiveness
16th–19th Century	Mercury	Applied as salves, pills (“Blue Mass”), or steam baths. It caused the “Great Spit” (excessive salivation), tooth loss, and organ failure. Verdict: Poisonous.
16th Century	Guaiacum (Holy Wood)	A decoction of wood from the Americas. It caused profuse sweating and vomiting. Verdict: Ineffective.
19th Century	Silver Nitrate / Potassium	Used to “cauterize” or irrigate the urethra in gonorrhea cases. Verdict: Excruciatingly painful.
Early 20th Century	Salvarsan (Arsenic)	Discovered in 1910, it was the first “magic bullet” that actually killed the bacteria, though it was still highly toxic.
1943–Present	Penicillin	The true cure. It revolutionized medicine by making syphilis and gonorrhea easily treatable for the first time in human history.

III. Famous Deaths from VD

Venereal disease was no respecter of class; it claimed the lives of kings, artists, and outlaws alike. Syphilis, in its “Tertiary” stage, can lead to neurosyphilis, causing dementia, paralysis, and a slow, agonizing death.⁷

Al Capone: The notorious gangster’s mind deteriorated in Alcatraz due to neurosyphilis.⁸ By the time he died in 1947, he was said to have the mental capacity of a 12-year-old child.⁹+1
Friedrich Nietzsche: The “God is Dead” philosopher suffered a mental collapse in 1889. While debated, many historians believe his madness and eventual death were caused by syphilis.¹⁰
Henri de Toulouse-Lautrec: The famous painter of the Parisian Moulin Rouge frequented brothels and died at age 36 from a combination of alcoholism and syphilis.
Scott Joplin: The “King of Ragtime” died in a mental institution at age 48, his musical career cut short by the tremors and dementia of neurosyphilis.¹¹
Lord Randolph Churchill: Father of Winston Churchill, he died at 45. While his family cited a “general decay,” modern historians widely believe it was advanced syphilis.

IV. Conclusion: A Moralized Medical History

The history of prostitution and VD is a reminder of how society often blames the vulnerable for the failures of public health. For centuries, the prostitute was the scapegoat, while the medical community relied on toxic metals to treat a disease they didn’t fully understand.¹² It wasn’t until the mid-20th century that science finally decoupled the “sin” from the “sickness.”