This suggested that while about 8% of Chester’s population had been infected by age 35, the figure for London was well over 20%.įrontispiece of Harris's List of Covent-Garden Ladies: or, Man of pleasure's kalender, for the year 1788. By dividing this figure by London’s population, falling within the catchment area of the hospitals and workhouses studied, they arrived at a crude annual rate of treatment per capita.īy then comparing this with existing data for Chester – and making further adjustments to account for demographic and social differences between the two cities – they converted London’s crude rate into a comparable cumulative probability rate. This helped the researchers, making it highly likely that the majority of patients they were counting in the records were suffering from significant protracted symptoms more characteristic of secondary syphilis than of gonorrhea, soft chancre, or chlamydia.Īfter making careful adjustments, Szreter and Siena reached a final conservative estimate of 2,807 inpatients being treated for pox annually across all institutions c.1775. Patients in London’s foul wards often battled their diseases for six months or more before seeking hospitalization. But the researchers also drew on evidence for St Bartholomew’s hospital workhouse infirmaries and two subscription hospitals, the Lock and the Misericordia, which also cared for ‘Foul’ men and women. Of particular value to the researchers were surviving admissions registers from the late 1760s through to the 1780s for St Thomas’s and Guy’s Hospitals which consistently housed 20–30 per cent of their patients in ‘foul’ wards reserved for residential treatment for the pox. Along the way, they excluded many patients to avoid counting the false positives that arise from syphilis’s notoriously tricky diagnosis. To maximise the accuracy of their estimates, Szreter and Siena drew on large quantities of data from hospital admission registers and inspection reports, and other sources to make numerous conservative estimates including for bed occupancy rates and duration of hospital stays. This care was provided by London’s largest hospitals, at least two specialist hospitals, and many poor law infirmaries, as well as privately for those who could afford it.