Dying to Heal: Women and Syphilis in Colonial Lima, Peru

In the early modern world, syphilis victims suffered through four stages of disease over a ten- to thirty-year time span. The first two phases manifested on the skin, beginning with painless ulcers near the site of infection (usually the genitals or mouth), which progressed to blotchy, red rashes on the palms of the hands and the soles of the feet. Those suffering from stage-two syphilis experienced skin rashes, painful sores, fevers, weight loss, hair loss, headache, fatigue, and muscle aches. Scars faded and symptoms subsided, but the illness could resurge anywhere from ten to thirty years later with ugly consequences.¹

Bearing the physical signs of disease garnered more than physical discomfort; it also invited judgment. In the colonial Spanish world, women faced a society entrenched with the Roman Catholic faith and and Iberian notions of female virtue. Unmarried women were expected to be modest, virginal, and discreet. Within this worldview, the physical manifestations of syphilis betrayed a sexually promiscuous lifestyle. Given the specific outbreak patterns of disease, around the genitals and on the hands and feet, it is not surprising that locals easily recognized Peruvian bubas (syphilis).

They were also aware it carried social stigma. Women who contracted syphilis were often judged as morally deficient, licentious, or too sexual. As Mary Lindemann notes, most early-modern Europeans assumed that men who slept with “[P]rofessional prostitutes and courtesans…flirts, and those who dressed above their station – would contract the disease.”² Syphilis afflicted the physical and social body.

The public price of syphilis enticed women to clandestinely buy the most powerful medicine on the market: mercury. As one record from July 1551 shows, this was the case in Lima, Peru, one of the Spanish empire’s largest South American cities and home to an ethnically and socially diverse population of Iberian, indigenous, and African peoples. Enslaved black women also obtained mercury, either by purchasing it or receiving it from their owners. As Linda Newson’s analysis of contemporary legal cases shows, Lima’s slave owners regularly used “agua de solimán” (mercuric chloride water) to treat slaves with bubas.³

People could access mercury cheaply, thus increasing its popularity as a treatment. It could be regionally sourced and it was used in Andean silver mines, which made it more affordable than other drugs imported from the Iberian peninsula. Purchasing mercury from an apothecary was also less expensive than visiting a physician. The art of pharmacy required fewer years of a formal university education, and therefore pharmacists charged less for their services. Mercury sales and fatalities came to a head to a head on July 24th, 1551, when Lima’s town council reported “some women and esclavas (female slaves) have taken mercuric chloride and died…which might have been overlooked if it weren’t for the widespread sales of mercury and other fatal [medicines] used to avoid illness and inconveniences.”⁴ Municipal leaders worried that apothecaries selling lethal, over-the-counter drugs endangered women, and that their shop assistants and slaves, who lacked Latin language skills, prepared dangerous medicines incorrectly.⁵

Lived Disease Experiences

Using sixteenth-century town council minutes to understand health culture is not without its limitations. The municipal scribe did not identify the names or number of deceased. All we know is that the victims included Spanish women (mujeres) and black female slaves (esclavas). While Lima’s town council records brim with weekly notes on city life and administrative issues, the July 1551 episode’s emphasis on female health and treatment appears as an outlier. Nevertheless, even this small blip in the documentary record reveals how some women in colonial Lima coped with an STI.

The secondary literature often overlooks ordinary disease experiences. Instead, scholars of disease and the Spanish Conquest emphasize the catastrophic effects of Old World diseases such as smallpox and measles on New World landscapes and indigenous peoples. In Alfred Cosby’s classic study of “ecological imperialism,” he casts the environment as the unintended conquistador, whereby plants, animals, and diseases invaded the New World, with deadly consequences to local landscapes and indigenous peoples.⁶

Yet epidemics and death rates overshadow quotidian disease experiences. How did people living in colonial Latin America deal with illnesses that were perhaps less threatening, but nevertheless uncomfortable, debilitating, embarrassing, or annoying? This incident demonstrates that Spanish and black enslaved women recognized the signs of disease, determined treatment options, and purchased (or were given) powerful medicines.

