For something that played such a prevalent role in life at the front, sex and venereal disease (or VD) have been largely underrepresented thus far in the public remembrance of the centenary of the First World War. In 1916, one in five of all admissions of British and Allied troops to hospitals in France and Belgium were for VD. With lengthy hospital stays and treatments, it became an issue of manpower. There were also fears about men carrying VD back to their homeland and spreading it among the population there. In particular, the wide-ranging treatments for VD don’t appear to have been given much space in current historiography. A project at work gave me an excuse to delve into the fascinating medical records held at the UK National Archives and to investigate this topic further.
Medical case sheets might not seem like the most interesting of documents. There can be shorthand and the stereotypical idea of terrible doctor’s handwriting to work through–and if you add to that the idea of these documents being filled in during wartime conditions, you might be asking why anyone would bother to delve into them. But if you are lucky, these records might help to answer questions such as “how was VD treated during the First World War?” and “did men admit outright that they had had a sexual relationship when visiting the doctor?”
I should explain the record series that is the focus of this essay. MH 106 is held at The National Archives (UK) and contains the First World War Representative Medical Records of Servicemen. The two boxes that I have examined — MH 106/2106 and MH 106/2107 — both focus on venereal disease in the early years of the war (1914-15), and can provide a wealth of information about the treatment of diseases such as syphilis and gonorrhea.
Some of the most interesting things in the medical case sheets are the reasons given for the men having contracted VD. It doesn’t appear all too often, but, when it does, the language used is fascinating. Most common is to find something along the lines of the gentleman who “had connection 10 — 12 days ago at Norwich” or the one who contracted syphilis “after connection.” Another commonly used phrase for how a man contracted VD was that he was “ō a woman,” plus however many days previous it had been. I’m presuming this is some sort of short-hand for “connection with a woman,” but if anyone has more insight into that, I’d love to hear!
My absolute favorite reason that I have come across in these sheets is the guy who “admits he ‘strained’ himself ‘at drill’ some days ago.” You can almost hear the lad-ish jeering that would accompany such an excuse. Unsurprisingly, there are also the cases where men deny that they have something like gonorrhea, even though the medic clearly knows based on the symptoms (like unusual discharge from the penis or inflammation of the foreskin) that it actually is a case of VD.
Hospital stays could be lengthy, and treatment not pleasant. It was the concealment of VD that was punishable, not the contracting of it. All the same, those who underwent treatment in hospital were penalized by hospital stoppages. This meant that any man who was admitted to hospital for reasons not connected to his service was liable to have money from his pay stopped in order to help fund his hospital treatment. For officers this was 2 shillings 6 pence, and for other ranks 7 pence, per day.1
The wide range of treatments tried in these records is particularly interesting. Circumcision, bed rest, light diet, urinary antiseptics, and anti-gonococcus serum are all listed in various sheets. Surgery for the removal of the inflamed foreskin or interventions with drugs are logical solutions, and ones that might cross your mind when thinking of how the doctor might deal with this situation. The focus on diet was one area which I hadn’t considered, but does make sense with the unimaginative and not particularly nutritious diet that was being consumed in the front lines.
The drug Salvarsan is also a common treatment listed. Salvarsan was the first so-called magic bullet. The first organic anti-syphilitic, the powder was dissolved and then injected into the buttocks — again, not particularly pleasant.2 But it was effective. It became the principal treatment for syphilis, until penicillin and other antibiotics became available later in the twentieth century.
There were other treatments, one of which was termed “slit up under gas.” A typical example concerned a patient who was admitted to the hospital on January 11, 1915 suffering from syphilis. The next day his penis was badly swollen and inflamed. This continued until January 18, when he underwent an operation, involving making a slit in his foreskin to allow some of the discharge to escape.
Other motions were put in place to try to combat the problem of VD. These don’t appear in MH 106, but I think they are worth briefly highlighting. One of the main practices was to exclude women from camps. However, nothing could be done when men were on leave. In these circumstances, the best hope of improving that state of matters potentially lay in developing agencies which already existed for educating both the civil and military population and warning them against the dangers of VD; treating persons affected before they communicate the “evil” to others; and the provision of prophylactic measures against infection. This idea of educating the public about the dangers of VD continued in the interwar period. By the Second World War, propaganda posters warning troops of contracting VD were a common sight. Soldiers were also supplied with condoms, as a barrier to prevent them from contracting VD.
This piece has focused on the British and Allied troops, given the nature of the documents that The National Archives holds. To gain some insight into the German side of things, I would recommend reading the relevant entry on the online 1914-1918 encyclopedia. Interestingly, that entry states that Germany had the lowest rates of VD amongst all of the fighting nations.
The numbers of men on the Allied side who were contracting VD was alarming to both the War Office and the respective governments, with the United Kingdom and Australia having very high rates. The fear with those who were far from home centered around them having more money and not being able to return to their partners with ease — therefore, visiting a prostitute could be an easy substitute.
I think these records are only the beginning in highlighting just how many men suffered from VD during this conflict, and I wish we had more for later years of the war! But two full boxes give good insight into both the struggles of doctors dealing with a huge manpower problem and the various treatments that were suggested to help get men back to the front line.
- Richard Marshall, “The British Army’s Fight Against Venereal Disease in the ‘Heroic Age of Prostitution,’” World War I Centenary, University of Oxford. Return to text.
- Brandy Shillace, “Of Syphilis and Salvarsan: The Danger and Promise of Cure,” Dittrick Museum Blog. Return to text.