NOELLE GALLAGHER’S fascinating and entertaining new book, Itch, Clap, Pox, is not so much about the reality of sexually transmitted infections (STIs) during the 18th century as it is about how STIs were imaginatively constructed during the period. The book is important and successful because it looks at how artists and writers used “venereal disease” (Gallagher intentionally deploys 18th-century terms throughout) to negotiate issues such as sexism, capitalism, nationalism, and racism.

At the beginning of each of the four chapters, Gallagher reminds us of the material realities of STIs. Eighteenth-century medicine hadn’t quite figured out distinctions among diseases such as syphilis, gonorrhea, genital scabies, erectile dysfunction, et cetera. Unsurprisingly, STIs were more common among soldiers and prostitutes, as members of both groups had numerous sexual partners. The diseases had unfortunate physical consequences, including black spots on the skin and, most prominently, the dissolution of the nasal cartilage. Illness proceeded in stages and might lead to death, but the infection could also be dormant, and it was unclear to what extent it could be treated or even cured. All of these uncertainties provided a canvas onto which 18th-century writers and artists could project their interpretations.

Itch, Clap, Pox divides these concerns and anxieties into four groups, each associated with particular symbols, figures, or tropes. Throughout the book, Gallagher offers examples culled from fictional and nonfictional texts, but also from visual representations (usually caricatures). Occasionally, she invokes canonical authors and works — for example, Tobias Smollett’s Roderick Random (1748), Henry Fielding’s Amelia (1751), Laurence Sterne’s Tristram Shandy (1759) — as well as well-known artists (William Hogarth, James Gillray, Thomas Rowlandson), but her argument seems more at home with anonymous texts and obscure images. Gallagher does not proceed chronologically but thematically, and she does not attempt to connect issues circulating during the Enlightenment period to our own time.

In the first chapter, Gallagher explores how military officers and politicians came to be associated with venereal disease. To some writers and artists, STIs were not calamities but rather signs of courage, honor, experience, sexual prowess, and willingness to take risks. In this figuration, venereal disease was likened to war wounds, and love (sexual or emotional) to war. However, the same metaphors were also used to criticize military and political leaders. Linking these figures to venereal disease provided “a platform for broader social critique, enabling writers and artists to interrogate the criteria — intellectual, political, economic, military — by which society apportions male power.” Typically male characteristics such as physical strength, political authority, financial clout, and social status were critiqued and ridiculed by being associated with something as pernicious as venereal disease. In other words, patriarchy was acknowledged, sometimes even celebrated, while also being undermined as sexist and connected with physical and moral decline.

The figure of the prostitute, the focus of Gallagher’s second chapter, is subject to at least two complications. First, writers and artists were uncertain whether the prostitute was simply a “purer” form of every woman — i.e., whether women in general should be held responsible for STIs or only prostitutes. In the end, Gallagher concludes, most writers and artists separated the two, thus avoiding a blanket misogyny, though the boundary remained blurry. The second complication was the question of whether prostitutes plied their trade out of desire and pleasure or whether they were victims of social and economic circumstances. There was no clear answer to this question, which allowed the prostitute to fulfill various rhetorical, symbolic, and ideological functions.

According to Gallagher, the prostitute was often associated with venereal disease in order to critique the growth of consumerism and capitalist enterprise. Like commercial goods, the prostitute circulates promiscuously, and her (or her customers’) lust is equated with greed in general; she is thus a symbol of how capitalism was changing society. At the same time, the prostitute is a typical victim of consumerism, subject to violence and discarded when she is out of fashion. Genuine or purported memoirs of prostitutes during the period illustrate these tensions: works such as Authentick Memoirs of the Life, Intrigues and Adventures of the Celebrated Sally Salisbury (1723), Genuine Memoirs of the Late Celebrated Jane D****s (1761), and The Life and Memoirs of the Late Miss Ann Catley, the Celebrated Actress (1789) “humanize the prostitute and elicit sympathy for her sufferings” but also “showcase the prostitute’s resilience, establishing her as the indomitable antiheroine of a life of vigorous sexual adventure.” Prostitutes show strength, discipline, and ambition, traits more frequently associated with men but also necessary for a new capitalist society of trade and industry.

The third chapter of Itch, Clap, Pox focuses on the link between venereal disease and the figure of the foreigner, whether from other parts of the British Isles, from the European continent, or from further abroad. Most often, however, this foreigner was French. According to Gallagher, the fact that STIs were always imagined to be coming from somewhere else was an expression of anxiety about trade, travel, and colonization. In other words, it was an attempt to establish and reinforce the boundaries of the nation. For example, through venereal disease, Scotland was linked to ignorance, poverty, and filth — and feared because its border with England was so permeable. Though Spain was a major colonial power, it could be denigrated through association with venereal disease. Just as the French supposedly infected the English with venereal disease, so they infected the country with other French “diseases” such as “effeminacy, luxury, foppery, and devotion to fashion, but also slavish submission to political or military despotism, arbitrary government, or ‘popery.’” Samuel Butler accused the French of threatening national security with sex toys in his mock epic Dildoides (1706).

In her fourth and final chapter, Gallagher (somewhat awkwardly) departs from human figures — officers and gentlemen, prostitutes, foreigners — to consider a specific body part, the nose. Because the nose often functioned as a gauge of sexual health, it “became an important symbol for conveying the precariousness of social boundaries — familial, racial, religious, socioeconomic — within the culture of eighteenth-century Britain.” In a way, this chapter recapitulates the previous three: Tristram Shandy makes notorious sport of the equation between nose and penis in its depiction of the eponymous hero and his family; Amelia in Fielding’s novel is cast out of society because of a disfigured nose; and a German doctor in Smollett’s The Expedition of Humphry Clinker (1771) is snubbed because of a mere wart on his nose. Incidentally, a missing nose made even a native English speaker sound like a foreigner.

Throughout the book, Gallagher is attentive to the ways venereal disease can be used to prop up nationalist and racist assumptions. Hogarth’s series of paintings and engravings, A Harlot’s Progress (1731–’32), links a diseased prostitute first to a Jew, then to a black boy, and finally to a monkey. By exposing how “seemingly opposite categories of being — virtue and vice, health and disease, whiteness and blackness, insider and outsider — might bleed into each other,” venereal disease constituted a threat to Englishness, whiteness, and (European) civilization in general. Gallagher shows clearly how 18th-century representations of venereal disease participated in the emerging discourse of modern racism.

Gallagher begins Itch, Clap, Pox by insisting that she will not compare past to present, yet in her conclusion she points out how the 18th-century imagination of venereal disease casts a shadow forward in the persistence of racism, xenophobia, classism, and sexism. In any case, her reticence shouldn’t stop the reader from considering relevant parallels. Most obviously (as Gallagher briefly acknowledges), the AIDS crisis was similarly taken up by writers and artists during the 1980s to address prevailing cultural anxieties. Indeed, Itch, Clap, Pox will be most successful if it gets the reader to interrogate the language and images we use to make our own ideological arguments today.

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Norbert Schürer is a professor in the English Department at California State University, Long Beach.