Early modern theories on disease, particularly the theory of four humors, contributed to mercury’s renown. The theory of four humors, taught at Iberian and Italian universities, held that four essential fluids maintained human bodies: phlegm, blood, black bile, and yellow bile. Accordingly, all humans contained unique fluid levels, with one dominant humor. The dominant humor determined an individual’s corporeal composition and influenced personality, physical characteristics, and health. It was critical for an individual to understand her natural composition and maintain a balance between the humors in the body.

Balance, achieved through diet, exercise, and the environment, maintained the body at its natural levels and ensured salubriousness. Imbalances created by excess humors triggered illness and death. Syphilis was allegedly caused by an excess of blood and black bile. Physicians, pharmacists, and consumers believed mercury counteracted the disease by expelling these superfluous liquids.

The goal of many treatments was to decrease the abundant fluid. Popular methods included enemas, purgatives, diuretics, expectorants, and skin plasters to cool or warm the skin. Plasters might also generate blisters and boils that could be burst, punctured, drained, or lanced. Thus, if the women of colonial Lima had followed the proper medical protocol, they would have visited a physician and undergone anything from topical applications of sarsaparilla (sourced from Guayaquil, Ecuador), bloodletting, or laxatives.⁷

Instead, the town council record details that Spanish women and black female slaves went straight to pharmacists for mercury, red sulfate of arsenic, and yellow arsenic.⁸ In the early-modern period, these drugs were usually applied externally as a salve, ointment, plaster, or rub.⁹ If patients sought a more immediate or intensive treatment, they might ingest the medication. The women discussed here were buying solimán (mercuric chloride), or liquid mercury.¹⁰

After drinking the metallic, burning solution, the body salivated uncontrollably and sweated profusely. The ache of dehydration took over as the abdomen contracted and erupted with bloody diarrhea. These results were exactly what women expected; they knew that mercury was a powerful medicine, so powerful it would purge bad humors from the body (blood and black bile). As Lindemann describes, “Mercury corroded the membranes of the mouth, loosened teeth in their sockets, and even ate away jawbones, often turning the mouth and throat into one large stinking ulcer.”¹¹

Yet it was precisely this corporeal violence that syphilis sufferers sought. According to popular European belief, mercury’s side effects were what made it a successful drug.¹² By expelling sweat, saliva, vomit, and diarrhea, the body purged excess blood and black bile. Unfortunately, though they may have had eradicating powers, mercury and arsenic were toxic.

To prevent the use of potentially lethal medications unless absolutely necessary, the town council intervened in local apothecary practices. On one level, this subverted the authority of the Royal Protomédicato, the official charged with regulating Lima’s medical trades. On another, it restricted prescription preparation and sales to licensed Iberian men, even though indigenous and African peoples had traditionally served Lima’s pharmacies.

Indigenous vendors sold regionally sourced plants and medicines to pharmacies, slave owners privately contracted pharmacists, and indigenous and free(d) blacks and slaves worked in apothecaries.¹³ But, in July 1551, the town council prohibited mestizo and African pharmacy assistants from preparing prescriptions and banned over-the-counter sales of mercury chloride, red sulfate arsenic, yellow arsenic, or any other fatal medicine.¹⁴

As we now know, mercury did not cure syphilis. Patients either slowly succumbed to the disease or were fatally poisoned. This episode highlights three lived disease realities in colonial Lima.  It underscores how some women in colonial Lima coped with the nuisance, discomforts, and “inconveniences” of sexually-transmitted diseases.¹⁵ It also shows that they self-diagnosed illness symptoms and pursued medical care. And it suggests the town council influenced racial and gendered restrictions in local medical practice. While the incident fades from the documentary record (it is not mentioned again in the town council records during the sixteenth century), it demonstrates how non-epidemic disease experiences are significant to the history of medicine and society.

Kathleen Kole de Peralta

Dr. Kathleen Kole de Peralta is an assistant professor of environmental history at Idaho State University. Her work integrates environmental studies and the digital humanities with early-modern Iberia and Peru to 1) capture the intrinsic, and historical relationship between environment and health in urban areas and demonstrate the evolution of health as a fluid, changing context depending on the social and cultural context in which it was produced, and 2) to use the digital humanities to make open-access projects on the early-modern period accessible to English- and Spanish-speaking audiences.

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